Objective To study the effect and molecular mechanism of vitamin D(VitD)on Tfh cells of MRL/lpr lupus mice.Methods C57/B6 mice and MRL/lpr lupus mice were transfected with siRNA to construct VDR knockout mouse models.Splenic Tfh cells of C57/B6 mice and MRL/lpr lupus mice were divided into control group,lupus group and VDRsiRNA lupus group(treated with vitamin D 0,1 and 10 nmol·L-1,respectively)by siRNA transfection.The percentage of Tfh cells was detected by flow cytometry.MRL/lpr lupus mice Peyer node Tfh cells were randomly divided into 7 groups,blank control group,vitamin D dose groups of 1 and 10 nmol·L-1,paricalcitol group(VitD 10 nmol·L-1+PA),VDRsiRNA control group,VDRsiRNA group(VitD 10 nmol·L-1),CaN inhibitor group(VitD 10 nmol·L-1+CsA),and incubated for 72 h.The concentration of calcium ions in Tfh of each group was detected.The expressions of AT1R,NFAT,CaN and P-CaN in Tfh cells were determined by Western blotting.Results The percentage of Tfh cells decreased significantly with the increase of vitamin D dose.Vitamin D CaN reduce the intracellular calcium concentration of Tfh,up-regulate the expression of AT1 protein in Tfh cells,and down-regulate the expression of CAN,P-CaN and NFAT protein in a dose-dependent manner,and the effect is more obvious when combined with PA.Conclusion Vitamin D may regulate the activation of follicular T helper cells in MRL/lpr mice via the Ca-CaN-NFAT pathway.

Objective:To investigate the prevalence of sarcopenia and potential influencing factors in middle-aged and elderly populations in Zhejiang Province.Methods:Data were obtained from Zhejiang Provincial Household Economic Status Survey, a cross-sectional survey was condcuted in middle-aged and olde adults selected through multi-stage sampling in three cities in Zhejiang (Huzhou, Jiaxing and Shaoxing) in July 2023. A total of 3 019 study participants, average age 62.3 years old, 53.5% men, were included according to the inclusion and exclusion criteria. Sarcopenia screening was conducted by using the questionnaire with five sarcopenia related-items. Univariable and multivariable logistic regression analysis was used to identify the factors associated with sarcopenia.Results:The prevalence of sarcopenia in the middle-aged and old study participants was 4.47%. Significant differences were observed between the participants with or without sarcopenia in terms of age, educational level, BMI, alcohol consumption status, diet habit, physical activity level, sleep quality, number of chronic diseases, childhood socioeconomic status, adulthood community socioeconomic status, muscle strength, walking assistance, ability to stand from seat, ability to climb stairs, and fall frequency ( P<0.05). Multivariable logistic regression analysis revealed that old age (≥75 years: OR=2.82, 95% CI: 1.60-4.97), low body weight ( OR=1.96, 95% CI: 1.06-3.62), unhealthy diet habit ( OR=1.57, 95% CI: 1.01-2.46), physical inactivity ( OR=5.80, 95% CI: 3.09-10.88), poor or very poor sleep quality ( OR=1.65, 95% CI:1.23-2.41), number of chronic diseases (1 chronic disease: OR=1.84, 95% CI: 1.08-3.14; 2 chronic diseases: OR=3.22, 95% CI: 1.81-5.71; 3 or more chronic diseases: OR=3.74, 95% CI: 2.11-6.65), poor childhood socioeconomic status ( OR=2.98, 95% CI: 1.23-7.20), and poor adulthood community socioeconomic status ( OR=3.87, 95% CI: 1.63-9.17) were significant risk factors for sarcopenia. Conclusions:The prevalence of sarcopenia was relatively low in middle-aged and old population in Zhejiang. Age, BMI, unhealthy diet, physical activity level, sleep quality, number of chronic diseases, childhood socioeconomic status, and adulthood community socioeconomic status were identified as significant influencing factors.

Objective:To investigate the prevalence of sarcopenia and potential influencing factors in middle-aged and elderly populations in Zhejiang Province.Methods:Data were obtained from Zhejiang Provincial Household Economic Status Survey, a cross-sectional survey was condcuted in middle-aged and olde adults selected through multi-stage sampling in three cities in Zhejiang (Huzhou, Jiaxing and Shaoxing) in July 2023. A total of 3 019 study participants, average age 62.3 years old, 53.5% men, were included according to the inclusion and exclusion criteria. Sarcopenia screening was conducted by using the questionnaire with five sarcopenia related-items. Univariable and multivariable logistic regression analysis was used to identify the factors associated with sarcopenia.Results:The prevalence of sarcopenia in the middle-aged and old study participants was 4.47%. Significant differences were observed between the participants with or without sarcopenia in terms of age, educational level, BMI, alcohol consumption status, diet habit, physical activity level, sleep quality, number of chronic diseases, childhood socioeconomic status, adulthood community socioeconomic status, muscle strength, walking assistance, ability to stand from seat, ability to climb stairs, and fall frequency ( P<0.05). Multivariable logistic regression analysis revealed that old age (≥75 years: OR=2.82, 95% CI: 1.60-4.97), low body weight ( OR=1.96, 95% CI: 1.06-3.62), unhealthy diet habit ( OR=1.57, 95% CI: 1.01-2.46), physical inactivity ( OR=5.80, 95% CI: 3.09-10.88), poor or very poor sleep quality ( OR=1.65, 95% CI:1.23-2.41), number of chronic diseases (1 chronic disease: OR=1.84, 95% CI: 1.08-3.14; 2 chronic diseases: OR=3.22, 95% CI: 1.81-5.71; 3 or more chronic diseases: OR=3.74, 95% CI: 2.11-6.65), poor childhood socioeconomic status ( OR=2.98, 95% CI: 1.23-7.20), and poor adulthood community socioeconomic status ( OR=3.87, 95% CI: 1.63-9.17) were significant risk factors for sarcopenia. Conclusions:The prevalence of sarcopenia was relatively low in middle-aged and old population in Zhejiang. Age, BMI, unhealthy diet, physical activity level, sleep quality, number of chronic diseases, childhood socioeconomic status, and adulthood community socioeconomic status were identified as significant influencing factors.

Objective To study the effect and molecular mechanism of vitamin D(VitD)on Tfh cells of MRL/lpr lupus mice.Methods C57/B6 mice and MRL/lpr lupus mice were transfected with siRNA to construct VDR knockout mouse models.Splenic Tfh cells of C57/B6 mice and MRL/lpr lupus mice were divided into control group,lupus group and VDRsiRNA lupus group(treated with vitamin D 0,1 and 10 nmol·L-1,respectively)by siRNA transfection.The percentage of Tfh cells was detected by flow cytometry.MRL/lpr lupus mice Peyer node Tfh cells were randomly divided into 7 groups,blank control group,vitamin D dose groups of 1 and 10 nmol·L-1,paricalcitol group(VitD 10 nmol·L-1+PA),VDRsiRNA control group,VDRsiRNA group(VitD 10 nmol·L-1),CaN inhibitor group(VitD 10 nmol·L-1+CsA),and incubated for 72 h.The concentration of calcium ions in Tfh of each group was detected.The expressions of AT1R,NFAT,CaN and P-CaN in Tfh cells were determined by Western blotting.Results The percentage of Tfh cells decreased significantly with the increase of vitamin D dose.Vitamin D CaN reduce the intracellular calcium concentration of Tfh,up-regulate the expression of AT1 protein in Tfh cells,and down-regulate the expression of CAN,P-CaN and NFAT protein in a dose-dependent manner,and the effect is more obvious when combined with PA.Conclusion Vitamin D may regulate the activation of follicular T helper cells in MRL/lpr mice via the Ca-CaN-NFAT pathway.

Objective To analyze the effects of glucocorticoid stent implantation combined with nasal endoscopic surgery on nasal ventilation function and serum levels of eosinophil cationic protein(ECP),fibronectin(Fn)and aquaporin-1(AQP-1)in patients with chronic sinusitis with nasal polyp(CSwNP).Methods 60 patients with CSwNP from January 2022 to February 2023 were included in the study,and then they were divided into experimental group and control group,with 30 cases in each,using random number table method.The experimental group was treated with glucocorticoid stent implantation based on the original nasal endoscopic surgery,and the control group was treated with nasal endoscopic surgery,and both groups were treated until 12 weeks after surgery.The two groups of nasal symptoms,quality of life,nasal structure and ventilation function,serum levels of ECP,Fn,AQP-1,and adverse reactions were compared.Results Compared before the treatment,scores of nasal mucosal structure(Lund-Mackay scale),nasal symptom visual analogue scale(VAS)(including:nasal obstruction,runny nose,stuffy head,decreased sense of smell,nasal dryness/scab)and serum levels of ECP were decreased,distance from minimum nasal cross section to anterior nostril(DCAN)was shortened in two groups 12 weeks after treatment,and the experimental group was lower than the control group,the differences were statistically significant(P<0.05).Compared before the treatment,12 weeks after treatment,the nasal minimum cross-sectional area(NMCA),score of world health organization abbreviated quality of life(WHOQOL-100),nasal cavity volume(NCV),serum levels of Fn,AQP-1 were increased in two groups,and the experimental group was higher than the control group,the differences were statistically significant(P<0.05).During treatment,the incidence of adverse reactions was similar between the two groups(P>0.05).Conclusion Glucocorticoid stent implantation combined with nasal endoscopic surgery can control nasal symptoms in patients with CSwNP,improve nasal structure and ventilation function,regulate serum levels of ECP,Fn,AQP-1,and improve patients'quality of life.

Objective To construct a vimentin glycosylated mutant plasmid,and to study its impact on rat adrenal chromaffin cell (PC12) cell differentiation.Methods The vimentin glycosylated mutant plasmid was constructed,and the gel electrophoretic was performed and the sequencing identification was performed. The empty plasmid pcDNA3.1b (control group),vimentin plasmid (Vim group) and vimentin glycosylated mutant plasmid (Vim mut group) were used to transfect PC12 cells,which were cultured for 0,3 d in the con-dictions of treatment and non-treatment of exogenous oligosaccharides (Cyclo-ManN pro) respectively,and the cell differentiation records and quantitative analysis (the cell average neurite length and differentiated neu-rite cells percentage) were performed.Results A recombinant plasmid containing a glycosylation site muta-tion site 19(T-G),97(A-G),100(T-G) was successfully constructed (about 1404 bp in size).Before and after Cyclo-ManN pro treatment,the average neurite length of PC12 cells and the percentage of differentiated neu-rite cells in the Vim group were greater than those in the control group and the Vim mut group[(61.98±19.03)μm vs.(51.09±14.45)μm,(51.49±14.78)μm,(6.60±0.25)％ vs. (4.27±0.18)％,(4.76±0.33)％;(78.01±18.31)μm vs. (69.98±12.85)μm,(68.45±13.84)μm,(10.62±0.25)％ vs. (8.11±1.22)％,(5.89±0.60)％],the difference was statistically significant (P<0.05).Conclusion The glycosyla-tion modification of vimentin could be used for PC12 cell differentiation.

Objective To assess the effect of ultrasonic thyroid artificial intelligence(AI)-assisted diagnostic system(AI-assisted diagnostic system)for diagnosing medullary thyroid carcinoma(MTC)compared with different physicians and taken papillary thyroid carcinoma(PTC)as the controls.Methods Totally 63 MTC,70 PTC and 62 benign thyroid nodules confirmed by pathology were enrolled.AI-assisted diagnostic system was utilized to analyze thyroid nodules and identify the likelihood of malignancy,and the probability value threshold was set at ≥0.40.All thyroid nodules were retrospectively reviewed and categorized by 3 physicians(1 senior physician,1 attending physician and 1 junior physician)according to Chinese thyroid imaging reporting and data system(C-TIRADS).The efficacy of AI-assisted diagnostic system and physicians for diagnosing MTC and PTC were evaluated.Results AI-assisted diagnostic system showed lower sensitivity,specificity,positive predictive value,negative predictive value,accuracy,and area under the curve(AUC)for diagnosing MTC and PTC compared with physicians.Significant differences of AUC were found between senior physician and AI-assisted diagnostic system,as well as between attending physician and AI-assisted diagnostic system for diagnosing MTC and PTC(all P＜0.01),while no significant difference of AUC was between junior physicians and AI-assisted diagnostic system(both P＞0.05).The sensitivity,specificity,positive predictive value,negative predictive value,accuracy and AUC for AI-assisted diagnostic system for diagnosing MTC were all lower than those for diagnosing PTC,but the AUC was not significantly different(P＞0.05).Conclusion Ultrasonic thyroid AI-assisted diagnostic system had relatively high value for diagnosing MTC.

Objective To establish a method to simultaneously determinate cobalt, nickel, arsenic, molybdenum, silver, cadmium and lead in blood and urine using inductively coupled plasma tandem mass spectrometry (ICP-MS/MS). Methods The blood samples were diluted 20 times with a mixed solution of nitric acid (0.10% V/V) and Triton X-100 (0.02% V/V). The urine samples were diluted 10 times with nitric acid (1.00% V/V). Yttrium-89, rhodium-103, and lutetium-175 were used as internal standards to decrease matrix interference, and either On-Mass mode or Mass-Shift mode was used to decrease mass spectrometry interference, with detection by ICP-MS/MS. Results The linear ranges of the seven elements were 0.100-10.000 μg/L, with the correlation coefficient >0.999 9. The detection limits for the seven elements in the blood and urine were 0.003-0.021 and 0.003-0.031 μg/L, respectively, and the minimum quantification limits were 0.009-0.064 and 0.009-0.094 μg/L, respectively. The recovery rates were 96.64%-102.90% and 96.34%-104.50% for the blood and urine, respectively. The within-run relative standard deviations (RSDs) were 0.32%-2.33% and 0.25%-2.31%, and the between-run RSDs were 1.07%-3.81% and 1.30%-3.62% for blood and urine, respectively. The samples were stable at 4 ℃ for at least 14 days. Conclusion ICP-MS/MS is a simple, sensitive, and accurate method for rapid detection of seven heavy metal elements in the blood and urine of occupational hazard-exposed workers.

Objective:To explore the influence of patient participation-based dietary intervention on nutritional status for patients with severe burn.Methods:From September 2017 to January 2019, 60 severe burn patients hospitalized in the department of burn and plastic surgery of Qingdao Municipal Hospital were recruited and divided into the experimental group ( n=30) and the control group ( n=30) according to the random number table method. The control group received a regular diet. While the experimental group received a patient participation-based dietary intervention(PPDI), The wound healing time and the value of nutritional status index, such as height, body mass index(BMI), serum albumin, serum prealbumin, in the two groups on admission, at 2 weeks after intervention, 4 weeks after intervention were compared. The nutritional knowledge questionnaire of burn patients and "3-day diet diary" were used for investigation. Results:The score of nutritional knowledge showed no significant difference between the two groups before intervention. After intervention, the score of nutritional knowledge in the experimental group was 21.40±2.42, significantly higher than that in the control group (19.00±2.26) ( t value was 3.975, P<0.01). For time effect and between-group effect, there were significant difference in serum albumin between two groups ( F values were 9.232, 4.651, P<0.05); the time effect and between-group effect of serum prealbumin were statistically significant ( F values were 11.592, 6.228, P < 0.05). The wound healing time in the experimental group was significantly lower than that in the control group ( t value was -3.801, P<0.01). Conclusions:Patient participation-based dietary intervention can effectively enhanced the level of nutritional knowledge, improved nutritional status, shortened wound healing time among patients with severe burn.

Objective To assess the value of bulbocavernosus reflex (BCR) in the differential diagnosis of Parkinson' s disease (PD) and multiple system atrophy (MSA).Methods BCR was compared in 55 patients with PD,20 patients with MSA,and 50 healthy controls,who were enrolled from the Department of Neurology,the First Affiliated Hospital of Wenzhou Medical University from May 2013 to April 2014.The clinical features of autonomic nerves dysfunction were also recorded.Results Among all related autonomic symptoms,the occurrence rate of constipation,urinary urgency and frequency in patients with MSA was higher than those with PD.The elicit percent of BCR in patients with PD was 93％,higher than those with MSA (70％).The average latency of BCR in patients with MSA was longer than those with PD (tmale left =16.275,tmale right =14.269,tfemale left =5.954,tfemmale right =5.905,all P ＜ 0.05).The degree of BCR amplitude decreasing in three groups was MSA ＞ PD ＞ healthy controls.There was statistically significant difference among three groups (Fmale left =75.73,Fmale right =73.13,Ffemale left =72.70,Ffemale right =59.44,all P ＜ 0.05).The area under receiver operating characteristic curve (ROC) in differential diagnosis of PD and MSA of the average latency of BCR in male and female was 0.947 and 0.948.The area under ROC curve in differential diagnosis of PD and MSA of the average amplitude of BCR in male and female was 0.886 and 0.920.The ROC curve showed the average latency of BCR in male of 44.80 ms with a sensitivity of 95％ and a specificity of 84％,and in female of 61.35 ms with a sensitivity of 86％ and a specificity of 88％ ; the average amplitude of BCR in male of 0.37 mV with a sensitivity of 96％ and a specificity of 68％,and in female of 0.36 mV with a sensitivity of 98％ and a specificity of 76％,which were critical cutoff values in differential diagnosis of PD and MSA with the best sensitivity and specificity.Conclusion The latency and amplitude of BCR test helps to increase the accuracy in the differential diagnosis of PD and MSA.