Objective: To analyze the characteristics of school injury among students aged 3 to 18 years in Yantian District of Shenzhen City, Guangdong Province, so as to provide the reference for developing the strategies for prevention and control of school injury. Methods: Data of the students aged 3 to 18 years who were initially diagnosed as injury in sentinel hospitals and whose injuries occurred in nurseries, primary or middle schools in Yantian District in 2023, were collected from the Shenzhen Injury Surveillance System. The onset time, places, activities, characteristics and sites of injury were descriptively analyzed. Results: A total of 1 681 cases of school injuries among students aged 3 to 18 years were reported in Yantian District in 2023, including 1 182 boys and 499 girls, with a boy-to-girl ratio of 2.37∶1. There were 206 preschool children (12.25%), 856 primary school students (50.92%), 358 junior high school students (21.30%) and 261 high school students (15.53%). The peak months for school injuries were February to June, accounting for 49.97%; the peak time period was from 15: 00 to 18: 59, accounting for 44.68%. The main causes of injuries included falls (41.94%) and blunt injury (33.85%). The activities at the time of injury mainly included leisure activities (57.70%) and physical activities (21.83%). Contusion/abrasion was the main characteristics (49.20%). Mild injury was predominant, accounting for 74.60%, and there was no fatal case. The top three injury sites were the head and neck, upper limbs and lower limbs, accounting for 36.94%, 27.54%, and 24.33%, respectively. Boys had higher proportions of blunt injuries and contusion/abrasion (AR=4.8 and 4.0). The proportion of sports injuries, sprains/strains and lower limb injuries increased with grade (all P<0.05). Conclusions School injury among students predominantly occur in spring when having leisure or physical activities in Yantian District. The main causes of injuries are falls and blunt injury, with boys and primary school students being the high-risk groups.

Objective To investigate the expression of hypoxia-inducible factor-1α (HIF-1α) in patients with traumatic brain injury (TBI) and their clinical significance. Methods Peripheral blood and brain tissue samples were obtained from 60 TBI patients. According to the GCS score, 60 TBI patients were divided into the moderate damage group, the severe damage group and the especially severe damage group. According to the different time points after the injury, the patients were divided into <6 hours group, 6-24 hours group, 24-72 hours group and >72 hours group. The 60 control brain tissue samples were obtained from patients with cerebral aneurysms and undergoing craniotomy at the same time; and control peripheral blood were collected from 60 healthy people. The levels of HIF-1α were measured with RT-PCR and Western blot . One-way ANOVA and t-test were used to analyze the results with SPSS 18.0. Results The expression of HIF-1α in the control group [peripheral blood: HIF-1α mRNA (0.35±0.12), HIF-1α protein (0.28±0.06) ;brain tissue: HIF-1α mRNA (0.65±0.08),HIF-1α protein (0.78±0.08)] was obviously lower than those in the TBI groups, and the differences were statistically significant (P<0.05). Along with the damage degree aggravating, the expression of HIF-1α was increased. The expression of HIF-1α in the especially severe damage group was statistically higher than those of the severe damage group and the moderate damage group (P<0.05). The expression of HIF-1α was increased along with the extension of time after the injury. The expression of HIF-1α in the 24-72 h group was significantly higher than those of the >72 h group, 6-24 h group and <6 h group (P<0.05). Conclusions The expression of HIF-1α is closely related to the severity of TBI and may play an important role in the progress of TBI.

ViewRay magnetic resonance (MR) guided radiotherapy system not only solves the problem of imaging dose,but also can set up accurately,online adaptive radiotherapy and gated irradiation according to magnetic resonance imaging (MRI).The development of this system provides a new technical means of accurate radiotherapy.This review describes the main structure of the ViewRay system,and summarizes quality assurance (QA),dosimetric comparison,respiratory motion management,online adaptive radiotherapy,and preliminary treatment effect.

Objective To explore the mechanism underlying the poor prognosis in cerebral infarction (CI) patients with low T3 syndrome by comparing the NIHSS scores in these patients with or without low T3 syndrome.Methods One hundred and sixty-two patients with CI,admitted to our hospital from January 2010 to December 2012,were chosen in our study; the levels of thyroid hormones,including triiodothyronine (T3),four iodine thyronine (T4),thyroid stimulating hormone (TSH),free Triiodothyronine (iT3) and free four iodine thyronine (fT4),were measured by radioimmunoassay.CI lesions and TOAST distribution were determined by cranial MRI,magnetic resonance angiography (MRA) or CT angiography (CTA),and carotid ultrasonography.NIHSS scores at the worst in cerebral infarction inpatients were detected.Results In the 162 patients with CI,29 patients (17.90％) were combined with low T3 symptom and 20 had fT3 level lower than the lowest normal level (2.63 pmol/L); and T4,fT4 and TSH levels were within normal limits.T3,fr3 and TSH levels in patients with low T3 symptom were significantly lower than those of patients without low T3 symptom (P＜0.05).The distribution of TOAST showed no significant difference between patients with low T3 symptom and patients without low T3 symptom (P＞0.05).In patients with large artery atherosclerosis-internal carotid artery,the NIHSS scores at the worst in patients with low T3 level were significantly higher as compared with those in patients with normal T3 levels (P＜0.05).Conclusion The neurologic impairment is more severe in large artery atherosclerosis-intemal carotid artery patients with low T3 level than those without low T3 level,which might be responsible for the poor prognosis of the illness with low T3 syndrome.

Objective To investigate the effectiveness and safety of argatroban combined with an-tiplatelet therapy in patients with acute mild-to-moderate atherosclerotic cerebral infarction within 72 hours after symptom onset.Methods A total of 452 patients with large atherosclerotic cerebral infarc-tion were enrolled and divided into two groups.The combined therapy group(n=286)received ar-gatroban combined with antiplatelet therapy,while the control group(n=166)received antiplatelet therapy alone.The National Institutes of Health Stroke Scale(NIHSS)score,modified Rankin Scale(mRS)score,early neurological deterioration(END),and occurrence of bleeding events were com-pared between the two groups using a Logistic regression model.Results Statistically significant differences were observed in age,smoking history,time from stroke onset to admission,low-density lipo-protein,and estimated glomerular filtration rate(eGFR)levels between the two groups(P＜0.05).No significant differences were found in infarction location,responsible artery,and atherosclerotic subtype between the combined therapy and control groups(P＞0.05).Among patients with atheroscleroticcerebral infarction,the proportion of patients with an mRS score of 0 to 2 at 90 days after combined therapy of argatrobanwas 85.3％,and was 74.5％in the control group(P＜0.05).In patients with an NIHSS score ≥3,the proportion of patients with an mRS score of 0 to 2 at 90 days in the combined therapy group was 19.3％,which was significantly lower than 60.8％in the control group(P＜0.05).For anterior circulation responsible artery occlusion,the proportion of patients with an mRS score of 0 to 2 at 90 days in the combined therapy group was 82.1％,and 67.2％in the control group(P＜0.05).Among atherosclerotic subtypes,the proportion of patients with penetrating ar-tery occlusion and an mRS score of 0 to 2 at 90 days was significantly higher in the combined therapy group compared to the control group(P＜0.05).Conclusion Argatroban combined with anti-platelet therapy can improve neurological outcomes in patients with acute mild-to-moderate athero-sclerotic ischemic stroke without increasing the risk of bleeding.The combined therapy offers more pronounced benefits in patients with anterior circulation ischemia and penetrating artery occlusion.

Objective:To describe the characteristics and change trends of incidence, mortality and disease burden of acute myocardial infarction (AMI) in Qingdao from 2014 to 2020.Methods:We analyzed the incidence data of AMI retrieved from Qingdao Chronic Diseases Surveillance System. The average annual percent change (AAPC) of morbidity and mortality of AMI were evaluated by using Joinpoint log-linear regression model. Disability adjusted life year (DALY) was used to estimate disease burden of AMI in Qingdao.Results:A total of 70 491 AMI cases and 50 832 deaths of AMI occurred in Qingdao from 2014 to 2020. The age-standardized morbidity and mortality were 54.71/100 000 and 36.55/100 000, respectively. During 2014-2020, the AAPC of age-standardized morbidity was 2.86% (95% CI: 0.42%-5.35%), and 4.30% (95% CI: 1.24%-7.45%) in men and 0.78% (95% CI: -0.89%-2.47%) in women, respectively. The log-linear regression model showed that age-standardized morbidity in age groups 30-39, 40-49 years increased rapidly, with the AAPCs of 8.92% (95% CI: 2.23%-16.06%) and 6.32% (95% CI: 3.30%-9.44%), respectively. The trend was also observed in age groups 30-39, 40-49 and 50-59 years in men, with the AAPCs of 11.25% (95% CI: 3.54%-19.54%), 6.73% (95% CI: 2.63%-10.99%) and 6.72% (95% CI: 2.98%-10.60%), respectively. There was no significant change in age-standardized mortality. The DALY rate increased from 7.49/1 000 in 2014 to 8.61/1 000 in 2020, with the AAPC of 1.97% (95% CI: 0.36%-3.60%). Conclusions:The age-standardized morbidity of AMI in men increased in Qingdao, especially in those aged 30-49 years, while age-standardized mortality rate of AMI was relatively stable from 2014 to 2020. The burden of disease of AMI increased in both men and women.

Objective To investigate the effectiveness and safety of argatroban combined with an-tiplatelet therapy in patients with acute mild-to-moderate atherosclerotic cerebral infarction within 72 hours after symptom onset.Methods A total of 452 patients with large atherosclerotic cerebral infarc-tion were enrolled and divided into two groups.The combined therapy group(n=286)received ar-gatroban combined with antiplatelet therapy,while the control group(n=166)received antiplatelet therapy alone.The National Institutes of Health Stroke Scale(NIHSS)score,modified Rankin Scale(mRS)score,early neurological deterioration(END),and occurrence of bleeding events were com-pared between the two groups using a Logistic regression model.Results Statistically significant differences were observed in age,smoking history,time from stroke onset to admission,low-density lipo-protein,and estimated glomerular filtration rate(eGFR)levels between the two groups(P＜0.05).No significant differences were found in infarction location,responsible artery,and atherosclerotic subtype between the combined therapy and control groups(P＞0.05).Among patients with atheroscleroticcerebral infarction,the proportion of patients with an mRS score of 0 to 2 at 90 days after combined therapy of argatrobanwas 85.3％,and was 74.5％in the control group(P＜0.05).In patients with an NIHSS score ≥3,the proportion of patients with an mRS score of 0 to 2 at 90 days in the combined therapy group was 19.3％,which was significantly lower than 60.8％in the control group(P＜0.05).For anterior circulation responsible artery occlusion,the proportion of patients with an mRS score of 0 to 2 at 90 days in the combined therapy group was 82.1％,and 67.2％in the control group(P＜0.05).Among atherosclerotic subtypes,the proportion of patients with penetrating ar-tery occlusion and an mRS score of 0 to 2 at 90 days was significantly higher in the combined therapy group compared to the control group(P＜0.05).Conclusion Argatroban combined with anti-platelet therapy can improve neurological outcomes in patients with acute mild-to-moderate athero-sclerotic ischemic stroke without increasing the risk of bleeding.The combined therapy offers more pronounced benefits in patients with anterior circulation ischemia and penetrating artery occlusion.

Objective: To investigate the expression of macrophage migration inhibitory factor (MIF) in pulmonary tissues from patients with chronic obstructive pulmonary disease (COPD) and the relationship with its clinical features. Methods: One hundred and eighty patients who underwent pulmonary bullectomy lobectomy due to pneumatocele from January 2015 to September 2018 in Longgang Central Hospital were enrolled and classified into patients without COPD (control group)and patients with COPD (COPD group), with 90 patients each group. According to the lung function parameters, 90 patients with COPD were divided into the mild COPD group, the moderate COPD group, and the severe COPD group. The levels of mRNA and protein of MIF were measured with RT-PCR, ELISA and Western blot. One-way ANOVA, Pearson correlation analysis and SNK-q test were used to analyze the results with SPSS 18.0, and P<0.05 was considered statistically significant. Results: The level of MIF in pulmonary tissues from the control group was obviously lower than those in the COPD group (P<0.05). The level of MIF in pulmonary tissues in the severe COPD group was obviously higher than those in pulmonary tissues in the mild COPD, moderate COPD and control groups (P<0.05). MIF was positively correlated with the lung function parameters (P<0.05). Conclusion The high expression of MIF in pulmonary tissues is closely related to the severity of COPD.

Ischemic stroke is a severe disorder resulting from acute cerebral thrombosis. Here we demonstrated that post-ischemic treatment with ciclopirox olamine (CPX), a potent antifungal clinical drug, alleviated brain infarction, neurological deficits and brain edema in a classic rat model of ischemic stroke. Single dose post-ischemic administration of CPX provided a long-lasting neuroprotective effect, which can be further enhanced by multiple doses administration of CPX. CPX also effectively reversed ischemia-induced neuronal loss, glial activation as well as blood-brain barrier (BBB) damage. Employing quantitative phosphoproteomic analysis, 130 phosphosites in 122 proteins were identified to be significantly regulated by CPX treatment in oxygen glucose deprivation (OGD)-exposed SH-SY5Y cells, which revealed that phosphokinases and cell cycle-related phosphoproteins were largely influenced. Subsequently, we demonstrated that CPX markedly enhanced the AKT (protein kinase B, PKB/AKT) and GSK3 (glycogen synthase kinase 3) phosphorylation in OGD-exposed SH-SY5Y cells, and regulated the cell cycle progression and nitric oxide (NO) release in lipopolysaccharide (LPS)-induced BV-2 cells, which may contribute to its ameliorative effects against ischemia-associated neuronal death and microglial inflammation. Our study suggests that CPX could be a promising compound to reduce multiple ischemic injuries; however, further studies will be needed to clarify the molecular mechanisms involved.