Objective:To assess iodine nutritional status and the prevalence of thyroid dysfunction in Kunming, Yunnan Province, along with correlation and risk factors between thyroid dysfunction and urinary iodine levels.Methods:This cross-sectional study was conducted from January 2014 to July 2016 using a multi-stage, stratified cluster sampling method. A total of 2 650 residents of Kunming, Yunnan Province, who met the inclusion criteria were selected. Data on participants′ demographics, physical measurements, and laboratory tests were collected through questionnaire and clinical assessments which led to 1 463 subjects in the final analysis considering missing data. Statistical analysis were performed using SPSS 26.0, while R Studio was used to model the nonlinear relationship between urinary iodine levels and the risk of thyroid dysfunction.Results:(1) Among 2 650 subjects, 755(28.5%) were diagnosed with thyroid dysfunction, with incidence rates of clinical hyperthyroidism(0.83%), subclinical hyperthyroidism(0.38%), clinical hypothyroidism(1.36%), subclinical hypothyroidism(17.66%), and isolated thyroid antibody positive(13.85%). The median urinary iodine concentration was 177.49(123.59, 251.85) μg/L, indicating adequate iodine nutritional. (2)Among the 1 463 subjects analyzed, significant differences in urinary iodine were found between healthy individual group and abnormal TSH group or abnormal TSH group and thyroid antibody positive group( H=-83.437, P=0.003; H=107.489, P=0.003). Logistic regression revealed that rural residents had a lower risk of thyroid dysfunction than urban residents( OR=0.429, 95% CI 0.256-0.717, P=0.001). Risk of thyroid disease increased with age, and TSH, thyroid peroxidase antibody(TPOAb), thyroglobulin antibody(TgAb), and urinary iodine levels were identified as significant risk factors, with a U-shaped relationship between urinary iodine levels and thyroid dysfunction. Conclusions:The prevalence of thyroid dysfunction in Kunming is comparable to the national average. The relationship between urinary iodine concentration and thyroid dysfunction follows a U-shaped curve. Factors including region, age, TSH, TPOAb, TgAb, and urinary iodine concentration are associated with thyroid dysfunction.

This paper interprets the best practice guidelines for Practice Education in Nursing published by the Registered Nurses' Association of Ontario (RNAO), providing a scientific basis and insights for the development and progress of nursing students' practical education in China. The goal is to improve the quality of nursing students' clinical practice and enhance their clinical service capabilities.

This paper interprets the best practice guidelines for Practice Education in Nursing published by the Registered Nurses' Association of Ontario (RNAO), providing a scientific basis and insights for the development and progress of nursing students' practical education in China. The goal is to improve the quality of nursing students' clinical practice and enhance their clinical service capabilities.

Objective:To assess iodine nutritional status and the prevalence of thyroid dysfunction in Kunming, Yunnan Province, along with correlation and risk factors between thyroid dysfunction and urinary iodine levels.Methods:This cross-sectional study was conducted from January 2014 to July 2016 using a multi-stage, stratified cluster sampling method. A total of 2 650 residents of Kunming, Yunnan Province, who met the inclusion criteria were selected. Data on participants′ demographics, physical measurements, and laboratory tests were collected through questionnaire and clinical assessments which led to 1 463 subjects in the final analysis considering missing data. Statistical analysis were performed using SPSS 26.0, while R Studio was used to model the nonlinear relationship between urinary iodine levels and the risk of thyroid dysfunction.Results:(1) Among 2 650 subjects, 755(28.5%) were diagnosed with thyroid dysfunction, with incidence rates of clinical hyperthyroidism(0.83%), subclinical hyperthyroidism(0.38%), clinical hypothyroidism(1.36%), subclinical hypothyroidism(17.66%), and isolated thyroid antibody positive(13.85%). The median urinary iodine concentration was 177.49(123.59, 251.85) μg/L, indicating adequate iodine nutritional. (2)Among the 1 463 subjects analyzed, significant differences in urinary iodine were found between healthy individual group and abnormal TSH group or abnormal TSH group and thyroid antibody positive group( H=-83.437, P=0.003; H=107.489, P=0.003). Logistic regression revealed that rural residents had a lower risk of thyroid dysfunction than urban residents( OR=0.429, 95% CI 0.256-0.717, P=0.001). Risk of thyroid disease increased with age, and TSH, thyroid peroxidase antibody(TPOAb), thyroglobulin antibody(TgAb), and urinary iodine levels were identified as significant risk factors, with a U-shaped relationship between urinary iodine levels and thyroid dysfunction. Conclusions:The prevalence of thyroid dysfunction in Kunming is comparable to the national average. The relationship between urinary iodine concentration and thyroid dysfunction follows a U-shaped curve. Factors including region, age, TSH, TPOAb, TgAb, and urinary iodine concentration are associated with thyroid dysfunction.

ObjectiveTo investigate the mechanism of Lycium barbarum polysaccharides （LBP） in promoting the activation of RAW264.7 macrophages. MethodRAW264.7 macrophages were stimulated with LBP at different concentrations （50， 100， 200 mg·L^-1）， and those stimulated with lipopolysaccharide （LPS） at 100 μg·L^-1 and galactose （Gal） at 100 mg·L^-1 as positive controls. After 24 h of LBP stimulation， the cell counting kit-8 （CCK-8） was used to detect the survival rate of RAW264.7 macrophages treated with LBP （0， 50， 100， 200， 400， 800 mg·L^-1）. The levels of interleukin-6 （IL-6） and interleukin-12 （IL-12） in cell culture supernatant were detected by enzyme-linked immunosorbent assay （ELISA）. The protein and mRNA expression of p38 mitogen-activated protein kinase （MAPK）， extracellular signal-regulated kinase （ERK）， c-Jun N-terminal kinase （JNK）， and nuclear factor κB （NF-κB） in Toll-like receptor 4 （TLR4）/Toll-like receptor 2 （TLR2）/macrophage galactose-type lectin （MGL） pathway of RAW264.7 macrophages was detected by Real-time fluorescence-based quantitative polymerase chain reaction （Real-time PCR） and Western blot. ResultCCK-8 results showed that compared with the results in the blank group， the survival rate of RAW264.7 macrophages decreased in the 400， 800 mg·L^-1 LBP groups （P<0.05）. ELISA results showed that compared with the blank group， 50 mg·L^-1 LBP could promote the secretion of IL-12 in RAW264.7 macrophages （P<0.01）. Compared with the blank group， 100 mg·L^-1 LBP and 200 mg·L^-1 LBP could promote the secretion of IL-6 in RAW264.7 macrophages （P<0.05， P<0.01）. Western blot results showed that compared with the blank group， the LBP groups （50， 100， 200 mg·L^-1） enhanced protein expression levels of MAPK key molecules （p-p38 MAPK， p-ERK， p-NF-κB， and p-JNK） in TLR4， TLR2， and MGL pathways （P<0.05， P<0.01）. Compared with the model group， the 200 mg·L^-1 LBP group could promote the expression level of p-NF-κB protein in RAW264.7 macrophages （P<0.01）. Real-time PCR results showed that compared with the blank group， the LBP groups （50， 100， and 200 mg·L^-1） enhanced the mRNA expression levels of MAPK key molecules （p38 MAPK， ERK， NF-κB， and JNK） in TLR4 and TLR2 pathways （P<0.05， P<0.01）. Compared with the model group， the 50 and 200 mg·L^-1 LBP groups could promote the mRNA expression levels of JNK and ERK2 in RAW264.7 macrophages （P<0.05， P<0.01）. ConclusionLBP can regulate the activation of RAW264.7 macrophages and participate in the immune response through the TLR2/TLR4/MGL pathway.

Acidosis, regardless of hypoxia involvement, is recognized as a chronic and harsh tumor microenvironment (TME) that educates malignant cells to thrive and metastasize. Although overwhelming evidence supports an acidic environment as a driver or ubiquitous hallmark of cancer progression, the unrevealed core mechanisms underlying the direct effect of acidification on tumorigenesis have hindered the discovery of novel therapeutic targets and clinical therapy. Here, chemical-induced and transgenic mouse models for colon, liver and lung cancer were established, respectively. miR-7 and TGF-β2 expressions were examined in clinical tissues (n = 184). RNA-seq, miRNA-seq, proteomics, biosynthesis analyses and functional studies were performed to validate the mechanisms involved in the acidic TME-induced lung cancer metastasis. Our data show that lung cancer is sensitive to the increased acidification of TME, and acidic TME-induced lung cancer metastasis via inhibition of miR-7-5p. TGF-β2 is a direct target of miR-7-5p. The reduced expression of miR-7-5p subsequently increases the expression of TGF-β2 which enhances the metastatic potential of the lung cancer. Indeed, overexpression of miR-7-5p reduces the acidic pH-enhanced lung cancer metastasis. Furthermore, the human lung tumor samples also show a reduced miR-7-5p expression but an elevated level of activated TGF-β2; the expressions of both miR-7-5p and TGF-β2 are correlated with patients' survival. We are the first to identify the role of the miR-7/TGF-β2 axis in acidic pH-enhanced lung cancer metastasis. Our study not only delineates how acidification directly affects tumorigenesis, but also suggests miR-7 is a novel reliable biomarker for acidic TME and a novel therapeutic target for non-small cell lung cancer (NSCLC) treatment. Our study opens an avenue to explore the pH-sensitive subcellular components as novel therapeutic targets for cancer treatment.

Objective:To learn about the incidence of hypertension in residents of arsenic exposure areas of Togtoh County, Inner Mongolia Autonomous Region, and to analyze the influencing factors of hypertension.Methods:In Inner Mongolia Autonomous Region, Ciweigou of Togtoh County, a drinking water-type endemic arsenic poisoning area, and Lanjiayao of Horinger County, a non-arsenic poisoning area with similar living habits and economic conditions, permanent residents who had lived for ≥10 years were selected as the survey subjects. Totally 116 residents of Ciweigou (exposure group) and 68 residents of Lanjiayao (control group) were included in the survey. Blood pressure was measured and the contents of arsenic, selenium, lead and chromium in urine were detected, multivariate logistic regression was used to analyze the influencing factors of hypertension.Results:The detection rates of hypertension in exposure group and control group were 53.45% (62/116) and 70.59% (48/68), respectively, and the difference between the two groups was statistically significant (χ 2 = 5.33, P = 0.022). The contents of arsenic, selenium and chromium in urine of exposure group were higher than those of control group, and the content of lead in urine was lower than that of control group, and the differences were statistically significant ( Z = 13.04, 6.34, 11.28, - 9.91, P < 0.001). The results of multivariate logistic regression analysis showed that female, age ≥60 years old and high urinary arsenic content were the influencing factors of hypertension [odds ratio ( OR) = 2.074, 2.004, 0.424, 95% confidence interval ( CI): 1.113 - 3.866, 1.035 - 3.879, 0.219 - 0.820] in arsenic exposure areas. Conclusion:Female, age ≥60 years old and high urinary arsenic content are the influencing factors of hypertension in arsenic exposure areas of Togtoh County, Inner Mongolia Autonomous Region.

Background::The potential impact of β cell function and insulin sensitivity on adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM) remains uncertain. We aimed to investigate the association between β cell dysfunction, insulin resistance, and the composite adverse pregnancy outcomes.Methods::This observational study included 482 women diagnosed with GDM during pregnancy. Quantitative metrics on β cell function and insulin sensitivity during pregnancy were calculated using traditional equations. The association of β cell dysfunction and insulin resistance with the risk of the composite adverse pregnancy outcomes was investigated using multivariable-adjusted logistic regression models.Results::Multivariable-adjusted odds ratios (ORs) of adverse pregnancy outcomes across quartiles of homeostatic model assessment for insulin resistance (HOMA-IR) were 1.00, 0.95, 1.34, and 2.25, respectively ( P for trend = 0.011). When HOMA-IR was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 1.34 (95% confidence interval 1.16-1.56) for each 1-unit increase in HOMA-IR. Multivariable-adjusted ORs of adverse pregnancy outcomes across quartiles of homeostatic model assessment for β cell function (HOMA-β) were 1.00, 0.51, 0.60, and 0.53, respectively ( P for trend = 0.068). When HOMA-β was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 0.57 (95% CI 0.24-0.90) for each 1-unit increase in HOMA-β. However, other quantitative metrics were not associated with the composite adverse pregnancy outcomes. Conclusions::We demonstrated a significant association of β cell function and insulin sensitivity with the risk of adverse pregnancy outcomes. We have provided additional evidence on the early identification of adverse pregnancy outcomes besides the glycemic values.

With the acceleration of aging and the changes of people's lifestyle and environment， the incidence of chronic non-communicable diseases （chronic diseases） in China is increasing， which has become a major public health problem. The number of sub-health people is even more and rising. The thought of treating disease before its onset emphasizes taking precautions against disease and preventing change after disease onset， which is one of the core contents of traditional Chinese medicine （TCM） theory. According to the theory of TCM， health as a dynamic balance of yin and yang and diseases can be prevented and treated by maintaining this balance. The "state adjustment" strategy suggests to treat diseases by adjusting the state of exuberance or decline based on recognizing and distinguishing "state"， which has important guiding significance for developing and evaluating the healthcare food produced with Chinese medicinal materials. Healthcare food plays a vital role in health promotion， chronic disease prevention， and quality of life improvement. At present， the healthcare food produced with Chinese medicinal materials in China generally lacks TCM guidance and fails to fully reflect the advantages of TCM. In this study， the development strategy， functional claims， evaluation methods， and existing problems of healthcare food were discussed. Furthermore， with diabetes as an example， the "state adjustment" strategy was introduced into product development and evaluation to provide ideas for promoting the rapid growth of healthcare food with TCM characteristics.

Objective To construct nursing sensitive indicators applicable to operating room,in order to provide standard and quantitative basis for nursing quality monitoring in operating room.Methods Based on American's National Database of Nursing Quality Indicators (NDNQI) and literature review,the key content of indicators and scientific measurement methods were determined by one round of internal inquiry and two rounds of expert consultation using Delphi technique.Results Operating room nursing quality sensitive indicators system was constructed,which contained 14 indicators.The expert authority coefficients were greater than 0.80 and the variation coefficients of each index were less than 0.3.The results were reliable.Conclusion A set of specialized,sensitive and practical nursing sensitive indicators were needed to facilitate sustainable development of operating room.