Objective:To investigate the clinical characteristics of omphalocele, and to assess the risk factors associated with adverse outcomes.Methods:A retrospective cohort study was conducted. Clinical data of 224 patients diagnosed with omphalocele, who were hospitalized at Children′s Hospital, Zhejiang University School of Medicine from January 2013 to December 2022, were collected. Based on their discharge outcomes, the patients were classified into 2 groups: favorable outcomes and unfavorable outcomes. Chi-square test or continuity correction χ2 test or Fisher exact probability method, and Mann-Whitney U test were used for intergroup comparisons. Logistic regression analysis was performed to identify risk factors associated with adverse outcomes in omphalocele. Results:Among the 224 patients with omphalocele, 126 were male. A total of 208 patients (92.9%) had favorable outcomes, while 16 patients (7.1%) had unfavorable outcomes. In the unfavorable outcomes group, 14 patients had giant omphaloceles, while 100 patients had giant omphaloceles in the favorable outcomes group. The rates of herniation of more than two intra-abdominal organs in the hernial sac, congenital heart defects, patent ductus arteriosus, pulmonary hypertension, sepsis and infection of the hernial sac, were all higher in the unfavorable outcomes group compared to the favorable outcomes group (all P<0.05). Patients with unfavorable outcomes had longer mechanical ventilation time, duration of oxygen use, duration of parenteral nutrition, hospital stays, and higher rates of parenteral nutrition-associated cholestasis compared to those with favorable outcomes (all P<0.01). Multivariate Logistic regression analysis indicated that pulmonary hypertension ( OR=9.39, 95% CI 1.20-73.32), sepsis ( OR=8.59, 95% CI 1.32-55.86), and congenital heart defects ( OR=6.55, 95% CI 1.11-38.73) were all independent risk factors for adverse outcomes in omphalocele (all P<0.05). Conclusions:Infants with omphalocele are prone to complications such as cardiovascular malformations, infections, and pulmonary hypertension. Adverse outcomes in omphalocele are associated with pulmonary hypertension, sepsis, and congenital heart defects.

Objective To explore the application of plasma 7 microRNA (miR7) testing in the differential diagnosis of very early-stage hepatocellular carcinoma (HCC). Methods This study is a multicenter real-world study. Patients with single hepatic lesion (maximum diameter≤2 cm) who underwent plasma miR7 testing at Zhongshan Hospital, Fudan University, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Anhui Provincial Hospital, and Peking University People’s Hospital between January 2019 and December 2024 were retrospectively enrolled. Patients were divided into very early-stage HCC group and non-HCC group, and the clinical pathological characteristics of the two groups were compared. The value of plasma miR7 levels, alpha-fetoprotein (AFP), and des-gamma-carboxy prothrombin (DCP) in the differential diagnosis of very early-stage HCC was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC). In patients with both negative AFP and DCP (AFP＜20 ng/mL, DCP＜40 mAU/mL), the diagnostic value of plasma miR7 for very early-stage HCC was analyzed. Results A total of 64 528 patients from 4 hospitals underwent miR7 testing, and 1 682 were finally included, of which 1 073 were diagnosed with very early-stage HCC and 609 were diagnosed with non-HCC. The positive rate of miR7 in HCC patients was significantly higher than that in non-HCC patients (67.9% vs 24.3%, P＜0.001). ROC curves showed that the AUCs for miR7, AFP, and DCP in distinguishing HCC patients from the non-HCC individuals were 0.718, 0.682, and 0.642, respectively. The sensitivities were 67.85%, 43.71%, and 44.45%, and the specificities were 75.70%, 92.78%, and 83.91%, respectively. The pairwise comparison of AUCs showed that the diagnostic efficacy of plasma miR7 detection was significantly better than that of AFP or DCP (P＜0.05). Although its specificity was slightly lower than AFP and DCP, the sensitivity was significantly higher. Among patients negative for both AFP and DCP, miR7 maintained an AUC of 0.728 for diagnosing very early-stage HCC, with 67.82% sensitivity and 77.73% specificity. Conclusions Plasma miR7 testing is a potential molecular marker with high sensitivity and specificity for the differential diagnosis of small hepatic nodules. In patients with very early-stage HCC lacking effective molecular markers (negative for both AFP and DCP), miR7 can serve as a novel and effective molecular marker to assist diagnosis.

The "integrated time-space" perspective of life in traditional Chinese medicine holds that structure and function respectively belong to the realms of space and time. The orderly integration of time and space not only supports the existence and development of life， but also serves as the foundation for biological evolution. Based on this standpoint， this paper proposes the spatiotemporal structural theory of visceral manifestation， characterized by the fusion of time and space， the integration of internal and external dimensions， and the absence of primary or secondary distinctions. Using the individual human body as the boundary， it delineates the man and nature spatiotemporal structure， based on the theory of the "correspondence between man and nature"， and the internal spatiotemporal structure of the living body. The man and nature spatiotemporal structure， with yin-yang and the five phases as its core， reveals the correspondence and connectivity between the external environment and the internal zang-fu organs within the spatiotemporal dimension. The internal temporal structure of the body refers to the collective physiological rhythms related to the zang-fu organs， while the spatial structure refers to the tangible forms， spatial positions， and connective structures of the zang-fu organs. The proposal of the spatiotemporal structural theory of visceral manifestation represents a rational reconstruction and practical exploration of the essential connotations of visceral manifestation， aiming to provide new perspectives for subsequent theoretical research and clinical applications.

Background The increasing demand for emergency services coupled with the special working environment has exacerbated occupational stress and work-related rumination among emergency medical dispatchers, which is noteworthy for its impact on dispatchers' sleep quality. Objective To explore the relationship among occupational stress, work-related rumination, and sleep quality of emergency medical dispatchers, so as to provide reference for improving sleep quality and maintaining physical and mental health of this occupational group. Methods A total of 386 emergency medical dispatchers from 16 provinces and municipalities including Beijing, Shanghai, Tianjin, Inner Mongolia, Zhejiang, Shanxi, Jiangxi, Anhui, Hubei, Hebei, Henan, Sichuan, Guizhou, Yunnan, Fujian, and Hainan of China were investigated with the Chinese version of Effort-Reward Imbalance Questionnaire, Work-Related Rumination Questionnaire, and Insomnia Severity Index. Spearman correlation was used to analyze the association among occupational stress, work-related rumination, and sleep quality. A structural equation model was constructed, with occupational stress as independent variable, the two dimensions of work-related rumination as mediating variables, and sleep quality as dependent variable, respectively. Bootstrap testing was then used to verify potential mediating effect of work-related rumination on the relationship between occupational stress and sleep quality among the emergency medical dispatchers. Results Among the enrolled emergency medical dispatchers, the effort-reward imbalance (ERI) index was 1.03, the score of affective rumination was 15.35±5.26, the score of problem-solving rumination was 17.64±4.63, and the total score of sleep quality was 21.10±6.53. Their ERI index was positively correlated with affective rumination scores (r=0.636, P<0.01), but not with problem-solving rumination scores (P>0.05). Their ERI index, affective rumination scores, and problem-solving rumination scores were positively correlated with sleep quality scores (P<0.05). The direct effect size of occupational stress on sleep quality was 0.627, the indirect effect size of affective rumination was 0.124, and the mediating effect of affective rumination accounted for 16.4% of the total effect (0.755), while the problem-solving rumination had no mediating effect on the relationship between occupational stress and sleep quality. Conclusion Occupational stress and affective rumination in emergency medical dispatchers can predict their sleep quality. Occupational stress can directly affect sleep quality, and indirectly affect it through affective rumination. Managers should pay attention to and evaluate the affective rumination level of emergency medical dispatchers, so as to take corresponding intervention measures to reduce their occupational stress and improve their sleep quality.

Objective To investigate the role of SIRT1/autophagy pathway in mediating the regulatory effect of lncRNA SOX2OT on 5-fluorouracil(5-FU)resistance in cholangiocarcinoma cells.Methods HCCC-9810 cells were used to construct a 5-FU-resistant cell model(HCCC-9810/5-FU cells),and the expression levels of lncRNA SOX2OT and SIRT1 mRNA and the protein expressions of SIRT1,Beclin1,LC3 and P62 were detected with qRT-PCR and Western blotting.The effects of transfection with a SOX2OT mimic on drug resistance and cell migration of HCCC-9810/5-FU cells were detected using CCK-8 assay and wound healing assay,and the changes in expressions of SOX2OT,SIRT1,Beclin1,LC3 and P62 were detected.Rescue experiment was performed by co-transfection of HCCC-9810/5-FU cells with both a SOX2OT-overexpressing plasmid and si-SIRT1 to confirm the role of SIRT1 in SOX2OT-mediated regulation of 5-FU resistance.A RNA pulldown assay was used to verify the targeted binding between SOX2OT and SIRT1.Results The proliferation of HCCC-9810 cells was significantly inhibited after treatment with different concentrations of 5-FU(P<0.05).The 5-FU-resistant cells showed significantly increased protein expressions of SIRT1,Beclin1 and p62,an increased LC3Ⅱ/LC3Ⅰ ratio,and enhanced expressions of SIRT1 mRNA and SOX2OT(P<0.05).Transfection of the resistant cells with SOX2OT mimic significantly enhanced cell migration and increased the protein expressions of SIRT1,Beclin1 and p62,the LC3Ⅱ/LC3Ⅰratio,and expression levels of SIRT1 mRNA and SOX2OT(P<0.05),and these changes were obviously attenuated by SIRT1 knockdown,which also resulted in lowered 5-FU resistance of the cells without significantly affecting the expression level of SOX2OT(P>0.05).RNA pulldown assay suggested that SOX2OT could directly bind to SIRT1.Conclusion LncRNA SOX2OT enhances 5-FU resistance in HCCC-9810 cells by promoting autophagy through up-regulating SIRT1 expression.

Objective:To explore the protective effect of Yiqi Fumai Lyophilized Injection (YQFM) on myocardial cell injury induced by doxorubicin and its mechanism.Methods:H9c2 cells were divided into the control group, the doxorubicin group, and the YQFM group. Cells in the control group were given routine incubated. H9c2 cells in the doxorubicin group were given doxorubicin (1 μmol/L) and incubated for 24 h. Cells in the YQFM group were given doxorubicin (1 μmol/L) and YQFM (1.5 mg/L) and incubated for 24 h. The cell viability, cell surface area, atrial natriuretic peptide, and brain natriuretic peptide protein expression levels were detected in each group. The levels of oxidative stress factors, including superoxide dismutase (SOD), malondialdehyde, glutathione peroxidase (GSH-Px) and catalase (CAT) were detected in each group. The apoptosis level, mitochondrial membrane potential, apoptotic associated protein such as B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X protein (Bax), and c-cysteinyl aspartate specific proteinase-3 (c-Caspase-3), p53 and protein expression level of phosphatidylinositol-3-kinase (PI3K)/protein kinase B (Akt) signaling pathway were detected in each group.Results:YQFM increased the viability ( P < 0.01), decreased the cell surface area ( P < 0.001), and the levels of atrial natriuretic peptide and brain natriuretic peptide proteins ( P < 0.05) of H9c2 cell in the doxorubicin group. In addition, the SOD, GSH-Px, and CAT levels in the YQFM group were higher than those in the doxorubicin group ( P < 0.05, 0.01), while the malondialdehyde level in the YQFM group was lower than that in the doxorubicin group ( P < 0.05). YQFM also reduced the apoptosis level of H9c2 cell in the doxorubicin group ( P < 0.01), increased the level of mitochondrial membrane potential ( P < 0.01) and the Bcl-2/Bax protein expression level ( P < 0.05), and decreased c-Caspase-3 and p53 protein expression levels ( P < 0.05). It was further found that the p-PI3K and p-Akt protein expression levels in the YQFM group were higher than those in the doxorubicin group ( P < 0.05, 0.01). Conclusions:YQFM can inhibit myocardial cell injury induced by doxorubicin, and its mechanism may be related to the inhibition of oxidative stress and activation of PI3K/Akt pathway.

Objective To investigate the role of SIRT1/autophagy pathway in mediating the regulatory effect of lncRNA SOX2OT on 5-fluorouracil(5-FU)resistance in cholangiocarcinoma cells.Methods HCCC-9810 cells were used to construct a 5-FU-resistant cell model(HCCC-9810/5-FU cells),and the expression levels of lncRNA SOX2OT and SIRT1 mRNA and the protein expressions of SIRT1,Beclin1,LC3 and P62 were detected with qRT-PCR and Western blotting.The effects of transfection with a SOX2OT mimic on drug resistance and cell migration of HCCC-9810/5-FU cells were detected using CCK-8 assay and wound healing assay,and the changes in expressions of SOX2OT,SIRT1,Beclin1,LC3 and P62 were detected.Rescue experiment was performed by co-transfection of HCCC-9810/5-FU cells with both a SOX2OT-overexpressing plasmid and si-SIRT1 to confirm the role of SIRT1 in SOX2OT-mediated regulation of 5-FU resistance.A RNA pulldown assay was used to verify the targeted binding between SOX2OT and SIRT1.Results The proliferation of HCCC-9810 cells was significantly inhibited after treatment with different concentrations of 5-FU(P<0.05).The 5-FU-resistant cells showed significantly increased protein expressions of SIRT1,Beclin1 and p62,an increased LC3Ⅱ/LC3Ⅰ ratio,and enhanced expressions of SIRT1 mRNA and SOX2OT(P<0.05).Transfection of the resistant cells with SOX2OT mimic significantly enhanced cell migration and increased the protein expressions of SIRT1,Beclin1 and p62,the LC3Ⅱ/LC3Ⅰratio,and expression levels of SIRT1 mRNA and SOX2OT(P<0.05),and these changes were obviously attenuated by SIRT1 knockdown,which also resulted in lowered 5-FU resistance of the cells without significantly affecting the expression level of SOX2OT(P>0.05).RNA pulldown assay suggested that SOX2OT could directly bind to SIRT1.Conclusion LncRNA SOX2OT enhances 5-FU resistance in HCCC-9810 cells by promoting autophagy through up-regulating SIRT1 expression.

Objective:To understand the factors hindering exercise rehabilitation in aged patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI) and provide a reference for clinical interventions.Methods:Aged CHD patients who underwent PCI in the Department of Cardiovascular Medicine at Hunan Provincial People's Hospital from January to June 2022 were selected by purposive sampling and underwent semi-structured interviews. Content analysis was employed for data analysis.Results:The factors hindering exercise rehabilitation in aged CHD patients after PCI can be categorized into two major groups: endogenous factors and exogenous factors. Endogenous factors were categorized into four themes: inadequate understanding, adverse disease experiences, weakness and physical dysfunction, and poor self-perception. Exogenous factors were categorized into four themes: lack of cardiac rehabilitation prescriptions and programs, social environmental barriers, insufficient family support, and restricted medical insurance coverage.Conclusions:The factors hindering exercise rehabilitation in aged CHD patients after PCI are diverse and complex. Prior to implementing exercise rehabilitation, healthcare professionals should thoroughly assess individuals' health conditions, rehabilitation needs, and limiting factors, and provide feasible rehabilitation content and formats.

Objective:To gain a deep understanding of the current cognition and training needs of nursing undergraduates regarding their emergency response teamwork skills, and to provide reference for the development of courses on emergency response teamwork among nursing undergraduates.Methods:From September to October 2023, purposive sampling was used to select 15 senior nursing undergraduates from Peking Union Medical College, Beijing University of Chinese Medicine, and Beijing City University as subjects for semi-structured interviews. Colazizzi 7-step analysis method was used to summarize and extract themes.Results:Three themes were extracted, including insufficient cognition and skill in emergency response, lack of emergency response teamwork cultivation, and the need for systematic and comprehensive training courses.Conclusions:Universities, hospitals, and other training institutions should work together to develop a systematic emergency response teamwork training course for nursing undergraduates, to cultivate the skills of nursing undergraduates and reserve talents for high-quality emergency response nursing teams.

Objective To employ a mouse model of ABI3BP gene deletion for the detection of postnatal changes in body weight and glucose metabolism and establish a different method of creating a mouse model of low birth weight.Methods Heterozygote mice were mated to produce ABI3BP gene knockout homozygote(ABI3BP-/-)mice,heterozygote(ABI3BP+/)mice,and wild-type(WT)mice.Adult mice from all three groups were evaluated for glucose metabolism markers,including the fasting blood glucose level,glucose tolerance,and insulin tolerance.Additionally,body weight was measured at various postnatal time periods,and the weight ratio of critical organs in adulthood was calculated.Results The gene sequencing result of the polymerase chain reaction product of ABI3BP-/-mice showed that frameshift mutations occurred in the knockout region,with quantitative reverse-transcription polymerase chain reaction analysis demonstrating significantly reduced ABI3BP expression in ABI3BP-/-mice compared with that in WT mice.Notably,the birth weight of ABI3BP-/-mice(1.25±0.08 g)was markedly lower than that of WT mice(1.34±0.12 g)(P＜0.05).Conversely,the weight of adult(120 d)ABI3BP-/mice(27.70±1.93 g)was significantly higher than that of WT mice(23.64±1.34 g)(P＜0.01).The ratios of key organ weights to body weight were not significantly different between the groups(P＞0.05).Fasting blood glucose and insulin tolerance tests showed no significant variations between the groups.However,glucose tolerance tests indicated that ABI3BP-/-mice had lower blood glucose levels(15.68±7.04 mmol/L)than WT mice(23.01±5.75 mmol/L).Conclusions Deletion of the ABI3BP gene result in mice with low birth weight,poor growth recuperation,and inadequate glucose tolerance in adulthood,similar to the clinical growth traits of low-birth-weight human neonates.Therefore,this mouse model is a promising choice for the study of low birth weight.