Objective To comprehensively investigate the levels of exposure and distribution characteristics of trihalomethanes (THMs) in drinking water in Guangzhou City, and evaluate the health risks of different groups of children, adolescents and adults, and to provide data and evidence for protecting human health and promoting risk control of drinking water. Methods According to the technical requirements of the ^"Standards for Drinking Water Quality Testing Methods^" (GB/T 5750-2023), the concentration of THMs, including trichloromethane (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM), and tribromomethane (TBM) in drinking water in Guangzhou City from 2023-2024 were detected. The health risk model recommended by USEPA was used for risk assessment．Results TCM, BDCM and DBCM were detected in the factory water and terminal water, with TCM contributing the most. There was a statistically significant difference (P<0.05) between the wet and dry seasons, and the concentration of TCM in the wet season was higher than that in the dry season. Among the multiple exposure factors, the amount of exposure through drinking water intake was much greater than that through skin absorption. The carcinogenic risk index of THMs for children, adolescents, and adults was 22.0×10^-6, 12.2×10^-6, and 11.4×10^-6, respectively, while the non-carcinogenic risk was less than 1. Conclusion The exposure risks of THMs in children, adolescents, and adults is within an acceptable range, but monitoring needs to be strengthened, with a particular focus on children.

Objective: To develop a prediction model for mild cognitive impairment (MCI) risk among the elderly, so as to provide a tool for MCI early screening. Methods : From July 2022 to September 2024, a multi-stage stratified random cluster sampling method was used to recruit permanent residents aged ≥65 years from the Xinjiang Uygur Autonomous Region as study participants. Data on sociodemographic characteristics, nutritional status, body composition indices, bone mineral density, and handgrip strength were collected through questionnaires and physical examinations. Sarcopenia was defined based on appendicular skeletal muscle index and handgrip strength. MCI was assessed using the Mini-Mental State Examination, with adjustments for educational level. Participants were randomly divided into a training set and a validation set in a 7∶3 ratio. LASSO regression and multivariable logistic regression models were employed to screen for predictors and construct an MCI risk prediction model. The predictive performance of the model was evaluated using receiver operating characteristic (ROC) curve and decision curve analysis (DCA). Results: A total of 1 641 participants were surveyed, including 755 males (46.01%) and 886 females (53.99%). The majority of participants were aged 65-<75 years, comprising 1 154 individuals (70.32%). MCI was detected in 517 participants, corresponding to a detection rate of 31.51%. Resultsfrom LASSO regression and multivariate logistic regression analysis showed that residence (rural, OR = 2.323, 95% CI: 1.682-3.210), age (75-<85 years, OR = 1.405, 95% CI: 1.019-1.937; ≥85 years, OR = 3.655, 95% CI: 1.696-7.875), educational level (primary school, OR = 0.341, 95% CI: 0.247-0.472; junior high school, OR = 0.255, 95% CI: 0.160-0.408; high school, OR = 0.286, 95% CI: 0.154-0.531; bachelor's degree or above, OR = 0.120, 95% CI: 0.041-0.351), history of alcohol consumption (yes, OR = 3.216, 95% CI: 2.164-4.779), risk of malnutrition (yes, OR = 1.464, 95% CI: 1.064-2.014), sarcopenia (yes, OR = 3.197, 95% CI: 2.332-4.385), and waist-to-hip ratio (abnormal, OR = 1.540, 95% CI: 1.159-2.048) were identified as predictive factors for MCI among the elderly. In the training set, the area under the ROC curve, sensitivity, and specificity were 0.788, 0.719, and 0.712, respectively. In the validation set, the corresponding values were 0.784, 0.913, and 0.542, respectively. DCA demonstrated that the model provided a higher clinical net benefit for predicting MCI risk when the risk threshold probability ranged from 0.124 to 0.764. Conclusion The prediction model developed in this study demonstrates good discriminative ability and clinical utility, indicating its substantial value for predicting the MCI risk among the elderly.

Driven by the widespread adoption of minimally invasive thoracic surgical techniques and the deepening integration of enhanced recovery after surgery (ERAS) protocols, evidence-based perioperative airway management has emerged as a pivotal determinant of surgical safety, pulmonary functional recovery, and long-term prognosis. Currently, substantial regional disparities in thoracic surgical expertise persist across China, manifesting as heterogeneity in preoperative assessment standardization, inconsistent airway preparation strategies, divergent approaches to complication prevention, and limited penetration of advanced anesthetic technologies. To promote the standardization of clinical practices in this domain among hospitals at all levels, a multidisciplinary expert consortium has initiated the development of the Chinese Guidelines for Perioperative Airway Management in Thoracic Surgery (2026 edition). This protocol systematically delineates the methodological framework and structural blueprint underpinning the guideline’s formulation. Compared to the 2020 edition, the updated guideline places specific emphasis on refining stratified criteria for preoperative cardiopulmonary reserve assessment, establishing standardized management pathways for non-intubated spontaneous-ventilation techniques, formulating individualized multimodal perioperative pulmonary rehabilitation regimens, and defining precise intervention workflows for persistent postoperative cough. Collectively, these measures aim to further reduce the baseline incidence of perioperative pulmonary complications and to provide robust support for the clinical translation of enhanced recovery principles within the field of thoracic surgery.

Transmissible gastroenteritis(TGE)is a highly contagious gastrointestinal disease of pigs caused by the transmissible gastroenteritis virus(TGEV).It results in severe diarrhea and high mortality in suckling piglets.As no specific treatment available,vaccination is considered to be one of the most cost-effective measures for preventing and controlling TGE.However,the immune protection provided by vaccines based on traditional TGEV strains is becoming inadequate due to the continuous emergence of strong and new strains of the virus,which poses a serious threat to the pig industry's health and development.Therefore,the development of new vaccines with im-proved efficiency and broad-spectrum coverage is urgently needed.This paper aims to summarize the pathogenic structural characteristics of TGEV,discuss the latest advancements in TGEV vac-cine research and development,and propose future strategies for the development of highly effec-tive TGEV vaccines.The findings of this paper can serve as a valuable reference for effectively pre-venting and controlling TGE in clinical practice.

Objective:Through imaging analysis, the association between the degree of paravertebral muscle fat infiltration (fat infiltration, FI), trabecular bone score (TBS) and the fracture risk of postmenopausal osteoporosis (OP) patients was explored.Methods:A retrospective selection was made of 110 postmenopausal female patients diagnosed with OP at Jiangnan Hospital Affiliated to Zhejiang Chinese Medical University from Mar. 2023 to Mar. 2024. Additionally, healthy postmenopausal individuals who underwent physical examinations during the same period were included in the healthy postmenopausal group. The levels of paravertebral muscle FI and TBS in the two groups were compared. Postmenopausal patients with OP were followed up for one year, and the incidence of fractures in the patients was analyzed by Kaplan-Meier curve. The patients were divided into the fracture group ( n=29) and the non-fracture group ( n=81). The clinical data of the two groups of patients at admission were compared. Binary Logistic regression was used to analyze the independent risk factors for fractures in patients. Spearman was used to analyze the correlation of fracture risk within one year among FI, TBS and postmenopausal OP patients. ROC was used to evaluate the predictive value of each independent risk factor. Results:The proportion of severe paraverteal muscle FI in the postmenopausal OP group was significantly higher than that in the healthy physical examination group (multifisis FI, erector spinae FI, psoas major muscle FI, χ2=14.96, 17.17, 16.08, all P=0.00), and the lumbar TBS level was significantly lower (t=4.52, P=0.00). The Kaplan-Meier curve indicated that the degree of paravertebral muscle FI affected the incidence of fractures in patients ( χ2=14.58, P=0.00), and the level of lumbar TBS also affected the incidence of fractures in patients ( χ2=6.02, P=0.01). The bone mineral density (BMD), cross-sectional area of the multifidus muscle (CSA), erectus spinae muscle area (CSA), and psoas major muscle area (CSA) of patients in the fracture group were significantly lower than those in the non-fracture group ( t=10.72, 3.40, 3.46, 2.12). P=0.00, 0.00, 0.00, 0.04), while the indicators of TNF-α, IL-6 and PCT were higher than those in the non-fracture group ( t=4.11, 4.96, 5.48, all P=0.00). Binary Logistic regression analysis showed that high-level BMD ( OR=0.52, 95%CI: 0.27-0.77, P=0.01) and TBS ( OR=0.68, 95 %CI: 0.48-0.93 ,P=0.02) were protective factors for fractures in postmenopausal patients with OP. Multifidus FI ( OR=1.73, 95 %CI: 1.48-1.98, P=0.03), erector spinae FI ( OR=1.25, 95%CI:1.10-1.50, P=0.01), and psoas major FI ( OR=1.96, 95 %CI: 1.71-2.21, P=0.03) is the risk factor. Spearman analysis indicated that the paravertebral muscle FI of patients at the first diagnosis of OP was positively correlated with the risk of fracture within one year after diagnosis ( r=0.88, 0.91, 0.82, P=0.01, 0.01, 0.02), while the BMD and TBS values were negatively correlated ( r=-0.92, -0.77, P=0.00, 0.02). ROC showed that the values of multifidus FI, erector spinae FI, psoas major FI, BMD and TBS at admission all had good predictive efficacy for fractures within one year in patients [area under the ROC curve (AUC) =0.88, 0.84, 0.86, 0.73, 0.82]. Moreover, the predictive efficiency of the joint model is higher (AUC=0.89) . Conclusions:Higher BMD and TBS levels protect against fractures in postmenopausal OP patients ( OR=0.523-0.675), while severe paraspinal muscle FI (multifidus: OR=1.726; erector spinae: OR=1.248; psoas: OR=1.961) increases risk. The combined model shows excellent predictive value (AUC=0.890), serving as effective clinical warning indicators for fracture risk assessment.

Objective The study aimed to investigate whether montelukast sodium could alleviate airway inflammatory responses in asthmatic mice by affecting the PHD2/HIF-1α pathway.Methods An allergic asthma model was established by ovalbumin(OVA)induction,and 18 female BALB/c mice were randomly divided into a control group(Con group),an asthma group(OVA group),and an asthma group with montelukast sodium intervention(30 mg/kg montelukast sodium by oral administration 1 h before OVA challenge,Mon group).HE staining was used to analyze the pathological changes in the lungs of mice.Blood cell analyzer and kits were used to determine the number of inflammatory cells and the levels of cytokines,the content of lactic acid and pyruvic acid in the lungs,respectively.RT-PCR and Western blot were used to detect the mRNA and protein expression of HIF-1α,PHD2,E-cad and p120 in the lungs of mice.Results Compared with the Con group,there was a significant increase in the number of eosinophils,lymphocytes,neutrophils and monocytes,the levels of IL-5,IL-13,complement factor D(CFD)and contents of lactate and pyruvate in the lungs of mice in the OVA group.Lung HIF-1α,PHD2,p120 and E-cad mRNA levels were reduced,meanwhile HIF-1α and PHD2 protein expression were upregulated but E-cad and p120 protein expression were downregulated(all with P<0.05).After montelukast sodium intervention,the number of eosinophils and monocytes and CFD expression were significantly decreased in the lungs of Mon group,the contents of lactate and pyruvate were basically restored to normal,and the mRNA and protein expression of HIF-1α,PHD2,p120 and E-cad were effectively improved.Conclusion Montelukast sodium could alleviate the airway inflammatory responses in the lungs of asthmatic mice by regulating the PHD2/HIF-1α signaling pathway.

Objective:Through imaging analysis, the association between the degree of paravertebral muscle fat infiltration (fat infiltration, FI), trabecular bone score (TBS) and the fracture risk of postmenopausal osteoporosis (OP) patients was explored.Methods:A retrospective selection was made of 110 postmenopausal female patients diagnosed with OP at Jiangnan Hospital Affiliated to Zhejiang Chinese Medical University from Mar. 2023 to Mar. 2024. Additionally, healthy postmenopausal individuals who underwent physical examinations during the same period were included in the healthy postmenopausal group. The levels of paravertebral muscle FI and TBS in the two groups were compared. Postmenopausal patients with OP were followed up for one year, and the incidence of fractures in the patients was analyzed by Kaplan-Meier curve. The patients were divided into the fracture group ( n=29) and the non-fracture group ( n=81). The clinical data of the two groups of patients at admission were compared. Binary Logistic regression was used to analyze the independent risk factors for fractures in patients. Spearman was used to analyze the correlation of fracture risk within one year among FI, TBS and postmenopausal OP patients. ROC was used to evaluate the predictive value of each independent risk factor. Results:The proportion of severe paraverteal muscle FI in the postmenopausal OP group was significantly higher than that in the healthy physical examination group (multifisis FI, erector spinae FI, psoas major muscle FI, χ2=14.96, 17.17, 16.08, all P=0.00), and the lumbar TBS level was significantly lower (t=4.52, P=0.00). The Kaplan-Meier curve indicated that the degree of paravertebral muscle FI affected the incidence of fractures in patients ( χ2=14.58, P=0.00), and the level of lumbar TBS also affected the incidence of fractures in patients ( χ2=6.02, P=0.01). The bone mineral density (BMD), cross-sectional area of the multifidus muscle (CSA), erectus spinae muscle area (CSA), and psoas major muscle area (CSA) of patients in the fracture group were significantly lower than those in the non-fracture group ( t=10.72, 3.40, 3.46, 2.12). P=0.00, 0.00, 0.00, 0.04), while the indicators of TNF-α, IL-6 and PCT were higher than those in the non-fracture group ( t=4.11, 4.96, 5.48, all P=0.00). Binary Logistic regression analysis showed that high-level BMD ( OR=0.52, 95%CI: 0.27-0.77, P=0.01) and TBS ( OR=0.68, 95 %CI: 0.48-0.93 ,P=0.02) were protective factors for fractures in postmenopausal patients with OP. Multifidus FI ( OR=1.73, 95 %CI: 1.48-1.98, P=0.03), erector spinae FI ( OR=1.25, 95%CI:1.10-1.50, P=0.01), and psoas major FI ( OR=1.96, 95 %CI: 1.71-2.21, P=0.03) is the risk factor. Spearman analysis indicated that the paravertebral muscle FI of patients at the first diagnosis of OP was positively correlated with the risk of fracture within one year after diagnosis ( r=0.88, 0.91, 0.82, P=0.01, 0.01, 0.02), while the BMD and TBS values were negatively correlated ( r=-0.92, -0.77, P=0.00, 0.02). ROC showed that the values of multifidus FI, erector spinae FI, psoas major FI, BMD and TBS at admission all had good predictive efficacy for fractures within one year in patients [area under the ROC curve (AUC) =0.88, 0.84, 0.86, 0.73, 0.82]. Moreover, the predictive efficiency of the joint model is higher (AUC=0.89) . Conclusions:Higher BMD and TBS levels protect against fractures in postmenopausal OP patients ( OR=0.523-0.675), while severe paraspinal muscle FI (multifidus: OR=1.726; erector spinae: OR=1.248; psoas: OR=1.961) increases risk. The combined model shows excellent predictive value (AUC=0.890), serving as effective clinical warning indicators for fracture risk assessment.

Objective:To investigate the effect of left colonic artery (LCA) preservation on rectal cancer patients' short-term postoperative anal function and quality of life.Methods:Two-hundred ninty-two patients with rectal cancer at the Department of Gastrointestinal Surgery of Peking University First Hospital between Jan 2022 and Dec 2023 were enrolled . The patients were divided into two groups according to whether the LCA was preserved during surgery or not. The LARS scale and EORTC QLQ-CR29 quality of life questionnaire were used to assess postoperative anal function and quality of life.Results:There were no significant differences between the two groups in terms of the amount of surgical blood loss and the number of lymph node dissections in the root No. 253 group and the time to postoperative voiding (all P>0.05). However, the LARS scores at 1 and 3 months postoperatively were significantly lower in the preserved LCA group than in the LCA nonpreserved group, especially for gas incontinence, loose stool leakage, and number of bowel movements (all P<0.05). The EORTC QLQ-CR29 scores showed that the LCA preserved group recovered significantly better than the non-preserved group in terms of postoperative voiding dysfunction ( P=0.007), urinary incontinence ( P=0.006), mucus discharge ( P=0.009), and fecal incontinence symptoms ( P<0.001). Male sexual dysfunction recovery was quicker in the preserved LCA group ( P=0.043), but there was no significant difference between the two groups at 3 months postoperatively( P>0.05). Conclusion:Preservation of the left colonic artery in low anterior resection of rectal cancer helps to reduce the incidence of postoperative low anterior resection syndrome, improve genitourinary symptoms, and improve patients' quality of life.

Objective:Analyze the risk factors of gastrointestinal perforation caused by foreign body and summarize the experience of surgical treatment of foreign bodies.Method:From Jan 2008 to Dec 2023, 89 patients with foreign bodies in the digestive tract were admitted to the Department of Gastrointestinal Surgery, Peking University First Hospital. Relevant data were collected and binary logistic regression was used to analyze the independent risk factors for intestinal perforation, resection and anastomosis of intestine or enterostomy/colostomy.Results:The mean age of 89 patients was (60.1±16.2) years old, 65 patients (73%) had unintentionally ingested foreign bodies. The most common foreign bodies were jujube pits (40 cases). Thirty-nine patients diagnosed with gastrointestinal perforation. Binary Logistic regression analysis showed that the total number of leukocytes ( OR=4.085, 95% CI: 1.214-13.745, P=0.023), sharp foreign body ( OR=26.124, 95% CI: 5.194-131.392, P<0.001), and the location of foreign body ( OR=3.980, 95% CI: 1.178-13.465, P=0.026) were the independent risk factors for gastrointestinal perforation. Thirty-three patients underwent gastrointestinal repair surgery, and 36 patients underwent resection and anastomosis of intestine or enterostomy/colostomy. Binary Logistic regression analysis showed that the foreign body located in the colorectum ( OR=71.928, 95% CI: 4.646-1 113.479, P=0.002) and the length of the foreign body ≤2.5 cm ( OR=5.791, 95% CI: 1.606-20.882, P=0.007) were the independent risk factors for resection and anastomosis of intestine or enterostomy/colostomy. Conclusions:Leukocyte count ≥10×10 9/L, sharp foreign body, and location of foreign body are independent risk factors for gastrointestinal perforation. Foreign body located in the colorectum and foreign body length ≤2.5 cm are risk factors for resection and anastomosis of intestine or enterostomy/colostomy.

Objective The study aimed to investigate whether montelukast sodium could alleviate airway inflammatory responses in asthmatic mice by affecting the PHD2/HIF-1α pathway.Methods An allergic asthma model was established by ovalbumin(OVA)induction,and 18 female BALB/c mice were randomly divided into a control group(Con group),an asthma group(OVA group),and an asthma group with montelukast sodium intervention(30 mg/kg montelukast sodium by oral administration 1 h before OVA challenge,Mon group).HE staining was used to analyze the pathological changes in the lungs of mice.Blood cell analyzer and kits were used to determine the number of inflammatory cells and the levels of cytokines,the content of lactic acid and pyruvic acid in the lungs,respectively.RT-PCR and Western blot were used to detect the mRNA and protein expression of HIF-1α,PHD2,E-cad and p120 in the lungs of mice.Results Compared with the Con group,there was a significant increase in the number of eosinophils,lymphocytes,neutrophils and monocytes,the levels of IL-5,IL-13,complement factor D(CFD)and contents of lactate and pyruvate in the lungs of mice in the OVA group.Lung HIF-1α,PHD2,p120 and E-cad mRNA levels were reduced,meanwhile HIF-1α and PHD2 protein expression were upregulated but E-cad and p120 protein expression were downregulated(all with P<0.05).After montelukast sodium intervention,the number of eosinophils and monocytes and CFD expression were significantly decreased in the lungs of Mon group,the contents of lactate and pyruvate were basically restored to normal,and the mRNA and protein expression of HIF-1α,PHD2,p120 and E-cad were effectively improved.Conclusion Montelukast sodium could alleviate the airway inflammatory responses in the lungs of asthmatic mice by regulating the PHD2/HIF-1α signaling pathway.