Objective: To analyze the trends of the frequency of meat, egg, and milk consumption among rural primary and junior high school students in central and western China covered by the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) from 2015 to 2023, so as to provide basis for formulating more targeted nutrition intervention policies and health education strategies. Methods: Using data from six rounds of monitoring and evaluation (2015-2021 and 2023), the study included 323 870 students from grade 3 to 9 across 22 provinces (autonomous regions and municipalities) in central and western China. The consumption frequencies of meat, egg, and milk over the past week were collected via questionnaires. The Cochran-Armitage trend test was used to analyze temporal trends, and multivariable Logistic regression models were employed to analyze factors associated with the frequency of meat, egg and milk consumption and to test for interaction effects between the year and gender, region, and grade level. Results: From 2015 to 2023, the proportion of students consuming meat, egg, and milk ≥1 time/day increased from 23.20 %, 10.71%, and 0.74% to 35.53%, 22.09%, and 26.63%, respectively. Trend tests indicated a significant upward trend for the daily intake of all three food categories for meat, egg and milk over the years ( Z =67.18, 64.90, 93.14, all P <0.01). Multivariable Logistic regression analysis showed that the daily meat intake was lower in the central region than in the western region ( OR=0.77, 95%CI =0.76-0.78), whereas the daily intake of eggs ( OR=1.19, 95%CI =1.17-1.22) and milk ( OR= 1.27 , 95%CI =1.24-1.29) was higher in the central region (all P <0.05). Compared with grade 3-4 students, junior high school students had lower daily intake of meat, eggs, and milk≥1 time/day ( OR =0.95, 0.77, 0.77, all P <0.05), with a declining trend as grade increased. Girls also had lower daily intake of meat, eggs, and milk ≥1 time/day than boys ( OR =0.95，0.93，0.91, all P < 0.05). Significant interactions were observed between year and region, as well as between year and grade (all P <0.05). Conclusion From 2015 to 2023, the NIPRCES improved the intake level of among rural students, but the situation of relatively insufficient intake of egg and milk among females, junior high school students and those in the western region still exists.

Objective To identify renal function and other readily accessible indicators influencing the prognosis of renal cell carcinoma (RCC) patients after nephrectomy, and to construct a prognostic prediction model based on them. Methods The clinical and pathological data of 624 RCC patients undergoing radical or partial nephrectomy in the First Hospital of Shanxi Medical University during Jan. 2013 and Dec. 2021 were retrospectively analyzed. The independent prognostic factors affecting postoperative overall survival (OS) were identified with LASSO algorithm combined with Cox regression analysis. Based on these factors, a nomogram was constructed to predict the 1-, 3-, and 5-year survival rates. The performance of the model was evaluated using the concordance index (C-index), time-dependent receiver operating characteristic (ROC) curves and the area under the curve (AUC), calibration plots, and decision curve analysis (DCA). Finally, the cutoff value of the nomogram was calculated to stratify patients into risk groups. Kaplan-Meier survival analysis with log-rank testing was performed to compare outcomes between the risk groups. Results Nine independent prognostic factors were identified, including age, smoking history, diabetes mellitus history, maximum tumor diameter, tumor subtype, N stage, Fuhrman grade, preoperative serum creatinine and cystatin C (P＜0.05). The nomogram achieved a C-index of 0.891, with time-dependent AUC of 0.920, 0.903, and 0.867 for 1-, 3-, and 5-year OS, respectively. Calibration curves showed excellent agreement with actual observations, and DCA demonstrated significant clinical net benefits across a wide threshold probability range. Using a cutoff score of 110.4, Kaplan-Meier analysis revealed statistically significant survival differences between risk groups (P＜0.001). Conclusion The proposed nomogram, incorporating renal function and other readily accessible clinical indicators, exhibits strong predictive accuracy for postoperative survival in RCC patients and may serve as a practical tool for individualized clinical decision-making.

BACKGROUND:Compared with conventional repetitive transcranial magnetic stimulation,Theta burst transcranial magnetic stimulation(TBS)has attracted extensive attention from scholars in various fields due to its advantages of short stimulation time,high efficiency,good safety and long-lasting effect,and the research popularity continues to rise.OBJECTIVE:Through the visual bibliometrics analysis of international TBS research in the past 20 years,to sort out the development context of TBS research,summarize the research status,reveal research hotspots and development trends,and provide reference for subsequent research.METHODS:Relevant studies on TBS from January 2005 to June 2024 were searched in the Web of Science Core Collection database.CiteSpace software was used to perform annual publication volume analysis,co-occurrence analysis of countries,institutions and authors,and co-citation analysis of references,journals and authors,keywords co-occurrence,clustering,time evolution and emergence analysis,and so on,and draw the visual knowledge map.RESULTS AND CONCLUSION:(1)After screening,a total of 1914 papers were included in the study,and the amount of TBS research has shown an overall increasing trend over the past 20 years,and it is expected to continue to be a hot topic of research in the future.(2)The top three countries in terms of number of publications are the United States,China and Italy,and the top three institutions are the University of Toronto,the University of London and Harvard Medical School.Pascual-leone Alvaro from Harvard Medical School has the most research achievements,and HUANG YZ from Chang Gung University has the most citations.NEURON is the most influential core journal.(3)Analyses of high-frequency keywords,highly cited references and clustering topics showed that the research hotspots of TBS in the past 20 years mainly focus on the mechanism of TBS on synaptic plasticity and neurophysiological activity,the effect of TBS on stimulating targets in different brain regions(including the motor cortex,dorsolateral prefrontal cortex,anterior cingulate cortex and cerebellum,etc.),and the therapeutic effect of TBS on neurological and psychiatric diseases(including depression,Parkinson's disease movement disorder,post-stroke movement disorder and cognitive impairment,and Alzheimer's disease memory disorders).(4)Keyword burst,literature emergence and keyword temporal evolution analyses showed that"major depression,application guidelines,rating scale,efficacy,disorder,refractory depression,meta-analysis,etc."are not only current research hotspots,but also future research trends.(5)In the future,TBS research should strengthen the regional cooperation of core authors and institutions,explore the clinical application in the treatment of refractory diseases,and realize the precision,personalization and optimization of TBS application by combining cutting-edge technologies and optimizing stimulus parameters,so as to solve more clinical problems.

AIM:To investigate the involvement of HIF-1α/VEGF regulation in its anti-angiogenesis effects using adjuvant-induced arthritis(AIA)rats.METHODS:AIA rats were orally treated by QLY ex-tract for 24 days.After sacrifice,the joints were subjected to histological examination,while the blood was used in ELISA or biochemical tests.In ad-dition,HUVEC cells were treated by QLY in vitro.MTT,wound-healing and tube-formation experi-ments were then performed.Expression of some relevant proteins in cells were investigated.RE-SULTS:Compared to the healthy controls,obvious synovial invasion and angiogenesis occurred in AIA rats.Blood levels of HIF-1α,VEGF,PDGF,and TGF-β1 were increased,while the ratio of MDA/SOD was decreased a lot.After QLY treatment,all these ab-normalities were attenuated.In vitro experiments,QLY showed notable potentials in inhibiting prolifer-ation,migration and tube-constructing abilities of HUVEC cells.Furthermore,it suppressed the ex-pression of p-MEK/MEK and p-ERK/ERK.CONCLU-SION:QLY can reduce the pathological functions of vascular endothelial cells by inhibiting HIF-1α/VEGF,and it consequently eased AIA-related abnor-mal angiogenesis in AIA rats'joints.

To summarize the nursing experience of 14 children after double lung transplantation for secondary bronchiolitis obliterans after hematopoietic stem cell transplantation(HSCT).Nursing points:to improve preoperative evaluation,actively improve the body status;to conduct the whole-process ECMO management to achieve early safe evacuation;to carry out the task feedback breathing training game to promote lung function;to implement the interest-oriented game exercise to promote muscle strength;to conduct the symptom-matched nutritional support,coping with gastrointestinal graft-host disease;to improve discharge preparation and empower primary caregivers.After careful nursing care,all of the 14 children were discharged smoothly.The follow-up result showed that the children had normal lung function and activities of daily living.

Objective To establish an expert consensus on home exercise for prevention and rehabilitation of breast cancer related lymphedema.Methods Evidence-based nursing method was used to systematically retrieve and evaluate relevant studies in databases and guideline networks,with a search period from the establishment of the databases to October 2023.Evidence was synthesized to form the expert consensus draft after literature screening,quality evaluation,evidence extraction and evidence integration.Then the final draft was formed through expert discussion meeting and 2 rounds of expert letter consultation.Results The consensus includes 5 dimensions with a total of 22 items,involving evaluation of home exercise,management of home exercise,principles of home exercise,program of home exercise and significance of home exercise.Conclusion This"consensus"was constructed in a scientific and rigorous way,and can provide guidance for promoting the home exercise for prevention and rehabilitation of breast cancer related lymphedema,and ensure the safe and effective implementation of home exercise rehabilitation.

Objective To explore the current status of bone metabolism abnormalities after lung transplantation and its influencing factors,and provide scientific references for the formulation of nursing intervention measures.Methods A retrospective analysis of the clinical data of 125 patients undergoing lung transplantation at a lung transplant center from June 2021 to August 2023 was conducted.The paired sample t-test was used to compare the trends in bone mineral density(BMD)before and after transplantation.Postoperative BMD was compared to domestic age-matched norms using the single sample t-test.Univariate analysis and unordered multinomial logistic regression were employed to identify factors associated with bone metabolism abnormalities post-transplantation.Results The incidence of bone metabolism abnormalities after lung transplantation was 62.4％,with osteopenia and osteoporosis rates at 36.8％and 25.6％,respectively.The BMD of the femoral neck and left hip joint generally showed a declining trend post-transplantation(P＜0.001).Additionally,both male and female patients had lower BMD than the age-matched national norms(P＜0.001).Logistic regression analysis indicated that pre-transplant Activities of Daily Living(ADL)score was a significant factor for post-transplant osteopenia(OR 0.957,95％CI 0.928～0.987).Female gender,pre-transplant low body weight,obesity,reduced forced expiratory volume in one second/forced vital capacity percentage(FEV1/FVC),and ADL score were significant factors for post-transplant osteoporosis,with OR values of 7.181,7.521,15.465,0.960,0.964;95％CI were 1.287～40.061,2.039～27.738,1.158～206.586,0.937～0.983,0.930～0.999,respectively.Conclusion Bone metabolism abnormalities are common in patients post-lung transplantation.Healthcare providers should pay particular attention to female patients,those with low pre-transplant body weight,obesity,reduced FEV1/FVC,and lower ADL scores.Timely,individualized,and multidisciplinary interventions are crucial to slowing postoperative bone loss,reducing the incidence of bone metabolism abnormalities,and improving the health-related quality of life for these patients.

BACKGROUND:Compared with conventional repetitive transcranial magnetic stimulation,Theta burst transcranial magnetic stimulation(TBS)has attracted extensive attention from scholars in various fields due to its advantages of short stimulation time,high efficiency,good safety and long-lasting effect,and the research popularity continues to rise.OBJECTIVE:Through the visual bibliometrics analysis of international TBS research in the past 20 years,to sort out the development context of TBS research,summarize the research status,reveal research hotspots and development trends,and provide reference for subsequent research.METHODS:Relevant studies on TBS from January 2005 to June 2024 were searched in the Web of Science Core Collection database.CiteSpace software was used to perform annual publication volume analysis,co-occurrence analysis of countries,institutions and authors,and co-citation analysis of references,journals and authors,keywords co-occurrence,clustering,time evolution and emergence analysis,and so on,and draw the visual knowledge map.RESULTS AND CONCLUSION:(1)After screening,a total of 1914 papers were included in the study,and the amount of TBS research has shown an overall increasing trend over the past 20 years,and it is expected to continue to be a hot topic of research in the future.(2)The top three countries in terms of number of publications are the United States,China and Italy,and the top three institutions are the University of Toronto,the University of London and Harvard Medical School.Pascual-leone Alvaro from Harvard Medical School has the most research achievements,and HUANG YZ from Chang Gung University has the most citations.NEURON is the most influential core journal.(3)Analyses of high-frequency keywords,highly cited references and clustering topics showed that the research hotspots of TBS in the past 20 years mainly focus on the mechanism of TBS on synaptic plasticity and neurophysiological activity,the effect of TBS on stimulating targets in different brain regions(including the motor cortex,dorsolateral prefrontal cortex,anterior cingulate cortex and cerebellum,etc.),and the therapeutic effect of TBS on neurological and psychiatric diseases(including depression,Parkinson's disease movement disorder,post-stroke movement disorder and cognitive impairment,and Alzheimer's disease memory disorders).(4)Keyword burst,literature emergence and keyword temporal evolution analyses showed that"major depression,application guidelines,rating scale,efficacy,disorder,refractory depression,meta-analysis,etc."are not only current research hotspots,but also future research trends.(5)In the future,TBS research should strengthen the regional cooperation of core authors and institutions,explore the clinical application in the treatment of refractory diseases,and realize the precision,personalization and optimization of TBS application by combining cutting-edge technologies and optimizing stimulus parameters,so as to solve more clinical problems.

Objective:To investigate the clinicopathological features, immunophenotypes, and molecular characteristics of PRRX1-rearranged fibroblastic tumor and to discuss their differential diagnoses.Methods:Four cases of PRRX1-rearranged fibroblastic tumor retrieved from Anning First People′s Hospital and Fudan University Shanghai Cancer Center and their clinicopathological features, immunophenotypes and molecular profiles were analyzed. The literature was reviewed.Results:All 4 cases occurred in adult women with an age of 34(27,41) years. Three tumors occurred in the low extremities and 1 in the trunk. The patients presented with a slowly growing mass or swelling, accompanied by pain in 1 patient. Three tumors were located in the subcutis, and 1 tumor in the intermuscular space. The duration lasted for 6 months to 1 year. Tumor ranged in size from 4.0 to 15.8 cm (mean 7.3 cm). At lower power, the tumors were well circumscribed, showing a multinodular architecture. They were composed of bland ovoid to short spindled cells arranged irregularly with interstitial ropey collagen fibers, and set in a fibrous to fibromyxoid matrix with a close resemblance to low-grade fibromyxoid sarcoma. However, all 4 tumors showed negative staining for MUC4. Two tumors were focally positive for S-100 and SOX10. Apart from vimentin, they were all negative for other immunohistochemical stains including SMA, desmin, CD34, STAT6 and β-catenin. The expression of H3K27Me3 was retained. The proliferative index measured by Ki-67 was less than 5%. RNA-sequencing analysis identified PRRX1::NCOA1 fusions in 3 cases, and PRRX1::KMT2D fusion in 1 case. Subsequent FISH study confirmed NCOA1 rearrangement in 3 cases harboring NCOA1 rearrangement. On follow-up (1-14 months), no patient developed either local recurrence or distant metastasis.Conclusions:PRRX1-rearranged fibroblastic tumor is a novel entity of soft tissue tumor that has a predilection for the trunk and extremities, characterized by PRRX1 gene rearrangement and benign clinical course. Familiarity with its clinicopathological features is helpful in the distinction from low-grade fibromyxoid sarcoma and other spindle cell tumors with overlapping features.

Objective To investigate the needs of the main caregivers of patients with spinal cord injury following neurogenic bowel dysfunction to participate in the whole process of intestinal management.Methods Nine main caregivers of patients with spinal cord injury in Jiangsu Province Hospital from January to Decem-ber,2024 were selected with objective sampling method.They were investigated face-to-face semi-structured in-depth interviews,and the data were analyzed,summarized and extracted by Colaizzi 7-step analysis method.Results Three themes and eight sub-themes were extracted:the needs of professional knowledge and skills standards in intestinal management(lack of intestinal training knowledge,lack of ability to acquire knowledge and different standards of medical institutions);the needs of physical ability and decision making ability participating in intesti-nal training(lack of participation,single decision-making behavior,excessive dependence on medical personnel);the desire for therapeutic benefits and the needs for building psychological confidence(concerns about the pa-tient's prognosis,overdependence on medication).Conclusion Clinical medical staff should pay attention to the actual needs and difficulties faced by the main caregivers of patients with neurogenic bowel dysfunction to participate in the entire intestinal management,and construct targeted training programs,strengthen the skills and knowledge training,to enhance their autonomy and responsi-bility,to achieve the rehabilitation goal better.