AIM:To analyze the influencing factors of postoperative malignant glaucoma(MG)in patients with primary angle-closure glaucoma(PACG)using logistic regression and decision tree models.METHODS:A retrospective study was conducted on PACG patients who underwent surgery at Eye Hospital of Handan City from March 2020 to March 2025. Patients were divided into two groups: the MG group, who developed MG within 6 mo postoperatively, and the non-MG group. Data were collected from the electronic medical record system. Univariate analysis was performed, followed by multivariate logistic regression to identify independent risk factors. A classification and regression tree model was constructed to visualize the hierarchical relationships among predictors. The predictive performance of the two models was evaluated and compared using receiver operating characteristic(ROC)curve analysis.RESULTS:Totally 182 cases(182 eyes)with PACG were enrolled in this study, including 91 cases(91 eyes)in the MG group and 91 cases(91 eyes)in the non-MG group. In the MG group, there were 53 males and 38 females; 69 cases were aged ≥60 y and 22 cases were aged <60 y. In the non-MG group, there were 47 males and 44 females; 33 cases were aged ≥60 y and 58 cases were aged <60 y. The non-MG group comprised 91 patients, including 47 males and 44 females. Among them, 33 cases were aged ≥60 y, and 58 cases were aged<60 y. The MG group had significantly higher proportions of patients aged ≥60 y, diabetes, moderate-stage PACG, persistent high intraocular pressure(IOP), complete anterior chamber angle closure, lens thickness <4.5 mm, axial length <22 mm, and severe postoperative inflammation compared to the non-MG group(all P<0.01). Multivariate Logistic regression identified the following as independent influencing factors for postoperative MG: age [OR (95%CI)=2.136(1.401-3.255)], PACG stage [OR (95%CI)=2.996(2.044-4.391)], IOP [OR (95%CI)=3.527(1.604-7.755)],anterior chamber angle [OR (95%CI)=4.826(2.498-9.324)], axial length [OR (95%CI)=5.125(1.265-20.771)], and severe postoperative inflammation [OR (95%CI)=2.338(1.478-3.699)](all P<0.05). The decision tree model selected six explanatory variables: age, PACG stage, IOP, anterior chamber angle status, axial length, and severe postoperative inflammation. Axial length was the primary splitting factor at the root node. The areas under the ROC curve(AUC)for the logistic regression and decision tree models were 0.913(0.863-0.950)and 0.921(0.872-0.956), respectively, with no significant difference between them(Z=0.561, P=0.575).CONCLUSION:Both the logistic regression and decision tree models effectively identify key influencing factors for postoperative MG in PACG patients, including age, PACG stage, IOP, anterior chamber angle status, axial length, and severe postoperative inflammation. The decision tree model offers an intuitive, visual representation of risk stratification, facilitating clinical decision-making. Both models are applicable for clinical risk assessment.

Objective:To investigate the association between peak growth hormone(GH) levels and body fat mass as well as body fat percentage in children with short stature.Methods:This retrospective study included 477 children diagnosed with short stature at the Affiliated Hospital of Jining Medical University between January 2021 and November 2024, based on data from the Growth and Development Disease Follow-up Cohort Study(GDDSD) in Shandong Province. Clinical data including anthropometric measurements, laboratory tests, and body composition were collected. The relationship between GH peak and body fat mass and percentage were analyzed using smooth curve fitting and multiple piecewise linear regression models.Results:In univariate linear regression analysis, both body fat mass and body fat percentage were positively correlated with age, height, weight, body mass index, triglycerides, low density lipoprotein-cholesterol, fasting blood glucose, total body water, protein, and skeletal muscle mass(all P<0.05), and negatively correlated with GH peak and high density lipoprotein-cholesterol. After adjusting for potential confounding factors, a nonlinear relationship was observed between GH peak and both body fat mass and body fat percentage, with inflection points at 6.80 ng/mL and 7.75 ng/mL, respectively. When GH peak was below the inflection point, it was significantly negatively correlated with body fat mass and percentage( P<0.001). However, when GH peak exceeded the inflection point, the associations were no longer statistically significant( P>0.05). Conclusions:This study demonstrates a nonlinear relationship between peak GH levels and body fat percentage in children with short stature. At lower GH peaks, both body fat mass and body fat percentage increase significantly, which may contribute to an elevated future risk of cardiovascular disease.

In recent years, the situation of climate change has intensified, posing a threat to public health. There is an urgent need to promote public health adaptation actions to climate change. In January 2025, the National Disease Control and Prevention Administration issued the "Guidelines for Public Health Adaptation Actions to Climate Change" (hereinafter referred to as the "Guidelines"). The Guidelines put forward 20 items of guidance on six categories of public health adaptation actions, including understanding basic concepts, comprehending important policies, learning core knowledge, paying attention to key populations, practicing a low-carbon lifestyle, and mastering protection skills. It elaborates on the key concepts and the latest policies that the public needs to understand, and also provides the behavioral concepts and protection skills that should be mastered to adapt to climate change. This article provides a systematic interpretation of the Guidelines, introducing the background, ideas, connotations, and applications of their compilation, with the aim of enhancing society′s cognitive understanding of the Guidelines.

Objective To investigate the effect of forsythigenin on the malignant progression of lung cancer cells by regulating the cyclic adenosine monophosphate/exchange protein directly activated by cAMP1/Ras-associated protein 1(cAMP/EPAC1/RAP1)signaling pathway.Methods Lung cancer cell line A549 was cultured in vitro and grouped into the control group,the low dose forsythigenin group(25 mg/L),the medium dose forsythigenin group(50 mg/L),the high dose forsythigenin group(100 mg/L),the high dose forsythigenin+specific increase in intracellular cAMP content(pertussis toxin PTX)group(100 mg/L forsythigenin+5 μmol/L PTX)and high dose forsythigenin+EPAC1 antagonist(ESI-09)group(100 mg/L forsythigenin+1.5 μmol/L ESI-09).CCK-8 experiment was applied to detect cell proliferation.Scratch test was applied to detect cell migration.Flow cytometry was applied to detect cell apoptosis.Transwell was applied to detect cell invasion.ELISA method was applied to detect cAMP level in cell supernatant.Western blot assay was applied to detect expression levels of cAMP/EPAC1/RAP1 signaling pathway proteins and apoptotic proteins[B lymphoblastoma-2(Bcl-2)and Bcl-2 associated X protein(Bax)].Results Compared with the control group,the OD450 value of A549 cells,number of cell invasions,scratch healing rate,level of cAMP,expression levels of Bcl-2,EPAC1 and RAP1 proteins were significantly reduced in the low dose,medium dose and high dose forsythigenin groups,and the expression of Bax protein and the rate of cell apoptosis were significantly increased in a dose-dependent manner(P＜0.05).Compared with the high-dose forsythigenin group,the OD450 value of A549 cells,scratch healing rate,number of cell invasions,level of cAMP,expression levels of Bcl-2,EPAC1 and RAP1 proteins were obviously increased in the high-dose forsythigenin+PTX group,the expression of Bax protein and the apoptosis rate were obviously reduced(P＜0.05).Levels of all indexes in the high dose forsythigenin+ESI-09 group were opposite.Conclusion Forsythigenin inhibits proliferation,migration,and invasion of A549 cells and promotes apoptosis by down-regulating the cAMP/EPAC1/RAP1 signaling pathway.

Objective:To establish a predictive model of neoadjuvant chemotherapy for human epidermal growth factor receptor 2 (HER2) positive breast cancer based on magnetic resonance imaging (MRI) parameters and multimodal ultrasound.Methods:The medical records of 279 patients with HER2 positive breast cancer admitted to Linyi People’s Hospital, Tai’an Central Hospital Affiliated to Qingdao University and Shandong First Medical University affiliated Provincial Hospital from Mar. 2021 to Nov. 2023 were retrospectively analyzed, and randomly divided into a training set ( n=223) and a validation set ( n=56) according to the 8∶2 law. All patients received neoadjuvant chemotherapy combined with targeted therapy and were divided into non-pathologic complete response (NpCR) and pathologic complete response (pCR) groups according to chemotherapy effect. By comparing MRI parameters and multimodal ultrasound parameters of the two groups, and the pCR risk model after neoadjuvant chemotherapy for HER2 positive breast cancer patients was constructed and verified. Results:After 3 cycles of chemotherapy, the incidence of pCR in 223 patients in the training set was 42.15%. Among 56 patients in the validation set, the incidence of pCR was 42.86%. The apparent diffusion coefficient (ADC) of pCR group was higher than NpCR group ( P<0.05). The peak systolic flow velocity (PSV), resistance index (RI), maximum radial change rate, area under the curve (AUC) and peak intensity (PI) in pCR group were higher than NpCR group ( P<0.05), and the ultrasound elastic score in pCR group was lower than NpCR group ( P<0.05). ΔADC ( OR=4.141, 95% CI: 1.820-9.421), maximum diameter change rate ( OR=5.212, 95% CI: 2.291-11.857), PI ( OR=4.802, 95% CI: 2.111-10.923) and ultrasonic elasticity score ( OR=6.629, 95% CI: 1.595-8.256) were the influencing factors of pCR after neoadjuvant chemotherapy for HER2 positive breast cancer ( P<0.05). The sensitivity and specificity of pCR predicted by the training set model after neoadjuvant chemotherapy for HER2 positive breast cancer were 90.43% (95% CI: 82.15%-95.26%), 91.47% (95% CI: 84.91%-95.45%), and the AUC was 0.904 (95% CI: 0.834-0.968). Validation set model predicted the pCR sensitivity after neoadjuvant chemotherapy for HER2 positive breast cancer was 87.50% (95% CI: 66.54%-96.71), specificity was 90.63% (95% CI: 73.83%-97.55%), and AUC was 0.897 (95% CI: 0.821-0.954) . Conclusion:The histogram model based on ΔADC, maximum radial rate of lesion change, PI and ultrasonic elasticity score can be used to evaluate the risk of pCR after neoadjuvant chemotherapy for HER2 positive breast cancer.

Objective To investigate the effect of forsythigenin on the malignant progression of lung cancer cells by regulating the cyclic adenosine monophosphate/exchange protein directly activated by cAMP1/Ras-associated protein 1(cAMP/EPAC1/RAP1)signaling pathway.Methods Lung cancer cell line A549 was cultured in vitro and grouped into the control group,the low dose forsythigenin group(25 mg/L),the medium dose forsythigenin group(50 mg/L),the high dose forsythigenin group(100 mg/L),the high dose forsythigenin+specific increase in intracellular cAMP content(pertussis toxin PTX)group(100 mg/L forsythigenin+5 μmol/L PTX)and high dose forsythigenin+EPAC1 antagonist(ESI-09)group(100 mg/L forsythigenin+1.5 μmol/L ESI-09).CCK-8 experiment was applied to detect cell proliferation.Scratch test was applied to detect cell migration.Flow cytometry was applied to detect cell apoptosis.Transwell was applied to detect cell invasion.ELISA method was applied to detect cAMP level in cell supernatant.Western blot assay was applied to detect expression levels of cAMP/EPAC1/RAP1 signaling pathway proteins and apoptotic proteins[B lymphoblastoma-2(Bcl-2)and Bcl-2 associated X protein(Bax)].Results Compared with the control group,the OD450 value of A549 cells,number of cell invasions,scratch healing rate,level of cAMP,expression levels of Bcl-2,EPAC1 and RAP1 proteins were significantly reduced in the low dose,medium dose and high dose forsythigenin groups,and the expression of Bax protein and the rate of cell apoptosis were significantly increased in a dose-dependent manner(P＜0.05).Compared with the high-dose forsythigenin group,the OD450 value of A549 cells,scratch healing rate,number of cell invasions,level of cAMP,expression levels of Bcl-2,EPAC1 and RAP1 proteins were obviously increased in the high-dose forsythigenin+PTX group,the expression of Bax protein and the apoptosis rate were obviously reduced(P＜0.05).Levels of all indexes in the high dose forsythigenin+ESI-09 group were opposite.Conclusion Forsythigenin inhibits proliferation,migration,and invasion of A549 cells and promotes apoptosis by down-regulating the cAMP/EPAC1/RAP1 signaling pathway.

OBJECTIVE To investigate the changes of air aerosols in the digestive endoscope cleaning and disinfec-tion room under real working conditions and observe the purification effects of aerosols under different ventilation and disinfection modes.METHODS Under the real working conditions(with both the air conditioner and recircu-lating air disinfection machine under the working mode),the air samples were collected every 1 hour from 8:00 to 16:00 from the digestive endoscope cleaning and disinfection room of Ren Ji Hospital,Shanghai Jiao Tong U-niversity School of Medicine from May 2023 to Oct.2023;the contents of particulate matters(PM)and microor-ganisms in the air were detected.At the busiest moment of the cleaning and disinfection room,the air was respec-tively sampled from the cleaning and disinfection room with the working condition modes of air condition systems,recirculating air disinfection machine or natural ventilation before the starting of systems and after the work for 0.5 hour,1 hour and 2 hours.The contents of PMs and microorganisms were detected.RESULTS The PM0.5 con-centrations during various time periods met the Grade 9 ISO clean room standard(≤35,200 particles/L)under the real working conditions,and the content of airborne viable particles also conformed to the Class Ⅲ environmental requirements(≤500 CFU/m3).All of the three ventilation and disinfection methods showed certain effects on purification of the con-tents of PM0.5 and microorganisms after the ventilation for 2 hours,the contents of PMs and microorganisms of the air disinfection machine group decreased most remarkably,followed by the air conditioner group,the natural ventilation group the least.There were no significant differences in the PM concentration and the content of microorganisms among the three groups at the time points;there were only significant differences in the PM concentration and the content of mi-croorganisms of the air disinfection machine group after the ventilation for 2 hours,0.5 hour and 1 hour(P＜0.05).CONCLUSIONS Both the air conditioning systems and recirculating air disinfection machine under the working con-dition mode have certain effect on purification of the contents of PM and microorganisms,and the specific effect need to be further studied.The implementation of multicenter dynamic surveillance with the help of intelli-gent techniques may provide reference for the optimization of ventilation and disinfection strategies.

This study aims to screen the diagnostic biomarkers for fecal antigen of Echinococcus granulosus(E.granulosus)in dogs with high specificity and sensitivity.The sheep-derived EgPSC artificially infected dogs were collected,and the negative and positive fecal samples of dogs with E.granulosus were prepared by arecoline hydrobromide leakage method.Polyclonal antibody,negative fecal antigen-polyclonal antibody conjugates and positive fecal antigen-polyclonal antibody conju-gates were purified by ammonium sulfate precipitation and affinity chromatography,three groups of samples were detected by ELISA and Western blot,LC-MS/MS and bioinformatics analysis were performed on the three groups of samples.The positive fecal antigen-polyclonal antibody con-jugate was used as the treatment group,the polyclonal antibody and the negative fecal antigen-polyclonal antibody conjugates were used as the control groups to screen the unique peptides of the treatment group.ELISA and Western blot showed that only the positive fecal antigen-polyclonal antibody conjugates were positive.According to LC-MS/MS and bioinformatics analysis,11 unique peptides were screened out only in the treatment group.Among them,3 proteins were related to E.granulosus,namely dysferlin,integrator complex 9 and diagnostic antigen gp50,which were mem-brane-associated proteins,INT complex components and diagnostic antigens.This study has pre-liminarily screened out three candidate canine E.granulosus fecal antigen diagnostic markers,pro-viding a reference for further exploration of diagnostic standards for E.granulosus,screening of echinococcosis target genes,and vaccine development.

OBJECTIVE To investigate the changes of air aerosols in the digestive endoscope cleaning and disinfec-tion room under real working conditions and observe the purification effects of aerosols under different ventilation and disinfection modes.METHODS Under the real working conditions(with both the air conditioner and recircu-lating air disinfection machine under the working mode),the air samples were collected every 1 hour from 8:00 to 16:00 from the digestive endoscope cleaning and disinfection room of Ren Ji Hospital,Shanghai Jiao Tong U-niversity School of Medicine from May 2023 to Oct.2023;the contents of particulate matters(PM)and microor-ganisms in the air were detected.At the busiest moment of the cleaning and disinfection room,the air was respec-tively sampled from the cleaning and disinfection room with the working condition modes of air condition systems,recirculating air disinfection machine or natural ventilation before the starting of systems and after the work for 0.5 hour,1 hour and 2 hours.The contents of PMs and microorganisms were detected.RESULTS The PM0.5 con-centrations during various time periods met the Grade 9 ISO clean room standard(≤35,200 particles/L)under the real working conditions,and the content of airborne viable particles also conformed to the Class Ⅲ environmental requirements(≤500 CFU/m3).All of the three ventilation and disinfection methods showed certain effects on purification of the con-tents of PM0.5 and microorganisms after the ventilation for 2 hours,the contents of PMs and microorganisms of the air disinfection machine group decreased most remarkably,followed by the air conditioner group,the natural ventilation group the least.There were no significant differences in the PM concentration and the content of microorganisms among the three groups at the time points;there were only significant differences in the PM concentration and the content of mi-croorganisms of the air disinfection machine group after the ventilation for 2 hours,0.5 hour and 1 hour(P＜0.05).CONCLUSIONS Both the air conditioning systems and recirculating air disinfection machine under the working con-dition mode have certain effect on purification of the contents of PM and microorganisms,and the specific effect need to be further studied.The implementation of multicenter dynamic surveillance with the help of intelli-gent techniques may provide reference for the optimization of ventilation and disinfection strategies.

Bone growth and development is a major determinant of height.Height development in children is the result of the proliferation and endochondral ossification of growth plate chondrocytes located at the ends of long bones and vertebrae.Short stature，also known as dwarfism，means that a child's height is less than two standard deviations of the normal interval for children of the same race，region，and sex，or below the 3rd percentile of the normal child growth curve，which is a common problem in pediatric endocrinology.A variety of physiological regulatory pathways involving growth plate and long bone development have been reported，and related gene defects may be the key mechanisms leading to growth disorders and abnormal skeletal development in children.The ACAN gene，which is associated with osteochondral dysplasia，has garnered widespread attention from numerous scholars in recent years.This article reviews the genetic etiology，clinical phenotype，treatment and management of short stature caused by ACAN gene mutation in children.