Objective To explore the nephrotoxic effects of exposure to perfluorobutanoic acid (PFBA) and its mechanism in mice, with a particular focus on analyzing the changes in kidney metabolism and their potential implications. Methods The specific pathogen free C57BL/6 mice were randomly divided into control group, low-dose group, and high-dose group, with 10 mice in each group. Mice in the three groups received intragastric administration of PFBA solution at doses of 0, 35 and 350 mg/kg body weight, once per day for seven consecutive days. The histopathological changes of kidneys of mice in these three groups were evaluated. Metabolomic profiling of mouse kidneys was performed using ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. Differentially accumulated metabolites (DAMs) were identified based on the Human Metabolome Database, and related metabolic pathways were analyzed through MetaboAnalyst 6.0 and Kyoto Encyclopedia of Genes and Genomes (KEGG). Results Histopathological analysis of kidneys showed that the renal pelvis mucosa of mice in the low-dose group presented focal mild inflammatory changes without marked structural damage, whereas mice in the high-dose group showed severe inflammation and partial destruction of renal structure. The kidney coefficient of mice in both low-dose group and the high-dose group decreased (both P<0.05), and the Paller scores of renal tissues increased (both P<0.05) compared with that in the control group. The Paller score of mouse renal tissue in the high-dose group was higher than that in the low-dose group (P<0.05). Metabolomic profiling identified 46 DAMs (26 upregulated, 20 downregulated) in the low-dose group and 104 DAMs (54 upregulated, 50 downregulated) in the high-dose group, with 26 shared DAMs between the two dose groups. KEGG pathway analysis revealed that DAMs were mainly involved in metabolic pathways such as glycerophospholipid metabolism, glycerolipid metabolism, sphingolipid and steroid hormone synthesis. Conclusion Acute exposure to PFBA can cause kidney injury in mice. Lipid metabolism pathways such as glycerophospholipid and sphingolipid metabolism is involved in the development of acute renal toxicity of PFBA.

Objective:To explore the effect of evidence-based standardized procedures(SOP)on urinary incontinence manage-ment in patients with radical prostatectomy.Methods:Sixty-three patients who underwent radical prostatectomy from October 2022 to September 2023 were included in the control group.And 63 patients who underwent radical prostatectomy from October 2023 to Sep-tember 2024 were included in the observation group.The patients in the control group received routine perioperative care.As an addi-tion,the SOP on urinary incontinence management was performed in the patients of observation group.The incidence of urinary inconti-nence,severity of urinary incontinence(1 h urine pad test),quality of life(Incontinence Quality of Life Questionnaire)and comfort level(General Comfort Question)of the two groups were compared after 3 and 6 months of surgery.Results:The incidence of urina-ry incontinence at 3 and 6 months after operation in the observation group was 36.51％and 19.05％,respectively,which were lower than those(53.97％and 38.10％)of the control group,respectively.And the incidence rates of the two groups decreased significant-ly(P＜0.05).The score of life quality after 3 months of operation was(56.17±12.75)in the control group,which was lower than that(70.41±14.50)of the observation group.The 3-month postoperative comfort score was(52.73±11.26)in the control group and(63.49±13.52)in the observation group.The 6-month postoperative incontinence quality of life score was(64.70±11.38)in the control group and(85.41±12.04)in the observation group.And the 6-month postoperative comfort score was(60.96±8.04)in the control group and(83.49±12.04)in the observation group.The quality of life and comfort scores of the two groups 6 months after operation were significantly improved than those 3 months after operation,and the improvement of the observation group was more obvi-ous than that of the control group(P＜0.05).There were significant differences in the degree of urinary incontinence between the two groups at 3 months and 6 months after operation(P＜0.05).Conclusion:SOP management for the patients underwent radical pros-tatectomy can be an effective method for reducing the incidence of postoperative urinary incontinence,which promotes the recovery of postoperative urinary control.

Following the evidence-based diagnosis and treatment guideline development method for common pediatric diseases,the The Guideline for the Diagnosis and Treatment of Pediatric Food Accumulation and Stagnation in Chinese Medicine was formed through literature retrieval,expert questionnaire survey,expert discussion meeting,and solicitation of opinions.The revised content includes the scope of the guideline,normative reference documents,terms and definitions,diagnosis,syndrome differentiation,treatment,pre-vention and nursing suggestions,etc.,aiming to update the clinical diagnosis and treatment plan of Chinese medicine for accumulation and provide important clinical decision-making references for clinical physicians to rationally apply the diagnosis and treatment plan of Chinese medicine in the prevention and treatment of accumulation and stagnation in Children.

Objective:To evaluate the relationship between nuclear receptor subfamily 1 group D member 1 (Rev-erbα) and ferroptosis in cardiomyocytes subjected to high-fat/high-glucose (HFHG) and hypoxia-reoxygenation (H/R) injury.Methods:H9c2 cardiomyocytes were cultured under normal conditions. The cells were divided into 4 groups ( n=13 each) using a random number table method: control group (C group), H/R group, HFHG group and HFHG+ H/R1 group. The cells were divided into 3 groups ( n=17 each) using a random number table method: HFHG+ H/R2 group, negative control siRNA + HFHG + H/R group (si-NC+ HFHG+ H/R group), and Rev-erbα gene knockdown + HFHG + H/R group (si-Rev-erbα+ HFHG+ H/R group). The cardiomyocyte model of HFHG combined with H/R injury was established by incubating cells with HFHG medium for 12 h, followed by 6 h of hypoxia and 2 h of reoxygenation. Rev-erbα gene was knocked down using siRNA technology. Cell viability was assessed using CCK-8 and Calcein AM/PI live-dead cell double staining kits. The expression of Rev-erbα, acyl-CoA synthetase long-chain family member 4 (ACSL4), and nuclear receptor coactivator 4 (NCOA4) was detected by Western blot. The levels of lipid peroxide (LPO) were measured by flow cytometry. Results:Compared with C group, the cell viability was significantly decreased, and the expression of Rev-erbα, ACSL4 and NCOA4 was up-regulated in HFHG, H/R and HFHG+ H/R1 groups( P<0.05). Compared with HFHG group or H/R group, the cell viability was significantly decreased, and the expression of Rev-erbα, ACSL4 and NCOA4 was up-regulated in HFHG+ H/R1 group ( P<0.05).There were no significant differences in the cell viability, levels of LPO, or expression of Rev-erbα, ACSL4 and NCOA4 between HFHG+ H/R2 group and si-NC+ HFHG+ H/R group ( P>0.05). Compared with HFHG+ H/R2 group, the cell viability was significantly increased, the levels of LPO were decreased, and the expression of Rev-erbα, ACSL4 and NCOA4 was down-regulated in si-Rev-erbα+ HFHG+ H/R group ( P<0.05). Conclusions:Rev-erbα participates in the process of HFHG and H/R injury to cardiomyocytes by negatively regulating ferroptosis.

Following the evidence-based diagnosis and treatment guideline development method for common pediatric diseases,the The Guideline for the Diagnosis and Treatment of Pediatric Food Accumulation and Stagnation in Chinese Medicine was formed through literature retrieval,expert questionnaire survey,expert discussion meeting,and solicitation of opinions.The revised content includes the scope of the guideline,normative reference documents,terms and definitions,diagnosis,syndrome differentiation,treatment,pre-vention and nursing suggestions,etc.,aiming to update the clinical diagnosis and treatment plan of Chinese medicine for accumulation and provide important clinical decision-making references for clinical physicians to rationally apply the diagnosis and treatment plan of Chinese medicine in the prevention and treatment of accumulation and stagnation in Children.

Objective:To evaluate the relationship between nuclear receptor subfamily 1 group D member 1 (Rev-erbα) and ferroptosis in cardiomyocytes subjected to high-fat/high-glucose (HFHG) and hypoxia-reoxygenation (H/R) injury.Methods:H9c2 cardiomyocytes were cultured under normal conditions. The cells were divided into 4 groups ( n=13 each) using a random number table method: control group (C group), H/R group, HFHG group and HFHG+ H/R1 group. The cells were divided into 3 groups ( n=17 each) using a random number table method: HFHG+ H/R2 group, negative control siRNA + HFHG + H/R group (si-NC+ HFHG+ H/R group), and Rev-erbα gene knockdown + HFHG + H/R group (si-Rev-erbα+ HFHG+ H/R group). The cardiomyocyte model of HFHG combined with H/R injury was established by incubating cells with HFHG medium for 12 h, followed by 6 h of hypoxia and 2 h of reoxygenation. Rev-erbα gene was knocked down using siRNA technology. Cell viability was assessed using CCK-8 and Calcein AM/PI live-dead cell double staining kits. The expression of Rev-erbα, acyl-CoA synthetase long-chain family member 4 (ACSL4), and nuclear receptor coactivator 4 (NCOA4) was detected by Western blot. The levels of lipid peroxide (LPO) were measured by flow cytometry. Results:Compared with C group, the cell viability was significantly decreased, and the expression of Rev-erbα, ACSL4 and NCOA4 was up-regulated in HFHG, H/R and HFHG+ H/R1 groups( P<0.05). Compared with HFHG group or H/R group, the cell viability was significantly decreased, and the expression of Rev-erbα, ACSL4 and NCOA4 was up-regulated in HFHG+ H/R1 group ( P<0.05).There were no significant differences in the cell viability, levels of LPO, or expression of Rev-erbα, ACSL4 and NCOA4 between HFHG+ H/R2 group and si-NC+ HFHG+ H/R group ( P>0.05). Compared with HFHG+ H/R2 group, the cell viability was significantly increased, the levels of LPO were decreased, and the expression of Rev-erbα, ACSL4 and NCOA4 was down-regulated in si-Rev-erbα+ HFHG+ H/R group ( P<0.05). Conclusions:Rev-erbα participates in the process of HFHG and H/R injury to cardiomyocytes by negatively regulating ferroptosis.

Objective To investigate the risk factors for bronchopulmonary dysplasia(BPD)in twin preterm infants with a gestational age of<34 weeks,and to provide a basis for early identification of BPD in twin preterm infants in clinical practice.Methods A retrospective analysis was performed for the twin preterm infants with a gestational age of<34 weeks who were admitted to 22 hospitals nationwide from January 2018 to December 2020.According to their conditions,they were divided into group A(both twins had BPD),group B(only one twin had BPD),and group C(neither twin had BPD).The risk factors for BPD in twin preterm infants were analyzed.Further analysis was conducted on group B to investigate the postnatal risk factors for BPD within twins.Results A total of 904 pairs of twins with a gestational age of<34 weeks were included in this study.The multivariate logistic regression analysis showed that compared with group C,birth weight discordance of>25%between the twins was an independent risk factor for BPD in one of the twins(OR=3.370,95%CI:1.500-7.568,P<0.05),and high gestational age at birth was a protective factor against BPD(P<0.05).The conditional logistic regression analysis of group B showed that small-for-gestational-age(SGA)birth was an independent risk factor for BPD in individual twins(OR=5.017,95%CI:1.040-24.190,P<0.05).Conclusions The development of BPD in twin preterm infants is associated with gestational age,birth weight discordance between the twins,and SGA birth.

Objective To investigate the attributable risk(AR)of Acinetobacter baumannii(AB)infection in criti-cally ill patients.Methods A multicenter retrospective cohort study was conducted among adult patients in inten-sive care unit(ICU).Patients with AB isolated from sterile body fluid and confirmed with AB infection in each cen-ter were selected as the infected group.According to the matching criteria that patients should be from the same pe-riod,in the same ICU,as well as with similar APACHE Ⅱ score(±5 points)and primary diagnosis,patients who did not infect with AB were selected as the non-infected group in a 1:2 ratio.The AR was calculated.Results The in-hospital mortality of patients with AB infection in sterile body fluid was 33.3％,and that of non-infected group was 23.1％,with no statistically significant difference between the two groups(P=0.069).The AR was 10.2％(95％CI:-2.3％-22.8％).There is no statistically significant difference in mortality between non-infected pa-tients and infected patients from whose blood,cerebrospinal fluid and other specimen sources AB were isolated(P＞0.05).After infected with AB,critically ill patients with the major diagnosis of pulmonary infection had the high-est AR.There was no statistically significant difference in mortality between patients in the infected and non-infec-ted groups(P＞0.05),or between other diagnostic classifications.Conclusion The prognosis of AB infection in critically ill patients is highly overestimated,but active healthcare-associated infection control for AB in the ICU should still be carried out.

Objective This study aimed to investigate the potential relationship between urinary metals copper (Cu), arsenic (As), strontium (Sr), barium (Ba), iron (Fe), lead (Pb) and manganese (Mn) and grip strength. Methods We used linear regression models, quantile g-computation and Bayesian kernel machine regression (BKMR) to assess the relationship between metals and grip strength.Results In the multimetal linear regression, Cu (β=-2.119), As (β=-1.318), Sr (β=-2.480), Ba (β=0.781), Fe (β= 1.130) and Mn (β=-0.404) were significantly correlated with grip strength (P < 0.05). The results of the quantile g-computation showed that the risk of occurrence of grip strength reduction was -1.007 (95％ confidence interval:-1.362, -0.652; P < 0.001) when each quartile of the mixture of the seven metals was increased. Bayesian kernel function regression model analysis showed that mixtures of the seven metals had a negative overall effect on grip strength, with Cu, As and Sr being negatively associated with grip strength levels. In the total population, potential interactions were observed between As and Mn and between Cu and Mn (Pinteractions of 0.003 and 0.018, respectively).Conclusion In summary, this study suggests that combined exposure to metal mixtures is negatively associated with grip strength. Cu, Sr and As were negatively correlated with grip strength levels, and there were potential interactions between As and Mn and between Cu and Mn.

Objective To investigate the role of miRNAs in maternal amniotic fluid exosomes in development of isolated ventriculomegaly(VM)in fetuses.Methods Amniotic fluid samples were collected from 9 cases of moderate isolated VM and 8 normal control cases to extract exosomal miRNA,and miRNA sequencing technique was used to identify differentially expressed miRNAs between the two groups.Three miRNAs with significant differential expression between the two groups,whose high expression was associated with VM,were selected for verification with RT-qPCR.Dual luciferase reporter assays were used to verify the regulatory effect of miR-122-5p on its predicted target genes AKT3 and CCDC88C.Gene ontology(GO)and KEGG pathway analyses were performed to explore the possible roles of the top 40 significant differential miRNAs in the pathophysiology of VM.Results We identified a total of 272 differentially expressed miRNAs in VM cases,including 43 up-regulated and 229 down-regulated miRNAs.The target genes of these differential miRNAs were associated with DNA and transcription factor binding,transmembrane transporter and nucleic acid binding transcription factor activity,and cell developmental process.These miRNAs were mostly enriched in the MAPK,cGMP-PKG and Wnt signaling pathways.Verification with RT-qPCR showed that miR-122-5p expression level was significantly lower in VM group than in the control group(P<0.05),which was consistent with miRNA sequencing results;let-7b-5p expression level was significantly lower in VM group,which was contrary to miRNA sequencing result.Dual luciferase reporter assays showed that miR-122-5p was not capable of regulating AKT3 or CCDC88C expressions.Conclusions The highly abundant differentially expressed miRNAs in maternal amniotic fluid exosomes play important roles in the occurrence of fetal VM possibly by regulating the MAPK,PI3K-Akt,Wnt and cGMP-PKG signaling pathways.