Approximately 300 million tons of plastic are produced globally each year,which has a serious impact on human health,marine life and the livestock industry.Microplastics have also been detected in meat and milk samples.Research has shown that nanoplastics(NP)(＜1 μm)and mi-croplastics(MP)(1 μm-5 mm)can affect the digestive,immune and reproductive systems of ani-mals.This experiment aims to investigate whether NP and MP regulate autophagy and damage the nervous system and spatial memory of animals.This experiment was divided into control group,nanoplastic group(PS-NP group,0.1 μm)and microplastic group(PS-MP group,1 μm),with 20 mice in each group.The mice were given 0.5 mL of PS-NP and PS-MP every day for 35 consecutive days,followed by neck amputation and brain analysis.The results showed that NPs and MPs of dif-ferent diameters caused varying degrees of damage to the brains of mice.In the behavioral tests of new object recognition,barnes maze and Y-shaped maze spatial memory,compared with the control group,the PS-NP group and PS-MP group showed a significant decrease in spatial memory ability of mice.HE staining results showed that neuronal cells in the PS-NP and PS-MP groups of mice exhibited shrinkage,decreased cell volume and deepened staining.The number of Nissl bodies de-creased,leading to dissolution and disappearance.RT-PCR and Western blot results showed that compared with the control group,the expression of glutamate receptors NR1,NR2A and NR2B in-creased in mice administered NP and MP orally,while the expression of autophagy related proteins Parkin,LC3B and Beclin1 was inhibited.In summary,this study suggests that nanoplastics and mi-croplastics stimulate glutamate receptors in mice by inhibiting the autophagy pathway,leading to impaired spatial memory.

Sleep is an active and complex neurophysiological process.Premature babies sleep most of the day，and adequate sleep is conducive to the growth and development of premature infants.Sleep problems may be more common in preterm infants，but the studies about sleep and neurodevelopment in preterm infants are rare.This review systematically expounds the characteristics of shortened sleep time and fragmented sleep patterns in preterm infants，and the related mechanisms affecting their sleep quality，and summarizes measures to improve the sleep quality of preterm infants，in order to improve the sleep quality of preterm infants and thus promote neurodevelopment.

Objective:To summarize the clinical characteristics and prognosis of infectious pulmonary artery pseudoaneurysm (IPAP) in pediatric patients.Methods:This case series study summarizes the clinical data of 3 children diagnosed with IPAP at the Children′s Hospital of Chongqing Medical University from January 2015 to December 2024.A comprehensive literature review was conducted by searching Chinese databases (China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, China VIP Database and Chinese Medical Journals Full Text Database) and the PubMed database through December 2024, using the keywords"infect""pseudoaneurysm""pulmonary artery". The clinical characteristics and prognosis of IPAP were synthesized by combining the reviewed literature.Results:The 3 cases included a 2-month-old male infant, a 6-year-3-month-old male child and a 12-year-old female child, all of whom presented with fever and various respiratory symptoms. Case 1 was complicated by a retro-orbital abscess, Case 2 had a history of chronic granulomatous disease and psoriasis, and Case 3 was diagnosed with patent ductus arteriosus. Enhanced CT imaging in all 3 cases revealed multiple IPAP, with 2 cases associated with pulmonary infection foci and 1 case linked to infective endocarditis. Accompanying complications included pleural effusion in all 3 cases, necrotizing pneumonia in 2 cases, and pulmonary embolism in 1 case. Of the 3 cases, 2 cases showed improvement after anti-infective treatment, while 1 case resulted in death. A total of 9 English-language studies were identified, while no suitable Chinese-language studies were found. Including these 3 cases, a total of 12 pediatric IPAP cases were analyzed. The predominant clinical manifestations included fever in 10 cases, cough in 6 cases and hemoptysis in 5 cases. The most frequently identified pathogen was methicillin-resistant Staphylococcus aureus found in 3 cases. Additionally, 6 cases were complicated by extra-pulmonary infections, 4 cases had a history of congenital heart disease and surgical intervention, 1 case underwent rectovestibular fistula repair and 4 cases exhibited immune dysfunction. Imaging characteristics revealed that 9 of the 12 cases were associated with pulmonary infection foci, while 1 case was related to infective endocarditis, and 2 cases had insufficient imaging data for accurate classification. A total of 7 cases presented with a single IPAP, predominantly located in the right lower lobe in 3 cases, while the remaining 5 cases had multiple IPAP. IPAP was complicated by pleural effusion in 8 cases, by necrotizing pneumonia in 8 cases (1 of which was suspected), and by lung abscess and pulmonary embolism in 3 cases each. Among the 12 cases, 5 cases received anti-infective therapy without lobectomy or embolization, of which 3 cases improved, 1 case showed no response, and 1 case died. Additionally, 6 cases underwent endovascular embolization, with 4 cases showing improvement and 2 cases resulting in death. Only 1 case underwent lobectomy and was discharged in stable condition. Conclusions:IPAP in children manifests with a broad spectrum of clinical signs, frequently accompanied by extra-pulmonary infections and immune dysfunction. Enhanced CT plays a crucial role in the diagnosis of IPAP. The prognosis of IPAP is closely linked to the treatment approach, and timely diagnosis along with personalized treatment are essential for improving survival rates.

Approximately 300 million tons of plastic are produced globally each year,which has a serious impact on human health,marine life and the livestock industry.Microplastics have also been detected in meat and milk samples.Research has shown that nanoplastics(NP)(＜1 μm)and mi-croplastics(MP)(1 μm-5 mm)can affect the digestive,immune and reproductive systems of ani-mals.This experiment aims to investigate whether NP and MP regulate autophagy and damage the nervous system and spatial memory of animals.This experiment was divided into control group,nanoplastic group(PS-NP group,0.1 μm)and microplastic group(PS-MP group,1 μm),with 20 mice in each group.The mice were given 0.5 mL of PS-NP and PS-MP every day for 35 consecutive days,followed by neck amputation and brain analysis.The results showed that NPs and MPs of dif-ferent diameters caused varying degrees of damage to the brains of mice.In the behavioral tests of new object recognition,barnes maze and Y-shaped maze spatial memory,compared with the control group,the PS-NP group and PS-MP group showed a significant decrease in spatial memory ability of mice.HE staining results showed that neuronal cells in the PS-NP and PS-MP groups of mice exhibited shrinkage,decreased cell volume and deepened staining.The number of Nissl bodies de-creased,leading to dissolution and disappearance.RT-PCR and Western blot results showed that compared with the control group,the expression of glutamate receptors NR1,NR2A and NR2B in-creased in mice administered NP and MP orally,while the expression of autophagy related proteins Parkin,LC3B and Beclin1 was inhibited.In summary,this study suggests that nanoplastics and mi-croplastics stimulate glutamate receptors in mice by inhibiting the autophagy pathway,leading to impaired spatial memory.

Objective:To summarize the clinical characteristics and prognosis of infectious pulmonary artery pseudoaneurysm (IPAP) in pediatric patients.Methods:This case series study summarizes the clinical data of 3 children diagnosed with IPAP at the Children′s Hospital of Chongqing Medical University from January 2015 to December 2024.A comprehensive literature review was conducted by searching Chinese databases (China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, China VIP Database and Chinese Medical Journals Full Text Database) and the PubMed database through December 2024, using the keywords"infect""pseudoaneurysm""pulmonary artery". The clinical characteristics and prognosis of IPAP were synthesized by combining the reviewed literature.Results:The 3 cases included a 2-month-old male infant, a 6-year-3-month-old male child and a 12-year-old female child, all of whom presented with fever and various respiratory symptoms. Case 1 was complicated by a retro-orbital abscess, Case 2 had a history of chronic granulomatous disease and psoriasis, and Case 3 was diagnosed with patent ductus arteriosus. Enhanced CT imaging in all 3 cases revealed multiple IPAP, with 2 cases associated with pulmonary infection foci and 1 case linked to infective endocarditis. Accompanying complications included pleural effusion in all 3 cases, necrotizing pneumonia in 2 cases, and pulmonary embolism in 1 case. Of the 3 cases, 2 cases showed improvement after anti-infective treatment, while 1 case resulted in death. A total of 9 English-language studies were identified, while no suitable Chinese-language studies were found. Including these 3 cases, a total of 12 pediatric IPAP cases were analyzed. The predominant clinical manifestations included fever in 10 cases, cough in 6 cases and hemoptysis in 5 cases. The most frequently identified pathogen was methicillin-resistant Staphylococcus aureus found in 3 cases. Additionally, 6 cases were complicated by extra-pulmonary infections, 4 cases had a history of congenital heart disease and surgical intervention, 1 case underwent rectovestibular fistula repair and 4 cases exhibited immune dysfunction. Imaging characteristics revealed that 9 of the 12 cases were associated with pulmonary infection foci, while 1 case was related to infective endocarditis, and 2 cases had insufficient imaging data for accurate classification. A total of 7 cases presented with a single IPAP, predominantly located in the right lower lobe in 3 cases, while the remaining 5 cases had multiple IPAP. IPAP was complicated by pleural effusion in 8 cases, by necrotizing pneumonia in 8 cases (1 of which was suspected), and by lung abscess and pulmonary embolism in 3 cases each. Among the 12 cases, 5 cases received anti-infective therapy without lobectomy or embolization, of which 3 cases improved, 1 case showed no response, and 1 case died. Additionally, 6 cases underwent endovascular embolization, with 4 cases showing improvement and 2 cases resulting in death. Only 1 case underwent lobectomy and was discharged in stable condition. Conclusions:IPAP in children manifests with a broad spectrum of clinical signs, frequently accompanied by extra-pulmonary infections and immune dysfunction. Enhanced CT plays a crucial role in the diagnosis of IPAP. The prognosis of IPAP is closely linked to the treatment approach, and timely diagnosis along with personalized treatment are essential for improving survival rates.

Objective:To analyze the research frontiers and trends in the research field of Tongxieyao Prescription.Methods:Research literature about Tongxieyao Prescription was retrieved from CNKI, VIP, Wanfang Data, SinoMed and Chinese Medical Journal Full Text Database from January 1, 2002 to July 13, 2022. NoteExpress 3.0 software was used to merge and remove the weight, and VOSviewer 1.6 and CiteSpace 5.8 software were used to analyze the author, research institution, key words and a knowledge map was drawn.Results:A total of 1 309 articles were included. The overall number of publications in this field was on the rise. Wang Jianwei of Heilongjiang University of Chinese Medicine (16 articles) published the most papers, and there was a lack of communication and cooperation between the author's teams. The publishing institutions were mainly TCM universities, and there were few influential institutions. Through co-occurrence and clustering analysis of keywords, it was found that the keywords in the field of Tongxieyao Prescription mainly focused on diarrhea, irritable bowel syndrome, gut microbiota, brain gut peptides, clinical efficacy, and other words. Keyword highlighting showed that gut microbiota was a research hotspot.Conclusions:The research on Tongxieyao Prescription focuses on the treatment of irritable bowel syndrome and ulcerative colitis with Tongxieyao Prescription. Its mechanism includes inflammatory factor pathway, immune pathway, intestinal flora and brain-gut axis regulation. At present, the prospect of Tongxieyao Prescription is bright, and basic research is active. It is still necessary to strengthen cooperation among scholars from various institutions to facilitate in-depth research progress.

Background: Galangin, commonly employed in traditional Chinese medicine for its diverse medicinal properties, exhibits potential in treating inflammatory pain. Nevertheless, its mechanism of action remains unclear. Methods: Mice were randomly divided into 4 groups for 7 days: a normal control group, a galangin-treated (25 and 50 mg/kg), and a positive control celecoxib (20 mg/kg). Analgesic and anti-inflammatory effects were evaluated using a hot plate test, acetic acid-induced writhing test, acetic acid-induced vascular permeability test, formalininduced paw licking test, and carrageenan-induced paw swelling test. The interplay between galangin, transient receptor potential vanilloid 1 (TRPV1), NF-κB, COX-2, and TNF-α proteins was evaluated via molecular docking. COX- 2, PGE2, IL-1β, IL-6, and TNF-α levels in serum were measured using ELISA after capsaicin administration (200 nmol/L). TRPV1 expression in the dorsal root ganglion was analyzed by Western blot. The quantities of substance P (SP) and calcitonin gene-related peptide (CGRP) were assessed using qPCR. Results: Galangin reduced hot plate-induced licking latency, acetic acid-induced contortions, carrageenantriggered foot inflammation, and capillary permeability in mice. It exhibited favorable affinity towards TRPV1, NF- κB, COX-2, and TNF-α, resulting in decreased levels of COX-2, PGE2, IL-1β, IL-6, and TNF-α in serum following capsaicin stimulation. Galangin effectively suppressed the upregulation of TRPV1 protein and associated receptor neuropeptides CGRP and SP mRNA, while concurrently inhibiting the expression of NF-κB, TNF-α, COX-2, and PGE2 mRNA. Conclusions Galangin exerts its anti-inflammatory pain effects by inhibiting TRPV1 activation and regulating COX-2, NF-κB/TNF-α expression, providing evidence for the use of galangin in the management of inflammatory pain.

The incidence of breast cancer currently ranks first among malignant tumors in women.Breast cancer exhibits high heterogeneity and can be classified into four molecular subtypes:luminal A,luminal B,human epidermal growth factor receptor 2(HER2)overexpression and triple-negative.However,previous molecular subtype classifications have limited treatment options for patients with HER2 low expression.In recent years,with the rapid development of antibody-drug conjugates(ADCs),new treatment options have emerged for breast cancer patients with HER2 low expression.This has also led to updates in the criteria for determining HER2 expression status in both domestic and international guidelines,based on immunohistochemistry(IHC)and in situ hybridization(ISH)testing,categorizing HER2 expression as HER2-positive(IHC 3+ or IHC 2+/ISH+),HER2 low expression(IHC 1+ or IHC 2+/ISH-),and HER2-negative(IHC 0).ADCs are immunotherapeutics composed of a linker that conjugates a monoclonal antibody with a cytotoxic payload.In the field of breast cancer,several large clinical trials have demonstrated clinical benefits of ADCs targeting HER2,such as trastuzumab emtansine(T-DM1),trastuzumab deruxtecan(T-DXd)and sacituzumab govitecan targeting trophoblast cell surface antigen 2(TROP2),in various molecular subtypes of breast cancer.With the phaseⅢ DESTINY-Breast03 trial and others,T-DXd has been found to have superior efficacy compared to T-DM1 in advanced HER2-positive breast cancer patients(approximately two times higher complete response rate,and four times longer median progression-free survival).T-DXd has now replaced T-DM1 as the recommended second-line therapy for HER2-positive breast cancer and as a second-line treatment option after local treatment for brain metastasis.The phase Ⅲ DESTINY-Breast04 trial confirmed that breast cancer patients with HER2 low expression can also benefit from T-DXd,further reshaping the treatment landscape for advanced breast cancer and supporting the need to redefine molecular subtypes of HER2-negative breast cancer.The phase Ⅲ ASCENT trial demonstrated that sacituzumab govitecan significantly improved survival and quality of life in triple-negative breast cancer(TNBC)patients,and the phase Ⅱ NeoSTAR study suggested its potential as neoadjuvant therapy in TNBC.Based on evidence,T-DM1,T-DXd and sacituzumab govitecan have been approved for marketing in both foreign and Chinese markets.Other ADC drugs,such as HER3-DXd,Dato-DXd and China-developed RC48,are also undergoing extensive clinical trials in the field of breast cancer and other tumors.Furthermore,there are several other ADCs targeting different molecular targets in active development.This article aimed to review the new advances related to ADCs therapy for breast cancer patients with different molecular subtypes and discuss the clinical application value of ADCs in breast cancer.

Objective: To preliminarily develop the Infectious Disease Prevention Health Literacy Scale for Chinese Middle School Students, as an important measuring tool for assessment of comprehensive abilities in infectious disease prevention of Chinese middle school students. Methods: The basic dimensional framework and item pool were established by literature review in the view of public health. Then Delphi method was used to modify the framework and item pool to scale 1.0. Panel discussion in middle school students was used to adjust the expression and structure of scale 1.0, turning it into scale 2.0. With the confirmation of theory experts subjects, the scale was preliminarily developed. Results: Literature review suggested that the basic dimension framework included five longitudinal dimensions and seven horizontal dimensions. According to Delphi method ( n =18), the Kendall s coefficient of concordance ( W ) of the scale was equal to 0.14 ( P <0.01), the average importance, proportion of full marks, coefficient of variation and weight coefficient of all dimensions and items met the inclusion criteria. According to panel discussion, the scale was finally adjusted into scale 2.0 with 53 items. Conclusion This study preliminarily established the Infectious Disease Prevention Health Literacy Scale for Chinese Middle School Students, which might be applied in both scientific research and practical use.

Adjuvant radiotherapy has become an important part of the standard treatment for breast cancer. Compared with the traditional postoperative radiotherapy, neoadjuvant radiotherapy has the theoretical advantages of more accurate target delineation, optimization of radiation strategy for breast reconstruction, increase of breast conservation surgery with tumor down-staging and avoiding breast surgery by improving pathological complete response rate, which have been confirmed by recent clinical research. Prospective studies are still needed for the optimal target delineation, dose fractionation, radiation-surgery interval, and combination with systemic therapies, aiming to provide the optimal treatment option for patients with early breast cancer.