Objective: To investigate the prevalence and influencing factors of menopausal syndrome among postmenopausal women in Pan'an County, Zhejiang Province, so as to provide the basis for guiding the health management of postmenopausal women. Methods: From May 2023 to April 2024, the postmenopausal women aged 40 to 69 years in Pan'an County were selected using the random cluster sampling method. Demographic information, lifestyle and prevalence of gynecological diseases were collected through questionnaire surveys. The prevalence of menopausal syndrome was assessed by modified Kupperman Score Scale. Factors affecting menopausal syndrome were analyzed by a multivariable logistic regression model. Results: A total of 816 postmenopausal women were surveyed, with an mean age of (57.63±2.92) years and a mean natural menopause age of (49.85±2.13) years. There were 574 cases with menopausal syndrome, with a prevalence of 70.34%. Flashes and sweating, insomnia and irritability were common symptoms, accounting for 62.87%, 47.43% and 41.18%, respectively. Multivariable logistic regression analysis showed that monthly personal income of ≤5 000 yuan (<3 000 yuan, OR=3.124, 95%CI: 1.829-5.335; 3 000-5 000 yuan, OR=2.399, 95%CI: 1.370-4.201) and having gynecological diseases (OR=1.970, 95%CI: 1.292-3.004) were associated with a higher risk of menopausal syndrome, while average (OR=0.141, 95%CI: 0.072-0.276) or sufficient sleep quality (OR=0.095, 95%CI: 0.049-0.185) were associated with a lower risk of menopausal syndrome. Conclusion The prevalence of menopausal syndrome among postmenopausal women in Pan'an County is relatively high, and is mainly influenced by personal economic status, sleep quality and the presence of gynecological diseases.

Objective To investigate the effect and its mechanism of Guanxinning tablet on carotid atherosclerotic plaque in a rat model.Methods The rats were randomly divided into control group,model group(to construct carot-id atherosclerosis plaque model),Guanxinning groups with low,medium and high dose of Guanxinning tablet(150,300 and 600 mg/kg),atorvastatin group(2 mg/kg),lithiumchloridemonohydrate(LiCl)(Wnt/β-catenin pathway activator)group(15 mg/kg),and Guanxinning plus LiCl group(600 mg/kg Guanxinning tablets+15 mg/kg LiCl),with 12 rats in each group.The intervention began at the third week and was administered once a day for 8 weeks.Olympus Au2700 automatic biochemical analyzer was used to detect the level of total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL)and high-density lipoprotein(HDL)in rat serum;ELISA was applied to detect the level of monocyte chemotactic protein(MCP-1)and hyper-sensitive C-reactive protein(hs-CRP)in rat se-rum;the level of oxidized low density lipoprotein(ox-LDL)and malondialdehyde(MDA)in rat serum were detected by spectrophotometry;HE staining was applied to find pathological changes in the common carotid artery of rats;Western blot was applied to detect the expression of Wnt3a,matrix metalloproteinase-9(MMP-9)and β-catenin in rat common carotid artery.Results Compared with the control group,the level of TG,TC,LDL,MCP-1,hs-CRP,ox-LDL,protein expression of MDA,MMP-9,Wnt3a,β-catenin and total plaque area/total arterial area ratio in-creased,the HDL level decreased in model group(P＜0.05);compared with the model group,the level of TG,TC,LDL,MCP-1,hs-CRP,ox-LDL,MDA,expression of MMP-9,Wnt3a,β-catenin protein and total plaque area/total arterial area ratio in the low,medium,and high dose groups of Guanxinning tablets decreased,the HDL level in-creased.The effect of Guanxinning tablets was dose-dependent,and the change trend of corresponding indicators in the LiCl group was opposite to the above(P＜0.05);compared with the high dose group of Guanxinning tablets,the TG,TC,LDL,MCP-1,hs-CRP,ox-LDL,MDA levels,MMP-9,Wnt3a,β-catenin protein expression,and total plaque area/total arterial area ratio in the high dose+LiCl group of Guanxinning tablets increased,the HDL level de-creased(P＜0.05).Conclusions Guanxinning tablet can inhibit the formation of atherosclerotic plaque in rats and the mechanismis potentially related to the regulation of Wnt/β-catenin pathway.

Objective:To explore the efficacy of online pulmonary rehabilitation (PR) management among community-dwelling patients with stable chronic obstructive pulmonary disease (COPD).Methods:This study was a single-center randomized controlled trail with an unblinded design. A total of 130 patients with stable COPD who visited Zhuanqiao Community Health Service Center in Shanghai Minhang District from October 2020 to March 2022 were randomly divided into study group and control group with 65 cases in each group. Both groups received conventional treatment, while patients in study group attended online rehabilitation management, including face-to-face rehabilitation instruction and multiple online guidance. Pulmonary ventilation function including forced vital capacity (FVC), forced expiratory volume in the first second (FEV 1) and percentage of forced expiratory volume in the first second to forced expiratoty volume (FEV 1%pred), modified British Medical Research Council Dyspnea Scale (mMRC), chronic obstructive pulmonary disease assessment test (CAT), score of 6 minutes walking distance (6MWD) and DOSE (dyspnea, degree of airflow obstruction, smoking status, the number of exacerbation) index were measured at baseline and after 8 weeks of rehabilitation, and compared between two groups. Results:The baseline data of the two groups were comparable. After 8 weeks of management, FVC, FEV 1, FEV 1%pred, mMRC, CAT, 6MWD and DOSE index of both groups were improved compared with the baseline level(control group: t=-7.799, -7.581, -9.010, 3.565, 9.887, -16.677, 3.795; study group: t=-12.623, -13.914, -17.644, 7.404, 22.457, -26.826, 7.968; all P<0.05). The FEV 1%pred, CAT and 6MWD in the study group were better than those in the control group ( t=-2.939, 2.277,-2.130, all P<0.05); while there were no significant differences in FVC, FEV 1, mMRC and DOSE index between the two groups( t=-0.162, -1.280, 0.925, 1.939,all P>0.05). Conclusions:The online pulmonary rehabilitation management can better improve lung function, dyspnea symptoms and exercise tolerance of patients with stable COPD, which can be used for rehabilitation training and management of community-dwelling patients.

Objective To analyze the application of Internet+5E rehabilitation nursing model in the main caregivers of cirrhosis Methods Totally 120 patients with liver cirrhosis who were admitted to our hospital from December 2020 to December 2023 were selected as the research objects.They were divided into a control group and a research group with 60 cases each according to the random number table method.The control group adopted conventional intervention measures,and the research group adopted the Internet+5E rehabilitation nursing mode.The care burden and self-efficacy of the main caregivers of the two groups were observed,and the liver function,negative emotions,quality of life,self-management level,and coping style of the patients were analyzed.Results After intervention,the burden of care scores for the two main caregivers decreased,self-efficacy scores increased,and the study group was lower/higher than the control group(P<0.05).After intervention,the total bilirubin(TBIL),aspartate transferase(AST)levels,liver function Child Pugh score,anxiety,depression,avoidance,and yield scores of the two groups of patients decreased,and the study group was lower than the control group(P<0.05);After intervention,the quality of life and self-management scores of the two groups of patients increased,and the study group was higher than the control group(P<0.05).Conclusion The intervention of the Internet+5E rehabilitation nursing model for patients with liver cirrhosis and main caregivers can reduce the burden of the main caregivers,improve the patients'self-management ability and quality of life,and improve the patients'coping style.

Objective To develop the assessment scale of proactive health behavior ability for the disabled elderly in nursing homes and to test its reliability and validity.Methods The first draft of the scale was formed by literature review,qualitative interviews and Delphi method.From December 2023 to March 2024,525 disabled elderly people from 9 nursing homes in Sichuan Province and Chongqing City were selected as the survey subjects,and item analysis and reliability and validity test were carried out on the scale.30 disabled elderly people were re-investigated after 2 weeks to calculate the retest reliability of the scale.Results The scale consisted of 4 dimensions and 27 items.Exploratory factor analysis extracted 4 common factors,with the cumulative vanance contribution rate of 65.992％,and confirmatory factor analysis showed that the modified model fitting index was within acceptable range.The content validity index at item level was 0.917-1.000,and that at scale level was 0.997.The Cronbach's α coefficient,test-retest reliability and split-half reliability of the total scale were 0.944,0.997 and 0.882,respectively.Conclusion The scale has good reliability and validity,and it can be used to evaluate the proactive health behavior ability of the disabled elderly in nursing homes.

Objective To evaluate the impact of poor sleep quality on occurrence of post-traumatic stress disorder(PTSD)in trauma patients.Methods We prospectively recruited 256 trauma patients hospitalized in 4 general hospitals in Zunyi during the period from October,2021 to November,2022,and 226 of the participants completed the PTSD survey and assessment.The patients'sleep quality within a month before trauma was estimated using Pittsburgh Sleep Quality Index(PSQI),and their sleep quality within 7 days after admission was monitored by smart bracelet sleep monitoring;the PTSD Checklist-Civilian Version(PCL-C)was used to detect the occurrence of PTSD during the follow-up.Results The detection rate of PTSD in the patients was 19.47%at 1 month and 17.61%at 3 months after trauma.The patients who developed PTSD had poorer sleep quality before the trauma,as shown by significantly higher PSQI scale scores(P<0.001),than those without PTSD,and they showed a sleep abnormality rate as high as 72.73%prior to PTSD onset.Within 7 days after admission,the patients developing PTSD had lower sleep quality scores with more frequent night awakenings(P<0.05).A 1 month and 3 months after trauma,the patients with PTSD had significantly higher PSQI scores than those without PTSD(P<0.05).Conclusion PTSD is more likely to occur in trauma patients with poor sleep quality before trauma.

In recent years,with the development of gene testing and new drug research,the diagnosis and treatment of inherited diseases have made rapid progress,corresponding to higher requirements for genetics education.As a teacher of medical genetics,the author joined the course remodeling during last 10 years from a web-based study of genetic disorders to a"case-based learning"supported by flipped classroom in order to optimize teaching effects and learning outcomes.The result of this remodeling project proposes a new strategy to guide perspectives course de-sign in future.

Objective:To explore the genetic etiology of a fetus with cryptophthalmos detected by prenatal ultrasonography.Methods:A fetus undergoing induced labor at 32nd gestational week due to absence of bilateral eye fissures detected by prenatal ultrasonography in January 2017 was selected as the study subject. Umbilical cord blood sample from the fetus and peripheral blood samples from its parents were collected for the extraction of genomic DNA. Pathogenic variants were screened through whole exome sequencing (WES) and verified by Sanger sequencing. Pathogenicity of candidate variants was verified by bioinformatic analysis and protein structure simulation. Based on the results of genetic testing, prenatal diagnosis was provided to the couple upon their subsequent pregnancy.Results:The couple had four adverse pregnancies previously. The aborted fetus was the fifth, with fused bilateral upper and lower eyelids, poorly developed eyeballs, adhesion of the cornea with the upper eyelid, low-set ears, and abnormal plantar creases, and was diagnosed with cryptophthalmos. WES and Sanger sequencing revealed that the fetus has harbored compound heterozygous variants of the FREM2 gene, namely c. 4537G>A (p.D1513N) and c.7292C>T (p.T2431M). Both variants were unreported associated with cryptophthalmos previously. Protein structure simulation showed that they may lead to loss of hydrogen bonds in the protein product. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), both variants were predicted to be likely pathogenic (PM1_Supporting+ PM2_Supporting+ PM5+ PP3+ PP4; PM2_Supporting+ PM3+ PP3+ PP4). The mother was performed prenatal diagnosis in her sixth pregnancy based on the variants detected in this family, and delivered a daughter with normal phenotype. Conclusion:The FREM2: c. 4537G>A and c. 7292C>T compound heterozygous variants probably underlay the pathogenesis of cryptophthalmos in this fetus. Above finding has enriched the mutational spectrum of the FREM2 gene.

Objective　To explore the effect of Mp1p on host macrophages through transcriptomics combined with metabolomics. Methods Firstly, a THP-1 macrophage strain (THP-1-Mp1p+) stably expressing Mp1p was constructed using lentivirus. Secondly, using high-throughput RNA sequencing (RNA Seq) technology, the expression level of intracellular mRNA was detected in transcriptomics analysis to determine differentially expressed genes; In metabolomics analysis, metabolite identification was performed through database comparison, and pathway analysis was performed on differential metabolites to reveal potential mechanisms of action. Finally, the results of metabolomics and transcriptomics were combined for analysis, and differential metabolites and genes were analyzed to further elucidate the mechanism of action of Mp1p on macrophages. Results Transcriptome analysis showed that, compared with the negative control group, the THP-1-Mp1p+ group had a total of 1 180 differentially expressed genes (DEGs), with 345 upregulated genes and 835 downregulated genes. GO enrichment analysis of DEGs showed that there were 135 differentially expressed genes, including 105 in biological processes (BP), 28 in cellular components (CC), and 2 in molecular functions (MF). The KEGG analysis results showed that the effect of Mp1p on THP-1 macrophages was highly correlated with the TNF pathway. The metabolomic analysis found that both the blank control group and the THP-1-Mp1p+ macrophage group achieved good separation between QC samples in both positive and negative ion modes. The threshold for significant differential metabolites was set at: VIP≥1 and T-test P<0.05, resulting in the identification of 488 differential metabolites, with 230 in the positive ion mode and 258 in the negative ion mode. Pathway enrichment analysis of the identified metabolites pointed to significant enrichment in metabolic pathways. The combined analysis confirmed that the tumor necrosis factor signaling pathway, interleukin-17 signaling pathway, and NF-kappaB signaling pathway were important metabolic pathways involved. Conclusions The virulence factor Mp1p may affect host macrophages by modulating the tumor necrosis factor signaling pathway, interleukin-17 signaling pathway, and NF-kappaB signaling pathway. The findings contribute to a better understanding of the mechanisms of action of Mp1p and may offer potential directions for the selection of relevant diagnostic and therapeutic targets in the future.

Objective To study the effect of miR-143-3p on pyroptosis of HCT-116 cells induced by LPS+ATP.Methods The targeting relationship between miR-143-3 p and TLR2 gene was detected by dual luciferase.The pyroptosis model was established after transfection of miR-143-3p mimic.Cell apoptosis was detected by flow cytometry,and the activity of Caspase-1 and LDH was detected by biochemical method.The levels of IL-1β and IL-18 were detected by ELISA.The mRNA levels of NF-κB,TLR2,NLRP3 and GSDMD were detected by q-PCR.The expression of NLRP3 and ASC was detected by immunofluorescence.The protein expressions of TLR2,GS-DMD,p-NF-κB p65 and cleave Caspase-1 were detected by Western blot.Results Dual luciferase assay showed that miR-143-3p targeted TLR2 expression.The expressions of NF-κB,TLR2,NLRP3,GSDMD mRNA and TLR2,GSDMD,p-NF-κB p65,cleave Caspase-1,ASC,NLRP3 protein in miR-143-3p mimic group and si TLR2 group were lower than those in model group.The activity of Caspase-1 and the content of LDH,IL-1β and IL-18 decreased.Conclusion miR-143-3p regulates pyroptosis of ulcerative colitis cells by targeting TLR2 gene and regulating NF-κB/NLRP3/Caspase-1 signaling pathway.