AIM:To study the effect of nicotinamide mononucleotide(NMN)on renal fibrosis in mice with Al-port syndrome(AS)through TGFβ/Smad3 pathway.METHODS:SPF grade female X-linked AS(COL4A5 KI)mice were divided into model group(AS group)and model drug administration group(AS+NMN group).while female C57BL/6 mice served as the wild-type(WT)group,with 7 to 8 mice in each group.The mice in the administration group were given oral administration at 8 weeks of age for 8 weeks to 16 weeks of age.The remaining mice were given saline intragastric ad-ministration.The ratio of urinary microalbumin to urinary creatinine(UACR)was measured by biochemical method.After sampling,the renal fibrosis was analyzed by Masson staining.The expression levels of desmin and α-smooth muscle actin(α-SMA)were detected by immunohistochemistry.The expressions of fibrosis-related proteins desmin,α-SMA,trans-forming growth factor β(TGFβ),Smad3,p-Smad3,and fibronectin were detected by Western blot.RESULTS:Com-pared with the model group,UACR(13 weeks,P＜0.01;15 weeks,P＜0.01)and fibrosis-related protein expression(P＜0.05)in AS mice were significantly decreased after NMN treatment.CONCLUSION:Treatment with NMN attenuates renal fibrosis in AS mice through TGFβ/Smad3 signaling pathway.

AIM:To study the effect of nicotinamide mononucleotide(NMN)on renal fibrosis in mice with Al-port syndrome(AS)through TGFβ/Smad3 pathway.METHODS:SPF grade female X-linked AS(COL4A5 KI)mice were divided into model group(AS group)and model drug administration group(AS+NMN group).while female C57BL/6 mice served as the wild-type(WT)group,with 7 to 8 mice in each group.The mice in the administration group were given oral administration at 8 weeks of age for 8 weeks to 16 weeks of age.The remaining mice were given saline intragastric ad-ministration.The ratio of urinary microalbumin to urinary creatinine(UACR)was measured by biochemical method.After sampling,the renal fibrosis was analyzed by Masson staining.The expression levels of desmin and α-smooth muscle actin(α-SMA)were detected by immunohistochemistry.The expressions of fibrosis-related proteins desmin,α-SMA,trans-forming growth factor β(TGFβ),Smad3,p-Smad3,and fibronectin were detected by Western blot.RESULTS:Com-pared with the model group,UACR(13 weeks,P＜0.01;15 weeks,P＜0.01)and fibrosis-related protein expression(P＜0.05)in AS mice were significantly decreased after NMN treatment.CONCLUSION:Treatment with NMN attenuates renal fibrosis in AS mice through TGFβ/Smad3 signaling pathway.

Objective To investigate the construction and value of radiation pneumonitis(RP)predic-tive model based on machine learning algorithm.Methods A retrospective analysis was conducted on the clin-ical data in 77 patients with breast cancer receiving radiotherapy and regular follow-up in this hospital from August 2019 to September 2022.The affected side lung was delineated on the localization CT as the area of in-terest and the radiomics features were extracted,meanwhile the affected side lung dosimetric parameters were extracted.After feature screening,the patients were divided into the training set and testing set by a 7∶3 rati-o.The features of positioning CT radiomics were extracted and combined with the dosimetry parameters of the affected side lung,and the model was established by using stochastic gradient descent(SGD)algorithm.The performance of the model was validated by using the area under the receiver operating characteristic(ROC)curve(AUC)and decision curve analysis(DCA).Results Among 77 patients,24 cases developed RP after ra-diotherapy end with an incidence rate of 31.17％.Compared with the patients without RP occurrence,V5,V10,V15,V20,V25,V30 and mean lung dose(MLD)in the patients with RP occurrence were higher,and the differ-ence was statistically significant(P＜0.05).In the training set,36 cases did not develop RP.17 cases devel-oped RP,in the testing set,17 cases did not develop RP and 7 cases developed RP.The affected side lung dosi-metric parameters had no statistical difference between the training set and testing set with and without RP occurrence(P＞0.05).After characteristics screening,the 8 optimal characteristics combinations were finally obtained.The average AUC of SGD model in 50％off cross-validation of the training set was 0.900 and AUC in the test set was 0.882.Conclusion The positioning CT radiomics features combined with dosimetry param-eters of the affected side lung has the good predictive value for RP after breast cancer radiotherapy.

Objective:To study the trend of menarche age in Han and Mongolian women born from 1951 to 2005 in Mongolian region.Methods:A cross-sectional cluster sampling survey method was adopted, From 2003 to 2019, a retrospective survey was carried out in three banners/counties in Tongliao region on the female population of Han and Mongols nationalities aged 16 to 46 and conducted under standardized survey procedures and quality control standards. The basic data of menarche age of women born between 1951 and 2005 were obtained. The changes and rules were analyzed by taking 1 year, 5 years and 10 years as nodes.Results:Totally 46 and conducted under standardized survey procedures and quality control standards 928 pepole (24 450 Han and 22 478 Mongolian) were recruited, the survey response rate was 96.09% (46 928/48 836). In one-year-period analysis, the menarche age gradually decreased from 1951 to 2005. The mean menarche age of Han and Mongolian women changed from (16.22±0.52) years and (15.86±1.24) years in 1951 to (12.37±1.15) years and (12.33±0.98) years in 2005, respectively. The mean menarche age of Han and Mongolian women decreased 3.85 years and 3.54 years. The trend of the mean menarche age's change showed a significant negative correlation with the years (all P<0.000 1). In five-year-period analysis, the mean menarche age of Han and Mongolian women changed from (15.54±1.45) years and (15.53±1.48) years from 1951 to 1955 to (12.41±0.97) years and (12.47±0.96) years from 2001 to 2005, the mean menarche age decreased 3.13 years (3.41 months ahead of schedule every 5 years on average) and 3.06 years (3.34 months ahead of schedule every 5 years on average) in Han and Mongolian women respectively. In ten-year-period analysis, the mean menarche age of Han and Mongolian women changed from (15.79±0.95) years and (15.53±1.33) years from 1951 to 1960 to (12.41±0.97) years and (12.47±0.96) years from 2001 to 2005, the mean menarche age decreased 3.38 years (6.76 months ahead of schedule every 10 years on average) and 3.06 years (6.12 months ahead of schedule every 10 years on average) in Han and Mongolian women respectively. During the 15 years from 1951 to 1965, 1966 to 1970, 1971 to 1990, and 1991 to 2000, they were concentrated at the ages of 15-16, 14-15, 13-14, and 12-13, respectively. The proportion of women at 11 years, 12 years and 13 years menarche age were 26.79% (457/1 706), 73.27% (1 250/1 706), and 92.85% (1 584/1 706) during 2001—2005 in Han women, while the proportion were 23.25% (653/2 809), 62.01% (1 742/2 809), and 90.14% (2 532/2 809) in Mongolian women. Conclusion:The menarche age decreased in Han and Mongolian women from 1951 to 2005, and the ethnic groups tended to be the same. It is recommended to start adolescent education at the age of 8-9 years and pay attention to the changing pattern of early onset of menarche.

Objective:To study the trend of menarche age in Han and Mongolian women born from 1951 to 2005 in Mongolian region.Methods:A cross-sectional cluster sampling survey method was adopted, From 2003 to 2019, a retrospective survey was carried out in three banners/counties in Tongliao region on the female population of Han and Mongols nationalities aged 16 to 46 and conducted under standardized survey procedures and quality control standards. The basic data of menarche age of women born between 1951 and 2005 were obtained. The changes and rules were analyzed by taking 1 year, 5 years and 10 years as nodes.Results:Totally 46 and conducted under standardized survey procedures and quality control standards 928 pepole (24 450 Han and 22 478 Mongolian) were recruited, the survey response rate was 96.09% (46 928/48 836). In one-year-period analysis, the menarche age gradually decreased from 1951 to 2005. The mean menarche age of Han and Mongolian women changed from (16.22±0.52) years and (15.86±1.24) years in 1951 to (12.37±1.15) years and (12.33±0.98) years in 2005, respectively. The mean menarche age of Han and Mongolian women decreased 3.85 years and 3.54 years. The trend of the mean menarche age's change showed a significant negative correlation with the years (all P<0.000 1). In five-year-period analysis, the mean menarche age of Han and Mongolian women changed from (15.54±1.45) years and (15.53±1.48) years from 1951 to 1955 to (12.41±0.97) years and (12.47±0.96) years from 2001 to 2005, the mean menarche age decreased 3.13 years (3.41 months ahead of schedule every 5 years on average) and 3.06 years (3.34 months ahead of schedule every 5 years on average) in Han and Mongolian women respectively. In ten-year-period analysis, the mean menarche age of Han and Mongolian women changed from (15.79±0.95) years and (15.53±1.33) years from 1951 to 1960 to (12.41±0.97) years and (12.47±0.96) years from 2001 to 2005, the mean menarche age decreased 3.38 years (6.76 months ahead of schedule every 10 years on average) and 3.06 years (6.12 months ahead of schedule every 10 years on average) in Han and Mongolian women respectively. During the 15 years from 1951 to 1965, 1966 to 1970, 1971 to 1990, and 1991 to 2000, they were concentrated at the ages of 15-16, 14-15, 13-14, and 12-13, respectively. The proportion of women at 11 years, 12 years and 13 years menarche age were 26.79% (457/1 706), 73.27% (1 250/1 706), and 92.85% (1 584/1 706) during 2001—2005 in Han women, while the proportion were 23.25% (653/2 809), 62.01% (1 742/2 809), and 90.14% (2 532/2 809) in Mongolian women. Conclusion:The menarche age decreased in Han and Mongolian women from 1951 to 2005, and the ethnic groups tended to be the same. It is recommended to start adolescent education at the age of 8-9 years and pay attention to the changing pattern of early onset of menarche.

Objective:To examine the association between parental characteristics and risk of autism spectrum disorder (ASD) in children.Methods:In this case-control study, the cases were defined as children who were diagnosed with ASD and were recruited from June 2018 to February 2019 in Shanghai Mental Center ( n=104). The controls were defined as children who did not have ASD and were recruited in the two community health centers in Jing-an District of Shanghai during the same period ( n=149). All children recruited in this study were 2-6 years old. A multivariate logistic regression model was used to examine the association between parental characteristics and the risk of ASD in offspring, and further to estimate the interaction coefficient. Results:According to multivariate regression analysis, the association between maternal age, previous pregnancy complication and the risk of ASD in children appeared to be not statistically significant. After adjusted, advanced paternal age (≥35 years old)( OR=3.65, 95% CI=1.19-11.15, P=0.023), parental disease before or during pregnancy ( OR=3.34, 95% CI=1.41-7.94, P=0.006) and gender of child (male) ( OR=5.84, 95% CI=2.98-11.44, P<0.001) were associated with increased risk of ASD. The results also showed that the boys whose father was 35 years old or more had a higher risk of ASD than the boys whose fahter was less 35 years old and the girls whose father was 35 years old or more ( P=0.005, P=0.006). Conclusion:Advanced paternal age was associated with increased risk of ASD in offspring and this effect may be more pronounced in boys.

Objective:To examine the association between parental characteristics and risk of autism spectrum disorder (ASD) in children.Methods:In this case-control study, the cases were defined as children who were diagnosed with ASD and were recruited from June 2018 to February 2019 in Shanghai Mental Center ( n=104). The controls were defined as children who did not have ASD and were recruited in the two community health centers in Jing-an District of Shanghai during the same period ( n=149). All children recruited in this study were 2-6 years old. A multivariate logistic regression model was used to examine the association between parental characteristics and the risk of ASD in offspring, and further to estimate the interaction coefficient. Results:According to multivariate regression analysis, the association between maternal age, previous pregnancy complication and the risk of ASD in children appeared to be not statistically significant. After adjusted, advanced paternal age (≥35 years old)( OR=3.65, 95% CI=1.19-11.15, P=0.023), parental disease before or during pregnancy ( OR=3.34, 95% CI=1.41-7.94, P=0.006) and gender of child (male) ( OR=5.84, 95% CI=2.98-11.44, P<0.001) were associated with increased risk of ASD. The results also showed that the boys whose father was 35 years old or more had a higher risk of ASD than the boys whose fahter was less 35 years old and the girls whose father was 35 years old or more ( P=0.005, P=0.006). Conclusion:Advanced paternal age was associated with increased risk of ASD in offspring and this effect may be more pronounced in boys.

Objective:To investigate the clinical value of ventricular intracranial pressure monitoring (V-ICPM) in gradient decompression for patients with traumatic cerebral hernia.Methods:The clinical data of 103 patients with traumatic cerebral hernia admitted to our hospital from October 2016 to October 2020 were retrospectively analyzed. These patients were divided into observation group ( n=49) and control group ( n=54) according to whether V-ICPM was applied. Patients in the observation group accepted V-ICPM before gradient decompression, and patients in the control group accepted gradient decompression directly. Incidence of malignant encephalocele, clinical short-term and long-term efficacies, and complications were compared between the two groups. According to intracranial pressure (ICP), the patients were divided into normal or slightly increased ICP (≤22 mmHg), moderate increased ICP (23-40 mmHg) and severe increased ICP (>40 mmHg); the relationship between ICP and prognoses was analyzed in the observation group. Results:(1) The incidences of intraoperative malignant encephalocele in the observation group (16.33%) were slightly lower than that in the control group (29.63%), without significant difference ( P>0.05). Twenty four h after gradient decompression, pupils recovered in 35 patients (71.43%) from the observation group and 28 patients (51.85%) from the control group, significant difference in the pupils recovery rate was noted between the two groups ( χ2=4.145, P=0.042); the Glasgow Coma Scale (GCS) scores between the observation group (8.43±2.56) and control group (7.39±2.47) showed statistical differences ( t=-2.095, P=0.039). Three months after gradient decompression, there were 7 patients with Glasgow Outcome Scale (GOS) scores of 5, 18 patients with scores of 4, 10 patients with scores of 3, 8 patients with scores of 2, and 6 patients with score of 1 in the observation group; there were 12 patients with GOS scores of 5, 17 patients with scores of 4, 12 patients with scores of 3, 7 patients with scores of 2, and 6 patients with score of 1 in the control group; the difference was not statistically significant ( Z=-0.681, P=0.496). (2) The higher the ICP in the observation group (initially and when the dura mater is cut), the worse the prognosis. Conclusion:The application of V-ICPM before gradient decompression cannot further improve the long-term prognosis of the patients, but it can provide intraoperative reference and prognosis prediction for the operators.

Objective:To investigate the clipping methods of ruptured posterior communicating artery (PCoA) aneurysms of medial posterior inferior type (aneurysms located at the medial posterior inferior part of internal carotid artery or occluded by the internal carotid artery) during conventional pterional craniotomy.Methods:Seven patients with ruptured PCoA aneurysms, admitted to our hospital from January 2004 to January 2020, were chosen in our study. The clinical data and surgical efficacies of these patients were retrospectively analyzed.Results:The anterior choroidal artery (AChA) was accidentally clipped in 2 patients during the surgery, of which one was released after adjustment and one was avoided after multiple adjustments. Due to severe acute brain swelling, the brain tissues of the anterior temporal lobe were removed for about 20 mm in 2 patients, and the anterior temporal lobe was retracted posteriorly by platens in 5 patients. All aneurysms disappeared in the postoperative CTA images, no residual neck was found, and the parent artery remained unobstructed. One patient had cerebral infarction in the AChA supplying area. All patients were followed up for 1-6 years, with an average of 27.6 months. Six patients recovered completely without neurological dysfunction. One patient had contralateral hemiplegia, with muscle strength grading III, walking on crutches, and basic living by himself.Conclusion:It's difficult to clip the ruptured PCoA aneurysms of medial posterior inferior type by conventional pterional craniotomy; so straight and curved aneurysm clips can be used to clip aneurysms by expanding the inter-cisternal space around the aneurysms.

Objective To investigate the risk factors,mechanism and treatment strategies of expanding regional brain injury (traumatic intracerebral contusion or hematoma) in patients with acute traumatic epidural hematoma (ATEDH) after surgical evacuation.Methods Fifty-nine patients with ATEDH,admired to and accepted surgical evacuation in our hospital from February 2013 to September 2018,were chosen in this study;their clinical data and CT imaging data were retrospectively analyzed.The volume ofintracranial hematoma was measured by 3D Slicer software.According to the progress of local brain injury revealed by first CT examination after surgical evacuation,patients with ATEDH were divided into progressive group and non-progressive group.Risk factors of patients with expanding regional brain injury after surgery were analyzed by univariate and multivariate Logistic regression analyses.Results After surgery,22 showed expanding regional brain injury,accounting for 37.29％:9 occurred expanding intracerebral hematoma,and 2 of them died after conservative treatment;two had both expanding intracerebral contusion and hematoma;11 expanding intracerebral contusion patients developed into hematoma,and three of them occurred delayed intracerebral hematoma adjacent to the area of ATEDH,and two underwent secondary craniotomy with good recovery.As compared with patients from the non-progressive group,progressive group had significantly higher percentages of patients with preoperative hyperglycemia (＞9.1 mmol/L),patients with preoperative abnormal coagulation and patients accepted decompressive craniectomy (P＜0.05).Multivariate Logistic regression analysis revealed that preoperative abnormal coagulation was an independent risk factor for expanding intracerebral contusion or hematoma after surgery (OR=6.498,95％CI:1.076-39.253,P=0.041).Conclusion Expanding regional brain injury has high morbidity in patients with ATEDH after surgery evacuation;preoperative abnormal coagulation is an independent risk factor for its occurrence.