Objective To establish normal reference values for left ventricular trabecular and papillary muscle mass(TPMM)in Chinese adults using MRI and to explore its impact factors.Methods A total of 168 healthy Chinese adults were retrospectively included,and compacted and total left ventricular myocardial mass(LVM)were measured using traditional and dedicated methods,respectively.TPMM was calculated from the difference between total and compacted LVM.Independent sample t-tests and analysis of variance were used to explore the differences in TPMM among genders and age groups,while multiple linear regression was used to explore the independent correlation between TPMM and age,gender,heart rate,systolic blood pressure(SBP),fasting blood glucose(FBG),and body mass index(BMI).Results TPMM for men was significantly larger than that for female(P<0.001).TPMM in the elderly group was significantly larger in female(P<0.05),but not in men.Multiple linear regression showed that BMI and SBP were both independently positively correlated with TPMM,and female and heart rate were independently negatively correlated with TPMM(P<0.05).Conclusion This study provides age-and gender-specific normal reference values for TPMM in Chinese adults.Gender,heart rate,BMI,and SBP are all independently associated with TPMM.

【Objective】 To investigate the screen exposure status in 3- to 6-year-old children in Minhang district and to analyze its determinants, so as to provide a basis for scientific intervention of screen exposure in children. 【Methods】 A total of 1 035 children aged 3 to 6 years were selected from 30 classes in 10 kindergartens in Minhang district by multi-stage cluster sampling in October 2022. An online questionnaire survey was conducted by their parents. Screen exposure was difined as spending more than one hour on video products per day. Multivariate Logistic regression model was adopted to analyze the determinants of children screen exposure. 【Results】 Among 1 035 children, 730 experienced screen exposure (70.53%). The average time of daily screen exposure was (1.67±0.98)h. The daily screen exposure time of children aged 3, 4, 5 and 6 years at weekends was (1.77±1.13), (1.76±1.04), (1.98±1.10)h and(2.08±1.22)h, respectively, and the difference was statistically significant (F=3.98, P<0.01). Multivariate Logistic analysis showed that age group of 5 years old (OR=1.79, 95%CI:1.19 - 2.68), the caregivers using video products for 1 - 2hours/day (OR=2.61, 95%CI:1.90 - 3.60) and >2hours/day (OR=2.10, 95%CI:1.35 - 3.27) when accompanying children, parents supporting children using video products(OR=1.59, 95%CI:1.17 - 2.15), children using video products before bedtime(OR=1.94, 95%CI:1.32 - 2.86), and unsupervised use of video products for children(OR=1.94, 95%CI:1.36 - 2.77) were independent risk factors for children′s screen exposure(P<0.05). Father′s education level of bachelor(OR=0.61,95%CI:0.43 - 0.89), master and above(OR=0.49, 95%CI:0.34 - 0.73) was a protective factor for children′s screen exposure(P<0.05). 【Conclusions】 Attention should be paid to the problem of screen exposure of 3 -to 6 - year-old children. Targeted efforts should be made to popularize the knowledge of the harm of early screen exposure to children among caregivers, caregivers are advocated for the rule formulation of screen behavior, scientifically regulate children′s screen exposure behaviors, and increase parent-child communication, so as to reduce the adverse effects of screen exposure on children′s health.

Objective To determine whether local gradient fluid shear stress(FSS)causes a specific distribution of intracellular calcium ion concentration,which ultimately determines the direction of cell migration.Methods Numerical simulations were performed using COMSOL software.The method of staining intracellular calcium ion for RAW264.7 osteoclast precursors was established.After applying gradient FSS on the cells,the distribution and dynamic changes of intracellular calcium ion concentration and cell migration parameters were analyzed.Results Osteoclast precursors tended to migrate towards regions with lower FSS,and oscillatory flow regulated the distribution of intracellular calcium ions along the direction of cell migration.After blocking phospholipase C(PLC),mechanosensitive cation-selective channels(MSCC),endoplasmic reticulum(ER),and removing extracellular calcium,the migration speed of cells towards the low FSS direction was significantly reduced,but the migration speed along the liquid flow direction was significantly enhanced.Meanwhile,the calcium ion distribution along the liquid flow direction was significantly increased.Conclusions Osteoclast precursors can sense the FSS gradient,resulting in a specific distribution of intracellular calcium ions along the direction of migration.This ultimately leads to the migration of osteoclast precursors towards regions with lower FSS.This study provides important basic data for ultimately elucidating the cellular and molecular mechanisms of bone tissue remodeling under dynamic external forces.

Objective:To visualize the relationship between different combinations of mechanical power exposure intensity-duration and death risk in mechanical ventilation patients using a visualization method.Methods:Critically ill patients receiving mechanical ventilation were selected from the Medical Information Mart for Intensive Care-Ⅳ v1.0 (MIMIC-Ⅳ v1.0) database. The patients were divided into four subgroups according to oxygenation index (PaO 2/FiO 2) including > 300 mmHg (1 mmHg≈0.133 kPa) group, 201-300 mmHg group, 101-200 mmHg group and ≤100 mmHg group. The baseline characteristics, ventilator parameters, and prognostic indicators for different patient populations were collected. For each patient, the mechanical power thresholds from low to high (5-30 J/min, increasing at intervals of 1 J/min) were used to evaluate the different exposures of mechanical power (above the set threshold was recorded as one exposure), and the number of events with different exposure intensity-duration combinations was counted based on their corresponding durations. Based on the 28-day survival/non-survival status, the number of exposures for survivors and non-survivors in each exposure intensity-duration combination was calculated, and the survival odds ratio ( OR) for different mechanical power exposure intensity-duration combinations was subsequently computed. Two-dimensional tables were generated with mechanical power exposure duration on the x-axis and exposure intensity on the y-axis, and the heatmap and its corresponding equipotential line view were used to visualize the OR value to assess the risk of death. Results:A total of 5 378 patients receiving mechanical ventilation were enrolled in the study, of whom 2 069 patients in the PaO 2/FiO 2 > 300 mmHg group, 813 patients in the 201-300 mmHg group, 1 493 patients in the 101-200 mmHg group, and 1 003 patients in the ≤100 mmHg group. The severity scores of patients, including sequential organ failure assessment (SOFA) score and simplified acute physiology score Ⅱ (SAPSⅡ), gradually increased following the decrease in PaO 2/FiO 2, and the incidence of co-morbidities also gradually increased. In terms of ventilator parameters, mechanical power was increased gradually with decrease in PaO 2/FiO 2, measuring 10.4 (7.8, 13.9), 11.3 (8.5, 14.7), 13.6 (10.0, 18.2), and 16.7 (12.5, 22.0) J/min ( P < 0.01). In terms of prognosis, 28-day mortality of patients was gradually increased with decrease in PaO 2/FiO 2 [29.1% (601/2 069), 26.9% (219/813), 28.1% (420/1 493), and 33.3% (334/1 003), respectively, P < 0.05]. In the heatmap, it could be observed that the 28-day death risk of mechanical ventilation patients was gradually increased with increase in mechanical power exposure intensity and long duration, showing two distinct areas: a region near the bottom left corner (representing low mechanical power exposure intensity and short duration) was blue, indicating a greater chance of survival. In contrast, another region near the top right corner (representing high mechanical power exposure intensity and long duration) was red, indicating a higher risk of death. According to the fitted lines of death risk, for the same risk of death, a shorter mechanical power exposure duration was required for higher exposure intensity, while lower mechanical power exposure intensity required a longer exposure duration. The above trend of change was similarly reflected in the overall population and different oxygenation populations. Conclusions:Cumulative mechanical power exposure to higher intensity and/or longer duration is associated with worse outcomes in mechanical ventilation patients. Considering both the mechanical power exposure intensity and duration may help to evaluate the effectiveness of lung protection in mechanical ventilation patients and guide adjustments in mechanical ventilation strategy to reduce the risk of ventilator-induced lung injury.

ObjectiveTo analyze the effects of different feeding patterns on the physical and nutritional status of children aged 6‒12 months， so as to provide reference for promoting scientific feeding and health development of infants and young children. MethodsChildren born between December 2019 and February 2020 and who had completed three follow-up visits at 6‒， 9‒ （8‒10 months） and 12‒ （11‒14 months） months old in all of the 13 communities of Minhang， Shanghai were selected. The subjects’ basic information was investigated by questionnaires. The indicators including feeding pattern， physical development （body weight， body length， head circumference） and nutritional status （the detection rate of overweight， obesity， low body weight， growth retardation， emaciation and iron deficiency anemia） were followed up in the outpatient department， with iron deficiency anemia only monitored at the 6‒ and 12‒ months old. According to different feeding patterns， the groups of 6‒ months old were divided into three groups of exclusive breast feeding （EBF）， mixed feeding （MF） and artificial feeding （AF）， while 9‒ and 12‒ months old were divided into MF and AF groups. The differences of basic information and follow-up results among the groups were analyzed. ResultsA total of 470 children were included， including 130 （27.66%）， 288 （61.28%） and 52 （11.06%） respectively in EBF， MF and AF groups at the 6‒ months old，and 319 （67.87%） and 196 （41.70%） in MF group at the 9‒ and 12‒ months old. There was no significant difference in the other follow-up results among the groups. The detection rate of iron deficiency anemia in 6‒ months old EBF （13.08%） was higher than that in MF group （5.90%） and AF group （1.92%） （χ²=8.40， P=0.010）， while it was still higher in 12‒ months old MF group （9.69%） than in AF group （2.92%） （χ²=9.68， P=0.002）. ConclusionThere is no significant difference in body weight，body length， head circumference， and the detection rates of overweight， obesity， low body weight， growth retardation and emaciation among the groups of different feeding patterns in the children aged 6‒12 months. The detection rate of iron deficiency anemia in the EBF and MF groups is significantly higher than that in the AF groups of children aged 6‒ and 12‒ months old.

Objective:To study the effect of excessive torsion of the umbilical cord on fetal or neonatal outcomes.Methods:The observation group was selected from the puerperae who delivered in Beijing Obstetrics and Gynecology Hospital from July 2016 to June 2020 with excessive torsion of the umbilical cord. In the same period, the puerperae without excessive torsion of the umbilical cord were selected as the control group with a ratio of 1∶1. The general condition, mode of delivery, perinatal outcomes, and the effect of different umbilical coiling index (UCI) [twisted umbilical cord weeks/umbilical cord length (cm)] on fetal and neonatal outcomes were retrospectively analyzed between two groups.Results:Compared with the control group, the observation group (1 780 cases) had smaller neonatal gestational age [(37.9±3.2) weeks vs. (38.4±2.9) weeks], birth weight [(3 007±726) g vs. (3 354±616) g] and length [(48.5±4.3) cm vs. (49.6±4.1) cm], but higher incidence of fetal distress [34.9% (622/1 780) vs. 12.9% (230/1 780)], neonatal asphyxia [1.5% (26/1 780) vs. 0.7% (13/1 780)], and cord blood pH<7.20 [4.2% (75/1 780) vs. 2.8% (49/1 780)], the difference was statistically significant ( P<0.05). The UCI≥0.73 group had lower neonatal gestational age, birth weight and length, but higher incidence of cord blood pH<7.20 and neonatal asphyxia than the UCI<0.73 group, with statistically significant differences ( P<0.05). Conclusions:Excessive torsion of the umbilical cord increases the incidence of fetal hypoxia and neonatal asphyxia and has a significant effect on neonatal gestational age, birth weight and length. The higher the UCI, the greater the impact on fetus and neonate.

Objective:To analyze the trend of maternal mortality ratio (MMR) and death causes in Tianjin from 2011 to 2020 and to guide the management of maternal health.Methods:All the reviews data of 89 maternal death cases in Tianjin from 2011 to 2020 were retrospectively collected to analyze the trend of MMR, rank order of death causes, and death review results using Chi-square test. Results:(1) The average MMR in Tianjin was 7.97/100 000 during the study period, showing an overall fluctuating decline. The highest MMR was 12.61/100 000 in 2014 and the lowest was 3.85/100 000 in 2019. (2) Among the dead pregnant women and parturients, non-registered residents had higher proportion of women with advanced age, no steady occupation/unemployment, below junior college education, multipara, or without maternal health manual compared with the registered residents [33.33% (8/24) vs 20.00% (13/65), χ2=46.18; 100.00%(24/24) vs 69.23%(45/65), χ2=9.53; 87.50% (21/24) vs 64.62% (42/65), χ2=4.44; 79.17% (19/24) vs 44.62% (29/65), χ2=8.42; 75.00%(18/24) vs 13.85% (9/65), χ2=31.02; all P<0.05]. (3) Direct obstetric factors and indirect factors that caused death were accounted for 57.30% (51/89) and 42.70% (38/89). The top five death causes were postpartum hemorrhage, hypertensive disease during pregnancy, sudden death, venous thrombosis and pulmonary embolism, and amniotic fluid embolism. (4) In terms of the maternal death review results, 39.33% (35/89) of maternal deaths were avoidable, among which 94.29% (33/35) were caused by direct obstetric factors and 5.71% (2/35) were indirect. (5) The main influencing factors of avoidable death causes were knowledge and skills inadequacy in the health care system (62.86%, 22/35), of which 86.36% (19/22) happened in health facilities at and below the district/county level. Conclusion:It is suggested to strengthen the medical care of health facilities at and below the district/county level and the maternal health management of the non-permanent residents to ensure maternal and infant safety and to further reduce the MMR.

ObjectiveTo analyze the prevalence and influencing factors of mental health problems among hypertensive patients in Ya'an city five years after the Lushan earthquake， so as to provide references for promoting the mental health of hypertensive patients in earthquake-stricken areas. MethodsStratified random cluster sampling method was adopted to select 800 hypertensive patients in Ya'an city in December 2018. The general information of patients were collected via a self-designed questionnaire， and their mental health problems were assessed via the 12-item General Health Questionnaire （GHQ-12）.Then Logistic regression analysis was applied to explore the influencing factors. ResultA total of 744 valid questionnaires （93.00%） were obtained， and mental health problems were detected in 79 cases （10.62%）. Univariate analysis denoted that the detection rate of mental health problems yielded statistical difference among patients of different marital status （P<0.01）， family per capita monthly income （P=0.012） and social assistance recipients （χ²=25.194， P<0.01）. Logistic regression analysis indicated that the unmarried/separated/divorced/widowed status （OR=3.879， P=0.015） and social assistance recipients （OR=4.705， P<0.01） were risk factors for mental health problems among hypertensive patients. ConclusionThe detection rate of mental health problems is low among hypertensive patients in Ya'an city， while the unmarried/separated/divorced/widowed and social assistance recipients may suffer more serious mental health problems.

【Objective】 To analyze the trend in group voluntary blood donation from 2012 to 2020 in Shandong, China, so as to provide scientific basis for establishing effective recruitment strategy and promoting voluntary blood donation. 【Methods】 The development trend was analyzed based on the total donations and volumes of group voluntary blood donation and the proportion of group blood donation to the annual total blood donation. 【Results】 The donations and volumes of group blood donation increased from 83 847 sessions and 130 647 units (1 U=200 mL) in 2012 to 263 003 sessions and 415 578 units in 2020, with an increase of 213.7% and 218.1%, respectively. The proportion of sessions and volumes of group blood donation increased from 10.1%(83 847/829 153) and 8.7%(130 647/1 494 111) in 2012 to 25.4%(263 003/1 035 410) and 22.7%(415 578/1 832 211) in 2020, respectively. The proportion of donations and volumes of group blood donation was higher in the high socioeconomic status (SES) districts than that in low SES districts. 【Conclusion】 The pattern of voluntary blood donation is shifting from street voluntary blood donation to group donation in Shandong China. It is necessary to optimize the recruitment strategy in the future to achieve sustainable and healthy development of voluntary blood donation.

The gut microbiota plays an important role in regulating the pharmacokinetics and pharmacodynamics of many drugs. FLZ, a novel squamosamide derivative, has been shown to have neuroprotective effects on experimental Parkinson's disease (PD) models. FLZ is under phase Ⅰ clinical trial now, while the underlying mechanisms contributing to the absorption of FLZ are still not fully elucidated. Due to the main metabolite of FLZ was abundant in feces but rare in urine and bile of mice, we focused on the gut microbiota to address how FLZ was metabolized and absorbed.