Objective To survey the levels and distributed status of serum vitamin D in children in Hanzhong city of Shaanxi,and provide a basis for the prevention of children with vitamin D deficiency.Methods A total of 6 780 children aged 1 to 6 years from March 2019 to February 2021 in Children's Health Clinic of Hanzhong Center Hospital for physical examination were selected as subjects.The levels of serum 25-hydroxyvitamin D[25(OH)D],serum 25-hydroxyvitamin D2[25(OH)D2]and serum 25-hydroxyvitamin D3[25(OH)D3]were measured by liquid chromatography-tandem mass spectrometry(LC-MS/MS),and the factors of ages and sexes and seasons were analyzed.Results The levels of serum 25(OH)D,25(OH)D2 and 25(OH)D3 in all children were 38.24±9.84 ng/ml,2.31±3.91 ng/ml and 35.93±9.93 ng/ml,respectively.The vitamin D deficiency rate,insufficiency rate and adequacy rate were 2.75％(186/6 780),18.29％(1 240/6 780)and 78.96％(5 354/6 780),respectively.The levels of serum 25(OH)D and 25(OH)D3 in children aged 1～2,2～3 and 3～6 years were gradually decreased with the growth of age,while the rate of vitamin D deficiency was increased,with significant differences(F=1 153.499,1 165.341,1 374.051,all P＜0.05).There were no significant differences in distributed status of serum of vitamin D and the levels of serum 25(OH)D,25(OH)D2 and 25(OH)D3 levels among different genders(t/x2=0.727,1.271,0.222,2.659,all P＞0.05).The levels of serum 25(OH)D and 25(OH)D3 in winter were lower than those in spring,summer and autumn,and the differences were statistically significant(q=6.853,7.281,6.801;5.341,6.225,5.989,all P＜0.01).The vitamin D deficiency rate in winter was higher than that in spring,summer and autumn(6.60％,2.64％,1.91％,1.66％).and the differences were statistically significant(x2=31.733,52.252,57.756,all P＜0.01).Conclusion A high incidence of vitamin D deficiency or insufficiency was found in children aged 3 to 6 in Hanzhong city.It was necessary to strengthen outdoor activities in winter,encourage monitoring of serum vitamin D levels,and supplement vitamin D if necessary.

Objective To screen the influencing factors of hepatitis C cirrhosis patients progressing to hepatocellular carcinoma(HCC)using commonly used laboratory testing indicators,establish a prediction model using these indicators and validate them.Methods A total of 231 patients with hepatitis C cirrhosis and 179 patients with hepatitis C HCC hospitalized at the First Affiliated Hospital of Xi'an Jiaotong University between June 2020 and May 2023 were enrolled as the training set,and 105 patients with hepatitis C cirrhosis and 86 patients with hepatitis C HCC hospitalized between June 2023 and February 2024 were enrolled as the validation set.The routine laboratory test indexes of the study subjects in the two groups within the training set were compared,and logistic regression analysis was applied to screen the independent predictors of hepatocellular carcinoma occurrence.Receiver operating characteristic(ROC)curve was used to construct the curve model and validate the model.Results The age,male ratio,ALT,AST,AFP,WBC,NEU,MO,PLT,MPV,PDW,Fbg,NLR and PLR levels of the HCC group were higher than those of the cirrhosis group in the training set(H=-9.07～-2.19),while the levels of INR and LMR were lower than those of the cirrhosis group(H=-4.49,-2.65),and the differences were significant(all P＜0.05).The differences in TP,eGFR,LY and AST/ALT values between the two groups of patients were not significant(H=-1.46～-0.15,all P＞0.05).Multifactorial Logistic regression analysis showed that age(OR=1.048,95％CI:1.023～1.074),Male(OR=1.467,95％CI:1.413～1.765),AST(OR=1.010,95％CI:1.002～1.019),NEU(OR=1.186,95％CI:1.018～1.382)and Fbg(OR=2.245,95％CI:1.639～3.076)were independent risk factors for hepatocellular carcinoma patients(all P＜0.05),and these five independent risk factors were used to construct the HCC column-line graph prediction model,with the AUC for the training set and the validation set AUC(95％Cl)were 0.813(0.771～0.854)and 0.712(0.639～0.784),respectively,and the Hosmer-Lemeshow test showed a good fit of the model with P=0.650 for the training set and P=0.310 for the validation set.Conclusion The prediction model of HCC based on age,gender,AST,NEU and Fbg can have good predictive efficacy and clinical application value.

Objective: To investigate the self-reported prevalence, clinical characteristics, complications of allergic rhinitis (AR) and the sensitization of outdoor air pollen allergens in children in the Inner mongolia grassland region. Methods: A multistage, stratified and random clustered sampling with a face-to-face interview survey study in children from 0 to 17 years old was performed together with 10 common allergen skin prick tests (SPT) and measurements of the daily pollen count in 6 regions in the Inner mongolia grassland region from May to August of 2015. SAS 9.4 software was used for data analysis. Results: A total of 2 443 subjects completed the study. The self-reported prevalence of AR was 26.6%. The prevalence of boys was higher than that of girls (28.8% vs 24.3%, χ²=6.157, P<0.05). Subjects from urban areas showed higher prevalence than rural areas (34.7% vs 18.8%, χ²=79.107, P<0.05). There was significant regional difference in the prevalence of AR among the six areas investigated (χ²=221.416, P<0.05). The main clinical symptoms of AR were sneezing (88.2%) and nasal congestion (78.6%). Among combined diseases, asthma accounted for 16.5% (107/650), rhinoconjunctivitis accounted for 47.9% (311/650). The peak season of AR was April and July, with the top SPT positive allergens of Artemisia species and chenopodium in this area. Conclusions The prevalence AR in children in the Inner mongolia grassland region is extremely high. Sneezing is the main clinical symptom. Rhinoconjunctivitis is the most common combined disease. High summer and autumn pollen exposure is the main cause of AR.

Objective To investigate the effect of emotional resilience group training on perceived stress,anxiety and depression in patients with gastrointestinal cancer.Methods 325 cases of patients with gastric cancer were divided into experimental group(n=163) and control group(n=162) by random digital table method.Two groups of patients were treated with chemotherapy and routine treatment and the experimental group was trained once a week for 8 weeks of emotional resilience group training.Chinese version perceived stress(CPSS),SDS and SAS were used to evaluate the effect of intervention before and after intervention.Results After 8 weeks of emotional elastic group training,the CPSS score((39.98±4.82) vs (33.96±5.02)),SAS score((48.83±4.58) vs (42.12±4.01)) and SDS score((49.23±4.12) vs (45.21±3.27))were lower than those before the intervention (all P＜ 0.05).The difference of CPSS ((-6.02 ± 3.74) vs (-0.19±2.78)),SAS((-6.71±3.86) vs (-0.39±5.62)) and SDS((-4.02±2.03) vs (-0.62±2.31)) before and after the intervention of the two groups were statistically significant(t=-9.325,-9.529,-6.132,P＜0.01).Conclusion Emotional resilience group training can effectively reduce the level of perceptual stress in patients with gastrointestinal cancer,and improve depression and anxiety.

Objective To investigate the imaging features and laboratory detection characteristics of tuberculous meningitis (TBM ) for achieving the purpose of early diagnosis and treatment.Methods Seventy-four patients with TBM in First Affiliated Hospital of Xi'an Jiaotong University from January 2013 to December 2015 were selected as the experimental group and 80 patients of non-TBM as the control group.All cases were performed ADA ,TB-DNA and acid-fast bacilli smear detection in cerebrospinal fluid ,and at the same time ,which was combined with tuberculous infection T-SPOT.TB test and compared with the results of ima-ging examination.Then the application values of various examinations were compared.Results The sensitivity of ADA ,TB-DNA , acid-fast bacilli smear ,T-SPOT.TB and the imaging examination for 74 patients with TBM were respectively 64.86% (48/74) , 33.78% (25/74) ,75.68% (56/74) ,10.81% (8/74) and 54.05% (40/74).The specificity were respectively 75.00% (60/80) , 100.00% (80/80) ,58.75% (47/80) ,100.00% (80/80) and 91.25% (73/80).Conclusion The difference in imaging and laboratory test indicators has a certain guiding significance for TBM clinical diagnosis.Except for clinical routine detection ,other detections should be perfected as far as possible ,conducting the comprehensive analysis can improve the accuracy of diagnosis.

Objective To investigate the clinic significance of real-time fluorescent quantity polymerase chain reaction(RT-PCR) for detection of Mycoplasma pneumoniae(MP) DNA in patients suspected with MP infection.Methods A total of 1 402 samples,including serum,sputum,pleural fluid,nasopharyngeal swab,alveolar irrigating solution and bronchial irrigating solution,were detected for MP-DNA by using RT-PCR.Results The total positive rate all samples were 12.20%.The positive rate of serum was the lowest,which was 2.36%.The positive rates of sputum,alveolar irrigating solution and bronchial irrigating solutions were relatively high,which were 62.96%,77.08% and 88.71%,respectively.Conclusion RT-PCR could be fitted for the detection of MP-DAN in various samples,which could be effective method for the diagnosis of MP infection.

Objective To understand the current situation of literature research of diabetes care in China by analyzing Chinese periodicals using bibliometric analysis,and to provide a direction of diabetes care in future research. Methods The topic retrieval was conducted in CNKI and Wanfang Database. The retrieved data was remerged through NoteExpress to obtain eligible documents. Bicomb analysis software was used to analyze the literature characteristics. Results Approximately 4431 Chinese papers that related to diabetes care were published from 1956 to 2016,and most productive in 2011 of 400 papers. Journal of Qilu Nursing ranked the first with 906(20.447%)posting volume,followed by Chinese Nursing Research and Chinese General Practice Nursing,with the total volume of 540(12.187%)and 538(12.142%)respectively. Only 187(4.220%) articles of diabetes care were published on Chinese Nursing Journal. The General Hospital of PLA had the highest publications of 70(1.579%)articles. The frequent key words for diabetes care were diabetic foot,type 2 diabetes,nursing intervention,health education,and the elderly,etc. Conclusions The research of diabetes care starts late but is rapidly developing in China. The quality of related publications is not good enough and the research is more likely to depend on diabetes medicine. The hotspot of current research is type 2 diabetes, diabetes in the elderly,diabetic foot,and the research frontiers is health education.

Objective To study the cyclooxygenase (COX-2) ,nuclear factor-κB (NF-κB) and vascular endothelial growth factor (VEGF) expression and clinical significance in triple negative breast cancer .Methods From January 2010 to December 2014 ,breast cancer treatment in our hospital 100 patients for the study ,50 patients with triple negative breast cancer ,50 cases of non-triple neg-ative breast cancer was detected by immunohistochemistry ,100 cases of breast cancer were detected by immunohistochemistry in or-ganizations COX-2 ,NF-κB and VEGF expression of lymphatic vessel invasion and lymph vessel density and D2-40 mark detection , statistical analysis of relevant clinical and pathological information .Results COX-2 in triple negative and non-triple negative breast cancer were 76% ,70% ,the difference was not statistically significant (P>0 .05) ,VEGF triple negative breast cancer and non-triple negative breast lesions in cancerous lesions positive expression rates of 60% and 36% ,respectively ,which had significant difference (P<0 .05) .NF-κB in triple negative breast cancer lesions and non-triple negative breast lesions positive expression rate was 66%and 32% ,respectively ,which had significant difference (P< 0 .05) .Triple negative breast cancer NF-κB and VEGF ,COX-2 and VEGF expression was significantly positively related to breast cancer .Conclusion Radiation and chemotherapy is a major means of triple negative breast cancer postoperative treatment ,while inhibiting the NF-κB ,the expression of VEGF and COX-2 is expected to become the new target for treatment of triple negative breast cancer ,is worth exploring .

Objective To compare the cumulative analgesic effects of electroacupuncture at Sanyinjiao (SP6), Xuanzhong (GB39) and non-acupoint in treating primary dysmenorrhea. Method By adopting a multi-centered randomized controlled study method, 501 patients recruited from Dongzhimen Hospital of Beijing University of Chinese Medicine, China-Japan Friendship Hospital, Beijing Hospital of Traditional Chinese Medicine of Capital Medical University, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Huguosi Hospital of Chinese Medicine of Beijing University of Chinese Medicine and the Outpatient of Shandong University of Traditional Chinese Medicine were randomized into a Sanyinjiao group, a Xuanzhong group, and a non-acupoint group, 167 subjects in each group. The electroacupuncture intervention was applied when dysmenorrhea flared up and the Visual Analogue Scale (VAS) ≥40 mm, with frequency at 2/100 Hz and intensity during patient’s endurance, 30 min each time, once a day, and for successive 3 d. Before the first treatment, 30 min after the first treatment, and respectively prior to the second and third treatment, VAS was used to measure the pain intensity. Meanwhile, the Retrospective Symptom Scale (RSS-COX 2) was investigated before the first treatment, right after the removal of needles for the first treatment, before the second and third treatment. Result The decrease of VAS in Sanyinjiao group was more significant than that in Xuanzhong group and non-acupoint group (MD=﹣2.92 mm, P=0.028; MD=﹣3.47 mm, P=0.009), while there was no significant difference between Xuanzhong group and non-acupoint group (MD=﹣0.56 mm, P=0.674); there were no significant differences in comparing the RSS-COX2 total score among the three groups (P=0.086). Conclusion Sanyinjiao (SP6) can produce a more significant cumulative analgesic effect for primary dysmenorrhea patient than Xuanzhong and non-acupoint, and the effects of Xuanzhong and non-acupoit are equivalent.

Objective To evaluate combined effect on different population through 2 459 data of SAA,hs-CRP and PCT from 8 three-level hospitals in Guangdong region.Methods Subjects were divided into five groups by ages,and every group had bacterial and virus type.In order to confirm diagnostic effect on infection,methods were performed including in tendency of SAA and hs-CRP,Paired t test between bacterial and virus group,efficiency of 3 indexes in judging infection depending on ROC and parameters,multiple logistic regression,consistency between positive bacterial infection and bacterial culture.Re-sults There were statistically significant differences in SAA and hs-CRP between bacterial and virus in infants and children (P <0.001).SAA had the biggest AUC area 0.824 with sensibility 71.8% and specificity 82.6% in younger group.Corre-sponding,hs-CRP had the biggest area 0.806 with sensibility 84%.There was the accuracy of 78.8% for differential diagno-sis in younger group,while 65.1% in elder group.AUC of SAA was 0.883 for positive bacterial culture with sensibility 71.2% and specificity 90.7%,accuracy of 95.2% for differential diagnosis.Conclusion There was obvious trend of age in SAA and hs-CRP,3 indexes could be used for differential diagnosis alone or combined,especially in younger group.SAA is the best index as a separated index.There is less value at ratio of SAA and hs-CRP.