Objective: To explore the association between processed food consumption and anxiety symptoms among college students in Yunnan Province, so as to provide a reference for the prevention and treatment of anxiety symptoms in this population. Methods: A cluster random sample of 2 515 first year students from two universities in Yunnan Province was selected to carry out a longitudinal investigation which included a baseline survey (November 2021, T1) and three follow up visits (June 2022, T2; November 2022, T3; June 2023, T4). The food frequency questionnaire was administered to assess processed food consumption, and the Depression Anxiety Stress Scale-21 (DASS-21, Chinese version) was used to evaluate anxiety symptoms. A generalized estimation equation model was used to analyze the relationship between processed food consumption and anxiety symptoms. Results: The detection rates of T1-T4 anxiety symptoms among college students in Yunnan Province were 29.70%, 36.70%, 37.69% and 38.73 %, respectively, and the corresponding anxiety symptom scores were 4(0,8), 4(0,10), 4(0,12), 2(0,14). After controlling for demographic variables and confounding factors in the generalized estimation equation model, a statistically significant association was found between consumption of carbonated beverages ( β=0.06, 95%CI =0.03-0.08), and other processed snacks ( β= 0.04 , 95%CI =0.01-0.07) ( P <0.05). The stratified analysis by gender showed that the consumption of carbonated beverages ( β=0.08, 95%CI =0.05-0.12) and fast food ( β=0.03, 95%CI =0.00-0.06) was significantly associated with anxiety symptoms in female college students ( P <0.05). There was no significant association between processed food consumption and anxiety symptoms in male college students ( P >0.05). Conclusions Processed food consumption by college students in Yunnan Province may increase the risk of anxiety symptoms, particularly among female students. There is a need to strengthen guidance in respect to processed food consumption, so as to prevent and treat anxiety symptoms.

Objective:To analyze the factors affecting delayed chemotherapy in children with Burkitt lymphoma (BL) and their influence on prognosis.Methods:Retrospective cohort study. Clinical data of 591 children aged ≤18 years with BL from May 2017 to December 2022 in China Net Childhood Lymphoma (CNCL) was collected. The patients were treated according to the protocol CNCL-BL-2017. According to the clinical characteristics, therapeutic regimen was divided into group A, group B and group C .Based on whether the total chemotherapy time was delayed, patients were divided into two groups: the delayed chemotherapy group and the non-delayed chemotherapy group. Based on the total delayed time of chemotherapy, patients in group C were divided into non-delayed chemotherapy group, 1-7 days delayed group and more than 7 days delayed group. Relationships between delayed chemotherapy and gender, age, tumor lysis syndrome before chemotherapy, bone marrow involvement, disease group (B/C group), serum lactate dehydrogenase (LDH) > 4 times than normal, grade Ⅲ-Ⅳ myelosuppression after chemotherapy, minimal residual disease in the interim assessment, and severe infection (including severe pneumonia, sepsis, meningitis, chickenpox, etc.) were analyzed. Logistic analysis was used to identify the relevant factors. Kaplan-Meier method was used to analyze the patients' survival information. Log-Rank was used for comparison between groups.Results:Among 591 patients, 504 were males and 87 were females, the follow-up time was 34.8 (18.6,50.1) months. The 3-year overall survival (OS) rate was (92.5±1.1)%,and the 3-year event-free survival (EFS) rate was (90.5±1.2)%. Seventy-three (12.4%) patients were in delayed chemotherapy group and 518 (87.6%) patients were in non-delayed chemotherapy group. The reasons for chemotherapy delay included 72 cases (98.6%) of severe infection, 65 cases (89.0%) of bone marrow suppression, 35 cases (47.9%) of organ dysfunction, 22 cases (30.1%) of tumor lysis syndrome,etc. There were 7 cases of chemotherapy delay in group B, which were seen in COPADM (vincristine+cyclophosphamide+prednisone+daunorubicin+methotrexate+intrathecal injection,4 cases) and CYM (methotrexate+cytarabine+intrathecal injection,3 cases) stages. There were 66 cases of chemotherapy delay in group C, which were common in COPADM (28 cases) and CYVE 1 (low dose cytarabine+high dose cytarabine+etoposide+methotrexate, 12 cases) stages. Multinomial Logistic regression analysis showed that the age over 10 years old ( OR=0.54,95% CI 0.30-0.93), tumor lysis syndrome before chemotherapy ( OR=0.48,95% CI 0.27-0.84) and grade Ⅲ-Ⅳ myelosuppression after chemotherapy ( OR=0.55,95% CI 0.33-0.91)were independent risk factors for chemotherapy delay.The 3-year OS rate and the 3-year EFS rate of children with Burkitt lymphoma in the delayed chemotherapy group were lower than those in the non-delayed chemotherapy group ((79.4±4.9)% vs. (94.2±1.1)%, (80.2±4.8)% vs. (92.0±1.2)%,both P<0.05). The 3-year OS rate of the group C with chemotherapy delay >7 days (42 cases) was lower than that of the group with chemotherapy delay of 1-7 days (22 cases) and the non-delay group (399 cases) ((76.7±6.9)% vs. (81.8±8.2)% vs. (92.7±1.3)%, P=0.002).The 3-year OS rate of the chemotherapy delay group (9 cases) in the COP (vincristine+cyclophosphamide+prednisone) phase was lower than that of the non-chemotherapy delay group (454 cases) ((66.7±15.7)% vs. (91.3±1.4)%, P=0.005). Similarly, the 3-year OS rate of the chemotherapy delay group (11 cases) in the COPADM1 phase was lower than that of the non-chemotherapy delay group (452 cases) ((63.6±14.5)% vs. (91.5±1.3)%, P=0.001). Conclusions:The delayed chemotherapy was related to the age over 10 years old, tumor lysis syndrome before chemotherapy and grade Ⅲ-Ⅳ myelosuppression after chemotherapy in pediatric BL. There is a significant relationship between delayed chemotherapy and prognosis of BL in children.

Objective:Using different machine learning methods to construct and screen the best prediction model for predicting the risk of death within 30 days after surgery in patients with acute type A aortic dissection.Methods:Five hundred and twenty-one patients with acute type A aortic dissection who underwent surgery between 2015 and 2022 were included, after collecting their perioperative date and screening them, 329 patients were retained. two different groups of predictor variables were generated by using Lasso regression and principal component analysis, after that, logistic regression, support vector machine algorithm, random forest algorithm, gradient boosting algorithm, and super learning algorithm were used to develop prediction models for the risk of death within 30 days after surgery. Finally, we compare the models and select the best one. Results:The AUC values for all models rangrd from 0.791-0.959. The model using Lasso regression to determine the predictor variables and built by the super learning algorithm had the best prediction with an AUC value of 0.959. Conclusion:The super learning algorithm better than other algorithms in predicting death within 30 days after acute type A aortic dissection.

Objective To investigate the efficacy of low-dose inhaled nitric oxide (iNO) in the treatment of severe hypoxemia after Sun’s operation. Methods The clinical data of patients undergoing Sun’s operation for acute Type A aortic dissection in our hospital from January 2020 to June 2022 were retrospectively analyzed. Patients who received conventional treatment before November 2021 were enrolled as a control group. After November 2021, iNO was used in our hospital, and the patients who received iNO as an iNO group. The preoperative clinical baseline data, perioperative clinical data and oxygenation index were compared between the two groups. Results A total of 54 patients were included in the control group, including 45 males and 9 females, with an average age of 53.0±10.9 years. A total of 27 patients were included in the iNO group, including 21 males and 6 females, with an average age of 52.0±10.6 years. The preoperative body mass index of the two groups was greater than 25 kg/m2, white blood cell count, C-reactive protein were significantly higher than normal level, but there was no statistical difference between the groups (P＞0.05). There were no statistical differences in intraoperative data between the two groups (P＞0.05). The iNO group had significantly shorter duration of mechanical ventilation, postoperative ICU stay, and postoperative hospital stay than the control group (P<0.001). After 12 h of iNO treatment, hypoxic condition improved obviously, oxygenation indices in 12 h, 24 h, 36 h,48 h, 60 h and 72 h in the iNO group were significantly higher than those in the control group (P<0.05). Conclusion The treatment of severe hypoxemia after Sun’s surgery with low-dose of iNO is safe and effective, can significantly improve oxygenation function, and has significant advantages in shortening ventilator use time, postoperative ICU stay and postoperative hospital stay, but it is not significant in changing postoperative mortality.

Objective: To investigate the incidence density of adult sleep disorders (SD) in Yinzhou District, Ningbo City, Zhejiang Province from 2017 to 2023, so as to provide insights into formulating the control measures of SD. Methods: The electronic health records of permanent residents aged 18 years and over in Yinzhou District from 2017 to 2023 were collected through the Yinzhou Regional Health Information Platform. New cases of SD were diagnosed for the first time a year after establishing health records. The incidence density was estimated using Poisson distribution. The temporal, population and regional distribution characteristics of new cases of SD were analyzed using a descriptively epidemiological method. Results: From 2017 to 2023, there were 1 255 129 permanent residents aged 18 years and over in Yinzhou District, with a total observed person-time of 6 292 884 person-years and a median of 5.67 (interquartile range, 3.74) person-years. There were 165 490 new cases of SD, including 67 095 males (40.54%) and 98 385 females (59.46%). The incidence density of SD in Yinzhou District from 2017 to 2023 was 26.30/1 000 person-years, with no significant trend observed (P>0.05). The incidence density of SD was higher in females than in males (29.63/1 000 person-years vs. 22.57/1 000 person-years, P<0.05). The highest incidence density of SD was observed in individuals aged 70 to <80 years (63.30/1 000 person-years), and the lowest was in individuals aged 18 to <30 years (7.24/1 000 person-years). The incidence density of SD in individuals aged 30 years and over was higher than that in individuals aged 18 to <30 years (all P<0.05). The incidence density of SD was 32.03/1 000 person-years in individuals with junior high school education or below, which was higher than individuals with senior high school/technical secondary school education (25.93/1 000 person-years) and college degree and above (18.87/1 000 person-years, all P<0.05). Dongliu Street, Dongjiao Street, and Baihe Street had relatively higher incidence densities of SD, at 45.11/1 000 person-years, 42.87/1 000 person-years and 40.16/1 000 person-years, respectively. Conclusions From 2017 to 2023, there was no significant trend in the incidence density of SD in Yinzhou District. Higher incidence density were observed in females, the elderly, and individuals living in central urban areas.

Objective To summarize the results and clinical experience of transcatheter valve-in-valve implantation using domestic self-expanding valve in patients with aortic degenerated bio-prosthesis. Methods From January 2019 to April 2023, the patients who underwent transcatheter valve-in-valve surgery in the Department of Cardiac Surgery of Tianjin Chest Hospital due to surgical bio-prosthesis failure were included. Characteristics of valves, perioperative complications, and hemodynamic manifestations during the early postoperative and follow-up period were analyzed. Results A total of 24 patients were enrolled, including 14 males and 10 females with an average age of 68.17±7.72 years, and the average interval between the two operations was 10.48±4.09 years. All patients were successfully discharged without complications such as coronary artery obstruction and pacemaker implantation, and the average transvalvular pressure gradient was 16.39±6.52 mm Hg before discharge. During the median follow-up time of 16 months, the left ventricular diastolic inner diameter and ejection fraction were continuously improved. Conclusion Transcatheter valve-in-valve using domestic self-expanding valves is safe and feasible to treat aortic bioprosthetic valve failure. Sound patient selection and surgical strategies are critical to achieve good hemodynamics.

Breast cancer remains a leading cause of mortality in women worldwide.Triple-negative breast cancer(TNBC)is a particularly aggressive subtype characterized by rapid progression,poor prognosis,and lack of clear therapeutic targets.In the clinic,delineation of tumor heterogeneity and development of effective drugs continue to pose considerable challenges.Within the scope of our study,high hetero-geneity inherent to breast cancer was uncovered based on the landscape constructed from both tumor and healthy breast tissue samples.Notably,TNBC exhibited significant specificity regarding cell prolif-eration,differentiation,and disease progression.Significant associations between tumor grade,prog-nosis,and TNBC oncogenes were established via pseudotime trajectory analysis.Consequently,we further performed comprehensive characterization of the TNBC microenvironment.A crucial epithelial subcluster,E8,was identified as highly malignant and strongly associated with tumor cell proliferation in TNBC.Additionally,epithelial-mesenchymal transition(EMT)-associated fibroblast and M2 macrophage subclusters exerted an influence on E8 through cellular interactions,contributing to tumor growth.Characteristic genes in these three cluster cells could therefore serve as potential therapeutic targets for TNBC.The collective findings provided valuable insights that assisted in the screening of a series of therapeutic drugs,such as pelitinib.We further confirmed the anti-cancer effect of pelitinib in an orthotopic 4T1 tumor-bearing mouse model.Overall,our study sheds light on the unique characteristics of TNBC at single-cell resolution and the crucial cell types associated with tumor cell proliferation that may serve as potent tools in the development of effective anti-cancer drugs.

Objective:To investigate the efficacy and safety of prolonged dual antiplatelet therapy (DAPT) (aspirin + clopidogrel) after coronary artery bypass grafting (CABG) for more than 12 months.Methods:1 900 patients who received CABG treatment in Tianjin Chest Hospital from January 2019 to October 2020 were continuously included, and 1 528 patients were finally identified according to the inclusion and exclusion criteria. According to whether the patients continued to take DAPT treatment 12 months after discharge, they were divided into the extended DAPT group and the standard DAPT group. Cox multivariate regression and propensity score matching (PSM) analysis were performed on major cardiovascular and cerebrovascular adverse events (MACCE) and clinically related bleeding events in the two groups during 12-24 months after discharge to evaluate the efficacy and safety of extended DAPT treatment for more than 12 months. Results:Of the 1 528 patients, 624 (40.8%) continued to take DAPT 12 months after discharge. Compared with patients receiving standard DAPT, patients receiving extended DAPT had a lower incidence of MACCE within 12 to 24 months ( HR=0.597, 95% CI: 0.399-0.892, P=0.012); ( HR=0.519, 95% CI: 0.338-0.798, P=0.003), and there was no significant increase in clinically relevant bleeding risk ( HR=1.209, 95% CI: 0.522-2.798, P=0.658), ( HR=1.112, 95% CI: 0.452-2.737, P=0.817). At the same time, prolonged DAPT treatment also brought a good net benefit. Conclusion:Prolonged DAPT treatment after CABG for more than 12 months significantly reduced the risk of ischemia at 12-24 months after surgery, and did not significantly increase the risk of bleeding at 12-24 months after surgery. It may be beneficial for patients treated with CABG to continue DAPT (aspirin+ clopidogrel) on the basis of intensive DAPT therapy for 1 year.

In vitro studies have established the prevalent theory that the mitochondrial kinase PINK1 protects neurodegeneration by removing damaged mitochondria in Parkinson's disease (PD). However, difficulty in detecting endogenous PINK1 protein in rodent brains and cell lines has prevented the rigorous investigation of the in vivo role of PINK1. Here we report that PINK1 kinase form is selectively expressed in the human and monkey brains. CRISPR/Cas9-mediated deficiency of PINK1 causes similar neurodegeneration in the brains of fetal and adult monkeys as well as cultured monkey neurons without affecting mitochondrial protein expression and morphology. Importantly, PINK1 mutations in the primate brain and human cells reduce protein phosphorylation that is important for neuronal function and survival. Our findings suggest that PINK1 kinase activity rather than its mitochondrial function is essential for the neuronal survival in the primate brains and that its kinase dysfunction could be involved in the pathogenesis of PD.

Objective:To evaluate the testing capacity of HIV-1 viral load testing laboratories, and to provide data references for further improving the accuracy of laboratory test result in China.Methods:The test result of 155 positive samples distributed by the National AIDS Reference Laboratory to each laboratory from 2005 to 2019 were summarized and grouped according to the test assay and sample number. The independent sample t-test was used to evaluate the economic status and the proficiency testing (PT) assessment period on the stability of the test results. And, one-way analysis of variance was used to evaluate the influence of the types of laboratories and reagents on the stability of test results.Results:The number of HIV-1 viral load testing laboratories increased from 13 in 2005 to 267 in 2019. The participating institutions were mainly centers for disease control and prevention(CDC)and hospitals. Since 2015, the excellent rate of laboratories has remained above 85%, and the unqualified rate has remained below 3%. The associated factor analysis showed that the laboratory testing stability of HIV-1 viral load associated with the PT assessment period and the types of testing reagents, and the laboratories participating in the PT assessment for more than 5 years showed better stability.Conclusions:Participating in the annual proficiency testing program helped improve the laboratory capability of HIV-1 viral load testing in China.