Objective:To investigate the effect of betaine in oxygen-glucose deprivation injury of rat brain microvascular endothelial cells(BMECs),and to clarify the regulatory effect of betaine on phosphoinositide 3-kinase(PI3K)/protein kinase B(AKT)pathway.Methods:Five SD rats aged 7 d were selected and the rat BMSEs were obtained.The oxygen-glucose deprivation model of rat BMECs was prepared under hypoxic and hypoglycemic conditions;the experiment was divdided into model group,and low dose,medium dose,and high dose of betaine groups and positive control group,at the same time,blank control group(without modeling)was set up.The BMECs in blank control group and model group were treated with fresh medium,the BMECs in positive control group were given a final concentration of 10 μmnol·L-1 nimodipine,and the BMECs in low,medium and high doses of betaine groups were treated with betaine at final concentration of 0.5,1.0 and 2.0 mmol·L-1,respectively.The survival rates of BMECs in various groups were determined by CCK-8 method at 12,24 and 48 h after culture;the activities of lactate dehydrogenase(LDH)and the levels of adenine ribonucleoside triphosphate(ATP)in the rat BMECs in various groups were determined using kits,and the levels of tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-1β,and IL-18 in supernatants of the BMECs in various groups were determined by enzyme-linked immunosorbent assay(ELISA);the activities of superoxide dismutase(SOD)and levels of malondialdehyde(MDA)in the BMECs in various groups were determined by kits;the transendothelial resistance(TEER)values of rat BMSCs in various groups were determined by TEER analyzer,and the horseradish peroxidase(HRP)permeabilities of BMECs in various groups were determined by an insertion cell culture apparatus.TUNEL staining was used to determine the apoptotic rates of rat BMECs in vaisous groups,and Western blotting method was used to determine the ratios of phosphory lated PI3K(p-PI3K)/PI3K and phosphorylated AKT(p-AKT)/AKT in the rat BMECs in various groups.Results:Compared with blank control group,the survival rate of BMECs,activity of SOD,and level of ATP,value of TEER,and ratios of p-PI3K/PI3K and p-AKT/AKT of the rat BMECs in model group were significantly decreased(P＜0.05),while the activity of LDH,the levels of TNF-α,IL-6,IL-1β,IL-18,and MDA,the apoptotic rate of the BMECs,and HRP permeability were significantly increased(P＜0.05).Compared with model group,the survival rates of the BMECs,activities of SOD,and levels of ATP,values of TEER,and ratios of p-PI3K/PI3K and p-AKT/AKT of the BMECs in low,medium,and high doses of betaine groups and positive control group were significantly increased(P＜0.05),while the activities of LDH,the levels of TNF-α,IL-6,IL-1β,IL-18,and MDA,the apoptotic rates of BMECs and HRP permeabilities were significantly decreased(P＜0.05).Conclusion:Betaine can significantly repair the oxygen-glucose deprivation/reperfusion injury in the rat BMECs,inhibit the oxidative damage and apoptosis of BMECs,and improve the permeability of the cells;its mechanism may be related to the regulation of the PI3K/AKT pathway.

In the current era filled with change and challenges,public hospitals,as a crucial part of the national healthcare system,urgently need to enhance their agility to swiftly respond to the ever-changing environment.Current it outlines the origins and connotations of organizational agility,argues for the necessity of organizational agility in public hospitals,and proposes the core competencies required to maintain organizational agility in public hospitals,namely:patient-centeredness,environmental sensitivity,proactive planning,organizational integration capability,flexibility,rapid response,iterative regulation,and continuous learning.Furthermore,it attempts to establish a cultivation pathway for organizational agility in public hospitals,encompassing multiple dimensions such as organizational culture,agile leadership,communication systems,organizational structure,the embedding of new productivity,management systems,partner management,training systems,performance evaluation,and compliance management.

Objective To investigate the effect of an enriched environment on glucose metabolism in the ischemic penumbra of rats with ischemic stroke(IS).Methods SD rats were subjected to middle cerebral artery ischemia to establish an IS model.The rats were ran-domly grouped and housed under different conditions with scheduled drug administration for 21 consecutive days.Neurological function scores and TTC staining were used to assess animal IS symptoms,whereas HPLC and Western blotting were used to detect glucose me-tabolic indicators and related protein expression,respectively.Results Compared to the model group,rats in the enriched envi-ronment group showed significant improvement in IS symptoms,with increased levels of glucose metabolic indicators and related protein expression.Compared to the positive drug group,rats in the positive drug+enriched environment group showed further improvement in IS symptoms,and the levels of glucose metabolic indicators and related protein expression were further enhanced.Conclusion Enriched environment can significantly improve IS symptoms in rats,and its mechanism may be related to an increase in glucose metabolic levels.

Objective To explore the influence of general medicine combined with family motivation management on the prognosis of cardiovascular and cerebrovascular disease patients.Methods A total of 120 cardiovascular and cerebrovascular diseases patients who received medical care at the First People's Hospital ofFuyang District from October 2023 to October 2024 were selected as subjects.They were divided into control group(n=60)and study group(n=60)by using a random number table method.Control group received standard nursing interventions,while study group underwent combined general medicine and family motivation management.Psychological status was assessed using the self-rating anxiety scale(SAS)and self-rating depression scale(SDS),with quality of life and self-management ability evaluated using the World Health Organization quality of life brief scale(WHOQOL-BREF)and exercise of self-care agency scale(ESCA).The triglycerides(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C),readmission rate and average length of stay before and after intervention were compared between two groups.Results After intervention,both groups showed decreased SAS and SDS scores,while WHOQOL-BREF scores and ESCA levels increased.Score of study group were statistically significant better than that of control group(P＜0.05).After intervention,HDL-C levels rose in both groups,whereas LDL-C,TG,and TC levels decreased.The improvement of each index in study group was better than that in control group(P＜0.05).The rehospitalization rate and average length of stay in study group were significantly lower than those in control group(P＜0.05).Conclusion The combination of general medicine and family motivation management can effectively optimize the prognosis of cardiovascular and cerebrovascular disease patients.

AIM:By establishing ischemic stroke(IS)rats and cell models,this study aimed to investigate the therapeutic effect of an enriched environment(EE)and to explore its impact on the neurotrophin 3(NT3)/p75 neuro-trophin receptor(p75NTR)signaling pathway.METHODS:The study consisted of in vivo and in vitro experiments.In vi-vo,Sprague-Dawley(SD)rats were randomly divided by weight into sham,IS,and IS+EE groups(n=10),with 8 addi-tional rats per group reserved for supplementary analyses.The IS model was established by the Longa suture occlusion method.Neurological and motor function deficits were assessed on days 1,3,7 and 14 post-modeling using the modified neurological severity score(mNSS).On days 3,7 and 14,4 additional rats from each group were sacrificed,and the whole-brain tissue was collected to measure infarct volume via 2,3,5-triphenyltetrazolium chloride(TTC)staining.On day 14,brain tissue was harvested for immunofluorescence staining to evaluate neuronal proliferation markers,while the ischemic penumbra was analyzed by Western blot for NT3/p75NTR pathway protein expression.In vitro,primary neural stem cells(NSCs)were isolated from fetal rats and cultured as neurospheres.These cells were divided into CON group and experimental groups treated with different concentrations of NT3 to evaluate the effects of NT3 on NSC proliferation and migration.Additionally,SH-SY5Y cell lines were used to establish an in vitro model of ischemic stroke through oxy-gen-glucose deprivation(OGD).These cells were treated with varying concentrations of NT3,along with CON and CON+NT3 groups,and a scratch assay was performed to assess the impact of NT3 on cell migration.RESULTS:EE significant-ly reduced neurological function scores in IS rats(P<0.05),prolonged latency in the rotarod test(P<0.05),and de-creased cerebral infarct area(P<0.05).EE further enhanced the protein expression of BrdU and Ki67 in the ischemic penumbra(P<0.05),as well as increased the co-expression of BrdU/DCX and BrdU/NeuN(P<0.05).Additionally,EE further upregulated the protein expression of NT3,p75NTR,PI3K,and Akt in the subventricular zone(SVZ)(P<0.05).In vitro,NT3(1 and 10 μg/L)significantly increased nestin expression(P<0.05)in the primary neural stem cell system.In the neural stem cell sphere system,compared to the CON group,1 μg/L NT3 markedly enhanced tubulin and phalloidin protein expression(P<0.05).In the scratch assay,1 ug/L NT3 significantly promoted the migration of both normal SH-SY5Y cells and OGD-induced SH-SY5Y cells compared to the CON group(P<0.05).CONCLUSION:Enriched envi-ronment activates the NT3/p75NTR signaling pathway,promoting the proliferation of NSCs in the SVZ and their migration to the ischemic penumbra,where they ultimately differentiate into neurons to replace those damaged,thereby contributing to the improvement of neurological function in rats with IS.

AIM:By establishing ischemic stroke(IS)rats and cell models,this study aimed to investigate the therapeutic effect of an enriched environment(EE)and to explore its impact on the neurotrophin 3(NT3)/p75 neuro-trophin receptor(p75NTR)signaling pathway.METHODS:The study consisted of in vivo and in vitro experiments.In vi-vo,Sprague-Dawley(SD)rats were randomly divided by weight into sham,IS,and IS+EE groups(n=10),with 8 addi-tional rats per group reserved for supplementary analyses.The IS model was established by the Longa suture occlusion method.Neurological and motor function deficits were assessed on days 1,3,7 and 14 post-modeling using the modified neurological severity score(mNSS).On days 3,7 and 14,4 additional rats from each group were sacrificed,and the whole-brain tissue was collected to measure infarct volume via 2,3,5-triphenyltetrazolium chloride(TTC)staining.On day 14,brain tissue was harvested for immunofluorescence staining to evaluate neuronal proliferation markers,while the ischemic penumbra was analyzed by Western blot for NT3/p75NTR pathway protein expression.In vitro,primary neural stem cells(NSCs)were isolated from fetal rats and cultured as neurospheres.These cells were divided into CON group and experimental groups treated with different concentrations of NT3 to evaluate the effects of NT3 on NSC proliferation and migration.Additionally,SH-SY5Y cell lines were used to establish an in vitro model of ischemic stroke through oxy-gen-glucose deprivation(OGD).These cells were treated with varying concentrations of NT3,along with CON and CON+NT3 groups,and a scratch assay was performed to assess the impact of NT3 on cell migration.RESULTS:EE significant-ly reduced neurological function scores in IS rats(P<0.05),prolonged latency in the rotarod test(P<0.05),and de-creased cerebral infarct area(P<0.05).EE further enhanced the protein expression of BrdU and Ki67 in the ischemic penumbra(P<0.05),as well as increased the co-expression of BrdU/DCX and BrdU/NeuN(P<0.05).Additionally,EE further upregulated the protein expression of NT3,p75NTR,PI3K,and Akt in the subventricular zone(SVZ)(P<0.05).In vitro,NT3(1 and 10 μg/L)significantly increased nestin expression(P<0.05)in the primary neural stem cell system.In the neural stem cell sphere system,compared to the CON group,1 μg/L NT3 markedly enhanced tubulin and phalloidin protein expression(P<0.05).In the scratch assay,1 ug/L NT3 significantly promoted the migration of both normal SH-SY5Y cells and OGD-induced SH-SY5Y cells compared to the CON group(P<0.05).CONCLUSION:Enriched envi-ronment activates the NT3/p75NTR signaling pathway,promoting the proliferation of NSCs in the SVZ and their migration to the ischemic penumbra,where they ultimately differentiate into neurons to replace those damaged,thereby contributing to the improvement of neurological function in rats with IS.

Objective To explore the influence of general medicine combined with family motivation management on the prognosis of cardiovascular and cerebrovascular disease patients.Methods A total of 120 cardiovascular and cerebrovascular diseases patients who received medical care at the First People's Hospital ofFuyang District from October 2023 to October 2024 were selected as subjects.They were divided into control group(n=60)and study group(n=60)by using a random number table method.Control group received standard nursing interventions,while study group underwent combined general medicine and family motivation management.Psychological status was assessed using the self-rating anxiety scale(SAS)and self-rating depression scale(SDS),with quality of life and self-management ability evaluated using the World Health Organization quality of life brief scale(WHOQOL-BREF)and exercise of self-care agency scale(ESCA).The triglycerides(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C),readmission rate and average length of stay before and after intervention were compared between two groups.Results After intervention,both groups showed decreased SAS and SDS scores,while WHOQOL-BREF scores and ESCA levels increased.Score of study group were statistically significant better than that of control group(P＜0.05).After intervention,HDL-C levels rose in both groups,whereas LDL-C,TG,and TC levels decreased.The improvement of each index in study group was better than that in control group(P＜0.05).The rehospitalization rate and average length of stay in study group were significantly lower than those in control group(P＜0.05).Conclusion The combination of general medicine and family motivation management can effectively optimize the prognosis of cardiovascular and cerebrovascular disease patients.

In the current era filled with change and challenges,public hospitals,as a crucial part of the national healthcare system,urgently need to enhance their agility to swiftly respond to the ever-changing environment.Current it outlines the origins and connotations of organizational agility,argues for the necessity of organizational agility in public hospitals,and proposes the core competencies required to maintain organizational agility in public hospitals,namely:patient-centeredness,environmental sensitivity,proactive planning,organizational integration capability,flexibility,rapid response,iterative regulation,and continuous learning.Furthermore,it attempts to establish a cultivation pathway for organizational agility in public hospitals,encompassing multiple dimensions such as organizational culture,agile leadership,communication systems,organizational structure,the embedding of new productivity,management systems,partner management,training systems,performance evaluation,and compliance management.

Objective To investigate the effect of an enriched environment on glucose metabolism in the ischemic penumbra of rats with ischemic stroke(IS).Methods SD rats were subjected to middle cerebral artery ischemia to establish an IS model.The rats were ran-domly grouped and housed under different conditions with scheduled drug administration for 21 consecutive days.Neurological function scores and TTC staining were used to assess animal IS symptoms,whereas HPLC and Western blotting were used to detect glucose me-tabolic indicators and related protein expression,respectively.Results Compared to the model group,rats in the enriched envi-ronment group showed significant improvement in IS symptoms,with increased levels of glucose metabolic indicators and related protein expression.Compared to the positive drug group,rats in the positive drug+enriched environment group showed further improvement in IS symptoms,and the levels of glucose metabolic indicators and related protein expression were further enhanced.Conclusion Enriched environment can significantly improve IS symptoms in rats,and its mechanism may be related to an increase in glucose metabolic levels.

Purpose: This study aimed to evaluate changes in ultrafast pulse wave velocity (ufPWV) in individuals with arterial stiffness and subclinical atherosclerosis (subAS), and to provide cutoff values. Methods: This retrospective study recruited 231 participants, including 67 patients with subAS. The pulse wave velocity was measured at the beginning and end of systole (PWV-BS and PWVES, respectively) using ultrafast ultrasonography to assess arterial stiffness. The right and left common carotid arteries were measured separately, and laboratory metabolic parameters were also collected. Participants were balanced between groups using propensity score matching (PSM) at a 1:1 ratio, adjusting for age, sex, and waist-to-hip ratio as potential confounders. Cutoff values of ufPWV for monitoring subAS were determined via receiver operating characteristic (ROC) curve analysis. Results: PWV-ES, unlike PWV-BS, was higher in the subAS subgroup than in the subAS-free group after PSM (all P<0.05). For each 1 m/s increase in left, right, and bilateral mean PWV-ES, the risk of subAS increased by 23% (95% confidence interval [CI], 1.04 to 1.46), 26% (95% CI, 1.07 to 1.52), and 38% (95% CI, 1.12 to 1.72), respectively. According to ROC analyses, predictive potential was found for left PWV-ES (cutoff value=7.910 m/s, P=0.002), right PWV-ES (cutoff value=6.615 m/s, P=0.003), and bilateral mean PWV-ES (cutoff value=7.415 m/s, P<0.001), but not for PWV-BS (all P>0.05). Conclusion PWV-ES measured using ultrafast ultrasonography was significantly higher in individuals with subAS than in those without. Specific PWV-ES cutoff values showed potential for predicting an increased risk of subAS.