Objective: To understand the nutritional literacy level and associated factors of primary and secondary school students in Beijing, so as to provide a scientific basis for improving student nutrition. Methods: From October 2022 to May 2023, a multi stage cluster random sampling method was employed to select a total of 14 568 primary, junior and senior high school students from 16 districts (ecluding the Economic Technological Development area) in Beijing. Through a survey questionnaire on nutritional literacy and dietary hehavior of school age children, basic information as well as data on nutritional literacy levels across four dimensions:nutrition related knowledge concepts, food selection, food preparation, and food intake dimensions were obtained. The Wilcoxon rank sum test, Kruskal-Wallis test, Spearman correlation analysis, Chi square test and binary Logistic regression were used for the analysis. Results: The median total score of nutritional literacy among primary and secondary school students in Beijing was 68.8. Approximately 26.0% of primary and secondary school students achieved nutritional literacy standards. The median scores and rates of meeting the standards for nutrition related knowledge concepts, food selection, food preparation and food intake dimensions were 23.0, 42.1%; 17.0, 27.4%; 6.5, 33.5%; 23.0, 33.3%, respectively. There were positive correlations between all pairs of the four dimensions ( r=0.33-0.49, P <0.05). The results of multiple Logistic regression analysis showed that primary school students, junior high school students, female students, suburban students, caregivers with a college education level and a bachelor s degree or above were the positive arrelation factors that promoted the achievement of nutritional literacy standards ( OR =2.21, 1.39, 1.18, 1.27, 1.42, 1.66, P <0.05). Conclusion The literacy level of primary and secondary school students in Beijing needs to be significantly improved. School stage, gender, region and caregiver s education level are associated factors.

Objective:To analyze the distribution of different SF3B1 genotypes in patients with myelodysplastic syndromes (MDS) and its prognostic value.Methods:Totally, 377MDS patients who were initially diagnosed in the First Affiliated Hospital of Nanjing Medical University from January 2014 to January 2022 were included in the retrospective analysis.The patients were divided into three different groups according to mutation stcote of SF3B1, including 317 patients with SF3B1 wild type (SF3B1 WT) (214 males and 103 females, 63(49, 71) years old),39 patients with SF3B1 K700E mutation(SF3B1 K700E(17 males and 22 females, 65(52, 73)years old)) and 21 patients with SF3B1 non-K700E mutation(SF3B1 non-K700E)(13 males and 8 females, 67(63, 73) years old). MDS-related 20 gene mutations were detected using targeted sequencing technology; Survival curves were constructed by the Kaplan-Meier method; Cox proportional hazards model was established to evaluate different factors at diagnosis on survival by univariate and multivariate analyses.. Results:Compared with SF3B1 non-K700E patients, SF3B1 K700E patients had a higher median absolute neutrophil count ( P=0.002) and were likely to be in the low/int-1 International Prognostic Scoring System (IPSS) categories ( P=0.023). A 20-gene targeted sequencing analysis showed that, compared with SF3B1 WT patients, SF3B1 K700E patients were associated with lower frequency of ASXL1 and U2AF1 mutations ( P=0.018 and P=0.003); while compared with SF3B1 non-K700E patients, the frequency of ASXL1 mutation was significantly lower in SF3B1 K700E cases ( P=0.029). Patients with SF3B1 K700E had better overall survival (OS) in comparison with SF3B1 WT and SF3B1 non-K700E in MDS patients ( P<0.001 and P=0.045, respectively). In comparison with SF3B1 WT patients, SF3B1 MUT patients had more favorable OS and progression-free survival (PFS) in MDS without excess blasts ( P<0.001 and P<0.001, respectively), but no significant difference was found in MDS with excess blasts ( P>0.05). Compared with SF3B1 WT patients, SF3B1 K700E patients had superior OS and PFS in the int-1 IPSS category ( P=0.010 and P=0.013, respectively). By multivariable analysis, the presence of SF3B1 K700Ewas an independent predictor of superior OS ( HR=0.461,95% CI 0.262-0.811, P=0.007). Conclusion:SF3B1 K700E and SF3B1 non-K700E patients had significantly improved OS in comparison with SF3B1 WT MDS patients. Furthermore, SF3B1 K700E patients were associated with a better OS compared with SF3B1 non-K700E MDS patients. SF3B1 mutation could not overcome the poor prognostic effect of excess blasts, which highlights the importance of the SF3B1 mutation subtype in risk assessment of MDS without excess blasts.

Objective To observe the application effects of scenario simulation combined with guided feedback teaching method in the teaching of endocrinology nursing interns.Methods A total of 180 nursing students who interned in the endocri-nology department of Southern Medical University Shenzhen Hospital from January 2020 to January 2023 were selected as the re-search subjects.Using a digital randomization method,the students were divided into a control group(90 cases)and an observa-tion group(90 cases).The control group received conventional teaching,while the observation group received scenario-based teaching combined with guided feedback teaching method.The intern performance,satisfaction of teaching instructors toward students,and students'satisfaction with teaching instructors were compared between the two groups.Results The intern per-formance of the observation group was higher and showed a greater improvement after training,with statistically significant differ-ences(P＜0.05).Both the students'satisfaction with teaching instructors and the teaching instructors'satisfaction with students in the observation group were higher than those in the control group,with statistically significant differences(P＜0.05).Conclusion The application of scenario simulation combined with guided feedback teaching method in the teaching of endocri-nology nursing interns can significantly improve students'intern performance,providing a more scientific basis for nursing intern-ship teaching.

Objective:To analyze the epidemiological trends and major risk attribution of pancreatic cancer in China, Japan and South Korea from 1990 to 2019.Methods:The descriptive epidemiological method was conducted. The overall incidence rate, mortality rate, age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of pancreatic cancer in China, Japan and South Korea from 1990 to 2019 were collected from the Global Burden of Disease (GBD) Database. Age-standardized rates were calculated based on the worldwide standardized population structure provided by GBD Database 2019. Observation indicators: (1) incidence and motality of pancreatic cancer in China, Japan and South Korea in 2019; (2) age-period-cohort model analysis of incidence and mortality rates of pancreatic cancer in China, Japan and South Korea from 1990 to 2019; (3) trends of ASIR and ASMR of pancreatic cancer in China, Japan and South Korea from 1990 to 2019; (4) trends of major risk attribution of pancreatic cancer related death in China, Japan and South Korea from 1990 to 2019. Count data were represented as absolute numbers, percentages and ratios. Joinpoint V.4.7.0.0 software was used to calculate the annual percentage change (APC), the average annual percentage change (AAPC) of incidence and mortality rates of pancreatic cancer in different time periods and 95% confidence interval (95% CI). The age-period-cohort model in STATA V.15.0 software was used to analyze the influence of different ages, periods and birth cohorts on the risk of onset and death of pancreatic cancer after controlling the other two variables, with the risk effect size described as relative risk (95% CI). Results:(1) Incidence and motality of pancreatic cancer in China, Japan and South Korea in 2019. In 2019, the incidence rate of pancreatic cancer in China increased from 0.07/100,000 among 15-19 years old to 64.01/100,000 among 85-89 years old, with increasing from 0.09/100,000 to 94.71/100,000 in males and from 0.04/100,000 to 47.47/100,000 in females. The mortality rate of pancreatic cancer in China increased from 0.04/100,000 among 15-19 years old to 79.58/100,000 among 85-89 years old, with increasing from 0.05/100,000 to 116.50/100,000 in males and from 0.03/100,000 to 59.69/100,000 in females. The incidence rate of pancreatic cancer in Japan increased from 0.03/100,000 among 15-19 years old to 162.26/100,000 among 85-89 years old, with increasing from 0.03/100,000 to 177.67/100,000 in males and from 0.04/100,000 to 153.67/100,000 in females. The mortality rate of pancreatic cancer in Japan increased from 0.02/100,000 among 15-19 years old to 154.88/100,000 among 85-89 years old, with increasing from 0.02/100,000 to 170.93/100,000 in males and from 0.02/100,000 to 145.94/100,000 in females. The incidence rate of pancreatic cancer in South Korea increased from 0.04/100,000 among 15-19 years old to 136.78/100,000 among 85-89 years old, with increasing from 0.03/100,000 to 153.78/100,000 in males and from 0.04/100,000 to 129.73/100,000 in females. The mortality rate of pancreatic cancer in South Korea increased from 0.02/100,000 among 15-19 years old to 135.98/100,000 among 85-89 years old, with increasing from 0.02/100,000 to 156.21/100,000 in males and from 0.02/100,000 to 127.59/100,000 in females. The peak incidence and mortality of pancreatic cancer in China were found in males aged 65-69 years, and the overall incidence and mortality of males in different age groups were higher than those of females in the same age group. In Japan, the peak incidence of pancreatic cancer occurred in females aged 80-84 years and the peak mortality occurred in males aged 75-79 years. The morbidity and mortality of males aged <80 years were higher than those of females in the same age group, while the morbidity and mortality of males aged ≥80 years were lower than those of females in the same age group. In South Korea, the peak incidence of pancreatic cancer occurred in females aged 80-84 years, and the peak mortality occurred in males aged 70-74 years. The morbidity and mortality of males aged <75 years were higher than those of females in the same age group, while the morbidity and mortality of males aged ≥75 years were lower than those of females in the same age group. (2) Age-period-cohort model analysis of incidence and mortality rates of pancreatic cancer in China, Japan and South Korea from 1990 to 2019. Age effect: after adjustment for the period and cohort effects, the risk of incidence and mortality rates of pancreatic cancer in both males and females of China, Japan and South Korea increased with age, which is more obvious in females than males, and more obvious in Japanese than Chinese and Korean populations. Period effect: after adjustment for age and cohort effects, the risk of incidence and mortality rates of pancreatic cancer in both males and females of China, Japan and South Korea increased from 1990 to 2019, with the period effect more significant in the Chinese population. Cohort effect: after adjustment for age and period effects, the risk of morbidity and mortality rates of pancreatic cancer decreased with the passage of birth cohort in China, Japan and South Korea. (3) Trends of ASIR and ASMR of pancreatic cancer in China, Japan and South Korea from 1990 to 2019. The ASIR and ASMR of pancreatic cancer in China increased yearly from 1990 to 2019, and the ASIR and ASMR in 2019 were 1.82 times and 1.79 times those in 1990, respectively. The ASIR and ASMR of pancreatic cancer in Japan showed a slowly increasing trend, and the ASIR and ASMR in 2019 were 1.09 times and 1.05 times those in 1990, respectively. The ASIR and ASMR of pancreatic cancer in South Korea increased firstly, then decreased, and slowly increased. From 1990 to 2019, the AAPC of ASIR of pancreatic cancer in China was 2.08% (95% CI as 1.91% to 2.24%, P<0.05) and AAPC of ASMR was 2.02% (95% CI as 1.86% to 2.19%, P<0.05). The AAPC of ASIR of pancreatic cancer in Japan was 0.28% (95% CI as 0.15% to 0.42%, P<0.05) and AAPC of ASMR was 0.13% (95% CI as 0.03% to 0.24%, P<0.05). The AAPC of ASIR of pancreatic cancer in South Korea was 0.50% (95% CI as 0.21% to 0.80%, P<0.05) and AAPC of ASMR was 0.15% (95% CI as -0.10% to 0.40%, P>0.05). (4) Trends of major risk attribution of pancreatic cancer related death in China, Japan and South Korea from 1990 to 2019. The main risk factors for pancreatic cancer related death in China, Japan and South Korea from 1990 to 2019 were smoking, high fasting glucose and high body mass index (BMI). The trend of pancreatic cancer related death, mainly attributed to smoking, showed that the proportion of Chinese males increased from 31.4% in 1990 to 34.1% in 2000, then decreased to 31.1% in 2015, and then showed a slow increase to 31.7% in 2019. The proportion of Chinese females increased from 6.7% in 1990 to 10.4% in 2005 and then dropped to 8.7% in 2019. The proportion of Japanese males decreased from 38.8% in 1990 to 26.9% in 2019 and the proportion of Japanese females decreased from 20.9% in 1990 to 14.8% in 2019. The proportion of South Korean males decreased from 37.5% in 1990 to 30.3% in 2019 and the proportion of South Korean females decreased from 12.6% in 1990 to 10.0% in 2019. The trend of pancreatic cancer related death proportion, mainly attributed to high fasting blood glucose, showed that the proportion of Chinese males increased from 5.9% in 1990 to 7.1% in 2019 and the propor-tion of Chinese females increased from 6.2% in 1990 to 6.8% in 2019. The proportion of Japanese males increased from 7.0% in 1990 to 7.7% in 2019 and the proportion of females increased from 5.0% in 1990 to 5.5% in 2019. The proportion of South Korean males increased from 6.8% in 1990 to 9.7% in 2019 and the proportion of females increased from 6.1% in 1990 to 8.2% in 2019. The trend of pancreatic cancer related deaths proportion, attributed mainly to high BMI, showed that the proportion of Chinese males increased from 1.3% in 1990 to 3.0% in 2019 and the proportion of females increased from 2.1% in 1990 to 4.3% in 2019. The proportion of Japanese males increased from 2.0% in 1990 to 2.4% in 2019 and the proportion of females increased from 3.1% in 1990 to 3.4% in 2019. The proportion of South Korean males increased from 1.9% in 1990 to 3.1% in 2019 and the proportion of females increased from 3.4% in 1990 to 4.3% in 2019. Conclusions:The incidence of pancreatic cancer in China may continue to rise but to be stable in Japan and South Korea. The incidence of pancreatic cancer in females, especially elderly women, needs more attention. Smoking remains the most critical risk factor for pancreatic cancer. More attention should also be paid to the increased risk of pancreatic cancer associated with high BMI and high fasting plasma glucose.

Objective:To investigate the predictive value of plasma lipocalin-2 (LCN2) for the clinical outcome of patients with acute minor ischemic stroke (MIS).Methods:Consecutive patients with acute MIS admitted to the Department of Neurology, Shengze Hospital Affiliated to Nanjing Medical University from October 9, 2017 to August 17, 2018 were selected prospectively. On the day of admission, the National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the degree of neurological impairment. The modified Rankin Scale was used to evaluate the clinical outcome at 90 d after the onset, and 0-1 was defined as a good outcome. Multivariate logistic regression model was used to analyze the correlation between plasma LCN2 and clinical outcome. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of plasma LCN2 for the clinical outcome of patients. Results:A total of 71 patients (68.99±11.24 years old) were enrolled in the study. Forty-six patients were male (64.8%). The median plasma LCN2 was 117.7 μg/L (interquartile range, 61.2-738.4 μg/L). Fifty-six patients (78.9%) had good outcomes, and 15 (21.1%) had poor outcomes. The age, baseline NIHSS score, plasma C-reactive protein and LCN2 of the good outcome group were significantly lower than those of the poor outcome group (all P<0.05). Multivariate logistic regression analysis showed that plasma LCN2 ≤117.7 μg/L (odds ratio 8.574, 95% confidence interval 1.755-41.874; P=0.008) and lower baseline NIHSS scores (for increasing by 1 point: odds ratio 0.396, 95% confidence interval 0.214-0.732; P=0.003) were independently related to good outcome. ROC curve analysis showed that the area under the curve for plasma LCN2 to predict a good outcome was 0.814 (95% confidence interval 0.709-0.918); the best cut-off value was 128.55 μg/L, and the corresponding sensitivity and specificity were 69.6% and 80.0%, respectively. Conclusions:Plasma LCN2 had a good predictive value for the clinical outcome of patients with acute MIS at 90 d after the onset.

Objective:To compare and analyze the calcification characteristics and diagnostic efficiency of different breast lesion types using digtal breast tomosynthesis (DBT) and full-field digital mammography (FFDM).Methods:Totally 1 263 patients who underwent both DBT and FFDM at the same time from January 2015 to December 2018 in Dahua Hospital, Xuhui district, Shanghai were analyzed retrospectively. Benign and malignant calcification should be confirmed by pathology or a follow-up of 24 months or more using mammography, and the results of DBT and FFDM were taken as a gold standard. The detection rate and diagnostic efficiency of different types of benign and malignant breast calcification with the two methods were compared and analyzed. The detection rate of morphology and distribution of malignant calcification were compared among groups.Results:There were 240 cases with non-dense breast including 56 cases with benign calcification and 13 cases with malignant calcification. Meanwhile, there were 1 023 cases with dense breast, including 356 cases with benign calcification and 63 cases with malignant calcification. In the cases of non-dense breast, the detection rates of benign calcification by DBT and FFDM were 22.9% (55/240) and 21.7% (52/240), whereas the rates of malignant calcification were 5.0% (12/240) and 4.6% (11/240), all without statistically significances（χ2=0.108, 0.046, P>0.05). No significant differences were observed in the morphology and distribution of malignant calcification detection rates ( P>0.05). In the cases of dense breast, the benign calcification detection rates by DBT and FFDM were 34.2% (350/1 023) and 31.9% (326/1 023), whereas the detection rates of malignant calcification were 6.0% (61/1 023) and 4.9% (50/1 023), all without statistically significances (χ2=1.273 and 1.153, P>0.05). DBT detected more cases of amorphous and cluster distribution of malignant calcification than FFDM, with statistically significant differences (χ2=12.921 and 11.667, P<0.05). The area under ROC curve of DBT and FFDM in diagnosis of non-dense breast were 0.993 and 0.992, and 0.987 and 0.964 in dense breast, respectively, with no significant differences ( Z= 0.136 and 1.391, P>0.05). Conclusions:Compared with FFDM, DBT shows no statistical difference in the diagnostic efficiency of breast calcification. However, it has certain advantages in detecting malignant, amorphous, and clustered calcification in dense breast. DBT has a potential to improve the accuracy of BI-RADS classification of breast calcification.

Objective: To investigate and analyze the amount and the type of fluid intake in spring among male college athletics in a university in Beijing, and to provide scientific basis and reference data for fluid intake-related education and formulating adequate water intake. Methods: A simple random sampling method was used to select 109 male sports crowd from a college in Beijing. The information on amount and types of fluid intake were recorded using the validated 7-day fluid specific diary. Results: The median amount of daily fluid intake among participants was 1 789 mL. The number of participants who reached the amount of adequate water intake for Chinese adult residents 60, which accounted for 55.1% of the total participants. There was difference on the amount of fluid intake among different participants after grouped by the quartiles of exercise consumption(χ2=9.20, P=0.03). There were also differences in the percentage of fluid intake reaching the recommended amount on adequate water intake(χ2=18.27, P=0.04). The median amount of plain water, dairy products, sports beverages, and other sugary beverages were 1 180, 40, 65, and 383 mL, respectively; which accounted for 67.1%, 2.2%, 3.7%, and 22.2% of daily fluid intake. There was difference on the amount of sports beverages among different participants after grouped by the quartiles of BF%(χ2=8.59, P=0.04). There was difference on the amount of sports beverages (χ2=8.25, P=0.00) and other sugar-sweetened beverages (χ2=8.57, P=0.02) among different participants after grouped by the quartiles of energy expenditure. Conclusion Among male sports population in a university in Beijing, the amount of fluid intake differed among different participants after grouped by the quartiles of exercise consumption. As the exercise consumption of participants increased, the water consumption increased. Participants mainly drink plain water, and there were differences on the types of fluid intake among participants with different BF% and different energy expenditure.

Objective: To understand the knowledge, attitudes and practices of drinking water among college students of Hebei Province, to provide evidence for health education. Methods: A total of 715 subjects were selected from a university in Baoding City, Hebei Province in March 2017 by random cluster sampling. Knowledge, attitude and behavior of drinking water among college students were investigated by self-designed questionnaires. Results: The awareness rate of water consumption of 1 500-1 700 mL was 19.0%, the awareness rate of drinking modes was 95.0%, the awareness rate of suitable drinking time was 30.1%, the awareness rate on drinking water was higher among girls and medical major sutdents (χ2=22.16, 12.49, P<0.05); the awareness rate on the relationship between insufficient drinking water and stroke, hypertension and coronary heart disease was generally low, with sophornore higher than freshman (χ2=11.10, P<0.05). The most common medium for accessing drinking water knowledge among the respondents was network (60.0%), followed by campus publicity/classroom teaching (48.3%). 99.6% of the respondents believed that drinking water was important to health, 98.3% were willing to change their drinking habits, 93.0% were willing to pay attention to drinking water education, and the proportion of female students was higher than that of male students (χ2=5.46, 6.49, 8.01, P<0.05). In real life, 48.4% of the respondents drank water on an empty stomach in the morning and 40.7% before going to bed. 45.5% of the respondents drank water when they thought of it. Conclusion College students in Hebei province are generally lack of appropriate awareness on water drinking, which varied in sex, grade and major. While the attitude towards water drinking is satisfactory, drinking behavior need to be improved.

Objective: To investigate and analyze the fluids intake, urine output and hydration status during spring among male college athletics from one university in Beijing, and to provide scientific evidence for launching targeted health education. Methods: A simple random sampling method was used to select 109 male students in college with habit of exercise.Total drinking fluids was assessed by 7-day 24-hour fluid intake questionnaire. The water from food was assessed by the duplicate portion method and the weight method. The urine samples of 24-hour was collected for 3 consecutive days, and the volume, osmolality and specific gravity of urine were measured. The energy expenditure in exercise was estimated by using the exercise plan. Results: The median drinking fluids intake, water from food, total fluids intake and urine volume were 1 789, 955, 2 701, 850 mL/d, respectively. 15.6% of the subjects were in proper hydration status, and 43.1% of the subjects were in dehydration. The differences between drinking fluids intake, water from food, total fluids intake and urine volume of subjects in the different BMI and BF% levels were not significant(P>0.05). The differences between drinking fluids intake and total fluids intake of subjects in the different energy expenditure in exercise levels were significant(χ2=9.20, 8.43, P<0.05). Conclusion Comparing with the normal college students, the drinking fluids intake and total fluids intake of male sports people were higher, the volume of urine was lower, and the hydration status was worse. The targeted health education about water intake was recommended.

OBJECTIVE：To preliminarily optimize the preparation technology of Ligustrazine pellicle ，and to study its in vitro percutaneous permeation characteristics. METHODS ：With the amounts of PVA- 124，ethyl alcohol ，glycerin，tween-80 and azone as factors ，single factor experiment was used to optimize the Ligustrazine pellicle matrix formulation ；modified scoring standard was used to evaluate the film formation time ，film formation ability ，ductility，uniformity and the presence of bubble. On the basis of the optimal matrix formulation ，the pellicle with different loading amount of ligustrazine （300，250，200，150，100，50 mg/mL） was prepared and its maximum loading amount was investigated. HPLC method was adopted to determine the content of ligustrazine，and methodology investigation was conducted. Isolated back skin of rats were collected ，the percutaneous permeation test was conducted for high ，medium and low loading amount （100，75，50 mg/mL）of Ligustrazine pellicle. At 15，30，45，60， 75，90，120，150，180 min，the sample was taken and the permeation rate of ligustrazine was calculated. RESULTS ：When the amounts of PVA- 124，ethyl alcohol，glycerin，tween-80 and azone were 2.5 g，7.0 mL，1.97 mL，0.07 mL，0.28 mL（in terms of 50 mL formulation amount ），the optimal matrix formulation of Ligustrazine pellicle was obtained. The maximum drug loading amount of ligustrazine was 100 mg/mL. The linear ranges of ligustrazine was 3.125-100 μg/mL. The specificity，precision， reproducibility，recovery and stability investigation of content determination method of ligustrazine were all in line with the requirements（RSD＜2％）. The permeation rate of high ，medium and low loading amount of Ligustrazine pellicle were 608.42， 384.19，158.20 μg（/ cm2·h）. CONCLUSIONS ：According to the optimized formulation ，the prepared Ligustrazine pellicle had a short film forming time ，stable and re liable quality ； the drug-loading amount was up to 100 mg/mL. The pellicle with drug-loading amount of 75 mg/mL had reached the penetration rate range of effective plasma concentration of ligustrazine treatment.