Objective Objective To analyze the potential spatial factors affecting the genetic differentiation of Oncomelania hupensis robertsoni in Yunnan Province. Methods A total of 13 administrative villages were selected from schistosomiasis-endemic areas of Yunnan Province as O. hupensis snail sampling sites. At least 200 snails were collected in each site, and the spatial variable data of each site were recorded, including longitude, latitude and altitude. Thirty active and Schistosoma japonicum uninfected O. hupensis snails were selected from each sampling site by means of the crawling method and the cercarial shedding method. Genomic DNA was extracted from O. hupensis snails. Following PCR amplification, purification of PCR amplification products and sequencing, the gene sequences of O. hupensis snail samples were spliced and edited using the DNAstar software and the NCBI database to yield the complete mitochondrial sequences of O. hupensis snails at each sampling site, and the mitochondrial genetic distance matrix of O. hupensis robertsoni was calculated at each sampling site. The geographical coordinates of each sampling site were marked using the software ArcGIS 10.2, and the straight-line geographical distance between each sampling site was calculated. The altitude difference, longitude difference and latitude difference between each sampling site were calculated using the Excel software, and the correlation between the mitochondrial genetic distance matrix of O. hupensis robertsoni and each spatial variable matrix was examined by using the Mantel test at 13 sampling sites in Yunnan Province. Results Among the 13 O. hupensis snail sampling sites in Yunnan Province, the largest mitochondrial genetic distance of O. hupensis robertsoni snail populations was seen between Anding Village, Nanjian Yi Autonomous County and Caizhuang Village, Midu County (26.244 2), and the largest geographical distance was seen between Dongyuan Village, Gucheng District and Cangling Village, Chuxiong County (272.64 km). The highest altitude difference was seen between Anding Village, Nanjian Yi Autonomous County and Dongyuan Village, Gucheng District (1 086.10 m), and the largest longitude difference was found between Qiandian Village, Eryuan County and Cangling Village, Chuxiong County (1.86°), while the largest latitude difference was measured between Leqiu Village, Nanjian Yi Autonomous County and Dongyuan Village, Gucheng District (1.81°). In addition, the mitochondrial genetic distance of O. hupensis robertsoni snail populations was positively correlated with altitude at 13 snail sampling sites in Yunnan Province (r = 0.542 8, P < 0.001), and showed no significant correlations with geographical distance (r = 0.093 4, P > 0.05), longitude (r = −0.199 5, P > 0.05) or latitude (r = 0.205 7, P > 0.05). Conclusion Altitude may be a potential spatial factor affecting the genetic differentiation of O. hupensis robertsoni in Yunnan Province.

Objective To compare the clinical efficacy, safety, and patient’ prognosis of catheter-directed thrombolysis (CDT) via anterior tibial vein and popliteal vein approaches in the treatment of acute lower extremity deep vein thrombosis (DVT). Methods A retrospective analysis was conducted on the clinical data of 195 patients diagnosed with acute mixed lower extremity DVT and treated with CDT in the Department of Interventional and Vascular Surgery, Affiliated Hospital of Nantong University from January 2020 to December 2023. Patients were divided into an observation group (anterior tibial vein approach, n＝97) and a control group (popliteal vein approach, n＝98) according to the puncture route. Baseline data, thrombolysis-related indices (urokinase dosage, coagulation function indices), efficacy measures (degree of thrombus dissolution, leg circumference difference, visual analogue scale [VAS] score, venous clinical severity score [VCSS]), recovery parameters (time to ambulation, length of hospital stay), complication rates, and long-term prognosis measures (Villalta score, incidence of post-thrombotic syndrome [PTS]) were compared between the two groups. Results There was no statistically significant difference in urokinase dosage and levels of coagulation function indices between the two groups. Postoperatively, the leg circumference difference at 15 cm below the knee, VAS score, and VCSS score were significantly lower in the observation group than in the control group (P＝0.001). The observation group had higher grade Ⅲ dissolution rates in the popliteal and anterior tibial veins compared to the control group (P＜0.05), while differences of dissolution rates in the iliac and femoral veins were not statistically significant. The observation group had shorter length of hospital stay and earlier ambulation times than the control group (P＝0.001). There were no significant differences in complication rates, Villalta scores, or PTS incidence between the two groups. Conclusions CDT via the anterior tibial vein puncture approach for acute mixed lower extremity DVT is superior to the popliteal vein approach in promoting resolution of lower extremity swelling, alleviating pain, improving venous clinical symptoms, and achieving higher thrombus dissolution rates in the popliteal and anterior tibial veins. It also enables faster recovery and demonstrates good safety.

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.

Postoperative pulmonary complications(PPCs)represent a frequent and severe challenge following surgery,particularly in patients undergoing thoracic or abdominal procedures that necessitate tracheal intubation and mechanical ventilation.PPCs typically manifest within 7 days post-surgery.Effective perioperative management,encompassing optimization of lung-protective ventilation strategies,real-time monitoring of pulmonary ventilation status,and timely interventions,can substantially decrease the incidence of PPCs.As an emerging non-invasive imaging modality,electrical impedance tomography(EIT)has garnered significant attention in recent years for its clinical applications,especially in perioperative lung-protective ventilation.EIT enables real-time and dynamic visualization of lung ventilation distribution,providing a critical foundation for developing personalized ventilation strategies.This significantly enhances the safety and efficacy of mechanical ventilation while improving patient outcomes.The aim of this article is to elucidate the fundamental principles and advantages of EIT,explore its role in perioperative lung protection,and examine its future development prospects,thereby offering additional reference and guidance for clinical practice.

Objective:To study the effects of epidermal growth factor(EGF)on the coordinated motor behaviors and changes of nigrostriatal dopaminergic system under the impact of EGF in middle-aged rats.Methods:Healthy aged Sprague Dawley(SD)rats were subcutaneously administered EGF(0.1 mg/ml)in the dorsal region for 7 days.Adhe-sive removal test,tapered beam walking test and descending a wire mesh pole test were performed to detect the changes in the coordinated motor behaviors of rats as well as changes in the expression of tyrosine hydroxylase(TH)and dopa-mine transporter(DAT)of nigrostriatal dopaminergic system in rats.Results:Middle-aged rats showed reduced behav-ioral parameters of adhesive removal test,tapered beam walking test and descending a wire mesh pole test compared with those of adult rats(P<0.05),which were improved after treatment with EGF(P<0.05).The expression of TH and DAT in nigrostriatal dopaminergic system was down-regulated in middle-aged rats compared with that in adult rats(P<0.01),however,which were up-regulated after treatment with EGF(P<0.01).Conclusion:EGF can amelio-rate the decline in coordinated motor behaviors and increases the activity of nigrostriatal dopaminergic system in middle-aged rats.

Objective:To study the effects of epidermal growth factor(EGF)on the coordinated motor behaviors and changes of nigrostriatal dopaminergic system under the impact of EGF in middle-aged rats.Methods:Healthy aged Sprague Dawley(SD)rats were subcutaneously administered EGF(0.1 mg/ml)in the dorsal region for 7 days.Adhe-sive removal test,tapered beam walking test and descending a wire mesh pole test were performed to detect the changes in the coordinated motor behaviors of rats as well as changes in the expression of tyrosine hydroxylase(TH)and dopa-mine transporter(DAT)of nigrostriatal dopaminergic system in rats.Results:Middle-aged rats showed reduced behav-ioral parameters of adhesive removal test,tapered beam walking test and descending a wire mesh pole test compared with those of adult rats(P<0.05),which were improved after treatment with EGF(P<0.05).The expression of TH and DAT in nigrostriatal dopaminergic system was down-regulated in middle-aged rats compared with that in adult rats(P<0.01),however,which were up-regulated after treatment with EGF(P<0.01).Conclusion:EGF can amelio-rate the decline in coordinated motor behaviors and increases the activity of nigrostriatal dopaminergic system in middle-aged rats.

Objective To summarize and analyze the main clinical characteristics,feature and composition changes of gut microbiota in elderly patients with severe pneumonia,and to further explore the potential correlation between the gut characteristics and the etiology of severe pneumonia in elderly patients.Methods Patients with severe pneu-monia admitted to the respiratory intensive care unit of a tertiary teaching hospital in Changsha were selected as the research subjects.Patients aged ≥65 years were assigned to the elderly severe pneumonia group,while those aged＜65 years were assigned to the non-elderly severe pneumonia group.Based on clinical characteristics and pathogen detection of lower respiratory secretion,the elderly severe pneumonia group was further divided into a pulmonary bacterial infection group and a pulmonary fungal infection group.The pulmonary bacterial infection group was sub-divided into Gram-positive bacteria group and Gram-negative bacteria group based on Gram-staining results.Clinical data of patients were collected,and fecal specimens within 24 hours after admission were obtained for 16S rRNA se-quencing.Differences in gut microbiota characteristics between two groups of patients were compared,and the cor-relation between clinical characteristics of patients in the elderly severe pneumonia group and the abundance of dif-ferential microbiota was analyzed.Subsequently,the gut microbiota characteristics of elderly patients in severe pneumonia group infected by different pathogens were analyzed.Results Gut microbiota analysis showed no signifi-cant statistical differences in α-and β-diversity indicices between patients in the elderly and non-elderly severe pneu-monia groups(both P＞0.05).Linear discriminant analysis effect size(LEFSe)analysis indicated that,compared with patients in the non-elderly severe pneumonia group,the relative abundance of opportunistic pathogens,inclu-ding Pseudomonadales,Moraxellaceae,and Acinetobacter,was significantly higher in patients in the elderly severe pneumonia group(all P＜0.05).Some differential gut microbiota in two groups of patients were correlated with clinical indicators in patients in the elderly severe pneumonia group(all P＜0.05).β-diversity analysis(principal co-ordinate analysis)combined with Anosim analysis revealed that in patients in elderly severe pneumonia group,there was significant differences in gut colony structures between patients in the bacterial and fungal infection groups(R=0.149,P=0.02).Compared with the fungal infection group,patients in bacterial infection group showed a signifi-cantly reduced abundance of probiotics,including Verrucomicrobiales and Collinsella,and opportunistic pathogens such as Akkermansia(all P＜0.05).Conclusion Elderly patients with severe pneumonia have a dysregulated gut microbiota with significantly increased abundance of pathogenic bacteria compared with non-elderly patients.Differ-ential gut microbiota of two groups of patients are correlated with some infection-related and organ function indica-tors in elderly patients with severe pneumonia.Compared with elderly patients with severe fungal pneumonia,those with severe bacterial pneumonia have significant differences in gut colony structures and a notably reduction in probi-otics abundance.

Objective:To analyze the role of the Hippo signaling pathway in epithelial-mesenchymal transition (EMT) of triple-negative breast cancer (TNBC) cells.Methods:70 patients with TNBC admitted to the Yan ′an People′s Hospital from April 2021 to September 2023 were selected. Before treatment, real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the mRNA expression levels of Hippo signaling pathway-related indicators (Yap, ta Z, mst 1) in peripheral blood, and the patients were treated with the TP regimen for 21 days. After the treatment, puncture biopsy was performed on the tumor tissues of the patients. They were divided into the transformation group and the non-transformation group based on whether EMT occurred. The influencing factors of EMT in tumor cells of TNBC patients were analyzed, and the value of the Hippo signaling pathway in predicting EMT in tumor cells of TNBC patients was analyzed.Results:After treatment, 18 cases (25.71%) of 70 patients with TNBC developed EMT. The proportion of tumor node metastasis (TNM) stage Ⅳ in the transformation group was (13/18), the level of Yap mRNA was (4.82±0.63), the level of taZ mRNA was (2.93±0.41), and the mst 1 mRNA level (3.09±0.51) and the long diameter of the tumor [(5.95±0.77)cm] were both higher than those in the non-transformation group [44.23%(23/52), (3.84±0.59), (2.34±0.39), (2.45±0.47), (4.14±0.63)cm] (all P<0.05). Binary logistic regression analysis revealed TNM stage Ⅳ [ OR=4.768, 95% CI(1.630, 13.951)], Yap mRNA [ OR=5.675, 95% CI(1.940, 16.602)], and taZ mRNA [ OR=5.124 95% CI(1.751, 14.992)], mst 1 mRNA [ OR=5.557, 95% CI(1.899, 16.257)], tumor long diameter [ OR=3.850, 95% CI(1.316, 11.263)] was an influencing factor for the occurrence of EMT in tumor cells of TNBC patients (all P<0.05). After analysis by the receiver operating characteristic (ROC) curve, the combined sensitivity of TNM stage Ⅳ, Yap mRNA, taZ mRNA, mst 1 mRNA, and tumor long diameter in predicting EMT in tumor cells of TNBC patients was 66.67%, 72.22%, 77.78%, 72.22%, 77.78%, and 88.89%, respectively. The specificities were 69.23%, 71.15%, 76.92%, 73.08%, 75.00% and 92.31% respectively. The combined prediction of TNM stage Ⅳ, Yap mRNA, taZ mRNA, mst 1 mRNA, and tumor long diameter in tumor cells of TNBC patients had a relatively high value (all P<0.05). Conclusions:The combined detection of TNM stage Ⅳ, Yap mRNA, taZ mRNA, mst 1 mRNA, and tumor long diameter can better predict the occurrence of EMT in tumor cells of patients with TNBC.

Objective To simulate modern social stress using a pre-pregnancy chronic mild stress(CMS)model and to explore the mechanisms of emotional,behavioral,and neurodevelopmental changes in male offspring of pre-pregnancy liver qi stagnation female mice through corticosterone(CORT)-brain-derived neurotrophic factor(BDNF)extracellular signal-regulated kinase(ERK)1/2 signaling cascade-mediated hippocampal injury.This study aimed to elucidate the impact of negative life events on offspring and the interventional mechanism of Shuyu Capsules.Methods CMS stress was used to induce pre-pregnancy depression in female rats(liver qi stagnation state),followed by intervention with Shuyu and fluoxetine capsules.After screening,male rats were mated and 12 male offspring from each group were selected for behavioral testing and detection of serum CORT levels by enzyme-linked immunosorbent assay.BDNF,ERK1/2,phospho(p)-ERK1/2,cAMP-response element binding protein(CREB),and p-CREB protein levels in the hippocampus were detected by Western Blot,and BDNF,ERK1,ERK2,and CREB mRNA levels in the hippocampus were detected by reverse transcription-polymerase chain reaction(RT-PCR),to verify the effects of pre-pregnancy CMS on the BDNF-ERK1/2-CREB signaling pathway and to investigate the key micro-mechanisms of Shuyu Capsules on emotional and learning memory-related behaviors of male offspring of females with pre-pregnancy liver qi stagnation syndrome.Results The distance,number of entries,and duration of stay in the central area in open-field experiments were significantly reduced in offspring in the model group(all P＜0.05).The escape latency during the exploration period of the water-maze experiment was significantly prolonged(P＜0.05)and the swimming distance,duration of the target quadrant,and number of platform crossings were significantly reduced(P＜0.05,P＜0.05,P＜0.01),the suspension time and frequency in the forced-swimming experiment were increased(P＜0.05,P＜0.01),and the incubation period was shortened(P＜0.05)in offspring in the model group.Prophylactic treatment with Shuyu Capsules and fluoxetine improved the depression-like behavior and cognitive impairment in the offspring in the model group.Biochemical tests showed that CORT levels were increased in the CMS model group(P＜0.05),BDNF,p-ERK1/2,and p-CREB protein levels in the hippocampus were decreased(all P＜0.05),and BDNF,ERK1,ERK2,and CREB mRNA levels were significantly reduced(P＜0.01,P＜0.05,P＜0.01,P＜0.05).Treatment with Shuyu Capsules and fluoxetine increased the CORT content and BDNF,ERK1/2,and CREB protein and mRNA levels in male offspring to varying degrees.Conclusions High levels of CORT in offspring act selectively on the hippocampus,exerting adverse effects on the emotional and learning memory functions of rats by downregulating the BDNF-ERK1/2 signaling cascade.The Chinese medicine Shuyu Capsules can reduce the impact of an adverse intrauterine environment on offspring development by correcting abnormal levels and pathways of glucocorticoids.

Objective To explore the role and potential mechanisms of plasma-activated solution(PAS)in alleviating dextran sulfate sodium salt(DSS)-induced ulcerative colitis.Methods We constructed a DSS-induced ulcerative colitis mouse model and evaluated the effect of PAS in vivo by observing mouse weight,calculating disease activity indexes,detecting inflammatory factors and oxidative stress indicators through ELISA.We also evaluated the effect of PAS on colon cell proliferation and migration ability through clone formation experiments,scratch experiments,and used Western blotting to determine the expression levels of proliferation-related proteins.Results PAS significantly reversed DSS-induced weight loss and increased disease activity indexes in mice(P＜0.05).The serum inflammatory cytokine levels(TNF-α,IL-6 and IL-1β)in PAS group were significantly reduced compared to those in DSS group(P＜0.05).PAS treatment could improve the imbalance of colonic redox homeostasis including changes of malondialdehyde,catalase and superoxide dismutase caused by DSS(P＜0.05).After the use of endothelial nitric oxide synthase inhibitors,changes in various indicators caused by in vivo PAS disappeared(P＜0.001).The clone formation ability of colon cells was stronger in the group treated with PAS,and the expression of proliferation-related proteins increased.Cell scratch experiments suggested that intervention with PAS could reverse the decrease in cell migration ability caused by lipopolysaccharide(P＜0.001).After the application of endothelial nitric oxide synthase inhibitors,the pro-proliferative and migratory effects of PAS disappeared(P＜0.05).Conclusion PAS alleviate DSS-induced colitis in mice and promote colonic epithelial cell repair through the eNOS pathway.