ObjectiveTo investigate the effect of nicotinamide adenine dinucleotide on vascular endothelial injury in hypertension and its molecular mechanism. MethodsC57BL/6J mice were randomly divided into saline group （Saline） and hypertension group （Ang Ⅱ， which were infused with Ang Ⅱ via subcutaneously implanted osmotic pumps）， and supplemented daily with nicotinamide mononucleotide （300 mg/kg）， a precursor of NAD⁺. Blood pressure， endothelial relaxation function and pulse wave velocity were measured after 4 weeks. Wound healing assay and adhesion assay were used to evaluate the function of endothelial cells in vitro. mtROS levels were detected by immunofluorescence staining. RT-PCR was used to detect the mRNA expression of mtDNA， SIRT3 and isocitrate dehydrogenase 2 （IDH2）. 8-hydroxy-2'-deoxyguanosine levels were detected by enzyme-linked immunosorbent assay. The protein expression levels of p-eNOS， eNOS， SIRT3 and IDH2 were detected by Western blot. ResultsNMN supplementation reduced blood pressure （P<0.001） and improved endothelial function and arterial stiffness （P<0.001） in hypertensive mice. In vitro， NMN improved endothelial function in AngII-stimulated endothelial cells （P<0.05） and attenuated mitochondrial oxidative stress levels （P<0.001）. Mechanistically， NMN elevated SIRT3 activity （P<0.001）， which subsequently enhanced IDH activity （P<0.001） and reduced oxidative stress levels in endothelial cells. Conversely， knockdown of IDH2 would reverse the effect of SIRT3 in improving endothelial function （P<0.001）. ConclusionNAD⁺ lowers blood pressure and enhances vascular function in hypertension by reducing the level of oxidative stress in endothelial cells through activation of the SIRT3/IDH2 signal pathway.

ObjectiveTo unearth novel circRNA-miRNA-mRNA network and potential drugs in ischemic stroke. MethodsData from the GEO database were utilized， focusing on three datasets （GSE115697， GSE51586， and GSE137482） that examine RNA expression levels in middle cerebral artery occlusion （MCAO） mouse models. Differentially expressed mRNA （DEmRNA）， DEcircRNA， and DEmiRNA were identified using the Limma package in R. A comprehensive strategy combining bioinformatics tools such as MiRWalk and StarBase was employed to identify circRNA-miRNA-mRNA networks associated with ischemic stroke. Hub sub-networks were screened and visualized using Cytoscape software. Functional analyses of the ceRNA networks were performed using Gene Ontology （GO） enrichment and Kyoto Encyclopedia of Genes and Genomics （KEGG） pathway analysis， with pathways containing more than 10 enriched genes and an false discovery rate （FDR） ＜ 0.05 considered statistically significant. Lastly， the Connectivity Map （CMap） was applied to identify potential therapeutic drugs for ischemic stroke and the MCAO model was established in wild-type mice to verify the therapeutic effect. ResultsTotally， 1，249 DEmRNA， 294 DEmiRNA and 70 DEcircRNA were identified and it was found that 3 circRNA-miRNA-mRNA networks might be closely related to ischemic stroke. Based on these findings， Austricine， Metyrapone and Desoxypeganine were the most likely drugs that able to reverse the changes caused by stroke-related ceRNA networks. Metyrapone， taken as an example， was validated to improve neurological function damage on the first （P=0.001 4） and second （P=0.016 1） days post-surgery and reduce infarct volume （P=0.004 9）， thereby exerting a neuroprotective effect in ischemic stroke. ConclusionsOur study provides a novel insight into the pathogenesis and therapy of ischemic stroke from the perspective of circRNA-miRNA-mRNA regulatory network. The three drugs predicted in our research provide new clues for the treatment of ischemic stroke.

OBJECTIVE To promote the application of drones in emergency rescue and related fields， expand “low-altitude+ medical” rescue services， and advance the standardization of “low-altitude+medical” distribution services. METHODS The Consensus on Low-altitude Transport and Delivery Services for Emergency Medicines via Drones （2025 Edition） （hereinafter referred to as the Consensus） was jointly initiated by the Division of Therapeutic Drug Monitoring， Chinese Pharmacological Society and the Expert Committee on Precision Medication of the Guangdong Pharmaceutical Association. Guangzhou Red Cross Hospital served as the leading unit， organizing 53 multidisciplinary experts nationwide to participate in drafting and reviewing. A nominal group technique was employed to discuss and finalize the consensus outline， resulting in a preliminary draft. Delphi method was employed， and 11 external review experts were invited to conduct the evaluation. After the experts’ opinions were analyzed and integrated， the Consensus was finalized. RESULTS & CONCLUSIONS The finalized Consensus includes its purpose， principles， and applicable scenarios， basic requirements， and operational procedures for low-altitude transport and delivery of emergency medications； distribution requirements and precautions for controlled substances， fragile medications， and temperature-sensitive medications； and recommendations for emergency medications supplies suitable for the low-altitude transportation and distribution. The release of this Consensus is expected to provide guidance and support for the standardization of “low-altitude+medical” distribution services and the application of low-altitude economy in the healthcare sector.

Objective:To observe the clinical efficacy of neck Gongfa exercise in intervening people at high risk for cervical spondylosis. Methods:A total of 212 participants from 8 companies at high risk for cervical spondylosis were divided into two groups using the random number table method,with 105 participants in the control group receiving health education and 107 participants in the trial group receiving an additional neck Gongfa exercise.After successive 3-month interventions,the two groups were compared in terms of cervical soft tissue tension and neck disability index(NDI)score.The incidence of cervical spondylosis was observed 3 months later. Results:During the process,10 cases dropped out in the trial group,and the control group had 9 dropout cases.After the intervention,the cervical soft tissue tension value and NDI score improved in both groups(P<0.05)and showed significant differences between the two groups(P<0.05).At the 3-month follow-up,the trial group had a lower incidence rate of cervical spondylosis than the control group(P<0.05). Conclusion:For people at high risk for cervical spondylosis,neck Gongfa exercise can effectively improve cervical soft tissue tension and motor dysfunction and lower the incidence of cervical spondylosis in the short run.

Objective:To explore the value of cardiac MRI (CMRI) in evaluating left atrial function in patients with postoperative tetralogy of Fallot (rTOF) and postoperative pulmonary stenosis (rPS).Methods:Totally 67 pediatric patients (49 with rTOF, 18 with rPS) with preserved left ventricular ejection fraction (EF) were recruited between January 2019 and October 2021 in Shanghai Children′s Medical Center, School of Medicine, Shanghai Jiao Tong University. Thirty-three healthy volunteers, matched in gender and age, were included as controls from July 2017 to August 2018. Left atrial EF, strain and strain rate of three phases (reservoir, conduit and pump), left atrial volume (maximum volume index, minimum volume index and pre-atrial contraction volume index) were measured with corresponding cardiac function analysis software. Then, the differences in these parameters were analyzed between the three groups by ANOVA or Kruskal-Wallis test with post hoc comparison and Bonferroni correction.Results:Compared with controls, patients with rTOF had lower reservoir function parameters (EF, strain and strain rate), conduit EF, conduit strain, and left atrial maximum volume index ( P<0.05), but higher pump EF ( P<0.05). In patients with rPS, only the reservoir strain rate decreased compared with controls ( P<0.05), and the remaining data showed no significant difference ( P>0.05). The reservoir and conduit EF and strain in patients with rPS were higher than those in patients with rTOF ( P<0.05). Conclusions:In patients with rTOF and rPS, left atrial function has changed despite the preservation of left ventricular EF, which may be an early marker of left ventricular diastolic dysfunction. In children with rTOF, left atrial reservoir and conduit functions decreased while the pump function increased. The reservoir and pump functions in rPS were better than those in rTOF. In addition, CMRI can detect left atrial dysfunction early before it enlarged.

In order to accurately master and understand the national occupational health standard Diagnosis for Occupational Radiation Thyroid Disease(GBZ 101-2020), the significance of the publication of this standard, the relevant background, the basic principles of the revision, the main basis for technical content revision, and the application of the standard are described. To provide guidance for t the physcians for occupational disease diagnosiss to understand the diagnostic principles, make correct diagnosis and avoid confusion in using the standard, so as to better protect the occupational health rights of radiation workers.

Objective:To analyze the research status, hotspots, and frontiers of kinesiophobia nursing both domestically and internationally, so as to provide reference for domestic research.Methods:Articles on kinesiophobia nursing published from January 1, 2002 to March 18, 2023 were searched on Chinese databases such as China National Knowledge Infrastructure, WanFang Data and VIP, as well as English databases such as Web of Science and Scopus. CiteSpace 6.2.R1 software was used to analyze authors, institutional collaboration networks, and keyword co-occurrence networks included in the article, and to draw visual graphs.Results:A total of 669 articles were included, and the number of publications increased year by year. Research hotspots mainly focused on fear avoidance beliefs, influencing factors, intervention methods and quality of life. The forefront of research mainly focused on the study of kinesiophobia among different populations, as well as the exploration of nursing theories and models.Conclusions:There are certain differences in research on kinesiophobia nursing both domestically and internationally. It is recommended that Chinese nursing researchers optimize risk assessment in this field, develop assessment scales, explore the effectiveness of different intervention methods, continue to promote the development of different nursing theories and models, enrich research on kinesiophobia, and improve patients' quality of life.

Objective: To investigate the effect of a metal occlusal surface and stress interruption design on minimally invasive prosthodontics for patients with distal extension absence and insufficient occlusal gingival distance. Methods : We retrospectively studied the case of minimally invasive prosthodontic (Vitallium 2000) combined with a metal occlusal surface for distal extension absence in a patient with insufficient occlusal gingival distance; the stress breaking design and pressure impression technology are examined, and relevant articles are reviewd. Results: The design effectively solves the problems of insufficient occlusal gingival distance, large occlusal force and easy denture fracture. Reviewing the relevant literature, stress interruption design can effectively protect abutment teeth, but the behavior of stress interruption design and stress conduction phenomena in the mouths of patients has not been reported. The T-scan test results of this study showed that before and after wearing the denture, the occlusal force distribution ratio of the patient changed from 77.5% on the left and 22.5% on the right to 61.3% on the left and 38.7% on the right. The occlusal force distribution ratio of the right dentition to the total occlusal force increased by 16.2%, and the occlusal force became better distributed. Further analysis showed that the occlusal forces on the left and right sides were nearly the same in the initial occlusion stage. As the occlusal force was further increased, the proportion of the occlusal force on the right side decreased in the middle of the occlusion stage and further decreased in the final occlusion stage until it reached a dynamic balance. The above T-scan test and literature review results suggest that this dynamic balance phenomenon of bite force is related to the stress interruption design and the stress conduction effect of the split framework. Conclusion The composite of stress interruption design and metal occlusal surface allows for minimally invasive prosthodontics for the treatment of distal extension absence in patients with insufficient occlusal gingival distance.

Objective:To investigate the value of whole-heart and volume-targeted balanced steady-state free precession(bSSFP) in the evaluation of coronary artery in children.Methods:Children with congenital heart disease and Kawasaki disease who underwent cardiac magnetic resonance imaging were retrospectively collected from January 2014 to December 2015, 197 cases(male: female 124∶73) were included according to the inclusion and exclusion criteria in this study. There were 189 cases of congenital heart disease and 8 Kawasaki disease, in which 23 cases had abnormal coronal arteries. Image quality of the coronary artery segments, the coronary artery origin and course, and coronary artery dimension in dual phase 3D bSSFP were analyzed. Chi-square test was used to evaluation the degree of accuracy and difference of coronal artery segments. T test was used to compare the diameter of left with right coronal artery in end systolic phase and mid to end diastolic phase.Results:Image quality was better in systolic phase than diastolic phase(3.9±0.5 and 3.5±0.7 respectively, P<0.001) for all cases. Combining the dual phases, the sensitivity, specificity and accuracy of dual phase 3D whole heart imaging in evaluating the coronal artery origin, course and shape was 100%. However, there was a little difference in revealing left anterior descending coronary artery, left circumflex artery and right coronary artery. There was significant difference in the clearly revealing the left anterior descending coronary artery and left circumflex artery( P<0.001). The left and right coronary artery dimension was larger in systolic phase than in mid-diastolic phase(left coronary artery 3.1±1.3 mm and 2.8±1.3 mm, respectively, right coronary artery(2.5±0.9) and(2.3±0.7)mm, respectively, P<0.001). Conclusion:Cardiac MR 3D bSSFP can retrospectively select coronary resting periods for optimal images, providing a more reliable imaging modality for the assessment of coronary arteries in children to make better clinical decision.

Objective:To analyze the clinical manifestations and duration of feeding intolerance (FI) in very low birth weight infants (VLBWI), explore the influencing factors of FI, so as to provide scientific basis for shortening the FI duration of VLBWI.Methods:From January 2018 to December 2020, 441 VLBWIs admitted to the Neonatal Intensive Care Unit of the Shandong Provincial Hospital Affiliated to Shandong First Medical University were selected as the research object by the convenient samplingto describe the clinical characteristics and duration of FI in children. Multivariate Logistic regression was used to analyze the influencing factors of FI duration of VLBWI. Totally 354 VLBWIs were included, excluding 41 children transferred from other hospitals 24 hours after birth, 10 children died before full gastrointestinal feeding, 4 children with stageⅡ or above neonatal necrotizing enterocolitis, 1 child with congenital gastrointestinal malformation, and 31 cases with incomplete data.Results:The incidence of FI in 354 VLBWI was 71.5% (253/354), and the average duration was 9 days. Multivariate Logistic regression analysis showed that the long time of invasive positive pressure ventilation [ OR=1.081, 95% CI (1.034, 1.130) ], formula feeding [ OR=1.751, 95% CI (1.009, 3.040) ] and hypertension during pregnancy [ OR=1.876, 95% CI (1.073, 3.279) ] were the risk factors for FI duration ( P<0.05), andbirth weight [ OR=0.355, 95% CI (0.185, 0.683) ]was the influencing factor of FI duration ( P=0.002) . Conclusions:The incidence of FI in VLBWI is high and the duration is long. Small gestational age and low weight premature infants are the high-risk groups of FI. In order to shorten the FI duration of VLBWI, medical and nursing staff should manage the blood pressure of pregnant women during pregnancy, strengthen the nursing of children during mechanical ventilation, withdraw the machine as soon as possible, and promote breastfeeding.