Objective: To explore the prevalence of elevated blood pressure and overweight/obesity and their comorbidities among Tibetan middle school students in Lhasa, and to analyze their association with lifestyle and other factors, so as to provide a basis for the intervention measures targeting elevated blood pressure, overweight and obesity among middle school students in high altitude area. Methods: Using a stratified cluster random sampling method in September 2021, a total of 1 488 Tibetan junior and high students from Lhasa City were investigated with blood pressure measurement, physical examination and questionnaire survey. The influencing factors of elevated blood pressure, overweight and obesity and their comorbidities association were analyzed by multivariate Logistic regression. Results: The prevalence of elevated blood pressure, overweight/obesity and their comorbidities were 17.8%, 17.4% , 5.0% respectively. Multivariate Logistic regression analysis showed that age( OR =0.81), residence, body mass inex(BMI) and gender were the influencing factors of elevated blood pressure; and the risks of elevated blood pressure in female students were higher than male students ( OR =1.89), suburban students were higher than urban students ( OR =8.06), overweight and obesity groups were higher than normal groups ( OR =2.55, 2.87) ( P <0.05). Adjusting for confounding factors such as gender, residence and school, and BMI (only for elevated blood pressure), daily screen time ≥2 h was positively correlated with elevated blood pressure, overweight/obesity and its comorbidities ( OR =1.56, 1.59 , 2.51) ( P <0.05). Conclusions The prevalence of elevated blood pressure, overweight/obesity are relatively high in Lhasa. Longer screen time is a common factor affecting with elevated blood pressure, overweight/obesity and comorbidities among Tibetan students. Measures should be taken intervene in the lifestyle of Tibetan students, in order to reduce elevated blood pressure and overweight/obesity.

Objective:To explore the mechanism of kidney-protecting spirit pill for the treatment of diabetic nephropathy(DN)based on the network pharmacology and molecular docking technology.Methods:The database of TCMSP and Swiss Target Prediction was searched to obtain the active ingredients and targets of kidney-protecting spirit pill,and the intersection with the disease targets was obtained.The protein-protein interaction(PPI)network of intersection targets was constructed,GO and KEGG enrichment were analyzed.The key targets and small molecules were obtained and their interactions were verified by molecular docking.Results:A total of 60 active ingredients and 112 therapeutic DN targets were predicted.The key components were Cerevisterol,3,9-di-O-methylnissolin,Jaranol,Palmidin A and 16α-Hydroxydehydrotrametenolic acid.The key targets were PIK3CA,MAPK1,AKT1,PIK3R1 and BCL2,which were closely related to cancer-related pathways,AGE-RAGE signaling pathway,endocrine resistance,lipids and atherosclerosis pathways in diabetic complications.Conclusion:The mechanism of kidney-protecting spirit pill in the treatment of DN is characterized by multi-components,multi-targets and multi-pathways,with synergistic effects between the herbs,which provides a basis for the study of the pharmacological effects of kidney-protecting spirit pill.

Hereditary hemochromatosis is a rare autosomal genetic disorder that can cause multi-organ dysfunction in the liver,pancreas,spleen,heart and pituitary gland,with diverse clinical manifestations,make the diagnosis difficult.In recent years,with the deepening of clinical understanding and the development of genetic diagnosis tools,the diagnostic rate of this disease has increased significantly.In this paper,we report a case of hereditary hemochromatosis type 3 involving multiple organs and complicated by severe heart failure,aiming to improve the clinicians'understanding of this disease and reduce the leakage and misdiagnosis.

Objective:To analyze the anatomical morphological characteristics of the trabecular bone of human mandibular condyle by observing the distribution of volume of interests (VOI).Methods:The micro-CT images of a right condyle specimen of a 61-year-old adult male was analyzed in this study. The cylindrical VOI with both diameter and height of 2 mm were arranged, according to a certain pattern, as many as possible at various levels within the trabecular bone of the condyle. Each VOI had no intersection area. The selected VOI were divided into 5 parts: medial part, middle part, lateral part, anterior part and posterior part, with 6 layers from top to bottom. And the distribution of the overall anatomical morphological characteristics of three-dimensional (3D) images of the trabecular bone of the condyle was analyzed by using seven morphological parameters of each VOI, i.e. bone mineral density (BMD), bone volume/total volume (BV/TV), bone surface area/bone volume (BS/BV), trabecular thickness (Tb.Th), trabecular bone number (Tb.N), trabecular spacing (Tb.Sp) and trabecular bone pattern factor (Tb.Pf).Results:In the present study, totally 34 VOI were selected from the condyle specimen.The morphological distribution of the VOI was uneven in the 3D structure of the trabecular bone of the human condyle. BMD, BV/TV, Tb.N and Tb.Th were much higher at the middle part, while showed the smallest at the medial part. The anterior part demonstrated much higher parameters than the posterior part at the first, second, fifth and sixth layers, respectively, however, the posterior part showed much higher parameters than the anterior part at the third and fourth layers, respectively. The BMD was much higher at the first [(332.66±97.11) mg/cm 3] and sixth [(255.79±45.68) mg/cm 3] layers, while the lowest at the second layer [(255.79±41.06) mg/cm 3]. The BV/TV and Tb.N were much higher at the first layer, with the lowest at the fifth layer. The Tb.Th at the first layer [(0.11±0.03) mm] was much higher than the others, which were similarly lower. The BS/BV, Tb.Sp and Tb.Pf were lower at the first layer and much higher at the medial and lateral parts, while were lower at the middle and anterior parts. The posterior part demonstrated much higher BS/BV, Tb.Sp and Tb.Pf than the anterior part at the first, fifth and sixth layers, respectively. However, the anterior part showed much higher scores than the posterior part at the third and fourth layers, respectively. The ANOVA results showed that the 7 morphological parameters of VOI were not statistically significant amongst the 6 layers ( P>0.05). However, the 6 out of the 7 parameters, i.e. BV/TV, BS/BV, Tb.Th, Tb.N, Tb.Sp and Tb.Pf, were statistically significant amongst the five parts ( P<0.05), while the only parameter of BMD was not statistically significant ( P>0.05). Conclusions:The anatomical distribution characteristics of the trabecular bone of condyle were analyzed by using 3D imaging measurement based on the VOI. The results showed uneven distributions and indicated that the method of dividing the trabecular bone of mandibular condyle into VOI sets, which accorded with its specific anatomical characteristics, was feasible for further reference.

Objective: To evaluate adolescents’ self-esteem and explore its influencing factors in order to provide basic evidence for improving self-esteem level and mental health of adolescents. Methods: A total of 5 709 adolescents of different characteristics from both urban and rural areas in six provinces were investigated anonymously with the method of computer-assisted self-interview (CASI). Self-esteem was evaluated by Self-Esteem Scale (SES, scored 10-40 points). Results: The average score of self-esteem was 28.15,28.40, 28.97 and 27.45 point for junior high students, senior high students, college students and out-of-school adolescents, respectively. The difference of the scores among the four groups was statistically significant(F=27.64, 14.41, P<0.01). More than 80% adolescents felt they were people of worth, were able to do things as most other people, took a positive attitude toward themselves and were satisfied with themselves. About 50% of adolescents thought they were no good at all at times. Less than 20% adolescents thought they had enough respect for themselves. About 11.57% to 22.22% of adolescents felt sad about their own gender, about 37.56% to 61.49% of adolescents often or sometimes felt sad about their body image. The multiple linear regression analysis showed that those who had a good overall feeling of family, satisfied with their own gender, and less worried about their body image tended to have a higher self-esteem scores among 4 groups(P<0.01). Other related influencing factors included parental education level, family economic status, only-child or not, birth place and parental preference for gender of their child. Conclusion Adolescents’ self-esteem was fair, and many factors were associated with it. It is necessary to strengthen the education on gender equality among parents and adolescents and to pay more attention to mental health of the adolescents, who were in rural areas, with poor family atmosphere and economic status.

Objective To study the expression of collapsin response mediator protein 2 (CRMP-2) in the visual cortex of monocular form deprivation amblyopia rats.Methods Sixty-four 14-day-old rats were randomly divided into monocular deprivation amblyopia group and normal control group by random number table method.Right eyelid margin suture was performed at 14 days after birth in the monocular deprivation amblyopia group.Eight rats in the monocular deprivation amblyopia group and the normal control group were observed at 14,21,45 and 120 days after birth,respectively.Flash visual evoked potential (F-VEP) was used to dectect the latency and amplitude of P1 wave.The expression of CRMP-2 in visual cortex was observed by immunohistochemical method.The use and care of the animals complied with Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.This study protocol was approved by Ethic Committee of the University of South China (No.20140228).Results F-VEP results showed that the amplitudes of P1 were decreased and latent periods of P1 were prolonged in the monocular deprivation amblyopia group compared with the normal control group (t=16.760,P =0.000;t =-22.919,P =0.000).CRMP-2 expression levels in the visual cortex of monocular deprivation amblyopia groups and normal control groups were compared at different time points after birth,and the differences were statistically significant (Fgroup =8.855,P =0.010;Ftime =63.091,P =0.000).Compared with normal control groups,the expressions of CRMP-2 at the postnatal 21,45 and 120 days were obviously decreased in the monocular deprivation amblyopia groups,the differences were statistically significant (all at P＜0.05).Conclusions CRMP-2 may be involved in the occurrence and development of amblyopia.

Objective:To investigate the clinical efficacy of mechanical solitaire AB stents thrombectomy combined with intra-arterial thrombolysis in the treatment of patient with acute ischemic stroke.Methods:Fifteen patients with acute ischemic stroke admitted into our hospital from August 2014 to August 2016 were treated with mechanical thrombectomy with solitaire AB stents plus intra-arterial thrombolysis.The National Institutes of Health Stroke Scale score (NIHSS) of all patients were evaluated before and after treatment to compare the clinical efficacy.The prognosis ofpatients between two groups were compared via evaluating modified Rankin score (mRS)and gelasijia coma score (GCS).Results:After mechanical thrombectomy with solitaire AB stents plus intra-arterial thrombolysis treatment,14 patients achieved complete or part recanalization,and 1 patient was terminated treatment due to vital signs instability,and the rate ofrecanalization was 93.3％.The NIHSS score of patients before treatment was 12.93± 4.25,which was much higher than that after treatment (4.33± 1.45,P＜0.05).After follow-up by 3 months,the good mRS scores were obtained in all 18 patients,including 2 patients with mRS score of 2,5 patients with 1,and 8 patients with 0.Additionally,there was no patient with re-obstruction during follow-up period.Conclusion:Mechanical thrombectomy with solitaire AB stents combined with intra-arterial thrombolysis had a good capability and safety in the treatment of patients with acute ischemic stroke.

Objective: To observe the dynamics of antibody response in great gerbils infected with Yersinia pestis in experiment. Method: A total of 211 great gerbils were captured in the southern margin of plague natural focus of Junggar Basin of the Xinjiang Uygur Autonomous Region in 2011. Among them, there were 167 great gerbils without infection of Y. pestis and 44 great gerbils infected by Y.pestis. Y.pestis No. 2504 was employed for this experimental strain, which was strong toxic strain with negativity in the reduction experiment of nitrate. 35 great gerbils without the infection of Y. pestis were divided randomly and averagely into 7 groups including 6 experimental groups and 1 control group. Great gerbils in the 1st to 6th experimental groups were exposed first with 1 × 10⁶-1 × 10¹¹ CFU/ml of bacterial fluid with 10 times of gradient dilution; groin areas of great gerbils in the control group were injected subcutaneously with physiological saline; and the amount of infection was all 1 ml. 17 great gerbils infected with Y. pestis and the first detection of F1-antibody titer in 1∶256-1∶4 096 were grouped according to F1-antibody titer: group 1∶4 096 (n=4), group 1∶2 048 (n=4), group 1∶1 024 (n=3), group 1∶512 (n=3) and group 1∶256 (n=3); and blood in caudal regions was collected in asepsis for the detection of F1-antibody, with a total of 5 times. 9 great gerbils which were selected from the remaining great gerbils infected with Y. pestis and detected F1-antibody negative 2 times were exposed 1×10⁶ CFU/ml of bacterial fluid for the second infection, with the amount of infection being 1 ml. Blood in caudal regions of great gerbils after the first and second infection were collected for the detection of plague F1-antibody on the 3rd, 5th, 7th, 15th, 30th, 60th, 90th and 120th day after infection. Declined regression models for great gerbils' antibodies were established with unary linear regression equation; declined change diagrams for the antibodies were drawn to observe the declined F1-antibody after great gerbils were exposed to Y. pestis. Results: In great gerbils with the first infection of Y. pestis, antibodies were detected in the 1 × 10⁶-1 × 10⁸ CFU/ml of group on the 30th, 15th and 15th day, respectively; the positive rates of antibody were 1/4, 3/4 and 4/5, respectively; the group 1×10⁷ and 1× 10⁸ CFU/ml reached to the highest antibody titer with 1∶256 on the 120th day; antibodies were revealed in the group 1×10⁹, 1×10¹⁰ and 1×10¹¹ CFU/ml from the 5th to 7th day when the seroconversion of all antibodies was observed; group 1×10¹¹ CFU/ml reached to the highest antibody titer on the 120th day with 1∶4 096. In the great gerbils with the second exposure to Y.pestis, positive antibodies were detected on the 3rd day with the positive rate being 2/9; and the highest antibody titer with 1∶2 048 was noted on the 90th day. Unary linear regression equation of declined F1 antibody of great gerbils was y=0.045x- 0.321 (F=115.40, P< 0.001), and the shortest duration for F1-antibody titer declining from 1∶4 096 to 0 was 140 d and the longest duration 200 d. Conclusion Great gerbils infected with the high concentration of Y. pestis fluid show shorter duration in producing F1-antibody, the antibody positive rate is also higher, and the highest antibody titer can reach 1∶4 096. The great gerbils could hold the plague F1 antibodies for a long time which was about 140 to 200 days from the highest titer.

Objective: To construct a three-dimensional (3D) finite element model and analyze the biomechanical characteristics during mandibular second molar mesialization using customized lingual appliances and mini-implant. Methods: One adult student volunteer from The First Affiliated Hospital of Zhengzhou University with lower left first molar extraction was selected. After CT scanning, Mimics, Geomagic, ANSYS were employed to develop a 3D finite element model including customized lingual brackets, stainless steel lingual arch wire, buccal buckles, lower dentition, periodontal ligaments and alveolar bone. Four different loading methods (1. the force of 1.470 N loaded at the lingual side only; 2, 3, 4. the forces of 0.490, 0.735 and 0.980 N loaded at both buccal and lingual sides, respectively.) were included. The initial displacements of the lower second molar and stress distribution in the periodontal ligaments were analyzed. Results: More uniform stress distributions in the periodontal membrane of mandibular left second molar were found when the mesial force were loaded at both buccal and lingual sides than the force loaded at lingual side only. More inclination of the second molar was observed when force loaded at both sides than at lingual side only. With the values of the force increased, the mesial inclination potential of the second molar, the initial movement of the second molar and the stress distribution in the periodontal membrane increased. Under the force of 0.735 N at both buccal and lingual sides, mesially inclined initial displacements of the mandibuar second molar were observed and the stress values of von Mises was in the suitable area. Conclusions Less second molar rotation was found when the force loaded at both buccal and lingual sides than loaded at lingual side only. However, force loaded at both sides would increase the measial inclination potential of the second molar.

Objective:TTo observe the clinical efficacy of noninvasive positive pressure ventilation(NIPPV)for AECOPD with respiratory failure and disturbance of consciousness.Methods:A total of 58 AECOPD patients with respiratory failure and consciousness in our hospital from 2011 July to August 2015 were randomly divided into NIPPV group and control group. The control group was received conventional therapy, and NIPPV was added to the NIPPV group. The heart rate(HR), respiratory rate(RR), Glasgow coma score(GCS) and blood gas analysis of patients before and after 24 h, 72 h of treatment, and the adverse reactions in NIPPV group were observed.Results: The PaCO2, RR, HR at 24 h and 72 h were significantly lower and PaO2 and GCS were significantly increased in NIPPV group. Compared to the control group, PaO2, PaCO2, HR and GCS after 24 h and 72 h were different (t=11.29,t=9.19,t=9.21,t=11.23,t=10.30,t=7.28, t=10.34,t=6.69;P<0.05) . NIPPV group had a higher cure rate and relatively low rate of endotracheal intubation than the control group. The differences are statistically significant(x2=10.07,x2=8.32,P<0.05). The hospital mortality is lower than the control group and there is no statistically significant(x2=3.50,P>0.05). Some patients in NIPPV group had initial discomfort, facial skin hyperemia erosion, mild gastrointestinal discomfort and fear, which were improved after symptomatic treatment.Conclusion: NIPPV treatment for AECOPD patients with respiratory failure and disturbance of consciousness which can effectively correct respiratory acidosis and CO2 retention. The spontaneous breathing and arterial oxygen level of patient can be gradually recovered, which are better than the conventional treatment.