Objective : Based on glycolysis of hypoxia inducible factor-1α(HIF-1α)/Bcl2/adenovirus E1B interacting protein 3(BNIP3) pathway, to study the mechanism of oxygen-induced retinal angiogenesis in neonatal mice. Methods : Human umbilical vein endothelial cells(HUVECs) were divided into normoxic group, hypoxia+si-NC group, hypoxia +si-HIF-1α group and hypoxia+si-HIF-1α+BNIP group. In normoxic group, HUVECs were exposed to normoxic(21% O2) and cultured. Hypoxia +si-NC group, hypoxia +si-HIF-1α group and hypoxia +si-HIF-1α+BNIP3 group were treated with si-NC, si-HIF-1α or si-HIF-1α combined with BNIP3 plasmid for 36 h, and then exposed to hypoxia(1% O2) for culture. The autophagy, glycolysis, proliferation, migration and tube formation of mitochondria were investigated by immunofluorescence, metabolic measurement, cell viability, scratch experiment and tube formation experiment. On the 7th day after birth, C57BL/6J mice were randomly assigned to different treatment groups: control group, oxygen-induced retinopathy(OIR) group, OIR+si-HIF-1α group and OIR+si-BNIP group. The neovascularization and vascular occlusion were measured. Results: Compared with normoxic group, the rate of LC3+MitoTracker+ spots, glucose uptake and lactic acid release in HUVECs in hypoxia +si-NC group increased significantly(P<0.001). Compared with hypoxia +si-NC group, the rate of LC3+MitoTracker+ spots, glucose uptake and lactic acid release in HUVECs in hypoxia +si-HIF-1α group decreased significantly(P<0.01). Compared with normoxic group, the proliferation activity of HUVECs in hypoxia +si-NC group decreased significantly(P<0.05), and the wound healing area and the number of tubes formed increased significantly(P<0.01). Compared with hypoxia+si-NC group, the proliferation activity of HUVECs in hypoxia +si-HIF-1α group decreased significantly at the 24th, 48th and 72th hours of culture(P<0.05), and the wound healing area and the number of tubes formed decreased significantly(P<0.001). Overexpression of BNIP3 reversed the effects of HIF-1α knock-down on mitochondrial autophagy, glycolysis and biological function. Compared with OIR group, the neovascularization and vascular occlusion areas in retina of mice in OIR+si-HIF-1α group and OIR+si-BNIP3 group reduced significantly(P<0.05). Conclusion HIF-1α/BNIP3 signaling pathway promotes mitochondrial autophagy activation in HUVECs under hypoxia, which plays an important role in controlling endothelial function and angiogenesis.

Background The decline of physical activity in the elderly due to aging may increase the risk of sarcopenia. Currently, there is a lack of evidence from large natural populations on the relationship between PA and sarcopenia. Objective To explore the relationship between PA and sarcopenia in the elderly aged 60 years and above in 10 provinces (autonomous regions) of China. Methods Data were retrieved from the 2022—2023 round of the China Development and Nutrition Health Impact Cohort. Personal basic information and PA data were collected by questionnaire survey. Skeletal muscle mass was measured by bio-electrical impedance analysis, muscle strength was measured using a grip dynamometer, and physical performance was reflected by 6-meter walk speed. The Asian Working Group for Sarcopenia (AWGS) 2019 criteria were used to diagnose sarcopenia. Light physical activity (LPA) duration, moderate-to-vigorous physical activity (MVPA) duration, and total physical activity volume were calculated. A total of 3326 residents aged ≥60 years with complete data were selected as the survey participants. Multiple logistic regression models and restricted cubic splines (RCS) were used to assess the association between PA duration/volume and sarcopenia. Results In 10 provinces (autonomous regions) of China, the prevalence of sarcopenia in the elderly aged 60 years and above was 5.5% (95%CI: 4.7%, 6.2%). The logistic regression analysis showed that compared with the elderly reporting 0-7.0 h·week⁻¹ in LPA duration, the risk of sarcopenia in the elderly with LPA duration of >14.0-21.0 h·week⁻¹ was reduced by 51% (OR=0.49, 95%CI: 0.26, 0.96). Compared with the elderly with total physical activity ≥15.0 metabolic equivalent of task (MET)-h·week⁻¹, those with <7.5 MET-h·week⁻¹ had a 2.24-fold increased risk of sarcopenia (OR=2.24, 95%CI: 1.17, 4.29). The RCS results found that LPA duration and total physical activity volume each showed a nonlinear dose-response relationship with the risk of sarcopenia (P_overall<0.05, P_non-linear<0.05). Compared with the elderly with an LPA duration of 0 h· week⁻¹, the risk of sarcopenia in the elderly with an LPA duration of 12.6 h· week⁻¹ was the lowest (OR=0.42, 95%CI: 0.21, 0.83). Compared with the elderly with a total physical activity volume of 15.0 MET-h· week⁻¹, the elderly with a total physical activity volume of 46.0 MET-h· week⁻¹ had the lowest risk of sarcopenia (OR=0.57, 95%CI: 0.38, 0.84). There was no statistically significant association between weekly MVPA duration and the risk of sarcopenia (P>0.05). Conclusion Increasing weekly LPA duration and total physical activity volume would help to reduce the risk of sarcopenia.

Objective: To explore the relative importance of different food attributes and levels in food decision making of school aged children, and to understand their meal preferences, so as to provide the evidence for formulating precise intervention strategies for dietary behaviours of school aged children. Methods: From May to June 2024, a total of 854 children aged 11 to 15 years old were selected from 2 middle schools (each school in urban and rural areas) in both Hubei Province and Anhui Province by stratified cluster random sampling method to conduct a D-optimal discrete choice experiment. The mixed Logit model was used to analyze children s preference for meal attributes and different levels, and to calculate the relative importance (RI) of attributes and willingness to pay (WTP) in meal choices. Results: The included five food attributes had statistical significance on meal choice of school aged children ( P <0.05). The relative importance of food attributes affecting the meal choices of school aged children in descending order were dining mode ( RI =31.26%), food varieties ( RI =30.56%), cooking method( RI =23.84%), taste( RI =8.06%) and price ( RI =6.27%). Among them, school aged children preferred home cooked meals ( β =0.74) (WTP=86.3 yuan),varied foods(grain/tubers+vegetables+fish, meat, eggs and beans) ( β =0.61) (WTP=71.9 yuan), fried/roasted cooking ( β =0.51) and spicy taste ( β =0.33).Price was negatively correlated with meal choices( β =-0.01) ( P <0.05). Based on residential area and body mass index (BMI), the stratified analysis showed that dining mode was highest in the relative importance for rural children with overweight and obese children ( RI =31.28%,34.17%), both of whom preferred home cooked meals ( β =0.76, 0.91), and meals containing fish, meat, eggs and beans with grain/tubers or grain/tubers and vegetables in terms of food choice (area: β =0.53, 0.53 ; BMI: β =0.55, 0.56) ( P <0.05). Conclusions School aged children have different preferences for different attributes of meals. The quality of school meals should be improved,the cost of buying healthy meals should be reduced,targeted family health education should be carried out,and healthy cooking methods should be advocated.

Ischemic obstruction is a dangerous condition with a high mortality rate.Professor Jin Shi proposed that vascular intesti-nal obstruction disease is based on the intestinal tract while the structure of mesenteric vascular structure in modern medicine is highly similar to the morphological description of"intestinal collateral"in traditional Chinese medicine.The"hypercoagulable state"of blood is highly consistent with the core of the pathogenesis of"intestinal stasis"in traditional Chinese medicine.Blood stasis is a key patho-logical product and pathogenic factor of vascular intestinal obstruction and it is necessary to pay attention to the combination of disease identification,clarification of urgency,and phased treatment.This study provides a theoretical basis and practical example for the treatment of vascular intestinal obstruction in traditional Chinese medicine.

Purpose To investigate the value of intratumoral and different ranges of peritumoral radiomics features of the primary lesion of breast cancer based on ultrasound images in predicting axillary lymph node metastasis(ALNM),and to explore the best peritumoral range.Materials and Methods A total of 312 cases confirmed by pathology in breast cancer patients with preoperative ultrasound images from June 2022 to February 2024 in Binzhou Medical University Hospital were retrospectively enrolled,and were randomly divided into training set and testing set according to the 7∶3 proportion.The tumor border of the ultrasound images was manually delineated as the intratumoral region of interest,and the peritumoral region of interest was obtained by conformal automatically extended different range(1,2,3,4 and 5 mm).The radiomics features were screened.Based on the selected optimal radiomics features,random forest classifier was used to construct three types of radiomics models(intratumoral model,5 peritumoral models,and 5 intratumoral+peritumoral models).The performance and clinical practicability of the models was assessed the area under the curve(AUC)and decision curve analysis.Results The AUCs of the intratumoral+peritumoral radiomics models for predicting ALNM in the training set and test set were 0.807-0.873,0.728-0.780,respectively,which were superior to those of the single intratumoral radiomics models(0.822,0.758)and peritumoral radiomics models(0.722-0.768,0.650-0.710).The intratumoral+peritumoral 3 mm radiomics model showed the best predictive performance,with AUC of 0.873 in the training set and 0.780 in the test set,respectively,and the decision curve showed that the model had a good clinical net benefit.Conclusion The combined intratumoral and peritumoral radiomics features of the primary lesion of breast cancer based on ultrasound images can effectively predict ALNM,and 3 mm peritumoral may be the best peritumoral range for predicting ALNM.

Purpose To investigate the value of intratumoral and different ranges of peritumoral radiomics features of the primary lesion of breast cancer based on ultrasound images in predicting axillary lymph node metastasis(ALNM),and to explore the best peritumoral range.Materials and Methods A total of 312 cases confirmed by pathology in breast cancer patients with preoperative ultrasound images from June 2022 to February 2024 in Binzhou Medical University Hospital were retrospectively enrolled,and were randomly divided into training set and testing set according to the 7∶3 proportion.The tumor border of the ultrasound images was manually delineated as the intratumoral region of interest,and the peritumoral region of interest was obtained by conformal automatically extended different range(1,2,3,4 and 5 mm).The radiomics features were screened.Based on the selected optimal radiomics features,random forest classifier was used to construct three types of radiomics models(intratumoral model,5 peritumoral models,and 5 intratumoral+peritumoral models).The performance and clinical practicability of the models was assessed the area under the curve(AUC)and decision curve analysis.Results The AUCs of the intratumoral+peritumoral radiomics models for predicting ALNM in the training set and test set were 0.807-0.873,0.728-0.780,respectively,which were superior to those of the single intratumoral radiomics models(0.822,0.758)and peritumoral radiomics models(0.722-0.768,0.650-0.710).The intratumoral+peritumoral 3 mm radiomics model showed the best predictive performance,with AUC of 0.873 in the training set and 0.780 in the test set,respectively,and the decision curve showed that the model had a good clinical net benefit.Conclusion The combined intratumoral and peritumoral radiomics features of the primary lesion of breast cancer based on ultrasound images can effectively predict ALNM,and 3 mm peritumoral may be the best peritumoral range for predicting ALNM.

Ischemic obstruction is a dangerous condition with a high mortality rate.Professor Jin Shi proposed that vascular intesti-nal obstruction disease is based on the intestinal tract while the structure of mesenteric vascular structure in modern medicine is highly similar to the morphological description of"intestinal collateral"in traditional Chinese medicine.The"hypercoagulable state"of blood is highly consistent with the core of the pathogenesis of"intestinal stasis"in traditional Chinese medicine.Blood stasis is a key patho-logical product and pathogenic factor of vascular intestinal obstruction and it is necessary to pay attention to the combination of disease identification,clarification of urgency,and phased treatment.This study provides a theoretical basis and practical example for the treatment of vascular intestinal obstruction in traditional Chinese medicine.

Objective:Dynamic navigation approaches are widely employed in the context of implant placement surgery.Implant surgery can be divided into immediate and delayed surgery according to the time of implantation.This retrospective study was developed to compare the accuracy of dynamic naviga-tion system for immediate and delayed implantations.Methods:In the study,medical records from all patients that had undergone implant surgery between August 2019 and June 2021 in the First Clinical Di-vision of the Peking University School and Hospital of Stomatology were retrospectively reviewed.There were 97 patients[53 males and 44 females,average age(47.14±11.99)years]and 97 implants(de-layed group:51;immediate group:46)that met with study inclusion criteria and were included.Implant placement accuracy was measured by the superposition of the planned implant position in the preoperative cone beam computed tomography(CBCT)image and the actual implant position in the postoperative CBCT image.The 3-dimensional(3D)entry deviation(3D deviation in the coronal aspect of the alveolar ridge),3D apex deviation(3D deviation in the apical area of the implant)and angular deviation were analyzed as the main observation index when comparing these two groups.The 2-dimensional(2D)horizontal deviation of the entry point and apex point,and the deviation of entry point depth and apex point depth were the secondary observation index.Results:The overall implant restoration survival rate was 100％,and no mechanical or biological complications were reported.The implantation success rate was 100％.The 3D entry deviation,3D apex deviation and angular deviation of all analyzed implants were(1.146±0.458)mm,(1.276±0.526)mm,3.022°±1.566°,respectively;while in the de-layed group these respective values were(1.157±0.478)mm,(1.285±0.481)mm and 2.936°±1.470° as compared with(1.134±0.440)mm,(1.265±0.780)mm,3.117°±1.677° in the immediate group.No significant differences(P=0.809,P=0.850,P=0.575)in accuracy were observed when comparing these two groups.Conclusion:Dynamic computer-assisted implant surgery system promotes accurate implantation,and both the immediate and delayed implantations exhibit similar levels of accura-cy under dynamic navigation system that meets the clinical demands.Dynamic navigation system is feasi-ble for immediate implantation.

Objective:To investigate the clinical, epidemic and laboratory characteristics of brucellosis in Hainan, and to summarize the experience of diagnosis and treatment.Methods:The epidemiological characteristics, clinical manifestations, laboratory results, treatment and prognosis of 27 inpatients with brucellosis admitted to the Second Affiliated Hospital of Hainan Medical University from January 2019 to December 2023 were retrospectively analyzed.Results:In 27 cases, the male to female ratio was 2.38 ∶ 1.00 (19 ∶ 8). Occupational distribution was dominated by farmers and herdsmen, with a total of 21 cases (77.8%). Twenty-one patients (77.8%) had a clear history of contact with cattle, sheep, and related products, and there was a phenomenon of family clustering. Eighteen patients (66.7%) developed symptoms from March to July. The clinical manifestations of the patients were lack of specificity, mainly fever (24 cases, 88.9%), dizziness and headache (13 cases, 48.1%), and low back pain (11 cases, 40.7%). Some patients also had symptoms and signs such as fatigue (8 cases), muscle pain (6 cases), chest tightness (4 cases), and splenomegaly (6 cases). Complications commonly included pulmonary infection (13 cases, 48.1%) and spinal involvement (11 cases, 40.7%). The positive rates of Brucella blood culture, tube agglutination test, Rose Bengal plate agglutination test, and cerebrospinal fluid or joint cavity effusion culture were 76.9% (20/26), 100.0% (21/21), 100.0% (11/11), and 3/4, respectively. The combination therapy of doxycycline and rifampicin showed good therapeutic effects, and 22 patients were cured. Conclusions:Hainan is not an epidemic area of brucellosis, and the clinical manifestations of the disease are not specific. The epidemic and clinical characteristics of the disease should be paid attention to in order to improve the level of diagnosis and treatment and control effectiveness.

Objective:To investigate the clinical, epidemic and laboratory characteristics of brucellosis in Hainan, and to summarize the experience of diagnosis and treatment.Methods:The epidemiological characteristics, clinical manifestations, laboratory results, treatment and prognosis of 27 inpatients with brucellosis admitted to the Second Affiliated Hospital of Hainan Medical University from January 2019 to December 2023 were retrospectively analyzed.Results:In 27 cases, the male to female ratio was 2.38 ∶ 1.00 (19 ∶ 8). Occupational distribution was dominated by farmers and herdsmen, with a total of 21 cases (77.8%). Twenty-one patients (77.8%) had a clear history of contact with cattle, sheep, and related products, and there was a phenomenon of family clustering. Eighteen patients (66.7%) developed symptoms from March to July. The clinical manifestations of the patients were lack of specificity, mainly fever (24 cases, 88.9%), dizziness and headache (13 cases, 48.1%), and low back pain (11 cases, 40.7%). Some patients also had symptoms and signs such as fatigue (8 cases), muscle pain (6 cases), chest tightness (4 cases), and splenomegaly (6 cases). Complications commonly included pulmonary infection (13 cases, 48.1%) and spinal involvement (11 cases, 40.7%). The positive rates of Brucella blood culture, tube agglutination test, Rose Bengal plate agglutination test, and cerebrospinal fluid or joint cavity effusion culture were 76.9% (20/26), 100.0% (21/21), 100.0% (11/11), and 3/4, respectively. The combination therapy of doxycycline and rifampicin showed good therapeutic effects, and 22 patients were cured. Conclusions:Hainan is not an epidemic area of brucellosis, and the clinical manifestations of the disease are not specific. The epidemic and clinical characteristics of the disease should be paid attention to in order to improve the level of diagnosis and treatment and control effectiveness.