Abstract To clarify the service targets, service contents, and safeguard mechanisms of the basic public service program for student vision health management, the study grounded in the current status of child and adolescent myopia prevention and control in China and integrated with the practical experience and innovative practices of Wuhan National Demonstration Area for Student Vision Health Management, takes education as the main thread and schools as the base, consolidating resources from multiple stakeholders including education administrative departments, schools, families, and professional technical service institutions. Centering on four core components—vision health education, monitoring and record keeping, risk prevention and control, and dynamic management, the study constructs a multi tiered basic public service system for vision health management of primary and secondary school students. It further proposes the use of an intelligent management platform and a "three tier color coded early warning" mechanism (red, yellow, blue) to prevent and control student myopia at the source, providing schools with replicable and operable implementation pathways to enhance the level of student vision health management.

The anti-inflammatory phytochemical investigation of the leaves of Illicium dunnianum (I. dunnianum) resulted in the isolation of five pairs of new lignans (1-5), and 7 known analogs (6-12). The separation of enantiomer mixtures 1-5 to 1a/1b-5a/5b was achieved using a chiral column with acetonitrile-water mixtures as eluents. The planar structures of 1-2 were previously undescribed, and the chiral separation and absolute configurations of 3-5 were reported for the first time. Their structures were determined through comprehensive spectroscopic data analysis [nuclear magnetic resonance (NMR), high-resolution electrospray ionization mass (HR-ESI-MS), infrared (IR), and ultraviolet (UV)] and quantum chemistry calculations (ECD). The new isolates were evaluated by measuring their inhibitory effect on NO in lipopolysaccharide (LPS)-stimulated BV-2 cells. Compounds 1a, 3a, 3b, and 5a demonstrated partial inhibition of NO production in a concentration-dependent manner. Western blot and real-time polymerase chain reaction (PCR) assays revealed that 1a down-regulated the messenger ribonucleic acid (mRNA) levels of tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), COX-2, and iNOS and the protein expressions of COX-2 and iNOS. This research provides guidance and evidence for the further development and utilization of I. dunnianum.
Lignans/isolation & purification* ; Plant Leaves/chemistry* ; Anti-Inflammatory Agents/isolation & purification* ; Mice ; Animals ; Molecular Structure ; Plant Extracts/pharmacology* ; Illicium/chemistry* ; Cyclooxygenase 2/immunology* ; Interleukin-6/immunology* ; Nitric Oxide/metabolism* ; Cell Line ; Tumor Necrosis Factor-alpha/immunology* ; Nitric Oxide Synthase Type II/immunology* ; Lipopolysaccharides

Objective:To observe the changes in serum estradiol (E 2) levels in pregnant women of different gestational weeks and their predictive value for early intrauterine pregnancy outcomes. Methods:A retrospective study was conducted involving 375 pregnant women who were treated at the Affiliated Yangming Hospital of Ningbo University (Yuyao People's Hospital) from September 2021 to September 2023. The clinical data were categorized based on pregnancy outcomes into three groups: a normal pregnancy group ( n = 150), a threatened miscarriage with continued pregnancy group ( n = 150), and a miscarriage group ( n = 75). The serum estradiol (E 2) levels at different gestational weeks were compared among the three groups: 5 to < 6 weeks (35-41 days), 6 to < 7 weeks (42-48 days), and 7 to 8 weeks (49-55 days). The predictive value of serum E 2 levels for early intrauterine pregnancy outcomes across different gestational weeks was analyzed using Receiver Operating Characteristic (ROC) curves. Results:In the normal pregnancy group, the serum E 2 levels at different gestational weeks were as follows: (1 691.87 ± 532.21) pmol/L for 5 to < 6 weeks, (2 376.64 ± 788.36) pmol/L for 6 to < 7 weeks, and (3 576.30 ± 1,190.06) pmol/L for 7 to 8 weeks. These values were significantly higher than those in the threatened miscarriage with continued pregnancy group [(1 409.28 ± 473.49) pmol/L, (1 893.13 ± 563.15) pmol/L, (2 035.79 ± 612.47) pmol/L, t = 5.15, 11.68, 6.60, all P < 0.05] and the miscarriage group [(906.49 ± 338.09) pmol/L, (923.63 ± 365.39) pmol/L, (950.27 ± 378.89) pmol/L, t = 16.19, 15.45, 21.50, all P < 0.05]. The serum E 2 levels at different gestational weeks in the threatened miscarriage with continued pregnancy group were significantly higher than those in the miscarriage group ( t = 7.48, 10.81, 8.89, all P < 0.05). Both the normal pregnancy group and the threatened miscarriage with continued pregnancy group showed an increasing trend in serum E 2 levels with advancing gestational weeks ( t = 6.74, 18.55, 7.58, 9.82, 11.81, 2.24, all P < 0.05). In contrast, the serum E 2 levels in the miscarriage group also increased with advancing gestational weeks, but the differences were not statistically significant ( P > 0.05). The results from the receiver operating characteristic curve analysis indicated that the areas under the curve for predicting early intrauterine pregnancy outcomes based on serum E 2 levels at different gestational weeks were 0.857, 0.810, and 0.839, demonstrating excellent diagnostic efficacy. Conclusions:Dynamic monitoring of serum E 2 levels is beneficial for predicting early intrauterine pregnancy outcomes and providing guidance for clinical diagnosis and treatment.

Objective:To construct logistic regression, decision tree, and neural network models to predict pressure injury in neurocritically ill patients using machine learning algorithms, and compare the predictive performance of the three models.Methods:The clinical data of 341 neurocritically ill patients who received treatment in the Department of Neurosurgery at The First Affiliated Hospital of Wenzhou Medical University from May 2020 to February 2023 were collected retrospectively. The patients were randomly divided into a training set and a testing set in a 7:3 ratio. Univariate and multivariate analyses were conducted based on the clinical data from the training set. According to the results of the multivariate analysis, logistic regression, decision tree, and neural network models were constructed. The predictive performance of the three models was validated and compared using receiver operating characteristic curve analysis.Results:Among the 341 patients, 35 developed pressure injury (a total of 40 occurrences), with an incidence rate of 10.26%. Multivariate analysis indicated that incontinence ( OR = 47.32, 95% CI: 1.360-1 647.700), decreased albumin levels ( OR = 0.56, 95% CI: 0.360-0.870), increased sensory ability ( OR = 0.00, 95% CI: 0.000-0.190), and increased mobility ( OR = 0.03, 95% CI: 0.000-0.390) were independent risk factors for pressure injury in neurocritically ill patients (all P < 0.05). Based on these independent risk factors, logistic regression, decision tree, and neural network models were constructed. Receiver operating characteristic curve analysis revealed that the area under the curve for the three models was 0.987 (95% CI: 0.941-0.999), 0.945 (95% CI: 0.881-0.980), and 0.908 (95% CI: 0.834-0.956), respectively. These results suggest that all three models exhibited high predictive performance for pressure injury in neurocritically ill patients, with the logistic regression model showing a significantly greater area under the curve than the neural network model. Conclusions:The occurrence of pressure injury in neurocritically ill patients is closely related to incontinence, albumin levels, sensory ability, and mobility. Constructing predictive models using machine learning algorithms can provide valuable insights for the early prevention and management of pressure injury in neurocritically ill patients.

Objective To explore the diagnostic value of 18F-fluorodeoxyglucose(FDG)PET/CT in primary pulmonary enteric adenocarcinoma.Methods The clinical and imaging data of 9 patients with primary pulmonary enteric adenocarcinoma who under-went 18F-FDG PET/CT examination were retrospectively analyzed,including lesion distribution,morphology,maximum standardized uptake value(SUVmax),clinical symptoms and signs,gastroscopy finding,puncture pathological results,and serum tumor markers[carbohydrate antigen 72-4(CA72-4),cytokeratin 19 fragment antigen 21-1(CYFRA21-1),carcinoembryonic antigen(CEA),carbo-hydrate antigen 199(CA199)].Results Pathological examination confirmed a diagnosis of primary pulmonary enteric adenocarcinoma after excluding gastrointestinal primary tumors through clinical evaluation.In all nine patients,18F-FDG PET/CT examination did not reveal any evidence of digestive system malignancies,and gastrointestinal microscopy was negative.Primary lesions were observed as masses or nodular types in 6 cases(5 in the left lung and 1 in the right lung),while 3 cases exhibited diffuse bilateral pulmonary involvement(manifested as multiple patchy opacities,nodules,ground-glass opacities,and consolidations).All pulmonary primary lesions showed increased 18F-FDG uptake,with SUVmax ranging from 2.7 to 12.8,mean 8.6±3.7.The six masses-or nodular-type primary lesions showed maximum diameters ranging from 2.1 to 10.5 cm,mean(5.23±3.06)cm.Four cases demonstrated hilar and mediastinal lymph node metastases,intrapulmonary metastases,and distant metastases,while 1 case showed only distant metastasis.Elevated levels of serum tumor markers were observed as follows:CA72-4 in 7 cases(10-273.3 U/mL),CEA in 7 cases(5-147.4 ng/mL),CA199 in 6 cases(31.22-4 364 U/mL),and CYFRA21-1 in 5 cases(8.31-99.7 ng/mL).Conclusion When pathological biopsy of a pulmonary lesion suggests primary pulmonary enteric adenocarcinoma after excluding gastrointestinal primary tumors,and 18F-FDG PET/CT shows no gastrointestinal masses,this may support the diagnosis of primary pulmonary enteric adenocarcinoma.

Objective To explore the value of multimodal ultrasound combined with sex hormone detection in evaluating endometrial receptivity in infertile patients.Methods Ninety-five infertile patients who received in vitro fertilization and embryo transfer treatment in Hangzhou Women's Hospital from January 2020 to February 2023 were selected as study objects,and they were divided into pregnant group(55 cases)and non-pregnant group(40 cases)according to the pregnancy status of the first embryo transfer.Sex hormone levels and multimodal ultrasound scores were compared between two groups,and receiver operating characteristic(ROC)curve was drawn to evaluate the value of each indicator in predicting pregnancy of infertile patients individually and in combination.Results The endometrial thickness score,endometrial volume score,vascular blood flow score and multimodal ultrasound score of pregnant group were significantly higher than those of non-pregnant group(P＜0.05).The levels of luteinizing hormone(LH),estradiol(E2)and progesterone(P)in pregnant group were significantly higher than those in non-pregnant group(P＜0.05).ROC curve results showed that the area under the curve(AUC)of LH,E2 and multimodal ultrasound scores in predicting pregnancy in infertile patients were all＞0.7,which had certain predictive value,and the three indicators combined with P had the highest predictive value,with an AUC of 0.889.Conclusion The combination of multimodal ultrasound and sex hormone detection can effectively evaluate the endometrial receptivity of infertile patients,and has certain reference value for predicting the pregnancy status of infertile patients.

Objective:To construct a VP8-mRNA vaccine using human rotavirus spike protein VP8 domain as the immunogen and analyze its immunogenicity in mice.Methods:The VP8-mRNA sequence was designed, optimized, and synthesized. The VP8 gene of rotavirus G1P[8] type was used to construct the plasmid pUC57-VP8-Kan-SapⅠ, which was then sequenced. The plasmid confirmed by sequencing was subjected to large-scale amplification and extraction, followed by linearization, in vitro transcription, and capping. The purified capped products were encapsulated with lipid nanoparticles using a microfluidic control apparatus. The encapsulated VP8-mRNA vaccine was administered intramuscularly to mice at 10, 15, and 20 μg. Serum samples were collected for antibody detection by ELISA. Cellular immune responses were detected by flow cytometry and ELISPOT. Statistical analysis was performed using one-way or two-way analysis of variance and Tukey-Kramer test. Results:The encapsulated VP8-mRNA vaccine was rounded and spherical, with a particle size of about 100 nm, a polymer dispersion index of 0.088, and an encapsulation rate of 92.3%. Two doses of VP8-mRNA vaccine immunization could induce a good immune response in mice. The level of IgG antibody induced after immunization in the 15 μg group was comparable to that of the 20 μg group, and there was no statistical difference ( P>0.05), but the antibody levels in the two groups were significantly higher than that in the 10 μg group ( P<0.000 1). VP8-mRNA vaccine could induce neutralizing antibodies against rotavirus G1 and G9 types. The highest level of neutralizing antibodies against rotavirus type G1 was observed in the 15 μg group, which was significantly higher than that in the 10 μg group ( P<0.05). All immunization groups exhibited good neutralizing ability against rotavirus G9 type. The results of ELISPOT showed that lymphocytes from mice in each vaccine group were able to secrete IFN-γ when stimulated with VP8 peptide. Flow cytometry showed that the proportions of CD8 + T cell subsets in the vaccine groups were higher than that in the control group. Conclusion:The VP8-mRNA vaccine has good immunogenicity in mice and can induce good humoral and T-cell immune responses.

Objective To investigate the clinical characteristics and influencing factors of pressure injury in patients with severe neurological diseases and to construct and evaluate a predictive model for it.Methods A retrospective research method was adopted to collect 250 patients with severe neuropathy admitted to the First Affiliated Hospital of Wenzhou Medical University from April 2020 to April 2024,and their clinical characteristics were collected.The patients were then divided into a pressure injury group(n=58)and a non-pressure injury group(n=192)based on whether they development pressure injury after treatment.Baseline data on patient coma or lethargy status,primary diagnosis requiring neurocritical care admission,and Acute Physiology and Chronic Health Evaluation(APACHE)Ⅱscores were collected.The area under the curve(AUC)of the receiver operating characteristic(ROC)curves for acute cerebrovascular disease,coma or lethargy status,and APACHE Ⅱ scores of the subjects was compared.Results Among the 250 patients with severe neurological diseases,58 had pressure injuries.Of these,35(60.34%)had mucosal pressure injuries,while 23(39.66%)had device-related pressure injuries.According to the National Pressure Injury Advisory Panel Pressure Injury Staging System,46 cases(79.31%)had stage 1 pressure injuries,8 cases(13.97%)had stage 2 pressure injuries,4 cases(6.90%)had stage 3 pressure injuries,and no patients had stage 4 pressure injuries.Logistic multivariate regression analysis showed that primary diagnosis requiring neurocritical care admission(odds ratio[OR]=3.102;95%CI,1.013-9.499),coma or lethargy status(OR=3.769;95%CI,1.237-11.478),and APACHE Ⅱ score(OR=0.201;95%CI,0.124-0.328)were influencing factors for pressure injury in patients with severe neurological diseases.The ROC results showed that the AUC of the prediction model combining the 3 influencing factors was 0.974(95%CI,0.957-0.992),and that the sensitivity and specificity were 91.40%and 93.70%,respectively.The prediction accuracy of the combination prediction model was 0.96,which was significantly higher than those of the prediction models based on the 3 separate influencing factors(P<0.05).The Hosmer-Lemeshow test showed that the model had a good fit(χ2=4.779,P=0.062),indicating that the model had a relatively high accuracy.Conclusion Acute cerebrovascular disease,coma or lethargy,and APACHE Ⅱ score have different predictive values for pressure injury in patients with severe neurological diseases.While acute cerebrovascular disease and coma or lethargy have the same predictive value separately,the combination prediction incorporating the 3 influencing factors demonstrated superior accuracy and holds considerable potential for clinical application.

Objective To explore the value of multimodal ultrasound combined with sex hormone detection in evaluating endometrial receptivity in infertile patients.Methods Ninety-five infertile patients who received in vitro fertilization and embryo transfer treatment in Hangzhou Women's Hospital from January 2020 to February 2023 were selected as study objects,and they were divided into pregnant group(55 cases)and non-pregnant group(40 cases)according to the pregnancy status of the first embryo transfer.Sex hormone levels and multimodal ultrasound scores were compared between two groups,and receiver operating characteristic(ROC)curve was drawn to evaluate the value of each indicator in predicting pregnancy of infertile patients individually and in combination.Results The endometrial thickness score,endometrial volume score,vascular blood flow score and multimodal ultrasound score of pregnant group were significantly higher than those of non-pregnant group(P＜0.05).The levels of luteinizing hormone(LH),estradiol(E2)and progesterone(P)in pregnant group were significantly higher than those in non-pregnant group(P＜0.05).ROC curve results showed that the area under the curve(AUC)of LH,E2 and multimodal ultrasound scores in predicting pregnancy in infertile patients were all＞0.7,which had certain predictive value,and the three indicators combined with P had the highest predictive value,with an AUC of 0.889.Conclusion The combination of multimodal ultrasound and sex hormone detection can effectively evaluate the endometrial receptivity of infertile patients,and has certain reference value for predicting the pregnancy status of infertile patients.