Objective To compare the distribution and expression differences of glycogen synthase kinase-3?(GSK3?) among normal adult,aged and amyloid beta(A?)-induced neurodegenerative rat brains,so as to explore its functional role in neurodegeneration. Methods Aggregated A? was microinjected into normal adult rat hippocampus under a stereotaxic system. The rats over 12 months were defined as aged rats. The distribution and localization of GSK3? were examined using immunohistochemistry. Western blotting was performed to assess expression change in cortex and hippocampus quantitatively. Results The GSK3? positive cells were distributed extensively around the whole brain and almost with neuron-like morphology. In normal adult rats,the strong anti-GSK3? immunoreactivity located in the neocortex pyramidal layer,hippocampus pyramidal layer,dentate gyrus,thalamus,substantia nigra,etc. The amount of GSK3? positive cells was much more in the aged and A?-injected group than in normal ones. The immunoreactive signals usually extend to the distal area of neurite in the A?-injected ones. Western blot showed that the expression intensity of GSK3? was stronger in the aged and neurodegenerative rat brain than in the normal adult rat brain. Conclusion The expression of GSK3? increases apparently in the neurons of aged and A?-injected brain. It may play a role in the neurodegenerative process.

Objective To investigate the effect of lithium chloride(LiCl),an inhibitor of glycogen synthase kinase-3beta(GSK-3beta),on proliferation and differentiation of neural stem cells(NSCs).Methods The NSCs were isolated from cortex of rat fetus and expanded in culturing system.Their morphological changes and attachment process were observed under microscope.The cell cycle dynamics of NSCs was examined with flow cytometry.And the expression of GSK-3β and β-catenin was examined quantitatively with Western blot.Results The culturing NSCs treated with LiCl were usually floated and much dispersed in the media.Many of the neurospheres became small and the time of attachment after serum induction became longer.Using flow cytometry,it was detected that the proportion of G1 phase NSCs declined gradually accompanying the increased concentration of LiCl,while the percentage of S and G2/M phase cells showed an increasing trend.Western blotting results revealed β-catenin expression increased whereas Gsk-3βdecreased gradually under the treatment of LiCl and also showed a dose dependent manner.Conclusion These results suggest that LiCl may promote the proliferation of NSCs and prevent them from differentiating,which may partly involve the activation of wnt/β-catenin signaling pathway.

Abstract The aging process is increasingly accelerating in China, and the improvement of health literacy is a prerequisite to achieving health for all, and is an important strategy to promote healthy aging. Based on recent studies pertaining to health literacy among the elderly, this review, from the perspective of aging, summarizes the level and common influencing factors of health literacy among Chinese elderly populations, and discusses the health literacy promotion strategies among the elderly, so as to provide insights into improving the health literacy surveillance and promotion quality and health literacy levels among the elderly.

Objective: To investigate the changing trends in the prevalence of health literacy among rural residents in Zhejiang Province from 2016 to 2021, so as to provide the evidence for formulating the health promotion strategy in rural areas. Methods: Rural residents' health literacy surveillance data were retrieved in Zhejiang Province from 2016 to 2021. The prevalence of health literacy was evaluated among rural residents according to the criteria defined by Chinese Center for Health Education, and standardized by Zhejiang Provincial population data captured from the national population census in China. The 6-year cumulative increase from 2016 to 2021 was estimated to investigate the changing trends in the prevalence of health literacy. Results: Totally 55 568 rural residents were monitored in Zhejiang Province from 2016 to 2021, including 26 893 men (48.40%) and 28 675 women (51.60%) and 32 156 residents at ages of 45 to 65 years (57.87%). The prevalence of health literacy was 18.00%, 21.52%, 25.53%, 27.54%, 30.85%, and 34.32% among rural residents in Zhejiang Province from 2016 to 2021, appearing a tendency towards a rise (χ2trend=661.376, P<0.001), and a 16.32% 6-year cumulative increase was seen. The prevalence of basic knowledge and concept, healthy lifestyle and behaviors and basic skills all appeared a tendency towards a rise (P<0.05), with 6-year cumulative increase rates of 24.48%, 11.08% and 8.11%, respectively. Among six categories of health issues, the prevalence of chronic disease prevention, scientific health outlook and health information literacy showed a tendency towards a rise year by year (P<0.05), with 6-year cumulative increase rates of 29.73%, 21.07% and 15.98%, respectively, and the prevalence of basic medical care, safety and first aid, and infectious disease prevention literacy appeared a fluctuation (P<0.05), with 6-year cumulative increase rates of 12.85%, 6.36% and -0.47%, respectively. The prevalence of health literacy appeared an overall tendency towards a rise in rural residents with different genders, age groups, educational levels and occupations (P<0.05), with a minor 6-year cumulative increase in residents at ages of 55 years and older and farmers, while a tendency towards a decline was seen among illiterate rural residents, with a 6-year cumulative rise of -3.16%. Conclusions The prevalence of health literacy appeared a tendency towards a rise among rural residents in Zhejiang Province from 2016 to 2021; however, the rate of increase reduced year by year. Health education and promotion should be enhanced targeting the elderly, individuals with low educational levels and farmers.

Objective: To investigate the prevalence of cigarette and electronic cigarette ( e-cigarette ) use among adults in Zhejiang Province, so as to provide insights into tobacco control. Methods : Thirty study sites were randomly sampled from Zhejiang Province in 2020 using a multi-stage stratified random sampling method, and permanent residents at ages of 15 to 69 years were selected as study subjects. A questionnaire was designed based on the questionnaire for the China Adult Tobacco Survey to collect subjects' demographic characteristics, cigarette and e-cigarette use, smoking cessation and exposure to secondhand smoke ( SHS ). The weighted prevalence of smoking, current smoking, current e-cigarette smoking, smoking cessation and exposure to SHS was estimated based on the Seventh National Population Census in 2020. Results : A total of 19 200 questionnaires were recovered, and 19 180 were valid, with an effective recovery rate of 99.90%. The respondents had a mean age of ( 50.30±12.90 ) years, with a male to female ratio of 1∶1.06 and an urban/rural population ratio of 1∶1.31. Among all the respondents, there were 6 033 smokers ( 31.45% ), 4 163 current smokers ( 21.70% ), 201 current e-cigarette users ( 1.05% ), 146 cigarette and e-cigarette dual users ( 0.76% ), 1 870 respondents quitting smoking ( 31.00% of smokers ) and 7 189 respondents with exposure to SHS ( 47.87% of non-smokers ). The weighted prevalence of smoking, current e-cigarette use, cigarette and e-cigarette dual uses, smoking cessation and exposure to SHS was 20.49%, 1.34%, 0.94%, 29.56% and 49.53% in Zhejiang Province, respectively, and the prevalence of current smoking, current e-cigarette use, cigarette and e-cigarette dual uses and exposure to SHS was 40.39%, 2.39%, 1.86% and 55.31% among males and 0.35%, 0.28%, <0.01% and 46.02% among females, respectively. The highest prevalence of current smoking was seen among respondents at ages of 55 to 64 years ( 24.24% ), while the highest prevalence of current e-cigarette use and cigarette and e-cigarette dual uses was seen in adults at ages of 25 to 34 years ( 2.18% and 1.58% ). Conclusions The prevalence of current e-cigarette use was higher among adults in Zhejiang Province in 2020 than the nationwide level in China. The prevalence of cigarette use was lower among adults in Zhejiang Province in 2020 than the nationwide level in China; however, improving the management of tobacco control in public places and the capacity building of smoking cessation services is still required to reduce the use of cigarettes and e-cigarettes.

Objective : To investigate the establishment of smoke-free environments in medical and healthcare institutions in Zhejiang Province, so as to provide the evidence for improving the implementation of the tobacco control policy in medical and healthcare institutions. Methods: Health administrative sectors and public health institutions at provincial, city and county levels, secondary and tertiary medical institutions, and community health service/township health centers in Zhejiang Province were enrolled. The status of institutional establishment of smoke-free environments was investigated through concealed photography and consulting medical service guides by the assigned the third-party professional investigation company in 2021. The layout of smoke-free environments and indoor smoking were assessed according to the Criteria for Scoring Smoking-free Medical and Healthcare Institutions. Results: Totally 547 medical and healthcare institutions were enrolled in this undercover investigation, including 102 health administrative sectors, 209 public health institutions, 146 secondary and tertiary medical institutions, and 90 community health service/township health centers. The gross mean scores of establishment of smoke-free environments were 83.41±12.19 among all medical and healthcare institutions, 82.02±10.73, 85.56±9.70 and 83.18±12.59 among province-, city- and county-level medical and healthcare institutions, respectively, and the gross mean scores of establishment of smoke-free environments were 82.60±12.27, 85.79±10.74, 80.89±13.85, 82.27±11.62 scores among health administrative sectors, public health institutions, secondary and tertiary medical institutions and community health service/township health centers, respectively. There were 315 institutions with no smoking signs at entrances (57.59%), 255 institutions posting no smoking signs ( 46.62% ), 245 institutions assigning two and more types of health education materials for tobacco control ( 44.79% ), 110 institutions with outdoor smoking areas ( 51.16% ), 66 secondary and tertiary medical institutions with smoking cessation clinics ( 45.20% ) and 354 institutions with carpet smoking bans in indoor places ( 64.72% ). Conclusions The overall establishment of smoke-free environments is satisfactory among medical and healthcare institutions in Zhejiang Province. Nevertheless, improving the coverage of no smoking signs and health education of tobacco control, promoting the standardized construction of smoking cessation clinics and establishing a long-action tobacco control mechanism are still needed.

The clinical data of 96 patients with type 2 diabetes mellitus (T2DM) treated in Department of endocrinology of our hospital from January 2016 to December 2017 were retrospectively analyzed. All patients had been treated with metformin ≥1 000 mg combined with sulfonylureas for>12 weeks and their glycosylated hemoglobin (HbA1c) was>7.5%. On the basis of the original scheme, 57 patients received oral sitagliptin (100 mg q.d, sitagliptin group) and 39 patients received insulin glargine injection (insulin group) for 26 weeks. The blood lipid, liver and kidney function were examined before and after treatment. The abdominal visceral fat area (VFA) was measured by CT scan. Results showed that the fasting plasma glucose (FPG) , 2-hour postprandial blood glucose (2 hPG) and HbA1c were significantly lower than baseline levels in both groups(P<0.05). The decrease of VFA in sitagliptin and insulin groups was by 9.6 (1.4,19.6)cm² and by 8.3(-2.2,26.8) cm², respectively; there was significant difference in variation of VFA before and after treatment between the two groups (P<0.05). There was no significant difference in blood pressure, liver function (ALT, AST) and estimated glomerular filtration rate (eGFR) before and after treatment in the sitagliptin group (P>0.05). Additional sitagliptin administration can effectively and safely reduce HbA1c and decrease the abdominal visceral fat content in T2DM patients who failed to metformin and sulfonylureas combined therapy.

Objective:To describe the prevalence of tobacco use among college students in Zhejiang Province and analyze the influencing factors of second-hand smoke exposure on campus.Methods:In 2021, college students were selected from 9 colleges through stratified multi-stage cluster sampling from Zhejiang Province and surveyed using questionnaire. A total of 6 530 questionnaires were distributed and 6 035 were returned, with 6 030 valid questionnaires (96.48%). A descriptive analysis of the demography characteristics, cigarettes and electronic cigarettes (e-cigarettes) use, and second-hand smoke exposure of the subjects was carried out, and chi-square test was used for statistical analysis and multivariate logistic regression analysis was used to analyze influencing factors of second-hand smoke exposure on campus.Results:The current smoking rate and current use rate of e-cigarettes among college students were 3.70% and 1.56%, respectively, and the dual use rate of cigarettes and e-cigarettes was 1.16%. The exposure rate of second-hand smoke among college students on campus was 25.06%, while the exposure rate of second-hand smoke in off campus places was 32.35%. The awareness rates of smoking related diseases among college students were as follows: lung cancer (92.02%), heart disease (73.15%), stroke (72.87%), and impotence (64.08%). The awareness rate of second-hand smoke related diseases were as follows: lung cancer in adults (91.11%), heart disease in adults (78.91%), and lung disease in children (89.35%). The multivariate logistic regression analysis showed that seven factors (including gender, school type, major, grade, smoking ban regulations, smoking scenes, and knowledge about the health hazards of second-hand smoke) had a statistically significant impact on college students′ exposure to second-hand smoke at school [ OR=2.63, 0.67, 0.69, (0.39, 0.60, 0.68), 0.51, 1.74, 0.72] (all P<0.01). Conclusions:The use of cigarettes and e-cigarettes among college students in Zhejiang Province is not optimistic, especially the use rate of e-cigarettes is higher than adult. The status of second-hand smoke exposure among college students remains serious, with male students, non-medical students, students of special programs, and senior college students having more severe second-hand smoke exposure on campus, and students with high awareness of second-hand smoke exposure, less exposure to smoking scenes from media, from college with comprehensive smoke-free regulations are less exposed to second-hand smoke on campus.

Objective:To investigate the level of health literacy and its influencing factors among residents aged 15-69 years with different chronic disease in Zhejiang Province.Methods:In this cross-sectional study, a stratified multistage whole cluster random sampling method was used to select 19 200 permanent residents aged 15-69 years from 30 monitoring sites in Zhejiang Province from June to November 2022, and a household questionnaire survey was carried out with the National Health Literacy Monitoring Questionnaire for the Population. The content of the survey included socio-demographic characteristics, health-related factors and health literacy level. A total of 19 200 questionnaires were distributed and 19 051 were collected, of which 18 857 (98.98%) were valid. The χ2 test was used to compare the health literacy levels of residents with different chronic diseases, and logistic regression was used to analyze the influencing factors of the health literacy levels. Results:The health literacy level of residents aged 15-69 in Zhejiang Province in 2022 was 38.36%. Among them, the health literacy level of patients with multiple chronic diseases was much lower than those with single chronic disease and those without chronic disease (14.70% vs 25.37%, 42.21%) ( χ2=483.05, P<0.001). It was positively associated between having multiple chronic diseases and insufficient health literacy ( OR=1.26, 95% CI: 1.01-1.58); compared with those without chronic disease ( OR=1.00), patients with multiple chronic diseases were significantly more likely to have inadequate health literacy in basic knowledge and concepts ( OR=1.29, 95% CI: 1.03-1.63), health behaviors ( OR=1.24, 95% CI: 1.01-1.53), basic skills ( OR=1.37, 95% CI: 1.11-1.69), and health information literacy ( OR=1.27, 95% CI: 1.08-1.50). Conclusions:The number of chronic diseases is a key factor that affects the residents′ health literacy level, and people with multiple chronic diseases are often associated with a higher risk of inadequate health literacy.

Objective To study the effect of hydrogen sulfide on the production of soluble fms-like tyrosine kinase 1 (sFlt-1) through a distintegrin and metalloproteinase 17 (ADAM17) in adipocytes. Methods 3T3-L1 cells were cultured and induced to differentiate into adipocytes, then treated with different doses of sodium hydrogen sulfide (NaHS), L-cysteine or transfected with cystathionine-γ-lyase ( CSE) siRNA, ADAM17 siRNA or treated with ADAM17 inhibitor, monoclonal antibody. 24 hours after treatment, the expression of ADAM17, CSE, and the production of sFlt-1 were determined. Results After the treatment of 10, 25, 50 nmol/L NaHS or 0. 5, 1. 0, 2. 0 μmol/L L-cysteine, the expression of ADAM17 and the production of sFlt-1 in adipocytes were significantly decreased, the higher dose of L-cysteine and sFlt-1, the lower expression of ADAM17 and the production of sFlt-1; the effect of 2.0 μmol/L L-cysteine decreasing the expression of ADAM17 and the production of sFlt-1 were reversed by transfection of CSE siRNA; after the transfection of ADAM17 siRNA and treatment of ADAM17 inhibitor or monoclonal antibody, the production of sFlt-1 in adipocytes were significantly decreased. Conclusion Hydrogen sulfide can reduce the production of sFlt-1 in adipocytes by downregulating the expression of ADAM17.