Objective: To investigate the associations between childhood obesity and performance of six minute walk test (6MWT), providing evidence for exercise tolerance assessment and exercise intervention strategies for children and adolescents. Methods: From March 2021 to December 2023, a cohort study was conducted among students recruited from a primary and secondary school in Chongqing, a total of 709 valid samples were included. The 6MWT was used to assess exercise tolerance, with vital signs measured before and after the test. Anthropometric indicators, including height, weight, and waist circumference, were measured using standardized procedures. Generalized additive models (GAM) and restricted cubic spline (RCS) regression were employed to analyze the nonlinear relationships between obesity related indicators and six minute walk distance (6MWD). Results: The mean 6MWD of participants was (602.59±70.73)m. GAM showed that after adjusting for confounding factors, body mass index (BMI) and weight had non linear relationships with 6MWD [effective degrees of freedom were 1.55 and 7.13 respectively], and overweight/obesity was associated with a decrease in 6MWD ( β =-18.65) (all P <0.01). Further RCS regression analysis showed that both BMI and weight showed an "inverted U shaped" non linear relationship with 6MWD in the overall population and sex stratified subgroups; the 6MWD of females was lower than that of males, and it showed a significant downward trend with the increase of BMI or weight (all P <0.05). Conclusion Body weight and BMI in children and adolescents have an important impact on 6MWD, and obesity in children and adolescents is markedly associated with decline in exercise tolerance.

The Janus kinase/signal transducers and activators of transcription (JAK-STAT) control natural killer (NK) cells development and cytotoxic functions, however, whether long non-coding RNAs (lncRNAs) are involved in this pathway remains unknown. We found that miR155HG was elevated in activated NK cells and promoted their proliferation and effector functions in both NK92 and induced-pluripotent stem cells (iPSCs)-derived NK (iPSC-NK) cells, without reliance on its derived miR-155 and micropeptide P155. Mechanistically, miR155HG bound to miR-6756 and relieved its repression of JAK3 expression, thereby promoting the JAK-STAT pathway and enhancing NK cell proliferation and function. Further investigations disclosed that upon cytokine stimulation, STAT3 directly interacts with miR155HG promoter and induces miR155HG transcription. Collectively, we identify a miR155HG-mediated positive feedback loop of the JAK-STAT signaling. Our study will also provide a power target regarding miR155HG for improving NK cell generation and effector function in the field of NK cell adoptive transfer therapy against cancer, especially iPSC-derived NK cells.

Chronic refractory wound （CRW） presents significant clinical treatment challenges due to pathological characteristics such as persistent inflammation， bacterial infection， oxidative stress and inadequate angiogenesis. Astragali Radix， a traditional Chinese medicinal herb， exerts multi-target pharmacological effects on CRW through its active components， including Astragalus polysaccharides， flavonoids， and astragaloside Ⅳ， etc. Fundamental studies indicate that these components promote CRW healing by modulating inflammatory responses， inhibiting pathogen growth， improving antioxidant capacity and stimulating neovascularization. Network pharmacology and bioinformatics studies have revealed that active components of Astragali Radix target and modulate key signaling nodes such as nuclear factor-κB， phosphatidylinositol 3-kinase/Akt， AMP-activated protein kinase， and vascular endothelial growth factor receptor， as well as inflammation-angiogenesis-related pathways， thereby synergistically exerting anti-inflammatory and pro-angiogenic effect. Clinical applications have demonstrated that oral formulations （e.g.， Huangqi guizhi decoction， Danggui huangqi decoction， etc.） reduce healing time of CRW and lower inflammatory marker levels， while topical preparations （e.g.， Zizhu ointment， Huangqi shengji ointment， electrostatically spun Astragalus polysaccharide composite nanofibre dressings， etc.） significantly improve healing rates of CRW and minimize complications.

Objective:To investigate the disease burden, clinical characteristics and independent risk factors affecting in-hospital outcomes of children with congenital heart disease (CHD) combined with heart failure (HF) in China.Methods:(1) Descriptive study: based on the global burden of disease study 2021, available data on children under 15 years of age with CHD and HF in China from 1990 to 2021 were collected. The prevalence and trends in different age subgroups (<1 year, 1-<2 years, 2-<5 years, 5-<10 years, 10-<15 years) were analyzed, and the annual percentage change (EAPC) was estimated using linear regression. (2) Retrospective cohort study: a total of 1 062 children with CHD and HF from a multicenter study on pediatric HF in China were included. The children were divided into two groups:<2 years group and 2-<18 years group. Data on demographics, clinical features, diagnosis, treatments, and in-hospital outcomes were analyzed. Mann-Whitney U test and chi-square test were used for group comparisons.Multivariable Logistic regression was applied to identify factors influencing outcomes (in-hospital mortality and adverse cardiovascular events). Results:(1) From 1990 to 2021, the number of children with CHD and HF in China increased from 333 000 (95% uncertainty interval ( UI) 271 000-405 000) to 368 000 (95% UI 296 000-459 000), a growth of 10.8% (95% UI 5.0%-16.6%). Concurrently the prevalence rate increased from 104.5 (95% UI 85.1-127.3) per 100 000 to 142.0 (95% UI 114.0-176.8) per 100 000, a growth of 35.9% (95% UI 28.7%-43.0%), with an EAPC of 1.5% (95% CI 1.2%-1.8%). Although the number of cases in the<1 year and 1-<2 years groups decreased by 41.0% and 25.6%, respectively, the prevalence in all age groups showed an upward trend:<1 year EAPC 0.6% (95% CI 0.5%-0.7%); 1-<2 years EAPC 0.9% (95% CI 0.8%-1.0%); 2-<5 years EAPC 1.2% (95% CI 1.0%-1.4%); 5-<10 years EAPC 1.5% (95% CI 1.2%-1.8%); 10-<15 years EAPC 2.1% (95% CI 1.9%-2.3%). (2) The multicenter study revealed that among 1 062 hospitalized children, 528 (49.7%) were male and 534 (50.3%) were female, with the age at admission of 5.4 (2.2,18.2) months. The majority of the children (77.9%, 827/1 062) were under 2 years of age, whereas 22.1% (235/1 062) were aged between 2-<18 years. Children with complex congenital heart defects accounted for the highest proportion (48.6%, 516/1 062), while those with isolated CHD made up 31.5% (335/1 062). Statistically significant differences were observed in several variables in demographics, clinical features, diagnosis, treatments, and outcomes between the two age groups (all P<0.05). The use of renin-angiotensin-aldosterone system inhibitors (41.1%, 436/1 062) and beta-blockers (8.7%, 92/1 062) was lower in hospitalized children with CHD and HF. Logistic regression identified complex CHD ( OR=7.73, 95% CI 2.24-26.63; OR=3.17, 95% CI 1.92-5.23), pulmonary hyperperfusion ( OR=2.15, 95% CI 1.01-4.18; OR=2.00, 95% CI 1.35-2.97), left ventricular ejection fraction<55% ( OR=2.13, 95% CI 1.08-4.21; OR=2.80, 95% CI 1.45-5.56), arterial oxygen partial pressure ( OR=0.99, 95% CI 0.98-0.99; OR=0.99, 95% CI 0.98-0.99), and serum calcium levels ( OR=0.31, 95% CI 0.17-0.58; OR=0.42, 95% CI 0.28-0.62) as independent risk factors for in-hospital mortality and cardiovascular events. Conclusions:The disease burden of CHD combined with HF in China has shown a continuous upward trend from 1990 to 2021, with higher growth rates in older age groups. Complex CHD, pulmonary hyperperfusion, left ventricular ejection fraction <55%, arterial oxygen partial pressure, and serum calcium concentration are independent risk factors for in-hospital mortality and cardiovascular events.

Objective:To investigate the disease burden, clinical characteristics and independent risk factors affecting in-hospital outcomes of children with congenital heart disease (CHD) combined with heart failure (HF) in China.Methods:(1) Descriptive study: based on the global burden of disease study 2021, available data on children under 15 years of age with CHD and HF in China from 1990 to 2021 were collected. The prevalence and trends in different age subgroups (<1 year, 1-<2 years, 2-<5 years, 5-<10 years, 10-<15 years) were analyzed, and the annual percentage change (EAPC) was estimated using linear regression. (2) Retrospective cohort study: a total of 1 062 children with CHD and HF from a multicenter study on pediatric HF in China were included. The children were divided into two groups:<2 years group and 2-<18 years group. Data on demographics, clinical features, diagnosis, treatments, and in-hospital outcomes were analyzed. Mann-Whitney U test and chi-square test were used for group comparisons.Multivariable Logistic regression was applied to identify factors influencing outcomes (in-hospital mortality and adverse cardiovascular events). Results:(1) From 1990 to 2021, the number of children with CHD and HF in China increased from 333 000 (95% uncertainty interval ( UI) 271 000-405 000) to 368 000 (95% UI 296 000-459 000), a growth of 10.8% (95% UI 5.0%-16.6%). Concurrently the prevalence rate increased from 104.5 (95% UI 85.1-127.3) per 100 000 to 142.0 (95% UI 114.0-176.8) per 100 000, a growth of 35.9% (95% UI 28.7%-43.0%), with an EAPC of 1.5% (95% CI 1.2%-1.8%). Although the number of cases in the<1 year and 1-<2 years groups decreased by 41.0% and 25.6%, respectively, the prevalence in all age groups showed an upward trend:<1 year EAPC 0.6% (95% CI 0.5%-0.7%); 1-<2 years EAPC 0.9% (95% CI 0.8%-1.0%); 2-<5 years EAPC 1.2% (95% CI 1.0%-1.4%); 5-<10 years EAPC 1.5% (95% CI 1.2%-1.8%); 10-<15 years EAPC 2.1% (95% CI 1.9%-2.3%). (2) The multicenter study revealed that among 1 062 hospitalized children, 528 (49.7%) were male and 534 (50.3%) were female, with the age at admission of 5.4 (2.2,18.2) months. The majority of the children (77.9%, 827/1 062) were under 2 years of age, whereas 22.1% (235/1 062) were aged between 2-<18 years. Children with complex congenital heart defects accounted for the highest proportion (48.6%, 516/1 062), while those with isolated CHD made up 31.5% (335/1 062). Statistically significant differences were observed in several variables in demographics, clinical features, diagnosis, treatments, and outcomes between the two age groups (all P<0.05). The use of renin-angiotensin-aldosterone system inhibitors (41.1%, 436/1 062) and beta-blockers (8.7%, 92/1 062) was lower in hospitalized children with CHD and HF. Logistic regression identified complex CHD ( OR=7.73, 95% CI 2.24-26.63; OR=3.17, 95% CI 1.92-5.23), pulmonary hyperperfusion ( OR=2.15, 95% CI 1.01-4.18; OR=2.00, 95% CI 1.35-2.97), left ventricular ejection fraction<55% ( OR=2.13, 95% CI 1.08-4.21; OR=2.80, 95% CI 1.45-5.56), arterial oxygen partial pressure ( OR=0.99, 95% CI 0.98-0.99; OR=0.99, 95% CI 0.98-0.99), and serum calcium levels ( OR=0.31, 95% CI 0.17-0.58; OR=0.42, 95% CI 0.28-0.62) as independent risk factors for in-hospital mortality and cardiovascular events. Conclusions:The disease burden of CHD combined with HF in China has shown a continuous upward trend from 1990 to 2021, with higher growth rates in older age groups. Complex CHD, pulmonary hyperperfusion, left ventricular ejection fraction <55%, arterial oxygen partial pressure, and serum calcium concentration are independent risk factors for in-hospital mortality and cardiovascular events.

Congenital heart disease (CHD) is one of the leading causes of heart failure (HF) in pediatrics.In 2024, the American Heart Association, based on existing knowledge and research findings, issued its first scientific statement on the assessment and management of HF in children and adolescents with CHD.The statement emphasizes the current lack of understanding of the epidemiology, pathophysiology, staging, and outcomes of chronic HF in pediatrics with CHD, and calls for the development of standardized definitions, monitoring protocols, and treatment strategies to improve the clinical outcomes and quality of life for this population.This article interprets the main content of the statement, aiming to provide reference and guidance for the accurate assessment and comprehensive management of chronic HF in children and adolescents with CHD.

Congenital heart disease (CHD) is the most frequent congenital malformation in children.With the improvement of the diagnosis and treatment of CHD, most children can survive to adulthood without suffering cardiovascular diseases.However, relevant research suggests that health-related quality of life (HRQOL) of some children with CHD after surgery still differs from that of healthy children of the same age.Based on a brief review of the concept of HRQOL, effective evaluation tools and the research status at home and abroad, disputes among relevant research conclusions in different countries or regions were discussed in this article.The influence of the child, family and diagnosis and treatment on postoperative HRQOL of children with CHD was analyzed.Approaches and response plans were put forward to improve postoperative HRQOL.In addition, the limitations of past research were pointed out, and suggestions were made on future research methods, tools and directions in this field.It′s hoped that this study can provide valuable information for CHD diagnosis and treatment and reference for follow-up research.

Objective:To evaluate the ability of Sysmex urine automatic analyzer UF-5000 to detect renal tubular epithelial cells, and to explore the value of detection of renal tubular epithelial cells in renal tubular injury of diabetes mellitus.Methods:Case control study. 452 urine samples were collected from the third Xiangya Third Hospital of Central South University from October 2018 to April 2019 (252 in the control group, 113 in diabetes without renal injury group and 87 in diabetes with renal injury group). All samples were detected by both UF-5000 and microscopic examination, established reference range for normal population, then contrasted the coincidence rate and uniformity of the two methods, to evaluate the ability of urine automatic analyzer UF-5000 to detect renal tubular epithelial cells, and the diagnostic value of tubular epithelial cells for renal tubular injury in diabetic patients. All statistical analyses were performed using SPSS17.0, Kappa consistency analysis, ROC curve analysis, Kruskal-Wallis test and Chi-square test were used.Results:The reference range of renal tubular epithelial cells by Sysmex urine automatic analyzer UF-5000 is 0-1.7/μl. The results of the two methods were analyzed by Kappa consistency analysis. The Kappa value was 0.699, P>0.05, which meant highly consistent. ROC curve analysis showed when cut-off value was 1.7/μl. The sensitivity, specificity and area under ROC curve were 0.791, 0.817 and 0.861 respectively. The median of renal tubular epithelial cells was 0.4/μl, 2.0/μl and 2.3/μl in the healthy control group, the diabetes without renal injury group and the diabetes with renal injury group, respectively; the positive rate of renal tubular epithelial cells in the three groups were 2.78%, 56.64% and 75.86% respectively. Compared with the control group, the median and positive rate of renal tubular epithelial cells in the diabetes without renal injury group and the diabetes with renal injury group were significant different; there was also significant difference in the positive rate of renal tubular epithelial cells between the two groups. Conclusion:Compared with the control group, the positive rate of urine renal tubular epithelial cells indiabetes without renal injury group is significantly higher, which is helpful to detect renal tubular injury, to carry out early intervention and to prolong the time of progression to chronic kidney disease.

Objective:To explore the association between nighttime sleep duration and semen quality.Methods:By using a cross-sectional study, 3357 men were investigated by questionnaire for nighttime sleep duration, the time of falling asleep and falling asleep duration in the Reproductive Center of Shenzhen People's Hospital from August 2017 to August 2018. Semen quality parameters were obtained by computer-aided semen analysis system (CASA). Multiple linear regression was used to analyze the relationship between nighttime sleep duration and semen quality parameters. According to age and body mass index (BMI) stratification, the relationship between nighttime sleep duration and semen quality parameters was further discussed.Results:Compared with males with nighttime sleep duration between 6-8 h, the sperm progressive motility and total motility were 49.15% and 59.49%, respectively, which were significantly lower in the males with nighttime sleep duration≥8 h after adjusting for age, BMI, abstinence time, exercise, drinking and smoking, with regression coefficients, β=-3.16, 95% confidence interval ( CI)=-5.77--0.55 and β=-3.22, 95% CI=-5.93--0.51, respectively. Compared with the shortest duration of falling asleep group (<10 min), the increase of falling asleep duration was related to the decrease of sperm progressive motility ( P=0.045). The total sperm motility of falling asleep duration between 31-60 min group was also significantly lower than that of the shortest falling asleep duration group （ β=-3.80, 95% CI=-6.54--1.06, P=0.007）. Further stratification analysis showed that among the subjects aged 35 to 39 years, the sperm progressive motility of men with nighttime sleep duration less than 6 h was lower than that of 6-8 h group ( β=-4.01, 95% CI=-7.84-0.18, P=0.04). And among the subjects aged more than 40 years, the total sperm number of the men who slept ≥8 h at night was lower than that of the men with nighttime sleep duration between 6-8 h （percentage changes: -47.84%, 95% CI=-72.29%--2.19%, P=0.04）. The progressive and total sperm motility of men with BMI≥24 kg/m 2 and nighttime sleep duration ≥8 h were lower than those with BMI≥24 kg/m 2 in 6-8 h nighttime sleep duration group, and the corresponding regression coefficients were β=-5.75, 95% CI=-10.40--1.10, P=0.02 and β=-6.85, 95% CI=-11.69--2.00, P=0.01. Conclusion:In men ≥40 years old or BMI≥24 kg/m 2, the nighttime sleep duration ≥8 h were associated with the decreased sperm progressive motility and total motility.

Objective:To explore the association between nighttime sleep duration and semen quality.Methods:By using a cross-sectional study, 3357 men were investigated by questionnaire for nighttime sleep duration, the time of falling asleep and falling asleep duration in the Reproductive Center of Shenzhen People's Hospital from August 2017 to August 2018. Semen quality parameters were obtained by computer-aided semen analysis system (CASA). Multiple linear regression was used to analyze the relationship between nighttime sleep duration and semen quality parameters. According to age and body mass index (BMI) stratification, the relationship between nighttime sleep duration and semen quality parameters was further discussed.Results:Compared with males with nighttime sleep duration between 6-8 h, the sperm progressive motility and total motility were 49.15% and 59.49%, respectively, which were significantly lower in the males with nighttime sleep duration≥8 h after adjusting for age, BMI, abstinence time, exercise, drinking and smoking, with regression coefficients, β=-3.16, 95% confidence interval ( CI)=-5.77--0.55 and β=-3.22, 95% CI=-5.93--0.51, respectively. Compared with the shortest duration of falling asleep group (<10 min), the increase of falling asleep duration was related to the decrease of sperm progressive motility ( P=0.045). The total sperm motility of falling asleep duration between 31-60 min group was also significantly lower than that of the shortest falling asleep duration group （ β=-3.80, 95% CI=-6.54--1.06, P=0.007）. Further stratification analysis showed that among the subjects aged 35 to 39 years, the sperm progressive motility of men with nighttime sleep duration less than 6 h was lower than that of 6-8 h group ( β=-4.01, 95% CI=-7.84-0.18, P=0.04). And among the subjects aged more than 40 years, the total sperm number of the men who slept ≥8 h at night was lower than that of the men with nighttime sleep duration between 6-8 h （percentage changes: -47.84%, 95% CI=-72.29%--2.19%, P=0.04）. The progressive and total sperm motility of men with BMI≥24 kg/m 2 and nighttime sleep duration ≥8 h were lower than those with BMI≥24 kg/m 2 in 6-8 h nighttime sleep duration group, and the corresponding regression coefficients were β=-5.75, 95% CI=-10.40--1.10, P=0.02 and β=-6.85, 95% CI=-11.69--2.00, P=0.01. Conclusion:In men ≥40 years old or BMI≥24 kg/m 2, the nighttime sleep duration ≥8 h were associated with the decreased sperm progressive motility and total motility.