Psychological factors have become significant contributors to the onset and progression of insomnia. This article explored the treatment of insomnia from the perspective of “liver governs wei qi （defensive qi）”. The concept of “liver governs wei qi （defensive qi）” is summarized in three aspects， firstly， the liver assists the spleen and stomach in transformation and transportation， governing the generation of wei qi； secondly， the liver aids lung qi diffusion and dispersion， governing the distribution of wei qi； thirdly， the liver regulates circadian rhythms， governing the circulation of wei qi. It is proposed that the clinical treatment of insomnia should focus on the following methods： for regulating the liver to harmonize the five viscera， and facilitate the circulation of wei qi， medicinals entering the liver channel include Chaihu （Bupleuri radix）， Baishao （Paeoniae Radix Alba）， Zhizi （Gardeniae Fructus）， and Suanzaoren （Ziziphi Spinosae Semen） could be commonly used； for nourishing the liver， the treatment should align with the day-night rhythm， and herbs such as Baihe （Lilium）， Hehuan （Albizia julibrissin）， and Yejiaoteng （Polygoni multiflori caulis） are commonly used； for soothing the liver and address both mental and physical health to calm wei qi， treatment should advocate verbal counseling， psychological regulation， and health education. Ultimately， this treatment approach can free liver qi to flow， soothe qi movement， restore the motion of wei qi， regulate during day and night， balance yin and yang， and resolve insomnia effectively.

Objective: To analyze the characteristics of first-visit cases of herpes zoster in Zhoushan City, Zhejiang Province from 2021 to 2023, so as to provide the reference for improving herpes zoster prevention and control measures. Methods: Data on the incidence and vaccination of first-visit herpes zoster cases at all levels of public medical institutions in Zhoushan City from 2021 to 2023 were collected through the Zhoushan Comprehensive Health Information Platform and Zhoushan Immunization Program Information Management System. The incidence and outpatient proportion were calculated. The population distribution, seasonal distribution, and clinical consultation status of first-visit herpes zoster cases were described. Results: From 2021 to 2023, a total of 15 156 first-visit herpes zoster cases were reported in Zhoushan City, with an average annual incidence of 5.36‰. The incidences for each year were 5.78‰, 5.29‰ and 5.02‰, respectively, and the outpatient proportions were 0.15%, 0.14% and 0.11%, respectively, showed decreasing trends (both P<0.05). The number of doses of recombinant herpes zoster vaccine or live attenuated herpes zoster vaccine administered were 130, 312, and 633, respectively. The main consultation department was dermatology, with 11 004 cases (72.60%). The primary clinical diagnosis was visceral herpes zoster, with 5 901 cases (38.94%). A total of 1 936 cases (12.77%) had at least one underlying medical condition. The mean age of onset was (56.08±16.23) years, and the incidence showed an upward trend with increasing age (P<0.05). There were 7 386 male cases and 7 770 female cases, with a male-to-female ratio of 0.95∶1. The incidence among males aged ≥50 years was lower than that among females (6.53‰ vs. 8.69‰, P<0.05). The onset of the disease exhibited a significant seasonal pattern, with a peak period from June 21st to August 21st, covering 75% of the cases Conclusions From 2021 to 2023, the incidence and outpatient proportion of herpes zoster in Zhoushan City decreased. Summer was the peak season for onset, and women and the elderly were the key populations. It is necessary to strengthen the collaborative diagnostic and treatment capabilities of key departments such as dermatology and enhance the enthusiasm for vaccination among key populations.

Humans ; Proto-Oncogene Proteins p21(ras)/genetics* ; Prognosis ; Biomarkers, Tumor/genetics* ; Mutation/genetics* ; Colorectal Neoplasms/genetics* ; Proto-Oncogene Proteins B-raf/metabolism*

ObjectiveTo understand the characteristics of PM_2.5 pollution in the air of Pearl River Delta city in Guangdong Province under the COVID-19 epidemic and the health risks of inhaling elements in PM_2.5. MethodsIn 2022， 10 PM_2.5 monitoring points were set up in 10 districts in Guangzhou， Shenzhen， Foshan and Zhuhai， and air samples were collected for 7 consecutive days every month to analyze the concentration of PM_2.5 and the 12 elements in PM_2.5. The classic "four-step" method was used to evaluate the carcinogenic risk and chronic non-carcinogenic risk of the elements in air PM_2.5 on health. The age-sensitive characteristics of metal elements were combined in the carcinogenic risk assessment， and age-sensitive factors were introduced to analyze the impact of air pollution on population health. ResultsA total of818 samples were collected. and the average annual PM_2.5 concentration in the four cities of the Pearl River Delta was 30.17 （1.00-166.00， s=21.06） μg·m^-3， which was lower than the concentration limit of the secondary standard of the Ambient Air Quality Standard （GB 3095-2012）. The difference of PM_2.5 concentration in the four cities was statistically significant. The PM_2.5 concentrations in Zhuhai and Shenzhen， which were located near the sea， were lower than those in Guangzhou and Foshan. The monthly mean concentration of PM_2.5 in the four cities was the lowest at 13.70 （4.00-34.00， s=5.93） μg·m^-3 in July and the highest at 57.73 （14.00-146.00， s=27.96） μg·m^-3 in January， showing a low concentration from May to October and a high concentration from November to April of the following year. The average daily PM_2.5 concentration exceeded the secondary standard for 29 days， mainly distributed in January and November. The average annual mass concentration of elements in PM_2.5 in the four cities was Al>Mn>Pb>As>Ni>Cr>Se>Sb>Cd>Tl>Be>Hg. AS and Mn have chronic non-carcinogenic risk in population， while Cr， AS， Cd， Be and Ni have carcinogenic risk in population. ConclusionThe PM_2.5 pollution levels of the four cities in the Pearl River Delta are low and variable. Coastal cities are lower than non-coastal cities， which shows the characteristics of first decreasing and then increasing throughout the year. The order of mass concentration of metal elements of PM_2.5 in four cities is basically the same except Be and Ni. As and Mn in PM_2.5 show a certain degree of chronic non-carcinogenic risk， and As， Cr， Cd， Ni and Be have a certain degree of carcinogenic risk. The four cities need to take effective intervention measures to continue to strengthen the pollution control and health protection of Cr， As， Cd and Mn in the air， and control the health burden caused by air pollution.

BACKGROUND:Current studies have confirmed that Ganoderma lucidum polysaccharides can promote nerve regeneration in neurodegeneration-related diseases.The occurrence of neurodegenerative diseases is closely related to mitochondrial dysfunction,but the role of Ganoderma lucidum polysaccharides on the regulation of apoptosis and mitochondrial function in neurodegenerative diseases is not yet clarified. OBJECTIVE:To explore the regulatory effects and mechanisms of Ganoderma lucidum polysaccharides on apoptosis and mitochondrial dysfunction in H2O2-induced SH-SY5Y cells. METHODS:SH-SY5Y cells were divided into three groups:control group,H2O2 group,and Ganoderma lucidum polysaccharides group.Cells in the control group were normally cultured.Cells in the H2O2 group were treated with 300 μmol/L H2O2 for 24 hours.In the Ganoderma lucidum polysaccharides group,the intervention with 300 μg/L Ganoderma lucidum polysaccharides was conducted first for 1-2 hours,followed by the addition of 300 μmol/L H2O2 for 24 hours.The mitochondrial membrane potential was detected by JC-1 kit.Apoptosis was detected by TUNEL staining kit.The activities of malondialdehyde and superoxide dismutase were detected by malondialdehyde test kit and superoxide dismutase test kit,respectively.The apoptosis and expression of mitochondrial dynamics-related proteins were detected by immunofluorescence staining and western blot assay. RESULTS AND CONCLUSION:(1)Compared with the control group,the mitochondrial membrane potential and superoxide dismutase activity were significantly reduced,as well as apoptotic rate and malondialdehyde levels were significantly increased in the H2O2 group(P<0.05).After treatment with Ganoderma lucidum polysaccharides,the membrane potential and superoxide dismutase activities were significantly increased,and apoptotic rate and malondialdehyde levels were significantly reduced compared with the H2O2 group(P<0.05).(2)The expression levels of pro-apoptotic proteins Bax and Caspase-3 were significantly increased,but the expression of anti-apoptotic protein Bcl-2 was significantly decreased in the H2O2 group compared with the control group(P<0.05).Compared with the H2O2 group,the levels of Bax and Caspase-3 were significantly decreased,but the expression of anti-apoptotic protein Bcl-2 was significantly increased in the Ganoderma lucidum polysaccharides group(P<0.05).(3)Compared with the control group,the expression of mitochondrial splitting proteins Fis1 and p-Drp1 was significantly increased,but the expression of mitochondrial fusion proteins OPA1,Mfn1,and Mfn2 was decreased in the H2O2 group(P<0.05).Compared with the H2O2 group,Fis1 and p-Drp1 expression was significantly reduced,but the expression levels of OPA1,Mfn1,and Mfn2 were significantly increased in the Ganoderma lucidum polysaccharides group(P<0.05).(4)The above results confirm that Ganoderma lucidum polysaccharides can attenuate H2O2-induced oxidative stress damage and apoptosis in SH-SY5Y cells by ameliorating mitochondrial dysfunction.

Objective To observe value of thin slice CT multiple signs combined with multiplanar reformation(MPR)for diagnosing tracheobronchial tuberculosis(TBTB).Methods Data of 234 TBTB patients who underwent chest thin slice CT scanning were retrospectively analyzed.MPR was performed,the direct signs and indirect signs of TBTB were observed.The diagnostic efficacy of axial plain CT images(direct observation)and of MPR combined with the former(combined observation)were compared.Results The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of direct observation was 38.88％(201/517),98.13％(1 789/1 823),85.53％(201/235),84.99％(1 789/2 105)and 85.04％(1 990/2 340),respectively,of combined observation was 91.10％(471/517),98.85％(1 802/1 823),95.54％(471/493),97.51％(1 802/1 848)and 97.14％(2 273/2 340),respectively.Significant differences of sensitivity,positive predictive value,negative predictive value and accuracy were found(all P＜0.001),whereas no significant difference of specificity was found between 2 methods(P＞0.05).Conclusion Thin slice CT multiple signs combined with MPR could be used to effectively diagnose TBTB.

Background and objective Lung cancer is a common malignant tumor of the lung.To explore the molecular mechanism of the occurrence and development of lung cancer is a hot topic in current research.Cyclic RNA D1(CircCCND1)is highly expressed in lung cancer and may be a potential target for the treatment of lung cancer.The aim of this study was to investigate the effect of CircCCND1 on the malignant biological behaviors of lung cancer cells by regulat-ing the miR-340-5p/transforming growth factor β-induced factor homeobox 1(TGIF1)axis.Methods The expression of CircCCND1,miR-340-5p,and TGIF1 mRNA in human normal lung epithelial cells BEAS-2B and human lung cancer H446 cells were detected.H446 cells cultured in vitro were randomly divided into control group,CircCCND1 siRNA group,miR-340-5p mimics group,negative control group,and CircCCND1 siRNA+miR-340-5p inhibitor group.Cell proliferation,mito-chondrial membrane potential,apoptosis,migration,and invasion were detected,and the expressions of CircCCND1,miR-340-5p,TGIF1 mRNA,BCL2-associated X protein(Bax),cleaved Caspase-3,N-cadherin,E-cadherin,and TGIF1 proteins in each group were detected.The targeting relationship of miR-340-5p with CircCCND1 and TGIF1 was verified.Results Compared with BEAS-2B cells,CircCCND1 and TGIF1 mRNA were increased in H446 cells,and miR-340-5p expression was decreased(P＜0.05).Knocking down CircCCND1 or up-regulating the expression of miR-340-5p inhibited the proliferation,migration and invasion of H446 cells,decreased the expression of TGIF1 mRNA and TGIF 1 protein,and promoted cell apop-tosis.Down-regulation of miR-340-5p could antagonize the inhibitory effect of CircCCND1 knockdown on the malignant bio-logical behavior of H446 lung cancer cells.CircCCND1 may target the down-regulation of miR-340-5p,and miR-340-5p may target the down-regulation of TGIF 1.Conclusion Knocking down CircCCND1 can inhibit the malignant behaviors of lung cancer H446 cells,which may be achieved through the regulation of miR-340-5p/TGIF1 axis.

Background::Few evidence is available in the early prediction models of behavioral and psychological symptoms of dementia (BPSD) in Alzheimer’s disease (AD). This study aimed to develop and validate a novel genetic-clinical-radiological nomogram for evaluating BPSD in patients with AD and explore its underlying nutritional mechanism.Methods::This retrospective study included 165 patients with AD from the Chinese Imaging, Biomarkers, and Lifestyle (CIBL) cohort between June 1, 2021, and March 31, 2022. Data on demographics, neuropsychological assessments, single-nucleotide polymorphisms of AD risk genes, and regional brain volumes were collected. A multivariate logistic regression model identified BPSD-associated factors, for subsequently constructing a diagnostic nomogram. This nomogram was internally validated through 1000-bootstrap resampling and externally validated using a time-series split based on the CIBL cohort data between June 1, 2022, and February 1, 2023. Area under receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were used to assess the discrimination, calibration, and clinical applicability of the nomogram.Results::Factors independently associated with BPSD were: CETP rs1800775 (odds ratio [OR] = 4.137, 95% confidence interval [CI]: 1.276-13.415, P = 0.018), decreased Mini Nutritional Assessment score (OR = 0.187, 95% CI: 0.086-0.405, P <0.001), increased caregiver burden inventory score (OR = 8.993, 95% CI: 3.830-21.119, P <0.001), and decreased brain stem volume (OR = 0.006, 95% CI: 0.001-0.191, P = 0.004). These variables were incorporated into the nomogram. The area under the ROC curve was 0.925 (95% CI: 0.884-0.967, P <0.001) in the internal validation and 0.791 (95% CI: 0.686-0.895, P <0.001) in the external validation. The calibration plots showed favorable consistency between the prediction of nomogram and actual observations, and the DCA showed that the model was clinically useful in both validations. Conclusion::A novel nomogram was established and validated based on lipid metabolism-related genes, nutritional status, and brain stem volumes, which may allow patients with AD to benefit from early triage and more intensive monitoring of BPSD.Registration::Chictr.org.cn, ChiCTR2100049131.

Objective To investigate changes of laboratory indicators and pathological features of Henoch-Schonlein purpura nephritis(HSPN)children after crescent formation,and to explore non-invasive biomarkers for predicting crescent formation.Methods A total of 278 children with HSPN who were hospitalized from January 2018 to July 2023 were selected and divided into the crescent formation group(196 cases)and the non crescent formation group(82 cases)based on their crescent formation status.Patients in the crescent formation group were sub-divided into the cellular crescent formation group(52 cases)and the cellular fibrous crescent formation group(144 cases)based on the type of crescent formation.Laboratory indicators and pathological characteristics were compared between different groups.The correlation between each indicator and the proportion of crescent formation was analyzed.The influencing factors of crescent formation were analyzed by Logistic regression.Receiver operating characteristic(ROC)curves were plotted,and the effectiveness of laboratory indicators in predicting crescent formation was evaluated.Results Compared with the non crescent formation group,24-hour urine protein quantification(24 hUP),urine immunoglobulin G/creatinine(UGCR),urine red blood cell count(URBC),neutrophil/lymphocyte ratio(NLR),blood urea nitrogen(BUN)and triglycerides(TG)were significantly increased in the crescent formation group.There were increased proportion of diffuse mesangial hyperplasia(Mb),renal tubular atrophy or interstitial fibrosis(T1)(P＜0.05).Compared with the cellular crescent group,the proportion of glomerular segmental sclerosis or adhesion(S1)and T1 were increased,and the proportion of crescent formation was higher in the cellular fibrous crescent group.The proportion of capillary endothelial cell proliferation(E1)was decreased in the cellular crescent group(P<0.05).Spearman correlation analysis showed that 24 hUP,UGCR,URBC,NLR,BUN,TG,Mb and T1 were positively correlated with the proportion of crescent formation(all P＜0.05).The results of multivariate Logistic regression analysis showed that elevated UGCR and T1 were risk factors for crescent formation.The area under the curve(AUC)predicted by UGCR for crescent formation was 0.731(95%CI:0.667-0.795,P＜0.05),with an optimal cutoff value of 5.00 mg/mmol,sensitivity of 0.744 and specificity of 0.610.Conclusion UGCR can be used as a non-invasive biomarker to assist in evaluating crescent formation in children with HSPN.

Objective:To analyze the gender difference in behavioral and psychological symptoms of dementia (BPSD) of amnestic mild cognitive impairment (aMCI) and Alzheimer′s disease (AD).Methods:It was a cross-sectional study. The clinical data of 201 patients with aMCI and 146 patients with AD were continuously collected from the Chinese Imaging, Biomarkers and Lifestyle Study of Alzheimer′s Disease (CIBL) cohort between June 1, 2021 to February 1, 2023 in Beijing Tiantan Hospital, Capital Medical University. The BPSD subtypes were compared between different gender. The gender-different BPSD subtypes were divided into depression group (126 cases) and non-depression group (221 cases), anxiety group (140 cases) and non-anxiety group (207 cases), indifference group (131 cases) and non-indifference group (216 cases). The sociodemographic data (age, sex, education level, marital status), hypertension, diabetes, stroke, heart disease, hyperlipidemia, smoking history, drinking history, carrier status of apolipoprotein E epsilon4 allele (APOE ε4), and the scores of the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Neuropsychiatric Inventory (NPI), Activity of Daily Living (ADL) were compared by using hypothesis testing. Multivariate logistic regression was used to analyze the gender differences of BPSD in aMCI and AD patients.Results:The incidence rates of depression and anxiety in female were both significantly higher than those in male (44.93% vs 23.57%, 44.93% vs 33.57%), and the incidence rate of apathy was significantly lower than that in male (32.37% vs 45.71%) (all P<0.05). The proportion of female and ADL scores in depression group were both significantly higher than those in non-depression group [73.81% vs 51.58%, 22.00 (20.00, 30.00) vs 20.00 (20.00, 26.00) points], and the proportion of smoking and drinking history and MoCA scores in depression group were all significantly lower than those in non-depression group [13.49% vs 25.79%, 19.84% vs 35.75%, 16.00 (10.00, 22.00) vs 19.00 (13.00, 24.00) points] (all P<0.05). The proportion of female and ADL scores in anxiety group were both significantly higher than those in non-anxiety group [66.43% vs 55.07%, 23.00 (20.00, 30.75) vs 20.00 (20.00, 25.00) points], and the MMSE and MoCA scores in anxiety group were both significantly lower than those in non-anxiety group [23.00 (16.00, 27.00) vs 24.00 (19.00, 28.00) points, 16.00 (10.00, 21.00) vs 20.00 (13.00, 13.00) points] (all P<0.05). The proportion of female and the MMSE and MoCA scores in apathy group were all significantly lower than those in non-apathy group [51.15% vs 64.81%, 19.00 (11.00, 25.00) vs 26.00 (22.00, 28.00) points, 14.00 (7.00, 19.00) vs 21.00 (15.25, 24.00) points], and the age, proportion of APOE ε4 carriers and ADL scores in apathy group were all significantly higher [67.0 (61.0, 76.0) vs 66.0 (60.0, 71.0) years, 42.74% vs 31.31%, 27.00 (22.00, 38.00) vs 20.00 (20.00, 22.00) points] (all P<0.05). Female ( OR=2.384, 95% CI: 1.274-4.459) and decrease in MoCA score ( OR=0.955, 95% CI: 0.914-0.998) were positively correlated with risk of depression. Female ( OR=1.704, 95% CI: 1.077-2.695) was positively correlated with risk of anxiety. Male ( OR=0.558, 95% CI: 0.333-0.936), decrease in MoCA scores ( OR=0.937, 95% CI: 0.894-0.983) and increase in ADL scores ( OR=1.070, 95% CI: 1.027-1.116) were positively correlated with risk of apathy (all P<0.05). Conclusions:There are significant gender differences in BPSD in aMCI and AD patients. Female is positively correlated with risk of depression and anxiety, while male is positively correlated with the occurrence of apathy. Clinical attention should be paid to hierarchical management of BPSD patients of different gender.