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.

ObjectiveTo interpret the main contents of the Expert Consensus on Clinical Application of Yifei Zhike Capsules （hereinafter referred to as the Consensus）， analyze its evidence basis， and explore future research directions， thus providing a reference for rational drug use in clinical practice. MethodsThe core contents of the Consensus are summarized. Focusing on clinical issues， this paper summarizes the recommendations and consensus suggestions in the Consensus and explains them from aspects such as indications， key advantages， usage and dosage， combined medication， contraindications， precautions， and safety. ResultsThe Consensus clearly states that Yifei Zhike capsules can be used for acute or chronic bronchitis， pulmonary tuberculosis and other respiratory system diseases. It for the first time proposes that the applicable TCM syndrome of Yifei Zhike capsules is Qi-Yin deficiency together with combined phlegm and stasis. For different diseases， the Consensus provides specific usage instructions， dosage， and treatment course recommendations， supplementing the contents not covered in the drug instructions. In terms of combined medication， the Consensus emphasizes the principle of using this drug in combination with standardized chemotherapy regimens or conventional Western medicines and the applicability for the treatment of pulmonary tuberculosis and moderate to severe acute or chronic bronchitis. In terms of safety， the Consensus proposes methods for identifying common adverse reactions， drug contraindications， and precautions based on a review of the existing data and preliminarily builds a risk management framework. However， the evidence on which the Consensus is based are mostly early studies， with small sample sizes， which result in the low evidence grades （mainly C and D） of some recommendations. ConclusionThe Consensus provides specific guidance for the clinical use of Yifei Zhike capsules. However， due to the limited quality of the existing research evidence， more high-quality clinical studies are needed in the future to further verify its efficacy， safety， and explore its broader application prospects.

Objective:To investigate the mechanisms of baicalin in treating septic acute liver injury through a combination of network pharmacology and animal experiments.Methods:Thirty male C57BL/6 mice (6 weeks old) were divided into five groups ( n=6): control group (normal saline), model group [lipopolysaccharide (LPS) 10 mg/kg, intraperitoneal injection], low-dose baicalin group (10 mg/kg), high-dose baicalin group (20 mg/kg), and baicalin-only group (20 mg/kg, without LPS). Baicalin was administered orally for 14 consecutive days prior to modeling. Mice were sacrificed 24 h after LPS injection. Alanine transaminase, aspartate transaminase liver tissue histopathology were measured; neutrophil infiltration was visualized using immunofluorescence; mRNA expression levels of interleukin (IL)-1β, IL-17, IL-6, and tumor necrosis factor (TNF)-α were detected by RT-qPCR; and the expression of Toll-like receptor 4 (TLR4) and phosphorylated nuclear factor (NF)-κB proteins were analyzed by Western blotting. Results:In the LPS model group, the ALT, AST, and histopathological injury score were (148.60±22.02) U/L, (81.58±11.59) U/L, and 8.50(7.75, 9.25), respectively. These indicators were significantly reduced in the high-dose baicalin group with (77.90±16.79) U/L, (49.92±14.89) U/L, and 1.00(1.00, 2.25) (all P<0.05). Compared with the LPS group, neutrophil infiltration in the liver of high-dose baicalin group was also significantly reduced [1.18%(0.98%, 1.22%) vs. 6.13%(5.41%, 8.69%), P<0.05]. RT-qPCR results showed that the relative mRNA expression levels of inflammatory cytokines IL-1β [(1.03±0.06) vs. (2.60±0.34)], IL-17 [(1.21±0.12) vs. (2.94 ± 0.39)], IL-6 [(1.37±0.26) vs. (2.73±0.18)], and TNF-α [(1.18±0.10) vs. (3.30±0.92)] were significantly decreased in the high-dose baicalin group compared with the LPS group (all P<0.05). Western blot analysis revealed that the relative protein expression levels of TLR4 [(1.25±0.13) vs. (1.73±0.06)] and phosphorylated NF-κB [(1.25±0.25) vs. (1.79±0.12)] were also significantly lower in the high-dose baicalin group (both P<0.05). Conclusion:Baicalin reduces liver injury in septic mice by downregula-ting the expression of pro-inflammatory cytokines IL-1β, IL-6, TNF-α, and IL-17, potentially through the inhibition of the TLR4/NF-κB signaling pathway.

Objective:To establish and evaluated a logistic regression model for predicting the acute biliary pancreatitis (ABP) based on liver-injury related indexes.Methods:Clinical data of 210 patients diagnosed with acute pancreatitis (AP) at the Affiliated Hospital of Jiangnan University from October 2020 to December 2022 were retrospectively analyzed, including 113 males and 97 females, with a median age of 52 years (range, 43 to 58). Among these, 88 were diagnosed with ABP and 122 with acute non-biliary pancreatitis (ANBP). Additionally, a test cohort was created using data from 101 AP patients diagnosed between January and December 2023, including 60 males and 41 females, with a median age of 53 years (range, 43 to 63). Based on the original dataset, univariate and multivariate logistic regression analyses were conducted to identify the factors influencing ABP. A prediction probability formula (Pre) was then established based on the multivariate results. The effectiveness of each indicator in predicting ABP was evaluated using the receiver operating characteristic (ROC) curve. The ROC curve analysis determined the optimal cutoff value of Pre, which was subsequently used to diagnose ABP and ANBP in the test cohort.Results:Multivariate logistic regression analysis showed the factors influencing ABP include direct bilirubin (DBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), cholinesterase (CHE), and fibrinogen (FIB). Based on the multivariate analysis results, the prediction probability formula (Pre) for ABP was established as follows: P=1/{1+ exp[-(4.807+ 0.134×DBIL-1.859×AST/ALT-0.0003×CHE-0.387×FIB)]}. ROC curve analysis revealed that the area under the curve (AUC) for Pre in predicting ABP was 0.858, with an optimal cutoff value of 0.56, at which the sensitivity was 69.3% and the specificity was 91.0%. Using the cutoff value of 0.56 for Pre, ABP was diagnosed when Pre≥0.56 and ANBP was diagnosed when Pre<0.56. This criterion was applied to diagnose patients in the test cohort, where the sensitivity and specificity of Pre for diagnosing ABP were 86.1% and 92.3%, respectively.Conclusion:The logistic regression model based on liver injury-related indicators is a valuable tool for clinically assessing the incidence of ABP.

Objective:To investigate the correlation between blood lipid levels and arterial stiffness in middle-aged and elderly Han Chinese individuals with angiotensin-converting enzyme(ACE)gene I/D polymorphism in Beijing.Methods:This was a cross-sectional study.The Han Chinese residents, aged 45 years and above, from Haidian District of Beijing, were recruited for the survey from May to August 2022.Based on the inclusion and exclusion criteria, 356 subjects were included, of which 100(28.09%)were male and 256(71.91%)were female.According to the population division criteria proposed by the World Health Organization, the subjects were divided into 253 cases in the middle-aged group[45-59 years old, median age 52.5(49.0, 56.0)years]and 103 cases in the elderly group[60-89 years old, median age 63.0(61.0, 65.0)years].Subjects were tested for ACE genotyping, lipids and brachial-ankle pulse wave velocity(baPWV).Lipid indices included triglyceride(TG), total cholesterol(TC), low density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C).Results:In the middle-aged group, there were no significant differences in plasma levels of TC, TG and HDL-C between individuals with the DD genotype and those with the ID/Ⅱ genotype(all P>0.05).Similarly, in the elderly group, no significant differences were observed in plasma TC, TG, and HDL-C levels between individuals with the DD genotype and those with the ID/Ⅱ genotype(all P>0.05).In the middle-aged group, plasma LDL-C levels were significantly higher in the DD phenotype than in the ID/Ⅱ phenotype( Z=-2.483, P=0.013), while there was no significant difference in plasma LDL-C levels between the two phenotypes in the elderly group( Z=-0.935, P=0.350).There were no significant differences in baPWV between the DD and ID/Ⅱ phenotypes in both the middle-aged and elderly groups( Z=-0.104, -1.490, P=0.917, 0.136).In the elderly group, plasma TG levels were positively correlated with baPWV in the DD phenotype( r=0.590, P=0.016).In the middle-aged group, plasma TG levels were positively correlated with baPWV in the ID/Ⅱ phenotype( r=0.158, P=0.019), while plasma HDL-C levels were negatively correlated with baPWV( r=-0.174, P=0.009). Conclusions:Among middle-aged and elderly individuals with different ACE gene I/D polymorphisms, there are differences in blood lipid indicators sensitive to arterial stiffness.For middle-aged individuals with the ID/Ⅱ phenotype, arterial stiffness is more sensitive to high TG and low HDL-C levels, whereas for elderly individuals with the DD phenotype, arterial stiffness is more sensitive to high TG levels.These findings offer an experimental foundation for tailored blood lipid management strategies across diverse populations, aiming to maintain cardiovascular health and reduce the occurrence of cardiovascular diseases.

Objective Based on the intervention map to develop a comprehensive nutrition education program for pancreaticoduodenectomy patients and to explore the effect of its clinical application,aiming at providing references for clinical nursing practice.Methods A convenience sampling method was used to select 76 patients who were to undergo pancreaticoduodenectomy in the department of hepatobiliary and pancreatic surgery of a tertiary hospital in Anhui Province as the study subjects.The 38 patients admitted from October 2021 to September 2022 were in a control group,and the 38 patients admitted from October 2022 to July 2023 were in an experimental group.The experimental group received the comprehensive nutritional education programme constructed in this study,and the control group used conventional nutrition health education measures,and the length of intervention for both groups was from pre-hospitalization to discharge for 6 months.Nutrition-related indicators,postoperative complications,hospitalisation time,hospitalisation costs and satisfaction were compared between the 2 groups.Results A total of 64 patients completed this study,with 33 in the experimental group and 31 in the control group.Repeated measurement analysis of variance showed that the interaction effects of BMI,total serum protein and serum preprotein were statistically significant(P＜0.05).The incidence of complications,hospitalization days and hospitalization costs of the experimental group were lower than those of the control group(P＜0.05).The scores of nutrition education-related satisfaction in the experimental group were higher than those in the control group(P＜0.001).Conclusion A comprehensive nutritional education program based on intervention map can improve the nutritional status of pancreaticoduodenectomy patients to a certain extent,reduce the occurrence of complications,and promote patients'recovery.

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.

Objective To explore the application of plasma-activated solution(PAS)in the treatment of peritoneal metastasis in mice.Methods A mice model of peritoneal tumor transplantation was established,and PAS was prepared for intervention in the mice.The growth of the peritoneally transplanted tumor was assessed using in vivo imaging technology,while the apoptosis level was evaluated through flow cytometry,immunofluorescence,and Western blotting.Results At the in vitro level,there was no significant impact on tumor cell apoptosis level under adherent conditions observed when utilizing PAS(P＞0.05).Under non-adherent condition,PAS significantly augmented tumor cell apoptosis level(P＜0.05),substantially increased the proportion of deceased cells(P＜0.05),and markedly elevated intracellular total and mitochondrial reactive oxygen species levels(P＜0.05).In vivo level,using PAS following peritoneal transplanted tumor formation exhibited no noteworthy influence on peritoneal transplanted tumor growth(P＞0.05),while immediate utilization of PAS during model conducting effectively reduced abdominal tumor spread(P＜0.05).Conclusion PAS inhibits tumor peritoneal dissemination in mice by promoting tumor cell anoikis.

Salvia miltiorrhiza (S. miltiorrhiza) represents a crucial component of traditional Chinese medicine, demonstrating effects on blood circulation activation and stasis removal, and has been widely utilized in asthma treatment. This study isolated a novel phenolic acid (S1) from S. miltiorrhiza and investigated its anti-asthmatic activity and underlying mechanisms for the first time. An allergic asthma (AA) model was established using ovalbumin (OVA). The mechanism of S1's effects on AA was investigated using multi-factor joint analysis, flow cytometry, and co-culture systems to facilitate clinical asthma treatment. S1 (10 or 20 mg·kg^-1) was administered daily to mice with OVA-induced AA (OVA-AA) during days 21-25. The study examined airway responsiveness, lung damage, inflammation, and levels of immunoglobulin E (IgE), PGD2, interleukins (IL-4, 5, 10, 13, 17A), tumor necrosis factor α (TNF-α), GM-CSF, CXCL1, CCL11, and mMCP-1. Additionally, mast cell (MC) activation and degranulation were explored, along with T helper type 17 (Th17)/Treg immune cells and TLR4 pathway biomarkers. The antagonistic activity of that specific antagonist of TLR4 (TAK-242) (1 µmol·L^-1), a specific TLR4 blocker, against S1 (10 µmol·L^-1) was examined in co-cultured 16HBE cells and bone marrow-derived cells (BMDCs) or splenic lymphocytes (SLs) induced with LPS (1 µg·mL^-1) to elucidate the TLR4 pathway's mediating role. S1 demonstrated reduced airway responsiveness, lung damage, and inflammation, with downregulation of IgE, PGD2, interleukins, TNF-α, GM-CSF, CXCL1, CCL11, and mMCP-1. It also impeded MC activation and degranulation, upregulated IL-10, and influenced Th17/Treg immune cell transformation following OVA challenge. Furthermore, S1 inhibited the TLR4 pathway in OVA-AA mice, and TLR4 antagonism enhanced S1's positive effects. Analysis using an OVA-AA mouse model demonstrated that S1 alleviates AA clinical symptoms, restores lung function, and inhibits airway response. S1's therapeutic effects occur through regulation of Th17/Treg immune cells and inflammation, attributable at least partially to the TLR4 pathway. This study provides molecular justification for S1 in AA treatment.

Objective:To investigate the clinical application value of whole brain computed tomography perfusion(CTP)imaging combined with computed tomography angiography(CTA)on head and neck in treating chronic ischemic cerebrovascular disease(ICVD)by superficial temporal artery-middle cerebral artery(STA-MCA)bypass.Methods:Fifty patients with suspected chronic ICVD who admitted to Chengdu Second People's Hospital and Deyang People's Hospital(29 cases from Chengdu Second People's Hospital and 21 cases from Deyang People's Hospital)from May 2020 to October 2024 were selected.All patients underwent whole-brain CTP examination and CTA examination on head and neck before the surgery,and then,the preoperative assessment efficacy of the combination of the two examination for patients with STA-MCA surgical indication was analyzed.The changes of the CTP parameters[cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT),time to drain(TTD),and time to maximum(Tmax)]between the affected side and the healthy side before surgery,and between them after surgery,and these parameter of affected side between before and after surgery were compared respectively.The course and the anastomosis conditions of the bypass vessels were analyzed through CTA images.The CTP parameters of patients with postoperative cerebral hyperperfusion syndrome(CHS)were statistically analyzed.Then,the relationship between the changes of cerebral perfusion values on the affected side after surgery and CHS,as well as the follow-up situation,were analyzed.Results:In 50 patients with suspected chronic ICVD,34 patients with surgical indication of STA-MCA bypass were screened out by CTA combined with CTP,who existed severely narrowed or occluded blood vessels accompanied by reduced CTP,and other 16 cases who did not meet surgical indication of STA-MCA bypass were excluded.In 34 patients with chronic ICVD,the preoperative CBF value of affected side was lower than that of healthy side,and the preoperative MTT,TTD and Tmax values of affected side were all higher than those of the healthy side,and the differences were statistically significant(t=6.648,6.030,10.638,14.063,P<0.05),while there was not significant difference in CBV value between two sides(P>0.05).In the affected side,the postoperative CBF value was higher than preoperative CBF value,and the postoperative MTT,TTD and Tmax values were lower than preoperative these indicators,and the differences were statistically significant(t=8.578,7.166,11.321,11.912,P<0.05).There was no significant difference in the CBV value between before and after surgery(P>0.05).In 34 patients with chronic ICVD,there was not significant difference in CTP parameters between the affected side and the healthy side in 28 patients with chronic ICVD after 6 patients with CHS were excluded(P>0.05).The results of CTA showed that the diameter size and course of superficial temporal artery of all patients were clearly displayed,and the bypass vessels of them were unblocked,and the anastomoses of them were well developed.All 34 patients with chronic ICVD successfully completed unilateral STA-MCA bypass surgery.After the surgery,based on the clinical symptoms and the CTP reexamination results of the patients,it was determined that 6 patients(17.7%)were CHS,whose appearances were the CBF value of affected side was(60.81±5.79)ml/100(g·min),which was significantly higher than that[(53.30±5.21)ml/100(g·min)]of the healthy side.The MTT value of affected side was(2.9±0.82)s,which was significantly lower than that of the healthy side(4.2±1.1)s,and the differences were statistically significant(t=2.358,2.341,P<0.05).In the postoperative follow-up of 2 to 17 months for patients,there was not dead case,and the clinical symptoms of the most of patients were improved significantly,and there was no serious adverse events.Conclusion:Whole-brain CTP combined with CTA examination on head and neck is conducive to accurately determine the degree of vascular stenosis and cerebral perfusion before surgery,and screen patients with chronic ICVD who occurred indications of STA-MCA surgery,and can also assess the patency of bypass vessels,the recovery degree of cerebral perfusion,and the possibility of occurring CHS after surgery,which has important clinical guiding value.