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The standardized training of general practitioners is the key to cultivate qualified general practitioners. Endocrine metabolic disease is an emerging discipline. Improving the clinical teaching quality of standardized training of general practitioners in the field of endocrine metabolic diseases is worthy of attention. In this paper, though analyzing teaching requirements and objectives,and based on our experience in clinical teaching practice, it summarized the problema in training of general practitioners in the field of endocrine metabolic diseases, such as the teaching content method, the teachers level, and student's own questions. Then, it puts forward countermeasures to improve and advance the training quality.

Background: Delirium is one of the most common problems in intensive care units (ICU), and it has a detrimental influence on the patients' health. Estimating the prevalence of delirium in ICU patients and understanding the risk factors for delirium are crucial tasks. Aim: To offer empirical support for early detection of the risk of delirium in ICU patients, we conducted a systematic review and meta‐analysis to analyse the incidence, prevalence and risk factors of delirium in ICU patients. Study Design: From inception to 19th December 2021, PubMed, Embase, Cochrane Library, Web of Science, China Knowledge Resource Integrated Database (CNKI), Wanfang Database, Chinese Biomedical Database (CBM) and Weipu Database (VIP) were searched for inclusion to the study. The quality of the included studies was assessed by two investigators independently. The outcomes of the meta‐analysis, which was conducted using the Stata 12.0 software, were reported using odds ratios (OR) and 95 percent confidence intervals (CI). Heterogeneity was determined using the I2 statistic. Results: In this meta‐analysis, 51 studies with a total of 39 076 patients were evaluated. The incidence and prevalence of delirium in ICU patients were 31 per 1000 and 33%, respectively. A total of 28 risk factors were identified. Of these 28 risk factors, the top five modifiable risk factors were pain (OR = 19.74, 95% CI [8.86–30.61]), use of physical restraints (OR = 15.46, 95% CI [3.68–27.25]), respiratory diseases (OR = 14.3, 95% CaI [8.42–20.19]), sleep deprivation (OR = 9.4, 95% CI [6.8–12.1]) and surgery (OR = 8.98, 95% CI [7–15.27]). Non‐modifiable risk factors included age (OR = 1.06, 95% CI[1.04, 1.07]) and gender (OR = 1.45, 95% CI[1.13, 1.77]). Of these 51 studies included in this analysis, 30 studies were shown with a low risk of bias while 21 studies were shown with a moderate risk of bias. Our results also demonstrated that 21 studies and 30 studies with intermediate methodological quality and low methodological quality respectively. Conclusion: Delirium was shown to be prevalent among ICU patients. There are 28 risk factors for delirium that we discovered. These risk factors can assist physicians, nurses and other health care professionals prevent delirium in ICU patients. Relevance to practice: Delirium in ICU patients can potentially be prevented through appropriate prevention strategies by intensive care staff. [ABSTRACT FROM AUTHOR]

Recently, gestational diabetes mellitus (GDM) exhibits an obvious trend of increase in pregnant mothers and usually causes several abnormities or diseases for the offspring. Although several studies have been reported for potential molecular mechanisms, relevant genes or mutated sites have not been intensively investigated in China. In the present study, 218 pregnant mothers (GDM group: 103 individuals and control group: 115 individuals) in China were enrolled to conduct genome-wide association study (GWAS) and pathway analyses for the purpose of related genes associated with GDM in China. Our results identified 23 SNPs exhibiting closely association with GDM using multiple tests. Annotation of these 23 SNPs identified four genes (SYNPR, CDH18, CTIF, and PTGIS), which suggests that the four genes may associate with GDM. GO enrichment and KEGG pathway analysis showed that gene SYNPR, CDH18, and PTGIS were enriched or located into the pathways or process associated with glycometabolism (e.g. insulin resistance and glucose tolerance), which further indicates that the three genes may associate with the GDM. The identification of these potential genes associating with GDM enriched the potential molecular mechanisms of GDM in Asia and will provide abundant stocks for subsequent clinical verifications for better understanding the molecular mechanisms, diagnosis, drug development and clinical treatment of GDM. [ABSTRACT FROM AUTHOR]

Theoretical investigations are performed on mechanism and kinetics of the reactions of ethyl radical C2H5 with NCO radical. The electronic structure information of the PES is obtained at the B3LYP/6-311++G(d,p) level of theory, and the single-point energies are refined by the CCSD(T)/6-311+G(3df,2p) level of theory. The rate constants for various product channels of the reaction in the temperature range of 200-2000K are predicted by performing VTST and RRKM calculations. The calculated results show that both the N and O atoms of the NCO radical can attack the C atom of C2H5 via a barrierless addition mechanism to form two energy-rich intermediates IM1 C2H5NCO(89.1 kcal/mol) and IM2 C2H5OCN(64.7 kcal/mol) on the singlet PES. Then they both dissociate to produce bimolecular products P1 C2H4 + HOCN and P2 C2H4 + HNCO. At high temperatures or low pressures, the reaction channel leading to bimolecular product P2 is dominant and the channel leading to P1 is the secondary, while, at low temperatures and high pressures, the collisional stabilization of the intermediate plays an important role and as a result IM2 becomes the primary product. The present results will enrich our understanding of the chemistry of the NCO radical in combustion processes. [ABSTRACT FROM AUTHOR]

Bovine aortic endothelial cells (BAECs) were cultured with high glucose (33 mmol/L), 4 mg/L green tea polyphenols (GTPs) or 4 mg/L GTPs co-treatment with high glucose for 24 h in the presence or absence of Bafilomycin-A1 (BAF). We observed that high glucose increased the accumulation of LC3-II. Treatment with BAF did not further increase the accumulation of LC3-II. Results also showed an increased level of p62 and decreased Beclin-1. However, GTPs showed inversed trends of those proteins. Furthermore, GTPs co-treatment with high glucose decreased the level of LC3-II and a much higher accumulation of LC3-II was observed in the presence of BAF in comparison with high glucose alone. Results also showed a decreased p62 and increased Beclin-1. The results demonstrated that GTPs alleviated autophagy inhibition induced by high glucose, which may be involved in the endothelial protective effects of green tea against hyperglycemia. [ABSTRACT FROM AUTHOR]

The authors report a case of primary aldosteronism (PA) with postoperative elevation of aldosterone treated effectively by finerenone. The patient was a hypertensive man with a 30‐year history of hypertension and sustained an acute myocardial infarction 5 years ago. Bilateral adrenal nodules with hyperplasia were detected and PA was confirmed. His blood potassium, direct renin concentration, and aldosterone level returned to normal after surgery of right adrenalectomy. However, 1 year after surgery, he experienced a decrease in blood potassium and an increase in aldosterone. A saline infusion test revealed an aldosterone level of 124.47 pg/mL. The patient consented to treatment with finerenone. His aldosterone and potassium levels and blood pressure have been controlled well during follow‐up. This case highlights the need to screen for secondary hypertension as early as possible. Finerenone may be effective for patients with PA who are not candidates for surgery and those not relieved after surgery. [ABSTRACT FROM AUTHOR]

The mechanism and kinetics for the reaction of the HO2 radical with the ethyl (C2H5) radical have been investigated theoretically. The electronic structure information of the potential energy surface (PES) is obtained at the MP2/6-311++G(d,p) level of theory, and the single-point energies are refined by the CCSD(T)/6-311+G(3df,2p) level of theory. The kinetics of the reaction with multiple channels have been studied by applying variational transition-state theory (VTST) and Rice–Ramsperger–Kassel–Marcus (RRKM) theory over wide temperature and pressure ranges (T = 220–3000 K; P = 1 × 10−4–100 bar). The calculated results show that the HO2 radical can attack C2H5 via a barrierless addition mechanism to form the energy-rich intermediate IM1 C2H5OOH (68.7 kcal/mol) on the singlet PES. The collisional stabilization intermediate IM1 is the predominant product of the reaction at high pressures and low temperatures, while the bimolecular product P1 C2H5O + OH becomes the primary product at lower pressures or higher temperatures. At the experimentally measured temperature 293 K and in the whole pressure range, the reaction yields P1 as major product, which is in good agreement with experiment results, and the branching ratios are predicted to change from 0.96 at 1 × 10−4 bar to 0.66 at 100 bar. Moreover, the direct H-abstraction product P16 C2H6 + 3O2 on the triplet PES is the secondary feasible product with a yield of 0.04 at the collisional limit of 293 K. The present results will be useful to gain deeper insight into the understanding of the kinetics of the C2H5 + HO2 reaction under atmospheric and practical combustion conditions. [ABSTRACT FROM AUTHOR]

Background: The obesity rate of adolescents is gradually increasing, which seriously affects their mental health, and sleep plays an important role in adolescent obesity., Aim: To investigate the relationship between sleep rhythm and obesity among adolescents and further explores the interactive effect of sleep rhythm and gender on adolescent obesity, providing a theoretical basis for developing interventions for adolescent obesity., Methods: Research data source Tianjin Mental Health Promotion Program for Students. From April to June 2022, this study selected 14201 students from 13 middle schools in a certain district of Tianjin as the research subject using the convenient cluster sampling method. Among these students, 13374 accepted and completed the survey, with an effective rate of 94.2%.The demographic data and basic information of adolescents, such as height and weight, were collected through a general situation questionnaire. The sleep rhythm of adolescents was evaluated using the reduced version of the morningness-eveningness questionnaire., Results: A total of 13374 participants (6629 females, accounting for 49.56%; the average age is 15.21 ± 1.433 years) were analyzed. Among them, the survey showed that 2942 adolescent were obesity, accounting for 22% and 2104 adolescent were overweight, accounting for 15.7%. Among them, 1692 male adolescents are obese, with an obesity rate of 25.1%, higher than 18.9% of female adolescents. There is a statistically significant difference between the three groups ( χ 2 = 231.522, P < 0.000). The obesity group has the smallest age (14.94 ± 1.442 years), and there is a statistical difference in age among the three groups ( F = 69.996, P < 0.000).Obesity rates are higher among individuals who are not-only-child, have residential experience within six months, have family economic poverty, and have evening-type sleep ( P < 0.05). Logistic regression analysis shows a correlation between sleep rhythm and adolescent obesity. Evening-type sleep rhythm can increase the risk of obesity in male adolescents [1.250 (1.067-1.468)], but the effect on female obesity is not remarkable. Further logistic regression analysis in the overall population demonstrates that the interaction between evening-type sleep rhythm and the male gender poses a risk of adolescent obesity [1.122 (1.043-1.208)]., Conclusion: Among adolescents, t he incidence of obesity in males is higher than in females. Evening-type sleep rhythm plays an important role in male obesity but has no significant effect on female obesity. Progressive analysis suggests an interactive effect of sleep rhythm and gender on adolescent obesity, and the combination of evening-type sleep and the male gender promotes the development of adolescent obesity. In formulating precautions against adolescent obesity, obesity in male adolescents with evening-type sleep should be a critical concern., Competing Interests: Conflict-of-interest statement: No conflict-of-interest statement., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Objective: To study the effects of Synaptotagmin1 gene knockout (Syt1 +/- ) on emotional behavior in mice and explore its possible mechanisms. Methods: Five 8-week-old male Syt1 +/- mice and five wild-type (WT) mice in the same litter were selected. The expressions of Syt1 in 6 mice brain regions of prelimbic cortex (PL), hippocampus (HIP), amygdala (AMY), accumbens nucleus (ACB), caudoputamen (CP) and ventral tegmental area (VTA) were detected by Immunofluorescence staining. Nine 8-week-old male Syt1 +/- mice and ten WT mice were selected as controls. The anxiety-like behaviors of adult Syt1 +/- mice and WT mice were detected by open field test, elevated plus maze test and forced swim test. In addition, five 8-week-old male Syt1 +/- mice and five WT mice were selected to detect the glutamate content in prelimbic cortex, hippocampus and amygdala. Results: Compared with WT mice, the number of Syt1 positive cells in PL, HIP, AMY, ACB, CP and VTA were decreased significantly in Syt1 +/- mice ( P ＜0.01); Syt1 +/- mice had less total movement distance in open field test ( P ＜0.01), more preference for peripheral area ( P ＜0.01) and less desire to explore the central platform ( P ＜0.01), while Syt1 +/- mice preferred to stay in a closed and safe environment ( P ＜0.01); the number ( P ＜0.05) and the time spent in open-arm explorations ( P ＜0.01) were reduced significantly; the immobile time of Syt1 +/- mice was increased in the forced swim test ( P ＜0.01). Meanwhile, the concentration of glutamate in the amygdala of Syt1 +/- mice was increased significantly ( P ＜0.01). Conclusion: Syt1 gene knockout leads to significant anxiety-like behavior in mice, which is deduced that related to the increase of glutamate content in the amygdala.

Aim: To explore the protective effect of bone marrow mesenchymal stem cells (BM MSCs) in the small intestinal mucosal barrier following heterotopic intestinal transplantation (HIT) in a rat model., Methods: BM MSCs were isolated from male Lewis rats by density gradient centrifugation, cultured, and analyzed by flow cytometry. The HIT models were divided into a non-rejection group, saline-treated rejection group (via penile vein), and BM MSC-treated group (via penile vein). Intestinal mucosal barrier injury was estimated by diamine oxidase (DAO) and D-lactic acid (D-LA) expression levels. Tumor necrosis factor-α (TNF-α), interferon-γ (INF-γ), interleukin-10 (IL-10), and transforming growth factor-β (TGF-β) were detected by enzyme-linked immunosorbent assay. Ultrastructural change of tight junctions (TJs) was observed under transmission electron microscope. Expression levels of the TJ proteins occludin and zona occludens (ZO)-1, affected by the inflammatory factors, were measured using real-time polymerase chain reaction and Western blotting., Results: The pathological score at each time point after surgery indicated significantly less serious injury in the BM MSCs-treated group than in the rejection group (P < 0.05). In the former, graft levels of DAO and D-LA were reduced, and TNF-α and INF-γ production was inhibited (at day 7: 10.6473 ± 0.0710 vs 17.2128 ± 0.4991, P < 0.05; 545.1506 ± 31.9416 vs 810.2637 ± 25.1175, P < 0.05). IL-10 and TGF-β production was increased greatly (at day 7: 125.7773 ± 4.7719 vs 80.3756 ± 2.5866, P < 0.05; 234.5273 ± 9.3980 vs 545.1506 ± 31.9416, P < 0.05). There was increased expression of occludin and ZO-1 protein (at day 7: 0.2674 ± 0.0128 vs 0.1352 ± 0.0142, P < 0.05; at day 5: 0.7189 ± 0.0289 vs 0.4556 ± 0.0242, P < 0.05) and mRNA (at day 7: 0.3860 ± 0.0254 vs 0.1673 ± 0.0369, P < 0.05; at day 5: 0.5727 ± 0.0419 vs 0.3598 ± 0.0242, P < 0.05)., Conclusion: BM MSCs can improve intestinal barrier permeability, repair TJs, and increase occludin and ZO-1 protein expression. With altered cytokine levels, they can protect the intestinal mucosa after transplantation.

In the present paper, studies on in-situ Raman spectra at high pressure up to 12.85 Gpa were performed on beta-carotene using a diamond anvil cell (DAC), and the effects of pressure on the characteristic peaks and pi-electron delocalization of beta-carotene were discussed. The results showed that Raman frequencies of the main characteristic peaks of beta-carotene shifted to high wavenumber with the increase in pressure. The relation between pressure and the three main characteristic peaks of beta-carotene was given as follows: nu1, (C==C) = 4. 74P + 1511.4, w (C-C) = 2.55P + 157.6 and nu3 (CH3) = 2.25P + 1011.3. Under the pressure of 5.38 GPa, Raman spectrum of nu1 + nu2 sum frequency of beta-carotene was subjected to cleavage. Fuethermore, the degree of relectron decolization was reduced with the increase in pressure, leading to C==C double bond more compressible than C-C bond on the main chain of beta-carotene.

In the present paper, DMSO/H2O mixture with the ratio of volume 1:1 was measured in the cooling process by Raman spectroscopy, and the Raman assignments was made to the DMSO molecular and water molecular. The results showed that the behavior between intra-molecular hydrogen bonds and inter-molecular hydrogen bonds of DMSO and water leads to the change in the Raman spectra of the S==O stretching vibration of DMSO and the O--H stretching vibration of water. Further analysis showed that the hydrogen bond between DMSO and water was enhanced in the course of temperature decreasing process (27 to -30 degrees C), and the intramolecular hydrogen bonds between water and water replaced the intermolecular hydrogen bonds of DMSO and water in the course of temperature decreasing process (-30 to -60 degrees C). The research provides experimental basis for hydrogen bonding theory in aqueous solution.