Objective: To evaluate the intervention effectiveness of co-occurrence and prevention for myopia and obesity among primary and secondary school students, so as to provide a scientific basis for the development of comprehensive intervention measures in myopia and obesity. Methods: From September 2022 to September 2023, a cluster random sampling method was used to select 6 primary schools and 6 junior high schools from Tongzhou District, Beijing. Participants were randomly assigned to an intervention group (914 before intervention and 754 after intervention) and a control group (868 before intervention and 652 after intervention), with an expected duration of one academic year. Based on the RE-AIM framework, integrate resources from families, schools, communities, and medical institutions to develop a school-based intervention technology packagefor the co-occurrence and prevention of myopia and obesity in children. The intervention group received intervention according to the comprehensive intervention technology package, while the control group did not receive any intervention measures. Relevant health indicators during the baseline period and after intervention were measured and collected, and groups were compared by Chi quest test, t-test and Wilcoxon rank sum test. Results: After intervention, the uncorrected visual acuity of primary and secondary school students in the intervention group (4.79±0.30) and the control group (4.77±0.33) both decreased compared to those before intervention (4.80±0.30, 4.90±0.32) ( t =-7.00,-5.24); the decrease in uncorrected visual acuity in the intervention group was smaller than that in the control group( t =5.33)( P <0.01). After intervention, body mass index, waist circumference, hip circumference, and body fat percentage of primary and secondary school students in the intervention group decreased compared to those before intervention. However, the changes in these indicators were not statistically significant ( t/Z =-0.03, - 0.36，- 0.30，- 0.01, P >0.05); the above indicators in the control group increased compared to those before intervention, but only hip circumference and body fat percentage showed statistically significant changes ( t/Z =2.17, 2.62, P <0.05). After intervention, both the intervention group and the control group showed increases in systolic and diastolic blood pressure compared to those before intervention(intervention group: t =2.16,5.29; control group: t =6.84,5.07); the intervention group had lower systolic and diastolic blood pressure than the control group( t = -5.27 , -2.08)( P <0.05). After intervention, the intervention and the control groups had statistically significant differences in cognitive accuracy(92.48%, 69.33%) in terms of "outdoor exercise can prevent myopia" and "having 5 servings of adult fist sized vegetables and fruits every day" ( χ 2=6.30, 7.86, P <0.05). There was a statistically significant difference in the proportion of primary and secondary school students in the intervention group (40.98%) and the control group (35.43%) for "who did not drink sugary drinks for every day in the past 7 days" ( χ 2=4.32, P <0.05). After intervention, the intervention group and the control group showed increases in "school outdoor activity duration on school days" and "outdoor activity duration on rest days" compared to those before intervention ( t/Z =-13.32,-9.71;- 2.59，-2.69）；the behavior rate of "visual acuity measurement frequency at least once every 3 months" in the intervention group (46.68%) and the control group (52.76%) increased compared to those before intervention (36.43%, 44.01%), and the increases in the intervention group were greater than that in the control group ( χ 2=17.52,11.08) ( P <0.05). Conclusions Comprehensive intervention measures have significant intervention effects on controlling the occurrence and development of comorbidity of myopia and obesity in children. It could actively promote collaboration and cooperation among families, schools, communities and medical institutions to reduce the occurrence of myopia and obesity among primary and secondary school students.

Objective Discuss the safety and effectiveness of flow diverter device and traditional stent inthetreatment of unruptured ophthalmic segment aneurysms.Methods A retrospective analysis from January 2017 to January 2023 was performed on the clinical data of 70 cases of unruptured aneurysms in the Department of Neurosurgery of Southern Theater General Hospital treated with stent-assisted embolization.According to the type of implanted stents,theywere divided into flow diverter device group(n = 21)and traditional stent group(n = 49),and the postoperative clinical effects and complications of the two groups were compared.Results The two groups of patients followed 3 to 24 months,with an average of(14.4±1.82)months.The results of periopera-tive and follow-up showed that the inclusion rate was higher in the flow diverter device group and the traditional stent group(93.3%vs.87.9%),with no significant difference(P>0.05),and the incidence of perioperative and short-term complications was lower(0 vs.6.1%)in the flow diverter device group than in the traditional stent group,and there currencies rate in the flow diverter device group was lower than that in the traditional stent group(0 vs.6.1%),but the difference was not significant(P>0.05).Conclusion Flow diverter devices and traditional stents in the treatment of unruptured ophthalmic segment aneurysmsare feasible,safe and effective.Preliminary results suggest that the incidence of short-term complications and retreatment is lower after treatment with flow diverter devices,and the operation time is short,but further studies are needed to validate long-term complica-tions in patients.

Malignant tumors in children are one of the most important diseases that threaten the health and quality of life of children and are the second most common cause of death in children.With the continuous improvement and progress of treatment technology, the long-term survival rate of children with tumor has been significantly improved, but both the disease itself and the treatment can impair the immune function of children, which makes them vulnerable to various infectious diseases and secondary serious complications, and even become a source of infection, endangering the health of others. Vaccination is the most cost-effective measure to prevent infectious diseases. For children with normal immune functions, the benefits of vaccination usually outweigh the disadvantages. However, there is a lack of detailed data on the vaccination situation, efficacy and safety of vaccine use for such immunocompromised tumor survivors, and there are no authoritative and uniform vaccination recommendations. This article reviewed and summarized the literature and consensus of some domestic and foreign scholars on current status of post-treatment vaccination status, efficacy and safety of vaccination for children with tumors after treatment, with the aim of providing a reference for the practice in this field in China.

Element doping is one of the strategies for increasing the activity of enzyme-like materials.In this study,cobalt,nitrogen and chlorine-doped carbon dots(Co,N,Cl-CDs)were prepared by one-step hydrothermal synthesis utilizing CoCl2 and glutamate as raw ingredients.In weakly acidic environments,Co,N,Cl-CDs exhibited high peroxidase-like activity and could catalyze the oxidation of 3,3′,5,5′-tetramethylbenzidine(TMB)by hydrogen peroxide into oxided TMB(oxTMB),resulting in a distinct color change.Free radical scavenging and electron spin resonance techniques were used to further investigate the catalytic reaction mechanism of Co,N,Cl-CDs,and the reactive intermediates produced during the reaction were identified as hydroxyl radical.Acid phosphatase(ACP)could catalyze the hydrolysis of sodium ascorbyl phosphate to release ascorbic acid,which could reduce the blue oxTMB into colorless TMB.Based on this principle,a colorimetric-switching sensing system for detection of ACP was developed by coupling Co,N,Cl-CDs and ACP.The sensing system demonstrated good linearity in ACP activity range of 0.5-20 U/L,with a detection limit of 0.17 U/L.The developed sensing system was used to detection of ACP in real serum samples with good recoveries(97.1%-105.7%)and reproducibility(RSD<5%).The sensing system developed here based on Co,N,Cl-CDs had many advantages such as low detection cost,process visualization,and high sensitivity,providing reference for detection of ACP.

ObjectiveTo observe the curative effect of Lishui Xiaogu plaster combined with liver disease therapeutic apparatus on the treatment of refractory ascites due to hepatitis B cirrhosis. MethodA total of 120 cases of refractory ascites due to hepatitis B cirrhosis were randomly divided into a control group and an observation group， with 60 cases in each group. The control group was treated with conventional western medicine and DSG-Ⅲ liver disease therapeutic apparatus， and the observation group was externally applied with Lishui Xiaogu plaster in the liver area and abdomen based on the control group. After 4 weeks of continuous treatment， the weight， abdominal circumference， 24-hour urine volume， the quantitative score of clinical symptoms， liver function， serum endothelin-1 （ET-1）， nitric oxide （NO）， and interferon-γ （IFN-γ） before and after treatment were observed in the patients of two groups. ResultAfter 4 weeks of treatment， the total effective rate of the observation group was 87.72% （50/57）， higher than 67.9% （38/56） in the control group （P<0.05） （χ²=6.411， P<0.05）. The changes in abdominal circumference， body weight， and 24-hour urine volume in the two groups were better than those before treatment （P<0.05）. In terms of traditional Chinese medicine （TCM） clinical symptom scores， there was no significant difference in the symptoms of appetite， fatigue， sleep， and yellowing of the body and eyes in the control group before and after treatment， and other indexes in the two groups were better than those before treatment （P<0.05）. The observation group was better than the control group in improving symptoms such as abdominal distension， hypochondriac pain， appetite， fatigue， and lower limb edema （P<0.05）， but there was no significant difference between the two groups in improving sleep and yellowing of the body and eyes. In the experiment， the total bilirubin （TBIL）， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， albumin/globulin ratio （AGR）， ET-1， NO， and IFN-γ in the two groups were all better than those before treatment （P<0.05）. Except that there was no significant difference between the two groups of TBIL， other indexes in the observation group were better than those in the control group （P<0.05）. In terms of portal vein hemodynamics， the portal vein diameter （D_PV）， the maximum blood flow velocity （V_max）， and portal vein blood flow （Q） in the two groups improved after treatment， and the D_PV， V_max， and Q in the observation group were better than those in the control group （P<0.05）. ConclusionExternal application of Lishui Xiaogu plaster combined with liver disease therapeutic apparatus significantly improves the effective rate of refractory ascites due to hepatitis B cirrhosis， and its mechanism is presumedly related to the decreasing of serum NO and ET-1 levels， the increasing of serum IFN-γ level， and the improvement of portal hemodynamics.

OBJECTIVE: To propose a deep learning target detection model AM- YOLO that integrates coordinate attention and efficient attention mechanism. METHODS: Mosaic image enhancement and MixUp mixed-class enhancement were used for image preprocessing. In the target detection model YOLOv5s with One-Stage structure and modified backbone network and neck network, the maximum pooling layer of the spatial pyramid of the backbone network was replaced with a two-dimensional maximum pooling layer, and the coordinate attention mechanism and the efficient channel attention mechanism were integrated into the C3 module and the backbone network of the model, respectively. The improved model was compared with the unmodified YOLOv5s model, YOLOv3 model, YOLOv3-SPP model, and YOLOv3-tiny model for relevant algorithmic indicators in comparative experiments. RESULTS: The AM-YOLO model incorporating coordinate attention and efficient channel attention mechanism effectively improved the accuracy of melanoma recognition with also a reduced size of the model weight. This model showed significantly better performance than other models in terms of precision, recall rate and mean average precision, and its mean average precision for benign and malignant melanoma reached 92.8% and 87.1%, respectively. CONCLUSION The deep learning-based target object detection algorithm model can be applied in recognition of melanoma targets.
Humans ; Melanoma ; Skin Neoplasms ; Algorithms ; Software ; Image Enhancement

Child ; China ; Evidence-Based Medicine ; Humans

An UPLC method was established for the direct determination of six major bioactive isosteroidal alkaloids, namely peimisine, imperialine, sipeimine-3-D-glucoside, verticinone, verticine and hupehenine from the bulbus of Fritillaria(Beimu), a commonly used antitussive traditional Chinese medicinal(TCM) herb. An Acquity UPLC~(TM) CSH C_(18) column(2.1 mm×100 mm, 1.7 μm) was used for all analysis. The investigated six compounds were all separated with gradient mobile phase consisting of 0.02% diethylamine-water-methanol at a flow rate of 0.3 mL·min~(-1). The temperature of sample manager was set at 20 ℃. Drift tube temperature was 45 ℃, and spray parameter was 40% with injection volume of 1 μL. Then, the further quality assessment of Beimu was carried out by cluster analysis(CA) and principal component analysis(PCA). The investigated all had good linearity(r≥0.998 9) over the tested ranges. The method is simple, accurate and reproducible, and can be used for determining the content of six major bioactive isosteroidal alkaloids.
Alkaloids/isolation & purification* ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal/chemistry* ; Fritillaria/chemistry* ; Phytochemicals/isolation & purification* ; Plant Roots/chemistry*

Coronavirus Disease 2019 (COVID-19), caused by a novel coronavirus (SARS-CoV-2), is a highly contagious disease. It firstly appeared in Wuhan, Hubei province of China in December 2019. During the next two months, it moved rapidly throughout China and spread to multiple countries through infected persons travelling by air. Most of the infected patients have mild symptoms including fever, fatigue and cough. But in severe cases, patients can progress rapidly and develop to the acute respiratory distress syndrome, septic shock, metabolic acidosis and coagulopathy. The new coronavirus was reported to spread via droplets, contact and natural aerosols from human-to-human. Therefore, high-risk aerosol-producing procedures such as endotracheal intubation may put the anesthesiologists at high risk of nosocomial infections. In fact, SARS-CoV-2 infection of anesthesiologists after endotracheal intubation for confirmed COVID-19 patients have been reported in hospitals in Wuhan. The expert panel of airway management in Chinese Society of Anaesthesiology has deliberated and drafted this recommendation, by which we hope to guide the performance of endotracheal intubation by frontline anesthesiologists and critical care physicians. During the airway management, enhanced droplet/airborne PPE should be applied to the health care providers. A good airway assessment before airway intervention is of vital importance. For patients with normal airway, awake intubation should be avoided and modified rapid sequence induction is strongly recommended. Sufficient muscle relaxant should be assured before intubation. For patients with difficult airway, good preparation of airway devices and detailed intubation plans should be made.

To construct a eukaryotic expression plasmid containing the luciferase reporter gene (Fluc) to quickly detect apoptosis. Four amino acids, Asp-Glu-Val-Asp (DEVD), the recognize motif of Caspase-3, were introduced into the middle of the Fluc-C and N fragment. Meanwhile, four amino acids, Asp-Glu-Val-Gly (DEVG), were selected as a negative control. Subsequently, the recombinant gene was cloned into the N and C terminal end of the split intein, and named as pFluc-DEVD and pFluc-DEVG. Then the plasmids were transfected into cells and renilla luciferase was co-transfected in each sample as an internal control for transfection efficiency. Then the apoptosis level was detected by the double luciferase reporter gene and the Western blotting analysis. The results showed that when apoptosis occurred, the content of firefly luciferase expressed in the pFluc-DEVD plasmid transfected group was about 3 times higher than pFluc-DEVG plasmid transfected group. Furthermore, Western blotting detection indicated that the Fluc level was significantly increased in pFluc-DEVD transfected group when pre-treated by apoptosis stimulants. The activation degree of Caspase-3 was closely related to the expression of Fluc, and had a significant statistical difference. These results confirmed that firefly luciferase protein expressed by pFluc-DEVD plasmid can be cleaved by the intracellular Caspase-3 enzyme, and this plasmid can accurately reflect the cell apoptosis level, which provides a useful method for quantitative detection of apoptosis.
Apoptosis ; Genes, Reporter ; Luciferases, Firefly ; Transfection