Objective: To explore the relationship between sleep quality and executive function among middle school students, so as to provide theoretical support for the promotion of adolescents physical and mental health development. Methods: From September to December 2023, 5 713 junior and senior high school students aged 13 to 18 were selected by stratified cluster random sampling method from Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi, and Urumqi. Pittsburgh Sleep Quality Index was used to conduct sleep quality survey. And conduct executive function was tested on middle school students, including inhibitory function, refresh function and conversion function tests. Spearman correlation and linear regression were used to analyze the relationship between sleep quality and executive function of middle school students. Results: The total Pittsburgh Sleep Quality Index (PSQI) score of boys was [4.0(2.0,6.0)] and that of girls was [5.0(3.0,6.0)], and the difference was statistically significant ( Z=-10.90, P < 0.01 ). The total PSQI score of boys was positively correlated with both 2-back reaction time and conversion function of executive function ( r =0.04, 0.04); the total PSQI score of girls was negatively correlated with 2-back reaction time ( r =-0.04) ( P <0.05). After controlling for variables such as mental health, physical activity and nutritional status,linear regression analyses showed that PSQI total score of middle school students was positively correlated with the inhibitory function and the conversion function response time [ B (95% CI )=1.28(0.21-2.34), 7.62(2.34-12.90), P <0.05]; the associations of total PSQI scores among middle school students with both 2-back and 1-back response time were not statistically significant [ B (95% CI )=-5.88(-16.14-4.37), 8.05( -3.39 -19.50), P >0.05]. Conclusion Positive correlations are observed on sleep quality with inhibitory and conversion functions of executive function among middle school students.

Objective:To predict the mechanism of Panacis Quinquefolii Radix- Acori Tatarinowii Rhizoma (PQ-AT) in the treatment of diabetes encephalopathy (DE) using network pharmacology combined with molecular docking; To conduct experimental verification.Methods:The active components and targets of PQ and AT were screened by TCMSP database. The GeneCards and Disgenet were used to collect DE related target genes. String database and Cytoscape software were used to structure PPI network and perform visualization analysis. The common targets were imported into Metascape platform for GO annotation and KEGG enrichment analysis. Molecular docking was used to verify the binding ability of active components to core targets. Rats were randomly divided into a blank group, a model group, and a low-dose group of PQ-AT (1.08 g/kg), a high-dose group of PQ-AT (2.16 g/kg), and a metformin group (0.18 g/kg) using a random number table. To establish the rat model of diabetes encephalopathy, intraperitoneal injection of streptozotocin was used in addition to the blank group. After a 12-week drug intervention, TNF-α and Cyclooxygenase-2 (PTGS2) protein expression in the cerebral cortex of rats was detected using Western blot.Results:A total of 26 active components in PQ-AT and 107 related targets of DE were obtained, mainly including TNF, JUN, and PTSG2, which were mainly concentrated in TNF signaling pathway, cancer and other signal pathways. Molecular docking showed that the main active components of PQ-AT had relatively stable binding activity with TNF-α and PTGS2. Western blot results shows that compared with the model group, the expressions of PTGS2 and TNF-α significantly decreased in each administration group ( P<0.05 or P<0.01). Conclusion:PQ-AT can act on TNF, CASP3, JUN, STAT3, PTGS2 and other core targets to regulate signal pathways such as TNF, and inhibit inflammatory reaction to achieve the effect of treating DE.

Objective To explore the biomechanical mechanism of pseudoaneurysm formation at the anastomotic site of vascular patch and the inhibitory effect of transforming growth factor(TGF β1)hydrogel on aneurysm.Methods The vascular patch model and the pseudoaneurysm model were constructed separately,and the two-way fluid-structure interaction method was used to numerically simulate the blood-vessel wall dynamic response at the anastomosis.Based on the analysis of mechanical parameters such as postoperative blood velocity,vessel wall shear stress and aneurysm wall displacement,the mechanisms of postoperative pseudoaneurysm formation and inhibition were studied.Results The numerical simulation results showed that the wall shear stress increased when the blood flowed through the front end of the patch.When the pseudoaneurysm has been formed after surgery,the aneurysm wall became significantly thicker following the injection of TGF β1 hydrogel into the aneurysmal wall,and the intratumoral shear stress and the aneurysmal wall displacement were decreased.Conclusion Pseudoaneurysms are easy to form at the front end of the anastomosis after surgery,and the injection of TGF β1 hydrogel into the aneurysm wall can effectively inhibit the formation and progression of pseudoaneurysm.The numerical simulation study provides a numerical basis for the mechanical mechanism study of the formation and progression of pseudoaneurysm after patch angioplasty.

Objective:To explore the influence of age on the passive stiffness of women′s quadriceps muscles and the relationship between stiffness and muscle functioning.Methods:Twenty healthy elderly women formed the senior-aged group, while 20 young, healthy women were selected as the young group. The passive stiffness of the subjects′ vastus medialis, rectus femoris and vastus lateralis muscles was measured using ultrasound shear wave imaging with the knee flexed to 30°, 60°, 90° and 105°. Both groups completed the 6-minute walk test (6MWT) and the five times sit-to-stand test (FTSST). Maximum voluntary isometric contraction (MIVC) strength during knee extension was also measured.Results:The passive muscle stiffness of the rectus femoris and vastus lateralis muscles was significantly greater in the senior-aged group when the knee was flexed at 60°, 90° or 105°. The 6MWT and FTSST times of the young group were of course significantly better, and their MIVC at 60° and 90° of knee flexion was also significantly stronger. Rectus femoris stiffness among the senior-aged group was negatively correlated with MIVC when the knee was flexed at 60°.Conclusions:The passive stiffness of the muscles studied increases with age, especially in stretching. When the knee joint is flexed at 60° there tends to be a negative correlation between the MIVC of the quadriceps femoris and the stiffness of the rectus femoris among elderly females.

Objective　To analyze the current situation and influencing factors of health-care seeking delay among pulmonary tuberculosis patients in Qingpu District of Shanghai from 2011 to 2022, and to provide a scientific basis for tuberculosis prevention and control. Methods　The data of pulmonary tuberculosis patients in Qingpu District of Shanghai from 2011 to 2022 was collected through the China Tuberculosis Information Management System to describe the distribution and change trend of the delay in health-care seeking. Univariate analysiswas performed using the chi-square (χ²) test, and the time trend of rates was tested with the trend chi-square (trend χ²) test. Multivariate logistic regression model analyzed the influencing factors of the delay in health-care seeking. Results　From 2011 to 2022, there were 3 488 cases of pulmonary tuberculosis in Qingpu District, with 1 438 patients experiencing health-care seeking delay. The median (quartile) number of days of delay was M (P25, P75) = 10 (2, 24) days, and the rate of health-care seeking delay was 41.23%. The annual rate of health-care seeking delay fluctuated between 33.88% and 50.45% from 2011 to 2022, with statistically significant differences between different years (χ²=38.355, P<0.001), and an upward trend in the health-care seeking delay rate was observed from 2020 to 2022 (χtrend²=13.290, P<0.001). Multivariate logistic regression analysis showed that compared to male, those under 25 years old, with local household registration, and detected through health check-ups, females (OR=1.21, 95%CI:1.04-1.41), those aged 45 to <65 (OR=1.36, 95%CI:1.06-1.75), intra-city migrants (OR=1.35, 95%CI:1.09-1.68), inter-provincial/overseas migrants (OR=1.50, 95%CI:1.23-1.83), and patients who directly sought medical care (OR=3.52, 95%CI:2.27-5.47), transfer treatment (OR=2.07,95%CI：1.31-3.25), referral (OR=2.16, 95%CI:1.36-3.44), follow-up (OR=3.07, 95%CI:1.74-5.44) patients with pulmonary tuberculosis were more likely to delay health-care, and the differences were statistically significant (P<0.05). Compared to sputum-positive patients, those with sputum-negative tests (OR=0.76, 95%CI: 0.59-0.97) were less likely to experience delayed health-care, and the difference was statistically significant (P<0.05). Conclusions　Health-care seeking delay of pulmonary tuberculosis patients is relatively common in Qingpu District of Shanghai. Corresponding intervention measures should be adopted for risk factors and key populations to further improve the health-care seeking delay.

Objective Based on construction and verification of the lumbar finite element model, the simulation calculation and injury prediction on dynamic response of normal lumbar model and L5 unilateral and bilateral spondylolysis models of the pilot were carried out, so as to explore the influence of persistent flight overload on normal and spondylolysis lumbar vertebrae of the pilot. Methods The precise finite element model of lumbavertebrae was established using reverse engineering software and computer-aided engineering (CAE) technology based on CT images. The validity of the lumbar vertebrae model was verified by static and dynamic in vitro experiments. The biomechanical simulation analysis on normal and spondylolysis lumbar vertebrae of the pilotunder persistent overload was carried out, and the spinal injury was predicted and analyzed by dynamic response index (DRI) injury evaluation and prediction method. Results The maximum isthmus stress of L5 vertebra in unilateral and bilateral spondylolysis models were 105. 29 MPa and 126. 32 MPa, respectively, which were significantly higher than those in normal model. The L4-5 and L5-S1 intervertebral discs of the spondylolysis model were more prone to premature degenerative changes than those of normal model. Combined with DRI spinal injury prediction method, the probability of spinal injury in normal lumbar vertebrae, lumbar vertebrae with L5 unilateral and bilateral spondylolysis were 0. 001 4% , 2. 26% and 3. 21% , respectively, and the probability of spinal injury was significantly increased after the occurrence of spondylolysis. Conclusions The spondylolysis increases the load of lumbar isthmus under flight overload. The results provide more accurate data support for the formulation of training programs and the development of protective devices to ensure flight safety

Wound infection is becoming a considerable healthcare crisis due to the abuse of antibiotics and the substantial production of multidrug-resistant bacteria. Seawater immersion wounds usually become a mortal trouble because of the infection of Vibrio vulnificus. Bdellovibrio bacteriovorus, one kind of natural predatory bacteria, is recognized as a promising biological therapy against intractable bacteria. Here, we prepared a B. bacteriovorus-loaded polyvinyl alcohol/alginate hydrogel for the topical treatment of the seawater immersion wounds infected by V. vulnificus. The B. bacteriovorus-loaded hydrogel (BG) owned highly microporous structures with the mean pore size of 90 μm, improving the rapid release of B. bacteriovorus from BG when contacting the aqueous surroundings. BG showed high biosafety with no L929 cell toxicity or hemolysis. More importantly, BG exhibited excellent in vitro anti-V. vulnificus effect. The highly effective infected wound treatment effect of BG was evaluated on mouse models, revealing significant reduction of local V. vulnificus, accelerated wound contraction, and alleviated inflammation. Besides the high bacterial inhibition of BG, BG remarkably reduced inflammatory response, promoted collagen deposition, neovascularization and re-epithelization, contributing to wound healing. BG is a promising topical biological formulation against infected wounds.

Immunogenic cell death (ICD) plays a major role in cancer immunotherapy by stimulating specific T cell responses and restoring the antitumor immune system. However, effective type II ICD inducers without biotoxicity are still very limited. Herein, a tentative drug- or photosensitizer-free strategy was developed by employing enzymatic self-assembly of the peptide F-pY-T to induce mitochondrial oxidative stress in cancer cells. Upon dephosphorylation catalyzed by alkaline phosphatase overexpressed on cancer cells, the peptide F-pY-T self-assembled to form nanoparticles, which were subsequently internalized. These affected the morphology of mitochondria and induced serious reactive oxygen species production, causing the ICD characterized by the release of danger-associated molecular patterns (DAMPs). DAMPs enhanced specific immune responses by promoting the maturation of DCs and the intratumoral infiltration of tumor-specific T cells to eradicate tumor cells. The dramatic immunotherapeutic capacity could be enhanced further by combination therapy of F-pY-T and anti-PD-L1 agents without visible biotoxicity in the main organs. Thus, our results revealed an alternative strategy to induce efficient ICD by physically promoting mitochondrial oxidative stress.

Objective To simulate dynamic response of cervical spine of the pilot during typical maneuver flight movements using finite element method, as well as make analysis and prediction on damage failure of the pilot neck during flight by impact injury and fatigue injury model of biological tissues.Methods A geometrically accurate finite element model of the neck was constructed, and validity of the model was verified by relevant examples. Then, the acceleration curves of centrifugal trainer under different modes were loaded for numerical simulation, and impact injury and fatigue injury of tissues were predicted by using the universal cervical injury criterion and the fatigue damage model of biological tissues.Results The maximum stress of the vertebrae and intervertebral disc caused by overload impact was 66.53 MPa and 58.63 MPa respectively during typical maneuver flight. According to the Nij injury criteria, the maximum Nij was 0.096, which was lower than the injury tolerance threshold of 1, and would not cause direct acute injury to cervical tissues. Based on fatigue damage model of biological tissues, it was found that cancellous bone suffered fatigue failure under the condition of uninterrupted repeated loading for more than 40 000 times. Considering the limited flight career of the pilot, the vertebral tissues would not be fractured due to the accumulation of fatigue damage.Conclusions To a certain extent, the results can contribute to formulating pilot training and flight plans, and also provide data support for the development of its protective equipment.

Objective:To explore the practical role of reflective teaching based on Bloom's educational theory in the standardized residency training of gynecology.Methods:A total of 31 residents who participated in the standardized residency training in the Gynecology Department of Beijing Shijitan Hospital Affiliated to Capital Medical University from July 2019 to January 2020 were classified as the control group, and 33 residents who participated in the standardized training from March 2020 to September 2020 were assigned to the observation group. The control group was given routine teaching, and the observation group was given reflective teaching based on Bloom's educational theory. The theoretical test scores and skill operation test scores before and after the training were compared between the two groups, and the clinical ability and teaching satisfaction of the two groups of residents were compared. SPSS 25.0 was used for t-test and Chi-square test. Results:After the standardized training, the scores of theoretical examination [(88.78±5.69) vs. (84.56±5.23)] and skill operation test [(89.37±5.75) vs. (85.22±5.34)] in the observation group were higher than those in the control group, with statistically significant differences. After the standardized training, the team cooperation ability, diagnosis and treatment technology operation ability, problem analysis and solving ability, clinical thinking ability and doctor-patient communication ability of the observation group were higher than those of the control group, and the differences were statistically significant. After the standardized training, the satisfactions with teaching mode, stimulating learning interest, improving self-study ability, improving diagnosis and treatment thinking ability, and improving problem analysis and solving ability in the observation group were higher than those in the control group, and the differences were statistically significant.Conclusion:Reflective teaching based on Bloom's educational theory can improve the professional theoretical knowledge level, clinical operation level, clinical ability and satisfaction of the gynecological residents, and help them to adapt to the clinical work faster.