Objective: To analyze the prevalence trends and associated factors of overweight and obesity among children and adolescents in Macao from 2005 to 2020, so as to provide evidence for developing health promotion strategies. Methods: Data were obtained from the Macao Citizen Physical Fitness Monitoring Database for the years 2005, 2010, 2015, and 2020 for participants aged 6-22 years. The χ 2 test was employed to analyze trends in detection rates, while univariate and multivariate Logistic regression analyses were conducted to identify influencing factors. Results: The overweight rate among Macaos children and adolescents increased from 10.4% in 2005 to 14.8% in 2020. The obesity rate rose from 6.8% to 12.1%, with the total detection rate increasing from 17.2% to 26.9%, and the differences were statistically significant ( χ 2 trend =46.7, 87.5, 145.9, P <0.01). Notably, the overweight/obesity rate among boys showed rapid growth ( χ 2 trend = 118.6, P <0.01), while girls exhibited a declining inflection point in 2020. Multivariate Logistic regression analysis revealed that children and adolescents with the following characteristics faced higher risks of overweight/obesity: a physical education performance score of 3 points (overweight: OR=2.34, 95%CI =1.10-4.96; obesity: OR=2.39, 95%CI =1.19-4.81), paternal obesity (overweight: OR=2.07, 95%CI =1.38-3.11; obesity: OR=1.51, 95%CI = 1.01-2.27), and maternal obesity (overweight: OR=1.69, 95%CI =1.08-2.63; obesity: OR=1.77, 95%CI =1.16- 2.71 ) ( P <0.05). Conversely, lower risks were observed in those who performed appropriate warm-up activities before exercise (obesity: OR=0.37, 95%CI =0.15-0.95), participated in two academic/non-sports extracurricular classes (obesity: OR=0.46, 95%CI =0.24-0.88), and reported moderate physical exertion during extracurricular exercise (obesity: OR=0.60, 95%CI =0.36-0.98) ( P <0.05) . Conclusions Overweight and obesity among Macao s children and adolescents remain severe, particularly among boys, while girls show early signs of improvement. It is recommended to establish a multi-sectoral collaborative prevention and control system to reduce childhood and adolescent obesity.

Objective:To investigate the protective effect of Akebia saponin D(ASD)on non-alcoholic fatty liver disease(NAFLD)in rats by regulating IL-6/STAT3 axis.Methods:Fifty SD rats were separated into control group,model group,low dose ASD group(ASD 20 mg/kg),high dose ASD group(ASD 40 mg/kg)and inhibitor group(ASD 40 mg/kg+IL-6/STAT3 signal pathway inhibitor LMT-28 3 mg/kg),with 10 rats in each group.Rats in control group were fed with standard diet,while the other four groups were fed with high fat and high sugar diet.All rats were fed for 6 consecutive weeks,and the corresponding dose of drugs was injected intraperitoneally from the 7th week,which were given drugs for 8 consecutive weeks.All rats were weighed to calculate liver index;levels of serum total cholesterol(TC),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and triglyceride(TG)were mea-sured by automatic biochemical analyzer;HE staining was used to observe pathological changes of rats liver;oil red staining was used to observe lipid accumulation in rats liver;expressions of IL-6,JAK1,STAT3 in rats liver were detected by qRT-PCR;Western blot was used to detect expressions of IL-6,JAK1,p-JAK1,STAT3 and p-STAT3 proteins.Results:Compared with control group,hepatocytes in liver tissue of model group were swollen,accompanied by many ballooning changes,severe cytoplasmic vacuolization,the structure of hepatic lobule was unclear,and accompanied by inflammatory cell infiltration,and obvious red granular lipid droplets occupied most of the cytoplasm,body mass,liver index,levels of serum TC,ALT,AST,TG,expressions of IL-6,JAK1,STAT3 mRNAs,and IL-6,p-JAK1/JAK1,p-STAT3/STAT3 proteins in liver tissue of rats were obviously increased(P<0.05);compared with model group,damage of hepatic lobule structure in low and high doses ASD groups were reduced,swelling and vacuolization of liver cells were reduced,and accumulation of lipid droplets in liver tissue was obviously reduced.Body mass,liver index,levels of serum TC,ALT,AST and TG in rats were obviously decreased(P<0.05),while expressions of IL-6,JAK1,STAT3 mRNAs and IL-6,p-JAK1/JAK1,p-STAT3/STAT3 proteins in liver tissue were further increased(P<0.05);LMT-28,an inhibitor of IL-6/STAT3 signaling pathway,attenuated the liver protective effect of ASD on NAFLD rats.Conclusion:ASD can protect liver of NAFLD rats by activating IL-6/STAT3 signaling pathway.

Objective:To investigate the protective effect of Akebia saponin D(ASD)on non-alcoholic fatty liver disease(NAFLD)in rats by regulating IL-6/STAT3 axis.Methods:Fifty SD rats were separated into control group,model group,low dose ASD group(ASD 20 mg/kg),high dose ASD group(ASD 40 mg/kg)and inhibitor group(ASD 40 mg/kg+IL-6/STAT3 signal pathway inhibitor LMT-28 3 mg/kg),with 10 rats in each group.Rats in control group were fed with standard diet,while the other four groups were fed with high fat and high sugar diet.All rats were fed for 6 consecutive weeks,and the corresponding dose of drugs was injected intraperitoneally from the 7th week,which were given drugs for 8 consecutive weeks.All rats were weighed to calculate liver index;levels of serum total cholesterol(TC),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and triglyceride(TG)were mea-sured by automatic biochemical analyzer;HE staining was used to observe pathological changes of rats liver;oil red staining was used to observe lipid accumulation in rats liver;expressions of IL-6,JAK1,STAT3 in rats liver were detected by qRT-PCR;Western blot was used to detect expressions of IL-6,JAK1,p-JAK1,STAT3 and p-STAT3 proteins.Results:Compared with control group,hepatocytes in liver tissue of model group were swollen,accompanied by many ballooning changes,severe cytoplasmic vacuolization,the structure of hepatic lobule was unclear,and accompanied by inflammatory cell infiltration,and obvious red granular lipid droplets occupied most of the cytoplasm,body mass,liver index,levels of serum TC,ALT,AST,TG,expressions of IL-6,JAK1,STAT3 mRNAs,and IL-6,p-JAK1/JAK1,p-STAT3/STAT3 proteins in liver tissue of rats were obviously increased(P<0.05);compared with model group,damage of hepatic lobule structure in low and high doses ASD groups were reduced,swelling and vacuolization of liver cells were reduced,and accumulation of lipid droplets in liver tissue was obviously reduced.Body mass,liver index,levels of serum TC,ALT,AST and TG in rats were obviously decreased(P<0.05),while expressions of IL-6,JAK1,STAT3 mRNAs and IL-6,p-JAK1/JAK1,p-STAT3/STAT3 proteins in liver tissue were further increased(P<0.05);LMT-28,an inhibitor of IL-6/STAT3 signaling pathway,attenuated the liver protective effect of ASD on NAFLD rats.Conclusion:ASD can protect liver of NAFLD rats by activating IL-6/STAT3 signaling pathway.

Objective:To explore the predictive value of serum sorting protein (Sortilin) combined with extracellular matrix metalloproteinase inducible factor (EMMPRIN) for in stent restenosis (ISR) after carotid artery stent placement (CAS).Methods:A total of 197 patients with carotid artery stenosis who underwent CAS treatment at the Capital Medical University Daxing Teaching Hospital from January 2018 to October 2020 were selected as the study subjects. All patients were followed up for 24 months after surgery and were divided into an ISR group (28 cases) and a non ISR group (169 cases) based on the occurrence of ISR. Enzyme linked immunosorbent assay (ELISA) was used to detect and compare the preoperative serum Sortilin and EMMPRIN levels between the two groups. We collected clinical data from patients and analyzed the influencing factors of post CAS ISR using univariate and multivariate logistic regression models. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum Sortilin and EMMPRIN for postoperative ISR in CAS.Results:The serum Sortilin, EMMPRIN, age, proportion of concomitant hypertension, degree of preoperative stenosis, neutrophil count (NEUT), platelet count (PLT), white blood cell count (WBC), high-sensitivity C-reactive protein (hs-CRP), triglycerides (TG), and total cholesterol (TC) in the ISR group were higher than those in the non ISR group (all P<0.05). The results of multivariate logistic regression analysis showed that PLT, WBC, and elevated serum Sortilin and EMMPRIN were independent risk factors for the occurrence of ISR after CAS surgery (all P<0.05). ROC curve analysis showed that the AUC under the ROC curve of serum Sortilin and EMMPRIN alone and in combination for predicting postoperative ISR in CAS were 0.735(95% CI: 0.546-0.918), 0.766(95% CI: 0.615-0.910), and 0.839(95% CI: 0.701-0.984), respectively. The predictive efficacy of the combined application was greater than that of the two indicators alone. Conclusions:Patients with postoperative ISR after CAS have abnormally elevated levels of serum Sortilin and EMMPRIN before surgery, which are independent risk factors for postoperative ISR. The combined detection of serum Sortilin and EMMPRIN has good predictive value for the risk of postoperative ISR in CAS.

Objective:To explore the value of combined detection of urinary kidney injury markers in the diagnosis of early-stage diabetic kidney disease (DKD), and to provide evidence for early-stage DKD screening.Methods:It was a retrospective study. The clinical data of patients with type 2 diabetes mellitus (T2DM) from the Second Affiliated Hospital of Hainan Medicine University from January 2022 to August 2023 were collected. According to urinary microalbumin/creatinine ratio (UACR), the patients were divided into three groups: isolated diabetes group (UACR < 30 mg/g), early-stage DKD group (30 mg/g ≤ UACR < 300 mg/g) and clinical DKD group (UACR ≥ 300 mg/g), and the differences of clinical data among three groups were compared. Glomerular injury markers urinary microalbumin, transferrin, immunoglobulin (Ig) and α2 macroglobulin, and renal tubule injury markers α1 microglobulin (α1-MG), β2 microglobulin (β2-MG), retinol-binding protein (RBP), N-acetyl-β- D-glucosidase (NAG), neutrophil gelatinase-associated lipid carrier protein (NGAL) were measured. Spearman correlation method was used to analyze the correlation between urinary kidney injury markers and clinical indicators. Multivariate logistic regression analysis method was used to analyze the risk factors of DKD occurrence (UACR > 300 mg/g). Receiver-operating characteristic curve was used to analyze the value of individual and combined detection of urinary renal injury markers in the diagnosis of early-stage DKD (30 mg/g ≤ UACR < 300 mg/g). Results:A total of 116 T2DM patients were enrolled in this study, aged (61.99±12.56) years old (30 to 91 years old), with 79 males (68.1%). There were 44 (37.9%) isolated diabetes patients, 27 (23.3%) early-stage DKD patients, and 45 (38.8%) clinical DKD patients. Serum creatinine (Scr, H=34.183, P<0.001) and blood urea nitrogen (BUN, H=34.082, P<0.001) in clinical DKD group were higher than those in isolated diabetes group and early-stage DKD group. Spearman correlation analysis showed that glomerular injury markers urinary microalbumin, transferrin, Ig and α2 macroglobulin were positively correlated with Scr, BUN and UACR, and negatively correlated with estimated glomerular filtration rate and serum albumin (all P<0.05). Renal tubule injury markers urinary α1-MG, β2-MG, NAG, RBP, and NGAL were positively correlated with Scr, BUN and UACR, and negatively correlated with estimated glomerular filtration rate and serum albumin (all P<0.05). Multivariate logistic regression analysis indicated that systolic blood pressure ≥ 140 mmHg ( OR=1.033, 95% CI 1.008-1.060, P=0.010), high urinary microalbumin ( OR=1.018, 95% CI 1.007-1.030, P=0.001), high urinary RBP ( OR=1.309, 95% CI 1.086-1.577, P=0.005), high urinary NGAL ( OR=1.004, 95% CI 1.000-1.008, P=0.037), low serum albumin ( OR=0.833, 95% CI 0.749-0.926, P=0.001) and low urinary Ig ( OR=0.994, 95% CI 0.990-0.999, P=0.018) were independent influencing factors of DKD occurrence. Receiver-operating characteristic curve revealed that the area under the curve ( AUC) was the largest for diagnosing early-stage DKD when urinary microalbumin was detected alone ( AUC=0.976, 95% CI 0.955-0.997, P<0.001), with sensitivity and specificity of 95.6% and 90.1%, respectively. The combined detection of urinary microalbumin + Ig + transferrin + α2 macroglobulin + α1-MG + β2-MG + NAG + RBP + NGAL had an AUC of 0.986 (95% CI 0.971-1.000, P<0.001), with sensitivity and specificity of 93.3% and 98.5%, respectively, which was better than each single index. Further optimized detection combination was urinary microalbumin combined with β2-MG and NGAL, which had the best diagnostic efficacy ( AUC=0.978, 95% CI 0.958-0.999, P<0.001), with sensitivity and specificity of 95.6% and 93.0%, respectively. Conclusions:Compared with the single detection of each index, the combined detection of urinary glomerular injury and renal tubule injury markers has higher value in diagnosing early-stage DKD. The combined detection of urinary microalbumin combined with β2-MG and NGAL has the highest value in diagnosing early-stage DKD.

Objective:To explore the risk factors for lymphoproliferative disorders (PTLD) in children with thalassemia major (TM) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:This was a retrospective case-control study.A total of 482 children with TM who underwent allo-HSCT at Shenzhen Children′s Hospital between January 2020 and December 2022 were selected and classified into the PTLD and non-PTLD groups according to the occurrence of PTLD.The risk factors for PTLD after allo-HSCT in children with TM were analyzed, and the diagnostic efficiency of relevant risk factors for PTLD was analyzed by receiver operating characteristic (ROC) curve.Results:A total of 25 out of 482 patients (5.2%, 25/482) developed PTLD about 114 (54-271) days after allo-HSCT.Among them, 12 cases (12/25, 48.0%) occurred within 100 days, and 22 cases (22/25, 88.0%) occurred within 1 year after allo-HSCT.Univariate analysis showed that there were significant differences in gender composition, type of transplant donor, number of natural killer cells and B lymphocytes in peripheral blood at 30 days after allo-HSCT, positive rate of plasma Epstein-Barr virus deoxyribonucleic acid (EBV-DNA) and incidence rate of acute graft-versus-host disease (aGVHD) between the 2 groups (all P<0.05).Multivariate Logistic regression analysis showed that female ( OR=3.196, 95% CI: 1.144-8.929), positive plasma EBV-DNA ( OR=17.523, 95% CI: 5.449-56.344) and aGVHD ( OR=3.156, 95% CI: 1.161-8.575) were independent risk factors for PTLD after allo-HSCT in TM children (all P<0.05).The ROC curve analysis showed that positive plasma EBV-DNA had an excellent accuracy in predicting the occurrence of PTLD after allo-HSCT (sensitivity was 0.796, specificity was 0.800, area under the curve was 0.803).If combined with aGVHD and gender, the area under the curve for the prediction of PTLD increased to 0.831. Conclusions:Female, positive plasma EBV-DNA and aGVHD are independent risk factors for PTLD after allo-HSCT in children with TM.It provides useful early warnings for the prediction and prevention of PTLD.

Objective:To construct an inpatient-outpatient-home step swallowing rehabilitation training program for partial laryngectomy patients.Methods:From June 2022 to May 2023, a preliminary program for inpatient-outpatient-home step swallowing rehabilitation training for partial laryngectomy patients was developed through literature search and analysis. Delphi method was used for two rounds of expert inquiry on the inpatient-outpatient-home step swallowing rehabilitation training program for partial laryngectomy patients.Results:A total of 15 experts were included for two rounds of expert inquiry. The effective response rates of the questionnaires from the two rounds of expert inquiries were 100.0% (15/15). The expert authority coefficients for the two rounds of inquiry were 0.885 and 0.855, respectively, and the Kendall harmony coefficients were 0.217 and 0.230, respectively ( P<0.01). The final inpatient-outpatient-home step swallowing rehabilitation training program for partial laryngectomy patients included three primary items (swallowing training step, swallowing training methods, and feeding guidance methods), 21 secondary items, and 35 tertiary items. Conclusions:The inpatient-outpatient-home step swallowing rehabilitation training program for partial laryngectomy patients based on the Delphi method has certain scientific and feasibility and can provide a reference for medical and nursing staff.

Objective:To explore the effect of staged rehabilitation nursing in patients undergoing arthroscopic rotator cuff repair.Methods:From January 2021 to December 2022, convenience sampling was used to select 73 patients who underwent arthroscopic rotator cuff repair in the Department of Hand Surgery at Affiliated Hospital of Nantong University as participants. According to the random number table method, patients were divided into a control group ( n=36) and an observation group ( n=37). Control group received routine rehabilitation nursing, while observation group received staged rehabilitation nursing. The University of California, Los Angeles (UCLA) Shoulder Rating Scale score, American Shoulder and Elbow Surgeons (ASES) Rating Scale score, Constant-Murley Shoulder Scale score, and complications during rehabilitation were compared between two groups of patients before and six months after intervention. Results:Six months after surgery, both groups showed an increase in UCLA scores and ASES scores compared to before the intervention ( P<0.05), and the scores of observation group were higher than those of control group, with statistical differences ( P<0.05). Six months after surgery, the Constant-Murley Shoulder Scale scores for daily life and shoulder range of motion in observation group were higher than those in control group, and the differences were statistically significant ( P<0.05). During the rehabilitation period, the incidence of complications in observation group was lower than that in control group with a statistical difference ( P<0.05) . Conclusions:Staged rehabilitation nursing in patients undergoing arthroscopic rotator cuff repair shows significant effects and can effectively promote patient recovery.

ObjectiveTo explore the effect of Tongluo Jiedu Xiezhuo prescription （TLJDXZ） on alleviating inflammatory response in rats with gouty arthritis （GA） by regulating the formation and release of neutrophil extracellular traps （NETs）. MethodOxonic acid potassium salt solution combined with uric acid sodium solution was used to establish the GA rat model by injection. Seventy-two SD rats were randomly divided into control model， model group， and low-， medium-， and high-dose （1.58， 3.15， and 6.30 g∙kg^-1） TLJDXZ groups， and colchicine group （0.30 mg∙kg^-1）. Ultra-high performance liquid chromatography-quadrupole-time-of-flight mass spectrometry （UPLC-Q-TOF-MS） was used to characterize the chemical components of TLJDXZ. HE staining was used to observe the ankle joint tissue structure of rats. Enzyme-linked immunosorbent assay （ELISA） was used to determine the levels of inflammatory factors interleukin （IL）-1β， IL-6，IL-8， blood uric acid （BUA） tumor necrosis factor （TNF）-α， reactive oxygen species （ROS）， and myeloperoxidase （MPO） in serum and tissue. PicoGreen staining method was used to measure ds-DNA concentration in plasma. Western blot was used to detect the expression of citrullinated histone H3 （Cit-H3） and MPO proteins. Immunofluorescence was used to detect the expression of neutrophil elastase （NE） and MPO. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect peptidylarginine deiminase 4 （PAD4） mRNA expression. ResultCompared with control group， the model group had severe joint swelling， with shed cell debris， synovial and connective tissue proliferation， and inflammatory cell punctate infiltration visible in the joint cavity. Blood circulation， oxidative damage， and inflammation in joint tissues significantly worsened （P<0.05）. The expression of NETs-related proteins Cit-H3， MPO， NE， and PAD4 was significantly upregulated （P<0.05）. Compared with the results in model group， joint damage in the TLJDXZ groups was significantly reduced， and the swelling was alleviated. The inflammatory infiltration in the joint cavity， cartilage and synovial morphology， and joint structure were significantly relieved. TLJDXZ significantly reduced oxidative damage and inflammation in peripheral blood circulation and joint tissues （P<0.05）. The expression of NETs-related proteins Cit-H3， MPO， NE， and PAD4 was significantly downregulated （P<0.05）. ConclusionTLJDXZ can effectively alleviate joint inflammatory response in GA rats， and its mechanism of action may be related to the regulation of the formation and release of NETs.

ObjectiveMetabolomics was utilized to investigate the preventive effect of notoginseng total saponins（NTS） on aspirin（acetyl salicylic acid， ASA）-induced small bowel injury in rats. MethodFifty male SD rats were randomly divided into normal and model groups， NTS high-dose and low-dose groups（62.5， 31.25 mg·kg^-1）， and positive drug group（omeprazole 2.08 mg·kg^-1+rebamipide 31.25 mg·kg^-1）， with 10 rats in each group. Except for the normal group， rats in other groups were given ASA enteric-coated pellets 10.41 mg·kg^-1 daily to establish a small intestine injury model. On this basis， each medication group was gavaged daily with the corresponding dose of drug， and the normal group and the model group were gavaged with an equal amount of drinking water. Changes in body mass and fecal characteristics of rats were recorded and scored during the period. After 14 weeks of administration， small intestinal tissues of each group were taken for hematoxylin-eosin（HE） staining， scanning electron microscopy to observe the damage， and the apparent damage of small intestine was scored. Serum from rats in the normal group， the model group， and the NTS high-dose group was taken and analyzed for metabolomics by ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap high-resolution mass spectrometry（UPLC-Q-Exactive Orbitrap MS）， and the data were processed by multivariate statistical analysis， the potential biomarkers were screened by variable importance in the projection（VIP） value≥1.0， fold change（FC）≥1.5 or ≤0.6 and t-test P<0.05， and pathway enrichment analysis of differential metabolites was performed in conjunction with Human Metabolome Database（HMDB） and Kyoto Encyclopedia of Genes and Genomes（KEGG）. ResultAfter 14 weeks of administration， the average body mass gain of the model group was lower than that of the normal group， and the NTS high-dose group was close to that of the normal group. Compared with the normal group， the fecal character score of rats in the model group was significantly increased（P<0.05）， and compared with the model group， the scores of the positive drug group and the NTS high-dose group were reduced， but the difference was not statistically significant. HE staining and scanning electron microscopy results showed that NTS could significantly improve ASA-induced small intestinal injury， compared with the normal group， the small bowel injury score of the model group was significantly increased（P<0.01）， compared with the model group， the small bowel injury scores of the NTS low and high dose groups were significantly reduced（P<0.05， P<0.01）. Serum metabolomics screened a total of 75 differential metabolites between the normal group and the model group， of which 55 were up-regulated and 20 were down-regulated， 76 differential metabolites between the model group and the NTS groups， of which 14 were up-regulated and 62 were down-regulated. NTS could modulate three differential metabolites（salicylic acid， 3-hydroxybenzoic acid and 4-hydroxybenzoic acid）， which were involved in 3 metabolic pathways， namely， the bile secretion， the biosynthesis of folic acid， and the biosynthesis of phenylalanine， tyrosine and tryptophan. ConclusionNTS can prevent ASA-induced small bowel injury， and the underlying mechanism may be related to the regulation of bile secretion and amino acid metabolic pathways in rats.