ObjectiveTo investigate the cadmium contamination levels in commercially available foods in Jinhua City, to assess the dietary cadmium exposure risk among Jinhua residents, and to provide a scientific basis for optimizing dietary recommendations and managing cadmium exposure risks. MethodsFrom 2013 to 2024, a total of 4 434 samples of 15 categories of commercially available foods from the Jinhua Food Safety Risk Monitoring System, including rice, milled and processed grains, fresh vegetables 1 (leafy vegetables, celery, and daylily flowers), fresh vegetables 2 (legume vegetables, root and tuber vegetables, and stem vegetables other than celery) , fresh vegetables 3 (all vegetables other than fresh vegetables 1 and fresh vegetables 2), fresh fruits, legumes and legume products, nuts and seeds, meat and meat products (excluding livestock and poultry offal and products made from them), eggs and egg products, milk and dairy products, fish, crustaceans (excluding sea crabs and mantis shrimp), sea crabs and mantis shrimp, and other aquatic products (bivalves, gastropods, cephalopods, and echinoderms), were collected from 9 counties (cities and districts) in Jinhua City to assess their cadmium contamination levels. Combining these results with data from the 2023 Jinhua City Resident Nutrition Surveillance Survey, the health risks associated with dietary cadmium exposure among residents of different ages and genders in Jinhua City were assessed according to the provisional tolerable monthly intake (PTMI, 25 μg·kg^-1) and margins of safety (MOS) recommended by the Joint FAO/WHO Expert Committee on Food Additives (JECFA). A MOS > 1 indicated that the risk of dietary cadmium exposure for residents was at an acceptable level，whereas a MOS ≤ 1 indicated that the risk of dietary cadmium exposure for residents was relatively high. ResultsThe cadmium detection rate in food was 73.55% (3 261/4 434), with 4.06% (180/4 434) of samples exceeding the limit. Foods with higher cadmium detection rates were in sea crabs and mantis shrimp (98.59%), fresh vegetables 1 (94.92%), and rice (87.93%). The median cadmium concentration was 0.010 mg·kg^-1. Food categories with higher cadmium concentrations included sea crabs and mantis shrimp (0.644 mg·kg^-1), rice (0.032 mg·kg^-1), and fresh vegetables 1 (0.020 mg·kg^-1). A total of 2 092 individuals were included in the population nutrition surveillance survey, and the average daily per capita food consumption was 887.97 g·d^-1, consisting of fresh vegetables (342.17 g·d^-1), meat and meat products (141.29 g·d^-1), and rice (110.70 g·d^-1). The 50th and 95th percentiles of cadmium mass fractions were used to define general and high exposure levels for assessing resident exposure risk. When assigning a value of 0 and the limit of detection (LOD) value to the contamination levels of undetected samples, at the general exposure level, the monthly average cadmium exposure for the residents was 5.08 and 5.15 μg·kg^-1 (based on body weight; same below), with MOS values of 4.92 and 4.85; the range of average cadmium exposure across different age and gender groups was 3.91‒6.70 and 3.97‒6.80 μg·kg^-1, with all MOS values >1, indicating that the dietary cadmium exposure risk for the residents was at an acceptable level. At the high exposure level, the average cadmium exposure for the residents was 36.02 μg·kg⁻¹, with an MOS value of 0.69; the average cadmium exposure levels for different age and gender groups ranged from 27.68 to 48.37 μg·kg⁻¹, with MOS values ranging from 0.52 to 0.90, all of which were <1; indicating that the dietary cadmium exposure risk for residents was relatively high. Dietary cadmium exposure among minors aged 6‒17 years in Jinhua City was higher than that among adults, and dietary cadmium exposure among females was higher than that among males. Rice and fresh vegetables were the major foods contributing to dietary cadmium exposure among residents in Jinhua City, each accounting for more than 30% of the total exposure contribution. ConclusionCommercially available foods in Jinhua City exhibit varying degrees of cadmium contamination, with higher levels primarily found in aquatic products such as sea crabs and mantis shrimp, fresh vegetables such as leafy greens, celery, and daylily flowers, as well as rice. The dietary cadmium exposure risk for residents of Jinhua City is at an acceptable level under general exposure conditions but poses a health risk under high exposure conditions. Monitoring of cadmium in relevant foods should be strengthened, and dietary guidance should be provided to high-risk groups including minors aged 6‒17 years and women.

In recent years, the relationship between intestinal flora dysbiosis and abnormal bile acid metabolism and anxiety has received widespread attention. This article discussed the biological mechanism of the pathogenesis of anxiety from the perspective of intestinal flora and bile acid metabolism, in order to provide new ideas and theoretical basis for the TCM prevention and treatment of anxiety. According to TCM, spleen and stomach belong to earth, liver and gallbladder belong to wood, when spleen qi is healthy, the normal distribution of water and grain essence can be achieved, so that the liver can be nourished, qi and blood is sufficient, and its excretory function is normal, and the bile is sufficient. Once the spleen is not healthy, the distribution of water and grain essence is good, affecting the metabolism of fluids, resulting in phlegm and dampness, the qi is not smooth, can affect the liver's excretory function; liver and wood depression for a long time, transgressing the spleen and earth, qi and blood lack of biochemical sources, the formation of soil congestion and wood depression of the pathological phenomenon will appear. From the viewpoint of modern medicine and molecular biology, changes in the structure of intestinal flora affect the organism through neurological, endocrine, immune and metabolic pathways, which is consistent with the pathogenesis of "congestion of the earth"; disorders in the metabolism of bile acids can lead to changes in neurotransmitters and synaptic structure in the brain, causing anxiety symptoms, which is consistent with the characteristics of "wood depression". The bile acid metabolism disorder can cause neurotransmitter and synaptic structure changes in the brain, causing anxiety symptoms, which is consistent with the characteristics of "wood depression". It is important to regulate the intestinal flora and bile acid metabolism pathway to ease the liver and strengthen the spleen to improve anxiety.

Objective: To investigate the feasibility of magnetic anastomosis for uretero-ileal anastomosis using experimental rabbit models. Methods: Six experimental rabbits were used as the models.The lower part of the left ureter was cut with scissors，the daughter magnet (DM) was placed in the middle of the ureter，and the distal end of the ureter was ligated.After that，the ileum wall was opened，the parent magnet (PM) was inserted through it，the positions of the PM and DM were adjusted so that their ends were attracted to each other，and then ileum wall incision was sutured.The operation time，intraoperative blood loss，postoperative complications and magnet discharge time were recorded.Two weeks after operation，left ureterography was performed to obtain the specimens of the uretero-ileal anastomosis，and to observe the patency of the anastomosis.The formation of the anastomosis was observed with naked eyes and light microscope. Results: Uretero-ileal magnetic anastomosis was performed successfully in 6 experimental rabbits.The operation time was 28-39（32.50±3.94） min，and the intraoperative blood loss was less than 5 mL.The rabbits recovered well after operation，and no complications were observed.All animals survived to the end point of observation.The disconnection time of magnet after operation was 9-13(10.83±1.72) days.The gross specimen showed that the anastomosis was patent.The histological observation showed that the mucosa of the anastomosis was continuous and smooth，and the anastomosis was well formed. Conclusion: Magnetic anastomosis is feasible for uretero-ileal anastomosis with simple operation and good anastomosis formation.After further experimental verification，this technique is expected to be used in clinical practice.

Hypertension is a systemic chronic vascular disease. From the perspective of Traditional Chinese Syndromes, hypertension belongs to the category of liver fire, vertigo, liver yang, headache and so on. Chinese medicine treatment of hypertension has gradually become a hot research topic, and using Chinese herbal medicine to reduce blood pressure has also achieved good results. In recent years, researches on anti-hypotension of Bidens pilosa L. has gradually increased. The related research of Bidens pilosa L., including the ancient literature, modern research, functional components and mechanism were mainly summarized, the application of Bidens pilosa L. in lowering blood pressure were anticipated, with a view to provide reference for the further development and utilization of Bidens pilosa L. in treatment of hypertension.

The human microbiome encompasses a diverse array of microorganisms and their functional interactions within the human body. It exhibits a vast diversity of species and complex roles across various body environments. Advanced sequencing technologies, such as 16S amplicon sequencing and metagenomic sequencing, facilitate in-depth analysis on this microbial community. Recent researches have suggested that characteristics of the human microbiome (such as diversity and composition of microbiome, involving metabolic pathways and metabolites) might be associated with the onset and progression of cardiovascular diseases. These findings provide valuable insights into the etiology of chronic diseases and might aid in the development of novel disease biomarkers and intervention strategies. This paper summarizes the designs, current status and key findings of current population-based research in this field, and introduce the future development and analyze the existing critical problems that need further investigations.

Objective To evaluate the feasibility of establishing canine rectovaginal fistula ani-mal model using magnetic surgery techniques.Methods Ten female Beagle dogs were randomly di-vided into study group(n=5)and control group(n=5).The study group underwent rectovaginal fistula modeling using magnetic surgery technology,while the control group was subjected to sharp puncture of the rectovaginal septum followed by indwelling rubber tube placement to establish the model.Surgical procedure duration and postoperative adverse events were recorded in both groups.Two weeks later,the magnets and rubber tubes were removed.The formation of rectovaginal fistulas in the animals of two groups was observed,and the success rates of model construction of two groups were statistically analyzed.Results Both groups successfully completed the preparation of the recto-vaginal fistula models.The operative time in both groups was less than 2 minutes.No adverse events such as magnet detachment were observed in the study group during the postoperative period.In the control group,the rubber tube dislodged on day 6 post-surgery in one dog,leading to spontaneous healing of the fistula.Two weeks after surgery,the magnets and rubber tubes were removed.Naked-eye observation showed that the rectovaginal fistula formed well in the experimental dogs of the study group,while the rectovaginal fistula formed well in 4 experimental dogs in the control group.The success rate of model construction in the study group was 100％,and was 80％in the control group.Conclusion The construction of a canine rectovaginal fistula model by magnetosurgical techniques has the advantages of simple operation and high success rate.Magnetosurgical techniques may serve as an ideal animal model for constructing and studying the histopathological changes and treatment methods of rectovaginal fistulas.

Objective:To investigate the relationship of several adiposity-related anthropometric parameters, including BMI, waist circumference (WC), waist-to-hip ratio (WHR), body fat percentage (BFP) and indoles in plasma with the incidence of atherosclerotic cardiovascular disease (ASCVD) in adults in China.Methods:In China Kadoorie Biobank (CKB) study, blood samples were collected from 2 183 participants in the first resurvey in 2008 to detect indoles. Participants' body weight, body height, WC, hip circumference, and BFP were measured at baseline survey in 2004 and resurvey in 2008, the BMI and WHR were calculated with standardized methods. The long-term follow-up of all participants started from the completion of the resurvey in 2008 until the occurrence of incident ASCVD, death, loss to follow-up or until December 31, 2018. CKB ascertained outcome status (incident ASCVD) through death and disease registries and national health insurance databases, supplemented by active follow-up. Multivariate linear regression model was used to estimate the associations of anthropometric measurements at baseline survey and the first resurvey, and changes in these measurements with 3 indoles [indole, indole-3-acetic acid (IAA), and indole-3-propionic acid (IPA)]. Cox proportional hazard regression model was used to estimate the associations between indoles and the risk for ASCVD.Results:Anthropometric measurements at baseline survey or the first resurvey were negatively associated with plasma IPA level. The regression coefficient ( β) of baseline BMI (per 1.0 kg/m 2) with 0.1 standard deviation ( SD) IPA was -0.23 (95% CI: -0.36 - -0.10) (false discovery rate=0.004). After adjusting for baseline BMI, the β of baseline WC, WHR and BFP with 0.1 SD IPA were -0.09 (95% CI: -0.18 - -0.01), -0.12 (95% CI: -0.19 - -0.05), and -0.20 (95% CI: -0.32 - -0.08), respectively. The annual change in BMI (difference between BMI in 2008 and 2004 divided by the time interval) was associated with indole and IAA, with β of 1.40 (95% CI: 0.58 - 2.21) and -1.07 (95% CI: -1.91 - -0.23), respectively, at each 0.1 increase of SD. Over a median ( Q1, Q3) follow-up of 10.46 (10.36, 10.53) years after 2008 resurvey, 236 cases of ASCVD were recorded. IAA and IPA levels were negatively associated with the risk for ASCVD, with hazard ratios for one SD increase of IAA and IPA of 0.87 (95% CI: 0.76 - 0.99) and 0.84 (95% CI: 0.73 - 0.96), respectively. Conclusions:Our results suggested that anthropometric measurements and their changing trends affect the levels of plasma imicrobial tryptophan metabolite levels, decreased levels of IAA and IPA levels are associated with increased risk of ASCVD and indoles in plasma including IPA and IAA might be the mediating factors for adiposity-induced ASCVD.

BACKGROUND:Human umbilical cord mesenchymal stem cell-derived exosomes are involved in multiple injury repair processes,and the effects and the specific mechanisms of renal ischemia/reperfusion injury have not been fully elucidated.OBJECTIVE:To investigate the molecular mechanism of human umbilical cord mesenchymal stem cell-derived exosomes in the treatment of renal ischemia/reperfusion injury.METHODS:(1) Human umbilical cord mesenchymal stem cells were cultured and exosomes were obtained and identified using an exosome extraction kit.(2) The distribution of exosomes in the kidney of mice with renal ischemia/reperfusion injury was examined by intravital fluorescence imaging.(3) Thirty C57/BL6 male mice were divided into five groups according to the random number table method:sham operation group,renal ischemia/reperfusion group,sham operation group+Compound C group,renal ischemia/reperfusion+exosome group (exosome group),and renal ischemia/reperfusion+exosome+Compound C group (exosome+Compound C group),with 6 mice in each group.Except the sham operation group,bilateral renal pedicles were clamped for 45 minutes and a mouse model of renal ischemia/reperfusion injury was established after 24 hours of reperfusion.In sham operation+Compound C group and exosome+Compound C group,AMPK inhibitor Compound C was intraperitoneally injected 30 minutes before model establishment.In the exosome group and exosome+Copmpound C group,exosomes were injected through the tail vein 15 minutes before renal pedicle clipping.The levels of serum creatinine and urea nitrogen,interleukin 6,and tumor necrosis factor α in renal tissue,and the expression of apoptosis-related factors in renal tissue were detected after 24 hours of reperfusion in each group.RESULTS AND CONCLUSION:(1) Human umbilical cord mesenchymal stem cell exosomes had the typical tea tray morphology,with the diameter distribution in the range of 40-160 nm,and expressed the specific marker membrane protein of exosome surface.(2) Murine kidneys after renal ischemia/reperfusion injury were more likely to gather human umbilical cord mesenchymal stem cell exosomes compared with the sham operation group.(3) Exosome pretreatment reduced renal injury and the level of renal cell apoptosis in mice treated with renal ischemia/reperfusion injury.Moreover,this protective effect could be reversed by AMPK inhibitors.These findings verify that human umbilical cord mesenchymal stem cell-derived exosomes exerting a protective effect on renal ischemia/reperfusion injury may be related to the activation of the AMPK/YAP1 pathway to antiapoptosis.

Objective:To investigate the efficacy of anatomical resection (AR) in the early stages of treating solitary hepatocellular carcinoma (HCC) combined with liver cirrhosis with a diameter of ≤5 cm in comparison to different surgical methods of preferential hepatic parenchymal preservation (non-anatomical liver resection, NAR).Methods:The clinical data of 1 390 cases with solitary HCC combined with liver cirrhosis at an early stage who underwent liver resection at Mengchao Hepatobiliary Hospital of Fujian Medical University and six other medical centers from September 2013 to May 2019 were retrospectively analyzed. Patients were divided into the AR group (486 cases) and the NAR group (904 cases) and the wide surgical margin (WSM) group (745 cases) and the narrow surgical margin (NSM) group (645 cases) according to whether they received AR and the width of the surgical margin (1 cm). The basic information of the patients, preoperative evaluation index data, and postoperative follow-up (follow-up every 3 months) were collected. The Kaplan-Meier method was used to plot the survival curve.The log-rank test was used to compare the difference in survival between the two groups. The Cox proportional hazards regression model was used to analyze the factors affecting the prognosis. Propensity score matching (PSM) was applied to reduce intergroup bias.Results:The overall survival (OS) rates for all patients at 1, 3, and 5 years were 95.5%, 79.9%, and 63.5%, respectively. The recurrence-free survival (RFS) rates were 81.5%, 59.0%, and 43.7%, respectively. There was a statistically significant difference in RFS rate between the AR group and the NAR group prior to PSM, but no statistically significant difference in OS rate (RFS rate: 47.0% vs. 41.9%, P<0.05; OS rate: 64.4% vs. 62.9%, P>0.05). The postoperative RFS rate and OS rate were significantly superior in the WSM group than those of the NSM group (RFS rate: 47.8% vs. 37.2%, P<0.001; OS rate: 69.0% vs. 57.3%, P<0.001). There was no statistically significant difference in OS rate and RFS rate between the AR group and the NAR group following PSM (RFS: 46.3% vs. 45.1%, P>0.05; OS rate: 64.0% vs. 64.3%, P>0.05).The 5-year OS and RFS rates in the WSM group were 66.8% and 60.2%, respectively. The 5-year OS and RFS rates for the NSM group were 48.7% and 41.4%, respectively, with a statistically significant difference ( P<0.05). Cox multivariate analysis indicated that serum albumin, tumor diameter, microvascular invasion, and surgical margin were independent prognostic factors affecting OS and RFS. The Child-Pugh grade and satellite lesions were independent prognostic factors affecting OS. Conclusion:Anatomical liver resection is not an independent risk factor for prognosis, but the state of the resection margin determines the prognosis of patients with solitary HCC combined with cirrhosis. Therefore, hepatic resection margins should be prioritized in such patients.

Objective:To develop machine learning models for interpreting brain maturity in preterm infants based on electroencephalographic (EEG) features and analyze factors affecting interpretation accuracy.Methods:This prospective study enrolled preterm infants requiring bedside EEG monitoring in the Department of Neonatology at the First Hospital of Jilin University from January 2023 to March 2024. Data from each integer-corrected gestational age (GA) group were randomly split into training and testing sets (7∶3 ratio) using Python's sklearn.model_selection.train_test_split function. Three machine learning models, including support vector regression (SVR), random forest, and decision tree, were employed to analyze EEG signals. Model performance was evaluated against manually interpreted GA as the gold standard using prediction deviation, mean absolute error (MAE), root mean square error (RMSE), and correlation coefficient ( r). Accuracy was defined based on the difference between predicted and manually interpreted GA (categorized into accurate and inaccurate groups), with a difference less than one week considered accurate. Statistical analyses included Chi-square test (or Fisher's exact test), t-test, Mann-Whitney U test, and multivariate logistic regression. Results:Among 241 preterm infants (training set: n=168; testing set: n=73), the random forest model demonstrated optimal performance: concordance rate 90.4% (66/73) with MAE 0.378 weeks, RMSE 0.577 weeks, and r=0.932 ( P<0.001). The decision tree model achieved 87.7% concordance (64/73) with MAE 0.316 weeks, while SVR showed 64.2% concordance (47/73) and MAE 0.840 weeks. Stratified by GA, random forest performed best in the 34 weeks group [concordance 100.0% (52/52), MAE 0.269 weeks], followed by the 32-34 weeks group [89.0% (81/91), MAE 0.448 weeks] and <32 weeks group [88.8% (87/98), MAE 0.561 weeks]. Compared to the accurate group ( n=205), the inaccurate group ( n=36) had higher rates of vaginal delivery [41.7% (15/36) vs. 19.5% (40/205), χ2=8.53], grade ≥Ⅱ intracranial hemorrhage [11.1% (4/36) vs. 2.4% (5/205), χ2=4.22], and periventricular echogenicity [33.3% (12/36) vs. 7.8% (16/205), χ2=17.03] (all P<0.05). Multivariate analysis identified vaginal delivery ( OR=0.190, 95% CI: 0.068-0.527), lower corrected GA ( OR=0.678, 95% CI: 0.488-0.941), and periventricular echogenicity ( OR=11.339, 95% CI: 3.250-39.559) as independent factors affecting accuracy (all P<0.05). Conclusion:The random forest-based model shows optimal accuracy for predicting brain maturity in preterm infants. Vaginal delivery, lower corrected GA, and periventricular echogenicity reduce its predictive accuracy.