Objective This study aimed to investigate the association between long-term radon exposure and changes in peripheral blood DNA methylation levels, as well as alterations in the expression of methylation-related regulatory genes (DNMT1, DNMT3A, and MBD2) among underground non-uranium metal miners. Methods Five non-uranium metal mines with varying levels of radon exposure were enrolled in this study. From each mine, 30 underground miners and 30 aboveground workers were randomly recruited. Basic demographic information was collected via a standardized questionnaire, and peripheral venous blood samples were obtained from all participants. An enzyme-linked immunosorbent assay (ELISA) colorimetric method was used to detect peripheral blood DNA methylation levels. Real-time quantitative PCR was used to measure mRNA expression levels of DNMT1, DNMT3A, and MBD2. These indicators were compared between underground and aboveground groups and among underground miners with different radon exposure levels. Multiple linear regression analysis was conducted to examine the associations between cumulative radon dose and two outcomes: peripheral blood DNA methylation levels, and the expression levels of methylation-related regulatory genes in underground miners. Results The average radon concentration in the underground workplaces of the five mines was 4,088 Bq/m³ (range: 116-18,188 Bq/m³), corresponding to an estimated annual effective dose of approximately 25.67 mSv for miners. The average radon concentration in aboveground workplaces was 58 Bq/m³ (range: 28-1796 Bq/m³), equivalent to an annual effective dose of approximately 0.51 mSv for aboveground workers. The average cumulative radon dose of underground miners was approximately 26.56 times that of aboveground workers (Z=−12.469, P<0.001). Compared with the aboveground workers, the peripheral blood DNA methylation level of underground miners was significantly decreased, approximately 0.77 times that of the aboveground group (Z=−2.313，P<0.05), accompanied by decreased expression of DNA methyltransferase genes DNMT1 and DNMT3A, which were 0.83 and 0.68 times those of the aboveground group, respectively (Z=−3.002、−4.190，P<0.01). After adjusting for age, working years, body mass index, smoking status, and alcohol consumption, multiple linear regression analysis revealed two key findings: cumulative radon dose was significantly and inversely correlated with peripheral blood DNA methylation levels (β=−0.752, P<0.001); and cumulative radon dose was significantly negatively associated with the expression of DNMT1 and DNMT3A (β=−0.319, −0.369, P<0.01). Conclusion The reduced DNA methylation levels and downregulated expression of DNA methyltransferase genes in underground miners are closely associated with long-term radon exposure.

Objective:To evaluate the anti-reflux effect of digestive tract reconstruction using esophageal-tubular gastric asymmetric anastomosis after radical resection of esophageal and esophagogastric junction cancer.Methods:The main steps were as follows:(1)oblique incision of the lower esophagus;(2)curved incision of the tubular anterior gastric wall;(3)the lower end of the esophagus was anastomosed to the tubular gastric incision with a 90-degree torsion; (4)The anterior wall of the anastomosis was reinforced with a transverse-inverted suture,the posterior wall with a folded suture,and the corners of the gastric stump were buried with sutures.The anastomosis operation time,postoperative complications and postoperative hospital stay were recorded;the reconstructed structure and anti-reflux effect of the anastomosis were observed by digestive tract radiography,gastroscopy and follow-up investigation.Results:The Department of Gastrointestinal and Thoracic Surgery of Huaian First People's Hospital, affiliated to Nanjing Medical University, treated 5 patients of esophagogastric junction cancer and 20 esophageal cancer cases between August 2022 and November 2024, including 19 men and 6 women, with a mean age of (66.7±7.4) years. The mean anastomosis time was (35.4±5.9) minutes, the intraoperative blood loss was (117.6±33.4) ml and the mean postoperative hospital stay was(16.6±5.2) days, with no complications such as anastomotic leakage and bleeding. Postoperative digestive tract radiography (Trendelenburg position)showed that all the patients had no contrast reflux,gastroscopy showed no signs of reflux esophagitis and bile reflux gastritis, the anastomosis showed an inverted whiskers valve-like structure. The median follow-up time was (16.8±6.3) months, and all patients had no reflux symptoms such as acid reflux and belching,and no acid suppressive medication was needed.Conclusion:The esophageal-tubular gastric asymmetric anastomosis is a safe and effective antireflux reconstruction technique.

The integration of artificial intelligence(AI)into medical practice has significantly impacted the field of cerebrovascular disease.AI algorithms are increasingly being employed to enhance the diagnosis and management of cerebrovascular conditions.However,the clinical application and accuracy of these AI tools require further rigorous evaluation.This review probes into the current applications of AI in diagnosis and decision-making in cerebrovascular disease,and explores the potential and challenges associated with their implementation.

Objective:To evaluate the anti-reflux effect of digestive tract reconstruction using esophageal-tubular gastric asymmetric anastomosis after radical resection of esophageal and esophagogastric junction cancer.Methods:The main steps were as follows:(1)oblique incision of the lower esophagus;(2)curved incision of the tubular anterior gastric wall;(3)the lower end of the esophagus was anastomosed to the tubular gastric incision with a 90-degree torsion; (4)The anterior wall of the anastomosis was reinforced with a transverse-inverted suture,the posterior wall with a folded suture,and the corners of the gastric stump were buried with sutures.The anastomosis operation time,postoperative complications and postoperative hospital stay were recorded;the reconstructed structure and anti-reflux effect of the anastomosis were observed by digestive tract radiography,gastroscopy and follow-up investigation.Results:The Department of Gastrointestinal and Thoracic Surgery of Huaian First People's Hospital, affiliated to Nanjing Medical University, treated 5 patients of esophagogastric junction cancer and 20 esophageal cancer cases between August 2022 and November 2024, including 19 men and 6 women, with a mean age of (66.7±7.4) years. The mean anastomosis time was (35.4±5.9) minutes, the intraoperative blood loss was (117.6±33.4) ml and the mean postoperative hospital stay was(16.6±5.2) days, with no complications such as anastomotic leakage and bleeding. Postoperative digestive tract radiography (Trendelenburg position)showed that all the patients had no contrast reflux,gastroscopy showed no signs of reflux esophagitis and bile reflux gastritis, the anastomosis showed an inverted whiskers valve-like structure. The median follow-up time was (16.8±6.3) months, and all patients had no reflux symptoms such as acid reflux and belching,and no acid suppressive medication was needed.Conclusion:The esophageal-tubular gastric asymmetric anastomosis is a safe and effective antireflux reconstruction technique.

Objective To explore the effects of different sealing methods in the treatment of liver failure patients using a dual plasma molecular adsorption system combined with plasma exchange.Methods A total of 120 patients with liver failure admitted between January 2022 and October 2024 were enrolled in the study and randomly divided into an observation group and a control group,each consisting of 60 patients.Both groups received treatment with a dual plasma molecular adsorption system combined with plasma exchange.The control group was administered heparin sodium for catheter sealing,whereas the observation group received protamine prior to hepa-rin sodium catheter sealing.The study compared the two groups in terms of liver function indicators—including aspartate aminotransferase(AST),alanine aminotransferase(ALT),and bilirubin—coagulation function indicators such as fibrinogen and international normalized ratio(INR),hemoglobin(HGB)levels,catheter blockage rates,and the incidence of adverse reactions.Results No statistically significant differences were observed in liver function,coagulation function,or routine blood parameters between the two patient groups following treatment(P>0.05).However,the incidence of blockage in the observation group(3.33%)was significantly lower than that in the control group(20.00%),with the difference being statistically significant(P<0.05).Additionally,no significant differences were found in the occurrence of adverse reactions between the two groups(P>0.05).Conclusions The treatment of liver failure involves the use of a dual plasma molecular adsorption system combined with plasma exchange.Administering protamine prior to heparin sodium sealing has minimal impact on the patient's liver function,blood parameters,coagulation profile,and incidence of adverse reactions,yet it effectively reduces the risk of circuit clotting.

African swine fever(ASF)caused by African swine fever virus(ASFV)is a febrile,hem-orrhage and highly fatal infectious disease in pigs,which poses a serious threat to the global pig in-dustry.Currently,no vaccine is available for the prevention and control of ASF,and several ASF vaccines,including gene deletion attenuated live vaccines,live vector vaccines,and subunit vaccines are under the development stage in the laboratory research.As one of the most promising vaccines,live vector vaccine has the characteristic of safety and simulation of the pathogen natural infection to effectively stimulate the innate and adaptive immune responses,which becomes one of the hotspots in the research and development of novel ASF vaccines.This review focuses on the pro-gress in using modified viruses as vectors for ASF live vector vaccines,and aims to provide valua-ble information for future development of safe and effective ASF vector vaccines.

Objective To investigate prognostic value of serum levels of cathepsin B(CTSB)and NADPH oxidase 4(NOX4)in patients with sepsis associated acute kidney injury(S-AKI).Methods A total of 306 pa-tients with sepsis treated to the hospital from June 2023 to June 2024 were selected,including 192 patients with S-AKI(S-AKI group)and 114 patients without S-AKI(non-S-AKI group).According to the prognosis of S-AKI patients,they were divided into poor prognosis group(n=127)and non-poor prognosis group(n=65).The differences of CTSB and NOX4 in different groups were compared.Pearson analysis was conducted to analyze the correlation between CTSB,NOX4 and clinical indicators.The influencing factors of poor prognosis in S-AKI patients was analyzed according to multivariate Logistic regression.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of CTSB and NOX4 on the poor prognosis of S-AKI pa-tients.Results Th e serum levels of CTSB,NOX4 and serum creatinine(SCr)in S-AKI group were signifi-cantly higher than those in non-S-AKI group(P＜0.05),while the mean arterial pressure and oxygenation in-dex were lower than those in non-S-AKI group(P＜0.05).Serum levels of CTSB and NOX4 in patients with sepsis were positively correlated with SCr(P＜0.05).Compared to non-poor prognosis group,the age,SCr,CTSB and NOX4 of patients in the poor prognosis group were higher,while the mean arterial pressure and ox-ygenation index were lower(P＜0.05).The increased mean arterial pressure and oxygenation index were pro-tective factors for poor prognosis in S-AKI patients(P＜0.05),and the increased age,SCr,CTSB and NOX4 levels were risk factors for poor prognosis in S-AKI patients(P＜0.05).ROC curve showed that the area un-der the curve(AUC)of CTSB combined with NOX4 was significantly higher than AUC of single detection of CTSB and NOX4(Z=4.066,P＜0.001,Z=3.801,P＜0.001).Conclusion The serum levels of CTSB and NOX4 in S-AKI patients are elevated,and can indirectly reflect kidney function.CTSB combined with NOX4 can significantly improve the prediction efficiency of poor prognosis in S-AKI patients,which has potential ap-plication value for clinical treatment and nursing.

Objective To explore the five-circuit and six-qi features of birth time and onset time of children with acute lymphoblastic leukemia(ALL).Methods A total of 877 cases of children with ALL from Children's Hospital of Soochow University from June 2021 to February 2023 were collected,and their five-circuit and six-qi features of birth time and onset time were analyzed.And then the correlation of five-circuit and six-qi features of birth time and onset time with ALL was explored preliminarily,and the pathogenic characteristics of congenital factors and acquired pathogenic factors were revealed.Results(1)The children who were born in the year with the heavenly stems being bing(the 3rd of the ten heavenly stems)and ding(the 4th of the ten heavenly stems)and with the earthly branches being shen(the 8th of the twelve earthly branches)and you(the 9th of the twelve earthly branches)are prone to suffer from ALL,and the birth year of children with ALL had the five-circuit and six-qi features of the joining of guest circuit with dominant circuit being rebellious.ALL is commonly seen in the year with the heavenly stems being geng(the 7th of the ten heavenly stems)and xin(the 8th of the ten heavenly stems)and with the earthly branches being zi(the 1st of the twelve earthly branches)and chou(the 2nd of the twelve earthly branches),and the onset year of ALL in children had the five-circuit and six-qi features of the yearly circuit being gold-circuit and water-circuit,sitian-zaiquan yearly circuit qi being shaoyin monarch-fire with yangming dryness-gold,taiyin damp-earth with taiyang cold-water,and the qi-circuit assimilation relationship being celestial correspondence,same celestial correspondence,celestial correspondence in convergent year,disharmony,mildly-rebellious,and celestial restriction.Conclusion Gold-dryness and water-cold are the congenital factors and acquired pathogenic factors of ALL.The onset of ALL in children is closely related to qi insufficiency and qi stagnation of wood and fire in five-circuit and six-qi theory.

Objective To explore the effects of transcranial magnetic stimulation combined with comprehensive rehabilitation therapy in children with autism.Methods A total of 120 children with autism who were admitted to Department of Rehabilitation Medicine,Nanjing Tongren Hospital from July 2020 to June 2023 were randomly divided into control group(60 cases,conventional rehabilitation therapy)and research group(60 cases,transcranial magnetic stimulation combined with comprehensive rehabilitation therapy).The scores of Psychoeducational Profile Third Edition(PEP-3),Autism Treatment Evaluation Checklist(ATEC),Autism Behavior Checklist(ABC),Childhood Autism Rating Scale(CARS)were compared between the two groups.Results PEP-3 scores in all dimensions were increased in both groups after 6 months of treatment,and the scores in the study group were significantly higher than those in the control group(all P<0.05).The scores of ATEC in all dimensions,CARS score,and ABC score were decreased in both groups after 6 months of treatment,and these scores in the study group were significantly lower than those in the control group(all P<0.05).Conclusion Transcranial magnetic stimulation combined with comprehensive rehabilitation therapy can help to ameliorate core symptoms of children with autism.It is worthy of clinical promotion.

Objective:To investigate the structural changes in the spinal cord in multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) and their relationship with clinical disability.Methods:This study was cross-sectional. A retrospective analysis of clinical and imaging data from 124 patients with MS (MS group), 101 patients with aquaporin-4 antibody-positive NMOSD (NMOSD group), and 110 healthy controls (HC group) from seven medical centers were conducted from January 2018 to October 2021. All subjects underwent 3D T 1WI, and the upper cervical spinal cord cross-sectional area (MUCCA) was segmented and measured. All patients completed the expanded disability status scale (EDSS) assessments at baseline and during follow-up, as well as the baseline 25-foot walk test (T25FW) and the nine-hole peg test (NHPT). Patients were classified into EDSS progression and non-progression groups based on follow-up EDSS scores. Comparisons of MUCCA among the three groups were conducted using analysis of covariance, controlling for age and sex as covariates. Pairwise comparisons between groups were performed using the HSD test. Univariate linear regression and logistic models were employed to identify candidate predictors of baseline clinical disability status or EDSS progression in the MS and NMOSD groups. L1 regularized multivariable linear regression analysis was used to determine independent predictors of baseline clinical disability status or EDSS progression. Independent predictors were then combined to establish a logistic regression model, and the model′s performance in predicting EDSS progression was evaluated using receiver operating characteristic analysis and the area under the curve (AUC). Results:A total of 144 patients completed follow-up EDSS assessments, with a follow-up duration of 3.30 (1.10, 6.42) years, including 82 patients in the MS group and 62 patients in the NMOSD group. Controlling for sex and age as covariates, the overall difference in MUCCA among the MS, NMOSD, and HC groups was statistically significant ( P=0.001). The MUCCA in the MS group was lower than that in the HC group, with a significant difference ( t=-2.54, P=0.007); the MUCCA in the NMOSD group was also lower than that in the HC group, with a significant difference ( t=-2.80, P=0.002). However, the difference in MUCCA between the MS and NMOSD groups was not statistically significant ( t=-0.40, P=0.882). In the MS group, MUCCA was an independent predictor of baseline EDSS score (β=-0.03), baseline T25FW score (β=-0.09), and baseline NHPT score (β=-0.30). In the NMOSD group, MUCCA (β=-0.08), age (β=0.06), and baseline EDSS score (β=-0.43) were independent predictors of EDSS progression, and the logistic regression model incorporating these three factors predicted EDSS progression with an AUC of 0.82. Conclusions:Significant spinal cord atrophy occurs in patients with both MS and NMOSD. Atrophy of the upper cervical spinal cord can predict the degree of disability in MS patients and the progression of clinical disability in NMOSD patients.