Objective: To investigate the nutritional status and influencing factors among Tibetan and Mongolian children and adolescents aged 7-18 years in high-altitude regions, so as to provide evidence for early prevention and control of malnutrition in this population. Methods: From May to June 2022, a cluster sampling method was employed to recruit 1 019 Tibetan and Mongolian children and adolescents aged 7-18 years from two primary and secondary schools in Golmud City. Physical examinations, dietary frequency questionnaires, and physical activity assessments were conducted. Nutritional status was classified as obesity, combined overweight/obesity, underweight, or central obesity according to national standards including Screening for Overweight and Obesity among School-age Children and Adolescents, Screening Standard for Malnutrition of School-age Children and Adolescents, Blue Book on Obesity Prevention and Control in China. Chi-square tests, t-test and Logistic regression analyses were performed to identify factors associated with different nutritional statuses. Results: The detection rates of obesity, combined overweight/obesity, underweight, and central obesity were 8.0%, 18.1%, 5.2%, and 19.7%, respectively. The height of children and adolescents across all age groups was generally lower than the national standard values. Tibetan participants exhibited significantly lower height-for-age Z-scores (HAZ)(9-10, 13-17 years, Z =2.01, 2.78, 4.16, 3.38, 4.12, 3.63, 3.00) and BMI-for-age Z-scores (BAZ) compared to Mongolian participants ( Z =-2.95, -2.47, -2.31, -2.89, -2.14, -2.17)( P < 0.05 ). Multivariate Logistic regression revealed that Mongolian children and adolescents had higher risks of obesity ( OR =2.20) and combined overweight/obesity ( OR = 2.18 ) ( P <0.05). Additionally, insufficient moderate-to-vigorous physical activity (MVPA) was associated with an increased risk of central obesity ( OR =1.48, P <0.05), compared with children and adolescents who meet the standard of MVPA. Conclusions The rates of overweight and obesity among Tibetan and Mongolian children and adolescents in Golmud City are higher, influenced by multiple factors. Nutrition interventions and physical activity strategies tailored to ethnic characteristics should be implemented, with emphasis on promoting MVPA to improve nutritional outcomes in this population.

ObjectiveTo analyze the clinical characteristics and imaging features of effectively treated pediatric Mycoplasma pneumoniae pneumonia （MPP） with pulmonary consolidation， follow up the volume changes of pulmonary consolidation on lung CT scans of the affected children， and investigate the resolution patterns of pulmonary consolidation， and predict the time required for complete resolution. MethodsWe enrolled children with MPP and pulmonary consolidation hospitalized in the Department of General Pediatrics at Children's Hospital of Chongqing Medical University between January 2018 and May 2024. Data collected included demographics， clinical symptoms， laboratory indicators， treatment status， imaging data during hospitalization， as well as follow-up lung CT data and reexamination intervals after discharge. Consolidation volumes were measured before and after the treatment to calculate the resolution rate and resolution velocity. Descriptive statistical analysis was performed on clinical characteristics， imaging features and consolidation resolution. ResultsAmong 238 children with MPP and lung consolidation， females slightly outnumbered males （the male to female ratio is 109 vs.129）， with a mean age of approximately 5 years. At admission， the median cough and fever durations were 7 （5-9） days and 6 （ 4-7） days， respectively. No significant increase was found in white blood cells count or lactate dehydrogenase（LDH）， and hypersensitive high-sensitivity C-reactive protein （CRP） slightly increased. Azithromycin was the first line of treatment in most cases， though second-line drugs increased in the recent two years due to the rising resistance. Bronchoalveolar lavage was performed in 66.8% （159/238） of children， and 33.2% （79/238） did not receive lavage. Consolidation was predominantly unilateral （206 unilateral vs. 32 bilateral） and right-sided （117 right-sided vs. 89 left-sided）. The ratio of consolidation volume to total lung volume was 4.48 （2.61-7.35） %， the consolidation resolution rate at follow-up was 96.08 （ 88.02-98.95） %， the reexamination interval was 17 （ 15-21） days， the resolution velocity was 2.15 （1.23-4.01） cm³/d， and the time to complete resolution was 18.96 （16.14-23.33） days . ConclusionsPulmonary consolidation in pediatric MPP achieves substantial resolution on CT within 2-3 weeks after effective clinical treatment. Initial consolidation volume and resolution velocity can predict the time required for complete resolution， thereby clinically guiding optimal CT follow-up scheduling.

OBJECTIVE To investigate the protective effect and potential mechanism of cornuside on diabetic nephropathy （DN） model mice. METHODS Male KK-Ay mice were fed with high-fat and high-sugar diet for two weeks to reproduce the DN model. The successfully modeled mice were randomly grouped into model group， aminoguanidine group （positive control，100 mg/kg） and cornuside group （100 mg/kg）， and male C57BL/6J mice were included as normal group， with 6 mice in each group. Administration groups were given relevant medicine intragastrically， and normal group and model group were given a constant volume of normal saline intragastrically， once a day， for 8 consecutive weeks. The levels of fasting blood glucose （FBG）， 24 h urinary protein， serum interleukin-12 （IL-12）， IL-10， blood urea nitrogen （BUN） and serum creatinine （Scr） were detected； the pathological injury， fibrotic change and glomerular microstructure of renal tissue were observed； the expressions of the receptor of advanced glycation end products （RAGE）， collagen type Ⅳ （COL-Ⅳ） and inducible nitric oxide synthase （iNOS） in renal cortex were detected in each group. RESULTS Compared with normal group， the renal cortex of mice in model group showed obvious inflammatory cell infiltration and fibrotic changes； the mesangial hyperplasia of glomerulus was serious and the basement membrane had a large number of irregular dark dense deposits； the levels of FBG and 24 h urinary protein， the serum levels of IL- 12， BUN and Scr， and the expression levels of RAGE， COL-Ⅳ and iNOS in the renal cortex were significantly increased， while the serum level of IL-10 was significantly decreased （P＜0.01）. Compared with the model group， the renal pathological injuries， fibrotic changes and glomerular microstructure of mice in administration groups were improved significantly， and the above quantitative indexes were generally improved （P＜0.05 or P＜0.01）. CONCLUSIONS Cornuside has a certain protective effect on DN model mice. It can inhibit the inflammatory response， reduce urinary protein excretion， and alleviate renal fibrosis， which may be related to the inhibition of the advanced glycation end products/RAGE signaling pathway.

Objective To analyze the prevalence and genetic characteristics of influenza A(H3N2) viruses in the city of Xiangyang in 2022-2023, and to provide a scientific basis for predicting the epidemic and mutation of influenza virus. Methods Throat swab specimens of the influenza like cases were collected from national influenza monitoring sentinel hospitals in Xiangyang every week. RNA was extracted from the specimens for influenza diagnosing using real-time RT-PCR．Viruses were isolated from H3N2 positive specimens, and HA and NA genes were amplified and sequenced．3D modeling analyses were conducted. Results The gene phylogenetic tree showed that the H3N2 isolates in 2022-2023 belonged to 3C.2a1b.2a1 and 3C.2a1b.2a2 branches, respectively. The A(H3N2) influenza virus strains all had amino acid point mutation sites on important antigenic determinants of HA protein. The epitope mutations of the 2022 A(H3N2) strain mainly occurred in regions B, C, and D. The epitope mutations of the A(H3N2) strain in 2023 mainly occurred in regions C and D. Different glycosylation sites of HA gene were found in 2022-2023 strains. No variation was found in key amino acid sites associated with neuraminidase inhibitor resistance. The difference of overall structure was not obvious in the three-dimensional simulation structure diagram. Conclusion The A(H3N2) influenza strains isolated in this study have shown antigenic drift, especially the mutation of HA, which may affect the protective effect of the vaccine on the local population and lead to influenza epidemic. The variations of HA and NA suggest that close attention should be paid to the epidemic and genetic variation of H3N2 subtype influenza virus, to provide a scientific basis for the selection of influenza virus vaccine strains and the prevention and control of influenza.

Objective To investigate the clinical value of intracoronary injection of recombinant human prourokinase for injection in patients with acute ST-segment elevation myocardial infarction(STEMI)undergoing emergency percutaneous coronary intervention(PCI).Methods Retrospective analysis was used to collect STEMI patients who underwent emergency PCI in department of cardiology from January to December 2019.According to the targeted injection of drugs through a guided catheter by intraoperative patients before stent implantation,the patients were divided into a tirofiban group(70 cases)and a recombinant human urokinase group(70 cases).TIMI blood flow grade,ST segment fall value(STR)of infarct-related artery,plasma D-dimer,left ventricular ejection fraction(LVEF)and coronary microcirculation dysfunction were compared between the two groups.At the same time,the general information of the patients,major adverse cardiovascular events(MACE)and bleeding were recorded.Results Compared with the tirofiban group,the TIMI blood flow level,LVEF,plasma D-dimer,and the proportion of the patients with STR＞70％in the recombinant human prourokinase group were significantly increased,while the incidence of slow flow/no reflow and MACE were significantly reduced,and the differences between the two groups were statistically significant(P＜0.05).The incidence of bleeding events in the recombinant human prourokinase group showed a downward trend,but there was no significant difference between the two groups(P＞0.05).Conclusion Intracoronary injection of recombinant human prourokinase through the guiding catheter can significantly improve myocardial perfusion and prognosis in patients with STEMI.It also reduces adverse cardiovascular events and has a high safety margin,which is worth promoting in the clinic.

Ameloblastoma is a benign tumor characterized by locally invasive phenotypes,leading to facial bone destruction and a high recurrence rate.However,the mechanisms governing tumor initiation and recurrence are poorly understood.Here,we uncovered cellular landscapes and mechanisms that underlie tumor recurrence in ameloblastoma at single-cell resolution.Our results revealed that ameloblastoma exhibits five tumor subpopulations varying with respect to immune response(IR),bone remodeling(BR),tooth development(TD),epithelial development(ED),and cell cycle(CC)signatures.Of note,we found that CC ameloblastoma cells were endowed with stemness and contributed to tumor recurrence,which was dominated by the EZH2-mediated program.Targeting EZH2 effectively eliminated CC ameloblastoma cells and inhibited tumor growth in ameloblastoma patient-derived organoids.These data described the tumor subpopulation and clarified the identity,function,and regulatory mechanism of CC ameloblastoma cells,providing a potential therapeutic target for ameloblastoma.

Gouty arthritis is a condition resulting from the dysregulation of purine metabolism in the human body. It is characterized by redness, swelling, recurrent episodes of hot pain, and joint stiffness. Currently, Western medicine primarily relies on uric acid-lowering, anti-inflammatory, and analgesic drugs, but these medications often have significant side effects. In contrast, external therapies in traditional Chinese medicine are considered simpler, safer, and less likely to produce adverse reactions, thus making them more appealing to patients. This article summarizes the various external treatment methods used in traditional Chinese medicine to alleviate the clinical symptoms of gouty arthritis, offering a novel approach for clinical management.

Objective To discuss the nursing cooperation method in CT-guided pulmonary nodule localization using indocyanine green combined with methylene blue.Methods A total of 81 patients,who needed to receive pulmonary nodule localization before thoracoscopic resection,were enrolled in this study.The nursing cooperation measures,including the preparation and injection of indocyanine green combined with methylene blue,breathing mode coordination,position management,precise localization coordination,and psychological care,were analyzed.Results Successful nodule localization was accomplished in all patients.No statistically significant difference in the incidence of adverse events existed between the patients with different clinical characteristics(P＞0.05).The gender,age,lesion site,nodule size,nodule-pleura distance,posture during puncturing and needle path route were not the factors influencing the occurrence of adverse reactions in patients receiving CT-guided pulmonary nodule localization using indocyanine green combined with methylene blue.Conclusion In performing CT-guided pulmonary nodule localization using indocyanine green combined with methylene blue,the nursing cooperation method carries generality and stability,which is suitable for patients with different clinical characteristics.

In the era of precision medicine,patients with lung cancer receive molecular subtype-based personalized management.The un-met clinical need initiated the concept of adaptive therapy,a novel personalized treatment strategy referring to the biomarker-directed treatment escalation or de-escalation based on the standard of care,aiming to improve efficacy,quality of life,and cost efficiency.Biomark-ers are validated under specific clinical scenarios to dynamically and stably predict disease-free status or efficacy.The optimal clinical scen-arios for adaptive therapy comprises post-treatment and radiologically lesion-free or metabolically inactive disease status.Several promising clinical situations are exploring de-escalation therapy,including epidermal growth factor receptor(EGFR)-mutated,totally resected non-small cell lung cancer(NSCLC),driver gene-negative,totally resected NSCLC,driver gene-negative,radiochemotherapy-treated,locally advanced NSCLC,and drug holidays for metastatic NSCLC.Therefore,circulating tumor DNA-minimal residual disease,(ctDNA-MRD)is considered an important biomarker.Concerning escalation therapy,this field is less well-supported with results,demanding further exploration.Related to future perspectives,more effort should be invested in focusing on patients with unmet clinical needs,even those with a standard of care,and providing biomarker-based adaptive therapy for efficacy and efficiency improvement.

Objective: To explore the related factors of negative conversion time (NCT) of nucleic acid in children with COVID-19. Methods: A retrospective cohort study was conducted. A total of 225 children who were diagnosed with COVID-19 and admitted to Changxing Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 3^rd to May 31^st 2022 were enrolled in the study. The infection age, gender, viral load, basic disease, clinical symptoms and information of accompanying caregivers were retrospectively analyzed. According to age, the children were divided into<3 years of age group and 3-<18 years of age group. According to the viral nucleic acid test results, the children were divided into positive accompanying caregiver group and negative accompanying caregiver group. Comparisons between groups were performed using Mann-Whitney U test or Chi-square test. Multivariate Logistic regression analysis was used to analyze the related factors of NCT of nucleic acid in children with COVID-19. Results: Among the 225 patients (120 boys and 105 girls) of age 2.8 (1.3, 6.2) years, 119 children <3 years and 106 children 3-<18 years of age, 19 cases were diagnosed with moderate COVID-19, and the other 206 cases were diagnosed with mild COVID-19. There were 141 patients in the positive accompanying caregiver group and 84 patients in the negative accompanying caregiver group.Patients 3-<18 years of age had a shorter NCT (5 (3, 7) vs.7 (4, 9) d, Z=-4.17, P<0.001) compared with patients <3 years of age. Patients in the negative accompanying caregiver group had a shorter NCT (5 (3, 7) vs.6 (4, 9) d,Z=-2.89,P=0.004) compared with patients in the positive accompanying caregiver group. Multivariate Logistic regression analysis showed that anorexia was associated with NCT of nucleic acid (OR=3.74,95%CI 1.69-8.31, P=0.001). Conclusion: Accompanying caregiver with positive nucleic acid test may prolong NCT of nucleic acid, and decreased appetite may be associated with prolonged NCT of nucleic acid in children with COVID-19.
Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male ; Young Adult ; China/epidemiology* ; COVID-19/genetics* ; Nucleic Acids ; Retrospective Studies