Background Platelet parameters are important indicators of cardiovascular risk, and environmental pollutants such as polychlorinated biphenyls (PCBs) may impair platelet function through oxidative stress. Objective To investigate the differential effects of single and mixed exposure to PCBs on platelet parameters among individuals with normal glucose tolerance (NGT), impaired fasting glucose (IFG), and type 2 diabetes mellitus (T2DM), and to evaluate the potential modifying role of a healthy lifestyle. Methods This study included 2249 participants (including 707 with NGT, 759 with IFG, and 783 with T2DM). Plasma PCB concentrations were measured using triple quadrupole gaschromatography-tandem mass spectrometry. Generalized linear regression was used to assess the associations between individual PCB congeners and platelet parameters. Quantile g-computation (QGC) and Bayesian kernel machine regression (BKMR) models were used to evaluate the overall effects of PCBs mixture exposure on platelet parameters across different glycemic states, as well as its interaction with healthy lifestyle score (HLS). Results Generalized linear regression analyses showed significant differences in the effects of PCBs on platelet parameters across different glycemic states (P<0.05). After adjusting for confounders, PCBs mixture exposure was significantly associated with lower platelet counts (PLT) in individuals with NGT (b=−10.60, 95%CI: −16.48, −4.71) and IFG (b=−12.91, 95%CI: −18.90, −6.92), whereas no significant association was observed in individuals with T2DM (P=0.051). Mean platelet volume (MPV) and platelet-large cell ratio (P-LCR) increased significantly with higher PCBs exposure levels across all three groups (P<0.05). BKMR analysis showed a positive association between PCBs mixture exposure and P-LCR, with the strongest association observed in the NGT group. Furthermore, a significant interaction was observed between HLS and PCBs mixture exposure, and a higher HLS attenuated the effects of PCBs on P-LCR. Conclusion Glycemic glycemic states may modify the effects of PCBs on platelets. Individuals with NGT appear more sensitive to PCBs exposure, whereas the T2DM state may attenuate this effect. Moreover, healthy lifestyles, including not smoking, moderate alcohol consumption, maintaining moderate-to-high physical activity, a healthy diet, and an appropriate body mass index (BMI), may mitigate the adverse effects of most PCBs on platelet parameters.

Background Platelet parameters are important indicators of cardiovascular risk, and environmental pollutants such as polychlorinated biphenyls (PCBs) may impair platelet function through oxidative stress. Objective To investigate the differential effects of single and mixed exposure to PCBs on platelet parameters among individuals with normal glucose tolerance (NGT), impaired fasting glucose (IFG), and type 2 diabetes mellitus (T2DM), and to evaluate the potential modifying role of a healthy lifestyle. Methods This study included 2249 participants (including 707 with NGT, 759 with IFG, and 783 with T2DM). Plasma PCB concentrations were measured using triple quadrupole gaschromatography-tandem mass spectrometry. Generalized linear regression was used to assess the associations between individual PCB congeners and platelet parameters. Quantile g-computation (QGC) and Bayesian kernel machine regression (BKMR) models were used to evaluate the overall effects of PCBs mixture exposure on platelet parameters across different glycemic states, as well as its interaction with healthy lifestyle score (HLS). Results Generalized linear regression analyses showed significant differences in the effects of PCBs on platelet parameters across different glycemic states (P<0.05). After adjusting for confounders, PCBs mixture exposure was significantly associated with lower platelet counts (PLT) in individuals with NGT (b=−10.60, 95%CI: −16.48, −4.71) and IFG (b=−12.91, 95%CI: −18.90, −6.92), whereas no significant association was observed in individuals with T2DM (P=0.051). Mean platelet volume (MPV) and platelet-large cell ratio (P-LCR) increased significantly with higher PCBs exposure levels across all three groups (P<0.05). BKMR analysis showed a positive association between PCBs mixture exposure and P-LCR, with the strongest association observed in the NGT group. Furthermore, a significant interaction was observed between HLS and PCBs mixture exposure, and a higher HLS attenuated the effects of PCBs on P-LCR. Conclusion Glycemic glycemic states may modify the effects of PCBs on platelets. Individuals with NGT appear more sensitive to PCBs exposure, whereas the T2DM state may attenuate this effect. Moreover, healthy lifestyles, including not smoking, moderate alcohol consumption, maintaining moderate-to-high physical activity, a healthy diet, and an appropriate body mass index (BMI), may mitigate the adverse effects of most PCBs on platelet parameters.

Objective·To investigate the association of serum osteoglycin(OGN)levels with renal function and blood pressure in non-diabetic patients with hypertension.Methods·Hypertensive patients without a diagnosis of diabetes mellitus were recruited from the Hypertension Department of Ruijin Hospital,Shanghai Jiaotong University School of Medicine.A total of 36 renal dysfunction patients(renal dysfunction group)and 38 normal renal function patients(normal renal function group),matched for age,gender and clinic blood pressure,were included in this study.Serum OGN concentrations were measured by the enzyme-linked immunosorbent assay(ELISA).Estimated glomerular filtration rate(eGFR)was calculated from serum creatinine using the Chronic Kidney Disease Epidemiology Collaboration(CKD-EPI)equation.The serum OGN levels were compared between the renal dysfunction group and the normal renal function group.The correlations of serum OGN level with eGFR and blood pressure were analyzed.Results·There was no significant statistical difference in serum OGN levels between the renal dysfunction group and the normal renal function group(P=0.708).Serum OGN levels were not significantly associated with eGFR(P=0.952).In the renal dysfunction group,mean arterial pressure,age and current smoking status were relevant factors of serum OGN levels(P<0.05).After adjustment for confounders,serum OGN levels were independently associated with clinic systolic and diastolic blood pressure,24-hour ambulatory mean systolic and diastolic blood pressure in the renal dysfunction group(P<0.05),but not in the normal renal function group(P?0.05).Conclusion·In non-diabetic patients with hypertension,serum OGN levels are not significantly associated with eGFR.In patients with renal dysfunction,higher serum OGN levels are independently associated with higher clinic systolic blood pressure,clinic diastolic blood pressure,24-hour ambulatory mean systolic and diastolic blood pressure.

Objective To analyze the disability level and long-term care needs assessment policies issued by 49 pilot cities in China's long-term care insurance system,providing insights for further improvement of the system.Methods Policy documents related to long-term care insurance,published between June 2016 and December 2024 on official platforms of local governments,the Ministry of Human Resources and Social Security,the National Healthcare Security Administration,and the National Public Service Platform for Standards Information,were retrieved.A comparative analysis was used to summarize and compare the content of these policy texts.Results Currently,there are 49 pilot cities implementing the long-term care insurance system in China.47 cities have issued disability level assessment standards,with 38 cities adopting the trial standards issued by the National Healthcare Security Administration.In 42 pilot cities,the disability level assessment includes indicators such as activities of daily living,cognitive function,and sensory and communication abilities.22 cities have issued policies related to care needs assessment.In most cities,the care needs assessment partially or fully includes indicators from the disability level assessment.Conclusion There is no national uniformity in disability level assessment standards,and the care needs assessment framework needs further improvement.It is recommended to standardize disability level assessment criteria,clearly delineate the boundaries and content of disability level and care needs assessments,and enhance the development of the care needs assessment system.

Objective To investigate the correlation between the attenuation of periappendiceal fat density and its relative CT value(rCT)with the severity of appendicitis,and whether rCT can evaluate the severity of acute appendicitis(AA).Methods A retro-spective selection was made of 79 patients who underwent whole-abdominal CT scans and were pathologically diagnosed with A A(45 with noncomplex A A,34 with complex AA)and 30 normal control group(NCG).Appendicitis-associated signs were recorded and the CT number of periappendiceal fat(CTa),CT number of mesenteric fat gap(CTm),CT number of abdominal anterior wall subcutaneous fat(CTaw),CT number of abdominal posterior wall subcutaneous fat(CTpw),CT number of retroperitoneal fat(CTrp),CT number of gluteal subcutaneous fat(CTgl),and CT number of psoasmajor muscle(CTps)were measured.The ratio of CTa to the CT values of the other 6 parts were calculated,defined as the rCT.Statistical analysis was performed using SPSS 20.0 soft-ware,and the differences were considered statistically significant at P＜0.05.Results Compared among the three groups,statistical differences were found between every two groups in CTa,rCTm,rCTaw,rCTpw,rCTrp,rCTgl,and rCTps(P＜0.05),and the rCT was the lowest in complex AA,followed by noncomplex A A.Receiver operating characteristic(ROC)curve analysis showed that rCTm,rCTaw,rCTpw,rCTrp,rCTgl,rCTps had diagnostic predictive value for both noncomplex AA and complex AA(P＜0.05).Conclusion The attenuation of periappendiceal fat density is associated with the severity of appendicitis,and rCT has certain diagnos-tic predictive value for assessing the severity of appendicitis.The diagnosis of noncomplex AA and complex AA is based on the 95％ confidence interval of rCT.

Objective To investigate the correlation between the attenuation of periappendiceal fat density and its relative CT value(rCT)with the severity of appendicitis,and whether rCT can evaluate the severity of acute appendicitis(AA).Methods A retro-spective selection was made of 79 patients who underwent whole-abdominal CT scans and were pathologically diagnosed with A A(45 with noncomplex A A,34 with complex AA)and 30 normal control group(NCG).Appendicitis-associated signs were recorded and the CT number of periappendiceal fat(CTa),CT number of mesenteric fat gap(CTm),CT number of abdominal anterior wall subcutaneous fat(CTaw),CT number of abdominal posterior wall subcutaneous fat(CTpw),CT number of retroperitoneal fat(CTrp),CT number of gluteal subcutaneous fat(CTgl),and CT number of psoasmajor muscle(CTps)were measured.The ratio of CTa to the CT values of the other 6 parts were calculated,defined as the rCT.Statistical analysis was performed using SPSS 20.0 soft-ware,and the differences were considered statistically significant at P＜0.05.Results Compared among the three groups,statistical differences were found between every two groups in CTa,rCTm,rCTaw,rCTpw,rCTrp,rCTgl,and rCTps(P＜0.05),and the rCT was the lowest in complex AA,followed by noncomplex A A.Receiver operating characteristic(ROC)curve analysis showed that rCTm,rCTaw,rCTpw,rCTrp,rCTgl,rCTps had diagnostic predictive value for both noncomplex AA and complex AA(P＜0.05).Conclusion The attenuation of periappendiceal fat density is associated with the severity of appendicitis,and rCT has certain diagnos-tic predictive value for assessing the severity of appendicitis.The diagnosis of noncomplex AA and complex AA is based on the 95％ confidence interval of rCT.

Estrogen, through binding to its receptors in the female endometrium, promotes the proliferation, differentiation, and angiogenesis of endometrial stromal cells, thereby playing a critical role in endometrial injury repair, regeneration, and the prevention and treatment of intrauterine adhesions. Currently, various estrogen-based pharmaceutical formulations are applied in clinical practice, and the development of related products is progressively advancing. This review systematically outlines the etiology of endometrial injury and the mechanisms by which estrogen facilitates endometrial repair and regeneration. Furthermore, it highlights recent research progress and clinical applications of estrogen-based therapies in endometrial regeneration, aiming to provide a valuable reference for relevant scientific research and clinical practice.

Undergraduate education is basis of postsecondary education.A crucial foundational topic in undergraduate medi-cal education is Medical Immunology,a field with a robust theoretical framework and broad application.Without teaching improve-ment,undergraduate education cannot be effective.In recent years,one of main tasks associated with Medical Immunology instruction at many universities has been reforming curriculum.This article evaluates and summarizes Medical Immunology education reform approaches used by fifteen universities,described several common teaching reform techniques in theoretical teaching,experimental teaching,etc,and methodically outlined Medical Immunology teaching reform strategies used at large universities,in order to examine a workable course for teaching reform in Medical Immunology by condensing these incredibly useful teaching reform techniques.

AIM:To investigate the immunosuppressive effects of M2-like tumor-associated macrophages(M2-TAMs)on CD8+T cells within the tumor microenvironment of esophageal cancer.METHODS:Multiplex fluores-cence immunohistochemistry was used to analyze the distribution of immune cells in esophageal cancer tissues.An in vitro co-culture system was established,and flow cytometry along with Calcein-AM/PI staining was employed to assess the im-pact of M2-TAMs on CD8+T cell function.The GEPIA database was utilized to evaluate the prognostic significance of PDCD1 expression in esophageal cancer patients and to analyze the correlations between gene expressions.Immunohisto-chemistry(IHC)was performed to detect the expression of TGF-β1 in esophageal cancer tissues.Flow cytometry and en-zyme-linked immunosorbent assay(ELISA)were used to measure PD-1,IFN-γ and TNF-α expression in CD8+T cells fol-lowing treatment with a TGF-β1 inhibitor.RESULTS:Compared with early-stage(stage I)esophageal cancer patients,the patients with advanced disease(stages Ⅱ to Ⅳ)exhibited dynamic changes in the infiltration of CD4+T cells,CD8+T cells,Tregs,and M2-TAMs within tumor tissues,with significant correlations observed among these cell populations(P<0.05).The distribution of M2-TAMs and Tregs was positively correlated with poor prognosis(P<0.05),while that of CD8+T cells was negatively correlated(P<0.05).In contrast,CD4+T cell infiltration showed no significant association with clinical outcomes(P>0.05).Co-culture of CD8+T cells with M2-TAMs resulted in significant downregulation of CD107a,granzyme B,IFN-γ and TNF-α expression(P<0.01).Additionally,M2-TAM-treated CD8+T cells co-cultured with esophageal cancer cells led to reduced apoptosis of cancer cells.High expression of PDCD1 was significantly associated with poor prognosis(P<0.05),and significant correlations were observed between CD8A and PDCD1 expression,as well as between TGF-β1 and CD274 gene expression(P<0.01).TGF-β1 was also significantly associated with CD163+macro-phage infiltration and the progression of esophageal cancer(P<0.05).Treatment with a TGF-β1 inhibitor in the M2-TAM and CD8+T cell co-culture system significantly down-regulated PD-1 expression and increased the secretion of IFN-γ and TNF-α(P<0.01).CONCLUSION:The TGF-β1 derived from M2-TAMs inhibits the antitumor activity of CD8+T cells in the esophageal cancer microenvironment,suggesting potential therapeutic targets for overcoming immunosuppression in esophageal cancer.

Objective:To explore the aperiodic components(1/f slopes)and their associations with cognitive impairment in patients with schizophrenia.Methods:Nineteen patients with schizophrenia according to the Interna-tional Statistical Classification of Diseases and Related Health Problem,Tenth Revision(ICD-10)and 21 normal controls were administrated the total Brief Assessment of Cognition in Schizophrenia(BACS)to measure the cogni-tive performance.The 5-minute eyes-closed and eyes-open resting EEG signals were collected and parameterized in-to aperiodic components(1/f slope).Finally,Pearson correlation was used to examine the relationships between the 1/f slope and cognition assessment scores.Results:The patients with schizophrenia had higher 1/f slope compared to HC on central location of scalp(P＜0.05).The vocal memory scores showed a significantly positive relation with 1/f slopes in patients with schizophrenia(anterior location:r=-0.68,P＜0.05;central location:r=-0.44,P＜0.05),but a significantly negative relation in normal controls(anterior location:r=0.57,P＜0.05;posterior lo-cation:r=0.54,P＜0.05).Conclusion:The 1/f slopes of EEG in schizophrenia were steeper than normal control,suggesting its strong cognitive functional significance and complex mechanisms in schizophrenia.