Lisheng Wang

Background: Symptom networks offer a new approach to explore the relationships among various symptoms and provide information for optimising precise symptom management strategies. However, no previous studies have identified the central symptoms of multidimensional frailty. Design: A cross‐sectional study was conducted from December 2023 to March 2024 in China. Settings and Participants: A total of 933 community‐dwelling older adults (aged 60 years or older) in China were recruited via convenience sampling. Methods: Sociodemographic variables, clinical variables and scores on the Tilburg Frailty Indicator were assessed in all participants. The qgraph package and IsingFit package of R software were applied to construct the symptom network. Three node centrality indices (strength, betweenness and closeness) and the expected influence were calculated to identify the central symptoms of the multidimensional frailty network. All statistical analyses were performed in R. Results: A total of 933 individuals were surveyed in this study, including 472 (50.6%) females. The median age of all participants was 71.0 years. A total of 408 subjects were assessed as multidimensional frailty. The prevalence of multidimensional frailty was 43.7%. The centrality indices revealed that ‘difficulty in walking’, ‘difficulty in maintaining balance’, and ‘feeling down’ were the symptoms with the largest strength and expected influence values. Conclusion: This study primarily utilised network analysis to construct a symptom network of multidimensional frailty among community‐dwelling older adults. The findings revealed that difficulty in walking, difficulty in maintaining balance, and feeling down were the most central symptoms. Implications: This study identified the central symptoms of multidimensional frailty in older adults, which may serve as primary intervention targets. Nursing staff could incorporate targeted physical and psychological interventions into person‐centred care plans. Reporting Methods: This study was reported in accordance with the STROBE guidelines. Patient or Public Contribution: No patient or public contribution was involved in this study.

Vascular endothelial damage due to ionizing radiation is the main pathological process of radiation injury and the main cause of damage to various organs in nuclear accidents. Ferroptosis plays an important role in ionizing radiation-induced cell death. We have previously reported that luteolin is highly resistant to ferroptosis. In the present study, body weight, microvessel count, H&E, and Masson staining results showed that luteolin rescued radial vascular injury in vivo. Cell Counting Kit 8 (CCK8), Giemsa staining clarified the anti-ferroptosis ability of luteolin with low toxicity. Malondialdehyde (MDA), superoxide dismutase (SOD), NADP⁺/NADPH, Fe²⁺ staining, dihydroethidium (DHE) and MitoTracker assays for ferroptosis-related metrics, we found that luteolin enhances human umbilical vein endothelial cells (HUVECs) antioxidant damage capacity. Drug affinity responsive target stability (DARTS), surface plasmon resonance (SPR), computer simulated docking and western blot showed that heat shock protein beta-1 (HSPB1) is one of the targets of luteolin action. Luteolin inhibits ferroptosis by promoting the protein expression of HSPB1/solute carrier family 7 member 11 (SLC7A11)/ glutathione peroxidase 4 (GPX4). In conclusion, we have preliminarily elucidated the antioxidant damage ferroptosis ability and the target of action of luteolin to provide a theoretical basis for the application of luteolin in radiation injury diseases.

The treatment of diabetes distress plays an important role in diabetes care; however, no meta-analysis has been performed to synthesize the short- and long-term effects of psychological interventions tailored for diabetes distress in people with type 2 diabetes. We aim to evaluate the evidence on tailored psychological interventions for diabetes distress as the primary outcome, focusing on individuals with type 2 diabetes. Two reviewers independently searched eight databases from their inception to September 2024. EndNote X9 was used to screen records. The Revised Cochrane risk-of-bias tool for randomized trials was used to assess the risk of bias. The GRADE system was used to assess the overall certainty of the evidence. A random effect model was used to determine the mean difference or standardized mean difference with 95% CIs. Subgroup analyses based on several intervention characteristics and sensitivity analyses were also conducted. Totally, 22,279 records were yielded, and we finally included 18 studies in our systematic review. The meta-analysis included data from 16 studies representing 1639 participants. Interventions types included mindfulness-based and cognitive behavioral therapy, among others. Duration of interventions ranged from 4 weeks to 6 months. We found that psychological interventions that measured diabetes distress significantly reduced diabetes distress in the short-term in people with type 2 diabetes (SMD= -0.56; 95% CI= -0.90, -0.22; p = 0.001). Subgroup analysis indicated that this effect could be enhanced when delivered in a group format, by psychologist, using a technology component, or including participants having elevated baseline diabetes distress. However, the short- and long-term effects on HbA1c were non-significant, with results showing (MD = 0.02; 95% CI = -0.23 to 0.26; p = 0.89) and (MD = -0.27; 95% CI = -0.64 to 0.10; p = 0.15), respectively. The long-term effect on diabetes distress was also non-significant (SMD = -0.45; 95% CI = -0.93 to 0.03; p = 0.07). Psychological interventions tailored for diabetes distress in people with type 2 diabetes are effective in reducing the level of diabetes distress immediately after the intervention. More trials are still needed to further enrich the evidence in this area.

Introduction: The vascular endothelium plays a pivotal role in maintaining vascular function and physiological balance. The degradation and injury of endothelial cells are critical pathological events in the progression of vascular diseases, leading to cell death. One such cell death mechanism, ferroptosis, is an iron-dependent form of necrosis characterized by extensive lipid peroxidation-mediated membrane damage and the toxic effects of iron and lipid peroxidation. Kaempferol, a flavonoid, is celebrated for its antioxidant, anti-inflammatory, and anti-cancer properties. Despite these benefits, the impact of Kaempferol on endothelial cell ferroptosis and its potential therapeutic applications in vascular diseases have yet to be fully elucidated. Methods: Cell viability was assessed using the Cell Counting Kit-8 (CCK-8) assay. Oxidative stress and lipid peroxidation were measured using Dihydroethidium (DHE) and C11-BODIPY 581/591, respectively. The protein and RNA levels of ferroptosis-associated molecules, including solute carrier family 7 member 11 (SLC7A11) and glutathione peroxidase 4 (GPX4), were determined through Western blotting and real-time fluorescence quantitative polymerase chain reaction (qPCR). Results: Treatment with a glutathione peroxidase 4 inhibitor (RSL3) led to rapid cytotoxicity in human umbilical vein endothelial cells (HUVECs). Notably, Kaempferol demonstrated a significant protective effect against RSL3-induced ferroptosis in HUVECs. Kaempferol treatment reduced the accumulation of reactive oxygen species (ROS) and exhibited distinctive morphological changes associated with ferroptosis. Moreover, Kaempferol treatment resulted in the upregulation of SLC7A11 and GPX4 expression in HUVECs, highlighting its potent ability to mitigate ferroptosis among tested flavonoids. Conclusions: Kaempferol effectively inhibited RSL3-induced ferroptosis in HUVECs by modulating the expression of SLC7A11 and GPX4, thereby reducing lipid peroxidation. These findings underscore the therapeutic potential of Kaempferol in the treatment of vascular diseases, paving the way for its application in clinical settings.

Cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) are the second most common cancers in women aged 20–39. While HPV screening can help with early detection of cervical cancer, many patients are already in the medium to late stages when they are identified. As a result, searching for novel biomarkers to predict CESC prognosis and propose molecular treatment targets is critical. TGFA is a polypeptide growth factor with a high affinity for the epidermal growth factor receptor. Several studies have shown that TGFA can improve cancer growth and progression, but data on its impact on the occurrence and advancement of CESC is limited. In this study, we used clinical data analysis and bioinformatics techniques to explore the relationship between TGFA and CESC. The results showed that TGFA was highly expressed in cervical cancer tissues and cells. TGFA knockdown can inhibit the proliferation, migration and invasion of cervical cancer cells. In addition, after TGFA knockout, the expression of IL family and MMP family proteins in CESC cell lines was significantly reduced. In conclusion, TGFA plays an important role in the occurrence and development of cervical cancer. Therefore, TGFA may become a new target for cervical cancer treatment.

Cancer-related fatigue (CRF) is a widespread symptom with high prevalence in cancer patients, seriously affecting their quality of life. In the context of precision care, constructing machine learning-based prediction models for early screening and assessment of CRF is beneficial to this situation. To further understand the predictors of CRF for model construction, we conducted a comprehensive search in PubMed, Web of Science, Embase, and Scopus databases, combining CRF with predictor-related terms. A total of 27 papers met the inclusion criteria. We evaluated the above studies into three subgroups following the predisposing, precipitating, and perpetuating (3P) factor model. (1) Predisposing factors—baseline fatigue, demographic characteristics, clinical characteristics, psychosocial traits and physical symptoms. (2) Precipitating factors—type and stage of chemotherapy, inflammatory factors, laboratory indicators and metabolic changes. (3) Perpetuating factors—a low level of physical activity and poorer nutritional status. Future research should prioritize large-scale prospective studies with emerging technologies to identify accurate predictors of CRF. The assessment and management of CRF should also focus on the above factors, especially the controllable precipitating factors, to improve the quality of life of cancer survivors.