Objective:To investigate the impact of air pollution on dynamic changes in lung function and further explore the association between genetic factors and lung function and its changes.Methods:Research data were from 14 506 participants in the United Kingdom Biobank with two complete baseline and follow-up lung function tests. Particulate matter [including particulate matter with aerodynamic diameter ≤2.5 μm and ≤10 μm (PM 2.5 and PM 10)], nitrogen dioxide (NO 2), and nitrogen oxides (NO x) concentrations were estimated using land-use regression models. Annual changes in lung function were calculated based on baseline and follow-up lung function tests. Polygenic risk scores (PRS) of lung function [forced expiratory volume in the first second (FEV 1), forced vital capacity (FVC), and the ratio of FEV 1 to FVC (FEV 1/FVC)] were constructed by genetic variations. The association between air pollution concentrations and lung function changes was analyzed by multiple linear regression models, and the impact of genetic factors on lung function and its changes was also assessed. Results:PM 2.5, PM 10, NO 2, and NO x showed a negative correlation with FVC changes [PM 2.5: -6.66 (95% CI: -9.92- -3.40) ml/year; PM 10: -0.40 (95% CI: -0.77- -0.03) ml/year; NO 2: -1.84 (95% CI: -2.60- -1.07) ml/year; NO x: -1.37 (95% CI: -2.27- -0.46) ml/year]. Additionally, PM 2.5, PM 10and NO 2 were also negatively correlated with changes in FEV 1 [PM 2.5: -3.19 (95% CI: -5.79- -0.59) ml/year; PM 10: -3.00 (95% CI: -5.92- -0.08) ml/year; NO 2: -0.95 (95% CI: -1.56- -0.34) ml/year]. PRS of lung function were positively correlated with baseline lung function (FVC, FEV 1, and FEV 1/FVC) and lung function changes (all β>0, all P<0.001). In different PRS stratification analyses, the effect of air pollution on lung function changes remained significant, and there was no apparent heterogeneity. Conclusions:PRS of lung function are significantly associated with baseline and lung function changes. Long-term exposure to air pollution accelerates the decline of lung function indicators such as FVC and FEV 1. The effects of air pollution are consistent in individuals with different genetic risk scores.

AIM:To explore the effect and mechanism of action of the aqueous extract of Fritillaria ussuriensis(FU-AE)against nonalcoholic fatty liver disease(NAFLD).METHODS:The association between Fritillaria ussuriensis Maxir.(FU)and NAFLD was analyzed by network pharmacology.A mouse model of NAFLD was induced in mice by high fat diet(HFD)+10%fructose drinking water,and three doses of Fritillaria ussuriensis aqueous extract were given to the mice for intervention.Colorimetric assay was used for detection of aspartate aminotransferase(AST),alanine aminotrans-ferase(ALT),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)levels in the serum of experimental mice.Hematoxylin and eosin staining was used to as-sess the pathological and histological changes in the liver of mice and to clarify the anti-NAFLD effect of aqueous extracts of Fritillaria ussuriensis.Liver tissue proteins were extracted,and expression of proteins related to the AMP-activated pro-tein kinase(AMPK)/acetyl-CoA carboxylase(ACC)pathway was detected by Western blot to clarify the mechanism of an-ti-NAFLD action of Fritillaria ussuriensis.The microbial composition of cecum contents was explored using 16S rRNA se-quencing to reveal the modulatory effect of the aqueous extract of Fritillaria ussuriensis on the structure of intestinal flora in mice with nonalcoholic fatty liver disease.RESULTS:Aqueous extract of Fritillaria ussuriensis(high dose)ameliorated exogenous adipocyte infiltration in the liver of mice with NAFLD(P<0.05).AST,ALT,TG,TC and LDL-C levels were significantly decreased(P<0.05)and HDL-C levels were significantly increased(P<0.05)in the high-dose group.Aque-ous extract of Fritillaria ussuriensis(high dose)significantly increased expression of phosphorylated AMPKα,AMPKα,and phosphorylated ACC in the livers of the model mice(P<0.05),significantly reduced expression of ACC(P<0.05),and significantly increased the relative abundance of the potentially beneficial bacteria Faecalibaculum rodentium,Lacto-bacillus johnsonii,Akkermansia muciniphila(P<0.05).CONCLUSION:Aqueous extract of Fritillaria ussuriensis may ameliorate NAFLD in mice by activating the AMPK/ACC pathway and modulating the structure of intestinal flora.

Objective To investigate the resistance level of Aedes albopictus to commonly used insecticides in Jinshan District, Shanghai, to provide a reference for standardizing the use of insecticides. Methods The larval dipping test was used to detect the resistance of Ae. Albopictus larvae to five kinds of insecticides, the SPSS 18.0 software was utilized to calculate the toxic regression equation and the median lethal concentration (LC50) of insecticides on the larvae. The resistance level was determined by evaluating the 24-hour mortality of adult Ae. Albopictus exposed to diagnostic doses of commonly used insecticides with the adult mosquito contact tube method. Results In 2018 and 2019, Ae. Albopictus larvae in the Jinshan District of Shanghai displayed moderate and high resistance to beta-cypermethrin, with resistance ratios of 25.03 and 65.96 folds respectively; high resistance to deltamethrin, with resistance ratios of 57.25 and 211.75 folds respectively; high resistance to permethrin, with resistance ratios of 46.17 and 243.36 folds. In 2018, 2019, 2021, and 2023, they showed moderate to high resistance to temephos with resistance ratios of 19.55, 23.94, 53.48, and 22.12 folds respectively. In 2021 and 2023, moderate resistance to fenitrothion was observed, with resistance ratios of 30.04 and 12.54 folds respectively. Adult Ae. Albopictus adults exhibited resistance to 0.03% deltamethrin, 0.07% lambda-cyhalothrin, 0.4% permethrin, and 0.08% beta-cypermethrin, with mortality rates ranging from 17.20% to 49.67% in 2021 and 2023. Potential resistance was observed to 0.7% lambda-cyhalothrin and 0.2% fenitrothion, with mortalities of 97.48% and 83.74% respectively. Sensitivity was noted to 0.05% propoxur with a mortality rate of 100.00%. Conclusions Ae. Albopictus in the Jinshan District, Shanghai, has developed varying resistance levels to different types of insecticides, including pyrethroids and organophosphates. It is recommended to strengthen the dynamic monitoring of the resistance of Ae. Albopictus and implement comprehensive prevention and control measures with a focus on environmental management, scientifically and rationally selecting hygienic insecticides to delay and mitigate the emergence of resistance.

Pharmaceutical excipients of animal origin, an important part in pharmaceutical excipients, are widely used in pharmaceutical preparations.However, compared with the pharmaceutical excipients of other origins, pharmaceutical excipients of animal origin have more special requirements in many aspects, such as raw materials, production, quality control, storage, supervision, etc.Chinese Pharmacopoeia 2020 first included the Guideline for Pharmaceutical Excipients of Animal Origin, which introduces the basic ideas and technical requirements for the life cycle quality control of pharmaceutical excipients of animal origin based on the risk management concept.This article illustrates the specificity of the pharmaceutical excipients of animal origin, and interprets the main contents of this guideline in conjunction with relevant domestic and foreign regulations and technical documents, thereby providing comprehensive reference for the implementation of the guideline.

Objective:To summarize the characteristics of nailfold capillaroscopy (NC) in patients with systemic lupus erythematosus (SLE) and explore its clinical significance.Methods:NC examination was performed in 162 SLE patients. The clinical data of SLE patients was collected. Tianniu NC scoring standard was used. The t test was applied to analyze the measurement data, the χ2 test was applied to analyze the counting data. the Pearson or Spearman test was used to evaluate the correlative factors of NC in patients with SLE. Results:NC abnormalities were seen in 87.7%(142/162) of SLE patients, and the incidence of mild, moderate and severe abnormalities was 29.0%(47 cases), 45.1%(73 cases) and 13.6%(22 cases) respectively. The most common NC abnormal manifestation in SLE patients was decreased blood flow velocity (86.4%). In patients with moderate to severe NC abnormalities, the proportions of patients with Raynaud's phenomenon (37.9% vs 23.9%, χ2=2.955, P=0.043) and interstitial lung disease (8.0% vs 0, χ2=5.213, P=0.023), and the level of D-Dimer [(1 992±2 279) μg/L vs (1 248±1 721) μg/L, t=-1.624, P=0.013] were significantly higher than those in the groups with normal/mild NC abnormalities. Correlation analysis demonstrated that Raynaud's phenomena, interstitial lung disease, pulmonary hypertension and D-Dimer were positively correlated with the NC abnormality. Conclusion:NC abnormalities are common in SLE patients. Decreased blood flow velocity is the most frequent manifestation. SLE patients with moderate to severe NC abnormalities should be actively screened for pulmonary hypertension and interstitial lung disease.

Objective: To determine the clinical benefits of internal mammary sentinel lymph node biopsy (IM-SLNB) acquired by breast cancer patients with clinically positive axillary lymph node (ALN), and further optimize the IM-SLNB indications. Methods: All primary breast cancer patients with clinically positive ALN from February 2014 to September 2017 were prospectively recruited in this study. IM-SLNB was performed under the guidance of the modified injection technique. The success rate and visualization rate of IM-SLNB, metastatic rate of internal mammary sentinel lymph node (IMSLN) and its related factors were analyzed, and the clinical benefits were accessed according to the current guidelines. Results: Among 126 patients, all of 94 patients (74.6%) who showed internal mammary drainage successfully underwent IM-SLNB. The incidence of internal mammary artery bleeding and pleural lesion were 4.3%(4/94) and 9.6%(9/94), respectively. The metastatic rate of IMSLN was 38.3% (36/94), which was significantly associated with the number of positive ALN (P<0.001) and tumor size (P=0.024). The lymph node staging of 94 patients who underwent IM-SLNB was more accurate. Among them, 36 cases with positive IMSLN underwent internal mammary radiotherapy (IMRT), while the other 58 cases with negative IMSLN avoided radiotherapy. Conclusions IM-SLNB should be routinely performed in patients with positive ALN. IM-SLNB can provide more accurate staging and guide tailored IMRT to benefit more breast cancer patients.

Objective To determine the clinical benefits of internal mammary sentinel lymph node biopsy (IM?SLNB) acquired by breast cancer patients with clinically positive axillary lymph node ( ALN), and further optimize the IM?SLNB indications. Methods All primary breast cancer patients with clinically positive ALN from February 2014 to September 2017 were prospectively recruited in this study.IM?SLNB was performed under the guidance of the modified injection technique. The success rate and visualization rate of IM?SLNB, metastatic rate of internal mammary sentinel lymph node ( IMSLN) and its related factors were analyzed, and the clinical benefits were accessed according to the current guidelines. Results Among 126 patients, all of 94 patients ( 74.6%) who showed internal mammary drainage successfully underwent IM?SLNB. The incidence of internal mammary artery bleeding and pleural lesion were 4.3%( 4／94) and 9.6%(9／94), respectively. The metastatic rate of IMSLN was 38.3%( 36／94), which was significantly associated with the number of positive ALN (P＜0.001) and tumor size (P＝0.024).The lymph node staging of 94 patients who underwent IM?SLNB was more accurate. Among them, 36 cases with positive IMSLN underwent internal mammary radiotherapy (IMRT), while the other 58 cases with negative IMSLN avoided radiotherapy. Conclusions IM?SLNB should be routinely performed in patients with positive ALN. IM?SLNB can provide more accurate staging and guide tailored IMRT to benefit more breast cancer patients.

Objective To determine the clinical benefits of internal mammary sentinel lymph node biopsy (IM?SLNB) acquired by breast cancer patients with clinically positive axillary lymph node ( ALN), and further optimize the IM?SLNB indications. Methods All primary breast cancer patients with clinically positive ALN from February 2014 to September 2017 were prospectively recruited in this study.IM?SLNB was performed under the guidance of the modified injection technique. The success rate and visualization rate of IM?SLNB, metastatic rate of internal mammary sentinel lymph node ( IMSLN) and its related factors were analyzed, and the clinical benefits were accessed according to the current guidelines. Results Among 126 patients, all of 94 patients ( 74.6%) who showed internal mammary drainage successfully underwent IM?SLNB. The incidence of internal mammary artery bleeding and pleural lesion were 4.3%( 4／94) and 9.6%(9／94), respectively. The metastatic rate of IMSLN was 38.3%( 36／94), which was significantly associated with the number of positive ALN (P＜0.001) and tumor size (P＝0.024).The lymph node staging of 94 patients who underwent IM?SLNB was more accurate. Among them, 36 cases with positive IMSLN underwent internal mammary radiotherapy (IMRT), while the other 58 cases with negative IMSLN avoided radiotherapy. Conclusions IM?SLNB should be routinely performed in patients with positive ALN. IM?SLNB can provide more accurate staging and guide tailored IMRT to benefit more breast cancer patients.

Objective To analyze the perioperative risk factors of postoperative complications after posterior lumbar fusion operation.Methods The clinical data of 654 patients with posterior lumbar fusion during 2010 and 2014 were retrospectively analyzed.Using x2 test and one-way ANOVA,the predicted risk factors were screened for further Logistic regression.Results The total complication rate was 11.6％ among all 654 patients.The major complications included cardiac infarction,deep infection,sepsis,neurological impairment,and secondary operation.And the minor complications included wound dehiscence,urinary tract infection,pulmonary infection,gastrointestinal bleeding,CSF leakage and others.According to x2 test and one-way ANOVA,renal function insufficiency,preoperative neurological injury,ASA higher than Ⅲ level,intraoperative blood loss,long operation length,and usage of autogenous bone were screened as risk factors of complications.Renal function insufficiency,preoperative neurological injury,intraoperative blood loss,and long operation length were screened as risk factors of minor complications.And male,renal function insufficiency,preoperative neurological injury,intervertebral fusion,and posteriolateral fusion were screened as risk factors of major complications.However,according to Logistic regression,the independent risk factor of complications were preoperative neurological injury and long operation length;independent risk factors of minor complications were renal function insufficiency,preoperative neurological injury and long operation length;and independent risk factor of major complications was preoperative neurological injury.Conclusion Preoperative neurological injury,renal function insufficiency and long operation length are proved to be the risk factors of postoperative complication in lumbar fusion surgery.

Objective To explore the effect and safety of enhanced recovery after surgery (ERAS) in the surgical treatment of common bile duct stones.Methods According to random number table,48 patients with common bile duct stones were randomly divided into the ERAS group and the control group.The patients of the control group received the traditional perioperative management and laparotomy exploration of common bile duct.The patients of the ERAS group received the ERAS perioperative management and laparoscopic exploration of common bile duct.The preoperative and postoperative level of C reactive protein (CRP),time to out-of-bed activity,time to food taking,time to anal exsufflation,postoperative hospital stay,hospitalization cost and postoperative complications between the two groups were compared.Results Compared with the control group,the ERAS group had lower levels of CRP on the postoperative 1 day and 3 days[d1:(102.6±13.5) mg/L vs.(81.3±17.3)mg/L;d3:(71.8±15.3)mg/L vs.(41.2±11.2)mg/L,t=2.553,3.287,all P<0.05],had shorter time to out-of-bed activity[(3.2±1.8)d vs.(0.9±0.4)d],time to food taking[(4.3±1.9)d vs.(1.8±1.2)d] and time to anal exsufflation[(2.5±0.7)d vs.(1.2±0.3)d],and had shorter operative hospital stay[(7.3±3.2)d vs.(3.8±1.4)d]and less hospitalization cost[(7 200±800)RMB vs.(5 900±700)RMB] (t=5.561,4.319,3.765,2.351,1.671,all P<0.05).The incidence rate of postoperative complications of the ERAS group decreased markedly (61.91% vs.18.52%,x2=25.82,P<0.05).Conclusion ERAS management in the surgical treatment of common bile duct stones is safe and effective,which can enhance the recovery of the patients.