In hypoxic-ischemic brain damage (HIBD), the programmed cell death known as ferroptosis is significantly activated. Microglial cells demonstrate a high level of sensitivity to iron accumulation. Understanding how to regulate the dual role of microglia and transforming the microglial ferroptosis to a moderate and controllable process has considerable implications for the targeted treatment in HIBD. This paper serves as an overview of microglia-mediated ferroptosis in HIBD as a disease model. We discuss various aspects centered around microglia, including pathophysiological mechanisms, polarization and functions of microglia, molecular mechanisms of ferroptosis, signaling pathways, and therapeutic strategies. The review aims to provide a reference for studies of ferroptosis in microglia.
Microglia/physiology* ; Ferroptosis/physiology* ; Humans ; Animals ; Hypoxia-Ischemia, Brain/pathology* ; Signal Transduction

To report a case of Stormorken syndrome(STRMK)diagnosed in adulthood and to study its clinical,pathological and genetic characteristics.The individual was a 31-year-old male whose symptoms started from childhood with epilepsy as initial symptom.He gradually developed progressive muscle weakness and atrophy.The patient's clinical data,laboratory results,and imaging studies were collected.A biopsy on the patient's left gastrocnemius muscle was conducted.Simultaneously,whole-exome sequencing on both the patient and his parents was performed.The physical examination of the patient showed short stature,proximal muscle weakness with lower limb predominance,accompanied by joint contracture and scoliosis.Abdominal CT examination revealed asplenia and magnetic resonance image(MRI)showed obvious fat infiltration in the bilateral lower limb muscle.Muscle biopsy was consistent with tubular-aggregate myopathy.Genetic test indicated that the patient had a c.326A>G(p.His109Arg)heterozygous mutation in the stromal interaction molecule 1(STIM1)gene,a known pathogenic mutation.This study further enables neurologists to gain a better understanding of this rare disease.

Objective:To analyze the early risk factors of necrotizing pneumonia (NP) in children with Mycoplasma pneumoniae pneumonia (MPP) and construct a clinical prediction model.Methods:In this case-control study, the clinical data of MPP patients who were hospitalized at Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology, from January 2021 to May 2024 were retrospectively analyzed.According to whether NP occurred, the children were divided into the NP group and the non-NP (NNP) group.A total of 62 and 124 children were included in the NP and NNP groups after nearest neighbor matching at a ratio of 1∶2 (with a caliper value of 0.02), respectively.LASSO regression was used to select the optimal factors, and the multivariate Logistic regression analysis was used to establish a clinical prediction model.Internal and external validation of the prediction model was then conducted.The receiver-operating characteristic (ROC) curve and calibration curve were used to evaluate the predictive ability and calibration of the prediction model.The clinical decision curve analysis (DCA) was used to evaluate its clinical predictive value.Results:The LASSO regression analysis showed that white blood cells (WBC), neutrophil percentage, C-reactive protein (CRP), procalcitonin, D-dimer, ferritin, fever duration, and lung consolidation were factors influencing the occurrence of NP in children with MPP ( P<0.05).The ROC analysis showed that the area under the curve (AUC) of the prediction model was 0.838 (95% CI: 0.765-0.911, P<0.001) in the training set, 0.834 (95% CI: 0.755-0.913, P<0.001) in the validation set, and 0.924 (95% CI: 0.902-0.981, P<0.001) in the external validation set.Bootstrap was used for repeated sampling for 1 000 times for internal validation, and the calibration curve showed that the model had good early consistency.The clinical DCA showed that the model had good clinical application value. Conclusions:WBC, CRP, D-dimer, ferritin, fever duration and lung consolidation have good value for the early prediction of MPNP in children.

To report a case of Stormorken syndrome(STRMK)diagnosed in adulthood and to study its clinical,pathological and genetic characteristics.The individual was a 31-year-old male whose symptoms started from childhood with epilepsy as initial symptom.He gradually developed progressive muscle weakness and atrophy.The patient's clinical data,laboratory results,and imaging studies were collected.A biopsy on the patient's left gastrocnemius muscle was conducted.Simultaneously,whole-exome sequencing on both the patient and his parents was performed.The physical examination of the patient showed short stature,proximal muscle weakness with lower limb predominance,accompanied by joint contracture and scoliosis.Abdominal CT examination revealed asplenia and magnetic resonance image(MRI)showed obvious fat infiltration in the bilateral lower limb muscle.Muscle biopsy was consistent with tubular-aggregate myopathy.Genetic test indicated that the patient had a c.326A>G(p.His109Arg)heterozygous mutation in the stromal interaction molecule 1(STIM1)gene,a known pathogenic mutation.This study further enables neurologists to gain a better understanding of this rare disease.

Objective:To analyze the early risk factors of necrotizing pneumonia (NP) in children with Mycoplasma pneumoniae pneumonia (MPP) and construct a clinical prediction model.Methods:In this case-control study, the clinical data of MPP patients who were hospitalized at Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology, from January 2021 to May 2024 were retrospectively analyzed.According to whether NP occurred, the children were divided into the NP group and the non-NP (NNP) group.A total of 62 and 124 children were included in the NP and NNP groups after nearest neighbor matching at a ratio of 1∶2 (with a caliper value of 0.02), respectively.LASSO regression was used to select the optimal factors, and the multivariate Logistic regression analysis was used to establish a clinical prediction model.Internal and external validation of the prediction model was then conducted.The receiver-operating characteristic (ROC) curve and calibration curve were used to evaluate the predictive ability and calibration of the prediction model.The clinical decision curve analysis (DCA) was used to evaluate its clinical predictive value.Results:The LASSO regression analysis showed that white blood cells (WBC), neutrophil percentage, C-reactive protein (CRP), procalcitonin, D-dimer, ferritin, fever duration, and lung consolidation were factors influencing the occurrence of NP in children with MPP ( P<0.05).The ROC analysis showed that the area under the curve (AUC) of the prediction model was 0.838 (95% CI: 0.765-0.911, P<0.001) in the training set, 0.834 (95% CI: 0.755-0.913, P<0.001) in the validation set, and 0.924 (95% CI: 0.902-0.981, P<0.001) in the external validation set.Bootstrap was used for repeated sampling for 1 000 times for internal validation, and the calibration curve showed that the model had good early consistency.The clinical DCA showed that the model had good clinical application value. Conclusions:WBC, CRP, D-dimer, ferritin, fever duration and lung consolidation have good value for the early prediction of MPNP in children.

Objective To explore the clinical features of the patients with prolactinoma and changes of pituitary function before and after surgery.Methods The clinical data of 72 patients with prolactinoma admit-ted and operatively treated in the neurosurgery department of the Second Hospital of Lanzhou University from June 2018 to January 2023 were analyzed retrospectively and their clinical characteristics and change character-istics of pituitary function before and after surgery were summarized.Results (1) Most of the patients with prolactinoma included in this study were macroadenomas,and its clinical manifestations were mainly tumor compression symptoms such as headache and vision diminution;(2) there was a statistically significant differ-ence in tumor invasiveness between the patients with preoperative PRL≥200.000 ng/mL and those with pre-operative PRL<200.000 ng/mL (P<0.05).(3) The PRL level of prolactinoma after surgical treatment in the patients with prolactinoma was significantly decreased compared to preoperative level,and the difference was statistically significant (P<0.05).(4) Among 72 patients,44 patients already had hypopituitarism before surgery,the pituitary function in 2 cases returned to normal,15 cases of hypopituitarism were newly increased and there were 57 cases of postoperative hypopituitarism.Preoperative hypopituitarism was positively correla-ted with postoperative hypopituitarism (r=0.433,P<0.05).By the logistic multifactorial regression analy-sis,the tumor maximal diameter was a risk factor for hypopituitarism occurrence before and after surgery (P<0.05),and the tumor invasiveness was a risk factor for postoperative hypopituitarism (P<0.05),where-as the BMI and PRL level,age,gender,and whether or not pituitary apoplexy occurring had no relationship with hypopituitarism (P>0.05).(5) The gonadal axis was the most common hypofunction in uniaxial sys-tem,and gonadal+thyroid axis was the most common biaxial involvement.Conclusion The surgical treat-ment in the patients with prolactinoma is effective for relieving tumor mass occupation and improving hyperp-rolactinemia.The pituitary function should be fully evaluated before and after surgery.For the patients with hypopituitarism occurrence,the hormone replacement therapy should be given in time,and at the same time the hormonal changes should be closely monitored.

Objective: To analyze the application of digital games for interventions to reduce risky sexual behavior among adolescents, so as to provide a reference for reducing adolescent risky sexual behavior. Methods: The study used PubMed, Web of Science, Cochrane Library, Scopus, Embase, China Biomedical Database, CNKI, Wanfang Database and VIP to carry out a literature search of the application of digital games for interventions aimed at reducing risky sexual behavior among adolescents covering the time period up until February 2024. Results: A total of 10 English articles were included, involving a total of 3 063 adolescents aged 10-24 years old. The publication time spanned from 2013 to 2023. The development and design of the digital games were mostly based on cognitive behavior theory and authentic decision making situations and dialogues. The game participants were divided into single party and multi party categories, mainly using virtual role playing, interactive narrative, and adventure challenges, and there were some differences in content. Digital game intervention had good feasibility and acceptability, which could improve adolescents sexual health knowledge, attitudes, self efficacy, and risk perception, so as to reduce the occurrence of risky behavior. Conclusion As an intervention aimed at reducing risky sexual behavior in adolescents, digital show has significant advantages and can serve as a new prevention and control strategy.

National health standards involve all kinds of technical requirements formulated and numbered in accordance with the procedures and formats stipulated in the standardisation system for the implementation of national health and hygiene laws, regulations and policies, and the protection of human health. The establishment of health standards in China should align with our legal framework, including laws, regulations, departmental rules, and health and hygiene policies. During the development of these standards, a comprehensive approach is advocated, encompassing in-depth investigations, rigorous demonstrations, and extensive stakeholder engagement. However, the process of standard formulation may suffer from insufficient research evidence. The evidence-based concept emphasizes the significance of evidence. Therefore, integrating evidence-based concept into the process of developing health standards can enhance the quality and scientific basis of these standards. This article systematically elucidates the current status and development process of health standards in China, explores the necessity and feasibility of incorporating evidence-based concept into the development of these standards, analyzes the challenges and opportunities, and presents reflections and suggestions.

Objective:To assess the effectiveness of a 6-month Ba Duan Jin exercise program in improving the balance of community-dwelling older adults.Methods:A two arms, parallel-group, cluster randomized controlled trial was conducted in 1 028 community residents aged 60-80 years in 40 communities in 5 provinces of China. Participants in the intervention group (20 communities, 523 people) received Ba Duan Jin exercise 5 days/week, 1 hour/day for 6 months, and three times of falls prevention health education, and the control group (20 communities, 505 people) received falls prevention health education same as the intervention group. The Berg balance scale (BBS) score was the leading outcome indicator, and the secondary outcome indicators included the length of time of standing on one foot (with eyes open and closed), standing in a tandem stance (with eyes open and closed), the closed circle test, and the timed up to test.Results:A total of 1 028 participants were included in the final analysis, including 731 women (71.11%) and 297 men (28.89%), and the age was (69.87±5.67) years. After the 3-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 3.05 (95% CI: 2.23-3.88) points ( P<0.001). After the 6-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 4.70 (95% CI: 4.03-5.37) points ( P<0.001). Ba Duan Jin showed significant improvement ( P<0.05) in all secondary outcomes after 6 months of exercise in the intervention group compared with the control group. Conclusions:This study showed that Ba Duan Jin exercise can improve balance in community-dwelling older adults aged 60-80. The longer the exercise time, the better the improvement.

Objective:To explore the role of arginine metabolism in the inflammatory response to influenza A virus (FluA) infection.Methods:Eighteen-month-old mice were infected with FluA via nasal drip, with samples collected on the 6th day post-infection. The concentration of cytokines was determined by the Luminex multifactor assay, while the metabolites in bronchoalveolar lavage fluid (BALF) were analyzed using targeted metabolomic method. Correlation analysis was employed to examine the correlation between cytokines and metabolites. Macrophages were infected with FluA at a multiplicity of infection (MOI) of 1 and cultured with different concentrations of arginine for 24 h. The mRNA and protein expression levels of interleukin (IL)-1β, IL-6, tumor necrosis factor α (TNF-α) and IL-10 were detected by real time fluorescence quantitative RT-PCR (qRT-PCR) and Cytometric Bead Array (CBA).Results:In comparison to the control group, the levels of surfactant protein D (SP-D), TNF-α, monocyte chemotactic protein-1 (MCP-1), IL-1α, IL-6, IL-10, recombinant S100 calcium binding protein (S100) A9, interferon inducible protein 10 (IP-10), macrophage inflammatory protein-1α (MIP-1α), matrix metalloprotein-9 (MMP-9), and Complement Factor D in BALF of FluA infection exhibited a significant elevation. The concentrations of arginine, aspartate, citrulline, glutamic acid, ornithine, proline, creatine, and sarcosine in arginine metabolism were up-regulated, which was correlated with most of elevated cytokine levels. The supplementation of arginine after FluA infection significantly decreased the levels of IL-1β, IL-6, and TNF-α, but increased the level of IL-10 in macrophages.Conclusions:Arginine reduces the inflammatory response induced by FluA infection in macrophages, suggesting that it may be a potential intervention target for severe pulmonary inflammation following FluA infection.