Objective:To assess the effect of joint exposure to multiple air pollutants on sleep structure in patients with stable chronic obstructive pulmonary disease (COPD), identify key air pollutants, and analyze potential influencing factors.Methods:In this panel study, 92 stable COPD patients were recruited. From March 2021 to September 2023 in Beijing, all participants completed 254 nights of sleep monitoring. The total sleep duration, light sleep duration, deep sleep duration and rapid eye movement sleep duration and their respective proportions in total sleep duration were recorded. The exposure levels of fine particulate matter (PM 2.5), inhalable particulate matter (PM 10), nitrogen dioxide (NO 2), ozone (O 3), sulfur dioxide (SO 2), and carbon monoxide (CO) were estimated based on the infiltration factor method and time-activity logs of participants. To assess the lag effect of air pollutants, moving average concentrations of air pollutants from 0-1 day to 0-3 months were calculated. The linear mixed-effect model and Bayesian kernel machine regression (BKMR) model were used to assess the single and joint effects of air pollutants on sleep structure parameters in COPD patients, respectively. Results:All six types of air pollutants were associated with changes in sleep structure, manifesting as an increase in total sleep duration and light sleep proportion and a reduction in deep sleep proportion. The effects of O 3 were strongest at lag 0-6 days, while other air pollutants were at lag 0-3 months. Joint exposure to multiple air pollutants exerted significant joint effects on sleep structure, and NO 2 was identified as the dominant pollutant. NO 2 had a posterior inclusion probability (PIP) greater than 0.5 for light sleep proportion (PIP=0.691) and deep sleep proportion (PIP=0.957). With an interquartile range (IQR) increase of 8.6 μg/m 3 in NO 2 at lag 0-3 months, the light sleep proportion increased by 10.5% (95% CI: 2.2%-19.4%), and the deep sleep proportion decreased by 19.5% (95% CI:-30.6%- -6.8%). Conclusion:Joint exposure to air pollutants is associated with changes in sleep structure in stable COPD patients, and NO 2 may be a key pollutant.

Objective:To explore the correlation of different HBV DNA loads with peripheral blood lymphocyte subsets and interleukin-6 (IL-6) in patients with chronic hepatitis B.Methods:A cross-sectional study was conducted. A total of 519 patients with chronic hepatitis B admitted to the Fifth Medical Center of the General Hospital of the People′s Liberation Army from April 2019 to June 2024 were included. The patients were divided into high, medium, and low viral load groups and a negative group based on HBV DNA load. Another 100 healthy individuals who underwent physical examinations during the same period were recruited as the control group. The quantities of peripheral blood lymphocyte subsets and IL-6 levels were compared among the groups. Meanwhile, alanine aminotransferase (ALT) levels were recorded and compared among the groups. The correlation of HBV DNA levels with lymphocyte subsets and IL-6 was analyzed using Pearson correlation analysis.Results:HBV DNA loads were negatively correlated with the counts of CD3 +, CD4 +, CD8 +, CD19 +, and CD56 + lymphocyte subsets (correlation coefficients r were -0.483, -0.508, -0.524, -0.573, and -0.561, respectively; all P<0.001) and positively correlated with IL-6 levels ( r=0.862, P<0.05). Compared with the control group, the counts of each lymphocyte subset were higher in the high, medium, and low viral load groups ( P<0.05). In the HBV DNA-negative chronic hepatitis B group, the counts of CD8 + and CD19 + lymphocyte subsets were significantly higher [712.32(526.00,898.64) and 495.62(345.74,645.50) cells/μl] than those in the control group [612.10(479.89,744.31) and 470.32 (396.00,544.64) cells/μl] ( P<0.05). Conclusion:The degree of HBV replication activity in patients with chronic hepatitis B is associated with the immune status of the body, and negatively correlated with the quantities of lymphocyte subsets and positively correlated with IL-6 levels.

Objective To explore the relationship between serum levels of anterior gradient 2(AGR2)and trimethylamine N-oxide(TMAO)and gut microbiota in children with inflammatory bowel disease(IBD).Methods A total of 145 IBD children were selected as the observation group,and children were divided into the ulcerative colitis group(64 cases)and the Crohn's disease group(81 cases)according to the disease type.Meanwhile,140 healthy children underwent physical examination in our hospital were included as the control group.Serum AGR2 and TMAO levels were detected by enzyme-linked immunosorbent assay(ELISA).The disease activity of ulcerative colitis and Crohn's disease were evaluated using the modified Mayo score and the Crohn's Disease Activity Index(CDAI)score,and patients were divided into the active group(75 cases)and the remission group(70 cases)according to the disease activity.Fecal samples were collected for identification and count of intestinal flora.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of serum AGR2 and TMAO levels in ulcerative colitis and Crohn's disease.The correlation between serum AGR2 and TMAO levels and intestinal flora was analyzed by Pearson test.Logistic regression was used to analyze the relationship between serum AGR2 and TMAO levels and the disease stage of children with IBD.Results The serum AGR2 level was lower in the ulcerative colitis group and the Crohn's disease group than that in the control group,and the serum TMAO level was higher than that in the control group(P＜0.05).The areas under the curve(AUC)of serum AGR2 and TMAO levels were 0.835,0.836 and 0.896 for diagnosis of ulcerative colitis alone and 0.859,0.864 and 0.964 for diagnosis of Crohn's disease.The serum AGR2 level and numbers of lactobacillus and bifidobacterium were significantly lower in the active group than those in the remission group,and the serum TMAO level and numbers of Escherichia coli,enterococcus,Helicobacter pylori and streptococcus were significantly higher in the active group than those in the remission group(P＜0.05).Serum AGR2 levels in IBD children were positively correlated with numbers of lactobacillus and bifidobacterium,and negatively correlated with numbers of Escherichia coli,Enterococcus,Helicobacter pylori and streptococcus(P＜0.05).Serum TMAO level was negatively correlated with numbers of lactobacillus and bifidobacterium,and positively correlated with numbers of Escherichia coli,Enterococcus,Helicobacter pylori and streptococcus(P＜0.05).The decreased serum AGR2 level and the increased TMAO level were risk factors for the disease progression to active stage in children with IBD(P＜0.05).Conclusion The combination of serum AGR2 and TMAO can effectively diagnose ulcerative colitis and Crohn's disease,and it is more valuable in the diagnosis of Crohn's disease.Abnormal expression of both may participate in the progression of IBD disease by affecting changes in gut microbiota structure.

Objective To explore the relationship between CT quantitative left heart structure parameters and recurrence after hypertrophic cardiomyopathy(HCM)and atrial fibrillation(AF)radiofrequency ablation(RFCA).Methods A total of 120 patients with HCM and AF admitted to our hospital from April 2021 to June 2023 were selected.Patients were divided into the relapse group and the non-recurrence group according to whether RFCA recurred 6 months after operation.All patients underwent CT examination,and left ventricular ejection fraction(LVEF),left atrial ejection fraction(LAEF),left atrial volume index(LAVI)and left atrial auricular volume of the two groups were analyzed.The clinical data of patients were collected.Logistic regression model was used to analyze the influencing factors of postoperative recurrence of RFCA in HCM patients with AF.Receiver operating characteristic curve(ROC)curve was used to analyze the predictive efficacy of left heart structure parameters for postoperative recurrence of RFCA in HCM patients with AF.Results The volume levels of LAVI and left auricle were higher in the relapsed group than those in the non-relapsed group,and the level of LAEF was lower than those in the non-relapsed group(P＜0.05).Logistic regression analysis showed that persistent atrial fibrillation,LAVI and high left atrial appendage volume were independent risk factors for postoperative recurrence in HCM patients with AF(P＜0.05),and high LAEF was protective factor(P＜0.05).The results of ROC curve analysis showed that the AUC value of LAVI,LAEF and left atrial appendage volume in predicting recurrence after RFCA in patients with HCM and AF was 0.902,which was higher than that of 0.789,0.755 and 0.675 of each individual test.The combined prediction efficiency of the three tests was higher than that of each single test(Z=2.177,2.555 and 3.628,P＜0.05).Conclusion High level of LAVI and left atrial appendage volume and low level of LAEF are risk factors for postoperative recurrence of RFCA.The combined detection of the three methods has high predictive value for postoperative recurrence of RFCA in HCM patients with AF.

Objective:To analyze the prenatal ultrasonographic features and prognosis of fetal perirenal urinoma.Methods:This retrospective study included eight fetuses with perirenal urinoma diagnosed by prenatal ultrasound in the Women and Children's Hospital of Chongqing Medical University from January 2017 to August 2023. Descriptive analysis was performed on their prenatal ultrasonographic features, intrauterine intervention measures, postnatal treatment, and prognosis.Results:Among the eight cases, the prenatal ultrasonographic diagnosis was consistent with the postnatal clinical diagnosis in seven cases, with one misdiagnosis (postnatally confirmed as giant renal cyst with multicystic dysplastic kidney). Prenatal ultrasonographic features of fetal perirenal urinoma included cystic mass adjacent to the renal capsule; obvious compression of the surrounding organs and the affected kidney; increased craniocaudal diameter of the affected kidney with thin parenchyma, increased echogenicity, indistinct corticomedullary differentiation, and pyeletasis; poorly visualized partial renal arteries; normal or mildly enlarged contralateral kidney; adequate bladder filling; normal amniotic fluid volume. Two cases underwent intrauterine cyst aspiration with subsequent cyst size reduction (slight re-enlargement during follow-up). Among the remaining six untreated cases, one case showed stable cyst size, while five cases exhibited initial significant cyst enlargement followed by stabilization or regression trend. All eight cases were born at full term (three delivered vaginally and five by cesarean section). The affected kidney was significantly atrophied within one week after birth by ultrasound observation. Impaired function of the affected kidney was shown in four patients by follow-up after discharge (including two cases of intrauterine treatment),one case abandoned treatment due to other illnesses, two cases were lost to follow-up after discharge.Conclusions:Prenatal ultrasound images of perirenal urinary cysts infetuses exhibit typical features. Intrauterine treatment can reduce the compression of large cysts and hydronephrosis on fetal organs, but there is no significant improvement in the recovery of renal function.

This study reported two cases of distal 18q deletions identified through non-invasive prenatal testing (NIPT). Case 1 harbored a de novo 20.4 Mb deletion of 46, XY, del(18) (q21.32q23), classified as pathogenic according to the American College of Medical Genetics and Genomics (ACMG) guidelines. Follow-up at five years of age revealed global developmental delay, congenital heart disease, and distinct facial features. Case 2 had a 5.71 Mb paternal-origin deletion of 46,XX,del(18)(q22.1q22.2), with only mild tricuspid regurgitation detected at eight months of age. These phenotypic discrepancies demonstrated that the clinical manifestations of 18q deletion syndrome were closely associated with the size of the deleted segment and the involved critical genes. Therefore, individualized genetic counseling and long-term follow-up were necessary for the affected children.

Objective:To investigate the current status of life stress and hypertension among couples of childbearing age across diverse economic regions in China, and to explore relevant influencing factors.Methods:This study was a cross-sectional study, with subjects from the “Research on the standardized system of comprehensive prevention and control of birth defects based on preconception-prenatal-postnatal whole chain”. From February to May 2021, urban and rural couples of childbearing age (18-49 years old) from Beijing, Henan, and Gansu provinces were enrolled, representing the eastern, central, and western regions of China, respectively. The detection rate, cognition and control of hypertension in the general population, as well as the detection rate of hypertension in different genders and regions were analyzed. Subjects were divided into hypertensive group and non-hypertensive group based on whether their blood pressure was≥140/90 mmHg (1 mmHg=0.133 kPa), and the general clinical data of the two groups were compared. Subjects were also divided into prehypertension and hypertension group and normal blood pressure group based on whether their blood pressure was≥130/80 mmHg, and the general clinical data of the two groups were compared, with subgroup analyses conducted by gender. Multifactorial logistic regression model was applied to identify factors associated with prehypertension and hypertension in both males and females.Results:A total of 1 942 couples of childbearing age, comprising 3 884 individuals, aged (29.8±5.2) years were enrolled, with 1 942 males (50.0%). The overall hypertension detection rate was 6.3% (246/3 884), with a detection rate of 10.5% (203/1 942) in males and 2.2% (43/1 942) in females. The hypertension detection rates in Beijing, Henan, and Gansu were 6.2% (92/1 482), 11.6% (139/1 200), and 1.2% (15/1 202), respectively. The overall detection rate of prehypertension and hypertension was 40.5% (1 574/3 884). Multifactorial logistic regression analysis showed that life pressure factors had no effect on female blood pressure levels ( P>0.05), while a significant or high level of life/work pressure was a risk factor for prehypertension and hypertension in males ( OR=2.30, 95% CI 1.06-4.99, P<0.05). Conclusion:The detection rate of prehypertension and hypertension among young couples of childbearing age in China is high, with poor awareness and control of hypertension. There are sex differences in the relationship between life pressure and blood pressure levels. Comprehensive consideration of individual living environments and mental health factors is crucial in blood pressure management. Measures to reduce life stress and enhance mental resilience should be implemented to address this public health issue.

Immunogenic cell death(ICD)is a form of cell death that can activate the immune system,especially in the treatment of cancer.ICD can enhance the recognition of tumors by the immune system and the release of damage associated molecular patterns(DAMPs),to achieve tumor cell death.Oncolytic viruses(OVs)can selectively infect and kill tumor cells without damaging normal cells.OVs are type Ⅱ ICD inducers that induce ICD in tumor cells by targeting the endoplasmic reticulum.Here,we review the characteristics of ICD and the mechanism of ICD induction by OVs.We also review the latest clinical progress involving ICD and discuss future treatment strategies for tumors.

Cytoglobin(Cygb)is a recently discov-ered astrocyte specific globin that is widely distrib-uted in mammalian visceral organs such as the lung,heart,spleen,liver,pancreas,stomach,small intestine,kidney,neuron,and bone tissue.It plays an important role in clearing reactive oxygen spe-cies,nitric oxide and nitrite signal transduction,al-leviating oxidative stress,anti-fibrosis,regulation of cell apoptosis and treatment of cancer,etc.It is worth noting that the anti-fibrosis role of Cygb has attracted increasing attention in recent years.The existing research has involved various fibrotic dis-eases such as the liver,pancreas,kidney,spleen,etc.,especially in the study of liver fibrosis,which has made great progress.This article system re-views the role of Cygb in various fibrotic diseases,with a focus on its mechanism of alleviating oxida-tive stress.Although the application of Cygb in fi-brotic diseases is still in its infancy and the underly-ing mechanisms still require extensive research and exploration,there is no doubt that Cygb can serve as a promising therapeutic target,with the poten-tial to be widely used in the prevention and treat-ment of fibrotic diseases.

This study aims to investigate the effects of Pulsatilla powder(PP)on colonic intestinal flora and tryptophan metabolism in piglets with diarrhea.Twenty-four weaned piglets were ran-domly divided into the normal control group,model group,self-healing group,and PP group.The model of piglet diarrhea was established by the compound factor of external evil+internal injury+epi-demic virus,and treated with PP.During the modeling period,the body weight,mental status and fecal patterns of piglets were monitored daily.After the experiment,the colon tissues were collect-ed for histopathological observation,and the inflammatory factors IL-1β and IL-6 in the colon tis-sue was detected by ELISA,16S rRNA was used to analyze colonic intestinal flora and RT-qPCR was used to determine the expression of genes related to tryptophan metabolism in the colon.The results showed that,compared with the model group,PP significantly improved the pathological status of the colon in piglets with diarrhea,with elevated body mass and a significant increase in goblet cells(P＜0.05);and significantly reduced the levels of IL-1β and IL-6 in the colon of diar-rhea piglets(P＜0.05).The results of intestinal flora showed that PP increased the abundance of Firmicutes(P＜0.01),Spirochaeota(P＜0.01)and Lactobacillus(P＜0.05),reduced the abun-dance of Bacteroidota(P＜0.05)、Prevotella_NK3B31_group(P＜0.05)and Clostridium_sensu_stricto 1(P＜0.01).Meanwhile,PP significantly reduced the expression level of TPH1 mRNA(P＜0.05),increased the expression levels of AhR(P＜0.05)and IL-22 mRNA in the co-lon of diarrhea piglets.These results indicates that PP may alleviate diarrhea in piglets by regula-ting colonic intestinal flora and genes related to intestinal tryptophan metabolism.This study pro-vides data support for the subsequent investigation of piglet diarrhea prevention and treatment.