Objective:To investigate the factors influencing poor visual function recovery in patients after refractive cataract surgery, and to provide an effective clinical predictive model for improving and preventing poor postoperative visual function in such patients.Methods:A retrospective study was conducted on 314 patients who underwent refractive cataract surgery in Xi'an Ai'ergucheng Eye Hospital Affiliated to Northwest University from January 2021 to June 2024. The best corrected visual acuity (BCVA) was used to evaluate the postoperative visual function of patients. Patients were divided into a good visual function recovery group of 252 cases and a poor visual function recovery group of 62 cases based on their visual function recovery. The differences in general clinical data, surgical-related information and aqueous humor cytokines between the two groups were compared. Correlation tests and Logistic regression analysis were used to identify factors closely associated with poor visual function recovery in patients after refractive cataract surgery. The predictive efficacy of these factors for poor visual function recovery was evaluated using the receiver operating characteristic (ROC) curve, area under the curve (AUC) and decision curve.Results:The age, proportion of diabetes, proportion of severe cataracts, preoperative fasting blood glucose (FBG) and preoperative glycosylated hemoglobin (HbA 1c) levels in the poor visual function recovery group were significantly higher than those in the good visual function recovery group: 66 (64, 68) years old vs. 64 (61, 66) years old, 32.3% (20/62) vs. 17.9% (45/252), 48.4% (30/62) vs. 32.1% (81/252), (5.73 ± 0.94) mmol/L vs. (5.29 ± 0.84) mmol/L, (6.39 ± 0.76)% vs. (5.86 ± 0.64)%, and the differences were statistically significant ( P<0.05). The operation time, proportion of intraoperative vitreous leakage and phacoemulsification time in the poor visual function recovery group were significantly higher than those in the good visual function recovery group: (34.23 ± 4.13) min vs. (32.55 ± 2.20) min, 45.2% (28/62) vs. 26.2% (66/252), (19.81 ± 2.96) min vs. (18.62 ± 1.49) min, and the differences were statistically significant ( P<0.05). The levels of aqueous humor interleukin (IL)-1β and vascular endothelial growth factor (VEGF)-A in the poor visual function recovery group were significantly higher than those in the good visual function recovery group: (20.17 ± 3.71) ng/L vs. (18.54 ± 2.16) ng/L, (130.11 ± 15.54) ng/L vs. (122.35 ± 6.74) ng/L, and the differences were statistically significant ( P<0.05). Spearman correlation analysis, univariate and multivariate Logistic regression analysis confirmed that age ( OR = 1.762, 95% CI 1.430 to 2.172), preoperative FBG ( OR = 2.272, 95% CI 1.387 to 3.721), preoperative HbA 1c ( OR = 2.823, 95% CI 1.517 to 5.254), diabetes ( OR = 5.413, 95% CI 1.162 to 25.222), intraoperative vitreous leakage ( OR = 4.751, 95% CI 1.877 to 8.309) and aqueous humor IL-1β ( OR = 1.195, 95% CI 1.031 to 1.386) were important risk factors for poor visual function recovery after refractive cataract surgery ( P<0.05). ROC and decision curve analysis found that the combined application of these risk factors had a high predictive efficacy for poor visual function recovery in patients after refractive cataract surgery, with an AUC (95% CI) of 0.885 (0.839 to 0.931) ( P<0.05). Conclusions:Older age, higher preoperative FBG and HbA 1c levels, diabetes, intraoperative vitreous overflow and higher levels of aqueous humor IL-1β are important factors contributing to poor visual function recovery in patients undergoing refractive cataract surgery. The model constructed based on these indicators has a high predictive efficacy for postoperative visual function recovery in patients undergoing refractive cataract surgery.

Objective:To investigate the factors influencing poor visual function recovery in patients after refractive cataract surgery, and to provide an effective clinical predictive model for improving and preventing poor postoperative visual function in such patients.Methods:A retrospective study was conducted on 314 patients who underwent refractive cataract surgery in Xi'an Ai'ergucheng Eye Hospital Affiliated to Northwest University from January 2021 to June 2024. The best corrected visual acuity (BCVA) was used to evaluate the postoperative visual function of patients. Patients were divided into a good visual function recovery group of 252 cases and a poor visual function recovery group of 62 cases based on their visual function recovery. The differences in general clinical data, surgical-related information and aqueous humor cytokines between the two groups were compared. Correlation tests and Logistic regression analysis were used to identify factors closely associated with poor visual function recovery in patients after refractive cataract surgery. The predictive efficacy of these factors for poor visual function recovery was evaluated using the receiver operating characteristic (ROC) curve, area under the curve (AUC) and decision curve.Results:The age, proportion of diabetes, proportion of severe cataracts, preoperative fasting blood glucose (FBG) and preoperative glycosylated hemoglobin (HbA 1c) levels in the poor visual function recovery group were significantly higher than those in the good visual function recovery group: 66 (64, 68) years old vs. 64 (61, 66) years old, 32.3% (20/62) vs. 17.9% (45/252), 48.4% (30/62) vs. 32.1% (81/252), (5.73 ± 0.94) mmol/L vs. (5.29 ± 0.84) mmol/L, (6.39 ± 0.76)% vs. (5.86 ± 0.64)%, and the differences were statistically significant ( P<0.05). The operation time, proportion of intraoperative vitreous leakage and phacoemulsification time in the poor visual function recovery group were significantly higher than those in the good visual function recovery group: (34.23 ± 4.13) min vs. (32.55 ± 2.20) min, 45.2% (28/62) vs. 26.2% (66/252), (19.81 ± 2.96) min vs. (18.62 ± 1.49) min, and the differences were statistically significant ( P<0.05). The levels of aqueous humor interleukin (IL)-1β and vascular endothelial growth factor (VEGF)-A in the poor visual function recovery group were significantly higher than those in the good visual function recovery group: (20.17 ± 3.71) ng/L vs. (18.54 ± 2.16) ng/L, (130.11 ± 15.54) ng/L vs. (122.35 ± 6.74) ng/L, and the differences were statistically significant ( P<0.05). Spearman correlation analysis, univariate and multivariate Logistic regression analysis confirmed that age ( OR = 1.762, 95% CI 1.430 to 2.172), preoperative FBG ( OR = 2.272, 95% CI 1.387 to 3.721), preoperative HbA 1c ( OR = 2.823, 95% CI 1.517 to 5.254), diabetes ( OR = 5.413, 95% CI 1.162 to 25.222), intraoperative vitreous leakage ( OR = 4.751, 95% CI 1.877 to 8.309) and aqueous humor IL-1β ( OR = 1.195, 95% CI 1.031 to 1.386) were important risk factors for poor visual function recovery after refractive cataract surgery ( P<0.05). ROC and decision curve analysis found that the combined application of these risk factors had a high predictive efficacy for poor visual function recovery in patients after refractive cataract surgery, with an AUC (95% CI) of 0.885 (0.839 to 0.931) ( P<0.05). Conclusions:Older age, higher preoperative FBG and HbA 1c levels, diabetes, intraoperative vitreous overflow and higher levels of aqueous humor IL-1β are important factors contributing to poor visual function recovery in patients undergoing refractive cataract surgery. The model constructed based on these indicators has a high predictive efficacy for postoperative visual function recovery in patients undergoing refractive cataract surgery.

【Objective】 To analyze the association of overweight and obesity with elevated blood pressure(BP) among children and adolescents in Mengzi City, in order to provide reference for making effective interventions. 【Methods】 A total of 30 classes of students in 14 schools were selected into this study by a stratified random cluster sampling method from October 2020 to September 2021. The paticipants completed a questionnaire survey, and had their height, weight and BP measured. Logistic regression analysis was used to evaluate the association of overweight and obesity with elevated BP. 【Results】 A total of 4 015 children and adolescents aged 7 - 17 years were involved in the study. The detection rate of overweight, obesity and elevated BP was 12.53%, 10.01% and 12.38%, respectively. The detection rate of elevated BP was 9.96%, 19.48% and 25.62% in normal weight, overweight and obese groups, respectively. The risk of elevated BP in the overweight and obese groups was 2.190 times(95%CI: 1.696 - 2.926, P<0.001) and 3.243 times(95%CI: 2.501 - 4.204, P<0.001) as high as that in normal weight groups. The dietary and exercise behaviors of 1 604 adolescents were analyzed, it was found that the detection rate of obesity was significntly higher in non-boarding students(15.09%) and those who consumed fresh fruits at least once a day(13.49%)(χ²=18.012, 7.225, P<0.05), the detection rate of elevated BP was significantly higher in among those who did not consume sugary beverages(16.88%), and performed moderate-to-high intensity physical exercise of 60 minutes or more ≤ 2 days per week(16.88%)(χ²=9.403, 14.921,P<0.01). 【Conclusions】 The risk of developing hypertension increases with the high prevalence of overweight and obesity and is strongly associated with multiple factors. Therefore, it is essential to conduct effective weight control and behavioral lifestyle interventions among children and adolescents.

Objective To investigate the knowledge and behavioral status of foot care among patients with type 2 diabetes in Xinjiekou Community in Beijing and analyze its influencing factors. Methods A convenient sampling method was used to select 278 diabetes patients from Xinjiekou Community in Beijing for questionnaire surveys, which included general information, foot care knowledge, and behaviors of the patients. Results The average score of foot care knowledge among the 278 patients was (71.65±14.59), indicating a moderate level overall. The average score of foot care behavior was (48.83±8.83), indicating a poor level overall. Multivariate stepwise regression analysis showed that gender, duration of diabetes, and whether the patients had received foot care education or not were independent influencing factors for both the foot care knowledge score and the foot care behavior score among community diabetes patients (P < 0.05). Pearson correlation analysis showed that a positive correlation between foot care knowledge and foot care behavior among community diabetes patients was observed(r=0.593, P < 0.001). Conclusion The level of foocare knowledge among diabetes patients in this community in Beijing is moderate, while the status of foot care behaviors is not optimistic. Community healthcare professionals should strengthen health education on foot care, improve patients' knowledge of foot care and compliance with foot care behaviors, and pay attention to male patients and those with a shorter duration of diabetes to reduce the occurrence of diabetic foot.

Objective: To explore cyberbullying and risk factors of middle school students, and to provide a reference for cyberbullying prevention in school settings. Methods: A stratified cluster random sampling method was used to select 12 940 students from three junior high schools and four senior high schools in Yixing City of Jiangsu Province, China, to conduct a questionnaire survey from March 1 to May 31, 2019. The Chi -square test was performed to compare differences in the prevalence of cyberbullying among groups with different sociodemographic characteristics, and the multivariate Logistic regression model was employed to analyze the risk factors. A risk predictive nomogram model was constructed and then verified. Results: Middle school students were found to be victims of cyberbullying at a rate of 12.3%. The Logistic regression results showed that alcohol use ( OR =1.93), lack of emotional management ( OR =1.30), feeling unsafe ( OR =1.70), not trusting people ( OR =1.66), increased daily online time ( OR =1.39), higher frequency of using social software or websites ( OR =2.24), poor relationships with family members ( OR =1.46), parental neglect ( OR =1.50), class leadership ( OR =1.30) and poor relationships with classmates ( OR =1.34) were risk factors for middle school students who were victims of cyberbullying ( P <0.05). Based on these 10 independent risk factors, the nomogram prediction model, had good discrimination ( AUC =0.73). Conclusion Cyberbullying is common among middle school students. Internet use, parental neglect and class leadership all have an impact on cyberbullying.

Objective:To analyze the status of neonatal respiratory distress syndrome (RDS) management in 10 hospitals in Northwest China over the past five years and to investigate the strategies for improving the prevention and treatment of RDS.Methods:This retrospective study involved premature infants with RDS who were admitted to the neonatal intensive care units (NICU) of 10 hospitals (six in Shaanxi Province, three in Gansu Province, and one in Xinjiang Uygur Autonomous Region) of the Northwest China Neonatal Collaborative Group within 3 d after birth from January 1 to December 31, 2016, and from January 1 to December 31, 2021. Basic information, perinatal condition, treatment approaches, complications, and prognosis of the patients were compared. T-test, rank sum, and Chi-square tests were used for statistical analysis. Result:(1) This study enrolled 322 premature infants with RDS in 2016 and 349 in 2021. Premature infants at the gestational age of 30 to 33 weeks were mainly affected, and the majority were male [64.3% (207/322) and 57.3% (200/349)]. The average maternal age in 2021 was older than that in 2016 [(30.6±4.8) years vs (28.6±5.4) years, t=24.02, P<0.001], and the proportion of women at advanced maternal age was also higher in 2021 [19.2% (67/349) vs 12.4% (40/322), χ2=4.18, P<0.05]. (2) The proportions of pregnancies conceived with assisted reproductive technologies [11.7% (41/349) vs 1.9% (6/322), χ2=25.12], underwent routine prenatal examinations [58.5% (204/349) vs 30.4% (98/322), χ2=53.33], exposed to steroids [62.2% (217/349) vs 28.6% (92/322), χ2=82.58] and delivered by cesarean section or elective cesarean section [73.6% (257/349) vs 51.6% (166/322), χ2=35.06; 24.1% (84/349) vs 6.5% (21/322), χ2=39.07], as well as the ratio of cesarean scar pregnancy [7.4% (26/349) vs 3.4% (11/322), χ2=5.23] were all higher in 2021 than those in 2016 (all P<0.05). Moreover, the incidence of fetal distress [30.1% (105/349) vs 20.2% (65/322), χ2=8.68], gestational hypertension [24.6% (86/349) vs 13.0% (42/322), χ2=14.59], premature rupture of membranes [16.0% (56/349) vs 10.2% (33/322), χ2=4.89], meconium-stained amniotic fluid [12.6% (44/349) vs 5.6% (18/322), χ2=9.83], placental abruption [10.3% (36/349) vs 5.3% (17/322), χ2=5.84], gestational diabetes mellitus [10.3% (36/349) vs 1.6%(5/322), χ2=22.41], chorioamnionitis [4.6%(16/349) vs 0.9% (3/322), χ2=8.12], thyroid dysfunction [4.3% (15/349) vs 0.6% (2/322), χ2=7.88] and heart disease [4.3% (15/349) vs 0.3% (1/322), χ2=9.17] were higher in 2021 than in 2016 (all P<0.05). (3) In 2021, the rate of pulmonary surfactant (PS) usage, the dosage of porcine PS, and the proportion of bovine PS usage were all significantly higher than those in 2016 [73.6% (257/349) vs 67.1% (216/322), χ2=11.62; (178.5±38.0) mg/kg vs (165.2±42.8) mg/kg, t=7.85; 47.9% (123/257) vs 19.4% (42/216), χ2=41.72; all P<0.01]. No significant difference in the incidence of intubation-surfactant-extubation (INSURE), early PS administration (≤2 h after birth), or the arterial blood gas values before and after PS treatment was found between the cases enrolled in 2021 and 2016. The duration of antibiotic treatment [7.0 d (5.0-14.0 d) vs 5.0 d (1.0-8.0 d), Z=7.55] and assisted ventilation [144 h (81-264 h) vs 73 h (47-134 h), Z=8.20] and the median hospital stay [24 d(14-42 d) vs 16 d (10-25 d), Z=6.74] were significantly longer in 2021 than in 2016 (all P<0.01). More patients required nasal intermittent positive pressure ventilation [29.6% (100/338) vs 1.0% (3/306), χ2=97.81] and conventional ventilation [42.6% (144/338) vs 30.1% (92/306), χ2=10.87] in 2021 as compared with those five years ago (both P<0.01). (4) In 2021, the incidence of patent ductus arteriosus [15.5% (54/349) vs 6.2% (20/322), χ2=63.40], bronchopulmonary dysplasia [9.2% (32/349) vs 2.8% (9/322), χ2=12.88], persistent pulmonary hypertension [5.4% (19/349) vs 0.6% (2/322), χ2=12.85], periventricular leukomalacia [4.3% (15/349) vs 1.2% (4/322), χ2=7.52] and pneumothorax [3.4% (12/349) vs 0.3% (1/322), χ2=9.68] increased as compared with those in 2016 (all P<0.05), while the incidence of nosocomial infection decreased significantly [7.4% (26/349) vs 19.6% (63/322), χ2=21.37, P<0.001]. (5) The cure rate of premature infants with RDS was 70.8% (247/349) in 2021, which was significantly higher than that in 2016 [56.2% (181/322), χ2=15.37, P<0.001]. Moreover, the rate of withdrawing treatment and the total mortality rate was lower in 2021 than in 2016 [7.7% (27/349) vs 14.3% (46/322), χ2=7.41; in-hospital: 1.4% (5/349) vs 5.6% (18/322), χ2=8.74; out of hospital: 8.3% (29/349) vs 13.7% (44/322), χ2=4.96; all P<0.05]. Conclusions:The clinical management of RDS in premature infants in the involved hospitals has been improved. However, there is room for improvement in prenatal examinations.

Objective:To explore the mediating effect of smoking, emotional control, and family relationship on the association between relational bullying victimization and perpetration.Method:A total of 11 462 participants were included in the study. Mediating effect model was used to analyze the mediating effect of smoking, emotional control, and family relationship between relational bullying victimization and perpetration.Results:Family relationship (mediation effect value: 0.119, 95% CI: 0.075-0.165, mediation ratio: 8.5%) and smoking (mediation effect value: 0.061, 95% CI: 0.031-0.105, mediation ratio: 4.4%) constitute a separate mediating effect. Family relationship, emotional control, and smoking constitute a chain mediation effect (mediation effect value: 0.007, 95% CI: 0.003-0.013, mediation ratio: 0.5%); family relationship and smoking constitute a chain mediation effect (mediation effect value: 0.036, 95% CI: 0.020-0.056, mediation ratio: 2.6%); emotional control and smoking constitute a chain mediating effect (mediation effect value: 0.007, 95% CI: 0.003-0.013, mediation ratio: 0.5%). Conclusion:Smoking, emotional control, and family relationship partially mediate relational bullying victimization and perpetration.

Objective:To investigate the epidemiology, evolution and transmission characteristics of HIV-1 CRF07_BC in Nanjing between 2015 and 2019 to provide scientific basis for precise prevention and control of HIV-1 transmission.Methods:Pol gene sequences of 319 patients with HIV-1 CRF07_BC infection in Nanjing were amplified and sequenced and a maximum likelihood phylogenetic tree was then constructed. Markov Chain Monte Carlo sampling method was used to generate Maximum Clade Credibility Tree. Bayesian Skyline Plot was used to reconstruct the changing trend of the effective population size. Pairwise gene distance method was used to construct molecular network to investigate the transmission features. Results:Among the 319 patients, 303 (95.0%) were male; 264 (82.8%) had multiple sexual partners; only 14 (4.4%) had been using condoms. Most of the infections were occurred in men who have sex with men (MSM), accounting for 77.4%. The maximum likelihood phylogenetic analysis of HIV-1 CRF07_BC revealed two clusters: Cluster1 and Cluster2. Cluster1 mainly contained the strains isolated from MSM and Cluster2 mainly consisted of the strains isolated from heterosexual patients. The most recent common ancestor was 2002.47(1999.91, 2005.43) year for Cluster1 and 1996.38(1992.55, 1999.76) year for Cluster2. The evolutionary rates (95% highest posterior density, 95%HPD) of Cluster1 and Cluster2 were 1.73×10 -3 (1.36×10 -3-2.16×10 -3) substitutions·site -1·year -1 and 2.09×10 -3 (1.50×10 -3 -2.79×10 -3 ) substitutions·site -1·year -1, respectively. The effective population sizes of Cluster1 and Cluster2 tended to be stable after 2002 and 2003, respectively. In addition, Cluster1 and Cluster2 formed eleven and eight unique branches, respectively, suggesting the possibility of divergent epidemics of this genotype. A total of 35 propagation clusters were formed in the molecular propagation network, including 92 Nanjing sequences with an average degree of 4.3. Males, MSM and people with multiple sexual partners were more likely to be connected to the network. Students and young patients were more likely to be connected to the network. Conclusions:HIV-1 CRF07_BC infection was characterized by low age, multiple sexual partners, unprotected behaviors and transmission among MSM in Nanjing from 2015 to 2019. It was recommended to pay more attention to students and young people, to formulate more effective prevention and control measures for high-risk sexual behaviors, and to carry out continuous molecular monitoring of CRF07_BC strain, so as to provide scientific basis for the prevention and control of HIV CRF07_BC.

OBJECTIVE: To survey the residents for their understanding of Coronavirus Disease 2019 (COVID-19)-related knowledge, attitude and practices (KAP) in two hard hit provinces of China to facilitate the governmental decisions on strategies against the disease. METHODS: We invited the participants from Hubei and Henan Provinces of China for an internetbased survey starting from 12:00 on February 21, 2020 to 12:00 on February 23. The survey included the general conditions, KAP of COVID-19, psychological status and living conditions of the residents. RESULTS: The effective response rate of the questionnaire was 98.9%. The mean (P25, P75) age of the participants was 19 (16, 40) years, and 54.3% of them were students. Social media were the most important source of information concerning the pandemic of the respondents. The respondents had a high awareness of person-to-person transmission of the virus through the respiratory tract or droplets but showed a relatively low level of awareness of the population susceptible to COVID-19 and its specific symptoms. The results of multivariate analysis showed that women, undergraduate students (including college students) and higher degree holders had better knowledge of COVID-19 ( < 0.05); the proportion of respondents who expressed to have different levels of psychological stressed such as worry, anxiety and panic reached 77.2%; 16.7% of the responders considered psychological interventions necessary for their psychological conditions; 63.6% of the respondents confessed a bias against the people returning from Hubei and Henan provinces, while 22.4% worried that they might be biased because of their residence in Hubei and Henan. The rate of personal protective equipment shortage was as high as 69.4%; the rates of the responders who would "covering the mouth and nose when coughing or sneezing", "properly use masks in accordance with regulations", "maintain proper hand hygiene ", "avoid gatherings with relatives and friends" and "refrain from going to public places" were 92.4%, 95.9%, 93.5%, 88.8% and 93.1%, respectively. Women and groups with good knowledge of the disease reported better protective behaviors against the diseases ( < 0.05). CONCLUSIONS The residents in Hubei and Henan Provinces have generally good KAP related to COVID-19, and the online platforms plays a positive role to in circulating epidemic-related information. It is essential to further increase the supply of the protective materials and pay more attention to the mental health of the residents during the pandemic, and psychological counseling and psychological protection should be provided if necessary.
Attitude ; Betacoronavirus ; Coronavirus Infections ; Female ; Humans ; Pandemics ; Pneumonia, Viral

ObjectiveTo search, appraise and summarize the best evidence of the diabetic foot assessment and provide a reference for the standardization of the clinical diabetic foot evaluation in China. MethodsOn the computer, the following websites as well as databases were searched: National Guideline Clearinghouse(NGC) of the USA, Registered Nurses' Association of Ontario(RNAO), National Institute for Health and Care Excellence(NICE) of UK, the Scottish Intercollegiate Guidelines Network(SIGN), New England Guidelines Group(NEGG), International Guidelines Network(IGN), American Center for Disease Control and Prevention(ACDC), World Council of Enterostomal therapists(WCET), Wound Ostomy Continence Nurses Society(WOCN), the International Working Group on Diabetic Foot(IWGDF), American Society for Wound Healing, American Diabetes Association(ADA), American Society for Vascular Surgery(ASVS), Society of Endocrinology of Chinese Medical Association, Clinical evidence, PubMed, ProQuest, Web of Science, Clinical Key, CINAHL, Best Practice, CNKI, VIP, Wanfang Data, Medlive from January of 2010 to July of 2018 about all evidence-based clinical practice guidelines and systematic reviews on assessment of diabetic foot. Two researchers evaluated the quality of the articles and performed materials extraction, and extracted the evidence from the qualified articles. ResultsA total of 7 articles were included among which 6 were guidelines and 1 was systemic review. After analyzing them, 9 categories and 32 items of the best evidence contents about diabetic foot assessment were concluded. ConclusionsThis study summarizes the best evidence for assessment of diabetic foot and provide evidence basis for medical institutions to improve clinical practice of diabetic foot assessment. When applying the evidence into clinical practice, it is necessary to evaluate specific situations, consider patients' values and willingness and select targeted evidence accordingly.