The European Society of Cardiology (ESC) released the "2024 ESC guidelines for the management of elevated blood pressure and hypertension" on August 30, 2024. This guideline updates the 2018 "Guidelines for the management of arterial hypertension." One notable update is the introduction of the concept of "elevated blood pressure" (120-139/70-89 mm Hg). Additionally, a new systolic blood pressure target range of 120-129 mm Hg has been proposed for most patients receiving antihypertensive treatment. The guideline also includes numerous additions or revisions in areas such as non-pharmacological interventions and device-based treatments for hypertension. This article interprets the guideline's recommendations on definition and classification of elevated blood pressure and hypertension, and cardiovascular disease risk assessment, diagnosing hypertension and investigating underlying causes, preventing and treating elevated blood pressure and hypertension. We provide a comparison interpretation with the 2018 "Guidelines for the management of arterial hypertension" and the "2017 ACC/AHA guideline on the prevention, detection, evaluation, and management of high blood pressure in adults."

Objective: To analyze the burden of bipolar disorder among adolescents aged 10-24 in China from 1990 to 2021 and its trend of change, so as to provide theoretical basis for the prevention and treatment of bipolar disorder. Methods: The latest data from the Global Burden of Disease (GBD) database in 2021 were selected. The Joinpoint regression model, age-period-cohort (APC) model, and bayesian age-period-cohort (BAPC) model were used to analyze and predict indicators such as the age standardized incidence rate and age standardized disability adjusted life year (DALY) rate of bipolar disorder among Chinese adolescents, and the average annual percent change (AAPC) was calculated. Results: From 1990 to 2021, the overall age standardized incidence rate (1990:22.92/100 000, 2021:23.17/100 000) showed an upward trend ( AAPC=0.03, t=8.20, P <0.01) and change trend of age standardized DALY rate (1990:33.61/100 000, 2021:33.76/100 000) was relatively flat ( AAPC=0.01, t= 0.99 , P =0.32). From 1990 to 2021, age standardized incidence rate and age standardized DALY rate of girls were higher than boys ( χ 2=16.38, P <0.01). The net drift values for the incidence rate and DALY rate of bipolar disorder among Chinese adolescents aged 10-24 years were -0.23% and -0.22%, respectively. The highest incidence rate of bipolar disorder among Chinese adolescents aged 10-24 years was observed in the 15-19 age group, with a rate of 33.14/100 000; the highest DALY risk was in the 20- 24 age group, with a rate of 57.26/100 000. The lowest incidence risk and DALY risk RR values for bipolar disorder among Chinese adolescents aged 10-24 years were observed in 2017-2021, with RR values of 0.99 (95% CI =0.97-1.00) and 0.98 (95% CI = 0.97- 0.99), respectively ( P <0.05). Similarly, the lowest incidence risk and DALY risk RR values for this age group were observed in the 2000-2004 birth cohort, both of which were 0.86 (95% CI =0.84-0.87) ( P <0.05). It was projected that the overall age standardized incidence rate and age standardized DALY rate of bipolar disorder among Chinese adolescents aged 10-24 years will continue to increase from 2022 to 2031, reaching 24.10/100 000 and 34.90/100 000, respectively, by 2031. Conclusions From 1990 to 2021, both the age standardized incidence rate and age standardized DALY rate of bipolar disorder among Chinese adolescents shows an upward trend. Special attention should be given to female adolescents, with a focus on controlling the age standardized incidence rate of bipolar disorder among 15-19 year-old adolescents and the age standardized DALY rate among 20-24 year-old ones. Efforts should be enhanced to increase awareness and screening for bipolar disorder among adolescents.

With the widespread use of antibiotics, drug-resistant bacterial infections have become a significant threat to human health. Finding new antibacterial strategies that can effectively control drug-resistant bacterial infections has become an urgent task. Unlike small molecule drugs that target bacterial proteins, antisense oligonucleotide (ASO) can target genes related to bacterial resistance, pathogenesis, growth, reproduction and biofilm formation. By regulating the expression of these genes, ASO can inhibit or kill bacteria, providing a novel approach for the development of antibacterial drugs. To overcome the challenge of delivering antisense oligonucleotide into bacterial cells, various drug delivery systems have been applied in this field, including cell-penetrating peptides, lipid nanoparticles and inorganic nanoparticles, which have injected new momentum into the development of antisense oligonucleotide in the antibacterial realm. This review summarizes the current development of small nucleic acid drugs, the antibacterial mechanisms, targets, sequences and delivery vectors of antisense oligonucleotide, providing a reference for the research and development of antisense oligonucleotide in the treatment of bacterial infections.

Objective: To explore the causal link of cumulative ecological risk and future orientation with health risk behaviors among higher vocational college students, so as to provide reference for reducing and preventing health risk behaviors among higher vocational college students. Methods: A longitudinal follow up study was conducted on 612 students using convenience sampling from 2 vocational colleges in Hunan Province. The Cumulative Ecological Risk Scale, Future Orientation Scale, and Health Risk Behavior Scale were used during three follow up visits (T1: September 2022, T2: June 2023, T3: March 2024), and a cross lagged panel model was constructed to examine the longitudinal causal relationship of cumulative ecological risk, future orientation and health risk behaviors. Analysis of longitudinal intermediary effect between variables by Bootstrap. Results: The cumulative ecological risk scores of T1, T2 and T3 among higher vocational college students were (2.94±1.44,2.99±1.63,3.02±1.54), future orientation scores (40.49±4.71,41.51±5.72,41.06±4.35) and health risk behavior scores (3.73±2.01,3.49±2.00,3.23±2.00). The results of repeated measures ANOVA showed that the future orientation score of T2 was higher than that of T1, and the main effect of measurement time was statistically significant ( F=5.09，P＜0.01,η 2=0.02). The health risk behavior score of T1 was higher than that of T2, and the health risk behavior score of T2 was higher than that of T3, and the main effect of measurement time was statistically significant ( F=10.12，P＜0.01,η 2=0.03).The cross lagged model showed good adaptability, with χ 2/df =7.20 ( P <0.01), relative fitting indicators GFI=0.98, CFI=0.99, TLI=0.96, IFI=0.99, NFI =0.99, and absolute fitting indicator RMSEA =0.06. Among them, the T1, T2 cumulative ecological risk showed negatively predictive effects on T2, T3 future orientation ( β =-0.24, -0.47 ), and T1, T2 cumulative ecological risk positively predicted T2, T3 health risk behavior ( β =0.20, 0.24), while T1, T2 future orientation negatively predicted T2, T3 health risk behavior ( β =-0.25, -0.18) ( P ＜0.01). Bootstrap test analysis found that T2 future orientation had a longitudinal mediating effect ( β=0.04, P ＜0.01) on the T1 cumulative ecological risk and T3 health risk behavior. Conclusions The accumulation of ecological risk among higher vocational college students can positively predict health risk behaviors, while future orientation can negatively predict healthrisk behaviors. Moreover, future orientation plays a longitudinal mediating role between accumulated ecological risks and health risk behaviors.

To guide transfusion practice in critically ill children who often need plasma and platelet transfusions, the Transfusion and Anemia Expertise Initiative-Control/Avoidance of Bleeding (TAXI-CAB) developed Recommendations and Expert Consensus for Plasma and Platelet Transfusion Practice in Critically Ill Children. This guideline addresses 53 recommendations related to plasma and platelet transfusion in critically ill children with 8 kinds of diseases, laboratory testing, selection/treatment of plasma and platelet components, and research priorities. This paper introduces the specific methods and results of the recommendation formation of the guideline.

Background Pneumoconiosis is a prevalent and severely harmful occupational disease in China. Objective To estimate disease burden and trends of different types of pneumoconiosis among Chinese males from 1992 to 2021, and to provide insights for pneumoconiosis prevention and control as well as the development of public health policies in China. Methods Based on the latest data from the Global Burden of Disease (GBD) study (2021), this study evaluated the disease burden of pneumoconiosis among Chinese males using indicators such as mortality rate and disability-adjusted life years (DALYs). Joinpoint regression model and age-period-cohort model were applied to analyze trends in the mortality rates of pneumoconiosis among Chinese males. Results From 1992 to 2021, the age-standardized DALYs rate, age-standardized years of life lost (YLLs) rate, age-standardized years lived with disability (YLDs) rate, and age-standardized mortality rate of pneumoconiosis among Chinese men all showed a downward trend, with average annual percentage changes (AAPC) of −2.63%, −2.81%, −0.87%, and −2.56%, respectively (P<0.05). Among the four types of pneumoconiosis, the disease burden of silicosis was the highest. The age-standardized mortality rates for silicosis, asbestosis, coal worker’s pneumoconiosis, and other types of pneumoconiosis had AAPC of −2.18%, −1.24%, −3.81%, and −3.21% (P<0.05), respectively. The age effects showed mortality rates for all types increased with age, particularly in silicosis and coal worker’s pneumoconiosis. The period effects showed a general decline in mortality risk, though silicosis remained significantly higher than other types. The cohort effects indicated that later birth cohorts had progressively lower mortality risks. Conclusion From 1992 to 2021, the burden of pneumoconiosis among Chinese males has shownsome alleviation; however, pneumoconiosis remains China’s most severe occupational disease. Given that males are the primary affected group in both incidence and mortality, continued attention and targeted preventive measures are essential. Effective control strategies should be tailored to address the specific characteristics of each type of pneumoconiosis.

Objective To investigate the effects of rhynchophylline on methamphetamine-dependent SH-SY5Y cells model and microRNA-375-3p(miR-375-3p)/embryonic lethal abnormal vision drosophila-like 4(Elavl4)expression.Methods A methamphetamine-dependent cell model by maximum safe dose induction was established.The cells were divided into normal group(complete culture medium),control group(complete culture medium+400 μmol·L-1 rhynchophylline incubated for 48 h),model group(complete culture medium+100 μmnol·L-1 methamphetamine incubated for 48 h)and experimental group(complete culture medium+400 μmol·L-1 rhynchophylline incubated for 15 min,then 100 μmol·L-1 methamphetamine incubated for 48 h).The cyclic adenosine monophosphate(cAMP)and 5-hydroxytryptamine(5-HT)expression were detected by enzyme-linked immunosorbent assay(ELISA),miR-375-3p expression was detected by quantitative real time polymerase chain reaction(qRT-PCR),and Elavl4 expression was detected by Western blot.Results The cAMP expression levels of normal group,control group,model group and experimental group were(6.33±0.93),(6.57±1.12),(10.89±1.03)and(7.81±1.32)pmol·mg-1;5-HT were(682.46±17.32),(690.31±15.09),(510.11±27.67)and(649.99±21.42)pg·mL-1;miR-375-3p expression were 1.00±0.13,1.13±0.24,3.48±0.18 and 1.58±0.19;Elavl4 expression were 1.00±0.05,0.89±0.10,0.50±0.09 and 0.90±0.11,respectively.The differences between above indicators in model group and normal group were statistically significant(P＜0.01,P＜0.05);the differences between above indicators in experimental group and model group were statistically significant(P＜0.01,P＜0.05).Conclusion This study preliminarily established a methamphetamine-dependent cell model,and also found that rhynchophylline may regulate miR-375-3p/Elavl4 expression to antagonize methamphetamine addiction.

Objective To investigate the potential mechanism of baicalin in the treatment of knee osteoarthritis rats.Methods Sixty rats were randomly divided into blank control group,sham operation group,model group(using freund's complete adjuvant to construct the model),experimental-L group(20 mg·kg-1 baicalin),experimental-H group(40 mg·kg-1 baicalin)and Y-27632 group(5 mg·kg-1 Rho kinase inhibitor Y-27632).Each group 10 rats.After 4 weeks of continuous treatment,joint swelling was detected and Lequesne MG score was assessed.Joint fluid and cartilage tissues were collected.Hematoxylin-eosin staining was used to observe the pathological changes of rat cartilage.The expression levels of interleukin-6(IL-6)and tumor necrosis factor-β(TNF-β)in joint fluid were detected by enzyme-linked immunosorbent assay(ELISA).Expression levels of Ras homologous gene family member A(RhoA),Rho-associated protein kinase 1(ROCK1)and Rho-associated protein kinase 2(ROCK2)mRNA were detected by real-time quantitative polymerase chain reaction(RT-qPCR).The protein expression levels of RhoA,ROCK1 and ROCK2 in cartilage were detected by Western blot.Results The knee diameters of blank control group,sham operation group,model group,experimental-L group,experimental-H group and Y-27632 group were(9.88±0.34),(9.96±0.31),(13.54±0.70),(13.35±0.54),(11.89±0.37)and(11.67±0.41)mm;IL-6 levels were(19.82±1.78),(20.69±1.84),(83.26±4.45),(83.62±4.71),(42.30±2.98)and(38.44±2.53)pg·mL-1;TNF-β levels were(8.86±1.41),(9.45±1.37),(33.71±2.63),(34.14±2.83),(23.71±1.93)and(20.85±1.69)pg·mL-1;RhoA mRNA expression levels were 1.00±0.13,1.04±0.11,1.69±0.26,1.64±0.20,1.24±0.18 and 1.14±0.17;ROCK1 mRNA expression levels were 1.00±0.15,1.02±0.12,1.48±0.19,1.53±0.21,1.21±0.17 and 1.16±0.18;ROCK2 mRNA expression levels were 1.00±0.14,1.06±0.11,1.41±0.20,1.43±0.18,1.18±0.17 and 1.15±0.16;model group was compared with sham operation group,experimental-H group was compared with model group or experimental-L group,Y-27632 was group compared with model group or experimental-L group,the differences of the above indexes were statistically significant(all P＜0.05).Conclusion Baicalin may reduce the inflammatory response of knee osteoarthritis rats by inhibiting RhoA/ROCK signaling pathway.

Objective: To analyze the burden indicators and trend predictions of eating disorders in Chinese adolescents aged 10-24 years from 1990 to 2019, so as to provide a reference for the prevention and control of eating disorders among adolescents. Methods: According to the latest data of the Global Burden of Disease Study(GBD) 2019 database classified by gender, age group and other indicators, the Joinpoint regression model and bayesian age period cohort model(BAPC) were used to analyze and predict the incidence rate, prevalence and disabilityadjusted life year (DALY) rate of eating disorders among Chinese adolescents aged 10 to 24 years old, and explore the trend of the disease burden of eating disorders in this population in the past three decades. Results: From 1990 to 2019, the overall crude incidence rate of eating disorders among adolescents in China increased from 278.93/105 to 422.27/105, and the crude incidence rate increased from 122.63/105 to 198.80/105, and the crude DALY rate increased from 26.67/105 to 43.50/105. In terms of gender, the standardized incidence rate, standardized prevalence rate and standardized DALY rate of eating disorders of boys and girls all showed an upward trend（boys：AAPC=1.52%，1.84%，1.86%，girls：AAPC=1.28%，1.74%，1.77%，P＜0.05）. The standardized incidence rate, standardized prevalence rate and standardized DALY rate of boys with eating disorders (54.97%, 68.88%, 69.75%) were higher than those of girls (44.26%, 64.48%, 65.56%), and the differences were statistically significant (χ2=201.45, 35.02, 34.55, P<0.05). In terms of age groups, the incidence rate of the 15-19yearold age group (524.10/105) was higher than that of other age groups (10-14yearold age:251.17/105, 20-24yearold age:476.49/105) (χ2=156.87, P<0.05), the prevalence rate of the 20-24yearold age group (278.67/105) and the DALY rate (60.83/105) were higher than those of other age groups (10-14yearold age:81.79/105,18.02/105, 15-19yearold age:221.81/105,48.59/105) (χ2=204.50,197.14, P<0.05). BAPC prediction model showed that in the future, the incidence rate of eating disorders among adolescents in China would still show an upward trend, but the prevalence rate and DALY rate would show a steady downward trend, which might reach 516.43/105, 188.41/105 and 41.23/105 respectively in 2030. Conclusions The burden of eating disorders among adolescents in China continues to increase, with boys and those aged 15-19 years being the key populations for prevention and treatment. All sectors of society should actively take relevant measures and pay attention to the prevention and treatment of adolescent eating disorders.

OBJECTIVE: To investigate short-term effectiveness of arthroscopic repair via modified subacromial viewing portal (hereinafter referred to as modified viewing portal) in treatment of LafosseⅠsubscapularis tendon tears. METHODS: A clinical data of 52 patients with LafosseⅠsubscapularis tendon tears, who underwent the arthroscopic repair via modified viewing portal between October 2020 and November 2022 and met the selective criteria, was retrospectively analyzed. There were 15 males and 37 females with an average age of 63.4 years (range, 41-76 years). Twelve patients had trauma history and the other 40 patients had no obvious inducement. The main clinical symptom was shoulder pain and the hug resistance tests were positive in all patients. The interval between symptom onset and admission ranged from 3 to 26 months (mean, 7.2 months). The shoulder pain and function were evaluated by visual analogue scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, and University of California Los Angeles (UCLA) score before operation and at 12 months after operation. The shoulder range of motion (ROM) of forward flexion, abduction, and external rotation and the internal rotation strength were measured before operation and at 3 and 12 months after operation. MRI was performed at 3-6 months after operation to assess the tendon healing and the structural integrity and tension of reattached tendon. Patient's satisfactions were calculated at last follow-up. RESULTS: All incisions healed by first intention, no complication such as incision infection or nerve injury occurred. All patients were followed up 12-37 months (mean, 18.5 months). The VAS, UCLA, and ASES scores at 12 months after operation significantly improved when compared with those before operation ( P<0.05). The ROMs of abduction and forward flexion and the internal rotation strength at 3 and 12 months significantly improved when compared with those before operation ( P<0.05); and the ROMs at 12 months significantly improved compared to that at 3 months ( P<0.05). However, there was no significant difference ( P>0.05) in the ROM of external rotation at 3 months compared to that before operation; but the ROM at 12 months significantly improved compared to that before operation and at 3 months after operation ( P<0.05). Thirty-one patients underwent MRI at 3-6 months, of which 28 patients possessed intact structural integrity, good tendon tension and tendon healing; 3 patients underwent tendon re-tear. At last follow-up, 41 patients (78.8%) were very satisfied with the effectiveness, 7 were satisfied (13.5%), and 4 were dissatisfied (7.7%). CONCLUSION Arthroscopic repair via modified viewing portal for Lafosse Ⅰsubscapularis tendon tears, which can achieve the satisfactory visualization and working space, can obtain good short-term effectiveness with low overall re-tear risk.
Male ; Female ; Humans ; Middle Aged ; Rotator Cuff/surgery* ; Rotator Cuff Injuries/surgery* ; Shoulder Pain ; Retrospective Studies ; Treatment Outcome ; Arthroscopy ; Shoulder Joint/surgery* ; Tendons/surgery* ; Range of Motion, Articular