Objective: To identify research priorities on physical and mental comorbidity among children and adolescents in Zhejiang Province, so as to provide a theoretical base for improving their physical and mental health. Methods: In May 2025, 77 experts in the fields of health and education from 11 cities in Zhejiang Province were selected by convenient sampling method to participate in the first round of expert consultation. In June, 2025, snowball sampling was used to expand to 194 experts for the second round of consultation, and it was convenient to select 21 students from primary schools to high schools in Zhejiang Province and 29 parents to empower the evaluation criteria. It applied the Child Health and Nutrition Research Initiative (CHNRI) method in a structured process, which encompassed the definition of the research field, generation of research ideas, scoring, and quantitative ranking of priorities. Research ideas were evaluated against 6 predefined criteria: effectiveness, safety, answerability, feasibility, sustainability, and scientific significance. Results: After 2 rounds of structured consultations, 81 research ideas on physical and mental comorbidity among children and adolescents were established and classified into 7 subthemes: epidemiological characteristics and influencing factors, optimization of primary service systems and policies, comprehensive intervention strategies for physical and mental comorbidity, biological mechanisms and clinical research, the impact of education and environment on physical and mental health, special populations and social support, and digital and technology driven disease prevention and intervention. The top 10 research priorities primarily centered on the subdomain of "epidemiological characteristics and influencing factors" (5 items). The top 3 research priorities were "the association between outdoor activity duration and the incidence of common diseases (including mental disorders) among children and adolescents" "the impact of outdoor activity duration on the physical and mental health of adolescents" "comprehensive intervention strategies for myopia, obesity, and their comorbidities among children and adolescents". Conclusion The framework of priority issues in the field of psychosomatic comorbidity of children and adolescents in Zhejiang Province based on CHNRI method provides a reference for optimizing the allocation of provincial research resources.

Background/Aims: Cholangiocarcinoma (CCA) is a primary malignant neoplasm with an extremely poor prognosis. While combined chemoradiotherapy has been demonstrated to delay CCA progression to a certain extent, the absence of specific molecular biomarkers or targets significantly hinders the diagnosis and treatment of CCA. Methods: Through cross-analysis of proteomics and ADMA modificationomics, we identified DDX1 overexpressed in CCA with elevated R602-ADMA modifications. HPLC-MS/MS identified PRMT1 as the methyltransferase and USP10 as the deubiquitinating enzyme for DDX1. Immunofluorescence and nuclear-cytoplasmic partitioning experiments confirmed DDX1’s nuclear localization. GO and KEGG analyses clarify the biological functions of DDX1 in response to hypoxia. RNA-seq transcriptomics analyzed key pathways influenced by DDX1. A hydrodynamic in situ CCA mouse model was established to validate the chemopreventive effects of the PRMT1-specific inhibitor GSK715 on CCA development. Results: DDX1 promotes CCA progression both in vivo and in vitro and can be inhibited by GSK715. Mechanistically, PRMT1 mediates ADMA modification at position R602 of DDX1. This modification promotes DDX1 nuclear localization by recruiting USP10 to deubiquitinate DDX1, while simultaneously inhibiting PRMT1 degradation. DDX1 promotes the transcription of PRMT1 and USP10 by binding to the mRNA 3’UTR region, establishing a positive feedback regulatory pathway. This mechanism promotes the occurrence and development of CCA and can serve as a target for the inhibitor GSK715 to suppress CCA progression. Conclusions Our study identified DDX1-R602-ADMA modification as a novel ADMA modification in CCA. It further confirmed its pivotal role in CCA progression. Targeting the USP10-PRMT1-DDX1 axis may represent a significant therapeutic approach for CCA.

Objective:To explore the impact of the interaction between alcohol consumption and overweight/obesity on the risk of hypertension.Methods:It was a cross-sectional study, and convenient sampling was used to enroll physical examination participants aged 18-60 years from the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, the Affiliated Hospital of Southwest Medical University and Luzhou People′s Hospital from June to November in 2020. All the participants were given questionnaire survey, physical examination and biochemical tests. A total of 5 000 questionnaires were distributed in the study, and 4 878 questionnaires were collected, of which 4 397 (90.14%) were valid. According to the diagnostic criteria for hypertension, the study participants were divided into hypertension group (1 128 cases) and non-hypertension group (3 269 cases), and t-test and chi-square test were used to compare the differences in gender, age, and other data between the two groups; and multivariate logistic regression analysis was used to analyze the association of alcohol consumption, overweight/obesity with the risk of hypertension and the interaction between alcohol consumption and overweight/obesity on the risk of hypertension, and relative excess risk of interaction, attributable proportion of interaction and the synergy index were used to evaluate the impact of the interaction between alcohol consumption and overweight/obesity on the risk of hypertension. Results:Among the 4 397 individuals included in the analysis, 3 116 were male and 1 281 were female, with a mean age of (42.42±8.83) years. The detection rate of hypertension was 25.7% (1 128/4 397). The risk of hypertension in overweight/obese individuals was 2.566 times ( OR=2.566, 95% CI: 2.167-3.038) higher than that of non-overweight/obese individuals, and the risk of hypertension in alcohol consumption individuals was 1.486 times ( OR=1.486, 95% CI: 1.250-1.766) higher than that of non-drinkers. The risk of hypertension in drinking+non-overweight/obesity group, non-drinking+overweight/obesity group, and drinking+overweight/obesity group was 1.468 times ( OR=1.468, 95% CI: 1.112-1.936), 2.538 times ( OR=2.538, 95% CI: 1.968-3.272), and 3.796 times ( OR=3.796, 95% CI: 2.963-4.863) higher than that of non-drinking+non-overweight/obesity group, respectively (all P<0.05). Alcohol consumption and overweight/obesity had an additive interaction effect on the risk of hypertension, and the relative excess risk of interaction, attributable proportion of interaction and the synergy index was 0.791 (95% CI: 0.158-1.424), 0.208 (95% CI: 0.049-0.368), 1.394 (95% CI: 1.030-1.888), respectively. There was no significant multiplicative interaction between alcohol consumption and overweight/obesity on the risk of hypertension ( P>0.05). Conclusions:Alcohol consumption and overweight/obesity are both associated higher risk of hypertension. In addition, there is an additive interaction between alcohol consumption and overweight/obesity on the risk of hypertension.

Objective To explore the molecular mechanism by which curcumin enhances the anti-tuberculosis function of macrophages through immune metabolic regulation mediated by liver X receptor α(LXRα)/ABCA1.Methods A model was established by infecting THP-1-derived macrophages with attenuated strain of Mycobacterium bovis(M.bovis).The control group,curcumin group,M.pavis group,M.pavis+LXRα agonist(T0901317)group,M.pavis+LXRα inhibitor(GSK2033)group,M.pavis+curcumin group,M.pavis+curcumin+GSK2033 group and M.pavis+curcumin+T0901317 group were set up.The protein and gene expressions of LXRα/ABCA1 were detected by Western blotting and real-time fluorescence quantitative polymerase chain reaction(RT-qPCR).The accumulation of lipid droplets was analyzed by Oil Red O staining and micro-assay.The lipid content of the supernatant was determined by a biochemical analyzer,and cell proliferation was assessed by the MTT method.Bacterial clearance capacity was evaluated by measuring intracellular bacterial load.Results Curcumin significantly upregulated the protein and gene expression of LXRα/ABCA1 in M.Bovis-infected macrophages,reduced intracellular lipid accumulation and promoted lipid efflux,while enhancing cell proliferation and reducing intracellular bacterial load(P<0.05,P<0.01).LXRα inhibitors could reverse the effect of curcumin,while agonists synergistically enhanced its effect.Correlation analysis showed that the expression of LXRα/ABCA1 in cells was negatively correlated with the intracellular bacterial load,while the lipid level was positively correlated with the intracellular bacterial load(P<0.01).Conclusion Curcumin activates the LXRα/ABCA1 pathway,coordinates the metabolic remodeling of macrophages and the enhancement of immune function,and forms a synergistic effect against tuberculosis,providing an experimental basis for the development of a novel host-directed treatment strategy for tuberculosis based on immune-metabolic regulation.

Aim To investigate the predictive value of lipoprotein(a)[Lp(a)]combined with systemic inflam-matory response index(SIRI)on in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)in patients with coronary heart disease.Methods The clinical data of 770 patients with coronary heart disease who underwent PCI in the Department of Cardiovascular Medicine of the First Affiliated Hospital of Xinjiang Medical University from May 2012 to December 2024 and underwent coronary angiography six months after surgery were collected.According to the imaging re-sults,the patients were divided into ISR group(n=194)and non-ISR group(n=576).Multivariate Logistic regression and random forest model were used to analyze the independent risk factors of ISR.Risk factors included in the analysis were glycated hemoglobin,SIRI,Lp(a),lymphocyte count,apolipoprotein A1(ApoA1)and residual cholesterol.Results The levels of Lp(a)and SIRI in the ISR group were significantly higher than those in the non-ISR group(P＜0.05).ROC curve analysis showed that the area under the curve of the combined indicator of Lp(a)and SIRI was 0.789,which was higher than the 0.652 of the single indicator Lp(a)and 0.778 of SIRI.Conclusion Lp(a)and SIRI are independent risk factors for the occurrence of ISR after PCI,and the combination of Lp(a)and SIRI can better predict the occurrence of ISR.

Objective To analyze serum prolactin(PRL)levels during pregnancy in healthy single pregnant women of childbearing age in Suzhou,and to establish and verify the reference interval of serum PRL.Methods From January to March,2022,the data of pregnant women with healthy single pregnancy at child-bearing age were collected and prospectively followed up until delivery.According to the gestational age,the subjects were divided into early pregnancy group(less than 14 weeks),middle pregnancy group(14-27+6 weeks)and late pregnancy group(≥28 weeks).PRL was determined by Soling LIAISON XL automatic chemi-luminescence immunoassay and LIAISON? prolactin.After eliminating outliers,the medical reference interval of serum PRL during pregnancy was established by percentile method(P2.5-P97.5).In addition,20 samples of healthy single pregnant women of childbearing age were randomly collected in early,middle and late pregnancy to verify the established reference interval.When no more than two PRL measurements in each group exceeded the established reference interval,they were considered validated.Results A total of 170 participants were included in the early pregnancy group,229 participants in the middle pregnancy group and 130 participants in the late pregnancy group.There were significant differences in serum PRL levels in pregnant women at different stages of pregnancy.With the increase of gestational age,serum PRL level increased.The reference intervals of serum PRL in early,middle and late pregnancy were 477-4270 mIU/L,1060-6574 mIU/L and 3497-18 274 mIU/L,respectively.All the established reference intervals were verified.Conclusion This study has established the reference interval of serum PRL during pregnancy of healthy single pregnant women of childbear-ing age in Suzhou area,to provide help for clinical rational application of this index,and further reference for the prevention of pregnancy-related diseases.

Acute respiratory distress syndrome(ARDS)is a common respiratory emergency,but current clinical treatment remains at the level of symptomatic support and there is a lack of effective targeted treatment measures.Our previous study confirmed that inhalation of hydrogen gas can reduce the acute lung injury of ARDS,but the application of hydrogen has flammable and explosive safety concerns.Drinking hydrogen-rich liquid or inhaling hydrogen gas has been shown to play an important role in scavenging reactive oxygen species and maintaining mitochondrial quality control balance,thus improving ARDS in patients and animal models.Coral calcium hydrogenation(CCH)is a new solid molecular hydrogen carrier prepared from coral calcium(CC).Whether and how CCH affects acute lung injury in ARDS re-mains unstudied.In this study,we observed the therapeutic effect of CCH on lipopolysaccharide(LPS)induced acute lung injury in ARDS mice.The survival rate of mice treated with CCH and hydrogen inhalation was found to be comparable,demonstrating a significant improvement compared to the untreated ARDS model group.CCH treatment significantly reduced pulmonary hemorrhage and edema,and improved pulmonary function and local microcirculation in ARDS mice.CCH promoted mitochon-drial peripheral division in the early course of ARDS by activating mitochondrial thioredoxin 2(Trx2),improved lung mitochondrial dysfunction induced by LPS,and reduced oxidative stress damage.The results indicate that CCH is a highly efficient hydrogen-rich agent that can attenuate acute lung injury of ARDS by improving the mitochondrial function through Trx2 activation.

Aim To study the renal protective effect of balanophora polysaccharide(BPS)on diabetic nephrop-athy(DN)mice and explore the related mechanisms.Methods A DN mouse model was induced using a high-fat diet combined with intraperitoneal injection of streptozotocin(STZ),which was indicated by fasting blood glucose higher than 11.1 mmol·L-1,accompa-nied by diabetic symptoms such as polydipsia,polydia-gia,polyuria and weight loss,then BPS intervention was performed.Body weight and fasting blood glucose of each group mice were detected;automatic biochemical analyzer was used to detect blood creatinine(SCr),blood urea nitrogen(BUN),24 h urinary protein(24 h UP),triglycerides(TG),total cholesterol(TC),alanine aminotransferase(ALT)content;ELISA was applied to determine serum inflammatory factor interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)level;HE and Masson staining were employed to observe renal his-topathological morphology;Western blot was used to de-tect Toll-like receptor 4(TLR4),myeloid differentiation factor 88(MyD88),nuclear factor κB(NF-κB)for pro-tein expression.Results Compared with the model group,after BPS,body weight and fasting blood glucose decreased(P＜0.01 or P＜0.05);SCr,BUN,24 h UP,TC,TG and ALT significantly decreased(P＜0.01 or P＜0.05);the levels of the proinflammatory factors TNF-α and IL-6 were significantly reduced(P＜0.01 or P＜0.05);renal tissue injury and fibrosis decreased;TLR4,MyD88,NF-κB protein expression significantly decreased(P＜0.01 or P＜0.05).Conclusion BPS has a protective effect on the kidneys of DN mice,re-ducing the blood glucose level,improving liver and kid-ney function,alleviating renal tissue damage and renal fibrosis,and reducing inflammation response.Its mecha-nism may be related to the regulation of TLR4/MyD88/NF-κB signaling pathway.

Objective To explore the effect of rituximab on cellular immunity and cytokines in children with new-onset steroid-sensitive nephrotic syndrome(SSNS).Methods Clinical data of 60 children with new-onset SSNS treated at Xuzhou Children's Hospital from December 2021 to March 2023 were retrospectively analyzed.Children were allocated according to rituximab use into a control group(no rituximab)and an observation group(rituximab).The relapse rate,T-lymphocyte subsets and cytokines before and after treatment,and the incidence of adverse reactions were compared between groups.Results The relapse rate was lower in the observation group than in the control group(27%vs 73%,P<0.05).After treatment,CD3+and CD4+T-lymphocyte counts,the CD4+/CD8+ratio,and serum interleukin-2 increased in the observation group and were higher than in the control group(P<0.05).Interleukin-6 and tumor necrosis factor-α levels decreased after treatment in the observation group and were lower than in the control group(P<0.05).After treatment,CD8+T-lymphocyte counts decreased,interferon-γ increased,and interleukin-10 decreased in both groups,with no significant differences between the two groups(P>0.05).The incidence of adverse reactions did not differ significantly between the two groups(P>0.05).Conclusions Rituximab can reduce the relapse rate in children with new-onset nephrotic syndrome and shows good safety.Its therapeutic effect is achieved by regulating the number and function of T cells and by modulating the anti-inflammatory effects of cytokines.

In view of the characteristics of H5N6 subtype avian influenza virus(AIV)that it has both high pathogenicity and the risk of cross-species transmission,posing a serious threat to the poultry farming industry and public health security,in order to effectively prevent and control the spread of H5N6 avian influenza,a rapid,sensitive and specific detection technolo-gy was established in this study.The specific monoclonal antibodies against the neuraminidase N6 protein of avian influenza A virus subtype H5N6 were obtained through hybridoma and monoclonal antibody technology.These antibodies were coupled and labeled with carboxyl-functionalized fluorescent quantum dots,along with previously prepared specific antibodies against the hemagglutinin H5 protein.A rapid fluorescence immunochromatographic detection method for the H5N6 subtype of avian influ-enza virus was established according to the principle of double-antibody sandwich immunochromatography.This method a-chieved a detection sensitivity of 1 ng/mL for recombinant hemagglutinin H5 subtype protein and 0.1 ng/mL for recombinant neuraminidase N6 subtype protein.Moreover,the method exhibited no cross-reactivity with other influenza subtypes or patho-gens,such as Newcastle disease(ND),infectious bronchitis(IB),and infectious laryngotracheitis(ILT),thus demonstrating good specificity.The method effectively identified the highly pathogenic avian influenza virus H5 subtype and directly distin-guished the H5N6 subtype with good accuracy.The fluorescent quantum dot immunochromatographic typing detection method established herein met the sensitivity,specificity,and accuracy requirements for H5N6 subtype detection,and can be further used for rapid detection of the H5 and H5N6 subtypes of avian influenza virus.