Objective : To investigate the mediating effect of negative emotions on visual impairment and resilience among middle-aged and elderly populations, so as to provide insights into improving psychological health among middle-aged and elderly populations. Methods: Demographic information, visual impairment, negative emotions and resilience in the residents at ages of 45 years and older were collected through the database of the Yushu Physical and Mental Health Survey carried out by Institute of Psychology of Chinese Academy of Sciences. Structural equation model was used to analyze the effects of visual impairment and resilience and the mediating role of negative emotions. Results: Totally 2 997 middle-aged and elderly populations were enrolled, with the median age of 50.00 (interquartile range, 47.00) years. There were 1 320 males (44.04%) and 1 677 females (55.96%), 1 627 illiterate persons (54.29%), and 2 780 married persons (92.76%). The scores of visual impairment, negative emotions and resilience were (6.79±2.59), (6.35±3.05) and (33.38±10.41) points, respectively. The results of structural equation model analysis showed that after adjusting for age, gender, educational level and marital status, visual impairment had a direct negative positive effect on resilience, with a direct effect value of -0.157 (95%CI: -0.177 to -0.137), and visual impairment could also negatively affect residence through negative emotions, with a mediating effect value of -0.112 (95%CI: -0.126 to -0.104), and the mediating effect contributed 41.64% to the total effect. Conclusion visual impairment could reduce residence directly or indirectly through the mediating effect of negative emotions among middle-aged and elderly populations.

With the rapid development of society and the improvement of Western medicine,the average life expectancy of the Chinese population has steadily increased. Since the beginning of the 21th century,China has officially entered an aging society and is currently in a phase of rapid growth in the elderly population. The effective management and improvement of the health levels of the elderly have become urgent issues that society needs to address. Traditional Chinese medicine (TCM),rooted in Chinese traditional culture,has developed a rich system of health preservation through thousands of years of historical practice,which has important guiding significance in actively coping with the aging of the population. This article discusses the historical evolution of the theory of health preservation in TCM,the interpretation of aging mechanisms by TCM,and the strategies for elderly health preservation from the perspective of TCM. By exploring TCM health preservation concepts,a theoretical framework for the health care of the elderly is constructed,so as to provide a scientific basis for their health management.

Objective:To explore the recovery of abdominal function and and satisfaction rate in patients who received lower abdominal skin flap repair of extensive soft tissue defects in the limbs based on three-dimensional computed tomography angiography(3D-CTA) technology.Methods:A retrospective study was performed to analyze clinical data from patients with extensive skin and soft tissue defects in the limbs, who were admitted to Shandong Provincial Third Hospital between March 2017 and February 2022. Patients were categorized into two groups: the superficial inferior epigastric artery (SIEA) group and the deep inferior epigastric perforator (DIEP) group, with SIEA flaps and DIEP flaps utilized respectively for tissue defect repair. Based on 3D-CTA imaging, the distribution range and vessel diameters of bilateral SIEA, superficial inferior epigastric veins (SIEV), and DIEP were delineated, facilitating the design and harvest of SIEA and DIEP flaps. Comparisons were drawn between preoperative 3D-CTA findings on the course and distribution of SIEA and SIEV, and intraoperative anatomical observations. In addition, the concordance between vessel diameters and pedicle lengths determined via preoperative 3D-CTA and intraoperative measurements was assessed. The flap survival, wound healing and surveyed patients’ satisfaction with wound repair were analyzed. A customized evaluation scale was utilized to assess abdominal contour one year post-surgery, scoring from 5 to 25, with higher scores indicating better outcomes. The abdominal health module of the BREAST-Q scale evaluated patients’ satisfaction with abdominal function preoperatively, three months postoperatively, and one year postoperatively, scoring from 20 to 100, with increasing scores indicating greater satisfaction. The measurement data that conform to the normal distribution were expressed as Mean±SD, and the comparison between the two groups was performed using independent samples t-test. The comparison were conducted at multiple time points, repeated measures analysis of variance was performed, and for the comparison of scores within the group, paired t-test was applied. Results:A total of 21 patients were included, 3 males and 18 females, with an age range of 21 to 60 years and a mean age of 41 years. The range of skin and soft tissue defects was from 10.0 cm × 5.0 cm to 22.0 cm × 14.0 cm, and the range of skin flap harvesting was from 11.0 cm × 6.0 cm to 23.0 cm × 15.0 cm. There were 11 cases in the SIEA group and 10 cases in the DIEP group. Preoperative 3D-CTA examination showed that the course and distribution of SIEA and SIEV were consistent with intraoperative anatomical observations. There was no statistically significant difference in the comparison of vessel diameters, pedicle lengths, and actual measurements between preoperative 3D-CTA examination and intraoperative measurements (all P > 0.05). No flap necrosis occurred postoperatively, wound healing was uneventful in all cases. At 1 year postoperatively, there was no statistically significant difference in abdominal contour scores between the SIEA and DIEP groups [(21.96±3.51) points vs. (21.62±3.17) points, P > 0.05]. Comparison of preoperative abdominal function satisfaction scores between the SIEA and DIEP groups showed no statistically significant difference [(87.56 ± 5.70) points vs. (85.79 ± 6.33) points, P > 0.05]. However, at 3 months and 1 year postoperatively, the SIEA group had higher scores than the DIEP group [at 3 months postoperatively, (77.62 ± 7.68) points vs. (65.21 ± 8.27) points; at 1 year postoperatively, (86.93 ± 5.65) points vs. (77.59 ± 5.92) points; both P < 0.01], indicating higher abdominal function satisfaction of the SIEA group postoperatively. The scores of both the SIEA and DIEP groups decreased at 3 months postoperatively compared to preoperative scores (both P < 0.01). At 1 year postoperatively, the score of the SIEA group was similar to preoperative levels, with no statistically significant difference ( P > 0.05), while the score of the DIEP group remained lower than preoperative levels ( P < 0.01). Conclusion:Reconstruction of extensive skin and soft tissue defects in the limbs using SIEA flaps, without injury to the deep tissues of the abdominal wall, allows for near-complete restoration of abdominal function and appearance to preoperative levels, with minimal impact on the donor site. Preoperative 3D-CTA reveals the anatomical variations in the vascular supply of SIEA flaps among individuals, achieving comparable wound repair outcomes to other lower abdominal flaps.

Objectives:To finely divide the aortic sinus into sections and accurately localize the coronary ostium through CARTO three-dimensional mapping,and to assess the clinical effects of treating aortic sinus cusps premature ventricular contraction(ASC-PVC)and the ablation risk in the corresponding area with zero X-ray radiofrequency ablation. Methods:A total of 66 patients who underwent radiofrequency ablation for ASC-PVC from January 2020 to January 2023 were included in this analysis,patients were divided into experimental group(n=34)and conventional group(n=32).In the conventional group,the CARTO 3 system was used to create an aortic sinus model through the conventional method.The earliest stimulating target was identified by using electrical stimulation mapping(ESM).Radiofrequency ablation treatment was performed after the distance between the target and the coronary ostium was precisely measured by coronary angiography through the hollow tube of the ablation catheter or coronary angiography tube.In the experimental group,the CARTO 3 system was used to build a model of the aortic sinus and the coronary ostium and aortic sinus were divided into sections.The earliest stimulating target was identified by ESM.After localizing coronary ostium through the impedance changing pattern on the ablation catheter tips,catheter ablation was performed with zero X-ray.The data regarding the impedance of the ablation catheter in the aortic sinus were collected.The total operative time,the operative time in the aortic sinus,contrast dosage,X-ray exposure time,immediate and short-term success rates of the operation and complication rates were compared between the two groups.Besides,the distribution of successfully ablated targets and their relationship with the risk of ablation were analyzed in both groups. Results:There was no significant statistical difference in the immediate and short-term success rates between the two groups(93.8%vs.94.1%;90.6%vs.88.2%,both P>0.05).The experimental group did not receive contrast agents during the operation,and the total operation time and intra-aortic sinus operation time in the experimental group were significantly shorter than those in the conventional group([58.76±4.94]min vs.[66.91±5.94]min,P<0.001;[43.12±4.49]min vs.[50.31±5.18]min,P<0.001).During the process of moving the ablation catheter from the intra-aortic sinus to the coronary artery opening and into the coronary artery,the impedance suddenly increased,which was significantly different from the impedance in other parts of the intra-aortic sinus(all P<0.001). Conclusions:Radiofrequency ablation of ASC-PVC with zero X-ray can simplify the procedures and shorten the operative time.The steep increase in impedance at the tip of the ablation catheter can be used as a basis for localizing the coronary ostium.Dividing the aortic sinus into sections allows a detailed assessment of the risk for ablation treatment at the targets.

Objective To investigate the effect of asiaticoside on blood pressure and relaxation of thoracic aorta in rats and explore the underlying mechanism.Methods SD rats treated with 50 and 100 mg/kg asiaticoside by daily gavage for 2 weeks were monitored for systolic blood pressure changes,and histological changes of the thoracic aorta were evaluated using HE staining.In isolated rat endothelium-intact and endothelium-denuded thoracic aorta rings,the effects of asiaticoside on relaxation of the aortic rings were tested at baseline and following norepinephrine(NE)-and KCl-induced constriction.The vascular relaxation effect of asiaticoside was further observed in NE-stimulated endothelium-intact rat aortic rings pretreated with L-nitroarginine methyl ester,indomethacin,zinc protoporphyrin Ⅸ,tetraethyl ammonium chloride,glibenclamide,barium chloride,Iberiotoxin,4-aminopyridine,or TASK-1-IN-1.The aortic rings were treated with KCl and NE followed by increasing concentrations of CaCl2 to investigate the effect of asiaticoside on vasoconstriction induced by external calcium influx and internal calcium release.Results Asiaticoside at 50 and 100 mg/kg significantly lowered systolic blood pressure in rats without affecting the thoracic aorta histomorphology.While not obviously affecting resting aortic rings with intact endothelium,asiaticoside at 100 mg/kg induced significant relaxation of the rings constricted by KCl and NE,but its effects differed between endothelium-intact and endothelium-denuded rings.In endothelium-intact aortic rings pretreated with indomethacin,ZnPP Ⅸ,barium chloride,glyburide,TASK-1-IN-1 and 4-aminopyridine,asiaticoside did not produce significant effect on NE-induced vasoconstriction,and tetraethylammonium,Iberiotoxin and L-nitroarginine methyl ester all inhibited the relaxation effect of asiaticoside.In KCl-and NE-treated rings,asiaticoside obviously inhibited CaCl2-induced vascular contraction.Conclusion Asiaticoside induces thoracic aorta relaxation by mediating high-conductance calcium-activated potassium channel opening,promoting nitric oxide release from endothelial cells and regulating Ca2+ influx and outflow,thereby reducing systolic blood pressure in rats.

Objective This work aimed to evaluate the effect of artificial aging on the translucency and color differ-ence(ΔE)of ultra-translucent zirconia and provide a reference for clinical application.Methods The discs of ultra-translucent zirconia from six brands(Wieland,3M ESPE,Amann Girrbach,Kuraray Noritake,Upcera,and Besmile)were cut and sintered according to each manufacturer's product instructions;the experimental groups were named ZNT,LVP,AG,KAT,UPC,and BSM,respectively.IPS e.max Press was used as the control group(PLT).The specimens(n=6)were prepared with a diameter of 14 mm and a thickness of 1 mm.The specimens were subjected to artificial aging treat-ment according to the following conditions:in an auto-clave at 134℃ at 0.2 MPa for 4,8,and 12 h.According to the CIE1976Lab system,the CIE L*,a*,and b* values of the specimens before and after aging were measured by a co-lorimeter.The translucency parameter(TP)and ΔE were calculated.Results The mean TP values of each group before aging inorder were PLT>KAT>AG>ZNT>BSM>UPC>LVP.We found no significant difference in translu-cency in all experimental groups after aging for 4 and 8 h compared with those before aging.After 12 h of aging,the TP values of the KAT and ZNT groups were not significantly different from those before aging,but the TP values of the AG,BSM,LVP,and UPC groups were significantly lower than those before aging(P<0.05).The TP value of the control group was significantly higher than that of the other experimental groups at different stages(P<0.05).ΔE=3.3 was con-sidered the visible color difference,and ΔE was less than 3.3 in all groups after 4 h of aging.After aging for 8 h,ΔE of the UPC group was slightly higher than 3.3.ΔE of the BSM and UPC groups was greater than 3.3 after 12 h of aging.Conclusion The TP and ΔE of different brands of ultra-translucent zirconia may change after various aging times.The translucency of some zirconia showed a decreasing trend and the color difference showed an increasing trend with the aging time.

Objective To investigate whether activation of mitochondrial acetal dehydrogenase 2(ALDH2)alleviates hypoxic pulmonary hypertension by regulating the SIRT1/PGC-1α signaling pathway.Methods Thirty 8-week-old C57 BL/6 mice were randomized into control,hypoxia,and hypoxia+Alda-1(an ALDH2 activator)group(n=10),and the mice in the latter two groups,along with 10 ALDH2 knockout(ALDH2-/-)mice,were exposed to hypoxia(10%O2,90%N2)with or without daily intraperitoneal injection of Alda-1 for 4 weeks.The changes in right ventricular function and pressure(RVSP)of the mice were evaluated by echocardiography and right ventricular catheter test,and pulmonary artery pressure was estimated based on RVSP.Pulmonary vascular remodeling,right ventricular injury,myocardial α-SMA expression,distal pulmonary arteriole muscle normalization,right ventricular cross-sectional area,myocardial cell hypertrophy,and right cardiac hypertrophy index were assessed with HE staining,immunofluorescence staining and WGA staining,and the expressions of ALDH2,SIRT1,PGC-1α,P16INK4A and P21CIP1 were detected.In pulmonary artery smooth muscle cells with hypoxic exposure,the effect of Alda-1 and EX527 on cell senescence and protein expressions was evaluated using β-galactose staining and Western blotting.Results The wild-type mice with hypoxic exposure showed significantly increased RVSP,right ventricular free wall thickness and myocardial expressions of P16INK4A and P21CIP1,which were effectively lowered by treatment with Alda-1 but further increased in ALDH2-/-mice.In cultured pulmonary artery smooth muscle cells,hypoxic exposure significantly increased senescent cell percentage and cellular expressions of P16INK4A and P21CIP1,which were all lowered by treatment with Alda-1,but its effect was obviously attenuated by EX527 treatment.Conclusion ALDH2 alleviates hypoxia-induced senescence of pulmonary artery smooth muscle cells by upregulating the SIRT1/PGC-1α signaling pathway to alleviate pulmonary hypertension in mice.

Objective To explore the effects of wogonin on cognitive function and neuroinflamma-tion in VaD rats by regulating AMPK/SIRT1 pathway.Methods 90 VaD rats were randomly di-vided into model group,low-,medium-and high-dose wogonin groups(50,100,200 mg/kg),and high dose+AMPK inhibitor(20 mg/kg)group,18 animals per group.Another 18 normal rats served as sham operation group.ELISA was utilized to measure the contents of IL-1β,TNF-α and IL-6 in hippocampal tissues.Western blotting was conducted to detect the expression of Iba-1,p-AMPK,AMPK and SIRT1 in hippocampal tissues.Results Compared with the sham operation group,the model group had longer escape latency,and elevated contents of IL-1β,TNF-α and IL-6,number of Iba-1 positive cells and expression level of Iba-1 protein in hippocampal tissue,shorter stay time at original platform,and lower expression of p-AMPK/AMPK and SIRT1 in hippocampal tissues(P＜0.05).Treatment of three doses of wogonin,in a dose-dependent man-ner,reduced escape latency,and decreased levels of IL-1β,TNF-α and IL-6,number of Iba-1 posi-tive cells and expression of Iba-1 protein in hippocampal tissue,but longer stay time at original platform,and enhanced expression of p-AMPK/AMPK and SIRT1 protein in hippocampal tissue when compared with the model group(P＜0.05).The high dose+AMPK inhibitor group showed longer escape latency(47.64±5.39 s vs 26.45±3.27 s),shorter stay time at original platform(21.78±3.51 s vs 35.22±5.02 s),increased levels of IL-1β,TNF-α and IL-6,number of Iba-1 positive cells and expression of Iba-1 protein in hippocampal tissue,and lower expression levels of p-AMPK/AMPK and SIRT1 in hippocampal tissue when compared with the high-dose group(P＜0.05).Conclusion Wogonin may improve cognitive function and hippocampal tissue patho-logical damage in VaD rats by activating the AMPK/SIRT1 pathway,and inhibit neuroinflammation.

Background::Clinical opportunistic screening is a cost-effective cancer screening modality. This study aimed to establish an easy-to-use diagnostic model serving as a risk stratification tool for identification of individuals with malignant gastric lesions for opportunistic screening.Methods::We developed a questionnaire-based diagnostic model using a joint dataset including two clinical cohorts from northern and southern China. The cohorts consisted of 17,360 outpatients who had undergone upper gastrointestinal endoscopic examination in endoscopic clinics. The final model was derived based on unconditional logistic regression, and predictors were selected according to the Akaike information criterion. External validation was carried out with 32,614 participants from a community-based randomized controlled trial.Results::This questionnaire-based diagnostic model for malignant gastric lesions had eight predictors, including advanced age, male gender, family history of gastric cancer, low body mass index, unexplained weight loss, consumption of leftover food, consumption of preserved food, and epigastric pain. This model showed high discriminative power in the development set with an area under the receiver operating characteristic curve (AUC) of 0.791 (95% confidence interval [CI]: 0.750–0.831). External validation of the model in the general population generated an AUC of 0.696 (95% CI: 0.570–0.822). This model showed an ideal ability for enriching prevalent malignant gastric lesions when applied to various scenarios.Conclusion::This easy-to-use questionnaire-based model for diagnosis of prevalent malignant gastric lesions may serve as an effective prescreening tool in clinical opportunistic screening for gastric cancer.

Liver diseases in pregnancy comprise both gestational liver disorders and acute and chronic hepatic disorders occurring coincidentally in pregnancy.Whether pregnancy-related or not,liver diseases in pregnancy are associated with a significant risk of maternal and fetal morbidity and mortality.Thus,the European Association for the Study of the Liver invited a panel of experts to develop clinical practice guidelines aimed at providing recommendations,based on the best available evidence,for the management of liver diseases in pregnancy for hepatologists,gastroenter-ologists,obstetric physicians,general physicians,training specialists and other healthcare professionals who provide care for this patient population.