AIM:To investigate the prevalence and associated factors of comorbid myopia and scoliosis among primary and junior school students in Binhu District, Wuxi, China.METHODS:A stratified cluster random sampling method was used to select students from 10 primary and junior schools in Binhu District for visual acuity testing, scoliosis examination, and a questionnaire survey on related factors. The relationship between scoliosis and myopia was detected using univariate analysis. A binary multivariable logistic regression model was applied to analyze the risk factors associated with comorbid myopia and scoliosis.RESULTS: A total of 17 951 students were selected, including 8948(49.85%)boys and 9003(50.15%)girls; 9784(54.50%)primary school students and 8167(45.50%)junior school students. The detection rates of myopia, scoliosis, and comorbidity were 68.30%, 2.95%, and 2.76%, respectively. The comorbidity rate was higher in girls(3.78%)than in boys(1.74%). Junior school students(3.67% in Grade 7-9)had a higher total comorbidity detection rate than primary school students(2.00% in Grade 4-6; all P<0.001). Logistic regression analysis showed that being in Grade 7-9 [odds ratio(OR)=4.43, 95% confidence interval(CI): 2.36-7.85], spending 2-3 h(OR=1.46, 95%CI: 1.02-2.16)or ≥3 h(OR=1.5, 95%CI: 1.21-2.55)on homework or reading after school, engaging in >60 min of moderate-to-vigorous physical activity >6 days per week(OR=1.39, 95%CI: 1.08-1.7), and not adjusting desk and chair height to match the student's height(OR=1.73, 95%CI: 1.2-2.25)were positively associated with comorbidity(all P<0.05).CONCLUSION: The prevalence of comorbid myopia and scoliosis among primary and junior school students in Binhu District of Wuxi is concerning. Reducing the time ofhomework or reading and writing after school and engaging in ≥60 min of moderate-to-vigorous physical activity at least three days per week may help lower the risk of comorbid myopia and scoliosis in this population.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To explore the value of deep learning image reconstruction(DLIR)by comparing subjective and objec-tive evaluation of DLIR and adaptive statistical iterative reconstruction(ASIR-V)images in gastric cancer CT.Methods Abdominal CT images in the venous phase of 80 untreated patients with primary gastric cancer were included,and five CT reconstruction meth-ods of 50％ASIR-V,80％ASIR-V,DLIR-low(DLIR-L),DLIR-medium(DLIR-M)and DLIR-high(DLIR-H)were adopted,respec-tively.The objective evaluation included background standard deviation(SD),signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR)values and pericancerous fat density resolution.The subjective evaluation included SD,overall image quality,the display of gastric cancer lesions,and diagnostic confidence in whether the serosal surface of the gastric wall was infiltrated.Results The subjective and objective evalua-tion indicators showed statistically significant differences among the five reconstruction models(P＜0.001).In terms of objective evalua-tion,the SD value of gastric cancer lesions in the DLIR-H was the lowest,while the SNR and CNR values were the highest among the five groups.In terms of subjective evaluation,the DLIR-M had the highest scores in gastric cancer lesions display,overall image quality and diagnostic confidence among the five groups.Conclusion Compared with ASIR-V,DLIR can significantly reduce image noise and improve image quality,and DLIR-M and DLIR-H are respectively the optimal subjective and objective reconstruction models for showing gastric cancer lesions.

Objective To explore the value of deep learning image reconstruction(DLIR)by comparing subjective and objec-tive evaluation of DLIR and adaptive statistical iterative reconstruction(ASIR-V)images in gastric cancer CT.Methods Abdominal CT images in the venous phase of 80 untreated patients with primary gastric cancer were included,and five CT reconstruction meth-ods of 50％ASIR-V,80％ASIR-V,DLIR-low(DLIR-L),DLIR-medium(DLIR-M)and DLIR-high(DLIR-H)were adopted,respec-tively.The objective evaluation included background standard deviation(SD),signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR)values and pericancerous fat density resolution.The subjective evaluation included SD,overall image quality,the display of gastric cancer lesions,and diagnostic confidence in whether the serosal surface of the gastric wall was infiltrated.Results The subjective and objective evalua-tion indicators showed statistically significant differences among the five reconstruction models(P＜0.001).In terms of objective evalua-tion,the SD value of gastric cancer lesions in the DLIR-H was the lowest,while the SNR and CNR values were the highest among the five groups.In terms of subjective evaluation,the DLIR-M had the highest scores in gastric cancer lesions display,overall image quality and diagnostic confidence among the five groups.Conclusion Compared with ASIR-V,DLIR can significantly reduce image noise and improve image quality,and DLIR-M and DLIR-H are respectively the optimal subjective and objective reconstruction models for showing gastric cancer lesions.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To investigate the correlation between cardiac polyps and gastroesophageal flap valve (GEFV).Methods:The clinical, endoscopic and pathological data of 349 patients with cardiac polyps (the cardiac polyp group) visiting Affiliated Hospital of Yangzhou University from January 1, 2016 to December 31, 2021 were retrospectively collected, and the same number of non-cardiac polyp patients (the non-cardiac polyp group) were matched in the same period as control according to the propensity score. The clinical, endoscopic and pathological data of the two groups were compared.Results:After matching with propensity score, there were 296 patients in each group, with no significant differences in smoking, acid reflux, heartburn, Helicobacter pylori infection, bile reflux, reflux esophagitis or pancreatitis between the two groups ( P>0.05). Compared with the non-cardiac polyp group, the risk of cardiac polyps increased in GEFV Ⅱ patients ( OR=3.046, 95%CI: 2.100-4.419, P<0.001) and GEFV Ⅲ patients ( OR=4.202, 95%CI: 2.299-7.681, P<0.001). Compared with the non-cardiac polyp group, the risk of cardiac polyps increased in patients with GEFV abnormalities ( OR=2.822, 95%CI: 1.615-4.931, P<0.001). GEFV abnormalities was associated with the cardiac polyp site ( χ2=22.169, P=0.003) and was not significantly associated with cardiac polyp size, number, morphology, intestinal metaplasia of the surrounding mucosa or intraepithelial neoplasia ( P>0.05). Conclusion:The occurrence of cardiac polyps is related to GEFV, and the patients with GEFV abnormalities are more likely to develop cardiac polyps.

BACKGROUND:Increasing evidence suggests that N6-methyladenosine(m6A)regulators are closely associated with osteoarthritis and are considered to be a new direction in the prevention and treatment of osteoarthritis,but their specific mechanism of action is unknown. OBJECTIVE:To conduct a bioinformatics analysis of the osteoarthritis gene microarray dataset in order to explore the role of m6A in osteoarthritis and analyze the pathogenesis of osteoarthritis. METHODS:The m6A regulators associated with osteoarthritis and their expression were first extracted from the GSE1919 dataset in the GEO database using R software,and then the results were analyzed by gene difference analysis and GO and KEGG enrichment analyses.Subsequently,the results of protein-protein interaction network topology analysis and machine learning results were intersected to obtain the m6A Hub regulators,which were validated by in vitro cellular experiments. RESULTS AND CONCLUSION:A total of 16 osteoarthritis-related m6A regulators were extracted and 11 m6A differential regulators,including ZC3H13,YTHDC1,YTHDF3 and HNRNPC,were obtained by differential analysis.GO enrichment analysis showed that osteoarthritis-related m6A differential regulators played a role in the biological processes such as mRNA transport,RNA catabolism,and regulation of insulin-like growth factor receptor signaling pathway.(3)KEGG enrichment analysis showed that the differential regulators were mainly involved in the p53,interleukin-17 and AMPK signaling pathways.The combined protein-protein interaction network topology analysis and machine learning results obtained the m6A Hub regulator-YTHDC1.(5)The results of in vitro cellular experiments showed that there was a significant difference in the expression of m6A key regulator between the control and experimental groups(P<0.05).To conclude,YTHDC1 is closely related to the development of osteoarthritis,which is expected to be a molecular target of m6A for the treatment of osteoarthritis.

Objective:To analyze the basic medical insurance fund balance status in China and the risk warning since the new medical reform,in order to provide decision-making references for the sustainable development of basic medical insurance fund in China.Methods:Collecting the data on the basic medical insurance fund in China from 2009 to 2022 for descriptive statistical analysis,and conduct fund balance risk warning analysis based on the risk warning interval.Results:During 2009-2021,the percentage of retirees enrolled in UEBMI has continued to increase,and there will still be a certain accumulated balance in the integrated fund.The number of participants in the URBMI has been decreased since 2020,the growth rate of fund expenditures became higher than the growth rate of fund revenues,the fund balance showed a decreasing trend.Conclusion:There are certain risks to the long-term balance of the basic medical insurance fund,which may caused by factors such as aging population,funding mechanisms,and treatment levels.

Objective:To investigate the effects and mechanism of metformin on the wound healing of full-thickness skin defects in diabetic rats.Methods:This study was an experimental study. Eighteen 8-week-old male Sprague Dawley rats were divided into control group, diabetes group, and diabetes+metformin group according to complete random grouping method, with 6 rats in each group. The latter two groups of rats were used to create diabetic models, and then four circular full-thickness skin defect wounds with a diameter of 5 mm were made on the back of 18 rats. Metformin F-127 hydrogel was applied only to the wounds of rats in diabetes+metformin group. The wound healing status on post injury day (POD) 7 and 13 was observed and the wound healing rate was calculated. The wound tissue on POD 7 and 13 was collected for hematoxylin-eosin staining to measure the length of re-epithelialized epidermis and calculate the change rates in diameters of epidermal and dermal wounds, for immunohistochemical staining to detect the relative expressions of keratin 10 and proliferating cell nuclear antigen (PCNA), and for Western blotting to detect the protein expressions of keratin 10 and PCNA. The sample size in all the above experiments was 8 except that in the last experiment was 3. The correlations between the relative expressions of keratin 10 and PCNA in wound tissue in three groups of rats and their wound healing rates, and the correlation between the relative expressions of keratin 10 and PCNA in wound tissue were analyzed.Results:On POD 7, the wound healing rates of rats in diabetes group and diabetes+metformin group were 81.48% (77.89%, 85.53%) and 93.04% (92.51%, 94.24%), which were significantly lower than 100% (97.17%, 100%) in control group (with Z values of 2.37 and -3.36, respectively, P<0.05); the wound healing rate of rats in diabetes+metformin group was significantly higher than that in diabetes group ( Z=3.45, P<0.05). On POD 13, the wound healing rates of rats in control group and diabetes+metformin group were both 100% (100%, 100%), which were significantly higher than 94.47% (90.68%, 99.82%) in diabetes group (with Z values of 2.90 and -2.90, respectively, P<0.05). On POD 7, the change rates in epidermal wound diameter of rats in control group and diabetes+metformin group were significantly higher than that in diabetes group (with Z values of 3.36 and -2.74, respectively, P<0.05). The change rates in dermal wound diameter of rats in the three groups were similar on POD 7 and 13 ( P>0.05). The lengths of re-epithelialized epidermis of rats in control group and diabetes+metformin group on POD 13 were significantly longer than that in diabetes group (with Z values of 3.34 and -2.64, respectively, P<0.05). The relative expressions of keratin 10 in wound tissue of rats in diabetes group on POD 7 and 13 were significantly higher than those in control group (with Z values of -3.36 and -3.26, respectively, P<0.05) and diabetes+metformin group (with Z values of 3.36 and 3.15, respectively, P<0.05), and the relative expression of keratin 10 in wound tissue of rats in diabetes+metformin group on POD 7 was significantly lower than that in control group ( Z=3.05, P<0.05); the relative expressions of PCNA in wound tissue of rats in diabetes group on POD 7 and 13 were significantly lower than those in control group (with both Z values of 3.36, P<0.05) and diabetes+metformin group (with both Z values of -3.36, P<0.05). The protein expressions of keratin 10 in wound tissue of rats in control group and diabetes+metformin group on POD 7 as well as that in diabetes+metformin group on POD 13 were significantly lower than those in diabetes group ( P<0.05), and the protein expressions of PCNA in wound tissue of rats in control group and diabetes+metformin group on POD 7 were significantly higher than that in diabetes group ( P<0.05). There was a significant positive correlation between the relative expression of keratin 10 in wound tissue and the wound healing rate in control group and diabetes+metformin group of rats (with r values of 0.78 and 0.71, respectively, P<0.05), there was a significant negative correlation between the relative expression of PCNA in wound tissue and the wound healing rate in diabetes+metformin group of rats ( r=-0.60, P<0.05), and there was a significant negative correlation between the relative expressions of PCNA and keratin 10 in wound tissue of rats in diabetes group and diabetes+metformin group (with r values of -0.41 and -0.49, respectively, P<0.05). Conclusions:The diabetic rats with full-thickness skin defect wound exhibit delayed healing, accompanied by up-regulation of keratin 10 and down-regulation of PCNA in keratinocytes in the wound tissue. Metformin can promote wound healing in diabetic rats with full-thickness skin defects by down-regulating keratin 10 expression and up-regulating PCNA expression in keratinocytes in the wound tissue, and the wound healing rate was positively correlated with the expression of keratin 10 and negatively correlated with the expression of PCNA.

Objective:We aimed to develop a novel visualized model based on nomogram to predict postoperative overall survival.Methods:This was a multicenter, retrospective, observational cohort study, including participants with histologically confirmed gastric and colorectal cancer who underwent radical surgery from 11 medical centers in China from August 1, 2015 to June 30, 2018. Baseline characteristics, histopathological data and nutritional status, as assessed using Nutrition Risk Screening 2002 (NRS 2002) score and the scored Patient-Generated Subjective Global Assessment, were collected. The least absolute shrinkage and selection operator regression and Cox regression were used to identify variables to be included in the predictive model. Internal and external validations were performed.Results:There were 681 and 127 patients in the training and validation cohorts, respectively. A total of 188 deaths were observed over a median follow-up period of 59 (range: 58 to 60) months. Two independent predictors of NRS 2002 and Tumor-Node-Metastasis (TNM) stage were identified and incorporated into the prediction nomogram model together with the factor of age. The model's concordance index for 1-, 3- and 5-year overall survival was 0.696, 0.724, and 0.738 in the training cohort and 0.801, 0.812, and 0.793 in the validation cohort, respectively.Conclusions:In this study, a new nomogram prediction model based on NRS 2002 score was developed and validated for predicting the overall postoperative survival of patients with gastric colorectal cancer. This model has good differentiation, calibration and clinical practicability in predicting the long-term survival rate of patients with gastrointestinal cancer after radical surgery.