AIM: To investigate the changes in serum levels of platelet-derived growth factor A(PDGFA), heme oxygenase 1(HMOX1)and suppressor of cytokine signaling 6(SOCS6)in patients with diabetic retinopathy(DR)at different stages, and their predictive value for prognosis. METHODS: Patients diagnosed with DR in Zibo No.148 Hospital from April 2023 to April 2024 were included as the study group, and patients with simple type 2 diabetes mellitus(T2DM)during the same period were included as the control group. DR patients were separated into non proliferative DR group(NPDR group)and proliferative DR group(PDR group)based on DR staging, and into good prognosis group and poor prognosis group based on prognosis. Enzyme-linked immunosorbent assay(ELISA)method was used to detect serum levels of PDGFA, HMOX1, and SOCS6, and Pearson method was performed to analyze their correlation with laboratory indicators. Multivariate logistic regression was used to explore the risk factors affecting poor prognosis in DR patients. Receiver operating characteristic(ROC)curves were plotted to explore the prognostic value of serum PDGFA, HMOX1, and SOCS6 levels for DR patients. RESULTS: Totally 128 DR patients(67 males and 61 females)with the mean age 50.65±8.57 y were included. The control group consisted of 120 T2DM patients(63 males, 57 females)with the mean age of 50.32±8.65 y. The NPDR group comprised 74 patients(39 males, 35 females)with mean age of 50.42±8.71 y; the PDR group included 54 patients(28 males, 26 females)with the mean age of 50.96±8.40 y; The good prognosis group comprised 81 patients(43 males, 38 females)with the mean age of 50.51±8.62 y; the poor prognosis group included 47 patients(24 males, 23 females)with the mean age of 50.89±8.48 y. Compared with the control group, the study group had significantly higher serum levels of PDGFA, HMOX1, and SOCS6(all P<0.05). The PDR group had significantly higher serum levels of PDGFA, HMOX1, and SOCS6 than the NPDR group(all P<0.05). The poor prognosis group had significantly higher serum levels of FBG, HbA1c, SOD, MDA, IL-6, TNF-α, PDGFA, HMOX1, and SOCS6 than the good prognosis group(all P<0.05). The serum PDGFA of DR patients was positively related to FBG, HbA1c, IL-6, and TNF-α levels(all P<0.05), HMOX1 was positively related to FBG, HbA1c, SOD, MDA, IL-6, and TNF-α levels(all P<0.05), and SOCS6 was positively related to FBG, IL-6, and TNF-α levels(all P<0.05). Elevated levels of serum PDGFA, HMOX1, SOCS6, and HbA1c were risk factors for the prognosis of DR patients(all P<0.05). The AUC values of serum PDGFA, HMOX1, and SOCS6 alone in predicting the prognosis of DR patients were 0.806, 0.822, and 0.826, respectively. The AUC of their joint prediction was 0.912, and the joint prediction was superior to individual prediction(Z joint-PDGFA=2.183, P=0.029; Z joint-HMOX1=2.308, P=0.021; Z joint-SOCS6=2.620, P=0.009). CONCLUSION: Serum PDGFA, HMOX1, SOCS6 are significantly correlated with DR staging and prognosis, all showing high predictive efficiency for the prognosis of DR patients, with certain clinical value.

Objective To describe the spatiotemporal distribution characteristics of Severe Fever with Thrombocytopenia Syndrome (SFTS) in Zibo City and identify its environmental influencing factors and potential high-risk areas, and to propose targeted strategies for SFTS prevention and control. Methods Data on SFTS incidence from 2010 to 2024 were collected. Spatiotemporal scan statistics were used to identify the time and area of SFTS clustering. The maximum entropy (MaxEnt) model was used to analyze environmental influencing factors and predict high-risk areas. Results From 2010 to 2024, a total of 459 cases of SFTS were reported in Zibo. The number of SFTS cases increased yearly, with a peak incidence from April to October each year. Spatiotemporal scan statistics showed the existence of one class I cluster and one class II cluster areas in Zibo. The class I cluster was in Yiyuan District and southern Boshan District, from April to September 2024. The class II cluster was in the center of Zichuan District, from July to September 2024. The MaxEnt model showed that yearly average atmospheric pressure (PRS), yearly average evaporation (EVP), yearly average sunshine duration (SSD) and goat density (Goat) were the key factors influencing the occurrence of SFTS. The predicted risk map showed that the area of high prevalence was 1116 km2, accounting for 18.71% of the total area of the city. Conclusion The spatiotemporal distribution of SFTS exhibits heterogeneity and is influenced by multidimensional environmental factors. This should be considered as a basis for delineating SFTS risk areas and developing SFTS prevention and control measures.

Objective To investigate the herpes zoster vaccination willingness in middle-aged population in Zibo City, and analyze its influencing factors. Methods A questionnaire survey was conducted among population aged 40-59 years in 24 streets of 8 districts and counties in Zibo City using stratified sampling method, and the willingness to vaccinate herpes zoster vaccine was statistically analyzed. The influencing factors of herpes zoster vaccination willingness in middle-aged population in Zibo City were analyzed. Results Among the 692 survey subjects, 654 cases (94.51%) were not vaccinated with herpes zoster vaccine, among which 170 cases (25.99%) were willing to be vaccinated. Multivariate logistic regression analysis showed that gender, age, education level, knowledge of herpes zoster, presence or absence of people with herpes zoster around them, knowledge of symptoms and sequelae of herpes zoster, knowledge of herpes zoster vaccine, knowledge of preventive effect of herpes zoster vaccine on herpes zoster, possible adverse reactions after vaccination, and acceptable effective rate of vaccine were the influencing factors of herpes zoster vaccination willingness in middle-aged population in Zibo City (P<0.05). Conclusion The willingness of herpes zoster vaccination is low in middle-aged population in Zibo City, and its influencing factors include gender, age, education level, herpes zoster cognition and vaccine cognition. It is necessary to strengthen the education of herpes zoster and vaccine among middle-aged population in Zibo City, and formulate promotion strategies based on individualized needs to enhance the vaccination willingness of people.

Objective: To analyze the demographic evolution of China over the forthcoming decade (2026-2035) and to systematically evaluate its potential implications for voluntary blood donation practices and the equilibrium of clinical blood supply and demand. Methods: Leveraging comprehensive blood collection and utilization data from 2021 to 2025 at the national, provincial (Shandong), and municipal (Zibo) levels, we identified and examined critical determinants influencing blood management systems. The DeepSeek-V3.2 large language model was deployed to project future population age structures, and to generate quantitative estimates for hospitalization volumes, clinical blood requirements, available blood supply, and donation frequencies for the target years 2030 and 2035, thereby furnishing an evidence base for strategic planning and priority-setting. Results: DeepSeek-derived projections indicate that the proportion of China's population aged 60 years and above will surpass 27% (370 million/1 380 million) by 2030 and exceed 30% (400 million/1 350 million) by 2035, signaling a marked acceleration in population aging. This demographic shift is projected to reduce the proportion of the national population eligible to donate blood from 59.2% (835 million out of 1.41 billion) to 52% (710 million out of 1.36 billion), while the demand for blood is expected to increase by 87.8% relative to 2024, rising from 26.927 million units to 50.56 million units. Sustaining blood supply-demand balance will necessitate progressive annual increases in donation rates. Under prevailing policy frameworks, the required blood donation rate among the eligible population in Shandong Province would need to rise by 122.57% by 2035 [from 20.07‰ (1.1641 million person-times/58 million people) to 44.67‰ (2.189 million person-times/49 million people)] to potentially satisfy projected clinical requirements. Conclusion: By integrating DeepSeek-V3.2, AI predictive models, and blood donation incentive measures, it is possible to monitor population demographics, forecast clinical blood demand, manage blood supplies, and ensure the long-term sustainability of clinical blood availability. It must be acknowledged, however, that the present analysis is constrained by a limited data foundation (comprising only five annual observation points); accordingly, the projections should be interpreted as directional trend indicators or methodological illustrations rather than definitive quantitative forecasts.

Objective To evaluate the transition rules of normal body mass index(BMI),overweight and metabolic syndrome(MetS)in patients with major depressive disorder(MDD).Methods Patients with MDD who had multiple admission records between Jan 2016 and Nov 2021 in Beijing Anding Hospital,Capital Medical University were included.Based on the overweight and metabolic syndrome status assessed at each admission,the patients were categorized into three states:normal BMI,overweight and metabolic syndrome.A multi-state Markov model was used to analyze the transition intensity and transition frequency between three states and the influence of covariates on transitions.Results A total of 892 records of 398 subjects were included,with a median age of 56 years old and 31.4% males.The median follow-up period was 40 months.The multi-state model showed that there were 494 transitions between the three states,of which 5.1% moved from normal BMI to overweight and 5.5% moved from overweight to MetS.The intensity of transition was the highest from overweight to MetS,9.52 times greater than overweight to normal BMI.After 48.53 months,MDD patients with normal BMI began to transition to MetS.For overweight MDD patients,the transition to MetS started after 8.77 months.MDD patients with normal BMI or overweight had 31.4% and 50.4% probabilities of developing Mets after 36 months.For MDD patients comorbid with MetS,the probability of staying at MetS was 51.2% after 36 months.Multivariate analysis showed that being unmarried was a risk factor against developing overweight in normal BMI MDD patients,while a higher level of education was a protective factor against developing MetS in overweight MDD patients.Conclusion MDD patients exhibited a higher intensity and risk of developing MetS,and it is not easy to reverse MetS,suggesting that BMI management and MetS intervention should be strengthened in MDD patients.

Objective:To explore the role of PTPN11 gene polymorphisms in Noonan syndrome (NS) and other related diseases and to evaluate the association between PTPN11 gene variants and various disease phenotypes.Methods:This study first described a case of 7-year-old girl diagnosed with Nonan symdrome who visited our department in Februay 2024 presented to our department six months ago and was diagnosed with Noonan syndrome. Whole-exome sequencing revealed a heterozygous variant in her PTPN11 gene, with the single nucleotide polymorphism (SNP) locus identified as rs121918457. Due to limited phenotypic data associated with rs121918457 in available databases, the cis-expression quantitative trait locus (cis-eQTL) rs12425405, located near the PTPN11 gene, was used as a proxy to further investigate the impact of PTPN11 gene expression regulation on various disease phenotypes. A PheWAS analysis was conducted to assess the statistical association between PTPN11 polymorphism and diverse phenotypic traits. All data were analyzed using the PheWeb online tool, and statistical significance was tested using the P-value. Bonferroni correction was applied for multiple comparisons to ensure the reliability of the results. The significance level was set at P<0.05, and the Bonferroni-corrected significance threshold was P=3.52×10 -5. Results:This case demonstrated that, in addition to the typical clinical features of Noonan syndrome, the child also presented with significant hypertension and autoimmune symptoms (such as joint pain, peripheral nerve damage, and positive antinuclear antibodies). The PheWAS analysis revealed significant statistical associations between the rs12425405 polymorphism and the following disease phenotypes: myocardial infarction ( P=1.90×10 -5), coronary atherosclerosis ( P=7.40×10 -5), ischemic heart disease ( P=2.30×10 -5), and hypertension ( P=8.8×10 -5). Additionally, rs12425405 showed statistical associations with some autoimmune symptoms (such as rheumatoid arthritis) ( P=0.027), but did not reach the corrected significance threshold ( P>3.52×10 -5). Conclusion:PTPN11 gene mutations are not only pathogenic factors in Noonan syndrome but may also play a critical role in the development of cardiovascular diseases and are associated with autoimmune symptoms. However, further research is needed to elucidate the functional mechanisms of the PTPN11 gene across multiple diseases and determine whether common genetic drivers are present.

Objective:To analyze the epidemiological characteristics of tick-borne encephalitis (TBE) in Heilongjiang province, to provide a scientific basis for the prevention and control of TBE.Methods:The epidemiological characteristics of TBE were systematically analyzed by the data of TBE cases reported in Disease Surveillance Information Reporting System.Results:A total of 1 127 TBE cases were reported from 2006 to 2020. The average age was 45.8 year, and the case fatality rate was 1.2%. Most TBE cases occurred from April to August, with a peak in June.Conclusions:This research elucidated the epidemiological characteristics of TBE in Heilongjiang province, and provides important basic data for the disease prevention and control.

Objective:To measure the length and curvature of the external auditory canal (EAC) centerline using a three-dimensional (3D) measurement method based on high-resolution computed tomography (HRCT).Methods:A retrospective analysis was conducted on HRCT images of healthy EAC from 49 patients (64 ears) examined at the Sixth Medical Center of the PLA General Hospital from June to October 2024. The cohort included 25 males (28 ears) and 24 females (36 ears), aged 22-78 years (mean age 47.3 years), categorized into age groups: 18-30 years (20 ears), 31-60 years (22 ears), and 61-80 years (22 ears). The EAC comprised 29 left and 35 right ears. 3D reconstruction of the EAC was performed using medical software (3D Slicer), and the central curve of the EAC was extracted using an improved measurement method to determine its length and curvature. Statistical analysis was performed using Origin Pro 2023 software to compare differences across genders, sides, and age groups.Results:The measurements of EAC length and curvature revealed that the EAC was significantly longer in males than in females (27.46 mm vs. 25.44 mm, P=0.014) and longer on the right side than on the left (27.99 mm vs. 25.87 mm, P=0.031). No statistically significant difference in EAC length was observed among the different age groups ( P>0.05). Furthermore, no statistically significant differences in EAC curvature were found regarding gender, side, or age group (all P>0.05). Conclusion:The HRCT-based 3D reconstruction technique enables the establishment of a rapid and effective automated workflow for extracting the central curve of the EAC and systematically measuring its length and curvature. The data obtained provide a reference and methodological support for further research on anatomical variations of the human EAC and its potential clinical applications, such as the design of otological instruments or surgical planning.

A traditional Chinese medicine(TCM)monomer is a bioactive compound extracted from Chinese herbal medicines possessing determined biological activity and pharmacological effects,and has gained much attention for treating neuronal diseases.However,the application of TCM monomers is limited by their low solubility and poor ability to cross the blood-brain barrier(BBB).Exosomes are small extracellular vesicles(EVs)ranging in size from 30 to 150 nm in diameter and can be used as drug delivery carriers that directly target cells or tissues with unique advantages,including low toxicity,low immunogenicity,high stability in blood,and the ability to cross the BBB.This review discusses the biogenesis,components,stability,surface modification,isolation technology,advantages,and disadvantages of exosomes as drug carriers and compares exosomes and other similar drug delivery systems.Furthermore,exosome-encapsulated TCM monomers exert neuroprotective roles,such as anti-inflammation,anti-apoptosis,anti-mitophagy,and anti-oxidation,in various neuronal diseases,including Alzheimer's disease(AD),Parkinson's disease(PD),multiple sclerosis(MS),and cerebral ischemia and reperfusion(CI/R)injury,as well as anti-drug resistance,anti-tumorigenesis,anti-angiogenesis,and promotion of apoptosis in brain tumors,providing more inspiration to promote the development of an exosome-based delivery tool in targeted therapy for neuronal diseases.

OBJECTIVE: To explore the mechanism for the occurrence and phenotypic characteristics of Turner syndrome based on a prenatally diagnosed case of a mosaic karyotype containing double pseudo-isodicentric X chromosome and a review of relevant literature. METHODS: A fetus diagnosed with increased risk for trisomy 21 at the Provincial Hospital Affiliated to Shandong First Medical University in August 2023 was selected as the study subject. Clinical data of the fetus was collected. Following amniocentesis, chromosomal G-banding karyotype analysis and chromosomal microarray analysis (CMA) were carried out. This study has been approved by the Ethics Committee of the Hospital (Ethics No.: SWYX No. 2022-287). RESULTS: The early-trimester screening suggested a high risk of trisomy 21 (1/19), with free β-hCG of 116 ng/mL (MoM value 2.35), PAPP-A of 0.394 ng/mL (MoM value 0.12), and NT value of 1.3 mm, though no abnormality was found in the fetus at 19 weeks gestation. The karyotype of amniocyte was determined as 46,X,psu idic(X)(p11.21)[55]/45,X[27]/47,X,psu idic(X)(p11.21)×2[5]/46,XX[13]. CMA has yielded a result of arr[GRCh37] Xp22.33p11.21(168552_55585678)×1[0.67],Xp11.21q28(55703291_155233098)×3[0.5]. CONCLUSION Karyotypes of Turner syndrome are complex and diverse, and a rare 46,X,psu idic(X)(p11.21)[55]/45,X[27]/47,X,psu idic(X)(p11.21)×2[5]/46,XX[13] mosaic karyotype with double pseudo-isodicentric X chromosome has been identified. Literature review suggested that this karyotype may lead to phenotypic diversification and a risk of reduced sensitivity to hormone therapy.
Humans ; Turner Syndrome/diagnosis* ; Female ; Pregnancy ; Chromosomes, Human, X/genetics* ; Mosaicism ; Prenatal Diagnosis ; Karyotyping ; Adult ; Karyotype ; Amniocentesis