Background: Gestational diabetes mellitus (GDM) is a metabolic disorder posing significant risks to maternal and infant health, with a lack of effective early screening markers. Therefore, identifying early screening biomarkers for GDM with higher sensitivity and specificity is urgently needed. Methods: High-throughput sequencing was employed to screen for key circular RNAs (circRNAs), which were then evaluated using reverse transcription quantitative polymerase chain reaction. Logistic regression analysis was conducted to examine the relationship between clinical characteristics, circRNA expression, and adverse pregnancy outcomes. The diagnostic accuracy of circRNAs for early and mid-pregnancy GDM was assessed using receiver operating characteristic curves. Pearson correlation analysis was utilized to explore the relationship between circRNA levels and oral glucose tolerance test results. A predictive model for early GDM was established using logistic regression. Results: Significant alterations in circRNA expression profiles were detected in GDM patients, with hsa_circ_0031560 and hsa_ circ_0000793 notably upregulated during the first and second trimesters. These circRNAs were associated with adverse pregnancy outcomes and effectively differentiated GDM patients, with second trimester cohorts achieving an area under the curve (AUC) of 0.836. In first trimester cohorts, these circRNAs identified potential GDM patients with AUCs of 0.832 and 0.765, respectively. The early GDM prediction model achieved an AUC of 0.904, validated in two independent cohorts. Conclusion Hsa_circ_0031560, hsa_circ_0000793, and the developed model serve as biomarkers for early prediction or midterm diagnosis of GDM, offering clinical tools for early GDM screening.

Objective:To explore how the teaching of ideological and political courses in colleges and universities can effectively guide online public opinion under the background of melted media,so as to cope with the challenges posed by diversified information transmission channels and complex and changeable online public opinion,thereby promoting the formation of correct values and ideological cognition among students.Methods:A total of 1 353 students who volunteered to participate in this survey in a university that offers courses related to online public opinion guidance were selected as the survey subjects.Multiple linear regression analysis was used to analyze how universities should teach students to deal with online hot topics through relevant ideological and political courses.Results:Results of multiple linear regression analysis indicated that the teaching of ideological and political courses in colleges and universities under the background of melted media significantly enhanced students'awareness of online public opinion,and the courses played a positive role in the guidance.The improvement of media literacy facilitated the formation of students'correct values and ideological cognition,effectively responding to the challenges of diversified information dissemination.Variables including the infringement of personal privacy by online public opinion,the enhancement of civic consciousness,the impact on learning,and the distortion of reality understanding all had an impact on students'perception of the teaching effect of ideological and political courses.Conclusions:The teaching of ideological and political courses in colleges and universities plays a significant role in guiding online public opinion under the background of melted media.By enhancing students'media literacy,discernment,and emotional management ability,it effectively promotes the formation of students'correct values and ideological ideological,and provides strong support for the healthy growth of students in the complex network environment.The important role of ideological and political teaching in cultivating students'comprehensive abilities and guiding them to correctly deal with online public opinion is emphasized.

Objective To explore the predictive value of maximum standardized uptake value(SUVmax)and mean standardized uptake value(SUVmean)parameters in 18F-prostate specific membrane antigen-1007 positron emission tomography/computed tomography(18F-PSMA-1007 PET/CT)for the diagnosis and disease progression of prostate cancer(PCa).Methods Eighty patients with suspected PCa who underwent 18F-PSMA-1007 PET/CT examination in the hospital were selected and divided into the PCa group(49 cases)and the non-PCa group(31 cases)according to the biopsy pathological results.The 18F-PSMA-1007 PET/CT parameters were collected in the two groups of patients at admission,including SUVmax and SUVmean.The prostate specific antigen(PSA)and prostate cancer histological grade(GLEASON)score were also collected in patients of the PCa group at admission and 3 months after admission.The diagnostic efficiency of 18F-PSMA-1007 PET/CT parameters on PCa was analyzed by receiver operating characteristic(ROC)curve.The correlation between 18F-PSMA-1007 PET/CT parameters of patients in the PCa group at admission and PSA,GLEASON score was analyzed by Pearson method.Results The SUVmax and SUVmean in the PCa group were higher than those in the non-PCa group(P＜0.05).ROC curve analysis showed that the areas under the curves(AUCs)of SUVmax and SUVmean were 0.887 and 0.843 respectively,the sensitivities were 80.65%and 83.87%,and the specificities were 87.76%and 73.47%respectively.The PSA and GLEASON score were lower 3 months after admission than those at admission in the PCa group(P＜0.05).Pearson correlation analysis showed that the SUVmax and SUVmean of patients in the PCa group at admission were positively correlated with PSA and GLEASON score at admission and 3 months after admission(P＜0.05).Conclusion SUVmax and SUVmean parameters of 18F-PSMA-1007 PET/CT have high predictive value for the diagnosis and disease progression of PCa.

Foot torsion stiffness refers to the foot's ability to resist deformation when subjected to torsional forces,and such characteristics play a crucial role in the prevention of sports injuries and design of athletic footwear.This review systematically summarizes the biomechanical research progress of foot torsion and shoe torsion,as well as the research and application of multi-segment foot models in foot-shoe torsion.The findings indicate that foot torsional stiffness significantly impacts lower limb kinematics,kinetics,and athletic performance.Optimizing this stiffness can improve stress distribution,reduce injury risk,and enhance performance.The future researches should focus on refining measurement techniques to enhance reliability and efficiency in clinical applications,providing a scientific foundation for sports injury prevention and footwear design.

The research on the cardiovascular toxicity of air pollutants is in urgent need of collaborative innovation across multiple models. This paper systematically reviewed the advantages and limitations of four principal research models of cardiotoxicity, including epidemiological model, mammalian model, zebrafish model, and in vitro model. Epidemiological models have been used to demonstrate a significant correlation between exposure to PM_2.5 and both the incidence and mortality of cardiovascular diseases within populations; however, these models face challenges in establishing causal inferences and interpreting individual mechanisms. Mammalian models have been applied to elucidate the pathogenic mechanisms of PM_2.5 at both the systemic and organ-specific levels, yet they encounter difficulties related to interspecies differences and throughput constraints. Zebrafish models, with their transparent embryos and observable development, offer a distinctive opportunity for high-throughput screening and mechanistic investigation of PM_2.5-induced cardiac developmental toxicity. Nonetheless, their cardiac physiological structure diverges from that of mammals, limiting their capacity to accurately model chronic conditions such as coronary heart disease. In vitro models, particularly human heart organoids and chip technologies, have provided profound insights into the direct toxic mechanisms of PM_2.5, including disruptions in calcium homeostasis, cellular senescence, and electrophysiological irregularities at the cellular and molecular levels. Despite these advancements, the complexity and developmental maturity of these models present challenges to their broader application. This paper proposed that the key to overcoming the bottlenecks of single models lies in the construction of an integrated evaluation system that combines “epidemiological studies, mammalian models, zebrafish models, and in vitro models”. By focusing on three aspects, namely model integration, technological convergence, and policy support, it is intended to collaboratively address issues such as standardization of multi-model data, simulation of complex exposure scenarios and susceptible life stages, and transformation pathways. This will provide innovative methodological support for the analysis of the cardiotoxic mechanisms of air pollutants, the assessment of environmental health impacts, and the formulation of precise prevention and control strategies.

To analyze the impact of salt reduction interventions on the knowledge, attitude and behavior regarding the salt reduction of students′ parents based on the home-school interaction model. In April 2021, parents of students in grades 3-5 from three primary schools in Yichang City were selected as the target population using a cluster sampling method, and the parent population was divided into an intervention group and a control group. In the intervention group, a comprehensive home-school interaction salt reduction intervention was implemented, and in the control group, no intervention measures were taken for students′ parents. Baseline and final surveys were conducted before and after the intervention period, which included general information, previous salt reduction interventions received, and salt reduction knowledge, attitude and behavior. Difference-in-difference (DID) method was used to compare the knowledge, attitude and behavior status of two groups before and after the intervention, and stratified analysis of parents with different literacy levels was conducted to assess the net effect of intervention implementation. The results showed that 740 parents completed the baseline and final surveys, with 231 in the intervention group and 509 in the control group. After propensity score matching, there were 231 (33.33%) in the intervention group and 462 (66.67%) in the control group. After the intervention, the proportion of the intervention group who obtained salt control spoons and pots, as well as salt reduction knowledge and advice through school, was 87.45%, 86.58% and 75.45%, respectively, which was significantly higher than that in the control group ( P<0.05). After the intervention, the proportion of parents with a high school and lower education who obtained salt control pots was higher in the intervention group (89.23%) than in the control group (74.49%), with significant differences ( P<0.05). The proportion of parents with a college degree or above who obtained salt control spoons and pots, as well as salt reduction knowledge and advice through school, was higher than that of the control group ( P<0.05). The results of DID method showed that after controlling for monthly income and other factors, the scores of parents′ salt reduction-related knowledge and low-salt behavior in the intervention group increased significantly higher than those in the control group, with DID values (95% CI) of 1.18 (0.15-2.21) and 0.62 (0.16-1.09), respectively, indicating a significant net effect of intervention implication. After stratification according to the education level of parents, this difference still existed in the college degree or above group, with DID values (95% CI) of 1.39 (0.13-2.66) and 0.76 (0.16-1.36), respectively. The home-school interaction model for salt reduction measures can improve the salt-related knowledge and low-salt behavioral choices of students′ parents.

Objective:This study aims to construct a quality evaluation index system for specialized disease databases. Through systematic assessment and optimization, it seeks to comprehensively enhance the quality and standardization of specialized disease cohort data. This initiative will provide more precise and reliable data support for disease research, the development of innovative drugs and medical devices, as well as policy formulation.Methods:By conducting a thorough analysis of domestic and international literature and policies related to clinical research data quality evaluation systems, preliminary quality evaluation indicators for specialized disease databases were established. Utilizing the Delphi method in two rounds, a quality evaluation system for specialized disease databases was constructed. The Analytic Hierarchy Process (AHP) and YAAHP 7.5 software were then employed to calculate the relative weights of indicators at various levels and their composite weights.Results:The two rounds of expert consultation achieved a 100.00% valid response rate, with an expert authority coefficient of 0.81 in both rounds. In the second round, the Kendall′s coordination coefficients for the first-level and second-level indicators reached 0.311 and 0.218, respectively ( P<0.05), indicating a good level of consensus among experts. The final specialized disease database quality evaluation system consists of 3 first-level indicators, 10 second-level indicators, and 32 third-level indicators. The first-level indicators include database construction, data quality, and cohort development, with weight coefficients of 31.82%, 41.49%, and 26.69%, respectively. The scientific validity of the indicator system was confirmed through reliability and validity analyses. When applied to assessing 58 specialized disease database projects from 36 medical institutions in a certain city, the results showed significant improvements in scores for database construction, data quality, and cohort development, with the most notable improvement observed in database construction. Conclusions:This study successfully developed a scientific, practical, and rationally weighted quality evaluation system for specialized disease databases, demonstrating high expert consensus and broad applicability.Validation studies have shown that this system effectively enhances the standardization and data quality of databases, providing robust technical support and assurance for specialized disease research and data resource sharing.

Objective:To prepare novel targeted lipid nanobubbles（MEB-NBs）that can be loaded with exosomes（Exo），and test the property and explore the specific invitro target-seeking ability of MEB-NBs. Methods:The core lipid nanobubbles（NBs）were prepared using mechanical oscillation methods，and Exo was connected to the NBs through membrane fusion. The target antibody MYH6 was linked to the NBs using a phospholipid coupling covalent method，resulting in the preparation of targeted lipid nanobubbles MEB-NBs loaded with Exo. The morphology，particle size，and surface potential of the prepared lipid nanobubbles MEB-NBs were observed，and the co-loading of Exo and NBs was verified using laser confocal and fluorescence resonance energy transfer techniques. The in vitro imaging capability and biosafety of MEB-NBs were evaluated，and the loading rate and drug content of Exo carried by MEB-NBs were measured. The ability of MEB-NBs to specifically target hiPSC-CMs cells was observed using flow cytometry，small animal in vivo imaging systems，and laser confocal microscopy. Results:The average particle size of the prepared MEB-NBs was（597.10 ± 47.70）nm，the surface potential was（-11.70 ± 0.21）mV，and the concentration was（2.43 ± 0.06）×10 7/ml. Laser confocal microscopy and FRET results confirmed that the Exo was effectively connected with the NBs；When the Exo concentration was 250 μg/ml，the Exo loading rate and drug loading of MEB-NBs were both 73.8%，and the results of laser confocal microscopy showed that MEB-NBs could be effectively targeted to hiPSC-CMs cells. MEB-NBs were well developed in vitro and had good biological safety. Conclusions:This study constructs novel Exo-loaded targeted lipid nanobubbles（MEB-NBs）that demonstrate stable physicochemical properties and ultrasound imaging capabilities. The developed MEB-NBs precisely target hiPSC-CMs cells，providing an innovative drug delivery system with enhanced therapeutic efficacy for Exo-based therapies.

Objective:To investigate the clinical effect of the divisional design in composite labia minora and clitoral hood reduction.Methods:A retrospective analysis was performed on 57 patients diagnosed with labia minora and clitoral hood hypertrophy at Department of Plastic Surgery, Nanjing Medical University Friendship Plastic Surgery Hospital between July 2018 and May 2021. The ages of the patients ranged from 24 to 45 years with an average of (31.0±8.2) years. Preoperative symptoms and surgical demands included: appearance concerns in 57 cases (100%), irritation during friction in 49 cases (86.0%), and discomfort during intercourse in 22 cases (38.6%). The complex hypertrophy was divided into simple labia minora hypertrophy and clitoral hood hypertrophy. Then the reduction of clitoris hood was performed according to the prepuce morphology, and labiaplasty was performed using edge resection. The operative effects, patient satisfaction, and postoperative complications were assessed.Results:All incisions healed primarily with no flap necrosis or marginal infections. Hematoma occurred in 1 case which recovered well after timely treatment. All patients were followed up for 3-12 months. 54 cases were satisfied with the labia minora and clitoral hood shape and reported no sensory abnormality. Bilateral asymmetry occurred in 2 cases, one of which required further surgical repair. Scar hyperplasia occurred and was gradually softened after 6 months in 1 case. Of the 57 patients with appearance concerns, 55 (96.5%) patients reported improved appearance postoperatively. Of the 49 patients with preoperative friction discomfort, 47 (95.9%) patients achieved symptom relief. Of the 22 patients reporting sexual discomfort, 15 (68.1%) patients noted enhanced sexual satisfaction postoperatively. Overall, 54 (94.7%) patients were satisfied, 2 (3.5%) patients were moderately satisfied, and 1 (1.8%) patient was unsatisfied.Conclusions:For patients with labia minora and clitoral hood hypertrophy, the application of divisional design is surgically simple and safe. It achieves satisfactory outcomes with no severe adverse reactions.

Objective:To explore the clinical effects of sequential treatment of extensive skin and soft tissue injuries of the lower leg accompanied by large segmental tibial defects by free transplantation of anterolateral thigh perforator flap combined with bone transport.Methods:This study was a retrospective observational study. From April 2020 to January 2024, 8 patients with extensive skin and soft tissue injuries of the lower leg accompanied by large segmental tibial defects who met the inclusion criteria were admitted to Beijing Dawanglu Emergency Rescue Hospital. Among them, there were 6 males and 2 females, aged 17 to 58 years. After debridement, the area was 17 cm×8 cm to 30 cm×12 cm, and the length of tibial defect was 9 to 12 cm. Stage Ⅰ surgery was performed by free transplantation of anterolateral thigh perforator flap to repair the extensive skin and soft tissue injuries of the lower leg and using autologous skin graft from the thigh to repair the remaining wound. Stage Ⅱ surgery was performed after wound healing, the external fixation bracket was removed and replaced with an Orthofix unilateral external fixation lengthening frame (hereinafter referred to as external fixation lengthening frame) to transport the proximal tibial osteotomy for repairing the large segmental bone defects. The intraoperative arteriovenous anastomosis and the blood supply of the flap during stage Ⅰ surgery were documented, along with the survival status of the flap/skin graft in the donor and recipient areas postoperatively, and the wound healing time in the recipient area. The time required for bone transport completion, the duration of external fixation retention, and the occurrence of complications during this period were recorded after stage Ⅱ surgery. During follow-up, the occurrence of adverse events in the recipient area was recorded. At the final follow-up, fracture healing of the affected limb was evaluated according to the Paley score, and limb function was observed.Results:In 2 patients, the descending branch of the lateral circumflex femoral artery and the accompanying vein were end-to-end anastomosed with the proximal anterior tibial or posterior tibial artery and vein for antegrade blood supply and antegrade reflux; in 2 patients, the descending branch of the lateral circumflex femoral artery was end-to-end anastomosed with the distal anterior tibial artery for retrograde blood supply, and the accompanying vein of the descending branch of the lateral circumflex femoral artery was end-to-end anastomosed with the proximal anterior tibial vein for antegrade reflux; in 3 patients, the descending branch of the lateral circumflex femoral artery was end-to-end anastomosed with the distal posterior tibial artery for retrograde blood supply, and the accompanying vein of the descending branch of the lateral circumflex femoral artery was end-to-end anastomosed with the distal posterior tibial vein for retrograde reflux; one patient underwent repair of the injury in the affected lower leg using a free cross-leg vascular pedicle flap from the healthy limb. The flaps/skin grafts in the donor and recipient areas of all 8 patients survived, and the wound healing time in recipient area was 14 to 30 days. The bone transport duration of the patients in this group was 93 to 125 days, and the external fixation lengthening frame was continuously retained for 7 to 14 months after the bone transport was stopped; during the bone transport period, 1 patient had pin tract infection, which was controlled after dressing change and enhanced nursing. During the follow-up, there was no ulceration of the wound surface in recipient area, and no osteomyelitis or fracture developed in the affected limb. At the last follow-up, the bone healing evaluation was all excellent; the walking posture and function of the affected limb were basically normal.Conclusions:The application of free transplantation of anterolateral thigh perforator flap combined with bone transport in the sequential treatment of extensive skin and soft tissue injuries of the lower leg accompanied by large segmental tibial defecst can achieve wound healing and functional reconstruction of bone defects, and has great clinical application value.