ObjectiveTo describe the characteristics of cardiorespiratory fitness levels in the baseline population of the South China Cohort， and to identify the potential contributing factors. MethodsFace-to-face surveys and physical examinations were conducted to collect information on demographic characteristics， medical histories， medications， lifestyles， and physical activity conditions. After excluding individuals with missing cardiorespiratory fitness-related data and covariates including physical activity and dietary information， a total of 77 024 participants aged 25 to 85 were included. Cardiorespiratory fitness levels were evaluated using a non-exercise algorithm， and low cardiorespiratory fitness level was defined as below the lower tertile of the population distribution. Logistic regression analysis was used to examine the distribution of low cardiorespiratory fitness level， and log-binomial regression and ordered logistic regression analyses were used to analyze the associations of cardiorespiratory fitness with demographic characteristics， socioeconomic factors， lifestyle factors （including alcohol consumption and dietary diversity）， and chronic diseases conditions （including diabetes， hypertension， pulmonary diseases， and cardiovascular diseases）. ResultsCardiorespiratory fitness levels showed a sufficiently normal distribution in both male and female group. We found that the proportion of low cardiorespiratory fitness level was higher among Han ethnicity， those with an educational level below 9th grade， households with an annual income of more than 100 000 Yuan， as well as those who drank alcohol at least one time per week and who exhibited low dietary diversity （all P＜0.001）. Ethnicity， socioeconomic status， lifestyle factors， and chronic diseases were found to be statistically associated with cardiorespiratory fitness levels in the South China population （all P＜0.001）. ConclusionCardiorespiratory fitness levels varied across different population groups in South China， with ethnicity， socioeconomic status， lifestyle factors， and chronic diseases serving as key determinants. Therefore， it is recommended that the public pay attention to cardiorespiratory fitness， as strengthening population-level monitoring and interventions for cardiorespiratory fitness carries significant public health implications.

ObjectiveTo investigate the temporal trend of weight-adjusted-waist index （WWI） and its association with the risk of incident cardiovascular diseases （CVD） among middle-aged and older Chinese adults. MethodsBased on the China Health and Retirement Longitudinal Study （CHARLS）， this research enrolled participants aged 45 and above with complete physical measurement data from the 2011， 2013， and 2015 waves. Complex sampling weights were applied to calculate the mean WWI， and the Mann-Kendall test was used to analyze its trend. From the 2011 baseline survey， individuals with a history of cardiovascular disease or missing key covariates were further excluded. New-onset cardiovascular outcome events were collected during follow-up until 2020. Participants were categorized into Q1–Q4 groups based on baseline WWI quartiles. Multivariable log-binomial regression models were constructed to assess the association between WWI and CVD， while restricted cubic splines were employed to evaluate potential nonlinear relationships. Sensitivity analyses were conducted to verify the robustness of the findings. ResultsFrom 2011 to 2015， the weighted mean WWI among Chinese middle-aged and older adults remained generally stable （2011： 11.17±1.68； 2013： 11.28±1.35； 2015： 11.24±1.59； P for trend <0.05）. During the longitudinal follow-up， 1 784 incident CVD cases were documented. After multivariable adjustment， each unit increase in WWI was associated with a 17% increased risk of CVD （RR： 1.17， 95%CI： 1.10-1.24）. Compared with the Q1 group， the risk of CVD in the Q2， Q3， and Q4 groups increased by 23% （RR： 1.23， 95% CI： 1.07-1.40）， 27% （RR： 1.27， 95% CI： 1.11-1.44）， and 40% （RR： 1.40， 95% CI： 1.22-1.60）， respectively. A significant linear trend was observed between the increasing WWI and elevated CVD risk （P for trend <0.001）. Subgroup analysis revealed a stronger association in participants aged 45-60 years （P for interaction <0.05）. The results of sensitivity analysis were consistent with the main research results. ConclusionsThe overall trend of WWI level in the middle-aged and elderly population in China is stable from 2011 to 2015. The higher level of WWI is associated with an increased risk of CVD， suggesting that WWI may be used as a simple and effective indicator to evaluate the risk of cardiovascular metabolism in middle-aged and elderly people.

ObjectiveTo explore the application effects of environmentally friendly reagents versus traditional reagents in tissue processing， paraffin sectioning， hematoxylin-eosin （HE） staining， special staining， and immunohistochemistry. MethodsPancreatic， renal， splenic， hepatic， pulmonary， skeletal muscle， and cardiac tissues were collected from mice and New Zealand rabbits， and randomly divided into a traditional group （Group A）， an environmentally friendly reagent I group （Group B）， and an environmentally friendly reagent Ⅱ group （Group C）. The processed tissue sections from all three groups were subjected to paraffin sections， HE staining， phosphotungstic acid-hematoxylin staining， and Mallory trichrome staining. The pancreatic tissue sections were subjected to immunohistochemical detection of insulin protein. Evaluation criteria included tissue morphological integrity， embedding operability， section quality， and staining effects. ResultsNo significant differences were observed among the three groups of samples in terms of fixation efficacy， embedding operations， and section quality. After HE staining， all groups exhibited bright nuclear and cytoplasmic staining with clear contrast， with excellent-and-good rates of 98%， 99%， and 97% for Groups A， B， and C， respectively， showing no statistically significant differences （A vs. B， P=0.561； A vs. C， P=0.651）. In phosphotungstic acid-hematoxylin staining， Groups A and C showed clear structural contrast and bright staining for striated muscle and collagen fibers， whereas Group B exhibited uneven staining. The excellent-and-good rates were 100%， 10%， and 95% for Groups A， B， and C， respectively， with significant differences between Group A and Group B （P＜0.01） but no statistical difference between Group A and Group C （P=0.311）. In Mallory trichrome staining， Groups A and B outperformed Group C. The excellent-and-good rates were 95%， 90%， and 15% for Groups A， B， and C， respectively， with significant differences between Group A and Group C （P＜0.01）， but no statistical difference between Group A and Group B （P=0.548）. Immunohistochemical results showed that Group A had a clean background with no non-specific staining， while Groups B and C exhibited significant non-specific staining， with statistically significant differences in non-specific staining rates between the groups （A vs. B， 5% vs. 100%， P＜0.01； A vs. C， 5% vs.100%， P＜0.01）. ConclusionIn HE staining， environmentally friendly reagents demonstrated effective tissue fixation and staining results comparable to traditional reagents， meeting the teaching requirements. For special staining， Group B and Group C performed better in Mallory trichrome staining and phosphotungstic acid-hematoxylin staining， respectively. However， environmentally friendly reagents exhibited non-specific staining issues in immunohistochemistry， where further optimization is required.

The underlying cause of low response rates to existing immunotherapies is that tumor cells dominate tumor immune escape through surface antigen deficiency and inducing tumor immunosuppressive microenvironment (TIME). Here, we proposed an in situ tumor cell engineering strategy to disrupt tumor immune escape at the root by restoring tumor cell MHC-I/tumor-specific antigen complex (MHC-I/TSA) expression to promote T-cell recognition and by silencing tumor cell CD55 to increase the ICOSL⁺ B-cell proportion and reverse the TIME. A doxorubicin (DOX) and dual-gene plasmid (MAC pDNA, encoding both MHC-I/ASMTNMELM and CD55-shRNA) coloaded drug delivery system (LCPN@ACD) with tumor targeting and charge/size dual-conversion properties was prepared. LCPN@ACD-induced ICD promoted DC maturation and enhanced T-cell activation and infiltration. LCPN@ACD enabled effective expression of MHC-I/TSA on tumor cells, increasing the ability of tumor cell recognition and killing. LCPN@ACD downregulated tumor cell CD55 expression, increased the proportion of ICOSL⁺ B cells and CTLs, and reversed the TIME, thus greatly improving the efficacy of αPD-1 and CAR-T therapies. The application of this in situ tumor cell engineering strategy eliminated the source of tumor immune escape, providing new ideas for solving the challenges of clinical immunotherapy.

Objective To explore the application effect of traditional Chinese medicine rolling egg therapy in the treatment of infantile diarrhea.Methods A retrospective analysis was conducted on the clinical data of children with diarrhea in Dongguan People's Hospital from April 2022 to April 2024.According to the treatment methods,they were divided into the control group and the combination group.The control group was treated with western medicine,while the combination group was combined with traditional Chinese medicine rolling egg therapy on the basis of the control group.7 d was a course of treatment,and a total of 2 courses of treatment was conducted.The clinical efficacy was evaluated,and the durations of clinical symptom changes after treatment were compared.The intestinal flora,immune function[immunoglobulin (Ig) A,IgG,IgM]and inflammatory factors[interleukin (IL)-6,IL-17,tumor necrosis factor (TNF) α]were observed before and after treatment.The treatment safety was analyzed,and the recurrence within 6 months of follow-up was counted.Results A total of 180 patients were included in the study,with 106 in the control group and 74 in the combination group.The total effective rate of the combination group was higher than that of the control group (P<0.05).After treatment,the time to stop diarrhea,reduce fever and change stool properties to normal in the combination group was lower than that in the control group (P<0.05);the number of Bifidobacteria and Lactobacilli in both groups was higher than that before treatment,and the number of combination group was higher than that of the control group (P<0.05);the number of Enterococcus faecalis and the levels of TNF-α,IL-6 and IL-17 were lower than those before treatment in both groups,and these in the combination group were lower than those in the control group (P<0.05);the levels of IgA,IgG and IgM were higher than those before treatment in the combination group (P<0.05),and the IgA level was significantly higher than that of the control group (P<0.05).At 6 months,the recurrence rate of the combination group was lower than that of the control group (P<0.05).Conclusion Traditional Chinese medicine rolling egg therapy combined with western medicine is effective in the treatment of children with diarrhea,and its mechanism may be related to the improvement of immune function,inflammatory response and intestinal flora.

Abstract Falls are the leading cause of accidental injury deaths among the elderly. Currently, the incidence and disease burden of falls among the elderly remain high. By understanding the influencing factors of falls among the elderly and formulating targeted preventive measures, the risk of falls can be effectively reduced. Studies have found that falls among the elderly are results of the interaction of multiple factors. When formulating fall prevention strategies, attention should be paid to fall risk assessment and stratification, fall prevention exercise support and health education, living environment improvement, and primary healthcare service enhancement. Reviewing publications pertaining to the epidemiological studies of falls from January 2004 to January 2024, this article summarizes the epidemiological characteristics, risk factors, prevention and control strategies of falls among the elderly, aiming to provide the reference for prevention and control.

Drowning is a common and serious injury worldwide, especially for children and young people. Drowning occurs frequently, resulting in heavy health and economic burdens to society. This paper summarizes the progress in the research of the epidemiology of drowning both at home and abroad, including the epidemiological characteristics, risk factors and intervention measures. Through analysis on existing research literature, it is found that there are large differences in the incidence characteristics of drowning in different regions. Men and children are at high risk for drowning. Age, being man, rural environment, lack of supervision, alcohol consumption, and underlying diseases are risk factors for drowning. It is suggested to pay more attention to the problem of drowning, improve people's awareness of drowning, take appropriate intervention measures and strengthen multi-sectoral collaboration to prevent and control the incidence of drowning.

Objective To understand the internal quality control(IQC)situation of routine biochemical projects in Guizhou Province from 2020 to 2022,and to use the analysis batch length sigma rule to select the appropriate IQC strategy for routine biochemical projects.Methods A sum of 41,41 and 52 laboratories were selected from the laboratories participating in the first external quality assessment(EQA)program of the routine biochemical project in the Guizhou Provincial Center for Clinical Laboratory from 2020 to 2022,which uniformly used two concentration levels of internal quality control products produced by Randox Company in the UK.The coefficient of variation(CV)was calculated based on their IQC information,and then these CV values were used to compare with imprecise performance specifications such as WS/T403-2012 standards.The IQC situation of routine biochemical projects of Guizhou Province in recent years was analyzed.Randomly 15 laboratories were selected each year to report the results of the triglyceride project,and their σ values were calculated.Based on the Westgard sigma rule flowcharts of the analysis batch length,appropriate quality control strategies were selected and the quality goal index(QGI)was calculated to evaluate analytical performance of laboratory detection system.Results In the current monthly CV,the proportion of laboratories that met the WS/T403-2012 standards for Ca and TP projects was relatively low,while the pass rates for 7 projects(P,CK,LDH and other projects)were all above 80%,showing an increasing trend year by year.The proportion of laboratories with the 7 projects(P,CK,LDH and other projects)meeting the performance specifications for biomedical variation(appropriate)all reached 90%,while the proportion of laboratories with 5 projects(Na,Ca,Cl and other projects)was relatively low.The proportion of 10 projects such as P,CK,and LDH in cumulative CV of laboratories that met the performance specifications for biomedical variation(appropriate)was over 90%.For the triglyceride project,from 2020 to 2022,there were 2,5 and 13 laboratories that reached 6 σ horizontal.Compared to values of 2020 and 2021 years,the trend of σ values changes of 2022 was increasing(t=3.855,3.511,P≤0.001),indicating that the analytical performance of these laboratories was getting better and better.Conclusion The IQC levels of routine biochemical projects in Guizhou Province were increasing year by year.The Westgard sigma rule of the analysis batch length is designed with personalized quality control rules for various laboratories in Guizhou Province,thus improving laboratory testing capabilities and better severing clinics.

OBJECTIVE: To evaluate the clinical diagnostic value of knee MRI at 90° flexed position for Ramp lesions of medial meniscus. METHODS: A total of 228 patients with knee pain as the main complaint who were admitted between September 2021 and September 2023 was selected as the research subjects, of which 51 patients met the selection criteria and were enrolled in the study. There were 31 males and 20 females with an average age of 38.6 years (range, 15-67 years). Body mass index was 17.2-28.7 kg/m ² (mean, 23.9 kg/m ²). There were 25 cases of left knee and 36 cases of right knee. The time from injury to admission was 0.1-14.3 weeks (mean, 2.1 weeks). Preoperative knee MRI at fully extended position (knee extension position) and 90° flexed position (knee flexion position) were performed to determine the presence of irregular signs at the posterior edge of the medial meniscus, and PHMM fluid high signal [i.e. complete fluid filling between the posterior horn of the medial meniscus (PHMM) and the capsule margin]. Findings obtained under arthroscopy served as the "gold standard" to analyze the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of MRI at knee extension and flexion positions for the two specific signs of Ramp lesion. RESULTS: Twenty-one patients (41.2%) were diagnosed with Ramp lesions by using arthroscopy, including 1 case of Thaunat type Ⅰ, 2 cases of type Ⅱ, 6 cases of type Ⅲ, 7 cases of type Ⅳ, and 5 cases of type Ⅴ. The positive rates of irregular signs at the posterior edge of the medial meniscus on MRI at knee extension and flexion positions were significantly different from the diagnosis of Ramp injury under arthroscopy ( P<0.05). The sensitivity, specificity, accuracy, PPV, and NPV of MRI in the diagnosis of irregular signs were 76.1%, 60.0%, 66.7%, 57.1%, and 78.3% respectively at knee extension position, and 85.7%, 73.3%, 78.4%, 69.2%, and 88.0% respectively at knee flexion position. The positive rates of PHMM fluid high signal on MRI at knee extension and flexion positions were significantly different from the diagnosis of Ramp injury under arthroscopy ( P<0.05). The sensitivity, specificity, accuracy, PPV, and NPV of MRI in diagnosing PHMM fluid high signal were 38.1%, 100%, 74.5%, 100%, and 69.8% respectively at knee extension position, and 85.7%, 100%, 94.1%, 100%, and 90.9% respectively at knee flexion position. CONCLUSION Knee MRI at 90° flexed position improves the diagnostic performance of the detection of medial meniscal Ramp lesions compared with MRI at fully extended position.
Humans ; Magnetic Resonance Imaging/methods* ; Female ; Male ; Tibial Meniscus Injuries/diagnostic imaging* ; Adult ; Menisci, Tibial/diagnostic imaging* ; Middle Aged ; Adolescent ; Young Adult ; Arthroscopy/methods* ; Aged ; Knee Injuries/diagnostic imaging* ; Range of Motion, Articular ; Knee Joint/diagnostic imaging* ; Sensitivity and Specificity

OBJECTIVE：To study the improvement effect and possible mechanism of Leontopodium leontopodioides combined with Astragalus membranaceus on the renal function of mesangial proliferative glomerulonephritis （MsPGN） model rats. METHODS：Totally 85 rats were randomly divided into sham operation group （n＝10）and modeling group （n＝75）. Sham operation group underwent sham operation ，and MsPGN model was induced by immunological method [Freund ’s adjuvant+BSA + lipopolysaccharide（LPS）] in modeling group. After successfully modeling ，70 rats were randomly divided into model group ，L. leontopodioides+A. membranaceus high-dose，medium-dose and low-dose groups （4.05，2.03，1.02 g/kg，by total crude drug ），L. leontopodioides alone group （2.70 g/kg，by crude drug ），Tripterygium glycosides tablet group （positive control 1，0.02 g/kg）， Lotensin tablet group （positive control 2，0.02 g/kg），with 10 rats in each group. Sham operation group and model group were given constant volume of normal saline intragastrically ； administration groups were given relevant drug solution intrasgastrcially at a volume of 15 mL/kg，once a day ，for consecutive 5 weeks. At last administration ，24 h urinary lnzyxyqy2003@163.com protein，urine creatinine and serum creatinine were determined in rats. The right kidney was weighed ，and HE staining was used to observe the pathomorpholog y changes of renal tissue. Immunohistochemistry was used to detect the protein expression of NF-κB p65 in renal tissue. Western blotting assay was used to determine the protein expressions of NF-κB p65，IκBα，ERK，p-ERK and p 38 MAPK in renal tissue. RESULTS ：Compared with sham operation group ，right kidney weight ，24 h urine protein and serum creatinine levels ，protein expressions of NF-κB p65， p-ERK and p 38 MAPK in renal tissue were increased significantly in model group （P＜0.05 or P＜0.01）；the level of urine creatinine and protein expression of IκBα in renal tissue were decreased significantly（P＜0.05 or P＜0.01）；there were obvious glomerular hypertrophy ，diffuse increase of mesangial cells ，necrosis of renal tubules and other pathomorphological changes in renal tissue. Compared with model group ，right kidney weight and serum creatinine level were decreased significantly in L. leontopodioides alone group （P＜0.05），while urine creatinine level was increased significantly （P＜0.05），but there was no statistical significance in the level of 24 h urine protein （P＞0.05）；the right kidney weight ，24 h urine protein ，serum creatinine level and protein expression levels of NF-κB p65，p-ERK and p38 MAPK in renal tissue were decreased significantly in L. leontopodioides+A. membranaceus high-dose group （P＜0.05），while the urine creatinine level and protein expression level of IκBα in renal tissue were increased significantly （P＜0.05 or P＜0.01）；there was no statistical significance in above indexes in L. leontopodioides+A. membranaceus medium-dose，low-dose groups （P＞0.05）；pathological changes of renal tissue were improved to different extents in administration groups ，especially in L. leontopodioides +A. membranaceus high-dose group. CONCLUSIONS ： High dose of L. leontopodioides +A. membranaceus can improve renal function of MsPGN model rats by inhibiting MAPK/NF-κB signal pathway.