Objective: To assess the nutritional supply status of school meals for primary and secondary school students in Henan Province, so as to provide a basis for scientific guidance of school meals. Methods: During 2021-2023, 115 lunch and dinner samples were collected from 25 primary and secondary schools in Zhoukou, Anyang and Luoyang of Henan Province by a direct selection method, and 13 nutrients were determined for each sample. The nutrient supply was evaluated based on Nutrition Guidelines of School Meals and Reference Intake of Dietary Nutrients for Chinese Residents (2023 Edition). Mann-Whitney U test was used to compare the differences of nutritional supply between urban and rural schools. Results: The median values for energy (709.77 kcal,1 kcal=4.18 kJ), fat energy supply ratio (0.27) and carbohydrate energy supply ratio (0.55) in the 66 lunches and dinners from primary school were within the recommended range. The supply of protein (28.39 g) and sodium (1 464.59 mg) was excessive. The median values of zinc (2.62 mg) and dietary fiber (5.19 g) were lower than the reference values. No statistically significant differences were observed in the supply of 13 nutrients between urban and rural primary schools( U = 427.00 -633.00, P > 0.05 ). Among 49 samples from secondary schools, the median value of energy supply (930.02 kcal), carbohydrate energy ratio ( 0.54 ) and fat energy supply ratio(0.25) were within the recommended range; and the median values of protein (38.82 g) and sodium (2 556.80 mg) were higher than the standard; and the median values of calcium (250.32 mg) and vitamin B1 (0.16 mg) were lower than the standard. Additionally, the differences in the level of vitamin B2 ( U =372.00) and zinc ( U =375.00) between the urban and rural secondary schools were statistically significant ( P <0.05). Conclusion Nutrient supply of primary and secondary school meals in three cities of Henan Province is inadequate and imbalanced, and the recipe need to be further optimized and improved.

Objective:To investigate the pathogen distribution and influencing factors for pulmonary infection after radical resection of esophageal cancer.Methods:The retrospective case-control study was conducted. The clinical data of 555 patients who underwent radical resection of esophageal cancer in Heping Hospital Affiliated to Changzhi Medical College from January 2021 to December 2022 were collected. There were 344 males and 211 females, aged (64±8)years. Obser-vation indicators: (1) incidence of postoperative pulmonary infection and pathogen distribution; (2) analysis of influencing factors for postoperative pulmonary infection. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. The comparisons of ordinal data were analyzed using the nonparametric test. Univariate analysis was performed using the corresponding statistical methods based on data type. Multivariate analysis was performed using the Logistic stepwise regre-ssion model advance method. Results:(1) Incidence of postoperative pulmonary infection and pathogen distribution. Among 555 patients, 91 cases had postoperative pulmonary infection, with the incidence as 16.40%(91/555). In 91 patients with postoperative pulmonary infection, 59 strains of bacteria were isolated and cultured. There were 53 strains of gram-negative bacteria, 3 strains of gram-positive bacteria and 3 strains of fungi, including 20 multidrug-resistant bacteria. Among the 53 strains of gram-negative bacteria, there were 18 strains of Acinetobacter baumannii (12 strains were multidrug resistant), 18 strains of Klebsiella pneumoniae (3 strains were multidrug resistant), 6 strains of Pseudomonas aeruginosa (2 strains were multidrug resistant), 2 strains of Escherichia coli, 2 strains of Enterobacter cloacae, and 2 strains of Haemophilus influenzae (2 strains of Escherichia coli and 1 strain of Enterobacter cloacae were multidrug resistant strains), 1 strain of Serratia marcescens, 1 strain of Citrobacter keri, 1 strain of Corynebacterium striatum, 1 strain of Proteus mirabilis and 1 strain of Klebsiella acidogenes. Among the 3 strains of Gram-positive bacteria, there were 2 strains of Staphylococcus aureus and 1 strain of Streptococcus pneumoniae. All the three strains of fungi were Candida albicans. Among the 18 strains of Acinetobacter baumannii, there were 12, 12, 11, 9, 8, 6 and 5 strains resistant to imipenem, ceftriaxone, ceftazidme, cefoperazone or sulbactam, ciprofloxacin, amicacin and levofloxacin, respectively. The above indexes of 18 strains of Klebsiella pneumoniae were 0, 1, 1, 1, 2, 0 and 2, respectively. (2) Analysis of influencing factors for postoperative pulmonary infection. Results of multivariate analysis showed that tumor pathological staging as stage Ⅱ and Ⅲ, duration of preoperative hospital stay ≥6 days, operation time ≥240 minutes, mode of operation as thoracotomy, type of antibiotics used in peri-operative period ≥3, and postoperative antibiotic use time ≥5 days were independent risk factors for postoperative pulmonary infection ( P<0.05). Conclusions:The main pathogenic bacteria of pulmonary infection after radical resection of esophageal cancer are Acinetobacter baumannii and Klebsiella pneumoniae. Tumor pathological staging as stage Ⅱ and Ⅲ, duration of preoperative hospital stay ≥6 days, operation time ≥240 minutes, mode of operation as thoracotomy, type of antibiotics used in perioperative period ≥3, and postoperative antibiotic use time ≥5 days are independent risk factors for pulmonary infection in patients with esophageal cancer after radical surgery.

Mixed lineage leukemia 1(MLL1) is a member of the "SET" histone methyltransferases family.MLL1 methyltransferase complex, consisting of MLL1, WDR5, RbBP5, Ash2L and DPY-30, regulates methylation level of histone H3 lysine 4 and is essential for the development of human hematopoietic system and self-renewal of blood cells.As an oncogenic protein produced by the translocation of MLL1 gene, the MLL1 fusion protein has been found in some patients with leukemia.Complete MLL1 enzyme complex is required to perform histone demethylation effect, therefore, targeting the protein-protein interaction of MLL1-WDR5 has become a potential strategy for the treatment of leukemia induced by MLL1 fusion protein.This review systematically summarizes the biological mechanism, structural information and inhibitors of MLL1-WDR5 protein-protein interaction, with a perspective based on previously reported data, aiming to provide some reference for further investigation.

Stimulator of interferon genes (STING) is an important factor in the auto-immune response of our bodies.Considering the mechanism of activating CD8+ T cells after the activation of STING protein, the combination of STING agonists and immune checkpoint inhibitors for the treatment of tumor immunotherapy has good clinical application prospect.In this paper, the research progress of molecular types, mechanism of action and structural modifications of STING agonists were reviewed.The developing tendency were outlined to provide some references for further investigation.

Lung cancers are the leading cause of cancer deaths worldwide and pose a grave threat to human life and health. Non-small cell lung cancer (NSCLC) is the most frequent malignancy occupying 80% of all lung cancer subtypes. Except for other mutations (

Objective The application of nano-carbon tracer technique in radical antegrade modular pancreatosplenectomy (RAMPS) to treat malignant tumors of pancreatic body and tail.To investigate whether radical anterograde modulization of pancreatic body and tail combined with nano-carbon tracer technique is more beneficial to the prognosis of patients.Methods From January 2014 to September 2018,a retrospective analysis was performed in 48 patients in Linyi Central Hospital,all patients underwent RAMPS,all of whom were pathologically proved to be pancreatic carcinoma of the body and tail.Based on whether the nano-carbon lymph node tracer was performed during the operation,the patients were divided into two groups:nano-carbon group (nano-carbon lymph node tracing) and conventional operation group (no nano-carbon lymph node tracer).The differences between the two groups were analyzed,including operative time,intraoperative blood loss,postoperative complications (pancreatic fistula),postoperative hospitalization time,postoperative pathological lymph node status (number of dissection,number of positive lymph nodes,the positive rate of lymph node black staining in nano-carbon group) and survival time after operation.The measurement data were expressed as mean ± standard deviation (Mean ± SD),t-test were used for comparison among groups;Chi-square test was used for comparison of counting data,and Kaplan-Meier test was used for comparison of survival rate.Results There was no significant difference in the time of operation [(4.45 ± 0.59) h vs (4.41 ±0.65) h],the amount of blood lost during operation [(447.39 ± 109.51) ml vs (434.8 ± 76.38) ml] and the time of hospitalization after operation [(16.52 ± 4.12) d vs (16.56 ±2.92) d] between the two groups (P＞0.05).There were 1 case of pancreatic fistula in the nano-carbon group and 2 cases of pancreatic fistula in the convertional operation group,but the difference was not statistically significant (P =0.55).The number of lymph nodes dissected and positive lymph nodes in nano-carbon group were significantly higher than those in conventional operation group [(18.26 ± 2.49) vs (12.16 ± 2.19);(5.52 ± 1.50) vs (3.32 ± 0.85).The difference was statistically significant (P ＜ 0.05).The positive rate of lymph nodes in black stained lymph nodes (38.10％,96/252) was significantly higher than that in non-stained lymph nodes (18.45％,31/168),and the difference was statistically significant (P ＜ 0.05).The average survival time in the nano-carbon group [(25.48 ± 11.74) months] was significantly longer than that in the conventional operation group [(15.80 ± 11.64) months],and the difference was statistically significant (P ＜ 0.05).Conclusions It is safe,effective and feasible to treat malignant tumors of pancreatic body and tail by RAMPS combined with nano-carbon tracer technique.The positive rate of lymph node dissection and the detection rate of total lymph nodes are increased,and the prognosis of patients is improved,to improve the survival time of patients after operation is improved.

Atomoxetine is a highly selective norepinephrine reuptake inhibitor. Based on the analysis of the literature methods, the synthesis process of atomoxetine was improved. Using 3-chloropropiophenone-1 as the raw material, optically pure target product was obtained by asymmetric reduction, Mitsunobu reaction and condensation reaction in three steps, with a total yield of 26%. The third-step methylation sealing operation was changed to the reaction under normal pressure, which increased the feasibility of industrialization. The improved process operation was simplified and the reaction conditions were mild, which would provide a new method for the preparation of atomoxetine.

The paper sorts out the achievements in informatization construction of disease prevention and control in the United States,summarizes the construction features,and puts forward the objective,requirements,functions and contents of Informatization construction of disease prevention and control of People's Armed Police forces in China based on its current situations.

Objective To evaluate the application value of combination of low kV,low mAs,and iterative model reconstruction (IMR) in carotid CT angiography.Methods Forty patients (BMI 20-25 kg/m2) were enrolled and randomly divided into routine dose group(20) and low dose group(20),The parameters in routine dose group were 120 kV,automatic mAs,and filter back projection(FBP);and that in low dose group were 80 kV,automatic mAs but upper limit 150 mAs,and FBP or IMR.All patients received the injection of 32 ml of iopamidol(370 mg I/100 ml) at a flow rate of 4 ml/s,followed by 50 ml normal saline at the same rate.The CT value and image noise(SD)of the aortic arch,left carotid artery bifurcation,and right carotid artery of rock bone were measured with region of interest(ROI) method,and then signal to noise ratios (SNR) and contrast to noise ratio (CNR)of image were calculated.The image quality was evaluated by two radiologists using a subjective four points scale on multiplanar reformated (MPR),maximum density projected (MIP) and volume rendered (VR) images.Volume CT dose index (CTDIvol),dose length product (DLP),and the effective dose (E) of each patient were recorded.Results CT values of carotid artery[(479.87 ± 70.28),(514.78 ± 82.69),(436.50 ± 89.87) HU] in low dose group were significantly higher than those in routine dose group [(295.63 ± 34.75),(325.09 ± 37.81),(286.93±36.46)HU](t =-6.47,-5.76,-3.66,P＜0.05).The SNR and CNR of IMR reconstructed image in low dose group were significantly higher than those of FBP reconstructed image in routine dose group (t =-7.54,-3.55,-5.31,-7.13,-5.28,-8.35,P＜0.05).The image quality of FBP reconstructed images in routine dose group and IMR reconstructed images in low dose group were all enough for diagnosis.The image quality of FBP reconstructed images in low dose group was significantly poorer than that in routine dose group and IMR reconstructed images in low dose group (Z =-2.87,-3.69,P ＜0.05).The effective dose in low dose group (0.57 ±0.13) mSv was 73％ less than that in routine dose group (2.22 ± 0.36) mSv.Conclusions Using low kV,low mAs,and IMR would help to obtain good carotid CT angiographic images and low radiation dose.

Objective To study the clinical efficacies of different surgical palliative treatments for patients with advanced pancreatic carcinoma.Methods A retrospective analysis was conducted on the clinical data of 119 patients with advanced pancreatic carcinoma who were treated in the department of General Surgery of Linyi's Central Hospital from January 2010 to January 2016.According to the different surgical methods the patients received,they were divided into the seed group (n =38),the radiofrequency ablation (RF) group (n =52) and the control group (n =29).Patients' general data,operation data,postoperative complications and follow-up profiles were analyzed.Results There was no significant difference in the patients'general data among the three groups of patients (P ＞ 0.05).The incidences of postoperative complication in the seed group,the RF group and the control group were 55.3％,38.5％ and 20.7％,respectively.There was significant differences between the incidences of postoperative complications between the seed group and the control group (P ＜ 0.05).There was no perioperative death.The postoperative follow-up rate was 91.6％.Pain in the seed group and the RF group significantly improved,while it was not significantly improved in the control group.There were significant differences in the postoperative pain scores (P ＜0.05).The 6 months,1-year and 2-year overall survival rates were 61.3％,25.9％,8.6％ respectively.The median survival was 8 months.In the seed group,the 6 months,1-year and 2-year survival rates were 75.2％,37.8％,18.9％ respectively.The median survival was 9 months.In the RF group,the 6 months,1-year and 2-year survival rates were 60.4％,25％,6.3％ respectively.The median survival was 8 months.In the control group,the 6 months,1-year and 2-year survival rates were 53.4％,15.3％,3.8％ respectively.The median survival was 6.5 months.On log-rank test,there was no significant difference in survival rates among the three groups (P =0.145).Conclusions Patients with advanced pancreatic carcinoma had poor prognosis.I125 radioactive particles implantation and radiofrequency ablation were useful to improve patients'quality of life and prolonged their survival.