Objective To promote professional training aid on healthcare talents in western China,this paper aims to explore methods and to evaluate the effectiveness of a new training system for underprivileged medical professionals from hospitals of western China.Methods Questionnaires and interviews were conducted to 115 trainees and their employers took part in the Counterpart Support Project.A retrospective analysis was done to evaluate key indicators of the trainees' professional competence.Results More than 90％ of the trainees have seen great improvement on basic healthcare knowledge,clinical skills,and diagnosis and treatment practice.About 80％ the participating hospitals have enjoyed varied degrees of growth in outpatient visits,surgical volume,number of inpatient and operational efficiency.(Increase level from 0％ to 50％) Conclusions Within the frist 3 years of implementation,this new model has been proven effective to enhance participants' overall professional competence,and by tapping into the significant resource of first class hospitals,this model will help greatly promoting the development of healthcare talents in Western China.

Objective To evaluate the efficacy of WeChat platform conbined with problem-based learning (PBL) teaching method when applied to the standardized training for residents in a department of anesthesiology.Methods Ninety-six residents who were undergoing the standardized training in the Department of Anesthesiology of our hospital were divided into 3 groups (n =32 each) using a random number table:lecture-based learning teaching method group,PBL teaching method group and WeChat platform plus PBL teaching method group.The examination scores after the end of teaching,satisfaction with teaching and scores of interest in anesthesiology were recorded.Results The total scores of examination,scores of comprehension memory problems,clinical application problems and comprehensive analysis problems,rate of satisfactory teaching and scores of interest in anesthesiology were significantly higher in WeChat platform plus PBL teaching method group than in the other two groups (P＜0.05).Conclusion WeChat platform combined with PBL teaching method can improve the teaching quality of the standardized training for residents in a department of anesthesiology and win praise from residents,and it is worth promoting the application.

Acute pancreatitis (AP) is an inflammatory disease of the pancreas. Its pathogenesis is not only related to abnormal activation of trypsinogen, but also related to calcium overload, mitochondrial dysfunction, impaired autophagy and endoplasmic reticulum stress. However, the mechanism has not been fully elucidated and needs to be further studied. Currently, there is no effective treatment for AP. It is difficult to prevent the loss of pancreatic function. An in-depth understanding of the pathophysiological mechanisms of AP may help to identify the potential therapeutic targets. Therefore, the purpose of this study is to review recent advances in the mechanism of AP in order to provide more research direction for treatment.

Malignant tumors usually have no obvious clinical symptoms in the early stage. Most patients are already in the advanced stage when they are diagnosed. Some patients have lost the opportunity for operation, resulting in poor prognosis. Therefore, how to find the best therapeutic target for such patients and improve the prognosis of patients has gradually become the focus of scholar′s attention. Recently, Kruppel-like factor (KLF) is a transcriptional regulator that can bind to the target DNA, and its family plays an important role in the occurrence and development of malignant tumors. It has also been confirmed that the KLF family affects the proliferation, differentiation and migration of tumor cells, but the specific mechanism is still not fully elucidate. Consequently, in order to further explored the effect of the KLF family on tumors, this study intends to briefly review the roles and regulatory mechanisms of the KLF family in the cell proliferation, differentiation and migration of malignant tumors, hoping to provide new target for the biological treatment of tumors.

Objective: To explore the relationship between sedentary behavior with cardiorespiratory fitness and executive function in adolescents, and to provide some references for sedentary behavior prevention and executive function improvement. Methods: From September to December 2022, a total of 5 018 adolescents aged 13 to 18 years were selected by stratified random sampling method in Shanghai, Suzhou, Taiyuan,Wuyuan, Xingyi, and Urumqi to conduct physical activity survey, as well as cardiorespiratory fitness and executive function assessment. Pearson s correlation was used to analyze the relationship between sedentary behavior, cardiorespiratory fitness and executive function. The mediation effect model was fitted by the bootstrap mediation procedure in the PROCESS (version 3.3 ) SPSS macro compiled by Haves, and the mediation effect of adolescents cardiorespiratory fitness in the relationship between static behavior and executive function was examined using model 4 in the PROCESS SPSS macro, where Boosrap method was used to compute the mediation effect of adolescents cardiorespiratory fitness. where the Boosrap method was used to calculate confidence intervals for the mediating effects. Results: Adolescents daily sedentary time was positively correlated with both the refreshing function (1-back and 2-back) and the switch function reaction time ( r =0.05, 0.07, 0.05, P <0.01). Adolescent VO 2max was negatively correlated with both the refreshing function (1-back,2-back) and the switching function ( r =-0.09, -0.14 , -0.11, P <0.01). Adolescents daily sedentary time was negatively correlated with VO 2max ( r =-0.04, P <0.01); cardiorespiratory fitness mediated effect values between sedentary behavior and refreshing function (1-back and 2-back) and converted function were 0.20(95% CI =0.06-0.36), 0.43(95% CI =0.14-0.74) and 0.13 (95% CI =0.04-0.22), with mediating effect shares of 6.87%, 8.33% and 8.59%, respectively. Conclusion The duration of sedentary behavior in adolescents is related to executive function performance, and cardiorespiratory fitness may serve as a mediator to mediate the association between sedentary behavior and executive function in adolescents.

The trends of age-associated change regarding lower facial fat compartments were different. The lower facial rejuvenation should be comprehensively evaluated according to the specific changes of the fat compartments, and master the anatomy of the lower blood vessels and nerves to improve the safety of clinical application. In recent years, the application of imaging methods in the study of facial fat compartments has helped to better understand the changes related to the aging of the lower part and provide new ideas for the effectiveness and safety of the volume recovery of the lower part. This article reviews the aging changes and applied anatomy of the fat compartments in the process of aging of the lower part, which helps surgeons to understand the related changes of aging of the lower part more deeply, and provides new theoretical basis and clinical enlightenment for the rejuvenationof the lower part based on the theory of fat rebalance.

The trends of age-associated change regarding lower facial fat compartments were different. The lower facial rejuvenation should be comprehensively evaluated according to the specific changes of the fat compartments, and master the anatomy of the lower blood vessels and nerves to improve the safety of clinical application. In recent years, the application of imaging methods in the study of facial fat compartments has helped to better understand the changes related to the aging of the lower part and provide new ideas for the effectiveness and safety of the volume recovery of the lower part. This article reviews the aging changes and applied anatomy of the fat compartments in the process of aging of the lower part, which helps surgeons to understand the related changes of aging of the lower part more deeply, and provides new theoretical basis and clinical enlightenment for the rejuvenationof the lower part based on the theory of fat rebalance.

Objective To investigate the correlations among homocysteine(Hcy)level,serum cystatin C (Cys-c)and diabetic peripheral neuropathy(DPN).Methods Two hundred and three diagnosed cases of type 2 diabetes were enrolled,including 123 DPN patients(DPN+)and 80 non-DPN(DPN-)patients.Levels of serum Hcy,Cys-c,high-sensitivity C-reactive protein(hs-CRP)and fiber fibrinogen(Fg)were detected.The above indi-cators and the baseline data such as sex,age,duration,BMI,WHR,HOMA-IR(CP),HOMA-islet(CP)were statistically analyzed. Results Hcy,Cys-c,and the duration of the DPN+ group were significantly higher than those in the DPN-group(P<0.05,respectively).HOMA-islet(CP)in the DPN-group was markedly higher than that in the DPN+group(P<0.01).The prevalence of DPN in the high level of Hcy group was much higher than that in the low and the normal level of Hcy group.Hcy was still significantly correlated with the Cys-c after taking the controlled procedure such as duration and fibrinogen. Conclusion High levels of Hcy and Cys-c are the criti-cal risk factors of DPN,collaborative determination of Hcy and Cys-c level might be of quitevaluable in early diag-nosis of DPN.

Objective:To analyze the effects of infectious complications [infected pancreatic necrosis (IPN) and extra-pancreatic infection (EPI)] on the outcomes of patients with severe acute pancreatitis (SAP), and evaluate the differences in infection time, infection site and infecting species between SAP patients with infections complications.Methods:The clinical data of 66 SAP patients with combined infectious complications admitted to Xuanwu Hospital, Capital Medical University from January 2014 to December 2020 were retrospectively analyzed, and SAP patients were divided into IPN group ( n=7), EPI group ( n=14) and co-infection (EPI+ IPN) group ( n=45) according to the type of infection. Whether the study data conformed to a normal distribution was assessed by the Shapiro-Wilk test, normally distributed measures were expressed as mean ± standard deviation ( ± s), and ANOVA was used for comparison between groups; skewed measures were expressed as median (interquartile range) [ M ( Q1, Q3)], and the rank-sum test was used for comparison between groups. Bonferroni correction was used for multiple group comparisons ( P value significance level reduced to 0.017). Quantitative data were compared between groups using the χ2 test or Fisher's exact probability method. Results:There were no statistical differences between the three groups in terms of baseline data at admission (gender, age, etiology, modified CTSI score, degree of pancreatic necrosis, and number of organ failure) ( P>0.05), patients in the EPI group were referred earlier than the other two groups ( P<0.05). In clinical treatment, patients in the IPN group and co-infection group required multiple minimally invasive interventions compared with those in the EPI group ( P<0.05), and the number of patients requiring combined nutritional support, length of intensive care unit stay, and total length of hospital stay were higher in the co-infection group than in the other two groups ( P<0.05). In addition, 360 strains of pathogenic bacteria were cultured in this study, with Gram-negative bacteria being the most common, and patients with SAP were more likely to have EPI in the early stage of disease onset, with bacteremia and respiratory tract infections in the early stage (≤14 d), and bacteremia, urinary tract infections, and catheter-associated infections in the late stage (>14 d). Conclusions:Among patients with SAP, patients in the co-infection group had higher surgical intervention, nutritional support and length of hospital stay than those in the single infection group. It is advisable to prioritize EPI in SAP patients with suspected infections, and the common infectious strains in SAP patients are still predominantly Gram-negative bacteria, and clinicians need to adjust the treatment plan in a timely manner according to the changes in patients′ conditions.

Background Lipid metabolism imbalance is tightly linked to the development and progression of multiple diseases. The phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/AKT/mTOR) signaling pathway is important for the regulation of lipid metabolism. However, whether silicosis is associated with lipid metabolic abnormalities has yet to be explored. Objective To observe the changes of lipid deposition, cholesterol, and phosphorylated proteins of PI3K/AKT/mTOR pathway in silicon dioxide (SiO₂)-induced MLE-12 cells and to explore potential mechanism of lipid composition regulated though the pathway. Methods (1) MLE-12 cells were stimulated with 50 mg·L⁻¹ SiO₂ suspension, and divided into fourgroups: a control group and three SiO₂ groups (12, 24, and 48 h of stimulation). (2) Cellproliferation was detected to determine an optimal dose of LY294002, an inhibitor of PI3K protein. LY294002 at 5 μmol·L⁻¹ was used for further study, in which MLE-12 cells cultured for 48 h were divided into four groups: a control group; a 50 mg·L⁻¹ SiO₂ suspension stimulation group; a 50 mg·L⁻¹ SiO₂ suspension and 5 μmol·L⁻¹ LY294002 treatment group; a 5 μmol·L⁻¹ LY294002 treatment group. Total cholesterol (TC), free cholesterol (FC), cholesterol ester (CE; total cholesterol minus free cholesterol), and triglycerides (TG) were measured with enzyme assay kits. Lipid deposition was observed using Oil Red O staining. The expressions of p-PI3K, p-AKT, and p-mTOR proteins were detected by Western blotting. Results (1) The contents of TC, FC, and CE in the 50 mg·L⁻¹ SiO₂-induced MLE-12 cells were increased compared to those of the control group in a time-dependent manner by trend analysis, and the increment at 24 and 48 h were significant. By 48 h, the contents of cholesterol indicators were all elevated: TC from (2.242±0.181) mg·g⁻¹ to (5.148±0.544) mg·g⁻¹, FC from (1.923±0.158) mg·g⁻¹ to (4.168±0.433) mg·g⁻¹, and CE from (0.318±0.067) mg·g⁻¹ to (0.978±0.134) mg·g⁻¹, compared with the control group (P<0.01). The changes of TG were not significant (P>0.05). The SiO₂ suspension induced orange-red particle deposition in the MLE-12 cells, especially at 48 h (P<0.01). The protein expression levels of p-PI3K, p-AKT, and p-mTOR in SiO₂-stimulated MLE-12 cells were higher than those of the control groups with the prolongation of stimulation time, which peaked at 48 h (P<0.01). (2) The contents of TC, FC, and CE in MLE-12 cells of the SiO₂ + LY294002 group were decreased, comparing to those of the SiO₂ stimulation only group (P<0.01), companied with less orange-red lipid deposition, and suppressed protein expression levels of p-PI3K, p-AKT, and p-mTOR (P<0.01). Conclusion SiO₂ could induce increases of cholesterol and lipid deposition through activation of PI3K/AKT/mTOR signaling pathway in MLE-12 cells.