Objective To investigate the relationship between serum ferritin(SF)and metabolic associated fatty liver disease(MAFLD)in adolescents.Methods This study utilized data from 2017 to 2020 national health and nutrition examination survey database,ultimately including 559 adolescents aged 12～18 years,divided into MAFLD group(119 cases)and non-MAFLD group(440 cases).Data on demographic characteristics,serum iron metabolism indicators,liver function,lipid profiles,glucose levels,and other relevant parameters were collected.Liver steatosis and fibrosis were assessed using vibration-controlled transient elastography.Pearson correlation and Logistic regression analyses were performed to evaluate the relationship between SF and MAFLD.Results SF levels were significantly higher in MAFLD group compared to non-MAFLD group(P<0.05).Pearson correlation analysis indicated that SF was positively correlated with the controlled attenuation parameter,liver stiffness measurement,body mass index(BMI),alanine aminotransferase(ALT),γ-glutamyl transferase,triglycerides,and uric acid levels(P<0.05),but negatively correlated with high-density lipoprotein cholesterol levels(P<0.05).Adolescents were divided into 4 groups according to the quartiles of SF levels(Q1 goup:SF 1.9-25.6ng/ml;Q2 goup:SF 25.7-41.7ng/ml;Q3 goup:SF 41.8-70.4ng/ml;Q4 goup:SF 70.5-445.0ng/ml).The results of Logistic regression analysis showed that when the variables were not adjusted,the risk of MAFLD in Q4 group adolescents was significantly increased,this association disappeared after adjusting for gender,age,race,BMI,and other factors.BMI(OR=1.250,95％CI:1.176-1.329),globulin(OR=2.991,95％CI:1.218-7.343),ALT(OR=1.052,95％CI:1.003-1.104),and white blood cell count(OR=1.225,95％CI:1.041-1.441)were identified as independent risk factors for MAFLD.Conclusion SF levels are significantly elevated in adolescents with MAFLD but are not independently associated with the occurrence of MAFLD.BMI,globulin,ALT,and white blood cell count are important risk factors for adolescent MAFLD.

Objective:To investigate the clinical efficacy of moxibustion(Mox)combined with low-dose tadalafil(TAD)in the treatment of diabetes mellitus-induced erectile dysfunction(DMED)with the syndrome of Qi deficiency and blood stasis.Meth-ods:According to the inclusion and exclusion criteria,we selected 90 patients with DMED for this trial and equally randomized them into a Mox,a TAD,and a Mox combined with TAD(Mox+TAD)group to be treated by mild Mox applied to the acupoints Zusanli,Sanyinjiao and Yinlingquan qd alt,oral medication with low-dose TAD at 5 mg per dose qd,and combination of the above two thera-pies,respectively,all for 4 weeks.We obtained from the patients their IIEF-5 scores,traditional Chinese medicine(TCM)symptoms scores,Erectile Hardness Scale(EHS)scores,corpus cavernosal hemodynamic indexes,and the peak systolic velocity(PSV),end diastolic velocity(EDV)and resistance index(RI)of the corpus cavernosal arteries before and after treatment,and compared them among the three groups.Results:The total effectiveness rate was significantly higher in the Mox+TAD(90.0％)than in the Mox(46.7％)and TAD groups(60.0％)(P＜0.05).Compared with the baseline,the IIEF-5 and EHS scores were increased,while the TCM symptoms scores decreased in all the three groups after treatment,more significantly in the Mox+TAD group than in the other two(P＜0.05).And the PSV and RI were remarkably increased,while the EDV decreased(P＜0.05)in all the three groups(P＜0.05)after treatment,with PSV even higher in the Mox+TAD than in the Mox and TAD groups(P＜0.05).Conclusion:Moxi-bustion combined with tadalafil has a definite efficacy and safety for the treatment of DMED,which can effectively improve the erectile function of the patients by increasing penile blood supply,benefiting qi and activating blood circulation.

Objective To investigate the effect of salvianolic acid B(Sal B)on high glucose(HG)induced necrotic apoptosis of retinal pigment epithelial cells(RPE)by regulating the receptor-interacting protein kinase 1(RIP1)/RIP3/mixed lineage kinase domain like protein(MLKL)signaling pathway.Methods RPE cells ARPE-19 were used as the research object and separated into control(Con)group,HG group,L-Sal B group,M-Sal B group,H-Sal B group,pcDNA3.1-NC group,and pcDNA3.1-RIP1 group.The qRT-PCR method was applied to detect the expression of RIP1,RIP3,and MLKL in ARPE-19 cells in each group.CCK8 was applied to detect ARPE-19 cell survival rate.Flow cytometry was applied to detect cell apoptosis.DCFH-DA fluorescent probe was applied to detect reactive oxygen species(ROS)level.ELISA was applied to detect the expression of tumor necrosis factor-α(TNF-α),interleukin(IL-1β),and IL-6.Western blot was applied to detect the expression of RIP1,RIP3,and MLKL proteins.Results The cell survival rate was lower in the HG group than in the Con group(P<0.05).The cell apoptosis rate,the proportion of ROS-positive cells,TNF-α,IL-1β,IL-6,and the mRNA and protein expressions of RIP1,RIP3,and MLKL were higher in the HG group than in the Con group(P<0.05).The cell survival rates were higher,while the cell apoptosis rates,the proportion of ROS-positive cells,TNF-α,IL-1β,IL-6,and the mRNA and protein expressions of RIP1,RIP3,and MLKL were lower in the L-Sal B,M-Sal B,and H-Sal B groups than in the HG group(P<0.05).The cell survival rates increased successively(P<0.05),while the cell apoptosis rates,the proportion of ROS-positive cells,TNF-α,IL-1β,IL-6,and the mRNA and protein expressions of RIP1,RIP3,and MLKL decreased successively in the L-Sal B,M-Sal B,and H-Sal B groups(P<0.05).The cell survival rate was lower(P<0.05),while the cell apoptosis rate,the proportion of ROS-positive cells,TNF-α,IL-1β,IL-6,and the mRNA and protein expressions of RIP1,RIP3,and MLKL were higher in the pcDNA3.1-RIP1 group than in the H-Sal B and pcDNA3.1-NC groups(P<0.05).Conclusions Sal B may inhibit the necrotic apoptosis of RPE cells induced by HG by suppressing the RIP1/RIP3/MLKL signaling pathway.

Aim To explore the therapeutic effects of resveratrol(Res)on hepatic inflammation and oxida-tive stress in rheumatoid arthritis(RA),and to eluci-date the relationship of the regulatory mechanism of the Nrf2/Keap1 signaling pathway in it.Methods A mouse model of arthritis was induced using chicken type Ⅱ collagen in combination with complete Freund's adjuvant,and Res was administered by tube feeding for treatment.Serum liver function indices and levels of hepatic inflammation and oxidative stress were detected in mice.An in vitro cellular model of hepatic inflam-mation and oxidative stress was established by treating mouse primary hepatocytes(MPHs)with TNF-α(5μg·L-1),cell proliferation inhibition was detected by CCK-8,and inflammation and oxidative stress-relat-ed indices were detected by protein blotting.The in-trinsic mechanisms by which Res attenuated hepatic in-flammation and oxidative stress in rheumatoid arthritis were explored by treating MPHs with Nrf2 inhibitor and Keap1 overexpression plasmid.Results Res signifi-cantly reduced the levels of inflammation and oxidative stress in hepatic tissues of collagen-induced arthritis mice as well as TNF-α-treated MPHs,and activated the Nrf2/Keap1 signaling pathway.Inflammation and oxidative stress levels in MPHs were exacerbated by the use of Nrf2 inhibitors and Keap1 overexpression,which promoted apoptosis.Conclusion Res attenuates he-patic inflammation and oxidative stress in rheumatoid arthritis via the Nrf2/Keap1 pathway.

Objective To construct a discharge preparation program for patients after total laryn-gectomy led by specialist nurses and explore its application effects.Methods A multidisciplinary team was established to construct a discharge preparation program for patients after total laryngectomy led by specialist nurses based on Meleis's transition theory.A total of 120 patients who underwent to-tal laryngectomy from April 2023 to October 2024 were selected as the study subjects.A total of 60 patients admitted from April to December 2023 were set as control group,and 60 patients admitted from January to October 2024 were set as intervention group.The intervention group implemented the discharge preparation program for patients after total laryngectomy led by specialist nurses,while the control group received conventional perioperative management after total laryngectomy.The discharge readiness,quality of discharge instruction,and incidence of complications during hospitalization on the day of discharge were compared between the two groups.Additionally,the scores of home health care experience at 1 and 3 months after discharge were compared between the two groups.Results On the day of discharge,the scores of each dimension and the total score of the discharge readinessscale in the intervention group were higher than those in the control group.The scores of the dimensions("Actually received content"and"Discharge instruction skills and effects")and the total score of the Quality of Discharge Instruction Scale in the intervention group were higher than those in the control group,with statistically significant differences(P＜0.05).The total incidence of complications during hospitalization in the intervention group was lower than that in the control group,with a sta-tistically significant difference(P＜0.05).At 1 and 3 months after discharge,the scores of the home health care experience scale in the intervention group were higher than those in the control group,with statistically significant differences(P＜0.05).Conclusion The construction of a dis-charge preparation service program for patients after total laryngectomy led by specialist nurses based on Meleis's transition theory can effectively improve the discharge readiness and quality of discharge instruction of patients undergoing total laryngectomy,reduce the incidence of complications,and im-prove the prognosis and early home health care level.

Aim To explore the therapeutic effects of resveratrol(Res)on hepatic inflammation and oxida-tive stress in rheumatoid arthritis(RA),and to eluci-date the relationship of the regulatory mechanism of the Nrf2/Keap1 signaling pathway in it.Methods A mouse model of arthritis was induced using chicken type Ⅱ collagen in combination with complete Freund's adjuvant,and Res was administered by tube feeding for treatment.Serum liver function indices and levels of hepatic inflammation and oxidative stress were detected in mice.An in vitro cellular model of hepatic inflam-mation and oxidative stress was established by treating mouse primary hepatocytes(MPHs)with TNF-α(5μg·L-1),cell proliferation inhibition was detected by CCK-8,and inflammation and oxidative stress-relat-ed indices were detected by protein blotting.The in-trinsic mechanisms by which Res attenuated hepatic in-flammation and oxidative stress in rheumatoid arthritis were explored by treating MPHs with Nrf2 inhibitor and Keap1 overexpression plasmid.Results Res signifi-cantly reduced the levels of inflammation and oxidative stress in hepatic tissues of collagen-induced arthritis mice as well as TNF-α-treated MPHs,and activated the Nrf2/Keap1 signaling pathway.Inflammation and oxidative stress levels in MPHs were exacerbated by the use of Nrf2 inhibitors and Keap1 overexpression,which promoted apoptosis.Conclusion Res attenuates he-patic inflammation and oxidative stress in rheumatoid arthritis via the Nrf2/Keap1 pathway.

OBJECTIVE T o explore the distribution of pathogens and risk factors for hospital-associated infections in the laryngeal cancer patients undergoing tracheotomy so as to provide theoretical bases for reasonable clinical use of antibiotics.METHODS Totally 118 laryngeal cancer and tracheotomy patients who were complicated with infec-tions and treated in otolaryngology head and neck surgery department of The First Medical Center of Chinese PLA General Hospital from Oct.2021 to Oct.2024 were retrospectively assigned as the infection group,meanwhile,the 118 patients who were not complicated with infections were chosen as the no infection group.The distribution and drug susceptibility rates of the pathogens isolated from clinical specimens of the patients with infections were observed,and the risk factors for the hospital-associated infections were explored.RESULTS Totally 168 strains of pathogens were isolated from the 118 patients with infections,107 of which were gram-negative bacteria,51 were gram-positive bacteria,and 10 were fungi.The result of multivariate logistic regression analysis showed that age(OR=2.435,95％CI:1.052 to 5.634),duration of tracheotomy(OR=3.525,95％CI:1.871 to 14.259),length of hospital stay(OR=2.829,95％CI:1.099 to 7.276)and complication with diabetes mellitus(OR=4.807,95％CI:1.704 to 13.557)were the risk factors for the hospital-associated infections in the laryngeal cancer pa-tients undergoing tracheotomy(P＜0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the laryngeal cancer and tracheotomy patients with hospital-associated infections.The age,duration of tracheotomy,length of hospital stay and complication with diabetes mellitus are the risk factors for the hospital-associated infections in the laryngeal cancer patients undergoing tracheotomy.It is necessary to formulate the prevention and control measures based on the above factors so as to reduce the incidence of infec-tions.

The incidence rate of kidney diseases in China has always remained high.At present,the clinical treat-ment mainly focuses on symptomatic treatment to delay the progression of the disease,and there is a lack of eco-nomical and effective treatment methods.MicroRNA plays an important regulatory role in the occurrence and devel-opment of diseases.This study aims to explore the role and regulatory mechanism of miR-142a-3p in adriamycin(ADR)-induced renal tubular epithelial cell(TCMK-1)injury,with a focus on its potential as a therapeutic target for ADR nephropathy.First,cell viability was assessed using the CCK-8 kit,and a mouse renal tubular epithelial cell model induced by ADR was established.Subsequently,alterations in miR-142a-3p and its target gene ATG16L1 mRNA levels were quantified using RT-qPCR.Western blotting was used to detect the protein levels of autophagy marker proteins and pyroptosis marker proteins.Monodansylcadaverin(MDC)staining was performed and the autophagy of cells was detected by flow cytometry.The results showed that the relative expression of miR-142a-3p in TCMK-1 cells induced by ADR was increased and the relative expression of its target gene ATG16L1 was decreased(P＜0.0001).Western blotting results showed that the levels of p62(P＜0.001)and pyroptosis-related proteins(P＜0.001)were increased,while the protein levels of autophagy-related proteins were decreased(P＜0.05).The flow cytometry results showed that there was no difference in the mean fluorescence intensity of autoph-agosomes between the ADR group and the autophagosome inhibitor group(3-MA group)(P＞0.05),indicating that after ADR induction,cell autophagy was inhibited and pyroptosis was enhanced.When the expression of miR-142a-3p was inhibited by transfecting miR-142a-3p inhibitor,the relative expression level of the target gene ATG16L1 was restored(P＜0.001).Western blotting showed that the protein level of p62(P＜0.01)and pyropto-sis-related proteins(P＜0.01)were decreased,and the protein level of autophagy-related proteins was restored(P＜0.001).Flow cytometry results further indicated that cell autophagy was restored(P＜0.0001).In conclusion,ADR targets A TG1 6L1 through miR-142a-3p to reduce the autophagy level of TCMK-1,and simultaneously activates GSDMD-mediated pyroptosis.

Objective:To explore the current status, research hotspots, and development trends of shared decision-making in the field of cardiovascular disease nursing, and to provide a reference for future research.Methods:Relevant literature on shared decision-making in cardiovascular disease nursing published up to October 31, 2024, was retrieved from the Web of Science Core Collection and China National Knowledge Infrastructure. CiteSpace 6.4.R1 software was used for visualized analysis.Results:A total of 2 748 publications were identified, including 2 446 in English and 302 in Chinese. The overall number of publications has shown an increasing trend. Research hotspots include quality of life, palliative care, machine learning, and artificial intelligence. The emerging trend involves integrating evidence-based approaches with artificial intelligence technologies to build scientific evidence frameworks that support patients in making optimal decisions.Conclusions:Research on shared decision-making in cardiovascular disease nursing has been increasing year by year but remains largely concentrated in developed countries. Future studies should draw on international research frontiers while considering China's national and cultural contexts, enhance academic exchange and collaboration, and explore effective strategies to promote shared decision-making between Medical staff and patients.

Objective:To investigate the clinical efficacy of moxibustion(Mox)combined with low-dose tadalafil(TAD)in the treatment of diabetes mellitus-induced erectile dysfunction(DMED)with the syndrome of Qi deficiency and blood stasis.Meth-ods:According to the inclusion and exclusion criteria,we selected 90 patients with DMED for this trial and equally randomized them into a Mox,a TAD,and a Mox combined with TAD(Mox+TAD)group to be treated by mild Mox applied to the acupoints Zusanli,Sanyinjiao and Yinlingquan qd alt,oral medication with low-dose TAD at 5 mg per dose qd,and combination of the above two thera-pies,respectively,all for 4 weeks.We obtained from the patients their IIEF-5 scores,traditional Chinese medicine(TCM)symptoms scores,Erectile Hardness Scale(EHS)scores,corpus cavernosal hemodynamic indexes,and the peak systolic velocity(PSV),end diastolic velocity(EDV)and resistance index(RI)of the corpus cavernosal arteries before and after treatment,and compared them among the three groups.Results:The total effectiveness rate was significantly higher in the Mox+TAD(90.0％)than in the Mox(46.7％)and TAD groups(60.0％)(P＜0.05).Compared with the baseline,the IIEF-5 and EHS scores were increased,while the TCM symptoms scores decreased in all the three groups after treatment,more significantly in the Mox+TAD group than in the other two(P＜0.05).And the PSV and RI were remarkably increased,while the EDV decreased(P＜0.05)in all the three groups(P＜0.05)after treatment,with PSV even higher in the Mox+TAD than in the Mox and TAD groups(P＜0.05).Conclusion:Moxi-bustion combined with tadalafil has a definite efficacy and safety for the treatment of DMED,which can effectively improve the erectile function of the patients by increasing penile blood supply,benefiting qi and activating blood circulation.