Background In 2021, chronic obstructive pulmonary disease (COPD) emerged as the forth leading cause of death in the world. However, the impact of air pollutants on COPD is still inconsistent across current studies. Objective To analyze the relationship between ambient sulfur dioxide (SO₂) exposure and hospital admissions for COPD in Lanzhou, and to examine the modified effects of SO₂ across different genders, age groups, and seasons. Methods A total of 20718 hospital admission records for COPD were collected from Lanzhou between 2016 and 2020, alongside synchronized data on SO₂ concentration and meteorological variables. A generalized additive model integrated with a distributed lag nonlinear model was used to assess the relationship and the lag effects between SO₂ exposure and COPD admissions. Potential confounders, including meteorological factors, day-of-the-week effect, and holidays, were controlled for, with a maximum lag period set at 7 d. Two-pollutant models and sensitivity analyses were conducted to ensure robustness. Results are expressed as relative risks (RR) with 95% confidence intervals (95%CI). Results During the study period, the average daily number of COPD admissions was 11.34±7.03. The average mass concentration of SO₂ was (23.72±12.35) μg·m⁻³. SO₂ exposure was positively correlated with COPD admissions; specifically, each 10 μg·m⁻³ increase in SO₂ concentration was associated with an RR of 1.440 (95%CI: 1.317, 1.573). Stratified analyses found that at a cumulative lag of 7 d, the RRs were higher among females, individuals aged ≥65 years, and during the cold season. Conversely, no significant increase in COPD admission risk related to SO₂ was observed during the warm season. For every 10 μg·m⁻³ increase in SO₂ concentration, the RR was 1.483 (95%CI: 1.311, 1.678) for females, 1.441 (95%CI: 1.311, 1.583) for those aged > 65 years， and 1.595 (95%CI: 1.313, 1.937) during the cold season. Conclusion Short-term exposure to ambient SO₂ exposure in Lanzhou is associated with an increased risk of COPD admission. The association is more pronounced among females, the elderly (aged> 65 years) and during the cold season.

Background: and Purpose Bilirubin has potent antioxidant, anti-inflammatory, and neuroprotective effects. Herein, we investigated whether total bilirubin (TBIL) modifies the association between hypertension and cerebral small vessel disease (CSVD). Methods: Data were obtained from the PolyvasculaR Evaluation for Cognitive Impairment and vaScular Events study. TBIL and direct bilirubin (DBIL) levels were assayed using fasting venous blood samples. Indirect bilirubin (IBIL) was calculated by subtracting DBIL from TBIL. TBIL was stratified as ≤17 μmol/L and >17 μmol/L based on the biological relevance of Gilbert’s syndrome. Hypertension was defined as blood pressure ≥140/90 mm Hg, self-reported hypertension history, or current use of antihypertensive agents. White matter hyperintensity, lacunes, cerebral microbleeds, and enlarged perivascular spaces were evaluated using magnetic resonance imaging and used to rate CSVD burden according to the criteria proposed by Wardlaw et al. and Rothwell et al. Results: This study included 3,061 participants, with a mean age of 61.2±6.7 years and 46.5% males. After adjusting for confounders, hypertension was associated with increased odds of presence of CSVD (Wardlaw: odds ratio [OR]=1.86, 95% confidence interval [CI] 1.41–2.44, P<0.001; Rothwell: OR=1.84, 95% CI 1.43–2.38, P<0.001) and higher modified total CSVD burden (common OR: 1.85, 95% CI 1.45–2.36, P<0.001) in participants with TBIL ≤17 μmol/L but not in TBIL >17 μmol/L (P for interaction <0.05). Johnson–Neyman analyses showed cut-off concentrations of 22.3–22.4 μmol/L for effect modification by TBIL. IBIL contributed to effect modification, whereas DBIL did not. Conclusions Mildly elevated TBIL may modify the association between hypertension and CSVD.

Bovine piroplasmosis, caused by infections with genus of Babesia and Theileria, is a tick-borne hemoparasitic disease. Recovered cattle often become asymptomatic persistent carriers, which represent potential sources of infection, and the pathogens of some forms of bovine piroplasmosis have zoonotic potential, which greatly threatens the public health security. Currently, the etiological diagnostic approaches of bovine piroplasmosis mainly include microscopy of blood smears, PCR assay, fluorescent quantitative real-time PCR assay, and loop-mediated isothermal amplification, and serological assay mainly includes indirect fluorescent antibody assay, enzyme-linked immunosorbent assay and immunochromatographic assay. This article systematically reviews the advances in the application of etiological approaches and serological assay for diagnosis of bovine piroplasmosis, and proposes future directions in the development of bovine piroplasmosis diagnosis, so as to provide insights into effective surveillance and precision control of bovine piroplasmosis in China.

ObjectiveTo observe the clinical efficacy of modified Yuejuwan in the treatment of thyroid cysts after microwave ablation. MethodsA total of 90 patients with thyroid cysts who met the inclusion criteria and treated in the First Affiliated Hospital of Hebei University of Chinese Medicine from September 2022 to December 2023 were randomly assigned to either the control group or the observation group， with 45 patients in each group. The control group received conventional postoperative drug treatment and was followed up regularly. The observation group was additionally administrated with modified Yuejuwan for one month and followed up regularly. The alterations in volume， thyroid function parameters ［thyroid-stimulating hormone （TSH）， free triiodothyronine （FT₃）， and free thyroxine （FT₄）］， quality of life scores， and clinical efficacy were monitored and compared between the two groups. Additionally， the safety profile was appraised. ResultsAfter treatment， both the observation group and the control group showed a reduction in cyst volume （P<0.05）， and the observation group exhibited a more significant reduction in cyst volume than the control group （P<0.05）. After treatment， both the observation group and the control group showed a decrease in TSH level and increases in FT₃ and FT₄ levels （P<0.05）， and the changes were more significant in the observation group （P<0.05）. In addition， both groups exhibited elevations in the quality of life scores （P<0.05）. Moreover， the observation group showed more increments in physiological， psychological， and social scores than the control group （P<0.05）. The total response rate of the observation group was higher than that of the control group （Z=-2.516， P<0.05）. The incidence of adverse reactions was similar between the two groups， with no statistically significant difference. ConclusionModified Yuejuwan is effective in the treatment of thyroid cysts after microwave ablation. It can promote the absorption of cysts， improve the thyroid function and quality of life， and has high safety.

ObjectiveTo observe the clinical efficacy of modified Yuejuwan in the treatment of thyroid cysts after microwave ablation. MethodsA total of 90 patients with thyroid cysts who met the inclusion criteria and treated in the First Affiliated Hospital of Hebei University of Chinese Medicine from September 2022 to December 2023 were randomly assigned to either the control group or the observation group， with 45 patients in each group. The control group received conventional postoperative drug treatment and was followed up regularly. The observation group was additionally administrated with modified Yuejuwan for one month and followed up regularly. The alterations in volume， thyroid function parameters ［thyroid-stimulating hormone （TSH）， free triiodothyronine （FT₃）， and free thyroxine （FT₄）］， quality of life scores， and clinical efficacy were monitored and compared between the two groups. Additionally， the safety profile was appraised. ResultsAfter treatment， both the observation group and the control group showed a reduction in cyst volume （P<0.05）， and the observation group exhibited a more significant reduction in cyst volume than the control group （P<0.05）. After treatment， both the observation group and the control group showed a decrease in TSH level and increases in FT₃ and FT₄ levels （P<0.05）， and the changes were more significant in the observation group （P<0.05）. In addition， both groups exhibited elevations in the quality of life scores （P<0.05）. Moreover， the observation group showed more increments in physiological， psychological， and social scores than the control group （P<0.05）. The total response rate of the observation group was higher than that of the control group （Z=-2.516， P<0.05）. The incidence of adverse reactions was similar between the two groups， with no statistically significant difference. ConclusionModified Yuejuwan is effective in the treatment of thyroid cysts after microwave ablation. It can promote the absorption of cysts， improve the thyroid function and quality of life， and has high safety.

Objective:To investigate the association of monocyte-to-high-density lipoprotein cholesterol ratio (MHR) with the severity of white matter hyperintensities (WMHs) and its spatial distribution.Methods:Patients admitted to the Department of Neurology, Jiangning Hospital Affiliated to Nanjing Medical University due to various chronic diseases or physical examinations between January 2023 and December 2024 were included retrospectively. Past medical history, clinical and imaging data were collected. The Fazekas scale was used to assess the severity of WMHs. According to the scoring results of periventricular WMHs (PVWMHs) and deep WMHs (DWMHs), WMHs were divided into no/mild group (0-1 points) and moderate/severe group (2-3 points). Multivariate logistic regression analysis was used to determine independent correlation factors for the severity of WMHs, PVWMHs, and DWMHs. Results:A total of 357 patients were included, aged 65.42±9.95 years, with 198 males (55.5%). There were 193 patients (54.1%) in the no/mild group and 164 (45.9%) in the moderate/severe group. Univariate analysis showed that the proportion of patients with hypertension, diabetes, history of cerebral infarction and cerebral hemorrhage, carotid plaque, and age, serum creatinine, monocyte count and MHR in the moderate/severe group were significantly higher than those in the no/mild group (all P<0.05). Multivariate logistic regression analysis showed a significant positive correlation between MHR and the severity of WMHs (odds ratio 3.138, 95% confidence interval 1.042-9.451; P=0.042). Further analysis showed a significant positive correlation between MHR and PVWMHs (odds ratio 3.384, 95% confidence interval 1.111-10.305; P=0.032), but no independent correlation with DWMHs. In addition, age and hypertension, diabetes, history of cerebral infarction and cerebral hemorrhage were significantly positively correlated with the severity of WMHs, PVWMHs and DWMHs. Conclusion:MHR is correlated with the severity of WMHs, and higher MHR is significantly associated with PVWMHs, but not with DWMHs.

Objective:To investigate the correlation between body mass index (BMI)/high-density lipoprotein cholesterol (HDL-C) ratio and cerebral small vessel disease (CSVD) in middle-aged and elderly people.Methods:Consecutive middle-aged and elderly patients (aged ≥40 years) who were hospitalized for chronic disease examinations in the Department of Neurology, Jiangning Hospital Affiliated to Nanjing Medical University between February 2022 and May 2024 were included prospectively. According to the overall burden score of CSVD, they were divided into CSVD group (≥1) and non-CSVD group (0). According to age, they divided into middle-aged group (40-59 years old) and elderly group (≥60 years old). The demographic characteristics and clinical data were collected. Binary multivariate logistic regression analysis was used to determine the independent correlation between BMI/HDL-C ratio and CSVD. Forest plot was used to analyze the correlation between BMI/HDL-C ratio and CSVD in different age groups. Results:A total of 710 patients were included, with an age of 66.0±10.0 years and 361 were males (50.8%). There were 261 patients (36.8%) in the CSVD group and 449 (63.2%) in the non-CSVD group. The BMI/HDL-C ratio in the CSVD group was significantly higher than that in the non-CSVD group (23.60±7.00 vs. 20.78±6.40; P<0.001). Multivariate logistic regression analysis showed that BMI/HDL-C ratio was an independent risk factor for CSVD in middle-aged and elderly populations (odds ratio 1.046, 95% confidence interval 1.027-1.064; P<0.001). There were 475 patients in the elderly group, of which 198 (41.7%) had CSVD; there were 235 patients in the middle-aged group, of which 63 (26.8%) had CSVD. Forest plot analysis showed that the association between BMI/HDL-C ratio and CSVD still had statistical significance in different age groups, but the effect intensity was higher in the elderly group than in the middle-aged group. Conclusion:The BMI/HDL-C ratio is independently correlated with CSVD in middle-aged and elderly population, particularly significant in the elderly population.

Objective:To investigate the feasibility and safety of implementing a domestic vehicle-mounted remote mobile robotic surgical system in thyroid surgery applications, integrated with 5G communication technology.Methods:Using the main system located on the vehicle-mounted mobile robot operating platform of the 960th Hospital of PLA Joint Logistics Support Force and the slave system of Weifang Traditional Chinese Hospital, the remote radical thyroidectomy 5G communication technology, and analyze the clinical and information transmission data of two female patients who underwent remote mobile robot thyroid cancer surgery on October 21, 2024 at Weifang Traditional Chinese Medicine Hospital.Results:The remote radical thyroidectomy was conducted by the robosurgeons utilizing a vehicle-mounted mobile robotic surgical system, and the procedure was successfully completed without necessitating intermediate open surgery. The operation durations for patient 1 and patient 2 were 135 minutes and 108 minutes, respectively, with 7 and 13 lymph nodes dissected, respectively. The average delay in surgical data transmission was recorded at 61.9 milliseconds, with no instances of signal interruption or frame loss. The procedure proceeded smoothly, without any jamming, and the audio and video transmissions were consistently clear. Follow up for 21 days after surgery showed no complications such as hoarseness, skin damage, or lymphatic fistula.Conclusion:The implementation of a vehicle-mounted remote mobile robotic surgery system for thyroid surgery has demonstrated safety and feasibility. Furthermore, the utilization of the 5G network offers rapid data transmission and minimal latency, closely approximating the therapeutic efficacy of traditional robotic thyroidectomy.

Objective To investigate the expression of serum tumor-associated antigens(TAAs)in patients with rheumatoid arthritis(RA)and analyze their clinical significance for RA.Methods A total of 214 RA patients were enrolled in the RA group,while 198 age-and gender-matched healthy individuals were included in the HC group.Rheumatoid factor(RF),anti-cyclic citrullinated peptide antibody(Anti-CCP),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),interleu-kin-6(IL-6),ferritin levels,as well as gender,age,disease duration,disease activity score(DAS28)and clinical manifestations were collected from the RA group.The expression of TAAs in RA patients and the clinical characteristics of TAA-positive patients were analyzed.Spearman correla-tion analysis was used to evaluate the relationships between TAAs and clinical indicators in RA pa-tients.Results The positive rate of carbohydrate antigen 125(CA125)in the RA group was 8.88％,which was significantly higher than 1.01％ in the HC group(P＜0.001).Serum CA125 and cytok-eratin fragment 19(CYFRA21-1)levels in the RA group were significantly higher than those in the HC group,whereas alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),carbohydrate anti-gen 199(CA199)and neuron-specific enolase(NSE)levels were significantly lower(P＜0.001).TAA-positive patients had significantly older age and higher rates of pulmonary interstitial lesions compared to TAA-negative patients(P＜0.05).Patients with DAS28 scores＞5.1 had significantly higher CA125 levels than those with DAS28 scores ≤5.1(P＜0.05).CA125 levelswere positively corre-lated with DAS28 scores,ESR,RF,and anti-CCP antibodies(r=0.142,0.140,0.268,0.183;P＜0.05).Conclusion In RA patients,the positivity rate and levels of some serum TAAs are ele-vated,and TAA-positive patients tend to be older and have higher incidence of pulmonary interstitial lesions.CA125 levels are positively correlated with RA disease activity.

Objective To investigate the correlations of calmodulin 1(CNN1)and asymmetric dimethylarginine(ADMA)expression with Wnt/β-catenin pathway in tissues of gastric cancer and their values for prognosis.Methods Surgical specimens and serum samples from 110 patients with gastric cancer,along with serum samples from 60 healthy individuals in the hospital were collected.Immunohistochemistry and real-time fluorescent quantitative PCR were used to detect the expression levels of CNN1 protein and CNN1 mRNA in gastric cancer tissues respectively;the enzyme-linked immunosorbent assay(ELISA)was used to detect the expression of ADMA in the serum of gastric cancer patients.The relationships of the CNN1 and ADMA expression with the clinicopathological characteristics in gastric cancer patients were analyzed.Kaplan-Meier survival curve was used to an-alyze the influence of CNN1 and ADMA expression on prognosis of gastric cancer patients;Cox re-gression analysis was used to explore independent factors affecting the prognosis of gastric cancer pa-tients;the Pearson correlation analysis was used to explore the correlation between CNN1 and ADMA expression in gastric cancer tissues,and to analyze the correlations of CNN1 mRNA and ADMA mRNA with Wnt/β-catenin signaling pathway-related indicators.Results The positive ex-pression rate of CNN1 protein in gastric cancer tissues was 38.18％(42/110),which was signifi-cantly lower than 57.27％(63/110)in adjacent tissues(x2=8.035,P=0.005).The serum ADMA level in gastric cancer patients was(0.54±0.17)μmol/L,which was significantly higher than(0.42±0.14)μmol/L in healthy individuals(t=4.752,P＜0.001).Patients with lymph node metastasis and advanced tumor stages had significantly decreased CNN1 protein positivity in gastric cancer tissues and increased serum ADMA expression(P＜0.05).The survival rate was 73.80％in the high CNN1 expression group(n=42),which was significantly higher than 39.71％in the low CNN1 expression group(n=68)(x2=22.300,P＜0.001);the survival rate was 45.68％in the high ADMA expression group(n=81),which was significantly lower than 72.41％in the low ADMA expression group(n=29)(x2=4.791,P=0.029).Univariate and multivariate Cox regression analysis showed that lymph node metastasis,advanced tumor staging,low CNN1 pro-tein expression,and high serum ADMA expression were independent risk factors for poor prognosis in gastric cancer patients(P＜0.05).The expression level of CNN1 mRNA in gastric cancer tissues was(0.41±0.13),which was significantly lower than(1.16±0.35)in adjacent tissues(t=21.068,P＜0.001).The expression levels of wnt3a mRNA and β-catenin mRNA in gastric cancer tissues were(2.02±0.42)and(2.59±0.58)respectively,both were significantly higher than(1.25±0.28)and(1.18±0.42)in adjacent tissues(t=15.999,P＜0.001;t=20.651,P＜0.001).CNN1 expression in gastric cancer tissues was negatively correlated with serum ADMA ex-pression in gastric cancer patients(r=-0.794,P＜0.001);CNN1 mRNA expression in gastric cancer tissues was negatively correlated with the expression of Wnt/β-catenin signaling pathway-re-lated indicators wnt3a mRNA and β-catenin mRNA(P＜0.001);serum ADMA mRNA expression in gastric cancer patients was positively correlated with the expression of Wnt/β-catenin signaling pathway-related indicators wnt3a mRNA and β-catenin mRNA(r=0.763,P＜0.001;r=0.874,P＜0.001).Conclusion The decreased expression of CNN1 and the increased expression of ser-um ADMA are independent risk factors for poor prognosis in gastric cancer patients,and their ex-pression levels are related to lymph node metastasis and tumor TNM staging.The expression levels of CNN 1 and ADMA are negatively correlated in gastric cancer tissues,which may be mediated by reg-ulating the Wnt/β-catenin signaling pathway.