Objective: To examine the association between health behaviors and depressive symptoms among junior and senior high school students, so as to provide evidence for combined behavioral interventions targeting adolescent mental health. Methods: From September to November 2023, a stratified cluster random sampling method was used to recruit 104 834 junior and senior high school students from all 13 prefecture level cities (124 districts/counties) in Heilongjiang Province, China. Multivariable Logistic regression models, as well as multiplicative and additive interaction analyses were employed to analyze the associations between health behaviors and depressive symptoms, and Chi-square tests for trend were conducted to explore ,the changing tendency in the risk of depressive symptoms with increasing numbers of health behaviors among junior and senior high school students. Results: Healthy diet ( OR =0.66, 95% CI =0.63-0.68), healthy physical activity ( OR =0.47, 95% CI =0.45-0.49), healthy outdoor activity ( OR =0.55, 95% CI =0.52-0.57), healthy sleep ( OR =0.72, 95% CI =0.69-0.75), and healthy screen use ( OR =0.79, 95% CI =0.76-0.82) were independently associated with lower rates of depressive symptoms (all P <0.01). The risk of depressive symptoms decreased progressively with an increasing cumulative number of health behaviors ( χ 2 trend =996.73, P <0.01). Except for the interaction between healthy diet and healthy sleep, significant additive interactions were observed among the remaining health behaviors( RERI =0.07-0.23,all P <0.05). The probability of depressive symptoms was lower among girls with 2-3 healthy behaviors than among boys ( Z =2.51, 2.65), lower among urban students with 2-3 healthy behaviors than among suburban county students ( Z =-2.36, -2.04), and lower among senior high school students with 2-4 healthy behaviors than among junior high school students ( Z =2.17, 2.10, 2.04) (all P <0.05). Conclusions Health behaviors are significantly associated with depressive symptoms among junior and senior high school students. The probability of depressive symptoms is lower among girls, urban students, and senior high school students who engage in multiple healthy behaviors. Implementing combined interventions targeting multiple health behaviors in these populations may yield greater benefits.

Objective:To analyze the clinical characteristics and outcomes of Haemophilus influenzae (Hi) meningitis in children. Methods:This is a retrospective case series study. This study included 34 Hi meningitis patients who admitted to Beijing Children′s Hospital, Capital Medical University, from January 1, 2010, to December 31, 2023. Data on clinical presentations, laboratory tests, hearing assessment and outcomes at discharge were collected. Patients were divided into 2 groups according to the outcome at discharge: favorable outcome group and unfavorable outcome group. Mann-Whitney U test and Fisher exact test was used to estimate the risk factors for an unfavorable outcome at discharge. Results:Thirty-four patients were enrolled. There were 16 males and 18 females. The age at onset ranged from 3 months to 12 years. Fever (34 patients (100%)), convulsions (17 patients (50%)), and coma (21 patients (62%)) were the common clinical presentations. Twenty-four patients (71%) developed complications. There were 15 patients (44%) needed treatment in the intensive care unit, 5 patients (15%) received intubation, and 4 patients (12%) had developed shock. The favorable outcome group included 23 patients, and the unfavorable outcome group included 11 patients. Female, patients with limb movement disability, dystonia, ventriculomegaly or hydrocephalus, and a concentration of glucose in the initial cerebrospinal fluid lower than 1 mmol/L were risk factors of unfavorable outcome at discharge (all P<0.05). Among the 23 patients (68%) in favorable outcomes group, 13 patients (57%) had data available on their long-term follow-up results, including 12 patients with favorable long-term outcomes and 1 patient with unfavorable long-term outcome. Among the 11 patients (32%) in unfavorable outcomegroup, 1 patient died, the other 10 patients (91%) had data available on their long-term outcomes. Eight patients had unfavorable long-term outcomes and 2 patients with favorable long-term outcomes. Patients who had unfavorable outcomes at discharge were at a greater risk of experiencing unfavorable long-term outcomes ( P=0.001). Conclusions:It is common for patients with Hi meningitis to have intracranial complications or develop into critical conditions. Patients who have limb movement disability, dystonia, ventriculomegaly or hydrocephalus, and who exhibit a concentration of glucose in the initial cerebrospinal fluid lower than 1 mmol/L tend to have unfavorable outcomes; they need to be assessed for sequelae.

Objective To investigate the relationships of serum levels of Xenin-25 and activin A with pregnancy outcomes in patients with gestational diabetes mellitus(GDM).Methods A total of 269 pregnant women with GDM admitted to our hospital between December 2020 and February 2023 were enrolled.Serum levels of Xenin-25 and activin A were measured,and pregnancy outcomes were recorded.Based on pregnancy outcomes,patients were divided into poor pregnancy outcome group(91 cases)and good pregnancy outcome group(178 cases).The influencing factors of adverse preg-nancy outcomes of GDM patients and the predictive value of Xenin-25 and activin A for GDM preg-nancy outcomes were analyzed.Results The poor pregnancy outcome group had higher age,pre-pregnancy body mass index(BMI),proportion of adverse obstetric history,as well as levels of fasting plasma glucose(FPG),glycated hemoglobin(HbA1c),and activin A compared to the good preg-nancy outcome group,and serum level of Xenin-25 was lower in the poor pregnancy outcome group(P＜0.05).High HbA1c and high activin A levels were identified as risk factors for pregnancy out-comes in GDM patients,while high Xenin-25 was a protective factor for pregnancy outcomes(P＜0.05).The areas under the curve(AUCs)for predicting adverse pregnancy outcomes in GDM pa-tients using Xenin-25 and activin A were 0.895 and 0.865,respectively,while the AUC for com-bined prediction was 0.981,which was higher than that of Xenin-25 or activin A alone(P＜0.05).Conclusion Xenin-25 and activin A in GDM patients are associated with adverse pregnancy outcomes and can serve as biomarkers for predicting pregnancy outcomes.

Abstract Breastfeeding has an irreplaceable effect on the growth and development of premature infants and the reduction of complications during hospitalization. In recent years, with the opening of China′s birth policy, the incidence of premature babies has increased, and the corresponding complications have also gradually increased. Breast milk not only carries a rich supply of nutrients, including rich proteins, lipids, sugars to support the normal growth and development of infants, but also contains a large number of immunoglobulins, hormones and other bioactive substances to promote the improvement of body immune function and the development of nervous system. In recent years, many studies have been carried out on the current situation of breast milk operation in breast milk bank, the collection and influencing factors of breast milk, the strategies of breast milk enrichment and its effects on the growth and development of premature infants and complications. Therefore, breast-feeding and intensive breast-feeding can effectively promote the growth and development of premature infants, and reduce the occurrence of complications.

Objective To investigate the relationship between serum G protein-coupled estrogen receptor 1(GPER1),complement factor H(CFH)levels and pregnancy outcomes in patients with gestational diabetes mellitus(GDM).Methods A total of 120 patients with GDM(GDM group)and 60 healthy pregnant women(control group)were included in this study.According to the pregnancy outcome,GDM patients were divided into the adverse pregnancy outcome(APO)group(50 cases)and the non-APO group(70 cases).The basic data of GDM patients were collected.Fasting blood glucose,fasting insulin and blood lipids were measured,and homeostasis model assessment of insulin resistance index(HOMA-IR)was calculated.The serum levels of GPER1 and CFH were detected by enzyme-linked immunosorbent assay.Pearson correlation analysis was used to analyze the correlation between serum levels of GPER1,CFH and HOMA-IR in GDM patients.Multivariate unconditional Logistic regression and receiver operating characteristic(ROC)curve were used to analyze the relationship between serum GPER1 and CFH levels and APO in GDM patients and to predict energy efficiency.Results Compared with the control group,serum levels of GPER1 and CFH were increased in the GDM group(P<0.05).Serum GPER1 and CFH levels were positively correlated with HOMA-IR in GDM patients(r=0.722 and 0.714,respectively,P<0.001).Compared with the non-APO group,serum levels of GPER1 and CFH were increased in the APO group(P<0.05).Elevated levels of HOMA-IR,GPER1 and CFH were independent risk factors for APO in GDM patients(P<0.05).The combined prediction of serum GPER1 and CFH[AUC=0.887(95%CI:0.816-0.937)]was superior to serum GPER1[AUC=0.789(95%CI:0.705-0.858)]and CFH[AUC=0.786(95%CI:0.701-0.856)]alone in predicting APO in GDM patients.Conclusion Serum levels of GPER1 and CFH in GDM patients are increased,which are closely related to the enhancement of insulin resistance and APO.The combination of the two has a higher predictive efficiency for APO.

Objective : To explore the polymorphism of endothelial nitric oxide synthase(eNOS) gene in umbilical cord blood of preterm infants and its relationship with major complications in preterm infants. Methods : A total of 254 preterm infants(<37 weeks) who were hospitalized were selected as the study subjects. Umbilical cord blood was collected at delivery to determine the genotypes and alleles of eNOS gene at three loci: rs61722009, rs2070744,and rs1799983. Clinical data of the preterm infants were recorded, and the relationship between eNOS gene polymorphism and major complications in preterm infants was analyzed. Results: (1) The TC+CC genotype at locus rs2070744 was an independent risk factor for bronchopulmonary dysplasia(BPD) in preterm infants, with an OR(95%CI) of 1.266(1.017-1.577).(2) The GT+TT genotype at locus rs1799983 was an independent risk factor for retinopathy prematurity(ROP), with an OR(95%CI) of 1.184(1.008-1.391).(3) The AB+AA genotype at locus rs61722009 was also an independent risk factor for ROP,with an OR(95%CI) of 1.335(1.033-1. 726).(4) There was no significant relationship between gene polymorphism and the occurrence of respiratory distress syndrome( RDS) and periventricular-intraventricular hemorrhage( PIVH). Conclusion eNOS gene polymorphism is associated with the occurrence of BPD and ROP in preterm infants. The evaluation of e NOS gene polymorphism by umbilical cord blood measurement is helpful for the prevention and correct management of some serious complications.

Cataract surgery is one of the most common ophthalmologic procedures. Advances in technology and medical policies have made it more precise. Residual refractive errors and deviation of target diopters are a main cause of dissatisfaction among patients. Refractive enhancement after cataract surgery can correct or eliminate these errors, improving patients' visual quality of life. There are multiple options for correcting residual refractive errors. The best approach depends on factors like the cause of the error, degrees of residual refractive errors, type of intraocular lens, ocular comorbidities, and patient preference. This paper summarizes the incidence and types of residual refractive errors, advancements in refractive enhancement surgeries, and provides practical solutions for clinical practice.

Objective To investigate the relationship between serum G protein-coupled estrogen receptor 1(GPER1),complement factor H(CFH)levels and pregnancy outcomes in patients with gestational diabetes mellitus(GDM).Methods A total of 120 patients with GDM(GDM group)and 60 healthy pregnant women(control group)were included in this study.According to the pregnancy outcome,GDM patients were divided into the adverse pregnancy outcome(APO)group(50 cases)and the non-APO group(70 cases).The basic data of GDM patients were collected.Fasting blood glucose,fasting insulin and blood lipids were measured,and homeostasis model assessment of insulin resistance index(HOMA-IR)was calculated.The serum levels of GPER1 and CFH were detected by enzyme-linked immunosorbent assay.Pearson correlation analysis was used to analyze the correlation between serum levels of GPER1,CFH and HOMA-IR in GDM patients.Multivariate unconditional Logistic regression and receiver operating characteristic(ROC)curve were used to analyze the relationship between serum GPER1 and CFH levels and APO in GDM patients and to predict energy efficiency.Results Compared with the control group,serum levels of GPER1 and CFH were increased in the GDM group(P<0.05).Serum GPER1 and CFH levels were positively correlated with HOMA-IR in GDM patients(r=0.722 and 0.714,respectively,P<0.001).Compared with the non-APO group,serum levels of GPER1 and CFH were increased in the APO group(P<0.05).Elevated levels of HOMA-IR,GPER1 and CFH were independent risk factors for APO in GDM patients(P<0.05).The combined prediction of serum GPER1 and CFH[AUC=0.887(95%CI:0.816-0.937)]was superior to serum GPER1[AUC=0.789(95%CI:0.705-0.858)]and CFH[AUC=0.786(95%CI:0.701-0.856)]alone in predicting APO in GDM patients.Conclusion Serum levels of GPER1 and CFH in GDM patients are increased,which are closely related to the enhancement of insulin resistance and APO.The combination of the two has a higher predictive efficiency for APO.

Objective:To analyze the clinical characteristics and outcomes of Haemophilus influenzae (Hi) meningitis in children. Methods:This is a retrospective case series study. This study included 34 Hi meningitis patients who admitted to Beijing Children′s Hospital, Capital Medical University, from January 1, 2010, to December 31, 2023. Data on clinical presentations, laboratory tests, hearing assessment and outcomes at discharge were collected. Patients were divided into 2 groups according to the outcome at discharge: favorable outcome group and unfavorable outcome group. Mann-Whitney U test and Fisher exact test was used to estimate the risk factors for an unfavorable outcome at discharge. Results:Thirty-four patients were enrolled. There were 16 males and 18 females. The age at onset ranged from 3 months to 12 years. Fever (34 patients (100%)), convulsions (17 patients (50%)), and coma (21 patients (62%)) were the common clinical presentations. Twenty-four patients (71%) developed complications. There were 15 patients (44%) needed treatment in the intensive care unit, 5 patients (15%) received intubation, and 4 patients (12%) had developed shock. The favorable outcome group included 23 patients, and the unfavorable outcome group included 11 patients. Female, patients with limb movement disability, dystonia, ventriculomegaly or hydrocephalus, and a concentration of glucose in the initial cerebrospinal fluid lower than 1 mmol/L were risk factors of unfavorable outcome at discharge (all P<0.05). Among the 23 patients (68%) in favorable outcomes group, 13 patients (57%) had data available on their long-term follow-up results, including 12 patients with favorable long-term outcomes and 1 patient with unfavorable long-term outcome. Among the 11 patients (32%) in unfavorable outcomegroup, 1 patient died, the other 10 patients (91%) had data available on their long-term outcomes. Eight patients had unfavorable long-term outcomes and 2 patients with favorable long-term outcomes. Patients who had unfavorable outcomes at discharge were at a greater risk of experiencing unfavorable long-term outcomes ( P=0.001). Conclusions:It is common for patients with Hi meningitis to have intracranial complications or develop into critical conditions. Patients who have limb movement disability, dystonia, ventriculomegaly or hydrocephalus, and who exhibit a concentration of glucose in the initial cerebrospinal fluid lower than 1 mmol/L tend to have unfavorable outcomes; they need to be assessed for sequelae.

As a classic prescription for invigorating spleen and replenishing qi, Sijunzi Decoction has a good clinical efficacy in the treatment of gastric cancer. It can improve chemotherapy resistance, reduce the toxic and side effects of chemotherapy, promote postoperative recovery, enhance immunity, improve the nutritional status of patients, improve the quality of life of patients and prevent precancerous lesions. Network pharmacology studies have shown that Sijunzi Decoction exerts anti-gastric cancer effects through multiple active ingredients, multiple targets and multiple pathways, and quercetin may be the main active component in Sijunzi Decoction to exert anti-gastric cancer effects. The main mechanisms of Sijunzi Decoction in the treatment of gastric cancer include regulating the expression of cell cycle and apoptosis-related gene proteins, and inhibiting the proliferation, migration, invasion and gastric cancer stem cell characteristics of gastric cancer cells.