The circadian system maintains physiological homeostasis by precisely orchestrating 24-hour cycles of metabolic and cardiovascular functions. Circadian disruption has been substantiated as a contributor to cardiometabolic dysfunction, significantly elevating the risk of obesity, type 2 diabetes, hypertension, and cardiovascular diseases, thereby emerging as a crucial target for global chronic disease prevention. In 2025, the American Heart Association (AHA) issued a dedicated scientific statement that systematically reviewed the regulatory mechanisms of circadian rhythms and their intrinsic links to cardiometabolic health. It highlighted the pivotal role of modifiable behavioral factors, including light exposure, sleep-wake patterns, meal timing, and timing of physical activity, and proposed multi-faceted intervention strategies centered on chronotherapy. Considering the distinct circadian characteristics and chronic disease epidemiology in the Chinese population compared to Western counterparts, this article, grounded in the statement's core framework and incorporating evidence from localized Chinese research, provides a systematic interpretation of the biological basis of circadian rhythms, the pathophysiological mechanisms underlying disruption-related diseases, and potential intervention pathways. It particularly discusses the applicability of the statement's conclusions to clinical practice and public health strategies in China, aiming to offer an evidence-based reference for developing a cardiometabolic health support system tailored to the national context.

Objective:To understand the current status of the actual protective effect of respiratory protective equipment (RPE) for workers exposed to trichloroethylene (TCE), and to explore the factors affecting the actual protective effect.Methods:From July to December 2023, a total of 75 workers occupationally exposed to TCE from 21 hardware and electronics manufacturing facilities in a province were selected as research objects by convenient sampling method. Workplace protection factor (WPF) was used as an index to evaluate the actual protective effect of workers' RPE. The concentration of TCE inside and outside the RPE was detected to calculate WPE, and the temperature, humidity and wind speed near the working place were measured, as well as the forced vital capacity, respiratory rate, heart rate and other indicators of the worker were measured. The log-transformed WPF value (lgWPF) followed a normal distribution. One-sample t-test was used to compare the difference between the mean lgWPF and the log value of the assigned protection factor (APF) of the half mask (lgAPF=1). Multiple linear regression model was used to investigate the influencing factors of lgWPF. Results:The lgWPF of 75 TCE-exposed workers ranged from 0.40 to 1.32 (0.84±0.22). The mean of lgWPF was lower than that of lgAPF, and the difference was statistically significant ( t=-6.37, P<0.001). After adjusting for confounding factors, the results of multiple linear regression showed that humidity, forced vital capacity and respiratory rate were negatively correlated with lgWPF ( β=-0.008, -0.079, -0.021, P<0.05) . Conclusion:The actual protective efficacy of RPE among workers exposed to TCE is suboptimal. High humidity, elevated forced vital capacity, and increased respiratory rate may be contributing factors to the diminished protective performance of RPE.

Objective:To understand the current status of the actual protective effect of respiratory protective equipment (RPE) for workers exposed to trichloroethylene (TCE), and to explore the factors affecting the actual protective effect.Methods:From July to December 2023, a total of 75 workers occupationally exposed to TCE from 21 hardware and electronics manufacturing facilities in a province were selected as research objects by convenient sampling method. Workplace protection factor (WPF) was used as an index to evaluate the actual protective effect of workers' RPE. The concentration of TCE inside and outside the RPE was detected to calculate WPE, and the temperature, humidity and wind speed near the working place were measured, as well as the forced vital capacity, respiratory rate, heart rate and other indicators of the worker were measured. The log-transformed WPF value (lgWPF) followed a normal distribution. One-sample t-test was used to compare the difference between the mean lgWPF and the log value of the assigned protection factor (APF) of the half mask (lgAPF=1). Multiple linear regression model was used to investigate the influencing factors of lgWPF. Results:The lgWPF of 75 TCE-exposed workers ranged from 0.40 to 1.32 (0.84±0.22). The mean of lgWPF was lower than that of lgAPF, and the difference was statistically significant ( t=-6.37, P<0.001). After adjusting for confounding factors, the results of multiple linear regression showed that humidity, forced vital capacity and respiratory rate were negatively correlated with lgWPF ( β=-0.008, -0.079, -0.021, P<0.05) . Conclusion:The actual protective efficacy of RPE among workers exposed to TCE is suboptimal. High humidity, elevated forced vital capacity, and increased respiratory rate may be contributing factors to the diminished protective performance of RPE.

Objective To investigate the immediate brain effect of acupuncture at Fengchi using amplitude of low-frequency fluctuation(ALFF)and functional connectivity by the resting-state functional magnetic resonance imaging(rs-fMRI)in patients with posterior circulation ischemia vertigo(PCIV).Methods Twenty patients with PCIV were enrolled.The dizziness handicap inventory(DHI)was used to evaluate the severity of vertigo.The patients were randomly divided into acupuncture group and sham acupoint acupuncture group.Rs-fMRI scan was performed before and after acupuncture.MATLAB-based DPABI 6.1 software was used to analyze rs-fMRI data.Correlation analysis was used between the altered ALFF values and DHI scores.The regions of altered ALFF were taken as seeds to analyze functional connectivity.Results Compared with the sham acupoint acupuncture group,the increased ALFF values were mainly located on the left precuneus,left superior frontal gyrus and left caudate nucleus after acupuncture in the acupuncture group;the decreased ALFF values were mainly located on the left cerebellum and right inferior occipital gyrus.The ALFF value of the left superior frontal gyrus was negatively correlated with the DHI score(P=0.04).The increased functional connectivity was mainly found between left precuneus and the right middle frontal gyrus,the right superior frontal gyrus,the decreased functional connectivity was mainly found between left precuneus and the bilateral paracentral lobule and right cerebellum.Conclusion The ALFF value and functional connectivity are different before and after acupuncture,indicating that the vestibular network,visual and motor brain regions functional activities are changed after needling at Fengchi,which may be the brain functional basis of Fengchi for vertigo in PCIV.

Objective To explore the causal relationship between sleep phenotype and idiopathic normal pressure hydrocephalus(iNPH)using two-sample bidirectional Mendelian randomization.Methods The exposure data including 8 sleep phenotypes used in this study were obtained from GWAS catalog,FinnGenR10 and MRCIEU GWAS.The outcome data for idiopathic normal-pressure hydrocephalus were obtained from FinnGen R10.We used the inverse-variance weighted(IVW)method to perform the principal analyses.Cochrane Q-statistics test was used to assess the heterogeneity and MR Egger-intercept test performed to evaluate the pleiotropy for sensitivity analyses.Results IVW result showed that frequent daytime nap was associated with higher odds of iNPH(OR=3.3393,95 CI%:1.0646-10.4742,P=0.0270).Cochrane Q-statistics test and MR Egger-intercept test showed that the MR analysis had no pleiotropy or heterogeneity(P>0.05).The external validation reproduced this result(OR=2.5660,95 CI%:1.1680-5.6373,P=0.0189;OR=4.0424,95 CI%:1.5709-10.4024,P=0.0038).Reverse Mendelian randomization suggested that iNPH did not have significant impact on sleep phenotype.Conclusion The frequency of daytime naps is causally associated with iNPH,and reducing the frequency of weekly daytime naps can reduce the risk of iNPH in the elderly population.

Objective To explore the causal relationship between sleep phenotype and idiopathic normal pressure hydrocephalus(iNPH)using two-sample bidirectional Mendelian randomization.Methods The exposure data including 8 sleep phenotypes used in this study were obtained from GWAS catalog,FinnGenR10 and MRCIEU GWAS.The outcome data for idiopathic normal-pressure hydrocephalus were obtained from FinnGen R10.We used the inverse-variance weighted(IVW)method to perform the principal analyses.Cochrane Q-statistics test was used to assess the heterogeneity and MR Egger-intercept test performed to evaluate the pleiotropy for sensitivity analyses.Results IVW result showed that frequent daytime nap was associated with higher odds of iNPH(OR=3.3393,95 CI%:1.0646-10.4742,P=0.0270).Cochrane Q-statistics test and MR Egger-intercept test showed that the MR analysis had no pleiotropy or heterogeneity(P>0.05).The external validation reproduced this result(OR=2.5660,95 CI%:1.1680-5.6373,P=0.0189;OR=4.0424,95 CI%:1.5709-10.4024,P=0.0038).Reverse Mendelian randomization suggested that iNPH did not have significant impact on sleep phenotype.Conclusion The frequency of daytime naps is causally associated with iNPH,and reducing the frequency of weekly daytime naps can reduce the risk of iNPH in the elderly population.

Objective:To study the risk factors of surgical therapy in neonates with necrotizing enterocolitis (NEC).Methods:From January 2016 to July 2020, neonates with a confirmed diagnosis of NEC (Bell's Stage Ⅱ and above) admitted to our hospital were retrospectively enrolled. They were assigned into surgical group and conservative group according to whether surgeries were performed. The conditions during perinatal period, clinical characteristics and laboratory examinations at the onset of NEC were compared between the two groups. Multivariate Logistic regression analysis was used to determine the risk factors of surgical therapy.Results:A total of 177 neonates with NEC were identified, including 62 cases (35.0%) in the surgical group and 115 cases (65.0%) in the conservative group. Multivariate Logistic regression analysis showed that male gender ( OR=3.178,95% CI 1.457~6.929, P=0.004), comorbidity with shock ( OR=3.434, 95% CI 1.112~10.607, P=0.032), mechanical ventilation>7 d before NEC onset ( OR=3.663, 95% CI 1.098~12.223, P=0.035) and lymphocytes <2.0×10 9/L ( OR=4.121, 95% CI 1.801~9.430, P=0.001) at the onset of NEC were independent risk factors for surgical therapy. Conclusions:Male gender, comorbidity with shock, mechanical ventilation >7 d before NEC and lymphocytopenia at the onset are independent risk factors for surgical therapy in neonates with NEC (Stage Ⅱ and above).

Objective     To investigate the vaccination rate of Coronavirus Disease 2019 (COVID-19) vaccine in patients undergoing cardiac mechanical valve replacement and to evaluate its effect on international normalized ratio (INR) value. Methods    We investigated 132 patients who had received cardiac mechanical valve replacement and followed up in the Department of Cardiovascular Surgery, West China Hospital of Sichuan University from May to October 2021. There were 51 males and 81 females aged 26-72 (53.01±9.51) years. Results    The vaccination coverage rate was 53.8%. Among the 61 unvaccinated patients, concerns about heart side-effects were the main reason. The average INR of the first review after vaccination was higher than that of the last review before vaccination, with a difference of 0.40±0.72 (P<0.001). Conclusion    The vaccination rate of patients after cardiac mechanical valve replacement is low. At the same time, COVID-19 vaccine may increase INR value, and it is suggested that patients should increase the frequency of review and adjust warfarin dosage after vaccination.

【Objective】 To study the annual financial expenditure in blood stations with different scales, and to establish the regression equation between blood collection units and total expenditure. 【Methods】 The annual total expenditure, the per capita cost of serving population, as well as the collection units of whole blood and apheresis platelet of 24 blood stations were collected. The financial expenditure required for collecting 10 000U blood was calculated.The statistical analysis was carried out with SPSS statistical software. 【Results】 From 2017 to 2020, the total annual financial expenditure of 24 blood stations showed an upward trend. The total expenditure among blood stations was different. The per capita cost of servicing population in the areas where the 24 blood stations were located had been increasing year by year. The 24 blood stations were divided into two grades according to the blood collection volume as 50 000 U, and the relationship equation between the blood collection volume and the annual total expenditure had been established. After testing, each equation was effective(P<0.05); There was no difference in the financial expenditure required for collecting 10 000U blood among blood stations with different scales. 【Conclusion】 From 2017 to 2020, the blood stations with an annual collection volume more than 50 000 U demonstrated a higher financial expenditure and the per capita cost of serving population than those <50 000 U. The blood collection volume of blood stations is significantly correlated with the annual total expenditure and the per capita cost of serving population.

Objective:To discuss the influence of high load and weightlessness environment on intervertebral disc by observing and analyzing the imaging changes of the spines in New Zealand white rabbits and the content changes of matrix metalloproteinase (MMP) and tissue inhibitor of metalloproteinase (TIMP) in the intervertebral disc under high load and weightlessness environment, and to provide theoretical basis for prevention and delay of lumbar intervertebral disc degeneration under high load and weightlessness environment.Methods:A total of 120 New Zealand white rabbits with balanced age and body weight were randomly and averagely divided into control groups (further grouped by 30 d, 60 d and 90 d) and high load/weightlessness groups (further grouped by 30 d, 60 d and 90 d) with residual single-blind method. High load was simulated by animal centrifuge and weightlessness was simulated by tail suspension. The imaging changes and the positive expression rates of MMP1, MMP3 and TIMP1 in intervertebral disc were detected, and the statistical differences between the high load/weightlessness group and the control group in different time periods were compared, as well as among the different exposure time in load/weightlessness groups.Results:From the imaging observation, the T2-weighted images of lumbar 6 sacral 1 intervertebral disc in experimental animals decreased to some extent. The positive rates of MMP1 and MMP3 in each high load/weightlessness group were higher than those in the control group for the same exposure time, and the differences were statistically significant ( t=22.97-145.51,all P<0.001). The positive rates of MMP1 and MMP3 increased with the extension of exposure time, and there were statistically differences among the groups with different exposure time in high load/weightlessness group ( F=2531.10, 1758.80, both P<0.001). The positive rate of TIMP1 in each high load/weightlessness group was higher than that in the control group for the same exposure time, and the difference was statistically significant ( t=29.34-65.05, all P<0.001). There was statistically difference on TIMP1 positive rate among different load/weightlessness exposure time groups ( F=462.20, P<0.001). Conclusions:High load/weightlessness can cause the MMP1, MMP3 and TIMP1 content changes in animal lumbar disc. The changes of TIMP1 are obvious in the early stage and the sensitivity is decreased in the late stage. High load/weightlessness may lead to changes in the contents of MMP and TIMP in intervertebral discs, which may accelerate intervertebral disc degeneration.