ObjectiveTo observe the clinical efficacy and safety of Huatan Quyu formula in treating cerebral small vessel disease （CSVD） with phlegm and blood stasis blocking collateral pattern via randomized controlled trial， and explore its mechanism of improving CSVD by regulating glymphatic system （GS） circulation. MethodsSixty-eight CSVD patients with phlegm and blood stasis blocking collateral pattern in the Department of Encephalopathy， Affiliated Hospital of Shaanxi University of Chinese Medicine from April to December 2024 were selected and randomly divided into an experimental group （34 cases） and a control group， with 34 cases in each group. Both groups received basic Western medicine treatment， while the experimental group additionally received Huatan Quyu formula. After a course of 12 weeks， the following parameters were compared between the two groups before and after treatment. Clinical outcomes were assessed using the Tinetti performance-oriented mobility assessment （POMA）， Montreal Cognitive Assessment （MoCA）， Scales for Outcomes in Parkinson's Disease-Autonomic （SCOPA-AUT）， and traditional Chinese medicine （TCM） syndrome scores of phlegm and blood stasis blocking collateral pattern. Perivascular space （PVS） in the frontal lobe/basal ganglia and cerebrospinal fluid （CSF） flow parameters in the cerebral aqueduct were evaluated by 3.0T brain MRI， cerebrospinal fluid flow imaging， and phase-contrast magnetic resonance imaging （PC-MRI）. Then， safety indicators were monitored， and SPSS 25.0 was used for statistical analysis. ResultsSixty-four patients completed the study （32 in each group）. ①Baseline data： No statistically significant difference was found between the two group. ②Efficacy indicators： After treatment， the experimental group exhibited significantly improved total POMA， SCOPA-AUT， and TCM syndrome scores （P<0.01）， outperforming the control group （P<0.05）. No significant change was observed in MoCA scores between the two groups. ③Imaging indicators： The experimental group showed a reduced PVS area alongside significantly increased CSF flow parameters （including downward flow during the systolic period， and upward flow during the diastolic period） （P<0.01）， which were superior to the control group （P<0.01）. ④Safety： The laboratory indicators were normal in both groups， with no drug-related adverse reactions. ConclusionFor CSVD patients with phlegm and blood stasis blocking collateral pattern， Huatan Quyu formula can safely and effectively improve motor function， autonomic nerve function， and TCM syndromes， with potential mechanisms related to pulsatile CSF flow enhancement and GS circulation efficiency improvement.

N⁶-methyladenosine (m⁶A) modification plays a critical role in cell cycle regulation, while the mechanism of m⁶A in regulating mitosis remains underexplored. Here, we found that the total m⁶A modification level in cells increased during mitosis by the liquid chromatography-mass spectrometry/mass spectrometry and m⁶A dot blot assays. Silencing methyltransferase-like 3 (METTL3) or METTL14 results in delayed mitosis, abnormal spindle assembly, and chromosome segregation defects by the immunofluorescence. By analyzing transcriptome-wide m⁶A targets in HeLa cells, we identified polo-like kinase 1 (PLK1) as a key gene modified by m⁶A in regulating mitosis. Specifically, through immunoblotting and RNA pulldown, m⁶A modification inhibits PLK1 translation via YTH N⁶-methyladenosine RNA binding protein 1, thus mediating cell cycle homeostasis. Demethylation of PLK1 mRNA leads to significant mitotic abnormalities. These findings highlight the critical role of m⁶A in regulating mitosis and the potential of m⁶A as a therapeutic target in proliferative diseases such as cancer.
Humans ; Polo-Like Kinase 1 ; Cell Cycle Proteins/metabolism* ; Proto-Oncogene Proteins/metabolism* ; Protein Serine-Threonine Kinases/metabolism* ; Mitosis/physiology* ; HeLa Cells ; Adenosine/genetics* ; Methyltransferases/metabolism* ; RNA, Messenger/metabolism* ; RNA-Binding Proteins/metabolism*

Micro/nanoplastics (MNPs), recognized as emerging environmental pollutants, are widely distributed in natural environments. Due to their small particle size and significant migratory capacity, MNPs can infiltrate diverse environmental matrices, then invade and accumulate in the organism via the skin, respiration, and digestion. Recently, concerns have grown over the detrimental effects and potential toxicity of MNPs on reproductive health. This review summarized published epidemiological and toxicological studies related to MNPs exposure and their effects on reproductive health. Firstly, this review critically examined the current landscape of epidemiological evidence and found that MNPs (e.g., polystyrene, polypropylene, polyvinyl chloride, polyethylene, etc.) are present in various biological specimens from both males and females, and their presence may be associated with an increased risk of reproductive disorders. Secondly, extensive toxicological studies revealed that MNPs exposure induces reproductive health damage through mechanisms such as disrupting the microstructure of reproductive organs and altering molecular-level expressions. Oxidative stress, inflammatory responses, and apoptosis are identified as potential links between MNPs exposure and reproductive damage. Finally, this review addressed the prevalent shortcomings in existing studies and proposed future directions to tackle the challenges posed by MNPs-induced reproductive harm. These insights aim to inform strategies for safeguarding public reproductive health and ecological security, providing a scientific foundation for mitigating risks associated with MNPs pollution.

Objective:To investigate the effect of "four-staff co-management" follow-up mode on risk factor control and medium-term prognosis improvement in patients with coronary heart disease after percutaneous coronary intervention (PCI).Methods:This was a intervention study. Patients with coronary heart disease who were admitted to the Xiamen Cardiovascular Hospital of Xiamen University from June 2021 to January 2022 and successfully discharged after PCI were included. According to the different types of follow-up after discharge, patients were divided into the traditional follow-up group and the "four-staff co-management" follow-up group. The "four-staff co-management" follow-up mode means that specialists, specialist managers in third-level A hospitals and general practitioners and health managers in basic hospitals were jointly responsible for post-discharge follow-up of PCI patients. Baseline clinical data were collected. The primary endpoints were the rate of compliance of coronary heart disease risk factor control at 12 months after surgery, the rate of secondary surgery, and the incidence of mid-term major adverse cardiovascular and cerebrovascular events (MACCE). Unplanned secondary PCI included symptom-driven secondary PCI and asymptomatic secondary PCI. MACCE includes myocardial infarction, hospitalization for heart failure, stroke, major bleeding, all-cause death, and composite endpoints including these events.Results:A total of 2 181 patients were enrolled, including 1 097 patients in the traditional follow-up group and 1 084 patients in the "four-staff co-management" follow-up group. At baseline, there were no statistically significant differences in gender, age, discharge diagnosis, co-existing diseases, echocardiographic indexes, and coronary artery lesions between the two groups (all P>0.05). There were no significant differences between the two groups in total PCI stent length, maximum internal diameter of stent, proportion of patients using drug balloon, proportion of patients with a planned second surgery during hospitalization, and discharge with drugs (all P>0.05). Twelve months after PCI, the reduction in HbA1c and low-density lipoprotein cholesterol was greater in the "four-staff co-management " follow-up group than that in the traditional follow-up group (all P<0.05), and the rate of reaching the standard for low-density lipoprotein cholesterol was higher than that in the traditional follow-up group ( P=0.001), but there was no statistical significance between the two groups for blood pressure and blood glucose (all P>0.05). During the follow-up period, the proportion of symptom-driven second operation patients was lower in the "four-staff co-management" follow-up group than that in the traditional follow-up group ( P<0.001), and there was no significant difference in the proportion of asymptomatic second operation patients between the two groups ( P=0.191). The proportion of hospitalized patients with heart failure in the "four-staff co-management" follow-up group was lower than that in the traditional follow-up group ( P=0.029), and there was no significant difference in the proportion of myocardial infarction, cerebral infarction, cerebral hemorrhage, massive hemorrhage, death and complex endpoint events between the two groups (all P>0.05). Conclusion:The "four-staff co-management" follow-up mode can effectively improve the control of risk factors and medium-term prognosis in patients with coronary heart disease after PCI.

Objective To evaluate the results of anorectal dynamics in patients with severe rec-tocele.Methods A retrospective analysis was conducted on the clinical data of 38 patients defini-tively diagnosed with severe rectocele at the pelvic floor center of the anorectal department of Nanjing Hospital of Traditional Chinese Medicine from January 2020 to January 2023.All patients underwent anorectal manometry,and the results of anorectal dynamics were analyzed.Results A total of 15 pa-tients(39.47％)had elevated anal resting pressure(ARP),20(52.63％)had normal ARP,and 3(7.89％)had decreased ARP.Five patients(13.16％)had elevated maximum anal sphincter pressure(MASP),9(23.68％)had normal MASP,and 24(63.16％)had decreased MASP.Nor-mal defecation relaxation reflex was observed in 15 patients(39.47％),and abnormal defecation re-laxation reflex was observed in 23 patients(60.53％).Ten patients(26.32％)had normal rectal defecation pressure,and 28(73.68％)had decreased rectal defecation pressure.Eleven patients(28.95％)had elevated rectal initial sensory threshold(RIST),27(71.05％)had normal RIST.Fifteen patients(39.47％)had elevated rectal defecation sensory threshold,21(55.26％)had normal rectal defecation sensory threshold,and 2(5.26％)had decreased rectal defecation sensory threshold.Three patients(7.89％)had elevated rectal maximum tolerable volume,26(68.42％)had normal rectal maximum tolerable volume,and 9(23.68％)had decreased rectal maximum tolerable vol-ume.ARP was moderately positively correlated with the chronic constipation severity(CSS)score(P=0.007,r=0.429),and abnormal defecation relaxation reflex was moderately negatively correla-ted with the CSS score(P=0.019,r=-0.329).In 3 patients(7.89％),both ARP and MASP were decreased,and both ARP and MASP were elevated in 5 patients(13.16％).Conclusion Pre-operative anorectal dynamics analysis is necessary for patients with severe rectocele to formulate a reasonable individualized surgical plan and postoperative rehabilitation program.

Objective To analyze the efficacy of modified transvaginal rectal repair(MTVRR)in patients with moderate to severe rectocele(RC).Methods A retrospective analysis was conducted on the clinical data of 21 female patients with RC who underwent MTVRR.The Constipation Scoring System(CSS)scale was used to assess patients'constipation symptoms before surgery and at 3,6,12 and 24 months after surgery,and the efficiency of symptom improvement was recorded.The occurrence of postoperative complications in RC patients was observed.Results All 21 patients successfully un-derwent the surgery,with surgical duration ranging from 25 to 135 minutes,with average of(83.14±30.39)minutes,and hospital stay ranging from 10 to 21 days,with average of(14.10±2.34)days.Postoperatively,one patient was lost during follow-up among 21 patients.The CSS scores of the remai-ning 20 patients were lower than those before surgery,with a statistically significant difference(P＜0.05).The overall effective rates of constipation symptom improvement at 3,6 and 12 months postop-eratively were 100.00％,90.00％and 80.00％,respectively.Among 20 patients,15 patients com-pleted 24-month follow-up after surgery,and the CSS score after surgery was lower than that before sur-gery,the difference was statistically significant(P＜0.05).The CSS scores of the remaining 15 pa-tients were lower than those before surgery,with a statistically significant difference(P＜0.05).The overall effective rate of constipation symptom improvement at 24 months postoperatively was 80.00％among 15 patients.During postoperative follow-up,it revealed that no complications occurred in any patient.Conclusion MTVRR can improve constipation symptoms in patients with RC,demonstra-ting good therapeutic efficacy.

Objective:To investigate the current situation and changing trends of coal-burning-borne endemic fluorosis (coal-burning-borne fluorosis) areas in Henan Province, and evaluate the effectiveness of prevention and control measures.Methods:From 2019 to 2021, monitoring was carried out in all villages affected by coal-burning-borne fluorosis in Henan Province. A simple random sampling method was used to select 30 households in each affected village each year to investigate the use of stoves and the formation of related healthy living behaviors. According to the criteria of "Diagnosis of Dental Fluorosis" (WS/T 208-2011), all children aged 8 to 12 in the affected villages were examined for dental fluorosis. The evaluation for control and elimination of the disease areas was carried out in accordance with the "Evaluation Approach for Control and Elimination of Priority Endemic Diseases (2019 Edition)".Results:From 2019 to 2021, a total of 7 472 households were monitored, the rate of qualified improved stoves were all ≥99.80%, the correct use rate of qualified improved stoves and correct drying of corn and pepper were reached 100%. From 2019 to 2021, the prevalence of dental fluorosis in children was 5.38% (237/4 405), 5.18% (232/4 477), and 3.68% (145/3 937), respectively, showing a declining trend (χ 2trend = 12.73, P < 0.001). The prevalence of dental fluorosis among children in affected villages was less than 15%. From 2019 to 2021, all affected villages in coal-burning-borne fluorosis in Henan Province had met the elimination criteria. Conclusion:Coal-burning-borne fluorosis areas in Henan Province have been continuously eliminated, with significant prevention and control effects, and the disease has been effectively controlled.

Objective To systematically evaluate robot-assisted gait training(RAGT)on motor function,ambulation and activities of daily living of patients after stroke and spinal cord injury(SCI),and to investigate the clinical value of differ-ent robotic technologies and control strategies.Methods In accordance with PRISMA guidelines,relevant randomized controlled trials(RCTs)published between 2020 and 2024 were identified from databases including Scopus,Web of Science,PubMed,Cochrane Library and CNKI.The PEDro scale was used to assess methodological quality,and a comprehensive analysis was performed on the therapeutic effects of RAGT on walking ability,balance,lower limb muscle strength and functional inde-pendence.Results Eight RCTs involving 702 participants were included,originating from countries such as China,Italy,India,Tur-key and Poland.The population consisted of adult patients with various subtypes of stroke or SCI.These studies were published in journals across geriatric neuroscience,biosciences,medicine and sports science.Interventions involved three categories of lower limb exoskeleton including treadmill-based systems(end-effector and exoskel-eton models),overground exoskeletons and specialized joint/platform-based robots.The training frequency was 20 to 45 minutes a time,once to twice a day,one to seven days a week,for a total of two to ten weeks.RAGT might significant improve gait parameters and lower limb muscle strength,though its impact on functional inde-pendence was heterogeneous.Adaptive control strategies(e.g.,assist-as-needed)proved superior to fixed-parame-ter modes.Treadmill-based systems(e.g.,Lokomat)were well-suited for early-stage rehabilitation,while over-ground exoskeletons(e.g.,EKSO-GT)better facilitated adaptation to real-world environments.Conclusion RAGT is an effective modality for improving gait and lower limb function of patients with stroke and SCI.The therapeutic outcome is contingent upon personalized setup of the exoskeleton and the implementation of adaptive control strategies.Different adaptive control modes have been developed for the three main types of lower limb exoskeleton.Rehabilitation training should consider the specific lower limb tasks with the robot's cor-responding adaptive movement and control modes.

Objective:To establish a reference interval for serum iodine of pregnant women with normal thyroid function and to analyze the relationship between serum iodine and thyroid disease risk.Methods:From July 2022 to October 2023, using cross-sectional survey method, pregnant women aged 18 to 48 years old who had lived in iodine-deficient areas in the six provinces of China (Shanxi Province, Fujian Province, Yunnan Province, Xinjiang Uygur Autonomous Region, Zhejiang Province, and Anhui Province) for more than six months were selected as the survey subjects. Blood samples were collected, serum iodine was tested, and the percentile method was used to establish a reference interval for serum iodine of pregnant women with normal thyroid function. Meanwhile, serum levels of free thyroxine, thyroid stimulating hormone, thyroglobulin antibody (TgAb), and thyroid peroxidase antibody (TPOAb) were tested, and logistic regression was used to analyze the relationship between serum iodine and thyroid disease risk.Results:A total of 1 409 pregnant women from 6 provinces were investigated, including 1 087 with normal thyroid function and 322 with abnormal thyroid function. The median serum iodine level of pregnant women with normal thyroid function was 79.74 μg/L, and the preliminary reference interval for serum iodine was 47.57 - 128.96 μg/L. When serum iodine levels were lower (< 47.57 μg/L), pregnant women had a significantly increased risk of developing TgAb positivity, TPOAb positivity, hypothyroxinemia, hypothyroidism, and autoimmune thyroiditis ( OR = 4.44, 2.91, 3.41, 41.67, 23.43, P < 0.05). When serum iodine levels were high (> 128.96 μg/L), pregnant women had a significantly increased risk of developing hyperthyroidism ( OR = 9.91, P = 0.001). Conclusions:The reference interval for serum iodine of pregnant women with normal thyroid function is successfully established. Low serum iodine levels are associated with an increased risk of TgAb positivity, TPOAb positivity, hypothyroxinemia, hypothyroidism, and autoimmune thyroiditis, while high serum iodine levels are associated with an increased risk of hyperthyroidism.