Objective To analyze the disease burden of lung cancer attributable to air pollution among the Chinese population from 1990 to 2021,providing a scientific basis for the prevention and control strategies of lung cancer.Methods Data on deaths,mortality rates,disability-adjusted life years(DALY)of lung cancer,and world population data attributable to air pollution in China from 1990 to 2021 were extracted from the global burden of disease study 2021(GBD 2021).The Joinpoint regression model was used to calculate the annual percentage change(APC)and average annual percentage change(AAPC)for analysis of disease burden.The age-period-cohort model was employed to investigate the effects of age,period,and cohort on the trends in lung cancer disease burden attributable to air pollution.Results The population attributable fraction(PAF)of lung cancer in China due to air pollution has shown a trend of decrease,with an average AAPC value of-1.16%(P<0.001).The numbers of death and DALYs generally increased by years,with an AAPC value of 2.14%and 1.54%,respectively(both P<0.001).However,the standardized mortality rate and standardized DALY rate initially increased and then decreased,with an AAPC value of 0.34%and-0.14%,respectively,showing no statistical significance.The mortality rate,standardized mortality rate,DALY rate,and standardized DALY rate of lung cancer attributable to air pollution were higher in males than in females.Age-period-cohort model analysis showed that the net drifts of lung cancer mortality rates attributable to air pollution for the overall population,males,and females were-1.52%,-1.33%,and-1.88%,respectively(all P<0.001).The death risk increased with age.There are higher mortality rates in males across all age groups compared to females,especially in the population over 50 years.The period effect showed a U-shape trend from 1990 to 2004,and a decreasing trend after 2005.There was a decreasing trend of death risk with the progression of birth cohorts.Conclusion From 1990 to 2021,the relative contribution of air pollution to lung cancer in China has gradually decreased,and the risk of lung cancer death attributable to air pollution has generally shown a downward trend.The risk is higher in males than in females,higher in elderly population,and lower with the progression of birth cohorts.Increased attention should be paid to high-risk groups such as males and the elderly population,and early screening and intervention for the disease should be strengthened to reduce the risk of lung cancer.

Objective:To evaluate the efficacy of transnasal high-flow humidified oxygen therapy in preventing hypoxemia in pediatric patients undergoing gastroscopy.Methods:In this prospective randomized controlled study, 226 pediatric patients, aged 6-12 yr, with a body mass index of 18-25 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing painless gastroscopy at Women and Children′s Hospital of Qingdao University from February 2022 to August 2023, were selected and divided into 2 groups ( n=113 each) using the simple randomization method: normal nasal cannula oxygen therapy group (group N) and transnasal high-flow humidified oxygen therapy group (group H). Anesthesia was induced with intravenous nalbuphine hydrochloride 0.1 mg/kg and propofol 2 mg/kg, and gastroscopy was performed when the Modified Observer′s Assessment of Alertness/Sedation score reached 1. During the operation, group N inhaled oxygen 5 L/min through the nasal catheter; group H inhaled a mixture of air and oxygen through a transnasal high-flow humidified oxygen therapy system at 2 L·kg -1·min -1 (not exceeding 40 L/min), with FiO 2 of 40%. Primary outcomes were the occurrence of hypoxemia and the lowest SpO 2. Secondary outcomes included the requirement for airway interventions (jaw thrust, mask ventilation, endotracheal intubation) and incidence of adverse events (nasal dryness, laryngospasm, apnea, upper airway obstruction, abdominal distension, nausea and vomiting) and endoscopist′s satisfaction with the procedure. Results:A total of 214 patients finally completed the trial, with 106 in group N and 108 in group H. Compared with group N, the incidence of hypoxemia was significantly decreased (17.9% [19/106] versus 2.8% [3/108]), the lowest SpO 2 was increased, the requirement for jaw lifting interventions was reduced, the incidence of nasal dryness was decreased, and the degree of endoscopist′s satisfaction with the procedure was increased ( P<0.05), and no significant change was found in the other outcomes in group H ( P>0.05). Conclusions:Transnasal high-flow humidified oxygen therapy can effectively prevent hypoxemia and raise the safety of pediatric patients during the gastroscopy.

Pulpitis is a common infective oral disease in clinical situations. The regulatory mechanisms of immune defense in pulpitis are still being investigated. Osteomodulin (OMD) is a small leucine-rich proteoglycan family member distributed in bones and teeth. It is a bioactive protein that promotes osteogenesis and suppresses the apoptosis of human dental pulp stem cells (hDPSCs). In this study, the role of OMD in pulpitis and the OMD-induced regulatory mechanism were investigated. The OMD expression in normal and inflamed human pulp tissues was detected via immunofluorescence staining. Intriguingly, the OMD expression decreased in the inflammatory infiltration area of pulpitis specimens. The cellular experiments demonstrated that recombined human OMD could resist the detrimental effects of lipopolysaccharide (LPS)-induced inflammation. A conditional Omd knockout mouse model with pulpal inflammation was established. LPS-induced inflammatory impairment significantly increased in conditional Omd knockout mice, whereas OMD administration exhibited a protective effect against pulpitis. Mechanistically, the transcriptome alterations of OMD overexpression showed significant enrichment in the nuclear factor-κB (NF-κB) signaling pathway. Interleukin-1 receptor 1 (IL1R1), a vital membrane receptor activating the NF-κB pathway, was significantly downregulated in OMD-overexpressing hDPSCs. Additionally, the interaction between OMD and IL1R1 was verified using co-immunoprecipitation and molecular docking. In vivo, excessive pulpal inflammation in Omd-deficient mice was rescued using an IL1R antagonist. Overall, OMD played a protective role in the inflammatory response via the IL1R1/NF-κB signaling pathway. OMD may optimize the immunomodulatory functions of hDPSCs and can be used for regenerative endodontics.
Pulpitis/metabolism* ; NF-kappa B/metabolism* ; Animals ; Signal Transduction ; Humans ; Mice ; Mice, Knockout ; Dental Pulp/metabolism* ; Disease Models, Animal ; Lipopolysaccharides

Objective To analyze the disease burden of lung cancer attributable to air pollution among the Chinese population from 1990 to 2021,providing a scientific basis for the prevention and control strategies of lung cancer.Methods Data on deaths,mortality rates,disability-adjusted life years(DALY)of lung cancer,and world population data attributable to air pollution in China from 1990 to 2021 were extracted from the global burden of disease study 2021(GBD 2021).The Joinpoint regression model was used to calculate the annual percentage change(APC)and average annual percentage change(AAPC)for analysis of disease burden.The age-period-cohort model was employed to investigate the effects of age,period,and cohort on the trends in lung cancer disease burden attributable to air pollution.Results The population attributable fraction(PAF)of lung cancer in China due to air pollution has shown a trend of decrease,with an average AAPC value of-1.16%(P<0.001).The numbers of death and DALYs generally increased by years,with an AAPC value of 2.14%and 1.54%,respectively(both P<0.001).However,the standardized mortality rate and standardized DALY rate initially increased and then decreased,with an AAPC value of 0.34%and-0.14%,respectively,showing no statistical significance.The mortality rate,standardized mortality rate,DALY rate,and standardized DALY rate of lung cancer attributable to air pollution were higher in males than in females.Age-period-cohort model analysis showed that the net drifts of lung cancer mortality rates attributable to air pollution for the overall population,males,and females were-1.52%,-1.33%,and-1.88%,respectively(all P<0.001).The death risk increased with age.There are higher mortality rates in males across all age groups compared to females,especially in the population over 50 years.The period effect showed a U-shape trend from 1990 to 2004,and a decreasing trend after 2005.There was a decreasing trend of death risk with the progression of birth cohorts.Conclusion From 1990 to 2021,the relative contribution of air pollution to lung cancer in China has gradually decreased,and the risk of lung cancer death attributable to air pollution has generally shown a downward trend.The risk is higher in males than in females,higher in elderly population,and lower with the progression of birth cohorts.Increased attention should be paid to high-risk groups such as males and the elderly population,and early screening and intervention for the disease should be strengthened to reduce the risk of lung cancer.

Objective:To evaluate the efficacy of transnasal high-flow humidified oxygen therapy in preventing hypoxemia in pediatric patients undergoing gastroscopy.Methods:In this prospective randomized controlled study, 226 pediatric patients, aged 6-12 yr, with a body mass index of 18-25 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing painless gastroscopy at Women and Children′s Hospital of Qingdao University from February 2022 to August 2023, were selected and divided into 2 groups ( n=113 each) using the simple randomization method: normal nasal cannula oxygen therapy group (group N) and transnasal high-flow humidified oxygen therapy group (group H). Anesthesia was induced with intravenous nalbuphine hydrochloride 0.1 mg/kg and propofol 2 mg/kg, and gastroscopy was performed when the Modified Observer′s Assessment of Alertness/Sedation score reached 1. During the operation, group N inhaled oxygen 5 L/min through the nasal catheter; group H inhaled a mixture of air and oxygen through a transnasal high-flow humidified oxygen therapy system at 2 L·kg -1·min -1 (not exceeding 40 L/min), with FiO 2 of 40%. Primary outcomes were the occurrence of hypoxemia and the lowest SpO 2. Secondary outcomes included the requirement for airway interventions (jaw thrust, mask ventilation, endotracheal intubation) and incidence of adverse events (nasal dryness, laryngospasm, apnea, upper airway obstruction, abdominal distension, nausea and vomiting) and endoscopist′s satisfaction with the procedure. Results:A total of 214 patients finally completed the trial, with 106 in group N and 108 in group H. Compared with group N, the incidence of hypoxemia was significantly decreased (17.9% [19/106] versus 2.8% [3/108]), the lowest SpO 2 was increased, the requirement for jaw lifting interventions was reduced, the incidence of nasal dryness was decreased, and the degree of endoscopist′s satisfaction with the procedure was increased ( P<0.05), and no significant change was found in the other outcomes in group H ( P>0.05). Conclusions:Transnasal high-flow humidified oxygen therapy can effectively prevent hypoxemia and raise the safety of pediatric patients during the gastroscopy.

Objective To investigate the epidemiological characteristics and spatial distribution characteristics of Clonorchis sinensis human infections in Guangdong Province from 2016 to 2022, so as to provide insights into formulation of the clonorchiasis control measures in the province. Methods Xinhui District of Jiangmen City, Longmen County of Huizhou City and Wengyuan County of Shaoguan City in Guangdong Province were selected as fixed surveillance sites for human clonorchiasis from 2016 to 2022, and additional 10% to 15% counties (districts) endemic for clonorchiasis were sampled from Guangdong Province as mobile surveillance sites each year from 2016 to 2022. A village (community) was randomly selected from each surveillance site according to the geographical orientations of east, west, south, north and middle, and subjects were randomly sampled from each village (community). C. sinensis eggs were detected in subjects’ stool samples using the Kato-Katz technique, and the prevalence and intensity of C. sinensis infections were calculated. In addition, subjects’ gender, age, ethnicity, educational level and occupation were collected. The Guangdong Provincial 1:1 million electronic map in vector format was downloaded from the National Geomatics Center of China, and kernel density analysis and spatial autocorrelation analysis of C. sinensis human infections in Guangdong Province from 2016 to 2022 were performed using the software ArcGIS 10.7. Results A total of 153 188 residents were tested for C. sinensis infections in Guangdong Province from 2016 to 2022, including 75 596 men (49.35%) and 77 592 women (50.65%), and there were 5 369 residents infected with C. sinensis, with 3.50% overall prevalence of infections. The prevalence rates of severe, moderate and mild C. sinensis infections were 0.76%, 7.26% and 91.97% among C. sinensis-infected residents in Guangdong Province from 2016 to 2022, and there were age-, gender-, ethnicity-, occupation- and educational level-specific prevalence of C. sinensis human infections (χ² = 2 578.31, 637.33, 52.22, 2 893.28 and 1 139.33, all P values < 0.05). Global spatial autocorrelation analysis showed a cluster in the prevalence of C. sinensis human infections in Guangdong Province (Moran’s I = 0.63, Z = 27.31, P < 0.05). Kernel density analysis showed that the prevalence of C. sinensis human infections with a high kernel density in Guangdong Province was mainly distributed along the Zhujiang River basin in Pearl River Delta areas, followed by in eastern and northern Guangdong Province. In addition, local spatial autocorrelation analysis identified 73 high-high clusters of the prevalence of C. sinensis human infections in Guangdong Province. Conclusions The prevalence of C. sinensis human infections was high in Guangdong Province from 2016 to 2022, and mild infection was predominant among all clonorchiasis cases, with spatial clusters identified in the prevalence of C. sinensis human infections. Targeted clonorchiasis control measures are required among high-risk populations and areas.

Objective:To establish UPLC fingerprint method and 2 contents determination methods of Buddleja officinalis; To provide a reference for improving the quality control standard and evaluation of Buddleja officinalis from different habitats.Methods:UPLC method was used to establish the fingerprints of 17 batches of Buddleja officinalis. The similarity evaluation, clustering analysis, principal component analysis and orthogonal partial least squares discriminant analysis were used to compare the quality differences of Buddleja officinalis from different habitats. The contents of acteoside and linarin in Buddleja officinalis were determined.Results:There were 12 common peaks in UPLC fingerprints of Buddleja officinalis, six of which were identified as echinacoside, acteoside, cynaroside, isoacteoside, linarin, and apigenin. The fingerprint similarity of 17 batches of Buddleja officinalis was more than 0.9; Buddleja officinalis from different habitats were classified into 2 groups. Five differential markers were determined by OPLS-DA analysis. The order of significance was acteoside > peak 3 > echinacoside > isoacteoside > linarin. Edgeworthia chrysantha was identified by the method of fingerprint as counterfeit. The results of content determination showed that the content of Buddleja officinalis in Hubei and Sichuan was the high and stable.Conclusion:The method can effectively analyze the differences of Buddleja officinalis from different habitats, and provide reference for the quality control of Buddleja officinalis.

Objective:To investigate the effect of tocilizumab (TCZ) on ventricular arrhythmias (VAs) after myocardial infarction (MI) in Sprague-Dawley rats and explore its potential mechanism.Methods:The random number table method was used to divide 32 adult male Sprague-Dawley rats into 4 groups: Sham group, TCZ group, MI group and MI+TCZ group, with 8 rats in each group. The MI model was established by ligation of the left anterior descending branch of the coronary artery in the MI and MI+TCZ groups, and only sutured without ligation in the Sham and TCZ groups. TCZ was injected into the left superior cervical ganglion (SCG) of rats in the TCZ and MI+TCZ groups after successful modeling or sham operation, and the same amount of normal saline was injected in the Sham and MI groups. 24 h after successful modeling, ECG of rats in each group was recorded, heart rate variability (HRV, including low frequency power (LF), high frequency power (HF), LF/HF ratio), QT interval, QTc interval were calculated, and left ventricular effective refractory period (ERP) and VA inducibility were measured. Myocardial infarct size and tissue changes were observed with triphenyl tetrazolium chloride staining and HE staining. Real-time PCR analysis was used to detect the messager RNA (mRNA) expression of interleukin-6 (IL-6) and signal transducer and activator of transcription (STAT) 3 in SCG and potassium voltage-gated channel subfamily D member 2 (Kcnd2) in myocardial infarction periphery. The expression of c-fos in SCG was detected by immunofluorescence staining.Results:Compared with Sham group and MI+TCZ group, rats in MI group had higher LF and LF/HF ratio, longer QT interval and QTc interval, more VAs induced, lower HF and shorter ERP ( P all<0.05). Triphenyl tetrazolium chloride staining and HE staining showed that rats in the Sham and TCZ groups had normal myocardial tissue structure, those in the MI group had severe myocardial injury, and those in the MI+TCZ group had less myocardial injury than those in the MI group. Real-ime PCR analysis showed that compared with Sham group and MI+TCZ group, mRNA expression levels of IL-6 and STAT3 in SCG of rats in MI group were higher, and mRNA expression level of myocardial Kcnd2 was lower ( P all<0.05). Immunofluorescence staining showed that the content of c-fos in SCG of rats in MI group was higher than that of Sham group and MI+TCZ group ( P all<0.05). Conclusions:TCZ may reduce neural activity of the SCG after MI by inhibiting the IL-6/STAT3 signaling pathway, thereby alleviating myocardial injury and inhibiting VAs.

Objective To discuss the clinical features,differential diagnosis and complication treatment of a patient with genetic visceral myopathy.Methods Medical history,physical examination and laboratory results of the patient were collected in detail.The pathology of previous surgery was reviewed.The patient's peripheral blood DNA was extracted and submitted for whole-exome sequencing.Subsequent Sanger sequencing was used to complete the pedigree verification of the mutation site.Results The patient was a young female presented with repeated in-complete intestinal obstruction since early childhood.She used to be misdiagnosed as Hirschsprung's disease for a long period and underwent multiple gastrointestinal segment resections.Her intestinal obstruction symptoms were temporarily relieved by surgeries,but severe diarrhea,mucus and bloody stools and malnutrition gradually occurred after the last operation.The patient had bacterial overgrowth in small intestinal tract and followed by intestinal op-portunistic infections secondary to chronic intestinal pseudo-obstruction.The symptoms improved after anti-infection and enteral element diet treatment.Further pathological consultation and whole-exome gene sequencing confirmed the diagnosis of visceral myopathy related to ATCG2 R148L mutation.Conclusions Patients with early onset of chronic intestinal pseudo-obstruction and have poor response to conventional treatment are recommended to perform genetic test.The patients with hereditary visceral myopathy are susceptible to opportunistic intestinal infection.At-tentions should also be paid to the prevention and treatment of complications to avoid unnecessary surgery.

Objective:To study the effects of different single cell phenotypes on the prognosis of patients with intrahepatic cholangiocarcinoma by using spatial analysis, providing clues for obtaining potential immunotherapeutic targets.Methods:This study was a retrospective cohort study. A total of 41 intrahepatic cholangiocarcinoma (ICC) patients who underwent surgery in Beijing Youan Hospital Affiliated to Capital Medical University from February 2013 to June 2019 were enrolled. According to the 5-year survival situation, the patients were divided into survival group ( n=10) and death group ( n=31). A metal label-based tissue imaging mass panel containing 36 related markers was designed and constructed for staining different components in tumor samples. Through the analysis of the type and quantity of different metacluster and spatial location information and combined with the clinical outcomes of patients with information, certain metaclusters were found related to the prognosis of patients. Measurement data with normal distribution were expressed as mean±standard deviation ( ± s), paired t-test was used for comparison between groups. Measurement data with skewed distribution were expressed as median, and rank sum test was used for comparison between groups. The chi-square test was used to compare the counting data between groups. Results:36 biomarkers of 41 ICC patients were located and quantified to generate 1 476 single-cell resolution histological images. The expression information of various markers was analyzed by t-distributed Stochastic Neighbor Embedding (tSNE), and subgroups annotations (1-29) were added. It revealed that the density of metacluster 7(CD8 + T cells) was lower in survival group. The density of metacluster 16(Bcl-2 + CK7 + cancer cells) within tumors, as well as the density of metacluster 3(Vista + GB + CD11b + neutrophils) within stroma were higher in death group. Conclusion:The density of metacluster 7(Activated CD8 + T cells), metacluster 16(Bcl-2 + CK7 + tumor cells) and a novel neutrophil metacluster 3(Vista + GB + CD11b + neutrophils) correlated with ICC patients prognosis.