Objective: To investigate the relationship between physical development indicators and the onset and progression of myopia among children and adolescents, so as to provide theoretical support for coordinated vision and physical health management. Methods: A prospective cohort study was conducted. In September 2022, 3 102 students from grade one in primary school to grade three in junior high school (five year primary school and four year junior high school) from six schools in Huantai County, Shandong Province, were selected using multistage cluster random sampling method to participate in an epidemiological survey on myopia, with follow up completed in September 2023. Follow up value minus baseline value( d ) was used to assess changes in physical development and vision indicators. Multivariate Logistic regression analysis was used to examine the relationship between physical development indicators and the incidence of myopia. Generalized linear models were established to analyze the relationship between physical development indicators and changes in d spherical equivalent (SE) and d axial length (AL) . Results: Multivariate Logistic regression analysis showed that, after adjusting for factors such as gender, age, and baseline body mass index, the third ( Q 3)and fourth ( Q 4)quartiles of d height showed increased risks of myopia onset within one year compared to the first quartile( Q 1) ( OR =1.85,95% CI =1.18-2.88; OR =1.74,95% CI =1.09-2.78,both P ＜0.05). Results from the generalized linear model indicated that, after adjusting for confounding factors such as gender, age, and baseline SE, d SE was negatively correlated with d height and d weight in children and adolescents ( β =-0.024, 95% CI =-0.031 to -0.018; β =-0.006, 95% CI =-0.011 to -0.001), d AL was positively correlated with d height and d weight in children and adolescents ( β =0.011, 95% CI =0.008-0.013; β =0.005, 95% CI =0.003-0.007) (all P ＜0.05). Conclusions Physical development indicators in children and adolescents were associated with the onset and progression of myopia. Dynamic monitoring and early intervention of myopia should be strengthened for children and adolescents with rapid height and weight gain to achieve coordinated management of myopia and physical development.

OBJECTIVE To investigate the improving effect and mechanism of Wenyang huayu formula on cerebral ischemia-reperfusion injury in rats based on nuclear factor-erythroid 2-related factor 2 （Nrf2）/glutathione peroxidase 4 （GPX4） signaling pathway and mitochondrial ferroptosis pathway. METHODS SD rats were randomly divided into sham operation group， model group，Nimodipine tablet group （10.8 mg/kg ）， and Wenyang huayu formula group （28 g/kg）， with 24 rats in each group. Except for the sham operation group， rats in other groups were all subjected to middle cerebral artery occlusion model by Longa thread occlusion method. After successful modeling， rats in each administration group were intragastrically gavaged with corresponding liquid for 7 days or 14 days， while rats in sham operation group and model group were given equal volume of normal saline once a day. At 7 and 14 days after administration， neurological deficit scores of rats were calculated； the ultrastructure of neuronal mitochondria in ischemic brain tissue of rats was observed；the contents of malondialdehyde （MDA）， glutathione （GSH） and Fe 2+ ， as well as the protein and mRNA expression levels of Nrf2， solute carrier family 7 member 11 （SLC7A11） and GPX4 in ischemic brain tissue of rats were detected. RESULTS At 7 and 14 days after administration， compared with the sham operation group， the neuronal mitochondria in ischemic brain tissue of rats in the model group showed typical changes of ferroptosis， and the injury continued to worsen over time； the neurological deficit scores， the contents of MDA and Fe 2+ were significantly increased （ P ＜0.05），while the content of GSH and the protein and mRNA expression levels of Nrf2， SLC7A11 and GPX4 were significantly decreased （ P ＜0.05）. Compared with the model group， the morphology of neuronal mitochondria in ischemic brain tissue of rats in Nimodipine tablet group and Wenyang huayu formula group was gradually improved over time， and the above quantitative indicators were significantly reversed （ P ＜0.05）；moreover， the improvement effect of most indicators in Wenyang huayu formula group was significantly better than that in Nimodipine tablet group （ P ＜0.05）. CONCLUSIONS Wenyang huayu formula can improve cerebral ischemia-reperfusion injury in rats， and its mechanism may be related to activating Nrf2/GPX4 signaling pathway and inhibiting mitochondrial ferroptosis.

Objective: To explore the association between CDKAL1 rs35261542, FAIM2 rs 3205718, and VGLL4 rs 2574704 polymorphisms with childhood obesity and related metabolic phenotypes to provide evidence for personalized prevention and management strategies. Methods: Based on the 2023 Long term Nutritional Health Effects of Early Childhood Nutrition Package Intervention project, the study enrolled 1 078 children aged 5-7 years from four counties in Henan (Songxian and Ruyang countries) and Guizhou (Guiding and Fuquan countries) provinces. Using BMI Z scores, 87 overweight and obese(OVOB) children were selected and matched by sex, age, and BMI Z score with 117 normal weight controls. Participants were further stratified into four metabolic phenotype groups: metabolically healthy normal weight (MHNW, n =51), metabolically unhealthy normal weight (MUNW, n =66), metabolically healthy obesity (MHO, n =31) and metabolically unhealthy obesity (MUO, n =56) based on four conventional cardiometabolic risk factor (CR) criteria. Data were collected through questionnaires, anthropometric measurements, serum biochemical tests, and KASP genotyping. The distribution of three genetic polymorphisms ( CDKAL1 rs35261542, FAIM2 rs3205718, VGLL4 rs 2574704) across metabolic subgroups was analyzed. Multivariate Logistic regression models assessed associations between these polymorphisms and obesity/metabolic phenotypes. Results: Multivariate Logistic regression analysis showed that Homozygous mutant AA genotype of CDKAL1 rs 35261542 was positively associated with OVOB( OR =3.63), MHO ( OR =11.04), MUO ( OR = 4.88 ) ( P <0.05). Homozygous TT genotype of FAIM2 rs 3205718 increased OVOB risk ( OR =4.44, P <0.05) but showed no association with metabolic phenotypes ( P >0.05). Homozygous mutant TT of VGLL4 rs 2574704 reduced the risks of MHO and MUO ( OR = 0.30, 0.24， P <0.05). Cumulative genetic effects analysis demonstrated carriers of 1 or 2 risk genotypes of rs 35261542 and rs 3205718 had progressively higher OVOB risk ( OR =2.53, 20.79), and the combination of rs 35261542 and rs 2574704 increased risks for both MHO ( OR =8.50) and MUO ( OR =5.00) ( P <0.05). Conclusions The AA genotype of rs 35261542 ( CDKAL1 ) positively correlates with childhood obesity and metabolic abnormalities. The TT genotype of rs 3205718 ( FAIM 2) increases obesity risk but not metabolic phenotypes. The TT genotype of rs 2574704 ( VGLL 4) shows protective effects against metabolic dysfunction. Risk genotypes exhibit dosedependent cumulative effects on obesity and metabolic outcomes.

Objective To analyze the relationship of red blood cell distribution width(RDW)and blood lipid metabolism indicators with carotid atherosclerotic plaque stability in elderly patients with acute cerebral infarction(ACI).Methods A total of 110 elderly ACI patients admitted in our hospital from March 2021 to November 2024 were retrospectively recruited,and according to their carotid plaque characteristics,they were divided into stable plaque group(48 cases)and unstable plaque group(62 cases).The RDW,and levels of TC,TG,HDLC,LDL-C and homocysteine(Hcy)were detected.Results The unstable plaque group had significantly higher levels of RDW,TC,TG,LDL-C and Hcy,but lower HDL-C level than the stable plaque group(P＜0.01).RDW,TC,TG,HDL-C,LDL-C and Hcy were the influencing factors of carotid atherosclerotic plaque stability in elderly ACI patients(P＜0.05,P＜0.01).ROC curve analysis suggested that the AUC value of combined detection of RDW,TC,TG,HDL-C,LDL-C and Hcy in evaluating the stability of carotid atherosclerotic plaque was 0.940(95％CI:0.898～0.983),and the combination had bet-ter efficiency than single indicator detection(P＜0.05).Conclusion RDW and blood lipid metabo-lism indicators are associated with the stability of carotid atherosclerotic plaque in elderly ACI patients,and they can be used as biochemical evaluation indicators for the stability.

Objective:To conduct a bibliometric analysis of research on auricular acupoint therapy (AAT) published between 2014 and 2024 in the China National Knowledge Infrastructure (CNKI) , in order to identify research hotspots and explore future research trends.Methods:CiteSpace, VOSviewer, and CNKI's bibliometric visualization platform were used to analyze publications from multiple perspectives, including annual publication trends, institutional distribution, author collaboration networks, keyword co-occurrence, and journal sources.Results:From 2014 to 2024, research on auricular acupoint therapy underwent a transition from rapid growth to steady development. The research focus shifted from traditional Chinese medicine theories to integration with modern neuroscience and technology. Domestic research was primarily concentrated in universities and institutes of traditional Chinese medicine, with collaboration mainly occurring at the regional level. Randomized controlled trials (RCTs) became the predominant study design, although issues related to methodological rigor persist. Keyword analysis showed a shift in research hotspots from traditional conditions like headache and insomnia to contemporary health concerns such as depression, anxiety, and hyperlipidemia.Conclusions:Auricular acupoint therapy is increasingly incorporating modern scientific and technological approaches. Research methodologies are becoming more standardized, and areas of application are continuously expanding. Future studies should focus on enhancing interdisciplinary collaboration, improving research design quality, and deepening international cooperation to promote the broader adoption and development of AAT within the global healthcare system.

Objective:To observe any impact of supplementing conventional rehabilitation training with electrothermal acupuncture on the upper limb motor functioning of hemiplegic stroke survivors.Methods:Thirty-six hemiplegic persons who had recently survived a stroke were divided at random into an electrothermal acupuncture group ( n=18) and a control group ( n=18). Both groups received conventional rehabilitation training, while the electrothermal acupuncture group was additionally provided with daily 30-minute sessions of electrothermal acupuncture, 6 days per week for 3 weeks. Before and after the treatment everyone′s upper limb motor functioning was quantified using the Fugl-Meyer assessment (FMA-UE), and their ability in the activities of daily living (ADL) was assessed using the modified Barthel index (MBI). The Hong Kong version of the functional test for the hemiplegic upper extremity (FTHUE-HK) was also administered. Surface electromyography (sEMG) was employed to compute the co-contraction ratios (CRs) of the agonist to antagonist muscles during elbow flexion and extension. Results:After the treatment, both groups exhibited significant improvements in their average FMA-UE, FTHUE-HK and MBI results, but with significantly greater improvement in the electrothermal acupuncture group. The root mean square values of the wrist flexor and extensor and elbow flexor muscles during flexion showed significant improvement in both groups, with the average values in the electrothermal acupuncture group significantly better than those of the control group. The CR values during elbow extension in the electrothermal acupuncture group demonstrated significant improvement compared to before the treatment.Conclusions:Supplementing conventional rehabilitation measures with electrothermal acupuncture can better increase the strength of the elbow and wrist extensor muscles in the early days after a stroke. It promotes the recruitment of muscle fibers in the extensor muscle group, reduces abnormal coordination patterns in the elbow joint, and improves upper limb motor function, the practicality of hand function, and ability in the activities of daily living.

Objective:To observe any impact of supplementing conventional rehabilitation training with electrothermal acupuncture on the upper limb motor functioning of hemiplegic stroke survivors.Methods:Thirty-six hemiplegic persons who had recently survived a stroke were divided at random into an electrothermal acupuncture group ( n=18) and a control group ( n=18). Both groups received conventional rehabilitation training, while the electrothermal acupuncture group was additionally provided with daily 30-minute sessions of electrothermal acupuncture, 6 days per week for 3 weeks. Before and after the treatment everyone′s upper limb motor functioning was quantified using the Fugl-Meyer assessment (FMA-UE), and their ability in the activities of daily living (ADL) was assessed using the modified Barthel index (MBI). The Hong Kong version of the functional test for the hemiplegic upper extremity (FTHUE-HK) was also administered. Surface electromyography (sEMG) was employed to compute the co-contraction ratios (CRs) of the agonist to antagonist muscles during elbow flexion and extension. Results:After the treatment, both groups exhibited significant improvements in their average FMA-UE, FTHUE-HK and MBI results, but with significantly greater improvement in the electrothermal acupuncture group. The root mean square values of the wrist flexor and extensor and elbow flexor muscles during flexion showed significant improvement in both groups, with the average values in the electrothermal acupuncture group significantly better than those of the control group. The CR values during elbow extension in the electrothermal acupuncture group demonstrated significant improvement compared to before the treatment.Conclusions:Supplementing conventional rehabilitation measures with electrothermal acupuncture can better increase the strength of the elbow and wrist extensor muscles in the early days after a stroke. It promotes the recruitment of muscle fibers in the extensor muscle group, reduces abnormal coordination patterns in the elbow joint, and improves upper limb motor function, the practicality of hand function, and ability in the activities of daily living.

Objective To understand the current situation and dynamic changing trends of healthcare-associated infection(HAI)in a tertiary first-class hospital in the northwest of Hunan Province from 2015 to 2024,and provide scientific basis for optimizing infection control strategies.Methods A single-day cross-sectional survey method was employed to investigate the HAI prevalence rates of hospitalized patients on the given survey day each year from 2015 to 2024.The standardized survey protocol on prevalence rate issued by the National Medical Institution Infec-tion Surveillance Network was strictly adhered,lanqingting real-time HAI monitoring management platform was adopted to retrieve cases from the hospital information system,and R4.2.2 was applied for statistical analysis.Results From 2015 to 2024,the prevalence rate of HAI decreased from 3.03％in 2015 to 1.76％in 2024(Z=-3.37,P＜0.001),and the HAI case prevalence rate decreased from 3.55％in 2015 to 2.20％in 2024(Z=-2.81,P=0.005).Department of critical care medicine continuously had the highest HAI case prevalence rate,which presented a downward trend over time(Z=-2.84,P=0.004).The main site of HAI was lower respiratory tract,accounting for 39.36％to 48.15％,bloodstream infection increased from 3.57％in 2015-2016 to 10.60％in 2023-2024(Z=2.41,P=0.016).A total of 302 strains of HAI pathogens were detected,including 212 strains(70.20％)of Gram-negative bacteria,mainly Pseudomonas aeruginosa(n=55,18.21％),Escherichia coli(n=45,14.90％),Acinetobacter baumannii(n=33,10.93％),and Klebsiella pneumoniae(n=31i,10.26％).65 strains(21.52％)of Gram-positive bacteria were identified,with Enterococcus faecium(n=19,6.29％)and Staphylococcus aureus(n=18,5.96％)accounting for the highest proportions.25 fungal strains(8.28％)were detected,mainly Candi-da albicans(n=11,3.64％).The use rate of antimicrobial agents showed a downward trend over the past decade(Z=-4.01,P＜0.001).Therapeutic antimicrobial use accounting for 82.42％,and its proportion increased over time(Z=6.02,P＜0.001).Prophylactic antimicrobial use accounted for 16.42％,showing a decreasing trend(Z=-2.75,P＜0.001).The pathogen detection rate presented an upward trend over the past decade(Z=13.01,P＜0.001).Conclusion The prevalence rate and case prevalence rate of HAI present a downward trend in this hospi-tal.In the future,it is necessary to establish a monitoring data-based dynamic analysis mechanism,achieve timely feedback and intervention in data monitoring,pay attention to high-risk links in department of critical care medicine,implement precise prevention and control mearsures,perform targeted prevention and control for lower respiratory tract,urinary tract,and bloodstream infection,optimize diagnosis and treatment processes,use antimicrobial agents rationally,and pay attention to the prevalence trend of Gram-negative bacteria.

OBJECTIVE To summarize the clinical characteristics and diagnosis and treatment experiences in dealing with non-severe Chlamydia psittaci pneumonia.METHODS The clinical data were collected from 34 patients who were diagnosed with non-severe C.psittaci pneumonia through quantitative polymerase chain reactiong(qPCR)for sputum in fever clinic of the First Medical Center of Chinese PLA General Hospital from Mar.2023 to Mar.2024 and were retrospectively analyzed.The clinical characteristics and treatment outcomes were evaluated.RESULTS The average age of the patients was(44.82±13.74)years old,the ratio of male to female was 1∶1.83;all of the patients had fever;major symptoms were cough(70.59％),pharyngodynia(44.12％),and flu-like symptoms(41.18％);82.35％of the patients had the history of contact with poultry.The C-reactive pro-tein(CRP)level,interleukin-6(IL-6),systemic inflammatory response index(SIRI)and aggregate index of sys-temic inflammation(AISI)were higher among the patients aged no less than 44 years old than among the patients less than 44 years old(P＜0.05);the percentage of lymphocytes of the patients aged no less than 44 years old was lower than that of the patients aged less than 44 years old(P＜0.05).As for the imaging findings,73.53％of the patients had consolidation shadows,26.47％had ground-glass opacities,and 32.35％involved both lungs.All of the patients received quinolones or tetracyclines for treatment of 7-14 days and all symptoms relieved.CT reexami-nated 1 month after the treatment showed that 55.88％of the cases had complete absorption of pulmonary infec-tious lesions,and 35.29％had partial absorption.CONCLUSIONS The patients with non-severe Chlamydia psitta-ci pneumonia are characterized by the history of contact with poultry,fever complicated with respiratory tract symptoms,rise of inflammatory markers(more significant among patients of advanced age)and lower lobe con-solidation shadow/ground-glass opacities.Early identification and standardized treatment may facilitate the favora-ble treatment outcomes.

OBJECTIVE To summarize the clinical characteristics and diagnosis and treatment experiences in dealing with non-severe Chlamydia psittaci pneumonia.METHODS The clinical data were collected from 34 patients who were diagnosed with non-severe C.psittaci pneumonia through quantitative polymerase chain reactiong(qPCR)for sputum in fever clinic of the First Medical Center of Chinese PLA General Hospital from Mar.2023 to Mar.2024 and were retrospectively analyzed.The clinical characteristics and treatment outcomes were evaluated.RESULTS The average age of the patients was(44.82±13.74)years old,the ratio of male to female was 1∶1.83;all of the patients had fever;major symptoms were cough(70.59％),pharyngodynia(44.12％),and flu-like symptoms(41.18％);82.35％of the patients had the history of contact with poultry.The C-reactive pro-tein(CRP)level,interleukin-6(IL-6),systemic inflammatory response index(SIRI)and aggregate index of sys-temic inflammation(AISI)were higher among the patients aged no less than 44 years old than among the patients less than 44 years old(P＜0.05);the percentage of lymphocytes of the patients aged no less than 44 years old was lower than that of the patients aged less than 44 years old(P＜0.05).As for the imaging findings,73.53％of the patients had consolidation shadows,26.47％had ground-glass opacities,and 32.35％involved both lungs.All of the patients received quinolones or tetracyclines for treatment of 7-14 days and all symptoms relieved.CT reexami-nated 1 month after the treatment showed that 55.88％of the cases had complete absorption of pulmonary infec-tious lesions,and 35.29％had partial absorption.CONCLUSIONS The patients with non-severe Chlamydia psitta-ci pneumonia are characterized by the history of contact with poultry,fever complicated with respiratory tract symptoms,rise of inflammatory markers(more significant among patients of advanced age)and lower lobe con-solidation shadow/ground-glass opacities.Early identification and standardized treatment may facilitate the favora-ble treatment outcomes.