AIM: To compare the differences in intraocular pressure and anterior segment biometric parameters among Tibetan populations permanent residing at different altitudes in Xizang autonomous region, and to explore the impact of high-altitude environments on ocular characteristics.

METHODS:This was a retrospective cross-sectional study. Data were collected from Tibetan patients who visited the People's Hospital of Xizang Autonomous Region from September 2019 to October 2021. Participants were divided into two groups based on their permanent residence altitude: a higher altitude group(2 500-3 750 m)and a very high-altitude group(>3 750 m). The eye with better best corrected visual acuity was selected for each participant. Intraocular pressure, refractive error, and anterior segment biometric measurements \〖white-to-white corneal diameter(WTW), central corneal thickness(CCT), anterior chamber depth(ACD), lens thickness(LT), axial length(AL)\〗 were recorded and compared between the two groups.

RESULTS: A total of 43 Tibetan patients(43 eyes)were enrolled in this study, comprising 23 males and 20 females, with a mean age of 57.88±13.90 y. There were 19 patients(19 eyes)in the very high-altitude group and 24 patients(24 eyes)in the higher altitude group. The mean intraocular pressure in the very high-altitude group was 11.79±1.72 mmHg, which was significantly lower than 13.44±2.43 mmHg in the higher altitude group(P=0.019). CCT in the very high-altitude group was 482.70±23.76 μm, significantly thinner than 503.00±31.09 μm in the higher altitude group(P=0.012). AL in the very high-altitude group was 22.96±0.96 mm, significantly shorter than 23.64±1.10 mm in the higher altitude group(P=0.020). No statistically significant differences were found between the two groups in WTW, ACD, LT, or refractive error(all P>0.05).

CONCLUSION:Among the Tibetan population in Xizang autonomous region, as the altitude of residence increases, intraocular pressure significantly decreases, CCT becomes thinner and AL shortens. These morphological changes suggest possible adaptive remodelling of the eye in very high-altitude environments, and a thinner cornea may be an important factor contributing to the lower measured intraocular pressure values.

Objective: To investigate the epidemiological and spatio-temporal characteristics of influenza in Jiaxing City, Zhejiang Province, so as to provide insights into perfecting the prevention and control strategies of influenza. Methods: Data of influenza in Jiaxing City from 2019 to 2023 were collected from the Chinese Disease Prevention and Control Information System. Population data of the same period were collected from the Zhejiang Health Information Network Reporting System. The epidemiological characteristics of influenza were analyzed using descriptive analysis. Vector map information was collected from the Open Street Map, and the spatio-temporal clustering characteristics of influenza were analyzed using spatial autocorrelation and spatio-temporal scanning. Results: A total of 181 501 cases of influenza were reported in Jiaxing City from 2019 to 2023, with an average annual reported incidence of 653.93/105. The majority of cases were aged 5 to <15 years (59 785 cases, 32.94%). The majority of the occupations were students (78 239 cases, 43.11%) and pre-school children (33 715 cases, 18.58%). The county (city, district) with the highest reported incidence was Haining City (1 451.70/105), and the town (street) with the highest reported incidence was Chang'an Town (1 932.78/105). Spatial autocorrelation analysis showed that the incidence of influenza in Jiaxing City from 2019 to 2023 had positive spatial correlations (all Moran's I>0, all P<0.05), with a high-high clustering in the southern region. Spatio-temporal scanning analysis showed that there was a spatio-temporal clustering of influenza in Jiaxing City from 2019 to 2023, with the southern region being the primary-type clustering area and the period between November and January of the following year being the clustering time. Conclusion There was a significant spatio-temporal clustering of influenza in Jiaxing City from 2019 to 2023, with winter being the peak season and the southern region being the primary area.

Objective:To explore the feasibility of using a simplified multiple sleep latency test (MSLT) for the diagnosis of narcolepsy type 1.Methods:Data from 158 patients with narcolepsy type 1 and 58 patients with non-type 1 narcolepsy who underwent overnight video-polysomnography (V-PSG) and MSLT in the Sleep Center, Department of Neurology, Xijing Hospital, Air Force Military Medical University from March 2019 to April 2024 were retrospectively collected. By reducing the number of naps in the MSLT, the diagnostic consistency between the simplified MSLT and the standard 5-nap MSLT was evaluated using the receiver operating characteristic (ROC) curve. The DeLong test was used to compare whether there was a statistically significant difference between the simplified MSLT and the standard 5-nap MSLT. Cohen′s Kappa statistical analysis was performed to compare the diagnostic consistency between the simplified MSLT and the standard 5-nap MSLT.Results:The age of the 216 patients who were ultimately enrolled was 17 (13, 30) years, including 152 male patients (70.4%). The Cohen′s Kappa between the simplified 3-nap MSLT and the standard 5-nap MSLT was 0.875, which was 0.903 between the simplified 4-nap MSLT and the standard 5-nap MSLT (Bonferroni-corrected, both P0.001), indicating high and statistically significant agreement for both simplified protocols with the standard test. However, the DeLong test revealed that the area under the curve of the standard 5-nap MSLT (0.900, 95% CI 0.863-0.938) differed significantly from that of the simplified 3-nap MSLT (0.860, 95% CI 0.817-0.904; P0.05), whereas no significant difference was observed between the standard 5-nap MSLT and the simplified 4-nap MSLT (0.876, 95% CI 0.834-0.918; P0.05). Consequently, performing only the first 4 naps was sufficient for diagnosing narcolepsy type 1. Conclusion:The simplified 4-nap MSLT, specifically the first to fourth naps, may be used for the diagnosis of narcolepsy type 1.

Objective: To explore the association between physical activity, anxiety symptoms and academic performance among junior high school students, so as to provide data support for optimizing school physical education and health work and formulating physical activity guidelines. Methods: From September to December 2022, a convenience cluster sampling method was used to survey 2 800 junior high school students in a middle school from Anqing City, Anhui Province. Data were collected on the students anxiety symptoms, academic performance, 24 hour physical activity [moderate to vigorous intensity physical activity(MVPA), light intensity physical activity(LPA), sedentary behavior(SB), and sleep(SLP) duration] as well as demographic characteristics. Compositional data analysis was used to explore the associations between 24 hour physical activity, anxiety symptoms and academic performance among junior high school students, and to predict the optimal time use combination pattern. Results: Among the junior high school students, 16.0% (447 students) reported anxiety symptoms, and 42.0% (1 175 students) achieved excellent or good academic performance. Compositional data analysis showed that increased SLP duration was associated with both reduced anxiety symptoms ( β =-0.18) and decreased academic performance ( β =-0.03) among junior high school students; increased MVPA duration was correlated with fewer anxiety symptoms ( β =-0.02) and lower academic performance ( β =-0.13); in contrast, increased SB duration was linked to more anxiety symptoms ( β =0.09) and higher academic performance ( β =0.09) (all P <0.01). LPA duration exhibited a non linear relationship with anxiety symptoms and academic performance in junior high school students (all P >0.05). The time use combination pattern corresponding to the lowest anxiety symptoms and highest academic performance (top 5%) in adolescents was 611 (520-640) minutes of SLP, 258 (230-320) minutes of SB, 454 (280-610) minutes of LPA, and 117 (20-200) minutes of MVPA per day. Conclusions The 24 hour physical activity of junior high school students is associated with anxiety symptoms and academic performance. Therefore, it is recommended to increase the time spent on SB, MVPA, and LPA for junior high school students, while reducing SB.

Objective:To explore the feasibility of using a simplified multiple sleep latency test (MSLT) for the diagnosis of narcolepsy type 1.Methods:Data from 158 patients with narcolepsy type 1 and 58 patients with non-type 1 narcolepsy who underwent overnight video-polysomnography (V-PSG) and MSLT in the Sleep Center, Department of Neurology, Xijing Hospital, Air Force Military Medical University from March 2019 to April 2024 were retrospectively collected. By reducing the number of naps in the MSLT, the diagnostic consistency between the simplified MSLT and the standard 5-nap MSLT was evaluated using the receiver operating characteristic (ROC) curve. The DeLong test was used to compare whether there was a statistically significant difference between the simplified MSLT and the standard 5-nap MSLT. Cohen′s Kappa statistical analysis was performed to compare the diagnostic consistency between the simplified MSLT and the standard 5-nap MSLT.Results:The age of the 216 patients who were ultimately enrolled was 17 (13, 30) years, including 152 male patients (70.4%). The Cohen′s Kappa between the simplified 3-nap MSLT and the standard 5-nap MSLT was 0.875, which was 0.903 between the simplified 4-nap MSLT and the standard 5-nap MSLT (Bonferroni-corrected, both P0.001), indicating high and statistically significant agreement for both simplified protocols with the standard test. However, the DeLong test revealed that the area under the curve of the standard 5-nap MSLT (0.900, 95% CI 0.863-0.938) differed significantly from that of the simplified 3-nap MSLT (0.860, 95% CI 0.817-0.904; P0.05), whereas no significant difference was observed between the standard 5-nap MSLT and the simplified 4-nap MSLT (0.876, 95% CI 0.834-0.918; P0.05). Consequently, performing only the first 4 naps was sufficient for diagnosing narcolepsy type 1. Conclusion:The simplified 4-nap MSLT, specifically the first to fourth naps, may be used for the diagnosis of narcolepsy type 1.

Objective:To establish a rapid quantitative PCR (qPCR) technique for Mycobacterium marinum skin infections, and to analyze its clinical diagnostic efficiency. Methods:DNA was extracted from Mycobacterium marinum colonies and serially diluted (10 -1 to 10 -8). Twelve pairs of previously reported primers and probes, as well as 6 pairs of newly designed primers and probes in this study, were used for qPCR amplification to identify the most sensitive primers and probes for the detection of Mycobacterium marinum. Skin lesion tissues were collected from 72 patients with confirmed Mycobacterium marinum infections (experimental group) and 68 with other mycobacterial infections (control group) at Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University & Shandong Academy of Medical Sciences in 2021. These skin tissues were subjected to qPCR amplification, interferon-gamma release assay (IGRA), acid-fast staining, and tissue culture to evaluate the diagnostic efficacy. Results:The newly designed primers and probes targeting the mycobacterial enhanced infection locus 2 (Mel2) demonstrated the highest sensitivity, with a detection limit of 0.86 copies/μl (cycle threshold value = 37) ; the qPCR amplification with the Mel2 primers/probes did not yield positive results when used for the detection of other mycobacteria (including Mycobacterium leprae and Staphylococcus spp) . Among the 72 patients in the experimental group, 44 were positive for qPCR with a sensitivity of 61.1% (95% CI: 49.6% - 71.5%), and 47 were positive for culture with a sensitivity of 65.2% (95% CI: 53.8% - 75.3%) ; all the 68 controls were negative for both qPCR and culture, with their specificities both being 100%. Among 65 patients subjected to IGRA, 31 were positive with a sensitivity of 47.7% (95% CI: 36.0% - 59.6%), while 16 out of 25 controls were negative for IGRA with a specificity of 64.0% (95% CI: 44.5% - 79.8%). Among 58 patients subjected to acid-fast staining, 37 were positive with a sensitivity of 63.8% (95% CI: 50.9% - 74.9%), and 52 out of 66 controls were negative for acid-fast staining with a specificity of 78.8% (95% CI: 67.5% - 86.9%). The combination of qPCR and culture resulted in a sensitivity of 93% and a specificity of 100% for the detection of Mycobacterium marinum. Conclusion:In this study, a highly sensitive qPCR assay was developed for the detection of Mycobacterium marinum, and its combination with culture could further improve the detection sensitivity.

Objective: To explore the social functioning characteristics of children with co ocurrence of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) for intervention reference. Methods: The Chinese Version of Swanson Nolan and Pelham, Version IV Scale-Parent Form(SNAP-IV), the Chinese Version of Weiss Functional Impairment Scale-Parent(WFIRS-P), and the Questionnaire-Children with Difficulties (QCD) were applied to 192 children with ADHD, 243 children with co occurrence of ADHD and ODD, who firstly visited the Department of Children Psychological Health of Zhuhai Maternal and Child Health Care Hospital, and 118 healthy control children from a school in Zhuhai. Results: The scores of attention deficit factor in SNAP-Ⅳ scale of children in three groups were[1.9(1.7, 2.1), 1.8(1.6, 1.9), 1.0(0.6, 1.2)], the scores of hyperactive impulsivity were[1.8(1.4, 2.1), 1.6(1.1, 1.8), 0.7(0.2, 1.0)] the scores of oppositional defiant were[1.6(1.5, 1.9), 1.0(0.8,1.1), 0.8(0.5, 1.0)], the differences were statistically significant( H=268.44, 237.97, 418.66, P <0.01). The dimensions and total scores of the three groups of children s WFIRS-P scale were family[0.8(0.6, 1.1), 0.6(0.3, 0.8), 0.3(0.1, 0.6)]; learning and school[0.8(0.5, 1.1), 0.8(0.5, 1.0), 0.3(0.1, 0.5)]; life skills[1.0(0.7, 1.2), 0.8(0.6, 1.0), 0.6(0.4, 0.8)]; self management [1.0(0.3, 1.0), 0.7(0.3, 1.0), 0.3(0.0, 0.7)]; social activities [0.7(0.4, 1.0), 0.6(0.3, 0.9), 0.3(0.0, 0.4 )]; adventure activities[0.3(0.2, 0.5), 0.2(0.1, 0.4), 0.1(0.0, 0.2)]; the total score[0.8(0.6, 1.0), 0.6(0.5, 0.8), 0.4( 0.2 , 0.6)], the difference between the groups was statistically significant( H=108.82, 122.45, 60.17, 40.58, 96.17, 76.57, 138.30, P <0.01). The difference between the QCD scale scores of children in the three groups was statistically significant[30.0( 24.0 , 37.0), 32.0(27.0, 40.0), 47.0(37.0, 52.3), H=124.65, P <0.01). Multiple regression analysis showed that attention deficit, and oppositional defiant symptoms were associated with both the total WFIRS-P score and the QCD score of children( R 2= 0.40 , 0.25, P <0.05). Conclusion Children with co occurrence of ADHD and ODD have more severe deficits in all dimensions of social functioning than children with ADHD, which might be associated with attention deficit and oppositional defiant symptoms.

Gelatin microspheres were discussed as a scaffold material for bone tissue engineering, with the advantages of its porosity, biodegradability, biocompatibility, and biosafety highlighted. This review discusses how bone regeneration is aided by the three fundamental components of bone tissue engineering-seed cells, bioactive substances, and scaffold materials-and how gelatin microspheres can be employed for in vitro seed cell cultivation to ensure efficient expansion. This review also points out that gelatin microspheres are advantageous as drug delivery systems because of their multifunctional nature, which slows drug release and improves overall effectiveness. Although gelatin microspheres are useful for bone tissue creation, the scaffolds that take into account their porous structure and mechanical characteristics might be difficult to be created. This review then discusses typical techniques for creating gelatin microspheres, their recent application in bone tissue engineering, as well as possible future research directions.
Tissue Engineering/methods* ; Tissue Scaffolds/chemistry* ; Gelatin/chemistry* ; Microspheres ; Bone and Bones ; Porosity

Objective:To explore the electro-clinical characteristics of sleep-related hypermotor epilepsy (SHE) in rapid eye movement (REM) stage.Methods:Five patients of SHE in REM stage were studied and followed up in the Electroencephalogram Monitoring Center, Department of Neurology, Xijing Hospital, the Air Force Military Medical University, from January 2016 to August 2021.Results:Among the 5 patients, there are 3 male patients, aged 21 to 46 years. A total of 23 seizures were monitored in 5 patients, of which 22 occurred in REM sleep and 1 occurred in non-REM Ⅲ sleep. Each attack lasted from 30 seconds to 1 minute, and was manifested as "hyperkinetic attack" during sleep, with or without disturbance of consciousness. There were no obvious abnormalities in electroencephalography during 13 attacks, with the focal sharp slow waves or slow waves during 9 attacks, and the focal slow waves occurrence at the end of the 10 attacks.Conclusion:Most of the hypermotor epileptic seizures in REM stage started from awakening reaction, and the interictal discharges occured in waking and non-REM sleep stage, which is necessary to distinguish from the REM sleep behavior disorder.

Mussle foot protein has a main component which is named dopa. Dopa can be used to promote a relatively firm adhesion of mussels to the surface of solid materials through forming dihydrogen bonds, π-π/π-cation bonds and chelating metals,etc. To exploit these interactions, there is the opportunity to apply dopa-inspired compounds to improve the dentin-resin bonding. The current review provides valuable information concerning the mechanism of adhesion mediated by mussel foot protein and describes the application of dopa-inspired compounds in the dentin-resin bonding. The article provides novel information for future research in optimization of the properties of dentin-resin bonding.