ObjectiveTo explore the associations among depressive symptoms, psychological resilience, and mental health literacy in adolescents, so as to provide new insights for interventions targeting adolescent depressive symptoms. MethodsA stratified multistage cluster sampling method was employed to select 2 723 students aged 10‒18 years from primary and secondary schools at different educational stages in Putuo District of Shanghai from December 2024 to January 2025. The Patient Health Questionnaire-9 (PHQ-9, total score0‒27, with a score ≥10 indicating positive depressive symptoms), the Resilience Scale for Chinese Adolescents (RSCA , total score 27‒135), and a mental health core knowledge awareness questionnaire (total score 0‒10) were utilized to assess depressive symptoms, psychological resilience, and mental health literacy, respectively. A network model was constructed using the nine PHQ-9 items (including anhedonia, depressed mood, sleep problems, fatigue, appetite problems, guilt, trouble concentrating, psychomotor symptoms, and self-harm or suicidal thoughts), five RSCA dimensions (including goal orientation, emotion regulation, positive cognition, family support, and interpersonal assistance), and the total mental health literacy score as nodes to analyze the association structure among these nodes. Standardized node strength, standardized expected influence, and standardized bridge expected influence were calculated. ResultsThe PHQ-9 score was 4.62±5.27, yielding a positive screening rate for depressive symptoms of 15.28%. The scores of the RSCA and mental health literacy were 97.71±20.58 and 9.00 (8.00, 10.00), respectively. Network analyses revealed that emotion regulation and depressed mood were core nodes in the network (standardized strength values were 1.74 and 0.97); they constituted the main connection between depressive symptoms and psychological resilience networks (edge weight was -0.17). Mental health literacy and positive cognition served as the main bridge nodes linking depressive symptoms and psychological resilience (standardized bridge expected influence values were 1.42 and 1.27). ConclusionDepressed mood, emotion regulation, positive cognition, and mental health literacy are closely associated with depressive symptoms, psychological resilience, and mental health literacy in adolescents. Strengthening interventions targeting emotion regulation, positive cognition and mental health literacy may contribute to the prevention and control of depressive symptoms among adolescents.

Objective:To explore the chain mediating effect of coping style and illness perception between intolerance of uncertainty and fear of disease progression in patients with intracranial aneurysm.Methods:A total of 270 patients with intracranial aneurysms admitted to the neurosurgery department of 2 hospitals in Guangzhou from October 2023 to June 2024 were selected by convenience sampling method. The general information questionnaire, intolerance of uncertainty scale-12, the brief disease perception questionnaire, medical coping mode questionnaire(MCMQ) and fear of progression questionnaire-short form were used to investigate the subjects. Statistical description and Spearman correlation analysis were performed using IBM SPSS 25.0 software, and AMOS 23.0 software was used to test and correct the structural equation models.Results:The total score of fear of disease progression in patients with intracranial aneurysms was 27.50(20.00, 34.00). The total score of intolerance of uncertainty was 23.50(19.75, 29.00). The sores of confrontation, avoidance and submission in MCMQ were 18.69±5.44, 12.00(10.00, 15.00) and 7.00(5.00, 9.00), respectively.The total score of illness perception was 37.23±11.60. Fear of disease progression was positively correlated with intolerance of uncertainty, submission and illness perception ( r=0.614, 0.696, 0.680, all P<0.01). The direct effect of intolerance of uncertainty on fear of disease progression was significant in patients with intracranial aneurysms ( β=0.431, P<0.001). Intolerance of uncertainty indirectly affected fear of disease progression through submission ( β=0.181, P<0.001) and illness perception ( β=0.092, P<0.001). Submission and illness perception played chain-mediating effect in the relationship between intolerance of uncertainty and fear of disease progression ( β=0.103, P<0.001). Conclusion:The intolerance of uncertainty in patients with intracranial aneurysms can positively predict the fear of disease progression. Submission and illness perception played a chain mediating role between intolerance of uncertainty and fear of disease progression in patients with intracranial aneurysms.

Objective:To evaluate the clinical outcomes of endoscopic-assisted polyether ether ketone (PEEK) patient-specific implant (PSI) revision for over-resected mandibles caused by the mandibular angle osteotomy.Methods:A retrospective analysis was conducted on 24 patients [8 males, 16 females, aged 19-57 (32.5±9.5) years] with 39 over-resected mandibles that underwent PEEK-PSI mandibular angle revision surgery at the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University from January 2019 to December 2023. Preoperative cone-beam computed tomography (CBCT) data were used to design and fabricate customized PEEK PSIs based on individual anatomical requirements. An intraoral incision approach with endoscopic assistance was employed to meticulously dissect soft tissue attachment around the angle region, followed by the implantation of a customized PEEK PSI. Postoperative CBCT scans were performed for 3D reconstruction, with root mean square error (RMSE) and maximum deviation (MaxD) as accuracy metrics. Patients′ satisfaction was assessed preoperatively and ≥6 months postoperatively using the face questionnaire (FACE-Q) scores, which included overall facial appearance, lower face and jawline, appearance distress, psychological health and social function.Results:All 24 patients achieved satisfactory recovery with primary healing of intraoral incisions. No complications such as infection, nerve injury, or implant rejection occurred during follow-up period. Patients′ facial appearance and jaw line contouring were significantly improved. Fine anatomical fitting between PEEK-PSI and defect areas was observed: RMSE ranged from 0.117 to 0.315 mm, and MaxD was (5.485±1.300) mm. FACE-Q scores demonstrated significant improvements after surgery in overall facial appearance [(49.8±5.4) vs (65.0±5.3) scores], lower face and jawline [(42.5±5.3) vs (56.1±4.6) scores], appearance distress [(60.0±6.9) vs (70.6±6.5) scores], psychological health [(62.0±5.0) vs (70.8±5.3) scores], and social function [(60.3±4.3) vs (69.3±5.8) scores] (all P<0.001). Conclusion:Endoscopic-assisted PEEK-PSI revision for over-resected mandibles following mandibular angle osteotomy exhibits high surgical precision and safety, effectively restoring mandibular contour and significantly enhancing patients′ satisfaction.

Objective:To investigate the clinical outcomes of precapsular pocket repositioning for correcting implant malposition following augmentation mammoplasty.Methods:A retrospective analysis was conducted on 29 female patients aged 25-37 (28.8±3.4) years who underwent precapsular pocket repositioning at the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University from December 2015 to August 2024. The surgical technique involved preserving the original capsule, creating a new implant pocket anterior to the capsule, and closing the original capsular space. Postoperative complications were recorded, and breast satisfaction was evaluated preoperatively and at 6 months postoperatively using the BREAST-questionnaire (BREAST-Q).Results:All 29 patients successfully underwent precapsular pocket repositioning with primary wound healing. During the follow-up period, all patients were satisfied with the correction of implant malposition. The mean BREAST-Q score improved significantly from (43.56±3.17) scores preoperatively to (72.56±13.49) scores at 6 months postoperatively ( P<0.001). No hematoma, implant rupture, recurrent malposition, capsular contracture, or surgical site infection occurred in any patient. Conclusion:Precapsular pocket repositioning provides favorable clinical outcomes for patients with implant malposition after augmentation mammoplasty, and there are no severe complications .

Objective:To evaluate the effects and underlying mechanisms of metabolites derived from the kidney-reinforcing, blood circulation-activating, and collateral dredging decoction on the proliferation of multiple myeloma (MM) KM3 cells.Methods:MM KM3 cells in the logarithmic growth phase were treated with 3%, 6%, 9%, or 12% metabolites of kidney-reinforcing, blood circulation-activating, and collateral dredging decoction. Cell viability was assessed using the CCK-8 assay. Apoptosis and necrosis were evaluated using flow cytometry and TUNEL staining. Mitochondrial and cellular ultrastructural changes were examined using transmission electron microscopy. mRNA and protein expression levels of dynamin-related protein 1 (Drp1), mitochondrial fission protein 1 (Fis1), mitochondrial fission factor (MFF), PTEN-induced kinase 1 (Pink1), and E3 ubiquitin ligase (Parkin) were determined through quantitative real-time PCR and western blotting. High-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) combined with network pharmacology, was utilized for reverse verification of the pharmacodynamic mechanisms and therapeutic targets underlying the anti-MM activity of this decoction.Results:The metabolites of the kidney-reinforcing, blood circulation-activating, and collateral dredging decoction inhibited KM3 cell proliferation and induced apoptosis in a dose-dependent manner. Transmission electron microscopy revealed increased mitochondrial fission and autophagic structures, with effects intensifying at higher metabolite concentrations. mRNA and protein expression of Drp1, Fis1, MFF, Pink1, and Parkin were significantly upregulated in treatment groups compared to controls ( P<0.05), with the most pronounced effects observed in the 12% metabolite group ( P<0.01). HPLC-MS/MS identified 121 bioactive compounds in BHTF, which shared 474 overlapping targets with MM. Enrichment analysis suggested that BHTF exerts antitumor effects primarily through apigenin, palmatine, and other key components by modulating TNF, NF-κB, and mitophagy pathways. Conclusion:The kidney-reinforcing and blood circulation-activating and collateral dredging decoction suppresses the proliferation of MM KM3 cells, potentially through mechanisms involving the regulation of mitochondrial dynamics and induction of autophagy.

Hand degloving injury represents one of the most severe forms of hand trauma, characterised by challenging treatment and a complex prognostic outcome. It is crucial to effectively utilise the degloved tissues in emergency or primary repair of a hand degloving injury. This consensus provides a comprehensive review of the existing literature on definition, classification, emergency assessment, debridement, judgment of skin viability, in situ repair of the degloved skin, and adjunctive treatment for degloving injury of hand. Based on conclusion of both domestic and international experiences, this expert consensus on the classification of hand degloving injury and the emergency repair with the avulsed skin is established, aiming to provide a guidance to surgeons on standardised treatment strategy and improve the management of hand degloving injury.

Objective:To adapt the English version of exteroceptive body awareness questionnaire (EBA-q) into Chinese, and evaluate its reliability and validity in college students.Methods:English version EBA-q was translated and culturally adapted into Chinese, and the tests were administered from October to December 2024, with valid data collected from 1 071 college students. Item analysis, exploratory factor analysis, confirmatory factor analysis, criterion-related validity analysis, and reliability analysis were conducted by SPSS 23.0 and Mplus 8.3 softwares.Results:(1) The Chinese version of EBA-q contained seventeen items across five factors: visual awareness, tactile awareness, body coordination, awareness of body changes and awareness of clothing fit. The five-factor measurement model fitted the data well ( χ2/ df=2.24, CFI=0.95, TLI=0.94, RMSEA=0.05, SRMR=0.06). (2) The EBA-q scores were positively correlated with the scores of noticing, body listening, public self-consciousness, and private self-consciousness ( r=0.46, 0.36, 0.09, 0.25, all P<0.01). (3)The Cronbach's α coefficient, split-half reliability and test-retest reliability of the Chinese version of EBA-q were 0.79, 0.85 and 0.77, respectively(all P<0.01). Conclusion:The Chinese version of the EBA-q has demonstrated good reliability in assessing external body awareness among college students, but its validity requires further verification.

This study aims to investigate the anti-inflammatory and anti-apoptotic effects of total flavonoids of hawthorn leaves(TFHL)on lipopolysaccharide(LPS)-induced inflammatory injury in rat intestinal epithelial(IEC-6)cells,as well as the underlying mechanisms.An in vitro inflam-mation model was first established by treating IEC-6 cells with lipopolysaccharide(LPS).IEC-6 cells were then incubated with three concentrations of TFHL for 24 h prior to a further 24 h LPS treatment.RT-qPCR was used to quantify mRNA levels of the inflammatory genes COX-2 and iN-OS,while Western blotting was used to assess protein levels of the apoptotic markers Bax,cleaved Caspase-3,Bcl-2,and the JNK/p-JNK signaling pathway.Finally,cells were pretreated with TFHL and/or the JNK inhibitor SP600125 for 24 h before LPS exposure for 24 h,in order to evaluate the combined effects of TFHL and SP600125 on LPS-induced inflammatory cytokine expression and apoptotic protein levels in IEC-6 cells.The results showed that,compared with the LPS group,the mRNA level of COX-2 and iNOS in the 2.5,5.0,10.0 mg/L TFHL group and the Bax and Caspase-3 protein levels decreased significantly(P＜0.01),and the Bcl-2 protein level was significantly higher(P＜0.01),p-JNK protein level and p-JNK/JNK ratio decreased significantly(P＜0.01);compared with the LPS group,the COX-2 and iNOS mRNA levels of the TFHL+LPS group de-creased significantly(P＜0.01),Bax,and Caspase-3 protein levels decreased significantly(P＜0.01),and the level of Bcl-2 protein increased significantly(P＜0.05);compared with the LPS group,the COX-2 and iNOS mRNA levels of the TFHL+SP600125 group decreased significantly(P＜0.01),Bax and Caspase-3 protein levels decreased significantly(P＜0.01),and Bcl-2 protein level increased significantly(P＜0.01).These findings indicate that TFHL exerts anti-inflammato-ry and anti-apoptotic effects in LPS-challenged IEC-6 cells by inhibiting the JNK signaling path-way.

Mesangial cell proliferation is an early pathological indicator of diabetic nephropathy (DN). Growing evidence highlights the pivotal role of paired-related homeobox 1 (Prrx1), a key regulator of cellular proliferation and tissue differentiation, in various disease pathogenesis. Notably, Prrx1 is highly expressed in mesangial cells under DN conditions. Both in vitro and in vivo studies have demonstrated that Prrx1 overexpression promotes mesangial cell proliferation and contributes to renal fibrosis in db/m mice. Conversely, Prrx1 knockdown markedly suppresses hyperglycemia-induced mesangial cell proliferation and mitigates renal fibrosis in db/db mice. Mechanistically, Prrx1 directly interacts with the Yes-associated protein 1 (YAP) promoter, leading to the upregulation of YAP expression. This upregulation promotes mesangial cell proliferation and exacerbates renal fibrosis. These findings emphasize the crucial role of Prrx1 upregulation in high glucose-induced mesangial cell proliferation, ultimately leading to renal fibrosis in DN. Therefore, targeting Prrx1 to downregulate its expression presents a promising therapeutic strategy for treating renal fibrosis associated with DN.

Objective To explore the MRI findings and clinical features of ovarian endometrioid carcinoma(OEC).Methods The preoperative data from 23 patients with surgical pathologic evidence of OEC were collected.The MRI signs[including shape,size,signal,enhancement mode,height of mural nodule,width,height-to-width ratio(HWR)],and apparent diffusion coefficient(ADC)value,as well as clinical features(including age,clinical manifestations,serological markers,pelvic effusion,lymph node metastasis,endometrial cancer,and endometriosis)were retrospectively analyzed.Results Among the 23 cases of OEC,21 exhibited cystic-solid masses with single cyst,and 20 cases displayed well-defined boundaries.The tumor sizes ranged from 4.3 to 17.5 cm.Lymph node metastasis was observed in 4 cases.Thirteen cases were accompanied by pelvic effusion.Additionally,6 cases(26%)with endometrial cancer,and 10 cases(43%)with endometriosis.Elevated CA125 levels were detected in 21 cases(91%),and elevated HE4 levels were found in 18 cases(78%).Regarding the cystic components of the tumors,both T2WI and fat suppression(FS)T2WI showed high signal intensity.In 9 cases,slightly high T1WI signal was detected with no enhancement,and mild enhancement was detected of the cyst wall.The mural nodule of the tumor were predominantly multifocal and wide-based,appearing isointense on T1WI and isoin-tense to slightly hyperintense on T2WI.They was measured with height of 1.8-10.3 cm,widths ranged from 2.7 to 10.6 cm,HWR of 0.68±0.15,high signal on diffusion weighted imaging(DWI),ADC values of(0.937±0.14)×10-3 mm2/s,and mainly showed progressive moderate to significant enhancement.Conclusion OEC typically exhibit a single cyst with multiple mural nodules.The mural nodules are predominantly multifocal and wide-based,with HWR of less than 0.69,limited diffusion,and moderate to signifi-cant enhancement.The enhancement of the parenchymal components is more pronounced than that of the cyst wall.Furthermore,OEC may be accompanied by pelvic effusion,endometrial cancer,endometriosis,and elevated serological markers.