Objective: To explore the relationship between socio ecological risk factors (SERF), physical activity (PA) developmental trajectories, and depressive symptoms among junior and senior high school students in Tianjin, in order to provide theoretical support for comprehensive interventions for adolescent depression. Methods: A longitudinal follow up design was adopted. In September 2022, a baseline survey was conducted using a stratified cluster random sampling method in two junior high schools and two senior high schools in Tianjin, collecting data on students basic information, SERF, PA, and depressive symptoms. Two follow up surveys were conducted in September 2023 and 2024, yielding 588 valid participants. Latent class growth analysis (LCGA) was used to identify PA developmental trajectory categories among junior and senior high school students. Logistic regression was applied to examine the associations between depressive symptoms and SERF as well as PA trajectories. Results: The detection rates of depressive symptoms among Tianjin junior and senior high school students over the three years were 26.53%, 20.24%, and 21.26 %, respectively. Depressive symptoms were positively correlated with SERF ( OR=1.04, 95%CI=1.03-1.05, P <0.05). The highest risks were observed in the individual dimension and family dimension ( OR =1.28, 1.21, both P <0.05). LCGA identified three PA trajectory groups:persistently low level (80.65%), persistently high level (4.58%), and slowly increasing group ( 14.77 %). Multivariate regression analysis showed that compared with the persistently low level PA, the slowly increasing PA significantly reduced the risk of depressive symptoms ( OR=0.44, 95%CI =0.20-0.88), while SERF still increased the risk of depressive symptoms ( OR=1.04, 95%CI =1.03-1.05) (both P <0.05). Conclusion SERF are risk factors for depression symptoms among junior and senior high school students, whereas slowly increasing PA development trajectory demonstrates a protective effect.

OBJECTIVE To compare the antihypertensive efficacy of sacubitril/valsartan versus benazepril in patients with perimenopausal hypertension， as well as their impacts on ventricular remodeling and inflammatory fibrosis. METHODS A total of 206 perimenopausal hypertensive patients in our hospital from January 1， 2023 to December 30， 2024 were retrospectively included.These patients were enrolled and divided into benazepril group （105 cases） and sacubitril/valsartan group （101 cases）. Benazepril group received Benazepril hydrochloride tablet， and sacubitril/valsartan group received Sacubitril valsartan sodium tablet. All patients were treated for 6 months. The blood pressure（systolic blood pressure and diastolic blood pressure） and blood pressure control status before and after treatment， echocardiographic indicators （left ventricular ejection fraction， left ventricular mass index， relative wall thickness， and early-diastolic peak transmitral flow velocity/early-diastolic peak velocity of the mitral annulus）， inflammatory fibrosis related indicators（high-sensitivity C-reactive protein，ratio of monocytes to lymphocytes，and ratio of neutrophils to lymphocytes）， as well as the occurrence of adverse reactions（hypotension，hyperkalemia，and angioedema） were observed in both groups before and after treatment. RESULTS The blood pressure control rate was significantly higher in the sacubitril/valsartan group than in benazepril group （ P ＜0.05）. After treatment， the blood pressure， echocardiographic indicators（except for left ventricular ejection fraction） ，and inflammatory fibrosis related indicators were significantly lower than those before treatment within the same group， and the sacubitril/valsartan group were significantly lower than the benazepril group （ P ＜0.05）. There were no statistically significant differences in the incidence of hypotension， hyperkalemia， angioedema， and overall adverse drug reactions between the two groups （ P ＞0.05）. CONCLUSIONS Compared with benazepril， sacubitril/valsartan provides superior blood-pressure control， reverses ventricular remodeling， attenuates inflammatory fibrosis in perimenopausal hypertensive patients， while maintaining a similar safety profile.

Objective To investigate the clinical safety and efficacy of predictive extracorporeal membrane oxygenation (ECMO) support during liver transplantation in high-risk recipients. Methods A single-center retrospective study was conducted. A total of 35 liver transplant recipients who underwent predictive ECMO assistance during surgery at the Second Affiliated Hospital of Guangxi Medical University from January 2021 to April 2025 were included. Baseline characteristics, ECMO application, ECMO operating parameters and hemodynamic conditions during ECMO operation were analyzed. The cumulative survival rate was calculated using the Kaplan-Meier method and survival curves were plotted. Results Veno-arterial ECMO in 35 recipients was established after induction of general anesthesia. The median ECMO operation time was 8.5 h, and the success rate of weaning from ECMO was 97%. The cardiac index (CI) during the non-liver period and the new liver period was higher than that before cannulation, and CI increased during the non-liver period and before weaning (all P<0.001). The mean invasive arterial pressure and central venous pressure remained stable. No ECMO-related complications occurred in the recipients. The average survival time was (25 ± 3) months. The main causes of death were severe pulmonary infection and multiple organ failure. Conclusions For liver transplant recipients with severe cardiopulmonary dysfunction, hemodynamic disorders, or multiple organ failure risk factors, implementing predictive ECMO support during liver transplantation through active risk prediction is a safe and effective circulatory guarantee strategy.

ObjectiveTo investigate the status and influencing factors of latent tuberculosis infection (LTBI) among close contacts of patients with bacteriologically confirmed pulmonary tuberculosis in Jing’an District, Shanghai, and to provide scientific evidence for the development of tuberculosis infection testing and preventive intervention strategies for close contacts of bacteriologically positive patients. MethodsFrom October 2022 to October 2023, patients with bacteriological confirmed pulmonary tuberculosis registered in Jing’an District, Shanghai, and their close contacts were enrolled as the research subjects. The close contacts were screened for tuberculosis infection using the interferon-γ release assay (IGRA). The chi-square test and binary logistic regression model were used to analyze factors influencing LTBI. ResultsA total of 112 close contacts were included, of whom 30 (26.79%) were male and 82 (73.21%) were female. The age ranged from 1 to 86 years, with a median (25th, 75th percentiles) of 47.50 (32.25, 61.00) years. The infection rate of LTBI was 21.43% (24/112), and the incidence of active pulmonary tuberculosis was 2.68% (3/112). Univariate analyses showed that a positive sputum smear of the index case, being a direct relative of the index case, co-living, and not wearing a mask were significantly associated with LTBI (all P<0.05). Multivariate logistic regression analyses showed that the risk of latent infection in close contacts of the index case with a positive sputum smear was 6.50 times higher than in those with a negative sputum smear (95%CI: 1.82‒23.25, P=0.004). ConclusionThe infection rate of LTBI in close contacts of patients with bacteriologically confirmed pulmonary tuberculosis in Jing’an District, Shanghai, is relatively high, and close contacts of sputum smear-positive patients face an even higher risk of infection. Therefore, tuberculosis infection screening and follow-up management should be strengthened for this population.

Objective To explore the changes in ability to cope with ethical conflicts in palliative care in neonatal intensive care units(NI CU)before and after ethical sensitivity theory training.Methods A descriptive phenomenological research method was employed.Using purposive sampling,we recruited 16 NICU nurses from a tertiary general comprehensive hospital in the city.After ethical sensitivity theory training between January and March 2025,the nurses participated in a semi-structured interview.Data were analyzed using Colaizzi's seven-step analysis method.Results All participants completed the interview.The data were abstracted to three main themes encompassing eight sub-themes:experiences of ethical conflict dilemmas before ethical sensitivity theory training(conflicts between treatment decision-making and family expectations,trust crises triggered by family cognitive biases),the changes of strategy to cope with ethical conflicts after ethical sensitivity theory training(individualized coping strategies,teamwork and communication,introduction and support of external resources),and the role of ethical sensitivity theory training in enhancing coping ability(improving the ability to identify ethical issues,optimizing the decision-making process,and promoting effective communication).Conclusion Palliative care nurses in the NICU face various ethical conflicts,and ethical sensitivity training can enhance their ability to manage these conflicts.

OBJECTIVE:Prolonged sedentary behavior can acutely reduce peripheral and central vascular function,thereby increasing the risk of cardiovascular disease.Interrupting sedentary behavior may be a potential practical strategy to prevent vascular dysfunction caused by prolonged sitting.However,current research findings on its acute effects are inconsistent,and specific application recommendations have not yet been established.This study aims to perform a Meta-analysis on the acute effects of interrupting sedentary behavior on peripheral and central vascular function in adults and to explore its regulatory factors.METHODS:Following PRISMA reporting guidelines,literature search was conducted in March 2024 using the keywords of"interrupting,""sedentary,"and"vascular function"in the Web of Science Core Collection,PubMed,and China National Knowledge Infrastructure(CNKI)databases.Acute randomized crossover trials addressing the acute effects of interrupting sedentary behavior on peripheral and central vascular function in adults were included.Risk of Bias 2 developed by Cochrane was used to assess bias risk,and the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)system was used to evaluate the evidence level.The"meta"and"metaphor"packages in R(version 4.2.0)were used for main effect aggregation(Hedge's g acted as the effect size indicator),publication bias testing,subgroup analysis,and regression analysis.RESULTS:Twenty-two randomized crossover trials involving 364 subjects(aged 21 to 70 years)were included.Meta-analysis results showed that compared with prolonged sitting,interrupting sedentary behavior acutely improved peripheral vascular blood flow volume(Hedge's g=0.48,95%confidence interval:0.14-0.82,P<0.01,I2=63%,low evidence level),shear stress(Hedge's g=0.65,95%confidence interval:0.37-0.93],P<0.01,I2=54%,moderate evidence level),and flow-mediated dilation(Hedge's g=0.43,95%confidence interval:0.15-0.72,P<0.01,I2=61%,moderate evidence level).Disease had a significant moderating effect on the main effect aggregation for blood flow volume(P=0.01 between subgroups),while the mode(P=0.01 between subgroups)and frequency(P=0.02 between subgroups)of interruptions had significant moderating effects on shear stress.Improvements in peripheral vascular shear stress from interrupting sedentary behavior were affected by age(β=-0.02,95%confidence interval:-0.03-0.01,P=0.09)and body mass index(β=-0.10,95%confidence interval:-0.18 to-0.02,P<0.01).Improvements in flow-mediated dilation were influenced by the total number of interruptions(β=-0.09,95%confidence interval:-0.17 to-0.01,P=0.03)and the duration of sitting during the control period(β=-0.21,95%confidence interval:-0.34 to-0.09,P<0.01).Each additional hour of sitting was associated with a 0.67%reduction in the acute improvement effect of flow-mediated dilation from interrupting sedentary behavior(P<0.01),and acute benefits disappeared when sitting control time exceeded 6 hours.A qualitative systematic review found that interrupting sedentary behavior did not significantly affect pulse wave velocity in various populations but could effectively prevent central vascular function decline in older adults due to prolonged sitting.CONCLUSION:Interrupting sedentary behavior acutely improves peripheral vascular blood flow volume(low evidence level),shear stress(moderate evidence level),and flow-mediated dilation(moderate evidence level)in adults and may prevent or protect against central vascular function decline in older adults due to prolonged sitting(very low evidence level).Characteristics of subjects(disease factors,sex,age,and body mass index),interruption intervention schemes(mode,frequency,total number of interruptions),and duration of sitting control all influence the acute improvement effects of interrupting sedentary behavior on vascular function.It is recommended that adults interrupt sedentary behavior with exercises involving large muscle groups,such as stair climbing,at high frequencies(e.g.,once every 40 minutes)with at least 5 minutes of moderate-to low-intensity activity each time,and limit the cumulative duration of prolonged sitting to no more than 6 hours per day.

Objective To investigate the neuroprotective effect of Dendrobium nobile Lindl(DNL)extract in a Caenorhabditis elegans(C.elegans)model of Parkinson's disease(PD).Methods C.elegans NL5901 and 6-hydroxydopamine(6-OHDA)induced N2,BZ555,PD4521,and CB7272 C.elegans strains were treated with DNL 7.5,15,and 30 mg/L.The survival rate,basal slowing response rate,α-synuclein(α-syn)aggregation,dopaminergic neurons(DNs),mitochondrial distribution density of body wall muscle cells,and protein levels in the membrane were observed.In addition,reactive oxygen species(ROS),superoxide dismutase(SOD)and glutathione(GSH)in 6-OHDA induced N2 was detected to explore the effect of DNL on the antioxidative stress ability of PD C.elegans models.Results Compared with that in the model group,the DN fluorescence intensity was significantly increased in nematodes treated with DNL and levodopa(L-DOPA)(P＜0.05,P＜0.0001),α-syn aggregation was significantly decreased(P＜0.05,P＜0.001,P＜0.0001),the basal slowing rate(P＜0.05,P＜0.01,P＜0.001),mitochondrial density(P＜0.05,P＜0.01,P＜0.001),mitochondrial intima protein content(P＜0.05,P＜0.001,P＜0.0001),SOD content(P＜0.05),and GSH content were all increased.The ROS content was reduced in nematodes(P＜0.01).The lifespans of N2 wild-type and PD C.elegans models were prolonged after DNL treatment(P＜0.05,P＜0.01,P＜0.001).Conclusions DNL can effectively improve motor paralysis in a C.elegans PD model,improve DN degradation,inhibit α-syn aggregation and neuronal damage,increase the antioxidative stress ability,and slow the aging process in C.elegans.

Objective To investigate the neuroprotective effect of Dendrobium nobile Lindl(DNL)extract in a Caenorhabditis elegans(C.elegans)model of Parkinson's disease(PD).Methods C.elegans NL5901 and 6-hydroxydopamine(6-OHDA)induced N2,BZ555,PD4521,and CB7272 C.elegans strains were treated with DNL 7.5,15,and 30 mg/L.The survival rate,basal slowing response rate,α-synuclein(α-syn)aggregation,dopaminergic neurons(DNs),mitochondrial distribution density of body wall muscle cells,and protein levels in the membrane were observed.In addition,reactive oxygen species(ROS),superoxide dismutase(SOD)and glutathione(GSH)in 6-OHDA induced N2 was detected to explore the effect of DNL on the antioxidative stress ability of PD C.elegans models.Results Compared with that in the model group,the DN fluorescence intensity was significantly increased in nematodes treated with DNL and levodopa(L-DOPA)(P＜0.05,P＜0.0001),α-syn aggregation was significantly decreased(P＜0.05,P＜0.001,P＜0.0001),the basal slowing rate(P＜0.05,P＜0.01,P＜0.001),mitochondrial density(P＜0.05,P＜0.01,P＜0.001),mitochondrial intima protein content(P＜0.05,P＜0.001,P＜0.0001),SOD content(P＜0.05),and GSH content were all increased.The ROS content was reduced in nematodes(P＜0.01).The lifespans of N2 wild-type and PD C.elegans models were prolonged after DNL treatment(P＜0.05,P＜0.01,P＜0.001).Conclusions DNL can effectively improve motor paralysis in a C.elegans PD model,improve DN degradation,inhibit α-syn aggregation and neuronal damage,increase the antioxidative stress ability,and slow the aging process in C.elegans.

OBJECTIVE:Prolonged sedentary behavior can acutely reduce peripheral and central vascular function,thereby increasing the risk of cardiovascular disease.Interrupting sedentary behavior may be a potential practical strategy to prevent vascular dysfunction caused by prolonged sitting.However,current research findings on its acute effects are inconsistent,and specific application recommendations have not yet been established.This study aims to perform a Meta-analysis on the acute effects of interrupting sedentary behavior on peripheral and central vascular function in adults and to explore its regulatory factors.METHODS:Following PRISMA reporting guidelines,literature search was conducted in March 2024 using the keywords of"interrupting,""sedentary,"and"vascular function"in the Web of Science Core Collection,PubMed,and China National Knowledge Infrastructure(CNKI)databases.Acute randomized crossover trials addressing the acute effects of interrupting sedentary behavior on peripheral and central vascular function in adults were included.Risk of Bias 2 developed by Cochrane was used to assess bias risk,and the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)system was used to evaluate the evidence level.The"meta"and"metaphor"packages in R(version 4.2.0)were used for main effect aggregation(Hedge's g acted as the effect size indicator),publication bias testing,subgroup analysis,and regression analysis.RESULTS:Twenty-two randomized crossover trials involving 364 subjects(aged 21 to 70 years)were included.Meta-analysis results showed that compared with prolonged sitting,interrupting sedentary behavior acutely improved peripheral vascular blood flow volume(Hedge's g=0.48,95%confidence interval:0.14-0.82,P<0.01,I2=63%,low evidence level),shear stress(Hedge's g=0.65,95%confidence interval:0.37-0.93],P<0.01,I2=54%,moderate evidence level),and flow-mediated dilation(Hedge's g=0.43,95%confidence interval:0.15-0.72,P<0.01,I2=61%,moderate evidence level).Disease had a significant moderating effect on the main effect aggregation for blood flow volume(P=0.01 between subgroups),while the mode(P=0.01 between subgroups)and frequency(P=0.02 between subgroups)of interruptions had significant moderating effects on shear stress.Improvements in peripheral vascular shear stress from interrupting sedentary behavior were affected by age(β=-0.02,95%confidence interval:-0.03-0.01,P=0.09)and body mass index(β=-0.10,95%confidence interval:-0.18 to-0.02,P<0.01).Improvements in flow-mediated dilation were influenced by the total number of interruptions(β=-0.09,95%confidence interval:-0.17 to-0.01,P=0.03)and the duration of sitting during the control period(β=-0.21,95%confidence interval:-0.34 to-0.09,P<0.01).Each additional hour of sitting was associated with a 0.67%reduction in the acute improvement effect of flow-mediated dilation from interrupting sedentary behavior(P<0.01),and acute benefits disappeared when sitting control time exceeded 6 hours.A qualitative systematic review found that interrupting sedentary behavior did not significantly affect pulse wave velocity in various populations but could effectively prevent central vascular function decline in older adults due to prolonged sitting.CONCLUSION:Interrupting sedentary behavior acutely improves peripheral vascular blood flow volume(low evidence level),shear stress(moderate evidence level),and flow-mediated dilation(moderate evidence level)in adults and may prevent or protect against central vascular function decline in older adults due to prolonged sitting(very low evidence level).Characteristics of subjects(disease factors,sex,age,and body mass index),interruption intervention schemes(mode,frequency,total number of interruptions),and duration of sitting control all influence the acute improvement effects of interrupting sedentary behavior on vascular function.It is recommended that adults interrupt sedentary behavior with exercises involving large muscle groups,such as stair climbing,at high frequencies(e.g.,once every 40 minutes)with at least 5 minutes of moderate-to low-intensity activity each time,and limit the cumulative duration of prolonged sitting to no more than 6 hours per day.

Objective:To explore the design requirements of nurses in the Neurointensive Care Unit (NICU) for the closed-eye pupil monitoring system, providing reference for the refinement and upgrade of the system.Methods:This study was descriptive and qualitative. From December 2024 to February 2025, 15 NICU nurses from Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, were selected using purposive sampling for semi-structured interviews. Content analysis method was used to analyze data and extract key themes.Results:NICU nurses' design requirements for closed-eye pupil monitoring system were categorized into six themes and 18 sub-themes, namely physical characteristics requirements (strong device stability, compact and lightweight design), comfort and safety requirements (wear comfort and safety, prevention of light source thermal injury, convenient disinfection and infection control, assisting eyelid closure), functional requirements (automated monitoring and data collection, intelligent alarm and alert mechanisms), operational requirements (ready-to-use, easy to wear, simple operation), data monitoring requirements (data storage and integrity, data visualization and timeliness, data analysis and prediction, system integration and data management), and extended functional requirements (consciousness state monitoring, fundus lesion examination, vision and visual field screening) .Conclusions:NICU nurses' design requirements for the closed-eye pupil monitoring system are multidimensional and multi-level. System developers should continuously optimize system design based on the actual needs of nurses.