Objective: To investigate factors influencing perioperative blood transfusion in patients with scarred uterus during pregnancy undergoing cesarean section, construct and validate a transfusion risk prediction model, and provide evidence for preoperative assessment and blood management. Methods: Clinical data of 405 patients undergoing cesarean section for scarred uterus during pregnancy at the First Affiliated Hospital of Xi'an Jiaotong University from January 2020 to December 2024 were retrospectively collected. The dataset was randomly divided into a training set (n=284) and a validation set (n=121) at a 7∶3 ratio. Within the training set, Firth-penalized logistic regression was employed for multivariate analysis to identify independent factors influencing perioperative blood transfusion and construct a predictive model. Model performance was evaluated in the validation set. Results: Multivariate Firth regression analysis showed that severe placenta previa (OR=75.566, 95%CI: 8.603-9979.174) and placenta accreta (OR=4.591, 95%CI: 1.120-19.416) were independent risk factors for perioperative blood transfusion, while preoperative red blood cell count (OR=0.189, 95%CI: 0.083-0.405) and fibrinogen levels (OR=0.588, 95%CI: 0.395-0.855) were protective factors. The predictive model constructed based on these four variables demonstrated good discriminatory performance, with areas under the receiver operating characteristic curves of 0.803 (95%CI: 0.740-0.867) and 0.753 (95%CI: 0.644-0.862) in the training and validation sets, respectively. Conclusion: For patients with scarred uterus during pregnancy undergoing cesarean section, severe placenta previa and placenta accreta significantly increase the risk of transfusion, while higher preoperative red blood cell count and fibrinogen levels exert a protective effect. The predictive model established in this study facilitates the identification of patients requiring transfusion, thereby enabling preoperative blood preparation and optimized blood management.

Neurodegenerative diseases such as Alzheimer's disease （AD）， Parkinson's disease （PD）， and Huntington's disease （HD） are increasingly becoming major challenges to global public health. The pathogenesis of these diseases is highly complex， with oxidative damage and ferroptosis emerging as potential core factors. Oxidative damage primarily results from the accumulation of reactive oxygen species （ROS） within cells， a process that impairs cellular function and viability. Ferroptosis， an iron-dependent form of programmed cell death， plays a crucial role in neuronal injury and apoptosis. Multiple studies indicate a significant interaction between oxidative damage and ferroptosis. This interplay not only accelerates the progression of neurodegenerative diseases but also offers new directions for potential therapeutic targets. This review systematically analyzes the mechanisms of oxidative damage and ferroptosis in various neurodegenerative diseases， evaluates current research frontiers， and explores feasible therapeutic strategies， aiming to provide new insights and perspectives for in-depth research in this field.

Background/Aims: Natural killer (NK) cell function is generally considered dampened in chronic hepatitis B virus (HBV) infection; however, the NK cell pool exhibits phenotypic and functional heterogeneity, and the antibody--mediated effect of NK cells remains less characterized. This study evaluated the dynamic changes in antibody-mediated NK cell responses and the involvement of distinct NK subsets across disease stages and during antiviral treatment. Methods: A T-cell receptor-like antibody specific for the HBV core 18–27 peptide (cTCRL-Ab) was used to determine the antibody-mediated effect of NK cells, and an array of NK cell surface markers were analyzed in cross-sectional and longitudinal cohorts of patients with chronic HBV infection. Single-cell RNA sequencing (scRNA-seq) was performed to identify the heterogeneity of NK subsets. Results: The cTCRL-Ab enabled the detection of NK cell cytolytic activity and IFNγ production. Notably, cTCRL-Ab-mediated NK cell responses were compromised in chronically HBV-infected patients, particularly in those receiving pegylated interferon-α (Peg-IFNα), which was associated with the downregulation of CD16 expression. Correspondingly, Peg-IFNα inhibited cTCRL-Ab-mediated NK cell function by reducing CD16 expression in vitro. scRNA-seq revealed that CD16 downregulation occurred mainly within a dysfunctional CD16hi NK subset exhibiting exhaustion properties. In contrast, an activated CD16hiNK subpopulation (CX3CR1⁺KLRC2–CD16hi) with high cytotoxicity was enriched in patients who experienced favorable treatment responses. Furthermore, the intrahepatic CX3CR1+KLRC2–CD16hi subset tended to exhibit functional restoration in HBsAg-loss individuals. Conclusions Our data contribute to the understanding of antibody-mediated responses of NK cells in chronic HBV infection, and highlight a previously unappreciated functional CX3CR1+KLRC2–CD16hiNK subset as a potential therapeutic target.

ObjectiveTo analyze the incidence rate and mortality of acute myocardial infarction (AMI) and their changing trends among the registered residents in Xiaoshan District, Hangzhou City from 2017 to 2023, so as to provide references for formulating policies related to AMI prevention. MethodsThe morbidity and mortality data of AMI among the registered residents in Xiaoshan District from 2017 to 2023 were collected through the Hangzhou Chronic Disease and Death Cause Monitoring System. Software such as Excel 2019, SPSS 25.0 and Joinpoint 4.9.1.0 were used to calculate the incidence rate, mortality, and average annual percentage change (AAPC) of AMI. ResultsFrom 2017 to 2023, the average annual crude incidence rate, age-standardized incidence rate using China standard population (ASIRC), and the age-standardized incidence rate using World standard population (ASIRW) of AMI in Xiaoshan District were 48.25/100 000, 29.14/100 000, and 21.64/100 000, respectively, and, from which the AAPCs were 5.495%, 6.010%, and 6.533%, respectively, all showing an upward trend. The average annual crude mortality rate, the age-standardized mortality rate using China standard population (ASMRC), and the age-standardized mortality rate using World standard population (ASMRW) were 11.76/100 000, 6.52/100 000, and 4.71/100 000, respectively, from which the AAPCs were -9.669%, -10.433% and -9.615%, respectively, all showing a downward trend. The average annual crude incidence rate of AMI was higher in males (65.87/100 000) than that in females (31.31/100 000). Moreover, the average annual crude mortality rate of AMI was higher in males (14.08/100 000) than that in females (9.52/100 000), and the difference was statistically significant (all P<0.001) .After age grouping, the crude incidence rate of AMI among the residents aged 35-, 45-, 55-, and 65- years in Xiaoshan District from 2017 to 2023 showed an upward trend over time, with AAPCs of 16.993%, 17.149%, 8.523%, and 5.002%, respectively. While the crude mortality rate in residents aged 35-, 75-, and 85-102 years showed an decreasing trend over time, with AAPCs of -23.977%, -15.467%, and -17.415%, respectively, but there was no statistically significant difference in the trends in incidence rate and mortality of other age groups (all P>0.05). ConclusionThe situation of AMI prevention and control among the registered residents in Xiaoshan District is not optimistic, and targeted measures should be strengthened for the male residents aged ≥35 years old.

Objective: To analyze the correlation between serum homocysteine (Hcy) and both folic acid (FA) and sperm DNA fragmentation index (DFI), so as to provide the evidence for male fertility assessment. Methods: Males who visited and measured the serum Hcy in the Reproductive Medicine Center of Huzhou Maternal and Child Health Care Hospital from September 2022 to September 2023 were selected as the study subjects. Sperm quality parameters and sperm DFI were analyzed by collecting sperm. Hcy and FA were measured by collecting venous blood. Participants were stratified into a high Hcy group (Hcy≥15.0 μmol/L) and a normal group (Hcy<15.0 μmol/L). The correlations between serum Hcy and FA and sperm DFI were evaluated using linear regression models. Results: A total of 173 participants were enrolled, including 39 in the high Hcy group and 134 in the normal group. The sperm concentration in the high Hcy group was significantly lower than that in the normal group [(91.77±61.11)×106/mL vs. (144.21±106.82)×106/mL, P<0.05]. No statistically significant differences were observed in semen volume, sperm motility, curvilinear velocity, straight-line velocity, average path velocity, or sperm morphology normal rate (all P>0.05). The FA level in the high Hcy group was lower than that in the normal group [(4.44±1.79) nmol/L vs. (7.64±3.68) nmol/L, P<0.05]. The sperm DFI in the high Hcy group was higher than that in the normal group [(19.21±8.85)% vs. (13.07±6.43)%, P<0.05]. Serum Hcy level showed a negative correlation with FA level (r=-0.369, P<0.05) and a positive correlation with sperm DFI (r=0.351, P<0.05). Conclusion Serum Hcy level is associated with sperm concentration, FA and sperm DFI, suggesting that serum Hcy may affect sperm quality.

Objective: To analyze the incidence trend of colorectal cancer in Xiaoshan District, Hangzhou City from 2010 to 2024, and predict the incidence of colorectal cancer from 2025 to 2027, so as to provide the evidence for improving the prevention and control strategies of colorectal cancer. Methods: Colorectal cancer incidence data from 2010 to 2024 in Xiaoshan District were collected through the Hangzhou Municipal Chronic Disease Monitoring Management System. The crude incidence of colorectal cancer was calculated, and standardized using the data from the Sixth National Population Census in 2010 (Chinese standardized rate) and the Segi's world standard population (world standardized rate). The trend of colorectal cancer incidence from 2010 to 2024 was analyzed using the average annual percent change (AAPC). An exponential smoothing state space model with trigonometric seasonality, box-cox transformation, ARMA errors, trend and seasonal components (TBATS) was established to forecast the crude incidence of colorectal cancer from 2025 to 2027. Results: There were 10 726 new cases of colorectal cancer in Xiaoshan District from 2010 to 2024. The crude incidence, Chinese standardized rate, and world standardized rate of colorectal cancer were 59.25/100 000, 38.62/100 000 and 29.50/100 000, respectively. The crude incidence, Chinese standardized rate, and world standardized rate of colorectal cancer in males were 70.56/100 000, 44.44/100 000and 35.58/100 000, respectively, while those in females were 48.37/100 000, 32.69/100 000 and 23.70/100 000, respectively. The Chinese standardized rate of colorectal cancer was significantly higher in males than in females (P<0.05). The crude incidence of colorectal cancer in males, females and the whole population showed upward trends from 2010 to 2024 (AAPC=4.916%, 3.795% and 4.442%, all P<0.05). The crude incidence of colorectal cancer in the groups of 0-<35, 35-<50, 50-<75 and ≥75 years were 1.75/100 000, 19.86/100 000, 112.28/100 000 and 272.99/100 000, respectively, showing an increasing trend with age (P<0.05). From 2010 to 2024, the crude incidence of colorectal cancer in the ≥75 years group showed an increasing trend (AAPC=4.470%, P<0.05), while no significant trend was observed in other age groups (all P>0.05). TBATS model demonstrated good fitting (predictive) performance, indicating a year-by-year increase in the crude incidence of colorectal cancer across the whole population from 2025 to 2027, with an estimated rate reaching 70.45/100 000 in 2027. Conclusions The crude incidence of colorectal cancer in Xiaoshan District showed an increasing trend from 2010 to 2024, and it is predicted to continue to increase from 2025 to 2027. Males and the elderly are the key populations for colorectal cancer prevention and control.

Objective To comprehensively understand the map of transcripts during mitosis and their regulatory mechanisms of HAP 1 cells by conducting transcriptome sequencing analysis after being released by mitotic synchro-nization arrest.Methods HAP1 cells were subjected to mitotic synchronous arrest with nocodazole and samples were collected after 0,20,80 min release,and RNA sequencing(RNA-seq)were performed.The transcriptome data was cleaned and the differentially expressed genes,expression trend clustering and functional enrichment com-bined with the protein interaction network were analyzed to explore the changes of signaling pathways in HAP 1 cells during mitosis.Results The transcriptome of HAP1 cells after synchronous release from mitosis underwent significant changes in time series,and differential gene cluster analysis revealed four gene clusters were enriched in important biological processes such as p53 signaling and cytoplasmic translation.Conclusions The transcriptome time-dependent dynamic changes during mitosis in HAP1 cells are coordinated regulation of key signaling pathways including cellular stress response,translational control and chromatin remodeling,ensuring a balance between growth and stress response upon mitotic exit.

ObjectiveTo analyze the trend of incidence, mortality rate and survival rate of breast cancer among women with registered residence in Xiaoshan District of Hangzhou City in Zhejiang Province from 2014 to 2023, and to provide a basis for improving breast cancer prevention and control strategies. MethodsData on the incidence and mortality of breast cancer among women with registered residence in Xiaoshan District from 2014 to 2023 were collected through Zhejiang Chronic Disease Monitoring and Management System. The crude incidence and mortality rate, as well as the age-standardized incidence and mortality rate using both the 2000 Chinese standard population (abbreviated as “Chinese ASR”) and Segi’s 1960 world standard population (“world ASR”) were calculated. Joinpoint model was employed to analyze the trends in incidence and mortality rate, while R software (version 4.1.1) was used to analyze the 5-year relative survival rate to assess the survival status of breast cancer patients. ResultsFrom 2014 to 2023, the crude incidence rate, the Chinese age-standardized incidence rate (ASIRC) and the world age-standardized incidence rate (ASIRW) of breast cancer among women with registered residence in Xiaoshan District were from 70.00/100 000 to 128.35/100 000, from 52.92/100 000 to 94.29/100 000, and from 40.82/100 000 to 72.07/100 000, respectively, with the corresponding average annual percentage changes (AAPC) of 5.80%, 4.63% and 4.71%, respectively, showing a significant increasing trend over the decade (all P<0.05). The incidence rate of breast cancer among people aged 30‒<40 years old or 50‒<75 years old exhibited a significant increase trend from 2014 to 2023 (all P<0.05). The crude mortality rate of breast cancer in female was from 7.75/100 000 to 12.34/100 000, the ASMRC of breast cancer in female was from 4.62/100 000 to 7.53/100 000, and the ASMRW of breast cancer in female was from 3.58/100 000 to 5.71/100 000, and the AAPC had no statistically significance. However, the mortality rate of breast cancer was increased with age (P<0.001). The 5-year age-standardized relative survival rate of breast cancer in female in Xiaoshan District was significantly higher in the 2016‒2018 period (94.46%) compared to the 2013‒2015 period (91.02%) (P<0.05). ConclusionFrom 2014 to 2023, the annual incidence of breast cancer among women with registered residence in Xiaoshan District of Hangzhou City in Zhejiang Province showed an increasing trend, while the change in mortality rate was not statistically significant. The 5-year survival rate of breast cancer in female was at a high level, indicating notable achievements in comprehensive prevention and control efforts. It is essential to continue to strengthen public awareness campaigns for breast cancer prevention and control, control breast cancer risk factors, actively carry out early diagnosis and treatment of breast cancer among target groups, and improve the quality of life for breast cancer patients.

Objective To investigate the clinical diagnostic value of serum sTREM2 level in patients with cerebral small vessel disease(CSVD)and its correlation with depression and its severity.Methods A total of 208 CSVD inpatients admitted in Department of Neurology of the First Affiliated Hospital of Shihezi University from December 2023 to November 2024 were en-rolled,and according to their score of HAMD,they were divided into a depression group(CSVD+D group,112 cases)and a non-depression group(CSVD—D group,96 cases).According to the 17-item HAMD,the depression group(CSVD+D group)was further divided into mild(8-17,n=80),moderate(18-24,n=27)and severe depression(≥25,n=5)subgroups.Another 208 healthy individuals who taking health checkups in the same period were selected and served as the control group.The general clinical data were compared among the groups and subgroups,and mul-tivariate logistic regression analysis was applied to identify the risk factors for the occurrence of depression and the relationship between sTREM2 and depression severity in the CSVD patients.ROC curve was plotted to evaluate the predicative performance of serum sTREM2 level for the occurrence of depression in the CSVD patients.Results The serum sTREM2 level was remark-ably higher in the CSVD patients than the control group(5.95±3.82 μg/L vs 1.40±1.21 μg/L,P＜0.01).ROC curve analysis indicated that the AUC value of serum sTREM2 level in predicting CSVD was 0.917,with a sensitivity of 87.52％and a specificity of 85.64％,and an optimal cut-ff value of 2.272 μg/L.The CSVD+D group also had significantly higher serum sTREM2 level than the CSVD—D group(6.40±3.93 μg/L vs 5.01±2.87 μg/L,P＜0.01).Multivariate logistic regression analysis showed that serum sTREM2 level was an independent influencing factor for occurrence of depression in the CSVD patients(OR=1.115,95％CI:1.019-1.220,P=0.018).Statistical difference was also observed in the patients without and with mild,moderate and severe depression(P＜0.05).Multivariate ordinal logistic regression analysis revealed that serum sTREM2 level was an independent influencing factor for mild,moderate and severe depression(OR=1.113,95％CI:1.013-1.223,P=0.026;OR=1.135,95％CI:1.004-1.284,P=0.043).The AUC value of serum sTREM2 level in predicting depressive symptoms in CSVD patients was 0.603.Conclusion Serum sTREM2 is closely associated with CSVD patients.Its level may provide certain reference value for clinical diagnosis of CSVD,and has potentially predictive value for the occurrence of depression in the CSVD patients.

Objective To identify novel biomarkers for predicting the risk of latent tuberculosis infection(LTBI)activation using bio-informatics and machine-learning algorithms and to establish a risk model.Methods The GSE112104 and GSE193777 datasets were obtained from the Gene Expression Omnibus.Differential gene expression and weighted gene co-expression network analyses were per-formed to identify ferroptosis-related differentially expressed genes(FRG-DEGs)associated with LTBI activation.Three machine-learning algorithms,least absolute shrinkage and selection operator,support vector machine-recursive feature elimination,and random forest,were used to identify ferroptosis-related hub genes(FRG-hubs).The reliability of these genes was validated using independent validation datasets and reverse transcription polymerase chain reaction(PCR).A risk model was established using R software.Results In the GSE 112104 dataset,296 genes were upregulated and 1 569 genes were downregulated in active tuberculosis compared to those in LTBI.Among the LTBI progressors,506 genes were upregulated and 1 132 genes were downregulated.Weighted correlation network analysis identified five gene modules,with the blue module showing the strongest correlation with LTBI activation(cor=0.62,P=0.000 04),con-taining 1 340 genes.Intersections with 728 ferroptosis-related genes resulted in eight FRG-DEGs.The machine-learning algorithms iden-tified four FRG-hubs:PLA2G6,GLS2,JUN,and AMN,whose expression decreased with LTBI activation.Reverse transcription PCR con-firmed this trend.A risk model based on these genes yielded an area under the curve of 0.98 to 1.00.Conclusion This study successfully identified novel biomarkers for predicting the risk of LTBI activation and developed an accurate predictive risk model.