Objective: To investigate the prevalence of overweight and obesity among children and adolescents in Yangzhou City, and its association with screen behaviors, so as to provide scientific evidence for weight management among students. Methods: In May 2025, an electronic questionnaire survey was conducted among children and adolescents in Yangzhou City. A total of 3 722 participants were selected from grades 4 to 12 in 18 primary and secondary schools (108 classes) by using stratified cluster random sampling. The Chi square test was used to compare the differences in the detection rates of overweight and obesity among children and adolescents with 5 types of screen behaviors (watching TV, playing electronic games, scrolling short videos, screen based learning, electronic socializing) in different time groups each day (never, >0~<2 h, ≥2 h). Multivariate Logistic regression analysis was performed to examine the associations of five types of screen behaviors, presence of electronic devices in the bedroom, and screen use during meals on the weight status of children and adolescents. Results: The prevalence of overweight and obesity among children and adolescents was 37.3%. For all five types of screen behaviors, the differences in the distribution of overweight and obesity detection rates among children and adolescents across the three time spent categories were statistically significant ( χ 2=30.76- 70.78 , all P <0.01). After adjusting for confounding factors, multivariate Logistic regression analysis revealed that frequent or always using screens during meals( OR =1.63, 95％ CI =1.14~2.31), playing video games ( OR =1.28, 95% CI =1.11-1.48), browsing short videos ( OR =1.29, 95％ CI=1.09-1.54), and screen based learning ( OR =1.26, 95％ CI =1.10-1.44) were significantly associated with overweight and obesity among children and adolescents (all P <0.05). Conclusions Excessive screen use is positively correlated with the incidence of overweight and obesity in children and adolescents. Targeted interventions on screen behaviors among children and adolescents are therefore warranted.

ObjectiveTo describe the disposal process of the first imported case of Zika virus disease in Shanghai, and to provide a reference for the prevention and control of imported infectious diseases in the future. MethodsA retrospective review was conducted of the process by which epidemiological investigation, etiological testing, and case management were performed by the Shanghai municipal-and district-level Centers for Disease Control and Prevention (CDC) after one imported case of Zika virus disease was identified by Shanghai Customs. ResultsOn April 8th, 2025, customs authority at a certain airport in Shanghai identified a febrile inbound case (case A, female, 40 years old). An antecubital venous blood specimen was obtained and analyzed by nucleic acid testing for various vector-borne pathogens, by which Zika virus nucleic acid was found to be positive. On 9 April, the district CDC collected antecubital venous blood specimens again from Case A and her three accompanying travelers (B, C, and D), and nucleic acid testing was conducted for multiple mosquito-borne infectious diseases. Case A again tested positive for Zika virus nucleic acid, while Traveler D (male, aged 6 years) tested positive for dengue virus nucleic acid. The other two travelers tested negative. Case A and Traveler D were subsequently transferred to a designated district hospital for isolation and treatment. After discharge, both cases left China and returned to their overseas residence. ConclusionCase A was the first imported case of Zika virus disease in Shanghai. For cases with a history of living in endemic areas of multiple infectious diseases such as dengue virus, Zika virus and chikungunya virus, it is necessary to carry out rapid testing of multiple pathogens simultaneously to prevent missed diagnosis or misdiagnosis.

Objective:To investigate the iodine nutrition status of children aged 8 - 10 and pregnant women in Xining City, Qinghai Province.Methods:From 2019 to 2021, a stratified cluster sampling method was used to divide 7 counties (districts) under the jurisdiction of Xining City, Qinghai Province into 5 sampling areas according to east, west, south, north, and center each year. One township (town, street) was selected from each area. Forty non boarding students aged 8 to 10 from each primary school (half male and half female, age balanced) and 20 pregnant women from each township (town, street) location were selected to collect edible salt samples at home and a random urine sample to measure salt iodine and urinary iodine level. B-ultrasound was used to measure thyroid volume in children and the goiter rate was calculated.Results:A total of 6 534 samples of household edible salt were collected from children and pregnant women, with an average salt iodine concentration of 25.58 mg/kg. The coverage rate of iodized salt was 97.50% (6 371/6 534), and the qualified iodized salt consumption rate was 89.46% (5 845/6 534). A total of 4 362 urine samples were collected from children, with a median urinary iodine level of 183.10 μg/L. The difference between different years was statistically significant ( H = 20.27, P < 0.001). A total of 2 169 urine samples were collected from pregnant women, with a median urinary iodine level of 168.90 μg/L. The difference between different years was statistically significant ( H = 107.09, P < 0.001). A total of 3 336 cases of thyroid gland examination were conducted in children, including 33 cases of thyroid enlargement, with a goiter rate of 0.99%. There was a statistically significant difference between different years (χ 2 = 15.00, P < 0.001). Conclusion:From 2019 to 2021, children aged 8 to 10 and pregnant women in Xining City are at an appropriate level of iodine, and the achievements in prevention and treatment of iodine deficiency disorders still need to be continuously consolidated.

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 iodine nutrition status of children aged 8 - 10 and pregnant women in Xining City, Qinghai Province.Methods:From 2019 to 2021, a stratified cluster sampling method was used to divide 7 counties (districts) under the jurisdiction of Xining City, Qinghai Province into 5 sampling areas according to east, west, south, north, and center each year. One township (town, street) was selected from each area. Forty non boarding students aged 8 to 10 from each primary school (half male and half female, age balanced) and 20 pregnant women from each township (town, street) location were selected to collect edible salt samples at home and a random urine sample to measure salt iodine and urinary iodine level. B-ultrasound was used to measure thyroid volume in children and the goiter rate was calculated.Results:A total of 6 534 samples of household edible salt were collected from children and pregnant women, with an average salt iodine concentration of 25.58 mg/kg. The coverage rate of iodized salt was 97.50% (6 371/6 534), and the qualified iodized salt consumption rate was 89.46% (5 845/6 534). A total of 4 362 urine samples were collected from children, with a median urinary iodine level of 183.10 μg/L. The difference between different years was statistically significant ( H = 20.27, P < 0.001). A total of 2 169 urine samples were collected from pregnant women, with a median urinary iodine level of 168.90 μg/L. The difference between different years was statistically significant ( H = 107.09, P < 0.001). A total of 3 336 cases of thyroid gland examination were conducted in children, including 33 cases of thyroid enlargement, with a goiter rate of 0.99%. There was a statistically significant difference between different years (χ 2 = 15.00, P < 0.001). Conclusion:From 2019 to 2021, children aged 8 to 10 and pregnant women in Xining City are at an appropriate level of iodine, and the achievements in prevention and treatment of iodine deficiency disorders still need to be continuously consolidated.

Objective: To explore the association between sleep quality, sleep duration with blood pressure in primary and secondary school students with different nutritional status, so as to provide a reference for targeted intervention measures. Methods: By using stratified cluster random sampling method, a total of 10 871 students aged 7 to 18 years were selected from 36 primary and secondary schools in 6 counties of Yangzhou from October to November 2023. Physical examination and questionnaire survey were conducted respectively. Student Health Status and Influencing Factors Questionnaire was used to collected basic information. The overweight/obesity and sleep quality of primary and secondary school students were determined according to the Screening for Overweight and Obesity among School age Children and Adolescents and the Pittsburgh Sleep Quality Index scale. The χ 2 test was used to compare the prevalence of elevated blood pressure in different groups of primary and secondary school students. Multivariate Logistic regression model was used to explore the association between sleep and blood pressure in primary and secondary school students. Results: The prevalence of elevated blood pressure among primary and secondary school students in Yangzhou was 13.86 %, higher among boys (15.13%) than girls (12.62%) ( χ 2=14.30, P <0.01). The elevated blood pressure rate of obese and overweight primary and secondary school students were 26.98% and 14.90%, respectively, higher than 8.71% of non overweight and obese children ( χ 2=482.58, P <0.01). There were statistically significant differences in elevated blood pressure rate among primary and secondary school students in different sleep quality and sleep duration ( χ 2= 8.45, 71.58, P <0.05). After controlling for gender, residence, educational stage, parental education, sedentary time, the results of multiple Logistic regression analysis showed that no correlation between sleep quality and elevated blood pressure under different nutritional status was found among primary and secondary school students. In primary and secondary school students with obesity, prevalence of elevated blood pressure was higher among those with sleep duration <8 and 8 to <9 h/d ( OR=1.54, 1.72, P <0.05). However, there was no significant association found in the other groups ( OR=1.04-1.28, P >0.05). In gender stratification, sleep duration < 8, 8 to <9 and 9 to <10 h/d of obese boys were positively correlated with elevated blood pressure ( OR=1.97, 2.09, 1.86, P <0.05). Conclusion Among obese primary and secondary school students, sleep duration <9 h/d is associated with an increased risk of elevated blood pressure, especially among obese boys.

Objective To investigate the efficacy and safety of endoscopic hematoma evacuation in treatment of non-isodense chronic subdural hematoma and subacute subdural hematoma.Method From June 2019 to June 2022,endoscopic surgery was performed on 18 cases of non-isodense chronic subdural hematoma and subacute subdural hematoma.Then analyze the indicators such as hematoma clearance rate,postoperative midline deviation reduction,surgical time,intraoperative blood loss,postoperative recurrence rate,Glasgow coma score (GCS) and modified Rankin scale (mRS) at different times.Result The average surgical time was (147.89±10.29) min,the intraoperative blood loss was (130.52±18.42) mL.The average preoperative hematoma volume of 18 patients was (111.91±34.25) mL,on the first day after surgery,CT scan showed that all the 16 hematoma cases were cleared,and the majority of 2 hematoma cases were cleared,the average hematoma clearance rate was 88.89％.Craniocerebral CT showed an average midline displacement of (11.49±3.23) mm before surgery,which returned to (6.19±2.61) mm on the first day after surgery,the difference was statistically significant (P<0.01);At 1 month after surgery,16 patients had a median midline displacement,while 2 patients had a median midline displacement of 1.21 and 2.23 mm,the median line regression rate was 88.89％ at 1 month after surgery;6 months after surgery,all the 18 patients had a median midline displacement,and the median line regression rate was 100.00％.All the 18 patients did not experience any further bleeding after surgery,one patient developed subdural effusion after surgery,which was absorbed after taking medication.After a follow-up of six months,all the 18 patients did not recur.The GCS on admission was (14.06±2.46),which improved to (15.00±0.00) at discharge,with a statistically significant difference (P<0.05);mRS on admission was (3.17±1.26),and decreased to (0.56±0.02) at discharge,with statistical significance (P<0.05).Conclusion Endoscopic removal of chronic and subacute subdural hematomas with non-isodense is a safe and effective method of hematoma removal.While achieving the effect of large bone flap craniotomy,it can significantly reduce the surgical complications and postoperative recurrence,have a less invasive.It is worthy clinical application.

Objective:To explore whether the muscarinic acetylcholine receptor M1(M1 AChR)regulate the expression of ionotropic glutamate receptor AMP A type subunit 1(GluA1)and ionotropic glutamate receptor AMP A type subunit 2(GluA2),thus participating in the effects of plateau hypoxia on learning and memory in rats.Methods:Rats were randomly divided into normoxic group(Control),plateau hypoxia group(Hypoxia)and plateau hypoxia+TAK-071(an agonist of M1AChR)group.Morris water maze was utilized to detect the learning and memory ability of rats.Immunohistochemistry was utilized to determine the distribution and expression levels of M1 AChR,GluA1,and GluA2 in hippocampal CA1 and CA3 areas of rats.Western Blot was utilized to determine the expression levels of M1 AChR,GluA1,p-GluA1(Ser845),GluA2 and p-GluA2(Ser880)in hippocampus of rats.RT-qPCR was utilized to determine the mRNA expression levels of M1 AChR,GluA1,GluA2,ionotropic glutamate receptor NMDA type subunit 2A(NR2A),tau and amyloid β-protein(Aβ)in hippocampus of rats.Results:Plateau hypoxia could significantly increase the escape latency of rats in the spatial navigation test and shorten the stay time of rats in the target quadrant in the spatial probe test,while TAK-071 treatment could significantly improve the memory status of rats damaged by plateau hypoxia in the spatial probe test.There was a good correlation between the expression of GluA1,GluA2 and M1 AChR in CA1 and CA3 regions of hippocampus.In hippocampus,the expressions of GluA1 and GluA2 were synchro-nized with their corresponding phosphorylated proteins,and the correlativity between GluA1 and GluA2 and M1 AChR changed due to plateau hypoxia was reversed after TAK-071 treatment.TAK-071 could significantly reduce(P＜0.05)the expression levels of M1 AChR,GluA1,GluA2,NR2A,tau and Aβ mRNA increased due to plateau hypoxia.Conclusion:Activating M1 AChR can improve the memory impairment of rats caused by plateau hypoxia by regulating the expression of GluA1,GluA2 and their phosphorylated proteins.

Objective:To investigate the expression characteristics of mucin 5B (MUC5B) protein and programmed cell death factor 4 (PDCD4) protein in patients with intrahepatic cholangiocarcinoma (ICC), and to construct a nomogram model for prognosis prediction.Methods:Clinical data of 100 patients who underwent radical surgical resection and were diagnosed as ICC by postoperative pathology from September 2009 to September 2020 in the Third Affiliated Hospital of Wenzhou Medical University were retrospectively selected, including 46 males and 54 females, aged (56.9±12.2) years old. Immunohistochemistry was used to detect the expression of MUC5B and PDCD4 protein in 100 cases of ICC and corresponding adjacent tissues respectively, and the relationship between them and clinicopathological factors of ICC patients was analyzed. Univariate and multivariate Cox regression analysis were performed to analyze the influencing factors on postoperative prognosis of ICC patients. The nomogram model was constructed using rms package and performed internal verification.Results:The positive expression rate of MUC5B protein in ICC was 76.0% (76/100), which was higher than that in para-cancer tissues 27.0%(27/100), and the difference was statistically significant ( χ2=11.33, P=0.015). While the positive expression rate of PDCD4 protein in ICC was 21.0%(21/100), which was lower than that in normal tissues 73.0% (73/100), and the difference was statistically significant ( χ2=15.57, P=0.007). Multivariate Cox regression analysis showed that ICC patients with carbohydrate antigen 19-9>37 kU/L, tumor length>5 cm, tumor TNM stage Ⅱ/Ⅲ, tumor medium/low differentiation, MUC5B positive expression, and PDCD4 negative expression had a high risk of short survival after resection (all P<0.05). The nomogram model was constructed based on the above indicators, and the C-index was 0.801. The postoperative survival calibration curve showed that the high predictive survival fit of the nomogram model, and the area under the receiver operating characteristic curve was 0.862. Conclusions:Positive expression of MUC5B protein and negative expression of PDCD4 protein in ICC tissue suggest poor prognosis of ICC patients. The nomogram model constructed on the basis of MUC5B and PDCD4 protein is well distinguished and has ideal predictive efficacy.

Objective To observe effect of reconstructing physiological fulcrum in the treatment of elderly patients with intertrochanteric fracture of the femur. Methods Clinical materials of 40 elderly patients with osteoporotic intertrochanteric fracture of femur in the Tongling City People's Hospital from October 2020 to October 2022 were retrospectively analyzed. Among them, 20 patients treated with proximal femoral nail anti-rotation (PFNA) were assigned to the PFNA group, and 20 patients treated with proximal femoral bionic nail (PFBN) were assigned to the PFBN group. The operation time, intraoperative blood loss, length of hospital stay, postoperative rehabilitation, and incidence of complications were compared between the two groups. Results The postoperative weight-bearing time in the PFBN group was (8.50±1.99) days, which was significantly shorter than (20.15±4.87) days in the PFNA group (P<0.05). There were no significant differences in operation time, intraoperative blood loss, length of hospital stay, fracture healing time, excellent and good rate of fracture reduction quality, and excellent and good rate of Harris score between the PFBN group and the PFNA group (P>0.05). During the follow-up period of 10 to 14 months, no patients had complications such as wound infection, bone nonunion, implant failure, or deep venous thrombosis. Conclusion Both PFBN and PFNA can effectively treat elderly patients with osteoporotic intertrochanteric fracture of femur. However, patients treated with PFBN can take bed-off activities earlier, which is beneficial for postoperative rehabilitation, and the reason may be related to the double triangular stable structure reconstructed by PFBN.