Diabetic wounds heal slowly or incompletely because of the microenvironment of hyperglycemia, high levels of reactive oxygen species (ROS), excessive inflammation, metabolic disorders and immune dysregulation, and the therapeutic effect is limited only by disruption of the reactive oxygen species (ROS)-inflammation cascade cycle. Here, a novel metal-polyphenolic nanozyme (Zn-DHM NPs) synthesized by the coordination of Zn²⁺ with dihydromyricetin (DHM) was designed, which not only has a superior ability to scavenge ROS and promote cell proliferation and migration but also functions in the regulation of metabolism and immune homeostasis. In vitro and in vivo experiments and RNA sequencing analyses revealed that Zn-DHM NPs could increase the levels of intracellular SOD and CAT enzymes to scavenge ROS and maintain the level of the mitochondrial membrane potential to reduce apoptosis. In terms of glucose metabolism, Zn-DHM NPs downregulated excessive levels of intracellular glucose and HK2, inhibited excessive glycolysis and downregulated the AGE-RAGE pathway to restore cellular function. In terms of immune regulation, Zn-DHM NPs not only downregulate M1/M2 levels to promote tissue repair but also maintain Th17/Treg homeostasis, downregulate the IL-17 signaling pathway to reduce inflammation, and upregulate FOXP3 to maintain immune homeostasis, thereby promoting early wound healing in diabetic mice. The development of Zn-DHM NPs provides a new therapeutic target to promote early healing of diabetic wounds.

Background: Maternal exposure to dietary factors during pregnancy may modulate the immunity of offspring by epigenetic programming. But the relationship between intrauterine environment and persistence of protective antibody after hepatitis B vaccination has not been reported. This study was to investigate the 5-year persistence of protective antibody response after primary hepatitis B vaccination, and its relationship with maternal folic acid supplementation. Materials and Methods: A total of 1461 children who completed a 3-dose 10 μg recombinant hepatitis B vaccine at birth and did not infect hepatitis B virus were followed up. Logistic regression and mediation analysis was used to explore the relationship between 5-year persistence of protective antibody and maternal nutrition. Results: Of 1403 children who did not revaccinated during the follow-up, 76.1% had protective hepatitis B surface antibody (anti-HBs) levels. Twenty percent of mothers did not take folate during pregnancy. Mediation analysis showed a total effect of folic acid supplementation on good persistence (odds ratio: 1.10, 95% CI: 1.03-1.17, p = 0.0010), a direct effect was 1.07 (95% CI: 1.01-1.13, p = 0.0128) and an indirect effect was 1.03 (95% CI: 1.00-1.06, p = 0.0672); the proportion of good persistence mediated by primary response was 30.3%. Conclusion: This study indicated a good protective anti-HBs persistence at year 5 after 10 μg recombination hepatitis B vaccination in infants. Maternal folic acid supplementation may improve the persistence of protective antibodies through other pathways. Multi-center cohort studies should be conducted to verify this conclusion.

Objective: The risk factors associated with hematoma formation following ultrasound (US)-guided vacuum-assisted excision (US-VAE) of breast fibroadenoma (FA), particularly those related to the US features of the lesions, remain unclear. This study aimed to investigate the US features influencing hematoma formation after US-VAE of FAs. Materials and methods: This retrospective analysis included 137 patients with 145 FA nodules who underwent US-VAE at our hospital from January 2018 to August 2024, and subsequently underwent US follow-up to monitor hematoma formation and absorption. The US features of the lesions, including size, number of nodules removed, location, depth, distance from the nipple, peripheral tissue structure, and color Doppler flow features, were retrospectively analyzed to identify the potential risk factors associated with hematoma formation. Results: Hematomas formed in 78 nodules (53.8%) 24–48 h after the US-VAE procedure and disappeared within 6 months in 77 cases (98.7%). In the multivariate logistic regression analysis, FA depth ≥ 1.5 cm or <0.7 cm (OR = 2.490, 95% CI: 1.056–5.872; p < 0.05), surrounding tissue mainly composed of fat (OR = 2.471, 95% CI: 1.043–5.857; p < 0.05), and rich blood supply (OR = 3.164, 95% CI: 1.444–6.934; p < 0.01) were independent risk factors for hematoma formation. Conclusion: Most hematomas that formed after US-VAE for breast FA disappeared within 6 months. FA depth ≥ 1.5 cm or <0.7 cm, surrounding tissue mainly composed of fat, and rich blood supply indicated the possibility of hematoma formation after US-VAE.

Objectives: To explore changes in cerebral blood flow (CBF) and white matter during wakeful rest in patients with obstructive sleep apnea (OSA). Methods: The subjects comprised OSA patients and age- and sex-matched non-sleep apnea (NSA) subjects from December 2020 to December 2021. All subjects underwent structural and arterial spin labeling MRI examinations using a 3.0 T MRI scanner. Intergroup differences in regional and global CBF and white matter hyperintensities (WMHs) were analyzed. Results: In this study, 100 (74 males) of 750 (439 males) subjects were diagnosed with OSA, so the prevalence of OSA in the general population was 13.3% (100/750), with 16.9% (74/439) in males and 8.4% (26/311) in females. Excluding four patients with incomplete imaging data, 96 OSA patients and 103 age- and sex-matched NSA subjects were included. At global level, OSA patients showed significantly decreased CBF values in gray matter and whole brain compared to NSA subjects (gray matter: p = 0.010; whole brain: p = 0.021). No significant difference in CBF values was found in WM between the two groups (p = 0.250). At regional level, compared with NSA subjects, patients with OSA exhibited significantly decreased regional CBF values mainly in right parietal lobe and right temporal lobe. Moreover, OSA patients had significantly higher WMHs burden than NSA subjects (p = 0.017). Conclusions: OSA patients exhibit decreased global and regional CBF values and increased WMHs burden. Advances in knowledge: These findings provide a basis for exploring neuropathological changes of OSA and for early and appropriate treatment.

Background Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most common chronic liver disease in the world and carries an increased risk of liver-related events, but no approved medicine. Electroacupuncture has been used to treat non-alcoholic fatty liver disease, but its effect was uncertain because of the poor quality of prior studies. We designed this trial to evaluate the efficacy and safety of electroacupuncture for MAFLD. Methods/design This is a multicentre, randomised, sham acupuncture-controlled, patient-blinded clinical trial. Participants will take part in a total of 20 weeks of study, containing three phases: a 4‐week run-in period, 12‐week treatment (36 sessions of acupuncture) and 4‐week follow‐up. A total of 144 eligible patients diagnosed with MAFLD will be randomly allocated to the electroacupuncture or sham acupuncture groups. The primary outcome is the percentage of relative liver fat reduction on the MRI proton density fat fraction from baseline to 12 weeks. Secondary outcomes include magnetic resonance elastography, liver and metabolic biomarkers, anthropometry parameters, blinding assessment, credibility and expectancy, and adverse events. All patients who receive randomisation will be included in the intent-to-treat analysis. Discussion The finding of this trial will provide evidence of the efficacy and safety of electroacupuncture for the treatment of MAFLD. The results of this study will be published in peer-reviewed journals. Trial registration number www.chictr.org.cn, ChiCTR2200060353. It was registered on 29 May 2022.

The relationship between prolonged blood glucose exposure and glymphatic system function of the brain remains unknown. This study aimed to investigate the association between cumulative blood glucose levels and neuroimaging metrics associated with glymphatic function. This study was conducted in a multicenter, community-based cohort study. Magnetic resonance imaging (MRI) data were collected once between 2020 and 2022. The assessment of brain glymphatic function can be conducted using the diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index. Cumulative fasting blood glucose (FBG) values from 2014 to 2018 were calculated for each participant as a prolonged exposure, while a single measurement of FBG at the same time of MRI acquisition represented a short-term exposure. A generalized linear model was used to evaluate the association of blood glucose exposure and DTI-ALPS index. A total of 251 subjects were included. Prolonged hyperglycemic exposure with FBG ≥ 7.0 mmol/L was significantly associated with lower average DTI-ALPS index (β = -0.058, 95 % confidence interval, -0.096 to -0.019). These findings remained significant among participants over 60 years old and those not taking hypoglycemic medication. No significant associations were observed in single measurement. Prolonged exposure to hyperglycemia is significantly associated with a lower average DTI-ALPS index, potentially playing a crucial role in the impairment of glymphatic function, especially among older adults. A well controlled blood glucose level may demonstrate a protective effect on glymphatic function, indicating better brain health.