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.

OBJECTIVE: To observe the clinical efficacy of wrist-ankle acupuncture in the treatment of functional frequent premature ventricular contractions (PVCs). METHODS: A total of 64 patients with functional frequent PVCs were randomly divided into an observation group and a control group, 32 cases in each group. The observation group was treated with wrist-ankle acupuncture at bilateral upper 1 and upper 2 on the wrist. The control group received sham acupuncture at the same points as the observation group. Both groups were treated once every day from Monday to Friday, with the needles retained for 60 min each time, for a total of 4 weeks. The TCM syndrome score, the 24-hour PVC count, and MOS 36-item short form health survey (SF-36) score were compared between the two groups before and after treatment, and the clinical efficacy was evaluated after treatment. RESULTS: After treatment, the TCM syndrome scores and the 24-hour PVC counts in both groups were reduced compared with those before treatment (P<0.01), and the above indexes in the observation group were lower than those in the control group (P<0.01). After treatment，scores of all SF-36 items in the observation group were increased compared with those before treatment (P<0.01); in the control group, the scores of general health (GH), social function (SF) and role-emotional (RE) were increased compared with those before treatment (P<0.05). After treatment, scores of all SF-36 items in the observation group were higher than those in the control group (P<0.01). The total effective rate in the observation group was 90.6% (29/32), which was higher than 46.9% (15/32) in the control group (P<0.01). CONCLUSION Wrist-ankle acupuncture has a significant clinical efficacy in the treatment of functional frequent PVCs. It can effectively improve symptoms such as chest tightness and palpitations, reduce 24-hour PVC count, and improve patients' quality of life.
Humans ; Acupuncture Therapy ; Male ; Female ; Middle Aged ; Adult ; Ventricular Premature Complexes/physiopathology* ; Ankle/physiopathology* ; Wrist/physiopathology* ; Acupuncture Points ; Treatment Outcome ; Aged ; Young Adult

Peritoneal dialysis (PD) is a crucial renal replacement therapy for end-stage renal disease (ESRD), offering significant advantages as high flexibility, hemodynamic stability, and high cost-effectiveness. However, prolonged exposure to intra-abdominal dialysate may predispose to the mechanical complication of abdominal external hernia. Abdominal external hernia may lead to various adverse clinical outcomes. In severe cases, it can progress to incarceration or even rupture, ultimately necessitating discontinuation of the therapy. The authors systematically review PD-associated abdominal external hernias, including their clinical landscape, risk factors, surgical treatment strategies and prognostic determinants. They also assess the effects of hernia repair on residual renal function, aiming to provide references for clinical decision-making.

Objective To investigate the association between cerebrospinal fluid(CSF)oligoclonal band(OCB)positivity and clinical manifestations in patients with neuromyelitis optica spectrum disorder(NMOSD).Methods A retrospective analysis of clinical data from patients with NMOSD treated at our hospital from May 2019 to January 2024 was conducted.Based on OCB test results,patients were categorized into OCB-positive and OCB-negative groups.We compared baseline characteristics between the two groups and analyzed the relationship between clinical features and OCB positivity.Results This study included a total of 62 patients,comprising 17 in the OCB+group and 45 in the OCB-group.Compared with the OCB-group,patients in the OCB+group exhibited more pronounced central nervous system inflammatory features.Specifically,OCB+group had significantly higher proportions of patients with cerebrospinal fluid white blood cell counts>8×10?/L(64.7%vs.26.7%,P=0.003)and elevated immunoglobulin indices(0.72 vs.0.61,P=0.037).Additionally,the OCB+group exhibited more complex and diverse clinical presentations.Specifically,this group showed a higher incidence of mild consciousness impairment during the acute phase(P=0.005)and a greater tendency to present with multiple core symptoms(≥3 core symptoms)occurring concurrently(52.9%vs.20.0%,P=0.025)and misdiagnosis(29.4%vs.8.9%,P=0.101).This was particularly notable when comparing to acute myelitis involving the cervical spinal cord(82.4%vs.53.3%,P=0.036)and acute diencephalic syndrome[41.2%vs.6.7%,P=0.004,including hyponatremia(35.3%vs.8.9%,P=0.033)].Multivariate logistic regression analysis demonstrated that OCB positivity(OR=3.895,95%CI:1.065-14.249)was significantly associated with the presence of multiple core symptoms.Conclusion In acute-phase NMOSD patients,OCB+is associated with significantly higher rates of co-occurrence of multiple core symptoms(≥3 core symptoms)and misdiagnosis.Notably,acute myelitis involving the cervical spinal cord and acute diencephalic clinical syndrome are particularly prevalent in this OCB+subgroup.The clinical manifestations are complex and diverse,suggesting the need for enhanced clinical identification and timely intervention.

Objective To explore the effects of heat-sensitive moxibustion intervention on the expression of programmed death re-ceptor-1(PD-1)and its downstream PI3K/Akt/mTOR signaling pathway-related proteins in ovalbumin(OVA)-induced allergic rhinitis(AR)rats,and to elucidate the potential mechanism of its therapeutic treatment of AR.Methods Sixty SD rats were randomly divided into the blank group(n=10)and the modeling group(n=50),and AR models were prepared with normal saline and OVA,re-spectively.After successful modeling,the modeled rats were randomly divided into model group(n=10),moxibustion group(n=20),positive drug group(n=10)and PD-1 inhibitor group(n=10).The blank group had no intervention;the model group and the positive drug group were given normal saline/fluticasone propionate nasal spray nasal drops,8μl/side,once a day for 21 days;the PD-1 inhibitor group was blocked from the intervention for7days before sensitization was stimulated;the moxibustion group was treated with thermal mox-ibustion moxa strips suspended on the"feishu point"(once a day,40minutes each time),and the changes of the body and tail tempera-tures were recorded in the course of the intervention,for a total of 21 days.After the last treatment,the moxibustion group was divided into moxibustion group(n=9)and thermal moxibustion group(n=11)according to the changes in body and tail temperature.After the inter-vention,hematoxylin-eosin staining was used to observe the morphology of nasal mucosa,immunofluorescence and Western blot was used to detect the expressions of PD-1 and PI3K/Akt/mTOR-related proteins,and real-time fluorescence quantitative polymerase chain re-action(RT-qPCR)was used to detect the expression of related genes in spleen tissues.Results Compared with the blank group,the expression of PD-1 and PI3K,Akt,mTOR and their phosphorylation levels were significantly elevated in the rats of model group(P＜0.05).After the intervention of thermal moxibustion,the protein and mRNA expression of PD-1 and PI3K,Akt,mTOR,as well as the ratios of p-PI3K/PI3K,p-Akt/Akt,and p-mTOR/mTOR were significantly decreased compared with that of the model group(P＜0.05),and the down-regulation tendency was similar to that of the moxibustion group,the positive drug group and the PD-1 inhibitor group.Conclusion Thermal moxibustion at the"feishu point"can effectively improve nasal inflammation and tissue damage in AR rats,and its mechanism may be related to the down-regulation of PD-1 expression and the inhibition of downstream PI3 K/Akt/mTOR signa-ling pathway activation.

Objective To investigate the association between cerebrospinal fluid(CSF)oligoclonal band(OCB)positivity and clinical manifestations in patients with neuromyelitis optica spectrum disorder(NMOSD).Methods A retrospective analysis of clinical data from patients with NMOSD treated at our hospital from May 2019 to January 2024 was conducted.Based on OCB test results,patients were categorized into OCB-positive and OCB-negative groups.We compared baseline characteristics between the two groups and analyzed the relationship between clinical features and OCB positivity.Results This study included a total of 62 patients,comprising 17 in the OCB+group and 45 in the OCB-group.Compared with the OCB-group,patients in the OCB+group exhibited more pronounced central nervous system inflammatory features.Specifically,OCB+group had significantly higher proportions of patients with cerebrospinal fluid white blood cell counts>8×10?/L(64.7%vs.26.7%,P=0.003)and elevated immunoglobulin indices(0.72 vs.0.61,P=0.037).Additionally,the OCB+group exhibited more complex and diverse clinical presentations.Specifically,this group showed a higher incidence of mild consciousness impairment during the acute phase(P=0.005)and a greater tendency to present with multiple core symptoms(≥3 core symptoms)occurring concurrently(52.9%vs.20.0%,P=0.025)and misdiagnosis(29.4%vs.8.9%,P=0.101).This was particularly notable when comparing to acute myelitis involving the cervical spinal cord(82.4%vs.53.3%,P=0.036)and acute diencephalic syndrome[41.2%vs.6.7%,P=0.004,including hyponatremia(35.3%vs.8.9%,P=0.033)].Multivariate logistic regression analysis demonstrated that OCB positivity(OR=3.895,95%CI:1.065-14.249)was significantly associated with the presence of multiple core symptoms.Conclusion In acute-phase NMOSD patients,OCB+is associated with significantly higher rates of co-occurrence of multiple core symptoms(≥3 core symptoms)and misdiagnosis.Notably,acute myelitis involving the cervical spinal cord and acute diencephalic clinical syndrome are particularly prevalent in this OCB+subgroup.The clinical manifestations are complex and diverse,suggesting the need for enhanced clinical identification and timely intervention.

[Objective]To explore the effects of astragalin(AST)on autophagy and apoptosis of astrocytes in the L4-5 dorsal horn of the spinal cord in mice with inflammatory pain induced by complete Freund's adjuvant(CFA).[Methods]Twenty-four male C57BL/6 mice,aged six months,were randomly assigned to four groups:control group,saline group,CFA model group,and CFA+AST group,six mice in each group.The inflammatory pain model was established by injection of 10 μL CFA into the right lateral malleolus fossa.The saline group were injected with an equal amount of normal saline at the same site.The inflammatory pain mice in CFA+AST group were further treated with AST(60 mg/kg)intraperitoneally once a day for 21 consecutive days.Multiplex immunofluorescence staining was used to detect the coexpression of autophagy-related factors including ATG 12 and Beclin-1,apoptosis-related factors including Cleaved-Caspase3 and Caspase9,and the astrocyte marker such as GFAP in the L4-5 spinal dorsal horn of the mice in each group.Western blot was used to examine the protein expression levels of autophagy-related proteins(ATG12,Beclin-1)and apoptosis-related proteins(Caspase 3,Caspase 9)in the L4-5 spinal dorsal horn of mice.[Results]Immunofluorescent staining showed that in the L4-5 dorsal horn of the spinal cord,the fluorescence intensity of ATG12(P<0.000 1)and Beclin-1(P<0.000 1)was significantly increased,while that of Cleaved-Caspase 3(P<0.001)and Caspase 9(P<0.000 1)was decreased in the CFA+AST group when compared to the CFA model group.Furthermore,AST could inhibit the activation of astrocytes.Western blot further confirmed that AST significantly upregulated the expression of ATG12(P<0.000 1)and Beclin-1(P<0.000 1)in the L4-5 spinal cord of CFA mice,and downregulated the expression of Caspase 3(P<0.01)and Caspase 9(P<0.001).[Conclusions]AST promotes autophagy of astrocytes and inhibits their apoptosis in the L4-5 spinal dorsal horn of CFA mice.

Objective To explore the effects of heat-sensitive moxibustion intervention on the expression of programmed death re-ceptor-1(PD-1)and its downstream PI3K/Akt/mTOR signaling pathway-related proteins in ovalbumin(OVA)-induced allergic rhinitis(AR)rats,and to elucidate the potential mechanism of its therapeutic treatment of AR.Methods Sixty SD rats were randomly divided into the blank group(n=10)and the modeling group(n=50),and AR models were prepared with normal saline and OVA,re-spectively.After successful modeling,the modeled rats were randomly divided into model group(n=10),moxibustion group(n=20),positive drug group(n=10)and PD-1 inhibitor group(n=10).The blank group had no intervention;the model group and the positive drug group were given normal saline/fluticasone propionate nasal spray nasal drops,8μl/side,once a day for 21 days;the PD-1 inhibitor group was blocked from the intervention for7days before sensitization was stimulated;the moxibustion group was treated with thermal mox-ibustion moxa strips suspended on the"feishu point"(once a day,40minutes each time),and the changes of the body and tail tempera-tures were recorded in the course of the intervention,for a total of 21 days.After the last treatment,the moxibustion group was divided into moxibustion group(n=9)and thermal moxibustion group(n=11)according to the changes in body and tail temperature.After the inter-vention,hematoxylin-eosin staining was used to observe the morphology of nasal mucosa,immunofluorescence and Western blot was used to detect the expressions of PD-1 and PI3K/Akt/mTOR-related proteins,and real-time fluorescence quantitative polymerase chain re-action(RT-qPCR)was used to detect the expression of related genes in spleen tissues.Results Compared with the blank group,the expression of PD-1 and PI3K,Akt,mTOR and their phosphorylation levels were significantly elevated in the rats of model group(P＜0.05).After the intervention of thermal moxibustion,the protein and mRNA expression of PD-1 and PI3K,Akt,mTOR,as well as the ratios of p-PI3K/PI3K,p-Akt/Akt,and p-mTOR/mTOR were significantly decreased compared with that of the model group(P＜0.05),and the down-regulation tendency was similar to that of the moxibustion group,the positive drug group and the PD-1 inhibitor group.Conclusion Thermal moxibustion at the"feishu point"can effectively improve nasal inflammation and tissue damage in AR rats,and its mechanism may be related to the down-regulation of PD-1 expression and the inhibition of downstream PI3 K/Akt/mTOR signa-ling pathway activation.

Objective:To explore the association between childhood trauma and prefrontal cortex functional networks in early adulthood using functional near-infrared spectroscopy(fNIRS).Methods:Twenty-eight individu-als with childhood trauma comprised the trauma group,while 32 without trauma formed the control group.The Childhood Trauma Questionnaire(CTQ)assessed abuse and neglect,the Ruminative Responses Scale(RRS)meas-ured repetitive thinking about negative events,and the Iowa Gambling Task(IGT)evaluated decision-making tend-encies.fNIRS data collected during the IGT were used to calculate degree centrality(DC),betweenness centrality(BC),and local efficiency(LE)in prefrontal networks.Mediation analysis explored relationships among childhood trauma,brain function(DC,BC,LE),and ruminative thinking.Results:Compared to controls,the trauma group had decreased DC in bilateral dorsolateral prefrontal cortices,increased DC,BC,and LE in the right inferior frontal gy-rus,and elevated LE in the bilateral frontal poles.BC and LE in the right inferior frontal gyrus partially mediated the relationship between CTQ sexual abuse and RRS scores(48.57％and 41.43％,respectively).Conclusion:Child-hood trauma is significantly associated with changes in prefrontal network properties in early adulthood.Sexual a-buse,in particular,may influence emotional regulation and cognitive functions by altering the network attributes of the right inferior frontal gyrus.

Based on WANG Xugao's"thirty liver-regulating methods,"this paper summarized the clinical thinking of treating diabetic kidney disease from the liver.The liver is closely associated with the pathogenesis of diabetic kidney disease,including internal heat,essence depletion,latent wind,and the accumulation and dissipation of a conglomeration of kidney collateral zhengjia.WANG Xugao's"thirty liver-regulating methods"comprehensively reveals the physiological and pathological changes of the liver,as well as clinical approaches for liver treatment.Liver qi stagnation can lead to the generation of internal heat,liver stagnation and deficiency can cause essence depletion and collateral obstruction,and disharmony of the liver wood can cause internal wind disturbance,which all contribute to the progression of diabetic kidney disease at different stages.Treatment generally follows the essence of"thirty liver-regulating methods."In the early stage,treatment should focus on treating liver heat by soothing the liver qi,clearing the liver fire,and removing damp-heat to resolve stagnation and heat.In the middle stage,treatment should focus on treating liver deficiency by nourishing the liver yin to clear heat,replenishing the essence and blood to tonify deficiency,and promoting blood circulation to remove stasis,thereby strengthening the foundation and nurturing the primal essence.In the later stage,treatment should focus on treating liver wind to prevent complications and improve the patient's quality of life.Throughout the entire process,liver collaterals are treated using pungent herbs to invigorate qi and open the liver channels,relieving blood stasis and promoting circulation.In conjunction with the above methods,flexible selection of effective formulas and drug pairs should be used,each addressing specific treatment goals.