Objective To elucidate how the overexpression of cystathionine-β-synthase(CBS)plays an antihypertensive role by affecting peroxisome proliferator-activated receptor γ coactivator-1α(PGC-1α)expression.Methods The adeno-associated viruses(AAVs),ones that overexpressed CBS,and another knocked down PGC-1α,were injected into the hypothalamic paraventricular nucleus(PVN)of spontaneously hypertensive rats(SHRs).The rats'blood pressure was monitored,and the level of norepinephrine(NE)was examined by ELISA;PVN inflammatory response,oxidative stress and tyrosine hydroxylase(TH)expression were detected with RT-qPCR and immunofluorescence.Results PVN overexpression of CBS could increase the transcription level of CBS(by 3.8 times,P＜0.05)and PGC-1α(by 1.6 times,P＜0.05)in PVN of SHR.PVN overexpression of CBS could reduce blood pressure in SHR(from 177.81 mmHg to 128.77 mmHg,P＜0.001),but PVN knockdown of PGC-1αweakened such effect(from 128.77 mmHg to 152.79 mmHg,P＜0.05).PVN overexpression of CBS could alleviate PVN inflammatory response and oxidative stress,but this effect was weakened or even eliminated when knocking down PGC-1α was performed at the same time.Conclusion PVN overexpression of CBS can reduce blood pressure in SHR,and this effect may be achieved by increasing the transcriptional level of PGC-1α,alleviating PVN inflammatory response,oxidative stress,and improving sympathetic nerve excitation.

Objective To investigate the influencing factors for low anterior resection syndrome(LARS)at one year after ileostomy reversal in patients who have undergone radical resection for rectal cancer,and to inform clinical interventions.Methods A retrospective cohort study was conducted on 312 patients who successfully underwent ileostomy reversal after radical resection for rectal cancer between January 2023 and January 2024 at 3 tertiary hospitals in Chongqing.Based on LARS scores at 1-year after stoma reversal,they were divided into a LARS group(score≥21)and a non-LARS group(score≤20).Clinical data were collected from the medical record system,including age,body mass index(BMI),sex,tumor size,tumor distance from the anal verge,T stage,N stage,date of low anterior resection,neoadjuvant therapy,postoperative chemotherapy,anastomotic leakage,and date of ileostomy reversal.Univariate analysis was used to screen potential influencing factors,and variables with P<0.2 were included in a multivariate logistic regression model.Binary stepwise regression analysis was applied to further analyze significant influencing factors for LARS at 1 year after ileostomy reversal.Results In the cohort,there were 127 patients assigned into the LARS group and 185 into the non-LARS group.The incidence of LARS at 1 year after ileostomy reversal was 40.70%,with mild cases accounting for 21.79%and severe ones for 18.91%,and a mean LARS score of 14.52±11.64.Multivariate logistic regression analysis showed that neoadjuvant therapy(yes vs no:OR=1.830,95%CI:1.088～3.089;P=0.023),tumor distance from anal verge≤5 cm(vs>5 cm:OR=2.044,95%CI:1.249～3.374;P=0.005),occurrence of anastomotic leakage(yes vs no:OR=7.470,95%CI:2.247～34.102;P=0.003),time to reversal(≥181 d vs 91～180 d:OR=2.297,95%CI:1.363～3.917;P=0.002),and N stage(N1～N2 vs N0:OR=1.650,95%CI:1.009～2.717;P=0.047)were significant influencing factors for LARS at 1 year after ileostomy reversal.Conclusion Our results suggest that anastomotic leakage,time to reversal≥181 d,tumor distance from anal verge≤5 cm,neoadjuvant therapy,and N stage N1～N2 are associated with the occurrence of LARS at 1 year after ileostomy reversal in patients following radical resection of rectal cancer.Clinical healthcare providers should implement early intervention and long-term follow-up for patients with high-risk factors both before and after stoma reversal.

Objective To elucidate how the overexpression of cystathionine-β-synthase(CBS)plays an antihypertensive role by affecting peroxisome proliferator-activated receptor γ coactivator-1α(PGC-1α)expression.Methods The adeno-associated viruses(AAVs),ones that overexpressed CBS,and another knocked down PGC-1α,were injected into the hypothalamic paraventricular nucleus(PVN)of spontaneously hypertensive rats(SHRs).The rats'blood pressure was monitored,and the level of norepinephrine(NE)was examined by ELISA;PVN inflammatory response,oxidative stress and tyrosine hydroxylase(TH)expression were detected with RT-qPCR and immunofluorescence.Results PVN overexpression of CBS could increase the transcription level of CBS(by 3.8 times,P＜0.05)and PGC-1α(by 1.6 times,P＜0.05)in PVN of SHR.PVN overexpression of CBS could reduce blood pressure in SHR(from 177.81 mmHg to 128.77 mmHg,P＜0.001),but PVN knockdown of PGC-1αweakened such effect(from 128.77 mmHg to 152.79 mmHg,P＜0.05).PVN overexpression of CBS could alleviate PVN inflammatory response and oxidative stress,but this effect was weakened or even eliminated when knocking down PGC-1α was performed at the same time.Conclusion PVN overexpression of CBS can reduce blood pressure in SHR,and this effect may be achieved by increasing the transcriptional level of PGC-1α,alleviating PVN inflammatory response,oxidative stress,and improving sympathetic nerve excitation.

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.

Objective: To investigate the visual acuity of primary and middle school students in Ningxia by using decision tree model and logistic regression, and to provide evidence for the prevention and control of visual acuity. Methods: Using stratified cluster sampling method, 3 257 children aged 7-18 years were randomly selected from Yinchuan and Wuzhong in Ningxia. Visual acuity test and questionnaire survey were conducted. The C 5.0 algorithm in Clementine12.0 and Logistic regression were used to analyze the factors associated with visual acuity. Results: The overall rate of low vision of the middle school of Ningxia was 62.6%, with girls (68.1%) higher than that of boys(56.8%)(P<0.01). There was a significant difference in the prevalence of low vision among different educational stages(P<0.01), with high school students had the highest detection rate(82.2%). Results of decision tree C 5.0 algorithm showed that educational stage, gender, time to do homework after school and frequency of moderate intensity exercise per week associated with poor eyesight of primary and secondary school students. Logistic regression results showed that girls, the distance between the eyes and the computer display screen <66 cm(OR=1.24, 95%CI=1.00-1.52), and the distance between the eyes and the textbook when reading was less than one foot (OR=2.05, 95%CI=1.23-3.40) were positively associated with poor vision. Low grade students and homework time <2 hours after school (OR=0.76, 95%CI=0.62-0.92) were negatively associated with lower risk of poor vision. Conclusion Educational stage, gender and time of homework after school are associated with the visual acuity of primary and secondary school students in Ningxia. It is suggested that prevention of myopia should start from the low-grade students, reducing after-school work for primary and secondary school students, and increasing outdoor activities. All the girls should be encouraged to engage in more outdoor activities, to prevent the occurrence and development of myopia.

Objective: To explore the feasibility and clinical effect of autologous fat concentrate combined with split-thickness skin grafts in the repair of venous ulcer. Methods: From January 2015 to December 2018, a total of 16 patients diagnosed with venous ulcer were admitted to our department, and all patients received symptomatic and supportive treatment such as local debridement and dressing change. After the granulation tissue grew well, all patients received autologous adipose concentrate combined with spilit-thickness skin graft for repair. Results: All the grafted skin survived well, and the survival rate of grafted skin at 2 weeks after surgery was 86% to 99%. All patients were followed up to 6 months after surgery. The wounds of all patients were healed during the follow-up period. One patient suffered local ulcer recurrence due to repeated friction after healing and the ulcer recovered after dressing changing treatment. All the other patients had no recurrence during the follow-up period. The scar hyperplasia in the skin transplantation area was not obvious and the healing quality was good. No significant surgical complications occurred. Conclusions Autologous lipoconcentrate combined with split-thickness skin grafts is an effective and safe method in the repair of venous ulcer, and the application of autologous lipoconcentrate can effectively improve the survival rate and healing quality of skin grafts.

Objective To determine the median effective dose (ED50) of oxycodone inhibiting responses to laryngeal mask airway (LMA) insertion when combined with propofol in the adult female patients.Methods Female patients,aged 18-60 yr,with body mass index of 18-24 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective gynecologic surgery,were included.ED50 of oxycodone was determined by up-and-down sequential technique.Anesthesia was induced by target-controlled infusion of propofol at target plasma concentration of 3.0 μg/ml.Oxycodone was injected at the initial dose of 0.11 mg/kg after the target effect-site and plasma concentrations were balanced.LMA was inserted at 5 min following injection.When the response to LMA insertion was positive,the concentration of oxycodone was increased/decreased in the next patient.The difference between the two successive doses was 0.02 mg/kg.LMA insertion response was defined as occurrence of swallowing,biting on the LMA and bucking and/or body movement during insertion.Probit analysis was used to calculate the ED50 and 95％ confidence interval of oxycodone inhibiting responses to LMA insertion when combined with propofol.Results The ED50 (95％ confidence interval) of oxycodone inhibiting responses to LMA insertion was 0.095 (0.080-0.108) mg/kg when combined with propofol.Conclusion The ED50 of oxycodone inhibiting responses to LMA insertion is 0.095 mg/kg when combined with propofol in the adult female patients.

Clinical pharmacists joined the team for treating a cerebral hemorrhage patient with hypertension. Medications were as-sessed by learning guidelines and consulting the related literature reports,and the regimen was adjusted according to the condition of the disease and drug characteristics during the whole process of pharmaceutical care. As a result, the clinical medication became more rea-sonable. The patient's blood pressure was controlled within the target range timely, and the vital signs were sufficiently stable so that the patient could be transferred to a general ward for the further treatment.

Objective To evaluate the modifiying efficacy of pectoral nerve ( Pecs) block com-bined with general anesthesia in patients undergoing radical mastectomy. Methods A total of 60 American Society of Anesthesiologists physical status Ⅰ or Ⅱ female patients, aged 40-64 yr, weighing 50-70 kg, scheduled for elective radical mastectomy, were divided into 2 groups ( n= 30 each) using a random num-ber table method: general anesthesia group ( group GA) and Pecs block combined with general anesthesia group ( group PB+GA) . The patients in group PB+GA received Pecs block guided by ultrasound. After the needle was advanced to the pleura plane between the pectoralis major and minor, 0. 33％ ropivacaine 15 ml was injected, and 0. 33％ ropivacaine 30 ml was injected into the surface of the serratus anterior muscle at the level of the third rib. Anesthesia was induced by intravenous injection of midazolam, propofol, sufen-tanil and cisatracurium and maintained by target-controlled infusion of propofol and intermittent intravenous boluses of sufentanil and cisatracurium. Bispectral index value was maintained at 40-60. Patient-controlled intravenous analgesia was performed with sufentanil at the end of surgery. Immediately after anesthesia in-duction, at 30 min and 2 h after skin incision, and at 2, 6 and 24 h after operation, peripheral venous blood samples were collected for determination of the concentrations of plasma epinephrine by radioimmuno-assay, and the blood samples were collected from the end of the finger at the same time for determination of blood glucose concentrations. The consumption of intraoperative sufentanil, emergence time, pressing times of patient-controlled analgesia ( PCA) and development of nausea and vomiting within 24 h after operation were recorded. Results Compared with group GA, blood glucose and plasma epinephrine concentrations were significantly decreased, the intraoperative sufentanil consumption was reduced, the emergence time was shortened, the pressing times of PCA were decreased at 2, 6 and 24 h after operation ( P<0. 05) , and no significant change was found in the incidence of postoperative nausea and vomiting in group PB+GA ( P>0. 05). Conclusion When Pecs block combined with general anesthesia is used in the patients undergoing radical mastectomy, it is helpful in reducing the opioid consumption and more helpful in inhibiting postoper-ative stress responses and pain responses than general anesthesia alone.

Objective:To explore the methods and ideas for developing pharmaceutical care in clinical practice. Methods: The pharmaceutical care performed by clinical pharmacists and the therapeutic scheme assisted by clinical pharmacists for one patient with adult purulent meningitis were analyzed retrospectively. Results and Conclusion:Through selection of anti-infective agents, treatment of adverse drug reactions and assessment of patients’ economic capacity,clinical pharmacists help provide reasonable medication to im-prove therapeutic efficacy, safety and economy.