Objective To investigate the association between the Chinese visceral adiposity index(CVAI)and the risk of stroke incidence in middle-aged and older adults(≥45 years)using data from the China Health and Retirement Longitudinal Study(CHARLS).Methods Data from the 2015,2018,and 2020 CHARLS surveys were analyzed,focusing on middle-aged and older adults.The primary outcome was the occur-rence of new stroke events(including both hemorrhagic and ischemic strokes)during the follow-up period.Co-variates included general demographic characteristics,lifestyle factors,health status,and blood biomarkers.Cox proportional hazards regression models were used to explore the dose-response relationship between CVAI and stroke risk.Results A total of 11 432 middle-aged and older adults were included,with a mean age of 60.24±9.56 years.Among them,6157(53.86%)were women and 5275(46.14%)were men.Over a me-dian follow-up period of 5 years,905 individuals(7.92%,905/11 432)experienced a stroke.After adjusting for demographic and lifestyle covariates,each interquartile range(IQR)increase in CVAI was associated with a 28%higher risk of stroke(HR=1.28,95%CI:1.20-1.36).Compared to the first quartile(Q1),the third(Q3:HR=1.60,95%CI:1.30-1.97)and fourth quartiles(Q4:HR=2.02,95%CI:1.65-2.47)were significantly associated with an increased risk of stroke.Interaction analysis revealed a significant interaction be-tween CVAI and gender(Pfor interaction＜0.001).Restricted cubic spline analysis demonstrated a non-linear rela-tionship between CVAI and stroke risk(Pnonlinear=0.005).Conclusions Higher CVAI levels are associated with an increased risk of stroke.CVAI serves as an effective biomarker for identifying individuals at high risk of stroke and can inform primary stroke prevention strategies.

OBJECTIVE To investigate the serotypes and antimicrobial resistance rate of clinically isolated Salmonel-la in a children's hospital in Suzhou,and to provide reference for the treatment of salmonellosis.METHOD Totally 177 strains of Salmonella isolated from Children's Hospital of Wujiang District from Jan.2021 to Dec.2023 were collected,and the results of serotypes and drug sensitivity of Salmonella were analyzed.RESULTS The male to fe-male isolation rate of Salmonella was 1.39∶1,with a median age of children infection at 1.3(0.8,2.3)years.The highest number of Salmonella strains were isolated in the month of Jun.,followed by Jul.,Aug.,Sep.,Oct.and May,collectively accounting for 82.49％of all isolates.Acute gastroenteritis was manifested in 142 cases(80.22％),with respiratory tract infections in 38 cases(21.47％)and septicemia in 7 cases(3.95％).The differ-ence in detection rates across the three years was not statistically significant(P=0.806).Salmonella Typhimuri-um was the predominant serotype,representing 54.24％of all isolates.The antimicrobial drug with the highest rate of resistance in Salmonella was ampicillin(71.35％,122/171),followed by sulfamethoxazole/metronidazole(43.60％,75/172),and ampicillin/sulbactam(30.23％,52/172),and no imipenem resistant strains were found.29.07％(50/172)of strains showed multidrug resistance.CONCLUSIONS Boys under three years of age are sus-ceptible to Salmonella infections in summer and fall in this region,with Salmonella Typhimurium being the pre-dominant serotype.Clinical attention should be paid to the characteristics of Salmonella infection and drug resist-ance,as well as the early diagnosis and rational use of antimicrobial drugs.

Objective:To explore the efficacy and safety of sivelestat sodium in patients with acute respiratory distress syndrome (ARDS) in the intensive care unit (ICU).Methods:Sixty patients with ARDS admitted to the ICU of the Fuyang Hospital Affiliated to Anhui Medical University from August 1, 2023 to November 1, 2024 were selected and divided into the control group (conventional treatment, 30 cases) and the sivelestat sodium group (treated with sivelestat sodium in addition to conventional treatment, 30 cases) by the random number table method. The clinical data such as inflammatory factors, blood gas analysis indicators, Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score and Sequential Organ Failure Assessment (SOFA) score of the two groups of patients before treatment and 3 days after treatment were compared. The prognostic indicators such as mechanical ventilation time, ICU stay time, total hospital stay time, 28-day mortality rate and clinical efficacy of the two groups of patients were compared.Results:Before treatment, there were no statistically significant differences in inflammatory factors, blood gas analysis indicators, APACHE Ⅱ score and SOFA score between the two groups of patients (all P>0.05). After 3 days of treatment, the improvement degrees of APACHE Ⅱ score, SOFA score, arterial partial pressure of oxygen (PaO 2), oxygenation index (PaO 2/FiO 2), procalcitonin (PCT), interleukin-6 (IL-6), and C-reactive protein (CRP) in the sivelestat sodium group were all greater than those in the control group. The differences were all statistically significant (all P<0.05); The mechanical ventilation time [(5.31±4.12) d vs (7.17±2.32)d] and ICU stay [(6.31±3.42)d vs (8.93±5.26)d] of patients in the sivelestat sodium group were significantly shorter than those in the control group, and the differences were statistically significant (all P<0.05). There was no statistically significant difference in the 28-day mortality rate between the sivelestat sodium group [20.00%(6/30)] and the control group [43.33%(13/30)] ( P>0.05). The total effective rate of treatment in the sivelestat sodium group was significantly higher than that in the control group [80.00%(24/30) vs 56.67%(17/30)], and the difference was statistically significant (χ 2=4.167, P=0.041). Conclusions:Sivelestat sodium is helpful in improving the physiological parameters of patients with ARDS, effectively reducing the levels of inflammatory factors in the body, shortening the duration of mechanical ventilation and ICU stay, but has no significant effect on the 28-day mortality rate.

OBJECTIVE To investigate the serotypes and antimicrobial resistance rate of clinically isolated Salmonel-la in a children's hospital in Suzhou,and to provide reference for the treatment of salmonellosis.METHOD Totally 177 strains of Salmonella isolated from Children's Hospital of Wujiang District from Jan.2021 to Dec.2023 were collected,and the results of serotypes and drug sensitivity of Salmonella were analyzed.RESULTS The male to fe-male isolation rate of Salmonella was 1.39∶1,with a median age of children infection at 1.3(0.8,2.3)years.The highest number of Salmonella strains were isolated in the month of Jun.,followed by Jul.,Aug.,Sep.,Oct.and May,collectively accounting for 82.49％of all isolates.Acute gastroenteritis was manifested in 142 cases(80.22％),with respiratory tract infections in 38 cases(21.47％)and septicemia in 7 cases(3.95％).The differ-ence in detection rates across the three years was not statistically significant(P=0.806).Salmonella Typhimuri-um was the predominant serotype,representing 54.24％of all isolates.The antimicrobial drug with the highest rate of resistance in Salmonella was ampicillin(71.35％,122/171),followed by sulfamethoxazole/metronidazole(43.60％,75/172),and ampicillin/sulbactam(30.23％,52/172),and no imipenem resistant strains were found.29.07％(50/172)of strains showed multidrug resistance.CONCLUSIONS Boys under three years of age are sus-ceptible to Salmonella infections in summer and fall in this region,with Salmonella Typhimurium being the pre-dominant serotype.Clinical attention should be paid to the characteristics of Salmonella infection and drug resist-ance,as well as the early diagnosis and rational use of antimicrobial drugs.

Objective:To explore the efficacy and safety of sivelestat sodium in patients with acute respiratory distress syndrome (ARDS) in the intensive care unit (ICU).Methods:Sixty patients with ARDS admitted to the ICU of the Fuyang Hospital Affiliated to Anhui Medical University from August 1, 2023 to November 1, 2024 were selected and divided into the control group (conventional treatment, 30 cases) and the sivelestat sodium group (treated with sivelestat sodium in addition to conventional treatment, 30 cases) by the random number table method. The clinical data such as inflammatory factors, blood gas analysis indicators, Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score and Sequential Organ Failure Assessment (SOFA) score of the two groups of patients before treatment and 3 days after treatment were compared. The prognostic indicators such as mechanical ventilation time, ICU stay time, total hospital stay time, 28-day mortality rate and clinical efficacy of the two groups of patients were compared.Results:Before treatment, there were no statistically significant differences in inflammatory factors, blood gas analysis indicators, APACHE Ⅱ score and SOFA score between the two groups of patients (all P>0.05). After 3 days of treatment, the improvement degrees of APACHE Ⅱ score, SOFA score, arterial partial pressure of oxygen (PaO 2), oxygenation index (PaO 2/FiO 2), procalcitonin (PCT), interleukin-6 (IL-6), and C-reactive protein (CRP) in the sivelestat sodium group were all greater than those in the control group. The differences were all statistically significant (all P<0.05); The mechanical ventilation time [(5.31±4.12) d vs (7.17±2.32)d] and ICU stay [(6.31±3.42)d vs (8.93±5.26)d] of patients in the sivelestat sodium group were significantly shorter than those in the control group, and the differences were statistically significant (all P<0.05). There was no statistically significant difference in the 28-day mortality rate between the sivelestat sodium group [20.00%(6/30)] and the control group [43.33%(13/30)] ( P>0.05). The total effective rate of treatment in the sivelestat sodium group was significantly higher than that in the control group [80.00%(24/30) vs 56.67%(17/30)], and the difference was statistically significant (χ 2=4.167, P=0.041). Conclusions:Sivelestat sodium is helpful in improving the physiological parameters of patients with ARDS, effectively reducing the levels of inflammatory factors in the body, shortening the duration of mechanical ventilation and ICU stay, but has no significant effect on the 28-day mortality rate.

Objective To investigate the association between the Chinese visceral adiposity index(CVAI)and the risk of stroke incidence in middle-aged and older adults(≥45 years)using data from the China Health and Retirement Longitudinal Study(CHARLS).Methods Data from the 2015,2018,and 2020 CHARLS surveys were analyzed,focusing on middle-aged and older adults.The primary outcome was the occur-rence of new stroke events(including both hemorrhagic and ischemic strokes)during the follow-up period.Co-variates included general demographic characteristics,lifestyle factors,health status,and blood biomarkers.Cox proportional hazards regression models were used to explore the dose-response relationship between CVAI and stroke risk.Results A total of 11 432 middle-aged and older adults were included,with a mean age of 60.24±9.56 years.Among them,6157(53.86%)were women and 5275(46.14%)were men.Over a me-dian follow-up period of 5 years,905 individuals(7.92%,905/11 432)experienced a stroke.After adjusting for demographic and lifestyle covariates,each interquartile range(IQR)increase in CVAI was associated with a 28%higher risk of stroke(HR=1.28,95%CI:1.20-1.36).Compared to the first quartile(Q1),the third(Q3:HR=1.60,95%CI:1.30-1.97)and fourth quartiles(Q4:HR=2.02,95%CI:1.65-2.47)were significantly associated with an increased risk of stroke.Interaction analysis revealed a significant interaction be-tween CVAI and gender(Pfor interaction＜0.001).Restricted cubic spline analysis demonstrated a non-linear rela-tionship between CVAI and stroke risk(Pnonlinear=0.005).Conclusions Higher CVAI levels are associated with an increased risk of stroke.CVAI serves as an effective biomarker for identifying individuals at high risk of stroke and can inform primary stroke prevention strategies.

Objective:To evaluate the efficacy and safety of CD30 antibody-drug conjugates (ADC) brentuximab vedotin (BV) combined with chemotherapy in children with refractory or relapsed classic Hodgkin′s lymphoma (R/R cHL).Methods:Clinical data (including age, gender, B symptoms, clinical stage, previous treatment, etc.) of the 10 R/R cHL children diagnosed and treated at Beijing Children′s Hospital Affiliated to Capital Medical University from October 2021 to August 2023 were analyzed retrospectively. According to the different intensity of chemotherapy drugs, the dose of BV applied in the same course of treatment was 1.8 mg/kg for BV applied once every 3 weeks, and 1.2 mg/kg for BV applied once every 2 weeks. All 10 patients received at least 2 cycles of BV combined with chemotherapy and were evaluated every 2 cycles. The patients were followed up until May 31, 2024. The infusion reactions and adverse reactions after treatment were recorded.Results:In all 10 patients, there were 7 males and 3 females, the age ranged from 5.3-16.9 years, and there were 6 cases of refractory and 4 cases of relapsed. There were 6 cases of nodular sclerosis type, 2 cases of mixed cell type, 1 case of lymphocyte-rich type, and 1 case of lymphodepletion type. There were 5 cases of stage Ⅳ and 5 cases of stage Ⅲ. Previous treatment was mainly chemotherapy, 4 cases received radiotherapy and 1 case received programmed cell death protein 1 (PD-1) antibody therapy. The follow-up time ranged from 9 to 27 months. A total of 43 courses with 49 doses of BV alone or combined with chemotherapy were recorded, and the number of courses was 2 to 10 times. All 10 children responded to the treatment, and 9 achieved complete remission. BV infusion was successfully completed in all cases. A total of 28 cases of grade 3 or above adverse events were recorded, mainly myelosuppression, all of which were related to chemotherapy and did not affect sequential treatment.Conclusion:Brentuximab vedotin has demonstrated efficacy and a tolerable safety profile in the treatment of refractory and relapsed CD30-positive Hodgkin′s lymphoma in children.

Objective To investigate the effect of the Piezo1 channel on tension-side angiogenesis and osteogenic remodeling during orthodontic tooth movement,so as to provide an experimental basis for accelerating orthodontic peri-odontal tissue remodeling.Methods This study was approved by the Animal Ethics Committee.Sixty healthy male Sprague-Dawley rats with bilateral maxillary incisors as the anchorage were selected,and nickel titanium tension springs were used to apply 0.5 N of force to the right maxillary first molar of the rats and construct an orthodontic tooth movement model.The rats were randomly divided into three groups(n=20 per group).On Days 0 and 8 of force appli-cation,equal volumes of saline(control group),100 μmol/L Piezo1 channel agonist(Yoda1 group),and 48 μmol/L Piezo1 channel inhibitor(GsMTx4 group)were injected into the buccal and palatal submucosa of the right maxillary first molar.Tooth movement distances were recorded on Days 1,3,7,and 14.Five rats from each group were sacrificed at each time point to obtain maxillary tissue samples.Hematoxylin and eosin(HE)staining was performed to observe the histophysiological changes in the tension-side periodontal tissues.Immunohistochemical staining was used to mark and count CD31-positive cells(microvascular quantification)and to detect the expression of osteocalcin(OCN)in the tension side.Results Measurements of tooth movement distance showed that the Yoda1 group exhibited significantly in-creased tooth movement distances on Days 3,7,and 14(0.238±0.008 mm,0.406±0.011 mm,and 0.746±0.013 mm,respectively)compared to the control group(P＜0.05).In contrast,the GsMTx4 group showed significantly reduced tooth movement distances on Day 7(0.282±0.011 mm)and Day 14(0.578±0.008 mm)compared to the control group(P＜0.05).HE staining results indicated that the periodontal ligament space on the tension side gradually widened with the duration of force application and then gradually returned to normal,with visible osteoblasts.Quantitative analysis of CD31-positive cells(microvascular quantification)showed that the Yoda1 group had significantly increased numbers of blood vessels on Day 3(8.027±0.225)and Day 7(14.320±0.471)compared to the control group(P＜0.05),peaking on Day 7 and then gradually decreasing.The GsMTx4 group showed significantly fewer blood vessels in the periodontal ligament on the tension side on Day 3(6.013±0.177),Day 7(9.187±0.678),and Day 14(12.613±0.334)compared to the control group(P＜0.05).Immunohistochemical results indicated that the Yoda1 group had significantly increased OCN expression on Days 1,3,7,and 14 compared to the control group(P＜0.05),while the GsMTx4 group showed re-duced OCN expression on Days 7 and 14(P＜0.05).Conclusion Activation of the Piezo1 channel promotes orthodon-tic tooth movement,tension-side angiogenesis,and osteogenic remodeling,while inhibition of the Piezo1 channel produces the opposite effect.

Objective To study the brain functional connectivity(FC)changes in patients with normal tension glau-coma(NTG)and healthy volunteers using FC technique of resting-state functional magnetic resonance imaging(rs-fMRI)based on V1 region seed point(ROI),so as to explore the pathogenesis and early diagnosis of NTG.Methods Fourteen NTG patients(NTG group)who met the inclusion criteria and 14 healthy controls(HCs group)were enrolled.The clinical data of all subjects were collected,and rs-fMRI was performed in both groups.The magnetic resonance data was pre-pro-cessed by software,and bilateral A1 regions were taken as the ROI to analyze their correction with the whole brain voxel time series and obtain the FC value between the ROI and the whole brain by comparison of FC values in resting state be-tween the groups.Pearson correlation analysis was used to explore the relationship between FC value in the brain regions with significant differences with the ROI and clinical variables in the NTG group.Results Compared with the subjects in the HCs group,there were no statistically significant differences in age,gender,body weight,cup-disc ratio and 24 h mean intraocular pressure of patients in the NTG group(all P＞0.05),and there were statistically significant differences in the best corrected visual acuity(BCVA)of both eyes and peripapillary retinal nerve fiber layer thickness(RNFLT)(all P＜0.05).The Pearson correlation analysis showed that FC value of the brain regions with abnormal FC to V1 region were cor-related with RNFLT in the NTG group(P＜0.05).ROI1-left superior frontal gyrus,ROI1-right superior frontal gyrus,ROI2-left cingulate gyrus and ROI2-right middle frontal gyrus were significantly positively correlated with RNFLT(all P＜0.05).Compared with the HCs group,the brain regions with reduced FC to the right ROI in the NTG group were the left superior frontal gyrus and right superior frontal gyrus;the brain regions with reduced FC to the left ROI were the left cingulate gyrus and right middle frontal gyrus.Conclusion Compared to healthy individuals,NTG patients have significant changes in the functional connections between certain specific brain regions and V1 region,including bilateral superior frontal gyrus,left cingulate gyrus,and middle frontal gyrus.The changes in brain functional activity may be caused by visual dysfunction caused by NTG,leading to functional impairment of the visual and cognitive emotion processing brain regions,which may be one of the potential neuropathological mechanisms in NTG patients.

Objective To investigate the inhibitory effect of GsMTx4 on pain sensation in rats during tooth movement,open field ex-periments and immunohistochemical staining by conducting.Methods Fifty-eight male SD rats aged 5-6 weeks were selected and a right maxillary tooth movement model was constructed.The rats were randomly divided into two groups:group A(control group)and group B(GsMTx4 group).They were also divided into 5 subgroups according to 4 h,1 d,3 d,5 d,and 7 d.The left maxillary of the rats in group A was used as group C(blank control group).The open-field test was used to evaluate the pain level of rats.Immunohisto-chemical staining was used to observe the expression of nerve growth factor(NGF)and calcitonin gene-related peptide(CGRP)in peri-odontal tissues.Results At 4 h,1 d,and 3 d,the total distance traveled by rats in group B within 5 minutes in the open-field was higher than that of group A(P＜0.05).At 4 h and 1 d,the percentage of time in the center of rats in group B was higher than that in group A(P＜0.05).The expressions of NGF and CGRP in groups A and B were higher than those in group C on 1 d,3 d,5 d,and 7 d(P＜0.05).The expression of NGF and CGRP in group B were lower than those in group A at 4 h,1 d,and 3 d(P＜0.05).Conclu-sion GsMTx4 can inhibit the expression of NGF and CGRP during tooth movement and relieve the pain caused by tooth movement.