Objective: To explore the association between vitamin D levels and sleep in children and adolescents，so as to provide a reference for promoting the sleep health of children and adolescents. Methods: From October to December, 2021, 4 827 primary and middle school students aged 6-17 in Shenzhen were selected by multistage cluster random sampling method, and their demographic information, family background, lifestyle and sleep status were obtained by facetoface questionnaire survey, and their fasting venous blood in the morning was collected to detect the serum 25(OH)D level. The relationship between serum vitamin D level and sleep characteristics was analyzed by binary Logistic regression, and stratified analysis was carried out according to gender. Results: The proportion of vitamin D deficiency was 41.1%, and the proportion of sleep deficiency was 19.4%. With the increase of vitamin D level, daily sleep duration of children and adolescents tended to increase (r=0.10,P<0.01). After adjusting for covariates such as gender and age, it was found that children and adolescents with insufficient vitamin D levels were more likely to experience sleep insufficiency, social jetlag, and late sleep on weekdays, with ORs being 1.32(95%CI=1.12-1.56), 1.35(95%CI=1.19-1.54), and 1.26(95%CI=1.05-1.52)(P<0.05). Sexstratified analysis showed that, among boys, vitamin D deficiency was associated with sleep deficiency, social jetlag, and late bedtime on weekdays and weekends[OR(95%CI)=1.42(1.14-1.77),1.25(1.04-1.49),1.39(1.06-1.82),1.86(1.19-2.92),P<0.05]. In girls, however, serum vitamin D levels were only associated with social jetlag with OR being 1.47 (95%CI=1.21-1.79, P<0.05). Conclusion Vitamin D levels are associated with various sleep characteristics in children and adolescents, with this association being more pronounced among boys.

With the purpose of improving the teaching quality of the course pathogen biology and immunology for students majoring in nursing and with the guidance of the output of talent training goals, this study introduced micro-video assignment in the teaching process as a supplement to the curriculum ideological and political education. This approach included the integration of curriculum ideological and political education in the whole process, the selection of micro-video topics, the distribution of tasks, the tracking and guidance by teacher in the whole process, and evaluation and rewards. This teaching reform used the traditional micro-video to achieve the transformation from "recorded by teachers for students" to "recorded by students for everyone". This improved the awareness and abilities of students in teamwork, lifelong learning, and independent learning. This allowed the development of a scientific questioning attitude and independent thinking ability, guiding students to establish scientific views of life and the world, and expanding the dimension of innovation in teaching the course of microbiology immunology.

Objective:To retrieve and summarize the best evidence for perioperative enhanced rehabilitation in adolescent idiopathic scoliosis patients, with the aim of providing evidence-based basis for relevant medical and nursing staff.Methods:Based on the "6S" evidence model, guideline, expert consensus, evidence summary, and systematic review of perioperative enhanced rehabilitation for adolescent idiopathic scoliosis patients were searched in British Medical Journal (BMJ) Best Practice, UpToDate, Joanna Briggs Institute Evidence-Based Health Care Center Database, Cochrane Library, Guidelines International Network, National Institute for Health and Clinical Excellence, National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, Registered Nurses ' Association of Ontario, CINAHL, PubMed, Embase, Web of Science, China National Knowledge Infrastructure, Medlive, WanFang Data, VIP, China Biomedical Medline Disc, and other Chinese and English databases. The search period was from database establishment to March 1, 2023. Two trained researchers independently evaluated literature quality and extracted evidence. Results:A total of 18 articles were included, including two guidelines, four expert consensus, two systematic reviews, two evidence summaries, three randomized controlled trials, and five quasi experimental studies. A total of 35 best evidence were formed from four aspects, namely preoperative management, intraoperative management, postoperative complication management, and functional exercise.Conclusions:The best evidence for enhanced rehabilitation of adolescent idiopathic scoliosis patients during the perioperative period summarized has guiding significance for clinical medical and nursing staff to carry out enhanced rehabilitation. Medical and nursing staff should develop rehabilitation nursing measures based on the concept of enhanced rehabilitation. However, it is still necessary to carefully consider the feasibility of the evidence and selectively apply it based on clinical scenarios and patient wishes.

Due to the non-targeted release and low solubility of anti-gastric cancer agent,apatinib(Apa),a first-line drug with long-term usage in a high dosage often induces multi-drug resistance and causes serious side effects.In order to avoid these drawbacks,lipid-film-coated Prussian blue nanoparticles(PB NPs)with hyaluronan(HA)modification was used for Apa loading to improve its solubility and targeting ability.Furthermore,anti-tumor compound of gamabufotalin(CS-6)was selected as a partner of Apa with reducing dosage for combinational gastric therapy.Thus,HA-Apa-Lip@PB-CS-6 NPs were constructed to synchro-nously transport the two drugs into tumor tissue.In vitro assay indicated that HA-Apa-Lip@PB-CS-6 NPs can synergistically inhibit proliferation and invasion/metastasis of BGC-823 cells via downregulating vascular endothelial growth factor receptor(VEGFR)and matrix metalloproteinase-9(MMP-9).In vivo assay demonstrated strongest anti-tumor growth and liver metastasis of HA-Apa-Lip@PB-CS-6 NPs adminis-tration in BGC-823 cells-bearing mice compared with other groups due to the excellent penetration in tumor tissues and outstanding synergistic effects.In summary,we have successfully developed a new nanocomplexes for synchronous Apa/CS-6 delivery and synergistic gastric cancer(GC)therapy.

Objective To examine the regulation of malignant progression of colorectal cancer by LINC00626 via the JAK1/STAT3/KHSRP signaling axis and its molecular mechanism.Methods 96 individuals diagnosed with colorectal cancer at our hospital during June 11,2021 and June 11,2023 were chosen as research subjects,and their cancerous tissue and nearby normal tissue were collected.Cultivate colorectal cancer cell lines(SW620,HCT116,HT29,DLD-1,LOVO,Caco-2)and normal colorectal cells(NCM460)in vitro,and detect the expression of LINC00626 and KHSRP in colorectal cancer tissue and cell lines using qRT-PCR.Screening out cell lines infected with lentivirus,SW620 and HCT116 cell lines were transfected with knockdown lentivirus and its control,while HT29 and DLD-1 cell lines were transfected with overexpressing lentivirus and its control,respectively.Select stable transfected cell lines for cell function experiments to detect proliferation,migration,and invasion abilities.Detection of the effect of LINC00626 on the growth and migration of colorectal cancer tumors in live mouse experiments.The expression level of KHSRP protein in stable labeled cells was determined using a western blot analysis.Rescue experimental research on the regulatory relationship between LINC00626 and KHSRP.Results qRT-PCR showed low expression of LINC00626 and high expression of KHSRP in colorectal cancer tissues and cell lines.Cell function experiments showed that compared with the sh-NC group,the sh-LINC00626 group promoted cell proliferation,migration,and invasion in SW620 and HCT116 cells,while the overexpression group showed the opposite.Cell rescue experiments showed that,LINC00626+KHSRP significantly reversed the promotion effects of knocking down LINC00626 on cell proliferation,migration,and invasion.In the nude mouse experiment,com-pared with the sh-NC group,the sh-LINC00626 group showed a significant increase in tumor volume and weight,cell proliferation rate,and the number of lung metastases from colorectal cancer in the nude mice;Overexpression results in the opposite.The signal pathway experiment revealed that relative to the sh-NC group,the expression levels of JAK1 and STAT3 mRNA in the sh-LINC00626 group were significantly increased,whereas the results in the overexpression group were the opposite.Conclusion LINC00626 suppression the malignant progression of colorec-tal cancer metastasis through the JAK1/STAT3/KHSRP signaling axis.

Objective:To explore the related factors of thrombocytopenia (TCP) occurrence in patients with cirrhosis.Methods:A cross-sectional study was conducted. Inpatients with an initial diagnosis of cirrhosis at Peking University First Hospital from January 1, 2010 to December 31, 2020 were included. Clinical data such as demographic characteristics, etiology of cirrhosis, complications of cirrhosis, laboratory indicators, Child-Pugh grade, invasive procedures, and mortality during hospitalization were collected. A logistic regression model was used to explore the related factors of TCP occurrence in patients with cirrhosis. Categorical variables were compared by the χ2 test. The inter-group comparison was performed using continuous variables, a t-test, one-way analysis of variance (ANOVA), or a nonparametric test. Results:There were a total of 2 592 cases of cirrhosis. 75 cases with incomplete clinical data were excluded. 2 517 cases were included for analysis. The median age was 58 (50, 67) years. Males accounted for 64%. 1 435 cases (57.0%) developed TCP, and 434 cases (17.2%) had grade 3-4 TCP. Gender, primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), and concomitant esophagogastric varices (EGV) were the major factors associated with TCP. Females were more prone to combine with TCP ( OR=1.32, 95% CI: 1.12-1.56, P=0.001). Patients combined with EGV ( OR=3.09, 95% CI: 2.63-3.65, P<0.001) were more prone to develop TCP, which was associated with the increased incidence of hypersplenism ( P<0.001). Patients with PBC ( OR=0.64, 95% CI: 0.50-0.82, P<0.001) and PSC ( OR=0.23, 95% CI: 0.06-0.65, P=0.010) were less prone to develop TCP, which was due to the shorter prothrombin time and better coagulation function of PBC patients ( P<0.001), and the lower proportion of hypersplenism in combined PSC patients ( P=0.004). Patients with TCP and grade 3-4 TCP had a higher rate of hemostatic procedures ( P<0.05), but a lower rate of liver biopsy ( P<0.05). Patients with grade 3-4 TCP had a higher nosocomial mortality rate compared to those without ( P=0.004). Conclusion:TCP is common in patients with cirrhosis. However, TCP occurrence is higher in female patients with EGV and lower in patients combined with PBC and PSC. TCP affects invasive procedures and is associated with adverse outcomes.

Objective:To explore the value of difference value and relative value of pulmonary vascular quantitative parameters of biphasic CT in diagnosis of chronic obstructive pulmonary disease (COPD) and high-risk groups.Methods:The study was a cross-sectional study. A retrospective study of 624 patients who underwent biphasic chest CT scanning in the Second Affiliated Hospital of PLA Naval Medical University from August 2018 to December 2020. Subjects were divided into three groups according to pulmonary function test: normal group ( n=321), preserved ratio impaired spirometry (PRISm) ( n=204) and COPD group ( n=99). The pulmonary vascular quantitative parameters were obtained by the workstation, including the number of pulmonary vessels (N total), cross-sectional area less than that of 5 mm 2 (N CSA5), vessel area (VA total) of 9, 12, 15, 18, 21 mm from the pleura, total blood vessels volume (TBV) and total blood vessels volume under 5 mm 2 (BV5) at expiratory and inspiratory phase. The difference value, relative value of biphasic CT were calculated. ANOVA test or Kruskal-Wallis H test was used to compare the differences of pulmonary vascular quantitative parameters among the three groups, and LSD or Bonferroni tests were used for multiple comparisons. Results:The N total, N CSA5, VA total of the whole lung in the inspiratory phase at the level of 9, 12, 15, 18 and 21 mm from the pleura and TBV, BV5 in the normal group, PRISm group and COPD group, showed an overall trend of decreasing and then increasing, and the PRISm group was lower than those of the normal group ( P<0.05). The differences in N total, N CSA5, VA total between the COPD group and the normal group at the level of 9 and 21 mm from the pleura were not statistically significant ( P>0.05), while the N total, N CSA5, V Atotal of biphasic difference value and relative value in COPD group demonstrated a significant difference from those in normal group ( P<0.05). Conclusion:The difference value and relative value of pulmonary vascular quantitative parameters in biphasic CT are more useful than single inspiratory-phase vascular parameters to differentiate the changes in pulmonary vascular remodeling between COPD patients and the normal population, and also to complement the pulmonary vascular characteristics of the PRISm population, which can provide a basis for early warning of COPD and high-risk populations.

Objective:To investigate the efficacy and safety of intravenous thrombolysis and antiplatelet therapy in patients with stroke warning syndrome (SWS), as well as influencing factors of the outcome in patients with SWS.Method:Patients with SWS admitted to the 521 st Hospital of Ordnance Group from June 1, 2018 to December 31, 2023 were retrospectively included. Some patients were treated with ateplase intravenous thrombolysis, followed by oral antiplatelet therapy; some patients only received antiplatelet therapy. The main outcome measure was the modified Rankin Scale score at 90 days after onset, with a score of 0-2 defined as good outcome. Results:A total of 35 patients with SWS were included, including 26 males (74.3%) with an age of 58.29±11.06 years. Nineteen patients (54.3%) received intravenous thrombolysis, and 27 (77.1%) had good outcome at 90 days. There was no statistically significant difference in demographic, baseline data, and good outcome between the intravenous thrombolysis group and the antiplatelet therapy group. One patient had new stroke and one had transient ischemic attack in the intravenous thrombolysis group. There were statistically significant differences in ABCD2 score, systolic blood pressure, low-density lipoprotein cholesterol, fasting blood glucose, highest National Institutes of Health Stroke Scale (NIHSS) score at onset, and symptom duration between the good outcome group and the poor outcome group (all P<0.05). Conclusions:The efficacy of intravenous thrombolysis is similar to that of antiplatelet drugs alone in treating SWS. ABCD2 score, systolic blood pressure, low-density lipoprotein cholesterol, fasting blood glucose, highest NIHSS score at onset, and duration of symptoms may be influencing factors for the outcome of patients with SWS.

【Objective】 To explore the correlation between different feeding styles of caregivers and diet quality of children with nutritional problems, in order to provide reference for making effective feeding guidance and intervention strategy. 【Methods】 From January 2022 to August 2023, 2- to 6-year-old children who had been enrolled in kindergartens or nurseries and their caregivers from the combined outpatient department of Child Healthcare and Nutrition in Shanghai Children′s Hospital were selected into this study.The amount of dinner served and consumed was obtained through the three-day dinner intake survey, and the Chinese Healthy Eating Index (CHEI) was calculated.Feeding styles were divided into four groups through the Caregiver Feeding Style Questionnaire.Pearson correlation analysis was used to determine the correlation between served and consumed CHEI score.Chi-square test, t-test and ANOVA were used to compare the differences in CHEI score for dinner consumed in children with different feeding styles. 【Results】 1) Totally 133 parent-child pairs were included in this study.There were 68 boys (51.1%) and 65 girls (48.9%), with an average age of (4.6±0.6) years.2) CHEI scores for dinner served was highly correlated with that for dinner consumed (r=0.90, P<0.05).There was statistically significant difference between the CHEI score for dinner served and consumed by authoritative and authoritarian feeding styles (t=2.538, 1.732, P<0.05).3) After adjusting body shape, children in the authoritative feeding style actually completed a significantly higher diet quality CHEI score than those in the authoritarian feeding style (P<0.05).4)Authoritative and indulgent feeding styles had statistical differences in the distribution of children′s body size (χ²=13.587, P=0.035). 【Conclusions】 Parents with authoritarian feeding style and indulgent feeding style have worse control over their children′s dietary completion.Children with authoritative feeding style have higher dietary quality than those with authoritarian feeding style.Children with indulgent feeding style may have a higher proportion of non-low weight than those with authoritative feeding style.Although feeding style could not reverse the outcome of body shape deviation in children with disease, it may have some positive effects.

OBJECTIVE To establish the specific chromatogram of Qianghuo Shengshi Tang(QHSS) reference sample, clarify the key quality attributes of QHSS, providing reference for the quality evaluation of QHSS reference sample. METHODS The SilGreen C18 column(4.6 mm×250 mm, 5 μm) was used. The mobile phase consisted acetonitrile and 0.2% formic acid aqueous solution. The detection wavelength was 328 nm. Established an HPLC characteristic spectrum analysis method for the reference sample of QHSS. A variety of chromatographic columns and different instruments were applied to investigate the adaptability of the system. HPLC-LTQ-Orbitrap MS was used to identify the specific peaks of the QHSS reference samples in positive ion mode. RESULTS There were 14 peaks in the specific chromatogram, which belonged to Notopterygii Rhizoma Et Radix, Angelicae Pubescentis Radix, Ligustici Rhizoma Et Radix, Chuanxiong Rhizome, Viticis Fructus, respectively. Ferulic acid(peak 3) was reference peak. A total of 22 compounds were identified by mass spectrometry, including coumarin and flavonoids. CONCLUSION The established specific chromatogram method of QHSS is simple, stable and reproducible. The material basis of QHSS reference sample is basically determined, providing a reference for the development and quality control of QHSS.