Objective To longitudinally investigate the characteristics of postoperative weight changes in patients with esophageal cancer and analyze its influencing factors, which can provide certain guidance for nutritional intervention in patients with esophageal cancer. Methods Patients with esophageal cancer who underwent surgical treatment at the Sichuan Cancer Hospital from December 2020 to February 2022 were prospectively included. The general information questionnaire and body composition analyzer were used to longitudinally investigate the patients’ weight and body composition before surgery (T0), 1 month after surgery (T1), 3 months after surgery (T2) and 6 months after surgery (T3), and the change characteristics were analyzed. The generalized estimating equation was used to analyze the influencing factors for postoperative weight changes in patients with esophageal cancer. Results A total of 130 patients were enrolled, including 110 males and 20 females, aged 42-79 (63.33±8.16) years. The weight and body composition of patients with esophageal cancer showed a continuous slow downward trend within 6 months after surgery. The weight loss rate of patients at 1, 3, and 6 months after surgery was 5.10%, 7.76%, and 9.86%, respectively. The analysis results of the influencing factors for postoperative weight showed that patients with the following characteristics had more weight loss: female (β=−7.703, P=0.001), ≥60 years (β=−3.657, P=0.010), smoking (β=4.622, P=0.010), low tumor differentiation degree (β=4.314, P=0.039), and high frequency of eating (β=−3.400, P=0.008). Conclusion Weight loss is an important health problem for patients with esophageal cancer after surgery, and patients have a continuous downward trend in weight within 6 months after surgery. Medical staff should pay special attention to the patients who are female, ≥60 years, having smoking history and low tumor differentiation degree.

The Expert Consensus on Clinical Application of Qinbaohong Zhike Oral Liquid in Treatment of Acute Bronchitis and Acute Attack of Chronic Bronchitis （GS/CACM 337-2023） was released by the China Association of Chinese Medicine on December 13^th， 2023. This expert consensus was developed by experts in methodology， pharmacy， and Chinese medicine in strict accordance with the development requirements of the China Association of Chinese Medicine （CACM） and based on the latest medical evidence and the clinical medication experience of well-known experts in the fields of respiratory medicine （pulmonary diseases） and pediatrics. This expert consensus defines the application of Qinbaohong Zhike oral liquid in the treatment of cough and excessive sputum caused by phlegm-heat obstructing lung， acute bronchitis， and acute attack of chronic bronchitis from the aspects of applicable populations， efficacy evaluation， usage， dosage， drug combination， and safety. It is expected to guide the rational drug use in medical and health institutions， give full play to the unique value of Qinbaohong Zhike oral liquid， and vigorously promote the inheritance and innovation of Chinese patent medicines.

ObjectiveTo observe the effects of modified Chaihu Shugansan on the calmodulin-dependent protein kinase Ⅱ（CaMKⅡ）/cAMP-response element binding protein （CREB） signaling pathway in the hippocampus and heart tissue of a rat model with myocardial ischemia and depression and explore the mechanism by which this formula prevents and treats coronary heart disease combined with depression. MethodsThe model of myocardial ischemia combined with depression was established by high-fat diet， intraperitoneal injection of isoproterenol （ISO）， and chronic unpredictable mild stress （CUMS）. A total of 108 SD male rats were randomly divided into normal group， model group， high （23.4 g·kg^-1）， medium （11.7 g·kg^-1）， and low （5.85 g·kg^-1） dose groups of modified Chaihu Shugansan， CaMKⅡ inhibitor （KN93） group， and KN93 + high， medium， and low dose groups of modified Chaihu Shugansan， with 12 rats in each group. From the first day of modeling to the end of modeling， drugs were administered once a day. In the seventh and eighth weeks， the KN93 group and the KN93 + high， medium， and low dose groups of modified Chaihu Shugansan were intraperitoneally injected with KN93 three times weekly. At the end of the eighth week， behavioral tests including sucrose preference， open field， and elevated plus maze were conducted. Electrocardiogram （ECG） lead Ⅱ changes were observed in each group of rats， and hematoxylin-eosin （HE） staining was performed to observe changes in heart tissue. Serum levels of triglycerides （TG）， total cholesterol （TC）， high-density lipoprotein （HDL）， low-density lipoprotein （LDL）， and lactate dehydrogenase （LDH） were measured by using an enzyme-labeled instrument. Creatine kinase （CK） and creatine kinase-MB （CK-MB） were detected by ultraviolet spectrophotometry， while serum monocyte chemoattractant protein-1 （MCP-1） was measured by enzyme-linked immunosorbent assay （ELISA）. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect mRNA expression of CaMKⅡ and CREB in hippocampal and heart tissue， and Western blot was performed to assess protein expression of CaMKⅡ， phosphorylated （p）-CaMKⅡ， CREB， and p-CREB. ResultsCompared to the normal group， the model group showed significant reductions in sucrose preference rate， total activity distance in the open field， number of entries into the center area of the open field， and percentage of entries into the open arms of the elevated plus maze （P<0.01）. The ECG showed ST-segment elevation， and HE staining showed serious degeneration of myocardial fibers， disordered arrangement， and infiltration of a large number of inflammatory cells. In addition， serum TC and LDL levels increased （P<0.01）， and HDL level decreased （P<0.01）. CK， CK-MB， LDH， and MCP-1 levels significantly increased （P<0.05， P<0.01）. The mRNA expression of CaMKⅡ and CREB and the protein expression of p-CaMKⅡ and p-CREB decreased in the hippocampal tissue （P<0.05， P<0.01）， but those increased in the heart tissue （P<0.01）. Compared to the model group， the high， medium， and low dose groups of modified Chaihu Shugansan showed improvements in these abnormalities. The KN93 group had reduced sucrose preference， total activity distance in the open field， number of entries into the center area of the open field， and percentage of entries into the open arms of the elevated plus maze （P<0.01）， as well as decreased serum CK， CK-MB， LDH， and MCP-1 levels （P<0.05， P<0.01）. KN93 also reduced ST-segment elevation， alleviated the degeneration degree of myocardial fibrosis， and lowered inflammatory cell infiltration. The mRNA expression of CaMKⅡ and CREB and the protein expression of p-CaMKⅡ and p-CREB in both the hippocampal and heart tissue were reduced （P<0.05， P<0.01）. The KN93 + high， medium， and low dose groups of modified Chaihu Shugansan showed further improvements in these abnormalities compared to the KN93 group. ConclusionThe modified Chaihu Shugansan exerts antidepressant and myocardial protective effects in rats with myocardial ischemia and depression， possibly related to bidirectional regulation of the CaMKⅡ/CREB signaling pathway， with the high-dose modified Chaihu Shugansan showing the best effects.

Rice (Oryza sativa L.), as a thermophilic crop, is highly susceptible to cold stress during its growth process. Chilling injury at the plumule stage and seedling stage often affects the morphological development and leads to yield reduction of rice. The exploration and utilization of cold tolerance genes are among the most direct and effective approaches to address cold stress in rice. To identify quantitative trait loci (QTLs) associated with cold tolerance at plumule and seedling stages, in this study, we measured the seedling rates and survived seedling rates of the indica rice cultivar 'HZ', the japonica cultivar 'Nekken2', and their 120 recombinant inbred lines (RILs) under cold stress. A previously constructed high-density genetic linkage map was used for the mapping of the QTLs conferring cold tolerance at the plumule and seedling stages. A total of 4 QTLs for plumule-stage cold tolerance and 9 QTLs for seedling-stage cold tolerance were detected, with the maximum limit of detection reaching 5.20. Notably, a genetically overlapping QTL for both plumule and seedling stages was identified on chromosome 8, spanning a physical interval of 24 432 953-25 295 129 bp. Candidate genes within the detected QTL intervals were screened, and quantitative real-time polymerase chain reaction (qRT-PCR) was conducted to analyze the gene expression during the plumule and seedling stages. The results revealed that LOC_Os03g06570, LOC_Os03g07100, LOC_Os06g08280, LOC_Os08g38440, LOC_Os08g39100, and LOC_Os08g39540 exhibited significantly differential expression between the parental lines. These genes were either significantly downregulated or upregulated under cold stress. Among them, the first three gene (LOC_Os03g06570, LOC_Os03g07100, and LOC_Os06g08280) were hypothesized to be key candidates regulating the cold tolerance of rice seedlings, while the latter three genes (LOC_Os08g38440, LOC_Os08g39100, and LOC_Os08g39540) were identified as comprehensive regulators of cold tolerance during both plumule and seedling stages. These findings lay a foundation for the fine mapping and cloning of cold tolerance genes at the plumule and seedling stages, providing valuable insights for breeding cold-tolerant rice varieties.
Quantitative Trait Loci/genetics* ; Oryza/growth & development* ; Seedlings/growth & development* ; Cold Temperature ; Chromosome Mapping ; Gene Expression Regulation, Plant

Objective To explore the reproductive health literacy of young female sailors,investigate the influence of long voyage on the health,and propose strategies on health education.Methods A total of 49 young female sailors were enrolled.Their healthy status was evaluated by annual medical records.The questionnaire survey was also conducted to evaluate general status related to reproductive health,knowledge pertaining to reproductive health,and health status after long voyage.Results Some female sailors had symptoms of thyroid diseases,such as hypothyroidism(32.65%),benign thyroid nodules(59.18%),and suspected papillary carcinoma(in one sailor,2.04%).Ultrasonography revealed breast nodules in 5 subjects(10.00%),mammary gland hyperplasia in 46 subjects(93.88%)and reproductive benign diseases in 6 subjects(12.24%).The physical and mental states significantly changed in the late stage of long voyage.The changes in work and living environment were the main factors affecting the emotional and psychological status in the long voyage.The discomfort in menstrual cycle piled up with the above-mentioned changes during a long voyage,and the menstruation significantly affected the duty of 36.73%of female sailors during a long voyage.Female sailors had little knowledge about the prevention and examination of breast cancer and thyroid cancer.Conclusion The living and work environment during a long voyage may affect the health of the thyroid,mammary gland and reproductive system of young female sailors.Active health education via online and offline ways is helpful to improve the health literacy and self-care of female sailors,subsequently enhancing the combat effectiveness.

Objective To explore the causal association between immune cells and allergic rhi-nitis using Mendelian randomization(MR)approach.Methods GWAS data for 731 types of im-mune cells and allergic rhinitis were obtained from genome-wide association study(GWAS)databas-es.A two-sample bidirectional MR analysis was conducted,with the inverse-variance weighted(IVW)method as the primary analytical approach,and the weighted median method,MR-Egger re-gression,simple mode method,and weighted mode method as supplementary approaches.Sensitivity analyses,including heterogeneity tests,pleiotropy tests,and the leave-one-out method,were per-formed.Bonferroni correction was applied to the preliminary results to enhance their reliability and rigor.Results The two-sample forward MR analysis revealed correlations between 67 immune cell phenotypes and allergic rhinitis.After Bonferroni correction,four immune cell phenotypes were finally identified.Among them,the expression of CD3 on CD39-positive activated CD4 regulatory T cells(OR=0.953,95％CI,0.931 to 0.978,P＜0.001,Padj=0.007),the expression of herpesvirus entry mediator(HVEM)on CD45RA-negative CD4+T cells(OR=0.965,95％CI,0.948 to 0.983,P＜0.001,Padj=0.008),and the percentage of human leukocyte antigen class DR(HLA-DR)-high-expressing monocytes among leukocytes(OR=0.929,95％CI,0.885 to 0.974,P=0.002,Padj=0.157)were protective factors for allergic rhinitis.In contrast,the percentage of transitional B cells among B cells(OR=1.094,95％CI,1.032 to 1.161,P=0.003,Padj=0.183)was a risk factor for allergic rhinitis.The reverse MR analysis showed no causal relationship between allergic rhinitis and the four immune cell phenotypes.Conclusion The two-sample forward MR analysis confirms a caus-al link between immune cells and allergic rhinitis.MR analysis has the advantages of reducing con-founding factor interference and avoiding reverse causation,providing a theoretical basis for in-depth research on immune mechanisms,sensitive biomarkers,and drug treatment targets of allergic rhinitis.

Objective:To investigate the distribution of physical and chemical water improvement areas of drinking water-borne endemic fluorosis in Inner Mongolia Autonomous Region, as well as the use of household water purifiers.Methods:From April to October 2021, a survey was conducted in a drinking water-borne endemic fluorosis areas in Inner Mongolia Autonomous Region where physical and chemical water improvement was carried out. The survey included the basic situation of the affected villages (number of permanent households, number of permanent residents, historical water fluoride content) and the use of residential water purifiers. Household peripheral water samples were collected to test the water fluoride content. Water purifier installation rate, normal usage rate, qualified water fluoride rate in normal usage, and the proportion of households covered by filter replacement departments were calculated.Results:In Inner Mongolia Autonomous Region, the physical and chemical water improvement areas of drinking water-borne endemic fluorosis were distributed in 2 735 villages in 11 leagues (cities) throughout the region, with 192 950 permanent households and 540 216 permanent residents. The average historical water fluoride content in all leagues (cities) was 2.18 mg/L, and the current average water fluoride content was 0.40 mg/L. A total of 134 763 water purifiers were installed, with an installation rate of 69.84% (134 763/192 950). A total of 10 773 households were surveyed, with 10 396 households using water purifiers normally and a normal usage rate of 96.50% (10 396/10 773). Among them, 10 158 households had qualified water fluoride of normal usage, with a qualified water fluoride rate of 97.71% (10 158/10 396). Of the 10 396 households using water purifiers normally, 3 974 households (38.23%) had filter cartridges used within one year, and 3 961 households had qualified water fluoride, with a qualified rate of water fluoride of 99.67% (3 961/3 974). Six thousand four hundred and twenty-two households (61.77%) had filter cartridges used for more than one year, with 6 197 households had qualified water fluoride and a qualified rate of water fluoride of 96.50% (6 197/6 422). There was a statistically significant difference in the qualified rate of water fluoride between purifiers with different filter cartridge usage times (χ 2 = 110.73, P < 0.001). Among the 10 773 surveyed households, the filter cartridges replacement department covered 10 470 households, accounting for 97.19% (10 470/10 773). Conclusions:In Inner Mongolia Autonomous Region, the physical and chemical water improvement areas of drinking water-borne endemic fluorosis are widely distributed, and the normal usage rate of household water purifiers is relatively high. The qualified rate of water fluoride in household water purifiers with filter cartridges used for more than one year is low.

Objective To investigate the causal relationship between gastroesophageal reflux disease(GERD)and different phenotypes of asthma based on Mendelian randomization(MR).Methods The dataset was pooled by genome-wide association studies(GWAS),in which the GERD data contained 602 604 cases,the unspecified asthma data contained 156 078 cases,139 591 cases of obesity-associated asthma,138 474 cases of pediatric asthma,140 308 cases of allergic asthma and 136 633 cases of eosinophilic asthma.The inverse va-riance weighting method was used as the main method of MR analysis,and the weighted median method,sim-ple model,weighted models and MR-Egger conducted the supplement,and the sensitivity analysis was carried out to assess the stability of the results.Results The MR analysis showed that unspecified asthma(OR=1.61,95％CI:1.45-1.77,P＜0.01),obesity-related asthma(OR=2.40,95％CI:1.98-2.90,P＜0.01),Childhood asthma(OR=1.56,95％CI:1.25-1.94,P＜0.01)and allergic asthma(OR=1.47,95％CI:1.25-1.74,P＜0.01)present the forward cause effect,but eosinophilic asthma had no causal relation with GERD(OR=1.31,95％CI:0.95-1.81,P=0.10).The sensitivity analysis showed that the horizontal pleiot-ropy and heterogeneity in the results did not exist.Conclusion GERD could lead to an increased risk of un-specified asthma asthma,obesity-associated asthma,pediatric asthma and allergic asthma,while the effect on eosinophilic asthma is not significant.

Objective:To investigate the epidemic status of drinking-tea type endemic fluorosis (fluorosis for short) in Inner Mongolia Autonomous Region (Inner Mongolia for short), and to provide theoretical basis and basic data for formulation and evaluation of prevention and control measures.Methods:From May to October 2022, a cross-sectional survey was conducted in key areas (168 administrative villages in 6 leagues or cities) identified in the 2019 regional census with tea drinking habits, daily per capita intake of tea fluoride > 3.5 mg, and patients with skeletal fluorosis. The drinking condition of brick tea in 10 households of each administrative village was investigated, and the brick tea samples were collected to detect fluoride level. The prevalence of dental fluorosis in children aged 8 - 12 and skeletal fluorosis in adults aged 16 and older was investigated, and urine samples of patients with skeletal fluorosis were collected to detect urinary fluoride levels.Results:Totally 98.40% (1 657/1 684) of the households in the surveyed areas had a habit of drinking brick tea, with an annual per capita consumption of brick tea and a daily per capita intake of tea fluoride of 5.07 kg and 5.38 mg, respectively. The qualified rate of fluoride level in brick tea samples was 55.64% (922/1 657), the average fluoride level of all other brick tea varieties exceeded the national standard limit (300 mg/kg) except for black brick tea (291.08 mg/kg). Totally 2 747 children aged 8 to 12 were examined, with a detection rate of 13.91% (382/2 747) for dental fluorosis. The disease was mainly mild. There was no statistically significant difference in the detection rate of dental fluorosis among different age groups (χ 2 = 5.53, P = 0.238). Totally 71 708 adults aged 16 and older were examined, and the detection rate of skeletal fluorosis was 1.02% (734/71 708). Patients were mainly aged between 50 and 70 years old, and the condition in each age group was mainly mild. Totally 715 urine samples of skeletal fluorosis patients were collected and tested, and 55.24% (395/715) of the urine samples had fluoride levels higher than 1.6 mg/L. Conclusions:In Inner Mongolia, the proportion of high fluoride brick tea in endemic areas of drinking-tea type fluorosis is high. The detection rates of dental fluorosis in children and skeletal fluorosis in adults are relatively high. The prevention and control situation of drinking-tea type fluorosis is still serious.

Acute respiratory distress syndrome is one of the common complications of sepsis syndrome, belonging to the "Chuan syndrome", "Baochuan", and "Chuantuo" in the TCM field, and the disease is mainly located in the lung. The main etiology and pathogenesis of sepsis syndrome is deficient healthy qi and blood stasis with toxin blocking collaterals. Blood stasis and toxin invade the lung, causing heat and toxin to burn the body fluid in the blood. Blood viscosity and poor circulation lead to the accumulation of blood stasis and toxin in the lung. Acute deficiency syndrome, heat toxin damaging qi, heat toxin burning body fluid deficiency with little ability to dissipate qi, resulting in deficiency of healthy qi, inability to regulate breathing, inability to consolidate body fluid, inability to promote blood circulation, causing phlegm, dampness, and blood stasis blocking the lung. This disease is characterized by blood stasis with toxin blocking collaterals, deficient lung qi, and obstruction of lung qi caused by phlegm, water, dampness, and blood stasis. Therefore, blood stasis with toxin blocking collaterals, as well as deficient healthy qi are TCM pathogenesis of ARDS with sepsis syndrome.