Objective:To assess the effect of short-term exposures to atmospheric fine particulate matter (PM 2.5) and its components on cognitive function in middle-aged and older people aged 40-89 and identify key components that affect cognitive function. Methods:From October 2018 to March 2019, a cross-sectional survey of middle-aged and older people aged 40-89 was conducted across 10 cities in Beijing-Tianjin-Hebei and neighboring regions of China. Data on PM 2.5 and its components were collected from the nearest air supermonitoring stations to the residential addresses. The cognitive function was assessed using the Min-Mental State Examination (MMSE) scale. Multiple linear regression models were used to assess the effect of short-term exposures to PM 2.5 and its components on cognitive function in middle-aged and older people. The restricted cubic spline function was used to fit the exposure-response relationship between different components and changes in MMSE scores. Results:The age of the 1 978 respondents was (65.1±13.4) years, and 976 (49.34%) were males. During the study period, the daily mean concentration of PM 2.5 was (71.2±43.2) μg/m 3, and the MMSE score was (28.2±3.7). The results of the multiple linear regression model showed that short-term exposures to PM 2.5 and its components were associated with cognitive decline in middle-aged and older people after adjusting for confounding factors, and the effect was higher at lag 0-28 days. For an interquartile range (64.3 μg/m 3) increase in PM 2.5 at lag 0-28 d, the MMSE score decreased by 5.91 (95% CI: 0.04, 11.77). For an interquartile range increase in organic carbon (OC), antimony (Sb), chromium (Cr), zinc (Zn), tin (Sn), and cadmium (Cd), the MMSE scores of middle-aged and older people decreased by 5.71 (95% CI: 1.69, 9.73), 4.67 (95% CI: 2.50, 6.84), 4.49 (95% CI: 1.05, 7.92), 3.65 (95% CI: 0.89, 6.42), 2.76 (95% CI: 1.22, 4.30), and 1.72 (95% CI: 0.53, 2.92). Conclusions:Short-term exposures to atmospheric PM 2.5 and its components (OC, Sb, Cr, Zn, Sn, and Cd) are associated with cognitive decline in middle-aged and older people.

Emergency surgery has always been an important component of general surgery, with major diseases including acute abdomen and trauma. With the differentiation and development of general surgery sub specialties, department of emergency surgery has begun to emerge, but its development faces various challenges, such as insufficient medical staff, inadequate treatment capabilities, and poor treatment outcomes. To change this situation, about 20 years ago, a new treatment model began to emerge in the United States, establishing a department of acute care surgery that integrates trauma, emergency general surgery, and surgical critical care. This model quickly spread worldwide and achieved remarkable achievements. In recent years, colleagues in the field of surgery in China have gradually recognized the advantages of this model and established acute care surgery. This article aims to elaborate on its development process, current situation, and future trends, providing reference for the prosperous development of acute care surgery in China.

Objective:To investigate the distribution of iodine in drinking water in Inner Mongolia Autonomous Region, and provide a basis for delineation of different types of water iodine areas and the adoption of targeted prevention and control measures, as well as scientific adjustment of intervention strategies.Methods:Using cross-sectional survey method, from June to December in 2017, a survey on the distribution of water iodine was conducted in the entire autonomous region on a township (street, Sumu, abbreviated as township) basis in accordance with the requirements of the "National Survey Plan for Iodine Content in Drinking Water". For townships with water iodine level greater than 10 μg/L found in the survey, the survey was conducted on an administrative village (community, Gacha, abbreviated as administrative village) basis. The water iodine of regions with water iodine level greater than 100 μg/L found in the survey were reviewed in 2018 - 2019. Arsenic-cerium catalytic spectrophotometry was used to test water iodine.Results:A total of 1 009 townships of 103 counties (cities, districts) were surveyed on a township by township basis, with a median water iodine of 6.7 μg/L. Among them, there were 707 townships with water iodine < 10 μg/L, accounting for 70.1%. There were 251 townships with water iodine of 10 - < 40 μg/L, accounting for 24.9%. There were 44 townships with water iodine of 40 - 100 μg/L, accounting for 4.4%. There were 7 townships with water iodine > 100 μg/L, accounting for 0.7%. A total of 3 326 administrative village of 298 townships were surveyed based on administrative villages, among which, 791 villages had water iodine < 10 μg/L, accounting for 23.8%. There were 2 031 villages with water iodine of 10 - < 40 μg/L, accounting for 61.1%. There were 468 villages with water iodine of 40 - 100 μg/L, accounting for 14.1%. There were 36 administrative villages with water iodine > 100 μg/L, accounting for 1.1%. After review, 96 administrative villages in 12 townships of 4 league cities had water iodine > 100 μg/L.Conclusions:Most areas in Inner Mongolia Autonomous Region are iodine deficiency areas, and there are localized areas with high iodine levels due to water sources. Different iodine supplementation or iodine reduction measures should be taken for areas with different water iodine levels.

Objective To discuss the application of bidirectional dual loop technique in retrieving Aegisy inferior vena cava filters.Methods The clinical data of 12 patients with deep vein thrombosis in the lower limbs complicated by pulmonary embolism,who received mechanical thrombectomy and Aegisy inferior vena cava(IVC)filter implantation at the Zhoukou Municipal Central Hospital of China from January 2016 to November 2023,were retrospectively analyzed.The retrieval of Aegisy IVC filters beyond the time window was tried by standard methods,guide wire stripping,balloon dilatation,unidirectional single loop technique,unidirectional dual loop technique,etc.However,because of the difficulty in retrieval of filter,bidirectional dual loop technique had to be used.The indwelling time of the IVC filters was 30-365 days,with an average time of 105 days.Results The IVC filter was completely removed in 11 patients.Angiography showed that IVC was unobstructed,no contrast extravasation was observed,and the average operation time was 126 minutes.The retrieval of filter failed in one patient,and the patient had to receive anticoagulation therapy lifelong.No surgery-related complications occurred.Conclusion For retrieving Aegisy IVC filters beyond the time window,bidirectional dual loop technique is clinically safe and effective,and this technology is worthy of clinical promotion and application.

Objectives:To evaluate the outcomes of cochlear implantation in prelingually deafened late-implanted patients with regular cochlear implant use and to analyze the influencing factors of rehabilitation effects.Methods:This before-after self-controlled study design included 60 subjects, comprising 36 males and 24 females, who had received cochlear implantation at Chinese PLA General Hospital. Post-implantation, all patients demonstrated continuous and regular use of cochlear implants (≥8 hours daily). Rehabilitation outcomes were evaluated by using the Categories of Auditory Performance scale (CAP), Meaningful Auditory Integration Scale (MAIS), Speech Intelligibility of Rating scale (SIR), Meaningful Use of Speech Scale (MUSS) and speech recognition score (SRS) in 2018 and 2023. 9 potential risk factors were analyzed by univariate analysis with SPSS 25.0. The influencing factors associated with outcomes were evaluated through multivariate logistic regression.Results:Longitudinal data of 60 participants followed-up in 2018 and 2023 were analyzed. The average duration of cochlear implant use for all patients was (11.3±3.0) years. The mean score of CAP, SIR and MUSS improved significantly over time. The mean CAP score before surgery was (1.0±0.9). From 2018 to 2023, the mean CAP score improved from (5.1±1.4) to (5.9±1.6), with a statistical significance ( P<0.01); the mean SIR score before surgery was (1.3±0.5), and the mean SIR score improved from (2.7±1.1) to (3.2±1.3), with a statistical significance ( P<0.01); the mean MUSS score increased from (16.8±9.7) to (21.1±10.9) between the two follow-ups, with a statistical significance ( P<0.01); the MAIS was only initiated in the 2023 follow-up, with a mean score of (31.0±10.2). The speech recognition score for monosyllabic words increased from (23.9±16.0)% to (25.2±13.0)%, with no statistically significant difference ( P=0.66). Preoperative residual hearing significantly predicted rehabilitation outcomes at univariate analysis ( P<0.05), but the statistical significance was lost at multivariate analysis ( P>0.05). Age at implantation was identified as an independent predictive factor by both univariate and multivariate analysis (Hazard Ratio, 0.88; 95% Confidence Interval 0.79-0.97; P=0.014). The cut-off point for predicting further rehabilitation effects was 19.2 years old. In the correlation analysis of different scales, the CAP score was positively correlated with the total score of MAIS. So were the SIR score and the total score of MUSS. Conclusions:For prelingually deafened late-implanted patients with regular CI use, there was still potential for further improvement of auditory and speech abilities even after 10 years post-implantation. Age at implantation was an independent predictive factor and the cut-off point was 19.2 years old.

Objective:To investigate the correlation of SERPINC1 and SERPINE1 gene polymorphisms with venous thromboembolism (VTE) in patients with malignant tumors.Methods:A retrospective case-control study was conducted. A total of 227 patients with malignant tumors in the Cancer Hospital Affiliated to Xinjiang Medical University from November 2023 to February 2024 were selected, of which 47 cases developed VTE (VTE group) and 180 cases did not develop VTE (non-VTE group). The patients' venous blood was collected, and D-dimer level was analyzed by using fully automatic coagulation analyzer; fluorescence staining was performed by using digoxin staining solution, and SERPINC1 rs2227589 locus and SERPINE1 rs1799762 locus were used as candidate genes, and fluorescence sequencing was performed by using multichannel fluorescence quantitative analyzer, and the frequencies of C, T, 4G and 5G genes were calculated.Results:There were no statistically significant differences in the age, gender, smoking, alcohol consumption, anticoagulant use, diabetes mellitus, hypertension, coronary artery disease, surgical treatment, intravenous cannulae, radiotherapy, chemotherapy, and targeted therapy between the 2 groups (all P > 0.05). The level of D-dimer in the VTE group was higher than that in the non-VTE group [(8.7±6.9) kg/m 2vs. (2.8±1.0) kg/m 2], and the difference was statistically significant ( t = 5.15, P < 0.001). The differences in C and T genotypes and gene frequencies at the SERPINC1 rs2227589 locus between the VTE group and the non-VTE group were not statistically significant (all P > 0.05). The differences in 4G and 5G genotypes and gene frequencies at the SERPINE1 rs1799762 locus between the VTE group and the non-VTE group were statistically significant (all P < 0.05), and 4G allele frequency in the VTE group was higher than that in the non-VTE group (52.13% vs. 39.72%), and the difference was statistically significant ( χ2 = 4.70, P = 0.030). Conclusions:The elevated expression of 4G allele at the SERPINE1 rs1799762 locus in patients with malignant tumors is associated with development of VTE.

Objective:To explore the potential mechanism underlying IL-6 production through the TLR7 signaling pathway,which regulates Th17 cell differentiation in the context of Coxsackievirus B3(CVB3)-induced acute viral myocarditis(AVMC).Meth-ods:A total of 110 patients diagnosed with AVMC were admitted to Quanzhou First Hospital,Fujian between January 2020 and Janu-ary 2023,alongside 93 healthy volunteers.CD4+T cells were isolated from the subjects'blood,and the levels of CVB3 and the number of Th17 cells were assessed.Subsequently,CD4+T cells were infected with CVB3,and the levels of Th17 cells,IL-17,IL-21,and TNF-α were measured.After knockdown of TLR7 or treatment with TLR7 inhibitors,the differentiation of CVB3-infected CD4+T cells into Th17 cells was observed.Results:In comparison to healthy controls,AVMC patients exhibited elevated plasma levels of hsCRP,IL-17,IL-21,and TNF-α(P<0.05).The levels of CVB3 mRNA in CD4+T cells were also notably higher in AVMC patients compared to healthy controls(P<0.05).The mean viral titer in AVMC patients measured 230 PFU/ml,while no detectable virus was found in healthy volunteers(P<0.05).In CD4+T cells,the count of Th17 cells was significantly increased in AVMC patients compared to healthy volunteers(P<0.05).Moreover,the number of Th17 cells in peripheral blood CD4+T cells of AVMC patients showed a positive correlation with CVB3 virus titer(P<0.05).Following CVB3 infection,the number of Th17 cells increased compared with the control group(P<0.05),accompanied by elevated levels of IL-17,IL-21,and TNF-α in the supernatant(P<0.05).Knockdown of TLR7 and CVB3 infection in CD4+T cells significantly reduced the levels of Th17 cells(P<0.05),while the expression level of phosphorylated-activated TLR7 increased significantly after CVB3 infection of CD4+T cells compared to the control group(P<0.05).Treatment with the TLR7 inhibitor M5049 and CVB3 infection led to a significant decrease in Th17 cell levels(P<0.05).The secretion of IL-6 in CD4+T cells increased after CVB3 infection(P<0.05),and this increase was mitigated by TLR7 knockdown and CVB3 infection(P<0.05)as well as TLR7 inhibitor M5049 treatment and CVB3 infection(P<0.05).Conclusion:CVB3 activates TLR7 via phosphoryla-tion,prompting CD4+T cells to release IL-6 and undergo differentiation into Th17 cells.Consequently,TLR7 emerges as a promising therapeutic target for AVMC.

Objective:To investigate the acute effects of persistent high exposure to atmospheric fine particulate matter (PM 2.5) on residents' outpatient visits for respiratory diseases. Methods:We collected daily outpatient records from 92 hospitals in 13 cities across the Beijing-Tianjin-Hebei region, along with daily PM 2.5, nitrogen dioxide (NO 2), and meteorological data from 2013 to 2018. Five persistent high PM 2.5 exposure scenarios were defined in terms of daily mean PM 2.5 concentrations (>75 μg/m 3 and >150 μg/m 3), duration (≥2 days and ≥3 days), and whether or not there was concurrent exposure to high levels of NO 2 (daily mean NO 2 concentration >50 μg/m 3). A two-stage statistical analysis strategy based on a generalized linear model was applied to conduct a time-series analysis to assess the exposure-response relationship between persistent high PM 2.5 exposure scenarios and residents' outpatient visits for a variety of respiratory diseases, and to estimate excess outpatient visits. Results:During the period, M ( Q1, Q3) PM 2.5 and NO 2 concentrations were 61.2 (42.3, 95.1) μg/m 3 and 40.2 (31.4, 54.4) μg/m 3, respectively, and the daily respiratory disease outpatient visits were 57 (52, 66) cases. When compared with non-permanent high PM 2.5 exposure periods, exposure scenarios with PM 2.5 >75 μg/m 3 and lasting for ≥2 days caused an increased risk of outpatient visits for respiratory diseases by 2.10% (95% CI: 1.44%-2.77%), and resulted in 43 787 (95% CI: 30 025-57 757) excess visits; in this scenario, the concurrent exposure to high levels of NO 2 had a greater acute effect on respiratory disease visits than the absence of exposure to high levels of NO 2 ( P<0.001). The risk of respiratory disease visits increased substantially by 4.41% (95% CI: 3.15%-5.68%) when the daily mean PM 2.5 concentration exceeded 150 μg/m 3 for ≥2 days. Subgroup disease analyses showed that scenarios with daily mean PM 2.5 concentrations exceeding 75 μg/m 3 for ≥3 days caused a significant increase in the risk of lower respiratory tract infections, chronic lower respiratory disease, and asthma visits. Conclusions:Sustained persistent high PM 2.5 exposure increases the risk of outpatient visits for various respiratory diseases; concurrent exposure to high concentrations of NO 2 leads to a greater risk of visiting the clinic, suggesting that the prevention and control of PM 2.5 pollution should be synchronized with the control of mobile source emissions, to synergistically manage the compound pollution of PM 2.5 and NO 2 in the atmosphere.

Objective:To select low-dose radiation-activated genes with intrinsic radiation protection by developing a model for adaptive responses to low-dose ionizing radiation, in order to explore the mechanisms behind the radiation resistance of the candidate genes.Methods:The cells were divided into adaptive response induction group and whole transcriptome sequencing group. The level of DNA damage was assessed using the γ-H2AX immunofluorescence assay. The low-dose radiation-activated candidate genes with radiation protection were selected through whole transcriptome sequencing and quantitative reverse transcription PCR (RT-qPCR)-based validation. The anti-radiation effect of candidate gene CCND1 was assessed based on CCK-8 cell proliferation and γ-H2AX immunofluorescence assay. After up- and down-regulation of CCND1 expression, the anti-radiation mechanism of CCND1 was preliminarily explored through transcriptome sequencing analysis.Results:A model for low-dose ionizing radiation-induced adaptive responses of lymphocytes was constructed. Using this model, six candidate genes with radiation protection, including CCND1, ZMAT3, MGAT3, DFFB, CYP4F2, ITGA6, were selected. Compared to the control group, overexpressed CCND1 led to significantly enhanced proliferation ability of AHH-1 cells ( t = 7.92-14.76, P < 0.05) and distinctly lowered level of DNA damage ( t = 2.79-9.68, P < 0.05) after 2 Gy of X-ray irradiation. Furthermore, compared to the control group, the CCND1 knockdown caused significantly decreased cell proliferation ability ( t = 13.58-26.25, P < 0.05) and notably elevated level of DNA damage of cells ( t = 2.87-7.61, P < 0.05). Transcriptome sequencing revealed that up- and down-regulation of CCND1 expression resulted in the activation of pathways related to cell growth, death, and damage repair. Conclusions:By selecting six low-dose-activated candidate genes with radiation protection and revealing the function of CCND1 in radiation protection, this study provides a new perspective for the development of radiation protection agents from the perspective of adaptive responses to low-dose radiation.

Objective To explore method for improving the colonization efficiency of Helicobacter pylori(Hp)in the mouse stomach and to determine if the proton pump inhibitor(PPI)pantoprazole can act as a colonization adjuvant to enhance Hp colonization,with the aim of providing an effective tool for establishing an Hp infection mouse model.Methods The Hp Sydney strain 1(SS1)was introduced and solid plate and liquid culture systems were established.The effects of different doses of pantoprazole on gastric acid secretion in mice were compared.The impact of Hp inoculation,alone or combined with pantoprazole pretreatment,on Hp colonization efficiency was analyzed using rapid urease tests,bacterial plate cultures,and TaqMan quantitative polymerase chain reaction.Results PPI pretreatment inhibited gastric acid secretion and promoted Hp colonization in the mouse stomach,to some extent.Conclusions PPI can serve as colonization adjuvants to enhanc e the efficiency of constructing Hp infection mouse models.