Objective: To under the prevalence of malnutrition and its associated factors in school aged children with cerebral palsy, so as to provide a basis for relevant departments to formulate targeted policies. Methods: From July to August 2023, the researchers selected 333 children with cerebral palsy and 960 children with other diseases aged 6-18 years who were residents of a social welfare institution in Guangzhou, China. Their height and weight were measured and a nutritional status analysis was carried out using a cluster sampling method. Multivariate Logistic analysis was performed to analyze the relative factors and malnutrition status of school aged children with cerebral palsy. Results: The prevalence of growth retardation among school aged children with cerebral palsy was 74.5%, with rates of stunting, normal nutrition status, and overweight/obesity being 17.7%, 7.2%, and 0.6%, respectively. The results of the univariate analysis revealed statistically significant differences in the detection rate of malnutrition among school aged children with cerebral palsy based on gender, gross motor function classification system (GMFCS) grading, and the presence of swallowing disorders ( χ 2=6.02, 15.23, 32.16, P <0.05). The results of the multivariate Logistic regression analysis showed that gender ( OR=0.37, 95%CI =0.15-0.91), dysphagia (OR=4.10, 95%CI =1.39-12.12), and GMFCS classification ( OR=1.45, 95%CI =1.04-3.01) were influencing factors of malnutrition ( P <0.05). Conclusions The detection rate of malnutrition among children and adolescents with cerebral palsy in welfare institutions was found to be relatively high, and influenced by various factors. Corresponding nutritional interventions should be developed and implemented based on the risk factors of malnutrition in school aged children with cerebral palsy to improve their nutritional status.

Objective To make an exhaustive study of the evolution,status quo and future developments of wearable technologies for monitoring of exercise across the world via knowledge graphs in order to provide reference for related research in China's military.Methods Data on wearable technologies for monitoring of exercise collected from literature that was retrieved from Web of Science was used as the subject.Bibliometrix and other visual analysis softwares were used to construct knowledge graphs.The essential characteristics of developments of wearable technologies for monitoring of exercise were explored in terms of trends of publication,co-occurrence networks and co-occurrence of key words.Results The field of wearable technologies for monitoring of exercise was growing fast.Institutional cooperation was characterized by intraregional cooperation.The United States held an important position in the global innovation cooperation network.Conclusion As the leading author of co-occurrence network,Professor Zhonglin Wang has contributed greatly to the collaboration between research teams.Artificial intelligence,big data,cloud computing and other technologies have become hotspots in this field.The application and development of new materials has gone a long way towards making monitoring devices thin,skin-friendly and traceless.

Objective To investigate the outcome of high-risk acute non-lymphocytic leukemia treated with sequential low-dose cytarabine and harringtonine(LD-HA) and standard induction. Methods 50 high-risk ANLL. patients (LD-HA group) who were regarded as unfit for intensive chemotherapy were chosen to receive LD-HA. Reinductive treatments with standard regimens would be given for those who did not achieve complete remission. 23 patients DA/HA group given two cycles of standard inductive regimens were taken as the control. Results In LD-HA group 80.0 %. (40/50) reached CR, 2 patients died shortly after inductive therapy. The median leukemia-free survival(LFS) was 19.6 months, and the median overall survival (OS) was 12.2 months. Overall survival was 57.0 % at 1 year, 24.1% at 3 years, and 18.8 % at 5 years. While the CR rate was 73.9 % for DA/HA group, and none died during the inductive therapy. LFS and OS was 19.8 months and 12.1 months, respectively. OS rate was 56.58 % at 1 year, 27.1% at 3 years, and 27.1% at 5 years.There were no difference on OS rates between 2 groups (x2 were 0.009, 0.237 and 1.807, respectively,P ＞0.05). Conclusion In patients who were unfit for intensive chemotherapy, sequential therapy with LD-HA and standard induction improved the rate of complete remission and the duration of survival.

Objective:To explore the brain activation intensity changes of depressed patients in the phase of expected value (EV), positive prediction error (+ PE) and negative prediction error (-PE) under uncertain (risky, ambiguous) decision-making.Methods:From July 2018 to February 2021, a total of 48 depressed patients in the Affiliated Hospital of Qingdao University were collected (depression group), and 69 sex-, age-, and educational level-matched healthy people were recruited as the control group. All participants completed risky and ambiguous decision-making tasks under the E-Prime system.SA-9800 brain functional audio-visual stimulation system and GE3.0 T functional magnetic resonance imaging (fMRI) scanners were used to conduct synchronous scanning and data acquisition. Using Xjview software to analyze the activation intensity of related brain areas to compare the activity intensity of the two groups.SPSS 16.0 software was used for chi square test, independent sample t-test. Results:Under risky decision-making, compared with the control group, the brain areas with reduced activation during EV phase in depression group were bilateral prefrontal cortex (PFC)(MNI coordinate: left x=-45, y=21, z=-6; right x=0, y=69, z=-3), left para hippocampal gyrus(PHG)(MNI coordinate: x=-9, y=0, z=-22), bilateral occipital lobe(OL)(MNI coordinate: left x=-51, y=-81, z=-3; right x=48, y=-84, z=-9)( P<0.05). The brain areas with reduced activation during + PE phase were bilateral PFC, left hippocampus (HIP), bilateral temporal lobe (TL), left middle occipital gyrus( P<0.05). The brain areas with reduced activation were bilateral PFC, right putamen, bilateral TL( P<0.05) during -PE phase. Under ambiguous decision-making, compared with the control group, the brain areas with reduced activation during EV phase in depression group were bilateral PFC, right OL( P<0.05); the brain areas with reduced activation during + PE phase were bilateral PFC, right putamen and hippocampus, bilateral TL, bilateral OL( P<0.05); and the brain areas with reduced activation were bilateral PFC, bilateral TL( P<0.05) during -PE phase. Conclusion:The study shows that the activities of reward brain areas such as PFC, limbic system and OL system are reduced during EV and PE phase under uncertain decision-making in depressed patients.

Objective: To quantitatively measure biological parameters of nanophthalmos and analyze the correlation between axial length (AL) and the other biological parameters. Methods: The clinical data of 71 eyes of 43 patients identified with nanophthalmos (AL≤20 mm) from September 2012 to August 2018 in Zhongshan Ophthalmic Center were retrospectively analyzed.All enrolled patients underwent ophthalmological examinations including best-corrected visual acuity, refraction, slit-lamp biomicroscopy, fundus examination, Goldmann applanation tonometry, A-scan ultrasound examinations, ultrasound biomicroscopy, spectral domain optical coherence tomography (SD-OCT) and nonmydriatic fundus photography.Pearson correlation analysis was used to analyze the relationship between AL and all biological parameters.This study followed the Declaration of Helsinki and was approved by the Ethics Committee of Zhongshan Ophthalmic Center (NO.2017KYPJ092). All patients signed informed consent. Results: Of the 43 patients, the average age was (46.00±12.75) years, the mean intraocular pressure was (24.97±14.87)mmHg (1 mmHg=0.133 kPa). The mean best corrected visual acuity was 1.14±0.79, the mean refraction was (11.61±4.09)D.The mean AL, central corneal thickness (CCT), central anterior chamber depth(ACD), anterior chamber width (ACW), len thickness(LT) and vitreous cavity length(VCL) was (17.13±1.57)mm, (550±60)μm, (1.64±0.37)mm, (11.17±0.61)mm, (5.01±0.51)mm and (10.10±1.80)mm, respectively.The average retinal nerve fiber layer thickness (mRNFLT), macular foveal retinal thickness (FRT) and subfoveal choroidal thickness (SFCT) was (98.51±40.93), (294.46±116.83) and (488.72±133.06)μm, respectively.The ratio of ACD to AL, LT to AL, and VCL to AL was 9.6%, 29.4% and 59.3%, respectively.The ACW and VCL were positively correlated with AL(r=0.432, 0.978; both at P<0.001); whereas, LT and FRT were negatively correlated with AL(r=-0.272, P=0.027; r=-0.679, P<0.001). There was no correlation between CCT, central ACD, mRNFLT, SFCT and AL (r=0.153, -0.053, -0.322, 0.063; all at P>0.05). Conclusions Nanophthalmos has the characteristics of narrow anterior and posterior segment structure.The ratio of LT to AL is increased and the ratio of VCL to AL is decreased.The AL is positively correlated with ACW and VCL, negatively correlated with LT and FRT.

The incidence and mortality rate of heart failure (HF) are increasing annually, resulting in a huge medical and economic burden worldwide. B-type natriuretic peptide (BNP) is the gold standard biomarker of HF recommended by national and international guidelines for the diagnosis and prognosis evaluation of HF. Recent studies suggest that BNP can be truncated in multiple forms by different enzymes rather than complete fragments in circulation, which can be contributing to the diagnosis and classification of HF. The immunoassay mostly used in clinics are unable to distinguish different truncated BNP forms due to cross-reactivity of antibody, while mass spectrometry is more accurate because it can easily distinguish through their mass-to-charge ratios. With the maturation of ambient ionization mass spectrometry and ion mobility mass spectrometry, it can help to simplify sample pre-treatment and improve the separation efficiency, in order to explore the clinical value of the heterogeneity of BNP truncated forms.

Objective To explore the current status and potential subtypes of frailty among family caregivers of patients with dementia,and to analyze the related influencing factors of different subtypes.Methods Dementia patients and their family caregivers in 8 community health service centers in Shanghai from June to October 2023 were recruited by convenience sampling.General information questionnaire,Tilburg Frailty Indicator(TFI),Pittsburgh Sleep Quality Index(PSQI),Self-Rating Depression Scale(SDS),Zarit Caregiver Burden Interview(ZBI),and Connor-Davidson Resilience Scale(CD-RISC)were conducted for investigation.Latent profile analysis was used to explore the potential subtypes of frailty among family caregivers of patients with dementia.The influencing factors associated with the potential subtypes were identified by univariate analysis and multivariate Logistic regression analysis.Results A total of 470 family caregivers of patients with dementia were surveyed,and 46.17％of them suffered from frailty.Frailty among family caregivers of patients with dementia can be classified into 3 potential subtypes:comprehensive-low frailty subtype(70.64％),psychosocial-medium frailty subtype(19.57％),and physical-high frailty subtype(9.79％).Family caregivers of patients with dementia who had poor sleep quality and suffered from 2 or more chronic diseases were more likely to be classified into the physical-high frailty subtype(P＜0.05).Family caregivers of patients with dementia who had higher levels of depression,lower mastery levels of caregiving knowledge and skills and spousal caregivers were more likely to be classified into the psychosocial-medium frailty subtype(P＜0.05).Family caregivers of patients with dementia who had higher levels of resilience were more likely to be classified into the comprehensive-low frailty subtype(P＜0.05).Conclusion The incidence of frailty among family caregivers of patients with dementia is at a high level with significant heterogeneity.It is suggested that medical staff should pay attention to the frailty of family caregivers,with a focus on family caregivers in the psychosocial-medium frailty subtype or physical-high frailty subtype,and take timely and targeted interventions according to the characteristics and influencing factors of different subtypes,so as to prevent or delay the occurrence and development of frailty.

Objective To analyze the BEST1 gene mutations and clinical features in patients with multifocal vitelliform retinopathy (MVR).Methods This is a retrospective case series study.Five MVR families with MVR,including 9 patients and 10 healthy family members were recruited.Clinical evaluations were performed in all MVR patients and their family members,including best-corrected visual acuity (BCVA),intraocular pressure (IOP),refraction,slit-lamp examination,90 D preset lens examination,gonioscopy,color fundus photography,optical coherence tomography (OCT),fundus autofluorescence (AF),ultrasound biomicroscopy (UBM) and axial length measurement.Electro-oculogram (EOG) was performed in 12 eyes and visual field were performed in 13 eyes.Peripheral blood samples were collected in all subjects to extract genomic DNA.Coding exons and flanking intronic regions of BEST 1 were amplified by polymerase chain reaction and analyzed by Sanger sequencing.Results Among the 5 MVR families,3 probands from three families had family history,including 1 family had autosomal dominant inheritance pattern.Two patients from 2 families were sporadic cases.Screening of BEST1 gene identified four mutations,including three missense mutations (c.140G＞T,p.R47L;c.232A＞T,p.I78F;c.698C＞T,p.P233L) and 1 deletion mutation (c.910_912del,p.D304del).Two mutations (p.R47L and p.I78F) were novel.The BCVA of affected eyes ranged from hand motion to 1.0.The mean IOP was (30.39± 11.86) mmHg (1 mmHg=0.133 kPa).The mean refractive diopter was (-0.33 ± 1.68) D.Twelve eyes had angle-closure glaucoma (ACG) and 4 eyes had angle closure (AC).EOG Arden ratio was below 1.55 in all patients.The mean anterior chamber depth was (2.17± 0.29) mm.Visual field showed defects varied from paracentral scotoma to diffuse defects.The mean axial length was (21.87± 0.63) mm.All MVR patients had multifocal vitelliform lesions in the posterior poles of retina.ACG eyes demonstrated pale optic disc with increased cup-to-disc ratio.OCT showed retinal edema,extensive serous retinal detachment and subretinal hyper-reflective deposits which had high autofluorescence in AF.The genetic testing and clinical examination were normal in 10 family members.Conclusions MVR patients harbored heterozygous mutation in the BEST1 gene.Two novel mutations (p.R47L and p.I78F) were identified.These patients had clinical features of multifocal vitelliform retinopathy and abnormal EOG.Most patients suffered from AC/ACG.

BACKGROUND:Intervertebral disc degeneration is an important cause of low back pain.At present,there are many modeling methods for disc degeneration in China and abroad,but there is not a model for low back pain due to disc degeneration. OBJECTIVE:To compare the effect of mechanical puncture combined with tumor necrosis factor α and complete Freund's adjuvant with a conventional disc mechanical puncture alone. METHODS:A total of 18 male adult Sprague-Dawley rats were randomly divided into 3 groups,with 6 animals in each group.No treatment was given in the blank group.Animal models of intervertebral disc degeneration were made in the L4-5 segments of rats in the control using conventional mechanical puncture.In the experimental group,on the basis of mechanical puncture,tumor necrosis factor α+complete Freund's adjuvant was injected into the L4-5 intervertebral discs using a microinjector to establish a model of disc degeneration induced by mechanical puncture combined with inflammatory factors.Four weeks after surgery,the pain threshold of rats was measured by the hot plate method for assessing the perception of heat injury in rats with intervertebral disc degeneration.MRI examination was performed to observe the disc degeneration in each group.ELISA was used to detect the levels of serum tumor necrosis factor α,interleukin 1β,interleukin 6 and prostaglandin E2.Hematoxylin-eosin and Safranin O-fast green staining were used to observe the morphological changes of the disc. RESULTS AND CONCLUSION:In terms of pain,the behavioral pain threshold of the experimental group was continuously decreased,and the levels of serum inflammatory factors were significantly higher compared with the control group.In terms of morphology,the MRI results showed that the L4-5 nucleus pulposus signal completely disappeared in the experimental group.Histopathological results showed that in the control group,the nucleus pulposus was intact,more notochord cells were visible,and some fiber rings were ruptured,while in the experimental group,there are fewer notochord cells and the structure of the nucleus pulposus and fibrous ring is disturbed,with the boundary disappearing.To conclude,mechanical puncture combined with tumor necrosis factor alpha and complete Freund's adjuvant can successfully establish a discogenic low back pain model in rats.This operation is simple and economical to achieve obvious disc degeneration and low back pain,with greatly shortened molding cycle.This model can be used as a reference for studying discogenic low back pain models.

Objective:To discuss the challenges and problems of the prevention and control of emerging infectious diseases in Shanghai as a megacities.Methods:An imported case of cutaneous anthrax occurred in Shanghai on May 30, 2019. Shanghai Municipal Center for Disease Control & Prevention conducted an epidemiological investigation and treatment of the cases; after this case, the data of patients with cutaneous anthrax were collected, and an epidemiological study was conducted. Meanwhile, the wound and blood samples of the patient were collected for laboratory testing.Results:Of the seven wound samples of the patient, 6 were positive for the Bacillus anthracis nucleic acid test, and the double serological test results showed a 4-fold increase in the titer of anthrax antibodies. Shanghai CDC conducted an epidemiological investigation of the confirmed cases and observed its contacts. After treatment, the patients recovered, and no other issues appeared among the 19 contacts. Conclusions:Shanghai must strengthen the training of clinicians on emerging infectious diseases to achieve early detection, diagnosis, and treatment of imported infectious diseases and reduce the incidence, spread, and death of the diseases. At the same time, multi-department joint prevention and control are needed to prevent and control secondary cases.