BACKGROUND:Macrophages play a key role in the occurrence and progression of lung diseases,and autophagy plays an important role in maintaining environmental homeostasis and functional stability in macrophages.It has been suggested that macrophage autophagic activity has two sides in lung inflammatory diseases.OBJECTIVE:To summarize the relationship between macrophage autophagy and lung diseases,thereby providing reference for exploring the prevention and treatment strategies of lung inflammatory diseases by targeting macrophage autophagy.METHODS:Literature retrieval was performed in CNKI and PubMed for relevant literature published from database inception to September 2024.The search terms were"macrophage autophagy,efferocytosis,macrophage polarization,acute lung injury,pneumonia,chronic obstructive pulmonary disease,pulmonary fibrosis,asthma"in Chinese and English,respectively.The search results were included or excluded based on the selection criteria,and 100 papers that met the criteria were finally included in the review.RESULTS AND CONCLUSION:(1)The obstruction of autophagy flow will induce the polarization imbalance of macrophages and impair their efferocytosis,resulting in the increase of M1 macrophages and aggravating inflammation.(2)The judgment of autophagic activity should be based on whether the autophagy flow is smooth or not,and it is essential to evaluate the degradation ability of autophagy.Some studies failed to comprehensively detect the degradation ability of autophagy lysosomes to assess whether the autophagy flow is unobtrusive.As a result,the so-called two-sided view of pulmonary macrophage autophagy in pulmonary inflammatory diseases in such studies is actually related to the one-sided judgment of autophagy activity.(3)The pathological manifestations vary across different pulmonary diseases and even at different stages of the same disease.Activation of macrophage autophagy plays a positive role in regulating pulmonary inflammatory homeostasis in conditions such as acute lung injury,infectious pneumonia,mild chronic obstructive pulmonary disease,early-stage pulmonary fibrosis,and secondary asthma.However,in the severe fibrotic stage of chronic obstructive pulmonary disease and the progressive stage of pulmonary fibrosis,the activation of pulmonary macrophage autophagy aggravates pulmonary fibrosis,reflecting the dual nature of macrophage autophagy.In allergic asthma,autophagy is activated in lung-resident macrophages but suppressed in infiltrating monocyte-derived macrophages from circulation.The former is closely related to airway stenosis,and the latter aggravates pneumonia disorders.Therefore,identifying the types and progression stages of lung diseases,along with accurately assessing autophagic activity,is crucial for future investigations into the relationship between macrophage autophagy and disease pathogenesis,thereby facilitating the development of therapeutic strategies in the future.

ObjectiveTo explore the mechanism by which the Shenfu Xiongze prescription regulates autophagy in rats with myocardial remodeling through the adenosine monophosphate-activated protein kinase （AMPK）/mammalian target of rapamycin （mTOR） signaling pathway. MethodsA rat model of myocardial remodeling induced by isoprenaline （ISO） was established. Rats were divided into the blank group，the model group，the low-，medium-， and high-dose groups of Shenfu Xiongze prescription，and the captopril group， 6 rats in each group. Except for the blank group，the rat model of myocardial remodeling was established in the other groups by intraperitoneal injection of 2.5 mg·kg^-1 ISO for 3 consecutive weeks. At the same time of modeling， the low-，medium-， and high-dose groups of Shenfu Xiongze prescription were administered the corresponding doses of Shenfu Xiongze prescription solution （8.4，16.8，and 33.6 g·kg^-1），and the captopril group was administered captopril solution （25 mg·kg^-1）. As for the blank group and the model group， the same volume of normal saline was given. The treatment was continued for 3 weeks. Echocardiography was used to observe the cardiac structure and function，and the heart weight index was detected. Masson staining and hematoxylin-eosin （HE） staining were used to observe the pathological morphology changes of myocardial tissue. The levels of interleukin-6 （IL-6） and B-type natriuretic peptide （BNP） in serum were detected by enzyme-linked immunosorbent assay （ELISA）. The expression of type Ⅰ collagen （Collagen Ⅰ），type Ⅲ collagen （Collagen Ⅲ），and microtubule-associated protein 1 light chain 3 （LC3） proteins in myocardial tissue was determined by immunohistochemistry. Autophagy was observed by transmission electron microscopy. The mRNA expression of Collagen Ⅰ，Collagen Ⅲ，α-smooth muscle actin （α-SMA），LC3，yeast Atg6 homolog protein （Beclin-1），AMPK，and mTOR in myocardial tissue was detected by quantitative real-time polymerase chain reaction （real-time PCR）. The protein expression of Collagen Ⅰ，α-SMA，transforming growth factor-β₁ （TGF-β₁），LC3，Beclin-1，p62， phosphorylation（p）-AMPK，p-mTOR，AMPK，and mTOR was detected by Western blot. ResultsCompared with the normal group，rats in the model group exhibited significantly decreased values of ejection fraction （EF） and left ventricular fractional shortening （FS） （P<0.01）， significantly increased values of left ventricular end-diastolic diameter （LVIDd） and left ventricular end-systolic diameter （LVIDs） （P<0.01）. Additionally， the model group also showed increased degrees of inflammatory infiltration and fibrosis of myocardial tissue， significantly elevated levels of serum IL-6 and BNP （P<0.01）， significantly increased mRNA and protein levels of Collagen Ⅰ，Collagen Ⅲ，α-SMA，and mTOR （P<0.01），and markedly decreased mRNA and protein levels of LC3，Beclin-1，and AMPK （P<0.05，P<0.01）. Compared with the model group， the low-，medium-， and high-dose groups of Shenfu Xiongze prescription presented significantly elevated EF and FS values （P<0.01） and lowered LVIDd and LVIDs （P<0.05）. In these groups， the inflammation and fibrosis were alleviated significantly. They also exhibited decreased serum levels of IL-6 and BNP （P<0.01）， significantly reduced protein expression of Collagen Ⅰ， α-SMA， TGF-β₁， p62， and p-mTOR （P<0.01）， significantly decreased mRNA expression of Collagen Ⅰ， Collagen Ⅲ， α-SMA， and mTOR （P<0.01）， and significantly increased mRNA and protein levels of LC3， Beclin-1， and AMPK （P<0.05，P<0.01）. ConclusionThe Shenfu Xiongze prescription can improve the myocardial remodeling induced by ISO in rats by regulating the autophagy level，enhance cardiac function，and reduce inflammatory and fibrotic levels. This effect may be achieved through the AMPK/mTOR signaling pathway.

The repair of bone defects is heavily influenced by the dynamic osteogenic microenvironment. Static scaffolds constructed by traditional 3D printing technology cannot simulate the dynamic nature of the microenvironment during bone defect repair due to the fixed structure, uncontrollable release of active factors, and difficult regeneration of blood vessels, among other factors. Breaking through the limitations of these static scaffolds and realizing the intelligent and dynamic regulation of the osteogenic microenvironment is a key scientific issue in the field of bone tissue engineering. 4D printing technology combines the dynamic responsiveness of bone restoration materials with the concept of intelligent design to regulate the micro and macro structure of scaffolds. This technology provides a new method for bone tissue engineering by responding to endogenous and exogenous stimuli and creating a better osteogenic microenvironment through functionalized design, including drug delivery and antibacterial function. However, this technology currently suffers from challenges related to dynamic response material design, insufficient precision of printing technology, and mismatches between multi-stimulus response systems, metabolic rhythms of bone tissue, and functionalized composite scaffolds. Future research should focus on the development of smart response materials with excellent dynamic responses and bioactivity, the creation of new printing technologies, and the design of personalized and precise bone repair solutions. The aim of this paper is to review the current research status of 4D printing for bone tissue engineering in terms of material types, response mechanisms, and applications to provide a theoretical basis for the development and clinical application of functional bone repair materials in the future.

Objective: To investigate the current status of latent tuberculosis infection (LTBI) among freshmen in junior and senior high schools in Lanzhou, so as to provide scientific basis for improving the tuberculosis prevention and control strategy in schools. Methods: The screening results of 74 516 freshmen in senior and boarding junior high schools in Lanzhou during 2023 and 2024 were collected. The Chi square test and multivariate Logistic regression model were applied to analyze LTBI level, strongly positive risk for tuberculin skin test (TST) and related factors of the freshmen. Results: During 2023 and 2024, the screening rate of tuberculosis among freshmen in senior and boarding junior high schools in Lanzhou was 93.45%, of which the positive rate for TST was 5.71%, the infection rate for LTBI was 3.80%, and the strongly positive rate for TST was 1.24%. There were statistically significant differences in the screening rate of tuberculosis among freshmen in different years, grades, regions, school types and districts ( χ 2=5.34, 2 463.88, 3 516.13, 132.34, 4 436.56, all P <0.05). Multivariate Logistic regression analysis showed that senior high schools ( OR =1.62, 2.18) and urban areas ( OR =2.08, 3.07 ) were all related factors for LTBI and strong positivity for TST among freshmen; schools located in Xigu District, Honggu District, Yongdeng County, Yuzhong County, and Lanzhou New Area ( OR =3.57, 5.67, 9.12, 3.70, 3.64) were related factors of strong positivity for TST among freshmen (all P <0.05). Conclusions The LTBI level among freshmen in senior and boarding junior high schools in Lanzhou is relatively low. Grades and regions are related factors for LTBI and strong positivity for TST.

BACKGROUND:Macrophages play a key role in the occurrence and progression of lung diseases,and autophagy plays an important role in maintaining environmental homeostasis and functional stability in macrophages.It has been suggested that macrophage autophagic activity has two sides in lung inflammatory diseases.OBJECTIVE:To summarize the relationship between macrophage autophagy and lung diseases,thereby providing reference for exploring the prevention and treatment strategies of lung inflammatory diseases by targeting macrophage autophagy.METHODS:Literature retrieval was performed in CNKI and PubMed for relevant literature published from database inception to September 2024.The search terms were"macrophage autophagy,efferocytosis,macrophage polarization,acute lung injury,pneumonia,chronic obstructive pulmonary disease,pulmonary fibrosis,asthma"in Chinese and English,respectively.The search results were included or excluded based on the selection criteria,and 100 papers that met the criteria were finally included in the review.RESULTS AND CONCLUSION:(1)The obstruction of autophagy flow will induce the polarization imbalance of macrophages and impair their efferocytosis,resulting in the increase of M1 macrophages and aggravating inflammation.(2)The judgment of autophagic activity should be based on whether the autophagy flow is smooth or not,and it is essential to evaluate the degradation ability of autophagy.Some studies failed to comprehensively detect the degradation ability of autophagy lysosomes to assess whether the autophagy flow is unobtrusive.As a result,the so-called two-sided view of pulmonary macrophage autophagy in pulmonary inflammatory diseases in such studies is actually related to the one-sided judgment of autophagy activity.(3)The pathological manifestations vary across different pulmonary diseases and even at different stages of the same disease.Activation of macrophage autophagy plays a positive role in regulating pulmonary inflammatory homeostasis in conditions such as acute lung injury,infectious pneumonia,mild chronic obstructive pulmonary disease,early-stage pulmonary fibrosis,and secondary asthma.However,in the severe fibrotic stage of chronic obstructive pulmonary disease and the progressive stage of pulmonary fibrosis,the activation of pulmonary macrophage autophagy aggravates pulmonary fibrosis,reflecting the dual nature of macrophage autophagy.In allergic asthma,autophagy is activated in lung-resident macrophages but suppressed in infiltrating monocyte-derived macrophages from circulation.The former is closely related to airway stenosis,and the latter aggravates pneumonia disorders.Therefore,identifying the types and progression stages of lung diseases,along with accurately assessing autophagic activity,is crucial for future investigations into the relationship between macrophage autophagy and disease pathogenesis,thereby facilitating the development of therapeutic strategies in the future.

Extracorporeal circulation serves as a vital auxiliary approach in cardiac surgery, and its introduction and application have directly driven a clinical revolution in cardiac surgical procedures. With the continuous advancement of clinical techniques in cardiac surgery, extracorporeal circulation technology has undergone constant innovation. To align with the trend of minimally invasive surgery, minimally invasive extracorporeal circulation (MiECC) technology has emerged. Its feasibility and safety have been preliminarily verified in clinical practice. This paper synthesizes domestic and international literature to expound on the development of MiECC and its advantages in clinical applications, aiming to further promote its adoption in China.

This study investigated the prevalence of hepatitis E virus(HEV)in rodents within the Inner Mongolia Autonomous Region.In 2024,liver,spleen,kidney,and lung tissue samples were collected from rodents in 11 leagues and cities across the Inner Mongolia Autonomous Region,including Hohhot,Baotou,Hulunbuir,Xing'an League,Tongliao,Chifeng,Xilin Gol League,Ulan-qab,Ordos,Bayannur,and Wuhai.Nested PCR(RT-PCR)was used to detect the conserved regions of the HEV open reading frame 1(ORF1)gene.The RT-PCR-positive products were sequenced,and phylogenetic and homology analysis of the obtained sequences was performed.A total of 816 rodents were captured in this investigation,including 319 Rattus norvegicus(39.09%,319/816),206 Musmusculus(25.25%,206/816),and 140 Mongolian gerbils(17.16%,140/816).The HEV infection rate among rodents in the In-ner Mongolia region was 3.68%(30/816).Sequencing of the RT-PCR-positive results and analysis of the nucleotide sequences yielded 30 HEV-positive rodent samples.Phylogenetic analysis identified these sequences as belonging to the HEV-C1 genotype.The prevalence of HEV was observed in brown rats(Rattus norvegicus)in five leagues and cities within the Inner Mongolia region,includ-ing Xing'an League,Chifeng City,Hulunbuir City,Xilin Gol League,and Tongliao City,with infection rates of 16.67%,10.00%,5.98%,3.30%,and 2.50%,respectively.Brown rats,a species of house rats,frequently inhabit areas near human residences and have close interactions with humans and livestock.Studies have shown that multiple subtypes of HEV can cause zoonotic infections.Therefore,strengthening the monitoring of pathogens carried by rodents in residential environments and optimizing the prevention and control of rodent-borne diseases will be essential.Timely dissemination of relevant infectious disease knowledge to local communities will also be crucial,to decrease the risk of human infection.

Objective:To explore the intervention effect of health nutrition model based on digital management on patients with gestational diabetes mellitus, and to provide reference for blood sugar control and pregnancy outcome improvement of gestational diabetes mellitus.Methods:Using a randomized controlled study method, totally 80 cases of gestational diabetes mellitus admitted to Langfang People's Hospital from October 2021 to March 2023 were prospectively selected and randomly divided into control group and experimental group according to the random number table method, with 40 cases in each group. The control group was given routine management, and the experimental group was combined with the health nutrition model based on digital management on this basis. Both groups began to intervene after the diagnosis of gestational diabetes mellitus, and the intervention lasted until one week before the patient's expected delivery. Follow-up to delivery. The delivery mode, weight gain during pregnancy, insulin use during pregnancy, pregnancy outcome and neonatal outcome of the two groups were statistically analyzed. The blood glucose level of the two groups before and after intervention were compared.Results:The age of the control group was 20-31 (26.25 ± 1.98) years old, while the age of the experimental group was 20-33 (25.93 ± 2.11) years old. The cesarean section rate in the experimental group was 32.50% (13/40), which was lower than that in the control group (57.50%, 23/40) ( χ2=5.05, P<0.05). The weight gain during pregnancy in the experimental group was (6.03 ± 0.89) kg, which was lower than (7.93 ± 1.36) kg in the control group ( t=7.39, P<0.05). After intervention, the levels of serum glycosylated hemoglobin, fasting blood glucose and 2 h postprandial blood glucose in the two groups were lower than those before intervention, and those in the experimental group were (5.19 ± 0.54) %, (4.98 ± 0.49) mmol/L, (6.04 ± 1.15) mmol/L, which were lower than (5.67 ± 0.75) %, (5.37 ± 0.54) mmol/L, (7.16 ± 1.36) mmol/L in the control group ( t=3.28, 3.42, 3.96, all P<0.05). The proportion of macrosomia in the experimental group was 2.50% (1/40), which was lower than 20.00% (8/40) in the control group ( χ2=4.51, P<0.05). The experimental group had no abnormal pregnancy outcome and neonatal outcome respectively as 92.50% (37/40) and 92.50% (37/40), which were 70.00% (28/40) and 57.50% (23/40) in the control group, their difference was statistically significant ( χ2=6.65, 13.07, both P<0.05). Conclusions:The application of health nutrition model based on digital management to intervene in patients with gestational diabetes could effectively improve their blood glucose control effect, improve pregnancy outcome and neonatal outcome, and hada good intervention effect.

Bisphenol A (BPA) is an environmental chemical that is widely exposed in human daily life. It has attracted much attention because of its estrogenic effect. Polycystic ovary syndrome (PCOS) is the most common endocrine metabolic disease in women of reproductive age. Its pathogenesis involves the interaction of genetic, environmental and endocrine disorders. In recent years, more and more studies have shown that BPA plays an important role in the occurrence and development of PCOS. BPA promotes the development of PCOS by interfering with insulin sensitivity, immune response and changing ovarian structure and function. In addition, BPA exposure levels are associated with hyperandrogenism, insulin resistance, obesity, dyslipidemia, and decreased ovarian reserve in PCOS patients. This review summarizes the effects of BPA on PCOS in terms of ovarian function, glucose and lipid metabolism, and inflammatory response, so as to provide theoretical basis for clinical intervention and prevention of BPA in the development of PCOS.

Objective:To investigate the relationship between the neutrophil- to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), C-reactive protein (CRP), and the efficacy of immunotherapy in patients with advanced non-small cell lung cancer (NSCLC).Methods:The clinical data of 47 patients with NSCLC who received immunotherapy at The First Affiliated Hospital of Anhui University of Science and Technology from December 2021 to May 2023 were retrospectively analyzed. Based on the duration of immunotherapy, patients with a duration of more than 1 year were classified as having a good immune response, while those with a duration of less than 1 year were classified as having a poor immune response. The clinical pathological characteristics of patients with good and poor immune responses were compared. The cutoff values for NLR, LMR, and CRP were calculated using receiver operating characteristic curves, and patients were grouped based on these cutoff values. The predictive probabilities of different combinations were compared. Univariate and multivariate Cox analyses were performed to identify factors affecting patient survival.Results:Significant differences were observed in the distribution of therapy lines (1 st-line vs. 2 nd-line treatment), NLR, LMR, and CRP levels between patients with good immune response and those with poor immune responses (all P < 0.05). The area under the curve (AUC) for NLR was 0.763 [95% CI: (0.608, 0.918)], the AUC for LMR was 0.715 [95% CI: (0.544, 0.875)], and the AUC for CRP was 0.697 [95% CI: (0.540, 0.853)]. To assess the diagnostic value of combined indicators in predicting the efficacy of immunotherapy in NSCLC, different indicators were combined, resulting in the variables NLR + LMR, NLR + CRP, LMR + CRP, and NLR + LMR + CRP. Receiver Operating Characteristic curves were plotted based on the probabilities. The combination of NLR + LMR + CRP showed the best predictive performance, with an AUC of 0.897 [95% CI: (0.806, 0.988)]. Univariate and multivariate Cox analyses indicated that LMR [ HR: 0.428; 95% CI: (0.213, 0.858), P = 0.017] and the distribution of treatment lines [ HR: 1.815; 95% CI: (1.005, 3.642), P = 0.033] were important independent prognostic factors for progression-free survival. Conclusions:NLR, LMR, and CRP are correlated with immunotherapy efficacy in patients with NSCLC and provide predictive value. LMR and treatment line are independent prognostic factors for progression-free survival.