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The effect of increasing the bonding pressure from 10 to 20 MPa (5 MPa interval) at 1050°C for 60 minutes on the diffusion bonded joint of reduced activation ferritic/martensitic (RAFM) steel was investigated. The results indicate that the quality of the bond improves accordingly with increasing bonding pressure. The oxide layer at the bonding interface underwent an evolution process from continuous to discontinuous and ultimately disappeared with the increase of bonding pressure. The optimal joint was achieved in this work at the pressure of 20 MPa. Considering the research of reliability of joints in engineering applications, the optimum joint was subjected to post-bonding heat treatment (PBHT) of 750°C for 90 minutes. The diffusion bonded sample subjected to PBHT exibits microstructural features and tensile properties similar to those of the base metal. It is noteworthy that the tensile fracture does not occur at the bonding interface, but in the base metal far away from the interface. This work can provide a feasible method for the removal of oxides at the diffusion bonding interface of RAFM steel and also contribute to the establishment and optimization of diffusion bonding processes, thereby improving the quality of the diffusion bonding joint.

Rainfall spatial variability is a crucial factor determining rainfall input in hydrological models and it significantly affects model simulation accuracy. We selected the Yangshudang watershed in the Zhanghe irrigation district of Yangtze River Basin of China to assess the impact of rainfall spatial variability on SWAT runoff simulation in hilly irrigation areas. Eight different rainfall station network distributions were established and rainfall data were processed, using the SWAT model nearest and Thiessen polygon interpolation methods to analyze rainfall spatial variations in the study area. This study investigated the effects of the number, layout, and rainfall grades of rainfall gauges on runoff simulation performance. The results indicated that a higher number of rainfall gauges and more uniform spatial distribution leads to better runoff simulation performance. Among the scenarios examined, using three rainfall gauges yielded the best results, with R2, NSE, and RSR values of 0.84, 0.81, and 0.44, respectively. Employing Thiessen polygon interpolation with three rainfall gauges the R2 value increased to 0.87, enhancing it by 3.57% and further reducing the simulation errors caused by rainfall spatial variability. Additionally, runoff simulation under different rainfall grades exhibited varying responses to rainfall spatial variability, with minimal impact observed during light rainfall and the greatest impact during moderate and heavy rainfall events. [ABSTRACT FROM AUTHOR]

Evaluating the eutrophication risk in reservoir areas is very important for environmental protection. However, the periodic backflow of water in reservoir areas makes evaluating the eutrophication of tributaries in reservoir areas more difficult. In this study, based on the basic principle of the copula function, combined with the water environment simulation results of the Pengxi River, a tributary of the Three Gorges Reservoir, a new perspective for considering the interaction between water environment variables was proposed to evaluate the joint eutrophication risk probability. The results showed that the fluidity of the whole Pengxi River was poor, which was conducive to the deposition and enrichment of pollutants. The total nitrogen (TN) in Hanfeng Lake and the main stream of the Pengxi River was always above the level of moderate eutrophication, while total phosphorus (TP) varied over a large range, from mesotrophic to hyper-eutrophic. In 2021, the joint risk probability of TP and TN was the highest, at 45%, when they were both hyper-eutrophic in Hanfeng Lake. When TP was slightly eutrophic and TN was moderately eutrophic, the joint risk probability was the highest in Pengxi River, at 42%. The relatively clean water of the Yangtze River flowing back into the Pengxi River reduces its eutrophication risk. The results of this study provide a scientific basis for the prevention and control of water eutrophication in the Three Gorges Reservoir. [ABSTRACT FROM AUTHOR]

Recently, graphitic carbon nitride (g-C3N4), a promising visible-light-driven semiconductor material, has received enormous attention for photocatalytic water splitting, organic pollutant degradation, and CO2 reduction. However, the photocatalytic activity of bulk g-C3N4 is restricted due to the insufficient light adsorption, ineffective utilization of photogenerated charge carriers, and low specific surface area. Compared with bulk g-C3N4, the three-dimensional graphitic carbon nitride based materials (3D CNBMs) have outstanding physical and chemical characteristics, such as large specific area, plentiful active sites, and excellent electrical conductivity. This article reviews the latest achievements in 3D CNBMs, and presents the state-of-the-art advances in the synthetic methods of 3D CNBMs. Meanwhile, various applications of 3D CNBMs in photocatalysis, photo-electrochemistry, and electrochemistry are systematically reviewed and discussed. In addition, possible improvements and perspectives of 3D CNBMs are proposed. This review aims to summarize a panorama of the up-to-date processes of 3D CNBMs in environmental and energy applications and provide some innovative thoughts to accelerate the ground-breaking research and development of 3D CNBMs for a sustainable future. [ABSTRACT FROM AUTHOR]

Both tea polyphenols (TP) and Lactobacillus rhamnosus have been shown to alleviate obesity, and regulate lipid metabolism. However, the combined effects and their underlying mechanisms of action remain elusive. In the present work, the effects of TP, Lactobacillus rhamnosus R5 (R5), and TP+R5 on blood lipids and the gut microbiota of mice fed with a high-fat diet were compared. Results showed that the combination of TP and R5 effectively increased the serum levels of high-density lipoprotein cholesterol (HDL-C), and decreased total cholesterol (TC) levels, low-density lipoprotein cholesterol (LDL-C) levels, and the atherosclerosis index (AI) in mice fed with a high-fat diet. The combination treatment resulted in a modification of the structure of the gut microbiota in mice, as evidenced by a decrease in the F/B ratio, and an increase in the abundance of beneficial genera, such as Akkermansia muciniphila, Faecalibaculum rodentium, and Ruminococcus_uncultured bacterium. Additionally, the contents of SCFAs (acetic, propionic, and butyric acids) in faeces also increased. These could provide new ideas for anti-obesity methods, and a theoretical basis for the development of foods combining probiotics and tea polyphenols. [ABSTRACT FROM AUTHOR]

The impact of plant health status change, specifically the effect of root rot infection, on rhizosphere microbial structure remains unclear. To address this knowledge gap, we investigated the dynamic variations in soil nutrient and rhizosphere microbial community during cowpea root rot infection. Samples of healthy and moderately to severely diseased cowpea rhizosphere soil were collected from a field in Xiangyang, Hubei, China, and high-throughput sequencing was used to detect changes in soil microbial communities. Our results showed that cowpea biomass decreased significantly with increased disease severity, and differences in soil pH and nutrients (NO3 --N, NH4 +-N, and available phosphorus) were observed between healthy and diseased rhizosphere, particularly under moderate diseased conditions. The process of root rot infection affected the bacterial and fungal community structure in the rhizosphere, but with inconsistent responses. Specifically, bacterial richness decreased with increased disease severity, while minor differences were observed in fungal alpha diversity. Principal coordinate analysis revealed significant disparities in rhizosphere bacteria and fungi under healthy and diseased conditions (moderate and severe). Moreover, while bacterial communities underwent notable alterations, fungal communities exhibited no significant changes between moderate and severe diseased conditions. In addition, Redundancy analysis showed that bacteria beta diversity was determined by available potassium and pH in the rhizosphere, whereas fungal beta diversity was determined by soil organic matter and pH. Overall, with root rot infection, both the soil nutrients and microbial community structure of cowpea significant changed. As a result, our study provides insights into the molecular mechanism underlying cowpea root rot and other plant rhizosphere microbial communities. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to investigate the diagnostic values of serum tumor markers in gastric carcinoma peritoneal metastasis and the therapeutic efficacy as well as safety of apatinib mesylate combined with Geo+Oxaliplatin (SOX) scheme treatment in gastric carcinoma peritoneal metastasis. PATIENTS AND METHODS: Sixty patients with gastric carcinoma peritoneal metastasis and 11 patients without gastric carcinoma peritoneal metastasis were selected as the research subjects. The levels of serum tumor markers [carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 125, CA211, CA242, CA724, and CA19-9] and abdominal irrigating solution exosome [micro ribonucleic acid (miR)-21 and miR320c] and the differences in their diagnostic values were compared and analyzed. The patients with gastric cancer peritoneal metastases are then divided into two groups, one for control (30 cases receiving just SOX scheme treatment) and the other for the experiment (30 cases receiving SOX scheme treatment plus apatinib mesylate). Besides, the differences in serum tumor marker level, therapeutic efficacy, overall survival (OS), complication rating, and Quality of Life Questionnaire-Core-30 (QLQ-C30) score among patients after treatment were compared. RESULTS: Demonstrated that serum carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 125, CA211, CA242, CA724, and CA19- 9 levels of patients in the transfer group were remarkably enhanced compared with those of patients in the non-transfer group, and the levels of abdominal irrigating solution exosome (miR21 and miR-320c) were reduced compared with those in non-transfer group (p<0.05). The area under the curve (AUC) of the diagnosis of gastric carcinoma peritoneal metastasis by each index were 0.553, 0.880, 0.832, 0.619, 0.863, 0.651, 0.918, and 0.903, respectively. Patients in the experimental group’s serum levels of CEA, CA125, CA211, CA242, CA724, and CA19-9 were noticeably lower after therapy compared to those in the control group, and their median OS was also noticeably longer (p<0.05). After treatment, the objective remission rate (ORR) and disease control rate (DCR) of the control group and experimental group amounted to 6.7% vs. 30.0% and 50.0% vs. 86.7%, respectively. ORR and DCR of the experimental group were notably higher (p<0.05). Between the patients in the control group and the experimental group, there were no glaring variations in the frequency of problems (hypertension, nausea, vomiting, bone marrow suppression, hand-foot syndrome, and leucopenia) (p>0.05). The cognitive function, emotional function, and life health scores of patients in the experimental group were significantly higher than those in the control group (p<0.05), which suggested that serum tumor markers and miR-21 as well as miR-320c showed high diagnostic efficiency in gastric carcinoma peritoneal metastasis. CONCLUSIONS: Apatinib mesylate combined with SOX scheme treatment was more effective in treating gastric carcinoma peritoneal metastasis and possessed the same safety as single SOX scheme treatment. Hence, it is worthy of clinical promotion. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The liver is a unique organ containing large populations of immune cells. Immunotherapy for liver cancer is a promising yet particularly challenging method. Therefore, it harbors great significance for the identification of immune-related subtypes and the potential therapeutic targets for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Firstly, we classified the HCC samples downloaded from the dataset of Cancer Genome Atlas (TCGA) into two clusters based on the immune cell infiltration. Thereafter, we identified the significant module and regulatory factors using the weighted gene co-expression network analysis (WGCNA). The immune competence of the regulatory factors was delineated through the ESTIMATE algorithm, the analysis of the tumor microenvironment, and pan-cancer analysis. In the single-cell RNA sequencing analysis, we further explored the immune competence of regulatory factors. We also collected the potential drugs targeting the regulatory factors. In addition, we constructed lncRNA-miRNA-mRNA interaction regulatory networks. Finally, western blot and quantitative real-time polymerase chain reaction (qRT-PCR) were conducted to verify the protein expression of regulatory genes in HCC cell lines and tissues. RESULTS: According to the immune cell infiltration, two immune-related subtypes-cluster 1 and cluster 2-were found. Patients in cluster 2 had a more significant immune infiltration than in cluster 1. Afterward, six significant regulatory genes were identified through WGCNA, and the expression in cluster 2 was high in cluster 1. We performed a comprehensive analysis to clarify the immune signature. The results showed that the six genes had significant immunological competence. Moreover, the expression of the six genes was similar to the subtypes' classification. In the analysis of the prognosis value, patients in cluster 2 had a better prognosis. In addition, the lncRNA in the lncRNA-miRNA-mRNA interaction regulatory networks was located in the nucleus and cytoplasm. In the single-cell RNA sequencing analysis, the six genes were related to the immune cell. We also identified potential drugs for CD6 and CLEC12A, which may provide potential therapeutic drugs. Finally, the regulatory genes were verified in the western blot and quantitative real-time polymerase chain reaction. CONCLUSIONS: The classification into two clusters based on the immune cell infiltration may provide a promising prospect for HCC through immunotherapy. The six regulatory genes may be potential therapeutic targets in the treatment of HCC. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The COVID-19 pandemic has influenced regular medical procedures and health-seeking behaviors. In this study, we aimed to investigate the influence of the COVID-19 pandemic on the presentation and prognosis of acute ischemic stroke (AIS) patients in county-level stroke centers. PATIENTS AND METHODS: We retrospectively collected AIS patients during the strict lockdown period (January 24, 2020, to March 27, 2020) and the corresponding "new normal" period (2021) of the COVID-19 pandemic. Patients seen during the same timeframe in 2019 were enrolled as controls. Statistical analysis was conducted to compare the clinical characteristics of AIS patients who presented during the lockdown and new normal periods and those who presented during the pre-COVID-19 pandemic period. RESULTS: A total of 134 AIS patients presented during the lockdown period (the 2020 group), 207 patients in the pre-COVID-19 period (the 2019 group) and 201 patients in the "new normal" period (the 2021 group). Compared to the 2019 group, there was approximately 1/3 reduction in the number of patients who presented during the lockdown period, while the number of patients who received IVT or EVT was similar between the two groups. The number of patients, baseline characteristics, workflow intervals and clinical outcomes presented during the "new normal" period were similar between the 2019 and 2021 groups. Logistic regression showed that lockdown or new normal status were not risk factors associated with a poor outcome at 90 days. CONCLUSIONS: In county-level city stroke centers, the COVID-19 lockdown resulted in a reduction in the number of patients with AIS admitted to the hospital but had no effect on patients treated with IVT or EVT. Lockdown or new normal status did not influence the prognosis of AIS patients. [ABSTRACT FROM AUTHOR]

To understand the jet flow characteristics of turbofan separate exhaust system, a parametric design method based on the initial Class Shape Transformation function was developed. HBPR and UHBPR turbofan separate exhaust systems were designed. Furthermore, the jet flow characteristics of the HBPR turbofan exhaust system under take-off condition with zero angle of attack were studied based on numerical simulation. The jet flow characteristics of the HBPR and UHBPR turbofan exhaust system under take-off condition with high angle of attack were also simulated. The effects of angle of attack and bypass ratio on the jet flow characteristics were investigated and the related flow mechanisms were analyzed. Results show that the axisymmetric plumes of the HBPR turbofan exhaust system are distributed around the engine axis under take-off condition with zero angle of attack. With the plug wake as the center, the core flow, the fan/core shear layer, the fan flow, the fan/free stream shear layer and the free stream are wrapped around the plug wake from inside out. Vortexes appear in the lee area at the back of the cowl and jet flow under take-off condition with high angle of attack. These vortexes cause cross sectional secondary flow and expose the highvelocity core flow to the low-velocity free stream. The contact area and velocity gradient in the mixing region among the free stream, fan flow and core flow increase. Therefore, the mixture among jet flow and free stream strengthens. So the high-velocity region, the high-vorticity region, and the high turbulence kinetic energy region shorten by 55.1%, 47.7% and 50.9% respectively. The vorticity values and turbulence kinetic energy level peak on the upper side of the exhaust plumes increase by about 30% and 87% respectively. Relative to these parameters from the HBPR turbofan exhaust system, the jet velocity peak value of UHBPR turbofan decreases by 5.5% under take-off condition with high angle of attack. The vorticity values and turbulence kinetic energy level reduce due to decreased velocity gradient in shear layers downstream of the nozzle exit plane. The turbulence kinetic energy level peak on the upper side of the exhaust plumes decreases by 29.3%. The reasons are that the contact area between high-velocity core flow and the free stream decreases due to thicker fan flow and the velocity gradient in the core flow and free stream mixing region decreases because of the lower core flow velocity. [ABSTRACT FROM AUTHOR]

This article discusses a case of lupus nephritis with posterior reversible encephalopathy syndrome (PRES) as the first manifestation. PRES is an acute neurological disorder characterized by various symptoms, including seizures and visual disturbances. Common triggers of PRES include lupus nephritis, autoimmune disease, and hypertension. The patient in this case experienced a sudden seizure and was diagnosed with stage IV lupus nephritis. Treatment with medications and supportive therapies resulted in symptom relief and renal remission. The article emphasizes the importance of early identification and treatment of PRES to prevent complications. [Extracted from the article]

The lesions are distributed preferentially on the distal extremities with classic target lesions and may accompany a mucosal injury. Physical examination showed multiple circular erythema and blisters with classic target lesions on the distal extremities (Fig. The patients in this manuscript have given written informed consent to the publication of their case details. [Extracted from the article]

Objective: To observe the efficacy of vocal cord botulinum toxin type A injection in the treatment of refractory laryngeal contact granuloma and to analyze the factors affecting the curative effect. Methods: Fifty-two patients with refractory laryngeal contact granuloma who received vocal cord botulinum toxin type A injection under topical anesthesia from May 2021 to May 2023 were analyzed retrospectively. Among them, 51 were males and 1 was female, aged 22-66 (48.98±8.87)years old. All patients were followed up for a minimum of 12 months. Outcome measures in terms of patient cure rate, total effective rate, complications and recurrence rate were calculated. The median [ M ( Q 1 , Q 3 )] was used to represent non-normally distributed measurement data, and Logistic regression analysis was used to determine independent risk factors affecting efficacy. Results: The cure rate of 52 patients with refractory laryngeal contact granuloma treated by vocal cord botulinum toxin type A injection was 78.8% (41/52), and the total effective rate (including cure, marked and effective) was 90.4% (47/52). The median number of injections was 1[1,2]. Following a single injection, the cure rate was 69.2% (36/52), and the median treatment duration for cured patients was 3 [3,3] months. Hoarseness occurred in 88.5% (46/52) of patients, with recovery within 3 months in all cases. Additionally, 21.2% (11/52) of the patients experienced cough, sore throat, dyspnea, all of whom recovered within 3 months. One patient among the 41 cured cases was lost to follow-up, and the recurrence rate at the 12th month was 17.5% (7/40). Multivariate regression analysis indicated that age, granuloma size, history of PPI treatment, previous corticosteroid injections, prior surgical excision, pharyngeal reflux, chronic cough, pharyngeal reflux, chronic cough and vocal overuse were not independent risk factors for cure and recurrence. Conclusion: Vocal cord botulinum toxin type A injection is an alternative for the treatment of refractory laryngeal contact granuloma, which offers benefits such ashigh cure rate, short treatment cycle and less injection times.

Objective: To evaluate the safety and efficacy of percutaneous transhepatic papillary balloon dilation (PTPBD) combined with flexible ureteroscopy-guided dual-frequency double-pulse ND:YAG (FREDDY) laser lithotripsy (PTPBD-FREDDY) for the treatment of giant (>1.5 cm diameter) common bile duct stones. Methods: A retrospective analysis was conducted on 26 patients with large-diameter difficult choledocholithiasis admitted to two medical centers from December 2017 to October 2021. Among these patients, four could not tolerate surgery or endoscopic treatment, six experienced failure of endoscopic treatment, and 16 refused to undergo endoscopic or surgical treatment. All patients underwent the PTPBD-FREDDY procedure. The FREDDY laser lithotripsy was performed under ureteroscopic guidance, followed by a balloon to push the stones into the duodenum. The primary endpoint was the technical success rate, and the secondary endpoints included the rate of stone recurrence and related complications. Results: All 26 patients successfully completed the operation, achieving a technical success rate of 100%. The average lithotripsy frequency and operation time for bilirubin stones were significantly higher than those of mixed stones and cholesterol stones ( P <0.01). The main postoperative complications included mild fever ( n =3), abdominal pain ( n =3), nausea ( n =2) and vomiting ( n =1). One patient experienced biliary tract bleeding, which improved after conservative treatment. No serious complications such as pancreatitis, sepsis, or biliary perforation were observed. After 2 years of follow-up, no cases of stone recurrence were observed. Conclusions: PTPBD-FREDDY is a safe and effective treatment for patients with giant common bile duct stones. It provides a new therapeutic option for patients with giant choledocholithiasis who can not tolerate surgery or have failed endoscopic treatment, demonstrating promising prospects.

Objective: To investigate the safety and efficacy of percutaneous superselective superior rectal artery embolization in the treatment of grades Ⅱ-Ⅲ internal hemorrhoids. Methods: The clinical data of 22 patients with grades Ⅱ-Ⅲ internal hemorrhoids who underwent superselective superior rectal artery embolization in the Department of Interventional and Minimally Invasive Tumor Therapy of the Second Hospital of Shandong University from September 2019 to February 2022 were retrospectively analyzed. According to the blood supply artery of hemorrhoids, superselective embolization was performed with embolization materials. The surgical efficacy,postoperative complications,and 12-month follow-up results were analyzed. The clinical score data (French bleeding score,quality of life score,prolapse score) were expressed using the median ( Q 1 , Q 3 ). The clinical scores before and after treatment were compared by the nonparametric rank sum test (Wilcoxon test),and the Z -value was calculated. P -values <0.05 indicate statistically significant differences. Results: The operation was successful in all 22 patients (technical success rate: 100%). The main postoperative side effects and complications included tenesmus (81.8%,18/22),anal bulge (68.2%,15/22),and mild pain in the anus (22.7%,5/22). The above reactions were improved 3-5 days after operation; three patients had congestion and dull pain at the puncture site,which improved spontaneously without treatment. The patients were followed up for 12 months. Compared with those prior to operation, the French bleeding score,quality of life score,and prolapse score were significantly improved (all P <0.05). Conclusion: Superselective superior rectal artery embolization is a relatively safe and low-risk treatment for grades Ⅱ-Ⅲ internal hemorrhoids. It is an option for the treatment of internal hemorrhoids,particularly hemorrhagic internal hemorrhoids.

Objective: To explore the current situation of professional identity of intern nursing students in Shandong Province, to analyze the potential characteristics of different categories of intern nursing students' professional identity, and to provide reference for formulating relevant intervention programs. Methods: From September to October 2023, using convenient cluster sampling, selected nursing students from different regions of Shandong Province colleges and universities as the research objects, a total of 1298 questionnaires were released and recovered, with 1221 valid questionnaires, and the effective recovery rate of questionnaires was 94.07%. General demographic data was collected, and information on nursing students' professional identity was investigated with the Nursing Students' Professional Identity Questionnaire, the Work Readiness Scale, and the Feedback Seeking Behavior Scale. Latent potential profiles of nursing students' sense of professional identity were analyzed by Mplus 8.3 software, and the best-fitting model was selected by the test of fitness and difference. The χ(2) test was used for comparison between groups of count data, analysis of variance (ANOVA) was used for comparison between groups of measure data, and the effects of each factor on different potential profiles were analyzed by multivariate logistic analysis. Results: A total of 1221 intern nursing students were 984 (80.6%) females and 237 (19.4%) males, aged (21.12±2.96) years old, with a total score of (64.23±14.99) for nursing students' professional identity. Nursing students' professional identity was divided into 3 categories: 98 (8.0%) in the low identity group, 624 (51.4%) in the medium identity group, and 496 (40.6%) in the high identity group. The gender, region, age, work readiness scores and feedback seeking behavior scores of nursing students in different categories were different, and the differences were statistically significant ( P <0.05). Compared with the high identity group, the nursing students in the low identity group were more likely to be included in the high identity group ( OR =0.390, 0.167, P =0.005, 0.006) with higher work readiness and better feedback seeking behavior. Compared with the high identity group, the higher work readiness and non-Jinan areas of the medium identity group were more likely to be included in the high identity group ( OR =0.597, 1.470, P =0.011, 0.012). Compared with the medium identity group, the more feedback seeking behaviors of the low identity group were more likely to be included in the medium identity group ( OR =10.411, P <0.001) . Conclusion: The level of professional identity of intern nursing students can be classified into 3 categories, and nursing administrators can improve work readiness and increase feedback seeking behaviors according to the potential characteristics of the different types to enhance the professional identity of nursing students.

Objective: To investigate the abnormal changes of intrinsic neural time scale (INT) in male smoking addicts based on whole brain resting state functional magnetic resonance imaging (rs-fMRI). Methods: A case-control study. The clinical data and whole brain rs-fMRI data of 139 male subjects, aged (34.1±8.8) years, recruited through the online platform from January 2019 to December 2021 were retrospectively analyzed. According to the existence of smoking addiction, they were divided into smoking addiction group ( n =83) and healthy control group ( n =56).INT was calculated to reflect the brain neural activity dynamics. Single sample t test was used to obtain the whole brain spatial distribution maps of INT in smoking addiction group and the control group. Then two-sample t test was conducted to explore the difference of INT between the smoking addition group and the healthy control group, with age and years of education as covariates. Finally, Spearman correlation analysis was used to explore the relationship between INT and nicotine dependence scale score and smoking index. Results: Subjects with smoking addiction and healthy control group showed a similar pattern of hierarchical neural timescales, namely shorter INT in sensorimotor areas and longer INT in parietal lobe, posterior cingulate cortex. In addition, in the smoking addiction group, the left medial occipital gyrus (peak t =-3.18), left suproccipital gyrus (peak t =-3.66), bilateral pericalar cleft cortex (left: peak t =-3.02, right: peak t =-3.22), bilateral lingual gyrus (left: peak t =-3.10, right: t peak=-3.04), left cuneus (peak t =-2.97), default network associated brain region [left anterior cuneus(peak t =-3.23), left angular gyrus (peak t =-3.07), and left posterior cingulate cortex (peak t =-3.54) were significantly lower than those of healthy controls (gaussian random field correction, voxel level all P <0.005, mass level all P <0.05). However, there was no significant correlation between INT and nicotine dependence scale score and smoking index (both P >0.05 after Bonferroni correction). Conclusion: Compared with healthy controls, smoking addicts showed abnormal changes in the dynamics of neural activity in the visual cortex and the default network.

Objective: To analyze the changes in optical coherence tomography angiography(OCTA)-related parameters before and after idiopathic macular hole (IMH) internal limiting membrane (ILM) flap inversion surgery and assess their impact on retinal sensitivity. Methods: A retrospective case series study was conducted, collecting clinical data of 30 patients (30 eyes) diagnosed with IMH who underwent vitrectomy combined with ILM flap inversion surgery at Shanxi Eye Hospital, affiliated with Shanxi Medical University, between January 2020 and December 2021. Visual acuity and best-corrected visual acuity were examined preoperatively and at 1, 3, and 6 months postoperatively. Microperimetry measured retinal sensitivity (RS), and OCTA measured retinal thickness (RT) as well as vessel density (VD) in the superficial capillary plexus (SCP) and deep capillary plexus (DCP). Statistical analysis was performed using t-tests, repeated measures analysis of variance, and Pearson correlation analysis. Results: Thirty patients with IMH (30 eyes) were included, with 3 males (3 eyes) and 27 females (27 eyes). The mean age was (62.5±3.0) years, and the follow-up time was (96.3±1.3) days, with a 100% closure rate of macular holes postoperatively. RT in the macular was significantly lower at 1, 3, and 6 months postoperatively compared to preoperative values ( F =46.21, P <0.001). The RT in the upper macular region showed statistically significant differences at different time points ( P <0.001). VD in the SCP layer showed no significant differences between the upper and lower macular regions at various time points ( F =3.21, P =0.601). VD in the upper region of the DCP layer increased at 1, 3, and 6 months postoperatively ( P <0.001). RS in the macular was higher at 1, 3, and 6 months postoperatively compared to preoperative values ( F =52.01, P <0.001). RS in the lower macular region increased at 3 and 6 months postoperatively ( P <0.001), while in the upper region, it increased only at 6 months postoperatively ( P <0.001). There was a positive correlation between RS and RT at 1 and 3 months postoperatively, but not at 6 months postoperatively in the upper macular region ( r =0.40, P =0.071). In the lower macular region, there was a positive correlation between RS and RT at 1 and 3 months postoperatively ( P <0.001). There was no correlation between RS in the upper macular region at 6 months postoperatively and preoperative RT ( r =0.43, P =0.072), but there was a positive correlation with RT at 3 months postoperatively ( r =0.58, P =0.041). Conclusions: After idiopathic macular hole internal limiting membrane flap inversion surgery, the OCTA-related parameters have changed. There are transient changes in deep vascular parameters and thinning of the retinal layers at the ILM inversion site, leading to decreased sensitivity.

Objective: To explore the evaluation effect of ultrasonography and Pirani score on tarsal deformity, treatment effect and pseudo-correction of congenital clubfoot in infants and young children, and the correlation between the two methods. Methods: This is a retrospective case series study. The clinical data of 26 children (40 feet) with congenital clubfoot who were evaluated by ultrasonography in the Third Affiliated Hospital of Zhengzhou University from January 2020 to January 2023 were retrospectively collected. There were 16 males and 10 females. The age at the first ultrasound examination was ( M (IQR)) 9.0 (18.0) days (range: 1 to 46 days). All patients were treated with Ponseti method by the same physician. The Pirani scores before and after treatment and at the last examination, and the talonavicular angle, calcaneocuboid angle and tibiocalcaneal angle measured by ultrasound were collected, and the treatment and follow-up were recorded. Paired sample t test, repeated measures analysis of variance or Kruskal-Wallis test were used for data comparison, and Spearman correlation analysis was used for correlation analysis. The receiver operating characteristic curve was used to calculate the efficacy of ultrasound in evaluating different Pirani scores. Results: The number of plaster fixation in 26 children was 4.0 (1.0) times (range: 2 to 8 times). The medial talonavicular angle and posterior tibiocalcaneal angle were significantly improved after treatment and at the last follow-up compared with those before treatment, and the differences were statistically significant (all P <0.01). There was no difference in lateral calcaneocuboid angle before and after treatment and at the last follow-up ( F =1.971, P >0.05). Pseudo-correction occurred in 2 cases (2 feet) during the treatment, with an incidence of 5%. Correlation analysis showed that there was a moderate positive correlation between talonavicular angle and Pirani midfoot score ( r =0.480, P <0.01). There was no correlation between calcaneocuboid angle and Pirani midfoot score ( r =0.114, P =0.105). There was a moderate negative correlation between tibial heel angle and Pirani hindfoot score ( r =-0.566, P <0.01). The cut-off point of Pirani midfoot score of 1.5 was 38.78°, the sensitivity was 0.90, the specificity was 0.56, and the area under the curve was 0.75. The cut-off value of angle was 27.51 °, the sensitivity was 0.16, the specificity was 0.92, and the area under the curve was 0.44.The cut-off points of Pirani midfoot score of 3.0 were 45.08°and 9.96°, the sensitivity was 0.94 and 0.91, the specificity was 0.37 and 0.42, and the area under the curve was 0.59 and 0.62, respectively. The cut-off values of Pirani hindfoot score of 2.0 and 3.0 were 167.46° and 160.15°, respectively. The sensitivity was 0.75 and 0.67, the specificity was 0.81 and 0.83, and the area under the curve was 0.78 and 0.71, respectively. Conclusion: Ultrasound can complement with Pirani score, visually and dynamically observe the morphology and position changes of talonavicular joint, calcaneocuboid joint and tibiotalocalcaneal joint, monitor the recovery and pseudo-correction of tarsal bones, and better evaluate the therapeutic effect.

Objective: To understand the impact of diet on glycemic control in community-managed patients with type 2 diabetes mellitus (T2DM) and provide evidence for implementing prevention strategies and measures for diabetes patients. Methods: Eight communities were randomly selected from Changshu and Wuhan in 2015, and T2DM patients managed in the community were selected to conduct questionnaire surveys, physical measurements, and blood glucose testing. Factor analysis was used to obtain dietary patterns. A binary logistic regression model was used to analyze the factors affecting glycemic control. Results: Finally, 1 818 T2DM patients were included, and the control rate of FPG was 57.59% (95% CI : 55.30%-59.86%), and the control rate of 2 h postprandial blood glucose (2 h PBG) was 24.90% (95% CI : 22.93%- 26.91%). Five dietary patterns were obtained by factor analysis: animal food pattern, fruit-aquatic products-potato patterns, vegetable-grain pattern, egg-milk-bean pattern, and oil-salt patterns. No-conditional multivariate logistic regression analysis showed that after adjusting for confounding factors, the reduced probability of FPG control was related to animal food pattern ( OR =0.71, 95% CI : 0.52-0.98) and fruit-aquatic products-potato patterns ( OR =0.71, 95% CI : 0.51-0.97). The decrease in the 2 h PBG control probability was related to fruit-aquatic products-potato patterns ( OR =0.60, 95% CI : 0.40-0.90). The increased probability of FPG and 2 h postprandial glucose control were both related to vegetable-grain pattern ( OR =1.41, 95% CI : 1.03-1.94; OR =1.68, 95% CI : 1.13-2.51) and egg-milk-bean pattern ( OR =1.75, 95% CI : 1.25-2.46; OR =1.56, 95% CI : 1.00-2.42). Compared with the Q 4 group of egg-milk-bean pattern, the FPG control rate of the combination of "fruit-aquatic products-potato pattern ( Q 4 group), vegetable-grain pattern ( Q 2 group), egg-milk-bean pattern ( Q 3 group)" was higher ( OR =6.79, 95% CI : 1.15-40.23, P =0.035). Compared with the Q 4 group of vegetable-grain pattern, the combination of "fruit-aquatic products-potato pattern ( Q 4 group), vegetable-grain pattern ( Q 3 group), egg-milk-bean pattern ( Q 2 group), oil-salt pattern ( Q 2 group)" had higher control rate of 2 h PBG ( OR =12.78, 95% CI : 1.26-130.05, P =0.031). Conclusions: A proper combination of dietary patterns and dietary patterns are more conducive to the control of FPG and 2 h PBG in T2DM patients managed in the communities of Wuhan and Changshu. Patient nutrition education should be strengthened, and the food-matching ability of patients should be improved.

Objective: To understand the passive smoking exposure status in adults aged ≥40 years in China. Methods: Local residents aged ≥40 years were enrolled as study subjects from 125 areas of chronic obstructive pulmonary disease (COPD) surveillance during 2014-2015 and 2019-2020 in 31 provinces of China. A total of 74 559 adults aged ≥40 years were selected through multi-stage stratified cluster sampling for a face to face questionnaire survey and the data from 64 142 study subjects were used for the analysis. The passive smoking exposure rate, the proportions of the adults reporting passive smoking exposure at four types of places and the proportion of the adults living with daily smokers were described by using complicated sampling weighting method, the related factors were analyzed and the results were compared with the data of COPD surveillance during 2014-2015. Results: The passive smoking exposure rate in the adults aged ≥40 years was 46.4% (95% CI : 44.1%-48.8%) in China during 2019-2020, and the rate was higher in women (47.2%, 95% CI :44.8%-49.7%) than in men (44.8%, 95% CI :42.0%-47.6%) and lower in the older people. The office workers had the highest passive smoking exposure rate. The proportions of those reporting passive smoking exposure at homes, workplaces, restaurants, and public transports were 24.3% (95% CI :22.2%-26.4%)、23.3% (95% CI :21.1%-25.5%)、6.6% (95% CI :5.3%-7.9%) and 2.2% (95% CI :1.6%-2.7%). The higher education level the adults had, the less passive smoking exposure at home they reported. The proportions of those living with daily smokers before 14 years old and since 14 years old were 56.4% and 59.2%. Compared with the data during 2014-2015, the overall passive smoking exposure rate in the adults aged ≥40 years during 2019-2020 showed an increase, and the difference was not significant ( P= 0.356); The passive smoking exposure rate at homes declined, but the exposure rate at workplaces increased, with the biggest increase found in those being engaged in farming, forestry, husbandry, fishery and water conservancy. Multivariate analysis indicated that the factors influencing the passive smoking exposure and the exposure proportions at different places included gender, age, occupation, and education level. Conclusions: The passive smoking exposure rate in China is still high, especially in those being engaged in farming, forestry, husbandry, fishery and water conservancy. It is necessary to strengthen supervision of the enforcement of current smoking bans in public places and promote the legislation of ban smoking in public places. More attention should be paid to smoking ban and protection against passive smoking exposure in women, people with lower education level and people being engaged in in farming, forestry, husbandry, fishery and water conservancy.

Objective: To understand the current status of occupational exposure to dust or harmful gases and occupational protection in people aged ≥40 years in China, and provide data support for the prevention and control of occupational dust or harmful gas exposure. Methods: The data were obtained from the surveillance for chronic obstructive pulmonary disease (COPD) in adults aged ≥40 years selected by multi-stage stratified cluster sampling from 125 surveillance points in 31 provinces (autonomous regions and municipalities) during 2014-2015 and 2019-2020, and relevant information about occupational dust or harmful gas exposure and protection measures were collected through face-to-face interviews. Occupational dust or harmful gas exposure rate and occupational protection rate were estimated by using weighting complex sampling methods, and then the results were compared. Results: From 2014 to 2015 and from 2019 to 2020, a total of 71 061 and 71 023 individuals aged ≥40 years were surveyed, respectively. The rate of occupational exposure to dust or hazardous gas was 33.8% (95% CI : 29.9%-37.7%) during 2019-2020. The occupational exposure rate was higher in men than in women and in rural residents than in urban residents. With the increase of education level, the rate of occupational exposure to dust or harmful gas showed a downward trend. The protection rate against occupational dust or hazardous gas exposure was 47.9% (95% CI : 43.2%-52.6%) during 2019-2020. Compared with 2014-2015, the rate of occupational exposure to dust or hazardous gas decreased by 10.7 percentage points in different gender, area and occupational groups and the occupational protection rate increased by 21.9 percentage points during 2019-2020. The decrease in occupational exposure rate was higher in western China than in eastern and central China, and the increase in occupational protection rate was higher in western China than in eastern and central China. Conclusions: The rate of occupational exposure to dust or harmful gas decreased and the rate of occupational protection against dust or harmful gas exposure increased in China during 2019-2020. However, about one-third of the population still suffer from the occupational exposure, and less than half of them take protection measures. It is necessary to pay more attention to the key populations, such as workers with lower cultural level and rural migrant workers, in occupational health practice.

Objective: To understand the prevalence of exposure to household cooking oil fumes in women ≥40 years old. Methods: The data were from Chronic Obstructive Pulmonary Disease (COPD) Surveillance in China during 2019-2020, which selected permanent residents ≥40 years old from 125 counties (districts) in 31 provinces (autonomous regions and municipalities) across the country by multi-stage stratified cluster random sampling method. The relevant demographic information and cooking oil fumes were collected by face-to-face interview. Our study served 37 164 women with complete cooking practice information as the subject. After complex sample weighting, we analyzed the prevalence of cooking oil fumes exposure in women from cooking time, kitchen characteristics, and Self-reported cooking oil fumes exposure. Results: In 2019, 83.9% (95% CI : 82.1% - 85.7%) and 4.5% (95% CI : 3.8% - 5.2%) of Chinese women ≥40 years old cooked daily and often, respectively. The average daily cooking duration is 1.8 hours/day, 31.1% of women who cooked daily more than 2.0 hours, and the average cumulative cooking years of cooking women were 32.8 years. 79.3% of cooking women used ventilation devices, and 3.2% cooked in the living room. 8.9% and 7.2% of cooking women in south China and northwest China cooked in the living room, significantly higher than in other regions ( P =0.036). The self-reported exposure rate to cooking oil fumes was 81.0% (95% CI : 79.3% - 82.7%). Rural, older, lower education level and women engaged in agriculture had a higher proportion of cooking daily, average daily cooking duration, cumulative cooking years, the proportion of cooking in the living room, and rate of self-reported cooking oil fumes exposure, but a lower proportion of using ventilation devices during cooking ( P <0.001). Conclusions: The exposure to household cooking oil fumes was serious in Chinese women, and some women still did not take any ventilation measures when cooking. More attention should be paid to the exposure to home cooking oil fumes and its health hazards in women, especially those with lower socioeconomic status.

Objective: To investigate the correlation between the cross-sectional area of the macular hole (MH) cavity and the blood flow density in different retinal layers, as well as the impact of cavity size on preoperative and postoperative retinal function in patients with idiopathic macular holes (IMH). Methods: A retrospective cohort study was conducted. Clinical data were collected from 18 patients (18 eyes) diagnosed with IMH who underwent vitrectomy combined with internal limiting membrane peeling at Shanxi Eye Hospital affiliated to Shanxi Medical University from August 2019 to December 2021. Visual acuity, best-corrected visual acuity (BCVA), spectral-domain optical coherence tomography (SD-OCT), optical coherence tomography angiography (OCTA), and multifocal electroretinography (mfERG) were performed preoperatively and at 1, 3, and 6 months postoperatively. Blood flow density data were collected for the overall retina, macular center fovea, and parafoveal regions, and the cavity cross-sectional area was measured using ImageJ software. Ten healthy subjects without retinal abnormalities who underwent mfERG at Shanxi Eye Hospital affiliated to Shanxi Medical University during the same period were included as a control group. One eye was randomly selected for each subject, with 5 left eyes and 5 right eyes. Statistical analysis was performed using Pearson correlation analysis, independent samples t-test, and repeated measures analysis of variance. Results: All 18 IMH patients had unilateral disease, including 3 males and 15 females, with an average age of (64.22±4.33) years and a duration of illness of 75 (38, 120) days. In the control group, consisting of 10 subjects, 4 were male and 6 were female, with an average age of (63.67±6.96) years. Preoperatively, all 18 affected eyes exhibited a macular hole cavity, which closed and disappeared one month postoperatively. The total cavity cross-sectional area was (4.84±2.28) mm2, with an average area of (0.27±0.13) mm 2 . The cavity cross-sectional area was positively correlated with the MH height ( r =0.82, P <0.001), ellipsoid zone disruption diameter ( r =0.74, P <0.001), and preoperative BCVA ( r =0.62, P =0.006). The cavity cross-sectional area was positively correlated with the blood flow density of the superficial macular center fovea ( r =0.47, P =0.049) and negatively correlated with the blood flow density of the deep retina ( r =-0.50, P =0.033) and deep parafoveal blood flow density ( r =-0.65, P =0.003). Compared to healthy eyes in the control group, IMH eyes showed decreased amplitudes of P1 and N1 waves in mfERG, prolonged P1 wave latency except at ring 1 (2.18° outward from the foveal center), and prolonged N1 wave latency except at ring 2 (7.46° outward from the foveal center) and 5 (29.75° outward from the foveal center) (all P <0.05). The cavity cross-sectional area was only related to the preoperative latency of the N1 wave at ring 2 ( r =0.64, P =0.004) and had an effect on the changes in the preoperative and postoperative latency of P1 and N1 waves at ring 1 and 5 ( F =4.94, 5.96; P =0.042, 0.027). Time changes had no effect on the preoperative and postoperative amplitudes and latencies of mfERG P1 and N1 waves (all P >0.05), but the interaction between cavity cross-sectional area and time had statistical significance for the amplitudes of P1 at ring 1 and N1 at ring 2( F =6.89, 3.76; P =0.003, 0.035). Conclusions: In patients with IMH, a larger macular hole cavity cross-sectional area is associated with lower blood flow density, particularly in the deep parafoveal region, poorer visual acuity, and decreased retinal function at 7.46° outward from the foveal center.

Objective: To investigate the value of T2 map and synthetic T2WI generated by T2 mapping in evaluating the histological type, pathological classification and depth of myometrial invasion of endometrial carcinoma (EC). Methods: Seventy-three patients with pathologically proven EC diagnosed at the First Affiliated Hospital of Zhengzhou University from December 2019 to December 2021 and 42 healthy volunteers were enrolled in the study. All subjects underwent conventional MRI, diffusion weighted imaging (DWI) and T2 mapping sequence for the pelvic cavity to test the T2 values and the apparent diffusion coefficient (ADC) of the focus nidus of the patients and the normal endometrium of the volunteers. The T2 and ADC values of EC vs normal endometrium, and those of different histological types and pathological grades were compared. The receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic performance of T2 and ADC values in determining the pathological type and classification of EC. In addition, two radiologists used synthetic T2WI combined with T2 map and conventional T2WI combined with DWI, respectively, to evaluate the depth of myometrial invasion, and compared the imaging results with the results of pathological diagnosis to evaluate the diagnostic efficacy of the two methods in determining the depth of myometrial invasion. Results: The T2 and ADC values of endometrial carcinoma were 85.0 (80.8, 92.5) ms and 0.71 (0.64, 0.77) ×10(-3) mm(2)/s, respectively, which were significantly lower than those of normal endometrium [147.4 (123.4, 176.7) ms and 1.46 (1.26, 1.76)×10(-3) mm(2)/s, respectively; both P <0.05]. The T2 values of endometrioid carcinoma (EA) [84.1 (79.5, 88.7) ms] were significantly lower than those of non-EA [98.8 (92.1, 102.8) ms; P <0.05]. There was no significant difference in ADC values between EA and non-EA ( P =0.075). The T2 values of G1, G2 and G3 groups in EA were 89.1 (84.4, 94.4) ms, 83.6 (80.9, 86.2) ms, and 76.5 (71.4, 80.3) ms, respectively. There were significant differences in the T2 values between G1 vs G2, G1 vs G3, and G2 vs G3 groups, respectively (all P <0.017). Significant difference was also found in the ADC values between the G1 and G3 groups ( P <0.017). The area under the ROC curve (AUC) of T2 values in distinguishing EA from non-EA was 0.867. The AUC of T2 values, ADC values and their combination in predicting high-grade EA was 0.888, 0.730 and 0.895, respectively. The accuracy of synthetic T2WI+ T2 map and conventional T2WI+ DWI in the diagnosis of deep myometrial invasion was 78.1% and 79.5%, respectively, with no significant difference ( P >0.05). Conclusions: T2 mapping has great potential in preoperative evaluation of EC. The quantitative T2 value can be used in the diagnosis, pathological classification and grading of EC. The combination of synthetic T2WI and T2 map may be helpful to determine the depth of myometrial invasion.

Tissue engineering has become a research hotspot regarding periodontal bone regeneration in recent years. Generally, stem cells used in periodontal tissue engineering are derived from healthy dental tissues, while restricted due to the strict indication of tooth extraction and limited sources. Stem cells in inflamed dental tissues mainly derive from inflamed pulp, periapical and periodontal tissues. Stem cells in inflamed dental tissues are abundant and retain most of the basic characteristics of stem cell compared with the ones derived from healthy dental tissues, which can be a promising source of stem cells for periodontal bone regeneration. In this review, we summarize the current application and prospect of stem cells in inflamed dental tissues on periodontal bone regeneration, and then discuss their feasibility as seed cells, in order to provide a reference for future research and clinical application of stem cells in inflamed dental tissues.

To establish and identify induced pluripotent stem cells (iPSCs) derived from patients with Aicardi-Goutières syndrome (AGS) with TREX1 gene 667G>A mutation, and obtain a specific induced pluripotent stem cell model for Aicardi-Goutières syndrome (AGS-iPSCs). A 3-year-old male child with Aicardi-Goutieres syndrome was admitted to Zhongshan People's Hospital in December 2020. After obtaining the informed consent of the patient's family members, 5 ml peripheral blood samples from the patient were collected, and mononuclear cells were isolated. Then,the peripheral blood mononuclear cells(PBMCs) were transduced with OCT3/4, SOX2, c-Myc and Klf4 by using Sendai virus, and PBMCs were reprogrammed into iPSCs. The pluripotency and differentiation ability of the cells were identified by cellular morphological analysis, real-time PCR, alkaline phosphatase staining (AP), immunofluorescence, teratoma formation experiments in mice. The results showed that the induced pluripotent stem cell line of Aicardi-Goutieres syndrome was successfully constructed and showed typical embryonic stem-like morphology after stable passage, RT-PCR showed mRNA expression of stem cell markers, AP staining was positive, OCT4, SOX2, NANOG, SSEA4, TRA-1-81 and TRA-1-60 pluripotency marker proteins were strongly expressed. In vivo teratoma formation experiments showed that iPSCs differentiate into the ectoderm (neural tube like tissue), mesoderm (vascular wall tissue) and endoderm (glandular tissue). Karyotype analysis also confirmed that iPSCs still maintained the original karyotype (46, XY). In conclusion, induced pluripotent stem cell line for Aicardi-Goutières syndrome was successfully established using Sendai virus, which provided an important model platform for studying the pathogenesis of the disease and for drug screening.

Objective: To understand the prevalence of smoking and its change in adults aged ≥40 years in China and provide evidence for the development of chronic obstructive pulmonary disease (COPD) prevention and control strategies. Methods: The data of this study were obtained from COPD surveillance in China during 2014-2015 and during 2019-2020. The surveillance covered 31 provinces (autonomous regions and municipalities). A multi-stage stratified cluster random sampling were used to select residents aged ≥40 years, and face-to-face interviews were conducted to collect the information about their tobacco use. After complex sampling weighting of the samples, the current smoking rate, average age to start smoking and average daily cigarette consumption of people with different characteristics during 2019-2020 were estimated, and the changes in the current smoking rate and average daily cigarette consumption were analyzed from 2014-2015 to 2019-2020. Results: During 2019-2020, the current smoking rate in adults aged ≥40 years was 27.2%, and the rate was much higher in men (52.1%) than in women (2.5%).The average age of the smokers to start smoking was 20.0 years old, and men usually started smoking at younger age (19.6 years) compared with women (27.9 years). The average daily cigarette consumption of daily smokers was 18.0 sticks, and the consumption of men (18.3 cigarettes) was higher than that of women (11.1 cigarettes). Compared with the surveillance results during 2014-2015, the current smoking rate had decreased by 2.8 percentage points in the general population, 4.1 percentage points in males, 1.6 percentage points in females, and the urban and rural areas fell by 3.1 percentage points and 2.5 percentage points, respectively. The average daily cigarette consumption decreased by 0.6 sticks. Conclusions: In recent years, the current smoking rate and average daily cigarette consumption in adults aged ≥40 years decreased in China, but smoking is still common in more than quarter of this population and more than half of men aged ≥40 years. It is necessary to take targeted tobacco control measures based on population and regional characteristics to further reduce the smoking level of the population.

Tuberculosis (TB) prophylactic therapy for latent infection, which can reduce the risk for the development of active TB, is an important measure in TB control. China recommends prophylactic therapy for latent tuberculosis infection (LTBI) in some key populations to reduce the risk for TB. Contacts of patients with multi-drug and rifampicin-resistant TB (MDR/RR-TB) are at high risk for the infection with drug-resistant pathogen, however, no unified prophylactic therapy regimen has been recommended for LTBI due to exposure to MDR/RR-TB patients. This paper summarizes the current MDR/RR-TB prophylactic therapy regimen and its protection effect based on the results of the retrieval of literature, guidelines, expert consensus and technical specifications to provide reference for the prevention and control of LTBI.

Objective: To establish a quantitative immunoassay method based on stable element labeling and inductively coupled plasma mass spectrometry (ICP-MS) for the detection of serum amyloid A (SAA) and evaluate its performance. Methods: An immunoassay system based on sandwich method was established with magnetic bead as carrier and holmium (Ho) as element tags. The binding ratio of hydrophilic streptavidin magnetic beads and biotinylated antibody, the amount of elemental antibody, and the reaction time were optimized to choose the optimal reaction conditions. According to the documents of Clinical and Laboratory Standards Institute (CLSI), the analytical performance was evaluated, including the limit of blank (LOB), linearity, accuracy, specificity, imprecision and interference test. Finally, 82 SAA plasma samples were collected after the turbidimetric inhibition immunoassay, and the newly established method was used for detection. Moreover, the detection results of the two methods were analyzed by Pearson correlation analysis. Results: The optimal binding ratio of hydrophilic streptavidin and biotinylated antibody was 1∶0.15, the amount of Ho-labeled antibody was 3 μl and the incubation time of the two reaction steps was 40 min and 30 min, respectively. The LOB was 0.6 ng/ml. The linearity was good within the range of 0-1 200 μg/L ( R 2 =0.998 9, P <0.001). The inter-batch precision of high-value samples and low-value samples was 9.42% and 7.95%, respectively, and the intra-batch precision was 14.56% and 13.56%, respectively. The recovery was 96.01%-104.76%. The cross-reaction rates with procalcitonin (PCT) and C-reactive protein (CRP) were 0.45% and 0.015%, respectively. When the concentration of triglyceride≤35.5 mg/L, bilirubin≤0.52 mg/L and hemoglobin≤2.4 g/L, the interference bias was less than 10%. The results of 82 SAA plasma samples were 12.65 (4.45, 59.03) mg/L by ICP-MS immunoassay and 18.23 (9.33, 68.72) mg/L by turbidimetric inhibition immunoassay, respectively. The newly established system was well correlated with turbidimetric inhibition immunoassay ( R 2 =0.983, P <0.001). Conclusion: The quantitative immunoassay for SAA with Ho as marker established in this study has high precision, good accuracy, high specificity, and wide linear range, which can meet the clinical testing requirements.

Objective: To investigate the prevalence and risk factors of diabetic peripheral artery disease (PAD) in patients with type 2 diabetes mellitus (T2DM) managed in primary health care in China. Methods: A total of 2 528 T2DM patients were selected using a two-stage cluster random sampling method based on the baseline survey of the "China Diabetic Foot Prevention Model Project." The study was conducted in 2015 among T2DM patients in 8 primary healthcare centers in Changshu county and Jiang'an district of Wuhan, China. Data collection methods included a questionnaire, body measurement, and blood glucose detection. The Ankle-Brachial Index (ABI) is the most widely used noninvasive vascular test. A binary logistic regression model was used to analyze the influence factors. Results: The prevalence of PAD was 11.2% among the diabetic patients managed in primary health care in the two cities. The prevalence of PAD under 55 years old, 55- years old, 65- years old, and ≥75 years old were 7.8%, 6.0%, 12.9% and 22.5%, respectively. Multivariate stepwise logistic regression identified influence factors included older age, higher education level, smoking, drinking, postprandial glucose uncontrol, and prior myocardial infarction or angina. Compared to age <55 years, the odds ratio for PAD were 0.74 for 55- years (95% CI : 0.43-1.28), 1.72 for 65- years (95% CI : 1.05-2.81), 3.56 for 75 years and above (95% CI : 2.07-6.11), respectively. Compared to patients with education in primary school and below, the odds ratio was 1.37 (95% CI : 0.97-1.94), 2.48 (95% CI : 1.73-3.55), 1.99 (95% CI : 1.26-3.13) for those with education levels of junior high school, senior high school, and college, respectively. Current smoking ( OR =1.49, 95% CI : 1.02-2.17), current drinking ( OR =0.45, 95% CI : 0.28-0.71), postprandial glucose uncontrol (2 h postprandial plasma glucose >10.0 mmol/L: OR =1.72, 95% CI : 1.22-2.43), and prior myocardial infarction or angina ( OR =2.32, 95% CI : 1.50-3.61) were influencing factors of PAD. Conclusions: Despite the high prevalence of PAD in diabetes managed in primary health care; multiple risk factors are not effectively aware of and under control. It is urgent to promote ABI screening and standardized management for diabetes, especially in primary health care.

The objective of this study was to investigate the effects of heat treatment (toasting) and particle size alterations (grinding; rolling) on nutrient utilization, ruminal fermentation, and supply of metabolizable protein (MP), and to study the interaction between processing conditions of fava beans and forage type. Six Danish Holstein dairy cows fitted with ruminal, duodenal, and ileal cannulas were used in a 6 × 4 incomplete Latin square design with 4 periods of 21-d duration. Cows were fed ad libitum with 6 experimental diets: diets high in either grass-clover silage or corn silage were combined with ground untoasted, ground toasted, or rolled untoasted fava beans. Samples of ruminal fluid, digesta from duodenum and ileum, and feces were collected, and nutrient digestibility was estimated using Cr 2 O 3 and TiO 2 as flow markers. Diets high in corn silage resulted in higher ruminal pH and higher proportion of propionate in ruminal volatile fatty acids compared with diets high in grass-clover silage. Diets high in corn silage resulted in higher apparent total-tract digestibility of crude protein and starch but lower apparent ruminal and total-tract digestibility of neutral detergent fiber compared with diets high in grass-clover silage. Rolling of fava beans decreased the in situ small intestinal disappearance of rumen-undegradable protein corrected for particle losses. Compared with grinding, rolling of fava beans reduced apparent ruminal digestibility of starch, true ruminal digestibility of organic matter, crude protein, and AA, and small intestinal digestibility of AA and starch. Grinding of fava beans increased apparent ruminal digestibility of neutral detergent fiber and reduced the proportion of propionate in ruminal volatile fatty acids compared with rolling of fava beans. In addition, rolling of fava beans had no effect on MP supply. Toasting of fava beans had no effect on in vivo nutrient digestibility except for an interaction with forage source on apparent ruminal dry matter and organic matter digestibility. Toasting of fava beans did not affect small intestinal digestion of individual and total AA, and therefore failed to increase MP supply. In conclusion, neither replacing grass-clover silage with corn silage, nor toasting nor rolling of fava beans had an effect on supply of MP., (The Authors. Published by Elsevier Inc. and Fass Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)

Objective: To explore the incidence and influencing factors of prediabetes in adults in China. Methods: Ten provinces (cities) were selected from the surveillance survey of chronic diseases and their risk factors in China in 2010; two monitoring sites were selected from each province (city) as follow-up spots, and a follow-up survey was conducted from 2016 to 2017. An unconditional logistic regression model was used to analyze the influencing factors of prediabetes. Results: A total of 5 578 participants were included in this study. During the follow-up period, 612 patients (268 males and 344 females) developed impaired glucose tolerone (IGT), with a total follow-up of 37 364.82 person-years, and the incidence of IGT was 16.4/1 000 person-years. Impaired fasting glucose (IFG) occurred in 290 patients (128 males and 162 females) with a total follow-up of 39 731.31 person-years, and the incidence of IFG was 7.3/1 000 person-years. The multivariate unconditional logistic regression model included age, urban and rural areas, family history of diabetes, BMI, central obesity, dyslipidemia, hypertension, and physical activity, and the results showed that age (≥50 years old: OR =1.60, 95% CI : 1.32-1.95), urban residents ( OR =1.41, 95% CI : 1.16-1.71), obesity ( OR =1.56, 95% CI : 1.12-2.19), dyslipidemia ( OR =1.52, 95% CI : 1.25-1.83), hypertension ( OR =1.32, 95% CI : 1.07-1.61) and physical inactivity ( OR =1.25, 95% CI : 1.04-1.50) increase the risk of IGT. Age (≥50 years old: OR =1.31, 95% CI : 1.01-1.70), family history of diabetes ( OR =1.71, 95% CI : 1.13-2.60), overweight ( OR =1.41, 95% CI : 1.04-1.92), obesity ( OR =2.09, 95% CI : 1.38-3.17) and hypertension ( OR =1.53, 95% CI : 1.18-2.00) increase the risk of IFG. Conclusions: The incidence of IGT is higher than the IFG. People aged 50 and above, overweight and obese people, hypertension patients, dyslipidemia patients, people with insufficient physical activity, and family history of diabetes are prone to prediabetic events.

Objective: To investigate the risk factors and outcomes of cytomegalovirus (CMV) infection post umbilical cord blood stem cell transplantation (UCBT) in children with primary immunodeficiency diseases (PID). Methods: Clinical data of 143 PID children who received UCBT in the Children's Hospital of Fudan University from January 2015 to June 2020 were collected retrospectively. CMV-DNA in the plasma was surveilled once or twice a week within 100 days post-UCBT. According to the CMV-DNA test results, children were divided into the CMV-infected group and the CMV-uninfected group. The incidence and risk factors of CMV infection were analyzed. At 1-month post-UCBT, the absolute lymphocyte count, ratio of lymphocyte subsets and immunoglobulin levels were compared between those whose CMV infection developed 1-month later post-UCBT and those not. Mann-Whitney U test and chi-squared test were used for comparision between groups. Kaplan-Meier survival analysis was used to analyze the impact of CMV infection on survival. Results: Among 143 patients, there were 113 males and 30 females, with a age of 14 (8, 27) months at UCBT. Chronic granulomatosis disease ( n =49), very-early-onset inflammatory bowel disease ( n =43) and severe combined immunodefiency ( n =29) were the three main kinds of PID. The rate of CMV infection was 21.7% (31/143), and the time of infection occurring was 44 (31, 49) days post-UCBT. The incidence of recurrent CMV infection was 4.2% (6/143) and refractory CMV infection was 4.9% (7/143).There was no significant difference in the first time CMV-DNA copy and peak CMV-DNA copy during treatment between the recurrent CMV infection group and the non-recurrent CMV infection group (32.8 (18.3, 63.1)×10 6 vs. 22.5 (13.2, 31.9)×10 6 copies/L, Z =-0.95, P =0.340;35.2 (20.2, 54.6)×10 6 vs. 28.4 (24.1, 53.5)×10 6 copies/L, Z =-0.10, P =0.920), so were those between the refractory CMV infection group and non-refractory CMV infection group (21.8 (13.1, 32.2)×10 6 vs. 25.9 (14.2, 12.2)×10 6 copies/L, Z =-1.04, P =0.299; 47.7 (27.9, 77.6)×10 6 vs. 27.7 (19.7,51.8)×10 6 copies/L, Z =-1.49, P = 0.137). The CMV-infected group accepted more reduced-intensity conditioning (RIC) regimen than the CMV-uninfected group (45.2% (14/31) vs . 25.0% (28/112), χ 2 =4.76, P< 0.05). The rate of CMV-seropositive recipients and Ⅱ-Ⅳ acute graft versus host diseases (aGVHD) are significantly higher in the CMV-infected group than the CMV-uninfected group (100% (31/31) vs . 78.6% (88/112), 64.5% (20/31) vs . 26.8% (30/112), χ 2 =7.98,15.20, both P <0.05). The follow-up time was 31.6 (13.2, 45.9) months, CMV infection had no effect on overall survival (OS) rate (χ 2 =0.02, P =0.843). There was significant difference in the survival rate among three groups of refractory CMV infection, non-refractory CMV infection and the CMV-uninfected (4/7 vs. 95.8% (23/24) vs. 86.6% (97/112), χ 2 =5.91, P =0.037), while there was no significant difference in the survival rate among three groups of recurrent CMV infection, non-recurrent CMV infection and the CMV-uninfected (5/6 vs. 88.0% (22/25) vs. 86.6% (97/112), χ 2 =0.43, P =0.896). Children who developed CMV infection after 30 days post-UCBT had lower absolute count and rate of CD4 + T cells and immunoglobulin G (IgG) level than those in the CMV-uninfected group (124.1 (81.5, 167.6) ×10 6 vs. 175.5 (108.3, 257.2) ×10 6 /L, 0.240 (0.164, 0.404) vs. 0.376 (0.222, 0.469), 9.3 (6.2, 14.7) vs. 13.6 (10.7, 16.4) g/L, Z =-2.48, -2.12,-2.47, all P <0.05), but have higher rate of CD8 + T cells than those in CMV-uninfected group (0.418 (0.281, 0.624) vs. 0.249 (0.154, 0.434), Z =-2.56, P =0.010). Conclusions: RIC regimen, grade Ⅱ-Ⅳ aGVHD and CMV-seropositive recipients are the main risk factors associated with CMV infection in PID patients post-UCBT. Survival rate of children with refractory CMV infection after UCBT is reduced. Immune reconstitution in children after UCBT should be regularly monitored, and frequency of CMV-DNA monitoring should be increased for children with delayed immune reconstitution.

Objective: To investigate the alterations in effective connection of default mode network (DMN) in long-term male smokers and its correlation with clinical characteristics of smoking. Methods: A total of 131 subjects through WeChat platform and underwent resting-state functional magnetic resonance (rs-fMRI) examinations were recruited, including 76 long-term smokers [long-term smoking group, male, aged 20 to 55 (32.1±6.3) years] and 55 non-smokers [healthy controls, male, aged 20 to 55(32.3±7.4) years] from January 2014 to December 2018. Long-term smokers were defined as those who smoked at least 10 cigarettes per day for more than 2 years, and met the Diagnostic and Statistical Manual of Mental Disorders-Four Edition (DSM-Ⅳ) criteria for substance dependence. Four major nodes of DMN, including left inferior parietal lobule (LIPL), right inferior parietal lobule (RIPL), posterior cingulate cortex (PCC), medial prefrontal cortex (mPFC) were chosen as for the region of interest. The effective connectivity (EC) alterations of DMN between smoking group and healthy controls were compared using dynamic causal modeling (DCM). The correlation between EC with significant difference among the two groups and Nicotine Dependence Scale (FTND) score, pack-year score and smoking duration were evaluated. Results: Compared to the healthy controls, the EC of LIPL to PCC and PCC to mPFC were decreased in the smoking group (EC = -0.091, -0.174, respectively, Bayesian-PP>0.95), and the EC of RIPL to PCC was increased (EC = 0.136, Bayesian-PP>0.95). Besides, EC of LIPL to PCC showed negative correlation with pack-year scores( r =-0.282, P =0.017). No significant linear correlations were observed between EC with significant group difference and FTND score or smoking duration ( r =-0.103、-0.089,all P >0.05). Conclusion: Long-term smokers showed multiple abnormalities in IPL-PCC-mPFC circuits, and associated with the pack-year scores.

Objective: To investigate the clinical manifestations, treatments, and prognosis of pediatric patients with Talaromyces marneffei infection. Methods: In this retrospective study, 7 children diagnosed with Talaromyces marneffei infection in Shenzhen Children's Hospital from July 2017 to October 2021 were recruited. The clinical features, radiology, pathogen detection, immunological evaluation, treatments, and prognosis were analyzed. Results: In 7 cases, 5 were male, 2 were females. The age was from 0.75 to 8.75 years. The main clinical manifestations were fever in 7 cases, cough in 6 cases, malnutrition in 4 cases, papules in 2 cases and medical history of recurrent infection in 3 cases. Physical examination showed that all 7 patients had hepatosplenomegaly, 4 had superficial lymphadenopathy. Laboratory examination showed that 6 cases had decreased hemoglobin and 3 cases had decreased platelet. Chest CT showed that 4 cases had patchy shadows, pleural effusion, mediastinal or axillary lymph node enlargement, 3 had nodular shadows and 2 had cavities. The positive ratio of Talaromyces marneffei culture was 2/2 with tissue samples, 4/5 with bone marrow. The positive ratio was 3/4 by metagenomic next generation sequencing. The fungus was detected in 3 cases by smear microscopy of bone marrow and (or) peripheral blood. All patients were negative for human immunodeficiency virus by the immune function assay. However, 5 cases were confirmed as primary immunodeficiency disease, including 2 cases with high IgM syndrome, 2 with STAT1 gene variation, and the last with severe combined immunodeficiency (IL2RG gene variation). Exclude 1 case which gave up treatment due to acute intracranial infection, and the other patients received effective treatments along with amphotericin B, voriconazole, and itraconazole alone or in combination. Two cases relapsed after medication withdrawal, but 1 case got complete rehabilitation after hematopoietic stem cell transplantation. Conclusions: The clinical manifestations involve multisystem, the common charateristics are fever and cough. The chest CT imaging manifestations are diverse, it should be considered in differentiating tuberculosis. The amphotericin B, voriconazole and itraconazole are effective, but it will easily relapse when withdrawing those antifungal agents.

γ-butyrolactone is a colorless transparent liquid used in the production of drugs such as cyclopropylamine and pyrrolidone, and is also used as an industrial solvent, diluent, curing agent, etc., and is listed as the third category of precursor chemicals control. There is less clinical exposure to γ-butyrolactone and insufficient studies on its withdrawal response. This article reports a case of severe life-threatening rhabdomyolysis in a patient with γ-butyrolactone withdrawal. After active treatment, the patient eventually recovered. The clinical characteristics and treatment methods of γ-butyrolactone withdrawal reaction were summarized, suggesting that severe withdrawal reaction may occur in γ-butyrolactone.