Objective: To determine the correlation between obesity related indicators and blood lipid levels among children and adolescents. Methods: A total of 5 812 participants were included. Height, weight, body composition, waist circumference, blood pressure were measured and fasting glucose and blood lipid levels were tested based on a cross sectional survey of children and adolescents 6-17 years in Beijing, 2022-2023. The body mass index (BMI), fat mass index (FMI), body roundness index (BRI) and waist to height ratio (WHtR) were calculated. Linear and Logistic regression were used to analyze the associations between the four obesity indicators (BMI, FMI, BRI, and WHtR) and blood lipids in children and adolescents. The area under the curve (AUC) of the receiver operating characteristic (ROC) was used to evaluate differences in the associations between different obesity indicators with dyslipidemia. Results: Linear regression showed that BMI, FMI, BRI, and WHtR were positively correlated with triglyceride (TG), low density lipoprotein cholesterol (LDL-C), and non high density lipoprotein cholesterol (non HDL-C) levels (boys: β 6-9 years =0.02-0.28, β 10-17 years =0.02-0.37; girls: β 6-9 years =0.02-0.28, β 10-17 years =0.03-0.25), and negatively correlated with the high density lipoprotein cholesterol (HDL-C) level in both genders across age subgroups (boys: β BMI = -0.03, β FMI = -0.04 , β BRI =-0.09, β WHtR =-0.17; girls: β BMI =-0.03, β FMI =-0.04, β BRI =-0.11, β WHtR =-0.20) (all P <0.01). The associations between total cholesterol (TC) and remnant cholesterol (RC) levels with obesity indicators differed significantly by gender and age. The TC level was positively associated with obesity indicators in boys of all ages ( β BMI =0.01, β FMI =0.03, β BRI = 0.08 , and β WHtR =0.16) but only with FMI, BRI, and WHtR in girls 6-9 years of age ( β FMI =0.02, β BRI =0.05, and β WHtR =0.08) (all P <0.05). The RC level had a negative correlation with BRI in boys 10-17 years of age ( β =-0.01) and a positive correlation with BMI in girls 6- 9 years of age ( β =0.00) (all P <0.05). Logistic regression indicated that elevated obesity indicators were significantly associated with higher risks of elevated TG, LDL-C, and non HDL-C levels and a decreased HDL-C level in all gender age stratas (all P <0.01). Only the BMI and FMI in girls 6-9 years of age were significantly related to a high RC ( OR =1.07, 1.07, both P <0.05). ROC analysis revealed that FMI, BRI, and WHtR were more predictive than BMI of elevated TG, LDL-C, and non HDL-C levels. The BMI was superior in predicting a decreased HDL-C level in boys, while no significant difference was detected among indicators in girls. Indeed, all obesity indicators had poor predictive performance for elevated TC, RC, and LDL-C levels in girls (all AUC<0.7). Conclusions Obesity indicators reflecting body fat content and fat distribution are shown to be closely associated with dyslipidemia in children and adolescents with obvious age and gender differences. The FMI, BRI, and WHtR have potential advantages in the early identification of dyslipidemia among children and adolescents compared to the BMI alone.

Based on clinical epidemiological data， it is believed that qi deficiency constitution is closely related to allergic diseases. According to the fundamental principles of traditional Chinese medicine （TCM） constitution theory， the intrinsic connection between qi deficiency constitution and allergic diseases is analyzed from the perspectives of inherited endowment， life process， environmental restriction， and the interplay of form and spirit. This paper discusses the key points of regulating qi deficiency constitution to prevent allergic diseases in three stages， prevention before illness， prevention of disease progression， and prevention of recurrence after recovery. It also distinguishes the treatment directions for regulating qi deficiency constitution to treat allergic diseases based on different disease locations such as the lung， spleen， and kidney. This aims to expand new ideas for the research on qi deficiency constitution and allergic diseases as well as the prevention and treatment of allergic diseases.

ObjectiveTo observe the clinical efficacy and safety of Dizhuo Huayu prescription combined with catgut embedding therapy in patients with nonalcoholic steatohepatitis （NASH） and dyslipidemia and explore the effect of the combined therapy on inflammatory cytokines interleukin （IL）-18 and IL-1β. MethodsA total of 82 patients with NASH and dyslipidemia from the Gastroenterology Department of the First Affiliated Hospital of Henan University of Chinese Medicine were randomly divided into a control group and a treatment group， with 41 patients in each group. The control group received Polyene Polyenylphosphatidylcholine Capsules， while the treatment group received Dizhuo Huayu prescription granules combined with catgut embedding. The treatment duration was 24 weeks for both groups. At weeks 0， 12， and 24， the traditional Chinese medicine （TCM） syndrome score， body mass index （BMI）， liver fat content assessed by Fibroscan （CAP value）， the level of alanine transaminase （ALT）， aspartate aminotransferase （AST）， gamma-glutamyl transferase （GGT）， total cholesterol （TC）， triglyceride （TG）， high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol （LDL-C）， and free fatty acid （FFA）， and the expression of inflammatory cytokines IL-18 and IL-1β in serum were observed. Adverse reactions in both groups were recorded. ResultsA comparison of the comprehensive therapeutic effects between the two groups after 24 weeks of treatment revealed that the total effective rate was 62.16% （23/37） in the control group and 85.71% （30/35） in the treatment group， with a statistically significant difference （χ² = 5.14， P<0.05）. At weeks 12 and 24 after treatment， the TCM syndrome score， BMI， CAP value， TC， TG， LDL-C， and FFA were all significantly lower in both groups compared to pre-treatment levels， while the HDL-C level significantly increased （P<0.05）. The effect was better at week 24 （P<0.05） than at week 12 （P<0.05）， and the treatment group showed better outcomes than the control group at weeks 12 and 24 after treatment （P<0.05）. After 24 weeks of treatment， both groups exhibited significant reductions in IL-18 and IL-1β levels （P<0.05）. The treatment group demonstrated superior efficacy compared to the control group after treatment （P<0.05）. Both groups experienced decreases in ALT， AST， and GGT levels after treatment （P<0.05）. However， there were no statistically significant differences between the 12-week and 24-week post-treatment values within each group， nor were there significant differences between the two groups. No significant adverse reactions were observed in both groups. ConclusionThe Dizhuo Huayu prescription combined with catgut embedding therapy is safe and effective in treating patients with NASH and dyslipidemia， exhibiting hepatoprotective， anti-inflammatory， lipid-regulating， and weight-reducing effects.

[Objective]To evaluate the utility of left atrial(LA)volume and strain measured by 4D auto left atrial quantification(4D auto LAQ)in differentiating pre-capillary from post-capillary pulmonary hypertension(PH),and to compare its discriminative performance with echocardiographic pulmonary to left atrial global strain ratio(ePLAGS).[Methods]A total of ninety-eight subjects with intermediate to high probability of PH were prospectively enrolled.Clinical history and laboratory data were collected.All patients underwent comprehensive transthoracic echocardiography,and LA volume and strain parameters were measured by dedicated commercial software for LA 4D analysis.[Results]Based on pulmonary arterial wedge pressure,patients were divided into pre-capillary PH group[n=39;mean age(53±24)years]and post-capillary PH group[n=59;mean age(57±18)years].Compared to the pre-capillary PH group,the post-capillary PH group showed significantly higher LAVImax,LAVImin and LAVIpreA but markedly lower LASr and LAScd.Multivariate logistic regression identified LAVImax[OR:1.40;95%CI:(1.052,1.872);P=0.021]and LAScd[OR:1.76;95%CI:(1.183,2.489);P=0.004]as independent predictors of post-capillary PH.ROC analysis demonstrated that LAVImax(AUC=0.82,P＜0.001)and LAScd(AUC=0.78,P＜0.001)had strong discriminating power for predicting post-capillary PH group,with optimal cutoff values of 35.69 mL/m2(sensitivity 86%,specificity 74%)and-9%(sensitivity 80%,specificity70%).[Conclusion]LAVImax and LAScd measured with 4D auto LAQ are robust parameters for distinguishing pre-capillary PH from post-capillary PH.

Stresses induced by the deficiency or excess of trace mineral elements, such as manganese (Mn), represent a common limiting factor for the production of crops like Brassica napus. To identify key genes involved in Mn allocation in B. napus and elucidate the underlying mechanisms, a member of the metal tolerance protein (MTP) family obtained in the previous screening of cDNA library of B. napus under Mn stress was selected as the research subject. Based on the sequence information and phylogenetic analysis, it was named as BnMTP10. It belongs to the Mn-cation diffusion facilitator (CDF) subfamily. Expression of BnMTP10 in yeast significantly improved the tolerance of transformants to excessive Mn and iron (Fe) and reduced the accumulation of Mn and Fe. However, the yeast transformants exhibited no significant changes in tolerance to excess cadmium, boron, aluminum, zinc, or copper. The qRT-PCR results demonstrated that the flowers of B. napus had the highest expression of BnMTP10, followed by roots and leaves. Subcellular localization studies revealed that BnMTP10 was localized in the endoplasmic reticulum (ER). Compared with wild-type plants, transgenic Arabidopsis overexpressing BnMTP10 exhibited enhanced tolerance to excessive Mn stress but showed no significant difference under Fe stress. Correspondingly, under excessive Mn stress, the Mn content in the roots of transgenic Arabidopsis increased significantly. However, under excessive Fe stress, the Fe content in transgenic Arabidopsis did not alter significantly. According to the results, we hypothesize that BnMTP10 may alleviate excessive Mn stress in plants by mediating Mn transport to the ER. This study facilitated our understanding of efficient mineral nutrients, and provided theoretical foundations and gene resources for breeding B. napus.
Brassica napus/genetics* ; Manganese/metabolism* ; Plants, Genetically Modified/genetics* ; Plant Proteins/physiology* ; Arabidopsis/metabolism* ; Gene Expression Regulation, Plant ; Phylogeny ; Cation Transport Proteins/metabolism* ; Stress, Physiological

This study aims to determine the nephrotoxic effects of 3-monochloropropanel-1,2-diol(3-MCPD)on female and male SD rats.A nephrotoxicity model was established by gavage of dif-ferent doses of 3-MCPD,and 80 SD rats were randomly divided into four groups:the control group(0 mg/kg 3-MCPD),low-dose group(15 mg/kg 3-MCPD),medium-dose group(30 mg/kg 3-MCPD),high-dose group(60 mg/kg 3-MCPD),with half female and half male.The body mass and food intake of the rats were recorded weekly,and the urine and blood and kidney tissues were col-lected after 28 consecutive days of gavage,and the blood erythrocyte count(WBC),white blood cell count(RBC),hemoglobin(HGB),erythrocyte-compaction-transfer-value(HCT),creatinine(CREA),serum urea nitrogen(BUN),and the indexes of blood phosphorus(P)and calcium(Ca)were detected;the level of kidney injury molecule(KIM-1)was measured by ELISA kit;the renal pathological changes was observed by histopathology method;and transcriptome sequencing was used to analyze differential genes in female and male rats.The results showed that 3-MCPD did not significantly affect the growth of male rats,but high doses significantly reduced the weight and food intake of female rats.The high-dose group of 3-MCPD caused a significant decrease in RBC,HGB,and HCT levels in both male and female rats,resulting in a significant increase in KIM-1 and P,and a significant decrease in Ca,but only a significant increase in CREA and BUN in female rats.Histopathology showed that in the high-dose group of male rats,only mild renal tubular dilation,epithelial cell edema,and clear tubular type were observed in the kidneys,while in female rats,a large number of renal sacs,clear tubular type,and interstitial inflammatory cells with fibrosis were observed in the kidneys.Transcriptome sequencing showed 1 712 differentially expressed genes in the high-dose group of female rats and 1 153 differentially expressed genes in the high-dose group of male rats.KEGG enrichment analysis showed that both male and female rats in the high-dose group experienced oxidative stress and cell apoptosis,but 3-MCPD may also participate in the process of kidney damage in females by inhibiting autophagy and inducing iron death pathways.The above results indicate that high-dose 3-MCPD has a more significant nephrotoxic effect on fe-male rats.

Objective:To apply artificial intelligence（AI）in classifying ovarian tumors on ultrasound images，and compare the diagnostic results of several sonographers with varying seniority levels.Methods:A total of 645 patients diagnosed with adnexal masses via gynecological ultrasound examination at Qilu Hospital of Shandong University from January 2021 to December 2024 were enrolled. Three deep learning architectures，i.e.，Alexnet，Densenet121，and Resnet50 were developed and used to internally test the classification effectiveness of ovarian tumors，while the optimal model was selected for external testing. Two junior sonographers and two senior sonographers were recruited to independently diagnose ovarian tumors in the external test dataset. Subsequently，the benign and malignant results of the model's predictions were disclosed to each sonographer，and their revised diagnoses on the same external test data in combination with the best AI model were recorded.Results:The optimal model achieved an accuracy of 0.941，sensitivity of 0.936，and specificity of 0.944 on the internal test dataset，and maintained robust performance on the external test dataset with accuracy of 0.891，sensitivity of 0.880，and specificity of 0.907. Compared to junior sonographers，the optimal model demonstrated significantly higher sensitivity in discriminating benign from malignant ovarian tumors（0.880 vs. 0.723，0.602；all P<0.05）. No statistically significant difference was observed in diagnostic accuracy between the optimal model and senior sonographer 1（ P=0.05）. With assistance from the optimal model，junior sonographers achieved significant improvements in both sensitivity and specificity（sensitivity：0.723 vs. 0.843，0.602 vs. 0.819；specificity：0.778 vs. 0.833，0.685 vs. 0.741；all P<0.05）. Conclusions:The optimal model achieves comparable performance to that of senior sonographers in ovarian tumor classification. With model assistance，the diagnostic performance of junior sonographers is significantly improved.

Objective:To establish a full-thickness skin defect wound model on rabbit dorsum and to observe the effects of platelet-rich plasma (PRP) with varying injection frequencies on wound healing.Methods:Forty New Zealand white rabbits were used, with two symmetrical 4.0 cm diameter circular full-thickness skin defects created along the spinal axis on each rabbit′s back, yielding 80 wounds. These wounds were randomly divided into 8 groups (4 experimental and 4 control groups, 10 wounds per group) using a random number table. Experimental group 1 and control group 1 received a single injection of autologous PRP or normal saline at the time of wound creation. Experimental group 2 and control group 2 received two injections at the time of wound creation and on day 5. Experimental group 3 and control group 3 received three injections at the time of wound creation and on day 5, day 10. Experimental group 4 and control group 4 received four injections at the time of wound creation and on day 5, day 10, day 15. Photographic documentation was performed on postoperative day 5, day 10, day 15 and day 20 to evaluate healing progression and calculate wound healing rates. Tissue samples harvested on day 20 underwent hematoxylin-eosin (HE) staining, Masson staining, and immunohistochemical staining to measure microvessel density.Results:The wound healing rate of each experimental group was higher than that of each control group. With the increase in the number of PRP injections, the wound healing rate became faster and the wound was closer to normal skin. The wound healing rates of the experimental group 3 and the experimental group 4 were higher than those of the experimental group 2, the experimental group 1, and the four control groups (all P<0.05). However, there was no statistically significant difference in the wound healing rate between the experimental group 3 and the experimental group 4 ( P>0.05). The results of HE staining indicated that with the increase in the number of PRP injections, there was less infiltration of inflammatory cells and more newly formed capillaries. The results of Masson staining suggested that as the number of PRP injections increased, the arrangement of collagen fibers became more regular. The results of immunohistochemical staining showed that the microvessel density of the four experimental groups was greater than that of the four control groups (all P<0.05). Conclusions:PRP injection enhances wound healing rates. Multiple PRP injections yield superior therapeutic outcomes compared to a single administration.

Stiff person syndrome (SPS) is a rare neuro-immune disorder characterized by exaggerated startle responses and muscle spasms in response to minor stimuli. SPS is often misdiagnosed as panic disorder or agoraphobia. This paper reported a case of a patient with SPS presenting symptoms similar to panic attack. The patient had been misdiagnosed as dystonia, anxiety disorder and panic attack. The patient was finally correctly diagnosed through multiple disciplinary team discussions. This study integrates a comprehensive understanding of symptomatology and patient-reported experiences with targeted neurological evaluations and supplementary diagnostic tools to improve the accuracy of etiological diagnoses. This study aims to enhance the ability of psychiatrists to recognize somatic diseases presenting with psychiatric symptoms and to improve clinical diagnostic and treatment levels.

Objective To explore the feasibility of prototype of flexible ultrasound array transducer for measuring intravascular diameter and blood flow velocity.Methods A prototype of flexible ultrasonic array transducer composed of a surface mount flexible ultrasonic array transducer(referred to as the transducer)and acquisition system was designed and fabricated.Doppler body model and vascular simulation control system was used to simulate human blood.Mindray M7 color multi-functional ultrasound diagnostic instrument(abbreviated as M7)and the prototype were adopted to detect pulse wave excitation mode,spectral morphology,echo signal time interval,blood flow velocity,etc.Taken the results of M7 as standards,the effectiveness of the prototype was evaluated.Then the inner diameter and flow velocity of left common carotid artery,left brachial artery and left radial artery of 20 healthy controls(HC)were measured respectively using M7 and the prototype,and the consistency of measurement results were analyzed to evaluate the accuracy of the prototype.The safety of the prototype was evaluated according to subjectively scoring the comfort level of HC applying the transducer and whether there was skin discomfort,injury,etc.after removing the transducer.Results The collected blood flow spectrum of the above vascular simulation control system acquire with the prototype were clear,and the spectral morphology,flow velocity,as well as echo signal time interval were basically consistent with those of M7.The consistency of the inner diameter of left common carotid artery,left brachial artery and left radial artery measured by the prototype and M7 in 20 HC were all very strong(ICC=0.919-0.992),while of flow velocities were moderate or very strong(ICC=0.524-0.831).The subjective score of comfort level of application of transducer was 3(2,3),and no skin discomfort occurred.Conclusion Flexible ultrasound array transducer technology could be used to measure intravascular diameter and blood flow velocity.