Objective: To systematically evaluate the association between random urinary electrolyte levels and hypertension among children and adolescents in Guizhou Province, so as to provide evidence for region specific dietary guidance and interventions. Methods: In 2023, a total of 2 480 children and adolescents aged 6 to 17 years were recruited from a nine-year coherent style school in Guizhou Province in a children health cohort, with follow ups conducted in 2024 and 2025. Random urine samples were collected to measure urinary sodium, potassium, calcium, and chloride, and the urinary sodium to potassium ratio (Na/K) was calculated. The diagnosis of hypertension was based on the criteria established by the Chinese Guidelines for Hypertension Prevention and Treatment (2024 revised edition) and relevant research. Linear mixed models and multinomial Logistic regression were used to assess the associations of urinary electrolytes with systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and the risk of hypertension. Results: At baseline, SBP, DBP, and MAP were 102.33 (94.33, 110.33), 61.33 (56.33, 67.00) and 75.22 (69.67, 81.33)mmHg among children and adolescents, respectively. After adjusting for potential confounders and two follow-ups, higher urinary Na/K ratio was positively associated with higher of SBP ( β=0.054, 95%CI =0.028- 0.081 ) and MAP ( β=0.038, 95%CI =0.010-0.066), as well as higher risks of hypertension ( OR=1.248, 95%CI =1.006-1.548) (all P <0.05). Higher of urinary chloride levels were positively associated with higher of SBP ( β=0.088, 95%CI = 0.009- 0.167), whereas higher of urinary potassium (SBP: β=-0.062, 95%CI =-0.096 to -0.028; MAP: β=-0.041, 95%CI = -0.078 to -0.005) and calcium levels (SBP: β=-0.036, 95%CI =-0.065 to -0.007) were negatively associated with blood pressure (all P < 0.05 ). Conclusion The urinary Na/K, as a comprehensive electrolyte marker, more stably reflects sodium load and excretory pressure in children and adolescents, and may serve as an early predictor of hypertension risk.

The brain-gut interaction theory is a multidimensional integrative concept based on the brain-gut axis， involving neural， endocrine， and immune regulatory networks as well as the gut microbiota. Zang-fu organs （脏腑） theory in traditional Chinese medicine （TCM） shows a high degree of consistency with the brain-gut interaction theory， and the core functions such as the spleen and stomach governing the ascending of the clear and descending of the turbid， the liver governing the free flow of qi， and the heart governing mental and emotional activities are closely associated with the multi-level regulatory mechanisms of the brain-gut axis. TCM therapy can modulate brain-gut interactions through multiple pathways in the treatment of spleen and stomach diseases， including the regulation of gastrointestinal hormone secretion， neurotransmitter levels， the hypothalamic-pituitary-adrenal （HPA） axis， immune homeostasis and inflammatory responses， as well as the gut microecology. However， current basic research on the brain-gut interaction theory in TCM for spleen and stomach diseases still faces several challenges， such as difficulties in integrating TCM spleen-stomach theory with modern pathophysiology， lack of innovation in research concepts， and limitations in research methodologies. It is therefore proposed that multidisciplinary collaboration， multi-omics technologies， and targeted research approaches should be adopted to provide more comprehensive methods for basic research on TCM spleen and stomach diseases， thereby promoting the in-depth development of brain-gut interaction theory.

ObjectiveTo quantitatively evaluate the effect of phrenic nerve-abdominal muscle electrical stimulation on pulmonary ventilation distribution in stroke patients using electrical impedance tomography (EIT). MethodsThirty-five stroke patients were enrolled at the First Affiliated Hospital of Chongqing Medical University from September, 2024 to June, 2025, and all received standardized phrenic nerve-abdominal muscle electrical stimulation. Percentage of ventilation in gravity-dependent regions of interesting (ROI%), center of ventilation (COV), global inhomogeneity index (GI) and change in end-expiratory lung impedance (ΔEELI) were measured with EIT monitoring before treatment (T0), immediately after treatment (T1), and at five, ten, 15, 20, 25, 30, 40 and 50 minutes after treatment (T2 to T9). ResultsThere were significant differences in ROI% (F = 7.003, P < 0.001) and COV (F = 5.722, P < 0.001) at different time points, both peaking at T1, followed by a downward trend until T5. No significant differences were observed in GI (F = 1.849, P = 0.097) and ΔEELI (F = 0.208, P = 0.871) across time points; however, GI at T7 was lower than that at T0 (P < 0.05). ConclusionPhrenic nerve-abdominal muscle electrical stimulation can improve the ventilation ratio in gravity-dependent regions and shift the center of ventilation dorsally. The improvement in ventilation distribution generally peaks at the end of treatment and lasts for approximately 20 minutes.

BACKGROUND: Lead is a persistent inorganic environmental pollutant with global implication for human health. Among the diseases associated with lead exposure, the damage to the central nervous system has received considerable attention. It has been reported that long-term lead exposure increases the risk of meningioma; however, the underlying mechanism remains poorly understood. Clinical studies have indicated that loss-of-function and mutations in the neurofibromin-2 (NF2) gene play a crucial role in promoting meningioma formation. METHODS: The effect of Pb on meningioma were tested in-vitro and in-vivo. Two human meningioma cell lines were used in this study, including NF2-wildtype IOMM-Lee cell and NF2-null CH157-MN cell. Cell viability, cell cycle and cell size were examined after Pb exposure. The expression of Merlin, mammalian sterile 20-like kinases 1 and 2 (MST1/2) and Yes-associated protein (YAP) from these two meningioma cells were analyzed by Western blot. A xenograft mouse model was constructed by subcutaneous injection of IOMM-Lee meningioma cells. RESULTS: This study demonstrated that treatment with lead induce dose-dependent proliferation in IOMM-Lee cell (with an EC₅₀ value of 19.6 µM). Moreover, IOMM-Lee cell exhibited augmented cell size in conjunction with elevated levels of phosphorylated histone H3, indicative of altered cell cycle progression resulting from lead exposure. However, no significant change was observed in the CH157-MN cell. Additionally, the Merlin-Hippo signaling pathway was inactivated with decreased Merlin and phosphorylation levels of MST1/2 and YAP, leading to increased YAP nuclear translocation in IOMM-Lee cells. However, there was no change in the Merlin-Hippo signaling pathway in CH157-MN cells after lead treatment. The administration of Pb resulted in an acceleration of the subcutaneous IOMM-Lee meningioma xenograft growth in mice. CONCLUSIONS Overall, the current study elucidates the potential mechanism by which lead exposure promotes the proliferation of meningioma with NF2 expression for the first time.
Meningioma/genetics* ; Neurofibromin 2/genetics* ; Humans ; Cell Proliferation/drug effects* ; Animals ; Signal Transduction/drug effects* ; Mice ; Hippo Signaling Pathway ; Lead/adverse effects* ; Cell Line, Tumor ; Protein Serine-Threonine Kinases/genetics* ; Meningeal Neoplasms ; Environmental Pollutants/adverse effects* ; Female

Objective:To analyze the mediating effect of cardiovascular health status (CVH) on the association between educational level and cardiovascular disease (CVD).Methods:The participants were from Shanghai Suburban Adult Cohort and Biobank, and questionnaire survey, physical examination, blood biochemistry were conducted from 2016 to 2020 for baseline information collection, and follow up was conducted until March 31, 2024 based on the medical data, CVD incidence data and death surveillance data at different levels. The associations of educational level, CVH and time to CVD onset of the study population were analyzed using the accelerated failure time model to analyze the mediating effects of CVH, health behaviors, and health factors in the association of educational level and time to CVD onset. The mediating effects of educational level, gender, and age moderated associations were also analyzed.Results:A total of 57 312 participants were included, with 2 780 new cases of CVD during a median follow-up of 6.71 (6.71-6.72) years, and a mean incidence density of 7.77/1 000 person-years (95% CI: 7.48/1 000 person-years -8.06/1 000 person-years). In total, the less educational level and the lower CVH, the higher CVD incidence density ( P<0.05). The results of accelerated failure time models showed that the time ratio for CVD-free survival was 1.15 (95% CI: 1.06-1.24) and 1.33 (95% CI: 1.10-1.60) for moderate and high educational level, respectively. The results of the mediation effect analysis showed that the association between moderate and high educational level and time to CVD onset was 29.60% (20.50%-50.00%) and 36.10% (23.80%-59.00%), 9.97% (5.07%-20.00%) and 13.84% (6.84%-29.00%), 15.24% (9.64%-27.00%) and 17.55% (11.58%-33.00%) of mediators mediated by CVH, health behaviors, health factors, respectively. Among them, there was an exposure-mediated interaction of educational level and a positive moderating effect of age. Conclusion:CVH, health behaviors and health factors had a proportionate mediating effect in the association between educational level and risk of CVD development.

Objective:o evaluate the clinical efficacy of the induced membrane technique combined with an antibiotic-impregnated bone cement-coated plate fixation in the treatment of chronic osteomyelitis of the distal femur.Methods:A retrospective study was performed on patients diagnosed with chronic osteomyelitis of the distal femur, who received the induced membrane technique combined with an antibiotic-impregnated bone cement-coated plate fixation at Southwest Hospital from November 2016 to December 2022. All patients underwent a two-stage surgical protocol. Stage I involved thorough debridement, placement of antibiotic-impregnated bone cement spacers, and internal fixation with antibiotic-impregnated bone cement-coated plates. Stage II comprised internal fixation for the repair and reconstruction of bone defects. Intraoperatively, microbial culture, antibiotic susceptibility testing, and pathological examination were conducted on bone tissue lesion samples to guide targeted anti-infective therapy. Postoperatively, laboratory markers including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), along with clinical manifestations (e.g., incision drainage, redness, fever, and pain), were monitored to exclude infection recurrence. Infection control was ultimately confirmed by intraoperative frozen section analysis during the second stage. Additionally, bone healing was evaluated via X-ray of the affected limb every month after the second-stage surgery, and lower limb function was assessed using the final knee range of motion (ROM) and the lower extremity function scale (LEFS).Results:A total of 104 patients met the inclusion criteria, including 70 males and 34 females, with a mean age of 35.2±12.13 years. Thirty-seven patients were diagnosed with chronic hematogenous osteomyelitis (CHO) and 67 with post-traumatic osteomyelitis (PTOM). The mean follow-up was 25.48±6.61 months (range, 12-38 months). After the first-stage surgery, infection recurred in 6 CHO and 15 PTOM patients, requiring repeated debridement. Two CHO patients experienced infection recurrence after second-stage reconstruction, which was successfully controlled with further staged treatment. Five PTOM patients developed nonunion after second-stage bone grafting but ultimately achieved bone union after revision surgery. At final follow-up, CRP levels were 4.45±4.23 mg/L (CHO) and 5.16±4.26 mg/L (PTOM), and ESR levels were 5.47±7.42 mm/h (CHO) and 8.51±8.72 mm/h (PTOM), all significantly lower than preoperative values (CRP: CHO 68.31±65.61, PTOM 42.71±80.46; ESR: CHO 52.18±34.29, PTOM 45.87±39.13; all P<0.05). All patients ultimately achieved bone union. One PTOM patient with a preoperative rupture of the knee extensor mechanism had limited improvement in ROM (15° preoperatively vs. 12° at 4-year follow-up). In the remaining patients, knee ROM at final follow-up was significantly improved (CHO: 101.38°±43.73°, PTOM: 94.28°±43.94°) compared with preoperative values (CHO: 57.17°± 4.53°, PTOM: 39.61°±52.61°; all P<0.05). The final LEFS scores were 72.18±9.51 (CHO) and 71.66±10.25 (PTOM). Conclusion:The findings of this study demonstrate that the combination of the "Chongqing Technique" and the "Membrane-Induced Technique" is effective in eradicating chronic osteomyelitis of the distal femur, promoting bone healing, and restoring satisfactory knee joint function.

In the era of precision medicine,integrating radionuclide-based molecular imaging with targeted internal radiotherapy,integrated theranostics of nuclear medicine emerged as a promising and rapidly advancing field to achieve both visualization and precise treatment of tumors.The advances of commonly used and emerging radiotheranostic agents in oncology were systematically reviewed in this article.

Objective Through the analysis of the clinical characteristics of post-interventional complications of ventilator-associ-ated pneumonia(VAP)in patients with hypertension and acute large vessel occlusive cerebral infarction(AIS-LVO),we aim to develop and validate a risk prediction model.Methods We conducted a retrospective analysis of clinical data from 107 patients hospitalized for hypertension with AIS-LVO at Dongguan Hospital of Guangzhou University of Traditional Chinese Medicine between July 2020 and Au-gust 2023.Patients were categorized into two groups based on their hospitalization:the VAP group,consisting of 64 patients who devel-oped VAP,and the non-VAP group,comprising 43 patients who did not experience VAP.Least absolute shrinkage and selection opera-tor regression(LASSO)analysis was employed to identify potential predictors.Subsequently,a nomogram model was constructed using multifactorial Logistic regression analysis.The model's discriminative ability,calibration,and clinical utility were assessed using the area(AUC)under the receiver operating characteristic(ROC)curve,calibration curves,and decision curve analysis(DCA).Results In 107 patients with hypertension and AIS-LVO who underwent interventional surgery,the incidence of VAP was 59.8％.The results revealed statistically significant differences between the two groups in terms of age,presence of atrial fibrillation,admission national institutes of health stroke scale(NIHSS)score,admission glasgow coma scale(GCS)score,impaired consciousness,swallowing dysfunction,opera-tive time,postoperative 24-hour systemic inflammatory response index(SIRI),duration of mechanical ventilation,length of ICU stay,and the presence of an indwelling gastrostomy tube(P＜0.05).Additionally,the incidence of poor functional outcomes was 57.8％in the VAP group compared to 14.0％in the non-VAP group,indicating a worse prognosis for patients in the VAP group.The variables i-dentified through LASSO regression screening were included in a multifactorial Logistic regression analysis.This analysis revealed that the SIRI and the duration of mechanical ventilation were independent risk factors for the development of VAP following intervention in patients with hypertension and AIS-LVO(P＜0.05).Conversely,the admission GCS score was identified as a protective factor(P＜0.05).These three indicators were utilized to construct a prognostic nomogram model.The model's internal validity was assessed using the Boot-strap method with 1000 resamples,and the calibration curves were found to be in close agreement with the ideal fitted line,exhibiting a mean absolute error of 0.029,indicating good curve accuracy.The Logistic regression model's goodness of fit was evaluated using the Hos-mer and Lemeshow test,which yielded a x2 value of 5.38 and a P-value of 0.716,suggesting a good fit.The AUC of the model was 0.812(95％confidence interval 0.730-0.894),and the DCA indicated that the model has favorable clinical applicability.Conclusion A prediction model based on admission GCS score,postoperative 24-hour SIRI,and duration of mechanical ventilation demonstrates a robust predictive value for the incidence of VAP following intervention in patients with hypertension and acute ischemic stroke with AIS-LVO.

Objective To investigate and analyze the construction and management status of drug clinical trial institu-tions in Jiangxi Province,and to provide a reference for institutions' standardized management and development.Methods The registered drug clinical trial institutions in Jiangxi Province were selected as the research objects in the"Drug and Medical De-vice Clinical Trial Institution Filing Management Information System",and the public data were retrieved.Questionnaires were sent to the registered medical institutions as"Questionnaire Star"to collect the questionnaire data.The data on the construction and management of drug clinical trial institutions were analyzed descriptively from multiple dimensions.Results By December 2023,52 drug clinical trial institutions and one vaccine clinical trial institution had been registered in Jiangxi Province.The organ-ization and management structure,personnel composition,hardware,and software of the registration institutions met the basic re-quirements for conducting drug clinical trials.In recent years,the number of drug clinical trial record institutions and the number of projects to undertake has increased year by year,and the management ability and comprehensive strength of clinical trial institu-tions have been continuously enhanced,and there is still a big gap compared with the developed areas of the pharmaceutical in-dustry.Conclusion There is unbalanced regional development,uneven ability of different institutions to undertake projects,a low level of clinical trial information management,and the comprehensive ability of clinical trials needs to be improved in Jiangxi Province.

F-FDG PET/CT is an ideal auxiliary tool for early and accurate diagnosis of malignant tumors in children.This guideline aimed to standardize 18F-FDG PET/CT examination process for malignant tumors in children,hence providing references for nuclear medicine professionals.