AIM:To explore the related factors of cerebral visual field defect after ischemic stroke and its impact on its long-term prognosis. METHODS: A retrospective study was conducted on patients with ischemic stroke admitted to the hospital from January 2021 to July 2023. Visual field examination was performed 7 d after onset, and patients were divided into cerebral visual field defect group and non-cerebral visual field defect group according to whether cerebral visual field defect occurred. Demographic information and clinical indicators were collected from both groups, and multivariate Logistic regression analysis was performed to identify factors associated with cerebral visual field defect after ischemic stroke. After discharge, a 2-year follow-up was conducted to calculate the number of poor prognosis, recurrence, and death cases to evaluate long-term prognosis.RESULTS:Among 218 patients with ischemic stroke, according to the visual field examination, 54 patients were in cerebral visual field defect group(incidence rate was 24.8%, 32 males and 22 females, mean age was 63.81±5.78 y)and 164 patients were in non-cerebral visual field defect group(95 males and 59 females, mean age was 62.78±6.01 y). There were no significant differences in gender, BMI, education level, smoking history, drinking history, diabetes, hypertension, hyperlipidemia, time from onset to admission, and type of infarction between the two groups(all P>0.05). There were significant differences in age, atrial fibrillation, degree of neurological deficit, infarct location and infarct volume between the two groups(all P<0.05). Multivariate Logistic regression analysis showed that the risk factor of cerebral visual field defect after ischemic stroke was the degree of neurological deficit at admission(OR: 5.106; 95%CI: 1.034-25.205), infarct location [parietal lobe(OR: 5.760; 95%CI: 1.643-20.194); temporal lobe(OR: 6.437; 95%CI: 1.591-26.036); occipital lobe(OR: 8.998; 95%CI:1.748-46.319)],infarct volume(OR: 5.123; 95%CI: 1.318-19.906). The poor prognosis and recurrence rate in the cerebral visual field defect group were higher than those in the non-cerebral visual field defect group(both P<0.05), and there was no difference in mortality rate between the two groups(P>0.05).CONCLUSION:The occurrence of cerebral visual field defects after ischemic stroke is closely related to the severity of the condition, infarct location and infarct volume infarction, and can lead to poor long-term prognosis. Therefore, prevention and treatment should be strengthened.

Tissue-resident memory T cells （T_RM cells） are a subset of memory T cells that reside in tissues， exhibit tissue specificity， and do not recirculate. When potential hazards threaten the liver， such as pathogen invasion （bacteria， viruses， etc.） and excessive autoimmune responses， T_RM cells are essential as the first line of immune defense， playing an important role in viral hepatitis， autoimmune liver disease， metabolic dysfunction-associated fatty liver disease， liver cirrhosis， and liver transplantation. Here， we present the immunophenotypes of T_RM cells in the liver and their surface markers and transcriptional profiles， aiming to clarify the role of T_RM cells in chronic liver diseases and explore their potential function as therapeutic targets in immunotherapy.

Astragaloside Ⅳ （AS-Ⅳ） is a natural triterpenoid saponin compound derived from Astragalus membranaceus and has shown significant potential in the regulation of liver diseases. This article reviews the latest research advances in AS-Ⅳ in the field of liver diseases in China and globally， and it is found that AS-Ⅳ exerts a liver-protecting effect by regulating lipid metabolism， exerting an anti-tumor/anti-inflammatory/anti-fibrotic effect， and modulating gut microbiota. Its mechanism of action involves multiple signaling pathways， such as AMPK， NLRP3， NF-κB， JAK2/STAT3， and Nrf2. These research findings provide a scientific basis for the development of liver-protecting drugs or functional foods based on the natural product AS-Ⅳ.

Objective To investigate the role of p300 in lipid metabolism disorders.Methods Bioinformatics analysis was performed to analyze the expression patterns of p300 in lipid metabolism disorder-related diseases and its correlation with SREBP-1c and downstream lipid metabolic enzymes.Immunofluorescence assay was used to detect the expression of p300 in the liver tissues of the patients with varying disease severity of non-alcoholic fatty liver disease(NAFLD).A mouse model of lipid metabolism disorder was established in male C57BL/6J mice by feeding high-fat diet(HFD)for 12 weeks.Western blotting was employed to assess p300 expression level in the liver tissues of HFD-fed mice.A cell model of lipid metabolism disorder was established in HepG2/AML-12 cells induced with free fatty acid(FFA).The effects of siRNA-mediated knockdown of p300 was observed to measure the levels of intracellular total cholesterol(TC)and triglyceride(TG),lipid deposition,and production of reactive oxygen species(ROS).Results Clinically,p300 was highly expressed in lipid metabolism disorders,and its level was positively correlated with NAFLD severity(P<0.05).Gene Set Enrichment Analysis(GSEA)revealed that p300 expression was significantly associated with fatty acid metabolism,cholesterol homeostasis,lipogenesis,PPAR signaling pathway,and peroxisome pathway.In vivo,p300 was significantly up-regulated in the livers of HFD-fed mice(P<0.01).In vitro,FFA stimulation markedly increased p300 expression in both HepG2 and AML-12 cells(P<0.01),whereas p300 knockdown significantly reduced intracellular TG and TC levels(P<0.01),attenuated lipid droplet accumulation,and reversed FFA-induced ROS elevation(P<0.01).Furthermore,p300 expression was positively correlated with the expression of SREBP-1c and its downstream key lipid synthesis enzymes.Conclusion p300 may promote hepatic lipid accumulation by acetylating and activating SREBP-1c and regulating downstream lipid metabolic enzymes,thereby affecting lipid synthesis and oxidative stress.These findings suggest that p300 may be a potential therapeutic target for lipid metabolism disorder-related diseases.

Objective To analyze the current status of occupational stress among primary and secondary school teachers, and explore the dose-response relationship between weekly work hours and occupational stress. Methods A total of 1 252 teachers from 13 primary and secondary schools in three prefecture-level cities of a central province of China were selected as the research subjects by the convenience sampling method. The Core Occupational Stress Scale was used to assess occupational stress levels of the teachers. Multivariate logistic regression analysis combined with restricted cubic spline models was applied to study the dose-response relationship between weekly work hours and occupational stress. Results The average weekly work hours were (55.3±15.9) hours, with 78.6% of teachers working more than 40.0 hours per week. The total score of occupational stress was (40.3±8.2) points, and the detection rate of occupational stress was 29.8%. Multivariate logistic regression analysis combined with restricted cubic spline models revealed a linear dose-response relationship in weekly work hours and occupational stress among teachers (P for overall trend <0.05, P for nonlinearity was 0.22). Result of age-stratified analysis showed that weekly work hours had a linear dose-response relationship with occupational stress risk in teachers aged 21-<31 and 31-<46 years (P for overall trend <0.05, P for nonlinearity was 0.71 and 0.27, respectively). However, no association was found between weekly work hours and occupational stress risk among teachers aged ≥46 years (P for overall trend =0.08, P for nonlinearity was 0.09). Conclusion There is a linear dose-response relationship between weekly work hours and occupational stress among primary and secondary school teachers in the province, with younger teachers being more susceptible to suffer occupational stress due to long working hours.

Tissue-resident memory T cells(TRM cells)are a subset of memory T cells that reside in tissues,exhibit tissue specificity,and do not recirculate.When potential hazards threaten the liver,such as pathogen invasion(bacteria,viruses,etc.)and excessive autoimmune responses,TRM cells are essential as the first line of immune defense,playing an important role in viral hepatitis,autoimmune liver disease,metabolic dysfunction-associated fatty liver disease,liver cirrhosis,and liver transplantation.Here,we present the immunophenotypes of TRM cells in the liver and their surface markers and transcriptional profiles,aiming to clarify the role of TRM cells in chronic liver diseases and explore their potential function as therapeutic targets in immunotherapy.

Objective To investigate the oral health status of the first-grade primary school students in Shanghai and analyze its influencing factors.Methods In 2021,Huangpu,Xuhui,Jiading,and Jing'an districts were selected in Shanghai by random sampling method.The first-grade students of 8 primary schools in these 4 districts were enrolled by random cluster sampling.Oral clinical examinations and questionnaires were conducted according to the criteria of the Fourth National Oral Health Epidemiological Survey.EpiData 3.1 software was used to create the database.SPSS 26.0 software was applied for statistical analysis.Chi-square test was used to compare the caries prevalence between groups,and two independent samples non-parametric test was used to compare the decayed,missing and filled teeth(DMFT)between groups.Multifactorial logistic regression model was used to analyzse the influencing factors of caries.Results A total of 824 informed consent forms and questionnaires were collected,of which 764 were completed,with an effective rate of 92.7％.The total caries prevalence of the participating students was 65.6％(501/764),and the mean DMFT was 3.24±3.47.A total of 2 473 carious teeth were found in the participating students,and 671 teeth were filled,with a filling rate of 27.1％.There were 7.91±2.76 permanent teeth erupted per student,and 56.3％(430/764)of the students had all 4 first permanent molars erupted.Multivariate logistic regression showed that eating sweets＞3 times a day(P=0.030),eating regularly before bedtime(P=0.001),and parents'cognition of kids'poor oral health status(P=0.025)were the influencing factors for the detection of caries in children.Conclusion The first-grade primary school students in Shanghai have high prevalence of caries.Eating sweets＞3 times a day,eating regularly before bedtime,and parents'cognition of kids'poor oral health status(P＜0.05)are the influencing factors for the detection of caries in children.

Objective Compared the 3-year retention rate and efficacy of levetiracetam(LEV),lamotrigine(LTG)and valproic acid(VPA)in patients with newly diagnosed epilepsy.Methods According to the antiepileptic drugs selected for the first time,323 patients with newly diagnosed epilepsy were divided into the LEV group,LTG group and VPA group.They were followed up for more than 3 years by telephone and outpatient clinic.Results There were significant differences in the single drug retention rate and epileptiform discharge rate among the LEV group,LTG group and VPA group in the first 3 years(all P<0.05).Compared with those in LEV group,the single drug retention rates in LTG group were significantly decreased in the first year and the second year(χ2=6.265,χ2=5.376;all P<0.025),the epileptiform discharge rate were significantly increased in the first year and the second year(χ2=14.011,χ2=8.574;all P<0.025);the single drug retention rate in VPA group were significantly decreased in the second year and the third year(χ2=6.226,χ2=10.112;all P<0.025),the epileptiform discharge rate was significantly increased in the first year,the second year and the third year(χ2=11.504,χ2=14.206,χ2=7.596;all P<0.025).There were significant differences in the survival curve of single drug retention and epileptiform discharge among the LEV group,LTG group and VPA group(χ2=9.349,P<0.05;χ2=7.395,P<0.05).The survival curve of single drug retention in LEV group was significantly higher than that in LTG group(χ2=4.451,P<0.05)and VPA group(χ2=9.464,P<0.05).The survival curve of epileptiform discharge in LEV group was significantly lower than that in VPA group(χ2=7.523,P<0.05).There was no significant difference in drug effective rate and no epileptic seizure rate in the first 3 years between LEV group,LTG group and VPA group(all P>0.05).There was a significant difference in the incidence of adverse drug reactions among the LEV group,LTG group and VPA group(χ2=8.068,P=0.018).Compared with that in LEV group,the incidence of adverse drug reactions in LTG group and VPA group were significantly increased(χ2=6.153,P=0.013;χ2=7.109,P=0.008).The main reasons for drug withdrawal,drug addiction and dressing change in LEV group were unsatisfactory curative effects,while those in LTG group and VPA group were adverse drug reactions.Conclusion The 3-year single drug retention rate of LEV is higher than that of LTG and VPA,and the EEG epileptiform discharge rate and the incidence of adverse drug reactions are significantly reduced,which was more suitable as the first choice for single drug treatment in patients with newly diagnosed epilepsy.

Objective To investigate the difference between self-perceived risk and objective risk of stroke in the elderly population in Haikou area and explore the related factors in order to deter-mine the role of stroke knowledge in self-perceived risk.Methods A cross-sectional questionnaire survey was conducted on 584 elderly patients who were selected by convenience sampling from those taking physical examination in the First Affiliated Hospital of Hainan Medical College from September 2022 to April 2023.According to the accuracy of self-perceived risk of stroke,they were divided into an under-estimation group(170 cases),an accurate-estimation group(329 cases)and an over-estimation group(85 cases).Their self-perceived risk of stroke was assessed with the Stroke Risk Perception Questionnaire,and the objective risk of stroke was assessed with the Screening Criteria of Stroke High-Risk Group Screening Intervention Project of National Health Commission.Multivariate logistic regression model was used to analyze the factors related to the accuracy of self-perceived risk of stroke.One-way ANOVA was used to analyze the correlation be-tween the accuracy of self-perceived stroke risk and stroke knowledge.Results The participants with low,moderate,and high self-perceived risk of stroke accounted for 75.5％,20.5％and 3.9％,respectively.Compared with the objective risk assessment,the percentages of the participants with self-perceived stroke risk were 29.1％,56.3％and 14.6％,respectively,in the under-,accurate-and over-estimation groups.Significant differences were observed in gender,education level,smoking,drinking,exercise,fatty diet,fruit,overweight or obesity,and dyslipidemia among all groups(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that smoking,regular exercise,overweight or obesity and dyslipidemia were associated with accuracy of stroke risk perception in the accurate and the over-estimation groups when the under-estimation group was regarded as control(P＜0.01).The total score of stroke knowledge was 6.81±3.63,7.17±3.47 and 8.07± 3.24,respectively in the 3 estimation groups.The accuracy of self-perceived stroke risk was corre-lated with stroke knowledge(F=3.756,P=0.024).Conclusion Targeted health education should be implemented to make the elderly establish correct awareness of stroke risk,promote healthy behaviors and habits,and achieve the goal of early stroke prevention.

Objective To investigate the mediating role of medical coping strategies in the relationship between perceived social support and resilience among patients with occupational pneumoconiosis (hereinafter referred to as pneumoconiosis). Methods A total of 240 pneumoconiosis patients were selected as the study subjects using the convenience sampling method. The Perceived Social Support Scale, the 10-item Connor-Davidson Resilience Scale and Medical Coping Strategies Questionnaire were used to evaluate their perceived social support, resilience and medical coping strategies. AMOS 26.0 software was used to construct the structural equation model. Results The average scores of perceived social support and resilience were (56.6±0.9) and (20.9±7.5), respectively. The scores for the dimensions of confrontation, avoidance and resignation of medical coping strategies were (20.2±3.6), (11.2±3.1) and (18.1±2.9), respectively. The score of resilience was positively correlated with the score of perceived social support, avoidance dimension and confrontation dimension of medical coping strategies (r=0.260, 0.176, 0.174, all P<0.01). It was negatively correlated with resignation coping (r=-0.292, P<0.01). The results of mediating effect test showed that the total effect of perceived social support on resilience was 0.252 [95% confidence interval (CI) was 0.056-0.448], which mainly affected the resilience by affecting the resignation coping (95%CI: -0.458 to -0.104), with the indirect effect value of 0.120, accounting for 47.6% of the total effect. Conclusion The resilience of pneumoconiosis patients is moderately low. Resignation coping in medical coping strategies plays a mediating role between perceived social support and resilience in pneumoconiosis patients.