Objective: To understand the serum vitamin D and vitamin K 1 levels of children in the Qingdao area, so as to provide scientific grounds for appropriate vitamin supplementation. Methods: A total of 4 469 children aged 0-14 years old, who attended the children s healthcare outpatient clinics of a tertiary hospital in Qingdao, were enrolled in the current study between January 2023 and July 2024. The levels of vitamin D and vitamin K 1 were measured by liquid chromatography tandem mass spectrometry. The inter group differences were analyzed using Chi square test, Wilcoxon rank sum test, and Kruskal-Wallis H test. The correlation analysis of vitamin D and vitamin K 1 levels with age was performed using the Spearman correlation. Results: The serum vitamin D level among children was 28.72(22.67, 36.26)ng/mL. The vitamin D deficiency and insufficiency rates were 2.10% and 14.59 %, respectively. The serum 25-(OH)D 2 level was 0.29(0.14, 0.53)ng/mL, the serum 25-(OH)D 3 level was 27.99( 21.78 , 35.57)ng/mL and the serum vitamin K 1 level was 0.54(0.29, 1.04)ng/mL. The vitamin K 1 deficiency rate was 13.76%. Among different age stages, the serum vitamin D level was highest in infancy [37.45(30.39, 43.87)ng/mL] and lowest in school age children [22.39(18.00, 26.97)ng/mL]; the level of vitamin K 1 was highest in preschool children [0.79(0.41, 1.51) ng/mL] and lowest in school age children[0.45 (0.26, 0.76) ng/mL]; the serum vitamin D deficiency and insufficiency rates were highest in school age children (5.03% and 30.81%); the vitamin K 1 deficiency rate was highest in infancy (21.53%) ( H/χ 2=1 698.31, 253.70 , 137.85 , 583.79, 89.30, all P <0.05). Among different seasons, the serum vitamin D and vitamin K 1 levels were lowest in the winter [26.74(18.37, 35.86) and 0.50 (0.27, 0.94)ng/mL; H =50.71, 7.86]; the vitamin D deficiency and insufficiency rates were highest in the winter (5.41% and 24.80%; χ 2=59.93, 83.35) (all P <0.05). The serum vitamin D level had a moderate negative correlation with age ( r =-0.62), and there was a low positive correlation between the serum vitamin D and vitamin K 1 levels in infancy and early childhood ( r =0.21, 0.26) (all P <0.05). Conclusions The serum vitamin D and vitamin K 1 levels are lowest in school age children and in the winter, and the serum vitamin K 1 deficiency rate is highest in infancy. There is a need to focus on critical periods of infancy and school age, and strengthen interventions during the high risk winter season. The nutritional status of vitamin D and vitamin K 1 in children should be enhanced.

Objective: To explore the effects of intergenerational parent-child separation on internalizing and externalizing behavioral problems among rural preschoolers aged 3-6 years, so as to provide empirical evidence for formulating targeted intervention strategies and blocking the intergenerational transmission of parent-child separation. Methods: From March to June, 2024, ten kindergartens were selected from rural areas of Nanling County, Wuhu City, Anhui Province, and 2 279 preschool children aged 3- 6 years, along with their fathers, mothers and primary caregivers, were recruited for survey by cluster convenient sampling method. Children s fathers and mothers reported their own childhood parent-child separation information separately. Information on the children s history of psychological and behavioral problems was reported by the primary caregivers. Information of internalizing and externalizing behavioral problems in preschool children was reported with Strengths and Difficulties Questionnaire (SDQ).The Chi square test was used to compare the differences in the detection rates of psychological and behavioral problems among children with different intergenerational continuity of parent-child separation. Binary Logistic regression model was applied to analyze the association between intergenerational continuity of parent-child separation and internalizing and externalizing behavioral problems in preschool children. Results: The detection rate of internalizing behavioral problems was 27.5% and externalizing behavioral problems was 19.1% among rural preschool children. There were significant differences in internalization behavior, externalization behavior, hyperactivity impulse and peer communication problems among preschool children in different types of parent-child separation groups( χ 2=14.29, 8.80, 17.26, 13.84, all P <0.05). Binary Logistic regression analysis showed that after adjusting for covariates such as children s gender, birth weight, and delivery mode, compared with children without separation, intergenerational continuity of parent-child separation group( OR =1.95), only child separation( OR =1.74) were associated with significant higher risk of conduct problems(both P ＜0.05). Parent-child separation intergenerational continuation groups( OR =1.68), only child separation( OR = 1.47) were associated with significant higher risk of peer problems(both P ＜0.05). Both types of parent-child separation experiences significantly increased the risk of children s prosocial behavior problems，among them, the intergenerational continuation group was 1.99 times that of the control group ( OR =1.99), and the childhood only separation group was 2.09 times that of the control group ( OR =2.09)(both P ＜0.05). Compared with children whose parents and children had no experience of parent-child separation, children in the intergenerational continuation group of parent-child separation had increased risks of both internalizing and externalizing behavior problems ( OR =1.53, 1.65, both P <0.05). Conclusion All types of parent-child separation are associated with internalizing and externalizing behavioral problems among rural children aged 3 to 6 years.

OBJECTIVE To explore the effect and mechanism of berberine in ameliorating asthma in mice by regulating glycolysis via the hypoxia inducible factor-1α （HIF-1α）/pyruvate dehydrogenase kinase-1 （PDHK1） pathway.METHODS Mice were randomly divided into blank control group， model group， low- and high-dose berberine groups （100， 200 mg/kg， intragastric administration）， dimethyloxalylglycine （DMOG， HIF-1α agonist） group （2 mg， intranasal instillation）， and berberine+DMOG group （intragastric administration of 200 mg/kg berberine plus intranasal instillation of 2 mg DMOG）， with 12 mice in each group. Except for the blank control group， mice in the remaining groups were subjected to ovalbumin-induced sensitization and challenge to establish the asthma model. During the challenge period， mice were given corresponding drugs or normal saline once a day for 6 consecutive days. At 24 h after the last challenge， pulmonary function and airway reactivity of mice were determined； the content of ovalbumin-specific immunoglobulin E （OVA-sIgE） in serum was detected； inflammatory cells in bronchoalveolar lavage fluid （BALF） were counted； bronchial inflammation and goblet cell hyperplasia were histologically evaluated； the levels of inflammatory cytokines [interleukin-4 （IL-4）， IL-5， IL-13]， contents of glycolytic products [lactic acid， pyruvic acid， adenosine triphosphate （ATP）]， as well as mRNA and protein expressions related to the HIF-1α/PDHK1 pathway in lung tissue were measured.RESULTS Compared with the model group， the low- and high-dose berberine groups exhibited significantly elevated or increased dynamic lung compliance， peak expiratory flow， forced vital capacity （FVC）， forced expiratory volume in 0.1 second （FEV 0.1 ）， and FEV 0.1 /FVC （ P ＜0.05）， accompanied by significantly decreased airway resistance and enhanced pause value （ P ＜0.05）. Moreover， serum OVA-sIgE content， counts of white blood cell， neutrophil， lymphocyte， monocyte， eosinophil and basophil in BALF， scores for bronchial inflammation and goblet cell hyperplasia， levels of pulmonary inflammatory cytokines and contents of glycolytic products， as well as mRNA and protein expressions of HIF-1α， PDHK1， pyruvate kinase M2 and lactate dehydrogenase A were all significantly reduced （ P ＜0.05）. DMOG pretreatment obviously reversed the protective effects of high-dose berberine in asthmatic mice （ P ＜0.05）.CONCLUSIONS Berberine can inhibit the HIF-1α/PDHK1 pathway to decrease glycolytic level， so as to ameliorate airway inflammation and airway hyperresponsiveness in asthmatic mice.

[Objective]To evaluate the efficacy of Shengjin Liyan Spray(SJLYS)in alleviating chemotherapy-induced xerostomia in lymphoma patients.[Methods]In this double-blind,randomized,placebo-controlled trial,120 lymphoma patients with chemotherapy-induced xerostomia were enrolled and equally allocated in experimental group(60 cases,receiving SJLYS)and control group(60 cases,receiving sterile water spray).The intervention was administered hourly during chemotherapy until bedtime.Primary outcomes included the numerical rating scale(NRS)for dry mouth,lip mucosal moisture score and unstimulated whole saliva(UWS)flow rate.Secondary outcome was the overall response rate.[Results]Post-treatment assessments demonstrated significantly better outcomes in experimental group,the NRS score of experimental group(2.41±1.10)was significantly lower than that of control group(4.15±1.28);the moisture score of the lip mucosa was(3.47±0.62)points,which was better than control group(2.60±0.78)points;the UWS was(0.53±0.10)mg/min,higher than that of control group(0.42±0.09)mg/min.The overall response rate in experimental group(78.33%)was markedly superior to control group(48.33%),and the above differences were statistically significant(P<0.05).[Conclusion]SJLYS significantly relieves xerostomia symptoms,enhances oral comfort,and optimizes quality of life in chemotherapy-treated lymphoma patients,demonstrating substantial clinical applicability.

Objective:To investigate the application of pedicled or perforator flaps transfer in the stage Ⅰ tissue defect repair after vulvar cancer surgery.Methods:From January 2005 to December 2023, 20 patients with vulvar cancer who underwent extensive episiectomy or extended episiectomy±inguinal lymph node resection+vulvar defect flap transfer were collected in Huanxing Cancer Hospital of Chaoyang District and Cancer Hospital and Peking Union Medical College, Chinese Academy of Medical Sciences. The survival status, appearance structure, sexual function satisfaction, tumor recurrence, and survival were analyzed.Results:(1) The median age of the 20 patients was 59 years (ranged: 29-73 years). There were 14 patients with recurrence and 6 patients with initial treatment. Pathological types: 14 cases of squamous cell carcinoma, 4 cases of Paget′s disease, 1 case of malignant melanoma, 1 case of adenoid cystic carcinoma (salivary gland type carcinoma). (2) Among the 20 patients, 6 cases underwent extensive episiotomy and 14 underwent extended episiotomy (1 of them underwent extensive excision of inguinal masses). Simultaneous inguinal lymphadenectomy (or dissection) were performed in 11 cases, including 7 cases of bilateral inguinal lymph node resection (or dissection) and 4 cases of unilateral inguinal lymph node resection (or dissection). Flap source: pedicled flap in 12 cases, perforator flap in 8 cases. All the 20 patients were removed at 10-14 days after operation, and all of them survived with rosy skin color and good elasticity. Seventeen cases of transferred flaps healed at stage Ⅰ, 2 cases healed at about 6 weeks due to incision leakage, and 1 case healed at 6 weeks after incision infection debridement. Six months after the operation, 2 cases felt that the pubic mound was thick and swollen. The other 18 cases showed vulva fullness and elasticity, no displacement of urethral opening, no deviation of urethra during urination, no stenosis of vaginal opening, no vulvar scar pain. In addition to 1 unmarried 29-year-old patient and 6 patients over 65 years old who had no sexual life before and after surgery, the other 13 patients had normal sexual life after surgery. (3) The follow-up period were 6 to 100 months, and 9 cases (45%, 9/20) relapsed during the follow-up period. There were 5 deaths (25%, 5/20), who were due to recurrence of vulvar cancer. The 5-year survival rate of 20 patients was 75%, including 83% in 6 patients with initial treatment and 71% in 14 patients with recurrence and reoperation.Conclusions:The combination of flap transfer for episioplasty with vulvar cancer surgery does not affect the wound healing. Because the external structure of the vulva is repaired, it could effectively improve the local wound healing ability and improve the organ function, and has good clinical application value.

Objective:To explore the impacts of 131I-NaI radiotherapy on the promotion of glycolysis and 18F-fluorodeoxyglucose ( 18F-FDG) uptake in pancreatic cancer cells via the induction of proviral integration moloney murineleukemia virus 2 (PIM2) and 6-phosphofructo-2-kinase/fructose-2, 6-biphosphatase 3 (PFKFB3). Methods:In the cell experiments, human pancreatic carcinoma cells-1 (PANC-1) were randomly divided into four groups: a control group, an HJ-PI01 group, a 131I-NaI group, and an HJ-PI01 + 131I-NaI group. Their aerobic glycolysis capacity was assessed by measuring glucose uptake, lactate production, and extracellular acidification rate (ECAR). In vivo animal experiments, 12 nu/nu female nude mice were given 100 μl (1 × 10 7 cells) of cell suspension through subcutaneous injection into the left lower limbs. When the tumor volume reached approximately 60 mm 3, these mice were divided into four groups (a control group, a HJ-PI01 group, a 131I-NaI group, and an HJ-PI01+ 131I-NaI group) using a random number table, with three mice in each group. After 14 days of treatment, 18F-FDG PET/CT imaging was performed to calculate the maximum standardized uptake value (SUV max) of the xenografts. Following PET/CT imaging, the tumor tissues were harvested and analyzed for PIM2, PFKFB3, and Ki-67 expressions using immunohistochemistry. Results:In cell experiments, compared to the control group, the HJ-PI01 group exhibited significant reduction in glucose uptake, lactate production, PFKFB3 protein expression, and ECAR in PANC-1 cells ( t = 4.59-13.98, P < 0.05). In contrast, the 131I-NaI group showed significant increases in these parameters ( t = 3.36-13.97, P < 0.05). Compared to the 131I-NaI group, the HJ-PI01+ 131I-NaI group showed significant reduction in glucose uptake, lactate production, PFKFB3 protein expression, and ECAR ( t = 5.14-20.87, P < 0.05). In the animal experiments, compared to the control group, the three groups displayed significant decrease in SUV max of 18F-FDG uptake in tumors ( t = 16.48, 22.49, 32.64, P < 0.001). Moreover, the HJ-PI01 + 131I-NaI group exhibite significantly lower SUV max than the 131I-NaI group ( t = 10.16, P < 0.001). Immunohistochemical analysis revealed that the HJ-PI01+ 131I-NaI group, compared to the 131I-NaI group, showed significantly lower Ki-67 expression and the PIM2/PFKFB3 signaling pathway in tumor tissues ( t = 3.27, 10.73, 14.85, P < 0.05). Conclusions:Glycolysis enhancement of PANC-1 cells, mediated by the PIM2/PFKFB3 signaling pathway inhibition, can significantly improve the anticancer capacity of 131I-NaI, providing a novel strategy for radiotherapy in pancreatic cancer.

To summarize the clinical practice of continuous medical service for patients at Shanghai Children′s Medical Center, affiliated with Shanghai Jiao Tong University School of Medicine, from September 2023 to December 2024, following the approval of its extended care qualification. This study utilized a mixed-methods research design that integrates quantitative and qualitative approaches. The quantitative study included a total of 117 subjects, with an age range of 18 to 35 years, an average age of 21.56 years, and a median age of 19 years; there were 59 males and 58 females. The disease types covered four major categories: childhood leukemia and solid tumors (68 cases), congenital structural malformations (25 cases), congenital hereditary metabolic diseases (4 cases), and rare diseases (20 cases). Among the subjects, 57.26% (67 cases) were first-time visitors to SCMC. The patients came from 20 provinces, autonomous regions, and municipalities across the country, with 88.03% (103 cases) from outside Shanghai. The treatment outcomes showed improvement or cure in 80.34% (94 cases) of the subjects, and there were no medical complaints. In addition, a qualitative study was conducted to deeply explore the experiences, confusions, and challenges of receiving or implementing continuous medical services from the perspectives of patients and their families, as well as medical staff. According to the inclusion and exclusion criteria, a total of 44 subjects were included in the study, among them, there were 12 patients, 12 family members who were taking care of the patients in SCMC, and 20 corresponding medical staff members. The results of the qualitative study showed that trust in the attending physicians of the children′s specialty hospital, a good doctor-patient relationship, satisfactory treatment outcomes, and support from medical insurance policies are the main driving forces for patients over 18 years old to receive continuous treatment at children′s specialty hospitals. The medical staff of the hospital also believed that this model can promote patient benefits. In conclusion, under the policy support of the Shanghai Municipal Health Commission, the "Six Fixed" Model for continuous treatment established by SCMC has achieved certain positive results in practice. This provides practical references for the development of continuous treatment in China and offers new strategies for the application of preventive medicine in the field of children′s health.

Objective To investigate the current nursing practice of nurses specializing in nutritional support in ICUs and analyze their influencing factors in order to improve the training program and promote the development of standardized and precise nursing practice.Methods Convenience sampling method was used to select nutritional support nurses in ICUs in 29 provinces(autonomous regions and municipalities)from October 2023 to March 2025,and the self-developed questionnaire on nursing practice behaviors of nutritional support nurses in ICUs was used to conduct the survey.SPSS 21.0 software was used for descriptive analysis and multiple linear regression analysis.Results A total of 774 questionnaires were distributed,and 766 valid questionnaires were collected,with a recovery rate of 98.97％,and the score of the questionnaire on nursing practice behaviors of nurses specializing in nutritional support in ICU was(90.41±1 1.82).The results of multiple linear regression analysis showed that gender,presence of a nutritional support nursing team in the hospital,a standardized process of nutritional support nursing in the department,clear positional responsibilities of the nutritional support nursing team members,and inclusion of the nutritional support status of the patients in the quality management of the department were the factors influencing the nursing practice behavior scores of the nurses specializing in nutritional support in ICUs(P＜0.05).Conclusion Nurses in the ICUs have a high level of nursing practice behavior,but there is a need for further standardization in parenteral nutrition infusion and monitoring of complications.ICU nursing managers should formulate improvement strategies to address the weaknesses of clinical practice,strengthen nutritional support training,and improve the quality management program,and further improve the practical ability of nurses specializing in nutritional support.

Objective:To develop a nomogram model based on the preoperative neutrophil-to-lymphocyte ratio and gamma-glutamyl transpeptidase (GGT) -to-platelet ratio (NLR-GPR) score to predict the prognosis of patients with hepatocellular carcinoma (HCC) undergoing hepatectomy.Methods:Clinical data of 284 patients with HCC who underwent curative resection at Taizhou Hospital of Zhejiang Province between January 2012 and September 2016 were retrospectively analyzed, including 235 males and 49 females, aged 57(51, 65) years. Clinical data, including gender, age, neutrophil count, lymphocyte count, platelet count, GGT, and total bilirubin, were collected. The Cox proportional hazards regression model was employed to assess the relationship between the preoperative NLR-GPR score and patient disease-free survival (DFS) and overall survival (OS). A nomogram was constructed based on the results of the multivariate analysis. Survival curves were generated using the Kaplan-Meier method, and differences between groups were evaluated using the log-rank test. The performance of the model was assessed by the concordance index (C-index).Results:The NLR-GPR score was found to be negatively correlated with both DFS and OS (both P<0.05), where a higher score indicated a poorer prognosis. Multivariate analysis identified the NLR-GPR score as an independent risk factor for both DFS ( HR=1.463, 95% CI: 1.135-1.887, P=0.003) and OS ( HR=1.734, 95% CI: 1.300-2.313, P<0.001). A nomogram was deve-loped based on the variables selected from the multivariate Cox regression analysis, including postoperative pleural effusion, AJCC stage, vascular invasion, and the NLR-GPR score. This nomogram demonstrated good predictive accuracy, with C-indices for DFS and OS of 0.676 and 0.726, respectively. Conclusion:The nomogram model, constructed based on the preoperative NLR-GPR score and relevant clinicopathological factors, can effectively predict the postoperative survival of patients with HCC undergoing hepatectomy.

The relationship between diabetes and orthodontic tooth movement has garnered increasing scholar-ly attention in recent years,coinciding with the rising prevalence of diabetes and the growing number of orthodontic proce-dures.Research indicates that diabetes may influence orthodontic tooth movement and treatment outcomes by impacting the health of periodontal tissues.This article offers a comprehensive review of the latest advancements in research regard-ing the effects of diabetes on orthodontic tooth movement and summarizes current treatment approaches for managing diabe-tes in conjunction with orthodontic care,including pharmacological and other therapeutic options.