Objective: To investigate the prevalence of undernutrition and its associated factors among left behind and non left behind primary and secondary school students in the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) areas of central and western China, so as to provide evidence for improving the nutritional status of children and adolescents. Methods: A survey was conducted among 123 782 students selected by random cluster sampling method in grades 3-9 from NIPRCES in central (Hebei, Shanxi, Heilongjiang, Jilin, Anhui, Jiangxi, Henan, Hunan, Hubei, and Hainan) and western (Gansu, Guangxi, Inner Mongolia, Ningxia, Tibet, Shaanxi, Guizhou, Sichuan, Xinjiang, the Xinjiang Production and Construction Corps, Yunnan, Qinghai, and Chongqing) China in 2023. Anthropometric measurements and questionnaires were used to assess nutritional and dietary status. The prevalence of undernutrition was compared between left behind and non left behind students by Chi square test, and associated factors were analyzed by three level Logistic mixed effects model. Results: The prevalence of undernutrition was 8.5% (4 326) in left behind students and 8.1% (5 905) in non left behind students. Three level Logistic mixed effect model analysis showed that whether left behind or non left behind, the undernutrition rates of primary and secondary students in western regions were higher than those of students in central regions [ OR (95% CI )=1.72(1.57-1.87),2.25(2.07- 2.43 )]; the undernutrition risk was lower for those whose fathers had a cultural level of high school or above [ OR (95% CI )=0.69(0.62-0.77),0.90(0.82-0.98)] or junior high school [ OR (95% CI )=0.72(0.66-0.79),0.92(0.85-0.99)] compared to those with primary school or below; picky eating or selective eating increased the risk of undernutrition [ OR (95% CI )=2.36(2.07-2.68),2.28(2.04-2.55)], and primary and secondary school students without nutritional content in health education classes had higher rates of undernutrition [ OR (95% CI )=1.12(1.03-1.23),1.09(1.01-1.17)](all P <0.05). Conclusion The prevalence of undernutrition is slightly higher in left behind primary and secondary students than in non left behind primary and secondary students in central and western NIPRCES areas, with variations across different characteristics.

Objective: To analyze the trends of the frequency of meat, egg, and milk consumption among rural primary and junior high school students in central and western China covered by the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) from 2015 to 2023, so as to provide basis for formulating more targeted nutrition intervention policies and health education strategies. Methods: Using data from six rounds of monitoring and evaluation (2015-2021 and 2023), the study included 323 870 students from grade 3 to 9 across 22 provinces (autonomous regions and municipalities) in central and western China. The consumption frequencies of meat, egg, and milk over the past week were collected via questionnaires. The Cochran-Armitage trend test was used to analyze temporal trends, and multivariable Logistic regression models were employed to analyze factors associated with the frequency of meat, egg and milk consumption and to test for interaction effects between the year and gender, region, and grade level. Results: From 2015 to 2023, the proportion of students consuming meat, egg, and milk ≥1 time/day increased from 23.20 %, 10.71%, and 0.74% to 35.53%, 22.09%, and 26.63%, respectively. Trend tests indicated a significant upward trend for the daily intake of all three food categories for meat, egg and milk over the years ( Z =67.18, 64.90, 93.14, all P <0.01). Multivariable Logistic regression analysis showed that the daily meat intake was lower in the central region than in the western region ( OR=0.77, 95%CI =0.76-0.78), whereas the daily intake of eggs ( OR=1.19, 95%CI =1.17-1.22) and milk ( OR= 1.27 , 95%CI =1.24-1.29) was higher in the central region (all P <0.05). Compared with grade 3-4 students, junior high school students had lower daily intake of meat, eggs, and milk≥1 time/day ( OR =0.95, 0.77, 0.77, all P <0.05), with a declining trend as grade increased. Girls also had lower daily intake of meat, eggs, and milk ≥1 time/day than boys ( OR =0.95，0.93，0.91, all P < 0.05). Significant interactions were observed between year and region, as well as between year and grade (all P <0.05). Conclusion From 2015 to 2023, the NIPRCES improved the intake level of among rural students, but the situation of relatively insufficient intake of egg and milk among females, junior high school students and those in the western region still exists.

This study aimed to investigate the effects of the peptide secreted protein isthmin-1 (ISM1) on the proliferation and apoptosis of non-small cell lung cancer (NSCLC) cells. ISM1 expression in NSCLC was detected by immunohistochemistry (IHC). ISM1 was overexpressed in lung cancer cell lines by transient transfection of ISM1 plasmids, or establishing ISM1 overexpression stable cell lines, or by treating cells with recombined ISM1 (rISM1). CCK-8 was used to examine cell growth. The intracellular signal transduction pathways regulated by rISM1 were analyzed by transcriptome sequencing, and verified by qRT-PCR and Western blot. The levels of intracellular ROS and apoptosis were further detected using the kit. The results showed that the expression of ISM1 was decreased in human NSCLC tissue samples compared to normal lung tissue samples. Overexpression of ISM1 or rISM1 treatment significantly suppressed the growth of lung cancer cells. RNA sequencing revealed that rISM1 mainly regulated the FoxO signaling pathway. rISM1 treatment decreased the expression of FoxO3 and FoxO1, increased reactive oxygen species (ROS) production, and induced cell apoptosis. These results suggest that ISM1 can inhibit the growth of NSCLC by regulating the FoxO signaling pathway. These findings provide new strategies for cancer therapy.

Objective:To investigate the predictive value of anti-Müllerian hormone (AMH) on the outcome of microscopic testicular sperm extraction (micro-TESE) in patients with non-mosaic Klinefelter syndrome (KS) of the clinical data and to identify effective predictors for successful micro-TESE.Methods:A retrospective case-control study was conducted on the clinical data of 118 non-mosaic KS patients treated at the Center for Reproductive Medicine of the First Affiliated Hospital of Zhengzhou University between May 2018 and September 2023. Patients were divided into two groups based on whether sperm were successfully retrieved via micro-TESE: the sperm retrieved group ( n=45) and the no sperm retrieved group ( n=73). Differences between the two groups were compared, and multivariate logistic regression analysis was used to identify factors influencing sperm retrieval. Changes in testicular volume and sex hormone levels before and after surgery were also assessed. Results:The sperm retrieval rate was 38.1% (45/118). Patients in the sperm retrieved group were significantly younger [(26.93±3.80) years] than those in the no sperm retrieved group [(28.27±3.92) years, P=0.029], and the AMH level was significantly higher [0.44 (0.18, 1.13) μg/L] than that in the no sperm retrieved group [0.10 (0.03, 0.22) μg/L, P<0.001]. AMH was identified as an independent predictor of micro-TESE outcome in non-mosaic KS patients ( OR=7.867, 95% CI: 2.727-27.242, P=0.001). The area under the receiver operating characteristic curve was 0.802 (95% CI: 0.722-0.883), and the optimal reference threshold for AMH was ≥0.265 μg/L. Postoperatively, testosterone levels decreased significantly by a median of 0.27 μg/L ( P=0.019), while luteinizing hormone levels increased by a median of 2.08 U/L ( P=0.049), with a more significant decline in testosterone levels observed in the no sperm retrieved group by a median of 0.29 μg/L ( P=0.022). Conclusion:AMH can predict successful micro-TESE in non-mosaic KS patients, with higher AMH levels indicating a higher likelihood of success.

Objective To evaluate the diagnostic efficacy of the Kaiser score for ultrasound(US)BI-RADS 4A lesions and the potential to avoid unnecessary biopsies.Methods Data of patients who underwent breast US and magnetic resonance imaging(MRI)between May 2019 and June 2023 were retrospectively collected,and all cases were confirmed by puncture biopsy or surgical pathology.The diagnostic efficacy of Kaiser score and MRI BI-RADS classification for US BI-RADS 4A lesions was calculated and compared using pathologic findings as the gold standard.Results A total of 119 lesions(74 benign and 45 malignant lesions)were found in the 119 patients.The diagnostic efficacy of the Kaiser score was significantly better than that of the MRI BI-RADS classification(AUC:0.88 vs.0.65,P＜0.000 1).The concordance of the Kaiser score results with the pathologic findings and the inter-observer concordance were better than that of the MRI BI-RADS classification.Unnecessary biopsies could be avoided in 87.8％(65/74)and 33.8％(25/74)of the cases when the Kaiser score and the MRI BI-RADS classification were applied for the diagnosis of US BI-RADS 4A lesions,respectively.Conclusion The Kaiser score can provide a diagnostic basis for risk stratification of US BI-RADS 4A lesions,and its diagnostic efficacy and inter-observer agreement are superior to those of MRI BI-RADS classification.

Purpose To explore the value of tumor intratumoral and peritumoral radiomics models based on dynamic contrast-enhanced MRI in predicting benign and malignant breast tumors.Materials and Methods This retrospective study analyzed clinical data and MRI imaging features from 309 patients with pathologically confirmed solitary breast tumors at the Second Affiliated Hospital of Xiamen Medical College from August 2018 to December 2022.The cohort was randomly divided into training(n=248)and testing(n=61)cohorts in an 8∶2 ratio.Using second-phase dynamic contrast-enhanced MRI images,five distinct peritumoral regions were segmented through 3D-Slicer software:intratumoral region,peritumoral 2 mm region,peritumoral 4 mm region,intratumoral combined with peritumoral 2 mm region and intratumoral combined with peritumoral 4 mm region.Radiomic features were extracted from these regions of interest.Machine learning algorithms integrated with Logistic regression analysis were employed for feature selection,with cross-validation techniques determining the optimal radiomic signature combination.Results Of 309 patients,150 were benign tumors and 159 were malignant tumors.The age,maximum diameter and enhancement type of benign and malignant breast tumors were statistically significant(Z/χ2=-7.695,-5.775,30.248;all P<0.001).For the region of interest of intratumoral combined with peritumoral 4 mm region,the area under curve,sensitivity,specificity,accuracy and F1 scores of the training and validation were 0.893,89.1%,75.0%,82.3%,0.838 and 0.881,74.2%,86.7%,80.3%,0.793,respectively.In the training set,the area under curve of intratumoral combined with peritumoral 4 mm region was significantly higher than that of intratumoral,peritumoral 2 mm,peritumoral 4 mm and intratumoral combined with peritumoral 2 mm regional imaging models(Z=2.506,2.982,3.392,2.157;all P<0.05).The Hosmer-Lemeshow test showed that the calibration curve of the model combined with region of interest of intratumoral combined with peritumoral 4 mm region was highly consistent with the ideal curve(training P=0.381,validation P=0.159).The decision curve indicated that the net benefit of the radiomics model in the region of interest of intratumoral combined with peritumoral 4 mm region was the highest when the risk threshold was between 0 and 1.0.Conclusion The radiomics model has good predictive performance in predicting benign or malignant breast tumors,among them the combined region of interest of intratumoral combined with peritumoral 4 mm region provides the best performance and highest benefit.The technology clinical application will provide a non-invasive predictive method for the differential diagnosis of benign and malignant breast tumors.

Objective:To explore the clinical characteristics, diagnosis, and treatment of chylous pleural effusion caused by liver cirrhosis.Methods:The clinical data of 19 cases of liver cirrhosis complicated with chylous pleural effusion admitted at Department of Lymphatic Surgery, Beijing Shijitan Hospital from Jun 2013 to Oct 2022 was retrospectively analyzed.Results:There were 12 males (63.2%) and 7 females (36.8%).Ten cases (52.6%) had right chylothorax, and 9 cases (47.4%) had bilateral chylothorax; Seventeen cases (89.5%) had concurrent ascites. Chest fluid examination: 3 cases were milky white (16%), 10 cases were yellow white (53%), 4 cases were orange yellow (21%), and 2 cases were pink (10%).There were 2 cases of exudate and 17 cases of transudate. By radionuclide lymphatic imaging, 9 cases showed increased radiation in the right chest cavity; One case showed increased radiation in the left chest cavity; Five cases showed bilateral chest radiation elevation. By lymphangiography,11 cases showed complete visualization of the thoracic duct, of which 10 cases showed obstruction at the outlet of the thoracic duct. The 10 patients underwent surgical treatment for the release of adhesions at the end of the thoracic duct, and the postoperative result was good. Six patients died during follow-up.Conclusions:Cirrhosis combined with chylous pleural effusion is rare in clinical practice and prognosis is poor. The laboratory examination of pleural effusion is an important basis for determining chylous pleural effusion. The lysis of adhesions at the end of the thoracic duct has a certain therapeutic effect on patients with lymphangiography indicating thoracic duct outlet obstruction.

Objective To explore the effect of back-pushing manipulation on motor ability and skele-tal muscle mitochondrial function in rats with chronic fatigue syndrome(CFS).Methods Twenty-four male Sprague-Dawley rats were randomly divided into a blank group of 8 and a modeling group of 16.The CFS rat model was established using forced weight-bearing swimming combined with chronic stress stimulation for 21 days.After successful modeling,the modeling group was further divided into the modeling control(MC)group and the back-pushing manipulation(BPM)group,each of 8.In the back-pushing manipulation group,all rats were given daily 20-minute back pushing for 14 consecu-tive days after modeling.Then,all groups were recorded semi-quantitative scores of general conditions(SQS-GC),body mass,and exhaustion swimming time(EST).Moreover,the grasping ability of limbs was assessed by using the mesh screen test(MST).After the intervention,the tissue of the erector spinae muscle was taken to detect the adenosine triphosphate(ATP)content using the biochemi-cal method,and the activities of mitochondrial respiratory chain complexes Ⅰ to Ⅳ were detected by using the spectrophotometric method.Results After modeling,compared with the blank group,the SQS-GC of the MC group and BPM groups were higher(P<0.01),while EST was shorter and the MST score was lower(P<0.01 or P<0.05).However,after intervention,compared with the MC group,the SQS-GC of the BPM group was lower(P<0.01),while EST and the MST score was higher(P<0.01 or P<0.05).Compared with the blank group,the ATP content of the modelling group was significantly lower(P<0.01),and the activities of mitochondrial respiratory chain complexes I,II,III,and IV de-creased significantly(P<0.01).However,after intervention,all the above values of the BPM group in-creased significantly,compared with the MC group(P<0.01 or P<0.05).Conclusion The back-pushing manipulation can improve the mitochondrial function and energy metabolism,as well as the exercise ca-pacity,and alleviate fatigue of CFS rats,which may be related to the improvement of the activities of mitochondrial respiratory chain complexes I,II,III,and IV,and the increase of ATP content in the skeletal muscles.

Objective:To optimize the anticoagulation monitoring process for extracorporeal membrane oxygenation (ECMO) patients by constructing an informatization module and evaluate its application effect.Methods:An informatization team was established, and based on literature review, an anticoagulation monitoring information sheet for ECMO patients was developed. Using a data-sharing architecture, existing hospital information management system, laboratory information management system, picture archiving and communication system, and ICU monitoring system were integrated to construct an ECMO anticoagulation monitoring informatization module with data sharing, real-time alerts, and information support functions. Clinical applications were observed for effect. A convenience sampling method was employed to select 60 ECMO patients treated in the ICU of the Affiliated Hospital of Qingdao University from October 2022 to September 2023. The patients admitted from October 2022 to March 2023 were designated as the control group ( n=30), using the conventional anticoagulation monitoring method; those admitted from April to September 2023 were designated as the experimental group ( n=30), using the anticoagulation monitoring informatization module. The anticoagulation monitoring timeliness rate, anticoagulant drug adjustment timeliness rate, and the incidence rates of thrombosis and bleeding were compared between the two groups. Results:The timeliness rate of anticoagulation monitoring and the timeliness rate of anticoagulant drug adjustment in the experimental group were (93.38±6.31) % and (91.90±4.71) %, respectively, which were higher than those in the control group (83.01±9.94) % and (83.49±12.83) %, with statistically significant differences (both P<0.01). The incidence rates of thrombosis and bleeding in the experimental group were 16.67% (5/30) and 26.67% (8/30), respectively, which were lower than those in the control group 40.00% (12/30) and 53.33% (16/30), with statistically significant differences (both P<0.05) . Conclusions:The optimized anticoagulation monitoring informatization process based on the anticoagulation monitoring informatization module demonstrates a good clinical application effect and can reduce the incidence of bleeding and thrombosis in ECMO patients.

Objective To explore the effect of back-pushing manipulation on motor ability and skele-tal muscle mitochondrial function in rats with chronic fatigue syndrome(CFS).Methods Twenty-four male Sprague-Dawley rats were randomly divided into a blank group of 8 and a modeling group of 16.The CFS rat model was established using forced weight-bearing swimming combined with chronic stress stimulation for 21 days.After successful modeling,the modeling group was further divided into the modeling control(MC)group and the back-pushing manipulation(BPM)group,each of 8.In the back-pushing manipulation group,all rats were given daily 20-minute back pushing for 14 consecu-tive days after modeling.Then,all groups were recorded semi-quantitative scores of general conditions(SQS-GC),body mass,and exhaustion swimming time(EST).Moreover,the grasping ability of limbs was assessed by using the mesh screen test(MST).After the intervention,the tissue of the erector spinae muscle was taken to detect the adenosine triphosphate(ATP)content using the biochemi-cal method,and the activities of mitochondrial respiratory chain complexes Ⅰ to Ⅳ were detected by using the spectrophotometric method.Results After modeling,compared with the blank group,the SQS-GC of the MC group and BPM groups were higher(P<0.01),while EST was shorter and the MST score was lower(P<0.01 or P<0.05).However,after intervention,compared with the MC group,the SQS-GC of the BPM group was lower(P<0.01),while EST and the MST score was higher(P<0.01 or P<0.05).Compared with the blank group,the ATP content of the modelling group was significantly lower(P<0.01),and the activities of mitochondrial respiratory chain complexes I,II,III,and IV de-creased significantly(P<0.01).However,after intervention,all the above values of the BPM group in-creased significantly,compared with the MC group(P<0.01 or P<0.05).Conclusion The back-pushing manipulation can improve the mitochondrial function and energy metabolism,as well as the exercise ca-pacity,and alleviate fatigue of CFS rats,which may be related to the improvement of the activities of mitochondrial respiratory chain complexes I,II,III,and IV,and the increase of ATP content in the skeletal muscles.