Objective To analyze the distribution and epidemic characteristics of child injury cases in Pingshan District from 2021 to 2022, and to provide evidence for the prevention and control of child injuries. Methods The injury monitoring data of Pingshan District from 2021 to 2022 were collected χ² and Post hoc testing were used for data analysis and comparison. Results From 2021 to 2022 , a total of 6 941 child injury cases were reported in Pingshan District, accounting for 20.58% of the total reported cases. Children aged 1 to 4 years old tended to be injured at home (58.49%, AR=23.75) and at night (43.74%, AR=5.34), and the injury causes mainly were falls/drops (49.22%, AR=4.66) and burns/scalds (2.98%, AR=7.15). Children aged 5 to 9 tended to be injured in schools and public places (26.55%%, AR=6.63) and public living places (18.51%, AR=3.33), and the injury causes mostly were animal attacks (26.48%, AR=6.97). Children aged 10 to 14 tended to be injured in schools and public places (31.39%, AR=10.81), highways/streets (17.71%, AR=3.78), as well as sports and activity places (12.20%, AR=15.66), and the injury causes tended to be knife/sharp instrument injuries. In the morning, injuries mostly occurred in schools and public places (17.98%, AR=3.24). In the afternoon, injuries tended to occur in schools and public places (39.41%, AR=9.89) as well as sports and activity places (37.50%, AR=3.52), and in the evening, injuries mostly occurred at home (46.49%, AR=10.17) and in public living places (46.07%, AR=5.44). Conclusion Governments, institutions, communities, and families should speed up the construction of a child injury prevention system with the participation of the whole society, and jointly create child-friendly environments in families, schools, public places, sports places, and road traffic . At the same time, it is necessary to strengthen injury prevention education , improve the injury prevention awareness and skills of students and guardians, and effectively reduce the occurrence of children's injuries starting from primary prevention.

Objective:To analyze the bacteria spectrum and antimicrobial resistance profile of bacterial meningitis among children in Baoji.Methods:Based on the acute meningeal and encephalitis syndrome surveillance project, cerebrospinal fluid samples were collected from 774 cases of bacterial meningitis in Baoji Municipal Maternal and Health Hospital from January 2016 to December 2023. Bacterial culture and drug sensitivity test were carried out.Results:A total of 105 positive strains were isolated with the detection rate of 13.57% (105/774). Among them, gram-positive strains accounted for 80.00% (84/105), mainly including Staphylococcus epidermidis, Staphylococcus hominis, and Streptococcus pneumoniae. Gram-negative bacteria accounted for 20.00% (21/105), and the predominant strain was Escherichia coli. Pathogenic bacteria were detected in every month of the year, with two peaks in March and September (26.67%, 28/105). The youngest was infected 20 min after birth, and the oldest was nine years old. There were statistical differences in the detection rates among different age groups (χ 2=35.91, P<0.05). The positive rate in the toddler group was lower than that in the infant group, the pre-school age group and the school age group, respectively (χ 2=15.01, 7.09, and 10.08; all P<0.05). There was no statistical difference between the toddler group and the neonate group (χ 2=1.60, P>0.05). The strains detected in the neonate group accounted for 44.76% (47/105), mainly including Escherichia coli and Staphylococcus epidermidis; the strains in the infant group accounted for 26.67% (28/105), mainly including Streptococcus pneumoniae; the strains in the toddler group accounted for 3.81% (4/105), mainly including Staphylococcus epidermidis; the strains in the pre-school age accounted for 11.43% (12/105), mainly including Staphylococcus epidermidis; the strains in the school age group accounted for 13.33% (14/105), mainly including Streptococcus pneumoniae. The results of drug sensitivity test showed that the resistance rates of Staphylococcus epidermidis to ampicillin/sulbactam, clindamycin, and levofloxacin were 47.06% (8/17), 41.18% (7/17), and 23.53% (4/17), respectively. Staphylococcus epidermidis strains were sensitive to vancomycin and linezolid. All of the Streptococcus pneumoniae strains were resistant to erythromycin and clindamycin, but sensitive to vancomycin and linezolid. The resistance rate of Streptococcus pneumoniae to penicillin was 69.23% (9/13). The resistance rates of Escherichia coli to ampicillin, levofloxacin, ceftriaxone, and cefotaxime were 66.67% (8/12), 41.67% (5/12), 33.33% (4/12), and 41.67% (5/12), respectively, but they were sensitive to ampicillin/sulbactam, cefoperazone/sulbactam, amikacin, and meropenem. Streptococcus agalactis strains were sensitive to penicillin, linezolid, and vancomycin, but resistant to erythromycin, clindamycin, ampicillin, and levofloxacin. Conclusions:The main pathogens causing bacterial meningitis in Baoji city are Staphylococcus epidermidis, Streptococcus pneumoniae, and Escherichia coli. The distribution of bacteria is varied in different age groups. The diagnosis and treatment of bacterial meningitis should be made based on the bacterial spectrum characteristics and the results of antimicrobial resistance profile.

Objective To investigate the clinical diagnostic value of routine electroencephalogram(EEG)combined with serum miR-146a and miR-129-5p levels in drug-resistant epilepsy.Methods Sixty patients with refractory epilepsy admitted to our hospital from June 2021 to June 2023 were included in the refractory epilepsy group,and 40 healthy volunteers were included in the control group.Human microvascular endothelial drug-resistant cells(HBMECs)continuously exposed to PHT2 were cultured in vitro and transfected with miR-NC(the miR-NC group),miR-146a mimics(the miR-146a mimics group)and miR-129-5p mimics(the miR-129-5p mimics group),respectively.Western blod assay was used to detect the expression of high-mobility group protein B1(HMGB1)in each group.Serum miR-146a and miR-129-5p levels were detected by fluorescent quantitative PCR(polymerase chain reaction),and serum HMGB1 protein expression was detected by Western blod assay.The sensitivity,specificity and accuracy of routine EEG,serum miR-146a and miR-129-5p levels and combined diagnosis of drug-resistant epilepsy were evaluated using the comprehensive consultation results of several expert physicians as the gold standard,and ROC curves were drawn.Results Compared with the control group,the expression of HMGB1 was significantly decreased in the drug-resistant group.Compared with the miR-NC group,HMGB1 expression was significantly decreased in the miR-129-5p mimics group and the miR-146a mimics group(P＜0.05).Compared with the healthy group,the serum HMGB1 protein expression was down-regulated and miR-146a and miR-129-5p expression levels were significantly up-regulated in the refractory epilepsy group.ROC curve analysis indicated that the area under the curve,sensitivity,specificity and accuracy of conventional EEG combined with serum miR-146a and miR-129-5p levels were higher in the diagnosis of refractory epilepsy than that of single diagnostic method.Conclusion The combination of routine EEG and serum miR-129-5p and miR-146a levels can provide help for the diagnosis of drug-resistant patients.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Guided by the theory of "kidney generates marrow"， the study elaborates the viewpoint that the route of Yin Heel Channel （阴跷脉） is consistent with the "kidney-marrow-brain" axis from the perspective of the circulation of the meridians and the relationship between the zang-fu organs. Accordingly， it is believed that disease of Yin Heel Channel and dysfunction of the "kidney-marrow-brain" axis are the core pathogenesis of children enuresis， and it is elaborated from the following three major aspects， firstly， insufficient kidney essence， dysfunction of the "kidney-marrow-brain" axis， secondly， disease of Yin Heel Channel and deficiency and cold in lower jiao， and thirdly， disease of Yin Heel Channel and loss of nourishment of Chong Vessel. It is proposed to use the mode of "firstly needle， secondly moxibustion， and lastly consolidation" to treat children enuresis. Needle is to adjust yin and yang， warm yang and tonify kidney， and wake up the brain and open the orifices. The acupoints in Yin Heel Channel such as Zhaohai （KI 6）， Jiaoxin （KI 8） and confluence points of the eight extraordinary vessels such as Waiguan （TE 5）， Zulinqi （GB 41） are used， together with Baihui （GV 20）， Yintang （EX-HN 3）， Guanyuan （CV 4）， Qixue （KI 13）， Dazhong （KI 4）. Moxibustion is to reinforce healthy qi and warm yang， bank up the root and consolidate the original qi by moxibustion at Shenque （CV 8）， Mingmen （GV 4）， and Xuanshu （GV 5）. Consolidation is to use acupoints application to consolidate the therapeutic effect， and Guanyuan （CV 4） & Pangguangshu （BL 28）， Qihai （CV 6） & Zhishi （BL 52）， and Shenque （CV 8） & Ciliao （BL 32） are commonly used as the three groups of acupoints to warm the kidney and stop collapse， regulate and tonify the qi and blood.

Objective To explore the changes in cerebral blood flow caused by mandibular retrusion,as well as the impact and potential mechanisms on stroke recovery.Methods 6-week-old SD male rats were selected as experi-mental subjects.The metal cannula was bonded to the rat maxillary incisor for one week,forcing mandibular retru-sion(MR).Cerebral blood flow was detected by laser speckle imaging.Cognitive function was detected by the Morris water.Then,the stroke model was constructed in MR rats by using the middle cerebral artery occlusion(MCAO)method for one week.Meanwhile,metal cannulae were then removed in rats to restore the lower jaw's position(MCAO RO),serving as a positive control group.Consequently,rats were randomly divided into the fol-lowing groups:Sham groups,MCAO groups,MCAO MR groups,and MCAO RO groups.Neurological recovery was assessed through the modified neurological severity score(mNSS).The area of cerebral infarction was evalua-ted by using triphenyltetrazolium(TTC)staining.The changes in nerve cells were observed by using hematoxylin eosin(HE)staining.The protein expression level of vascular endothelial growth factor(VEGF)was detected by immunohistochemistry.The protein expression levels of platelet-endothelial cell adhesion molecule(CD31),sirtuin 6(SIRT6),and thioredoxin interaction protein(TXNIP)were detected by Western blot.The mRNA expression levels of SIRT6,TXNIP,and VEGF were determined by qRT-PCR.Microglia activation marker molecule 1(IBA-1)was detected by immunofluorescence.Resluts Because of mandibular retrusion,laser speckle showed de-creased cerebral blood flow,and the water maze showed decreased cognitive function.Compared to other groups,MCAO MR showed a larger ischemic area in TTC staining,while HE staining and neurological scoring showed poo-rer neurological function recovery.Western blot and qRT-PCR showed that the MCAO MR group inhibited the mR-NA and protein expression levels of SIRT6,upregulated the mRNA and protein expression levels of TXNIP,and in-creased the activation of microglia.Conclusion Mandibular retrusion reduces cerebral blood flow and alters cogni-tive function in rats.Mandibular retrusion inhibits recovery in stroke through the SIRT6/TXNIP axis.

Objective To evaluate the efficacy of a modified sericin hydrogel scaffold loaded with dexamethasone(SMH-CD/DEX)scaffold for promoting bone defect healing by stimulating anti-inflammatory macrophage polarization.Methods The light-curable SMH-CD/DEX scaffold was prepared using dexamethasone-loaded NH2-β-cyclodextrin(NH2-β-CD)and sericin hydrogel and characterized by scanning electron microscopy(SEM),Fourier transform infrared spectroscopy(FTIR),biocompatibility assessment and drug release test.THP-1 macrophages incubated with the scaffold were examined for protein expressions of iNOS and Arg-1,mRNA expressions of IL-6,Il-10,Arg-1 and iNOS,and surface markers CD86 and CD206 using Western blotting,RT-qPCR,and flow cytometry.In a co-culture system of human periodontal ligament stem cells(HPDLSCs)and THP-1 macrophages,the osteogenic ability of the stem cells incubated with the scaffold was evaluated by detecting protein expressions of COL1A1 and Runx2 and expressions of ALP,Runx2,OCN and BMP2 mRNA,ALP staining,and alizarin red staining.In a rat model of mandibular bone defect,the osteogenic effect of the scaffold was assessed by observing bone regeneration using micro-CT and histopathological staining.Results In THP-1 macrophages,incubation with SMH-CD/DEX scaffold significantly enhanced protein expressions of Arg-1 and mRNA expressions of IL-10 and Arg-1 and lowered iNOS protein expression and IL-6 and iNOS mRNA expressions.In the co-culture system,SMH-CD/DEX effectively increased the protein expressions of COL1A1 and Runx2 and mRNA expressions of ALP and BMP2 in HPDLSCs and promoted their osteogenic differentiation.In the rat models,implantation of SMH-CD/DEX scaffold significantly promoted bone repair and bone regeneration in the bone defect.Conclusion The SMH-CD/DEX scaffold capable of sustained dexamethasone release promotes osteogenic differentiation of stem cells and bone defect repair in rats by regulating M2 polarization.

Objective To evaluate the efficacy of a modified sericin hydrogel scaffold loaded with dexamethasone(SMH-CD/DEX)scaffold for promoting bone defect healing by stimulating anti-inflammatory macrophage polarization.Methods The light-curable SMH-CD/DEX scaffold was prepared using dexamethasone-loaded NH2-β-cyclodextrin(NH2-β-CD)and sericin hydrogel and characterized by scanning electron microscopy(SEM),Fourier transform infrared spectroscopy(FTIR),biocompatibility assessment and drug release test.THP-1 macrophages incubated with the scaffold were examined for protein expressions of iNOS and Arg-1,mRNA expressions of IL-6,Il-10,Arg-1 and iNOS,and surface markers CD86 and CD206 using Western blotting,RT-qPCR,and flow cytometry.In a co-culture system of human periodontal ligament stem cells(HPDLSCs)and THP-1 macrophages,the osteogenic ability of the stem cells incubated with the scaffold was evaluated by detecting protein expressions of COL1A1 and Runx2 and expressions of ALP,Runx2,OCN and BMP2 mRNA,ALP staining,and alizarin red staining.In a rat model of mandibular bone defect,the osteogenic effect of the scaffold was assessed by observing bone regeneration using micro-CT and histopathological staining.Results In THP-1 macrophages,incubation with SMH-CD/DEX scaffold significantly enhanced protein expressions of Arg-1 and mRNA expressions of IL-10 and Arg-1 and lowered iNOS protein expression and IL-6 and iNOS mRNA expressions.In the co-culture system,SMH-CD/DEX effectively increased the protein expressions of COL1A1 and Runx2 and mRNA expressions of ALP and BMP2 in HPDLSCs and promoted their osteogenic differentiation.In the rat models,implantation of SMH-CD/DEX scaffold significantly promoted bone repair and bone regeneration in the bone defect.Conclusion The SMH-CD/DEX scaffold capable of sustained dexamethasone release promotes osteogenic differentiation of stem cells and bone defect repair in rats by regulating M2 polarization.

Objective A wearable wireless chest patch monitoring terminal is designed to realize the acquisition,processing,and wireless transmission of ECG,respiration,and body temperature signals.Methods The analog front-end ADS1292R,which integrates respiratory impedance and ECG front-end,is utilized to collect human ECG and respiratory signals.The body temperature is collected using a low-power,high-precision digital temperature sensor MAX30208.A filter algorithm for signal processing and wireless transmission is designed through a low-power nRF52840 Bluetooth SoC with an Arm Cortex-M4F kernel.Results The experimental results show that the designed monitoring terminal can monitor the ECG,respiration,and body temperature parameters of the human body in real-time and send the monitoring results via Bluetooth,with a continuous working time of more than 13 hours.Conclusion The wearable wireless chest patch monitoring terminal features good portability,long standby time,and high measurement accuracy,and it has promising application prospects in the fields of family health monitoring,mobile medical treatment,and smart healthcare.

Objective To evaluate the applicability of the comprehensive index method for assessing occupational health risks on chemical hazards in key work sites of a metal product enterprise. Methods A metal product enterprise in Beijing City was chosen as the research subject using the convenience sampling method. Occupational health investigations and chemical hazard monitoring were conducted at four work sites: grinding machine operation, welding, cutting, and painting. The comprehensive index method was used to determine the risk levels of chemical hazards. Results The grinding dust in the grinding machine operation work site was assessed as moderate risk. The nitrogen oxides and ozone in the welding (southeast) work sites were assessed as moderate risk. The nitrogen oxides ozone and welding fumes in the welding (northwest) and cutting work site were assessed as moderate risk. Benzene in the painting work site was assessed as moderate risk. All chemical hazards in other work sites were determined to pose low risks. Co-exposures to nitrogen oxides and ozone in the two welding work sites and cutting work site were classified as moderate risk. Co-exposure to ethylbenzene, xylene, methanol, ethyl acetate, and butyl acetate in the painting work site also posed moderate risk, while the co-exposure to toluene and methanol in the painting work site was assessed as low risk. Conclusion The comprehensive index method could be used for the occupational health risk assessment in the metal product enterprise. The enterprise should strengthen hazard control measures for exposure to grinding dust, welding fumes, nitrogen oxides, ozone, and benzene, and closely monitor the health risks associated with co-exposures of chemical hazards.