Objective: To explore whether the long-term and frequent use of citrate anticoagulants negatively affects the bone metabolism balance of female frequent plateletpheresis donors, so as to better protect their health. Methods: A total of 65 female plateletpheresis donors and 55 female whole-blood donors from Guangzhou Blood Center (May to December 2024) were enrolled as experimental and control groups respectively, stratified into age subgroups (18-39 years and 40-60 years). Serum levels of 25-hydroxyvitamin D [25(OH)D], procollagen type I N-terminal propeptide (PINP), osteocalcin (OC), and type I collagen carboxy-terminal telopeptide (CTX) were measured. Differences in bone metabolism markers between experimental and control groups across age subgroups were compared. ANOVA was used to analyze dose-response relationships between donation age, annual apheresis donation frequency, and biochemical indicators. Results: In the 40-60 age subgroup, 25(OH)D levels were significantly lower in the experimental group (P<0.05), exhibiting a linear increase with age and a linear decrease with annual donation frequency. No significant differences in CTX or PINP levels were observed between experimental and control groups in either age subgroup. Conclusion: High-frequency plateletpheresis donation does not disrupt bone metabolic balance in female donors. However, it is associated with reduced vitamin D levels in female donors aged >40 years, potentially increasing the risk of osteoporosis. Vitamin D supplementation is recommended for high-frequency female plateletpheresis donors in this age group.

Based on the theory of traditional Chinese medicine （TCM） chronomedicine， this paper explores the pathogenesis and treatment strategies of colorectal cancer mediated by circadian rhythm disorders. It is believed that the imbalance of yin and yang is isomorphic to the disorder of biological clock genes， which is the root cause of the disease. The disharmony of ying and wei （营卫） corresponds to the imbalance of immunity and metabolism， which is the pivot of the disease. The disorder of qi movement is related to the imbalance of intestinal barrier， which is the manifestation of the disease. Accordingly， relevant strategies are proposed， including chronochemotherapy regimen that aligns with biological rhythms to enhance efficacy and reduce toxicity， acupuncture based on the ebb and flow of midnight and midday which selects acupoints along meridians to harmonize qi and blood， and a timed medication strategy that matches the disease mechanism by administering drugs at optimal times. These strategies aim to deepen the understanding of the pathogenesis of colorectal cancer mediated by circadian rhythm disorders from the perspective of TCM chronomedicine， thereby providing new ideas for clinical practice.

Background:Acupuncture(AP)is widely used in hospitalized patients.However,high-quality evidence supporting its use in patients with sepsis-induced gastrointestinal dysfunction remains limited.Objective:This study aims to conduct a systematic review and meta-analysis to evaluate the effects of AP in patients with sepsis-induced gastrointestinal dysfunction.Methods:PubMed,Embase,Web of Science,SinoMed,VIP Database,Wanfang Data Knowledge Service Platform,China National Knowledge Infrastructure,and the Cochrane Library were searched from inception to March 10,2024.We included randomized controlled trials(RCTs)that focused on adult patients with sepsis receiving AP and compared them with a control group.The primary outcome was gastrointestinal indicators.Sensitivity analysis,subgroup analysis,and assessment of publication bias were conducted to explore the potential heterogeneity among the included studies.Results:A total of 23 RCTs involving 1603 patients were included.Overall,AP significantly improved gastrointestinal indicators,including intra-abdominal pressure(mean difference[MD]=-1.97cm H2O;95％confidence interval[CI]:-2.77,-1.16;P＜0.00001),bowel sounds(MD=0.91 per minute;95％CI:0.66,1.16;P＜0.00001),and gastric residual volume(MD=-46.94mL;95％CI:-83.45,-10.43;P=0.01).These findings were corroborated by subgroup and sensitivity analyses.AP also showed significant benefits in inflammation indicators(procalcitonin,tumor necrosis factor-α,and interleukin-6),gastrointestinal function indicators(D-lactate,diamine oxidase,intestinal fatty acid-binding protein,and motilin),disease severity scores(Acute Physiology and Chronic Health Evaluation Ⅱ score and gastrointestinal dysfunction score),clinical prognosis,and other critical clinical outcomes(total effective rate and time to achieve target enteral nutrition)(all P values＜0.05).Additionally,the mortality rate in the AP group was comparable to that of the control group.Conclusion:Our findings suggest that AP significantly improves gastrointestinal indicators and other clinical outcomes in patients with sepsis and gastrointestinal dysfunction,indicating its potential as a promising therapeutic option.However,due to the small sample sizes and substantial heterogeneity among the included studies,further high-quality,multicenter RCTs are needed to validate these results.

Purpose To investigate the expression of bone sialoprotein(BSP)in the tissues and cells of endome-trial cancer(EC)and its effects on the proliferation and invasion of EC cells.Methods The expression of BSP was assessed by immunohistochemistry in 235 EC tissues and 88 normal endometrial tissues,and its correlation with clinico-pathological features was analyzed.Western blot was used to compare BSP levels between human endometrial carcinoma cell line(HHUA)and normal human endumetial epithelial cells(HEEC).BSP was knocked down in HHUA cells via transient transfection,and the cells were divided into blank control group and BSP-knockdown group.The effects of BSP knockdown on cell cycle,proliferation,migration,invasion,and apoptosis were evaluated using PI staining,CCK-8,scratch,Transwell,and Annexin V-FITC assays,respectively.Protein levels of TGF-β signaling pathway compo-nents were analyzed by Western blot.Results BSP expression was significantly higher in EC tissues than in normal endometrium(P＜0.001)and correlated with lymph node metastasis and advanced FIGO stage(P＜0.05).BSP pro-tein level was also significantly elevated in HHUA cells(2.455 8±0.008 9)compared to HEECs(1.571 2±0.005 4)(P＜0.01).After knockdown,compared with the control group,the proliferation index(74.4±3.33),migration rate(0.48±0.03),and invasion ability(0.36±0.11)of the cells were increased,and the apoptosis rate(25.97％)of the cells was increased(P＜0.05).Furthermore,the expression levels of TGF-β signaling pathway downstream proteins TGF-β1(0.290 4±0.002 3)、TGF-β2(0.292 9±0.001 6)、Smad2(0.469 3±0.001 1)、Smad3(0.247 0±0.001 7)、pAKT(0.382 1±0.001 9)、ATK(0.119 6±0.001 6)and MEK1(0.258 9±0.000 3)in the BSP-knockdown group of EC cells decreased(P＜0.01).Conclusion BSP is highly expressed in endometrial cancer and promotes cancer cell proliferation,invasion,and metastasis by activating the TGF-β signaling pathway.

Background:Acupuncture(AP)is widely used in hospitalized patients.However,high-quality evidence supporting its use in patients with sepsis-induced gastrointestinal dysfunction remains limited.Objective:This study aims to conduct a systematic review and meta-analysis to evaluate the effects of AP in patients with sepsis-induced gastrointestinal dysfunction.Methods:PubMed,Embase,Web of Science,SinoMed,VIP Database,Wanfang Data Knowledge Service Platform,China National Knowledge Infrastructure,and the Cochrane Library were searched from inception to March 10,2024.We included randomized controlled trials(RCTs)that focused on adult patients with sepsis receiving AP and compared them with a control group.The primary outcome was gastrointestinal indicators.Sensitivity analysis,subgroup analysis,and assessment of publication bias were conducted to explore the potential heterogeneity among the included studies.Results:A total of 23 RCTs involving 1603 patients were included.Overall,AP significantly improved gastrointestinal indicators,including intra-abdominal pressure(mean difference[MD]=-1.97cm H2O;95％confidence interval[CI]:-2.77,-1.16;P＜0.00001),bowel sounds(MD=0.91 per minute;95％CI:0.66,1.16;P＜0.00001),and gastric residual volume(MD=-46.94mL;95％CI:-83.45,-10.43;P=0.01).These findings were corroborated by subgroup and sensitivity analyses.AP also showed significant benefits in inflammation indicators(procalcitonin,tumor necrosis factor-α,and interleukin-6),gastrointestinal function indicators(D-lactate,diamine oxidase,intestinal fatty acid-binding protein,and motilin),disease severity scores(Acute Physiology and Chronic Health Evaluation Ⅱ score and gastrointestinal dysfunction score),clinical prognosis,and other critical clinical outcomes(total effective rate and time to achieve target enteral nutrition)(all P values＜0.05).Additionally,the mortality rate in the AP group was comparable to that of the control group.Conclusion:Our findings suggest that AP significantly improves gastrointestinal indicators and other clinical outcomes in patients with sepsis and gastrointestinal dysfunction,indicating its potential as a promising therapeutic option.However,due to the small sample sizes and substantial heterogeneity among the included studies,further high-quality,multicenter RCTs are needed to validate these results.

Background: Acupuncture (AP) is widely used in hospitalized patients. However, high-quality evidence supporting its use in patients with sepsis-induced gastrointestinal dysfunction remains limited. Objective: This study aims to conduct a systematic review and meta-analysis to evaluate the effects of AP in patients with sepsisinduced gastrointestinal dysfunction. Methods: PubMed, Embase, Web of Science, SinoMed, VIP Database, Wanfang Data Knowledge Service Platform, China National Knowledge Infrastructure, and the Cochrane Library were searched from inception to March 10, 2024. We included randomized controlled trials (RCTs) that focused on adult patients with sepsis receiving AP and compared them with a control group. The primary outcome was gastrointestinal indicators. Sensitivity analysis, subgroup analysis, and assessment of publication bias were conducted to explore the potential heterogeneity among the included studies. Results: A total of 23 RCTs involving 1603 patients were included. Overall, AP significantly improved gastrointestinal indicators, including intra-abdominal pressure (mean difference [MD] = -1.97 cm H O; 95% confidence interval [CI]: -2.77, -1.16; P < 0.00001), bowel sounds (MD = 0.91 per minute; 95% CI: 0.66, 1.16; P < 0.00001), and gastric residual volume (MD = -46.94 mL; 95% CI:-83.45, -10.43; P = 0.01). These findings were corroborated by subgroup and sensitivity analyses. AP also showed significant benefits in inflammation indicators (procalcitonin, tumor necrosis factor-α, and interleukin-6), gastrointestinal function indicators(D-lactate, diamine oxidase, intestinal fatty acid-binding protein, and motilin), disease severity scores (Acute Physiology and Chronic Health Evaluation II score and gastrointestinal dysfunction score), clinical prognosis, and other critical clinical outcomes (total effective rate and time to achieve target enteral nutrition) (all P values < 0.05). Additionally, the mortality rate in the AP group was comparable to that of the control group. Conclusion: Our findings suggest that AP significantly improves gastrointestinal indicators and other clinical outcomes in patients with sepsis and gastrointestinal dysfunction, indicating its potential as a promising therapeutic option. However, due to the small sample sizes and substantial heterogeneity among the included studies, further high-quality, multicenter RCTs are needed to validate these results.

Purpose To investigate the expression of bone sialoprotein(BSP)in the tissues and cells of endome-trial cancer(EC)and its effects on the proliferation and invasion of EC cells.Methods The expression of BSP was assessed by immunohistochemistry in 235 EC tissues and 88 normal endometrial tissues,and its correlation with clinico-pathological features was analyzed.Western blot was used to compare BSP levels between human endometrial carcinoma cell line(HHUA)and normal human endumetial epithelial cells(HEEC).BSP was knocked down in HHUA cells via transient transfection,and the cells were divided into blank control group and BSP-knockdown group.The effects of BSP knockdown on cell cycle,proliferation,migration,invasion,and apoptosis were evaluated using PI staining,CCK-8,scratch,Transwell,and Annexin V-FITC assays,respectively.Protein levels of TGF-β signaling pathway compo-nents were analyzed by Western blot.Results BSP expression was significantly higher in EC tissues than in normal endometrium(P＜0.001)and correlated with lymph node metastasis and advanced FIGO stage(P＜0.05).BSP pro-tein level was also significantly elevated in HHUA cells(2.455 8±0.008 9)compared to HEECs(1.571 2±0.005 4)(P＜0.01).After knockdown,compared with the control group,the proliferation index(74.4±3.33),migration rate(0.48±0.03),and invasion ability(0.36±0.11)of the cells were increased,and the apoptosis rate(25.97％)of the cells was increased(P＜0.05).Furthermore,the expression levels of TGF-β signaling pathway downstream proteins TGF-β1(0.290 4±0.002 3)、TGF-β2(0.292 9±0.001 6)、Smad2(0.469 3±0.001 1)、Smad3(0.247 0±0.001 7)、pAKT(0.382 1±0.001 9)、ATK(0.119 6±0.001 6)and MEK1(0.258 9±0.000 3)in the BSP-knockdown group of EC cells decreased(P＜0.01).Conclusion BSP is highly expressed in endometrial cancer and promotes cancer cell proliferation,invasion,and metastasis by activating the TGF-β signaling pathway.

Objective:To clarify the application effect of information-guided enteral nutrition-associated diarrhea (ENAD) management process in patients with chronic obstructive pulmonary disease (COPD) undergoing non-invasive assisted ventilation.Methods:A mixed cohort study of pre- and post-control was conducted. Thirty-nine patients with COPD who were admitted to the emergency intensive care unit (ICU) of Huzhou First People's Hospital from July 1, 2021 to July 31, 2022 were enrolled. Taking the completion of the software development of ENAD management software for critically ill patients on January 28, 2022 as the time node, 20 patients admitted from July 1, 2021 to January 28, 2022 were set as the control group, and 19 patients admitted from January 29 to July 31, 2022 were set as the observation group. The two groups of patients received the same enteral nutrition support treatment, and the control group implemented the conventional ENAD treatment process with enteral nutrition intolerance disposal process as the core. On the basis of the control group, the observation group implemented the information-guided ENAD treatment process, and the system software actively captured the information of ENAD patients and reminded the medical team to improve the patient's diarrhea-related examination and provide alternative treatment plans. The duration of antidiarrhea, feeding interruption rate, and energy and protein intake, blood biochemical indexes, incidence of abnormal blood electrolyte metabolism, daily continuous non-invasive assisted ventilation and endotracheal intubation after 7 days of targeted diarrhea intervention were compared between the two groups.Results:Except for the basal pulse rate, there were no significant differences in gender distribution, age, and vital signs, basic nutritional status, arterial blood gas analysis and blood biochemistry at admission between the two groups, indicating comparability between the two groups. When ENAD occurred, the patients in the observation group obtained earlier cessation of diarrhea than those in the control group [days: 3.00 (2.00, 3.25) vs. 4.00 (3.00, 5.00), P < 0.01], and the feeding interruption rate was significantly lower than that in the control group [10.53% (2/19) vs. 65.00% (13/20), P < 0.01]. After 7 days of diarrhea intervention, the energy intake of the observation group was significantly higher than that of the control group [kJ·kg -1·d -1: 66.28 (43.34, 70.36) vs. 47.88 (34.60, 52.32), P < 0.01], the levels of hemoglobin (Hb), albumin (Alb) and serum prealbumin (PAB) were significantly higher than those in the control group [Hb (g/L): 119.79±10.04 vs. 110.20±7.75, Alb (g/L): 36.00 (33.75, 37.25) vs. 31.00 (30.00, 33.00), PAB (mg/L): 155.79±25.78 vs. 140.95±14.97, all P < 0.05], the daily continuous non-invasive assisted ventilation duration was significantly shorter than that of the control group [hours: 14 (12, 16) vs. 16 (14, 18), P < 0.01], and the arterial partial pressure of carbon dioxide (PaCO 2) was significantly lower than that of the control group [mmHg (1 mmHg ≈ 0.133 kPa): 66.00 (62.00, 70.00) vs. 68.00 (67.50, 70.05), P < 0.05]. However, there were no significant differences in protein intake, incidence of abnormal electrolyte metabolism, and incidence of endotracheal intubation due to acute respiratory failure between the two groups. Conclusion:The information-guided ENAD treatment process can enable the COPD patients undergoing continuous non-invasive assisted ventilation who experience ENAD to receive earlier cessation of diarrhea, and improve the protein energy metabolism and respiratory function of the patients.

Objective:To explore the relationship between illness perceptions and disability, and the relative importance of association of illness perceptions items and disability in HIV-infected people aged ≥50 years in Sichuan Province.Methods:By using multi-stage cluster sampling, the baseline data of a cohort of HIV-infected people aged ≥50 years in 5 counties (district) in Sichuan were obtained from 2018 to 2021. The disability was evalauted with instrumental activities of daily living scale (IADL), and the illness perception was evaluated by using brief illness perception questionnaire. General additive model and general linear model were used to analyze the association between illness perceptions and IADL. Weighted sum quartile sum regression was used to find the dominant items on the association. Software R was used for statistical anlysis.Results:A total of 1 587 HIV-inbfected peoeple aged ≥50 years were included in this study. The prevalence of disability was 26.1% ( n=414). The median score of illness perception was 33. The illness perceptions had a negative effect on the IADL score ( β=-0.15, P<0.001) and the partial score of IADL declined when illness perception score was larger than 38 ( P<0.05). Personal control (32.98%) and consequence (22.50%) whose weight were higher than average (12.50%) were the dominant items on the association between the score of illness perception and IADL score. Conclusions:The prevalence of disability in HIV-infected people aged ≥50 years in Sichuan was high. It is necessary to intervent on personal control and consequence in HIV-infected people aged ≥50 years when their illness perception scores are high to prevent the incidence and development of disability.

Objective:To explore the application of the Simodont dental trainer in preclinical manual dexterity training for dental students of different grades, and to discuss its effect by quantitatively evaluating their practice results.Methods:The evaluation was conducted among 118 students in the Department of Stomatology, Shantou University Medical College from Batch 2015 to Batch 2018. Each student had five different manual dexterity modules for training. Each module had three levels of difficulty and was required to be completed in 30 minutes. The assessment index included Target, Leeway Bottom and Sides, Container Bottom and Sides, which was provided by the Simodont dental trainer. The operating time (in seconds), the displacement of the dental hand pieces and the dental mirrors (in meters) were simultaneously recorded. SPSS 25.0 was used for statistical analysis.Results:For the index Target, Leeway Bottom and Sides, Container Bottom and Sides, the results showed that there was a statistical difference between students who passed pre-clinical training and who did not take the professional course ( P < 0.001). For the index Target, differences were showed among students from different grades in all modules ( P < 0.001). Conclusion:The circle module, channel module, hollow-circle module and cross-module in the Simodont dental trainer have sensitivity to discriminate the manual dexterity of different levels of dental students. The further assessment of the discrimination of the manual dexterity is required for assume-block module. The Simodont dental trainer can quantitatively measure the manual dexterity of dental students, which is important for the quantitative evaluation of dental preclinical education.