Objective To understand the current situation of nutrition literacy of primary and secondary school students in Shijingshan District of Beijing, and analyze its influencing factors, and to put forward targeted suggestions for improving the students’ nutrition literacy and promoting their healthy growth. Methods A multi-stage stratified cluster sampling method was used to select 2480 primary and secondary school students and their parents from 5 primary schools, 3 middle schools and 1 high school in Shijingshan District. The multivariate logistic regression model was used to analyze the factors influencing the attainment rate of nutrition literacy. Results The median score of nutrition literacy of 2480 primary and secondary school students from grades 1 to 12 was 77.86 (in hundred-mark system), the quartile range (IQR) was 16.96, and the attainment rate of nutrition literacy was 42.46%. The cognitive level (45.12%) was higher than the skill level (41.20%) among students from grades 3 to 12. In terms of skills, the attainment rate of food preparation was the lowest, at 30.38%. The scores of nutrition literacy of girls were higher than those of boys, and the scores of primary school students were higher than those of secondary school students. Students with different levels of caregiver’s education, family income, and family food environment had different scores of nutrition literacy, and the differences were statistically significant (P<0.05). Multivariate logistic regression analysis showed that the attainment rate of nutrition literacy was closely related to student’s gender and study stage, caregiver’s education level, and family food environment. Conclusion The nutrition literacy of primary and secondary school students in Shijingshan District still needs to be improved, especially in the aspect of skills. Targeted nutrition education should be carried out.

Objective: To analyze the prevalence and determinants of comorbid overweight/obesity and elevated blood pressure among primary and secondary school students in Yangzhou City, and to explore the association between sleep patterns, eating behavior and the comorbidity of overweight/obesity and elevated blood pressure, so as to provide reference for developing prevention strategies targeting common comorbidities in students. Methods: By using stratified cluster random sampling, a total of 8 735 primary and secondary school students were selected from 36 schools in six counties of Yangzhou from October to November 2023. Students underwent physical examinations and a questionnaire survey was conducted using the questionnaire on students health status and influencing factors. The Chi square test was used to compare the detection rate of comorbid overweight/obesity and elevated blood pressure in different groups of primary and secondary school students. The Logistic regression model was used to explore the association between sleep and dietary behaviors and their combined effects and coexistence. Results: The detection rate of comorbid overweight/obesity and elevated blood pressure among primary and secondary school students in Yangzhou was 9.85%, which was higher among boys (12.14%) than girls (7.59%)( χ 2=50.86, P <0.01). After controlling for gender, residence, educational stage, parental education, smoking, drinking, and moderate to vigorous exercise, multivariate Logistic regression analysis showed that irregular breakfast consumption and inadequate daily sleep were associated with a higher risk of comorbidities compared with regular breakfast consumption and adequate daily sleep among overall and primary school students (overall: OR =1.52, 95% CI =1.18- 1.96 , primary school students: OR =2.79, 95% CI =1.61-4.82)(both P <0.05). From the perspective of primary school students of different genders, the risk of comorbidities in girls who consumed breakfast irregularly and had inadequate daily sleep was 3.59 times higher than that in girls who consumed breakfast irregularly and had inadequate daily sleep (95% CI =1.65-7.82, P <0.01). Conclusion The sleep patterns and breakfast behaviors of primary and secondary school students are found to be associated with comorbid overweight/obesity and elevated blood pressure, especially in primary school girls.

Objective To investigate the role of circular RNAs(circRNA)in Alzheimer's disease(AD)and its potential mechanism.Methods Six-month-old APP/PS1 mouse model of AD and wild type(WT)mice were subjected and then randomly divided into WT group,WT+circ-Olfm1 knockout group,AD group(transgenic APP/PS1 mice),AD+circ-Olfm1 knockout group,AD+FOXO3a knockout group,with 3 mice in each group.① The total RNA of mouse brain was extracted,and the differential expression of circRNAs and mRNAs between the AD mice and WT mice was detected,and the obtained circRNAs and mRNAs were analyzed with gene ontology(GO)analysis.② RT-qPCR was used to detect the expression of the top 10 up-regulated and down-regulated circRNAs,as well as the expression of circ-Olfm1 and miR-330-5p.③ Lentiviral vectors were prepared and stereotaxically injected into the cortex or hippocampus of WT and AD mice to knock out circ-Olfm1 gene.Water maze test was used to evaluate the effect of circ-Olfm1 knockout on cognitive function,and immunofluorescence assay was employed to observe the deposition of amyloid β(Aβ)plaque in the brain.④ The interaction between circ-Olfm1 and miR-330-5p was verified by double luciferase reporter gene analysis.⑤ The protein levels of AMPK and FOXO3a were detected by Western blotting.⑥ Transmission electron microscopy was utilized to observe the mitochondria of the hippocampus.⑦ The levels of inflammatory factors IL-6,IL-1β and TNF-α were detected by ELISA.Results There were totally 52 differentially expressed circRNAs identified between the AD and WT mice,including 28 up-regulated and 24 down-regulated(fold change>1.5,P<0.05).These differentially expressed genes are mainly involved in signal transduction,learning and memory and other functions.circ-Olfm1 was identified as the most significantly differentially expressed circRNA,which is highly expressed in the neurons and up-regulated in the cerebral cortex and hippocampus of the AD mice.Knockout of circ-Olfm1 reduced the number of Aβ plaques in the cerebral cortex and hippocampus of AD mice(P<0.01).In starBase database,there are complementary sequences observed between circ-Olfm1 and miR-330-5p.Western blotting showed that the addition of Aβ42 significantly increased the expression of AMPK and FOXO3a in the neuronal cells(P<0.01).And silencing circ-Olfm1 led to decreased expression of AMPK and FOXO3a in neuronal cells+Aβ42(P<0.01).ELISA revealed that knockout of FOXO3a significantly increased the levels of inflammatory factors IL-6,IL-1β,and TNF-α(P<0.01).Transmission electron microscopy displayed that knocking FOXO3a out significantly aggravated mitochondrial damage(P<0.01).Conclusion circ-Olfm1 is up-regulated in the brain tissue and neurons+Aβ42 of AD rats,and the mechanism of cognitive impairment in AD rats may be through its regulating FOXO3a protein.

Primary liver cancer is a highly malignant tumor of the digestive tract, charac-terized by an insidious onset and frequently accompanied by local progression or distant metastasis. Although surgical resection is typically the optimal treatment for patients with locally resectable tumors, the major challenge in achieving long-term survival prognosis lies in the high postoperative recurrence rate. Due to the substantial heterogeneity and complexity of primary liver cancer, a multimodal comprehensive treatment approach involving surgical resection, systemic therapy ( e.g., targeted therapy, chemotherapy, immunotherapy), and/or local treatment is commonly employed. As research regarding primary liver cancer continues to progress, it becomes crucial for surgical oncologists to acquire a deep understanding and proficiency in the latest surgical diagnostic and treatment methods, along with optimal patient selection and management strategies. The authors aim to comprehensively elaborate on the latest practice guidelines for surgically treatment of primary liver cancer and systematically outline the key points in evaluating primary liver cancer, primarily focusing on hepatocellular carcinoma and intrahepatic bile duct carcinoma, and offer pertinent recommendations for clinical treatment, thus providing robust evidence in the clinical management and decision-making for patients with primary liver cancer.

Objective:To investigate the relationship between the cerebral small vascular disease (CSVD) total burden and the imaging markers and the degree of unilateral middle cerebral artery (MCA) stenosis.Methods:The study was a cross-sectional study. Clinical and imaging data of patients with chronic unilateral MCA stenosis who underwent multimodal MRI from October 2015 to January 2019 in the First Medical Center of PLA General Hospital were retrospectively analyzed. A total of 261 patients were included, 187 males and 74 females. According to the degree of MCA stenosis, the patients were divided into 102 cases in severe stenosis-occlusion group (stenosis degree ≥70%) and 159 cases in mild-moderate stenosis group (stenosis degree <70%). CSVD imaging marker scores (including white matter hyperintensity, perivascular space, cerebral microbleed, and lacune of presumed vascular origin) were assessed according to the ?standards for reporting vascular changes on neuroimaging 1 in the 2 groups, and the CSVD total burden score was calculated. Mann-Whitney U test was used to compare the indicators between the two groups, and the CSVD total burden score and imaging marker scores were ultimately included in a multifactorial binary logistic regression to assess the association of CSVD imaging markers with severe stenosis-occlusion of the MCA after adjusting for vascular risk factors (age, gender, drinking, smoking, hypertension, hyperlipidemia, atrial fibrillation and coronary heart disease). Results:There were significant differences in the CSVD total burden, centrum semiovale perivascular space and lacune of presumed vascular origin score between the mild-to-moderate stenosis group and the severe stenosis-occlusion group (all P<0.05), and none of the differences in the remaining imaging marker scores were statistically significant (all P>0.05). Multivariate binary logistics regression analysis showed CSVD total burden score ( OR=1.300, 95% CI 1.047-1.613, P=0.017), centrum semiovale perivascular space score ( OR=2.099, 95% CI 1.540-2.860, P<0.001) and lacune of presumed vascular origin score ( OR=2.609, 95% CI 1.294-5.261, P=0.007) were independent associated with severe stenosis-occlusion of MCA. Conclusion:The higher CSVD total burden score, centrum semiovale perivascular space score and lacune of presumed vascular origin score are associated with severe stenosis-occlusion of MCA.

Objective To compare the efficacy of TightRope loop plate and Endobutton plate in the treatment of acromioclavicular joint dislocation.Methods A retrospective analysis was conducted on 94 patients with acromioclavicular joint dislocation who were treated at this center from March 2021 to February 2023.They were divided into two groups based on different admission date.The Group E(n =47)received Endobutton plate treatment between March 2021 and February 2022,while the Group T(n =47)received TightRope loop plate treatment between March 2022 and February 2023.At the last follow-up,the perioperative indicators,Visual Analogue Scale(VAS),Constant-Murley shoulder joint function scores,and surgical complications were compared between the two groups.Results The surgical time,intraoperative bleeding,incision length,and VAS scores at 7 days after surgery in the Group T were shorter or lower than those in the Group E(P<0.05).There were no statistical differences in the incidence of perioperative nerve injury,internal fixation displacement,clavicle fracture,vascular injury,and infection between the two groups(P>0.05).The subjective and objective scores of Constant-Murley shoulder joint function in both groups at9 months after surgery showed significant improvement compared to preoperative scores(all P =0.000).There was no significant difference in the subjective and objective scores of Constant-Murley shoulder joint function between the two groups at 9 months after surgery(P>0.05).Conclusions The treatment of acromioclavicular joint dislocation with TightRope loop plate ot or Endobutton plate has a significant effect and can effectively improve shoulder joint function.Compared with Endobutton plate,use of TightRope loop plate has minor surgical trauma,less bleeding,and significantly reduced postoperative pain,being more conducive to early functional exercise for patients.

Objective:Chronic urticaria presents a chronic process of recurrent attacks,and its first-line treatment is second-generation antihistamine with limited treatment options.The efficacy of antihistamine varies among individuals and cannot meet the needs of all patients.This study aims to explore the clinical efficacy and safety of Zhiyang Xiaozhen granules combined with antihistamine in the treatment of chronic urticaria patients. Methods:We retrospectively analyzed the clinical data of patients with chronic urticaria who visited the Xiangya Hospital of Central South University from April 2020 to March 2021.The patients who received conventional second-generation antihistamine treatment were selected as a control group,while the patients who received combined treatment with Zhiyang Xiaozhen granules on the basis of conventional second-generation antihistamine treatment were selected as an observation group.The differences in the Weekly Urticaria Activity Score(UAS7)and Dermatology Life Quality Index(DLQI)between the 2 groups before and 4 weeks after treatment were compared.The Symptom Score Reduce Index(SSRI)was used to evaluate and compare the efficacy of the 2 treatment regimens. Results:After 4 weeks of treatment,the UAS7 levels in both groups were significantly reduced(P=0.001 and P<0.001,respectively).The effective rates of the control group and the observation group were 61.11%and 59.38%,respectively when converting UAS7 to SSRI for efficacy evaluation,and there was no statistically significant difference in efficacy between the 2 groups(P>0.05);however,when converting DLQI to SSRI for efficacy evaluation,the effective rates of the control group and the observation group were 33.33%and 46.88%,respectively,and the difference in efficacy between the 2 groups was statistically significant(P<0.001).There were 3 patients with adverse drug reactions related to drowsiness in both groups. Conclusion:The combination of Zhiyang Xiaozhen granules and second-generation antihistamine can effectively improve disease activity in patients with chronic urticaria,and the improvement in quality of life is better than that with the second-generation antihistamine alone.

The long-term efficacy and complications of implantable diaphragm pacer (IDP) in a child with cervical spinal cord injury (CSCI) in the Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center in September 2022 were retrospective analyzed.A male child had quadriplegia without an obvious cause at the age of 12 years, and he was then lived completely with the assistance of mechanical ventilation.At the age of 14 years, he could wean off the ventilator in unilateral diaphragmatic pacing mode.However, mechanical ventilation was re-given for months after 5 years due to pneumonia, and then the IDP was re-given with the self-felt decreased pacing effect.After hospitalization, the patient was examined with mild diaphragmatic atrophy, secondary flat chest, and mild scoliosis.After optimization of the transdiaphragmatic pacing threshold and rehabilitation, his respiratory function improved.IDP can be used in CSCI for long time, while flat chest and scoliosis that limited the expansion of the lungs should be considered.At the meantime, the increased abdominal spasm affected the abdominal compliance, leading to the decrease in the efficiency of the diaphragm.

Objective To investigate the effects of amylin,also known as islet amyloid polypeptide(IAPP),on learning and memory abilities and the phosphatidylinositol 3-kinase/protein kinase B(PI3K/Akt)signaling pathway in APP/PS1 mice.Methods A total of 20 APP/PS1 mice were randomly divided into Alzheimer's disease(AD)group and IAPP group,with 10 mice in each group.The mice in the latter group were given an intraperitoneal injection of 0.5 μmol/L IAPP,and those of the former group received same dose of PBS.Both interventions were given once per day,for 10 weeks.Morris water maze test was used to measure the learning and memory abilities;HE staining was employed to observe the pathological changes in the hippocampus;Transmission electron microscopy was utilized to observe the ultrastructure of hippocampal neurons;Biochemical assay were conducted to detect the contents of glutathione peroxidase(GSH-Px),malondialdehyde(MDA)and superoxide dismutase(SOD)in hippocampal tissues;ELISA was applied to measure the levels of inflammatory factors such as IL-1β,IL-6,and TNF-α as well as content of Aβ42 in hippocampal tissues;And Western blotting was conducted to detect the expression of PI3K/Akt proteins.Results Compared with the AD group,significantly shorter platform latency(P＜0.01),increased number of traversing the platform and longer time to explore the hidden platform(P＜0.01)were observed in the IAPP group,but no such difference was seen in the swimming speed of the mice.HE staining displayed that the IAPP group had more and well-arranged nerve cells in the hippocampal tissue when compared with the AD group(P＜0.05).Lower Aβ protein expression(P＜0.01),reduced oxidative stress and decreased contents of inflammatory factors(P＜0.01)in hippocampal tissue were observed in the IAPP group than the AD group.The IAPP group showed clearer structure of neuronal mitochondria,reduced vacuolization,and better arranged microtubules and microfilaments,and elevated expression of p-PI3K/PI3K and p-Akt/Akt proteins when compared with the AD group(P＜0.01).Conclusion Amylin can reduce oxidative stress and inflammatory responses,improve learning and memory abilities in AD mice,and promote the activity of PI3K/Akt signaling pathway.

Objective To investigate the value of iterative decomposition of water and fat with echo asymmetry and least-squares(IDEAL-IQ)sequence in evaluating the correlation between renal ectopic fat deposition and early diabetic kidney disease(DKD)in patients with diabetes mellitus(DM).Methods A total of 51 patients with T1DM or T2DM were enrolled in this study from the Endocrinology and Metabolism Department in Affiliated Jinhua Hospital,Zhejiang University School of Medicine during January 2022 to July 2023.All the patients were divided into two groups according to the results of urine albumin creatinine ratio(UACR):normal or slightly increased urinary micro albumin group(NAU,UACR<30 mg/g,n=27)and diabetic kidney disease group(DKD,UACR 30～300 mg/g,n=24).Meanwhile,55 healthy subjects in health examination were selected as control group(NC).Pearson correlation analysis was used to analyze the correlation between renal FF and other indicators.Logistic regression analysis was used to analyze the influencing factors of early DKD,and the diagnostic efficiency of renal FF for early DKD was analyzed by the ROC curve.Results Serum creatinine(Scr)and renal fat fraction(FF)value were higher in DKD group than in NC and NAU groups(P<0.05).Pearson correlation analysis showed that kidney FF were positively correlated with UACR and Hcy(P<0.05).Logistic regression analysis showed that after adjusting for confounding factors,renal FF was a contributing factor to early DKD.The ROC curve revealed that model 2 had the highest diagnostic efficiency,with AUC=0.801,sensitivity of 66.7%,specificity of 85.2%,accuracy of 80.0%,and a renal FF cut-off value was 2.46%.Conclusion IDEAL-IQ could non-invasively measure the renal fat content in DM patients,and the renal FF were significantly associated with DKD in early stage.