: To analyze the prevalence of anemia and iron deficiency among primary and secondary school students in Rural Nutrition Improvement Program areas of Guizhou Province in 2023, and to explore the related factors, so as to provide evidence for Rural Nutrition Improvement Program optimization. Methods: In September 2023, a stratified random cluster sampling strategy was used to select 40 rural compulsory education schools with rural nutrition improvement program in five counties of Guizhou Province. School level questionnaire was employed to collect information of basic characteristics and school meal implementation. A total of 7 826 primary and secondary school students aged 6-16 underwent anthropometry and hemoglobin (Hb) determination; serum ferritin (SF) was additionally measured in a random subsample of 1 795 pupils. Students in Grade 3 and above also completed a questionnaire covering demographic characteristics, dietary behaviours and nutrition knowledge. Group comparisons were conducted by Chi square test or Fisher s exact test, and multivariable Logistic regression models were constructed to identify factors associated with anemia and iron deficiency. Results: The overall Hb level was (133.21±12.95)g/L, with an anemia prevalence of 7.17%. The overall SF level was (69.58±59.01)μg/L, with an iron deficiency prevalence of 2.73%. Multivariable analysis showed that stunting ( OR =1.88), school menus without nutrient calculation ( OR =1.61) and absence of menu planning software in the current semester ( OR =2.34) independently increased anemia risk, whereas obesity reduced it ( OR =0.54) (all P <0.05). Girls ( OR =4.16) and Grades 7-9 ( OR =5.93) increased iron deficiency risk (both P <0.05). Compared with rarely eating fresh vegetables, students with consuming <3 kinds per day ( OR =0.08) or exactly 3 kinds per day ( OR =0.06) had lower iron deficiency risks (both P <0.05). Conclusions Anemia and iron deficiency are prevalent among primary and secondary school students in Guizhou. Targeted intervention measures should be implemented for key populations to enhance the effectiveness of nutrition improvement program.

ObjectiveTo investigate the effect of Semaphorin 3A （Sema3A） on the progression of pathological cardiac hypertrophy. MethodsWild-type C57BL 6J mice， Sema3A global overexpressing （Sema3A/Cre-ER^TM） mice， and their littermate controls （Cre-ER^TM） were used， with 6 mice per group. A pressure-overload induced cardiac hypertrophy model was established via transverse aortic constriction （TAC）， with a sham-operated group （Sham） as the control. Cardiac hypertrophy was assessed by gross morphology， heart weight/body weight ratio （HW/BW）， heart weight/tibia length ratio （HW/HL）， and heart weight/lung weight ratio （HW/PW）. Cardiac function was evaluated by measuring ejection fraction （EF） and fractional shortening （FS） via echocardiography. In heart tissues， the mRNA level of atrial natriuretic peptide （ANP） and Sema3A were detected by RT-qPCR， Sema3A protein level was detected by western blot， morphological structure was detected by hematoxylin and eosin （HE） staining， level of fibrosis was detected by Masson’s trichrome staining， and angiogenesis was detected by immunohistochemical detection of CD31. For in vitro experiments， rat H9C2 cardiomyocytes were treated with angiotensin Ⅱ （Ang Ⅱ） to induce hypertrophy， with PBS-treated cells as the control. After 48 hours， the mRNA expression of ANP， B-type natriuretic peptide （BNP） and Sema3A were measured by RT-qPCR， and Sema3A protein level was assessed by western blot. ResultsAt the animal level， compared with the sham group， mice subjected to TAC showed significantly increased mRNA levels of ANP in cardiac tissue， as well as markedly elevated mRNA and protein levels of Sema3A （all P<0.05）. Compared with the Cre-ER^TM + TAC group， the Sema3A/Cre-ER^TM + TAC group exhibited more pronounced cardiac hypertrophy， greater ventricular wall thickening， higher HW/BW， HW/HL， and HW/PW ratios， more significant reductions in EF and FS， more severe cardiac fibrosis， and a significant decrease in cardiac CD31 expression levels （all P<0.05）. At the cellular level， compared with the control group， H9C2 cells treated with Ang Ⅱ displayed significantly increased mRNA levels of ANP and BNP， along with markedly elevated mRNA and protein levels of Sema3A （all P<0.05）. ConclusionSema3A promotes the progression of pressure overload-induced cardiac hypertrophy by inhibiting angiogenesis.

Objective To summarize and analyze the clinical efficacy of negative pressure suction bell in the treatment of young children (≤6 years) with pectus excavatum. Methods The relevant clinical medical records of the children with pectus excavatum who received negative pressure suction bell treatment in the Outpatient Department of Children’s Hospital of Chongqing Medical University from May 2019 to January 2023 were collected. The age, sex, type, severity, depth of depression, duration of use and prognosis of children with pectus excavatum were retrospectively analyzed. Results A total of 100 pediatric patients were ultimately included in the study, comprising 74 males and 26 females. The age distribution was 57 patients aged 0-3 years and 43 patients aged 3-6 years. All patients were prescribed and used a negative pressure suction device for at least 3 months, after which they returned to our department's outpatient clinic for follow-up. The treatment demonstrated clinical effectiveness in 99 patients, yielding an efficacy rate of 99.00%. The excellent/good rate was 52.00%, and the complication rate was 8.00%. After treatment, the Haller index and the depth of sternal depression were reduced compared with those before treatment (P<0.001), and there was no statistical difference in the effective rate and excellent/good rate between different genders, different ages, different types of pectus excavatum, or different severity (P＞0.05). Conclusion Negative pressure suction bell is safe and effective in the treatment of young children (≤6 years) with pectus excavatum, and the correction effect has nothing to do with gender, type and severity.

Central venous pressure(CVP)is a commonly used hemodynamic index in clinical practice,and the accuracy of its measurement results is influenced by the measurement technical specifications.Based on research evidence and clinical practice,this article interprets the main content of the group standard of CVP measurement technology,and proposes suggestions for its use.It aims to guide clinical nursing staff to correctly understand the principles and methods of CVP measurement,and promote the standardization of nursing practice and the accuracy of measurement results.

Dysfunction of the diaphragm is a common problem in mechanically ventilated patients and is closely related to various adverse outcomes.This review summarizes the evaluation methods of diaphragm function,the association between diaphragm dysfunction and adverse clinical outcomes in critically ill mechanically ventilated patients,and the protective effect of diaphragm function on adverse outcomes related to mechanical ventilation.The aim is to provide references for medical staff to optimize evaluation techniques,develop personalized nursing plans,and improve patients' quality of life and health outcomes.

Objective To explore the diagnostic value of serum sex hormone binding globulin(SHBG),in-sulin-like growth factor-1(IGF-1)and bone age index(BAI)in girls with precocious puberty(PP).Methods A total of 220 girls with PP who were treated in this hospital from January 2022 to August 2024 were selected as the research subjects.The research subjects were divided into 104 children with central preco-cious puberty(CPP,CPP group)and 116 children with simple premature thelarche(SPT,SPT group)accord-ing to the type of the patients' disease.Another 110 girls with normal physical examination and development during the same period were selected as the control group.The levels of serum SHBG and IGF-1 in each group were determined and BAI was calculated.The diagnostic efficacy of the combined detection of serum SHBG,IGF-1 and BAI for CPP was analyzed through the receiver operating characteristic curve,and the correlation between serum SHBG,IGF-1,BAI and sex hormone indicators in girls with PP was analyzed by Pearson corre-lation analysis.Results The levels of height,basal follicle-stimulating hormone(FSH),basal luteinizing hor-mone(LH),and estradiol(E2)in the CPP group and the SPT group were higher than those in the control group,and the differences were statistically significant(P＜0.05).The serum SHBG levels in the CPP group and the SPT group were lower than those in the control group,and the differences were statistically significant(P＜0.05).The serum IGF-1 and BAI in the CPP group and the SPT group were higher than those in the control group,and the differences were statistically significant(P＜0.05).The area under the curve(AUC)of the three combined diagnoses of PP in girls was 0.941,which was significantly larger than those of IGF-1 and BAI(Z=8.140,9.470,both P＜0.05).The AUC of the three combined diagnoses of CPP in girls was 0.958,which was significantly higher than those of the single tests of serum SHBG,IGF-1,and BAI(Z=2.821,7.363,6.412,all P＜0.05).The levels of serum SHBG in PP of girls were negatively correlated with those of IGF-1,BAI,basal FSH,basal LH and E2(P＜0.05).Serum IGF-1 was positively correlated with BAI,basal FSH and basal LH(P＜0.05),but not correlated with E2(P＞0.05).BAI was positively correla-ted with the levels of basal FSH,basal LH and E2(P＜0.05).Conclusion The combination of serum SHBG and IGF-1 with BAI has certain diagnostic value for PP in girls,especially for the diagnosis of CPP,which is significantly superior to a single test.

Objective:To compare the impact of the AlignRT-based optical guidance method with the traditional marker line method on the accuracy of positioning, and explore the effect of patient′s different thoracic characteristic parameters on the precision of optical guidance positioning.Methods:A total of sixty breast cancer patients who received post breast-conserving radiotherapy at Anhui Cancer Hospital from July 2022 to September 2023 were retrospectively selected. Then these patients were equally divided into traditional cross hairs set-up (marker line group) and surface-guided set-up (SGRT group). The cone-beam CT scanning results were used as the gold standard, the three-dimensional set-up errors and the CTV-PTV target area external radiotherapy boundaries of two groups were studied comparatively. Multiple patient′s thoracic characteristic parameters were defined and the correction between each parameter and set-up error of SGRT was analyzed.Results:The mean value of three-dimensional set-up errors in the SGRT group and the marker line group was within 0.2 cm and 0.5 cm, respectively. The differences in three-dimensional set-up errors and total displacements between two groups were statistically significant ( z=-2.93, -3.21, -2.59, -4.76, P<0.05). The SGRT group reduced the CTV-PTV boundary from 0.5 cm of conventional marker line group to 0.3 cm. The thoracic aspect ratio H/W, the affected side pinch angle α1, and the healthy side pinch angle α2 were positively correlated with the x-direction posing error ( r=0.49, 0.59, 0.71, P<0.05); whereas, the affected side and the healthy side mammary gland heights D1 and D2 were negatively correlated with the z-direction posing error ( r=-0.46, -0.49, P<0.05). Conclusions:For breast-conserving postoperative radiotherapy patients, SGRT can obtain a more accurate radiotherapy set-up than the traditional marker line method, and can effectively reduce the target area externally expanded range. Meanwhile, the monitoring accuracy of SGRT is affected by the patient′s thoracic characteristic parameters, and clinical attention should be paid to breast-conserving radiotherapy patients with thick body shape, narrow body width, and small breast glands.

OBJECTIVE To explore the changes of microribonucleic acid(miR)-223,miR-155 and miR-125 in the neonates with sepsis and analyze the distribution of pathogens so as to provide bases for clinical diagnosis and treatment of neonates with sepsis.METHODS A total of 39 neonates with sepsis who were treated in Jinan Second Maternal and Child Health Hospital from May 2021 to May 2023 were enrolled in the study and were assigned as the study group,meanwhile,42 healthy neonates who were born in the hospital were chosen as the control group.The distribution and drug resistance of the pathogens isolated from the neonates of the study group were statistically analyzed.The relative expression levels of peripheral blood miR-223,miR-155 and miR-125 were com-pared between the two groups,and the values of the three indexes in diagnosis of neonatal sepsis were analyzed.RESULTS Totally 46 strains of pathogens were isolated from the 39 neonates with sepsis,20 of which were Escherichia coli,and 10 were Staphylococcus aureus.The E.coli strains were resistant to ampicillin,tetra-cycline,ciprofloxacin and cefazolin;the S.aureus strains were resistant to penicillin,erythromycin,cefazolin and clindamycin,with the drug resistance rates higher than 50％.The expression level of miR-223 of the study group was 2.13±0.70,higher than that of the control group,the expression level of miR-125 of the study group was 0.92±0.30,higher than that of the control group;while the expression level of miR-155 of the study group was 2.08±0.68,lower than that of the control group(P＜0.05).The area under the curve(AUC)of the joint detec-tion of miR-223,miR-155 and miR-125 was 0.945 in diagnosis of neonatal sepsis,with the sensitivity 92.31％,the specificity 88.10％.CONCLUSIONS E.coli and S.aureus are dominant among the pathogens isolated from the neonates with sepsis.The neonates with sepsis show abnormal expressions of peripheral blood miR-223,miR-155 and miR-125,and the joint detection of the three indexes has high value in diagnosis of neonatal sepsis.

Dysfunction of the diaphragm is a common problem in mechanically ventilated patients and is closely related to various adverse outcomes.This review summarizes the evaluation methods of diaphragm function,the association between diaphragm dysfunction and adverse clinical outcomes in critically ill mechanically ventilated patients,and the protective effect of diaphragm function on adverse outcomes related to mechanical ventilation.The aim is to provide references for medical staff to optimize evaluation techniques,develop personalized nursing plans,and improve patients' quality of life and health outcomes.

Objective:To explore the prognostic influencing factors of patients with pulmonary large cell neuroendocrine carcinoma (LCNEC), to develop a nomogram-based predictive model for the overall survival (OS) of LCNEC patients and to make validation.Methods:The clinical data of 2 947 patients with LCNEC in the Surveillance, Epidemiology, and End Results (SEER) database (the modeling group) and 147 patients with LCNEC in Beijing Chest Hospital Affiliated to Capital Medical University from 2010 to 2023 (the validation group). The data of patients in the both groups were compared. Cox proportional hazards model was used to screen out the factors influencing the OS of patients with LCNEC. A nomogram model was constructed to predict the OS based on the multivariate analysis result. Internal validation of the predictive model's performance was conducted through 500 repeated samplings based on the Bootstrap method. The predictive performance of the nomogram model was evaluated by using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. The consistency index (CI) was used to analyze the discrimination of the nomogram model in predicting the survival of LCNEC patients; calibration curves were used to analyze the consistency between the survival predicted by the nomogram model and the actual survival outcomes; and the decision curve analysis (DCA) was used to assess the net benefit of the model for actual clinical decision-making.Results:The differences in the proportions of patients with different age, gender, race, tumor staging, N stage, M stage, hepatic metastasis or not, pulmonary metastasis or not, chemotherapy and radiotherapy or not between the modeling group and the validation group were statistically significant (all P < 0.05). The median OS time of LCNEC patients in the modeling group was 14.0 months, with the 1-year OS rate of 53.3% and the 5-year OS rate of 21.2%; the median OS time of LCNEC patients in the validation group was 17.5 months, with the 1-year OS rate of 58.7%; there was no statistically significant difference in OS between the 2 groups ( P = 0.280). In the modeling group, the median OS time of female and male LCNEC patients was 18.0 and 12.0 months, respectively, and the difference in OS between the 2 groups was statistically significant ( P < 0.05); for patients with stage Ⅰ-Ⅱ, Ⅲ, and Ⅳ LCNEC, the median OS time was 48.0, 16.0, and 6.0 months, respectively, and the difference in OS among the 3 groups was statistically significant ( P < 0.05); the median OS time of patients receiving surgery and not receiving surgery was 28.0 and 8.0 months, respectively, and the difference in OS between the 2 groups was statistically significant ( P < 0.05). The differences in OS among female and male, patients in stages Ⅰ-Ⅱ, Ⅲ and Ⅳ, patients who underwent surgery or not were statistically significant (all P < 0.05). The results of multivariate Cox regression analysis in the modeling group showed that patients aged >60 years old (>60 years old vs. ≤60 years old: HR = 1.234, 95% CI: 1.114-1.367, P < 0.01), M 1 stage (M 1 stage vs. M 0 stage, HR = 2.646,95% CI: 2.385-2.935, P < 0.001), T 2-4 stage (T 2-4 stage vs. T 1 stage: HR = 1.199, 95% CI: 1.147-1.252, P < 0.001), N 1-3 stage (N 1-3 stage vs. N 0 stage: HR = 1.281, 95% CI: 1.225-1.340, P < 0.001) were independent risk factors of the OS in patients with LCNEC; female (female vs. male: HR = 0.877, 95% CI: 0.805-0.956, P = 0.003), surgery (yes vs. no: HR = 0.612, 95% CI: 0.554-0.676, P < 0.001), chemotherapy (yes vs. no: HR = 0.520, 95% CI: 0.470-0.575, P < 0.001) were independent protective factors of the OS in patients with LCNEC. A nomogram model for predicting 1, 3, and 5-year OS rates of LCNEC patients was constructed based on age, gender, T stage, N stage, M stage, surgery and chemotherapy. The result of ROC curve analysis indicated that the AUC of the nomogram model for predicting 1, 3, and 5-year OS rates in the modeling group was 0.822, 0.821 and 0.821, respectively, while the AUC of 1-year OS rate predicted by the validation group was 0.660. The CI of the modeling group and the validation group was 0.756 and 0.660, respectively. The calibration curve showed that 1, 3, and 5-year OS rates predicted by the modeling group were highly consistent with the actual OS rates. The DCA showed that the nomogram model for predicting OS in the modeling group and the validation group both had good clinical net benefits. Conclusions:The constructed nomogram model for predicting the prognosis of LCNEC patients is proved to be reliable and has good clinical values.