ObjectiveTo investigate the contamination status of ochratoxin A (OTA) in commercially available food products in Shanghai, and to assess OTA exposure levels and the associated non-carcinogenic and carcinogenic risks among pregnant women by integrating dietary consumption data of this population. MethodsThe levels of OTA contamination in 1 520 food samples collected in Shanghai from 2022 to 2023 were determined using liquid chromatography-tandem mass spectrometry. An exposure assessment model was developed based on the dietary consumption levels of pregnant women from the 2016‒2017 Shanghai Pregnant Women Dietary Monitoring Survey to calculate the estimated daily intake (EDI) of OTA, the margin of exposure for non-carcinogenic toxicity (MOE₁), and the margin of exposure for carcinogenic toxicity (MOE₂). An MOE₁ greater than 200 and an MOE₂ greater than 10 000 indicate that the non-carcinogenic toxicity and carcinogenic toxicity resulting from exposure are negligible, respectively. For samples with OTA contamination levels below the limit of detection (LOD), which accounted for more than 80% of the samples, the OTA levels were assigned values of 0 and LOD, respectively, for subsequent calculations. ResultsThe detection rates of OTA in cereals, nuts, dried fruits, and alcohol samples collected in 2022 were 2.03%, 0, 0, and 0, respectively. The OTA detection rates in cereals, nuts, dried fruits, beans, and alcohol samples collected in 2023 were 2.50%, 0.39%, 2.47%, 1.67%, and 13.33%, respectively. For pregnant women in Shanghai in 2022, simulation results indicated that when assigning a value of 0 and the LOD, theP₅₀ values of EDI for dietary OTA exposure were 0.05 and 0.72 ng·(kg·d)^-1, respectively, and the P₉₅ values of EDI for dietary OTA exposure were 0.25 and 2.40 ng·(kg·d)^-1, respectively. For pregnant women in Shanghai in 2023, the P₅₀ values of EDI for dietary OTA exposure were 0.04 and 1.00 ng·(kg·d)^-1, respectively, and the P₉₅ values of EDI for dietary OTA exposure were 0.23 and 2.67 ng·(kg·d)^-1, respectively, both substantially below the tolerable daily intake (TDI) for OTA [17 ng·(kg·d)^-1]. The EDI for dietary OTA exposure in 100.0% of Shanghai pregnant women was lower than the TDI, indicating an overall low level of dietary OTA exposure among this population. For 100.0% of pregnant women, the MOE₁ for dietary OTA exposure exceeded 200. When assigned a value of 0, the MOE₂ for 100.0% of pregnant women in both 2022 and 2023 exceeded10 000. When assigned the LOD value, 72.3% and 81.8% of pregnant women in 2022 and 2023, respectively, had an MOE₂ exceeding 10 000. ConclusionFrom 2022 to 2023, samples of cereals, nuts, dried fruits, beans, and alcohol sold in Shanghai exhibited varying degrees of OTA contamination. The overall EDI of OTA exposure among pregnant women in Shanghai remained at a low level. The non-carcinogenic and carcinogenic risks associated with OTA exposure were generally low and at controllable levels.

Background Deoxynivalenol (DON), a priority contaminant for food safety risk monitoring, is produced by Fusarium spp. infesting crops, and its common derivatives are 3-acetyl-DON (3A-DON) and 15-acetyl-DON (15A-DON), which have been shown to possess gastrointestinal toxicity, immunotoxicity, reproductive toxicity, and cytotoxicity. Due to the stable physicochemical properties of the DON family of toxins (DONs), they cannot be effectively removed during food processing, thus following the food chain, entering the human body, and posing health risks. Objective To understand the contamination status of DONs in commercial foods (cereals and bakery products) in Shanghai in 2022–2023, and to assess the exposure risk of DONs in pregnant women by combining their dietary consumption data. Methods Liquid chromatography tandem mass spectrometry (LC-MS/MS) was used to determine the contamination level of DONs in 1 100 food samples (cereals and baked goods) collected in 2022 and 944 samples collected in 2023 from Shanghai. The dietary monitoring data of pregnant women in Shanghai from 2016 to 2017 were adopted. The monitoring employed the food frequency questionnaire distributed among pregnant women through a combination of online telephone enquiry and offline on-site face-to-face survey to estimate their food consumption levels. An exposure assessment model was established to calculate the exposure level to DONs, and the probability distribution of the DONs exposure level in the pregnant women group in Shanghai was obtained by applying @Risk 7.5 software and simulating the calculation according to the Monte Carlo principle. With reference to the tolerable daily intake (TDI) of DONs [1.00 µg·(kg·d)⁻¹] proposed by the Joint FAO/WHO Expert Committee on Food Additives, the risk of exposure to DONs from commercial cereals and bakery products in pregnant women in Shanghai was assessed. Results DONs were detected in cereal and bakery samples collected in 2022 and 2023 with different levels of contamination. The level of DONs in cereal foods in 2023 (mean: 36.33 µg·kg⁻¹) decreased compared to 2022 (mean: 23.64 µg·kg⁻¹). However, the positive rate (71.67%) and level (mean: 51.22 µg·kg⁻¹) of DONs in bakery products increased significantly compared with 2022 (positive rate: 10.00%, mean: 24.39 µg·kg⁻¹). The mean consumption of cereals in 783 pregnant women was 222.48 g·d⁻¹ and the mean consumption of bakery products was 36.07 g·d⁻¹, and there was no statistically significant difference in the intake of all types of cereals and bakery products across the early, middle, and late stages of pregnancy. The modelled intakes of DONs via commercial cereals and bakery products for pregnant women in Shanghai were calculated to be 0.20 and 0.57 µg·(kg·d)⁻¹ in 2022 for the mean level and the 95th percentile level, respectively, and 0.16 µg·(kg·d)⁻¹ and 0.35 µg·(kg·d)⁻¹ in 2023, respectively. The results of the health risk assessment showed that pregnant women in Shanghai had 2.6% and 1.4% probability of exposure to DONs from cereal consumption in 2022 and 2023, respectively. Conclusion The risk of exposure of pregnant women in Shanghai to DONs via commercial cereals and bakery products is relatively low (1.4%-2.6%). However, considering the physical sensitivity of pregnant women, they should avoid consuming moldy grains and appropriately reduce intake of bakery products.

Objective To investigate the role and molecular mechanism of ginsenoside Rb1(Rb1)in regulating neutrophil extracellular trapping networks(NETs)to intervene in atherosclerosis(AS).Methods In vivo:an AS model was constructed with ApoE knockout mice superimposed on a high-fat diet.The pathological and morphological changes of aortic root plaques were observed by HE staining and oil red O staining;Immunofluorescence labelling of neutrophils citrullinated histones(Cit-H3)and macrophages as well as IL-1β at the aortic root plaque site were used to assess the inflammatory infiltration.In vitro:NETs induced by PMA and cholesterol crystals were taken as models respectively.Direct effect of Rb1 against NETs formation assessed by Sytox staining and immunofluorescence staining with Cit-H3 and myeloperoxidase.Rb1 on ROS levels was assessed by DCFH-DA.Rb1 on histone H3 citrulline modification was assessed by Western blotting.Results In vivo:Rb1 significantly inhibited plaque formation,lipid deposition(P<0.05)and intra-plaque inflammatory infiltration(P<0.05).In vitro:Rb1 significantly inhibited NETs formation(P<0.05),neutrophil ROS levels(P<0.05),and Cit-H3 levels(P<0.05).Conclusions Rb1 significantly inhibited AS progression by inhibiting plaque NETs formation,which may be partly through the inhibition of histone H3 citrullination resulting from activation of the neutrophil oxidative stress pathway.

Sodium valproate (VPA) is a widely used antiepileptic drug and mood stabilizer in both neurology and psychiatry. Valproate-induced hyperammonemic encephalopathy (VHE) is a rare but serious complication associated with its use. This paper reports a clinical case of a patient with bipolar disorder who developed VHE after self-administering, a rapid short-term dose escalation of VPA. The patient exhibited symptoms including nausea, vomiting, altered consciousness, and disorientation shortly after the dosage increase. Following prompt discontinuation of VPA and symptomatic treatment including cathartic therapy to promote drug elimination, the patient gradually regained consciousness and physical symptoms resolved. Through a review of this case and relevant literature, this article discusses the pathophysiological mechanisms, clinical manifestations, diagnosis, and treatment of VHE, to provide clinical reference for healthcare professionals.

Objective:To investigate the longitudinal relationship between childhood abuse and suicidal ideation in adolescents, and provide a theoretical basis for the prevention and intervention of suicidal ideation among adolescents.Methods:A self-control study was made.A 1-year follow-up survey was conducted among 2 052 junior high school students in Xinxiang and Fuzhou from November 2023 (T1) to November 2024 (T2) using the Childhood Abuse Questionnaire and the Adolescent Suicidal Ideation Scale.Data were analyzed using cross-lagged modeling.Results:Baseline (T1) and one-year follow-up (T2) assessments showed the mean score for childhood abuse was 42.43±13.34 at T1 and 42.45±15.36 at T2, and the mean score for suicidal ideation was 15.14±6.28 at T1 and 17.46±7.65 at T2.There were positive correlations between T1 childhood abuse and T1 suicidal ideation, T2 childhood abuse, T2 suicidal ideation( r=0.18, 0.35, 0.47), T1 suicidal ideation and T2 childhood abuse, T2 suicidal ideation( r=0.05, 0.44), as well as T2 suicidal ideation and T2 childhood abuse( r=0.26)(all P<0.05). Cross-lagged analysis indicated that childhood abuse at T1 positively predicted suicidal ideation at T2 ( β=0.38, P<0.001), while suicidal ideation at T1 did not predict childhood abuse at T2 ( β=-0.01, P>0.05). Conclusions:Childhood abuse is a precursor to suicidal ideation in adolescents, and childhood experiences of abuse significantly increases the risk of subsequent suicidal ideation.

Objective To investigate the role and molecular mechanism of ginsenoside Rb1(Rb1)in regulating neutrophil extracellular trapping networks(NETs)to intervene in atherosclerosis(AS).Methods In vivo:an AS model was constructed with ApoE knockout mice superimposed on a high-fat diet.The pathological and morphological changes of aortic root plaques were observed by HE staining and oil red O staining;Immunofluorescence labelling of neutrophils citrullinated histones(Cit-H3)and macrophages as well as IL-1β at the aortic root plaque site were used to assess the inflammatory infiltration.In vitro:NETs induced by PMA and cholesterol crystals were taken as models respectively.Direct effect of Rb1 against NETs formation assessed by Sytox staining and immunofluorescence staining with Cit-H3 and myeloperoxidase.Rb1 on ROS levels was assessed by DCFH-DA.Rb1 on histone H3 citrulline modification was assessed by Western blotting.Results In vivo:Rb1 significantly inhibited plaque formation,lipid deposition(P<0.05)and intra-plaque inflammatory infiltration(P<0.05).In vitro:Rb1 significantly inhibited NETs formation(P<0.05),neutrophil ROS levels(P<0.05),and Cit-H3 levels(P<0.05).Conclusions Rb1 significantly inhibited AS progression by inhibiting plaque NETs formation,which may be partly through the inhibition of histone H3 citrullination resulting from activation of the neutrophil oxidative stress pathway.

Objective:To investigate the longitudinal relationship between childhood abuse and suicidal ideation in adolescents, and provide a theoretical basis for the prevention and intervention of suicidal ideation among adolescents.Methods:A self-control study was made.A 1-year follow-up survey was conducted among 2 052 junior high school students in Xinxiang and Fuzhou from November 2023 (T1) to November 2024 (T2) using the Childhood Abuse Questionnaire and the Adolescent Suicidal Ideation Scale.Data were analyzed using cross-lagged modeling.Results:Baseline (T1) and one-year follow-up (T2) assessments showed the mean score for childhood abuse was 42.43±13.34 at T1 and 42.45±15.36 at T2, and the mean score for suicidal ideation was 15.14±6.28 at T1 and 17.46±7.65 at T2.There were positive correlations between T1 childhood abuse and T1 suicidal ideation, T2 childhood abuse, T2 suicidal ideation( r=0.18, 0.35, 0.47), T1 suicidal ideation and T2 childhood abuse, T2 suicidal ideation( r=0.05, 0.44), as well as T2 suicidal ideation and T2 childhood abuse( r=0.26)(all P<0.05). Cross-lagged analysis indicated that childhood abuse at T1 positively predicted suicidal ideation at T2 ( β=0.38, P<0.001), while suicidal ideation at T1 did not predict childhood abuse at T2 ( β=-0.01, P>0.05). Conclusions:Childhood abuse is a precursor to suicidal ideation in adolescents, and childhood experiences of abuse significantly increases the risk of subsequent suicidal ideation.

Sodium valproate (VPA) is a widely used antiepileptic drug and mood stabilizer in both neurology and psychiatry. Valproate-induced hyperammonemic encephalopathy (VHE) is a rare but serious complication associated with its use. This paper reports a clinical case of a patient with bipolar disorder who developed VHE after self-administering, a rapid short-term dose escalation of VPA. The patient exhibited symptoms including nausea, vomiting, altered consciousness, and disorientation shortly after the dosage increase. Following prompt discontinuation of VPA and symptomatic treatment including cathartic therapy to promote drug elimination, the patient gradually regained consciousness and physical symptoms resolved. Through a review of this case and relevant literature, this article discusses the pathophysiological mechanisms, clinical manifestations, diagnosis, and treatment of VHE, to provide clinical reference for healthcare professionals.

Ischemic stroke （IS） is the most common type of stroke that can lead to severe neurological dysfunction while effective diagnostic and therapeutic methods are currently limited. Exosomes are natural vesicles that can play a key role in intercellular communication by delivering proteins， lipids， and nucleic acids. Notably，IS could cause changes in the level and content of exosome， which can serve as a potential biomarker to assist the diagnosis and treatment of IS. This article reviews the potential diagnostic value of exosomes，discusses their repair effects， and explores the potential application as drug carriers in IS. We also provide a concise summary of the current clinical research status based on exosomes.
Exosomes ; Diagnosis

ObjectiveTo conduct comprehensive assessment of internal and external cadmium exposure and health risks for Shanghai residents. MethodsCadmium levels in food samples were calculated by employing two dietary exposure assessment methods， total diet study （TDS） and food frequency questionnaire （FFQ）， to estimate the daily dietary cadmium exposure of Shanghai residents. The provisional tolerable monthly intake （PTMI） of cadmium set by joint food and agriculture organization/WHO expert committee on food additives （JECFA） was applied to evaluate the health risk. Differences in dietary and urinary cadmium were compared by rank-sum test among different regions， age， gender， smoking status， and BMI groups， and the association between internal and external cadmium exposure was investigated by correlation analysis. ResultsThe mean value of urinary cadmium for 1 300 respondents was 0.542 μg·L^-1. Urinary cadmium was higher in the population in central urban and urban-rural fringe areas than in the suburban area， higher in the older age group than in the younger age group， and higher in the smoking group than in the non-smoking group （all P<0.01）. The two assessment methods showed that the mean values of daily dietary cadmium exposure for Shanghai residents were 0.306 and 0.090 μg·kg^-1， with 3.69% and 0.85% of Shanghai residents exceeding the PTMI， respectively. Correlation analyses showed that dietary exposure to cadmium based on the FFQ method was positively correlated with the urinary cadmium level when smoking status， age， gender， and BMI were adjusted. ConclusionDietary exposure to cadmium of Shanghai residents is mainly derived from vegetables， aquatic products， cereals and potatoes， and is overall at a low-risk level. Dietary exposure assessment based on FFQ and risk monitoring data can effectively estimate long-term cadmium exposure.