Cadmium is a pervasive environmental pollutant with strong bioaccumulative properties and multisystem toxici-ty.Elderly individuals,as a vulnerable group,are particularly susceptible to the detrimental effects of long-term cadmium expo-sure on cognitive function.This review summarizes domestic and international research on the association between cadmium ex-posure,cognitive impairment in older adults,and Alzheimer's disease,while also discussing the potential underlying biological mechanisms.Current epidemiological studies predominantly use cross-sectional or case-control designs.Numerous studies have reported that cadmium exposure is associated with cognitive impairment in the elderly and an increased incidence or mortality of Alzheimer's disease.The neurotoxic mechanisms of cadmium are complex and varied,including disruption of the blood-brain barrier,impairment of mitochondrial function,interference with synaptic transmission,induction of autophagy and apoptosis,as well as disturbances in metal ion homeostasis and glycogen metabolism.Although numerous studies support the adverse effects of cadmium exposure on cognitive function in the elderly,these conclusions remain controversial,and the underlying biological mechanisms have not been fully elucidated.Therefore,further prospective cohort studies and in-depth biological research are ur-gently needed to better understand the health risks posed by cadmium exposure in the elderly.

Objective To investigate the relationship between the mRNA expression levels of colony stimulating factor 2 receptor subunit beta CSF2RB and granase A(GZMA)in peripheral blood mononuclear cells(PBMC)of patients with acute myocardial infarction(AMI)and ventricular remodeling after percutaneous coronary intervention(PCI).Methods A total of 161 AMI patients admitted to the First Affiliated Hospital of Hebei North University from February 2022 to August 2023 were selected as the study objects,and were further divided into non-remodeling group(n=105)and remodeling group(n=56)according to whether ventricular remodeling was possible.A total of 85 patients with coronary heart disease who did not have myocardial infarction were taken as control group.The clinical data of patients were collected,and the expression levels of CSF2RB and GZMA mRNA in peripheral blood mononuclear cells were detected by real-time fluorescence quantitative PCR.Cardiac structural parameters were detected by echocardiography,and the relationship between CSF2RB and GZMA mRNA levels and cardiac structural parameters was analyzed by Pearson correlation.The influencing factors of ventricular remodeling in AMI patients were analyzed by univariate and Logistic regression,and P<0.05 was considered statistically significant.Results The mRNA expression of CSF2RB(1.15±0.28 vs 1.80±0.37),GZMA(0.85±0.16 vs 1.15±0.26),Cys C and Hcy levels were compared between the two groups,and the differences were statistically significant(t=-39.002～-4.854,all P<0.05).The follow-up was up to August 2024.Among 161 AMI patients who underwent PCI,56 cases had ventricular remodeling.The expression level of CSF2RB mRNA(1.85±0.31),GZMA mRNA(1.27±0.29)in the reconstructed group were significantly higher than that in the non-reconstructed group(1.71±0.34,1.12±0.30),and the differences were statistically significant(t=2.564,3.057,all P<0.001).LAD,LVEDD,LVPWTd and IVST in the postoperative reconstruction group were higher than those in the non-reconstruction group(t=11.247～26.008),and LVEF was lower than that in the reconstruction group(t=-15.271),with statistical significance(all P<0.001).The level of CSF2RB and GZMA in AMI patients was positively correlated with LAD,LVEDD,LVPWTd and IVST(rCSF2RB mRNA=0.657～0.754,rGZMA mRNA=0.512～0.745),and negatively correlated with LVEF(r=-0.684,-0.754),with statistical significance(all P<0.05).There was a statistically significant differences in the levels of Cys C and Hcy between the reconstructed group and non-reconstructed group after the use of aldehyed steroid receptor antagonsts(t=5.495,20.710,30.906,all P<0.05).Logistic regression analysis showed that CSF2RBmRNA＞1.79,GZMAmRNA＞1.18,Hcy＞20.15μmol/L and no use of aldosterol receptorantagonists were independent risk factors for ventricular remodeling in AMI patients.LVEF＞58.11%was an independent protective factor for ventricular remodeling in AMI patients(Wald χ2=1.137～3.206,P<0.05).Conclusion The expression levels of CSF2RB and GZMA in PBMC of AMI patients were significantly increased.CSF2RB and GZMA are independent risk factors for postoperative ventricular remodeling in patients with AMI,and can be used as potential diagnostic markers for ventricular remodeling after acute myocardial infarction.

Extensive penile ulcer secondary to granulomatosis with polyangiitis（GPA）is clinically rare. This study reports a 20-year-old male patient with pathologically confirmed GPA-induced penile ulcers. Following control of GPA progression and wound infection management，reconstruction using a scrotal pedicled flap was performed to address the penile skin defect. The follow-up of 1 year results demonstrated favorable flap survival and significant improvement in penile appearance.

Purpose To identify hepatocellular carcinoma that responds to repetitive transcatheter arterial chemoembolization(TACE)based on CT radiomics.Materials and Methods A total of 96 patients diagnosed as hepatocellular carcinoma in the First Affiliated Hospital of Xinjiang Medical University from February 2018 to May 2024 were randomly divided into a training group(n=67)and internal validation group(n=29)at a ratio of 7∶3.All patients received three or more TACE treatments.Radiomics features were extracted from lipiodol of the target-lesions by semi-automatic segmentation on the axial CT image after TACE within 24 hours.The radiomics model were constructed by five features for differentiating non-response group from response group.Receiver operating characteristic curve analysis and decision curve were performed to evaluate the performance of the model.Results Child-Pugh classification(OR=2.737,P<0.05),BCLC stage(OR=2.907,P<0.05),multifocal tumors(OR=4.505,P<0.01)and alpha-fetoprotein(OR=1.002,P<0.01)were independent risk factors for predicting tumor response after TACE.The area under the curve of the non-contrast CT based model and the arterial-enhanced CT based model were 0.813 and 0.831 in the experimental group;0.748 and 0.788 in the validation group,respectively.Both of the two models showed good prediction performance.Conclusion The radiomics model based on CT imaging features after first TACE is effectively for differentiating non-response group from response group,lipiodol retention patterns from the target lesion can be the imaging biomarkers for TACE response prediction.

Thousands of variant gene sequences of SARS-CoV-2 have been emerged since the COVID-19 epidemic broke out in Dec.2019.Alpha(B.1.1.7),Beta(B.1.351),Gamma(P.1),Delta(B.1.617.2)and Omicron(B.1.1.529)were the most representative variants.With the continuous emergence of new variants,the predomi-nant strain in the global pandemic as of Jan.2025 is the Omicron BA.2.86-derived mutant,JN.1.The effectiveness of drugs against Omicron variants remains a key research focus in the treatment of SARS-CoV-2 infections.The infectiousness and pathogenicity of the variants altered remarkably due to mutations in the genome on S protein of the mutant strains,and these emerging variants are more likely to evade immunity and were more infectious than the previous prevalent variants.During the process of combating with the constantly emerging novel variants,drugs showed various effects on treatment of diseases caused by different variants.New drugs and treatment coun-termeasures are constantly updated with the prevalence of various variants.The current status of research on pres-ent drugs for treatment of SARS-CoV-2 and the therapeutic effects on emerging variants are reviewed in the article so as to provide reference for prevention and treatment of the upcoming evolved variants.

Oropharyngeal squamous cell carcinoma(OPSCC)is a malignant tumor originating from the squamous epithelium of the oro-pharyngeal mucosa,accounting for more than 90％of oropharyngeal malignancies.In recent years,human papillomavirus(HPV)infec-tion has become one of the primary etiological factors of oropharyngeal squamous carcinoma.The incidence of HPV-associated oropharyn-geal squamous carcinoma has been rising annually,with a noticeable trend toward younger populations,posing a significant threat to hu-man health.Due to the distinct biological behavior and clinical characteristics of HPV-associated oropharyngeal squamous carcinoma com-pared to its non-HPV-related counterpart,the diagnostic and treatment strategies for oropharyngeal squamous carcinoma have undergone substantial changes.Prevention and screening for oropharyngeal squamous carcinoma are of critical importance.The diagnostic and treat-ment process involves multi-disciplinary collaboration,including oral and maxillofacial surgery,otolaryngology,head and neck surgery,oncology,radiology and pathology.Based on evidence from clinical practice,a comprehensive,integrated diagnostic and therapeutic ap-proach has been established,centered around the concept of"prevention,screening,diagnosis,treatment,and rehabilitation",covering the entire patient lifecycle and providing a valuable reference for clinical practice.

Central nervous system(CNS)degenerative disorders refer to a spectrum of pathological alterations triggered by struc-tural damage to cerebral neural tissues,clinically manifested as diverse neurological dysfunction syndromes,including multiple sclerosis(MS),neurodegenerative diseases(NDs),and ische-mic stroke.The hallmark pathological features of these disorders involve irreversible neuronal damage and decompensation of functional neural networks,ultimately leading to progressive neurological deficits.Notably,with the accelerating global popu-lation aging,the incidence of these diseases has surged signifi-cantly.According to WHO statistics,they now rank among the top three global causes of disability and mortality.Current re-search has confirmed that the pathogenesis of CNS degenerative disorders exhibits high heterogeneity,encompassing multifaceted pathophysiological processes such as genetic predisposition,oxi-dative stress,protein misfolding,and metabolic dysregulation.This intricate pathogenic network not only complicates clinical differential diagnosis but also poses substantial challenges to the development of precision therapeutic strategies.Importantly,re-cent studies have revealed that mitochondrial homeostasis disrup-tion-induced inflammatory cascades(termed mitochondrial in-flammation)play a pivotal regulatory role in neurodegenerative progression.Key molecular mechanisms include impaired mito-phagy,aberrant mitochondrial DNA(mtDNA)release and NL-RP3 inflammasome activation.This review systematically deci-phers the molecular regulatory network of mitochondrial inflam-mation,with a focus on its biological effects in critical pathologi-cal events such as blood-brain barrier disruption,microglial hy-peractivation and neuronal apoptosis.The overarching aim is to provide a theoretical foundation for developing innovative thera-peutic strategies targeting mitochondrial homeostasis restoration.

Objective To develop and validate a nomogram model for predicting recurrence after radiofre-quency catheter ablation(RFCA)in patients with atrial fibrillation and heart failure using body surface electrocar-diogram indicators and clinical indicators.Methods We retrospectively analyzed 305 patients with atrial fibrilla-tion complicated with heart failure who underwent RFCA from January 2019 to January 2024.Patients were random-ized into training set(213 cases)and validation set(92 cases)at a ratio of 7:3 and followed up for at least 1 year.Based on the recurrence status,the patients were divided into recurrence group and non-recurrence group,with body surface electrocardiogram indicators and clinical indicators collected.Multivariate logistic regression analysis identified for risk factors for post RFCA recurrence,which were used to construct a nomogram.Model performance was assessed using the area under the receiver operating characteristic curve(AUC),Hosmer-Lemeshow test,calibration curves,and decision curve analysis(DCA).Results Among the 305 patients,84(27.54％)experi-enced recurrence after treatment.In the training set,61 patients had recurrence and 152 did not.No statistical differences were observed between the training set and the validation set(all P>0.05).In the training set,the recurrence group exhibited a higher proportion of persistent atrial fibrillation and significantly higher CHA2DS2-VASc scores,larger left atrial diameter,longer PR interval,and higher levels of NLR and NT-proBNP compared to the non-recurrence group(all P<0.05).Multivariate stepwise regression analysis revealed that high CHA2DS2-VASc score,long left atrial diameter,prolonged PR interval,and high NLR were independent risk factors of recurrence after RFCA(P<0.05)A four-factor prediction model was established as:Ln(P/1-P)=-12.87+0.84*CHA2DS2-VASc score+0.11* left atrial diameter+0.03*PR interval+0.31*NLR.The training and validation models showed AUCs of 0.85(95％CI:0.80～0.91)and 0.85(95％CI:0.76～0.94),respectively,suggesting that the model had good predictive efficiency.Hosmer-Lemeshow test results(χ2=2.43,P=0.965 for the training set;χ2=5.30,P=0.725 for the validation set)confirmed model fit,indicating that the fitted probability value was consistent with the actual probability value.Calibration curves after 1 000 times of Bootstrap repeated sampling showed the bias calibration curves of the training set and the validation set had good consistency with the actual curves,both close to the ideal curve.DCA revealed clinical utility across a wide threshold probability range(0.02～1.0 for the training set;0.04～1.0 for the validation set).Conclusion This nomogram,based on body surface electrocardiogram indicators and clinical indicators,effectively predicts post-RFCA recurrence in atrial fibrillation and heart failure patients,offering a useful tool for early assessment of recurrence risk.

Nanopore sequencing,as a representative of third-generation sequencing technology,is widely used in molecular biology research.It offers several advantages,including high throughput,ultra-long read lengths,real-time sequencing,and the absence of amplification and labeling requirements.This technology has been applied for the detection of various pathogens,genomic typing,structural variation analysis,and personalized treatment guidance,making it valuable for pathogen monitoring and medical research.This article focuses on the principles of nanopore sequencing technology,its advantages,and its applications in molecular biology and molecular medicine.The limitations of nanopore sequencing and its future development directions are also summarized,providing new perspectives for further research in this field.

Objective To analyze the risk factors for increased drainage volume after open transforaminal lumbar interbody fusion(TLIF),and to establish a predictive model and then validate it.Methods The clinical data of 680 patients who underwent open TLIF at the General Hospital of Northern Theater Command from January 2016 to December 2019 were collected and the patients were randomly divided into the training group(n=476)and the validation group(n=204).Taking the predictive factors screened out by LASSO regression analysis as independent variables,a multivariate Logistic regression predictive model was constructed.The model was internally validated through the receiver operating characteristic(ROC)curve,Hosmer-Lemeshow goodness-of-fit test,and calibration curve,and its clinical utility was assessed via decision curve analysis(DCA).Results LASSO regression analysis screened out four predictive variables:age,number of surgical segments,operative duration,and intraoperative blood loss.The multivariate Logistic regression predictive model demonstrated that age≥60 years,number of surgical segments≥4,operative duration≥2 hours,and intraoperative blood loss≥200 mL were independent influencing factors for the increased postoperative drainage volume in patients undergoing TLIF(P<0.05).ROC curve analysis revealed an area under the curve(AUC)of 0.816(95%CI:0.798 to 0.867)in the training group and 0.783(95%CI:0.685 to 0.823)in the validation group,indicating that the predictive model had good discriminatory ability.Additionally,the Hosmer-Lemeshow goodness-of-fit test and calibration curve indicated that the predictive model had a good degree of fit,and the predicted probability was basically consistent with the actual probability,demonstrating a good calibration.The DCA results confirmed that this predictive model could be applied in clinical practice.Conclusion The risk factors for increased drainage volume after open TLIF include age,number of surgical segments,operative duration,and intraoperative blood loss.The predictive model established based on these factors demonstrates good performance,and it can be applied in clinical guidance for the selection of drainage tube removal time after TLIF.