ObjectiveTo investigate the influenza vaccination coverage among kindergarten and primary school children in Zhejiang Province in 2023 and analyze the influencing factors, and to provide the basis for improving the effect of influenza vaccination in children. MethodsA multi-stage random cluster sampling method was used to select 3 681 parents of children from 10 primary schools and kindergartens based on economic level and geographical distribution in Zhejiang Province, who participated in an online questionnaire survey, including basic information about the children and their parents, parents’ knowledge about influenza, and their willingness to vaccination. ResultsAmong the 3 681 parents surveyed, 33.82% (1 245/3 681) reported that their children received influenza vaccination in 2023. Multivariate logistic regression analysis showed that factors contributing to children’s influenza vaccination included both parents [adjusted OR (95%CI): 1.56 (1.32‒1.84)] and children [6.04 (5.04‒7.27)] having a history of influenza vaccination, parents’ conviction the influenza vaccine could protect children from severe diseases [1.43 (1.19‒1.74)], and the willingness of most parents would let their children get vaccinated [1.40 (1.13‒1.74)]. In contrast, vaccine hesitancy among parents [0.55 (0.43‒0.69)] and the belief that influenza is just a common cold [0.80 (0.65‒1.00)] were hindering factors. ConclusionThe influenza vaccination coverage among children is insufficient. Both the vaccination history of parents and children, as well as parents’ correct understanding of influenza and the effectiveness of influenza vaccine, significantly influence the influenza vaccination status in children. Efforts to address vaccine hesitancy and misconceptions about influenza are essential to improve vaccination rates.

OBJECTIVE To explore the efficacy and influencing factors of intravitreal injection of ranibizumab in the treatment of macular edema （ME） secondary to retinal vein obstruction （RVO） with different optical coherence tomography （OCT） subtypes. METHODS A retrospective study was conducted on 150 patients with ME secondary to RVO treated at Dept. of Ocular Trauma of Tianjin Eye Hospital between January 1， 2021 and January 1， 2024. According to OCT findings， patients were classified into the diffuse retinal thickening （DRT） group （48 cases）， cystoid macular edema （CME） group （83 cases）， and serous retinal detachment （SRD） group （19 cases）. The best corrected visual acuity （BCVA） and central macular thickness （CMT） were compared before and at 1， 3 and 6 months after treatment. Clinical efficacies of 3 groups were compared based on CMT and fluorescein fundus angiography （FFA） findings before and after treatment. Adverse events and the number of additional injections of ranibizumab during treatment were compared among 3 groups. Using “ineffectiveness” in clinical outcomes at 6 months post- treatment as the dependent variable and patients’ baseline data as the independent variables， a multivariate Logistic regression analysis was conducted to identify risk factors influencing the clinical efficacy of ranibizumab. RESULTS The proportion of branch RVO was significantly higher in the CME and SRD groups than in the DRT group （P＜0.05）， while central RVO （CRVO） was more frequent in the DRT group than in the CME and SRD groups （P＜0.05）. The proportion of patients with ischemia was highest in the SRD group， followed by the CME and DRT groups （P＜0.05）， while the proportion of patients with ischemia in the CME group was significantly higher than that in the DRT group （P＜0.05）. Before treatment， the BCVA and CMT showed no significant differences among the 3 groups （P＞0.05）. After treatment， BCVA and CMT in all 3 groups were significantly reduced compared to those before treatment （P＜0.05）. At different treatment time points， patients in the CME group and SRD group consistently showed significantly higher BCVA and CMT values compared to those in the DRT group （P＜0.05）. Six months after treatment， the differences in clinical efficacy among the 3 groups were statistically significant （P＜0.05）， with the proportion of non-responders in the SRD group being significantly higher than that in the DRT group and the CME group （P＜0.05）. The number of additional injections of ranibizumab in patients from the CME group and the SRD group was significantly more than that in the DRT group （P＜0.05）. The incidence of adverse reactions did not differ significantly among 3 groups （P＞0.05）. Multivariate Logistic regression revealed that CRVO and ischemic type were common risk factors affecting the clinical efficacy of ranibizumab in all 3 groups， while longer disease duration was an independent risk factor for the clinical efficacy of ranibizumab in patients from the DRT group. CONCLUSIONS The therapeutic efficacy of ranibizumab varies among different OCT phenotypes of ME secondary to RVO. DRT patients achieve the best visual improvement， SRD patients have the highest non-response rate， and CME/SRD patients require more additional injections of ranibizumab. CRVO and ischemia are shared adverse prognostic factors for poor prognosis in various subtypes of ME secondary to RVO. Individualized treatment and follow-up strategies should be developed based on OCT patterns and risk factors.

Objective:To conduct a scoping review of research on the use of cosmetic care in breast cancer patients.Methods:Using Arksey and O'Malley's scoping review framework, PubMed, Web of Science, CINAHL, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, VIP and China Biology Medicine disc were searched for studies related to the application of cosmetic care in breast cancer patients. The search time limit was from the date construction to December 5th, 2023. The included literature were summarized and analyzed.Results:A total of 14 articles were included in this study. The intervention forms of cosmetic care were mainly education and training, group meetings, hands-on training, interviews, communication and sharing, lectures, and seminars; the content of the interventions included appearance knowledge training, image advice, make-up seminars, wig counseling and care, facial care, body care, face fixation, and prosthetic wear; and the endpoint indicators were mainly quality of life indicators, physiological indicators, psychological indicators, and social indicators.Conclusions:The content elements of the cosmetic care program were diversified, and the application of the program to breast cancer patients showed effectiveness in four aspects: quality of life, physiology, psychology, and society.

Objective To investigate the current status and awareness of pharmaceutical services in hospitals in Guizhou province and to provide a reference for exploring and carrying out pharmaceutical service fees.Methods The questionnaire was designed by the"wjx.cn"website.Three kinds of questionnaires were designed for pharmacists,doctors,nurses,and patients as the research objects,with corresponding differences in some questions,and promoted on WeChat,Dingxiangyuan,and other network platforms.Results A total of 655 questionnaires were collected,and 639 valid questionnaires were recovered,with an effective recovery rate of 97.56%.324 pharmacists(50.70%),82 doctors and nurses(12.83%),233 patients(36.46%)were surveyed.The average approval score of these three groups of respondents on pharmaceutical service fees was 4.67,4.23,and 4.22,respectively(full score:5).Conclusions Overall,pharmacists'professional services have received support from medical staff and patients.However,patients'pharmaceutical service projects currently focus on dispensing services.The recognition of pharmacists'work and the public's awareness of pharmaceutical services can be improved by enhancing the professional ability of pharmacists,strengthening publicity and guidance,and exploring"Internet+pharmaceutical services",etc.,to promote the sustainable development of pharmaceutical services.

Objective To investigate the current status of off-label drug use(OLDU)management in tertiary hospitals of Guizhou province and to provide baseline evidence for developing a unified administration regulation for OLDU in Guizhou province.Methods In line with the relevant policies and regulations,a questionnaire including basic information about the person filling out the form,basic information about the hospitals,and information about OLDU was developed.The questionnaire was sent to 84 tertiary hospitals in Guizhou province through the Wenjuanxing.Results A total of 84 questionnaires were distributed and recovered,with a response rate of 100.00%.Of the 84 hospitals,77 had OLDU,of which 68(88.31%)had established a management system for OLDU.Among the 77 hospitals with OLDU,65(84.42%),42(54.55%),58(75.32%),36(46.75%),15(19.48%),and 21(27.27%)hospitals respectively,required approval from the Committee on Drug Administration and Pharmacotherapy before OLDU,restricted the qualifications of doctors prescribing OLDU,required informed consent from patients or their families before OLDU,recorded the matters and reasons in the medical records of patients treated with OLDU,followed up patients in their files and evaluated the reasonableness of the OLDU,and carried out special reviews for OLDU.Only 30(38.96%)hospitals have set up a catalogue of OLDUs,and 58(75.32%)hospitals have urgent needs to set up a unified provincial catalogue of OLDUs.Conclusion The pharmacy administration level of OLDU in tertiary hospitals of Guizhou province is relatively low,so there is an urgent need to establish a unified OLDU management system and medication catalog.

The incidence of myopia among Chinese adolescents is progressively rising, indicating a distinct trend toward younger age onset.This paper aims to comprehensively review the impact of various visual performance on myopia and its progression, with a specific emphasis on accommodative function, convergence function, and ocular position. A meticulous exploration of accommodation function, encompassing accommodative amplitude, accommodative facility, accommodative response, positive relative accommodation, and negative relative accommodation, has been undertaken to elucidate its contributory role in myopia progression. Concurrently, an exhaustive analysis of convergence function has been conducted including esotropia and exotropia, convergence insufficiency and convergence excess, fusional function vergence, divergence insufficiency, and excess, providing a nuanced understanding of convergence's implications for myopia advancement. Furthermore, the influence of ocular position on myopia progression, along with other factors affecting perceptual ocular position and intermittent exotropia, is discussed. The primary objective of this article is to unveil the multifaceted visual performance influencing myopia and its progression, elucidating the paramount significance of accommodative function, convergence function, and ocular position in this context.

As one of the key enzymes in cell metabolism, the activity of citrate synthase 3 (CS3) regulates the substance and energy metabolism of organisms. The protein members of CS3 family were identified from the whole genome of apple, and bioinformatics analysis was performed and expression patterns were analyzed to provide a theoretical basis for studying the potential function of CS3 gene in apple. BLASTp was used to identify members of the apple CS3 family based on the GDR database, and the basic information of CS3 protein sequence, subcellular localization, domain composition, phylogenetic relationship and chromosome localization were analyzed by Pfam, SMART, MEGA5.0, clustalx.exe, ExPASy Proteomics Server, MEGAX, SOPMA, MEME, WoLF PSORT and other software. The tissue expression and inducible expression characteristics of 6 CS3 genes in apple were determined by acid content and real-time fluorescence quantitative polymerase chain reaction (qRT-PCR). Apple CS3 gene family contains 6 members, and these CS3 proteins contain 473-608 amino acid residues, with isoelectric point distribution between 7.21 and 8.82. Subcellular localization results showed that CS3 protein was located in mitochondria and chloroplasts, respectively. Phylogenetic analysis divided them into 3 categories, and the number of genes in each subfamily was 2. Chromosome localization analysis showed that CS3 gene was distributed on different chromosomes of apple. The secondary structure of protein is mainly α-helix, followed by random curling, and the proportion of β-angle is the smallest. The 6 members were all expressed in different apple tissues. The overall expression trend from high to low was the highest relative expression content of MdCS3.4, followed by MdCS3.6, and the relative expression level of other members was in the order of MdCS3.3 > MdCS3.2 > MdCS3.1 > MdCS3.5. qRT-PCR results showed that MdCS3.1 and MdCS3.3 genes had the highest relative expression in the pulp of 'Chengji No. 1' with low acid content, and MdCS3.2 and MdCS3.3 genes in the pulp of 'Asda' with higher acid content had the highest relative expression. Therefore, in this study, the relative expression of CS3 gene in apple cultivars with different acid content in different apple varieties was detected, and its role in apple fruit acid synthesis was analyzed. The experimental results showed that the relative expression of CS3 gene in different apple varieties was different, which provided a reference for the subsequent study of the quality formation mechanism of apple.
Citric Acid ; Malus/genetics* ; Citrate (si)-Synthase ; Phylogeny ; Citrates

【Objective】 To compare the killing effects of different concentrations of gentamicin (0, 10, 20, 50, 100, and 200 μg/mL) on uropathogenic Escherichia coli (UPEC) and its cytotoxicities on urinary urothelial cells and inflammatory cells such as macrophages in vitro. 【Methods】 The killing effects of different concentrations of gentamicin on different amounts (10⁸, 10⁷, and 10⁶) of UPEC strain J96 were compared. The cytotoxicities of different concentrations of gentamicin on primary cultured male C57BL/6 mouse renal tubular epithelial cells, mouse macrophages and human bladder epithelial cell line J82 at different time points (2 h and 24 h) were detected by CCK-8 assay. According to the experiments above, we chose appropriate gentamicin concentrations and incubation time in in vitro cell culture experiments to verify J96 adhesion and invasion to mouse renal tubular epithelial cells or phagocytosis and clearance of J96 by mouse macrophages. 【Results】 The killing effect of gentamicin (≥10 μg/mL) on J96 was stronger than that of 1% P/S (P<0.000 1). High concentrations of gentamicin (≥100 μg/mL) could kill up to 10⁸ J96 within 30 min. 50 μg/mL gentamincin treatment for 2 h was cytotoxic for human bladder epithelial cell line J82 (P<0.05). 【Conclusion】 The appropriate concentration and duration of gentamicin treatment for different cells in vitro were determined. Urothelial cells, especially human bladder epithelial cell line J82, were more sensitive to gentamicin.

OBJECTIVE To investigate the effect of Guanxinning tablets(GXN) on early heart failure model rats, and to explore the protective mechanism of GXN on heart failure rats from the perspective of intestinal flora. METHODS Six rats who underwent sham operation were set as sham operation group. Took 80 SD rats to undergo aortic arch stenosis and established a heart failure rat model. The surviving rats were divided into 4 groups, namely the model control group, the positive control group(captopril tablets 12.5 mg·kg–1), high-dose and low-dose of GXN group(600, 1 200 mg·kg–1). The 4 groups were administered continuously for 8 weeks. Cardiac ultrasonography was performed every 4 week. Serum NT-proBNP, hs-CRP, IL-6, TNF-α, SOD and MDA levels were measured. The effects of GXN on the structure and function of intestinal flora were observed based on the high-throughput sequencing technology and bioinformatics analysis of 16S gut microbiome. RESULTS Compared to the model control group, after giving different doses of GXN, the survival rate of rats increased, and the thickness of the ventricular wall decreased to varying degrees. The weight of the heart and coefficient of the heart were all reduced. GXN could also reduce the level of inflammatory factors, inhibit the level increase of NT-proBNP in rats, and increase the activity of serum SOD. In addition, GXN intervention could significantly improve the intestinal flora diversity of rats with heart failure, the possible target genera of GXN were Akkermansia genera, Phascolarctobacterium genera and Oxalobacter genera. The effect of GXN on intestinal function in rats with heart failure might be concentrated in non-homologous end-joining, influenza A, carotenoid synthesis, indole alkaloids biosynthesis, betalain biosynthesis, renin-angiotensin system and other biological pathways. CONCLUSION The protective effect of GXN on early heart failure rats may be related to the regulation of intestinal flora pathway.

Objective To investigate the effect of"zero channel"emergency mode on the treatment of patients with severe traumatic brain injury.Methods A total of 147 patients with severe traumatic brain injury admitted to the Second Hospital of Jiaxing from January 2020 to December 2021 were selected as study objects.Sixty-two patients hospitalized in traditional emergency mode from January to December 2020 were included in control group,and 85 patients hospitalized in"zero channel"emergency mode from January to December 2021 were included in observation group.The initiation time of rescue,completion time of CT examination,completion time of blood transfusion,duration of operation,clinical prognosis and complication rate were compared between two groups.Results The initiation time of rescue,completion time of CT examination,completion time of blood transfusion,and duration of operation in observation group were significantly shorter than those in control group(P<0.05).The proportion of good recovery in observation group was significantly higher than that in control group(68.20%vs.38.70%,χ2=12.671,P<0.001).The complication rate of observation group was significantly lower than that of control group(21.18%vs.80.65%,χ2=51.000,P<0.001).Conclusion"Zero channel"emergency mode can effectively shorten the treatment time of patients with severe traumatic brain injury,improve the success rate of rescue,reduce the incidence of complications,worthy of clinical use and promotion.