Objective To evaluate the transition rules of normal body mass index(BMI),overweight and metabolic syndrome(MetS)in patients with major depressive disorder(MDD).Methods Patients with MDD who had multiple admission records between Jan 2016 and Nov 2021 in Beijing Anding Hospital,Capital Medical University were included.Based on the overweight and metabolic syndrome status assessed at each admission,the patients were categorized into three states:normal BMI,overweight and metabolic syndrome.A multi-state Markov model was used to analyze the transition intensity and transition frequency between three states and the influence of covariates on transitions.Results A total of 892 records of 398 subjects were included,with a median age of 56 years old and 31.4% males.The median follow-up period was 40 months.The multi-state model showed that there were 494 transitions between the three states,of which 5.1% moved from normal BMI to overweight and 5.5% moved from overweight to MetS.The intensity of transition was the highest from overweight to MetS,9.52 times greater than overweight to normal BMI.After 48.53 months,MDD patients with normal BMI began to transition to MetS.For overweight MDD patients,the transition to MetS started after 8.77 months.MDD patients with normal BMI or overweight had 31.4% and 50.4% probabilities of developing Mets after 36 months.For MDD patients comorbid with MetS,the probability of staying at MetS was 51.2% after 36 months.Multivariate analysis showed that being unmarried was a risk factor against developing overweight in normal BMI MDD patients,while a higher level of education was a protective factor against developing MetS in overweight MDD patients.Conclusion MDD patients exhibited a higher intensity and risk of developing MetS,and it is not easy to reverse MetS,suggesting that BMI management and MetS intervention should be strengthened in MDD patients.

ObjectiveTo analyze the characteristic expression patterns of six neurotransmitters including 5-hydroxytryptamine （5-HT）， dopamine （DA）， acetylcholine （ACh）， norepinephrine （NE）， inhibitory neurotransmitter （INH）， and excitatory neurotransmitter （EXC） in the whole brain and different brain regions of depression patients by Search of Encephalo Telex （SET）， providing new ideas for the study of heterogeneous etiology of depression. Methods（1） A retrospective study was conducted on supra-slow signals of EEG fluctuations in 1 028 patients with depression. The SET system was used to obtain the expression information of six neurotransmitters in the whole brain and 12 brain regions： left frontal region （F3）， right frontal region （F4）， left central region （C3）， right central region （C4）， left parietal region （P3）， right parietal region （P4）， left occipital region （O1）， right occipital region （O2）， left anterior temporal region （F7）， right anterior temporal region （F8）， left posterior temporal region （T5）， and right posterior temporal region （T6）. The expression information of each neurotransmitter was compared with the normal model， and it was found that single neurotransmitter was in one of three states： increased， decreased， or normal expression. The simultaneous expression states of six neurotransmitters in the brain space were referred to as the expression pattern of multiple neurotransmitters. （2） A MySQL database was established to analyze the actual expression patterns of different neurotransmitters in the whole brain of patients with depression. （3） Factor analysis was conducted to further analyze the characteristic rules of 78 variables of neurotransmitters in the whole brain and 12 brain regions in depression patients. Results（1） The expression of single neurotransmitters in the whole brain and different brain regions of the total depression population showed one of three expression states （increased/decreased/normal）， being normal in the majority. The decreased and increased expression of 5-HT， ACh， DA， INH， EXC， and NE in the whole brain occurred in 6% and 25%， 31% and 17%， 36% and 9%， 15% and 31%， 32% and 14%， and 22% and 22%， respectively. （2） The antagonizing pairs of neurotransmitters （EXC/INH， DA/5-HT， and ACh/NE） showed significant antagonistic relationships in the whole brain and different brain regions， with a strong negative correlation between EXC and INH （P<0.01， |r| values ranging from 0.69 to 0.76）， a strong negative correlation between DA and 5-HT （P<0.01， |r| values ranging from 0.83 to 0.90）， and a moderate negative correlation between ACh and NE （P<0.01， with |r| values ranging from 0.56 to 0.66）. Meanwhile， non-antagonizing pairs of neurotransmitters in the whole brain and different brain regions also showed correlations， with DA/NE （P<0.01， |r| values ranging from 0.38 to 0.46） and NE/EXC （P<0.01， |r| values ranging from 0.56 to 0.61） showing weak and moderate negative correlations， respectively， and DA/EXC showing a weak positive correlation （P<0.01， |r| values ranging from 0.38 to 0.47）. （3） The six neurotransmitters in the 1 028 patients with depression presented a total of 170 expression patterns in the whole brain. The top 30 expression patterns were reported in this paper， with a cumulative rate of 60.60%， including patterns ① INH+/5-HT-/ACh+/DA+/NE-/EXC- （9.05%）， ② INH+/5-HT-/ACh↓/DA+/NE-/EXC- （4.57%）， and ③ INH+/5-HT-/ACh+/DA+/NE↓/EXC- （3.31%）. That is， the proportion of depression patients with normal levels of all the six neurotransmitters was 9.05%， and the patients with at least one neurotransmitter abnormality accounted for 91.95%. （4） The factor analysis extracted 22 common factors from 78 variables in the whole brain and different brain regions. These common factors showed the absolute values of loadings ranging from 0.32 to 0.86 and the eigenvalues （F） ranging from 1.03 to 13.43， with a cumulative contribution rate of 76.82%. The characteristic expression patterns included ① ACh_P3↓/ACh_W↓/ACh_C3↓/ACh_F3↓/ACh_O1↓/ACh_T5↓/ACh_F7↓/NE_P3↑/NE_W↑/NE_C3↑/NE_F3↑/NE_O1↑/NE_T5↑/NE_F7↑ （F=13.43， whole brain）， ② 5-HT_O2↑/DA_O2↓/5-HT_P4↑/DA_P4↓/5-HT_W↑/DA_W↓/5-HT_C4↑/DA_C4↓ （F=5.94）， and ③ EXC_F4↓/DA_F4↓/NE_F4↑/INH_F4↑/5-HT_F4↑/ACh_F4↓ （F=5.33）. ConclusionThe actual 170 expression patterns of 6 neurotransmitters in the whole brain of 1 028 depression patients indicate that depression is a heterogeneous disease with individualized characteristics. The 22 characteristic expression patterns in the whole brain and 12 brain regions verify the pathogenesis hypothesis of multi-neurotransmitters oscillation imbalance in brains of depression patients. In summary， this study provides new guidance for the etiology， diagnosis， and treatment of depression and establishes a methodological foundation for the effectiveness evaluation of individualized treatment of depression by traditional Chinese medicine based on the objective biological markers.

ObjectiveTo analyze the characteristic expression patterns of six neurotransmitters including 5-hydroxytryptamine （5-HT）， dopamine （DA）， acetylcholine （ACh）， norepinephrine （NE）， inhibitory neurotransmitter （INH）， and excitatory neurotransmitter （EXC） in the whole brain and different brain regions of depression patients by Search of Encephalo Telex （SET）， providing new ideas for the study of heterogeneous etiology of depression. Methods（1） A retrospective study was conducted on supra-slow signals of EEG fluctuations in 1 028 patients with depression. The SET system was used to obtain the expression information of six neurotransmitters in the whole brain and 12 brain regions： left frontal region （F3）， right frontal region （F4）， left central region （C3）， right central region （C4）， left parietal region （P3）， right parietal region （P4）， left occipital region （O1）， right occipital region （O2）， left anterior temporal region （F7）， right anterior temporal region （F8）， left posterior temporal region （T5）， and right posterior temporal region （T6）. The expression information of each neurotransmitter was compared with the normal model， and it was found that single neurotransmitter was in one of three states： increased， decreased， or normal expression. The simultaneous expression states of six neurotransmitters in the brain space were referred to as the expression pattern of multiple neurotransmitters. （2） A MySQL database was established to analyze the actual expression patterns of different neurotransmitters in the whole brain of patients with depression. （3） Factor analysis was conducted to further analyze the characteristic rules of 78 variables of neurotransmitters in the whole brain and 12 brain regions in depression patients. Results（1） The expression of single neurotransmitters in the whole brain and different brain regions of the total depression population showed one of three expression states （increased/decreased/normal）， being normal in the majority. The decreased and increased expression of 5-HT， ACh， DA， INH， EXC， and NE in the whole brain occurred in 6% and 25%， 31% and 17%， 36% and 9%， 15% and 31%， 32% and 14%， and 22% and 22%， respectively. （2） The antagonizing pairs of neurotransmitters （EXC/INH， DA/5-HT， and ACh/NE） showed significant antagonistic relationships in the whole brain and different brain regions， with a strong negative correlation between EXC and INH （P<0.01， |r| values ranging from 0.69 to 0.76）， a strong negative correlation between DA and 5-HT （P<0.01， |r| values ranging from 0.83 to 0.90）， and a moderate negative correlation between ACh and NE （P<0.01， with |r| values ranging from 0.56 to 0.66）. Meanwhile， non-antagonizing pairs of neurotransmitters in the whole brain and different brain regions also showed correlations， with DA/NE （P<0.01， |r| values ranging from 0.38 to 0.46） and NE/EXC （P<0.01， |r| values ranging from 0.56 to 0.61） showing weak and moderate negative correlations， respectively， and DA/EXC showing a weak positive correlation （P<0.01， |r| values ranging from 0.38 to 0.47）. （3） The six neurotransmitters in the 1 028 patients with depression presented a total of 170 expression patterns in the whole brain. The top 30 expression patterns were reported in this paper， with a cumulative rate of 60.60%， including patterns ① INH+/5-HT-/ACh+/DA+/NE-/EXC- （9.05%）， ② INH+/5-HT-/ACh↓/DA+/NE-/EXC- （4.57%）， and ③ INH+/5-HT-/ACh+/DA+/NE↓/EXC- （3.31%）. That is， the proportion of depression patients with normal levels of all the six neurotransmitters was 9.05%， and the patients with at least one neurotransmitter abnormality accounted for 91.95%. （4） The factor analysis extracted 22 common factors from 78 variables in the whole brain and different brain regions. These common factors showed the absolute values of loadings ranging from 0.32 to 0.86 and the eigenvalues （F） ranging from 1.03 to 13.43， with a cumulative contribution rate of 76.82%. The characteristic expression patterns included ① ACh_P3↓/ACh_W↓/ACh_C3↓/ACh_F3↓/ACh_O1↓/ACh_T5↓/ACh_F7↓/NE_P3↑/NE_W↑/NE_C3↑/NE_F3↑/NE_O1↑/NE_T5↑/NE_F7↑ （F=13.43， whole brain）， ② 5-HT_O2↑/DA_O2↓/5-HT_P4↑/DA_P4↓/5-HT_W↑/DA_W↓/5-HT_C4↑/DA_C4↓ （F=5.94）， and ③ EXC_F4↓/DA_F4↓/NE_F4↑/INH_F4↑/5-HT_F4↑/ACh_F4↓ （F=5.33）. ConclusionThe actual 170 expression patterns of 6 neurotransmitters in the whole brain of 1 028 depression patients indicate that depression is a heterogeneous disease with individualized characteristics. The 22 characteristic expression patterns in the whole brain and 12 brain regions verify the pathogenesis hypothesis of multi-neurotransmitters oscillation imbalance in brains of depression patients. In summary， this study provides new guidance for the etiology， diagnosis， and treatment of depression and establishes a methodological foundation for the effectiveness evaluation of individualized treatment of depression by traditional Chinese medicine based on the objective biological markers.

Objective:To investigate the role of microglial polarization modulated by triggering receptor expressed on myeloid cells 2/insulin-like growth factor-1(TREM2/IGF-1) in hypertensive model mice exposed to diesel exhaust particulate matter (DPM), with a focus on its implications for anxious- and depressive-like behaviors.Methods:SPF-grade male C57BL/6J mice were divided into the control group, the hypertension group, the DPM group, and the hypertension+ DPM group according to the principle of weight-matching, with 10 mice in each group. The hypertension model was established by intraperitoneal injection of angiotensin Ⅱ (AngⅡ) in hypertension group and hypertension+ DPM group, and mice in the control group and DPM group were intraperitoneally injected with an equivalent amount of 0.9% NaCl solution.DPM suspension was instilled into the nasal cavity of the mice in DPM group and hypertension+ DPM group(1 μg/μL, 10 μL, once a day for 56 days).Behavioral tests, including the sucrose preference test, tail suspension test, elevated plus maze test, and open field test, were conducted to evaluate anxious- and depressive-like behaviors.TREM2-overexpressing BV2 cell model was established through plasmid transfection technology.Western blot was applied to measure the protein expression of IL-1β, IL-6, TNF-α, iNOS, Arg-1, TREM2 and IGF-1.SPSS 23.0 software was used for statistical analysis, one-way ANOVA was used for comparison among multiple groups, and LSD- t test was used for post-hoc testing. Results:(1)There were statistically significant differences in the sucrose preference rate, immobility time in the tail suspension test, percentage of time and number of entries into the open arms in the elevated plus maze, as well as the total distance, percentage of time spent in the central area in the open field test among the four groups of mice( F=22.82, 21.60, 36.17, 20.99, 5.85, 13.24, all P<0.01).The sucrose preference rate, percentage of time spent in the open arms, percentage of number of entries into the open arms, total distance and percentage of time spent in the central area of the DPM group and the hypertension group were lower than those of the control group( P<0.05), while the immobility time of the two group was higher than that of the control group( P<0.05). The sucrose preference rate((55.62±4.46)%) and percentage of time spent in the open arms((4.17±0.62)%) of the hypertension+ DPM group were lower than those of the DPM group((60.78±3.21)%, (6.44±0.89)%) and the hypertension group((66.26±4.25)%, (6.53±1.29)%)(all P<0.05), while the immobility time((155.42±12.50)s) was higher than that of the DPM group((129.03±5.43)s) and the hypertension group((129.28±10.55)s)(both P<0.05).(2)Western blot analysis revealed statistically significant differences in protein expression of IL-1β, IL-6, TNF-α, iNOS, Arg-1, and TREM2/IGF-1 in the medial prefrontal cortex(mPFC) among the four experimental groups( F=12.23, 10.51, 33.89, 145.40, 11.85, 15.56, 33.11, all P<0.05).The hypertension+ DPM group demonstrated significantly higher protein expression of IL-1β and IL-6 compared to the hypertension group (all P<0.05). Relative to the hypertension+ DPM group, TNF-α and iNOS protein expression was elevated in both the hypertension group and DPM group, whereas Arg-1 protein expression was lower in the hypertension group(all P<0.05). Additionally, TREM2 and IGF-1 protein expression in the hypertension and DPM groups were lower than those in the control group but higher than those in the hypertension+ DPM group(all P<0.05).(3)The protein expressions of IL-1β, IL-6 and TNF-α in BV2 cells of the DPM+ AngⅡ-TREM2 overexpression group were lower than those of the DPM+ AngⅡ group. The expression of iNOS was lower than that in the DPM+ AngⅡ group, while the expression of Arg-1 was higher than that in the DPM+ AngⅡ group(all P<0.05). Conclusion:DPM exposure aggravates anxious- and depressive-like behaviors in hypertensive model mice, with TREM2/IGF-1-regulated microglial polarization playing a significant role in this process.

Objective:To investigate the role of microglial polarization modulated by triggering receptor expressed on myeloid cells 2/insulin-like growth factor-1(TREM2/IGF-1) in hypertensive model mice exposed to diesel exhaust particulate matter (DPM), with a focus on its implications for anxious- and depressive-like behaviors.Methods:SPF-grade male C57BL/6J mice were divided into the control group, the hypertension group, the DPM group, and the hypertension+ DPM group according to the principle of weight-matching, with 10 mice in each group. The hypertension model was established by intraperitoneal injection of angiotensin Ⅱ (AngⅡ) in hypertension group and hypertension+ DPM group, and mice in the control group and DPM group were intraperitoneally injected with an equivalent amount of 0.9% NaCl solution.DPM suspension was instilled into the nasal cavity of the mice in DPM group and hypertension+ DPM group(1 μg/μL, 10 μL, once a day for 56 days).Behavioral tests, including the sucrose preference test, tail suspension test, elevated plus maze test, and open field test, were conducted to evaluate anxious- and depressive-like behaviors.TREM2-overexpressing BV2 cell model was established through plasmid transfection technology.Western blot was applied to measure the protein expression of IL-1β, IL-6, TNF-α, iNOS, Arg-1, TREM2 and IGF-1.SPSS 23.0 software was used for statistical analysis, one-way ANOVA was used for comparison among multiple groups, and LSD- t test was used for post-hoc testing. Results:(1)There were statistically significant differences in the sucrose preference rate, immobility time in the tail suspension test, percentage of time and number of entries into the open arms in the elevated plus maze, as well as the total distance, percentage of time spent in the central area in the open field test among the four groups of mice( F=22.82, 21.60, 36.17, 20.99, 5.85, 13.24, all P<0.01).The sucrose preference rate, percentage of time spent in the open arms, percentage of number of entries into the open arms, total distance and percentage of time spent in the central area of the DPM group and the hypertension group were lower than those of the control group( P<0.05), while the immobility time of the two group was higher than that of the control group( P<0.05). The sucrose preference rate((55.62±4.46)%) and percentage of time spent in the open arms((4.17±0.62)%) of the hypertension+ DPM group were lower than those of the DPM group((60.78±3.21)%, (6.44±0.89)%) and the hypertension group((66.26±4.25)%, (6.53±1.29)%)(all P<0.05), while the immobility time((155.42±12.50)s) was higher than that of the DPM group((129.03±5.43)s) and the hypertension group((129.28±10.55)s)(both P<0.05).(2)Western blot analysis revealed statistically significant differences in protein expression of IL-1β, IL-6, TNF-α, iNOS, Arg-1, and TREM2/IGF-1 in the medial prefrontal cortex(mPFC) among the four experimental groups( F=12.23, 10.51, 33.89, 145.40, 11.85, 15.56, 33.11, all P<0.05).The hypertension+ DPM group demonstrated significantly higher protein expression of IL-1β and IL-6 compared to the hypertension group (all P<0.05). Relative to the hypertension+ DPM group, TNF-α and iNOS protein expression was elevated in both the hypertension group and DPM group, whereas Arg-1 protein expression was lower in the hypertension group(all P<0.05). Additionally, TREM2 and IGF-1 protein expression in the hypertension and DPM groups were lower than those in the control group but higher than those in the hypertension+ DPM group(all P<0.05).(3)The protein expressions of IL-1β, IL-6 and TNF-α in BV2 cells of the DPM+ AngⅡ-TREM2 overexpression group were lower than those of the DPM+ AngⅡ group. The expression of iNOS was lower than that in the DPM+ AngⅡ group, while the expression of Arg-1 was higher than that in the DPM+ AngⅡ group(all P<0.05). Conclusion:DPM exposure aggravates anxious- and depressive-like behaviors in hypertensive model mice, with TREM2/IGF-1-regulated microglial polarization playing a significant role in this process.

Objective To evaluate the transition rules of normal body mass index(BMI),overweight and metabolic syndrome(MetS)in patients with major depressive disorder(MDD).Methods Patients with MDD who had multiple admission records between Jan 2016 and Nov 2021 in Beijing Anding Hospital,Capital Medical University were included.Based on the overweight and metabolic syndrome status assessed at each admission,the patients were categorized into three states:normal BMI,overweight and metabolic syndrome.A multi-state Markov model was used to analyze the transition intensity and transition frequency between three states and the influence of covariates on transitions.Results A total of 892 records of 398 subjects were included,with a median age of 56 years old and 31.4% males.The median follow-up period was 40 months.The multi-state model showed that there were 494 transitions between the three states,of which 5.1% moved from normal BMI to overweight and 5.5% moved from overweight to MetS.The intensity of transition was the highest from overweight to MetS,9.52 times greater than overweight to normal BMI.After 48.53 months,MDD patients with normal BMI began to transition to MetS.For overweight MDD patients,the transition to MetS started after 8.77 months.MDD patients with normal BMI or overweight had 31.4% and 50.4% probabilities of developing Mets after 36 months.For MDD patients comorbid with MetS,the probability of staying at MetS was 51.2% after 36 months.Multivariate analysis showed that being unmarried was a risk factor against developing overweight in normal BMI MDD patients,while a higher level of education was a protective factor against developing MetS in overweight MDD patients.Conclusion MDD patients exhibited a higher intensity and risk of developing MetS,and it is not easy to reverse MetS,suggesting that BMI management and MetS intervention should be strengthened in MDD patients.

Objective:To investigate the concern about pollen broadcasting in Chinese population from multiple dimensions and to understand the information about allergic rhinitis (AR) in China by analyzing related factors.Methods:From March 1 to September 30, 2022, a large-scale multi-center cross-sectional survey was conducted based on the Questionnaire Star platform in 21 Chinese hospitals. A total of 7 056 subjects from 7 regions in China: Northeast, North, East, Central, South, Southwest, and Northwest China were included. Basic characteristics (including social demographic characteristics and disease characteristics of AR patients), concern about pollen broadcasting, the willingness of pollen-induced AR (PiAR) patients to receive pollen broadcasting, and the treatment satisfaction rate of AR patients were collected. The chi-square test, multivariate linear regression model, and Logistic regression analysis were used to analyze the concern about pollen broadcasting in the Chinese population and related factors from multiple dimensions.Results:Among 7 056 subjects, 23.02% were concerned about pollen broadcasting. Among 3 176 self-reported AR and 1 019 PiAR patients, 25.60% and 39.16% were concerned about pollen broadcasting, respectively, which was higher than that of non-AR or non-PiAR subjects ( χ2 value was 21.74 and 175.11, respectively, both P<0.001). Among AR patients, the proportion of spring and autumn allergen-positive patients concerned about pollen broadcasting was higher than that in perennial allergen-positive patients ( χ2 value was 20.90 and 19.51, respectively, both P<0.001). The proportion of AR patients with asthma, sinusitis, allergic conjunctivitis, and cardiovascular and cerebrovascular diseases was higher than those without complications ( χ2 value was 50.83, 21.97, 56.78, 7.62, respectively, all P<0.05). The proportion of AR patients in North China who could find pollen broadcasting locally was 31.01%, significantly higher than those in other regions (all P<0.05). Multivariate linear regression model analysis showed that among PiAR patients, those with higher per capita household income and higher AR disease cognition levels had been concerned about pollen broadcasting in the past, and those complicated with allergic conjunctivitis had stronger intention to receive pollen broadcasting (B value was 0.24, 0.13, 0.66, 0.47, respectively, all P<0.05). The higher the disease cognition level of PiAR patients, the stronger their willingness to actively participate in treatment ( R2=0.72, P<0.001). Only 18.89% of AR patients felt satisfied with the treatment effect. Logistic regression analysis showed that in AR patients, the treatment satisfaction rate was significantly higher among those concerned about pollen broadcasting compared to those who were not ( OR=1.83, P<0.001). Conclusions:Currently, the dissemination of pollen broadcasting in China is hindered by various factors such as disease cognition level. The treatment satisfaction among AR patients remains unsatisfactory.

ObjectiveTo investigate the intervention effect of heat shock protein 60 (HSP60) on learning and memory impairment induced by combined exposure to lead and hypertension in mice, and the relative mechanism of triggering receptor expressed on myeloid cells 2 (TREM2). Methods Specific pathogen-free C57BL/6J male mice were randomly divided into control group, hypertension group, lead-exposed group and lead-exposed + hypertension group, or into control group, heat shock protein 60 (HSP60) control group, lead-exposed + hypertension group and HSP60 intervention group, with 10 mice in each group. Mice of hypertension group and lead-exposed + hypertension group were intraperitoneally injected with angiotensin Ⅱ at a dose of 0.5 mg/(kg·d) for seven consecutive days to induce hypertension model. Mice of the lead-exposed group, lead-exposed + hypertension group, and HSP60 intervention group were given lead acetate drinking water with a mass concentration of 250.0 mg/L, while mice in the control group, hypertension group, and HSP60 control group were given purified water for 12 weeks. Mice of the HSP60 control group and HSP60 intervention group were intraperitoneally injected with a solution of HSP60 at a dose of 4 mg/kg body weight, every other day for a total of three times at the 12th week. The learning and memory ability of mice was detected using the Morris water maze test. The enzyme-linked immunosorbent assay was used to detect the levels of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α (TNF-α) in the hippocampal tissues of the mice. The relative expression of ionized calcium binding adaptor molecule-1 (IBA1) and TREM2 protein in the hippocampus of mice was detected using Western blot. Results i) The number of platform crossings of the mice in the hypertension group and the lead-exposed group was lower than that in the control group (both P<0.05). The escape latency of the mice on the third day was longer and the number of platform crossings was lower in the lead-exposed + hypertension group compared with the control group, hypertension group and lead-exposed group (all P<0.05). The levels of IL-1β, IL-6, and TNF-α in the hippocampus of the other three groups increased compared with the control group (all P<0.05). The relative expression of IBA1 protein in the hippocampus of lead-exposed group and lead-exposed + hypertension group increased (all P<0.05), while the relative protein expression of TREM2 decreased compared with the control group (all P<0.05). The levels of IL-1β, IL-6, TNF-α, and the relative protein expression of IBA1 protein in the hippocampus of the lead-exposed+hypertension group were higher (all P<0.05), and relative expression of TREM2 protein was lower (P<0.05) than those in the hypertension group. The level of TNF-α and the relative expression of IBA1 protein in the hippocampus of lead-exposed+hypertension group were higher than those in lead-exposed group (all P<0.05). ii) The escape latency of mice in the lead-exposed + hypertension group was longer than that in the control group (P<0.05), and the number of platform crossings was fewer than that in the control group (P<0.05). The escape latency of mice in the HSP60 intervention group was shortened (P<0.05), the number of platform crossings increased (P<0.05), and the levels of IL-1β, IL-6, TNF-α and relative expression of IBA1 protein decreased in the hippocampus (all P<0.05), while the relative expression of TREM2 protein increased (P<0.05) compared with the lead-exposed+hypertension group. Conclusion Combined exposure of lead and hypertension has a synergistic effect on learning and memory impairment in mice. The mechanism may be related to the inhibition of TREM2 expression by lead in the hippocampus of hypertensive mice and aggravating the neuroinflammatory response. Intervention with TREM2 receptor agonist HSP60 can alleviate learning and memory impairment in mice exposed to lead and hypertension by up-regulating TREM2 expression in the hippocampus.

Objective To explore the etiology,types,treatment,and prognosis of new-onset epilep-sy in elderly dementia.Methods A retrospective analysis was conducted on 45 new-onset epilepsy in elderly dementia admitted to our department from January 2017 to December 2023.According to their etiology,they were divided into a degenerative dementia group(with AD as the main cause,AD dementia group,24 cases,)and a non-degenerative dementia group(non-AD dementia group,21 cases).Seizure types and and electroencephalogram(EEG)findings were compared be-tween the two groups.The medication and efficacy were also compared between the two groups in 3 months after treatment with antiepileptic drugs.Results Each patient had at least one type of seizure.The AD dementia group had a lower incidence of generalized seizure,but higher incidences of focal seizure and non-convulsive seizure(NCS)when compared with the non-AD dementia group(P＜0.05,P＜0.01).At least one type of abnormal EEG findings was observed in each pa-tient,but there was no statistical difference in the occurrence of EEG abnormalities between the two groups(P＞0.05).Among the 45 patients,42(93.3％)received antiepileptic drugs,and 38(90.5％)patients were well controlled,with the AD dementia group having a higher effective rate of single antiepileptic drug than the non-AD dementia group(95.5％vs 85.7％,P＜0.05).Conclu-sion Dementia combined with epilepsy(especially NCS)is often hard to detect,and continuous EEG monitoring is essential for elderly dementia patients.Most new-onset epilepsy in elderly de-mentia can be effectively controlled through antiepileptic drug therapy.

Objective:To investigate the current situation of informatization construction and application of operating rooms in hospitals in Sichuan Province.Methods:Stratified sampling method was used to investigate the informatization of operating rooms in 254 hospitals above the second level in 20 regions of Sichuan Province from September to October 2021. Self-designed questionnaire was used to carry out information management in 3 dimensions, including general information, patient care in operating room, medical consumables and equipment, with a total of 32 items.Results:66.5% (169/254) of hospitals used operating room information management system for management. In terms of the application of information technology in operation management, preoperative visits accounted for 15.4% (39/254) , surgical nursing documents accounted for 57.5% (146/254) , surgical pathological specimens accounted for 10.6% (27/254) , and surgical patient transportation and handover accounted for 12.2% (31/254) . 36.6% (93/254) of hospitals implemented information management of consumables, 21.3% (54/254) of hospitals implemented equipment information management, 28.7% (73/254) of hospitals used surgical instrument traceability management systems, 17.2% (44/254) of hospitals used operating room behavior management systems, 24.8% (63/254) of hospitals built a remote video education and broadcasting system and 11.8% (30/254) of hospitals built a telemedicine service system.Conclusions:In the construction of hospital informatization and intelligent promotion, the informatization construction of operating room in this investigation area has made progress, but the development and deepening degree of business informatization management needs to be further strengthened.