Objective To investigate the effects and potential mechanisms of polystyrene micro/nanoplastics(PS-MNPs)on testicular Sertoli cells.Methods Sixty male C57BL/6N mice(8 weeks old)were randomly divided into a control group(deionized water),a PS-NPs group[particle size of 20 nm,2.5 mg/(kg·d)],and a PS-MPs group[particle size of 5 μm,2.5 mg/(kg·d)],with 20 mice in each group.The corresponding agents were gavaged once daily for 6 months.HE staining was used to observe the histopathological and morphological changes in the testicular tissues.Immunohistochemistry of marker proteins was employed to evaluate the changes in the number of Sertoli cells.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses were performed to identify functions and signaling pathways enriched in the testicular transcriptome.Mouse testicular Sertoli cell line TM4 was divided into a control group(deionized water),a 2.5NPs group(2.5 μg/mL),and a 2.5MPs group(2.5 μg/mL).All groups received continuous exposure through 130 cell passages.Cell viability and proliferative capacity were evaluated using CCK-8 assay and EdU incorporation,while cell migration was assessed using transwell and cell scratch assays.RT-qPCR and Western blotting were used to detect the changes in the expression of key molecules regulating mesenchymal phenotypic transformation(MPT)at mRNA and protein levels.Results Pathological analysis revealed that,when compared to the control group,PS-NPs and PS-MPs treatment resulted in extended spaces between testicular seminiferous tubules,loosely arranged spermatogenic cells,and enhanced vacuolization.Immunohistochemical analysis of marker proteins indicated a decreasing trend in the number of testicular Sertoli cells in the PS-NPs and PS-MPs groups than the control group,with the PS-NPs group having statistical significance(P<0.01).GO and KEGG enrichment analyses revealed that PS-MNPs exposure-related altered genes were significantly enriched in cell adhesion signaling pathways(P<0.05).PS-MPs exposure significantly inhibited the growth and migration ability of TM4 cells(P<0.05),but PS-NPs exposure had no such effect on cell growth but notably enhanced cell migration ability.PS-NPs exposure inhibited the expression levels of E-cadherin and ZO-1(P<0.01)and up-regulated the expression of N-cadherin and vimentin(P<0.01),and PS-MPs exposure led to significant up-regulation of vimentin(P<0.01)and down-regulation of E-cadherin,N-cadherin,and ZO-1(P<0.05).Both PS-MPs and PS-NPs exposure up-regulated the mRNA levels of Snail2,Twist1,and Zeb2(P<0.01).Conclusion Exposure of PS-MNPs leads to abnormal proliferation and migration of TM4 cells,induces decreases in cell-cell contacts among Sertoli cells and spermatogenic cells at all levels possibly through MPT,and thus results in testicular damage.

Objective To investigate whether long-term low-dose exposure to polystyrene microplastics(PS-MPs)induces ferroptosis in testicular Sertoli cells and then leads to testicular injury.Methods Forty 8-week-old male C57BL/6 mice were randomly divided into a control group(deionized water group)and a PS-MPs group[2.5 mg/(kg·d)],with 20 mice in each group.Corresponding agents were gavaged once a day for 12 consecutive months.HE staining and Prussian blue staining were used to detect histopathological damage and accumulation of ferrous ions in the testes.Electron transmission microscopy was employed to observe the mitochondrial morphology of testicular Sertoli cells.Mouse Sertoli cell line TM4 was divided into a Con group(standard culture)and an MPs group(2.5 μg/mL PS-MPs).After both groups underwent continuous exposure and passed up to the 100th generation,morphological changes were observed under the microscope;cell viability was detected with CCK8 assay,and production of reactive oxygen species(ROS)and mitochondrial membrane potential(MMP)were detected with a ROS probe and a mitochondrial membrane potential probe(JC-1),respectively.Flow cytometry,ferrous ion(Fe2+)kit and Western blotting were applied to detect cell apoptosis,intracellular iron ion content,and protein levels of key molecules of ferroptosis in tissues and cells.Results Long-term exposure to PS-MPs resulted in significantly reduced diameter and thickness of mouse varicocele(P<0.01),fewer testicular Sertoli cells(P<0.05),with characteristic ferroptosis alterations in the mitochondria,and increased accumulation of ferrous ions in testicular tissue.Exposure to PS-MPs down-regulated the key molecules of ferroptosis,glutathione peroxidase 4(GPX4)and ferritin light chain(FTL)when compared with the control group(P<0.05).In the cell model,long-term PS-MPs exposure led to morphological changes and decreased cell viability(P<0.05),more production of ROS(P<0.01),and decrease in MMP(P<0.05)of TM4 cells.The exposure had no effect on cell apoptosis,but elevated the intracellular content of ferric ions(P<0.01),and down-regulated GPX4 and FTL protein levels(P<0.05).Conclusion Long-term low-dose exposure to PS-MPs induces mitochondrial damage and oxidative stress in testicular Sertoli cells,activates the ferroptosis pathway,and ultimately leads to testicular injury in mice.

Background: In acute and chronic renal inflammatory diseases, the activation of inflammatory cells is involved in the defect of erythropoietin (EPO) production. Ras guanine nucleotide-releasing protein-4 (RasGRP4) promotes renal inflammatory injury in type 2 diabetes mellitus (T2DM). Our study aimed to investigate the role and mechanism of RasGRP4 in the production of renal EPO in diabetes. Methods: The degree of tissue injury was observed by pathological staining. Inflammatory cell infiltration was analyzed by immunohistochemical staining. Serum EPO levels were detected by enzyme-linked immunosorbent assay, and EPO production and renal interstitial fibrosis were analyzed by immunofluorescence. Quantitative real-time polymerase chain reaction and Western blotting were used to detect the expression of key inflammatory factors and the activation of signaling pathways. In vitro, the interaction between peripheral blood mononuclear cells (PBMCs) and C3H10T1/2 cells was investigated via cell coculture experiments. Results: RasGRP4 decreased the expression of hypoxia-inducible factor 2-alpha (HIF2A) via the ubiquitination–proteasome degradation pathway and promoted myofibroblastic transformation by activating critical inflammatory pathways, consequently reducing the production of EPO in T2DM mice. Conclusion RasGRP4 participates in the production of renal EPO in diabetic mice by affecting the secretion of proinflammatory cytokines in PBMCs, degrading HIF2A, and promoting the myofibroblastic transformation of C3H10T1/2 cells.

Background: In acute and chronic renal inflammatory diseases, the activation of inflammatory cells is involved in the defect of erythropoietin (EPO) production. Ras guanine nucleotide-releasing protein-4 (RasGRP4) promotes renal inflammatory injury in type 2 diabetes mellitus (T2DM). Our study aimed to investigate the role and mechanism of RasGRP4 in the production of renal EPO in diabetes. Methods: The degree of tissue injury was observed by pathological staining. Inflammatory cell infiltration was analyzed by immunohistochemical staining. Serum EPO levels were detected by enzyme-linked immunosorbent assay, and EPO production and renal interstitial fibrosis were analyzed by immunofluorescence. Quantitative real-time polymerase chain reaction and Western blotting were used to detect the expression of key inflammatory factors and the activation of signaling pathways. In vitro, the interaction between peripheral blood mononuclear cells (PBMCs) and C3H10T1/2 cells was investigated via cell coculture experiments. Results: RasGRP4 decreased the expression of hypoxia-inducible factor 2-alpha (HIF2A) via the ubiquitination–proteasome degradation pathway and promoted myofibroblastic transformation by activating critical inflammatory pathways, consequently reducing the production of EPO in T2DM mice. Conclusion RasGRP4 participates in the production of renal EPO in diabetic mice by affecting the secretion of proinflammatory cytokines in PBMCs, degrading HIF2A, and promoting the myofibroblastic transformation of C3H10T1/2 cells.

Background: In acute and chronic renal inflammatory diseases, the activation of inflammatory cells is involved in the defect of erythropoietin (EPO) production. Ras guanine nucleotide-releasing protein-4 (RasGRP4) promotes renal inflammatory injury in type 2 diabetes mellitus (T2DM). Our study aimed to investigate the role and mechanism of RasGRP4 in the production of renal EPO in diabetes. Methods: The degree of tissue injury was observed by pathological staining. Inflammatory cell infiltration was analyzed by immunohistochemical staining. Serum EPO levels were detected by enzyme-linked immunosorbent assay, and EPO production and renal interstitial fibrosis were analyzed by immunofluorescence. Quantitative real-time polymerase chain reaction and Western blotting were used to detect the expression of key inflammatory factors and the activation of signaling pathways. In vitro, the interaction between peripheral blood mononuclear cells (PBMCs) and C3H10T1/2 cells was investigated via cell coculture experiments. Results: RasGRP4 decreased the expression of hypoxia-inducible factor 2-alpha (HIF2A) via the ubiquitination–proteasome degradation pathway and promoted myofibroblastic transformation by activating critical inflammatory pathways, consequently reducing the production of EPO in T2DM mice. Conclusion RasGRP4 participates in the production of renal EPO in diabetic mice by affecting the secretion of proinflammatory cytokines in PBMCs, degrading HIF2A, and promoting the myofibroblastic transformation of C3H10T1/2 cells.

Background: In acute and chronic renal inflammatory diseases, the activation of inflammatory cells is involved in the defect of erythropoietin (EPO) production. Ras guanine nucleotide-releasing protein-4 (RasGRP4) promotes renal inflammatory injury in type 2 diabetes mellitus (T2DM). Our study aimed to investigate the role and mechanism of RasGRP4 in the production of renal EPO in diabetes. Methods: The degree of tissue injury was observed by pathological staining. Inflammatory cell infiltration was analyzed by immunohistochemical staining. Serum EPO levels were detected by enzyme-linked immunosorbent assay, and EPO production and renal interstitial fibrosis were analyzed by immunofluorescence. Quantitative real-time polymerase chain reaction and Western blotting were used to detect the expression of key inflammatory factors and the activation of signaling pathways. In vitro, the interaction between peripheral blood mononuclear cells (PBMCs) and C3H10T1/2 cells was investigated via cell coculture experiments. Results: RasGRP4 decreased the expression of hypoxia-inducible factor 2-alpha (HIF2A) via the ubiquitination–proteasome degradation pathway and promoted myofibroblastic transformation by activating critical inflammatory pathways, consequently reducing the production of EPO in T2DM mice. Conclusion RasGRP4 participates in the production of renal EPO in diabetic mice by affecting the secretion of proinflammatory cytokines in PBMCs, degrading HIF2A, and promoting the myofibroblastic transformation of C3H10T1/2 cells.

Occupational noise-induced hearing loss (NIHL) is an irreversible sensorineural hearing loss that severely endangers workers’ health, making early screening crucial. This article reviewed the research progress on early screening methods for occupational NIHL, introduced the testing mechanisms of three core screening methods—tympanometry, otoacoustic emissions, and extended high-frequency audiometry —and summarized their clinical application advantages and limitations. It is proposed that multimodal combined detection (e.g., the combination of tympanometry, otoacoustic emissions, and extended high-frequency audiometry) can significantly improve the accuracy and comprehensiveness of early screening. Meanwhile, future studies with prospective cohort design are encouraged to verify the long-term monitoring value of each method and to strengthen the joint development of screening technologies with cutting-edge approaches such as machine learning, in order to further improve screening efficiency and provide stronger protection for workers’ hearing health.

Objective To investigate the effect of percutaneous balloon mitral valvuloplasty under echocardiographic guidance for patients with moderate to severe mitral stenosis during pregnancy. Methods A retrospective observational study was conducted to include pregnant women who were diagnosed with moderate to severe mitral stenosis and underwent percutaneous balloon mitral valvuloplasty under echocardiographic guidance in Fuwai Hospital from August 2018 to June 2022, and their baseline characteristics, surgical outcomes, echocardiographic results, and follow-up results were analyzed. Results A total of 3 pregnant women aged 30-35 years, with gestational age of 19-26 weeks, and New York Heart Association (NYHA) function class Ⅲ were included. All the procedures were successfully performed. The mitral valve orifice area increased from 0.9 cm2 preoperatively to 2.1 cm2 postoperatively. The mean transvalvular pressure gradient decreased from 15.0 mm Hg preoperatively to 6.7 mm Hg postoperatively. No perioperative adverse events occurred. The follow-up time ranged from 3 to 48 months. All patients delivered uneventfully and returned to normal life, with maternal-fetal safety. Conclusion Percutaneous balloon mitral valvuloplasty under echocardiographic guidance is a feasible and effective procedure for the treatment of patients with moderate to severe mitral stenosis in pregnancy, with satisfactory maternal-fetal outcomes.

Population pharmacokinetics is a research technique based on computer simulation and data analysis, and it has been employed to investigate the dynamic behavior of drug metabolism in different populations. This approach could address practical challenges such as prolonged clinical trial durations, high costs, and increased difficulty in traditional clinical trials. By comprehensively analyzing differences in the internal drug metabolism processes across populations with varying physiological and pathological conditions, population pharmacokinetics has emerged as an effective method to optimize drug development and clinical applications. This article provides a preliminary overview of the essence of population pharmacokinetics, its application in clinical trials, and potential future trends. We hope to serve as a reference and guidance for the application of new technologies and methods in clinical trials.

Experiential teaching is a practical, reflective, and situational teaching method. Based on the systematic review of literature published worldwide, this paper summarizes the characteristics and organizational forms of experiential teaching, with a focus on its current application and existing problems in teaching geriatric nursing. This review provides suggestions for the reform of teaching methods of geriatric nursing in China.