A 51-year-old male presented with nasal obstruction, followed by progressive hearing loss and blurred vision. Imaging identified space-occupying lesions in the paranasal sinuses, orbits, and paraspinal regions, while laboratory tests confirmed positive anti-proteinase 3 anti-neutrophil cytoplasmic antibody(PR3- ANCA) immunoglobulin G (IgG)and markedly elevated serum IgG4. Despite treatment with corticosteroids, immunosuppressants, and radiotherapy, the patient exhibited steroid dependency with relentless disease progression. Following multidisciplinary consultation, a diagnosis of inflammatory myofibroblastic tumor (IMT) coexisting with ANCA- associated vasculitis (AAV) was favored, though IgG4-related disease remained a critical differential. Ultimately, profound immunosuppression precipitated a severe herpesvirus infection, leading to disseminated intravascular coagulation and multiple organ dysfunction syndrome. This case underscores the rarity and diagnostic complexity of concurrent IMT and AAV, highlights the therapeutic dilemma of balancing primary disease control against fatal opportunistic infections, and emphasizes the critical role of multidisciplinary collaboration in the diagnosis and treatment of complex diseases.

Objective To analyze the prevalence of malignant tumors in cancer registration areas in Hubei Province in 2021. Methods Data on the incidence and mortality of malignant tumors from 31 cancer registries in Hubei Province in 2021 were collected. Incidence, mortality (crude rate, ASRC, and ASRW), and cumulative rates in the 0-74-year-old age group were calculated by gender, urban-rural area, and age group. Descriptive epidemiological methods were used to describe and analyze the incidence and mortality characteristics of malignant tumors in cancer registration areas in Hubei Province in 2021. Results In 2021, malignant tumors in cancer registration areas in Hubei Province had an incidence of 329.62/10⁵, an ASIRC of 189.33/10⁵, an ASIRW of 201.50/10⁵, and a cumulative rate of 20.81% in the 0-74-year-old age group. Malignant tumors had a mortality rate of 183.59/10⁵, an ASMRC of 90.36/10⁵, an ASMRW of 103.22/10⁵, and a cumulative rate of 10.26% in the 0-74-year-old age group. Incidence and mortality were higher in males than in females, with incidence rates in urban areas being significantly higher than those in rural areas, whereas urban and rural mortality rates showed no significant difference. The incidence of malignant tumors gradually increased with age, peaking in the 75-79-year-old age group. Mortality rose rapidly after 45 years and peaked in the 85+-year-old age group. Significant gender and urban–rural differences were found in the incidence and mortality of malignant tumors. The leading cause of incidence across the province was lung cancer, followed by female breast, thyroid, colorectal, and liver cancers. The top five causes of death were lung, liver, stomach, colorectal, and esophageal cancers. The incidence rates of female breast, thyroid, and colorectal cancers were higher in urban areas than in rural areas, whereas the burden of liver and cervical cancers was more prominent in rural areas than in urban areas. Significant differences were found in the incidence of malignant tumors among different cities and counties. Conclusion In 2021, the burden of malignant tumors in cancer registration areas in Hubei Province was primarily caused by lung, digestive tract, liver, and female breast cancers, with significant regional differences. This situation seriously endangers the health of residents. Comprehensive prevention and control measures should be continuously strengthened to reduce the burden of malignant tumors.

ObjectiveTo describe the characteristics of cardiorespiratory fitness levels in the baseline population of the South China Cohort， and to identify the potential contributing factors. MethodsFace-to-face surveys and physical examinations were conducted to collect information on demographic characteristics， medical histories， medications， lifestyles， and physical activity conditions. After excluding individuals with missing cardiorespiratory fitness-related data and covariates including physical activity and dietary information， a total of 77 024 participants aged 25 to 85 were included. Cardiorespiratory fitness levels were evaluated using a non-exercise algorithm， and low cardiorespiratory fitness level was defined as below the lower tertile of the population distribution. Logistic regression analysis was used to examine the distribution of low cardiorespiratory fitness level， and log-binomial regression and ordered logistic regression analyses were used to analyze the associations of cardiorespiratory fitness with demographic characteristics， socioeconomic factors， lifestyle factors （including alcohol consumption and dietary diversity）， and chronic diseases conditions （including diabetes， hypertension， pulmonary diseases， and cardiovascular diseases）. ResultsCardiorespiratory fitness levels showed a sufficiently normal distribution in both male and female group. We found that the proportion of low cardiorespiratory fitness level was higher among Han ethnicity， those with an educational level below 9th grade， households with an annual income of more than 100 000 Yuan， as well as those who drank alcohol at least one time per week and who exhibited low dietary diversity （all P＜0.001）. Ethnicity， socioeconomic status， lifestyle factors， and chronic diseases were found to be statistically associated with cardiorespiratory fitness levels in the South China population （all P＜0.001）. ConclusionCardiorespiratory fitness levels varied across different population groups in South China， with ethnicity， socioeconomic status， lifestyle factors， and chronic diseases serving as key determinants. Therefore， it is recommended that the public pay attention to cardiorespiratory fitness， as strengthening population-level monitoring and interventions for cardiorespiratory fitness carries significant public health implications.

ObjectiveTo investigate the temporal trend of weight-adjusted-waist index （WWI） and its association with the risk of incident cardiovascular diseases （CVD） among middle-aged and older Chinese adults. MethodsBased on the China Health and Retirement Longitudinal Study （CHARLS）， this research enrolled participants aged 45 and above with complete physical measurement data from the 2011， 2013， and 2015 waves. Complex sampling weights were applied to calculate the mean WWI， and the Mann-Kendall test was used to analyze its trend. From the 2011 baseline survey， individuals with a history of cardiovascular disease or missing key covariates were further excluded. New-onset cardiovascular outcome events were collected during follow-up until 2020. Participants were categorized into Q1–Q4 groups based on baseline WWI quartiles. Multivariable log-binomial regression models were constructed to assess the association between WWI and CVD， while restricted cubic splines were employed to evaluate potential nonlinear relationships. Sensitivity analyses were conducted to verify the robustness of the findings. ResultsFrom 2011 to 2015， the weighted mean WWI among Chinese middle-aged and older adults remained generally stable （2011： 11.17±1.68； 2013： 11.28±1.35； 2015： 11.24±1.59； P for trend <0.05）. During the longitudinal follow-up， 1 784 incident CVD cases were documented. After multivariable adjustment， each unit increase in WWI was associated with a 17% increased risk of CVD （RR： 1.17， 95%CI： 1.10-1.24）. Compared with the Q1 group， the risk of CVD in the Q2， Q3， and Q4 groups increased by 23% （RR： 1.23， 95% CI： 1.07-1.40）， 27% （RR： 1.27， 95% CI： 1.11-1.44）， and 40% （RR： 1.40， 95% CI： 1.22-1.60）， respectively. A significant linear trend was observed between the increasing WWI and elevated CVD risk （P for trend <0.001）. Subgroup analysis revealed a stronger association in participants aged 45-60 years （P for interaction <0.05）. The results of sensitivity analysis were consistent with the main research results. ConclusionsThe overall trend of WWI level in the middle-aged and elderly population in China is stable from 2011 to 2015. The higher level of WWI is associated with an increased risk of CVD， suggesting that WWI may be used as a simple and effective indicator to evaluate the risk of cardiovascular metabolism in middle-aged and elderly people.

Objective: To explore the network structure of anxiety and depressive symptoms, and psychotic like experiences in junior and senior high school students with different sleep qualities, and to provide a reference for improving sleep quality in the population. Methods: A cross sectional online survey was conducted among 22 997 junior and senior high school students from seven junior and senior high schools in Luzhou City, Sichuan Province, using convenience sampling. The Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and the 16item Prodromal Questionnaire (PQ-16) were administered. Independent sample t-test was used to compare mental health status between adolescents with and without sleep problems. Network analysis was applied to examine the symptom association patterns across gender and school stage subgroups. Results: The prevalence of sleep problems among junior and senior high school students was 22.58%. The total anxiety symptom score (8.92± 4.02 ), total depressive symptom score (13.35±5.66), and scores for each factor of PQ-16 (perceptual and sensory abnormalities, thinking abnormalities, negative symptoms, and specific perceptual and sensory abnormalities) (3.32±3.32, 2.08±2.36, 3.36± 2.74 , 1.44±1.86) in the group with sleep problems were all significantly higher than those in the group without sleep problems ( 3.43 ±3.33, 5.03±4.73; 0.63±1.52, 0.47±1.11, 0.77±1.48, 0.25±0.79), with statistically significant differences ( t =99.60, 106.54, 82.49, 68.51, 89.09, 67.30, all P <0.01). In females with sleep problems, the anxiety-depressive symptoms edge weight was the highest (0.44). In males with sleep problems, the "sleep latency-sleep efficiency" edge weight was the highest (0.43), and the strength centrality values of "perceptual abnormalities" "medication factor" and "sleep latency" ranked the higher (1.32, 1.31 and 1.25). The network connectivity strength of the sleep problem group was higher in senior high school students than in junior high school students, and the strength centrality (1.12) and betweenness centrality (0.12) of negative symptoms were higher than those in junior high school students (1.02 and 0.11). Conclusions The network associations between sleep problems and psychological symptoms in junior and senior high school students exhibit gender and school stage specific characteristics. Differentiated intervention strategies should be tailored to specific subgroups.

Objective Using cockroach surveillance data in Nanjing from 2017 to 2024, we have descriptively analyzed population characteristics and changes in insecticide resistance among Blattella germanica, and have established a seasonal Autoregressive Integrated Moving Average (ARIMA) model to predict monthly population densities in Nanjing spanning the year 2025. Methods B. germanica density and infestation rate were monitored using the sticky trap method, and insecticide resistance was assessed using the residual contact method. Our ARIMA model was applied to fit and estimate cockroach density fluctuations over time. Results From 2017 to 2024, B. germanica accounted for 94.90% of all cockroach specimens captured in Nanjing, with an average density of 0.37 cockroaches per trap and an average infestation rate of 5.56%. Significant differences in density and infestation rate were observed among different habitats (P＜0.001). Significant downward annual trends in both density and infestation rate were found (P＜0.05). ARIMA was found to be the optimal model for fitting the density data from 2017 to 2024 (0, 1, 1) × (0, 1, 1)1 2. Conclusions From 2017 to 2024, B. germanica was overwhelmingly the dominant cockroach species in Nanjing, with both its density and infestation rate declining annually. A positive correlation was observed between the amount and proportion of insecticide use and the development of insecticide resistance (P＜0.05). The established model demonstrated good performance in predicting monthly B. germanica densities in Nanjing throughout 2025, providing a valuable reference for future surveillance and control efforts.

The sensitive scalp is a complex syndrome characterised by abnormal nerve sensations, such as stinging, itching, burning, and tightness, and diminished tolerance to physical or chemical stimuli that would not typically cause such unpleasant responses, with its pathology involving physical barrier destruction at the stratum corneum level, neural hyperreactivity and sensory nerve sensitization, and local immunological dysregulation and chronic low‑grade inflammation. The homeostasis of the scalp microenvironment plays a crucial regulatory role in maintaining the hair follicle growth cycle, yet this “soil” factor has long been underappreciated in hair loss research, which has traditionally centered on intrinsic follicular defects, such as genetic predisposition or androgen-driven mechanisms. In this review, we summarized the potential mechanisms underlying the imbalance in the “barrier-neural-immune” network in sensitive scalps. Sensitive scalp is further manifested as impaired skin barrier, including increased transepidermal water loss and abnormal lipid secretion. These alterations are accompanied by increased surface pH, excessive secretion of sebum rich in free fatty acids, reduced microbial diversity, and dysbiosis characterized by a reduction in Cutibacterium and an increase in Staphylococcus colonization. Mechanistically, we also analyzed how neurogenic inflammation, mediated by substances such as substance P (SP) and calcitonin gene-related peptide (CGRP), along with persistent low-grade inflammation, disrupts the microenvironment of the hair follicle stem cell niche through mechanisms involving mechanosensitive ion channels (e.g., Piezo1), oxidative stress, and cytokine cascades. When the barrier is compromised, the weakened stratum corneum may facilitate the penetration of external stimuli, sensitizing cutaneous nerve endings. Those hyperresponsive nerves then fire off neuropeptides like substance P and CGRP. These peptides activate mast cells and other immune cells via the MrgprB2 receptor, prompting degranulation and a wave of pro-inflammatory mediators that kick off neurogenic inflammation. At the same time, oxidative stress and inflammatory cytokines drive a persistent low-grade inflammation that directly damages the hair follicle stem cell niche. Physical compression from shrinking hair shafts activates Piezo1 channels, setting off calcium influx and Caspase‑3‑dependent apoptotic signaling. We primarily considered the interactions between inflammatory signaling and the sensitization of the androgen receptor (AR) pathway, as well as the inhibition of the Wnt/β‑catenin pathway, which may subsequently contribute to hair follicle miniaturization and disruption of the growth cycle. The inflammatory microenvironment appears to boost AR expression in dermal papilla cells, making them more sensitive to dihydrotestosterone (DHT). This heightened sensitivity may promote the expression of transforming growth factor-β1 (TGF-β1), TGF-β2, and Dickkopf-1 (DKK1), which suppress the Wnt/β‑catenin pathway—essential for follicle growth and regeneration—potentially accelerating follicular miniaturization and stalling the growth cycle. Coupled with direct inflammatory apoptosis, oxidative stress, and circadian disruption, these routes may collectively speed up hair follicle stem cell depletion and diffuse hair thinning. These findings point to the need for more mechanistic and translational research to test the proposed pathways and explore therapies that target the microenvironment in sensitive scalp-related hair loss. Ultimately, we hope to provide theoretical support for the intervention of hair loss by restoring the steady state of the scalp microenvironment and combining with new precision delivery technologies such as microneedles.

Hematologic malignancies,such as lymphoma,myeloma,and myeloid neoplasms,can occur in extramedullary tissues.Traditional histopathological morphology and immunohistochemical staining have lim-itations,including time-consuming specimen processing,prolonged reporting cycles,and relatively low sensi-tivity in cases of limited cell numbers.Flow cytometry offers significant advantages in detecting tissue sam-ples,such as rapid processing,shorter reporting cycles,and high accuracy and sensitivity,making it an effective complement to histopathological and immunohistochemical methods.However,the application of flow cytome-try in tissue sample detection currently lacks standardized protocols for sample collection and preservation,single-cell suspension preparation,antibody panel design for limited samples,data analysis,and result repor-ting.To promote the standardized application of flow cytometry in detecting hematologic tumor cells in tissue samples,the Cell Analysis Professional Committee of the Chinese Society of Biotechnology organized experts to develop the Chinese Expert Consensus on Flow Cytometry for Detecting Hematologic Tumor Cells in Tis-sue Samples(hereinafter referred to as the Consensus).This Consensus elaborates on the technical aspects of flow cytometry for tissue sample detection,covering sample processing,antibody panel design,data analysis,reporting content,and quality management.It particularly emphasizes recommended antibody panels and data analysis methods for flow cytometry when tissue sample cell counts are low.This article aims to interpret the key points of the Consensus to facilitate its better application in clinical practice.

Objective To explore the correlation between the levels of serum circUSP36 and circBPTF in patients with diabetic retinopathy(DR)and the severity of the disease.Methods Totally 175 DR patients who visited Luzhou People's Hospital from January 2022 to October 2024 were selected as the research sub-jects.According to the international clinical DR classification standard,they were divided into the non-signifi-cant DR group(NDR group),non-proliferative DR group(NPDR group),and proliferative DR group(PDR group),with 72 cases in the NDR group,63 cases in the NPDR group,and 40 cases in the PDR group.Another 50 healthy individuals who underwent physical examinations during the same period were selected as the con-trol group.The levels of serum circUSP36 and circBPTF in each group were determined by fluorescence quan-titative PCR.The correlation between the expression levels of serum circUSP36 and circBPTF in patients of the PDR group was analyzed by Pearson method.Logistic regression analysis was used to analyze the factors of DR.Receiver operating characteristic(ROC)curve was used to analyze the evaluation value of the expres-sion levels of serum circUSP36 and circBPTF in DR patients for the severity of DR.Results There were sta-tistically significant differences in the levels of circUSP36,circBPTF,fasting plasma glucose(FPG),2-hour postprandial blood glucose(2 hPG),glycated hemoglobin(HbA1c)between the NDR group,the NPDR group,the PDR group and the control group(P＜0.05).The levels of circUSP36,circBPTF,FPG,2 hPG and HbA1c increased with the severity of DR(P＜0.05).The expression levels of serum circUSP36 and circBPTF in patients of the PDR group were positively correlated(r=0.441,P=0.004).The duration of T2DM,high circUSP36,and high circBPTF were all independent risk factors for PDR(P＜0.05).The area under the curve(AUC)of serum circUSP36 and circBPTF alone and in combination for predicting NPDR were 0.678,0.698,and 0.775,respectively,and the predictive value of the combination of serum circUSP36 and circBPTF was su-perior to that of their individual detections(P＜0.05).The AUCs of serum circUSP36 and circBPTF alone and in combination for predicting PDR were 0.788,0.787,and 0.859,respectively,and the combination of the two was superior to their individual detections(P＜0.05).Conclusion The levels of serum circUSP36 and circBPTF are elevated in DR patients,and with the aggravation of DR,the expression levels of both show an upward trend.The combined detection of the two has certain predictive value for the severity of DR.

Objective To explore the pathogenic mechanisms of Legionella pneumophila(L.pneumophila)infection inhibiting the fusion of endosome-lysosome fusion in mouse macrophages.Methods Twelve C57 mice were randomly divided into control group and L.pneumophila infection group(n=6 each).After anesthesia,an equal volume of physiological saline or L.pneumophila solution was administered nasally.Body weight changes were monitored for 3 consecutive days,and the lungs were extracted to assess injury.Hematoxylin and eosin(HE)staining and immunohistochemical staining were performed to observe the pathological characteristics of lung tissue in both groups.Transcriptome sequencing was utilized to analyze differentially expressed genes(DEGs)and associated signaling pathways in lung tissues.Mouse bone marrow macrophages(BMDMs)were isolated and co-cultured with L.pneumophila,with infection status confirmed by immunofluorescence staining.Transcriptome sequencing was employed to analyze DEGs and enriched related signaling pathways before and after infection.Core genes involved in the post-infection signaling pathway were identified,and the consistency of their mRNA expression levels in vivo and in vitro was verified using RT-qPCR.The expression of relevant proteins was detected by Western Blotting,and bacterial proliferation assays were conducted to evaluate the intracellular replication of L.pneumophila.Results Compared with control group,the body weight of mice in L.pneumophila infection group significantly decreased(P<0.001)on the second and third day post-infection.Edema and red hepatoid degeneration were observed in both left and right lung tissues,with lesion areas spreading from the hilum to the lung periphery.HE staining revealed increased inflammatory cell infiltration in the alveolar spaces,thickening of alveolar septa and increased fibrin exudation in L.pneumophila infection group.Immunohistochemistry results showed a significant increase in myeloperoxidase(MPO)activity in the lung tissue infected mice(P<0.001).Transcriptome sequencing identified 2550 DEGs,with 1444 up-regulated genes and 1106 down-regulated genes.KEGG enrichment analysis indicated that these DEGs were mainly involved in pathways related to tumor necrosis factor,rheumatoid arthritis,Rap1,PI3K-Ak,and phagosome pathways.Immunofluorescence results showed in vitro proliferation of L.pneumophila within mouse BMDMs.Transcriptome sequencing identified 2550 DEGs,including 1677 up-regulated genes and 873 down-regulated genes.KEGG enrichment analysis showed that enrichment in pathway related to transcription dysregulation in cancer,PI3K-Akt and phagosome pathways.Thirteen core genes,including tubulin β1(Tubb1),were identified from the overlap between mouse lung tissue and BMDMs.RT-qPCR results demonstrated a significant decrease in Tubb1 expression in both lung tissue and BMDMs infected with L.pneumophila(P<0.001).Western Blotting results revealed significant decreases in Rab7,Tubb1,and LAMP2 protein expression(P<0.05),and increases in iNOS and MPO expression(P<0.05).Intracellular proliferation experiments indicated that L.pneumophila gradually increased within BMDMs over time.Conclusion The potential mechanism of L.pneumophila infection in mouse macrophages involves the down-regulation of Rab7/Tubb1/LAMP2 which inhibits the endosome-lysosome fusion.