Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.

AIM:To investigate the mechanism by which resveratrol(RSV)alleviates intestinal ischemia-re-perfusion(I/R)injury through modulation of the Wnt/β-catenin signaling pathway.METHODS:Twenty-four male C57BL/6J mice were randomly allocated into four experimental groups:the sham group,I/R group,I/R+RSV(treatment)group,and I/R+RSV+XAV939(inhibitor)group,with 6 mice per group.In the I/R,treatment,and inhibitor groups,the superior mesenteric artery was clamped for 45 minutes and then reperfused for 2 hours to establish the intestinal I/R injury model.The sham group underwent vascular dissection without occlusion.The treatment and inhibitor groups received dai-ly intraperitoneal injections of 15 mg/kg resveratrol for 5 d preoperatively,and the other two groups were intraperitoneally injected with an equal volume of 0.1%dimethyl sulfoxide.The inhibitor group additionally received 10 mg/kg XAV939 30 minutes pre-ischemia.HE staining was used to observe the pathological changes in the intestinal tissues,and the Chiu score standard was used to evaluate the pathological damage.Apoptosis was evaluated through TUNEL staining and the apoptotic index(AI).Diamine oxidase(DAO)level was measured by ELISA.The expression levels of B-cell lymphoma 2(Bcl-2),Bcl-2-associated X protein,cleaved caspase-3,Wnt3a and β-catenin proteins were detected by Western blot.RESULTS:Compared with sham group,the mice in I/R group showed significantly increased Chiu score,elevated DAO level and AI(P<0.05),up-regulated cleaved caspase-3 and Bax protein levels,and down-regulated Bcl-2,Wnt3a and β-catenin protein levels(P<0.05).Treatment with RSV reversed these alterations(P<0.05).XAV939 co-administration abolished the protective effects of RSV(P<0.05).CONCLUSION:Resveratrol ameliorates intestinal I/R injury by acti-vating the Wnt/β-catenin signaling pathway and suppressing apoptosis.

Objective Maintain a sable differential pressure inside the Underwater Positive Pressure Protective Suit(UPPPS)to ensure normal breathing and safe underwater operations for the diver.Methods Utilize a pressure regulator as the UPPPS's pressure control valve to automatically maintain the differential pressure inside the suit.Results By establishing a physical model,the relationship between the steady-state differential pressure with the ventilation flow rate and the ambient pressure was obtained.(1)The ventilation flow rate is positively correlated with the steady-state differential pressure,the higher the ventilation flow rate,the greater the steady-state differential pressure.(2)At the same ventilation flow rate,the larger the ambient pressure is,the smaller the steady-state differential pressure is.Underwater unmanned and manned experiments using the UWT suit were conducted.The expermental results are in agreement with the theoretical analysis.Conclusion The performance of pressure regulator has been verified by the underwater experiments,it effectively stabilizes the differential pressure within the UPPPS.

Objective To investigate the role of quercetin(QUE)in ferroptosis during intestinal ischemia-reperfusion(IR)injury and elucidate its underlying mechanisms.Methods ① Potential target genes of QUE were predicted using the TCMSP,PharmMapper,and SwissTargetPredictive databases.Target genes associated with intestinal IR injury and ferroptosis were collected from GeneCards,PharmGKB,and OMIM databases.After overlapping genes were identified and analyzed,protein-protein interaction(PPI)networks were constructed using the STRING database and then visualized with Cytoscape 3.10.0.Molecular docking was performed to validate the binding conformations between QUE and key targets.② In vivo experiments were conducted to verify QUE's protective effects against intestinal IR injury.Thirty-six SPF-grade male C57BL/6J mice(6～8 weeks old,body weight:22±2 g)were randomly divided into Sham,Sham+QUE,IR,IR+QUE,IR+QUE+erastin(IR+QUE+Era),and IR+QUE+kevetrin hydrochloride(IR+QUE+KH)groups,with 6 mice in each group.Mouse model of intestinal IR injury was induced by 45 min ischemia of the superior mesenteric artery followed by 60 min reperfusion.HE staining was used to observe histopathological changes in the intestinal tissues.ELISA was employed to the serum or intestinal contents of diamine oxidase(DAO),pro-inflammatory cytokines(TNF-α,IL-6,IL-1β),and ferroptosis markers[glutathione(GSH)and Fe2+].Western blotting was utilized to detect the protein expression of glutathione peroxidase 4(GPX4),acyl-CoA synthetase long-chain family member 4(ACSL4),and tumor protein 53(p53).Results ① Network pharmacology identified 460 QUE targets,1 552 intestinal IR injury targets,and 1 967 ferroptosis-related targets,and 92 overlapping genes were identified as potential therapeutic targets.Molecular docking revealed a strong binding affinity between QUE and p53(binding energy:-6.8 kcal/mol).② In vivo experiments demonstrated that the IR+QUE group exhibited reduced intestinal damage and lower Chiu's score(P<0.05),decreased serum DAO content but elevated intestinal DAO content(P<0.05),decreased levels of TNF-α,IL-6,and IL-1β in the serum and intestinal tissues(P<0.05),reduced Fe2+accumulation,and increased GSH content(P<0.05),and up-regulated GPX4(P<0.05)and down-regulated ACSL4 and p53 expression(P<0.05)at protein level when compared with the IR group.While,the administration of ferroptosis agonist Era,or p53 agonist KH resulted in diminished therapeutic effects of QUE(P<0.05)when compared with the IR+QUE group.Conclusion QUE alleviates intestinal IR injury by inhibiting ferroptosis,which may be associated with its down-regulating p53 expression.

Objective To investigate whether remimazolam attenuates intestinal ischemia-reperfusion(I/R)injury in mice by regulating ferroptosis through connexin-43(CX43).Methods Molecular docking was applied to predict the binding affinity of remimazolam to CX43.A total of 72 SPF-grade adult male C57BL/6J mice(6～8 weeks old,weighing 20～25 g)were subjected.Thirty of them were randomly divided into sham operation group(Sham group),I/R group 1,and I/R+10,20 and 40 mg/kg remimazolam groups(RM10,RM20 and RM40 groups),with 6 mice in each group.Another 30 mice were randomly assigned into 5 groups(n=6),I/R group 2,erastin group(E group),I/R+40 mg/kg remimazolam group 2(RM40 group 2),I/R+Fer-1 group(Fer-1 group),and erastin+40 mg/kg remimazolam group(ERM group).The left 12 mice were randomly and equally grouped into I/R+RM+oe-NC group(oe-NC group)and I/R+RM+oe-CX43 group(oe-CX43 group).The Fer-1 group was given an intraperitoneal injection of 5 mg/kg Fer-1 in 1 h prior to reperfusion,the E group was given 10 mg/kg erastin intraperitoneally 1 d before modeling,and all the remimazolam groups,the oe-NC group and the oe-CX43 group were injected intravenously with corresponding doses of remimazolam 30 min pre-modeling,while the oe-NC and oe-CX43 groups were injected with empty vector virus and overexpression of CX43 vector virus,respectively,48 h before the administration of remimazolam.A mouse intestinal I/R injury model was constructed by clamping the superior mesenteric artery for 45 min and reperfusion for 30 min.The small intestine tissues were harvested and observed for pathological changes,and the intestinal mucosal damage was assessed with Chiu's score.The contents of Fe2+,total iron,malondialdehyde(MDA),glutathione(GSH),and superoxide dismutase(SOD)were detected by colorimetric assay;the production of reactive oxygen species(ROS)was determined by DHE probe;the expression of ferroptosis-related genes was determined by RT-qPCR;and the expression levels of CX43,GPX4,and SLC7A11 were detected by Western blotting.Results Molecular docking indicated that remimazolam had a binding energy of-6.699 kcal/mol with CX43 protein,suggesting good binding affinity between them.Compared with the Sham group,the I/R group 1 showed increases in Chiu's scores and CX43 expression(P<0.05),along with pathological damage to intestinal tissues,and elevated contents of Fe2+,total iron,ROS and MDA(P<0.05),and down-regulated GPX4 and SLC7A11(P<0.05).Compared with the I/R group 1,Chiu's score was reduced in the RM40 group,and CX43 was significantly down-regulated(P<0.05),contents of Fe2+,total iron,ROS,and MDA were decreased(P<0.05),and expression levels of GPX4 and SLC7A11 were enhanced(P<0.05),and severity of intestinal histological damage was attenuated in both the RM40 and Fer-1 groups.Compared with the E group,the ERM group had the decreases in CX43 expression level(P<0.05),Fe2+,total iron,ROS,and MDA contents(P<0.05),and increases in GPX4 and SLC7A11 expression levels(P<0.05),with the improvement in intestinal tissue.Compared with the oe-NC group,overexpression of CX43 resulted in the increased CX43 expression,elevated contents of Fe2+,total iron,ROS and MDA(P<0.05)and decreased expression of GPX4 and SLC7A11(P<0.05),leading to the exacerbated injury in intestinal tissue.Conclusion Remimazolam attenuates intestinal I/R injury by inhibiting ferroptosis through down-regulating CX43 expression.

Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.

AIM:To investigate the mechanism by which resveratrol(RSV)alleviates intestinal ischemia-re-perfusion(I/R)injury through modulation of the Wnt/β-catenin signaling pathway.METHODS:Twenty-four male C57BL/6J mice were randomly allocated into four experimental groups:the sham group,I/R group,I/R+RSV(treatment)group,and I/R+RSV+XAV939(inhibitor)group,with 6 mice per group.In the I/R,treatment,and inhibitor groups,the superior mesenteric artery was clamped for 45 minutes and then reperfused for 2 hours to establish the intestinal I/R injury model.The sham group underwent vascular dissection without occlusion.The treatment and inhibitor groups received dai-ly intraperitoneal injections of 15 mg/kg resveratrol for 5 d preoperatively,and the other two groups were intraperitoneally injected with an equal volume of 0.1%dimethyl sulfoxide.The inhibitor group additionally received 10 mg/kg XAV939 30 minutes pre-ischemia.HE staining was used to observe the pathological changes in the intestinal tissues,and the Chiu score standard was used to evaluate the pathological damage.Apoptosis was evaluated through TUNEL staining and the apoptotic index(AI).Diamine oxidase(DAO)level was measured by ELISA.The expression levels of B-cell lymphoma 2(Bcl-2),Bcl-2-associated X protein,cleaved caspase-3,Wnt3a and β-catenin proteins were detected by Western blot.RESULTS:Compared with sham group,the mice in I/R group showed significantly increased Chiu score,elevated DAO level and AI(P<0.05),up-regulated cleaved caspase-3 and Bax protein levels,and down-regulated Bcl-2,Wnt3a and β-catenin protein levels(P<0.05).Treatment with RSV reversed these alterations(P<0.05).XAV939 co-administration abolished the protective effects of RSV(P<0.05).CONCLUSION:Resveratrol ameliorates intestinal I/R injury by acti-vating the Wnt/β-catenin signaling pathway and suppressing apoptosis.

OBJECTIVE Exploring the effects of juvenile-onset recurrent respiratory papillomatosis on growth and development,intellectual level,and psychological status.METHODS The clinical data of 40 patients with JORRP who attended Beijing Tongren Hospital of Capital Medical University from January to December 2023(observation group)and 40 healthy adolescents who had medical checkups at the hospital during the same period(control group)were retrospectively analyzed.The body mass index(BMI),Raven's standard progressive matrices(SPM),and the feelings of inadequacy scale(FIS)were used to evaluate the growth and development,intelligence level,and psychological status of the enrolled population.RESULTS BMI was(21.320±3.609)kg/m2 in the observation group and(22.250±2.685)kg/m2 in the control group.The difference between the two groups was not statistically significant(U=668.000,P>0.05).According to the standard conversion of SPM scores,the proportion of observation group with good intelligence level was 5%(2/40),average level was 55%(22/40),below average level was 35%(14/40),and low level was 5%(2/40),while 5%(2/40)of the control group had good intelligence,90%(36/40)had average intelligence,and 5%(2/40)had below average intelligence.The differences in SPM total scores and scores of perceptual discrimination ability in group A,series relationship ability in group D and abstract reasoning ability in group E between the two groups were statistically significant(P<0.05).The intelligence levels of both groups were related to their living areas(|r|>0.3,P<0.05).The difference in FIS scores between the observation group and the control group was statistically significant(86.650±21.680 vs.62.250±9.446,U=270.000,P<0.001).The age of first onset in the observation group was negatively correlated with its sense of inferiority(|r|>0.3,P<0.05).There was no correlation between the number of surgeries in the observation group and their intelligence level and FIS scores(|r|<0.3,P>0.05).CONCLUSION JORRP does not affect the growth and development of patients,but can increase their sense of inferiority to a certain extent,which has a negative impact on their mental health.

OBJECTIVE To observe the long-term efficacy of type-Ⅰ thyroplasty under general anesthesia in the treatment of glottal insufficiency caused by unilateral vocal cord paralysis.METHODS A total of 52 patients with unilateral vocal cord paralysis who underwent type-Ⅰ thyroplasty under general anesthesia at Beijing Tongren Hospital from January 2017 to June 2023 were followed up for more than one year to analyze their efficacy.RESULTS All 52 patients underwent surgery successfully under general anesthesia,and hoarseness improved after operation.Coughing caused by drinking water was reduced or disappeared,and the vocal cords moved inward with improved glottal closure.One year after operation,there was no significant change in the position of the affected vocal cords compared to one week after surgery.The visual analog scale(VAS)scores of all patients with voice disorders decreased sequentially before surgery,one week after surgery,and one year after surgery(80.28±13.49 vs.37.78±19.15 vs.26.26±21.29,P<0.05).The preoperative and one-year postoperative voice perception assessment(GRBAS)showed statistically differences in grade(G),rough(R),breathy(B),and asthenia(A)scores(2.70±0.47 vs.1.09±0.66,2.52±0.54 vs.0.85±0.67,2.85±0.36 vs.0.67±0.65,2.74±0.44 vs.0.61±0.80,P<0.05)except for strain(S).Compared with preoperative results,one-year postoperatively showed a significant decrease in jitter and shimmer(4.61±2.61 vs.3.05±2.37,9.52±3.91 vs.7.11±2.78,P<0.05),and a significant prolongation of maximum phonation time(MPT)[(5.87±2.70)s vs.(14.50±4.30)s,P<0.05].No patients experienced perioperative adverse events.CONCLUSION Type-Ⅰ thyroplasty is an effective surgical method for treatment of vocal cord paralysis.The type-Ⅰ thyroplasty under general anesthesia is safe and effective,which not only significantly improves the symptoms of hoarseness in patients,but also has stable therapeutic effects and can maintain the results for a long time.At the same time,the patient has no pain during the procedure.

Objective:To systematically evaluate the prevalence of malnutrition in elderly patients with diabetes.Methods:A total of eight databases, namely PubMed, Embase, Web of Science, The Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), and VIP Database, were systematically searched for cross-sectional studies on malnutrition in elderly diabetic patients published from the inception of the databases to September 13, 2023. Two researchers independently conducted literature screening, data extraction, and quality assessment. Data analysis was performed using Stata 16.0 software.Results:A total of 22 studies were included, involving 6 349 elderly diabetic patients. Results of the meta-analysis showed that the overall prevalence of malnutrition in elderly patients with diabetes was 32.3% (95% CI: 0.21 to 0.43), and the prevalence of at-risk of malnutrition was 49.0% (95% CI: 0.31 to 0.67). Subgroup analysis showed that the prevalence of malnutrition in elderly diabetic patients with chronic complications (56.8%) was significantly higher than those without chronic complications (21.9%). Inpatients also showed a higher prevalence compared with outpatients and community (44.4%, 29.0%, and 18.5%, respectively). The prevalence of malnutrition as per mini-nutritional assessment scale was higher than that as per mini-nutritional assessment short-form scale (35.8% vs. 23.3%, P<0.05). There was no significant difference in the prevalence of malnutrition in elderly diabetic patients of different genders ( P>0.05). Conclusions:The prevalence of malnutrition and at-risk of malnutrition in elderly diabetic patients is high. In clinical practice, we should not only strengthen the early diagnosis of malnutrition in patients, but also emphasize the screening of malnutrition risk, implement timely corresponding interventions, and promote patient education on nutrition and health, to improve the prognosis and quality of life in elderly diabetes patients.