Background Air pollution exposure has a significant impact on maternal and child health. However, the research on the association between ambient ozone (O₃) exposure during pregnancy and the risk of premature birth in newborns is limited, and the conclusions are inconsistent. Objective To investigate the association of ambient O₃ exposure during pregnancy with the risk of preterm birth in Guangdong Province. Methods Data of pregnant women in Guangzhou from 2013 to 2019 and Foshan from 2018 to 2023 were collected, and O₃ concentrations during different trimesters were assessed according to maternal residential addresses. Bilinear interpolation was used to evaluate the concentrations of air pollution. A cohort study design was adopted in our study. Restricted cubic spline curves were used to evaluate the exposure-response relationship between O₃ exposure and preterm birth risk and explore potential exposure threshold of O₃. Logistic regression models were used to evaluate the association of O₃ exposure with preterm birth. Results A total of 702 924 pregnant women were included in this study, of whom 43 051 (6.12%) were preterm. The average O₃ exposure concentrations of pregnant women during the first, second, third, and whole trimesters were 95.51, 97.51, 100.60, and 97.87 μg·m⁻³, respectively. We observed J-shaped associations between O₃ exposure and preterm birth risk during the second, third, and whole trimesters of pregnancy using restricted cubic spline curves. This study found that there were threshold concentrations between O₃ exposure and preterm birth risk during different gestational periods, and the threshold concentrations in the first, second, third, and whole trimesters were 112.32, 99.83, 111.74, and 112.46 μg·m⁻³, respectively. During the second, third, and whole trimesters of pregnancy, after adjusting for maternal age, baby sex, pre-pregnancy body mass index, mode of delivery, baby birth weight, gestational diabetes, and gestational hypertension, the odds ratios (OR) of preterm birth were 1.02 (95%CI: 1.01, 1.04), 1.02 (95%CI: 1.00, 1.03), and 1.17 (95%CI: 1.13, 1.21) for each 10 μg·m⁻³ increase in O₃ concentration above the O₃ threshold. No significant association was found between O₃ exposure and the risk of preterm birth during the first trimester. Conclusion There is a nonlinear association between the risk of preterm birth and O₃ exposure during pregnancy, and higher concentrations of O₃ exposure during pregnancy are associated with the risk of preterm birth. Above the O₃ threshold concentration during pregnancy, especially during the second, third, and whole trimesters, the risk of preterm birth elevates with the increase of O₃ exposure concentrations.

Objective To investigate the relationship between abnormal expression of angiotensin-converting enzyme(ACE)and lipoprotein(a)[Lp(a)]with hypertension-diabetes comorbidity.Methods A case-control analysis was conducted on 342 patients with metabolic diseases admitted in our hospital between January 2021 and May 2024,and they were divided into in a diabetes-hypertension comorbidity group(114 cases),a diabetes group(114 cases)and a hypertension group(114 cases).Another 114 matched healthy individuals who taking physical examination in our hospital during the same period were subjected and served as the control group.Clinical data were collected and serum levels of ACE and Lp(a)were measured in all the groups.Multivariate logistic regression analysis was applied to analyze the independent risk factors for hypertension-diabetes comorbidity,and ROC curve analysis was performed to evaluate and predict the efficacy.Results The serum levels of ACE and Lp(a)were significantly higher in the comorbidity group than the control,hypertension and diabetes groups(P＜0.01),and in the hypertension and diabe-tes groups than the control group(P＜0.01).After adjusting for waist-to-hip ratio,alanine amin-otransferase and triglyceride,multivariate logistic regression analysis revealed that serum ACE and Lp(a)still were risk factors for the occurrence of hypertension-diabetes comorbidity(P＜0.01).ROC curve analysis demonstrated that when the cut-off value was 39.01 pg/L,ACE had an AUC value of 0.884(95％CI:0.789-0.980),a sensitivity of 76.67％and a specificity of 75.28％in predicting the comorbidity,and when the cut-off value for Lp(a)was 254.33 mg/L,the AUC value was 0.899(95％CI:0.799-0.919),the sensitivity was 85.83％,and the specificity was 82.22％.Their combination improved the AUC value to 0.993(95％CI:0.979-1.000),with a sensitivity of 95.00％and a specificity of 95.28％in the prediction.Conclusion Serum ACE and Lp(a)are independent risk factors for hypertension-diabetes comorbidity,and can be combined together and regarded as biomarkers for early identification of the comorbidity.

Objective: To explore the diagnostic value of a column chart constructed based on composite inflammatory indicators for cardiac valve calcification(CVC) in peritoneal dialysis(PD) patients. Methods: A retrospe-ctive analysis was conducted on the data of 117 PD patients admitted in the past 5 years, and the patients were divided into a CVC group and a non CVC group based on whether they had formed CVC. The general clinical data of the two groups were compared, and univariate and multivariate binary logistic regression analyses were used to determine the predictive variables and construct a predictive model. The two predictive models, which only included traditional factors and included composite inflammation indicators at the same time, were evaluated from the aspects of discrimination, calibration, and clinical practicality. Reclassification analysis was used to evaluate the improvement of the column chart model in identifying CVC formation in PD patients. Results: A prediction model was established by incorporating six predictive variables: age, pan immune inflammatory value, blood calcium, C-reactive protein/albumin, low-density lipoprotein cholesterol, and parathyroid hormone. The area under the curve of the traditional prediction model without composite inflammatory indicators and the column chart prediction model with composite inflammatory indicators were 0.909 4(95%CI: 0.858 0-0.960 7) and 0.972 7(95%CI: 0.947 7-0.997 7), respectively, indicating good discriminability of the column chart prediction model. The calibration curve showed that the calibration curves before and after calibration were close to the fitting line, indicating that the calibration degree of the column chart prediction model was high. The decision curve showed that the column chart prediction model had a high net benefit. By calculating the net reclassification index and comprehensive discriminant improvement index. It was found that the column chart model had a significant improvement in identifying the risk of CVC formation in PD patients, indicating its good clinical effectiveness. Conclusion The column chart prediction model constructed with age, pan immune inflammatory value, blood calcium, C-reactive protein/albumin, low-density lipoprotein cholesterol, and parathyroid hormone can help identify the risk of CVC in PD patients and provide guidance for clinical diagnosis and treatment.

ObjectiveTo investigate the effect of Yuejuwan on lipid metabolism in serum， prefrontal cortex and hippocampus of depressed mice based on lipidomics， and to explore the potential pathways for improving lipid metabolism to prevent depression. MethodsSeven-week-old C57BL/6 mice were randomly divided into blank group， model group， Yuejuwan group（3.6 g·kg^-1） and fluoxetine group（10 mg·kg^-1）， and chronic unpredictable mild stress（CUMS） was used to establish the depression model. After 3 weeks of modeling， each administration group was gavaged with the corresponding drug solution according to the dose， and mice in the blank and model groups were given an equal volume of deionised water by gavage， one time/d for 2 weeks. After administration， the antidepressant effect of Yuejuwan was evaluated by neurobehavioral indices such as sucrose preference test， open field test， tail suspension test and forced swimming test. An automatic biochemical analyzer was used to measure contents of total cholesterol（TC）， triglyceride（TG）， low-density lipoprotein cholesterol（LDL-C）， high-density lipoprotein cholesterol（HDL-C）， aspartate aminotransferase（AST） and alanine aminotransferase（ALT） in mouse serum. Lipidomic analysis of mouse serum， prefrontal cortex and hippocampus was performed based on ultra-performance liquid chromatography-linear ion trap-electrostatic field orbitrap mass spectrometry（UPLC-LTQ-Orbitrap-MS）， and the expression of mammalian target of rapamycin（mTOR）， ribosomal protein S6 kinase（S6K）， phosphorylation（p）-mTOR， p-S6K in gastric tissues of mice was detected by Western blot. ResultsCompared with the blank group， mice in the model group exhibited significantly reduced sucrose preference rate and center movement time in the open field test（P<0.01）， the immobility times in the tail suspension test and forced swimming test were significantly increased（P<0.01）， and serum levels of TC， TG， LDL-C， HDL-C， AST and ALT were significantly elevated（P<0.05， P<0.01）. Compared with the model group， the Yuejuwan group showed a significant increase in the sucrose preference rate and center movement time in the open field test（P<0.01）， the immobility times in the tail suspension test and forced swimming test were significantly reduced（P<0.01）， and the serum levels of TC， TG， LDL-C， AST and ALT were significantly decreased（P<0.05， P<0.01）. Lipidomic analysis revealed that Yuejuwan had a significant effect on lipid metabolism in serum， prefrontal cortex and hippocampus of depressed mice， and The differential lipid metabolites were mainly enriched in the metabolic pathways of glycerophospholipid metabolism， sphingolipid signaling， and glycosylphosphatidylinositol-anchored protein biosynthesis， among which the glycerophospholipid metabolic pathway was the most significant. Western blot results showed that compared with the blank group， the relative expression levels of p-mTOR/mTOR and p-S6K/S6K in the gastric tissues of mice in the model group were significantly increased（P<0.01）. In comparison with the model group， the relative expression levels of p-mTOR/mTOR and p-S6K/S6K in the gastric tissues of mice in the Yuejuwan group were significantly decreased（P<0.01）. ConclusionThe intervention of Yuejuwan on lipid metabolism is one of the potential pathways for its antidepressant effect， which may be related to the regulation of mTOR/S6K signaling pathway upstream of lipid metabolism in the gastric tissues.

Objective To investigate the relationship between abnormal expression of angiotensin-converting enzyme(ACE)and lipoprotein(a)[Lp(a)]with hypertension-diabetes comorbidity.Methods A case-control analysis was conducted on 342 patients with metabolic diseases admitted in our hospital between January 2021 and May 2024,and they were divided into in a diabetes-hypertension comorbidity group(114 cases),a diabetes group(114 cases)and a hypertension group(114 cases).Another 114 matched healthy individuals who taking physical examination in our hospital during the same period were subjected and served as the control group.Clinical data were collected and serum levels of ACE and Lp(a)were measured in all the groups.Multivariate logistic regression analysis was applied to analyze the independent risk factors for hypertension-diabetes comorbidity,and ROC curve analysis was performed to evaluate and predict the efficacy.Results The serum levels of ACE and Lp(a)were significantly higher in the comorbidity group than the control,hypertension and diabetes groups(P＜0.01),and in the hypertension and diabe-tes groups than the control group(P＜0.01).After adjusting for waist-to-hip ratio,alanine amin-otransferase and triglyceride,multivariate logistic regression analysis revealed that serum ACE and Lp(a)still were risk factors for the occurrence of hypertension-diabetes comorbidity(P＜0.01).ROC curve analysis demonstrated that when the cut-off value was 39.01 pg/L,ACE had an AUC value of 0.884(95％CI:0.789-0.980),a sensitivity of 76.67％and a specificity of 75.28％in predicting the comorbidity,and when the cut-off value for Lp(a)was 254.33 mg/L,the AUC value was 0.899(95％CI:0.799-0.919),the sensitivity was 85.83％,and the specificity was 82.22％.Their combination improved the AUC value to 0.993(95％CI:0.979-1.000),with a sensitivity of 95.00％and a specificity of 95.28％in the prediction.Conclusion Serum ACE and Lp(a)are independent risk factors for hypertension-diabetes comorbidity,and can be combined together and regarded as biomarkers for early identification of the comorbidity.

Objective:Using the established epilepsy patient database to validate the efficacy of the web-based epilepsy diagnosis and anti-seizure medications (ASM) selection tool, EpiPick, for domestic epilepsy patients.Methods:The retrospective collection of clinical data was conducted on patients aged 10 and above who were diagnosed with epilepsy at the Comprehensive Epilepsy Center of the First Affiliated Hospital of Kunming Medical University from January 2017 to December 2020, with regular follow-up and complete information. According to the first ASM recommended by the EpiPick tool and whether they are consistent with the actual ASM used by patients, patients were divided into EpiPick group and clinical group to verify the effectiveness of the EpiPick tool in selecting ASM. The drug retention rate, Engel score, and cumulative probability of no consecutive episodes within 30 months after using the first ASM were compared between the 2 groups, and Kaplan-Meier survival curves were drawn. Finally, the diagnostic results provided by the EpiPick tool were compared with the actual types of epileptic seizures diagnosed clinically, and consistency tests were performed.Results:A total of 364 epilepsy patients were included, including 237 in the EpiPick group and 127 in the clinical group. The ASM retention rates of patients in the EpiPick group and clinical group were 67.9%(161/237) and 56.7%(72/127), respectively, with statistically significant differences (χ2=4.534, P=0.039). Grades Ⅰ, Ⅱ, Ⅲ and Ⅳ according to the Engel scores in the EpiPick group patients who took the first ASM after diagnosis accounted for 47.3%(112/237), 14.8%(35/237), 12.7%(30/237), and 25.3%(60/237), respectively, compared to the clinical group of 32.3%(41/127), 11.8%(15/127), 11.0%(14/127), and 44.9%(57/127), respectively. There was a statistically significant difference in Engel scores between the 2 groups (χ2=14.968, P=0.002). The cumulative seizure-free rates in the EpiPick group at the 1st, 6th, 12th, 30th month and above after starting the first ASM were 73.8%, 61.2%, 53.2%, and 50.6%, respectively, which in the clinical group were 52.0%, 44.1%, 40.2%, and 33.5%, respectively. The logrank test showed a statistically significant difference in the cumulative probability of consecutive seizure freedom between the 2 groups ( HR=0.644 ,95% CI 0.476-0.871 ,P<0.001). After grouping by seizure type [focal seizures (196 cases) and generalized seizures (168 cases)], the cumulative seizure-free rates at the 1st, 6th, 12th, 30th month and above after starting ASM were significantly higher in the EpiPick group than in the clinical group (comparison between the 2 groups in patients with focal seizures: HR=0.654, 95%CI 0.443-0.964, P=0.004; comparison between the 2 groups in patients with generalised seizures: HR=0.586, 95%CI 0.361-0.954, P=0.014). Among 364 patients, 293 cases were clinically diagnosed with seizure classification consistent with the classification results of EpiPick tool. Agreement between the algorithm and the experts in classifying generalized seizures was 83.9%(104/124), which in classifying focal seizures was 78.8%(189/240; Kappa=0.591, P<0.001). Conclusion:Web-based EpiPick tool is suitable to be used to select the first ASM, and is portable for Chinese non-epilepsy specialists to choose ASM for epilepsy patients.

Objective:To explore the differences of the circadian rhythm gene polymorphisms between patients with major depressive disorder and those with bipolar disorder, providing a genetic basis for differential diagnosis.Methods:70 patients who were still diagnosed with major depressive disorder after 5 years and 68 patients who were still diagnosed with bipolar disorder from Zhongda Hospital affiliated to Southeast University from 2012 to 2018 were included in this study. Single nucleotide polymorphisms (SNPs) of circadian rhythm gene were selected for genetic testing. And the differences in genotype frequency, allele frequency, and haplotypes of each SNP between major depressive disorder and bipolar disorder were analyzed using UNPHASED 3.1.7.Results:The analysis of genotype frequency revealed statistically significant differences in genotype frequency of PER1rs2253820, PER1rs2735611, PER3rs12566042, PER3rs17031614, and PER3rs79372391 between the two groups ( OR(95% CI)=2.386(1.173-4.854), 2.357(1.166-4.764), 0.351(0.176-0.703), 0.389(0.196-0.773), 0.389(0.196-0.773) respectively; all P<0.05). Haplotype analysis showed that the T-C-C-T-G haplotype, in CLOCK loci (rs12505266, rs2272073, rs3817444, rs11133389 and rs12505265) was significantly different between major depressive disorder group and bipolar disorder group ( OR(95% CI)=0.108(0.010-1.185), P=0.027). Conclusion:There are significant differences in circadian rhythm gene polymorphisms between patients with major depressive disorder and bipolar disorder. Carrying the PER1rs2253820TT and PER1rs2735611GG genotypes is a risk factors for bipolar disorder.

Objective To investigate the effects of MCSO on physiological behavior and antioxidant index in D.melanogaster.Methods One-day-old wild type D.melanogaster was divided into control group,0.25％,0.5％,1％,2％and 4％dose groups,as well as male and female groups.The control group was exposed to the base medium,and each dose group was exposed to the MCSO medium added with 0.25％,0.5％,1％,2％and 4％concentrations,respectively.The optimal dosage concentration and time of administration were investigated by climbing experiment.Then the flies were divided into control group,model group and MCSO group.The model group was established by depriving the flies of sleep through repeated nocturnal light stimulation.Period of drug treatment,appetite test,negative geotaxis ability test,stress test,olfactory memory test,and sleep-wake rhythm detection were used to explore the effects of MCSO on their physiological behavior.The activities of super oxidase dismutase(SOD),catalase(CAT),and malondialdehyde(MDA)were detected by enzyme-linked immunosorbent assay.Results MCSO enhanced the locomotory ability of 30-day-old D.melanogaster(P＜0.01),increased the activity of SOD and CAT(P＜0.01),and decreased the concentration of MDA(P＜0.01).Improve olfactory memory of senile fruit flies.After sleep deprivation,the night sleep time of female Drosophila model group was reduced(P＜0.05),and that of male Drosophila model group was reduced(P＜0.01).After feeding MCSO,the night sleep time of female drosophila model group was extended(P＜0.05),and that of male drosophila model group was extended(P＜0.01).Conclusions MCSO had a certain antioxidant effect,prolonging the sleep time and improving the olfactory memory of sleep-deprived Drosophila.

AIM: To analyze the abnormal refractive status of infants and young children aged 6 to 48 months, and to provide basis for the correction of ametropia and the early prevention and treatment of amblyopia.METHODS: Infants and young children aged 6 to 48 months were examined for refraction by Spot vision screener for natural optometry. Clinical data of infants and young children with refractive abnormalities were collected, Ciliary muscle paralysis agent was used for retinoscopy and optometry, and the results were statistically analyzed.RESULTS: A total of 168 cases(336 eyes)with abnormal Spot refractive outcomes were collected, with a high proportion of hyperopia and astigmatism abnormalities, 38.4% and 28.6%, respectively, while the proportion of myopia was low(12.2%). There were 90 cases of anisometropia(≥1.00 D), among which 41 cases(45.6%)were astigmatic anisometropia, 33 cases(36.7%)were hyperopic anisometropia, and 16 cases(17.8%)were myopic anisometropia, accounting for the least proportion. A total of 109 infants and young children with Spot refractive abnormalities completed ciliary muscle paralysis retinal optometry. The analysis of the difference and correlation between Spot diopter and post ciliary muscle paralysis optometry results showed that the difference in astigmatism was 0.34±0.64 D(P<0.001), the difference in hyperopia was -2.10±1.27 D(P<0.001), and the difference in myopia was -0.43±0.91 D(P=0.023). Although there was a statistical difference between the two results, astigmatism, hyperopia, and myopia were highly positively correlated, respectively(r=0.694, 0.762, 0.909).CONCLUSION: The main refractive abnormalities in infants and young children aged 6 to 48 months are astigmatism, hyperopia, and anisometropia, with fewer abnormalities in myopia. For screening abnormalities, further ciliary muscle paralysis agent retinoscopy and optometry should be performed, and glasses correction should be given to effectively prevent refractive amblyopia in infants and young children.

Objective To investigate the epidemiological status of toxic diffuse goiter hyperthyroidism (abbreviated as hyperthyroidism) in Xining area and analyze its influencing factors. Methods Patients with toxic diffuse goiter and hyperthyroidism who were hospitalized in Class ⅲ Grade A hospitals in Xining from January 2020 to January 2023 were collected as the experimental group by random cluster sampling method. During the same period, 500 healthy people in each hospital were selected as the control group. The general data of the patients were collected and the levels of thyroid function indexes of the two groups were detected. Multivariate logistic regression was used to analyze the influencing factors of diffuse goiter with hyperthyroidism. Results A total of 718 questionnaires were collected in this study, and 705 questionnaires were collected after excluding invalid questionnaires. There were 234 males and 471 females in 705 patients with diffuse goiter and hyperthyroidism. The most common age was 41-50 years, followed by 51-60 years and 31-40 years. The serum TSH level of the experimental group was lower than that of the control group, and the levels of FT3 and FT4 were higher than those of the control group ( P < 0.05 ) . There was no significant difference in family history, thyroid texture and thyroid imaging between the two groups ( P > 0.05 ). There were significant differences in exophthalmos and thyroid weight between the two groups (P<0.05). Multivariate Logistic regression analysis showed that exophthalmos, thyroid weight ≥30g , TSH , FT3 and FT4 were independent risk factors for the experimental group ( P < 0.05) . Conclusion Gender, age, exophthalmos, thyroid weight and thyroid related hormone levels are the influencing factors of diffuse goiter and hyperthyroidism in Xining area . Thyroid function should be monitored for early prevention and treatment of the disease.