Objective The aim of this study was to investigate the correlation between the interaction of uric acid and inflammatory factors and hyperuricemia in overweight/obese patients. Methods The personnel with hyperuricemia who underwent physical examination in our hospital from September 2021 to September 2022 were selected as the study subjects, and they were divided into 100 cases of overweight group and 90 cases of obese group according to the BMI index; 120 cases of healthy and non-hyperuricemic personnel were randomly selected as the control group; venous blood of the three groups was collected in 5 mL after 8 h of fasting, and were tested respectively for serum uric acid, lipid indexes and inflammatory factors: IL-6, IL-2, IFN-γ, TNF-α, IL-4, IL-10. Results Glucose, triglycerides, total cholesterol, and LDL were significantly higher in the obese group versus the overweight group (P<0.001), while HDL was significantly lower than the control group (P<0.001), and these changes were more pronounced in the obese group (P<0.001).The Pearson correlation coefficient pointed out that the levels of serum uric acid in patients with hyperuricosuric acid were significantly associated with the pro-inflammatory factors IL- 6, IL-2, IFN-γ, and TNF-α were significantly positively correlated (P<0.001), whereas they were significantly negatively correlated with the anti-inflammatory factors IL-4, IL-10 (P<0.001). Conclusion High uric acid levels in overweight/obese patients can cause enhanced inflammatory responses and reduced expression levels of anti-inflammatory factors, and the interaction between uric acid and pro-inflammatory factors aggravates the condition of patients with hyperuricemia.

Objective: To analyze the association between drinking behaviors and anxiety symptoms, with the mediating role of insomnia symptoms among college freshmen, so as to provide a reference basis for reducing the occurrence of anxiety symptoms in college freshmen. Methods: From October to December 2021, 31 856 freshmen were selected by the purposive sampling method in 22 colleges across 11 provinces (Fujian, Jiangsu, Guangdong, Henan, Anhui, Hubei, Shanxi, Jiangxi, Shaanxi, Yunnan, Chongqing) in China. The Semi quantitative Food Frequency Questionnaire was used to investigate college freshmen drinking behaviors. The Depression Anxiety Stress Scale 21 and the Insomnia Severity Index were used to assess anxiety symptoms and insomnia symptoms in college freshmen. The generalized linear model was employed to analyze the association between drinking behaviors and anxiety symptoms in college freshmen, and the structural equation modeling was used to assess the mediating effect of insomnia symptoms on the association. Results: The detection rate of anxiety symptoms among college freshmen was 28.2%, the detection rates of the mild, moderate, severe and extremely severe were 6.6%, 15.9%, 3.2% and 2.6%, respectively. While 23.6% of college freshmen reported drinking in the past month, the rates were 39.8% among boys and 15.9% among girls. After adjusting for demographic variables (ethnicity, education, major, etc.) and confounding variables (self evaluation of learning burden, number of close friends, screen time, etc.), the results of generalized linear model analysis showed that beer consumption was associated with anxiety symptoms in college freshmen( β =0.09, 95% CI =0.04-0.14), girls( β =0.14, 95% CI =0.07-0.21) and those aged 19-20 years ( β =0.12, 95% CI =0.05-0.19)(all P <0.05). Red wine consumption was associated with anxiety symptoms in male students ( β =0.13, 95% CI =0.02-0.24, P <0.05). Alcohol and beer consumption were associated with insomnia in college freshmen[ β (95% CI ) =0.22(0.08-0.36),0.31(0.23-0.39),both P <0.01]. Insomnia symptoms partially mediated the association between drinking behaviors and anxiety symptoms among college freshmen with a mediating effect value of 0.05, accounting for 50.49% of the total effect. Conclusions Insomnia symptoms partially mediates the association between drinking behaviors and anxiety symptoms in college freshmen. Measures should be taken to simultaneously intervene in the drinking behaviors and insomnia symptoms of college freshmen to prevent the occurrence of their anxiety symptoms.

Objective To investigate the effect of 24-hour perioperative application of dexme-detomidine on the occurrence of postoperative atrial fibrillation and delirium in patients undergoing aortic root reconstruction.Methods A total of 600 patients scheduled for elective cardiac surgery under cardiopulmonary bypass were selected as the study subjects.Eventually,584 patients were in-cluded in the randomized grouping,with 292 patients in treatment group and 292 patients in control group.The treatment group received dexmedetomidine treatment,while the control group received sa-line placebo treatment.The occurrence of atrial fibrillation and delirium events,as well as other clini-cal indicators,in the two groups of patients within 5 days after surgery were observed,and the differ-ences in atrial fibrillation and delirium events among different subgroups were analyzed.Results The incidence rates of atrial fibrillation and delirium events within 5 days postoperatively in the treatment group were lower than those in the control group,with statistically significant differences(P＜0.05).Subgroup analysis showed that for atrial fibrillation events,dexmedetomidine had a protective effect when the cardiopulmonary bypass time was＞180 min,the aortic cross-clamping time was＞120 min.For delirium events,dexmedetomidine had a protective effect when the cardiopulmonary bypass time was ≤180 min,the aortic cross-clamping time was ≤120 min,there was no significant increase in creatinine,no significant decrease in left ventricular ejection fraction(LVEF),the European System for Cardiac Operative Risk Evaluation Ⅱ score at low risk,and the allogeneic red blood cell transfu-sion volume was ≤2 U.Conclusion The 24-hour perioperative application of dexmedetomidine in-patients undergoing aortic root reconstruction can reduce the incidence of postoperative atrial fibrilla-tion and delirium.

Objective:To evaluate the efficacy of 3D printing technology combined with computer navigation-assisted screw implantation in the treatment of atlantoaxial instability (AAI) complicated by vertebral artery anomalies.Methods:A retrospective case series study was conducted to analyze the clinical data of 23 patients with AAI complicated by vertebral artery anomalies who were admitted to Honghui Hospital of Xi′an Jiaotong University between January 2019 and January 2023, including 10 males and 13 females, aged 19-70 years [(51.0±13.3)years]. Vertebral artery anomalies were categorized into unilateral high-riding vertebral artery with unilateral dominance ( n=14), bilateral high-riding vertebral arteries with unilateral dominance ( n=6), and ponticulus posticus ( n=3). All the patients underwent preoperative planning using a 3D-printed model of the atlantoaxial complex with the vertebral artery, followed by posterior atlantoaxial pedicle screw fixation with computer-assisted navigation. Operative duration and intraoperative blood loss were recorded. The accuracy of pedicle screw placement was assessed at 3 days postoperatively using the Gertzbein-Robbins classification. Visual analogue scale (VAS) scores and Japanese Orthopedic Association (JOA) scores were evaluated preoperatively, at 3 days, 3 months postoperatively, and at the last follow-up. Bony fusion was assessed using cervical CT with 3D reconstruction at the last follow-up. Complications were also observed. Results:All the patients were followed up for 12-19 months [(15.1±1.9)months]. The operative duration was 125-167 minutes [(140.6±10.9)minutes] and intraoperative blood loss was 200-600 ml [(295.7±77.8)ml]. At 3 days postoperatively, all the 66 pedicle screws were safely placed, with 60 screws (91%) rated as Gertzbein-Robbins Grade 0 and 6 screws (9%) as Grade 1. At 3 days and 3 months postoperatively, and at the last follow-up, the VAS scores were (4.0±1.0)points, (2.0±0.6)points, and (1.3±0.5)points, and the JOA scores were (14.2±1.2)points, (16.0±0.8)points, and (16.6±0.5)points, both of which were not only significantly improved compared with preoperative (5.6±1.3)points and (12.8±1.5)points, but also further improved over time ( P<0.05). At the last follow-up, 22 patients (96%) achieved satisfactory atlantoaxial bony fusion. No vertebral artery injury, spinal cord or nerve injury, cerebrospinal fluid leakage, or screw loosening were observed in any patients. Conclusion:For patients with AAI complicated by vertebral artery anomalies, 3D printing combined with computer navigation-assisted navigation for atlantoaxial pedicle screw implantation offers multiple advantages, including minimal surgical trauma, high screw placement accuracy, pain relief, neurological function improvement, high fusion rate, and lowered incidence of complications.

Objective:To review the applications of key technologies of 5G+helicopter medical rescue and predict future developments. Literature resource and selection Related literature in this field that was published at home and abroad. Literature quotation Forty articles published at home and abroad. Literature synthesis 5G+helicopter medical rescue is a new medical rescue model that integrates airborne 5G network technology, body area network disease awareness technology and 5G air-ground collaborative rapid diagnosis and treatment technology. It can shorten the time and space distance of medical rescue and improve the efficiency. The clinical applications of 5G+helicopter medical rescue, including the development of rescue schemes, daily and disaster scenarios 5G networking schemes, and air-ground collaborative emergency rescue information sharing platforms, have delivered remarkable results in the field of medical rescue. Despite the challenges facing 5G technology such as high cost and inconsistent technical standards, its development will promote innovation and progress in low-airspace helicopter medical rescue and offer more efficient, more accurate and safer rescue services. Conclusions:It is recommended that 5G network be given more weight, the auto-flight technology of helicopters developed, rescue command and dispatch platforms established, rescue personnel better-trained and supervision and safety guarantee be enhanced.

Objective:To evaluate the efficacy of 3D printing technology combined with computer navigation-assisted screw implantation in the treatment of atlantoaxial instability (AAI) complicated by vertebral artery anomalies.Methods:A retrospective case series study was conducted to analyze the clinical data of 23 patients with AAI complicated by vertebral artery anomalies who were admitted to Honghui Hospital of Xi′an Jiaotong University between January 2019 and January 2023, including 10 males and 13 females, aged 19-70 years [(51.0±13.3)years]. Vertebral artery anomalies were categorized into unilateral high-riding vertebral artery with unilateral dominance ( n=14), bilateral high-riding vertebral arteries with unilateral dominance ( n=6), and ponticulus posticus ( n=3). All the patients underwent preoperative planning using a 3D-printed model of the atlantoaxial complex with the vertebral artery, followed by posterior atlantoaxial pedicle screw fixation with computer-assisted navigation. Operative duration and intraoperative blood loss were recorded. The accuracy of pedicle screw placement was assessed at 3 days postoperatively using the Gertzbein-Robbins classification. Visual analogue scale (VAS) scores and Japanese Orthopedic Association (JOA) scores were evaluated preoperatively, at 3 days, 3 months postoperatively, and at the last follow-up. Bony fusion was assessed using cervical CT with 3D reconstruction at the last follow-up. Complications were also observed. Results:All the patients were followed up for 12-19 months [(15.1±1.9)months]. The operative duration was 125-167 minutes [(140.6±10.9)minutes] and intraoperative blood loss was 200-600 ml [(295.7±77.8)ml]. At 3 days postoperatively, all the 66 pedicle screws were safely placed, with 60 screws (91%) rated as Gertzbein-Robbins Grade 0 and 6 screws (9%) as Grade 1. At 3 days and 3 months postoperatively, and at the last follow-up, the VAS scores were (4.0±1.0)points, (2.0±0.6)points, and (1.3±0.5)points, and the JOA scores were (14.2±1.2)points, (16.0±0.8)points, and (16.6±0.5)points, both of which were not only significantly improved compared with preoperative (5.6±1.3)points and (12.8±1.5)points, but also further improved over time ( P<0.05). At the last follow-up, 22 patients (96%) achieved satisfactory atlantoaxial bony fusion. No vertebral artery injury, spinal cord or nerve injury, cerebrospinal fluid leakage, or screw loosening were observed in any patients. Conclusion:For patients with AAI complicated by vertebral artery anomalies, 3D printing combined with computer navigation-assisted navigation for atlantoaxial pedicle screw implantation offers multiple advantages, including minimal surgical trauma, high screw placement accuracy, pain relief, neurological function improvement, high fusion rate, and lowered incidence of complications.

Objective:To review the applications of key technologies of 5G+helicopter medical rescue and predict future developments. Literature resource and selection Related literature in this field that was published at home and abroad. Literature quotation Forty articles published at home and abroad. Literature synthesis 5G+helicopter medical rescue is a new medical rescue model that integrates airborne 5G network technology, body area network disease awareness technology and 5G air-ground collaborative rapid diagnosis and treatment technology. It can shorten the time and space distance of medical rescue and improve the efficiency. The clinical applications of 5G+helicopter medical rescue, including the development of rescue schemes, daily and disaster scenarios 5G networking schemes, and air-ground collaborative emergency rescue information sharing platforms, have delivered remarkable results in the field of medical rescue. Despite the challenges facing 5G technology such as high cost and inconsistent technical standards, its development will promote innovation and progress in low-airspace helicopter medical rescue and offer more efficient, more accurate and safer rescue services. Conclusions:It is recommended that 5G network be given more weight, the auto-flight technology of helicopters developed, rescue command and dispatch platforms established, rescue personnel better-trained and supervision and safety guarantee be enhanced.

Cancer is a major global health issue. Effective therapeutic strategies can prolong patients’ survival and reduce the costs of treatment. Drug repurposing, which identifies new therapeutic uses for approved drugs, is a promising approach with the advantages of reducing research costs, shortening development time, and increasing efficiency and safety. Disulfiram (DSF), a Food and Drug Administration (FDA)-approved drug used to treat chronic alcoholism, has a great potential as an anticancer drug by targeting diverse human malignancies. Several studies show the antitumor effects of DSF, particularly the combination of DSF and copper (DSF/Cu), on a wide range of cancers such as glioblastoma (GBM), breast cancer, liver cancer, pancreatic cancer, and melanoma. In this review, we summarize the antitumor mechanisms of DSF/Cu, including induction of intracellular reactive oxygen species (ROS) and various cell death signaling pathways, and inhibition of proteasome activity, as well as inhibition of nuclear factor-kappa B (NF-κB) signaling. Furthermore, we highlight the ability of DSF/Cu to target cancer stem cells (CSCs), which provides a new approach to prevent tumor recurrence and metastasis. Strikingly, DSF/Cu inhibits several molecular targets associated with drug resistance, and therefore it is becoming a novel option to increase the sensitivity of chemo-resistant and radio-resistant patients. Studies of DSF/Cu may shed light on its improved application to clinical tumor treatment.

Objective To investigate the effect and mechanism of galactose on the expression of sialic-acid-binding immunoglobulin-like lectin 9(Siglec-9)glycan ligand on human primarily cultured pulmonary artery endothelial cells.Methods The expression of Siglec-9 glycan ligand on the endothelial cell surface and the type of glycosidic bonds at the end of this ligand were identified by flow cytometry.Endothelial cells were treated with L-glucose,glucose,N-acetylglucose,mannose,N-acetylmannose,galactose,sialic acid and sucrose for 48 h,and the expression of Siglec-9 glycan ligand in endothelial cells was detected by flow cytometry.The endothelial cells were divided into the control group and the galactose group(n=3).Western blotting,flow cytometry,and immunofluorescence assay were employed to investigate the impact of galactose on the Siglec-9 glycan ligand in endothelial cells.After α2-3,6,8 sialidase treatment for endothelial cells,Western blotting was used to detected the effect of galactose on the recovery time of Siglec-9 glycan ligand in endothelial cells.Endothelial cells were treated with galactose,Western blotting was used to detect and analyze the expression levels of intracellular sialic acid synthetases(GNE,NANS,NANP,CMAS,NPL and ST3Gals),and the mRNA expression levels of the relevant proteins were verified by RT-qPCR.Western blotting was used to detect the changes of Siglec-9 glycan ligand level in endothelial cells after siRNA knockdown in NANP,CMAS and ST3Gal-Ⅲ.The effect of the increase of Siglec-9 ligand on apoptosis and phagocytosis of macrophages was analyzed by macrophage co-culture experiments.Results Endothelial cells showed the expression of Siglec-9 ligand and the ligand was a sialic acid glycoprotein linked to α 2-3 sialic acid at the end.Compared with the control group,the expression level of this ligand on endothelial cells in the galactose group was increased significantly(P＜0.01),but the addition of galactose had no effect on the self-recovery time of the ligand.Compared with the control group,the expression levels of NANP,CMAS and ST3Gal-Ⅲ in endothelial cells treated with galactose were increased(P＜0.05,P＜0.01),respectively.The results of RT-qPCR verification were consistent with those results.After the expression of NANP,CMAS or ST3Gal-Ⅲ was inhibited,the level of Siglec-9 glycan ligand in endothelial cells was decreased(P＜0.01).In the co-culture experiment,compared with the untreated group,galactose-treated endothelial cells promoted the apoptosis of macrophages(P＜0.01)and reduced their phagocytosis(P＜0.05).Conclusion Galactose up-regulates the level of Siglec-9 glycan ligand on endothelial cells through the NANP-CMAS-ST3Gal-Ⅲ pathway,thereby inhibiting the activity of macrophages.

Objective To investigate the role of cardiac rehabilitation program in the early recovery after minimally invasive incision coronary artery bypass grafting with general anesthesia. Methods A retrospective study was performed on the patients who underwent minimally invasive incision coronary artery bypass grafting from January 2015 to January 2020 with general anesthesia in our hospital. The patients were divided into a cardiac rehabilitation group and a control group. The clinical data of the patients were collected in 6 months and 12 months after the beginning of cardiac rehabilitation program and were analyzed by propensity score-matching analysis with a ratio of 1∶1. The main outcomes were the peak oxygen uptake (VO2 peak) of cardiopulmonary function test and the number of patients attending cardiovascular specialties in tertiary hospitals during the follow-up period (20 months). Results A total of 600 patients were enrolled, including 200 patients in the cardiac rehabilitation group [137 males and 63 females, aged 61.00 (56.00, 65.00) years] and 400 patients in the control group [285 males and 115 females, aged 60.00 (56.00, 65.00) years]. After matching, 176 patients were included in each group, and the basical clinical data of the pateints were comparable (P>0.05). The VO2 peak of the cardiac rehabilitation group after 6 months and 12 months of cardiac rehabilitation was significantly different from that of the control group [6 months: 1.96 (1.59, 2.38) L/min vs. 1.72 (1.38, 2.12) L/min, P<0.001; 12 months: 2.40 (2.21, 2.63) L/min vs. 2.12 (1.83, 2.45) L/min, P<0.001]. During the follow-up period, there was a statistical difference in the cardiovascular specialist visits in tertiary hospitals (P=0.004). Conclusion Cardiac rehabilitation program has a positive effect on the recovery of minimally invasive incision coronary artery bypass grafting with general anesthesia, and can improve the exercise ability of patients.