Objective: To investigate the ability of different concentrations of piceatannol (PIC) solution to biomodify decalcified dentin matrices in primary teeth, thereby providing a theoretical basis for improving the durability of resin-dentin bonding. Methods: This study was approved by the Medical Ethics Committee of the institution. Molecular docking was performed to predict the interaction effects of PIC with type I collagen and matrix metalloproteinases (MMPs) in dentin. A total of 124 clinically extracted intact primary molars were selected due to retention; of these, 76 were prepared into 60 completely decalcified dentin beams and 24 dentin slices. The 60 beams were equally allocated for dry mass loss and swelling ratio testing (30 beams each). For both experiments, the beams were randomly divided into five groups (n = 6): a control group, 5% glutaraldehyde group, and 2.5, 5, and 10 mg/mL PIC solution groups. This was to evaluate the anti-enzymatic hydrolytic properties and mechanical performance of type I collagen. Of the 24 slices, 15 were assigned to the aforementioned five groups (n = 3) for Fourier-transform infrared spectroscopy (FTIR) to explore the cross-linking mechanism. The remaining nine slices were randomly divided into three groups (n = 3): distilled water group A (SEM examination prior to enzymatic hydrolysis), distilled water group B (SEM examination after enzymatic hydrolysis), and a 10 mg/mL PIC solution group (SEM examination after treatment with 10 mg/mL PIC and subsequent enzymatic hydrolysis). This was to evaluate the cross-linking effect on demineralized dentin collagen. The remaining 48 molars were fabricated into bonding specimens and randomly divided into four groups (n = 12): a control group (distilled water group) and 2.5, 5, and 10 mg/mL PIC groups. Immediate and aged shear bond strength (SBS) were measured, and failure modes were observed under a stereomicroscope to investigate the impact of different PIC concentrations on the bonding durability of primary tooth dentin. Results: Molecular docking revealed strong binding activity between PIC and type I collagen/MMPs via hydrogen bonds, electrostatic potential, and hydrophobic forces; the FTIR results confirmed hydrogen bond formation. In the dry mass loss test, mass loss rates in the 2.5, 5, and 10 mg/mL PIC groups were significantly lower than that in the control group (P < 0.05), with the 10 mg/mL PIC group showing the most optimized cross-linking effect. Swelling tests indicated that all three PIC concentrations reduced the swelling ratio of the demineralized matrix, effectively improving its mechanical properties. SEM showed that collagen from the 10 mg/mL PIC group retained its natural three-dimensional network post-enzymolysis, contrasting sharply with the disintegrated collagen in the enzymolyzed distilled water group B but resembling the morphology of the non-enzymolyzed distilled water group A. SBS results demonstrated that the 10 mg/mL PIC group exhibited significantly higher bond strengths than the control group in both the immediate and aged tests (P < 0.05); immediate SBS in the 10 mg/mL PIC group was also significantly greater than that in the 2.5 mg/mL PIC group (P < 0.05), while no other intergroup differences were found (P > 0.05). Failure mode analysis indicated predominantly mixed fractures, with the proportion of interfacial fractures decreasing as PIC concentration increased compared with the control group. Conclusion A 10 mg/mL PIC solution can effectively cross-link decalcified dentin matrices in primary teeth, enhancing the anti-enzymatic hydrolytic capacity and mechanical properties during clinical operation, thereby promoting bond strength and interface stability, which promises to improve the long-term durability of resin-dentin bonding.

Background: s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model. Methods: Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort. Results: In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM). Conclusions Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.

Objective To explore the relationship between hemorheology and Carotid Atherosclerosis.Methods The clinical data of 153 patients who underwent both hemorheological testing and carotid artery ultrasound were divided into a CAS group(n=96)and a non-CAS group(n=57)based on ultrasound findings.Clinical data and laboratory indicators were compared between two groups.Multivariate logistic regression analysis was used to explore the influencing factors of CAS.The ROC curves graph were drawn to observe the role of hemorheological indicators in predicting CAS and select the optimal cutoff value based on the maximum Youden index.Results The CAS group demonstrated higher levels in age,BMI,RBC aggregation index,low&high shear reduced viscosity of whole blood,plasma viscosity and fibrinogen compared to the non-CAS group(P<0.05).The multivariate logistic regression analysis showed that plasma viscosity(OR=38.270,95%CI:1.206～1214.508),age(OR=1.119,95%CI:1.065～1.176)were risk factors for the occurrence of CAS(P<0.05).The ROC curves showed that the area under the curve(AUC)of plasma viscosity and age were 0.623、0.728.Conclusion CAS patients have high levels of plasma viscosity and advanged age compared to the patient without CAS.Elevated plasma viscosity and age is a risk factor for CAS,with plasma viscosity≥1.46 mPa·s,over the age of 56.5 as a significant value for predicting CAS.

Objective To develop a quality evaluation indicator system for"Internet+indwelling tubes home nursing services"for a standardised evaluation process.Methods Based on the structure-process-outcome(SPO)model,a quality assessment indicator system for"Internet+indwelling tubes home nursing services"was developed.This system was refined via a comprehensive literature review,semi-structured interviews,clinical expertise,and a two-round Delphi consultation involving 20 experts from clinical nursing,nursing management,human resource management,public health and information technology.Results The effective recovery rate from both rounds of Delphi consultation was 100.00%.The authority coefficients for two-rounds of expert consultation were both at 0.785.Kendall's W coefficients for secondary indicators were 0.201 and 0.280,and 0.214 and 0.226 for tertiary indicators,all were statistically significant(P<0.05).After 2 rounds of expert consultation,the system demonstrated strong reliability:mean importance weights for all indicators exceeded 4.0,coefficients of variation were below 0.2,and full score rates included or surpassed 20%.The finalised quality evaluation indicator system for"Internet+indwelling tubes home nursing services"included 3 primary indicators(allocation of pipeline nursing service resources,implementation of pipeline nursing service resources,and feedback on the effectiveness of pipeline nursing service resources),12 secondary indicators,and 70 tertiary indicators.Conclusion The quality evaluation indicator system for"Internet+indwelling tubes home nursing services"developed in this study is scientifically reliable,practical and applicable for evaluation of the quality of"Internet+"pipeline home nursing services.

Objective To investigate the role and mechanisms of acyl-CoA synthetase long-chain family member 3(ACSL3)m6A modification in suppressing ferroptosis during cisplatin resistance in non-small cell lung cancer.Methods In vitro,cisplatin-resistant human lung adenocarcinoma A549/DDP cells were subjected to the following interventions:transduction with lentiviral vectors expressing ACSL3 short hairpin RNA,transfection with Wilms'tumor 1-associating protein(WTAP)small interfering RNA(siRNA)plasmids,or co-transfection with WTAP siRNA plasmids and ACSL3 overexpression plasmids.After 48 hours,all the groups were replaced with complete medium containing 1 μg/mL cisplatin and continued to culture for 24 h.A549(or A549/DDP)cells infected with ACSL3 short hairpin RNA lentivirus were subcutaneously inoculated into the backs of nude mice to establish a subcutaneous xenograft model.Immunofluorescence assay was performed to detect ACSL3 protein expression in cisplatin-treated or normally cultured A549 and A549/DDP cells.Cisplatin sensitivity was evaluated using colony formation assays.FerroOrange staining and total iron assay kits were used to measure intracellular and tissue iron levels.Lipid peroxidation was detected using the BODIPY 581/591 C11 probe.ACSL3 m6A methylation was analyzed by MeRIP-qPCR,while RNA decay assays evaluated ACSL3 mRNA stability.qRT-PCR and Western blotting were used to measure mRNA and protein expressions of ACSL3 and WTAP.Ferritin and COX2 levels were measured by immunohistochemistry.Results After cisplatin treatment,the decrease in ACSL3 expression was significantly smaller in A549/DDP cells[(48.70±3.81)％]than in A549 cells[(65.62±2.53)％].ACSL3 knockdown significantly reduced the colony formation capacity of A549/DDP cells,but increased FerroOrange intensity,total iron levels and lipid peroxidation levels(P＜0.05).Cisplatin reduced ACSL3 m6A methylation in A549/DDP cells,with a less decline than in A549 cells(P＜0.05).WTAP knockdown accelerated ACSL3 mRNA decay and reduced m6A enrichment of ACSL3.Compared to A549/DDP cells with only WTAP knockdown,those with combined si-WTAP knockdown and ACSL3 overexpression showed increased colony formation capacity,but decreased FerroOrange intensity,total iron levels,and lipid peroxidation levels.In vivo,ACSL3 knockdown upregulated COX2 and ferritin levels,increased Fe2+and ROS levels in tumor tissues,and suppressed tumor growth.Conclusion WTAP suppresses ferroptosis and reduces cisplatin sensitivity in A549 cells by mediating m6A modification of ACSL3 mRNA,thereby regulating the progression of lung cancer.

The success of"New Medical Sciences"in higher education requires effective tools in evalua-ting students'performance in courses.Previously,we reported a teamwork(T),critique(C)and ap-preciation(A)(TCA)ideological and political model,a teaching model widely applied in Basic Medical courses.TCA is an abbreviation derived from Tricarboxylic Acid Cycle in Biochemistry as an analogy for nurturing the abilities of thinking and teamwork(T),critique(C)and appreciation(A),which hope-fully could provide students with moral norms for cognition,science and life.This paper further explores the tools to assess the educational outcomes of the TCA model,by which teachers can collect feedback and reflect on teaching quality and effectiveness.Addressing the challenges of individual differences in large classes,fragmented learning feedback,and the difficulty of measuring meta-cognition in educational evaluation,this study employs strategies of value-added assessment,matrix assessment and norm-transfer-able assessment to evaluate the TCA abilities from the aspects of thinking quality,thinking creativity,co-operation ability,iterative thinking,dialectical thinking and job responsibility.By modifying/using 18 e-valuation tools in Education and Psychology,we have established a rubric system composed of 30 primary indicators(with 11 newly designed,10 partly modified and 9 directly adopted),along with 49 secondary indicators and 98 tertiary indicators to enhance the feasibility of the evaluation process.This rubric sys-tem was applied to Biochemistry teaching among the five-year-program undergraduates at Air Force Medi-cal University.Specifically,thinking and teamwork are evaluated by creative works from"the magic bio-chemical-circle",while critiques are assessed in large classes under the guidance of basic and clinical teachers,coupled with appreciation measured by job responsibility in a task-driven virtual reality(VR)project.The results indicate that Biochemistry teaching not only accumulates knowledge in students,but also achieves the goals in nurturing values and cognition.The inclusion of creative performance evalua-tion,cooperative learning and clinical case studies,can enhance students'interpersonal skills,coopera-tion,quality of thinking,creative thinking,iterative thinking and dialectical thinking to varying degrees.TCA-based Biochemistry teaching has a long-lasting impact on character education,and is capable of in-ducing positive long-term changes in students'cognition and lifestyle.Taken together,with the help of this rubric system,teachers can promptly acknowledge the effectiveness of their teaching,thereby facilita-ting their teaching strategies.

Objective To develop a quality evaluation indicator system for"Internet+indwelling tubes home nursing services"for a standardised evaluation process.Methods Based on the structure-process-outcome(SPO)model,a quality assessment indicator system for"Internet+indwelling tubes home nursing services"was developed.This system was refined via a comprehensive literature review,semi-structured interviews,clinical expertise,and a two-round Delphi consultation involving 20 experts from clinical nursing,nursing management,human resource management,public health and information technology.Results The effective recovery rate from both rounds of Delphi consultation was 100.00%.The authority coefficients for two-rounds of expert consultation were both at 0.785.Kendall's W coefficients for secondary indicators were 0.201 and 0.280,and 0.214 and 0.226 for tertiary indicators,all were statistically significant(P<0.05).After 2 rounds of expert consultation,the system demonstrated strong reliability:mean importance weights for all indicators exceeded 4.0,coefficients of variation were below 0.2,and full score rates included or surpassed 20%.The finalised quality evaluation indicator system for"Internet+indwelling tubes home nursing services"included 3 primary indicators(allocation of pipeline nursing service resources,implementation of pipeline nursing service resources,and feedback on the effectiveness of pipeline nursing service resources),12 secondary indicators,and 70 tertiary indicators.Conclusion The quality evaluation indicator system for"Internet+indwelling tubes home nursing services"developed in this study is scientifically reliable,practical and applicable for evaluation of the quality of"Internet+"pipeline home nursing services.

Background: s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model. Methods: Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort. Results: In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM). Conclusions Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.

Background: s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model. Methods: Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort. Results: In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM). Conclusions Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.