Objective To study the correlation between the changes of matrix metalloproteinase-9(MMP-9)and neutrophil/lymphocyte ratio(NLR)before and after the revascularization of acute ischemic stroke(AIS),so as to find biomarkers to predict the bleeding transformation risk of AIS patients.Methods From February 2022 to December 2022,161 patients admitted to the Stroke Center of Qujing Hospital Affiliated to Kunming Medical University with AIS werre divided in to the hemorrhagic transformation group and the non-hemorrhagic transfor-mation groupand treated with revascularization(intravenous thrombolysis,endovascular treatment,combined the intravenous thrombolysis with endovascular treatment).Among them,there were 46 cases in the hemorrhagic transformation group and 115 cases in the non hemorrhagic transformation group.And the general data,NLR value and MMP-9 before and after the revascularization were compared between the two groups.Results There was no statistical difference in general data between the two groups(all P>0.05)except for C-reactive protein in hemorrhagic transformation group and in non-hemorrhagic transformation group(P<0.001).The white blood cells,neutrophils,neutrophil percentage,neutrophil absolute value,lymphocyte absolute value,NLR and MMP-9 value in hemorrhagic transformation group were significantly higher than those in non-hemorrhagic transformation group before the treatment and there was a statistical significance(P<0.05).After revascularization,the indexes of blood routine and MMP-9 were significantly higher than those before the revascularization,and the increase in hemorrhagic transformation group was more obvious than that in non-hemorrhagic transformation group and there was a statistical significance(P<0.001),The ROC curve showed that the area under the curve(AUC)of NLR and MMP-9 predicting bleeding transformation after AIS revascularization were 0.74 and 0.90.Conclusion NLR,MMP-9 are associated with the risk of bleeding transformation in AIS patients after the revascularization and can they can be used as the predictive factors for bleeding transformation risk.

Objective To explore the effects of Buyang Huanwu Decoction on neuronal cell apoptosis after cerebral ischemia based on mediating Cav1 in regulating Wnt pathway.Methods Male wild-type(WT)and Cav1-/-(KO)C57BL/6 mice were randomly divided into sham-operation group,model group and Buyang Huanwu Decoction group(18.5 g/kg).Cerebral ischemia model was prepared using middle cerebral artery occlusion method,and drug intervention was given for 14 days.Neurobehavioral score was performed,HE staining was used to observe the morphology of ischemic cortical area of brain tissue,TUNEL staining was used to detect neuronal apoptosis in ischemic cortical area,immunohistochemistry was used to detect the expressions of apoptosis related proteins and Wnt1,glycogen synthase kinase 3β(GSK3β)and β-catenin protein in ischemic cortical area.Results Compared with the same genotype sham-operation group,the neurobehavioral score of the model group mice significantly increased,neuronal cells in the ischemic cortical area showed vacuolar changes,with nuclear condensation and widened intercellular spaces,the apoptosis rate of nerve cells significantly increased,with increased expressions of Bax,GSK3β and decreased expressions of Bcl-2,Wnt1 and β-catenin(P<0.01).Compared with the same genotype model group,the neurobehavioral score of mice in Buyang Huanwu Decoction group were significantly decreased,the pathological damage of the ischemic cortical area improved,the apoptosis rate of nerve cells decreased,the expressions of Bax and GSK3β decreased,and the expressions of Bcl-2,Wnt1 and β-catenin increased(P<0.01).Compared with the WT model group,the KO model group showed an increase in neurobehavioral score,aggravated damage in ischemic cortical area,significantly increased neuronal apoptosis rate,and increased expression of GSK3β(P<0.05).Compared with the WT Buyang Huanwu Decoction group,the KO Buyang Huanwu Decoction group showed an increase in neurobehavioral score,aggravated damage in ischemic cortical area,significantly increased neuronal apoptosis rate,increased expressions of Bax and GSK3β,and decreased expressions of Bcl-2,Wnt1 and β-catenin(P<0.01).Conclusion Buyang Huanwu Decoction can inhibit neuronal cell apoptosis after cerebral ischemia,and its mechanism may be related to regulating the expressions of apoptosis-related proteins by mediating Cav1 to regulate the Wnt signaling pathway.

[This corrects the article DOI: 10.1016/j.apsb.2023.04.002.].

Objective: To analyze the epidemiological characteristics and genetic characteristics of sapovirus (SaV) in a cluster of schools in Changzhou, so as to provide a reference for the treatment of clustered vomiting and diarrhea events in schools. Methods: The epidemiological data and laboratory test data of sapovirus clusters in Changzhou from 2019 to 2022 were collected and analyzed. Partial VP1 genes of SaV positive samples were amplified and sequenced for phylogenetic analysis. Results: A total of 8 cases of clusters of SaV epidemics were reported in Changzhou City from 2019 to 2022, with 118 reported cases. The total attack rate was 1.47%, and the median of the attack number was 15. There were 6 outbreaks in kindergartens and 2 outbreaks in primary schools, which were reported in the epidemic period from September to December. The main clinical manifestations were vomiting (113 cases, 95.76 %), abdominal pain (39 cases, 33.05%), and diarrhea (16 cases, 13.56%). Among the 8 outbreaks, 17 sample strains were successfully sequenced. 5 outbreaks were GII.3 , and the other 3 outbreaks were GI.1, GI .3 and GII.2. GI and GII were the main genotypes in this area, and GII .3 was the predominant strain. Conclusion SaV is an important pathogen in the clusters of vomiting and diarrhea in schools after the transmission of norovirus. Continuous surveillance of SaV should be carried out to further understand its epidemiological characteristics and genotype distribution, so as to provide scientific basis for the prevention and control of the epidemic in schools.

During the carcinoma transformation of colitis， the imbalance of “metabolic-immune interaction” resulted from abnormal energy and metabolic substrates flow and direction was the key process， which caused by intercellular metabolic competition. Based on traditional Chinese medicine （TCM） theory and clinical research， we found that “fire failing to warm earth” is the key pathogenesis of colon-cancer transformation. “Fire” was a synonym for TCM to understand the energy metabolism， combined modern medical research findings， we thought energy metabolism disorders was a microcosmic manifestation of the “fire decline”， while abnormal immune function was the biological basis of “earth deficiency”. The imbalance between “metabolism-immune interaction” and the “fire failing to warm earth” pathogenesis of colitis-cancer transformation demonstrated the different understanding of the same pathological mechanism between western medicine and TCM. For treatment， it could be effectivce to delay the transformation of colitis-cancer by synergistically regulated the energy metabolism - “replenish fire” and enhanced the immune function - “nourish earth”， which was called the methods of replenishing fire to nourish earth.

Mevalonate metabolism plays an important role in regulating tumor growth and progression; however, its role in immune evasion and immune checkpoint modulation remains unclear. Here, we found that non-small cell lung cancer (NSCLC) patients with higher plasma mevalonate response better to anti-PD-(L)1 therapy, as indicated by prolonged progression-free survival and overall survival. Plasma mevalonate levels were positively correlated with programmed death ligand-1 (PD-L1) expression in tumor tissues. In NSCLC cell lines and patient-derived cells, supplementation of mevalonate significantly up-regulated the expression of PD-L1, whereas deprivation of mevalonate reduced PD-L1 expression. Mevalonate increased CD274 mRNA level but did not affect CD274 transcription. Further, we confirmed that mevalonate improved CD274 mRNA stability. Mevalonate promoted the affinity of the AU-rich element-binding protein HuR to the 3'-UTR regions of CD274 mRNA and thereby stabilized CD274 mRNA. By in vivo study, we further confirmed that mevalonate addition enhanced the anti-tumor effect of anti-PD-L1, increased the infiltration of CD8⁺ T cells, and improved cytotoxic function of T cells. Collectively, our findings discovered plasma mevalonate levels positively correlated with the therapeutic efficacy of anti-PD-(L)1 antibody, and provided the evidence that mevalonate supplementation could be an immunosensitizer in NSCLC.

Background Air quality health index (AQHI) has been widely used to quantify the health effects of multiple pollutants observed in population-based epidemiological studies, and can better reflect the widespread linear non-threshold between air pollution and health effects. Objective To explore an AQHI for pediatric respiratory diseases (AQHI_r) in Shanghai and evaluate its feasibility. Methods The daily numbers of hospital outpatient visits for pediatric respiratory diseases from 2015 to 2019 were obtained from five general hospitals in Xuhui, Baoshan, Hongkou, Jinshan, and Chongming Districts of Shanghai. Monitoring data on air pollutants (PM_2.5, PM₁₀, SO₂, NO₂, and O₃), air quality index (AQI), and meteorological variables (temperature, relative humidity, air pressure, and wind speed) were collected from five air quality monitoring sites nearest to selected hospitals. Time-series analysis using generalized additive model (GAM) was conducted to estimate the associations between respiratory-related pediatric outpatient visits and the concentrations of air pollutants. The sum of excess risk (ER) of hospital outpatient visits was used to construct AQHI_r. To assess the predictive power of AQHI_r, the associations of AQHI_r and AQI with the number of pediatric respiratory outpatient visits in three hospitals in Xuhui, Hongkou, and Chongming districts were compared. Results Air pollutants had various effects on respiratory diseases outpatient visits. PM_2.5, NO₂, and O₃ had most significant impacts on lag0 day and the associated ERs of hospital outpatient visits for each 10 μg·m⁻³ increase in pollutant concentration were 1.27% (95%CI: 0.88%-1.66%), 0.75% (95%CI: 0.40%-1.11%), and 0.36% (95%CI: 0.10%-0.62%), respectively. PM₁₀ and SO₂ had most significant impacts on lag3 day and the associated ERs of hospital outpatient visits for each 10 μg·m⁻³ increase in pollutant concentration were 0.81% (95%CI: 0.51%-1.12%) and 5.64% (95%CI: 3.37%-7.96%), respectively. There were significant effects of combinations of two pollutants among PM_2.5, PM₁₀, NO₂, SO₂, and O₃ except for PM₁₀+NO₂, SO₂+PM_2.5, and SO₂+NO₂ (P<0.05). According to the results of single-pollutant and two-pollutant models, PM_2.5, NO₂, SO₂, and O₃ were selected to construct AQHI_r. The comparison showed that for every interquartile range increase in AQHI_r, the ER for pediatric outpatient visits was higher than that for the value corresponding to AQI. Conclusion Air pollutants in Shanghai have an impact on the number of pediatric respiratory outpatient visits. The AQHI_r based on and outpatient visits for pediatric respiratory diseases can be a sensitive index to predict the effects of air pollution on children's respiratory health.

Objective: To investigate the retention rate and anticaries effects of pit and fissure sealant in the first permanent after 5 years among children in Henan Province. Methods: Random cluster sampling was used in 8 counties/districts of Henan Province that participated in the comprehensive intervention program for children s oral diseases in 2015. One project school was selected from each county, and two classes of sixth grade students were selected from each school. In the selected class, children who underwent pit and fissure sealing in the first permanent molars in 2015 were treated as the experimental group, and children who met the indications but did not undergo pit and fissure sealing were treated as the control group. The retention of sealant and caries in the first permanent molars were investigated. Results: After 5 years of pit and fissure sealing, the complete retention rate, partial retention rate and complete abscission rate were 15.84%, 55.32% and 28.84%, respectively. The incidence of caries in the experimental group (19.02%, 0.44±0.87) was lower than that in the control group (27.91%, 0.54±1.00) ( χ 2/t =11.98, 2.63, P <0.05). The caries reduction rate was 31.85%. The rate of net benefit was 8.59%. The higher the retention rate of sealant, the lower the incidence of caries ( χ 2=167.16, P <0.01). Conclusion The long term effect of the comprehensive intervention project on children s oral diseases in Henan Province is promising. Pit and fissure sealant can effectively prevent caries in children s first permanent molars.

Objective: To understand the changes of students nutritional status in the National Nutrition Improvement Program for Rural Compulsory Education Students (NNIPRCES) of Henan Province, and to provide scientific basis for designating scientific nutritional intervention measures. Methods: About 20%-30% of primary schools and middle schools in the pilot counties in Henan Province were selected to monitor the nutritional status of students. Surveillance data from 2012 to 2019 were analyzed. Results: From 2012 to 2019(no surveillance data were available in 2018), the detection rates of mild thinness were 4.0%, 3.3%, 3.3%, 3.6%, 3.1%, 2.9%, 4.4%, respectively; the detection rates of moderate and severe thinness were 4.5%, 4.5%, 4.4%, 4.6%, 3.9%, 3.6%, 5.1%, respectively; the detection rates of overweight were 9.6%, 12.4%, 12.3%, 12.2%, 12.7%, 13.4%, 11.1%, respectively; and the detection rates of obesity were 3.9%, 6.8%, 6.7%, 6.2%, 7.6%, 7.2%, 5.8%, respectively. The differences were statistically significant (χ 2=1 032.29, 4 771.39, P<0.05). The detection rates of 2019 mild (5.0%, 3.7%) and moderate to severe thinness (5.9%, 4.3%) were the highest for both male and female students, and the highest for primary school students and junior middle school students were the highest for 2019 mild (4.1%, 6.0%) and moderate to severe thinness (5.1%, 4.9%), with statistical significance (χ 2=653.22, 486.46, 919.07, 306.27, P<0.05). The detection rate of overweight was the highest in both males and females (14.8%, 11.8%) in 2017, and the detection rate of obesity was the highest in 2016 (8.3%, 6.9%). The detection rates of overweight and obesity in primary school students were the highest in 2017 and 2016 (13.7%, 8.4%), and the detection rates in middle school students were the highest in 2017 (11.5%, 3.0%), with statistical significance (χ 2=2 391.65, 2 371.74, 4 827.75, 512.64, P<0.05). Conclusion In the early stage of the implementation of NNIPRCES in Henan Province, malnutrition among students has improved, however, the contem porary malnutrition shows increasing trend, and the co occurrence of malnutrition and obesity calls for targeted nutritional intervention measures.

Objective: To analyze the prevalence of poor vision and eyeglass prescription, refractive examination among primary school students of grade 4-6 in Henan, so as to provide scientific basis for precise interventions for student vision health. Methods: A stratified cluster random sampling method was used to investigate a total of 29 187 students of grade 4-6 from 17 cities in Henan Province. Distant vision examination and questionnaire survey were conducted. Results: The overall prevalence of poor vision for grade 4-6 students in Henan was 63.6%, with girls (69.0%) higher than boys (59.0%),urban students (65.3%) higher than suburban students (62.5%)( χ 2=312.6, 23.6, P <0.01). The prevalence of severe poor vision was 28.5%.With the increase of grade, the detection rate of poor vision and severe poor vision increased( χ 2 trend =278.7, 775.4, P <0.01). Totally 13.2% of pupil did not have a visual examination in the past year. The rate of wearing glasses was 27.0% for students with poor eyesight and 3.2% for students with poor monocular eyesight. Totally 46.8% of the students wearing glasses received mydriatic optometry before wearing glasses. Conclusion The problem of poor vision among students of grade 4-6 in Henan is prominent, so it is necessary to strengthen eyesight monitoring and eye health education.