Objective: To explore the relationship of screen time and sleep duration with screening myopia among junior and senior high school students, so as to provide evidence for the prevention and control of myopia among students. Methods: From March to October 2024, 429 junior and senior high school students from a district of Guangzhou were selected using stratified cluster random sampling method. Standardized logarithmic visual acuity chart was used for vision assessment, while Questionnaire for the Physical Health Monitoring System of Students in Guangzhou was employed to collect students screen time and sleep duration. The Chi square test was used to compare differences across different groups, and binary Logistic regression analysis was employed to analyze the association of screen time and sleep duration with screening myopia. Results: The overall prevalence of screening myopia was 79.5%, with significant differences across educational stage, sex, screen time and sleep duration groups( χ 2=41.64, 9.75, 23.89 , 8.17, all P <0.05).Binary Logistic regression analysis revealed that, compared to the high screen time & insufficient sleep group, the low screen & sufficient sleep group ( OR=0.25, 95%CI =0.09-0.68), the low screen & insufficient sleep group ( OR= 0.27 , 95%CI =0.13-0.56), and the high screen & sufficient sleep group ( OR=0.26, 95%CI =0.10-0.70) exhibited significantly lower screening myopia risks (all P <0.05). After adjusting for sex and educational stage, low screen time & insufficient sleep was significantly associated with screening myopia ( OR=0.48, 95%CI =0.23-0.98); the multiplicative interaction term was statistically significant ( OR=0.99,95%CI =0.98-1.00)(both P <0.05). Conclusion The interaction effect between screen time and sleep duration in relation to screening myopia suggests a need to focus on daily routines and screen use habits among junior and senior high school students for ensuring sufficient sleep and limiting screen exposure.

Acute-on-chronic liver failure （ACLF） is a complex clinical syndrome， and early identification and accurate prognostic evaluation are of great importance for patient treatment and management. In recent years， with in-depth research on the pathogenesis of ACLF， multiple prognostic biomarkers have been proposed and used in clinical practice. This article systematically reviews the research advances in prognostic biomarkers for ACLF from the aspects of clinical predictive models， immunological biomarkers， metabolic biomarkers， genetic and epigenetic biomarkers， microbiome-related biomarkers， and emerging technologies such as artificial intelligence and multi-omics， and it also discusses the value and application prospects of these biomarkers in the prognostic evaluation of ACLF and proposes future research directions， in order to provide a scientific and comprehensive reference for clinicians， guide individualized treatment and management of ACLF patients， and finally improve the clinical outcomes of patients.

OBJECTIVE To analyze the 7 species of common pathogens causing acute respiratory infection(ARI)in children in Zhongshan,Guangdong,from 2019 to 2023,and to provide references for preventive measures and clinical treatment of ARI.METHODS A total of 14 261 children with ARI aged 14 years and younger,hospital-ized in the Pediatric Department of Zhongshan City People's Hospital from Jan.2019 to Oct.2022 and from Mar.to Dec.2023,were selected as the study subjects.The positive detection rates of seven common respiratory pathogens were compared across three periods:pre-pandemic period(2019),pandemic control period(from 2020 to Oct.2022)and normalization period(from Mar.to Dec.2023)of COVID-19.RESULTS The overall detection rates of pathogens were 59.72％,37.83％and 85.82％in the pre-pandemic,control and normalization periods,respectively.The pathogens with the highest detection rates were Streptococcus pneumoniae(Spn)at 19.81％,respiratory syncytial virus(RSV)at 11.33％,Mycoplasma pneumoniae(MP)at 9.53％,Haemophilus influ-enzae(Hi)at 5.90％,influenza A virus(FluA)at 3.49％,adenovirus(ADV)at 3.30％and Bordetella pertussis(BP)at 0.72％.The mixed infection rate was 8.46％in the pre-pandemic period,mainly involving"MP+Spn"and"Spn+RSV".During the pandemic control period,the mixed infection rates were 4.95％,4.65％and 3.66％,respectively.After the pandemic normalization,the mixed infection rate rose to 17.75％,mainly invol-ving"Hi+Spn"and"Spn+RSV".The detection rates of RSV were 7.82％,11.90％and 14.44％in the pre-pan-demic,control and normalization periods,respectively,with a delayed epidemic pattern observed.The detection rates of Spn were 26.47％,17.45％and 16.99％in the three periods,respectively.The detection rates of MP were 12.53％,1.83％and 24.17％,respectively,with a delayed outbreak observed.CONCLUSIONS The preven-tion and control of COVID-19 involves non-pharmaceutical interventions,which are later lifted.The transmission of these seven common respiratory pathogens is affected,necessitating continuous monitoring of the pathogens.

Objective To establish a model to predict the severity of patients with COVID-19 associated diarrhea by analyzing the differences of laboratory detection indicators in different grades of patients with COVID-19 associated diarrhea.Methods A total of 649 COVID-19 patients combined with diarrhea hospitalized in Wuhan Huoshenshan Hospital from February 2020 to April 2020 were retrospectively selected,and the patients with obvious causes of diarrhea had been excluded.They were further divided into the common group(n=282),severe group(n=314),and critical group(n=53),and the differences in clinical and laboratory indicators among the three groups were compared.The XGBoost model was established,and its diagnostic efficacy in predicting the severity of patients with COVID-19 associated diarrhea was evaluated by the ROC curve.Results There were statistically significant differences in blood routine test,liver function,electrolytes,fecal occult blood and other laboratory indicators among the three groups of COVID-19 associ-ated diarrhea(P＜0.05).The white blood cell count,absolute value and percentage of neutrophils,and levels of serum lactate dehydro-genase(LDH),α-hydroxybutyrate dehydrogenase(α-HBDH),γ-glutamyl transpeptidase(GGT),B-type natriuretic peptide,and blord glucose(Glu)in the critical group were significantly higher than those in the common group and severe group(P＜0.05),while the percentages of lymphocytes,monocytes,eosinophils,and basophils,and chloride concentration were significantly lower than those in the common group and severe group(P＜0.05).The results of the ROC curve showed that the prediction model constructed by eight indicators,including C-reactive protein(CRP),LDH,interleukin-6(IL-6),Glu,PT％activity,chloride(Cl-),D-dimer(DD),and procalcitonin(PCT),had significant predictive value for critical patients(AUCROC=0.939),but no obvious predictive value for the patients in the common group(AUCROC=0.630)and severe group(AUCROC=0.553).Conclusion The COVID-19 patients com-bined with diarrhea have a higher probability of developing severe or critical conditions compared with those without diarrhea.The indi-cators such as CRP,LDH,IL-6,Glu,PT％activity,Cl-,DD,and PCT have significant predictive value on whether the COVID-19 patients combined with diarrhea turn to critical illness.

Objective To establish a model to predict the severity of patients with COVID-19 associated diarrhea by analyzing the differences of laboratory detection indicators in different grades of patients with COVID-19 associated diarrhea.Methods A total of 649 COVID-19 patients combined with diarrhea hospitalized in Wuhan Huoshenshan Hospital from February 2020 to April 2020 were retrospectively selected,and the patients with obvious causes of diarrhea had been excluded.They were further divided into the common group(n=282),severe group(n=314),and critical group(n=53),and the differences in clinical and laboratory indicators among the three groups were compared.The XGBoost model was established,and its diagnostic efficacy in predicting the severity of patients with COVID-19 associated diarrhea was evaluated by the ROC curve.Results There were statistically significant differences in blood routine test,liver function,electrolytes,fecal occult blood and other laboratory indicators among the three groups of COVID-19 associ-ated diarrhea(P＜0.05).The white blood cell count,absolute value and percentage of neutrophils,and levels of serum lactate dehydro-genase(LDH),α-hydroxybutyrate dehydrogenase(α-HBDH),γ-glutamyl transpeptidase(GGT),B-type natriuretic peptide,and blord glucose(Glu)in the critical group were significantly higher than those in the common group and severe group(P＜0.05),while the percentages of lymphocytes,monocytes,eosinophils,and basophils,and chloride concentration were significantly lower than those in the common group and severe group(P＜0.05).The results of the ROC curve showed that the prediction model constructed by eight indicators,including C-reactive protein(CRP),LDH,interleukin-6(IL-6),Glu,PT％activity,chloride(Cl-),D-dimer(DD),and procalcitonin(PCT),had significant predictive value for critical patients(AUCROC=0.939),but no obvious predictive value for the patients in the common group(AUCROC=0.630)and severe group(AUCROC=0.553).Conclusion The COVID-19 patients com-bined with diarrhea have a higher probability of developing severe or critical conditions compared with those without diarrhea.The indi-cators such as CRP,LDH,IL-6,Glu,PT％activity,Cl-,DD,and PCT have significant predictive value on whether the COVID-19 patients combined with diarrhea turn to critical illness.

OBJECTIVE To analyze the 7 species of common pathogens causing acute respiratory infection(ARI)in children in Zhongshan,Guangdong,from 2019 to 2023,and to provide references for preventive measures and clinical treatment of ARI.METHODS A total of 14 261 children with ARI aged 14 years and younger,hospital-ized in the Pediatric Department of Zhongshan City People's Hospital from Jan.2019 to Oct.2022 and from Mar.to Dec.2023,were selected as the study subjects.The positive detection rates of seven common respiratory pathogens were compared across three periods:pre-pandemic period(2019),pandemic control period(from 2020 to Oct.2022)and normalization period(from Mar.to Dec.2023)of COVID-19.RESULTS The overall detection rates of pathogens were 59.72％,37.83％and 85.82％in the pre-pandemic,control and normalization periods,respectively.The pathogens with the highest detection rates were Streptococcus pneumoniae(Spn)at 19.81％,respiratory syncytial virus(RSV)at 11.33％,Mycoplasma pneumoniae(MP)at 9.53％,Haemophilus influ-enzae(Hi)at 5.90％,influenza A virus(FluA)at 3.49％,adenovirus(ADV)at 3.30％and Bordetella pertussis(BP)at 0.72％.The mixed infection rate was 8.46％in the pre-pandemic period,mainly involving"MP+Spn"and"Spn+RSV".During the pandemic control period,the mixed infection rates were 4.95％,4.65％and 3.66％,respectively.After the pandemic normalization,the mixed infection rate rose to 17.75％,mainly invol-ving"Hi+Spn"and"Spn+RSV".The detection rates of RSV were 7.82％,11.90％and 14.44％in the pre-pan-demic,control and normalization periods,respectively,with a delayed epidemic pattern observed.The detection rates of Spn were 26.47％,17.45％and 16.99％in the three periods,respectively.The detection rates of MP were 12.53％,1.83％and 24.17％,respectively,with a delayed outbreak observed.CONCLUSIONS The preven-tion and control of COVID-19 involves non-pharmaceutical interventions,which are later lifted.The transmission of these seven common respiratory pathogens is affected,necessitating continuous monitoring of the pathogens.

High mobility group box 1 (HMGB1), when released extracellularly, plays a pivotal role in the development of spinal cord synapses and exacerbates autoimmune diseases within the central nervous system. In experimental autoimmune encephalomyelitis (EAE), a condition that models multiple sclerosis, the levels of extracellular HMGB1 and interleukin-33 (IL-33) have been found to be inversely correlated. However, the mechanism by which IL-33 deficiency enhances HMGB1 release during EAE remains elusive. Our study elucidates a potential signaling pathway whereby the absence of IL-33 leads to increased binding of P300/CBP-associated factor with HMGB1 in the nuclei of astrocytes, upregulating HMGB1 acetylation and promoting its release from astrocyte nuclei in the spinal cord of EAE mice. Conversely, the addition of IL-33 counteracts the TNF-α-induced increase in HMGB1 and acetylated HMGB1 levels in primary astrocytes. These findings underscore the potential of IL-33-associated signaling pathways as a therapeutic target for EAE treatment.
Animals ; Encephalomyelitis, Autoimmune, Experimental/metabolism* ; Astrocytes/metabolism* ; Interleukin-33/metabolism* ; HMGB1 Protein/metabolism* ; Acetylation ; Mice, Knockout ; Mice, Inbred C57BL ; p300-CBP Transcription Factors/metabolism* ; Mice ; Spinal Cord/metabolism* ; Cells, Cultured ; Female ; Signal Transduction

Objective: To examine the associations between three adipokines (omentin-1, nesfatin-1 and apelin) and diabetic retinopathy (DR) among patients with type 2 diabetes mellitus (T2DM), so as to provide the basis for the prevention and control of DR. Methods: The T2DM patients hospitalized in Lishui TCM Hospital from August 2021 to May 2023 were selected and divided into three groups: no diabetic retinopathy (NDR) group, non-proliferative diabetic retinopathy (NPDR) group, and proliferative diabetic retinopathy (PDR) group based on fundus fluorescein angiography. Data on gender, age, and course of T2DM were collected through questionnaires, and serum omentin-1, nesfatin-1, apelin, and related blood biochemical indicators were measured. The associations of omentin-1, nesfatin-1 and apelin with DR were analyzed using a multinomial logistic regression model. Results: A total of 150 T2DM patients were enrolled, including 58 cases in the NDR group, 60 cases in the NPDR group, and 32 cases in the PDR group, with males accounting for 60.34%, 45.00% and 68.75%, respectively. The mean ages were (54.79±14.40), (57.03±12.20) and (57.72±10.70) years, respectively. The median (interquartile range) courses of T2DM were 7.00 (7.75), 10.00 (8.00) and 10.00 (5.00) years, respectively. Compared with the NDR group, the NPDR group had lower levels of omentin-1 and nesfatin-1 and higher level of apelin, while the PDR group had higher level of omentin-1 and lower level of apelin (all P<0.05). Compared with the NPDR group, the PDR group had higher levels of omentin-1 and nesfatin-1 and lower level of apelin (all P<0.05). Multinomial logistic regression analysis showed that omentin-1 level was statistically associated with NPDR (OR=0.503, 95%CI: 0.291-0.871) and PDR (OR=7.862, 95%CI: 2.956-20.910); nesfatin-1 (OR=0.971, 95%CI: 0.953-0.989) and apelin (OR=3.266, 95%CI: 1.817-5.868) levels were statistically associated with NPDR. Conclusion Serum levels of omentin-1, nesfatin-1 and apelin were associated with different stages of DR among T2DM patients.

Objective:To investigate the effects of Jianpi Rougan Xifeng Decoction on the behaviors and the Ca 2+ -CaM-CaMK Ⅱ signaling pathway in the striatum of rats with tic disorder models. Methods:Seventy-two SPF-grade SD male rats were randomly divided into blank group, model group, tiapride group (15.93 mg/kg, intragastric administration), low-dose (4.32 g/kg, intragastric administration), medium-dose (8.64 g/kg, intragastric administration) and high-dose (17.28 g/kg, intragastric administration) Jianpi Rougan Xifeng Decoction groups, with 12 rats in each group. Rats in the blank group and model group were gavaged with 0.5 mg/kg of distilled water while rats in other 4 groups were gavaged with corresponding drugs, all rats were gavaged once a day for 28 days.The evaluations of motor behavior and stereotyped behavior were conducted using the Kadasah scoring method and the Diamond scoring method. Calcium content in the striatum was detected using a calcium assay kit. Immunohistochemical analysis was employed to detect the expression of dopamine transporter (DAT) and inositol 1, 4, 5-triphosphate (IP3) in the striatum of rats. Western blot was used to assess the expression of calmodulin (CaM) and calcium/calmodulin-dependent protein kinase Ⅱ (CaMK Ⅱ) in the striatum. RT-PCR was utilized to detect the expression of CaM and CaMK Ⅱ mRNA in the striatum. All data were processed using SPSS 26.0 software, and comparisons among multiple groups were performed using one-way ANOVA and Kruskal-Wallis test.Results:(1) After four weeks of pharmacological intervention, statistically significant differences were observed in the locomotor activity scores and stereotyped scores among the six groups of rats ( H=41.20, 44.24, both P<0.01). Specifically, the locomotor activity scores(3.00(3.00, 3.25), 1.00(0.75, 1.25), 1.00(0.75, 2.00), 1.00(0, 1.00)) and stereotyped scores(3.00(3.00, 4.00), 1.00(0.75, 2.00), 2.00(0.75, 2.00), 1.00(0, 1.25)) in the tiapride group and the medium- and high-dose Jianpi Rougan Xifeng Decoction groups were significantly lower than those in the model group (all P<0.01). (2) Results from the calcium assay kit revealed statistically significant differences in striatal calcium content among the six groups of rats ( F=146.67, P<0.01). The calcium content in the tiapride group and the medium- and high-dose Jianpi Rougan Xifeng Decoction groups was significantly lower than that in the model group (all P<0.01). Additionally, the calcium content in the medium-dose ((0.40±0.02)mmol/g) and high-dose ((0.30±0.03)mmol/g) Jianpi Rougan Xifeng Decoction groups was lower than that in the low-dose group ((0.48±0.02)mmol/g) (both P<0.01). (3) Immunohistochemical results showed that there were statistically significant differences in the mean optical density values of DAT and IP3 in the striatum among the six groups of rats ( F=25.57, 154.98, both P<0.01). The IP3 mean optical density in the tiapride group and the Jianpi Rougan Xifeng Decoction groups with medium and high doses exhibited lower values compared to the model group (all P<0.05), whereas the DAT mean optical density displayed higher values in these groups compared to the model group (all P<0.05). The low-dose Jianpi Rougan Xifeng Decoction group also exhibited a lower optical density value of IP3 compared to the model group( P<0.05). The optical density values of IP3 (2.68±0.21, 2.40±0.22) in the medium-dose and high-dose Jianpi Rougan Xifeng Decoction groups were lower than that in the low-dose group (4.27±0.23) (both P<0.01). (4) Western blot results indicated that there were statistically significant differences in the protein expression levels of CaM and CaMK Ⅱ in the striatum among the six groups of rats ( F=233.03, 118.60, both P<0.01). The protein expression levels of CaM and CaMK Ⅱ in the tiapride group and the low-dose, medium-dose, and high-dose Jianpi Rougan Xifeng Decoction groups were lower than those in the model group (all P<0.01). The protein expression levels of CaM (1.02±0.06, 0.84±0.02) and CaMK Ⅱ (0.48±0.03, 0.40±0.02) in the medium-dose and high-dose Jianpi Rougan Xifeng Decoction groups were lower than those in the low-dose group (1.21±0.03, 0.57±0.02)) (all P<0.05). Additionally, the protein expression level of CaM in the high-dose Jianpi Rougan Xifeng Decoction group was lower than that in the medium-dose group( P<0.05).(5) The RT-PCR results indicated significant variations in the mRNA expression levels of CaM and CaMK Ⅱ within the striatum across the six groups rats ( F=30.54, 20.78, both P<0.01). The mRNA expression levels of CaM and CaMK Ⅱ in the tiapride group and the high-dose Jianpi Rougan Xifeng Decoction group were lower than those in the model group (both P<0.05). The mRNA expression levels of CaMK Ⅱ (1.38±0.17) in the high-dose Jianpi Rougan Xifeng Decoction group were lower than those in the low-dose group (1.99±0.27) ( P<0.01). Conclusion:Jianpi Rougan Xifeng Decoction can improve locomotor activity and stereotyped behavior in rats with tic disorder model. The mechanism may be through inhibiting the Ca 2+ -CaM-CaMK Ⅱ signaling pathway and regulating the expression of DAT and IP3, thereby modulating the release and recovery of dopamine and reducing the occurrence of tic symptoms.

Objective:To investigate the effects of Jianpi Rougan Xifeng Decoction on the behaviors and the Ca 2+ -CaM-CaMK Ⅱ signaling pathway in the striatum of rats with tic disorder models. Methods:Seventy-two SPF-grade SD male rats were randomly divided into blank group, model group, tiapride group (15.93 mg/kg, intragastric administration), low-dose (4.32 g/kg, intragastric administration), medium-dose (8.64 g/kg, intragastric administration) and high-dose (17.28 g/kg, intragastric administration) Jianpi Rougan Xifeng Decoction groups, with 12 rats in each group. Rats in the blank group and model group were gavaged with 0.5 mg/kg of distilled water while rats in other 4 groups were gavaged with corresponding drugs, all rats were gavaged once a day for 28 days.The evaluations of motor behavior and stereotyped behavior were conducted using the Kadasah scoring method and the Diamond scoring method. Calcium content in the striatum was detected using a calcium assay kit. Immunohistochemical analysis was employed to detect the expression of dopamine transporter (DAT) and inositol 1, 4, 5-triphosphate (IP3) in the striatum of rats. Western blot was used to assess the expression of calmodulin (CaM) and calcium/calmodulin-dependent protein kinase Ⅱ (CaMK Ⅱ) in the striatum. RT-PCR was utilized to detect the expression of CaM and CaMK Ⅱ mRNA in the striatum. All data were processed using SPSS 26.0 software, and comparisons among multiple groups were performed using one-way ANOVA and Kruskal-Wallis test.Results:(1) After four weeks of pharmacological intervention, statistically significant differences were observed in the locomotor activity scores and stereotyped scores among the six groups of rats ( H=41.20, 44.24, both P<0.01). Specifically, the locomotor activity scores(3.00(3.00, 3.25), 1.00(0.75, 1.25), 1.00(0.75, 2.00), 1.00(0, 1.00)) and stereotyped scores(3.00(3.00, 4.00), 1.00(0.75, 2.00), 2.00(0.75, 2.00), 1.00(0, 1.25)) in the tiapride group and the medium- and high-dose Jianpi Rougan Xifeng Decoction groups were significantly lower than those in the model group (all P<0.01). (2) Results from the calcium assay kit revealed statistically significant differences in striatal calcium content among the six groups of rats ( F=146.67, P<0.01). The calcium content in the tiapride group and the medium- and high-dose Jianpi Rougan Xifeng Decoction groups was significantly lower than that in the model group (all P<0.01). Additionally, the calcium content in the medium-dose ((0.40±0.02)mmol/g) and high-dose ((0.30±0.03)mmol/g) Jianpi Rougan Xifeng Decoction groups was lower than that in the low-dose group ((0.48±0.02)mmol/g) (both P<0.01). (3) Immunohistochemical results showed that there were statistically significant differences in the mean optical density values of DAT and IP3 in the striatum among the six groups of rats ( F=25.57, 154.98, both P<0.01). The IP3 mean optical density in the tiapride group and the Jianpi Rougan Xifeng Decoction groups with medium and high doses exhibited lower values compared to the model group (all P<0.05), whereas the DAT mean optical density displayed higher values in these groups compared to the model group (all P<0.05). The low-dose Jianpi Rougan Xifeng Decoction group also exhibited a lower optical density value of IP3 compared to the model group( P<0.05). The optical density values of IP3 (2.68±0.21, 2.40±0.22) in the medium-dose and high-dose Jianpi Rougan Xifeng Decoction groups were lower than that in the low-dose group (4.27±0.23) (both P<0.01). (4) Western blot results indicated that there were statistically significant differences in the protein expression levels of CaM and CaMK Ⅱ in the striatum among the six groups of rats ( F=233.03, 118.60, both P<0.01). The protein expression levels of CaM and CaMK Ⅱ in the tiapride group and the low-dose, medium-dose, and high-dose Jianpi Rougan Xifeng Decoction groups were lower than those in the model group (all P<0.01). The protein expression levels of CaM (1.02±0.06, 0.84±0.02) and CaMK Ⅱ (0.48±0.03, 0.40±0.02) in the medium-dose and high-dose Jianpi Rougan Xifeng Decoction groups were lower than those in the low-dose group (1.21±0.03, 0.57±0.02)) (all P<0.05). Additionally, the protein expression level of CaM in the high-dose Jianpi Rougan Xifeng Decoction group was lower than that in the medium-dose group( P<0.05).(5) The RT-PCR results indicated significant variations in the mRNA expression levels of CaM and CaMK Ⅱ within the striatum across the six groups rats ( F=30.54, 20.78, both P<0.01). The mRNA expression levels of CaM and CaMK Ⅱ in the tiapride group and the high-dose Jianpi Rougan Xifeng Decoction group were lower than those in the model group (both P<0.05). The mRNA expression levels of CaMK Ⅱ (1.38±0.17) in the high-dose Jianpi Rougan Xifeng Decoction group were lower than those in the low-dose group (1.99±0.27) ( P<0.01). Conclusion:Jianpi Rougan Xifeng Decoction can improve locomotor activity and stereotyped behavior in rats with tic disorder model. The mechanism may be through inhibiting the Ca 2+ -CaM-CaMK Ⅱ signaling pathway and regulating the expression of DAT and IP3, thereby modulating the release and recovery of dopamine and reducing the occurrence of tic symptoms.