Objective:To explore the value of cardiodynamicsgram (CDG) obtained from electrocardiogram (ECG) data by radial basis functionradial basis function (RBF) neural network in early diagnosis of patients with acute coronary syndrome (ACS).Methods:Retrospective analysis method was used. Patients with chest pain as the main initial symptom in the emergency department of Baoan District People's Hospital of Shenzhen from October 2021 to September 2022 were enrolled. Baseline data were collected, including gender, age, smoking history, family history of coronary heart disease and history of hypertension, diabetes, hyperlipidemia, and atherosclerosis. The first 12-lead ECG was recorded after admission to the emergency department, and electrocardiodynamics analysis was performed to generate CDG. Receiver operator characteristic curve (ROC curve) was plotted to analyze the value of CDG and ECG in the early diagnosis of ACS and non-ST segment elevation ACS (NSTE-ACS). Sensitivity, specificity, area under the ROC curve (AUC), and 95% confidence interval (95% CI) were calculated. CDG and coronary angiography results of 3 patients with ACS with normal ECG were observed and analyzed. Non-ACS patients with normal ECG but positive CDG were followed for 30 days for adverse cardiovascular events. Results:A total of 384 patients with chest pain were included, including 169 patients with ACS and 215 patients without ACS. The proportion of male (87.0% vs. 53.0%), smoking history (37.9% vs. 12.1%), hypertension (46.2% vs. 22.3%), diabetes (24.3% vs. 7.9%), hyperlipidemia (55.0% vs. 14.0%) and history of atherosclerosis (22.5% vs. 2.3%) in ACS group were significantly higher than those in non-ACS group (all P < 0.05). The ROC curve showed that the AUC of CDG diagnosis of ACS was higher than that of ECG [AUC (95% CI): 0.88 (0.66-0.76) vs. 0.71 (0.84-0.92)], the sensitivity was 92.8%, 78.6%, and the specificity was 83.3%, 64.2%, respectively. The AUC of CDG diagnosis of NSTE-ACS was higher than that of ECG [AUC (95% CI): 0.85 (0.80-0.90) vs. 0.63 (0.56-0.69)], the sensitivity was 87.1%, 61.3%, and the specificity was 83.3%, 64.2%, respectively. CDG of 3 patients with ACS with normal ECG showed disordered state, and coronary angiography showed ≥70% stenosis of major coronary branches. Of 215 non-ACS patients, 20 had a normal ECG but positive CDG, and 3 developed ST segment elevation myocardial infarction (STEMI) within 30 days, and 2 developed unstable angina (UA) within 30 days. Conclusion:CDG has high value in early diagnosis of ACS patients and is expected to become an important means of early diagnosis of ACS in emergency.

Objective:To evaluate the association between preoperative serum β 2-microglobulin (β 2MG) concentrations and postoperative delirium (POD) in elderly patients. Methods:The study selected patients who underwent knee or hip arthroplasty under spinal-epidural anesthesia on an elective basis at Qingdao Municipal Hospital from May 2021 to November 2022. The patients were divided into a POD group and a non-POD group based on the occurrence of POD. The study was conducted as part of the Perioperative Neurocognitive Impairment and Biomarkers Lifestyle Cohort, which was a nested case-control study. The study collected baseline data from two groups of patients and analyzed the differences between them. Logistic regression was used to identify the risk factors for POD. The stability of the regression model was tested using sensitivity analysis. The mediation model was used to examine whether cerebrospinal fluid (CSF) biomarkers mediated the relationship between β 2MG and POD. The receiver operating characteristic curve was drawn and the area under the curve was calculated to evaluate the accuracy of preoperative β 2MG concentrations and CSF biomarker concentration in predicting POD. Results:There were 57 cases in POD group and 449 cases in non-POD group. The results of logistic regression analysis showed that the increased β 2MG and CSF total tau protein (t-tau) concentrations were risk factors for POD, and the increased CSF β-amyloid 42 concentration was a protective factor for POD after adjustment for multiple confounders such as age, gender, education, Mini-Mental State Examination, history of hypertension and infusion volume ( P<0.05). The results of mediation analysis showed that the serum β 2MG′s effect on POD was partly mediated by t-tau (18.1%). The results of the receiver operating characteristic curve showed that the area under the curve of the β 2MG concentration combined with the CSF biomarker concentration was 0.742. Conclusions:Elevated preoperative serum β 2MG concentration is a risk factor for POD in elderly patients, and the relationship may be partly mediated by CSF t-tau.

Objective:To evaluate the relationship between preoperative serum bilirubin concentrations and postoperative delirium (POD) in the patients undergoing knee or hip replacement.Methods:Medical records from 413 patients undergoing knee or hip arthroplasty were selected from August 2020 to October 2023 at Qingdao Municipal Hospital using a nested case-control design based on the PNDABLE study cohort. The patients were divided into POD group ( n=77) and non-POD group ( n=336) according to whether POD occurred. Univariate analysis was used to analyze the influencing factors. Logistic regression was used to identify the risk factors for POD. The significance of mediation effect was tested. The receiver operating characteristic curve was drawn to evaluate the accuracy of risk factors in predicting POD. Results:There were significant differences in age, education time, ratio of diabetes history, Memorial Delirium Assessment Scale score, total bilirubin concentration, direct bilirubin concentration, indirect bilirubin concentration, Aβ 42 concentration, p-tau concentration, t-tau concentration, Aβ 42/p-tau ratio and Aβ 42/t-tau ratio between POD group and non-POD group ( P<0.05). The results of logistic regression analysis showed that preoperative serum total bilirubin, direct bilirubin and indirect bilirubin were risk factors for POD ( P<0.05). The results of mediation effects showed that the concentration of total tau protein in CSF partly mediated the relationship between high serum total bilirubin, direct bilirubin and indirect bilirubin concentrations and POD. The area under the receiver operating characteristic curve of total bilirubin, direct bilirubin and indirect bilirubin combined with CSF biomarker concentrations in predicting POD was 0.83 ( P<0.001). Conclusions:Preoperative elevated concentrations of total bilirubin, direct bilirubin and indirect bilirubin are risk factors for POD in the patients undergoing knee or hip replacement. CSF t-tau concentration has a partly mediating role in the association between serum total bilirubin, direct bilirubin and indirect bilirubin concentrations and the development of POD.

Objective: To investigate the prevalence and associated factors of sexting among college students in Jiangxi Province, so as to provide a reference for sexual education interventions in colleges. Methods: A combined method of random cluster sampling and convenience sampling was used to conduct an anonymous questionnaire survey on 13 042 students from 14 colleges in Jiangxi Province in October 2023. A self designed questionnaire was used to collect data on sexting among students, and Chi square tests and binary Logistic regression analysis were conducted to explore the factors associated with sexting among college students in Jiangxi Province. Results: The reported rate of sexting among college students in Jiangxi Province was 11.5%. Binary Logistic regression analysis showed that female students, non only children, and those who do not view pornographic novels/videos/films had a lower likelihood of engaging in sexting ( OR =0.72, 0.83, 0.23, P <0.05). Students who identified as homosexual, lacked knowledge about AIDS, did not mind premarital sex, and had indifferent attitudes towards multiple sexual partners were more likely to engage in sexting ( OR =1.66, 1.53, 1.25, 2.26, 1.78, P <0.05). Students who smoke, drink, and report a history of high risk sexual behavior were more likely to engage in sexting behavior ( OR=1.38-12.20, P <0.05); night owls showed a negative correlation with sexting behavior ( OR=0.24-0.58, P <0.05). Conclusions A significant proportion of college students in Jiangxi Province engage in sexting. It is recommended that colleges and universities strengthen their sexual education efforts and focus on cultivating internet literacy to promote the physical and mental health development of college students.

Objective To study the properties and antimicrobial activity of the novel self-assembled antimicrobial peptide(AMP)CR-16,and to provide experimental evidence for the treatment of bacterial infections.Methods CR-16 was designed and synthesized based on the structure of antimicrobial peptides Buforin Ⅱ and LfcinB.Dynamic light scattering(DLS),transmission electron microscopy(TEM),and X-ray diffraction(XRD)were used to characterize CR-16.Based on the results of critical micelle concentration(CMC),the self-assembled properties of CR-16 were investigated using atomic force microscopy(AFM)and circular dichroism(CD).The minimum inhibitory concentration(MIC)was used to study the inhibitory effect of CR-16 while transmission electron microscopy(TEM)was adopted to observe the interactions between CR-16 and the outer membrane of bacteria.Results AMP CR-16 was prepared as self-assemblies,which were regularly spherical in shape and stable in activity.CR-16 could inhibit both the growth of Escherichia coli and,more importantly,the growth of NDM-1-producing carbapenem-resistant Escherichia coli,promising good prospects in treating infections caused by antibiotic-resistant bacteria.Conclusion CR-16 can be self-assembled and deliver antibacterial effects against Escherichia coli.

Objective:This study targets students enrolled in the Sino-foreign joint clinical medicine program collaboratively run by Chongqing Medical University, China and the University of Leicester, UK, aiming to propose suggestions and improvement measures on optimizing students' learning experiences and promoting the high-quality development of Sino-foreign cooperative education through questionnaire survey analysis.Methods:This study utilized convenience sampling and a self-designed questionnaire to collect feedback on the curriculum system and teaching methods, the adaptability of the educational system to the Chinese clinical practitioner examination, and the approaches and benefits of studying abroad. The data were presented as percentages.Results:Among the 75 respondents, 32 (42.67%) students expressed overall satisfaction or high satisfaction with the curriculum system and teaching methods. Specifically, 22 (29.33%) students were satisfied or very satisfied with the teaching methods of the Sino-foreign joint medical courses. Regarding the educational system's adaptability to the Chinese clinical practitioner examination, 74 (98.67%) students felt that the medical education provided by the joint program needed further adjustments or improvements, of whom 53 (70.67%) students believed that the content of the joint program was somewhat or not well aligned with the requirements of the Chinese practitioner examination, and 55 (73.33%) students thought that the joint program's discipline structure was not sufficiently comprehensive for training medical professionals. In terms of studying abroad, 57 (76.00%) students felt that overseas study had a positive impact on enhancing their overall quality.Conclusions:The joint clinical medicine program at our university draws on British educational principles to improve overall student quality. In response to students' needs regarding the curriculum system, teaching methods, and practitioner examination, the university plans to refine its teaching content and methods by implementing innovative training concepts, focusing on interdisciplinary integration, streamlining the curriculum, increasing tutoring, and promoting case-based group discussions to improve classroom teaching quality.

AIM:To investigate the expression of lipolysis-stimulated lipoprotein receptor(LSR)in dextran sodium sulfate(DSS)-induced colitis mice,and the effects of Lsr-specific knockout and overexpression in intestinal epithe-lium on intestinal inflammation in colitis mice.METHODS:C57BL/6J mice were administered 3%(w/v)DSS in drink-ing water for 6 days to induce colitis.Following the experiment,RNA-seq was employed to screen differentially expressed genes between the control group and experimental group.Changes in LSR expression were assessed using RT-qPCR,Western blot,and immunofluorescence staining.Intestinal epithelial Lsr-specific knockout mice were generated using the Cre-loxP system and subjected to DSS-induced colitis.Colitis severity was evaluated through changes in body weight,dis-ease activity index(DAI)score,colon length,and hematoxylin-eosin(HE)staining.Additionally,serum levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),IL-6,and IL-18 were measured via ELISA.Immunofluorescence staining was utilized to detect neutrophil and macrophage infiltration in colon tissues,while periodic acid-Schiff(PAS)staining was used to observe goblet cell numbers.Furthermore,adeno-associated virus(AAV-Lsr)was intraperitoneally injected to achieve LSR overexpression.Successful LSR overexpression was confirmed,and a DSS-induced colitis model was established using similar methods to observe intestinal inflammation.RESULTS:Results showed decreased LSR ex-pression in DSS-induced colitis mice.Intestinal epithelial Lsr-specific knockout mice exhibited increased susceptibility to DSS-induced colitis,evidenced by significantly reduced body weight(P<0.05),increased DAI(P<0.01),shortened co-lon length(P<0.05),and exacerbated pathological injury.Levels of pro-inflammatory cytokines TNF-α(P<0.05),IL-1β(P<0.01),IL-6(P<0.05),and IL-18(P<0.01)were significantly elevated,along with increased inflammatory cell infiltration and reduced goblet cell numbers in the colon.Conversely,LSR overexpression via AAV significantly alleviated intestinal inflammation in DSS-induced colitis mice.CONCLUSION:In conclusion,LSR expression decreased in DSS-induced colitis mice,and its loss exacerbated intestinal inflammation in this model.AAV-mediated LSR overexpression provided therapeutic relief from intestinal inflammation in DSS-induced colitis mice.

Lysine specific demethylase1(LSD1)is a flavin adenine dinucleotide(FAD)-dependent monoamine oxidase.Studies have confirmed that aberrant expression of LSD1 is closely related to tumor metastasis and proliferation,and is currently one of the important targets for tumor-targeted therapy.In addition,LSD1 is involved in the development of various conditions such as neurodegenerative diseases,cardiovascular diseases,and inflammatory responses.Currently,several inhibitors have been developed for the clinical research stage.In this paper,the structure and mechanism of action of LSD1 and the research progress of LSD1 inhibitors are briefly introduced to provide some reference for the design and development of novel LSD1 inhibitors.

Objective:To evaluate the relationship between physical activity (PA) and postoperative delirium (POD) in elderly patients undergoing knee or hip arthroplasty.Methods:The study was conducted as part of the Perioperative Neurocognitive Impairment and Biomarkers Lifestyle Cohort, which was a nested case-control study. Medical records from elderly patients undergoing elective knee or hip arthroplasty under spinal-epidural anesthesia at Qingdao Municipal Hospital from August 2022 to August 2023 were collected. The patients were divided into a POD group ( n=89) and a non-POD group ( n=221) based on the occurrence of POD. Peripheral blood samples were collected before surgery, and the cerebrospinal fluid (CSF) 2 ml was extracted after successful puncture under spinal-epidural anesthesia for determination of the concentrations of amyloid-β 42 (Aβ 42), total tau protein (t-tau), and phosphorylated tau protein (p-tau) by enzyme-linked immunosorbent assay. Logistic regression was used to analyze the influencing factors of POD, and the mediation analysis was conducted to examine the mediating role of CSF biomarker in the relationship between PA and POD. Results:Logistic regression analysis showed that the increased concentration of CSF biomarkers Aβ 42 ( OR=0.997, P=0.006), elevated ratio of Aβ 42/t-tau ( OR=0.642, P=0.003), elevated ratio of Aβ 42/p-tau ratio ( OR=0.872, P=0.001) and PA ( OR=0.374, P=0.001) were protective factors for POD, while the elevated concentrations of t-tau ( OR=1.006, P=0.001) and p-tau ( OR=1.030, P=0.011) were risk factors for POD after adjusting for multi-confounders such as hypertension, diabetes, history of drinking, years of education and Mini-Mental State Examination score. The results of the mediation analysis showed that Aβ 42 (20%), t-tau (16%), Aβ 42/t-tau (23%) and Aβ 42/p-tau (28%) played mediating roles in the relationship between PA and POD. Conclusions:PA is a protective factor for POD in elderly patients undergoing knee or hip arthroplasty and CSF biomarkers may play a mediating role in the relationship between PA and POD.

Objective:To evaluate the relationship between the preoperative sleep quality and postoperative delirium (POD) in elderly patients.Methods:Three hundred and eighty-nine patients of either sex, aged 65-90 yr, with American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, who underwent elective knee/hip arthroplasty under combined spinal-epidural anesthesia in Qingdao Municipal Hospital from May 2022 to October 2023, were selected. The Pittsburgh Sleep Quality Index scale was applied at 1 day before surgery to assess the sleep quality within 1 month before surgery. The cerebrospinal fluid (CSF) specimens 2 ml were withdrawn from the subarachnoid space before anesthesia for determination of the concentrations of biomarkers (β-amyloid), total tau protein [t-tau], and phosphorylated tau protein [p-tau]) by enzyme-linked immunosorbent assay. Patients were divided into POD group and non-POD group based on whether delirium occurred within 7 days after surgery. Logistic regression was used to identify the risk factors for POD, and the sensitivity analysis was used to test the stability of the regression models. The mediation model was used to examine whether CSF biomarkers mediated the link between sleep quality and POD. The accuracy of preoperative sleep quality and CSF biomarker concentrations in predicting the occurrence of POD was evaluated by plotting the receiver operating characteristic curve and calculating the area under the curve.Results:Two hundred and seventy-nine patients were finally included, with 33 patients in POD group and 246 patients in non-POD group. The results of logistic regression analysis showed that shorter sleep duration, use of hypnotics, daytime dysfunction within 1 month before surgery, elevated t-tau concentrations in CSF, and elevated p-tau concentrations in CSF were risk factors for POD after adjusting for multiple confounding factors such as age, sex, body mass index, years of education, Mini-Mental State Examination score, and VAS score. The results of mediating effect showed that the effect of use of hypnotics and daytime dysfunction within 1 month before surgery on POD was partially mediated by p-tau concentrations in CSF (>10%). The area under the curve of combination of daytime dysfunction, sleep duration, use of hypnotics within 1 month before surgery, and CSF biomarker concentrations in predicting POD was 0.979.Conclusions:Shortened sleep duration, use of hypnotic, and daytime dysfunction with 1 month before surgery are risk factors for POD in elderly patients, and the association between use of hypnotics and daytime dysfunction and POD is partially mediated by p-tau in CSF.