Objective: To explore the early effects of birth weight at different gestational ages on blood pressure trajectory among primary school students, so as to provide evidence for incorporating gestational age birth weight into individualized early warning and intervention strategies for childhood hypertension. Methods: From May to November 2023, a purposeful sampling method was used to recruit 1 676 students in grade 1-3 from three primary schools in a certain urban district of Chongqing. Follow up assessments were conducted in May 2024(T1), November 2024(T2), and May 2025(T3). General demographic and birth related information were collected via self administered questionnaires, while height, weight and blood pressure were obtained through physical examinations. Linear mixed effects model was used to analyze the associations between birth weight at different gestational ages and blood pressure trajectories. Results: During the T1-T3 period, the systolic blood pressure of boys were 98.5 (93.0, 104.5 ),98.5 (93.5, 105.0), and 97.5 (92.5, 103.5)mmHg, respectively, while the diastolic blood pressure were 60.5 (56.5, 65.0), 61.5 ( 57.0 , 65.5), and 60.0 (56.0, 64.0)mmHg, respectively. For girls, the systolic blood pressure were 95.5 (90.0, 102.0),95.5 (90.5, 101.5), and 96.0 (90.5, 101.5)mmHg, respectively, and the diastolic blood pressure were 60.5 (56.0, 64.5 ),61.5 (57.5, 65.5), and 59.5 (56.0, 63.0)mmHg, respectively. Through Friedman test within both boys and girls, diostolic blood pressure were statistically significant across three measurements( χ 2=48.85，81.54，both P <0.01). The proportion of normal blood pressure increased , and the proportion of prehypertension and hypertension decreased with time( χ 2=39.72，25.62，both P < 0.01 ). Linear mixed effects model analysis revealed that after adjusting for age, sex, household income monthly, parental education, family history of hypertension and maternal pregnancy complications, large for gestational age had significantly higher trajectories of systolic ( β = 1.50) and diastolic( β =0.94) blood pressure compared to appropriate for gestational age(both P <0.01). Conclusion Large for gestational age is associated with elevated blood pressure trajectories during school age, and it may be considered as an early indicator for individualized screening and intervention for childhood hypertension.

Objective To explore the relationship between the levels of serum CXC chemokine ligand 9(CXCL9)and neurogranin(NG)and the condition and prognosis of patients with acute ischemic stroke(AIS).Methods A total of 93 confirmed AIS patients(case group)admitted to Xuzhou First People's Hospi-tal from September 2020 to September 2022 were selected as the research subjects.Another 80 physically healthy individuals with similar gender and age to the case group during the same period were selected as the control group.The case group was divided into the mild group(n=27),the moderate group(n=41),and the severe group(n=25)based on the National Institutes of Health Stroke Scale(NIHSS)score.Three months after treatment,they were divided into the good prognosis group(n=71)and the poor prognosis group(n=22)based on the modified Rankin scale(mRS)score.The levels of serum CXCL9 and NG in each group were detected by enzyme-linked immunosorbent assay,and other clinical data were collected.The correlations be-tween serum CXCL9,NG and NIHSS score and mRS score were analyzed by Pearson product-moment correla-tion analysis.The influencing factors of poor prognosis were analyzed by Logistic regression,and the predic-tive value of poor prognosis was evaluated by the receiver operating characteristic curve.Results Compared with the control group,the levels of serum CXCL9 and NG in the case group increased,and the differences were statistically significant(all P＜0.05).Compared with the mild group,the levels of serum CXCL9 and NG in the moderate group and the severe group increased.The levels of serum CXCL9 and NG in the severe group were higher than those in the moderate group,and the differences were statistically significant(all P＜0.05).Serum CXCL9 and NG were positively correlated with NIHSS score and mRS score(P＜0.05).Com-pared with the good prognosis group,the poor prognosis group had a larger cerebral infarction volume,a more severe condition,and higher levels of serum CXCL9 and NG,the differences were statistically significant(all P＜0.05).Elevated serum CXCL9 and NG were independent risk factors for poor prognosis in AIS patients(OR=1.667,1.589,P＜0.05).The area under the curve of serum CXCL9,NG and their combination for pre-dicting poor prognosis was 0.828,0.809 and 0.931,respectively,and the predictive value of the combination of the two was greater than that of any single indicator(Z=2.556,2.783,P＜0.05).Conclusion Serum CXCL9 and NG are upregulated in AIS patients and are related to the disease condition and prognosis.Early combined detection can assist in clinical assessment of the disease severity and prediction of the risk of poor prognosis.

BACKGROUND:Dysfunction of macrophage efferocytosis can induce local and systemic inflammatory damage and is associated with a variety of obesity-related metabolic diseases.Moreover,compounds targeting efferocytosis have shown good therapeutic effects. OBJECTIVE:By reviewing the effects of obesity on macrophage efferocytosis,to analyze the key mechanism by which obesity inhibits efferocytosis,to summarize the research progress in compounds targeting efferocytosis to treat obesity-related metabolic diseases,so as to provide new ideas for fully understanding efferocytosis and its relationship with metabolic diseases,aiming to provide new strategies for disease prevention and treatment. METHODS:The English search terms were"efferocytosis,metabolism,obesity,obese,atherosclerosis,non-alcoholic steatohepatitis,neurodegeneration,tumor,osteoarthritis,diabetes,compound,medicine,treatment,"which were used for literature retrieval in PubMed and Web of Science.The Chinese search term was"efferocytosis,"which was used for literature retrieval in CNKI,VIP and WanFang datebases.Ninety-nine papers were finally included in the review analysis after a rigorous screening process. RESULTS AND CONCLUSION:In the process of efferocytosis,the"Find me"and"Eat me"processes involving a large number of apoptotic cell derived factors are mainly regulated by apoptotic cells.The efferocytosis factor involved in cytoskeletal remodeling and digestion are mainly derived from macrophages,which are crucial for efferocytosis activity.These results suggest that the"Find me"and"Eat me"factors mainly reflect the condition of apoptosis,and it is more scientific to select the expression of factors involved in cytoskeletal remodeling and digestion when evaluating the efferocytosis activity of macrophages.Obesity inhibits efferocytosis,and shows an inhibitory effect on most digestive factors,but has a stress-induced activation effect on most"Find me,""Eat me"and cytoskeletal recombination factors,which further indicates the decisive effect of digestive stage on efferocytosis and suggests that it is not reliable for some studies to evaluate the efferocytosis based on the increased expression of"Find me"and"Eat me"factors.Targeting cytokines in the digestive phase may be more effective when discussing future intervention strategies targeting macrophages efferocytosis.The efferocytosis activators of macrophages are effective in the treatment of various metabolic diseases,but the efferocytosis inhibitors in tumor tissue show good anticancer effects,suggesting that the role of efferocytosis should be rationally evaluated according to the characteristics of tissue inflammation.Efferocytosis is a relatively new concept proposed in 2003,with a short research history and complex efferocytosis factors.Current studies on obesity and efferocytosis only involve a tip of the iceberg and most of them are at a superficial level and a large number of scientific experiments are needed to further validate the mechanisms.

BACKGROUND:Hydroxy safflower yellow A has anti-ischemia,anti-oxidation,anti-thrombotic and anti-inflammatory effects.Whether it affects neuronal pyroptosis after glucose-oxygen deprivation/reglucose-reoxygenation is still unclear. OBJECTIVE:To investigate the protective effect of hydroxy safflower yellow A on neuronal pyroptosis and its mechanism. METHODS:HT22 cells in logarithmic growth phase were randomly divided into five groups:normal group,model group,hydroxy safflower yellow A group,colivelin group,and colivelin+hydroxy safflower yellow A group.HT22 cells were treated with glucose-oxygen deprivation/reglucose-reoxygenation to establish neuronal pyroptosis model,and then treated with STAT3 agonist Colivelin and hydroxy safflower yellow A.JC-1 probe was employed to assess changes in mitochondrial membrane potential.Reactive oxygen species kit was used to determine the content of reactive oxygen species in cells.GSDMD/TUNEL staining was conducted to observe cell pyroptosis.Immunofluorescence analysis was performed to detect STAT3 and GSDMD protein expression.RT-PCR was utilized for assessing mRNA expression levels of STAT3,NLRP3,and Caspase-1.Western blot assay was utilized to measure the protein expression levels of p-STAT3,NLRP3,GSDMD,Cleaved-caspase-1,and interleukin-1β. RESULTS AND CONCLUSION:(1)Compared with the normal group,the number of pyroptotic cells increased in HT22 cells in the model group along with a significant increase in protein expression levels of p-STAT3,NLRP3,Cleaved-caspase-1,GSDMD,and interleukin-1β.Compared with the model group,the number of pyroptotic cells reduced,and the expression of pyroptosis-related proteins significantly decreased in the hydroxy safflower yellow A group.(2)In comparison with the model group,pyroptosis worsened in the colivelin group where mitochondrial membrane potential decreased along with elevated reactive oxygen species content and increased mRNA expression levels of STAT3,NLRP3,and Caspase-1,as well as increased protein expression levels of p-STAT3,NLRP3,GSDMD,Cleaved-caspase-1,and interleukin-1β.Compared with the Colivelin group,above indexes were improved in the colivelin+hydroxy safflower yellow A group.These results suggest that hydroxy safflower yellow A plays a neuroprotective role through STAT3 signaling pathway to inhibit HT22 pyroptosis after glucose-oxygen deprivation/reglucose-reoxygenation treatment.

ObjectiveTo analyze the distribution, drug resistance characteristics, and changing trends of Acinetobacter baumannii (AB) isolated from environmental surfaces and healthcare workers’ hands in a grade Ⅱ level A general hospital in Xuhui District of Shanghai from 2018 to 2023, and to provide reference for infection control in the hospital. MethodsEnvironmental samples were collected quarterly from critical surfaces and healthcare workers’ hands in the intensive care unit (ICU), geriatrics, and respiratory departments from 2018 to 2023. Clinical isolates were obtained from all patients with AB infections in ICU, geriatrics, respiratory department, rehabilitation department, infectious diseases department, emergency department, cardiology department, and orthopedics of the hospital from 2018 to 2023. Retrospective analyses were performed on AB detection rates, strain origins, resistance rates to commonly used antimicrobial agents, and resistance gene features, comparing the antimicrobial resistance between clinically isolated strains and environmentally isolated strains. ResultsFrom 2018 to 2023, a total of 1 416 samples were collected from the hospital and a total of 272 strains of AB were detected, with a positive detection rate of 19.21%. The detection rate gradually decreased year-on-year (χ²_trend=45.290, P<0.001). The majority of samples originated from patient-contacted items (34.56%, 94/272), followed by shared items (26.84%, 73/272) and healthcare worker-contacted items (15.07%, 41/272). From 2018 to 2023, the resistance rate of AB on environmental surfaces and healthcare workers’ hands to commonly tested antibiotics in the hospital ranged from 10% to 40%. The resistance rates to cefotaxime (42.52%) and piperacillin (38.58%) were relative high, while the resistance to polymyxin E (1.57%), polymyxin B (2.36%), and doxycycline (3.94%) maintained low. The annual fluctuations in resistance to cefotaxime, piperacillin, ceftriaxone, tobramycin, doxycycline, minocycline and cotrimoxazole were statistically significant (all P<0.05). There were statistically significant differences in the resistance of clinical and environmental isolates to ampicillin/sulbactam, cefepime, ceftazidime, subamphetamine, meropenem, piperacillin, aztreonam, gentamicin, tobramycin, minocycline, ciprofloxacin, levofloxacin, and cotrimoxazole in the hospital from 2018 to 2023 (all P<0.05). The resistance rate of clinical isolates was generally high, especially to β-lactam and quinolone drugs, which were mostly above 80% [such as cefepime (93.86%), cefotaxime (97.37%), imipenem (98.25%), and ciprofloxacin (99.12%)]. The resistance rate of environmental isolated strains to similar antibiotics was relatively lower, mostly concentrated at 10%‒30%. The whole-genome sequencing of 34 carbapenem-resistant Acinetobacter baumannii (CRAB) strains isolated from the hospital environment in 2023 revealed that the main resistance mechanism was overexpression of efflux pumps (51.97%), followed by changes in target sites (32.46%). Among the 34 CRAB strains, carbapenem resistance genes OXA-23 and OXA-51 were detected in 6 strains (17.65%), while genes such as KPC, IMP, VIM, and SIM were not detected. ConclusionFrom 2018 to 2023, AB in the hospital environment exhibited high resistance rates to certain antimicrobial agents and carried multiple resistance genes, indicating a potential transmission risk. It is necessary to further strengthen bacterial resistance monitoring and hospital infection control, and use antibiotics reasonably.

Under the background of the Healthy China strategy， the integration of traditional Chinese medicine （TCM） into the public health emergency response system has become an important measure to enhance the capacity for coping with public health emergencies. In recent years， the role of TCM in responding to such emergencies has become increasingly prominent. Taking major emerging epidemics as an example， TCM has developed a rich theoretical system and practical experience in epidemic prevention and treatment over thousands of years， and has played a significant role in successive outbreaks with its unique advantages. Based on the concept of ''preventing disease before its onset'' and the theoretical framework of treatment based on syndrome differentiation， TCM has achieved remarkable results through early intervention and full participation in the integrated model of TCM and Western medicine， from severe acute respiratory syndrome （SARS） to corona virus disease-2019 （COVID-19）， in improving clinical symptoms and outcomes， reducing adverse reactions， and promoting recovery. From the perspective of the Healthy China strategy， this paper systematically reviews the historical development of TCM in epidemic prevention and treatment， with particular attention to recent epidemics such as SARS， influenza A （H1N1）， and COVID-19. It further examines the similarities and differences between TCM and Western medicine in responding to major emerging epidemics， as well as relevant policies related to TCM in epidemic prevention and control. In addition， it summarizes the existing problems in TCM's role in the prevention and treatment of major emerging epidemics， and explores measures to improve its rapid response capacity under the Healthy China strategy. This study not only provides a ''Chinese solution'' for the prevention and control of newly emerging infectious diseases worldwide， but also offers theoretical and practical references for strengthening the public health emergency response system， carrying strategic significance for promoting the modernization and internationalization of TCM.

Schizophrenia (SZ) stands as a severe psychiatric disorder. This study applied diffusion tensor imaging (DTI) data in conjunction with graph neural networks to distinguish SZ patients from normal controls (NCs) and showcases the superior performance of a graph neural network integrating combined fractional anisotropy and fiber number brain network features, achieving an accuracy of 73.79% in distinguishing SZ patients from NCs. Beyond mere discrimination, our study delved deeper into the advantages of utilizing white matter brain network features for identifying SZ patients through interpretable model analysis and gene expression analysis. These analyses uncovered intricate interrelationships between brain imaging markers and genetic biomarkers, providing novel insights into the neuropathological basis of SZ. In summary, our findings underscore the potential of graph neural networks applied to multimodal DTI data for enhancing SZ detection through an integrated analysis of neuroimaging and genetic features.
Humans ; Schizophrenia/pathology* ; Diffusion Tensor Imaging/methods* ; Male ; Female ; Adult ; Brain/metabolism* ; Young Adult ; Middle Aged ; White Matter/pathology* ; Gene Expression ; Nerve Net/diagnostic imaging* ; Graph Neural Networks

Purpose This study aimed to evaluate the consistency of human epidermal growth factor receptor 2(HER2)status between primary breast cancer lesions and lung metastatic lesions and to establish a prognostic model for predicting the survival rate of HER2 low expression(HER2-low)breast cancer patients with lung metastasis.Methods Clinicopathological data from a cohort of 252 patients with breast cancer and lung metastasis were retrospec-tively analyzed.Results 50.00％of the patients had HER2-low expression in metastatic lesions,and HER2-low ex-pression was the most prevalent subgroup in both primary and metastatic lesions.A discordance in HER2 status be-tween primary and metastatic sites was observed in 28.07％of cases.The most frequent shift was from HER2-zero in the primary tumor to HER2-low expression in the metastasis(12.28％of all cases).Estrogen receptor(ER)status,menopausal status,and histological type were identified as independent prognostic factors for overall survival(OS)by univariate and multivariate Cox regression analyses.A prognostic model incorporating these factors was constructed to predict 3-year and 5-year survival.The model demonstrated area under the curve(AUC)values of 0.765 and 0.780 for 3-year and 5-year OS in the training cohort,and 0.667 and 0.706 in the validation cohort,respectively.Conclu-sion HER2-low expression is the most common subtype among breast cancer patients with lung metastasis.The ob-served shift from HER2-zero in primary lesions to HER2-low in metastases underscores the clinical necessity of re-biop-sy at metastatic sites.The developed prognostic model effectively predicts OS in this patient population.

Objective:To analyze the epidemiological characteristics and changing trends of elderly patients with drug-resistant pulmonary tuberculosis(DR-PTB)at Beijing Chest Hospital, Capital Medical University, in order to provide references for clinical prevention and treatment.Methods:Data were retrospectively collected from all DR-PTB cases hospitalized in the electronic medical record system of Beijing Chest Hospital from 2019 to 2023.The epidemiological characteristics including classification, gender, age, occupation and their changing trends among elderly DR-PTB patients were analyzed.Results:Among 1 981 hospitalized DR-PTB patients, 400(20.19%)were elderly[aged 60-92 years, mean(68.67±7.01)years], showing an overall increasing trend from 2019 to 2023.Mono-resistant PTB was the most common(198 cases, 49.50%), followed by multidrug-resistant PTB(170 cases, 42.50%), extensively drug-resistant PTB(21 cases, 5.25%), and polyresistant PTB(11 cases, 2.75%).Among the elderly DR-PTB patients, 287 cases(71.75%)were male, 200 cases(50.00%)were initial treatment cases, 377 cases(94.25%)were Han nationality, 165 cases(41.25%)were Beijing residents, 185 cases(46.25%)were employees of enterprises and institutions, 109 cases(27.25%)were farmers, 68 cases(17.00%)were unemployed individuals, 202 cases(50.50%)were pathogen-positive cases(smear and culture positive), and 228 cases(57.00%), 331 cases(82.75%), 196 cases(49.00%)were patients with comorbidities, complications, and extrapulmonary tuberculosis, respectively.There were no significant differences between elderly and non-elderly groups in ethnicity, treatment classification, or comorbidities(all P>0.05).However, significantly differences were found in gender ( χ2=12.718, P<0.001), occupation ( χ2=97.500, P<0.001), patient origin ( χ2=119.771, P<0.001), pathogen detection results ( χ2=10.101, P=0.001), and drug resistance patterns ( χ2=15.990, P=0.001).The proportion of elderly DR-PTB patients showed an overall increasing trend, with rises in females(25.64%-28.70%), unemployed individuals(7.69%-20.37%), other occupations(5.13%-19.40%), Han ethnicity(91.03%-99.07%), initial treatment(33.33%-57.41%), smear-negative but culture-positive cases(46.15%-53.70%), polyresistant PTB(1.28%-9.26%), and extensively drug-resistant PTB(1.28%-3.70%). Conclusions:Among elderly DR-PTB patients, the proportions of female, unemployed individuals and other occupations, initial treatment cases, smear-negative but culture-positive cases, polyresistant PTB, and extensively drug-resistant PTB are increasing annually.Future efforts should focus on targeted prevention and treatment for key populations to further reduce the rate of elderly DR-PTB.

OBJECTIVE To analyze the reasons for the outbreak of suspected carbapenem-resistant Acinetobacter baumannii(CRAB)infections in the neurosurgical intensive care unit to take comprehensive prevention and con-trol measures to control the spread of infections,and to provide a reference for the control of multidrug-resistant organisms(MDRO)infections in intensive care units.METHODS Epidemiological data were collected from five patients with CRAB infections in the neurosurgical intensive care unit of Gansu Provincial People's Hospital in Mar.2024,and environmental hygiene monitoring and comprehensive infection prevention and control measures were conducted.RESULTS A total of five cases of lower respiratory tract infections occurred,all of which were hospital-acquired infections,and all patients had consistent spatial-temporal distribution.A.baumannii was detec-ted in the sputum cultures of all patients,and all were resistant to carbapenems,aminoglycosides and some β-lac-tam drugs.Before the implementation of comprehensive prevention and control measures,a total of 25 samples from the surfaces and the hands of health workers were collected,with a pass rate of 52.00％;CRAB was detected on the surface of treatment carts and the wall of sputum suction bottles in the treatment room,with a detection rate of 8.00％.After the implementation,a total of 24 samples were collected,with a pass rate of 100.00％,and the difference was statistically significant when compared with the pre-implementation period(χ2=16.987,P<0.001).Through the implementation of comprehensive measures such as isolation,standardization of the ward cleaning and disinfection process,strengthening hand hygiene,standardization of sterile operations and personnel management,the indicators such as hand hygiene compliance rate,the execution rate of multi-drug-resistant bac-terial preventive and control measures and the fluorescent marker removal rate were all improved,and the suspec-ted CRAB infection outbreak was timely controlled.CONCLUSION This suspected CRAB hospital-acquired infec-tion outbreak may be related to a variety of factors,and timely environmental hygiene monitoring and comprehen-sive infection prevention and control measures can effectively control the spread of CRAB infection.