Objective: To understand the occurrence and predictive factors of depressive symptoms among multi ethnic middle school students in Yunnan Province, so as to provide a referential framework for schools to carry out targeted mental health education. Methods: From October to December 2022, 8 500 first grade students from 23 middle schools were selected from 11 minority areas in Yunnan Province by cluster random sampling method. Demographic information and data relating to the students lifestyles were collected by questionnaire, and the Children s Depression Inventory (CDI) was used to evaluate depressive symptoms. Chi square test was performed to compare differences in the detection rate of depressive symptoms among first grade middle school students for univariate analysis. A decision tree model of depressive symptoms in middle school students was established by using the Chi squared automatic interaction detector (CHAID). Results: The detection rate of depressive symptoms among first grade students from multi ethnic middle schools in Yunnan Province was 28.26%. The decision tree model of depressive symptoms was academic stress ( χ 2=469.08) at the first level, breakfast behaviors (low/moderate academic stress: χ 2=155.49; severe academic stress: χ 2=105.24) at the second level, and the number of close friends (low/moderate academic stress and consuming breakfast 0- 2 days weekly: χ 2=23.15; low/moderate academic stress and consuming breakfast 3-4 days weekly: χ 2=14.99; severe academic stress and consuming breakfast 0-2 days weekly: χ 2=29.26; severe academic stress and consuming breakfast 3-4 days weekly: χ 2=20.15), ethnicity ( χ 2=78.22) and drinking ( χ 2=50.36) at the third level ( P <0.01). Conclusions The study identifies academic stress, breakfast behaviors, number of close friends, drinking and ethnicity as predictive factors of depressive symptoms among multi ethnic middle school students in Yunnan Province. Schools should develop targeted strategies for preventing and managing depressive symptoms in middle school students, so as to reduce their occurrence.

Objective:To assess the effects of heart valve replacement under extracorporeal circulation(ECC)on left ventricular function and regulatory T cells in elderly patients with rheumatic heart disease(RHD).Methods:113 elderly patients with rheumatic heart disease receiving ECC heart valve replacement at our hospital from September 2018 to September 2020 were selected retrospectively as subjects.Another 113 healthy people from the same period were selected as the control group.Patients in the observation group received ECC heart valve replacement.Left heart function and regulatory T cells were compared between the two groups.Results:Before surgery, the left atrial transverse diameter(LA)of RHD patients was significantly increased compared with the control group[(56.2±9.3)mm vs.(29.4±3.5)mm, t=28.670, P<0.001], and the left ventricular end diastolic diameter(LVDD)[(32.4±7.7)mm vs.(38.4±8.5)mm, t=5.561, P<0.001], left ventricular ejection fraction(LVEF)[(58.4±11.5)% vs.(65.6±10.5)%, t=4.915, P<0.001]and cardiac output(CO)[(3.7±2.6)L/min vs.(4.7±1.6)L/min, t=3.482, P<0.001]were significantly decreased compared with the control group.There were no significant changes in left heart function parameter values 10 min and 1 day after surgery(all P>0.05).One month after surgery, the inner diameter of pulmonary artery(PA)[(25.2±3.8)mm vs.(31.2±5.6)mm, t=9.659, P<0.001]and LA[(46.2±7.8)mm vs.(56.2±9.3)mm, t=8.758, P<0.001]were decreased compared with those before surgery, while changes in right ventricular end diastolic inner diameter(RVDD)and left ventricular end diastolic inner diameter(LVDD)were not significant, and there were no significant differences in LVEF, CO and LVFS(all P>0.05).The proportion of CD25 + CD4 + T cells in lymphocytes and the proportion of CD4 + CD25 + Foxp3 + Treg cells in CD4 + T cells in RHD patients before surgery were significantly lower than those in the control group( P<0.01).The proportions decreased 10 min and 1 day after surgery, but increased 3 days after surgery and returned to preoperative levels 7 days after surgery, but were still significantly lower than those in the control group( P<0.05). Conclusions:After ECC heart valve replacement in elderly RHD patients, the left atrium will shrink for a short time and tricuspid regurgitation can recover, with reduced damage of cellular immune function, but its contractile function remains unchanged.

目的：探讨miRNA-490-3p调控Smad2/TGF-β对结直肠癌奥沙利铂化疗敏感性的影响。方法：选取100例结直肠癌（colorectal cancer，CRC）根治性手术后奥沙利铂（oxaliplatin，OXA）同种联合化疗患者作为研究对象，根据化疗情况分为耐药组（n=40）和非耐药组（n=60），用qPCR检测两组外周血miRNA-490-3p水平；选取人CRC细胞株SW480和CRC奥沙利铂（OXA）耐药型细胞株OXA-SW480进行研究，先用qPCR检测两种细胞株中miRNA-490-3p表达水平；后将miRNA-490-3p过表达载体转染OXA-SW480（过表达组），并设立空载体组（空载体转染OXA-SW480）和空白对照组（OXA-SW480未经任何处理）。用CCK-8检测各组细胞增殖能力，同时用不同浓度OXA处理各组细胞，计算其半数抑制浓度（IC50）；用Annexin-V-FITC/PI染色流式细胞术检测各组细胞凋亡率；用WB检测各组Smad2和TGF-β蛋白表达水平。结果：在CRC患者中，耐药组外周血miR-490-3p水平显著低于非耐药组，在CRC细胞株中，OXA-SW480耐药株细胞miR-490-3p水平显著低于正常株SW480细胞（P<0.05）。与空载体组和空白对照组相比，过表达组miR-490-3p水平显著降低（均P<0.05），增殖抑制率显著升高（均P<0.05），细胞凋亡率显著升高（均P<0.01），Smad2蛋白水平显著降低（均P<0.05），TGF-β蛋白水平显著升高（均P<0.05）。经OXA处理后，过表达组的IC50显著低于空载体组和空白对照组（均P<0.05）。经Pearson相关法分析，miR-490-3p与Smad2的表达呈负相关（r=–0.943，P<0.01），miR-490-3p与TGF-β的表达呈正相关（r=0.961，P<0.01）。结论：过表达miRNA-490-3p可增加CRC SW480细胞的OXA敏感性，此作用Smad2/TGF-β信号通路有关。

Objective To compare the effects of 2 vascular accesses via arteriovenous fistula(AVF)and tunnel-cuffed catheter(TCC)in elderly patients with maintenance hemodialysis(MHD).Methods A total of 103 elderly MHD patients were selected and divided into the AVF group(43 cases)and the TCC group(60 cases)according to different vascular pathways.Laboratory indexes of serum creatinine,uric acid,parathyroid hormone(PTH),serum calcium,blood phosphorus,hemoglobin,triglyceride and total cholesterol were compared between the two groups on dialysis day after receiving regular hemodialysis treatment for 1 year.Blood flow and urea clearance in vascular pathway were also compared between the two groups.The left ventricular end-diastolic diameter(LVEDd),the left ventricular posterior end-diastolic thickness(LVPWT),the ventricular septal end-diastolic thickness(IVSTd),ejection fraction(EF),the maximum flow velocity ratio(E/A)of the left atrial ventricle at the early and late diastolic stages and pulmonary artery pressure were examined by echocardiography after regular hemodialysis treatment for 1 year.The occurrence rates of left ventricular systolic dysfunction and diastolic dysfunction were recorded.Hemodialysis access associated infection,mechanical injury and heart failure during dialysis were also recorded.Results There were no significant differences in laboratory indexes between the two groups(P＞0.05).LVEDd,IVSTd,LVPWT,incidence rates of left ventricular systolic dysfunction,diastolic dysfunction,blood flow through vascular channels,Kt/V and mechanical injury were higher in the AVF group than those in the TCC group,while the ratio of hemodialysis access associated infection,E/A and EF values were lower in the AVF group than those in the TCC group(P＜0.05).There were no significant differences in incidence rates of pulmonary arterial pressure and heart failure between the two groups(P＞0.05).Conclusion For elderly MHD patients,the appropriate dialysis access should be determined after evaluating underlying diseases and vascular conditions.

Objective: To investigate the association of sugar sweetened beverage (SSB) consumption with insomnia and depressive symptoms among first grade middle school students from Yunnan Province, so as to provide evidence to guide interventions for the treatment of these symptoms in this population. Methods: From October to December 2022, 8 500 firstgrade middle school students from 11 counties in Yunnan Province were selected by cluster random sampling. Depressive symptoms, SSB consumption, and insomnia symptoms among students were evaluated by the Child Depression Scale (CDI), dietary frequency questionnaire, and Insomnia Severity Index (ISI). A Logistic regression model was employed to analyze the relationship between SSB consumption, insomnia, depressive symptoms, and their interaction effects among students. Results: The detection rate of depressive symptoms was 28.3%, and having insomnia symptoms ( OR=6.07, 95%CI =5.46-6.75), consuming carbonated beverages ( OR=1.20, 95%CI =1.08-1.34), tea ( OR=1.13, 95%CI =1.02-1.25), energy drinks ( OR=1.36, 95%CI =1.23-1.50), and other beverages ( OR=1.32, 95%CI =1.19-1.45) were positively correlated with depressive symptoms among first grade middle school students ( P < 0.05). Carbonated beverages (additive effect: OR=2.96, 95%CI =2.72-3.22, multiplicative effect: OR=4.75, 95%CI =4.25- 5.32 ), fruit drinks (additive effect: OR=2.61, 95%CI =2.40-2.82; multiplicative effect: OR=4.43, 95%CI =3.94-4.97), tea (additive effect: OR=2.70, 95%CI =2.47-2.89; multiplicative effect: OR=4.34, 95%CI =3.86-4.89), energy drinks (additive effect: OR=2.82, 95%CI =2.61-3.05; multiplicative effect: OR=4.48, 95%CI =3.92-5.12), sweetened milk (additive effect: OR= 2.73, 95%CI =2.06-2.96; multiplicative effect: OR=4.61, 95%CI =4.12-5.17) and other beverages (additive effect: OR= 2.73 , 95%CI =2.53-2.95; multiplicative effect: OR=4.56, 95%CI =4.00-5.20) had both additive and multiplicative effects with insomnia, and increased the risk of depressive symptoms in first grade middle school students ( P <0.01). Conclusions The interaction between the consumption of SSB and insomnia symptoms may increase the risk of depressive symptoms among first grade middle school students in Yunnan Province. It is necessary to advocate middle school students to reduce SSB intake, in order to decrease the occurrence of depressive symptoms among this population.

Objective:To observe the changes of neutrophil to lymphocyte ratio and lung function of patients defined by different TCM syndromes with acute exacerbation of chronic obstructive pulmonary disease.Methods:A total of 181 patients with acute exacerbation of chronic obstructive pulmonary disease in our hospital from January 2016 to Novenber 2018 were included and divided into 5 groups accoding to different TCM syndromes, which were wind-cold invading lung syndrome (26), external cold and internal fluid syndrome (40), phlegm-heat obstructing lung syndrome (48), phlegm-dampness blocked syndrome (48), an heart spirit confused by phlegm syndrome (19). Then tested the blood for each group, and calculated NLR; tested c-reactive protein, and lung function, and measured with COPD Assessment Test (CAT) and Modified British Medical Research Council (mMRC); conducted 6MWT, then the BODE index and Charlson Comorbidity Index (CCI) scores were calculated.Results:The NLR, CRP level in patients with external cold and internal fluid syndrome and an heart spirit confused by phlegm syndromeby phlegm were significantly higher than those of other syndrome ( P<0.05 or P<0.01), and FEV1% Pred was significantly lower than that of phlegm-dampness blocked syndrome ( P=0.024); the 6-minute walking distance of patients with external cold and internal fluid syndrome was significantly shorter than that of phlegm-heat obstructing lung syndrome and phlegm-dampness blocked syndrome ( P=0.006, P=0.024). The comparison of mMRC grades among the syndromes was statistically significant ( F=26.367, P=0.049). The BODE index of patients external cold and internal fluid syndrome was higher than that of patients phlegm-heat obstructing lung syndrome ( P=0.015), and the CCI score of patients an heart spirit confused by phlegm syndrome was higher than that of patients phlegm-dampness blocked syndrome ( P=0.012). The BODE index of patients with external cold internal fluid syndrome was significantly higher than that of phlegm-heat obstructing lung syndrome ( P=0.015). The CCI score of patients with mental disorder caused by phlegm was significantly higher than that of phlegm-dampness blocked lung syndrome ( P=0.012). Conclusions:There were significantly differences in neutrophil to lymphocyte ratio, CRP and 6-minute walking distance among different TCM syndromes in patients with acute exacerbation of chronic obstructive pulmonary disease. The inflammation in patients with external cold and internal fluid syndrome and mental disorder caused by phlegmare much severe, but there might be no difference in dyspnea and prognosis among TCM syndromes.

Objective To investigate the effects of pretreatment with Xuebijing injection on renal tubular injury in rats with contrast-induced acute kidney injury(CI-AKI).Methods Twenty-four Sprague-Dawley(SD)rats were selected and divided into normal group,model group,control group,and treatment group according to the random number table method,with 6 rats in each group.The animal model of CI-AKI was prepared by adopting iohexol,and the normal group was not subjected to any treatment.The rats in the treatment group were injected with Xuebijing injection via the tail vein 15 hours before modeling until 24 hours after modeling.The injection volume was 10 mL/kg for every 6 hours.The control group was injected with normal saline at the same time point.After 24 hours of modeling,the urine of rats in each group was collected to determine the levels of blood urea nitrogen(BUN)and urine N-acetyl-β-D-gluco-aminidase(uNAG),and the blood was collected to determine the levels of serum creatinine(SCr).Then the rats were killed and the kidney tissues were extracted,and then stained with hematoxylin-eosin(HE),and the pathological changes of the kidney tissues were observed under the light microscope.Results BUN,SCr and uNAG were significantly higher in the model group than those in the normal group[BUN(μmol/L):37.29±6.18 vs.6.37±1.19,SCr(mmol/L):30.43±4.44 vs.14.90±1.61,uNAG(U/L):47.77±4.71 vs.11.32±3.62,all P<0.01];BUN,SCr and uNAG levels were obviously decreased in the treatment group compared to the model group[BUN(μmol/L):9.45±3.04 vs.37.29±6.18,SCr(mmol/L):19.83±2.16 vs.30.43±4.44,uNAG(U/L):21.70±6.21 vs.47.77±4.71,all P<0.05],however,BUN and uNAG in the treatment group were still significantly higher than those in the normal group[BUN(μmol/L):9.45±3.04 vs.6.37±1.19,uNAG(U/L):21.70±6.21 vs.11.32±3.62,P<0.05 or P<0.01];SCr in the treatment group was not statistically significant compared to the normal group(μmol/L:19.83±2.16 vs.14.90±1.61,P>0.05).Under the light microscope,the renal tubular epithelial cells at the junction of cortex and dermatomedulla in the kidneys of the model group were obviously vacuolated,accompanied by cell detachment and necrosis,and the tubules were dilated,with no obvious lesions in the glomeruli.The degree of damage in the control group and the treatment group was reduced compared with that in the model group.The degree of renal tubular damage in the model group was higher than that in the normal group;while the degree of renal tubular damage in the control group was significantly lower than that in the model group;and the degree of renal tubular damage in the treatment group was lower than that in the model group.There was no statistically significant difference in the degree of renal tubular damage between the treatment group and the control group.Conclusion Xuebijing injection may exert a protective effect on renal function in rats with CI-AKI by attenuating renal tubular injury.

Background/Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) has become an increasingly important health challenge, with a substantial rise linked to changing lifestyles and global obesity. Ursolic acid, a natural pentacyclic triterpenoid, has been explored for its potential therapeutic effects. Given its multifunctional bioactive properties, this research further revealed the pharmacological mechanisms of ursolic acid on MASLD. Methods: Drug target chips and bioinformatics analysis were combined in this study to explore the potential therapeutic effects of ursolic acid on MASLD. Molecular docking simulations, surface plasmon resonance analyses, pull-down experiments, and co-immunoprecipitation assays were used to verify the direct interactions. Gene knockdown mice were generated, and high-fat diets were used to validate drug efficacy. Furthermore, initial CD4+ T cells were isolated and stimulated to demonstrate our findings. Results: In this study, the multifunctional extracellular matrix phosphorylated glycoprotein secreted phosphoprotein 1 (SPP1) was investigated, highlighting its capability to induce Th17 cell differentiation, amplifying inflammatory cascades, and subsequently promoting the evolution of MASLD. In addition, this study revealed that in addition to the canonical TGF-β/IL-6 cytokine pathway, SPP1 can directly interact with ITGB1 and CD44, orchestrating Th17 cell differentiation via their joint downstream ERK signaling pathway. Remarkably, ursolic acid intervention notably suppressed the protein activity of SPP1, suggesting a promising avenue for ameliorating the immunoinflammatory trajectory in MASLD progression. Conclusions Ursolic acid could improve immune inflammation in MASLD by modulating SPP1-mediated Th17 cell differentiation via the ERK signaling pathway, which is orchestrated jointly by ITGB1 and CD44, emerging as a linchpin in this molecular cascade.