Objective: To investigate the association of physical activity and screen time with overweight and obesity among children and adolescents with special needs in Tianjin, so as to provide scientific evidence for childhood obesity prevention and intervention measures in the population. Methods: From January 2022 to June 2024, 296 children and adolescents with intellectual disabilities and autism spectrum disorders aged 2-18 years were recruited from special education schools and institutions in Tianjin. Height and weight were measured, and a standardized questionnaire was used to assess physical activity and screen time. Binary Logistic regression analysis was carried out to investigate the association of physical activity and screen time with overweight and obesity. Results: The prevalence of overweight and obesity among children and adolescents with special needs in Tianjin were 17.2% and 21.6%, respectively, and the combined prevalence of overweight and obesity was 38.9%. The median of moderatetovigorous physical activity (MVPA) time was 0.20 h/d, and physical activity sufficiency rate was 7.8%. The median of screen time was 1.79 h/d, and the screen time compliance rate was 68.2%. The binary Logistic regression results showed that lower levels of MVPA time and increased screen time were associated with a higher risk of overweight and obesity among children and adolescents with special needs [OR(95%CI)=1.80(1.06-3.07), 2.40(1.42-4.07),P<0.05]. Conclusions Insufficient physical activity and excessive screen time are associated with an increased risk of overweight and obesity among children and adolescents with special needs. Therefore, comprehensive intervention measures should be implemented as early as possible to prevent and reduce the incidence of overweight and obesity in this population.

Myopia is a common eye disease among children and adolescents, and it is also a major and common public health problem for children and adolescents worldwide. Although the myopia rate among children and adolescents in different provinces , cities , and regions varies , the incidence of myopia is generally high , showing a trend of high incidence and younger age. Myopia in children and adolescents is closely related to sleep conditions . The sleep time of most children and adolescents in China does not reach the recommended length of time for this age group, and their sleep quality is poor, which affects their study and life. The biological connection and molecular mechanism between sleep and myopia are hot topics in clinical research . This article reviews the epidemiological characteristics of myopia and sleep status in children and adolescents , as well as the biological mechanisms between sleep and myopia , with the aim of providing a theoretical basis for preventing myopia in children and adolescents.

Objective: To understand the current situation and related factors of screening myopia among students in special education schools, so as to provide evidence for promoting the health level of this population. Methods: From November 2021 to December 2023, a total of 281 students from 6 special education schools in 5 districts of Tianjin were selected by cluster random sampling method for computer optometry visual acuity examination for non ciliary paralysis and questionnaire survey. Multiple Logistic regression was performed to analyze the influencing factors of screening myopia among special education students. Results: The screening myopia detection rate among these special education students in Tianjin was 27.0%, and the screening myopia detection rates of students with autism, developmental delays, and intellectual disabilities were 22.4%, 12.5%, and 33.0%, respectively. The degree of myopia increased with age ( χ 2 trend =22.65, P <0.01). Multivariate Logistic regression analysis showed that age(10-13 years old: OR =5.40, 14-17 years old: OR =8.40, 18-23 years old: OR =6.02), accommodation(non resident: OR =0.29), daily mobile phone usage ≥2 hours ( OR =2.37), and daily computer/tablet usage ≥2 hours ( OR =2.70) were the risk factors for screening myopia among special education students ( P <0.05). Conclusions The detection rate and degree of screening myopia increase with age in special education students. Prolonged screen time exposure is a primary risk factor for screening myopia in special education students. Effective myopia prevention and control strategies should be designed according to the characteristics of special education students.

Objective To investigate the modified Woodcock score of intracranial arterial calcification(IAC)in acute ischemic stroke patients with intracranial large or medium vessel occlusion and its impact on the outcome of endovascular treatment and surgery.Methods The patients who underwent mechanical thrombectomy for acute isch-emic stroke due to large or medium vessel occlusion in our hospital from January 2017 to July 2021 were enrolled,and related demographic and clinical variables were analyzed,including age,sex,and National Institutes of Health Stroke Scale(NIHSS).Pearson correlation analysis,linear regression analysis,and logistic regression analysis were used for modeling to determine the association between symptomatic IAC and outcome,and the variables that were sig-nificantly associated with outcome were used for adjustment,with P<0.05 as statistically significant.Results Of all acute ischemic stroke patients,74(53.6%)were found to have intracranial vascular calcification on CT images on admission.The modified Woodcock score on the ipsilateral side of the diseased vessels had a certain value in predict-ing the prognosis of mechanical thrombectomy for large vessel occlusion,and the logistic regression analysis showed that calcification score on the ipsilateral side was negatively correlated with the modified Rankin Scale(mRS)score(P=0.026),and the use of balloons was positively correlated with mRS score(P=0.035).Data analysis showed that the patients with a high level of low-density lipoprotein(LDL)tended to have high total hospital costs,high costs of surgical materials,a high possibility of stent implantation,and a low recanalization rate.Conclusion Intracranial arterial calcification score has a certain application value in mechanical thrombectomy for acute ischemic stroke.Pa-tients with high LDL tend to have high total hospital costs,high costs of surgical materials,a high possibility of stent implantation,and a low recalculation rate after surgery.

Objective: To apply eye-tracking technology to measure the fixation duration of children and adolescents with autism spectrum disorder (ASD) towards emotional faces, so as to provide potential objective indicators for the diagnosis and intervention of ASD. Methods: Case-control studies related to emotional faces in ASD children and adolescents aged 3-18 years were searched in PubMed, Web of Science, CNKI and Wanfang, with a search period spanning from the inception of the databases to April 1, 2024. The Newcastle-Ottawa Scale (NOS) was employed to assess the quality of the retrieved articles, and a Meta analysis was conducted by Stata 17.0 software. Results: A total of 18 articles were included, encompassing 361 participants in the ASD group and 413 in the control group. All studies scored ≥6 on the NOS, indicating high research quality. Compared to the control group, the ASD group demonstrated significantly shorter fixation duration ( P <0.01) towards specific emotional faces, including happy faces under the paradigm of self-made and same ethnicity emotional faces ( SMD =-1.05, -1.16), neutral faces in domestic literature ( SMD = -1.00), angry and sad faces under clinical diagnosis criteria ( SMD =-1.73, -1.29), and fearful faces under Chinese Classification and Diagnostic Criteria of Mental Disorders, Version 3 (CCMD-Ⅲ) ( SMD =-1.51). Conclusion Children and adolescents with ASD exhibit abnormal eye tracking indicators towards certain emotional faces, which may serve as early warning indicators for the diagnosis of ASD.

Objective:To study the clinical and immunological features of two case of rare antisynthetase syndrome (ASS), so as to improve the level of diagnosis and treatment.Methods:Two cases with rare antisynthetase syndrome admitted to the First Affiliated Hospital of Zhengzhou University from July 2020 to August 2022 were collected.Results:The two rare ASS were anti-Zo antibody and anti-Ha antibody positive patients, both of which had interstitial lung disease (ILD) as the main clinical manifestation and positive anti-Ro52 antibody. Two rare antisynthetase autoantibodies manifested cytoplasmic ANA indirect immunofluorescence (IIF) staining pattern, but it is different from the cytoplasmic dense speckled pattern of several common ASS antibodies. After treatment with glucocorticoids and immunosuppressants, case 1 died of respiratory failure due to a long course of disease and late diagnosis, the lung lesions of case 2 improved significantly.Conclusion:When encountering the cytoplasmic ANA fluorescent pattern in ILD patients, especially with anti-Ro52 antibody, it is necessary to screen more myositis specific antibodies to rule out the possibility of rare ASS.

Objective:To construct a prediction model for peripherally inserted central catheter-related upper extremity deep vein thrombosis (PICC-UEDVT) in patients with traumatic brain injury (TBI) and validate its effectiveness.Methods:A case-control study was conducted on the clinical data of 222 TBI patients admitted to Xiangya Hospital of Central South University from January 2019 to December 2021, including 171 males and 51 females, aged 18-86 years [54.5(46.0, 65.0)years]. Glasgow coma scale (GCS) motor score was 4.0(3.0, 5.0)points on the day of catheterization. A total of 82 patients (36.9%) had PICC-UEDVT. The patients were randomly divided with a ratio of 7∶3 into training set ( n=156, including 58 with PICC-UEDVT) and validation set ( n=66, including 24 with PICC-UEDVT) using R programming language. The baseline data of general information, intravenous medication, catheterization, and laboratory indices were compared between the training set and the validation set. Lasso regression analysis was employed to identify those variables, with the diagnosis of PICC-UEDVT as the outcome variable. Variables with non-zero regression coefficients were included in a multifactorial Logistic regression model and independent variables were selected based on the Akaike Information Criterion (AIC) of R programming language. The regression equation was constructed, based on which, the predictive nomogram model was constructed for PICC-UEDVT in TBI patients. Receiver operating characteristic (ROC) curves for the training set and validation set were plotted and the discriminability of the model was assessed. The calibration of the model was evaluated using the Hosmer-Lemeshow (H-L) goodness-of-fit test and calibration curves and the clinical practicality of the model was assessed with decision curve analysis (DCA). Results:The baseline analysis of both the training set and the validation set demonstrated a well-balanced sample distribution. Through Lasso regression analysis, 5 prediction variables were identified: GCS motor score on the day of catheterization, Caprini score on the day of catheterization, use of glucocorticoids, tip position of the catheter, and D-dimer (D-D) level before catheterization. The multivariate Logistic regression analysis revealed that the Caprini score on the day of catheterization ( OR=1.20, 95% CI 1.08, 1.33), use of glucocorticoids ( OR=3.13, 95% CI 0.99, 10.46), and D-D level before catheterization ( OR=1.16, 95% CI 1.07, 1.33) were independent risk factors for PICC-UEDVT in TBI patients. The regression equation was developed as: Logit [ P/(1- P)]=-2.56+0.18×"Caprini score on the day of catheterization"+1.14×"use of glucocorticoids"+0.15×"D-D level before catheterization". In the prediction model which was constructed based on the equation, the AUC values for the training set and validation set were 0.73 (95% CI 0.65, 0.81) and 0.77 (95% CI 0.65, 0.87) respectively. The H-L goodness-of-fit test indicated χ2=3.28, P=0.950 for the training set and χ2=13.05, P=0.160 for the validation set. Calibration curves for both sets demonstrated alignment between the actual and predicted probabilities of PICC-UEDVT in TBI patients. DCA results showed that the net benefit rate of patients was optimal when the threshold probability ranged from 15% to 72% for the training set and from 10% to 81% for the validation set. Conclusion:The prediction model based on the Caprini score on the day of catheterization, use of glucocorticoids, and D-D level before catheterization demonstrates good predictive accuracy, calibration and clinical practicality in predicting PICC-UEDVT in TBI patients.

Objective:To explore the feasibility and value of performing a three-sided encapsulation procedure based on fascia anatomy in laparoscopic lateral lymph node dissection (LLND) for middle and low rectal cancer.Methods:This was a retrospective review. The study cohort comprised patients who met the diagnostic criteria for rectal cancer according to the Chinese Guidelines for the Diagnosis and Treatment of Colorectal Cancer, had a short lymph node diameter of >5 mm on the lateral side within the 15 days before surgery, were evaluated as feasible candidates for laparoscopic total mesorectal excision+LLND surgery, had been diagnosed with low or intermediate level rectal cancer, and whose tumor was less than 8 cm away from the anal verge according to pathological examination of the operative specimen. Patients with a history of other malignant tumors of the abdomen or with incomplete follow-up data were excluded. Forty-two patients with middle and low rectal cancer who had undergone lateral lymph node dissection in diagnosis and treatment center of Gastrointestinal Cancer of Guangdong Hospital of Chinese Medicine from Jan.2018 to Dec.2022 were enrolled. There were 24 men (57.1%) and 18 women (42.9%) aged 58.4±11.8 years and the median BMI was 22.5 (19.3–24.1) kg/m 2. The main point of the three-sided encapsulation procedure is to expand the external side medial to the external iliac artery and vein, narrowing the range of exterior side dissection. The anterior-medial side is designed to expand the vesical fascia to define the range of anterior-medial side extension. The internal side is fully extended to the ureterohypogastric nerve fascia; the distal point of the caudal extension reaches the level of the Alcock canal and the bottom reaches the piriformis, enabling dissection of the obturator nerve and No.283 lymph nodes. No.263D lymph nodes are dissected by exposing the internal iliac artery and its branches, dissecting the group No.263P lymph nodes, and severing the inferior vesical artery. Finally, the lateral lymphatic tissue is completely resected. Relevant variables were recorded, including the number of lateral lymph nodes detected, the rate of lymph node metastasis, operation duration, intraoperative blood loss, postoperative complications, postoperative hospital stay, and 3-year overall survival rate. Results:Laparoscopic surgery was successfully completed in all patients with no conversions to open surgery and no intraoperative complications. Twenty-seven (64.3%) of the study patients underwent left-sided LLND, 10 (23.8%) right-sided LLND, and five (11.9%) bilateral LLND, with lymph nodes cleared on both sides. All patients' lymph nodes were examined pathologically. A median of 17.0 (11.7, 26.0) lymph nodes was detected, the median of lateral lymph nodes being 5.0 (2.0, 10.2). The median operation time was 254.5 (199.0, 325.2) minutes. The median intra-operative blood loss was 50.0 (30.0, 100.0) mL. All patients were diagnosed with adenocarcinoma by pathological examination of the operative specimen. Two patients developed postoperative intestinal obstruction, one lymphatic leakage, and one a perineal incision infection. There were no cases of anastomotic leakage. The median postoperative hospital stay was 6.0 (5.0, 7.0) days and the median follow-up time 23.5 (9.0, 36.7) months. During follow-up, three patients (7.1%) died of tumor recurrence and metastasis. Two (4.8%) experienced mild urinary dysfunction, and one (2.4%) had moderate postoperative erectile dysfunction. One patient (2.4%) was found to have prostate and lung metastases 3 month after surgery. The 3-year overall survival rate was 74.4%.Conclusions:Three sided encapsulation is a safe and feasible procedure for LLND, achieving accurate and complete clearance of lateral lymphatic tissue.

Our recent studies for nonnucleoside reverse transcriptase inhibitors identified a highly potent compound JK-4b against WT HIV-1 (EC₅₀ = 1.0 nmol/L), but the poor metabolic stability in human liver microsomes (t _1/2 = 14.6 min) and insufficient selectivity (SI = 2059) with high cytotoxicity (CC₅₀ = 2.08 μmol/L) remained major issues associated with JK-4b. The present efforts were devoted to the introduction of fluorine into the biphenyl ring of JK-4b, leading to the discovery of a novel series of fluorine-substituted NH₂-biphenyl-diarylpyrimidines with noticeable inhibitory activity toward WT HIV-1 strain (EC₅₀ = 1.8-349 nmol/L). The best compound 5t in this collection (EC₅₀ = 1.8 nmol/L, CC₅₀ = 117 μmol/L) was 32-fold in selectivity (SI = 66,443) compared to JK-4b and showed remarkable potency toward clinically multiple mutant strains, such as L100I, K103N, E138K, and Y181C. The metabolic stability of 5t was also significantly improved (t _1/2 = 74.52 min), approximately 5-fold higher than JK-4b in human liver microsomes (t _1/2 = 14.6 min). Also, 5t possessed good stability in both human and monkey plasma. No significant in vitro inhibition effect toward CYP enzyme and hERG was observed. The single-dose acute toxicity test did not induce mice death or obvious pathological damage. These findings pave the way for further development of 5t as a drug candidate.

Objective:To investigate the clinical efficacy of adjuvant therapy with Yinhuang Qingfei Capsule in the treatment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) caused by accumulation of phlegm and heat in the lung. Methods:A total of 300 patients with AECOPD admitted to Wenling Hospital of Traditional Chinese Medicine from January 2019 to December 2020 were included in this study. They were randomly divided into observation and control groups ( n = 150/group). The control group was treated with conventional therapy, and the observation group was treated with adjuvant therapy with Yinhuang Qingfei Capsule based on conventional therapy. All patients were treated for 14 consecutive days. The clinical efficacy, lung function indexes and serum inflammatory factors pre- and post-treatment as well as adverse reactions were compared between the two groups. Results:Total response rate was significantly higher in the observation group than the control group [88.0% (132/150) vs. 75.3% (113/150), χ2 = 8.04, P < 0.05]. After treatment, cough score [(2.31 ± 0.49) points], sputum score [(1.93 ± 0.35) points] and wheezing score [(0.91 ± 0.22) points] in the observation group were lower compared with the control group [(2.89 ± 0.54) points, (2.22 ± 0.43) points, (1.36 ± 0.27) points, t = 9.30, 6.41, 15.82, all P < 0.001]. Serum interleukin-6 (IL-6) [(3.04 ± 1.25) μg/L], C-reactive protein [(26.44 ± 2.31) mg/L] and procalcitonin [(1.25 ± 0.97) μg/L] in the observation group were lower compared with the control group [(3.66 ± 1.32) μg/L, (31.39 ± 2.26) mg/L, (1.79 ± 1.06) μg/L, t = 4.18, 11.18, 4.60, all P < 0.001]. Forced vital capacity [(1.89 ± 0.54) L], forced expiratory volume in 1 second (FEV 1) [(64.22 ± 5.80)%] and FEV 1/FVC value [(59.16 ± 5.52)%] in the observation group were higher compared with the control group [(1.58 ± 0.57) L, (60.13 ± 5.77)%pred, (54.43 ± 5.37)%, t = 4.84, 6.12, 7.52, all P < 0.05]. There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Yinhuang Qingfei Capsule can effectively relieve the clinical symptoms of patients with AECOPD caused by accumulation of phlegm and heat in the lung, improves lung function, reduces inflammatory response, and has no obvious adverse reactions. This study is innovative and scientific and deserves clinical promotion.