Microglia are the resident immune cells in the central nervous system(CNS),and play a dual role in maintaining brain homeostasis and mediating neuroprotection.Under normal conditions,microglia maintain brain homeostasis by monitoring environmental changes.When nerve damage or certain pathological stimuli occur,microglia are rapidly activated and initiate a series of complex immune responses to induce neuroinflammation.This proper activation of microglia can protect the brain by inhibiting or clearing various pathogens,but excessive neuroinflammation can lead to neuronal damage and even death.This imbalance of inflammatory response is one of the core features of pathological development of many CNS inflammatory diseases,such as Alzheimer's disease,Parkinson's disease,sepsis-associated encephalopathy,and ischemic strokes.In recent years,with the rapid development of frontier biotechnology such as single-cell sequencing,proteinomics and gene editing,important progress has been made in understanding the molecular mechanism by which microglia participate in CNS inflammatory diseases,especially in the activation of inflammatory corpuscles,epigenetic modifications,and metabolic reprogramming.However,due to the heterogeneity and duality of microglia under different pathological conditions,therapeutic methods targeting microglia have not yet been widely used in clinical practice.In summary,this article takes microglia as the starting point and introduces the molecular mechanisms of their involvement in the occurrence and development of CNS inflammatory diseases and its targeted regulatory treatment strategy,aiming to provide theoretical reference for the subsequent precise regulation of microglia function and the development of more targeted therapeutic drugs.

Objective To investigate the effects of glycerol ingestion on pure tone audiometry(PTA),distor-tion products otoacoustic emission(DPOAE),and electrocochleography(ECochG)in patients with Ménière disease(MD).Methods Glycerol test was conducted in 50 patients with MD.PTA was performed in four series:before glycerol intake,1,2 and 3 hours after intake.DPOAE and ECochG were performed before glycerol intake and 2 hours after intake.All results were analyzed to assess the effect of glycerol on cochlear function of patients with MD.Results ① 55％of MD patients tested positive in PTA glycerol test,and the positive rate increased gradually after 1-3 hours of glycerin ingestion(P＜0.05).For the 33 positive ears,the pure tone threshold decreased the most between 1-2 hours and reached the lowest thresholds at 3 hours.Thresholds at 0.5 kHz,1 kHz,2 kHz dropped the most.② The positive rate of DPOAE glycerol test was 56.67％,with 34 positive ears showing a sig-nificant increase in amplitude between 0.75-2 kHz of f2.③ The positive rate of ECochG glycerin test was 13.64％.The decrease of-SP/AP ratio was not statistically significant before and after ingestion of glycerin(P＞0.05).Conclusion Ingestion of glycerin could alter to varying degrees of the results of PTA,DPOAE and ECo-chG,and influence the cochlear function to some extent.

Microglia are the resident immune cells in the central nervous system(CNS),and play a dual role in maintaining brain homeostasis and mediating neuroprotection.Under normal conditions,microglia maintain brain homeostasis by monitoring environmental changes.When nerve damage or certain pathological stimuli occur,microglia are rapidly activated and initiate a series of complex immune responses to induce neuroinflammation.This proper activation of microglia can protect the brain by inhibiting or clearing various pathogens,but excessive neuroinflammation can lead to neuronal damage and even death.This imbalance of inflammatory response is one of the core features of pathological development of many CNS inflammatory diseases,such as Alzheimer's disease,Parkinson's disease,sepsis-associated encephalopathy,and ischemic strokes.In recent years,with the rapid development of frontier biotechnology such as single-cell sequencing,proteinomics and gene editing,important progress has been made in understanding the molecular mechanism by which microglia participate in CNS inflammatory diseases,especially in the activation of inflammatory corpuscles,epigenetic modifications,and metabolic reprogramming.However,due to the heterogeneity and duality of microglia under different pathological conditions,therapeutic methods targeting microglia have not yet been widely used in clinical practice.In summary,this article takes microglia as the starting point and introduces the molecular mechanisms of their involvement in the occurrence and development of CNS inflammatory diseases and its targeted regulatory treatment strategy,aiming to provide theoretical reference for the subsequent precise regulation of microglia function and the development of more targeted therapeutic drugs.

Objective:To investigate the utilization of inpatient service and influencing factors among pneumoconiosis patients in Chongqing within one year, and to provide a reference basis for the formulation of relevant policies by health management departments.Methods:From October 2020 to October 2023, a multi-stage cluster random sampling method was adopted to select 2002 patients with confirmed pneumoconiosis as the research subjects. A questionnaire survey was conducted on their basic information, inpatient service utilization within one year, treatment for pneumoconiosis-related symptoms, and choice of medical service institutions. Chi-square test and logistic regression were used for statistical analysis.Results:All 2002 pneumoconiosis patients were male, with 40.16% (804/2002) aged 46-55 years old, and 83.32% (1668/2002) currently residing in rural areas. The monthly income of the patients was 833 (167, 2000) yuan, and 22.03% (441/2002) had no income. 30.97% (620/2002) of the patients spent more than 5001 yuan per year on treatment for pneumoconiosis, and 14.64% (293/2002) had debts of more than 5001 yuan. 42.06% (842/2002) had no work-related injury insurance. 21.68% (434/2002) of the patients self-assessed their health status as very poor or poor. The one-year inpatient rate of the patients was 51.25% (1026/2002), and the total inpatient time within one year was 18 (10, 51) days. The inpatient expenses were 6000 (1000, 16625) yuan. Through univariate analysis, the one-year inpatient rates of pneumoconiosis patients were statistically significantly different among different age groups, current employment status, annual household income levels, types of pneumoconiosis, stages of pneumoconiosis, presence or absence of work-related injury insurance, whether receiving minimum living allowances and social assistance related to pneumoconiosis, and different segments of self-assessed health status ( P<0.05). Patients with stage Ⅲ pneumoconiosis, those who received social assistance and minimum living allowances related to pneumoconiosis had higher one-year inpatient rates ( P<0.05), with OR values of 3.893, 1.859, and 2.589, respectively. Conclusion:The utilization of inpatient service by pneumoconiosis patients is influenced by demographic characteristics, social support, and disease factors. It is necessary to enhance the occupational disease diagnosis and treatment capabilities of primary health institutions, build a multi-level social support network, and ensure that patients can conveniently access medical services.

Objective To investigate the effects of glycerol ingestion on pure tone audiometry(PTA),distor-tion products otoacoustic emission(DPOAE),and electrocochleography(ECochG)in patients with Ménière disease(MD).Methods Glycerol test was conducted in 50 patients with MD.PTA was performed in four series:before glycerol intake,1,2 and 3 hours after intake.DPOAE and ECochG were performed before glycerol intake and 2 hours after intake.All results were analyzed to assess the effect of glycerol on cochlear function of patients with MD.Results ① 55％of MD patients tested positive in PTA glycerol test,and the positive rate increased gradually after 1-3 hours of glycerin ingestion(P＜0.05).For the 33 positive ears,the pure tone threshold decreased the most between 1-2 hours and reached the lowest thresholds at 3 hours.Thresholds at 0.5 kHz,1 kHz,2 kHz dropped the most.② The positive rate of DPOAE glycerol test was 56.67％,with 34 positive ears showing a sig-nificant increase in amplitude between 0.75-2 kHz of f2.③ The positive rate of ECochG glycerin test was 13.64％.The decrease of-SP/AP ratio was not statistically significant before and after ingestion of glycerin(P＞0.05).Conclusion Ingestion of glycerin could alter to varying degrees of the results of PTA,DPOAE and ECo-chG,and influence the cochlear function to some extent.

Objective:To investigate the utilization of inpatient service and influencing factors among pneumoconiosis patients in Chongqing within one year, and to provide a reference basis for the formulation of relevant policies by health management departments.Methods:From October 2020 to October 2023, a multi-stage cluster random sampling method was adopted to select 2002 patients with confirmed pneumoconiosis as the research subjects. A questionnaire survey was conducted on their basic information, inpatient service utilization within one year, treatment for pneumoconiosis-related symptoms, and choice of medical service institutions. Chi-square test and logistic regression were used for statistical analysis.Results:All 2002 pneumoconiosis patients were male, with 40.16% (804/2002) aged 46-55 years old, and 83.32% (1668/2002) currently residing in rural areas. The monthly income of the patients was 833 (167, 2000) yuan, and 22.03% (441/2002) had no income. 30.97% (620/2002) of the patients spent more than 5001 yuan per year on treatment for pneumoconiosis, and 14.64% (293/2002) had debts of more than 5001 yuan. 42.06% (842/2002) had no work-related injury insurance. 21.68% (434/2002) of the patients self-assessed their health status as very poor or poor. The one-year inpatient rate of the patients was 51.25% (1026/2002), and the total inpatient time within one year was 18 (10, 51) days. The inpatient expenses were 6000 (1000, 16625) yuan. Through univariate analysis, the one-year inpatient rates of pneumoconiosis patients were statistically significantly different among different age groups, current employment status, annual household income levels, types of pneumoconiosis, stages of pneumoconiosis, presence or absence of work-related injury insurance, whether receiving minimum living allowances and social assistance related to pneumoconiosis, and different segments of self-assessed health status ( P<0.05). Patients with stage Ⅲ pneumoconiosis, those who received social assistance and minimum living allowances related to pneumoconiosis had higher one-year inpatient rates ( P<0.05), with OR values of 3.893, 1.859, and 2.589, respectively. Conclusion:The utilization of inpatient service by pneumoconiosis patients is influenced by demographic characteristics, social support, and disease factors. It is necessary to enhance the occupational disease diagnosis and treatment capabilities of primary health institutions, build a multi-level social support network, and ensure that patients can conveniently access medical services.

Objective:To simulate the neuroendoscopy assisted contralateral cervical 7 (C 7) nerve transfer via prespinal route and measure its relevant anatomical landmarks to explore the clinical feasibility and efficacy of this surgical approach for central upper limb spastic paralysis. Methods:(1) Six fresh cadaver specimens of the head and neck were obtained. Linear incisions of approximately 5 cm were made above the midpoint of the bilateral clavicles to simulate neuroendoscopy assisted contralateral C 7 nerve transfer via prespinal route. With the superior margin of midpoint of the clavicle as central point, distance to the distal bifurcation of the C 7 nerve, distances to the superior or inferior trunks of the proximal brachial plexus nerves, and distances to the exit of the intervertebral foramina of the C 6, C 7, and C 8 nerves were measured. (2) One patient with upper limb spastic paralysis after intracerebral hemorrhage accepted neuroendoscopy assisted contralateral C 7 nerve transfer via prespinal route; the clinical data and efficacy of the patient were retrospectively analyzed. Results:(1) The C 7 nerve, the upper trunk of brachial plexus formed by the C 5 and C 6 nerves and the lower trunk of brachial plexus formed by the C 8 and T 1 nerves could be exposed after neuroendoscopy assisted contralateral C 7 nerve transfer via prespinal route. The distance between the superior margin of midpoint of the clavicle and the distal bifurcation of the C 7 nerve is (2.20±0.11) cm, and its distance to the superior trunk of the proximal brachial plexus is (2.62±0.10) cm, and its distance to the inforior trunk of the proximal brachial plexus nerve is (2.72±0.11) cm. The distance between the superior margin of midpoint of the clavicle and the proximal C 7 nerve (at the exit of the intervertebral foramen) is (7.22±0.15) cm, its distance to the proximal C 6 nerve (at the exit of the intervertebral foramen) is (7.84±0.12) cm, and its distance to the proximal C 8 nerve (at the exit of the intervertebral foramen) is (6.96±0.12) cm. (2) The patient with central upper limb spastic paralysis accepted neuroendoscopy assisted contralateral C 7 nerve transfer via prespinal route successfully, with surgical time lasting for 2 h and bleeding amount of 20 mL. After surgery, the incision healed well, and the patient experienced pain and numbness in the healthy side of the upper limb with subsided symptoms one month after surgery. The spasticity symptoms of the affected upper limb obviously improved after surgery with decreased muscle tone. Follow-up after discharge was performed for 14 months, and the muscle strength of the affected upper limb recovered to level 1 +. Conclusion:Neuroendoscopy assisted contralateral C 7 nerve transfer via prespinal route can expose the proximal and distal C 7 nerves, with minimal invasion; this clinical study has preliminarily confirmed the safety and effectiveness of this transfer via prespinal route in central upper limb spastic paralysis.

OBJECTIVES: This study aims to investigate the genome-wide DNA methylation and transcriptome expression profiles of peripheral blood mononuclear cells (PBMCs) in patients with systemic sclerosis (SSc) with interstitial lung disease (ILD), and to analyze the effects of DNA methylation on Wnt/β-catenin and chemokine signaling pathways. METHODS: PBMCs were collected from 19 patients with SSc (SSc group) and 18 healthy persons (control group). Among SSc patients, there were 10 patients with ILD (SSc with ILD subgroup) and 9 patients without ILD (SSc without ILD subgroup). The genome-wide DNA methylation and gene expression level were analyzed by using Illumina 450K methylation chip and Illumina HT-12 v4.0 gene expression profiling chip. The effect of DNA methylation on Wnt/β-catenin and chemokine signal pathways was investigated. RESULTS: Genome-wide DNA methylation analysis identified 71 hypermethylated CpG sites and 98 hypomethylated CpG sites in the SSc with ILD subgroup compared with the SSc without ILD subgroup. Transcriptome analysis distinguished 164 upregulated genes and 191 downregulated genes in the SSc with ILD subgroup as compared with the SSc without ILD subgroup. In PBMCs of the SSc group, 35 genes in Wnt/β-catenin signaling pathway were hypomethylated, while frizzled-1 (FZD1), mitogen-activated protein kinase 9 (MAPK9), mothers against DPP homolog 2 (SMAD2), transcription factor 7-like 2 (TCF7L2), and wingless-type MMTV integration site family, member 5B (WNT5B) mRNA expressions were upregulated as compared with the control group (all P<0.05). Compared with the SSc without ILD subgroup, the mRNA expressions of dickkopf homolog 2 (DKK2), FZD1, MAPK9 were upregulated in the SSc with ILD subgroup, but the differences were not statistically significant (all P>0.05). In PBMCs of the SSc group, 38 genes in chemokine signaling pathway were hypomethylated, while β-arrestin 1 (ARRB1), C-X-C motif chemokine ligand 10 (CXCL10), C-X-C motif chemokine ligand 16 (CXCL16), FGR, and neutrophil cytosolic factor 1C (NCF1C) mRNA expressions were upregulated as compared with the control group (all P<0.05). Compared with the SSc without ILD subgroup, the mRNA expressions of ARRB1, CXCL10, CXCL16 were upregulated in the SSc with ILD subgroup, but the differences were not statistically significant (all P>0.05). CONCLUSIONS There are differences in DNA methylation and transcriptome profiles between SSc with ILD and SSc without ILD. The expression levels of multiple genes in Wnt/β- catenin and chemokine signaling pathways are upregulated, which might be associatea with the pathogenesis of SSc.
Humans ; DNA Methylation ; Transcriptome ; beta Catenin ; Leukocytes, Mononuclear ; Ligands ; DNA ; RNA, Messenger/genetics*

ObjectiveTo perform the analysis of influenza surveillance in Dehong from 2016 to 2020 and determine the epidemic situation of influenza and prevalent virus strains， so as to provide evidence for local influenza prevention and control. MethodsThe influenza surveillance data in Dehong Prefecture was collected from January 2016 to December 2020. Statistical analysis was conducted by descriptive epidemiological methods. ResultsA total of 4 146 samples from influenza-like illness cases were examined. The 502 specimens tested positive for influenza virus， including 311 cases with influenza A virus and 136 cases with influenza B virus， resulting in a positive rate of 12.11%. The positive rate was the highest in 2017， followed by 2019， and the lowest in 2020 （P < 0.05）. It peaked in winter and fall. Furthermore， it was the lowest among children aged 0‒4 years and the highest among adults aged 25‒59 （P < 0.001）. In addition， positive rate did not differ significantly by gender（P>0.05） ConclusionThe positive rate of influenza has decreased in Dehong since January 2020. The influenza epidemic is seasonal， mainly in fall and winter， except 2020. Influenza A virus is predominant， compared to alternating influenza B virus.

Objective:To investigate the diagnostic efficacy and clinical application value of 99Tc m-diethylene triamine pentaacetic acid (DTPA) SPECT/CT imaging in cerebrospinal fluid leakage (CSFL). Methods:A total of 23 patients (11 males, 12 females; age (44.2±15.1) years) who underwent endoscopic repair surgery for suspected CSFL in Shanghai Jiao Tong University Affiliated Sixth People′s Hospital between April 2018 and January 2020 were retrospectively reviewed. All patients performed 99Tc m-DTPA SPECT/CT imaging, paranasal sinus high resolution CT (HRCT) and MRI before surgery. The diagnostic efficacies of 3 imaging techniques were calculated according to the result of surgery regarded as the golden standard. χ2 test was used to compare the qualitative and localized diagnostic efficacies of 3 imaging techniques for CSFL. Results:Of 23 patients, 21 were finally confirmed with CSFL and 24 leak locations were identified according to the results of surgery; the other 2 patients had no obvious CSFL and no leak location was found during the operation. The sensitivity and accuracy of 99Tc m-DTPA SPECT/CT, MRI and HRCT for the diagnosis of CSFL were 100%(21/21) and 95.7%(22/23), 85.7%(18/21) and 82.6%(19/23), 76.2%(16/21) and 69.6%(16/23), respectively. The accuracy of 99Tc m-DTPA SPECT/CT, MRI and HRCT for the diagnosis of leak location was 79.2%(19/24), 50.0%(12/24) and 45.8%(11/24), respectively. There was no statistically significant difference of diagnostic efficacies for CSFL among 3 imaging techniques ( χ2 values: 0.451-3.453, all P>0.05). For leak location, the diagnostic efficacy of 99Tc m-DTPA SPECT/CT was significantly better than that of MRI and HRCT ( χ2 values: 4.463, 5.689, both P<0.05). Conclusion:99Tc m-DTPA SPECT/CT imaging shows an excellent diagnosis efficacy not only for CSFL but also for leak location, which is helpful for guiding surgery.