Objective: To examine the associations between 24 hour movement behavior allocation patterns and physical fitness as well as serum high sensitivity C-reactive protein (hsCRP) levels among female college students, providing evidence for developing personalized health promotion strategies. Methods: In September 2025, 48 female college students aged 18-22 years were recruited from a comprehensive university from Shanghai. Continuous 24 hour movement behaviors were monitored using a triaxial accelerometer (ActiGraph GT3X+). Serum hsCRP levels were measured (≥1 000 ng/mL was log grade inflammation), and physical fitness indicators including upper limb muscle strength, vital capacity, and maximal oxygen consumption (VO 2max ) were assessed. Spearman rank correlation analysis was used to evaluate the correlation between variables. Compositional data analysis combined with multiple linear regression was employed to construct isotemporal substitution models, evaluating the effects of substituting 30 minutes of one behavior for another on hsCRP and VO 2max . Results: Female college students had the longest average daily sedentary behavior (SB) time (643.2±103.2)min, which was higher than sleep time (452.4±90.0)min, light physical activity (LPA) time (279.0±76.8)min and moderate to vigorous physical activity (MVPA) time (66.0±21.6)min. Correlation analysis revealed that vigorous physical activity (VPA) was positively correlated with hsCRP levels among female college students ( r=0.47, P <0.05). Substituting 30 minutes of MVPA with sleep, SB or LPA significantly reduced predicted hsCRP levels among female college students ( β = -0.90, -0.90, -0.73), replacing 30 minutes of sleep with MVPA significantly increased predicted VO 2max levels ( β =5.12) (all P <0.05). The low grade inflammation group exhibited longer durations of high intensity activity participation and higher mean values for height, body weight, and grip strength compared to the normal group ( t =2.17, 2.52, 2.21, all P <0.05). Within the normal inflammation group, MVPA was positively associated with VO 2max ( β =0.18), while sleep was negatively associated ( β =-0.07) (both P <0.05). In contrast, no statistically significant associations were observed between any activity behavior and VO 2max in the low grade inflammation group (all P >0.05). Conclusions MVPA exerts bidirectional effects on the health of female college students. While it enhances cardiorespiratory fitness, it may concurrently elevate chronic low grade inflammation levels. To maximize health benefits, intervention programs focused on increasing MVPA should also give full consideration to the importance of restorative sleep.

Objective:To evaluate the effectiveness of T-piece resuscitator as a respiratory support strategy during the transport of critically ill premature infants,and to provide a scientific basis for clinical decision-making.Methods:A total of 280 critically ill premature newborns hospitalized in the NICU of Fifth Medical Center of Chinese People's Liberation Army General Hospital from January 2017 to December 2023 were included.Infants were categorized into three groups based on the respiratory support method given during transport: the ventilator group(108 cases),the T-piece group(102 cases),and the resuscitation sac group(70 cases).The transport distance,general condition at birth,prenatal conditions,dyspnea symptoms at admission,blood gas analysis results,clinical diagnosis,clinical intervations,and related treatment among the three groups were retrospectively analyzed.Results:There were no significant differences in the transport distance,the number of endotrached intubations during transport,the main complications during pregnancy,the general condition at birth,and the history of asphyxia among the three groups(all P>0.05).The incidence of triple-concave sign at admission in T-piece group was significantly lower than that in resuscitation sac group (41.7% vs.62.9%, P=0.005),and the arterial carbon dioxide tension(PaCO 2) at admission was also significantly lower in T-piece group than that in resuscitation sac group[(41.194±8.720) mmHg vs.(45.360±13.998) mmHg, P=0.034].Furthermore,the T-piece group had significantly lower rates of type II respiratory failure(0.9% vs.22.9%),respiratory acidosis(9.3% vs.27.1%),hypoxemia(7.4% vs.28.6%),hyperoxygen partial pressure(1.9% vs.28.6%),neonatal respiratory distress syndrome(66.7% vs.87.1%),and intracranial hemorrhage(18.5% vs.38.6%) during hospitalization compared to the resuscitation sac group (all P<0.05).The proportion of tracheal intubations(63.9% vs.87.1%) and the time of using non-invasive ventilator[1.0(1.0,2.0)d vs.1.0(1.0,6.0)d] were also significantly lower in T-piece group compared to the resuscitation sac group(both P<0.05).Compared with the respiratory group,there were no statistically significant differences in the aforementioned indicators for the T-piece group. Conclusion:The T-piece resuscitator can provide stable and adjustable positive end-inspiratory pressure and positive expiratory pressure,as well as a stable inspired oxygen flow rate,without increasing the risk of invasive procedures and severe complications.Its application during the transport and treatment of critically ill premature infants has definite clinical value.

Objective To identify determinants of subtherapeutic voriconazole(VRCZ)concentrations in allogeneic hematopoietic stem cell transplantation(allo-HSCT)recipients and to develop/validate a nomogram-based risk prediction model.Methods This study retrospectively analyzed 310 VRCZ therapeutic drug monitoring(TDM)measurements from allo-HSCT recipients at 310 patients who under went allo-HSCT surgery at Hebei Yanda Ludaopei Hospital from October 2022 to October 2024 and received VRCZ for the prevention and treatment of invasive fungal infections before transplantion were selected as the study subjects.Cases were stratified into target-concentration group(0.5～5.0μg/ml)and subtherapeutic group(<0.5μg/ml).Through single factor and multiple factor Logistic regression analysis,indeipendent predictive factors forvecz plasma concentration non-compliance were screened,and a column chart prediction model(NPM)was constructed.The performance of the model was evaluateding area under the receiver operating characteristic curve(AUC),Hosmer-Lemeshow(H-L)goodness-of-fit test,and decision curve analysis(DCA).Results Among 310 VRCZ-TDM measurements,71.61%(222/310)achieved target concentrations.Multivariate analysis showed that CYP2C19 intermediate metabolite,daily dose of cyclosporine A(CSA),daily dose of VRCZ,creatinine(Cr)>97 μmol/L,albumin(Alb)and C-reactive protein(CRP)were independent influencing factors for VRCZ blood drug concentration non-compliance(Wald χ2=4.046～13.221,all P＜0.05).The nomogram demonstrated excellent discrimination,calibration(H-L goodness of fit test χ2=2.663,P=0.954),and clinical utility with net benefit across 0.05～0.96 risk thresholds.Conclusion The nomogram incorporating CYP2C19 gene phenotype,daily CSA dosing,daily VRCZ dosing,Cr levels,Alb and CRP provides a validated tool for optimizing VRCZ therapy in allo-HSCT recipients,enabling precision dosing strategies.

A 66-year-old female patient self-administered Jingyaokang capsules (a compound preparation of traditional Chinese medicines, 3 capsules thrice daily orally) due to lumbar pain. The patient developed oliguria and edema of bilateral lower limbs after 3 doses of medication on the same day. The laboratory tests showed WBC 7.3×10 9/L, neutrophil percentage 0.70, blood urea 12.7 mmol/L, blood crea- tinine 179 μmol/L, and blood uric acid 461 μmol/L. The kidney function tests 15 days ago showed no abnormalities in the patient. Acute kidney injury caused by Jingyaokang capsules was considered. The drug was stopped and symptomatic treatments including torasemide and maintenance of fluid balance were given. The patient′s urine output gradually increased. Five days later, the patient′s edema of bilateral lower limbs disappeared, and her blood urea and creatinine decreased to normal range. The acute kidney injury in the patient may be related to strychni semen component in the Jingyaokang capsules.

Objective:To explore the clinical characteristics, treatment, and prognosis of patients with spondyloarthritis (SpA) and clinically insignificant monoclonal garmmopathy of undetermined significance (MGUS).Methods:A retrospective study was performed to analyze the clinical characteristics of patients simultaneously diagnosed with both SpA and MGUS at the First Affiliated Hospital to Zhengzhou University between January 2020 and December 2024, supplemented by a literature review.Results:Among the 5 patients (2 males, 3 females; age range 33~65 years), 4 presented with peripheral arthritis and 2 with extra-articular manifestations. All patients demonstrated elevated globulin and IgG levels, with 4 being HLA-B27 positive. M-protein typing revealed IgG/κ in 3 cases and IgA/λ in 2. All five patients underwent both X-ray and MRI examinations, with sacroiliitis being detected in 4 cases. Three patients with long disease duration showed poor response to conventional therapy (NSAIDs/DMARDs). Targeted therapies yielded variable outcomes: one patient achieved normalized globulin/IgG levels with etanercept (3-year follow-up without MGUS progression); another showed marked clinical improvement and significant globulin/IgG reduction with JAK inhibitor (tofacitinib, treated for 7 years); while a third demonstrated no symptom relief then switching from TNF-α inhibitor to IL-17 inhibitor.Conclusion:Persistent hyperglobulinemia in SpA patients warrants MGUS screening. Those with SpA-MGUS may require targeted therapies, where JAK inhibitors and monoclonal TNF-α inhibitors appear to be the preferred options, though long-term monitoring for MGUS progression remains essential.

Objective:To analyze the situation of rodents carrying Hantavirus and the genetic and evolutionary characteristics of the virus in Zibo city, Shandong province in 2022, and provide reference for the scientific prevention and control of hemorrhagic fever with renal syndrome (HFRS).Methods:Real-time quantitative PCR (RT-qPCR) was used to detect hantavirus (HV) nucleic acids in rodent lung tissues and identify HV genotypes. Each nucleic acid fragment was designed to amplify various gene fragments by segment, and the whole genome of Hantavirus was sequenced by second generation sequencing. Sequence assembly was performed using SeqMan 7.1.0.44, a subprogram of DNAStar. Sequence alignment and evolutionary analysis were conducted using MEGA 7.0 and BioEdit software.Results:A total of 270 host animals were captured in this survey. Among them, 13 rodent lung samples tested positive for Hantavirus, resulting in a virus-positive rate of 4.8%. The full-genome sequences of four hantavirus strains were successfully obtained, all identified as Seoul virus (SEOV) genotype. Four Hantavirus-positive samples showed high nucleotide sequence homology in the M gene and belonged to the SEOV S3 subtype. These strains exhibited high similarity with those from Hebei, Liaoning, and Beijing. The amino acid sequences of the nucleoprotein and glycoprotein immunogenic epitopes were identical to those of the vaccine strain Z37.Conclusions:This study successfully determined the full genome sequences of four hantavirus strains from Zibo city, Shandong province. The genotypes are primarily SEOV, with the subtype being S3. The homology of genes within the same subtype is high, with no significant variations observed. The alignment of immune epitopes in key proteins suggests that the current vaccine may provide protection against locally circulating strains, but further in-depth research is still required.

Objective: To investigate the current status of iron metabolism among apheresis donors in Guangzhou and analyze the improvement effects of health education on iron deficiency in frequent apheresis donors. Methods: Using a generalized linear mixed model (GLMM), a 180-day follow-up was conducted on 261 eligible apheresis donors at the Guangzhou Blood Center from January to July 2024. Hemoglobin (Hb), serum ferritin (SF), unsaturated iron-binding capacity (UIBC), total iron-binding capacity (TIBC), and transferrin saturation (TS) were selected as outcome variables. The effects of gender, age group, and number of donations within 180 days on these outcomes were analyzed and modeled. A general linear model (GLM) with repeated measures was applied to 55 donors who received health education interventions, comparing changes in Hb and iron metabolism-related indicators before and after follow-up and health education. Results: No significant difference in Hb levels was observed between first-time and regular apheresis donors, but SF levels were significantly higher in first-time donors (F=6.195, P<0.05). The GLMM revealed that female donors exhibited more significant reductions in Hb (T=-12.546) and SF (T=-5.829)(P<0.05 for both). Age group showed no interactive effects on Hb or SF changes. While number of donations within 180 days had no interactive effect on Hb, SF levels significantly decreased with increased number of donations (using ≥9 donations as the reference group; P<0.05 for all groups). After health education, Hb levels remained unchanged, but SF increased compared to pre-intervention levels (mean difference: -18.571, P<0.05), though a declining trend persisted compared to baseline (mean difference from baseline to post-intervention: 23.068,P<0.05). Conclusion: Female and number of donations are primary factors contributing to SF reduction in apheresis donors. Health education interventions promote SF recovery. Extending donation intervals and reinforcing iron deficiency-related health education may improve iron status in donors.

Working memory is an executive memory process that includes encoding, maintenance, and retrieval. These processes can be modulated by transcranial alternating current stimulation (tACS) with sinusoidal waves. However, little is known about the impact of the rate of current change on working memory. In this study, we aimed to investigate the effects of two types of tACS with different rates of current change on working memory performance and brain activity. We applied a randomized, single-blind design and divided 81 young participants who received triangular wave tACS, sinusoidal wave tACS, or sham stimulation into three groups. Participants performed n-back tasks, and electroencephalograms were recorded before, during, and after active or sham stimulation. Compared to the baseline, working memory performance (accuracy and response time) improved after stimulation under all stimulation conditions. According to drift-diffusion model analysis, triangular wave tACS significantly increased the efficiency of non-target information processing. In addition, compared with sham conditions, triangular wave tACS reduced alpha power oscillations in the occipital lobe throughout the encoding period, while sinusoidal wave tACS increased theta power in the central frontal region only during the later encoding period. The brain network connectivity results showed that triangular wave tACS improved the clustering coefficient, local efficiency, and node degree intensity in the early encoding stage, and these parameters were positively correlated with the non-target drift rate and decision starting point. Our findings on how tACS modulates working memory indicate that triangular wave tACS significantly enhances brain network connectivity during the early encoding stage, demonstrating an improvement in the efficiency of working memory processing. In contrast, sinusoidal wave tACS increased the theta power during the later encoding stage, suggesting its potential critical role in late-stage information processing. These findings provide valuable insights into the potential mechanisms by which tACS modulates working memory.
Humans ; Memory, Short-Term/physiology* ; Male ; Female ; Young Adult ; Transcranial Direct Current Stimulation/methods* ; Brain/physiology* ; Adult ; Electroencephalography ; Single-Blind Method

Objective To report cases of checkpoint inhibitor pneumonitis （CIP） in patients with advanced biliary tract cancer, aiming to provide additional approaches for the assessment, treatment, and monitoring of this condition. Methods Three patients developed oxygen desaturation and interstitial lung lesions during chemotherapy combined with immunotherapy, and were diagnosed with CIP in collaboration with the respiratory department. Antitumor therapy was discontinued in the acute phase, and glucocorticoids were administered, with regular monitoring of disease progression. During follow-up, case 1 developed lung metastasis; case 2 showed improvement; case 3 had concurrent infection and tumor progression. Results Glucocorticoids improved lung lesions and hypoxic symptoms in patients with CIP, but attention should be paid to the potential for concurrent infections and tumor progression. Conclusions Comprehensive assessment and early identification of CIP are crucial for patients with advanced biliary tract cancer. For those with recurrent symptoms after glucocorticoid therapy, timely and accurate adjustment of the treatment regimen is essential.

Objective In response to the prevalent issue of insufficient professional quality among nursing staff working in care homes,this study aims to conduct a foundational assessment using the"Medical and Elderly Care Integration Institution Elderly Care Staff Professional Quality Assessment Scale"based on the job competency theory,and then investigate the effective-ness of the"333"tiered training model following the initial assessment.Methods A convenience sampling method was used to select 160 caregivers from care homes in Wuxi.The caregivers were equally divided into an experimental group and a control group.A baseline assessment of professional competence was conducted using the professional quality assessment indicator system before training.The experimental group was treated with a tiered training model and training program,which were proposed using literature research and questionnaire survey methods and according to the results of baseline professional quality assessment.The control group did not undergo tiered training,but took the same training program as in the experimental group.SPSS 21.0 soft-ware was used for analysing the training outcome data.Results By comparison,the experimental group showed significantly re-duced learning time and had significantly higher assessment scores.The satisfaction degree of the elderly people and the caregiv-ers of the experimental group was significantly higher than that of the control group.The satisfaction ratings with training course design,training methods,and information-based teaching in the experimental group were significantly higher than those in the control group.Conclusion Assessing the professional quality of medical and elderly caregivers is essential for tired training.Tiered training is an effective way to improve the quality and efficiency of training,and a complete training organization system and a sound management mechanism are essential guarantees for implementing tiered training.