Objective: To understand the current status and associated factors of sleep problems among preschool children in Hainan Province, so as to provide scientific evidence for improving sleep health in this population. Methods: From January 2021 to June 2022, a total of 4 105 preschool children aged 3-6 years from 62 kindergartens in Hainan Province were selected using stratified cluster random sampling method. Demographic information and lifestyle habits were collected through the Hainan Province Child Growth and Development Survey Questionnaire. The Children s Sleep Habits Questionnaire (CSHQ) was employed to assess sleep status. Unconditional binary Logistic regression model was applied to investigate the associated factors of sleep problems among preschool children. Results: The overall CSHQ score for children was 58.03±18.84, with 80.95% of preschool children exhibiting sleep related issues. The top three most prevalent sleep problem domains were bedtime resistance (72.42%), sleep anxiety ( 54.88 %), and parasomnias (38.86%). Logistic regression analysis revealed that higher family annual income ( OR=0.60, 95%CI = 0.45-0.79), higher maternal education level ( OR=0.53, 95%CI =0.32-0.89), regular or daily vitamin D supplementation ( OR=0.77, 95%CI =0.60-0.99), and fully self initiated eating behavior ( OR=0.71, 95%CI =0.59-0.85) were negatively related with children s sleep problems; in addition, screen exposure ( OR=1.27, 95%CI =1.06-1.51) and picky eating ( OR= 1.47 , 95%CI =1.21-1.78) were positively related to children s sleep problems (all P <0.05). Conclusion The high detection rate of sleep problems among preschool children in Hainan Province is multifactorially associated with family environment, dietary habits, and lifestyle behaviors.

Objective To establish a competency evaluation indicator system for school physicians. Methods A preliminary pool of competency indicators for school physicians was established through systematic literature review and policy document analysis. The Delphi method was used to conduct two rounds of expert consultations with 16 experts who involve in educational administration, clinical medicine, public health management, and school healthcare. Based on the opinions of the experts, the indicator system was screened, revised, and refined to establish the final competency evaluation indicator system for school physicians. Results The questionnaire recovery rates of the two rounds of expert consultations were both 100.0%. The expert authority coefficient were 0.93 and 0.94, and Kendall′s coefficients of concordance were 0.21 and 0.26, respectively (both P<0.01). The final competency evaluation indicator system for school physicians consisted of five primary indicators, including basic medical service capacity, school health service capacity, health education and communication capacity, professional ethics and competency, and self-improvement capacity, as well as 35 secondary indicators (items). All indicators received relatively high importance scores. The system demonstrated a reasonable structure, good scientific validity, and practical applicability. Conclusion The competency evaluation indicator system for school physicians developed in this study demonstrates high scientific validity and practicality. It can serve as an important tool for school physician management, competency development, and performance evaluation, providing references for improving school health service quality and strengthening the construction of school physician teams.

The high incidence and mortality rates of gastric cancer pose a significant burden on human health and public health systems. Peritoneal metastasis is one of the main routes of metastasis in gastric cancer, and patients with this condition have poor prognosis. With advancements in medicine and sociology, the concept of integrated medicine emerged in the late 1980s. It emphasizes treating patients as holistic entities, integrating various medical fields multidimensionally, and combining medicine with other fields. This article organizes the management of gastric cancer peritoneal metastasis around the core concept of "Prevention, Screening, Diagnosis, Treatment, and Rehabilitation": Prevention relies on standardized tumor-free surgical techniques and intraoperative interventions. Screening involves early detection of peritoneal metastasis through integrated technologies. Diagnosis combines multiple methods, including laparoscopic exploration with cytological and histopathological examination, imaging studies, peritoneal fluid cytology, and artificial intelligence. Treatment encompasses comprehensive strategies such as intraperitoneal and systemic chemotherapy, cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy, pressurized intraperitoneal aerosolized chemotherapy, dendritic cell vaccines combined with nivolumab, and supportive care for managing ascites, malignant bowel obstruction, and nutritional support. This integrated medical perspective offers new insights into the management of gastric cancer peritoneal metastasis.

The high incidence and mortality rates of gastric cancer pose a significant burden on human health and public health systems. Peritoneal metastasis is one of the main routes of metastasis in gastric cancer, and patients with this condition have poor prognosis. With advancements in medicine and sociology, the concept of integrated medicine emerged in the late 1980s. It emphasizes treating patients as holistic entities, integrating various medical fields multidimensionally, and combining medicine with other fields. This article organizes the management of gastric cancer peritoneal metastasis around the core concept of "Prevention, Screening, Diagnosis, Treatment, and Rehabilitation": Prevention relies on standardized tumor-free surgical techniques and intraoperative interventions. Screening involves early detection of peritoneal metastasis through integrated technologies. Diagnosis combines multiple methods, including laparoscopic exploration with cytological and histopathological examination, imaging studies, peritoneal fluid cytology, and artificial intelligence. Treatment encompasses comprehensive strategies such as intraperitoneal and systemic chemotherapy, cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy, pressurized intraperitoneal aerosolized chemotherapy, dendritic cell vaccines combined with nivolumab, and supportive care for managing ascites, malignant bowel obstruction, and nutritional support. This integrated medical perspective offers new insights into the management of gastric cancer peritoneal metastasis.

The blood-brain barrier(BBB)is a semi-permeable biological barrier between brain tissue and plasma,however,its physical,enzymatic and immune properties,as well as its unique transport mechanism severely limit the entry of therapeutic drugs and diagnostic agents into the brain,which poses great challenges for the prevention and treatment of brain diseases.Hence,this review summarizes and discusses the complex structural components and various transport mechanisms of BBB,and interprets the difficulties and feasible ways of drug delivery across BBB.Furthermore,the latest research progress and future development trends of various delivery systems for brain drug delivery are introduced and discussed to provide references for further perfecting their design and driving their transformation.Finally,this review discusses the pathological changes of BBB in brain diseases and the design of drug delivery strategies for pathological BBB.Collectively,this review highlights the design and optimization of drug delivery strategies across the BBB based on nano-delivery system and provides accessible guide for current opportunities and challenges of intracerebral drug delivery.

OBJECTIVE: To investigate the independent risk factors for short-term mortality in patients with spontaneous cerebellar hemorrhage (SCH) based on Mimics software of medical image control system. METHODS: The clinical data of SCH patients treated at Shengjing Hospital of China Medical University from January, 2010 to December, 2021 was retrospectively analyzed and compared, including gender, age, underlyin g diseases, Glasgow coma scale (GCS) and blood pressure at admission, laboratory indicators, imaging data, and short-term (3 weeks after onset) survival status. The imaging examination parameters were accurately calculated using Mimics software, including hematoma volume, longest diameter, and maximum cross-sectional area of cerebellar hemorrhage. Multivariate Logistic regression analysis was used to evaluate the independent risk factors for short-term death in SCH patients. Receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive value of the four significant factors on short-term mortality in SCH patients. RESULTS: A total of 202 patients with SCH were included, of which 42 patients (20.8%) died within 3 weeks of onset and 160 patients (79.2%) survived. Univariate analysis showed that, compared with the survival group, the death group had significantly higher blood glucose, hematoma volume, hematoma longest diameter, hematoma maximum cross-sectional area, the ratio of hematoma maximum cross-section area and the corresponding posterior cranial fossa area, while GCS score was significantly lower, the distance from hematoma edge to the cerebral aqueduct center, and the distance from hematoma edge to the edge of brainstem were significantly shorter, the differences were statistically significant. Multivariate Logistic regression analysis showed that GCS score at admission [odds ratio (OR) = 0.875, 95% confidence interval (95%CI) was 0.767-0.998], hematoma volume (OR = 1.068, 95%CI was 1.022-1.115), the longest diameter of hematoma (OR = 1.086, 95%CI was 1.049-1.124), and the ratio of hematoma maximum cross-section area and the corresponding posterior cranial fossa area (OR = 1.119, 95%CI was 1.060-1.181) were independent risk factors for short-term mortality in SCH patients (all P < 0.05). ROC curve analysis showed that the area under the ROC curve (AUC) for predicting short-term death of patients with SCH were 0.738, 0.839, 0.728 and 0.727, respectively. When the GCS score was 12 at admission, the sensitivity was 85.0% and the specificity was 57.1%. When the hematoma volume was 8.40 mL, the sensitivity was 95.2% and the specificity was 65.0%. When the longest diameter of the hematoma was 47.10 mm, the sensitivity was 57.1% and the specificity was 80.6%. When the ratio of hematoma maximum cross-section area and the corresponding posterior cranial fossa area was 0.11, the sensitivity was 88.1% and the specificity was 48.7%. CONCLUSIONS GCS score < 12 on admission, hematoma volume > 8.40 mL, hematoma longest diameter > 47.10 mm, the ratio of hematoma maximum cross-section area and the corresponding posterior cranial fossa area > 0.11 suggest a higher risk of short-term mortality in SCH patients.
Humans ; Male ; Female ; Risk Factors ; Retrospective Studies ; Middle Aged ; Aged ; Software ; Adult ; Cerebral Hemorrhage/diagnosis* ; Logistic Models

Objective:To investigate the effects of computerized cognitive remediation therapy (CCRT) combined with social skill training on the improvement of negative symptoms of schizophrenia.Methods:A total of 102 schizophrenic patients who received treatment in Shanxi Province Social Welfare Kangning Psychiatry Hospital from March 2019 to June 2021 were included in this study. They were randomly divided into an intervention group and a control group ( n = 51/group). During the intervention process, because of the reasons such as midway discharge, only 93 patients were included in the final analysis, consisting of 47 patients in the intervention group and 46 patients in the control group. All patients received social skills training. Patients in the intervention group received 8-week CCRT. The Positive and Negative Syndrome Scale and Social Skills Checklist were used to evaluate curative effect in the two groups. Results:After treatment, total score of the Positive and Negative Syndrome Scale and the score of negative symptoms in the intervention group were (46.36 ± 9.33) points and (11.15 ± 3.53) points, respectively, which were significantly lower than (51.06 ± 10.26) points and (16.42 ± 4.75) points in the control group ( t = 2.07, 5.41, both P < 0.05). The total score of Social Skills Checklist, conflict resolution ability score and relationship building ability score in the intervention group were (16.05 ± 6.85) points, (3.36 ± 1.65) points and (3.14 ± 1.83) points, respectively, which were significantly lower than (21.08 ± 8.24) points, (5.92 ± 2.35) points and (6.75 ± 2.51) points, respectively ( t = 2.87, 5.34, 7.00, all P < 0.01). Conclusion:CCRT combined with social skill training can effectively improve the negative symptoms of patients with schizophrenia.

Gastric cancer (GC) is known as a top malignant type of tumors worldwide. Despite the recent decrease in mortality rates, the prognosis remains poor. Therefore, it is necessary to find novel biomarkers with early diagnostic value for GC. In this study, we present a large-scale proteomic analysis of 30 GC tissues and 30 matched healthy tissues using label-free global proteome profiling. Our results identified 537 differentially expressed proteins, including 280 upregulated and 257 downregulated pro-teins. The ingenuity pathway analysis (IPA) results indicated that the sirtuin signaling pathway was the most activated pathway in GC tissues whereas oxidative phosphorylation was the most inhibited. More-over, the most activated molecular function was cellular movement, including tissue invasion by tumor cell lines. Based on IPA results, 15 hub proteins were screened. Using the receiver operating character-istic curve, most of hub proteins showed a high diagnostic power in distinguishing between tumors and healthy controls. A four-protein (ATP5B-ATP5O-NDUFB4-NDUFB8) diagnostic signature was built using a random forest model. The area under the curve (AUC) values of this model were 0.996 and 0.886 for the training and testing sets, respectively, suggesting that the four-protein signature has a high diag-nostic power. This signature was further tested with independent datasets using plasma enzyme-linked immune sorbent assays, resulting in an AUC value of 0.778 for distinguishing GC tissues from healthy controls, and using immunohistochemical tissue microarray analysis, resulting in an AUC value of 0.805. In conclusion, this study identifies potential biomarkers and improves our understanding of the pathogenesis, providing novel therapeutic targets for GC.

AIM: To study the effects of taurine at different doses on renal oxidative stress and inflammation induced by paraquat in rats.METHODS: Male SD rats (n=48) were randomly divided into 4 groups: negative control group, paraquat group, paraquat + low-dose taurine group, and paraquat + high-dose taurine group.The serum levels of creatinine and urea nitrogen were detected by a biochemical analyzer.The levels of malondialdehyde (MDA) and superoxide dismutase (SOD) were measured by colorimetry.The plasma concentrations of IL-6 and intercellular adhesion molecule (ICAM)-1 were detected by ELISA.Renal reactive oxygen species (ROS) was checked by fluorescence probe dihydroethidium (DHE).The protein levels of renal p-P38 MAPK, p-ERK1/2 and p-JNK were determined by Western blot.The mRNA expression of TNF-α, IL-6 and TGF-β1 was detected by real-time PCR.RESULTS: Serum creatinine and urea nitrogen increased after paraquat poisoning, and decreased after feeding with taurine in poisoned rats, with better result in high-dose taurine group.Taurine reduced the oxidative stress and inflammation in the renal tissue, and also reduced the protein levels of p-JNK, p-ERK1/2 and p-P38 in the kidney of paraquat-poisoned rats.CONCLUSION: Taurine attenuates renal injury induced by paraquat poisoning in rats.The mechanism may be related to reducing renal MAPK activity, oxidative stress and inflammatory response.

Goiter, Nodular ; diagnosis ; Humans ; Thoracic Wall ; pathology