1.Exercise Modulates Protein Acylation to Improve Cardiovascular Diseases
Feng-Yi LI ; Wen-Hua HUANG ; Jing ZHANG
Progress in Biochemistry and Biophysics 2025;52(6):1453-1467
		                        		
		                        			
		                        			The pathogenesis of cardiovascular diseases (CVD) is complex, and dynamic imbalances in protein acylation modification are significantly associated with the development of CVD. In recent years, most studies on exercise-regulated protein acylation modifications to improve cardiovascular function have focused on acetylation and lactylation. Protein acylation modifications are usually affected by exercise intensity. High-intensity exercise directly affects oxidative stress and cellular energy supply, such as changes in ATP and NAD+ levels; moderate-intensity exercise is often accompanied by improvements in aerobic metabolism, such as fatty acid β-oxidation and TCA cycle, which modulate mitochondrial biogenesis. The above processes may affect the acylation status of relevant regulatory enzymes and functional proteins, thereby altering their function and activity and triggering signaling cascades to adapt to exercise’s metabolic demands and stresses. Exercise regulates the levels of acylation modifications of H3K9, H3K14, H3K18, and H3K23, which are involved in regulating the transcriptional expression of genes involved in oxidative stress, glycolysis, inflammation, and hypertrophic response by altering chromatin structure and function. Exercise can regulate the acylation modification of non-histone-specific sites in the cardiovascular system involved in mitochondrial function, glycolipid metabolism, fibrosis, protein synthesis, and other biological processes, and participates in the regulation of protein activity and function by altering the stability, localization, and interaction of proteins, and ultimately works together to achieve the improvement of cardiovascular phenotypes and biological functions. Exercise affects acyl donor concentration, acyltransferase, and deacetylase expression and activity by influencing acyl donor concentration, acyltransferase, and deacetylase. Exercise regulates the abundance of acyl donors such as acetyl coenzyme A, propionyl coenzyme A, butyryl coenzyme A, succinyl coenzyme A, and lactoyl coenzyme A by promoting glucose and lipid metabolism and improving intestinal bacterial flora, which in turn affects protein acylation modification, accelerates oxidative decarboxylation of pyruvic acid in the body, and activates the energy-sensing molecule, adenosine monophosphate-activated protein kinase (AMPK), to improve cardiovascular function. Exercise may affect protein acylation modifications in the cardiovascular system by regulating the activity and expression of adenoviral E1A binding protein of 300 kDa (p300)/cyclic adenosine monophosphate response element-binding protein (CBP), general control nonderepressible 5-related N-acetyltransferases (GNAT), and alanyl-transfer t-RNA synthetase (AARS), which in turn improves cardiovascular function. The relationship between exercise and cardiovascular deacetylases has attracted much attention, with SIRT1 and SIRT3 of the silence information regulator (SIRT) family of proteins being the most studied. Exercise may exert transient or long-term stable cardiovascular protective benefits by promoting the enzymatic activity and expression of SIRT1, SIRT3, and HDAC2, inhibiting the enzymatic activity and expression of HDAC4, and mediating the deacylation of metabolic regulation-related enzymes, cytokines, and molecules of signaling pathways. This review introduces the role of protein acylation modification on CVD and the effect of exercise-mediated protein acylation modification on CVD. Based on the existing studies, it analyzes the possible mechanisms of exercise-regulated protein acylation modification to improve CVD from the perspectives of acylation modification donors, acyltransferases, and deacetylases. Deciphering the regulation of cardiovascular protein acylation and modification by exercise and exploring the essential clues to improve cardiovascular disease can enrich the theoretical basis for exercise to promote cardiovascular health. However, it is also significant for developing new cardiovascular disease prevention and treatment targets. 
		                        		
		                        		
		                        		
		                        	
2.Glutamate Receptor Antagonists Attenuate Stereotyped Behaviors via Modulating BDNF Levels in Obsessive-complusive Disorder Model Mice
Weijie WANG ; Yuchong LUO ; Dongmiao HUANG ; Chen YANG ; Jihui YUE ; Xianglan WANG ; Shenglin WEN
Journal of Sun Yat-sen University(Medical Sciences) 2025;46(3):475-485
		                        		
		                        			
		                        			ObjectiveTo explore whether fluoroethylnormemantine (FENM), an NMDA receptor antagonist, could improve compulsive-like behaviors and to investigate its underlying mechanisms in the RU24969-induced obsessive-compulsive disorder (OCD) mouse model. MethodsThirty-two mice were randomly assigned to four groups: Saline (n=8), RU24969 (n=8), RU+FENM (n=8), and FENM (n=8). Mice received FENM or an equivalent volume of saline for pre-treatment, followed by RU24969 or saline for model induction 30 minutes later. Behavioral tests were performed 1 hour after modeling, and serum samples were collected to measure the level of brain-derived neurotrophic factor (BDNF). Evans Blue dye was intravenously injected to assess dye content in brain tissue, thereby evaluating potential blood-brain barrier damage. ResultsFENM treatment significantly improved repetitive stereotyped circling behavior (F=39.850, P<0.001) and alleviated persistent motor activity (F=50.200, P<0.001) in RU24969 model mice. Additionally, FENM treatment significantly increased serum BDNF level in RU24969-induced OCD mice (F=18.930, P<0.001). ConclusionsFENM , an NMDA receptor antagonist, may alleviate compulsive behaviors in OCD mice by modulating BDNF levels , thereby exerting anti-compulsive effects. Neither the RU24969 model nor FENM treatment significantly affectes blood-brain barrier integrity. 
		                        		
		                        		
		                        		
		                        	
3.Effects of fractionated low-dose ionizing radiation on differentially expressed genes in ferroptosis of human bronchial epithelial cells
Min ZHANG ; Lingyu ZHANG ; Yashi CAI ; Huixian LI ; Yanting CHEN ; Guanyou CHEN ; Xin LAN ; Changyong WEN ; Weixu HUANG ; Jianming ZOU ; Huifeng CHEN
Chinese Journal of Radiological Health 2025;34(3):310-317
		                        		
		                        			
		                        			Objective To investigate the effects of fractionated low-dose ionizing radiation (LDIR) on the ferroptosis in human bronchial epithelial (HBE) cells as well as the associated differentially expressed genes (DEGs), biological processes, and signaling pathways. Methods HBE cells were exposed to different single doses of X-ray irradiation (0, 25, 50, 75, and 100 mGy) for 24, 48, and 72 h, respectively. The change in cell viability was detected by MTT assay. Cells were irradiated with 0, 25, 50, and 100 mGy X-rays 5 times, with 48 h between each irradiation and a dose rate of 50 mGy/min. Cells were harvested 24 h after irradiation for the measurement of the expression of ferroptosis-related genes SLC7A11 and GPX4 at the mRNA and protein levels, cellular iron content, and the expression of FTH1 and FTL mRNAs. High-throughput sequencing was used to screen for the DEGs in each dose group, followed by Gene Ontology-Biological Process (GO-BP) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, and Gene Set Enrichment Analysis (GSEA). Results Compared with the control group, single-dose LDIR significantly increased cell proliferation at 75 mGy after 24 h (P < 0.05), at 50, 75, and 100 mGy after 48 h (P < 0.05), and at 75 and 100 mGy after 72 h (P < 0.05). Compared with the control group, at the end of the fifth fractionated LDIR, SLC7A11 and GPX4 mRNAs decreased at all doses (P < 0.05), SLC7A11 protein decreased at all doses, GPX4 protein decreased at 25 and 100 mGy, iron content increased at all doses, and FTH1 and FTL mRNAs decreased at all doses (P< 0.05). Sequencing analysis identified 248, 30, and 291 DEGs and 10, 2, and 9 ferroptosis-associated genes at the three doses compared to the control. Gene Ontology-Biological Process analysis showed that DEGs were mainly enriched in biological processes such as response to lipids, cell death, and response to unfolded proteins. Kyoto Encyclopedia of Genes and Genomes analysis showed that DEGs were mainly enriched in the JAK-STAT signaling pathway, lipids and atherosclerosis, ferroptosis, protein processing in the endoplasmic reticulum, and FoxO signaling pathway. Gene set enrichment analysis showed that DEGs were mainly enriched in ferroptosis, fatty acid degradation, and glutathione metabolism. Conclusion Fractionated low-dose radiation induced ferroptosis in HBE cells, and DEGs were predominantly enriched in biological processes and signaling pathways related to inflammation, ferroptosis, and endoplasmic reticulum stress.
		                        		
		                        		
		                        		
		                        	
4.Cross sectional and cross lagged network analyses of Internet addiction among university students
GOU Hao, HUANG Wenying, SUN Qunqun, HU Chang, ZHANG Wen, XIANG Luyao, SONG Chao
Chinese Journal of School Health 2025;46(9):1287-1291
		                        		
		                        			Objective:
		                        			To understand the dynamic temporal evolution pathways of Internet addiction among university students and to identify the core driving nodes, so as to provide theoretical evidences for the precise implementation of targeted interventions.
		                        		
		                        			Methods:
		                        			Using a convenient cluster sampling method, a total of 1 066 full time freshmen and sophomores were recruited from three universities in Guizhou, Jiangxi, and Guangdong Provinces for a follow up survey (T1:January-March 2024; T2:January-March 2025). The Revised Chen Internet Addiction Scale (CIAS-R) was employed to assess the status of Internet addiction among university students, and cross sectional as well as cross lagged panel network models were constructed to analyze Internet addiction and its multidimensional influencing factors.
		                        		
		                        			Results:
		                        			The T1 network comprised 19 nodes and 114 non zero edges, while the T2 network comprised 19 nodes and 126 non zero edges. Cross sectional network analysis revealed the strongest association between  "insufficient  sleep" and "daytime fatigue"; the core nodes were "first thought upon waking for going online" and "feeling low after disconnection" (characteristics of psychological dependence) at T1, while the core nodes shifted to "impaired health" and "excitement when online" (characteristics of functional impairment and addictive psychodynamic features) at T2. Cross lagged network analysis further indicated that "reduced leisure" directly predicted "sleep compression", and a bidirectional relationship was observed between "needing more time to achieve satisfaction" and "academic decline".
		                        		
		                        			Conclusions
		                        			Internet addiction among university students exhibits dynamic evolutionary characteristics. Stage specific targeted interventions focusing on core driving nodes are needed, integrating behavioral regulation and academic support to break the vicious cycle and enhancing the ability to cope with real life demands.
		                        		
		                        		
		                        		
		                        	
5.Sishenwan Restores Intestinal Barrier in Rat Model of Diarrhea-predominant Irritable Bowel Syndrome Due to Spleen-kidney Yang Deficiency by Regulating Intestinal Flora and Short-chain Fatty Acids
Qian ZHANG ; Siqi LI ; HUYUNLIAN ; Na WEN ; Chaoqun HUANG ; Binbin LIU ; Chengxia SU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):80-89
		                        		
		                        			
		                        			ObjectiveTo investigate the effect and mechanism of Sishenwan in restoring the intestinal barrier function in the rat model of diarrhea-predominant irritable bowel syndrome (IBS-D) due to spleen-kidney Yang deficiency based on intestinal flora and short-chain fatty acids. MethodsAfter the delivery of 10 SPF-grade pregnant rats, 4 male suckling rats were kept in each litter for the experiment. The male suckling rats were randomly allocated into blank, model, low-dose (3.51 g·kg-1) Sishenwan, high-dose (7.02 g·kg-1) Sishenwan, and Peifeikang (0.54 g·kg-1) groups, with 8 rats in each group. The blank group was fed conventionally, and the other groups were subjected to mother-child separation and Sennae Folium gavage (1 g·mL-1, 10 mL·kg-1) for the modeling of IBS-D due to spleen-kidney Yang deficiency. After the modeling was completed, the rats in Sishenwan groups were administrated with the corresponding dose of Sishenwan decoction by gavage, and the Peifeikang group with bifidobacterium triple live powder+normal saline suspension. The blank and model groups were treated with an equal volume of normal saline by gavage. The general conditions and fecal characteristics of rats were observed. After 2 weeks of administration, the rats were anesthetized for sample collection. The pathological changes of the colon tissue in rats were observed by hematoxylin-eosin staining. Enzyme-linked immunosorbent assay was employed to measure the levels of transforming growth factor-beta (TGF-β), interleukin-10 (IL-10), and interleukin-22 (IL-22). Immumohistochemical staining (IHC) was performed to detect the positive expression of zonula occludens-1 (ZO-1) and occludin in the colon tissue. Western blot was employed to determine the protein levels of ZO-1 and occludin in the colon tissue of rats, and 16S rRNA gene sequencing was performed for intestinal flora. Gas chromatography-mass spectrometry was employed to determine the content of short-chain fatty acids (SCFAs) in the cecum contents of rats. ResultsThe colon tissue in the blank group presented a clear structure, neat glands, and no inflammatory cell infiltration. In the model group, the colon tissue showcased a disorganized structure, irregular arrangement of glands, and inflammatory cell infiltration. Compared with the model group, the low-dose and high-dose Sishenwan groups and the Peifeikang group exhibited an intact colon tissue structure, regular arrangement of glands, and reduced inflammatory cell infiltration. Compared with the blank group, the modeling lowered the levels of TGF-β, IL-10, and IL-22 in the serum (P<0.01), down-regulated the protein levels of ZO-1 and occludin in the colon tissue (P<0.01), and decreased the content of acetic acid and propionic acid and increased the content of butyric acid in cecum contents (P<0.05). Compared with the model group, low-dose and high-dose Sishenwan raised the levels of TGF-β, IL-10, and IL-22 in the serum (P<0.05, P<0.01), and Peifeikang elevated the levels of TGF-β and IL-10 in the serum (P<0.01). High-dose Sishenwan and Peifeikang up-regulated the protein levels of ZO-1 and occludin (P<0.05, P<0.01), increased the content of acetic acid and propionic acid in cecum contents (P<0.05), and decreased the content of butyric acid (P<0.05). The 16S rRNA gene sequencing results showed that the intestinal flora structure of the model group changed compared with that of the blank group. Compared with the model group, Sishenwan and Peifeikang increased the relative abundance of Lachnospiraceae, Muribaculaceae, Akkermansiaceae, Ligilactobacillus, UBA3282, Akkermansia, and Corynebacterium while reducing the relative abundance of Oscillospiraceae, Desulfovibrionaceae, Lactobacillus, Romboutsia, and Desulfovibrio. They can restore the intestinal flora structure similar to that in the blank group. ConclusionSishenwan can alleviate diarrhea symptoms and colonic mucosal inflammation, increase the expression of tight junction proteins in the colonic mucosa, and strengthen the intestinal barrier in IBS-D rats with the syndrome of spleen-kidney Yang deficiency. The mechanism of action may be related to optimizing the structure and balance of intestinal flora and regulating the SCFAs, and the effect of high-dose Sishenwan is obvious. 
		                        		
		                        		
		                        		
		                        	
6.Sishenwan Restores Intestinal Barrier in Rat Model of Diarrhea-predominant Irritable Bowel Syndrome Due to Spleen-kidney Yang Deficiency by Regulating Intestinal Flora and Short-chain Fatty Acids
Qian ZHANG ; Siqi LI ; HUYUNLIAN ; Na WEN ; Chaoqun HUANG ; Binbin LIU ; Chengxia SU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):80-89
		                        		
		                        			
		                        			ObjectiveTo investigate the effect and mechanism of Sishenwan in restoring the intestinal barrier function in the rat model of diarrhea-predominant irritable bowel syndrome (IBS-D) due to spleen-kidney Yang deficiency based on intestinal flora and short-chain fatty acids. MethodsAfter the delivery of 10 SPF-grade pregnant rats, 4 male suckling rats were kept in each litter for the experiment. The male suckling rats were randomly allocated into blank, model, low-dose (3.51 g·kg-1) Sishenwan, high-dose (7.02 g·kg-1) Sishenwan, and Peifeikang (0.54 g·kg-1) groups, with 8 rats in each group. The blank group was fed conventionally, and the other groups were subjected to mother-child separation and Sennae Folium gavage (1 g·mL-1, 10 mL·kg-1) for the modeling of IBS-D due to spleen-kidney Yang deficiency. After the modeling was completed, the rats in Sishenwan groups were administrated with the corresponding dose of Sishenwan decoction by gavage, and the Peifeikang group with bifidobacterium triple live powder+normal saline suspension. The blank and model groups were treated with an equal volume of normal saline by gavage. The general conditions and fecal characteristics of rats were observed. After 2 weeks of administration, the rats were anesthetized for sample collection. The pathological changes of the colon tissue in rats were observed by hematoxylin-eosin staining. Enzyme-linked immunosorbent assay was employed to measure the levels of transforming growth factor-beta (TGF-β), interleukin-10 (IL-10), and interleukin-22 (IL-22). Immumohistochemical staining (IHC) was performed to detect the positive expression of zonula occludens-1 (ZO-1) and occludin in the colon tissue. Western blot was employed to determine the protein levels of ZO-1 and occludin in the colon tissue of rats, and 16S rRNA gene sequencing was performed for intestinal flora. Gas chromatography-mass spectrometry was employed to determine the content of short-chain fatty acids (SCFAs) in the cecum contents of rats. ResultsThe colon tissue in the blank group presented a clear structure, neat glands, and no inflammatory cell infiltration. In the model group, the colon tissue showcased a disorganized structure, irregular arrangement of glands, and inflammatory cell infiltration. Compared with the model group, the low-dose and high-dose Sishenwan groups and the Peifeikang group exhibited an intact colon tissue structure, regular arrangement of glands, and reduced inflammatory cell infiltration. Compared with the blank group, the modeling lowered the levels of TGF-β, IL-10, and IL-22 in the serum (P<0.01), down-regulated the protein levels of ZO-1 and occludin in the colon tissue (P<0.01), and decreased the content of acetic acid and propionic acid and increased the content of butyric acid in cecum contents (P<0.05). Compared with the model group, low-dose and high-dose Sishenwan raised the levels of TGF-β, IL-10, and IL-22 in the serum (P<0.05, P<0.01), and Peifeikang elevated the levels of TGF-β and IL-10 in the serum (P<0.01). High-dose Sishenwan and Peifeikang up-regulated the protein levels of ZO-1 and occludin (P<0.05, P<0.01), increased the content of acetic acid and propionic acid in cecum contents (P<0.05), and decreased the content of butyric acid (P<0.05). The 16S rRNA gene sequencing results showed that the intestinal flora structure of the model group changed compared with that of the blank group. Compared with the model group, Sishenwan and Peifeikang increased the relative abundance of Lachnospiraceae, Muribaculaceae, Akkermansiaceae, Ligilactobacillus, UBA3282, Akkermansia, and Corynebacterium while reducing the relative abundance of Oscillospiraceae, Desulfovibrionaceae, Lactobacillus, Romboutsia, and Desulfovibrio. They can restore the intestinal flora structure similar to that in the blank group. ConclusionSishenwan can alleviate diarrhea symptoms and colonic mucosal inflammation, increase the expression of tight junction proteins in the colonic mucosa, and strengthen the intestinal barrier in IBS-D rats with the syndrome of spleen-kidney Yang deficiency. The mechanism of action may be related to optimizing the structure and balance of intestinal flora and regulating the SCFAs, and the effect of high-dose Sishenwan is obvious. 
		                        		
		                        		
		                        		
		                        	
7.Changes in glucose metabolism and intestinal flora in patients with type 2 diabetes mellitus after high-intensity intermittent exercise
Hanglin YU ; Haodong TIAN ; Shiyuan WEN ; Li HUANG ; Haowei LIU ; Hansen LI ; Peisong WANG ; Li PENG
Chinese Journal of Tissue Engineering Research 2025;29(2):286-293
		                        		
		                        			
		                        			BACKGROUND:Exercise has a regulatory effect on intestinal flora and glucose metabolism,but the effects of high-intensity intermittent exercise on intestinal flora and glucose metabolism in patients with type 2 diabetes mellitus are unclear. OBJECTIVE:To investigate the effects of high-intensity intermittent exercise on glucose metabolism and intestinal flora in patients with type 2 diabetes mellitus. METHODS:Eleven patients with type 2 diabetes mellitus were recruited,among which,two were lost to the follow-up and nine were finally enrolled.High-intensity intermittent exercise intervention was conducted 3 times per week for 6 continuous weeks.Fasting blood and fecal samples were collected before and after the intervention.Glucose metabolism indexes were detected in the blood samples,and intestinal flora was detected in the fecal samples.Changes in glucose metabolism indexes and intestinal flora indexes of the patients with type 2 diabetes mellitus before and after the intervention were compared. RESULTS AND CONCLUSION:After 6 weeks of high-intensity intermittent exercise intervention,fasting blood glucose and glycosylated serum protein levels in patients were significantly reduced(P<0.05),and fasting insulin,although not significantly changed,was decreased compared with before intervention.Alpha diversity analysis showed that the diversity(Shannon index),richness(Chao index)and coverage(Coverage index)did not change significantly.Venn diagrams showed that the relative abundance of Bacteroidetes,Actinobacteria,Proteobacteria,and Fusobacteria in the intestinal flora of the patients increased,and the relative abundance of Firmicutes decreased,and a significant decrease was seen in Ruminococcus_torques and Ruminococcus_gnavus in the Firmicutes,which were both positively correlated with the abnormalities of the glycemic metabolism-related indicators,as well as with other disease development.All these findings indicate that high-intensity intermittent exercise intervention has an improvement effect on the glycemic metabolism-related indexes of patients with type 2 diabetes mellitus,and the abundance of beneficial flora in the intestinal tract increases,and the abundance of harmful flora decreased,enhancing the stability of the intestinal flora in patients.
		                        		
		                        		
		                        		
		                        	
8.Conditioned medium of osteoclasts promotes angiogenesis in endothelial cells after lactic acid intervention
Hongli HUANG ; Wen NIE ; Yuying MAI ; Yuan QIN ; Hongbing LIAO
Chinese Journal of Tissue Engineering Research 2025;29(11):2210-2217
		                        		
		                        			
		                        			BACKGROUND:As a degradable scaffold material for bone tissue engineering,lactic acid is widely used in tissue regeneration and repair research,and plays an important role in promoting tissue healing,new bone formation and angiogenesis. OBJECTIVE:To observe the effect of lactic acid degradation products on osteoclasts and to investigate the effects of lactic-interfered osteoclast conditioned medium on the proliferation,migration and tube-forming capacity of human umbilical vein endothelial cells. METHODS:(1)The mouse monocyte macrophage cell line RAW264.7 at logarithmic growth period was selected,and adherent cells were cultured in the osteoclast induction medium(DMEM medium with nuclear factor-κB receptor-activating factor ligand and 10%fetal bovine serum)containing different concentrations of lactic acid(0,5,10,20 mmol/L).After 5 days of culture,tartrate-resistant acid phosphatase staining and cytoskeletal fibrillar actin staining were conducted.After 24 hours of culture,RT-PCR was used to detect the mRNA expression of tartrate-resistant acid phosphatase 5.(2)RAW264.7 cells at logarithmic growth period were selected and adherent cells were divided into two groups.Control group was cultured in the osteoclast induction medium,while experimental group was cultured in the osteoclast induction medium containing 10 mmol/L lactic acid.After 5 days of culture,the medium in each group was removed and the cells in the two groups were cultured in the serum-free DMEM medium for another 24 hours.Cell supernatant was then collected and used as the conditioned medium after mixed with an equal volume of DMEM medium containing 10%fetal bovine serum.Human umbilical vein endothelial cells at the logarithmic growth phase were taken and separately co-cultured with the conditioned medium of the control and experimental groups.The proliferation,migration and tube-forming ability of human umbilical vein endothelial cells were observed by cell counting kit-8 assay,migration assay,scratch assay and tube-forming assay.The mRNA and protein expression of angiogenesis-related genes and proteins were observed by RT-PCR and western blot. RESULTS AND CONCLUSION:Tartrate-resistant acid phosphatase staining and cytoskeletal fibrillar actin staining showed that 5 and 10 mmol/L lactic acid promoted osteoclastic differentiation of RAW264.7 cells and the promoting effect of 10 mmol/L lactate was more significant.RT-PCR results showed that the expression of tartrate-resistant acid phosphatase-5 mRNA of osteoclast-related genes was the highest when the lactic acid concentration was 5,10,and 20 mmol/L(P<0.05),especially 10 mmol/L.Compared with the control group,the proliferation,migration and tube-forming abilities of human umbilical vein endothelial cells were significantly increased in the experimental group(P<0.05).Compared with the control group,the expression levels of vascular endothelial growth factor and angiogenin 1 mRNA and protein were increased in the experimental group(P<0.05).To conclude,lactate-induced osteoclast conditioned medium could promote the angiogenesis of endothelial cells,and the mechanism may be related to the promotion of the expression of vascular endothelial growth factor and angiogenin 1.
		                        		
		                        		
		                        		
		                        	
9.Protective strategies and management recommendations for medical staff based on NIOSH's Managing Hazardous Drug Exposures: Information for Healthcare Settings (2023 Edition)
Hengjuan LIANG ; Bo YANG ; Jing WEN ; Xiaohong HUANG
Journal of Environmental and Occupational Medicine 2025;42(2):232-237
		                        		
		                        			
		                        			The Hazardous Drug Exposure Management: Information for Healthcare Settings (2023 Edition) released by the National Institute for Occupational Safety and Health (NIOSH) of US provided detailed protection recommendations for medical personnel to mitigate the risks of occupational exposure to hazardous drugs. This study reviewed the literature in terms of hazard identification, occupational exposure assessment, risk assessment, risk management planning, and waste and spill control. It also explored the precautions for each step of hazardous drug handling, aiming to raise medical personnel's awareness of hazardous drug protection and improve their self-protection skills. The findings provided valuable references for medical institutions to develop hazardous drug disposal plans and reduce employees' exposure to hazardous drugs and occupational injuries.
		                        		
		                        		
		                        		
		                        	
10.A Retrospective Study of Rescue Injuries and Agonal Injuries in 640 Death Cases
Xuanyi LI ; Guoli LV ; Wen YANG ; Chunlei WU ; Xiaoshan LIU ; Bin LUO ; Xinbiao LIAO ; Erwen HUANG
Journal of Sun Yat-sen University(Medical Sciences) 2025;46(1):81-87
		                        		
		                        			
		                        			ObjectiveTo clearly identify the difference between rescue injuries and agonal injuries and to avoid duplicate identifications and misidentifications. MethodsBased on the forensic pathological data of 5 923 cases of death cause identification from 2013 to 2022 in Sun Yat-sen University Forensic Identification Center and Guangzhou Tianhe District Branch of Guangzhou Public Security Bureau, this study retrospectively studied the characteristics of rescue injuries and agonal injuries seen in cause of death identification and their influence on cause of death identification. ResultsAmong all the 5 923 cases, 640 cases were found to have rescue injuries or agonal injuries, and 624 cases received treatment, of which 609 cases were found to have rescue injuries (97.60%), 44 cases were found to have agonal injuries, and 13 cases were found to have both types of injuries. Among the 640 cases, 441 were male and 199 were female. The age of death was discontinuously distributed from 0 to 95 years old. The leading cause of death was disease, followed by mechanical injury and asphyxia. The main manifestations of rescue injuries were rib and sternum fractures, soft tissue injuries in the prechest area or face, and pericardial rupture. The most common injuries in agonal stage were falling after unconsciousness, inhalation of foreign body in respiratory tract or multiple violent injuries. Among the 640 cases, 19 cases were repeatedly identified, including 15 cases of rescue injuries, 6 cases of agonal injuries, and 2 cases of both types of injuries. Compared with the cases where neither type of injuries was detected, the repeated identification rate of treatment injuries and agonal injuries was significantly increased (χ²=4.04, P=0.044; χ²=43.49, P<0.001). Among the 640 cases, 11 cases (1.72%) were misidentified as the initial injuries in the first identification, and 13 cases had combined rescue injuries or agonal injuries that were involved in death. ConclusionsBy elucidating the epidemiological characteristics of the two types of injuries, this study proved that the two types of injuries were associated with higher rates of repeated identification and misidentification, which provided a reference for reducing repeated identification and misidentification and improving the accuracy of cause of death identification. 
		                        		
		                        		
		                        		
		                        	
            

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