Background Asthma poses a serious threat to children's growth, development, and mental health, thus there has been an increasing focus on the control of asthma morbidity in children and the assessment of its risk factors. A growing body of research has found that exposure to ambient air pollutants an significatly increase the risk of childhood asthma. Objective To understand the changes of ambient air pollutant concentrations in Nanjing and asthma outpatient visits to Nanjing Children's Hospital, and to quantitatively analyze the effects of exposure to different ambient air pollutants on children's asthma outpatient visits. Methods Daily data of ambient air pollutants fine particulate matter (PM_2.5), inhalable particle (PM₁₀), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), carbon monoxide (CO), ozone (O₃), meteorological factors (air temperature & relative humidity), and outpatient visits due to asthma in the hospital from January 1, 2019 to December 31, 2023 were collected, and a generalized additive model based on quasi poisson distributions was used to quantitatively analyze the short-term effects of ambient air pollutant exposure on outpatient visits due to asthma in the hospital. Results The annual average concentrations of PM_2.5, PM₁₀, SO₂, and NO₂ in Nanjing from 2019 to 2023 did not exceed the national limits. For single-day lagged effects, the single-pollutant model showed that the effects of PM_2.5, PM₁₀, NO₂, and CO on children's asthma outpatient visits were greatest for every 10 units increase at lag0, with excess risk (ER) of 1.39% (95%CI: 0.65%, 2.14%), 1.46% (95%CI: 0.97%, 1.95%), 5.46% (95%CI: 4.36%, 6.57%), and 0.18% (95%CI: 0.11%, 0.26%), respectively, and SO₂ reached the maximum effect at lag1, with an ER of 23.15% (95%CI: 13.57%, 33.53%) for each 10 units increase in concentration. Different pollutants reached their maximum cumulative lag effects at different time. The PM₁₀, PM_2.5, SO₂, NO₂, and CO showed the largest cumulative lag effects at lag01, lag01, lag02, lag02, and lag03, respectively, with ERs of 1.35% (95%CI: 0.77%, 1.92%), 0.96% (95%CI: 0.10%, 1.83%), 28.50% (95%CI: 15.49%, 42.98%), 6.92% (95%CI: 5.53%, 8.33%), and 0.31% (95%CI: 0.20%, 0.42%), respectively. The influences of PM_2.5 and PM₁₀ on outpatient visits due to asthma in the hospital became more pronounced with advancing age, while the associations with NO₂, SO₂, and CO were weakened as children grew older. Conclusion Ambient air pollutants (PM_2.5, PM₁₀, SO₂, NO₂, CO) can increase childhood asthma visits, and different pollutants have varied effects on the number of asthmatic children's visits at different ages.

OBJECTIVE: To investigate the biological activity and antitumor effect of pegylated recombinant human interleukin 2 (PEG-rhIL-2) obtained by site-specific conjugation of polyethylene glycol (PEG) with non-natural amino acids, and to explore its antitumor mechanism. METHODS: The binding activities of PEG-rhIL-2 at three different sites (T41, Y45, and V91) to human interleukin 2 receptors α (IL-2R_α) and β (IL-2R_β) and were detected by surface plasmon resonance (SPR) technology. Western blot was used to detect the levels of the Janus kinase-signal transducer and activator of transcription 5 (JAK-STAT5) signaling pathway activated by different doses of rhIL-2 and PEG-rhIL-2 in CTTL-2 and YT cells. Blood was collected after a single administration in mice to detect the drug concentration at different time points and evaluate the pharmacokinetic parameters of Y45-PEG-rhIL-2. Mouse hepatoma cell line Hepa1-6, pancreatic cancer cell line Pan-02, and colon cancer cell line MC-38 were selected. Tumor models were constructed in C57BL/6 mice. Different doses of Y45-PEG-rhIL-2 and excipient control were administrated respectively to evaluate the tumor suppression effect of the drug. In the MC-38 colon cancer model, the tumor suppression effect of Y45-PEG-rhIL-2 combined with anti-programmed death-1 (PD-1) monoclonal antibody was evaluated. Hepa1-6 mouse tumor models were constructed and rhIL-2, Y45-rhIL-2 and Y45-PEG-rhIL-2 were administrated respectively. The proportion of tumor-infiltrating lymphocytes was analyzed by flow cytometry. RESULTS: The SPR detection results showed that the binding activities of PEG-rhIL-2 to IL-2R_α/IL-2R_β were both reduced. The affinity of Y45-PEG-rhIL-2 to IL-2R_α was reduced to approximately 1/250, and its affinity to IL-2R_β was reduced to 1/3. Western blot results showed that the activity of Y45-PEG-rhIL-2 in stimulating JAK-STAT5 signaling in CTLL-2 cells expressing heterotrimeric IL-2 receptor complex IL-2R_αβγwas reduced to approximately 1/300, while its activity in YT cells expressing heterodimeric IL-2 receptor complex IL-2R_βγwas reduced to approximately 1/3. The pharmacokinetic evaluation after a single dose in the mice showed that the elimination half-life of Y45-PEG-rhIL-2 was 17.7 h. Y45-PEG-rhIL-2 has pharmacokinetic characteristics superior to those of rhIL-2. Y45-PEG-rhIL-2 showed dose-dependent tumor suppression activity, and the combination of Y45-PEG-rhIL-2 and anti-PD-1 antibody had a better tumor-inhibiting effect than the single use of Y45-PEG-rhIL-2 or anti-PD-1 antibody. Flow cytometry analysis demonstrated that 72 h after the administration of Y45-PEG-rhIL-2, the proportion of tumor-infiltrating cytotoxic T lymphocytes (CD8⁺T cells) increased by 86.84%. At 120 h after administration, the ratio of CD8⁺T cells to regulatory T cells (Treg) increased by 75.10%. CONCLUSION Y45-PEG-rhIL-2 obtained by site-specific conjugation via non-natural amino acids changed its receptor binding activity and inhibited tumor growth in dose-dependent manner in multiple tumor models by regulating CD8⁺T cells.
Interleukin-2/pharmacokinetics* ; Animals ; Mice ; Humans ; Recombinant Proteins/pharmacology* ; Polyethylene Glycols/chemistry* ; Cell Line, Tumor ; Antineoplastic Agents/pharmacokinetics* ; Signal Transduction/drug effects* ; STAT5 Transcription Factor/metabolism* ; Interleukin-2 Receptor alpha Subunit/metabolism* ; Interleukin-2 Receptor beta Subunit/metabolism*

Objective:To explore the clinical, imaging, and pathological features of glottic squamous cell carcinoma of the larynx and their relationship with prognosis. Methods:A retrospective analysis was conducted on the clinical, imaging, and pathological data of 130 patients with glottic squamous cell carcinoma of the larynx who were treated at the First People's Hospital of Yinchuan and the General Hospital of Ningxia Medical University from January 2018 to March 2023. Imaging examinations （CT and MRI） were used to evaluate the lesion boundary clarity, density, enhancement nature, and enhancement degree. Postoperative pathological examination was used to determine the pathological nature, immunohistochemistry, etc. Statistical methods such as χ² test, Spearman correlation analysis, multivariate logistic regression analysis, and Kaplan-Meier method were used to analyze the data. Results:Among the 130 patients, 127 were male and 3 were female, with an average age of （61.92±9.595） years. There was a correlation between clinical, imaging, and pathological features. Multivariate analysis showed that heterogeneous MRI density （OR=12.414;P=0.019） and squamous cell carcinoma as a subtype were correlated. The initial symptom of non-hoarseness （HR=6.045;P=0.010） and unclear MRI boundary （HR=12.559; P=0.029） were independent risk factors for poor prognosis in patients with glottic squamous cell carcinoma of the larynx. Conclusion:There is a correlation between the clinical, imaging, and pathological features of patients with glottic squamous cell carcinoma of the larynx, and they can affect prognosis. The initial symptom of non-hoarseness and unclear MRI boundary of the tumor are independent risk factors for poor prognosis.
Humans ; Laryngeal Neoplasms/diagnosis* ; Prognosis ; Male ; Female ; Retrospective Studies ; Middle Aged ; Carcinoma, Squamous Cell/diagnosis* ; Magnetic Resonance Imaging ; Glottis/pathology* ; Tomography, X-Ray Computed ; Aged

Objective:To investigate the clinical characteristics and major allergens of patients with pollen-food allergy syndrome（PFAS） and their correlation with the severity of symptoms, and to provide a basis for identifying high-risk patients, optimizing the allergen testing process and developing individualized dietary management strategies. Methods:The clinical data of 166 patients with PFAS admitted to our hospital from January 2021 to July 2023 were retrospectively analyzed. The clinical symptoms, pollen types and food allergy of the patients were analyzed by questionnaire survey and serum specific IgE detection. phi coefficient, Apriori algorithm modeling and multivariate logistic regression analysis were used to evaluate the association between allergen and symptom severity. Results:Artemisia pollen was the most common allergen in this area, with a positive rate of 96.39%. Peach and mango were the most common food allergens, which caused allergic reactions in 24.10% and 22.89% of patients, respectively. Oral mucosal symptoms were the main symptoms. Correlation analysis showed that there was a correlation between pollen allergens and allergenic food. Association rule analysis showed that when the patient was allergic to the combination of peanuts and trees, the probability of high severity of symptoms was 82.35%. Multivariate analysis showed that ragweed allergy was significantly positively correlated with the severity of PFAS symptoms. Conclusion:Artemisia pollen and related food allergens play an important role in the pathogenesis of PFAS. Association rule mining and network map analysis revealed direct associations between peanut and tree combination allergy and symptom severity, as well as potential links between other inhaled allergens and specific food allergies. Ragweed and peach allergy are independent risk factors for the aggravation of PFAS symptoms, which can be used as early warning indicators. These results help to improve the screening of high-risk patients and the construction of regional allergen databases.
Humans ; Food Hypersensitivity/immunology* ; Allergens/immunology* ; Retrospective Studies ; Pollen/immunology* ; Cross Reactions ; Immunoglobulin E/blood* ; Rhinitis, Allergic, Seasonal/immunology* ; Artemisia/immunology* ; Male ; Female ; Adult ; Prunus persica/immunology* ; Arachis/immunology* ; Middle Aged ; Surveys and Questionnaires ; Oral Allergy Syndrome

Objective To explore the impact of different delay time of umbilical cord ligation on the outcome of preterm infants.Methods A total of 266 preterm infants born in the obstetric department of this hospital from January 2021 to December 2022 were selected as the research subjects and divided into the in-stant group(umbilical cord ligation immediately after birth,n=53),30 s group(delayed umbilical cord liga-tion for 30 s,n=50),60 s group(delayed umbilical cord ligation for 60 s,n=55),90 s group(delayed umbili-cal cord ligation for 90 s,n=55)and 120 s group(delayed umbilical cord ligation for 120 s,n=52)according to the random number table method.The Hb and HCT levels and the incidence rates of anemia,blood transfu-sion,hyperbilirubinemia,intracranial hemorrhage,necrotizing enterocolitis(NEC)and bronchopulmonary dys-plasia(BPD)after birth were compared among 5 groups.Results The Hb and HCT levels at 24 h after birth in the 60,90,120 s groups were higher than those in the instant group and 30 s group,moreover the 120 s group was higher than the 60 s group and 90 s group,and the differences were statistically significant(P＜0.05).The anemia incidence rate and blood transfusion rate in the 60,90,120 s groups were lower than those in the instant group and 30 s group,and the differences were statistically significant(P＜0.05).The hyperbil-irubinemia incidence rate in the 120 s group was higher than that in the other 4 groups,and the difference was statistically significant(P＜0.05).The intracranial hemorrhage incidence rate in the 60,90,120 s groups were lower than those in the instant group and 30 s group,and the differences were statistically significant(P＜0.05).The NEC incidence rate in the 60 s and 90 s group was lower than that in the instant group and 30 s group,but the 120 s group was higher than that in the other 4 groups,and the differences were statistically significant(P＜0.05).The BPD incidence rate had no statistical difference among 5 groups(P＞0.05).Con-clusion Delayed umbilical cord ligation for 60 s or 90 s could improve the outcomes of preterm infants.

Objective To explore the effects of Emotional Freedom Techniques combined with PERMA model intervention on fear of disease progression and quality of life in postoperative liver cancer patients.Methods A total of 58 liver cancer patients admitted from September 2023 to February 2024 were randomly divided into the experimental group(n=29)and the control group(n=29)using a random number table method.The experimental group received Emotional Freedom Techniques combined with PERMA-based positive psychological intervention,while the control group received the holistic nursing and routine psychological guidance.Both groups underwent the continuous intervention for 8 weeks.Outcomes were assessed using the Fear of Progression Questionnaire-Short Form(FoP-Q-SF),Distress Thermometer(DT),Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),Cancer Fatigue Scale(CFS),Athens Insomnia Scale(AIS)and Index of Well-Being(IWB).Results After the intervention,the experimental group showed the significantly lower scores than those in the control group in FoP-Q-SF(24.97±2.34/34.10±8.46),DT(2.24±0.95/2.93±1.33),SAS(49.55±1.35/58.55±4.60),SDS(51.86±1.58/61.79±4.00),CFS(4.03±0.94/5.10±1.18),and AIS(2.45±1.12/4.07±0.96)(all P<0.05),while the IWB score(10.56±1.74/7.39±2.05)was significantly higher than that in the control group(P<0.05).Conclusion The combination of Emotional Freedom Techniques and PERMA model intervention can effectively alleviate the disease-related fears,improve the negative emotions,reduce the physical symptoms and enhance the subjective well-being in postoperative liver cancer patients,and it has a significant clinical application value.

Objective To explore the clinical features and prognostic factors of gastric cancer patients liver metastasis.Methods Data from 7055 patients with gastric cancer were retrieved from Surveillance,Epidemiology and End Results(SEER)database between 2010 and 2015.The patients were divided into the liver metastases group(901 cases)and the non-liver metastases group(6154 cases)according to whether liver metastasis occurred.Univariate and multivariate Cox regression were used to analyze the prognostic risk factors,and the Kaplan-Meier method was used for survival analysis.Results There was a significant difference in age,gender,race,T stage,N stage,primary surgery,radiotherapy and tumor size between the two groups(P<0.05),and the median survival time of patients in the liver metastases group was 6 months,non-liver metastases group was 25 months.Cox regression analysis showed that age(P=0.009),tumor grade(P<0.001),surgery(P<0.001)and chemotherapy(P<0.001)were the main factors affecting the prognosis of gastric cancer with liver metastases.Conclusion Age,tumor grade,surgery and chemotherapy were the prognostic risk factors for gastric cancer with liver metastases.A nomogram based on age,tumor grade,surgery and chemotherapy has a good survival prediction significance for gastric cancer with liver metastases.

Objective:To observe the effects of repetitive transcranial magnetic stimulation(rTMS)on cognitive function,neuropsychiatric behavioral symptoms,expression of plasma microRNA-125b(miR-125b)and phosphorylated Tau181 protein(P-Tau181)of patients with Alzheimer's disease(AD). Method:Thirty-four patients with mild to moderate AD were screened and randomly divided into control group(n=16)and experimental group(n=18).The control group received cognitive training and repetitive tran-scranial magnetic pseudo-stimulation,and the experimental group received cognitive training and repetitive tran-scranial magnetic real stimulation.The magnetic stimulation intensity was 100％resting movement threshold(RMT),frequency was 10Hz.It's administered once a day,5 days a week for 4 weeks.The stimulation site were the left dorsolateral prefrontal lobe and left temporal lobe.The Addenbrooke Ⅲ cognitive examination(ACE-Ⅲ),mini-mental state scale(MMSE)and neuropsychiatric inventory(NPI)were evaluated before and af-ter treatment.The microRNA-125b expression was detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)and the concentration of P-Tau181 was determined by enzyme-linked immunosorbent assay(ELISA). Result:After treatment,the scores of ACE-Ⅲ,MMSE and NPI,miR-125b and P-Tau181 in the experimental group were significantly improved compared with those before treatment(P＜0.05).There was no improvement of all indexes in the control group(P＞0.05). Conclusion:rTMS improve the cognitive function and neuropsychiatric symptoms of patients with mild to mod-erate AD,which may be related to the promotion of plasma miR-125b expression and inhibition of P-Taul81 protein production by rTMS.It is worthy for clinical application.

Objective To observe the value of transesophageal echocardiography(TEE)for guiding left atrial appendage closure(LAAC)with LAmbre occluder.Methods Data of 40 non-valvular atrial fibrillation(NVAF)patients who underwent LA AC with LAmbre occluder were retrospectively analyzed.CT angiography(CTA)before treatment,TEE and digital subtraction angiography(DSA)findings during LAAC were comparatively observed,and the correlations of the anchor area diameter and left atrial appendage opening diameter measured with the above three as well as occluder size were analyzed,and TEE and DSA for evaluating peri-device leak(PDL)were compared.Results LAAC were successfully performed with LAmbre occlude in all 40 cases.The diameter of the fixed umbrella was positively correlated with anchor area diameter measured with CTA,TEE and DSA(r=0.79,0.82,0.91,all P＜0.01),of occlusion umbrella was positively correlated with left atrial appendage opening diameter measured with CTA,TEE and DSA(r=0.56,0.89,0.86,all P＜0.01).Immediately after the release of occluder in LAAC,PDL occurred in 16 cases and were detected with both TEE and DSA,while in the rest 24 cases no PDL was found with neither TEE nor DSA.Conclusion TEE had comparable value to DSA for guiding LAAC using LAmbre occluder.

Objective: First-line bevacizumab plus carboplatin and paclitaxel (CP) is approved for stage III/IV ovarian cancer treatment following initial surgical resection, based on global phase III GOG-0218 and ICON7 trials. This study evaluated the efficacy and safety of bevacizumab + CP as first-line ovarian cancer therapy in Chinese patients. Methods: Patients with newly diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV epithelial ovarian, fallopian tube, or primary peritoneal cancer post-primary surgery were randomized 1:1 to receive 6 cycles of CP with bevacizumab/ placebo, followed by bevacizumab/placebo maintenance until unacceptable toxicity or disease progression. Primary endpoint was investigator-assessed progression-free survival (PFS). Stratification factors were FIGO stage and debulking status (stage III optimally debulked vs stage III suboptimally debulked vs stage IV) and Eastern Cooperative Oncology Group performance status (0 vs 1 or 2). Results: Of randomized patients, 51 received bevacizumab + CP and 49 received placebo + CP. Median PFS was 22.6 months with bevacizumab + CP (95% confidence interval [CI]=18.6, not estimable) and 12.3 months (95% CI=9.5, 15.0) with placebo + CP (stratified hazard ratio=0.30; 95% CI=0.17, 0.53). Treatment-related grade 3/4 adverse events occurred in 46 of 49 (94%) patients receiving bevacizumab + CP, and 34 of 50 (68%) receiving placebo + CP. Conclusion Bevacizumab + CP showed clinically meaningful improvement in PFS vs placebo + CP, consistent with GOG-0218 results. Safety data were aligned with the known bevacizumab safety profile. These results support first-line bevacizumab + CP therapy in Chinese patients with ovarian cancer.