With the rapid development of social economy and the continuous improvement of human living standard, the incidence, fatality and recurrence rates of cardiovascular disease (CVD) are increasing year by year, which seriously affects people's life and health. Conventional therapeutic drugs have limited improvement on the disability rate, so the search for new therapeutic drugs and action targets has become one of the hotspots of current research. In recent years, the therapeutic role of the natural compound rosmarinic acid (RA) in CVD has attracted much attention, which is capable of preventing CVD by modulating multiple signalling pathways and exerting physiological activities such as antioxidant, anti-apoptotic, anti-inflammatory, anti-platelet aggregation, as well as anti-coagulation and endothelial function protection. In this paper, the role of RA in the prevention of CVD is systematically sorted out, and its mechanism of action is summarised and analysed, with a view to providing a scientific basis and important support for the in-depth exploration of the prevention value of RA in CVD and its further development as a prevention drug.

Objective:To summarize the best evidence for non-pharmacological management of postoperative delirium in adult liver transplant recipients, providing reference for postoperative delirium management in liver transplant recipients.Methods:Evidence on non-pharmacological management of postoperative delirium in adult liver transplant recipients was retrieved through computer in databases such as UpToDate, British Medical Journal (BMJ) Best Practice, Embase, PubMed, Cochrane Library, Joanna Briggs Institute Evidence-Based Health Care Center Database, Guidelines International Network, China Biology Medicine disc, China National Knowledge Infrastructure, WanFang Data, and VIP. The search period was from database establishment to January 31, 2023. The types of literature included guidelines, clinical decision-making, best practices, systematic review, summary of evidence, and expert consensus. Two researchers conducted quality evaluation and evidence extraction on the included literature.Results:A total of 10 articles were included, involving 1 clinical decision-making, 4 guidelines, 3 systematic reviews, and 2 expert consensuses. A total of 25 best pieces of evidence for non-pharmacological management of postoperative delirium in adult liver transplant recipients were summarized from four aspects, including screening, evaluation, non-pharmacological prevention, and non-pharmacological treatment.Conclusions:The best evidence on non-pharmacological management of postoperative delirium in adult liver transplant recipients summarized provides a reference for postoperative delirium management in liver transplant recipients.

Objective:To explore the relationship between individual resilience, work stress, and work engagement among nurses in Emergency Department.Methods:A questionnaire survey was conducted on 350 nurses from six Class Ⅲ Grade A hospitals in Shandong Province from April to September 2022, using the General Information Questionnaire, the Chinese version of the Stressor Scale for Emergency Nurse, the Chinese version of the Utrecht Work Engagement Scale, and the Medical Staff Composition Resilience Scale. Pearson correlation was used to analyze the correlation between nurse work stress, work engagement, and individual resilience. The structural equation model was constructed using a mediating effect testing program to analyze the relationships between variables.Results:A total of 350 questionnaires were distributed, and 330 valid questionnaires were collected, with an effective response rate of 94.28%. The scores of nurse work engagement, work stress, and individual resilience were (54.26±10.08), (77.36±25.48), and (67.76±12.33), respectively. Work stress was negatively correlated with work engagement and individual resilience (all P<0.01), while individual resilience was positively correlated with work engagement ( P<0.01). Individual resilience was a mediating variable between work stress and work engagement among nurses in Emergency Department, with a mediating effect accounting for 31.38% of the total effect. Conclusions:Most nurses of Emergency Department have moderate levels of work stress, work engagement, and individual resilience. Individual resilience partially mediates the relationship between work stress and work engagement among nurses in Emergency Department. Nursing managers should attach importance to the organizational culture atmosphere and develop corresponding measures to enhance the individual resilience of nurses and encourage them to be energetic and enthusiastic in their work.

Accurately assessing and positioning the current development status of disciplines can help hospitals formulate targeted disciplinary development strategies and achieve disciplinary development goals. In 2022, a large tertiary public hospital established a discipline-demand-oriented " pyramid" hierarchical discipline evaluation system based on Maslow′s need-hierarchy theory. The discipline evaluation system set six levels of evaluation indicators from low to high, including medical quality and safety, department operation, sub specialty construction, scientific and educational achievements, platform construction, and talent cultivation(including 6 primary indicators, 21 secondary indicators, and 44 tertiary indicators). By applying the evaluation system and providing feedback on the evaluation results in the form of " disciplinary diagnostic reports" and " disciplinary evaluation conferences, " the hospital′s discipline construction had been improved at six levels. From 2022 to 2023, the hospital added five national clinical key specialties; The number of sub major construction disciplines increased from 18 in 2021 to 61 in 2023, and patient satisfaction increased from 94.64% to 96.25%. This evaluation system could objectively reflect the level of discipline development, lead the high-quality development of disciplines, and provide references for other public hospitals to promote discipline development.

PI3Kγ and PI3Kδ have important regulatory roles in the immune system, and targeting these two subtypes helps to reshape the tumor microenvironment. PI3Kγ and PI3Kδ are potential targets for tumor immunotherapy. In this study, a series of new pyrazolopyrimidine derivatives were designed and synthesized on the basis of our previously reported PI3K inhibitors, resulting in the discovery of compound 16l as a potent and selective PI3Kγ/δ dual inhibitor. Compound 16l demonstrated strong biochemical potencies against PI3Kγ and PI3Kδ with IC₅₀ values of 0.11 and 0.79 nmol·L^-1. In cell-based assays, it potently inhibited the PI3Kγ and PI3Kδ mediated Akt S473 phosphorylation with EC₅₀ values of 3 and 7 nmol·L^-1. In vivo, compound 16l exhibited acceptable pharmacokinetic properties in Sprague-Dawley (SD) rats and suppressed the tumor growth in a MC38 syngeneic mouse model. The animal experiments were approved by the Animal Ethics Committee of Hefei Institutes of Physical Science, Chinese Academy of Sciences (approval number: DWLL-2000-06). In addition, no appreciable human ether-a-go-go-related gene (hERG) inhibition was observed for compound 16l even at 30 μmol·L^-1. These results suggested that compound 16l might be a potential research tool for studying the PI3Kγ/δ mediated signaling pathways.

Objective To evaluates the impact of early application of neuromuscular electrical stimulation(NMES)on muscle strength,clinical outcomes,and long-term quality of life improvements in patients with severe acute pancreatitis(SAP)complicated with acute respiratory distress syndrome(ARDS).Methods A total of 75 patients diagnosed with SAP and ARDS admitted in Department of Critical Care Medicine of our hospital from September 2022 to August 2023 were recruited and then randomly divided into NMES group(n=37)and control group(n=38).After 16 patients were excluded,including 8 died during treatment,3 discharged and 5 received palliative care,there were finally 29 patients in the NMES group and 30 in the control group.Within 48 h after ICU admission,the NMES group received NMES 1 h per day,for 7 d in addition to standard rehabilitation intervention.While,the control group were given conventional interventions for rehabilitation.Assessments at baseline and post-treatment included the incidence of ICU-acquired weakness(ICU-AW),Medical Research Council(MRC)score,duration of mechanical ventilation,lengths of ICU and total hospital stays,and activity,thickness and thickening fraction of the diaphragm.Mortality rates and Barthel index(BI)for self-care ability in 1,3 and 6 months after discharge were recorded for follow-up assessments.Results The NMES group had significantly lower incidence of ICU-AW(P＜0.05),higher upper and lower limb MRC scores and overall MRC score at ICU discharge(P＜0.05),shorter durations of mechanical ventilation,ICU stay,and total hospital stay when compared with the control group(P＜0.05).There was no statistical difference in the BI at 1 month post-discharge between the 2 groups,but the indexes at 3 and 6 months were notably higher in the NMES group than the control group(P＜0.05).No obvious differences were observed between the 2 groups in terms of diaphragm activity,thickness,or thickening scores at enrollment,ICU discharge,or hospital discharge,nor in mortality rates at 1,3,and 6 months after discharge.Conclusion Combined NMES and early rehabilitation therapy can improve muscle strength and reduce length of hospital stay in SAP patients complicated with ARDS,and may enhance long-term quality of life.However,it does not significantly affect diaphragm function or mortality rates.

Objective To evaluate the effectiveness of treatment for osteoarthritis of the first carpometacarpal joint.Methods From June 2019 to June 2022,15 patients with osteoarthritis of the first carpometacarpal joint underwent a combined procedure of trapezium excision,first carpometacarpal joint arthroplasty,ligament reconstruction,and tendon interposition.Surgical efficacy was assessed using X-rays,thumb joint range of motion,grip strength,pinch strength,and pain rating(VAS).Results 9 months postoperative follow-up revealed significant pain reduction,increased thumb range of motion,enhanced grip and pinch strength,with an overall surgical excellence rate of 86.7％.Conclusion Trapeziecotomy arthroplasty with ligament reconstruction and tendon tamponade demonstrates significant efficacy in treating osteoarthritis of the first carpometacarpal joint,effectively alleviating pain,improving thumb mobility,and enhancing hand strength.The method is simple and effective.

Objective: Sialidosis type 2 has variants that are both catalytically inactive (severe), while sialidosis type 1 has at least one catalytically active (mild) variant. This study aimed to discuss the structural changes associated with these variants in a newly reported family carrying N-acetyl-α-neuraminidase-1 (NEU1) variants and explore the clinical characteristics of different combinations of variants in sialidosis type 1. Methods: First, whole-exome sequencing and detailed clinical examinations were performed on the family. Second, structural analyses, including assessments of energy, flexibility and polar contacts, were conducted for several NEU1 variants, and a sialidase activity assay was performed. Third, previous NEU1 variants were systematically reviewed, and the clinical characteristics of patients in the severe-mild and mild-mild groups with sialidosis type 1 were analyzed. Results: We report a novel family with sialidosis type 1 and the compound heterozygous variants S182G and V143E. The newly identified V143E variant was predicted to be a mild variant through structural analysis and was confirmed by a sialidase activity assay. Cherry-red spots were more prevalent in the severe-mild group, and ataxia was more common in the mild-mild group. Impaired cognition was found only in the severe-mild group. Moreover, patients with cherry-red spots and abnormal electroencephalographies and visual evoked potentials had a relatively early age of onset, whereas patients with myoclonus had a late onset. Conclusion Changes in flexibility and local polar contacts may be indicators of NEU1 pathogenicity. Sialidosis type 1 can be divided into two subgroups according to the variant combinations, and patients with these two subtypes have different clinical characteristics.

Objective: To study the association between eating at night and skipping breakfast with college students anxiety symptoms, and to provide reference basis for preventing and alleviating college students anxiety symptoms. Methods: A cross sectional survey was conducted among 9 960 freshman from three universities in Kunming and Dali, Yunnan Province. The dietary frequency questionnaire was used to evaluate the dietary behavior of college students. The Depression Anxiety Stress Scale-21 (DASS-21) was used to evaluate the anxiety symptoms of college students. The association of late night snack and breakfast skipping with the association of anxiety symptoms in college students used generalized linear model and Logistic regression model. Results: The proportion of college students who reported eating at night and breakfast skipping in the last month was 72.5%(7 217/9 960) and 61.6%(6 131/9 960) respectively. The detection rate of anxiety symptoms in college students was 28.9%(2 875/9 960). There was a statistical significance between eating at night with anxiety symptoms( OR =1.40-2.54), and breakfast skipping with anxiety symptoms( OR =1.23-1.60)( P <0.05). The interaction between eating late at night and breakfast skipping was positively correlated with college students anxiety symptoms (multiplicative interaction, β=0.06, 95%CI=0.02- 0.10 , P<0.01; additive interaction, OR=2.00, 95%CI=1.59-2.51, P <0.01). Conclusion The study suggests that the college students who eat at night and frequently skipped breakfast are more likely to have anxiety symptoms. It suggested to promote the formation of healthy eating habits of college students, so as to reduce the occurrence of anxiety sympotoms.

Osteoporosis （OP） and osteoarthritis （OA） are common bone diseases in clinic. OP is a systemic skeletal disease， and OA is a chronic degenerative joint disease with high prevalence and disability rates. With the advent of the aging population， the incidence rate of OA and OP is increasing year by year， and they have become common diseases of the elderly. The quality of life and physical and mental health of patients are severely affected by the above two bone diseases. Chinese medicine has a long history of treating bone diseases， with a good clinical effect on preventing and treating OP， OA， and other bone diseases with few side effects. It is one of the commonly used methods to treat bone diseases. Polysaccharides， as one of the active substances of Chinese medicine， have various pharmacological activities and a wide range of sources with low toxicity， and their effect cannot be ignored. The role of polysaccharides in the treatment of bone diseases has been deeply studied. It has been found that the mechanism of Chinese medicine polysaccharides in treating OP and OA involves multiple levels， targets， and pathways. Through the analysis and summary of the relevant literature on the mechanism of Chinese medicine polysaccharides in treating OP and OA， it was found that Chinese medicine polysaccharides mainly treated OP by regulating the bone dynamic balance between osteoblasts and osteoclasts and affecting bone marrow mesenchymal stem cells and bone microstructure. The mechanism of Chinese medicine polysaccharides in the treatment of OA is related to the regulation of chondrocyte growth， the increase in the proteoglycan and collagen content in the cartilage matrix， and the reduction of oxygen free radical content and inflammatory mediator level. This study aimed to further explore the internal relationship among mechanisms of Chinese medicine polysaccharides in the treatment of bone diseases， to provide relevant ideas for the study of Chinese medicine polysaccharides in the treatment of bone diseases.