Objective: To evaluate the dietary quality of residents in Wenzhou City, Zhejiang Province, so as to provide the basis for future health education and nutrition intervention programs. Methods: A stratified multi-stage random sampling method was used to select residents aged 18 years and older in 6 counties (cities, districts) of Wenzhou City as the study subjects, “24-hour dietary review for 3 consecutive days” was adopted to collect dietary intake, and the diet balance index (DBI_16) scoring method was applied to evaluate the dietary quality. Results: This study analyzed the dietary quality of 406 residents in Wenzhou City, including 197 males (48.52%) and 209 females (51.48%). The majority of the residents were aged 18-44 years (254 residents, 62.56%). The median DBI total score was -31 (interquartile range, 8), and 404 residents had insufficient dietary intake, accounting for 99.51%. The median DBI positive score was 5 (interquartile range, 6), and 288 residents had appropriate dietary intake, accounting for 70.94%. The median DBI negative score was 37 (interquartile range, 6), and 210 residents had a high level of insufficient dietary intake, accounting for 51.72%. Five dietary patterns, namely A, B, C, E and F, were identified, with pattern B being the most dominant, accounting for 75.62% of the total (307 individuals). Patterns D, H, I and G were not observed. Conclusions The dietary quality of the residents surveyed indicates the existence of dietary imbalances, mainly manifesting as inadequate intake. It is recommended to strengthen nutritional and health guidance.

Objective To study the rheological properties of terbinafine hydrochloride cream,and provide a research basis for the consistency of this product.Methods The Kinexus rheometer was used to determine the dynamic and steady rheological parameters of terbinafine hydrochloride cream.Comparative studies on the rheological curves,yield stress,viscosity measurement,linear viscoelasticity and creep recovery of original and generic terbinafine hydrochloride cream were carried out.Results The original and generic terbinafine hydrochloride cream were both non-Newtonian fluid with shear thinning.The yield stress of three generic were similar to the original.The linear viscoelastic region of three generic were similar to the original,and the ranges of linear viscoelastic were both 0.01％-1％,the elastic moduli were all greater than the viscosity moduli and were viscoelastic materials.It could be seen from the creep recovery curve that the creep behavior of three generic were basically the same with the original.Conclusion Among the six terbinafine hydrochloride creams measured experimentally,the rheological properties of most generic drugs are basically the same as the original.

Objective:To investigate the prevalence of hyperuricemia (HUA) in Bozidun Kirghiz township of Xinjiang Aksu region, and to explore the risk factors for the occurrence of HUA in the local area.Methods:A cross-sectional survey study was conducted by randomly selecting 9 villages in Bozidun Kirgiz Township by the whole-group sampling method and questionnaire were distributed to the households. The questionnaire included: demographic information, history of past illness, personal history, and all subjects were measured for height, weight, blood pressure, abdominal circumference, etc. The diagnostic of HUA if the serum uric acid (SUA) level >420 μmol/L in men or >360 μmol/L in women. The incidences of HUA in different age, sex, food type and life style behavior were analyzed. T test, non-parametric test and Chi-square test were used to analyze the differences among the groups, and logistic regression was used to analyze the risk factors. Results:①A total of 2 138 subjects were surveyed, among which 68 patients were with HUA, the prevalence of HUA in Bozidun Kirghiz township, Aksu region in the general population was 3.18%(68/2 138); the prevalence rate in men was 4.60%(45/978), 45 patients were identified; and the prevalence rate in women was 1.98%(23/1 160), 23 patients were identified. The peak age of HUA in male and female patients was 51~60 years old. ②The prevalence of HUA was lower in those who consumed dairy products ( χ2=6.91, P=0.017), nuts ( χ2=8.43, P=0.038) and eggs ( χ2=7.38, P=0.023), and lower in those who consumed more. Different intake of cereals ( χ2=0.87, P=0.647), meat( χ2=0.82, P=0.662), vegetables and fruits( χ2=5.22, P=0.073) had no effect on the prevalence of HUA.③In terms of different life behaviors, the prevalence of HUA in men who had been smoking was higher than those who had never smoked (57.78%, 28.89%, 13.33%, χ2=8.16, P=0.017). In the relationship between drinking and HUA, the prevalence rates of male always drinking, ever drinking and never drinking were 80.00%, 11.11% and 3.89%, respectively, the difference was statistically significant ( χ2=6.67, P=0.038). ④Multi-factor logistic regression analysis showed that high BMI, old age, high TG, increased Cr and increased WBC were risk factors for the occurrence of HUA [ OR(95% CI)=1.13(1.04, 1.23), 1.03(1.00,1.05),1.39(1.00, 1.93), 1.03(1.02, 1.05), 1.27(1.07, 1.49), all P<0.05]. Conclusion:The prevalence of HUA in Bozidun Kirgiz township in Aksu prefecture of Xinjiang is lower than that in other areas with continental climate. High BMI, old age, high TG, increased Cr and increased WBC count are risk factors for the development of HUA .

Background and purpose:Epidermal growth factor receptor exon 20 T790M(EGFR T790M)mutation is one of the acquired resistance mechanisms in non-small cell lung cancer(NSCLC)against first-/second-generation EGFR tyrosine kinase inhibitors(EGFR TKIs).Additionally,EGFR T790M mutation can also be observed in NSCLC patients who have not undergone EGFR TKIs treatment.This study aimed to compare the clinical pathological characteristics and prognostic differences between NSCLC patients with de novo and acquired EGFR T790M mutation,and further explore the immune microenvironment features of acquired T790M mutation in NSCLC.Methods:This study retrospectively included 3 762 cases of NSCLC diagnosed at Fudan University Shanghai Cancer Center from April 2020 to September 2022.Among them,2 070 cases(55.02%)exhibited EGFR mutations,and 556 cases(14.77%)received EGFR TKIs treatment.Specifically,there were 119 cases(3.16%)of NSCLC with EGFR T790M mutation,including 51 cases(1.35%)of de novo T790M mutation and 68 cases(1.81%)of acquired EGFR T790M mutation.Clinical data of the patients were collected for comparative analysis between NSCLC patients with de novo and acquired T790M mutation.Multiple immunofluorescence histochemistry(mIHC)was employed to explore the immune microenvironment characteristics of NSCLC patients with acquired T790M mutation.Results:The proportion of de novo and acquired T790M mutations was higher in female patients compared to males.Patients with de novo T790M mutation tended to be younger.Both de novo and acquired T790M mutations were more commonly found in poorly differentiated carcinomas.Among NSCLC patients with de novo T790M mutation,there was a higher rate of programmed death ligand-1(PD-L1)expression(60.00%).In contrast,among NSCLC patients with acquired T790M mutation,the rate of PD-L1 expression was lower(22.39%).Acquired T790M mutation in NSCLC was often accompanied by TP53 alterations(39.7%).Cox regression analysis results indicated that mesenchymal to epithelial transition(MET)factor alteration was a risk factor for the occurrence of acquired T790M mutation(P=0.000 5).The average overall survival(OS)showed no significant difference between de novo and acquired T790M mutations(35.4 and 37.3 months respectively).However,patients with acquired T790M mutation exhibited a higher proportion of recurrence and metastasis.In acquired T790M mutation,there was a higher presence of immune cell infiltration within the stromal compartment,such as CD20+B cells,CD23+B cells,CD8+T cells,CD8+PD-1-/+cells,CD20+PD-1-/+cells and CD23+PD-1-/+cells.Additionally,the study found that when EGFR was accompanied by tumor suppressor gene(TSG)alterations,the average distance between tumor cells and CD8+T cells,CD20+B cells,CD8+PD-1+cells,CD20+PD-1+cells and CD23+PD-1+cells was closer compared to cases with only EGFR mutations.Conclusion:In comparison to patients with de novo T790M mutation,patients with acquired T790M mutation exhibit a lower rate of PD-L1 positivity.Acquired T790M mutation often accompanies TP53 alterations,and MET alteration is identified as a risk factor triggering acquired T790M mutation.Although patients with acquired T790M mutation face higher risk of recurrence and metastasis,their average OS does not significantly differ from those with de novo T790M mutation.In cases of acquired T790M mutation,the presence of TSG mutations can alter the spatial distribution of immune cells,potentially leading to benefits from immunotherapy.

AIM:To investigate the mechanism of hyperplasia of mammary gland(HMG)and the potential differential metabolites in rats based on the serum metabolomics assessment by liquid chromatography-mass spectrometry(LC-MS).METHODS:Twelve specific-pathogen-free(SPF)-grade female Wistar rats were randomly and equally as-signed to the normal and model groups.The model group received intramuscular injections of estradiol benzoate(0.5 mg·kg-1·d-1)for 21 d,followed by intramuscular injections of progesterone(4 mg·kg-1·d-1)for 7 d for preparing the HMG model.The body weight and nipple diameter of the rats were measured,and the histopathological changes in their mamma-ry gland were monitored.After the successful establishment of the model,rat serum was collected for LC-MS metabolomics analysis,the differential metabolites in the serum of the normal and model group rats were analyzed by principal compo-nent analysis(PCA)and partial least squares discriminant analysis(PLS-DA),and the metabolic pathway analysis of dif-ferential markers through the Kyoto Encyclopedia of Genes and Genomes(KEGG)open database was performed.RE-SULTS:Compared with the normal rats in the control group,no significant change was observed in the body weight(P>0.05),the diameter of the nipple was significantly enlarged(P<0.01),the hematoxylin-eosin(HE)staining section of the mammary gland displayed typical HMG morphology,which together indicated that the modeling was successful.The metabolic patterns of the serum samples from both groups were significantly different,and 30 potentially differential metab-olites were identified based on the variable importance in projection(VIP)≥2.0 and P<0.05,mainly including 3-dehydro-cholic acid,alcoholic acid,glycocholate-3-sulfate,glycine-deoxycholan-3-sulfate,glycine-deoxycholan-3-sulfate,3a,7b,and 12a trihydroxycholan-3-sulfate,cholic acid,and glycolic acid.Further receiver operating characteristic(ROC)analysis revealed that the area under the curve(AUC)of the 13 metabolites was>0.9,implying the possible high sensitiv-ity for the diagnosis of HMG.According to the KEGG pathway enrichment analysis,most of the differential metabolites were mainly concentrated in aldosterone synthesis and secretion,sphingomyelin metabolism,arachidonic acid metabo-lism,apoptosis and cholesterol metabolism.CONCLUSION:The pathogenesis of estrogen-and progesterone-induced HMG in rats may be related to the altered bile acids,their derivatives metabolism,and the lipid metabolism pathways.The 13 differential metabolites identified by serum metabolomics with high sensitivity may thus provide a reference for the diagnosis of HMG.

Objective:To understand the negative experiences of male master of nursing students during their studies.Methods:In this qualitative study, totally 11 male master of nursing students from China Medical University and Wuhan University were selected by purposive sampling in March 2023 for semi-structured interviews, and the data were analyzed using the KJ method.Results:Four themes were extracted: research pressure, pressure of time and finances, confusion about the future and development, and lack of identification with the nursing profession.Conclusions:Male master of nursing students experience negative emotions during their studies. Nursing educators and administrators should pay attention to the emotional management of male master of nursing students and gradually improve the training methods for nursing graduate students.

Objective To develop and validate a risk prediction model based on early platelet-related parameters for bronchopulmonary dysplasia(BPD)in neonates admitted to the neonatal intensive care unit(NICU),and to facilitate early identification and intervention in high-risk populations.Methods Clinical data of 291 preterm infants with a gestational age(GA)≤32 weeks or a birth weight(BW)＜1 500 g,admitted to the NICU,were retrospectively analyzed.Out of these,214 cases were selected as the modeling group.This group was further categorized into the BPD group(n=76)and the non-BPD group(n=138),based on whether they required oxygen therapy at 28 days post-birth.Perinatal data,platelet-related parameters and other indicators between the two groups.Univariate and multivariate Logistic regression analyses were conducted to identify BPD risk factors,followed by the construction of a nomogram.An additional cohort of 105 preterm infants with GA≤32 weeks or BW＜1 500 g,were used to validate the model.This cohort was divided into the BPD group(n=43)and the non-BPD(n=62)group.Receiver operating characteristic(ROC)curve and calibration curve were used to internally verify the efficiency of the prediction model.Results The Logistic regression analysis identified GA,BW,Apgar score at 5 minutes≤7,invasive ventilation,platelet count(PLT)and mean platelet volume(MPV)as significant factors in the model(P＜0.05).The constructed nomogram was formulated using R language,and the areas under the ROC curve(AUC)for the three models were 0.908,0.931 and 0.918,respectively(P＜0.05).The verification group was verified by Bootstrap.The calibration curve showed a good fit.The internal validation AUC values of the three models were 0.877,0.890 and 0.886,respectively.Conclusion GA,BW,invasive ventilation,Apgar score at 5 minutes≤7,MPV and PLT are key risk factors for BPD onset.The risk prediction model based on these indicators can effectively predict BPD,providing clinicians with a valuable tool for early detection and intervention in the development of BPD.

Objective To investigate the changes in microglia phenotype after cerebral ischemia reperfusion(1R)injury and the effects of adenosine on nerve injury of cerebral IR injured rats.Methods Thirty-six healthy male Sprague Dawley rats were randomly divided into the sham operation(Sham)group,IR group,and adenosine pretreatment(AP)group,with 12 rats in each group.Before modeling,rats in the AP group were intraperitoneally injected with 2 mL of adenosine injection daily for 3 consecutive days,and rats in the Sham group and IR group were intraperitoneally injected with 2 mL of normal saline daily for 3 consecutive days.The middle cerebral artery occlusion models of rats in the IR group and AP group were constructed by using the suture-occluded method,and only the carotid artery of rats was isolated in the Sham group without ligation of blood vessels.At 2 hours after modeling,the neuroethology of rats in each group were evaluated according to a 5-point neurobehavioral scale.At 24 hours after restoring the blood perfusion in the middle cerebral artery,the rats in each group were executed,and their brain tissues were removed.The morphological changes of the brain tissues in the ischemic penumbra region were observed after hematoxylin-eosin(HE)staining.The co-expression of M1-type microglia markers and M2-type microglia markers was detected by immunofluorescence staining.The relative expression levels of pro-inflammatory factors inducible nitric oxide synthase(iNOS),tumor necrosis factor-α(TNF-α)and interleukin(IL)-1β released by M1-type microglia,and anti-inflammatory factors IL-4,IL-10 and transforming growth factor-β(TGF-β)released by M2-type microglia were detected by quantitative real-time polymerase chain reaction(qRT-PCR).Results The neurobehavioral scores of rats in the IR group and AP group were significantly higher than those in the Sham group,and the neurobehavioral score of rats in the IR group was significantly higher than that in the AP group(P＜0.05).HE staining results showed that the brain cells of rats in the Sham group were structurally complete and tightly arranged,with visible nuclei and no interstitial edema;the brain cells of rats in the IR group were structurally damaged and irregularly arranged,with loose cytoplasm and vacuoles in the cytosome;the structure of brain cells of rat in the AP group was better than that in the IR group,and there were many regularly-arranged normal cells,with complete nuclei.Immunofluorescence staining results showed that the number of M1-type and M2-type microglia in the ischemic penumbra region of rats in the IR group and AP group was significantly higher than that in the Sham group;the number of M1-type microglia in the IR group was significantly higher than that in the AP group,and the number of M2-type microglia was significantly lower than that in the AP group(P＜0.05).qRT-PCR results showed that the relative expression levels of pro-inflammatory cytokines TNF-α,IL-1β,iNOS and anti-inflammatory cytokines IL-4,IL-10,TGF-β in the IR group and AP group were significantly higher than those in the Sham group(P＜0.05);the relative expression levels of pro-inflammatory factors TNF-α,IL-1β and iNOS in the AP group were significantly lower than those in the IR group(P＜0.05),while the relative expression levels of anti-inflammatory factors IL-4,IL-10 and TGF-β were significantly higher than those in the IR group(P＜0.05).Conclusion AP can promote the polarization of microglia from M1 type to M2 type,inhibit the release of pro-inflammatory factors,increases the expression of anti-inflammatory factors,and thus has a neuroprotective effect on rats after cerebral IR injury.

Objective:To investigate the application effect of the thinking pattern of "Six Thinking Hats" combined with case-based learning-reference induced self-education (CBL-RISE) teaching in clinical practice teaching of thoracic surgery.Methods:A total of 122 interns who received clinical practice teaching in Department of Thoracic Surgery in the Second Xiangya Hospital of Central South University were selected as subjects, and according to the admission order, they were divided into control group (61 interns receiving routine teaching) and observation group (61 interns receiving the thinking pattern of "Six Thinking Hats" combined with CBL-RISE teaching). After teaching, the two groups were compared in terms of assessment scores, self-learning ability, clinical thinking ability, self-expression ability, and recognition of teaching. SPSS 22.0 was used to perform the t-test and the chi-square test. Results:The observation group had significantly higher theoretical and skill assessment scores than the control group [mastery of basic knowledge: (55.42±3.65) vs. (49.57±3.23), P<0.05; case analysis: (20.13±2.19) vs. (16.42±2.74), P<0.05; medical record writing: (18.29±2.17) vs. (15.12±2.05), P<0.05; operational ability: (20.32±2.04) vs. (17.51±1.89), P<0.05; performance score: (30.34±3.24) vs. (27.19±3.07), P<0.05]. After practice teaching, both groups had increases in the scores of self-learning ability and clinical thinking ability, and the observation group had significantly higher scores than the control group [self-learning ability: (90.73±6.88) vs. (85.54±6.53), P<0.05; clinical thinking ability: (105.62±10.19) vs. (100.47±10.45), P<0.05]. Compared with the control group, the observation group had a significantly better self-expression ability ( P<0.05) and a significantly higher degree of recognition of teaching ( P<0.05). Conclusions:The thinking pattern of "Six Thinking Hats" combined with CBL-RISE teaching can improve the assessment scores of interns in thoracic surgery and stimulate their learning ability, thinking ability, and self-expression ability.

The neurovascular unit (NVU) is highly responsible for cerebral homeostasis and its dysfunction emerges as a critical contributor to Alzheimer's disease (AD) pathology. Hence, rescuing NVU dysfunction might be a viable approach to AD treatments. Here, we fabricated a self-regulated muti-functional nano-modulator (siR/PIO@RP) that can intelligently navigate to damaged blood-brain barrier and release therapeutical cargoes for synergetic AD therapy. The resulting siR/PIO@RP enables self-regulation of its distribution in accordance with the physio/pathological state (low/high RAGE expression) of the target site via a feedback loop. siR/PIO@RP is capable of performing intricate tasks and goes beyond the capabilities of single-target therapeutic agents utilized in AD therapy, such as reducing cerebral Aβ load, relieving neuroinflammation, and alleviating the dysfunction of NVU. Overall, the current study provides proof of concept that normalizing NVU holds promise as a means of alleviating AD symptoms.