Objective: To understand the status of vision of Tibetan students aged 7-18 in China, and to provide the theoretical basis for prevention and controlling work of short-sightedness and making relevant policies. Methods: Cross-sectional survey method was applied to collect information of the eyesight of 2 418 Tibetan students and that of gender, age and work-and-rest habit of 1 910 students, and the status of eyesight of Tibetan students was analyzed, and Logistic regression analysis method was used to probe into the influencing factors of eyesight. Results: The mean left eye visual value was (4.75±0.33),and the median was 4.75(P25=4.5，P75=5.0). The mean right eye visual value was (4.74±0.33),and the median was 4.90(P25=4.5, P75=5.0). 1 520 students were detected with myopia, with the detection rate of 62.9%. The prevalence of myopia among Tibetan female students was higher than that of male (P<0.01). The detection rate of myopia was increased with age both in left and right eyes. Logistic regression model showed that students with insufficient physical education courses each week were associated with evaluated risk of myopia,compared with those with sufficient courses(OR=1.43, 95%CI=1.05-1.94, P<0.05). Conclusion The prevalence of myopia among Tibetan students aged 7-18 years old is rather high, and females are worse than males, senior students were worse than junior students. After controlling for factors like grade and gender, insufficient physical education courses at school is a risk factor of myopia.

Objective: To investigate the prevalence of drinking-tea type endemic fluorosis among children in Lhasa, Tibet, and to provide basic data for the early prevention of dental fluorosis and skeletal fluorosis among children. Methods: Stratified cluster random sampling method was used to select primary school 1 991 students in 6 counties. Results: The detection rate of dental fluorosis was 27.2%, the index of dental fluorosis was 0.44, and the total severity of fluorosis prevalence was identified as very mild among 6 counties. The detection rate of dental fluorosis increased with the age of the children：male and female increased by 36.2 and 28.5 percentage points,respectively. There was no significant difference between male and female students(χ2=0.08, P> 0.05). The urine fluoride test results suggested that urine fluoride concentration among participate children was below the standard limits value(geometric mean of urinary fluorine <1.4 mg/L). Conclusion The prevalence of tea-drinking type endemic fluorosis among children in Lhasa is more serious compared with that from other regions of China. The cumulative effect of fluorine in human body makes older students more prone to dental fluorosis. It is suggested that more school-based health education programs should be carried out to prevent tea drinking type endemic fluorosis.

Objective:To evaluate the effect of early mobilization on mortality in intensive care unit (ICU) patients with mechanical ventilation after discharge by Meta-analysis.Methods:Databases including SinoMed, China National Knowledge Infrastructure (CNKI), Wanfang data, PubMed, the Cochrane Library, Web of Science, and Embase were searched from inception to September 17th, 2020, to collect randomized controlled trials (RCT) about early mobilization on mortality of patients with mechanical ventilation in ICU after discharge, the references included in the literature were traced. The control group was given routine care, the experimental group was given early mobilization on the basis of the control group, including passive or active mobilization on the bed, sitting on the bed, standing by the bed, transferring to the bedside chair and assisting walking. The literature screening, data extracting, and the bias risk assessment of included studies were conducted independently by two reviewers. Stata 12.0 software was then used to perform Meta-analysis. Funnel plot was used to test publication bias.Results:A total of 10 RCT studies involving 1 323 patients were included, with 660 patients in the control group and 663 patients in the experimental group. The results of literature quality evaluation showed that 7 studies were grade A and 3 studies were grade B, indicating that the overall quality of included literatures was high. The Meta-analysis results showed that early mobilization did not increase the mortality of patients with mechanical ventilation in ICU after discharge [odds ratio ( OR) = 0.92, 95% confidence interval (95% CI) was 0.75-1.13, P = 0.449]. Subgroup analysis results showed that early mobilization had a tendency to reduce the mortality of ICU patients with mechanical ventilation at 3, 6 and 12 months after discharge, but the difference was not statistically significant (3-month mortality: OR = 1.02, 95% CI was 0.74-1.40, P = 0.927; 6-month mortality: OR = 0.95, 95% CI was 0.70-1.27, P = 0.712; 12-month mortality: OR = 0.60, 95% CI was 0.33-1.10, P = 0.101). Funnel plot showed that the distribution of included literatures was not completely symmetrical, suggesting that publication bias might exist. Conclusions:Early mobilization does not increase the mortality of ICU patients with mechanical ventilation after discharge. Although it tends to have a favorable outcome in reducing mortality, and has a trend to reduce the mortality. However, due to the small number of included literatures, small sample size and differences in the specific implementation of early mobilization among various studies, a large number of high-quality RCT studies are still needed for further verification.

Objective: To understand epidemiological characteristics of echinococcosis among children and adolescents in Lhasa, and to provide basic data and theoretical support for echinococcosis prevention and control. Methods: The data of echinococcosis screening in Lhasa in 2017 were collected from 3-18 years old, and portable ultrasound and serum echinococcosis antibody tests were used for screening, and the diagnosis was made based on the epidemiological history and clinical manifestations. Results: The overall echinococcosis detection rate of children and adolescents aged 3-18 years in Lhasa was 0.12% (114/95 835).Among different age groups, the echinococcosis rate of children and adolescents aged 16 to 18 was the highest (0.17%). Among the population with different education levels, the echinococcosis rate of children and adolescents with primary education level was the highest (0.45%).The echinococcosis detection rate of herdsmen was the highest among different occupational groups (0.59%). Among the population with different living patterns, echinococcosis rate was the highest (0.70%) in "settled in winter and nomadic in summer" group. The rate of echinococcosis of children and adolescents were the highest in "nomadism" group and "half farming and half nomadism" group (both 0.20%) among different family production mode. Among different endemic counties, the echinococcosis detection rate of children and adolescents in Dangxiong county and Mozhugongka county were the highest, both of which are 0.18%.All the above differences are statistically significant(χ2=16.77,23.76,69.76,16.49,14.74,25.25,P<0.01).There was no significant difference in echinococcosis detection rate between boys and girls(P>0.05). Conclusion Echinococcosis is more likely to be detected in children and adolescents who are older and have a lower education level, whose production and lifestyle are involved in animal husbandry, and who live at a higher altitude. Therefore, the prevention and control of echinococcosis among children and adolescents, especially the health education, should be the focus of the government’s work.

Objective To explore the alteration of the peripheral thyroid hormone level in patients with chronic alcohol dependence and its relationship with depressive emotion.Methods Data were collected from 21 male patients with chronic alcohol dependence (case group) and 21 male health control (control group).Hamilton Depression Scale-24 (HAMD-24) and Alcohol Dependence Screening Scale (MAST) were used.The level of thyroid stimulating hormone (TSH),free triiodothyronine (FT3),free thyroxine (FT4),triiodothyronine (T3) and four iodine thyroxine (T4) of case group and control group were separately determined.The level of above-mentioned hormones and scale score of case group were evaluated in the first and sixth week of the period of temperance.Data of control group were collected once at baseline.Results The level of FT3 in case group was decreased significantly in the first week of the period of temperance compared with the control group ((4.34± 1.01) pmol/L,(5.85 ± 0.78) pmol/L,t =5.56,P＜ 0.01),while the level of TSH in case group was increased((2.62±0.69) uIU/ml,(1.70±0.81)uIU/ml,t=-3.96,P＜0.01).The level of FT3 and T3 in case group decreased significantly in the sixth week of the period of temperance comparedwith the control group(FT3:(5.22±0.92) pmol/L,(5.85±0.78) pmol/L,t=2.45,P＜ 0.05;T3:(1.54±0.54)pmol/L,(1.84±0.34)pmol/L,t=2.92,P＜0.01).The level of FT3 of the case group in the first week decreased significantly compared with the sixth week in the period of temperance (t=-4.12,P＜0.01),while the level of FT4 were increased significantly (t=-3.93,P＜0.01).In case group,the scores of HAMD-24 and the level of T3 (r=-0.465,P＜0.05),TSH (r=-0.489,P＜0.05) were negative correlation in the first week of the period of temperance.No correlation were observed between the score of HAMD-24 and the level of FT3,FT4,TSH,T3,T4 (r=-0.303-0.047,all P＞ 0.05)in the sixth week of the period of temperance.Conclusion The level of serum thyroid is disordered in patients with chronic alcohol dependence.The disorder will recover in the period of temperance and is associated with depressive emotion.

Objective: To observe the safety and clinical efficacy of tumor antigen-pulsed dendritic cell(DC) vaccine in treatment of advanced malignant tumor.Methods: Ninety-one patients with non-small cell lung cancer,colon and rectal cancer,melanoma,renal carcinoma,breast cancer and other malignant tumors were enrolled in this study.All patients met the selecting standard and signed informed consent.Human dendritic cells were obtained from peripheral blood monocytes by culturing them with granulocyte macrophage-colony stimulating factor and interleukin-4.DC vaccine was prepared from tumor antigen pulsed immature dendritic cells in vitro.Patients received the vaccine therapy once every week and one cycle was defined as once every week for 3 weeks.Results: All the patients received 96 cycles of DC vaccine treatment.Symptoms of toxicity included fever,shivering,aching pain of muscle,asthenia,itching,stifle and transient fatigue;most of the symptoms automatically recovered.Clinical efficacy of the treatment was evaluated in 76 patients.Thirty-one of the 76 patients were stable after treatment and 45 were in progressive situation,with the clinical benefiting rate being 40.8%.Eighty-five patients were followed up.The median time for progression was 2.6 months;the overall survival time was 0.9-30.6 months;and the median survival period was 4.5 months,with the one year survival rate being 9.2%.Conclusion: The results suggest that the DC vaccine therapy is well tolerated in treating patients with advanced malignant tumors and has satisfactory clinical benefit;the clinical value of DC vaccine therapy needs to be further observed.

Objective To investigate the correlation of suicidal ideation with social support and quality of life among only-child loss people.Methods Totally 320 only-child loss people were collected by using stratified cluster random sampling method.Social support rating scale(SSRS) and general quality of life inventory(GQOLI) were used to investigate the suicidal ideation status.The association of suicidal ideation with social support and quality of life was analyzed by Pearson correlation analysis.Results The suicidal risk rate of only-child loss people was 45.0％.Compared with control group((4.87±2.32),(35.50±9.33),(139.46±37.80)),only-child loss group had lower scores in suicidal ideation,SSRS,GQOLI ((8.94±3.99),(29.97±9.15),(29.97±9.15) respectively,t=1.997-15.009,P＜0.05 or P＜0.01).The suicidal ideation total score was negatively correlated with scores of SSRS and all its 4 items,GQOLI,physical function,psychological function(r=-0.121--0.270,P＜0.05 or P＜0.01).The score of suicidal ideation in the past year was positively correlated with scores of material function (r=0.135,P＜ 0.05).Regression analysis showed that age,marriage,objective support,subjective support and GQOLI were the influencing factors(t=-3.251-3.160,P＜ 0.01 or P＜0.05).Conclusion Only-child loss people have higher suicidal risks,which is negatively correlated with lower social support and quality of life,and influenced by age,marriage,SSRS and GQOLI factors.

Objective: To investigate the effect of exposure to particulate matter ≤10 μm in aerodynamic diameter (PM₁₀) on sperm quality in different stages of sperm development. Methods: This cross-sectional study included 1 827 patients attending the reproductive medicine center in Renmin Hospital of Wuhan University during April 2013 to January 2015. Air pollution data from January 2013 to January 2015 was obtained from the database of Wuhan Municipal Environmental Protection Bureau. The generalized linear model was employed to assess the association between each exposure variables and sperm parameters for several exposure windows (0-9, 10-14, 15-69, 70-90, 0-90 days before sampling) . Results: The average levels of PM₁₀ was (116.2±71.6) μg/m³ during the research period. Sperm volume was (75.4±49.1) ×10⁶/ml in sample population, (29.4±16.2) % in progressive motility and (51.8±21.6) % in total motility. Exposure to PM₁₀ was inversely associated with sperm concentration (β:-0.319; 95%CI:-0.529,-0.046) during 70-90 lag days. PM₁₀ exposure during the 0-90 lag days was significantly associated with progressive motility (β:-0.312; 95%CI:-0.527,-0.097) and total motility (β:-0.347; 95%CI:-0.636,-0.059) after adjusted for age, education level, BMI, smoking, abstinence time, temperature, humidity and season. Conclusion Exposure to PM₁₀ was associated with statistically significant decrements in sperm concentration and motility, and the adverse impact on sperm concentration was significantly in early phases of spermatogenesis.

Objective: To analyze the influence of atmospheric particulate matters (PM_2.5 and PM₁₀) on low-birth-weight (LBW) infants at different periods of gestation. Methods: We conducted a systematic literature search for 2 471 articles related to particulate matter and LBW published from January 1st 2000 to January 1st 2016 using the PubMed, Cochrane Library, Web of Science, Science Direct, Chinese Web of Knowledge, Wanfang and Weipu, and the keywords were" air pollution" , "adverse birth outcomes" , "adverse pregnancy outcomes" , "low birth weight/LBW" . According to criteria, 27 literatures were selected and included. Metafor package of the R 3.1.1 Software was used to check the heterogeneity and merge the effect value of the selected literatures, and sensitivity analysis and publication bias were detected and adjusted. Results: A total of 2 471 studies selected form the databases, 27 enrolled in this analysis according to the inclusion and exclusion criteria. Each 10 μg/m³ increase in PM_2.5 was associated with combined OR values of 1st trimester, 2nd trimester, 3rd trimester and entire gestation at 1.02(95% CI: 0.87-1.19), 1.03 (95% CI: 0.91-1.16) , 1.07 (95%CI: 1.04-1.11) and 1.09 (95%CI: 1.04-1.15), respectively. And 10 μg/m³ increase in PM₁₀ was associated with combined OR values of 1st trimester, 2nd trimester, 3rd trimester and entire gestation at 1.66 (95%CI: 1.06-2.61), 1.58 (95%CI:1.28-1.95) , 1.38 (95%CI: 1.23-1.56) and 1.04 (95%CI: 0.99-1.09), respectively. After adjusting the bias of publication, each 10 μg/m³ increase in PM_2.5 was associated with the risk of low birth weight at 1.11 (95%CI: 1.02-1.21). Conclusion This meta analysis supports an adverse impact of maternal exposure to particulate air pollution on low birth weight, varying in effects by exposure period.

Objective:To determine the risk factors for permanent nerve damage (PND) after aortic arch surgery in patients with acute type A aortic dissection (AAAD).Methods:This was a retrospective case-control study. The medical records from patients of both sexes with AAAD, aged > 18 yr, of American Society of Anesthesiologists Physical Status classification IV, who underwent aortic arch surgery in the Second Hospital of Hebei Medical University from December 2018 to December 2023, were collected. The patients were divided into non-PND group and PND group according to whether PND occurred after operation. The preoperative data of patients were collected, including age, gender, body mass index; comorbidities (hypertension, coronary heart disease, diabetes mellitus), history of smoking, history of stroke, and history of cardiovascular surgeries; syncope at onset, preoperative low SpO 2, preoperative low systolic blood pressure, and preoperative low diastolic blood pressure. The intraoperative data included surgical procedure (total aortic arch replacement or half aortic arch replacement), selective antegrade cerebral perfusion during operation, cardiopulmonary bypass (CPB) time, aortic cross-clamp time, post-parallel time, moderate hypothermia circulatory arrest time, nasopharyngeal temperature and rectal temperature during circulatory arrest, and BIS value during circulatory arrest; blood pressure during cardiopulmonary bypass and after restoration of heart beat; the incidence of dysfunction after recovery of heart beat and difficulty in hemostasis after termination of CPB. The aforementioned indicators were analyzed for difference, and the indicators with P<0.05 were included in the multivariate logistic regression analysis. Results:A total of 292 patients were ultimately included, among which 73 developed postoperative PND, resulting in an incidence of 25.0%. The results of multivariate logistic regression analysis showed that age ≥62 yr ( OR=3.783, 95% confidence interval [ CI] 1.513-10.346, P=0.006), preoperative hypertension ( OR=2.230, 95% CI 1.118-4.715, P=0.028), syncope at onset ( OR=3.001, 95% CI 1.343-6.710, P=0.007), BIS value > 14 during circulatory arrest ( OR=2.439, 95% CI 1.249-4.755, P=0.009) and difficult hemostasis after termination of CPB ( OR=3.465, 95% CI 1.758-6.882, P<0.001) were risk factors for PND after surgery. Conclusions:Age ≥ 62 yr, history of hypertension, syncope at onset, BIS value greater than 14 during circulatory arrest and difficulty in hemostasis after termination of CPB are risk factors for PND after aortic arch surgery in patients with AAAD.