Background Exposure to air pollutants increases the risk of diseases in multiple systems, including respiratory and cardiovascular systems, yet its association with neurological diseases remains unclear. Objective To quantitatively evaluate the association between short-term exposure to air pollutants and outpatient and emergency visits for neurological diseases, identify potential susceptible populations, and quantify associated disease burden. Methods Daily 24-hour average concentrations of fine particulate matter (PM_2.5), inhalable particulate matter (PM₁₀), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), and carbon monoxide (CO), daily maximum 8-hour average concentration of ozone (O₃), daily meteorological data (24-hour average temperature, 24-hour average relative humidity), and data on daily outpatient and emergency department visits for neurological diseases from two hospitals in Conghua District, Guangzhou, China, were collected from 2015 to 2022. A time-stratified case-crossover design was adopted, and a conditional Poisson regression model was constructed to analyze the association between air pollution exposure and neurological disease visits. Two-pollutant models and sensitivity analysis were used to validate model stability. Stratified analyses by season (cold season: from November to March; warm season: from April to October), sex (male, female), and age (≤45 years, 46–60 years, ≥61 years) were performed to identify vulnerable group. Additionally, the number and proportion of neurological disease visits attributable to short-term air pollutant exposure were calculated. Results A total of 72 673 outpatient and emergency department visits for neurological diseases were included during the study period. Most of the patients were middle-aged and elderly individuals (69.89% were over 45 years old) and females (60.25%). The results of single-pollutant models showed that for each interquartile range (IQR) increase in exposure to PM_2.5, PM₁₀, SO₂, NO₂, CO, and O₃, the risk of outpatient and emergency department visits for neurological diseases increased by 7.54% (95%CI: 4.69%, 10.46%), 6.66% (95%CI: 3.92%, 9.46%), 16.72% (95%CI: 10.58%, 23.19%), 8.12% (95%CI: 4.82%, 11.53%), 5.60% (95%CI: 2.34%, 8.97%), and 6.11% (95%CI: 2.91%, 9.40%), respectively. The results of the two-pollutant model showed that the association between PM_2.5 and SO₂ exposure and outpatient and emergency department visits for neurological diseases were relatively stable. The stratified analyses showed that the effect of SO₂ was stronger in the cold season. It was estimated that 8.32% (95%CI: 5.55%, 10.96%) and 6.65% (95%CI: 4.27%, 8.96%) of the outpatient and emergency department visits were attributable to short-term exposure to SO₂ and PM_2.5, respectively. Conclusion Exposure to PM_2.5 and SO₂ is associated with increased risks of outpatient and emergency visits for neurological diseases. SO₂ shows stronger effects during the cold season, and exposure to air pollution contributes to up to 8.32% of neurological disease visits.

Major depressive disorder (MDD) is a common mental disorder, whose pathogenesis has not been fully elucidated. Recent studies have shown that gut microbiota can regulate the permeability of blood-brain barrier (BBB) through microbiota-gut-brain axis, thereby affecting the function of brain regions related to emotion and participating in MDD development. This article reviews the recent advance in gut microbiota in the pathogenesis and treatment of MDD, with the aim of providing a reference for clinical treatment of MDD.

Objective To quantitatively assess the association of short-term exposure to polycyclic aromatic hydrocarbons (PAHs) in ambient fine particulate matter (PM2.5) with residents mortality. Methods A time-stratified case-crossover study was conducted from 2020 to 2022 among 10606 non-accidental residents by using the Guangzhou Cause of Death Surveillance System in Conghua District, Guangzhou. Exposure levels of PAHs in PM_2.5 and meteorological data during the study period were obtained from the Center for Disease Control and Prevention in Conghua District and the China Meteorological Administration Land Data Assimilation System (CLDAS-V2.0), respectively. Conditional Poisson regression model was used to estimate the exposure-response association between PAHs and the mortality risk. Results Fluoranthene, chrysene, benzo[k]fluoranthene, benzo[a]pyrene, and indeno[1,2,3-cd]pyrene were significantly associated with an increased risk of mortality. For every one interquartile range increase in exposure levels, the non-accidental mortality risks increased by 8.33% (95% CI: 1.80%, 15.27%), 4.67% (95% CI: 1.86%, 7.57%), 6.07% (95% CI: 2.08%, 10.21%), 4.62% (95% CI: 1.85%, 7.47%), and 4.70% (95% CI: 0.53%, 9.03%), respectively. The estimated non accidental deaths attributable to exposure to fluoranthene, chrysene, benzo[k]fluorine, benzo[a]pyrene and indine[1,2,3-cd]pyrene were 5.91%, 6.08%, 6.51%, 6.46%, and 4.21%, respectively. Conclusions Short-term exposure to PAHs in PM_2.5, including fluoranthene, chrysene, benzo[k]fluoranthene, benzo[a]pyrene and indine[1,2,3-cd]pyrene, was significantly associated with an increased risk of mortality among residents.

Major depressive disorder (MDD) is a common mental disorder, whose pathogenesis has not been fully elucidated. Recent studies have shown that gut microbiota can regulate the permeability of blood-brain barrier (BBB) through microbiota-gut-brain axis, thereby affecting the function of brain regions related to emotion and participating in MDD development. This article reviews the recent advance in gut microbiota in the pathogenesis and treatment of MDD, with the aim of providing a reference for clinical treatment of MDD.

Objective To evaluate the application value of percutaneous angle positioning system based on augmented reality in improving the accuracy of liver puncture.Methods A canine liver with an embedded marking ring was used as the target for puncture.A skilled physician with over 5 years of experience in liver puncture and a novice physician with limited experience in liver puncture separately performed liver puncture using either the augmented reality-based percutaneous angle localization system(navigation)or CT-guided technique alone(non-navigation).The corresponding puncturing data of non-navigation skilled group(Group A),non-navigation non-skilled group(Group B),navigation skilled group(Group C),and navigation non-skilled group(Group D)were obtained.The differences in the evaluation indicators,including the number of CT scans,number of needle adjustment,time spent for operation,and distance of error,between Group A and Group B,between Group C and Group D,between Group A and Group C,and between Group B and Group D,were analyzed.Results Statistically significant differences in the number of CT scans,number of needle adjustment,time spent for operation,and distance of error existed between Group A and Group B,between Group A and Group C,and between Group B and Group D(all P＜0.0 5),while the differences in the number of CT scans,number of needle adjustment,time spent for operation,and distance of error between Group C and Group D were not statistically significant(all P＞0.05)Conclusion In performing liver puncture,the use of percutaneous angle localization system can reduce the number of CT scans,number of needle adjustment,time spent for operation and distance of error,and improve the puncture accuracy as well,which provides a basis for the clinical utilization of this system and the employment of this system-guided puncture technology in primary hospitals.(J Intervent Radiol,2024,33:507-511)

Objective To construct an integrated pharmaceutical care model for chronic respiratory system disease patients,and to provide policy recommendations.Methods A field survey,a semi-structured interview,and a questionnaire survey were comprehensively used to investigate the effect of the reform and the status quo of pharmaceutical care for chronic respiratory diseases after the medicine consistency reform in the medical alliance of Chongqing.Subsequently,the rainbow model was used to assess the challenges in the macro,meso,micro,and supporting element's dimensions,and the integrated pharmaceutical care model was established as a consequence.Results The primary issues involved in the medical alliance were as followed:insufficient joint reformation for public health services,medical insurance,and medical production and circulation(JRPMM);deficient supporting policies;a dearth of information support;an inadequately list of medications;insufficient collaboration among chronic disease specialties;and unstandardized pharmaceutical care.Consequently,the following recommendations were:in the macro dimension,to strengthen the JRPMM to enhance the service capacity of primary hospitals and to develop suitable human resource coordination mechanisms.In the meso dimension,to intensify the reform of pharmaceutical care in the medical alliance and enhance specialty collaboration horizontally.In the micro dimension,to establish a pharmaceutical management committee in the medical alliance,to formulate pharmaceutical technical specifications for the hierarchical medical system,and to combine"talent and technology"training innovatively.In the supporting elements dimension,to bolster information support in the area and to develop suitable incentives and assessment institutions.Conclusion This paper reported an integrated pharmaceutical care model for chronic respiratory diseases,which could serve as a reference for standardizing the hierarchical medical system for chronic diseases.

Objective:To investigate the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with maintenance hemodialysis (MHD) in Jiangsu province during SARS-CoV-2 pandemic in China from December 7, 2022 to January 27, 2023, and to analyze the influencing factors of all-cause death.Methods:It was a multi-center cross-sectional investigation. Structured questionnaire was used to collect patient information by medical staff of each hemodialysis center (room) as investigators. Part of the demography data and laboratory examination data came from the Jiangsu Province Hemodialysis Data Information System. MHD patients from hemodialysis centers (rooms) at all levels of medical institutions and independent hemodialysis institutions in Jiangsu province during the outbreak of SARS-CoV-2 infection were included, and the clinical characteristics and all-cause mortality of confirmed and suspected cases of SARS-CoV-2 infection were analyzed.Results:Questionnaire surveys and data analysis on 57 278 patients in 407 hemodialysis centers (rooms) were completed, accounting for 90.41% of the total number of MHD patients (63 357 cases) in Jiangsu province during the same period. There were 24 038 cases (41.97%) of SARS-CoV-2 infection and 14 805 cases (25.85%) of suspected infection, which were widely distributed in all dialysis centers in Jiangsu province. After clinical classification of 38 843 confirmed and suspected SARS-CoV-2 infection cases, 3 662 cases were severe and critical cases, accounting for 9.43% of the infected and suspected cases. Among the patients who had completed the questionnaires, there were 1 812 all-cause deaths, with an all-cause mortality rate of 3.16%. Multivariate logistic regression analysis showed that elderly (taking ≤50 years as a reference, 51-59 years: OR=1.583, 95% CI 1.279-1.933, P=0.001; 60-69 years: OR=3.972, 95% CI 3.271-4.858, P<0.001; 70-79 years: OR=7.236, 95% CI 5.917-8.698, P<0.001; ≥80 years: OR=11.738, 95% CI 9.459-14.663, P<0.001), male ( OR=1.371, 95% CI 1.229-1.529, P<0.001), and co-infection with hepatitis B virus (HBV) (positive serum HBV surface antigen, OR=0.629, 95% CI 0.484-0.817, P<0.001) were independent influencing factors for all cause mortality. Receiver-operating characteristic curve analysis showed that the area under the curve for male, age and current HBV infection prediction of all-cause death was 0.529 ( P<0.001), 0.724 ( P<0.001) and 0.514 ( P=0.042), respectively, and the cut-off value for age prediction of all-cause death was 65.5 years old. Compared with patients without HBV infection, MHD patients with HBV infection significantly reduced the proportion of severe and critically ill patients, all-cause hospitalizations and all cause deaths when infected with SARS-CoV-2 (4.99% vs. 6.41%, χ2=6.136, P=0.013; 8.90% vs. 11.44%, χ2=11.662, P<0.001; 2.01% vs. 3.37%, χ2=10.713, P=0.001, respectively). Conclusion:The MHD patients in Jiangsu province are susceptible to SARS-CoV-2. Elderly age and male gender are independent risk factors for death in MHD patients during the epidemic, while the HBV infection may be a protective factor for death of MHD patients infected with SARS-CoV-2.

Objective:To study the differences of intestinal flora between neonatal rats with intrauterine hypoxia and healthy neonatal rats using high-throughput sequencing technology to determine the effects of intrauterine hypoxia on neonatal intestinal flora.Methods:Intrauterine hypoxia model were established in neonatal rats. On d1 and d7 after birth, intestinal samples were collected from intrauterine hypoxic group and normal control group and assigned into INH1 group (intrauterine hypoxia d1), INH7 group (intrauterine hypoxia d7), NOR1 group (normal control d1) and NOR7 group (normal control d7). 16S rRNA sequencing were conducted using these samples and the differences in the diversity, richness and composition of the flora among the groups were compared.Results:(1) The Alpha diversity of the intestinal flora in the INH1 group was higher than the NOR1 group. Specifically, both sobs and chao indices, representing the richness of the flora, in INH1 group were significantly higher than the NOR1 group (sobs index: 114.5±35.6 vs. 50.5±21.3, chao index: 135.6±38.5 vs. 73.9±28.8)( P<0.05). Compared with the NOR7 group, the mean values of sobs, ace, chao, simpson and shannon indices in the INH7 group showed no significant differences ( P>0.05). (2) At the phylum and genus level, the dominant bacterial groups in the intrauterine hypoxia group on d1 were firmicutes and streptococcus and proteus and escherichia for the normal control group. The difference of intestinal flora between intrauterine hypoxia group and the normal control group on d7 was smaller than the difference between the two groups on d1. Compared with INH1 group, the INH7 group had increased escherichia composition and decreased streptococcus composition. Conclusions:Intrauterine hypoxia changes the initial colonization and later affects the abundance and structural composition of the intestinal flora in newborn rats.

Objective:To explore the effects of platelet parameters, coagulation indexes, platelet and lymphocyte ratio (PLR) values, neutrophil and lymphocyte ratio (NLR) values on coagulation disorders and perinatal outcomes in pregnant women with intrahepatic cholestasis of pregnancy (ICP).Methods:A retrospective analysis of prothrombin time (PT) and activated partial thromboplastin time (activated partial) of 106 ICP patients (ICP group) and 138 normal pregnant women (control group) delivered from Gansu Provincial People's Hospital from January 2017 to December 2018 was performed. Activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-D), platelet count, mean platelet volume (MPV), platelet distribution red blood cell distribution width (RDW), number of white blood cell (WBC), PLR, NLR, and postpartum hemorrhage and perinatal outcomes were compared between the two groups. Further based on whether serum bile acid (TBA) was ≥40 μmol/L, the patients in ICP group were divided into mild ICP subgroup and severe ICP subgroup, and the changes in the difference indicators were analyzed between the two subgroups.Results:Compared with control group, MPV ( t=4.929, P<0.001), FIB ( t=3.509, P<0.001), D-D ( t=7.834, P<0.001) and NLR ( t=4.098, P<0.001) were significantly increased in ICP group ( P<0.05). Platelet count ( t=4.367, P<0.001) and PLR ( t=2.448, P=0.015) were significantly decreased in ICP pregnant women. The incidence of postpartum hemorrhage ( t=10.003, P<0.001), fetal distress (χ 2=17.194, P<0.001), preterm birth rate (χ 2=13.938, P<0.001) and transfer into neonatal intensive care unit (NICU)(χ 2=29.736, P<0.001) in ICP group was higher than that in control group. Apgar score ( t=3.234, P=0.001) and neonatal birth weight ( t=6.509, P<0.001) in ICP group were lower than those in control group. Further analysis of ICP components for severe ICP and mild ICP revealed significant differences in MPV ( t=2.376, P=0.019), FIB ( t=2.174, P=0.032), D-D ( t=3.074, P=0.003), WBC ( t=2.021, P=0.046), neutrophil count ( t=2.131, P=0.035), NLR ( t=2.864, P=0.005), etc. Postpartum hemorrhage ( t=3.257, P=0.002), the preterm birth rate (χ 2=4.025, P=0.045), birth weight ( t=3.126, P=0.002), and transfer rate to the NICU (χ 2=5.518, P=0.019) were also significantly different between the two groups. Conclusion:ICP pregnant women have abnormal coagulation and fibrinolysis, which may lead to postpartum hemorrhage. The incidence of poor perinatal outcomes is high, which should be highly valued by the clinic. It is of great significance to evaluate the pregnancy outcome of pregnant women with ICP by analyzing the coagulation function and inflammatory markers of ICP pregnant women.

Objective:To explore the effects of platelet parameters, coagulation indexes, platelet and lymphocyte ratio (PLR) values, neutrophil and lymphocyte ratio (NLR) values on coagulation disorders and perinatal outcomes in pregnant women with intrahepatic cholestasis of pregnancy (ICP).Methods:A retrospective analysis of prothrombin time (PT) and activated partial thromboplastin time (activated partial) of 106 ICP patients (ICP group) and 138 normal pregnant women (control group) delivered from Gansu Provincial People's Hospital from January 2017 to December 2018 was performed. Activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-D), platelet count, mean platelet volume (MPV), platelet distribution red blood cell distribution width (RDW), number of white blood cell (WBC), PLR, NLR, and postpartum hemorrhage and perinatal outcomes were compared between the two groups. Further based on whether serum bile acid (TBA) was ≥40 μmol/L, the patients in ICP group were divided into mild ICP subgroup and severe ICP subgroup, and the changes in the difference indicators were analyzed between the two subgroups.Results:Compared with control group, MPV ( t=4.929, P<0.001), FIB ( t=3.509, P<0.001), D-D ( t=7.834, P<0.001) and NLR ( t=4.098, P<0.001) were significantly increased in ICP group ( P<0.05). Platelet count ( t=4.367, P<0.001) and PLR ( t=2.448, P=0.015) were significantly decreased in ICP pregnant women. The incidence of postpartum hemorrhage ( t=10.003, P<0.001), fetal distress (χ 2=17.194, P<0.001), preterm birth rate (χ 2=13.938, P<0.001) and transfer into neonatal intensive care unit (NICU)(χ 2=29.736, P<0.001) in ICP group was higher than that in control group. Apgar score ( t=3.234, P=0.001) and neonatal birth weight ( t=6.509, P<0.001) in ICP group were lower than those in control group. Further analysis of ICP components for severe ICP and mild ICP revealed significant differences in MPV ( t=2.376, P=0.019), FIB ( t=2.174, P=0.032), D-D ( t=3.074, P=0.003), WBC ( t=2.021, P=0.046), neutrophil count ( t=2.131, P=0.035), NLR ( t=2.864, P=0.005), etc. Postpartum hemorrhage ( t=3.257, P=0.002), the preterm birth rate (χ 2=4.025, P=0.045), birth weight ( t=3.126, P=0.002), and transfer rate to the NICU (χ 2=5.518, P=0.019) were also significantly different between the two groups. Conclusion:ICP pregnant women have abnormal coagulation and fibrinolysis, which may lead to postpartum hemorrhage. The incidence of poor perinatal outcomes is high, which should be highly valued by the clinic. It is of great significance to evaluate the pregnancy outcome of pregnant women with ICP by analyzing the coagulation function and inflammatory markers of ICP pregnant women.