Shanxi Medical University

The formation of C(sp³)‐N bonds constitutes a pivotal transformation in functional molecule synthesis, with conventional methods predominantly relying on polar substitution paradigms. To address the inherent limitations of existing approaches, we report a radical‐mediated strategy for sp³ C‐N bond formation via cross‐coupling between carbon‐centered radicals and iminyl radicals. This mechanistically distinct pathway circumvents the substrate tolerance limitations associated with N‐nucleophiles and base‐mediated side reactions. Under energy transfer catalytic conditions, oxime esters exhibit dual functionality as both N‐radical precursors and initiators for xanthate ester‐derived carbon radicals. This synergistic activation strategy not only enhances atom economy and environmental sustainability but also results in the concurrent formation of S‐phenyl dithiocarbonate byproducts, which can serve as valuable building blocks in synthetic chemistry.

Room‐temperature phosphorescent carbon dots (RTP CDs) are promising afterglow materials applied in bioimaging owing to their long‐lived emission and biocompatibility. Achieving RTP CDs with long emission wavelengths in aqueous environments remains challenging because of the influence of surface and carbon core states of CDs on luminescence. Herein, thermally annealed solid CDs encapsulated with SiO2 are developed in this work to obtain yellow‐green RTP CD composites (A‐CDs@SiO2) with redshifted emission wavelengths. After thermal annealing, the carbonization degree of CDs increases, resulting in a redshift of their optimal phosphorescence emission wavelength from 500 to 525 nm, and the phosphorescence lifetime of CDs reaches 926.97 ms. Additionally, the optimal phosphorescence emission wavelength of A‐CDs@SiO2 is 513 nm. SiO2 encapsulation restricted the movement of luminescent centers, thereby extending the phosphorescence lifetime of CDs in aqueous solution to 1263.40 ms. Biological imaging experiments confirmed that the obtained A‐CDs@SiO2 exhibited significant phosphorescence signals in mice with a phosphorescence intensity of 1.490 × 10⁵ p/(s cm² sr), and the phosphorescence signals can still be collected after re‐excitation within 1 h. Therefore, as a bioluminescent afterglow probe, A‐CDs@SiO2 demonstrates great potential in bioimaging.

Purpose To examine the relationship between biological aging and the prevalence of NAFLD. Method We used the recommended sampling weights to account for the complex survey design of NHANES. The analysis, utilizing data from 2005 to 2016, aimed to investigate the impact of biological aging on NAFLD prevalence using various statistical methods. A restricted cubic spline (RCS) model was applied to explore the dose-response relationship, while logistic regression examined linear associations. The robustness of the association across different subgroups was also tested. Result The study included 2786 participants. We found significant associations between NAFLD and the following biological aging metrics: AL score (OR (95%CI) = 1.1932 (1.0597 ~ 1.3435), P = 0.0035), HD (OR (95%CI) = 1.2092 (1.0565 ~ 1.3839), P = 0.0058), and PA (OR (95%CI) = 1.7564 (1.1949 ~ 2.5818), P = 0.0042). All biological aging metrics were identified as independent predictors. PA was most associated with the prevalence of NAFLD. The associations persisted across most subgroups. Conclusion The prevalence of NAFLD was associated with biological aging, emphasizing the importance of addressing potential health risks related to aging.

2‐Pyridone is a crucial building block in bioactive natural products and serves as a vital intermediate for the synthesis of bioactive nitrogen‐containing heterocycles. Recent advancements in transition metal‐catalyzed C–H functionalization have enabled the direct modification of 2‐pyridones, circumventing the need for pre‐functionalization. In this study, we report a Rh(III)‐catalyzed, C6‐selective C–H heteroarylation of 2‐pyridones using cyclic iodonium ylides as carbene precursors. The versatility and broad applicability of this method are demonstrated through the efficient synthesis of diverse compounds featuring both 2‐pyridone‐pyridine and cyclic 1,3‐dicarbonyl derivatives.

Epilepsy is a neurological disorder characterized by recurrent seizures caused by excessive electrical discharges in brain cells, posing significant diagnostic and therapeutic challenges. Dynamic brain network analysis via electroencephalography (EEG) has emerged as a powerful tool for capturing transient functional connectivity changes, offering advantages over static networks. In this study, we propose a Dynamic Temporal-Spatial Graph Attention Network (DTS-GAN) to address the limitations of fixed-topology graph models in analysing time-varying brain networks. By integrating graph signal processing with a hybrid deep learning framework, DTS-GAN collaboratively extracts spatiotemporal features through two key modules: an LSTM-based temporal encoder to model long-term dependencies in EEG sequences, and a dynamic graph attention network with probabilistic Gaussian connectivity, enabling adaptive learning of transient functional interactions across electrode nodes. Experiments on the TUSZ dataset demonstrate that DTS-GAN achieves 89–91% accuracy and a weighted F1-score of 87–91% in classifying seven seizure types, significantly outperforming baseline models. The multi-head attention mechanism and dynamic graph generation strategy effectively resolve the temporal variability of functional connectivity. These results highlight the potential of DTS-GAN in providing precise and automated seizure detection, serving as a robust tool for clinical EEG analysis.

The composition and diversity of the skin microbiome are affected by several factors, including the working environment, which plays an active role in shaping microbial communities in human skin. Previous studies have shown that residual microbial communities on personal items can be used to identify their owners. However, few studies have used the skin microbiome to identify occupations in different populations or evaluate whether the skin microbiome can be used as a tool for forensic investigations. Here, we collected palm and cuff swabs from three occupational groups—cooks, medical staff, and students—and performed next-generation sequencing targeting the 16S rRNA gene to characterise the microbial communities associated with each profession. We found that different occupational environments resulted in different skin microbial community compositions. Actinobacteria and Firmicutes were the dominant phyla in the student samples. Compared with the other two occupations, cooks had the highest relative abundances of Bacteroides and Cyanobacteria. Additionally, cuff samples from medical staff had the highest relative abundances of Proteobacteria. Principal co-ordinate analysis results indicated that the samples were roughly divided into three clusters according to their occupation. Furthermore, linear discriminant analysis effect size results showed that cooks, medical staff, and students had their own unique biomarkers, cooks exhibited seven shared biomarkers between palm and cuff samples, medical staff showed 2, while students demonstrated the highest congruence which was 13 shared biomarkers. This suggested that some palm skin microbial communities could be transferred to the cuffs through contact friction. Thus, there were also microbial communities present in cuff samples that could be used to identify the owner’s occupations, suggesting that skin microorganisms left on personal items via daily contact could also be used to provide information about an individual’s occupation. Finally, we constructed a random forest model based on the composition and relative abundance of the microbiota to infer the subject’s occupation, achieving an accuracy of 76.92% for the palm testing dataset and 73.33% for the cuff testing dataset; all of the cuff sample datasets showed an accuracy of 70.97%. These findings suggested that an individual’s occupation can be inferred not only from the skin microbiota but also from the microbiota left on the cuffs of the individual’s clothes. Further studies are needed; however, these results demonstrate the potential of the skin microbiota as a forensic tool for predicting population occupations.

Objective This study aims to explore whether Naples prognostic score (NPS) serves as a novel and original prognostic tool for predicting long-term survival in stage III breast cancer patients undergoing operation. Methods This retrospective study included 306 cases of stage III breast cancer patients hospitalized in our hospital from January 2014 to December 2018. In this study, NPS was based on five objective markers: (1) serum albumin level; (2) total cholesterol; (3) neutrophil to lymphocyte ratio; (4) lymphocyte to monocyte ratio. Survival curves of DFS and OS differences were visualized by Kaplan–Meier method and Log rank test. The variables with p < 0.05 in univariate analysis were performed in the multivariate Cox proportional hazard model analysis, and the p-values < 0.05 was considered the underlying independent variables. Nomogram was constructed by the multivariate Cox proportional hazard model analysis. Results Significant variations for DFS and OS categorized according to prognostic risk for the different NPS (DFS: χ²=24.926, P < 0.0001; OS: χ²=31.207, P < 0.0001). According to multivariable Cox analysis, NPS was an independent prognostic factor of DFS [Group 0 had significantly better prognosis than group 1 (HR = 2.733, 95% CI: 1.446–5.166, P = 0.002) and group 2 (HR = 4.990, 95% CI: 2.555–9.746), P < 0.001)] and OS [Group 0 had significantly better prognosis than group 1 (HR = 2.437, 95% CI: 1.288–4.610, P = 0.006) and group 2 (HR = 5.707, 95% CI: 2.900–11.231), P < 0.001)], respectively. Nomogram prognostic model exhibited excellent predictive performance on DFS [C-index: 0.692 (95% CI: 0.584–0.782)] and OS [C-index: 0.711 (95% CI: 0.606–0.797)] for stage III breast cancer. Conclusion NPS serves as a predictive tool for assessing the prognosis of stage III breast cancer after surgery. Nomogram prognostic model based on NPS show good prediction ability.

Background To compare oncological outcomes of radical hysterectomy (RH) and radiochemotherapy (R‐CT) for stage IIIC1 (FIGO 2018) cervical adenocarcinoma patients. Methods Based on the Chinese Cervical Cancer Clinical Diagnosis and Treatment Project Database, we retrospectively reviewed 236 cases of FIGO stage IIIC1 cervical adenocarcinoma diagnosed between 2005 and 2019. The 5‐year overall survival (OS) and 5‐year disease‐free survival (DFS) rates were compared between the two treatment groups using multivariate Cox regression models and the log‐rank test, both in the overall study population and after propensity score matching (PSM). Results From 63 926 patients, we selected 236 cases, including 203 in the RH group and 33 in the R‐CT group. In the overall study population, R‐CT was associated with significantly worse 5‐year OS (51.8% vs. 67.2%, p < 0.05) and 5‐year DFS (43.1% vs. 60.1%, p < 0.05) compared to RH. Multivariate analysis revealed that R‐CT was an independent risk factor for 5‐year DFS (hazard ratio [HR] = 2.226, 95% confidence interval [CI] 1.141–4.343, p < 0.05) but not for 5‐year OS (HR = 1.834, 95% CI: 0.829–4.061, p > 0.05) in FIGO stage IIIC1 cervical adenocarcinoma. After matching ( n = 26 in R‐CT group vs. 73 in RH group), the R‐CT group showed significantly lower 5‐year OS (50.3% vs. 77.4%, p < 0.05) and DFS (38.2% vs. 65.0%, p < 0.05) compared to the RH group. In the matched cohort, R‐CT remained an independent risk factor for 5‐year DFS (HR = 2.299, 95% CI: 1.113–4.750, p < 0.05) but not for 5‐year OS (HR = 1.926, 95% CI: 0.792–4.682, p > 0.05). Conclusion Among patients with stage FIGO 2018 IIIC1 cervical cancer adenocarcinoma, R‐CT was not associated with better oncological outcomes than RH. Radiotherapy should not be the only recommended treatment.

Peripheral nerve injuries frequently result in sensory and motor dysfunction, significantly impacting patients' quality of life. Consequently, promoting regeneration and functional recovery following such injuries has become a primary focus of clinical research. Currently, autologous nerve transplantation is considered the gold standard for the treatment of peripheral nerve defects. However, this approach presents several limitations, including a scarcity of donor tissues, the potential formation of painful neuromas, and damage to the donor site. This article reviews recent advancements in the field of peripheral nerve regeneration and repair, aiming to provide valuable insights for the clinical management of peripheral nerve injuries.

Patients with dental caries and periodontal problems may experience tooth loss, leading to alveolar bone resorption, maxillary sinus hyperpneumatization, and ultimately affecting implant implantation due to insufficient bone height. Maxillary sinus elevation surgery increases bone height by lifting the sinus membrane, solving the problem of insufficient bone height during dental implant surgery in the posterior region. This review summarizes the surgical methods, indications, and contraindications of maxillary sinus elevation surgery, and summarizes the advantages and disadvantages of various methods currently used in clinical practice. This review aims to provide practical guidance for the future development of maxillary sinus elevation surgery through a detailed review of current literature.

Broadband and highly sensitive mid-infrared (MIR) light detection and imaging play a crucial role in environmental monitoring, gas detection, biomedical applications, and national defense security. However, the detection of high-frequency, long-distance dynamic targets with MIR thermal emission is still limited by the long response time of commercial detectors and intense environmental noise. Here, we demonstrate a noise-tolerance intra-cavity enhanced broadband MIR upconversion system by counting the upconverted lights through a high-sensitivity single photon detector. The intra-cavity enhanced pump power of 1064 nm reaches about 200 W, resulting in a high upconversion efficiency with the MIR spectra ranging from 3 μm to 5 μm. By performing discrete Fourier transformations of the arrival time of each upconverted photon, the frequency-domain imaging manifests a strong noise-tolerance feature, even under the ratio of the noise-to-signal of up to 100. The excellent performance of our system has also been evidenced by measuring the rotation frequency of a turbojet engine in outdoor conditions. Our proposal offers promising applications to recognize long-distance dynamic targets, such as airplanes and unmanned aerial vehicles, in real-world scenarios with the highly desired suppression of intense background noise and stray light.

This study aims to explore whether bilirubin can act as a biomarker of oxidative stress in type 1 diabetes mellitus (T1DM) by analyzing the serum bilirubin levels and possible influencing factors in different disease states and durations in children with T1DM. This is a retrospective study. The medical records of 1652 inpatients with T1DM and 101 healthy children in Shanxi Provincial Children’s Hospital from 2014 to 2023 were collected and divided into different subgroups. The relevant indices in different disease states and durations in the T1DM group were statistically analyzed, particularly the serum bilirubin levels and possible influencing factors. Compared to children without diabetic ketoacidosis (DKA)/diabetic ketosis (DK), children with DKA/DK exhibited higher random blood glucose (RBG), HbA1C, total bilirubin (TBil), and indirect bilirubin (IBil) ( P < .05). Compared to the control group, the levels of TBil and IBil in the newly-diagnosed and established T1DM children were statistically significantly higher ( P < .05). Compared to newly-diagnosed T1DM children, serum TBil and IBil levels were statistically significantly lower in the established T1DM group and subgroups with different disease durations ( P < .05). TBil and IBil were correlated with the status of blood glucose control and can be reflected by RBG, HbA1C, and DKA/DK ( P < .05), but had no correlation was observed with disease duration ( P > .05). Serum bilirubin possesses the potential to be a biomarker of oxidative stress in T1DM children.

Background This study aims to evaluate the symptom burden of advanced liver cancer, explore factors related to quality of life (QoL), and investigate the relationship between insomnia and QoL. Methods This is a secondary analysis of a multicenter cross‐sectional study that included data from patients with advanced liver cancer ( n = 364) recruited from 10 cancer centers across China. Participants were required to complete Patient Health Questionnaire‐9 (PHQ‐9), MD Anderson Symptom Inventory (MDASI), Insomnia Severity Index (ISI), 5‐level EQ‐5D (EQ‐5D‐5L). Factors associated with QoL were identified through a multiple stepwise linear regression model and the LASSO regression approach. The mediating effect between insomnia and quality of life was tested using the bootstrap method. Results The three most prevalent symptoms were fatigue (17.0%), sleep disturbance (16.2%), and pain (15.8%). Insomnia, depression, and the 13 core symptoms in the MDASI were strongly correlated with reduced QoL (all p < 0.001). The mediating effect analysis showed that depression, dry mouth, pain, forgetfulness and fatigue were partial mediating variables between insomnia and QoL. Conclusion Various physical and psychological symptoms could affect the QoL in patients with advanced liver cancer. Insomnia and related symptoms such as depression, dry mouth, pain, forgetfulness and fatigue should be identified and appropriately addressed to improve QoL for this population.

Background Acute gastrointestinal injury (AGI) has a relatively high prevalence among elderly critically ill patients in non-intensive care units (non-ICUs), and significantly influences their clinical outcomes. Therefore, it is important to identify people at risk for AGI and take preventive measures as early as possible. Objective We aimed to construct and validate a risk prediction model for AGI in non-ICU elderly critically ill patients. Design Case–control study. Participants In total, 538 elderly critically ill patients admitted to the general medical department of a tertiary hospital in Shanxi from April 2021 to May 2024. Main Measures Influential factors for AGI were determined using univariate and multifactorial logistic regression analyses. We constructed a risk prediction model and created a nomogram. The bootstrap resampling method was utilized for internal validation. A total of 151 patients from different time periods were selected for the external validation. Key Results The multifactorial logistic regression analysis revealed that the independent predictors for AGI were the duration of antibiotic use, number of vasoactive drugs, delayed enteral nutrition, age-corrected Charlson comorbidity index, and white blood cell count, all of which were included in the model and created a nomogram. The Omnibus test showed that the overall efficacy of the model was good ( P < 0.001). The area under the receiver operating characteristic curve (AUC) was 0.807, the corrected AUC was 0.806, and the AUC was 0.796 for external validation, indicating good model discrimination. The calibration curves and Hosmer–Lemeshow tests revealed that the model was well calibrated ( P = 0.627, Brier = 0.172 in internal validation; and P = 0.366, Brier = 0.182 in external validation). The clinical decision curves showed that the model had good clinical utility. Conclusions AGI is common in non-ICU elderly critically ill patients. This AGI risk prediction model can be used as a screening tool to identify high-risk patients for AGI and assist clinical decision making.

Breast ultrasound plays a significant role in the non-invasive screening and diagnosis of breast cancer. The application of immunotherapy for breast cancer can significantly prolong the overall survival of advanced patients, which is an important research area of breast cancer treatment. The combination of ultrasound and immunotherapy helps patients diagnose and predict survival and develop a personalized treatment plan. This study analyzed the correlation between the clinical and ultrasonic characteristics of breast cancer and immune-related genes. First, the differential expression of immune-related genes was obtained using the GEO and IMMPORT database. Then, differentially expressed immune-related genes related to the overall survival of breast cancer were obtained using the GEPIA and Kaplan-Meier plotter platforms. Additionally, clinical, ultrasonic characteristics and pathological specimens of breast cancer patients’ tumors were collected. Whole transcriptome sequencing and immunohistochemical staining were performed on the tumor specimens to obtain gene expression. CXCL2, MIA, NR3C2, PTX3, S100B, SAA1, SAA2, and CXCL9 genes were correlated with each other and with clinical and ultrasonic characteristics. The high expression of MIA was related to the positive expression of PR in breast cancer. The low expression of NR3C2 was correlated with the clinical characteristics of tumor size ≥ 20 mm, later stage, Her-2 positive, Ki-67 ≥ 20%. NR3C2 was negatively correlated with the value of PKI and AUC in contrast-enhanced ultrasound parameters, and positively correlated with the value of AT and TTP. The expression of the PTX3 gene was also negatively correlated with the value of PKI and Emax of shear wave elastography. SAA2 was related to the presence or absence of edge burrs characterized by ultrasound. The expression of the CXCL9 gene was associated with the age of onset and tumor stage. In this study, 8 differentially expressed immune-related genes related to the overall survival of breast cancer were screened, which had been proved to be associated with some characteristics of cancer in previous studies, and could be further studied in the subsequent immunotherapy of breast cancer. Some clinical and ultrasonic characteristics of breast cancer were significantly correlated with immune-related genes, such as NR3C2, SAA2, and CXCL9. Further analysis of these genes provides new ideas for the diagnosis and treatment of breast cancer.