Objective: To understand the growth and development levels of four physical measurements in children aged 3-6 years in China, so as to provide a reference for child nutrition improvement and health promotion. Methods: A stratified random sampling method was used to collect physical measurement data from 120 kindergartens 25 842 children aged 3-6 years across 24 provinces and cities in seven natural geographical regions of North China, Northeast China, East China, Central China, South China, Southwest China and Northwest China from 2020 to 2023. The development levels of head circumference, chest circumference, waist circumference, and hip circumference were evaluated using a grading method. The analysis of gender and age differences was conducted using Mann-Whitney U- test and Kruskal-Wallis test, and the comparison of abnormal detection rates for different genders was conducted using Chi square test. Results: The distribution range of children aged 3-6 was 51.74(50.08, 53.33) cm in terms of head circumference, 55.73(52.09, 59.04) cm in terms of chest circumference, 53.04(48.92, 56.40) cm in terms of waist circumference, and 59.36(56.30, 62.32) cm in terms of hip circumference. The detection rate of abnormal head circumference in boys and girls aged 3-6 years old was relatively high (19.71%-42.02%), and the detection rate of abnormal physical circumference development levels in boys was higher than that in girls of all ages ( χ 2=5.63-83.35, P <0.05). The detection rate of abnormal hip circumference (4.89%-6.53%) and chest circumference (4.51%-6.38%) in boys and girls aged 3-6 was relatively low, and there was no statistically significant difference in the abnormal rate between different ages and genders ( χ 2=0.00-1.61, 0.00-3.71, P >0.05). The detection rate of abnormal waist circumference in boys and girls aged 3-6 was relatively high (13.70%-42.45%), and the detection rate of abnormal waist circumference in girls was higher than that in boys aged 4-6 groups ( χ 2=10.49-58.18, P < 0.05). Conclusions The overall physical development of children aged 3-6 years in China is improving, but the abnormal detection rates for head circumference and waist circumference are relatively high. Child healthcare should focus on preventing and treating abdominal obesity, with differentiated health intervention strategies based on different age groups and genders.

Objective: To analyze the relationship between body mass index(BMI) during pre pregnancy, maternal lipid levels during early pregnancy and childhood overweight and obesity, as well as the mediating role of maternal lipid levels during early pregnancy in pre pregnancy BMI and childhood overweight and obesity, providing scientific evidence for developing obesity prevention strategies in preschool children. Methods: Using data from Peking University Birth Cohort in Tongzhou (PKUBC-T) collected between June 2018 and September 2022, the study included 1 292 mother-child pairs. Participants were stratified into two groups based on children s BMI Z scores at age 3: an overweight/obesity risk group (BMI Z >1, n =173) and a non overweight/obesity risk group (BMI Z ≤1, n =1 119).Multivariate Logistic regression was conducted to analyze the associations between pre pregnancy BMI, maternal lipid levels[total cholesterol(TC),triglyceride（TG）,high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),TC/HDL-C,TG/HDL-C,LDL-C/HDL-C] during early pregnancy and childhood overweight and obesity. The mediating effect of maternal lipid levels during early pregnancy on pre pregnancy BMI and childhood overweight and obesity was further explored. Results: There were statistically significant differences in pregnancy BMI levels, early pregnancy blood LDL-C ,TC/HDL-C,LDL-C/HDL-C levels between the overweight and obesity risk group and the non overweight and obesity risk group ( χ 2/Z =19.01, 2.48, 2.48, 2.71, all P <0.05). Multivariate Logistic regression analysis showed that pre pregnancy BMI, LDL-C, TC/HDL-C and LDL-C/HDL-C in early pregnancy were significantly associated with childhood overweight and obesity ( OR =1.09, 1.42, 1.49, 1.60, all P <0.05). LDL-C, TC/HDL-C and LDL-C/HDL-C in early pregnancy played a significant mediating role on pre pregnancy BMI and childhood obesity and the mediating effects accounted for 7.3%, 10.2%, 23.5% of the total effects, respectively (all P <0.05). Conclusions Maternal hyperlipidemia during early pregnancy partially mediated the association between pre pregnancy obesity and childhood obesity. Both pre pregnancy obesity and maternal hyperlipidemia during early pregnancy are risk factors for obesity in preschool children.

Objective: To investigate the prevalence of work-related musculoskeletal disorders (WMSDs) and influencing factors among vegetable greenhouse workers, so as to provide insights into relevant intervention measurements. Methods: Workers from 4 vegetable greenhouse villages were sampled in the suburbs of Xining City using a cluster sampling method from March to April 2023. Participants' demographic information, characteristics of greenhouse operation and prevalence of WMSDs were collected using questionnaire surveys. Factors affecting the prevalence of WMSDs among vegetable greenhouse workers were identified using a multivariable logistic regression model. Results: A total of 550 questionnaires were distributed, and 518 valid questionnaires were recovered, with an effective response rate of 94.18%. There were 264 males (50.97%) and 254 females (49.03%), and 269 participants (51.93%) aged 50 years and older. The prevalence of WMSDs among vegetable greenhouse workers was 40.93% (212 cases). Waist, neck and back were mainly affected, with 185 (35.71%), 157 (30.31%), and 153 (29.54%) cases, respectively. Multivariable logistic regression analysis showed that workers who smoke (OR=2.406, 95%CI: 1.133-5.110), worked 8 hours and longer per day (OR=6.618, 95%CI: 3.492-12.542) and lift heavy loads of about 20 kg (OR=1.770, 95%CI: 1.013-3.092) had a higher risk of WMSDs. Conclusions WMSDs occurred in 40.93% of vegetable greenhouse workers in Xining City, and waist, neck and back were mainly affected. Smoking, working duration and lifting heavy loads may influence the prevalence of WMSDs among vegetable greenhouse workers in Xining City.

Objective To explore the relationship between health literacy of chronic diseases and the effect of blood glucose control in newly diagnosed and prediabetes patients. Methods A total of 180 newly diagnosed and prediabetes patients treated in the Western Theater Command General Hospital from January 2021 to January 2023 were selected, including 94 newly diagnosed and 86 prediabetes patients. The health literacy of chronic diseases in these patients was evaluated by using the health literacy management scale (HeLMS) developed by Jordan et al. The differences of clinical general information and blood glucose control between patients with adequate and insufficient health literacy were analyzed. Results Among the 180 patients, the total score of information acquisition ability, communication and interaction ability, willingness to improve health, willingness for financial support, total score of health literacy, and adequate proportion of health literacy assessed by HeLMS were (35.54 ± 7.21), (33.02 ± 8.15), (15.54 ± 3.92), (7.10 ± 0.98), (91.87 ± 7.28), and 51.67%, respectively. The age of patients with adequate health literacy in the newly diagnosed diabetes group was (52.23 ± 7.15) years old, which was significantly lower than that of patients with insufficient health literacy (P<0.05). The proportions of patients with high school education and above, monthly income ≥ 3000 yuan, and relatives engaged in medical work were 68.09%, 68.09%, and 34.04%, respectively, which were significantly higher than those of patients with insufficient health literacy (P<0.05). The age of patients with adequate health literacy in prediabetes group was (82.23 ± 4.15) years old, which was significantly lower than that of patients with insufficient health literacy (P<0.05). The proportions of patients with high school education and above, monthly income ≥ 3000 yuan, number of children ≥ 2, and relatives engaged in medical work were 65.22%, 67.39%, 34.78%, and 41.30%, respectively, which were significantly higher than those of patients with insufficient health literacy (P<0.05). The fasting blood glucose, glycosylated hemoglobin and 2h postprandial blood glucose of patients with adequate health literacy in the newly diagnosed diabetes group after treatment were (6.43 ± 0.93) mmol/L, (6.02 ± 0.91)% and (7.71 ± 1.01) mmol/L, respectively, which were significantly lower than those of patients with insufficient health literacy (P<0.05). The fasting blood glucose, glycosylated hemoglobin and 2h postprandial blood glucose in patients with adequate health literacy in prediabetes group after treatment were (5.21 ± 0.37) mmol/L, (5.20 ± 0.40)% and (6.20 ± 0.92) mmol/L, respectively, which were significantly lower than those in patients with insufficient health literacy (P<0.05). Conclusion The chronic disease health literacy of prediabetes and new-onset patients is related to the age, education and monthly income level, number of children, relatives engaged in medical work of patients, and the level of health literacy is helpful to the control of blood glucose.

Female ; Humans ; Endodermal Sinus Tumor/pathology* ; Adenocarcinoma/pathology* ; Choriocarcinoma/pathology*

Objective: To investigate the clinicopathological characteristics of esophageal carcinoma with gland duct differentiation. Methods: The clinical, morphologic and immunohistochemical (IHC) features of eight cases of esophageal carcinoma with gland duct differentiation diagnosed from 2012 to 2022 at the First Affiliated Hospital of Soochow University were summarized. Results: There were four males and four females, with a mean age of 68.5 (range 59-82) years. Two tumors were located in middle esophagus, five in the lower esophagus, and one in the cardia. The mean diameter was 2.4 cm (range 0.6-4.5 cm). The tumor had a bilayer epithelial structure, including the inner luminal epithelium and the outer basal epithelium. Immunohistochemistry showed that CK7 (8/8) and CK18 (8/8) were positive in the inner epithelium. p40 (8/8), p63 (8/8) and CK5/6 (8/8) were positive in the outer epithelium. SMA, calponin and CD117 were all negative. p53 mutants were found in all eight cases (strong and diffuse positivity in 6/8; complete loss of expression in 2/8). No columnar metaplasia, intestinal metaplasia and ectopic gastric mucosa were observed in the surface squamous epithelium in the cases. The mean follow-up time was 21.5 months (range 5-51 months). Seven patients survived and one patient died 31 months after surgery due to recurrence and liver metastasis. Conclusion: Esophageal carcinoma with esophageal gland duct differentiation is a rare tumor with unique histologic and IHC characteristics.
Male ; Female ; Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Esophageal Neoplasms/pathology* ; Epithelium/pathology* ; Metaplasia/metabolism* ; Carcinoma/pathology*

Humans ; Herpesvirus 4, Human ; Epstein-Barr Virus Infections/complications* ; Cholangiocarcinoma/pathology* ; Carcinoma, Squamous Cell ; Bile Ducts, Intrahepatic/pathology* ; Bile Duct Neoplasms/pathology*

Humans ; Thyroid Cancer, Papillary ; Neck/pathology* ; Lymph Nodes/pathology* ; Thyroid Neoplasms/pathology* ; Lymphoma, T-Cell/pathology*

Objective: To investigate the clinicopathological features of perivascular epithelioid cell tumor (PEComa) of the lung. Methods: Eight PEComa cases of the lung diagnosed at the First Affiliated Hospital of Soochow University, Suzhou, China from July 2008 to December 2021 were collected and subject to immunohistochemical staining, fluorescence in situ hybridization and next generation sequencing. The relevant literature was reviewed and the clinicopathological features were analyzed. Results: There were 5 males and 3 females, aged from 18 to 70 years (mean 39 years). There were 3 cases of the right upper lung, 3 cases of the left lower lung, 1 case of the left upper lung and 1 case of the right middle lung. Seven cases were solitary and 1 case was multifocal (4 lesions). Seven cases were benign while one was malignant. The tumors were all located in the peripheral part of the lung, with a maximum diameter of 0.2-4.0 cm. Grossly, they were oval and well circumscribed. Microscopically, the tumor cells were oval, short spindle-shaped, arranged in solid nests, acinar or hemangiopericytoma-like patterns, with clear or eosinophilic cytoplasm. The stroma was rich in blood vessels with hyalinization. Coagulated necrosis and high-grade nuclei were seen in the malignant case, and calcification was seen in 2 cases. Immunohistochemically, the tumor cells were positive for Melan A (8/8), HMB45 (7/8), CD34 (6/8), TFE3 (4/7), and SMA (3/8). All cases were negative for CKpan and S-100. TFE3 (Xp11.2) gene fusion was examined using the TFE3 break-apart fluorescence in situ hybridization in 5 cases, in which only the malignant case was positive. The next generation sequencing revealed the SFPQ-TFE3 [t(X;1)(p11.2;p34)] fusion. Follow-up of the patients ranged from 12 to 173 months while one patient was lost to the follow-up. The malignant case had tumor metastasis to the brain 4 years after the operation and then received radiotherapy. Other 6 cases had no recurrence and metastasis, and all the 7 patients survived. Conclusions: Most of the PEComas of the lung are benign. When there are malignant morphological features such as necrosis, high-grade nuclei or SFPQ-TFE3 gene fusion, close follow-up seems necessary.
Male ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Perivascular Epithelioid Cell Neoplasms/pathology* ; Lung/pathology* ; Basic Helix-Loop-Helix Leucine Zipper Transcription Factors/genetics* ; Necrosis ; Biomarkers, Tumor/analysis*

Objective: To explore the potential pathogenesis of clear cell renal cell carcinoma (ccRCC) based on the HIF-1α/ACLY signaling pathway, as well as to provide new ideas for the treatment of ccRCC. Methods: Seventy-eight ccRCC cases diagnosed at the First Affiliated Hospital of Soochow University, Suzhou, China were collected. The VHL mutation was examined using exon sequencing. The expression of HIF-1α/ACLY in VHL-mutated ccRCC was evaluated using immunohistochemical staining and further validated in VHL-mutated ccRCC cell lines (786-O, A498, UM-RC-2, SNU-333, and Caki-2) using Western blot. The mRNA and protein levels of ACLY were detected using real-time quantitative PCR and Western blot after overexpression or interference with HIF-1α in ccRCC cell lines. HeLa cells were treated with CoCl₂ and hypoxia (1%O₂) to activate HIF-1α and then subject to the detection of the ACLY mRNA and protein levels. The potential molecular mechanism of HIF-1α-induced ACLY activation was explored through JASPAR database combined with chromatin immunoprecipitation assay (ChIP) and luciferase reporter gene assay. The effect of HIF-1α/ACLY regulation axis on lipid accumulation was detected using BODIPY staining and other cell biological techniques. The expression of ACLY was compared between patients with ccRCC and those with benign lesions, and the feasibility of ACLY as a prognostic indicator for ccRCC was explored through survival analysis. Results: Exon sequencing revealed that 55 (70.5%) of the 78 ccRCC patients harbored a VHL inactivation mutation, and HIF-1α expression was associated with ACLY protein levels. The protein levels of ACLY and HIF-1α in ccRCC cell lines carrying VHL mutation were also correlated to various degrees. Overexpression of HIF-1α in A498 cells increased the mRNA and protein levels of ACLY, and knockdown of HIF-1α in Caki-2 cells inhibited the mRNA and protein levels of ACLY (P<0.001 for all). CoCl₂ and hypoxia treatment significantly increased the mRNA and protein levels of ACLY by activating HIF-1α (P<0.001 for all). The quantification of transcriptional activity of luciferase reporter gene and ChIP-qPCR results suggested that HIF-1α could directly bind to ACLY promoter region to transcriptionally activate ACLY expression and increase ACLY protein level (P<0.001 for all). The results of BODIPY staining suggested that the content of free fatty acids in cell lines was associated with the levels of HIF-1α and ACLY. The depletion of HIF-1α could effectively reduce the accumulation of lipid in cells, while the overexpression of ACLY could reverse this process. At the same time, cell function experiments showed that the proliferation rate of ccRCC cells with HIF-1α knockdown was significantly decreased, and overexpression of ACLY could restore proliferation of these tumor cells (P<0.001). Survival analysis further showed that compared with the ccRCC patients with low ACLY expression, the ccRCC patients with high ACLY expression had a poorer prognosis and a shorter median survival (P<0.001). Conclusions: VHL mutation-mediated HIF-1α overexpression in ccRCC promotes lipid synthesis and tumor progression by activating ACLY. Targeting the HIF-1α/ACLY signaling axis may provide a theoretical basis for the clinical diagnosis and treatment of ccRCC.
Humans ; Carcinoma, Renal Cell/pathology* ; Kidney Neoplasms/pathology* ; HeLa Cells ; Von Hippel-Lindau Tumor Suppressor Protein/genetics* ; Mutation ; Signal Transduction ; Luciferases/therapeutic use* ; Hypoxia/genetics* ; RNA, Messenger ; Lipids/therapeutic use* ; Hypoxia-Inducible Factor 1, alpha Subunit/genetics* ; Cell Line, Tumor ; Gene Expression Regulation, Neoplastic