Starting from the intrinsic relationship between the glymphatic system and the core pathogenesis of vascular cognitive impairment （VCI）， including internal dampness， phlegm turbidity， and blood stasis， this paper explores clinical approaches to the diagnosis and treatment of VCI. Dysfunction of the kidney's role in governing water leads to the accumulation of dampness， phlegm turbidity， and blood stasis， which are key pathological mechanisms underlying the onset and progression of VCI. The glymphatic system participates in the circulation of cerebrospinal fluid within the central nervous system， and its impairment can result in reduced clearance of soluble metabolic waste products in the brain， a crucial factor contributing to VCI. It is proposed that the "kidney governing water" function is related to the glymphatic system， and that the cerebral collaterals correspond structurally to the glymphatic pathways. Clinically， therapies aimed at tonifying the kidney， resolving phlegm， activating blood circulation， and unblocking collaterals， such as modified Kaixin Powder （开心散）， which eliminates dampness and turbidity， transforms phlegm， restores consciousness， enhances cognition， and strengthens the brain， are commonly employed. These treatments may improve VCI prognosis by regulating glymphatic system function， providing a theoretical basis for the prevention and treatment of VCI with traditional Chinese medicine.

Objective To select the appropriate batch length and quality control procedure for the blood cell analysis project of the Women and Children's Hospital of Leshan with an online calculation tool of internal quality control frequency,and explored the measurement frequency of blood cell analysis laboratory quality control. Methods The coefficient of variation of blood cell analysis internal quality control of the Women and Children's Hospital of Leshan from April to December 2023 was collected as the imprecision of the project.The results of the laboratory participating in the 2023 National Health Commission inter-laboratory quality evaluation blood count experiment were used to evaluate the bias of each item. The allowable total error (TEa) for blood cell analysis items specified in WS/T 406-2012.Data were entered into the Westgard In-House Quality Control Frequency Calculator to calculate 10 corresponding batch lengths and different candidate statistical quality control (SQC) procedures online,including multi-rule,single-rule,and quality control concentration levels from 1 to 4.Combined with the actual situation of the laboratory,the SQC program with relatively simple quality control rules and relatively long batch length was selected. Results In blood cell analysis,13s,N=2 rule was used for WBC,HGB,MCV,MCH,MCHC,PLT,corresponding to the batch length of 1000. 13s/22s/R4s,N=2 rule was used for HCT,the corresponding batch length was 563,and the quality control frequency was 1 time per day. RBC was selected 13s/22s/R4s,N=2 rule,the corresponding batch length was 151,and the quality control frequency was 2 times a day or priority was given to improving the detection performance. Conclusion The Westgard internal quality control frequency calculator is an easy-to-use tool that allows select the right batch length and SQC program for lab,which can adjust the SQC protocol to needs.

Objective To select the appropriate batch length and quality control procedure for the blood cell analysis project of the Women and Children's Hospital of Leshan with an online calculation tool of internal quality control frequency,and explored the measurement frequency of blood cell analysis laboratory quality control. Methods The coefficient of variation of blood cell analysis internal quality control of the Women and Children's Hospital of Leshan from April to December 2023 was collected as the imprecision of the project.The results of the laboratory participating in the 2023 National Health Commission inter-laboratory quality evaluation blood count experiment were used to evaluate the bias of each item. The allowable total error (TEa) for blood cell analysis items specified in WS/T 406-2012.Data were entered into the Westgard In-House Quality Control Frequency Calculator to calculate 10 corresponding batch lengths and different candidate statistical quality control (SQC) procedures online,including multi-rule,single-rule,and quality control concentration levels from 1 to 4.Combined with the actual situation of the laboratory,the SQC program with relatively simple quality control rules and relatively long batch length was selected. Results In blood cell analysis,13s,N=2 rule was used for WBC,HGB,MCV,MCH,MCHC,PLT,corresponding to the batch length of 1000. 13s/22s/R4s,N=2 rule was used for HCT,the corresponding batch length was 563,and the quality control frequency was 1 time per day. RBC was selected 13s/22s/R4s,N=2 rule,the corresponding batch length was 151,and the quality control frequency was 2 times a day or priority was given to improving the detection performance. Conclusion The Westgard internal quality control frequency calculator is an easy-to-use tool that allows select the right batch length and SQC program for lab,which can adjust the SQC protocol to needs.

Objective To investigate the expressions of transmembrane protein 8(Tspan8)and integrin α5(ITGA5)in breast cancer and their relationship with clinicopathological features and prognosis.Methods A total of 136 breast cancer patients admitted to the hospital from April 2018 to April 2020 were enrolled in the study.Breast cancer tissue samples and corresponding paracancerous tissue samples were collected.The ex-pressions of Tspan8 and ITGA5 in breast cancer tissues and corresponding adjacent tissues were detected by immunohistochemistry.The relationship between the expressions of Tspan8 and ITGA5 and the clinicopatho-logical characteristics of breast cancer patients was analyzed.The discharged breast cancer patients were fol-lowed up for 36 months,and the survival status of the patients was recorded.The 3-year survival rate of breast cancer patients with different clinicopathological characteristics was compared.Multivariate Cox regression was used to analyze the influencing factors of axillary lymph node metastasis in breast cancer patients.Results The positive expression rates of Tspan8 and ITGA5 in breast cancer tissues were higher than those in adjacent tissues(P＜0.05).The positive expression rates of Tspan8 and ITGA5 in breast cancer patients with poor differentiation,tumor maximum diameter ≥3 cm,TNM stage Ⅲ-Ⅳ,axillary lymph node metastasis and other molecular subtypes were higher than those in moderate/well differentiation,tumor maximum diam-eter＜3 cm,TNM stage Ⅰ-Ⅱ,no axillary lymph node metastasis and triple negative subtype(P＜0.05).The 3-year survival rate of patients with positive expression of Tspan8 and ITGA5 was significantly lower than that of patients with negative expression of Tspan8 and ITGA5(P＜0.05).The 3-year survival rate of patients with poor differentiation,TNM stage Ⅲ-Ⅳ,axillary lymph node metastasis,other molecular sub-types and positive expressions of Tspan8 and ITGA5 were lower than those of patients with moderate/high differentiation,TNM stage Ⅰ-Ⅱ,no axillary lymph node metastasis,triple negative subtype and negative ex-pressions of Tspan8 and ITGA5(P＜0.05).TNM stage Ⅲ-Ⅳ(HR=2.289,95％CI:1.519-3.447),other molecular subtypes(HR=2.622,95％CI:1.744-3.942),Tspan8 positive expression(HR=3.622,95％CI:2.159-6.077)and ITGA5 positive expression(HR=3.142,95％CI:2.022-4.884)were risk factors for ax-illary lymph node metastasis in breast cancer patients(P＜0.05).Conclusion Tspan8 and ITGA5 are highly expressed in breast cancer patients,which are related to the clinicopathological characteristics and prognosis of patients.

Background Preterm birth-related complications are the leading cause of death in newborns and children under the age of 5 years. Maternal heat exposure has been associated with both sleep status during pregnancy and the increased risk of preterm birth. However, whether sleep status could mediate the association between heat exposure and preterm birth remains unclear. Objective To evaluate the association between maternal heat exposure in early pregnancy and preterm birth, and to further explore potential mediation effect of sleep status on the association between heat exposure and preterm birth. Methods A birth cohort was established in Guangzhou Panyu Maternal Child Health Hospital (Guangzhou Panyu District He Xian Memorial Hospital) from 2017 until now. Pregnant women (with gestational age between 8 and 13 weeks) were included in this study when they presented to the hospital for their first prenatal care visit and signed an informed consent. Then they were followed up until delivery. A total of 3 268 pregnant women were included for the final analysis. Questionnaires were distributed to collect the demographic characteristics, lifestyles, and sleep status of pregnant women. Daily meteorological data during the study period were collected from meteorological monitoring stations in Guangzhou and the average ambient mean temperature of four weeks before the survey was calculated and assigned for each pregnancy. The 75th, 80th, 85th, 90th, and 95th percentiles (P₇₅, P₈₀, P₈₅, P₉₀, and P₉₅) of the average ambient temperature of all pregnant women were used as the thresholds to define heat exposure. Logistic regression was used to evaluate the effects of heat exposure in different definitions on preterm birth and sleep status (sleep duration, night sleep timing, and wake up timing). The mediation effects of sleep status on the relationship between heat exposure and preterm birth were also analyzed. Results Among all the included participants, 165 newborns were preterm births with an incidence rate of 5.0%. Heat exposures with thresholds of P₉₀ and P₉₅ increased the risk of preterm birth, with ORs (95%CIs) of 1.66 (1.04-2.57) and 1.90 (1.03-3.33), respectively (P<0.05). Heat exposures with thresholds of P₇₅, P₈₀, P₈₅, P₉₀, and P₉₅ decreased the sleep duration (<9 h vs. ≥9 h, control group: ≥9 h), and the ORs (95%CIs) were 1.51 (1.25-1.83), 1.44 (1.17-1.77), 1.35 (1.08-1.70), 1.43 (1.09-1.87), and 1.45 (1.00-2.13), respectively. Heat exposures with P₇₅ and P₈₀ thresholds resulted in earlier wake up timing (<8: 00 vs. ≥8: 00, control group: <8: 00), with ORs (95%CIs) of 0.77 (0.63-0.93) and 0.76(0.61-0.93), respectively. No significant association was observed between heat exposure and night sleep timing. The mediation analyses showed that under heat exposure with P₉₀ threshold, a statistically significant mediation effect was observed for sleep duration, and the proportion mediated was 6.07% (95%CI: 0.17%-25.00%) (P<0.05). No significant mediation effect was observed for night sleep timing and wake up timing. Conclusion An elevated risk of preterm birth after heat exposure in early pregnancy may be partly mediated through reducing sleep duration.

Biologics have become the first-line drugs in the treatment of moderate to severe inflammatory bowel disease (IBD) , and anti-tumor necrosis factor-α (TNF-α) monoclonal antibodies are widely used now. However, during the course of treatment, patients′ primary non-response and secondary failure often occur. This article mainly reviews some related biomarkers from the perspectives of genetics, cytokines, intestinal microbiome and routine laboratory indicators to predict the response of anti-TNF-α monoclonal antibodies, and then monitor the efficacy of drugs to help the clinicians to switch the treatment and optimize the therapeutic schedule in time.

Biologics have become the first-line drugs in the treatment of moderate to severe inflammatory bowel disease (IBD) , and anti-tumor necrosis factor-α (TNF-α) monoclonal antibodies are widely used now. However, during the course of treatment, patients′ primary non-response and secondary failure often occur. This article mainly reviews some related biomarkers from the perspectives of genetics, cytokines, intestinal microbiome and routine laboratory indicators to predict the response of anti-TNF-α monoclonal antibodies, and then monitor the efficacy of drugs to help the clinicians to switch the treatment and optimize the therapeutic schedule in time.

Objective: To compare the effects of different types of strength training on upper limbs’ body composition and maximum strength and bone density of male university students, so as to provide a reference for college students to choose reasonable resistance training methods. Methods: Forty-two male university students were randomly divided into three experimental groups: maximum-strength group, MS(n=12); speed-strength group, SS(n=15); strength-endurance group, SE(n=15). All subjects were subject to resistance training for 6 weeks, twice a week. Incremental load method was used to determine the maximum strength of the subject to develop a training program. Upper limbs’ Body Composition and BMD were performed by Dual energy X-ray absorptionmetry. Results: After the continuous training for 6 weeks, maximum strength of upper limbs increased significantly with training time，SE grows faster[(51.00±4.81)(67.20±5.66)(76.87±6.21)kg]; The body fat percentage of SS group and SE group decreased significantly[(13.50±4.10)%，(12.60±2.80)%；(13.70±3.80)%，(12.70±3.10)%](t=2.35，2.30，P<0.05), while LM of upper limb increased significantly[(5.19±0.59)(5.86±0.61)；(5.27±0.72)(6.21±0.59)kg](t=-2.48，-2.94，P<0.05). There was no significant difference in the body fat percentage and LM of upper limb between MS group[(14.0±3.3)%，(13.6±2.3)%] and SE group[(5.33±0.81)(5.41±0.79)kg](t=0.31，-0.22，P>0.05); BMC and BMD of upper limbs increased in all groups, but the increase of SS group and SE group was statistically significant(t=-3.07，-2.43，P<0.05). Conclusion Strength endurance resistance training for male college students can effectively promote muscle strength growth, increase bone density and improve upper limb composition.

Objective To explore the influence of gender and age on auditory startle reflex in healthy adults.Methods A total of 150 healthy volunteers (92 males and 58 females) aged from 18 to 60 years were recruited for this study.A modified startle reflex paradigm was adopted.Furthermore,gender-age differences on startle magnitude,habituation,perceived spatial co-location induced prepulse inhibition (PSC-PPI) and perceived spatial separation-induced prepulse inhibition (PSS-PPI) in healthy volunteers were analyzed.Results ① There was no significant difference in amplitude and habituation of startie reflex between males and females (F=0.29,P=0.593;F=1.57,P=0.212).PSC-PPI and PSS-PPI were significantly higher in males (PSC-PPI:(34.68± 20.81) ％,PSS-PPI:(44.56 ± 23.19) ％) than those in females (PSC-PPI:(23.11±22.43)％,PSS-PPI:(35.21±25.09)％) (F=9.48,P=0.002;F=4.76,P=0.031).② There was a negative correlation between startle magnitude and age (r=-0.29,P＜0.01),however,no obvious correlations between age and PSC-PPI or PSS-PPI as well as habituation were observed.③Bivariate analysis of variance showed that no interaction between gender and age was found to the indexes of startle reflex(F=0.71-1.36,all P＞0.05).Conclusions There are differences for gender and age in the indexes of startle reflex.In detail,age chiefly influences startle magnitude,while gender mainly affects the prepulse inhibition.

Objective To investigate severe complications of inferior vena cava filter (IVCF) applying for preventing pulmonary embo-lism after spinal cord injury. Methods From December 2014 to July 2015, 95 patients with acute spinal cord injury (SCI) in our hospital were retrospected. Results Deep venous thrombosis (DVT) appeared in 23 cases, in which 15 cases placed IVCF. All patients accepted anti-coagulant therapy, except 10 cases with contraindication. 3 cases had severe complication, in which 2 cases had comprehensive DVT distal to IVCF, with both lower limbs severe swelling, acute renal inadequacy and hypertension;1 case had continuous hyperpyrexia. Conclusion Although the IVCF placement was widely used in acute SCI for preventing pulmonary embolism in patients with DVT, however, the selec-tion of IVCF and complication prevention should be taken into account.