Organophosphate flame retardants (OPFRs) have been widely used as the main alternatives to bromine-based flame retardants, resulting in their widespread detection in environmental media and even in human blood. The potential health risks arising therefrom, particularly the direct impacts on the blood system, have become a focus in the field of environmental health. This article systematically reviewed the latest research progress on the hematotoxicity of OPFRs, covering three core aspects: the toxic effects aspect, which systematically elaborated on the bidirectional interference of OPFRs with coagulation function, their toxic effects on the hematopoietic system, and their disruptive effects on blood biochemical metabolism; the mechanistic analysis aspect, which dissected the multi-pathway, multi-target toxic mechanism network of OPFRs, including common pathways based on oxidative stress and inflammatory responses, the direct and indirect regulation of coagulation function mediated by nuclear receptors and endocrine disruption, and the disturbance of blood cell production at the source through disruption of the hematopoietic microenvironment; and the risk assessment aspect, which, in response to the limitations of traditional methods, focused on the application prospects and core advantages of novel approaches based on structure-activity relationships in filling data gaps and achieving precise risk prediction. This review aims to systematically summarize the research progress on the mechanisms of OPFR-induced hematotoxicity, providing systematic theoretical support for subsequent in-depth mechanistic studies, targeted epidemiological investigations, and the optimization of risk assessment models.

AIM: To investigate the current incidence of retinopathy of prematurity(ROP)in Sichuan Province and analyze its risk factors, providing a scientific basis for establishing and improving the regional ROP screening and prevention system.METHODS: A retrospective study was conducted on premature infants who underwent fundus screening at the Departments of Ophthalmology and Neonatology of Sichuan Provincial Maternity and Child Health Care Hospital from January 20, 2017 to February 10, 2025. The incidence of ROP was calculated. The patients were divided into ROP group and non-ROP group according to whether ROP occurred, and the clinical characteristics of the two groups were compared. Multivariate Logistic regression was used to analyze risk factors for ROP.RESULTS:This study included a total of 861 premature infants, with 445 males(51.7%)and 416 females(48.3%).ROP occurred in 166 cases, with an incidence rate of 19.3%, and the non-ROP group consisted of 695 cases. The mean gestational age of the ROP and non-ROP groups was 30.24±2.20 and 33.06±1.90 wk(P<0.01), while the mean birth weight was 1438.94±389.66 and 1977.32±438.68 g(P<0.01). By comparing the clinical data of the two groups of preterm infants, the following factors were found to be associated with the occurrence of ROP: younger gestational age, low birth weight, history of oxygen therapy, respiratory distress syndrome, intracranial hemorrhage, neonatal anemia, bronchopulmonary dysplasia, patent ductus arteriosus, and sepsis(all P<0.01). Multivariate Logistic regression analysis revealed that gestational age(OR=0.685,95%CI:0.592-0.792,P<0.01), birth weight(OR=0.999,95%CI:0.998-0.999,P<0.01), and respiratory distress syndrome(OR=2.312,95%CI:1.313-4.070,P<0.01)were risk factors for ROP. Gestational age had the greatest impact.The younger the gestational age at birth, the higher the risk of ROP.CONCLUSION:The incidence of ROP in Sichuan Province is relatively high compared to multicenter results from China. Significant risk factors include younger gestational age, low birth weight, and respiratory distress syndrome. Screening criteria should be formulated based on the local incidence of ROP, and a screening, prevention, and treatment system for ROP should be established and improved.

Objective To explore the effect of different pontic designs in resisting stress interruption effect and roller coaster phenomenon through three-dimensional finite element analysis,providing clinical guidance for the application of clear aligners in extraction cases.Methods Four three-dimensional finite element models of different pontic designs in the extraction area of clear aligners were established,including the pontic-free connection design,the conventional hollow pontic design,the partially solid-filled pontic design and the fully solid-filled pontic design.All four aligner models were individually assembled with the dental arch model.A 0.2 mm distal movement of the canine was simulated to observe the initial displacement and periodontal ligament stress distribution of canine and second premolar in each group of models.Results The initial displacement tendency diagram revealed that in all experimental conditions,both the canine and second premolar exhibited tipping movement patterns.However,significant variations in initial displacement magnitudes were observed across different pontic designs.The fully solid-filled pontic-connected clear aligner model exhibited the greatest initial displacement values(both crown and root)and the maximum initial displacement magnitude.Notably,this kind of design displayed movement characteristics closer to bodily movement,indicating superior control efficacy in tooth positioning.Periodontal ligament stress analysis revealed that the fully solid-filled pontic-connected clear aligner model generated the highest maximum principal stress in the periodontal ligament.Conclusion This three-dimensional finite element study reveals that the application of solid-filled pontic in clear aligner therapy could improve biomechanical control at extraction sites by minimizing aligner distortion,reducing stress interruption effect and preventing the roller coaster phenomenon.

Objective To observe the efficacy and safety of mechanical thrombectomy in acute ischemic stroke patients after vertebral-basilar artery stent implantation.Methods From May 2018 to October 2022,patients with acute vertebral basilar artery occlusion who underwent mechanical thrombectomy were retrospectively analyzed.The patients were divided into two groups:stent occlusion group and acute atherosclerotic stenosis occlusion(ICAS)group.The baseline characteristics of the two groups were balanced by propensity score matching method.The successful recanalization rate,90-day good outcome rate,90-day mortality rate,and symptomatic intracranial hemorrhage rate were compared.Results We enrolled 107 patients,with 14 cases in stent occlusion group and 93 cases in ICAS group.We analyzed 14 pairs by propensity score matching,including 14 cases in stent occlusion group and 27 cases in ICAS group.The successful recanalization rate and 90-day good outcome rate was lower in stent occlusion group than in ICAS group[(78.6％(11/14)vs.100％(27/27),P=0.062,28.6％(4/14)vs.44.4％(12/27),X2=0.976,P=0.323],but there was no statistical difference.The 90-day mortality rate in the stent occlusion group was significantly higher than that in the ICAS group[57.1％(8/14)vs.25.9％(7/27),x2=3.873,P=0.049].The incidence of symptomatic intracranial hemorrhage was higher in the stent occlusion group than in the ICAS group,with no statistical difference[35.7％(5/14)vs.14.8％(4/27),x2=1.289,P=0.256].Conclusion The successful recanalization rate,90-day good outcome rate,and incidence of symptomatic intracranial hemorrhage in stent occlusion group did not significantly differ from those in ICAS group,but the 90-day mortality rate was significantly higher in the former group.

Objective To observe the efficacy and safety of mechanical thrombectomy in acute ischemic stroke patients after vertebral-basilar artery stent implantation.Methods From May 2018 to October 2022,patients with acute vertebral basilar artery occlusion who underwent mechanical thrombectomy were retrospectively analyzed.The patients were divided into two groups:stent occlusion group and acute atherosclerotic stenosis occlusion(ICAS)group.The baseline characteristics of the two groups were balanced by propensity score matching method.The successful recanalization rate,90-day good outcome rate,90-day mortality rate,and symptomatic intracranial hemorrhage rate were compared.Results We enrolled 107 patients,with 14 cases in stent occlusion group and 93 cases in ICAS group.We analyzed 14 pairs by propensity score matching,including 14 cases in stent occlusion group and 27 cases in ICAS group.The successful recanalization rate and 90-day good outcome rate was lower in stent occlusion group than in ICAS group[(78.6％(11/14)vs.100％(27/27),P=0.062,28.6％(4/14)vs.44.4％(12/27),X2=0.976,P=0.323],but there was no statistical difference.The 90-day mortality rate in the stent occlusion group was significantly higher than that in the ICAS group[57.1％(8/14)vs.25.9％(7/27),x2=3.873,P=0.049].The incidence of symptomatic intracranial hemorrhage was higher in the stent occlusion group than in the ICAS group,with no statistical difference[35.7％(5/14)vs.14.8％(4/27),x2=1.289,P=0.256].Conclusion The successful recanalization rate,90-day good outcome rate,and incidence of symptomatic intracranial hemorrhage in stent occlusion group did not significantly differ from those in ICAS group,but the 90-day mortality rate was significantly higher in the former group.

Objective:To evaluate the efficacy and long-term outcomes of fludarabine, cyclophosphamide, and rituximab (FCR) in treatment-na?ve patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) .Methods:Clinical data from 68 CLL/SLL patients treated with FCR at Jiangsu Province Hospital (August 2008–May 2021) were retrospectively analyzed to assess efficacy, safety, and survival outcomes.Results:Among 68 patients [46 males, 22 females; median age 55 (47, 60) years], 13.1% (8/61) had a complex karyotype, 32.3% (20/62) had immunoglobulin heavy variable region mutated (IGHV-M) type, 6.6% (4/61) had del (17p), and 14.8% (8/54) had del (11q). Patients received a median of 6 (4, 6) FCR cycles. The overall response rate was 88.2% (60/68), including 47.0% (32/68) complete remissions. Over a median follow-up of 82 (59, 98) months, 66.2% (45/68) experienced disease progression. Median progression-free survival was 56 (21, 123) months, while median overall survival was not reached. The 5- and 10-year PFS rates were 42.6% (95% CI: 31.9–56.8% ) and 28.7% (95% CI: 19.0–43.4% ), respectively. Poor PFS was associated with del (17p) ( HR=5.04, 95% CI: 1.72–14.74, P=0.003), del (11q) ( HR=5.27, 95% CI: 2.11–13.15, P<0.001), IGHV unmutated (IGHV-UM) ( HR=4.11, 95% CI: 1.72–9.79, P=0.001), complex karyotype (CK) ( HR=3.53, 95% CI: 1.58–7.85, P=0.002), β 2-microglobulin >3.5 mg/L ( HR=2.87, 95% CI: 1.37–6.01, P=0.005). In multivariate analysis, IGHV-UM remained an independent predictor of PFS ( HR=8.63, 95% CI: 1.09–68.40, P=0.042). Sixteen patients with IGHV-M and lacking del (17p) or CK had a median PFS of 123 (58,123) months and a 5-year PFS rate of 70.7% (95% CI: 49.7–99.1% ), reaching a plateau after 5 years with no recurrences by 10 years. Common grade 3–4 adverse events included hematologic toxicity (44.1%, 30/68), infection (36.7%, 25/68), and liver dysfunction (4.4%, 3/68). Among 25 patients receiving single-agent BTK inhibitors after FCR progression, median follow-up was 45 (26, 64) months; 36% (9/25) experienced disease progression, with a median PFS time of 55 (27, 55) months. Conclusion:First-line FCR provides durable long-term benefits for patients with IGHV-M CLL without del (17p) or CK.

With the development of society,the incidence of obesity has increased year by year in recent years,which has seriously jeopardized public health and safety,and has been a hot spot in the field of endocrine research.At the same time,obesity is also an important cause of a variety of metabolic diseases,such as metabolic syndrome,pre-diabetes,hypertension and polycystic ovary syndrome and other diseases,but the etiology and mechanism of obesity have not been completely clear,and basic research on obesity of traditional Chinese and western medicine still needs to be widely carried out.In this paper,animal models of obesity and its complications will be comprehensively summarized,and the model principles will be elaborated in combination with TCM syndromes and western medicine mechanisms,and evaluate their merits and demerits,so as to provide references for the selection of reasonable animal models for relevant experimental studies of obesity.

Experimental teaching is an important component of the course Medical Immunology,which requires the use of experimental animals and the execution of experimental animals by medical students.By applying the carbon dioxide euthanasia system,it can effectively reduce the pain of experimental animals,ensure their welfare,and meet ethical requirements.It can also improve the efficiency of experimental teaching in Medical Immunology,reduce environmental pollution,and promote medical students to estab-lish scientific values and worldviews that pay attention to experimental animals and respect life,which is conducive to becoming future medical service talents.In the experimental teaching of Medical Immunology,the appropriate application of carbon dioxide euthanasia system combined with effective ideological and political construction of the curriculum can further implement the Party's educational policy of cultivating morality and talents,and lay a good foundation for cultivating medical talents with comprehensive knowledge,high skills and excellent quality.

Objective To analyze the current quality of treatment for hospitalized cancer patients in Bei-jing,identify major issues in treatment practices,and propose improvements.Methods Nine hospitals in Beijing were selected for examination.Expert on-site interviews and medical record sampling were conducted.The"Bei-jing Cancer Diagnosis and Treatment Quality Control Checklist"was used to assess the hardware,management,anti-cancer drug therapy,radiation therapy,and surgical treatment during cancer treatment at these hospitals from January to October 2023.The relevant problems were analyzed.Results Among the nine hospitals,two(22.2％)were equipped with laminar flow rooms,and three(33.3％)had intravenous drug preparation centers.In terms of institutional management,seven hospitals(77.8％)had standardized anti-cancer drug prescription authority management,eight(88.9％)had complete emergency plans,and five(55.6％)had oncology specialist pharmacists.Regarding anti-cancer drug therapy,the areas with higher completion rates included pathology diag-nosis support(97.6％),routine pre-treatment examinations(96.3％),adverse reaction evaluation(92.7％),discharge summaries(95.1％),and admission records(91.5％).However,the accuracy of tumor staging before treatment(70.7％)and the evaluation of therapeutic efficacy after drug treatment(76.9％)needed improvement.The oncology specialty significantly outperformed the non-oncology specialty in terms of the accuracy rate of TNM staging(86.0％vs.46.9％,P＜0.001),the completeness of informed consent forms(100％vs.68.8％,P＜0.001),the completeness of drug indication evaluation(96.0％vs.78.1％,P=0.025),the completeness of admission medical history records(98.0％vs.81.3％,P=0.008),the rationality of drug dosage(96.0％vs.75.0％,P=0.005),the rationality of drug infusion time(100％vs.62.5％,P＜0.001),and the rationality of the order of drug infusion(100％vs.87.5％,P=0.010).Although the quality of radiation therapy was high,the subsequent evaluation of therapeutic efficacy(39.3％)requires enhancement.In surgical treatment,the preoper-ative pathology diagnosis support rate(78.1％)and the accuracy of tumor staging(37.5％)were relatively low,indicating issues with incomplete preoperative evaluation and the absence of multidisciplinary discussions.Conclusions There remains significant room for improvement in the quality of cancer treatment in China.It is recommended to standardize tumor staging assessment processes,strengthen entry assessments for non-oncology departments,promote the implementation of multidisciplinary treatment models,and establish a multi-department collaborative management model.Continuous monitoring of cancer diagnosis and treatment quality indicators is es-sential to promote ongoing improvements in cancer treatment quality.

Objective:To evaluate the efficacy and long-term outcomes of fludarabine, cyclophosphamide, and rituximab (FCR) in treatment-na?ve patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) .Methods:Clinical data from 68 CLL/SLL patients treated with FCR at Jiangsu Province Hospital (August 2008–May 2021) were retrospectively analyzed to assess efficacy, safety, and survival outcomes.Results:Among 68 patients [46 males, 22 females; median age 55 (47, 60) years], 13.1% (8/61) had a complex karyotype, 32.3% (20/62) had immunoglobulin heavy variable region mutated (IGHV-M) type, 6.6% (4/61) had del (17p), and 14.8% (8/54) had del (11q). Patients received a median of 6 (4, 6) FCR cycles. The overall response rate was 88.2% (60/68), including 47.0% (32/68) complete remissions. Over a median follow-up of 82 (59, 98) months, 66.2% (45/68) experienced disease progression. Median progression-free survival was 56 (21, 123) months, while median overall survival was not reached. The 5- and 10-year PFS rates were 42.6% (95% CI: 31.9–56.8% ) and 28.7% (95% CI: 19.0–43.4% ), respectively. Poor PFS was associated with del (17p) ( HR=5.04, 95% CI: 1.72–14.74, P=0.003), del (11q) ( HR=5.27, 95% CI: 2.11–13.15, P<0.001), IGHV unmutated (IGHV-UM) ( HR=4.11, 95% CI: 1.72–9.79, P=0.001), complex karyotype (CK) ( HR=3.53, 95% CI: 1.58–7.85, P=0.002), β 2-microglobulin >3.5 mg/L ( HR=2.87, 95% CI: 1.37–6.01, P=0.005). In multivariate analysis, IGHV-UM remained an independent predictor of PFS ( HR=8.63, 95% CI: 1.09–68.40, P=0.042). Sixteen patients with IGHV-M and lacking del (17p) or CK had a median PFS of 123 (58,123) months and a 5-year PFS rate of 70.7% (95% CI: 49.7–99.1% ), reaching a plateau after 5 years with no recurrences by 10 years. Common grade 3–4 adverse events included hematologic toxicity (44.1%, 30/68), infection (36.7%, 25/68), and liver dysfunction (4.4%, 3/68). Among 25 patients receiving single-agent BTK inhibitors after FCR progression, median follow-up was 45 (26, 64) months; 36% (9/25) experienced disease progression, with a median PFS time of 55 (27, 55) months. Conclusion:First-line FCR provides durable long-term benefits for patients with IGHV-M CLL without del (17p) or CK.