Objective: To investigate the level of health literacy and its influencing factors among university students in Xi'an City, so as to provide the basis for improving the health literacy level among university students. Methods: Students from five comprehensive universities in Xi'an City were selected using a multi-stage stratified random cluster sampling method from September to December 2023. Data of basic information and health literacy were collected using questionnaire surveys. The health literacy level of university students was analyzed and factors affecting health literacy level among university students were analyzed using a multivariable logistic regression model. Results: A total of 1 815 students were surveyed, including 803 males (44.24%) and 1 012 females (55.76%), and had a mean age of (20.07±1.70) years. The overall health literacy level was 40.17%. The health literacy levels of basic knowledge and concept, healthy lifestyle and behaviors, and basic skills were 61.98%, 41.32% and 27.82%, respectively. The health literacy levels of safety and first aid, scientific health outlook, health information, chronic disease prevention and control, infectious disease prevention and control, and basic medical care were 73.44%, 70.14%, 53.50%, 50.36%, 39.34% and 33.72%, respectively. Multivariable logistic regression analysis showed that the university students who were female (OR=1.339, 95%CI: 1.034-1.733), majored in medicine (OR=1.668, 95%CI: 1.306-2.129), had a normal body mass index (OR=1.326, 95%CI: 1.056-1.688) and had no smoking history (OR=2.072, 95%CI: 1.122-2.192) had higher health literacy levels. Conclusions The health literacy levels among university students in Xi'an City are relatively low in terms of basic skills, infectious disease prevention and control, and basic medical care. Gender, major, body mass index and smoking history are influencing factors for health literacy level among university students.

ObjectiveTo investigate the role and mechanism of podoplanin （PDPN） in hepatic stellate cell （HSC） activation and liver fibrosis. MethodsLiver biopsy samples were collected from 75 patients with chronic hepatitis B who attended Department of Infectious Diseases， Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine， for the first time from September 2019 to June 2022， and RT-PCR and immunohistochemistry were used to measure the expression of PDPN in liver tissue of patients in different stages of liver fibrosis. A total of 12 male C57/BL6 mice were randomly divided into control group and model group. The mice in the model group were given intraperitoneal injection of 10% CCl₄， and those in the control group were injected with an equal volume of olive oil， for 6 weeks. HE staining and Sirius Red staining were used to observe liver histopathological changes； primary mouse liver cells were separated to measure the mRNA expression of PDPN in various types of cells； primary mouse HSCs were treated with PDPN protein， followed by treatment with the NF-‍κB inhibitor BAY11-708， to measure the expression of inflammatory factors in HSCs induced by PDPN. The independent-samples t test was used for comparison of normally distributed continuous data between two groups； a one-way analysis of variance was used for comparison between multiple groups， and the least significant difference t-test was used for further comparison between two groups. The Spearman correlation analysis was used to investigate data correlation. ResultsAs for the liver biopsy samples， there was a relatively low mRNA expression level of PDPN in normal liver， and there was a significant increase in the mRNA expression level of PDPN in liver tissue of stage S3 or S4 fibrosis （all P<0.001）. Immunohistochemical staining showed that PDPN was mainly expressed in the fibrous septum and the hepatic sinusoid， and the PDPN-positive area in S4 liver tissue was significantly higher than that in S0 liver tissue （t=8.892， P=0.001）. In normal mice， PDPN was mainly expressed in the hepatic sinusoid， and there was a significant increase in the expression of PDPN in CCl₄ model mice （t=0.95， P<0.001）， mainly in the fibrous septum. RT-PCR showed a significant increase in the mRNA expression of PDPN in the CCl₄ model mice （t=11.25， P=0.002）. Compared with hepatocytes， HSCs， Kupffer cells， and bile duct endothelial cells， hepatic sinusoidal endothelial cells showed a significantly high expression level of PDPN （F=20.56， P<0.001）. Compared with the control group， the primary mouse HSCs treated by PDPN protein for 15 minutes showed significant increases in the mRNA expression levels of the inflammation-related factors TNFα， CCL3， CXCL1， and CXCR1 （all P<0.05）， and there were significant reductions in the levels of these indicators after treatment with BAY11-7082 （all P<0.05）. ConclusionThere is an increase in the expression of PDPN mainly in hepatic sinusoidal endothelial cells during liver fibrosis， and PDPN regulates HSC activation and promotes the progression of liver fibrosis via the NF-κB signaling pathway.

Objective To investigate the influencing factors of nosocomial pneumonia in elderly pa-tients with CHD and HF.Methods A total of 196 elderly CHD patients with HF diagnosed and treated in our department from March 2021 to August 2023 were enrolled,and divided into infec-ted group(n=52)and non-infected group(n=144)based on whether pulmonary infection oc-curred during hospitalization.Logistic regression analysis was used to identify the risk factors af-fecting secondary nosocomial pulmonary infection.Based on these risk factors,a comprehensive in-dex was built.ROC curve was drawn to analyze the diagnostic value of the index for secondary nosocomial pulmonary infection.Results The infected group had significantly advanced age,lar-ger proportions of NYHA grade Ⅲ to Ⅳ,smoking history,diabetes history,mechanical ventila-tion time＞48 h,length of hospital stay＞14 d,and albumin at admission＜30 g/L,and higher RDW at admission when compared with the non-infected group(P＜0.05,P＜0.01).Logistic regression analysis showed that NYHA grade Ⅲ to Ⅳ,diabetes history,mechanical ventilation time＞48 h,length of hospitalization＞14 d,albumin＜30 g/L at admission and RDW at admis-sion were risk factors for secondary nosocomial pulmonary infection in elderly CHD patients with HF(OR=2.398,95％CI:1.157-4.969;OR=2.732,95％CI:1.278-5.839;OR=2.607,95％CI:1.138-5.973;OR=3.368,95％CI:1.567-7.242;OR=2.677,95％CI:1.218-5.886;OR=1.762,95％CI:1.488-61.222).ROC curve analysis indicated that the AUC value of NYHA grade Ⅲ to Ⅳ,diabetes history,mechanical ventilation time＞48 h,length of hospitalization＞14 d,albumin＜30 g/L at admission and RDW at admission in predicting secondary nosocomial pulmonary infec-tion in elderly CHD patients with HF was 0.598,0.620,0.586,0.595,0.615 and 0.850,respectively,and the value of the comprehensive index was 0.743,which is superior to that of above single indi-cator(P＜0.05).Conclusion Age,NYHA grade,smoking history,diabetes history,mechanical ventilation time,hospital stay and albumin and RDW levels at admission have adverse effects on secondary nosocomial pulmonary infection in elderly CHD patients with HF.Our built compre-hensive index based on these risk factors has high efficacy in predicting nosocomial pulmonary in-fection.

Objective To establish an animal model of dampness-syndrome in mice (single model) and evaluate its characteristics of dampness-syndrome. The above-mentioned mice with dampness syndrome were used to construct mice model of ischemic stroke (double model) and observe the effect of dampness-pathogenic on the outcome of stroke. Methods Healthy C57BL/6J male mice were randomly divided into dampness-syndrome (including sham-surgery group and ischemic stroke group,with 10 mice in each group) and non dampness-syndrome groups (including sham-surgery group and ischemic stroke group,with 10 mice in each group). The dampness-syndrome group was fed with high-fat diet and the non dampness-syndrome group was fed with normal diet for 12 weeks. After the mice model of dampness-syndrome was successfully established,transient middle cerebral artery occlusion/reperfusion (tMCAO/R) surgery was used to replicate an ischemic stroke mice model. Evaluation indicators for dampness-syndrome mice model:the general status including body weight,morphology,posture,activity status,and physical characteristics,the histopathological observation of the aorta (oil red O staining,Masson-trichrome staining) and liver (HE staining,oil red O staining),electron microscopic observation of the tongue tissue (scanning electron microscopy,electron microscopy),blood lipid levels[total cholesterol(TC),triglycerides(TG)]and liver coefficient. Evaluation indicators for ischemic stroke mice model:neurological function score and the cerebral infarction volume ratio. Results Compared with the non dampness-syndrome group,the mice in the dampness-syndrome group showed an increased in body weight,poor hair color,sparse hair,fatigue and laziness,mental atrophy,anorexia and lethargy. It was observed that the aortic lumen was narrowed,the intima was significantly thickened,lipid plaque deposition was increased,and foam cells were visible. A large amount of red lipid droplets appeared in liver cells. There were obvious lipid infiltration and diffuse steatosis. Increased keratosis of the mucosal layer of tongue tissue,the thicker stratum corneum,lipofuscin,and bacteria on the tongue surface were found. Serum TG and TC levels significantly increased(P<0.01),and the liver coefficient significantly decreased (P<0.001). Compared with non dampness-syndrome group (sham-surgery group),neurological function score and the cerebral infarction volume ratio in dampness-syndrome ischemic stroke group obviously increased (P<0.001). Conclusion High-fat feeding for 12 weeks combined with tMCAO/R modeling can successfully establish a mice model with dampness-syndrome ischemic stroke,and the neurological function score and cerebral infarction volume in the dampness-syndrome ischemic stroke group was more severe than that in the non dampness-syndrome ischemic stroke group.

Objective:To investigate the expression of long non-coding RNA (lncRNA) MTATP6P1 in melanoma and its effect on the proliferation, migration and invasion of melanoma cells by targeting miRNA-411-5p (miR-411-5p).Methods:A total of 461 samples of melanoma tissues and paracancerous tissues (>2 cm from the tumor margin) were collected from the tumor-associated lncRNA database (TANRIC database updated in July 2021), and the expression of MTATP6P1 was compared between the two groups. The bioinformatics software lncRNA Disease v2.0 was used to predict the possible binding site microRNA (miRNA) of MTATP6P1. Real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) was used to detect the relative expression level of MTATP6P1 in melanoma cells A-375, WM266-4, VMM5A, A2058 and normal human epidermal melanocytes PIG1; and the lowest relative expression level of cells in MTATP6P1 were divided into MTATP6P1 group (transfected with MTATP6P1 overexpression plasmid) and NC group (transfected with blank plasmid). The proliferation ability of A-375 cells was detected by using CCK-8 method; the migration ability of A-375 cells was detected by using scratch test; the invasion ability of A-375 cells was detected by using Transwell assay; the targeting relationship between MTATP6P1 and miR-411-5p was detected by using dual luciferase reporter gene assay; Western blot was used to detect the expression of ERK signaling pathway related proteins in cells.Results:The relative expression levels of MTATP6P1 in melanoma tissues and adjacent tissues were 9.82±0.58 and 11.56±0.16, respectively. The expression level of MTATP6P1 in melanoma tissues was lower than that in paracancerous tissues ( t = 9.56, P = 0.009). The relative expression levels of MTATP6P1 in normal human epidermal melanocyte PIG1 and melanoma cells A-375, WM266-4, VMM5A, and A2058 were 1.01±0.13, 0.12±0.02, 0.66±0.04, 0.39±0.07, 0.49±0.05; the relative expression level of MTATP6P1 in melanoma cells was lower than that in PIG1 cells (all P < 0.05), and then A-375 cells with the lowest relative expression level were taken to perform the subsequent experiments. The relative expression levels of MTATP6P1 in A-375 cells of MTATP6P1 group and NC group were 14.83±1.67 and 1.02±0.30, respectively ( t = 8.13, P < 0.001). After 16, 24, 32, and 40 h of culture, the proliferation ability of the cells in the MTATP6P1 group was lower than that in NC group (all P < 0.05). The scratch healing rates of A-375 cells in MTATP6P1 group and NC group were (26±7)% and (55±4)%, respectively; the scratch healing rate in MTATP6P1 group was lower than that in NC group ( t = 3.48, P = 0.009). The invasive number of A-375 cells in MTATP6P1 group and NC group were (32±12) and (116±17), respectively; the number of invasive cells in MTATP6P1 group was lower than that in NC group ( t = 4.11, P = 0.006). The results of dual luciferase reporter gene assay showed that there was a targeting relationship between MTATP6P1 and miR-411-5p. The relative expression level of miR-411-5p in A-375 cells of MTATP6P1 group and NC group was 1.04±0.16 and 5.37±0.68, respectively; the expression level of miR-411-5p in MTATP6P1 group was lower than that in NC group ( t = 6.20, P < 0.001). The expressions of ERK signaling pathway proteins p-Ras, p-Raf, p-MEK1, p-RSK, and AP-1 in A-375 cells of MTATP6P1 group were lower than those in NC group. Conclusions:MTATP6P1 inhibits the proliferation, migration and invasion of melanoma A-375 cells through targeting miR-411-5p.

Objective:To explore the coverage of influenza and pneumonia vaccination and factors influencing the vaccination in children.Methods:A cross-sectional questionnaire survey was conducted in children's parents in Beijing and Gansu by using two-stage cluster-sampling to investigate the influenza and pneumonia vaccination rates and influencing factors in children.Results:A total of 2 377 parents were included in the study, and the results indicated that the influenza vaccination coverage was 35.93% and the pneumonia vaccination coverage was 16.58% in children in survey areas, the vaccination rate of both vaccines was 11.65%. The top three reasons for vaccination for both vaccines were being aware of severity of the diseases (influenza vaccine: 36.02%; pneumonia vaccine: 49.61%), being required by school or organization (influenza vaccine: 28.76%; pneumonia vaccine: 25.45%) and being aware of the susceptibility of the diseases (influenza vaccine: 26.41%; pneumonia vaccine: 13.88%). The top three reasons for having no vaccinations were personal unwillingness, concern about vaccine and vaccine accessibility. Families with multi children, living in rural areas and lower family income were the negative factors for both types of vaccinations.Conclusions:The influenza and pneumonia vaccination coverage in children need further improvement, and rural families and families with multi children are the key concern groups for expanding vaccination coverage. Health education about influenza and pneumonia vaccinations, coordinating vaccine supply and decreasing vaccine prices play an important role in improving influenza and pneumonia vaccination coverage.

Objective:To screen the pivotal genes involved in the occurrence and development of HBV-associated HCC. Additionally, perform validation and biological function analysis to evaluate changes in the expression of pivotal genes and their prognostic value in patients with hepatocellular carcinoma.Methods:The GSE121248 gene expression profile data of HBV-HCC patients were searched and downloaded from the GEO database. The R language was used to compare the differences in gene expression between hepatocellular carcinoma and paracancerous tissues. KEGG and GO function enrichment analyses were performed on the differential genes. PPI plots and pivotal gene screening were carried out through online tools like STRING and Cytoscape software. 369 cases of hepatocellular carcinoma and 160 healthy controls in TCGA and GTEx were used as validation cohorts to verify the expression levels of the pivotal genes. A Kaplan-Meier plot was drawn to evaluate the prognostic value of the pivotal gene.Results:A total of 120 differentially expressed genes were screened, of which 89 were up-regulated and 31 were down-regulated. Differential genes were mainly enriched in the metabolic pathways related to retinol metabolism, cytochrome P450 metabolism, and the p53 signaling pathway. The top 10 differential genes were selected as pivotal genes by the Cytoscape plug-in cytoHubba. There were significant differences in the expression levels of four types of CCNB1, CDK1, RRM2, and TOP2A genes in the validation cohort. All four types of genes were up-regulated. Survival analysis showed that patients with elevated expression levels of four genes had a poorer prognosis, with statistical differences in results.Conclusion:Four types of genes, CCNB1, CDK1, RRM2, and TOP2A, have high expression levels in patients with HBV-HCC and are correlated to shorter survival times, making them a potential target for diagnosis, prognosis, and treatment.

【Objective】 To compare the ability of body mass index （BMI）， body fat percentage （BFP）， waist circumference （WC）， waist-to-height ratio （WHtR）， visceral fat index （VFI） and the combinations of two kinds of obesity indices to predict the risk of hypertension. 【Methods】 Data collected in the baseline survey of “Gansu Province’s Urban and Rural Natural Population Cohort Establishment and Tumor Follow-up Study” were analyzed. Area under the curve （AUC） of ROC curve with covariates was used to analyze and compare the effects of individual obesity evaluation index and the combination of two kinds of obesity indices in predicting the risk of hypertension. 【Results】 Analyses of data of 20，079 adults showed that the AUC of BMI， WC， WHtR， BFP and VFI was 0.636， 0.604， 0.615， 0.614 and 0.619， respectively. AUC of the combination of BMI and WC （0.643） was higher than that of BMI （0.636）； however， the change rate of AUC was only 1.09%. AUC of the combinations of WC， WHtR and VFI， the three central obesity evaluation indices， and BFP， a general obesity evaluation index， were lower than that of BMI. The optimal cutoff value for BMI was 24.2 kg/m². 【Conclusion】 The effect of BMI in predicting the risk of hypertension is better than that of BFP， WC， WHtR and VFI. The effects of the combinations of the two kinds of obesity evaluation indices are not better than that of BMI. To prevent and control hypertension， adults should keep their BMI under overweight.

Objective:To explore the effects of nursing interventions under feedforward control on postoperative patient controlled intravenous analgesia (PCIA) in patients undergoing thoracoscopic lobectomy.Methods:Sixty patients who used PCIA pumps after thoracoscopic lobectomy in Shanxi Bethune Hospital from October 2018 to September 2019 were selected and randomly divided into a control group and a test group according to the random number table, with 30 cases in each group. Patients in the control group used PCIA pumps alone, while patients in the test group underwent nursing interventions under feedforward control combined with PCIA pumps. The Visual Analog Scale (VAS) and Ramsay scores were used to assess the analgesia and sedation of the patients in the two groups at 12, 24, 36, and 48 h postoperatively. The dose of analgesic pump medication, the number of self-controlled compressions of the analgesic pump, and the occurrence of adverse reactions at 48 h postoperatively were recorded. The satisfaction with nursing care was rated.Results:The VAS scores at 12, 24, 36 and 48 h postoperatively in the test group were lower than those in the control group, and the Ramsay scores were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The dose of analgesic pump medication and the number of self-controlled compressions of the analgesic pump in the test group were less than those in the control group, and the overall patient satisfaction scores were higher than those in the control group, and the incidence of adverse reactions was lower than that in the control group, and the differences were all statistically significant ( P<0.05) . Conclusions:Nursing interventions under feedforward control in the postoperative analgesic management of patients undergoing thoracoscopic lobectomy can significantly improve the analgesic effect of postoperative PCIA pumps, reduce the incidence of related adverse reactions, and further improve patient satisfaction, which is worth applying and promoting.

Objective:To prepare ultrasound-responsive nanodroplets with block polymer PEG-PCL as shell and perfluoropentane (PFP) as core, and study the effects of mechanical index (MI) on contrast-enhanced imaging properties of nanodroplet.Methods:PEG-PCL micelles were first prepared by dialysis, and then the micelles were mixed with PFP for emulsification to obtain nanodroplets. The particle size and zeta potential of nanodroplets were measured, and the morphology of nanodroplets were observed using transmission electron microscope (TEM). The stability of nanodroplets after storage at 25 ℃ and 37 ℃ was investigated. The phase transition and contrast-enhanced imaging of nanodroplets in vitro under a series of mechanical index (MI) were studied using an ultrasound diagnostic instrument.Results:The particle size of the nanodroplets was (356.6±5.6)nm, and the zeta potential was -(7.30±0.14)mV. The nanodroplets were close to spherical under TEM and had a clear core-shell structure. The particle size and dispersion of the nanodroplets increased after storage at 37 ℃ and 25 ℃. For imaging in vitro, no acoustic signal were observed at 25 ℃ when the MI varied from 0.08 to 1.0. At 37 ℃, acoustic signals were observed when MI≥0.4, and the intensity was stronger for higher MIs.Conclusions:The contrast-enhanced imaging of nanodroplets are closely related to the MI, and a higher MI could induce the phase transition of more nanodroplets and produce stronger contrast enhancement. This study could provide basis for the application of polymeric nanodroplets in ultrasound diagnosis and targeted therapy.