Abstract On October 13 2023, the Beijing Economic and Technological Development Area Center for Disease Control and Prevention recAAAAAeived a report from a school indicating an outbreak of fever among students in Class 2, Grade 4. An on-site epidemiological investigation was immediately conducted. A total of 14 cases were reported, all of whom were students, with an attack rate of 34.15%. The onset of illness was concentrated between October 6 and 15, with the main clinical symptoms being fever, cough and fatigue. There were no cases of hospitalization, severe illness or death. Seven cases tested positive for Mycoplasma pneumoniae P1-Ⅱ. Based on the on-site investigation and laboratory test results, it was an outbreak of influenza-like illness caused by Mycoplasma pneumoniae infection. The likely cause of the spread was cases infecting other classmates through respiratory droplets while attending class. The outbreak occurred only in one class and did not spread to neighboring classes. Schools should actively carry out health education to raise awareness among parents for reporting infectious diseases, and strengthen morning and afternoon screenings to improve the sensitivity of identification.

Objective To explore the relationship between responsibility and social adaptation of the left-behind middle school students and to provide evidence for mental health education of left-behind children.Methods 290 left-behind middle school students were selected by cluster-random-sampling.All of them were assessed by the middle school students' social adaptability scale (SAS-SSS),the inventory of parent and peer attachment (IPPA) and the scale of high school students' responsibility.Results The correlation between responsibility,attachment behavior and social adaptation of left-behind middle school students were significant(r=0.39,r=0.56,P＜0.01).There were significant differences between gender on the responsibility(male(202.64±26.78) vs female(212.67±23.24)).Regression analysis showed that mother attachment,overall responsibility,general responsibility and special fault responsibility could predict the social adaptation(P＜0.05).Responsibility and its factors played a mediating role between attachment and adaptation,taking 52.1％,20.1％,30.8％,9.1％,47.9％,40.7％ proportion of the total effect.Conclusion Responsibility is an important factor affecting the social adaptation of left-behind middle school students.

Objective To evaluate the clinical characteristics of aortic dissection in pregnant patients with Marfan syndrome and the maternal and fetal outcomes in cardiovascular surgery. Methods Seven pregnant women with Marfan syndrome with aortic dissection were identified, who were treated in Beijing Anzhen Hospital Affiliated to Capital Medical University between January 2012 and September 2014. Patient charts were reviewed for cardiovascular surgery, occurrence of complications, clinical features and the maternal and fetal outcomes. Results (1)Among 7 patients, 4 cases were diagnosed as type A aortic dissection and 3 were cases diagnosed as type B aortic dissection. The diagnosis mainly depends on CT angiography. New York Heart Association(NYHA)classify into 5 of levelⅡ, 1 of levelⅢ, 1 of leveIⅣ. Except for 1 patient with cardiac tamponade lead to heart failure, the remaining 6 cases had no complications.(2)Three patients underwent heart surgery with cardiopulmonary bypass in second trimester and two patients underwent heart surgery in third trimester. Two patients terminated pregnancy before heart surgery(one of whom underwent artificial abortion,one of whom underwent cesarean section in second trimester).(3)The methods of cardiovascular surgeries were as follow:3 of Bentall+Sun′, 1 of Bentall+Sun′+right coronary artery bypass grafting, 1 of Bentall, 1 of the whole chest aorta replacement surgery, and 1 of femoral artery catheter chest aorta with membrane mesh stent implantation. The diameter of aortic roots measured during operation were 5 cm in 2 cases, 7 cm in 2 cases and 10 cm in 2 cases respectively. Among the 7 cases, 3 were conducted cesarean sections during cardiovascular surgery,1 was terminated pregnancy due to intrauterine fetal death after cardiovascular surgery, and 1 was conducted cesarean section due to severe early-onset preeclampsia at 30 weeks of pregnancy after cardiovascular surgery. (4)Among the 7 cases, 3 were conducted cesarean sections during cardiovascular surgery, the order of which was implemented cesarean section under general anesthesia firstly and then operated cardiovascular surgery with cardiopulmonary bypass and heparinization. Two were conducted cardiovascular surgery after termination of pregnancy by early artificial abortion operation or hysterotomy. 1 was conducted Bentall surgery at 18 weeks of pregnancy, after that the patient was receiving warfarin until the fetal brain hemorrhage was examined by ultrasound at 31 weeks of pregnancy;the patient was conducted cesarean section due to intrauterine fetal death. 1 was conducted heart surgery at 24 weeks of pregnancy and continue the pregnancy to 30 weeks, was conducted cesarean section due to severe early-onset preeclampsia at 30 weeks of pregnancy.(5)Among 7 patients, three patients underwent heart surgery with cardiopulmonary bypass combined with cesarean section. Two patients terminated pregnancy after heart surgery. Two patients terminated pregnancy before heart surgery. Six patients were alive and one patient died of multiple organ failure.(6)3 cases of newborn with birth body mass between 1 080 to 1 490 g.1 case of birth died after 14 d. 2 cases for newborns were alive without exception. Conclusion Aortic dissection poses serious risk for pregnant women with Marfan syndrome and the fetus, and the mortality rates for both the mother and the fetus are high. Early diagnosis and appropriate treatment should be based on maternal and fetal conditions (such as aortic dissection, gestational age). When fetus is mature, cardiovascular surgery should be carried out with cesarean section. A multi-disciplinary team between obstetric and cardiovascular surgery is crucial to the outcome of these critical patients.

Objective To evaluate the role of interlukin-6 and signal transducer and activator of transcription 3 (IL-6/STAT3) signaling pathway in the up-regulation of high mobility group box 1 (HMGB1) expression in lung tissues in septic rats.Methods Ninety healthy male Wistar rats,aged 10-14 weeks,weighing 250-300 g,were randomly divided into 3 groups (n =30 each):sham operation group (group S),cecal ligation and puncture (CLP) group and anti-IL-6 monoclonal antibody group (group IL-6).Sepsis was induced by CLP.Anti-IL-6 monoclonal antibody 0.5 mg/kg was injected intraperitoneally 1 h before CLP,while the equal volume of normal saline was given in groups S and CLP.Six rats in each group were sacrificed at 6,12,24,48 and 72 h after CLP and lungs were removed for determination of HMGB1 content (by RT-PCR),HMGB1 mRNA expression (by ELISA) and STAT3-DNA binding activity (by electrophoretic mobility shift assay) in lung tissues.Results Compared with S group,HMGB1 content,HMGB1 mRNA expression and STAT3-DNA binding activity were significantly increased in groups CLP and IL-6 (P ＜ 0.05).HMGB1 content,HMGB1 mRNA expression and STAT3-DNA binding activity were significantly lower in group IL-6 than in group CLP (P ＜ 0.05).Conclusion IL-6/STAT3 signaling pathway is involved in the up-regulation of HMGB1 expression in lung tissues in septic rats.

Objective To investigate effects of ischemic postconditioning on the nitric oxide ( NO) and nitric oxide synthase ( NOS) in diabetic rat brain tissues .Methods Thirty Wistar rats were diabetic models induced by intraperitoneal injuction of stepto-zotocin (STZ), and randomly divided into three groups: Control group (normal, diabetic), cerebral ischemia group, and ischemic postconditioning ( I-POST) group.The rats of cerebral ischemia group and ischemic postconditioning group were made model of cere -bral ischemia by ligation carotid artery .Hematoxylin-eosin ( HE) was used to observe their pathological changes in control and diabetic groups.Enzyme-linked immunosorbent assay ( ELISA) method was used to detect the expression and changes of NO and NOS in the sera in each group .Western Blot method was used to investigate the expression and changes of NOS in the retinal tissues in each group .Results For I-POST group , brain tissue defects were decreased , neuronal cells were increased , serum inducible NOS ( iNOS) content was significantly lower than endothelial NOS (eNOS) and neuronal NOS (nNOS) ( P <0.05), brain tissue iNOS expression was significantly weaker than ischemia group ( P <0.05 ) and was not different from normal group ( P >0.05 ) .Conclusions Is-chemic postconditioning can protect the brain tissue of diabetic rats by inhibiting NOS activity especially iNOS .

Aim: To establish the HPLC and LC-MC methods for the quality analysis of the different species of Radix Paeoniae Alba cultivated in Bozhou. Methods: The LC-MS method was applied to analyze the chemical composition of the cultivated species, the HPLC method was applied to determine the contents of paeoniforin, ben-zoic acid and paeonivayin in crude drugs and processing products. Results: 10 characteristic peaks were identified by LC-MS with reference standards. The significant difference was observed in the chemical compositions of 3 cultivated species. The significant difference was observed in the chemical compositions of 3 cultivated species. The content of paeoniflorin was increased significantly after traditional processing. The results indicated the 4-year-old pubang and 5-year-old xiantiao are the best cultivated species. Conclusion: The methods are simple, rapid and precise to assess and control the quality of different species of Radix Paeoniae Alba cultivated in Bozhou.

Objective To study the variation characteristics of peripheral blood β-catenin and DKK1 levels in patients with rheumatoid arthritis (RA) and the correlation with bone and joint damage.Methods One hundred and eight patients with RA (observation group) and 110 healthy individuals (control group) were selected.The bone mineral density(B MD) in the femur (femur neck,Ward area,greater trochanter,total femur area) and lumbar spine (L2,3,4) were measured by dual-energy X-ray absorptiometry instrument.X-ray for two hands were evaluated according to the Sharp score.The peripheral blood β-catenin and DKK1 levels were detected by enzyme-linked immunosorbent assay (ELISA).Multiple analysis was completed by multiple linear regression and Logistic regression.Results The peripheral blood DKK1 level in observation group was significantly higher than that in control group [(8.2 ±5.0) mg/L vs.(6.1 ±4.2)mg/L],there was statistical difference (t =2.452,P =0.025),but there was no statistical difference in β-catenin level between the 2 groups (t =15.947,P =0.142).Compared to control group,patients with RA had lower BMD at femur and lumbar spine (P ＜ 0.01).The incidence of osteoporosis in observation group was significantly higher than that in control group [31.5％ (34/108) vs.15.5％ (17/110)],there was statistical difference (x2 =9.289,P =0.005).The correlation analysis results showed that the peripheral blood DKK1 was positive correlation with erythrocyte sedimentation rate (ESR),28-jonit disease activity score (DAS28),alkaline phosphatase (AKP) and two hands X-ray joint narrowing space score in patient with RA (P ＜ 0.01 or ＜ 0.05) ;the peripheral blood β-catenin level was positively correlated with ESR and AKP (P ＜ 0.01 or ＜ 0.05).The multiple linear regression results showed that the disease duration,health assessment questionnaires (HAQ),DKK1 influenced two hands X-ray joint narrowing space score; but the age,disease duration,HAQ influenced two hands X-ray bony erosion score.The multiple Logistic regression results showed that the two hands X-ray Sharp score was the risk factor of osteoporosis at femur in patients with RA; but the age was the risk factor of osteoporosis at lumbar in patients with RA.Conclusions Peripheral blood DKK1 level in patients with RA increases significantly,while there is no apparent alteration in β-catenin level.Peripheral blood DKK1 level is correlated with disease activity and joint space narrow score.

Objective: To investigate the prevalence and influencing factors of poor eyesight among primary and middle school students in Tongzhou District, Beijing Municipality, so as to provide the evidence for developing control strategies for poor eyesight among primary and middle school students. Methods: Grades 3 to 6 students in district- and township-level primary schools, grades 1 to 3 students in district- and township-level junior high schools, and grades 1 to 3 district- and township-level high schools were sampled in Tongzhou District using the stratified cluster sampling method from 2020 to 2021. Basic information, daily activity, sleep duration and eye-using habits were collected using the specific questionnaires for poor eyesight and influencing factors among students in the 2018 national program for common diseases and health risk factors surveillance program among Chinese students, and the height and body weight were measured. Factors affecting poor eyesight were among primary and middle school students identified using a multivariable logistic regression model. Results: A total of 771 valid questionnaires were recovered, and the respondents included 392 male students (50.84%) and 379 female students (49.16%), and 321 primary school students (41.63%), 228 junior high school students (29.57%) and 222 high school students (28.79%). The prevalence of poor eyesight was 73.54% among the respondents. Multivariable logistic regression analysis showed that education phase (junior high school, OR=2.940, 95%CI: 1.931-4.476; high school, OR=5.998, 95%CI: 3.701-9.723) , obesity (OR=1.989, 95%CI: 1.258-3.146), daily exercise duration of less than 1 h (OR=1.931, 95%CI: 1.351-2.760), daily sleep duration of less than 8 h (OR=1.719, 95%CI: 1.193-2.477), at least 33 cm distance between a reading book and eyes (sometimes, OR=2.165, 95%CI: 1.320-3.550; never, OR=2.634, 95%CI: 1.767-3.928) and continuous short-distance eye use duration of 1 h and longer (OR=1.455, 95%CI: 1.020-2.078) were associated with poor eyesight among primary and middle school students. Conclusions The prevalence of poor eyesight is high among primary and middle school students in Tongzhou District. Higher grade, obesity, inadequate exercise and sleep duration and poor eye-using habits may increase the risk of poor eyesight.

AIM: To study the protective effects of Naokangning (Rhizoma Chuanxiong, Radix salviae miltiorrhizae, Hirudo, etc.) against cerebral ischemia. METHODS: We observed the effect of Naokangning on mice's resistance to cerebral ischemia when bilateral common carotid arteries and vagus nerves were ligated and hypoxia under normal pressure and airtight circumstance; With the model of partial cerebral ischemia by blocking rats'middle cer ebral artery (MACO):the effects of Naokangning on the activity of superoxide dismutase (SOD) and creatine kinas e(CK), the content of malondialdehyde (MDA) and nitric oxide (NO) were measured. RESULTS: Naokangning significantly raised mice's ability of anti-cerebral ischemia and prolonged span of life in hypoxia, Moreover, it also obviously improved the activity of SOD, reduced content of MDA in cerebrum, content of NO and activity of CK in blood serum after ischemia. CONCLUSION: Naokangning could strikingly protect brain caused by cerebral ischemia.

Objective To analyse the difference of effects of different tidal volume mechanical ventilation strategies in infants with severe congenital heart disease after curative.Methods Sixty-eight cases were chosen from CICU of Anhui Provincial Children's Hospital during Oct 2010 to Jan 2012.Thirty-two cases in A group were used in ventilation strategy by lower tidal volumes (6 ～ 10 ml/kg),36 cases in B group were used in ventilation strategy by larger tidal volumes (10 ～ 15 ml/kg).The time of mechanical ventilation,duration of ICU stay and postoperative complications were compared between the two groups.Results The time of mechanical ventilation of B group was shorter than that of A group [(8.6 ± 2.5) d vs (11.7 ± 3.2) d],duration of ICU stay of B group was shorter than that of A group [(11.4 ± 4.8) d vs (15.6 ± 5.7) d],there were statistical differences between two groups(P ＜ 0.0l).The incidence rate of ventilator associated pneumonia and pneumothorax were 6.3％ and 3.1％ in A group,which were 5.6％ and 5.6％ in B group,there were no statistical differences between two groups (P ＞ 0.05).Conclusion The effects of mechanical ventilation with larger tidal volumes is better than that with lower tidal volumes in infants with congenital heart disease postoperative therapy.