Objective: To investigate the current status of screening myopia and anxiety symptoms and associated factors among junior and senior high school students in Beijing, so as to provide evidence for myopia prevention and control and the improvement of mental health among adolescents. Methods: From September to November 2024, a total of 17 245 junior high schools, general senior high schools and vocational high schools from 16 districts in Beijing were enrolled by stratified cluster sampling method. Questionnaire surveys and vision screening were conducted to collect data on anxiety symptom and screening diagnosed myopia. The Chi square test was used to analyze the co-occurrence of myopia and anxiety symptoms, and binary Logistic regression analysis was adopted to explore the related factors of the co-occurrence. Results: The overall detection rate of cooccurrence screening myopia and anxiety symptoms among Beijing junior and senior high school students was 6.00%. The detection rate was higher in females ( 7.15 %) than in males (4.90%), higher in urban areas (6.65%) than in suburban areas (5.41%), and higher in general senior high school students (7.61%) than in vocational high school students (6.46%) and junior high school students (4.65%). All differences were statistically significant ( χ 2=38.49, 11.66, 54.88, all P <0.01). Binary Logistic regression analysis showed that female gender ( OR =1.43), general senior high school ( OR =1.60), vocational high school ( OR =1.59), daily sugar sweetened beverage intake ( OR =1.66), participation in academic extracurricular classes in preschool ( OR =1.30), electronic screen use for more than 2 hours per day ( OR =1.21), and insufficient sleep ( OR =2.41) were associated with an increased risk of co-occurring screening diagnosed myopia and anxiety symptoms (all P <0.05). Conclusions The co-occurrence of screening diagnosed of myopia and anxiety symptoms among junior and senior high school students in Beijing is common. Female gender, senior high school students, and unhealthy lifestyle behaviors are all risk factors for the co-occurrence of myopia and anxiety symptom. Comprehensive intervention measures can be adopted to simultaneously promote vision protection and mental health among junior and senior high school students.

Diabetic foot ulcer (DFU) have emerged as a serious global health issue due to its high rates of occurrence, disability, and mortality. DFU exhibit an exceptionally high recurrence rate, driven by a combination of behavioral and biological factors, leading to the recognition of fully epithelialized ulcers as being in "remission" rather than cured. However, the pathogenic factors underlying recurrent DFU (RDFU) remain poorly understood. This review examines the epidemiological characteristics and pathophysiological mechanisms of RDFU. Key mechanisms include neuropathy, angiopathy, epigenetic modifications, and metabolic memory. Research demonstrates that RDFU development results from the interplay of multiple factors: hyperglycemia-induced metabolic abnormalities, chronic inflammatory responses, vascular and neurological damage, as well as dysregulated epigenetic control. These factors interact synergistically, creating a vicious cycle that increases the risk of recurrence and delays recovery. By synthesizing current knowledge, this review aims to provide a foundation for future research and clinical management of RDFU. The insights presented support the development of personalized treatment strategies and effective preventive measures to reduce recurrence and improve patient outcomes.

ObjectiveTo investigate the expression level of lysophosphatidyllecithin acyltransferase 4 （LPCAT4） in pancreatic cancer and its effect on the proliferation of pancreatic cancer cells. MethodsIn this study， the differentially expressed genes of patients with KRAS mutant and wild-type pancreatic cancer were analyzed by online database LinkedOmics. The LPCAT4 expression in pancreatic cancer tissues was analyzed online by the University of Alabama at Birmingham Cancer Data Analysis （UALCAN）， Sangerbox and gene expression profile interaction analysis 2 （GEPIA2）. Kaplan-Meier Plotter database was used to explore the correlation between LPCAT4 and the prognosis of patients with pancreatic cancer. The expression of LPCAT4 in human pancreatic cancer cells were detected by quantitative real-time PCR and Western blot analysis. LPCAT4 was knocked down in the high-expressing SW1990 cell line and overexpressed in the low-expressing MIA PaCa-2 cell line. The effects of LPCAT4 expression on cell proliferation were assessed using CCK-8 and EdU assays. STRING and GEPIA2 databases were used to obtain LPCAT4 binding and coexpressed genes in tumors， which were then analyzed by GO and KEGG. ResultsAnalysis of the LinkedOmics online database revealed a significant upregulation of LPCAT4 in patients with KRAS mutant pancreatic cancer compared to patients with KRAS wild-type pancreatic cancer. The online analysis of GEPIA2， UALCAN and Sangerbox 3.0 showed that the expression of LPCAT4 was higher in pancreatic cancer than in normal tissues. Analysis of the Kaplan-Meier Plotter database revealed that high LPCAT4 expression was associated with poorer prognosis in pancreatic cancer patients.Western blot and qPCR results showed that expression of LPCAT4 in pancreatic cancer cell lines was significantly higher than in normal pancreatic ductal epithelial cells. Knockdown of LPCAT4 in SW1990 cells inhibited proliferation， while overexpression in MIA PaCa-2 cells promoted proliferation. Enrichment analysis indicated that LPCAT4 was closely related to sulfur metabolism. ConclusionsLPCAT4 is highly expressed in pancreatic cancer and is associated with poor prognosis of patients. It plays a significant regulatory role in the proliferation of pancreatic cancer cells， with its expression level closely correlated with cell proliferation capacity. These findings reveal the critical role of LPCAT4 in the malignant progression of pancreatic cancer and provide important evidence for its potential as a therapeutic target.

As an independent first-level discipline,an appropriate classification of nursing science is significant.In China,each nursing degree-granting institution has developed its own secondary-level discipline directions based on its research characteristics and strengths,with varying names and research scopes.Furthermore,there is no unified global classification system.This paper,based on the characteristics of nursing as a discipline and combined with China's discipline classification principles,used literature analysis,comprehensive classification,philosophical reflection,logical reasoning,and expert consultation methods to explore the connotation of nursing,its unique research objects and scope,and to construct a secondary-level discipline classification system for nursing science that is suitable for China's national conditions.The paper also discussed the challenges faced by the nursing discipline and its future development directions,providing theoretical and practical guidance for the development of the nursing discipline.

Objective:To explore the human epidermal growth factor receptor 2 gene(HER2) expression amplification in endometrial cancer (EC) with different p53 expression patterns based on molecular typing, as well as their correlation and impact on prognosis.Methods:A retrospective analysis was conducted on 282 patients with EC who underwent surgical treatment at Dalian Women and Children′s Medical Center (Group) from January 2016 to December 2018 with complete clinical and pathological data. Immunohistochemistry and fluorescence in situ hybridization were used to detect the amplification of HER2 gene expression in paraffin- embedded tumor tissue of patients after surgery and confirmed the expression of p53. The clinical data were collected and tracked follow-up.Results:There were significant differences between HER2-positive patients and HER2-negative patients in the age of onset, pathological types of tumor tissue, depth of muscle infiltration, and tumor differentiation ( P< 0.05). The 5-year survival rate and 5-year progression-free survival rate of HER2-positive patients were lower than those of HER2-negative patients (45.45% vs. 95.16%, 45.45% vs. 95.11%), and there were statistical differences ( P<0.01). The positive expression of HER2 in EC tissues was positively correlated with p53 mutant expression ( r = 0.409, P<0.01). Among p53 wild-type EC patients, the 5-year survival rate was 98.4% for HER2-negative patients and 100.00% for HER2-positive patients. In the patients with p53 mutant EC, 58.05% and 37.50%, respectively, there was a statistical difference ( P<0.01). The 5-year progression-free survival rates were 97.50%, 100.00%, 60.20%, and 37.50%, respectively, and there was a statistical difference ( P<0.01). Conclusions:There is a significant positive correlation between HER2 positive overexpression and p53 mutant expression in EC tissue, and there is an inherent synergy between the two expressions. HER2 positive over expression is a key factor for poor prognosis in EC patients. Patients with HER2- positive over expression and p53 mutant expression have poorer 5-year overall survival and progression- free survival compared to other groups.

Objective:To explore the human epidermal growth factor receptor 2 gene(HER2) expression amplification in endometrial cancer (EC) with different p53 expression patterns based on molecular typing, as well as their correlation and impact on prognosis.Methods:A retrospective analysis was conducted on 282 patients with EC who underwent surgical treatment at Dalian Women and Children′s Medical Center (Group) from January 2016 to December 2018 with complete clinical and pathological data. Immunohistochemistry and fluorescence in situ hybridization were used to detect the amplification of HER2 gene expression in paraffin- embedded tumor tissue of patients after surgery and confirmed the expression of p53. The clinical data were collected and tracked follow-up.Results:There were significant differences between HER2-positive patients and HER2-negative patients in the age of onset, pathological types of tumor tissue, depth of muscle infiltration, and tumor differentiation ( P< 0.05). The 5-year survival rate and 5-year progression-free survival rate of HER2-positive patients were lower than those of HER2-negative patients (45.45% vs. 95.16%, 45.45% vs. 95.11%), and there were statistical differences ( P<0.01). The positive expression of HER2 in EC tissues was positively correlated with p53 mutant expression ( r = 0.409, P<0.01). Among p53 wild-type EC patients, the 5-year survival rate was 98.4% for HER2-negative patients and 100.00% for HER2-positive patients. In the patients with p53 mutant EC, 58.05% and 37.50%, respectively, there was a statistical difference ( P<0.01). The 5-year progression-free survival rates were 97.50%, 100.00%, 60.20%, and 37.50%, respectively, and there was a statistical difference ( P<0.01). Conclusions:There is a significant positive correlation between HER2 positive overexpression and p53 mutant expression in EC tissue, and there is an inherent synergy between the two expressions. HER2 positive over expression is a key factor for poor prognosis in EC patients. Patients with HER2- positive over expression and p53 mutant expression have poorer 5-year overall survival and progression- free survival compared to other groups.

Diabetic foot ulcer (DFU) have emerged as a serious global health issue due to its high rates of occurrence, disability, and mortality. DFU exhibit an exceptionally high recurrence rate, driven by a combination of behavioral and biological factors, leading to the recognition of fully epithelialized ulcers as being in "remission" rather than cured. However, the pathogenic factors underlying recurrent DFU (RDFU) remain poorly understood. This review examines the epidemiological characteristics and pathophysiological mechanisms of RDFU. Key mechanisms include neuropathy, angiopathy, epigenetic modifications, and metabolic memory. Research demonstrates that RDFU development results from the interplay of multiple factors: hyperglycemia-induced metabolic abnormalities, chronic inflammatory responses, vascular and neurological damage, as well as dysregulated epigenetic control. These factors interact synergistically, creating a vicious cycle that increases the risk of recurrence and delays recovery. By synthesizing current knowledge, this review aims to provide a foundation for future research and clinical management of RDFU. The insights presented support the development of personalized treatment strategies and effective preventive measures to reduce recurrence and improve patient outcomes.

As an independent first-level discipline,an appropriate classification of nursing science is significant.In China,each nursing degree-granting institution has developed its own secondary-level discipline directions based on its research characteristics and strengths,with varying names and research scopes.Furthermore,there is no unified global classification system.This paper,based on the characteristics of nursing as a discipline and combined with China's discipline classification principles,used literature analysis,comprehensive classification,philosophical reflection,logical reasoning,and expert consultation methods to explore the connotation of nursing,its unique research objects and scope,and to construct a secondary-level discipline classification system for nursing science that is suitable for China's national conditions.The paper also discussed the challenges faced by the nursing discipline and its future development directions,providing theoretical and practical guidance for the development of the nursing discipline.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

Objective: To investigate the characteristics and trends of malaria cases in Lishui City, Zhejiang Province from 2012 to 2023, so as to provide a basis for improving malaria prevention and control measures. Methods: Case data of malaria in Lishui City from 2012 to 2023 were collected from the Parasitic Disease Control Information Management System of the National Information System for Disease Control and Prevention in China. The parasite species, source of infection, temporal distribution, population distribution, geographical distribution, and clinical diagnosis and treatment of the cases were descriptively analyzed. Results: A total of 169 malaria cases were reported in Lishui City from 2012 to 2023, and P. falciparum malaria was the main type, accounting for 79.88% (135 cases). The positive rate of Plasmodium detection was 3.30‰(169/51 212), the highest was 5.41‰ (18/3 327) in 2017, and the lowest was 0.38‰ (1/2 632) in 2021. Malaria cases were reported in every month from 2012 to 2023, with 91 cases (53.85%) reported from May to October. There were 168 imported cases, of which 163 (96.45%) originated from Africa. There were 127 male cases (75.15%), and the majority of cases were aged 20 to 49 years, with 138 cases accounting for 81.65%. The majority of the occupation was overseas labor export workers, with 164 cases accounting for 97.04%. A total of 161 cases (95.27%) were registered residents of Lishui City, and cases were reported from all nine counties (cities, districts), with Qingtian County and Liandu District having the higher numbers of 98 and 41 cases, respectively. The median interval from onset to hospital visit for malaria cases was 2.00 (interquartile range, 4.00) days, and the median interval from hospital visit to diagnosis was 0 (interquartile range, 1.00) day. The diagnostic rate of first-diagnosed malaria cases in municipal and county medical institutions was 95.90% (117/122) and 91.49% (43/47), respectively, with no statistical significance (P>0.05). Conclusions The P. falciparum malaria was the predominant type in Lishui City from 2012 to 2023, with the majority of cases being imported. Male overseas labor export personnel aged 20 to <50 were the key demographic.