Organophosphate flame retardants (OPFRs) have been widely used as the main alternatives to bromine-based flame retardants, resulting in their widespread detection in environmental media and even in human blood. The potential health risks arising therefrom, particularly the direct impacts on the blood system, have become a focus in the field of environmental health. This article systematically reviewed the latest research progress on the hematotoxicity of OPFRs, covering three core aspects: the toxic effects aspect, which systematically elaborated on the bidirectional interference of OPFRs with coagulation function, their toxic effects on the hematopoietic system, and their disruptive effects on blood biochemical metabolism; the mechanistic analysis aspect, which dissected the multi-pathway, multi-target toxic mechanism network of OPFRs, including common pathways based on oxidative stress and inflammatory responses, the direct and indirect regulation of coagulation function mediated by nuclear receptors and endocrine disruption, and the disturbance of blood cell production at the source through disruption of the hematopoietic microenvironment; and the risk assessment aspect, which, in response to the limitations of traditional methods, focused on the application prospects and core advantages of novel approaches based on structure-activity relationships in filling data gaps and achieving precise risk prediction. This review aims to systematically summarize the research progress on the mechanisms of OPFR-induced hematotoxicity, providing systematic theoretical support for subsequent in-depth mechanistic studies, targeted epidemiological investigations, and the optimization of risk assessment models.

ObjectiveTo analyze the risk factors for long-term cardiovascular events in patients undergoing long-term peritoneal dialysis （PD）， and to construct and validate a visual nomogram prediction model based on multiple parameters. MethodsA prospective cohort study was conducted， consecutively enrolling 248 maintenance PD patients （dialysis duration ≥ 3 months）. Demographic characteristics， clinical indicators， laboratory parameters， and echocardiographic indices （including left ventricular ejection fraction ［LVEF］， ratio of early diastolic mitral inflow velocity to early diastolic mitral annular velocity （E/e’）， etc.） were collected. The composite endpoint was defined as the occurrence of cardiovascular events or cardiovascular death， with non-cardiovascular death as the competing risk and loss to follow-up or the end of follow-up as censoring events. Fine-Gray competing risks model was used to screen independent predictors， based on which a nomogram model was constructed. Internal validation was performed using the Bootstrap method （1 000 resamplings）， and the concordance index （C-index） and time-dependent receiver operating characteristic （time-dependent ROC） curve were calculated to evaluate the model performance. ResultsWith a median follow-up of 29 months （interquartile range： 24–35 months）， 88 patients （35.48%） reached the composite endpoint， including 80 cases of cardiovascular events and 8 cases of cardiovascular death， and 4 patients died of non-cardiovascular causes. Multivariate Fine-Gray analysis revealed that age， diabetes mellitus， hemoglobin （HGB） level and E/e' ratio were independent influencing factors of the composite endpoint. Specifically， each 1-year increase in age was associated with a 3.0% increase in the risk of the composite endpoint （HR=1.030， P=0.006）； patients with diabetes mellitus had a 167.9% higher risk compared with non-diabetic patients （HR=2.679， P=0.007）； each 1g/L increase in HGB level contributed to a 1.5% reduction in the risk （HR=0.985， P=0.003）； and each 0.1 increase in E/e' ratio led to a 7.2% increase in the risk （HR=1.072， P=0.045）. The nomogram model had a C-index of 0.76 （95% CI： 0.698–0.820）， and the AUC of the time-dependent ROC curve reached 0.849 at 23 months of follow-up. ConclusionIncreased age， complicated with diabetes mellitus， decreased HGB， and elevated E/e' ratio are independent risk factors of long-term occurrence of cardiovascular events and cardiovascular death in patients undergoing long-term PD. The nomogram model constructed based on the above variables has good predictive value and clinical applicability， which can provide a reference for cardiovascular risk stratification and individualized intervention in long-term PD patients.

BACKGROUND:Cervical disc herniation can cause pain in the neck and shoulder area,as well as radiating pain in the upper limbs.The incidence rate is increasing year by year and tends to affect younger individuals.Fully understanding the biomechanical characteristics of the cervical spine in adolescents is of great significance for preventing and delaying the onset of cervical disc herniation in this age group. OBJECTIVE:To reconstruct cervical spine models for both healthy adolescents and adolescent patients with cervical disc herniation utilizing finite element analysis techniques,to analyze the motion range of the C1-T1 cervical vertebrae as well as the biomechanical characteristics of the annulus fibrosus,nucleus pulposus,endplates,and the cartilage of the small joints. METHODS:A normal adolescent's cervical spine and an adolescent patient with cervical disc herniation were selected in this study.The continuous scan cervical spine CT raw image data were imported into Mimics 21.0 in DICOM format.The C1-T1 vertebrae were reconstructed separately.Subsequently,the established models were imported into the 3-Matic software for disc reconstruction.The perfected models were then imported into Hypermesh software for meshing of the vertebrae,nucleus pulposus,annulus fibrosus,and ligaments,creating valid geometric models.After assigning material properties,the final models were imported into ABAQUS software to observe the joint motion range of the C1-C7 cervical vertebrae segments under different conditions,and to analyze the biomechanical characteristics of the annulus fibrosus,nucleus pulposus,endplates,and small joint cartilage of each cervical spine segment. RESULTS AND CONCLUSION:(1)In six different conditions,the joint motion range of the C1 vertebra in the cervical spine models of both normal adolescent and adolescent patient with cervical disc herniation was higher than that of the other vertebrae.Additionally,the joint motion range of each cervical spine segment in normal adolescent was greater than that in adolescent patient with cervical disc herniation.(2)In the cervical spine model of normal adolescent,the maximum stress values in the annulus fibrosus and nucleus pulposus were found on the left side during C2-3 flexion conditions(0.43 MPa and 0.17 MPa,respectively).In the cervical spine model of adolescent patient with cervical disc herniation,the maximum stress values were found on the left side during C7-T1 flexion conditions(0.54 MPa and 0.18 MPa,respectively).(3)In the cervical spine model of normal adolescent,the maximum stress value on the endplate was found on the left side of the upper endplate of C3 during flexion conditions(1.46 MPa).In the model of adolescent patient with cervical disc herniation,the maximum stress value on the endplate was found on the left side of the lower endplate of C7 during flexion conditions(1.32 MPa).(4)In the cervical spine model of normal adolescent,the maximum stress value in the small joint cartilage was found in the C2-3 left rotation conditions(0.98 MPa).In adolescent patient with cervical disc herniation,the stress in the small joint cartilage significantly increased under different conditions,especially in C1-2,with the maximum stress found during left flexion(3.50 MPa).(5)It is concluded that compared to normal adolescent,adolescent patient with cervical disc herniation exhibits altered cervical curvature and a decrease in overall joint motion range in the cervical spine.In adolescent with cervical disc herniation,there is a significant increase in stress on the annulus fibrosus,nucleus pulposus,and endplates in the C7-T1 segment.The stress on the left articular cartilage of the C1-2 is notable.Abnormal cervical curvature may be the primary factor causing these stress changes.

Colorectal cancer(CRC)is a prevalent malignancy of the digestive tract in China;it exhibits aggressive progression that is closely associated with tumor microenvironment(TME)modulation.Tumor-associated macrophages,which are pivotal immunomodulatory com-ponents of the TME,demonstrate remarkable functional heterogeneity.Among these,secreted phosphoprotein 1-positive tumor-associated macrophages(SPP1+TAMs)represent a distinct subset with well-characterized protumorigenic properties.Evidence indicates that SPP1+TAMs exhibit a unique spatial distribution pattern in CRC tissues,with pronounced enrichment at the invasive tumor front and metastatic niches.Through the secretion of SPP1 and other effector molecules,this subset orchestrates multifaceted oncogenic processes,including tumor cell adhesion,migration,angiogenesis,and metastatic dissemination.This review systematically elucidates the spatial distribution,molecular reg-ulatory mechanisms,and clinical implications of SPP1+TAMs in CRC,thereby providing a theoretical foundation for developingnovel diagnost-ic biomarkers and targeted therapeutic strategies.

[Objective]To explore the academic characteristics and the current status of active inheritance of the acupuncture and moxibustion schools in northern Zhejiang.[Methods]Through literature search,data query,personnel interview and other ways,collect the relevant records of acupuncture and moxibustion in northern Zhejiang,sort out the representative schools and summarize their common academic characteristics.[Results]Upon reviewing the literature,it was discovered that the acupuncture and moxibustion schools in northern Zhejiang had a long and storied history,holding a significant position within the academic system of the"Xiushui medical school".Through historical medical research and interviews,it was summarized that the acupuncture and moxibustion in northern Zhejiang possessed five major academic characteristics:precise acupoint selection,diligent study of classics,skillful application of techniques,compassionate medical practice and emphasis on moxibustion therapy.However,the schools faced challenges such as slow transmission,traditional methods and limited dissemination scope during the process of inheritance.[Conclusion]The acupuncture and moxibustion schools in northern Zhejiang have demonstrated distinct academic characteristics and potential for intergenerational innovation in acupoint theory,manual skills and humanistic care.Their inheritance practices have deepened the academic connotations of the"Xiushui medical school".In the future,it is essential to enhance the current status of active inheritance through modern technology and communication methods to promote the widespread dissemination and sustainable development of the academic ideas of northern Zhejiang acupuncture and moxibustion.

Objective To analyze the modeling and evaluation method for vascular restenosis animal models in the last 10 years,to provide a reference for improving animal models of vascular restenosis.Methods Literature related to vascular restenosis was retrieved from mainstream Chinese and English databases from 2013 to 2023.Data on experimental animal strains,modeling method,modeling cycles,and detection method were extracted from the included literature,and a database was established using Excel for summary analysis.Results Among the 122 identified articles,the main experimental animals were rats,rabbits,and pigs,and most animals were male.The most common modeling method was balloon injury,and the modeling cycle was mainly within 4～8 weeks.The main detection indexes were histopathology,accounting for 37.18％,including routine hematoxylin-eosin,Masson,and Elastica van Gieson(EVG)staining.Conclusions The translatability of porcine vascular restenosis models is currently more in line with expectations,but their cost is high and they are unpopular,and rats and rabbits thus remain the main animal models.Balloon injury is the main mode of modeling.Different animal models and modeling method for vascular restenosis have advantages and disadvantages,and the model should be selected according to the experimental purpose.Animal models of vascular restenosis still have some limitations,however,and better animal models are required in the future.

Inflammatory bowel disease(IBD)is a non-specific chronic inflammatory bowel condition.Crohn's disease(CD)and ulcerative colitis(UC)are the 2 main types of IBD.IBD is prone to recurrent attacks,which is associated with many factors,such as immune dysfunction,intestinal microenvironment homeostasis imbalance,and environmental and genetic factors;however,its specific pathogenesis is still unclear.Zebrafish has recently emerged as an emerging animal model and have been used extensively for mechanistic research into IBD,model construction,activity evaluation,and screening of anti-IBD agents,due to their unique biological advantages.Based on the latest research progress using zebrafish in the field of IBD,this review systematically introduces the intestinal development characteristics,tissue structure,intestinal immunity,IBD model,and the application of drug screening in zebrafish,to demonstrate the value of zebrafish in the study of IBD.

Duodenum-preserving pancreatic head resection， also known as Beger surgery， has a high incidence rate of bile duct injury after surgery， while the treatment modality for bile duct injury depends on the severity of the injury， and endoscopic therapy is often challenging in case of severe bile duct injury. Recently a patient with biliary fistula after Beger surgery was admitted to Affiliated Hangzhou First People’s Hospital， Westlake University， and successful diagnosis and treatment were achieved through oral choledochoscopy-assisted percutaneous-endoscopic rendezvous technique.

Objective To analyze the modeling and evaluation method for vascular restenosis animal models in the last 10 years,to provide a reference for improving animal models of vascular restenosis.Methods Literature related to vascular restenosis was retrieved from mainstream Chinese and English databases from 2013 to 2023.Data on experimental animal strains,modeling method,modeling cycles,and detection method were extracted from the included literature,and a database was established using Excel for summary analysis.Results Among the 122 identified articles,the main experimental animals were rats,rabbits,and pigs,and most animals were male.The most common modeling method was balloon injury,and the modeling cycle was mainly within 4～8 weeks.The main detection indexes were histopathology,accounting for 37.18％,including routine hematoxylin-eosin,Masson,and Elastica van Gieson(EVG)staining.Conclusions The translatability of porcine vascular restenosis models is currently more in line with expectations,but their cost is high and they are unpopular,and rats and rabbits thus remain the main animal models.Balloon injury is the main mode of modeling.Different animal models and modeling method for vascular restenosis have advantages and disadvantages,and the model should be selected according to the experimental purpose.Animal models of vascular restenosis still have some limitations,however,and better animal models are required in the future.

Objective:To assess the trends in the burden of periodontal disease among individuals aged 60 years and above in China from 1990 to 2021, thereby providing a scientific foundation for the development of targeted prevention and control strategies for periodontal disease in the elderly.Methods:Utilizing data from the Global Burden of Disease Study 2021 (GBD 2021), key indicators including incidence, prevalence, and disability-adjusted life years (DALY) rates were analyzed. Age-standardized rates were determined using the global standard population. Trends in the disease burden of periodontal disease among the elderly population in China from 1990 to 2021 were analyzed using Joinpoint regression analysis, and an autoregressive integrated moving average (ARIMA) model was applied to forecast the disease burden from 2022 to 2036.Results:The annual average percentage changes (AAPC) in the number of incident cases, prevalent cases, and DALYs due to periodontal disease among individuals aged 60 years and above in China from 1990 to 2021 were 3.215% (95% CI: 3.149%-3.281%, P<0.05), 3.161% (95% CI:3.037%-3.286%, P<0.05), and 3.091%(95% CI: 2.887%-3.296%, P<0.05), respectively. The results indicated that the average annual change trends of the number of incident cases, number of prevalent cases, and number of DALYs were real upward trends. Compared with other age groups, the number of incident cases, prevalent cases, and DALYs were the highest among the population aged 60-69 years. The AAPC for age-standardized incidence rate, prevalence, and DALY rates were -0.012% (95% CI:-0.031%-0.008%, P>0.05), 0.023% (95% CI:-0.070%-0.116%, P>0.05), and 0.013% (95% CI:-0.089%-0.115%, P>0.05), respectively. This indicated that the average annual change trends of the age-standardized incidence rate, age-standardized prevalence rate, and age-standardized DALY rate might be caused by random fluctuations. Males exhibited higher prevalence and DALY rates than females across all age groups ( P<0.05), whereas the incidence rates showed minimal differences between males and females across all age groups. The ARIMA forecast model indicated that the age-standardized incidence rate among males in the elderly population in China was relatively stable, while that among females showed a downward trend; the age-standardized prevalence and DALY rates followed a pattern of "decline-rise-decline". Conclusions:The disease burden of periodontal disease among Chinese adults aged 60 and above showed an overall upward trend from 1990 to 2021, with males and individuals aged 60-69 identified as high-risk groups. With the exacerbation of aging, the prevention and control situation remains severe, necessitating the implementation of gender-differentiated interventions to reduce the disease burden.