Background Diesel engines are widely used in transportation, agriculture, construction, industry, and other fields. Diesel exhaust, classified as a Group 1 carcinogen, emits particles (DEP) that can penetrate deep into the respiratory tract, posing significant health risks. DEP pollution is particularly severe in confined environments, necessitating effective control measures. Objective Under laboratory simulation conditions, to explore the spatiotemporal distribution characteristics of the mass and number concentrations of DEP as it diffuses indoors and to reveal the effects of ventilation and additional airflow on indoor DEP pollution levels. Methods A diesel engine was placed in a laboratory (length 3.39 m × width 2.85 m × height 2.4 m) with its exhaust emitted from east to west. An air purifier was installed 1 m south of the engine. Eight measurement points (1 m horizontal distance from the exhaust outlet, height: 1 m/1.5 m) were setup to monitor DEP concentrations using portable laser particle sizers. The effects of engine power (4.05 kW vs. 5.15 kW), ventilation (maximum airflow: 600 m³·h⁻¹), additional airflow intensity (low and high), and direction (forward/reverse) on DEP pollution were analyzed. DEP levels of 5 diesel vehicle models were also compared. Results The mass and number concentrations of DEP indoors increased immediately after the diesel engine started. The peak mass concentration time at the eastern measurement point (−1, 0) m opposite to the exhaust direction (17.70 min) was significantly longer than that at the western (1, 0) m (16.20 min), southern (0, -1) m (14.45 min), and northern (0, 1) m (12.70 min) points (P<0.05), with no significant differences between the other points (western, southern, and northern) (P>0.05). The northern point (0, 1) m exhibited the highest DEP mass and number concentration peaks (174.62 μg·m⁻³, 1319.85 p·cm⁻³), significantly exceeding those at the southern (0, −1) m (129.89 μg·m⁻³, 1175.24 p·cm⁻³), eastern (−1, 0) m (140.12 μg·m⁻³, 1120.53 p·cm⁻³), and western (1, 0) m (147.60 μg·m⁻³, 818.62 p·cm⁻³) points (P<0.05), and no significant differences were observed among other points (P>0.05). There were no significant differences in peak DEP mass and number concentrations by measurement heights (P>0.05). Diesel engine power, ventilation, airflow intensity, and airflow direction had no significant effect on the time of peak DEP concentration (P>0.05). However, higher engine power (5.15 kW) produced greater DEP peaks [(186.66±19.29) μg·m⁻³, (1382.79±122.56) p·cm⁻³] than the 4.05 kW engine power [(168.41±12.65) μg·m⁻³, (1284.45±71.30) p·cm⁻³] (P<0.05). The peak mass concentration [(342.04±35.03) μg·m⁻³] and number concentration [(1886.87±57.91) p·cm⁻³] of DEP in the non-ventilated group were significantly higher than those in the ventilated group [(186.66±19.29) μg·m⁻³, (1382.79±122.56) p·cm⁻³] (P<0.001). Forward airflow elevated DEP mass concentrations compared to reverse airflow (287.71 μg·m⁻³ vs. 243.74 μg·m⁻³, t=−2.592, P=0.009), but no effects on DEP number concentration (P>0.05). Significant differences in mass concentration were observed among selected 5 vehicle models (Z=38.109, P<0.001). Conclusion The operation of diesel engines will emit a large amount of particulate matter, causing pollution in enclosed spaces. Diesel engines with greater power have higher levels of DEP pollution emissions. Based on the spatiotemporal distribution characteristics, it is recommended to set the operation position in the reverse direction of exhaust emissions and close to air purifiers, while avoiding the use of additional air flow equipment.

OBJECTIVE To conduct rapid health technology assessment （HTA） of ulinastatin （UTI）， and to evaluate the efficacy， safety and cost-effectiveness of UTI in the treatment of acute pancreatitis （AP）. METHODS Retrieved from PubMed， Embase， the Cochrane Library， CNKI， Wanfang database， CBM and official websites of HTA institutions， the systematic review （SR）/meta-analysis， economic evaluation and HTA reports of UTI in the treatment of AP were collected from the inception to Apr. 2024. Two researchers independently conducted screening， quality evaluation and data extraction according to the admission and exclusion criteria， and descriptive analysis was adopted to analyze and summarize the data. RESULTS A total of 19 studies were included， involving 15 SR/meta-analysis and 4 economic studies， and no HTA report was retrieved. In the treatment of AP， UTI showed clear advantages over conventional treatment alone in terms of improving the overall effective rate， shortening the recovery time of amylase， reducing the time required to relieve abdominal pain and distension， lowering the mortality rate， and decreasing the average hospital stay. Compared to other positive drugs （carbendate mesylate， octreotide， somatostatin， etc.）， its efficacy is similar， with a favorable safety profile. As far as the current research was concerned， UTI had obvious economic advantages over other positive drugs. CONCLUSIONS UTI is safe and effective in the treatment of AP， and has economic advantages.

Objective To screen the specific cytokines of tuberculous pleural effusion(plTB)by using liquid array technique to establish a diagnostic model and discuss its application value.Methods A total of 86 patients with plTB(plTB group)were included,including 41 patients in the confirmed plTB group and 45 patients in the clinically diagnosed plTB group.There were 42 other patients with pleural effusion in the control group.Seventeen cytokines in pleural effusion were analyzed by liquid array technology.Interleukin(IL)-1β,IL-2,IL-4,IL-5,IL-6,IL-8,IL-9,IL-10,gamma-interferon-induced protein 10(IP-10),IL-15,IL-17F,IL-27,tumor necrosis factor(TNF)-α,monocyte chemotactic protein-1(MCP-1),the expression levels of macrophage inflammatory protein-3a(MIP-3α),macrophage colony-stimulating factor(M-CSF)and β-interferon(IFN-β)were detected.Difference factors between the confirmed plTB group and the control group were screened,and the receiver operating characteristic(ROC)curve was drawn in the confirmed plTB patients.IP-10,IL-27 and MCP-1 with AUC>0.850 and specificity>80%were combined to diagnose plTB,and were compared with adenylate deaminase(ADA)and T-SPOT.TB in pleural effusion to evaluate the diagnostic efficacy.Results The levels of IL-2,IP-10,IL-27,TNF-α and MCP-1 were higher in the confirmed plTB group than those in the control group(P＜0.05).The sensitivity and specificity of IP-10,IL-27 and MCP-1 in the diagnosis of plTB were 87.8%and 81.0%.The sensitivity of three-factor combined diagnosis in 45 patients with plTB was still as high as 86.7%,and there was no significant difference in sensitivity compared with that in the diagnosed plTB group(P＞0.05).In the plTB group,the sensitivity of IP-10,IL-27 and MCP-1 combined detection was 87.2%,which was higher than that of T-SPOT.TB(81.4%)and ADA(54.7%).Conclusion The application of liquid array technology to the joint detection of pleural effusion IP-10,IL-27 and MCP-1 can provide help for the diagnosis of plTB.

Nephroptosis,a rare condition in urology,often results from inadequate support of the kidney's perinephric fat structures,leading to excessive renal mobility.It typically occurs in lean,tall,young females.Some cases manifest with abdominal pain and renal dysfunction.Open nephropexy,laparoscopic nephropexy and percutaneous nephropexy are all effective methods in the treatment of nephroptosis,among which percutaneous nephropexy is associated with less trauma and lower costs.Modifications to percutaneous nephropexy by the authors'team are also introduced mentioned in this article.

Objective:To evaluate auditory spatial discrimination capabilities in patients with mild to moderately severe symmetrical sensorineural hearing loss (SNHL) and to compare the impact of different psychophysical testing methods on Minimum Audible Angle (MAA) and test duration.Methods:A total of 105 symmetrical SNHL patients aged from 18 to 60 years old were enrolled from April to July 2023, including 56 males and 49 females. They were divided into three groups based on PTA: mild, moderate, and moderately severe hearing loss, with 35 individuals in each group. Additionally, a control group of 35 individuals with normal hearing was tested, including 18 males and 17 females. Participants underwent four distinct psychophysical discrimination tests: the block up-down, 1-up/1-down, 1-up/2-down, and 1-up/3-down procedures. We recorded the MAA and test duration for each. We employed repeated measures of ANOVA to compare the MAA and test duration across different methods and groups, and Pearson′s correlation to assess the relationship between MAA and degree of hearing loss.Results:MAA of sound localization in patients with symmetrical SNHL was significantly positively correlated with the degree of hearing loss ( r=0.59, P<0.01). Significant deterioration in MAA was observed as hearing loss progressed to the moderate level (PTA≥35 dBHL, P<0.01). The testing methods significantly influenced MAA and testing duration ( F=24.02, P<0.01; F=75.56, P<0.01) and the 1-up/1-down method was the quickest, averaging only (0.69±0.32) mins. Conclusions:The horizontal plane auditory spatial discrimination abilities in patients with symmetrical SNHL is impaired progressively with increasing hearing loss, notably beyond moderate hearing loss levels. Different psychophysical methods influence both MAA and test duration, the quicker 1-up/1-down method is recommended for assessing MAA in symmetrical SNHL patients.

Disturbances of gut microbiota may affect the balance of the host immune system.The metabolism of gut microbiota produces many bioactive molecules interacting with host,typically secondary bile acids(SBAs).SBAs are involved in regulating the energy metabolism and the expression of inflammatory response-related genes by bind-ing to membrane receptors and nuclear receptors,such as takeda G protein-coupled receptor(TGR5)and farnesol X receptor(FXR),which are essential for maintaining host immune homeostasis.

Aging and age-related ailments have emerged as critical challenges and great burdens within the global contemporary society.Addressing these concerns is an imperative task,with the aims of postponing the aging process and finding effective treatments for age-related degenerative diseases.Recent investigations have highlighted the significant roles of nicotinamide adenine dinucleotide(NAD+)in the realm of anti-aging.It has been empirically evidenced that supplementation with nicotinamide mononucleotide(NMN)can elevate NAD+levels in the body,thereby ameliorating certain age-related degenerative diseases.The principal anti-aging mechanisms of NMN essentially lie in its impact on cellular energy metabolism,inhibition of cell apoptosis,modulation of immune function,and preservation of genomic stability,which collectively contribute to the deferral of the aging process.This paper critically reviews and evaluates existing research on the anti-aging mechanisms of NMN,elucidates the inherent limitations of current research,and proposes novel avenues for anti-aging investigations.

Objective To investigate the clinical symptoms and psychological health status of migraine patients.Methods A total of 120 migraine patients admitted to Xingtai People's Hospital from September 14,2022 to July 30,2023 were selected and divided into mild pain group(0-3 points,51 cases),moderate pain group(4-6 points,48 cases),and severe pain group(7-10 points,21 cases)according to numerical rating scale.General clinical data,headache impact test-6(HIT-6),patient health questionnaire-9(PHQ-9),generalized anxiety disorder(GAD-7)and Pittsburgh sleep quality index(PSQI)were collected.Results The scores of HIT-6,PHQ-9,GAD-7,and PSQI of migraine patients were(56.33±11.30)points,(3.38±1.51)points,(3.01±0.58)points,and(4.73±0.78)points,respectively.There were statistically significant differences in the duration and total number of headache attacks among three groups(P＜0.05).With the aggravation of headache degree,the duration of headache attacks increased and the number of attacks increased.There were statistically significant differences in the scores of HIT-6 and GAD-7 among three groups(P＜0.05),and the scores of HIT-6 and GAD-7 increased with the aggravation of headache.Conclusion There are differences in the daily life impact,anxiety,pain duration and frequency of migraine in patients with different degrees of migraine.

Pulmonary hypertension (PH) is an extremely malignant pulmonary vascular disease of unknown etiology. ADAR1 is an RNA editing enzyme that converts adenosine in RNA to inosine, thereby affecting RNA expression. However, the role of ADAR1 in PH development remains unclear. In the present study, we investigated the biological role and molecular mechanism of ADAR1 in PH pulmonary vascular remodeling. Overexpression of ADAR1 aggravated PH progression and promoted the proliferation of pulmonary artery smooth muscle cells (PASMCs). Conversely, inhibition of ADAR1 produced opposite effects. High-throughput whole transcriptome sequencing showed that ADAR1 was an important regulator of circRNAs in PH. CircCDK17 level was significantly lowered in the serum of PH patients. The effects of ADAR1 on cell cycle progression and proliferation were mediated by circCDK17. ADAR1 affects the stability of circCDK17 by mediating A-to-I modification at the A5 and A293 sites of circCDK17 to prevent it from m1A modification. We demonstrate for the first time that ADAR1 contributes to the PH development, at least partially, through m1A modification of circCDK17 and the subsequent PASMCs proliferation. Our study provides a novel therapeutic strategy for treatment of PH and the evidence for circCDK17 as a potential novel marker for the diagnosis of this disease.

Objective:To evaluate the effect of mixed reality (MR) in the standardized resident training on oral and maxillofacial-head and neck tumor surgery.Methods:Twenty resident doctors, who received standardized training in the department of maxillofacial oncology of our hospital, were randomly divided into experimental group and control group. The MR teaching method was used in the experimental group, while the traditional teaching method was used in the control group. The teaching effect was evaluated by theoretical and operational tests and a questionnaire survey. Statistical analysis was performed with the SPSS 24.0 software. Statistical comparisons were performed by the Students' t-test or the Wilcoxon rank correlation test. Results:The theoretical test results showed that the scores of the experimental group were significantly higher than those of the control group (85.30±3.59 vs. 80.20±5.63, t = 2.41, P = 0.027). The operational test results showed that the scores of the experimental group were significantly higher than those of the control group (89.20±5.07 vs. 82.30±6.36, t = 2.68, P = 0.015). The questionnaire survey results showed that the MR teaching helped to easily acquire the knowledge of head and neck anatomy and operation skills. Besides, the doctors in the experimental group were more active and glad to communicate with others than those in the control group. In addition, the MR teaching method improved the learning interest of doctors. The doctors in the experimental group were more satisfied with the teaching effect than those in the control group, and they recommended that the MR teaching method be used in clinical training and teaching on oral and maxillofacial-head and neck tumor surgery. Conclusion:MR teaching can help doctors understand and master the knowledge of head and neck anatomy and operation skills and improve their learning interest, achieving a good teaching effect, so it has important application value in the standardized resident training on oral and maxillofacial-head and neck tumor surgery.