BACKGROUND:Several observational studies have found a close relationship between thyroid function levels and sarcopenia,but the causal relationship between thyroid function levels and the onset of sarcopenia is not yet clear. OBJECTIVE:To investigate the causal relationship between thyroid function levels and sarcopenia using a two sample Mendelian randomization method. METHODS:A two sample Mendelian randomization analysis was conducted using genome-wide association study data on thyrotropin,free triiodothyronine,free tetraiodothyronine,subclinical hyperthyroidism,subclinical hypothyroidism,and four related phenotypes of sarcopenia-lefthand grip strength,right hand grip strength,limb lean mass,and gait speed.The inverse-variance weighted method,weighted median method,simple mode method,weighted median estimator method,and MR Egger regression method were used as analysis methods,while heterogeneity test,pleiotropy test,MR-PRESSO,leave-one-out method,funnel plot and other methods were used for sensitivity analysis. RESULTS AND CONCLUSION:Elevated levels of thyroid-stimulating hormone increased left-(β=0.02,SE=0.01,P=0.01)and right-handed grip strength(β=0.02,SE=0.01,P=0.01),an increase in free triiodothyronine decreased left-(β=-0.06,SE=0.02,P=9.5×10-5)and right-handed grip strength(β=-0.07,SE=0.02,P=9.3×10-5),and subclinical hyperthyroidism decreased gait speed(β=-4.4×10-3,SE=1.7×10-3,P=0.01).The sensitivity analysis results were basically consistent with the main analysis results.To conclude,an increase in thyroid-stimulating hormone is a protective factor for sarcopenia,and elevation of free triiodothyronine and subclinical hyperthyroidism may increase the risk of sarcopenia.

Petroleum hydrocarbon pollution has become one of the global environmental problems, posing a serious threat to the environment and human health. Microbial remediation plays an important role in the remediation of petroleum hydrocarbon-contaminated environment. Nevertheless, the stress factors present in the environment polluted by petroleum hydrocarbons limit the effectiveness of microbial remediation. This paper reviews the common stress factors in petroleum hydrocarbon-polluted environment and the response mechanisms of microorganisms to these factors. Furthermore, we introduce the methods to improve microbial tolerance, such as irrational modification, rational modification based on systems biology tools or tolerance mechanisms, and the construction of microbial consortia. The application of these methods is expected to improve the viability and remediation efficiency of microorganisms in petroleum hydrocarbon-contaminated environment and provide new perspectives and technical support for environmental remediation.
Biodegradation, Environmental ; Petroleum/metabolism* ; Hydrocarbons/isolation & purification* ; Bacteria/genetics* ; Environmental Pollutants/isolation & purification* ; Petroleum Pollution

Objective:To investigate the risk factors of acute respiratory distress syndrome(ARDS)after traumatic hemorrhagic shock.Methods:This was a retrospective cohort study of 314 patients with traumatic hemorrhagic shock at Trauma Medicine Center,Peking University People's Hospital from De-cember 2012 to August 2021,including 152 male patients and 162 female patients,with a median age of 63.00(49.75-82.00)years.The demographic data,past medical history,injury assessment,vital signs,laboratory examination and other indicators of these patients during hospitalization were recorded.These patients were divided into two groups,ARDS group(n=89)and non-ARDS group(n=225)ac-cording to whether there was ARDS within 7 d of admission.Risk factors for ARDS were identified using Logistic regression.The C-statistic expressed as a percentage[area under curve(AUC)of the receiver operating characteristic(ROC)curve]was used to assess the discrimination of the model.Results:The incidence of ARDS after traumatic hemorrhagic shock was 28.34％.Finally,Logistic regression model showed that the independent risk factors of ARDS after traumatic hemorrhagic shock included male,histo-ry of coronary heart disease,high acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,road traffic accident and elevated troponin Ⅰ.The OR and 95％confidence intervals(CI)were 4.01(95％CI:1.75-9.20),5.22(95％CI:1.29-21.08),1.07(95％CI:1.02-1.57),2.53(95％CI:1.21-5.28),and 1.26(95％CI:1.02-1.57),respectively;the P values were 0.001,0.020,0.009,0.014,and 0.034,respectively.The ROC curve was used to analyze the value of each risk factor in predicting ARDS.It was found that the AUC for predicting ARDS after traumatic hemor-rhagic shock was 0.59(95％CI:0.51-0.68)formale,0.55(95％CI:0.46-0.64)for history of coronary heart disease,0.65(95％CI:0.57-0.73)for APACHE Ⅱ score,0.58(95％CI:0.50-0.67)for road traffic accident,and 0.73(95％CI:0.66-0.80)for elevated troponin Ⅰ,with an overall predictive value of 0.81(95％CI:0.74-0.88).Conclusion:The incidence of ARDS in pa-tients with traumatic hemorrhagic shock is high,and male,history of coronary heart disease,high APACHE Ⅱ score,road traffic accident and elevated troponin Ⅰ are independent risk factors for ARDS after traumatic hemorrhagic shock.Timely monitoring these indicators is conducive to early detection and treatment of ARDS after traumatic hemorrhagic shock.

Background In the Global Burden of Disease research, it has been found that atmospheric fine particulate matter (PM_2.5) pollution significantly harms human health. Currently, there is limited research on polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) that exhibit high toxicity effects in PM_2.5 . Objective By studying the spatiotemporal distribution and variation characteristics of PCDD/Fs in PM_2.5 in Pudong area of Shanghai, to assess the associated population health risk. Methods This study set up 28 sampling points in Pudong area. One sample of PM_2.5 was collected during winter (February 2022) and summer (July 2022) at each site, with a sampling period lasting 24 h. The concentration of PM_2.5 was measured by membrane filter method, and the content of 17 kinds of 2,3,7,8-substituted chlorinated PCDD/Fs in the samples was analyzed using isotope dilution. Seasonal variations (winter and summer) in the concentrations of PM_2.5 and PCDD/Fs were evaluated, sources of PCDD/Fs pollution were tracing by principal component analysis, and health risks to the population from respiratory exposure to PCDD/Fs were estimated by VLIER-HUMAAN model. Results The PM_2.5 concentrations in the 28 samples ranged from 10 to 126 μg·m⁻³, while the concentrations of PCDD/Fs in PM_2.5 ranged from 58 to 2625 fg·m⁻³. The concentration of PM_2.5 during winter (11-126 μg·m⁻³) was higher than that during summer (10-60 μg·m⁻³). The concentration range of PCDD/Fs in winter was from 58 to 2625 fg·m⁻³, which corresponded to a range of toxic equivalent quantity (WHO-TEQ) concentration from 2.99 to 40.97 fg·m⁻³ when taking World Health Organization's toxic equivalency factor (WHO-TEQ); the concentration range of PCDD/Fs in summer was from 72 to 446 fg·m⁻³, which corresponded to a range of WHO-TEQ concentration from 2.66 to 16.61 fg·m⁻³. This range in summer was significantly lower than that observed in winter. The results of principal component analysis revealed that waste incineration was the primary source of PCDD/Fs in winter PM_2.5 in the area, whereas traffic emissions emerged as the main source in summer. The assessment of Pudong residents' respiratory exposure to PCDD/Fs in PM_2.5 showed significantly higher exposure of children in summer and winter than that of adults, indicating higher susceptibility of children to air pollutants. Both the hazard ratios (HR) for children and adults were below 1, while the cancer risks (CR) ranged from 8.41×10⁻⁸ to 2.35×10⁻⁶. Notably, during winter, the CR at 4 locations slightly exceeds 1×10⁻⁶, indicating a potential carcinogenic risk. Conclusion The overall pollution level of PCDD/Fs in PM_2.5 in Pudong area is relatively low, but it shows clear seasonal patterns. Waste incineration and traffic are the main sources of PCDD/Fs in PM_2.5 in the area. Although the cancer risk of exposure to PCDD/Fs in PM_2.5 for children or adults is relatively low, there is a certain risk at some locations in winter, necessitating additional monitoring and control.

Objective To explore the clinical efficacy of fluoxetine hydrochloride capsules and escitalopram oxalate tablets in the treatment of first-episode depression disorder.Methods Eighty patients with first-episode depression disorder who were hospitalized in the 14th district of Integrated Traditional Chinese and Western Medicine of Xiamen Xianyue Hospital from February to November 2023 were selected,and divided into fluoxetine hydrochloride capsules group(n=40)and escitalopram oxalate tablets group(n=40)according to random number method;Conducted the Hamilton depression scale(HAMD)estimates before treatment and four weeks after treatment,to analyze and compare the clinical efficacy of two groups.Results After four weeks of treatment,the HAMD scores of all patients significantly decreased compared to before treatment in this group(P＜0.01);There was no statistically significant difference between two groups(P＞0.05).There was no statistically significant difference in the total effective rate between two groups(P＞0.05).Conclusion Escitalopram oxalate tablets and fluoxetine hydrochloride capsules were both effective in treatment of the first-episode depression disorder patients,and the total effective rates of them were similar.

Objective:To investigate the effect of ship-shaped expanded polytetrafluoroethylene (e-PTFE) nasal prosthesis in rhinoplasty.Methods:From February 2016 to June 2021, 86 patients, including 9 males and 77 females, aged 18-47 (24±5) years old, were admitted to Chengdu High-tech Zone Xinyuerong Medical Aesthetic Clinic for cosmetic treatment of rhinoplasty. All patients underwent rhinoplasty with the application of ship-shaped e-PTFE and autologous cartilage. The postoperative complications, glabellar fullness, inverted brow triangle, nasal polygon aesthetic shape and patient satisfaction were evaluated. These data were measured and analyzed, including the nasal length, nasal tip height, nasal frontal angle and nasal facial angle before and after the operation.Results:In 86 patients, the incision healed in one stage after surgery, and 8 cases had nasal vestibular scar hyperplasia. All patients were followed up for 1-5 years: 84 cases obtained satisfactory nasal morphology, and 2 cases recovered naturally after adjusting and lowering the prosthesis height half a year after surgery because the interbrow area was too full. 74 patients (86%) were very satisfied, 10 cases (11.6%) were satisfied. The nasal length was (4.07±0.20) cm, the nasal tip height was (2.66±0.36) cm, the nasal frontal angle was (106.42±8.04)°, and the nasal face angle was (15.90±0.85)°before operation. The nasal length was (4.23±0.20) cm, the nasal tip height was (2.59±0.26) cm, the naso-frontal angle was (113.69±6.34)°, and the naso-facial angle was (21.57±0.78)° at eighteen months after operation. There were statistically significant differences in nasal length, naso-frontal angle and naso-facial angle ( t=-5.51, -5.96, -52.31, P<0.01), but no statistically significant differences in nasal tip height ( t=1.47, P=0.146). Conclusions:The ship-shaped e-PTFE can be shaped to reflect the aesthetic of the nose dorsum, which is similar to the anatomical structure of the nose dorsum, increase the stability and authenticity of the prosthesis, and is worthy of clinical application.

【Objective】 To evaluate the effect of one-beat acquisition with wide detector CT on the image quality and diagnostic efficiency of coronary CT angiography (CCTA) in patients with atrial fibrillation. 【Methods】 A total of 52 consecutive patients with atrial fibrillation, including 31 males, (67.32±11.45) years old, who underwent CCTA from July 2022 to February 2023, were analyzed retrospectively. All patients underwent one-beat acquisition CCTA. The subjective and objective image quality of the coronary arteries was evaluated, and using invasive coronary catheter angiography as the gold standard, the diagnostic efficacy of stenosis degrees above moderate and severe degrees was calculated, respectively. 【Results】 Subjective evaluation results: 92.31% (384/416) of the vascular segments were rated as excellent or good, and the diagnosable rate reached 98.08% (408/416, subjective score ≥3 points). Objective evaluation results: The CT value of the right coronary artery, anterior descending branch, and circumflex branch was (433.41±95.17)HU, (422.69±92.81)HU and (420.27±95.43)HU, respectively; the contrast-to-noise ratio was 38.46±7.54, 32.46±13.78 and 37.74±8.89, respectively. The total diagnostic accuracy, sensitivity, and specificity was 94.71%, 87.9% and 96.62%, respectively, for moderate stenosis and 96.15%, 83.64% and 98.06% for severe stenosis. 【Conclusion】 One-beat acquisition with wide detector CT can obtain high-quality coronary artery images and high diagnostic accuracy for patients with atrial fibrillation without radiation dose increase to patients. It has good clinical application value for patients with atrial fibrillation.

Lung cancer is the malignant tumor with the highest morbidity and mortality in China. Non-small cell lung cancer (NSCLC) is the main pathological subtype of lung cancer. On April 13, 2023, the National Comprehensive Cancer Network (NCCN) released the third edition of the 2023 NCCN Oncology Clinical Practice Guidelines: Non-small Cell Lung Cancer, which reflects the latest advances in international lung cancer research. This article will interpret the main updated contents of the new edition of the guidelines, and compare it with the third edition of the NCCN guidelines in 2022, so as to provide references about the diagnosis and treatment of NSCLC for clinical medical personnel in China.
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Humans ; Carcinoma, Non-Small-Cell Lung ; China ; Lung Neoplasms ; Thorax

Objective: To explore the factors associated with the transplant outcomes after the treatment of preimplantation genetic testing (PGT) for infertile patients. Methods: A retrospective analysis of data of frozen⁃thawed embryo transfers in PGT for structural rearrangements/PGT for monogenic ( PGT⁃SR/PGT⁃M) cycles was performed. According to the transplant outcomes , it was divided into the pregnancy group (74 cases) and the nonpregnancy group (74 cases) . The factors including male age , female age , duration of infertility , number of abortion , female BMI , follicle⁃stimulating hormone (FSH) , luteinizing hormone ( LH) , estradiol( E2) , progesterone(P) , blood glucose , insulin , albumin , total cholesterol , triglycerides , high⁃density lipoprotein( HDL) , parents ′causes of infertility , type of chromosomal abnormality , number of retrieved oocyte , number of meiosis II( MII) , number of fertilization , number of two pronuclei(2PN) , endometrial thickness on embryo transfer day , endometrial preparation , day of embryo development , presence of a top quality embryo ( TQE) or not were analyzed by the Mann⁃Whitney U test and Pearson ′s chi⁃square test. The probability of transplant outcomes in correlation with the relevant parameters analyzed was measured with multivariate logistic regression analysis. Results: Univariate analysis indicated that E2 , insulin , total cholesterol , triglycerides and endometrial preparation were significantly associated with transplant outcomes in PGT⁃SR , PGT⁃M cycles (P < 0. 05) . Multiple logistic regression analysis revealed that lower levels of insulin ( OR = 0. 14 , 95% CI = 0. 03 - 0. 27) and triglycerides ( OR = 1. 38 , 95% CI = 0. 14 -2. 78) in women were beneficial to transplant outcomes in PGT cycles. For endometrial preparation , compared with natural cycles , hormone replacement therapy (HRT) cycles ( OR = 3. 52 , 95% CI = 2. 54 - 4. 65) were another factor to improve transplant outcomes. Conclusion There is a correlation between the levels of insulin and triglycerides , endometrial preparation and transplant outcomes in PGT cycles. In detail , lower levels of insulin and triglycerides , and the HRT cycle can lead to a better transplant outcome.

Objective:To investigate the change in 25-hydroxy vitamin D (25-OHD) levels in hospitalized newborns in the neonatal intensive care unit (NICU) between baseline and vitamin D supplementation, and to explore the effect of different levels of vitamin D on the complications.Method:A prospective study was conducted on the newborns admitted to NICU at Jingzhou Hospital Affiliated to Yangtze University within 72 h after birth from January 2021 to January 2022. Vitamin D supplementation was initiated after the detection of basal 25-OHD levels within 72 h after birth. Serum 25-OHD levels were measured after 2, 4, and 6 weeks of supplementation. Newborns were categorized into four groups according to the basal 25-OHD level: sufficient, insufficient, deficient, and severely deficient groups. The analysis of variants, independent sample t-test, paired sample t-test, Chi-square test, or Fisher's exact probability method were employed to evaluate the differences in basal 25-OHD levels among newborns with different clinical conditions and gestational ages, as well as the variation in 25-OHD levels before and after supplementation among the four groups. Furthermore, differences in the morbidity and mortality among different basal status groups were analyzed. Result:(1) During the study period, 626 cases met the inclusion criteria, and after excluding seven cases, 619 infants were ultimately included in the study with serum 25-OHD level within 72 h being (21.8±10.1) ng/ml. There were 134 cases (21.6%) in the sufficient group, 208 cases (33.6%) in the insufficient group, 186 cases (30.0%) in the deficient group, and 91 cases (14.7%) in the severe deficient group. (2) No statistically significant differences were observed in the basal 25-OHD levels regardless of the genders, gestational age, birth month, number of fetuses or small for gestational age (all P>0.05). (3) Among all infants, 158 cases continued to supplement vitamin D for two weeks, 64 cases continued for four weeks, and 13 cases continued for six weeks, with all of them discharged within eight weeks. Compared with the basal 25-OHD levels, there were no statistically significant differences in the serum 25-OHD levels among the sufficient, insufficient, deficient, and severely deficient groups after two weeks of supplementation [(37.1±9.3) vs. (36.8±4.9) ng/ml, (24.7±7.2) vs. (24.7±2.9) ng/ml, (16.0±7.6) vs. (15.4±2.9) ng/ml, (8.1±5.6) vs. (7.6±1.4) ng/ml; t=0.18, 0.04, 0.65 and 0.48, respectively; all P>0.05]. After four weeks of supplementation, however, the serum 25-OHD levels in the four groups were higher than those before supplementation [(40.0±5.2) vs. (35.8±3.9) ng/ml, (29.7±6.4) vs. (24.5±2.9) ng/ml, (20.3±7.1) vs. (15.6±3.0) ng/ml, (14.9±7.3) vs. (6.5±2.3) ng/ml; t=2.13, 2.66, 5.08 and 7.64, respectively; all P<0.05]. (4) The incidence of hypocalcemia [23.1% (21/91) vs. 9.7% (18/186)] and neonatal respiratory distress syndrome [15.4% (14/91) vs. 3.2% (6/186)] were higher in the severely deficient group than those in the deficient group ( χ2=9.07 and 13.49, both P<0.008). No statistically significant differences were observed in the incidence of neonatal sepsis, neonatal necrotizing enterocolitis, bronchopulmonary dysplasia, retinopathy of prematurity, and mortality among the four groups (all P>0.05). Conclusions:The insufficiency of 25-OHD levels and vitamin D deficiency were prevalent in NICU neonates. Vitamin D status did not significantly differ among newborns with varying gestational ages. A prolonged period of sustained vitamin D supplementation may be required to elevate the serum 25-OHD level. The incidence of hypocalcemia and neonatal respiratory distress syndrome are higher in newborns with severe vitamin D deficiency.