Objective: To identify the stakeholders of prevention and control of obesity among middle school students and analyze their motivations and interest demands for participation, in order to provide constructive recommendations for facilitating their effective engagement of stakeholders in prevention and control of obesity among middle school students. Methods: Stakeholders and their types were identified through a combination of literature analysis and consultation with 17 experts in children and adolescents for prevention and control of obesity. From December 2023 to January 2024, by applying convenience sampling, face to face semi structured interviews were conducted with 11 individuals engaged in prevention and control of obesity for middle school students and focus group interviews were conducted with 48 students and parents. Thematic analysis was employed to obtain motivations and interest demands for stakeholder involvement in prevention and control of obesity. Results: A total of 29 subcategories within 7 major categories of stakeholders were identified, including government and relevant functional departments, non profit organizations and communities, forprofit organizations and individuals, schools, professional and technical personnel, families and individuals, and scientific research institutions, with 28 subcategories being confirmed stakeholders. Among these stakeholders, there were 3 types of cooperative relationships:management, cooperation, and service. There were some factors hindering cooperation among stakeholders including imperfections in specialized policies and lack of long term cooperative mechanisms, flaws and interest conflicts in the evaluation system, insufficiency of material resources, and poor health values. In response to these challenges, interviewees proposed to convene a working group for the prevention and control of adolescent obesity. They also suggested making a contract of responsibility, strengthening supervision over for profit organizations, enhancing advocating efforts for prevention and control of obesity, and increasing financial support. Conclusions The prevention and control of obesity for middle school students can be facilitated by forming a collaborative alliance based on the roles and relationships of stakeholders identified in the present study. Perceived conflicts of interest among stakeholders can be reconciled by employing strategies of interest integration, goal alignment, and spiritual integration, to enhance the feasibility, participation and sustainability of obesity intervention.

Objective:To investigate the application of phase angle by bioelectrical impedance in the assessment of malnutrition and its correlation with nutrtition status as measured by several different screening tools in patients on maintenance hemodialysis (MHD).Methods:This was a cross-sectional study, including 151 patients on MHD. Bioelectrical impedance analysis was used to detect body composition in hemodialysis patients. Nutritional Risk Screening 2002 (NRS 2002) scores, body mass index (BMI) and the Global Leadership Initiative on Malnutrition (GLIM) criteria were used to investigate the prevalence of malnutrition in MHD patients. The correlation between phase angle and nutrition-related indicators such as visceral fat area, body weight, skeletal muscle, and serum albumin in MHD patients was analyzed, and the consistency between phase angle and the three screening tools was examined.Results:In a total of 151 patients on MHD, the malnutrition prevalence as measured by BMI, NRS 2002 score and GLIM criteria was 9.27%, 27.81% and 54.97%, respectively. Phase angle in MHD patients was positively correlated with BMI( P<0.01), negatively correlated with impaired nutrition score of NRS 2002( P<0.01), and also associated with nutrition screening results as measured by GLIM criteria( P<0.001). Further study showed that phase angle was positively correlated with body weight, skeletal muscle and serum albumin( P<0.01), but negatively with visceral fat area and extracellular water/total body water( P<0.01). Conclusions:Malnutrition is highly prevalent in MHD patients. Phase angle showed good consistency with BMI, NRS 2002 and GLIM criteria in terms of malnutrition screening, implying the potential application in the assessment of malnutrition in MHD patients. However, the clinical relevance still needs corroboration with future large-scale researches.

Objective:To investigate the psychological crisis status of parents of pediatric bipolar disorder (PBD) patients and establish a risk prediction model, in order to provide a reference for medical workers to screen parents' mental health status early.Methods:This study was a cross-sectional study. Using the convenient sampling method, a total of 478 parents of children with PBD who were treated in the Second Affiliated Hospital of Wenzhou Medical University in Zhejiang Province from January 2020 to May 2021 were selected as the research subjects. They were randomly divided into the modeling group ( n=318) and the validation group ( n=160) in a ratio of 2∶1. Questionnaires were conducted using general information questionnaires and Symptom Self-rating Scale. Univariate analysis and logistic regression were used to analyze the influencing factors of psychological crisis in the modeling group, and H- L test and receiver operating characteristic curve were used to verify the predictive performance of the model. Results:The detection rate of psychological crisis among the parents of 318 children with PBD was 25.7%, of which the detection rate was 26.1% in the modeling group and 25.0% in the validation group. First onset ( OR=2.337, P<0.05) , parental gender ( OR=1.846, P<0.05) , conscious care burden ( OR=3.527, P<0.05) , religious belief ( OR=3.113, P<0.05) and children's age ( OR=1.969, P<0.05) were independent predictors of psychological crisis in parents of children with PBD. Conclusions:Medical workers need to be good at observing the psychological status of parents of children, predict the risk of psychological crisis in parents in advance and timely conduct targeted interventions according to the risk level, so as to improve the psychological adaptability of parents and improve their mental health.

Objective:To investigate the psychological crisis status of parents of pediatric bipolar disorder (PBD) patients and establish a risk prediction model, in order to provide a reference for medical workers to screen parents' mental health status early.Methods:This study was a cross-sectional study. Using the convenient sampling method, a total of 478 parents of children with PBD who were treated in the Second Affiliated Hospital of Wenzhou Medical University in Zhejiang Province from January 2020 to May 2021 were selected as the research subjects. They were randomly divided into the modeling group ( n=318) and the validation group ( n=160) in a ratio of 2∶1. Questionnaires were conducted using general information questionnaires and Symptom Self-rating Scale. Univariate analysis and logistic regression were used to analyze the influencing factors of psychological crisis in the modeling group, and H- L test and receiver operating characteristic curve were used to verify the predictive performance of the model. Results:The detection rate of psychological crisis among the parents of 318 children with PBD was 25.7%, of which the detection rate was 26.1% in the modeling group and 25.0% in the validation group. First onset ( OR=2.337, P<0.05) , parental gender ( OR=1.846, P<0.05) , conscious care burden ( OR=3.527, P<0.05) , religious belief ( OR=3.113, P<0.05) and children's age ( OR=1.969, P<0.05) were independent predictors of psychological crisis in parents of children with PBD. Conclusions:Medical workers need to be good at observing the psychological status of parents of children, predict the risk of psychological crisis in parents in advance and timely conduct targeted interventions according to the risk level, so as to improve the psychological adaptability of parents and improve their mental health.

Objective:To investigate the expression and clinical significance of SKA3 protein in cholangiocarcinoma, and the effect of interfering SKA3 expression in vitro on the proliferation, invasion, and migration of cholangiocarcinoma SSP-25 cells, as well as its possible mechanism.Methods:The clinicopathological data, cancer tissues, and paracancerous tissues from 172 patients with distal cholangiocarcinoma in Beijing Friendship Hospital, Capital Medical University between January 2015 and December 2020 were retrospectively collected. Immunohistochemical method was used to detect the expression level of SKA3 protein in cancer tissues and paracancerous tissues. Transfection of SKA3 small interfering RNA (siRNA) into cholangiocarcinoma SSP-25 cells was used as si-SKA3 group, and the untreated SSP-25 cells were used as the control group. Cell immunofluorescence staining and Western blot were used to detect the transfection effect; CCK-8 method and cell colony formation experiment were used to observe changes in cell proliferation; cell scratch assay was used to monitor cell invasion; Western blot was used to detect the expression of PI3K-AKT signaling pathway related proteins.Results:Among 172 patients with cholangiocarcinoma, there were 116 males and 56 females; the age of 54 cases was under 60 years, and age of 118 cases was equal to or more than 60 years. The positive rate of SKA3 protein in cholangiocarcinoma tissues was higher than that in paracancerous tissues [78.49% (135/172) vs. 13.95% (24/172)], and the difference was statistically significant ( χ2 = 42.78, P < 0.01). The positive rate of SKA3 protein in cancer tissues of cholangiocarcinoma patients with nerve invasion [84.35% (124/147) vs. 44.00% (11/25)] and lymph node metastasis [88.78% (87/98) vs. 64.86% (48/74)] was higher than that of patients without nerve invasion and without lymph node metastasis, and the differences were statistically significant (all P < 0.05). There were no statistically significant differences in the positive rate of SKA3 protein in cancer tissues of patients stratified by age, gender, tumor diameter, TNM stage, and tumor differentiation (all P > 0.05). The CCK-8 method showed that after 72 h of cultivation, the proliferation ability of SSP-25 cells in the si-SKA3 group (expressed as absorbance value at 450 nm) was lower than that in the control group (0.56±0.05 vs. 0.83±0.06), and the difference was statistically significant ( t = 3.06, P = 0.06). After 2 weeks of cultivation, the colony formation experiment showed that the number of colony formation of SSP-25 cells in the si-SKA3 group was lower than that in the control group. After 24 h of cultivation, the scratch healing rates of SSP-25 cells in the si-SKA3 group and the control group were (31±6) % and (72±5)%, respectively, and the difference was statistically significant ( t = 5.63, P = 0.013).Western blot analysis showed that the relative expression levels of p-PI3K and p-AKT proteins in the PI3K-AKT signaling pathway were lower than those in the control group, and the difference was statistically significant (all P < 0.05). Conclusions:SKA3 protein is highly expressed in cholangiocarcinoma tissues, and may related to nerve invasion and lymph node metastasis. Interfering SKA3 expression can inhibit the proliferation and invasion of cholangiocarcinoma SSP-25 cells, and its mechanism may be related to the inhibition of the PI3K-AKT signaling pathway.

OBJECTIVE To explore the effectiveness, potential mechanism and compatibility characteristics of efficacy groups of Dunhuang medical prescription Daxiefei decoction in preventing and treating pneumonia based on chemical bioinformatics method. METHODS To study the effect of Daxiefei decoction freeze-dried powder solution on the proliferation activity of lung epithelial cells through cell experiments. Daxiefei decoction was divided into three groups: clearing away heat group, resolving phlegm group, and nourishing Yin group according to its efficacy characteristics. The chemical components of Daxiefei decoction were obtained by TCMSP database and literature search, and the targets were predicted in Swiss Target Prediction database. Pneumonia disease targets were obtained by DrugBank, TTD, Genecards and DisGeNET databases. STRING database and Cytoscape were used to construct the intersection target interaction network and "drug-component-target- pathway" network and DAVID database was used for KEGG pathway enrichment analysis. The network was used to analyze the scientific connotation of the compatibility of efficacy groups. Furthermore, molecular docking was used to evaluate the target-compound affinity and molecular dynamics was used to explore the dynamic molecular mechanism. RESULTS Cell experiments showed that Daxiefei decoction can maintain the proliferation of lung epithelial cells, reverse the decrease of mitochondrial activity induced by LPS and reduce apoptosis. Complex network analysis showed that the pathways enriched by the three functional groups contained in Daxiefei decoction were mainly distributed in two modules: inflammation regulation and reducing airway mucus hypersecretion. Each module was connected by a common target gene and had its own focus. The results of molecular docking showed that the components quercetin, baicalein, isorhamnetin etc. might be the effective multi-target components of Daxiefei decoction. SRC, EGFR, PPARA etc. had good affinity with each potential active component, which might be a potential target of Daxiefei decoction for preventing and treating pneumonia. Molecular dynamics simulation showed that the potential active component quercetin formed stable intermolecular interactions with SRC. CONCLUSION This study initially reveal the material basis and molecular mechanism of Daxiefei decoction in the prevention and treatment of pneumonia. It also explores the scientific connotation of Daxiefei decoction in the prevention and treatment of pneumonia with different efficacy groups, and its modern development and clinical application provide chemical bioinformatics basis.