BACKGROUND:Promoting skin wound healing is a huge challenge facing global public health.To promote faster and higher-quality wound healing,it is necessary to explore more advantageous dressings to address this problem.OBJECTIVE:To investigate the hemostatic properties of acellular dermal matrix hydrogel and its effect on skin wound healing.METHODS:(1)Acellular dermal matrix hydrogel was prepared,and the differences in microscopic morphology and main components between it and acellular dermal matrix were analyzed.(2)Acellular dermal matrix hydrogel and chitosan hydrogel were used to cover the femoral artery puncture site of rats,and the bleeding quality and coagulation time were recorded.Acellular dermal matrix hydrogel and chitosan hydrogel were mixed with rat anticoagulated blood,and the coagulation index within 30 minutes was detected.(3)A full-thickness skin defect model with a diameter of 12 mm was made on the back of 18 SD rats,and they were randomly divided into 3 groups,with 6 rats in each group:the model group used PBS to clean the wound,and the control group and the experimental group used chitosan hydrogel and acellular dermal matrix hydrogel to cover the wound,respectively.The hydrogel dressing was changed every day,and the treatment was continued for 14 days,and the wound healing was observed.On day 3 after modeling,immunofluorescence staining of inducible nitric oxide synthase(M1 macrophages)and CD206(M2 macrophages)was performed on the wound surface.On day 14 after modeling,hematoxylin-eosin staining,Masson staining,and CD31 immunohistochemical staining were performed on the wound surface.RESULTS AND CONCLUSION:(1)Scanning electron microscopy revealed that the acellular dermal matrix hydrogel had a porous structure,and the Fourier transform infrared spectrum showed that it had the same main components as the acellular dermal matrix.(2)Both acellular dermal matrix hydrogel and chitosan hydrogel had obvious hemostatic ability in vivo.In the in vitro coagulation experiments,the coagulation index of acellular dermal matrix hydrogel was significantly higher than that of chitosan hydrogel.(3)In the rat skin full-thickness defect model,both acellular dermal matrix hydrogel and chitosan hydrogel could improve the wound healing rate.Hematoxylin-eosin and Masson staining results showed that acellular dermal matrix hydrogel could reduce the infiltration of inflammatory cells in the center of the wound.Both acellular dermal matrix hydrogel and chitosan hydrogel could decrease scar width and increase collagen deposition rate.CD31 immunohistochemical staining results showed that both hydrogels could promote angiogenesis in the wound site.Immunofluorescence staining results showed that both hydrogels could reduce the proportion of M1 macrophages and increase the proportion of M2 macrophages,and the effect of acellular dermal matrix hydrogel was stronger than that of chitosan hydrogel.(4)The results show that the acellular dermal matrix hydrogel has good hemostatic properties and the ability to promote wound healing.

The occupational population in China faces increasingly complex health risks, with a growing burden of chronic diseases and multimorbidity. Based on data from the China Health and Nutrition Survey (CHNS), this special column systematically analyzed trends in dietary structure, nutrient intake, and metabolic abnormalities among different occupational groups from 1989 to 2018, revealing the combined effects of occupational categories and dietary behaviors on multimorbidity risk. The findings highlight that rational dietary patterns and healthy behaviors are key modifiable factors. It is recommended to leverage workplaces as platforms for nutritional interventions and behavioral improvement, thereby improving health literacy among the occupational population. Furthermore, the establishment of a multi-sectoral health promotion mechanism is recommended to guide dietary optimization and lifestyle transformation, contributing to chronic disease prevention and occupational health protection.

Background With China's socioeconomic development, significant lifestyle changes have occurred among occupational groups, leading to alterations in cardiovascular metabolic risk factors. However, few studies have examined the secular trends of these risk factors in China's working population. Objective To analyze the trends in cardiovascular metabolic risk factors among the occupational population in nine provinces of China from 2009 to 2018, and to explore the associations between different occupational types and these risk factors, along with their clustering patterns, thereby providing evidence for targeted interventions. Methods This study utilized data from the China Health and Nutrition Survey (CHNS) in 2009, 2015, and 2018. The dataset covered 13274 employed individuals aged 18-59 years. Only participants with complete blood test results and physical measurement data were included in the final analysis. The average annual percentage change (AAPC) in the positive rates of risk factors was calculated using Joinpoint regression to analyze temporal trends. Multinomial logistic regression and binary logistic regression models were employed to examine the cross-sectional associations between occupational types (categorized as white-collar workers, agricultural workers, blue-collar workers, service workers, and others) and nine cardiovascular metabolic risk factors and their clustering (defined as having ≥2 risk factors) in 2018. Results A total of 8451 participants were included. From 2009 to 2018, significant increasing trends (AAPC>0, P<0.05) were observed for overweight, obesity, central obesity, borderline elevated triglycerides (TG), borderline elevated to elevated total cholesterol (TC), borderline elevated low-density lipoprotein cholesterol (LDL-C), elevated blood pressure and hypertension, diabetes. The most rapid increases were found for obesity (AAPC=6.07%, 95%CI: 3.42%, 8.88%), hypertension (AAPC=4.10%, 95%CI: 0.62%, 7.77%), and central obesity (AAPC=3.27%, 95%CI: 1.24%, 5.36%). The clustering rate of risk factors increased from 62.3% in 2009 to 73.2% in 2018 (AAPC=1.87%, 95%CI: 1.02%, 2.73%). The cross-sectional analysis in 2018, after adjusting for confounders, showed that compared with white-collar workers, blue-collar workers had a significantly lower risk of overweight (OR=0.67, 95%CI: 0.48, 0.95), central obesity (OR=0.65, 95%CI: 0.45, 0.92), and borderline high TG (OR=0.54, 95%CI: 0.35, 0.82). In contrast, agricultural workers had a higher risk of hypertension (OR=1.76, 95%CI: 1.14, 2.72). Conclusion Between 2009 and 2015, the burden of most cardiometabolic risk factors increases significantly among the Chinese occupational population, with the rate of increase slowing by 2018. Risks vary across occupational types, among which blue- collar workers report lower target outcomes. Targeted interventions focusing on the rapidly increasing risk factors and high-risk occupational groups are recommended.

BACKGROUND:Promoting skin wound healing is a huge challenge facing global public health.To promote faster and higher-quality wound healing,it is necessary to explore more advantageous dressings to address this problem.OBJECTIVE:To investigate the hemostatic properties of acellular dermal matrix hydrogel and its effect on skin wound healing.METHODS:(1)Acellular dermal matrix hydrogel was prepared,and the differences in microscopic morphology and main components between it and acellular dermal matrix were analyzed.(2)Acellular dermal matrix hydrogel and chitosan hydrogel were used to cover the femoral artery puncture site of rats,and the bleeding quality and coagulation time were recorded.Acellular dermal matrix hydrogel and chitosan hydrogel were mixed with rat anticoagulated blood,and the coagulation index within 30 minutes was detected.(3)A full-thickness skin defect model with a diameter of 12 mm was made on the back of 18 SD rats,and they were randomly divided into 3 groups,with 6 rats in each group:the model group used PBS to clean the wound,and the control group and the experimental group used chitosan hydrogel and acellular dermal matrix hydrogel to cover the wound,respectively.The hydrogel dressing was changed every day,and the treatment was continued for 14 days,and the wound healing was observed.On day 3 after modeling,immunofluorescence staining of inducible nitric oxide synthase(M1 macrophages)and CD206(M2 macrophages)was performed on the wound surface.On day 14 after modeling,hematoxylin-eosin staining,Masson staining,and CD31 immunohistochemical staining were performed on the wound surface.RESULTS AND CONCLUSION:(1)Scanning electron microscopy revealed that the acellular dermal matrix hydrogel had a porous structure,and the Fourier transform infrared spectrum showed that it had the same main components as the acellular dermal matrix.(2)Both acellular dermal matrix hydrogel and chitosan hydrogel had obvious hemostatic ability in vivo.In the in vitro coagulation experiments,the coagulation index of acellular dermal matrix hydrogel was significantly higher than that of chitosan hydrogel.(3)In the rat skin full-thickness defect model,both acellular dermal matrix hydrogel and chitosan hydrogel could improve the wound healing rate.Hematoxylin-eosin and Masson staining results showed that acellular dermal matrix hydrogel could reduce the infiltration of inflammatory cells in the center of the wound.Both acellular dermal matrix hydrogel and chitosan hydrogel could decrease scar width and increase collagen deposition rate.CD31 immunohistochemical staining results showed that both hydrogels could promote angiogenesis in the wound site.Immunofluorescence staining results showed that both hydrogels could reduce the proportion of M1 macrophages and increase the proportion of M2 macrophages,and the effect of acellular dermal matrix hydrogel was stronger than that of chitosan hydrogel.(4)The results show that the acellular dermal matrix hydrogel has good hemostatic properties and the ability to promote wound healing.

End-stage liver disease (ESLD) covers the end-stage of acute and chronic liver diseases, mainly involving decompensated cirrhosis, various types of liver failure, and advanced liver cancer. Hepatocyte transplantation has shown promise in treating ESLD, but its clinical application is hampered by the shortage of donor hepatocytes. Cell therapy, an emerging effective treatment for ESLD, faces the same limitation due to scarce hepatocyte availability. Hepatocyte-like cells (HLCs), which are terminally differentiated cells, can be induced from both stem cells and somatic cells. As HLCs exhibit the morphology and function of primary hepatocytes, they offer a promising supplementary source of hepatocytes for cell therapy. First, we provide a background for the differentiation and maturation of primary hepatocytes. Subsequently, based on the current insights into the molecular pathways that regulate hepatocyte differentiation in vivo, we describe a strategy for establishing HLC derived from either stem cells or somatic cells. The key characteristics of these HLCs are also detailed. Furthermore, HLC offers therapeutic potential for liver failure, and HLC-based liver organoids and bioartificial liver systems have demonstrated the ability to provide liver functions, offering an innovative approach to treating various types of ESLD. Despite their promise, challenges such as efficiency in differentiation and functional maturation need to be addressed to improve the clinical application of HLCs. This review discusses these advancements and outlines the therapeutic potential and current challenges of HLC therapy for ESLD.

Objective: To investigate the characteristics of psychological symptoms and the associated factors among students with close contact to tuberculosis in school settings,so as to provide evidence for school tuberculosis control and mental health interventions. Methods: A cross sectional study was conducted in April 2023 from 4 schools in Hangzhou using a multistage cluster random sampling method. Students identified as close contacts of tuberculosis cases ( n =406) were assigned to the exposure group, while non close contact students ( n =426) were matched at a 1∶1 ratio within the same schools as the non exposure group. A questionnaire survey was employed to collect data on general demographic and family sociological information. Psychological symptoms were assessed using the Symptom Check List-90 (SCL-90). A global severity index (GSI) score ≥2.0 was defined as moderate to severe psychological symptoms (MSPS). Logistic regression analysis was performed to identify associated factors. Results: The overall MSPS detection rate was 15.38%. The detection rate in the exposure group (20.69%) was significantly higher than the non exposure group (10.33%)( χ 2=17.14, P <0.05). Multivariate Logistic regression analysis showed that middle or lower family economic status ( OR =1.90, 95% CI =1.10-3.28) and poor interaction with others ( OR =2.95, 95% CI =1.79-4.88) were independent factors associated with MSPS among the exposure group (both P <0.05). Conclusions Students who are close contacts of school tuberculosis cases have a relatively high MSPS detection rate. Poor family economic status and poor interaction with social personnel are the main factors influencing MSPS. Schools should simultaneously strengthen psychological health support targeting factors in tuberculosis prevention and control.

Psychological problems are significant factors that contribute to the occurrence of postoperative complications, reduced quality of life, and prolonged hospital stays. Lung cancer patients who require surgery often experience high psychological stress related to both the disease and the treatment, making them more susceptible to depression and anxiety. Therefore, timely intervention to address these psychological issues is crucial for promoting postoperative recovery and improving patients' quality of life. This paper will review the current status, impact, and interventions for depression and anxiety-related psychological problems in lung cancer surgery patients.

ObjectiveTo explore the ethical dilemmas of patients in a cancer specialty hospital in the context of the smart hospital and to propose relevant countermeasures. MethodsUsing the purposive sampling method， medical staff from a tertiary cancer specialty hospital in a certain city were selected as research subjects from December 2023 to January 2024. Qualitative interviews were conducted on the ethical dilemmas of the specialized cancer patients in the context of the smart hospital， and Nvivo 12.0 software was used for data transcription and analysis. ResultsThree themes were extracted. First， the ethical dilemmas faced by specialized cancer patients in the context of smart hospitals， including the ethical dilemma between privacy protection and information disclosure， the right to life and choice， fairness and priority， and scientific research and clinical practice. Second， smart hospitals relied on advanced information technology to improve the level of medical teaching and research， but this had led to various ethical dilemmas mentioned above. Medical staff should correctly view and scientifically respond to these ethical dilemmas. Third， the response strategies for ethical dilemmas in cancer specialty hospitals in the context of smart hospitals include improving relevant policies and regulations， optimizing medical resource allocation， strengthening ethics education of medical staff， enhancing doctor-patient communication， and strengthening feedback and regulatory mechanisms. ConclusionMedical institutions should strengthen ethical supervision while promoting innovation and application of medical information technology， to ensure compliance and sustainability in the development of smart hospitals.

Objective To observe the differences in gut microbiota in chronic unpredictable mild stress(CUMS)-induced depression model rats of both sexes,and to provide experimental evidence for exploring sex differences in depression onset.Methods Thirty-two healthy SD rats were divided randomly into four groups based on sex:Male control group(Control-M),Female control group(Control-F),Male model group(Model-M),and Female model group(Model-F)(n=8 rats per group).Rats in the control groups were fed without stimulation,while rats in the model groups were stimulated using the 28 d CUMS-induced depression method.After successful modeling,fresh feces were collected from all rats for high-throughput 16S rRNA sequencing.Behavioral observations were also conducted before and after preparing the model.Results The result of sucrose-preference,open-field,and forced-swimming tests differed significantly between the control and model groups.The result of the sucrose-preference test also differed between the sexes,while there was no difference in the open-field or forced-swimming test between the sexes.The α and β diversity of the gut microbiota genera showed an upward trend in the CUMS group compared with the control group.The ratio of Firmicutes/Bacteroidetes and the richness of the Roseburia and Lachnospiraceae_NK4A136_group were decreased in male rats but showed an increasing trend in female rats.Conclusions The ratio of Firmicutes/Bacteroidetes in the gut microbiota may be a key factor affecting the difference in the onset of depression between males and females,while the Roseburia and Lachnospiraceae_NK4A136_group be potential factors in correcting the gut microbiota and improving the symptoms of depression.

Objective:To evaluate the efficacy of ultrasound-guided subcostal quadratus lumborum block combined with general anesthesia in laparoscopic bariatric surgery.Methods:In this prospective randomized controlled study, 80 American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱpatients, aged 18-40 yr, with a body mass index of 30-45 kg/m 2, of cardiac function classification Ⅰ or Ⅱ, who underwent laparoscopic bariatric surgery at the First Affiliated Hospital of Nanjing Medical University from February 2023 to May 2023, were selected and divided into 2 groups ( n=40 each) using a table of random numbers: general anesthesia group (GA group) and subcostal quadratus lumborum block combined with general anesthesia group (SQB+ GA group). Both groups received combined intravenous-inhalational anesthesia. Patients in SQB+ GA group underwent bilateral ultrasound-guided subcostal quadratus lumborum block with 20 ml of 0.375% ropivacaine before anesthesia induction. Oxycodone was administered for analgesia during the post-anesthesia care unit (PACU) stay. Patient-controlled intravenous analgesia with sufentanil and granisetron was used after returning to the ward. When the visual analog scale score >4 within 24 h after surgery, flurbiprofen axetil 50 mg was intravenously given as rescue analgesic. The intraoperative consumption of remifentanil and use of vasoactive drugs were recorded. The effective pressing times of patient-controlled analgesia and requirement for rescue analgesia were recorded. The tracheal extubation time, PACU stay time, use of oxycodone during PACU stay, and occurrence of hypoxemia after tracheal extubation and occurrence of adverse reactions within 24 h after surgery was also recorded. Arterial blood gas analysis was performed at discharge from PACU. Results:Compared with GA group, the intraoperative consumption of remifentanil was significantly reduced, the usage rate of oxycodone, effective pressing times of patient-controlled analgesia and rate of rescue analgesia were significantly decreased, the PaO 2 and PaCO 2 at discharge from PACU were decreased, the tracheal extubation time and PACU stay time were shortened, and the incidence of hypoxemia after tracheal extubation and postoperative nausea and vomiting was decreased in SQB+ GA group ( P<0.05). Conclusions:Compared with general anesthesia alone, ultrasound-guided subcostal quadratus lumborum block combined with general anesthesia can reduce the intraoperative consumption of opioids, alleviate postoperative pain, and decrease the occurrence of postoperative adverse reactions when used in laparoscopic bariatric surgery.