Objective To investigate the temporal changes in pathological damage and macrophage polarization in liver and spleen tissues of mice infected with Angiostrongylus cantonensis, and to preliminarily unravel the peripheral immune responses during the early stage of A. cantonensis infection. Methods Forty female BALB/c mice at ages of 6 to 8 weeks were randomly divided into four groups, including the control group and 7-, 14-, and 21-day infection groups, with 10 mice in each group. Each mouse in the infection groups was inoculated with 30 third-stage (L3) larvae of A. cantonensis by oral gavage, and five mice were randomly selected from each infection group on days 7, 14, and 21 post-infection, while mice in the control group were given the same volume of physiological saline and five mice were randomly selected from the control group on the day of oral gavage. Mouse liver and spleen tissues were sampled. The histopathological changes of mouse liver and spleen tissues were observed using hematoxylin and eosin (HE) staining, and the percentage of positive staining area and the co-localization positive rates of the macrophage surface antigens F4/80, CD86, and CD206 were quantified in mouse liver and spleen tissues using immunohistochemical and immunofluorescence staining. In addition, five mice were collected from each infection group on days 7, 14, and 21 post-infection, and five mice were collected from the control group on the day of oral gavage. Mouse liver and spleen tissues were sampled for detection of macrophage markers CD86 and CD206 and macrophage phenotyping using flow cytometry, and the expression of M1 macrophage markers, including inducible nitric oxide synthase (Nos2), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and M2 markers, including arginase 1 (Arg1), mannose receptor C-type 1 (Mrc1) and chitinase-like protein 3 (Chil3) was quantified in mouse liver and spleen tissues using real-time quantitative PCR (RT-qPCR) assay. Results Proliferative lesions of the hepatocyte were observed in mouse liver tissues and the follicular structures of the mouse spleen white pulp were disrupted 21 days post-infection with A. cantonensis. Immunohistochemical staining showed that there were significant differences in the percentages of F4/80, CD86 and CD206 positive staining areas in the liver and spleen tissues among the four groups of mice (F = 242.40, 197.14, 183.19, 157.65, 242.35 and 146.24; all P values < 0.001), and the percentages of positive staining in the liver and spleen tissues of mice in the 14-day infection group [(4.45 ± 0.51)%, (3.74 ± 0.67)%, (8.32 ± 0.72)%, (16.56 ± 1.14)%, (11.62 ± 0.52)%, and (8.29 ± 0.72)%, respectively] and the 21-day infection group [(3.70 ± 0.11)%, (3.22 ± 0.43)%, (11.53 ± 1.03)%, (12.59 ± 1.05)%, (9.02 ± 0.83)%, and (11.67 ± 1.10)%, respectively] were higher than in the control group [(0.35 ± 0.16)%, (0.40 ± 0.02)%, (0.93 ± 0.05)%, (2.78 ± 0.26)%, (2.33 ± 0.20)%, and (1.85 ± 0.20)%, respectively] (all P values < 0.05). Immunofluorescence staining showed significant differences in the positive rates of F4/80 co-localization with CD86 and CD206 in mouse liver and spleen tissues among the four groups (F = 24.42, 25.28, 54.51 and 130.55; all P values < 0.001). Flow cytometry detected significant differences in the proportions of CD86⁺ and CD206⁺ macrophages in mouse liver and spleen tissues among the four groups (F = 67.98, 18.41, 29.77, 172.80; all P values < 0.001), and the proportions of CD206⁺ macrophages in the liver and spleen of the 21-day infection group were significantly higher than those in the control group [(9.25 ± 2.55)% vs (3.83 ± 0.72)%, and (4.22 ± 0.56)% vs (0.47 ± 0.18)%, respectively] (both P values < 0.05). In addition, RT-qPCR assay quantified significant differences in the relative mRNA expression of M1 macrophage markers (IL-1β, TNF-α and Nos2) and M2 macrophage markers (Arg1, Chil3 and Mrc1) in mouse liver and spleen tissues among the four groups (F = 41.30, 31.82, 199.33, 19.96, 62.01, 119.76, 23.67, 95.90, 72.27, 82.59, 123.41 and 29.75; all P values < 0.05). Conclusions A. cantonensis infection may cause progressive pathological damage in mouse liver and spleen tissues, accompanied by dynamic temporal changes in macrophage polarization. M1 macrophage polarization predominates at the early stage of A. cantonensis infection and shifts towards M2 polarization at the later stages, suggesting that M2 polarization may participate in immune regulation at late stages of A. cantonensis infection by suppressing excessive inflammatory responses and promoting tissue repair.

Objective: To evaluate the safety of the simultaneous administration of diphtheria, tetanus and acellular pertussis combined vaccine (DTaP) and group A and C meningococcal polysaccharide vaccine (MPSV-AC), so as to provide a scientific reference for vaccination strategies among school age children. Methods: Vaccination data and adverse reaction data for 2025 were collected from the Fujian Provincial Immunization Program Information Management System and the National Immunization Program Information System. The Chi-square test and Poisson regression model were used to compare the risk of adverse reactions between concurrent and separate vaccination. Results: In 2025, a total of 90 854 doses of DTaP were administered to children who turned 6 years old, with 107 adverse reactions reported, yielding an adverse reaction reporting rate of 117.77 per 100 000. A total of 95 913 doses of MPSV-AC were administered, with 50 adverse reactions reported, yielding an adverse reaction reporting rate of 52.13 per 100 000. All adverse reactions following DTaP and MPSV-AC vaccination in children were common reactions, predominantly local redness, swelling, and induration, with no reported abnormal reactions. The reported rate of common reactions was 112.91 per 100 000 in the concurrent DTaP+MPSV-AC group; in the separate groups, the reported rates of common reactions were 120.75 per 100 000 for DTaP and 17.92 per 100 000 for MPSV-AC, with statistically significant difference ( χ 2=46.23, P < 0.01 ). The risk of common adverse reactions in the simultaneous vaccination group did not differ significantly from that in the DTaP only group ( RR =1.07, P =0.74), but was significantly lower than that in the MPSV-AC only group ( RR =0.16, P <0.01). The risks of fever (11.58 per 100 000), pruritus, rash, myalgia, gastrointestinal symptoms, and other symptoms (23.16 per 100 000) in the simultaneous vaccination group were not significantly different from those in either single vaccine group ( RR-DTaP =0.92, 1.84, RR-MPSV-AC =0.56, 0.35, both P >0.05). The two most frequently reported reactions in both the simultaneous vaccination and DTaP only groups were local redness/swelling (95.54 per 100 000 and 117.20 per 100 000) and induration (31.85 per 100 000 and 42.62 per 100 000) at the injection site. In the simultaneous vaccination group, 92.50% of clinical symptoms occurred within 48 h, and the risks of occurrence at <24 h, 24-<48 h , and ≥48 h were not significantly different from those in the DTaP only group ( RR =1.00, 0.98, 1.43, all P >0.05). Conclusion The simultaneous administration of DTaP and MPSV-AC does not increase the risk of adverse reactions and may serve as a reference for administering both vaccines concurrently in children aged 6 years.

Objective:To assess the effect of joint exposure to multiple air pollutants on sleep structure in patients with stable chronic obstructive pulmonary disease (COPD), identify key air pollutants, and analyze potential influencing factors.Methods:In this panel study, 92 stable COPD patients were recruited. From March 2021 to September 2023 in Beijing, all participants completed 254 nights of sleep monitoring. The total sleep duration, light sleep duration, deep sleep duration and rapid eye movement sleep duration and their respective proportions in total sleep duration were recorded. The exposure levels of fine particulate matter (PM 2.5), inhalable particulate matter (PM 10), nitrogen dioxide (NO 2), ozone (O 3), sulfur dioxide (SO 2), and carbon monoxide (CO) were estimated based on the infiltration factor method and time-activity logs of participants. To assess the lag effect of air pollutants, moving average concentrations of air pollutants from 0-1 day to 0-3 months were calculated. The linear mixed-effect model and Bayesian kernel machine regression (BKMR) model were used to assess the single and joint effects of air pollutants on sleep structure parameters in COPD patients, respectively. Results:All six types of air pollutants were associated with changes in sleep structure, manifesting as an increase in total sleep duration and light sleep proportion and a reduction in deep sleep proportion. The effects of O 3 were strongest at lag 0-6 days, while other air pollutants were at lag 0-3 months. Joint exposure to multiple air pollutants exerted significant joint effects on sleep structure, and NO 2 was identified as the dominant pollutant. NO 2 had a posterior inclusion probability (PIP) greater than 0.5 for light sleep proportion (PIP=0.691) and deep sleep proportion (PIP=0.957). With an interquartile range (IQR) increase of 8.6 μg/m 3 in NO 2 at lag 0-3 months, the light sleep proportion increased by 10.5% (95% CI: 2.2%-19.4%), and the deep sleep proportion decreased by 19.5% (95% CI:-30.6%- -6.8%). Conclusion:Joint exposure to air pollutants is associated with changes in sleep structure in stable COPD patients, and NO 2 may be a key pollutant.

Objective To investigate the effect of irisin regulating early B cytokine 3(EBF3)/arachidonic acid-15-lipoxygenase(ALOX15)pathway on the proliferation and migration of lung adenocarcinoma cells.Methods A549 cells were assigned into the irisin solvent group,the irisin group,the sh-NC group,the EBF3 inhibitor(sh-EBF3)group,the irisin+sh-NC group and the irisin+sh-EBF3 group randomly.5-bromo-2-deoxyuracil(EdU)staining and CCK-8 method were applied to detect cell proliferation.5-Scratch experiment was applied to detect the scratch healing rate.2',7'-dichlorofluorescein diacetate(DCFH-DA)staining was applied to detect the level of reactive oxygen species(ROS)in cells.The reagent kit was used to detect glutathione(GSH),malondialdehyde(MDA)and ferrous ion(Fe2+)in cells.Transmission electron microscopy was applied to observe mitochondrial morphology in A549 cells.QRT-PCR was applied to detect mRNA levels of proliferating cell nuclear antigen(PCNA),matrix metalloproteinase 2(MMP-2)and glutathione peroxidase 4(GPX4)in A549 cells.Western blot assay was applied to detect EBF3 and ALOX15 proteins in cells.Results Compared with the irisin solvent group,the mitochondria of A549 cells in the irisin group showed ferroptosis characteristics,the positive rate of EdU,OD450 value,scratch healing rate,GSH level,PCNA,MMP-2 and GPX4 mRNA levels decreased,and the ROS relative fluorescence intensity,MDA,Fe2+level,and EBF3 and ALOX15 protein levels increased(P＜0.05).Compared with the sh-NC group,the mitochondrial ferroptosis phenomenon of A549 cells was reduced in the sh-EBF3 group,the positive rate of EdU,OD450 value,scratch healing rate,GSH level,PCNA,MMP-2 and GPX4 mRNA levels increased,and the ROS relative fluorescence intensity,MDA,Fe2+levels and EBF3 and ALOX15 protein levels reduced(P＜0.05).Sh-EBF3 reversed the effect of irisin on ferroptosis,proliferation and migration of A549 cells.Conclusion Irisin may induce ferroptosis in A549 cells and inhibit cell proliferation and migration by activating the EBF3/ALOX15 pathway.

Objective To understand the awareness and willingness of primary medical staff in Songjiang District, Shanghai towards human papillomavirus (HPV) and its vaccines, and to provide references for improving the vaccination willingness of HPV vaccine and primary prevention of cervical cancer. Methods From July to August 2023, a questionnaire survey was conducted among the in-service medical staff in 17 community health service centers in Songjiang District, Shanghai, using the random sampling method. Descriptive analysis, χ² test and logistic regression were used for statistical analysis. Results A total of 951 valid questionnaires were collected during the survey. The awareness rate of HPV among medical staff was 92.74%, and the awareness rate of HPV vaccine was 93.38%. The maximum score for HPV knowledge was 6 points, with an average score of (3.99±1.34) points. The maximum score for HPV vaccine knowledge was 10 points, with an average score of (5.63±1.61) points. 881 (92.64%) medical staff were willing to receive or recommend HPV vaccination. Multivariate analysis showed that concerns about being infected with HPV (OR=2.648, 95% CI: 1.459-4.806), qualified score on HPV vaccine knowledge (OR=1.717, 95% CI: 1.012-2.912), high price burden of HPV vaccine (OR=0.343, 95% CI: 0.157-0.746), and concerns about side effects of vaccination (OR=0.443, 95% CI: 0.243-0.805) were the influencing factors for medical staff's willingness to vaccinate. Conclusion There is insufficient knowledge of HPV and its vaccines among primary medical personnel in Songjiang District, Shanghai. It is necessary to strengthen the continuing education of medical personnel through multiple channels, supplement the HPV-related knowledge system, and eliminate their concerns about vaccines.

Objective:To assess the effect of joint exposure to multiple air pollutants on sleep structure in patients with stable chronic obstructive pulmonary disease (COPD), identify key air pollutants, and analyze potential influencing factors.Methods:In this panel study, 92 stable COPD patients were recruited. From March 2021 to September 2023 in Beijing, all participants completed 254 nights of sleep monitoring. The total sleep duration, light sleep duration, deep sleep duration and rapid eye movement sleep duration and their respective proportions in total sleep duration were recorded. The exposure levels of fine particulate matter (PM 2.5), inhalable particulate matter (PM 10), nitrogen dioxide (NO 2), ozone (O 3), sulfur dioxide (SO 2), and carbon monoxide (CO) were estimated based on the infiltration factor method and time-activity logs of participants. To assess the lag effect of air pollutants, moving average concentrations of air pollutants from 0-1 day to 0-3 months were calculated. The linear mixed-effect model and Bayesian kernel machine regression (BKMR) model were used to assess the single and joint effects of air pollutants on sleep structure parameters in COPD patients, respectively. Results:All six types of air pollutants were associated with changes in sleep structure, manifesting as an increase in total sleep duration and light sleep proportion and a reduction in deep sleep proportion. The effects of O 3 were strongest at lag 0-6 days, while other air pollutants were at lag 0-3 months. Joint exposure to multiple air pollutants exerted significant joint effects on sleep structure, and NO 2 was identified as the dominant pollutant. NO 2 had a posterior inclusion probability (PIP) greater than 0.5 for light sleep proportion (PIP=0.691) and deep sleep proportion (PIP=0.957). With an interquartile range (IQR) increase of 8.6 μg/m 3 in NO 2 at lag 0-3 months, the light sleep proportion increased by 10.5% (95% CI: 2.2%-19.4%), and the deep sleep proportion decreased by 19.5% (95% CI:-30.6%- -6.8%). Conclusion:Joint exposure to air pollutants is associated with changes in sleep structure in stable COPD patients, and NO 2 may be a key pollutant.

Objective To investigate the effect of irisin regulating early B cytokine 3(EBF3)/arachidonic acid-15-lipoxygenase(ALOX15)pathway on the proliferation and migration of lung adenocarcinoma cells.Methods A549 cells were assigned into the irisin solvent group,the irisin group,the sh-NC group,the EBF3 inhibitor(sh-EBF3)group,the irisin+sh-NC group and the irisin+sh-EBF3 group randomly.5-bromo-2-deoxyuracil(EdU)staining and CCK-8 method were applied to detect cell proliferation.5-Scratch experiment was applied to detect the scratch healing rate.2',7'-dichlorofluorescein diacetate(DCFH-DA)staining was applied to detect the level of reactive oxygen species(ROS)in cells.The reagent kit was used to detect glutathione(GSH),malondialdehyde(MDA)and ferrous ion(Fe2+)in cells.Transmission electron microscopy was applied to observe mitochondrial morphology in A549 cells.QRT-PCR was applied to detect mRNA levels of proliferating cell nuclear antigen(PCNA),matrix metalloproteinase 2(MMP-2)and glutathione peroxidase 4(GPX4)in A549 cells.Western blot assay was applied to detect EBF3 and ALOX15 proteins in cells.Results Compared with the irisin solvent group,the mitochondria of A549 cells in the irisin group showed ferroptosis characteristics,the positive rate of EdU,OD450 value,scratch healing rate,GSH level,PCNA,MMP-2 and GPX4 mRNA levels decreased,and the ROS relative fluorescence intensity,MDA,Fe2+level,and EBF3 and ALOX15 protein levels increased(P＜0.05).Compared with the sh-NC group,the mitochondrial ferroptosis phenomenon of A549 cells was reduced in the sh-EBF3 group,the positive rate of EdU,OD450 value,scratch healing rate,GSH level,PCNA,MMP-2 and GPX4 mRNA levels increased,and the ROS relative fluorescence intensity,MDA,Fe2+levels and EBF3 and ALOX15 protein levels reduced(P＜0.05).Sh-EBF3 reversed the effect of irisin on ferroptosis,proliferation and migration of A549 cells.Conclusion Irisin may induce ferroptosis in A549 cells and inhibit cell proliferation and migration by activating the EBF3/ALOX15 pathway.

Objective:To explore the effects of multidisciplinary continuous nursing based on the transtheoretical model (TTM) in patients after radiofrequency ablation for atrial fibrillation.Methods:Using a convenience sampling method, 280 patients who underwent radiofrequency ablation for atrial fibrillation at the China-Japan Union Hospital of Jilin University from January to December 2024 were enrolled. Patients treated from January to June 2024 were assigned to the control group ( n=140), and those treated from July to December 2024 were assigned to the intervention group ( n=140). The control group received routine continuous nursing, while the intervention group received multidisciplinary continuous nursing guided by the transtheoretical model. The 8-item Morisky Medication Adherence Scale (MMAS-8), Self-Rated Abilities for Health Practices Scale (SRAHP), Depression Anxiety and Stress Scale (DASS-21), and the Chinese Quality of Life Questionnaire for Cardiovascular Patients (CQQC) were used to evaluate the intervention effects. Results:A total of 135 patients in the control group and 137 patients in the intervention group completed the study. After the intervention, the MMAS-8, CQQC, and SRAHP scores of the intervention group were higher than those of the control group, with statistically significant differences ( P<0.05). The anxiety and stress subscale scores of the DASS-21 were lower in the intervention group compared with the control group, with statistically significant differences ( P<0.05) . Conclusions:Multidisciplinary continuous nursing based on the transtheoretical model can improve medication adherence, reduce negative psychological states, promote healthy behavior formation, and enhance the quality of life of patients after radiofrequency ablation for atrial fibrillation.

Objective:To explore latent categories and influencing factors of disease uncertainty in atrial fibrillation patients undergoing radiofrequency ablation (RFA) .Methods:Convenience sampling was used to select 346 atrial fibrillation patients who underwent RFA from February 2022 to July 2024 at China-Japan Union Hospital of Jilin University. Patients were surveyed using the General Information Questionnaire, Mishel Uncertainty in Illness Scale-Adult Form (MUIS-A), Brief Illness Perception Questionnaire, Chinese version of the Sense of Coherence-13, and Family APGAR Index. Latent categories and influencing factors of disease uncertainty in atrial fibrillation patients with RFA were explored using latent profile analysis and Logistic regression analysis.Results:A total of 346 questionnaires were distributed and 328 valid questionnaires were recovered, with a valid recovery rate of 94.80% (328/346). The total MUIS-A score for 328 patients with atrial fibrillation was (97.06±9.41). Three latent categories of disease uncertainty existed in 328 atrial fibrillation patients with RFA, namely high-level disease uncertainty group ( n=138), intermediate-level disease uncertainty group ( n=120), and low-level disease uncertainty group ( n=70). Age, education level, number of RFA, type of atrial fibrillation, perception of disease, sense of coherence, and family care were the factors influencing the disease uncertainty in patients with atrial fibrillation ( P<0.05) . Conclusions:Disease uncertainty after RFA in patients with atrial fibrillation is above the intermediate level. Nursing staff should provide precise interventions for patients with different latent categories of disease uncertainty in conjunction with its influencing factors.

Objective:To explore the developmental trajectories of care dependency in patients after percutaneous coronary intervention (PCI) and to identify its influencing factors.Methods:A convenience sampling method was used to recruit patients who underwent PCI at China-Japan Friendship Hospital of Jilin University from August 2023 to July 2024. The Chinese version of the Care Dependency Scale was administered at 1 week, 1 month, 3 months, and 6 months postoperatively. A latent growth mixture model was employed to identify trajectories of care dependency. Logistic regression analysis was used to examine the influencing factors.Results:A total of 397 questionnaires were distributed, and 389 valid questionnaires were returned, with a response rate of 97.98% (389/397). Three distinct trajectories of care dependency were identified among the 389 patients: stable low dependency, recovering high dependency, and persistent high dependency. Age, cardiac function classification, number of comorbidities, frailty, self-efficacy, and utilization of chronic disease resources were significantly associated with different trajectory classes ( P<0.05) . Conclusions:Care dependency after PCI exhibits heterogeneity in its developmental trajectories. Patients in the persistent high-dependency group represent a high-risk subgroup requiring special attention. Nursing staff should enhance their ability to recognize trajectory patterns and implement precise interventions based on trajectory type and influencing factors.