ObjectiveTo explore the possible mechanisms of Shoutai Wan （寿胎丸） in treating recurrent miscarriage （RSA） from the perspective of immune tolerance under the acidic microenvironment at the maternal-fetal interface. MethodsFemale CBA/J mice were randomly divided into normal group， model group， progesterone group， and Shoutai Wan group， with 15 mice in each group. The mice in the normal group and model group were given 0.2 ml distilled water by gavage each day， the Shoutai Wan group given Shoutai Wan decoction 0.15 g/（10 g·d） by gavage， the progesterone group given progesterone tablets 0.44 mg/（10 g·d） by gavage. After gavage for 14 days， the mice were cohabited. Female CBA/J mice in the normal group were mated with male BALB/c mice at a ratio of 2∶1， and female CBA/J mice in the other groups were mated with male DBA/2 mice at a ratio of 2∶1 to establish the RSA mouse model. Vaginal smears were taken from the female mice the next morning， and the appearance of a large number of spermatozoa and the presence of a vaginal plug were considered as the first day of pregnancy. After the appearance of the plug， the mice were continued to be administered according to the previous method until the 10th day of pregnancy. On the 10th day of pregnancy， maternal-fetal interface tissues were collected from each group of mice， and lactate dehydrogenase colorimetric method was used to detect lactate （LA） content； qPCR method and Western blot method were used to detect the expression of immune-related factors interleukin-4 （IL-4）， interferon-gamma （IFN-γ）， transforming growth factor beta 1 （TGF-β1）， and forkhead box protein 3 （Foxp3） mRNA and protein； flow cytometry was used to detect the numbers of helper T lymphocyte 1 （Th1）， helper T lymphocyte 2 （Th2）， regulatory T cell （Treg）， classical macrophage （M1）， and alternative macrophage （M2）. The bivariate Pearson test was used to analyze the correlation between LA content and the numbers of Th1， Th2， Treg， M1， and M2 cells， as well as the correlation between LA content and the expression of IL-4， IFN-γ， TGF-β1， Foxp3 protein， and mRNA. ResultsOn the 10th day of pregnancy， compared with the normal group， the LA content decreased in the model group， and the expression of IL-4， TGF-β1， Foxp3 protein and mRNA in the maternal-fetal interface tissues decreased， while the expression of IFN-γ protein and mRNA increased. The numbers of Th1 and M1 cells increased， while the numbers of Th2， Treg， and M2 cells decreased （P＜0.05 or P＜0.01）. Compared with the model group， the LA content increased in the Shoutai Wan group and progesterone group. The expression of IL-4， TGF-β1， Foxp3 protein and mRNA in the maternal-fetal interface tissues increased， while the expression of IFN-γ protein and mRNA decreased. The numbers of Th1 and M1 cells decreased， while the numbers of Th2， Treg， and M2 cells increased （P＜0.05 or P＜0.01）. The LA content was positively correlated with the numbers of Th2， Treg， and M2 cells， and the expression of IL-4， TGF-β1， Foxp3 protein， and mRNA （P＜0.05 or P＜0.01）； the LA content was negatively correlated with the numbers of Th1， M1 cells， and the expression of IFN-γ protein and mRNA （P＜0.05 or P＜0.01）. ConclusionShoutai Wan may improve immune tolerance by regulating the expression of immune-related factors in the acidic microenvironment at the maternal-fetal interface of RSA model mice， thereby exerting its role in preventing miscarriage.

To achieve the goals of carbon peak and carbon neutrality (double carbon), China has been updating and developing low-carbon coal-fired power generation technology. While reducing carbon dioxide emissions, it has achieved a significant reduction in emissions of pollutants such as particulate matter, sulfur dioxide, and nitrogen oxides. However, at the same time, with the relative increase in emissions of certain pollutants such as sulfur trioxide, ammonia, and volatile organic compounds, the types and proportions of pollutant emissions have changed. This study summarized the technological improvements in coal-fired power generation both domestically and internationally, as well as the types and proportions of pollutants emitted by different coal-fired power generation modes. It also reviewed the epidemiological research progress on the impact of pollutants emitted from coal-fired power generation on the cardiopulmonary health of the population, expounded environmental impact of different coal-fired power models, and analyzed the changes in population exposure load and cardiopulmonary health benefits of low-carbon coal-fired power generation emissions, aiming to provide references for achieving carbon reduction and emission reduction goals and protecting the health of the population.

To achieve the goals of carbon peak and carbon neutrality (double carbon), China has been updating and developing low-carbon coal-fired power generation technology. While reducing carbon dioxide emissions, it has achieved a significant reduction in emissions of pollutants such as particulate matter, sulfur dioxide, and nitrogen oxides. However, at the same time, with the relative increase in emissions of certain pollutants such as sulfur trioxide, ammonia, and volatile organic compounds, the types and proportions of pollutant emissions have changed. This study summarized the technological improvements in coal-fired power generation both domestically and internationally, as well as the types and proportions of pollutants emitted by different coal-fired power generation modes. It also reviewed the epidemiological research progress on the impact of pollutants emitted from coal-fired power generation on the cardiopulmonary health of the population, expounded environmental impact of different coal-fired power models, and analyzed the changes in population exposure load and cardiopulmonary health benefits of low-carbon coal-fired power generation emissions, aiming to provide references for achieving carbon reduction and emission reduction goals and protecting the health of the population.

Objective To investigate the prognostic value of prognostic nutritional index (PNI) and modified Glasgow prognostic score (mGPS) in patients with cervical cancer. Methods A total of 120 patients with cervical cancer were selected as the study subjects. Patients' data were collected and analyzed, with follow-up conducted until June 30, 2023. Kaplan-Meier method was used to plot survival curves. Log-rank test and Cox regression analysis were employed to identify prognostic factors. Results The median follow-up time for patients in this study was 61 months, with a median survival time of 52 months. During the follow-up period, 41 patients (34.17%) died. The 3-year and 5-year survival rates were 82.50% and 66.67%, respectively. Receiver operating characteristic (ROC) curves showed that the areas under the curve (AUC) for PNI, mGPS, albumin (ALB), lymphocytes (LYM), C-reactive protein (CRP), and neutrophils (NEU) in predicting patient prognosis were 0.90, 0.81, 0.84, 0.86, 0.82, and 0.71, respectively. The optimal cutoff values were determined to be 41.80 for PNI, 0.50 points for mGPS, 34.25 g/L for ALB, 1.44×10⁹/L for LYM, 5.45×10⁹/L for CRP and 7.25 mg/L for NEU. Cox regression analysis indicated that PNI (HR=4.18, 95%CI=2.83 to 9.21, P=0.015), mGPS [HR=1.95, 95%CI=1.37 to 3.59, P < 0.001 (mGPS=1 point); HR=3.07, 95%CI=2.38 to 5.36, P < 0.001(mGPS=2 points)] and International Federation of Gynecology and Obstetrics (FIGO) staging [HR=2.03, 95%CI=1.34 to 3.85, P=0.030(FIGO stage=stage Ⅲ); HR=3.46, 95%CI=2.15 to 6.62, P=0.003 (FIGO stage=stage Ⅳ)]were significant risk factors affecting the prognosis of cervical cancer patients. Conclusion PNI, mGPS and FIGO staging are important predictors of prognosis in cervical cancer patients. Attention to PNI and mGPS before treatment may help improve clinical outcomes.

OBJECTIVE: To validate the effectiveness of a novel comprehensive classification for intertrochanteric fracture (ITF). METHODS: The study included 616 patients with ITF, including 279 males (45.29%) and 337 females (54.71%); the age ranged from 23 to 100 years, with an average of 72.5 years. Two orthopaedic residents (observers Ⅰ and Ⅱ) and two senior orthopaedic surgeons (observers Ⅲ and Ⅳ) were selected to classify the CT imaging data of 616 patients in a random order by using the AO/Orthopaedic Trauma Association (AO/OTA) classification of 1996/2007 edition, the AO/OTA classification of 2018 edition, and the novel comprehensive classification method at an interval of 1 month. Kappa consistency test was used to evaluate the intra-observer and inter-observer consistency of the three ITF classification systems. RESULTS: The inter-observer consistency of the three classification systems evaluated by 4 observers twice showed that the 3 classification systems had strong inter-observer consistency. Among them, the κ value of the novel comprehensive classification was higher than that of the AO/OTA classification of 1996/2007 edition and 2018 edition, and the experience of observers had a certain impact on the classification results, and the inter-observer consistency of orthopaedic residents was slightly better than that of senior orthopaedic surgeons. The intra-observer consistency of two evaluations of three classification systems by 4 observers showed that the consistency of the novel comprehensive classification was better for the other 3 observers, except that the consistency of observer Ⅳ in the AO/OTA classification of 2018 version was slightly higher than that of the novel comprehensive classification. The results showed that the novel comprehensive classification has higher repeatability, and the intra-observer consistency of senior orthopaedic surgeons was better than that of orthopaedic residents. CONCLUSION The novel comprehensive classification system has good intra- and inter-observer consistency, and has high validity in the classification of CT images of ITF patients; the experience of observers has a certain impact on the results of the three classification systems, and those with more experiences have higher intra-observer consistency.
Male ; Female ; Humans ; Young Adult ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Observer Variation ; Reproducibility of Results ; Hip Fractures/surgery* ; Tomography, X-Ray Computed/methods* ; Radiography

Objective:To analyze the clinical features, postoperative recurrence and prognostic factors of young patients with cervical cancer.Methods:The clinical data of hospitalized cervical cancer patients in the Affiliated Hospital of Qingdao University from January 2004 to March 2019 were retrospectively studied. 243 young cervical cancer patients ≤35 years old were selected as the study group. The method of case-control study was adopted. In the same period, 250 first and second cervical cancer patients aged >35 years were randomly selected as the control group. The clinical data of the two groups were compared, and the survival curves of the two groups were analyzed. The clinical data of patients with postoperative recurrence (17 cases) and patients without recurrence (164 cases) in the study group were compared, and the related data affecting the prognosis of young cervical cancer patients were analyzed by univariate and multivariate analysis. Statistical data were compared by χ 2 test or exact probability method. Kaplan-meier method was used to estimate survival rate and draw survival curve. Survival rate was compared by Long-Rank test. COX regression model was used for multivariate analysis. Results:Compared with the control group, the young cervical cancer patients had earlier age of marriage, menstruate, fewer pregnancies, no preoperative adjuvant therapy, more nerve infiltration and ovarian preservation, the difference was statistically significant (χ 2 values were 94.58, 67.54, 60.53, 5.44, 13.64, 5.51, and 118.24, respectively; P values were <0.001, <0.001, <0.001, 0.025, 0.022, <0.001, respectively). The proportion of irregular vaginal bleeding in study group (13.17%(32/243)) was lower than that in control group (30.40%(76/250)), and the proportion of contact vaginal bleeding (52.26%(127/243)) was higher than that in control group (43.20%(108/250)). There were significant differences between the two groups (χ 2 values were 21.39 and 4.06, respectively; P values were < 0.001 and 0.044, respectively). There was no significant difference in Kaplan-Meier survival rate between the study group and the control group (χ 2=0.03, P=0.859). Univariate analysis showed that the International Federation of Gynecology and Obstetrics(FIGO), whether to retain ovary, depth of cervical invasion, nerve invasion, lymphatic vascular space invasion and pelvic lymph node metastasis were the influencing factors of 5-year survival rate of young cervical cancer patients ( P values were 0.016, 0.008, 0.014, 0.017, 0.004, <0.001, respectively). Multivariate analysis showed FIGO staging ( OR=2.073, 95% CI: 1.017-4.228, P=0.045), lymphatic vascular space infiltration ( OR=0.041, 95% CI: 0.005-0.341, P=0.019) and pelvic lymph node metastasis ( OR=0.027, 95% CI: 0.004-0.197, P<0.001) were risk factors affecting the prognosis of young cervical cancer. The patients with low FIGO stage, no lymphatic vascular space infiltration and pelvic lymph node metastasis have a good prognosis. Conclusion In young patients with cervical cancer, the first clinical feature is mainly contact vaginal bleeding. The prognosis of young patients with cervical cancer and 5 years survival rate there was no statistically significant difference compared with control group. The later FIGO staging , no ovarinan retention and the deeper cervical infiltration depth , with the nerve or between lymphatic vascular invasion and pelvic lymph node metastasis in young patients with cervical cancer had poor prognosis, and FIGO stage, lymphatic vessel space invasion and pelvic lymph node metastasis were the most significant factors.

Objective To explore the effect of coronavirus disease 2019 (COVID-19) on the frequency of chest CT scan. Methods A retrospective study was conducted to extract information on the number of outpatient, emergency, and inpatient visits and patients who had chest CT imaging examination from January 1 to December 31, 2020 and in the same period in 2019 through the hospital’s medical data platform for analysis, and the chi-square test was used to analyze whether the difference in the proportion of patients who had chest CT imaging examination between 2019 and 2020 was statistically significant. Results The proportion of outpatients and emergency patients with chest CT examination was significantly higher in 2020 than in 2019 (2.48% vs 1.47%, χ² = 581.7, P < 0.000). The proportion of inpatients who underwent chest CT examination was significantly higher in 2020 than in 2019 (35.47% vs 28.01%, χ² = 182.0, P < 0.000). Conclusion Under the COVID-19 epidemic, the proportion of chest CT examination in this hospital in 2020 shows a significant upward trend compared with the same period in 2019, which will increase the collective dose due to medical exposure, and the hospital should pay attention to the determination of the legitimacy of chest CT scan.

Aging/metabolism* ; Animals ; Gene Expression Regulation ; Macaca fascicularis ; Retina/metabolism* ; Single-Cell Analysis

COVID-19 has swept globally and Pakistan is no exception.To investigate the initial introductions and transmissions of the SARS-CoV-2 in Pakistan,we performed the largest genomic epidemiology study of COVID-19 in Pakistan and generated 150 complete SARS-CoV-2 genome sequences from samples collected from March 16 to June 1,2020.We identified a total of 347 mutated positions,31 of which were over-represented in Pakistan.Meanwhile,we found over 1000 intra-host single-nucleotide variants(iSNVs).Several of them occurred concurrently,indicating possible interactions among them or coevolution.Some of the high-frequency iSNVs in Pakistan were not observed in the global population,suggesting strong purifying selections.The genomic epidemiology revealed five distinctive spreading clusters.The largest cluster consisted of 74 viruses which were derived from different geographic locations of Pakistan and formed a deep hierarchical structure,indicating an extensive and persistent nation-wide transmission of the virus that was probably attributed to a signature mutation(G8371T in ORF 1ab)of this cluster.Further-more,28 putative international introductions were identified,several of which are consistent with the epidemiological investigations.In all,this study has inferred the possible pathways of introduc-tions and transmissions of SARS-CoV-2 in Pakistan,which could aid ongoing and future viral surveillance and COVID-19 control.

Objective:To establish a quick and convenient method for detecting human adenoviruses (Human adenoviruses, HAdV) based on immunochromatographic assay (ICA).Methods:Two antibody clones, 3C11 and 7E6 were found to bind to all tested HAdVs and then subsequently processed into ICA. The specificity and sensitivity were evaluated using representative strains of the respiratory HAdV types, including HAdV-1, 2, 3, 4, 5, 6, 7, 10 and a gastroenteric type HAdV-41 together with the original throat swabs of 10 HAdV patients confirmed by nuclear acid testing (NAT).Results:The ICA exhibited high specificity to HAdVs and its detection limitation ranged from 0.16 to 10 3 half tissue culture infectious dose (TCID 50)/ml for different types of HAdVs. All clinic samples with successful virus isolation tested by this ICA showed positive result . Conclusions:The ICA developed in the present study will be suitable for HAdVs screening in clinic setting, especially for those of respiratory types.