Objective: To investigate the status and influencing factors of nutritional health knowledge awareness among primary and middle school students in Wenzhou City, Zhejiang Province, so as to provide a basis for carrying out targeted nutrition health education for students. Methods: The stratified cluster random sampling method was used to select students from 48 schools across 12 counties (cities and districts) in Wenzhou City as survey subjects from October 2023 to February 2024. Basic information, parental information, and nutritional health knowledge were collected using the Questionnaire on nutritional health knowledge for School-Age Children. The awareness rate of nutritional health knowledge was analyzed. Multivariable logistic regression model was used to analyze the influencing factors for nutritional health knowledge awareness among primary and middle school students. Results: The survey included 4 405 boys, accounting for 51.42%, and 4 161 girls, accounting for 48.58%. The sample consisted of 2 497 pupils in Grades 1-3 (29.15%), 2 591 pupils in Grades 4-6 (30.25%), 1 739 junior high school students (20.30%), and 1 739 senior high school students (20.30%). The median score of nutrition health knowledge was 75.00 (interquartile range, 19.00), and the awareness rate was 4 524 (52.81%). Multivariable logistic regression analysis showed that girls (OR=1.317, 95%CI: 1.198-1.447), primary school students (Grades 1-3, OR=7.830, 95%CI: 6.444-9.513; Grades 4-6, OR=1.276, 95%CI: 1.066-1.528), and those whose mothers had an educational level above junior high school (senior high school/technical secondary school/technical school/junior college, OR=1.188, 95%CI: 1.044-1.352; bachelor' s degree or above, OR=1.194, 95%CI: 1.024-1.392) had a higher likelihood of nutrition and health knowledge awareness. Conversely, students who were overweight or obese (OR=0.798, 95%CI: 0.671-0.950), lived in school (OR=0.763, 95%CI: 0.650-0.895), and had a daily outdoor activity duration of <30 minutes (OR=0.641, 95%CI: 0.570-0.721) had a lower likelihood of nutritional health knowledge awareness. Conclusions The awareness rate of nutritional health knowledge among primary and middle school students in Wenzhou City needs to be improved, and is mainly influenced by gender, educational stage, body mass index, mother' s educational level, and outdoor activity duration. It is recommended to implement differentiated health education strategies and build a "family-school-community" linkage mechanism to improve students' nutrition health literacy.

Adhering to the guidance of party building is an essential requirement for comprehensively promoting the high-quality development of public hospitals.How to solve the problem of"two skins"of party building and business,further promote the deep integration of the party and business has become an important topic for the party building of public hospitals in the new era.Taking Jieyang People's Hospital as an example,this paper introduces the innovation and exploration experience on the par-ty building work round in the hospital,the working mechanism of which is"1+5+5+4"of"Party building leading,five re-sponsibility coordination,five-step linkage and four-type integration".This approach effectively promotes the deep integration and promotion of the party and business,which further lead the high-quality development of various work in the hospital.It can pro-vide reference for exploring and improving the system and mechanism of the integration of party and business,and further promote party leadership in promoting high-quality development in public hospitals.

Objective To establish the therapeutic effect prediction model of platelet transfusion in hematological patients,and receiver operating characteristic(ROC)curve and clinical cases are used to evaluate the clinical application value of the predic-tion model.Methods A total of 485 patients with hematological diseases who received platelet transfusion therapy in Kailuan General Hospital from January 2020 to December 2023 were selected,corrected count increment(CCI)was used to divide the patients into platelet transfusion effective group(n=340)and transfusion ineffective group(n=145).Multivariate Logistic regres-sion analysis was used to establish the prediction model of platelet infusion efficacy,and ROC curve was used to evaluate the application effect of the forcasting model.109 clinical cases were used to verify the practical application effect of the model,and the sensitivity,specificity and accuracy were calculated.Results Among 485 patients with hematological diseases,the incidence of ineffective platelet transfusion was 29.90%(145/485).Compated with the effective group,the ineffective group had more previous platelet transfusions was higher,and the difference was statistically significant(t=-4.435,P<0.05).In the ineffective group,there were more cases of hyperplenism,aplastic anemia and lymphoma,higher infection rate and higher positive rate of platelet antibody,and the differences were statistically significant(χ2=6.301～37.522,all P<0.05).Multivariate Logistic regres-sion analysis found that previous platelet infusion times,infection,leukemia,aplastic anemia and platelet antibodies were risk factors for ineffective platelet transfusion in patients with hematological diseases(Wald χ2=5.224～21.548,all P<0.05).Based on these risk factors,platelet infusion effect prediction models 1 and 2 were constructed.ROC curve was used to evaluate the application effect of the prediction model.The area under the curve(AUC),cut-offpoint,sensitivity and specificity of model 1 were 0.884,0.042,82.35%,88.89%.The AUC,cut-offpoint,corresponding sensitivity and specificity of prediction model 2 were 0.910,59.784,81.18%,94.44%,respectively.The Z values of model 1 and model 2 were 12.159 and 13.151,respectively.The prediction effect of model 2 was better than that of model 1.The actual application results showed that the sensitivity,specificity and accuracy of prediction model 1,2 were 85.71%,92.05%,90.89%and 90.48%,93.18%,92.66%,respectively.Conclusion The ineffective rate of platelet transfusion in hematological patients is relatively high.The prediction models 1 and 2 for platelet transfusion effectiveness have good results in predicting ineffective platelet transfusion,and prediction model 2 is better than pre-diction model 1,which can provide reliable basis for hematological patients on accurate platelet transfusion.

[Objective]To summarize the clinical experience of Professor YAO Xinmiao's experience in treating restless legs syndrome(RLS)with acupotomy from four sinews separately under the theoretical guidance of"bones can stand upright with sinews",with a view to illustrate the theoretical basis and clinical application of treating RLS with acupotomy from four sinews.[Methods]Through the clinical study with Professor YAO,combined with the review of Chinese medical ancient Books and modern medical research literature on RLS,the overview of RLS,the theoretical overview of"bone can stand upright with sinews",and Professor YAO's opinions on the theoretical basis and clinical practice of treating RLS with acupotomy from four sinews separately are elaborated,and Professor YAO's idea of identification and treatment of RLS are analyzed.[Results]RLS is a central nervous system sensory dysfunction disease,and traditional treatment has problems such as significant side effects,drug tolerance and symptom rebound.The theory of"bones can stand upright with sinews"emphasizes the dominant position of tendons in the concept of balance between sinews and bones.Professor YAO believes that the onset of RLS is caused by the disruption of the balance between sinews and bones.Sinew of foot-Taiyang,sinew of foot-Shaoyang,sinew of foot-Jueyin,sinew of foot-Shaoyin are closely related to RLS.Doctors need to flexibly use acupuncture techniques such as perpendicular needling,Hegu needling and superficial needling to treat RLS based on characteristics of the four sinews separately.Meanwhile,doctors need to base themselves on the concept of muscle bone balance,focus on the training of core stability,reduce recurrence and improve long-term efficacy.[Conclusion]Professor YAO's emphasis on the concept of balance between sinews and bones based on the concept of"bone can stand upright with sinews"not only has important guiding significance in the treatment of musculoskeletal disorders with acupotomy,but also has high application value in the treatment of neuromuscular disorders with acupotomy,which is worth learning and promoting.

OBJECTIVE To explore the mechanism of Shaoyao gancao decoction in improving intestinal motility in rats with slow transit constipation(STC)by regulating acid-sensitive ion channel 3(ASIC3)/extracellular signal-regulated kinase(ERK)signaling pathway.METHODS SD rats were used to construct an STC model by gavage with compound diphenoxylate.The successfully modeled rats were randomly divided into model group,Shaoyao gancao decoction group(1.5 g/mL),lactulose group(208.4 mg/mL,positive control),and combined inhibition group(Shaoyao gancao decoction 1.5 g/mL+amiloride hydrochloride 20 μg/kg),with 12 rats in each group.Additionally,12 healthy rats were selected as the blank group.They were given relevant medicine once a day and continuously intervened for 14 days.After intervention,the intestinal propulsion function and visceral sensitivity of the model rats were detected.The expression of ASIC3 in the colon tissue of rats was observed by immunohistochemical staining.mRNA expressions of ASIC3,ERK1 and ERK2 as well as protein expressions of ASIC3,ERK1/2 and phosphorylated ERK1/2(p-ERK1/2)in colon tissue of rats were detected;the ultrastructural changes of the enteric nervous system(ENS)-interstitial cell of Cajal(ICC)-smooth muscle cell(SMC)network in the rat colon were observed under electron microscopy.RESULTS Compared with the model group,the intestinal propulsion rate of the Shaoyao gancao decoction group was significantly increased,while the visceral pain threshold was significantly decreased.The proportion of the positive area of ASIC3 in the colonic tissue was significantly increased.The relative mRNA expression levels of ERK1,ERK2,and ASIC3,as well as the relative protein expression levels of p-ERK1/2 and ASIC3,and the p-ERK1/2 to ERK1/2 in the colonic tissue,were all significantly increased(P＜0.05 or P＜0.01).Additionally,there was marked repair of the morphological structure of ICC and SMC,with closer gap junctions observed.Compared with the Shaoyao gancao decoction group,the combined inhibition group exhibited a diminished improvement in intestinal motility of rats,with statistically significant differences in the levels of some indicators(P＜0.05 or P＜0.01);the repairing of the morphological structure of ICC and SMC was notably attenuated.CONCLUSIONS Shaoyao gancao decoction can effectively improve the intestinal transmission function and promote intestinal repair in STC rats,and its mechanism may be related to regulating the balance of the ENS-ICC-SMC network mediated by the ASIC3/ERK signaling pathway,thus promoting intestinal motility and reducing visceral sensitivity.

Objectives:To investigate the predictive value of epicardial fat volume(EFV)and atrioventricular groove fat thickness(AVGT)—morphological biomarkers of epicardial adipose tissue—for major adverse cardiovascular events(MACE)in patients with dilated cardiomyopathy(DCM).Methods:This study enrolled 216 DCM patients.EFV and AVGT were obtained from cardiac magnetic resonance imaging(CMR).Patients were divided into event-free group(n=142)and event group(n=74)based on MACE occurrence during follow-up.Receiver operating characteristic(ROC)curve analysis was used to determine optimal cutoff values.Survival differences were assessed using Kaplan-Meier analysis,Cox proportional hazards regression analysis was used to identify independent risk factors,and restricted cubic spline(RCS)models were used to evaluate dose-response relationships.Results:AVGT and EFV were significantly higher in the event group than in event-free group(both P<0.05).ROC analysis identified optimal MACE-predicting cutoffs as follows:AVGT≥7.74 mm(area under the curve[AUC]=0.57)and EFV≥78.6 ml(AUC=0.62).Kaplan-Meier analysis revealed significantly lower MACE-free survival rates in patients with AVGT≥7.74 mm and EFV≥78.6 ml(both P<0.05).Cox regression analysis confirmed that AVGT(HR=2.18,95%CI:1.34-3.54)and EFV(HR=1.81,95%CI:1.11-2.96)were independent MACE risk factors(both P<0.05)in this patient cohort.RCS models demonstrated the significant linear associations between EFV/AVGT and MACE risk(bothoverall P<0.05).Conclusions:EFV and AVGT,the non-invasive imaging biomarkers quantifying and characterizing fat distribution,are independently correlated with elevated MACE risk in DCM patients.These metrics serve as potential prognostic indicators,enriching risk stratification indicators for early identification of high-risk patients and guiding personalized medication strategies.

Objective To establish the therapeutic effect prediction model of platelet transfusion in hematological patients,and receiver operating characteristic(ROC)curve and clinical cases are used to evaluate the clinical application value of the predic-tion model.Methods A total of 485 patients with hematological diseases who received platelet transfusion therapy in Kailuan General Hospital from January 2020 to December 2023 were selected,corrected count increment(CCI)was used to divide the patients into platelet transfusion effective group(n=340)and transfusion ineffective group(n=145).Multivariate Logistic regres-sion analysis was used to establish the prediction model of platelet infusion efficacy,and ROC curve was used to evaluate the application effect of the forcasting model.109 clinical cases were used to verify the practical application effect of the model,and the sensitivity,specificity and accuracy were calculated.Results Among 485 patients with hematological diseases,the incidence of ineffective platelet transfusion was 29.90%(145/485).Compated with the effective group,the ineffective group had more previous platelet transfusions was higher,and the difference was statistically significant(t=-4.435,P<0.05).In the ineffective group,there were more cases of hyperplenism,aplastic anemia and lymphoma,higher infection rate and higher positive rate of platelet antibody,and the differences were statistically significant(χ2=6.301～37.522,all P<0.05).Multivariate Logistic regres-sion analysis found that previous platelet infusion times,infection,leukemia,aplastic anemia and platelet antibodies were risk factors for ineffective platelet transfusion in patients with hematological diseases(Wald χ2=5.224～21.548,all P<0.05).Based on these risk factors,platelet infusion effect prediction models 1 and 2 were constructed.ROC curve was used to evaluate the application effect of the prediction model.The area under the curve(AUC),cut-offpoint,sensitivity and specificity of model 1 were 0.884,0.042,82.35%,88.89%.The AUC,cut-offpoint,corresponding sensitivity and specificity of prediction model 2 were 0.910,59.784,81.18%,94.44%,respectively.The Z values of model 1 and model 2 were 12.159 and 13.151,respectively.The prediction effect of model 2 was better than that of model 1.The actual application results showed that the sensitivity,specificity and accuracy of prediction model 1,2 were 85.71%,92.05%,90.89%and 90.48%,93.18%,92.66%,respectively.Conclusion The ineffective rate of platelet transfusion in hematological patients is relatively high.The prediction models 1 and 2 for platelet transfusion effectiveness have good results in predicting ineffective platelet transfusion,and prediction model 2 is better than pre-diction model 1,which can provide reliable basis for hematological patients on accurate platelet transfusion.

Pancreaticoduodenectomy is a difficult and risky operation, and postoperative bleeding is one of its serious complications. Fully understanding the potential risk factors of postoperative pancreatic bleeding and taking effective preventive measures, conducting scientific assessment and reasonable treatment decisions for postoperative bleeding are the keys to reducing the mortality rate after PD and increasing the safety of the surgery. This article briefly expounds the etiology, diagnosis, treatment and preventive measures of postoperative bleeding after pancreaticoduodenectomy.

Objective To identify potential drug target genes associated with idiopathic pulmonary fibrosis(IPF)and predict therapeutic candidates using a two-sample Mendelian randomization(MR)approach across the druggable genome.Methods Druggable genome data from the DGIdb database and Finan were integrated to identify overlapping genes.A two-sample MR analysis was performed to infer causal relationships between genes and IPF.Functional enrichment analyses,including Gene Ontology(GO)and Kyoto encyclopedia of genes and genomes(KEGG),were conducted to explore biological pathways.Drug-target interactions were predicted via DSigDB database screening,followed by molecular docking simulations to evaluate binding affinities.Results Among the 2588 overlapping druggable genes,thirty exhibited significant causal associations with IPF(P＜0.05).Four hub genes(NOD2,LATS2,LTA,and TCF7L2)were enriched in IPF-related pathways,notably Hippo and TNF signaling.Six potential therapeutics were identified:oxyphenbutazone,moexipril,α-galactosylceramide,GSK429286A,CGP74514A,and JW-7-24-1.Molecular docking confirmed strong binding affinities between these drugs and their targets.Conclusion This study has identified thirty druggable gene targets and six candidate drugs for IPF.The enrichment of hub genes in key pathways and validated drug-target interactions provide insights into IPF therapies.

The gut microbiome actively regulates host immunity,digestive processes,and the function of the intesti-nal endocrine system.Additionally,it modulates host neural signal transmission and nutrient metabolism through metabo-lite generation.Vascular calcification involves the deposition of calcium phosphate in blood vessel walls,secondary to metabolic disorders such as chronic kidney disease,atherosclerosis,diabetes,and osteoporosis.Recent research spanning the past two decades has indicated a close correlation between shifts in the composition and functionality of the gut microbiota,along with its metabolites,and the onset of metabolic disease-related vascular calcification.This paper pres-ents a comprehensive review of the roles and mechanisms of the gut microbiota in this context.