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WNT5B glycoprotein belongs to the Wnt protein family. Limited investigations revealed a possible role of WNT5B in malignancies, such as triple-negative breast cancer and oral squamous cell carcinoma. However, whether WNT5B contributes to the progression of lung adenocarcinoma (LAD) remains unclear. Here, we initially determine that WNT5B is highly expressed in LAD and is positively correlated with lymph node metastasis and TNM stage. Consistently, clinical analysis reveals WNT5B as an independent prognostic biomarker in LAD. Silencing WNT5B suppresses the proliferation of LAD both in vitro and in vivo by interfering G1/S cell-cycle progression and modulating amino acid metabolism, revealing its remarkable oncogenic role in LAD. Of note, we also identified miR-5587-3p as a negative upstream regulator of WNT5B in LAD, which may help develop therapies targeting LAD patients with high WNT5B expression. Taken together, our results revealed an oncogenic role of WNT5B in LAD, which could be a prognostic biomarker and promising therapeutic target for LAD patients.

Body language plays a vital role in emotion perception, yet the involuntary neural mechanisms through which individuals with social anxiety process these signals remain unclear. This research investigates these mechanisms by analyzing visual components such as P3a, P1, and N190 within a three-stimulus oddball paradigm. Participants were classified into high social anxiety (HSA, n = 31) and low social anxiety (LSA, n = 26) groups using the Liebowitz Social Anxiety Scale (LSAS). The paradigm employed custom-designed distractors depicting positive, negative, and neutral body expressions to examine the involuntary processing of these stimuli. The findings indicate that individuals with high social anxiety (HSA) showed significantly higher P3a amplitudes than those with low social anxiety (LSA), especially for positive body expressions. In contrast, negative expressions elicited the weakest amplitudes. The N190 component responded most strongly to positive expressions and least to negative ones, while the P1 component showed uniform responses across all types. HSA individuals process body expressions more intensely and are highly sensitive to them, regardless of valence. This insight can inform interventions targeting their cognitive and emotional biases. •Investigates involuntary processing of body expressions in social anxiety using ERPs.•High social anxiety group shows heightened P3a amplitudes for positive body expressions.•N190 component reveals sensitivity to emotional valence, with highest response to positive expressions.•Findings suggest biased cognitive resource allocation in high social anxiety individuals.

Background Spontaneous pneumomediastinum and/or pneumothorax (SPM/P) have been Linked to unfavorable outcome in anti-melanoma differentiation-associated gene 5 positive dermatomyositis (MDA5 + DM) patients. This study attempted to investigate the prognostic value of SPM/P and identify the predisposing factors of SPM/P in patients with interstitial lung disease (ILD) complicated with MDA5 + DM. Methods This study was conducted in a large inception cohort of MDA5 + DM-ILD (from 2014 to 2023) at Shanghai Renji Hospital. Baseline demographic data, pulmonary function tests, high-resolution CT imaging, laboratory parameters and survival status within 12 months were collected and compared between survivors and deceased patients, as well as between patients with and without SPM/P. Kaplan–Meier curves were plotted and Cox regression models were applied to identify prognostic factors. Furthermore, logistic regression analysis was employed to determine the predictors of SPM/P development. Results In a cohort of 523 MDA5 + DM-ILD patients, 92 (17.6%) developed SPM/P. Of those, 63 SPM/P cases occurred within 3 months since ILD onset and had a significantly higher 12-month mortality than those without SPM/P (82.5% versus. 35.4%, p  < 0.001). Multivariable Cox regression model identified SPM/P occurred within 3 months as an independent risk factor for survival (HR 1.59, 95% CI 1.09–2.34, P  = 0.018). Predisposing factors for SPM/P included severe restrictive ventilation dysfunction, male sex, and CMV viremia. Conclusions SPM/P occurred within 3 months since ILD onset was identified as a poor prognostic factor in MDA5 + DM-ILD. A refined FVC%-based staging system combining SPM/P was proposed for better risk stratification and to gauge clinical trial design.

Background: To compare clinical outcomes of Lotrafilcon A and Balafilcon A silicone hydrogel bandage contact lenses (BCLs) following transepithelial photorefractive keratectomy (TPRK). Methods: A randomized, double-blind, contralateral eye study enrolled 41 TPRK patients (82 eyes), with each eye randomly assigned one BCL type. Assessments included uncorrected (UDVA) and corrected (CDVA) distance visual acuity, ocular pain and irritation, epithelial healing, limbal and conjunctival hyperemia, lens mobility, and the amount of protein deposition on the BCLs. Results: Postoperative day 1 pain score was lower in Group A (2.80 ± 2.35) than in Group B (4.44 ± 2.46, p = 0.003). Group A had significantly less protein deposition (day 3: 9.92 ± 9.82 vs. 25.75 ± 9.86 μg, p < 0.001; day 4: 9.47 ± 10.06 vs. 32.60 ± 16.71 μg, p = 0.005). No statistically significant differences were observed between the two groups in terms of corneal epithelial defect area, corneal epithelial healing time, UDVA, CDVA, limbal or conjunctival hyperemia, and lens movement. Conclusions: Lotrafilcon A outperformed Balafilcon A in reducing ocular pain, foreign body sensation, and protein deposition, suggesting that Lotrafilcon A may be a more suitable therapeutic BCL option following TPRK.

Compare surgical outcomes of Robot‑Assisted Radical Prostatectomy (RARP) between patients with and without depression. This retrospective study included consecutive patients who underwent RARP at three tertiary hospitals between January 2021 and December 2023. Patients were divided into intervention and control groups based on the presence of a confirmed diagnosis of depression and the use of antidepressants for more than six months. prior to surgery. Depression, lower urinary tract symptoms (LUTS), and overall quality of life were assessed using the Self‑Rating Depression (SDS), Patient Health Questionnaire (PHQ), International Prostate Symptom Score (IPSS), and 36‑Item Short Form Health Survey (SF-36) scales. Other parameters included demographic characteristics, surgery-related indicators, and urinary incontinence. A total of 245 men underwent RARP surgery, and 205 patients (84%) completed the preoperative surveys and were analyzed. There were no significant differences in the demographic characteristics, initial PSA level, Gleason score, prostate volume, and T staging between the two groups. Additionally, both groups showed significant improvements in SDS scores, IPSS, SF-36-VT scores, and PHQ scores at the sixth month postoperatively compared to those preoperatively (all P  < 0.05). Compared to the control group, the intervention group had higher preoperative and postoperative SDS and PHQ scores as well as lower SF-36 VT scores. Although there was no difference in the preoperative IPSS between the two groups, the intervention group had higher postoperative IPSS and lower rates of urinary incontinence recovery (all P  < 0.05). Patients undergoing RARP who received preoperative antidepressant treatment for depression showed similar clinical symptom improvement post-surgery compared to those without depression; however, they experienced relatively more severe LUTS.

At present, metagenomic next-generation sequencing (mNGS) based on Illumina platform has been widely reported for pathogen detection. There are few studies on the diagnosis of major pathogens and treatment regulation using mNGS based on Illumina versus Nanopore. We aim to evaluate the clinical value of metagenomic next-generation sequencing (mNGS) by Illumina and Nanopore for the detection of pathogens in bronchoalveolar lavage fluid (BALF) in suspected community-acquired pneumonia (CAP) patients. BALF samples collected from 66 suspected CAP patients within 48 hours of hospitalization were divided into two parts, one for conventional culture and the other for mNGS by two platforms (Illumina and Nanopore). The clinical value based on infection diagnosis, diagnostic performance for main pathogens and treatment guidance were assessed. More types of species were detected by Nanopore than Illumina, especially in viruses, fungus and mycobacterium. Illumina and Nanopore showed similar detectability in bacterium except for mycobacterium tuberculosis complex/nontuberculosis mycobacteria. Pathogenic infection was established or excluded in 53 of 66 patients. There was little difference in the coincidence rate between Illumina and Nanopore with the clinical diagnosis, but both were superior to the culture (57.81%, 59.38%, 25%, respectively). Compared with Illumina, the diagnostic area under the curve of Nanopore was higher in fungi, but lower in bacteria and Chlamydia psittaci. There was no statistically significant difference between Illumina and Nanopore in guiding drug treatment (56.1% vs. 50%, p =0.43), but both were superior to the culture (56.1% vs. 28.8%, p =0.01; 50% vs. 28.8%, p =0.01). Single inflammatory indicators could not be used to determine whether the patients with culture-negative BALF were established or excluded from infection. The species detected at 1 h and 4 h by Nanopore were consistent to some extent, and its turn-around time (TAT) was significantly shorter than Illumina ( p <0.01). Illumina and Nanopore both have its own advantages in pathogenic diagnosis and play similar roles in infection diagnosis and guiding clinical treatment. Nanopore has a relatively short TAT, which may be promising in rapid etiological diagnosis of acute and critically ill patients.

Postoperative anxiety following voluntary medical male circumcision (VMMC) poses a significant health challenge, with limited telemedicine access and inadequate communication compromising recovery and adherence. Narrative-based interventions have shown promise in reducing psychological distress in other contexts, and large language models may enable automated follow-up, but their role in VMMC care remains underexplored. We evaluated the effect of a narrative-enhanced tool (NET) on anxiety, sleep quality, quality of life, and pain management and identified risk factors for postoperative anxiety. We also assessed the feasibility of an artificial intelligence-assisted consultation (AAC) system in improving follow-up efficiency. From October 1, 2023, to April 29, 2024, patients aged ≥15 years undergoing VMMC were recruited and randomized 1:1 to a standardized risk tool (SRT) or NET group. In addition to the routine postoperative communication, the NET group received a narrative video highlighting positive recovery experiences. Both groups accessed an AAC chatbot for automated follow-ups. Primary outcomes were anxiety levels measured by the 7-item Generalized Anxiety Disorder scale (GAD-7), sleep quality measured by Pittsburgh Sleep Quality Index, quality of life measured by 3-level EuroQoL 5D questionnaire, and pain levels measured by Numerical Rating Scale. Secondary outcomes included analgesic use, satisfaction, and health care worker efficiency. Repeated measures ANOVA assessed trends and regression identified risk factors for anxiety. Between October 1, 2023, and April 29, 2024, 671 eligible participants were enrolled, with 388 completing the 30-day follow-up (SRT group: n=189, mean age 26.21, SD 3.69 years; NET group: n=199, mean age 26.41, SD 3.56 years; P=.60). Both groups exhibited increased anxiety levels, diminished quality of life, and poorer sleep quality during the 30-day postoperative period. However, compared to SRT, the NET group demonstrated lower GAD-7 scores (7.06, SD 2.73 vs. 9.95, SD 3.50; P<.001), improved sleep quality (12.29, SD 3.57 vs 13.20, SD 3.54; P=.01), higher quality of life scores (0.87, SD 0.07 vs 0.84, SD 0.09; P<.001), more regular analgesic use (154/173, 89.02% vs 100/169, 59.17%; P<.001), reduced opioid consumption (5/173, 2.89% vs 25/169, 14.79%; P<.001), and higher pain medication satisfaction (4.21, SD 0.69 vs 3.76, SD 0.97; P<.001). Multivariate analysis identified SRT assignment, inability to recall opioid risk levels, hematoma, swelling, and pain as independent risk factors for elevated GAD-7 scores. Implementation of the AAC substantially reduced health care worker follow-up time (2.34, SD 1.95 min vs 7.85, SD 2.65 min; P<.001). The study demonstrates that narrative is effective in reducing anxiety, improving quality of life, and improving pain management post-VMMC. The integration of artificial intelligence into clinical follow-up protocols has the potential to enhance health care worker efficiency without compromising patient satisfaction.

Rituximab (RTX) has been commonly used for the treatment of patients with severe or refractory systemic lupus erythematosus (SLE), yet real-world data concerning RTX as the first-line treatment in newly diagnosed moderate-to-severe SLE patients is lacking. We conducted a retrospective cohort study using a newly diagnosed (<3 months) hospitalized Systemic Lupus Inception Cohort (hSLIC) at our center between April 1, 2013 and September 1, 2022. All patients were followed up for at least 12 months or until death. The cohort included patients on RTX ( = 104) as the first-line treatment and those on conventional immunosuppressants (IS) ( = 154) as comparators. Propensity-score-based inverse probability of treatment weighting (IPTW) was used to minimize possible confounding factors. The primary outcome analyses included attainment of modified lupus low disease activity state (mLLDAS) and remission by 12 months. The secondary outcomes focused on mortality, major flare rates, and the incidence of adverse events of interest, i.e., major infections. After IPTW, 76.0%/50.5% of RTX-treated patients achieved mLLDAS/remission versus 45.8%/9.7% in the conventional IS group during 12 months of follow-up, respectively ( = 0.005 and < 0.001). The sensitivity analyses with renal or neuropsychiatric lupus removal and timeline breakout (pre- versus post-November 2019) confirmed the robustness of RTX's efficacy in achieving mLLDAS and remission outcomes. Additionally, the incidence of major infections was similar between the two groups (12.5% vs. 8.4%, = 0.288). In patients with newly diagnosed moderate-to-severe SLE, upfront treatment with RTX was associated with improved clinical outcomes compared to conventional immunosuppressive therapy in terms of achieving low disease activity or remission by 12 months.

Background Our team has previously found that the stimulator of interferon genes (STING) plays a more significant anti-tumor role in host immune cells than in tumor cells. Although STING is necessary for CD8 + T cells to exert immunological activity, its effect on CD8 + T cells remains debatable. In this study, we used both in vitro and in vivo models to explore the metabolic effects of STING on CD8 + T cells. Methods Peripheral blood lymphocytes were procured from non-small cell lung cancer (NSCLC) patients receiving anti-PD-1 therapy to investigate the correlation between STING expression levels, CD8 + T-cell subsets, and immunotherapy efficacy. STING knockout (STING-KO) mice were used for in vivo studies. RNA-seq, seahorse, flow cytometry, electron microscopy, qPCR, immunofluorescence, western blotting, and immunoprecipitation were performed to explore the underlying mechanisms of STING in regulating CD8 + T cell function. Results We discovered that the expression level of STING in immune cells exhibited a significant correlation with immunotherapy efficacy, as well as with the proportion of central memory CD8 + T cells. Moreover, we found that the loss of the STING gene results in a reduction in the number of mitochondria and a change in the metabolic pathway selection, thereby inducing excessive glycolysis in CD8 + T cells. This excessive glycolysis generates high levels of lactate, which further inhibits IFN-γ secretion and impacts memory T cell differentiation. Correcting the glycolysis disorder partially restored function and IFN-γ secretion, rescued the central memory CD8 + T subset, and improved immunotherapy in STING-KO mice. This provides a new treatment strategy for patients with low STING expression and a poor response to immunotherapy. Conclusion Intrinsic STING of CD8 + T cells affects their function through the HK2/Lactate/IFN-γ axis and affects memory differentiation by regulating glycolysis.

Acute respiratory distress syndrome (ARDS) are major causes of mortality of critically ill patients. Impaired macrophage-mediated clearance of apoptotic cells (efferocytosis) in ARDS contributes to prolonged inflammation, yet the underlying mechanisms remain unclear. In this study, we investigated the role of geranylgeranyl diphosphate synthase (GGPPS) in efferocytosis during lung injury resolution. We identified dynamic changes in GGPPS expression in lung macrophages and circulating monocytes throughout the progression and resolution phases of acute lung injury (ALI). Myeloid-specific GGPPS knockout mice exhibited prolonged lung inflammation, increased accumulation of apoptotic neutrophils, a higher number of recruited macrophages, and a reduced number of resident macrophages. Notably, recruited macrophages play a dominant role in efferocytosis compared to resident macrophages. GGPPS deficiency suppressed efferocytosis in both macrophage subsets in vivo and in vitro. Mechanistically, GGPPS knockout disrupted AXL signaling in recruited macrophages. Importantly, administration of geranylgeraniol (GGOH) rescued the delayed resolution of lung injury, restored efferocytosis, and increased the suppressed AXL expression in CKO mice. Collectively, this study identifies GGPPS as a key regulator of AXL-mediated efferocytosis in recruited macrophages, highlighting its potential as a therapeutic target to accelerate ARDS resolution.