Objective: To investigate the impact of preschool children s aquatic motor skill (AMS) acquisition on their fundamental motor skill (FMS) development and the correlation between AMS and FMS development, so ao to provide a scientific basis for early childhood education and physical education teaching. Methods: From April to June 2024, 60 children, recruited by random sampling from a kindergarten in Taiyuan, were stratified randomly divided into an experimental group ( n =30) and a control group ( n =30). The experimental group were further divided into five classes of six each. They received AMS practice interventions twice weekly, 40 minutes per session, over eight weeks (16 sessions total) at a designated swimming center. The control group maintained their usual routine. Children s FMS and AMS were assessed pre and post intervention using the Test of Gross Motor Development-3rd (TGMD3) and Actual Aquatic Skills Test (AAST), respectively. Before and after test comparisons within and between groups employed t-tests, Wilcoxon signedrank tests, ANCOVA (including ranktransformed ANCOVA), and Cohen s d effect sizes were calculated for standardized mean differences. Spearman rank correlation was used to analyze relationships between FMS and AMS. Results: After the aquatic learning, the experimental group scored significantly higher than the control group on locomotor skills ( F=20.47, P <0.01, η 2=0.26), FMS ( F=4.59, P =0.04, η 2=0.08), and AMS ( F=109.71, P<0.01, η 2=0.79). The experimental groups improvement in locomotor skills 5.0(3.8, 7.3) versus the control group (2.8±2.5) yielded a medium effect size (Cohen s d =0.71); AMS gains in the experimental group [26.0(20.8, 28.0)] versus controls [1.0(0, 2.3)] showed a very large effect size (Cohen s d =4.73) (both P <0.01). Among preschool children, AMS acquisition was positively correlated with locomotor skills ( r =0.39) and overall FMS ( r =0.43)(both P <0.05). Skill specific assessments revealed lower proficiency in headfirst entry (immersion), treading water, and sagittalplane rotation. Conclusion Preschool children s acquisition of AMS has a positive effect on their FMS, with mutual facilitation between the two, especially in locomotor abilities.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Objective:To explore the characteristics of depression,anxiety,and stress symptoms among Chinese men who have sex with men(MSM),to determine the links of psychological resilience with these symptoms at the symptom level,and to provide insights for tailoring mental health intervention measures for MSM.Methods:A cross-sectional survey was conducted in southwestern China(Chongqing and Sichuan)from May to August 2022.The Depression,Anxiety,and Stress Scale-21 was used to assess mental health-related symptoms in MSM.Psychological resilience was evaluated using the brief version of the Connor-Davidson Resilience Scale.A regularized partial correlation network was constructed,and then a Bayesian network was established to identify potential causal rela-tionships in symptoms.A flow network was used to explore the link between psychological resilience and symptoms of anxiety,depres-sion,and stress.Results:A total of 938 MSM were included in the analysis.The proportion of MSM with depression,anxiety,and stress was 29.74%."Panic","scared","no relax",and"down-hearted"showed high expected influence.Bridging symptoms were"panic","down-hearted",and"agitated".Central and bridging symptoms also appeared at the top of the Bayesian network.Psychological resil-ience was negatively correlated with"no initiative","down-hearted","meaningless","panic",and"no relax".Conclusion:Central symptoms"panic","scared","no relax",and"down-hearted",as well as bridging symptoms"panic","down-hearted",and"agi-tated"are identified through network analysis.The potential causal priority of these symptoms is prominent.Interventions tailored to central and bridging symptoms may be effective,and interventions for enhancing psychological resilience may alleviate negative emotion-related symptoms,especially depressive symptoms in the MSM population.

Objective To investigate the predictive value of serum microRNA(miRNA)-143-3p and miR-188-5p levels for poor prognosis in patients with acute cerebral infarction(ACI)after thrombolysis.Methods From February 2022 to February 2024,121 patients with acute cerebral infarction(ACI)who visited the hospital(all treated with thrombolysis)were selected as the study group.They were assigned into mild and moderate to severe groups based on the severity of their condition.They were into good prognosis group and poor prognosis group based on their postoperative condition.In addition,another 121 healthy individuals who underwent physical check ups during the same period were as the control group.The qRT-PCR method was applied to detect the expression levels of miR-143-3p and miR-188-5p.Pearson correlation was applied to analyze the correlation between serum miR-143-3p,miR-188-5p and NIHSS score.The influencing factors of poor prognosis in ACI patients after throm-bolysis were analyzed using multiple logistic regression.ROC curve was plotted to analyze the predictive value of serum miR-143-3p and miR-188-5p for poor prognosis after thrombolysis in ACI patients.Results The serum miR-143-3p level in the study group was higher than that in the control group(P<0.05),and the miR-188-5p level was lower than that in the control group(P<0.05);The serum miR-143-3p and NIHSS score in the mild,moderate and severe groups were increased in turn,and the level of miR-188-5p was decreased in turn(P<0.05);Serum miR-143-3p was negatively correlated with miR-188-5p(P<0.05);Diabetes,time from onset to throm-bolysis,NIHSS score at admission,miR-143-3p and miR-143-3p were the influencing factors of poor prognosis in ACI patients after thrombolysis;The AUC of the joint of serum miR-143-3p and miR-188-5p in predicting poor prognosis after thrombolysis in ACI patients was 0.871,and the joint of the two was better than their individual predictions(Z=2.683,2.703,P<0.05).Conclusions The level of serum miR-143-3p in ACI patients is significantly increased,and the level of serum miR-188-5p is significantly decreased,which is a poor prognostic factor for ACI patients after thrombolysis.The combination of the two has higher diagnostic value.

Hepatocellular carcinoma(HCC)is a cancer with extremely high mortality and incidence rates.In recent years,with the development of multidisciplinary approaches,key characteristics of cancer have gradually been revealed.Studies have shown that dysregulated energy metabolism and metabolic reprogramming in tumor cells form the basis for tumor cell growth and are critical factors in shaping the tumor microenvironment,immune evasion,and drug resistance.Non-coding RNAs(ncRNAs),as important regulatory factors,play a crucial role in the metabolic reprogramming of HCC.This article focuses on summarizing the mech-anisms by which ncRNAs regulate metabolic repro-gramming in HCC and explores their applications in clinical diagnosis,treatment,and prognostic assess-ment,aiming to provide new perspectives for effec-tive HCC treatment and the development of novel drug targets.

Hepatocellular carcinoma(HCC)is a cancer with extremely high mortality and incidence rates.In recent years,with the development of multidisciplinary approaches,key characteristics of cancer have gradually been revealed.Studies have shown that dysregulated energy metabolism and metabolic reprogramming in tumor cells form the basis for tumor cell growth and are critical factors in shaping the tumor microenvironment,immune evasion,and drug resistance.Non-coding RNAs(ncRNAs),as important regulatory factors,play a crucial role in the metabolic reprogramming of HCC.This article focuses on summarizing the mech-anisms by which ncRNAs regulate metabolic repro-gramming in HCC and explores their applications in clinical diagnosis,treatment,and prognostic assess-ment,aiming to provide new perspectives for effec-tive HCC treatment and the development of novel drug targets.

Objective To investigate the predictive value of serum microRNA(miRNA)-143-3p and miR-188-5p levels for poor prognosis in patients with acute cerebral infarction(ACI)after thrombolysis.Methods From February 2022 to February 2024,121 patients with acute cerebral infarction(ACI)who visited the hospital(all treated with thrombolysis)were selected as the study group.They were assigned into mild and moderate to severe groups based on the severity of their condition.They were into good prognosis group and poor prognosis group based on their postoperative condition.In addition,another 121 healthy individuals who underwent physical check ups during the same period were as the control group.The qRT-PCR method was applied to detect the expression levels of miR-143-3p and miR-188-5p.Pearson correlation was applied to analyze the correlation between serum miR-143-3p,miR-188-5p and NIHSS score.The influencing factors of poor prognosis in ACI patients after throm-bolysis were analyzed using multiple logistic regression.ROC curve was plotted to analyze the predictive value of serum miR-143-3p and miR-188-5p for poor prognosis after thrombolysis in ACI patients.Results The serum miR-143-3p level in the study group was higher than that in the control group(P<0.05),and the miR-188-5p level was lower than that in the control group(P<0.05);The serum miR-143-3p and NIHSS score in the mild,moderate and severe groups were increased in turn,and the level of miR-188-5p was decreased in turn(P<0.05);Serum miR-143-3p was negatively correlated with miR-188-5p(P<0.05);Diabetes,time from onset to throm-bolysis,NIHSS score at admission,miR-143-3p and miR-143-3p were the influencing factors of poor prognosis in ACI patients after thrombolysis;The AUC of the joint of serum miR-143-3p and miR-188-5p in predicting poor prognosis after thrombolysis in ACI patients was 0.871,and the joint of the two was better than their individual predictions(Z=2.683,2.703,P<0.05).Conclusions The level of serum miR-143-3p in ACI patients is significantly increased,and the level of serum miR-188-5p is significantly decreased,which is a poor prognostic factor for ACI patients after thrombolysis.The combination of the two has higher diagnostic value.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Immunosuppressants(including cyclosporine,tacrolimus,mycophenolate esters,glucocorticoids,etc.)are the first choice of drugs to prevent organ rejection after liver transplantation,which can effectively reduce the host immune response to the graft,improve the success rate of transplantation,and prolong the survival of patients.Liver transplantation is associated with intestinal flora,while immunosuppressive agents interact with intestinal flora.Immunosuppressive agents change the abundance,composition and metabolites of intestinal flora,while a series of enzymes and metabolites produced by intestinal flora may chemically alter the absorption and metabolism of immunosuppressants.In addition,the incidence of postoperative infection in liver transplantion patients is relatively high,while gut flora affects inflammatory factors,and immunosuppressants interact with inflammatory factors.To some extent,immunosuppressants can be thought of as acting through intestinal flora in patients after liver transplantation.

OBJECTIVE To evaluate the influence of gene polymorphism on plasma minimum concentration(cmin)of voriconazole(VRZ)in patients with invasive fungal infection.METHODS The Cochrane Library,Embase,PubMed,Web of Science,China Biomedical Literature Database,CNKI,VIP and Wanfang Data were searched for literature on the correlation between gene polymorphisms andcmin of VRZ from inception to April 2024.After screening the literature,extracting data,and evaluating the quality of the literature,meta-analysis was performed using R 4.3.2 software.RESULTS A total of 21 studies with 2 454 patients were included.The results of meta-analysis showed that the VRZ cmin of CYP2C19 IM and PM types was significantly higher than EM type,and the VRZ cmin of IM type was significantly lower than PM type(P＜0.01).The VRZ cmin of CYP2C9 rs1057910 AA type was significantly higher than AC/CC type,and that of CYP3A5 rs776746 CC type was significantly higher than TT type(P＜0.01).The VRZ cmin of POR rs10954732 GG type was significantly higher than GA and AA types,and that of POR rs1057868 CT type was significantly lower than TT type(P＜0.01).The VRZ cminof ABCB1 rs1045642 CC type was significantly higher than TT type(P＜0.05).The VRZ cmin of NR1I2 rs2472677 CT type was significantly higher than TT type,and rs7643645 AA type was significantly higher than AG type(P＜0.05).The VRZ cmin of ABCC2 rs717620 CC type was significantly lower than CT type and TT type,and the CT type was significantly lower than TT type(P＜0.01).CONCLUSIONS Mutant alleles in CYP2C19,CYP2C9 rs1057910,CYP3A5 rs776746,POR rs10954732,ABCB1 rs1045642 and NR1I2 rs7643645 can lead to a decrease in VRZ plasma concentration,and mutant allele in ABCC2 rs717620 can lead to an increase in VRZ plasma concentration.