On plateaus,the low-oxygen and low-pressure environment is likely to lead to cognitive impairments,negatively impacting individuals newly exposed to high altitudes.This paper reviews how high-altitude environments impair cognitive functions and explores protective strategies in terms of oxygen-enriched and pressurization technologies,neuroregulation techniques,and approaches to endogenous protection.It is recommended that future research focus on personalized cognitive protection and training,the construction of integrated protection systems based on multi-technology convergence,and the investigation of long-term effectiveness and sustainability.These efforts are expected to result in more comprehensive strategies for cognitive protection and enhancement in high-altitude operations.

In recent years, the bacteriophage Φ29 (Phi29) DNA polymerase has garnered increasing attention due to its high-fidelity amplification capacity at constant temperatures. To advance the industrial application of this type of isothermal polymerases, this study mined and characterized new enzymes from the microbial metagenome based on the known Phi29 DNA polymerase sequence. The results revealed that a new enzyme, Php29 DNA polymerase, was identified in the microbial metagenome with plants as the hosts. This enzyme exhibited higher strand displacement activity, with a 59.5% similarity to bacteriophage Φ29. Experimental validation demonstrated that the enzyme had 3'→5' exonuclease activity, and its amplification products can serve as substrates for further catalytic reactions. The discovery and validation of Php29 DNA polymerase gives insights into the future industrial application of isothermal polymerases.
DNA-Directed DNA Polymerase/metabolism* ; Bacillus Phages/genetics* ; Metagenome

Objective To analyze the factors influencing iodine nutritional status in pregnant women dur-ing pregnancy,based on thyroid function and thyroid autoantibody levels,and to explore the association between iodine nutritional abnormalities and pregnancy outcomes.Methods A total of 838 pregnant women who underwent routine prenatal checkups at Qinghai Provincial People's Hospital between January 2021 and June 2023 were pro-spectively enrolled in this study.All participants were followed until delivery.Seven cases were lost to follow-up,resulting in a final sample size of 831 participants.Among them,276 were in the first trimester,384 in the second trimester,and 171 in the third trimester.Data on urinary iodine concentration(UIC),urinary creatinine(UCr),thyroid function indicators,and thyroid autoantibodies were collected.Based on their iodine nutritional status,the participants were categorized into either the iodine-sufficient group or the iodine-abnormal group(including iodine-deficient,iodine-hyper-sufficient,and iodine-excessive subgroups).This study analyzed the iodine nutritional sta-tus of pregnant women during different gestational periods,compared thyroid function indices,prevalence of thy-roid diseases,and the positivity rates of thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb),and thyroid-stimulating hormone receptor antibody(TRAb)among different iodine status groups.Additionally,ad-verse pregnancy outcomes were compared across groups.Multivariate logistic regression analysis was conducted to identify risk factors associated with iodine abnormalities during pregnancy,and a predictive model was developed to assess its potential predictive value.Results Among the 831 pregnant women included in the study,373 cases(44.89％)exhibited iodine sufficiency,while 458 cases(55.11％)presented with iodine abnormalities,including 282 cases of iodine deficiency,144 cases of iodine hypersufficiency,and 32 cases of iodine excess.No statistically significant differences were observed in the iodine nutritional status across different trimesters(P>0.05).The se-rum level of thyroid-stimulating hormone(TSH)was significantly higher in the iodine abnormal group compared to the iodine sufficient group(P<0.05).Additionally,the iodine abnormal group demonstrated higher positivity rates of TPOAb alone,TGAb,and TRAb,as well as increased incidence of thyroid dysfunction and total adverse pregnancy outcomes compared to the iodine sufficient group(all P<0.05).These adverse indicators were also sig-nificantly elevated in the iodine-deficient,iodine super-sufficient,and iodine overdose subgroups compared to the iodine sufficient group(P<0.05).Elevated serum TSH levels and the presence of TPOAb,TGAb,and TRAb were identified as risk factors for iodine abnormalities during pregnancy(P<0.05).The predictive model con-structed for identifying iodine abnormalities in pregnant women demonstrated an area under the curve(AUC)of 0.876,with a sensitivity of 72.27％and a specificity of 89.01％.Conclusions The prevalence of iodine nutritional abnormalities among pregnant women during pregnancy was high,with most cases presenting iodine deficiency.These abnormalities were associated with thyroid function,thyroid autoimmunity,and pregnancy outcomes,but showed no significant correlation with gestational age.Furthermore,the prediction model developed based on iden-tified risk factors demonstrated effective performance in predicting iodine nutritional abnormalities during preg-nancy.

Objective To investigate the relationship between peripheral blood composite inflammatory in-dexes[systemic immune inflammatory index(SII),lymphocyte to monocyte ratio(LMR),eosinophil to neu-trophil ratio(ENR),neutrophil to lymphocyte ratio(NLR)]and the severity of respiratory adenovirus(AdV)infection and concurrent wheezing in children.Methods A total of 154 children with respiratory AdV infec-tion(study group)who were admitted to the hospital from June 2022 to May 2024 and 154 healthy children who underwent physical examinations(control group)were selected.Children with respiratory AdV infection were divided into mild group(86 cases)and severe group(68 cases)according to the pediatric sequential or-gan failure assessment(p-SOFA),and children were divided into wheezing group(79 cases)and non-wheezing group(75 cases)according to whether wheezing occurred in children with respiratory AdV infection.The pe-ripheral blood SII,LMR,ENR and NLR in each group were detected and compared,the correlation between peripheral blood SII,LMR,ENR,NLR and the severity of respiratory AdV infection in children was analyzed by Pearson method.The factors affecting wheezing in children with respiratory AdV infection were analyzed by univariate and multivariate Logistic regression analysis.The diagnostic value of peripheral blood composite inflammatory indexes for the severity of respiratory AdV infection and concurrent wheezing in children was e-valuated by drawing the receiver operating characteristic curve.Results The peripheral blood SII,ENR and NLR in severe group were higher than those in mild group and control group(P＜0.05),while the peripheral blood SII,ENR and NLR in mild group were higher than those in control group(P＜0.05).The peripheral blood LMR in severe group was lower than those in mild group and control group(P＜0.05),while the pe-ripheral blood LMR in mild group was lower than that in control group(P＜0.05).The p-SOFA in severe group was higher than that in mild group(P＜0.05).Peripheral blood SII,ENR and NLR in children with re-spiratory AdV infection were positively correlated with p-SOFA(r=0.512,0.439,0.507,P＜0.05),and LMR was negatively correlated with p-SOFA(r=-0.436,P＜0.05).The area under the curve(AUC)of the single detection of SII,LMR,ENR and NLR for diagnosing severe respiratory AdV infection were 0.785,0.809,0.784 and 0.834 respectively,and the AUC of combined detection was 0.916,which was larger than those of single detection(P＜0.05).SII,ENR and NLR in wheezing group were higher than those in non-wheezing group(P＜0.05),and LMR was lower than that in non-wheezing group(P＜0.05).Small airway disease,high SII,high ENR and high NLR were risk factors for wheezing in children with respiratory AdV in-fection(P＜0.05),and high LMR was a protective factor(P＜0.05).The AUC of the single detection of SII,LMR,ENR and NLR for diagnosing wheezing in children with respiratory AdV infection were 0.778,0.771,0.757 and 0.805 respectively,and the AUC of combined diagnosis was 0.884,which was larger than those of single detection(P＜0.05).Conclusion The peripheral blood SII,ENR and NLR in children with respiratory AdV infection increase,and the LMR decreases,which are closely related to the aggravation of the severity of the disease and the concurrent wheezing.The combined detection of four indexes has high value in the diagno-sis of the severity of the disease and the risk of concurrent wheezing.

Objective:To evaluate the relationship between intraoperative mechanical power and postoperative pulmonary complications in patients undergoing long-duration neurosurgery.Methods:This was a case-control study. Based on the duration of mechanical ventilation>8 h, the clinical data(baseline characteristics, intraoperative information and hospitalization) of patients underwent first elective craniotomy under general anesthesia at Tianjin Huanhu Hospital from January 1, 2019 to December 31, 2021 were retrospectively collected. The patients were divided into pulmonary complication group (group P) and non-pulmonary complication group (group N) based on the occurrence of postoperative pulmonary complications. Ventilation-related risk factors for postoperative pulmonary complications were identified by the multivariate logistic regression analysis, and the accuracy of intraoperative tidal volume, peak airway pressure, respiratory rate and mechanical power in predicting postoperative pulmonary complications was assessed using the receiver operating characteristic curve.Results:A total of 555 patients were finally included, with 247 patients in group P and 308 patients in group N. The duration of mechanical ventilation, tidal volume, peak airway pressure, respiratory rate, mechanical power, length of hospitalization and mortality during hospitalization were significantly higher in group P than in group N ( P<0.05). The results of multivariate logistic regression analysis showed that intraoperative peak airway pressure, respiratory rate and mechanical power were risk factors for postoperative pulmonary complications ( P<0.05). The area under the receiver operating characteristic curve (95% confidence interval) of intraoperative peak airway pressure, respiratory rate and mechanical power in predicting postoperative pulmonary complications was 0.726(0.572-0.666), 0.619(0.684-0.768) and 0.958(0.942-0.974)respectively. Conclusions:Intraoperative mechanical power is an independent risk factor for postoperative pulmonary complications and an important ventilation parameter for predicting postoperative pulmonary complications in patients undergoing long-duration neurosurgery.

Objective The purpose of writing the"expert consensus on humanistic care for patients in hospice care"(hereinafter referred to as the"consensus")aims to standardize the practice of humanistic care in the field of hospice care,ensuring that humanistic care is integrated throughout the entire service process for hospice care patients and their families.Methods A systematic search was conducted in domestic and foreign databases for literature related to hospice care and humanistic care,including guidelines,expert consensuses,systematic reviews or Meta-analyses,and evidence summaries.High-quality evidence was evaluated,extracted,and summarized to form the initial draft of the"consensus".From June to October 2024,20 experts from the fields of hospice care,nursing humanities,and evidence-based nursing were invited to participate in 1 round of expert consultation.Among them,13 experts were selected for 2 rounds of expert demonstration meetings.After collating and analyzing the experts' opinions,the initial draft was revised and refined,ultimately resulting in the final version of the"consensus".Results The effective response rate of the consultation questionnaire was 100％,with expert authority coefficient of 0.880,judgment coefficient of 0.935,and familiarity level of 0.825.The Kendall harmony coefficient of the expert consultation was 0.134(P＜0.05).The"consensus"consisted of 13 aspects,including the targets and objectives,principles,institutional guarantees,environmental requirements,etc.Conclusion This"consensus"possesses strong scientific rigor and practicality,which can provide guidance and references for the practice of humanistic care in the field of hospice care,promoting the standardization and humanization of hospice care services.

The treatment of hair loss often involves the use of oral medications, topical applications and hair transplantation. However, these methods come with drawbacks such as poor effectiveness, significant side effects, high recurrence rates, or high costs. In recent years, fractional laser therapy has emerged as a new choice for hair loss treatment due to its safety, effectiveness and high tolerance. Nonetheless, its mechanism of action in treating hair loss, application protocols and therapeutic outcomes need further clarification for broader clinical application. This article summarizes the treatment principles of fractional laser therapy, elaborates on the application effects and safety of different types of fractional lasers in treating hair loss, providing these for clinical references.

Objective To compare ovulation recovery rate and metabolic indicators between ethinyl-estradiol/drospirenone(EE/DRSP)combined with orlistat and EE/DRSP alone in overweight/obese patients with polycystic ovary syndrome(PCOS).Methods This study was a randomized controlled clinical trial conducted based on the 2004 Rotterdam criteria.From October 2020 to December 2023,180 overweight/obese PCOS patients aged 20-40 were recruited from the Department of Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University.The patients were randomly divided into two groups in a 1∶2 ratio.Among them,60 patients received treatment with EE/DRSP(EE20 μg,DRSP 3 mg),while 120 patients received a combination treatment of EE/DRSP and orlistat(360 mg/d).The height,weight,waist circumference,hip circumference,and blood pressure of the patients were measured before treatment and after 12 weeks of treatment.Laboratory tests included measurements of follicle-stimulating hormone(FSH),luteinizing hormone(LH),fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR),free androgen index(FAI),alanine transaminase(ALT),aspartate transaminase(AST),gamma-glutamyl transferase(GGT),fasting plasma glucose(FPG),total cholesterol(TC),triglycerides(TG),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C),lipoprotein(a)[Lp(a)],sex hormone-binding globulin(SHBG),total testosterone(T),and free testosterone(FT).After 12 weeks of treatment,the medication was discontinued,and natural ovulation was observed.Results After 12 weeks of treatment,the ovulation rate of the EE/DRSP combined with orlistat group reached 70.8%,while the natural ovulation rate of the EE/DRSP group alone was only 35%,indicating that the ovulation rate was significantly increased after EE/DRSP combined with orlistat treatment.After 12 weeks of treatment,both groups showed a significant decrease in total testosterone,free testosterone,and low-density lipoprotein levels(all P<0.05),and the decrease in BMI,waist circumference,fasting insulin,and HOMA-IR in the EE/DRSP combined with orlistat group was greater than that in the EE/DRSP group alone(P<0.05).After treatment,both groups showed a significant increase in high-density lipoprotein and triglyceride levels(all P<0.05),with no significant changes in total cholesterol and fasting blood glucose(all P>0.05).Conclusion After 12 weeks of treatment,EE/DRSP combined with orlistat can significantly improve the ovulation rate of PCOS patients.It is superior to EE/DRSP alone in reducing androgen levels,body weight,insulin resistance,and low-density lipoprotein levels.