Objective: To investigate the level of health literacy among residents in Karamay City, Xinjiang Uygur Autonomous Region, so as to provide insights into formulating health promotion strategies. Methods: Based on the Health Literacy Surveillance Program in Karamay City, demographic information and health literacy data were collected from residents aged 15 to 69 years in Karamay City in 2022, and levels of health literacy was analyzed. Factors affecting health literacy were identified using a multivariable logistic regression model. Results: A total of 1 473 respondents were included, with a mean age of (39.62±15.09) years. There were 751 men (50.98%) and 722 women (49.02%). The level of health literacy was 28.31%, and the prevalence rates of basic healthy knowledge and attitudes, healthy lifestyles and behaviors and basic health-related skills were 39.31%, 27.36% and 30.75%, respectively. The prevalence rates of safety and first aid, scientific health outlook, health information, chronic disease prevention, infectious disease prevention and basic medical care were 58.93%, 49.29%, 48.88%, 33.67%, 29.74% and 27.77%, respectively. Multivariable logistic regression analysis identified age (45 to 54 years OR=2.329, 95%CI: 1.005-5.398), ethnicity (ethnic minority, OR=0.459, 95%CI: 0.341-0.617), educational level (primary school and below, OR=0.213, 95%CI: 0.102-0.444; junior high school, OR=0.302, 95%CI: 0.193-0.471; high school, OR=0.579, 95%CI: 0.428-0.784), and annual household income (less than 10 000 Yuan, OR=0.352, 95%CI: 0.199-0.624; 10 000 to 30 000 Yuan, OR=0.447, 95%CI: 0.279-0.717; 30 000 to 50 000 Yuan, OR=0.598, 95%CI: 0.407-0.880) as factors affecting health literacy among residents in Karamay City. Conclusion The level of health literacy was 28.31% among residents in Karamay City in 2022. Health education and promotion should be carried out targeting residents of different ages, ethnicities, educational levels and annual household income, in order to further enhance the level of health literacy among residents in Karamay City.

Objective:To evaluate the correlation between vascular hyperintensity of magnetic resonance fluid-attenuated inversion recovery (FLAIR) sequence(FVH) and related parameters of magnetic resonance perfusion weighted imaging (MR-PWI) in patients with middle cerebral artery stenosis cerebral infarction, and to explore the hemodynamic factors related to FVH and the effect of FVH on the short-term clinical prognosis of patients.Methods:A total of 116 patients with middle cerebral artery stenosis cerebral infarction in the Department of Neurology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University from January 2020 to December 2022 were collected.According to the diagnostic criteria of FVH, they were divided into FVH (+ ) group (78 cases) and FVH(-) group (38 cases). All patients underwent magnetic resonance(MR) and MR-PWI scans.Demographic and cerebrovascular risk factors were collected, clinical neurological function of patients was assessed by national institate of health stroke scale(NIHSS) upon admission and discharge, and cognitive function of patients was assessed by mini-mental state examination (MMSE). Short-term clinical outcome was assessed using modified Rankin scale(mRS) at the 90th day after discharge.The degree of middle cerebral artery stenosis, positive or negative FVH, FVH score, hypoperfusion volume and MR-PWI related parameters, including peak time (Tmax), mean transit time (MTT), cerebral blood volume (CBV) and cerebral blood flow (CBF), were evaluated in relation to clinical symptoms.SPSS 22.0 statistical software was used for t test, Chi-square test and Pearson correlation analysis. Results:There were significant differences in hypoperfusion volume, Tmax, MTT and CBF between FVH (+ ) group and FVH(-) group( t=1.989, 3.830, 5.223, 3.911, all P<0.05). In terms of short-term clinical outcome, the improvement rate of neurological function ((8.25±6.39)%, (12.22±6.08)%) and MMSE score(25.48±1.59), (26.31±1.26) in FVH (+ ) group were significantly lower than those in FVH(-) group, and the number of patients with progressive stroke during hospitalization in FVH(+ ) group was more than that of FVH(-) group(22(28.21%), 4(10.53%)) (all P<0.05). Pearson correlation analysis showed that FVH score was positively correlated with hypoperfusion volume ( r=0.786, P<0.01) and MTT ( r=0.692, P<0.01), and negatively correlated with CBF ( r=-0.568, P<0.01), but no significant correlation with the degree of arterial stenosis ( r=0.363, P>0.05). Conclusion:FVH is closely related to the Tmax, MTT and CBF values shown in MR-PWI, and the incidence of stroke in progression and short-term adverse prognosis are more likely in FVH(+ ) group, suggesting that FVH can be used as a convenient imaging indicator to reflect the hypoperfusion status of patients with middle cerebral artery stenosis cerebral infarction, and can provide an objective basis for further individualized treatment.

Progressive encephalomyelitis with rigidity and myoclonus (PERM) is a specific subtype of the stiff-person syndrome, which is rare and difficult to diagnose clinically. A case of PERM in a 66-year-old female with a fluctuating progressive course was reported in this article. She had increased facial muscle tone, pruritus and sensory hypersensitivity mainly in the head and neck, medullary involvement syndrome and bilateral lower limb rigidity as the main clinical manifestations, and a previous history of pulmonary malignancy, thymoma, typeⅠ diabetes and Hashimoto′s thyroiditis. The patient′s serum and cerebrospinal fluid were positive for anti-glutamic acid decarboxylase antibody. The electromyogram showed a large number of motor unit potentials in the trunk and proximal extremities in the quiet state, which were significantly enhanced during spastic episodes, consistent with the electromyographic manifestations of stiff-person syndrome. The final diagnosis was PERM, and immunotherapy including gamma globulin and hormone responded well. PERM is a rare neurological autoimmune disease with atypical early symptoms, which can be easily misdiagnosed, and it requires attention to avoid delaying the diagnosis.

Organ transplantation is an effective treatment for end-stage organ failure. However, organ shortage has always been a common problem faced by countries around the world. The recognition and active participation of intensive care unit (ICU) medical staff in organ donation contributes to promoting the development of organ donation, thereby alleviating the shortage of donor organ. In this article, the key strategies of ICU donor management to promote organ donation and the key strategies of ICU medical staff management to promote organ donation were summarized, aiming to provide reference for organ donation practitioners (especially ICU medical staff) and jointly facilitate the professional development of organ donation.

Objective:To investigate the correlation between fluid-attenuated inversion recovery vascular hyperintensities(FVH) and prognosis and cognitive dysfunction in patients with internal watershed cerebral infarction(IWI).Methods:Totally106 patients with IWI were selected.According to FVH diagnostic criteria, there were 59 cases in FVH (+ ) group and 47 cases in FVH (-) group.Demographic data and risk factors of cerebrovascular disease were collected to assess the clinical neurological function of the patients at admission and discharge, and the short-term outcome was assessed by modified RANKIN scale (mRS) score at 90 days after discharge.The cognitive function of patients was assessed by MMSE scale.Results:There was no significant difference in NIHSS score between the two groups on admission ( P>0.05). The NIHSS score of FVH (+ ) group((3.37±2.33))at discharge was significantly lower than that of the FVH (-) group ((4.43±2.72))( P<0.05). The rate of neural function improvement and mRS score after discharge 90 days in FVH (+ ) group((42.16±12.20)%, (1.75±1.12)) was significantly higher than that in FVH (-) group((37.58±13.64)%, (2.19±1.38))(both P<0.05). The scores of orientation, recall and language ability of MMSE in FVH (+ ) group ((9.26±0.21), (1.66±0.27), (7.69±0.44) respectively)were significantly lower than those of FVH (-) group((9.43±0.36), (1.83±0.34), (7.85±0.28) respectively)(all P<0.05). There was no significant difference in memory, attention and calculation between the two groups ( P>0.05). Conclusion:FVH has no correlation with the severity of IWI patients when they are admitted to hospital.FVH may be used as an imaging sign for prognosis evaluation of patients with IWI .However, IWI patients with FVH may have more severe cognitive impairment.

Objective To approach the significance of changes of percutaneous-arterial blood carbon dioxide partial pressure difference [P(tc-a)CO2] in liquid resuscitation of patients with septic shock. Methods One hundred and sixty-eight patients with septic shock admitted and treated in the Department of Intensive Care Unit (ICU) of Quzhou People's Hospital from January 2015 to January 2018 were enrolled, and after early goal-directed therapy (EGDT) for 6 hours, according to central venous oxygen saturation (ScvO2) and lactate clearance (LC), they were divided into ScvO2 and LC achievement group (ScvO2 ≥ 0.7 and LC≥10%), ScvO2 achievement group (ScvO2 ≥ 0.7 and LC < 10%), LC achievement group (ScvO2 < 0.7 and LC≥10%), and un-achievement group (ScvO2 < 0.7 and LC < 10%). The mechanical ventilation time, ICU hospitalization time, 28-day mortality, P(tc-a)CO2 etc. were compared among the four groups; the receiver operating characteristic curve (ROC) was used to evaluate the predictive value of P(tc-a)CO2 for 28-day prognosis in patients with septic shock. Results The trends of mechanical ventilation time, ICU hospitalization time, and 28-day mortality were all ScvO2 and LC achievement group < LC achievement group < ScvO2 achievement group < un-achievement group [the mechanical ventilation times (days) were respectively 6.12±2.59, 8.43±3.24, 11.78±4.12, 13.03±4.75, ICU hospitalization times (days) were 10.31±2.32, 13.85±3.56, 16.41±3.83, 18.52±4.05, and 28-day mortality rates were 28.85% (15/52), 40.91% (18/44), 51.28% (20/39), 69.70% (23/33)] and the differences among the four groups were statistically significant (all P < 0.05). After 6 hours of EGDT, the heart rate (HR), lactate (Lac), and P(tc-a)CO2 were lower than those before fluid resuscitation, but the mean arterial pressure (MAP), central venous pressure (CVP), and ScvO2 were higher than those before fluid resuscitation among four groups. Except CVP, the differences of other indicators compared among the ScvO2 and LC achievement group, ScvO2 achievement group, LC achievement group and un-achievement group were statistically significant (all P < 0.05). After 6 hours of EGDT, HR, Lac, P(tc-a)CO2 in ScvO2 and LC achievement group, ScvO2 achievement group and LC achievement group were significantly lower than those in the un-achievement group [HR (bpm): 89.05±29.43, 98.82±30.21, 94.33±28.64 vs. 112.85±32.74, Lac (mmol/L): 2.97±1.95, 3.87±2.32, 2.69±1.52 vs. 4.17±2.44, P(tc-a)CO2 (mmHg, 1 mmHg = 0133 kPa): 7.18±4.61, 12.61±5.34, 9.71±4.11 vs. 16.56±10.19], MAP and ScvO2 were significantly higher than those of the un-achievement group [MAP (mmHg): 88.05±21.67, 77.33±18.56, 83.11±19.71 vs. 70.32±18.79, ScvO2: 0.76±0.14, 0.75±0.16, 0.67±0.14 vs. 0.63±0.18, all P < 0.05]. The P(tc-a)CO2 of 28 days survivors were significantly lower than that of the deaths among four groups (mmHg: 5.78±2.27 vs. 14.14±3.65, 7.07±2.81 vs. 15.06±4.11, 6.35±2.09 vs. 14.94±4.06, 7.93±3.81 vs. 18.34±4.63, all P < 0.05). When P(tc-a)CO2 > 7.24 mmHg predicted 28-day mortality in ScvO2 and LC achievement group, the sensitivity was 89.29%, specificity was 91.45%, and the area under ROC curve (AUC) was 0.86; when P(tc-a)CO2 > 9.46 mmHg predicted 28-day mortality in LC achievement group, the sensitivity was 88.72%, specificity was 85.83% and AUC was 0.91; when P(tc-a)CO2 >12.05 mmHg predicted 28-day mortality in ScvO2 achievement group, the sensitivity was 82.79%, specificity was 86.90% and AUC was 0.79; when P(tc-a)CO2 > 16.22 mmHg predicted 28-day mortality in un-achievement group, the sensitivity was 73.35%, specificity was 80.68% and AUC was 0.68. Conclusion P(tc-a)CO2 can be used as an indicator to evaluate fluid resuscitation effect and prognosis in patients with septic shock.

Nuclear receptors are transcriptional regulators involved in almost all biological processes such as cell growth, differentiation, apoptosis, substance metabolism and tumor formation, and they can be regulated by small molecules that bind to them. Autophagy is a special way of programmed cell death and it is a highly conserved metabolic process. Once autophagy defects or excessive autophagy occur, the disease will develop. In recent years, numerous studies have shown that nuclear receptors are related to autophagy. Therefore, this paper mainly reviews the research progress on nuclear receptors involved in the regulation of autophagy, and focuses on the mechanism of several nuclear receptors involved in the regulation of autophagy, aiming at understanding the molecular basis of how nuclear receptors participate in regulating autophagy, as well as providing possible ideas and strategies for the treatment of corresponding diseases.

Objective To study the colonization rate and antibiotic resistance of group B Streptococcus (GBS) in gravidas during late pregnancy,and to evaluate the effectiveness of GBS screening in late pregnancy and intrapartum antibiotic prophylaxis (IAP) for the prevention of neonatal early-onset GBS disease (EOGBS).Methods A retrospective study was conducted to analyze the colonization rate and antibiotic resistance pattern of GBS in 14 204 gravidas who were screened for GBS at 35-37 gestational weeks during March 2016 to March 2018 in the University of Hongkong-Shenzhen Hospital (HKU-SZH).Differences in the incidence of EOGBS before and after GBS screening and IAP were analyzed using Chi-square or Fisher's exact test.Results Among the 14 204 gravidas,2 027 cases were GBS positive with a colonization rate of 14.27％.Incidence rates of EOGBS before and after GBS screening were 0.6‰ (4/6 356) and 0.07‰ (1/14 403),respectively (Fisher's exact test,P=0.033).GBS isolates were 100％ (2 027/2 027) sensitive to penicillin and vancomycin.Resistance rates to clindamycin and erythromycin were 67.2％(1 363/2 027) and 65.7％ (1 332/2 027),respectively.Conclusions Routine GBS screening in late pregnancy and IAP can significantly decrease the incidence of EOGBS.Penicillin is the optimal choice for prevention and treatment of GBS infection.

Objective To evaluate the effect of enteral immune nutrition on the occurrence of acute kidney injury(AKI) in sepsis patients. Methods A retrospective study was conducted, 80 patients with sepsis admitted and treated in the intensive care unit (ICU) of Quzhou People's Hospital from January 2015 to December 2016 were enrolled, and according to different treatment programs, they were divided into an immune nutrition group and a standard nutrition group, each group 40 cases. The two groups received an equal amount of calories and nitrogen in enteral nutrition (EN). After treatment, the changes of serum total protein (TP), albumin (Alb), prealbumin (PA), hemoglobin (Hb), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin (IL-6, IL-10), infection site, length of stay in ICU, mortality in ICU, AKI incidence, AKI staging, etc in the two groups were observed. Results ① After treatment, the nutritional indicators TP, Alb, PA, Hb levels were significantly increased, the serum inflammatory factors CRP, TNF-α, IL-6 were obviously decreased and IL-10 was markedly increased in the two groups compared with those before treatment (all P < 0.05), the changes in the immune nutrition group were more obvious than those in the standard nutrition group [TP (g/L): 60.84±5.90 vs. 58.32±6.11, Alb (g/L): 33.95±3.83 vs. 31.79±3.44, PA (g/L): 0.24±0.04 vs. 0.21±0.03, Hb (g/L): 117.47±16.15 vs. 112.50±15.71, CRP (mg/L): 53.04±23.76 vs. 82.33±37.09, TNF-α (ng/L): 20.29±17.74 vs. 29.63±18.43, IL-6 (ng/L): 50.74±28.55 vs. 80.32±31.67, IL-10 (ng/L): 41.09±24.65 vs. 40.86±24.73]; ② The length of stay in ICU (days: 10.54±4.33 vs. 14.80±5.19), ICU mortality [15.00% (6/40) vs. 32.50% (13/40)] and the incidence of AKI [22.50% (9/40) vs. 47.50% (19/40)] of immune nutrition group were significantly lower than those of standard nutrition group (all P < 0.05); There were 9 cases of AKI mainly at stage I andⅡ (8 cases) in the immune nutrition group, while in the standard nutrition group there were 19 cases with AKI mainly at stageⅢ (11 cases). Conclusion The enteral immune nutrition can effectively reduce the incidence of AKI in sepsis patients, and the mechanism may be related to the immune nutritional preparation can inhibit the expressions of pro-inflammatory factors such as TNF-α, IL-6, etc.

Objective To compare the curative effect of percutaneous endoscopic lumbar discectomy (PELD) and microendoscopic discectomy (MED) in lumbar disc herniation.Methods A literature search was performed in PubMed, Web of Science, Embase, Wanfang, CNKI. Two authors reviewed all articles individually. The methodological quality of RCTs was assessed by the Cochrane risk of bias tool, and the quality of retrospective studies was evaluated by the modified Newcastle-Ottawa scale. The data was extracted by the Review Manager 5.30.Results A total of 19 articles were brought into this Meta-analysis. The outcomes were divided into primary outcomes and secondary outcomes. Excerpt for the short-term VAS score was lower in PELD group (P = 0.010), other index, including long-term VAS score (P = 0.120), ODI score (P = 0.260), complication (P = 0.100) and recurrence (P = 0.100), didn't had significant difference in two groups. The blood loss (P = 0.000), hospital stay (P = 0.000) and the length of incision (P = 0.000) were all superiority in PELD group. Whereas the operative time was shorter in MED group (P = 0.001).Conclusion PELD was a more minimally invasive and secure technique in lumbar disc herniation.