: To analyze the prevalence of anemia and iron deficiency among primary and secondary school students in Rural Nutrition Improvement Program areas of Guizhou Province in 2023, and to explore the related factors, so as to provide evidence for Rural Nutrition Improvement Program optimization. Methods: In September 2023, a stratified random cluster sampling strategy was used to select 40 rural compulsory education schools with rural nutrition improvement program in five counties of Guizhou Province. School level questionnaire was employed to collect information of basic characteristics and school meal implementation. A total of 7 826 primary and secondary school students aged 6-16 underwent anthropometry and hemoglobin (Hb) determination; serum ferritin (SF) was additionally measured in a random subsample of 1 795 pupils. Students in Grade 3 and above also completed a questionnaire covering demographic characteristics, dietary behaviours and nutrition knowledge. Group comparisons were conducted by Chi square test or Fisher s exact test, and multivariable Logistic regression models were constructed to identify factors associated with anemia and iron deficiency. Results: The overall Hb level was (133.21±12.95)g/L, with an anemia prevalence of 7.17%. The overall SF level was (69.58±59.01)μg/L, with an iron deficiency prevalence of 2.73%. Multivariable analysis showed that stunting ( OR =1.88), school menus without nutrient calculation ( OR =1.61) and absence of menu planning software in the current semester ( OR =2.34) independently increased anemia risk, whereas obesity reduced it ( OR =0.54) (all P <0.05). Girls ( OR =4.16) and Grades 7-9 ( OR =5.93) increased iron deficiency risk (both P <0.05). Compared with rarely eating fresh vegetables, students with consuming <3 kinds per day ( OR =0.08) or exactly 3 kinds per day ( OR =0.06) had lower iron deficiency risks (both P <0.05). Conclusions Anemia and iron deficiency are prevalent among primary and secondary school students in Guizhou. Targeted intervention measures should be implemented for key populations to enhance the effectiveness of nutrition improvement program.

Dysfunction of the diaphragm is a common problem in mechanically ventilated patients and is closely related to various adverse outcomes.This review summarizes the evaluation methods of diaphragm function,the association between diaphragm dysfunction and adverse clinical outcomes in critically ill mechanically ventilated patients,and the protective effect of diaphragm function on adverse outcomes related to mechanical ventilation.The aim is to provide references for medical staff to optimize evaluation techniques,develop personalized nursing plans,and improve patients' quality of life and health outcomes.

Objective To explore the diagnostic value of serum sex hormone binding globulin(SHBG),in-sulin-like growth factor-1(IGF-1)and bone age index(BAI)in girls with precocious puberty(PP).Methods A total of 220 girls with PP who were treated in this hospital from January 2022 to August 2024 were selected as the research subjects.The research subjects were divided into 104 children with central preco-cious puberty(CPP,CPP group)and 116 children with simple premature thelarche(SPT,SPT group)accord-ing to the type of the patients' disease.Another 110 girls with normal physical examination and development during the same period were selected as the control group.The levels of serum SHBG and IGF-1 in each group were determined and BAI was calculated.The diagnostic efficacy of the combined detection of serum SHBG,IGF-1 and BAI for CPP was analyzed through the receiver operating characteristic curve,and the correlation between serum SHBG,IGF-1,BAI and sex hormone indicators in girls with PP was analyzed by Pearson corre-lation analysis.Results The levels of height,basal follicle-stimulating hormone(FSH),basal luteinizing hor-mone(LH),and estradiol(E2)in the CPP group and the SPT group were higher than those in the control group,and the differences were statistically significant(P＜0.05).The serum SHBG levels in the CPP group and the SPT group were lower than those in the control group,and the differences were statistically significant(P＜0.05).The serum IGF-1 and BAI in the CPP group and the SPT group were higher than those in the control group,and the differences were statistically significant(P＜0.05).The area under the curve(AUC)of the three combined diagnoses of PP in girls was 0.941,which was significantly larger than those of IGF-1 and BAI(Z=8.140,9.470,both P＜0.05).The AUC of the three combined diagnoses of CPP in girls was 0.958,which was significantly higher than those of the single tests of serum SHBG,IGF-1,and BAI(Z=2.821,7.363,6.412,all P＜0.05).The levels of serum SHBG in PP of girls were negatively correlated with those of IGF-1,BAI,basal FSH,basal LH and E2(P＜0.05).Serum IGF-1 was positively correlated with BAI,basal FSH and basal LH(P＜0.05),but not correlated with E2(P＞0.05).BAI was positively correla-ted with the levels of basal FSH,basal LH and E2(P＜0.05).Conclusion The combination of serum SHBG and IGF-1 with BAI has certain diagnostic value for PP in girls,especially for the diagnosis of CPP,which is significantly superior to a single test.

Objective:To explore glucose and lipid metabolism in obese children and its correlation with precocious puberty.Methods:A total of 65 obese children (obese group) and 65 children with normal body weight (control group) who underwent physical examination at the Beijing Luhe Hospital Affiliated to Capital Medical University from March 2021 to March 2023 were retrospectively selected. Glucose and lipid metabolism indexes of the two groups were detected, and precocious puberty was evaluated according to Tanner staging criteria. Spearman test was used to analyze the correlation between glucose and lipid metabolism indexes and precocious puberty. Logistic regression analysis was used to screen the risk factors of precocious puberty in obese children.Results:The levels of fasting blood glucose (FPG), 2-hour postprandial blood glucose(2 h PG), glycosylated hemoglobin (HbA 1c), fasting insulin (FINS), insulin resistance index (HOMA-IR), triacylglycerol (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and uric acid (UA) in the obese group were higher than those in the control group: 5.90(5.50, 6.50) mmol/L vs. 4.90(4.40, 5.30) mmol/L, (8.46 ± 1.38) mmol/L vs. (7.39 ± 0.87) mmol/L, 5.90(5.10, 6.70)% vs. 5.30(4.50, 5.70)%, (10.67 ± 2.46) mU/L vs. (5.14 ± 1.22) mU/L, 2.10(1.90, 2.30) vs. 1.10(1.00, 1.30), (141.95 ± 34.92) mmol/L vs. (95.21 ± 12.40) mmol/L, (153.82 ± 25.44) mmol/L vs. (143.59 ± 18.47) mmol/L, 80.50(72.10, 94.50) mmol/L vs. 65.10(59.30, 69.80) mmol/L, 293.20(271.80, 330.70) μmol/L vs. 250.90(210.80, 286.90) μmol/L; while the level of high-density lipoprotein cholesterol (HDL-C) was lower than that in the control group: 53.70(50.10, 58.00) mmol/L vs. 59.30(56.70, 62.60) mmol/L, there were statistical differences ( P<0.05). The incidence of precocious puberty in boys and girls in the obesity group was higher than those in the control group: 23.68%(9/65) vs. 0; 37.04%(10/65) vs. 7.41%(2/65), there were statistical differences ( P<0.05). The results of the Spearman test showed that the Tanner scores of testis and pubic hair in boys and breast and pubic hair in girls in the obesity group were positively correlated with FPG, 2 h PG, HbA 1c, FINS, HOMA-IR, TG, TC, LDL-C and UA ( P<0.05), and there was a negative correlation with HDL-C ( P<0.05). The results of multivariate Logistic regression analysis showed that increased levels of FPG, HbA 1c, FINS, HOMA-IR, TG, TC and UA were risk factors for precocious puberty in obese children ( OR>1, P<0.05). Conclusions:Obesity is associated with precocious puberty and the disorder of glucose and lipid metabolism is related to precocious puberty.

Objective To summarize and analyze the clinical efficacy of negative pressure suction bell in the treatment of young children (≤6 years) with pectus excavatum. Methods The relevant clinical medical records of the children with pectus excavatum who received negative pressure suction bell treatment in the Outpatient Department of Children’s Hospital of Chongqing Medical University from May 2019 to January 2023 were collected. The age, sex, type, severity, depth of depression, duration of use and prognosis of children with pectus excavatum were retrospectively analyzed. Results A total of 100 pediatric patients were ultimately included in the study, comprising 74 males and 26 females. The age distribution was 57 patients aged 0-3 years and 43 patients aged 3-6 years. All patients were prescribed and used a negative pressure suction device for at least 3 months, after which they returned to our department's outpatient clinic for follow-up. The treatment demonstrated clinical effectiveness in 99 patients, yielding an efficacy rate of 99.00%. The excellent/good rate was 52.00%, and the complication rate was 8.00%. After treatment, the Haller index and the depth of sternal depression were reduced compared with those before treatment (P<0.001), and there was no statistical difference in the effective rate and excellent/good rate between different genders, different ages, different types of pectus excavatum, or different severity (P＞0.05). Conclusion Negative pressure suction bell is safe and effective in the treatment of young children (≤6 years) with pectus excavatum, and the correction effect has nothing to do with gender, type and severity.

Objective:To compare the impact of the AlignRT-based optical guidance method with the traditional marker line method on the accuracy of positioning, and explore the effect of patient′s different thoracic characteristic parameters on the precision of optical guidance positioning.Methods:A total of sixty breast cancer patients who received post breast-conserving radiotherapy at Anhui Cancer Hospital from July 2022 to September 2023 were retrospectively selected. Then these patients were equally divided into traditional cross hairs set-up (marker line group) and surface-guided set-up (SGRT group). The cone-beam CT scanning results were used as the gold standard, the three-dimensional set-up errors and the CTV-PTV target area external radiotherapy boundaries of two groups were studied comparatively. Multiple patient′s thoracic characteristic parameters were defined and the correction between each parameter and set-up error of SGRT was analyzed.Results:The mean value of three-dimensional set-up errors in the SGRT group and the marker line group was within 0.2 cm and 0.5 cm, respectively. The differences in three-dimensional set-up errors and total displacements between two groups were statistically significant ( z=-2.93, -3.21, -2.59, -4.76, P<0.05). The SGRT group reduced the CTV-PTV boundary from 0.5 cm of conventional marker line group to 0.3 cm. The thoracic aspect ratio H/W, the affected side pinch angle α1, and the healthy side pinch angle α2 were positively correlated with the x-direction posing error ( r=0.49, 0.59, 0.71, P<0.05); whereas, the affected side and the healthy side mammary gland heights D1 and D2 were negatively correlated with the z-direction posing error ( r=-0.46, -0.49, P<0.05). Conclusions:For breast-conserving postoperative radiotherapy patients, SGRT can obtain a more accurate radiotherapy set-up than the traditional marker line method, and can effectively reduce the target area externally expanded range. Meanwhile, the monitoring accuracy of SGRT is affected by the patient′s thoracic characteristic parameters, and clinical attention should be paid to breast-conserving radiotherapy patients with thick body shape, narrow body width, and small breast glands.

OBJECTIVE To explore the changes of microribonucleic acid(miR)-223,miR-155 and miR-125 in the neonates with sepsis and analyze the distribution of pathogens so as to provide bases for clinical diagnosis and treatment of neonates with sepsis.METHODS A total of 39 neonates with sepsis who were treated in Jinan Second Maternal and Child Health Hospital from May 2021 to May 2023 were enrolled in the study and were assigned as the study group,meanwhile,42 healthy neonates who were born in the hospital were chosen as the control group.The distribution and drug resistance of the pathogens isolated from the neonates of the study group were statistically analyzed.The relative expression levels of peripheral blood miR-223,miR-155 and miR-125 were com-pared between the two groups,and the values of the three indexes in diagnosis of neonatal sepsis were analyzed.RESULTS Totally 46 strains of pathogens were isolated from the 39 neonates with sepsis,20 of which were Escherichia coli,and 10 were Staphylococcus aureus.The E.coli strains were resistant to ampicillin,tetra-cycline,ciprofloxacin and cefazolin;the S.aureus strains were resistant to penicillin,erythromycin,cefazolin and clindamycin,with the drug resistance rates higher than 50％.The expression level of miR-223 of the study group was 2.13±0.70,higher than that of the control group,the expression level of miR-125 of the study group was 0.92±0.30,higher than that of the control group;while the expression level of miR-155 of the study group was 2.08±0.68,lower than that of the control group(P＜0.05).The area under the curve(AUC)of the joint detec-tion of miR-223,miR-155 and miR-125 was 0.945 in diagnosis of neonatal sepsis,with the sensitivity 92.31％,the specificity 88.10％.CONCLUSIONS E.coli and S.aureus are dominant among the pathogens isolated from the neonates with sepsis.The neonates with sepsis show abnormal expressions of peripheral blood miR-223,miR-155 and miR-125,and the joint detection of the three indexes has high value in diagnosis of neonatal sepsis.

Central venous pressure(CVP)is a commonly used hemodynamic index in clinical practice,and the accuracy of its measurement results is influenced by the measurement technical specifications.Based on research evidence and clinical practice,this article interprets the main content of the group standard of CVP measurement technology,and proposes suggestions for its use.It aims to guide clinical nursing staff to correctly understand the principles and methods of CVP measurement,and promote the standardization of nursing practice and the accuracy of measurement results.

Objective:To investigate the effects and underlying molecular mechanisms of Utidelone (UTD1) in small cell lung cancer (SCLC).Methods:The study utilized small cell lung cancer H446 and H1048 cell lines along with animal models. Cell proliferation, cell cycle progression, apoptosis, autophagy, and related activities following UTD1 treatment were assessed using Cell Counting Kit-8 (CCK-8), flow cytometry, immunofluorescence staining, reactive oxygen species (ROS) generation assay, and Western blot analysis. The involvement of the ROS/adenosine monophosphate-activated protein kinase (AMPK) signaling pathway was also examined. Data analysis was performed using GraphPad Prism version 8 software.Results:UTD1 inhibited the viability of H446 and H1048 cells in a dose- and time-dependent manner. The half inhibitory concentrations (IC 50) of UTD1 for H446 and H1048 cells were 0.675 and 0.439 μg/ml, respectively. The proportion of cells in the G 2/M phase for H446 and H1048 cells in the UTD1 group at 6 h, 12 h, and 24 h was [(53.86±4.54)%, (68.59±5.49)%, (60.89±3.26)%] and [(46.83±2.20)%, (60.67±3.44)%, (57.88±5.11)%], which were significantly higher than that in the control group, except for the proportion of H1048 cells at 6 h [(38.99±2.60)% vs. (40.73±2.50)%, P＜0.05]. The apoptosis rates were [(23.57±0.12)%, (35.79±1.59)%, and (46.15±4.57)%] for H446 cells and [(23.05±2.70)%, (37.73±2.97)%, and (43.39±3.31)% for H1048 cells], all of which were significantly higher than those in the control group [(6.44±0.96)%, (6.31±0.75)%, respectively; all P＜0.05]. The number of LC3 fluorescent spots was [(56±11), (69±8), and (66±8)] for H446 cells and [(39±7), (56±12), and (50±11)] for H1048 cells, both significantly higher than those in the control group [(13±6) and (12±5), respectively; both P＜0.05]. The relative fluorescence intensity of ROS was 2.54±0.48, 2.85±0.68, and 5.03±0.72 for H446 cells and 2.26±0.51, 4.17±0.35, and 4.66±0.51 for H1048 cells, which were also significantly higher than those in the control group ( P＜0.05). The expression levels of cyclin B1, cyclin A2, and P21 of H446 cells in the three time points were [(0.63±0.07, 0.33±0.05, 0.23±0.04), (0.68±0.08, 0.46±0.03, 0.27±0.06), and (0.64±0.03, 0.32±0.05, 0.22±0.03), respectively], all significantly lower compared to the control group ( P＜0.05). The apoptosis rates of H446 and H1048 cells in the UTD1+Z-VAD-FMK group were (19.97±3.19)% and (17.68±3.14)%, both lower than those in the UTD1 group [(40.73±3.35)% and (39.82±2.45)%, respectively; all P＜0.05]. The absorbance values of H446 and H1048 cells in the UTD1+3-MA group were significantly higher than those in the UTD1 group at 6h, 12h, and 24h (all P＜0.05). The levels of p-AMPKα/AMPKα, LC3-II expression, and the percentage of apoptotic cells in the H446 and H1048 cells of the UTD1+NAC group were [(1.33±0.09, 1.33±0.11), (1.49±0.16, 1.55±0.05), (17.24±2.15)%, and (19.40±4.28)%], all of which were lower than those observed in the UTD1 group [(1.98±0.17, 2.23±0.23), (2.81±0.19, 2.49±0.38), (38.07±3.53)%, and (41.20±1.87)%, all P＜0.05]. The number of LC3 fluorescence points and the percentage of apoptotic cells in the H446 and H1048 cells of the UTD1+si-AMPKα group [(24±5, 23±3), (18.35±1.15)%, and (19.15±3.46)%] were all lower than those in the UTD1+si-NC group [(46±6, 36±6), (39.34±1.77)%, and (39.50±2.15)%, all P＜0.05]. The tumor inhibition rates in small cell lung cancer tumor-bearing nude mice for the 2.5 mg/kg UTD1 group and the 5 mg/kg UTD1 group were 46.43% and 58.33%, respectively. Furthermore, the proportions of apoptosis-positive cells and p-AMPKα-positive cells in the UTD1 group were significantly higher compared to the control group, while the levels of Ki-67 positivity were significantly reduced. Conclusion:UTD1 inhibits SCLC cell proliferation, induces G 2/M phase arrest, and promotes cell apoptosis and autophagy through the activation of the ROS/AMPK signaling pathway.

The new era imposes heightened demands on medical professionals,who must not only possess a solid theoretical foundation but also exhibit strong practical skills and innovative capabilities.The quality of medical func-tional laboratory construction is crucial for cultivating high-caliber medical talents.In light of the current developmental status and trends regarding functional experiment teaching within Chinese higher education institutions,particularly the disparities in development across various regions and institutions,the Functional Experiment Teaching Committee of the Chinese Pathophysiology Society has developed an expert consensus on laboratory construction standards.This consensus was established through comprehensive investigations,research,and extensive discussions to provide a reference for di-verse institutions to continuously enhance their levels of laboratory construction.