BackgroundPrevious studies have identified a close relationship among psychological neglect and abuse， negative affect， different stages of adolescence， and suicidal ideation. However， the mechanisms underlying the impact of psychological abuse and neglect on suicidal ideation among left-behind adolescents remain unclear， and this field of research is still in its relative infancy. ObjectiveTo explore the relationship between psychological neglect/abuse and suicidal ideation among left-behind adolescents， as well as the mediating role of negative affect and the moderating effect of different stages of adolescence， so as to provide insights for preventing and intervening suicidal ideation in this population. MethodsFrom November 2021 to May 2022， a cluster random sampling technique was utilized to select 2 309 left-behind adolescents in western China. Assessments were conducted using the Child Psychological Abuse and Neglect Scale （CPANS）， the Positive and Negative Suicide Ideation （PANSI） and the Positive and Negative Affect Schedule for Children （PANAS-C）. Spearman correlation coefficients were calculated across all samples， and Process 4.1 was employed to test the mediating role of negative affect and the moderating role of different stages of adolescence in the pathway linking psychological abuse/neglect to suicidal ideation. ResultsA total of 2 119 left-behind adolescents （mean age： 14.94±1.20 years） completed the study， with males comprising 51.34% （1 088/2 119） and females 48.66% （1 031/2 119）.Among left-behind adolescents， scores on CPANS psychological neglect subscale showed positive correlations with both psychological abuse subscale scores and PANAS-C negative affect subscale scores （r=0.446， 0.496， P<0.01）. Additionally， CPANS psychological neglect and psychological abuse subscale scores were also positively correlated with PANSI scores （r=0.487， 0.508， P<0.01）. Furthermore， PANAS-C negative affect subscale scores demonstrated a positive correlation with PANSI scores （r=0.499， P<0.01）. Negative affect partially mediated the relationship between psychological abuse/psychological neglect and suicidal ideation， with effect sizes of 0.166 （95% CI： 0.141~0.191） and 0.131 （95% CI： 0.112~0.152）. Different stages of adolescence moderated the latter part （negative emotion → suicidal ideation） of the indirect mediation path from psychological neglect to suicidal ideation through negative affect （β=-0.066， P<0.01）. ConclusionBoth psychological neglect and psychological abuse may influence suicidal ideation among left-behind adolescents via negative affect. Moreover， different stages of adolescence may moderate the indirect path from psychological neglect to suicide ideation through negative affect.

Sensorineural hearing loss (SNHL), the most commonly-occurring form of hearing loss, is caused mainly by injury to or the loss of hair cells and spiral ganglion neurons in the cochlea. Numerous environmental and physiological factors have been shown to cause acquired SNHL, such as ototoxic drugs, noise exposure, aging, infections, and diseases. Several programmed cell death (PCD) pathways have been reported to be involved in SNHL, especially some novel PCD pathways that have only recently been reported, such as ferroptosis, necroptosis, and pyroptosis. Here we summarize these PCD pathways and their roles and mechanisms in SNHL, aiming to provide new insights and potential therapeutic strategies for SNHL by targeting these PCD pathways.
Humans ; Hearing Loss, Sensorineural/metabolism* ; Necroptosis/drug effects* ; Pyroptosis/drug effects* ; Ferroptosis/drug effects* ; Animals

Lung cancer is one of the malignant tumors with the highest mortality and the fastest growing incidence,which seriously threatens human life and health.With the popularization of low-dose spiral CT and the enhancement of public awareness of physical examination,more and more ground-glass nodules have been detected.Accumulating studies have shown that for patients with nodules diameter≤2 cm and ground-glass opacity≥50% ,under the condition of ensuring the cutting edge,thoracoscopic sublobectomy or subsegmentectomy can more effectively preserve the lung function of patients,and has gradually become the recommended surgical method.In recent years,with the continuous improvement of thoracoscopic surgery technology,thoracoscopic subsegmentectomy and combined subsegmentectomy have been gradually carried out.Compared with lobectomy and segmentectomy,subsegmental resection can retain more normal lung tissue and reduce the loss of lung function under the condition of ensuring the safe cutting edge.However,thoracoscopic subsegmental resection requires a higher level of surgical technique and anatomical knowledge for the operator,and is rarely reported in relevant literature.Therefore,this article reviews the progress of anatomical subsegmentectomy and combined subsegmentectomy in the treatment of early non-small cell lung cancer.

Objective To promote the construction of a national party building indicator system for public hospitals,provide reference for the development of system documents such as quality evaluation methods for party building work in public hospitals.Methods Conduct a comprehensive and systematic collection,organization,and analysis of policy documents related to party building in public hospitals in China since 2018,and organize expert discussions.Results The positive coefficients of the three rounds of expert discussions were all 100％,and the expert authority coefficient was 0.878.A party building indicator system was constructed with 7 primary indicators and 40 secondary indicators,including leadership system and decision-making mechanism,leadership team and cadre talent team construction,grassroots party organization construction,party member team construction,medical ethics and clean governance construction,party building work guarantee,and others.Conclusion The indicator system has been unanimously recognized by experts and is authoritative and feasible,laying the foundation for the refined party building work in public hospitals.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

OBJECTIVE: To investigate the effect of galectin-1 on biological behaviors of lung adenocarcinoma cells and the underlying mechanism. METHODS: The expression levels of galectin-1 mRNA were detected in 8 pairs of lung adenocarcinoma tissues and adjacent normal tissues and in lung adenocarcinoma cell lines A549 and H1299 and normal bronchial epithelial cell line BEAS-2b using qRT-PCR. The effect of galectin-1 knockdown by RNA interference on the proliferation, invasion and migration abilities and apoptosis of lung adenocarcinoma cells were examined using CCK8 assay, Transwell assay, scratch assay and flow cytometry. Western blotting was performed to detect the expressions of apoptosis-related proteins BAX, BCL-2, and caspase-3 and the proteins involved in the AKT and ERK pathways. RESULTS: The mRNA expression of galectin-1 was significantly increased in lung cancer tissues and lung adenocarcinoma cell lines (P < 0.05). In lung adenocarcinoma cells, galectin-1 knockdown significantly inhibited cell proliferation, migration and invasion and obviously increased cell apoptosis rate (P < 0.05), causing also significant reduction of the phosphorylation level of ERK signaling pathway (P < 0.05). CONCLUSION Galectin-1 knockdown inhibits proliferation, migration, and invasion and promotes apoptosis of lung adenocarcinoma cells, and this effect is mediated probably by inhibition of the phosphorylation levels of the ERK pathway.
Humans ; Adenocarcinoma of Lung ; Apoptosis ; Lung Neoplasms ; MAP Kinase Signaling System ; Cell Proliferation

ObjectiveTo assess the predictive performance of four creatinine-based equations for estimated glomerular filtration rate （eGFR）： 2012 chronic kidney disease epidemiology collaboration （CKD-EPIcr） equation ， 2021CKD-EPIcr equation， Xiangya equation and European kidney function consortium （EKFC） equation. MethodsA total of 198 patients with chronic kidney disease from the Third Affiliated Hospital of Sun Yat-sen University and the Kiang Wu Hospital in Macau were enrolled. We compared the GFR measured （mGFR） by iohexol plasma clearance and the eGFR calculated by four equations. The agreement between mGFR and eGFR was analyzed by Bland-Altman plots， concordance correlation coefficient （CCC）， coverage probability （CP） and total deviation index （TDI）. The performance of eGFR equations， including their bias， precision， root square mean error （RSME）， and percentage of estimates within 30% deviation of measured GFR （P₃₀）， were evaluated. Bootstrap method （2 000 samples） was used to calculate bias， interquartile range （IQR）， RSME， and 95% confidence intervals （CI） for P_30. After selecting the optimal eGFR equation as the reference， we statisticlly tested other equations by ① Wilcoxon signed-rank test for bias； ② McNemar-Bowker test for P₃₀； ③ comparing RMSE and IQR with independent samples t test after 2 000 bootstrap samples were obtained. ResultsThe median mGFR and four eGFR equations （EKFC， 2012CKD-EPIcr， 2021CKD-EPIcr and Xiangya equation） in the overall population were 56.2 mL·min^-1·（1.73m²）^-1， 67.1 mL·min^-1·（1.73m²）^-1， 73.0 mL·min^-1·（1.73m²）^-1， 66.9 mL·min^-1·（1.73m²）^-1 and 63.8 mL·min^-1·（1.73m²）^-1， respectively. The Bland-Altman plots showed that EKFC equation had the lowest mean difference and the narrowest 95% limit of agreement. The EKFC equation had the optimal performance on CCC， TDI and CP with values of 0.90， 24.41 and 0.50， respectively. Overall， the bias， accuracy， P₃₀ and RSME from the EKFC equation was -0.99， 14.64， 0.80， and 14.68， respectively， with 95% CI ranging from -2.53 to 0.94， 11.82 to 17.35， 0.73 to 0.85， and 12.69 to 17.35， respectively， which were superior to those values from other three eGFR equations. The differences were statistically significant （all P < 0.05）. The results in the mGFR subgroups were basically consistent with the overall trend. ConclusionsOf the four eGFR equations validated in this study， the EKFC equation comprehensively surpasses 2012CKD-EPIcr equation， 2021CKD-EPIcr equation， and Xiangya equation. With P₃₀>75%， the EKFC equation can meet clinical diagnostic needs. Therefore， the EKFC equation is recommended for estimating GFR in a Chinese population， but more participants need be included to further support this conclusion.

ObjectiveTo investigate the predictive effect of high density lipoprotein （HDL） to C-reactive protein （CRP） ratio （HDL/CRP） on the progression of chronic kidney disease （CKD） in non-dialysis patients. MethodsNon-dialysis chronic kidney disease patients with at least two sets of follow-up data from the Third Affiliated Hospital of Sun Yat-sen University （Tian-he and Ling-nan districts）from 2015 to 2019 were enrolled. The baseline demographic characteristics and biochemical examination results were collected from the electronic medical record system. The patients were grouped according to the quantile of Ln（HDL/CRP）. The demographic and biochemical data were compared among groups by one-way ANOVA for normal distribution continuous variables， Kruskal-Wallis rank-sum test for non-normal distribution continuous variables， and Chi-square analysis for categorical variables. The relationship between HDL/CRP and baseline eGFR was investigated by correlation analysis， univariate and multivariate linear regression analysis. The Cox survival analysis were used to investigate the predictive effect of Ln（HDL/CRP） on renal deterioration events. ResultsTotally 9 142 patients with CKD were enrolled， and 439 patients were included in the end. There were 100 patients （22.8%） with chronic glomerulonephritis， 145 patients （33%） with diabetic nephropathy， 40 patients （9.1%） with hypertensive nephropathy， and 154 patients （35.1%） with other causes. According to Ln（HDL/CRP） quartile， group Quartile4 had a lower incidence of renal deterioration than the other three groups （11% vs. 21.1% to 21.8%） and had the highest baseline eGFR level. From Quartile1 to quartile 4 groups， age， Hba1c and APOA1 levels decreased gradually. The prevalence of chronic heart failure， BMI， hemoglobin， albumin， TC， LDL， TG， APOB100 levels were different among groups. Through correlation analysis， Ln （HDL/CRP） were positively correlated with baseline eGFR（r=0.162， P=0.001）. After adjusting for a variety of factors by Cox regression analysis， Ln （HDL/CRP） could be included in the final equation when defined deterioration of renal function as end point ［HR=0.79， 95%CI （0.69， 0.91）， P=0.001］. ConclusionHDL/CRP can reflect the severity of chronic kidney disease， and the ratio of HDL and CRP can predict the progression of chronic kidney disease in non-dialysis patient.

ObjectiveTo investigate the association of metabolic syndrome （MetS） and its components with rapid estimated glomerular filtration rate （eGFR） decline. MethodsThe China health and retirement longitudinal study （CHARLS） is a nationally representative cohort study focusing on physical and psychological health as well as social activities of middle-aged and elderly households. Cohort data could be obtained free of charge after application at the CHARLS website. We screened baseline data in 2011 and follow-up data in 2015 of CHARLS， selected those populations aged 45 and older， eGFR≥60 mL·min^-1·（1.73m²）^-1， without previous malignant tumors， heart disease， stroke and kidney disease， excluding those with missing values and outliers. Rapid eGFR decline was defined as an average annual decrease in eGFR of more than 3 mL·min^-1·（1.73m²）^-1. The 4400 participants enrolled were categorized into rapid eGFR decline group （770） and non-rapid eGFR decline group （3 630）. Logistic regression was performed to test the association of MetS and its components with rapid decline of eGFR. ResultsCompared with subjects without MetS， in subjects with MetS， we found no association between MetS and rapid eGFR decline after controlling for confounding factors （P>0.05）， with an OR （95%CI） of 0.988 （0.811~1.204）. After adjustment for confounding factors， the MetS components associated with rapid eGFR decline were central obesity （OR = 0.968， 95% CI： 0.778~1.204， P = 0.767）， elevated blood glucose （OR = 0.840， 95% CI： 0.715~0.986， P = 0.032）， hypertension （OR = 1.087， 95% CI： 0.919~1.285， P = 0.328）， decreased high-density lipoprotein cholesterol （OR = 1.085， 95% CI： 0.895~1.316， P = 0.404） and elevated triglyceride （OR = 1.110， 95% CI： 0.918~1.343， P = 0.281）. ConclusionsMetS was not an independent risk factor of rapid eGFR decline in the middle-aged and elderly populations， and elevated blood glucose was associated with the reduced risk of rapid eGFR decline. The false renal benefit caused by elevated blood sugar might be related to the renal hyperperfusion and hyperfiltration in the early stage of the disease. We need further follow-up to observe the dynamic effects of the MetS and its components on renal function.

Since December 2019, novel coronavirus pneumonia (NCP) has been reported in Wuhan, Hubei Province, and spreads rapidly to all through Hubei Province and even to the whole country. The virus is 2019 novel coronavirus (2019-nCoV), never been seen previously in human, but all the population is generally susceptible. The virus spreads through many ways and is highly infectious, which brings great difficulties to the prevention and control of NCP. Based on the needs of orthopedic trauma patients for emergency surgery and review of the latest NCP diagnosis and treatment strategy and the latest principles and principles of evidence-based medicine in traumatic orthopedics, the authors put forward this expert consensus to systematically standardize the clinical pathway and protective measures of emergency surgery for orthopedic trauma patients during prevention and control of NCP and provide reference for the emergency surgical treatment of orthopedic trauma patients in hospitals at all levels.