Objective: To analyze the space time characteristics of poor vision among primary and secondary school students in Chengdu, in order to provide the reference for formulating myopia prevention and control policies for students. Methods: The data relating to poor vision among primary and secondary school students in Chengdu from 2021 to 2023 were sourced from the Sichuan Students Physical Health Big Data Center. The districts and counties of Chengdu were divided into three circles, including the main urban area, suburban districts and counties, and suburban districts and counties. The Chi square test was used for inter group comparison, and the Cochran-Armitage test was used to analyze the trend of changes. Global and local Moran s I were used to analyze spatial clustering. Results: The detection rates of poor vision among primary and secondary school students in Chengdu from 2021 to 2023 were 62.47%, 61.61% and 60.78%, respectively, showing a decreasing trend ( Z=-32.01, P <0.01). For each year, the higher detection rate of poor vision among students was detected in the higher level of education, and differences were statistically significant ( χ 2=161 549.47, 173 471.87, 233 459.09, P <0.01). The rate of poor vision among primary and secondary school students gradually decreased from the central districts and counties of Chengdu to the surrounding districts and counties for each year, and the differences were statistically significant ( χ 2=299.20, 776.22, 633.16, P <0.01). The spatial autocorrelation analysis showed that the first circle of Chengdu City was mainly characterized by high-high agglomeration ( P <0.01), with the rate of poor vision among primary school students in Wuhou District in 2023 exhibiting a low-high anomaly. The third circle was mainly characterized by low-low aggregation ( P <0.01), while the spatial clusterings of the second circle was not significant ( P >0.05). Conclusions The myopia prevention and control work in Chengdu has achieved preliminary results. It should continue to consolidate existing achievements and implement targeted myopia prevention and control measures based on regional characteristics.

AIM: To explore the effect of ethanol extract of costusroot (EEC) on gastric mucosa in gastric ulcer rats and related mechanism. METHODS: The rats were randomly divided into 5 groups: normal group, model group, sucralfate group, low-EEC group and high-EEC group, and anhydrous alcohol was administrated intragastrically to replicate gastric ulcer model in groups other than the normal. Changes in the area of gastric ulcer were observed and the inhibition rate of ulcer was calculated. The pathological changes of gastric tissue were measured by HE staining, and the protein expression levels of Bax and Bcl-2 were tested by immunohistochemistry and Western blot. RESULTS: EEC inhibited the formation of ulcer area in model rats and alleviated the histopathological damage to the stomach caused by ethanol. While enhancing the expression of Bcl-2 protein (P<0.01), it effectively inhibited the overexpression of Bax (P<0.01). CONCLUSION: EEC has a strong function of anti-gastric ulcers, and its mechanism of action might be related to the regulation of the protein expression level of Bax and Bcl-2 to inhibit the apoptosis of gastri mucosal cells.

Objective: To understand the incidence and trend of pulmonary tuberculosis among students in Bengbu city during 2010 to 2018. Methods: Descriptive epidemiological method was adopted to analyze data from "Bengbu tuberculosis management information system" during 2010-2018. Trend of student tuberculosis prevalence, epidemiological characteristics and management of medical registration card were analyzed. Results: During 2010-2018, there were 681 cases of tuberculosis among students registered in Bengbu city, with an average annual incidence of 12.98/100 000. Majority of the cases aged 15-19 years, and were reported in the first quarter. Four clusters of outbreaks were reported. Most of the patients were found through symptomatic treatment. The average rate of delay a patient visited medical center was 48.60%, and the average rate of diagnosis delay was 23.79% . The delay rate of the patients showed a downward trend ( χ 2=31.64, P <0.01). The rate of delayed diagnosis was increasing ( χ 2=15.76, P <0.01). Among the 681 report cards, 248 were incomplete, with an incomplete rate of 36.42%. The completeness of the infectious disease report card showed an increasing trend year by year ( χ 2=383.81, P <0.01). Conclusion Tuberculosis epidemic among students in Bengbu warrants further attention. Collaboration should be strengthened between health and education departments. Implementation and dissemination of prevention programs, school health education, and regular physical examination and routine epidemic monitoring should be encouraged.

Objective To investigate the characteristics and the enhanced patterns of carotid plaque using contrast-enhanced ultrasound (CEUS) and patients with cerebral infarction.Methods The patients with carotid plaque were divided into two groups according to whether they had cerebral infarction:54 patients (62 plaques with CEUS) with cerebral infarction were included in group A,and 48 patients (54 plaques with CEUS) without cerebral infarction were included in group B.The plaques were divided into four grades according to the degree of plaque enhancement.According to the source of intraplaque contrast agents,plaque enhancement patterns were divided into adventitia enhancement,lumen enhancement and mixed enhancement.To analyze the degree and pattern of carotid plaque enhancement in the two groups.Results Carotid plaque enhancement in cerebral infarction group was mainly grade 3 (26/62) and grade 4 (22/62),while that in non-cerebral infarction group was mainly grade 2 (20/54) and grade 3 (20/54).There was significant difference between the two groups in the proportion of carotid plaque enhancement of grade 2 (P =0.019) and grade 4 (P =0.041).The proportion of plaque adventitia enhancement model in group A(27/59) was lower than that in group B (37/50),with statistically significant difference (P =0.003).While the proportion of mixed enhancement mode in group A was significantly higher than that in group B (P =0.003).Conclusions The enhancement of carotid plaque was obvious in cerebral infarction patients,and the mixed enhancement pattern was more common.It suggested that the communication between vascular cavity and plaque might be an important factor leading to cerebral infarction.

Objective To study on the relationship between the serum level of highsensitivity c-reaction protein (hs-CR),matrix metalloproteinase 9 (MMT-9),tissue inhibitor of metalloproteinase 1 (TIMP-1) and carotid plaque stability in elderly people.Methods According to the carotid ultrasonography examination,120 old people were divided into vulnerable plaque group (group A,n =45),stable plaque group (group B,n =41) and no plaque group (group C,n =34),and serum levels of hs-CRP,MMP-9,TIMP-1 in each group were also detected.Results The serum levels of hs-CRP and MMP-9 of unstable plaque group and stable plaque group were higher than those of non-plaque group (P ＜ 0.05).hsCRP and MMP-9 were positively correlated with carotid plaque unstability,while TIMP-1 was negatively correlated with carotid plaque unstability,hs-CRP,MMP-9 and TIMP-1 were independent risk factors for carotid plaque stability.Conclusions Serum levels of hs-CRP,MMP-9 and TIMP-1 are closely related to the stability of carotid plaque.Elevated levels of hs-CRP and MMP-9 increase the risk of carotid plaque,and elevated levels of TIMP-1 decrease the risk of carotid plaque.

Objective To discuss the influence of gestational hypothyroxinemia to the pregnancy outcomes and fetus development,and find the evidence of hormone replacement therapy.Methods The clinical data of 1141 gravida admitted from Nov.2014 to Oct.2015 were retrospectively analyzed,including the data of systematic antenatal examination,all the data of pregnancy,the materials of delivery,the last ultrasound examination,production status and the thyroid stimulating hormone (TSH) of the newborn etc.,to find the difference of related index.Results Of the 1141 gravida with integral data,200 had past history of thyroid disease,189 showed below normal of free thyroxine (FT4) and 752 were normal ones.The 189 gravida with normal TSH but lower FT4 were divided into group A (0-5％ lower than the normal FT4 value,n=60),group B (5％-10％ lower than the normal FT4 value,n=40) and group C (10％ and above lower than the normal FT4 value,n=89).The ones with both normal TSH and FT4 value served as control group.Compared to the control group,the higher premature delivery rate,incidence of gestational diabetes mellitus and cesarean delivery rate (P＜0.05) were found in group C,and more gravida in group B had a history of hypertension and dyslipidemia during pregnancy (P＜0.05).The cesarean delivery rate of group B and C were higher than group A.Meanwhile,the rate of group B was higher than control group (P＞0.05).At delivery,the maternal weight,BMI,diastolic pressure,and head circumference of fetus in the last ultrasound examination were higher in group C than in control group (P＜0.01),but the gestational weeks of the newborn were shorter in group C (38.55 ± 1.86 weeks) than in control group (39.14 ± 1.57 weeks,P＜0.01).The 189 gravida with lower FT4 were divided into two groups according to the thyroid peroxidase antibody (TPOAb) level.The head circumference of fetus in the last ultrasound examination was higher in TPOAb(+) group than in TPOAb(-) group (45.99 ± 62.36cm vs.33.23 ± 2.08cm,P＜0.01).Conclusions The influence of gestational hypothyroxinemia to pregnancy outcomes and fetus development cannot be ignored,especially for the pregnant women with lower FT4 value (10％ and above lower than the normal) or with positive TPOAb.It is suggested to take the thyroid function test in the early stage of pregnancy for those pregnant women mentioned above.

Objective To systematically evaluate the risk factors for upper extremity lymphedema after breast cancer treatment and the strength of their associations.Methods PubMed,Ovid,EMbase,and the Cochrane Library were searched to identify clinical trials published up to December 2012.The quality of included studies was assessed by the Newcastle-Ottawa Scale;data analysis was performed by Stata 10.0 and RevMan 5.2;the strength of associations between risk factors and breast cancer-related upper extremity lymphedema was described as odds ratio (OR) and 95％ confidence intervals (CI).Results Twenty-two studies involving 10106 patients were included in the meta-analysis.The risk factors for upper extremity lymphedema after breast cancer treatment mainly included axillary lymph node dissection (OR =2.72,95％ CI=1.06-6.99,P=0.038),hypertension (OR=1.84,95％ CI=1.38-2.44,P=0.000),body mass index (OR =1.68,95％ CI=1.22-2.32,P =0.001),and radiotherapy (OR =1.65,95％ CI =1.20-2.25,P =0.002),while no significant associations were found for such factors as chemotherapy,age,number of positive lymph nodes,and number of dissected lymph nodes.Conclusions The incidence of upper extremity lymphedema is high among patients with breast cancer after treatment,and axillary lymph node dissection,hypertension,body mass index,and radiotherapy are the main risk factors for lymphedema after breast cancer treatment.

OBJECTIVETo investigate serum APPL1 level in patients with newly diagnosed type 2 diabetes mellitus (T2DM) and analyze its correlation with body mass index (BMI), waist-to-hip ratio (WHR), blood pressure, fasting plasma glucose, fasting blood insulin, HbA1c, and insulin resistance (HOMA-IR).

METHODSerum APPL1 levels were determined using ELISA in 22 normal control subjects and 63 patients with newly diagnosed T2DM, and HOMA-IR of the subjects was calculated using the HOMA model.

RESULTSThe diabetic patients had significantly elevated levels of serum APPL1 compared with the control subjects (85.71∓27.39 vs 64.52∓16.28 pg/ml, P<0.01), with also significantly increased BMI, WHR, SBP, FINS, LgHOMA-IR (P<0.01) and LDL-C (P<0.05) but lowered HDL-C (P<0.01). Fasting serum APPL1 levels were positively correlated with FPG, FINS, and HOMA-IR (r=0.215, 0.297, 0.334, P=0.014, 0.006, 0.002, respectively). In multiple linear regression analysis with APPL1 as the dependent variable, HOMA-IR (β=0.329, P=0.002) was included in the equation.

CONCLUSIONPatients with newly diagnosed T2DM have elevated serum APPL1 levels, suggesting the involvement of APPL1 in the development of T2DM.

Adaptor Proteins, Signal Transducing ; blood ; Adult ; Blood Glucose ; Case-Control Studies ; Diabetes Mellitus, Type 2 ; blood ; diagnosis ; Female ; Glucose Tolerance Test ; Humans ; Insulin Resistance ; Male ; Middle Aged

ObjectiveTo investigate the lipid metabolism in ketosis-prone type 2 diabetes mellitus (T2DM) patients classified by Aβ classification scheme.Methods Two hundred and seventy-seven ketosis-prone T2DM patients were classified according to the A β classification scheme which was based on the presence or absence of pancreatic islet β-cell autoantibody and fasting C peptide:A-β- group (78 cases ),A+ β -group (41 cases ),A- β + group ( 113 cases ) and A+ β + group (45 cases).The levels of blood lipid were determined and compared in the four groups.ResultsIn A- β -,A+ β -,A- β + and A+ β +groups,the levels of triglyeride (TG) were separately (1.72 ± 1.07),(1.86 ± 1.04),(2.21 ± 1.66) and (2.60 ± 1.87 )mmol/L,the levels of very low density lipoprotein-cholesterol(VLDL-C) were separately (0.57 ±0.45),(0.61 ±0.48),(0.79 ±0.63) and(0.81 ±0.62) mmol/L,and there were significant differences in TG and VLDL-C among the four groups(P =0.004 and 0.010).There were significant differences in TG and VLDL-C between β + group ( 158 cases) and β - group ( 119 cases) [ (2.32 ± 1.72) mmol/L vs.(1.77 ± 1.06)mmol/L,(0.80 ±0.63) mmol/L vs.(0.58 ±0.46) mmol/L,P =0.001 and 0.001 ].Conclusions Ketosis-prone T2DM patients with different situations of pancreatic islet β-cell autoimmunity and function are different in lipid metabolism,so it is very lmportant to evaluate the blood lipid and perform related lipid-lowering therapy in order to reduce the occurrence of diabetic complication.

Objective To investigate factors and neonatal outcomes associated with histologic chorioamnionitis (HCA) in preterm premature rupture of membranes (PPROM).MethodsFrom Jan.2008 to Jun.2011,230 women with PPROM at 28 -33 +6 weeks of gestation undergoing deliveries in the Second Affiliated Hospital of Wenzhou Medical College were studied retrospectively.According to placental histopathologic findings,those patients were categorized into two groups,including 138 cases in histologic chorioamnionitis (HCA group ) and 65 cases in non-chorioamnionitis (control)group.Age,parity,gestational age of PPROM and delivery,latency period,oligohydramnios,white blood cell (WBC) count and serum C-reactive protein (CRP) level at admission and before delivery,the incidence of neonatal respiratory distress syndrome (NRDS),neonatal pneumonia,bronchopulmonary dysplasia,necrotizing enterocolitis,early-onset neonatal sepsis,abnormal brain sonography findings and mortality were compared between two groups.Results( 1 ) The incidence of HCA was 68.0.％ ( 138/203 ) in all 203 cases with PPROM.(2) The occurring ruptured membrane gestation in HCA group was ( 31.1 ± 1.5 ) weeks,which were significantly earlier than (32.0 ± 1.3 ) weeks in control group ( P ＜ 0.05 ).The level of CRP of (8.2 ± 14.9) mg/L before delivery in HCA group was significantly higher than (5.5 ±7.2) mg/L in control group (P ＜ 0.05).The rate of oligohydramnios and cesearean sections were 55.1％ (76/138) and 45.7％ (63/138) in HCA group,which were significantly higher than 30.8％ (20/65) and 29.2％ (19/65) in control group (P ＜0.05).There were no significant difference in patient's age,parity,WBC count and CRP at admission between two groups (P ＞ 0.05 ).The latency period did not show significant difference between (140± 116) hours in HCA group and (129 ± 125) hours in control group (P ＞ 0.05).(3) Using multivariable logistic regression models,oligohydramnios ( OR =2.937 ),gestational age of PPROM ＜ 32 weeks ( OR =2.352),serum CRP level ＞ 8 mg/L before delivery ( OR =4.923 ) and latency period ＞ 48 -168 hours (OR =4.439) were significantly associated with HCA (P ＜0.05).(4) The gestational age of delivery and birth weight of HCA group were significantly lower than those of control group [ ( 32.0 ± 1.5 ) weeks vs.( 32.7 ± 1.5 ) weeks,( 1680 ± 379) g vs.(2017 ± 333) g,respectively,P ＜ 0.05 ].The incidence of Apgar ＜7,abnormal brain sonograhy findings, neonatal pneumonia,bronchopulmonary dysplasia,early-onset neonatal sepsis and mortality in HCA group were significantly higher than those in control group [20.3％ (28/138) vs.7.7％ (5/65),14.5％ (20/138) vs.4.6％ (3/65),12.3％ (17/138) vs.3.1％(2/65),5.8％ (8/138) vs.0,6.5％ (9/138) vs.0,12.3％ (17/138) vs.3.1％ (2/65),respectively,P ＜ 0.05 ].The incidence of necrotizing enterocolitis ( 1.5％,2/138 ) in HCA group was higher than that of controlgroup(0) and the incidence of NRDS ( 18.8％,26/138) in HCA group did not show statistical difference with 21.4％ ( 14/65 ) in control group ( P ＞ 0.05 ).ConclusionsIt was found that HCA was significantly correlated with lower gestational age of PPROM,higher serum CRP level before delivery,prolonged latency period and oligohydramnios in PPROM.HCA could increase the neonatal morbidity and mortality.