Objective:To gain a understanding of the occurrence of cognitive impairment among residents in drinking water-borne endemic fluorosis (drinking water-borne fluorosis) areas, and to study its influencing factors.Methods:In March 2023, a cluster sampling method was used to select local residents aged 18 and above from the drinking water-borne fluorosis areas in Jishan County, Shanxi Province as survey subjects. General demographic data were collected through face-to-face surveys, and a random urine sample was collected once to determine urinary fluoride level. Cognitive function was assessed using the mini-mental state examination (MMSE), and the survey subjects were divided into a cognitive impairment group ( < 27 points) and a control group (27 - 30 points) based on the MMSE scores. A multiple logistic regression model and a decision tree model based on chi-squared automatic interaction detector were constructed to analyze the factors affecting cognitive impairment, and the model fitting effect was evaluated using receiver operating characteristic (ROC) curve.Results:A total of 3 301 subjects were included in the survey, including 2 081 females and 1 220 males. There were 1 515 subjects < 60 years old and 1 786 subjects ≥60 years old, with urinary fluoride level [ M ( Q1, Q3)] of 2.92 (1.78, 4.54) mg/L. There were 1 939 cases in the cognitive impairment group and 1 362 cases in the control group, with a detection rate of 58.74% (1 939/3 301) for cognitive impairment; and the differences in gender, age, education level, marital status, annual household income, alcohol consumption, smoking distribution, and urinary fluoride level between the two groups were statistically significant ( P < 0.05). The results of multiple logistic regression analysis showed that female, ≥60 years, and urinary fluoride > 4.54 mg/L were risk factors for cognitive impairment [ OR (95% CI): 1.25 (1.01, 1.54), 2.66 (2.26, 3.14), 1.32 (1.06, 1.65), P < 0.05]. Education level of primary school or above, annual household income≥12 000 yuan, and mild alcohol consumption were protective factors for cognitive impairment [ OR (95% CI): 0.15 (0.09, 0.25), 0.58 (0.48, 0.68), 0.67 (0.51, 0.87), P < 0.05]. The analysis results of the decision tree model showed that age had the greatest impact on the occurrence of cognitive impairment, followed by annual household income, education level, and urinary fluoride. The areas under the ROC curves of the multiple logistic regression and decision tree model were 0.72 and 0.70 ( P < 0.001), respectively, indicating good model fitting performance. Conclusion:The detection rate of cognitive impairment in residents of drinking water-borne fluorosis areas is relatively high, and age, annual household income, education level, and urinary fluoride are all influencing factors for occurrence of cognitive impairment.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Trichinella spiralis zinc metalloproteinase NAS-36 gene(TsNas36)is a member of the zinc metalloproteinase family found in excretory secretory products(ESP)of T.spiralis.In this study,TsNas36 gene was cloned and expressed,and its biological characteristics and temporal and spatial characteristics were identified.These results provide a theoretical and material basis for ex-ploring the biological function of TsNas36 gene.Bioinformatics analysis showed that TsNas36 was 470 amino acids(AA)in length with a molecular weight of about 54.69 kDa,no transmembrane region,and contained a signal peptide(1-20 AA),an Astacins domain(116-320 AA)and a CUB domain(355-470 AA).There were five active site residues located at amino acids 216(His),217(Glu),220(His),226(His)and 275(Tyr).The expression plasmid pET-28a(+)/TsNas36 was constructed and induced to express in E.coli BL21(DE3)to obtain the recombinant protein rTs-Nas36.The recombinant protein was used to immunize rabbits to obtain anti-rTsNas36 polyclonal antibody serum.Indirect ELISA results showed that the antibody titer reached 1∶105.qRT-PCR and Western blot results showed that the transcription levels of TsNas36 were significantly higher in newborn larvae(NBL)than in adult worm(AW)and muscle larva(ML)stages.Immunofluo-rescence results showed that TsNas36 was only localized in the epidermis of NBL.In summary,this study characterized the biological characteristics of the TsNas36 gene and found that this gene is highly period-specific and may be involved in the unique developmental process of NBL.

Magnetic stimulation has made significant strides in the treatment of psychiatric disorders. Nonetheless, current magnetic stimulation techniques lack the precision to accurately modulate specific nuclei and cannot realize deep brain magnetic stimulation. To address this, we utilized superparamagnetic iron oxide nanoparticles as mediators to achieve precise targeting and penetration. We investigated the effects of magnetic fields with varying frequencies on neuronal activity and compared the activation effects on neurons using a 10-Hz precise magneto-stimulation system (pMSS) with repetitive transcranial magnetic stimulation in mice. Oxytocin levels, dendritic morphology and density, and mouse behavior were measured before and after pMSS intervention. Our findings suggest that pMSS can activate oxytocinergic neurons, leading to upregulation of oxytocin secretion and neurite outgrowth. As a result, sociability was rapidly improved after a one-week pMSS treatment regimen. These results demonstrate a promising magneto-stimulation method for regulating neuronal activity in deep brain nuclei and provide a promising therapeutic approach for autism spectrum disorder.
Animals ; Autism Spectrum Disorder/physiopathology* ; Paraventricular Hypothalamic Nucleus/physiology* ; Disease Models, Animal ; Transcranial Magnetic Stimulation/methods* ; Male ; Social Behavior ; Mice ; Oxytocin/metabolism* ; Mice, Inbred C57BL ; Neurons/physiology*

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To investigate the relationship between oxygen consumption (VO 2), carbon dioxide production (VCO 2), and Oxygen Consumption/lactate (VO 2/Lac) with risk of death in patients with severe ARDS. Methods:A retrospective cohort study method was used, and the study subjects were hospitalized for >5 days adult patients with severe ARDS in the central intensive care unit of Henan Provincial People's Hospital from 1 March 2020 to 30 June 2023. The following patients were excluded: IC test was not completed on the 4th day of ICU admission, IC test results were unreliable, mechanical ventilation duration had exceeded 48 h at the time of ICU transfer or admission, palliative care patients and pregnant and parturient women. Using indirect calorimetry to determine VO 2 and VCO 2 values on the 4th day of admission, reviewing medical records to obtain general condition, disease information, blood gas analysis (including lactate value), diagnostic and therapeutic measures, and following up deaths by telephone and time of death. The primary outcome measure was death at 90 days, and the secondary outcome measure was death at 28 days, length of stay in ICU, total length of stay, and total hospitalization cost. Cox regression analysis and linear regression analysis were used to investigate the relationship between VO 2, VCO 2, VO 2/Lac and primary and secondary outcome indexes. Results:A total of 216 patients were enrolled, 78 patients (36.1%) died and 138 patients (63.9%) survived at 90 days. After correction for confounders, the results of multifactorial Cox regression analysis suggested that compared with the Q4 group, HR (95% CI) for 90-day risk of death in the VO 2 Q1 and Q2 groups was 3.21 (1.38, 7.49) and 3.24 (1.42, 7.38), and HR (95% CI) for 90-day risk of death in the VCO 2 Q1, Q2 and Q3 groups was 5.88 (2.33, 14.84), 4.26 (1. 60, 11.34) and 3.54 (1.34, 9.35), respectively, and the HR (95% CI) for 90-day risk of death in the VO 2/Lac Q1, Q2 and Q3 groups were 8.72 (3.01, 25.25), 8.43 (2.91, 24.47) and 4.04 (1.34, 12.17) respectively. P-trends were all <0.05, indicating that VO 2, VCO 2 and VO 2/Lac were linearly and negatively associated with the risk of 90-day mortality. In addition, VO 2, VCO 2, and VO 2/Lac were negatively associated with 28-day risk of death and higher VO 2/Lac was negatively associated with length of ICU stay. Conclusions:VO 2, VCO 2 and VO 2/Lac were negatively associated with 90-day mortality risk and 28-day mortality risk in patients with severe ARDS and may be independent risk factors predicting mortality risk of such patients.

Objective:To design a set of simulation system for surgical operation based on virtual reality(VR)technique and intelligent scoring functions,so as to assess its clinical application effect.Methods:The Digital Imaging and Communications in Medicine(DICOM)images of typical patients were collected.Materialise Interactive Medical Image Control System(MIMICS)software was adopted to reconstruct the three-dimensional(3D)model of diseased organs.Surgical instrument models were constructed by using 3D Max software.Unity 3D software was adopted to construct simulation system for surgical operation with VR+intelligent scoring.A total of 40 surgical resident physicians,who were employed with 3 years since 2019 in The Second Affiliated Hospital of Kunming Medical University,were selected.They were divided into observation group and control group,with 20 cases in each group.The observation group used simulation system for surgical operation to conduct intelligent scoring for cholecystectomy under laparoscope,and the control group used conventional scoring for surgical operation.The scores of surgical operation and test between the two groups were compared.Results:The mean value of surgical operation time of the observation group was(1.72±0.41)h,and the average incidence of complication was(0.03±0.02)%,both of them of the observation group were significantly lower than those of the control group[(2.25±0.42)h and(0.05±0.03)%].The differences of them between two groups were statistically significant(t=9.00,4.08,P<0.05).The test scores of surgical operation of the observation group was also significantly higher than that of the control group(t=5.26,P<0.001).Conclusion:The developed simulation system for surgical operation with VR+intelligent scoring can significantly enhance users'surgical operation skills and improve learning outcomes,which has favorable prospects in future applications.

Objective To investigate the correlation and predictive value of serum ferritin(SF),25(OH)D and early renal damage in children with new type 1 diabetes mellitus(T1DM).Methods A total of 102 newly diagnosed T1DM children admitted to the Department of Endocrinology,Genetics and Metabolism of our hospital from January 2020 to June 2023 were collected as the study objects.According to UACR,the study subjects were divided into T1DM group<30 mg/g(n=50),microalbuminuria group 30～300 mg/g(MUAlb)group(n=32),and macroalbuminuria group>300 mg/g(CUAlb)group(n=20).Another 65 healthy children who underwent physical examination during the same period were selected as normal control(NC)group.General data and biochemical indexes of all groups were compared to analyze the correlation and predictive value of changes in SF and 25(OH)D levels with early renal damage.Results The levels of SF and TG in NC,T1DM,MUAlb and CUAlb groups increased in turn(P<0.05),while 25(OH)D decreased in turn(P<0.05).The levels of TC,FC-P,FPG and HbA1c in the T1DM,MUAlb and CUAlb groups were higher than those in the NC group(P<0.05),and the levels of FIns was lower than that in the NC group(P<0.05).The level of LDL-C in MUAlb and CUAlb groups were higher than in NC group(P<0.05),the levels of TC,FPG and HbA1c in MUAlb and CUAlb groups were higher than those in T1DM group(P<0.05),and UACR was higher than that in NC and T1DM groups(P<0.05).LDL-C in MUAlb group was higher than that in T1DM group(P<0.05).Blood urea in the CUAlb group were higher than those in the NC group(P<0.05),Scr and UACR was higher than that in the MUA1b group(P<0.05),and eGFR was higher than that in the T1DM,MUAlb,and CUAlb groups(P<0.05).Spearman correlation analysis showed that SF were positively correlated with TC,LDL-C,TG,UACR and HbA1c(P<0.05)and negatively correlated with 25(OH)D(P<0.05).25(OH)D was negatively correlated with TC,LDL-C,TG,UACR,HbA1c(P<0.05).Logistic regression analysis showed that SF and 25(OH)D were the influencing factors of early renal injury in children with T1DM.ROC curve analysis showed that the area under the curve of SF and 25(OH)D was 0.813 and 0.808,with the sensitivity 67.3%and 78.8%,the specificity 80.0%and 72.0%,and the cut-off values were 113.6 ng/ml and 54.17 nmol/L,respectively.Conclusions The changes in serum SF and 25(OH)D levels are associated with different stages of early renal damage and may be involved in the occurrence and development of early renal damage in children with T1DM.

Trichinella spiralis zinc metalloproteinase NAS-36 gene(TsNas36)is a member of the zinc metalloproteinase family found in excretory secretory products(ESP)of T.spiralis.In this study,TsNas36 gene was cloned and expressed,and its biological characteristics and temporal and spatial characteristics were identified.These results provide a theoretical and material basis for ex-ploring the biological function of TsNas36 gene.Bioinformatics analysis showed that TsNas36 was 470 amino acids(AA)in length with a molecular weight of about 54.69 kDa,no transmembrane region,and contained a signal peptide(1-20 AA),an Astacins domain(116-320 AA)and a CUB domain(355-470 AA).There were five active site residues located at amino acids 216(His),217(Glu),220(His),226(His)and 275(Tyr).The expression plasmid pET-28a(+)/TsNas36 was constructed and induced to express in E.coli BL21(DE3)to obtain the recombinant protein rTs-Nas36.The recombinant protein was used to immunize rabbits to obtain anti-rTsNas36 polyclonal antibody serum.Indirect ELISA results showed that the antibody titer reached 1∶105.qRT-PCR and Western blot results showed that the transcription levels of TsNas36 were significantly higher in newborn larvae(NBL)than in adult worm(AW)and muscle larva(ML)stages.Immunofluo-rescence results showed that TsNas36 was only localized in the epidermis of NBL.In summary,this study characterized the biological characteristics of the TsNas36 gene and found that this gene is highly period-specific and may be involved in the unique developmental process of NBL.

Objective To investigate the correlation and predictive value of serum ferritin(SF),25(OH)D and early renal damage in children with new type 1 diabetes mellitus(T1DM).Methods A total of 102 newly diagnosed T1DM children admitted to the Department of Endocrinology,Genetics and Metabolism of our hospital from January 2020 to June 2023 were collected as the study objects.According to UACR,the study subjects were divided into T1DM group<30 mg/g(n=50),microalbuminuria group 30～300 mg/g(MUAlb)group(n=32),and macroalbuminuria group>300 mg/g(CUAlb)group(n=20).Another 65 healthy children who underwent physical examination during the same period were selected as normal control(NC)group.General data and biochemical indexes of all groups were compared to analyze the correlation and predictive value of changes in SF and 25(OH)D levels with early renal damage.Results The levels of SF and TG in NC,T1DM,MUAlb and CUAlb groups increased in turn(P<0.05),while 25(OH)D decreased in turn(P<0.05).The levels of TC,FC-P,FPG and HbA1c in the T1DM,MUAlb and CUAlb groups were higher than those in the NC group(P<0.05),and the levels of FIns was lower than that in the NC group(P<0.05).The level of LDL-C in MUAlb and CUAlb groups were higher than in NC group(P<0.05),the levels of TC,FPG and HbA1c in MUAlb and CUAlb groups were higher than those in T1DM group(P<0.05),and UACR was higher than that in NC and T1DM groups(P<0.05).LDL-C in MUAlb group was higher than that in T1DM group(P<0.05).Blood urea in the CUAlb group were higher than those in the NC group(P<0.05),Scr and UACR was higher than that in the MUA1b group(P<0.05),and eGFR was higher than that in the T1DM,MUAlb,and CUAlb groups(P<0.05).Spearman correlation analysis showed that SF were positively correlated with TC,LDL-C,TG,UACR and HbA1c(P<0.05)and negatively correlated with 25(OH)D(P<0.05).25(OH)D was negatively correlated with TC,LDL-C,TG,UACR,HbA1c(P<0.05).Logistic regression analysis showed that SF and 25(OH)D were the influencing factors of early renal injury in children with T1DM.ROC curve analysis showed that the area under the curve of SF and 25(OH)D was 0.813 and 0.808,with the sensitivity 67.3%and 78.8%,the specificity 80.0%and 72.0%,and the cut-off values were 113.6 ng/ml and 54.17 nmol/L,respectively.Conclusions The changes in serum SF and 25(OH)D levels are associated with different stages of early renal damage and may be involved in the occurrence and development of early renal damage in children with T1DM.