Objective: To analyze the status of outdoor activities on weekends among children and adolescents of different educational stages in Shanghai and their impact on myopia, so as to provide a basis for formulating more specific prevention and control protocol of myopia. Methods: From September to October 2022, a stratified cluster random sampling method was employed to select 84 schools (27 kindergartens, 21 primary schools, 15 junior high schools and 21 high schools) across Shanghai, enrolling a total of 28 654 children and adolescents aged 4 to 18 for the study. Ophthalmic examinations were conducted to ascertain the prevalence of myopia among children and adolescents. Additionally, a questionnaire survey was administered to collect data on outdoor activity duration and associated factors. Multivariate Logistic regression analysis was utilized to investigate the associated factors of outdoor activity levels on weekends. Results: The overall myopia detection rate among children and adolescents was 58.4%, with a higher rate observed in girls (59.2%) compared to boys (57.6%). The myopia detection rates for children and adolescents with an average daily outdoor activity duration of ≥2 h and <2 h on weekends were 54.6% and 68.8%, and the differences were statistically significant ( χ 2=8.12,460.89, P <0.01). Multivariable Logistic regression analysis revealed that girls ( OR =0.80), those with a myopic parent ( OR =0.68), schools from urban districts ( OR =0.72), higher education stages (primary school: OR =0.65, junior high school: OR =0.24, high school: OR =0.14) and spending≥2 h/d on homework during weekends ( OR =0.57) among children and adolescents were less likely to engage in outdoor activities for ≥2 h on weekends ( P <0.01). After incorporating gender, parental myopia status, educational stage, school location, average daily duration on weekends for spending on homework, electronic product usage and outdoor activities as dependent variables in a multivariate Logistic regression analysis, the results showed that children and adolescents with an average outdoor activity duration for ≥2 h on weekends had a lower risk of myopia ( OR =0.86, P < 0.01). Conclusions The level of outdoor activity among children and adolescents on weekends needs to be improved. Outdoor activities on weekends is an associated factor for myopia among children and adolescents. Particularly, girls, those with myopic parents, schools from urban districts, and spending long hours on homework during weekends among children and adolescents require increased attention.

Objective: To investigate the visual acuity and correction conditions of children and adolescents in Shanghai, so as to provide a scientific basis for developing intervention measures to prevent myopia and protect vision among children and adolescents. Methods: From October to December 2022, a stratified cluster random sampling survey was conducted, involving 47 034 students from 16 municipal districts in Shanghai, covering kindergartens (≥5 years), primary schools, middle schools, general high schools and vocational high schools. According to the Guidelines for Screening Refractive Errors in Primary and Secondary School Students, the Standard Logarithmic Visual acuity Chart was used to examine naked vision and corrected vision of students, and general information was collected. The distribution and severity of visual impairment in different age groups were analyzed, and χ 2 tests and multivariate Logistic regression were used to explore factors associated with visual impairment. Results: The detection rate of visual impairment among children and adolescents was 76.2%, with a higher rate among females (78.8%) than males ( 73.8 %), higher among Han ethic students ( 76.2 %) than minority students (71.2%), and higher among urban students (76.7%) than suburban students (75.8%), all with statistically significant differences ( χ 2=162.6, 10.4, 5.5, P <0.05). The rate of visual impairment initially decreased and then increased with age, reaching its lowest at age 7 (53.8%) and peaking at age 17 (89.6%) ( χ 2 trend = 3 467.0 , P <0.05). Severe visual impairment accounted for the majority, at 56.6%, and there was a positive correlation between the severity of visual impairment and age among children and adolescents ( r =0.45, P <0.05). Multivariate Logistic regression showed that age, BMI, gender, ethnicity and urban suburban status were associated with visual impairment ( OR =1.18, 1.01, 1.38 , 0.79, 0.88, P <0.05). Among those with moderate to severe visual impairment, the rate of spectacle lens usage was 62.8%, yet only 44.8 % of those who used spectacle lens had fully corrected visual acuity. Females (64.9%) had higher spectacle lens usage rates than males (60.6%), and general high school students had the highest spectacle lens usage (83.9%), and there were statistically significant differences in gender and academic stages ( χ 2=57.7, 4 592.8, P <0.05). Conclusions The rate of spectacle lens usage among students with moderate to severe visual impairment is relatively low, and even after using spectacle lens, some students still do not achieve adequate corrected visual acuity. Efforts should focus on enhancing public awareness of eye health and refractive correction and improving the accessibility of related health services.

Objective:To study the distribution and changes of dopamine transporter (DAT) in guinea pig eyes under different light patterns.Methods:Thirty-six 3-week-old white ordinary-grade guinea pigs were randomly selected and divided into groups of 10 000 lx, 5 000 lx, and 500 lx, with 12 guinea pigs in each group exposed to strong light, medium strong light, and normal light, respectively.Each group was randomly divided into 3 subgroups, with 4 guinea pigs in each subgroup.The 3 subgroups of 500 lx group received light exposure for 5, 20, and 40 minutes, respectively.The 3 subgroups of 5 000 lx group received light exposure for 2, 4, and 40 minutes, respectively.The 3 subgroups of 10 000 lx group received light exposure for 2, 5, and 20 minutes, respectively.After light treatment, each group of guinea pigs was injected with 99mTc-TRODAT-1 for SPECT DAT imaging, and image data were collected by Micro-SPECT.The region of interest (ROI) of guinea pig retinas was analyzed using Micro-CT software.The counts of ROI were expressed as Sum, which reflected the relative distribution or density of DAT.The DAT density between experimental and control eyes of guinea pigs after light exposure, the differences in DAT density between guinea pig eyes under different light intensities, the differences in DAT density between guinea pig eyes after different light durations, and the cumulative and interactive effects of light intensity and light duration on DAT aggregation in guinea pigs were compared.Another 3 guinea pigs were selected, and after light exposure, the 3 guinea pigs' eyes underwent continuous image acquisition for 6 hours at 20-minute intervals, and 18 images per guinea pig were acquired to analyze the trend of DAT density in guinea pig eyes over time.This study was approved by the Ethics Committee of Shanghai General Hospital (No.2020SQ196). Results:The DAT density (Sum value) of experimental eyes at 500, 5 000, and 10 000 lx were 5 598.97±3 159.38, 8 636.78±2 503.16, and 7 407.39±2 053.41, respectively, significantly higher than 4 388.89±2 902.90, 5 981.92±3 057.44, and 5 091.32±2 039.36 of control eyes ( t=5.31, 4.69, 11.80; all at P<0.001). At 500 lx, there was a statistically significant difference in DAT density between the experimental and control eyes of guinea pigs at different light exposure durations ( F=14.01, P<0.01), while no significant difference was found at other light intensities at different light exposure durations (both at P>0.05). When the light exposure time was 5 minutes, the difference in DAT density between the experimental and control eyes of guinea pigs was significantly greater in the 10 000 lx group than in the 500 lx group ( t=-13.22, P<0.001). There was no statistically significant difference between different groups at other light exposure durations (all at P>0.05). No cumulative or interactive effects of light intensity and light duration were found on the differences in DAT density (all at P>0.05). Continuous scanning after illumination showed that DAT density in guinea pig retinas first increased to a peak over time and then gradually returned to normal values. Conclusions:Light, even under moderate or normal light levels, can cause an increase in the secretion of DAT in the retina and stimulate the production of DAT.Light intensity and duration have no cumulative or interactive effects on the distribution and density of retinal DAT.

Renal interstitial fibrosis (RIF) is the crucial pathway in chronic kidney disease (CKD) leading to the end-stage renal failure. However, the underlying mechanism of Shen Qi Wan (SQW) on RIF is not fully understood. In the current study, we investigated the role of Aquaporin 1 (AQP1) in SQW on tubular epithelial-to-mesenchymal transition (EMT). A RIF mouse model induced by adenine and a TGF-β1-stimulated HK-2 cell model were etablished to explore the involvement of AQP 1 in the protective effect of SQW on EMT in vitro and in vivo. Subsequently, the molecular mechanism of SQW on EMT was explored in HK-2 cells with AQP1 knockdown. The results indicated that SQW alleviated kidney injury and renal collagen deposition in the kidneys of mice induced by adenine, increased the protein expression of E-cadherin and AQP1 expression, and decreased the expression of vimentin and α-smooth muscle actin (α-SMA). Similarly, treatmement with SQW-containing serum significantly halted EMT process in TGF-β1 stimulated HK-2 cells. The expression of snail and slug was significantly upregulated in HK-2 cells after knockdown of AQP1. AQP1 knockdown also increased the mRNA expression of vimentin and α-SMA, and decreased the expression of E-cadherin. The protein expression of vimentin increased, while the expression of E-cadherin and CK-18 significantly decreased after AQP1 knockdown in HK-2 cells. These results revealed that AQP1 knockdown promoted EMT. Furthermore, AQP1 knockdown abolished the protective effect of SQW-containing serum on EMT in HK-2 cells. In sum, SQW attentuates EMT process in RIF through upregulation of the expression of AQP1.
Drugs, Chinese Herbal/pharmacology* ; Humans ; Animals ; Mice ; Male ; Cell Line ; Rats ; Kidney/physiology* ; Fibrosis/drug therapy* ; Renal Insufficiency, Chronic/drug therapy* ; Adenine ; Epithelial-Mesenchymal Transition ; Aquaporin 1/metabolism*

Abstract Subjective social status and life skill level are important influencing factors of adolescent health risk behaviors, and they interact with each other and jointly act on adolescent health risk behaviors, which make the mechanism of adolescent health risk behaviors become more diverse and complex. The current paper reviews the correlations among subjective social status, life skill level and adolescent health risk behaviors, in order to explore the joint influence of subjective social status and life skill level on adolescent health risk behaviors, then provides future directions for exploring possible mechanisms, and proposes recommendations for effective prevention strategies of adolescent health risk behaviors.

Objective: To understand comprehensive sexuality education knowledge among junior high school students in China, and to analyze relevant influencing factors to provide scientific basis for the implementation of school based sexuality education or comprehensive sexuality education in the future. Methods: By using convenient sampling method, a cross sectional survey was conducted among 4 545 students at grade 1 to grade 3 from junior middle schools in Beijing, Liaoning, Sichuan, Chongqing, Yunnan, Henan, using an online electronic questionnaire during September to October 2021. The questionnaire included general demographic information, subjective social status, sex education received at home and school, bullying, as well as knowledge, attitude, practice and needs towards comprehensive sexuality education. Results: The average score of the comprehensive sexuality education knowledge was (12.21±3.10) points, which was converted to (71.82±18.21) points based on the percentage based system. The scores varied by grade, sex and sexuality education setting, significantly higher in grade 3 students (12.69±2.99), girls (12.28±3.01) ( P < 0.01), and students who have received sex education at home (12.67±2.88) and students who received sex education at school (12.63±2.91), as well as those who had actively searched for sex information online had a higher score (12.71±2.94) ( t =35.10, 28.78, 10.55, P <0.01).Further analysis using multiple linear regression and Logistic regression, "whether you have received sex education at home" "whether you have received sex education at school" "whether you have searched the Internet actively" and "whether it is necessary to carry out comprehensive sex education" are still correlated with the score of comprehensive sex education knowledge; "self reported bullying" was still associated with "subjective social status" score, correct rate of question 2, and "shyness and inferiority toward the development of secondary sexual characteristics" ( P <0.01). Conclusion The current comprehensive sexuality education knowledge among junior high school students needs to be improved. The level of implementation of sexuality education in different settings varies, but the implementation of sexuality education in schools can help improve students comprehensive sexuality education knowledge level.

Objective: To preliminarily develop the Infectious Disease Prevention Health Literacy Scale for Chinese Middle School Students, as an important measuring tool for assessment of comprehensive abilities in infectious disease prevention of Chinese middle school students. Methods: The basic dimensional framework and item pool were established by literature review in the view of public health. Then Delphi method was used to modify the framework and item pool to scale 1.0. Panel discussion in middle school students was used to adjust the expression and structure of scale 1.0, turning it into scale 2.0. With the confirmation of theory experts subjects, the scale was preliminarily developed. Results: Literature review suggested that the basic dimension framework included five longitudinal dimensions and seven horizontal dimensions. According to Delphi method ( n =18), the Kendall s coefficient of concordance ( W ) of the scale was equal to 0.14 ( P <0.01), the average importance, proportion of full marks, coefficient of variation and weight coefficient of all dimensions and items met the inclusion criteria. According to panel discussion, the scale was finally adjusted into scale 2.0 with 53 items. Conclusion This study preliminarily established the Infectious Disease Prevention Health Literacy Scale for Chinese Middle School Students, which might be applied in both scientific research and practical use.

Objective:To explore the clinical characteristics of neonate with arrhythmia and the potential risk factors for cardiac insufficiency.Methods:Research data were collected from the cases of neonate with arrhythmia from January 2017 to June 2021 at the Neonatology Department at Children′s Hospital Capital Institute of Pediatrics.A retrospective analysis was conducted to summarize the clinical features and analyze the risk factors of arrhythmia leading to cardiac insufficiency.Results:A total of 90 cases were enrolled, with a male to female ratio of 1.43∶1(53∶37), and the median gestational age was 39(37, 40)weeks; with 16(17.8%) premature infants, 74 full-term infants(82.2%), and the median onset age was 3(0, 11)days.In this group, 63.3% cases(57/90)were irregular rhythmic arrhythmias, of which 66.7%(38/57)were atrial premature contractions, 23.3%(21/90) were tachyarrhythmias, and 13.3%(12/90)were bradyarrhythmias.Additionally, 80.0%(72/90)of the cases had no typical clinical manifestations.Besides, 37.7%(34/90)of the patients had single infection factor, and 4.4%(4/90)of the patients had infection with perinatal hypoxia asphyxia.The ratio of the premature birth, maternal autoimmune diseases and the tachyarrhythmia were higher in heart failure group than those in normal heart function group(71.4% vs.13.3%, P<0.001; 28.6% vs.3.6%, P=0.006; 100% vs.16.9%, P<0.001). The random forest model showed that the factors of premature delivery and maternal autoimmune disease had the greatest influence on cardiac function, and the analysis of 21 tachyarrhythmias showed that the duration of arrhythmia had the greatest influence on cardiac function. Conclusion:Atrial premature contraction is the most common in neonate with arrhythmia, and with non-typical clinical manifestations.The infection and the infection combined with perinatal asphyxia are the main influencing factors of neonate with arrhythmia.Premature delivery, maternal autoimmune disease and the duration of tachyarrhythmias are the main risk factors of neonatal arrhythmias leading to cardiac dysfunction.

Objective : This experiment was carried out to study the effects of chronic inflammatory pain on the gut flora of mice by 16S rRNA high⁃throughput sequencing. Methods : Twelve specific pathogen free (SPF) C57BL/ 6J mice were randomly divided into CFA group and mock group , with 6 mice in each group. Chronic inflammatory pain model was established by intraplantar injection of CFA in the right posterior pelma of C57BL/6J mice. In the control group , normal saline was injected by intraplantar injection in the same position. Two weeks later, the mice were euthanized , and the feces in the colon were collected. The feces of two mice in the same group were mixed , detected and analyzed by 16S rRNA high⁃throughput sequencing technology. Results : Compared with mock group , the abundance and diversity of gut flora in CFA group decreased. The abundance of Firmicutes and TM7 increased at the phylum level , the abundance of Aerococcus , Lactobacillus and Desulfovibrio increased significantly at the fami ⁃ ly and genus level , while the abundance of Psychrobacter, Prevotella , Oscillospira and Bifidobacterium decreased significantly compared to mock group. In addition , many biomarkers were found from the level of the phylum to the genus. Conclusion The gut microflora structure , especially the dominant flora , has changed significantly in mice with chronic inflammatory pain , which can provide basis for the treatment of microecological imbalance caused by chronic inflammatory pain and the improvement of patients ′ negative emotions through“ gut brain axis”.

Objective:To evaluate the application effect of vascularized iliac crest-tensor fascia lata flap(VIC-TFLF) based on deep circumflex iliac artery and vein in mandibular and oral soft tissue defect reconstruction.Methods:Retrospective analysis of the clinical data of patients with mandible and oral soft tissue defects in Henan Provincial People’s Hospital from October 2020 to March 2022. All cases were performed with computer-aided design and three-dimensional printing to make the models and guide plates. VIC-TFLF was used to repair and reconstruct the oral and mandible defects, the tensor fascia lata flap was used to repair the intraoral soft tissue defect, and the fascia lata was exposed to the mouth directly. After operation, the color, texture and change of intraoral flap were observed, and the recovery and complications were followed up.Results:In this study, 7 patients were included, 4 males and 3 females, aged 27-64 years old, with an average of 50.1 years old. There were 5 cases of squamous cell carcinoma of mandible gingival and cheek, 1 case of postoperative defect of pleomorphic adenocarcinoma of mandible, and 1 case of postoperative defect of ameloblastoma of mandible. According to the defect range of soft and hard tissue after resection, the flap areas of tensor fascia lata were 6.0 cm×3.0 cm-8.0 cm×6.0 cm, and the iliac bones were 3.7 cm×2.4 cm-9.2 cm×2.5 cm. All the composite tissue flaps survived, without distal necrosis, delayed wound healing and marginal fistula. The patients were followed up for 4-19 months, with an average of 11.7 months. The morphology and functions of the mandible and oral soft tissue were well recovered. The surface of tensor fascia lata was exposed to the oral cavity directly, which showed signs of mucosalization within 1 week after operation. The mucosalization was basically completed within 1 month, which was close to normal oral mucosal appearance, and could be reconstructed to produce better oral mucosal appearance in the later period. The wounds in the donor site healed well, and there was no abnormality in lower limb movement and thigh flexion. Among them, 3 patients had numbness on the lateral thigh skin of the donor site 3-5 days after operation. After 6 months of follow-up, the numbness in 2 cases disappeared, and 1 case was significantly reduced.Conclusions:The VIC-TFLF could obtain great appearance and function, with fewer complications and relatively small damage to the donor site, in repair and reconstruction of mandibular defects combined with oral soft tissue defects.