Abstract:Objective：To identify and validate differentially expressed circulating microRNAs（miRNAs）and to evaluate their potential diagnosis and prognosis value in heart failure with preserved ejection fraction（HFpEF）. Methods：A total of 45 participants were initially enrolled，including 30 patients with HFpEF and 15 non - heart failure（non -HF）controls. Pooled plasma samples were analyzed by high-throughput miRNA sequencing to screen for differentially expressed candidate miRNAs. Subsequently，133 HFpEF patients and 53 non-heart failure patients hospitalized during the same period were continuously enrolled as the validation cohort，and quantitative real-time reverse transcription polymerase chain reaction（qRT-PCR）was used to validate the candidate miRNAs. Receiver operating characteristic（ROC）curves were constructed and the area under the curve（AUC）were calculated to evaluate their diagnostic performance. Major adverse cardiovascular events（MACE）were defined as cardiovascular death or heart failure rehospitalization.HFpEF patients were followed up for a median duration of 216 days（interquartile range：199-260 days）. The relationship between plasma miRNAs and the occurrence of MACE was analyzed，and survival curves were plotted using the Kaplan-Meier method. At the same time，univariate and multivariate Cox proportional hazards regression models were used to analyze the risk factors affecting the prognosis of HFpEF patients. Results：Compared with the control group，plasma hsa -miR -130a -3p was significantly upregulated in HFpEF patients[1.93（1.10，2.96）vs. 0.98（0.79，1.19）；P<0.001]. ROC analysis showed that miR-130a-3p effectively differentiated HFpEF patients from controls，with an AUC of 0.791（95% CI：0.728-0.853，P<0.001）and an optimal cutoff value of 1.459，with a sensitivity of 62.41% and specificity of 94.34%. Based on the levels of miR-130a-3p，HFpEF patients were categorized into high-and low - expression groups. Kaplan -Meier analysis revealed that patients with high miR - 130a - 3p expression had a significantly higher cumulative incidence of MACE than those with low expression（26.98% vs. 6.15%，log - rank P=0.002）. Multivariate Cox regression further confirmed that high expression of plasma miR - 130a -3p was an independent risk factor for poor prognosis in HfpEF patients[hazard ratio（HR）=2.197，95% CI：1.254 - 3.847，P=0.006]. Conclusion：Circulating miR - 130a - 3p is a promising diagnostic and prognostic biomarker for HFpEF. Its high expression is closely associated with adverse cardiovascular outcomes，suggesting that circulating miR - 130a - 3p may serve as a novel biomarker for HFpEF diagnosis and risk stratification. Further validation in larger multicenter prospective cohorts is warranted.

Abstract:Objective：To develop and externally validate a patient - level prediction model for postoperative frailty in adults undergoing cardiac surgery. Methods：Our study included patients who underwent cardiac surgery at the First Affiliated Hospital of Nanjing Medical University between January and December 2023. Frailty was assessed one month postoperatively using the FRAIL scale，and patients were categorized into frailty and non-frailty groups. Three machine learning algorithms，least absolute shrinkage and selection operator（LASSO），random forest（RF），and extreme gradient boosting（XGBoost），were employed to identify common predictors. A nomogram prediction model was subsequently constructed using Logistic regression. The model’s discriminative ability was evaluated using the receiver operating characteristic（ROC）curve and the area under the curve（AUC）. Calibration curves assessed consistency，and decision curve analysis（DCA）evaluated clinical utility. The model was validated internally and externally.Results：A total of 301 patients were included. Among them，235 patients were divided into a training set（n=165）and an internal validation set（n=70）at a ratio of 7∶3，while the remaining 66 patients served as temporal validation. Based on the machine learning results，four common predictors were identified：age，preoperative left ventricular ejection fraction（LVEF），preoperative albumin level，and preoperative left ventricular end - diastolic dimension（LVDd）. These were used to construct the nomogram. The modeldemonstrated excellent discriminative ability in the training set（AUC=0.846，95% CI：0.763-0.928），internal validation set（AUC=0.821，95%CI：0.701-0.940），and temporal validation set（AUC=0.846，95%CI：0.740-0.951）. The calibration curve indicated high consistency between predicted and observed risks. Decision curve analysis further confirmed its good clinical practicality. Conclusion：The nomogram prediction model for post-cardiac surgery frailty，based on patient age，preoperative albumin level，LVEF，and LVDd，exhibits good predictive performance and clinical applicability，facilitating the early identification of high-risk patients.

Abstract:Objective：To assess the influencing factors and the prognostic characteristics for the mismatch between Alberta Stroke Program Early Computed Tomography Score（ASPECTS）on non-contrast computed tomography（NCCT）and infarct core volume on CT perfusion（CTP）imaging in acute ischemic stroke（AIS）patients. Methods：The clinical and imaging data of 449 AIS patients with large vessel occlusion of anterior circulation who underwent NCCT and CTP evaluation from October 2019 to August 2023 were retrospectively analyzed. The RAPID software was used to automatically calculate the NCCT-ASPECTS and the infarct core volume of CTP.“NCCT -CTP mismatch”was defined as low ASPECTS with small ischemic core（LASC，ASPECTS< 6 points，CTP infarct corevolume< 70 mL）and high ASPECTS with large ischemic core（HALC，ASPECTS≥6 points，CTP infarct core volume≥70 mL）. A modified Rankin Scale（mRS）score of 0-2 at 90-day follow-up after endovascular thrombectomy（EVT）was defined as good prognosis.The multivariable logistic regression analysis were used to assess the independent influencing factors for NCCT - CTP mismatch.Results：Among the 449 AIS patients，145 patients had NCCT-CTP mismatch，and 52（35.9%）NCCT-CTP mismatch patients achieved good outcomes after EVT. The results of multivariate logistic regression analysis showed that intravenous thrombolysis（IVT）before imaging assessment（OR=1.833；95%CI：1.205-2.790，P=0.005）and higher baseline NIHSS score（OR=1.055；95%CI：1.028-1.083，P<0.001）were independent influencing factors for NCCT -CTP mismatch in AIS patients. In the subgroup analysis for NCCT -CTP mismatch patients，patients with LASC exhibited longer stroke onset time[306（219，482）min vs. 125（63，307）min，P=0.004]and a higher rate of hemorrhagic infarction（66.9% vs. 33.3%，P=0.021）after EVT than patients with HALC. Conclusions：About 35% NCCT-CTP mismatch AIS patients can benefit from EVT. The IVT using before baseline imaging and a higher admission NIHSS score were independent influencing factors for NCCT-CTP mismatch.

Abstract:Objective：To investigate proteomic and transcriptomic differences between exosomes derived from sex-specific human embryonic stem cells（hESC - exo）and human amniotic mesenchymal stem cells（hAMSC - exo）at the molecular level. Methods：A defined cell culture system optimized for exosome research was established. High - quality exosomes were isolated via ultracentrifugation from male and female lines of hESCs and hAMSCs. Proteomic characterization was performed using liquid chromatography -tandem mass spectrometry（LC - MS/MS），while microRNA（miRNA）profiles were determined by high -throughput sequencing. Bioinformatics analysis subsequently identified key biological processes and pathways regulated by the exosomes. Results：At both proteomic and transcriptomic levels，exosomes derived from male and female hAMSCs exhibited similar molecular profiles，whereas those originating from male and female hESCs showed significant sex - based differences. Integrated miRNA profiling and proteomic analysis revealed that hESC-exo were primarily associated with developmental and metabolic processes，while hAMSC-exo predominantly participated in immune and metabolic functions. Conclusion：Through systematic proteomic and miRNA sequencing analyses of sex-specific exosomes derived from hAMSCs and hESCs，this study predicted their biological functions and revealed theirpotential applications across multiple domains. These findings provide novel perspectives for selecting optimal cell sources in preclinical and clinical trials.

Abstract:Objective：To investigate the effects of DIX domain -containing protein 1（Dixdc1）on the proliferation，migration，and polarization of astrocytes following traumatic brain injury（TBI）in mice. Methods：A mouse TBI model was established using the controlled cortical impact（CCI）device. Western blot was used to examine the expression of Dixdc1，glial fibrillary acidic protein（GFAP），the neurotoxic astrocyte marker complement 3（C3），and the neuroprotective astrocyte marker S100 calcium-binding protein A10（S100A10）before and after injury. Immunohistochemical staining was performed to observe the expression and distribution of Dixdc1 and GFAP，and immunofluorescence staining was used to observe the colocalization of Dixdc1 with GFAP. Short hairpin RNA（shRNA）was used to knock down Dixdc1 levels in mouse astrocytes C8-D1A. Lipopolysaccharide（LPS）stimulation was then applied to mimic the activated state of astrocytes in vitro. Western blot was performed to detect expression changes of Dixdc1，GFAP，C3，S100A10，as well as cell proliferation and migration - related proteins. Flow cytometry was performed to analyze the cell cycle，accompanied by Western blot detection of S-phase-related proteins. RT-PCR was used to detect the expression of astrocyte polarization markers. Cellular immunofluorescence was employed to detect the fluorescence intensity of C3 and S100A10. Additionally，Western blot was performed to assess the phosphorylation levels of signal transducer and activator of transcription 3（STAT3）. Results：Compared with the Sham group，the protein expression levels of Dixdc1 and GFAP were upregulated in the cerebral cortex of TBI mice.Dixdc1 was expressed in astrocytes within the peri-lesional cortical regions. Following LPS stimulation，the protein expression levels of both Dixdc1 and GFAP were upregulated in C8 - D1A cells. Scratch assay and EdU assay demonstrated that knockdown of Dixdc1suppressed LPS - induced astrocyte proliferation and migration，downregulated the expression of associated proteins，reduced the proportion of cells in the S phase of the cell cycle，and decreased CyclinA and CDK2 protein levels. C3 showed elevated expression levels during the acute phase but declined thereafter，whereas S100A10 demonstrated an inverse temporal pattern. Dixdc1 knockdown may inhibit LPS-induced A1-type astrocyte polarization by reducing STAT3 phosphorylation levels，which concurrently downregulated C3 protein expression and upregulated S100A10 protein expression. Conclusion：Following TBI，Dixdc1 protein expression was upregulated in astrocytes. Knockdown of Dixdc1 significantly suppressed LPS-induced proliferation，migration，cell cycle and STAT3phosphorylation of A1-type astrocytes.

Abstract:Objective：To establish a workflow using a microplate imaging system for screening monoclonal cell strains with high fluorescent protein expression after stable transfection. Methods：Human bronchial epithelial（HBE）cells were transfected with green fluorescent protein（GFP）gene using a lentiviral vector. Single cells with strong fluorescence were sorted by flow cytometry into a 96-well plate. According to the established screening protocol，four rounds of stepwise screening were performed using the imaging and analysis functions of the microplate imaging system：on the day of sorting，wells containing a single cell were identified；when the majority of clonal clusters contained more than 20 cells，wells with clonal clusters were selected；after trypsinization and transfer of cells from the selected wells to new wells，wells with cells exhibiting higher mean fluorescence intensity were identified；when rapidly proliferating cells expanded 4-8 fold，wells with cells exhibiting normal proliferation were selected. The stably transfected cells were continuously maintained under the same culture conditions as the monoclonal cells. When the monoclonal cells proliferated to an adequate number，flow cytometry and fluorescence imaging were used to compare the fluorescence intensity between the finally selected monoclonal cell strains and the stably transfected cells. Results：Following the screening protocol，89 wells containing a singlecell，19 wells with clonal clusters，6 wells with cells exhibiting higher mean fluorescence intensity，and 3 wells with normally proliferating cells were successively identified. Flow cytometric analysis demonstrated that the monoclonal cell strains from these three wells exhibited an approximately 9-fold increase in mean fluorescence intensity and a significant increase in the percentage of cells exhibiting strong GFP fluorescence，compared to the stably transfected cells. This improvement was corroborated by microplate imaging，which revealed markedly superior GFP fluorescence in the monoclonal cell strains. Conclusion：Using a microplate imaging system in combination with the established screening protocol enables stepwise and efficient screening of monoclonal cell strains with high fluorescent protein expression after stable transfection. Compared to traditional microscopy or other imaging methods，this approach is simpler，more convenient，and holds significant potential for broader application.

Abstract:Objective：To analyze and compare the trends in the incidence of four types of hepatitis between Jiangsu province and the whole nation，reveal the regional characteristics and current status of hepatitis incidence in Jiangsu province，and provide a reference for hepatitis prevention and control efforts in Jiangsu province and the whole nation. Methods：Descriptive epidemiological methods，average annual percent change and spatiotemporal scan statistical methods were used to analyze and compare the incidence data of four types of hepatitis（hepatitis A，B，C and E）in Jiangsu province and the whole nation from 2004 to 2022. Results：The average incidence rates（1/100 000）of four types of hepatitis in Jiangsu province and nationwide from 2004 to 2022 were 1.55 and 2.72for hepatitis A，18.70 and 75.24 for hepatitis B，3.50 and 11.85 for hepatitis C，and 3.80 and 1.77 for hepatitis E，respectively. The change trend of incidence rate in recent years is as follows：nationwide，hepatitis A remained a stable trend（2012-2022，P>0.10），hepatitis B remained a stable trend（2014-2022，P>0.50），hepatitis C displayed a downward trend（2019-2022，P<0.001），andhepatitis E remained a stable trend（2013-2022，P>0.50）；In Jiangsu province，hepatitis A remained a stable trend（2013-2022，P>0.20），hepatitis B showed an upward trend（2012-2022，P<0.05），hepatitis C showed an upward trend（2004-2022，P<0.001），and hepatitis E demonstrated a declining trend（2011-2022，P<0.001）. Spatiotemporal scan statistical analysis revealed that three low-incidence clusters for hepatitis A nationwide all included Jiangsu province，one of three low - incidence clusters for hepatitis B nationwide included Jiangsu province，two of four low-incidence clusters for hepatitis C in nationwide included Jiangsu province，and three high-incidence clusters for hepatitis E in nationwide all included Jiangsu province. Conclusion：From 2004 to 2022，nationwide，hepatitis B had the highest average incidence rate，followed by hepatitis C，hepatitis A，and hepatitis E，respectively. In Jiangsu province，hepatitis B also had the highest average incidence rate，followed by hepatitis E，hepatitis C，and hepatitis A respectively. The average incidence rates of hepatitis A，B，and C in Jiangsu province were lower than the national average，while the average incidence rate of hepatitis E was higher than the national average. The focus of the national hepatitis prevention and control strategy should be on reducing the incidence rate of hepatitis B and shifting the stable trends of hepatitis A（2012- 2022）and hepatitis E（2013- 2022）incidence rates to a declining trend. The focus of hepatitis prevention and control strategy in Jiangsu province should be on reducing the incidence rates of hepatitis B and hepatitis E，as well as reversing the upward trend of hepatitis C（2004-2022）incidence and the stable trend of hepatitis A（2013-2022）incidence to a declining trend.

Abstract:Objective：To investigate the relationship between changes in ultrasound echo characteristics of the diaphragm and peripheral skeletal muscles and weaning outcome and prognosis in mechanically ventilated patients with sepsis，in order to explore the potential value of muscle ultrasound in guiding the early and accurate assessment of patients with sepsis. Methods：Mechanically ventilated septic patients admitted to the Department of Critical Care Medicine of Affiliated Hospital of Nantong University from January 2023 to December 2024 were selected as the study subjects，and the ultrasound images of diaphragm and quadriceps femoris were consecutively observed and analyzed at the time of admission to the ICU，48h，and discharge from the ICU. The echogenicity of diaphragm（EDi）/echogenicity of rectus femoris（ERF）ratio（EDi/ERF）and the thickness of diaphragm（Tdi）/quadriceps muscle layerthickness（Q-MT）ratio（Tdi/Q-MT）were calculated. According to the trend of EDi/ERF and Tdi/Q-MT，the patients were categorized into the group with increasing ratio and the group with decreasing ratio. The weaning success rate，duration of mechanical ventilation，length of stay，and 28- day survival rate of the two groups were compared separately to evaluate the guiding value of changes in the ultrasound characteristics of the diaphragm and peripheral skeletal muscles on the clinical outcome of mechanically ventilated patients with sepsis. Results：A total of 110 patients were enrolled in the study，and the patients in the group with increased EDi/ERF ratio had a significantly lower weaning success rate（P=0.043），a significantly longer mechanical ventilation time（P=0.019），and a significantly lower 28-day survival rate（P=0.008）than those in the group with decreased EDi/ERF ratio. No statistically significant differences in weaning success rate，duration of mechanical ventilation，and 28-day survival rate were found between the group with increased Tdi/Q-MT ratio and decreased Tdi/Q-MT ratio（P>0.05）. The Cox proportional hazards model showed that enhanced EDi and increased EDi/ERF ratio were significant risk factors affecting the 28 - day cumulative weaning success rate（HR=0.306，P=0.045；HR=0.287，P=0.031，respectively）. Conclusion：The early presence of increased echogenicity of diaphragm and increased diaphragm to peripheral skeletal muscle echogenicity ratio are both associated with lower weaning success rate and poorer clinical prognosis in mechanically ventilated patients with sepsis.

Abstract:Objective：To investigate the impact of different numbers of readout points（N_read）on image quality in zero echo time（ZTE）imaging of the lumbar spine，and to determine the optimal N_read. Methods：Sixteen healthy volunteers were recruited and underwent coronal ZTE scans of the lumbar spine with three different N_read（128，144，and 160），to obtain three sets of images（N_read-128，N_read -144，and N_read -160）. The signal intensity of the cortical bone，muscle，and cancellous bone was measured in each set，and the standard deviation of subcutaneous fat was defined as noise to calculate the signal -to - noise ratio（SNR）and contrast -to - noise ratio（CNR）. Two observers subjectively evaluated the three sets of images using a 4-point scale across four aspects：cortical bone depiction，anatomical structure clarity，perceived image noise，and overall image quality. Inter-observer agreement was assessed using weighted Kappa statistics. Repeated - measures ANOVA was used to compare SNR and CNR，and the Friedman test was used to compare subjective image quality scores，with Bonferroni correction applied for post-hoc analyses. Results：For the SNR in all measured regions（cortical bone，muscle，and cancellous bone）and the CNR between tissues（cortical bone-muscle，cortical-cancellous bone），the results consistently showed N_read -160>N_read -144>N_read -128（P<0.001）. In terms of subjective evaluation，the scores for the N_read -160 set were significantly higher than those for the N_read-128 set（P<0.001），while the difference between the N_read-160 set and the N_read-144 set was not statistically significant（P>0.05）. Conclusion：In ZTE scanning of the lumbar spine，increasing N_read helps improve image quality.N_read -144 provides high SNR and CNR，and its subjective image quality scores are comparable to those of N_read -160. Considering both scanning time and image quality，144 is recommended as the optimal N_read for ZTE imaging of the lumbar spine.

Abstract:Objective：To construct and validate prediction models for all - cause mortality in maintenance hemodialysis（MHD）patients using diverse machine learning algorithms. Methods：Clinical data were collected from 694 patients across four hemodialysis centers in Jiangsu Province，including 591 MHD patients from three tertiary Grade A hospitals in Wuxi City（January 2017-December2023）and 103 patients from one secondary Grade A hospital in Yancheng City（January-December 2024）. The 591 cases were randomly divided into a training set（n=414）and a validation set（n=177）at a 7∶3 ratio for model development and internal validation，while the remaining 103 cases served as a test set for external validation. Predictors were selected via the least absolute selection and shrinkage operator（LASSO）method. Patients were randomly divided into training（n=414）and validation（n=177）sets. Ten machine learning algorithms were employed to develop risk prediction models. Receiver operating characteristic（ROC）curves were plotted to evaluate predictive performance. The calibration accuracy of model-predicted probabilities was assessed using calibration curves，while decision curve analysis（DCA）was employed to quantify the clinical net benefit across varying decision thresholds. External validation utilized the area under the curve（AUC）to assess the generalization capability of the optimal model. Shapley Additive exPlanations（SHAP）were applied to rank variable importance. Results：The all-cause mortality rate was 42.6%（252/591）. Among the 10 models，the support vector machine（SVM）exhibited optimal performance，the AUC was 0.928，the sensitivity was 89.47%，and the accuracy was 0.919，and the evaluation of calibration curve and DCA showed that the consistency and benefit of the model are still good，the Brier score of 0.089 indicates that the model demonstrates low predictive error and favorable calibration performance on the internal validation dataset，suggesting its reliability in probabilistic forecasting. External validation yielded an AUC of 0.835，indicating robust generalization capability of the model. The SHAP plot showed that the importance ranking of the influencing factors for all-cause mortality was living alone，tunneled cuffed catheter（TCC），prealbumin，albumin，Charlson comorbidity index（CCI）score，iPTH<300 pg/mL，age，junior high school education or lower，blood urea nitrogen -to - creatinine ratio，diabetic nephropathy，college degree or higher education and sex. Conclusion：The SVM-based prediction model demonstrates robust performance in forecastingall-cause mortality among MHD patients，facilitating early identification of high-risk individuals and supporting clinical decision-making.

Abstract:Objective：To investigate the diagnosis，treatment，and prognosis of cholecystoduodenal fistula complicated with gallstone ileus. Methods：This study retrospectively analyzed clinical data from 19 patients with cholecystoduodenal fistula and gallstone ileus treated at the First Affiliated Hospital of Nanjing Medical University from October 2019 to October 2024. Results：Among the 19 patients，9 were male and 10 were female，with a median age of 76 years. All patients presented with abdominal distension and pain，with a history of cholelithiasis spanning several years. After imaging confirmation，individualized surgical approaches—including enterolithotomy，single - or two - stage cholecystectomy，and fistula repair—were performed based on stone characteristics and patient status. Postoperatively，two cases developed incision infections，while all others recovered and were discharged without mortality. Conclusion：Cholecystoduodenal fistula with gallstone ileus is relatively rare，manifests with complex presentations，often involves multiple complications，and carries high perioperative risks. Personalized treatment strategies should be tailored to individual patient conditions.

Abstract:Objective：To investigate the pathological characteristics of patients with non - alcoholic fatty liver disease（NAFLD），their correlation with the magnetic resonance imaging estimated proton density fat fraction（MRI - PDFF）and liver function，and to explore the diagnostic value of MRI -PDFF in NAFLD. Methods：A total of 67 patients with NAFLD at the Department of Infectious Diseases，Affiliated Hospital of Nanjing University of Traditional Chinese Medicine were recruited from June 1，2021 to August 30，2023. Clinical characteristics were retrospectively analyzed based on different pathological fat content and non - alcoholic fatty liver disease activity score（NAS）. Correlations among pathological fat content，NAS，MRI - PDFF，body mass index（BMI），alanine aminotransferase（ALT），and aspartate aminotransferase（AST）were examined. A total of 33 individuals without hepatic steatosis confirmed by liver pathology were included as controls. The diagnostic value of MRI - PDFF for NAFLD was analyzed by receiver operating characteristic（ROC）curve. Results：Age，BMI，ALT，AST，MRI - PDFF，and NAS scores showed significant differences among different levels of pathological fat content. Similarly，BMI，ALT，AST，and MRI - PDFF differed significantly among differentNAS scores. Liver MRI-PDFF was significantly related to pathological fat content（r=0.775，P<0.001），and moderately related to NAS（r=0.478，P<0.001）and BMI（r=0.402，P=0.001）. Compared with the control group，the area under the curve（AUC）of MRI-PDFF for diagnosing NAFLD was 0.989，with a sensitivity of 0.94，specificity of 0.97，and an optimal cutoff value of 4.42%. Conclusion：MRI-PDFF is a quantitative measurement that can accurately reflect liver fat content，suitable for dynamic assessment and therapeutic monitoring of hepatic steatosis.

Abstract:During embryonic development，the eyes originate from the neural tube and share a common origin with the brain，resulting in highly similar anatomical structures and functional characteristics. In recent years，increasing evidence has revealed significant pathological correlations between ocular degenerative diseases and central nervous system neurodegenerative diseases.Typical ocular degenerative diseases，such as age-related macular degeneration，glaucoma，and diabetic retinopathy，are not only major causes of visual impairment and blindness but also share close mechanistic links with neurodegenerative diseases like Alzheimer’s disease and Parkinson’s disease. This review systematically summarizes the potential common pathological pathways between the brain and the eye in neurodegenerative diseases. It elaborates on the intrinsic connections between ocular and cerebral degeneration from the perspectives of toxic protein accumulation，myeloid cell dysfunction，abnormal activation of inflammatory responses，synaptic dysfunction，and impairment of lymphatic clearance systems. The aim is to provide new perspectives and research insights into the mechanisms，early intervention，and targeted treatment of neurodegenerative diseases affecting both the eye and the brain.

Abstract:Aerobic exercise and resistance exercise have their own focuses in improving muscle mass，cardiopulmonary function，neurocognition，and endocrine metabolism，etc. However，their effects are not uniform，but are significantly modulated by age. Based on a review of the characteristics of the effects of aerobic exercise and resistance exercise on the body，this paper focuses on exploring the age heterogeneity of the effects of exercise on the skeletal muscle system，cardiovascular system，nervous system and endocrine metabolism system in the elderly and young groups，systematically integrating the evidence of the interaction between exercise and age，and analyzing its potential mechanisms. Compared to younger individuals，aging leads to functional decline and metabolic alterations in the above mentioned systems. Consequently，older adults exhibit distinct characteristics in their physiological responses，adaptive capacity，and degree of benefit from exercise. Examples include attenuated post -exercise muscle protein synthesis，more pronounced cardiovascular and neuroprotective effects，and diminished recovery capacity. Therefore，when designing safe and effective exercise regimens for the elderly，it is essential to consider age - specific factors and judiciously select the exercise modality，intensity，and duration.

Abstract:Lysine-specific demethylase 6B（KDM6B）is an important epigenetic factor in the Jumonji C domain-containing protein family（JmjC）. It not only plays an epigenetic role in cell differentiation，inflammatory response，tissue homeostasis，and neurological diseases，but also plays an important role in macrophage function and immune response. KDM6B is the sole member of the JmjC family that can respond to Toll-like receptor（TLR）signals. It is activated under the stimulation of TLR signals and thereby fulfills its function. Studies have found that KDM6B can affect macrophages by regulating the polarization of macrophages，affecting the expression of cytokines and participating in the regulation of tumor microenvironment. Therefore，KDM6B plays an important role in the physiological and pathological processes such as immune response，inflammatory response，and tumor. As a key epigenetic factor，KDM6B regulates the functions of macrophages，including the polarization，inflammatory response，and pro-fibrotic activities of macrophages，and is expected to become a potential target for the study of immune，inflammatory，and tumor-related diseases.

Abstract:Lung transplantation（LTx）is an effective treatment for end-stage lung disease，significantly prolonging patient survival and improving quality of life. However，bronchiolitis obliterans syndrome（BOS），which represents a frequent manifestation of chronic rejection following LTx，significantly compromises long - term patient survival. Consequently，early diagnosis and comprehensive treatment are crucial for improving prognosis，while exploration of individualized therapeutic strategies is needed to optimize clinical management. This review comprehensively examines the clinical manifestations，diagnostic approaches，pathogenesis，risk factors，therapeutic strategies，and prognostic characteristics of BOS，aiming to provide evidence-based guidance for clinical management and future research directions.

Abstract: