Objective: To explore the longitudinal associations between dietary macronutrients and lung function in schoolaged children, so as to provide the nutritional research evidence for promoting children s lung health. Methods: In November 2021, two primary schools located in Chengdu, Sichuan Province were selected from the Southwest China Childhood Nutrition and Growth (SCCNG) cohort by a stratified cluster random sampling method, enrolling a total of 1 112 school aged children aged 8 to 13 years. At baseline, the dietary and sociodemographic characteristics of the children were assessed. One year later, the forced vital capacity (FVC) of the children was measured and converted into Z scores (FVC- Z ), while the vital capacity index (VCI) was also calculated. Generalized linear regression analysis was employed to examine the associations between dietary macronutrients and lung function, considering interactions with gender and age, followed by stratified analysis. Results: After adjusting for confounding factors, the analysis results of the generalized linear regression model showed that the carbohydrate energy ratio was negatively correlated with FVC- Z ( β =-0.02) and VCI ( β =-0.16), while the fat energy ratio showed a positive correlation with FVC- Z ( β =0.03) and VCI ( β =0.23) ( P <0.05). The protein energy ratio was positively correlated with FVC- Z ( β =0.09) and VCI ( β =0.60) specifically in girls ( P <0.05). Additionally, there was an interaction effect of age on the associations between macronutrients and lung function ( P <0.01); in children aged 8-9 and 10-11, the carbohydrate energy supply ratio was negatively correlated with FVC- Z ( β =-0.04, -0.03) and VCI ( β =-0.29, -0.21), and fat energy supply ratio was positively correlated with FVC- Z ( β =0.07, 0.05) and VCI ( β =0.46, 0.32) ( P <0.05). Conclusions There are age and sex differences in the association of dietary macronutrients with lung function, with a low carbohydrate, high fat diet promoting lung function in children. Additionally, protein intake appears to have a positive influence on the lung function of girls. The early school age period may represent a critical window for dietary interventions aimed at promoting lung health.

Objective To summarize the best evidence of early rehabilitation management of hand function in patients with hand burn,and provide basis for medical personnel to carry out early rehabilitation management of hand burn.Methods According to the 5S model,all evidence on early rehabilitation management of hand function in patients with hand burns was retrieved from databases and websites including UpToDate,BMJ Best Practice,NICE,RNAO,GIN,and so on.The retrieved evidence included clinical decisions,guidelines,evidence summaries,expert consensuses,systematic reviews,Meta analysis.The search period of the summary of best evidence,expert concensus and guidelines are from the establishment of the database to December 20,2024,and the search period of the systematic reviews is from January 1,2019 to December 20,2024.Quality evaluation of literature,evidence extraction and summary were conducted.The evidence was graded according to JBI evidence pre-grading system 2014.Results Totally 17 pieces of the literature were included,including 1 clinical decision,4 guidelines,6 evidence summaries,3 expert consensus articles,and 3 systematic reviews.Totally pieces of best evidence were summarized,including 7 aspects of assessment,hand positioning,treatment of edema,dressing,use of orthotics,joint mobility training,and health education.Conclusion This study summarized the best evidence of early rehabilitation management of hand function in patients with hand burn,and provided evidence-based evidence for clinical rehabilitation management plan.According to the clinical situation,the medical staff can apply the evidence to clinical practice,so as to improve the hand function and quality of life of patients.

Objective:To explore the value of endorectal echodefecography（EDF）in the evaluation of functional anorectal disorders（FAD）.Methods:A total of 67 patients clinically diagnosed with FAD who underwent EDF at the Sixth Affiliated Hospital of Sun Yat-Sen University from September 2021 to August 2024 were retrospectively collected. EDF was performed using a combination of transrectal and transperineal scans. XRD was used as the reference standard.Results:The diagnostic accuracy，sensitivity，specificity，positive predictive value，and negative predictive value of EDF for common FADs were as follows：for rectocele，85.1%，84.6%，85.4%，78.6%，and 89.7%；for rectal intussusception，79.1%，50.0%，93.3%，78.6%，and 79.2%；for external rectal prolapse，94.0%，71.4%，100%，100%，and 93.0%；for anismus，82.1%，66.7%，82.8%，15.4%，and 98.1%；for perineal descent，65.7%，54.2%，72.1%，52.0%，and 52.0%.Conclusions:EDF is valuable for evaluating FAD，especially for external rectal prolapse and rectocele. It can serve as an effective complement to XRD and provide a non-invasive and safe imaging method for FAD diagnosis.

Objective:To establish a reference interval for serum iodine of pregnant women with normal thyroid function and to analyze the relationship between serum iodine and thyroid disease risk.Methods:From July 2022 to October 2023, using cross-sectional survey method, pregnant women aged 18 to 48 years old who had lived in iodine-deficient areas in the six provinces of China (Shanxi Province, Fujian Province, Yunnan Province, Xinjiang Uygur Autonomous Region, Zhejiang Province, and Anhui Province) for more than six months were selected as the survey subjects. Blood samples were collected, serum iodine was tested, and the percentile method was used to establish a reference interval for serum iodine of pregnant women with normal thyroid function. Meanwhile, serum levels of free thyroxine, thyroid stimulating hormone, thyroglobulin antibody (TgAb), and thyroid peroxidase antibody (TPOAb) were tested, and logistic regression was used to analyze the relationship between serum iodine and thyroid disease risk.Results:A total of 1 409 pregnant women from 6 provinces were investigated, including 1 087 with normal thyroid function and 322 with abnormal thyroid function. The median serum iodine level of pregnant women with normal thyroid function was 79.74 μg/L, and the preliminary reference interval for serum iodine was 47.57 - 128.96 μg/L. When serum iodine levels were lower (< 47.57 μg/L), pregnant women had a significantly increased risk of developing TgAb positivity, TPOAb positivity, hypothyroxinemia, hypothyroidism, and autoimmune thyroiditis ( OR = 4.44, 2.91, 3.41, 41.67, 23.43, P < 0.05). When serum iodine levels were high (> 128.96 μg/L), pregnant women had a significantly increased risk of developing hyperthyroidism ( OR = 9.91, P = 0.001). Conclusions:The reference interval for serum iodine of pregnant women with normal thyroid function is successfully established. Low serum iodine levels are associated with an increased risk of TgAb positivity, TPOAb positivity, hypothyroxinemia, hypothyroidism, and autoimmune thyroiditis, while high serum iodine levels are associated with an increased risk of hyperthyroidism.

Objective To summarize the best evidence of early rehabilitation management of hand function in patients with hand burn,and provide basis for medical personnel to carry out early rehabilitation management of hand burn.Methods According to the 5S model,all evidence on early rehabilitation management of hand function in patients with hand burns was retrieved from databases and websites including UpToDate,BMJ Best Practice,NICE,RNAO,GIN,and so on.The retrieved evidence included clinical decisions,guidelines,evidence summaries,expert consensuses,systematic reviews,Meta analysis.The search period of the summary of best evidence,expert concensus and guidelines are from the establishment of the database to December 20,2024,and the search period of the systematic reviews is from January 1,2019 to December 20,2024.Quality evaluation of literature,evidence extraction and summary were conducted.The evidence was graded according to JBI evidence pre-grading system 2014.Results Totally 17 pieces of the literature were included,including 1 clinical decision,4 guidelines,6 evidence summaries,3 expert consensus articles,and 3 systematic reviews.Totally pieces of best evidence were summarized,including 7 aspects of assessment,hand positioning,treatment of edema,dressing,use of orthotics,joint mobility training,and health education.Conclusion This study summarized the best evidence of early rehabilitation management of hand function in patients with hand burn,and provided evidence-based evidence for clinical rehabilitation management plan.According to the clinical situation,the medical staff can apply the evidence to clinical practice,so as to improve the hand function and quality of life of patients.

Objective:To establish a reference interval for serum iodine of pregnant women with normal thyroid function and to analyze the relationship between serum iodine and thyroid disease risk.Methods:From July 2022 to October 2023, using cross-sectional survey method, pregnant women aged 18 to 48 years old who had lived in iodine-deficient areas in the six provinces of China (Shanxi Province, Fujian Province, Yunnan Province, Xinjiang Uygur Autonomous Region, Zhejiang Province, and Anhui Province) for more than six months were selected as the survey subjects. Blood samples were collected, serum iodine was tested, and the percentile method was used to establish a reference interval for serum iodine of pregnant women with normal thyroid function. Meanwhile, serum levels of free thyroxine, thyroid stimulating hormone, thyroglobulin antibody (TgAb), and thyroid peroxidase antibody (TPOAb) were tested, and logistic regression was used to analyze the relationship between serum iodine and thyroid disease risk.Results:A total of 1 409 pregnant women from 6 provinces were investigated, including 1 087 with normal thyroid function and 322 with abnormal thyroid function. The median serum iodine level of pregnant women with normal thyroid function was 79.74 μg/L, and the preliminary reference interval for serum iodine was 47.57 - 128.96 μg/L. When serum iodine levels were lower (< 47.57 μg/L), pregnant women had a significantly increased risk of developing TgAb positivity, TPOAb positivity, hypothyroxinemia, hypothyroidism, and autoimmune thyroiditis ( OR = 4.44, 2.91, 3.41, 41.67, 23.43, P < 0.05). When serum iodine levels were high (> 128.96 μg/L), pregnant women had a significantly increased risk of developing hyperthyroidism ( OR = 9.91, P = 0.001). Conclusions:The reference interval for serum iodine of pregnant women with normal thyroid function is successfully established. Low serum iodine levels are associated with an increased risk of TgAb positivity, TPOAb positivity, hypothyroxinemia, hypothyroidism, and autoimmune thyroiditis, while high serum iodine levels are associated with an increased risk of hyperthyroidism.

Objective:To explore the value of endorectal echodefecography（EDF）in the evaluation of functional anorectal disorders（FAD）.Methods:A total of 67 patients clinically diagnosed with FAD who underwent EDF at the Sixth Affiliated Hospital of Sun Yat-Sen University from September 2021 to August 2024 were retrospectively collected. EDF was performed using a combination of transrectal and transperineal scans. XRD was used as the reference standard.Results:The diagnostic accuracy，sensitivity，specificity，positive predictive value，and negative predictive value of EDF for common FADs were as follows：for rectocele，85.1%，84.6%，85.4%，78.6%，and 89.7%；for rectal intussusception，79.1%，50.0%，93.3%，78.6%，and 79.2%；for external rectal prolapse，94.0%，71.4%，100%，100%，and 93.0%；for anismus，82.1%，66.7%，82.8%，15.4%，and 98.1%；for perineal descent，65.7%，54.2%，72.1%，52.0%，and 52.0%.Conclusions:EDF is valuable for evaluating FAD，especially for external rectal prolapse and rectocele. It can serve as an effective complement to XRD and provide a non-invasive and safe imaging method for FAD diagnosis.

Due to the limitations of current anti-HBV therapies, the HBV core (HBc or HBcAg) protein assembly modulators (CpAMs) are believed to be potential anti-HBV agents. Therefore, discovering safe and efficient CpAMs is of great value. In this study, we established a HiBiT-based high-throughput screening system targeting HBc and screened novel CpAMs from an in-house marine chemicals library. A novel lead compound 8a, a derivative of the marine natural product naamidine J, has been successfully screened for potential anti-HBV activity. Bioactivity-driven synthesis was then conducted, and the structure‒activity relationship was analyzed, resulting in the discovery of the most effective compound 11a (IC₅₀ = 0.24 μmol/L). Furthermore, 11a was found to significantly inhibit HBV replication in multiple cell models and exhibit a synergistic effect with tenofovir disoproxil fumarate (TDF) and IFNa2 in vitro for anti-HBV activity. Treatment with 11a in a hydrodynamic-injection mouse model demonstrated significant anti-HBV activity without apparent hepatotoxicity. These findings suggest that the naamidine J derivative 11a could be used as the HBV core protein assembly modulator to develop safe and effective anti-HBV therapies.

Objective:To explore the application effect of intelligent referral mode in examinees with major positive results in physical examinations in a health medical center.Methods:A cross-sectional study was conducted from January 2022 to December 2023 with subjects receiving physical examinations. Those subjects with major positive results from January 2022 to December 2022 in the Health Medical Center of the Second Affiliated Hospital of Chongqing Medical University were selected as the routine referral group, and those with major positive results from January 2023 to December 2023 were selected as the intelligent referral group. The routine referral group received routine health education from the chief inspector in the health medical center, suggesting them to get outpatient consultation. On the basis of ordinary referral, the intelligent referral group received health education from a referral team composed of nurses and specialists based on internet technology to digitally integrate and share patients′ medical records, examination results, imaging data and other medical information. The subects in the intelligent referral group were provided with a green channel for outpatient consultation and medical treatment immediately. The visiting rate, hospitalization rate, average visiting time, and overall satisfaction of the subjects after being notified of abnormal results were compared between the two groups. According to the positive results, the subjects were divided into four subgroups: ultrasound examination group, radiology group, clinical laboratory group and blood pressure group.Results:After the notification, there were significant differences in hospital visit rate (84.8% vs 67.2%, χ 2=168.4), hospitalization rate (48.8% vs 36.5%, χ 2=17.80), average visit time (116 min vs 301 min, Z=-15.82), and overall satisfaction score (9.70±0.62 vs 8.29±1.26, t=-33.47) between intelligent referral group and general referral group (all P<0.01). The classification statistics of major abnormal results showed that the consultation rates in subjects with ultrasound, radiology, clinical laboratory and blood pressure abnormities in the intelligent referral group were all higher than those in the general referral group (87.9% vs 70.4%, 89.9% vs 70.6%, 80.6% vs 60.2%, 57.2% vs 41.3%, respectively; χ 2=41.91, 39.37, 19.37, 6.20, all P<0.05); the hospitalization rates in subjects with ultrasound, radiology and blood pressure abnormities in the intelligent referral group were all higher than those in the general referral group (66.8% vs 64%, 55.7% vs 42.2%, 18.7% vs 11.2%, respectively; χ 2=16.86, 11.91, 8.68, all P<0.05); the mean consultation times in subjects with ultrasound, radiology and clinical laboratory abnormities in the intelligent referral group were all significantly shorter than those in the general referral group (96 min vs 308 min, 110 min vs 300 min, 122 min vs 286 min, Z=-11.38, -9.27, -7.63, all P<0.01); the overall satisfaction scores in subjects with ultrasound examination, radiology, clinical laboratory and blood pressure abnormities in the intelligent referral group were all higher than those in the general referral group (9.69±0.60 vs 8.36±1.21, 9.09±0.62 vs 8.26±1.27, 9.74±0.69 vs 8.25±1.31; 9.68±0.59 vs 8.34±1.35, respectively; t=-18.47, -18.52, -14.42, -11.77, all P<0.01). Conclusions:The application of intelligent referral mode can improve the visiting rate and hospitalization rate of examinees with major positive results of physical examination, shorten their visiting time, and thus improve their satisfaction.

Objective To systematically evaluate the efficacy of traditional Chinese medicine(TCM)in the treatment of recurrent spontaneous abortion and their regulatory effects of levels of peripheral blood Th17 cells and Treg cells.Methods Computer retrieval of CNKI,WanFang,VIP,SinoMed,FMRS,PubMed,Cochrane Library,Embase,Web of science and other databases were carried out.RCTS related to the regulation of Th17 and Treg cells by TCM in the treatment of recurrent spontaneous abortion,published from the establishment of the database to June 2023 were screened.Two reviewers evaluated the quality of the literature according to the Cochrane handbook.RevMan5.4 software was used for Meta-Analysis.Results A total of 10 studies that involved 1 052 patients were included.The Meta-Analysis results showed that compared to the control group,the effective rate[RR=1.20,95%CI(1.11,1.30),P＜0.000 01],live birth rate[RR=1.32,95%CI(1.16,1.50),P＜0.000 01]and the reduction of adverse drug reactions[RR=0.34,95%CI(0.14,0.83),P=0.02]were significantly improved by the intervention of TCM.After treatment with TCM,the expression of Th17 cells was decreased[MD=-0.71,95%CI(-1.01,-0.41),P＜0.000 01],and the expression of Treg cells was increased[SMD=1.21,95%CI(0.80,1.62),P＜0.000 01].The ratio of Th17/Treg cells was decreased[SMD=-2.62,95%CI(-4.09,-1.14),P=0.000 5].Conclusion TCM used for post-pregnancy or before and after pregnancy can significantly improve the clinical symptoms and live birth rate of patients with recurrent spontaneous abortion,wihch showed high safety.Moreover,TCM can reduce the expression of Th17 cells,up-regulate the expression of Treg cells and regulate the immune balance of Th17/Treg cells,which is conducive to embryonic development after pregnancy.