The endothelial glycocalyx（EG）is a villous polyglycoprotein complex that covers the apical membrane of endothelial cells，situated between the blood vessel wall and the bloodstream.Due to its unique physiological position，the EG plays a crucial role in vascular permeability，mechanical conduction，coagulation，inflammation，and other processes.EG injury can cause endothelial barrier dysfunction，increase vascular permeability，and promote inflammation and thrombosis.Recent studies have revealed that the involvement of EG in inflammatory responses may contribute significantly to the pathogenesis of certain rheumatic and immune diseases as well as multi-system inflammatory syndrome，Kawasaki disease，rheumatoid arthritis，systemic lupus erythematosus and antiphospholipid syndrome，etc.This review paper aims to provide an overview of the structure and function of EG while highlighting its research progress in diagnosing and treating rheumatic and immune diseases.

Based on the actual situation of rapid increase in obesity prevalence and the current lack of a professional weight loss and bariatric surgery treatment platform in Macao, coupled with the continouous rise in the obesity population, the further development and refine-ment of obesity treatment methods has become particularly urgent. Against this backdrop, the authors conduct an in-depth discussion to analyze how Macao, leveraging its unqiue geographical location and favorable policy advantages within the broader context of collaborative development in the Guangdong-Hong Kong-Macao greater bay area, can actively explore future development paths and potential challenges in the fields of bariatric and metabolic medicine and surgery, with the aim to provide a robust reference for advancing related medical technologies in Macao, thereby enhancing the overall level of obesity treatment in the region.

Formate is an important solar fuel, with large application potential in bioconversion. Especially, the win-win collaboration is achieved when formate is applied to the cultivation of microalgae, which combines the advantages from both artificial and natural photosynthesis. However, the inhibition of formate on the photosynthetic electron transport hinders the application of formate at high concentrations. The engineering or directed evolution of the regulation pathway is a case-by-case and time-consuming strategy. Here, we developed a new strategy by introducing a Stenotrophomonas sp. strain which was isolated and identified from the long-term self-evolution process of Chlamydomonas reinhardtii for adapting to high concentrations of formate. The co-culture with the strain or the fermentation broth relieved the inhibition of formate (50 mmol/L) on C. reinhardtii and promoted the growth of the microalga. Especially, the protein content increased significantly to nearly 50% of the dried weight. In addition, the co-culture also benefited the growth of both Chlorella pyrenoidesa and Synechocystis sp. PCC 6803 exposed to formate, which indicated broader applicability of this strategy. This strategy provides the opportunity to overcome the bottleneck in the formate-mediated artificial-natural hybrid photosynthesis and to aid the development of technologies for solar energy-driven production of bulk biomass, including proteins, by carbon dioxide reduction.
Photosynthesis/physiology* ; Formates/pharmacology* ; Stenotrophomonas/growth & development* ; Microalgae/metabolism* ; Chlamydomonas reinhardtii/growth & development*

Commonly used anesthetic sedatives(opioids,benzodiazepines,ketamine,propofol,etc.)share the risk of inducing respiratory depression,and their multi-target mechanism of action pres-ents significant heterogeneity.Opioids inhibit the rhythmic activity of the respiratory center of the medulla bulbar(such as the PreB?tzinger complex and parbrachial nucleus)by activating both the μ-opioid receptor and the G-protein-gated inwardly-rectifying potassium channel and β-arrestin signaling pathway,resulting in decreased respiratory frequency and amplitude.Benzodiazepines enhance inhibitory neurotransmis-sion mediated by γ-aminobutyric acid receptors,reduce the sensitivity of chemoreceptors to PaCO2 and PaO2,and lead to a decreased tidal volume and upper airway obstruction.Ketamine inhibits respiratory drive and respiratory muscle function by blocking N-methyl-D-aspartic acid receptors and indirectly affecting the μ-opioid receptor.In addition,propofol inhibits pre-expiratory neuronal activity and relaxes upper airway muscles by activating the GABAA receptor β3 subunit.Currently,specific antagonists(naloxone/flumazenil)and respiratory stimulants(doxapram)are clinically used to treat respiratory depression,but they have defects such as short duration of action and insufficient specificity.The devel-opment of novel stimulants targeting μ-opioid receptor agonists and the D-serine release pathway of astrocytes,as well as broad-spectrum antidotes based on"molecular cage"technology,has become a new sphere of research that aims at precisely reversing respiratory depression while preserving analgesic and sedative effects.This article reviews the biological mechanisms of respiratory depression caused by sedative hypnotic anesthetic drugs,explores the advantages and disadvantages of treatments currently availabe,and proposes new strategies for improving respiratory depression in the future.

Commonly used anesthetic sedatives(opioids,benzodiazepines,ketamine,propofol,etc.)share the risk of inducing respiratory depression,and their multi-target mechanism of action pres-ents significant heterogeneity.Opioids inhibit the rhythmic activity of the respiratory center of the medulla bulbar(such as the PreB?tzinger complex and parbrachial nucleus)by activating both the μ-opioid receptor and the G-protein-gated inwardly-rectifying potassium channel and β-arrestin signaling pathway,resulting in decreased respiratory frequency and amplitude.Benzodiazepines enhance inhibitory neurotransmis-sion mediated by γ-aminobutyric acid receptors,reduce the sensitivity of chemoreceptors to PaCO2 and PaO2,and lead to a decreased tidal volume and upper airway obstruction.Ketamine inhibits respiratory drive and respiratory muscle function by blocking N-methyl-D-aspartic acid receptors and indirectly affecting the μ-opioid receptor.In addition,propofol inhibits pre-expiratory neuronal activity and relaxes upper airway muscles by activating the GABAA receptor β3 subunit.Currently,specific antagonists(naloxone/flumazenil)and respiratory stimulants(doxapram)are clinically used to treat respiratory depression,but they have defects such as short duration of action and insufficient specificity.The devel-opment of novel stimulants targeting μ-opioid receptor agonists and the D-serine release pathway of astrocytes,as well as broad-spectrum antidotes based on"molecular cage"technology,has become a new sphere of research that aims at precisely reversing respiratory depression while preserving analgesic and sedative effects.This article reviews the biological mechanisms of respiratory depression caused by sedative hypnotic anesthetic drugs,explores the advantages and disadvantages of treatments currently availabe,and proposes new strategies for improving respiratory depression in the future.

Mixed reality technology combines the benefits of virtual reality and augmented reality to provide a new experience of virtual and real-world interaction, demonstrating great potential in nursing education. This paper reviews the application progress of mixed reality in basic nursing teaching, clinical skills training, personalized learning pathways, and teamwork, and looks ahead to future developments, innovations, and challenges of mixed reality technology to advance nursing education.

Based on the actual situation of rapid increase in obesity prevalence and the current lack of a professional weight loss and bariatric surgery treatment platform in Macao, coupled with the continouous rise in the obesity population, the further development and refine-ment of obesity treatment methods has become particularly urgent. Against this backdrop, the authors conduct an in-depth discussion to analyze how Macao, leveraging its unqiue geographical location and favorable policy advantages within the broader context of collaborative development in the Guangdong-Hong Kong-Macao greater bay area, can actively explore future development paths and potential challenges in the fields of bariatric and metabolic medicine and surgery, with the aim to provide a robust reference for advancing related medical technologies in Macao, thereby enhancing the overall level of obesity treatment in the region.

Mixed reality technology combines the benefits of virtual reality and augmented reality to provide a new experience of virtual and real-world interaction, demonstrating great potential in nursing education. This paper reviews the application progress of mixed reality in basic nursing teaching, clinical skills training, personalized learning pathways, and teamwork, and looks ahead to future developments, innovations, and challenges of mixed reality technology to advance nursing education.

Objective To investigate the causal associations between components of metabolic syndrome(MetS)and endometrial carcinoma using Mendelian randomization(MR).Methods Data mining of the Genome-Wide Association Studies(GWAS)database was performed,with the exposure factors being MetS components(lipids,blood pressure,blood glucose,and obesity)and the outcome factor being endometrial carcinoma.MR analyses were performed with the help of regression models,including MR-Egger method,weighted median method,and inverse variance weighted(IVW)method,and the causal relationship between MetS components and endometrial carcinoma was evaluated by odds ratio(OR).Reverse MR analysis was performed for the MetS components found to have a causal relationship with endometrial carcinoma in the forward MR analysis.Results After applying Benjamini-Hochberg correction,IVW results showed a causal relationship between multiple MetS components(obesity,lipids,blood pressure,and blood glucose)and endometrial carcinoma.Specifically,the three components of obesity,including body mass index,overweight,and percentage of body fat,were causally associated with an increased risk of endometrial carcinoma(P＜0.001,OR＞1).In blood lipids,high cholesterol levels(P＜0.001,OR＜1),high triglyceride levels,and high phospholipid levels were causally associated with a reduced risk of endometrial carcinoma(P＜0.05,OR＜1).Regarding blood pressure,heart disease,atherosclerosis,and stroke were causally associated with a reduced risk of endometrial carcinoma(P＜0.05,OR＜1).Regarding blood glucose,low fasting insulin levels,type 1 diabetes mellitus,insulin resistance,and high glycated hemoglobin levels were causally associated with a reduced risk of endometrial carcinoma(P＜0.05,OR＜1),while type 2 diabetes mellitus and high fasting insulin levels were causally associated with an increased risk of endometrial carcinoma(P＜0.05,OR＞1).Reverse MR analysis did not produce any evidence for a reverse causality between the above positive MetS components and endometrial carcinoma.Conclusion The MR study suggests that obesity and type 2 diabetes mellitus are risk factors for endometrial carcinoma,while other MetS components,including hyperlipidemia,cardiovascular diseases,insulin resistance,and complications of diabetes mellitus,are protective factors for endometrial carcinoma.Further research is needed to clarify the association between MetS and endometrial carcinoma and to further explore the underlying mechanisms involved.