Objective: To understand classroom environmental conditions and their association with spinal curvature abnormalities among students of primary and secondary schools in Guizhou Province, so as to provide a basis for formulating school health policies and scientific prevention and control measures for abnormal spinal curvature in students. Methods: Using a stratified random sampling method, 471 schools (2 811 classrooms) were selected annually across the province from 2022 to 2024 in order to monitor and evaluate classroom environment according to national standards. Spinal examinations were conducted for 196 606 (2022), 194 876 (2023), and 195 048 (2024) students, and χ 2 test was used to analyze the correlation of desk and chair compliance with student spinal curvature abnormalities. Results: The qualified rates of classroom blackboard illuminance uniformity ( 85.41 %) and the blackboard size (82.24%) were the highest in primary and secondary schools in Guizhou Province, while the average blackboard surface illumination qualified rate (20.10%) was the lowest. The average desk illumination (50.11%-58.63%), desk illumination uniformity (61.92%-72.27%) and qualified noise rate (50.04%-51.94%) increased significantly in 3 years; in addition, the compliance rate of desks and chairs decreased from 25.00% to 13.52%, and the differences were all statistically significant ( χ 2=42.48, 80.93, 46.09, 129.72, all P <0.05). Middle school classrooms outperformed primary schools in terms of per capita area, average blackboard illuminance, blackboard illuminance uniformity, average desktop illuminance, desktop illuminance uniformity, and noise compliance ( χ 2=311.55, 12.41, 20.64, 40.76, 10.25, 52.47), but had lower compliance for blackboard size and reflectance ( χ 2=537.29, 7.59) (all P <0.01). Urban schools had higher compliance than suburban schools for per capita area, average blackboard illuminance, average desktop illuminance, and desktop illuminance uniformity ( χ 2=73.71, 17.68, 29.30 , 36.03), but lower compliance for desk-chair suitability, blackboard size, and blackboard reflectance ( χ 2=4.72, 26.02, 5.43 ) (all P <0.05). The spinal curvature abnormality detection rate was 0.83%. A significant association was found between abnormality detection and desk-chair non compliance ( χ 2=223.85, P <0.01). Conclusions Classroom environment hygiene in Guizhou schools is suboptimal. Strengthening school environmental hygiene infrastructure and greater attention to its impact on student s health are essential.

Objective: To understand the epidemiological characteristics of abnormalities spinal curvature among children and adolescents in Karst landform in Guizhou Province, so as to provide a scientific basis for targeted comprehensive intervention. Methods: From September to December 2023, 194 875 children and adolescents aged 6-18 were selected from all countieldistricts of 9 cities (prefectures) in Guizhou Province by stratified random cluster sampling method according to the proportion of Karst landform area in Guizhou Province for carrying out spinal curvature abnormality screening, and a questionnaire survey was conducted on 139 449 students in the fourth grade and above of primary school. Binary Logistic regression was used for multivariate analysis. Results: The detection rate of abnormal spinal curvature among children and adolescents aged 6-18 in Guizhou Province was 1.13%. The detection rates of abnormal spinal curvature in areas with a high proportion of Karst landform, areas with a low proportion of Karst landform, intercalation areas, and nonKarst landform areas were 1.10%, 2.00%, 0.90%, and 0.60%, respectively. Among them, the detection rates of abnormal spinal curvature in female students (2.40%, 1.60%, 0.90%) in areas with a low proportion of Karst landform, intercalation areas and nonKarst landform were higher than those in male students (1.60%, 0.10%, 0.30) (χ2=12.66, 112.69, 30.22, all P<0.05). The detection rates of abnormal spinal curvature among senior high school students (2.00%, 4.30%, 1.40%, 1.30%) in different Karst landform distributions were successively higher than those among junior high school students (1.40%, 3.20%, 1.00%, 0.60%) and primary school students (0.70%, 0.80%, 0.60%, 0.30%) (χ2=306.11, 175.80, 14.24, 39.57, all P<0.05). The results of multivariate Logistic regression analysis showed that the detection rates of abnormal spinal curvature in both highproportion and lowproportion Karst landform areas were higher than those in nonKarst landform areas [OR(95%CI)=1.84(1.05-2.25), 1.60(1.23-2.09), both P<0.05]. Conclusion The detection rate of abnormal spinal curvature in children and adolescents aged 6-18 in Guizhou Province is related to the distribution of Karst landform, so it is necessary to strengthen screening and appropriate comprehensive interventions.

Objective To explore the correlation between eosinophils(EOS),interleukin-17A(IL-17A),tumor necrosis factor α(TNF-α)and vascular endothelial growth factor(VEGF)in peripheral blood and my-coplasma pneumoniae infection with wheezing in children.Methods A total of 98 children with mycoplasma pneumoniae infection diagnosed and treated in the hospital from January 2022 to May 2023 were selected as the study group.The study group was divided into wheezing group(32 cases)and non-wheezing group(66 ca-ses)according to whether they were accompanied by wheezing,and 30 children with lobar pneumonia without wheezing who were examined by fiberoptic bronchoscopy during the same period were selected as the control group.The levels of EOS,IL-17A,TNF-α and VEGF in peripheral blood of different groups were compared,and the correlation between the four indexes and mycoplasma pneumoniae infection with wheezing in children was analyzed.Results The levels of EOS,IL-17A,TNF-α and VEGF in peripheral blood of the study group were significantly higher than those of the control group,and the differences were statistically significant(P＜0.05).The differences in the levels of EOS,IL-17A,TNF-α and VEGF in the peripheral blood of the three groups were statistically significant(P＜0.05).Specifically,the levels of EOS,IL-17A,TNF-α and VEGF in the wheezing group were significantly higher than those in the non-wheezing group and the control group,and the differences were statistically significant(P＜0.05),and the levels of EOS,IL-17A,TNF-α and VEGF in the non-wheezing group were significantly higher than those in the control group,and the differences were sta-tistically significant(P＜0.05).Pearson correlation analysis showed that the levels of EOS,IL-17A,TNF-α and VEGF in peripheral blood were positively correlated with mycoplasma pneumoniae infection with wheez-ing in children(P＜0.05).Using wheezing as a state variable and plotting the receiver operating characteristic(ROC)curve,it was found that the area under the curve of peripheral blood EOS,IL-17A,TNF-α and VEGF for distinguishing mycoplasma pneumoniae infection with wheezing in children was 0.658,0.960,0.948,and 0.937.Conclusion Peripheral blood EOS,IL-17A,TNF-α,The level of VEGF is positively correlated with Mycoplasma pneumoniae infection with wheezing in children,which could be used for clinical differentiation of mycoplasma pneumoniae infection with wheezing in children.

This paper reviewed the concept of organizational silence, elaborated on the content, evaluation methods, reliability, validity, characteristics, and other aspects of nurse organizational silence assessment tools, and compares the basic characteristics, content, and application of each tool. The aim was to provide reference for selection of appropriate assessment tools to identify nurse organizational silence, as well as for the development of comprehensive assessment tools and the early formulation of management strategies.

【Objective】 To explore the role and mechanism of TRPC6 in apoptosis of glomerular mesangial cells (HBZY-1) induced by endoplasmic reticulum stress (ERS). 【Methods】 The experiment groups were classified as follows: normal control (NC), thapsigargin (TG), TG+SKF96365, and TG+TRPC6 siRNA groups. Transcription and protein expressions of TRPC6 and ERS related proteins (GRP78 and Caspase12) were detected by qRT-PCR and Western blotting. Additionally, cell apoptosis was measured by flow cytometry and Hoechst33258. Finally, Fluo-4 AM Ca²⁺ imaging technique was used to determine changes of intracellular calcium ( [Ca²⁺] i) by laser scanning confocal microscope. 【Results】 Morphological changes of apoptotic cells were characterized by nuclear enrichment or nuclear fragmentation, and the apoptosis rate was increased after TG stimulation. The expressions of TRPC6 and ERS related proteins (GRP78 and Caspase12) were elevated in TG group compared with NC group (P<0.05). Pre-incubation of HBZY-1 cells with SKF96365 and TRPC6 siRNA decreased cell apoptosis (P<0.05). The entry of [Ca²⁺] i also increased after TG stimulation (P<0.05). The expressions of TRPC6, GRP78 and Caspase12 were downregulated compared with TG group after treatment with SKF96365 and TRPC6 siRNA accompanied by decreased [Ca²⁺] i (P<0.05). 【Conclusion】 Taken together, this study suggests that inhibition of TRPC6 can alleviate TG-induced HBZY-1 cell apoptosis.

【Objective】 To analyze the basic characteristics of whole blood donors from blood stations before and after the outbreak of COVID-19. 【Methods】 After excluding invalid data, data related to the basic characteristics of whole blood donors collected from 26 blood stations in China during 2018 to 2021 were statistically analyzed, including the trend of total whole blood donors, the number of repeated blood donors, the frequency of blood donation, the average age of donors and the recruitment of first-time blood donors. 【Results】 Affected by the epidemic, 8 out of 14 indicators were with large variations, accounting for 57%. The overall growth rate of total whole blood donors during the epidemic was higher than before the epidemic (P<0.05).The number of repeated blood donors has shown an increased trend, with a higher number during the epidemic than before (P<0.05). The frequency of blood donation was lower during the epidemic than before(P<0.05).Average ages of blood donors and female blood donors fluctuated widely during the epidemic, both higher than those before the epidemic(P<0.05).The donation rate of first-time blood donors <25 years old and ≥25 years old varied widely and irregularly during the epidemic (both P<0.05). The percentage of first-time blood donors fluctuated irregularly during the epidemic, with overall percentage lower than that before the epidemic(P<0.05). 【Conclusion】 Whole blood donors from 26 blood stations increased after the outbreak of COVID-19, and some indicators in certain areas showed significant fluctuations during the epidemic.

China is stepping up its standardized management of investigator initiated trials(IIT)carried out by medical and health institutions, spotlighting the establishment and improvement of the quality control system of IIT projects than ever before. The authors retrieved official websites of clinical research related units of medical institutions and research institutes at home and abroad, and by means of literature review analyzed the current quality management of IIT projects at home and abroad. They found such setbacks as lack of quality management standards and norms, imperfect quality control mechanism, poor awareness of quality risk, insufficient quality supervision and poor quality control ability of clinical researchers. Based on the above, the paper made the following recommendations for building an IIT project quality control system in China: developing quality management standards and norms, setting up a systematic quality control mechanism(i.e., exploring a three-level quality control mode composed of the project team/department-hospital-national supervision institution/peer review expert team, and implementing the whole process quality control mechanism), strengthening policy guidance and system construction, and strengthening the standardized training of clinical researchers.

Objectives:To study the clinical significance of time to positive (TTP) of blood culture for neonatal sepsis.Methods:From August 2016 to June 2019, a retrospective study was conducted in patients with positive blood cultures admitted to the Neonatology Department of our hospital. The patients were assigned into different groups according to the species of pathogen, types of neonatal sepsis and the samples contaminated or not. TTP of different groups were analyzed.Results:A total of 307 cases with positive blood cultures were identified from 10 035 cases with blood culture specimens. Among the 307 cases, 162 were contaminated (the contaminated group) and 145 (1.4%) were diagnosed of neonatal sepsis (the pathogenic group). The proportion of TTP <24 h, 24~<48 h, 48~<72 h and ≥72 h in the 145 sepsis cases were 90.3% (131/145), 7.6% (11/145), 1.4% (2/145) and 0.7% (1/145), respectively. The median TTP was 9.0 h in early-onset sepsis (EOS) group and 11.5 h in late-onset sepsis (LOS) group. The median TTP of the contaminated group was 24.5 (19.9, 30.5)h, which was longer than 11.1 (8.1,16.2)h of the pathogenic group ( P<0.05). The median TTP of Gram (+) group was 14.0 (9.4,18.8)h, which was longer than 9.6 (7.5,11.3)h of Gram (-) group ( P<0.05). The median TTP of fungi group was 32.5 (25.5, 39.0) h, which was longer than 10.6 (8.1, 15.5)h of bacteria group ( P<0.05). Conclusions:Different pathogens has different TTP for neonatal sepsis. If blood culture maintains negative for more than 72 h, empiric use of antibiotics may be discontinued for patients of suspected sepsis without specific clinical manifestations or other lab results.

Objective:To investigate the risk factors of systolic dysfunction early complicated in patients with isolated traumatic brain injury (iTBI) and to evaluate the influence of complicated systolic dysfunction on the prognosis of iTBI patients.Methods:From January 2017 to October 2018, 123 patients with moderate or severe iTBI admitted to Trauma Centre in our hospital were included in the study, and patients with previous cardiovascular diseases were excluded. Left ventricular systolic function was assessed by transthoracic echocardiography within 24 h after admission. The patients were divided into normal systolic function group ( n=100) and systolic dysfunction group ( n=23) according to the results of echocardiography. Data were collected from all patients on admission, including GCS score, systolic blood pressure, heart rate, high-sensitivity cardiac troponin T (hs-cTnT), clinical treatment variables (use of sedative drugs, vasoactive drugs, etc.), craniotomy or not and clinical outcomes (survival or death) during hospitalization. Logistic regression analysis was used to analyze the related factors for iTBI patients complicated with systolic dysfunction, and receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of each index for iTBI patients complicated with cardiac insufficiency. Results:The systolic blood pressure (147.3±23.3) mmHg, the heart rate (96.1±26.3) beats/min and the hs-cTnT level (16.48±8.17) pg/mL in the systolic dysfunction group were higher than those in the normal systolic function group on admission (all P<0.05); and the GCS score in the systolic dysfunction group was lower than that in the normal systolic function group ( P<0.05). Logistic regression analysis showed that the heart rate ( OR=1.129, 95% CI: 1.001-1.516; P=0.038), the GCS score ( OR=0.640, 95% CI: 0.445-0.920; P=0.016) and the hs-cTnT level ( OR=1.054, 95% CI: 1.009-1.101; P=0.002) on admission were independent risk factors for iTBI patients complicated with systolic dysfunction. The area under the ROC curve (AUC) of the hs-cTnT levelon admission was the largest (AUC=0.863, P<0.01). The in-hospital mortality of patients in the systolic dysfunction group was higher than that of patients in the normal systolic function group (52.5% vs 22%, P=0.004). Conclusions:The heart rate, the GCS score and the serum hs-cTnT level on admission were independent risk factors for iTBI patients complicated with systolic dysfunction. The hs-cTnT level could better predict the occurrence of cardiac systolic dysfuncion, and higher in-hospital mortality was found in iTBI patients complicated with systolic dysfunction. Therefore, early detection and timely intervention may improve the prognosis of these patients.

Objective:To provide a reference for integrated medical education reform in medical colleges by analyzing the scores of National Staged Examination of Clinical Physician Qualification (NSECPQ).Methods:The NSECPQ scores of our students in 2019 were analyzed by hypothesis testing. Chi-test was used to compare the pass rate of the examination, and the t-test was used to compare the total scores, the average mastery of disciplines and the average mastery of the system. Results:The total scores and pass rate of the examination of the students in the framework of integrated medicine education were significantly higher than those in traditional medical education. There was no significant difference in the scores of some subjects between the two educational frameworks, the scores of some subjects of the students in the framework of integrated medicine education were even lower than those in traditional medical education. For example, under the integrated medical education mode, the students' average mastery of obstetrics is 4.04 points, slightly lower than the students under the traditional medical education mode (4.11 points). It shows that the reform of integrated medical education still has some shortcomings in the teaching of some disciplines and systems.Conclusion:When implementing the teaching reform of integrated medical education in medical colleges, special attention should be paid to comparing the examination syllabus of clinical physician qualification, reasonably arranging the teaching contents of integrated medical courses, and strengthening the training of teaching staff and the construction of teaching teams, so as to ensure the teaching quality of integrated medical education reform.