Objective:To construct an evidence-based practice program for dietary management of patients with non-dialysis chronic kidney disease (CKD) based on best evidence and to evaluate the effectiveness of its application.Methods:The best evidence for dietary management of non-dialysis CKD patients was summarized. From September to October 2022, following the evidence clinical transformation model of the Fudan University Centre for Evidence-based Nursing, the best evidence was screened and evidence-based practice program were developed, taking into account patients' wishes, expert opinions, and clinical contexts. From November 2022 through March 2023, baseline reviews, analysis of barriers and facilitators were implemented. Between April 2023 and April 2024, evidence-based practice was carried out in the Department of Nephrology of the Second Affiliated Hospital of Guangzhou Medical University to compare the implementation rate of review indicators at the system, practitioner, and patient levels, and practitioners' knowledge before and after the application of evidence.Results:A total of 14 review indicators were developed. The implementation rate of the 12 review indicators and the practitioners' knowledge of the CKD diet were elevated after the evidence-based practice ( P<0.05) . Conclusions:Evidence-based practice program for dietary management of patients with non-dialysis CKD has a positive effect on improving practitioners' knowledge of non-dialysis CKD diets, implementation rate of dietary management behaviors, and patients' dietary behaviors.

Objective:To explore the effects of high-intensity interval training(HIIT)and semaglutide on cardiomyopathy and glycophagy in db/db mice.Method:Forty male db/db mice were randomly divided into diabetic control group(DC,n=10),diabetic+exercise group(DE,n=10),diabetic+semaglutide group(DM,n=10)and diabetic+exercise+semaglutide group(EM,n=10).DE mice and EM mice were conducted a 8-week HIIT treadmill protocol,DM mice and EM mice received daily subcutaneous neck injections of semaglutide at 0.05mg/kg.Body weight and fasting blood glucose were measured regularly.Echocardiography was used to detect cardiac function at the end of the intervention.Myocardial morphology was evaluated by H&E staining;The H&E staining was used to observe the myocardial morphological changes;fibrosis by Masson staining;glycogen accumulation by periodic acid-Schiff staining;and cardiomyocyte hypertrophy by wheat germ agglutinin(WGA)staining.The glycophagy was observed by transmission electron microscopy.Western Blot quantified the IRS-1,P-PI3K,PI3K,p-AKT,AKT,p-GSK3β,GSK3β,p-AMPK,AMPK,p-mTOR,mTOR,LC3Ⅱ/Ⅰ,TFEB and GABARAPL1 in myocar-dial tissue.Result:Compared with DC group,HIIT and/or semaglutide intervention reduced body weight and fasting glu-cose,improved cardiac function and myocardial morphology,decreased fibrosis and cardiomyocyte hypertrophy(reduced cross-sectional area,P<0.05),and lowered glycogen accumulation.Autophagosomes and autophagy vac-uoles containing different amounts of glycogen granule were observed by transmission electron microscopy.Compared with DC group,the protein level of p-mTOR/mTOR in DE mice was significantly decreased,and the protein levels of LC3Ⅱ/Ⅰ,TFEB and GABARAPL1 in DE mice were significantly increased(P<0.05).The phosphorylation levels of AKT and GSK3β in DM mice was significantly increased,and the protein level of TFEB and GABARAPL1 in DM mice was significantly increased(P<0.05).The protein levels of IRS-1,LC3Ⅱ/Ⅰ,TFEB and GABAPARAL1 in EM mice significantly increased,the phosphorylation levels of PI3K,AKT,GSK3β and AMPK were significantly increased.The p-mTOR/mTOR ratio of autophagy negative regula-tor in EM mice was decreased(P<0.05).Compared with single treatment group,the AMPK phosphorylation and LC3Ⅱ/Ⅰ protein expression in EM group were significantly increased(P<0.05).Conclusion:HIIT and semaglutide can improve myocardial fibrosis,glycogen accumulation and cardiac func-tion in db/db mice,and the combined intervention group yields the most pronounced effects,which may be re-lated to AMPK/mTOR pathway activation,enhanced cardiac glycophagy,and reduced myocardial injury.

Objective:To explore the effects of high-intensity interval training(HIIT)and semaglutide on cardiomyopathy and glycophagy in db/db mice.Method:Forty male db/db mice were randomly divided into diabetic control group(DC,n=10),diabetic+exercise group(DE,n=10),diabetic+semaglutide group(DM,n=10)and diabetic+exercise+semaglutide group(EM,n=10).DE mice and EM mice were conducted a 8-week HIIT treadmill protocol,DM mice and EM mice received daily subcutaneous neck injections of semaglutide at 0.05mg/kg.Body weight and fasting blood glucose were measured regularly.Echocardiography was used to detect cardiac function at the end of the intervention.Myocardial morphology was evaluated by H&E staining;The H&E staining was used to observe the myocardial morphological changes;fibrosis by Masson staining;glycogen accumulation by periodic acid-Schiff staining;and cardiomyocyte hypertrophy by wheat germ agglutinin(WGA)staining.The glycophagy was observed by transmission electron microscopy.Western Blot quantified the IRS-1,P-PI3K,PI3K,p-AKT,AKT,p-GSK3β,GSK3β,p-AMPK,AMPK,p-mTOR,mTOR,LC3Ⅱ/Ⅰ,TFEB and GABARAPL1 in myocar-dial tissue.Result:Compared with DC group,HIIT and/or semaglutide intervention reduced body weight and fasting glu-cose,improved cardiac function and myocardial morphology,decreased fibrosis and cardiomyocyte hypertrophy(reduced cross-sectional area,P<0.05),and lowered glycogen accumulation.Autophagosomes and autophagy vac-uoles containing different amounts of glycogen granule were observed by transmission electron microscopy.Compared with DC group,the protein level of p-mTOR/mTOR in DE mice was significantly decreased,and the protein levels of LC3Ⅱ/Ⅰ,TFEB and GABARAPL1 in DE mice were significantly increased(P<0.05).The phosphorylation levels of AKT and GSK3β in DM mice was significantly increased,and the protein level of TFEB and GABARAPL1 in DM mice was significantly increased(P<0.05).The protein levels of IRS-1,LC3Ⅱ/Ⅰ,TFEB and GABAPARAL1 in EM mice significantly increased,the phosphorylation levels of PI3K,AKT,GSK3β and AMPK were significantly increased.The p-mTOR/mTOR ratio of autophagy negative regula-tor in EM mice was decreased(P<0.05).Compared with single treatment group,the AMPK phosphorylation and LC3Ⅱ/Ⅰ protein expression in EM group were significantly increased(P<0.05).Conclusion:HIIT and semaglutide can improve myocardial fibrosis,glycogen accumulation and cardiac func-tion in db/db mice,and the combined intervention group yields the most pronounced effects,which may be re-lated to AMPK/mTOR pathway activation,enhanced cardiac glycophagy,and reduced myocardial injury.

Objective:To construct an evidence-based practice program for dietary management of patients with non-dialysis chronic kidney disease (CKD) based on best evidence and to evaluate the effectiveness of its application.Methods:The best evidence for dietary management of non-dialysis CKD patients was summarized. From September to October 2022, following the evidence clinical transformation model of the Fudan University Centre for Evidence-based Nursing, the best evidence was screened and evidence-based practice program were developed, taking into account patients' wishes, expert opinions, and clinical contexts. From November 2022 through March 2023, baseline reviews, analysis of barriers and facilitators were implemented. Between April 2023 and April 2024, evidence-based practice was carried out in the Department of Nephrology of the Second Affiliated Hospital of Guangzhou Medical University to compare the implementation rate of review indicators at the system, practitioner, and patient levels, and practitioners' knowledge before and after the application of evidence.Results:A total of 14 review indicators were developed. The implementation rate of the 12 review indicators and the practitioners' knowledge of the CKD diet were elevated after the evidence-based practice ( P<0.05) . Conclusions:Evidence-based practice program for dietary management of patients with non-dialysis CKD has a positive effect on improving practitioners' knowledge of non-dialysis CKD diets, implementation rate of dietary management behaviors, and patients' dietary behaviors.