Objective:To understand the current status of anemia, iron deficiency, and iron-deficiency anemia among preschool children in China.Methods:A cross-sectional study was conducted with a multi-stage stratified sampling method to select 150 streets or townships from 10 Chinese provinces, autonomous regions, or municipalities (East: Jiangsu, Zhejiang, Shandong, and Hainan; Central: Henan; West: Chongqing, Shaanxi, Guizhou, and Xinjiang; Northeast: Liaoning). From May 2022 to April 2023, a total of 21 470 children, including community-based children aged 0.5 to<3.0 years receiving child health care and kindergarten-based children aged 3.0 to<7.0 years, were surveyed. They were divided into 3 age groups: infants (0.5 to<1.0 year), toddlers (1.0 to<3.0 years), and preschoolers (3.0 to<7.0 years). Basic information such as sex and date of birth of the children was collected, and peripheral blood samples were obtained for routine blood tests and serum ferritin measurement. The prevalence rates of anemia, iron deficiency, and iron-deficiency anemia were analyzed, and the prevalence rate differences were compared among different ages, sex, urban and rural areas, and regions using the chi-square test.Results:A total of 21 460 valid responses were collected, including 10 780 boys (50.2%). The number of infants, toddlers, and preschoolers were 2 645 (12.3%), 6 244 (29.1%), and 12 571 (58.6%), respectively. The hemoglobin level was (126.7±14.8) g/L, and the serum ferritin level was 32.3 (18.5, 50.1) μg/L. The overall rates of anemia, iron deficiency, and iron-deficiency anemia were 10.4% (2 230/21 460), 28.3% (6 070/21 460), and 3.9% (845/21 460), respectively. The prevalence rate of anemia was higher for boys than for girls (10.9% (1 173/10 780) vs. 9.9% (1 057/10 680), χ2=5.58, P=0.018), with statistically significant differences in the rates for infants, toddlers and preschoolers (18.0% (475/2 645), 10.6% (662/6 244), and 8.7% (1 093/12 571), respectively, χ2=201.81, P<0.01), and the rate was significantly higher for children in rural than that in urban area (11.8% (1 516/12 883) vs. 8.3% (714/8 577), χ2=65.54, P<0.01), with statistically significant differences in the rates by region ( χ2=126.60, P<0.01), with the highest rate of 15.8% (343/2 173) for children in Central region, and the lowest rate of 5.3% (108/2 053) in Northeastern region. The prevalence rates of iron deficiency were 33.8% (895/2 645), 32.2% (2 011/6 244), and 25.2% (3 164/12 571) in infants, toddlers, and preschoolers, respectively, and 30.0% (3 229/10 780) in boys vs. 26.6% (2 841/10 680) in girls, 21.7% (1 913/8 821), 40.0% (870/2 173), 27.1% (2 283/8 413), 48.9% (1 004/2 053) in Eastern, Central, Western, and Northeastern regions, respectively, and each between-group showed a significant statistical difference ( χ2=147.71, 29.73, 773.02, all P<0.01). The prevalence rate of iron-deficiency anemia showed a significant statistical difference between urban and rural areas, 2.9% (251/8 577) vs. 4.6% (594/12 883) ( χ2=38.62, P<0.01), while the difference in iron deficiency prevalence was not significant ( χ2=0.51, P=0.476). Conclusions:There has been a notable improvement in iron deficiency and iron-deficiency anemia among preschool children in China, but the situation remains concerning. Particular attention should be paid to the prevention and control of iron deficiency and iron-deficiency anemia, especially among infants and children in the Central, Western, and Northeastern regions of China.

Objective:To analyze any changes in the functional connectivity between the seed points of the dorsolateral prefrontal cortex (DLPFC) and the whole brain, as well as any fluctuations in the low-frequency amplitude among persons with post-stroke depression (PSD). The aim was to develop correlations among functional imaging results, clinical scales, and inflammation indicators including high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), interleukin 2 (IL-2), interleukin 10 (IL-10), interleukin 17a (IL-17a) and interferon-γ (IFN-γ).Methods:Between 2016 and 2020, 55 ischemic stroke survivors were tested. The 28 scoring 7 or more on the Hamilton Depression Scale (HAMD-17) formed the PSD group, while the 27 others formed the control group. Functional magnetic resonance images were collected, and serum inflammation indicators were determined.Results:When seed points in the left DLPFC were used, in the PSD group the frontal cortex (FC) decreased in one cluster, with a voxel of 129mm3 and the MNI coordinates (x=9, y=30, z=33) indicating that the anatomical automatic labeling (AAL) brain regions were the Cingulum_Ant_L, Cingulum_Mid_R and the frontal_Sup_Medial_L. When the right DLPFC was used as the seed point the FC again decreased in one cluster, with voxels of 44mm 3 and the MNI coordinates (x=-27, y=12, z=47) referring to the AAL brain region of the frontal_Mid_L. In the PSD group, the FC value of abnormal brain areas with the R-DLPFC as the seed point was positively correlated with time since stroke. In the control group, the FC value of abnormal brain areas with L-DLPFC as the seed point was negatively correlated with MoCA, while with R-DLPFC as the seed point it was positively correlated with IFN-γ. The FC values of abnormal areas of the brain showed no significant correlation with other clinical scales, inflammation indicators or lesion volume. Conclusion:Abnormal functional connections within the executive control network and between the salience networks may participate in the mechanism of PSD, and may be related to the time since stroke, cognitive functioning, and IFN-γ levels.

Objective:To explore a surgical method for patients with moderate to severe hypertrophy of the labia minora, obvious pigmentation, and bilateral asymmetry.Methods:From August 2016 to August 2018, we applied a combined wedge resection and marginal arc resection to 23 cases of labia minora hypertrophy.Results:There were no complications such as infection and hematoma, and the incision healed in one stage. The follow-up period was from 1 month to 6 months. The width of the labia minora did not exceed 1.5 cm, and the appearance was natural, beautiful and rejuvenated. The patients were satisfied.Conclusions:Layered wedge resection combined with edge arc resection of the labia minora has the advantages of natural youthful appearance, low secondary surgical repair rate, fewer postoperative complications, and high patient satisfaction. It is agood approach for the labia majora, especially the moderate to severe type. Patients with obvious pigmentation and bilateral asymmetry are an ideal candidates for this method.

Objective:To investigate the effect of modified alar reduction with external incision to correct alar hypertrophy.Methods:From January 2017 to January 2019, 16 patients(1 male and 15 females, aged 21 to 39 with alar hypertrophy were treated in the plastic surgery department of the Second Affiliated Hospital of Nanchang University. Modified alar reduction with external incision were applied. In order to rotate the free alar lobules, the incision was extended in nasal lobules to the vestibular floor and remove part of the vestibular tissue of the alar lobules during the operation. Then the free alar was moved into the nostril to make the alar junction shift inward and upward, and reposition the alar junction to correct the alar hypertrophy and the wide nasal base. Photos of patients in frontal, side, and basal view before operation, 1 month, 6 months after operation. Intercanthal distance (ICD)、interinter-alar width (IW)、nasal base width (BW) were measured. The ratios of IW, BW and ICD before operation, 1 month, and 6 months after operation, and the narrowing rate of IW and BW at 1 month and 6 months after operation were summarized. The incision scar was evaluated with reference to the Vancouver Scar Scale. Normally distributed variables were compared using an paired t test. Nonparametric continuous variables were compared using Wilcoxon rank sum test. When P<0.05, the difference is considered statistically significant. Results:Sixteen patients were followed up for 6 to 12 months, averaged of 8 months. The IW/ICD of 16 patients at preoperation, after operation 1 month and 6 months were 1.160±0.080, 1.049±0.047 (0.110±0.049 decrease than before operation) and 1.038±0.047 (0.120±0.049 decrease than before operation). The differences were statistically significant ( P<0.05). The IW constriction rates were 9.3% at 1 month after operation and 10.2% at 6 months after operation. BW/ICD at preoperation, after operation 1 month and 6 months were 1.035±0.047, 0.960±0.039(0.072±0.019 smaller than preoperation), and 0.950±0.034(0.079±0.020 smaller than preoperation). Compared with preoperative data, the difference was statistically significant ( P<0.05). The BW reduction rates were 7.0% at 1 month after operation and 7.6% at 6 months after operation. The Vancouver Scar Scale score was 3(2.25, 3) at 1 month after operation, 1(0.25, 1) at 3 months after operation and 1(0, 1) at 6 months after operation. The differences were statistically significant ( P<0.05). There was a statistically significant difference between 3 months after surgery and 1 month after surgery ( Z=-3.472, P=0.001). There was no statistically significant difference between 6 months after surgery and 3 months after surgery ( Z=-1.414, P=0.157). All patients had no significant postoperative complications such as incision infection, asymmetry of nasal alae, obstruction of nasal ventilation, etc. Postoperative alar and nasal base profiles were significantly improved. Conclusions:Modified alar reduction with external incision can effectively treat alar hypertrophy without obvious postoperative complications. It is a good operation to correct alar hypertrophy.

Objective:This study aims to explore the potential effects of adipose-derived stem cell-extracellular vesicles(ASC-EVs) on TGFβ-Smad signaling pathway during myofibroblast trans-differentiation in vitro. Methods:ASCs were isolated from liposuction and flow cytometry was used to detect the surface protein markers. ASC-EVs were isolated from the supernatant of the third to fifth generation ASCs, and the microscopic morphology was observed by transmission electron microscope. The particle size distribution was detected by nano-particle tracking analyzer NanoSight and the membrane surface marker proteins CD63, Alix and TSG101 were detected by flow cytometry. The uptake of EVs by dermal fibroblasts co-cultured with PKH67 fluorescence labeled ASC-EVs was observed by confocal microscope. Dermal fibroblasts were continuously induced by TGFβ1 for five days, and ASC-EVs at the dose of 50 and 100 μg/ml were added. The expression of α-SMA and Smad-2/3/4 were detected by immunofluorescence staining, RT-PCR and Western Blot.Results:The results of flow cytometry showed that the surface markers CD73, CD49d, CD90 and CD105 of the third generation ASCs, were positive, and CD34 and CD45 were negative. Under transmission electron microscope, ASC-EVs was a round membranous vesicle with clear edge and surrounded by bilayer phospholipid membrane. The particle size of more than 95% of the ASC-EVs was distributed between 30 nm to 261 nm, with an average of (166.0±86.1)nm. The specific marker proteins of extracellular vesicle, CD63, Alix and TSG101 were highly expressed. Under confocal microscope, ASC-EVs with green fluorescence were uptake by dermal fibroblasts and distributed in the cytoplasm, and part of ASC-EVs was distributed around the nucleus.TGF-β1 induced a significant increase in the expression of α-SMA in dermal fibroblasts, and the addition of 50 or 100 μg/ml ASC-EVs reduced the expression of α-SMA genes and proteins, but did not show a dose-dependent manner. The gene and protein expression changes of Smad-2/3/4 were consistent with α-SMA. In addition, ASC-EVs could significantly reduced the content of type Ⅰ collagen in the supernatant, but had no significant effect on the secretion of type Ⅲ collagen.Conclusions:The mechanism of ASC-EVs inhibiting scar hyperplasia may be closely related to the suppression of TGF-β-Smad signaling pathway in dermal fibroblasts, inhibition of myofibroblast trans-differentiation and reduction of type Ⅰ collagen secretion.

Objective:To explore a surgical method for patients with moderate to severe hypertrophy of the labia minora, obvious pigmentation, and bilateral asymmetry.Methods:From August 2016 to August 2018, we applied a combined wedge resection and marginal arc resection to 23 cases of labia minora hypertrophy.Results:There were no complications such as infection and hematoma, and the incision healed in one stage. The follow-up period was from 1 month to 6 months. The width of the labia minora did not exceed 1.5 cm, and the appearance was natural, beautiful and rejuvenated. The patients were satisfied.Conclusions:Layered wedge resection combined with edge arc resection of the labia minora has the advantages of natural youthful appearance, low secondary surgical repair rate, fewer postoperative complications, and high patient satisfaction. It is agood approach for the labia majora, especially the moderate to severe type. Patients with obvious pigmentation and bilateral asymmetry are an ideal candidates for this method.

Objective:To investigate the effect of modified alar reduction with external incision to correct alar hypertrophy.Methods:From January 2017 to January 2019, 16 patients(1 male and 15 females, aged 21 to 39 with alar hypertrophy were treated in the plastic surgery department of the Second Affiliated Hospital of Nanchang University. Modified alar reduction with external incision were applied. In order to rotate the free alar lobules, the incision was extended in nasal lobules to the vestibular floor and remove part of the vestibular tissue of the alar lobules during the operation. Then the free alar was moved into the nostril to make the alar junction shift inward and upward, and reposition the alar junction to correct the alar hypertrophy and the wide nasal base. Photos of patients in frontal, side, and basal view before operation, 1 month, 6 months after operation. Intercanthal distance (ICD)、interinter-alar width (IW)、nasal base width (BW) were measured. The ratios of IW, BW and ICD before operation, 1 month, and 6 months after operation, and the narrowing rate of IW and BW at 1 month and 6 months after operation were summarized. The incision scar was evaluated with reference to the Vancouver Scar Scale. Normally distributed variables were compared using an paired t test. Nonparametric continuous variables were compared using Wilcoxon rank sum test. When P<0.05, the difference is considered statistically significant. Results:Sixteen patients were followed up for 6 to 12 months, averaged of 8 months. The IW/ICD of 16 patients at preoperation, after operation 1 month and 6 months were 1.160±0.080, 1.049±0.047 (0.110±0.049 decrease than before operation) and 1.038±0.047 (0.120±0.049 decrease than before operation). The differences were statistically significant ( P<0.05). The IW constriction rates were 9.3% at 1 month after operation and 10.2% at 6 months after operation. BW/ICD at preoperation, after operation 1 month and 6 months were 1.035±0.047, 0.960±0.039(0.072±0.019 smaller than preoperation), and 0.950±0.034(0.079±0.020 smaller than preoperation). Compared with preoperative data, the difference was statistically significant ( P<0.05). The BW reduction rates were 7.0% at 1 month after operation and 7.6% at 6 months after operation. The Vancouver Scar Scale score was 3(2.25, 3) at 1 month after operation, 1(0.25, 1) at 3 months after operation and 1(0, 1) at 6 months after operation. The differences were statistically significant ( P<0.05). There was a statistically significant difference between 3 months after surgery and 1 month after surgery ( Z=-3.472, P=0.001). There was no statistically significant difference between 6 months after surgery and 3 months after surgery ( Z=-1.414, P=0.157). All patients had no significant postoperative complications such as incision infection, asymmetry of nasal alae, obstruction of nasal ventilation, etc. Postoperative alar and nasal base profiles were significantly improved. Conclusions:Modified alar reduction with external incision can effectively treat alar hypertrophy without obvious postoperative complications. It is a good operation to correct alar hypertrophy.

Objective:This study aims to explore the potential effects of adipose-derived stem cell-extracellular vesicles(ASC-EVs) on TGFβ-Smad signaling pathway during myofibroblast trans-differentiation in vitro. Methods:ASCs were isolated from liposuction and flow cytometry was used to detect the surface protein markers. ASC-EVs were isolated from the supernatant of the third to fifth generation ASCs, and the microscopic morphology was observed by transmission electron microscope. The particle size distribution was detected by nano-particle tracking analyzer NanoSight and the membrane surface marker proteins CD63, Alix and TSG101 were detected by flow cytometry. The uptake of EVs by dermal fibroblasts co-cultured with PKH67 fluorescence labeled ASC-EVs was observed by confocal microscope. Dermal fibroblasts were continuously induced by TGFβ1 for five days, and ASC-EVs at the dose of 50 and 100 μg/ml were added. The expression of α-SMA and Smad-2/3/4 were detected by immunofluorescence staining, RT-PCR and Western Blot.Results:The results of flow cytometry showed that the surface markers CD73, CD49d, CD90 and CD105 of the third generation ASCs, were positive, and CD34 and CD45 were negative. Under transmission electron microscope, ASC-EVs was a round membranous vesicle with clear edge and surrounded by bilayer phospholipid membrane. The particle size of more than 95% of the ASC-EVs was distributed between 30 nm to 261 nm, with an average of (166.0±86.1)nm. The specific marker proteins of extracellular vesicle, CD63, Alix and TSG101 were highly expressed. Under confocal microscope, ASC-EVs with green fluorescence were uptake by dermal fibroblasts and distributed in the cytoplasm, and part of ASC-EVs was distributed around the nucleus.TGF-β1 induced a significant increase in the expression of α-SMA in dermal fibroblasts, and the addition of 50 or 100 μg/ml ASC-EVs reduced the expression of α-SMA genes and proteins, but did not show a dose-dependent manner. The gene and protein expression changes of Smad-2/3/4 were consistent with α-SMA. In addition, ASC-EVs could significantly reduced the content of type Ⅰ collagen in the supernatant, but had no significant effect on the secretion of type Ⅲ collagen.Conclusions:The mechanism of ASC-EVs inhibiting scar hyperplasia may be closely related to the suppression of TGF-β-Smad signaling pathway in dermal fibroblasts, inhibition of myofibroblast trans-differentiation and reduction of type Ⅰ collagen secretion.

The data of registered general practitioners (GPs) in Shanghai Pudong New Area from 2014 to 2017 were collected through literature review and institutional investigation. The status of registered GPs was analyzed longitudinally by the methods of descriptive statistics and comparative analysis. The total number of registered GPs in Pudong New Area was increased from 1 227 in 2014 to 1 469 in 2017 and increased by 19.7%, with an average annual growth rate of 6.18%. But the human resources of GPs in Pudong New Area were not sufficient and the recruitment of GPs in grass-roots increased slowly. GPs in community health service centers in remote rural areas steadily increased year by year, however, the uneven distribution still existed. The proportion of GPs with senior professional titles had steadily increased, but it was still low.

Objective To observe the changes of short-chain acyl-CoA dehydrogenase (SCAD) expression on human umbilical vein endothelial cell (HUVEC) apoptosis and investigate its relationship with apoptosis. Methods The HUVEC was cultured normally for 2-3 days. The apoptotic model of HUVEC was established by tert-butyl hydrogen peroxide (tBHP). The HUVEC was treated by different concentrations of tBHP (0, 10, 20, 30, 40, 50 μmol/L) for 12 hours and different time (0, 3, 6, 9, 12 hours) with 50 μmol/L tBHP to establish the apoptotic model of HUVEC. The cell viability was detected by methyl thiazolyl tetrazolium (MTT), the mRNA expression of SCAD was determined by real-time polymerase chain reaction (PCR), the protein expression of SCAD was achieved by Western Blot. The best concentrate and time were determined to interfere the HUVEC to achieve the apoptotic model of HUVEC. The SCAD gene of HUVEC was knocked down by RNA interference sequence (siRNA274, siRNA414, siRNA679). The mRNA expression of SCAD, the protein expression of SCAD and the activity of SCAD enzyme were detected to achieve the best RNA interference sequence. The HUVEC was intervened by the best RNA interference sequence and tBHP. The cell activity and apoptosis rate, the enzyme activity of SCAD, the mRNA and protein expression of SCAD, the contents of reactive oxygen species (ROS), aderosine triphosphate (ATP) and free fatty acid (FFA) were detected to observe the effect of SCAD on apoptosis of HUVEC. Results ① The cell viability, the mRNA expression and the protein expression of SCAD were decreased gradually in a concentration and time dependent manner with the increase of tBHP concentration and the prolongation of intervention time. The decline was most significant in the group of the 50 μmol/L tBHP to interfere HUVEC for 12 hours. ② The siRNA679 transfection was the most significant in reducing SCAD mRNA and protein expressions among the three interference sequences (siRNA274, siRNA414, siRNA679). ③ Compare with blank control group, the cell viability was significantly decreased in the siRNA679 group (A value: 0.48±0.09 vs. 1.00±0.09, P < 0.01), the apoptotic rate of HUVEC was significantly increased [(29.96±2.09)% vs. (2.90±1.90)%, P < 0.01], the expression of SCAD mRNA and SCAD protein, the activity of SCAD enzyme and the content of ATP were significantly decreased [SCAD mRNA (2-ΔΔCt): 0.50±0.16 vs. 1.34±0.12, SCAD/α-Tubulin: 0.67±0.11 vs. 1.00±0.06, the activity of SCAD enzyme (kU/g): 0.38±0.04 vs. 0.53±0.04, the content of ATP (μmol/g): 0.14±0.02 vs. 0.19±0.01, all P < 0.05], the contents of FFA and ROS were significantly increased [FFA (nmol/g): 0.84±0.07 vs. 0.47±0.04, ROS (average fluorescence intensity): 647.5±23.7 vs. 434.2±46.5, both P < 0.01]. Meanwhile, SCAD siRNA treatment triggered the same apoptosis as HUVEC treated with tBHP. Conclusions Down-regulation of SCAD may play an important role in HUVEC apoptosis. Increase in the expression of SCAD may become an important part in intervening HUVEC apoptosis.