: To explore the relationship between metal exposure level and blood pressure, so as to provide a scientific basis for verifying the relationship between metal exposure and elevated blood pressure among primary school students. Methods: In July 2022, a total of 555 students of second to sixth grade were selected by cluster random sampling method from two primary schools in Zhuxi County, Shiyan City, Hubei Province. A questionnaire survey was conducted to obtain the socio demographic characteristics and living habits of the participants. The height, weight, body mass index(BMI) and blood pressure were obtained by physical examination. At the same time, the urine of the subjects was collected, and the metal mass fraction in urine was detected by inductively coupled plasma mass spectrometry. The relationship between metal mass fraction in urine and blood pressure was analyzed by generalized linear regression. Results: The detection rate of elevated blood pressure in primary school students was 15.86% , and there was a statistically significant difference in the detection rate of elevated blood pressure among obese primary school students (yes:37.25%,no:13.69%, χ 2=19.28, P <0.01).There were statistically significant differences in BMI[15.80( 14.69 ， 17.92 )，17.87(15.49，20.89)kg/m 2] between the non elevated blood pressure group and the elevated blood pressure group of elementary school students ( Z =-4.67, P <0.01). The geometric mean mass fraction of zinc in urine was the highest ( 6 942.86 μg/g), titanium was the lowest (2.20 μg/g). Zinc and lead were positively correlated with elevated systolic blood pressure( β = 0.054 , 0.014), zinc and cadmium were positively correlated with elevated diastolic blood pressure ( β =0.038,0.029) ( P <0.05). Conclusions Metal zinc, lead and cadmium concentration are associated with elevated blood pressure. It is necessary to intervene and control the exposure of zinc, lead and cadmium in the environment to promote the blood pressure health of primary school students.

BACKGROUND:Clinical skin wound healing continues to be a significant concern,and tissue repair research has moved to the forefront with the development of biomaterials with immunomodulatory properties.Therefore,it is crucial to research wound dressings that have immunomodulatory properties. OBJECTIVE:To prepare chitosan hydrogels that have been modified by arginine with different configurations and assess their capacity to speed up wound healing in a rat animal model. METHODS:(1)In vitro trial:Chitosan modified by pure L-arginine,pure D-arginine,and L-arginine and D-arginine was synthesized by EDC/NHS system,which was then crosslinked with aldehyde-modified four-arm polyethylene glycol.Different chitosan-based hydrogels(CS-L,CS-D,and CS-DL)were finally formed via the Schiff base reaction.Three kinds of hydrogel extracts were co-cultured with fibroblasts respectively.Hydrogel cytocompatibility was assessed using the CCK-8 assay and live/dead staining.The effect of hydrogel on the migration capacity of fibroblasts was assessed by using a scratch test.Three kinds of hydrogels were incubated with rat erythrocyte suspension respectively to evaluate the hemocompatibility of the hydrogels.The hydrogel extract was co-cultured with RAW264.7 macrophages to test the hydrogels'capacity to enhance macrophage NO generation and polarize macrophage phenotype.(2)In vivo experiment:A total of 36 adult SD rats were divided into 4 groups with 9 rats in each group by the random number table method.Two full-layer skin defect wounds of 2 cm×2 cm were made on the back of each rat.Normal saline was added to the wounds of the control group,and corresponding hydrogel was added to the wounds of the CS-L,CS-D,and CS-DL groups,respectively,and then bandaged and fixed.The wound healing was observed regularly after operation.Hematoxylin-eosin staining was performed at 3,10,and 21 days after operation.The samples were collected 10 days after operation and M2 macrophage immunofluorescence staining was performed. RESULTS AND CONCLUSION:(1)In vitro experiments:Under scanning electron microscopy,the three kinds of hydrogels exhibited obvious interpenetrating network structures with pore sizes ranging from 70-200 μm.The three kinds of hydrogels have good swelling performance,degradation performance,self-healing performance,and suitable mechanical strength.The three kinds of hydrogels had good cytocompatibility and hemocompatibility and could promote the migration of fibroblasts.All three kinds of hydrogels had the ability to promote the polarization of macrophages,and CS-D hydrogels had the strongest ability to promote the polarization of macrophages.CS-L hydrogel could significantly promote the production of NO in macrophages.(2)In vivo experiment:3 and 10 days after operation,the wound healing rate in the CS-L and CS-D groups was higher than that in the control group(P<0.05).After 21 days,the wound healing rate of the three hydrogel groups was higher than that of the control group.Hematoxylin-eosin staining displayed that a large number of inflammatory cells were infiltrated in the wound tissue of rats in all groups,accompanied by neovessels and fibroblasts 3 days after operation.10 days after operation,there was still more inflammatory cell infiltration in the wound of the control group,and the inflammation of the other three groups was improved,especially the decrease of inflammatory cells in the CS-D group was more obvious.21 days after operation,the wound epithelium of each group was well repaired,and there was basically no inflammatory cell infiltration in the CS-L and CS-D groups,while there was still a small amount of inflammatory cell infiltration in the control group.Immunofluorescence staining revealed that the number of M2-type macrophages in the CS-D group was higher than that in the other three groups(P<0.05).(3)The results conclude that chitosan hydrogels modified by different configurations of arginine can promote wound healing through different mechanisms.

A 82-year-old man was admitted to hospital with fever,unresponsiveness,elevated hypersensitive C-reactive protein and neutrophile granulocyte.Ceftriaxone was administrated by intravenous dripping in the emergency room,but the effect was not satisfactory.Following his admission to the ward,cefoperazone sulbactam were given.Elizabethkingia meningoseptica was identified by blood culture and further confirmed by 16S rRNA sequencing.The lumbar puncture showed that cerebrospinal fluid pressure was 80 mmH2O(1 mmH2O=0.0098 kPa)and biochemical results were normal.After 11 days of cefoperazone sulbactam treatment,the patient was discharged with negative blood culture.The hypersensitive C-reactive protein and neutrophile granulocyte had also declined.The patient received levofloxacin tablets for anti-infection treatment for 14 d after discharge.No signs of infection were observed in three months'following up.

Objective:To investigate the effects of regular yoga practice on pulmonary function and mechanical parameters of diaphragm.Methods:Eighty regular yoga practitioners, including 40 practicing for≤5 year (yoga≤5 years group) and 40 for>5 year (yoga>5 years group) were recruited in Shanxi Norman Bethune Hospital from January 2024 to April 2024; and 40 sedentary subjects were also recruited as the control group. The diaphragmatic motion was evaluated by two-dimensional ultrasound and speckle tracking ultrasound in all subjects, the parameters, including displacement, fractional thickening, strain and strain rate of diaphragm were observed at rest and deep breathing. At the same time, the pulmonary function tests were performed, the indexes including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV 1) and one-second rate (FEV 1/FVC) were measured in all subjects. The mechanical parameters of diaphragm and the pulmonary function were compared among three groups. Results:There were no significant differences in gender ( χ2= 0.346), age ( F=1.16), height ( F=0.45), weight ( F=0.11) and body mass index (BMI) ( F=0.07) among the three groups (all P>0.05).At the rest status, there was no significant difference in diaphragm displacement, thickening rate and strain among three groups ( F=1.21, 2.10 and 0.23,all P>0.05); the strain rate of yoga>5 years group was lower than that of other two groups ( t=-4.23、-4.10, all P<0.05); however, there was no significant difference between yoga≤5 years group and control group ( t=-0.06, P>0.05). During deep breathing, the increment of displacement, thickening rate, strain and strain rate of diaphragm in yoga>5 years group was larger than that in other tow groups, while the increment of yoga≤5 years group was larger than that in control group ( F=25.82, 60.99, 17.29 and 52.46, all P<0.05); the increment of FVC, FEV 1 and FEV 1/FVC in yoga>5 years group was larger than other two groups, whilc the increment of yoga≤5 years group was larger than that of sedentary group (F=4.49, 7.32 and 39.71, all P<0.05). The diaphragmatic displacement was positively correlated with FVC ( r=0.290, P<0.05), and diaphragmatic displacement and thickening rate were positively correlated with FEV 1 and FEV 1/FVC (0.333 and 0.448, 0.231 and 0.599, all P<0.05), the strain and strain rate of diaphragm were negatively correlated with FEV 1 and FEV 1/FVC ( r=-0.399 and -0.719, -0.355 and -0.796, all P<0.05). Conclusion:The regular yoga practice can improve the movement capacity and efficiency of diaphragm, improve the pulmonary function, and there is a negative correlation between the strain rate and the mechanical parameters of diaphragm and FEV 1, FEV 1/FVC.

Objective:To evaluate the effects of exogenous biliverdin (BV) on the expression of Litaf in PC12 cells subjected to oxygen-glucose deprivation and restoration (OGD/R).Methods:PC12 cells were seeded in a 96-well cell culture plate at a density of 1×10 4 cells/well for 3 days and were divided into 3 groups ( n=18 each) by a random number table method: control group (group C), OGD/R group, and biliverdin group (BV group). Group C was incubated in a 37 ℃ incubator (95% air+ 5%CO 2) for 6 h. To establish the OGD/R model, cells were incubated with sugar-free medium in a 37 ℃ incubator (95% air+ 5%CO 2) for 2 h, and the medium was then replaced with normal medium and cells were continuously incubated in a 37 ℃ incubator (95% N 2+ 5% CO 2). In BV group, 2 μg/ml biliverdin was added immediately after oxygen-glucose restoration.Cells in 6 wells in each group were selected at 6 h of restoration for determination of the expression of Litaf protein and mRNA (by real-time polymerase chain reaction) and tumor necrosis factor-alpha (TNF-α) concentration (by enzyme-linked immunosorbent assay). Results:Compared with group C, the expression of Litaf protein and mRNA was significantly up-regulated, and TNF-α concentration in supernatant was increased in group OGD/R ( P<0.05). Compared with group OGD/R, the expression of Litaf protein and mRNA was significantly down-regulated, and TNF-α concentration in supernatant was decreased in group BV ( P<0.05). Conclusion:The mechanism by which exogenous biliverdin reduces OGD/R damage to PC12 cells is related to inhibiting up-regulated expression of Litaf and alleviating the inflammatory responses.

Objective:To evaluate the effect of propofol anesthesia on autophagy in hippocampal neurons of newborn rats.Methods:Thirty-nine healthy Sprague-Dawley rats, aged 7 days, weighing 10-12 g, were divided into 3 groups ( n=13 each) using a random number table method: control group (group C), fat emulsion group (group F) and propofol group (group P). Normal saline 8 ml/kg was intraperitoneally injected for 5 consecutive days in group C. Medium-/long-chain fatty emulsion injection 8 ml/kg was intraperitoneally injected for 5 consecutive days in group F. Medium-/long-chain propofol injection 80 mg/kg was intraperitoneally injected for 5 consecutive days in group P. Five rats were sacrificed on 1st day after the end of propofol anesthesia, and hippocampal tissues were taken for determination of the expression of microtubule-associated protein 1 light chain 3B (LC3B) and Beclin-1 (by Western blot). The remaining rats in each group underwent the Morris water maze test on 19th day after the end of propofol anesthesia (30 days after birth), and the escape latency, percentage of time of staying at the target quadrant and the number of crossing the original platform were recorded. Results:Compared with group C, no significant change was found in the expression of hippocampal LC3B and Beclin-1, escape latency, percentage of time of staying at the target quadrant, and the number of crossing the original platform in group F ( P>0.05), and the expression of hippocampal LC3B and Beclin-1 was significantly up-regulated, the escape latency was prolonged, percentage of time of staying at the target quadrant was decreased, and the number of crossing the original platform was decreased in group P ( P<0.05 or 0.01). Conclusion:The mechanism by which propofol anesthesia causes long-term cognitive dysfunction may be related to promoting autophagy in hippocampal neurons of newborn rats.

Objective:To explore the clinical characteristics and management of childhood acute lymphoblastic leukemia (ALL) complicated with cerebral venous thrombosis (CVT).Methods:The clinical data of 14 ALL children complicated with CVT who were admitted to Department of Pediatrics of Sun Yat-sen Memorial Hospital and underwent chemotherapy from January 2011 to October 2019 were collected retrospectively. The clinical manifestations, coagulation function, imaging findings, treatment plan and prognosis of patients were analyzed.Results:CVT was diagnosed in 14 (2.8%, 14/505) cases, with a median age of 10 (3-14) years at onset, 11 cases occurred in the stage of induction remission, and the acute onsets were mainly characterized by convulsions (9 cases), consciousness disorders (6 cases) and headache (4 cases). Coagulation function test showed that, before the CVT, antithrombin Ⅲ activity was lower than 60% in 8 cases, D-dimer elevated on the day of onset in 8 cases. Arteriovenous angiography showed filling defects in single (9 cases) or multiple (5 cases) venous sinuses. The most common site of venous sinus enlargement was superior sagittal sinus (10 cases). Secondary cerebral hemorrhage was found in 5 cases. Anticoagulation therapy included combination of low-molecular-weight heparin (LMWH) and warfarin in 9 cases, sequential application of LMWH and warfarin in 2 cases, and LMWH alone in 3 cases. Patients accepted further asparaginase and no CVT recurrence or progression was found.Conclusions:The secondary coagulation dysfunction during induction remission chemotherapy is the major risk factor for CVT in ALL, which needs active monitoring and early prevention. Arteriovenous angiography can diagnose accurately, and the prognosis of anticoagulant therapy with LMWH and warfarin is optimistic.

Objective: To investigate the value of shear wave elastography (SWE) in the early diagnosis of hepatic cirrhosis nephropathy. Methods: Seventy-three hepatic cirrhosis patients with normal conventional renal function were enrolled in the study, and were subdivided into Child-Pugh A group, Child-Pugh B group and Child-Pugh C group. Forty healthy volunteers were served as the control group. All the subjects underwent SWE to obtain the Young′s modulus value of left renal cortex, medulla and parenchyma which included Emax, Emin, Emean. The Young′s modulus value were compared among different groups. Results: Compared to the control group, the Emax, Emean of left renal cortex, modulus and parenchyma in hepatic cirrhosis group were higher(P<0.05). Compared to the control group, there was no significant difference in Emax, Emin and Emean of left renal cortex, medulla and parenchyma in group A(P>0.05). The Emax and Emean of left renal cortex, medulla and parenchyma were higher both in group B and group C than those in control group(P<0.05). Comparison of liver cirrhosis among groups, the Emax and Emean of left renal cortex, medulla and parenchyma in group B and group C were higher than those of group A(P<0.05), there was no significant difference between group B and group C(P>0.05). Conclusions SWE can quantitatively determine the elastic parameters of renal tissue in patients with different degrees of cirrhosis, the change of renal tissue elasticity is earlier than that of routine laboratory examination, SWE can early detect renal tissue damage in patients with liver cirrhosis.

Objective To measure the ratio of the length between upper edge of eyebrow and edge of lower eyelid(L1)/the length between edge of lower eyelid and nasal base(L2)in the fordless-eyelid and upper lid ptosis patients who received levator aponeurosis folding surgery. To analyze the change in the proportion of midfa-cial aesthetics. Methods From December 2015 to October 2016,a total of 21 patients were recruited as study group. Those patientswere diagnosed with foldless eyelid and upper lid ptosis. They received levator aponeurosis folding procedures were carried out in our departmentand the pre- and post-operative photographs were collected. Full-face pictures of 20 Chinese female movie stars were prepared as control group. The ratiosof L1/L2(J)were measured via Adobe Photoshop CS6. The statistical significance was analyzed and the change of midfacial propor-tion was evaluated. Results In study group,the mean value of pre- and post-operative L1/L2(J1)is 0.746 and (J2)0.657 postoperatively. In control group,the mean value of L1/L2(J3)is 0.667. Statistical differences showed between the pre- and post-operative samples and between pre-operative samples and control group. There was no statistical difference between post-operative and control group samples. The ratios between L1 and L2 in post-opera-tive samples are close to those in control group ,which are closer to the golden radio. Conclusions Levator aponeurosis folding can effectively lower eyebrow in patients with upper lid ptosis and shorten the length between eyebrow and lower eyelid. Therefore harvesting a more appropriate and harmonious ratio of L1/L2 according the golden section theory. The changes in the proportion of midfacial aesthetics after operation could be used as a key point in the pre-operative communication and post-operative effect evaluation ,besides the size of palpebral fissure and corneal exposure rate.

Objective To investigate the effects of vagus nerve electrostimulation (VNS) on the brain damage of rat middle cerebral artery occlusion (MCAO)/reperfusion model and its mechanism. Methods Twenty four adult male SD rats were randomly divided into two groups (12 each): MCAO/reperfusion group (MCAO group) and MCAO/reperfusion+VNS group (MCAO+VNS group). Subsequently, the neurological function deficit was determined by neurological scoring according to Zea Long scoring method 24h after MCAO/reperfusion. The cerebral infarction volume was determined by TTC assay. The cell apoptosis in brain damage zone was determined by TUNEL assay. Then, the effect of VNS on cAMP response element binding protein (CREB) and p-CREB protein expression was determined by Western blotting. The effect of VNS on Bcl-2 and Bax expression was determined by immunohistochemistry assay. Results Compared with MCAO group, VNS significantly inhibited MCAO-induced neurological deficit (P<0.01), decreased brain infarct volume (P<0.01) and cell apoptosis (P<0.01), increased the expression of p-CREB protein (P<0.01) and the number of Bcl-2-position cells (P<0.01) together with decreasing the number of Bax-position cells (P<0.01). However, VNS did not affect the expression of CREB protein (P>0.05). Conclusion VNS may ameliorate MCAO-induced neurological deficit and decrease brain infarct volume, which may be related to the promotion of p-CREB protein expression level.