Background Obstructive sleep apnea (OSA) is a sleep disorder characterized by recurrent episodes of obstruction of the upper airway during sleep. Given the substantial number of OSA patients, it is urgently in need to address the burden on society. Current available evidence linking outdoor light at night (LAN) to OSA is scarce. Objective To explore the relationships regarding outdoor LAN and OSA among residents in Southern China. Methods A total of 3925 hospitalized patients in Guangdong Provincial People's Hospital Sleep Center were recruited between January 1, 2005 and December 31, 2015. The severity of OSA was determined by apnea-hypopnea index (AHI) using polysomnography or home sleep test. The annual Suomi National Polar-orbiting Partnership Visible Infrared Imaging Radiometer Suite (NPP-VIIRS)-like LAN data with a 500 m spatial resolution were used to evaluate outdoor LAN levels of the participants 1, 3, and 5 years before undergoing sleep monitoring. Generalized linear regression models were utilized to examine the associations of outdoor LAN with OSA. Results The ORs (95%CIs) of OSA, mild OSA, and moderate OSA were 1.175 (1.021, 1.351), 1.215 (1.038, 1.421), and 1.195 (1.003, 1.425) respectively for per interquartile range (IQR) increment in three-year average outdoor LAN. The results of stratified analyses showed a higher OR of 1.933 (95%CI: 1.424, 2.637) in female than male participants (P _interaction < 0.001). Additionally, the ORs of OSA did not substantially change using one-year/ five-year instead of three-year average outdoor LAN. Conclusion Our findings demonstrate that an elevated outdoor LAN is significantly associated with higher odds of OSA (especially mild and moderate OSA) in Southern China, especially in females. An effective outdoor LAN management and policy-making framework has been suggested as potential preventive measures to reduce burden of OSA.

Objective To analyze the virus subtypes, molecular evolutional and molecular transmission network features of the first confirmed mpox case in Huai’an City, Jiangsu Province, so as to provide insights into understanding of the transmission and evolution dynamics of mpox virus and formulation of the mpox control strategy in the city. Methods Genomic DNA was extracted from swabs of the first confirmed mpox case’s skin lesions in Huai’an City, and the amplicon sequencing library was constructed using the hypersensitive mpox virus whole-genome capture kit. High-throughput sequencing was performed using the GridION X5 nanopore sequencer on the Nanopore sequencing platform, and single nucleotide polymorphism (SNP) analysis of mpox virus genome sequences was performed following sequence assembly. In addition, phylogenetic analysis, genetic genealogy and molecular traceability analysis were performed. Results The virus whole genome sequence of the first confirmed mpox case was successfully obtained by high-throughput sequencing, with a full length of 197 182 bp, and was named hMpxV/China/JS-HA01/2023, which belonged to the clade IIb (West African clade) lineage B.1.3. Compared with the mpox virus reference sequence MPXV-M5312_HM12_Rivers-001 (GenBank accession number: NC_063383), the genome sequence of the Huai’an virus isolate carried 86 SNPs, including 40 SNPs in the coding region as non-synonymous mutations and 73 SNPs as nucleotide mutations caused by APOBEC3 (APOBEC3). Of the 97 mpox virus gene sequences, 79 sequences were included in the molecular network (81.44%), and the threshold of the genetic distance accessed to the network was 0.35/10⁵. There were two large molecular transmission clusters and one scattered cluster in the molecular transmission network of the mpox virus, andthehMpxV/China/JS-HA01/2023 sequence was located in the large cluster. The 97 gene sequences formed 92 haplotypes, including three shared haplotypes Hap_4, Hap_6 and Hap_38, and an exclusive haplotype Hap_1 of hMpxV/China/JS-HA01/2023 generated from mutation of the exclusive haplotype Hap_43, while the exclusive haplotype Hap_43 was generated from mutation of the shared haplotype Hap_38. Conclusions The whole genome sequence of the mpox virus isolated from the first confirmed mpox case in Huai’an City has been successfully obtained, and the molecular evolutionary and molecular transmission network characteristics of the virus have been preliminarily understood.

“Chinese Pharmacopoeia” is the legal basis for drug development, production, operation, use and management in China, and the Chinese Pharmacopoeia 2025 Edition is going to be issued and implemented. This article introduces the revision and amendment situations, analyzes the characteristics of the new edition of the Pharmacopoeia and the future development direction of national standards for better understanding and implementation of the latest edition of pharmacopoeia.

Objective: To explore the association between vitamin D levels and sleep in children and adolescents，so as to provide a reference for promoting the sleep health of children and adolescents. Methods: From October to December, 2021, 4 827 primary and middle school students aged 6-17 in Shenzhen were selected by multistage cluster random sampling method, and their demographic information, family background, lifestyle and sleep status were obtained by facetoface questionnaire survey, and their fasting venous blood in the morning was collected to detect the serum 25(OH)D level. The relationship between serum vitamin D level and sleep characteristics was analyzed by binary Logistic regression, and stratified analysis was carried out according to gender. Results: The proportion of vitamin D deficiency was 41.1%, and the proportion of sleep deficiency was 19.4%. With the increase of vitamin D level, daily sleep duration of children and adolescents tended to increase (r=0.10,P<0.01). After adjusting for covariates such as gender and age, it was found that children and adolescents with insufficient vitamin D levels were more likely to experience sleep insufficiency, social jetlag, and late sleep on weekdays, with ORs being 1.32(95%CI=1.12-1.56), 1.35(95%CI=1.19-1.54), and 1.26(95%CI=1.05-1.52)(P<0.05). Sexstratified analysis showed that, among boys, vitamin D deficiency was associated with sleep deficiency, social jetlag, and late bedtime on weekdays and weekends[OR(95%CI)=1.42(1.14-1.77),1.25(1.04-1.49),1.39(1.06-1.82),1.86(1.19-2.92),P<0.05]. In girls, however, serum vitamin D levels were only associated with social jetlag with OR being 1.47 (95%CI=1.21-1.79, P<0.05). Conclusion Vitamin D levels are associated with various sleep characteristics in children and adolescents, with this association being more pronounced among boys.

[Objective] To explore the relationship between neutrophil activation under cardiopulmonary bypass (CPB) and the incidence of cardiac surgery-associated acute kidney injury (CS-AKI). [Methods] This prospective cohort study enrolled adult patients who scheduled for cardiac surgery under CPB at West China Hospital between May 1, 2022 and March 31, 2023. The primary outcome was acute kidney injury (AKI). Blood samples (5 mL) were obtained from the central vein before surgery, at rewarming, at the end of CPB, and 24 hours after surgery. Neutrophils were labeled with CD11b, CD54 and other markers. To assess the effect of neutrophils activation on AKI, propensity score matching (PSM) was employed to equilibrate covariates between the groups. [Results] A total of 120 patients included into the study, and 17 (14.2%) developed AKI. Both CD11b⁺ and CD54⁺ neutrophils significantly increased during the rewarming phase and the increases were kept until 24 hours after surgery. During rewarming, the numbers of CD11b⁺ neutrophils were significantly higher in AKI compared to non-AKI (4.71×10⁹/L vs 3.31×10⁹/L, Z=-2.14, P<0.05). Similarly, the CD54⁺ neutrophils counts were also significantly higher in AKI than in non-AKI before surgery (2.75×10⁹/L vs 1.79×10⁹/L, Z=-2.99, P<0.05), during rewarming (3.12×10⁹/L vs 1.62×10⁹/L, Z=-4.34, P<0.05), and at the end of CPB (4.28×10⁹/L vs 2.14×10⁹/L, Z=-3.91, P<0.05). An analysis of 32 matched patients (16 in each group) revealed that CD11b⁺ and CD54⁺ neutrophil levels of AKI were 1.74 folds (4.83×10⁹/L vs 2.77×10⁹/L, Z=-2.72, P<0.05) and 2.34 folds (3.32×10⁹/L vs 1.42×10⁹/L, Z=-4.12, P<0.05), respectively, of non-AKI at rewarming phase. [Conclusion] Neutrophils are activated during CPB, and they can be identified by CD11b/CD54 markers. The activated neutrophils of AKI patients are approximately 2 folds of non-AKI during the rewarming phase, with disparity reached peak between groups during rewarming. These findings suggest the removal of 50% of activated neutrophils during the rewarming phase may be effective to reduce the risk of AKI.

Objective To explore the construction of α-1,3-galactosyltransferase (GGTA1) gene-knockout (GTKO) Diannan miniature pigs and the kidney xenotransplantation from pigs to rhesus macaques, and to assess the effectiveness of GTKO pigs. Methods The GTKO Diannan miniature pigs were constructed using the CRISPR/Cas9 gene-editing system and somatic cell cloning technology. The phenotype of GTKO pigs was verified through polymerase chain reaction, Sanger sequencing and immunofluorescence staining. Flow cytometry was used to detect antigen-antibody (IgM) binding and complement-dependent cytotoxicity. Kidney xenotransplantation was performed from GTKO pigs to rhesus macaques. The humoral immunity, cellular immunity, coagulation and physiological indicators of the recipient monkeys were monitored. The function and pathological changes of the transplanted kidneys were analyzed using ultrasonography, hematoxylin-eosin staining, immunohistochemical staining and immunofluorescence staining. Results Single-guide RNA (sgRNA) targeting exon 4 of the GGTA1 gene in Diannan miniature pigs was designed. The pGL3-GGTA1-sgRNA1-GFP vector was transfected into fetal fibroblasts of Diannan miniature pigs. After puromycin selection, two cell clones, C59# and C89#, were identified as GGTA1 gene-knockout clones. These clones were expanded to form cell lines, which were used as donor cells for somatic cell nuclear transfer. The reconstructed embryos were transferred into the oviducts of trihybrid surrogate sows, resulting in 13 fetal pigs. Among them, fetuses F04 and F11 exhibited biallelic mutations in the GGTA1 gene, and F04 had a normal karyotype. Using this GTKO fetal pig for recloning and transferring the reconstructed embryos into the oviducts of trihybrid surrogate sows, seven surviving piglets were obtained, all of which did not express α-Gal epitope. The binding of IgM from the serum of rhesus monkey 20# to GTKO pig PBMC was reduced, and the survival rate of GTKO pig PBMC in the complement-dependent cytotoxicity assay was higher than that of wild-type pig. GTKO pig kidneys were harvested and perfused until completely white. After the left kidney of the recipient monkey was removed, the pig kidney was heterotopically transplanted. Following vascular anastomosis and blood flow restoration, the pig kidney rapidly turned pink without hyperacute rejection (HAR). Urine appeared in the ureter 6 minutes later, indicating successful kidney transplantation. The right kidney of the recipient was then removed. Seven days after transplantation, the transplanted kidney had good blood flow, the recipient monkey's serum creatinine level was stable, and serum potassium and cystatin C levels were effectively controlled, although they increased 10 days after transplantation. Seven days after transplantation, the levels of white blood cells, lymphocytes, monocytes and eosinophils in the recipient monkey increased, while platelet count and fibrinogen levels decreased. The activated partial thromboplastin time, thrombin time and prothrombin time remained relatively stable but later showed an upward trend. The recipient monkey survived for 10 days. At autopsy, the transplanted kidney was found to be congested, swollen and necrotic, with a small amount of IgG deposition in the renal tissue, and a large amount of IgM, complement C3c and C4d deposition, as well as CD68⁺ macrophage infiltration. Conclusions The kidneys of GTKO Diannan miniature pigs may maintain normal renal function for a certain period in rhesus macaques and effectively overcome HAR, confirming the effectiveness of GTKO pigs for xenotransplantation.

Objective To analyze the relationship between serum levels of bone morphogenetic protein-2(BMP-2)and N-terminal middle molecular fragment of osteocalcin(N-MID)and postoperative hip joint dys-function in elderly patients with intertrochanteric fractures of the femur.Methods A total of 96 elderly pa-tients with intertrochanteric fractures of the femur who were treated in the hospital from February 2022 to June 2023 were selected.Based on the Harris score of postoperative hip joint function,they were grouped into a postoperative good group(n=67)and a postoperative poor group(n=29).Clinical data of all patients were collected,and serum levels of BMP-2 and N-MID were detected and compared.Spearman method was applied to analyze the relationship between serum BMP-2,N-MID levels and postoperative hip joint dysfunction in pa-tients.The influencing factors of postoperative hip joint dysfunction in patients were analyzed using Multivari-ate Logistic regression.The predictive value of serum BMP-2 and N-MID levels for postoperative hip joint dys-function in patients was analyzed using receiver operating characteristic(ROC)curve.Results There were obvious differences in Evans-Jensen classification of fractures,presence of postoperative complications,postop-erative internal fixation methods,and osteoporosis grading between the postoperative good group and the post-operative poor group(P＜0.05).The serum levels of BMP-2 and N-MID in the postoperative poor group were greatly lower than those in the postoperative good group,and the differences were statistically significant(P＜0.05).The serum levels of BMP-2 and N-MID in elderly patients with intertrochanteric fractures of the femur were negatively correlated with postoperative hip joint function(r=-0.564,-0.638,P＜0.05).Ev-ans-Jensen classification Ⅲ-Ⅴ,postoperative complications and osteoporosis grade 4-6 were all risk factors for postoperative hip joint dysfunction in elderly patients with intertrochanteric fractures of the femur(P＜0.05),while elevated serum BMP-2 and N-MID levels were protective factors(P＜0.05).The area under the curve(AUC)of single and combined detection of serum BMP-2,N-MID for postoperative hip joint dysfunc-tion in patients was 0.932,0.883,and 0.977,respectively,and the value of the combined detection was higher(Z combination-BMP-2=2.220,P=0.026;Z combination-N-NMID=3.162,P=0.002).Conclusion The serum levels of BMP-2 and N-MID in elderly patients with hip joint dysfunction after surgery for intertrochanteric fractures of the fe-mur are greatly reduced,and are negatively correlated with postoperative hip joint function.The combination of the two could better predict postoperative hip joint dysfunction in patients.

Objective:To investigate the effects of 5-aminolevulinic acid (5-ALA)-mediated photodynamic therapy on apoptosis in cervical cancer HeLa cells.Methods:The ultraviolet absorption spectrum and fluorescence spectrum of protoporphyrin Ⅸ were measured using a UV spectrophotometer and a fluorescence spectrometer, respectively. The cell viability of HeLa cells treated with different concentrations (0, 10, 20, 40, 60, 80, 100, 120 and 140 μg/ml) of 5-ALA was assessed using the CCK-8 assay. Hoechst 33342 and dichlorofluorescein diacetate (DCFH-DA) staining methods were utilized, and the production of protoporphyrin Ⅸ and reactive oxygen species in the control group and laser + 150, 200 μg/ml 5-ALA groups were observed using a laser scanning confocal microscope. Apoptosis in the control group, laser group, 5-ALA group, and laser + 5-ALA group was detected using Annexin V-fluorescein isothiocyanate (FITC)/propidium iodide (PI) double staining and live-dead cell staining methods.Results:The UV absorption spectrum showed an absorption peak of protoporphyrin Ⅸ at 406 nm, and the fluorescence spectrum revealed a distinct characteristic peak at 635 nm. The CCK-8 assay result indicated a gradual decrease in cell viability with increasing concentrations of 5-ALA. Laser scanning confocal microscopy results demonstrated that 5-ALA could be converted into protoporphyrin Ⅸ within cells, emitting red fluorescence. In the laser + 5-ALA group, the green fluorescence of reactive oxygen species from HeLa cells labeled with DCFH-DA fluorescent probes were detected. Flow cytometry results showed that the apoptosis rates in the control, laser, 5-ALA, and laser + 5-ALA groups were 12.55%, 12.41%, 13.51%, and 28.31%, respectively. Live-dead cell staining indicated a significant occurrence of apoptosis in laser + 5-ALA group.Conclusions:5-ALA mediated photodynamic therapy can induce apoptosis in HeLa cells through the generation of reactive oxygen species.

Objective To analyze the differences of clinical features of acute gout flare and postoperative infection under arthroscopy of knee gouty arthritis patients to offer guiding opinions of clinical diagnosis and treatment.Methods Between Jan-uary 2017 and December 2022,235 patients with gouty knee osteoarthritis were admitted,and underwent arthroscopic debride-ment combined with synovectomy.Among them,35 cases had fever with a temperature higher than 38 ℃ postoperatively while acute inflammatory appears under redness,swelling,heat and pain of the operated joints.There were 29 males and 6 females,with an average age of(41.48±13.90)years old.Among them 23 patients were diagnosed with acute gout attack,and recovered well after being given colchicine and prednisolone;12 patients were diagnosed with postoperative joint infection,and were cured after being given anti-infective treatments and cleaning and rinsing of the joint cavity.The two groups of patients were compared and analyzed in terms of preoperative general data,surgical conditions,hematology,joint fluid,limb function and other clinical characteristics.Results There were no significant difference in the preoperative general data between two groups.The onset of fever in the postoperative acute gout flare group occurred mostly within 48 hours,significantly earlier than that in the postoperative infection group(P=0.037).The visual analogue scale score was significantly higher in the acute gout flare group(5.32±1.38)score than in the postoperative infection group(2.45±0.68)score(P=0.000),while 14 patients with acute gout flare were accompanied by severe pain in other joints.Hematologically,indicators such as white blood cell counts and ra-tios were significantly higher in both groups.In terms of inflammatory indicators,IL-6,erythrocyte sedimentation rate,procal-citonin and other inflammatory indicators were significantly elevated in both groups,but there was no statistical difference be-tween two groups.The C-reactive protein level in the postoperative infection group(220.97±1 16.30)mg·L-1 was higher than that in the postoperative acute gout attack group(120.67±82.45)mg·L-1(P=0.006).Blood uric acid(316.55±112.84)μmol·L-1 was higher in the acute postoperative gout flare group than in the postoperative infection group(159.14±126.92)μmol·L-1(P=0.001).In the joint fluid examination of the postoperative infection group,the glucose metabolism indicator was signifi-cantly lower than that of the acute gout flare group,and five of them had positive bacterial cultures Conclusion The symptoms of acute gout flare could be mistaken as postoperative infection due to their similarity,therefore requires careful differentiation.Differential diagnosis should be based on a combination of clinical signs,hematology and joint fluid findings,and targeted treatment should be given to avoid serious complications.

Objective To study the anti-inflammatory and analgesic effects of Ski protein overexpression on writing in mice induced by acetic acid.Methods Eight-week-old male ICR mice were administered 0.7%acetic acid solution(0.1 mL/10 g)to induce a writhing reaction.The mice were divided into sham,acetic acid,acetic acid+ibuprofen,acetic acid+ad-EGFP,acetic acid+ad-ski-1,acetic acid+ad-ski-2,and acetic acid+sulfasalazine groups(n=10 mice per group).The time to the first appearance of twisting and the number of twists within 15 min were recorded.Small intestine tissues were removed to identify the effect of adenovirus transfection and to detect protein expression levels of pro-inflammatory factors and pain biomarkers and protein expression of nuclear factor(NF)-κB p65 and its binding with Ski protein.Results Ski protein was successfully overexpressed in small intestine after intraperitoneal injection of Ad-ski adenovirus.Overexpressed Ski protein delayed the start and decreased the frequency of writhing,comparable to ibuprofen(P＞0.05).Groups in which ski protein was overexpressed showed significantly inhibited protein expression of pro-inflammatory factors and pain biomarkers compared with the acetic acid group(P＜0.05).Moreover,NF-κB p65 formed complexes with Ski.Conclusions Overexpression of Ski protein has anti-inflammatory and analgesic effects on acetic acid-induced inflammatory pain by inhibiting the expression of inflammatory factors and pain biomarkers,via regulation of the NF-κB signaling pathway.