Objective: To investigate the status and influencing factors of nutritional health knowledge awareness among primary and middle school students in Wenzhou City, Zhejiang Province, so as to provide a basis for carrying out targeted nutrition health education for students. Methods: The stratified cluster random sampling method was used to select students from 48 schools across 12 counties (cities and districts) in Wenzhou City as survey subjects from October 2023 to February 2024. Basic information, parental information, and nutritional health knowledge were collected using the Questionnaire on nutritional health knowledge for School-Age Children. The awareness rate of nutritional health knowledge was analyzed. Multivariable logistic regression model was used to analyze the influencing factors for nutritional health knowledge awareness among primary and middle school students. Results: The survey included 4 405 boys, accounting for 51.42%, and 4 161 girls, accounting for 48.58%. The sample consisted of 2 497 pupils in Grades 1-3 (29.15%), 2 591 pupils in Grades 4-6 (30.25%), 1 739 junior high school students (20.30%), and 1 739 senior high school students (20.30%). The median score of nutrition health knowledge was 75.00 (interquartile range, 19.00), and the awareness rate was 4 524 (52.81%). Multivariable logistic regression analysis showed that girls (OR=1.317, 95%CI: 1.198-1.447), primary school students (Grades 1-3, OR=7.830, 95%CI: 6.444-9.513; Grades 4-6, OR=1.276, 95%CI: 1.066-1.528), and those whose mothers had an educational level above junior high school (senior high school/technical secondary school/technical school/junior college, OR=1.188, 95%CI: 1.044-1.352; bachelor' s degree or above, OR=1.194, 95%CI: 1.024-1.392) had a higher likelihood of nutrition and health knowledge awareness. Conversely, students who were overweight or obese (OR=0.798, 95%CI: 0.671-0.950), lived in school (OR=0.763, 95%CI: 0.650-0.895), and had a daily outdoor activity duration of <30 minutes (OR=0.641, 95%CI: 0.570-0.721) had a lower likelihood of nutritional health knowledge awareness. Conclusions The awareness rate of nutritional health knowledge among primary and middle school students in Wenzhou City needs to be improved, and is mainly influenced by gender, educational stage, body mass index, mother' s educational level, and outdoor activity duration. It is recommended to implement differentiated health education strategies and build a "family-school-community" linkage mechanism to improve students' nutrition health literacy.

Objective To investigate the early dynamic changes of biomarkers associated with capillary leak syndrome(CLS)in patients with severe acute pancreatitis(SAP)and their correlation with multiple organ failure(MOF).Methods A total of 171 SAP patients admitted to the West China Centre of Excellence for Pancreatitis,West China Hospital,Sichuan University between September 1,2019 and December 31,2020 were enrolled for this study.The patients were divided into MOF and non-MOF groups based on the occurrence of MOF in the first 5 days of hospitalization,and were further divided into subgroups based on the presence of moderate-to-severe intra-abdominal hypertension(IAH).We performed dynamic monitoring of the blood biomarkers(hematocrit[HCT].blood urea nitrogen[BUN].and creatinine[Cr]),plasma proteins(albumin[Alb].total protein[TP].and non-albumin plasma proteins[NAPP]),and intra-abdominal pressure.Trends in these indicators across groups were analyzed comprehensively.Results No significant differences in baseline data between the two groups were observed.The baseline data of the 2 groups were comparable.The MOF group had significantly higher rates of persistent systemic inflammatory response syndrome(SIRS)lasting 48 hours(91.3％vs.71.8％),ICU admission(70.4％vs.17.6％),and length-of-stay([32±17.7]days vs.[19.0±12.2]days)compared to those of the non-MOF group(P＜0.05).The incidences of respiratory,circulatory,and renal failures were higher in the MOF group than those in the non-MOF group,showing significant differences in circulatory failure(69％vs.3.5％)and renal failure(65.5％vs.3.5％)(P＜0.05).In the first 5 days of hospitalization,the MOF group showed significantly elevated BUN and Cr levels,while Alb and TP levels dropped rapidly upon admission and then gradually recovered.The NAPP level of the MOF group continued to decrease after admission,and on the third day after admission,the NAPP level was lower than that of the Non-MOF group,showing statistically significant difference(P＜0.001).The Alb/NAPP ratio of the MOF group decreased significantly on day 1 and then rapidly increased,showing significant differences between the groups on days 3 and 4(P=0.001).Subgroup analysis of MOF patients with moderate-to-severe IAH revealed similar trends in the dynamic changes and the overall changes in the indicators,and the difference was even more pronounced.The mixed linear model showed that the average levels of HCT,BUN,Alb/NAPP,and Alb/TP were higher and increased over time in the MOF combined with IAP subgroup(P＜0.001).Conclusion The CLS model of SAP patients is validated,confirming that CLS is a key factor in the progression from SIRS to MOF.The loss of NAPP is an early and important indicator of CLS persistence and progression to MOF.Additionally,moderate-to-severe IAH accelerates the deterioration of MOF.These findings provide valuable insights into the potential mechanisms of MOF and warrant further validation through large-scale prospective studies.

Objective To explore the mechanism of ferroptosis induced by endoplasmic reticulum stress(ERs)in acute respiratory distress syndrome(ARDS).Methods In order to determine the effects of LPS on oxidative stress and Fe2+level of mouse capillary alveolar epithelial cells(MLE12 cells),the cells were treated with LPS(0,1,2,5 μg/ml)for 24 h.To verify the role of ferroptosis in lipopolysaccharide(LPS)-induced cell death,MLE12 cells were divided into control(Con)group,iron removal inhibitor(Fer-1)group,LPS group and LPS+Fer-1 group.LPS+Fer-1 group was pretreated with 10 μmol/L Fer-1 for 6 h,then the cells were exposed to 5 μg/ml LPS for 24 h.Con group was treated with solvent DMSO for 24 h.Fer-1 group was pretreated with 10 μmol/L Fer-1 for 6 h,and then treated with DMSO for 24 h.The cells in LPS group were exposed to 5 μg/ml LPS for 24 h.The MLE12 cells were divided into three groups:Con+Vector group,Con+sequence similarity family 134 mem-ber B(FAM134B)group,LPS+Vector group and LPS+FAM134B group.After transfected with vector or FAM134B overexpression plasmid for 48 h,the cells were exposed or not exposed to 5 μg/ml LPS for 24 h.Cell vi-ability was measured by CCK-8.The levels of malondialdehyde(MDA),glutathione and iron,the protein levels of ferroptosis markers[cyclooxygenase 2(PTGS2),glutathione peroxidase 4(GPX4)]and ERs markers[glucose reg-ulatory protein 78(GRP78),activated transcription factor 4(ATF4)and C/EBP homologous protein(CHOP)]were measured in different groups.In order to further confirm the results of in vitro cell experiments,40 mice were randomly divided into Con+Vector group,Con+FAM134B group,LPS+Vector group and LPS+FAM134B group,with 10 mice in each group.LPS-induced sepsis models were established in LPS+Vector group and LPS+FAM134B group,and the levels of GPX4 and ERs in lung tissue were evaluated by immunofluorescence staining and protein blot.Results LPS treatment increased the levels of PTGS2 and MDA,and decreased the levels of GPX4 and GSH in MLE12 cells in a dose-dependent manner.Compared with LPS group,the cell viability,GPX4 and GSH levels in LPS+Fer-1 group increased significantly(P<0.05),while the PTGS2 protein level and MDA level decreased significantly(P<0.05).Compared with LPS+Vector group,LPS+FAM134B group significantly increased cell viability(P<0.05),decreased PTGS2 protein level(P<0.05)and increased GPX4 level(P<0.05).At the same time,the level of MDA in LPS+FAM134B group was lower than that in LPS+Vector group(P<0.05),and the level of GSH was higher than that in LPS+Vector group(P<0.05).In animal experiment,compared with LPS+Vector group,the expression levels of 4-HNE,ATF4 and CHOP in lung tissue of LPS+FAM134B group decreased significantly(P<0.05),and the expression levels of GPX4,FAM134B group in-creased significantly(P<0.05).Conclusion LPS induces ferroptosis and ERs in MLE12 cells in a dose-depend-ent manner.Activating the endoplasmic reticulum autophagy associated FAM134B receptor helps to inhibit ERs and alleviate cell ferroptosis.

Myopia-associated optic neuropathy has become an important cause of visual impairment with the increasing prevalence of myopia in recent years.However,the mechanisms for its occurrence and development are still in primary re-search.Numerous studies suggest that structural changes in the optic disc that often occur in the progress of myopia may be closely associated with optic neuropathy.The optic disc is stretched mechanically with the growth of the axial length,resulting in changes in its morphology,biomechanics and blood flow,which may induce optic neuropathy.This review summarized the relationship between pathophysiological histostructural and biomechanical changes,including scleral con-nective tissue remodeling,peripapillary atrophy,tilt and torsion of optic disc,and thinning of lamina cribrosa and peripapil-lary scleral margin,and optic neuropathy in myopic patients,hoping to provide a new insight for early detection and pre-vention of myopia-associated optic neuropathy.

Objective:To compare the therapeutic effects of 0.05% cyclosporine and 0.1% fluorometholone eye drops in patients with moderate and severe dry eye.Methods:A randomized controlled study was conducted.Fifty-two patients (52 eyes) with moderate to severe dry eye in Tianjin Medical University Eye Hospital from August 2021 to December 2022 were enrolled and randomly divided into 0.05% cyclosporine group and 0.1% fluorometholone group by random number table method, with 26 cases (26 eyes) in each group.Patients received 0.05% cyclosporine eye drops (2 times/day) and 0.1% fluorometholone eye drops (2 times/day) combined with calf blood deproteinized extract eye drops (4 times/day) according to the grouping.Before and 1, 3 and 6 months after treatment, clinical symptoms and signs were observed and Ocular Surface Disease Index (OSDI) score, corneal fluorescein staining (CFS) score, Schirmer Ⅰ test (SⅠT), non-invasive first tear film break-up time (NIBUTf), and conjunctival goblet cell (CGC) density were recorded.Before treatment and after 6 months of treatment, changes in corneal nerves and dendritic cells (DC) were observed by in vivo confocal microscopy (IVCM).This study adhered to the Declaration of Helsinki and was approved by the Medical Ethics Committee of Eye Hospital of Tianjin Medical University (No.2021KY-17).Written informed consent was obtained from each subject. Results:Compared with the 0.1% fluorometholone group, CFS score decreased after 1 month of treatment, but SⅠT, NIBUTf and CFS score increased after 3 months of treatment, and OSDI score, SⅠT and CFS score decreased after 6 months of treatment in the 0.05% cyclosporine group, showing statistically significant differences (all at P<0.05).Compared with baseline, in the 0.05% cyclosporine group, NIBUTf increased and CFS score decreased after 1 month of treatment, OSDI score and CFS score decreased, SⅠT and NIBUTf increased after 3 and 6 months of treatment, showing statistically significant differences (all at P<0.05).In the 0.1% fluorometholone group, CFS score decreased after 3 months of treatment, OSDI score and CFS score decreased, SⅠT increased after 6 months of treatment compared to baseline, showing statistically significant differences (all at P<0.05).OSDI score and CFS score decreased, SⅠT increased after 6 months of treatment compared to 3 months of treatment in the 0.05% cyclosporine group, and the differences were statistically significant (all at P<0.05).Baseline and CGC densities after 1, 3 and 6 months of treatment were (147.66±17.29), (195.44±15.46), (210.36±19.15) and (282.09±22.63)cells/mm 2 in the 0.05% cyclosporine group and (138.09±17.29), (95.67±15.46), (117.77±19.15) and (109.13±22.63)cells/mm 2 in the 0.1% fluorometholone group, respectively, with a statistically significant overall difference ( Fgroup=11.724, P<0.001; Ftime=4.837, P=0.005).Compared with the 0.1% fluorometholone group, CGC density in the 0.05% cyclosporine group increased after 1, 3 and 6 months of treatment, with statistically significant differences (all at P<0.05).Compared with baseline, the CGC density increased in the 0.05% cyclosporine group after 1, 3 and 6 months of treatment, and the differences were statistically significant (all at P<0.05).Compared with the 0.1% fluorometholone group, the corneal nerve fiber density in the 0.05% cyclosporine group increased after 6 months of treatment, and corneal DC density, area and dendrite number decreased, showing statistically significant differences (all at P<0.05). Conclusions:Cyclosporine 0.05% eye drops combined with calf blood deproteinized extract eye drops can improve symptoms and signs in patients with moderate to severe dry eye, and the long-term effect is better than that of 0.1% fluorometholone plus calf blood deproteinized extract eye drops.

Objective:To study the high risk factors of hypothermia in premature infants with gestational age ≤34 weeks, and to analyze the incidence of hypothermia before and after the implementation of the quality improvement program of hypothermia in hospital and its influence on various systemic complications, aiming to improve the early identification of hypothermia and to reveal the important clinical significance of temperature management in time.Methods:Clinical data of preterm infants born in Maternal and Child Health Hospital of Hubei Province from May 2017 to December 2018, with gestational age ≤34 weeks, and admitted within 1 hour after birth were collected.According to the admission temperature, the infants were divided into normal temperature group (36.5-37.5 ℃), mild hypothermia group (36.0-36.4 ℃), moderate hypothermia gsroup (32.0-35.9 ℃), and severe hypothermia group (<32.0 ℃). The high risk factors of hypothermia in premature infants were analyzed.The incidence and degree of hypothermia and the effects on the systemic complications before and after the implementation of the hypothermia quality improvement program were compared.Results:A total of 306 premature infants were enrolled in the study, including 63(20.6%)cases in the normal temperature group, 115(37.6%) cases in the mild hypothermia group, and 128(41.8%) cases in the moderate hypothermia group, without severe hypothermia.Infants with birth asphyxia were at higher risk for hypothermia( OR=0.195, 95% CI 0.046-0.833, P=0.027); the lower the Apgar score at 1 min( r=0.123, P=0.032)and 5 min after birth( r=0.136, P=0.017), the higher the risk of admission hypothermia.After the quality improvement project, the incidence of admission hypothermia decreased from 82.3% to 73.8%( χ2=32.67, P<0.001), and the use of pulmonary surfactant in infants with respiratory distress syndrome was significantly reduced(70.0% vs. 32.0%, χ2=40.11, P<0.001), and the incidence of hypotension within 72 hours after birth decreased(11.8% vs. 4.9%, χ2=3.87, P<0.049). Conclusion:Birth asphyxia is a risk factor for admission hypothermia in premature infants, and Apgar score is associated with admission hypothermia in premature infants.Temperature management of preterm infants can significantly reduce the incidence of hypothermia and hypotension, and reduce the use of pulmonary surfactant in respiratory distress syndrome infants.

Background: The treatment of trigeminal neuralgia remains a challenging issue.Stem cells from human exfoliated deciduous teeth (SHED) provide optimized therapy for chronic pain. This study aimed to investigate the mechanisms underlying the attenuation of trigeminal neuralgia by SHED. Methods: Trigeminal neuralgia was induced by chronic constriction injury of the infraorbital nerve. The mechanical threshold was assessed after model establishment and local SHED transplantation. Endoplasmic reticulum (ER) morphology and Caspase12 expression in trigeminal ganglion (TG) was evaluated as well. BiP expression was observed in PC12 cells induced by tunicamycin. Results: The local transplantation of SHED could relieve trigeminal neuralgia in rats.Further, transmission electron microscopy revealed swelling of the ER in rats with trigeminal neuralgia. Moreover, SHED inhibited the tunicamycin-induced up-regulated expression of BiP mRNA and protein in vitro. Additionally, SHED decreased the up-regulated expression of Caspase12 mRNA and protein in the TG of rats caused by trigeminal neuralgia after chronic constriction injury of the infraorbital nerve mode. Conclusions This findings demonstrated that SHED could alleviate pain by relieving ER stress which provide potential basic evidence for clinical pain treatment.

Objective:To observe the clinical efficacy, safety, compliance, and cost-effectiveness of rush immunotherapy (RIT) and conventional immunotherapy (CIT) in patients with allergic rhinitis (AR), so as to evaluate the clinical significance of CIT and preliminarily explore its economic value.Methods:A study was conducted on 72 AR patients who had received specific immunotherapy from Oct 2019 to Jun 2020 in the Department of Otorhinolaryngology, the First Affiliated Hospital of Chongqing Medical University, including 39 males and 33 females, aging 8 to 60 years. RIT or CIT was performed respectively according to the patients′ wishes. There were 35 cases in the RIT group and 37 cases in the CIT group, all subjects were followed up for 1 year. Visual analysis scale (VAS) and effectiveness were used to evaluate the clinical efficacy. Systemic adverse reactions were used to assess safety. Failure rate was calculated to evaluate the compliance. The cost and cost-effectiveness ratio (CER) were conducted to evaluate the health economics preliminarily.Results:After half a year and one year′s treatment, both RIT and CIT groups had significant clinical efficacy and RIT group had more significant clinical efficacy than CIT group at half a year (76.67% vs 46.67%, χ 2=7.37, P=0.007). During the dose accumulation phase, there was no significant difference in the incidence of systemic adverse reactions between the two groups (8.57% vs 8.10%, χ 2=0.05, P=0.943), while the drop-out rate in the RIT group was significantly lower than that in the CIT group (0 vs 13.51%, χ 2=5.08, P=0.024). After one year, the costs in RIT group were significantly higher ((8 163.08±452.67) yuan vs (7 385.87±369.92) yuan, t=-2.78, P=0.009), while there was no statistical differences in CER between the two groups ((3 298.06±1 374.09) yuan/point vs (3 154.38±1 532.51) yuan/point, t=-0.36, P=0.418). Conclusions:Both RIT and CIT are beneficial for AR, and they have similar clinical efficacy, safety, and CER. RIT is more effective in the early stage, with higher patient compliance. Thus, RIT is worth promoting and exploring in clinic.

Objeetive : The epidemiological characteristics of confirmed cases of the 2019 novel coronavirus diseases (COVID-19) which was reported in Wenzhou by February 28,2020 were described and analyzed to provide evidence for prevention and control measures in next stage. Methods: The field investigation method was employed on all suspected and confirmed cases. The data of time,spatial and population distribution, source of infection and detective routes of all confirmed cases of COVID-19 in Wenzhou were collected and extracted from the reports of field investigation and the National Diseases Prevention and Control Information System. Results: As of February 20,2020,504 confirmed cases of COVID-19 were diagnosed in Wenzhou, which included one death case. Among all 13 counties, the highest number of confirmed cases were distributed in Yueqing,Ruian and Lucheng. Among 504 cases, the male to female ratio was reported as 1.14:1. The youngest case was 2 years old while the oldest case was 93 years old. Most of the confirmed cases were among people between the ages of 25 and 64 years old. The most common occupation of the confirmed cases was businessman,which accounts for 29.76% (150 cases). Clinical symptoms of the first confirmed case of COVID-19 in Wenzhou occurred on January 4, 2020. Approximately 70% of cases had the first symptoms from January 19 to February 1. The daily number of new cases on January 24 and January 26 were the highest while the number of new cases per day declined significantly after February 2, and there were no new cases after February 14. Among all confirmed cases, the infection source of 61.71% cases were related to Wuhan. As of February 20, 2020, a total of 79 clusters were reported in Wenzhou, which involved 330 cases. Approximately 30% of confirmed cases came to hospitals unaccompanied by community staffs, and cases which confirmed after February 13 were basically found in central isolation locations or by grid checkers. Conclusions The main reason for the high case numbers of COVID-19 in Wenzhou, in Zhejiang province, was the high number of wenzhou citizens who work in Wuhan. Imported cases account for the most confirmed cases during the early period, while mainly confirmed cases were local cases during the middle and late periods. The outcomes suggest the prevention and control measures employed by Wenzhou government, which included closed-loop control and quantitative control, have achieved remarkable results and the epidemic of COVID-19 in Wenzhou has been initially controlled.

OBJECTIVETo identify novel common mutations among patients with non-syndromic hearing loss (NSHL).

METHODSHigh-throughput gene capture technology was used to analyze 18 patients with NSHL in whom common mutations of deafness genes including GJB2, SLC26A4, GJB3, and mtDNA were excluded. Suspected mutation was verified with Sanger sequencing.

RESULTSNext generation sequencing has identified 62 mutations in 29 genes associated with hearing loss, which included 54 missense mutations, 4 splicing mutations, 3 deletional mutations, and 1 nonsense mutation. Mutations occurring more than twice in the 18 patients were verified by Sanger sequencing. This has confirmed 15 mutations in 8 genes, including 3 missense mutations (p.C2184G, p.L2825P, p.H1888Y) which have not been reported previously. Meanwhile, p.L445W, p.D866N, and IVS919-2A>G were common causative mutations.

CONCLUSIONA number of common causative mutations, e.g., p.L445W, p.D866N, IVS919-2A>G, have been identified by high-throughput capture technology, which may facilitate the research and genetic diagnosis for hearing loss.

DNA, Mitochondrial ; genetics ; Deafness ; genetics ; Female ; Hearing Loss ; genetics ; High-Throughput Nucleotide Sequencing ; methods ; Humans ; Male ; Mutation ; genetics