ObjectiveTo investigate the safety and efficacy of puncture cyanoacrylate selective seal （PCSS） under endoscopic ultrasound in the treatment of gastroesophageal varices （GOV）. MethodsA total of 100 patients with liver cirrhosis who underwent endoscopic therapy for the secondary prevention of GOV bleeding in Beijing Ditan Hospital， Capital Medical University， from March 1 to December 31， 2023 were enrolled and randomly divided into PCSS group and traditional endoscopy group. The patients were followed up for 6 months after surgery， and the two groups were compared in terms of clinical outcome and complications. The primary outcome measure was the rate of alleviation or disappearance of GOV， and the secondary outcome measure was variceal rebleeding and death. The independent-samples t test was used for comparison of normally distributed or approximately normally distributed quantitative data between two groups， and the Wilcoxon non-parametric test was used for comparison of non-normally distributed quantitative data between two groups； the chi-square test or the Fisher’s exact test was used for comparison of qualitative data between two groups. ResultsThere were 50 patients in the PCSS group， among whom 1 patient was lost to follow-up， and there were 50 patients in the traditional endoscopy group， among whom 3 patients were lost to follow-up. There were no significant differences between the two groups in baseline data such as age， sex， Child-Pugh class， varices grade， and GOV typing （all P>0.05）. Compared with the traditional endoscopy group， the PCSS group had significantly better results of the number of endoscopic treatment sessions （t=-15.671， P=0.001）， the total amount of tissue adhesive used （t=-2.830， P=0.006）， and the rate of alleviation or eradication of varices sclerosis （χ²=7.078， P=0.029）. Both groups had low rates of postoperative rebleeding， adverse reactions， and complications， and there were no significant differences between the two groups （all P>0.05）. ConclusionCompared with traditional endoscopy， PCSS can significantly enhance treatment outcome while maintaining safety standards.

Objective: To examine the relationship between self-management behaviors and time perspective among patients with comorbid diabetes, so as to provide the evidence for improving self-management behaviors among patients with comorbid diabetes. Methods: The patients with comorbid diabetes who were registered in the chronic disease health management system of Minhang District, Shanghai Municipality in 2021, followed up regularly, and lived in Meilong Town were recruited. Demographic information and family history of diabetes were collected through questionnaire surveys. Time perspective and self-management behaviors were assessed using the Zimbardo Time Perspective Inventory and Diabetes Self-Management Behavior Scale, respectively. The relationship between self-management behaviors and time perspective was analyzed using a multivariable ordinal logistic regression model. Results: A total of 907 patients with comorbid diabetes were enrolled, including 472 males (52.04%) and 435 females (47.96%). There were 652 cases aged 65 years and above, accounting for 71.89%. In terms of the types of time perspective, 280 patients were future-oriented (30.87%), 236 were balanced (26.02%), 162 were sensation-seeking (17.86%), 123 were fatalistic (13.56%), and 106 were negative (11.69%). In terms of the self-management behaviors, 46 patients were good (5.07%), 643 were moderate (70.89%), and 218 were poor (24.04%). Multivariable ordinal logistic regression analysis showed that after adjusting for age, gender, educational level, marital status, occupation status, monthly income, and family history of diabetes, the patients with comorbid diabetes who had a future-oriented time perspective had better self-management behaviors (OR=1.874, 95%CI: 1.204-2.915). Conclusion The self-management behaviors among patients with comorbid diabetes are moderate to poor, and patients with a future-oriented time perspective can better engage in self-management behaviors.

ObjectiveTo investigate the safety and efficacy of endoscopic ultrasound-guided tissue adhesive injection with the assistance of metal clips in the treatment of cirrhotic patients with gastric varices and gastric-renal shunt （GRS）. MethodsThe patients who attended Beijing Ditan Hospital， Capital Medical University， due to liver cirrhosis and gastric varices from February to June 2023 were enrolled， and all patients were confirmed to have GRS and received endoscopic ultrasound-guided tissue adhesive injection with the assistance of metal clips. The primary evaluation index was alleviation or disappearance of varicose veins after surgery， and the secondary evaluation indices were surgical completion and complications. ResultsA total of 11 patients were enrolled in this study， among whom there were 7 male patients and 4 female patients， with a median age of 55 years. Of all patients， 1 had Child class A liver function， 7 had Child class B liver function， and 3 had Child class C liver function. The maximum （median） diameter of the shunt was 8 mm， and the minimum （median） diameter of the shunt was 4 mm. The median blood flow velocity of the target vessel was 11 cm/s before treatment and 5 cm/s after occlusion with metal clips. The median amount of tissue adhesive injected was 2 mL， and the amount of lauromacrogol used was 1 mL. Disappearance of blood flow signals was observed in all patients after surgery （100%）， and the success rate of surgery was 100%. No patient experienced rebleeding after follow-up for 6 weeks. Gastroscopy at 1 month after surgery showed that gastric varices were eradicated or almost disappeared in 9 patients and were alleviated in 2 patients. ConclusionEndoscopic ultrasound-guided tissue adhesive injection with the assistance of metal clips is a feasible， safe， and effective treatment method for cirrhotic patients with gastric varices and GRS.

ObjectiveTo investigate the incidence of hypertension and its influencing factors in community-dwellers at risk for high blood pressure in Minhang District of Shanghai， and to provide scientific evidence for the community management. MethodsA retrospective cohort study was conducted using the electronic health records of community-dwellers at risk for high blood pressure in Minhang District， Shanghai from January 1， 2011 to December 31， 2017. The study end-point was the occurrence of hypertension，and the followup was finished in December 2021. A total of 17 265 community-dwellers at risk for high blood pressure were enrolled in our study. Log-rank test and Cox regression analysis were used to determine the influencing factors. ResultsAfter 6.04 years of follow-up， the hypertension incidence among community-dwellers at risk for high blood pressure in Minhang District of Shanghai was 25.5%. Family history of hypertension （HR=1.250， 95%CI： 1.168‒1.338）， family history of stroke （HR=1.295， 95%CI： 1.080‒1.553）， history of diabetes （HR=1.203， 95%CI： 1.076‒1.345）， daily smoking （HR=1.187， 95%CI： 1.087‒1.296）， overweight （HR=1.393， 95%CI：1.308‒1.484）， obesity（HR=1.903， 95%CI： 1.719‒2.106）， high values of normal blood pressure （HR=1.275， 95%CI： 1.195‒1.359） and advanced age （HR=1.033， 95%CI： 1.030‒1.036） were all risk factors. Emaciation （HR=0.649， 95%CI： 0.500‒0.840） was a protective factors. ConclusionBlood pressure monitoring should be strengthened for people elderly， with family history of hypertension， family history of stroke， diabetes or high values of normal blood pressure， so as to diagnose hypertension early. Timely intervention measures should be taken for community-dwellers with unhealthy lifestyles such as smoking， overweight and obesity.

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 provide reference for basic analysis of the pharmacodynamic substance in Stahlianthus involucratus. METHODS Overall 24 SD male rats were randomly divided into blank group （purified water）， and administration group （ethanol extract of S. involucratus， 15.75 g/kg， calculated by crude drug）， with 12 rats in each group. They were given drug liquid/purified water intragastrically， twice a day， every 6-8 h， for consecutive 3 days. After medication， the blood， urine and fecal samples were collected from two groups of rats. UPLC-Q-Exactive-MS technology was used to identify the chemical constituents in the ethanol extract of S. involucratus， and metabolites in the blood， urine and fecal of rats after intragastrical administration of the ethanol extract of S. involucratus. Multivariate statistical analysis was employed to screen various serum metabolites. Metabolic pathways were analyzed by MetaboAnalyst 5.0 platform. RESULTS A total of 38 chemical constituents were identified from the ethanol extract of S. involucratus， including fourteen prototype components and three metabolites identified from 5 urine samples， nine prototype components identified from fecal samples， and ten prototype components and one metabolite identified from serum samples. A total of 71 differential metabolites were screened from two groups of rat serum samples， of which 44 differential metabolites， such as ferulic acid， glycyrrhizin， were up-regulated and 27 differential metabolites， such as arachidonic acid， phenylacetylglutamine， were down-regulated. The 71 differential metabolites were mainly enriched in 11 metabolic pathways， including phenylalanine metabolism， linoleic acid metabolism， arachidonic acid metabolism， and tryptophan metabolism. CONCLUSIONS Ferulic acid， liquiritigenin， isofraxidin and formononetin may be the material basis that directly exert pharmacological effects of S. involucratus. S. involucratus may exert anti-inflammatory effects by affecting metabolic pathways， including arachidonic acid metabolism and tryptophan metabolism.

Objective: To explore the association of milk tea consumption with comorbid of overweight/obesity and depressive symptoms among college students, so as to provide a reference for promoting the physical and mental health of college students. Methods: A questionnaire survey was conducted from August to October 2023 using convenience sampling among 13 920 students from nine universities in Shanghai, Jiangxi, and Hubei provinces (municipality directly under the central government). Information on college students demographic characteristics, milk tea consumption, overweight/obesity status, and depressive symptoms was collected. Chi square tests were used to compare the association between different demographic characteristics and milk tea consumption with comorbid overweight/obesity and depressive symptoms. Multivariate Logistic regression analysis was performed to infer the strength of the association. Results: The detection rate of comorbidity of overweight/obesity and depressive symptoms was 5.8% among college students. The univariate analysis revealed statistically significant differences in the detection rate of comorbidity of overweight/obesity and depressive symptoms among various groups, including gender, grade, parents education level, only child status, family economic status, meeting moderate to high levels of physical activity standards, sleep quality, and frequent fast food consumption ( χ 2= 82.10, 23.07, 8.91, 10.87 , 4.56, 47.60, 17.60, 386.74, 96.61, P <0.05). There were also statistically significant differences between groups based on milk tea consumption frequency and quantity ( χ 2=42.12, 38.76, P <0.01). Compared with the group of without consuming milk tea, Logistic regression analysis showed that college students who consumed milk tea 4-5 times and ≥6 times had higher risk of comorbid overweight/obesity and depressive symptoms ( OR =1.98, 2.46), and college students who consumed 1-1 500 mL and ≥3 000 mL of milk tea also had higher comorbidity risk ( OR =1.52, 1.22) ( P <0.05). Conclusions Frequent and excessive milk tea consumption among college students may increase the risk of comorbid of overweight/obesity and depressive symptoms. It is recommended to reduce the frequency and quantity of milk tea consumption to improve college students physical and mental health.

Objective: To provide high-quality clinical evidence of the efficacy of Tibetan medicine Honghua Ruyi (HHRY) pills for endometriosis-associated dysmenorrhea. Methods: This study constitutes a multicenter, randomized, double-blind, placebo-controlled trial encompassing a three-menstrual cycle intervention followed by a three-menstrual cycle follow-up period. A total of 164 eligible females with endometriosis-associated dysmenorrhea were randomly divided into HHRY pills and placebo groups in a 1:1 ratio. The primary outcome included dysmenorrhea symptoms assessed using Visual Analog Scale (VAS) scores and quality of life, whereas the secondary outcome measures included the maximum VAS for non-menstrual pelvic pain, duration of pain episodes (in days), frequency and quantity of the consumption of ibuprofen sustained-release capsules (or other non-steroidal anti-inflammatory drugs), and days off work/study for staff/student due to dysmenorrhea, ovarian cyst, and/or pelvic nodule size. The safety was monitored throughout the treatment period. All the analyses were based on the intention-to-treat principle. For continuous outcomes, simple or multiple linear regressions were used to estimate the differences between the HHRY pills and placebo groups, with categorical data expressed as the number and percentage of occurrences. Differences were compared using the chi-square test or Fisher's exact test. The predefined analysis was adjusted for concomitant treatment, a variable considered to be associated with outcomes but unaffected by treatment allocation. Estimates of treatment effects were reported with 95% confidence intervals. Two-tailed P values ≤ .05 were considered statistically significant. Conclusion Positive results from this trial, upon completion would provide robust evidence for the efficacy and safety of HHRY pills in treating dysmenorrhea in patients with endometriosis.

ObjectiveTo explore the cumulative incidence of diabetes mellitus and its influencing factors among the diabetes mellitus high-risk groups in Minhang District of Shanghai, and to provide a basis for the development of community-based diabetes mellitus early prevention and treatment strategies in Shanghai. MethodsThe data of this study were collected from the screening project of diabetes mellitus high-risk groups in Minhang District of Shanghai, which was carried out from 2016‒2017. A total of 12 278 people were screened, of which 10 442 were at high risk based on the results of blood glucose diagnosis except those with diabetes. People diagnosed with abnormal fasting blood glucose, impaired fasting blood glucose and abnormal glucose tolerance were classified into the abnormal blood glucose group, and those with normal fasting blood glucose were classified into the normal blood glucose group. In 2023, the cumulative incidence of diabetes mellitus in the 2 groups was followed up, furthermore, the influencing factors of diabetes mellitus were analyzed. ResultsA total of 8 774 cases within the high-risk groups were followed up in 2023, of which 808 cases progressed to diabetes. Of the 8 774 cases, the cumulative incidence of diabetes mellitus in the abnormal blood glucose group (n=2 163) was 16.37% (354/2 163), and that in the normal blood glucose group (n=6 611) was 6.87% (454/6 611), and the difference in cumulative incidence of diabetes mellitus between the 2 groups was statistically significant (χ²=175.88, P<0.001). A history of impaired glucose regulation (OR=2.828, 95%CI: 2.177‒3.675), family history of type 2 diabetes (OR=1.294, 95%CI: 1.047‒1.600), hypertension (OR=1.268, 95%CI: 1.083‒1.485), dyslipidemia (OR=1.205, 95%CI: 1.003‒1.448), overweight/obesity (OR=1.526, 95%CI: 1.300‒1.792) were positively correlated with the cumulative incidence of type 2 diabetes, while female gender (OR=0.785, 95%CI: 0.675‒0.914) and sedentary lifestyle (OR=0.506, 95%CI: 0.374‒0.685) were negatively correlated with the cumulative incidence of type 2 diabetes. ConclusionBlood glucose monitoring should be strengthened in diabetes mellitus high-risk groups with an impaired glucose regulation history, a family history of type 2 diabetes, hypertension, and dyslipidemia, so as to achieve early detection of diabetes. Timely intervention measures should be taken for high-risk population with unhealthy lifestyle or overweight/obesity.

Nitrate is the main form of inorganic nitrogen that crop absorbs, and nitrate transporter 2 (NRT2) is a high affinity transporter using nitrate as a specific substrate. When the available nitrate is limited, the high affinity transport systems are activated and play an important role in the process of nitrate absorption and transport. Most NRT2 cannot transport nitrates alone and require the assistance of a helper protein belonging to nitrate assimilation related family (NAR2) to complete the absorption or transport of nitrates. Crop nitrogen utilization efficiency is affected by environmental conditions, and there are differences between varieties, so it is of great significance to develop varieties with high nitrogen utilization efficiency. Sorghum bicolor has high stress tolerance and is more efficient in soil nitrogen uptake and utilization. The S. bicolor genome database was scanned to systematically analyze the gene structure, chromosomal localization, physicochemical properties, secondary structure and transmembrane domain, signal peptide and subcellular localization, promoter region cis-acting elements, phylogenetic evolution, single nucleotide polymorphism (SNP) recognition and annotation, and selection pressure of the gene family members. Through bioinformatics analysis, 5 NRT2 gene members (designated as SbNRT2-1a, SbNRT2-1b, SbNRT2-2, SbNRT2-3, and SbNRT2-4) and 2 NAR2 gene members (designated as SbNRT3-1 and SbNRT3-2) were identified, the number of which was less than that of foxtail millet. SbNRT2/3 were distributed on 3 chromosomes, and could be divided into four subfamilies. The genetic structure of the same subfamilies was highly similar. The average value of SbNRT2/3 hydrophilicity was positive, indicating that they were all hydrophobic proteins, whereas α-helix and random coil accounted for more than 70% of the total secondary structure. Subcellular localization occurred on plasma membrane, where SbNRT2 proteins did not contain signal peptides, but SbNRT3 proteins contained signal peptides. Further analysis revealed that the number of transmembrane domains of the SbNRT2s family members was greater than 10, while that of the SbNRT3s were 2. There was a close collinearity between NRT2/3s of S. bicolor and Zea mays. Protein domains analysis showed the presence of MFS_1 and NAR2 protein domains, which supported executing high affinity nitrate transport. Phylogenetic tree analysis showed that SbNRT2/3 were more closely related to those of Z. mays and Setaria italic. Analysis of gene promoter cis-acting elements indicated that the promoter region of SbNRT2/3 had several plant hormones and stress response elements, which might respond to growth and environmental cues. Gene expression heat map showed that SbNRT2-3 and SbNRT3-1 were induced by nitrate in the root and stem, respectively, and SbNRT2-4 and SbNRT2-3 were induced by low nitrogen in the root and stem. Non-synonymous SNP variants were found in SbNRT2-4 and SbNRT2-1a. Selection pressure analysis showed that the SbNRT2/3 were subject to purification and selection during evolution. The expression of SbNRT2/3 gene and the effect of aphid infection were consistent with the expression analysis results of genes in different tissues, and SbNRT2-1b and SbNRT3-1 were significantly expressed in the roots of aphid lines 5-27sug, and the expression levels of SbNRT2-3, SbNRT2-4 and SbNRT3-2 were significantly reduced in sorghum aphid infested leaves. Overall, genome-wide identification, expression and DNA variation analysis of NRT2/3 gene family of Sorghum bicolor provided a basis for elucidating the high efficiency of sorghum in nitrogen utilization.
Nitrate Transporters ; Nitrates/metabolism* ; Sorghum/metabolism* ; Anion Transport Proteins/metabolism* ; Phylogeny ; Protein Sorting Signals/genetics* ; Nitrogen/metabolism* ; DNA ; Gene Expression Regulation, Plant ; Plant Proteins/metabolism*