Objective: To analyze the status of outdoor activities on weekends among children and adolescents of different educational stages in Shanghai and their impact on myopia, so as to provide a basis for formulating more specific prevention and control protocol of myopia. Methods: From September to October 2022, a stratified cluster random sampling method was employed to select 84 schools (27 kindergartens, 21 primary schools, 15 junior high schools and 21 high schools) across Shanghai, enrolling a total of 28 654 children and adolescents aged 4 to 18 for the study. Ophthalmic examinations were conducted to ascertain the prevalence of myopia among children and adolescents. Additionally, a questionnaire survey was administered to collect data on outdoor activity duration and associated factors. Multivariate Logistic regression analysis was utilized to investigate the associated factors of outdoor activity levels on weekends. Results: The overall myopia detection rate among children and adolescents was 58.4%, with a higher rate observed in girls (59.2%) compared to boys (57.6%). The myopia detection rates for children and adolescents with an average daily outdoor activity duration of ≥2 h and <2 h on weekends were 54.6% and 68.8%, and the differences were statistically significant ( χ 2=8.12,460.89, P <0.01). Multivariable Logistic regression analysis revealed that girls ( OR =0.80), those with a myopic parent ( OR =0.68), schools from urban districts ( OR =0.72), higher education stages (primary school: OR =0.65, junior high school: OR =0.24, high school: OR =0.14) and spending≥2 h/d on homework during weekends ( OR =0.57) among children and adolescents were less likely to engage in outdoor activities for ≥2 h on weekends ( P <0.01). After incorporating gender, parental myopia status, educational stage, school location, average daily duration on weekends for spending on homework, electronic product usage and outdoor activities as dependent variables in a multivariate Logistic regression analysis, the results showed that children and adolescents with an average outdoor activity duration for ≥2 h on weekends had a lower risk of myopia ( OR =0.86, P < 0.01). Conclusions The level of outdoor activity among children and adolescents on weekends needs to be improved. Outdoor activities on weekends is an associated factor for myopia among children and adolescents. Particularly, girls, those with myopic parents, schools from urban districts, and spending long hours on homework during weekends among children and adolescents require increased attention.

Objective: To investigate the visual acuity and correction conditions of children and adolescents in Shanghai, so as to provide a scientific basis for developing intervention measures to prevent myopia and protect vision among children and adolescents. Methods: From October to December 2022, a stratified cluster random sampling survey was conducted, involving 47 034 students from 16 municipal districts in Shanghai, covering kindergartens (≥5 years), primary schools, middle schools, general high schools and vocational high schools. According to the Guidelines for Screening Refractive Errors in Primary and Secondary School Students, the Standard Logarithmic Visual acuity Chart was used to examine naked vision and corrected vision of students, and general information was collected. The distribution and severity of visual impairment in different age groups were analyzed, and χ 2 tests and multivariate Logistic regression were used to explore factors associated with visual impairment. Results: The detection rate of visual impairment among children and adolescents was 76.2%, with a higher rate among females (78.8%) than males ( 73.8 %), higher among Han ethic students ( 76.2 %) than minority students (71.2%), and higher among urban students (76.7%) than suburban students (75.8%), all with statistically significant differences ( χ 2=162.6, 10.4, 5.5, P <0.05). The rate of visual impairment initially decreased and then increased with age, reaching its lowest at age 7 (53.8%) and peaking at age 17 (89.6%) ( χ 2 trend = 3 467.0 , P <0.05). Severe visual impairment accounted for the majority, at 56.6%, and there was a positive correlation between the severity of visual impairment and age among children and adolescents ( r =0.45, P <0.05). Multivariate Logistic regression showed that age, BMI, gender, ethnicity and urban suburban status were associated with visual impairment ( OR =1.18, 1.01, 1.38 , 0.79, 0.88, P <0.05). Among those with moderate to severe visual impairment, the rate of spectacle lens usage was 62.8%, yet only 44.8 % of those who used spectacle lens had fully corrected visual acuity. Females (64.9%) had higher spectacle lens usage rates than males (60.6%), and general high school students had the highest spectacle lens usage (83.9%), and there were statistically significant differences in gender and academic stages ( χ 2=57.7, 4 592.8, P <0.05). Conclusions The rate of spectacle lens usage among students with moderate to severe visual impairment is relatively low, and even after using spectacle lens, some students still do not achieve adequate corrected visual acuity. Efforts should focus on enhancing public awareness of eye health and refractive correction and improving the accessibility of related health services.

Emerging evidence suggests that dysbiosis of the gut microbiota is associated with the pathogenesis of Parkinson's disease (PD), a prevalent neurodegenerative disorder. The microbiota-gut-brain axis plays a crucial role in the development and progression of PD, and numerous studies have demonstrated the potential therapeutic benefits of modulations in the intestinal microbiota. This review provides insights into the characterization of the gut microbiota in patients with PD and highlights associations with clinical symptoms and underlying mechanisms. The discussion underscores the increased influence of the gut microbiota in the pathogenesis of PD. While the relationship is not fully elucidated, existing research demonstrates a strong correlation between changes in the composition of gut microbiota and disease development, and further investigation is warranted to explain the specific underlying mechanisms.
Humans ; Parkinson Disease/microbiology* ; Gastrointestinal Microbiome/physiology* ; Dysbiosis/microbiology*

Objective:To evaluate the relationship between preoperative gut microbiota and post-operative ventilator-associated pneumonia (VAP) in patients undergoing coronary artery bypass grafting.Methods:This was a secondary analysis of a previous research project study. Patients who received invasive mechanical ventilation treatment after elective off-pump coronary artery bypass grafting at the Second Hospital of Hebei Medical University from April to September 2023 were selected and divided into VAP group and non-VAP group based on whether VAP occurred after surgery. Fecal samples were collected from patients before surgery, and 16S rRNA gene sequencing was used to analyze the characteristics of preoperative gut microbiota in the two groups. The differences in the diversity of gut microbiota between the two groups were compared. The linear discriminant analysis was used to identify the gut microbiota with significant differences between groups (differential bacteria), and logistic regression analysis was conducted to assess the association between differential bacteria and VAP. Receiver operating characteristic curves were drawn to analyze the predictive value of the differential bacteria for VAP.Results:A total of 79 patients were finally included, with 25 in VAP group and 54 in non-VAP group. The Beta diversity analysis showed statistically significant differences between VAP group and non-VAP group (pseudo- F=2.00, P=0.002). The linear discriminant analysis indicated that Bifidobacterium, Blautia and Megamonas were enriched in non-VAP group, while Klebsiella was enriched in VAP group. Multivariate logistic regression analysis showed that the relative abundance of Bifidobacterium was a protective factor for postoperative VAP ( OR=0.32, 95% confidence interval [ CI] 0.15-0.71, P=0.005), and the relative abundance of Klebsiella was a risk factor for postoperative VAP ( OR=2.49, 95% CI 1.143-5.43, P=0.022). The area under the receiver operating characteristic curve of the relative abundance of Bifidobacterium for predicting VAP was 0.80 (95% CI 0.69-0.90, P<0.001) and of the relative abundance of Klebsiella was 0.70 (95% CI 0.57-0.83, P=0.005). Conclusions:Bifidobacterium is a protective factor, while Klebsiella is a risk factor for postoperative VAP in patients undergoing coronary artery bypass grafting, and the relative abundance of both bacteria has a certain predictive value for VAP.

Objective:To evaluate the relationship between preoperative gut microbiota and post-operative ventilator-associated pneumonia (VAP) in patients undergoing coronary artery bypass grafting.Methods:This was a secondary analysis of a previous research project study. Patients who received invasive mechanical ventilation treatment after elective off-pump coronary artery bypass grafting at the Second Hospital of Hebei Medical University from April to September 2023 were selected and divided into VAP group and non-VAP group based on whether VAP occurred after surgery. Fecal samples were collected from patients before surgery, and 16S rRNA gene sequencing was used to analyze the characteristics of preoperative gut microbiota in the two groups. The differences in the diversity of gut microbiota between the two groups were compared. The linear discriminant analysis was used to identify the gut microbiota with significant differences between groups (differential bacteria), and logistic regression analysis was conducted to assess the association between differential bacteria and VAP. Receiver operating characteristic curves were drawn to analyze the predictive value of the differential bacteria for VAP.Results:A total of 79 patients were finally included, with 25 in VAP group and 54 in non-VAP group. The Beta diversity analysis showed statistically significant differences between VAP group and non-VAP group (pseudo- F=2.00, P=0.002). The linear discriminant analysis indicated that Bifidobacterium, Blautia and Megamonas were enriched in non-VAP group, while Klebsiella was enriched in VAP group. Multivariate logistic regression analysis showed that the relative abundance of Bifidobacterium was a protective factor for postoperative VAP ( OR=0.32, 95% confidence interval [ CI] 0.15-0.71, P=0.005), and the relative abundance of Klebsiella was a risk factor for postoperative VAP ( OR=2.49, 95% CI 1.143-5.43, P=0.022). The area under the receiver operating characteristic curve of the relative abundance of Bifidobacterium for predicting VAP was 0.80 (95% CI 0.69-0.90, P<0.001) and of the relative abundance of Klebsiella was 0.70 (95% CI 0.57-0.83, P=0.005). Conclusions:Bifidobacterium is a protective factor, while Klebsiella is a risk factor for postoperative VAP in patients undergoing coronary artery bypass grafting, and the relative abundance of both bacteria has a certain predictive value for VAP.

Objective:To study the distribution and changes of dopamine transporter (DAT) in guinea pig eyes under different light patterns.Methods:Thirty-six 3-week-old white ordinary-grade guinea pigs were randomly selected and divided into groups of 10 000 lx, 5 000 lx, and 500 lx, with 12 guinea pigs in each group exposed to strong light, medium strong light, and normal light, respectively.Each group was randomly divided into 3 subgroups, with 4 guinea pigs in each subgroup.The 3 subgroups of 500 lx group received light exposure for 5, 20, and 40 minutes, respectively.The 3 subgroups of 5 000 lx group received light exposure for 2, 4, and 40 minutes, respectively.The 3 subgroups of 10 000 lx group received light exposure for 2, 5, and 20 minutes, respectively.After light treatment, each group of guinea pigs was injected with 99mTc-TRODAT-1 for SPECT DAT imaging, and image data were collected by Micro-SPECT.The region of interest (ROI) of guinea pig retinas was analyzed using Micro-CT software.The counts of ROI were expressed as Sum, which reflected the relative distribution or density of DAT.The DAT density between experimental and control eyes of guinea pigs after light exposure, the differences in DAT density between guinea pig eyes under different light intensities, the differences in DAT density between guinea pig eyes after different light durations, and the cumulative and interactive effects of light intensity and light duration on DAT aggregation in guinea pigs were compared.Another 3 guinea pigs were selected, and after light exposure, the 3 guinea pigs' eyes underwent continuous image acquisition for 6 hours at 20-minute intervals, and 18 images per guinea pig were acquired to analyze the trend of DAT density in guinea pig eyes over time.This study was approved by the Ethics Committee of Shanghai General Hospital (No.2020SQ196). Results:The DAT density (Sum value) of experimental eyes at 500, 5 000, and 10 000 lx were 5 598.97±3 159.38, 8 636.78±2 503.16, and 7 407.39±2 053.41, respectively, significantly higher than 4 388.89±2 902.90, 5 981.92±3 057.44, and 5 091.32±2 039.36 of control eyes ( t=5.31, 4.69, 11.80; all at P<0.001). At 500 lx, there was a statistically significant difference in DAT density between the experimental and control eyes of guinea pigs at different light exposure durations ( F=14.01, P<0.01), while no significant difference was found at other light intensities at different light exposure durations (both at P>0.05). When the light exposure time was 5 minutes, the difference in DAT density between the experimental and control eyes of guinea pigs was significantly greater in the 10 000 lx group than in the 500 lx group ( t=-13.22, P<0.001). There was no statistically significant difference between different groups at other light exposure durations (all at P>0.05). No cumulative or interactive effects of light intensity and light duration were found on the differences in DAT density (all at P>0.05). Continuous scanning after illumination showed that DAT density in guinea pig retinas first increased to a peak over time and then gradually returned to normal values. Conclusions:Light, even under moderate or normal light levels, can cause an increase in the secretion of DAT in the retina and stimulate the production of DAT.Light intensity and duration have no cumulative or interactive effects on the distribution and density of retinal DAT.

Objective:To explore the effects of simulated microgravity on carotid oxidative stress and anti-oxidative stress in rats by using a rat tail-suspension model to simulate the hemodynamic changes caused by microgravity.Methods:Twelve healthy adult male Sprague-Dawley rats were completely randomized into control group and simulated suspension group, with 6 rats in each group. The rats in control group were fed in standard laboratory environment and could move freely. The feeding environment of the simulated suspension group rats was the same as that of the control group, and the tail suspension was maintained for 4 weeks. The differentially expressed genes in carotid tissue were obtained by transcriptome sequencing, and analyzed by volcano plot, Venn diagram and heatmap. The differentially expressed genes were further analyzed by Gene Ontology and the Kyoto encyclopedia of genes and genomes. Dihydroethidium staining was used to detect the content of reactive oxygen species in rat carotid artery. Western blotting was used to detect the expression changes of pro-oxidative stress factor nicotinamide adenine dinucleotide phosphate oxidase 4 and anti-oxidative stress factors Kelch-like ECH-associated protein-1, nuclear factor-E2 related factor 2, heme oxygenase-1, and nicotinamide adenine dinucleotide phosphate quinone oxidoreductase-1 in each group. The contents/activities of malondialdehyde, superoxide dismutase, catalase, reduced glutathione and oxidized glutathione in each group were detected using the thiobarbituric acid method, 4-[2-(2-methoxy-4-nitrophenyl)-3-(4-nitrophenyl)tetrazol-2-ium-5-yl]benzene-1,3-disulfonate sodium method and colorimetry.Results:Compared with the rats in control group, the wet weight of soleus muscle and the ratio of the wet weight of soleus muscle to body weight in simulated suspension group rats were decreased ( t=19.98, 17.34, both P<0.001), and the differences were significant. Eighty differentially expressed genes related to oxidative stress were screened by transcriptional sequencing (52 up-regulated and 28 down-regulated), which were closely related to vascular remodeling pathways, including cyclic guanosine monophosphate-protein kinase G signal pathway, mitogen-activated protein kinase signal pathway, phosphoinositide 3-kinase-Akt signal pathway, protein processing in endoplasmic reticulum and lipid metabolism and atherosclerosis-related signal pathways. These genes were mainly involved in response to antioxidant defense, chaperone-mediated autophagy, stress fiber, contractile actin filament bundle, actin filament bundle, growth factor activity, chaperone binding and cytokine activity. Compared with the control group, the levels of reactive oxygen species ( t=3.83, P=0.028) and malondialdehyde ( t=8.75, P<0.001) in the simulated suspension group were significantly increased. The protein expression of nicotinamide adenine dinucleotide phosphate oxidase 4 ( t=11.49 , P<0.001) was significantly increased, with statistical significance. The activities of antioxidant stress related factors superoxide dismutase ( t=6.44, P=0.001), catalase ( t=6.83, P=0.001), and the ratio of reduced glutathione to oxidized glutathione ( t=3.46, P=0.003), and nuclear factor-E2 related factor 2 ( t=28.18, P<0.001), heme oxygenase-1 ( t=8.03, P<0.001), and nicotinamide adenine dinucleotide phosphate quinone oxidoreductase-1 ( t=9.71, P<0.001) were significantly decreased, the protein expression of Kelch-like ECH-associated protein-1 ( t=5.06, P<0.001) was increased, and the differences were statistically significant. Conclusions:Simulated microgravity can enhance the level of carotid oxidative stress in rats, including promoting the expression of pro-oxidative stress-related factors and suppressing the activity of anti-oxidative stress pathways. Their combined action will lead to the oxidative stress injury of carotid arteries. This process may be one of the key mechanisms involved in the remodeling of arterial structure and function induced by simulated microgravity.

Objective To investigate the current status of unplanned readmission to the ICU in neurosurgical patients and to study its influencing factors,aiming to inform the construction of targeted nursing interventions for medical staff.Methods From January 2020 to September 2022,the relevant data of patients transferred out from the ICU of a tertiary-level hospital in Beijing were retrospectively analyzed.After using propensity score matching,a sample with balanced covariates between groups was obtained,and single-factor and Logistic regression analyses were used to study the influencing factors of unplanned readmission to the ICU in neurosurgical patients.Results The data of a total of 4 789 patients were included,and 159 patients(3.32％)had unplanned readmission to the ICU.Respiratory failure and pulmonary infection were the main respiratory complications causing unplanned readmission to the ICU in neurosurgical patients.Logistic regression analysis showed that the duration of mechanical ventilation,the length of the first stay in the ICU,tracheal intubations ≥2 times,presence of cerebrospinal fluid drainage tube or lumbar drainage tube,existence of mild to moderate consciousness disorder at discharge from ICU,low white blood cell count,and low hemoglobin count were independent influencing factors for unplanned readmission to ICUs in neurosurgical patients(P＜0.05).Conclusion Medical staff should pay attention to the high-risk group of unplanned return to the ICU,assess the risk of transfer in a timely manner,carry out targeted nursing measures and strengthen the quality of nursing care to reduce the incidence of unplanned retum to the ICU in neurosurgical patients.

Objective To investigate the current status of unplanned readmission to the ICU in neurosurgical patients and to study its influencing factors,aiming to inform the construction of targeted nursing interventions for medical staff.Methods From January 2020 to September 2022,the relevant data of patients transferred out from the ICU of a tertiary-level hospital in Beijing were retrospectively analyzed.After using propensity score matching,a sample with balanced covariates between groups was obtained,and single-factor and Logistic regression analyses were used to study the influencing factors of unplanned readmission to the ICU in neurosurgical patients.Results The data of a total of 4 789 patients were included,and 159 patients(3.32％)had unplanned readmission to the ICU.Respiratory failure and pulmonary infection were the main respiratory complications causing unplanned readmission to the ICU in neurosurgical patients.Logistic regression analysis showed that the duration of mechanical ventilation,the length of the first stay in the ICU,tracheal intubations ≥2 times,presence of cerebrospinal fluid drainage tube or lumbar drainage tube,existence of mild to moderate consciousness disorder at discharge from ICU,low white blood cell count,and low hemoglobin count were independent influencing factors for unplanned readmission to ICUs in neurosurgical patients(P＜0.05).Conclusion Medical staff should pay attention to the high-risk group of unplanned return to the ICU,assess the risk of transfer in a timely manner,carry out targeted nursing measures and strengthen the quality of nursing care to reduce the incidence of unplanned retum to the ICU in neurosurgical patients.

Objective:To explore the effects of simulated microgravity on carotid oxidative stress and anti-oxidative stress in rats by using a rat tail-suspension model to simulate the hemodynamic changes caused by microgravity.Methods:Twelve healthy adult male Sprague-Dawley rats were completely randomized into control group and simulated suspension group, with 6 rats in each group. The rats in control group were fed in standard laboratory environment and could move freely. The feeding environment of the simulated suspension group rats was the same as that of the control group, and the tail suspension was maintained for 4 weeks. The differentially expressed genes in carotid tissue were obtained by transcriptome sequencing, and analyzed by volcano plot, Venn diagram and heatmap. The differentially expressed genes were further analyzed by Gene Ontology and the Kyoto encyclopedia of genes and genomes. Dihydroethidium staining was used to detect the content of reactive oxygen species in rat carotid artery. Western blotting was used to detect the expression changes of pro-oxidative stress factor nicotinamide adenine dinucleotide phosphate oxidase 4 and anti-oxidative stress factors Kelch-like ECH-associated protein-1, nuclear factor-E2 related factor 2, heme oxygenase-1, and nicotinamide adenine dinucleotide phosphate quinone oxidoreductase-1 in each group. The contents/activities of malondialdehyde, superoxide dismutase, catalase, reduced glutathione and oxidized glutathione in each group were detected using the thiobarbituric acid method, 4-[2-(2-methoxy-4-nitrophenyl)-3-(4-nitrophenyl)tetrazol-2-ium-5-yl]benzene-1,3-disulfonate sodium method and colorimetry.Results:Compared with the rats in control group, the wet weight of soleus muscle and the ratio of the wet weight of soleus muscle to body weight in simulated suspension group rats were decreased ( t=19.98, 17.34, both P<0.001), and the differences were significant. Eighty differentially expressed genes related to oxidative stress were screened by transcriptional sequencing (52 up-regulated and 28 down-regulated), which were closely related to vascular remodeling pathways, including cyclic guanosine monophosphate-protein kinase G signal pathway, mitogen-activated protein kinase signal pathway, phosphoinositide 3-kinase-Akt signal pathway, protein processing in endoplasmic reticulum and lipid metabolism and atherosclerosis-related signal pathways. These genes were mainly involved in response to antioxidant defense, chaperone-mediated autophagy, stress fiber, contractile actin filament bundle, actin filament bundle, growth factor activity, chaperone binding and cytokine activity. Compared with the control group, the levels of reactive oxygen species ( t=3.83, P=0.028) and malondialdehyde ( t=8.75, P<0.001) in the simulated suspension group were significantly increased. The protein expression of nicotinamide adenine dinucleotide phosphate oxidase 4 ( t=11.49 , P<0.001) was significantly increased, with statistical significance. The activities of antioxidant stress related factors superoxide dismutase ( t=6.44, P=0.001), catalase ( t=6.83, P=0.001), and the ratio of reduced glutathione to oxidized glutathione ( t=3.46, P=0.003), and nuclear factor-E2 related factor 2 ( t=28.18, P<0.001), heme oxygenase-1 ( t=8.03, P<0.001), and nicotinamide adenine dinucleotide phosphate quinone oxidoreductase-1 ( t=9.71, P<0.001) were significantly decreased, the protein expression of Kelch-like ECH-associated protein-1 ( t=5.06, P<0.001) was increased, and the differences were statistically significant. Conclusions:Simulated microgravity can enhance the level of carotid oxidative stress in rats, including promoting the expression of pro-oxidative stress-related factors and suppressing the activity of anti-oxidative stress pathways. Their combined action will lead to the oxidative stress injury of carotid arteries. This process may be one of the key mechanisms involved in the remodeling of arterial structure and function induced by simulated microgravity.