Objective: To explore the related factors of type 2 diabetes mellitus (T2DM) in overweight and obese children and adolescents, so as to provide scientific evidence for early screening and making targeted comprehensive prevention and control strategies. Methods: A total of 332 overweight and obese children and adolescents aged 6-18 years who visited the department of pediatric endocrinology of a tertiary hospital in Liaoning Province from February 2023 to July 2025 were selected. A case control design was adopted, and the subjects were divided into the case group (overweight/obese children and adolescents with T2DM, n =166) and the control group (overweight/obese children and adolescents without diabetes, n =166) based on 1∶1 propensity score matching. Information on demographic characteristics, dietary and lifestyle behaviors was collected through questionnaires. Multivariate Logistic regression analysis was used to analyze the related factors of T2DM in overweight and obese children and adolescents. Results: The average body mass index of overweight and obese children and adolescents was (28.50±5.23)kg/m 2. Multivariate Logistic regression analysis showed that family history of diabetes ( OR=6.71, 95%CI =3.35-14.05), age at onset of weight gain <6 years ( OR=4.08, 95%CI =2.13-8.13), hyperphagia ( OR=2.46, 95%CI =1.25-4.97), and preference for fried foods ( OR= 2.42 , 95%CI =1.21-4.99) were associated with an increased risk of T2DM in overweight and obese children and adolescents (all P < 0.05). In contrast, vitamin D supplementation during pregnancy ( OR=0.50, 95%CI =0.25-0.99), frequent sun exposure during pregnancy of mothers ( OR=0.48, 95%CI =0.24-0.97), breastfeeding ( OR=0.35, 95%CI =0.18-0.66), vitamin D supplementation after 3 years of age ( OR=0.31, 95%CI =0.14-0.68), and active commuting to school ( OR=0.29, 95%CI =0.15-0.58) were associated with a reduced risk of T2DM in overweight and obese children and adolescents (all P <0.05). Conclusions The occurrence of T2DM in overweight and obese children and adolescents is closely related to early onset obesity, genetic background, dietary behaviors, and physical activity. A continuous comprehensive prevention and control strategy from pregnancy to school age should be established to reduce the risk of the disease.

Objective To investigate the effects and underlying mechanisms of a spray prepared from exosomes derived from M2 macrophages induced by interleukin-4 （IL-4） and tantalum particles （Ta） on the healing of pressure ulcers. Methods Bone marrow-derived macrophages were polarized into M2 macrophages using IL-4 or Ta, and exosomes （Exo-IL-4/Exo-Ta） were extracted. The regulatory effects of Exo-IL-4/Exo-Ta on M1 macrophage phenotypes and fibroblast matrix secretion were evaluated in vitro. Proteomic analysis was conducted to explore the biological processes and regulatory networks associated with Exo-Ta. A rat pressure ulcer model was used to assess the effects of Exo-IL-4/Exo-Ta spray on wound healing rate, inflammatory cell infiltration, and collagen deposition. Results In vitro, Exo-IL-4/Exo-Ta induced the polarization of M1 macrophages to M2 macrophages, reduced the secretion of pro-inflammatory factors, and promoted the expression of anti-inflammatory substances. Additionally, Exo-IL-4/Exo-Ta enhanced the production of collagen and fibronectin in fibroblasts. Proteomic analysis revealed that Exo-Ta primarily participated in biological processes such as energy metabolism and macromolecule biosynthesis. In vivo, Exo-IL-4/Exo-Ta spray accelerated wound healing, reduced inflammatory infiltration, and improved tissue remodeling in the rat pressure ulcer model. Conclusion Exosome sprays derived from M2 macrophages could accelerate pressure ulcer healing by modulating inflammation and promoting tissue regeneration, which demonstrated excellent clinical application potential.

ObjectiveTo explore the effects of the Tibetan medicine Sanwei Doukoutang （SWDK） on cognitive dysfunction in mice suffering from Alzheimer's disease （AD） and its related mechanism. MethodsFifty SPF 5 × FAD mice were randomly divided into model group， total ginsenoside group（0.04 g·kg^-1）， high-， medium-， and low-dose groups of SWDK （32.60， 16.30， 8.15 g·kg^-1）， with 10 mice in each group， and ten wild-type mice of the same age were used as the normal group， male and female in 1∶1. Gavage administration was performed once daily for 8 weeks. The Morris water maze test and contextual fear memory experiment were used to observe learning and memory function. Hematoxylin-eosin （HE） staining was utilized to observe the changes in the pathomorphology of brain tissue in mice. The levels of synaptophysin （SYP） and postsynaptic dense substance 95 （PSD95） in mice serum were detected by enzyme-linked immunosorbent assay （ELISA）. The positive expression of brain-derived neurotrophic factor（BDNF） in the dentate gyrus （DG） region of mouse brain tissue was observed by immunohistochemistry （IHC）. The protein levels of BDNF， Wnt family member 3A（Wnt3a）， and β-catenin were detected in the hippocampus of mice by Western blot. ResultsCompared with the normal group of mice， the model group of mice had significantly more complex swimming routes and lower swimming speed （P<0.01）， significantly lower percentage of time spent in the target quadrant （P<0.01）， and a significantly lower percentage of freezing time （P<0.05）. The number of neurons in the hippocampal region of mice was obviously reduced and unevenly arranged. The levels of SYP and PSD95（P<0.01） in the serum of mice were reduced， and the positive expression of BDNF in the DG region of the brain tissue of mice was reduced. The levels of hippocampal BDNF， Wnt3a， and β-catenin proteins in the hippocampus of mice were obviously reduced （P<0.05， P<0.01）. Compared with the model group， the mice in the SWDK group and the total ginsenoside group had significantly shorter swimming routes， the high- and medium- dose SWDK groups significantly higher swimming speeds （P<0.01）， significantly higher percentage of time spent in the target quadrant （P<0.01）， obviously higher percentage of Freezing time （P<0.05）， and obviously more neurons in the hippocampal region of the mice with tighter arrangement. The mice had elevated levels of serum SYP （P<0.05， P<0.01）， PSD95 （P<0.01）， increased BDNF-positive cells in the DG region of brain tissue， and obviously elevated levels of BDNF， Wnt3a， and β-catenin proteins in the hippocampus of mice （P<0.05， P<0.01）. ConclusionSWDK can significantly improve the cognitive dysfunction of AD mice， and its mechanism may be related to regulating the Wnt/β-catenin signaling pathway， which promotes BDNF expression and thereby enhances synaptic plasticity， allowing neuronal signaling to be restored.

ObjectiveTo explore the effects of the Tibetan medicine Sanwei Doukoutang （SWDK） on cognitive dysfunction in mice suffering from Alzheimer's disease （AD） and its related mechanism. MethodsFifty SPF 5 × FAD mice were randomly divided into model group， total ginsenoside group（0.04 g·kg^-1）， high-， medium-， and low-dose groups of SWDK （32.60， 16.30， 8.15 g·kg^-1）， with 10 mice in each group， and ten wild-type mice of the same age were used as the normal group， male and female in 1∶1. Gavage administration was performed once daily for 8 weeks. The Morris water maze test and contextual fear memory experiment were used to observe learning and memory function. Hematoxylin-eosin （HE） staining was utilized to observe the changes in the pathomorphology of brain tissue in mice. The levels of synaptophysin （SYP） and postsynaptic dense substance 95 （PSD95） in mice serum were detected by enzyme-linked immunosorbent assay （ELISA）. The positive expression of brain-derived neurotrophic factor（BDNF） in the dentate gyrus （DG） region of mouse brain tissue was observed by immunohistochemistry （IHC）. The protein levels of BDNF， Wnt family member 3A（Wnt3a）， and β-catenin were detected in the hippocampus of mice by Western blot. ResultsCompared with the normal group of mice， the model group of mice had significantly more complex swimming routes and lower swimming speed （P<0.01）， significantly lower percentage of time spent in the target quadrant （P<0.01）， and a significantly lower percentage of freezing time （P<0.05）. The number of neurons in the hippocampal region of mice was obviously reduced and unevenly arranged. The levels of SYP and PSD95（P<0.01） in the serum of mice were reduced， and the positive expression of BDNF in the DG region of the brain tissue of mice was reduced. The levels of hippocampal BDNF， Wnt3a， and β-catenin proteins in the hippocampus of mice were obviously reduced （P<0.05， P<0.01）. Compared with the model group， the mice in the SWDK group and the total ginsenoside group had significantly shorter swimming routes， the high- and medium- dose SWDK groups significantly higher swimming speeds （P<0.01）， significantly higher percentage of time spent in the target quadrant （P<0.01）， obviously higher percentage of Freezing time （P<0.05）， and obviously more neurons in the hippocampal region of the mice with tighter arrangement. The mice had elevated levels of serum SYP （P<0.05， P<0.01）， PSD95 （P<0.01）， increased BDNF-positive cells in the DG region of brain tissue， and obviously elevated levels of BDNF， Wnt3a， and β-catenin proteins in the hippocampus of mice （P<0.05， P<0.01）. ConclusionSWDK can significantly improve the cognitive dysfunction of AD mice， and its mechanism may be related to regulating the Wnt/β-catenin signaling pathway， which promotes BDNF expression and thereby enhances synaptic plasticity， allowing neuronal signaling to be restored.

To develop biocontrol agents for the control of kiwifruit bacterial canker, we isolated a strain CXG2-5 with inhibitory activity against Pseudomonas syringae pv. actinidiae (Psa), the pathogen of kiwifruit bacterial canker, from the rhizosphere soil of kiwifruit by the plate confrontation test. The strain was identified by morphological observation, physiological and biochemical tests, and molecular biological methods. The indoor control efficacy of the strain was determined by the inoculation of the strain into detached branches with wounds and into leaf discs by vacuum infiltration. The ability of the strain to expand and colonize leaf veins was determined by fluorescent labeling and scanning electron microscopy. Subsequently, the strain was prepared into microcapsules, the field control efficacy of which was evaluated. The strain CXG2-5 was identified as Pseudomonas benzenivorans. It demonstrated good antagonistic activity against Psa, with an inhibition zone diameter of 22 mm and an inhibition rate of 72.7%. The preventive effects of the strain on kiwifruit bacterial canker were better than the therapeutic effects on both detached branches and leaves, with the preventive effects reaching 65% and 92.4%, respectively. The control effect of microcapsules of this strain in the field reached 60.89%, which was slightly lower than that of 20% kasugamycin and higher than that of Bacillus subtilis wettable powder. In conclusion, strain CXG2-5 serves as a candidate for the control of kiwifruit bacterial canker, and the prepared microcapsules have good value for development and application.
Actinidia/microbiology* ; Plant Diseases/prevention & control* ; Pseudomonas syringae ; Pseudomonas/isolation & purification* ; Capsules ; Antibiosis ; Biological Control Agents ; Pest Control, Biological/methods*

OBJECTIVE To explore the potential mechanisms of astragalin （AG） in allevating ulcerative colitis （UC） in mice through modulation of the intestinal flora. METHODS Male C57BL/6 mice were randomly divided into normal group （CON group）， model group [dextran sodium sulfate （DSS） group]， 5-aminosalicylic acid group （5-ASA group）， AG low-dose group and high-dose group （AGL and AGH groups）， with 8 mice in each group. The mice UC model was established by drinking 3% DSS solution continuously for 7 days in all groups except the CON group. After that， 3% DSS solution was replaced by water， and the mice of each drug group were gavaged with the corresponding drug solution. Mice in the CON and DSS groups were gavaged with an equal volume of normal saline， once a day， for 7 days. After the last gavage， the body weight change index， disease activity index （DAI） score， colon length and spleen index， and levels of inflammatory factors （tumor necrosis factor-α， interleukin-1β， interleukin-6） were compared among the mice in each group； pathological changes in colonic tissues of the mice were observed in each group， and the pathological score and the percentage of goblet cells were compared； mRNA expressions of barrier-related factors [occludin and ZO-1] and inflammation-related factors [silencing information regulatory factor 1 （SIRT1）， c-Jun N-terminal kinase （JNK） and p38 mitogen-activated protein kinase （p38 MAPK）] were detected in each group of mice； the changes in the intestinal flora of mice in each group were analyzed and the contents of intestinal metabolites short-chain fatty acids （SCFAs） was determined. Using DSS and AG-treated fecal bacterial liquid as an intervention， the mechanism of anti-UC effect of AG was further verified by a fecal microbiota transplant experiment. RESULTS Compared with the CON group， the intestinal mucosal structure of mice in the DSS group was severely damaged， with obvious infiltration of inflammatory cells collapsing the wall； their body weight change index， colon length， the percentage of goblet cells， mRNA expressions of occludin， ZO-1 and SIRT1， Chao1 and Shannon indexes， and contents of acetic acid and butyric acid were significantly reduced， shortened or down-regulated （P＜0.05）； however， DAI score， spleen index， levels of inflammatory factors， pathological score， as well as mRNA expressions of p38 MAPK and JNK， were all significantly increased or up-regulated （P＜0.05）. Compared with the DSS group， colon tissue lesions of AG mice in all dose groups showed different degrees of improvement， and the above quantitative indexes were generally regressed （P＜0.05）， and the intervention effect of AG-treated fecal bacterial fluid was basically the same as that of AG. CONCLUSIONS AG can improve relevant symptoms in UC mice and reduce their inflammatory response and colonic histopathological changes. The above effects may be related to regulating the diversity of intestinal flora in mice， increasing the contents of butyric acid and propionic acid， and promoting the repair of the colonic mucosal barrier， thus regulating the expressions of genes related to the SIRT1/p38 MAPK inflammatory pathway.

Objective:To investigate the correlation between frailty and immune markers in elderly patients diagnosed with heart failure with preserved ejection fraction(HFpEF).Methods:A total of 416 elderly patients with HFpEF, who were hospitalized in the Department of Geriatrics at Henan Provincial People's Hospital from March 2021 to December 2023, were selected as research subjects.The Fried frailty phenotype was employed to assess frailty.Fasting venous blood samples were collected to measure levels of CD4+ T lymphocytes, CD8+ T lymphocytes, the CD4+ /CD8+ ratio, and immunoglobulins A, M, and G. Spearman correlation analysis and multiple linear regression analysis were conducted to evaluate the relationship between frailty scores and immune markers.Results:Spearman correlation analysis revealed a significant association between frailty score and the CD4+ /CD8+ ratio( r=-0.659, P<0.001), immunoglobulin A( r=-0.454, P<0.001), immunoglobulin M( r=-0.522, P<0.001), and immunoglobulin G( r=-0.802, P<0.001).Furthermore, multiple linear regression analysis indicated that, after adjusting for confounding factors, frailty score served as a significant negative predictor of the CD4+ /CD8+ ratio( β=-0.562, P<0.001), immunoglobulin A( β=-0.366, P<0.001), immunoglobulin M( β=-0.445, P<0.001), and immunoglobulin G( β=-0.772, P<0.001).In comparison to the non-frail group, the frail group exhibited significantly lower values for the CD4+ /CD8+ ratio( β=-0.666, P<0.001)and levels of immunoglobulin A( β=-0.514, P<0.001), immunoglobulin M( β=-0.526, P<0.001), and immunoglobulin G( β=-0.814, P<0.001). Conclusions:In hospitalized elderly patients with heart failure with HFpEF, frailty serves as an independent risk factor for the reduction of the CD4+ /CD8+ ratio, as well as levels of immunoglobulin A, immunoglobulin M, and immunoglobulin G. Furthermore, the frailty score demonstrates a significant negative predictive value for these immunological markers.Therefore, it is essential to enhance our understanding of frailty and to prioritize its prevention and treatment, as this may help mitigate immune dysfunction and promote recovery in elderly patients.

Objective To explore the chain-mediating effect of anxiety and maladaptive coping strategies on perceived social support and post-traumatic stress disorder(PTSD)in primary caregivers of children with acute leukemia.Methods Two hundred primary care-givers of children with acute leukemia treated in the Pediatric Hematology Department of Shengjing Hospital of China Medical University between September 2022 and April 2023 were selected.A general information questionnaire,Perceived Social Support Scale,Self-Rating Anxiety Scale,Trait Coping Style Questionnaire,and Post-Traumatic Stress Disorder Checklist-Civilian Version were used for the survey.Pearson's correlation analysis was performed to determine the relationships between anxiety,maladaptive coping,perceived social sup-port,and PTSD.The chain-mediating effect was determined by structural equation modeling using Analysis of Moment Structures software and the Bootstrap method.Results PTSD was negatively correlated with perceived social support(r=-0.179,P＜0.05)and positively correlated with anxiety and maladaptive coping(r=0.762,P＜0.01;r=0.423,P＜0.01).Anxiety and maladaptive coping had chain-me-diating roles in the relationship between perceived social support and PTSD.Conclusion Perceived social support can indirectly affect the PTSD level of a caregiver through the chain-mediating effect of anxiety and maladaptive coping strategies.In clinical practice,enhancing caregivers perception of social support can alleviate anxiety,promote positive coping strategies,reduce negative coping strate-gies,and effectively reduce the risk of developing PTSD.

Objective To study the therapeutic effects of Yigan Fupi decoction(YGFP)on irritable bowel syndrome(IBS)and its mechanism of action in repairing the intestinal barrier and reducing IBS sensitivity through the PKA/PKC-CREB pathway.Methods Baby rats separated from their mother were randomly divided into a model control(M)and a YGFP group,while baby rats without maternal separation were used as a normal control(N)group.The YGFP group was given YGFP for 4 weeks.Abdominal withdrawal reflux was used to evaluate intestinal sensitivity.Liquid chromatography tandem mass spectrometry and ELISA were used to detect bile acid metabolite concentrations and serum levels of interleukin(IL)-6 and CXCL1,respectively.HE staining was used to observe pathological changes in the colon,and Western Blot and immunohistochemistry were used to analyze the relative protein expression levels of PKA,PKC,CREB,5HT2AR,5-HT7R,ZO-1,and Claudin 1.Results Compared with the normal control group,the M group showed a significantly decreased visceral pain threshold,significantly increased levels of total bile acid metabolites,IL-6,and CXCL1,significantly increased relative expression of PKA,PKC,CREB,5HT2AR,and 5-HT7R,and significantly decreased relative expression of ZO-1 and Claudin 1.Compared with the M group,the YGFP group showed a significantly increased visceral pain threshold,significantly reduced levels of total bile acid metabolites,IL-6,and CXCL1,significantly reduced relative expression of PKA,PKC,CREB,5HT2AR,and 5-HT7R,and increased relative expression of ZO-1 and Claudin 1.Conclusions YGFP effectively improved IBS through a mechanism that may involve repair of the intestinal barrier and reduced sensitivity through the PKA/PKC-CREB pathway.

A 36-year-old male patient presented with repeated myocardial infarction. Despite regular dual-antiplatelet therapy and intensive lipid-lowering therapy, he still experienced restenosis after coronary stent implantation. He then transferred to the Zhongshan Hospital, Fudan University. According to the disease history, combined with coronary artery inflammation observed by PET/CT and effective anti-inflammatory treatment, he was finally diagnosed with Behçet’s disease (BD) combined with isolated coronary arteritis. BD has been included in the Chinese Second Catalog of Rare Diseases, and the disease that only involves the coronary arteries is even rarer, which makes it very easy to misdiagnose and underdiagnosis in clinical practice. Strengthening the understanding of the complex clinical phenotypes of various vasculitis, attaching importance to multidisciplinary consultation, and dynamically following up are of great value for the early diagnosis of this disease.