Objective: To investigate the association between outdoor light at night (LAN) exposure and sleep quality among primary and secondary school students, and to examine the pathways of negative affects including depressive, stress and anxiety symptoms, so as to provide a theoretical basis for optimizing the school environment and enhancing the physical and mental well being of students. Methods: In December 2024, a total of 36 885 students from 154 primary and secondary schools in Suzhou, Nantong, and Changzhou were included via a stratified cluster sampling method. Sleep quality and negative affect were assessed by using the Pittsburgh Sleep Quality Index (PSQI), Center for Epidemiologic Studies Depression Scale (CES-D), Generalized Anxiety Disorder-7 (GAD-7), and Depression, Anxiety and Stress Scale-21 (DASS-21), respectively. Outdoor LAN exposure data were obtained from the national polar orbiting partnership visible infrared imaging radiometer suite nighttime light(NPP-VIIRS NTL) dataset provided by the National Earth System Science Data Center. Multivariate Logistic regression model was employed to analyze the association between LAN exposure and sleep quality across different regions, with stratification by monitoring site. Spearman correlation analysis was used to examine the relationships between LAN, negative affect, and sleep quality. The mediating role of negative affect was tested by using Model 4 of the PROCESS macro. Results: The detection rates among students were 13.95%( n =5 147) for depressive symptom, 16.72%( n =6 166) for stress symptom, and 17.49%( n =6 451) for anxiety symptom. The median outdoor LAN exposure was 28.85(19.10, 41.44)nW/(cm 2 · ( sr). After adjusting for confounders, multivariate Logistic regression analysis showed that high LAN exposure ( Q 4) was positively associated with sleep problems (urban areas: OR =1.28, 95% CI = 1.17- 1.41; rural areas: OR =1.21, 95% CI =1.07-1.36; both P <0.05). Spearman correlation analysis revealed significant positive correlations between LAN exposure, depressive symptoms, stress symptoms, anxiety symptoms, and sleep quality ( r =0.03-0.75, all P < 0.01). The mediation analysis indicated that all dimensions of negative affect significantly mediated the relationship between high LAN exposure and poor sleep quality (all P <0.01). Specifically, the indirect effects were 0.03 (95% CI =0.02-0.05) for depressive symptom, 0.05(95% CI =0.03-0.08) for stress symptom, and 0.07(95% CI =0.05-0.09) for anxiety symptom. Overall, 31.9% of the total effect was mediated by negative affect, with anxiety (14.89%) being the strongest mediator, followed by stress (10.64%) and depression(6.38%). Conclusion Reducing high levels of outdoor LAN exposure and implementing interventions targeting negative affect may contribute to improved sleep quality among primary and secondary school students.

Multimodal fusion research in traditional Chinese medicine （TCM） inspection has greatly improved the accuracy of identification results with the help of emerging technologies in science and technology. At present， multimodal fusion technology is used in the integration of the parameters collected by the inspection instruments and the analysis of the parameters， which is represented by the development and application of the tongue inspection instrument， the face inspection instrument and the eye inspection instrument. However， the multimodal fusion research of TCM inspection has problems such as insufficient comprehensiveness and accuracy of parameter acquisition， difficulty in parameter integration for fusion analysis， and low clinical practicability of identification results. It is believed that， while keeping up with the cutting-edge science and technology， research on multimodal fusion of TCM inspection should be guided by the holism concept of TCM， and should focus on the enhancement of comprehensiveness and accuracy of multimodal parameter acquisition， standardisation of parameter fusion， and fusion of identification results， so as to gradually promote the objectivity， intelligence and modernisation of the four diagnostic methods of TCM.

BACKGROUND:Unicompartmental knee arthroplasty has been paid more and more attention because of its advantages of fewer traumas,less blood loss,less complications,faster recovery,excellent knee function and high prosthetic survival rate.Most of the relevant reports focused on its clinical effect,but the changes in the levels of relevant inflammatory cytokines in patients after unicompartmental knee arthroplasty were rarely reported. OBJECTIVE:To investigate the effect of unicompartmental knee arthroplasty in patients with medial compartment osteoarthritis of the knee and the changes of interleukin-1,interleukin-6,and tumor necrosis factor-α levels. METHODS:A total of 30 patients with medial compartment osteoarthritis of the knee who received unicompartmental knee arthroplasty from September 2021 to March 2023 and met the inclusion criteria were selected as the study subjects.Medial angle of proximal tibia,femoral and tibial angle,pain visual analog scale score,hospital for special surgery score,knee joint range of motion,synovial fluid interleukin-1,interleukin-6,and tumor necrosis factor-α levels before and after surgery were compared and statistically analyzed. RESULTS AND CONCLUSION:(1)All 30 patients had grade I wound healing.All patients were followed up for more than 6 months after surgery.There were no complications such as prosthesis loosening and dislocation of prosthesis liner in all patients.(2)The medial proximal tibia angle and the femoral and tibial angles measured after operation were significantly improved(P<0.05).(3)The visual analog scale score,hospital for special surgery score and range of motion measured at 1,3,and 6 months after operation were better than those before operation(P<0.05),and showed a gradual improvement(P<0.05).(4)The levels of interleukin-1,interleukin-6,and tumor necrosis factor-α in synovial fluid at 3 and 6 months after operation were decreased gradually compared with those before operation(P<0.05)and showed a gradual downward trend at each time point after operation.(5)It is indicated that unicompartmental knee arthroplasty can effectively treat medial compartment osteoarthritis of the knee,significantly relieve pain,restore knee joint function,improve knee varus deformity and lower limb strength line,and reduce the levels of inflammatory cytokines interleukin-1,interleukin-6,and tumor necrosis factor-α in joints to a certain extent.

Objective This study aims to analyze the proteomic characteristics of peripheral blood in patients with lung cancer coexistent with pulmonary tuberculosis(LC-PTB),identify the differential proteins compared with lung cancer(LC)patients,and conduct functional analysis on these proteins.Methods The study included 8 LC-PTB patients and 10 LC patients.The LC patients were newly diagnosed and confirmed by pathology and did not receive any anti-tumor treatment before,while the PTB patients were Mycobacterium tuberculosis positive at the time of sampling.Liquid chromatography-tandem mass spectrometry(LC-MS/MS)was applied to perform proteomic mass spectrometry to assess the differential proteins,and then functional analysis was conducted via bioinformatics.Results A total of 5,185 proteins were detected between two groups.Through differential expression screening,190 proteins(58 upregulated and 132 downregulated)were identified to be differentially expressed.Subcellular localization analysis revealed that the differential proteins were mainly concentrated in the cytoplasm,nucleus,and extracellular matrix.KEGG pathway and GO analysis showed the roles of differential proteins in biological processes including immune response,metabolism,and secretion regulation.Protein interaction network analysis highlighted the importance of SORT1,SAR1B,RPS6KB1,VWF,SHC1,SRPRB,CTSD,TARDBP,RPLP0,PSMA2,RPS6,XPO1,PRKACB,and HLA-DRB1 in LC-PTB.Additionally,the expression changes in proteins like ADA2,MAP3K1,and GLS2 might be closely associated with the development of LC-PTB.Conclusions The proteomic profile comprehensively described the proteomic characteristics of LC-PTB and identified numerous differentially expressed proteins,which could provide further clues for research on biological mechanism of LC-PTB.

Objective:To establish and internally validate a visualized model for predicting the severity of acute pancreatitis (AP).Methods:From September 1st 2017 to August 31st 2020, 600 patients with AP diagnosed in the First Affiliated Hospital of Kunming Medical University were enrolled. According to the Atlanta classification of AP, the 600 patients were divided into severe acute pancreatitis (SAP) group (128 cases) and non-severe acute pancreatitis (NSAP) group (472 cases). The general clinical data (age, gender, body mass index, etc), laboratory indicators (fasting blood glucose, urea nitrogen, creatinine, etc.), complicated with ascites or pleural effusion, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores and bedside index of severity in acute pancreatitis (BISAP) score between the two groups were compared. The potential predictors of SAP were screened with least absolute shrinkage and selection operator (LASSO). The screened predictors were included in the multivariate logistic regression analysis to establish the logistic regression model. The operation characteristic curves of the model, APACHE Ⅱ scores and BISAP were drawn, the discriminative capability of the model was evaluated by comparing the area under the curve (AUC). Calibration, Hosmer-Lemesshow test and decision curve analysis (DCA) were used to evaluate the accuracy and clinical practicability of the prediction model. Bootstrap was used for internally validation of the model. Independent sample t test, Wilcoxon test and chi-square test were used for statistical analysis. Results:The difference of gender composition ratio between SAP and NSAP group was statistically significant ( χ2=4.092, P<0.05). The fatality rate of SAP group was higher than that of NSAP group(21.1%, 27/128 vs. 0, 0/472); the length of hospital stay of SAP group was longer than that of NSAP group((20.33±16.21) d vs. (8.42±4.26) d); the hospitalization cost, fasting blood glucose level, urea nitrogen level, creatinine level, C-reactive protein(CRP) level, D-dimer level, fibrinogen level, white blood cell count, percentage of neutrophils, neutrophil-lymphocyte ratio, APACHEⅡ and BISAP scores, the incidence of complicated with pleural effusion or ascites and the constituent ratio of alcoholic etiology of SAP group were all higher than those of NASP group (44 837.58 yuan (23 017.73 yuan, 102 579.77 yuan) vs. 12 301.46 yuan (8 649.26 yuan, 18 823.88 yuan); (10.48±4.84) mmol/L vs. (8.45±4.80) mmol/L; (8.80±6.50) mmol/L vs. (4.90±2.33) mmol/L; (139.56±127.75) mmol/L vs. (80.05±38.54) mmol/L; (187.33±87.25) mg/L vs. (90.81±82.53) mg/L; 5.19 mg/L (2.96 mg/L, 8.52 mg/L) vs.1.29 mg/L (0.53 mg/L, 2.87 mg/L); 6.13 mg/L (4.64 mg/L, 7.31 mg/L) vs. 4.58 mg/L (3.50 mg/L, 5.98 mg/L); (14.87±5.82)×10 9/L vs. (11.79±4.86)×10 9/L; 0.84±0.12 vs.0.78±0.12; 13.16±7.57 vs. 8.77±7.28; 9.80±6.09 vs. 3.79±2.59; 2.12±0.89 vs. 1.04±0.78; 65.6%, 84/128 vs. 12.9%, 61/472; 70.3%, 90/128 vs. 20.3%, 96/472; 18.8%, 24/128 vs. 11.4%, 54/472); serum albumin level, blood calcium level, and hematocrit level of SAP group were all lower than those of NSAP group ((30.86±4.95) g/L vs. (37.14±5.44) g/L; (1.98±0.31) mmol/L vs. (2.16±0.20) mmol/L; (42.40±8.67)% vs.(44.30±6.45)%), and the differences were all statistically significant ( χ2=99.403, t=8.235, Z=-13.330, t=4.239, 10.759, 5.207 and 11.227, Z=-11.406 and -6.234, t=6.097, 4.829, 6.011, 10.899 and 12.395, χ2=152.604, 117.563 and 4.757, t=-11.788, -6.180 and -2.310, all P<0.05). LASSO regression analysis screened out four predictors of CRP, urea nitrogen, D-dimer and ascites. The results of multivariate logistic regression analysis showed that CRP (odds ratio ( OR)=1.009, 95% (confidence interval) CI 1.006 to 1.012), urea nitrogen( OR=1.185, 95% CI 1.097 to 1.280), D-dimer( OR=1.166 95% CI 1.082 to 1.256), ascites ( OR= 4.848, 95% CI 2.829 to 8.307) were the independent predictors of SAP (all P<0.01). The AUC of the model (0.895 , 95% CI 0.865 to 0.926) was higher than those of the APACHE Ⅱ(AUC=0.835, 95% CI 0.791 to 0.878)and BISAP score (AUC=0.803, 95% CI 0.760 to 0.846), and the differences were statistically significant ( Z=2.578 and 4.466, both P<0.05). The results predicted by the model in the calibration chart and the Hosmer-Lemesshow test were highly consistent with the results of actual clinical observation. When the probability of SAP in the model was 10% to 95%, the DCA curve of the model was higher than the two extreme lines, which had certain clinical practical value. After bootstrap internal validation, the model had a high discrimination ability (AUC=0.892), and its predicted AP severity curve was still in good agreement with the actual clinical AP severity curve. Conclusion:The prediction model established based on CRP, urea nitrogen, D-dimer and ascites can predict the severity of AP, and help doctors to make more scientific clinical decision.

Objective:To explore the clinical features of acute pancreatitis (AP) complicated with portal vein system thrombosis (PVST) and the clinical prediction of symptomatic PVST.Methods:From January 2014 to December 2019, at First Affiliated Hospital and Second Affiliated Hospital of Kunming Medical University, 152 hospitalized patients who met the diagnostic criteria of AP complicated with PVST and had complete clinical data were retrospectively analyzed, and the clinical characteristics of them were analyzed. According to whether there were clinical manifestations caused by PVST (esophago-gastric variceal bleeding, persistent ascites, intestinal ischemia), AP patients complicated with PVST were divided into symptomatic group ( n=48) and asymptomatic group ( n=104). The differences in general information, laboratory test indicators, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), Balthazar computed tomography (CT) score, local and systemic complications were compared between symptomatic group and asymptomatic group. Two independent sample t test, two sample rank sum test, and chi-square test were used for statistical analysis. The binary logistic regression was used for multivariate analysis. Results:The severe acute pancreatitis (SAP) complicated with PVST was common, accounted for 73.0% (111/152), and the hospital mortality rate was 14.5% (22/152). The splenic vein (46.1%, 70/152) was the most common single vessel involved. The hospital stay of the symptomatic group was longer than that of the asymptomatic group, the hospitalization costs and hospital mortality of the symptomatic group were both higher than those of the asymptomatic group ((26.31±19.38) d vs. (15.11±9.31) d, (103 463.68±15 312.74) yuan vs. (37 199.38±4 647.17) yuan, 25.0%, 12/48 vs. 9.6%, 10/104, respectively), and the differences were statistically significant ( t=-3.809 and -4.141, χ2=6.280; all P<0.05). The lactic acid dehydrogenase, C-reactive protein, and prothrombin time of the symptomatic group were all higher than those of the asymptomatic group (4.78 μmol·s -1·L -1, 2.96 μmol·s -1·L -1 to 7.82 μmol·s -1·L -1 vs. 4.42 μmol·s -1·L -1, 3.29 μmol·s -1·L -1 to 9.30 μmol·s -1·L -1; 69.53 mg/L, 29.49 mg/L to 147.14 mg/L vs. 40.90 mg/L, 8.88 mg/L to 104.89 mg/L; (16.88±8.23) s vs. (14.12±1.59) s), however the hematocrit and blood calcium in the symptomatic group were both lower than those of the asymptomatic group ((34.97±8.96)% vs. (39.18±7.17)%, (2.01±0.32) mmol/L vs. (2.17±0.19) mmol/L), and the differences were all statistically significant ( Z=-2.067 and -1.977, t=-2.281, 3.072 and 3.083; all P<0.05). The scores of APACHE Ⅱand Balthazar CT, the rate of local complications of pancreatic necrosis, and systemic complications including abdominal hemorrhage, septic shock, acute respiratory distress syndrome, lung infection and pleural effusion of the symptomatic group were higher than those of the asymptomatic group (7.21±3.84 vs. 5.27±2.31, 7.10±1.57 vs. 4.83±1.87, 87.5%, 42/48 vs. 28.8%, 30/104; 10.4%, 5/48 vs. 1.9%, 2/104; 18.8%, 9/48 vs. 1.9%, 2/104; 25.0%, 12/48 vs. 3.8%, 4/104; 91.7%, 44/48 vs. 60.6%, 63/104; 85.4%, 41/48 vs. 49.0%, 51/104; respectively), and the differences were statistically significant ( t=-3.241 and -7.331, χ2=45.320, 5.393, 13.852, 15.604, 15.323 and 18.191; all P<0.05). The results of binary logistic regression showed that Balthazar CT score was an independent risk factor for symptomatic PVST ( P<0.01), and odds ratio (95% confidence interval) was 1.79 (1.41 to 2.29). Conclusions:Balthazar CT score is an influencing factor of symptomatic PVST in AP patients, and patients with high scores should be treated early to improve the prognosis.

The etiology and pathogenesis of autoimmune hepatitis (AIH) remain unclear and are currently considered to be associated with genetic susceptibility and environmental factors. Regulatory T (Treg) cells play an immunosuppressive role by secreting IL-10 and TGFβ, while T helper 17 (Th17) cells mainly promote inflammatory response, suggesting that Treg cells, Th17 cells, and the dynamic balance between them may be involved in the development and progression of AIH; however, further studies are needed to explore related participation mechanisms. This article reviews the association between Treg/Th17 cells and AIH in recent years and elaborates on their mechanism of action and therapeutic targets.

This paper analyzes the causes and risks of common design and development changes of laser treatment equipment, studies the changes of key components and their corresponding control measures, forms the identification method of design changes of laser treatment equipment, and gives suggestions on how to deal with design and development changes, so as to provide references for inspectors during on-site inspection.
Humans ; Laser Therapy ; instrumentation ; Risk Factors

Objective:To investigate the relationship between the changes of serum lipoprotein associated phospholipase A2 (Lp-PLA2), human Parkinson′s protein 7 (PARK7), erythropoietin (EPO) and neurological deficit score (NIHSS) and carotid intima-media thickness (CIMT) in patients with acute ischemic stroke (AIS).Methods:150 patients with AIS diagnosed in our hospital from January 2016 to January 2018 (AIS group) and 80 healthy subjects were selected as the control group. The Lp-PLA2, PARK7, EPO levels were compared between the two groups according to NIHSS score (mild, moderate and severe), carotid atherosclerotic plaque (unstable plaque, stable plaque, no plaque).Results:The serum level of Lp-PLA2, PARK7, EPO and CIMT values in the AIS group were significantly higher than those in the control group ( P<0.05). The Lp-PLA2 and PARK7 levels in the mild, moderate and severe AIS patients were gradually increased among the three groups, with statistically significant difference ( P<0.05). There was no significant difference in EPO levels between the different NIHSS groups ( P>0.05); The levels of Lp-PLA2, PARK7 and EPO of AIS patients in non plaque group, stable plaque group and unstable plaque group were gradually increased among the groups, and the difference between the two groups was statistically significant ( P<0.05). The level of Lp-PLA2 and PARK7 in patients with AIS and the NIHSS scores showed a significant positive correlation ( P<0.05). There was a significant positive correlation between Lp-PLA2, PARK7, EPO and CIMT in patients with AIS ( P<0.05). Conclusions:The serum levels of Lp-PLA2, PARK7 and EPO were significantly increased in AIS patients. Lp-PLA2, PARK7 were related to the aggravation of neurological deficits in potential patients. Lp-PLA2, PARK7 and EPO were related to the increase of carotid intima-media thickness in potential patients.

Objective To investigate the effects and mechanism of verbascoside on hypoxia-induced memory impairment.Methods The eight-arm maze was used to train mice′s spatial memory ability.After successful training, mice were randomly divided into five groups:a normoxic control group (distilled water, 0.1ml/10g), hypoxic model group (distilled water, 0.1ml/10g), the verbascoside low dose group (50 mg/kg), medium dose group (150 mg/kg), and high dose group (300mg/kg) were administered orally once a day for a total of 7days.After administration on the fourth day, except for the normoxic control group was placed in the animal room (1 500m), the remaining four groups were placed in a large-scale hypobaric chamber to simulate the hypoxic environment of the plateau (7 500m, 3days).Eight-armed maze test (4 000m) was used and the plasma and brain tissues were dissected out and measured for reactive oxygen species (ROS) in the brain, malondialdehyde (MDA), reduced glutathione (GSH) and total superoxide dismutase (T-SOD) activity in plasma and brain.Results Compared with the normoxic control group, the indexes of the eight-armed maze, ROS and MDA in the brain, MDA in the plasma of the hypoxia model group were significantly increased, and the GSH and T-SOD enzyme activities in the brain and plasma were notably decreased.Compared with the hypoxic model group, the indexes of the eight-armed maze, ROS and MDA in the brain, MDA in the plasma in the various groups of verbascoside were reduced more or less, the GSH and T-SOD enzyme activities in the brain and plasma slightly were increased.Conclusion Verbascoside could ameliorate the hypoxic memory impairment at high altitude, which might be related to the stabilization of the body′s antioxidant enzyme system balance and