Adrenal hemangioma is a rare neoplasm.The clinical data of a case of adrenal cavernous hemangioma and review of related literatures are herewith presented.Adrenal cavernous hemangioma is often nonfunctioning and benign.CT and MRI show the features of hemangioma.The treatment depends on the size of the mass,and the diagnosis is based on pathology.

To summarize the clinical data of two cases with severe hyponatremia diagnosed as adrenal insuffiency combined with syndrome of inappropriate secret on of antidiuretic hormone(SIADH),and to review related literatures.Case 1 diagnosed as Addison's disease for 27 years and developed severe hyponatremia again but did not response well to sufficient glucocorticoid.Further examination showed SIADH caused by lung cancer and tolvaptan worked well.Case 2 was diagnosed as SIADH caused by lung cancer and responsed well to tolvaptan.However,hyponatremia reoccurred with the decreasing level of ACTH and cortisol during the chemotherapy.It was thought that hyponatremia was caused by drug-related adrenal insuffiency and glucocorticoid replacement therapy achieved good response.Both primary/secondary adrenal insuffiency and SIADH can lead to severe hyponatremia,but it is rare that the two situations exist in one patient and occur in different time.We should consider the possibility of the situations when we make differential diagnosis of refractory hyponatremia,monitoring the curative effects carefully,then correct the diagnosis timely,and reduce missed diagnosis and misdiagnosis.

Objective To analyze the clinical risk factors of hemorrhagic transformation (HT) of cardiogenic cerebral embolism and the influence of HT on outcome. Methods The clinical data of 115 inpatients were reviewed from May, 2012 to December, 2015. They were di-vided into HT group (n=58) and non-HT group (n=57). The age, anticoagulant therapy, thrombolytic therapy, infarction diameter, diabetes, coronary heart disease, hyperlipidemia, the National Institutes of Health Stroke Scale (NIHSS) score and HAS-BLED score were compared. The risk factors for HT was screened with the multivariate Logistic regression. NIHSS score and Modified Rankin Scale (mRS) score as hos-pitalization, and one month and three months after stroke were compared. Results There were significant difference in NIHSS score (t=-2.991, P=0.003) and HAS-BLED score (t=-2.499, P=0.014), as well as infarction diameter (χ2=8.355, P=0.004) between HT group and non-HT group. NIHSS score (OR=1.127, P=0.027), HAS-BLED score (OR=1.783, P=0.03) and infarction diameter (OR=4.390, P=0.035) were the risk factors for HT. The incidence of HT was less in low-risk group (HAS-BLED score=0-2) than in high-risk group (HAS-BLED score≥3) (χ2=4.643, P=0.031). The NIHSS score as hospitalization, and one month and three months after stroke were all more in HT group than in non-HT group (t>2.387, P<0.05). The mRS score was more in HT group as hospitalization (t=-2.262, P=0.026), but not significant one and three months later (t<1.468, P>0.05). Conclusion HT tends to happen in the patients of cerebral embolism patients after atrial fibril-lation with severe neural function defect, large infarction diameter and high HAS-BLED score. The neural function is poor in those with HT.

Objective: To investigate the prevalence of depression and anxiety and its relationship with bullying and violent behaviors among middle school students in Beijing, so as to provide a scientific basis for promoting the mental health of middle school students. Methods: A total of 18 379 junior high school, general high school, and vocational high school students from 16 districts of Beijing were selected by stratified cluster random sampling from September to November, 2023. The χ2 test was used to analyze the depression or anxiety symptom and injuryrelated behaviors such as bullying among middle school students. Logistics regression was used to analyze the correlation between depression or anxiety symptom and injury correlation behaviors among middle school students. Results: The detection rates of depression symptoms and anxiety symptoms were 18.2% and 8.6% among middle school students in Beijing, and the comorbidity was 7.6%. The reporting rate of school bullying was 3.3%. The results of Logistic regression showed that girls (OR=1.23), high school students (OR=1.85) and vocational high school students (OR=1.91), school bullying (OR=3.83), being scolded and beaten by parents (OR=3.32) and being exposed to cyber violence (OR=4.43) were positive factors related to depression symptoms; and nonresidential students (OR=0.87) was a negative factor related to depression symptoms (P<0.05).Girls (OR=1.32), high school students (OR=1.77) and vocational high school students (OR=1.50), school bullying(OR=3.63), being scolded and beaten by parents (OR=3.41) and being exposed to cyber violence (OR=3.33) were positive factore related to anxiety symptoms (P<0.05). Conclusions The depression and anxiety symptoms among middle school students in Beijing are closely related to the behaviors of school bullying and experiencing violence from parents or the Internet. Various measures should be taken to reduce the situation of school bullying, being scolded and beaten by parents and cyber violence among middle school students to promote their mental health.

Stigma is common in patients with head and neck cancer, which greatly affects their physical and mental health and the quality of life. This article summarizes the research progress of stigma in patients with head and neck cancer from the aspects of research status, measurement tools, influencing factors and intervention strategies, in order to provide a reference for carrying out the research on stigma in patients with head and neck cancer in China.

Objective: To analyze high myopia and dioptre changes in middle school students in Beijing from 2019 to 2022, so as to provide a basis for formulating preventive and control measures. Methods: Using stratified cluster random sampling, 16 districts of Beijing were divided into four groups, each of which was respectively composed of 83, 83, 84, and 84 middle schools, in order to examine non cycloplegic auto refraction among the senior grades 1 to 3 students from September to October in each year (from 2019 to 2022). Finally, the dataset results of each of the four groups (21 589, 21 161, 21 561, 21 123) were compared by the Chi square test and trend Chi square test. Trend changes were evaluated by annual percentage change (APC). Results: The rates of high myopia were higher in female students than in males from 2019 to 2022 (15.60%,14.59%; 15.33%, 14.44%; 14.65 %, 14.17%; 14.63%,13.84%), and the difference in 2019 was statistically significant ( χ 2=4.93, P <0.05). The rates of high myopia in middle school students in urban areas were significantly higher than those in rural areas(16.45%, 13.78%; 16.81 %, 13.00%; 15.84%, 13.06%; 15.85%, 12.72%), and the differences were statistically significant ( χ 2=30.18, 60.43, 33.92 , 42.23, P <0.05). With the increase of grade, the rates of high myopia increased ( χ 2 trend =674.56, 608.38, 655.21, 676.89, P <0.05), with junior grade 3 students being the most robust. The rate of high myopia in middle school students from 2019 to 2022 decreased from 15.09 to 14.22%, with an average annual rate of 2.08% ( APC=-2.08, t=-7.99, P ＜0.05). The refractive error of high myopia middle school students in 2019 and 2022 were -7.44(-10.25, -6.00) and -7.38(-10.00, -6.00)D, respectively, with no statistically significant difference ( H=4.30, P >0.05). Conclusions The rate of high myopia in middle school students in Beijing shows a decreasing trend, but it remains at a high level. It is necessary to classify the prevention and control strategy, and standardize the measures in order to manage early onset, high incidence rates, and severe myopia.

Objective: To analyze the current status and related factors of comorbidity of myopia, obesity, and depression symptoms among middle school students in Beijing, so as to provide a basis for comprehensive public health interventions for common diseases. Methods: Through stratified cluster random sampling in October 2022, a total of 11 262 junior high school, senior high school, and vocational high school students in 16 districts of Beijing were surveyed with self administered questionnaires, physical examinations and visual acuity examinations. The χ 2 test and binary Logistic regression model were used to analyze group differences in the comorbidity of myopia, obesity and depression symptoms and factors influencing the comorbidity. Stratified analysis was applied to analyze the associations between health risk behaviors and the comorbidity. Results: The detection rate of comorbidity of myopia, obesity, and depression symptoms among middle school students in Beijing was 3.35%, the comorbidity rate among vocational high school students (4.61%) was higher than that in junior high school students (2.80%) and senior high school students (3.41%). The comorbidity rate was higher among students in suburban areas (3.66%) than that in urban areas (2.92%), and the differences was statistically significant ( χ 2=15.02, 4.63, P <0.05). Binary Logistic regression analyses indicated that middle school students with poor dietary behaviors ( OR =1.59) and excessive screen time ( OR =1.70) were associated with elevated risk of comorbidity of myopia, obesity, and depression symptoms. Both boys and girls with poor dietary behaviors ( OR =1.63, 1.69) and excessive screen time ( OR =1.45, 2.23) had elevated likelihood of comorbidity of myopia, obesity and depression symptoms. Students in junior high school and senior high school with poor dietary behaviors ( OR =2.16, 1.47) and excessive screen time ( OR =2.20, 1.63 ) had elevated likelihood of comorbidity of myopia, obesity, and depression symptoms ( P <0.05). Conclusions The current status of comorbidity of myopia, obesity, and depression symptoms among middle school students in Beijing is concerning. Schools and parents should work together to guide students to develop healthy behaviors such as balanced diet and moderate video, in order to achieve the goal of controlling myopia, obesity and depression symptoms.

Objective: To investigate the comorbidity of screening myopia and scoliosis among primary and secondary school students in Beijing from 2019 to 2022 and its influencing factors, in order to provide new ideas for comprehensive prevention and control of myopia and scoliosis in children and adolescents. Methods: From 2019 to 2022, 34 923, 34 321, 36 008 and 35 598 primary and secondary school students in Beijing were selected by stratified cluster random sampling method, and visual acuity examination, scoliosis examination and questionnaire survey were conducted on them. Chisquare test was used to analyze the intergroup differences between screening myopia and scoliosis among primary and secondary school students, and the correlation factors between screening myopia and scoliosis were analyzed by multivariate Logistic regression. Results: From 2019 to 2022, the prevalence of screening myopia increased by year,while scoliosis decreased by year, and the comorbidity rate in 2022 (0.69%) decreased by 1.62% compared with 2019 (2.31%). In 2022, screening myopia with scoliosis rates (0.98%) than urban suburbs (0.50%), high school students (1.65%) >professional high school students (1.21%) >junior middle school students (0.76%) >primary school students (0.22%) (χ2=28.97, 153.55, P<0.01). The results of multivariate Logistic analysis found that insufficient sleep time and parents did not limit the use of electronic screen time were the risk factors for screening myopia and scoliosis [OR(95%CI)=1.59(1.20-2.12), 1.34(1.02-1.76), P<0.05]. Teachers often or always remind that reading and writing posture and one hour or more of moderateintensity physical activity every day were protective factors for screening myopia and scoliosis [OR(95%CI)=0.70(0.52-0.96), 0.56(0.34-0.92), P<0.05]. Conclusions The comorbidity of acadmic screening myopia and scdiosis is not optimistic in Beijing. Attention should be paid to the reading and writing posture and related behavioral habits of children and adolescents, and ensure that children in each school section have sufficient sleep time, so as to prevent the occurrence and development of screening myopia and scoliosis.

Objective: To evaluate the radiological tumor response patterns and compare the response assessments based on immunebased therapeutics Response Evaluation Criteria in Solid Tumors (iRECIST) and RECIST 1.1 in metastatic clear-cell renal cell carcinoma (mccRCC) patients treated with programmed cell death-1 (PD-1) inhibitors. Materials and Methods: All mccRCC patients treated with PD-1 inhibitors at Henan Cancer Hospital, China, between January 2018 and April 2019, were retrospectively studied. A total of 30 mccRCC patients (20 males and 10 females; mean age, 55.6 years; age range, 37–79 years) were analyzed. The target lesions were quantified on consecutive CT scans during therapy using iRECIST and RECIST 1.1. The tumor growth rate was calculated before and after therapy initiation. The response patterns were analyzed, and the differences in tumor response assessments of the two criteria were compared. The intra- and inter-observer variabilities of iRECIST and RECIST 1.1 were also analyzed. Results: The objective response rate throughout therapy was 50% (95% confidence interval [CI]: 32.1–67.9) based on iRECIST and 30% (95% CI: 13.6–46.4) based on RECIST 1.1. The time-to-progression (TTP) based on iRECIST was longer than that based on RECIST 1.1 (median TTP: not reached vs. 170 days, p = 0.04). iRECIST and RECIST 1.1 were discordant in 8 cases, which were evaluated as immune-unconfirmed PD based on iRECIST and PD based on RECIST 1.1. Six patients (20%, 6/30) had pseudoprogression based on iRECIST, of which four demonstrated early pseudoprogression and two had delayed pseudoprogression.Significant differences in the tumor response assessments based on the two criteria were observed (p < 0.001). No patients demonstrated hyperprogression during the study period. Conclusion Our study confirmed that the iRECIST criteria are more capable of capturing immune-related atypical responses during immunotherapy, whereas conventional RECIST 1.1 may underestimate the benefit of PD-1 inhibitors. Pseudoprogression is not rare in mccRCC patients during PD-1 inhibitor therapy, and it may last for more than the recommended maximum of 8 weeks, indicating a limitation of the current strategy for immune response monitoring.

Objective To analyze the correlation between vitamin D levels and vascular endothelial function and plasma renin activity (PRA) in hypertensive patients.Methods 415 patients with essential hypertension admitted to our hospital from January 1 to December 2017 were selected as the experimental group.142 healthy subjects who received physical examination and met the included indicators were selected as the control group.The blood biochemical indexes and the 25 (OH) D contents in the blood of two groups were detected and analyzed.The experimental group was divided into vitamin D mild deficiency group (15-30 mmol/L),severe deficiency group [25 (OH) D ＜ 15 mmol/L] and normal group [25 (OH)D ＞ 30 mmol/L] according to vitamin D content.The endothelial function (RHI value) and renin were compared in the three groups,and multiple linear regression analysis was performed on endothelial function and orthotopic renin activity and related factors.Results The diastolic blood pressure,vitamin D content and blood lipid biochemical indexes of the experimental group and the control group were significantly different (P ＞ 0.05).The higher the vitamin D content,the lower the plasma renin activity PRA;the RHI value of the vitamin D severe deficiency group was lower than the vitamin D normal group [(1.4 ±0.15)mmol/L vs (1.6 ± 0.20) mmol/L] (P ＜ 0.05).Vitamin D was negatively correlated with 24 hours systolic blood pressure (24 h SSD),the standard deviation of 24 hours diastolic blood pressure (24 h DSD),the Standard deviation of daytime systolic blood pressure (dSSD),the Standard deviation of daytime diastolic blood pressure (dDSD),the Standard deviation of nighttime systolic blood pressure (nSSD),the Standard deviation of nighttime diastolic blood pressure (nDSD) (P ＜ 0.05),and positively correlated with the decrease of night systolic blood pressure and night diastolic blood pressure.Vitamin D and total cholesterol were independent influencing factors of endothelial function (P ＜ 0.01).Vitamin D and 24 h mean heart rate were independent influencing factors of orthostatic renin activity (P ＜ 0.01).Conclusions The low vitamin D content in patients with essential hypertension affects endothelial function and plasma renin activity,which should be paid more attention in clinical practice.