Objective:To explore the effect of Ephedrine on oxygen glucose deprivation/reoxygenation(OGD/R)induced neu-ronal injury by regulating receptor interacting protein-1/receptor interacting protein-3/mixed lineage kinase domain-like protein(RIP1/RIP3/MLKL)signaling pathway.Methods:OGD/R model was constructed by hypoxia/reoxygenation;human cortical neuron HCN cells were separated into control group,model group(OGD/R group),Ephedrine group(800 μg/ml),Compound 6i group(RIP1 acti-vator Compound 6i,0.94 μmol/L),Ephedrine+Compound 6i group(800 μg/ml Ephedrine+0.94 μmol/L Compound 6i),Nec-1 group(RIP1 specific inhibitor Nec-1,5 μmol/L)and Ephedrine+Nec-1 group(800 μg/ml Ephedrine+5 μmol/L Nec-1);CCK-8 method was applied to detect HCN cell proliferation;DCFH-DA method was applied to detect ROS level in HCN cells;flow cytometry was ap-plied to detect HCN cell apoptosis;ELISA was applied to detect levels of TNF-α and IL-6;Western blot was applied to detect RIP1/RIP3/MLKL signaling pathway and apoptotic proteins expressions in HCN cells.Results:Compared with control group,ROS level,apop-tosis rate,p-MLKL,RIP3,Bax,IL-6,TNF-α and RIP1 expressions of HCN cells in OGD/R group were significantly increased,A450 value and Bcl-2 protein were significantly decreased(P<0.05);compared with OGD/R group,ROS level,apoptosis rate,p-MLKL,RIP3,Bax,IL-6,TNF-α and RIP1 expressions of HCN cells in Ephedrine group and Nec-1 group were significantly reduced,A450 val-ue and Bcl-2 protein were significantly increased,the trend of Compound 6i group was opposite(P<0.05);Compound 6i was able to weaken the effect of Ephedrine in improving OGD/R induced neuronal injury,Nec-1 was able to enhance the effect of Ephedrine in im-proving OGD/R induced neuronal injury.Conclusion:Ephedrine attenuates OGD/R induced neuronal injury by inhibiting RIP1/RIP3/MLKL signaling pathway.

In recent decades, the global community has encountered several significant viral outbreaks, including the Ebola epidemic in West Africa, the Zika virus epidemic in South America, and the recent worldwide COVID-19 pandemic. In these instances, the deployment of effective vaccines has been instrumental in protecting public health. Nevertheless, as new challenges emerge in the prevention and management of infectious diseases, the traditional model of global vaccine development confronts both unprecedented opportunities and challenges. These circumstances underscore the limitations inherent in conventional vaccine development, particularly the protracted timelines and substantial costs involved. This article examines innovative approaches in contemporary vaccine clinical trials, investigates randomization techniques specific to vaccine studies, and delineates essential statistical considerations pertinent to vaccine trial design. The objective is to provide scientific support for vaccine development and to foster ongoing innovation and optimization within the realm of vaccine research and development.

This study investigated the role of the nuclear factor of activated T cells c3 (NFATc3) in vascular smooth muscle cells (VSMCs) during aortic aneurysm and dissection (AAD) progression and the underlying molecular mechanisms. Cytoplasmic and nuclear NFATc3 levels were elevated in human and mouse AAD. VSMC-NFATc3 deletion reduced thoracic AAD (TAAD) and abdominal aortic aneurysm (AAA) progression in mice, contrary to VSMC-NFATc3 overexpression. VSMC-NFATc3 deletion reduced extracellular matrix (ECM) degradation and maintained the VSMC contractile phenotype. Nuclear NFATc3 targeted and transcriptionally upregulated matrix metalloproteinase 9 (MMP9) and MMP2, promoting ECM degradation and AAD development. NFATc3 promoted VSMC phenotypic switching by binding to eukaryotic elongation factor 2 (eEF2) and inhibiting its phosphorylation in the VSMC cytoplasm. Restoring eEF2 reversed the beneficial effects in VSMC-specific NFATc3-knockout mice. Cabamiquine-targets eEF2 and inhibits protein synthesis-inhibited AAD development and progression in VSMC-NFATc3-overexpressing mice. VSMC-NFATc3 promoted VSMC switch and ECM degradation while exacerbating AAD development, making it a novel potential therapeutic target for preventing and treating AAD.

In recent decades, the global community has encountered several significant viral outbreaks, including the Ebola epidemic in West Africa, the Zika virus epidemic in South America, and the recent worldwide COVID-19 pandemic. In these instances, the deployment of effective vaccines has been instrumental in protecting public health. Nevertheless, as new challenges emerge in the prevention and management of infectious diseases, the traditional model of global vaccine development confronts both unprecedented opportunities and challenges. These circumstances underscore the limitations inherent in conventional vaccine development, particularly the protracted timelines and substantial costs involved. This article examines innovative approaches in contemporary vaccine clinical trials, investigates randomization techniques specific to vaccine studies, and delineates essential statistical considerations pertinent to vaccine trial design. The objective is to provide scientific support for vaccine development and to foster ongoing innovation and optimization within the realm of vaccine research and development.

Objective:To explore the effect of Ephedrine on oxygen glucose deprivation/reoxygenation(OGD/R)induced neu-ronal injury by regulating receptor interacting protein-1/receptor interacting protein-3/mixed lineage kinase domain-like protein(RIP1/RIP3/MLKL)signaling pathway.Methods:OGD/R model was constructed by hypoxia/reoxygenation;human cortical neuron HCN cells were separated into control group,model group(OGD/R group),Ephedrine group(800 μg/ml),Compound 6i group(RIP1 acti-vator Compound 6i,0.94 μmol/L),Ephedrine+Compound 6i group(800 μg/ml Ephedrine+0.94 μmol/L Compound 6i),Nec-1 group(RIP1 specific inhibitor Nec-1,5 μmol/L)and Ephedrine+Nec-1 group(800 μg/ml Ephedrine+5 μmol/L Nec-1);CCK-8 method was applied to detect HCN cell proliferation;DCFH-DA method was applied to detect ROS level in HCN cells;flow cytometry was ap-plied to detect HCN cell apoptosis;ELISA was applied to detect levels of TNF-α and IL-6;Western blot was applied to detect RIP1/RIP3/MLKL signaling pathway and apoptotic proteins expressions in HCN cells.Results:Compared with control group,ROS level,apop-tosis rate,p-MLKL,RIP3,Bax,IL-6,TNF-α and RIP1 expressions of HCN cells in OGD/R group were significantly increased,A450 value and Bcl-2 protein were significantly decreased(P<0.05);compared with OGD/R group,ROS level,apoptosis rate,p-MLKL,RIP3,Bax,IL-6,TNF-α and RIP1 expressions of HCN cells in Ephedrine group and Nec-1 group were significantly reduced,A450 val-ue and Bcl-2 protein were significantly increased,the trend of Compound 6i group was opposite(P<0.05);Compound 6i was able to weaken the effect of Ephedrine in improving OGD/R induced neuronal injury,Nec-1 was able to enhance the effect of Ephedrine in im-proving OGD/R induced neuronal injury.Conclusion:Ephedrine attenuates OGD/R induced neuronal injury by inhibiting RIP1/RIP3/MLKL signaling pathway.

This article reports a rare case of systemic lupus erythematosus (SLE) complicated with rectal ulcer and stenosis, with difficulty in defecation as the main manifestation. Through multiple multidisciplinary consultations and joint decision-making between doctors and patients, combined with surgical and pathological comprehensive diagnosis, monism is considered: SLE affects the rectum. The patient has a good prognosis after undergoing medication, endoscopic local treatment, and surgical treatment.

Objective:To understand intensive care unit(ICU)doctors'opinions and suggestions on implementing palliative care,and provides a reference basis for the implementation of palliative care in Chinese ICU.Methods:A purposive sampling technique was used to conduct one-on-one semi-structured interviews with 11 ICU doctors.Colaizzi's phenomenological analysis method was utilized to code,classify,interpret,and comprehensively analyze the interview data.Results:A total of 4 themes and 18 sub-themes was extracted,including cognitive biases toward palliative care,the belief that implementing palliative care in the ICU has significant humanistic implications(palliative care practice is the most perfect embodiment of medical humanities,palliative care in the ICU can alleviate patient pain and reduce invasive operations,palliative care can achieve comfortable care for ICU patients,palliative care focuses on maintaining the dignity of ICU patients,palliative care can pay attention to the inner voice of ICU patients,and implementing palliative care will help to more effectively allocate resources),difficulties faced by ICU in carrying out palliative care(lack of clarity in relevant policies at the legal level,closed management environment in the ICU,insufficient manpower in the ICU and lack of palliative care professional team,inadequate understanding of ICU patients'families,lack of death education,not included in medical insurance payments,and lack of communication skills of young doctors),strategies to promote the development of palliative care in the ICU(ICU palliative care can be piloted first,the development of ICU palliative care screening tools will help with the development of palliative care,the palliative environment and the handling of death procedures can be further optimized,and the application and implementation of scientific methods to shorten the gap between evidence and practice of palliative care).Conclusions:The integration of palliative care and ICU in China is still blank.The significance of implementing palliative care in ICU should be emphasized,ICU doctors'knowledge and skills of palliative care should be improved from multiple perspectives,patient preference should be emphasized to improve the knowledge and acceptance of palliative care of ICU patients'families,and the promotion of palliative care in ICU clinical practice should be pioneered and piloted.

BACKGROUND:In clinical application,the therapeutic effect of transcranial magnetic stimulation depends on the ability to accurately target the areas of the brain that need to be stimulated.In recent years,with the development of neuronavigation systems,mobile augmented reality technology,and the new methods of processing magnetic resonance imaging(MRI)data,the accuracy of stimulus target localization and the optimization of target selection are expected to improve further. OBJECTIVE:To review the principle of MRI-based image navigation and its application in transcranial magnetic stimulation and summarize the roles of different modal MRI data analyses in guiding the selection of target areas for transcranial magnetic stimulation. METHODS:An online computer search for relevant literature was performed in PubMed,CNKI database and WanFang database,with the keywords"transcranial magnetic stimulation,coil positioning,neuronavigation,augmented reality,magnetic resonance,theory."Finally,63 documents were included for review. RESULTS AND CONCLUSION:Among the traditional methods of positioning transcranial magnetic stimulation coils,the"5 cm rule"and the international electroencephalogram 10-20 positioning method are the most commonly used.These methods have the advantages of simplicity and economy,but they rely too much on the operator's experience and there were technical differences between operators.The neuronavigation system,which is based on stereotactic technology,is the guiding method for positioning transcranial magnetic stimulation coils with the highest visual degree and accuracy.It achieves visual positioning through MRI data acquisition,3D brain reconstruction,head model registration and stereogeometric positioning.It has high application value in clinical treatment and scientific research,but it cannot be promoted in medical institutions due to its high cost.For various medical institutions,mobile augmented reality is a cost-effective and efficient alternative to the neuronavigation system,which achieves visual positioning of brain tissue under the scalp through MRI data acquisition,2D/3D image construction,virtual image and real brain image superposition.It has the advantages of directly visualization and low cost,and is expected to be popularized and applied in primary medical units.Although the superiority of clinical efficacy of visual coil positioning over the electroencephalogram 10-20 localization strategy has not yet been fully demonstrated,with the progress of brain MRI data analysis,visual positioning is expected to further optimize the target selection strategy of transcranial magnetic stimulation therapy and to improve the response rate and individuation degree of transcranial magnetic stimulation treatment.This is a promising and challenging research direction in the future.

Objective: To investigate the incidence trend of diabetes among children and adolescents in Ningbo City, Zhejiang Province from 2011 to 2021, so as to provide the basis for the prevention and control of diabetes among children and adolescents. Methods: Data on diabetes incidence among children and adolescents aged 0 to 18 years in Ningbo City were collected through the Diabetes Monitoring Platform of the Ningbo Chronic Disease Collaborative Management System from 2011 to 2021. Crude incidence rates were calculated and standardized using data from the Sixth National Population Census in 2010. The trend of incidence rates were analyzed by average annual percent change (AAPC). Results: A total of 701 cases of diabetes among children and adolescents were reported in Ningbo City from 2011 to 2021. The crude and standardized incidence rates were 6.86/105 and 7.27/105, respectively, showing upward trends (AAPC=5.886%, 7.147%, both P<0.05). The crude and standardized incidence rates of type 1 diabetes mellitus were 3.36/105 and 3.35/105, respectively, with no significant trend observed (AAPC=1.229%, 1.449%, both P>0.05). The crude incidence rate was higher in children and adolescents aged 10 to <15 years (4.56/105) than in other age groups (all P<0.05). The standardized incidence rate was higher in females than in males (3.49/105 vs. 3.04/105, P<0.05). The standardized incidence rate was higher in urban areas than in rural areas (3.60/105 vs. 3.15/105, P<0.05). The crude and standardized incidence rates of type 2 diabetes mellitus were 3.43/105 and 3.87/105, respectively, showing upward trends (AAPC=4.904%, 7.579%, both P<0.05). The crude incidence rate was higher in children and adolescents aged 15 to 18 years (10.53/105) than in other groups (all P<0.05). The crude incidence rates in children and adolescents who aged 10 to <15 years and 15 to 18 years showed upward trends (AAPC=15.030%, 6.637%, both P<0.05). The standardized incidence rate was higher in males than in females (4.01/105 vs. 3.57/105, P<0.05). The standardized incidence rate was higher in urban areas than in rural areas (4.57/105 vs. 3.34/105, P<0.05). Conclusions From 2011 to 2021, the incidence of type 2 diabetes mellitus showed an upward trend, with cases mainly concentrated in children and adolescents aged 15 to 18 years, males, and those living in urban areas. The incidence of type 1 diabetes mellitus remained stable, with cases mainly concentrated in children and adolescents aged 10 to <15 years, females, and those living in urban areas.

Mitochondrial dysfunction after spinal cord injury (SCI) is recognized as a crucial pathological mechanism for secondary SCI. Studies have indicated that mitochondrial transfer plays a significant role in the process of neural regeneration following injury. After mitochondria migrating to injured neurons, they mainly function via enhancing the energy metabolism level of damaged neurons and reducing oxidative stress. In this article, we present an exhaustive overview on mechanism of mitochondrial transfer, and impact on neural regeneration after mitochondrial transfer so as to provide valuable insights for further exploring the role of mitochondrial transfer in SCI progression and offer innovative perspective on potential therapeutic strategies for SCI.