Based on the data from the 5^th National Physical Fitness Surveillance in China, this study aimed to explore the relationship between abnormal body weight and physical fitness levels in older adults.

A 71-year-old male presented with esophageal cancer and severe aortic valve regurgitation. Treatment strategies for such patients are controversial. Considering the risks of cardiopulmonary bypass and potential esophageal cancer metastasis, we successfully performed transcatheter aortic valve implantation and minimally invasive three-incision thoracolaparoscopy combined with radical resection of esophageal cancer (McKeown) simultaneously in the elderly patient who did not require neoadjuvant treatment. This dual minimally invasive procedure took 6 hours and the patient recovered smoothly without any surgical complications.

ObjectiveTo investigate the effect of Gelian Tiaotang pills on renal fibrosis in db/db mice based on the nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 （NLRP3）/cysteinyl aspartate-specific proteinase （Caspase）-1/gasdermin D （GSDMD） signaling pathway. MethodsForty db/db mice were randomly assigned into model， positive control （0.001 3 g·kg·d^-1 dapagliflozin suspension）， and high-， medium-， and low-dose Gelian Tiaotang pills （3.12， 1.56， and 0.78 g·kg·d^-1 suspension of Gelian Tiaotang pills， respectively） groups， with 8 mice in each group. Eight db/m mice were selected as the normal group. The normal group and model group were given equal volumes of pure water， while the drug interventions groups were administrated with corresponding agents by gavage once a day for 12 consecutive weeks. The general conditions of mice were observed daily. The fasting blood glucose （FBG） and body mass were measured every 4 weeks. Kidneys were weighed after sampling， and the kidney index was calculated. An automatic biochemical analyzer was used to measure the serum levels of triglyceride （TG）， total cholesterol （TC）， serum creatinine （SCr）， and blood urea nitrogen （BUN）. The pathological changes， extracellular matrix deposition， and renal fibrosis degree were examined by hematoxylin-eosin， periodic acid-schiff （PAS）， and Masson staining， respectively. Enzyme-linked immunosorbent assay was employed to measure the levels of interleukin （IL）-1β and IL-18 in the renal tissue. Immunohistochemistry （IHC） was used to detect the localization and expression of fibronectin and collagen Ⅰ in the renal tissue. Western blot was employed to determine the protein levels of NLRP3， Caspase-1， cleaved Caspase-1， GSDMD， and GSDMD-N in the renal tissue. ResultsCompared with the normal group， the model group generally had poor general states and increases in the body mass， kidney weight， kidney index， and levels of FBG， TG， TC， SCr， and BUN （P<0.01）. In addition， glomerular pyknosis， increased matrix， vacuolar degeneration of renal tubular epithelial cells， and interstitial infiltration of inflammatory cells were observed in the model group （P<0.01）， together with rises in the levels of IL-1β and IL-18 in the renal tissue （P<0.01） and up-regulated protein levels of NLRP3， Caspase-1， cleaved Caspase-1， GSDMD， GSDMD-N， fibronectin， and collagen Ⅰ in the renal tissue （P<0.01）. Compared with the model group， 12 weeks of drug interventions reduced the body mass， kidney weight， and kidney index and lowered the levels of FBG， TG， TC， SCr， and BUN in the serum and IL-1β and IL-18 in the renal tissue （P<0.05， P<0.01）. Furthermore， drug interventions ameliorated the renal lesions and down-regulated the protein levels of NLRP3， Caspase-1， cleaved Caspase-1， GSDMD， GSDMD-N， fibronectin， and collagen Ⅰ in the renal tissue （P<0.05， P<0.01）. The high-dose group of Gelian Tiaotang pills had the best effects. ConclusionGelian Tiaotang pills may inhibit pyroptosis and reduce inflammatory responses by regulating the NLRP3/Caspase-1/GSDMD signaling pathway， thus delaying the process of renal fibrosis in diabetes.

ObjectiveBased on transcriptomics， to explore the mechanism of Hei Xiaoyaosan regulating the phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） signaling pathway to improve the learning and memory ability of insomnia rats with liver depression syndrome. MethodsSixty 8-week-old male SD rats were randomly divided into the blank group， model group， eszopiclone group （0.09 mg·kg^-1）， and low， medium， and high dose groups of Hei Xiaoyaosan （3.82， 7.65， 15.30 g·kg^-1）， with ten rats in each group. Except for the blank group， the other groups were induced insomnia rat model with liver depression by chronic restraint， tail clamping stimulation and intraperitoneal injection of p-chlorophenylalanine （PCPA）. Each treatment group received intragastric administration according to the specified dosage， once a day for 14 consecutive days. The pentobarbital sodium cooperative sleep test， open field test， and Morris water maze test were used to test the sleep quality， depressive-like behavior， and learning and memory abilities of rats. Additionally， enzyme-linked immunosorbent assay （ELISA） was used to detect the contents of 5-hydroxytryptamine （5-HT）， γ-aminobutyric acid （GABA）， brain-derived neurotrophic factor （BDNF）， glial cell line-derived neurotrophic factor （GDNF） and nitric oxide （NO） in hippocampus. Hematoxylin-eosin （HE） staining was performed to observe pathological changes of the hippocampal tissue， while terminal deoxynucleotidyl transferase deoxyuridine triphosphate （dUTP） nick end labeling （TUNEL） was used to evaluate apoptosis of hippocampal neurons. Transcriptomic sequencing technology was employed to identify differentially expressed genes in hippocampus between the model group and the blank group， as well as between the medium-dose group of Hei Xiaoyaosan and the model group. Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analysis were performed on the intersecting genes. Subsequently， the enriched key genes and signaling pathways were analyzed and verified. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was utilized to assess the mRNA expression levels of phosphatase and tensin homolog （PTEN）， B-cell lymphoma-2 （Bcl-2）-like protein 11 （BCL2L11）， and mitogen-activated protein kinase 1 （MAPK1） in hippocampus， and Western blot was employed to evaluate the protein expressions of PI3K， phosphorylation （p）-PI3K， Akt， p-Akt， Bcl-2， Bcl-2-associated X protein （Bax）， and cleaved Caspase-3 in the same tissue. ResultsCompared with the blank group， the model group exhibited a reduction in body weight， an increase in sleep latency， and a decrease in sleep duration （P<0.01）. Additionally， rats showed obvious depression-like behavior， and their learning and memory abilities decreased. Furthermore， the contents of 5-HT， GABA， NO， BDNF and GDNF in hippocampus decreased （P<0.01）. Histological examination revealed a disorganized cell arrangement in the CA1 region of the hippocampus， characterized by irregular cell shapes， a reduced cell count， deeply stained and pyknotic nuclei， increased vacuolar degeneration， and an elevated apoptosis rate （P<0.01）. Compared with the model group， the body weight of the high and medium dose groups of Hei Xiaoyaosan increased， the sleep latency shortened and the sleep time prolonged （P<0.05， P<0.01）. Additionally， depression-like behavior and learning and memory abilities of rats were significantly improved， the levels of 5-HT， GABA， NO， BDNF and GDNF in the hippocampus increased （P<0.05， P<0.01）. These interventions also ameliorated pathological damage in the hippocampal CA1 area and reduced the apoptosis of hippocampal neurons （P<0.01）. Transcriptomic sequencing results indicated that Hei Xiaoyaosan might exert a therapeutic effect by regulating PI3K/Akt pathway through key mRNAs such as PTEN， BCL2L11， and MAPK1. The roles of these key mRNAs and proteins within PI3K/Akt pathway were further validated. In comparison to the blank group， the expression levels of PTEN， BCL2L11 and MAPK1 mRNA in the hippocampus of rats in the model group were increased （P<0.01）， while the protein expression levels of p-PI3K， p-Akt and Bcl-2 were decreased （P<0.01）， and the protein expression levels of PTEN， Bax and cleaved Caspase-3 were increased （P<0.01）. Compared with the model group， the high-dose and medium-dose groups of Hei Xiaoyaosan could down-regulate the expressions of PTEN， BCL2L11 and MAPK1 mRNAs （P<0.01）， up-regulate the expressions of p-PI3K， p-Akt and Bcl-2 proteins （P<0.01）， and down-regulate the protein expressions of PTEN， Bax and cleaved Caspase-3 （P<0.05， P<0.01）. ConclusionHei Xiaoyaosan may regulate PI3K/Akt signaling pathway by down-regulating expressions of key genes such as PTEN， BCL2L11 and MAPK1， and thus improve the learning and memory abilities of insomnia rats with liver depression syndrome.

Compound amino acid injection is a general term for preparations with amino acids as the main compo-nents,with a wide variety,complex classification and similar common names,which not only brings challenges to drug selection and clinical use,but also brings drug safety risks to patients.From the point of view of clinical appli-cation,this paper puts forward some suggestions close to the clinical significance,hoping to optimize the manage-ment of this kind of preparation.

Objective:To evaluate the effects of abdomen breathing training combined with electrogalvanic stimulation and biological feedback therapy for postpartum pelvic floor hypertonicity. Method:Ninety-six women with postpartum pelvic floor hypertonicity in Chenghua Women's and Children's Pel-vic Floor Rehabilitation Clinic of West China Second Hospital from January to December 2022 were randomly divided into treatment and control groups.The control group(n=48)was treated with electrogalvanic stimula-tion for 10 minutes and biological feedback for 10 minutes.The treatment group(n=48)received electrogalvan-ic stimulation for 10 minutes,biological feedback for 10 minutes,and abdomen breathing training for 5-10 minutes.Two teams received treatment 2-3 times per week and 10 times in total.The visual analogue scale(VAS)of pelvic floor myofascial pain,pre-baseline rest and post-baseline rest,pelvic floor muscle strength(ac-cording to the 0-5 Oxford scale),phasic(flick)contractions,tonic contractions and the female sexual func-tion index(FSFI)scores of the two groups were evaluated before and after treatment. Result:The VAS score of the pelvic floor myofascial pain,pre-baseline rest,and post-baseline rest were lower than those before the intervention in both groups(P＜0.05).Pelvic floor muscle strength,phasic(flick)contrac-tions,tonic contractions,FSFI scores,were higher than those before the intervention(P＜0.05).After intervention,the VAS score of pelvic floor myofascial palpation tenderness and resting potential of pelvic floor muscles in the treatment group were all lower than those in the control group(P＜0.05),the scores of hand-tested pelvic floor muscle strength and female sexual function index scale were higher than those in the control group(P＜0.05). Conclusion:Abdomen breathing training combined with electrogalvanic stimulation and biological feedback sig-nificantly improved the postpartum pelvic floor hypertonicity and pelvic floor myofascial pain,boosted sexual function in postpartum,which is more advantageous than using the electrical stimulation and biofeedback alone.

Objective:io investigate the expression level and clinical correlation of microRNA-144/451 gene cluster(miR-144/451)in different types of anemia.Methods:The peripheral blood of patients with aplastic anemia(AA),myelodysplastic syndrome(MDS)and diffuse large B-cell lymphoma(DLBCL)who had been diagnosed with anemia for the first time and after chemotherapy were collected.The expression levels of miR-144 and miR-451 were measured by RT-qPCR,and the correlation between the expression levels of miR-144 and miR-451 and routine laboratory indexes was analyzed by Spearman correlation analysis.Results:The expression levels of miR-144 and miR-451 in the peripheral blood of AA and MDS patients were significantly lower than those in normal controls(all P＜0.0 1).No statistical differences were observed in the expression level of miR-144 in three subgroups of DLBCL patients(P＞0.05),while the expression level of miR-451 in peripheral blood of three subgroups of DLBCL patients were significantly higher than those in normal controls(all P＜0.05).Correlation analysis showed that the expression levels of miR-144 and miR-451 in AA patients were positively correlated with red blood cell distribution width-coefficient of variation(RDW-CV)(r=0.629,0.574).There were no significant correlations between the expression levels of miR-144 and miR-451 and laboratory parameters in MDS and DLBCL patients.Conclusion:Different types of anemia disorders have varying levels of miR-144 and miR-451 expression,which is anticipated to develop into a secondary diagnostic and differential diagnostic indicator for clinical anemia diseases.

Objective:To analyze the genes related to platelet activation in essential thrombocythemia (ET)based on transcriptome sequencing technology (RNA-seq ),and to explore the potential targets related to ET thrombosis. Methods:Blood samples from ET patients and healthy individuals were collected for RNA-seq,and differentially expressed lncRNAs,miRNAs,and mRNAs were selected to construct a lncRNA-miRNA-mRNA regulatory network. Differential mRNAs in the regulatory network were enriched and analyzed using Gene Ontology (GO ) and Kyoto Encyclopedia of Genes and Genomes (KEGG).The real-time PCR method was applied to validate differential mRNAs on crucial signaling pathways.Results:A total of 32 lncRNAs (3 up-regulated,29 down-regulated),16 miRNAs (8 up-regulated,8 down-regulated),and 35 mRNAs (27 up-regulated,8 down-regulated)were identified as differentially expressed.Among them,5 lncRNAs,12 miRNAs,and 19 mRNAs constituted the regulatory network.KEGG enrichment analysis showed that the differential mRNAs were related to the platelet activation signaling pathway,and there were 6 differential mRNAs related to platelet activation,namely F2R,ITGA2B,ITGB1,ITGB3,PTGS1,and GP1 BB,which were all up-regulated in their expression.RT-PCR results showed that the expression of five mRNAs including F2R,ITGA2B,ITGB1,ITGB3,and GP1BB were upregulated in ET patients compared with healthy subjects,and consistent with RNA-seq results,while PTGS1 expression was not significantly different.Conclusion:Differential mRNAs in ET patients are related to the platelet activation pathway,and F2R,ITGA2B,ITGB1,ITGB3,and GP1BB mRNAs may serve as novel targets associated with platelet activation in ET.

Acute myeloid leukemia (AML) is the most common and highly heterogeneous acute leukemia in adults. Despite the continuous optimization of prognostic risk stratification and treatment regimens,the overall long-term survival rate of AML patients remains low. The emergence of single cell sequencing (SCS) technology has overcome the defects of traditional sequencing to a certain extent,and realized the transformation of the research of malignant tumors from cell population level to single cell level. Consequently,it has been widely applied in many biological fields. This review mainly focuses on the application of SCS technology in the analysis of tumor heterogeneity,disease evolution,changes in tumor microenvironment,elucidation of drug resistance mechanisms and search for potential therapeutic targets in AML.

Objective:To explore the mental health level of Chinese adults aged 20~79 years and its association with exercise based on the surveillance data.Methods:A cross-sectional study was conducted in a total of 161 901 samples from the Fifth National Physical Fitness Surveillance, including 121 928 adults aged 20-59 years and 39 973 elderly aged 60-79 years. The mental health status was assessed by a comprehensive questionnaire, and the participation in frequency and duration of exercise were investigated. Chi-square test and Logistic regression were applied to test the relationship between exercise and mental health using SPSS 26.0 software.Results:The rate of depressive symptoms among residents aged 20-79 years in China was 16.6%(26 311/158 518). In the adults aged 20-59 years, the rates of depression and anxiety symptoms were 18.0%(21 465/119 409) and 13.8%(16 435/119 444), respectively, and the proportion of those who often or always felt stressed was 15.3%(18 373/120 444). In the elderly aged 60-79 years, the rate of depression symptoms was 12.4%(4 846/39 109), the proportion of those with loneliness scale scores higher than 25 was 32.8%(12 650/38 525), and 4.0%(1 587/39 395) elderly often or always felt stressed. Compared with the non-exercisers, the risk of depression symptoms in the exercisers was reduced by 20% ( β=-0.22, OR=0.80, 95% CI: 0.78-0.82). With increased frequency and intensity of physical exercise, the mental health condition improved significantly. For those who exercised at least 3 days a week and had moderate intensity or above, the detection rate of depression symptoms decreased by 35% ( β=-0.39, OR=0.65, 95% CI: 0.63-0.67).The negative associations between exercise and depression were found in different ages, genders and resident subgroups. The risk of anxiety was 6% lower in the adults who participated in physical activity ( β=-0.06, OR=0.94, 95% CI: 0.91-0.97) and 15% lower in those who exercised over 3 days per week at moderate-to-vigorous intensity ( β=-0.16, OR=0.85, 95% CI: 0.81-0.89). No association between exercise and risk of stress was observed ( P>0.05), but the positive effect was also found as exercise frequency and intensity increased. Older adults with exercise had a reduced risk of high loneliness scores by 50% ( β=-0.70, OR=0.50, 95% CI: 0.47-0.52) and a 35% lower detection of stress risk ( β=-0.43, OR=0.65, 95% CI: 0.59-0.72). Conclusion:Exercise was significantly and meaningfully associated with self-reported mental health.Exercise can actively and effectively prevent and improve mental health.