Objective To evaluate the clinical effect of regulating expiratory airway pressure of noninvasive ventilation(NIV)to treat overlap syndrome(OS)with respiratory failure by pressure titration in monitor during sleep.Method Individuals who met the following criteria were selected for the study:(1)OS with respiratory failure confiemed by polysomnogram(PSC)and pulmonary function tests;(2)ability to tolerate PSG tests all night;(3)lucid consciousness and spontaneous breathing upon awaken and(4)ability to tolerate NIV.The criteria of exclusion were:(1)frequent expectoration of blood or hemoptysis;(2)spontaneous pneumothorax;(3)severe prosopo-trauma or facial ulcer and(4)large amount of secretion in the airway.From August 2005 to Decentber 2008,27 patients were selected with two patients excluded.The remaining 25 patients treated with noninvasive bi-level positive airway pressure(BiPAP)were randomly assigned to titration group or control group.During sleep,the patients of titration group were put under the optimal expiratory airway pressure[EPAP,(8.8 ± 0.5)cmH2O]which was got from titration by AutoCPAP ventilator and the EPAP decreased immediately to 5 cmH2O when the patients wake up next day.In the patients of control group,the EPAP was maintained at 5 cm H2O round the clock.The degree of apnoea and the hypopnea index(AHI),the results of arterial blood gas analysis(pH,PaO2,PaCO2)in the morning,the lowest pulse oxygen saturation(SPO2LOW)and the arterial blood gas level at 10 am before and after ventilation,duration of taking off ventilator at night,complications of NIV,incidence of air leakage and invasive ventilation after NIV were comparatively analyzed between the two groups.Results Compared with the control group,the titration group showed a notably increase in the value of SPO2LOW[(25.9± 11.3)%vs.(14.9±8.4)%;P＜0.05].The PaO2 level was significantly higher in the titration group(29.4±4.4)mmHg than that in the control group(22.6 ± 2.1)mmHg(P＜0.0001);however,the PaCO2 level in the titration group(16.8 ±7.3)mmHg was not significant different from that in the control group(20.0±6.3)mmHg(P＞0.05).The PaO2 level at 10am in the titration group(28.9 ± 6.7)mmHg was not significant different from that in the control group(31.3 ± 7.7)mmHg(P＞0.05);however,the PaCO2 level in the titration group(23.3 ±5.7)mmHg was higher than that in the control group(18.2 ±5.0)mmHg(P＜0.05).Conclusions Regulating EPAP of NIV to treat overlap syndrome with respiratory failure by pressure titration in monitor during sleep was more effective at improving hypoxemia and carbon dioxide retention than traditional methods without adjusting the EPAP to the optimal level.The optimal didn't increase carbon dioxide retention at night,confirming that the method was safe.

Objective: To explore the associated factors in the implementation of the "random" sampling inspection of the lighting institutions in kindergartens, outofschool training institutions and primary and secondary schools in 2019 (Supervision Letter [2019] No. 314 of National Health Office) (hereinafter referred to as the "Plan"), and to provide reference for better implementation of the Plan. Methods: A survey of schoolbased myopia prevention and control was conducted in 23 provincial, municipal and countylevel health supervision institutions in China. The main contents of the survey focused on the introduction, implementation and implementation of the program. Results: The implementation of the "plan" was significantly associated with the specific work organized and coordinated by the health administrative department, clear responsibility of various departments, and collaboration with educational institutions[OR(95%CI)=1.57(1.05-2.36), 0.05(0.03-0.10), 0.31(0.19-0.52), 0.03(0.01-0.09), 0.12(0.04-0.37), P<0.05]. It was also associated with independent school health supervision department, one and two fulltime school health supervision staff equipment, onsite quick inspection of health supervision institutions, school selfexamination[OR=1.87(1.33-2.62), 0.62(0.40-0.97), 2.37(1.82-3.09), 1.62(1.09-2.40), P<0.05]. Conclusion The program needs to be implemented through multiple departments and is associated with multiple factors. It is of great importance to strengthen multisector collaboration and clarify the responsibility of various departments for the health supervision of schoolbased myopia prevention and control.

Objective: To understand the Implementation of Comprehensive Evaluation of School Health (GB/T 18205-2012) and associated factors, so as to provide rationalization proposals for future revision of standards. Methods: A questionnaire survey was conducted on 436 schools, 56 health supervision agencies and 55 disease control agencies in Liaoning Province, and the main contents include the investigation of awareness rate, training, application, rationality and application of evaluation items and indicators. Results: Totally 44 supervision agencies and 29 CDCs had independent school health departments, with significant differences in faculty equipment ( t =8.53， P <0.05). The standard was trained in 100% of municipal supervision agencies, 22.50% of district and county level, 46.15% of municipal CDC ,50.00% of district county CDC; 61.54% of municipal and 45.00% of district and county supervision agencies conducted evaluations in accordance with this standard, 53.85% of the municipal CDC, 60.00% of county CDC jointly completed the standard; 30.77% of municipal and 52.50% of district and county supervisory bodies informed the educational administration of the results of the comprehensive evaluation. Conclusion The establishment of school health professional departments and the training of management objects affect the implementation of comprehensive evaluation of school health, so it is necessary to combine the actual work to modify some of the important indicators, and strengthen the application of comprehensive evaluation results.

OBJECTIVE: To explore the therapeutic mechanism of Liushen Wan (LSW) against colitis-associated colorectal cancer (CAC) by network pharmacology. METHODS: TCMSP, BATMAN-TCM, CNKI, PubMed, Genecards, OMIM, and TTD databases were used to obtain the related targets of LSW and CAC. The common targets of LSW and CAC were obtained using Venny online website. The PPI network was constructed using Cytoscape 3.8.2 to screen the core targets of LSW in the treatment of CAC. GO and KEGG enrichment analysis were conducted using DAVID database. The therapeutic effect of LSW on CAC was evaluated in a C57BL/6J mouse model of AOM/DSS-induced CAC by observing the changes in body weight, disease activity index, colon length, and size and number of the tumor. HE staining and RT-qPCR were used to analyze the effect of LSW on inflammatory mediators. Immunohistochemistry and TUNEL staining were used to evaluate the effect of LSW on the proliferation and apoptosis of AOM/DSS-treated colon tumor cells. Immunohistochemistry and Western blotting were used to detect the effects of LSW on the expression of TLR4 proteins in CAC mice. RESULTS: Network pharmacology analysis identified 69 common targets of LSW and CAC, and 33 hub targets were screened in the PPI network. KEGG pathway enrichment analysis suggested that the effect of LSW on CAC was mediated by the Toll-like receptor signaling pathway. In the mouse model of AOM/DSS-induced CAC, LSW significantly inhibited colitis-associated tumorigenesis, reduced tumor number and tumor load (P < 0.05), obviously improved histopathological changes in the colon, downregulated the mRNA levels of proinflammatory cytokines, and inhibited the proliferation (P < 0.01) and promoted apoptosis of colon tumor cells (P < 0.001). LSW also significantly decreased TLR4 protein expression in the colon tissue (P < 0.05). CONCLUSION LSW can inhibit CAC in mice possibly by regulating the expression of TLR4 to reduce intestinal inflammation, inhibit colon tumor cell proliferation and promote their apoptosis.
Mice ; Animals ; Toll-Like Receptor 4 ; Colitis-Associated Neoplasms ; Network Pharmacology ; Mice, Inbred C57BL ; Colonic Neoplasms/pathology*

Objective To analyze the prevalence and genetic characteristics of influenza A(H3N2) viruses in the city of Xiangyang in 2022-2023, and to provide a scientific basis for predicting the epidemic and mutation of influenza virus. Methods Throat swab specimens of the influenza like cases were collected from national influenza monitoring sentinel hospitals in Xiangyang every week. RNA was extracted from the specimens for influenza diagnosing using real-time RT-PCR．Viruses were isolated from H3N2 positive specimens, and HA and NA genes were amplified and sequenced．3D modeling analyses were conducted. Results The gene phylogenetic tree showed that the H3N2 isolates in 2022-2023 belonged to 3C.2a1b.2a1 and 3C.2a1b.2a2 branches, respectively. The A(H3N2) influenza virus strains all had amino acid point mutation sites on important antigenic determinants of HA protein. The epitope mutations of the 2022 A(H3N2) strain mainly occurred in regions B, C, and D. The epitope mutations of the A(H3N2) strain in 2023 mainly occurred in regions C and D. Different glycosylation sites of HA gene were found in 2022-2023 strains. No variation was found in key amino acid sites associated with neuraminidase inhibitor resistance. The difference of overall structure was not obvious in the three-dimensional simulation structure diagram. Conclusion The A(H3N2) influenza strains isolated in this study have shown antigenic drift, especially the mutation of HA, which may affect the protective effect of the vaccine on the local population and lead to influenza epidemic. The variations of HA and NA suggest that close attention should be paid to the epidemic and genetic variation of H3N2 subtype influenza virus, to provide a scientific basis for the selection of influenza virus vaccine strains and the prevention and control of influenza.