Bile acids (BAs) serve not only as key facilitators of lipid absorption but also as crucial signaling molecules regulating glucose and lipid metabolism, inflammation, and overall energy homeostasis. Aging profoundly alters BA metabolism, characterized by shifts in biosynthetic pathways, compositional changes, disrupted receptor-mediated signaling, and alterations in gut microbiota interactions. These age-related changes contribute to the onset and progression of metabolic conditions, including type 2 diabetes, obesity, metabolic dysfunction-associated fatty liver disease, and neurodegenerative disorders. An increased abundance of hydrophobic and cytotoxic BAs has been associated with systemic inflammation, metabolic rigidity (disruption of metabolic flexibility), and organ dysfunction. Targeting BA signaling—through pharmacological modulation of farnesoid X receptor and Takeda G protein-coupled receptor 5 or microbiota-directed therapies—offers promising strategies to mitigate aging-related metabolic decline. A deeper understanding of how BA metabolism evolves over the lifespan may unveil novel interventions to promote healthy aging and prevent age-related disease.

Abstract To clarify the service targets, service contents, and safeguard mechanisms of the basic public service program for student vision health management, the study grounded in the current status of child and adolescent myopia prevention and control in China and integrated with the practical experience and innovative practices of Wuhan National Demonstration Area for Student Vision Health Management, takes education as the main thread and schools as the base, consolidating resources from multiple stakeholders including education administrative departments, schools, families, and professional technical service institutions. Centering on four core components—vision health education, monitoring and record keeping, risk prevention and control, and dynamic management, the study constructs a multi tiered basic public service system for vision health management of primary and secondary school students. It further proposes the use of an intelligent management platform and a "three tier color coded early warning" mechanism (red, yellow, blue) to prevent and control student myopia at the source, providing schools with replicable and operable implementation pathways to enhance the level of student vision health management.

Objective:To investigate the clinicopathological features, pathological classification, and molecular characteristics of pulmonary hamartomas.Methods:A retrospective analysis was conducted on 316 cases of pulmonary hamartomas diagnosed at Nanjing Chest Hospital, Nanjing, China from January 2015 to June 2024. Next generation sequencing (NGS) was performed on 15 cases of this study. The clinical data, histopathological features, immunophenotypes, and molecular alterations were analyzed. Relevant literature was reviewed.Results:Among the 316 patients, there were 154 males and 162 females, with an average age of 56±10 years. Among the 316 cases, 310 were intrapulmonary hamartomas and 6 were intraluminal bronchial hamartomas. Microscopically, there were complex proliferative mesenchymal components and epithelial components, presenting various combinations and hamartomatous morphologies. These hamartomas were morphologically classified into mesenchymal-type hamartomas (cartilaginous, fibrous, smooth muscle, adipose tissue, and mixed types) and epithelial-mesenchymal mixed-type hamartomas (respiratory epithelial-mesenchymal mixed and mucosal gland-mesenchymal mixed types). The cartilaginous hamartomas accounted for 72.8% (230/316) of them, and the non-cartilaginous hamartoma accounted for 27.2% (86/316). Secondary changes such as calcification, ossification, collagenization, mucin degeneration, and cystic changes were commonly present. The immunophenotype was CK7 +/TTF1 + for respiratory epithelial cells, or TTF1 -/CK7 +/p40 + for interstitial cells. Interstitial cells might express desmin, SMA, S-100, caldesmon, etc, while CD34 +/CD10 +/ER + spindle-shaped interstitial cells were also commonly noted. Genetic variations were detected in 11 of the 15 cases that were subject to NGS, including HMGA2-related fusion genes, EP300 mutations, FLT1 mutations, JAK1 mutations, SETD2 and TAP2 mutations, and high-copy amplification of CDK4/PHF1/TSPAN31. The patients were followed up for 6 to 110 months without any known recurrence or metastasis. Conclusions:Pulmonary hamartomas mainly occur in the peripheral lung parenchyma, with the cartilaginous type being the most common. Their clinical pathological and molecular features of pulmonary hamartomas are characterized and the histological types are roughly ascertained in this study, with emphasis of the key points of diagnosis and differential diagnosis. Classification of pulmonary hamartomas is valuable for guiding future research. Pulmonary hamartomas overall have a good prognosis. However, those with cystic changes or intraluminal hamartomas in the bronchus may cause serious airway lesions and therefore require special attention.

Objective:To evaluate the long-term outcomes and predictors of coronary atherosclerotic lesions deemed functionally non-ischemic (quantitative flow ratio(QFR)>0.80) and deferred from intervention.Methods:This study is a post-hoc analysis of the FAVOR Ⅲ China trial, which enrolled 3 825 patients with stable or unstable angina pectoris or with myocardial infarction occurring at least 72 hours prior to screening, between December 5, 2018 and January 9, 2020 from 26 research centers in China. Coronary vessels with QFR>0.80 and without interventional treatment were analyzed in this study. The primary endpoint was 3-year target vessel revascularization. Vessels with revascularization (revascularized group) during follow-up were matched 1∶1 using propensity score matching to comparable vessels without revascularization (non-revascularized group). Multivariate Cox regression analysis was used to identify the risk factors for target vessel revascularization (TVR).Results:A total of 6 212 functionally negative vessels with deferred intervention were included in the final analysis, among which 153 vessels (2.5%) underwent TVR during a 3-year follow-up. Prior to propensity score matching, 6 059 vessels comprised the non-revascularized group. At the vessel level, compared to the non-revascularized group, the revascularized group exhibited a significantly higher proportion of males (79.1% (121/153) vs. 70.2% (4 253/6 059), P=0.018), higher body mass index ((25.6±4.0) kg/m2 vs. (24.3±5.2) kg/m2, P=0.003), and a higher prevalence of hypertension (73.9% (113/153) vs. 65.1% (3 944/6 059), P=0.025). And 152 pairs of vessels were successfully matched. Multivariate Cox regression analysis identified in-stent restenosis lesions ( HR=2.59, 95% CI 1.28-5.23, P=0.008) as an independent risk factor for target vessel revascularization. Conclusions:Coronary lesions classified as functionally non-ischemic at baseline are not entirely stable and may progress to lesions that requiring revascularization over time. In-stent restenosis emerges as a critical independent predictor of revascularization.

Objective:To investigate the clinicopathological features, pathological classification, and molecular characteristics of pulmonary hamartomas.Methods:A retrospective analysis was conducted on 316 cases of pulmonary hamartomas diagnosed at Nanjing Chest Hospital, Nanjing, China from January 2015 to June 2024. Next generation sequencing (NGS) was performed on 15 cases of this study. The clinical data, histopathological features, immunophenotypes, and molecular alterations were analyzed. Relevant literature was reviewed.Results:Among the 316 patients, there were 154 males and 162 females, with an average age of 56±10 years. Among the 316 cases, 310 were intrapulmonary hamartomas and 6 were intraluminal bronchial hamartomas. Microscopically, there were complex proliferative mesenchymal components and epithelial components, presenting various combinations and hamartomatous morphologies. These hamartomas were morphologically classified into mesenchymal-type hamartomas (cartilaginous, fibrous, smooth muscle, adipose tissue, and mixed types) and epithelial-mesenchymal mixed-type hamartomas (respiratory epithelial-mesenchymal mixed and mucosal gland-mesenchymal mixed types). The cartilaginous hamartomas accounted for 72.8% (230/316) of them, and the non-cartilaginous hamartoma accounted for 27.2% (86/316). Secondary changes such as calcification, ossification, collagenization, mucin degeneration, and cystic changes were commonly present. The immunophenotype was CK7 +/TTF1 + for respiratory epithelial cells, or TTF1 -/CK7 +/p40 + for interstitial cells. Interstitial cells might express desmin, SMA, S-100, caldesmon, etc, while CD34 +/CD10 +/ER + spindle-shaped interstitial cells were also commonly noted. Genetic variations were detected in 11 of the 15 cases that were subject to NGS, including HMGA2-related fusion genes, EP300 mutations, FLT1 mutations, JAK1 mutations, SETD2 and TAP2 mutations, and high-copy amplification of CDK4/PHF1/TSPAN31. The patients were followed up for 6 to 110 months without any known recurrence or metastasis. Conclusions:Pulmonary hamartomas mainly occur in the peripheral lung parenchyma, with the cartilaginous type being the most common. Their clinical pathological and molecular features of pulmonary hamartomas are characterized and the histological types are roughly ascertained in this study, with emphasis of the key points of diagnosis and differential diagnosis. Classification of pulmonary hamartomas is valuable for guiding future research. Pulmonary hamartomas overall have a good prognosis. However, those with cystic changes or intraluminal hamartomas in the bronchus may cause serious airway lesions and therefore require special attention.

Objective To explore the relationship among sleep quality, fatigue and work-related musculoskeletal disorders (WMSDs) in firefighters, and to examine the mediating effect of fatigue between sleep quality and the risk of WMSDs. Methods A total of 271 firefighters from three prefecture-level cities in Jiangsu Province were selected as the study subjects by a convenient sampling method. The Chinese Musculoskeletal Disorders Questionnaire, Pittsburgh Sleep Quality Index (PSQI), and Fatigue Scale-14 were used to assess WMSDs, sleep quality and fatigue status among the study subjects. The effect of sleep quality and fatigue on WMSDs was analyzed, as well as the mediating role of fatigue between sleep quality and the risk of WMSDs. Results The annual prevalence of WMSDs among the firefighters was 68.6%. The firefighters who had poor and very poor sleep quality accounted for 36.2% and 7.7%, respectively. There were 88.6% of firefighters reported fatigue. The total scores of PSQI and fatigue of firefighters in WMSDs group were higher than those in non-WMSDs group (all P<0.01). Binary logistic regression analysis showed that the higher the total score of PSQI, the worse the sleep quality, and the higher the risk of WMSDs in firefighters (all P<0.01). The higher the total score of fatigue, the higher the risk of WMSDs (P<0.01), and the risk of WMSDs in the fatigue group was higher than that in the non-fatigue group among the firefighters (P<0.01). The direct effect of sleep quality on WMSDs in firefighters was 0.028 [95% confidence interval (CI): 0.012-0.050, P<0.01], and its indirect effect on WMSDs mediated by fatigue was 0.027 (95%CI: 0.018-0.040, P<0.01). Fatigue played a mediating role in sleep quality and WMSDs, with the mediating ratio of 0.491 (95%CI: 0.304-0.740, P<0.01). Conclusion Poor sleep quality and fatigue are related to an increased risk of WMSDs in firefighters in a dose-response manner. Fatigue plays a mediating role between sleep quality and the risk of WMSDs.

Objective:To evaluate the effect of terlipressin combined with dopamine on intraoperative renal perfusion and early postoperative renal function in patients undergoing living-donor kidney transplantation.Methods:In this prospective cohort study, 84 patients of either sex, aged 18-64 yr, with a body mass index of 18.5-28.0 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅲ or Ⅳ, undergoing living-donor kidney transplantation at the First Affiliated Hospital of Zhengzhou University from September 2022 to July 2024, in whom dopamine was continuously infused during operation to maintain fluctuation in the mean arterial pressure within 10% of the baseline value, were selected and divided into dopamine group (group D, n=42) and dopamine+ terlipressin group (group DT, n=42) based on whether terlipressin was used during operation. Terlipressin was continuously infused at a constant rate even before induction in group DT. The renal artery resistance index, intraoperative urine output, urine output within 24 h after surgery, concentration of creatinine within 7 days after surgery, glomerular filtration rate and delayed postoperative transplanted renal function were recorded. Results:Compared with group D, the intraoperative renal vascular resistance index was significantly reduced, the intraoperative urine output was increased ( P<0.01), and no statistical change was found in the urine output within 24 h after surgery, concentration of creatinine within 7 days after surgery, glomerular filtration rate and incidence of delayed postoperative transplanted renal function in group DT ( P>0.05). Conclusions:Terlipressin combined with dopamine provides better efficacy than dopamine alone in improving intraoperative renal perfusion and exerts no effect on early postoperative renal function in patients undergoing living-donor kidney transplantation.

Objective:To discuss the effect of Yes-associated protein(YAP)silencing on the proliferation,migration,and invasion capabilities of the human cervical cancer(CC)SiHa cells.Methods:The human CC SiHa cells were cultured in vitro,and the lentiviral YAP shRNA was transfected into the SiHa cells to establish stably transfected YAP-shRNA experimental group(sh-YAP group)and empty plasmid control group(control group).Western blotting method was used to detect the silencing effect of YAP;immunofluorescence method was used to detect the microfilament number and morphology of actin filaments(F-actin)in the cells in both groups;CCK-8 method was used to detect the survival rates of the cells in two groups;Transwell chamber assay and wound healing assay were used to detect the numbers of migration and invasion cells and scratch healing rates of the cells in two groups;Western blotting method was used to detect the expression levels of epithelial-mesenchymal transition(EMT)markers(E-cadherin and Snail),DNA damage repair-related proteins(γ-H2AX),and apoptosis-related proteins[c-MYC and B-cell lymphoma-2(Bcl-2)]in the cells in two groups.Results:The results of lentiviral YAP shRNA transfection into SiHa cells showed that the expression level of YAP protein in the SiHa cells was significantly decreased(P＜0.05).The immunofluorescence results showed that after YAP silencing,the F-actin in SiHa cells was sparse and regularly arranged,with a reduced number of cells and a shriveled appearance.The CCK-8 results showed that compared with control group,the survival rate of the SiHa cells in sh-YAP group was significantly decreased cultured for 24 and 48 h(P＜0.01).The results of Transwell chamber assay and the wound healing assay showed that compared with control group,the numbers of migration and invasion SiHa cells in sh-YAP group were significantly decreased(P＜0.01),and the cell scratch healing rates were signifiantly decreased(P＜0.05).The Western blotting results showed that compared with control group,the expression level of E-cadherin protein in the cells in sh-YAP group was increased(P＜0.05),and the expression levels of c-MYC,Bcl-2,and γ-H2AX proteins were decreased(P＜0.05 or P＜0.01).Conclusion:YAP gene silencing leads to the depolymerization of F-actin in the human CC SiHa cells and regulates the apoptosis and DNA damage repair,potentially reversing the EMT process,thereby inhibiting the proliferation and migration of the tumor cells.

Objective To compare the efficacy and adherence of rivaroxaban versus low-molecular-weight heparin for prophylactic anticoagulation in cancer patients with venous thromboembolism(VTE).Methods A total of 120 intermediate-to-high VTE risk patients with malignant tumors admitted to Depart-ment of Hematology and Oncology,West China Longquan Hospital of Sichuan University between September 2021 and December 2022,were randomly assigned to the rivaroxaban group(n=60)and the low-molecular-weight heparin group(n=60)using the random number table.The rivaroxaban group received oral Rivaroxa-ban,while the low-molecular-weight heparin group received subcutaneous injections of low-molecular-weight heparin sodium for prophylactic anticoagulation.All patients were followed up for 180 days.The primary end-point was medication adherence.The secondary endpoints included the incidence of VTE,bleeding events,and changes in coagulation parameters.Results The rate of good medication adherence was significantly higher in the rivaroxaban group than in the low-molecular-weight heparin group(95.00％vs.88.33％,P＜0.05).However,there were no statistically significant differences in the incidence of VTE or overall bleeding events between the two groups(P＜0.05).Following treatment,parameters including fibrinogen,prothrombin time(PT),and D-dimer levels showed significant improvement from baseline in both groups.Compared to the low-molecular-weight heparin group,the Rivaroxaban group demonstrated significantly higher fibrinogen levels,shorter PT,and lower D-dimer levels(P＜0.05).Stepwise logistic regression analysis identified the post-treatment platelet(PLT)count as a significant factor influencing bleeding events during prophylactic antico-agulation(P＜0.05).Khorana score≥3(high risk)was identified as a risk factor for bleeding events(P＜0.05).The incidence of clinically relevant non-major bleeding(CRNMB)was higher in the rivaroxaban group[11.67％(7/60)]compared to the low-molecular-weight heparin group[8.33％(5/60)],although the differ-ence was not statistically significant(P＜0.05).Kaplan-Meier curve analysis revealed no significant difference in the cumulative incidence of bleeding-free events between the two groups(P＜0.05).Conclusion Oral ri-varoxaban and subcutaneous low-molecular-weight heparin demonstrate comparable efficacy and safety for VTE prevention in cancer patients,but rivaroxaban significantly improves patient's adherence.

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.