OBJECTIVE To investigate the application and influencing factors of sodium-dependent glucose transporters 2 inhibitors（SGLT-2i） in patients with heart failure with preserved ejection fraction（HFpEF） in the real world. METHODS Data from 358 patients with HFpEF who were hospitalized at the First Affiliated Hospital of Chongqing Medical University from May 2023 to May 2024 were retrospectively collected. The patients were divided into the SGLT-2i group and the non-SGLT-2i group based on whether they were prescribed SGLT-2i upon discharge. Baseline characteristics， comorbidities， and differences in drug treatment were compared between the two groups. Based on univariate analysis， multivariate Logistic regression analysis was performed to identify independent influencing factors of SGLT-2i use in patients with HFpEF， followed by further stratified analysis. RESULTS Among 358 HFpEF patients， the overall utilization rate of SGLT-2i was 33.5%. Combined with type 2 diabetes [OR＝9.063，95%CI（4.924-16.679） ] ， atrial fibrillation [OR＝3.135，95%CI（1.590-6.178） ] ， coronary artery heart disease [OR＝1.888，95%CI（1.072-3.327） ] and the use of loop diuretics [OR＝3.822， 95%CI （1.588-9.200） ] were all independent influencing factors for the use of SGLT-2i in patients with HFpEF （ P ＜0.05）. The results of the stratified descriptive analysis were consistent with those of the multivariate analysis， showing a higher utilization rate of SGLT-2i among patients with concomitant T2DM，atrial fibrillation， coronary artery heart disease， and those receiving loop diuretics （ P ＜0.05）； whereas the utilization rate of SGLT-2i was comparable across patients with different levels of renal function （ P ＞0.05）. CONCLUSIONS In the real-world clinical practice， the utilization of SGLT-2i in patients with HFpEF remains suboptimal， and treatment coverage still needs to be improved. Their use of SGLT-2i is primarily influenced by the presence of type 2 diabetes， atrial fibrillation， coronary artery heart disease， and the use of loop diuretics.

Objective To analyze the efficacy of the"sandwich"technique for treating varicocele(VC).Methods A total of 310 patients with VC(365 affected veins)were selected and divided into interventional treatment group and non-interventional treatment group.The baseline data,hospitalization data,and 6-month follow-up data of the two groups were analyzed.Results The age of patients in the interventional treatment group was significantly lower than that in the non-interventional treatment group(P＜0.05).The surgical time and hospital stay in the interventional treatment group were significantly lower than those in the non-interventional treatment group(P＜0.05).In the non-interventional treatment group,two patients experienced surgical site infections,and one patient opted for interventional treatment due to recurrence after non-interventional treatment.After surgery,the diameter of the spermatic vein significantly decreased in both the interventional and non-interventional treatment(P＜0.05).Conclusion The"sandwich"technique(embolization coil combined with foam sclerotherapy)is an effective treatment for VC.

Objective·To fabricate a 3D-printed dental crown and bridge resin slurry using digital light processing(DLP)technology,investigate the influence of different printing parameters on its mechanical properties,determine the optimal printing parameters,and optimize the composition ratio of DLP-printed crown and bridge resin.Methods·Based on the viscosity characteristics of the mixture,the optimal ratio of urethane dimethacrylate(UDMA)to poly(propylene glycol)dimethacrylate(PPGDMA)was explored.After silanizing silicon dioxide(SiO2),it was mixed with UDMA,PPGDMA,and 2,4,6-trimethylbenzoyl bis(p-tolyl)phosphine oxide(TMO)to prepare DLP-printed dental crown and bridge resin slurries with different solid contents,and their rheological properties were tested.The Beer-Lambert equation was used to calculate the light penetration depth and critical exposure energy of the printing slurry.Based on these values,different exposure intensities,exposure times,post-curing times,and layer thicknesses were set respectively to carry out a series of printing experiments.By comparing and analyzing the flexural strength of the products under different printing parameters,the optimal printing parameter combination was screened out.Results·Viscosity tests showed that the optimal UDMA-to-PPGDMA ratio was 6∶4.The rheological behavior of printing slurries with different solid contents was tested,and the results showed that the DLP-printed dental crown and bridge resin with a solid content of 22%exhibited the best printing performance.According to the Beer-Lambert analysis,the light penetration depth Dp of the printing slurry was 119.79 μm,and the critical exposure energy Ec was 25.54 mJ/cm2.When the exposure intensity was 20 mW/cm2,the flexural strength reached a maximum of(132.39±8.92)MPa,and the difference was statistically significant(P<0.05).The flexural results of different exposure times showed that the flexural strength could reach(131.73±9.43)MPa when the single-layer exposure time was 3.0 s,and there was no significant difference when the exposure time was further increased.The flexural results of different post-curing times showed that when the post-curing time reached 30 min,there was no significant relationship between the flexural strength value and the increase in post-curing time.Regarding the influence of different layer thicknesses on the flexural performance,the test results showed that when the layer thickness was 50 μm,the result was the best,and the difference was statistically significant(P<0.001).Conclusion·Based on viscosity and rheological tests,a DLP-printable crown and bridge resin slurry was successfully developed.The optimal printing parameters were determined through statistical analysis of flexural strength:exposure intensity of 20 mW/cm2,exposure time of 3.0 s,post-curing time of 30 min,and a layer thickness of 50 μm.

Objective To investigate the causal relationship between frailty and epilepsy based on the traditional Chinese medicine(TCM)theory of"epilepsy caused by frailty"utilizing a two-sample Mendelian randomization approach,to enrich the modern connota-tion of the"epilepsy caused by frailty"theory and provide a theoretical basis for treating epilepsy from a frailty perspective in TCM.Methods Data on frailty and epilepsy were extracted from publicly available genome-wide association study summary datasets.Single nucleotide polymorphism(SNP)were selected as instrumental variable under the conditions of P＜5 x 10-8,a linkage disequilibrium co-efficient of 0.001,and a linkage disequilibrium region width of 10000kb.Mendelian randomization analysis was performed using five methods:MR-Egger regression,weighted median,inverse variance weighting,simple mode and weighted mode,with inverse variance weighting as the primary analysis method.The causal relationship between frailty and epilepsy was interpreted using OR and 95％CI.Pleiotropy was assessed using the MR-Egger intercept and MR-PRESSO analysis methods,while heterogeneity was analyzed using MR-Egger Cochran's Q test,and sensitivity analysis was conducted using the leave-one-out method.Results The results of inverse variance weighting and weighted median analysis indicated that there was a positive causal relationship between frailty and epilepsy.This result passed pleiotropy tests,confirming its robustness.Conclusion Frailty is associated with an increased risk of epilepsy,which is consistent with the TCM understanding of"epilepsy caused by frailty".It is suggested that in clinical treatment,besides conventional ap-proaches such as resolving phlegm,eliminating blood stasis,calming wind,and opening orifices,there should be a greater emphasis on tonifying frailty and nurturing the body's vital energy.

Objective To investigate the causal relationship between frailty and epilepsy based on the traditional Chinese medicine(TCM)theory of"epilepsy caused by frailty"utilizing a two-sample Mendelian randomization approach,to enrich the modern connota-tion of the"epilepsy caused by frailty"theory and provide a theoretical basis for treating epilepsy from a frailty perspective in TCM.Methods Data on frailty and epilepsy were extracted from publicly available genome-wide association study summary datasets.Single nucleotide polymorphism(SNP)were selected as instrumental variable under the conditions of P＜5 x 10-8,a linkage disequilibrium co-efficient of 0.001,and a linkage disequilibrium region width of 10000kb.Mendelian randomization analysis was performed using five methods:MR-Egger regression,weighted median,inverse variance weighting,simple mode and weighted mode,with inverse variance weighting as the primary analysis method.The causal relationship between frailty and epilepsy was interpreted using OR and 95％CI.Pleiotropy was assessed using the MR-Egger intercept and MR-PRESSO analysis methods,while heterogeneity was analyzed using MR-Egger Cochran's Q test,and sensitivity analysis was conducted using the leave-one-out method.Results The results of inverse variance weighting and weighted median analysis indicated that there was a positive causal relationship between frailty and epilepsy.This result passed pleiotropy tests,confirming its robustness.Conclusion Frailty is associated with an increased risk of epilepsy,which is consistent with the TCM understanding of"epilepsy caused by frailty".It is suggested that in clinical treatment,besides conventional ap-proaches such as resolving phlegm,eliminating blood stasis,calming wind,and opening orifices,there should be a greater emphasis on tonifying frailty and nurturing the body's vital energy.

Objective·To fabricate a 3D-printed dental crown and bridge resin slurry using digital light processing(DLP)technology,investigate the influence of different printing parameters on its mechanical properties,determine the optimal printing parameters,and optimize the composition ratio of DLP-printed crown and bridge resin.Methods·Based on the viscosity characteristics of the mixture,the optimal ratio of urethane dimethacrylate(UDMA)to poly(propylene glycol)dimethacrylate(PPGDMA)was explored.After silanizing silicon dioxide(SiO2),it was mixed with UDMA,PPGDMA,and 2,4,6-trimethylbenzoyl bis(p-tolyl)phosphine oxide(TMO)to prepare DLP-printed dental crown and bridge resin slurries with different solid contents,and their rheological properties were tested.The Beer-Lambert equation was used to calculate the light penetration depth and critical exposure energy of the printing slurry.Based on these values,different exposure intensities,exposure times,post-curing times,and layer thicknesses were set respectively to carry out a series of printing experiments.By comparing and analyzing the flexural strength of the products under different printing parameters,the optimal printing parameter combination was screened out.Results·Viscosity tests showed that the optimal UDMA-to-PPGDMA ratio was 6∶4.The rheological behavior of printing slurries with different solid contents was tested,and the results showed that the DLP-printed dental crown and bridge resin with a solid content of 22%exhibited the best printing performance.According to the Beer-Lambert analysis,the light penetration depth Dp of the printing slurry was 119.79 μm,and the critical exposure energy Ec was 25.54 mJ/cm2.When the exposure intensity was 20 mW/cm2,the flexural strength reached a maximum of(132.39±8.92)MPa,and the difference was statistically significant(P<0.05).The flexural results of different exposure times showed that the flexural strength could reach(131.73±9.43)MPa when the single-layer exposure time was 3.0 s,and there was no significant difference when the exposure time was further increased.The flexural results of different post-curing times showed that when the post-curing time reached 30 min,there was no significant relationship between the flexural strength value and the increase in post-curing time.Regarding the influence of different layer thicknesses on the flexural performance,the test results showed that when the layer thickness was 50 μm,the result was the best,and the difference was statistically significant(P<0.001).Conclusion·Based on viscosity and rheological tests,a DLP-printable crown and bridge resin slurry was successfully developed.The optimal printing parameters were determined through statistical analysis of flexural strength:exposure intensity of 20 mW/cm2,exposure time of 3.0 s,post-curing time of 30 min,and a layer thickness of 50 μm.

Objective:To investigate the differential expression profiles of long non-coding RNAs(LncRNAs) and messenger RNAs(mRNAs) regulated by soluble dipeptidyl peptidase-4(sDPP4) during vascular smooth muscle cell calcification, and to explore the potential underlying calcification mechanisms.Methods:DPP4 levels in blood vessels and peripheral blood of diabetic patients were measured using Western blotting(WB) and real-time quantitative PCR(RT-qPCR). A cellular calcification model was established by treating human aortic vascular smooth muscle cells(HASMCs) with sDPP4. The effects of sDPP4 on HASMCs were assessed by WB, RT-qPCR, alizarin red staining, and calcium content determination. High-throughput sequencing was performed to analyze the differential expression profiles of LncRNA and mRNA following sDPP4 treatment. Among them, LncRNA ENST00000540293, which exhibited the most pronounced downregulation and was located adjacent to the matrix metalloproteinase-1(MMP-1) gene, was selected for further investigation. The osteogenic transdifferentiation of HASMCs after silencing LncRNA ENST00000540293 was evaluated using WB, RT-qPCR, alizarin red staining, and immunofluorescence-based cytoskeletal staining.Results:DPP4 expression was significantly elevated in both blood vessels and peripheral blood of diabetic patients. sDPP4 stimulation upregulated the protein levels of osteopontin(OPN) and runt-related transcription factor 2(RUNX2) in HASMCs, enhanced alizarin red staining, and increased intracellular calcium deposition. RNA sequencing revealed significant downregulation of LncRNA ENST00000540293 following sDPP4 exposure, while GO and pathway analysis indicated a marked increase in extracellular matrix binding activity(GO: 0050840). Silencing LncRNA ENST00000540293 suppressed α-smooth muscle actin(α-SMA) expression, promoted OPN and RUNX2 expression, increased calcification as shown by positive alizarin red staining, and cytoskeletal staining demonstrated osteogenic transdifferentiation of HASMCs, accompanied by a significant rise in MMP-1 protein level.Conclusion:sDPP4 promotes osteogenic transdifferentiation of HASMCs, potentially by downregulating LncRNA ENST00000540293. MMP-1 may be a potential target regulated by LncRNA ENST00000540293.

Objective To analyze the efficacy of the"sandwich"technique for treating varicocele(VC).Methods A total of 310 patients with VC(365 affected veins)were selected and divided into interventional treatment group and non-interventional treatment group.The baseline data,hospitalization data,and 6-month follow-up data of the two groups were analyzed.Results The age of patients in the interventional treatment group was significantly lower than that in the non-interventional treatment group(P＜0.05).The surgical time and hospital stay in the interventional treatment group were significantly lower than those in the non-interventional treatment group(P＜0.05).In the non-interventional treatment group,two patients experienced surgical site infections,and one patient opted for interventional treatment due to recurrence after non-interventional treatment.After surgery,the diameter of the spermatic vein significantly decreased in both the interventional and non-interventional treatment(P＜0.05).Conclusion The"sandwich"technique(embolization coil combined with foam sclerotherapy)is an effective treatment for VC.

OBJECTIVE To investigate and analyze the current situation and problems of the advanced personnel en-gaging in the hospital-acquired infection control during their training period and explore the existing countermeas-ures and future development.METHODS The literatures regarding to the advanced study in China were retrieved from databases,the subjects of the literatures covered infection control-related advanced study practice,discipline construction,position competence,talent cultivation,scientific research innovation,professional title evaluation,laws,regulations and development plans.From Aug.2024 to Nov.2024,a questionnaire survey and face-to-face interviews were conducted among 36 advanced study personnel from 9 provinces of China who engaged in hos-pital-acquired infection control in the First Medical Center of Chinese PLA General Hospital.Eventually,36 ques-tionnaires were retrieved,all of which were valid with a questionnaire recovery rate of 100.00％.RESULTS Among the 36 advanced study personnel of hospital-acquired infection control,58.33％were medium-grade professional ti-tle;preventive medicine(41.67％),clinical medicine(25.00％)and nursing(16.67％)ranked the top 3 majors.The personnel engaged in the infection control for more than 6 years,and the duration of the advanced study was generally 3 or 6 months.In reality,the personnel faced the choices in terms of the purposes of further education,learning approaches and learning contents.The advanced study personnel also encountered the problems of challenges from promotion,improvement of position competency,integration with clinical training,supervision and practice,as well as physiological,psychological and family pressure.CONCLUSION Aiming at the problems that the advanced study personnel are generally concerned about,such as how to scientifically and effectively carry out hospital-acquired infection control advanced study and preset and solve the problems that may encounter,it is necessary to formulate targeted training programmes so as to provide bases and enlightenment for establishment of a long-term mechanism for advanced study of infection control in China.

BACKGROUND:Topical administration of tranexamic acid can be used for anti-skin pigmentation,but its large polarity makes it difficult to break through the cuticle barrier and cell membrane when administered topically,and the subcutaneous accumulation concentration is not easy to reach the effective therapeutic concentration.OBJECTIVE:To design functionalized self-assembled micelles to enhance the anti-pigmentation effect of tranexamic acid.METHODS:The plant polyphenol derivative epigallocatechin gallate palmitate and metformin were used as carrier materials.The self-assembled micelles with synergistic anti-pigging activity and enhanced drug permeability were prepared by hydrogen bonding and electrostatic interaction.The nanoscale properties and stability of self-assembled drug-loaded micelles were tested,and their transdermal permeability was evaluated,and their biocompatibility and cellular effects were investigated.RESULTS AND CONCLUSION:(1)Functional self-assembled drug-carrying micelles with average particle size of(176.27±5.23)nm,polydispersity coefficient of 0.23±0.02,and the Zeta potential of(-25.67±0.98)mV had good stability.The mass concentrations of tranexamic acid and metformin in the self-assembled drug-carrying micelles were(20.03±0.12)and(6.67±0.08)mg/mL,respectively.The drug loadings of tranexamic acid and metformin in the self-assembled drug-carrying micelles were(19.97±0.12)％and(6.65±0.08)％,respectively.(2)In vitro transdermal results showed that the self-assembled drug-carrying micelles had higher penetration and intradermal retention per unit skin area,and could penetrate and diffuse to deeper parts of the skin.(3)MTT assay results demonstrated that undrug-loaded self-assembled micelles containing tranexamic acid 50-250 μg/mL had no toxic effects on mouse fibroblasts and mouse skin melanoma cells.The self-assembled drug-carrying micelles containing tranexamic acid 500 μg/mL had a slight toxic effect on mouse skin melanoma cells.The self-assembled drug-carrying micelles containing 50-500 μg/mL of tranexamic acid did not cause hemolysis and had good biological safety.(4)In vitro cell culture results showed that self-assembled drug-carrying micelles containing 500 μg/mL tranexamic acid could significantly inhibit the tyrosinase activity and melanin release of mouse skin melanoma cells,and the inhibitory effect was stronger than that of tranexamic acid solution or metformin solution alone.These results indicated that functionalized self-assembled micelles could synergize with tranexamic acid to inhibit tyrosinase activity,reduce melanin synthesis,and enhance the anti-skin pigmentation effect of tranexamic acid.