Objective: To analyze the association between fine particulate matter (PM2.5) exposure in the air and dyslipidemia among primary school students, in order to provide the evidencebased support for the prevention and control of chronic diseases in children. Methods: The random sampling method was used to select 625 students from two primary schools in Anhui Province and Tianjin City from May to June 2024. Based on the home address, the annual average exposure levels of PM2.5 were obtained in 3 years before investigation, 2 years before investigation, and the past year before investigation. Fasting blood samples were collected for the detection of total cholesterol, triglycerides (TG), highdensity lipoprotein cholesterol and lowdensity lipoprotein cholesterol. Linear regression modeling was used to analyze the association between PM2.5 exposure and dyslipidemia among primary school students. Results: The rate of dyslipidemia among primary school students was 14.72% in the present study. The results of linear regression analysis showed that the TG increased by 0.019(95%CI=0.012-0.025)，0.023(95%CI=0.016-0.030) and 0.021(95%CI=0.014-0.027) mmol/L for every 1 μg/m3 increase of PM2.5 in the past year before investigation, 2 years before investigation and 3 years before investigation respectively (P<0.05). The results of binary Logisitic analysis showed that the risks of dyslipidemia in primary school students were positively correlated with PM2.5 mass concentration in the past year before investigation, 2 years before investigation, and 3 years before investigation [OR(95%CI)=1.06(1.02-1.11), 1.06(1.01-1.12), 1.06(1.01-1.11), P<0.05]. Conclusions PM2.5 exposure is associated with increased risk of dyslipidemia among primary school students. To protect the health of primary school students, effective measures should be taken to improve air quality.

Objective To investigate the correlation between spread through air space (STAS) of sub-centimeter non-small cell lung cancer and clinical characteristics and radiological features, constructing a nomogram risk prediction model for STAS to provide a reference for the preoperative planning of sub-centimeter non-small cell lung cancer patients. Methods The data of patients with sub-centimeter non-small cell lung cancer who underwent surgical treatment in Nanjing Drum Tower Hospital from January 2022 to October 2023 were retrospectively collected. According to the pathological diagnosis of whether the tumor was accompanied with STAS, they were divided into a STAS positive group and a STAS negative group. The clinical and radiological data of the two groups were collected for univariate logistic regression analysis, and the variables with statistical differences were included in the multivariate analysis. Finally, independent risk factors for STAS were screened out and a nomogram model was constructed. The sensitivity and specificity were calculated based on the Youden index, and area under the curve (AUC), calibration plots and decision curve analysis (DCA) were used to evaluate the performance of the model. Results A total of 112 patients were collected, which included 17 patients in the STAS positive group, consisting of 11 males and 6 females, with a mean age of (59.0±10.3) years. The STAS negative group included 95 patients, with 30 males and 65 females, and a mean age of (56.8±10.3) years. Univariate logistic regression analysis showed that male, anti-GAGE7 antibody positive, mean CT value and spiculation were associated with the occurrence of STAS (P＜0.05). Multivariate regression analysis showed that associations between STAS and male (OR=5.974, 95%CI 1.495 to 23.872), anti-GAGE7 antibody positive (OR=11.760, 95%CI 1.619 to 85.408) and mean CT value (OR=1.008, 95%CI 1.004 to 1.013) were still significant (P＜0.05), while the association between STAS and spiculation was not significant anymore (P=0.438). Based on the above three independent predictors, a nomogram model of STAS in sub-centimeter non-small cell lung cancer was constructed. The AUC value of the model was 0.890, the sensitivity was 76.5%, and the specificity was 91.6%. The calibration curve was well fitted, suggesting that the model had a good prediction efficiency for STAS. The DCA plot showed that the model had a good clinically utility. Conclusion Male, anti-GAGE7 antibody positive and mean CT value are independent predictors of STAS positivity of sub-centimeter non-small cell lung cancer, and the nomogram model established in this study has a good predictive value and provides reference for preoperative planning of patients.

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

OBJECTIVES: Investigating the protective effect of naringenin (NAR) on the osteogenic potential of human periodontal ligament stem cells (hPDLSCs) under oxidative stress and its related mechanisms. METHODS: The oxidative damage model of hPDLSCs was established using hydrogen peroxide (H₂O₂) andthe hPDLSCs were treated with different concentrations of NAR and 0.5 μmol/L forkhead box protein O-1 (FOXO1) inhibitor AS1842856. After that, the cell counting kit-8 (CCK8) was used to determine the optimal concentrations of H₂O₂ and NAR. The alkaline phosphatase (ALP) staining and real time fluorescent quantitative reverse transcription polymerase chain reaction (qRT-PCR) were employed to assess the expression of ALP, runt-related transcription factor 2 (RUNX2) and osteocalcin (OCN) in hPDLSCs of each group. The enzyme-linked immunosorbent assay (ELISA) and 2',7'-dichlorofluorescin diacetate (DCFH-DA) staining were utilized to evaluate the expression of reactive oxygen species (ROS), malondialdehyde (MDA) and lactate dehydrogenase (LDH) in hPDLSCs. Meanwhile, qRT-PCR and western blot were used to detect the expression levels of FOXO1 and β-catenin, both are pathway related genes and proteins. RESULTS: H₂O₂ exposure led to an increase in oxidative damage in hPDLSCs, characterized by a rise in intracellular ROS levels and increased expression of MDA and LDH (P<0.05). At the same time, the osteogenic differentiation ability of hPDLSCs decreased, as evidenced by lighter ALP staining and reduced expression levels of osteogenic differentiation-related genes ALP, RUNX2 and OCN (P<0.05). Co-treatment with NAR alleviated the oxidative damage in hPDLSCs, enhanced their antioxidant capacity, and restored their osteogenic ability. The FOXO1 inhibitor AS1842856 downregulated the expression of β-catenin (P<0.05) and significantly diminished both the antioxidant effect of NAR and its ability to restore osteogenesis (P<0.05). CONCLUSIONS NAR can enhance the antioxidant capacity of hPDLSCs by activating the FOXO1/β-catenin signaling pathway within hPDLSCs, thereby mitigating oxidative stress damage and alleviating the loss of osteogenic capacity.
Humans ; Oxidative Stress/drug effects* ; Periodontal Ligament/cytology* ; Hydrogen Peroxide ; Forkhead Box Protein O1/metabolism* ; Stem Cells/cytology* ; Flavanones/pharmacology* ; beta Catenin/metabolism* ; Osteogenesis/drug effects* ; Signal Transduction ; Core Binding Factor Alpha 1 Subunit/metabolism* ; Alkaline Phosphatase/metabolism* ; Osteocalcin/metabolism* ; Cells, Cultured ; Cell Differentiation/drug effects*

Objective:To investigate the efficacy and safety of endovascular treatment (EVT) in young patients with symptomatic intracranial atherosclerotic stenosis (sICAS).Methods:Young patients with sICAS admitted to the Department of Neurology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University, Medical School from January 2020 to July 2024 were included retrospectively. According to the therapeutic modalities, they were divided into a best medical treatment (BMT) group and an EVT group. The efficacy outcome was any stroke recurrence or death within 30 days and 1 year. The safety outcome was symptomatic intracranial hemorrhage (sICH) within 30 days and restenosis within 1 year.Results:A total of 113 patients were enrolled, including 85 males (75.2%), with a median age of 43 (interquartile range, 37-48) years; 44 patients (38.9%) received EVT, and 69 (61.1%) received BMT. Among the 44 patients who underwent EVT, 8 (18.2%) underwent balloon angioplasty and 36 (81.8%) underwent stenting. There was no significant difference in the incidence of stroke recurrence or death within 30 days (2.9% vs. 2.3%) and sICH incidence (0% vs. 2.3%) between the BMT group and the EVT group. However, the 1-year stroke recurrence or death rate in the EVT group was significantly lower than that in the BMT group (18.8% vs. 4.5%; P=0.029). Cox proportional hazards regression analysis showed that EVT was independently associated with a lower incidence of stroke recurrence or death within 1 year (hazard ratio 0.225, 95% confidence interval 0.051-0.996; P<0.05). The median age of the balloon angioplasty group was significantly lower than that of the stenting group (33.5 years vs. 46 years; P=0.007), while there were no significant differences in other demographic and baseline data. There was no significant difference in all efficacy and safety outcome between the balloon angioplasty group and the stenting group. Conclusions:For young patients with sICAS who have an unsatisfactory response to drug treatment, EVT can reduce the risk of stroke recurrence or death within 1 year without increasing the risk of sICH. The safety and efficacy of balloon angioplasty and stenting are similar.

BACKGROUND:Studies have shown that there is a close association between spinal cord injury and ferroptosis,and that tetramethylpyrazine has the function of regulating redox reactions. OBJECTIVE:To investigate the regulatory effect of tetramethylpyrazine on ferroptosis in rats with spinal cord injury and its mechanism. METHODS:Thirty-six female specific pathogen-free Sprague-Dawley rats were randomly divided into sham-operated group,model group and tetramethylpyrazine group,with 12 rats in each group.Animal models of spinal cord injury were established using the modified Allen's method in the latter two groups.No treatment was given in the sham-operated group,while rats in the model and tetramethylpyrazine groups were given intraperitoneal injection of normal saline and tetramethylpyrazine solution,once a day,for 28 days. RESULTS AND CONCLUSION:The Basso,Beattie&Bresnahan Locomotor Rating Scale score in the tetramethylpyrazine group was lower than that in the sham-operated group but higher than that in the model group after 14,21,and 28 days of treatment(P＜0.05).After 28 days of treatment,hematoxylin-eosin staining showed that in the model group,the spinal cord tissue of rats showed cavity formation,necrotic tissue and inflammatory infiltration with fibrous tissue formation;in the tetramethylpyrazine group,the area of spinal cord tissue defects was smaller,and inflammatory infiltration and fibrous tissue formation were less than those in the model group.After 28 days of treatment,Prussian blue staining showed that a large amount of iron deposition was seen in the spinal cord tissue of rats in the model group,and less iron deposition was seen in the spinal cord tissue of rats in the tetramethylpyrazine group than in the model group.After 28 days of treatment,the levels of glutathione and superoxide dismutase in the rat spinal cord tissue were decreased(P＜0.05)and the level of malondialdehyde was increased in the model group compared with the sham-operated group(P＜0.05);the levels of glutathione and superoxide dismutase in the rat spinal cord tissue were increased(P＜0.05)and the level of malondialdehyde was decreased in the tetramethylpyrazine group compared with the model group(P＜0.05).After 28 days of treatment,qRT-PCR and western blot assay showed that the mRNA and protein levels of glutathione peroxidase 4,ferritin heavy chain,and ferroportin in the rat spinal cord tissue in the model group were decreased compared with those in the sham-operated group(P＜0.05),while the mRNA and protein levels of glutathione peroxidase 4,ferritin heavy chain,and ferroportin in the rat spinal cord tissue in the tetramethylpyrazine group were increased compared with those in the model group(P＜0.05).Immunofluorescence staining showed that after 28 days of treatment,the neuronal nuclei positive staining in the spinal cord of rats was the most in the sham-operated group and the least in the model group.To conclude,tetramethylpyrazine can improve motor function and play a neuroprotective role in rats with spinal cord injury by regulating ferroptosis.

Non-small cell lung cancer (NSCLC) ranks the first among malignant tumors in China and even in the whole world. In recent years, the developement of genetic testing technology, particularly tumor gene sequencing, has provided a solid basis for the clinical molecular diagnosis of NSCLC, which has greatly increased the chances of patients benefiting from targeted therapy or immunotherapy, and ultimately extending their survival. Standardizing the use of tumor gene sequencing is crucial for the precision medicine in NSCLC. This paper discusses the normalization of tumor gene sequencing technology in the clinical molecular diagnostic pathway of NSCLC, which may promote the standardized use of tumor gene sequencing technology in targeted therapy or immunotherapy drug selection, toxicity and side effect prediction, efficacy monitoring, recurrence and prognosis evaluation of NSCLC patients. This article discusses the standardization of the application of tumor gene sequencing technology in the clinical molecular diagnosis pathway of NSCLC. Additionally, it offers a foundation for the uniform use of tumor gene sequencing technology in other solid tumors.

Objective:To investigate the efficacy and safety of Enterprise stenting in the treatment of symptomatic middle cerebral artery atherosclerotic stenosis.Methods:Patients with symptomatic middle cerebral artery atherosclerotic stenosis underwent Enterprise stenting in the Department of Neurology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from January 2020 to December 2022 were retrospectively included. The degree of residual stenosis, periprocedural complications, in-stent restenosis and stroke recurrence during follow-up were evaluated.Results:A total of 75 patients were enrolled, including 55 males (73.3%), aged 58±9.7 years. The last preprocedural symptom was stroke in 65 cases (86.7%) and transient ischemic attack in 10 cases (13.3%). Sixty-seven patients (89.3%) had the M1 segment stenosis of the middle cerebral artery, and 8 (10.7%) had the M2 segment stenosis. The degree of stenosis was 88.4%±8.90%. The median time from the last onset to stenting was 18 days (interquartile range, 13-24 days). The procedural success rate was 100%, and the residual stenosis degree was 17.3%±6.1%. Four patients (5.3%) experienced periprocedural complications, including three ischemic strokes and one symptomatic intracranial hemorrhage. Sixty-one patients (81.3%) completed 3- to 12-month follow-up, of which 7 patients (11.5%) had in-stent restenosis and 2 (3.3%) had recurrent ischemic stroke.Conclusion:Enterprise stenting may be safe and effective in the treatment of symptomatic middle cerebral artery stenosis.

Objective To investigate the effect of transcutaneous electrical acupoint stimulation(TEAS)on emergence agitation(EA)in children undergoing selective posterior rhizotomy(SPR).Methods Forty-two children with cerebral palsy undergoing SPR were selected,20 males and 22 females,aged 6-12 years,BMI 13-24 kg/m2,ASA physical status Ⅰ or Ⅱ,randomly divided into two groups:TEAS group(group T)and control group(group C),21 children in each group.Children in group T re-ceived TEAS at the bilateral acupoints of Neiguan and Hegu from 30 minutes before anesthesia induction to the end of surgery.In group C,electrodes were placed on the same acupoints without electrical stimulation.All children in both groups received total intravenous anesthesia.HR and MAP were recorded at the time of entry,extubation,5,15,30 minutes after extubation.The consumption of remifentanil and propofol during the procedure were recorded.The time of operation and extubation were recorded.The Wong-Baker faces pain scale-revised(FPS-R)and the pediatric anesthesia emergence delirium(PAED)were recorded at 15 minutes after extubation,and the incidence of EA was assessed by PAED.While,the occurrence of post-operative nausea and vomiting(PONV)was recorded.Results Compared with that at the time of entry,HR at the time of extubation,5,15 minutes after extubation and MAP at the time of extubation,5,15,30 minutes after extubation in group C were significantly increased(P＜0.05),HR and MAP at the time of extubation,5,15 minutes after extubationin group T were significantly increased(P＜0.05).Compared with group C,HR was significantly slower and MAP was significantly lower in group T at the time of extuba-tion,5,15,30 minutes after extubation(P＜0.05).Compared with group C,the consumption of remifen-tanil during operation was reduced,the time of extubation was significantly shortened,the FPS-R and PAED were significantly decreased,and the incidence of EA were significantly reduced(P＜0.05).There were no significant differences in the time of operation,the consumption of propofol during operation and the inci-dence of PONV.Conclusion TEAS is beneficial to prevent the occurrence of EA in pediatric patients un-dergoing SPR,stabilize hemodynamics,reduce the dosage of opioids during surgery,reduce the postopera-tive pain,andaccelerate the time of anesthesia resuscitation.