With the rapid development of mobile internet technology, mobile health application (mHealth APP) are increasingly widely used in the field of health management and have been proven to play an important role in the management of chronic diseases. Solid organ transplant recipients face complex health management needs after surgery, including postoperative follow-up, medication management, prevention and treatment of complications and comorbidities, and lifestyle adjustment. mHealth APP can provide solid organ transplant recipients with convenient self-management tools. Although some progress has been made in this field, there are still many challenges, such as insufficient user experience, technological dependence, and data security risks. Therefore, this article discusses the development process, main functions and current application status of mHealth APP, and analyzes its advantages in improving the self-management ability of solid organ transplant recipients, promoting doctor-patient communication and reducing the incidence of complications. At the same time, based on the practical experience of author’s team in developing the “TransMate” mHealth APP, we propose the directions that mHealth APPs should focus on in the future, in order to provide more effective support and services for the health management of solid organ transplant recipients.

Objective Uranium compounds are critical materials in the nuclear industry, and their mining, processing, and use pose occupational exposure risks. Epidemiological studies have shown that uranium exposure can impair health, with acute uranium poisoning primarily causing structural and functional damage to the kidneys. Currently, the molecular mechanisms underlying uranium-induced kidney injury remain unclear, and traditional biological models used in toxicological research are inadequate for simulating the human microenvironment. This study employed a human kidney organoid model system to elucidate the nephrotoxic mechanisms of uranyl ions, providing a scientific basis for the prevention and control of uranium poisoning. Methods Kidney organoids were constructed using the human embryonic stem cell line H1 and exposed to solutions with different uranyl ion concentrations. Morphological observation, ATP detection, reactive oxygen species detection, apoptosis assay, and untargeted metabolomics analysis were performed. Mechanisms of toxicity were further explored through KEGG pathway enrichment analysis. Results Uranium exposure led to structural damage in the organoids, accompanied by a dose-dependent decrease in ATP levels, accumulation of reactive oxygen species, and increased apoptosis rate. After 24-hour exposure to 300 μmol/L uranium, significantly disturbed differential metabolites and five core metabolic pathways were identified. Conclusion Uranium induces oxidative stress, mitochondrial dysfunction (ATP reduction), and metabolic disorder (disruption of phospholipid/amino acid metabolism), which synergistically cause DNA damage, apoptosis, and/or necrosis. These findings provide new insights into the mechanisms of uranium-induced kidney injury and support the development of prevention and control strategies.

AIM:This study aims to explore the effects and underlying mechanisms of caloric restriction(CR)on folic acid(FA)-induced acute kidney injury(AKI)in mice.METHODS:An AKI model was established by in-traperitoneal injection of FA(250 mg/kg).(1)Twenty male C57BL/6J mice(20～25 g)were randomly assigned to 4 groups(n=5):sham+ad libitum(AL),FA+AL,sham+CR,and FA+CR.The mice in CR groups were subjected to a 66%reduction in daily food intake within a limited feeding window for 2 weeks,while those in AL groups had unrestricted access to food.All mice had free access to water,and their body weight changes were monitored throughout the experi-ment.(2)An additional set of twenty male C57BL/6J mice were divided into 4 groups(n=5):control,A769662,FA,and FA+A769662.The AMP-activated protein kinase(AMPK)agonist A769662(30 mg/kg)was administered intraperito-neally for 3 d prior to FA injection.(3)Modeling of tubule-specific AMPK knockout(RT-AMPK-CKO)mice followed the same protocol as wild-type C57BL/6J mice.Blood and kidney tissues were harvested 48 h after FA injection.Serum creati-nine(SCr)and blood urea nitrogen(BUN)levels were measured using an automatic biochemical analyzer.The kidney pa-thology was examined by HE staining.The malondialdehyde(MDA)level and the reduced/oxidized glutathione(GSH/GSSG)ratio were assessed using assay kits.The protein levels of p-AMPK,AMPK,and ferroptosis-related markers were evaluated by Western blot and immunohistochemistry.RESULTS:(1)After 2 weeks,CR significantly reduced body weight and increased p-AMPK level compared with AL group(P<0.05).(2)Compared with FA+AL group,the mice in FA+CR and FA+A769662 groups exhibited notably lowered SCr and BUN levels,reduced expression of kidney injury mole-cule-1 and neutrophil gelatinase-associated lipocalin,lowered tubular injury scores,decreased long-chain fatty acid-CoA ligase 4(FACL4)and 4-hydroxynonenal levels,restored glutathione peroxidase 4(GPX4)expression,decreased MDA level,and enhanced GSH/GSSG ratio(P<0.05).(3)In the FA-induced renal injury model,RT-AMPK-CKO mice showed no significant differences compared with wild-type mice(P>0.05).However,in the FA+CR model,RT-AMPK-CKO mice failed to exhibit renal protection,with increased lipid peroxidation,elevated MDA level,and reduced GSH/GSSG ratio(P<0.05).Furthermore,CR-induced down-regulation of FACL4 and up-regulation of GPX4 were significantly reversed in RT-AMPK-CKO mice(P<0.05).CONCLUSION:The CR attenuates FA-induced AKI in mice by activating AMPK and inhibiting ferroptosis.

AIM:This study aims to explore the effects and underlying mechanisms of caloric restriction(CR)on folic acid(FA)-induced acute kidney injury(AKI)in mice.METHODS:An AKI model was established by in-traperitoneal injection of FA(250 mg/kg).(1)Twenty male C57BL/6J mice(20～25 g)were randomly assigned to 4 groups(n=5):sham+ad libitum(AL),FA+AL,sham+CR,and FA+CR.The mice in CR groups were subjected to a 66%reduction in daily food intake within a limited feeding window for 2 weeks,while those in AL groups had unrestricted access to food.All mice had free access to water,and their body weight changes were monitored throughout the experi-ment.(2)An additional set of twenty male C57BL/6J mice were divided into 4 groups(n=5):control,A769662,FA,and FA+A769662.The AMP-activated protein kinase(AMPK)agonist A769662(30 mg/kg)was administered intraperito-neally for 3 d prior to FA injection.(3)Modeling of tubule-specific AMPK knockout(RT-AMPK-CKO)mice followed the same protocol as wild-type C57BL/6J mice.Blood and kidney tissues were harvested 48 h after FA injection.Serum creati-nine(SCr)and blood urea nitrogen(BUN)levels were measured using an automatic biochemical analyzer.The kidney pa-thology was examined by HE staining.The malondialdehyde(MDA)level and the reduced/oxidized glutathione(GSH/GSSG)ratio were assessed using assay kits.The protein levels of p-AMPK,AMPK,and ferroptosis-related markers were evaluated by Western blot and immunohistochemistry.RESULTS:(1)After 2 weeks,CR significantly reduced body weight and increased p-AMPK level compared with AL group(P<0.05).(2)Compared with FA+AL group,the mice in FA+CR and FA+A769662 groups exhibited notably lowered SCr and BUN levels,reduced expression of kidney injury mole-cule-1 and neutrophil gelatinase-associated lipocalin,lowered tubular injury scores,decreased long-chain fatty acid-CoA ligase 4(FACL4)and 4-hydroxynonenal levels,restored glutathione peroxidase 4(GPX4)expression,decreased MDA level,and enhanced GSH/GSSG ratio(P<0.05).(3)In the FA-induced renal injury model,RT-AMPK-CKO mice showed no significant differences compared with wild-type mice(P>0.05).However,in the FA+CR model,RT-AMPK-CKO mice failed to exhibit renal protection,with increased lipid peroxidation,elevated MDA level,and reduced GSH/GSSG ratio(P<0.05).Furthermore,CR-induced down-regulation of FACL4 and up-regulation of GPX4 were significantly reversed in RT-AMPK-CKO mice(P<0.05).CONCLUSION:The CR attenuates FA-induced AKI in mice by activating AMPK and inhibiting ferroptosis.

Objective To form the expert consensus on the limb management of patients with transvenous temporary cardiac pacing,standardize the limb management of patients with transvenous temporary cardiac pacing,and reduce complications related to the limb.Methods Using evidence-based methods,the evidence in this field was searched,evaluated and summarized,and relevant recommendations and research conclusions were extracted and classified by the level of evidence quality,and then the first draft of the consensus was formed.From December 2023 to January 2024,through 2 rounds of expert consultation and 4 rounds of expert meetings,the content was adjusted and the consensus was reached.Results Totally 16 experts participated in the consultation.The positive coefficient is 100%;the authoritative coefficient is 0.847 and 0.836;the average value of each index is more than＞3.8;the coefficient of variation is less than 0.21.The Kendall's harmony coefficient of the 2 rounds of expert consultation is 0.372 and 0.314,respectively,which were statistically significant.The consensus covers the preoperative,intraoperative and postoperative on limb management of patients with transvenous temporary cardiac pacing.Totally 11 themes were involved,including the preoperative preparation,position and catheter fixation in operation,position and catheter fixation in postoperative,activity,turn and transfer,duty shift on limb,nursing care after withdrawal of the catheter,prevention of deep vein thrombosis of the operative limb and prevent infection.Conclusion The consensus is highly scientific,and it is helpful to standardize the limb management of patients with transvenous temporary cardiac pacing.

Objective To understand the implementation of the nursing group standards for oxygen inhalation therapy in clinical practice,and to provide a reference for improving the nursing practice of oxygen therapy.Methods A convenience sampling method was used to investigate nurses from 902 hospitals in 24 provinces and municipalities directly under the central government using a self-designed questionnaire from December 15th,2022,to January 14th,2023.The content of questionnaire included whether they had implemented the recommendations of the oxygen therapy standards,the knowledge of safety related to oxygen therapy,and the components of oxygen therapy prescriptions,the indications used for patients receiving oxygen therapy and practice status of oxygen therapy.Results A total of 10481 questionnaires were returned,of which 10447 were valid,with a valid questionnaire recovery rate of 99.68%.63.14%of the nurses indicated that the hospital had organized training on oxygen therapy standards.Only 47.82%of nurses know the correct use of the Venturi mask.41.90%of nurses could indicate the correct indicator of flow adjustment.31.88%of the nurses stated that they will adjust the oxygen flow rate based on the oxygenation status of carbon dioxide storage patients.Only 19.56%of nurses indicated that humidification is applied in oxygen therapy based on the oxygen flow and duration.Conclusion Even though nurses had received training related to oxygen therapy standards,the level of knowledge of oxygen therapy standards was still low;therefore continuous systematic training was needed,and the implementation of the content of oxygen therapy standards needed to be further standardized.Healthcare institutions would focus on organizing systematic training and maintaining the training effect,enhancing infrastructure and providing support for implementation.Recommendation to the nursing administration is to explore how to comprehensively and continuously implementing the oxygen therapy nursing standards with the ultimate goal of providing patients safer and more accurate oxygen therapy.

Objective To observe the impact of ultrasonic image quality on the consistency of artificial intelligence(Al)assisted diagnosis system and manual measurements of biological indicators of developmental dysplasia of hip(DDH).Methods Hip ultrasonic data of 75 DDH and 345 non-DDH children were retrospectively analyzed,and the quality of ultrasonic images were subjectively scored.An evaluation model of ultrasonic image quality was constructed based on 140 ultrasonic images acquired from 140 cases(group A,containing 25 DDH and 115 non-DDH)using entropy weighting method,the weight of anatomic structures and impact factors related to DDH were obtained.The comprehensive image quality scores of other ultrasonic images acquired from 280 cases(group B,including 50 DDH and 230 non-DDH)were calculated,and the images in group B were classified into grade A,B and C in descending order.The consistency of AI and manual measurements of DDH biological indicators in group B was assessed.Results The weight of each anatomic structure and impact factors of DDH obtained with the model were as follows:The lower edge of iliac branch＞ilium＞glenoid labrum＞bony margin＞femoral head＞motion artifacts.In group B,grade A was observed in 67(9 DDH and 58 non-DDH),grade B was found in 160(26 DDH and 134 non-DDH),while grade C was noticed in 53(15 DDH and 38 non DDH)images.Except for β,femoral head coverage(FHC)and femoral head length diameter,the consistencies between AI and manual measurements of other indicators of DDH were grade A＞B＞C.In group B,AI and manual measurements were more consistent in DDH than in non-DDH cases.Conclusion Ultrasonic image quality affected the consistency between AI and manual measurements of biological indicators of DDH.When image quality was not good enough,further attention should be paid to measurement of FHC and sizes of femoral head.

Objective:To compare the effect and biotoxicity of tert-butyl acetate (TBA) and ethyl butyrate (EB) on stone dissolution in vitro.Methods:Ten gallstone samples from patients with multiple gallbladder stones were selected and the cholesterol content was analyzed by HPLC. Stone dissolution tests of TBA and EB were performed on cholesterol gallstone in vitro, and the weight of stone at each time point was recorded, meanwhile, methyl tert-butyl ether (MTBE) was used as the control. The inhibitory effects of MTBE, TBA and EB on proliferation of human normal liver cell line LO2 were analyzed by cell proliferation inhibition assay. Flow cytometry was used to analyze the effects of MTBE, TBA and EB on the early and late apoptosis of LO2 cells, and the changes of reactive oxygen species level in LO2 cells were also analyzed.Results:Of the 10 gallbladder gallstones, 6 were cholesterol gallstones and 4 were non-cholesterol gallstones. Stone dissolution experiment showed that the remaining stones of MTBE, TBA and EB groups were (47.83±3.84)%, (58.12±4.53)% and (75.75±4.61)% 30 minutes later. The remaining stones were (18.38±6.47)%, (33.82±6.22)% and (56.38±3.91)% 90 minutes later. MTBE had the best stone dissolution effect in vitro, the stone dissolution effect of TBA was slightly weaker than MTBE, and the stone dissolution effect of EB was relatively weak in all ( P<0.05). The cell proliferation inhibition experiment showed that the cell viability of the control group, MTBE group and TBA group were (100.00±4.46)%, (96.79±4.32)% and (93.72±3.51)%, respectively, and there were no significant differences among the three groups ( P>0.05). However, the cell viability of EB group (87.57±5.29)% was lower than the above three groups, and the differences were statistically significant ( P<0.001). The early apoptosis and late apoptosis of the control group were (1.67±0.15)% and (1.27±0.06)%, respectively. EB induced early apoptosis (15.90±0.53)% ( P<0.001) and late apoptosis (5.13±0.76)% ( P<0.05). However, MTBE and TBA had no significant effect on cell apoptosis ( P>0.05). Compared with control group, MTBE, TBA and EB all significantly inhibited the level of reactive oxygen species ( P<0.05), and the inhibitory effect of EB was the most obvious. Conclusions:TBA has good stone dissolution effect and biosafety for gallbladder cholesterol stones in vitro, while EB has relatively poor performance. TBA is a potential drug for gallstone dissolution.

Objective: To explore the effect of neck exercises on improving the shoulder and neck symptoms of senior high school students in Zhuhai. Methods: From February 2019 to July 2019, 805 senior high school students from 20 classes in 10 middle schools in Zhuhai were selected by multi-stage random sampling method, and randomly divided into two groups based on the class. The final observation group consisted of 405 cases and the control group consisted of 400 cases. The observation group was intervened by neck exercise based with isometric contraction exercise for 12 weeks, while the control group was intervened by routine intervention. The changes of VAS, NDI and PSQI were compared before and after the intervention between the two groups, and the subjects who met the diagnosis criteria of cervical spondylosis were analyzed in subgroups. Results: A total of 112 students met the diagnostic criteria of cervical spondylosis, the prevalence rate was 13.9%. among them, 58 cases were diagnosed in the control group and 54 cases in the observation group. After the intervention, the VAS pain level of the observation group was lower than that of the control group (Z=-3.37, P<0.01), and the NDI score was significantly lower than that of the control group (t=-20.05, P<0.01). After the intervention, the PSQI subjective sleep quality, sleep time, sleep efficiency, sleep disorder, daytime dysfunction dimension scores and total scores of the observation group were significantly lower than those of the control group (t=-10.36, -7.66, -12.39, -9.78, -9.06, -11.31, -16.56, P<0.05). Conclusion The incidence of cervical spondylosis is high in senior high school students in Zhuhai. The neck exercise focusing on isometric strengthening can effectively improve the symptoms and sleep quality of cervical vertebrae.

Objective:To investigate the effect of flexible visiting policies in ICUs by comparing with restrictive visiting policies.Methods:English database (Pubmed, embase, Cochrane library, scopus, OvidSP, Wiley Online library, Google scholar and web of science) and Chinese database (CNKI, VIP, CBM and Wanfang) are retrieved, the search time is up to February 2020. The included literatures were evaluated quantitatively and qualitatively.Results:The flexible visiting policies can reduce the risk of delirium in ICU patients [RR=0.59, 95%CI=(0.36,0.96)], shorten the length of stay [MD=-0.21, 95%CI=(-0.35,-0.06)], improve patients' anxiety symptoms [MD=-2.2, 95%CI=(-3.8,-0.61)], reduce the incidence of anxiety and depression and improve the nursing satisfaction of patients and their families, without increasing the risk of ICU acquired infection [RR= 0.77, 95% CI= (0.51, 1.16)] and patient mortality (RR= 0.82, 95% CI= (0.53, 1.26)]. Sensitivity analysis suggested that the results were stable.Conclusions:Compared with the current restrictive visitation policies, the flexible visitation system can reduce the risk of delirium, improve anxiety symptoms and depression, and obtain more satisfaction from family members and patients, and It can be tried further.