Objective: To analyze the association of eating dining locations and their association with nutritional status among Chinese children aged 6-17 years,so as to provide reference for guiding children s reasonable diet. Methods: Stratified random cluster sampling was used to select children aged 6 to 17 years from 28 cities and rural areas of 14 provinces in East, North, Central, South, Southwest, Northwest, Northeast of China, and a total of 52 535 children were included in the study from 2019 to 2021. Information including dining locations, demographic characteristics, dietary intakes and physical activity were collected through a questionnaire survey. Fasting body height and weight were measured in the morning. Unordered multiclass Logistic regression analysis was conducted to assess the relationship between dining locations and nutritional status in children. Results: Regarding children s dining locations, 66.3% ate breakfast at home,25.8% ate breakfast at school,7.9% ate breakfast outside (small dining tables, restaurants, stalls, etc.); 67.7% ate dinner at home,29.0% ate dinner at school,3.3% ate dinner outside; and 63.6% ate lunch at school,30.8% ate lunch at home,5.7% ate lunch outside. The prevalence rates of overweight/obesity and undernutrition were 28.6% and 9.3%, respectively. The adjusted multiclass Logistic regression analysis (controlling for age, region, parental education, household income, total energy intake, and moderate-to-vigorous physical activity) demonstrated that, compared to eating at home, school based breakfast and dinner consumption was associated with significantly lower overweight/obesity risks for both genders (boys: breakfast OR =0.70, 95% CI =0.65-0.75; dinner OR =0.80, 95% CI = 0.74- 0.86; girls: breakfast OR = 0.89 , 95% CI = 0.82-0.96; dinner OR =0.88, 95% CI =0.81-0.95), whereas eating lunch away from home significantly increased overweight/obesity risks (boys: OR =1.32, 95% CI =1.17-1.48; girls: OR =1.43, 95% CI =1.26- 1.62 ), with all associations being statistically significant ( P <0.05). After adjusting for confounding factors, boys who ate breakfast away from home showed a significantly reduced risk of undernutrition ( OR =0.80,95% CI =0.66-0.97), while those consuming lunch away from home had an increased risk ( OR =1.26, 95% CI =1.01-1.57) ( P <0.05). Conclusions The choice of dining locations for children is becoming more diverse, and a relatively high proportion of children eat meals outside the home and at school. Eating out have a higher risk of malnutrition for children. School feeding may be beneficial to children s physical health.

The cellular and molecular components of the tumor immune microenvironment (TIME) and their information exchange processes significantly influence the trends of anti-tumor immunity. In recent years, numerous studies have begun to evaluate TIME in the context of previous cancer treatment strategies. This review will systematically summarize the compositional characteristics of TIME and, based on this foundation, explore the impact of current cancer therapies on the remodeling of TIME, aiming to provide new insights for the development of innovative immune combination therapies that can convert TIME into an anti-tumor profile.
Tumor Microenvironment/immunology* ; Humans ; Neoplasms/therapy* ; Immunotherapy/methods* ; Animals

Objective To investigate the differential expression genes(DEGs)related to angiogenesis in rosacea(RA)by utilizing bioinformatics analysis in order to screen the key genes and verify their mRNA expression levels.Methods The gene microarray dataset GSE65914 was retrieved from the Gene Expression Omnibus(GEO)repository.Analyzed by R programming,the dataset was refined to identify DEGs related to RA,and then cross-referenced with angiogenesis-related genes from the GeneCards database to get a subset specific to RA angiogenesis.The process of identifying key genes was augmented by employing protein-protein interaction(PPI)network analysis and Cytoscape-based computational algorithms.The mRNA expression levels of the aforementioned pivotal genes were detected by real-time fluorescent quantitative reverse transcription PCR(RT-qPCR).Results A total of 947 RA-associated DEGs were identified from GEO dataset,and then 202 genes related to RA angiogenesis were further delineated.PPI network analysis and Cytoscape algorithm finally identified 3 key genes,that is,CXCL8,IL-1B,and STAT1.The results of RT-qPCR showed that the mRNA expression levels of MIP-2,GCP-2,IL-1B and STAT1 in RA lesions were significantly higher than those in normal controls(P<0.05).Conclusion With aid of bioinformatics analysis,our study has screened and validated key genes associated with angiogenesis in RA,namely CXCL8,IL-1B,and STAT1,which providing a theoretical basis for elucidating the potential mechanisms underlying RA-induced angiogenesis and developing targeted therapeutic strategies.

Objective To investigate the effects of electroacupuncture at Neiguan(PC6)combined with Buyang Huanwu Decoction on myocardial edema-related proteins and its cardioprotective role in mice with acute high-altitude hypoxic myocardial injury,and to explore the potential mechanisms by which this combined therapy ameliorates acute hypoxic myocardial damage.Methods Mice were randomly divided into control,hypoxia model,electroacupuncture at Neiguan,Buyang Huanwu Decoction,and electroacupuncture at Neiguan+Buyang Huanwu Decoction groups.Except for the normal control group,all other groups were subjected to the establishment of an acute high-altitude hypoxia-induced myocardial injury model.Four days before entering the low-pressure hypoxia animal simulation chamber,the electroacupuncture at Neiguan group was treated with bilateral electroacupuncture at Neiguan,the Buyang Huanwu Decoction group was treated with Buyang Huanwu Decoction by gavage,and the electroacupuncture at Neiguan+Buyang Huanwu Decoction group was treated with a combination of electroacupuncture at Neiguan and Buyang Huanwu Decoction.The intervention lasted for 7 days.The normal control group and the hypoxia model group were handled normally without any other treatment.Myocardial pathology and ultrastructure were evaluated using HE staining and transmission electron microscopy.Serum levels of creatine kinase-MB(CK-MB)and cardiac troponin I(cTn-I)were measured by ELISA.Western blot was performed to quantify β1-AR,cAMP,PKA,and AQP1 protein expression.Results Compared with normal control group,the hypoxia model group exhibited significant myocardial damage,elevated cardiac biomarkers,and upregulated β1-AR/cAMP/PKA pathway proteins with increased AQP1 expression(all P<0.01).The electroacupuncture at Neiguan+Buyang Huanwu Decoction group demonstrated attenuated myocardial injury,reduced biomarker levels,and downregulated target proteins(all P<0.01)versus the hypoxia model group.Conclusion Electroacupuncture at Neiguan combined with Buyang Huanwu Decoction alleviates myocardial edema and injury in acute hypobaric hypoxia by reducing vascular permeability,potentially via suppression of the β1-AR/cAMP/PKA pathway and subsequent inhibition of AQP1 expression.

OBJECTIVE: To investigate the clinical characteristics and genetic etiology of eight members from a pedigree affected with epidermolysis bullosa (EB). METHODS: A girl presented with recurrent, unexplained blisters on the palmar and plantar skin for 8 years and sought medical care in October 2024 was enrolled as the study subject. A retrospective study was conducted to collect the child's clinical data, and a detailed medical history was taken for her family members. Peripheral venous blood samples were collected from the child and her parents for genomic DNA extraction. Whole-exome sequencing (WES) was performed. Candidate variant was validated by Sanger sequencing. The pathogenicity of the candidate variants was classified in accordance with the Standards and Guidelines for the Interpretation of Sequence Variants issued by the American College of Medical Genetics and Genomics (ACMG, hereinafter referred to as the "ACMG Guidelines"). This study was approved by the Medical Ethics Committee of the 980th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army (Ethics No.: 2019-KY-01). RESULTS: The proband was an 8-year-and-4-month-old female. Four months after birth, she had developed recurrent blisters on the palmar and plantar skin without obvious triggers, accompanied by significant pain. Symptoms were more severe in summer and slightly relieved in winter. Although symptomatic treatment could alleviate the symptoms, she was unable to participate in physical activities. A detailed family history revealed that her great-grandfather, grandfather, father, half-brother, great-aunt, great-aunt's son and two grandsons, as well as her aunt and aunt's son, had similar clinical manifestations. WES revealed that she has harbored a heterozygous c.556-16(IVS1)C>G (NM_000424.4) variant in the KRT5 gene, which was identified as a splice site mutation. Reverse transcription sequencing confirmed that this variant can disrupt normal splicing, resulting in retention of a 15 bp sequence in the first intron. Sanger sequencing demonstrated that the variant was inherited from the father, and the 6 aforementioned relatives with similar phenotypes have all carried the same variant (the great-grandfather, grandfather, and great-aunt had declined genetic testing due to advanced age). Based on the ACMG guidelines, this variant was classified as pathogenic (PS3+PM2_Supporting+PP3+PP1_strong). CONCLUSION Patients with epidermolysis bullosa simplex may exhibit clinical features including blistering on the skin or mucous membranes of friction-prone sites (e.g. hands, feet, elbows, and knees) following minor trauma or friction, as well as increased skin fragility. The c.556-16(IVS1)C>G (rs376462752) variant of the KRT5 gene probably underlay the pathogenesis of EB in this child. Above findings have enriched the mutational spectrum of the KRT5 gene.
Child ; Female ; Humans ; Infant ; Male ; China ; Epidermolysis Bullosa Simplex/genetics* ; Exome Sequencing ; Keratin-5/genetics* ; Mutation ; Pedigree ; Retrospective Studies ; East Asian People/genetics*

Objective:To analyze the iodine nutrition status of pregnant women in Weihai City before and after (2022, 2023) the iodine deficiency disorders (IDD) intervention, evaluate the effectiveness of intervention measures, and provide a scientific basis for adjusting IDD prevention strategies in the city.Methods:In May 2023, the intervention action of IDD was carried out for pregnent women in Weihai City. In April 2022 and December 2023, respectively, a cross-sectional survey method was conducted in four districts (cities) of Weihai City. Each district (city) was divided into five areas (east, west, south, north, and central) each year, and one township (street) was selected from each areas. At least 20 pregnant women were selected from each township (street) as survey subjects, and their household salt samples and random urine samples were collected to measure salt iodine and urinary iodine concentrations, and to compare the test results.Results:A total of 922 household salt samples were tested, including 530 iodized salt samples and 469 qualified iodized salt samples. The median salt iodine was 24.00 mg/kg. The coverage rate of iodized salt, the qualified rate of iodized salt, and the consumption rate of qualified iodized salt were 57.48%, 88.49%, and 50.87%, respectively. No significant difference was observed in medians salt iodine between 2022 (24.26 mg/kg) and 2023 (24.00 mg/kg, Z = - 1.58, P = 0.113). However, the coverage rate of iodized salt and the consumption rate of qualified iodized salt in 2023 werehigher than those in 2022 [73.72% (373/506) vs 37.74% (157/416), 65.22% (330/506) vs 33.41% (139/416), χ 2 = 120.90, 92.40, P < 0.001]. A total of 922 urine samples were collected from pregnant women, with a median urinary iodine of 135.90 μg/L. The median urinary iodine of pregnant women in 2022 was 113.55 μg/L. There was a statistically significant difference in medians urinary iodine among different regions ( H = 27.91, P < 0.001). The median urinary iodine of pregnant women in 2023 was 153.00 μg/L. There was no statistically significant difference in medians urinary iodine among different regions ( H = 3.33, P = 0.343). The medians urinary iodine of pregnant women in Huancui District, Wendeng District, and Rushan City in 2023 (156.60, 155.00, 140.85 μg/L) were higher than those in 2022 (93.60, 110.00, 110.70 μg/L), and the differences were statistically significant ( Z = - 5.44, - 4.92, - 5.99, P < 0.001). The median urinary iodine of pregnant women in Weihai City in 2023 showed a statistically significant difference compared to 2022 ( Z = - 7.62, P < 0.001). Conclusions:The IDD intervention measures in Weihai City have achieved good results, and the coverage of iodized salt, the consumption rate of qualified iodized salt, and the iodine nutrition level of pregnant women have improved. We should continue to implement intervention measures, improve the iodine nutrition level of key populations, and maintain a sustained elimination of IDD.

Objective:To evaluate the efficacy and safety of a Chinese herbal mask in the treatment of melanized-type melasma by stereological measurements.Methods:A randomized, controlled, evaluator- and statistician-blind clinical study was conducted. A total of 116 patients with melasma who met the inclusion and exclusion criteria were selected and equally divided into two groups by using a random number table method, with 58 patients in each group. The treatment group received topical treatment with a Chinese herbal mask once a night, while the control group received topical hydroquinone cream in the morning and evening twice daily. The course of treatment lasted 12 weeks, with follow-ups every 4 weeks, and an additional follow-up was performed 12 weeks after discontinuation of treatment. A facial image analyzer and a reflectance confocal microscopy (RCM) were used to collect images before and after treatment. Melasma area and severity index (MASI) scores and RCM scores served as outcome measures, and stereological measurement methods were employed to compare scores before and after treatment; response rates and recurrence rates were calculated, and adverse reactions were observed and recorded. Statistical analyses were performed using the chi-square test and t test. Results:A total of 54 patients in the treatment group and 47 patients in the control group completed the study. After 4- and 8-week treatment, there were no significant differences in MASI scores or RCM scores between the two groups (all P > 0.05) ; after 12-week treatment, the MASI scores and RCM scores were significantly lower in the treatment group (2.91 ± 1.16, 5.48 ± 1.60, respectively) than in the control group (3.99 ± 2.03, 6.66 ± 1.88, t = -3.32, -3.37, respectively, both P < 0.01). After the end of treatment, there was no significant difference in the response rate between the treatment group (44/54, 81.5%) and the control group (34/47, 72.3%; χ2 = 0.12, P > 0.05). Twelve weeks after discontinuation of treatment, 2 patients (3.7%) relapsed in the treatment group, while 15 (31.9%) relapsed in the control group, showing a significant difference in recurrence rates between the two groups ( χ2 = 12.34, P < 0.01). Adverse reactions occurred in 2 patients (3.7%) in the treatment group and 6 (11.5%) in the control group, and there was no significant difference in the incidence of adverse reactions between the two groups ( χ2 = 1.34, P > 0.05) . Conclusions:The Chinese herbal mask was safe and effective in the treatment of melanized-type melasma. The application of the facial image analyzer and RCM technology in combination with stereological measurement methods has certain value in reducing the subjectivity in efficacy evaluation for melasma.

Objective:To compare and analyze the similarities and differences in clinical manifestations, laboratory findings, pathological characteristics, and prognosis between urticarial vasculitis (UV) and chronic spontaneous urticaria with pigmentation (CSUwp) .Methods:A retrospective analysis was conducted on the clinical data and follow-up results from 35 UV patients and 54 CSUwp patients who attended the Department of Dermatology, Southwest Hospital, Army Medical University from 2014 to 2024. The clinical characteristics (duration of rash, pigmentation, petechiae and ecchymosis, itching, burning sensation, fever, fatigue, skin lesion characteristics, etc.) , laboratory test results, pathological features, and prognosis were compared between the two groups. Statistical analysis was carried out by t test, chi-square test, Mann-Whitney U test, and Kaplan-Meier survival analysis. Results:There were no significant differences in gender, age, or age of onset between the UV group and CSUwp group (all P < 0.05) . The proportions of patients with petechiae/purpura (68.57% [24/35] vs. 11.11% [6/54]) , and those with burning sensation (22.86% [8/35] vs. 3.70% [2/54]) were significantly higher in the UV group than in the CSUwp group (both P < 0.05) . Compared with the CSUwp patients, the UV patients presented with a greater number of lesions, larger lesion areas, and more frequent involvement of the lower limbs (all P < 0.05) , also showed significantly higher incidence rates of peripheral blood complement reduction, perivascular neutrophil infiltration, nuclear dust, fibrinoid necrosis of the vessel wall, and erythrocyte extravasation (all P < 0.05) , as well as more extensive dermal perivascular inflammation ( Z = -4.506, P < 0.001) . Among patients who achieved remission, the natural disease course was significantly longer in the CSUwp patients than in the UV patients (6.00 [2.5, 24] months vs. 2.00 [0.5, 24] months; Z = -2.618, P = 0.009]. However, the survival analysis showed no significant difference in the natural disease course or clinical outcomes between the two groups ( χ2 = 2.771, P = 0.096) . There were also no significant differences in rash duration or in the incidence rates of itching, angioedema, or joint pain between the two groups (all P > 0.05) . Conclusions:UV patients exhibited certain differences from CSUwp patients in clinical characteristics, laboratory test results, histopathological features, and prognosis. However, whether their natural disease courses differ requires further follow-up studies to confirm.

OBJECTIVE To observe intervention effect of salvianolic acid B based on JAK2/STAT3 pathways on the rats with Escherichia coli infection-induced pyelonephritis.METHODS Totally 60 SPF grade male SD rats were in-cluded in the study and were randomly divided into the control group with 21 rats,the model group(Escherichia coli infection-induced pyelonephritis)with 18 rats and the salvianolic acid B group(Escherichia coli infection-in-duced pyelonephritis+salvianolic acid B)with 18 rats.The control group and the model group were treated with same volume of normal saline for gavage,the salvianolic acid B group was given 12.5 mg/kg salvianolic acid B wa-ter solution for gavage.The levels of related biochemical indexes[secretory immunoglobulin A(SlgA),urine cre-atinine and serum creatinine]were detected for the groups.The organ indexes and relative expression levels of JAK2/STAT3 signaling pathways were observed and compared among the groups.RESULTS There were significant differences in the levels of blood indexes among the three groups of rats(P＜0.05).The SlgA level of the model group was(13.51±1.18)μg/ml,lower than(25.64±4.51)μg/ml of the control group(P＜0.05);the SlgA level of the salvian-olic acid B group was(25.34±2.95)μg/ml,higher than that of the model group(P＜0.05).There were no significant differences in the bladder indexes among the three groups;the ratio of left kidney to right kidney and the renal indexes were higher in the model group than in the control group(P＜0.05);the ratio of left kidney to right kidney and the renal indexes were lower in the salvianolic acid B group than in the model group(P＜0.05).There were significant differences in the relative expression levels of JAK2/STAT 3 signaling pathways among the three groups(P＜0.05);the levels of JAK2 and STAT 3 of the model group were higher than those of the control group(P＜0.05);the levels of JAK2 and STAT 3 of the salvianolic acid B group were lower than those of the model group(P＜0.05).CONCLUSION The salvian-olic acid B based on JAK2/STAT3 pathways may improve the indexes of the rats with E.coli infection-induced pyelonephritis and effectively improve the overall symptoms.

OBJECTIVE: To construct machine learning prediction model for sepsis-associated encephalopathy (SAE), and analyze the application value of the model on early identification of SAE risk in elderly septic patients. METHODS: Patients aged over 60 years with a primary diagnosis of sepsis admitted to intensive care unit (ICU) from 2008 to 2023 were selected from Medical Information Mart for Intensive Care-IV 2.2 (MIMIC-IV 2.2). Demographic variables, disease severity scores, comorbidities, interventions, laboratory indicators, and hospitalization details were collected. Key factors associated with SAE were identified using univariate Logistic regression analysis. The data were randomly divided into training and validation sets in a 7 : 3 ratio. Multivariable Logistic regression analysis was conducted in the training set and visualized using a nomogram model for prediction of SAE. The discrimination of the model was evaluated in the validation set using the receiver operator characteristic curve (ROC curve), and its calibration was assessed using calibration curve. Furthermore, multiple machine learning algorithms, including multi-layer perceptron (MLP), support vector machine (SVM), naive bayes (NB), gradient boosting machine (GBM), random forest (RF), and extreme gradient boosting (XGB), were constructed in the training set. Their predictive performance was subsequently evaluated on the validation set. Taking the XGB model as an example, the interpretability of the model through the SHapley Additive exPlanations (SHAP) algorithm was enhanced to identify the key predictive factors and their contributions. RESULTS: A total of 2 204 septic patients were finally enrolled, of whom 840 developed SAE (38.1%). A total of 21 variables associated with SAE were screened through univariate Logistic regression analysis. Multivariable Logistic regression analysis showed that endotracheal intubation [odds ratio (OR) = 0.40, 95% confidence interval (95%CI) was 0.19-0.88, P < 0.001], oxygen therapy (OR = 0.76, 95%CI was 0.53-0.95, P = 0.023), tracheotomy (OR = 0.20, 95%CI was 0.07-0.53, P < 0.001), continuous renal replacement therapy (CRRT; OR = 0.32, 95%CI was 0.15-0.70, P < 0.001), cerebrovascular disease (OR = 0.31, 95%CI was 0.16-0.60, P < 0.001), rheumatic disease (OR = 0.44, 95%CI was 0.19-0.99, P < 0.001), male (OR = 0.68, 95%CI was 0.54-0.86, P = 0.001), and maximum anion gap (AG; OR = 0.95, 95%CI was 0.93-0.97, P < 0.001) were associated with an decreased probability of SAE, and age (OR = 1.05, 95%CI was 1.03-1.06, P < 0.001), acute physiology score III (APSIII; OR = 1.02, 95%CI was 1.01-1.02, P < 0.001), Oxford acute severity of illness score (OASIS; OR = 1.04, 95%CI was 1.03-1.06, P < 0.001), and length of hospital stay (OR = 1.01, 95%CI was 1.01-1.02, P < 0.001) were associated with an increased probability of SAE. A nomogram model was constructed based on these variables. In the validation set, ROC curve analysis showed that the model achieved an area under the ROC curve (AUC) of 0.723, and the calibration curve showed good consistency between the predicted probability of the model and the observed probability. Among the machine learning algorithms, including MLP, SVM, NB, GBM, RF, and XGB, the SVM model and RF model demonstrated relatively good predictive performance, with AUC of 0.748 and 0.739, respectively, and the sensitivity was both exceeding 85%. The predictive performance of the XGB model was explained through SHAP analysis, and the results indicated that APSIII score (SHAP value was 0.871), age (SHAP value was 0.521), and OASIS score (SHAP value was 0.443) were important factors affecting the predictive performance of the model. CONCLUSIONS The machine learning-based SAE prediction model exhibits good predictive capability and holds significant application value for the early identification of SAE risk in elderly septic patients.
Humans ; Machine Learning ; Aged ; Sepsis-Associated Encephalopathy ; Sepsis/complications* ; Intensive Care Units ; Logistic Models ; Middle Aged ; Male ; ROC Curve ; Female ; Bayes Theorem ; Nomograms ; Support Vector Machine ; Algorithms