BACKGROUND:In recent years,with the rapid development of biomedicine,the study of brain aging and exosomes has attracted more and more attention,but there is no bibliometrics analysis in this field. OBJECTIVE:To objectively analyze domestic and foreign literature on brain aging and exosomes in the past 15 years,to summarize the research status,hot spots,and development trends in this field. METHODS:Using the core database of Web of Science as a search platform,we downloaded the literature on brain aging and exosomes published from the establishment of the database to December 28,2022,and analyzed the data from the aspects of country or region,institution,author,keywords,and co-cited literature using CiteSpace 6.1.R6 visualization software. RESULTS AND CONCLUSION:A total of 1 045 research articles were included,and the number of publications on brain aging and exosomes research both domestically and internationally was showing an increasing trend year by year.The United States ranked first with 429 papers,and China ranked second with 277 papers.Louisiana State University ranked first with 16 articles.Professor Lukiw Walter J from Louisiana State University in the United States was the author with the highest number of publications,and Professor Bartel DP from the Massachusetts Institute of Technology was the author with the most citations.The most prolific Journal was the International Journal of Molecular Sciences.Alzheimer's disease,microRNA,gene expression,extracellular vesicles,exosomes,oxidative stress,and biomarkers are the most relevant terms.According to the research on hot topics,biomarkers have become a new research hotspot.The above results indicate that the research on brain aging and exosomes has gradually increased in the past 15 years.The research direction has gradually shifted from the initial exploration of the expression of miRNAs in central nervous system diseases related to brain aging to the search for biomarkers that can identify and diagnose neurodegenerative diseases.The study of exocrine miRNAs to protect central nervous system from damage has emerged as promising therapeutic strategy.

Objective: To compare and analyze the antibacterial effects of platelets against five common clinical pathogenic bacteria including MRSA, SE, SA, E. coli, and CRKP, and to preliminarily explore the role of DCD sensitivity in the observed variations of antibacterial effects. Methods: The same number of platelets were used to establish co-culture systems of platelets and platelet lysates with the five pathogenic bacteria. The antibacterial effects of platelets and platelet lysates on the five pathogenic bacteria were evaluated by observing the turbidity of the bacterial solution, measuring the OD value of the bacterial solution and counting the colonies. The supernatant protein of platelets co-cultured with MRSA was collected for quantitative proteomics analysis to explore the important antibacterial proteins of platelets. The content of DCD in the supernatant after co-culture of platelets and platelet lysates with the five pathogenic bacteria was detected by ELISA to preliminarily analyze the reasons for the different antibacterial effects of platelets on the five pathogenic bacteria. Results: Compared with the control group of MRSA, SA, and SE, the turbidity of the bacterial solution decreased after co-culture of platelets and platelet lysates with MRSA, SA, and SE for 12 h, and the OD value and colony count were significantly reduced (P<0.05). The turbidity of the bacterial solution did not change significantly after co-culture of platelets and platelet lysates with E. coli for 24 h, but the OD value decreased (P<0.05), and the colony count decreased to 10 CFU/mL but the difference was not statistically significant (P>0.05). Compared with the control group of CRKP, the turbidity, OD value, and colony count of the bacterial solution did not change significantly after co-culture of platelets and platelet lysates with CRKP (P>0.05). Proteomics results showed that after co-culture with MRSA, important proteins related to platelet activation, including collagen, fibrinogen, von Willebrand factor, integrin αIIbβ3, platelet glycoprotein V and IV were significantly up-regulated. ELISA results showed that after co-culture with the five pathogenic bacteria, platelets could secrete a large amount of DCD, with the content around 3 μg/mL. Conclusion: The antibacterial effect of platelets on Gram-positive bacteria MRSA, SA, and SE is better than that on Gram-negative bacteria E. coli and CRKP, and platelets have the best antibacterial effect on MRSA. The differences in antibacterial effects of platelets on the five pathogenic bacteria may be related to the sensitivity of DCD antibacterial peptides to the five pathogenic bacteria.

Objective To explore the epidemic characteristics of common pneumonia pathogens in preschool children in Xining area and analyze the influencing factors of progression to severe pneumonia. Methods A total of 522 preschool children with pneumonia who were treated in our hospital from May 2021 to March 2024 were retrospectively selected as the research subjects. Sputum samples from children were taken to identify the pathogens and analyze their pathogenic epidemic characteristics.According to the diagnostic criteria in the 2019 version of ^“Standards for the Diagnosis and Treatment of Community-Acquired Pneumonia in Children^”, determine whether it is severe pneumonia, and collect the clinical data of the children.Logistic regression was used to analyze the influencing factors of the progression of common pneumonia to severe pneumonia. Results Among the 522 children with pneumonia, 522 cases were infected with pathogens, of which 447 cases were single infection (85.63%), 75 cases were mixed infection (14.36%). A total of 597 pathogens were detected, including 257 viruses (43.05%), 240 bacteria (40.20%), 68 mycoplasma pneumoniae (11.39%) and 32 chlamydia pneumoniae (5.36) . The detection rates of Streptococcus pneumoniae (149, 24.96%) and respiratory syncytial virus (118, 19.77%) were higher. Logistic regression results showed that length of hospital stay (OR=2.235, 95% CI: 1.552-3.439), ICU admission (OR=2.426, 95% CI: 1.769-3.881), intestinal microbiota disorder (OR=1.626, 95% CI: 1.335-2.842), multi-drug resistance (OR=2.086, 95%CI 1.417-2.905), mixed infection (OR=3.134, 95% CI : 2.217-8.857), nutritional risk (OR=2.783, 95% CI: 2.038-4.764), CRP (OR=2.589, 95% CI: 1.805-4.117), PCT (OR=1.486, 95%CI: 1.077-1.649), and white blood cells (OR=1.329, 95% CI: 1.021-1.536) were all associated with the risk of severe pneumonia (P<0.05). Conclusion The main pathogens of pneumonia in preschool children in Xining are Streptococcus pneumoniae and respiratory syncytial virus. Paying attention to the treatment of children with intestinal disorders, multiple infections, and malnutrition is of great significance to improve the progression of pneumonia.

Objective To retrospectively analyze the efficacy and safety of low-dose antithymocyte globulin(ATG)combined with low-dose post transplantation cyclophosphamide(PTCY)in prevention of graft versus host disease(GVHD)after haploidentical transplantation.Methods Clinical data of 90 patients receiving haplotype matched transplantation in No.920 Hospital of PLA Joint Logistic Support Force from January 2022 to February 2023 were collected,and they were divided into study group(n=47)and control group(n=43)according to different GVHD prevention programs.The patients of the study group were given low-dose ATG combined with low-dose PTCY,and those of the control group received standard dose of PTCY.The implantation status,occurrence of GVHD,survival status and other indicators were analyzed between the 2 groups.Results ① Both groups of patients were successfully implanted,the median duration for neutrophil implantation(11 vs 17 d,P＜0.05)and platelet implantation(12 vs 20 d,P＜0.05)was significantly shorter in the study group than the control group.The incidence of grade Ⅱ～Ⅳ aGVHD(12.8％vs 34.9％,P＜0.05)and grade Ⅲ～Ⅳ aGVHD(6.4％ vs 20.9％,P＜0.05)was significantly lower in the study group than the control group,so was the non-recurrent mortality rate(6.4％vs 20.9％,P＜0.05)and the incidence of hemorrhagic cystitis(12.8％ vs 34.9％,P＜0.05).② By the end of the study,there were no significant differences in the incidence of mild and moderate and severe cGVHD,recurrence rate,reactivation rates of EBV and CMV,overall survival rate or progression-free survival rate between the 2 groups.Conclusion For haploidentical transplantation,low-dose ATG combined with low-dose PTCY has the advantages of lower incidence of GVHD,non-recurrent mortality,incidence of hemorrhagic cystitis and faster implantation.

ObjectiveTo analyze the research status and trends in low-level occupational benzene exposure. Methods Articles on low-level occupational benzene exposure from Chinese and English journals from January 1st, 2000, to December 31th, 2022 were retrieved using the Web of Science and the China National Knowledge Infrastructure, and a bibliometric analysis was conducted. Results A total of 327 articles were included in the analysis, comprising 216 English articles and 111 Chinese articles. i) The number of articles published in English fluctuates greatly over the years, without a trend of continuous growth or decline. Authors from 359 research institutions in 45 countries and regions have published relevant English articles in 97 kinds of journals, involving 281 grants from 226 foundations. The top three countries in terms of articles amount were the United States, Italy, and China, with 81, 46, and 43 papers, respectively. The English articles mainly focused on mechanistic research at the genetic level, such as hematotoxicity, oxidative stress, and DNA damage. ii) The number of Chinese articles increased gradually after 2012, with the growth peak in 2017. Authors from 127 research institutions in 26 provinces, autonomous regions, and municipalities published Chinese articles in 51 kinds of journals, involving 154 grants from 78 foundations. Chinese articles tended to focus on benzene-induced hematotoxicity and occupational health damage. Conclusion Most studies on low-level occupational benzene exposure were conducted in China, the United States and Italy, focused on hematotoxicity. Monitoring international research topics and hotspots of the field has certain reference value for related research in China.

Objective:To investigate the prevalence of adult skeletal fluorosis caused by drinking tea-type endemic fluorosis in Yushu Tibetan Autonomous Prefecture (hereinafter referred to as Yushu Prefecture), Qinghai Province, and provide scientific basis for prevention and control of the disease.Methods:In August 2021, one village was selected as a survey site in six counties (cities) in Yushu Prefecture, including Nangqian, Chindu, Yushu, Zadoi, Qumarlêb, and Zhiduo. Drinking water samples and 10 brick tea samples were collected from each village to determine the fluoride content in water and brick tea; at least 100 permanent residents aged ≥ 25, who had a habit of drinking brick tea and had lived in the local area for more than 5 years, were selected for X-ray imaging to examine the prevalence of adult skeletal fluorosis.Results:A total of 75 samples of residential drinking water were collected, with a fluoride content of (0.21 ± 0.05) mg/L, ranging from 0.11 to 0.34 mg/L; 60 samples of brick tea, with a fluoride content of (626.70 ± 157.27) mg/kg, ranging from 324.00 to 2 102.00 mg/kg. A total of 1 136 adults were examined, and 318 cases of skeletal fluorosis were diagnosed, with a detection rate of 27.99%. Among them, the detection rates of mild, moderate, and severe skeletal fluorosis were 20.95% (238/1 136), 6.07% (69/1 136), and 0.97% (11/1 136), respectively, with mild symptoms being the main. The detection rates of skeletal fluorosis in males and females were 29.09% (121/416) and 27.36% (197/720), respectively, with no statistically significant difference between the gender (χ 2 = 0.39, P = 0.533). Comparison of the skeletal fluorosis in different gender, the differences were statistically significant (χ 2 = 22.31, P < 0.001). The detection rates of skeletal fluorosis in the age groups of 25 - 35, 36 - 45, 46 - 55, 56 - 65, 66 - 75, and ≥76 years old were 6.86% (7/102), 22.37% (51/228), 24.02% (92/383), 37.44% (73/195), 43.48% (70/161), and 37.31% (25/67), respectively. The differences between the groups were statistically significant (χ 2 = 59.84, P < 0.001). Moreover, there was a statistically significant difference in the composition of skeletal fluorosis among different age groups ( H = 37.66, P < 0.001). The Spearman correlation analysis results showed that the severity of adult skeletal fluorosis was positively correlated with age ( r = 0.34, P < 0.001). Conclusions:There is a certain degree of prevalence of adult skeletal fluorosis in Yushu Prefecture. And as age increases, the condition of skeletal fluorosis becomes more severe.

ObjectiveTo observe the clinical effectiveness and safety of Sanjie Waifu Formula （散结外敷方） application therapy for benign thyroid nodules of qi constraint and phlegm obstruction syndrome. MethodsEighty patients with benign thyroid nodules of qi constraint and phlegm obstruction syndrome were randomly divided into 40 cases each in a treatment group and a control group. The control group was given health education and follow-up observation， while the treatment group applied Sanjie Waifu Formula externally on the basis of the control group，6~8 h each time ， once a day. Both groups took 30 days as a course， and were observed for 3 consecutive courses. The main effectiveness indexes of both groups were compared before and after treatment， including the volume of thyroid nodules， the maximum diameter of the largest nodule， the scores of traditional Chinese medicine （TCM） syndrome， and the secondary effectiveness indexes of serum thyroid function including free triiodothyronine （FT₃）， free thyroxine （FT₄）， thyrotropin （TSH） levels were also observed. The effectiveness of the TCM syndrome of both groups was compared after treatment. Meanwhile， the safety indexes were observed before and after treatment， such as the blood routine， liver and kidney function indexes， and the occurrence of adverse reactions during the study was recorded. ResultsCompared with in group before treatment， the volume of thyroid nodules， the maximum diameter of the largest nodule， and the TCM symptom scores were lowered in both groups after treatment （P＜0.05 or P＜0.01）. Comparing between groups after treatment， the difference in thyroid nodule volume was not statistically significant （P＞0.05）， but the maximum diameter of the largest nodule and the TCM symptom scores of the treatment group were lower than those of the control group （P＜0.01）. The total effective rate of TCM syndrome in the treatment group was 77.50% （31/40）， which was significantly higher than that of the control group with 52.5% （21/40， P＜0.01）. Thyroid function， blood routine and liver and kidney function indexes of both groups before and after treatment were compared between and within groups， and the differences were not statistically significant （P＞0.05）， and they were all within the normal range. During the treatment period， no allergic reactions such as skin itching， red rash and blisters occurred in the treatment group. ConclusionThe external application of Sanjie Waifu Formula can improve the clinical symptoms of patients with benign thyroid nodules， reduce volume and the maximum diameter of nodules， and has no significant effects on thyroid function and show good safety.

Objective:To sinicize the Gerontological Nurse Teacher Scale (GeNTS) and to test reliability and validity of the Chinese version, so as to provide a scientific measuring tool for the ability assessment of geriatric nursing teachers in China.Methods:The scale was translated according to the Brislin model and revised to form the Chinese version. The Chinese version of the GeNTS was used to facilitate the sampling of 375 nursing students from Sichuan Vocational College of Health and Rehabilitation, Neijiang Health Vocational College, and Sichuan Nursing Vocational College from June to August, 2023. SPSS 23.0 was used to analyze the data, and the critical ratio method, homogeneity test, Cronbach α coefficient method were used for item analysis, expert content validity index was used for content validity, exploratory factor method was used for structural validity test, internal consistency reliability, folding reliability, and re-test reliability were used for reliability test, and AMOS 28.0 was used for validation factor analysis.Results:The Chinese version of the GeNTS had 30 entries, and five common factors were extracted by exploratory factor analysis, with a cumulative of 82.462%. Validated factor analysis showed that the χ2/ df = 2.501, root mean square error of qpproximation (RMSEA) = 0.051, stamdardized root mean square residual (SRMR) = 0.043, incremental fit index (IFI) = 0.968, and normed-fit index (NFI) = 0.956, all of which were in the acceptable range, and the content validity of the Chinese version of the GeNTS was 0.837, with a Cronbach alpha coefficient of 0.977, a folded half reliability of 0.924, and a retest reliability of 0.924. Conclusions:The Chinese version of the Gerontological Nurse Teacher Scale has good reliability and validity. It is usefull to assess the situation of elderly nursing teachers in stimulating students′career interest in China.

Objective To compare the effects of two exercise intensities on metabolic syndrome(MS).Methods Forty-nine MS patients hospitalized in Taiyuan Central Hospital from December,2022 to January 2024 were selected and randomly divided into two groups:a standard group(n=24)and individual group(n=25).All patients underwent cardiopulmonary exercise test(CPET)before and after treatment,collecting major indexes including body parameter,body component,and metabolic indicator for prescribing exercise programs.The standard group was trained with exercise intensity prescribed on heart rate reserve,while the individual group received the exercise with intensity prescribed on ventilatory threshold.Both groups received equal energy consumption exercise intervention with the same exercise frequency for 12 weeks.Results The two groups demonstrated significant improvements in waist circumference(WC),body mass index(BMI),body fat related indexes,and systolic blood pressure after intervention(P<0.05).The individual group showed significant improvements inWC,BMI and body fat related indexes as compared to the standard group(P<0.05).Both groups showed significant improvements in peak oxygen uptake,(PeakVO2),peak load power(Peak WR),peak metabolic equivalent(PeakMets),and peak respiratory exchange ratio(Peak RER)after intervention(P<0.05).The individual group presented significant improvements in peak heart rate(HRpeak),peak oxygen pulse(Peak VO2/HR),and maximum voluntary ventilation(MVV)(P<0.05)after intervention.Before intervention,the standard group demonstrated significantly higher levels in PeakVO2 and Peak MET compared to the individual group(P<0.05),but after intervention the two groups showed no significant differences in the two indexes.After the intervention,the individual group demonstrated insignificant improvements in all indexes compared to the standard group(P>0.05).Conclusions Both exercise prescriptions based on CPET can effectively improve the health-related indicators of MS patients on condition of moderate exercise intensity.However,the program prescribed based on individualized ventilatory threshold shows superiority to the program prescribed based on maximum physiological value in improving these indicators.

Patients with metabolic syndrome(MS)are at potential risk for cardiovascular disease and have received increasing public and medical attention.Studies have shown that regular physical exercise can effectively regulate meta-bolic indicators such as blood pressure,blood sugar and blood lipids,and play a positive role in reducing the risk of cardio-vascular disease and improving the prognosis of patients.Exercise intensity has been identified as the most important as-pect in reducing the risk of cardiovascular death and all-cause mortality in exercise intervention.Therefore,the design of exercise prescription which is both scientific and satisfying individual differences has become the focus of research.Most of the current clinical studies are based on the percentage of exercise intensity as the basis for the formulation of standard-ized exercise prescription for MS patients,while the studies on the individualized threshold of exercise intensity based on cardiopulmonary exercise test(CPET)are still few.CPET has shown that individualized exercise prescription can effec-tively reduce body composition index,blood pressure and blood glucose,improve cardiorespiratory function,exercise en-durance and quality of life in MS patients.This paper reviewed the development of individualized exercise programs with different intensification according to threshold indexes in CPET,analyzed the intervention effects and possible mechanisms for MS patients and subgroups,and provided certain reference for the formulation and implementation of personalized exer-cise prescriptions for MS patients,and also provided references for in-depth research on individualized exercise intervention for MS.