Objective To investigate the protective effects and mechanisms of sulodexide on renal fibrosis induced by prolonged warm ischemia. Methods An in vivo ischemia-reperfusion injury (IRI) model was established in rats, which were randomly divided into Sham group, IRI 60 min group (IRI group), and IRI 60 min + sulodexide group (IRI+SDX group), with 20 rats in each group. Pathological examination was used to evaluate renal tissue injury and fibrosis levels in each group. Immunohistochemistry was performed to detect the expression levels of kidney injury molecule (KIM)-1, intercellular adhesion molecule (ICAM)-1, von Willebrand factor (vWF), transforming growth factor (TGF)-β, α-smooth muscle actin (SMA), and type I collagen (COL-1). Immunofluorescence staining was used to detect CD31 expression. Real-time quantitative polymerase chain reaction was employed to measure the expression of KIM-1, ICAM-1, tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6 in renal tissues. Transmission electron microscopy was used to observe the structure of the renal glycocalyx. Evans blue dye was injected to assess renal vascular permeability. Rat survival was recorded, and serum levels of syndecan (SDC)-1, heparan sulfate (HS) and serum creatinine were measured. An ex vivo perfusion model was also established, with rats randomly assigned to either the hypothermic oxygenated machine perfusion (HOPE) group or the HOPE+SDX group (five rats per group). Perfusion parameters were recorded after 2 hours of ex vivo perfusion. Results One day after reperfusion, compared with the Sham group, the IRI group exhibited more severe renal tissue injury, higher tubular injury scores, increased expression of KIM-1, ICAM-1 and vWF, decreased CD31 expression, elevated serum levels of SDC-1 and HS, increased vascular permeability, and higher expression of TNF-α, IL-1β and IL-6. Compared with the IRI group, the IRI+SDX group showed reduced renal tissue injury, lower tubular injury scores, decreased expression of KIM-1, ICAM-1 and vWF, increased CD31 expression, lower serum levels of SDC-1 and HS, decreased vascular permeability, and reduced expression of TNF-α, IL-1β and IL-6 (all P < 0.05). Ten days after reperfusion, renal tissue injury was further alleviated in the IRI+SDX group. Twenty-five days after reperfusion, the IRI+SDX group exhibited decreased expression of TGF-β, α-SMA, and COL-1, as well as reduced collagen deposition area (all P < 0.05). Compared with the HOPE group, the HOPE+SDX group showed increased renal perfusion flow and decreased intrarenal vascular resistance (both P < 0.01). Conclusions Sulodexide may alleviates renal IRI and fibrosis caused by prolonged warm ischemia by inhibiting inflammatory responses and protecting vascular endothelial glycocalyx.

Objective: To analyze the prevalence trends and associated factors of overweight and obesity among children and adolescents in Macao from 2005 to 2020, so as to provide evidence for developing health promotion strategies. Methods: Data were obtained from the Macao Citizen Physical Fitness Monitoring Database for the years 2005, 2010, 2015, and 2020 for participants aged 6-22 years. The χ 2 test was employed to analyze trends in detection rates, while univariate and multivariate Logistic regression analyses were conducted to identify influencing factors. Results: The overweight rate among Macaos children and adolescents increased from 10.4% in 2005 to 14.8% in 2020. The obesity rate rose from 6.8% to 12.1%, with the total detection rate increasing from 17.2% to 26.9%, and the differences were statistically significant ( χ 2 trend =46.7, 87.5, 145.9, P <0.01). Notably, the overweight/obesity rate among boys showed rapid growth ( χ 2 trend = 118.6, P <0.01), while girls exhibited a declining inflection point in 2020. Multivariate Logistic regression analysis revealed that children and adolescents with the following characteristics faced higher risks of overweight/obesity: a physical education performance score of 3 points (overweight: OR=2.34, 95%CI =1.10-4.96; obesity: OR=2.39, 95%CI =1.19-4.81), paternal obesity (overweight: OR=2.07, 95%CI =1.38-3.11; obesity: OR=1.51, 95%CI = 1.01-2.27), and maternal obesity (overweight: OR=1.69, 95%CI =1.08-2.63; obesity: OR=1.77, 95%CI =1.16- 2.71 ) ( P <0.05). Conversely, lower risks were observed in those who performed appropriate warm-up activities before exercise (obesity: OR=0.37, 95%CI =0.15-0.95), participated in two academic/non-sports extracurricular classes (obesity: OR=0.46, 95%CI =0.24-0.88), and reported moderate physical exertion during extracurricular exercise (obesity: OR=0.60, 95%CI =0.36-0.98) ( P <0.05) . Conclusions Overweight and obesity among Macao s children and adolescents remain severe, particularly among boys, while girls show early signs of improvement. It is recommended to establish a multi-sectoral collaborative prevention and control system to reduce childhood and adolescent obesity.

Objective:To explore the application of observation teaching discussion (OTD) in vascular surgery nursing intern teaching under the guidance of process-oriented guided inquiry learning (POGIL) theory.Methods:Forty nursing students who were doing their internship in The First Affiliated Hospital of Xi'an Jiaotong University from July 2022 to July 2023 were randomly divided into two groups using a random number table: control group (20 students, OTD teaching) and observation group (20 students, POGIL theory-guided teaching) . The two groups were compared for competence assessment scores before entering the department and 3 days prior to departure from the department, autonomous learning ability scale scores, Competency Inventory for Registered Nurses (CIRN) scores, and Chinese Problem Solving Inventory (CPSI) scores. T-tests and chi-square tests were conducted using SPSS 22.0. Results:Three days prior to departure from the department, the theoretical performance and practical performance were significantly better in the observation group [(91.67±5.22) and (89.69±4.36) points, respectively] than in the control group [(84.53±4.75) and (82.41±4.18) points, respectively] ( P<0.05). The observation group also performed significantly better than the control group in autonomous learning ability scale score [(139.52±13.52) vs. (128.86±10.76)], CIRN score [(207.73±6.23) vs. (195.67±5.98)], and CPSI score [(103.60±4.72) vs. (92.18±5.03)] (all P<0.05). Conclusions:The application of OTD in vascular surgery nursing intern teaching under the guidance of POGIL theory can improve the autonomous learning ability, core ability, and problem-solving ability of nursing interns.

Objective:To explore the expressions and clinical significances of tripartite motif-containing protein 28 (TRIM28), 3-phosphoinositide-dependent protein kinase-1 (PDK1), and N-cadherin in pancreatic carcinoma.Methods:A total of 72 patients diagnosed with pancreatic carcinoma underwent radical resection in the Department of Hepatobiliary Surgery, Binzhou People′s Hospital from January 2009 to November 2022 were selected, all of which were pathologically diagnosed as pancreatic ductal adenocarcinoma (PDAC). Immunohistochemistry was used to detect the expression of TRIM28, PDK1, and N-cadherin in 72 cases of pancreatic carcinoma and paracancerous tissues, to explore the correlation between the expression of them and the clinicopathological features of pancreatic carcinoma, and to analyze the influence of their expression and clinicopathological characteristics on the prognosis of patients. The count data were expressed as the number of cases and percentage, and the Chi-square test was used for comparison between groups. Spearman method was used for correlation analysis. Kaplan-Meier method was used for survival analysis, and Log-rank test was used to compare the survival rate, and univariate and multivariate Cox regression analysis were used to analyze the risk factors affecting prognosis.Results:The positive rates of TRIM28 (72.22%), PDK1 (65.28%) and N-cadherin (61.11%) in PDAC were significantly higher than those in para-cancerous tissues (26.39%, 33.33%, 34.72%). Moreover, the patients with high expression of the three had the characteristics of low differentiation, late stage, and lymph node metastasis ( P<0.05). TRIM28 was positively correlated with PDK1 and N-cadherin expression in PDAC ( r=0.720, P<0.001; r=0.714, P<0.001), N-cadherin and PDK1 expression in PDAC was also positively correlated ( r=0.854, P<0.001). Kaplan-Meier survival curve showed that the 2-year survival rate of patients with positive TRIM28, PDK1 and N-cadherin (13.46%, 14.89%, 13.64%) was significantly lower than that of patients with negative tumor (50.00%, 40.00%, 39.29%), the differences were statistically significant ( P<0.05). Univariate Cox regression analysis showed that patients with poor differentiation, nerve infiltration and lymph node metastasis, TNM stage Ⅲ+ Ⅳ, TRIM28 positive, PDK1 positive and N-cadherin positive had a significantly increased risk of death within 2 years after surgery ( P<0.05). Multivariate Cox regression analysis showed that poor differentiation, nerve infiltration, TNM stage Ⅲ+ Ⅳ and TRIM28 positive were independent risk factors for poor prognosis of patients with PDAC ( P<0.05). Conclusions:TRIM28, PDK1 and N-cadherin are highly expressed in PDAC, and the expression level is significantly correlated with the malignant degree of PDAC. TRIM28 is an independent risk factor for the prognosis of patients with PDAC.

Objective:To investigate effect of SARI expression induced by IFN-β on proliferation and apoptosis of acute myelo-blastic leukemia(AML)cells,and to explore its potential regulatory molecules.Methods:qPCR and Western blot were used to screen AML cells with low SARI expression as experimental cell lines.AML cells were treated with different concentrations of IFN-β,and expression of SARI was detected by qPCR and Western blot at different time to select appropriate concentration and time of IFN-β.RNA-Seq transcriptome sequencing and KEGG enrichment analysis were used to preliminarily screen potential regulatory molecules of IFN-β-induced SARI expression in AML cells.AML cells were treated with corresponding molecular inhibitors combined with IFN-β,cell proliferation was detected by MTS assay,and apoptosis was detected by flow cytometry.To clear this molecule was involved in IFN-β-induced SARI expression on AML cell proliferation and apoptosis.Results:SARI expression in HL60 and NB4 cells were rela-tively decreased,so they were selected as experimental cell lines.After treatment with 1 ng/ml IFN-β for 12 h,SARI expression in AML cells was increased,cell proliferation was inhibited and apoptosis were increased.STAT1 was screened as a potential regulatory mole-cule for IFN-β-induced SARI expression.After inhibiting STAT1,effects of IFN-β on SARI expression,proliferation inhibition and apop-tosis promotion of AML cells were reversed significantly.Conclusion:IFN-β can promote SARI expression in AML cells by STAT1,in-hibit cell proliferation and promote apoptosis.

Objective:To investigate the current status of scientific fitness literacy (SFL) and its influencing factors among Chinese adults aged 20-59 years.Methods:Totally 63 338 adults aged 20-59 years in the status of national fitness activities in 2020 from 1 January to 31 March 2020 were selected as the subjects, and they were divided into four age groups, namely, the 20-29 age group, the 30-39 age group, the 40-49 age group and the 50-59 age group. Data were analyzed by SPSS 29.0.Comparative analyses for age, gender, urban-rural difference were carried out by applying non-parametric tests, and multiple regression models were applied to find the influencing factors of SFL.Results:The SFL score of Chinese adults aged 20-59 years was 53.40 (41.67, 63.73), and the scores of cognition, attitude, ability and skills, behavior and habits sub-dimensions were 86.11 (72.22, 100.00), 62.96 (50.62, 75.31), 27.78 (11.11, 44.44) and 33.33 (11.11, 55.56), respectively. The SFL and the four sub-dimensions were demonstrated to have higher scores for males than females, and higher scores for adults in urban area than those in rural area(all P<0.01). The multiple regression results showed that regular exercise at a fitness facility (20-29 age group: β=0.321, t=5.940, P<0.01; 30-39 age group: β=0.187, t=2.937, P<0.01; 40-49 age group: β=0.230, t=3.988, P<0.01; 50-59 age group: β=0.415, t=5.671, P<0.01) was the Chinese adults' common influence factor on SFL.Motivation, evaluation by those around them, experience from exercising, and convenience and atmosphere of exercising were the main influence factors in the 20-29 and 30-39 age groups(all P<0.05).Comfort level of fitness venue, convenience, safety, and support of fitness place were the main influence factors in adults aged 40-59 years(all P<0.05). Conclusions:Chinese adults aged 20-59 years old have high SFL awareness scores, but low overall SFL scores. Surrounding people's evaluation, experience in exercise, comfort level of fitness place, convenience, safety and fitness policy support are the influential factors of scientific fitness literacy.

Objective:To investigate the impact of body mass index (BMI) on delayed extubation of patients with acute Stanford type A aortic dissection (ATAAD).Methods:A total of 400 ATAAD patients who were admitted to our hospital from October 2021 to October 2023 and underwent surgical treatment were selected as the research objects. According to BMI, they were divided into obese group (BMI≥28 kg/m 2, 119 cases) and non-obese group (BMI<28 kg/m 2, 281 cases). The differences of preoperative clinical characteristics, intraoperative and postoperative data between the two groups were compared. Starting from transferring to the ICU and ending with the first successful extubation, The risk factors of postoperative invasive mechanical ventilation time ≥ 48 h in ATAAD patients were analyzed, and the predictive efficacy of related factors for postoperative invasive mechanical ventilation time ≥ 48 h in ATAAD patients was evaluated. Results:Compared with the non-obese group, the proportion of hypertension, diabetes, admission heart rate, admission systolic blood pressure, admission diastolic blood pressure and preoperative white blood cell count in the obese group were significantly increased, and the differences were statistically significant ( P<0.05). The cardiopulmonary bypass time, aortic cross-clamp time, operation time, red blood cell transfusion volume, invasive mechanical ventilation time, secondary operation rate and total hospitalization cost in the obese group were significantly higher than those in the non-obese group, and the differences were statistically significant ( P<0.05). Univariate logistic regression analysis showed that BMI, cardiopulmonary bypass time, ascending aortic cross-clamp time, operation time, age, hypertension, and red blood cell transfusion were related factors for postoperative invasive mechanical ventilation time ≥48 h in ATAAD patients ( P<0.05). Logistic multivariate regression analysis showed that increased BMI ( OR=1.213, P<0.05) and increased age ( OR=1.020, P<0.05) were independent risk predictors of postoperative invasive mechanical ventilation time≥48 h in ATAAD patients. Receiver operating characteristic curve ( ROC) analysis showed that the area under the ROC curve ( AUC) of BMI for predicting the duration of postoperative invasive mechanical ventilation in ATAAD patients≥48 h was 0.682 ( P<0.05), and the best predictive cut-off value was 25.64 kg/m 2. Conclusion:BMI≥28kg/m 2 increases the difficulty of surgery and the duration of invasive mechanical ventilation in ATAAD patients. BMI has a high predictive value for the duration of invasive mechanical ventilation in ATAAD patients after surgery ≥48 h, and effective intervention measures can be formulated to improve the treatment effect of patients.

The early diagnosis of congenital heart disease is very important. Ultrasound is widely used in the early diagnosis and evaluation of congenital heart disease because of its advantages of non-radiation, non-invasive property and portability.Speckle tracking imaging has the advantages of being free from angle, efficient and accurate, which makes up for some shortcomings of traditional echocardiography. It greatly improves the diagnosis accuracy of fetal congenital heart disease, especially congenital heart disease with outflow tract obstruction.Myocardial strain index and left ventricular torsion can more accurately evaluate myocardial function,help to judge prognosis, choose the time of operation and assist perioperative management. Blood speck tracking helps identify different blood flow patterns and may become an important diagnostic tool for the diagnosis and treatment of congenital heart disease.

Objective To analyze the expression of miR-4524a-3p in peripheral blood mononuclear cells(PBMCs)and major immune cell subsets of patients with systemic lupus erythematosus(SLE),and evaluate its clinical application.Methods Peripheral blood samples were collected from SLE patients and healthy controls,followed by isolation of PBMCs,CD3+T lymphocytes,CD19+B lymphocytes,and CD14+monocytes using human peripheral blood lymphocyte isolation solution(Ficoll)and immunomagnetic bead cell sorting.The expression level of miR-4524a-3p was quantified using fluorescence quantitative PCR.Pearson's linear correlation analysis was per-formed to assess the relationship between miR-4524a-3p expression and the disease activity score in SLE patients(SLEDAI).Additionally,the diagnostic efficacy of miR-4524a-3p for SLE was evaluated by constructing a receiver operating characteristic curve(ROC).Results The expression of miR-4524a-3p was significantly decreased in PBMCs(P<0.05),CD3+T cells(P<0.001),and CD14+monocytes(P<0.001)from patients with SLE compared to healthy controls.Furthermore,it exhibited a negative correlation with SLEDAI score(r=-0.406,P<0.01).Notably,the expression level of miR-4524a-3p was significantly lower in patients with moderate or severe active stage than those in mild and inactive stages(P<0.01).In addition,the SLE subgroup with lupus nephritis and joint involvement displayed lower levels of miR-4524a-3p compared to the subgroup without such manifestations(P<0.01).Importantly,ROC analysis demonstrated that miR-4524a-3p holds promising diagnostic value for SLE.Conclusion The expression of miR-4524a-3p was significantly diminished in CD3+T cells and CD14+monocytes derived from patients with SLE,exhibiting a close association with disease activity and demonstrating potential clinical diagnostic value for SLE.

Recent innovations in nanomaterials inspire abundant novel tumor-targeting CRISPR-based gene therapies. However, the therapeutic efficiency of traditional targeted nanotherapeutic strategies is limited by that the biomarkers vary in a spatiotemporal-dependent manner with tumor progression. Here, we propose a self-amplifying logic-gated gene editing strategy for gene/H₂O₂-mediated/starvation multimodal cancer therapy. In this approach, a hypoxia-degradable covalent-organic framework (COF) is synthesized to coat a-ZIF-8 in which glucose oxidase (GOx) and CRISPR system are packaged. To intensify intracellular redox dyshomeostasis, DNAzymes which can cleave catalase mRNA are loaded as well. When the nanosystem gets into the tumor, the weakly acidic and hypoxic microenvironment degrades the ZIF-8@COF to activate GOx, which amplifies intracellular H⁺ and hypoxia, accelerating the nanocarrier degradation to guarantee available CRISPR plasmid and GOx release in target cells. These tandem reactions deplete glucose and oxygen, leading to logic-gated-triggered gene editing as well as synergistic gene/H₂O₂-mediated/starvation therapy. Overall, this approach highlights the biocomputing-based CRISPR delivery and underscores the great potential of precise cancer therapy.