Objective To investigate the effect of remote ischemic postconditioning （RIPostC） on the serum levels of matrix metallopeptidase-9 （MMP-9）， hypoxia-inducible factor 1α （HIF-1α）， and interleukin-1β （IL-1β） in patients with acute ischemic stroke （AIS）， and to further clarify the mechanism and clinical significance of RIPostC in the treatment of AIS. Methods A total of 115 AIS patients who were admitted to Suzhou First People’s Hospital from May 2024 to February 2025 were enrolled， among whom 60 patients receiving conventional treatment were enrolled as control group， and 55 patients receiving RIPostC combined with conventional treatment for 7 consecutive days were enrolled as experimental group. ELISA was used to measure the serum levels of MMP-9， HIF-1α， and IL-1β， and National Institutes of Health Stroke Scale （NIHSS） was used to assess neurological function. Results After treatment， the experimental group had a significant increase in the level of HIF-1α （P<0.001） and significant reductions in the levels of MMP-9 and IL-1β （P<0.001）. The experimental group had a significantly better NIHSS score than the control group （P<0.001）. The increase in the serum level of HIF-1α could promote neurological function recovery. Conclusion RIPostC combined with conventional treatment can promote early neurological recovery in AIS patients， possibly by regulating the HIF-1α signaling pathway.

ObjectiveTo explore the effects of "dryness pathogen" on a bronchial asthma rat model from the perspective of the prostaglandin D₂ （PGD₂）/eosinophil （EOS） axis. MethodsForty SD rats were randomly divided into five groups， blank group， asthma group， mild dryness asthma group， moderate dryness asthma group， and severe dryness asthma group， with 8 rats in each group. The asthma model was induced in the asthma group using ovalbumin （OVA）， while the asthma-dryness syndrome groups were modeled using a climate chamber combined with OVA to establish animal models of bronchial asthma with Northwest dryness syndrome. During modeling， general behavioral performance of the rats in each group was observed and recorded， and body weight， water intake， and asthma symptom scores were compared. On day 21 of the modeling， small animal respiratory system testing was used to measure respiratory rate and intermittent respiratory contraction index. Pathological changes in rat lung tissues were observed using HE staining. Giemsa staining was used to observe eosinophil （EOS） infiltration in lung tissues and calculate EOS counts. ELISA was used to detect serum levels of prostaglandin D₂ （PGD₂）， interleukin-5 （IL-5）， and interleukin-4 （IL-4）. Western Blot was used to detect eosinophil peroxidase （EPX） and prostaglandin D₂ receptor （CRTH2） protein levels in rat lung tissues. ResultsCompared to the blank group， the average water intake of rats in all asthma-dryness groups increased （P＜0.01）. The body weight of rats decreased in the moderate and severe asthma-dryness groups on day 14， and in all modelling groups on day 21 （P＜0.05 or P＜0.01）. Across all model groups， the asthma symptom score， respiratory rate， intermittent respiratory contraction index， EOS count in lung tissue， serum levels of PGD₂， IL-5， and IL-4， as well as the relative protein expression levels of EPX and CRTH2 in lung tissue all significantly increased （P＜0.01）. Compared to the asthma group， the water intake of rats in the mild， moderate， and severe asthma-dryness groups increased （P＜0.01）. On day 21 of the experiment， the body weight of rats in the moderate and severe asthma-dryness groups decreased （P＜0.05）， and the respiratory rate of rats in all asthma-dryness groups increased， as well as the serum levels of PGD₂， IL-5， and IL-4， and the relative protein expression levels of EPX and CRTH2 in lung tissues （P＜0.05 or P＜0.01）. Furthermore， in the moderate and severe asthma-dryness groups， the asthma symptom scores and intermittent respiratory contraction indices were elevated， and the EOS counts in lung tissue increased （P＜0.05 or P＜0.01）. Compared to the mild asthma-dryness group， serum levels of PGD₂， IL-5， and IL-4 in the severe asthma-dryness group increased， as well as the relative protein expression levels of EPX and CRTH2 in lung tissue （P＜0.05 or P＜0.01）. Pathological observation showed that rats in all asthma-dryness syndrome groups exhibited increased inflammatory infiltration in the lung tissue， alveolar wall thickening， luminal narrowing， pulmonary interstitial congestion， and aggravated viscous secretions. These pathological manifestations worsened as the degree of dryness increased. ConclusionThe "dryness pathogenic factor" can exacerbate bronchial asthma symptoms and lung tissue pathological damage through the PGD₂/EOS axis， and the damage progressively worsens with the increasing severity of the dryness pathogen.

Objective:To evaluate the relationship between intraoperative mechanical power and postoperative pulmonary complications in patients undergoing long-duration neurosurgery.Methods:This was a case-control study. Based on the duration of mechanical ventilation>8 h, the clinical data(baseline characteristics, intraoperative information and hospitalization) of patients underwent first elective craniotomy under general anesthesia at Tianjin Huanhu Hospital from January 1, 2019 to December 31, 2021 were retrospectively collected. The patients were divided into pulmonary complication group (group P) and non-pulmonary complication group (group N) based on the occurrence of postoperative pulmonary complications. Ventilation-related risk factors for postoperative pulmonary complications were identified by the multivariate logistic regression analysis, and the accuracy of intraoperative tidal volume, peak airway pressure, respiratory rate and mechanical power in predicting postoperative pulmonary complications was assessed using the receiver operating characteristic curve.Results:A total of 555 patients were finally included, with 247 patients in group P and 308 patients in group N. The duration of mechanical ventilation, tidal volume, peak airway pressure, respiratory rate, mechanical power, length of hospitalization and mortality during hospitalization were significantly higher in group P than in group N ( P<0.05). The results of multivariate logistic regression analysis showed that intraoperative peak airway pressure, respiratory rate and mechanical power were risk factors for postoperative pulmonary complications ( P<0.05). The area under the receiver operating characteristic curve (95% confidence interval) of intraoperative peak airway pressure, respiratory rate and mechanical power in predicting postoperative pulmonary complications was 0.726(0.572-0.666), 0.619(0.684-0.768) and 0.958(0.942-0.974)respectively. Conclusions:Intraoperative mechanical power is an independent risk factor for postoperative pulmonary complications and an important ventilation parameter for predicting postoperative pulmonary complications in patients undergoing long-duration neurosurgery.

Objective:To analyze the trend of the health literacy level of Chinese residents from 2012 to 2023 and predict the health literacy level from 2024 to 2027.Methods:The study collected data on the health literacy surveillance of Chinese residents from 2012 to 2023. The Joinpoint regression model was used to calculate the average annual percent change (AAPC) and analyze the trend. The interrupted time series analysis with Prais-Winsten transformed generalized least squares estimation was employed to investigate the impact of the"Healthy China 2030" policy on residents′ health literacy levels. Joinpoint regression, autoregressive integrated moving average model and grey forecasting models were established to select the optimal model for forecasting health literacy levels from 2024 to 2027.Results:The results showed that the health literacy level of Chinese residents increased from 8.80% in 2012 to 29.70% in 2023 (AAPC=11.65%, P<0.05). The health literacy level of urban and rural residents increased from 11.79% and 7.13% in 2012 to 33.25% and 26.23% in 2023, respectively (AAPC=9.57% and 12.60%, both P<0.05). Rural (1.59% per year) saw a lower average annual increase than urban (1.79% per year), widening the urban-rural health literacy gap. All aspects of health literacy, including basic knowledge and concepts, healthy lifestyles and behaviors, and health skills, showed an upward trend. The literacy level of six health issues—safety and first aid, scientific health views, health information, infectious disease prevention, chronic disease prevention, and basic medical care—also exhibited rising trends. Interrupted time series analysis indicated a significant further increase in the health literacy level of Chinese residents after the implementation of the "Healthy China 2030" policy, with the growth rate increasing from 0.615% per year before implementation to 2.655% per year afterwards. The Joinpoint regression model showed superior predictive performance compared to autoregressive integrated moving average model and grey forecasting models. The prediction results suggested a continued upward trend in the health literacy level from 2024 to 2027, reaching 32.68%, 35.62%, 38.84%, and 42.34%, respectively. Conclusion:From 2012 to 2023, the overall and various aspects of health literacy among Chinese residents show a continuous upward trend. This study predicts that the level of residents′ health literacy will continue to rise by 2027.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Diabetes mellitus(DM)is a systemic endocrine disease associated with a disorder or defi-ciency of glucose metabolism caused by the obstruction or lack of insulin resistance.Conventional drugs for the treatment of DM have limited efficacy for its complications,and there are many drugs side effects,so it is urgent to find innovative and efficient treatment methods.Mesenchymal stem cells(MSCs)have multiple dif-ferentiation potentials,can reduce insulin resistance,promote microvascular repair,improve oxidative stress and inhibit fibrosis,and can also regulate the immune microenvironment in the body.They can also be trans-ferred to the spleen to regulate the immune microenvironment in vivo and transplant healthy mitochondria to restore the function of damaged cells,among other properties,which hold great promise for the treatment of DM complications.This article briefly reviews the current treatment and pathophysiological mechanisms of MSCs on various complications caused by DM,which is expected to provide a reference and theoretical basis for the clinical treatment of DM in the future.

Ferroptosis has been shown to mediate the development of fibrosis. Polyphyllin VII (PP7), a bioactive component of Paris polyphylla, exhibits potent anti-inflammatory activity and can significantly alleviate liver fibrosis. In this study, treatment with PP7 significantly inhibited the proliferation and activation of hepatic stellate cells (HSCs), which could be suppressed by a ferroptosis inhibitor. In addition, it promoted HSC ferroptosis by suppressing glutathione (GSH) peroxidase 4 (GPX4) and enhanced the expression of CX3C chemokine ligand 1 (CX3CL1). Depletion of CX3CL1 attenuated the effects of PP7 on the activation and ferroptosis of HSCs and the expression of GPX4. Notably, CX3CL1 directly interacted with GPX4, triggering HSC ferroptosis. The transcription factor hypermethylated in cancer 1 (Hic1), which binds to the Cx3cl1 promoter, increased the expression of CX3CL1. Its absence resulted in downregulation of CX3CL1, suppressing the GPX4-dependent ferroptosis of PP7-treated HSCs and promoting their activation. HIC1 was found to directly interact with PP7 at the GLY164 site. Co-culture experiments showed that PP7-induced HSC ferroptosis attenuated macrophage recruitment by regulating inflammation-related genes. HSC-specific inhibition of HIC1 counteracted PP7-induced collagen depletion and HSC ferroptosis in vivo. These findings suggest that PP7 induces HSC ferroptosis through the HIC1/CX3CL1/GPX4 axis.

Objective To study the role of photobiomodulation(PBM)in promoting the repair of spinal cord injury(SCI)by regulating microglial cells.Methods Forty-five C57BL/6J mice were randomly divided into the sham operation(Sham)group,surgery(SCI)group and the treatment(SCI+PBM)group,with 15 mice in each.After laminectomy of the T10 vertebral body in the three groups of mice,the SCI group and the SCI+PBM group were used to construct the model of spinal cord hemisection.The SCI+PBM group received immediate PBM treatment after spinal cord injury,while the other two groups did not.On the 1st,3rd,7th,14th,21st and 28th days(D1,D3,D7,D14,D21,D28)after the operation,the Basso Mouse Scale(BMS)was used to assess the recovery of the hind limb motor function of the mice.On the 28th day post operatively,immunofluorescence was used to detect the changes of neurons in the areas of injury in the three groups of mice.Quantitative real-time PCR and Western blotting experiments were used to detect the phenotypic changes of BV2 cells under the interventions of PBM with inflammatory stimulation.Western blotting experiments were conducted to detect the effects of PBM on the nuclear factor kappa-B(NF-κB)pathway.Results On the 28th day after the operation,the results of the mouse motor assessment showed that the BMS scores and related behaviors of the mice in the SCI+PBM group were better than those of the mice in the SCI group(P＜0.05),and the neurons in the SCI+PBM group far outnumbered those in the SCI group(P＜0.05).The results of quantitative real-time PCR and Western blotting experiments showed that on the 14th day after the operation,PBM promoted the activation of M2-type microglial cells in vivo but inhibited the activation of M1-type microglial cells.In vitro experiments confirmed that PBM could promote the polarization of BV2 cells towards M2-type microglial cells.In addition,PBM inhibited the activation of the NF-κB pathway in injured spinal cords and in activated BV2 cells.Conclusion PBM can promote the repair of spinal cord injury in SCI mice by promoting microglial cells through inhibiting the NF-κB pathway.

Ferroptosis has been shown to mediate the development of fibrosis.Polyphyllin Ⅶ(PP7),a bioactive component of Paris polyphylla,exhibits potent anti-inflammatory activity and can significantly alleviate liver fibrosis.In this study,treatment with PP7 significantly inhibited the proliferation and activation of hepatic stellate cells(HSCs),which could be suppressed by a ferroptosis inhibitor.In addition,it promoted HSC ferroptosis by suppressing glutathione(GSH)peroxidase 4(GPX4)and enhanced the expression of CX3C chemokine ligand 1(CX3CL1).Depletion of CX3CL1 attenuated the effects of PP7 on the activation and ferroptosis of HSCs and the expression of GPX4.Notably,CX3CL1 directly interacted with GPX4,triggering HSC ferroptosis.The transcription factor hypermethylated in cancer 1(Hic1),which binds to the Cx3cl1 promoter,increased the expression of CX3CL1.Its absence resulted in downregulation of CX3CL1,sup-pressing the GPX4-dependent ferroptosis of PP7-treated HSCs and promoting their activation.HIC1 was found to directly interact with PP7 at the GLY164 site.Co-culture experiments showed that PP7-induced HSC ferroptosis attenuated macrophage recruitment by regulating inflammation-related genes.HSC-specific inhibition of HIC1 counteracted PP7-induced collagen depletion and HSC ferroptosis in vivo.These findings suggest that PP7 induces HSC ferroptosis through the HIC1/CX3CL1/GPX4 axis.

Background The power industry is characterized by typical shift work systems, with 24-hour uninterrupted work demands, high intensity and high standard job characteristics, as well as emergent task pressure, which exposes employees to the long-term dual pressure of shift work and occupational stress and may lead to occupational burnout. It not only endangers the physical and mental health of employees, but also threaten the safe and stable operation of the power system. Objective To explore the impact of shift work and occupational stress, as well as their potential interaction, on occupational burnout among employees in power enterprises. Methods From November 2024 to April 2025, cluster sampling was used to select 1378 workers from two power companies in Fuzhou. A self-designed questionnaire, the Effort-Reward Imbalance model, and the Maslach Burnout Inventory were used to investigate the participants’ general information，shift work patterns, occupational stress, and occupational burnout. Statistical analysis was conducted using SPSS 19.0 software. Chi-square test was employed for intergroup comparison. Logistic regression was used to examine the associations between shift work, occupational stress, and job burnout. The multiplicative interaction and additive interaction between shift work and occupational stress on occupational burnout were evaluated. Results A total of 1378 questionnaires were distributed, and 1113 were valid questionnaires, with an effective rate of 80.77%. Among the participants, 37.92% were engaged in shift work, the positive rate of occupational stress was 29.83%, and the positive rate of occupational burnout was 55.80%. The logistic regression analysis showed that after adjusting for confounding factors, the risks of occupational burnout in the non-shift x occupational stress group and the shift x occupational stress group were 1.59 times (95%CI: 1.12, 2.27; P=0.01) and 4.07 times (95%CI: 2.56, 6.45; P<0.01) higher than that in the non-shift x non-occupational stress group. A multiplicative interaction (shift work and occupational stress b=0.75, P=0.01, OR=2.12, 95%CI: 1.18, 3.80) and an additive interaction (relative excess risk ratio=2.24, 95%CI: 0.54, 3.94; attributable fraction=0.55, 95%CI: 0.32, 0.78; interaction index=3.71, 95%CI: 1.47, 9.40) between shift work and occupational stress on job burnout were identified. Conclusion Shift work and occupational stress are risk factors for occupational burnout among employees in power enterprises, and there is a synergistic interaction between these two factors in terms of their impact on occupational burnout.