Background Platelet parameters are important indicators of cardiovascular risk, and environmental pollutants such as polychlorinated biphenyls (PCBs) may impair platelet function through oxidative stress. Objective To investigate the differential effects of single and mixed exposure to PCBs on platelet parameters among individuals with normal glucose tolerance (NGT), impaired fasting glucose (IFG), and type 2 diabetes mellitus (T2DM), and to evaluate the potential modifying role of a healthy lifestyle. Methods This study included 2249 participants (including 707 with NGT, 759 with IFG, and 783 with T2DM). Plasma PCB concentrations were measured using triple quadrupole gaschromatography-tandem mass spectrometry. Generalized linear regression was used to assess the associations between individual PCB congeners and platelet parameters. Quantile g-computation (QGC) and Bayesian kernel machine regression (BKMR) models were used to evaluate the overall effects of PCBs mixture exposure on platelet parameters across different glycemic states, as well as its interaction with healthy lifestyle score (HLS). Results Generalized linear regression analyses showed significant differences in the effects of PCBs on platelet parameters across different glycemic states (P<0.05). After adjusting for confounders, PCBs mixture exposure was significantly associated with lower platelet counts (PLT) in individuals with NGT (b=−10.60, 95%CI: −16.48, −4.71) and IFG (b=−12.91, 95%CI: −18.90, −6.92), whereas no significant association was observed in individuals with T2DM (P=0.051). Mean platelet volume (MPV) and platelet-large cell ratio (P-LCR) increased significantly with higher PCBs exposure levels across all three groups (P<0.05). BKMR analysis showed a positive association between PCBs mixture exposure and P-LCR, with the strongest association observed in the NGT group. Furthermore, a significant interaction was observed between HLS and PCBs mixture exposure, and a higher HLS attenuated the effects of PCBs on P-LCR. Conclusion Glycemic glycemic states may modify the effects of PCBs on platelets. Individuals with NGT appear more sensitive to PCBs exposure, whereas the T2DM state may attenuate this effect. Moreover, healthy lifestyles, including not smoking, moderate alcohol consumption, maintaining moderate-to-high physical activity, a healthy diet, and an appropriate body mass index (BMI), may mitigate the adverse effects of most PCBs on platelet parameters.

Background Platelet parameters are important indicators of cardiovascular risk, and environmental pollutants such as polychlorinated biphenyls (PCBs) may impair platelet function through oxidative stress. Objective To investigate the differential effects of single and mixed exposure to PCBs on platelet parameters among individuals with normal glucose tolerance (NGT), impaired fasting glucose (IFG), and type 2 diabetes mellitus (T2DM), and to evaluate the potential modifying role of a healthy lifestyle. Methods This study included 2249 participants (including 707 with NGT, 759 with IFG, and 783 with T2DM). Plasma PCB concentrations were measured using triple quadrupole gaschromatography-tandem mass spectrometry. Generalized linear regression was used to assess the associations between individual PCB congeners and platelet parameters. Quantile g-computation (QGC) and Bayesian kernel machine regression (BKMR) models were used to evaluate the overall effects of PCBs mixture exposure on platelet parameters across different glycemic states, as well as its interaction with healthy lifestyle score (HLS). Results Generalized linear regression analyses showed significant differences in the effects of PCBs on platelet parameters across different glycemic states (P<0.05). After adjusting for confounders, PCBs mixture exposure was significantly associated with lower platelet counts (PLT) in individuals with NGT (b=−10.60, 95%CI: −16.48, −4.71) and IFG (b=−12.91, 95%CI: −18.90, −6.92), whereas no significant association was observed in individuals with T2DM (P=0.051). Mean platelet volume (MPV) and platelet-large cell ratio (P-LCR) increased significantly with higher PCBs exposure levels across all three groups (P<0.05). BKMR analysis showed a positive association between PCBs mixture exposure and P-LCR, with the strongest association observed in the NGT group. Furthermore, a significant interaction was observed between HLS and PCBs mixture exposure, and a higher HLS attenuated the effects of PCBs on P-LCR. Conclusion Glycemic glycemic states may modify the effects of PCBs on platelets. Individuals with NGT appear more sensitive to PCBs exposure, whereas the T2DM state may attenuate this effect. Moreover, healthy lifestyles, including not smoking, moderate alcohol consumption, maintaining moderate-to-high physical activity, a healthy diet, and an appropriate body mass index (BMI), may mitigate the adverse effects of most PCBs on platelet parameters.

End-stage liver disease (ESLD) covers the end-stage of acute and chronic liver diseases, mainly involving decompensated cirrhosis, various types of liver failure, and advanced liver cancer. Hepatocyte transplantation has shown promise in treating ESLD, but its clinical application is hampered by the shortage of donor hepatocytes. Cell therapy, an emerging effective treatment for ESLD, faces the same limitation due to scarce hepatocyte availability. Hepatocyte-like cells (HLCs), which are terminally differentiated cells, can be induced from both stem cells and somatic cells. As HLCs exhibit the morphology and function of primary hepatocytes, they offer a promising supplementary source of hepatocytes for cell therapy. First, we provide a background for the differentiation and maturation of primary hepatocytes. Subsequently, based on the current insights into the molecular pathways that regulate hepatocyte differentiation in vivo, we describe a strategy for establishing HLC derived from either stem cells or somatic cells. The key characteristics of these HLCs are also detailed. Furthermore, HLC offers therapeutic potential for liver failure, and HLC-based liver organoids and bioartificial liver systems have demonstrated the ability to provide liver functions, offering an innovative approach to treating various types of ESLD. Despite their promise, challenges such as efficiency in differentiation and functional maturation need to be addressed to improve the clinical application of HLCs. This review discusses these advancements and outlines the therapeutic potential and current challenges of HLC therapy for ESLD.

ObjectiveTo investigate the association between perioperative troponin elevation and the occurrence of major adverse cardiac events （MACE） in elderly patients with colorectal cancer， and to provide evidence for optimizing perioperative management strategies. MethodsA total of 268 elderly patients aged 70 years and above who underwent colorectal cancer surgery were retrospectively enrolled. They were divided into a conventional management group （87 cases） and a standardized management group （181 cases） according to the perioperative management strategy. Binary logistic regression analysis was used to identify the independent influencing factors for the occurrence of major adverse cardiac events. P-value ≤ 0.05 was considered statistically significant. ResultsAmong the 268 patients， the overall incidence of perioperative major adverse cardiac events was 4.5% （12/268）. The total incidence of major adverse cardiac events in the conventional management group was 8.0% （7/87）， which was significantly higher than that in the standardized management group （2.8%， 5/181；P=0.05）. Specifically， the incidences of myocardial infarction， heart failure， and death in the conventional management group were markedly higher than those in the standardized management group （8.0% vs. 2.2%， 4.6% vs. 0.6%， 4.6% vs. 0.6%， all P＜0.05）， while no significant difference was observed in the incidence of cardiogenic shock between the two groups （1.1% vs. 1.1%， P＞0.05）. Postoperative troponin elevation was significantly associated with the occurrence of perioperative major adverse cardiac events except for cardiogenic shock （including total cardiovascular events， myocardial infarction， heart failure， and death） （all P＜0.05）， and it was identified as a strong independent risk factor for perioperative major adverse cardiac events in these patients. ConclusionCompared with conventional management， standardized perioperative troponin management can significantly reduce the risks of myocardial infarction， heart failure， and death， and also exhibits a potential protective trend against cardiogenic shock. Postoperative troponin elevation is a strong independent risk factor for the occurrence of perioperative major adverse cardiac events.

The recombinant human thyroid-stimulating hormone (rhTSH) can be used for differentiated thyroid cancer (DTC) preparation before ¹³¹I therapy, and follow-up. Since its approval by the American Food and Drug Administration (FDA) in 1998, rhTSH has been clinically used in European countries, the United States, and other countries for nearly 30 years. In April 2024, China’s first independently developed rhTSH agent was approved. Based on clinical experience and evidence from domestic and international studies, an expert consensus on the application of rhTSH has been developed following thorough consultations among experts. The consensus offers evidence-based recommendations to guide the appropriate use of rhTSH in clinical practice.

Objective: To analyze the epidemiological characteristics and spatio-temporal clustering characteristics of pulmonary tuberculosis (PTB) among the elderly population in Zhuji City, Zhejiang Province from 2014 to 2024, so as to provide the evidence for formulating differentiated PTB prevention and control measures for the elderly population. Methods: Data of PTB cases aged ≥60 years in Zhuji City from 2014 to 2024 were collected from the Tuberculosis Management Information System of the China Disease Prevention and Control Information System. Descriptive epidemiological methods were used to analyze the distribution characteristics of PTB cases among the elderly population. The average annual percent change (AAPC) and annual percent change (APC) were used to analyze the trends in PTB registration rates among the elderly population from 2014 to 2024. Spatial autocorrelation analysis and spatio-temporal scan analysis were used to analyze the spatio-temporal clustering characteristics of PTB among the elderly population. Results: A total of 1 852 PTB cases aged ≥60 years were registered in Zhuji City from 2014 to 2024, with an average annual registration rate of 59.82/105, showing an overall declining trend (AAPC=-3.494%, P<0.05). The registration rate showed a downward trend from 2014 to 2020 (APC=-8.709%, P<0.05), while trend in the registration rate from 2020 to 2024 was not statistically significant (P>0.05). The majority cases were males and farmers, with 1 395 and 1 446 cases respectively, accounting for 75.32% and 78.08%. Spatial autocorrelation analysis showed that PTB among the elderly population showed spatial clustering distribution in 2015 and 2023, with Moran's I values of 0.249 and 0.323, respectively (both P<0.05). High-high clustering areas were predominantly located in estern and northern parts of the city, while low-low clustering areas concentrated in the southeastern area. Spatio-temporal scan analysis showed that there was one spatio-temporal clustering area of PTB among the elderly population, concentrated central, western, and northern regions of Zhuji City, with the clustering period spanning from April 2014 to September 2019. Conclusions The registration rate of PTB among the elderly population in Zhuji City from 2014 to 2024 showed an overall declining trend, with cases predominantly occurring among males and farmers. The clustered areas were mainly in the central, western, and northern parts of the city. It is recommended to strengthen PTB prevention and control for key populations in clustering areas.

Objective:To investigate the mechanism of Compound Mufurong Nasal Ointment in interfering with allergic rhinitis in young rats based on the Th1/Th2 cytokines and c-jun N-terminal kinase (JNK) signaling pathway.Methods:Totally 60 young SD male rats were divided into normal group, model group, experimental group, Western medicine group, and combination group according to random number table method, with 12 rats in each group. Except for the normal group, allergic rhinitis rat models were prepared by intraperitoneal injection of ovalbumin and nasal instillation of ovalbumin sensitization in all other groups of rats. After successful modeling, the normal group and the model group were given 0.9% sodium chloride injection 50 μl nasal drip, and the experimental group, the Western medicine group and the combination group were given compound Mufurong Nasal Ointment, fluticasone propionate nasal spray, compound Mufurong Nasal Ointment and fluticasone propionate nasal spray respectively. HE staining was used to observe the pathological morphology of nasal mucosal tissue; ELISA method was used to detect the levels of total IgE, interferon - γ (IFN - γ), IL-1 β, and IL-4 in the serum and nasal lavage fluid of rats in each group; Western blot was used to detect the expressions of JNK and p-JNK proteins in nasal tissues of rats in each group; Immunohistochemistry was used to detect the expressions of p-JNK and p-c-Jun proteins in nasal mucosal tissue.Results:Compared with model group, the levels of IgE, IL-1β and IL-4 in serum and nasal lavage solution of experimental group, western medicine group and combination group decreased ( P<0.05), IFN-γ level increased ( P<0.05); the expressions of JNK and p-JNK protein decreased ( P<0.05), and the expressions of p-JNK and p-c-Jun decreased ( P<0.05). Conclusion:Compound Mufurong Nasal Ointment may regulate Th1/Th2 cytokines through the JNK signaling pathway, inhibit Th2 over-expression, thereby reducing IgE, IL-1 β, IL-4 levels in serum and nasal lavage fluid, up-regulating IFN - γ levels, and intervening in the occurrence of allergic rhinitis.

The theory of five spirits(mind,eternal soul,corporeal soul,consciousness and will)is an important part of traditional Chinese medicine(TCM)theory,which reveals the human mental and psychological activities.Five-spirit theory takes the shape of modern cognitive psychology.Language is an important part of cognitive activities.Under the guidance of the five-spirit theory of TCM,and by combining the research results of modern cognitive psychology,this paper initially constructs a language processing model,and proposes that heart-mind,spleen-consciousness,kidney-will,and liver-soul are all involved in the formation of language.Moreover,the pathogenesis of post-stroke aphasia(PSA)is explored from the perspective of the five spirits.It is proposed that PSA refers to the comorbidity of body and spirit,and its pathogenesis is related to the disorders of the five spirits.After analyzing the clinical manifestations of PSA,it is suggested that malnutrition of heart-mind and insufficient kidney-will contribute to the pathogenesis of auditory comprehension and reading obstacles in patients with PSA,and the deactivation of liver-soul is closely related to spontaneous speech and naming obstacles.The treatment of PSA should be focused on nourishing blood and tranquilizing mind,enhancing consciousness and strengthening will,and suppressing liver to tranquilize soul.And the prescriptions of Pingbu Zhenxin Pills,Zhiyi Decoction plus Dingzhi Pills,and Dinghun Decoction can be chosen for modified use.The acupuncture and moxibustion can also be used for PSA,by performance mainly on the acupoints of heart meridians,pericardial meridians,spleen meridians,kidney meridians and liver meridians.The syndrome differentiation and treatment system for PSA with the combination of Chinese medicine and acupuncture based on the five-spirit theory makes up for the shortcomings of stress on the physique while ignorance of the spirit in the conventional zang-fu organ syndrome differentiation,and expands the methods for early intervention of PSA with TCM and approaches to improve the prognosis of rehabilitation.