AIM: To investigate the potential causal relationship between gut microbiota(GM)and primary open-angle glaucoma(POAG)based on a two-sample Mendelian randomization(MR)analysis.METHODS: The exposure data was derived from the Genome-Wide Association Studies(GWAS)of GM at the University of Bristol, while the outcome data for POAG was sourced from the MRC Integrative Epidemiology Unit(IEU)Open GWAS database. In this study, inverse variance weighted(IVW), MR Egger, weighted median(WM), Simple Mode, and Weighted Mode were analyzed to investigate the potential causal relationships between GM and POAG. IVW was used as the primary method for this study, and sensitivity analysis was conducted to assess the reliability of the MR analysis.RESULTS: The IVW analysis revealed that Butyrivibrio(OR=1.170, 95%CI: 1.057-1.295, P=0.002), Howardella(OR=1.188, 95%CI: 1.043-1.355, P=0.010), and LachnospiraceaeUCG001(OR=1.229, 95%CI: 1.016-1.485, P=0.033)were correlated with the risk of POAG. Conversely, Candidatus Soleaferrea(OR=0.810, 95%CI: 0.670-0.981, P=0.031), Ruminococcustorquesgroup(OR=0.656, 95%CI: 0.453-0.950, P=0.026), and RuminococcaceaeUCG013(OR=0.770, 95%CI: 0.598-0.990, P=0.041)were protective factors for POAG. Sensitivity analysis showed that there were no heterogeneity and pleiotropy among the instrumental variables.CONCLUSION: The MR study indicated a causal relationship between GM and POAG. Given the sight-threatening characteristic of POAG, early identification and intervention in the relative factors was significant for the prognosis of POAG.

Objective To analyze the epidemiological characteristics and spatial-temporal distribution of drug-resistant tuberculosis in Pudong New Area from 2016 to 2021 and to provide scientific basis for the prevention and control of drug-resistant tuberculosis. Methods The data of tuberculosis patients in Pudong New Area from 2016 to 2021 were collected through the Tuberculosis Information Management System of China Disease Prevention and Control Information System. The geographic information database was established by ArcGIS software and the vector map of Pudong New Area for trend surface analysis and spatial autocorrelation analysis . Results From 2016 to 2021, a total of 3916 patients with etiological positive tuberculosis were found to be drug resistant with the drug resistance rate of 13.13%. The drug resistance rate of each year showed a decreasing trend (χ²_trend=14.917, P<0.001). The rates of drug resistance of male, retiree, age 50~<60 years old, 60~<70 years old and recurrent patient were higher. From 2016 to 2021, the incidence of drug-resistant TB showed no spatial aggregation.In the south - north direction, the north is higher than the south generally. In the east - west direction, the west is higher than the east generally. Conclusion Drug resistance screening should be strengthened for men, retirees, over 50 years old, and recurrent TB patients,. Prevention and control measures should be strengthened in street towns with dense population and large floating population.

ObjectiveTo investigate the mechanism of Atractylodis Macrocephalae Rhizoma（AMR） in the treatment of slow-transmission constipation（STC） by observing the effects of AMR on short-chain fatty acids and intestinal barries in STC mice. MethodForty-eight male KM mice were randomly divided into blank group， model group， AMR low-， medium-， high-dose groups（2.5， 5， 10 g·kg^-1） and mosapride group（2.5 mg·kg^-1）. Except for the blank group， all groups were gavaged with loperamide suspension（5 mg·kg^-1） twice daily for 14 d to construct the STC mouse model. At the same time， each drug administration group was given the corresponding drug by gavage for consecutive 14 d， the blank and model groups were gavaged with equal volume of distilled water. The effects of the treatment of AMR on body mass， defecation frequency， fecal water content and intestinal propulsion rate of mice were observed， the pathological changes of mouse colon were observed by hematoxylin-eosin（HE） staining and periodic acid-Schiff（PAS） staining， the levels of gastrin（GAS） and motilin（MTL） in serum were detected by enzyme-linked immunosorbent assay（ELISA）， gas chromatography-mass spectrometry（GC-MS） was used to detect the contents of short-chain fatty acids（SCFAs） in mouse feces， real-time fluorescence quantitative polymerase chain reaction（Real-time PCR） and Western blot were used to determine the mRNA and protein expression levels of zonula occludens-1（ZO-1）， Occludin， and Claudin-1 in the colon of mice. ResultCompared with the blank group， the body mass， defecation frequency， fecal water content and intestinal propulsion rate of mice in the model group were significantly decreased（P<0.05， P<0.01）， the arrangement of colonic tissues was disordered， and the number of goblet cells was reduced， the levels of GAS and MTL in serum were significantly decreased（P<0.01）， and the levels of SCFAs in the feces were on a decreasing trend， with the contents of acetic acid， propionic acid， butyric acid， isobutyric acid and valeric acid were significantly decreased（P<0.05， P<0.01）， the mRNA and protein expression levels of ZO-1， Occludin and Claudin-1 in the colonic tissues were significantly decreased（P<0.01）. The above results suggested that STC mouse model was successfully constructed. Compared with the model group， the body mass， defecation frequency， fecal water content and intestinal propulsion rate of mice in AMP administration groups all increased significantly（P<0.05， P<0.01）， the mucosal layer of the colonic tissues was structurally intact without obvious damage， and the number of goblet cells increased， serum levels of GAS and MTL were significantly increased（P<0.01）， the contents of SCFAs in the feces were all on a rising trend， with the contents of acetic， propionic， butyric and isobutyric acids rising significantly（P<0.05， P<0.01）， the mRNA and protein expression levels of ZO-1， Occludin and Claudin-1 in the colonic tissues were significantly increased（P<0.05， P<0.01）. ConclusionAMR is able to improve the constipation symptoms in STC mice， and its mechanism may be related to increasing the contents of SCFAs in the intestine as well as promoting the mRNA and protein expression levels of ZO-1， Occludin and Claudin-1 in the colon.

Background::The goal of the assisted reproductive treatment is to transfer one euploid blastocyst and to help infertile women giving birth one healthy neonate. Some algorithms have been used to assess the ploidy status of embryos derived from couples with normal chromosome, who subjected to preimplantation genetic testing for aneuploidy (PGT-A) treatment. However, it is currently unknown whether artificial intelligence model can be used to assess the euploidy status of blastocyst derived from populations with chromosomal rearrangement.Methods::From February 2020 to May 2021, we collected the whole raw time-lapse videos at multiple focal planes from in vitro cultured embryos, the clinical information of couples, and the comprehensive chromosome screening results of those blastocysts that had received PGT treatment. Initially, we developed a novel deep learning model called the Attentive Multi-Focus Selection Network (AMSNet) to analyze time-lapse videos in real time and predict blastocyst formation. Building upon AMSNet, we integrated additional clinically predictive variables and created a second deep learning model, the Attentive Multi-Focus Video and Clinical Information Fusion Network (AMCFNet), to assess the euploidy status of embryos. The efficacy of the AMCFNet was further tested in embryos with parental chromosomal rearrangements. The receiver operating characteristic curve (ROC) was used to evaluate the superiority of the model. Results::A total of 4112 embryos with complete time-lapse videos were enrolled for the blastocyst formation prediction task, and 1422 qualified blastocysts received PGT-A ( n = 589) or PGT for chromosomal structural rearrangement (PGT-SR, n = 833) were enrolled for the euploidy assessment task in this study. The AMSNet model using seven focal raw time-lapse videos has the best real-time accuracy. The real-time accuracy for AMSNet to predict blastocyst formation reached above 70% on the day 2 of embryo culture, and then increased to 80% on the day 4 of embryo culture. Combing with 4 clinical features of couples, the AUC of AMCFNet with 7 focal points increased to 0.729 in blastocysts derived from couples with chromosomal rearrangement. Conclusion::Integrating seven focal raw time-lapse images of embryos and parental clinical information, AMCFNet model have the capability of assessing euploidy status in blastocysts derived from couples with chromosomal rearrangement.

Objective To investigate the effects of terahertz(THz)radiation on mouse testicular tissue and its potential molecular mechanisms.Methods A total of 125 male C57BL/6J mice(6～8 weeks old)were randomly divided into control group and low-,medium-and high-radiation power groups.The mice of the latter 3 groups were exposed to THz radiation at a frequency of 2.5 T,with an average power density of 38,115,or 318 mW/cm2,for 5 or 10 min.The detection time was immediately or 24 h after exposure.HE staining was used to observe pathological damage.ELISA was employed to detect the expression of inflammatory factors in testicular tissue.RNA-seq was utilized to detect the global changes of gene expression.The differentially expressed genes(DEGs)were screened and bioinformatics was used to cluster them.The screened genes were further analyzed with RT-qPCR to determine the time-dependent and dose-dependent relationships of the expression with THz exposure.Finally,sperm quality was evaluated morphologically using a microscope.Results Three doses of THz radiation exposure did not cause significant pathological damages to mouse testicular tissue.TNF-α expression was increased immediately after exposure at average power density of 115 mW/cm2(P＜0.01),and the expression of IL-1β and TNF-α were both increased when the dose reached 318 mW/cm2(P＜0.01).However,all the 3 factors returned to normal levels in 24 h after exposure.RNA-seq results showed that THz radiation exposure caused abnormal expression of 56 genes.Cluster analysis indicated that these DEGs were mainly enriched in immune and inflammatory responses,enzyme activity,sperm development and capacitation functions.Then for 5 selected key genes,Crisp1,Adam7,Ltf,Rnase9,and Bsph1,the expression of Crisp1 and Rnase9 was decreased immediately after exposure to 115 mW/cm2 THz radiation,the dose of 318 mW/cm2 resulted in obvious changes in the expression of the 5 genes(P＜0.05),and their expression returned to normal levels in 24 h after exposure.Morphological observation displayed that exposure to all the 3 doses of THz had no influence on sperm quality.Conclusion THz radiation exposure causes temporary inflammatory response in testicular tissue and abnormal expression of sperm functions-related genes.However,these changes return to normal 24 h after exposure,and additionally,do not impair sperm quality.

In recent years, the high temperature and heatwaves have seriously affected the health of Chinese residents, and there is an important need for public health protection guidelines for high temperature and heatwaves in China. The National Bureau of Disease Control and Prevention has organized experts to fully investigate the evidence from epidemiological research on the health of populations in high temperature and heatwaves globally and in China, analyze the health hazards and protection needs of different populations, and put forward practical and effective individual protection measures and health recommendations. For this reason, the "Guideline for Public Health Protection against High Temperature and Heatwaves" (referred to as the "Guideline") was officially issued in June 2023. This article interprets the background and significance of the Guideline, the principles of compilation, the main considerations, the main contents, the implementations and promotions and other aspects, to improve the understanding of the content of the Guideline and strengthen the publicity and implementations.

In recent years, the high temperature and heatwaves have seriously affected the health of Chinese residents, and there is an important need for public health protection guidelines for high temperature and heatwaves in China. The National Bureau of Disease Control and Prevention has organized experts to fully investigate the evidence from epidemiological research on the health of populations in high temperature and heatwaves globally and in China, analyze the health hazards and protection needs of different populations, and put forward practical and effective individual protection measures and health recommendations. For this reason, the "Guideline for Public Health Protection against High Temperature and Heatwaves" (referred to as the "Guideline") was officially issued in June 2023. This article interprets the background and significance of the Guideline, the principles of compilation, the main considerations, the main contents, the implementations and promotions and other aspects, to improve the understanding of the content of the Guideline and strengthen the publicity and implementations.

Objective To analyze blood lipid levels in patients with myelodysplastic syndrome(MDS)and further explore the factors associated with abnormal blood lipids.Methods Eighty-eight newly diagnosed MDS patients were selected as the study group,and 100 healthy subjects were selected as the control group.Fasting blood lipid levels,triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),apolipoprotein A1(ApoA1)and ApoB were detected before treatment in the study group and the control group.The differences of serum lipid levels in MDS patients with different WHO-MDS classification,modified International Prognostic Score System(IPSS-R)karyotype,risk stratification and TP53 mutation were investigated.The correlation between ApoA1 level and clinical indicators of MDS patients was analyzed,and clinical indicators of different ApoA1 level groups were compared.Results The levels of TC,HDL-C,LDL-C,ApoA1 and ApoB were significantly lower in the study group than those in the control group(P＜0.01).There were no significant differences in TG,TC,HDL-C,LDL-C,ApoA1 and ApoB levels between different subgroups.The ApoA1 level was lower in the IPSS-R high-risk stratification group than that of the IPSS-R low-risk stratification group(P＜0.05).There were no significant differences in lipid levels between the different karyotype groups.The level of ApoA1 was lower in the TP53 mutant group than that in the non-TP53 mutant group(P＜0.05).Correlation analysis showed that ApoA1 level was positively correlated with body mass index(BMI,P＜0.05),and negatively correlated with patient age,percentage of bone marrow original cells,IPSS-R karyotype grouping,IPSS-R risk grouping and TP53 gene mutation(P＜0.05).The BMI level was lower in the low ApoA1 group than that of the high ApoA1 group(P＜0.05).The percentage of bone marrow original cells and TP53 gene mutation rate of MDS patients were higher in the low ApoA1 group than those in the high ApoA1 group(P＜0.05).Conclusion The plasma lipid level in MDS patients is significantly lower than that of healthy controls,and levels of ApoA1 varied significantly in different disease states,which may be associated with TP53 gene mutation.

Objective Improving the limb management strategy for patients undergoing coronary intervention through radial artery puncture and observe the application effect,and to provide scientific basis for the prevention of limb complications.Methods From March 2023 to February 2024,patients who underwent coronary intervention in the Cardiovascular Department of a Tertiary A hospital in Wenzhou City were selected.They were randomly di-vided into an experimental group of 241 cases and a control group of 236 cases using a random number table method.After surgery,they were all treated with a rotary hemostatic device for compression hemostasis.The experi-mental group implement improvement strategies for surgical limb management,specifically underwent a reverse Bar-beau test upon returning to the ward after surgery to achieve non-occlusive compression,followed by decompression every hour.The compression intensity of the control group was guided by palpating the distal radial artery pulsa-tion,and the first decompression was performed 1 hour after surgery,followed by decompression at intervals of every 2 hours.The main evaluation indicators are the incidence of surgical limb complications and simplified Chinese version of General Comfort Questionnaire(GCQ)scores in 2 groups of patients,while the secondary evaluation indi-cators are the duration of compression and the number of decompression times in both groups.Results The inci-dence of postoperative complications in the experimental group was 14.11%,which was statistically significant com-pared to 44.49%in the control group(χ2=53.308,P<0.001).The GCQ score of the experimental group was(77.71±5.43)points,which was higher than(74.66±5.83)points in the control group,and the difference was statistically signif-icant(t=-3.354,P=0.001).The compression duration of(172±52)minutes and decompression frequency of 2(2,3)in the experimental group were lower than(289±60)minutes and 4(3,4)in the control group,and the differences were statistically significant(P<0.001).Conclusion The non-occlusive compression method of the radial artery based on the reverse Barbeau test can significantly reduce limb complications in patients undergoing coronary inter-vention,shorten the duration of hemostatic compression,reduce the number of depressions,and improve patient com-fort.It provides objective basis for nursing staff to evaluate the intensity of hemostatic compression and the timing of decompression.

Objective To study the effect of mitochondrial reactive oxygen species(ROS)on male fertility and its application value in assisted reproduction so as to provide a new method for fertility assessment and etiological treatment of male infertility.Methods The relationship between sperm ROS and male infertility,sperm nuclear DNA integrity and sperm membrane function was analyzed.Then the relationships of the ROS of sperms for fertiliza-tion with fertilization rate,cleavage rate,embryo rate and pregnancy outcome were analyzed.Results(1)The percentage of the high ROS in sperm membrane of the male infertility group was significantly higher than that of the normal fertility group(P<0.01),but there was no statistical difference in the percentage of the high ROS in the sperm mitochondria between the two groups.(2)The normal rate of sperm membrane function in the normal group was significantly higher than that in the abnormal group(P<0.01),but there was no significant difference in the sperm DNA fragmentation index(DFI)between the groups.(3)There was significant difference in the fertilization rate between the IVF control group and IVF observation group,but no significant difference was seen in the cleavage rate,excellent embryo rate and clinical pregnancy rate between the groups.Conclusion Sperm ROS is related to male fertility to some extent.Abnormal ROS may lead to impaired sperm membrane function and affect sperm fertilization ability,thus affecting male fertility.The detection of ROS in sperm can be used as a new method to evaluate male fertility and provide a basis for diagnosis or treatment of male infertility.For patients with ART or infertility,the appropriate time to conceive can be selected according to the sperm ROS level.