ObjectiveTo explore the role of the histone deacetylase Sirtuin-1 （SIRT1）/p53 signaling pathway in promoting apoptosis of non-small cell lung cancer cells （NSCLC） induced by the co-stimulatory molecule B7 homolog 3 （B7-H3）. MethodsThe GEPIA 2 platform was used for survival analysis of NSCLC patients based on B7⁃H3 gene expression levels. The Gene Enrichment Analysis （GSEA） method was used to analyze the enrichment characteristics of B7⁃H3 molecules in the gene set of cell apoptosis. In the non-small cell lung cancer A549 cell line， B7⁃H3 was knocked down， and the protein expression levels of SIRT1 and p53 were detected by Western blot. B7⁃H3 was overexpressed in A549 cells and the apoptosis rate was analyzed by flow cytometry after Annexin V/PI double staining. Overexpression of B7⁃H3 and knockdown of SIRT1 were performed in A549 cell line. The expression levels of p53 and apoptosis-related proteins B-cell lymphoma/leukemia-2 （Bcl-2） and Bcl-2-associated X protein （Bax） were detected respectively by Western blot. Cell apoptosis rate was analyzed by flow cytometry after Annexin V/PI double staining. ResultsThe overall survival of the B7-H3 high-expression group was significantly lower than that of the low-expression group （P<0.01）. B7-H3 was significantly enriched in the cell apoptosis signaling pathway and the p53 signaling pathway （P<0.05）. Compared with the control group， the expression of SIRT1 was significantly downregulated， and p53 was significantly upregulated in the B7⁃H3 knockdown group （both P<0.001）. Overexpression of B7-H3 significantly up-regulated SIRT1 protein expression （P<0.05）， down-regulated p53 expression （P<0.01）， and markedly increased the Bcl-2/Bax ratio of apoptosis-related proteins （P<0.001）. The results of Annexin V/PI double staining showed that the apoptosis rate of A549 cells with overexpressed B7⁃H3 decreased （the apoptosis rate of the control group was 26.72%±4.13%， while that of the B7⁃H3 overexpression group was 13.87%±0.82%； P<0.01）. In B7-H3-overexpressing cell lines， SIRT1 knockdown significantly reversed apoptosis （P<0.05）， up-regulated p53 protein expression （P<0.001）， and markedly reduced the Bcl-2/Bax ratio （P<0.001）. ConclusionB7-H3 molecule inhibits the apoptosis of non-small cell lung cancer cells via the SIRT1/p53 signaling pathway.

A 51-year-old male presented with nasal obstruction, followed by progressive hearing loss and blurred vision. Imaging identified space-occupying lesions in the paranasal sinuses, orbits, and paraspinal regions, while laboratory tests confirmed positive anti-proteinase 3 anti-neutrophil cytoplasmic antibody(PR3- ANCA) immunoglobulin G (IgG)and markedly elevated serum IgG4. Despite treatment with corticosteroids, immunosuppressants, and radiotherapy, the patient exhibited steroid dependency with relentless disease progression. Following multidisciplinary consultation, a diagnosis of inflammatory myofibroblastic tumor (IMT) coexisting with ANCA- associated vasculitis (AAV) was favored, though IgG4-related disease remained a critical differential. Ultimately, profound immunosuppression precipitated a severe herpesvirus infection, leading to disseminated intravascular coagulation and multiple organ dysfunction syndrome. This case underscores the rarity and diagnostic complexity of concurrent IMT and AAV, highlights the therapeutic dilemma of balancing primary disease control against fatal opportunistic infections, and emphasizes the critical role of multidisciplinary collaboration in the diagnosis and treatment of complex diseases.

Background: and Purpose Live cell-based assays (LCBA) are increasingly used for serological antibody detection due to their ability to preserve antigen conformation, offering moderately higher sensitivity than fixed cell-based assays. However, the clinical necessity of prioritizing LCBA for the detection of aquaporin-4 immunoglobulin G (AQP4-IgG) in neuromyelitis optica spectrum disorder (NMOSD) remains unclear, especially when compared to its established role in diagnosing myelin oligodendrocyte glycoprotein antibody-associated disease. Methods: We compared the performance of live cell-based assays using immunofluorescence (LCBA-IF) and fixed cell-based assays using immunofluorescence (FCBA-IF) in detecting AQP4-IgG in 90 cases of NMOSD meeting 2015 International Panel for Neuromyelitis Optica Diagnosis criteria, alongside 40 controls. Additionally, we further investigated the relationship between AQP4-IgG titers as measured by LCBA-IF and FCBA-IF and clinical parameters in NMOSD patients. Results: Results showed 96.9% agreement between LCBA-IF and FCBA-IF (Cohen’s κ=0.935), with a strong Spearman correlation (0.977, p<0.001). Both methods demonstrated 100% specificity, with LCBA-IF showing slightly higher sensitivity compared to FCBA-IF. Within LCBAIF-tested groups, statistically significant differences in annualized relapse rates were observed across all pairwise comparisons (low-titer vs. moderate-titer, low-titer vs. high-titer, and moderate-titer vs. high-titer; all p<0.050). However, this association reached statistical significance in some FCBA-IF-tested groups. Conclusions Overall, there is a strong concordance between LCBA-IF and FCBA-IF in detecting AQP4-IgG, where LCBA-IF shows slightly higher sensitivity. Furthermore, there is a potential link between elevated AQP4-IgG titers and an increased risk of relapse, and this correlation may appear more pronounced when using LCBA-IF.

Objective : To establish an enzyme-linked immunosorbent assay (ELISA) for exosome B7-H3 in plas- ma , and to explore the clinical significance and diagnostic value of exosome B7-H3 in plasma from non-small cell lung cancer (NSCLC) . Methods : The plasma of 70 NSCLC patients (NSCLC group) and 36 healthy controls (HC group) were collected . Exosomes and microvesicles in plasma were separated by ultra-fast centrifuge method , and the expression levels of B7-H3 in plasma exosomes in NSCLC groups and HC groups were compared by Western blot method . In NSCLC group , the expression levels of B7-H3 in plasma exosomes and microvesicles in NSCLC group were compared . A simple and feasible ELISA method was established to detect the expression level of exosome B7 - H3 in plasma by means of polyethylene glycol (PEG) precipitation and its clinical significance was analyzed . Lo- gistic regression model was established to predict plasma-derived exosome B7-H3 as a risk factor , and receiver op- erating characteristic curve (ROC) was used to investigate the diagnostic value of exosome B7-H3 in NSCLC . Results: For exosomes and microvesicles in plasma which were extracted by ultracentrifugation , Western blot results showed that the expression level of B7-H3 in plasma exosomes of NSCLC group was higher than that of HC group (P = 0. 032) , and the expression level of B7-H3 in plasma exosomes was higher than that of microvesicles of NSCLC group (P = 0. 012) . The expression level of exosome B7-H3 in plasma extracted by PEG precipitation was also higher in NSCLC group than that in HC group (P = 0. 024) . The expression level of exosome B7-H3 in plasma of NSCLC patients was not related to gender , age , smoking or pathological type , but was related to T stage (P = 0. 002) , N stage (P < 0. 001) , M stage (P = 0. 010) and AJCC stage (P < 0. 001) . Multivariate Logistic regres- sion analysis identified exosome B7-H3 in plasma as a risk factor for NSCLC . ROC analysis showed that the sensi- tivity of exosome B7-H3 in plasma for the diagnosis of NSCLC (0. 843) was higher than that of carcinoembryonic antigen (CEA) (0. 743) , whereas the specificity (0. 722) was lower than that of CEA (0. 833) . Combined de- tection of exosome B7-H3 and CEA (AUC = 0. 928 , 95% CI:0. 877 - 0. 979) had a higher diagnostic performance for NSCLC . Conclusion B7-H3 in plasma exosomes is related to the cancer staging of NSCLC , and the combined detection of exosome B7-H3 and CEA in plasma is conducive to the laboratory diagnosis of NSCLC .

As China accelerates its efforts in deep space exploration and long-duration space missions, including the operationalization of the Tiangong Space Station and the development of manned lunar missions, safeguarding astronauts’ physiological and cognitive functions under extreme space conditions becomes a pressing scientific imperative. Among the multifactorial stressors of spaceflight, microgravity emerges as a particularly potent disruptor of neurobehavioral homeostasis. Dopamine (DA) plays a central role in regulating behavior under space microgravity by influencing reward processing, motivation, executive function and sensorimotor integration. Changes in gravity disrupt dopaminergic signaling at multiple levels, leading to impairments in motor coordination, cognitive flexibility, and emotional stability. Microgravity exposure induces a cascade of neurobiological changes that challenge dopaminergic stability at multiple levels: from the transcriptional regulation of DA synthesis enzymes and the excitability of DA neurons, to receptor distribution dynamics and the efficiency of downstream signaling pathways. These changes involve downregulation of tyrosine hydroxylase in the substantia nigra, reduced phosphorylation of DA receptors, and alterations in vesicular monoamine transporter expression, all of which compromise synaptic DA availability. Experimental findings from space analog studies and simulated microgravity models suggest that gravitational unloading alters striatal and mesocorticolimbic DA circuitry, resulting in diminished motor coordination, impaired vestibular compensation, and decreased cognitive flexibility. These alterations not only compromise astronauts’ operational performance but also elevate the risk of mood disturbances and motivational deficits during prolonged missions. The review systematically synthesizes current findings across multiple domains: molecular neurobiology, behavioral neuroscience, and gravitational physiology. It highlights that maintaining DA homeostasis is pivotal in preserving neuroplasticity, particularly within brain regions critical to adaptation, such as the basal ganglia, prefrontal cortex, and cerebellum. The paper also discusses the dual-edged nature of DA plasticity: while adaptive remodeling of synapses and receptor sensitivity can serve as compensatory mechanisms under stress, chronic dopaminergic imbalance may lead to maladaptive outcomes, such as cognitive rigidity and motor dysregulation. Furthermore, we propose a conceptual framework that integrates homeostatic neuroregulation with the demands of space environmental adaptation. By drawing from interdisciplinary research, the review underscores the potential of multiple intervention strategies including pharmacological treatment, nutritional support, neural stimulation techniques, and most importantly, structured physical exercise. Recent rodent studies demonstrate that treadmill exercise upregulates DA transporter expression in the dorsal striatum, enhances tyrosine hydroxylase activity, and increases DA release during cognitive tasks, indicating both protective and restorative effects on dopaminergic networks. Thus, exercise is highlighted as a key approach because of its sustained effects on DA production, receptor function, and brain plasticity, making it a strong candidate for developing effective measures to support astronauts in maintaining cognitive and emotional stability during space missions. In conclusion, the paper not only underscores the centrality of DA homeostasis in space neuroscience but also reflects the authors’ broader academic viewpoint: understanding the neurochemical substrates of behavior under microgravity is fundamental to both space health and terrestrial neuroscience. By bridging basic neurobiology with applied space medicine, this work contributes to the emerging field of gravitational neurobiology and provides a foundation for future research into individualized performance optimization in extreme environments.

Objective　To analyze and study the status quo and deficiencies in the construction of talent teams at all levels of CDCs in Hainan Province and put forward countermeasures to provide a reference basis for the high-quality development of talent team construction in all levels of CDCs in Hainan Province. Methods Using field surveys and data retrieval, spatial analysis was employed to compare the overall differences in human resource status of the provincial-level CDC and CDCs in five regional areas (East, West, South, North, and Central Hainan). The coordination between human resource allocation and development strategies was analyzed. A descriptive analysis mainly utilized CDC survey questionnaires and other research forms to explore the health human resources of the province's CDCs. Results The professional and technical personnel in the provincial CDCs comprise 1 431 individuals, accounting for 82.3% (1 431/1 739) of the total number of actual employees, which falls short of the Central Institutional Reform Commission's (CIRC) mandate that technical professionals comprise at least 85% of the total workforce (CIRC Document [2014] No. 2). Among Hainan's CDC personnel, 115 individuals are recognized as high-level talents within the Hainan Free Trade Port framework. These include one Class C talent, 22 Class D talents, and 93 Class E talents. Class A, B, and C-level talents are deficient. The majority of staff at both the provincial and regional CDCs hold bachelor's degrees. There is a significant proportion of staff with associate degrees or lower qualifications, coupled with a severe shortage of highly educated personnel. Postgraduates with master’s degrees or above account for 27.8% (65/233) in the provincial CDC, indicating low educational credentials among personnel in Hainan's CDCs. The central region, characterized by slower economic and social development, faces greater challenges in attracting and retaining high-level talent. There is a scarcity of public health professionals with interdisciplinary expertise. Some public health staff lack clinical knowledge, experience, and skills in disease treatment. Furthermore, there is a need to strengthen on-site emergency response capabilities for public health emergencies. The structural ratio of senior, intermediate, and junior professional and technical positions in the provincial CDC is 40%∶45%∶15%. The position settings are limited to ranking levels without distinction by professional category, leading to a bottleneck-type competition like crossing the "one log bridge" for technical position promotions. Conclusion　Hainan Province faces significant challenges in developing its public health workforce, both in technical expertise and management capacity. Especially under the context of the closure operation of the Hainan Free Trade Port, it is necessary to continuously strengthen top-level talent design to cultivate a favorable policy, system, and cultural environment, thereby promoting the sustained and healthy development of the province's public health career.

Objective:To summarize and compare the clinical characteristics of immune checkpoint inhibitor-associated pneumonia(CIP)in elderly and non-elderly lung cancer patients treated with immune checkpoint inhibitors(ICIs).Methods:We conducted a retrospective analysis of the clinical data from 61 patients who developed CIP following ICIs treatment in the Respiratory and Critical Care Medicine Department and the Oncology Department of Beijing Hospital from May 2016 to April 2024.The clinical characteristics of patients aged 65 years and older were compared with those of patients younger than 65 years.Results:A total of 61 patients were included in the study, with 26 patients in the group aged <65 years[aged 39-64(56.3±5.6)years].Within this group, the clinical grades were distributed as follows: 5 patients in grade 1(G1), 12 in grade 2(G2), 7 in grade 3(G3), and 2 in grade 4(G4).Twelve patients underwent bronchoscopy, while 17 patients received corticosteroid therapy after developing CIP.Additionally, 20 patients permanently discontinued immunotherapy due to CIP.Notably, one patient showed improvement in CIP following treatment, which allowed for the continuation of ICIs.Importantly, no patients in this group experienced mortality due to CIP.In the group aged ≥65 years[aged 65-83(71.9±4.9)years], there were 35 patients, categorized as follows: 4 in G1, 22 in G2, 5 in G3, and 4 in G4.Twenty-one patients underwent bronchoscopy, 31 received corticosteroid therapy after developing CIP, and 30 patients permanently discontinued immunotherapy due to CIP.Similarly, one patient in this group demonstrated improvement in CIP following treatment, which permitted the continuation of ICIs.Importantly, no patients in this group experienced mortality due to CIP.Compared to patients aged <65 years, those aged ≥65 years experienced a shorter median time to the occurrence of CIP, with a median of 2(1, 4)months versus 5.5(2, 8)months for the younger group( Z=-3.231, P=0.001).Furthermore, a higher proportion of patients aged ≥65 years received corticosteroid therapy after developing CIP(88.57% or 31 cases)compared to 65.38%(17 cases)in the younger group( χ2=4.704, P=0.030).There were no statistically significant differences in the occurrence of CIP symptoms or chest imaging characteristics between the two age groups(both P>0.05). Conclusions:Patients aged 65 years and older experience a shorter median time to develop CIP following the use of ICIs.However, there is no significant difference in clinical outcomes when compared to the group aged under 65 years, provided that early identification and diagnosis are achieved.

Objective:To investigate the contributing factors to elevated blood pressure in borderline cases during medical selection for recruitment of Air Force flying cadets in order to enhance the accuracy of selection.Methods:Blood pressure was measured among 2 350 male high school graduates in the 2022 re-selection phase of medical selection of Air Force flying cadets. None of the participants had a family history of hypertension according to previous health checkups. Identified through blood pressure measurement, subjects with borderline hypertension were assigned to an intervention group (self-intervention with personalized correction plans) and a control group (self-intervention alone) using a random number table. Standardized blood pressure measurements and comprehensive medical history reviews were performed to compare pre- and post-intervention outcomes across the 2 groups, followed by an investigation into the causative mechanisms of elevated blood pressure.Results:Among the 102 cases of borderline hypertension (51 per group) identified, primary contributing factors included the white-coat phenomenon (41.2%), pre-examination physical activity (17.6%), pre-examination medications (3.9%) and poor sleep quality (35.3%). No significant differences in systolic blood pressure (SBP) or diastolic blood pressure (DBP) were observed between the 2 groups at baseline (both P>0.05). After interventions, the intervention group showed significantly lower SBP ( t=3.13, P=0.002) and DBP ( t=7.68, P<0.001) than the control group. Both groups exhibited reductions in SBP and DBP from baseline ( t=6.63, 8.97, 4.13, 2.03, P<0.001, <0.001, <0.001, =0.043). The percentage of students with normal blood pressure was 96.1% (49/51) in the intervention group and 78.4% (40/51) in the control group. Conclusions:Transient blood pressure elevation in selection settings primarily stems from the white-coat phenomenon, physical exertion, medications and sleep disturbances. Standardizing blood pressure measurement protocols and addressing transient factors can help avoid unwarranted disqualifications and ensure the accuracy of selection.

The aim of this study was to investigate the trend in testicular volume changes after orchiopexy in children with cryptorchidism. The clinical data of 854 children with cryptorchidism who underwent orchiopexy between January 2013 and December 2016 in Shenzhen Children's Hospital (Shenzhen, China) were retrospectively analyzed. The mean (standard deviation) age of the patients was 2.8 (2.5) years, and the duration of follow-up ranged from 1 year to 5 years. Ultrasonography was conducted preoperatively and postoperatively. The variables analyzed included age at the time of surgery, type of surgical procedure, laterality, preoperative testicular position, preoperative and postoperative testicular volumes, and the testicular volume ratio of them. The average testicular volumes preoperatively and at 1 year, 2 years, 3 years, and 5 years postoperatively were 0.27 ml, 0.38 ml, 0.53 ml, 0.87 ml, and 1.00 ml, respectively ( P < 0.001). The corresponding testicular volume ratios were 0.67, 0.76, 0.80, 0.83, and 0.84 ( P < 0.001). The mean volume of the undescended testes was significantly smaller than the mean normative value ( P < 0.001, lower than the 10 th percentile). The postoperative testicular volumes in children with cryptorchidism were generally lower than those in healthy boys but were still greater than the 10 th percentile and exhibited an increasing trend. The older the child is at the time of surgery, the larger the gap in volume between the affected and normal testes. Although testicular volume tends to gradually increase after orchiopexy for cryptorchidism, it could not normalizes. Earlier surgery results in affected testicular volumes closer to those of healthy boys.
Humans ; Male ; Cryptorchidism/diagnostic imaging* ; Orchiopexy ; Child, Preschool ; Testis/surgery* ; Retrospective Studies ; Organ Size ; Ultrasonography ; Infant ; Child ; Postoperative Period ; Follow-Up Studies

OBJECTIVES: To evaluate the safety and efficacy of thiotepa (TT)-containing conditioning regimens for allogeneic hematopoietic stem cell transplantation (HSCT) in children with inborn errors of immunity (IEI). METHODS: Clinical data of 22 children with IEI who underwent HSCT were retrospectively reviewed. Survival after HSCT was estimated using the Kaplan-Meier method. RESULTS: Nine patients received a traditional conditioning regimen (fludarabine + busulfan + cyclophosphamide/etoposide) and underwent peripheral blood stem cell transplantation (PBSCT). Thirteen patients received a TT-containing modified conditioning regimen (TT + fludarabine + busulfan + cyclophosphamide), including seven PBSCT and six umbilical cord blood transplantation (UCBT) cases. Successful engraftment with complete donor chimerism was achieved in all patients. Acute graft-versus-host disease occurred in 12 patients (one with grade III and the remaining with grade I-II). Chronic graft-versus-host disease occurred in one patient. The incidence of EB viremia in UCBT patients was lower than that in PBSCT patients (P<0.05). Over a median follow-up of 36.0 months, one death occurred. The 3-year overall survival (OS) rate was 100% for the modified regimen and 88.9% ± 10.5% for the traditional regimen (P=0.229). When comparing transplantation types, the 3-year OS rates were 100% for UCBT and 93.8% ± 6.1% for PBSCT (P>0.05), and the 3-year event-free survival rates were 100% and 87.1% ± 8.6%, respectively (P>0.05). CONCLUSIONS TT-containing conditioning for allogeneic HSCT in children with IEI is safe and effective. Both UCBT and PBSCT may achieve high success rates.
Humans ; Retrospective Studies ; Transplantation Conditioning/methods* ; Thiotepa/therapeutic use* ; Hematopoietic Stem Cell Transplantation/adverse effects* ; Male ; Female ; Child, Preschool ; Infant ; Child ; Transplantation, Homologous ; Graft vs Host Disease ; Adolescent