Objective To investigate the prevalence of thyroid nodules in the physical examination population in Mianyang region and analyze its association with metabolic syndrome. Methods A retrospective study was conducted on 9 978 individuals who underwent health examinations at our hospital from January 2024 to May 2025. Thyroid examinations were performed using color Doppler ultrasound to analyze the prevalence of thyroid nodules in this population. Clinical data of all subjects were collected, and logistic regression analysis was employed to assess the association between metabolic syndrome and the risk of thyroid nodule development. Results The prevalence of thyroid nodules in the physical examination population of Mianyang region was 17.98% (1 794/9 978). The logistic regression results showed that after adjusting for gender, age, BMI, occupation, consumption of non-iodized salt, staying up late, daily sleep duration, anxiety, and depression, metabolic syndrome (OR=6.593, 95% CI: 3.961-10.975) was associated with thyroid nodules (P<0.05). Conclusion The prevalence of thyroid nodules among the physical examination population in the Mianyang area is 17.98%, and metabolic syndrome remains associated with the risk of thyroid nodules after effectively controlling for confounding factors.

Objective: To explore the association between the HLA antibody positivity rate in female blood donors and pregnancy history, number of pregnancies, interval from the last pregnancy to blood donation, and age, to identify associated variables using a univariate generalized additive model (GAM), and to further analyze the predictive role of characteristic variables for HLA antibody positivity using a random forest model. Methods: HLA antibody detection was performed on 391 female blood donors using the Luminex immunomagnetic bead method. The correlation between pregnancy-related factors and HLA antibodies was analyzed using the Chi-square test. Based on R software, a univariate GAM was first constructed to analyze the association types between characteristic variables and the HLA antibody positivity rate, followed by the construction of a random forest model to evaluate the predictive value of the variables. Results: Among the 391 female blood donors without a transfusion history, the overall HLA antibody positivity rate was 26.34%. The positivity rate in donors with a pregnancy history was significantly higher than that in those without (30.09% vs 9.72%, P<0.05), and HLA antibody positivity rate increased linearly with the number of pregnancies (P<0.05). In the univariate GAM, age and number of deliveries exhibited a non-linear association with the HLA antibody positivity rate (the positivity rate increased sharply between 25-35 years of age and stabilized after 3 deliveries). Besides, the interval from the last pregnancy to blood donation showed a linear association with the HLA antibody positivity rate, and the positivity rate decreased as the interval prolonged (P<0.05). In the random forest model, age (mean decrease gini=29.26) and interval from the last pregnancy to blood donation (mean decrease gini=22.02) were core predictive variables: age was more conducive to identifying positive samples, while the interval from the last pregnancy to blood donation was more helpful for excluding negative samples. The number of deliveries (mean decrease accuracy=16.98) made a significant contribution to predicting positive samples, whereas the number of abortions had no impact. The model had an AUC of 0.583 (95% CI: 0.593 8-0.770 2), indicating a certain predictive value. Conclusion: The associated variables identified by the univariate GAM model, including age, interval from the last pregnancy to blood donation, and number of deliveries, provide a basis for key variables in the random forest model. All three variables have predictive value for HLA antibody positivity, which can provide evidence-based support for personalized transfusion management and stratified screening of female blood donors in this region.

In March 2024, three male and two female specimens of the genus Lispe were intercepted on cargo ships inbound for Wan Zai Port under Gongbei Customs. Based on morphological characteristics and molecular analysis, the specimens were identified as Lispe pumila. In this study, we describe the morphological features, diagnostic characteristics, and geographical distribution of L. pumila, with the aim of providing a reference for the identification of this species when intercepted at ports.

Background and aims The mechanism of cholestatic liver injury (CLI) is unclear, and effective therapies are lacking. While peroxisome proliferator-activated receptor alpha (PPARα) agonists show potential hepatoprotective effect and pyroptosis is implicated in hepatocellular damage, how PPARα activation mitigates lithocholic acid (LCA)-induced pyroptosis remains unknown. Methods The hepatoprotective effect of PPARα agonists was evaluated in a mouse model of intrahepatic cholestasis induced by LCA. Liver injury was assessed via serum biochemistry, hematoxylin and eosin and TUNEL staining, and electron microscopy. Pyroptosis pathways were analyzed using real-time quantitative polymerase chain reaction, Western blot, and co-immunoprecipitation. Results Combined morphological, histopathological, and biochemical analyses confirmed that PPARα activation protects against CLI. Compared with LCA treatment alone, PPARα activation significantly attenuated the elevation of serum lactate dehydrogenase (LDH), the increased TUNEL-positive cells, and the formation of hepatocyte membrane pores. Mechanistically, PPARα activation suppressed both NOD-like receptor protein 3 (NLRP3) inflammasome-mediated pyroptosis and apoptosis protease-activating factor-1 (APAF-1)/CASPASE-3/GSDME-mediated pyroptosis. Furthermore, PPARα agonist pretreatment inhibited activation of the nuclear factor-kappa B (NF-κB) and forkhead box O1 (FOXO1) signaling pathways. Conclusions PPARα protects against LCA-induced CLI by inhibiting both NLRP3 inflammasome-mediated pyroptosis associated with NF-κB and APAF-1/CASPASE-3/GSDME-mediated pyroptosis associated with the FOXO1 signaling pathway.

BackgroundSuicide and self-injury risk in patients with depression disorder is associated with pain symptoms， but the relationships between specific pain types and their severity and distinct self-injury/suicide risk phenotypes remain controversial. ObjectiveTo explore whether somatic pain can reflect different self-injury/suicide risk phenotypes， and to provide references for the clinical identification of suicide and self-injury risk in patients with depression. MethodsBased on data from the National Survey on Symptomatology of Depression （NSSD）， 3 275 patients who met the diagnostic criteria for major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders， fourth edition， text revision （DSM-IV-TR） were recruited. According to previous suicidal behavior， suicidal ideation and self-injury behavior in the past two weeks， patients were divided into the no self-injury/suicide risk group， self-injury group， and high suicide-risk group. The occurrence of headache， muscle soreness， trunk pain， limb pain， and other pain symptoms was assessed using the structured symptom assessment instrument of the NSSD. With the no self-injury/suicide risk group as the reference， an ordinal Logistic regression model was used to analyze the associations between the risk groups and the occurrence frequency of pain， with demographic and clinical characteristics entered into the model as covariates for adjustment. ResultsA total of 3 211 patients （98.05%） were included in the analysis， including 1 329 cases （41.39%） in the no self-injury/suicide risk group， 415 cases （12.92%） in the self-injury group， and 1 467 cases （45.69%） in the high suicide-risk group. Compared with the no self-injury/suicide risk group， the occurrence frequencies of headache （OR=1.526， 95% CI： 1.221–1.894） and muscle soreness （OR=1.287， 95% CI： 1.034–1.597） were higher in the self-injury group， and the occurrence frequencies of headache （OR=0.583， 95% CI： 0.504–0.672）， muscle soreness （OR=0.682， 95% CI： 0.597–0.780）， trunk pain （OR=0.557， 95% CI： 0.475–0.634）， limb pain （OR=0.454， 95% CI： 0.384–0.522）， and other pain difficult to localize （OR=0.542， 95% CI： 0.472–0.631） were all lower in the high suicide-risk group. ConclusionPatients with depression disorder across different self-injury and suicide risk phenotypes exhibit distinct pain characteristics， and these differences may provide a reference for the clinical identification of suicide and self-injury risk in patients with depression disorder. ［Funded by The National Key Research and Development Program of China during the "13th Five-Year Plan" period （number， 2016YFC1307100）； Shanghai Key Clinical Specialties Construction Project］

Helicobacter pylori （H. pylori） infection is not only associated with gastrointestinal diseases， but also potentially links with neuropsychiatric disorders revealed by recent studies. Through a systematic review of the existing literature， this review summarizes epidemiological evidence for the association between H. pylori infection and diseases such as Parkinson′s disease （PD）， Alzheimer′s disease （AD）， multiple sclerosis （MS）， migraine， depression， and anxiety disorders， and further explores potential mechanisms by which it affects central nervous system function， including neural pathways mediated by the enteric nervous system and the vagus nerve， immune pathways mediated by inflammatory cytokines， and endocrine pathways mediated by gut microbial metabolites. Additionally， the current challenges facing H. pylori eradication therapy and the prospects for emerging adjuvant strategies such as probiotics and fecal microbiota transplantation are discussed. Finally， future research directions are outlined， emphasizing the need for prospective cohort studies based on standardized diagnostic methods and further investigation using animal models to elucidate the pathophysiological mechanisms， with the aim of providing new perspectives for the prevention， treatment， and early intervention of related neuropsychiatric disorders.

ObjectiveTo investigate the efficacy of Poge Jiuxin decoction （PGJXD） on fluid resuscitation in septic shock patients and its effects on vascular endothelial function based on clinical randomized controlled trials （RCTs） and network pharmacology， and to reveal its molecular mechanisms and signaling pathways through network pharmacology. MethodsSeventy-two septic shock patients were enrolled and randomly assigned to either the treatment group or the control group （36 cases each） through a random number table. Both groups received conventional Western medical treatment for sepsis. Additionally， the treatment group received PGJXD （100 mL， twice daily） for 3 consecutive days. The two groups were compared in terms of the Sequential Organ Failure Assessment （SOFA） score， Acute Physiology and Chronic Health Evaluation Ⅱ （APACHE Ⅱ） score， vascular endothelial function indicators ［endothelium-derived relaxing factor （EDRF）， nitric oxide （NO）， and 6-keto-prostaglandin F_1α （6-keto-PGF_1α）］， inflammation indicators ［tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， nuclear factor kappa-B （NF-κB）， and procalcitonin （PCT）］， perfusion indicators ［mean arterial pressure （MAP）， lactate （Lac）， and 72-hour lactate clearance rate （Lcr）］， fluid resuscitation target achievement time， vasopressor use duration， length of hospital stay， and 28-day mortality. Databases including TCMSP， HIT 2.0， and Uniprot were searched for active components of PGJXD and their targets. Gene targets for septic shock were obtained from GeneCards， OMIM， and DrugBank databases. Venny software was used to identify common targets between PGJXD and septic shock. Cytoscape software and the STRING database were utilized to construct a "drug-component-target-disease" network and a protein-protein interaction （PPI） network. Gene Ontology （GO） functional enrichment analysis， Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway analysis， and molecular docking were performed to explore the molecular mechanisms and signaling pathways of PGJXD in treating septic shock. ResultsFive patients withdrew from the treatment group and seven from the control group. After treatment， both groups showed decreases （P<0.01） in APACHE Ⅱ score， SOFA score， EDRF， 6-keto-PGF_1α， TNF-α， IL-6， NF-κB， PCT， MAP， and Lac， and increases in NO （P<0.01）. The treatment group exhibited more significant decreases （P<0.05， P<0.01） in APACHE Ⅱ score， SOFA score， 6-keto-PGF_1α， TNF-α， IL-6， NF-κB， MAP， Lac， Lcr， fluid resuscitation target achievement time， and vasopressor use duration than the control group. Differences in EDRF， NO， PCT， length of hospital stay， and 28-day mortality were not statistically significant. No significant adverse reactions were observed in either group during treatment. Network pharmacology identified 189 components and 257 potential targets of PGJXD， and 136 common targets shared by PGJXD and septic shock. GO enrichment analysis primarily involved positive regulation of cell migration， response to peptide， response to inorganic substance， etc. KEGG enrichment analysis mainly implicated signaling pathways such as NF-κB， VEGF， and Relaxin. ConclusionPGJXD can significantly ameliorate the condition of septic shock patients and enhance the efficacy of fluid resuscitation. Its key mechanism may involve protecting vascular endothelial cells by regulating the TNF-α/NF-κB signaling pathway and reducing the inflammatory response.

Objective To explore the association between mid-upper arm circumference(MUAC)and sarcopenia in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 402 middle-aged and elderly patients with T2DM admitted to Nanjing Drum Tower Hospital Group Suqian Hospital from March 2022 to October 2024 were selected.Among them,308 patients with simple diabetes mellitus were included in non-sarcopenia group,and 94 patients with combined sarcopenia were included in sarcopenia group.Multivariate Logistic regression analysis was used to determine the association between MU AC and sarcopenia in middle-aged and elderly patients with T2DM.The predictive ability of MUAC for sarcopenia in middle-aged and elderly patients with T2DM was evaluated by using the receiver operating characteristic curve.Results There were statistically significant differences in age,body mass index,MUAC,triglycerides,direct bilirubin,alanine aminotransferase,aspartate aminotransferase,appendicular skeletal muscle mass,appendicular skeletal muscle mass index,grip strength and 6-meter walking speed between two groups of patients(P＜0.05).The results of multivariate Logistic regression showed that a smaller MUAC and increased age were both risk factors for sarcopenia in middle-aged and elderly patients with T2DM(P＜0.05).The optimal cutoff value of MUAC for diagnosing sarcopenia in middle-aged and elderly patients with T2DM:27.90cm for males and 26.95cm for females.Conclusion MUAC is associated with sarcopenia in middle-aged and elderly patients with T2DM and can be used for the early identification and diagnosis of middle-aged and elderly T2DM patients with sarcopenia.

OBJECTIVE To analyze the outcomes of hearing screening and rescreening among preschool children in two districts and eight counties of Xinyang City,to explore the major etiological patterns,and to evaluate parental awareness of childhood hearing health,thereby providing evidence for regional preschool hearing health management.METHODS A total of 4 020 preschool children aged 3.0-6.5 years who underwent hearing screening in Xinyang between January 2023 and January 2025 were included.The initial screening employed transient evoked otoacoustic emissions(TEOAE)and tympanometry.Children who failed the initial screening were rescreened one month later under standardized conditions using tympanometry and distortion product otoacoustic emissions(DPOAE).Those who still failed underwent further auditory evaluations,including auditory steady-state response(ASSR),auditory brainstem response(ABR),and imaging examinations.Prior to rescreening,parents or guardians completed a structured questionnaire on hearing health knowledge and perceptions of their child's auditory behaviors.RESULTS The initial screening failure rate was 12.1%(121/1 002)in the counties and 6.1%(184/3018)in the districts,with a significant difference between the two groups(χ2=37.51,P<0.001).The age of children who failed the initial screening was(5.74±0.90)years in the counties and(4.99±0.93)years in the districts,also significantly different(t=7.03,P<0.001).Overall,305 children failed the initial screening(7.6%,305/4 020).At rescreening,127 cases(41.6%,127/305)remained abnormal;118 of them completed further testing and were diagnosed with otitis media with effusion(OME)in 111 cases(94.1%,some with concurrent sinusitis or adenoid/tonsillar hypertrophy),sensorineural hearing loss in 5 cases(4.2%),and cholesteatoma in 2 cases(1.7%).Parental survey results showed that 92.1%were unaware of ototoxic drugs,38.1%of parents of affected children failed to recognize their child's hearing problems,while 21.3%of parents of normal-hearing children misjudged their child as having poor auditory responses.CONCLUSION OME was the most common cause of hearing abnormalities in preschool children in Xinyang.Higher failure rates in county-level areas highlight the need to strengthen regional preschool hearing screening systems.Parental awareness of childhood hearing health was insufficient,underscoring the importance of targeted health education to improve early recognition and timely intervention,thereby supporting optimal language,learning,and social development in preschool children.

Under the background of forensic medicine becoming a first-level discipline,the opportuni-ties and challenges of discipline development coexist.Starting from the actual situation and characteris-tics of local medical colleges and universities,this paper discusses the problems and solutions for the development of forensic medicine discipline from the perspective of building a regional high-level medical university.Combined with the experiences of carrying out forensic medicine education in our college,this paper supplies our thoughts and practices on improving the discipline system,enhancing the ability to serve society,perfecting the talent cultivation model and promoting forensic culture,to provide reference and inspiration for the development of forensic medicine in other universities,jointly promote the advancement of forensic medicine in China to a new stage,and contribute the wisdom and strength of forensic medical experts to the construction of a law-based China,a safe China and a healthy China.