Objective:To develop an E-chart visual acuity recognition card suitable for children aged 2-4 years and to design a child-friendly gamified intervention method to improve the success rate, compliance, and parental satisfaction in visual acuity testing for this age group.Methods:A non-concurrent historical control study design was employed, involving 143 children aged 2-4 years and parents who attended the ophthalmology outpatient clinic of Renmin Hospital of Wuhan University from January to June 2023. The children were divided into the control group and the intervention group based on their appointment times. Both groups underwent binocular visual acuity testing using the E-chart visual acuity recognition cards. The control group received conventional visual acuity testing, while the intervention group was subjected to a child-friendly gamified intervention. The effectiveness of the intervention was assessed by comparing the success rate of visual acuity testing, examination compliance, and parental satisfaction between the two groups.Results:Finally, the sample size of the control group and the intervention group were 69 and 74 cases. The children in the control group was (3.06 ± 0.47) years old, with 36 males and 33 females; whereas the children in the intervention group was (2.99 ± 0.45) years old, with 38 males and 36 females. The parents in the control group was (29.37 ± 4.00) years old, with 24 males and 45 females; whereas the parents in the intervention group was (29.35 ± 3.50) years old, with 27 males and 47 females. The success rate of visual acuity testing in the intervention group was significantly higher at 63.5% (47/74) compared to the control group′s 34.8% (24/69), with a statistically significant difference ( χ2=7.45, P<0.01). The compliance of the children during the examination in the intervention group, categorized as no grade I cases, 19 gradeⅡcases, 21 gradeⅢcases, and 34 grade Ⅳ cases, was significantly higher than that of the control group, which had 17 grade I cases, 23 gradeⅡcases, 15 grade Ⅲcases, and 14 grade Ⅳ cases ( Z=4.61, P<0.01). In terms of parental satisfaction, the intervention group′s satisfaction score was (4.53 ± 0.56) points, which was significantly higher than the control group′s score of (3.74 ± 0.78) points, indicating a statistically significant difference ( t=-4.88, P<0.01). Conclusions:The child-friendly gamified intervention significantly improved the success rate and compliance of visual acuity testing in children aged 2-4 years and increased parental satisfaction. This intervention provides an effective solution for visual acuity testing in children aged 2-4 years.

Inflammatory bowel disease(IBD)is a serious disorder,and exploration of active compounds to treat it is necessary.An acidic polysaccharide named SUSP-4 was purified from Selaginella uncinata(Desv.)Spring,which contained galacturonic acid,galactose,xylose,arabinose,and rhamnose with the main chain structure of →4)-α-D-GalAp-(1 → and →6)-β-D-Galp-(1 → and the branched structure of →5)-α-L-Araf-(1 →.Animal experiments showed that compared with Model group,SUSP-4 significantly improved body weight status,disease activity index(DAI),colonic shortening,and histopathological damage,and elevated occludin and zonula occludens protein 1(ZO-1)expression in mice induced by dextran sulfate sodium salt(DSS).16S ribosomal RNA(rRNA)sequencing indicated that SUSP-4 markedly downregulated the level of Akkermansia and Alistipes.Metabolomics results confirmed that SUSP-4 obviously elevated thiamine levels compared with Model mice by adjusting thiamine metabolism,which was further confirmed by a targeted metabolism study.Fecal transplantation experiments showed that SUSP-4 exerted an anti-IBD effect by altering the intestinal flora in mice.A mechanistic study showed that SUSP-4 markedly inhibited macrophage activation by decreasing the levels of phospho-nuclear factor kappa-B(p-NF-κB)and cyclooxygenase-2(COX-2)and elevating NF-E2-related factor 2(Nrf2)levels compared with Model group.In conclusion,SUSP-4 affected thiamine metabolism by regulating Akker-mania and inhibited macrophage activation to adjust NF-κB/Nrf2/COX-2-mediated inflammation and oxidative stress against IBD.This is the first time that plant polysaccharides have been shown to affect thiamine metabolism against IBD,showing great potential for in-depth research and development applications.

Objective:To analyze effects of dietary intervention on health outcome in patients with polycystic ovary syndrome.Methods:PubMed, Cochrane Library, Web of Science, Embase, China Biology Medicine disc, CNKI and WanFang Data were searched by the computer, and clinical RCTs about dietary intervention in patients with polycystic ovary syndrome were included. The retrieval time was up to August 2020. Two trained researchers independently screened the literature, extracted data and evaluated the quality. Meta-analysis was performed using RevMan 5.3 software.Results:A total of 9 clinical RCTs were included, including 697 patients with polycystic ovary syndrome. The results of Meta-analysis showed that compared with the control group, dietary intervention could reduce the body weight ( MD=-2.22, 95% CI -2.75--1.68, P<0.001) , body mass index ( MD=-1.05, 95% CI -1.24--0.87, P<0.001) , waist circumference ( MD=-2.35, 95% CI -4.17--0.53, P=0.01) , fasting blood glucose ( MD=-0.12, 95% CI -0.18--0.05, P<0.001) , fasting insulin ( MD=-4.77, 95% CI -5.59--3.96, P<0.001) , insulin resistance index assessed by steady-state model ( MD=-0.93, 95% CI -1.29--0.57, P<0.001) , luteinizing hormone ( MD=-0.46, 95% CI -0.90--0.03, P=0.040) , follicle-stimulating hormone ( MD=-0.16, 95% CI -0.31--0.01, P=0.030) , total testosterone ( MD=-0.33, 95% CI -0.53--0.13, P<0.001) , increase sex hormone-binding globulin ( MD=8.02, 95% CI 5.55-10.49, P<0.001) and pregnancy rate ( RR=18.38, 95% CI 4.47-75.55, P<0.001) of patients with polycystic ovary syndrome. Conclusions:Dietary intervention can improve the pregnancy rate of patients with polycystic ovary syndrome, improve the endocrine and metabolic status and reduce the level of insulin resistance and human measurable indicators.

Objective:To investigate the people's cardiopulmonary resuscitation (CPR) ability in Hunan Province and whether there are differences in the skill level of CPR among respondents of different ages and education levels.Methods:A self-made questionnaire was conducted to survey people in Hunan Province by means of WeChat from May 2018 to April 2019. The questionnaire referred to 2016 National consensus on cardiopulmonary resuscitation in China issued by Cardiopulmonary Resuscitation Specialized Committee of Chinese Research Hospital Association and 2017 version of American Heart Association (AHA) CPR operational guide, and combined with the CPR assessment scale of Hunan Provincial People's Hospital. The contents of the survey included the basic information of the subjects, the common knowledge and skills of first aid, the willingness to learn CPR skills and implement CPR, and the operational requirements of high quality CPR, etc. Results:A total of 6 563 people received the on-site first aid knowledge questionnaire, and 4 355 people completed and submitted the questionnaire. The recovery rate was 66.36%, of which 3 602 valid questionnaires were from IP in Hunan Province, and the qualified rate was 82.71%. Among the subjects, 1 532 were men (42.53%) and 2 070 were women (57.47%). The majority aged group from 19 to 30 (59.41%) and from 31 to 50 (36.70%). 307 were rural (8.52%) and 3 295 were urban (91.48%); and the majority levels of education were senior or technical secondary school (38.26%) and undergraduate or junior college (44.50%). Of the 3 602 respondents, 39.09% indicated that they had been exposed to CPR knowledge and only 0.36% indicated that they did not wish to participate in CPR training. 69.93% of the respondents said they would actively to help if they wet cardic arrest, and 97.92% of those were willing to do so if the patients were relatives or friends. The survey results showed that only 8.91% of respondents chose relatively high-quality CPR options (chest compressions were performed first, the pressing point was located in the sternum of the midpoint of bilateral nipple line, the pressing frequency was 100-120 times/min, pressing depth was 5-6 cm, the ratio of chest compression to artificial ventilation was 30∶2). Among these people, the correct rate was higher in the ages of 31-50 years old and ≤ 18, 19-30 than those ≥51 years old (12.71% vs. 0%, 6.87%, 8.70%, χ2 = 41.420, P < 0.01). The correct rate of education at graduate level and above was higher than those in junior middle school and below, high school or technical secondary school, undergraduate or junior college (19.57% vs. 2.07%, 3.41%, 13.72%, χ2 = 152.262, P < 0.01). Conclusions:The public in Hunan Province have a strong sense of first aid, and some of the theoretical knowledge of CPR. People between 31 years old and 50 years old of age and with graduate education and above know more about CPR, but the overall mastery of CPR skills is poor. It is necessary to further improve the ability of the public as the first witness by teaching various skills of CPR in various forms.

Objective To reconcile previous studies on the impact of transitional nursing intervention on quality of life in patients with chronic obstructive pulmonary disease (COPD) after discharge from the Chinese population. Methods PubMed, EMBASE, Cochrane Library, Clinical Trial, CBM, Joanna Briggs Institute Library, MEDLINE, Wanfang database and CNKI database, Vip database were searched by computer. The literatures about the influence of transitional nursing on the quality of life of COPD patients were searched until January 1, 2018. the data were analyzed by Rev Man 5.3 software. The results showed that P<0.05 on both sides was statistically significant. Results Five clinical studies were included, and the data were combined according to the symptom, activity, social psychology and St.George's Respiratory Questionnaire (SGRQ) total score in the SGRQ scale. Mean difference and its 95％confidence interval of symptoms, activities, social psychology and SGRQ score were-13.09 (-18.71,-7.48), 12.05 (-14.55,-9.45),-17.87 (-22.27,-13.46) and-15.42 (-19.74,-11.10) (Z=4.57-9.42, all P <0.05). Conclusions The transitional nursing has a significant positive effect on improving the quality of life among patients with COPD, which can effectively improve the psychosocial status of patients, and make the patients respond more actively to the problems in the process of treatment and rehabilitation.

With the increasing prevalence of chronic obstructive pulmonary disease (COPD) and the extremely high mortality, disability, symptom burden and dysfunction, as well as the need for continuous drug management and care and increased rehospitalization rate, it brings patients, families and even society huge economic burden. The transitional care model provides non-drug treatment method to help patients get through the transition period safely and steadily, it also improves patients' self-care ability, quality of life and reduce hospital readmission. This review will start from the concept of disease management in transitional period, elaborate on the problems and core elements of transitional caring, then discuss the application of advanced practice nurse-dominated transitional caring mode in COPD, so as to provide theoretical and practical basis for improving the quality of chronic diseases management in China.

Objective: To investigate the changes of brain gray matter volume in patients with occupational noise-induced hearing loss by voxel based morphometry (VBM) . Methods: 16 age-and education-matched healthy controls and 42 patients with occupational noise induced hearing loss, including 27 in mild group and 15 in severe group, received MRI 3D-FSPGR sequence T1WI sagittal scan, and then underwent VBM of brain gray matter volume data analysis. Results: The brain gray matter volume of the left occipitotemporal lateral gyrus, the anterior cingulate gyrus, the bilateral angular gyrus, the precuneus and the near midline area of cerebellum differed between experimental group and control group (P<0.01) . Conclusion The volume of gray matter in specific brain areas of patients with occupational noise-induced hearing loss was changed, and the effect of noise on brain structure was revealed from the perspective of imaging.

Objective To detect gap junction protein Cx45, gap junction protein Cx40 and Tumor Necrosis Fαctor-α(TNF-α) expression in the infarcted myocardium, and to study their combined effects. Methods Immunohisto-chemical staining (S-P immunohistochemical staining method) and qRT PCR detection of gap junction were used to identify protein Cx45, Cx40 and TNF-α respectively in 30 cases of late early myocardial ischemic stroke group and 30 cases of myocardial infarction due to sudden death group with control group being 20 cases of normal expression in myocardial group. The effect of the different expressions was compared in the different groups. Results Immuno-histochemical results: Between the two groups, Cx45 expression was higher in the sudden death group compared to normal myocardium. Cx40 expression was decreased significantly in the sudden death group when compared to normal myocardial group while TNF-α expression was high. The expressions had significant differences in the three groups (P<0.05). Qrt - PCR results showed that the mRNΑ expression of Cx45, Cx40 and TNF-α was consistent with their respective protein expression and that there was statistically significant difference in three groups (P<0.01). Cx45, Cx40 and TNF-α had a correlation in the three groups of cardiac muscle. Conclusion Gap junction protein Cx45, Cx40 and TNF-α expression can be useful indicators for the diagnosis of the cause of sudden cardiac death.

OBJECTIVETo observe the impacts of electroacupuncture (EA) on microgliacytes and astrocytes of cervical spinal cord in rats with thyroid incisional pain and explore the mechanism of acupuncture anesthesia in thyroid surgery.

METHODSSixty Wistar male rats were randomized into a normal group, a model group, a Futu (LI 18) group, a Hegu (LI 4)-Neiguan (PC 6) group and a Zusanli (ST 36)-Yanglingquan (GB 34) group, 12 rats in each one. Except the normal group, a longitudinal incision, about 1.5 cm in length was done along the neck midline in the rats of the rest groups to prepare the model of thyroid incisional pain. In the Futu (LI 18) group, the Hegu (LI 4)-Neiguan (PC 6) group and the Zusanli (ST 36)-Yanglingquan (GB 34) group, after modeling for 4 h, 24 h and 48 h, EA was applied to bilateral "Futu" (LI 18), "Hegu" (LI 4) "Neiguan" (PC 6) and"Zusanli" (ST 36) "Yanglingquan" (GB 34) separately, once a day, continuously for 3 days. In the normal group and the model group, no any intervention was applied. The thermal radiant apparatus was used to detect the thermal pain threshold (PT). The fluorescence quantitative RT-PCR and the Western blotting (WB) were used to determine the expressions of protein and gene of microglia activation markers Iba1 and CD11b and the astrocyte specific protein marker, glial fibrillary acid protein (GFAP) in cervical spinal cord (Cto C) after intervention in the rats of each group.

RESULTSAfter intervention, as compared with the normal group, in the model group, the neck PT was reduced apparently (<0.05), the expressions of Iba1 and CD11b and GFAP mRNA as well as the protein expressions in the spinal cord of Cto Cwere up-regulated apparently (<0.05,<0.01). As compared with the model group, in the Futu (LI 18) and the Hegu (LI 4)-Neiguan (PC 6) group, PT was increased significantly (both<0.05) and that did not change apparently in the Zusanli (ST 36)-Yanglingquan (GB 34) group (>0.05). In the Futu (LI 18) group, the protein and gene expressions of Iba1, CD11b and GFAP were lower than those in the model group (all<0.05). In the Hegu (LI 4)-Neiguan (PC 6) group, the expressions of Iba1 mRNA, CD11b protein, GFAP mRNA and protein were all lower apparently than those in the model group (all<0.05). In the Zusanli (ST 36)-Yanglingquan (GB 34) group, the expressions of Iba1, CD11b and GFAP proteins were not different significantly as compared with the model group (all>0.05). In the Zusanli (ST 36)-Yanglingquan (GB 34) group, the expressions of Iba1 mRNA and CD11b mRNA and protein expressions in the spinal cord of Cto Cwere higher apparently than those in the Futu (LI 18) group (<0.01,<0.05); the expressions of Iba1 mRNA and CD11b protein expressions were higher than those in the Hegu (LI 4)-Neiguan (PC 6) group (all<0.05); GFAP mRNA and protein expressions were higher apparently than those in the Futu (LI 18) group and the Hegu (LI 4)-Neiguan (PC 6) group (all<0.05).

CONCLUSIONSEA at "Futu" (LI 18) or "Hegu" (LI 4), "Neiguan" (PC 6) relieves the acute neck incisional pain in the rats and its effect may be closely relevant with the down-regulation of the activities of microgliacytes and astrocytes in the spinal cords.

Objective To develop a dual real-time fluorescent RT-PCR method for rapid detection of enterovirus(EV)and en terovirus type 71(EV71).Methods Specific primers and probes were designed and the dual real-time fluorescent RT-PCR reaction system was established.The quantitative standard curve was drawn;its sensitivity and precision were evaluated.Feces and throat swab specimens of 109 clinical patients with hand foot and mouth disease were collected and tested by using this method.Then the obtained results were compared with those detected by commercial EV71 PCR kit.Results The relative coefficient(2)of EV and EV71 standard curve established by the dual real-time fluorescent RT-PCR method were both 0.998.Its sensitivity reached 0.5 TCID50/mL for detecting EV and 0.05 TCID50/mL for detecting EV71.The within-run precision for detecting EV and EV71 was ＜3％ and total precision≤4％.The results showed good specificity for the detection of enterovirus and non-enterovirus.In 109 detected clinical samples,84 cases of EV positive samples were detected,in which 56 cases were EV71 positive with the total positive rate of 51.4 ％,which was consistent with the result of simple fluorescent RT-PCR commercialization kit(P=1.000).Conclusion The established dual real-time fluorescent RT-PCR method has high sensitivity and good stability,which has an important significance for early high throughput rapid diagnosis of hand foot and mouth disease.