Objective To investigate the protective effect and mechanism of tanshinone ⅡA on D-galactosamine(D-GalN)-induced acute liver failure in rats.Methods SD rats were randomly di-vided into control group,model group(intraperitoneal injection of 1.1 g/kg D-GalN),low-dose group(intraperitoneal injection of 1.1 g/kg D-GalN+daily gavage of 25 mg/kg tanshinone ⅡA),and High-dose group(intraperitoneal injection of 1.1 g/kg D-GalN+daily gavage of 50 mg/kg tan-shinone ⅡA).Liver function indicators[aspartate aminotransferase(AST),alanine aminotransferase(ALT),and γ-glutamyltransferase(γ-GT)]were measured using a Hitachi7600-210 biochemical an-alyzer,and serum total bilirubin(TBIL)and direct bilirubin(DBIL)levels were determined.The mitotic index(MI)and proliferating cell nuclear antigen(PCNA)positivity in liver tissues were examined.Enzyme-linked immunosorbent assay(ELISA)was used to detect plasma levels of tumor necrosis factor(TNF-α),interleukin(IL)-1β,IL-10,and IL-6 in rats from each group.Kits were employed to measure superoxide dismutase(SOD),glutathione(GSH),and malondialdehyde(MDA)contents in liver tissues of rats from each group.The TUNEL method was adopted to detect hepatocyte apoptosis rates in liver tissues,and immunoblotting was used to assess the expression of phosphorylated extracellular signal-regulated kinase 1/2(p-ERK1/2)and extracellular signal-regu-lated kinase 1/2(ERK1/2)proteins in liver tissues.Results Compared with the control group,the model group exhibited increased p-ERK1/2 protein expression(P＜0.05).Compared with the model group,both the low-dose and high-dose groups showed decreased p-ERK1/2 protein expres-sion(P＜0.05).The model group had an increased hepatocyte apoptosis index compared with the control group(P＜0.05).Both the low-dose and high-dose groups demonstrated decreased hepato-cyte apoptosis indices compared with the model group(P＜0.05).Compared with the control group,the model group had increased MDA levels and decreased SOD and GSH levels(P＜0.05).Both the low-dose and high-dose groups exhibited decreased MDA levels and increased SOD and GSH levels compared with the model group(P＜0.05).The model group showed increased levels of TNF-α,IL-1β,IL-10,and IL-6 compared with the control group(P＜0.05).Both the low-dose and high-dose groups had decreased levels of TNF-α,IL-1 β,IL-10,and IL-6 compared with the model group(P＜0.05).Compared with the control group,the model group had decreased MI and PCNA positivity rates(P＜0.05).Both the low-dose and high-dose groups exhibited increased MI and PCNA positivity rates compared with the model group(P＜0.05).The model group had in-creased AST,ALT,γ-GT,TBIL and DBIL values compared with the control group(P＜0.05).Both the low-dose and high-dose groups showed decreased AST,ALT,γ-GT,TBIL and DBIL val-ues compared with the model group(P＜0.05).Conclusion Tanshinone ⅡA may alleviate D-GalN-induced acute liver failure in rats through the ERK1/2 signaling pathway.

Objective:To explore the association between healthy lifestyle and co-morbidity of overweight/obesity and myopia in adolescents.Methods:Based on the Shanghai Municipal Dynamic Cohort of Student Common Diseases, we used the group-based trajectory model (GBTM) to establish a model for the development of adolescents' healthy lifestyle trajectories aged 11-14 years and the Cox proportional hazard regression model to assess the effects of different healthy lifestyles on the co-morbidity of overweight/obesity and myopia in adolescents.Results:A total of 2 331 adolescents were included in the analysis. The average follow-up time was 1.87 years, with age of (11.44±0.45) years at the initial follow-up, among 1 106 boys and 1 225 girls. During the 2-year follow-up period, the incidence rates of overweight/obesity, myopia, and co-occurrence of overweight/obesity and myopia were 25.9%, 77.0%, and 13.7%, respectively. GBTM identified 3 healthy lifestyles: the unhealthy group (7.3%), the relatively healthy group (50.2%), and the healthy group (42.5%). The risk of overweight/obesity was lower in the relatively healthy group than in the unhealthy group ( HR=0.694, 95% CI: 0.508-0.947). There was no statistically significant association between the GBTM lifestyle subgroups and myopia ( P>0.05). The risk of co-occurrence of overweight/obesity and myopia was lower in both relatively healthy group and healthy group than in the unhealthy group (relatively healthy group: HR=0.515, 95% CI: 0.348-0.763; healthy group: HR=0.571, 95% CI: 0.384-0.849). Sensitivity analyses showed this result to be stable for myopia, overweight/obesity and myopia co-morbidities. Conclusion:Persistent unhealthy lifestyle increases the risk of overweight/obesity and myopia co-occurrence in adolescents.

Objective To investigate the clinical utility of krebs von den lungen-6(KL-6),a sialoglycan antigen,in the auxiliary diagnosis of idiopathic pulmonary hemosiderosis(IPH)in children.Methods A total of 140 children admitted to the First Affiliated Hospital of Guangzhou Medical University from June 2014 to July 2024 were categorized into a case group and a control group.The case group was further subdivided into four subgroups based on disease type:IPH group(n=32),interstitial lung disease(ILD)group(n=22),pneumonia(PN)group(n=60),and non-pulmonary disease(NPD)group(n=26).Serum KL-6 levels were measured for all children across these groups,and the differences in KL-6 expression between children with IPH and those without IPH(including the ILD,PN,and NPD groups)were analyzed.Results The positive rates of KL-6 in each group of children,from highest to lowest,were as follows:IPH(68.75%),ILD(45.45%),PN(1.69%),and NPD(0.00%).The differences in positive rates between groups were statistically significant(χ2=66.10,P<0.001).The mean serum level of KL-6 in the IPH group was significantly higher than that in the PN group(Z=-6.92,P<0.001).Diagnostic test results indicated that the area under the ROC curve was 0.940(95%CI:0.89 to 1.00,P<0.001),with a cut off value of 392.00 U/mL,sensitivity of 81.30%,and specificity of 95.00%.Conclusions KL-6 demonstrates significant diagnostic value in distinguishing IPH children from those with PN and NPD,making it a promising blood biomarker for aiding in the diagnosis of IPH.

Objective To investigate the effects of fractionated low-dose ionizing radiation (LDIR) on the ferroptosis in human bronchial epithelial (HBE) cells as well as the associated differentially expressed genes (DEGs), biological processes, and signaling pathways. Methods HBE cells were exposed to different single doses of X-ray irradiation (0, 25, 50, 75, and 100 mGy) for 24, 48, and 72 h, respectively. The change in cell viability was detected by MTT assay. Cells were irradiated with 0, 25, 50, and 100 mGy X-rays 5 times, with 48 h between each irradiation and a dose rate of 50 mGy/min. Cells were harvested 24 h after irradiation for the measurement of the expression of ferroptosis-related genes SLC7A11 and GPX4 at the mRNA and protein levels, cellular iron content, and the expression of FTH1 and FTL mRNAs. High-throughput sequencing was used to screen for the DEGs in each dose group, followed by Gene Ontology-Biological Process (GO-BP) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, and Gene Set Enrichment Analysis (GSEA). Results Compared with the control group, single-dose LDIR significantly increased cell proliferation at 75 mGy after 24 h (P < 0.05), at 50, 75, and 100 mGy after 48 h (P < 0.05), and at 75 and 100 mGy after 72 h (P < 0.05). Compared with the control group, at the end of the fifth fractionated LDIR, SLC7A11 and GPX4 mRNAs decreased at all doses (P < 0.05), SLC7A11 protein decreased at all doses, GPX4 protein decreased at 25 and 100 mGy, iron content increased at all doses, and FTH1 and FTL mRNAs decreased at all doses (P< 0.05). Sequencing analysis identified 248, 30, and 291 DEGs and 10, 2, and 9 ferroptosis-associated genes at the three doses compared to the control. Gene Ontology-Biological Process analysis showed that DEGs were mainly enriched in biological processes such as response to lipids, cell death, and response to unfolded proteins. Kyoto Encyclopedia of Genes and Genomes analysis showed that DEGs were mainly enriched in the JAK-STAT signaling pathway, lipids and atherosclerosis, ferroptosis, protein processing in the endoplasmic reticulum, and FoxO signaling pathway. Gene set enrichment analysis showed that DEGs were mainly enriched in ferroptosis, fatty acid degradation, and glutathione metabolism. Conclusion Fractionated low-dose radiation induced ferroptosis in HBE cells, and DEGs were predominantly enriched in biological processes and signaling pathways related to inflammation, ferroptosis, and endoplasmic reticulum stress.

Background In recent years, the increasingly widespread application of nuclear and medical radiation technologies has resulted in a large number of occupational populations exposed to low-dose ionizing radiation (LDIR). At present, there is no consistent conclusion on the effects of long-term exposure to LDIR on the metabolic health of the occupational population. Objective To explore the association between long-term exposure to LDIR and metabolic syndrome (MetS) among medical radiologists. Methods A cross-sectional study was conducted to enroll 6431 medical radiologists who ordered occupational health checkups from January 2022 to December 2023, and basic information such as demographic characteristics, occupational characteristics, lifestyles, and dietary habits was collected through questionnaires. Physical examinations were conducted using a standardized protocol. Individual dose equivalents of occupational external exposure were monitored by dosimeters worn by medical radiologists. Logistic regression model was used for identifying influencing factors of MetS and sensitivity analysis, and restricted cubic spline model was used to explore the dose-response relationship between cumulative effective dose and MetS. Two-stage linear regression was used to evaluate threshold effect of association between cumulative effective dose and MetS. Results The positive rate of MetS was 13.6% (877/6431) among the enrolled 6431 study participants. The logistic regression showed that gender, age, monthly income, body mass index (BMI), cumulative effective dose, and smoking were influencing factors for MetS. The risk of MetS was higher in males (OR=1.511, 95%CI: 1.209, 1.888); using the < 30 years old group as reference, the risk of MetS was higher in the 30-39 years old (OR=1.509, 95%CI: 1.095, 2.079), 40-49 years old (OR=2.214, 95%CI: 1.551, 3.161), and ≥50 years old (OR=3.480, 95%CI: 2.338, 5.181) groups; using the <10000 yuan group as reference, the risk of MetS was lower in the group with a monthly income of 10000-14999 yuan (OR=0.715, 95%CI: 0.582, 0.878); the risk of MetS was higher in the BMI ≥ 24 kg·m⁻² group (OR=7.548, 95%CI: 6.223, 9.156); using the < 0.76 mSv group as reference, the risk of MetS was higher in the cumulative effective dose of 0.76-2.73 mSv group (OR=1.270, 95%CI: 1.017, 1.586); the risk of MetS was higher in the smoking group (OR=1.734, 95%CI: 1.428, 2.107). The results of restricted cubic spline showed that the cumulative effective dose was nonlinearly correlated with MetS (P _{non-linearity}=0.028), with an inflection point of 1.25 mSv. The risk of developing MetS increased by 34.1% for each unit increase in cumulative effective dose up to 1.25 mSv, whereas above 1.25 mSv, the statistical association was not significant. The sensitivity analysis results showed that after excluding the self-reported hypertensive and diabetic patients, the cumulative effective dose 0.76-2.73 mSv group still had an increased risk of developing MetS compared with the < 0.76 mSv group (P < 0.05), and the results were robust. Conclusion Among medical radiologists, male, age, BMI, and smoking are positively correlated with MetS, and monthly income is negatively correlated with MetS; cumulative effective dose is non-linearly correlated with MetS among medical radiologists.

Objective:To explore the association between healthy lifestyle and co-morbidity of overweight/obesity and myopia in adolescents.Methods:Based on the Shanghai Municipal Dynamic Cohort of Student Common Diseases, we used the group-based trajectory model (GBTM) to establish a model for the development of adolescents' healthy lifestyle trajectories aged 11-14 years and the Cox proportional hazard regression model to assess the effects of different healthy lifestyles on the co-morbidity of overweight/obesity and myopia in adolescents.Results:A total of 2 331 adolescents were included in the analysis. The average follow-up time was 1.87 years, with age of (11.44±0.45) years at the initial follow-up, among 1 106 boys and 1 225 girls. During the 2-year follow-up period, the incidence rates of overweight/obesity, myopia, and co-occurrence of overweight/obesity and myopia were 25.9%, 77.0%, and 13.7%, respectively. GBTM identified 3 healthy lifestyles: the unhealthy group (7.3%), the relatively healthy group (50.2%), and the healthy group (42.5%). The risk of overweight/obesity was lower in the relatively healthy group than in the unhealthy group ( HR=0.694, 95% CI: 0.508-0.947). There was no statistically significant association between the GBTM lifestyle subgroups and myopia ( P>0.05). The risk of co-occurrence of overweight/obesity and myopia was lower in both relatively healthy group and healthy group than in the unhealthy group (relatively healthy group: HR=0.515, 95% CI: 0.348-0.763; healthy group: HR=0.571, 95% CI: 0.384-0.849). Sensitivity analyses showed this result to be stable for myopia, overweight/obesity and myopia co-morbidities. Conclusion:Persistent unhealthy lifestyle increases the risk of overweight/obesity and myopia co-occurrence in adolescents.

Objective:To detect the levels of sex hormones and insulin in follicular fluid(FF)and the expression level of phosphatase and tensin homolog deleted on chromosome ten(PTEN)in granulosa cells in the infertile patients with polycystic ovary syndrome(PCOS),and to preliminarily explain the correlations between the insulin level and the expression level of PTEN mRNA.Methods:Seventy infertile patients were selected as the subjects and divided into PCOS group and control group(tubal obstruction or infertility due to male factors)according to infertility factors.All patients received in vitro fertilization-embryo transfer(IVF-ET)treatment.FF and ovarian granulosa cells were collected on the day of ovulation.The expression levels of PTEN mRNA in ovarian granulosa cells of the patients in two groups were detected by real-time fluorescence quantitative PCR(RT-qPCR)method.The levels of sex hormone and insulin in FF were measured by electrochemiluminescence.The correlations of the PTEN mRNA expression level in ovarian granulosa cells and testosterone(T)in FF with the level of insulin in FF were analyzed by Spearman correlation analysis method.Results:There were no significant differences in age,infertility years,body mass index(BMI),basic sex hormone,total dose of gonadotropin(Gn)and days of ovulation induction in two groups(P＞0.05).Compared with control group,the anti-Mullerian hormone(AMH)and antral follicle counting(AFC)of the patients in PCOS group were significantly increased(P＜0.05).The RT-qPCR results showed that the PTEN mRNA expression level in ovarian granulosa cells of the patients in the PCOS group was higher than that in control group(P＜0.001).The electrochemiluminescence results showed that the levels of T and insulin in FF of the patients in PCOS group were higher than those in control group(P＜0.05),whereas the estrogen and progesterone levels were lower than those in control group(P＜0.05).The Spearman correlation analysis showed that that T level in FF was positively correlated with the insulin level of the patients in PCOS group(r=0.577,P＜0.001),and the PTEN mRNA expression level in ovarian granulosa cells was positively correlated with the insulin levels in FF(r=0.616,P＜0.001);in control group,there was no correlation between T level and insulin level in FF(r=0.266,P=0.123),and there was no correlation between the expression level of PTEN mRNA in granulosa cells and the insulin level in FF in control group(r=-0.214,P=0.216).Conclusion:The high expression of PTEN in granulosa cells of the infertile patients with PCOS may be related to the local hyperinsulin level in the ovary,and PTEN participates in the occurrence and development of PCOS.

Objective To investigate the clinical utility of krebs von den lungen-6(KL-6),a sialoglycan antigen,in the auxiliary diagnosis of idiopathic pulmonary hemosiderosis(IPH)in children.Methods A total of 140 children admitted to the First Affiliated Hospital of Guangzhou Medical University from June 2014 to July 2024 were categorized into a case group and a control group.The case group was further subdivided into four subgroups based on disease type:IPH group(n=32),interstitial lung disease(ILD)group(n=22),pneumonia(PN)group(n=60),and non-pulmonary disease(NPD)group(n=26).Serum KL-6 levels were measured for all children across these groups,and the differences in KL-6 expression between children with IPH and those without IPH(including the ILD,PN,and NPD groups)were analyzed.Results The positive rates of KL-6 in each group of children,from highest to lowest,were as follows:IPH(68.75%),ILD(45.45%),PN(1.69%),and NPD(0.00%).The differences in positive rates between groups were statistically significant(χ2=66.10,P<0.001).The mean serum level of KL-6 in the IPH group was significantly higher than that in the PN group(Z=-6.92,P<0.001).Diagnostic test results indicated that the area under the ROC curve was 0.940(95%CI:0.89 to 1.00,P<0.001),with a cut off value of 392.00 U/mL,sensitivity of 81.30%,and specificity of 95.00%.Conclusions KL-6 demonstrates significant diagnostic value in distinguishing IPH children from those with PN and NPD,making it a promising blood biomarker for aiding in the diagnosis of IPH.

Objective To explore the predictive value of CT radiomics and morphological features for the prognosis and survival in non-small cell lung cancer(NSCLC)patients.Methods The clinic data of 300 NSCLC patients(300 lesions)were downloaded from the Cancer Imaging Archive,with 210 randomly selected as the training set and 90 as the test set.According to the prognosis and survival,the patients were divided into two groups with survival period≤3 and＞3 years.3D Slicer software was used to delineate the regions of interest layer by layer in CT images,and the radiomics features were extracted from each region of interest.Both t-test and least absolute shrinkage and selection operator were utilized for radiomics feature screening.Three types of prediction models,namely radiomics model,morphological model and combined model,were constructed with Logistic regression,whose performances were evaluated using the receiver operating characteristic(ROC)curve.Results The differences in radiomics labels and mediastinal lymph node metastasis between the training set and the test set were statistically significant.For radiomics model,morphological model and combined model,the area under the ROC curve was 0.784(95%CI:0.722-0.847),0.734(95%CI:0.664-0.804)and 0.748(95%CI:0.680-0.815)in the training set,and 0.737(95%CI:0.630-0.844),0.665(95%CI:0.554-0.777)and 0.687(95%CI:0.578-0.797)in the test set,which demonstrated that radiomics model had the best diagnostic performance.Conclusion The CT radiomics model can effectively predict the prognosis and survival in NSCLC patients.

Objective: To understand the current status and associated factors of comorbidity of common illnesses among primary and middle school students in Shanghai, so as to provide a reference for improving the pathogenic environment and preventing the occurrence of comorbidity of common illnesses. Methods: From September to November 2021, a stratified cluster sampling method was used to select 30 331 middle school students from 112 schools in 16 districts of Shanghai, each with 2 primary schools, 2 junior high schools, 2 high schools and 1 vocational high school. Elementary school students, their health status and influencing factor questionnaires were analyzed. Results: The detection rate of two or more common diseases such as myopia, overweight and obesity, high blood pressure, and abnormal spinal curvature among primary and secondary school students in Shanghai was 38.91%, of which 29.64% of primary and secondary school students had two diseases at the same time, and 9.19% had three diseases, 0.09% had 4 diseases. The detection rate of comorbidity was higher in boys (44.12%) than in girls (33.40%), and higher in junior high school students (40.40%) than in high school students (38.58%) and primary school students (38.01%). The differences were statistically significant (χ2=366.44, 50.33, P<0.01). Multifactor Logistic regression analysis showed that girls sometimes supervise themselves and often remind themselves that their sitting and standing postures were negatively correlated with the common comorbidities of primary and secondary school students (OR=0.64, 0.93, 0.90); junior middle school students and watching TV/d ≥1 h, using computers for ≥1 h/d, and using mobile electronic devices for >1 h/d were positively correlated with the comorbidity of common diseases among primary and secondary school students (OR=1.07, 1.10, 1.06, 1.10) (P<0.05). Conclusions The prevalence of comorbidity of common illnesses among primary and middle school students in Shanghai is not optimistic, which might be associated with combined effects of various external environmental factors. Targeted intervention should be implemented to effectively prevent the occurrence of comorbidities among students.