Panvascular diseases are systemic diseases with atherosclerosis as the pathological core， involving multiple vascular beds and target organs throughout the body. Due to their wide range and complexity， the traditional single-discipline prevention and treatment model struggles to meet the needs of systematic management， while clinical diagnosis often remains one-sided and insufficient， leading to delayed treatment. Literature reviews show that panvascular diseases involve a wide range of lesion sites， numerous influencing factors， and are prone to endangering life and health. It is urgent to construct a comprehensive and whole-course prevention and treatment management system， with vascular health as the goal and patients as the core. First， early screening and risk assessment should be conducted for high-risk groups. In terms of treatment decisions for patients， multi-disciplinary collaboration is needed to establish a scientific and standardized prevention and treatment path. Second， it is important to attach great importance to a people-centered approach， enhance patients' familiarity with the disease through cognitive intervention， and shift from passive treatment to active health care. Thirdly， it is needed to leverage the advantages of modern science and technology， promote the deep integration of artificial intelligence innovations and modern medicine， and help traditional diagnosis and treatment plans evolve towards precision， intelligence， and personalization. This will open up new paths for the modernization of the whole-course management of pan-vascular diseases. Fourth， efforts should be made to continue to carry forward and innovate the characteristics of traditional Chinese medicine， adhere to equal emphasis on modern and traditional medicine， promote complementary advantages and coordinated development of Chinese and Western medicine， and form a unique Chinese model for the whole-course management of panvascular diseases. Fifth， through the reintegration and redistribution of government， medical insurance， and medical resources， comprehensive talents in the broad vascular disciplines should be cultivated and an efficient hierarchical management model established， providing reference and guidance for the whole-course management of comprehensive diseases in the future.

ObjectiveTo investigate the association between single and combined exposure to arsenic （As）， mercury （Hg）， and cadmium （Cd） in urine and hearing loss in adults. MethodsA total of 400 adult patients were recruited for the study， comprising 200 participants in the normal hearing group and 200 in the hearing loss group. General demographic information of the study subjects was collected by a self-administered questionnaire， morning urine samples were tested for As， Hg， and Cd concentrations， and hearing status was assessed by Pure Tone Audiometry. A binary Logistic regression model was used to explore the association between the concentrations of the three metals in urine and hearing loss， and a Bayesian kernel-machine regression （BKMR） model was used to further explore the association between the concentrations of the three metal mixtures and hearing loss. ResultsAfter correction for urinary creatinine， As， Hg， and Cd concentrations were higher in the hearing loss group than those in the normal hearing group （P<0.05）. Binary Logistic regression indicated that concentrations of As， Hg， and Cd were positively associated with hearing loss， and the risk of hearing loss was significantly higher in the second quartile of Cd concentration compared to the first quartile （OR=2.000， 95%CI： 1.009-3.964）. BKMR modeling analysis showed that the combined exposure levels of As， Hg， and Cd significantly increased the risk of hearing loss， with Cd being the most important contributor （posterior inclusion probability=0.412）， and that there were potential interactions between As and Cd， and Cd and Hg. ConclusionCombined exposure to As， Hg， and Cd in urine is significantly associated with adult hearing loss， with Cd being the primary contributor in the exposure combination. The interactions between As and Cd， as well as Cd and Hg， may have adverse effects on hearing loss.

AIM:This study aimed to investigate the effect of ischemic post-conditioning(I-post-C)on lung ischemia-reperfusion injury(LIRI)in rats and relationship between I-post-C and zinc homeostasis.METHODS:SPF SD rats(6～8 weeks old)were randomly divided into four groups,with eight rats in each group:control group,ischemia/reper-fusion(I/R)group,I-post-C group and I-post-C+zinc ion chelator TPEN group.Inductively coupled plasma mass spec-trometry(ICP-MS)was used to measure the concentration of zinc ions in lung tissues.HE staining,lung wet/dry weight ra-tio(W/D),total lung water content(TLW),and index of quantitative assessment(IQA)of lung injury were used to detect the degree of lung tissue injury in each group.Mitochondrial membrane potential was measured using extraction and JC-1 mitochondrial membrane potential detection kits.TUNEL assay was used to detect the level of apoptosis in lung tissues.Western blot was used to detect the protein expression levels of caspase-3,solute carrier family 39 member 8(SLC39A8/ZIP8),solute carrier family 30 member 9(SLC30A9/ZNT9),and PI3K/AKT/GSK-3β in lung tissues of each group.RT-qPCR was used to detect ZIP8 and ZNT9.RESULTS:Compared to the control group,the I/R group showed significantly aggravated lung tissue injury(P<0.01),decreased zinc ion levels(P<0.01),enhanced cell apoptosis(P<0.05),re-duced mitochondrial membrane potential(P<0.01),decreased PI3K/AKT/GSK-3β phosphorylation levels(P<0.05,P<0.01),increased cleaved caspase-3/pro-caspase-3 ratio(P<0.01),and reduced ZIP8 expression(P<0.05).Compared to the I/R group,the I-post-C group exhibited alleviated injury(P<0.05 or P<0.01),increased zinc ion levels(P<0.01),reduced apoptosis(P<0.01),restored mitochondrial membrane potential(P<0.01),elevated PI3K/AKT/GSK-3β phosphorylation levels(P<0.05,P<0.01),decreased cleaved caspase-3/pro-caspase-3 ratio(P<0.05),and in-creased ZIP8 expression(P<0.05).Compared to the I-post-C group,the I-post-C+TPEN group demonstrated aggravated injury(P<0.01),decreased zinc ion levels(P<0.01),enhanced apoptosis(P<0.01),reduced mitochondrial membrane potential(P<0.05),decreased PI3K/AKT/GSK-3β phosphorylation levels(P<0.05,P<0.01),increased cleaved cas-pase-3/pro-caspase-3 ratio(P<0.05),and reduced ZIP8 expression(P<0.05).ZNT9 expression showed no significant differences among the groups(P>0.05).CONCLUSION:Ischemic postconditioning can improve LIRI by regulating zinc homeostasis,activating PI3K/AKT signaling pathway,inactivating glycogen synthase kinase 3β,inhibiting the de-cline of mitochondrial membrane potential,and antagonizing cell apoptosis in rats.

Objective:To analyze the developmental trajectories of depressive symptoms in middle school students and their relationship with school connection and self-efficacy,and to provide evidence for the prevention of early adolescent depressive symptoms.Methods:In March(T1),June(T2),December(T3),809 middle school students were followed up in 2023 using the Patient Health Questionnaire-9(PHQ-9),School Connection Scale(SCS)and General Self-Efficacy Scale(GSES).The heterogeneity of the developmental trajectory of depressive symptoms in early adolescents was analyzed by the latent variable growth mixed model(LGMM),and the relation-ship between the developmental trajectory of depressive symptoms and school connection and self-efficacy was ana-lyzed by multiple logistic regression.Results:LGMM results showed that the development trajectory of early de-pressive symptoms in adolescents could be divided into:"low level-remission group"(65.3％),"low level-stable group"(28.6％)and"medium level-worsening group"(6.1％).Logistic regression analysis showed that male students(OR=0.62,95％CI=0.44-0.86)and school connection(OR=0.91,95％CI=0.88-0.94)were the protective factors in the"low level-stable group".Boys(OR=0.26,95％CI=0.13-0.53),school connection(OR=0.93,95％CI=0.88-0.98),and self-efficacy(OR=0.90,95％CI=0.85-0.96)were the protective fac-tors in the"medium level-worsening".Conclusion:There is heterogeneity in the developmental trajectory of early adolescent depressive symptoms,and school connection and self-efficacy are protective factors for the development of early adolescent depressive symptoms.

Objective:To analyze the developmental trajectories of depressive symptoms in middle school students and their relationship with school connection and self-efficacy,and to provide evidence for the prevention of early adolescent depressive symptoms.Methods:In March(T1),June(T2),December(T3),809 middle school students were followed up in 2023 using the Patient Health Questionnaire-9(PHQ-9),School Connection Scale(SCS)and General Self-Efficacy Scale(GSES).The heterogeneity of the developmental trajectory of depressive symptoms in early adolescents was analyzed by the latent variable growth mixed model(LGMM),and the relation-ship between the developmental trajectory of depressive symptoms and school connection and self-efficacy was ana-lyzed by multiple logistic regression.Results:LGMM results showed that the development trajectory of early de-pressive symptoms in adolescents could be divided into:"low level-remission group"(65.3％),"low level-stable group"(28.6％)and"medium level-worsening group"(6.1％).Logistic regression analysis showed that male students(OR=0.62,95％CI=0.44-0.86)and school connection(OR=0.91,95％CI=0.88-0.94)were the protective factors in the"low level-stable group".Boys(OR=0.26,95％CI=0.13-0.53),school connection(OR=0.93,95％CI=0.88-0.98),and self-efficacy(OR=0.90,95％CI=0.85-0.96)were the protective fac-tors in the"medium level-worsening".Conclusion:There is heterogeneity in the developmental trajectory of early adolescent depressive symptoms,and school connection and self-efficacy are protective factors for the development of early adolescent depressive symptoms.

Objective To investigate the contamination status of cloth mouse pads in dental clinics,and provide theoretical basis for standardizing environmental surface disinfection and scientific intervention in dental clinics.Methods The contamination status of cloth mouse pads in 5 dental clinics were investigated by adenosine triphos-phate(ATP)fluorescence detection method,visual observation method,and bacterial culture method.Disinfection efficacy of ultraviolet disinfection method and wiping disinfection using two types of disinfectant wipes on cloth mouse pads and photovoltaic glass mouse pads was compared.Intervention measures(using photovoltaic glass mouse pads,regular cleaning and disinfecting)were taken,and contamination status of cloth mouse pads in different departments before and after intervention was compared.Results The baseline investigation found that the conta-mination status of mouse pads varied in different dental clinics.The qualified rate of bacterial culture of mouse pads in department of endodontics was the lowest(20.00％),followed by the department of periodontology(30.00％).There was statistically significant difference in ATP detection values between two types of disinfectant wipes before and after wiping and disinfecting photovoltaic glass mouse pads(both P＜0.001).After using photovoltaic glass mouse pads,the contamination of mouse pads in 5 dental clinics was alleviated,and the qualified rate of ATP detec-tion increased(＞80％),compared with qualified rate of ATP detection before intervention,differences were all sta-tistically significant(all P＜0.001).Conclusion The contamination of the cloth mouse pads in dental clinics is seri-ous,and the conventional cloth mouse pad is difficult to be cleaned and disinfected.It is suggested that medical in-stitutions use the mouse pad which is convenient for cleaning and disinfection,and specify the disinfection method and frequency to control the contamination of the mouse pads.

Objective:To investigate the clinical application value of expanded non-invasive prenatal testing(NIPT-plus)in screening for fetal chromosome copy number variations(CNV).Methods:From January 2021 to December 2023,141 pregnant women who voluntarily underwent amniocentesis at the Prenatal Diagnostic Centre of Urumqi Maternal and Child Health Hospital due to NIPT-plus suggesting a high risk of fetal CNV were selected.Amniotic fluid samples were collected for fetal chromosome karyotyping and chromosome microarray analysis(CMA).Pregnant women who underwent the above tests signed an informed consent form,and all cases were followed up forpregnancy outcome.Results:Among 141 NIPT-plus screen positive pregnant women,41 true posi-tive cases were detected by chromosomal karyotype analysis and CMA.The positive predictive value(PPV)for NIPT-plus screening for CNV was 29.08％(41/141).There was no statistically significant difference(P＞0.05)in the PPV of CNV detected by NIPT plus among different ages,indications and variant types.However,the PPV of CNV size＜10 Mb was significantly higher than that of CNV size≥ 10 Mb,and the difference was statistically signif-icant(39.62％vs.22.73％,P＜0.05).Among the 41 true positive cases,in addition to CNV,the CMA also detec-ted 7 cases of regions of Homozygosity(ROH),accounting for 17.07％(7/41)of the cases,two of which involved imprinted genes located on chromosomes 6 and 7.All continued pregnancy after genetic counselling and no signif-icant abnormalities were seen at neonatal follow-up after birth.Conclusions:NIPT-plus screening for fetal CNV has some clinical value,especially for CNV with fragment size＜10Mb,but accuracy needs to be further improved;CMA as a molecular diagnostic technique can detect ROH in cases where NIPT-plus suggests CNV abnormali-ties,and the combined use of the two techniques also opens new avenues for screening and diagnosis of prenatal imprinted diseases.

Objective To investigate the relationship between stationing years of personnel on an island and their traditional Chinese medicine(TCM)constitution,thus providing a reference for adjusting the health status of stationed personnel,preventing and treating diseases.Methods Based on The Scale of Constitution in Chinese Medicine Questionnaire,TCM constitution of 734 personnel stationed on an island was investigated.Pearson χ2 method was used for data analysis.Results Of the 734 personnel stationed on an island 345(47.0%)were of the balanced constitution type and 389(53.0%)were of the biased constitution types.Among the people with biased constitution types,composite constitution accounted for 80.5%(313 people)and the simple accounted for the rest(19.5%,76 people).The top three types of the biased were dampness heat(15.2%),qi deficiency(14.0%),and yin deficiency(10.7%).The distribution of TCM constitution types was significantly different in terms of stationing years on the island(P<0.05).There was a significant difference in the balanced type and yin deficiency type between people with stationing time≤2 years and>8 years(P<0.05).There was a significant difference in qi deficiency type and qi depression type between people with stationing time≤2 years and>5 years(P<0.05).Compared to people with stationing time≤2 years,significant difference was found in yang deficiency type in people with stationing time ranging from 2 to 5 years and those with>8 years(P<0.05).There were significant differences in the phlegm dampness type,blood stasis type,and specific diathesis type between people with stationing time≤2 years and people with stationing time ranging from>2～5 years and>8 years(P<0.05).There were significant differences in the dampness heat type between people with stationing time≤2 years and people with stationing time ranging from>5～8 years and>8 years,between pepole with stationing time ranging from>2～5 years and people with stationing time>8 years(P<0.05).Conclusion The dampness heat type,qi deficiency type and yin deficiency type are common biased TCM constitution in personnel stationed on islands.The longer the time spent on islands,the greater the possibility of forming biased constitution.

Objective To reveal the thermally induced denaturation of wild-type human γ D-crystallin(HGD)and congenital cataract-related mutant(HGD P23T),and compare the differences in the structural changes between wild-type and mutants during a heating process.Methods HGD and HGD P23T were expressed and purified.The temperature-dependent intrinsic fluorescence intensity and static light scattering intensity of the protein samples were measured to reveal the temperature-dependent folding and aggregation structural changes of HGD and HGD P23T.Results When the temperature was below 70℃,the barycentric mean of the intrinsic fluorescence of HGD and HGD P23T shifted towards a longer wavelength with increasing temperature and the fluorescence intensity de-creased indicating the unfolded protein conformations.The conformational stability of HGD P23T was weaker than that of HGD.When temperature was higher than 70℃,the static light scattering intensity increased significantly with temperature,indicating protein aggregation upon heating.Relative to the wild-type,HGD P23T showed a stronger aggregation potency.Conclusions Heating disrupts the folding conformation of Γd-crystallin,induces the unfolded protein to aggregate.The disease-associated P23T mutation significantly reduces the conformational stability of Γd-crystallin.

AIM:To investigate the protective effect and mechanism of zinc ions on lung ischemia/reperfusion injury(LIRI)in rats.METHODS:SPF SD rats aged 6～8 weeks were divided randomly into 4 groups:control(control)group,ischemia/reperfusion(I/R)group,zinc chloride(ZnCl2)+I/R group,and PI3K inhibitor(LY294002)+ZnCl2+I/R group.Inductively coupled plasma mass spectrometry(ICP-MS)was used to measure the concentration of zinc ions in lung tissues,while the degree of lung tissue injury was assessed by HE staining,the alveolar damage index,and the lung wet/dry weight ratio.qPCR was used to detect the mRNA expression of solute carrier family 39 member 8(SLC39A8/ZIP8),with the TUNEL assay used to determine the level of apoptosis in lung tissue.The phosphorylation levels of caspase3,PI3K,AKT,GSK-3β,ZIP8,and solute carrier family 30 member 9(SLC30A9/ZNT9)were detected by Western blot,while the mitochondrial membrane potential was measured by the mitochondrial extraction kit and JC-1 mitochondrial mem-brane potential detection kit.RESULTS:Compared with the I/R group,the zinc ion level in the ZnCl2+I/R group in-creased(P<0.01),with the qPCR results showing that the expression level of ZIP8 also increased(P<0.01).The West-ern blot results demonstrated that the phosphorylation levels of PI3K/AKT/GSK-3β and cleaved caspase-3/pro were both in-creased(P<0.01 or P<0.05).In addition,the level of caspase-3 was decreased(P<0.01),the ZIP8 level was increased(P<0.05),whereas the level of ZNT9 was not significantly different(P>0.05).The mitochondrial membrane potential was increased(P<0.01)and the level of apoptosis was decreased(P<0.01).The results of HE staining,total lung water(TLW),lung index of quantitative assessment of histology(IQA),and lung tissue wet/dry weight ratio showed that the de-gree of injury was reduced significantly(P<0.05 or P<0.01).Compared with the ZnCl2+I/R group,the LY294002+Zn-Cl2+I/R group had a significant reduction in zinc ion levels(P<0.05),while qPCR showed a significant reduction in ZIP8 expression(P<0.01).Western blot showed that the phosphorylation level of PI3K/AKT/GSK-3β was decreased(P<0.01),the level of caspase-3/pro-caspase-3 was increased(P<0.01)the level of ZIP8 was decreased(P<0.05),al-though there was no significant difference in ZNT9(P>0.05).Measurements of the mitochondrial membrane potential demonstrated a significant decrease(P<0.01),while the TUNEL results showed that the level of apoptosis had increased(P<0.05).HE staining,TLW,IQA and lung tissue wet/dry weight ratio indicated that the degree of injury was aggravated significantly(P<0.05 or P<0.01).CONCLUSION:Administration of zinc chloride in rats has a protective role in lung ischemia/reperfusion injury by activating the PI3K/AKT pathway,leading to inactivation of GSK-3β,stabilization of the mitochondrial membrane potential level,and inhibition of cell apoptosis.