Liver regeneration following injury aids the restoration of liver mass and the recovery of liver function. In the present study we investigated the contribution of megakaryocytic leukemia 1 (MKL1), a transcriptional modulator, to liver regeneration. We report that both MKL1 expression and its nuclear translocation correlated with hepatocyte proliferation in cell and animal models of liver regeneration and in liver failure patients. Mice with MKL1 deletion exhibited defective regenerative response in the liver. Transcriptomic analysis revealed that MKL1 interacted with E2F1 to program pro-regenerative transcription. MAPKAPK2 mediated phosphorylation primed MKL1 for its interaction with E2F1. Of interest, phospholipase d2 promoted MKL1 nuclear accumulation and liver regeneration by catalyzing production of phosphatidic acid (PA). PA administration stimulated hepatocyte proliferation and enhanced survival in a MKL1-dependent manner in a pre-clinical model of liver failure. Finally, PA levels was detected to be positively correlated with expression of pro-regenerative genes and inversely correlated with liver injury in liver failure patients. In conclusion, our data reveal a novel mechanism whereby MKL1 contributes to liver regeneration. Screening for small-molecule compounds boosting MKL1 activity may be considered as a reasonable approach to treat acute liver failure.

Objective:To study the distribution of TCM constitutions in maintenance hemodialysis (MHD) patients.Methods:This is a multicenter cross-sectional study. The general clinical data, dialysis-related parameters and physical and chemical examination data of MHD patients from 6 dialysis centers in Sichuan were collected. At the same time, DS01-A tongue and facial pulse information collection system was used for TCM constitution discrimination.Results:A total of 232 MHD patients were enrolled , and 417 kinds of TCM constitutions were detected, including 59 patients (25.43%) with moderate constitution and 173 patients (74.57%) with biased constitution. Phlegm-dampness was the most common type of solid constitution 47 patients (20.26%). The most common deficiency constitution was qi deficiency 86 patients (37.07%). There were certain differences in the physical distribution of patients with different gender, age, dialysis age, BMI, and whether they had diabetes, hypertension or anemia.Conclusions:The TCM constitutions of MHD patients are mainly biased constitution. Gender, age, BMI, diabetes or hypertension have a certain impact on the distribution of TCM constitutions. At the same time, different constitutions may have an impact on the anemia of MHD patients. The intervention of TCM constitutions on MHD patients may be beneficial to the prognosis of MHD patients.

With the wide use of screen media, screen exposure shows a trend of younger age, and the screen exposure of children and adolescents has become a global public health issue of concern. Childhood and adolescence are important stages of growth and development, as well as critical periods of cognitive ability, emotional development and socialization. Previous studies have shown that screen time is closely related to the mental health of children and adolescents, but few studies have focused on the correlation between screen content and their mental health. The screen content for children and adolescents mainly comes from traditional TV and emerging interactive electronic media. Children and adolescents are highly sensitive to screen content. This paper summarizes the current situation of screen content for children and adolescents and reviews the correlation between screen content and their mental health issues. It also reveals the potential mechanism of the correlation between the two to provide a theoretical basis for the selection and supervision of screen content for children and adolescents.

With the wide use of screen media, screen exposure shows a trend of younger age, and the screen exposure of children and adolescents has become a global public health issue of concern. Childhood and adolescence are important stages of growth and development, as well as critical periods of cognitive ability, emotional development and socialization. Previous studies have shown that screen time is closely related to the mental health of children and adolescents, but few studies have focused on the correlation between screen content and their mental health. The screen content for children and adolescents mainly comes from traditional TV and emerging interactive electronic media. Children and adolescents are highly sensitive to screen content. This paper summarizes the current situation of screen content for children and adolescents and reviews the correlation between screen content and their mental health issues. It also reveals the potential mechanism of the correlation between the two to provide a theoretical basis for the selection and supervision of screen content for children and adolescents.

Objective:To gain an in-depth understanding of the communication needs of Intensive Care Unit (ICU) mechanical ventilation patients during the mechanical ventilation process.Methods:This study was a descriptive qualitative study. From January to June 2022, purposive sampling was used to select 15 awake ICU patients with mechanical ventilation at Xuanwu Hospital of Capital Medical University as the research objects, and in-depth interviews were conducted. The content analysis method was used to analyze interview data, summarize and generalize themes.Results:Two themes and ten sub-themes were extracted, namely the multiple needs during mechanical ventilation (physiological needs, communication and physical expression, constraints and activities, longing for family companionship, discomfort to the ICU environment), complex feelings and experiences during mechanical ventilation (pain caused by mechanical ventilation, fear of awakening from sedation, anxiety and concern about the condition, unpleasant communication and nursing experiences, negative emotions) .Conclusions:Medical and nursing staff should promptly identify the communication needs of ICU mechanical ventilation patients, apply intelligent communication tools, provide personalized intervention measures, and meet the communication needs of patients.

Objective:To develop the College Students'Susceptibility to Telecom Network Fraud Question-naire(CSSTNFQ)and test its validity and reliability.Methods:Combined with the deep interviews and literature a-nalysis,the structural model of college students'susceptibility to telecom network fraud was constructed and the pre-liminary questionnaire was compiled.Totally 429 college students were selected for item analysis and exploratory factor analysis.Totally 845 college students were selected for confirmatory factor analysis and internal consistency reliability test,and 62 of them were retested two weeks later.In addition,375 college students were selected for cri-terion related validity test.The Vulnerability to Fraud Scale(VFS)was used to test the validity of the criterion.Results:The questionnaire contained 25 items,including 6 dimensions(internet usage habits,internet trust propensity,information processing mode,anti-fraud knowledge reservation,demand preference and self-control),which explained 60.33％of the variance variation.Confirmatory factor analysis showed that the 6 factor structure model fitted well(x2/df=3.42,GFI=0.92,CFI=0.93,IFI=0.93,TLI=0.92,RMSEA=0.05,SRMR=0.05).The CSSTNFQ total scores and the scores of each factor were positively correlated with the VFS total scores(ICC=0.12-0.62,Ps＜0.01).The Cronbach's α coefficients of the total questionnaire and the 5 factors ranged 0.73 to 0.88,and the test-retest reliabilities ranged 0.77 to 0.93.Conclusion:The College Students'Susceptibility to Tele-com Network Fraud Questionnaire(CSSTNFQ)has good validity and reliability.

Objective:To explore the therapeutic effect of ultrasound intervention combined with support in the treatment of diabetic patients with severe cholecystitis and the risk factors of septic shock.Methods:A total of 81 diabetic patients with severe cholecystitis treated in the emergency department of Beijing Friendship Hospital from January to December 2021 were retrospectively selected and divided into sepsis group ( n=41) and septic shock group ( n=40). The clinical data of the patients were collected, and the curative effect of ultrasound intervention combined with supportive treatment for diabetic patients with severe cholecystitis was analyzed. logistic regression and receiver operating characteristic (ROC) curve were used to predict the risk factors for diabetic patients with severe cholecystitis to develop septic shock. Results:In the sepsis group, 5 cases were positive in bile culture and 2 cases were positive in blood culture. In the septic shock group, 28 cases were positive in bile culture and 12 cases were positive in blood culture. The concentration of glycosylated hemoglobin (HbA 1c) before treatment, gallbladder width and final 28-day all-cause mortality in the sepsis group were lower than those in the shock group (all P<0.05). Before treatment, procalcitonin (PCT), lactic acid (Lac), shock index (SI) and Sequential Organ Failure Assessment (SOFA) scores in the sepsis group were lower than those in the sepsis shock group (all P<0.05). The mean arterial pressure (MAP) was higher than that of the shock group ( P<0.01). After treatment for the sepsis group and the septic shock group, white blood cell (WBC), neutrophilic granulocyte percentage (NEU%), platelet (PLT), PCT, C-reactive protein (CRP), total bilirubin (TBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), MAP, heart rate (HR), Lac, SI and SOFA scores were improved (all P<0.05). After treatment, D-dimer decreased in the sepsis group ( P<0.05), but there was no significant difference in D-dimer between the sepsis shock group and before treatment ( P=0.729 5). Multivariate logistic regression showed that HbA 1c, PCT and MAP were independent risk factors for septic shock in diabetic patients with severe cholecystosis ( OR=9.19, 1.32, 0.58, all P<0.05). The area under ROC curve of SOFA score, HbA 1c and PCT for predicting septic shock due to cholecystitis in diabetic patients were 0.878, 0.918 and 0.715. Conclusions:Ultrasound intervention combined with supportive treatment can significantly alleviate the condition of patients with severe cholecystitis, but early intervention is still needed to reduce the risk of death. HbA 1c and PCT can be used as independent risk factors for septic shock in diabetic patients with severe cholecystitis.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To investigate the current status and quality and safety of radiation therapy resources in medical institutions in Hunan province.Methods:The basic situation questionnaire, quality and safety self-assessment form were designed according to the content of the survey, distributed and recovered through the network, and the survey was conducted on all medical institutions (excluding military hospitals) conducting radiotherapy in Hunan province in 2022, and the quality and safety evaluation was checked by the Hunan Radiotherapy Quality Control Center using stratified sampling field inspection. The differences between the self-evaluation scores of radiotherapy quality and safety and the on-site inspection scores of each unit was compared using Wilcoxon test.Results:By the end of 2022, there were 76 medical institutions (excluding military hospitals) conducting radiotherapy in Hunan province, including 62 tertiary hospitals and 14 secondary hospitals, with a total of 44 253 radiotherapy patients admitted annually. The total number of personnel engaged in radiotherapy was 1 381, including 746 physicians, 205 physicists, 397 technicians and 33 maintenance engineers. There were a total of 88 accelerators (including 3 tomotherapy units), 10 gamma knives, and 28 rear-loading machines, with 1.33 gas pedals per million population. There were 36 units that were carrying out three-dimensional conformal technology, 60 static intensity modulation technology, 20 volumetric rotational intensity modulation, 27 stereotactic radiotherapy, 44 image-guided radiotherapy, 33 respiratory motion management, and 27 rear-loading radiotherapy. In the quality and safety evaluation situation, the basic requirements of radiotherapy specialty scored high, with 2 units achieving full marks and no failing units. Radiotherapy personnel and organization, radiotherapy process, documentation record score and other aspects of no full-score units, the score was concentrated in 60~＜80 points, and all have part of the unit failed.Conclusions:The radiotherapy industry in Hunan province has been developed steadily in recent years in general, and the structure of radiotherapy personnel tends to be reasonable, but there still exists uneven distribution of radiotherapy resources, poor utilization of equipment in some areas, and inadequate development of technology. The overall quality and safety evaluation are good, but there are still many deficiencies in the organizational requirements of radiotherapy personnel, process requirements and documentation, which need to be continuously optimized and improved in the future, and at the same time, field inspections will be intensified to ensure the quality and safety of radiotherapy.

Objective:To evaluate the clinical efficacy of single-wide-tunnel endoscopic submucosal dissection with single-clip-line traction (W-ESTD) for the treatment of early esophageal cancer and precancerous lesions with large area (≥ 3/4 circumference).Methods:A retrospective analysis was performed on patient data of large early esophageal cancer or precancerous lesions treated with digestive endoscopy at the Affiliated Huai'an NO.1 People's Hospital of Nanjing Medical University from January 2018 to January 2023. Patients were divided into W-ESTD group and endoscopic submucosal double-tunnel dissection (D-ESTD) group based on the technique used. Surgical speed, en bloc resection rate, R0 resection rate, curative resection rate, intraoperative and postoperative complications were compared between the two groups.Results:A total of 44 patients with large early esophageal cancer or precancerous lesions were included in this study, including 23 cases in the W-ESTD group and 21 cases in the D-ESTD group. There was no statistically significant difference in baseline data between the two groups ( P>0.05). The operating speeds of W-ESTD and D-ESTD groups were 29.97±11.89 mm2/min and 22.65±6.30 mm2/min, respectively, with significant difference ( t=2.580, P=0.014). There was no statistically significant difference between the two groups in terms of en bloc resection rate [95.7% (22/23) VS 100.0% (21/21), P=1.000], R0 resection rate [87.0% (20/23) VS 90.5% (19/21), P=1.000], or curative resection rate [73.9% (17/23) VS 85.7% (18/21), P=0.462]. No recurrence occurred. Intraoperative muscular injury occurred in 3 cases in the W-ESTD group and 5 cases in the D-ESTD group, and postoperative esophageal stricture occurred in 11 cases and 8 cases respectively, with no significant differences between the two groups ( P>0.05). Conclusion:Compared to D-ESTD, W-ESTD can significantly improve surgical speed and demonstrate itself as a safe and effective approach for treating large early esophageal cancer and precancerous lesions.