Objective: To systematically evaluate the prevalence and influencing factors of screen exposure among preschool children in China, so as to provide evidence for formulating scientific intervention strategies. Methods: Retrieve relevant studies on screen exposure among preschool children from PubMed, Web of Science, Embase, Cochrane Library, China Biomedical Literature Database, CNKI, VIP, and Wanfang databases from the time of estaldishment to June 29, 2025. Meta analysis was performed using Stata 16.0 software. Results: A total of 43 studies were included. Meta analysis showed that the prevalence of screen exposure among preschool children in China was 46.0% (95% CI = 38.9 %-53.1%, P <0.01). Girls, non only child, father s age<35 years, both parents having an educational level of high school or below, being cared for by grandparents, rural residence, parents having no exercise habit, parental support for the use of screen devices, and parental screen time>1 h/d were influencing factors for screen exposure among preschool children [ OR (95% CI ) were 0.85(0.78-0.92), 1.09(1.04-1.15), 1.45(1.22-1.71), 1.38(1.24- 1.54 ), 1.78(1.32-2.40), 1.39(1.16-1.65), 1.38(1.13-1.69), 1.67(1.40-1.98), 1.70(1.38-2.10), 1.59(1.04-2.43), all P <0.05]. Conclusion The prevalence of screen exposure among preschool children in China is relatively high, and relevant child health promotion strategies should be formulated to reduce its occurrence.

OBJECTIVE: Therapeutic angiogenesis has become a promising approach for treating ischemic heart disease (IHD). The present study aims to investigate the effects of Qishen Granule (QSG) on angiogenesis in myocardial ischemia (MI) and the potential mechanism. METHODS: In vivo study was conducted on rat model of myocardial infarction. QSG was performed daily at a dose of 2.352 g/kg for four weeks. Cardiac function was assessed by echocardiogram and pro-angiogenic effects were evaluated by Laser Doppler and CD31 expression. Oxygen-glucose deprivation (OGD) was applied in cultured human umbilical vein endothelial cells (HUVECs). Cell viability, wound healing and tube formation assay were used to test functions of HUVECs. ELISA and Western blots were used to assess protein expressions of bone morphogenetic protein 2-delta-like 4-notch homolog 1 (BMP2-Dll4-Notch1) signaling pathway. RESULTS: The results showed that QSG improved heart function, cardiac blood flow and microvessel density in myocardial ischemic rats. In vitro, QSG protected HUVECs by promoting the cell viability and tube formation. QSG upregulated bone morphogenetic protein-2 (BMP2) and downregulated delta-like 4 (Dll4) and notch homolog 1 (Notch1) expressions both in rats and HUVECs. CONCLUSION QSG protected against MI by promoting angiogenesis through BMP2-Dll4-Notch1 pathway. BMP2 might be a promising therapeutic target for IHD.

Objective:To investigate the impact of early invasive arterial blood pressure (IBP) monitoring on survival and neurological outcomes in out-of-hospital cardiac arrest (OHCA) patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR).Methods:This retrospective cohort study analyzed 44 OHCA patients receiving ECPR between January 2021 and January 2023. Patients were divided into: Early intervention group : IBP established within 3 min of ECMO initiation; Late intervention group : IBP established after ICU admission. Baseline characteristics, ECMO parameters, and clinical outcomes were compared. Multivariable logistic regression (adjusted for age, initial rhythm, etc.) and Spearman's correlation were used.Results:This study included a total of 44 patients treated with OHCA and ECPR, divided into an early intervention group of 23 cases and a late intervention group of 21 cases. The early intervention group showed significantly higher: Survival to discharge (43.5% vs. 9.5%, P<0.05), Good neurological recovery (CPC 1-2: 34.8% vs. 9.5%, P<0.05).Early intervention independently predicted survival (adjusted OR=18.84, 95% CI:1.97-179.98, P=0.01). Stratified analysis by pH (cutoff 7.0) demonstrated consistent benefits in both pH>7.0 ( aOR=0.392, 95% CI:0.106-0.678) and pH≤7.0 subgroups ( aOR=0.385, 95% CI: 0.075-0.695; interaction P=0.183). Early IBP positively correlated with CPC scores ( ρ=0.40, P=0.007). Conclusions:Early IBP monitoring significantly improves survival and neurological outcomes in OHCA-ECPR patients, supporting its integration into standardized protocols.

Objective To explore the expression levels of cholinesterase (CHE) and haptoglobin (HPT) in serum of children with recurrent respiratory tract infections (RRTI) and their value in evaluation of prognosis. Methods A total of 112 children with RRTI were selected and included in the RRTI group, and 95 normal children who underwent physical examination during the same period were randomly selected and included in control group. According to the severity of the disease, patients in the RRTI group were divided into mild group of 38 cases, moderate group of 40 cases, and severe group of 34 cases. The levels of serum CHE, HPT, interleukin-1 (IL-1), interleukin-6 (IL-6), immunoglobulin A (IgA), immunoglobulin M (IgM), as well as CD3⁺ and CD3⁺CD4⁺ were detected. The correlation between CHE and HPT in RRTI children was analyzed. The predictive value of serum CHE and HPT expression levels on the prognosis of RRTI children was analyzed. Results The CHE expression level in the RRTI group was significantly lower than that in the control group, while the HPT level was significantly higher (P < 0.05). The CHE level in severe RRTI patients was significantly lower than that in the moderate and mild groups, and the moderate group was significantly lower than the mild group; the HPT level in severe RRTI children was significantly higher than that in the moderate and mild groups, and the moderate group was significantly higher than the mild group (P < 0.05). The CHE expression level in RRTI children was negatively correlated with the HPT expression level (r=-0.637, P < 0.001). The levels of IL-1, IgA, IgM, CD3⁺ and CD3⁺CD4⁺, in the RRTI group were significantly lower than those in the control group, while the IL-6 level was significantly higher (P < 0.05). The CHE expression level in RRTI children was positively correlated with IL-1, IgA, IgM, CD3⁺and CD3⁺CD4⁺, and negatively correlated with IL-6; the HPT expression level was negatively correlated with IL-1, IgA, IgM, CD3⁺ and CD3⁺CD4⁺, and positively correlated with IL-6 (P < 0.05). The serum CHE expression level in RRTI children with good prognosis was significantly higher than that in RRTI children with poor prognosis, while the HPT level was significantly lower (P < 0.05). The area under the curve (AUC) of the combined prediction of CHE and HPT for the prognosis of RRTI children was higher than that of their individual predictions, and the difference was statistically significant (P < 0.05). Conclusion In the serum of RRTI children, CHE is lowly expressed, while HPT is highly expressed. The combined evaluation of CHE and HPT has high prognostic value for RRTI patients.

Objective To investigate the clinical application and safety of DSA-guided infusion port implantation via internal jugular vein,subclavian vein and axillary vein.Methods A total of 827 patients with malignant tumors,who underwent DSA-guided intravenous infusion port implantation at the Jiangyin Municipal People's Hospital of China between March 28,2016 and June 28,2018,were enrolled in this study.According to the used approach in the port implantation,the patients were divided into internal jugular vein group(group A,n=125),subclavian vein group(group B,n=87),and axillary vein group(group C,n=615).The success rate of puncturing and the incidence of complications were compared between each other among the three groups.Results The success rates of the DSA-guided first-time puncturing in group A,B and C were 98.40％(123/125),94.25％(82/87),and 97.89％(602/615)respectively,the difference was statistically significant(P＜0.05);the success rate of puncturing in group B was lower than that in group C,and among the other groups there was no statistically significant difference(P＞0.05).All patients were followed up for a mean period of(15.56±2.91)months(range of 3-26 months).The overall incidence of postoperative early complications was 3.75％,which in group A was 4.00％(5/125),in group B was 9.20％(8/87),and in group C was 2.93％(18/615),and the incidence of complications in group B was obviously higher than that in group C(P＜0.0167).There was no statistically significant difference in the incidence of various complications between each other among the three groups(P＞0.05).The overall incidence of postoperative long-term complications was 4.72％(39/827),which in group A was 4.80％,in group B was 14.95％,and in group C was 3.25％,and the incidence of complications in group B was strikingly higher than that in group A and group C,the difference was statistically significant(P＜0.05).Comparison of groups for the rates of various complications showed that the incidence of catheter fracture in group B was higher than that in group C,and the clipping syndrome occurred only in group B,the difference was statistically significant(P＜0.0167).There was no significant difference in the incidence of other complications between each other among the three groups(P＞0.05).The abnormal port-taking rate was 1.45％,including 3 patients in group A,7 patients in group B,and 2 patients in group C.The postoperative abnormal port-taking rate in group B was the highest(8.05％),which was significantly different from that in group C(P＜0.0167).Conclusion For intravenous infusion port implantation,axillary vein approach is clinically safe,comfortable,minimally-invasive and highly-efficient method,it is superior to internal jugular vein approach and subclavian vein approach in effectively reducing the incidence of complications and improving the postoperative abnormal port-taking rate of patients.Therefore,this technique can be regarded as a first choice in clinical practice.(J Intervent Radiol,2023,32:1212-1216)

[摘 要] 目的：探讨肝转移对晚期胃癌患者免疫治疗效果的影响。方法：收集2019年2月至2022年1月在南京医科大学附属常州第二人民医院肿瘤中心接受过免疫治疗的晚期胃癌患者的临床资料，进行回顾性分析，利用卡方检验或Fisher确切概率法进行基线特征比较，利用卡方检验和Kaplan-Meier生存分析方法进行有肝转移与无肝转移胃癌患者的疗效和生存期的比较。结果：共有48例晚期胃癌患者纳入分析，根据有无肝转移将患者分为肝转移队列（n=20）和无肝转移队列（n=28）。有肝转移较无肝转移胃癌患者体力状况更差。肝转移队列与无肝转移队列的ORR分别为15.0%和35.7%（P>0.05），DCR分别为65.0%和82.1%（P>0.05）；中位PFS在两组分别为5.0个月和11.2个月（HR=0.40，P<0.05），中位OS分别为12.0个月和19.0个月（P>0.05）。结论：胃癌肝转移患者免疫治疗的疗效差于无肝转移的患者。

Corneal densitometry is a biological property of corneal tissue, which is related to the transparency of cornea, and can be used to describe the degree of corneal transparency.At present, corneal densitometry has been used in the auxiliary diagnosis and severity evaluation of corneal diseases, as well as in the evaluation of the surgical outcome and the postoperative follow-up, even some systemic diseases affecting the cornea.The measurement of corneal densitometry is an objective, non-invasive and repeatable method to evaluate corneal transparency, which has important reference values for the monitoring of corneal and systemic health.In this article, the application of corneal densitometry in clinical practices was reviewed.

Objective:To understand the duration of survival and related influencing factors of HIV/AIDS patients in Liuzhou city.Methods:Both life table method and Kaplan-Meier method were used to calculate the average survival time of HIV/AIDS patients aged ≥15 years reported in Liuzhou city from 2008 to 2018. Factors related to the duration of HIV/AIDS patients were analyzed by univariate and multivariate Cox regression models.Results:A total of 14 856 patients with HIV/AIDS were involved in this study and with the average duration of survival time as 98.74 (95 %CI: 97.73-99.75) months. The cumulative survival rates of 1, 3, 5 and 10 years were 77.0%, 72.0%, 68.0%, 61.0% respectively. Results from the multivariate Cox proportional risk regression analysis showed that factors as sex, level of education, age when HIV infection was confirmed, occupation, route of transmission, source of samples, results of the first CD 4 test and antiviral treatment were all related to the duration of survival to the HIV/AIDS patients. Conclusions:Strategies involving early detection of HIV infection, improvement of the CD 4 initial detection rate and early antiviral treatment will help to significantly reduce the risk of death in HIV/AIDS population. Focus should be on male, middle-aged and elderly (over 41 years old), junior high school education or below farmers and migrant worker populations.

Background and Purpose: With the rapid development of minimally invasive technique, robotic surgery is widely used in the gynecological surgery. This study aimed to compare the clinical data of roboticassisted laparoscopy and laparotomy in the treatment of early ovarian cancer. Methods: A total of 22 patients with early ovarian cancer receiving stage Ⅰ operation between Jan. 2015 and Dec. 2016 in Jilin Province Tumor Hospital were randomly divided into two groups: 8 patients received robotic-assisted surgery (robotic-assisted laparoscopic group), 14 patients received laparotomy (laparotomy group). Results: All patients underwent successful operation without changing surgical approach. The operation time in robotic-assisted laparoscopic group was longer than that in laparotomy group [(194.50±10.90) min vs (178.71±10.58) min, P＜0.05]. Blood loss volume [(60.10±8.88) mL vs (73.71±12.99) mL], 24 hours postoperative drainage volumes of robotic-assisted laparoscopic group were less than those in laparotomy group [(96.88±10.21) mL vs (108.00±11.43) mL, P＜0.05]. Others had no statistical significance (P＞0.05). Conclusion: In the clinical treatment of early ovarian cancer, there is no difference between robotic-assisted laparoscopic operation and laparotomy. Robotic-assisted laparoscopic operation is worthy of clinical promotion and application.

Cardiac surgery is the latest and fastest growing subject in surgery, which is character-ized by complex diseases and strong specialization.The standardized training of non cardiac surgery is short of time for the residents in cardiac surgery, and the teaching has certain complexity and particularity. The department of cardiac surgery of the Xinjiang Uygur Autonomous Region people's Hospital has analyzed the subject characteristics of the major, and explored the reform of cardiac surgery teaching. We adopted a variety of teaching forms to enhance clinical thinking ability and clinical practice ability as the focus of training, and strengthen clinical operation skills according to individual differences among residents. We improved the enthusiasm and initiative of the non-cardiac surgery residents to learn, training residents standardized,standardized diagnosis and treatment behavior,improve the quality of training.