Objective: To understand the allocation and use of safety seats for preschool children and explore its related factors, so as to provide a scientific reference for promoting the usage of safety seats. Methods: A stratified random cluster sampling method was used to select 3 143 parents of preschool children aged 3 to 6 from six kindergartens in Shunyi District, Beijing from January 3 to 10, 2022. An online questionnaire survey was conducted to collect and evaluate the equipment and use of child safety seats in different characteristics of preschool children, as well as their scores of health beliefs. Multiple factor Logistic regression analysis was used to investigated the related factors of safety seat configuration and use. Results: The equipping rate and usage rate of safety seats for preschool children were 66.56% and 58.45%, respectively. The proportion of equipped and used safety seats for preschool children in core families (69.52%, 62.23%) were higher than that in large families (64.35%, 55.62%), only child families ( 72.39 %, 64.87%) were higher than non only child families (61.49%, 52.86%), and urban families (71.63%, 63.04%) were higher than rural families (52.31%, 45.51%) ( χ 2=9.23, 13.86; 41.72, 46.44; 101.96 ,76.97,all P <0.05) . As the educational level of parents ( χ 2 trend =154.23,98.76) and annual income of the family ( χ 2 trend =155.78,127.69) rised, the reporting rates of the equipped and used child safety seats in the family also increased(all P <0.05 ). There were statistically significant differences in the scores of different dimensions of health beliefs for the provision ( t =-20.22-18.16) and use ( t =24.32-24.17) of safety seats for preschool children(all P <0.05). After adjusting for child sex, child age, family annual income, parental education level, family type, whether the child was an only child, and place of residence，multivariate Logistic regression analysis showed that preschool children with higher perceived susceptibility score( OR =1.11, 1.08), higher self efficacy score( OR =1.23, 1.33), and higher suggestive factors score( OR =1.08, 1.12) were more likely to have and use safety seats in their families, while preschool children with higher perceived impairments score( OR =0.82, 0.80) were less likely to have and use safety seats in their families (all P <0.05). Conclusions The installation rate of child safety seats needs to be improved, and there is also a certain gap in their use after installation. Parents of preschool children should improve susceptibility and self efficacy to safety seat equipment and use, and perceptual barriers should be reduced.

Infection is an important trigger for the initiation of pancreatic islet autoimmunity in type 1 diabetes mellitus （T1DM）. From the perspective of latent pathogen and dryness disorder， this study analyzes the core pathogenesis and dynamic evolution of T1DM in the subclinical and clinical stages. Combined with the T1DM "constraint， heat， deficiency， damage" state and target differentiation and treatment theory， the course of infection-induced T1DM is divided into three stages， including latent dryness， dry-heat and collateral damage. The "latent dryness" stage corresponds to the subclinical phase of T1DM， while the "dry-heat" stage corresponds to the clinical phase， and the "collateral damage" stage corresponds to the phase in which chronic complications develop. Treatment principles include supplementing deficiency and dispelling pathogen during the "latent dryness" stage， clearing heat and moistening dryness in the "dry-heat" stage， and dissolving stasis and unblocking collaterals in the "collateral damage" stage. Furthermore， syndrome-targeted and target-directed therapeutic modifications were made according to T1DM-related autoimmune activity， metabolic comorbidities， and vascular comorbidities， providing a reference for clinical management of T1DM.

This paper comprehensively discusses on the potential neurobiological mechanisms of acupuncture in the treatment of tobacco dependence， focusing on three important aspects， including acupuncture's regulation of tobacco dependence behavior， effects of acupuncture on withdrawal syndrome， and the role of acupuncture in preventing relapse. It is found that acupuncture can inhibit drug-seeking behavior by regulating the reward pathway and related neurons， such as dopamine， thus modulating tobacco dependence behavior. It also alleviates withdrawal symptoms by improving the oral environment of smokers and reducing negative emotions after quitting. Furthermore， acupuncture can prevent relapse by decreasing brain network activity related to smoking cravings and improving cognitive brain functions like addiction memory. Currently， research on the specific neurobiological mechanism of acupuncture in treating tobacco dependence and the involved neural circuits is limited. Future research directions are proposed， including the evaluation of clinical effects， exploration of specific therapeutic mechanisms， investigation of brain pathology， and strengthening the exploration of brain functions. Additionally， combining modern technologies to clarify the neural circuits involved in acupuncture intervention will provide a basis for acupuncture treatment of tobacco addiction.

Purpose: Cancer has become a significant major public health concern, making the discovery of new cancer markers or therapeutic targets exceptionally important. Elevated expression of tumor necrosis factor receptor superfamily member 12A (TNFRSF12A) expression has been observed in certain types of cancer. This project aims to investigate the function of TNFRSF12A in tumors and the underlying mechanisms. Materials and Methods: Various websites were utilized for conducting the bioinformatics analysis. Tumor cell lines with stable knockdown or overexpression of TNFRSF12A were established for cell phenotyping experiments and subcutaneous tumorigenesis in BALB/c mice. RNA-seq was employed to investigate the mechanism of TNFRSF12A. Results: TNFRSF12A was upregulated in the majority of cancers and associated with a poor prognosis. Knockdown TNFRSF12A hindered the colorectal cancer progression, while overexpression facilitated malignancy both in vitro and in vivo. TNFRSF12A overexpression led to increased nuclear factor кB (NF-κB) signaling and significant upregulation of baculoviral IAP repeat containing 3 (BIRC3), a transcription target of the NF-κB member RELA, and it was experimentally confirmed to be a critical downstream factor of TNFRSF12A. Therefore, we speculated the existence of a TNFRSF12A/RELA/BIRC3 regulatory axis in colorectal cancer. Conclusion TNFRSF12A is upregulated in various cancer types and associated with a poor prognosis. In colorectal cancer, elevated TNFRSF12A expression promotes tumor growth, potentially through the TNFRSF12A/RELA/BIRC3 regulatory axis.

Objective: To analyze the serological characteristics of anti-Mur antibodies and investigate the distribution frequency of the Mur antigen among voluntary blood donors in Shiyan, thereby providing a basis for guiding clinical transfusion and establishing a Mur blood type database. Methods: ABO blood grouping of donors and patients was performed using an automated blood typing analyzer and the gel card method, respectively. Unexpected antibody screening and identification were performed using the saline, tube anti-human globulin, and polybrene methods. The specificity of anti-Mur antibodies was confirmed using Fisher's exact probability test. Plasma treated with 2-mercaptoethanol was used to distinguish IgM and IgG antibodies. IgM and IgG anti-Mur titers were determined by the saline tube method and the anti-human globulin tube method, respectively, at 4℃, room temperature, and 37℃. A total of 1 659 donor red blood cell samples were initially screened for the Mur antigen phenotype using three samples of human-derived anti-Mur plasma by the micro-tube method. Donors who tested positive for Mur antigen were further tested by the direct antiglobulin test (DAT); those with negative results were confirmed for Mur antigen by the gel card and polybrene methods. Results: Three blood samples were identified to contain mixed IgG and IgM anti-Mur antibodies. The titers of both IgM and IgG anti-Mur antibodies were highest at 4℃, intermediate at room temperature, and lowest at 37℃. The positive frequency of the Mur antigen among voluntary blood donors in Shiyan was 1.99% (33/1 659). Conclusion: anti-Mur antibodies were detected in both blood donors and patients in our region. The Mur antigen shows a certain distribution frequency among voluntary blood donors in Shiyan. Screening for the Mur blood type and establishing a corresponding database could enhance transfusion safety.

Purpose: Cancer has become a significant major public health concern, making the discovery of new cancer markers or therapeutic targets exceptionally important. Elevated expression of tumor necrosis factor receptor superfamily member 12A (TNFRSF12A) expression has been observed in certain types of cancer. This project aims to investigate the function of TNFRSF12A in tumors and the underlying mechanisms. Materials and Methods: Various websites were utilized for conducting the bioinformatics analysis. Tumor cell lines with stable knockdown or overexpression of TNFRSF12A were established for cell phenotyping experiments and subcutaneous tumorigenesis in BALB/c mice. RNA-seq was employed to investigate the mechanism of TNFRSF12A. Results: TNFRSF12A was upregulated in the majority of cancers and associated with a poor prognosis. Knockdown TNFRSF12A hindered the colorectal cancer progression, while overexpression facilitated malignancy both in vitro and in vivo. TNFRSF12A overexpression led to increased nuclear factor кB (NF-κB) signaling and significant upregulation of baculoviral IAP repeat containing 3 (BIRC3), a transcription target of the NF-κB member RELA, and it was experimentally confirmed to be a critical downstream factor of TNFRSF12A. Therefore, we speculated the existence of a TNFRSF12A/RELA/BIRC3 regulatory axis in colorectal cancer. Conclusion TNFRSF12A is upregulated in various cancer types and associated with a poor prognosis. In colorectal cancer, elevated TNFRSF12A expression promotes tumor growth, potentially through the TNFRSF12A/RELA/BIRC3 regulatory axis.

Objective Exploring the application effect of fragmented resistance exercise in the exercise rehabili-tation of elderly patients with chronic obstructive pulmonary disease,providing references for improving their quality of life.Methods From October to December 2024,96 elderly patients with chronic obstructive pulmonary disease admitted to a tertiary hospital in Pingdingshan city were conveniently selected as the research subjects.They were randomly divided into an experimental group and a control group(all n=48)using a random number table method.The experimental group received a fragmented resistance exercise program on the basis of routine pulmonary reha-bilitation,while the control group received routine pulmonary rehabilitation nursing care for a duration of 3 months.The lung function,exercise endurance,quality of life,and exercise compliance were compared between the 2 groups before and after intervention.Results The experimental group ultimately included 46 cases,while the control group ultimately included 47 cases.The lung function of the experimental group was better than that of the control group after 3 months of intervention(P＜0.05),and the exercise compliance scores of the experimental group were high-er than those of the control group after 1 and 3 months of intervention(P＜0.001).Repeated measures ANOVA showed that there was an interaction effect(P＜0.05)in the comparison of exercise endurance and quality of life between the 2 groups.Simple effects analysis showed that the experimental group had better exercise endurance after 3 months of intervention than the control group(P＜0.05),and better quality of life after 1 and 3 months of intervention than the control group(P＜0.05).Conclusion Fragmented resistance exercise can effectively improve lung function,enhance exercise endurance and compliance,and improve quality of life in elderly patients with chronic obstructive pul-monary disease.

Objective:To evaluate the effect of liposomal bupivacaine transversus abdominis plane block (TAPB) on the postoperative quality of recovery in patients undergoing laparoscopic colorectal surgery.Methods:In this randomized controlled trial, 100 patients of either sex, aged 18-75 yr, with a body mass index of 18.5-29.9 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, scheduled for elective laparoscopic colorectal surgery, were allocated into 2 groups ( n=50 each) in a 1∶1 ratio using a random number table method: liposomal bupivacaine TAPB group (LB group) and hydrochloric bupivacaine TAPB group (HB group). Before anesthesia induction, ultrasound-guided bilateral TAPB was performed, liposomal bupivacaine (266 mg) 40 ml (20 ml per side) was injected in LB group, and bupivacaine hydrochloride (100 mg) 40 ml (20 ml per side) was injected in HB group. When pain scores at rest ≥4 within 72 h after the end of surgery, patient-controlled intravenous analgesia with morphine injectio 3 mg was used. The Quality of Recovery-15 scale score was recorded at 24, 48 and 72 h postoperatively. The time to first rescue analgesia and total consumption of morphine within 72 h after operation were recorded. The occurrence of adverse reactions, including nausea and vomiting, urinary retention, pruritus, local anesthetic toxicity and hematoma at the puncture site, was recorded within 72 h after surgery. Results:Compared to HB group, Quality of Recovery-15 scale scores were significantly increased at 24, 48 and 72 h postoperatively, the time to first rescue analgesia was prolonged, the consumption of morphine was reduced within 72 h postoperatively, and the incidence of postoperative nausea and vomiting was decreased( P<0.05), and no statistically significant changes in the incidence of urinary retention or pruritus were found within 72 h postoperatively in LB group ( P>0.05). No local anesthetic toxicity or hematoma at the puncture site occurred in either group. Conclusions:Liposomal bupivacaine TAPB can improve the postoperative quality of recovery in the patients undergoing laparoscopic radical resection for colorectal cancer.

Objective:To determine the clinical issues in the Clinical practice guidelines for postoperative pain management in adults (2024 edition). Methods:A preliminary list of clinical issues for the guidelines was developed through literature review, clinical surveys, and expert interviews. This was followed by two rounds of Delphi questionnaire surveys, with quality control and statistical analysis conducted using expert positive coefficient, mean item scores, full score ratio, coefficient of variation, Cronbach′s α coefficient, and expert authority level to finalize the list of clinical issues.Results:The experts participating in the Delphi questionnaire surveys had multidisciplinary collaborative backgrounds and regional representativeness, with a high level of authority. The overall positive coefficient of expert participation in the surveys was 78.9%. Through two rounds of the Delphi method and based on the screening criteria of a mean score ≥3.5, coefficient of variation ≤30%, and full score ratio ≥30%, 17 clinical issues were ultimately included following an expert consensus meeting.Conclusions:Through the Delphi method and rigorous quality control, the clinical issues in the Clinical practice guidelines for postoperative pain management in adults (2024 edition) are determined, laying a foundation for the subsequent development of the guidelines.

Objective:To evaluate the effectiveness of fosaprepitant in preventing postoperative nausea and vomiting (PONV) following gynecological laparoscopic surgery.Methods:In this randomized parallel-controlled trial, 100 American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients, aged 18-64 yr, undergoing elective gynecological laparoscopic surgery under general anesthesia at the First Affiliated Hospital of Zhengzhou University, were selected and divided into 2 groups ( n=50 each) in a ratio of 1∶1 using blocked randomization: fosaprepitant group (group F) and tropisetron group (group T). At 30 min before anesthesia induction, fosaprepitant 150 mg was intravenously infused in group F, and tropisetron 5 mg was intravenously infused in group T, both diluted in 150 ml of normal saline. Anesthesia was induced by intravenous injection of midazolam, etomidate, sufentanil and cisatracurium. Anesthesia was maintained by intravenous infusion of remifentanil and propofol. Patient-controlled intravenous analgesia was performed with hydromorphone at the end of operation until 48 h after operation. Metoclopramide was given as rescue antiemetic. The PONV, requirement for antiemetic drugs and related adverse reactions were recorded within 24 h after surgery. Results:The incidence of PONV (10% vs 30%), the incidence of vomiting(2% vs 16%) and the rescue rate of antiemetic drugs(2% vs 12%)were significantly lower in group F than in group T ( P<0.05). There was no significant difference in the incidence of related adverse reactions between the two groups ( P>0.05). Conclusions:Intravenous infusion of fosaprepitant 150 mg at 30 min before anesthesia induction effectively prevents PONV in patients undergoing gynecological laparoscopic surgery, and the efficacy is superior to that of the conventional use of tropisetron.