ObjectiveTo investigate the effects of Huangqi Jianzhongtang （HQJZ） on macrophage polarization and fat consumption in cancer cachexia （CC） mice. MethodsUltra-performance liquid chromatography-quadrupole/electrostatic field Orbitrap high-resolution mass spectrometry （UPLC-Q-Orbitrap HRMS） was used to control the quality of HQJZ. （1） In vitro experiment： HQJZ-containing serum was prepared， and the optimal concentration was determined by cytotoxicity assay. Mouse monocyte-derived macrophages （RAW264.7） were cultured and randomly divided into six groups， including a blank group， a classically activated macrophages （M1） group， an alternatively activated macrophages （M2） group， a HQJZ + blank group， a HQJZ+M1 group， and a HQJZ + M2 group. The relative expression of macrophage marker genes CD86， inducible nitric oxide synthase （iNOS）， CD206， and arginase-1 （Arg1） was detected by real-time quantitative polymerase chain reaction （Real-time PCR ）. （2） In vivo experiment： Thirty-two BALB/c mice were randomly divided into a control group， a model group， a medroxyprogesterone acetate （MPA） group， and a HQJZ group. Except for the control group， the other mice were injected with CT-26 colon cancer cells to establish a CC model. Mice in the MPA and HQJZ groups were given MPA （0.13 g·kg^-1·d^-1） or HQJZ （13.13 g·kg^-1·d^-1） by gavage， respectively， while mice in the control and model groups were given an equal volume of saline by gavage， with interventions continued for 10 d. Real-time PCR was used to detect the expression of macrophage markers （iNOS， Arg1， CD86， CD206） and fat browning-related genes uncoupling protein 1 （UCP1） and peroxisome proliferator-activated receptor γ （PPARγ） in epididymal adipose tissue. Western blot （WB） was used to detect protein expression levels of UCP1 and PPARγ. Micro-computed tomography （micro-CT） was used to measure residual fat volume， and hematoxylin-eosin （HE） staining was used to assess fat browning and calculate pathological scores. ResultsIn vitro， the dominant effective concentration of HQJZ-containing serum was 12.5%. Real-time PCR results showed that， compared with the blank group， Arg1 expression decreased in the HQJZ+blank group （P<0.05）， CD206 showed a downward trend without statistical significance， while iNOS and CD86 expression were significantly increased （P<0.05）. Compared with the M1 group， Arg1 and CD206 expression decreased in the HQJZ+M1 group （P<0.05）. Compared with the M2 group， CD206 expression decreased in the HQJZ+M2 group （P<0.05）， CD86 expression increased significantly （P<0.01）. In vivo， Real-time PCR results showed that， compared with the control group， CD86 and CD206 expression levels were significantly increased in the model group （P<0.01）. Compared with the model group， CD206 expression in the MPA group was significantly decreased （P<0.01）. In the HQJZ group， CD206 was significantly decreased （P<0.01）. WB results showed that， compared with the model group， protein expression of UCP1 and PPARγ was significantly reduced in the HQJZ group （P<0.05， P<0.01）. micro-CT results showed that the total white fat volume in the HQJZ group was greater than that in the model group （P<0.05）. HE staining results showed that pathological scores in the HQJZ group were lower than those in the model group （P<0.05）. ConclusionHQJZ may inhibit white adipose tissue browning by promoting macrophage M1 polarization and suppressing M2 polarization， thereby delaying fat consumption in CC mice.

Background Cadmium (Cd) is a highly toxic heavy metal. Chronic low-dose cadmium exposure can lead to renal tubular dysfunction. However, the precise mechanisms by which cadmium induces renal tubular injury through disruption of intracellular metabolic networks remain incompletely understood. Objective To investigate the toxic effects of cadmium exposure on human renal tubular epithelial cells (HK-2) and to elucidate the associated metabolic regulatory network from the perspective of metabolic reprogramming. Methods An in vitro HK-2 cell injury model was established using 5 μmol·L⁻¹ cadmium chloride (CdCl₂). The expression of the renal injury marker kidney injury molecule-1 (KIM-1) was determined by Western blot (WB). Glycolytic capacity was evaluated by metabolic flux analysis. Mitochondrial reactive oxygen species (ROS) production was assessed with a fluorescent probe. Mitochondrial membrane potential (MMP) was evaluated after JC-1 staining. Intracellular adenosine triphosphate (ATP) levels were measured using an ATP assay kit. In addition, untargeted metabolomics analysis was conducted to characterize alterations in the intracellular metabolic fingerprint profile and to explore the metabolic pathway changes underlying cadmium-induced renal tubular epithelial cell injury. Results Cadmium exposure induced injury in HK-2 cells, as indicated by mitochondrial membrane depolarization, increased mitochondrial ROS levels, and decreased intracellular ATP levels. Metabolic flux analysis further revealed significant metabolic reprogramming, characterized by compensatory increases in basal glycolytic rate and maximal glycolytic capacity. Untargeted metabolomics showed depletion of the long-chain acylcarnitine pool and deficiency of key metabolic cofactors, suggesting impaired fatty acid oxidation and mitochondrial energy metabolism. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis indicated that the differential metabolites were mainly enriched in oxidative phosphorylation and glycerophospholipid metabolism. Correlation analysis showed that acylcarnitines were negatively correlated with nucleic acid metabolism-related metabolites, whereas ATP was positively correlated with lysophosphatidylcholine, suggesting that cadmium exposure-induced mitochondrial dysfunction may be accompanied by abnormal DNA metabolism and lipid peroxidation. Conclusion Cadmium exposure could induce impaired mitochondrial function, and promote glycolytic metabolic reprogramming in renal tubular epithelial cells. These findings provide new insights into the metabolic mechanisms underlying cadmium-induced nephrotoxicity and may help identify potential metabolic targets for intervention.

ObjectiveTo investigate the patterns of chronic disease comorbidity among permanent elderly residents in Xuhui District of Shanghai, and to analyze the impact of different comorbidity patterns on the elderly’s ability to perform activities of daily living. MethodsBased on data from the 2015 and 2021 Surveys on Health Status and Health Service Utilization among Permanent Residents in Xuhui District of Shanghai, the study included permanent residents who fully participated in both surveys, were aged 60 years or older at the 2015 survey, self-reported having a chronic disease, and reported no significant changes in their chronic disease status between the two surveys. A prospective cohort study design was adopted, using the 2015 data as the baseline and the 2021 survey data as follow-up data. Physical examinations and questionnaire surveys were conducted by the Shanghai Xuhui District Center for Disease Control and Prevention in the subdistricts and towns within the jurisdiction from April to July in both 2015 and 2021. Latent class analysis (LCA) was used to classify comorbidity patterns across 11 types of chronic diseases. The smaller the values of the Akaike information criterion (AIC), the Bayesian information criterion (BIC), and the sample-corrected Bayesian information criterion (aBIC), the better the model fits. The Barthel index (BI) and the Lawton and Brody Instrumental Activities of Daily Living Scale (LB-IADL) were used to assess the participants’ activities of daily living (ADL) and instrumental activities of daily living (IADL). Multiple linear regression and multivariate logistic regression models were used to analyze the association between different comorbidity patterns and ADL and IADL. ResultsA total of 1 608 study participants were enrolled. Among them, 671 (41.73%) self-reported having no chronic diseases. The prevalence of 11 types of chronic diseases was as follows: hypertension in 743 participants (46.21%), heart disease in 148 participants (9.20%), cerebrovascular disease in 37 participants (2.30%), diabetes or abnormal blood glucose in 310 participants (19.28%), other endocrine system diseases (non-diabetic) in 39 participants (2.43%), malignant tumors in 37 participants (2.30%), chronic lung disease in 16 participants (1.00%), gout in 8 participants (0.50%), musculoskeletal disorders in 34 participants (2.11%), gastric or digestive system diseases in 27 participants (1.68%), and dyslipidemia in 15 participants (0.93%). LCA was used to classify comorbidity patterns of chronic diseases among older adults into 1 to 9 latent category combinations. Model 5 (i.e., 5 latent categories) had the lowest BIC (7 112.69) and aBIC (6 909.38), with a relatively low AIC (6 768.20), indicating the best model fit; thus, five latent categories represented the optimal combination in this study. The five latent categories (and their respective proportions of study participants) were the healthy control group (41.73%), the hypertension group (31.28%), the diabetes-hypertension group (19.28%), the severe illness group (5.29%), and the other metabolic diseases group (2.43%). According to multiple linear regression analyses, compared with the healthy control group, the diabetes-hypertension group had significantly lower BI-20 scores (b=-0.952, 95%CI: -1.317‒ -0.587, P<0.001) and lower IADL scores (b=-0.744, 95%CI: -0.999‒ -0.489, P<0.001); the severe illness group (b=-0.644, 95%CI: -1.072‒ -0.217, P=0.003) and the hypertension group (b=-0.344, 95%CI: -0.562‒ -0.125, P=0.002) had lower IADL scores. According to multivariate logistic regression analyses, compared with the healthy control group, older adults in the diabetes-hypertension group had a higher risk of disability (OR=2.835, 95%CI: 1.392‒5.774), impaired ADL function (OR=2.470, 95%CI: 1.637‒3.726), and impaired IADL function (OR=1.739, 95%CI: 1.264‒2.392); older adults in the severe illness group had a higher risk of impaired ADL function (OR=2.206, 95%CI: 1.171‒4.155). ConclusionAmong the elderly participating in the Survey on Health Status and Health Service Utilization of Permanent Residents in Xuhui District of Shanghai, diabetes-hypertension is one of the key chronic disease comorbidity combinations and has adverse effects on both ADL and IADL. Community health management should prioritize the elderly with diabetes-hypertension comorbidity, and strengthen early screening and comprehensive interventions to slow the decline in ADL and IADL.

Objective: To assess parental expectations for the development of children with autism spectrum disorder (ASD) and identify factors associated with these expectations, so as to provide references for improving rehabilitation outcomes and long term development in children with ASD. Methods: From June 2024 to January 2026, a total of 877 children with ASD and their parents were recruited from 27 rehabilitation institutions in Hefei. The children had been diagnosed by chief physicians at tertiary level hospitals. Demographic characteristics and data on parental expectations were collected by the Parental Expectations Questionnaire. Differences in parental expectations between groups were assessed using the Mann-Whitney U- test and Kruskal-Wallis H-test, and associated factors were examined using quantile regression. Results: The mean item score for overall parental expectations among parents of children with ASD was (4.55±0.47), and scores for all dimensions were higher than those among parents of typically developing children ( t =11.11-31.14, all P <0.01). Child age, school enrollment, and maternal personality were associated with daily living expectation scores, learning and special talents and strengths expectation scores, and special talents and strengths expectation scores, respectively ( H =6.16-8.18, all P <0.05). Parents of preterm children had higher expectations for social interaction, physical and mental well being, and daily living than parents of non-preterm children ( Z =-2.56, -2.48, -2.39, all P <0.05). Multivariate quantile regression analysis showed that children’s age was associated with the expected level of self care ability; school enrollment status was associated with the expected level of learning and specialty strengths; maternal personality was associated with the expected levels of social competence, physical and mental health, self care ability, and specialty strengths; parental age was associated with the expected levels of physical and mental health and specialty strengths; and parental educational attainment was associated with the expected level of self care ability ( β =-0.36-0.41, all P <0.05). Conclusion Parents of children with ASD in Hefei generally have high expectations for their children s development across the domains of learning, daily living, social interaction, and physical and mental well being.

[Objective]To explore the therapeutic effect of wrist-ankle acupuncture in postoperative analgesia of mixed hemorrhoids.[Methods]Eighty patients with mixed hemorrhoid after surgery under lumbar anesthesia were randomly divided into experimental group and control group,with 40 cases in each group.The control group received routine postoperative treatment and nonsteroidal anti-inflammatory drugs(NSAIDs),100 mg Tramadol was intramuscularly injected when the visual analogue score(VAS)≥7.The experimental group received wrist-ankle acupuncture treatment firstly when the VAS≥7,if the VAS was still≥7 after half an hour,the 100 mg Tramadol was intramuscularly injected.Compare the VAS scores of two groups before the first intervention and 0.5 hour after the intervention,as well as at 6,12,18,24,36 and 48 hours after surgery.Compare the frequency of Tramadol use at 48 hours after surgery and the changes in prostaglandin E2(PGE2)and 5-hydroxytryptamine(5-HT)levels before and 0.5 hour after the first intervention.[Results]There was no significant statistical difference in VAS scores between experimental group and control group before the first intervention(P＞0.05).The VAS scores of both groups 0.5 hour after the first intervention were lower than before the intervention in the same group(P＜0.05).The VAS score of experimental group patients after the first intervention for 0.5 hour was higher than that of control group(P＜0.05).The VAS scores of experimental group at 6,12,18,24,36 and 48h after surgery were lower than those of control group at the same time point(P＜0.05).The frequency of using Tramadol in experimental group was lower than that in control group 48 hours after surgery(P＜0.05).There was no significant statistical difference in PGE2 and 5-HT levels between experimental group and control group before intervention(P＞0.05).The PGE2 and 5-HT levels in experimental group and control group decreased after intervention for 0.5 hour compared to before intervention in the same group(P＜0.05).The PGE2 and 5-HT levels in experimental group were higher than those in control group after 0.5 hour of intervention(P＜0.05).[Conclusion]Wrist-ankle acupuncture therapy can effectively alleviate postoperative pain in patients with mixed hemorrhoids,reduce the use of postoperative analgesics,and its analgesic mechanism may be related to downregulating the serum levels of PGE2 and 5-HT,which has certain clinical application value..

Crohn's disease (CD) is a refractory and recurrent chronic inflammatory bowel disease with an unclear etiology. In addition to intestinal symptoms, the disease is often accompanied by various extraintestinal manifestations. Studies have found that abnormalities in central nervous system activity in CD patients are closely related to the brain-gut axis, which may be one of the reasons for the high incidence of adverse emotions such as anxiety and depression. Functional magnetic resonance imaging (fMRI) has been widely used in the field of neurogastroenterology due to its non-invasiveness, high spatial resolution, and whole-brain coverage. This article reviews the application and progress of fMRI in CD brain functional study, aiming to comprehensively analyze and integrate the impact of the disease on brain function and provide a reference for clinical diagnosis, treatment, and future research.

Objective:To explore the relationship between urinary cadmium levels and thyroid hormone levels in people aged 40-89 years old in selected areas of China.Methods:Based on the "Investigation of the Impact of Soil Quality of Agricultural Land on Human Health in Typical Areas" project from October 2019 to August 2020, a multi-stage stratified random sampling method was used to include 6 588 middle-aged and older adults aged 40-89. Demographic characteristics, dietary frequency and disease status were collected through the questionnaire and physical examination. Urinary cadmium and urinary creatinine were detected by random midstream urine. Fasting venous blood was collected for the detection of Triiodothyronine (T3) and Thyroxine (T4). The linear mixed effects model was used to explore the association of urine cadmium levels with thyroid hormone levels. Its dose-response relationship was explored by using the restricted cubic spline.Results:The age of the subjects was (63.48±12.18) years, with males accounting for 51.28%. The M ( Q 1,Q 3) of urinary cadmium level, T3 and T4 was 2.48 (1.36, 4.42) μg/g·creatinine, (1.96±0.51) nmol/L and (113.75±29.11) nmol/L, respectively. The linear mixed effects model showed that the changes of T3 and T4 were 0.027 (0.009, 0.044) nmol/L and 2.019 (1.084, 2.953) nmol/L for each one-unit increase (natural logarithm transformed) of urinary cadmium. The restricted cubic spline showed that there was a positive nonlinear association between urinary cadmium and T3 as well as T4 (all Pnonlinear<0.05). Conclusion:In selected areas of China, the urinary cadmium level of middle-aged and older adults aged 40-89 years is positively associated with T3 and T4.

Objective:To investigate the prevalence and risk factors of overweight and obesity among Chinese children aged 3-18 years from 11 provinces, antonomous regions, or municipalities.Methods:This national cross-sectional community health survey utilized a multistage stratified cluster-random sampling method to recruit 193 997 nationally representative participants from 11 provinces, autonomous regions, or municipalities between January 2017 and December 2019. All participants underwent physical examinations, and their caregivers completed questionnaires assessing participants′ dietary, lifestyle, familial, and perinatal information. Multilevel multinomial logistic regression models were employed to identify the potential risk factors.Results:The cohort comprised 193 997 children (102 178 boys, 91 819 girls),aged (10±4) years. Overall prevalence rates were 30 574(15.8%)overweight children and 17 217(8.9%) obesity children. Boys exhibited higher overweight and obesity rates than girls (17.0% (17 368/102 178) vs. 14.4% (13 206/102 178), 11.3% (11 553/91 819) vs. 6.2% (5 664/91 819), χ2=249.12,1 578.69,both P<0.001). The detection rates of obesity in Tanner stage 2 and 3 were the highest in boys and girls, with 13.4%(2 231/16 665) and 8.6%(880/10 221) respectively. Risk factors for obesity included parental overweight (paternal OR=2.34 and maternal OR=2.29), annual household income of 100 000-200 000 yuan (compared with<100 000 yuan, OR=1.04), higher paternal education (compared with below high school,high school and a college education OR=1.09,1.14), birth weight >4.0 kg (≤5 and>5 years old OR=1.74, 1.44,respectively), and western food consumption≥1 time/month (compared with<1, 1-2, 3-4,>4 times/month OR=1.36, 1.30, 1.67(≤5 years), 1.19, 1.16, 1.15 (>5 years), respectively) (all P<0.05). Conversely, coarse grain intake≥1 times/week (compared with<1 times/week, every day, 3-4, 1-2 times/week OR=0.74, 0.80, 0.71 (≤5 years), 0.75, 0.87, 0.90(>5 years), respectively, all P<0.05) was associated with reduced obesity risk. Conclusions:Obesity epidemiology in children demonstrates significant heterogeneity across age, gender, geographic regions, and pubertal stages. It is necessary to establish a personalized prevention and control strategy.

Objective:To analyze the clinical features of children with infection-related eosinophilic lung diseases (ELD) caused by common respiratory pathogens.Methods:A retrospective cohort study was conducted. The clinical features, auxiliary examinations, treatments, and prognoses of 134 children with infection-related ELD caused by common respiratory pathogens at Yuying Children′s Hospital from January 2014 to June 2024 were collected. Participants were divided into the mild and severe groups based on whether the proportion of eosinophils in bronchoalveolar lavage fluid (BALF) exceeded 0.25. Chi-square test or Fisher exact test was used to analyze the differences between the two groups, and Logistic regression was performed to examine the correlation between BALF eosinophilia and the clinical outcomes.Results:Among the 134 children, 73 were males and 61 were females, with an age of 6.9 (4.6, 8.8) years on admission. A total of 154 pathogen detections were recorded, including 116 cases (75.3%) of Mycoplasma pneumoniae, 8 cases (5.2%) of influenza A virus, 6 cases (3.9%) of Streptococcus pneumoniae, and 6 cases (3.9%) of Chlamydia pneumoniae, among others. The percentage of eosinophils in the BALF of all children was 0.10 (0.07, 0.15). There were 117 cases in the mild group and 17 cases in the severe group. Compared with the mild group, significantly greater proportion of children in the severe group presented dyspnea (10/17 vs. 17.1% (20/117)), wheezing (7/17 vs. 8.5% (10/117)), respiratory failure (8/17 vs. 7.7% (9/117)), single lobe ≥2/3 consolidation (7/17 vs. 12.8% (15/117)), atelectasis (7/17 vs. 12.0% (14/117)), pleural effusion (7/17 vs. 16.2% (19/117)), plastic bronchiolitis (4/17 vs. 4.3% (5/117)), and systemic corticosteroid prescription (14/17 vs. 51.3% (60/117)) (all P<0.05). Univariate Logistic regression analysis revealed that severe eosinophilia in BALF was significantly associated with an elevated risk of respiratory failure ( OR=10.67, 95% CI 3.31-34.38, P<0.001), single lobe ≥2/3 consolidation ( OR=4.76, 95% CI 1.57-14.41, P=0.006), atelectasis ( OR=5.15, 95% CI 1.69-15.72, P=0.004), pleural effusion ( OR=3.61, 95% CI 1.22-10.67, P=0.020), and plastic bronchitis ( OR=6.89, 95% CI 1.64-28.94, P=0.008). Among the 126 children who were followed up, 106 cases (84.1%) were cured, 20 cases (15.9%) improved, and no relapses or deaths occurred. Conclusions:Mycoplasma pneumoniae and influenza A virus are common pathogens in children with infection-related ELD and the percentage of eosinophils in BALF is mildly increased, and the severe cases exhibit more severe clinical features and more significant pulmonary abnormalities, such as lobar consolidation and lung atelectasis. The prognosis is generally favorable.

Objective To explore the effects of sigma-1 receptor(Sig-1R)on brain function in rats after cardiopulmo-nary resuscitation and its protective role in brain injury.Methods Rats were randomly assigned to four groups with 20 in each:sham-operated control(sham group),6-hour post-resuscitation(PR 6 h group),12-hour post-resuscitation(PR 12 h group)and 24-hour post-resuscitation(PR 24 h group).In the latter three groups,cardiac arrest was induced by as-phyxiation,and cardiopulmonary resuscitation was performed 6 minutes after cardiac arrest.The rats were scored for neu-rological deficits at 6,12 and 24 hrs after resuscitation,respectively;after that,the rats were executed,and the expres-sion of Sig-1R protein,mitochondrial function index,and endoplasmic reticulum stress index apoptosis index were detec-ted by Western blot and immunohistochemistry.The correlation between Sig-1R and mitochondrial,endoplasmic reticulum stress and apoptosis indexes was evaluated.Results Compared with the sham-operated group,the rats in test group showed a gradual decrease in neurological deficit scores,Sig-1R protein expression,brain tissue adenosine triphos-phate(ATP)concentration and mitochondrial membrane potential(MMP)levels at 6,12,and 24 hrs of PR(P＜0.05);CHOP protein,activated cleaved caspase-12 and cleaved caspase-3 protein expression were consistently elevated(P＜0.05).In addition,Sig-1R was negatively correlated with brain tissue endoplasmic reticulum stress and apoptosis(P＜0.05)but positively correlated with mitochondrial membrane potential level(P＜0.05).Conclusions Sig-1R ex-pression in rat brain tissue correlates with brain injury after cardiopulmonary resuscitation and potential mechanism seems to be neuronal protection through modulating mitochondrial function and endoplasmic reticulum stress.