As human deep space exploration enters a practical phase, ensuring astronaut health and safety has become a critical determinant of mission success. The cerebrovascular system, essential for maintaining brain function, is highly sensitive to environmental changes. Cerebrovascular diseases represent one of the characteristic adverse effects of deep space conditions such as microgravity and high-energy radiation, and have emerged as a frontier challenge in space medicine. Based on experiences from manned space missions, major research challenges persist, particularly the lack of experimental data specific to the lunar environment and the unclear threshold for low-dose radiation-induced injury. Elucidating the mechanisms and multifactorial interactions by which deep space environments impact cerebrovascular structure and function, and summarizing the key risk factors, pathological processes, and recent advances in monitoring and early-warning technologies for cerebrovascular diseases in lunar astronauts, and of crucial importance. A comprehensive understanding of the interplay between deep space environmental stressors and cerebrovascular injury, as well as the development of personalized prevention and intervention strategies, will provide both theoretical and practical foundations for safeguarding cerebrovascular health in future Chinese deep space missions, while promoting progress in related biomedical research, technological innovation, and international collaboration.
Humans ; Astronauts ; Cerebrovascular Disorders/etiology* ; Space Flight ; Weightlessness/adverse effects* ; Risk Factors ; Moon

Objective:To explore the clinical value of syndecan-1 (SDC1), asymmetric dimethylarginine (ADMA) assessment in the early diagnosis and course monitoring of patients with type 2 diabetic kidney disease (DKD).Methods:This is a cross-sectional study. A total of 232 patients with type 2 diabetes admitted to the Department of Endocrinology of Kailuan General Hospital from December 2020 to December 2021 were included. The general biochemical indexes, SDC1 and ADMA were detected. According to urinary albumin/creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR), patients were divided into simple diabetes group (50 cases) and DKD group (182 cases). According to the risk of progression of DKD, the DKD group was further divided into low-progression diabetic nephropathy (LDKD) subgroup (90 cases), medium-progression diabetic nephropathy(MDKD)subgroup (55 cases), and high-progression diabetic nephropathy(HDKD) subgroup (37 cases). Forty healthy people undergoing physical examination during the same period in our hospital were selected as the healthy control group. According to the quartile value of N-acetyl-β-D-glucosaminase/urinary creatinine (NAG/Ucr), the DKD group was divided into Q1- Q4 subgroups, with 45, 45, 46 and 46 cases, respectively. Spearman correlation was used to analyze the correlation between SDC1, ADMA and glomerular and renal tubule injury indexes in DKD patients. Multifactor ordered Logistic regression was used to analyze the influencing factors of the progression risk of DKD and renal tubular injury. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of SDC1 and ADMA for DKD. Results:The levels of systolic blood pressure, diastolic blood pressure, triglyceride (TG), serum creatinine (Scr), uric acid (UA), NAG/Ucr, SDC1 and ADMA in DKD group were higher than those in SDM group and healthy control group (all P<0.05). The levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (ApoB), and hemoglobin A1c (HbA 1c) in DKD group were higher than those in healthy control group, and the level of high density lipoprotein cholesterol (HDL-C) was lower than that in healthy control group (all P<0.05). The SDC1 level in HDKD subgroup was higher than that in SDM group and LDKD subgroup, and the ADMA level was higher than that in SDM group and lower than that in LDKD subgroup (all P<0.05). SDC1 level in MDKD subgroup was higher than that in SDM group and LDKD subgroup, ADMA level was higher than that in SDM group, but lower than that in LDKD subgroup (all P<0.05).The levels of SDC1 and ADMA in LDKD subgroup were higher than those in SDM group (all P<0.05). The levels of TC, AporB, HbA 1c, Scr, UACR and SDC1 in NAG/Ucr Q4 subgroup were higher than those in Q1 subgroup, the levels of Scr, UACR and SDC1 were higher than those in Q2 subgroup, and the levels of HbA 1c, Scr, UACR and SDC1 in Q3 subgroup were higher than those in Q1 subgroup (all P<0.05). Spearman correlation analysis showed that SDC1 was positively correlated with UACR, NAG/Ucr ( r=0.757, 0.566, all P<0.05),and was negatively correlated with eGFR ( r=-0.337, P<0.05). ADMA was positively correlated with UACR, NAG/Ucr ( r=0.197, 0.142, all P<0.05). Multifactor ordered Logistic regression analysis showed that SDC1, NAG/Ucr and Scr were the independent influencing factors of progression risk in DKD patients ( OR=2.043, 1.067, 1.047, 0.660, 1.394, all P<0.05), while SDC1, HbA 1c and ACR were the independent influencing factors of renal tubule injury in DKD patients ( OR=1.177, 1.193, 1.002,all P<0.05). ROC curve showed that the area under the curve (AUC) of SDC1 for DKD diagnosis was 0.979, the sensitivity was 92.31%, and the specificity was 92.22%, while the AUC of ADMA for DKD diagnosis was 0.745, the sensitivity was 81.32%, and the specificity was 60.00%. The AUC, sensitivity and specificity of the combined diagnosis of DKD were 0.981, 90.66% and 95.66%. Conclusions:SDC1 is an independent risk factor of DKD progression and tubular injury in DKD patients, which can be used to diagnose early DKD and monitor the progression of DKD. ADMA is suitable for early screening of DKD.

Objective:To investigate the mediating effect of rumination in primiparae on the expectation gap of social support and postpartum depression, so as to provide a reference basis for early detection and intervention in the regulation of meternal postpartum depression.Methods:In this cross-sectional study, questionnaires were administered from November 2021 to March 2022 using the general information questionnaire, the Ruminant Thinking Response Scale, the Postpartum Social Support Scale, and the Edinburgh Postpartum Depression Scale to 266 primiparae at three tertiary level A hospitals, the First Affiliated Hospital of Xi′an Jiaotong University, the Second Affiliated Hospital of Xi′an Jiaotong University, and the Northwest Women′s and Children′s Hospital, for postpartum review, and the relationship between ruminant thinking, social support expectation gap, and postpartum depression was analyzed using correlation analysis, structural equation modeling, and application of Bootsrap method.Results:The social support expectation gap, ruminative thinking, and postpartum depression average scores were (16.74 ± 12.77), (39.43 ± 4.14), (6.77 ± 2.77) points, respectively.There were positive correlations between social support expectation gap and ruminative thinking, postpartum depression, and ruminative thinking and postpartum depression ( r=0.62, 0.75, 0.70, all P<0.01). Primiparae ruminative thinking partially mediated the relationship between social support expectation gap and postpartum depression, with the mediating effect accounting for 22% of the total effect. Conclusions:Social support expectation gap can directly affect the occurrence of postpartum depression, but also indirectly through ruminative thinking, and postpartum depression can be prevented and intervened from the perspective of reducing ruminative thinking in clinical practice.

Objective: To explore the effect of miniscrew-assisted rapid palatal expansion (MARPE) on mandible position in the treatment of adult skeletal Class Ⅰ malocclusion with maxillary transverse deficiency. Methods: In this retrospective study, 20 cases of adult skeletal Class Ⅰ malocclusion with maxillary transverse deficiency treated with MARPE in our hospital from July 2019 to March 2022 were selected as research objects. CBCT data of three time points before treatment (T0), immediately after expansion (T1) and six months after retention (T2) were collected. The head position was standardized and calibrated by Dolphin software, and then mandible landmarks (left and right Condylion, left and right Gonion, Menton) were positioned. The linear distance changes of each landmark relative to the reference plane of coronal plane, axial plane and sagittal plane were measured, which represented the sagittal, vertical and horizontal displacement of mandible respectively. Repeated measurement ANOVA and LSD multiple comparison were used to evaluate the position change of each landmark. Results : The Menton and right Gonion rotated clockwise at T1, and relapsed to the initial position at T2. No lateral displacement of Menton was found. Conclusion When MARPE is used to treat skeletal Class Ⅰ malocclusion with maxillary transverse deficiency, it causes a transient clockwise rotation of the mandiblar. The mandible does not show sagittal, vertical and horizontal position changes in long-term evaluation.

Objective:To study the clinical value of N-terminal pro-B-type natriuretic peptide (NTproBNP) predicting the risk of bronchopulmonary dysplasia (BPD) in very/extremely low birth weight infants (VLBWI/ELBWI).Methods:From June 2017 to December 2019, VLBWI/ELBWI admitted to neonatal department in our hospital were enrolled in this non-interventional prospective study. According to the occurrence of BPD, the infants were assigned into BPD group and non-BPD group. Infants in BPD group were further assigned into mild, moderate and severe BPD groups. Plasma NTproBNP were measured on 14 d, 21 d, 28 d, 35 d, 42 d and 49 d after birth. Repeated-measures ANOVA was used to determine the differences of NTproBNP at different time points in each group.Results:A total of 190 infants were enrolled, including 36 cases in BPD group (18, 13 and 5 cases in mild, moderate and severe BPD group, respectively) and 154 cases in non-BPD group. The gestational age, birth weight and 5-min Apgar score in BPD group were lower than non-BPD group. BPD group had significantly higher incidences of retinopathy of prematurity, patent ductus arteriosus and necrotizing enterocolitis and significantly longer duration of invasive mechanical ventilation and noninvasive ventilation than non-BPD group ( P<0.05).No significant differences existed in NTproBNP levels between BPD group and non-BPD group on 42 d and 49 d ( P>0.05). At other time points, NTproBNP levels in BPD group were significantly higher than non-BPD group ( P<0.05). NTproBNP level in severe BPD group was the highest on 14 d. No significant differences existed in NTproBNP levels between mild and moderate groups on 28 d ( P>0.05). At other time points, NTproBNP in severe BPD group was higher than mild and moderate BPD groups ( P<0.001). The receiver operating characteristic curve analysis showed the best cut-off value of NTproBNP was 982 pg/ml on 14 d (AUC=0.907, 95% CI 0.831~0.983). Conclusions:VLBWI/ELBWI with BPD have higher levels of NTproBNP. And the more severe of BPD, the higher the NTproBNP level. NTproBNP has certain predictive values for BPD in VLBWI/ELBWI.

Objective:To analyze the effects of espO gene knockout on the biological characteristics of enterhemorrhagic Escherichia coli (EHEC). Methods:Two-step methods mediated by the suicide plasmid pCVD442-Δ espO and plasmid pTrc99a were used to construct the espO gene-deleted strain (Δ espO) and the complemented mutant (CΔ espO), respectively. HeLa cells were infected with different EHEC strains to analyze the biological functions and lethal effects of espO gene during infection. Results:PCR, electrophoresis and gene sequencing showed that the Δ espO and CΔ espO mutants were successfully constructed. Compared with the wild-type strain, neither the Δ espO nor CΔ espO mutant showed significant difference in growth rate, indicating that the espO gene had no influence on the growth and replication of EHEC. Furthermore, EspO could activate the tumor necrosis factor receptor (TNF)-induced NF-κB signaling pathway, while the effector protein NleB could inhibit the process. EspO could not inhibit the death of HeLa cells induced by TNF or TNF-related apoptosis-inducing ligand (TRAIL) after EHEC infection. Conclusions:In this study, we successfully constructed the espO gene-deleted and complemented mutants of EHEC and preliminarily analyzed the interaction between espO gene and host cells and the effects of espO gene on cell apoptosis during infection, which provided reference for further research on the in vitro biochemical activity and in vivo pathogenic roles of EspO.

Objective To study the protective effects and preliminary mechanisms of endothelial progenitor cells-derived microvesicles (EPC-MVs) on hypoxic-ischemic brain damage (HIBD) in newborn rats by using the HIBD model.Method Rat endothelial progenitor cells (EPCs) were cultured and microvesicles were extracted from EPCs culture medium by ultracentrifugation.A total of 60 neonatal SD rats were randomly assigned into control group,HIBD group,saline group and EPC-MVs group.The HIBD model was prepared in HIBD group,saline group and EPC-MVs group.After the preparation of the HIBD model,rats in saline group and EPC-MVs group received intraventricular injection with saline and EPC-MVs,respectively.After 72 hours,the rats were sacrificed for brain tissue,cerebral infarction was detected by TTC staining,vascular endothelial growth factor (VEGF) mRNA was tested by real-time PCR,protein western blot was used to detect changes in VEGF protein expression.Result Cells extracted and cultured from the spleen of 12-week-old SD rats were confirmed as EPCs by morphology and flow cytometry.EPC-MVs isolated by high-speed centrifugation from EPCs culture supernatant met the morphological characteristics of microvesicles by transmission electron microscopy.The infarcted brain tissue was not detected in the control group.The cerebral infarction volume ratios of HIBD group,saline group and EPC-MVs group were (80.3 ± 6.3) ％,(77.9 ± 8.9) ％,(35.2 ± 7.7) ％,respectively.The infarct volume of EPC-MVs group was significantly lower than that of HIBD group and saline group (P ＜ 0.001).The expression of VEGF mRNA and protein in HIBD group,saline group and EPC-MVs group were higher than those in control group (P ＜0.001).Among them,EPC-MVs group had the most significant increase,compared with the other three experimental groups,and the difference was statistically significant (P ＜ 0.001).There was no significant difference between saline group and HIBD group in the expression of VEGF mRNA and protein (P ＞ 0.05).Conclusion Intraventricular injection of EPC-MVs can attenuate HIBD in neonatal rats,and the mechanism may be related to up-regulation of VEGF expression.

Objective To compare the anesthetic effect of sufentanil combined with propofol and remifentanil combined with propofol in hysteroscopic surgery, and to provide a scientific basis for the selection of clinical anesthesia methods. Methods From November 2016 to March 2017, 94 patients in Lishui central hospital underwent hysteroscopic surgery were divided into the observation group and the control group according the anesthesia way, 47 cases in each group. The control group were given remifentanil(1 μg/kg) combined with propofol(2 mg/kg) by intravenous injection, the observation group were given sufentanil(0.2 μg/kg) combined with propofol(2 mg/kg). The mean arterial pressure(MAP), respiration (RR), pulse oxygen saturation (SpO2), heart rate (HR), the onset time of anesthesia, the postoperative recovery time, the recovery time of orientation and Ramsay sedation score in the two groups were recorded and compared before anesthesia, 2 min after anesthesia, 10 min after operation, 10min after operation finished. Results Compared with before anesthesia, MAP, RR, SpO2, HR index decreased significantly after anesthesia, the differences have statistical significance (P<0.05), the control group compared to the index value, the observation group and the control group of convergence and the decline of difference, group showed no statistically significant difference the observation group was more stable; comparison between the 10min group and MAP HR index after surgery, there was significant difference between two groups (P<0.05). The onset time of anesthesia, postoperative recovery time, orientation recovery time, Ramsay score difference between the groups was not statistically significant sedation score difference was statistically significant between group VAS, observation group than in the control group (P<0.05). Conclusion Sufentanil combined with propofol anesthesia were used in hysteroscopic surgery, which can better maintain the vital signs of patients, effectively reduce postoperative pain.

Objective:To develop murine models of Th2 response induced by shrimp tropomyosin (ST). Methods:Mice were sensitized with ST for 6 weeks. The serum antigen-special IgE (sIgE),total IgE and sIgG level,Th1/Th2 cytokines production were measured by ELISA. The basophil activation in mice was measured by flow cytometry. Results:The intraperitoneal sensitization with ST for 6 weeks induced significant increase of serum sIgE,total IgE and sIgG (sIgG1,sIgG2a and sIgG2b) level in mice. Th2 cell response was induced and cytokines (IL-4,IL-5,IL-10 and IL-13) production increased in splenocytes stimulated by ST,while Th1 cytokine (IFN-γ) production decreased. As the markers of basophil activation,CD200R and CD41 expression also increased in response to ST. Conclusion:The Th2 response is dominant in ST-induced anaphylaxis in mice.

TongJi University School of Medicine has performed teaching reforms in the early stage of medical students through curriculum integration of life science,the introduction of PBL,and designing of comprehensive experiments to achieve comprehensive professional competence of medical students.The results showed that the training system is beneficial to the cultivation of students' clinical thinking and early medical professional competence.It has been recognized by both students and faculty.Preliminary practice has proved to be successful.