ObjectiveTo improve the quality and service performance of community visual health services in Shanghai, and to establish a set of reasonable and effective evaluation index system for community visual health services. MethodsCentered on the national and Shanghai-based visual health policies and based on the current status and development trends of community visual health service program in Shanghai, the candidate indicators were formed through literature review and expert interviews, firstly. The framework of an evaluation index system was formulated through qualitative research successively, which was further revised and perfected using the Delphi method. Coefficient weights were calculated using the analytic hierarchy process (AHP), culminating in the establishment of the community visual health evaluation index system, lastly. ResultsA total of 22 visual health experts from district-level center for disease control, hospital ophthalmology and leaders in charging of visual health service in community health centers participated in the Delphi questionnaire survey, with a questionnaire recovery rate of 100% and an expert authority coefficient of 0.86, indicating high credibility. After a round of correspondence to experts’ importance ratings and discussions, a comprehensive evaluation index system comprising 3 primary indicators, 12 secondary indicators, and 47 tertiary indicators, along with 5 additional indicators, was finalized. ConclusionAn index system tailored to effective evaluation for community visual health initiatives was drawn up in this study, which can promote the capacity building in community eye health services, facilitating the high-quality development of visual health courses, and enhancing residents’ eye health.

Near-surface ozone is a profoundly reactive and highly oxidizing gas and one of the critical respiratory toxicants. Numerous epidemiological investigations have indicated that asthmatic individuals are the vulnerable group of ozone exposure， and there is a strong correlation between ozone exposure and asthma morbidity and mortality rates. The potential mechanisms include oxidative stress， inflammatory response， autonomic nerve impairment， and immune dysfunction. The present study summarized and discussed the effect of ozone exposure on asthma and its underlying biological mechanisms in order to galvanize public cognizance concerning the perils of ozone pollution and serve as a reference for future research on ozone exposure and asthma.

Integrating evidence from animal experiments is a critical component of biomedical research, providing essential prior information for in-depth investigations of disease mechanisms and new drug development. Animal models have played an irreplaceable role in simulating human diseases. However, the integration of evidence from animal experiments has faced numerous challenges, including insufficient emphasis, significant heterogeneity in study designs, high publication bias, and discrepancies with clinical research practices. This paper first identifies existing issues in the original research evidence from animal experiments, such as the selection and applicability of animal models, considerations in the design of experimental studies, and factors influencing the translation of animal experimental evidence. It then discusses various methods for integrating this evidence, including systematic review and meta-analysis, overview of systematic review/umbrella review, scoping review, and evidence mapping, while highlighting recent advancements in their application. Finally, the paper addresses the main challenges currently encountered in the integration of evidence from animal experiments and proposes targeted improvement strategies aimed at enhancing the efficiency of translating research outcomes into clinical practice and promoting the advancement of evidence-based medicine. By continuously optimizing original experimental research protocols and evidence integration practices, this work aims to establish a more efficient and scientific environment for the synthesis of evidence from animal experiments, ultimately contributing to clinical trials and human health.

Objective To investigate the effect of intestinal mucosal Toll-like receptor 4/nuclear factor κB (TLR4/NF-κB) signaling pathway on renal damage in pseudo-sterile IgA nephropathy (IgAN) mice. Methods C57BL/6 mice were randomly divided into experimental group (pseudosterile mouse model group), control group (IgAN mouse model group), pseudosterile mouse blank group, and normal mouse blank group. Pseudosterile mice were established by intragastric administration of quadruple antibiotics once a day for 14 days. The pseudosterile IgAN mouse model was set up by combination of oral bovine serum albumin (BSA) administration and staphylococcal enterotoxin B (SEB) injection. The pathological changes of renal tissue were observed by immunofluorescence staining and PAS staining, and the intestinal mucosa barrier damage indicators lipopolysaccharide(LPS), soluble intercellular adhesion molecule 1(sICAM-1) and D-lactate(D-LAC) were analyzed by ELISA. Biochemical analysis was used to test 24 hour urine protein, serum creatinine and blood urea nitrogen. The mRNA and protein levels of Toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88) and nuclear factor κB (NF-κB) were detected by reverse transcription PCR and Western blot analysis. Results The kidney damage of pseudosterile IgAN mice was more severe than that of IgAN mice, and the expressions of intestinal mucosal barrier damage markers (LPS, sICAM-1 and D-LAC) were significantly increased in pseudosterile IgAN mice. In addition, the expressions of TLR4, MyD88, and NF-κB level were all up-regulated in the intestinal tissues of IgAN pseudosterile mice. Conclusion Intestinal flora disturbance leads to intestinal mucosal barrier damage and induces activation of TLR4 signaling pathway to mediate renal injury in IgAN.
Animals ; Mice ; Mice, Inbred C57BL ; Glomerulonephritis, IGA ; NF-kappa B ; Toll-Like Receptor 4/genetics* ; Lipopolysaccharides ; Myeloid Differentiation Factor 88/genetics* ; Kidney ; Intestinal Mucosa ; Infertility ; Disease Models, Animal

Objective:To explore the expression and clinical significance of ASB6 in colorectal cancer tissue.Methods:The cancer tissues and para-carcinoma tissues were selected from 106 patients with colorectal cancer admitted to the Department of Gastrointestinal Surgery, Third Affiliated Hospital of Shandong First Medical University from January 2015 to January 2018. Immunohistochemical method was used to detect the expression level of ASB6 protein in tissues, and the correlation between its expression and clinical pathological characteristics of patients was analyzed. At the same time, the expression of ASB6 mRNA in colorectal cancer tissues and para-carcinoma tissues was detected by quantitative real-time PCR (qRT-PCR). The Kaplan-Meier survival analysis method was used to explore the relationship between the expression of ASB6 and prognosis in colorectal cancer patients. The Cox regression model was used to analyze the independent prognostic factors of colorectal cancer patients.Results:The high expression rate of ASB6 in colorectal cancer tissues (67.9%, 72/106) was significantly higher than that in para-carcinoma tissues (10.4%, 11/106, χ2=73.67, P<0.001). Further analysis showed that the expression of ASB6 protein was significantly correlated with lymph node metastasis ( χ2=7.34, P=0.007) and TNM stage ( χ2=16.85, P<0.001). There was no significant correlation between the expression of ASB6 protein and age ( χ2=0.42, P=0.516), sex ( χ2=0.76, P=0.385), tumor size ( χ2=0.91, P=0.341), tumor location ( χ2=2.29, P=0.130), histological classification ( χ2<0.01, P>0.999), differentiation degree ( χ2=2.54, P=0.111) and distant metastasis ( χ2=3.38, P=0.066). qRT-PCR results showed that the expression level of ASB6 mRNA in colorectal cancer tissues was significantly higher than that in para-carcinoma tissues (5.37±0.13 vs. 3.39±0.09, t=-12.48, P<0.001). Kaplan-Meier survival analysis showed that the overall 5-year survival rates of patients in the ASB6 high expression group (72 cases) and the ASB6 low expression group (34 cases) were 45.8% and 73.5%, respectively ( χ2=6.82, P=0.009). Univariate survival analysis found that ASB6 protein expression ( HR=3.09, 95% CI: 1.25-7.65, P=0.015), lymph node metastasis ( HR=0.41, 95% CI: 0.21-0.82, P=0.011), distant metastasis ( HR=0.20, 95% CI: 0.10-0.42, P<0.001), and TNM stage ( HR=0.10, 95% CI: 0.03-0.32, P<0.001) were prognostic factors, while multivariate Cox survival analysis found that distant metastasis ( HR=0.22, 95% CI: 0.09-0.50, P<0.001) and TNM stage ( HR=0.25, 95% CI: 0.11-0.58, P<0.001) were independent prognostic factors. Conclusion:The expression of ASB6 in colorectal cancer tissues is significantly higher than that in para-carcinoma tissues, and the prognosis of patients with high expression of ASB6 is significantly worse than that of patients with low expression of ASB6. ASB6 can be used as an important indicator for early monitoring and postoperative survival assessment of colorectal cancer patients in the future.

Objective To investigate the recognition efficiency of AI model based on deep learning for cardiac conduction system(CCS).Methods HE staining sections of cardiac muscle and CCS of 17 cases of non-sudden death were selected,and the gold standard was unanimous recognition by 2 forensic pathologists with more than 20 years of CCS diagnosis experience.Inception V3 algorithm was used to establish AI model and complete CCS identification training and testing.Confusion matrix,accuracy,precision,recall,F1 score,ROC curve and AUC value were used to evaluate the effectiveness of AI model,and accuracy,sensitivity and specificity were used to evaluate the efficiency of manual independent and AI-assisted manual recognition for CCS.Results The accuracy of AI model was 87.3%,the precision was 91.9%,the recall was 81.9%,the F1 score was 86.6%,and the AUC value was 95.3%.The accuracy of AI model was higher than that of senior forensic pathologists.There was no statistical significance in the accuracy of AI-assisted senior forensic pathologists in identifying CCS compared with manual independent detection(P>0.05),while the accuracy of AI-assisted intermediate and junior forensic pathologists in identifying CCS was increased by 8%and 14.33%,respectively,with statistical significance(P<0.05).The accuracy rate of AI-assisted junior forensic pathologists to identify CCS was higher than that of intermediate forensic pathologists in self-diagnosis.Conclusion The AI model could be used for the automatic recognition of CCS,and could improve the diagnostic efficiency of CCS and narrow the gap between the forensic pathologists with low experience and that with high experience.

Objectives:To explore obesity prevalence and its association with dietary patterns among Tibetan pastoralists during the urbanization transition in Qinghai Province.Methods:Using an open cohort study design, 1 003 subjects were enrolled at baseline in 2018, 599 were followed up, and 1 012 were newly recruited in 2022. A total of 1 913 adults over 18 years were included in the study, and a questionnaire survey and health examination were conducted. Factor analysis was used to identify dietary patterns, and a mixed-effects model was used to analyze the association between dietary patterns and obesity.Results:From 2018 to 2022, the prevalence rates of overweight, obesity, and central obesity were 27.6%, 33.8%, and 54.6%, respectively. Age-sex-standardized prevalence of obesity and central obesity increased. Three dietary patterns were identified: the modern pattern was characterized by frequent consumption of pork, poultry, processed meat, fresh fruits, sugary drinks, salty snacks, etcetera; the urban pattern was characterized by frequent consumption of refined carbohydrates, beef and mutton, vegetables and eggs, etcetera; and pastoral pattern featured frequent consumption of tsamba, Tibetan cheese, buttered/milk tea, and whole-fat dairy products. After adjusting for demographic characteristics, socioeconomic status, and lifestyle factors, compared with the T1, subjects in the T3 of urban pattern scores were more likely to be overweight ( OR=2.09, 95% CI: 1.10-3.95) and overweight/obese ( OR=1.23, 95% CI: 1.00-1.51), whereas those in the T3 of pastoral pattern scores had a lower risk of overweight ( OR=0.45, 95% CI: 0.24-0.84), obesity ( OR=0.81, 95% CI: 0.69-0.95), overweight/obesity ( OR=0.75, 95% CI: 0.61-0.91) and central obesity ( OR=0.58, 95% CI: 0.38-0.89). Conclusions:Prevalence of obesity and central obesity was high among Tibetan pastoralists during the urbanization transition. Urban dietary pattern was a risk factor for overweight and overweight/obesity, whereas pastoral dietary pattern was a protective factor for overweight, obesity, overweight/obesity, and central obesity. Tailored interventions are needed to improve local people's health.