Objective To explore the current situation of disease perception in patients with tophi and its correlation with the quality of life. Methods A retrospective analysis was conducted on 303 gout patients admitted to the Shanghai Sixth People's Hospital from January 2023 to December 2024. The patients were classified into tophi gout (n=150) and non-tophi gout (n=153) groups based on whether they were tophi gout or not. The current disease perception status and quality of life of the two groups were compared using Simplified Chinese Version of the Disease Cognition Questionnaire (BIPQ) and Short Form of Health Survey (SF-36). Logistic regression was used to analyze the influencing factors of the quality of life of patients with tophi gout. Results Compared with the non-tophaceous gout group, the tophaceous gout group had a higher BIPQ score, and a lower SF-36 score (P<0.05). Among patients with tophaceous gout, 80 cases had good quality of life, and 70 cases had poor quality of life. These patients were included in the good quality of life group (n=80) and the poor quality of life group (n=70), respectively. Compared with the good quality of life group, patients in the poor quality of life group had longer gout course and average duration of each gout attack, as well as higher 20-item tophi impact questionnaire (TIQ-20) score and BIPQ score (P<0.05). Logistic regression analysis showed that the course of gout (OR=1.070, 95% CI: 1.017-1.126, P=0.009), TIQ-20 score (OR=1.048, 95% CI: 1.022-1.075, P<0.001), and BIPQ score (OR=1.055, 95%CI: 1.009-1.104, P=0.019) were risk factors affecting the quality of life in patients with tophaceous gout (P<0.05). Conclusion The course of gout, TIQ-20 score and BIPQ score are risk factors affecting the quality of life of patients with tophi gout.

Copper is an essential trace element in the human body, extensively involved in key physiological and biochemical processes such as antioxidant defense, energy metabolism, neural signaling, and immune regulation. In recent years, increasing research has focused on the potential role of copper dyshomeostasis in the development of chronic diseases. Studies indicate that abnormal copper levels, particularly elevated free copper, may increase the risk of cardiovascular disease, neurodegenerative disorders, diabetes, and cancer by inducing oxidative stress, impairing mitochondrial function, and disrupting immune regulation. Concurrently, copper homeostasis abnormalities have been demonstrated to be closely associated with increased all-cause mortality and accelerated aging. This systematic review comprehensively examined physiological functions, metabolic pathways, and environmental exposure characteristics of copper. It emphasized the epidemiological and mechanistic links between copper metabolism disorders and multiple chronic diseases, while exploring the potential applications of copper ion transporters and chelating agents in disease intervention. This work provides scientific evidence for the prevention, control, and precision treatment of copper-related chronic diseases.

Objective To analyze the rules and characteristics of cross-allergy cases related to drug-related medical disputes,and to provide reference for the formulation of cross-allergy prescription review strategy.Methods The judgments of cross-allergy related medical damage liability disputes recorded in the legal document database of Beijing Yingke Law Firm and the Chinese Judgment Document Network database from August 2010 to June 2023 were analyzed,the causes of relevant disputes were summarized and analyzed,and more comprehensive response measures were formulated.Results A total of 65 judgments were retrieved,and seven judgments were included.The main drugs causing cross allergy were antibiotics(penicillins,cephalosporins and sulfonamides).Seven cases of medical disputes,all of which were ruled by the court that the medical party had medical errors due to cross-allergies,and had to bear 30％to 80％of the compensation liability.The main reasons for the punishment were that the doctor did not pay enough attention to the patient's past history of allergy and chose unreasonable drugs.Conclusion Medical institutions can reduce the risk of cross-allergy by means of information technology,and play the role of pharmacists in prescription review and pharmaceutical care.Physicians should pay attention to the patient's past history,earnly inquire,strengthen medication education and monitoring,reduce the threat of adverse reactions to the patient's life safety and related drug disputes,and protect the legitimate rights and interests of both doctors and patients.

Objective:To analyze the clinical phenotype, sperm morphological characteristics and assisted reproductive therapy efficiency in patients with total globozoospermia.Methods:Four male patients with total globozoospermia were collected during November 2019 to May 2022 from Reproductive Medical and Genetic Center, the People's Hospital of Guangxi Zhuang Autonomous Region. Peripheral blood samples were collected for genetic detection and the whole exome sequencing to explore the pathogenic genes. Semen characteristics, sperm morphology and ultrastructure were analyzed. Four patients were treated with intracytoplasmic sperm injection (ICSI) combined with artificial oocyte activation (AOA). Conventional ICSI cycles ( n=9) were selected as control group, and the development dynamic parameters were monitored by Time-lapse. The fertilization and embryo development parameters, developmental dynamic parameters and clinical outcomes were analyzed between the two groups. Results:Four patients were complicated with low sperm motility and increased sperm DNA fragmentation. Sperm morphology analysis and acrosome fluorescence staining represented that all the spermatozoas were with a small round head lacked of acrosome. By the transmission electron microscope, it was observed that round-headed spermatozoas were lacked of acrosome completely, loose chromatin structure, vacuolation and other abnormal changes in the head, mitochondrial sheath in neck were reduced arranged in disorder, and the structure of "9+2" of the flagellar axial filament was incomplete. Of the 4 patients, 1 was homozygous deletion of DPY19L2 gene and 1 was homozygous frameshift mutation of DPY19L2 gene. There were no significance differences in fertilization rate, two pronuclei fertilization rate, day 3 high-quality embryo rate, day 6 blastocyst formation rate and day 6 high-quality blastocyst formation rate between total globozoospermia group and control group (all P>0.05). The developmental dynamic parameters as the time at which the second polar body is extruded, the time when both (or the last) PN disappear, two to six discrete cells in the total globozoospermia group were significantly earlier than those in control group, and the difference was statistically significant (all P<0.05). There was no significant difference in the embryo cleavage patterns between the two groups ( P>0.05). Among the 4 patients with total globozoospermia, 2 live births with signal healthy male baby were achieved by fresh embryo transfer, and 2 live births with one signal healthy male baby and one healthy female baby were achieved by frozen-thawed embryo transfer respectively. Conclusion:Abnormal morphology characteristics of spermatozoas from patients with total globozoospermia are obvious, patients with total globozoospermia could have favorable clinical outcomes following ICSI combined with AOA.

Objective:To analyze the clinical phenotype, sperm morphological characteristics and assisted reproductive therapy efficiency in patients with total globozoospermia.Methods:Four male patients with total globozoospermia were collected during November 2019 to May 2022 from Reproductive Medical and Genetic Center, the People's Hospital of Guangxi Zhuang Autonomous Region. Peripheral blood samples were collected for genetic detection and the whole exome sequencing to explore the pathogenic genes. Semen characteristics, sperm morphology and ultrastructure were analyzed. Four patients were treated with intracytoplasmic sperm injection (ICSI) combined with artificial oocyte activation (AOA). Conventional ICSI cycles ( n=9) were selected as control group, and the development dynamic parameters were monitored by Time-lapse. The fertilization and embryo development parameters, developmental dynamic parameters and clinical outcomes were analyzed between the two groups. Results:Four patients were complicated with low sperm motility and increased sperm DNA fragmentation. Sperm morphology analysis and acrosome fluorescence staining represented that all the spermatozoas were with a small round head lacked of acrosome. By the transmission electron microscope, it was observed that round-headed spermatozoas were lacked of acrosome completely, loose chromatin structure, vacuolation and other abnormal changes in the head, mitochondrial sheath in neck were reduced arranged in disorder, and the structure of "9+2" of the flagellar axial filament was incomplete. Of the 4 patients, 1 was homozygous deletion of DPY19L2 gene and 1 was homozygous frameshift mutation of DPY19L2 gene. There were no significance differences in fertilization rate, two pronuclei fertilization rate, day 3 high-quality embryo rate, day 6 blastocyst formation rate and day 6 high-quality blastocyst formation rate between total globozoospermia group and control group (all P>0.05). The developmental dynamic parameters as the time at which the second polar body is extruded, the time when both (or the last) PN disappear, two to six discrete cells in the total globozoospermia group were significantly earlier than those in control group, and the difference was statistically significant (all P<0.05). There was no significant difference in the embryo cleavage patterns between the two groups ( P>0.05). Among the 4 patients with total globozoospermia, 2 live births with signal healthy male baby were achieved by fresh embryo transfer, and 2 live births with one signal healthy male baby and one healthy female baby were achieved by frozen-thawed embryo transfer respectively. Conclusion:Abnormal morphology characteristics of spermatozoas from patients with total globozoospermia are obvious, patients with total globozoospermia could have favorable clinical outcomes following ICSI combined with AOA.

ObjectiveTo explore the influencing factors of willingness to quit smoking in smokers， and to provide reference for further smoking cessation intervention. MethodsThrough purposive sampling， smokers were recruited from 4 residential communities and 3 companies in Shanghai for an online questionnaire survey. The survey included general demographic characteristics， willingness to quit smoking， smoking condition， tobacco addiction， awareness of influence of smoking， smoking abstinence self-efficacy， and smoking rationalization belief. T-test， χ² test and multiple logistic regression were used to analyze the data. ResultsA total of 336 valid questionnaires were collected. The average age of the smokers was （37.1±10.2） years， and most of their education level was college or above （58.3%）. The daily number of cigarette use was （11.46±7.22） and most of smokers were classified as low nicotine dependence （58.3%）. Today 248 smokers planned to quit smoking in the next six months. Compared with smokers with low smoking abstinence self-efficacy， smokers with high self-efficacy were more likely to quit smoking （OR=2.406，95%CI： 1.357‒4.267）； Smokers with low smoking rationalization belief were more likely to quit smoking than those with high rationalization belief （OR=2.112， 95%CI： 1.167‒3.821）. ConclusionSmoking abstinence self-efficacy has a positive impact on willingness to quit smoking， while smoking rationalization belief has a negative impact on the willingness to quit smoking. Efforts to improve smoking abstinence self-efficacy and dispel smoking rationalization beliefs of smokers should be made to promote the intention to quit among smokers.

Abstract E cigarette has become more and more popular among adolescents, and the awareness and use of e cigarettes among middle and high school students have shown a significant upward trend. E cigarette use is not only harmful to adolescent health, but also may become a gateway to other addictive substances. Individual characteristics, products features, environment and other factors were associated with e cigarette use among adolescents. The purpose of the review is to understand the current status and associated factors of adolescent e cigarette use, so as to provide scientific suggestions for the prevention of e cigarette use among adolescents.

ObjectiveTo evaluate the warning effect of different tobacco packaging on teenagers and provide an objective evidence for improving tobacco packaging in China. MethodsA multi-stage cluster sampling method was used to investigate students from two middle schools and two high schools in Huangpu District， Shanghai with a self-filled questionnaire survey， and a total of 1 238 valid questionnaires were collected. Epidata 3.1 was used to input data and SPSS 20.0 was used for data analysis. ResultsAbout 69% of the respondents supported printing pictures of diseases on tobacco packages in China， and 81.58% thought graphic warnings should cover more than 70% of the tobacco package. The effect of graphic health warning labels was better than that of text-only warning labels （P<0.05）， and the effect of real photos was better than abstract pictures. In addition， labels with real graphic warnings had the highest scores in terms of preventing youth smoking and the degree of support， which was significantly different from abstract graphic warning labels and text-only warning labels （P<0.05）. ConclusionCigarette packs with graphic health warnings have a stronger effect on teenagers than plain text health warnings. Teenagers support the use of graphic warnings. It is recommended to apply graphic health warnings with real photos of diseases on the cigarette packages to maximize the effect of the health warnings.

Objective:To investigate the effect of hyperbaric oxygen (HBO) therapy on microglia polarization after traumatic brain injury (TBI) in rats.Methods:A total of 168 8-week-old SD rats were randomly divided into sham operation (SH) group, sham operation+ HBO (SH+ HBO) group, traumatic brain injury (TBI) group, and traumatic brain injury+ HBO (TBI+ HBO) group, with 42 rats in each group. The TBI rat model and sham operation rat model were established. The observation time points of each group were 1 h, 6 h, 12 h, 24 h, 72 h, 7 d and 14 d. The SH+ HBO group and the TBI+ HBO group were treated with HBO. The modified neurological severity score (mNSS) was used to evaluate the recovery of the neurological function in TBI rats. After taking the injured brain tissues from the decapitated rats, the inducible nitric oxide synthase (iNOS), a microglia marker, and chitinase 3-like 3 (YM1) were detected by Western blotting. The expression levels of IL-6 and IL-10 were detected by ELISA.Results:Compared with the TBI group, mNSS in the TBI+ HBO group was decreased significantly at 7 d and 14 d after injury ( P<0.05). Compared with the SH group and the SH+ HBO group, the expression levels of iNOS protein in brain tissues of the TBI group and the TBI+ HBO group were significantly increased at 24 h, 72 h, and 7 d after TBI ( P<0.05). Compared with the TBI group, the expression levels of iNOS protein in brain tissues of the TBI+ HBO group were significantly decreased at 72 h and 7 d after TBI ( P<0.05). Compared with the SH group and the SH+ HBO group, the expression levels of YM1 protein in brain tissues of the TBI group and the TBI+ HBO group were significantly increased at 6 h, 12 h, 24 h, and 72 h after TBI ( P<0.05); compared with the TBI group, the expression levels of YM1 protein in brain tissues of the TBI+ HBO group were significantly increased at 12 h and 24 h after TBI ( P<0.05). Compared with the SH group and the SH+ HBO group, the expression levels of IL-6 in the TBI group and the TBI+ HBO group were increased significantly after TBI ( P<0.05); compared with the TBI group, the expression levels of IL-6 in the TBI+ HBO group were decreased significantly at 24 h, 72 h, and 7 d after TBI ( P<0.05). Compared with the SH group and the SH+ HBO group, the expression levels of IL-10 in the TBI group and the TBI+ HBO group were significantly increased after TBI ( P<0.05); compared with the TBI group, the expression levels of IL-10 in the TBI+ HBO group were significantly increased at 24 h and 72 h after TBI ( P<0.05). Conclusion:HBO treatment can effectively improve the hypoxic-ischemic state in injured brain tissues of TBI rats, promote the restoration of blood-brain barrier, facilitate the repopulating of M2 type microglia, and promote the polarization of microglia from M1 to M2 in the early stage of brain injury.

Objective:To investigate the effect of hyperbaric oxygen (HBO) therapy on microglia polarization after traumatic brain injury (TBI) in rats.Methods:A total of 168 8-week-old SD rats were randomly divided into sham operation (SH) group, sham operation+ HBO (SH+ HBO) group, traumatic brain injury (TBI) group, and traumatic brain injury+ HBO (TBI+ HBO) group, with 42 rats in each group. The TBI rat model and sham operation rat model were established. The observation time points of each group were 1 h, 6 h, 12 h, 24 h, 72 h, 7 d and 14 d. The SH+ HBO group and the TBI+ HBO group were treated with HBO. The modified neurological severity score (mNSS) was used to evaluate the recovery of the neurological function in TBI rats. After taking the injured brain tissues from the decapitated rats, the inducible nitric oxide synthase (iNOS), a microglia marker, and chitinase 3-like 3 (YM1) were detected by Western blotting. The expression levels of IL-6 and IL-10 were detected by ELISA.Results:Compared with the TBI group, mNSS in the TBI+ HBO group was decreased significantly at 7 d and 14 d after injury ( P<0.05). Compared with the SH group and the SH+ HBO group, the expression levels of iNOS protein in brain tissues of the TBI group and the TBI+ HBO group were significantly increased at 24 h, 72 h, and 7 d after TBI ( P<0.05). Compared with the TBI group, the expression levels of iNOS protein in brain tissues of the TBI+ HBO group were significantly decreased at 72 h and 7 d after TBI ( P<0.05). Compared with the SH group and the SH+ HBO group, the expression levels of YM1 protein in brain tissues of the TBI group and the TBI+ HBO group were significantly increased at 6 h, 12 h, 24 h, and 72 h after TBI ( P<0.05); compared with the TBI group, the expression levels of YM1 protein in brain tissues of the TBI+ HBO group were significantly increased at 12 h and 24 h after TBI ( P<0.05). Compared with the SH group and the SH+ HBO group, the expression levels of IL-6 in the TBI group and the TBI+ HBO group were increased significantly after TBI ( P<0.05); compared with the TBI group, the expression levels of IL-6 in the TBI+ HBO group were decreased significantly at 24 h, 72 h, and 7 d after TBI ( P<0.05). Compared with the SH group and the SH+ HBO group, the expression levels of IL-10 in the TBI group and the TBI+ HBO group were significantly increased after TBI ( P<0.05); compared with the TBI group, the expression levels of IL-10 in the TBI+ HBO group were significantly increased at 24 h and 72 h after TBI ( P<0.05). Conclusion:HBO treatment can effectively improve the hypoxic-ischemic state in injured brain tissues of TBI rats, promote the restoration of blood-brain barrier, facilitate the repopulating of M2 type microglia, and promote the polarization of microglia from M1 to M2 in the early stage of brain injury.