Objective: To investigate the availability and use of child safety seats among children aged 0-3 years, so as to provide the basis for improving riding safety for children. Methods: Parents of children aged 0-3 years in Huangpu District, Shanghai Municipality, were recruited using the stratified multistage random sampling method from May to July 2024. Demographic information, family travel patterns, the use of child safety seat and related health beliefs were collected using questionnaire surveys. Factors affecting the use of child safety seats were identified using a multivariable logistic regression model. Results: Totally 514 valid questionnaires were recovered, with an effective rate of 96.98%. The respondents included 122 fathers (23.74%) and 392 mothers (76.26%), with a median age of 34.00 (interquartile range, 5.00) years. There were 446 families equipping with child safety seats, accounting for 86.77%; and 169 families using child safety seats, accounting for 32.88%. Multivariable logistic regression analysis showed that the parents who had children aged >1-2 years (OR=0.597, 95%CI: 0.366-0.973), travelled 2-4 times per month (OR=0.359, 95%CI: 0.213-0.607) or once per month or less (OR=0.384, 95%CI: 0.202-0.729), and scored high in perceived barrier (OR=0.634, 95%CI: 0.486-0.827) were less likely to use child safety seats; the parents who had children with local household registration (OR=2.506, 95%CI: 1.356-4.633), travelled 5-<10 km (OR=1.887, 95%CI: 1.148-3.101) or ≥10 km (OR=2.319, 95%CI: 1.355-3.967), always wore seat belts (OR=2.342, 95%CI: 1.212-4.524), scored high in perceived susceptibility (OR=1.392, 95%CI: 1.091-1.778) and self-efficacy (OR=1.413, 95%CI: 1.156-1.727) were more likely to use child safety seats. Conclusions Equipping family cars with child safety seats and using them can prevent and reduce traffic injuries among children aged 0-3 years. It is recommended to strengthen publicity to promote the use of child safety seats.

AIM: To investigate the risk factors associated with the recurrence of macular edema secondary to branch retinal vein occlusion(BRVO-ME)after anti-vascular endothelial growth factor(anti-VEGF)therapy.METHODS:A total of 32 patients(32 eyes)with BRVO-ME who were treated at the ophthalmology department of the Affiliated Hospital of Shandong Second Medical University from February 2021 to June 2022 were selected. They were treated with a 3+pro re nata (PRN)anti-VEGF regimen and followed up for 6 mo. Following 3 consecutive anti-VEGF injections, patients were categorized into a non-recurrence group and a recurrence group based on central macular thickness(CMT)measured by optical coherence tomography(OCT)at 6 mo post-treatment. Aqueous humor levels of various cytokines levels were quantified using suspension assay method. Demographic characteristics, CMT, and cytokine levels were compared between the two groups, and their correlations with the recurrence of BRVO-ME after anti-VEGF treatment were analyzed.RESULTS:At 6 months post-treatment, ME resolved in 19 eyes(no recurrence group), while 13 eyes showed persistent or recurrent ME(recurrence group). Compared to baseline, the CMT significantly improved in both groups at 1 d, 1, and 6 mo post-treatment(all P<0.05). However, the recurrence group exhibited significantly higher baseline, 1 d and 6 mo post-treatment CMT values than the non-recurrence group(all P<0.05). The aqueous humor levels of VEGF and monocyte chemoattractant protein-1(MCP-1)at baseline were significantly higher in the recurrence group than the non-recurrence group(all P<0.05). Spearman correlation analysis revealed positive associations between baseline CMT and interlukin IL-1β, IL-5, IL-12, MCP-1 and IP-10 levels(all P<0.05). Multivariable Logistic regression analysis identified baseline CMT and MCP-1 levels as independent risk factors for BRVO-ME recurrence(OR>1, P<0.05).CONCLUSION: Elevated baseline CMT and aqueous humor MCP-1 levels were identified as independent risk factors for BRVO-ME recurrence after anti-VEGF therapy. Patients exhibiting higher baseline CMT and MCP-1 levels demonstrated significantly increased susceptibility to recurrence.

Objective To compare the clinical outcomes and retinal volume changes in patients with ischemic and non-ischemic macular edema secondary to branch retinal vein occlusion(BRVO-ME)using optical coherence tomography angiography(OCTA).Methods The clinical data of 34 ischemic BRVO-ME patients(34 eyes,ischemic group)and 21 non-ischemic BRVO-ME patients(21 eyes,non-ischemic group)were retrospectively analyzed.Patients in both groups re-ceived intravitreal injections of ranibizumab.The best corrected visual acuity(BCVA)and retinal volume of the macular ar-ea were assessed before,1 day,1 week,1 month,3 months and 6 months after the treatment.Results The BCVA(log-MAR)at 1 day after the treatment was 0.63±0.37 in the ischemic group and 0.44±0.22 in the non-ischemic group,and the difference was statistically significant(P=0.017).The retinal volumes of the outer retina,the full retina,and the Farafovea and Perifovea subdivisions of the full retina before the treatment were(6.42±1.90)mm3,(8.75±1.82)mm3,(3.20±0.87)mm3 and(5.10±0.89)mm3 in the ischemic group and(5.52±1.57)mm3,(7.83±1.56)mm3,(2.80± 0.71)mm3,and(4.66±0.77)mm3 in the non-ischemic group,respectively;1 day after treatment,they were(4.97± 1.18)mm3,(7.46±1.47)mm3,(2.62±0.60)mm3 and(4.53±0.80)mm3 in the ischemic group and(4.25±0.48)mm3,(6.58±0.56)mm3,(2.26±0.26)mm3 and(4.06±0.40)mm3 in the non-ischemic group,respectively;at 1 week after the treatment,they were(4.40±0.82)mm3,(6.90±0.85)mm3,(2.38±0.36)mm3 and(4.24±0.49)mm3 in the ischemic group and(4.04±0.35)mm3,(6.33±0.49)mm3,(2.15±0.19)mm3 and(3.95±0.35)mm3 in the non-ische-mic group,respectively,and the differences between the two groups were statistically significant(all P＜0.05).The a-mount of retinal volume change from baseline in the outer retina and the full retina was(-2.48±2.38)mm3 and(-2.54±2.38)mm3 in the ischemic group,and(-1.31±1.58)mm3 and(-1.38±1.58)mm3 in the non-ischemic group at 1 month after treatment,respectively,and the differences between the two groups were statistically significant(both P＜0.05).Conclusion Ranibizumab is effective in treating both ischemic and non-ischemic BRVO-ME.The short-term visu-al prognosis is better in the non-ischemic group than the ischemic group,and the retinal volume is higher in the ischemic group than the non-ischemic group.However,no significant difference is observed in the visual prognosis or retinal volume between the two groups after long-term treatment.

Objective:To compare the consistency of lymphoma multigene detection panels based on next-generation sequencing (NGS) with FISH detection of B-cell lymphoma gene rearrangement.Methods:From January 2019 to May 2023, fusion genes detected by lymphoma-related 413 genes that targeted capture sequencing of 489 B-cell lymphoma tissues embedded in paraffin were collected from Henan Cancer Hospital, and the results were compared with simultaneous FISH detection of four break/fusion genes: BCL2, BCL6, MYC, and CCND1. Consistency was defined as both methods yielding positive or negative results for the same sample. The relationship between fusion mutation abundance in NGS and the positivity rate of cells in FISH was also analyzed.Results:Kappa consistency analysis revealed high consistency between NGS and FISH in detecting the four B-cell lymphoma-related gene rearrangement ( P<0.001 for all) ; however, the detection rates of positive individuals differed for the four genes. Compared with FISH, NGS demonstrated a higher detection rate for BCL2 rearrangement, a lower detection rate for BCL6 and MYC rearrangement, and a similar detection rate for CCND1 rearrangement. No correlation was found between fusion mutation abundance in NGS and the positivity rate of cells in FISH. Conclusions:NGS and FISH detection of B-cell lymphoma gene rearrangement demonstrate overall good consistency. NGS is superior to FISH in detecting BCL2 rearrangement, inferior in detecting MYC rearrangement, and comparable in detecting CCND1 rearrangement.

Objective:Cerebral ischemia reperfusion injury(CIRI)can cause damage to distant organs,such as the gastrointestinal tract,through the gut-brain axis.Melatonin is known to play a neuroprotective role by activating specific receptor pathways.However,the changes of melatonin receptors in the gastrointestinal tract after brain injury and their relationship with intestinal injury are still unclear.Methods:Twenty-four male Sprague-Dawley rats were randomly di-vided into the Sham group and CIRI group.The CIRI model was prepared by Zea-Longa method.The jejunum,ileum,and colon tissues of the rats were collected 2 h after ischemia and 24 h after reperfusion.The damage of intestinal and brain tissues was observed by using 2,3,5-triphenyl tetrazolium chloride(TTC)and HE staining.The positive expres-sion of zonula occludens-1(ZO-1)and Claudin5 was observed by immunofluorescence staining.The melatonin receptor 1(MT1)and melatonin receptor 2(MT2)expression was detected by reverse transcription-quantitative polymerase chain reaction(RT-qPCR),immunofluorescence staining and Western Blot.The correlation between the melatonin receptors and intestinal tight junction proteins was analyzed by general linear regression.Results:TTC staining showed that the infarct size of rats in the CIRI group was significantly higher than that in the Sham group.HE staining showed that intestinal villi was broken and shortened,and goblet cells were reduced in the CIRI group.The results of immuno-fluorescence staining revealed that the positive expression of ZO-1 and Claudin5 in the intestinal tissues of rats in the CIRI group was significantly lower than that in the Sham group(P＜0.05).Compared with the Sham group,the RT-qPCR revealed a significantly lower expression of MT1 and MT2 mRNA in the CIRI group(P＜0.05),and the decrease in colon tissue was the most obvious.The results of immunofluorescence staining and WB also showed that the expression of MTl and MT2 in the CIRI group was significantly lower than that in the Sham group(P＜0.05).A gen-eral linear regression analysis revealed the difference in mean fluorescence intensities of MT1+and MT2+between the Sham group and the CIRI group were positively correlated with the difference of ZO-1+and Claudin5+between the two groups.Conclusion:After CIRI,the expression of both MT1 and MT2 receptors in various intestinal segments was de-creased,and the decrease in colon tissue was the most significant.It is suggested that the poor recovery of stroke may be related to the decrease of melatonin receptor.

Objective:To analyze the distribution of clopidogrel metabolism-related gene variability in Kawasaki disease (KD) children with coronary artery lesions (CAL) across different age groups and the impact of genetic variability on the efficacy of clopidogrel antiplatelet therapy.Methods:A retrospective cohort study was conducted. Clinical data were collected from 46 KD children with CAL who were hospitalized in the Cardiovascular Center of Children′s Hospital of Fudan University between January 2021 and August 2022 and were treated with clopidogrel, including gender, age, body mass index, course of KD, CAL severity grade, and baseline platelet count. According to their age, the children were divided into ≥2-year-old group and <2-year-old group. Their platelet responsiveness was assessed by adenosine diphosphate-induced platelet inhibition rate (ADPi) calculated via thromboelastography, and children were categorized into high on-treatment platelet reactivity (HTPR) and normal on-treatment platelet reactivity (NTPR) groups. Genotypes of CYP2C19, PON1 and ABCB1 were detected. The t test, one-way analysis of variance and Chi-square test were used for intergroup comparison. Results:Among the 46 KD children with CAL, 34 were male and 12 were female; 37 were ≥2-year-old and 9 were <2-year-old; 25 cases were in the HTPR group and 21 cases were in the NTPR group, with 19 HTPR and 18 NTPR in the ≥2-year-old group, and 6 HTPR and 3 NTPR in the <2-year-old group. Genetic analysis showed that 92 alleles among the 46 children, with frequencies of CYP2C19*1, CYP2C19*2, CYP2C19*3, CYP2C19*17, PON1 192Q, PON1 192R, ABCB1 3435C, ABCB1 3435T at 59% (54/92), 32% (29/92), 9% (8/92), 1% (1/92), 36% (36/92), 64% (59/92), 63% (58/92) and 37% (34/92), respectively. Analysis of the impact of genotype on ADPi revealed that in children aged ≥2 years, those with CYP2C19*1/*3 genotype had significantly lower ADPi than those with CYP2C19*1/*1 genotype ((34±15)% vs. (61±29)%, t=2.18, P=0.036). There were also no significant difference in ADPi among children with PON1 192Q homozygous, PON1 192R heterozygote and PON1 192R homozygous genotypes ((40±22)% vs. (52±33)% vs. (65±27)%, F=2.17, P=0.130), or among those with ABCB1 3435C homozygous, ABCB1 3435T heterozygote and ABCB1 3435T homozygous genotypes ((55±34)% vs. (60±27)% vs. (49±24)%, F=0.33, P=0.719). In <2-year-old group, there were no significant differences in ADPi across CYP2C19*1/*1, CYP2C19*1/*2 and CYP2C19*2*2 genotypes ((40±20)% vs. (53±37)% vs. (34±16)%, F=0.37, P>0.05). There were no significant differences in ADPi across CYP2C19*1/*1 and CYP2C19*1/*3 genotypes ((44±27)% vs. (42±20)%, t=0.08, P>0.05). There were no significant differences in ADPi across PON1 192Q homozygous, PON1 192R heterozygote and PON1 192R homozygous genotypes (45% vs. (55±27)% vs. (24±5)%, F=1.83, P>0.05). There were no significant differences in ADPi across ABCB1 3435C homozygous, ABCB1 3435T heterozygote and ABCB1 3435T homozygous genotypes ((36±16)% vs. (50±35)% vs. 45%, F=0.29, P>0.05). The risk analysis of HTPR in different genotypes revealed that in children aged ≥2 years, carrying at least 1 or 2 loss-of-function alleles of CYP2C19 was a risk factor for HTPR ( OR=4.69, 10.00, 95% CI 1.11-19.83, 0.84-119.32, P=0.033, 0.046, respectively), and PON1 192R homozygosity and carrying at least one PON1 192R allele were protective factors against HTPR ( OR=0.08, 0.13, 95% CI 0.01-0.86, 0.01-1.19, P=0.019, 0.043, respectively). Conclusion:KD children aged ≥2 years carrying CYP2C19 loss-of-function alleles and PON1 192Q are more likely to develop HTPR.

Objective To investigate the incidence of motoric cognitive risk(MCR)syndrome and declines in both motor and cognitive functions in elderly patients with enlarged perivascular spaces(EPVS).Methods A total of 113 patients(≥60 years old)with EPVS identified by head MRI admitted to our department from March 1 to November 30,2023 were consecutively recrui-ted,and according to having MCR syndrome or not,they were divided into MCR group(44 cases)and non-MCR group(69 cases).Cognitive function and motor function were assessed with aid of Montreal Cognitive Scale(MoCA),Simple Mental State Examination Scale(MMSE),trail making test,and motor function assessments,including Tinetti Balance and Gait Scale,Short Physical Performance Battery(SPPB),8-meter walk,Timed up and Go test(TUGT),walking and contin-uous subtraction task(WSS),walking and semantic fluency task(WSF),and TUGT and serial subtraction task(TUGSS).The motor and cognitive functions were compared between the two groups,and the risk factors related to MCR syndrome in EPVS patients were analyzed by multi-variate logistic regression.Results Compared with the non-MCR group,the MCR group had low-er MoCA score,total SPPB score,8-meter walk speed,and longer times of TMT-A,TMT-B,WSS,WSF and TUGSS(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that in Model 1(including variables with differences in univariate analysis),MoCA score,8-meter walk speed,and TUGSS time were independent risk factors for MCR syndrome in EPVS patients(P＜0.05,P＜0.01);in Model 2(adjusting for age,sex,education level,and comorbidities),MoCA score(OR=0.621,95％CI:0.432-0.929,P=0.010),8-meter walk speed(OR=1.332,95％CI:1.115-1.591,P=0.002),and TUGSS time(OR=0.393,95％CI:0.232-0.665,P=0.001)re-mained independent risk factors for MCR syndrome in EPVS patients.Conclusion Among elderly EPVS patients,those with MCR syndrome show significantly worse cognitive and motor function compared to those without.MoCA score,8-meter walk speed,and TUGSS time are related factors for MCR occurrence in EPVS patients.

Objective Nicotinamide phosphoribosyltransferase (Nampt) is a new therapeutic target for ischemic stroke. The aim of this study was to investigate protective effect of liver-derived Nampt on ischemic stroke. Methods Liver-specific Nampt knockout mice were generated using the Cre/loxP system. Nampt^loxP/loxP mice were crossed with liver-specific Cre recombinase expression mice (Alb-Cre), and the progeny genotypes were identified by polymerase chain reaction. Body weight of knockout mice and control mice were measured. Nampt in liver and brain was determined by Western blot assay. Middle cerebral artery occlusion (MCAO), a classical ischemic stroke model, was generated in liver-specific Nampt knockout mice and control mice by electrocoagulation. After 24 h of modeling, neurological deficit scores of each group were evaluated and TTC staining was performed to determine the cerebral infarction volume. The level of plasma Nampt in each group was determined by ELISA. Results Liver-specific Nampt knockout mice with the genotype of Nampt^loxP/loxPAlb-Cre were successfully constructed. The hepatic Nampt expression in knockout mice was significantly decreased by 74.2% compared to control mice, while there was no significant difference in the expression of brain Nampt protein between the knockout group and the control group. Specific knockout of liver Nampt gene expression had no effect on the body weight of mice. Under normal physiological conditions, there was no significant difference in plasma Nampt levels between liver-specific Nampt knockout mice and control mice of the same gender. 24 h after MCAO modeling, there were no significant differences in neurological deficit scores, cerebral infarct volume and plasma Nampt concentration between liver-specific Nampt knockout group and control group. Conclusion Liver-specific Nampt knockout mice are successfully constructed. Liver-derived Nampt has no significant protective effects on ischemic stroke.

Objective:To investigate the relationship between left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), wall motion score (WMS) of echocardiographic indexes and serum heart type fatty acid binding protein (h-FABP), chitinase-3 like protein-1 (YKL-40) and their predictive value for prognosis in patients with acute myocardial infarction (AMI).Methods:A retrospective selection of 130 AMI patients admitted from January 2020 to March 2021 in the University of Hong Kong Shenzhen Hospital were selected as the research objects. According to whether major adverse cardiovascular events or death occurred within 30 d, they were divided into a good prognosis group (85 cases) and a poor prognosis group (45 cases). The echocardiographic indexes, serum h-FABP and YKL-40 levels were compared between the two groups, the correlation between serum indexes and color Doppler ultrasound indexes and the value of echocardiographic indexes for prognosis were also analyzed.Results:When the poor prognosis group was admitted to the hospital and after 1 week of treatment, the LVEF was lower than that in good prognosis group: (40.12±4.10)% vs. (44.37±5.06)% and (47.62±4.83)% vs. (53.29±5.31)%; the LVEDD, WMS, serum h-FABP and YKL-40 level were higher than those in good prognosis group: (52.78±3.67) mm vs. (49.16±3.14) mm and (48.35±4.08) mm vs. (44.20±3.72) mm, (23.42±3.11) scores vs. (20.09±2.87) scores and (20.07±3.70) scores vs. (15.20±2.34) scores, (28.76±4.22) mg/L vs. (22.35±3.19) mg/L and (20.04±3.33) mg/L vs. (14.20±2.76) mg/L, (40.17±5.10) μg/L vs. (34.83±3.25) μg/L and (32.09±4.38) μg/L vs. (27.20±3.07) μg/L, and there were statistical differences ( P<0.05). LVEF was negatively correlated with serum h-FABP and YKL-40 neither at admission nor 1 week after treatment, and LVEDD and WMS were positively correlated with serum h-FABP and YKL-40 ( P<0.05). The areas under the curve for combined prediction of prognosis by LVEF, LVEDD, and WMS was the largest at 0.873. The survival rates of high-risk patients indicated with LVEF, LVEDD, and WMS were lower than that of low-risk patients: 56.52% vs. 90.91%, 52.38% vs. 91.67%, and 54.17% vs. 95.24%, and there were statistical differences ( P<0.05). Conclusions:The echocardiographic parameters LVEF, LVEDD and WMS in patients with AMI are closely related to serum h-FABP and YKL-40, which can provide an objective basis for the evaluation of myocardial pathophysiological changes. Moreover, the combined detection of LVEF, LVEDD, and WMS can be used to further assess the prognostic survival status, with a positive significance for guiding clinical treatment plans.

Objective: To investigate the value of lipid accumulation product (LAP) and visceral fat index (VAI) for prediction of metabolic syndrome (MS). Methods: Based on the 2018 Survey on Chronic Diseases and Risk Factors in Yantai City of Shandong Province, residents at ages of 45 years and older were sampled, and subjects' age, disease history, waist circumstance (WC), body mass index (BMI), blood pressure and blood lipid were collected to calculate LAP and VAI. MS was diagnosed with the a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity (JIS definition) and the recommended criteria proposed by the Chinese Diabetes Society (CDS) of Chinese Medical Association (CDS criteria), and the values of LAP and VAI for MS screening were evaluated using the receiver operating characteristic (ROC) curve analysis. Results: Totally 9 366 subjects were enrolled, including 4 340 men (46.34%) and 5 026 women (53.66%), and had a mean age of (54.49±9.73) years. According to the CDS criteria, the prevalence of MS was 24.58%, and LAP and VAI showed areas under the ROC curve (AUC) of 0.837 (95%CI: 0.828-0.846) and 0.751 (95%CI: 0.739-0.762), sensitivities of 78.82% and 63.31% and optimal cut-off values of 44.64 and 1.86 for screening of MS. According to the JIS definition, the prevalence of MS was 35.26%, and LAP and VAI showed AUC values of 0.842 (95%CI: 0.834-0.850) and 0.790 (95%CI: 0.780-0.800), sensitivities of 75.73% and 68.42% and optimal cut-off values of 42.01 and 1.67 for screening of MS. Conclusions Both LAP and VAI are effective for screening MS among middle-aged and elderly residents, and LAP presents a higher accuracy than VAI.