Abstract To promote adolescents active participation in physical activity and improve sleep quality, the article analyzes the relationship of adolescent physical activity with subjective sleep satisfaction, sleep latency, sleep continuity, sleep efficiency, and sleep duration. It explores potential mechanisms underlying the link between physical activity and sleep quality, including physiological mechanisms (circadian rhythms, body temperature, neuroendocrine systems, and immune function), and psychological mechanisms (stress relief, improvement of negative emotions, and promotion of mental relaxation). Based on existing research, it is recommended that adolescents engage in moderate to vigorous physical activity daily to promote improved sleep quality.

Initial gastrointestinal endocrine cells (GIECs) likely appear at the proximal and distal sites of abdominal intestines and may take a close topographical relation with neural elements in the gut. We examined immunohistochemically-stained sections from 10 fetuses at approximately 8–18 weeks of gestational age (36–155 mm of crown-rump length). Irrespective of whether physiological herniation was present (early 5 specimens) or absent (the other 5), the duodenum and jejunum had well-developed mucosa with villi containing abundant flask-like chromogranin-positive cells. In the earlier 5 specimens, the rectum, standing up to a level of the umbilicus, had a lumen and villi with a few positive cells, but the colon carried neither the lumen or chromogranin-positive cells. The initial GIECs seemed to appear in the basal payer of the epithelium at the distal and proximal foci depending on double pathways of neural crest cell migration. Less number of the colic chromograninpositive cells, more than 5-times difference in density relative to small intestine, was seen in the larger 5 specimens. The appearance of GIECs was delayed at the anal transitional zone (a border area between the columnar and squamous epithelia).The reactivity of neuronal nitric oxide synthase was restricted in the myenteric plexus, whereas clusters of slender calretininpositive cells existed in the lamina propria or core of villi in the duodenum and colon. Relatively small, round or oval positive cells were also seen in the basal layer of the columnar epithelium. Therefore, calretinin-positive cells might exist closely to GIECs in the developing villi.

Meconium is changed from defoliated intestinal villi with apoptosis. A meconium corpuscle is a limited architecture in the meconium at the light microscopic level. In histological and immunohistochemical sections of the abdomen from 40 fetuses at 20–31 weeks of gestation, we found 12 fetuses with meconium and examined the architecture.A solid or loose meconium was seen depending on sites. The solid meconium in the colon and rectum contained numerous spherical or rugby ball-like corpuscles comprising of a core with tightly-packed atrophied cells and a laminar fibrous sheath.The solid meconium surrounded and incorporated villi that maintained the original architecture. The loose meconium was seen not only in the stomach and duodenum but also, depending on specimens, in the colon and rectum. It was composed of a large mucosal fold, a single small villus and/or fragmented epithelia. Notably, these mucosal tissues still contained chromogranin-positive gastrointestinal cells and cytokeratin-positive epithelia. A large ring-like meconium was composed of the entirely circular mucosa or epithelia that seemed to be detached along the muscularis mucosae or the basal lamina.A sheath-like fibrous structure in meconium seemed to originate from the lamina propria and basal lamina of villi. A defoliation of villi with apoptosis seemed difficult to explain a detachment of the entirely circular mucosa or epithelia in large fetuses examined. The latter event might require a specific mechanism such as an in utero intussusception in which a proximal side of the colon was invaginated into the distal lumen.

Objective: To investigate the association between brain and muscle Arnt like protein 1( BMAL 1) gene and ambulatory blood pressure (ABP) parameters in college students, and to explore the influence of the interaction between the gene and weight status on the ABP levels, so as to provide reference for early prevention of chronic cardiovascular diseases related to hypertension. Methods: During September 2022 to June 2024, a total of 510 college students were recruited from a university in Changsha, China for on site questionnaire investigation, physical examination, ABP monitoring and genotyping testing. Multiple linear regression method was used to explore the association between the BMAL 1 gene and ABP indicators. An interaction term was included in the general linear model of multiple linear regression to analyze the interactive effects of BMAL 1 gene polymorphisms and weight status on ABP levels. Results: The prevalence of abnormal 24 hour blood pressure, abnormal daytime blood pressure, and abnormal nighttime blood pressure were 3.3%, 3.1%, and 3.9%, respectively. Multiple linear regression analysis showed that the BMAL 1/rs7950226 polymorphism was positively correlated with the 24 hour diastolic blood pressure(DBP) and the daytime DBP level after adjusting for gender, age, and body mass index( β =0.87,0.99, both P <0.05). Also, interaction between BMAL 1/ rs 11022775 and weight status on the nighttime DBP level ( P interaction =0.03) was found. The CC genotype carriers had significantly higher nighttime DBP level ( β =3.52, P <0.05) among overweight/obesity college students, but no differences in nocturnal DBP levels were observed between CC genotype carriers and TT+CT genotype carriers among college students with normal body weight( P > 0.05). Conclusions The rs 7950226 polymorphism is associated with 24 hours DBP and daytime DBP levels. Significant interaction between rs 11022775 with weight status on the nighttime DBP level is found among college students.

Objective·To explore the antitumor effects and potential mechanisms of combining phosphoinositide 3-kinase,FYVE-type zinc finger containing(PIKfyve)inhibitor YM201636 with the stimulator of interferon genes(STING)agonist diABZI in STING pathway-deficient melanoma.Methods·The mRNA and protein expression levels of STING in human cancer cell lines were obtained from the Cancer Cell Line Encyclopedia(CCLE)and UniProt databases.Based on median expression values,melanoma cell lines with high STING mRNA but low protein expression were identified.Quantitative real-time PCR(qRT-PCR)and Western blotting were performed to validate STING mRNA and protein expression in human melanoma cells.The murine melanoma cell line YUMM1.7,characterized by low STING protein expression,was selected through Western blotting.The ability of YM201636 to restore STING protein expression in YUMM1.7 cells was evaluated.STING agonist diABZI was then applied in combination with YM201636 to analyze the synergistic tumor cell-killing effect through CCK-8 assay.Western blotting was used to detect the phosphorylation of TANK-binding kinase 1(TBK1)and interferon regulatory factor 3(IRF3),and qRT-PCR was used to evaluate type Ⅰ interferon expression.A mouse melanoma model was established and treated with YM201636,diABZI,or their combination.Tumor volume was measured,and treatment efficacy was assessed.RNA sequencing and immunofluorescence staining were performed to analyze immune cell infiltration in the tumor microenvironment.Results·Database analyses,qRT-PCR,and Western blotting confirmed that some human melanoma cell lines exhibited high STING mRNA expression but low STING protein levels.YM201636 significantly increased STING protein expression in YUMM1.7 cells(P<0.001).Combined treatment with YM201636 and diABZI significantly enhanced phosphorylation of TBK1 and IRF3(P<0.05),indicating effective activation of the STING signaling pathway.This combination also promoted the expression of type Ⅰ interferons(P<0.001)and enhanced tumor cell killing in vitro.In vivo,the combination therapy markedly suppressed melanoma growth compared to monotherapy.Immune profiling of the tumor microenvironment revealed significantly increased infiltration of CD4? T cells and CD8? T cells in the combination treatment group(P<0.05).Conclusion·The PIKfyve inhibitor YM201636 could restore STING protein expression in STING-deficient melanoma and enhance the antitumor efficacy of the STING agonist diABZI,offering a promising therapeutic strategy for tumors with defective STING signaling.

The scientific research and innovation capabilities of medical students are intrinsically linked to the sustained and high-quality development of national healthcare initiatives.Cultivating outstanding medi-cal students with independent scientific capabilities and innovative consciousness is a critical component in the education and training of high-level medical professionals.Our investigation revealed that within the imperfections of the cultivating model,some faculty and students at medical schools have an insufficient understanding of scientific research and innovation and lack motivation for engaging in such activities,which hinder the progression of scientific research activities.Consequently,we initiated a teaching practice and exploratory study on the"tutorial system"aimed at fostering medical students'scientific research and innovation abilities.Based on the principle of"research informing teaching,teaching and research advan-cing together,"this study implements a"tutorial system"coordinated by tutors,supplemented by graduate and undergraduate student mentors,to cultivate innovative thinking,stimulate interest in scientific re-search,and enhance practical and research skills among medical students.Through collaborative efforts within"scientific research innovation teams,"various educational methods—including preliminary re-search,in-class and extracurricular activities,intra-group and inter-group interactions,and theoretical and practical applications—are employed to improve and strengthen the cultivation of medical students'scientif-ic research and innovation abilities.This study aims to provide valuable references for optimizing medical education management systems and enhancing the quality of medical student training.

Objectives:Utilizing an advanced and high-capacity data acquisition system tailored for elderly patients with valvular heart disease,we aimed to establish standardized data acquisition protocols and define variable sets for a clinical research big data platform dedicated to this condition.Guided by clinical treatment decisions,we implemented a standardized and uniform evaluation process for valvular heart disease.This initiative might culminate in the creation of the first comprehensive database for elderly valvular heart disease,encompassing clinical information,functional assessments,multimodal imaging,treatment modalities,and follow-up data.Methods:Variables were selected based on past clinical studies and literature,both domestic and international,and considering key guidelines,advancements in valvular heart disease,and China's clinical practices.Standards for data variables,imaging techniques,data acquisition,multi-channel verification,and quality control were established.Variables are then classified by their properties and generation time.Results:This comprehensive set of variables encompassed a total of 567 relevant variables,which were generated throughout the entire diagnosis and treatment process of patients with valvular heart disease,starting from admission and extending to those required for clinical research.The variable set was divided into six distinct parts:clinical information(encompassing demographics,admission details,clinical manifestations,comorbidities,medical history,physical examination,auxiliary examinations,and comprehensive assessment of frailty in the elderly),echocardiography,cardiac computed tomography(CT),treatment(including surgery,valve intervention therapy,non-valve intervention therapy,and medication therapy),clinical outcomes,and follow-up.Specifically,it included 14 variables related to demographic and admission information;22 variables encompassing clinical manifestations and physical examination;63 variables concerning medical history and comorbidities;49 variables for inspection and examination;15 variables for the comprehensive evaluation of frail elderly individuals;55 variables of echocardiography,including complete dynamic images at 4 time points,6 cross-sections per point,and corresponding Doppler spectra);131 variables for cardiac CT,including baseline and postoperative raw image uploads(encompassing non-enhanced electrocardiography[ECG]-gated cardiac CT scans,ECG-gated full-phase CT angiography(CTA)scans,and large-scale non-ECG-gated spiral CTA scans);51 variables for surgical diagnosis and treatment;72 variables for valve intervention therapy;33 variables for non-valvular interventional therapy;27 variables for medication information;and 35 variables for clinical outcomes.The follow-up integration comprises 140 variables,along with the upload of raw echocardiography and CT images.Conclusions:Through the establishment of data collection standards and variable standards for the big data platform of valvular heart disease,the standardization and normalization of comprehensive evaluation,diagnosis and treatment,and clinical research of patients with valvular heart disease can be achieved.As a national level big data research platform that can be sustainably used for clinical research and innovative development of valvular heart disease,it will provide support for long-term monitoring of valvular heart disease,real-world data analysis,clinical research(observational and randomized controlled trials),technological innovation,drug and device development,and post market evaluation.

The scientific research and innovation capabilities of medical students are intrinsically linked to the sustained and high-quality development of national healthcare initiatives.Cultivating outstanding medi-cal students with independent scientific capabilities and innovative consciousness is a critical component in the education and training of high-level medical professionals.Our investigation revealed that within the imperfections of the cultivating model,some faculty and students at medical schools have an insufficient understanding of scientific research and innovation and lack motivation for engaging in such activities,which hinder the progression of scientific research activities.Consequently,we initiated a teaching practice and exploratory study on the"tutorial system"aimed at fostering medical students'scientific research and innovation abilities.Based on the principle of"research informing teaching,teaching and research advan-cing together,"this study implements a"tutorial system"coordinated by tutors,supplemented by graduate and undergraduate student mentors,to cultivate innovative thinking,stimulate interest in scientific re-search,and enhance practical and research skills among medical students.Through collaborative efforts within"scientific research innovation teams,"various educational methods—including preliminary re-search,in-class and extracurricular activities,intra-group and inter-group interactions,and theoretical and practical applications—are employed to improve and strengthen the cultivation of medical students'scientif-ic research and innovation abilities.This study aims to provide valuable references for optimizing medical education management systems and enhancing the quality of medical student training.

Objective:To explore the therapeutic mechanism of moxibustion in Crohn disease(CD)-associated intestinal fibrosis by observing its effects on the angiotensin-converting enzyme(ACE)/angiotensin Ⅱ(Ang Ⅱ)/angiotensin Ⅱ type 1 receptor(AT1R)axis in CD mouse models.Methods:Six randomly selected male C57BL/6 mice were assigned to a normal group,while the remaining mice were administered 0.1 mL of 2,4,6-trinitrobenzene sulfonic acid via enema to establish a CD intestinal fibrosis model.After successful modeling,the mice were randomly divided into a model group,a moxibustion group,and a Western medication group,with 6 rats in each group.The normal group and the model group only received grabbing without intervention.In the moxibustion group,mild moxibustion was applied to Qihai(CV6)and bilateral Tianshu(ST25)once a day for 10 min each time over 7 consecutive days.The Western medication group was administered mesalazine suspension via oral gavage once a day for 7 consecutive days.At the end of the intervention,the general condition,disease activity index(DAI)score,and gross colon score of mice in each group were evaluated.Hematoxylin-eosin staining was used to observe and score the histological changes in the colon tissue in each group.Masson staining was used to observe colonic fibrosis and the ratio of collagen-positive areas was analyzed;the expression of Ang Ⅱ in the colon tissue was detected by the enzyme-linked immunosorbent assay;immunohistochemistry and real-time quantitative reverse transcription polymerase chain reaction were used to detect the protein and mRNA expression of ACE and AT1R in the colon tissue,respectively;Western blotting was used to detect the expression of transforming growth factor(TGF)-β1 and connective tissue growth factor(CTGF)in the colon tissue.Results:Compared to the normal group,the DAI score,gross colon score,colonic histological score,collagen-positive area ratio,ACE protein and mRNA,Ang Ⅱ protein,AT1R protein and mRNA,TGF-β1 protein,and CTGF protein in the colon tissue in the model group increased significantly(P<0.01).In contrast,the above indicators in both the moxibustion group and the Western medication group reduced significantly compared to the model group(P<0.01 or P<0.05).There was no statistical difference in these indicators between the moxibustion group and the Western medication group(P>0.05).Conclusion:Moxibustion can alleviate intestinal fibrosis in CD mice,and its therapeutic mechanism may be associated with the regulation of colonic ACE/AngⅡ/AT1R axis.

Objective:To observe any effect of combining repeated transcranial magnetic stimulation (rTMS) with electro-acupuncture in treating post-stroke cognitive impairment (PISC).Methods:Three groups of PISC patients were formed through random selection: an rTMS group, an electro-acupuncture group, and a combined group. In addition to routine medication and conventional rehabilitation training, the rTMS and electro-acupuncture groups received rTMS and electro-acupuncture treatment, while the combined group underwent both for six weeks. Before the treatment, immediately afterward and 3, 6, and 12 months later, everyone′s cognitive functioning was assessed using the Montreal Cognitive Assessment (MoCA). The modified Barthel Index (MBI), the 17-item Hamilton Depression Rating Scale (HAMD-17), and the National Institutes of Health Stroke Scale (NIHSS) were also applied. Transcranial Doppler ultrasound (TCD) was employed to measure the mean cerebral blood flow velocity (Vm), pulsatility index (PI), and breath-holding index (BHI) in the subjects′ bilateral middle cerebral arteries (MCAs). The total effectiveness rates and the incidence of adverse reactions were compared among the three groups.Results:The MoCA scores, MBI scores, HAMD-17 scores, NIHSS scores, and Vm of the MCA had improved significantly in all three groups right after the treatment. There was further significant improvement in the average MoCA scores 12 months later. The combined group showed significantly higher MoCA scores than the other two groups at each time point after the treatment. That group also had superior MBI, HAMD-17 and NIHSS scores and a better BHI compared to the other 2 groups, on average. Its total effectiveness rate was significantly higher too. There was no significant difference in the incidence of adverse reactions among the groups.Conclusions:Combining rTMS with electro-acupuncture significantly improves cognition, ADL ability, depression and neurological functioning after a stroke. The combined treatment is worthy of wider clinical application.