Background Large-for-gestational-age (LGA) births are associated with adverse perinatal outcomes and increased risks of offspring obesity, metabolic syndrome, and cardiovascular diseases later in life. Beyond traditional risk factors, exposure to environmental factors, especially fine particulate matter (PM_2.5), before and during pregnancy may contribute to excessive fetal growth; however, the roles of specific chemical constituents and critical exposure windows remain unclear. Objective To examine the associations between maternal exposures to PM_2.5 and its chemical constituents before and during pregnancy and the risk of delivering LGA infants. Methods Singleton pregnancies from the National Free Preconception Health Examination Project between 2010 and 2014 were included. Individual exposures to PM_2.5 and its constituents were estimated for preconception and pregnancy windows using geocoded residential addresses. The associations of single and mixed exposures with LGA risk were analyzed using generalized linear models (GLMs) and qg-computation. Results Exposures to PM_2.5 and its major chemical constituents were significantly associated with an increased LGA risk, with differences in effect magnitude across components. Secondary inorganic aerosols showed the strongest associations. For full-pregnancy exposure, nitrate (OR=1.330, 95%CI: 1.313, 1.347), ammonium (OR=1.279, 95%CI: 1.263, 1.295), and sulfate (OR=1.242, 95%CI: 1.227, 1.257) had larger effects on LGA risk than black carbon and organic matter. Analysis by exposure window indicated that the month preceding conception and the third trimester of pregnancy were critical exposure windows for susceptibility, while the strongest effect was observed for full-pregnancy exposure, suggesting a cumulative effect over time. Mixed exposure analysis further showed that nitrate and sulfate consistently accounted for the main positive contributions across different time windows. Conclusion Maternal exposures to PM_2.5 and its chemical components before and during pregnancy are associated with an elevated LGA risk. Nitrate and sulfate show consistent and strong associations across pregnancy stages, underscoring the importance of component composition and exposure timing in fetal overgrowth.

Objective To analyze the disease burden and trends of bladder cancer in China and globally from 1992 to 2021.  Methods Using the GBD 2021 database, the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) rates of bladder cancer in China and globally from 1992–2021 were analyzed. Average annual percentage change (AAPC) was calculated using Joinpoint regression. Subgroup analyses by sex and age were conducted, and a Bayesian age-period-cohort (BAPC) model was used to predict trends in age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) for the next 15 years.  Results In 2021, China reported 106 000 new cases (ASIR: 5.14/100 000), 571 000 prevalent cases (age-standardized prevalence rate, ASPR: 26.61/100 000), 43 000 deaths (ASMR: 2.34/100 000), and a DALY rate of 45.31/100 000. From 1992–2021, China showed upward trends in ASIR and ASPR but declines in ASMR and DALYs, while global ASIR, ASMR, and DALYs decreased overall with slow ASPR growth. The peak cases in China and globally were both concentrated in the 65-79 age group, with a significantly higher burden on males than females. In China, smoking-related ASMR and ASDR exceeded global averages and rose, whereas high glucose-related indexes were lower and declined. Projections for 2021–2036 indicated that the global incidence and mortality rates would be rising, but ASIR/ASPR would be declining, while in China, the incidence rate would continue to rise, and the mortality rate will stabilize, with a significant increase in ASIR and a gradual decrease in ASPR.  Conclusion From 1992 to 2021, the incidence of bladder cancer in China has shown a continuous upward trend and is projected to persist in the future, with significant gender and age differences. Particular attention should be given to elderly males aged 85-89. The disease burden of bladder cancer attributable to smoking continues to rise, highlighting the urgent need to strengthen tobacco control policies.

Objective:To study the effects of Qingre Lishi Prescription on ATP-P2X7R-IL-1β signaling pathway in rats with acute gouty arthritis.Methods:Otally 60 SPF-grade SD rats were divided into normal group, model group, colchicine group, and Qingre Lishi Prescription low-, medium- and high-dosage groups according to random number table method; the normal group and model group were given distilled water at a dosage of 10 ml/kg by gavage, the colchicine group was given colchicine solution at a dosage of 0.6 mg/kg by gavage, and Qingre Lishi Prescription low-, medium- and high-dosage groups were given Qingre Lishi Prescription extract suspension at dosages of 11.76, 23.52, and 47.04 g/kg by gavage, once a day for 7 consecutive days. Except for the normal group, AGA models were prepared by gavage on the 4th day in all other groups, and the swelling index of the right posterior ankle joint of rats was measured at 6, 12, 24, 48, and 72 hours after modeling; after 7 days of administration, samples were taken and HE staining was used to observe the pathological changes in the synovial tissue of the right posterior ankle joint. ELISA was used to detect the levels of serum ATP, IL-1 β, IL-8, and IL-37, and immunohistochemistry was used to detect the positive rates of P2X7R and IL-1 β proteins in the synovial tissue of the right posterior ankle joint.Results:At 6, 12, 24, 48, and 72 hours after modeling, compared with the model group, the swelling index of the colchicine group and Qingre Lishi Prescription low-dosage group decreased ( P<0.01); the levels of serum ATP, IL - β, IL-8, and IL-37 decreased in the colchicine group and Qingre Lishi Prescription low-, medium-, and high-dosage groups ( P<0.01); the expressions of P2X7R and IL-1 β proteins in the synovial tissue of the right posterior ankle was reduced in the colchicine group and Qingre Lishi Prescription high-dosage group ( P<0.05). Conclusion:Qingre Lishi Prescription may improve joint swelling and alleviate synovial tissue inflammation in AGA model rats through ATP/P2X7R/IL-1β-mediated inflammatory factor pathway.

Objective To investigate the effects of increasing the ejection seat backrest angle on the body pressure distribution of pilots of different body types,and to provide a basis for the design of ejection seats,flight training,and the development of strategies to alleviate muscle fatigue.Methods Male fighter pilots were divided into normal and overweight groups according to their body mass index(BMI),and a total of 40 pilots were tested for the distribution of sitting pressure under the two seat inclination angles of 20°and 33°by using the body pressure distribution measurement system.The effects of different seat inclination angles on sitting comfort were also analyzed.Results The pressure distributions of pilots with different body types were significantly different at different seat inclination angles.Compared with the 20°seat,the 33°seat condition had a larger cushion contact area[F(1,78)=40.281,P<0.001],a smaller average pressure and average pressure gradient[F(1,78)=32.030,P<0.001;F(1,78)=12.594,P<0.001],and significantly reduced average,maximum pressure,and maximal pressure gradients for the backrest[F(1,78)=10.516,P=0.002;F(1,78)=26.803,P<0.001;F(1,78)=4.918,P=0.029,respectively].In addition,overweight individuals with BMI had a notable increase in the cushion contact area[F(1,78)=21.038,P<0.001]and the backrest contact area[F(1,78)=8.301,P=0.005].No significant interaction was observed for angle and BMI.Conclusion An increased seat inclination angle results in a more uniform distribution of pressure across the human body,thereby increasing comfort.Moreover,the disparities in pressure and backrest distribution across disparate body types at varying seat angles provide a vital foundation for the optimized design of seating.

Objective To investigate the impact of blood sampling from different sites on coagula-tion results during systemic heparin anticoagulation period treated by continuous renal replacement therapy(CRRT).Methods Seventy-eight patients undergoing CRRT with systemic heparin anticoag-ulation were selected.Using a self-control method,blood samples were simultaneously collected from sampling port at input end of the CRRT extracorporeal circuit,the arterial pressure monitoring cathe-ter,and the peripheral vein of the patients.The four coagulation parameters were tested,and the differences in coagulation results among the blood sampling sites were compared.Results During CRRT with systemic heparin anticoagulation,the four coagulation parameters using blood samples col-lected from the sampling port at the input end of the CRRT extracorporeal circuit,the arterial pressure monitoring catheter,and the peripheral vein showed no statistically significant differences(P＞0.05).Subgroup analyses based on different hemofiltration machines and heparin doses also showed no statisti-cally significant differences(P＞0.05).Conclusion During CRRT,blood sampling from the sam-pling port at the input end of the circuit or the arterial pressure monitoring catheter can be used as an alternative to peripheral venous blood sampling,with no impact on coagulation results.

This article retrospectively analyzed the clinical data of three recipients who developed acute antibody mediated rejection (AMR) after receiving different courses of immunotherapy prior to liver transplantation for hepatocellular carcinoma. It focused on their diagnostic and therapeutic processes, including the immunosuppressive induction regimen [rabbit anti-human thymocyte globulin (rATG) + methylprednisolone] , postoperative liver function changes, diagnostic methods for acute AMR (such as allograft liver biopsy, panel reactive antibody testing, and donor-specific antibody testing) , and the combination treatment strategies used (rATG, rituximab, intravenous immunoglobulin, and plasma exchange). The aim of this article is to summarize the clinical characteristics, diagnosis, and treatment experiences of acute AMR occurring after liver transplantation in patients with liver cancer who had received immunotherapy, explore the potential risks involved, and provide a reference for clinicians in managing such cases.

Objective To investigate the diversity and composition of gut fungi microbiota in patients with polycystic kidney disease(PKD)and its correlation with clinical indicators.Methods A total of 44 PKD patients,44 patients with non-polycystic chronic kidney disease(NPCKD)and 22 healthy controls(HC)admitted to our hospital from February 2023 to February 2024 were recruited.ITS1 DNA sequencing was applied to analyze the gut fungal composition.Bioinformatics analysis was used to compare the diversity and structural differences of fungi among the 3 groups.Pearson correlation analysis was performed to analyze the relationship between gut fungi and clinical indicators.Results There were no significant differences in baseline characteristics(gender,age,body mass index,etc.)among the 3 groups,but statistical differences were seen in terms of serum indicators(such as serum creatinine,blood urea nitrogen,uric acid,estimated glomerular filtration rate,etc.)(P<0.01).Alpha diversity analysis showed no significant difference was seen between the PKD and HC groups,but the PKD group had significant differences to the NPCKD group(P<0.01).Beta diversity analysis revealed significant differences among the 3 groups and in pairwise comparisons(P=0.001).Fungi composition analysis found that the abundance of Candida was significantly higher in the PKD group than the other 2 groups(P<0.01),while the abundances of Aspergillus and Cladosporium were significantly lower in the PKD group than the HC group(P<0.05).Linear discriminant analysis(LEFSe)indicated that Candida was significantly enriched,while Aspergillus and Cladosporium were significantly reduced in the PKD group.Correlation analysis revealed that the abundance of Cladosporium was negatively correlated with cyst diameter and immunoglobulin light chain Kappa/Lambda ratio in the PKD group(P<0.05),while the abundance of Candida was positively correlated with liver/kidney cyst diameter(P<0.01).Conclusion PKD patients exhibit characteristic changes in gut fungi diversity and composition.The abundances of Cladosporium and Candida are closely associated with clinical indicators of PKD patients.

Objective To analyze the diversity and composition of gut microbiota in individuals with circadian rhythm disruption and their correlation with cognition.Methods Night shift workers and regular shift workers were subjected from our hospital during August 2022 and October 2024.The participants with circadian rhythm disorders were assigned into an experimental group(n=24),and those with normal circadian rhythms were into a control group(n=24).Their height,weight,age,gender,body mass index(BMI)and fresh fecal samples were collected,and Montreal Cognitive Assessment(MoCA)and Mini-Mental State Examination(MMSE)were used to evaluate their mental status.Metagenomics,Alpha and Beta diversity analyses,Linear Discriminant Analysis Effect Size(LEfSe),and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis were employed to investigate the diversity and function characteristics of gut microbiota in the participants.Results There were no statistical differences between the 2 groups in baseline data,such as height,weight,gender,age,and BMI(P>0.05).Alpha diversity analysis indicated that no statistical differences were observed in the ACE,Chao1,Shannon,or Simpson indices between the 2 groups,while beta diversity analysis revealed significant differences(P<0.01),suggesting different structure of gut microbiota between them.In the experimental group,the abundance of Faecalibacterium prausnitzii and Agathobacter rectalis was decreased,while that of Escherichia coli and Phocaeicola vulgaratus was increased,with significant differences when compared with the control group(P<0.05).Additionally,KEGG functional analysis showed that the experimental group had obviously higher expression levels in Th17 cell differentiation and the IL-17 signaling pathway than the control group(P<0.05).Agathobacter rectalis and Faecalibacterium prausnitzii were positively correlated with MoCA score and MMSE score(P<0.05,P<0.01).Agathobacter rectalis was negatively correlated with the IL-17 signaling pathway and Th17 cell differentiation.Conclusion Individuals with circadian rhythm disorders have significant changes in the structure and function of gut microbiota when compared to those with normal circadian rhythms.Agathobacter rectalis may be involved in the regulation of the IL-17 signaling pathway and differentiation of Th17 cells,thereby possibly impacting the increases of cognitive score related to circadian rhythm disorders.

Objective To explore the underlying mechanisms by which time-restricted feeding(TRF)attenuates dextran sodium sulfate(DSS)-induced colitis in mice via modulation of regenerating islet-derived protein 3 gamma(Reg3γ)expression and gut microbiota.Methods Six-week-old C57BL/6 mice were stratified by body weight and randomized into ad libitum feeding(AL)and TRF groups(n=7).The AL mice were given unrestricted food access,whereas the TRF mice were allowed feeding only during 00:00 and 08:00 daily,for totally 4 weeks.Mouse colitis model was induced at the fourth week by adding 2.5%dextran sodium sulfate(DSS)in drinking water for 6 d.Disease severity and the effects of TRF were assessed with disease activity index(DAI)scoring,colon length measurement,HE staining and histopathological scoring,and mRNA expression levels of regenerating islet-derived 3 gamma(Reg3g)and inflammatory cytokines in colonic tissues.Another 14 mice were randomized into AL plus antibiotic cocktail(AL+ABX)and TRF plus antibiotic cocktail(TRF+ABX)groups,with 7 animals in each group.ABX was administered to deplete gut microbiota and evaluate the microbiota dependence of TRF in attenuating colitis.Fecal samples from AL and TRF mice were analyzed by 16S ribosomal RNA sequencing(16S rRNA-seq),and serum lipopolysaccharide(LPS)level was measured.The colonic epithelial cells were collected for RNA-seq.Results After modeling,the AL mice exhibited typical colitis symptoms,such as weight loss,diarrhea,and hematochezia.TRF intervention significantly attenuated these above symptoms,with lower DAI scores from day 4 post-modeling(P<0.001),reduced colon shortening(P<0.01),preserved tissue architecture,and decreased inflammation.RT-qPCR analysis showed that TRF down-regulated colonic mRNA expression levels of Reg3g and pro-inflammatory cytokines(IL-1 β,IL-6,TNF-α)(P<0.05)while up-regulated that of anti-inflammatory factor IL-10(P<0.000 1)when compared with the corresponding levels in AL mice.ABX treatment led no significant differences between the AL+ABX and TRF+ABX groups in term of DAI score,colon length,or histopathology.Obviously down-regulated Reg3g was observed in the TRF+ABX group than the AL+ABX group(P<0.05),whereas L-1β,IL-6,TNF-α and IL-10 showed no notable changes.16S rRNA-seq revealed that TRF markedly reshaped gut microbiota composition,with increased Gram-positive bacterial abundance,reduced Gram-negative bacteria,with concomitant lower serum LPS level(P<0.001).RNA-seq also indicated significant suppression of NF-κB and other inflammation-related signaling pathways in the TRF group.Conclusion TRF attenuates DSS-induced colitis in mice by downr-egulating Reg3γ expression,reshaping gut microbiota,and reducing serum LPS level,and thereby suppressing NF-κB-mediated inflammatory signaling pathways.

Objective:To analyze the clinical characteristics of patients with adverse reactions to facial skin-lightening cosmetics.Methods:A retrospective analysis was conducted on the adverse reaction reports caused by facial skin-lightening cosmetics in the cosmetic adverse reaction reporting system of Yantai city of Shandong province from July 2020 to December 2023. The general information of the patients (such as age, gender), reporting sources, clinical characteristics (types of adverse reactions, skin lesion morphology and subjective symptoms), and channels for purchasing cosmetics were summarized and analyzed.Results:A total of 450 cases of adverse reactions caused by facial skin-lightening cosmetics were identified, predominantly involving females (429 cases, 95.33%). Age distribution was most commonly found from 31 to 40 years (174 cases, 38.67%), followed by 21 to 30 years (130 cases, 28.89%), 41 to 50 years (71 cases. 15.78%), ≥51 years (46 cases, 10.22%), and ≤20 years (29 cases, 6.44%). The main sources of reporting were medical and health institutions (401 cases, 89.11%), followed by cosmetics operators (22 cases, 4.89%), patients (20 cases, 4.44%), business enterprises (3 cases, 0.67%), market supervision and administration bureaus (3 cases, 0.67%), and medical cosmetology hospital (1 case, 0.22%). Cosmetic contact dermatitis was the most common type of cosmetic adverse reaction (416 cases,91.43%), and the common skin lesions included erythema (342 cases,45.00%), papula (166 cases,21.84%), edema and so on. The common symptoms were pruritus (369 cases,49.20% ), burning sensation (158 cases,21.07%) and so on. Online sales was the main purchasing channel (333 cases, 74.01%).Conclusions:The adverse reactions caused by facial skin-lightening cosmetics are mainly found in women, and contact dermatitis is the most common type of cosmetic adverse reaction, predominantly presenting with erythema and manifesting as pruritus.