Objective To investigate the factors influencing hyperdynamic circulation-related indicators in patients with liver cirrhosis and ascites.Methods A retrospective analysis was conducted on the clinical data of 377 patients diagnosed with cirrhosis-associated ascites at the Third People's Hospital of Kunming between October 2022 and October 2024.Patients were categorized into grade 1,grade 2,and grade 3 ascites groups according to ascites severity grading.The general demographic characteristics and clinical parameters of the three groups were compared.Potential positive predictors were initially identified through univariate analyses,including Spearman correlation and non-parametric tests.Binary logistic regression and multiple linear regression models were subsequently employed to investigate the factors influencing high dynamic circulation-related indicators(heart rate[HR],E/A ratio,and left ventricular diastolic function[LVDF])in patients with cirrhosis-related ascites.Results Significant differences in the incidence of HR,the ratio of early to late diastolic filling velocities(E/A),and LVDF were observed among different ascites groups(P<0.05).Age,ascites depth,serum chloride(Cl-),CO2,red cell distribution width coefficient of variation(RDW-CV),and etiology were identified as independent determinants of HR in patients with liver cirrhosis and ascites.Age,white blood cell count(WBC),albumin(ALB),and etiology were independent determinants of E/A in patients with liver cirrhosis and ascites.Age(OR=1.088,95%CI 1.062-1.114,P<0.001)and serum potassium(K+)(OR=1.919,95%CI 1.218-3.025,P=0.005)were independent risk factors for LVDF in patients with cirrhotic ascites,whereas RDW-CV(OR=0.902,95%CI 0.883-0.961,P=0.023)and ALB(OR=0.921,95%CI 0.883-0.961,P<0.001)were identified as protective factors.Conclusions Serum ALB is an independent influencing factor for E/A ratio and LVDF in cirrhotic patients with ascites and hyperdynamic circulation.K+and RDW-CV are also independent predictors of LVDF,whereas Cl-independently influences heart rate.Clinical monitoring and targeted intervention for these parameters should be emphasized.

Objective To explore the relationship between corrected QT interval(QTc)and short-term mortality rate in patients with cirrhotic ascites and the predictive value of QTc combined with Child-Pugh class for short-term death.Methods Patients hospitalized with cirrhotic ascites from October 2022 to March 2024 were selected as study subjects(training set,n=245),and similar patients from April to October 2024 were included for external validation(validation set,n=88).Patients'demographic data,basic clinical data,and first electrocardiography related indicators on admission were collected.Patients were divided into a death group and a survival group according to the 30-day follow-up result.The influencing factors for prognosis were explored by Lasso regression and univariate and multivariate binary logistic regression.A death risk nomogram model was constructed and evaluated by receiver operating characteristic curve(ROC curve),calibration curve,and decision curve.Data were analyzed for normality using Shapiro-Wilk test.Pairwise comparison for continuous data that were normally distributed was conducted by the independent-samples t test.Pairwise comparison for continuous data that were not normally distributed was conducted by the Mann-Whitney U test.Pairwise comparison for categorical data was performed using the chi-square test.Results The mortality rates were 35.1%(86/245)in the training set and 30.7%(27/88)in the validation set.Lasso regression showed that combined tumor,QTc,hematocrit,total bilirubin(TBil),direct bilirubin,alkaline phosphatase,albumin,cholinesterase,high-density lipoprotein cholesterol,carcinoembryonic antigen,international normalized ratio,model for end-stage liver disease(MELD),and Child-Pugh class were potential influencing factors for 30-day death in patients with cirrhotic ascites.Univariate and multivariate logistic regression showed that QTc(odds ratio[OR]=1.010,95%confidence interval[CI]:1.001-1.020,P=0.039),presence of tumor(OR=6.904,95%CI:2.997-12.391,P<0.001),TBil(OR=1.009,95%CI:1.004-1.014,P=0.001),and Child-Pugh class(OR=2.532,95%CI:1.256-5.105,P=0.009)were independent risk factors for 30-day death in patients with cirrhotic ascites.For the nomogram model constructed based on the results of the multivariate logistic analysis,the area under the ROC curve in the training set was 0.824;the sensitivity and specificity were 81.1%and 74.4%,respectively;the Hosmer-Lemeshow goodness-of-fit test showed P=0.673;the mean absolute error of the calibration curve was 0.020.The area under the ROC curve in the validation set was 0.886;the sensitivity and specificity were 91.8%and 70.4%,respectively;the Hosmer-Lemeshow goodness-of-fit test showed P=0.965;the mean absolute error of the calibration curve was 0.032.With the threshold probability of 0.15 to 0.85,the decision curve suggested a good benefit.The area under the ROC curve of the predictive model(0.824)was greater than conventional MELD score(0.700),MELD-Na score(0.698),and Child-Pugh score(0.674)(all P<0.05).Conclusion QTc is an independent predictor of short-term death in patients with cirrhotic ascites,and the prognostic model including QTc and Child-Pugh class has a good predictive value for short-term mortality rate.

Objective To investigate the factors influencing hyperdynamic circulation-related indicators in patients with liver cirrhosis and ascites.Methods A retrospective analysis was conducted on the clinical data of 377 patients diagnosed with cirrhosis-associated ascites at the Third People's Hospital of Kunming between October 2022 and October 2024.Patients were categorized into grade 1,grade 2,and grade 3 ascites groups according to ascites severity grading.The general demographic characteristics and clinical parameters of the three groups were compared.Potential positive predictors were initially identified through univariate analyses,including Spearman correlation and non-parametric tests.Binary logistic regression and multiple linear regression models were subsequently employed to investigate the factors influencing high dynamic circulation-related indicators(heart rate[HR],E/A ratio,and left ventricular diastolic function[LVDF])in patients with cirrhosis-related ascites.Results Significant differences in the incidence of HR,the ratio of early to late diastolic filling velocities(E/A),and LVDF were observed among different ascites groups(P<0.05).Age,ascites depth,serum chloride(Cl-),CO2,red cell distribution width coefficient of variation(RDW-CV),and etiology were identified as independent determinants of HR in patients with liver cirrhosis and ascites.Age,white blood cell count(WBC),albumin(ALB),and etiology were independent determinants of E/A in patients with liver cirrhosis and ascites.Age(OR=1.088,95%CI 1.062-1.114,P<0.001)and serum potassium(K+)(OR=1.919,95%CI 1.218-3.025,P=0.005)were independent risk factors for LVDF in patients with cirrhotic ascites,whereas RDW-CV(OR=0.902,95%CI 0.883-0.961,P=0.023)and ALB(OR=0.921,95%CI 0.883-0.961,P<0.001)were identified as protective factors.Conclusions Serum ALB is an independent influencing factor for E/A ratio and LVDF in cirrhotic patients with ascites and hyperdynamic circulation.K+and RDW-CV are also independent predictors of LVDF,whereas Cl-independently influences heart rate.Clinical monitoring and targeted intervention for these parameters should be emphasized.

Objective: To explore the prevalence of screening myopia and depressive symptom among primary and secondary school students in Xuzhou, and to explore the association of sleep and screen time on the coexistence of screening myopia and depressive symptom, so as to provide scientific references for developing intervention strategies to address the development of myopia and promote mental health in children and adolescents. Methods: From September to October 2024, a stratified cluster random sampling method was used to select 6 605 students in grade 4 to 12 in 2 urban and 2 suburban districts in Xuzhou. The students health condition and influencing factors questionnaire were used to assess students basic information, sleep time, and screen time. The Center for Epidemiological Studies Depression Scale (CES-D) was used to assess primary and secondary school students depressive symptom.Unaided distance visual acuity examination was conducted, and refractive assessment was performed using an automated refractometer without cycloplegic agents. The Chi-square test and multiple Logistic regression analysis were used to evaluate the association of sleep and screen time with the coexistence of screening myopia and depressive symptom. Results: The detection rates of screening myopia, depressive symptom, and screening myopia and depressive symptoms co morbidity among primary and secondary school students in Xuzhou were 60.35%, 4.45% and 18.61% respectively. Results from the multinomial Logistic regression analysis, using the healthy group as the reference and after adjusting for confounding factors, showed that students with insufficient sleep duration were more likely to have depressive symptom ( OR=1.57, 95%CI =1.08-2.27) and the coexistence of screening myopia and depressive symptom ( OR=1.85, 95%CI =1.45-2.36). Students with daily screen time≥2 h were more likely to have depressive symptom only ( OR=1.41, 95%CI =1.04-1.93) and the coexistence of screening myopia and depressive symptom ( OR=1.31, 95%CI =1.06-1.61). Further stratified analysis based on sufficient and insufficient sleep duration revealed that only in the insufficient sleep duration group, students with daily screen time≥2 h had an increased risk of depressive symptom only ( OR=1.49, 95%CI =1.07-2.07) and the coexistence of screening positive myopia and depressive symptom ( OR=1.40, 95%CI =1.11- 1.77 ) (all P <0.05). Conclusions Primary and secondary school students with insufficient sleep duration and daily screen time≥2 h have higher risks of depressive symptoms and the coexistence of screening myopia and depressive symptoms. It is recommended to ensure adequate sleep duration and limit screen time for children and adolescents.

Efficient drug response prediction is crucial for reducing drug development costs and time, but current computational models struggle with limited experimental data and out-of-distribution issues between in vitro and in vivo settings. To address this, we introduced drug response prediction meta-learner (metaDRP), a novel few-shot learning model designed to enhance predictive accuracy with limited sample sizes across diverse drug-tissue tasks. metaDRP achieves performance comparable to state-of-the-art models in both genomics of drug sensitivity in cancer (GDSC) drug screening and in vivo datasets, while effectively mitigating out-of-distribution problems, making it reliable for translating findings from controlled environments to clinical applications. Additionally, metaDRP's inherent interpretability offers reliable insights into drug mechanisms of action, such as elucidating the pathways and molecular targets of drugs like epothilone B and pemetrexed. This work provides a promising approach to overcoming data scarcity and out-of-distribution challenges in drug response prediction, while promoting the integration of few-shot learning in this field.

ObjectiveTo analyze the hygienic status of tableware cleaning and disinfection in 41 catering facilities of Shanghai in 2020, to identify its influencing factors, so as to propose evidence-based improvements for future scientific supervision. MethodsA field survey was conducted on the cleaning and disinfection methods of tableware in 41 catering establishments in Shanghai. A total of 180 tableware samples were collected and tested for four indicators, including free residual chlorine, anionic synthetic detergent residues, coliforms, and total number of bacterial colonies. The results were classified and statistically analyzed based on the type of catering establishment, tableware material, tableware function, and cleaning and disinfection methods. ResultsThe tableware passed the tests for coliforms and free residual chlorine. The qualification rate for anionic synthetic detergent residues was 48.89% (88/180), with an average of 0.02 mg per 100 cm² and a maximum of0.25 mg per 100 cm² (This unit complied with the requirements of national standardard: GB 14934—2016). Based on the type of catering enterprises, large restaurants had the lowest qualification rate for anionic synthetic detergent residues in tableware at 46.15%. In terms of the function of tableware, chopsticks had the lowest qualification rate for anionic synthetic detergent residues at 26.32%. The detection rate of total number of bacterial colonies in tableware was 42.22% (76/180), with an average of 0.5 log₁₀ (CFU·mL⁻¹) and a maximum of 3.4 log₁₀ (CFU·mL⁻¹). Among them, medium-sized restaurants had the highest detection rate of total number of bacterial colonies in tableware at 47.73% (21/44). ConclusionThe qualification rate of anionic synthetic detergent residues in tableware is relatively low.It is recommended to strengthen research on the occurrence patterns of unqualified tableware and establish early warning values for the qualification rate of anionic synthetic detergent residues, enhance law enforcement inspections on relevant catering establishments, guide enterprises to fulfill their main responsibilities, and improve the quality and safety of tableware.

Objective To analysis the efficacy and safety of antiviral therapy in patients with chronic hepatitis B virus in indeterminate phase based on the new guidelines(2022 Edition of the Guidelines for the Prevention and Treatment of Chronic Hepatitis B).Methods A total of 170 patients with newly diagnosed HBV infection who visited the Third People's Hospital of Kunming from August 1,2020,to July 31,2024,were selected as study subjects.The clinical indicators of patients with normal ALT in the indeterminate phase were analyzed after 12 weeks,24 weeks,and 48 weeks of antiviral treatment,as well as those who did not receive antiviral treatment for 48 weeks.Results(1)Among the 170 patients with normal ALT during the indeterminate phase of HBV infection,the treatment group consisted of 125 patients(36 HBeAg positive and 89 HBeAg negative),while the untreated group had 45 patients.In the treatment group,the HBV-DNA load and HBsAg titer decreased significantly after 48 weeks compared to before treatment,with statistically significant differences(both P<0.05).In the untreated group,the HBV-DNA load showed an upward trend,and the HBsAg titer slightly decreased,with statistically significant differences(both P<0.05).(2)The CVR rate in the treatment group after 48 weeks was 66.67%(24/36)for HBeAg positive patients and 95.51%(85/89)for HBeAg negative patients,with a statistically significant difference(P<0.05).(3)The treatment group showed a significant decrease in GGT and AFP after 48 weeks compared to before treatment,while the untreated group saw an increase in ALT,GGT,and AFP,with statistically significant differences(all P<0.05).(4)The fibrosis indicators APRI,FIB-4,and LSM in the treatment group significantly decreased after 48 weeks compared to before treatment,with statistically significant differences(all P<0.05).(5)The safety indicators CREA,blood calcium,and blood phosphorus in the treatment group significantly decreased after 48 weeks compared to before treatment,with statistically significant differences(all P<0.05).Conclusion Expanding the antiviral treatment indications according to the new guidelines for patients with normal ALT in the indeterminate phase of HBV infection demonstrates good efficacy in controlling HBV-DNA,improving CVR rates,and enhancing fibrosis indicators,while also showing favorable renal safety.However,there may be a risk of osteoporosis due to calcium and phosphorus metabolism disorders,necessitating enhanced monitoring and prevention.

Objective To explore the relationship between corrected QT interval(QTc)and short-term mortality rate in patients with cirrhotic ascites and the predictive value of QTc combined with Child-Pugh class for short-term death.Methods Patients hospitalized with cirrhotic ascites from October 2022 to March 2024 were selected as study subjects(training set,n=245),and similar patients from April to October 2024 were included for external validation(validation set,n=88).Patients'demographic data,basic clinical data,and first electrocardiography related indicators on admission were collected.Patients were divided into a death group and a survival group according to the 30-day follow-up result.The influencing factors for prognosis were explored by Lasso regression and univariate and multivariate binary logistic regression.A death risk nomogram model was constructed and evaluated by receiver operating characteristic curve(ROC curve),calibration curve,and decision curve.Data were analyzed for normality using Shapiro-Wilk test.Pairwise comparison for continuous data that were normally distributed was conducted by the independent-samples t test.Pairwise comparison for continuous data that were not normally distributed was conducted by the Mann-Whitney U test.Pairwise comparison for categorical data was performed using the chi-square test.Results The mortality rates were 35.1%(86/245)in the training set and 30.7%(27/88)in the validation set.Lasso regression showed that combined tumor,QTc,hematocrit,total bilirubin(TBil),direct bilirubin,alkaline phosphatase,albumin,cholinesterase,high-density lipoprotein cholesterol,carcinoembryonic antigen,international normalized ratio,model for end-stage liver disease(MELD),and Child-Pugh class were potential influencing factors for 30-day death in patients with cirrhotic ascites.Univariate and multivariate logistic regression showed that QTc(odds ratio[OR]=1.010,95%confidence interval[CI]:1.001-1.020,P=0.039),presence of tumor(OR=6.904,95%CI:2.997-12.391,P<0.001),TBil(OR=1.009,95%CI:1.004-1.014,P=0.001),and Child-Pugh class(OR=2.532,95%CI:1.256-5.105,P=0.009)were independent risk factors for 30-day death in patients with cirrhotic ascites.For the nomogram model constructed based on the results of the multivariate logistic analysis,the area under the ROC curve in the training set was 0.824;the sensitivity and specificity were 81.1%and 74.4%,respectively;the Hosmer-Lemeshow goodness-of-fit test showed P=0.673;the mean absolute error of the calibration curve was 0.020.The area under the ROC curve in the validation set was 0.886;the sensitivity and specificity were 91.8%and 70.4%,respectively;the Hosmer-Lemeshow goodness-of-fit test showed P=0.965;the mean absolute error of the calibration curve was 0.032.With the threshold probability of 0.15 to 0.85,the decision curve suggested a good benefit.The area under the ROC curve of the predictive model(0.824)was greater than conventional MELD score(0.700),MELD-Na score(0.698),and Child-Pugh score(0.674)(all P<0.05).Conclusion QTc is an independent predictor of short-term death in patients with cirrhotic ascites,and the prognostic model including QTc and Child-Pugh class has a good predictive value for short-term mortality rate.

Objective To explore the improvements of high-fat intake on lung injury induced by Paragonimus proliferus infection in rats, and to preliminarily explore the mechanisms underlying the role of cytochrome P450 4A1 (CYP 4A1) in the improve ments. Methods SD rats were randomly assigned into three groups, including the normal control group (n = 10), the infection and normal diet group (n = 12) and the infection and high-fat diet group (n = 12). Rats in the normal control group were fed with normal diet and without any other treatments, and animals in the infection and normal diet group were subcutaneously injected with 8 excysted metacercariae of P. proliferus via the abdominal wall, followed by feeding with normal diet, while rats in the infection and high-fat diet group were subcutaneously injected with 8 excysted metacercariae of P. proliferus via the abdominal wall, followed by feeding with high-fat diet. All rats were sacrificed 28 weeks post-infection, and serum samples and lung specimens were collected. Following hematoxylin-eosin (HE) staining of rat lung specimens, the rat lung injury was observed under an optical microscope, and alveolitis was evaluated using semi-quantitative scoring. Serum interleukin-1β (IL-1β) and tumor necrosis factor alpha (TNF-α) levels were measured using enzyme-linked immunosorbent assay (ELISA), and the cytochrome P450 4A1 (CYP 4A1) expression was quantified in rat lung specimens at transcriptional and translational levels using quantitative real-time PCR (qPCR) and Western blotting assays. Results Alveolar wall thickening, edema and inflammatory cell infiltration were alleviated 28 weeks post-infection with P. proliferus in rats in the infection and high-fat diet group relative to the infection and normal diet group, and no alveolar consolidation was seen in the infection and high-fat diet group. The semi-quantitative score of alveolitis was significantly higher in the infection and normal diet group [(2.200 ± 0.289) points] than in the normal control group [(0.300 ± 0.083) points] and the infection and high-fat diet group [(1.300 ± 0.475) points] (both P values < 0.05), and higher serum IL-1β [(151.586 ± 20.492)] pg/mL and TNF-α levels [(180.207 ± 23.379) pg/mL] were detected in the infection and normal diet group than in the normal control group [IL-1β: (103.226 ± 3.366) pg/mL; TNF-α: (144.807 ± 1.348) pg/mL] and the infection and high-fat diet group [IL-1β: (110.131 ± 12.946) pg/mL; TNF-α: (131.764 ± 27.831) pg/mL] (all P values < 0.05). In addition, lower CYP 4A1 mRNA (3.00 ± 0.81) and protein expression (0.40 ± 0.02) was quantified in lung specimens in the infection and normal diet group than in the normal control group [(5.03 ± 2.05) and (0.84 ± 0.14)] and the infection and high-fat diet group [(11.19 ± 3.51) and (0.68 ± 0.18)] (all P values < 0.05). Conclusion High-fat intake may alleviate lung injuries caused by P. proliferus infection in rats through up-regulating CYP 4A1 expression in lung tissues at both translational and transcriptional levels.

Objective: To assess the effectiveness of online and offline myopia prevention and control health education interventions using wearable behavior monitoring tools for non myopic elementary school students,so as to provide evidence based medical support for public health practices. Methods: From May to June in 2021, two schools were selected within the same county in Jiangsu Province. School 1 conducted online and offline parental health education ( n =111), while school 2 exclusively conducted offline health education activities, representing the traditional intervention group ( n =122). Students from both schools underwent monitoring through wearable behavior tracking tools, with feedback reports provided (eye distance, eye duration, ambient light, and outdoor exposure time). Both schools relied on activities to carry out health education interventions, and organized the distribution of promotional materials and display boards. The intervention group also established WeChat groups to conduct online "Healthy Parents Action" (answering and providing feedback on health knowledge related to myopia prevention and control, myopia prevention and control, science popularization, etc. raised by parents). Evaluation criteria included myopia rates, post dilation refractive error, and axial length, with a tracking period of two years (from 2021 to 2023). Additionally, the study collected refractive parameters from non myopic students who did not participate in wearable tool monitoring in the 12 classes across the two schools. Results: The baseline results indicated that there were no significant differences between the two groups in terms of refractive parameters and wearable tool monitoring results (including screen time, viewing distance, outdoor exposure time, and homework light exposure)( t/Z/χ 2=1.94,1.17,0.58,0.40,0.80,0.69,0.32, P >0.05). After a two-year follow up, in the first and second year, the myopia rate of the online Healthy Parents Action group (11.4%, 29.7%) were lower than that of the traditional group (26.2%, 50.9%), and the degree of refractive change in the intervention group [0.63(0.38,1.19)D] was lower than that of the traditional group [0.91(0.40,1.50)D], and all the differences were statistically significant( χ 2/ Z =4.93，10.37，2.29， P <0.05). However, there were no significant differences ( P >0.05) in axial length changes between the two groups over the twoyear intervention period. Nevertheless, in the second year, the axial length change in the traditional group [0.35(0.20,0.65)mm] was lower than that in the natural observation group [0.55(0.30,0.75)mm], and this difference was statistically significant ( Z =1.92, P <0.05). Conclusions Online and offline myopia prevention and control health education can effectively reduce myopia rates. The intervention mode combining wearable behavior monitoring tools with online health education may have better effects, but further large sample and multi center studies are needed to provide additional evidence and confirmation.