Background Pyrethroid pesticides (PYRs) can cross the placental barrier to cause intrauterine fetal exposure, which may lead to developmental immunotoxicity (DIT). However, the specific effect of maternal PYR exposure during pregnancy on the cellular immune function of 1-year-old children remains unclear. Objective To explore the effect of PYRs exposure throughout the entire pregnancy on peripheral blood lymphocytes in 1-year-old children and potential sensitive window period of PYRs exposure. Methods A birth cohort was established by enrolling pregnant women in their first trimester and following them and their infants until one year of age. Ultra-high performance liquid chromatography-tandem mass spectrometry was used to detect the levels of PYRs metabolites, including 3-phenoxybenzoic acid (3PBA), 4-fluoro-3-phenoxybenzoic acid (4F3PBA), and cis-3-(2,2-dichlorovinyl)-2,2- dimethylcyclopropane carboxylic acid (cis-DBCA), in the urine of pregnant women during the first trimester (gestational weeks 6-12), the second trimester (gestational weeks 21-24), and the third trimester (gestational weeks 33-36). Peripheral blood leukocyte and lymphocyte counts were measured in children at 12 months of age using the Coulter principle combined with flow cytometry. Exposure levels of PYRs metabolites in each trimester were divided into low, moderate, and high exposure groups based on the 25th (P₂₅) and 75th (P₇₅) percentiles. Meanwhile, participants were classified as having repeated high or low exposure if their metabolite levels were > P₇₅ or <P₂₅ in at least two trimesters, respectively, while all others were categorized as having repeated moderate exposure. Generalized linear models were used to analyze the associations between trimester-specific and repeated PYRs metabolite exposure levels and the peripheral blood white blood cell (WBC) and lymphocyte counts in children aged 1 year. Results A total of 336 mother-child pairs were included in this study. For the pregnant women, the total detection rates of maternal urinary 3PBA, 4F3PBA, and cis-DBCA across the three trimesters of pregnancy were 80.5%, 100.0%, and 81.3%, respectively; and median creatinine-corrected concentrations were 0.24, 0.36, and 0.42 μg·g⁻¹, respectively. In children aged 1 year, the mean WBC and lymphocyte counts in peripheral blood were (8.9±2.0)×10⁹·L⁻¹ and (5.7±1.6)×10⁹·L⁻¹, respectively. The results of the generalized linear model analysis indicated that compared to the low exposure group, the high cis-DBCA exposure group during the third trimester of pregnancy had significantly lower peripheral blood WBC count (β=−0.87, 95%CI: −1.51, −0.23) and lymphocyte count (β=−0.64, 95%CI: −1.15, −0.13); and the repeated high-exposure group of cis-DBCA had significantly lower peripheral blood WBC count (β=−1.34, 95%CI: −2.34, −0.34) and lymphocyte count (β=−0.80, 95%CI: −1.60, −0.01) than the repeated low exposure group. Similarly, the repeated moderate-exposure group of cis-DBCA had a significantly lower peripheral blood WBC count (β=−0.83, 95%CI: −1.59, −0.07) than the repeated low exposure group. Conclusion High maternal exposure to PYRs with cis-DBCA as the major metabolite exposure is associated with decreased peripheral leukocyte and lymphocyte counts in children aged 1 year, and repeated high-level exposure throughout gestation appears to exacerbate DIT in offspring. The third trimester of pregnancy maybe a sensitive window for children's DIT induced by exposure to PYRs during pregnancy.

Objective To investigate the application value of bedside ultrasound measurement of gastric antrum cross-sectional area(CSA)combined with acute gastrointestinal injury ultrasound(AGIUS)score in guiding early individualized enteral nutrition therapy for sepsis patients.Methods From January 2023 to July 2024,61 sepsis patients meeting diagnostic criteria were enrolled and divided into an observation group(n=30)and a control group(n=31).The observation group underwent bedside ultrasound monitoring of gastric antrum CSA to calculate gastric residual volume(GRV)and AGIUS score for formulating individualized en-teral nutrition strategies.The control group used gastric tube withdrawal method for GRV measurement to guide enteral nutrition.Clinical baseline characteristics,enteral nutrition-related complications,nutritional/in-fection indicators,and disease severity parameters were compared between groups.Predictive efficacy was ana-lyzed using receiver operating characteristic(ROC)curve and area under the curve(AUC).Results Both groups showed gradual increases in enteral nutrition feeding rates and total volumes over time,with the obser-vation group demonstrating significantly higher values than the control group at each time point(P＜0.05).The observation group started nasogastric feeding earlier than the control group(P＜0.05).Target calorie a-chievement rates on day 3,5,and 7 were better in the observation group(P＜0.05).The incidence of feeding intolerance progressively decreased in the observation group but increased in the control group over day 1,3,and 5,with significant intergroup differences at each time point(P＜0.05).By day 7,the observation group exhibited significantly higher prealbumin(PA),albumin(ALB),and transferrin(TF)levels compared to day 1 and the control group(P＜0.05).Both groups showed reductions in APACHE Ⅱ,SOFA,and AGI scores by day 7,with the observation group displaying significantly lower scores than the control group(P＜0.05).The observation group had shorter ICU stays[(10.83±3.26)d vs.(14.55±3.14)d,P＜0.05].The combination of gastric antrum CSA measurement and AGIUS scoring demonstrated excellent predictive value for feeding intolerance(AUC=0.920,95％CI:0.848-0.963),with 95.50％sensitivity and 82.50％specificity,achieving 87.60％predictive accuracy.Conclusion Bedside ultrasound measurement of gastric antrum cross-sectional area(CSA)combined with AGIUS scoring shows good effect as a safe and effective monitoring modality for guiding early individualized enteral nutrition therapy in sepsis patients.

T-cell acute lymphoblastic leukemia (T-ALL) is a highly aggressive hematologic malignancy with a poor prognosis, despite advancements in treatment. Many patients struggle with relapse or refractory disease. Investigating the role of the super-enhancer (SE) regulated gene ubiquitin-specific protease 20 (USP20) in T-ALL could enhance targeted therapies and improve clinical outcomes. Analysis of histone H3 lysine 27 acetylation (H3K27ac) chromatin immunoprecipitation sequencing (ChIP-seq) data from six T-ALL cell lines and seven pediatric samples identified USP20 as an SE-regulated driver gene. Utilizing the Cancer Cell Line Encyclopedia (CCLE) and BloodSpot databases, it was found that USP20 is specifically highly expressed in T-ALL. Knocking down USP20 with short hairpin RNA (shRNA) increased apoptosis and inhibited proliferation in T-ALL cells. In vivo studies showed that USP20 knockdown reduced tumor growth and improved survival. The USP20 inhibitor GSK2643943A demonstrated similar anti-tumor effects. Mass spectrometry, RNA-Seq, and immunoprecipitation revealed that USP20 interacted with hypoxia-inducible factor 1 subunit alpha (HIF1A) and stabilized it by deubiquitination. Cleavage under targets and tagmentation (CUT&Tag) results indicated that USP20 co-localized with HIF1A, jointly modulating target genes in T-ALL. This study identifies USP20 as a therapeutic target in T-ALL and suggests GSK2643943A as a potential treatment strategy.

Objective:To summarize medication safety assessment tools for clinical nurses both domestically and internationally.Methods:Guided by the Joanna Briggs Institute (JBI) scoping review methodology, a systematic search was conducted across CINAHL, Embase, PubMed, Web of Science, SinoMed, China National Knowledge Infrastructure, and WanFang Data. The search period was from the establishment of database to January 1, 2025. Medication safety assessment tools for clinical nurses were extracted, relevant content was systematically analyzed, and the retrieval results were reported in a standardized manner.Results:A total of 28 studies were included, involving 15 medication safety assessment tools for clinical nurses. Assessment methods employed multidimensional and graded self-assessment formats. Based on evaluation perspectives, these tools were categorized into six types, including operational standardization monitoring, cognitive bias calibration, environmental stress testing, capability threshold identification, reporting barrier analysis, and medication information systems. The assessment tools had high reliability and validity, multiple types, and diverse evaluation perspectives.Conclusions:Researchers should carefully select and use assessment tools based on research characteristics. It is necessary to enhance the autonomy of nursing research on medication safety, develop comprehensive and accurate clinical nurse medication safety assessment tools that are adapted to China's clinical context, and promote the improvement of nurse medication safety.

Objective:To summarize medication safety assessment tools for clinical nurses both domestically and internationally.Methods:Guided by the Joanna Briggs Institute (JBI) scoping review methodology, a systematic search was conducted across CINAHL, Embase, PubMed, Web of Science, SinoMed, China National Knowledge Infrastructure, and WanFang Data. The search period was from the establishment of database to January 1, 2025. Medication safety assessment tools for clinical nurses were extracted, relevant content was systematically analyzed, and the retrieval results were reported in a standardized manner.Results:A total of 28 studies were included, involving 15 medication safety assessment tools for clinical nurses. Assessment methods employed multidimensional and graded self-assessment formats. Based on evaluation perspectives, these tools were categorized into six types, including operational standardization monitoring, cognitive bias calibration, environmental stress testing, capability threshold identification, reporting barrier analysis, and medication information systems. The assessment tools had high reliability and validity, multiple types, and diverse evaluation perspectives.Conclusions:Researchers should carefully select and use assessment tools based on research characteristics. It is necessary to enhance the autonomy of nursing research on medication safety, develop comprehensive and accurate clinical nurse medication safety assessment tools that are adapted to China's clinical context, and promote the improvement of nurse medication safety.

Objective:To investigate the impact of frailty on post-stroke depression (PSD) in patients with acute ischemic stroke and to identify risk factors for PSD in order to construct a risk prediction model.Methods:A convenience sampling method was used to recruit a total of 450 patients with acute ischemic stroke who were treated in the Department of Neurology at the Affiliated Hospital of Jining Medical University from March 2023 to April 2024. Data were collected using the Edmonton Frail Scale, Hamilton Depression Rating Scale, Barthel Index (Activities of Daily Living, ADL), Pittsburgh Sleep Quality Index, and Morse Fall Scale. Binary logistic regression analysis was performed to explore the impact of frailty on PSD and to identify other risk factors. Based on the results, a predictive model was developed.Results:A total of 450 questionnaires were distributed, with 412 valid responses returned, yielding a valid response rate of 91.56%. The incidence of PSD among the 412 patients was 45.63% (188/412). Binary Logistic regression analysis showed that frailty, sleep disturbance, C-reactive protein (CRP), and ADL score were the influencing factors for PSD in patients with acute ischemic stroke ( P<0.05). These factors were incorporated into the predictive model, and a risk nomogram was constructed. The area under the curve of the model was 0.764 [95% CI (0.716, 0.811) ], indicating good discriminative ability. Internal validation of the nomogram using the Hosmer-Lemeshow goodness-of-fit test showed χ 2=5.883, P=0.66 ( P>0.05), suggesting good calibration of the model. Conclusions:Frailty increases the risk of post-stroke depression in patients with acute ischemic stroke. Sleep disturbance, CRP level, and ADL score are important screening indicators for PSD risk. Targeted assessment and early intervention are recommended to reduce the likelihood of PSD.

Objective:To quantitatively summarize the catechol-O-methyltransferase ( COMT) gene Val158Met polymorphism and the risk of obsessive-compulsive disorder (OCD). Methods:We searched databases including PubMed, Embase, Weipu and Wanfang for randomized controlled trials (RCTs) investigating the association between COMT gene polymorphisms and OCD up to November 1, 2023. Studies that reported genotype frequencies for both OCD patients and general healthy controls were included. Stata11 software was used to calculate pooled odds ratios ( OR) with 95% CI, perform heterogeneity test, and assess publication bias. Results:19 studies with 2, 393 OCD patients and 4, 134 healthy controls were included. The overall results showed that the Val158Met polymorphism was associated with OCD patients (allele model: OR=1.10, 95% CI: 1.02-1.20, P=0.016; homozygote model: OR=1.25, 95% CI:1.05-1.49, P=0.014; recessive model: OR=1.18, 95% CI:1.01-1.37, P=0.040). In the ethnic-stratified analysis, this significant association was mainly observed in Caucasians (allele model: OR=1.17, 95% CI:1.06-1.30, P=0.003; homozygote model: OR=1.35, 95% CI: 1.08-1.67, P=0.008; recessive model: OR=1.21, 95% CI: 1.01-1.44, P=0.041; dominant: OR=1.20, 95% CI: 1.01-1.43 P=0.040), but not in Asians. In gender-stratified analysis, Met-homozygote was associated with male OCD ( OR=1.75, 95% CI: 1.00-3.04, P=0.049). Moreover, the additional analysis found that the risk of OCD was significantly increased in Caucasian males (allele model: OR=1.48, 95% CI: 1.08-2.03, P=0.014; heterozygote model: OR=1.41, 95% CI: 1.03-1.93, P=0.030; dominant model: OR=1.60, 95% CI:1.08-2.38, P=0.020). Conclusion:This meta-analysis suggests that the COMT gene Val158Met polymorphism is associated with an increased risk of OCD in males, particularly in Caucasian males.

Objective:To investigate the impact of frailty on post-stroke depression (PSD) in patients with acute ischemic stroke and to identify risk factors for PSD in order to construct a risk prediction model.Methods:A convenience sampling method was used to recruit a total of 450 patients with acute ischemic stroke who were treated in the Department of Neurology at the Affiliated Hospital of Jining Medical University from March 2023 to April 2024. Data were collected using the Edmonton Frail Scale, Hamilton Depression Rating Scale, Barthel Index (Activities of Daily Living, ADL), Pittsburgh Sleep Quality Index, and Morse Fall Scale. Binary logistic regression analysis was performed to explore the impact of frailty on PSD and to identify other risk factors. Based on the results, a predictive model was developed.Results:A total of 450 questionnaires were distributed, with 412 valid responses returned, yielding a valid response rate of 91.56%. The incidence of PSD among the 412 patients was 45.63% (188/412). Binary Logistic regression analysis showed that frailty, sleep disturbance, C-reactive protein (CRP), and ADL score were the influencing factors for PSD in patients with acute ischemic stroke ( P<0.05). These factors were incorporated into the predictive model, and a risk nomogram was constructed. The area under the curve of the model was 0.764 [95% CI (0.716, 0.811) ], indicating good discriminative ability. Internal validation of the nomogram using the Hosmer-Lemeshow goodness-of-fit test showed χ 2=5.883, P=0.66 ( P>0.05), suggesting good calibration of the model. Conclusions:Frailty increases the risk of post-stroke depression in patients with acute ischemic stroke. Sleep disturbance, CRP level, and ADL score are important screening indicators for PSD risk. Targeted assessment and early intervention are recommended to reduce the likelihood of PSD.

Objective:To quantitatively summarize the catechol-O-methyltransferase ( COMT) gene Val158Met polymorphism and the risk of obsessive-compulsive disorder (OCD). Methods:We searched databases including PubMed, Embase, Weipu and Wanfang for randomized controlled trials (RCTs) investigating the association between COMT gene polymorphisms and OCD up to November 1, 2023. Studies that reported genotype frequencies for both OCD patients and general healthy controls were included. Stata11 software was used to calculate pooled odds ratios ( OR) with 95% CI, perform heterogeneity test, and assess publication bias. Results:19 studies with 2, 393 OCD patients and 4, 134 healthy controls were included. The overall results showed that the Val158Met polymorphism was associated with OCD patients (allele model: OR=1.10, 95% CI: 1.02-1.20, P=0.016; homozygote model: OR=1.25, 95% CI:1.05-1.49, P=0.014; recessive model: OR=1.18, 95% CI:1.01-1.37, P=0.040). In the ethnic-stratified analysis, this significant association was mainly observed in Caucasians (allele model: OR=1.17, 95% CI:1.06-1.30, P=0.003; homozygote model: OR=1.35, 95% CI: 1.08-1.67, P=0.008; recessive model: OR=1.21, 95% CI: 1.01-1.44, P=0.041; dominant: OR=1.20, 95% CI: 1.01-1.43 P=0.040), but not in Asians. In gender-stratified analysis, Met-homozygote was associated with male OCD ( OR=1.75, 95% CI: 1.00-3.04, P=0.049). Moreover, the additional analysis found that the risk of OCD was significantly increased in Caucasian males (allele model: OR=1.48, 95% CI: 1.08-2.03, P=0.014; heterozygote model: OR=1.41, 95% CI: 1.03-1.93, P=0.030; dominant model: OR=1.60, 95% CI:1.08-2.38, P=0.020). Conclusion:This meta-analysis suggests that the COMT gene Val158Met polymorphism is associated with an increased risk of OCD in males, particularly in Caucasian males.

Objective:To explore the correlation between frailty and carotid plaque stability in patients with ischemic stroke.Methods:This study was a cross-sectional study. From May to December 2023, convenience sampling was used to select 360 patients with ischemic stroke in the Department of Neurology of Affiliated Hospital of Jining Medical University and underwent carotid artery color Doppler ultrasound examination as the study subject. Patients were surveyed using the General Information Questionnaire, Barthel Index and the Edmonton Frail Scale. Carotid artery color Doppler ultrasound was used to evaluate the stability of carotid plaques in patients. Multivariate Logistic regression was used to explore the correlation between frailty and carotid plaque stability.Results:A total of 360 questionnaires were distributed, and 352 valid questionnaires were collected, with a valid response rate of 97.78%. The incidence of frailty in 352 ischemic stroke patients was 44.89% (158/352). Multivariate analysis showed that compared to stable plaques, unstable carotid plaques were an independent risk factor for frailty in patients with ischemic stroke ( OR=2.127, 95% confidence interval: 1.247-3.626) . Conclusions:Compared to stable plaques, unstable carotid plaques increase the risk of frailty in patients with ischemic stroke. Strengthening the assessment of carotid plaques in patients with ischemic stroke by nursing staff can early identify high-risk individuals for frailty, and timely carry out personalized interventions, thereby reducing the occurrence of adverse health events in patients.