AIM:This study aims to investigate how nuclear factor E2-related factor 2(Nrf2)influences the proliferation of primary rat pulmonary artery smooth muscle cells(PASMCs)under CoCl2-induced hypoxic conditions,spe-cifically through the aerobic glycolysis pathway,and to elucidate its potential mechanisms of action.METHODS:Prima-ry Sprague-Dawley(SD)rat PASMCs were isolated via enzymatic digestion and exposed to 200 μmol/L CoCl2 to establish a chemical hypoxia cell model.Experiments were conducted at various time points(0,6,24 and 48 h)to assess changes in the protein expression of key aerobic glycolysis enzymes[pyruvate kinase M2(PKM2),lactate dehydrogenase A(LDHA)and monocarboxylate transporter 4(MCT4)]and proliferating cell nuclear antigen(PCNA)in PASMCs subjected to CoCl2 stimulation.The optimal concentrations of the Nrf2 activator dimethyl fumarate(DMF)and the inhibitor ML385 were de-termined using Western blot analysis.Subsequently,the cells were divided into four groups:normoxic control(NC)group,CoCl2 group,CoCl2+DMF group,and NC+ML385 group.The proliferation and migration abilities,along with the protein expression levels of HIF-1α,Nrf2,and key aerobic glycolysis enzymes,were assessed in PASMCs from each group.RESULTS:In the hypoxic model of rat PASMCs induced by CoCl2,Nrf2 protein levels significantly decreased over time(P<0.05),while the levels of key enzymes and PCNA protein significantly increased(P<0.05).Furthermore,the migratory capability of PASMCs was markedly enhanced(P<0.05).Under DMF intervention,the protein expression of key aerobic glycolysis enzymes decreased significantly,along with a reduction in the proliferation and migration abilities of rat PASMCs(P<0.05).Conversely,the experimental results showed opposite trends when Nrf2 expression was inhibit-ed by ML385(P<0.05).CONCLUSION:Nrf2 plays a crucial role in mitigating the proliferation and migration of chemi-cally hypoxic primary rat PASMCs by downregulating aerobic glycolysis.

Objective: To evaluate the feasibility of a V-shaped incision in the resection of a superficial parotid gland benign tumor by comparison with a modified Blair incision. To provide a basis for evaluating the clinical application value of the V-shaped incision. Methods: This study was reviewed and approved by the ethics committee, and informed consent was obtained from the patients. Data from 61 patients with a benign tumor on the superficial parotid gland who had surgery at People’s Hospital of Xinjiang Uygur Autonomous Region from September 2021 to September 2023 were collected and analyzed. The maximum diameter of the tumor included in the patient should not exceed 4 cm. The patients were divided into two groups based on the different surgical incisions: a V-shaped incision group (29 cases) and modified Blair incision group (32 cases). Several comparisons were made between the group: operation time; postoperative drainage volume; facial nerve function, pain, and complication in the operation area; and aesthetic effect of the surgical incision. The patients were followed up for 6 months. The 61 patients were further divided into groups based on the locations of the tumors: tumors around the earlobe and tumors in the lower pole of the parotid gland. Results: There were no significant differences in operation time, postoperative House-Brackmann grading system (HBGs) facial nerve function score, and visual analogue scale (VAS) pain score between the two groups (P>0.05). The postoperative drainage volume and Vancouver scar scale (VSS) score of the V-shaped incision group were higher than the modified Blair incision group (P<0.05). The incidence of great auricular nerve numbness was lower in the V-shaped incision group than the modified Blair incision group (P<0.05). The operation time of the V-shaped incision applied to excise the tumor around the earlobe was shorter than the modified Blair incision (P<0.05). Conclusion The V-shaped incision is a concealed facial incision, surgeons should be aware that some patients who receive this incision have a large amount of postoperative drainage and the retroauricular region is prone to scar hyperplasia.

AIM:This study aims to investigate how nuclear factor E2-related factor 2(Nrf2)influences the proliferation of primary rat pulmonary artery smooth muscle cells(PASMCs)under CoCl2-induced hypoxic conditions,spe-cifically through the aerobic glycolysis pathway,and to elucidate its potential mechanisms of action.METHODS:Prima-ry Sprague-Dawley(SD)rat PASMCs were isolated via enzymatic digestion and exposed to 200 μmol/L CoCl2 to establish a chemical hypoxia cell model.Experiments were conducted at various time points(0,6,24 and 48 h)to assess changes in the protein expression of key aerobic glycolysis enzymes[pyruvate kinase M2(PKM2),lactate dehydrogenase A(LDHA)and monocarboxylate transporter 4(MCT4)]and proliferating cell nuclear antigen(PCNA)in PASMCs subjected to CoCl2 stimulation.The optimal concentrations of the Nrf2 activator dimethyl fumarate(DMF)and the inhibitor ML385 were de-termined using Western blot analysis.Subsequently,the cells were divided into four groups:normoxic control(NC)group,CoCl2 group,CoCl2+DMF group,and NC+ML385 group.The proliferation and migration abilities,along with the protein expression levels of HIF-1α,Nrf2,and key aerobic glycolysis enzymes,were assessed in PASMCs from each group.RESULTS:In the hypoxic model of rat PASMCs induced by CoCl2,Nrf2 protein levels significantly decreased over time(P<0.05),while the levels of key enzymes and PCNA protein significantly increased(P<0.05).Furthermore,the migratory capability of PASMCs was markedly enhanced(P<0.05).Under DMF intervention,the protein expression of key aerobic glycolysis enzymes decreased significantly,along with a reduction in the proliferation and migration abilities of rat PASMCs(P<0.05).Conversely,the experimental results showed opposite trends when Nrf2 expression was inhibit-ed by ML385(P<0.05).CONCLUSION:Nrf2 plays a crucial role in mitigating the proliferation and migration of chemi-cally hypoxic primary rat PASMCs by downregulating aerobic glycolysis.

Objective: To investigate the association between edentulism and the risk of social isolation in middle-aged and elderly populations, provide empirical evidence for formulating social isolation prevention and intervention policies targeting edentulous middle-aged and elderly populations. Methods: Data were derived from the baseline survey (2011) and three follow-ups (2013, 2015, 2018) of the China Health and Retirement Longitudinal Study (CHARLS). Participants were enrolled in the follow-up from the baseline. Those identified as socially isolated in any of the follow-up surveys conducted in 2013, 2015, or 2018 were considered to have reached the endpoint; otherwise, the follow-up was continued until the end of the 2018 survey; 9 870 individuals were ultimately included. Subjects were grouped by edentulism status. Chi-square test and multivariate Cox regression analysis were performed using Stata 17.0. Results: During a median follow-up of 6.54 years, 1 800 cases of social isolation occurred, with an incidence rate of 18.23%（17.47%~18.99%）. Multivariate Cox regression showed that edentulism was associated with an increased risk of social isolation (HR=1.21, 95% CI: 1.03-1.42) after adjusting for confounders. Subgroup analysis revealed population heterogeneity. Sensitivity analyses confirmed the stability of the results. Conclusion Edentulism is associated with an increased risk of social isolation in middle-aged and elderly adults.

Objective: To investigate the trends in incidence and mortality of thyroid cancer in cancer registration areas of Xinjiang Uygur Autonomous Region from 2016 to 2020 and its epidemiological status in 2020, so as to provide the basis for improving prevention and control measures for thyroid cancer. Methods: The data of thyroid cancer incidence and mortality from 2016 to 2020 in four cancer registration areas of Xinjiang Uygur Autonomous Region were collected through the Tumor Registry. The crude incidence and crude mortality were calculated. The Chinese population-standardized rate and world population-standardized rate were calculated using the age structure of the standard population from the Fifth National Population Census in 2000 and Segi's world standard population. The incidence and mortality characteristics of thyroid cancer in different genders and ages in 2020 were described. The trends in the Chinese population-standardized incidence and mortality of thyroid cancer in Xinjiang Uygur Autonomous from 2016 to 2020 were assessed using the average annual percent change (AAPC). Results: In 2020, the crude, Chinese population-standardized and world population-standardized incidences of thyroid cancer in Xinjiang Uygur Autonomous Region were 32.91/100 000, 26.99/100 000, and 25.53/100 000, respectively. The crude, Chinese population-standardized and world population-standardized mortalities of thyroid cancer were 1.25/100 000, 0.96/100 000, and 0.98/100 000, respectively. The Chinese population-standardized incidence and mortality of thyroid cancer in females were 2.44 times and 2.20 times those in males, respectively. The crude incidence of thyroid cancer was increased after age of twenty years, with a peak at age of 55 to 60 years (76.73/100 000) before rapidly declining. In contrast, the crude mortality remained low across all age groups, with the highest rate observed at age of 70 to 75 years (13.70/100 000). From 2016 to 2020, the Chinese population-standardized incidence and mortality of thyroid cancer showed no significant changes (both P>0.05). Conclusions From 2016 to 2020, the trends in incidence and mortality of thyroid cancer in cancer registration areas of Xinjiang Uygur Autonomous Region were stable. The disease burden of thyroid cancer was higher in females than in males. The crude incidence first rised and then declined with age, peaks at age of 55-<60 years.

Objective:To analyze the associated factors and cumulative effects of cardiometabolic multimorbidity (CMM) among residents in southern Xinjiang.Methods:A stratified random cluster sampling method was used to conduct questionnaire surveys, physical examinations and laboratory tests among the personnel of the 51st Brigade, 3rd Division, Xinjiang, in 2016. The multivariate logistic regression, multivariate linear regression, restricted cubic spline, and network analysis methods were used to study the association of lifestyle (smoking, alcohol consumption and physical activity), socioeconomic (occupation, education and marital status) and clinical factors (waist circumference, body mass index and family history) with CMM.Results:A total of 12 773 study subjects were included. The prevalence of cardiovascular metabolic diseases among residents in southern Xinjiang was 52.49%. Specifically, the prevalence rates of dyslipidemia, hypertension, coronary heart disease, diabetes, and stroke were 31.14%, 29.95%, 6.78%, 6.26%, and 2.47%, respectively, and the prevalence of CMM was 19.06%. Multivariate logistic regression analysis revealed that the associations between clinical and socioeconomic factors and CMM significantly increased with higher scores. Specifically, the OR rose from 1.75 (clinical factors) and 1.07 (socioeconomic factors) on a score of 1 to 4.41 and 1.93 on a score of 3, respectively. The association between lifestyle factors and CMM was only observed at higher scores ( OR=1.26, 95% CI:1.07~1.62). The trend test using the scores of each group as continuous variables in the model showed that the risk of disease increased with the accumulation of clinical, socioeconomic and lifestyle factors (all P<0.05). Restricted cubic spline analysis demonstrated a non-linear relationship between the total number of associated factors and CMM ( Poverall<0.05 and Pnon-linear<0.05). Network analysis identified hypertension (strength=0.42) as the “core node” among the five diseases. When analyzing the three types of influencing factors, hypertension (strength=0.68), dyslipidemia (strength=0.47), coronary heart disease (strength=0.37), and clinical factors (strength=0.53) emerged as “core nodes”. In the network of nine associated factors, abnormal waist circumference and BMI (strength=0.90 and 0.84) were identified as “key factors”, while hypertension (strength=0.68) and dyslipidemia (strength=0.52) were identified as “key diseases”. Conclusion:The prevalence of CMM among residents in southern Xinjiang is high, and there is a cumulative effect of multiple factors. Hypertension and dyslipidemia are key diseases in the multimorbidity network, while abnormal BMI and waist circumference are key associated factors.

Thyroid nodules (TNs) are defined as discrete lesions within the thyroid gland. Pregnancy, as a unique physiological stage, presents challenges for both clinicians and pregnant women when TNs are detected. Epidemiological studies have shown that the occurrence and development of TNs are closely related to hormonal changes during pregnancy, geographical location, and iodine intake. Thyroid ultrasonography is the best imaging method for evaluating TNs in pregnant women, which requires combined screening with serological diagnosis and multidisciplinary consultation (clinical endocrinologists, thyroid surgeons, and gynecologists, etc.) to discuss treatment indications, methods, and appropriate timing. Meanwhile, monitoring and follow-up during pregnancy should be conducted to assess the prognosis of both the mother and the fetus. This article focuses on reviewing the relevant research progress of TNs during pregnancy, and provides references for diagnosis, intervention, and treatment of TNs in the gestational period.

Objective:To analyze the associated factors and cumulative effects of cardiometabolic multimorbidity (CMM) among residents in southern Xinjiang.Methods:A stratified random cluster sampling method was used to conduct questionnaire surveys, physical examinations and laboratory tests among the personnel of the 51st Brigade, 3rd Division, Xinjiang, in 2016. The multivariate logistic regression, multivariate linear regression, restricted cubic spline, and network analysis methods were used to study the association of lifestyle (smoking, alcohol consumption and physical activity), socioeconomic (occupation, education and marital status) and clinical factors (waist circumference, body mass index and family history) with CMM.Results:A total of 12 773 study subjects were included. The prevalence of cardiovascular metabolic diseases among residents in southern Xinjiang was 52.49%. Specifically, the prevalence rates of dyslipidemia, hypertension, coronary heart disease, diabetes, and stroke were 31.14%, 29.95%, 6.78%, 6.26%, and 2.47%, respectively, and the prevalence of CMM was 19.06%. Multivariate logistic regression analysis revealed that the associations between clinical and socioeconomic factors and CMM significantly increased with higher scores. Specifically, the OR rose from 1.75 (clinical factors) and 1.07 (socioeconomic factors) on a score of 1 to 4.41 and 1.93 on a score of 3, respectively. The association between lifestyle factors and CMM was only observed at higher scores ( OR=1.26, 95% CI:1.07~1.62). The trend test using the scores of each group as continuous variables in the model showed that the risk of disease increased with the accumulation of clinical, socioeconomic and lifestyle factors (all P<0.05). Restricted cubic spline analysis demonstrated a non-linear relationship between the total number of associated factors and CMM ( Poverall<0.05 and Pnon-linear<0.05). Network analysis identified hypertension (strength=0.42) as the “core node” among the five diseases. When analyzing the three types of influencing factors, hypertension (strength=0.68), dyslipidemia (strength=0.47), coronary heart disease (strength=0.37), and clinical factors (strength=0.53) emerged as “core nodes”. In the network of nine associated factors, abnormal waist circumference and BMI (strength=0.90 and 0.84) were identified as “key factors”, while hypertension (strength=0.68) and dyslipidemia (strength=0.52) were identified as “key diseases”. Conclusion:The prevalence of CMM among residents in southern Xinjiang is high, and there is a cumulative effect of multiple factors. Hypertension and dyslipidemia are key diseases in the multimorbidity network, while abnormal BMI and waist circumference are key associated factors.

Thyroid nodules (TNs) are defined as discrete lesions within the thyroid gland. Pregnancy, as a unique physiological stage, presents challenges for both clinicians and pregnant women when TNs are detected. Epidemiological studies have shown that the occurrence and development of TNs are closely related to hormonal changes during pregnancy, geographical location, and iodine intake. Thyroid ultrasonography is the best imaging method for evaluating TNs in pregnant women, which requires combined screening with serological diagnosis and multidisciplinary consultation (clinical endocrinologists, thyroid surgeons, and gynecologists, etc.) to discuss treatment indications, methods, and appropriate timing. Meanwhile, monitoring and follow-up during pregnancy should be conducted to assess the prognosis of both the mother and the fetus. This article focuses on reviewing the relevant research progress of TNs during pregnancy, and provides references for diagnosis, intervention, and treatment of TNs in the gestational period.

Objectives:To investigate the clinical characteristics of noncontiguous spinal tuberculosis and the efficacy and prognosis of one-stage posterior debridement,bone graft fusion and internal fixation for the treat-ment of noncontiguous spinal tuberculosis.Methods:The clinical data of 31 patients with noncontiguous spinal tuberculosis treated in our hospital between July 2016 and May 2022 were retrospectively analyzed,in-cluding 18 males and 13 females,aged 49.5±27.5 years.There were 24 cases with 2 lesions and 7 cases with 3 lesions.Responsible vertebrae were clarified,and surgical lesions,fusion segments,and internal fixation methods were determined for each patient,so as to develop individualized surgical plans.The patients were followed up for 29.7±14.7 months(15-85 months).The operative time,intraoperative blood loss,and intraoper-ative and postoperative complications were recorded.Erythrocyte sedimentation rate(ESR)and C-reactive pro-tein(CRP)were examined and recorded before operation,at 1 month,3 months,and 1 year after operation,and at the last follow-up.Visual analogue scale(VAS)was used to evaluate the pain before operation,at 1 week,1 month,3 months,1 year after operation and at the last follow-up.Cobb angle was measured before operation,at 1 week after operation,and at the last follow-up.The American Spinal Injury Association(ASIA)classification was recorded before operation and at the last follow-up.Bridwell bone healing criteria were used to evaluate postoperative tuberculosis activity,symptom improvement,deformity correction,and bone healing at the last follow-up.Results:Among the 31 patients,20(65.4％)had only one lesion(65.4％),23(74.2％)were admitted to the hospital with pain as the main complaint,15(48.4％)had only pain symptoms during the course of the disease,11 cases(35.5％)had only one lesion with pain symptoms,and 18(58.1％)patients had at least one lesion missed at the initial diagnosis.All the patients were successfully operated.The operative time was 280.0±52.2min(165-330min),and blood loss was 567.7±332.0mL(150-1000mL).There were 4 cases of cerebrospinal fluid leakage and 3 cases of incision infection after operation,which were cured after symptomatic treatment.All foci of tuberculosis were cured without recurrence or retransmission.At pre-operation,1 month,3 months,1 year after surgery,and at the last follow-up,ESR was 41.5±26.3mm/h,16.3±13.4mm/h,12.5±6.3mm/h,11.4±5.2mm/h,and 9.2±3.1mm/h,and the levels of CRP were 32.8±23.2mg/L,7.3±5.6mg/L,6.2±4.1mg/L,5.1±3.7mg/L,2.8±2.3mg/L,which were both significantly lower after operation than those before operation(P＜0.05).The VAS score was 6.4±2.4,2.4±1.7,2.3±1.3,1.6±0.9,0.9±0.7,and 0.4±0.3 before operation,at 1 week,1 month,3 months,1 year after operation,and at the last follow-up,which was significantly improved after operation when compared with that before operation(P＜0.05).The Cobb angle was 25.7°±4.9° before operation,15.4°±2.1° at 1 week after operation,and 17.1°±2.3° at the last follow-up,and there were significant differences between the postoperative angles and preoperative angles(P＜0.05).Among the 10 patients with preoperative neurological impairment,1 patient with preoperative grade A recovered to grade C at the last follow-up.Among the 4 patients with preoperative grade B,1 patient recovered to grade C and 3 to grade D.Of the 5 patients with preoperative grade C,2 recovered to grade D and 3 to grade E.All 42 bone graft lesions achieved bone fusion at 6-12 months after operation.At the last follow-up,34 lesions healed in Bridwell grade Ⅰ and 8 in Bridwell grade Ⅱ.Conclusions:For patients with noncontiguous spinal tuberculosis,one-stage posterior debridement,bone graft fusion and internal fixation is safe and efficient after determining responsible vertebrae and lesion features,which can obtain satisfactory results.