Objective: To evaluate the characteristics and related factors of physical activities both inside and outside the kindergarten among preschool children, so as to provide a reference for promoting targeted physical activities among different types of children in the future. Methods: From April 2016 to December 2022, 706 preschool children aged 3 to 6 years from the Shanghai parent child cohort followed up. Accelerometers were used to measure their physical activities during kindergarten hours, and a parent questionnaire was employed to assess their physical activities and screen time outside the kindergarten. Restrictive cubic spline analysis was used to examine the relationship between moderate to vigorous physical activities (MVPA) inside and outside the kindergarten. Cluster analysis was performed to identify physical activity patterns among children, and multinomial Logistic regression analysis was conducted to explore the influencing factors of these physical activity patterns. Results: On weekdays, preschooler accumulated an average of (40.83±15.71) minutes of MVPA inside the kindergarten and 30(15, 53) minutes outside daily. Restricted cubic spline analysis revealed an inverted U shaped relationship between MVPA inside and outside the kindergarten. Cluster analysis identified four groups: low daily MVPA but active inside (196, 27.8%), moderate daily MVPA but high screen time outside (97, 13.7%), adequate daily MVPA and relatively active outside (96, 13.6%), and low daily MVPA and relatively inactive both inside and outside (317, 44.9%). Compared to the reference group of adequate daily MVPA and relatively active outside, children with screen time exceeding 60 minutes at 2 years old were more likely to belong to the group with adequate daily MVPA but more screen time outside ( OR =3.84, 95% CI =1.16-12.74, P <0.05). Boys had a lower likelihood of being in the group with low daily MVPA and relatively inactive both inside and outside ( OR =0.33, 95% CI =0.16-0.70, P <0.05). Children from neighborhoods with insufficient sport facilities were more likely to be in the low daily MVPA and relatively inactive group ( OR =2.20, 95% CI = 1.05 -4.63, P <0.05). Conclusions Behavior patterns of physical activity and screen time for both inside and outside the kindergarten vary greatly among different children. Screen time at the age of 2 and the sports facilities around the commuinty are key factors influencing the physical activity pattern. It is recommended to implement personalized intervention plans in collaboration with schools and families for different types of children.

Objective From the perspective of China's health system,evaluate the cost-effectiveness of furmonertinib compared to gefitinib in first-line monotherapy for EGFR mutation-positive advanced non-small cell lung cancer.Methods Based on the FURLONG study of phase Ⅲ clinical trials,a three-state partitioned survival model was constructed and combined with parameters such as treatment cost,utility value,the incidence of adverse reactions,and discount rate;the total incremental cost-effectiveness ratio(ICER)was simulated.Then,the ICER value was compared with the willingness to pay(WTP)value to determine the economic feasibility of furmonertinib compared to gefitinib as a first-line treatment for EGFR mutation-positive advanced non-small cell lung cancer.Results The basic analysis results show that the treatment group with furmonertinib incurred an additional cost of 85 786 yuan compared to the treatment group with gefitinib,but obtained an additional 0.62 QALYs,with an incremental cost-effectiveness ratio of 138 306 yuan,which is less than three times China's per capita GDP.One-way sensitivity analysis shows that the best support treatment cost,PFS utility value,and PD utility value significantly impact the ICER results.The results of probability sensitivity analysis show that when the WTP is three times China's per capita GDP,the probability of economic viability of the furmonertinib group compared to the gefitinib group is 100.0%.The scenario analysis results verified the robustness of the underlying analysis results.Conclusion Under the willingness to pay threshold of three times China's per capita GDP in 2022,Choosing furmonertinib as a first-line monotherapy for EGFR mutation-positive advanced non-small cell lung cancer is more cost-effective than gefitinib.

OBJECTIVE To study the effects and m echanism of eriocalyxin B （EriB）on epithelial -mesenchymal transition （EMT）of colon cancer cells . METHODS The colon cancer cells HT 29 and HCT 116 as research objects . Scratch-healing assay and Transwell assay were used to detect the effects of EriB on migration and invasion of two kinds of cells . Western blot method was used to detect the effects of EriB （1.0 μmol/L），EriB+Wnt/β-catenin signaling pathway agonist Licl （1.0 μmol/L EriB+ 10 mmol/L Licl）or EriB+Wnt/ β-catenin signaling pathway inhibitor XAV 939（1.0 μmol/L EriB+ 10 μmol/L XAV 939）on the expressions of EMT related proteins [E-cadherin，N-cadherin，Snail] and Wnt/ β-catenin signaling pathway related proteins [β-catenin，c-myc， cyclin D 1，TCF4]. RESULTS EriB can significantly inhibit the invasion and migration of two kinds of cells （P＜0.01）. EriB significantly reduced the protein expressions of N -cadherin，Snail，β-catenin，c-myc，cyclin D 1 and TCF 4 while increases the protein expression of E -cadherin（P＜0.05 or P＜0.01）. After EriB combined with Licl ，the protein expressions of β-catenin，c- myc，cyclin D 1 and TCF 4 in the two kinds of cells were reverse d（P＜0.05 or P＜0.01）. After combined with XAV 939，the protein expressions of β-catenin and N -cadherin were further down -regulated（P＜0.05 or P＜0.01）；the protein expression of E -cadherin was further up -regulated（P＜0.01），while migration rate was decreased significantly （P＜0.01）. CONCLUSIONS EriB can inhibit the epithelial -mesenchymal transition of colon 19SXHZ0351） cancer cells by inhibiting the activation of Wnt/ β -catenin

Objective:To determine the alteration of miRNA profile of human tonsillar epithelial cells induced by enterovirus-A71 (EV-A71) infection.Methods:Human tonsillar epithelial cells UT-SCC-60B were infected with EV-A71 at multiplicities of infection (MOI) of 1 and total RNA was extracted using Trizol reagent. Small RNA library was constructed and high-throughput sequencing was performed using Illumina NextSeq 500. Differential significantly expressed known and novel miRNAs and putative targets were selected after the processing of raw data. Gene ontology (GO), kyoto encyclopedia of genes and genomes (KEGG) pathways were analyzed through online database. Kinds of miRNA could target EV-A71 genome was determined through psRNATarget. Validations of random selected miRNAs were done through real-time RT-PCR.Results:A total of 61 known significantly expressed miRNAs (21 miRNAs were down-regulated and 40 miRNAs were up-regulated) and 559 novel significantly expressed miRNAs were identified through high-throughput sequencing. Novel significantly expressed miRNA had typical "hairpin structure" of pre-miRNA. Fold changes of hsa-miR-517b-3p and hsa-miR-199a-5p which was determined by real-time RT-PCR had similar change trends with high-throughput sequencing. Putative targets of significantly expressed miRNA were referred to different biological processes and signaling pathways. A total of 24 significant miRNAs (5 known significantly expressed miRNAs and 19 novel significantly expressed miRNAs) had "seed sequence" in EV-A71 genome.Conclusions:Expression of miRNA profile in UT-SCC-60B was significantly changed by EV-A71 infection and the identified significantly expressed miRNAs potential target EV-A71 genome to regulate EV-A71 replication.

Objective:To research the metabolomic alterations of human lung bronchial epithelial cells infected with human rhinovirus 1B (HRV1B).Methods:Untargeted metabolomics was used to determine the metabolomic alterations in human lung bronchial epithelial cells (BEAS-2B) 6 h, 12 h and during the dynamic process (6 h∶12 h) after HRV1B infection.Results:A total of 93 differentially significant metabolites (DSMs) (47 DSMs were up-regulated and 46 DSMs were down-regulated) and 88 DSMs (37 DSMs were up-regulated and 51 DSMs were down-regulated) at post infection of HRV1B in BEAS-2B at 6 h or 12 h, respectively. A total of 30 DSMs (12 DSMs were up-regulated and 18 DSMs were down-regulated) in a dynamic process (6 h∶12 h) after HRV1B infection. Unknown metabolites took up most proportions. The trends of fatty acid, lipid, amino acid, nucleotide and carbohydrate were increased along with the prolonging of HRV1B infection. DSMs such as Diisononyl phthalate was co-detected DSMs among three groups.Conclusions:Metabolites such as fatty acid, lipid, amino acid, nucleotide and carbohydrate of BEAS-2B cells are changed induced by HRV1B infection.

Objective To study effect of electroacupunture on reactive astrogliosis of rats after spinal cord injury. Methods A total of 36 SD rats were randomly divided into the sham group, model group and electroacupuncture group, 12 rats in each group. The sham group only underwent laminectomy without spinal cord injury, and the impactor was used to establish spinal cord injury model in model group and electroacupuncture group. The electroacupuncture group was given electroacupuncture after operation, while the rest groups were given the same condition of grabing. The Basso Beattie Bresnahan (BBB) scores of rats were recorded daily after operation and rats were sacrificed on the 14th day after administration. Nissl staining was used to observe the morphology of neurons. The expression of GFAP was detected by immunofluorescence. The expression of GFAP protein was detected by Western blot. Results The fifth days after the intervention, the BBB score of the electroacupuncture group was significantly higher than that of the model group (P<0.05). Compared with the model group, the expression of GFAP in electroacupuncture group significantly decreased (F=23.831, P<0.001), the expression of GFAP protein in electroacupuncture group significantly decreased (F=15.883, P<0.001), the expression of IL-1β and TNF-α in electroacupuncture group significantly decreased (F=82.773, 113.487, P<0.001). Conclusions The electroacupuncture can inhibit the expression GFAP and astrogliosis to inhibit inflamation after spinal cord injury in rats, which is conducive to the repair of neurons and the recovery of limb motor function in rats.

Objective: To investigate the application of single-molecule PCR (SM-PCR) in the detection of plasma ctDNA for the treat-ment of patients with advanced lung adenocarcinoma. Methods: In total, 30 patients diagnosed with advanced lung adenocarcinoma were enrolled between June 2017 and May 2018. ctDNA fragments of the target genes (EGFR, KRAS, BRAF, ALK, HER2, and TP53) from the blood samples were enriched by SM-PCR, and DNA libraries were prepared. Finally, a high-throughput sequencing was performed. The EGFR detection of tumor tissue samples was performed using real-time fluorescence PCR based on the amplification refractory mutation system (ARMS) and consistency in the results of EGFR mutation detection in the plasma and tissue was compared. Results:The results of both the methods were consistent (Kappa=0.867, P<0.001). The McNemar's test also indicated that the results are not statistically different (P=0.500). Conclusions: SM-PCR can be used for the detection of plasma EGFR mutations. The target detection sites are more comprehensive and multiple mutations can be detected at the same time. Results of the analysis are more precise and can be absolutely quantified.

Objective: To assess the significance of DDAVP use in the diagnosis and treatment of VWD. Methods: An analysis of 15 VWD cases who referred to Hematology Division of First affiliated Hospital of Soochow University and treated with DDAVP from March 2016 to August 2018 was conducted. Efficacy and treatment response of DDAVP were monitored by observations of changes in factor Ⅷ procoagulant (FⅧ∶C) and von Willebrand Factor (VWF) related indicators before and 2 h after DDAVP injection. Results: Of 15 cases with VWD, 7 males and 8 females with a median age of 23 (6-46) years, 7 of 9 type I VWD patients achieved complete response (CR) , 1 type 2A VWD case CR, 5 type 3 VWD ones no response (NR) . The VWF multimer analysis in 5 patients combined with other plasma VWF values were in accordance with the known diagnosis. Conclusions DDAVP was effective in most type 1 patients, and ineffective in some type 2 and almost all type 3 cases. It was helpful for diagnosis and subsequent treatment planning.

Objective? To construct a suitable triage tool foremergency nurses in China for patients with non-traumatic chest pain. Methods? Based on the framework of "Standardized Procedure of Hospital Emergency Departments", through reading the relevant literature at home and abroad, in-depth interviews with triage nurses and clinical observation, a preliminary design of triage items for patients with non-traumatic chest pain was made, and the severity of patients was divided into three levels. Using Delphi expert consultation method, through two rounds of consultation with 27 experts,preliminary indicators and classification criteria were extracted and determined. Results? The effective recovery rates of the two rounds of questionnaires were 100% and 96.1%, respectively; the expert authority coefficient was 0.75 and 0.78, and the Kendall's W coordination coefficient of the two rounds of expert consultation was 0.397 and 0.487 (P＜0.01). After two rounds of expert consultation, the coefficient of variation of the indicators ranged from 0.00 to 0.22. After two rounds of expert consultation, five indicators (chest pain characteristics, heart rate, systolic blood pressure, finger pulse oxygen, electrocardiogram) in triage were finally determined. Each index was classified intoⅠ,Ⅱ and Ⅲ according to the critical degree. Conclusions The application of Delphi method in determining the indicators of emergency triage criteria for patients with non-traumatic chest pain has high reliability and scientificity, and is suitable for emergency nurses to use.

Objective To investigate the clinical effect of minimally invasive extraction of anterior tooth residual root after root separation.Methods A total of 400 patients receivinganterior tooth residual root extraction were collected in the clinic of oral and maxillofacial surgery department between January 2015 and December 2016.The patients were divided into a control group and a study group according to their sequence to see the doctor,with an odd for the study group and an even for the control group.In the study group,residual roots were separated mesiodistally by high speed turbine before using minimally invasive extraction tool;while in the control group residual roots were extracted only using minimally invasive extraction tool.The surgical duration,postoperative damage rate of the lip side plate,degree of pain and patient satisfaction in the two groups were analyzed.Results The surgical duration was shorter in the study group compared with the control group (P ＜ 0.05).The postoperative damage rate of the lip side plate and the degree of pain were lower,while patient satisfaction was higher in the study group than in the control group (P ＜ 0.05).Conclusions The postoperative damage rate of the lip side plate is significantly lower in minimally invasive extraction of anterior tooth residual root after root separation.Smaller trauma is conducive to the implant afterwards.Root separation in minimally invasive extraction of anterior tooth residual root is valuable for clinical application.