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This paper takes the application of international Chinese to foreigners on the Internet as the research object. A variety of features are constructed according to the characteristics of international and foreign Chinese texts and networks. This paper selects three features: dictionary-based sentiment value feature, expression feature, and improved semantic feature. A text sentiment classification model is formed by fusing multiple features. Compared with the traditional model and other single-feature models on the self-built dataset, the experimental results show that its sentiment classification ability has been effectively improved. The results show that the accuracy, recall, and F1 value of the fused multilevel feature MFCNN model are much higher than the accuracy, recall, and F1 value of other models. This also shows that the improved model of this method has a better effect of improving the accuracy.

Orexin offers protection against cerebral ischaemia–reperfusion injury, with high altitude playing a key role in modulating its expression. This study aimed to investigate the effect of high altitude on orexin expression and its pathophysiological mechanisms involved in high altitude stroke injury. In this study, changes of orexin expression were observed by simulating hypoxia at different altitudes, and the changes of orexin and its receptor were analysed by constructing a middle cerebral artery occlusion (MCAO) model after high altitude simulation. Finally, the protective effect of orexin on cerebral ischaemia–reperfusion injury was evaluated by exogenous orexin intervention. The results indicated that at an altitude of 4000 m, orexin expression was increased, but then decreased at higher altitudes. Rats exposed to 4000 m hypoxia simulation and MCAO exhibited increased orexin and type 1 receptor expression. Exogenous orexin A administration reduced infarct size, improved microcirculation blood flow in the ischaemic cortex, accelerated blood flow, elevated blood oxygen saturation and mitigated systemic oxidative stress and inflammation. These findings confirm our hypothesis that 4000 m altitude promotes orexin expression, thereby attenuating cerebral ischaemia–reperfusion injury through enhanced microcirculation, reduced oxidative stress and inflammation. Schematic illustration of the experimental design. This study investigated the role of Orexin A in the pathogenesis of ischemic stroke at high altitude. What is the central question of this study? What is the effects of high altitude on orexin expression and what are its pathophysiological mechanisms involved in high altitude stroke injury? What is the main finding and its importance? 4000 m altitude promotes orexin expression, thereby attenuating cerebral ischaemia–reperfusion injury through enhanced microcirculation and reduced oxidative stress and inflammation.

Dyskalemia are associated with an increased risk of mortality in patients undergoing maintenance hemodialysis (MHD). However, studies evaluating the impact of serum potassium variability on mortality in MHD patients are scarce. To investigate serum potassium variability and its association with prognosis in MHD patients, we conducted a retrospective study on maintenance hemodialysis patients from three campus of Renji Hospital between June 2018 and December 2022. The exposure of interest was serum potassium variability defined as the coefficient of variation of serum potassium levels (CVSP). Cox regression models and Kaplan-Meier survival analysis were used to assess the prognostic significance of serum potassium variability. In a subgroup analysis, the association between serum potassium variability and prognosis was investigated in patients within normal serum potassium concentration range. Total of 588 maintenance hemodialysis patients were included. During a median follow-up of 45 months (24, 54), 121 patients (20.6%) died. The survival analysis suggested significantly higher survival rates for both all-cause ( p  < 0.01) and cardiovascular ( p  < 0.01) death in patients in the highest group of CVSP (H-CVSP) compared with those in the the lowest group (L-CVSP). After adjustment, the all-cause mortality hazard ratio compared to L-CVSP was 2.17 [95% confidence interval (CI) 1.18, 3.97] for H-CVSP ( p  < 0.05) and was 2.53 [95%CI 1.03, 6.22] for cardiovascular mortality ( p  < 0.05). In the subgroup analysis, 493 patients (83.8%) presented normokalemia (the mean of serum potassium levels ≥ 3.5mmol/L and ≤ 5.0mmol/L) were included. Similar association was found between serum potassium variability and accumulated survival rates, and higher serum potassium variablity was remained an independent risk factor for cardiovascular mortality (2.69, 95% CI 1.07–6.78, p  < 0.05) in patients within normal serum potassium concentration range. In conclusion, a higher serum potassium variability was associated with all-cause and cardiovascular mortality in maintenance haemodialysis patients, even in the normal range.

Background Body image plays a significant role in emotional and behavioral health. This study examined the short-term longitudinal association between body image satisfaction and disordered eating behaviors (DEBs) among students at two Tibetan universities, considering theory-driven sequential indirect roles of anxiety and depressive symptoms. Methods A longitudinal survey was conducted among 2,993 first- and second-year university students in Xizang, with a baseline assessment in September 2021 and a follow-up in December 2021. Participants completed standardized questionnaires assessing body image satisfaction, anxiety, depressive symptoms, and DEBs. Statistical analyses included t-tests, ANOVA, Pearson correlations, and structural equation modeling (SEM) using robust maximum likelihood estimation (MLR) with bootstrap confidence intervals (1,000 resamples). Results SEM analyses indicated that body image satisfaction was prospectively associated with lower DEBs (β = −0.050, 95% CI = − 0.099 to − 0.008). Depressive symptoms independently mediated this association (β = −0.010, 95% CI = − 0.019 to − 0.003), whereas the indirect pathway through anxiety alone was not significant (β = −0.005, 95% CI = − 0.014 to 0.006). A sequential indirect pathway involving anxiety and depressive symptoms was significant (β = −0.033, 95% CI = − 0.047 to − 0.021). The total indirect effect was also significant (β = −0.048, 95% CI = − 0.065 to − 0.033). Model fit was acceptable (CFI = 0.961, TLI = 0.911, RMSEA = 0.060, SRMR = 0.021). Conclusions These findings highlight the potential roles of anxiety and depressive symptoms in the association between body image satisfaction and DEBs, suggesting that interventions targeting body image and emotional health may help reduce the risk of DEBs.

High‐altitude exercise affects cardiac function. This study investigated how altitude and exercise intensity interacted to affect cardiac function of Sprague‐Dawley rats. Four altitudes (410, 3600, 4600 and 5600 m) and three exercise intensities (non‐exercise (N), low‐intensity exercise (L) and high‐intensity exercise (H)) were tested combinatorically. After 4 weeks of exercise, cardiac function and specific markers of myocardial injury were assessed. With regard to cardiac function, (a) at the same intensity, stroke volume and left ventricular end‐diastolic volume were higher in the 3600 m group but lower in the 4600 and 5600 m groups; and (b) the heart rate increased with altitude and intensity. The biochemical results showed that the levels of creatine kinase, myoglobin and cardiac troponin I generally increased with increasing altitude and exercise intensity, significantly for creatine kinase and myoglobin at 4600 and 5600 m. For pathological results, (a) in the non‐exercise group, pathological damage was observed only in the 5600 N group; and (b) in the exercised state, varying degrees of injury were noted, except for the 410 and 3600 L groups. There may be a turning point at 3600 m where the injury to the heart increases. Myocardial injury markers exhibited abnormalities before cardiac dysfunction. Detecting these markers is crucial to provide warnings for the individual from cardiac disease during high‐altitude exercise. What is the central question of this study? Exercise at high altitude increases the burden of heart, thus affecting cardiac function and causing myocardial damage: what changes occur for markers of myocardial injury, cardiac function and structure, and what is the turning point of cardiac injury? What is the main finding and its importance? As the altitude and exercise intensity increase, there may be a turning point at 3600 m where the injury to the heart increases. Myocardial injury markers show abnormalities before cardiac dysfunction. It is important to detect these markers to provide a warning for the individual from cardiac disease while exercising at high altitude.

Immune checkpoint inhibitors (ICIs) have changed the paradigm of cancer treatment, but their effectiveness in some patients with epidermal growth factor receptor (EGFR) mutations is unsatisfactory. Therefore, it is necessary to develop a new biomarker for combined immunotherapy strategies to maximize the clinical benefits. We collected and investigated 34 pan-cancer scRNA-Seq cohorts from The Cancer Genome Atlas (TCGA) and 10 bulk RNA-Seq cohorts utilizing multiple machine learning (ML) algorithms to identify and verify a representative EGFR-related gene signature (EGFR.Sig) as a predictive biomarker for immunotherapy response. Core genes were identified as Hub-EGFR.Sig to predict the prognosis of cancers and to understand the crosstalk between EGFR and the tumor immune microenvironment (TIME). EGFR.Sig can accurately predict the ICI response with an AUC of 0.77, demonstrating superior predictive performance compared to previously established signatures. Twelve core genes in EGFR.Sig were identified as Hub-EGFR.Sig, of which 4 immune resistance genes were previously verified in different CRISPR cohorts. Notably, the prognosis most related to Hub-EGFR.Sig was bladder cancer, which can be divided into two clusters with different responses to immunotherapy based on Hub-EGFR.Sig. We developed a promising pan-cancer signature based on EGFR-related genes to serve as a biomarker for immunotherapy response and survival outcome prediction. Furthermore, core genes were identified for future targeting, which will pave the way for improving the effect of immunotherapy in the context of combination immunotherapies.

Objectives Although postoperative radiotherapy (PORT) could reduce the incidence of local recurrence in patients with IIIA-N2 non-small cell lung cancer (NSCLC), the role of PORT on survival in patients with surgically treated stage IIIA-N2 NSCLC remains controversial. Therefore, this study was designed to evaluate the effect of PORT on survival for patients with surgically treated stage IIIA-N2 NSCLC. Materials and methods This study population was chosen from the Surveillance, Epidemiology, and End Results database. The Cox proportional hazards regression analysis was used to determine significant contributors to overall survival (OS) and cancer special survival (CSS) outcomes. To balance baseline characteristics between the non-PORT group and PORT group, propensity score matching (PSM) with 1:1 propensity nearest-neighbor match by 0.001 matching tolerance was conducted by R software. Furthermore, a Kaplan–Meier curve was used to visualize the OS and CSS between the PORT group and non-PORT group survival probability. Results Of all evaluated cases, 4511 with IIIA-N2 NSCLC were eligible for inclusion, of which 1920 were enrolled into the PORT group. On univariate analysis and multivariate analysis, sex, age, year of diagnosis, race, histologic type, T stage, PORT, use of chemotherapy, and positive regional nodes were significantly associated with OS and CSS in IIIA-N2 NSCLC ( P  < 0.05). However, PORT was not significantly associated with OS (univariate HR = 0.92, 95%CI 0.85–0.99, P  = 0.02; multivariate HR = 1.01, 95%CI 0.93–1.08, P  = 0.91) and CSS (univariate HR = 0.92, 95%CI 0.85–1.01, P  = 0.06; multivariate HR = 1.103 95%CI 0.94–1.12, P  = 0.56) in IIIA-N2 NSCLC. Meanwhile, after PSM, neither OS nor CSS did differ significantly between the non-PORT group and PORT group (OS HR = 1.08, 95%CI 0.98–1.19, P  = 0.12; CSS HR = 1.10, 95%CI 0.99–1.23, P  = 0.07). Conclusion PORT did not contribute to a survival benefit in patients with surgically treated stage IIIA-N2 NSCLC.

Tibet is an area in China with a high incidence of stroke, typically attributed to hypobaric hypoxia. The present study aimed to observe the neuronal injury of ischemic stroke after hypobaric hypoxia and explore the mechanism by which N-methyl-D-aspartate receptor (NMDAR) and its downstream pathways are involved. This study employed a hypobaric chamber to imitate high altitude at 4000 m. After hypoxia, the middle cerebral artery occlusion (MCAO) model was used to mimic ischemic stroke. Behavioral tests and measurements of infarct area were used to observe neuronal injuries. The expression of NMDAR, Ca2+/calmodulin-dependent protein kinase II (CaMKII) and phosphorylated CaMKII (Threonine 286) (P-CaMKII) was tested by western blot, and hematological tests were used to count the number of red blood cells (RBCs) and hemoglobin. Compared with the plain+MCAO group, the neurological deficit scores and infarct area of rats in the 4000 m + MCAO group were all decreased, and the protein expression of NMDAR, CaMKII and P-CaMKII was reduced. Compared with the plain group, the numbers of RBCs, hemoglobin and hematocrit were increased in the 4000 m group; compared with the 4000 m groups, the three indexes were increased in the 4000 m + MCAO groups. The neuronal injuries after hypoxia were not more serious than those in rats enduring ischemia and reperfusion in plain. The underlying mechanisms were related to the decreased expression of NMDAR and CaMKII; furthermore, the increased numbers of RBCs and hemoglobin may be crucial mechanisms for the incidence and development of ischemic stroke at high altitude.

We have shown that angiotensin II (Ang II) and angiotensin-(1-7) [Ang-(1-7)] increased arterial blood pressure (BP) via glutamate release when microinjected into the rostral ventrolateral medulla (RVLM) in normotensive rats (control). In the present study, we tested the hypothesis that Ang II and Ang-(1-7) in the RVLM are differentially activated in stress-induced hypertension (SIH) by comparing the effects of microinjection of Ang II, Ang-(1-7), and their receptor antagonists on BP and amino acid release in SIH and control rats. We found that Ang II had greater pressor effect, and more excitatory (glutamate) and less inhibitory (taurine and γ-aminobutyric acid) amino acid release in SIH than in control animals. Losartan, a selective AT₁ receptor (AT₁R) antagonist, decreased mean BP in SIH but not in control rats. PD123319, a selective AT₂ receptor (AT₂R) antagonist, increased mean BP in control but not in SIH rats. However, Ang-(1-7) and its selective Mas receptor antagonist Ang779 evoked similar effects on BP and amino acid release in both SIH and control rats. Furthermore, we found that in the RVLM, AT₁R, ACE protein expression (western blot) and ACE mRNA (real-time PCR) were significantly higher, whereas AT₂R protein, ACE2 mRNA and protein expression were significantly lower in SIH than in control rats. Mas receptor expression was similar in the two groups. The results support our hypothesis and demonstrate that upregulation of Ang II by AT₁R, not Ang-(1-7), system in the RVLM causes hypertension in SIH rats by increasing excitatory and suppressing inhibitory amino acid release.