Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is the main pathogen that causes COVID-19,which is fast-mutating and highly transmissible.The infection has led to a global epidemic.As the main preventive and control measure,vaccination plays a critical role in fighting a-gainst COVID-19.Although a large number of epitope-based and mucosal vaccines have been stud-ied,few peptide epitope vaccines targeting the mucosa and their functional evaluation have been re-ported.In this study,we used SARS-CoV-2 structural protein M peptide epitope predicted by the IEDB database as an antigenic target to design the MS-3S gene containing 3 050 and 1 229 signal peptides and DCpep optimized for insertion into MS2 phage coat proteins.The expression plasmid pSIP:MS-3S was constructed by cloning the PCR fragments seamlessly and was transformed into Lactiplantibacillus plantarum 18 to obtain the recombinant bacterium LP18:MS-3S.Expression conditions such as induction time,inducer concentration,rotational speed and initial pH were opti-mized.The intranasal immunization experiments were performed to examine the vaccine efficacy.The results showed that the 916 bp-long target gene MS-3S modified and optimized was amplified and used to successfully construct the recombinant bacterial strain LP18:MS-3S.The optimal con-ditions for recombinant protein expression were obtained and verified by Western blot,flow cy-tometry,immunofluorescence and other detection methods.The optimal expression conditions were determined as follows:induction time was 4 h with 100 pg/L of SppIP as the optimal induction concentration.Antibody-specific for the epitope was verified by ELISA experiments in serum,alve-olar lavage fluid and fecal dilutions of mice.In summary,a recombinant bacterial strain expressing the epitope antigen of the SARS-CoV-2 M protein peptide was constructed.The obtained protein can induce the body to produce humoral and mucosal immunity,which lays the foundation for the development of a vaccine candidate for the mucosal immunity of COVID-19.

Liposarcoma is a common soft tissue malignant tumor with multiple histological types,among which well-differenti-ated liposarcoma and dedifferentiated liposarcoma are the largest subgroups of liposarcoma.After conventional treatment,the 5-year survival rate of patients with dedifferentiated liposarcoma has not been significantly improved.In recent years,immunotherapy has shown significant efficacy in tumors such as melanoma and lung cancer,and has been widely studied in well-differentiated liposarcoma and dedifferentiated liposarcoma.This article summarizes the clinical and genetic features of well-differentiated liposarcoma and dedi-fferentiated liposarcoma,conventional treatment methods,and the application of immunotherapy in liposarcoma,including immune checkpoint inhibitors,adoptive cell therapy,oncolytic viruses,cancer vaccines,and immunotherapy combined with other treatment op-tions.Integrating immune-related treatment options for liposarcoma is an urgent problem to be solved,and it also provides broad ideas for clinical work to understand liposarcoma and new management and treatment strategies.

Objective:To explore the clinical effects of parallel combined flow-through perforator flaps in the treatment of circular hot crush injuries in limbs with blood supply disorder.Methods:The study was a retrospective observational study. From April 2016 to December 2022, 4 cases with circular hot crush injuries in limbs with blood supply disorder were admitted to the Department of Burns and Plastic Surgery of the 988 th Hospital of Joint Logistics Support Force of PLA, including 3 males and 1 female, aged from 24 to 48 years. Among them, 2 cases were injured in the calf and 2 cases were injured in the forearm. After emergency debridement, the area of skin and soft tissue defects was from 20 cm×20 cm to 44 cm×20 cm. The patients had defects in tibialis anterior and posterior tibial arteries with a length of 13 to 18 cm, and in ulnar and radial arteries with a length of 9 to 12 cm. Flaps were designed and cut, including a flow-through anterolateral thigh perforator flap with area of 20 cm×9 cm to 24 cm×21 cm carrying the descending branch of the lateral circumflex femoral artery and the accompanying veins of 8 to 18 cm in length; and a flow-through posterior tibial artery perforator flap with area of 21 cm×13 cm and 20 cm×14 cm carrying the posterior tibial artery, the accompanying veins with a length of 14 and 17 cm respectively, and the great saphenous vein with a length of 22 and 21 cm. The circular hot crush injury wounds in the calf with blood supply disorder were repaired by a parallel combination of flow-through posterior tibial artery perforator flap and flow-through anterolateral thigh perforator flap, and the circular hot crush injury wounds in the forearm with blood supply disorder were repaired by a parallel combination of bilateral flow-through anterolateral thigh perforator flap, and the injured main vessels were reconstructed. The donor site wounds of flap were closed directly or treated with split-thickness skin grafts from abdomen. After surgery, the blood supply and survival of the flap and distal affected limb, the healing of wounds in the donor and recipient sites, the survival of the skin graft in the flap donor site were observed. During follow-up, the condition of flaps, the appearance, blood supply, and function of affected limbs were observed. At the last follow-up, the foot and ankle functions were evaluated according to the scoring standards of American Orthopedic Foot and Ankle Association, and the wrist and hand function was evaluated according to the trial standard of replantation of amputated upper limb function assessment of the Hand Surgery of Chinese Medical Association. Results:The flaps and distal affected limbs of 4 patients had good blood circulation and successfully survived after surgery. The wounds of 3 cases successfully healed, while one patient with circular hot crush injury in the forearm experienced exudation in the recipient site in the later stage, and the wound healed after re-expansion and suturing. The donor site wounds healed smoothly, and the skin grafts successfully survived. During follow-up of 12 to 24 months after surgery, the flaps were slightly swollen, the limbs had good appearance, normal blood circulation, and fine functional recovery. At the last follow-up, the foot and ankle function of 2 patients with circular hot crush injuries in the calf was evaluated as good in 1 case and commonly in 1 case; the wrist and hand function of 2 patients with circular hot crush injuries in the forearm was evaluated as excellent in 1 case and good in 1 case.Conclusions:The parallel combined flow-through perforator flap can reconstruct the damaged main blood vessels and repair the wound at the same time. It can not only effectively save the limb, but also restore part of the function of the affected limb. It is one of the effective methods to treat the circular hot crush injuries in limbs with blood supply disorder.

Purpose To investigate the expression status of GNL3 in gastric cancer,and to explore the role of GNL3 in tumor proliferation,invasion and migration.Methods The ex-pression of GNL3 mRNA in gastric cancer tissues was analyzed by searching database.The expression of GNL3 protein in 51 gastric cancer tissues and 51 adjacent non-tumor tissues was de-tected by immunohistochemistry(IHC)SP method.The correla-tion between GNL3 protein expression and gastric cancer clinical pathological features was analyzed by x2 test.The expression of GNL3 in gastric cancer cells was silenced by transfection of sh-RNA,and the silencing efficiency was verified by Western blot.The effect of silencing GNL3 on the proliferation of gastric cancer cells was examined by CCK-8,colony formation and EdU stai-ning.In addition,wound-healing assay and Transwell assay were performed to detect the effect of GNL3 silencing on cell invasion and migration.Results SangerBox and UALCAN database re-trieval showed that the expression of GNL3 mRNA was signifi-cantly increased in gastric cancer tissues(P＜0.01).IHC stai-ning showed that the positive expression rate of GNL3 protein in gastric cancer tissues was 96.1％,and the high expression rate was 78.4％,which was significantly higher than that in adjacent non-tumor tissues(74.5％,51.0％,P＜0.01).Moreover,the high expression of GNL3 was significantly correlated with lymph node metastasis in gastric cancer patients(x2=4.933,P=0.026).CCK-8,colony formation and EdU staining showed that GNL3 silencing inhibited the proliferation of gastric cancer cell SGC-7901.The wound-healing and Transwell assay showed that GNL3 silencing inhibited the migration and invasion of gastric cancer cell.Conclusion The GNL3 protein is highly expressed in gastric cancer tissues,and closely related to the proliferation,migration and invasion of gastric cancer cells.

Objective:To observe the application of the controlled respiratory persistence monitor designed based on the principle of rhythmic temperature variations in artificial airways among different populations and in various artificial airways,and to discuss the feasibility and efficacy of monitoring controlled respiration persistence,and to provide a new method for the clinical respiratory monitoring.Methods:A total of 60 adult patients scheduled for general anesthesia,and 30 pediatric patients aged from 1 to 3 years old,classified as American Society of Anesthesiologists(ASA)Ⅰ-Ⅱ,were selected.A total of 60 adult patients were randomly divided into adult tracheal intubation(ATI)group and adult laryngeal mask(ALM)group,and there were 30 cases in each group.Additionally,30 pediatric patients aged from 1 to 3 years old were regarded as pediatric tracheal intubation(CTI)group.After induction of general anesthesia,the patients in CTI and ATI groups were underwent tracheal intubation,while the patients in ALM group were given a laryngeal mask inserted and were connected to the anesthesia machine for mechanical ventilation.Whether or not the device could detect the respiratory rate(RR)of the patients in various groups was observed;the RR detected by the device and the frequency set on the anesthesia machine in various groups were compared.All the patients in three groups were simulated three common clinical scenarios of continuous respiration changes before surgery:disconnection of the breathing circuit,failure to switch from manual to mechanical control on the anesthesia machine,and slow air leakage in the breathing circuit.The ways to report the alert and start time of the atarm by the monitors were compared.Results:The controlled respiratory persistence monitor was able to detect the RR of the patients in three groups,and there was no significantly difference between the RR detected by the device and the frequency set on the anesthesia machine(P＞0.05).In the simulated scenarios of common respiratory persistence changes,all the patients in three groups received an artificial voice alarm signaling"Attention,breathing has stopped.",which was acknowledged.There was no significant difference in the start time of alarm of the controlled respiratory persistence monitor between ATI group and ALM group(P＞0.05).Compared with the start time of alarm of the patients in the same group across different scenarios,compared with slow air leakage in the breathing circuit,the start time to alarm for circuit disconnection and failure to switch from manual to mechanical control was shorter(P＜0.05).Conclusion:The clinical application of the controlled respiratory persistence monitor device designed based on the principle of detecting rhythmic temperature variations within artificial airways is feasible and effective in different populations and artificial airways.This device offers a new method for monitoring the respiratory continuity and ensuring the respiratory safety during surgery.

Objective : To study the effect of deep learning applied to the assisted diagnosis of radiolucent lesions and radiopaque lesions of the jaws in panoramic radiography and to reduce the missed diagnosis, with early screening to assist doctors to improve the diagnostic accuracy. Methods: This study was approved by the Ethics Committee of the West China Stomatological Hospital of Sichuan University. The YOLO v8m-p2 neural network model was constructed with 443 panoramic images as a subject to read. The labeled images were divided into 354 training sets, 45 verification sets, and 44 test sets, which were used for model training, verification, and testing. Accuracy, recall, F-1 score, G score, and mAP50 were used to evaluate the detection performance of the model. Results: 443 panoramic images covered the common benign lesions of the jaw, the number of radiolucent lesions of the jaw was 318, containing dentigerous cyst, odontogenic keratocyst, and ameloblastoma. The number of radiopaque lesions was 145, containing idiopathic osteosclerosis, odontoma, cementoma, and cemento-osseous dysplasia; the samples are well representative. The accuracy of the YOLO v8m-p2 neural network model in identifying jaw lesions was 0.887, and the recall, F-1 score, G score, and mAP50 were 0.860, 0.873, 0.873, and 0.863, respectively. The recall rates of dentigerous cyst, odontogenic keratocyst, and ameloblastoma were 0.833, 0.941, and 0.875, respectively. Conclusion YOLO v8m-p2 neural network model has good diagnostic performance in preliminary detection of radiolucent and radiopaque lesions of the jaws in panoramic radiography and multi-classification monitoring of radiolucent lesions of jaws, which can assist doctors to screen jaw diseases in panoramic radiography.

Objective: To explore the mediating effect of depressive symptom on the relationship between peer bullying patterns and suicidal ideation, and to provide suggestions for school bullying and suicide prevention for adolescents. Methods: A follow up cohort was established in a junior middle school in Suixi County, Anhui Province in September 2019 (T1). The first follow up was conducted in September 2020 (T2). A total of 1 687 junior high school students participated in this study. Self designed peer bullying questionnaire,center for Epidemiological Studies Depression Scale for children,and questions regarding suicide related behaviors were administered. Results: Prevalence of suicidal ideation, victimization and bullying were 28.3%, 27.0% and 24.4%, respectively. The latent class analysis(LCA) identified three heterogeneous peer bullying classes: low aggressive victims(71.4%), high aggressive victims(3.3%), high verbal and relational aggressive victims( 25.3 %). The low aggressive victims class was used as the reference group, T1 depressive symptom mediated the association between high aggressive victims(mediating effect=0.43, P < 0.05 ), high verbal and relational aggressive victims class (mediating effect= 0.29 , P <0.05) and T2 suicidal ideation. Conclusion Depressive symptom plays a mediating role in the relationship between peer bullying and suicidal ideation. In order to prevent peer bullying and suicide related psychological behaviors of adolescents, educators should pay attention to adolescents mental health when formulating corresponding measures.

Objective: To explore the association between acute stress response during the outbreak of COVID 19 and peer bullying behaviors during the normalized management of COVID 19 among middle school students, and to provide a basis for developing relevant measures for peer bullying prevention. Methods: In December 2020, a total of 2 219 students from two junior middle schools in South Anhui(Xuancheng City) and North Anhui(Huaibei City), were selected to participate in this study by using the cluster sampling method. The occurrence of verbal bullying, relational bullying, physical bullying and cyberbullying behaviors among victims and perpetrators of bullying, and self rated acute stress response during the outbreak of COVID 19 (social isolation) were investigated. Multiple Logistic regression models were conducted to explore the relationship between different levels of acute stress response during the COVID 19 outbreak and peer bullying behaviors among middle school students. Results: The reported rate of peer bullying, being bullied by others and bullying others during the COVID19 normalized management were 65.8%, 63.8% and 27.1%, respectively. The reporting rate of verbal bullying victimization was the highest (54.8%) and cyberbullying others was the lowest (4.6%). The mean score of acute stress response among middle school students during the COVID 19 outbreak was (6.50±1.67). Except for physically bullying others, the reported rate of other bullying behaviors was the highest in the high level acute stress response group ( P <0.05). Multiple Logistic regression models showed that high levels of acute stress response were associated with high risk of verbal bullying victimization ( OR =1.38), relational bullying victimization ( OR =2.28), physical bullying victimization ( OR =1.87) and cyberbullying victimization ( OR =2.30) after adjusting for related confounders. In the high level acute stress response group, verbal bullying ( OR =1.80), relational bullying ( OR =1.99), physical bullying ( OR =1.76) and cyberbullying ( OR =2.32) had higher risks of bullying others than in the low level acute stress response group ( P <0.05). Conclusion High levels of acute stress response are associated with different peer bullying behaviors, with stronger associations with cyberbullying.

Objective: To explore the relationship between different types of bullying behavior and depressive symptoms among adolescents, and to provide scientific basis for further prevention of peer bullying. Methods: Based on the follow up data of 1 687 adolescents from Huaibei City, Anhui Province in September 2019 (T1) and September 2020 (T2), the autoregressive cross lagged analysis was employed to explore the relationship between different types of peer bullying and depressive symptoms. Results: The scores of bullying behaviors (physical bullying, verbal bullying, relational bullying and cyber bullying) and depressive symptoms at T2 were lower than those at T1,and the differences were statistically significant ( t =13.60, 8.61,7.24,3.76,8.29, P <0.01). There was a positive correlation between bullying behavior and depressive symptoms ( P <0.01). The results from cross lagged regression analysis showed that physical, verbal, relational and cyber bullying at T1 could positively predict depressive symptoms at T2 ( β = 0.06 , 0.04, 0.12, 0.05), and physical, verbal, relational and cyber bullying at T1 could positively predict depressive symptoms at T2 ( β =0.07, 0.10, 0.13, 0.10) ( P <0.05). Conclusion There were bidirectional associations between adolescent peer bullying and depressive symptoms.

Abstract Adolescent cyberbullying refers to adolescents who are subjected to offensive and violent behavior in social network environments through electronic technologies. Due to the anonymity of the Internet and the rapidity of transmission, cyberbullying has a serious and far reaching impact on the physical and mental health of teenagers. With the development of information technology, various forms of cyberbullying have emerged, and the formation mechanism and influencing factors of cyberbullying are diverse and complex. This article systematically reviews the research progress in cyberbullying by evaluating the epidemic characteristics, influencing factors, and related theoretical models that are relevant to adolescents, so as to provide a referential framework to build a public health system that can prevent cyberbullying in families, schools, and society.