Objective Tetanus is a serious infectious diseases with high mortality,which is an important global public health issue.This study aims to analyze the epidemiological burden and changing trends of tetanus in China from 1990 to 2021,providing a basis for disease prevention and control.Methods Epidemiological indicators and global socio-demographic index(SDI)related to tetanus in China were retrieved and collected from the 2021 Global Burden of Disease database(GBD 2021).The trend analysis of the incidence rate,mortality rate and disability-ad-justed life years(DALYs)rate of tetanus in China from 1990 to 2021 was conducted by Joinpoint 5.3 software.Results From 1990 to 2021,the age-standardized incidence rate(ASIR),age-standardized mortality rate(ASMR),and age-standardized disability-adjusted life years(DALYs)rate of tetanus in China decreased significantly(average annual percent change[AAPC]＜0,P＜0.001),with males being significantly higher than females.The crude incidence rate,crude mortality rate,and crude DALYs rate for all age groups showed overall declining trends,with the lar-gest decline in the 0-14 years age group.In 2021,the crude incidence rate,crude mortality rate,and crude DALYs rate of tetanus in the population aged 70-years were higher than those in the population aged 0-14,15-49,and 50-69 years groups.The ASIR,ASMR,and age-standardized DALYs rate of tetanus in China in 2021 were lower than the global level,only higher than those in the high SDI regions.Conclusion From 1990 to 2021,the disease burden of tetanus in China varied with gender and age,with an overall declining trend over time.It is necessary to strengthen tetanus health education for males and the ≥70 years population,and to improve the overall level of pri-mary prevention measures for tetanus.

AIM:To investigate the therapeutic effects and potential mechanism of pachymic acid(PA)on li-popolysaccharide(LPS)-induced acute kidney injury(AKI)in mice.METHODS:(1)Genes related to AKI were screened using the DAVID database.Core genes were identified by intersecting related genes and analyzed using Cyto-scape software.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)analyses were performed through the DAVID database for the cross-targets.Molecular docking and activity assays were conducted on the primary core targets.(2)A total of 100 C57BL/6J mice were randomly divided into five groups:normal control(NC),model(LPS),solvent control(LPS+DMSO),and treatment groups(LPS+PA-10 and LPS+PA-20),with 20 mice in each group.The LPS-AKI model was established by intraperitoneal injection of 18 mg/kg LPS.The treatment groups received 10 mg/kg and 20 mg/kg PA,respectively,and the solvent control group was administered an equivalent dose of DMSO.Mice were euthanized 24 h after injection.Serum was collected for biochemical analysis,and Western blot was used to detect neutro-phil gelatinase-associated lipocalin(NGAL),kidney injury molecule-1(KIM-1),caspase-3,cleaved caspase-3,interleu-kin-1β(IL-1β),and monocyte chemoattractant protein-1(MCP-1)protein expression.RT-qPCR was employed to detect inflammatory factor mRNA levels.Molecular docking was used to simulate the optimal binding site of PA to caspase-3.En-zyme activity assays were performed to assess caspase protein activity,and renal lesions were observed via hematoxylin and eosin(HE)staining.Apoptosis was detected by TUNEL staining.RESULTS:(1)Thirty-one potential targets of PA against AKI were identified through network pharmacology.GO and KEGG enrichment analyses indicated that these tar-gets were primarily involved in immune response,inflammatory processes,apoptosis and survival,angiogenesis and hemo-dynamics,oxidative stress,and endoplasmic reticulum stress.Key targets included CASP3(caspase-3),PTGS2,BCL2,CCL2,and CYP219.(2)PA treatment improved renal function and reduced tubular epithelial injury.It significantly de-creased NGAL,KIM-1,and cleaved caspase-3 protein levels,as well as inflammatory factors TNF-α,IL-1β,and MCP-1 mRNA and protein expression.PA also reduced apoptosis of renal tubular epithelial cells.Enzyme activity assays and mo-lecular docking revealed that PA exerted its anti-apoptotic effect by directly binding to caspase-3,thereby inhibiting its ac-tivation by caspase-8.CONCLUSION:PA demonstrated a therapeutic effect in LPS-AKI,potentially through the inhibi-tion of inflammatory factor synthesis and release,as well as the inhibition of caspase-3 activation by caspase-8,reducing apoptosis in renal tubular epithelial cells.

AIM:To investigate the therapeutic effects and potential mechanism of pachymic acid(PA)on li-popolysaccharide(LPS)-induced acute kidney injury(AKI)in mice.METHODS:(1)Genes related to AKI were screened using the DAVID database.Core genes were identified by intersecting related genes and analyzed using Cyto-scape software.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)analyses were performed through the DAVID database for the cross-targets.Molecular docking and activity assays were conducted on the primary core targets.(2)A total of 100 C57BL/6J mice were randomly divided into five groups:normal control(NC),model(LPS),solvent control(LPS+DMSO),and treatment groups(LPS+PA-10 and LPS+PA-20),with 20 mice in each group.The LPS-AKI model was established by intraperitoneal injection of 18 mg/kg LPS.The treatment groups received 10 mg/kg and 20 mg/kg PA,respectively,and the solvent control group was administered an equivalent dose of DMSO.Mice were euthanized 24 h after injection.Serum was collected for biochemical analysis,and Western blot was used to detect neutro-phil gelatinase-associated lipocalin(NGAL),kidney injury molecule-1(KIM-1),caspase-3,cleaved caspase-3,interleu-kin-1β(IL-1β),and monocyte chemoattractant protein-1(MCP-1)protein expression.RT-qPCR was employed to detect inflammatory factor mRNA levels.Molecular docking was used to simulate the optimal binding site of PA to caspase-3.En-zyme activity assays were performed to assess caspase protein activity,and renal lesions were observed via hematoxylin and eosin(HE)staining.Apoptosis was detected by TUNEL staining.RESULTS:(1)Thirty-one potential targets of PA against AKI were identified through network pharmacology.GO and KEGG enrichment analyses indicated that these tar-gets were primarily involved in immune response,inflammatory processes,apoptosis and survival,angiogenesis and hemo-dynamics,oxidative stress,and endoplasmic reticulum stress.Key targets included CASP3(caspase-3),PTGS2,BCL2,CCL2,and CYP219.(2)PA treatment improved renal function and reduced tubular epithelial injury.It significantly de-creased NGAL,KIM-1,and cleaved caspase-3 protein levels,as well as inflammatory factors TNF-α,IL-1β,and MCP-1 mRNA and protein expression.PA also reduced apoptosis of renal tubular epithelial cells.Enzyme activity assays and mo-lecular docking revealed that PA exerted its anti-apoptotic effect by directly binding to caspase-3,thereby inhibiting its ac-tivation by caspase-8.CONCLUSION:PA demonstrated a therapeutic effect in LPS-AKI,potentially through the inhibi-tion of inflammatory factor synthesis and release,as well as the inhibition of caspase-3 activation by caspase-8,reducing apoptosis in renal tubular epithelial cells.

Objective Tetanus is a serious infectious diseases with high mortality,which is an important global public health issue.This study aims to analyze the epidemiological burden and changing trends of tetanus in China from 1990 to 2021,providing a basis for disease prevention and control.Methods Epidemiological indicators and global socio-demographic index(SDI)related to tetanus in China were retrieved and collected from the 2021 Global Burden of Disease database(GBD 2021).The trend analysis of the incidence rate,mortality rate and disability-ad-justed life years(DALYs)rate of tetanus in China from 1990 to 2021 was conducted by Joinpoint 5.3 software.Results From 1990 to 2021,the age-standardized incidence rate(ASIR),age-standardized mortality rate(ASMR),and age-standardized disability-adjusted life years(DALYs)rate of tetanus in China decreased significantly(average annual percent change[AAPC]＜0,P＜0.001),with males being significantly higher than females.The crude incidence rate,crude mortality rate,and crude DALYs rate for all age groups showed overall declining trends,with the lar-gest decline in the 0-14 years age group.In 2021,the crude incidence rate,crude mortality rate,and crude DALYs rate of tetanus in the population aged 70-years were higher than those in the population aged 0-14,15-49,and 50-69 years groups.The ASIR,ASMR,and age-standardized DALYs rate of tetanus in China in 2021 were lower than the global level,only higher than those in the high SDI regions.Conclusion From 1990 to 2021,the disease burden of tetanus in China varied with gender and age,with an overall declining trend over time.It is necessary to strengthen tetanus health education for males and the ≥70 years population,and to improve the overall level of pri-mary prevention measures for tetanus.

Objective:To investigate the risk factors for bleeding and thrombosis during extracorporeal membrane oxygenation (ECMO) therapy in critically ill patients and determine the best predictors of coagulation-related complications.Methods:A retrospective analysis was performed on patients who received ECMO for respiratory or circulatory failure at Xiangya Hospital of Central South University from January 2020 to December 2022. The outcome was whether bleeding or thrombosis occurred from 24 h after ECMO insertion to before weaning. The differences in demographic characteristics, weaning conditions, prognosis, routine blood tests, organ function, coagulation and blood product transfusion of each group were compared. Logistic regression analysis was used to evaluate the risk factors for bleeding and thrombosis, and ROC curve evaluation was used to assess their capacity to predict complications.Results:A total of 61 patients with ECMO were enrolled, with 21 cases of bleeding and 14 cases of thrombosis during ECMO. Compared with the nonbleeding group, the activated partial thromboplastin time, thromboplastin time (TT), and transfusions of frozen plasma and red blood cells were higher in the bleeding group (all P<0.05). Compared with the nonthrombotic group, the increase in body weight, D-dimer (DD), fibrinogen degradation product (FDP), and improvement of arterial oxygen partial pressure (ΔPO 2) within 24 h were significantly higher in the thrombotic group (all P<0.05). Logistic regression analysis revealed that TT ( OR=1.039, 95% CI: 1.006~1.072, P=0.018) and frozen plasma transfusion volume ( OR=1.046, 95% CI: 1.010-1.083, P=0.012) were risk factors for bleeding events. FDP ( OR=1.030, 95% CI: 1.009-1.051, P=0.005), DD ( OR=1.181, 95% CI: 1.044-1.336, P=0.008), and ΔPO 2 ( OR=1.007, 95% CI: 1.002-1.012, P=0.006) were risk factors for thrombosis. According to ROC curve analysis, the AUCs of TT, frozen plasma transfusion, and combined indexes for predicting bleeding were 0.712, 0.690, and 0.816, respectively. The combined indices had a cut-off value of 0.273, a sensitivity of 75.61%, and a specificity of 80.00%. The AUCs of FDP, DD, ΔPO 2, and combined FDP with ΔPO 2 for predicting thrombosis were 0.778, 0.748, 0.786, and 0.868, respectively. The cut-off value of the combined index was 0.157, the sensitivity was 68.09%, and the specificity was 92.86%. Conclusions:TT combined with frozen plasma transfusion volume predicted bleeding optimally, while FDP plus ΔPO 2 predicted thrombotic events better during ECMO treatment in critically ill patients.

Natural extracellular vesicles (EVs) play important roles in many life processes such as in the intermolecular transfer of substances and genetic information exchanges. Investigating the origins and working mechanisms of natural EVs may provide an understanding of life activities, especially regarding the occurrence and development of diseases. Additionally, due to their vesicular structure, EVs (in small molecules, nucleic acids, proteins, etc.) could act as efficient drug-delivery carriers. Herein, we describe the sources and biological functions of various EVs, summarize the roles of EVs in disease diagnosis and treatment, and review the application of EVs as drug-delivery carriers. We also assess the challenges and perspectives of EVs in biomedical applications.

Objective: To explore the best indication for veneers and to improve the repair success rate by investigating the effects of different types of dentin exposure on the shear bond strength of cast porcelain veneers with two new veneer bonding systems. Methods: Bonding interfaces with 0%, 25%, 50%, 75% and 100% dentin exposure were designed and fabricated. The bonding interfaces were divided into groups A, B, C, D and E. Sixty 4-mm x 4-mm x 2-mm (length x width x thickness) ceramic specimens were bonded by using two bonding systems, The VN-A, VN-B, VN-C, VN-D and VN-E groups were bonded with Variolink bonding system, and the PF-A, PF-B, PF-C, PF-D and PF-E were bonded with Panavia F bonding system (six specimens per group). The bonded specimens were stored in a distilled water bath at (37 + 1)℃ for 24 hours. The fracture load was tested by a universal testing machine, and the fracture type was observed by scanning electron microscopy. Results : The VN-A (25.14 ± 3.40 MPa), VN-B (22.54 ± 4.48 MPa), VN-C (19.59 ± 2.21 MPa), PF-A (20.61 ± 2.42 MPa), PF-B (18.08 ± 4.11 MPa), PF-C (17.06 ± 2.29 MPa) groups’ shear bond strengths were above 17 MPa. The VN-A group had the highest shear bond strength value. There was no statistically significant difference in bond strength between the VN-A group and the VN-B and VN-C groups (P > 0.05) or the PF-A and PF-B groups (P > 0.05); however, the differences between VN-A and the VN-D and VN-E groups (P < 0.05) and between PF-A and the PF-C and PF-D and PF-E groups (P < 0.05) were statistically significant. The differences between the VN-A group and PF-A group (P < 0.05) were statistically significant. The fracture modes of the VN-A, PF-A, VN-B, PF-B, and VN-C groups mainly included resin cement cohesive failure and mixed failure; the VN-D, VN-E, PF-C, PF-D and PF-E groups were dominated by interface failure and mixed failure. Conclusion When the dentin exposure is greater than 50%, the shear bond strength value of the veneer was significantly affected. To obtain a better clinical effect, the dentin exposure rate should be less than 25%.

Objective To study the changes in miRNAs expression in the exosomes of human umbilical vein endothelial cells(HUVECs) after 60 Co γ-rays expose using microRNA(miRNA) chips and bioinformatics techniques so as to provide new clues to the mechanism of radiation-induced vascular tissue injury and its bystander effects.Methods HUVECs exosomes were collected in the control and 4 Gy irradiated cells by ultra-high-speed centrifugation,and further confirmed using transmission electron microscopy (TEM) and Western blotting of exosomes biomarkers.miRNA microarray was used to analyze miRNA expression profiles of exosomes and cells.Also,real-time quantitative PCR(qRT-PCR) was used to verify differentially expressed miRNAs,and the miRDB and TargetScan were performed to predict the target genes of the differentially expressed miRNAs.Bioinformatics analysis was performed using DAVID,KEGG and other online tools.Results Compared with the control exosomes from non-irradiated HUVECs,miRNA microarray analysis revealed that 5 up-regulated,and 13 down-regulated miRNAs were identified in the exosomes from HUVECs at 0.5 h after 4 Gy-irradiation,and 16 up-regulated and 5 down-regulated miRNAs at 2 h after 4 Gy-irradiation.Moreover,38 and 85 miRNAs were differentially expressed respectively in the HUVECs at 0.5 h and 2 h after radiation.The difference was statistically significant(P<0.01).The results of bioinformatics showed that these miRNAs might exert the radiation-induced bystander effect (RIBE) by regulating MAPK signal pathways,RAS and PI3K-Akt signal pathways.Conclusion The ionizing radiation injury significantly alters the components and expression levels of exosomal miRNAs,which play important roles in regulating the signal pathways in response to radiation.

Applying scientific literature in the teaching of nutrition and food hygiene is neces-sary. It can not only deepen students' understanding of the course and improve students' English level and scientific research ability, but also can improve teachers' professional skill. To improve the effi-ciency of teaching, teachers should choose literature close to the course and pay attention to selecting review literature and English literature. Textbook should be principal line of study during the teach-ing. Teachers should control the number and timing of explaining literature and grasp the complexity of literature. In order to facilitate students' understanding, teachers should make full use of related figures and tables.

To summarize the etiological factor and to assess the therapeutic effect for neovascular glaucoma(NVG).Methods A retrospective study of 28 cases (29 eyes) with NVG was performed. The mean age, proportion of sex and primary ocular disease, incidence of symptom, sign and postoperative complication were analyzed. Results 78 6% of the patients were over 40 years old. 62% of the patients were secondary to the ocular ischemic disease such as central retina vein occlusion and proliferative diabetic retinopathy. The clinical characters included intraocular pressure (IOP) increasing, pain, mixed conjunctival congestion and rubeosis iridis. The mean IOP reduction was 19.5 mmHg in 29 eyes after antiglaucomatous drags treatment and 19.13mmHg in 23 eyes after Hunan aqueous humor drainage (HAD) implantation. The common postoperative complications were flat anterior chamber and choroidal detachment. The success rate of HAD implantation was 87%.Conclusions NVG was commonly secondary to ocular ischemic disease. Although prevention was the principal, reducing IOP and ameliorating ischemic situation were as the same important.