Objective To explore the risk factors for myocardial injury in esophagogastric variceal bleeding(EGVB)patients with liver cirrhosis during hospitalization.Methods A case-control trial was conducted on 235 EGVB patients admitted to our hospital between May 2021 and July 2022.Their basic information,laboratory results and relevant data during hospitalization were collected.According to their myocardial enzyme profiles during hospitalization,they were divided into myocardial injury group(n=46)and non-myocardial injury group(n=189).Univariate regression analysis and clinical correlation analysis were used to preliminarily screen the risk factors for myocardial injury secondary to EGVB caused by liver cirrhosis.Then,multivariate logistic regression analysis was used to further screen the risk factors.A nomogram was constructed based on the selected risk factors and the occurrence of myocardial injury.Receiver operating characteristic(ROC)curve was plotted to analyze the independent predictive value of these factors alone or combined together.Calibration curve analysis and internal verification were utilized to evaluate the predictive performance of the nomogram model.Subgroup verification was performed in the myocardial infarction group.Results Univariate analysis revealed that statistical differences were observed in age,sex,hypertension,renal disease,underlying diseases,vomiting,leukocytosis,increased alanine aminotransferase(ALT)or aspartate aminotransferase(AST),albumin,red blood cell hematocrit(HCT),international normalized ratio(INR),endoscopy within 6 h after admission,and Child-Pugh(CP)class between the myocardial injury group and the non-myocardial injury group(P＜0.01).Multivariate logistic regression analysis showed that age(P=0.014,OR=1.153,95％CI:1.030～1.291),underlying diseases(P=0.005,OR=1.122,95％CI:1.032～2.437),and albumin(P=0.012,OR=0.449,95％CI:0.241～0.837)were independent risk factors for inhospital myocardial injury in EGVB patients with liver cirrhosis.The AUC value of the above indicators combined together for predicting myocardial injury was 0.902.Hosmer-Lemeshow test and calibration curve analysis indicated that the nomogram had good prediction consistency(Chi-square=12.88,P=0.615).Internal verification correctly distinguished 86.4％of verification objects.Subgroup analysis of myocardial injury patients showed that albumin was also an independent risk factor for in-hospital myocardial injury in this population(AUC=0.80).Conclusion Age,underlying diseases,and albumin level are independent risk factors for in-hospital myocardial injury in EGVB patients with liver cirrhosis.Albumin level can be used as an independent risk factor for predicting myocardial infarction.Combination of the above 3 indicators has a high diagnostic value in early identification and prevention of myocardial injury in this patient population.

Protein as the allergens could lead to allergy. In addition, a widespread class of allergens were known as glycans of N-glycoprotein. N-glycoprotein contained oligosaccharide linked by covalent bonds with protein. Recently,studies implicated that allergy was associated with glycans of heterologous N-glycoprotein found in food, inhalants, insect toxins, etc. The N-glycan structure of N-glycoprotein allergen has exerted an influence on the binding between allergens and IgE, while the recognition and presentation of allergens by antigen-presenting cells (APCs) were also affected. Some researches showed thatN-glycan structure of allergen was remodeled by N-glycosidase, such as cFase I, gpcXylase, as binding of allergen and IgE partly decreased. Thus, allergic problems caused by N-glycoproteins could potentially be solved by modifying or altering the structure ofN-glycoprotein allergens, addressing the root of the issue. Mechanism of N-glycans associated allergy could also be elaborated through glycosylation enzymes, alterations of host glycosylation. This article hopes to provide a separate insight for glycoimmunology perspective, and an alternative strategy for clinical prevention or therapy of allergic diseases.

Objective To investigate the knowledge,demand,and use of clinical practice guide-lines(CPGs)among anesthesia professionals in Gansu province,and to explore the strategies and barriers during the implementation process.Methods A questionnaire survey was conducted to investigated the knowledge,demand,and use of CPGs,as well as the strategies and barriers during the process of guideline implementation.Statistical analysis was applied to the collected data.Results A total of 339 valid question-naires were collected,96.8%of the respondents were aware of the guidelines,and the majority of the re-spondents(86.4%)consulted the guidelines when they encountered problems in clinical practice.The main barriers for guideline utilization were identified as lack of convenience(70.2%),limited availability chan-nels(64.3%)or restricted access rights(56.9%)to obtain the guidelines,inadequate training(31.3%),and language barriers(21.5%).Multiple forms of assisting guideline use and opening up guideline access were considered by most respondents as important ways to promote guideline implementation.Conclusion Anesthesia professionals in Gansu province demonstrated good levels of awareness and compliance with guidelines.However,the primary barriers to utilization were attributed to the guidelines themselves or diffi-culties in accessing them.It is recommended to establish a national guideline clearinghouse,provide imple-mentation tools,and enhance healthcare professional training to facilitate the promotion and application of guidelines in the future.

Healthy lifestyles and good living habits are effective strategies and important approaches to prevent chronic non-communicable diseases. With the development of evidence-based medicine, the evidence translation system has made some achievements in clinical practice. There is, however, no comprehensive, professional and efficient system for translating lifestyle evidence globally. Therefore, the Health Lifestyle Evidence (HLSE) Group of Lanzhou University constructed the HLSE Evidence Translation System (https://hlse.cn/), with the aim of synthesizing, evaluating, translating, and applying lifestyle-related evidence resources. This paper aims to introduce the functional module design of the evidence translation system, the system development process and testing, introduce the interface design and function demonstration, and explain the significance of constructing the HLSE.

Healthy lifestyles and good living habits are effective strategies and important approaches to prevent chronic non-communicable diseases. With the development of evidence-based medicine, the evidence translation system has made some achievements in clinical practice. There is, however, no comprehensive, professional and efficient system for translating lifestyle evidence globally. Therefore, the Health Lifestyle Evidence (HLSE) Group of Lanzhou University constructed the HLSE Evidence Translation System (https://hlse.cn/), with the aim of synthesizing, evaluating, translating, and applying lifestyle-related evidence resources. This paper aims to introduce the functional module design of the evidence translation system, the system development process and testing, introduce the interface design and function demonstration, and explain the significance of constructing the HLSE.

Objective To observe the application effect and safety of continuous adductor canal block(ACB)with different doses of dexmedetomidine(DEX)combined with ropivacaine in postoperative analgesia of total knee arthroplasty(TKA).Methods Patients with TKA were enrolled as the research subjects and were divided into low-dose group,middle-dose group and high-dose group by the random number table method.At 10 min before induction of general anesthesia,all the groups were given 20 mL of 0.5％ropivacaine loading dose for ACB,placed nerve block indwelling catheter,and started ACB analgesia pump after the end of surgery.Low-dose group,middle-dose group and high-dose group were given 0.5,1.0 and 1.5 μg·kg-1 DEX+0.25％ropivacaine for a total of 100 mL,with a background dose of 4 mL·h-1and a control dose of 4 mL,and they locked for 30 min and continuously treated for 48 h.The surgical parameters and postoperative recovery quality of the two groups were compared.Visual analogue scale(VAS)was used to evaluate the pain status in resting state and motion state at 2,6,12,24 and 48 h after surgery.The number of effective compressions of self-controlled analgesia pump and the dosage of remedial analgesics at 48 h after surgery were counted and the safety evaluation was performed.Results No cases dropped out during treatment,and finally 30 cases were included in low-dose,middle-dose and high-dose groups,respectively.The first ambulation times in low-dose,middle-dose and high-dose groups were(54.22±8.37),(47.68±7.65)and(52.79±8.74)h;the time of active knee flexion 90° were(8.90±3.10),(7.20±2.70)and(8.60±2.40)d;the motion VAS scores were(3.86±0.59),(3.57±0.51)and(3.48±0.52)points at 48 h after surgery;the times of first analgesia pump compression within 48 h after surgery were(10.57±3.87),(12.45±3.63)and(13.36±3.56)h;the number of effective compressions of self-controlled analgesia pump were(6.11±2.18),(3.76±1.14)and(3.24±1.07)times;the remedial analgesia rates were 13.33％,0 and 0;at 6 h after surgery,quadriceps muscle strength scores were(4.81±0.21),(4.75±0.23)and(4.61±0.26)points,and the incidence rates of adverse drug reactions were 20.00％,6.67％and 6.67％,respectively.There were statistically significant differences in the above indicators between low-dose group and middle-dose group except for the incidence of adverse drug reactions(all P＜0.05).There were statistical differences between low-dose group and high-dose group except for the incidence of adverse drug reactions(all P＜0.05),but there were no statistical differences between middle-dose group and high-dose group(all P＞0.05).Conclusion The use of 1.0 μg·kg-1DEX combined with ropivacaine for ACB in TKA patients can achieve good postoperative analgesia effect and it has small impact on muscle strength and has good safety,thus this dose can be used as a clinical recommended dose.

Objective To explore the effects of Qingshen Granules(QSG)on adenine-induced renal fibrosis in mice and in uric acid(UA)-stimulated NRK-49F cells and its mechanism for regulating exosomes,miR-330-3p and CREBBP.Methods A mouse model of adenine-induced renal fibrosis were treated daily with QSG at 8.0 g·kg-1·d-1 via gavage for 12 weeks.An adeno-associated virus vector was injected into the tail vein,and renal tissues of the mice were collected for analyzing exosomal marker proteins CD9,Hsp70,and TSG101 and expressions of Col-Ⅲ,α-SMA,FN,and E-cad using Western blotting and immunofluorescence and for observing pathological changes using HE and Masson staining.In the cell experiment,NRK-49F cells were stimulated with uric acid(400 μmol/L)followed by treatment with QSG-medicated serum from SD rats,and the changes in expressions of the exosomal markers and Col-Ⅲ,α-SMA,FN,and E-cad were analyzed.Dual luciferase reporter assay was employed to examine the targeting relationship between miR-330-3p and CREBBP,whose expressions were detected by RT-qPCR and Western blotting in treated NRK-49F cells.Results The mouse models of adenine-induced renal fibrosis showed significantly increased levels of CD9,Hsp70,and TSG101,which were decreased by treatment with QSG.The expressions of Col-Ⅲ,α-SMA,and FN increased and E-cad decreased in the mouse models but these changes were reversed by QSG treatment.QSG treatment obviously alleviated renal fibrosis in the mouse models.Intravenous injection of adeno-associated viral vector obviously inhibited miR-330-3p,increased CREBBP levels,and reduced fibrosis in the mouse models.Dual luciferase assay confirmed CREBBP as a target of miR-330-3p,which was consistent with the results of the cell experiments.Conclusion QSG inhibits renal fibrosis in mice by regulating the exosomes,reducing miR-330-3p levels,and increasing CREBBP expression.

Objective To describe the current state of research and future research hotspots through a metrological analysis of the literature in the field of forensic anthropological remains identification re-search.Methods The data retrieved and extracted from the Web of Science Core Collection (WoSCC),the core database of the Web of Science information service platform (hereinafter referred to as "WoS"),was used to analyze the trends and topic changes in research on forensic identification of human re-mains from 1991 to 2022.Network visualisation of publication trends,countries (regions),institutions,authors and topics related to the identification of remains in forensic anthropology was analysed using python 3.9.2 and Gephi 0.10.Results A total of 873 papers written in English in the field of forensic anthropological remains identification research were obtained.The journal with the largest number of publications was Forensic Science International (164 articles).The country (region) with the largest number of published papers was China (90 articles).Katholieke Univ Leuven (Netherlands,21 articles) was the institution with the largest number of publications.Topic analysis revealed that the focus of forensic anthropological remains identification research was sex estimation and age estimation,and the most commonly studied remains were teeth.Conclusion The volume of publications in the field of forensic anthropological remains identification research has a distinct phasing.However,the scope of both international and domestic collaborations remains limited.Traditionally,human remains identifica-tion has primarily relied on key areas such as the pelvis,skull,and teeth.Looking ahead,future re-search will likely focus on the more accurate and efficient identification of multiple skeletal remains through the use of machine learning and deep learning techniques.

Objective To study the protective effect and possible mechanism of dexmedetomidine on sevoflurane-induced cognitive impairment.Methods 40 rats were randomly divided into a blank group,model group,dexmedetomidine group,and combination group,10 for each group.A rat model of sevoflurane-induced cognitive impairment was established in the model group,dexmedetomidine group,and combination group.The dexmedetomidine group and combination group were intraperitoneally injected with dexmedetomidine of 50 μg/kg 30 min before modeling,so was the combination group injected with sulindac of 5 mg/kg.The blank group and model group were intravenously injected with equal amount of saline.Morris water maze test was used to detect cognitive function.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum levels of homocysteine(Hcy)and monocyte chemoattractant protein-1(MCP-1);high-performance liquid chromatography was used to detect hippocampal glutamate(Glu)and γ-aminobutyric acid(GABA)contents.Immunoblotting was used to detect hippocampal glycogen synthase kinase 3β(GSK-3β)and β-catenin protein expression levels.Results The escape latency in the dexmedetomidine group rats was shorter than that in the model group(P<0.05),the number of crossing the original platform was greater than that in the model group(P<0.05),and duration staying in the original platform quadrant was longer than that in the model group(P<0.05).The escape latency in the combination group was longer than that in the dexmedetomidine group(P<0.05),the number of crossing the original platform was smaller than that in the dexmedetomidine group(P<0.05),and duration staying in the original platform quad-rant was shorter than that in the dexmedetomidine group(P<0.05).Serum levels of Hcy and MCP-1 were higher in the model group than in the blank group(P<0.05),lower in the dexmedetomidine group than in the model group(P<0.05),and higher in the combination group than in the dexmedetomidine group(P<0.05).Hippocam-pal Glu content was higher in the model group than in the blank group(P<0.05),while GABA content was lower(P<0.05).Hippocampal Glu content was lower in the dexmedetomidine group than in the model group(P<0.05),whereas GABA content was higher group(P<0.05).Hippocampal Glu content was higher in the combination group than in the dexmedetomidine group(P<0.05),and GABA content was lower(P<0.05).Hippocampal GSK-3β protein expression level was higher in the model group than in the blank group(P<0.05),but the β-catenin protein expression level was lower(P<0.05).Hippocampal GSK-3β protein expression level was lower in the dexmedetomidine group than in the model group(P<0.05),while β-catenin protein expression level was higher(P<0.05).Hippocampal GSK-3β protein expression level was higher in the combination group than in the dexme-detomidine group(P<0.05),whereas β-catenin protein expression level was lower(P<0.05).Conclusions Dexmedetomidine may improve cognitive function in rats with sevoflurane-induced cognitive impairment by activat-ing the Wnt/β-catenin signaling pathway,reducing inflammation,and enhancing neurotransmitter activity.

Objective To explore the effects of Qingshen Granules(QSG)on adenine-induced renal fibrosis in mice and in uric acid(UA)-stimulated NRK-49F cells and its mechanism for regulating exosomes,miR-330-3p and CREBBP.Methods A mouse model of adenine-induced renal fibrosis were treated daily with QSG at 8.0 g·kg-1·d-1 via gavage for 12 weeks.An adeno-associated virus vector was injected into the tail vein,and renal tissues of the mice were collected for analyzing exosomal marker proteins CD9,Hsp70,and TSG101 and expressions of Col-Ⅲ,α-SMA,FN,and E-cad using Western blotting and immunofluorescence and for observing pathological changes using HE and Masson staining.In the cell experiment,NRK-49F cells were stimulated with uric acid(400 μmol/L)followed by treatment with QSG-medicated serum from SD rats,and the changes in expressions of the exosomal markers and Col-Ⅲ,α-SMA,FN,and E-cad were analyzed.Dual luciferase reporter assay was employed to examine the targeting relationship between miR-330-3p and CREBBP,whose expressions were detected by RT-qPCR and Western blotting in treated NRK-49F cells.Results The mouse models of adenine-induced renal fibrosis showed significantly increased levels of CD9,Hsp70,and TSG101,which were decreased by treatment with QSG.The expressions of Col-Ⅲ,α-SMA,and FN increased and E-cad decreased in the mouse models but these changes were reversed by QSG treatment.QSG treatment obviously alleviated renal fibrosis in the mouse models.Intravenous injection of adeno-associated viral vector obviously inhibited miR-330-3p,increased CREBBP levels,and reduced fibrosis in the mouse models.Dual luciferase assay confirmed CREBBP as a target of miR-330-3p,which was consistent with the results of the cell experiments.Conclusion QSG inhibits renal fibrosis in mice by regulating the exosomes,reducing miR-330-3p levels,and increasing CREBBP expression.