Objective:To establish 30-day of age transcutaneous bilirubin (TcB) reference curves for healthy neonates, and to investigate regional variations in bilirubin dynamics.Methods:A multicenter retrospective cohort study was conducted. A total of 220 950 healthy neonates born at a gestational age of 35-<42 weeks, with a birth weight ≥2 000 g, who did not receive phototherapy within 60 h after birth were recruited. All of them underwent remote TcB monitoring using the Bilibaby remote jaundice monitoring system between August 1 st, 2020 and December 31 st, 2024 in 426 hospitals. TcB data were collected within the period from birth to 30-day of age. The P40, P75, and P95 of TcB values were calculated, and dynamic TcB curves for 30-day of age were constructed. Patterns of bilirubin change, rates of change, and transition outcomes were described. Regional comparisons between South and North were conducted using linear mixed-effects models for TcB trajectories and Pearson′s chi-square test for outcome differences. Results:A total of 220 950 neonates were included, of whom 101 711 (46.03%) were female. Gestational age at birth was (38.75±1.12) weeks, and birth weight was (3 272±417) g. TcB levels increased rapidly within 3-day of age, peaked at 4-6-day of age, with peak values at P40, P75, and P95 of 200.6, 239.7 and 275.4 μmol/L (11.8, 14.1 and 16.2 mg/dl), respectively. TcB levels gradually declined thereafter and stabilized after 13-day of age, with values at P40, P75, and P95 fluctuating between 147.9-159.8, 190.4-200.6, and 231.2-239.7 μmol/L (8.7-9.4, 11.2-11.8, 13.6-14.1 mg/dl), respectively. Notably, among neonates categorized as low-or low-intermediate-risk within 3-day of age, 6 700 (12.76%) progressed to intermediate-high or high risk between 4 and 30 days of age. Before 13-day of age, TcB levels in the southern regions were consistently higher than those in the northern regions ( P=0.039); from 14 to 30 days of age, the overall TcB levels had no statistically difference, but the temporal changes in TcB still showed regional differences (degrees of freedom=3, all interaction P<0.05). Among neonates classified as low-or low-intermediate risk within 3-day of age, 25 326 were from southern regions, of whom 4 254 (16.80%) progressed to intermediate-high or high risk between 4 and 30 days of age. In northern regions, 27 193 neonates were classified as low-or low-intermediate risk within 3-day of age, among whom 2 446 (8.99%) progressed to intermediate-high or high risk. The risk progression between the 2 regions had statistically difference ( χ2=716.49, P<0.001). Conclusions:A TcB percentile curve for neonates within 30-day of age was established, revealing that both the overall TcB level and its temporal trend were higher in southern than in northern newborns. These findings provide baseline data to support continuous management of neonatal jaundice.

Objective:To establish 30-day of age transcutaneous bilirubin (TcB) reference curves for healthy neonates, and to investigate regional variations in bilirubin dynamics.Methods:A multicenter retrospective cohort study was conducted. A total of 220 950 healthy neonates born at a gestational age of 35-<42 weeks, with a birth weight ≥2 000 g, who did not receive phototherapy within 60 h after birth were recruited. All of them underwent remote TcB monitoring using the Bilibaby remote jaundice monitoring system between August 1 st, 2020 and December 31 st, 2024 in 426 hospitals. TcB data were collected within the period from birth to 30-day of age. The P40, P75, and P95 of TcB values were calculated, and dynamic TcB curves for 30-day of age were constructed. Patterns of bilirubin change, rates of change, and transition outcomes were described. Regional comparisons between South and North were conducted using linear mixed-effects models for TcB trajectories and Pearson′s chi-square test for outcome differences. Results:A total of 220 950 neonates were included, of whom 101 711 (46.03%) were female. Gestational age at birth was (38.75±1.12) weeks, and birth weight was (3 272±417) g. TcB levels increased rapidly within 3-day of age, peaked at 4-6-day of age, with peak values at P40, P75, and P95 of 200.6, 239.7 and 275.4 μmol/L (11.8, 14.1 and 16.2 mg/dl), respectively. TcB levels gradually declined thereafter and stabilized after 13-day of age, with values at P40, P75, and P95 fluctuating between 147.9-159.8, 190.4-200.6, and 231.2-239.7 μmol/L (8.7-9.4, 11.2-11.8, 13.6-14.1 mg/dl), respectively. Notably, among neonates categorized as low-or low-intermediate-risk within 3-day of age, 6 700 (12.76%) progressed to intermediate-high or high risk between 4 and 30 days of age. Before 13-day of age, TcB levels in the southern regions were consistently higher than those in the northern regions ( P=0.039); from 14 to 30 days of age, the overall TcB levels had no statistically difference, but the temporal changes in TcB still showed regional differences (degrees of freedom=3, all interaction P<0.05). Among neonates classified as low-or low-intermediate risk within 3-day of age, 25 326 were from southern regions, of whom 4 254 (16.80%) progressed to intermediate-high or high risk between 4 and 30 days of age. In northern regions, 27 193 neonates were classified as low-or low-intermediate risk within 3-day of age, among whom 2 446 (8.99%) progressed to intermediate-high or high risk. The risk progression between the 2 regions had statistically difference ( χ2=716.49, P<0.001). Conclusions:A TcB percentile curve for neonates within 30-day of age was established, revealing that both the overall TcB level and its temporal trend were higher in southern than in northern newborns. These findings provide baseline data to support continuous management of neonatal jaundice.

miR-135 is a highly conserved miRNA in mammals and includes miR-135a and miR-135b.Recent studies have shown that miR-135b is a key regulatory factor in cardio-cerebrovascular diseases.It is involved in regulating the pathological process of myocardial infarction,myocardial ischemia/reperfusion injury,cardiac hypertrophy,atrial fibrillation,diabetic cardiomyopathy,atherosclerosis,pulmonary hyperten-sion,cerebral ischemia/reperfusion injury,Parkinson's disease,and Alzheimer's disease.Obviously,miR-135b is an emerging player in cardio-cerebrovascular diseases and is expected to be an important target for the treatment of cardio-cerebrovascular diseases.However,the crucial role of miR-135b in cardio-cerebrovascular diseases and its underlying mechanism of action has not been reviewed.Therefore,in this review,we aimed to comprehensively summarize the role of miR-135b and the signaling pathway mediated by miR-135b in cardio-cerebrovascular diseases.Drugs targeting miR-135b for the treatment of diseases and related patents,highlighting the importance of this target and its utility as a therapeutic target for cardio-cerebrovascular diseases,have been discussed.

Mycobacterium neoaurum has the ability to produce steroidal intermediates known as 22-hydroxy-23, 24-bisnorchol-4-en-3-one (BA) upon the knockout of the genes for either the hydroxyacyl-CoA dehydrogenase (Hsd4A) or acyl-CoA thiolase (FadA5). In a previous study, we discovered a novel metabolite in the fermentation products when the fadA5 gene was deleted. This research aims to elucidate the metabolic pathway of this metabolite through structural identification, homologous sequence analysis of the fadA5 gene, phylogenetic tree analysis of M. neoaurum HGMS2, and gene knockout. Our findings revealed that the metabolite is a C23 metabolic intermediate, named 24-norchol-4-ene-3, 22-dione (designated as 3-OPD). It is formed when a thioesterase (TE) catalyzes the formation of a β-ketonic acid by removing CoA from the side chain of 3, 22-dioxo-25, 26-bisnorchol-4-ene-24-oyl CoA (22-O-BNC-CoA), followed by spontaneously undergoing decarboxylation. These results have the potential to contribute to the development of novel steroid intermediates.
Mycobacterium/metabolism* ; Phylogeny ; Steroids/metabolism* ; Metabolic Networks and Pathways ; Sterols/metabolism*

Objective: To investigate the clinical value of transvaginal three-dimensional ultrasonography in the differential diagnosis of benign and malignant endometrial diseases after menopause. Methods: From April 2015 to April 2017, the imaging data of transvaginal three-dimensional ultrasonography of 184 patients with benign and malignant breast tumors in the Second People's Hospital of Yuhang District were retrospectively analyzed.The peak systolic flow velocity, resistance index, peak systolic velocity, intimal arterial resistance index and blood flow display rate of uterine artery of benign and malignant endometrial diseases were compared. Results: The accuracy, sensitivity and specificity of transvaginal three-dimensional ultrasonography in the diagnosis of endometrial diseases were 91.30%(168/184), 92.00%(46/50), 91.04%(122/134), respectively.There were no statistically significant differences in the peak systolic flow velocity, resistance index, peak systolic velocity of patients with benign and malignant endometrial diseases by transvaginal three-dimensional ultrasonography(t=1.17, 0.88, 0.51, all P>0.05). The intimal arterial resistance index of patients with malignant endometrial diseases by transvaginal three-dimensional ultrasonography was significantly lower than patients with benign endometrial diseases(t=2.59, P<0.05). The blood flow display rates of uterine artery of patients with malignant endometrial diseases by transvaginal three-dimensional ultrasonography were 19.40%(26/134), 92.00%(46/50). The blood flow display rate of uterine artery of patients with malignant endometrial diseases by transvaginal three-dimensional ultrasonography was significantly higher than patients with benign endometrial diseases(χ²=7.26, P<0.05). Conclusion Transvaginal three-dimensional ultrasonography in the differential diagnosis of benign and malignant endometrial diseases after menopause has higher accuracy, sensitivity and specificity.

Objective To investigate the differential diagnostic value of computed tomography (CT) combined with serum tumor markers in borderline ovarian tumors (BOT) and benign epithelial ovarian tumors (BET).Methods The CT data in 28 patients with BOT and 41 patients with BET,both confirmed by surgery and pathological,were analyzed retrospectively.Their preoperative serum carbohydrate antigen 125 (CA125),human epididymis secretory protein 4 (HE4) and carcinoembryonic antigen (CEA) detection results were collected.The CT images features and serum tumor markers levels were compared between the two groups.Results The difference in the appearance rate of tumor solid composition,thick septum and wall nodule between the two groups had statistical significance (x2 =25.135,5.240,5.066,P＜0.05).The serum CA125 level had statistical difference between the two groups (Z=3.202,P＜0.05),while serum HE4 and CEA levels had no statistically significant difference between the two groups(Z=0.330,1.122,P＞0.05).The optimal critical value,sensitivity and specificity of serum CA125 level in differential diagnosis of two kinds of tumor was 42.45 U/mL,53.6％ and 85.4％.The overall diagnostic rate of solid composition and thick septum for diagnosing the two kinds of tumor was 78.5 ％.The overall diagnostic rate of solid composition,thick septum and CA125 level for diagnosing the two kinds of tumor was 81.2％.Conclusion The appearance of solid composition,thick septum and serum CA125 level increase in epithelial ovarian tumor may help to identify BOT and BET.

Objective To investigate the feasibility and cosmetic results of endoscopic thyroidectomy via breast areola approach.Methods From January 2004 to January 2006,endoscopic thyroidectomy was performed through the breast areola approach in 18 patients with benign thyroid mass.Results The surgery was accomplished successfully in all the 18 cases.The operation time ranged 45-120 min(mean,62 min) for unilateral resection and 90-180 min(mean,98 min) for bilateral resection.The intraoperative blood loss ranged 6-20 ml(mean,11 ml) for unilateral resection,and 15-70 ml(mean,29.5 ml) for bilateral resection.Postoperative hospital stay was 3-5 days.No complication occurred after the operation.The patients were followed up for 6-12 months(mean,9 months).The wound healed well in all the patients,inconspicuous scars or no recurrence was observed during the follow-up.Conclusions Endoscopic thyroidectomy via breast areola approach is a safe and feasible procedure with satisfying neck cosmetic outcome.