Background Swimming is becoming increasingly popular for its combined leisure and fitness benefits. However, polluted swimming pool water may pose various health risks. Previous studies have indicated that health indicators of swimming venues have lower qualification rates compared to other public places, highlighting the urgent need to optimize hygiene management measures. Objective To assess the overall hygiene status and identify the key factors influencing water quality in Shanghai’s swimming venues from 2010 to 2024, and to provide a scientific basis for optimizing water quality management. Methods Water quality was assessed in three stages (2010—2019, 2020—2022, and 2023—2024) based on the monitoring data of Shanghai’s swimming venues (2010—2024). The influences of monitoring stage, region, season, scale, day of week, and per capita attendance on water quality were analyzed using chi-square tests and logistic regression. Results From 2010 to 2024, water quality was monitored in 1478 swimming venues. The compliance rates of turbidity, pH, urea, oxidation-reduction potential, free residual chlorine, combined residual chlorine, total bacteria, coliforms, and heat-resistant coliforms in swimming pool water, and free residual chlorine in the foot disinfection basin water samples were 99.56%, 94.73%, 73.00%, 47.50%, 56.55%, 54.12%, 97.74%, 99.49%, 99.90%, and 69.19%, respectively. The overall water quality compliance rate was 85.28%. The main non-compliant indicators for swimming pool water were urea, ORP, free residual chlorine, and combined residual chlorine, along with free chlorine residual in the foot disinfection basin water samples. Using the period before the implementation of the new national standard as reference, the results of logistic regression revealed that the qualification rates of urea, ORP, and free residual chlorine in the swimming pool water samples, as well as free residual chlorine in foot disinfection basin water samples, were significantly higher during the two phases after launching the new standard (2020–2022 and 2023–2024), and the associated odds ratios (95%CI) were 1.28 (1.00, 1.64) and 1.48 (1.12, 1.95), 13.35 (7.63, 23.37) and 10.78 (7.00, 16.60), 2.54 (1.81, 3.58) and 3.18 (2.41, 4.20), and 3.14 (2.14, 4.60) and 2.83 (1.89, 4.23), respectively. Compared with the reference group, those sampled in urban pools and in non-summer seasons showed higher qualification rates of urea and ORP; in contrast, the pools with high visitor flow showed lower qualification rates of free residual chlorine in both water samples of swimming pools and foot disinfection basins (P<0.05). Conclusion The implementation of the new national standard has effectively enhanced the management standards and significantly improved overall water quality of swimming venues in Shanghai. However, the compliance rates of free residual chlorine and urea in swimming pool water still need further improvement. The compliance of some indicators is influenced by region, season, scale, and average passenger flow, particularly in small suburban swimming venues. Future efforts should focus on refining water quality management strategies and enhancing public health management.

ObjectiveTo explore the protective effect and underlying mechanism of Gegen Qinliantang on cognitive function in db/db mice with diabetic cognitive impairment （DCI）. MethodsThirty-two 8-week-old male db/db mice were randomly assigned to the model group， dapagliflozin group （1.0 mg·kg^-1·d^-1）， low-dose Gegen Qinliantang group （6.24 g·kg^-1·d^-1）， and high-dose Gegen Qinliantang group （24.96 g·kg^-1·d^-1）. Eight db/m mice served as the normal group. All mice were administered the corresponding treatment once daily by gavage for 10 consecutive weeks. Body weight and fasting blood glucose （FBG） were dynamically monitored. The Morris water maze test was used to evaluate cognitive function. Hematoxylin-eosin （HE） staining and Nissl staining were used to observe pathological changes in the hippocampus. Enzyme-linked immunosorbent assay （ELISA） was employed to measure the levels of tumor necrosis factor-α （TNF-α） and interleukin-1β （IL-1β） in hippocampal tissue. Immunofluorescence double staining was used to detect the co-expression of M1 microglial marker CD16/32 and ionized calcium-binding adapter molecule 1 （IBA1） in the hippocampus. Western blot analysis was performed to detect the protein expression of postsynaptic density protein 95 （PSD-95）， synapsin （SYN）， nuclear factor-κB p65 （NF-κB p65）， and phosphorylated NF-κB p65 （p-NF-κB p65） in the hippocampus. ResultsCompared with the normal group， the model group showed significantly increased body weight and FBG levels （P<0.01）， significantly prolonged escape latency and reduced platform crossings in the Morris water maze test （P<0.01）， disordered arrangement of hippocampal neurons， nuclear pyknosis， increased neuronal necrosis， reduced Nissl bodies， decreased expression of synaptic proteins PSD-95 and SYN （P<0.01）， increased CD16/32⁺ /IBA1⁺ positive rate， elevated levels of TNF-α and IL-1β， and an increased p-NF-κB p65/NF-κB p65 ratio （P<0.01）. Compared with the model group， the dapagliflozin group exhibited significantly reduced FBG levels at weeks 5 and 10 （P<0.05， P<0.01） and increased body weight. The high-dose Gegen Qinliantang group showed significantly reduced FBG at week 10 （P<0.05）. Escape latency was significantly reduced on days 3 and 5 of the water maze test in the dapagliflozin group and on day 5 in the high-dose Gegen Qinliantang group （P<0.05）. Platform crossings were significantly increased in both the dapagliflozin group and the high-dose Gegen Qinliantang group （P<0.05）. Hippocampal pathological damage was alleviated to varying degrees in the dapagliflozin group and the low- and high-dose Gegen Qinliantang groups， with significantly increased expression of PSD-95 and SYN （P<0.01）. Further studies revealed that both low- and high-dose Gegen Qinliantang reduced hippocampal IL-1β levels and the CD16/32⁺/IBA1⁺ positive rate of microglia， while the high-dose group also significantly reduced hippocampal TNF-α levels and the p-NF-κB p65/NF-κB p65 （P<0.05， P<0.01）. ConclusionGegen Qinliantang can improve hyperglycemia， cognitive dysfunction， and synaptic damage in DCI， inhibit M1 polarization of microglia and neuroinflammation， and its mechanism may be related to the inhibition of NF-κB activation.

ObjectiveTo explore the protective effect and underlying mechanism of Gegen Qinliantang on cognitive function in db/db mice with diabetic cognitive impairment （DCI）. MethodsThirty-two 8-week-old male db/db mice were randomly assigned to the model group， dapagliflozin group （1.0 mg·kg^-1·d^-1）， low-dose Gegen Qinliantang group （6.24 g·kg^-1·d^-1）， and high-dose Gegen Qinliantang group （24.96 g·kg^-1·d^-1）. Eight db/m mice served as the normal group. All mice were administered the corresponding treatment once daily by gavage for 10 consecutive weeks. Body weight and fasting blood glucose （FBG） were dynamically monitored. The Morris water maze test was used to evaluate cognitive function. Hematoxylin-eosin （HE） staining and Nissl staining were used to observe pathological changes in the hippocampus. Enzyme-linked immunosorbent assay （ELISA） was employed to measure the levels of tumor necrosis factor-α （TNF-α） and interleukin-1β （IL-1β） in hippocampal tissue. Immunofluorescence double staining was used to detect the co-expression of M1 microglial marker CD16/32 and ionized calcium-binding adapter molecule 1 （IBA1） in the hippocampus. Western blot analysis was performed to detect the protein expression of postsynaptic density protein 95 （PSD-95）， synapsin （SYN）， nuclear factor-κB p65 （NF-κB p65）， and phosphorylated NF-κB p65 （p-NF-κB p65） in the hippocampus. ResultsCompared with the normal group， the model group showed significantly increased body weight and FBG levels （P<0.01）， significantly prolonged escape latency and reduced platform crossings in the Morris water maze test （P<0.01）， disordered arrangement of hippocampal neurons， nuclear pyknosis， increased neuronal necrosis， reduced Nissl bodies， decreased expression of synaptic proteins PSD-95 and SYN （P<0.01）， increased CD16/32⁺ /IBA1⁺ positive rate， elevated levels of TNF-α and IL-1β， and an increased p-NF-κB p65/NF-κB p65 ratio （P<0.01）. Compared with the model group， the dapagliflozin group exhibited significantly reduced FBG levels at weeks 5 and 10 （P<0.05， P<0.01） and increased body weight. The high-dose Gegen Qinliantang group showed significantly reduced FBG at week 10 （P<0.05）. Escape latency was significantly reduced on days 3 and 5 of the water maze test in the dapagliflozin group and on day 5 in the high-dose Gegen Qinliantang group （P<0.05）. Platform crossings were significantly increased in both the dapagliflozin group and the high-dose Gegen Qinliantang group （P<0.05）. Hippocampal pathological damage was alleviated to varying degrees in the dapagliflozin group and the low- and high-dose Gegen Qinliantang groups， with significantly increased expression of PSD-95 and SYN （P<0.01）. Further studies revealed that both low- and high-dose Gegen Qinliantang reduced hippocampal IL-1β levels and the CD16/32⁺/IBA1⁺ positive rate of microglia， while the high-dose group also significantly reduced hippocampal TNF-α levels and the p-NF-κB p65/NF-κB p65 （P<0.05， P<0.01）. ConclusionGegen Qinliantang can improve hyperglycemia， cognitive dysfunction， and synaptic damage in DCI， inhibit M1 polarization of microglia and neuroinflammation， and its mechanism may be related to the inhibition of NF-κB activation.

Objective:To develop rat models of oral mucosa ulcer using distinct experimental methodologies,fulfilling research requirements and adhering to the ethical standards for animal care.Methods:96 SD rats were randomly allocated into groups.The rats in control group(n=8)were regularly fed without other treatment.Those in chemical cauterization groups were treated by 20％,40％,60％of glacial acetic acid(GAA)on oral mucosa(n=8);in mechanical damage groups by 30 000 r/min high speed drill induced trauma of 10,20 and 30 mm2 respectively(n=8);in ionizing radiation groups were treated with 10,12,15,20 and 30 Gy on the mucosa respectively(n=8).After the ulcer was appeared,the morphology of the mucosa were observed,the mucosal tissue lesions were examined by HE,Masson and immunofluorescence staining,the expression of TNF-α and IL-1β were detected by qPCR and ELISA respectively,and the body conditions such as diet and body weight of the rats were observed,the pain,dis-tress and discomfor of the rats were evaluated by MORTON&Griffits Guidelines.Results:40％and 60％GAA,20 mm2 and 30 mm2 friction damage and ionizing radiation of 12 Gy or greater may induce oral mucosa ulcer with a diseas coruse of 6-7 d in SD rats.TNF-α and IL-1β mRNA expression in the damaged tissue,the related protein expression in blood serum of the rats were in-creased.MORTON&Griffits Guidelines analysis showed 40％GAA,20 mm2 friction damage and 12 Gy ionizing radiation induced the lowest scores of pain,distress and discomfort of the rats with compatible oral mocosa ulcere induced by the relevat treatment.Conclusion:40％GAA,20 mm2 of friction damage and 12 Gy of ionizing radiation can reliably establish oral mucosa ulcer models and minimize adverse effects on SD rats,and accord with ethical standards of 3R for laboratory animal.

Retinopathy of prematurity (ROP) is a type of proliferative retinal disease occurring in premature, low birth weight infants, and is one of the most common blinding diseases in infants and young children.In recent years, anti-vascular endothelial growth factor (VEGF) therapy has shown good effect in treating ROP, and has become the preferred treatment for some ROP.However, the anti-VEGF treatment of ROP still faces the bottleneck of uncertain treatment timing and lack of objective criteria for efficacy evaluation.In recent years, artificial intelligence (AI) has not only been widely used in the screening and diagnosis of ROP, but also has made progress in evaluating treatment timing, therapeutic effect and follow-up plan in anti-VEGF treatment of ROP.At the same time, AI also shows potential in the prediction of efficacy and disease progression after anti-VEGF treatment of ROP.Therefore, based on recent relevant studies at home and abroad, this article reviews and looks forward to the application of AI in the evaluation of anti-VEGF treatment of ROP.

Objective To investigate the correlations of interleukin-1 β(IL-1β)level and per-centage of CD16+CD56+natural killer(NK)cells in peripheral blood with severity of disease in pa-tients with pulmonary tuberculosis.Methods A total of 150 patients with active pulmonary tubercu-losis(APTB)in the Suqian First People's Hospital from January 1,2021 to September 1,2023 were selected as APTB group,and 150 patients with inactive pulmonary tuberculosis(IPTB)in the same period were selected as IPTB group.Level of IL-1 β and percentage of CD16+CD56+NK cells in pe-ripheral blood of patients with different disease severities were compared,and their correlations with severity of disease were analyzed.Results In the APTB group,level of IL-1 β in the peripheral blood was significantly higher than that in the IPTB group,while the percentage of CD16+CD56+NK cells was significantly lower(P＜0.001).In the mild,moderate,and severe groups,level of IL-1 βshowed a significant gradual increasing trend in peripheral blood,while the percentage of CD16+CD56+NK cells showed a significant gradual decreasing trend(P＜0.001).After treatment,the level of IL-1β in the peripheral blood decreased significantly,while the percentage of CD16+CD56+NK cells increased significantly in the APTB group(P＜0.001).Correlation analysis revealed that level of IL-1β in the peripheral blood of patients with pulmonary tuberculosis was positively correlated with severity of disease(r=0.732,P＜0.001),while the percentage of CD16+CD56+NK cells was negatively correlated with severity of disease(r=-0.612,P＜0.001).Conclusion Level of IL-1β in the peripheral blood is elevated while the percentage of CD16+CD56+NK cells is de-creased in patients with pulmonary tuberculosis,which is closely related to the severity of APTB.

Objective:To evaluate the value of acid-base indicators and strong ion gap (SIG) in the prognostic diagnosis of patients with acute paraquat poisoning (APP).Methods:The medical records of 78 APP patients admitted to the First People′s Hospital of Lianyungang from March 2021 to March 2024 were analyzed retrospectively. The patients were divided into the death group ( n=56) and the survival group ( n=22) according to their prognosis. Clinical data, acid-base indicators, and SIG levels were compared between the two groups. Logistic regression analysis was used to identify the influencing factors of prognosis in APP patients and construct a nomogram. Receiver operating characteristic (ROC) curve was established to analyze the diagnostic value of combined acid-base indicators and SIG for the prognosis of APP patients. Results:There were no statistically significant differences in gender, age, body mass index, time from poisoning to treatment, history of diabetes, or history of hypertension between the two groups (all P>0.05). The levels of anion gap (AG), bicarbonate ion (HCO 3-), lactic acid (Lac), and SIG in the death group were higher than those in the survival group (all P<0.05). Logistic regression analysis showed that AG, HCO 3-, Lac, and SIG levels were influencing factors for the prognosis of APP patients (all P<0.05). ROC curve results indicated that the area under the curve (AUC) of AG, HCO 3-, Lac, and SIG combined in predicting the prognosis of APP patients was significantly higher than that of single prediction. Conclusions:Acid-base indicators and SIG have good diagnostic value for the prognosis of APP patients.

Objective To retrospectively analyze the correlation between inflammatory markers in complete blood counts(CBC)and influenza A virus infection in patients visited the outpatient department of Nanjing First Hospital.Methods The suspected influenza A virus infection patients visited the outpatient department of Nanjing First Hospital from February to March 2023 were collected and di-vided into the positive and negative groups based on the detection results of influenza A virus antigen.The differences in inflammatory markers in CBC between the two groups were compared.The Logistic regression analysis was used to evaluate the correlation between inflammatory markers and influenza A virus infection.Meanwhile,the restricted cubic spline(RCS)and age subgroup(≤6 years,7-12 years,13-17 years,and ≥18 years)analysis were also performed.Results A total of 1 487 outpatients were included,of which 404(27.2％)were positive for influenza A virus antigen.The Logistic regression analysis showed that white blood cell count(WBC),lymphocyte percentage(LY％),and lymphocyte count(LYM)were significantly negatively correlated with influenza A virus infection(P＜0.01),while the neutrophil percentage(NE％),monocyte/lymphocyte ratio(MLR),and neutrophil/lymphocyte ratio(NLR)were significantly positively correlated with influenza A virus infection(P＜0.01).The RCS analysis exhibited the same trend.The age subgroup analysis showed that when the age was greater than 6 years,LYM was significantly negatively correlated with influenza A virus infection(P＜0.01).When the age was greater than 12 years,MLR was significantly positively correlated with influenza A virus infec-tion(P＜0.01).Conclusion The WBC,LY％,LYM,NE％,MLR,and NLR in CBC parameters are important indicators associated with the occurrence of Influenza A virus infection,especially LYM in patients aged over 6 years and MLR in patients aged over 12 years,which may serve as biomarkers for the diagnosis and differential diagnosis of influenza A virus infection.

Retinopathy of prematurity (ROP) is a type of proliferative retinal disease occurring in premature, low birth weight infants, and is one of the most common blinding diseases in infants and young children.In recent years, anti-vascular endothelial growth factor (VEGF) therapy has shown good effect in treating ROP, and has become the preferred treatment for some ROP.However, the anti-VEGF treatment of ROP still faces the bottleneck of uncertain treatment timing and lack of objective criteria for efficacy evaluation.In recent years, artificial intelligence (AI) has not only been widely used in the screening and diagnosis of ROP, but also has made progress in evaluating treatment timing, therapeutic effect and follow-up plan in anti-VEGF treatment of ROP.At the same time, AI also shows potential in the prediction of efficacy and disease progression after anti-VEGF treatment of ROP.Therefore, based on recent relevant studies at home and abroad, this article reviews and looks forward to the application of AI in the evaluation of anti-VEGF treatment of ROP.

Objective To retrospectively analyze the correlation between inflammatory markers in complete blood counts(CBC)and influenza A virus infection in patients visited the outpatient department of Nanjing First Hospital.Methods The suspected influenza A virus infection patients visited the outpatient department of Nanjing First Hospital from February to March 2023 were collected and di-vided into the positive and negative groups based on the detection results of influenza A virus antigen.The differences in inflammatory markers in CBC between the two groups were compared.The Logistic regression analysis was used to evaluate the correlation between inflammatory markers and influenza A virus infection.Meanwhile,the restricted cubic spline(RCS)and age subgroup(≤6 years,7-12 years,13-17 years,and ≥18 years)analysis were also performed.Results A total of 1 487 outpatients were included,of which 404(27.2％)were positive for influenza A virus antigen.The Logistic regression analysis showed that white blood cell count(WBC),lymphocyte percentage(LY％),and lymphocyte count(LYM)were significantly negatively correlated with influenza A virus infection(P＜0.01),while the neutrophil percentage(NE％),monocyte/lymphocyte ratio(MLR),and neutrophil/lymphocyte ratio(NLR)were significantly positively correlated with influenza A virus infection(P＜0.01).The RCS analysis exhibited the same trend.The age subgroup analysis showed that when the age was greater than 6 years,LYM was significantly negatively correlated with influenza A virus infection(P＜0.01).When the age was greater than 12 years,MLR was significantly positively correlated with influenza A virus infec-tion(P＜0.01).Conclusion The WBC,LY％,LYM,NE％,MLR,and NLR in CBC parameters are important indicators associated with the occurrence of Influenza A virus infection,especially LYM in patients aged over 6 years and MLR in patients aged over 12 years,which may serve as biomarkers for the diagnosis and differential diagnosis of influenza A virus infection.