Background: Despite the known association between chronic inflammation and reduced muscle mass, there is a gap in research regarding the association between the systemic immune-inflammation index (SII) and sarcopenic obesity (SO). This study aims to assess the relationship between SII and SO in middle-aged and elderly adults and the mediating role of triglyceride-glucose index (TyG). Methods: This cross-sectional study involved 2,719 participants aged 45–90 years who underwent health check-ups. SO was evaluated by combining sarcopenia [assessed by handgrip strength and appendicular skeletal muscle index (ASMI)] with obesity (determined by body fat percentage). Association between SII and SO, sarcopenia, and obesity in middle-aged and elderly individuals was examined using multivariable logistic regression, restricted cubic spline analysis, and subgroup analysis. Bidirectional mediation analysis was conducted to determine the direct and indirect effects through SII and TyG. Results: The study included 2,719 participants, of which 228 had SO (8.4%). SO prevalence increased as the SII quartiles rose (P_{for trend} <0.001). SII (per SD increase) had a significantly positive association with SO in both middle-aged individuals (OR = 1.69, 95% CI: 1.43 ~ 1.99) and older adults (OR = 2.52, 95% CI: 1.68 ~ 3.77). The relationship between SII and SO was found to be non-linear (P_nonlinear0.05). Conclusions: Elevated levels of SII were associated with an increased risk of SO in middle-aged and elderly adults, especially in the elderly population, and elevated TyG levels played a role in this relationship.

Heat shock protein 90 (HSP90) is widely found in brain tissue. HSP90 inhibition has been proven to have neuroprotective effects on ischemic strokes. In order to study the role of HSP90 in traumatic brain injury (TBI), we carried out the present study. A novel inhibitor of the HSP90 protein, 17‐dimethylaminoethylamino‐17‐demethoxygeldanamycin (17‐DA), has been investigated for its function on the blood‐brain barrier (BBB) damage after traumatic brain injury (TBI) in mouse models. These C57BL/6 mice were used as a TBI model and received 17‐DA (0.1 mg/kg/d, intraperitoneally) until the experiment ended. To find out whether 17‐DA may protect against TBI in vitro, bEnd.3 cells belonging to mouse brain microvascular endothelium were used. The HSP90 protein expressions were raised after TBI at the pericontusional area, especially at 3 d. Our study suggested that 17‐DA‐treated mice improved the recovery ability of neurological deficits and decreased brain edema, Evans blue extravasation, and the loss of tight junction proteins (TJPs) post‐TBI. 17‐DA significantly promoted cell proliferation and alleviated apoptosis by inhibiting the generation of intracellular reactive oxygen species (ROS) to downregulate cleaved caspase‐3, matrix metallopeptidase‐ (MMP‐) 2, MMP‐9, and P‐P65 in bEnd.3 cells after the injury. As a result, we assumed that the HSP90 protein was activated post‐TBI, and inhibition of HSP90 protein reduced the disruption of BBB and improved the neurobehavioral scores in a mouse model of TBI through the action of 17‐DA, which inhibited ROS generation and regulated MMP‐2, MMP‐9, NF‐κB, and caspase‐associated pathways. Thus, blocking HSP90 protein may be a potential therapeutic strategy for TBI.

Introduction. Hemorrhagic transformation (HT) is one of the most common complications of ischemic stroke which is exacerbated by hyperglycemia. Oxidative stress, inflammatory response, and matrix metalloproteinases (MMPs) have been evidenced to play a vital role in the pathophysiology of HT. Our previous study has reported that 17‐DMAG, an Hsp90 inhibitor, protects the brain against ischemic injury via inhibiting inflammation and reducing MMP‐9 after ischemia. However, whether 17‐DMAG would attenuate HT in hyperglycemic middle cerebral artery occlusion (MCAO) rats is still unknown. Methods. Acute hyperglycemia was induced by an injection of 50% dextrose. Rats were pretreated with 17‐DMAG before MCAO. Infarction volume, hemorrhagic volume neurological scores, expressions of inflammatory molecules and tight junction proteins, and activity of MMP‐2 and MMP‐9 were assessed 24 h after MCAO. Results. 17‐DMAG was found to reduce HT, improve neurological function, and inhibit expressions of inflammatory molecules and the activation of MMPs at 24 h after MCAO. Conclusion. These results implicated that Hsp90 could be a novel therapeutic target in HT following ischemic stroke.

Objective. This study is aimed at investigating the early diagnosis and efficacy of emergency treatments of nine patients with severe multiple injuries accompanied by traumatic aortic dissection (TAD). Methods. Patients who sustained severe multiple injuries accompanied by TAD following a car accident ( $n=6$ ) and falls from a height ( $n=3$ ) were treated in the emergency department of our hospital from October 2017 to July 2021. Data of these patients, including seven men and two women (average age, $53\pm 15.2$ years; range, 18–83 years) were analysed retrospectively. Upon hospital arrival, the multidisciplinary treatment (MDT) trauma team, composed of doctors and nurses, immediately performed resuscitation following the Green Channel Consultation and Treatment Process for Severe Multiple Injuries. Life-threatening injuries were managed urgently. Blood tests and blood preparation and bedside B-scan ultrasonography and CT were performed. Aortic computed tomography angiography (CTA) was conducted decisively in patients suspected of TAD so that endovascular graft exclusion (EVGE) with the aortic covered stent can be performed promptly, followed by emergency management, second-stage surgery, and intensive care according to the injury control strategy. Results. This study included nine patients suffering from severe multiple injuries accompanied by Stanford type B TAD, with injury severity scores ranging from 35 to 43 points. Six patients underwent EVGE while receiving emergency treatment, whereas two patients who also had intracranial haemorrhage underwent selective EVGE. One case of TAD missed in the emergency department was detected 13 days after hospitalisation; therefore, the patient promptly underwent EVGE. Emergency procedures performed included exploratory laparotomy and splenectomy ( $n=2$ ), thoracic closed drainage ( $n=5$ ), haemothoracotomy ( $n=3$ ), second-stage fracture surgery ( $n=4$ ), and tracheotomy ( $n=1$ ). Postinjury complications included haemorrhagic shock, coagulation disorders, hyoxaemia, pulmonary infection, renal insufficiency, and hypoproteinaemia; however, all patients recovered after intensive care treatment. Aortic CTA after EVGE revealed the disappearance of the dissection and the resorption of the intermural haematoma. However, varying degrees of stenosis or occlusion were observed in the left subclavian artery. Nine patients with severe multiple injuries were treated satisfactorily by the MDT, without fatalities, and all patients were discharged for rehabilitation. Conclusion. In this study, procedures including resuscitation, urgent aortic CTA for definitive diagnosis, prompt EVGE, emergency injury control surgery, second-stage definitive surgery, intensive care treatment, and rehabilitation were rationally performed by the emergency MDT trauma team. Overall, this continuous and seamless process is a key factor for the successful treatment of patients with severe multiple injuries accompanied by TAD.

Background: For lung transplant recipients, going back to work is a crucial sign of improved quality of life and post-operative social rehabilitation. However, the re-employment rate for this group is typically poor. Significant individual variances result from the process, which is heavily impacted by intricate physiological, psychological, and social aspects. Support measures frequently lack specificity since there is currently a lack of thorough understanding of the distinct needs and experiences of various patient groups. Objective: This study examines the real-life experiences, challenges, and coping mechanisms of lung transplant recipients returning to work, and develops user personas for workforce reintegration to uncover cohort diversity and inform targeted vocational rehabilitation interventions. Methods: We conducted a secondary qualitative analysis of in-depth interviews with 38 lung transplant recipients from a tertiary hospital in Jiangsu Province. Using Graneheim and Lundman’s content analysis and persona development, we identified and visualised distinct return-to-work profiles based on shared characteristics and behaviours. Results: Four return-to-work profiles were established: (1) Rapid Return Type – Patients who resumed work, recovered well, and actively reintegrated into society; (2) Meandering Return Type – Patients who returned to work but required ongoing balancing of health and occupational demands; (3) Life-Centred Type – Patients who voluntarily relinquished employment, prioritising health and recuperation; (4) Conflicted and Hesitant Type – Patients who have not returned to work but harbour a desire to do so, hindered by physical, psychological, and social barriers. Conclusion: Lung transplant recipients’ return to work experiences are highly varied and impacted by a variety of circumstances, including social, psychological, physiological, and economic aspects. Finding these profiles helps policymakers, rehabilitation teams, and clinicians comprehend the internal differences in this patient population. This knowledge makes it easier to provide individualized, categorized, and stratified vocational rehabilitation assistance, which fosters long-term social and professional integration.

Background: Social participation and dietary patterns have been associated with cognitive function in older adults, and potential interactions may exist between social and behavioral factors. Understanding these associations may help identify potential targets for prevention and intervention efforts. Therefore, this study aimed to examine the network relationships among dietary patterns, social participation patterns, and cognitive function domains, and to visualize these complex associations using network analysis. Methods: A total of 9,539 adults aged ≥60 years were included from the Chinese Longitudinal Healthy Longevity Survey (CLHLS, 2017–2018). Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination (MMSE). Dietary patterns and social participation patterns were derived based on commonly consumed foods and social activities. Restricted cubic spline (RCS) analysis was conducted to analyze the dose-response relationships. Network analysis was conducted to identify central and bridging nodes, and network stability was evaluated using case-dropping bootstrap procedures. Results: Network analysis revealed that M3 (Attention and Calculation), M5 (Language), and M1 (Orientation) showed the highest expected influence, while S3 (Leisure and Entertainment-based Social Participation), M3 (Attention and Calculation), and S1 (Housework-related Social Participation) showed the highest bridge strength. The correlation stability coefficient of the centrality, expected influence, and bridge strength is 0.75, indicating that the network exhibits good stability. RCS analyses revealed both linear and nonlinear dose–response relationships between lifestyle factors and cognitive function domains, with stronger effects observed at lower exposure levels for certain variables. Conclusions: This exploratory study identified complex associations among dietary patterns, social participation patterns, and cognitive function domains in Chinese older adults. These findings provide a basis for future longitudinal and interventional research.