ObjectiveBy establishing a light sleep deprivation （SD） model and using the traditional Chinese medicine （TCM） compound Sancao Anshen prescription for intervention， this study aims to observe one of the effects of Sancao Anshen prescription on the sleep and depressive states of zebrafish in the SD model and explore the mechanism of action of this drug in regulating the cyclic adenosine monophosphate （cAMP）/protein kinase A （PKA） signaling pathway. MethodsA total of 240 six-month-old wild-type AB zebrafish were randomly divided into a blank group， a model group， low-dose， medium-dose， and high-dose groups of Sancao Anshen prescription （0.28， 0.83， 2.48 g·L^-1）， and a melatonin group （0.2 g·L^-1）， with 40 fish in each group. Except for the blank group， all others were exposed to LED lights （150 lux） for three days to construct the sleep deprivation model， and were treated with the corresponding doses of Sancao Anshen decoction and melatonin solution for three days. 24 h movement behavior was used to detect diurnal movement trajectories. A T-shaped maze was employed to detect learning and memory functions， and a new tank experiment was conducted to detect depression-like behaviors in zebrafish. Hematoxylin-eosin （HE） staining was used to observe the morphology of hypothalamic neurons， and transmission electron microscopy was utilized to observe the ultrastructure of hypothalamic cells. Immunohistochemical （IHC） was used to measure the positive expression of tumor necrosis factor-α （TNF-α） and interleukin-1β （IL-1β） in the hypothalamus， and enzyme-linked immunosorbent assay （ELISA） was employed to determine the content of cAMP， 5-hydroxytryptamine （5-HT）， gamma-aminobutyric acid （GABA）， and glutamic acid （Glu） in brain tissue. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot were used to measure the expression of PKA， cAMP response element-binding （CREB）， and brain-derived neurotrophic factor （BDNF） mRNAs and proteins and their phosphorylation levels （p-PKA， p-CREB） in brain tissue. ResultsCompared with those in the blank group， the resting time and resting count in the model group decreased significantly （P<0.01）， while the gross motor time and gross motor count increased significantly （P<0.01）. The latency time to enter the EC region in each administration group increased significantly （P<0.01）. The exploration time towards the top and the number of times entering the top decreased significantly （P<0.01）， and the incubation period of the first ascent increased significantly （P<0.01）. The number of hypothalamic neurons decreased significantly， and the neurons exhibited irregular shapes， sparse arrangement， and nuclear condensation. Nuclear collapse， nuclear membrane rupture and dissolution， chromatin condensation， mitochondrial swelling and deformity， and plate-like cristae rupture or disappearance were observed. The positive expression of TNF-α and IL-1β in the hypothalamus was significantly decreased （P<0.01）. The content of cAMP， GABA， and 5-HT in brain tissue was significantly downregulated， while the content of Glu was significantly upregulated （P<0.01）. The mRNA of PKA， CREB， and BDNF was significantly downregulated （P<0.01）， and the protein expression of p-PKA， p-PKA/PKA， p-CREB， p-CREB/CREB， and BDNF was significantly decreased （P<0.05， P<0.01）. Compared with those in the model group， the resting time in the medium-dose and high-dose groups of Sancao Anshen prescription and the melatonin group increased （P<0.05， P<0.01）， and the resting count in each administration group significantly increased （P<0.05， P<0.01）. The gross motor time and gross motor count significantly decreased （P<0.05， P<0.01）. The latency time to enter the EC region decreased （P<0.01）， and the exploration time towards the top increased （P<0.01）. The time for the first ascent in the high-dose group of Sancao Anshen prescription and the melatonin group was shortened （P<0.05， P<0.01）， and the number of times entering the top increased （P<0.01）. The morphology of neurons in each administration group improved， with the gap decreased， the nuclear membrane relatively intact， and mitochondrial swelling improved. The positive expression of IL-1β in each administration group significantly decreased （P<0.01）. The positive expression of TNF-α in the medium-dose and high-dose groups of Sancao Anshen prescription and the melatonin group significantly decreased （P<0.01）. The Glu content in the low-dose group of Sancao Anshen prescription decreased， while cAMP and GABA levels increased （P<0.05， P<0.01）. There was no statistically significant difference in 5-HT content. The medium-dose and high-dose groups of Sancao Anshen prescription and the melatonin group all showed significant increases in cAMP， 5-HT， and GABA levels （P<0.01）， and a significant decrease in Glu content （P<0.01）. The mRNA of CREB in the low-dose group of Sancao Anshen prescription was significantly upregulated （P<0.01）， while there was no statistically significant difference in the mRNA of PKA and BDNF. The mRNA of PKA， CREB， and BDNF in the medium-dose and high-dose groups of Sancao Anshen prescription and the melatonin group were all significantly upregulated （P<0.01）. The protein expression of p-PKA， p-PKA/PKA， p-CREB， p-CREB/CREB， and BDNF in the high-dose group of Sancao Anshen prescription and the melatonin group increased significantly （P<0.05， P<0.01）， and the protein expression of p-PKA， p-CREB， and BDNF in the medium-dose group of Sancao Anshen prescription increased （P<0.05）. ConclusionThe improvement of sleep and depressive states in zebrafish with the SD model by Sancao Anshen prescription may be related to the inhibition of inflammatory factors such as TNF-α and IL-1β， the reduction in Glu， and the elevation in the content of neurotransmitters such as GABA and 5-HT via the cAMP/PKA signaling pathway.

: To analyze the prevalence of anemia and iron deficiency among primary and secondary school students in Rural Nutrition Improvement Program areas of Guizhou Province in 2023, and to explore the related factors, so as to provide evidence for Rural Nutrition Improvement Program optimization. Methods: In September 2023, a stratified random cluster sampling strategy was used to select 40 rural compulsory education schools with rural nutrition improvement program in five counties of Guizhou Province. School level questionnaire was employed to collect information of basic characteristics and school meal implementation. A total of 7 826 primary and secondary school students aged 6-16 underwent anthropometry and hemoglobin (Hb) determination; serum ferritin (SF) was additionally measured in a random subsample of 1 795 pupils. Students in Grade 3 and above also completed a questionnaire covering demographic characteristics, dietary behaviours and nutrition knowledge. Group comparisons were conducted by Chi square test or Fisher s exact test, and multivariable Logistic regression models were constructed to identify factors associated with anemia and iron deficiency. Results: The overall Hb level was (133.21±12.95)g/L, with an anemia prevalence of 7.17%. The overall SF level was (69.58±59.01)μg/L, with an iron deficiency prevalence of 2.73%. Multivariable analysis showed that stunting ( OR =1.88), school menus without nutrient calculation ( OR =1.61) and absence of menu planning software in the current semester ( OR =2.34) independently increased anemia risk, whereas obesity reduced it ( OR =0.54) (all P <0.05). Girls ( OR =4.16) and Grades 7-9 ( OR =5.93) increased iron deficiency risk (both P <0.05). Compared with rarely eating fresh vegetables, students with consuming <3 kinds per day ( OR =0.08) or exactly 3 kinds per day ( OR =0.06) had lower iron deficiency risks (both P <0.05). Conclusions Anemia and iron deficiency are prevalent among primary and secondary school students in Guizhou. Targeted intervention measures should be implemented for key populations to enhance the effectiveness of nutrition improvement program.

Background Per- and poly-fluoroalkyl substances (PFAS) can influence gestational diabetes mellitus (GDM); however, current studies on their association are limited and have yielded inconsistent findings. Objective To investigate the association between maternal exposure to PFAS, as measured by urinary concentrations in early pregnancy, and the risk of developing GDM. Methods Based on the Wuhu Birth Cohort in Anhui Province conducted between 2020 and 2023, this study included 1910 pregnant women. Urine samples were collected during the first trimester, and a 75 g oral glucose tolerance test (OGTT) was completed at 24–28 gestational weeks. The concentrations of six PFAS in urine were measured using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Participants were categorized into low, medium, and high exposure groups according to tertiles of individual PFAS concentrations. Logistic regression analysis was employed to assess the potential impact of early-pregnancy PFAS exposure levels on the risk of GDM, with stratified analyses by maternal age and fetal sex. A generalized weighted quantile sum regression (gWQS) model was applied to evaluate the relative weight distribution of the six PFAS in their mixture effect. Results The logistic regression results revealed that both medium exposure to perfluorohexane sulfonate (PFHxS) (OR=1.475, 95%CI: 1.040, 2.093) and high exposure to perfluorononanoic acid (PFNA) (OR=1.430, 95%CI: 1.013, 2.018) were positively associated with diagnosed GDM. This association was more pronounced among women older than 28 years. Among pregnant women carrying male fetuses, high-level exposures to per fluorohexanoic acid (PFHxA) (OR=1.708, 95%CI: 1.006, 2.899) and PFHxS (OR=2.116, 95%CI: 1.247, 3.584) showed positive associations with diagnosed GDM. In contrast, among those carrying female fetuses, moderate perfluorooctanesulfonic acid (PFOS) exposure was associated with a lower risk of GDM (OR=0.542, 95%CI: 0.311, 0.946). The gWQS results demonstrated that PFOS (0.48) and perfluorobutane sulfonate (PFBS) (0.34) contributed the most to the mixture effect. Conclusion Early-pregnancy exposure to PFAS (particularly PFHxS and PFNA) may be an etiological factor for GDM, with maternal age and fetal sex potentially acting as effect modifiers in this association.

Background Depressive symptoms have become a significant factor affecting the physical and mental health of the occupational population, and workers in petroleum refining enterprises face multiple stressors in their work environment. Objective To explore the impact of occupational noise exposure on depressive symptoms among workers in a petroleum refining enterprise. Methods This cross-sectional study was conducted in July 2024 using a questionnaire survey among workers of a petroleum refining enterprise in Hainan Province. Basic information of the subjects was collected. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to measure depressive symptoms, the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) scale was used to assess sleep quality, and the Chinese version of the Effort-Reward Imbalance (ERI) scale was used to evaluate occupational stress. Chi-square test was employed to compare the differences in reporting depressive symptoms among populations with different characteristics. Binary logistic regression models were used to analyze the impact of occupational noise exposure and other factors on depressive symptoms. Results The overall positive rate of depressive symptoms in the study population was 42.7%. The results of the multifactor analysis indicated that compared with the control group, employees in both the low-exposure and high-exposure groups had elevated odds of depressive symptoms, with OR (95%CI) of 2.244 (1.131, 4.454) and 1.970 (1.009, 3.850), respectively. This association remained robust after adjusting for potential confounders, including gender, age, work tenure, and other occupational exposures. Additionally, female [OR (95%CI)=1.483 (1.039, 2.118)], exposure to benzene, toluene, or xylene [OR (95%CI)=1.621 (1.208, 2.174)], sleep disturbance [OR (95%CI)=3.772 (2.942, 4.838)], and occupational stress [OR (95%CI)=2.018 (1.575, 2.585)] were also significantly associated with higher odds of depressive symptoms. Conclusion The positive rate of depressive symptoms is relatively high among employees in this petrochemical enterprise, and occupational noise exposure may be a risk factor for depressive symptoms.

Liumotang comes from the Yuan dynasty's Effective Prescription Handed Down for Generations of Physicians. It is composed of six medicinal materials： Arecae Semen， Aquilariae Lignum Resinatum， Aucklandiae Radix， Linderae Radix， Rhei Radix et Rhizoma， and Aurantii Fructus. It is a classical formula for treating abdominal pain due to Qi stagnation and constipation accompanied by heat. This study systematically collated the records of Liumotang in ancient medical books and modern clinical literature and conducted in-depth analysis and textual research on its formula source， main diseases， composition， dosage， medical books， container capacity， processing， preparation method， usage， drug basis， formula meaning， and other key information， so as to provide a powerful reference for the development and clinical application of compound preparations of the classical formula Liumotang. The results show that Liumotang was first seen in Effective Prescription Handed Down for Generations of Physicians， and many medical books of the past dynasties have imitated this. In terms of drug basis， the dried and mature seeds of the palm plant Areca catechu， resin-containing wood of the Daphneaceae plant Aquilaria sinensis， the dried roots of the Asteraceae plant woody Aucklandia lappa， the dried tuber root of the Lauraceae plant Lindera aggregata， the dried roots and rhizomes of the knotweed plant， R. palmatum， R.tangutikum， and R. officinale， and the dried and unripe fruits of the citrus genus C. aurantium and its cultivated varieties from the family Rutaceae were selected. In terms of dosage， through the textual research on bowls in the Ming and Qing dynasties， combined with the conversion of medicines and bowl capacity in the Qing dynasty， it was estimated that the dosage of each drug in the Yuan dynasty was 10.86 g. In the Ming and Qing dynasties， the dosage of drugs was mostly equal， but the dosage of drugs was somewhat different. In terms of processing， preparation method， and usage， in the medical books of the past dynasties， the processing of drugs has slightly changed， but raw drugs are used in all preparations. The preparation method and usage did not change much during the Yuan， Ming， and Qing dynasties， except for certain differences in dosage. In terms of syndrome， Liumotang was first used to treat abdominal pain due to Qi stagnation and constipation accompanied by heat. Medical books of the past dynasties often omit the symptoms of heat. In modern clinical practice， Liumotang is mainly used in the digestive system and urinary system diseases and is mostly used to treat constipation-predominant irritable bowel syndrome， biliary reflux gastritis， functional constipation， slow transit constipation， and other diseases， with no adverse reactions found yet. The above results provide a reliable scientific basis for the development and clinical treatment of Liumotang compound preparations.

ObjectiveTo investigate the effects of jujuboside A （JuA） on the learning and memory abilities and histopathological changes in the rat model of vascular cognitive impairment （VCI） and explore the potential mechanisms by which JuA treats VCI. MethodsA total of 50 male SPF-grade SD rats were randomized into a sham operation group （n=10）， a blank control group （n=10）， and a modeling group （n=30）. The rats in the modeling group underwent bilateral carotid artery ligation （2-VO） for the modeling of VCI. After stabilization， the VCI rats were randomized into model， JuA （20 mg·kg^-¹）， and donepezil （0.45 mg·kg^-¹） groups. After 4 weeks of gavage， the novel object recognition and Morris water maze tests were conducted to evaluate the learning and memory abilities of rats. Nissl staining was employed to evaluate the morphology and number of hippocampal neurons. Real-time PCR was employed to measure the mRNA levels of glycogen synthase kinase-3β （GSK-3β）， cAMP response element-binding protein （CREB）， B cell lymphoma-2 （Bcl-2）， phosphatidylinositol 3-kinase （PI3K）， and protein kinase B （Akt） in the hippocampal tissue. Western blot was employed to quantify the protein levels of GSK-3β， p-GSK-3β， p-CREB， Bcl-2， PI3K， p-PI3K， Akt， and p-Akt in the hippocampal tissue. ResultCompared with the sham operation group， the model group exhibited declines in the learning and memory abilities （P<0.01）， neuronal damage and decreased neurons in the hippocampal CA1 region （P<0.01）， up-regulation in the mRNA level of GSK-3β （P<0.01）， and down-regulation in the mRNA levels of PI3K， Akt， CREB， and Bcl-2， as well as the protein levels of p-PI3K， p-Akt， p-GSK-3β， p-CREB， and Bcl-2 （P<0.01）. In comparison to the model group， both the JuA and donepezil groups demonstrated improvements in the learning and memory abilities （P<0.05， P<0.01）， with reduced neuronal damage and increased neurons （P<0.05， P<0.01）. In addition， the two groups showed down-regulation in the mRNA level of GSK-3β （P<0.01） and up-regulation in the mRNA levels of PI3K， Akt， CREB， and Bcl-2 and the protein levels of p-PI3K， p-Akt， p-GSK-3β， p-CREB， and Bcl-2 （P<0.05， P<0.01）. There were no statistically significant differences between the blank control and sham operation groups in terms of the learning and memory abilities， neuron count， and mRNA and protein levels of PI3K/Akt/GSK-3β pathway-related factors. ConclusionJuA can ameliorate the cognitive impairment in the rat model of VCI by activating the PI3K/Akt signaling pathway， reducing the apoptosis of hippocampal neurons， and alleviating the hippocampal neuronal damage.

Objective To explore the infection status and clinical characteristics of human parvovirus B19 (HPV-B19) in patients with hematological disease. Methods A total of 94 patients with benign hematological disease, 128 patients with hematological malignancy, and 89 healthy individuals at Shanghai Eighth People’s Hospital from February 2019 to February 2020 were selected. The levels of specific IgM and nucleic acid of HPV-B19 in the plasma were detected using ELISA and PCR. The infection rates among the 3 groups and clinical characteristics between HPV-B19 positive and negative patients with hematological disease were compared. Results The positive rate of HPV-B19 IgM was 9.6% (9/94), the positive rate of nucleic acid was 11.7% (11/94), and the overall infection rate of HPV-B19 (IgM and/or nucleic acid positive) was 14.9% (14/94) in benign group of patients. The positive rate of HPV-B19 IgM was 18.0% (23/128), the positive rate of nucleic acid was 19.5% (25/128), and the overall infection rate of HPV-B19 was 26.6% (34/128) in malignant group of patients. The positive rate of HPV-B19 IgM was 1.1% (1/89), the positive rate of nucleic acid was 2.2% (2/89), and the overall infection rate of HPV-B19 was 2.2% (2/89) in healthy controls. The overall HPV-B19 infection rate in benign group of patients was higher than that in healthy controls (P＝0.006). The overall HPV-B19 infection rate was higher in malignant group of patients than that in benign group of patients (P＝0.037) and healthy controls (P＜0.001). In the benign group, the HPV-B19 infection rates in patients with pure red cell aplasia (PRCA), autoimmune hemolytic anemia (AIHA), immune thrombocytopenic purpura (ITP), and aplastic anemia (AA) were higher, with 44.4% (4/9), 27.3% (3/11), 25.0% (4/16), and 21.4% (3/14), respectively. In the malignant group, the HPV-B19 infection rates in patients with non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia (CLL) were higher, with 42.9% (9/21) and 37.5% (6/16), respectively. The HPV-B19 positive patients in both hematological disease groups were older (P＜0.05). In patients with NHL, CLL or multiple myeloma (MM), HPV-B19 infection decreased the reticulocyte ratio (P＜0.05); in patients with NHL, acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL), HPV-B19 infection prolonged bone marrow suppression time after chemotherapy (P＜0.05). Conclusions HPV-B19 infection rate in patients with hematological disease is elevated and HPV-B19 infection may influence the condition and treatment efficiency of these patients.

Objectives: This study aimed to validate the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, identify infection risk factors among air passengers subject to a 14-day mandatory quarantine, and evaluate the accuracy of mass symptom-based screening criteria at an airport. Methods: This retrospective cohort study analyzed data from 116 004 air passengers who entered Thailand through Suvarnabhumi Airport in Bangkok from April 2020 to September 2020. The incidence of SARS-CoV-2 infection, risk characteristics, and accuracy indices of symptom-based screening were calculated. Results: The overall incidence of SARS-CoV-2 was 0.5%, or 540 infections per 100 000 air passengers. Identified risk factors included sex, nationality, continent of departure, on-arrival screening results, and month of travel. Positive screening results indicated a higher risk and positive likelihood ratio for SARS-CoV-2 infection. However, the on-arrival screening criteria demonstrated low sensitivity and area under the receiver operating characteristic curve. Conclusions The current study confirms previous findings that the risk of SARS-CoV-2 infection during air travel is low. However, this might result from strict pre-departure screening and the SARS-CoV-2 test requirement for arriving passengers. The symptom-based screening criteria used upon arrival showed a low probability of identifying positive cases, suggesting that incorporating additional criteria could help detect asymptomatic infections. The integrated screening and quarantine model proved effective in preventing the spread of the virus into local communities.

Objectives: Immunization has been identified as a specific nutrition-related intervention to address the direct causes of stunting. This study examines the association between basic immunization status and stunting among toddlers in Indonesia. Methods: We conducted a cross-sectional analysis using data from the 2021 Study of Indonesia’s Nutritional Status. A total of 70 267 toddlers, aged 12 months to 59 months, were examined. Cox regression was employed to calculate adjusted prevalence ratios (aPRs) with their 95% confidence intervals (CIs). Results: The prevalence of stunting among children aged 12 months to 59 months in Indonesia was 23.1%, while 74.9% of children under 5 years old had complete basic immunization status. Multivariable analysis revealed a statistically significant association between basic immunization status and the incidence of stunting. Relative to toddlers with complete basic immunization, those with incomplete (partial) immunization were at a 1.18 times higher risk of stunting (aPR, 1.18; 95% CI, 1.15 to 1.22). Furthermore, toddlers who had not been immunized at all faced an even greater stunting risk (aPR, 1.27; 95% CI, 1.17 to 1.37). This association persisted after adjusting for variables such as maternal education, economic status, and the child’s birth weight. Conclusions Basic immunization status influences the incidence of stunting in toddlers aged 12 months to 59 months. Thus, parents must ensure that their children’s immunizations are completed according to the recommended schedule. Additionally, it is crucial to increase parental awareness regarding health service utilization, disease prevention, and the nutritional needs of toddlers.

Chronic myeloid leukemia (CML) typically progresses from a chronic phase to an accelerated phase, and eventually to a blast crisis, often involving the bone marrow and peripheral blood, if left untreated. Central nervous system (CNS) involvement is an uncommon manifestation of CML, particularly as an isolated CNS relapse. Here, we present a rare case of CML in lymphoid blast crisis with an isolated CNS relapse. A 46-year-old female with underlying CML in lymphoid blast crisis, previously treated with chemotherapy and tyrosine kinase inhibitors, presented with visual disturbances. Imaging and cerebrospinal fluid analysis confirmed leukemic infiltration of the CNS without evidence of a systemic disease. Isolated CNS involvement is an atypical complication of CML and presents significant therapeutic challenges owing to the blood-brain barrier, which limits the efficacy of systemic therapies. Subsequently, the patient was treated with intrathecal chemotherapy targeting the CNS. Despite aggressive treatment, CNS relapse remains a major concern due to the limited penetration of standard therapies into the CNS. This case underscores the importance of early recognition of CNS symptoms in CML patients, particularly in those with blast crisis, and highlights the need for tailored therapeutic strategies to manage this rare and challenging manifestation.