Objective: To develop and validate a clinically actionable prediction model for postoperative pulmonary complications (PPCs) in cardiac surgery patients, focusing on modifiable preoperative risk factors amenable to targeted optimization. Methods: In this prospective observational cohort study, 492 adults undergoing open-chest cardiac surgery between August 15, 2023 and December 31, 2023 were analyzed. Prespecified predictors included gas exchange variables, pulmonary function, inspiratory muscle strength, and physical performance. Univariable and multivariable logistic regression analyses were used to develop the prediction model. Discrimination was assessed by the area under the receiver operating characteristic curve (AUC). Results: A total of 90 patients (14.1%) developed PPCs after surgery. Five independent predictors were identified: elevated arterial PaCO2 (odds ratio [OR] 1.12, 95% confidence interval [CI] 1.00–1.26), oxygen desaturation (SpO2<93%) (OR 12.47, 95% CI 3.51–48.13), reduced gait speed (OR 0.17, 95% CI 0.04–0.71), lower FEV1/FVC ratio (OR 0.96, 95% CI 0.92–1.00), and diminished inspiratory muscle strength (MIP % predicted) (OR 0.96, 95% CI 0.92–0.99). The model demonstrated good discriminative ability with an AUC of 0.86 (95% CI 0.80–0.93) in the training cohort and 0.87 (95% CI 0.74–0.93) in the validation cohort. Conclusion This parsimonious model achieved high predictive accuracy using five modifiable physiological variables. By targeting abnormalities in gas exchange, pulmonary mechanics, muscle strength, and functional reserve, the model offers a practical tool to guide individualized prehabilitation strategies for reducing PPC risk in cardiac surgery patients.

This study reports a new species of Culicoides(Avaritia)isolated from Xunke County, Heilongjiang Province, China. The new species, Culicoides(Avaritia)dongshanensis Liu et Wang, sp. nov., was identified and illustrated based on female adults. Its diagnostic characteristics are as follows: eyes contiguous over a short distance, with short interfacetal hair, antennal ratio(AR)of 1.20, palpal ratio(PR)of 2.16, wing length of 0.83 mm, mandible with 15 teeth, one pale spot in base cell M1, one pale spot in cell M4, two pale spots in cell A, and two unequal spermathecae. Type specimens were deposited at the Center for Disease Control and Prevention of the Northern Theater Command.

Background Pulmonary heart disease (PHD) is a critical cardiopulmonary disease in high-altitude areas, with pulmonary hypertension (PH) as its central pathological basis. Cold and hypoxia are vital environmental characteristics of high-altitude regions; however, their joint effect on the hospitalization risk for PHD and the underlying biological mechanisms remain unclear. Objective To evaluate the associations of cold, hypoxia, and their joint exposure with PHD hospitalization risk, and to investigate PH-related pathological changes induced by combined cold and hypoxic exposure and the intervention effects of γ-aminobutyric acid (GABA) in rats. Methods Based on hospitalization data for 92986 PHD cases from 333 hospitals in Gansu Province (2018–2022), a generalized additive model (GAM) with a quasi-Poisson distribution was used to assess the associations between daily mean temperature, atmospheric oxygen content (AOC) and the daily number of PHD hospitalizations. Four joint exposure categories were constructed using the fifth percentile of temperature (P₅, −7.90℃) and AOC grades (high or low) to assess the associations between different exposure combinations and daily PHD hospital admissions. To further investigate PH-related pathological changes and the intervention effects of GABA, 24 specific-pathogen-free male Sprague–Dawley rats were randomly assigned to four groups (n=6): normal temperature and normoxia control group (NC), combined cold and hypoxia exposure group (CH), combined exposure plus low-dose GABA intervention group (CHL), and combined exposure plus high-dose GABA intervention group (CHH). After 5 weeks, pulmonary hemodynamics and vascular remodeling were evaluated. Gut microbiota and inflammatory cytokines in lung tissue were assessed using 16S rRNA sequencing and enzyme-linked immunosorbent assay (ELISA), respectively. Results Each 1 g·m⁻³ decrease in AOC and each 1 ℃ decrease in daily mean temperature were associated with 2.6% (RR=1.026, 95%CI: 1.024, 1.027) and 1.8% (RR=1.018, 95%CI: 1.015, 1.020) increases in PHD hospitalization risk, respectively. Compared with the non-low-temperature and high-AOC group, the low-temperature and low-AOC group had the highest risk estimate (RR=1.673, 95%CI: 1.567, 1.785). Animal experiments demonstrated that, compared with the NC group, rats in the CH group showed shortened pulmonary artery acceleration time (PAT) and increased mean pulmonary artery pressure (MPAP), right ventricular hypertrophy index (RVHI), pulmonary arterial wall thickness, and α-smooth muscle actin (α-SMA) expression (P<0.05). The Observed Species and Chao1 indices of the gut microbiota were significantly lower in the CH group than in the NC group (P<0.05), while levels of tumor necrosis factor-alpha (TNF-α) and interleukin-1beta (IL-1β) in lung tissue were elevated (P<0.05). GABA intervention improved selected hemodynamic, vascular remodeling, and inflammatory indices. Conclusion Decreases in daily mean temperature and AOC are associated with an increased risk of PHD hospitalization, with the highest risk estimate observed in the low-temperature and low-AOC group. Animal experiments suggest that combined cold and hypoxic exposure induce PH-related pathological changes accompanied by alterations in the gut microbiota and pulmonary inflammation. GABA may partially ameliorate these changes.

Objective To investigate the effects of Chaihuang Qingyi Huoxue Granules on multiple organ damage induced by caerulein combined with lipopolysaccharide in mice with severe acute pancreatitis(SAP).Methods Twenty-four C57BL/6J mice were randomly divided into three groups:control(n=8),SAP(n=8)and Chaihuang Qingyi Huoxue Granules(CHQY group,n=8).Mice in SAP and CHQY groups were intraperitoneally injected with caerulein(50 μg/kg)at hourly intervals for 7 consecutive times,followed by an immediate intraperitoneal injection of lipopolysaccharide(10 mg/kg).Mice in control group received an equal volume of normal saline.After the successful establishment of the model,CHQY group mice were administered Chaihuang Qingyi Huoxue Granules[3.185 g/(kg·d)]via gavage,while control and SAP group mice received an equal volume of normal saline.Twenty-four hours post-modeling,mice were anesthetized,and serum was collected and separated for analysis of the activities of amylase(AMY),lipase(LPS),aspartate transaminase(AST),alanine transaminase(ALT)and the contents of creatinine(CREA)and urea(UREA)using an automatic biochemical analyzer.Serum levels of interleukin(IL)-1β,IL-6,IL-8,IL-18,and tumor necrosis factor-α(TNF-α)were measured by ELISA.Tissue samples from pancreas,lung,liver,kidney,and small intestine were collected for histopathological examination using hematoxylin-eosin(HE)staining and scored.The expression of nuclear factor-κB p65(NF-κB p65)was detected in all tissues by immunohistochemistry.Results Compared with control group,the activities of AMY,LPS,AST and ALT,and the contents of CREA,UREA,IL-1β,IL-6,IL-8,IL-18,and TNF-α were increased(P<0.05).Pathological injuries in the pancreas,lung,liver,kidney,and small intestine was significant,with increased pathological scores and a higher proportion of NF-κB p65 positive cells(P<0.05).Compared with SAP group,the activities of AMY,LPS,AST,ALT,and the contents of CREA,UREA,IL-1β,IL-6,IL-8,IL-18,and TNF-α in the serum of CHQY group were decreased(P<0.05).Pathological injuries in the pancreas,lung,liver,kidney and small intestine were reduced,with lower pathological scores and a decreased proportion of NF-κB p65 positive cells(P<0.05).Conclusion Chaihuang Qingyi Huoxue Granules have a certain therapeutic effect on SAP model mice,which may be related to reducing inflammation response and improving multiple organ damage such as the pancreas,lung,liver,kidney and small intestine.

Lung cancer has the highest incidence and mortality among malignant tumors in China.Persistent subsolid nodules(SSNs)are closely associated with early-stage lung adenocarcinoma.Artificial intelligence(AI),as an emerging technology,is capable of performing in-depth analysis of large-scale imaging data through autonomous learning and possesses the ability to predict outcomes from new data,demonstrating great potential and application prospects in the assessment of SSNs.AI can not only effectively assist radiologists in diagnosis and treatment,but also improve work efficiency while reducing misdiagnosis and missed diagnosis rates.This review summarizes the recent applications and research progress of AI in the assessment of SSNs,to provide new insights for the diagnosis and treatment of SSNs.

Alzheimer's disease(AD)is a common neurodegenerative disease in the elderly.Increasing evidence shows that peripheral immune cells are involved in the occurrence and development of AD.Both gut microbiota dysbiosis and abnormalities of peripheral immune cells occur in the early stage of AD.The gut microbiota can influence the central nervous system through mechanisms such as the gut-brain axis and the regulatory effects on peripheral immune cells.AD treatment methods targeting the gut microbiota and immune cells have been receiving increasing attention.This review summarizes the regulatory effects and mechanisms of the gut microbiota on peripheral immune cells,as well as the research progress on the gut microbiota's roles in the occurrence and development of AD,aiming to provide new ideas for relevant research on the prevention,diagnosis,and treatment of AD.

Objective To report a case of tibial synovial sarcoma and review relevant literature to enhance understanding of this disease.Methods The clinical data of a patient with tibial synovial sarcoma treated at Kaifeng Central Hospital were retrospectively analyzed.A literature search was conducted in domestic and international databases,including China National Knowledge Infrastructure(CNKI),Wanfang Data,PubMed,Web of Science,and Embase,up to July 2024.Relevant literature was comprehensively reviewed to summarize the imaging and pathological characteristics,treatment,and prognosis of synovial sarcoma.Results A 29-year-old female patient was admitted with left lower extremity pain.X-ray examination revealed a proximal tibia space-occupying lesion suggestive of malignancy,and a mid-tibial space-occupying lesion considered benign.Contrast-enhanced computed tomography(CT)and plain magnetic resonance imaging(MRI)of the proximal tibial lesion also suggested malignancy.Ultrasound-guided biopsy of the proximal tibial tumor revealed a poorly differentiated malignant tumor.Immunohistochemistry results indicated monophasic synovial sarcoma,requiring genetic testing for definitive diagnosis.The patient underwent wide resection of the proximal left tibial malignancy with tumor-type artificial joint replacement,combined with curettage and bone cement filling for the left mid-tibial lesion under anesthesia.Postoperative pathology of space-occupying lesions in the proximal tibia confirmed monophasic synovial sarcoma,and fluorescence in situ hybridization(FISH)demonstrated a rupture of the synovial sarcoma translocation gene(SYT)(i.e.,SS18 positive).There was no recurrence or metastasis found in the patient during the reexamination 6 months after postoperative chemotherapy.As of July 2024,15 cases of genetically confirmed primary intraosseous synovial sarcoma have been reported internationally.Symptoms included pain and swelling,with a medical history of 1-2 years.The X-ray and CT findings showed osteolytic destruction with bone cortical discontinuity.In 13 cases,the intraosseous masses extended to the extraosseous area;in 2 cases,punctate calcifications were detected within the masses.Plain MRI scan showed iso-signal or hypo-signal on T1WI and hyper-signal,iso-signal,and hypo-signal on fat-suppressed T2WI,and enhanced MRI scan demonstrated heterogeneous enhancement.Pathological examination showed spindle-shaped cells under microscopy.Immunohistochemistry results showed positive epithelial membrane antigen(EMA),broad-spectrum cytokeratin(AE1/AE3),Ewing's sarcoma marker(CD99),and transducin-like enhancer of Split 1(TLE1).Twelve patients underwent surgical treatment;6 patients received adjuvant chemotherapy after surgery,of whom 4 developed local recurrence or distant metastasis at initial diagnosis,and 3 died during follow-up.Among the 6 patients who did not receive adjuvant chemotherapy,3 suffered from recurrence or distant metastasis.Conclusions Primary intraosseous synovial sarcoma is a rare malignant tumor with non-specific clinical manifestations.Imaging features typically include osteolytic destruction and intraosseous masses extending extraosseously,suggesting an intraosseous origin.Pathology and immunohistochemistry aid diagnosis,but definitive confirmation relies on further genetic testing.At present,the main treatment regimens for synovial sarcoma involve comprehensive therapies such as surgery and adjuvant chemotherapy,and the prognosis of patients is poor.

Objective To investigate the protective effects of the ANXA1(Annexin A1)mimetic peptide Ac2-26 on mice with severe heatstroke(HS)and its underlying mechanisms.Methods Twenty-four adult healthy male C57BL/6J mice weighing 20-25 g were randomly divided into four groups using a simple random sampling method:control group(Con group),Con+Ac2-26 group,severe heatstroke group(HS group),and severe heatstroke+Ac2-26 group(HS+Ac2-26 group),with 6 mice in each group.Mice in Con+Ac2-26 group and HS+Ac2-26 group were injected intraperitoneally with Ac2-26(6 mg/kg),and the remaining mice of two groups were injected intraperitoneally with normal saline of equivalent volume.One hour after drug administration,mice in HS group and HS+Ac2-26 group were placed in a high-temperature and high-humidity simulated environment[(37.0±0.5)℃,75%±5%humidity],while mice in Con group and Con+Ac2-26 were kept in a room temperature and humidity environment[(24±0.5)℃and 40±5%humidity]throughout the experiment.The anal temperature of the mice was recorded every 5 minutes;when the anal temperature of mice in HS group and HS+Ac2-26 group reached 42℃,they were removed from the high-temperature environment and placed in a room temperature environment for 6 hours of rewarming,after which blood samples of mice in each group were collected.Flow cytometry was used to detect the proportion of neutrophils and the expression levels of Cd11b and Cd62L(molecules related to neutrophil activation).Enzyme-linked immunosorbent assay(ELISA)was used to measure the plasma levels of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6),IL-10,and IL-4.Hematoxylin-eosin staining(HE staining)was performed to observe the pathological changes in lung,kidney and liver tissues.Furthermore,RNA sequencing(RNA-seq)was conducted to detect changes in neutrophil gene expression.Results Compared with Con group,Con+Ac2-26 group showed no significant increase in neutrophil proportion,decreased expression of CD62L and CD11b,no significant changes in cytokine levels,and no obvious pathological changes in lung,kidney,or liver tissues.Compared with HS group,the time for mice in HS+Ac2-26 group to reach an anal temperature of 42℃and the time to develop hypothermia after model establishment were both prolonged(P<0.05);the proportion of neutrophils was reduced(P<0.05);the plasma levels of pro-inflammatory cytokines TNF-α and IL-6 were decreased(P<0.05);and the plasma level of anti-inflammatory cytokine IL-10 was increased(P<0.05).HE staining results showed that compared with HS group,HS+Ac2-26 group had a reduced range of inflammatory cell infiltration in lung,kidney,and liver tissues.RNA-seq results revealed that compared with HS group,HS+Ac2-26 group had decreased expression levels of molecules related to the oxidative phosphorylation signaling pathways and neutrophil extracellular trap(NETs).Conclusion Annexin A1 mimetic peptide Ac2-26 may reduce the pro-inflammatory response and alleviate the heatstroke-induced organ histopathologic damage in heatstroke mice by inhibiting oxidative phosphorylation in heat-stressed cells and NETs formation.

Objective To investigate the status of population dynamics and distribution changes of Aedes aegypti in Guangdong Province.Methods Continuous monitoring was conducted from May 2018 to July 2024 in Wushi Town and Qishui Town,Leizhou City,Zhanjiang City,Guangdong Province.Additionally,a survey of the distribution of Ae.aegypti along the Leizhou Peninsula coast was carried out.Results The density of Ae.aegypti in Zhanjiang showed a gradual decline from 2018 to 2024.The last detection of adult Ae.aegypti in Wushi Town was in September 2021,and the last larva was found in October 2023.No Ae.aegypti was detected in Qishui Town during surveys from 2021 to 2024.A survey of 18 coastal villages in the Leizhou Peninsula revealed no detections of Ae.aegypti.Conclusions This study provides a basis for understanding the distribution and population density fluctuations of Ae.aegypti,assessing its invasion risk,and scientifically conducting relevant prevention and control efforts.

Objective To investigate the relationship between morphometric parameters of the cerebral cortex and the efficacy of repetitive transcranial magnetic stimulation(rTMS)in the treatment of tardive dyskinesia(TD).Methods A total of 105 schizophrenic patients with TD undergoing basic treatment were enrolled,and randomly divided into group A(n=35),group B(n=35)and group C(n=35).Group A received rTMS at 1 Hz,group B received rTMS at 10 Hz,and group C received sham stimulation.All groups were treated for 12 weeks.The severity of TD was assessed using the Ab-normal Involuntary Movement Scale(AIMS)before and after treatment.The Repeatable Battery for the Assessment of Neuropsychological Status(RBANS)and the Positive and Negative Syndrome Scale(PANSS)in Chinese were used to evaluate patients'neuropsychological status and symptom severity.magnetic resonance imaging(MRI)was employed to scan the left prefrontal cortex of patients to obtain parameters of cortical thickness,surface area and volume.Pearson correlation analysis was used to an-alyze the relationship between cortical morphological parameters and the efficacy of rTMS for TD in pa-tients.Results After treatment,AIMS scores in the three groups were significantly lower than before treatment,and the group A was significantly lower than the group B and group C(P＜0.05).After treatment,RBANS scores were significantly higher and PANSS scores were significantly lower in three groups than before treatment(P＜0.05).After treatment,the RBANS score of the group A was significantly higher than that of the group B and group C,and the group B was significantly higher than the group C(P＜0.05);the PANSS score of the group A was significantly lower than that of the group B and group C,and the group B was significantly lower than the group C(P＜0.05).Af-ter treatment,cortical morphological parameters(cortical thickness,surface area and volume)in the group A and group B were significantly higher than before treatment,and the group A was signif-icantly higher than the group B(P＜0.05).The therapeutic effect of the group A was positively correlated with cortical thickness,surface area and volume(P＜0.05).Conclusion The morpho-metric parameters of the left prefrontal cortex are associated with the efficacy of rTMS in treating TD.The rTMS at 1 Hz can facilitate structural remodeling of the motor cortex,thereby improving treat-ment outcomes for TD patients.