ObjectiveTo investigate the mechanism of action of remifentanil （RMZL） in alleviating lung ischemia-reperfusion injury （LIRI） in rats by inhibiting pyroptosis through modulating hypoxia inducible factor-1α （HIF-1α）/NOD-like receptor thermal protein domain associated protein 3 （NLRP3） pathway. MethodsRats were stochastically assigned into Control group， LIRI group， RMZL low-dose group， RMZL medium-dose group， RMZL high-dose group， and RMZL high-dose+HIF-1α activator dimethyloxallyl glycine （DMOG） group， with 18 rats in each group. Rats in Control group only had their left pulmonary hilum free and did not undergo ischemia-reperfusion treatment. Except for the Control group， LIRI models were constructed in all other groups. Rats in LIRI group were intraperitoneally injected with an equal amount of physiological saline 15 minutes before constructing LIRI model； rats in Control group were intraperitoneally injected with an equal amount of physiological saline 15 minutes before freeing left pulmonary hilum； rats in other groups were intraperitoneally injected with corresponding dose of drug 15 minutes before constructing LIRI model. The wet/dry weight ratio of lungs was calculated. HE staining was used to study lung tissue pathology. Immunofluorescence staining was used to detect the relative fluorescence intensity of gasdermin D （GSDMD） and NLRP3 double positive cells in lung tissue. ELISA was used to detect interleukin-1β and IL-18 in lung tissue. Western blot was used to detect HIF-1α， NLRP3， cysteine-aspartic protease-1 （Cleaved caspase-1）， and gasdermin D-N （GSDMD-N） proteins in lung tissue. ResultsCompared to the Control group， the LIRI group showed disordered alveolar structure， thickened alveolar septa， and abundant inflammatory cell infiltration in rats. The lung wet/dry weight ratio， relative fluorescence intensity of GSDMD and NLRP3 double positive cells in lung tissue， IL-1β， IL-18 levels， and HIF-1α， NLRP3， Cleaved caspase-1， and GSDMD-N proteins increased （P0.05）. For the LIRI group， rats in the RMZL low， medium， and high-dose groups displayed attenuated alveolar septal thickening and reduced inflammatory cell infiltration. The lung wet/dry weight ratio， relative fluorescence intensity of GSDMD and NLRP3 double positive cells in lung tissue， IL-1β， IL-18 levels， and HIF-1α， NLRP3， Cleaved caspase-1， and GSDMD-N proteins declined， and the RMZL high-dose group showed the most prominent trend （P0.05）. Compared with the RMZL high-dose group， rats in the RMZL high-dose+DMOG group exhibited thickened alveolar septa and more inflammatory cell infiltration， along with increased lung wet/dry weight ratio， relative fluorescence intensity of GSDMD and NLRP3 double positive cells in lung tissue， levels of IL-1β and IL-18， and protein expression of HIF-1α， NLRP3， Cleaved caspase-1， and GSDMD-N （P0.05）. ConclusionRMZL may inhibit pyroptosis in LIRI rats by suppressing HIF-1α/NLRP3 pathway.

Objective: To understand the allocation and use of safety seats for preschool children and explore its related factors, so as to provide a scientific reference for promoting the usage of safety seats. Methods: A stratified random cluster sampling method was used to select 3 143 parents of preschool children aged 3 to 6 from six kindergartens in Shunyi District, Beijing from January 3 to 10, 2022. An online questionnaire survey was conducted to collect and evaluate the equipment and use of child safety seats in different characteristics of preschool children, as well as their scores of health beliefs. Multiple factor Logistic regression analysis was used to investigated the related factors of safety seat configuration and use. Results: The equipping rate and usage rate of safety seats for preschool children were 66.56% and 58.45%, respectively. The proportion of equipped and used safety seats for preschool children in core families (69.52%, 62.23%) were higher than that in large families (64.35%, 55.62%), only child families ( 72.39 %, 64.87%) were higher than non only child families (61.49%, 52.86%), and urban families (71.63%, 63.04%) were higher than rural families (52.31%, 45.51%) ( χ 2=9.23, 13.86; 41.72, 46.44; 101.96 ,76.97,all P <0.05) . As the educational level of parents ( χ 2 trend =154.23,98.76) and annual income of the family ( χ 2 trend =155.78,127.69) rised, the reporting rates of the equipped and used child safety seats in the family also increased(all P <0.05 ). There were statistically significant differences in the scores of different dimensions of health beliefs for the provision ( t =-20.22-18.16) and use ( t =24.32-24.17) of safety seats for preschool children(all P <0.05). After adjusting for child sex, child age, family annual income, parental education level, family type, whether the child was an only child, and place of residence，multivariate Logistic regression analysis showed that preschool children with higher perceived susceptibility score( OR =1.11, 1.08), higher self efficacy score( OR =1.23, 1.33), and higher suggestive factors score( OR =1.08, 1.12) were more likely to have and use safety seats in their families, while preschool children with higher perceived impairments score( OR =0.82, 0.80) were less likely to have and use safety seats in their families (all P <0.05). Conclusions The installation rate of child safety seats needs to be improved, and there is also a certain gap in their use after installation. Parents of preschool children should improve susceptibility and self efficacy to safety seat equipment and use, and perceptual barriers should be reduced.

Objective: To understand the current status and related factors of oral health behavior in preschool children, so as to provide scientific basis for improving parents oral health care abilities. Methods: From March 5 to 12, 2024, using a stratified cluster sampling method, an online questionnaire survey was conducted among parents of 1 381 preschool children aged 3-6 from 6 selected kindergartens of a district in Beijing. A structural equation model (SEM) was constructed based on the Theory of Planned Behavior framework to analyze the factors associated with preschool children s oral health behaviors. Results: The rates of parental assistance in brushing teeth, regular oral examination, and postprandial rinsing were 44.4%, 18.6% and 23.6%, respectively. Attitude, subjective norms were positively correlated with oral health behavior intention ( r =0.61, 0.55); attitude, perceived behavioral control, and behavioral intention were positively correlated with oral health behavior ( r =0.14, 0.13, 0.16) (all P < 0.01 ). The results of the SEM showed that attitude and subjective norms had a significant direct effect on oral health behavior intention ( β = 0.42 , 0.40), and the direct effect of perceived behavioral control on oral health behavior was statistically significant ( β =0.42) (all P <0.01). Conclusions The overall level of oral health behavior among preschool children needs to be improved. Perceived behavioral control is the most direct positive related factor of oral health behavior. In the future, intervention measures should focus on perceived behavioral control as the entry point and provide systematic intervention guidance in combination with planned behavior theory.

Objective: To investigate the health literacy level and its influencing factors among the elderly in Shunyi District, Beijing Municipality, so as to provide the evidence for developing health literacy intervention measures and improving the elderly's health literacy level. Methods: From September to November 2024, permanent residents aged ≥60 years in Shunyi District were selected by a multi-stage random sampling method combined with probability proportionate to size sampling method. The Chinese Elderly Health Literacy Questionnaire was used to conduct face-to-face surveys on basic information, health status, and health literacy. The health literacy level of the elderly was analyzed. Multivariable logistic regression model and decision tree model were used to analyze the influencing factors for health literacy level of the elderly. Results: There were 285 males (47.50%) and 315 females (52.50%). The mean age was (68.91±7.38) years. The health literacy level of the elderly was 14.33%. The literacy levels of basic concepts, basic knowledge, and basic skills were 43.33%, 5.33%, and 50.83%, respectively. The literacy levels of scientific aging concept, intrinsic capacity and geriatric syndromes, healthy lifestyle, information acquisition and self-care, health service utilization and chronic disease management, and safety and first aid were 52.33%, 7.17%, 51.83%, 58.83%, 72.00%, and 4.33%, respectively. Multivariable logistic regression analysis showed that educational level (high school/technical secondary school/technical school and above, OR=2.376, 95%CI: 1.020-5.532), monthly household income per capita (1 000-<3 500 yuan, OR=2.973, 95%CI: 1.349-6.555), residence (urban, OR=3.836, 95%CI: 2.071-7.105), and health attention (relatively concerned, OR=4.164, 95%CI: 1.779-9.742) were influencing factors for health literacy level of the elderly. Decision tree model results showed that educational level, monthly household income per capita, residence, and health attention were influencing factors for health literacy level of the elderly, with residence being the main influencing factor. Elderly people living in urban areas, relatively concerned about health, and with high school/technical secondary school/technical school and above educational level had higher health literacy level (40.00%). Conclusions The health literacy level of the elderly in Shunyi District is mainly affected by educational level, monthly household income per capita, residence, and health attention. It is recommended to focus on rural elderly with lower educational level, monthly household income per capita, and health attention.

Objective To investigate the relationship between cerebral perfusion status,blood pressure variability,and prognosis in patients with moyamoya disease following cerebral revascularization.Methods A retrospective analysis was conducted on 108 patients who underwent their first combined cerebral revascularization between January 2019 and July 2022 at the Department of Neurosurgery,First Affiliated Hospital of Henan University,and Henan Provincial People's Hospital.Based on postoperative cerebral perfusion improvement,patients were categorized into a"good"group and a"general"group.Baseline characteristics,key imaging parameters,blood pressure variability,and symptom scores were compared and analyzed between the two groups.Results In this study,there were 55 cases in the good group and 53 cases in the general group.According to the comparative analysis of the postoperative indicators between the good group and the general group,Statistically significant differences were observed in symptom improvement[42(79.25%)vs.52(94.55%)],TIA[22(41.51%)vs.11(20.00%)],and cerebral infarction[6(11.32%)vs.0(0.00%)],mRS score and the Matsushima classification(P<0.05).However,there was no statistically significant difference in the BPV-related index between the two groups of patients before the operation(all P>0.05).When comparing nine blood pressure variability(BPV)-related indices including the mean of 24-hour,daytime,and nighttime systolic blood pressure,coefficient of variability(CV),and average real variability(ARV)between the two groups,no significant differences were observed in the BPV-related indices before surgery between the two groups(P>0.05).The differences in the BPV-related indices before and after surgery(postoperative index-preoperative index)between the two groups were statistically significant(P<0.05).Postoperative cerebral perfusion status was positively correlated with prognosis and negatively correlated with BPV.Conclusion Patients with good improvement in cerebral perfusion status after combined revascularization for moyamoya disease have less blood pressure variability and better prognosis.

Objective:To investigate the clinical efficacy of endoscopic lumbar interbody fusion (Endo-LIF) versus minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of lumbar disc herniation in older adult patients. Methods:The medical records of 120 older adult patients with lumbar disc herniation who underwent surgical treatment at Tunliu Hospital, The Second People's Hospital of Changzhi from January 2021 to January 2023 were retrospectively collected. According to different surgical methods, the patients were divided into the Endo-LIF group and the MIS-TLIF group, with 60 patients in each group. Surgery-related indicators, Visual Analog Scale score, Oswestry Disability Index score, the Japanese Orthopaedic Association score, imaging indicators, complications, and patient satisfaction were compared between the two groups.Results:Patients in the Endo-LIF group had shorter surgery duration [(76.29 ± 8.35) minutes vs. (80.85 ± 9.15) minutes, t = -11.93, P < 0.001], less intraoperative bleeding [(31.37 ± 4.57) mL vs. (45.47 ± 6.26) mL, t = -9.66, P < 0.001], shorter postoperative bed rest duration [(1.02 ± 0.54) days vs. (2.51 ± 0.83) days, t = -5.49, P = 0.042], and shorter hospital stay [(5.25 ± 1.67) days vs. (7.43 ± 2.82) days, t = -5.16, P = 0.039] compared with the MIS-TLI group. The Endo-LIF group had more intraoperative fluoroscopy sessions [(7.62 ± 2.63) times vs. (6.91 ± 1.84) times, t = 8.53, P < 0.001] compared with the MIS-TLI group. There were no statistically significant differences in Visual Analog Scale score, Oswestry Disability Index score, or Japanese Orthopaedic Association score between the two groups before and after intervention (all P > 0.05). There were no significant differences in intervertebral height index and range of motion of the affected segments between the two groups before and after intervention (both P > 0.05). The incidence of complications did not differ significantly between the two groups ( P > 0.05). However, patient satisfaction was higher in the Endo-LIF group compared with the MIS-TLI group [91.67% (55/60) vs. 78.33% (13/60), χ2 = 4.18, P = 0.041]. Conclusions:The postoperative recovery indicators at 3 months were comparable between the Endo-LIF and MIS-TLI procedures; however, the surgical indicators for the Endo-LIF procedure were more favorable. Therefore, Endo-LIF is recommended for older adult patients with lumbar disc herniation.

Objective To investigate the relationship between cerebral perfusion status,blood pressure variability,and prognosis in patients with moyamoya disease following cerebral revascularization.Methods A retrospective analysis was conducted on 108 patients who underwent their first combined cerebral revascularization between January 2019 and July 2022 at the Department of Neurosurgery,First Affiliated Hospital of Henan University,and Henan Provincial People's Hospital.Based on postoperative cerebral perfusion improvement,patients were categorized into a"good"group and a"general"group.Baseline characteristics,key imaging parameters,blood pressure variability,and symptom scores were compared and analyzed between the two groups.Results In this study,there were 55 cases in the good group and 53 cases in the general group.According to the comparative analysis of the postoperative indicators between the good group and the general group,Statistically significant differences were observed in symptom improvement[42(79.25%)vs.52(94.55%)],TIA[22(41.51%)vs.11(20.00%)],and cerebral infarction[6(11.32%)vs.0(0.00%)],mRS score and the Matsushima classification(P<0.05).However,there was no statistically significant difference in the BPV-related index between the two groups of patients before the operation(all P>0.05).When comparing nine blood pressure variability(BPV)-related indices including the mean of 24-hour,daytime,and nighttime systolic blood pressure,coefficient of variability(CV),and average real variability(ARV)between the two groups,no significant differences were observed in the BPV-related indices before surgery between the two groups(P>0.05).The differences in the BPV-related indices before and after surgery(postoperative index-preoperative index)between the two groups were statistically significant(P<0.05).Postoperative cerebral perfusion status was positively correlated with prognosis and negatively correlated with BPV.Conclusion Patients with good improvement in cerebral perfusion status after combined revascularization for moyamoya disease have less blood pressure variability and better prognosis.

Objective:To investigate the clinical efficacy of endoscopic lumbar interbody fusion (Endo-LIF) versus minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of lumbar disc herniation in older adult patients. Methods:The medical records of 120 older adult patients with lumbar disc herniation who underwent surgical treatment at Tunliu Hospital, The Second People's Hospital of Changzhi from January 2021 to January 2023 were retrospectively collected. According to different surgical methods, the patients were divided into the Endo-LIF group and the MIS-TLIF group, with 60 patients in each group. Surgery-related indicators, Visual Analog Scale score, Oswestry Disability Index score, the Japanese Orthopaedic Association score, imaging indicators, complications, and patient satisfaction were compared between the two groups.Results:Patients in the Endo-LIF group had shorter surgery duration [(76.29 ± 8.35) minutes vs. (80.85 ± 9.15) minutes, t = -11.93, P < 0.001], less intraoperative bleeding [(31.37 ± 4.57) mL vs. (45.47 ± 6.26) mL, t = -9.66, P < 0.001], shorter postoperative bed rest duration [(1.02 ± 0.54) days vs. (2.51 ± 0.83) days, t = -5.49, P = 0.042], and shorter hospital stay [(5.25 ± 1.67) days vs. (7.43 ± 2.82) days, t = -5.16, P = 0.039] compared with the MIS-TLI group. The Endo-LIF group had more intraoperative fluoroscopy sessions [(7.62 ± 2.63) times vs. (6.91 ± 1.84) times, t = 8.53, P < 0.001] compared with the MIS-TLI group. There were no statistically significant differences in Visual Analog Scale score, Oswestry Disability Index score, or Japanese Orthopaedic Association score between the two groups before and after intervention (all P > 0.05). There were no significant differences in intervertebral height index and range of motion of the affected segments between the two groups before and after intervention (both P > 0.05). The incidence of complications did not differ significantly between the two groups ( P > 0.05). However, patient satisfaction was higher in the Endo-LIF group compared with the MIS-TLI group [91.67% (55/60) vs. 78.33% (13/60), χ2 = 4.18, P = 0.041]. Conclusions:The postoperative recovery indicators at 3 months were comparable between the Endo-LIF and MIS-TLI procedures; however, the surgical indicators for the Endo-LIF procedure were more favorable. Therefore, Endo-LIF is recommended for older adult patients with lumbar disc herniation.

Objective: To investigate the smoking cessation intention and attempt to quit smoking among smokers at ages of 15 years and older in a district of Beijing Municipality, so as to provide insights into formulation of tobacco control interventions. Methods: Permanent residents at ages of 15 years and older were sampled using a multi-stage stratified cluster sampling method from a district in Beijing Municipality, and all smokers were recruited. Participants' demographic features, tobacco use, intention to quit smoking, attempts to quit smoking and awareness of tobacco-related hazards were collected using the Beijing Adult Tobacco Survey. The intention and attempts to quit smoking were analyzed among smokers, and factors affecting the attempt to quit smoking were identified using a multivariable logistic regression model. Results: A total of 687 smokers were surveyed, including 669 men (97.38%), 497 from rural areas (72.34%), 351 daily smokers (51.09%), 336 occasional smokers (48.91%), 329 with intention to quit smoking (47.89%), and 178 with attempts to quit smoking during the past one year (25.91%). Univariable analysis showed that area, age, educational level, smoking status, tobacco health literacy and tobacco control information acquired from media were factors affecting intention and attempts to quit smoking among smokers (P<0.05). Multivariable logistic regression analysis showed that smokers with intention to quit smoking (OR=5.444, 95%CI: 3.585-8.268) and occasional smoking (OR=2.142, 95%CI: 1.312-3.497) were more likely to attempt to quit smoking. Conclusions Approximately half of smokers have intention to quit smoking in a district of Beijing Municipality; however, the percentage of attempts to quit smoking is low. Targeted interventions are required for smokers with different characteristics to improve the intention to quit smoking and promote smoking-quitting behaviors.

OBJECTIVE: To study the trend of surgical type, surgical procedure and etiological distribution of upper urinary tract repair in recent 10 years. METHODS: The preoperative and perioperative variables and follow-up data of upper urinary tract reconstruction surgery in RECUTTER (Reconstruction of Urinary Tract: Technology, Epidemiology and Result) database from 2010 to 2021 were searched, collected and analyzed. The surgical type, surgical procedure, duration of hospitalization, time of operation, incidence of short-term complications, and proportion of the patients undergoing reoperations were compared between the two groups of 2010-2017 period and 2018-2021 period. RESULTS: A total of 1 072 patients were included in the RECUTTER database. Congenital factors and iatrogenic injuries were the main causes of upper urinary tract repair. Among them, 129 (12.0%) patients had open operation, 403 (37.6%) patients had laparoscopic surgery, 322 (30.0%) patients had robot-assisted laparoscopic surgery and 218 (20.3%) patients had endourological procedure. In the last decade, the total number of surgeries showed a noticeable increasing annual trend and the proportion of robot-assisted laparoscopic surgery in 2018-2021 was significantly higher than that in 2010-2017 (P < 0.001). The 1 072 patients included 124 (11.6%) cases of ileal ureter replacements, 440 (41.1%) cases of pyeloplasty, 229 (21.4%) cases of balloon dilation, 109 (10.2%) cases of ureteral reimplantation, 49 (4.6%) cases of boari flap-Psoas hitch surgery, 60 (5.6%) cases of uretero-ureteral anastomosis, 61 (5.7%) cases of lingual mucosal onlay graft ureteroplasty or appendiceal onlay flap ureteroplasty. Pyeloplasty and balloon dilatation had been the main types of surgery, while the proportion of lingual mucosal onlay graft ureteroplasty plus appendiceal onlay flap ureteroplasty had increased significantly in recent years (P < 0.05). In addition, the time of operation was significantly increased (P < 0.05) after 2018, which was considered to be related to the sharp increase in the proportion of robot-assisted laparoscopic surgery. We found that minimally invasive surgery (endourological procedure and robot-assisted laparoscopic surgery) as an independent risk factor (P=0.050, OR=0.472) could reduce the incidence of short-term post-operative complications. CONCLUSION We have justified the value of the RECUTTER database, created by the Institute of Urology, Peking University in data support for clinical research work, and provided valuable experience for the construction of other multi-center databases at home and abroad. In recent 10 years, we have observed that, in upper urinary tract reconstruction surgery, the surgery type tends to be minimally invasive and the surgery procedure tends to be complicated, suggesting the superiority of robot-assisted laparoscopic surgery.
Humans ; Laparoscopy/methods* ; Retrospective Studies ; Robotic Surgical Procedures ; Treatment Outcome ; Ureter/surgery* ; Ureteral Obstruction/surgery* ; Urologic Surgical Procedures/methods*