Microplastics and nanoplastics (MPs/NPs) are ubiquitous environmental pollutants that act as endocrine-disrupting chemicals (EDCs), raising significant concerns about their impact on human health. Research highlights the hazardous effects of MPs/NPs on both male and female reproductive systems, influencing germ cells, embryo development, and progeny. Additionally, studies show that MPs/NPs affect the gene expression of anabolic steroid hormones in vitro and in vivo, inducing reproductive toxicity through mechanisms such as oxidative stress and inflammation. Considering these adverse effects, identifying natural compounds that can mitigate the toxicity of MPs/NPs is increasingly important. Plants offer a wealth of antioxidants and anti-inflammatory compounds that can counteract these harmful effects. Among these, anthocyanins, natural colorants responsible for the vibrant hues of fruits and flowers, exhibit a wide range of biological activities, including antioxidant, anti-inflammatory, and anti-neoplastic properties. Moreover, anthocyanins can modulate sex hormone levels and alleviate reproductive toxicity. Cyanidin-3-glucoside (C3G), one of the most extensively studied anthocyanins, shows promise in reducing reproductive toxicity, particularly in females, and in protecting male reproductive organs, including the testis and epididymis. This protective effect is believed to result from its interaction with steroid receptors, specifically the androgen and estrogen receptors (ERs). These findings highlight the need to explore the mechanisms by which anthocyanins mitigate the reproductive toxicity caused by MPs/NPs. This review provides novel insights into how natural compounds can be leveraged to lessen the impact of environmental contaminants on human health, especially concerning reproductive health.

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Objective:To observe the effect of ankle joint proprioception training on ankle joint proprioception, balance and gait in patients with thalamic infarction.Methods:Fifty-six patients with thalamic infarction were divided into a control group and a treatment group, each of 28, using a random number table. Both groups were given conventional lower limb rehabilitation training, but the treatment group was additionally provided with ankle joint proprioception training. Before and after 4 weeks of the treatment, the Tecnobody proprioception testing system was used to determine the average trajectory error rate (ATE) and the time taken in the test. The Berg Balance Scale (BBS) and a balance tester were used to assess balance. A gait analyzer was used to collect spatial-temporal measures of the patients′ walking, including the stride amplitude, stride rate, the proportion of the time spent in the swing phase, and foot dorsiflexion and plantarflexion angles.Results:After the treatment, the time used, ATE, ankle proprioception, BBS scores, static balance test scores, stability limits, stride length, stride rate, swing phase time percentage, and foot dorsiflexion and plantarflexion angles had improved in both groups compared with before the treatment ( P≤0.05). Compared with the control group, the treatment group had a smaller average ATE, spent less time on the ankle proprioception test, had higher BBS scores, had lower scores on the static balance test, had larger limits of stability, took longer strides at a faster rate, and spent a greater percentage of time in the swing phase. That group also showed greater ankle dorsiflexion and plantarflexion on average ( P≤0.05). ATE difference of the affected lower limb and the time to complete the ankle proprioception test were positively correlated with the gap in the static balance ability test, and negatively correlated with the gaps in the BBS score, the limits of stability, stride length, stride rate, and the time share of the swing phase, as well as the dorsiflexion and plantarflexion angles of the foot. Conclusions:Ankle proprioception training, in addition to effectively improving ankle proprioception, can improve the balance and gait of persons with thalamic infarction. It is worthy of clinical application and promotion.

Objective:To investigate the short-term efficacy and safety of rituximab (RTX) in children with calcineurin inhibitor (CNI) resistant steroid resistant nephrotic syndrome (SRNS).Methods:A retrospective case analysis was conducted. Thirteen children with CNI resistant SRNS who were regularly treated with RTX (375 mg/m 2 per dose (maximum dose 500 mg), 1 dose per week, a total of 4 doses) in Department of Nephrology, Children′s Hospital of Fudan University from January 2016 to December 2023 were enrolled. The general data, disease related information, urinary protein/creatinine, serum albumin, blood creatinine before RTX treatment, immunosuppressants, adverse events, and monthly urinary protein/creatinine, serum albumin, and blood creatinine indexes within 6 months after RTX treatment were collected. The changes of urinary protein/creatinine, serum albumin and estimated glomerular filtration rate (eGFR) before and after RTX at 3 and 6 months were analyzed by using paired sample t test and Wilcoxon signed-rank test. Results:Among the 13 patients, 8 were male and 5 were female. The age of disease onset was 4.0 (2.9, 6.8) years and the age of RTX treatment was 9.8 (5.9, 13.6) years. There were 8 cases of focal segmental glomerulosclerosis, 3 cases of minimal change disease and 2 cases of mesangial proliferative glomerulonephritis. No clinically significant gene variation was detected in 12 cases and the other one did not receive gene test. Before RTX treatment, 11 cases were in chronic kidney disease stage G1, and 1 case each was in stage G2 and stage G3. Ten children completed 4 doses of RTX treatment, 1 patient completed 3 doses, and 2 patients completed 2 doses. Urinary protein/creatinine in 13 children at 3 and 6 months after RTX treatment was significantly lower than baseline (0.60 (0.13, 2.04), 0.49 (0.28, 1.10) vs. 1.44 (0.76, 4.11) mg/mg, Z=-2.34, -2.34, both P<0.05), and serum albumin was significantly higher than baseline ((35±8), (34±7) vs. (30±6) g/L, t=2.30, 2.60, both P<0.05). The eGFR at 6 months after RTX treatment was not significantly different from the baseline ((110±32) vs. (113±35) ml/(min·1.73 m 2), t=-0.76, P>0.05)). No serious adverse reactions occurred in this study. Conclusion:RTX could reduce urinary protein and increase serum albumin in short-term treatment in children with CNI resistant SRNS without significant side effects.

Objective To explore the clinical characteristics of the patients with follicular cysts and menstrual disorders.Methods A total of 178 women with follicular cysts complicated by menstrual disorders were recruited,who were aged 23-53(38.62±6.35)years and came to the Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital between August 2022 and July 2024.The participants were divided into three groups according to the age,with 27 women in the age group of 21-30 years(Group 1),77 in the age group of 31-40 years(Group 2),and 74 in the age group of>40 years(Group 3).The age and menstruation of these patients were collected,the body height,weight,follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),progesterone(Po),total testosterone(TT),prolactin(PRL),anti-müllerian hormone(AMH)and thyroid function[blood routine and blood clotting for patients with abnormal uterine bleeding(AUB)]were measured,and the diameter of ovarian cyst and the thickness of endometrium were examined.The clinical characteristics of the patients with follicular cysts complicated by menstrual disorders were described and compared with each other among the three age groups.Results ① Among 178 patients,61(34.3%)patients presented with complaints of cessation of regular menstruation or amenorrhea and 117(65.7%)with complaints of AUB.Out of 178 patients,13(7.3%)patients developed anemia due to AUB,and all the patients were treated with medication.② Follicular cysts disappeared in 1 month for 124(69.7%)patients,disappeared in 2 months for 176(98.9%)patients,and disappeared in 3 months for 178(100%)patients.A total of 177(99.4%)patients had follicular cysts with a diameter less than 5 cm,and only 1(0.6%)patient had follicular cysts with a diameter≥5 cm.③ The overall prevalence of diminished ovarian reserve(DOR)in patients with follicular cysts complicated by menstrual disorders was 82.0%,and the prevalence of DOR was 70.2%for the patients under 40 years old.The prevalence of DOR in three age groups was 37.0%(10/27),81.8%(63/77),and 98.6%(73/74),respectively.The prevalence of DOR gradually increased with age.④ The median AMH values for Group 1,Group 2,and Group 3 were 1.55,0.51,and 0.15 ng/mL,respectively.The FSH level in Group 3 was significantly higher than that in Groups 1 and 2(adjusted P<0.05),while the AMH level was significantly lower than that in Groups 1 and 2(adjusted P<0.05).The AMH level in Group 2 was lower than that in Group 1(adjusted P<0.05).Conclusion Patients with follicular cysts complicated by menstrual disorders are recommended to receive medication treatment,rather than just expecting treatment.The prevalence of DOR in patients with follicular cysts complicated by menstrual disorders is significantly higher than that in normal women,even in women younger than 40 years old.Therefore,it is essential to evaluate the ovarian reserve of these patients while treating menstrual disorders,particularly for young women with fertility needs.

Neurosyphilis （NS） is a group of diseases with a series of nervous system symptoms when Treponema pallidum infects the central nervous system， with an unknown pathogenesis and significant heterogeneity in clinical manifestations. It is called the “universal imitator”， leading to a high misdiagnosis rate in clinical practice. Cognitive impairment is one of the most common clinical manifestations of NS， but delayed diagnosis may cause irreversible neuronal damage. Therefore， early identification of NS with the main manifestation of mild cognitive impairment is of great importance for achieving a good prognosis of patients. This article reports a case of NS with the main manifestation of mild cognitive impairment and reviews its clinical features， in order to improve the understanding of this disease among clinicians.
Neurosyphilis

Microplastics and nanoplastics(MPs/NPs)are ubiquitous environmental pollutants that act as endocrine-disrupting chemicals(EDCs),raising significant concerns about their impact on human health,Research highlights the hazardous effects of MPs/NPs on both male and female reproductive systems,influencing germ cells,embryo development,and progeny.Additionally,studies show that MPs/NPs affect the gene expression of anabolic steroid hormones in vitro and in vivo,inducing reproductive toxicity through mechanisms such as oxidative stress and inflammation,Considering these adverse effects,identifying natural compounds that can mitigate the toxicity of MPs/NPs is increasingly important.Plants offer a wealth of antioxidants and anti-inflammatory compounds that can counteract these harmful effects.Among these,anthocyanins,natural colorants responsible for the vibrant hues of fruits and flowers,exhibit a wide range of biological activities,including antioxidant,anti-inflammatory,and anti-neoplastic properties.Moreover,anthocyanins can modulate sex hormone levels and alleviate reproductive toxicity.Cyanidin-3-glucoside(C3G),one of the most extensively studied anthocyanins,shows promise in reducing reproductive toxicity,particularly in females,and in protecting male reproductive organs,including the testis and epididymis.This protective effect is believed to result from its interaction with steroid receptors,specifically the androgen and estrogen receptors(ERs).These findings highlight the need to explore the mechanisms by which anthocyanins mitigate the reproductive toxicity caused by MPs/NPs.This review provides novel insights into how natural compounds can be leveraged to lessen the impact of environmental contaminants on human health,especially concerning reproductive health.

This study aims to understand the epidemic distribution characteristics,antimicrobial resistance,virulence genes,and biofilm adhesion ability of Enterococcus in yaks on the Tibetan plateau.Three hundred and forty-six fresh yak fecal samples and 311 milk samples were collected from four provinces on the Tibetan plateau(Xizang,Sichuan,Gansu,Qinghai),totaling 657 sam-ples.Bacterial isolation and identification were conducted,followed by 16S rDNA gene detection and the construction of a systematic evolutionary tree.The isolated strains were tested for antimi-crobial resistance and virulence genes using PCR,and sensitivity tests were performed using 18 types of antibiotics.The biofilm adhesion ability of the isolated bacteria was determined using an improved semi-quantitative crystal violet staining method.The results showed that the total isola-tion rate of Enterococcus was 32.27％,with Sichuan having the highest at 60.23％,followed by Gansu,Qinghai,and Tibet autonomous region at 42.70％,23.47％,and 18.31％respectively.In terms of sample types,the isolation rate in fecal samples was 36.71％,and in milk samples,it was 27.33％.Through PCR amplification,bands of approximately 1 400 bp were obtained,and 5 strains were selected for evolutionary analysis,forming a separate cluster.Among the 212 isolated strains,a high resistance to clindamycin,quinupristin-dalfopristin,linezolid,levofloxacin,and erythromycin was observed,with various resistance phenomena,accounting for 60.85％.Only 5 out of 12 resist-ant genes were detected,namely erm(B),tet(L),tet(O),tet(M),and ant(6)-Ia.All 13 virulence genes were detected in Enterococcus,with detection rates in the range of 5.19％to 95.76％,where cpd was 95.75％,gelE was 91.98％,efaA was 86.79％,asal was 86.32％,and the rest ranged from 5.19％to 55.66％.The fsr virulence gene was not detected in Enterococcus from milk sources.Among the isolated strains,3.30％showed medium adhesive ability,48.58％showed weak adhesive ability,and 48.11％showed no adhesive ability.The above research revealed the preva-lence of yak derived Enterococcus,the carrying status of resistance and virulence genes,and the correlation between biofilm phenotypes,laying the foundation for mastering research data on yak-derived Enterococcus in the Tibetan plateau.

Objective:To explore the correlation among sensory information processing, self-regulation abilities, and clinical symptoms in children with autism spectrum disorder (ASD).Methods:From December 1, 2023 to May 1, 2024, a total of 73 ASD children aged 3-7 years old meeting the inclusion criteria were recruited, and they were divided into mild group ( n=20), moderate group ( n=26), and severe group ( n=27) based on clinical symptoms.The sensory processing and self-regulation checklist (SPSRC) was used to assess sensory processing and self-regulation abilities. Clinical symptoms of ASD were assessed by the social responsiveness scale (SRS), the autism behavior checklist (ABC), and the childhood autism rating scale (CARS). Statistical analysis was conducted by SPSS 25.0 software, including Chi-square test, one-way ANOVA, and Pearson correlation analysis. Results:Abnormal rates of sensory processing across the six domains in ASD children were as follows: auditory (31.51%, 23/73), visual (32.88%, 24/73), tactile (32.88%, 24/73), gustatory/olfactory (32.88%, 24/73), vestibular (24.66%, 18/73), and proprioception (27.40%, 20/73).Abnormal rates of self-regulation abilities across the three domains were as follows: physiological state (38.36%, 28/73), emotional regulation (49.32%, 36/73), and adaptability (31.51%, 23/73).The severe group showed higher abnormal rates in SPSRC domains compared to the moderate and mild groups (all P<0.05). Total scores of each SPSRC domain were negatively correlated with total scores of SRS, ABC, and CARS ( r=-0.648--0.236, all P<0.05). Conclusion:The more severe the impairment in sensory processing and self-regulation abilities in ASD children, the more severe their clinical symptoms. Improving sensory processing and self-regulation abilities may contribute to the rehabilitation of children with ASD.

Objective:To develop and validate the reliability and validity of the care giver assessment via observation (CGAO) in general hospital .Methods:From July 4, 2022 to June 24, 2023, a total of 120 adult inpatients with somatic diseases in Peking Union Medical College Hospital were selected by cluster sampling. All patients completed the CGAO, union physio-psycho-social assessment questionnaire (UPPSAQ-70) and patient health questionnaire-9 item (PHQ-9) assessment simultaneously. Exploratory factor analysis and item response theory analysis were used to explore the structural validity of CGAO by SPSS 26.0 software.The symptoms items and suicide risk assessed by UPPSAQ-70 and PHQ-9 were used as criteria to verify criterion validity.Results:Through exploratory factor analysis, a single-factor model could be constructed. The analysis based on item response theory suggested that it had a good fit with the single-factor stepwise response model ( χ2/ df=1.307, RMSEA=0.051, CFI=0.986, TLI=0.983). The CGAO total score was significantly positively correlated with the total scores of PHQ-9 and UPPSAQ-70 ( r=0.639, 0.518, both P<0.001). The Cronbach's α coefficient of the CGAO full scale was 0.735. Conclusion:CGAO has good reliability and validity in evaluating mental behavior of patients, and is suitable for early recognition of mental behavior abnormalities of inpatients in general hospitals.