Objective: To understand the current situation of academic burnout among primary and middle school students and to explore its associated factors, so as to provide a scientific guidance and preventing and amelioration academic burnout among primary and middle school students. Methods: Between September and October 2023, a total of 10 474 primary and middle school students residing in Wuxi City participated in a questionnaire survey and physical examination conducted through stratified cluster random sampling. Latent profile analysis was used to classify academic burnout among primary and middle school students. Furthermore, differences in the types of academic burnout among children and adolescents with varying characteristics were examined using the Chi square test. Additionally, multinomial Logistic regression analysis was utilized to identify the associated factors for academic burnout. Results: The academic burnout of primary and middle school students was divided into 4 categories:no/light academic burnout group(43.6%),physical and mental exhaustion group (32.9%), low achievement group(15.0%), high physical and mental exhaustion/high academic burnout group(8.5%). Middle and high school students, boys, not living with parents, smoking, daily screen time ≥2 hours, suffering from campus bullying, sometimes/often subjected to cyber attacks, abused by parents were more likely to have high physical and mental exhaustion/high academic alienation among primary and middle school students ( OR=1.70, 1.42, 1.56, 1.56, 2.31, 1.48, 2.94, 3.03, 5.94, 2.08, P <0.01). Conclusions The phenomenon of academic burnout among primary and middle school students is prominent. And targeted intervention measures shoould be actively taken to prevent and reduce the occurrence of academic burnout among primary and middle school students.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

We reported the discovery of six novel coumarins, toddasirins A-F (1-6), each endowed with modified isoprenyl or geranyl side chains, derived from the roots of Toddalia asiatica. Comprehensive structural elucidation was achieved through multispectroscopic analyses, single-crystal X-ray diffraction experiments, and advanced quantum mechanical electronic circular dichroism (ECD) calculations. Furthermore, the anti-inflammatory activity of these compounds was assessed. Notably, compounds 1-3 and 6 demonstrated notable inhibitory effects on nitric oxide (NO) production in lipopolysaccharide (LPS)-induced RAW 264.7 cells, with 50% inhibitory concentration (IC₅₀) values of 3.22, 4.78, 8.90, and 4.31 μmol·L^-1, respectively.
Mice ; Animals ; Coumarins/chemistry* ; Rutaceae/chemistry* ; Anti-Inflammatory Agents/pharmacology* ; Plant Extracts/chemistry* ; RAW 264.7 Cells ; Nitric Oxide ; Molecular Structure

Objectives:To investigate the clinical and genetic features of young Chinese patients with myeloproliferative neoplasms (MPN) .Methods:In this cross-sectional study, anonymous questionnaires were distributed to patients with MPN patients nationwide. The respondents were divided into 3 groups based on their age at diagnosis: young (≤40 years) , middle-aged (41-60 years) , and elderly (>60 years) . We compared the clinical and genetic characteristics of three groups of MPN patients.Results:1727 assessable questionnaires were collected. There were 453 (26.2%) young respondents with MPNs, including 274 with essential thrombocythemia (ET) , 80 with polycythemia vera (PV) , and 99 with myelofibrosis. Among the young group, 178 (39.3%) were male, and the median age was 31 (18-40) years. In comparison to middle-aged and elderly respondents, young respondents with MPN were more likely to present with a higher proportion of unmarried status (all P<0.001) , a higher education level (all P<0.001) , less comorbidity (ies) , fewer medications (all P<0.001) , and low-risk stratification (all P<0.001) . Younger respondents experienced headache (ET, P<0.001; PV, P=0.007; MF, P=0.001) at diagnosis, had splenomegaly at diagnosis (PV, P<0.001) , and survey (ET, P=0.052; PV, P=0.063) . Younger respondents had fewer thrombotic events at diagnosis (ET, P<0.001; PV, P=0.011) and during the survey (ET, P<0.001; PV, P=0.003) . JAK2 mutations were found in fewer young people (ET, P<0.001; PV, P<0.001; MF, P=0.013) ; however, CALR mutations were found in more young people (ET, P<0.001; MF, P=0.015) . Furthermore, mutations in non-driver genes (ET, P=0.042; PV, P=0.043; MF, P=0.004) and high-molecular risk mutations (ET, P=0.024; PV, P=0.023; MF, P=0.001) were found in fewer young respondents. Conclusion:Compared with middle-aged and elderly patients, young patients with MPN had unique clinical and genetic characteristics.

8-hydroxy-2'-deoxyguanosine (8-OHdG) is a sensitive and stable biomarker for evaluating DNA oxidative damage. A rapid and sensitive colloidal gold immunochromatographic strip was developed for 8-OHdG detection by a competitive method. The sample pad (glass cellulose film), bonding pad (glass cellulose film), nitrocellulose film and absorbent pad were pasted on the polyvinyl chloride (PVC) base plate to construct the test strip. Colloidal gold (AuNPs) was prepared by the reduction of chloroauric acid with sodium citrate. 8-OHdG antibody (Ab) was coated on the outer layer of AuNPs to form Ab@AuNPs as a probe. Bovine serum albumin (BSA) and 8-OHdG were conjugated with carbodiimide hydrochloride to prepare an artificial antigen, which was used as the coating antigen of detection line. Goat anti mouse polyclonal antibody IgG was used as the coating antibody of control line. The experimental parameters were optimized including the type of nitrocellulose membrane, the formula of loading solution, and the spraying amount of gold labeled antibody. The results showed that the appropriate nitrocellulose membrane was CN 95. The optimal loading solution included BSA (1%), Tween-20 (3%), sucrose (3%) and NaCl (0.9%). The optimal spraying amount of gold labeled antibody was 4 μL. 8-OHdG can be detected by the strip under visible light, and the level of 8-OHdG in urine can be preliminarily determined by comparing the color intensity of T line and C line. The 8-OHdG concentration in urine was further calculated by the gray value of T line and the threshold of detection was 2.55 μg/L. This colloidal gold immunochromatographic strip is simple, rapid and specific for detecting 8-OHdG in human urine to preliminarily evaluate the human status.
8-Hydroxy-2'-Deoxyguanosine ; Animals ; Antibodies, Monoclonal ; Gold ; Gold Colloid/chemistry* ; Metal Nanoparticles ; Mice ; Sensitivity and Specificity

Objectives:To explore health-related quality of life (HRQoL) and identify its associated variables in Chinese patients with Philadelphia-negative myeloproliferative neoplasms (MPNs) .Methods:In this cross-sectional study, anonymous questionnaires were distributed to adult patients with MPNs to assess symptom burden measured by MPN-10 and HRQoL measured by Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) .Results:The data from 1405 respondents with MPNs, including 645 (45.9%) with essential thrombocythemia (ET) , 297 (21.1%) with polycythemia vera (PV) , and 463 (33.0%) with myelofibrosis (MF) , were analyzed. 646 (46.0%) respondents were male. The median age was 56 (range, 18-99) years. The mean MPN-10 scores were 13.0±12.7, 15.0±14.7, and 21.0±16.6 ( P<0.001) , and the physical component summary (PCS) and mental component summary (MCS) scores were 48.0±8.5, 47.0±9.0, and 42.0±10.0 ( P<0.001) and 51.0±11.0, 50.0±10.8, and 49.0±11.1 ( P=0.002) for respondents with ET, PV, and MF, respectively. Respondents with MF reported the lowest score of physical functioning, role functioning, emotional functioning, cognitive functioning, social function, and global health status (all P<0.01) and the highest score of fatigue, pain, dyspnea, appetite loss, diarrhea, and financial problems (all P<0.05) in EORTC QLQ-C30. Multivariate analyses revealed that higher MPN-10 scores were significantly associated with lower PCS (-0.220 to -0.277, P<0.001) and MCS (-0.244 to -0.329, P<0.001) scores; increasing age (-1.923 to -4.869; all P<0.05) , lower PCS score. Additionally, comorbidity (ies) , symptom at diagnosis, splenomegaly, anemia, unknown driver gene, and higher annual out-of-pocket cost were significantly associated with lower PCS and/or MCS scores. However, age ≥ 60 years, urban household registration, concomitant medication, and receiving ruxolitinib therapy in respondents with MF were associated with higher MCS scores. Weak correlations were found between MPN-10 score (except the subscale of appetite loss and constipation) and EORTC QLQ-C30 score in majority of subscales in respondents with ET (| r| = 0.193-0.457, all P<0.001) , PV (| r| = 0.192-0.529, all P<0.01) , and MF (| r| = 0.180-0.488, all P<0.001) , respectively. Conclusions:HRQoL in patients with MPN was significantly reduced, especially in patients with MF. Sociodemographic and clinical variables were significantly associated with the HRQoL in patients with MPNs.

Objective:To analyze levels of carnitine and acylcarnitine in peripheral blood from septic infants and to investigate their changes and clinical values in sepsis in infants.Methods:This retrospective research involved 46 septic infants and 55 infants with noninfectious diseases who were hospitalized in Xinhua Hospital, Shanghai Jiao Tong University School of Medicine.The clinical data were collected, the levels of carnitine and acylcarnitine in peripheral blood measured by tandem mass spectrometry were compared between the two groups, and the correlations of acylcarnitine levels with CRP and PCT were analyzed respectively.The septic infants were divided into two groups according to whether there were complications or not.The levels of free carnitine and acylcarnitine were compared between the two groups.Results:The levels of C6DC, C14: 1, C14OH and C16OH in peripheral blood were significantly higher in septic infants than those with noninfectious diseases( Z=-2.52、-2.05、-2.68、-2.82, all P<0.05). There is no significant difference in free carnitine level between two groups.These four acylcarnitine levels were positively correlated with PCT( r=0.44、0.44、0.40、0.49, all P<0.01). In septic group, the percent of infants with abnormal levels of C16OH was significantly higher in infants with complications than those without complications( χ2=4.51, P<0.05). Conclusion:The peripheral blood levels of several acylcarnitine elevate in septic infants, and have positive correlations with the strength of infection.Meanwhile, there is a higher proportion of having abnormal level of long chain acylcarnitine among infants with complications than those without complications.These results suggest that lipid metabolism has changed in septic infants and detecting acylcarnitine levels can be helpful in assessing the severity of sepsis.

Current studies have found that breast milk contains multiple growth factors with important biological functions, which play an important role in growth and immune regulation in early life.Epidermal growth factor(EGF)can promote the proliferation and differentiation of neonatal gastrointestinal mucosa epithelium, and can prevent the development of necrotizing colitis.Transforming growth factors(TGF)include transforming growth factor α and transforming growth factor β.Transforming growth factor α is related to gastrointestinal function, while transforming growth factor β promotes IgA production and has immunomodulatory effect.Hepatocyte growth factor(HGF)can not only promote gastrointestinal tract development as a nutritional factor, but also may work as an immune factor to enhance immunity.Neurotrophic factors promote early neurogenesis in the offspring of preeclampsia mothers.At the same time, the content of these growth factors in breast milk is related to the gestational age, region, diet and other factors.This article summarizes the research progress and clinical application value of these growth factors.

Objective: To develop and evaluate an automatic intensity-modulated radiation therapy (IMRT) program for cervical cancer based on a database of overlap volume histogram (OVH) and high-quality cervical IMRT plans for previously-treated patients. Methods: A database consisting of high-quality IMRT plans and OVHs from 200 cervical cancer patients was established. OVHs of another 26 cervical cancer patients were converted into gray level images to calculate the image similarity compared with those from the database. The planning optimization function of the patients from the database with the highest image similarity was selected and inherent Pinnacle³ scripts were utilized to automatically generate IMRT plan. Finally, the dosimetric parameters, plan quality and design time were statistically compared between the automatic and manual plans. Results: The target coverage, conformity index and homogeneity index did not significantly differ between two plans (all P>0.05). The V₄₀, V₄₅ and mean dose for the rectum in the automatic plans were significantly decreased by 6.1%, 1.3% and 50.7 cGy than those in the manual plans (all P<0.05). Compared with the manual plans, the mean dose for the intestine and femur in the automatic plans were significantly reduced by 31.7 cGy and 188.9 cGy (both P<0.05), whereas the mean dose for the ilium was slightly decreased by 92.3 cGy in the automatic plans (P>0.05). The plan design time was shortened by 71% in the automatic plans. Conclusions The automatic IMRT plans based on a database of OVH and high-quality IMRT plans can not only significantly shorten the plan design time, but also reduce the irradiated dose of normal tissues without compromising the target coverage and conformity index.

Objective: To investigate the effect of leading health education path on the clinical nursing of patients with atlantoaxial fracture. Methods: A retrospective case control study was conducted to analyze 38 patients with atlantoaxial fractures admitted to our hospital from January 2017 to February 2018. There were 31 males and 7 females, aged 21-65 years [(49.6±12.5)years]. In the control group, there were 15 males and four females, aged 25-63 years [(48.6±15.3)years]. All patients underwent posterior atlantoaxial pedicle screw fixation. Among the patients in control group, there were eight with atlas fracture, four with axial fracture, and seven with atlantoaxial fracture, of which there were five patients of grade C and 14 of grade D according to the American Spinal Injury Association (ASIA) score. There were 16 males and three females, aged 21-62 years [(51.2±12.3)years] in the study group which adopted the leading health education path to provide patients step by step with knowledge of atlantoaxial fracture. In the study group, there were seven patients with atlas fracture, six with axial fracture, and six with atlantoaxial fracture, of which there were seven patients of grade C and 12 patients of grade D based on ASIA. The visual analogue score (VAS) at 1 week and 1 month after operation, Japanese Orthopedic Association (JOA) score at 1 and 6 months after operation, related knowledge mastery, nursing satisfaction, complication incidence, and ASIA grading improvement were compared between the two groups. Results: The VAS was (2.1±1.3)points at one week after operation and (1.1±0.6)points at one month after operation in the study group, lower than those of control group [(3.4±2.4)points and (2.1±1.2)points] (P<0.05). The JOA score of the study group was (15.9±1.5)points, higher than that of the control group [(14.7±1.3)points] (P<0.05). The scores of knowledge mastery including basic knowledge, appropriate medication, complications prevention and functional exercise were (23.2±2.4)points, (24.1±1.7)points, (21.5±3.1)points and (22.8±1.6)points respectively in the study group, all of which were higher than those of control group [(14.4±3.1)points, (12.9±2.1)points, (15.4±4.3)points and (13.4±3.5)points] (P<0.05). The satisfaction with nursing in the study group was also higher than that of the control group (P<0.05). In the study group, one patient (5%) had pulmonary infection, and in the control group nine patients (47%) had complications including two with lower extremity vein embolism, four with urinary tract infection, two with pulmonary infection, and one with pressure injury (P<0.05). In the study group, there was one patient of grade C, five of grade D and 13 of Grade E according to ASIA; in the control group, there were two of grade C, six of grade D and 11 of Grade E (P>0.05). Conclusion The leading health education path for patients with atlantoaxial fracture to adopt staged treatment guidance is conducive to relieving pain and improving cervical function, reducing the incidence of complications, and deepening the mastery of relevant knowledge.