Objective: To understand the impact of childhood trauma on psychological distress among upper grade elemetary school students, and to explore the mediating role of leisure activities in the relationship, so as to provide a basis for developing mental health intervention strategies. Methods: From August to November 2024, a combination of convenience sampling and stratified cluster random sampling was employed to recruit 1 373 fourth to sixth grade students from four primary schools in Harbin. The Childhood Trauma Questionnaire(CTQ), a self designed leisure activity scale (including active and passive leisure activities), and the Kessler Psychological Distress Scale (K10) were used to assess childhood trauma experiences, leisure activities, and levels of psychological distress. Spearman correlation analysis and linear regression analysis were conducted to explore the relationships among childhood trauma, leisure types, leisure time, and psychological distress. Based on the mediation analysis framework proposed by Hayes (Model 4), the mediating role of leisure types in the relationship between childhood trauma and psychological distress was examined. Results: Totally 19.1% of the upper elemetary school students exhibited psychological distress, while 30.2% had experienced childhood trauma. During school days, 64.6% of the students were reported of having leisure time concentrated between 1 and 5 hours per day, whereas 67.4% reported leisure time exceeding 5 hours per day on weekends. After controlling for potential demographic confounders such as gender, grade, ethnicity, household registration, being an only child, parents educational level, co residence, and whether parents are first time married,linear regression analysis showed that childhood trauma experience had positive predictive effect on psychological distress in upper primary school students( β =0.20, P <0.01). Leisure time showed no statistically significant association with psychological distress, both on school days ( β =-0.58 to -0.56) and weekends ( β =0.26- 0.98 )(all P >0.05). Active leisure activities were negatively associated with psychological distress ( β =-0.20), while passive leisure activities were positively associated with psychological distress ( β =0.29)(both P <0.01). Leisure type partially mediated the relationship between childhood trauma and psychological distress, accounting for 11.7% of the indirect effect. Conclusion Childhood trauma experiences positively predict psychological distress in upper elementary school students, and affect psychological distress through active leisure and passive leisure.

ObjectiveTo analyze the differences in color， odor and volatile components of Citri Reticulatae Pericarpium（CRP） before and after being stir-fried with Halloysitum Rubrum， and to explore the material basis of enhancing the effect of strengthening spleen after processing and the scientific connotation of decoction pieces processed with Halloysitum Rubrum as the auxiliary material. MethodsThe volatile components of the samples before and after processing were identified and relatively quantified by headspace gas chromatography-mass spectrometry（HS-GC-MS）， and the volatile components were analyzed by principal component analysis（PCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA）. According to the principle of variable importance in the projection（VIP） value>1.5， volatile differential components before and after processing were screened. And combined with intelligent sensory technologies such as colorimeter and electronic nose， the chroma and odor information of CRP before and after being stir-fried with Halloysitum Rubrum were identified. Pearson correlation analysis was used to explore the correlation between volatile differential components and chroma values. ResultsA total of 112 volatile components were identified from CRP and CRP stir-fried with Halloysitum Rubrum， of which 84 were from CRP and 97 were from CRP stir-fried with Halloysitum Rubrum. And 7 differential components were selected， including α-pinene， β-myrcene， linalool， sabinene， ocimene isomer mixture， A-ocimene， and δ-elemene. After being processed with Halloysitum Rubrum， the brightness value（L^*）， yellow-blue value（b^*） and total chromatic value（E^*_ab） of CRP were decreased（P<0.01）， and red-green value（a^*） was increased（P<0.01）， the response values of S4， S5， S10 and S13 sensors were significantly increased（P<0.05）， and the response values of S3 and S8 sensors were significantly decreased（P<0.05）. Correlation analysis showed that α-pinene and β-myrcene were negatively correlated with L^* and E^*_ab， but positively correlated with a^*. Sabinene was positively correlated with L^* and E^*_ab. Linalool was positively correlated with L^* and E^*_ab， and negatively correlated with a^*. The ocimene isomer mixture was positively correlated with the L^*. ConclusionAfter being processed with Halloysitum Rubrum， the appearance color， odor and volatile components of CRP change significantly， and α-pinene， β-myrcene， sabinene， linalool and A-ocimene are the characteristic volatile components before and after processing， which can provide references for the quality evaluation and clinical application of CRP and its processed products.

ObjectiveTo analyze the differences in color， odor and volatile components of Citri Reticulatae Pericarpium（CRP） before and after being stir-fried with Halloysitum Rubrum， and to explore the material basis of enhancing the effect of strengthening spleen after processing and the scientific connotation of decoction pieces processed with Halloysitum Rubrum as the auxiliary material. MethodsThe volatile components of the samples before and after processing were identified and relatively quantified by headspace gas chromatography-mass spectrometry（HS-GC-MS）， and the volatile components were analyzed by principal component analysis（PCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA）. According to the principle of variable importance in the projection（VIP） value>1.5， volatile differential components before and after processing were screened. And combined with intelligent sensory technologies such as colorimeter and electronic nose， the chroma and odor information of CRP before and after being stir-fried with Halloysitum Rubrum were identified. Pearson correlation analysis was used to explore the correlation between volatile differential components and chroma values. ResultsA total of 112 volatile components were identified from CRP and CRP stir-fried with Halloysitum Rubrum， of which 84 were from CRP and 97 were from CRP stir-fried with Halloysitum Rubrum. And 7 differential components were selected， including α-pinene， β-myrcene， linalool， sabinene， ocimene isomer mixture， A-ocimene， and δ-elemene. After being processed with Halloysitum Rubrum， the brightness value（L^*）， yellow-blue value（b^*） and total chromatic value（E^*_ab） of CRP were decreased（P<0.01）， and red-green value（a^*） was increased（P<0.01）， the response values of S4， S5， S10 and S13 sensors were significantly increased（P<0.05）， and the response values of S3 and S8 sensors were significantly decreased（P<0.05）. Correlation analysis showed that α-pinene and β-myrcene were negatively correlated with L^* and E^*_ab， but positively correlated with a^*. Sabinene was positively correlated with L^* and E^*_ab. Linalool was positively correlated with L^* and E^*_ab， and negatively correlated with a^*. The ocimene isomer mixture was positively correlated with the L^*. ConclusionAfter being processed with Halloysitum Rubrum， the appearance color， odor and volatile components of CRP change significantly， and α-pinene， β-myrcene， sabinene， linalool and A-ocimene are the characteristic volatile components before and after processing， which can provide references for the quality evaluation and clinical application of CRP and its processed products.

ObjectiveBy comparing the composition and content of volatile components in raw products， wine-washed products and wine-fried products of Ligusticum sinense cv. Chaxiong rhizome（LSCR）， to investigate the influence of wine processing on the volatile components of LSCR， in order to provide a basis for the development of quality standards for LSCR and its processed products. MethodsElectronic nose was used to identify the odors of LSCR， wine-washed and wine-fried LSCR， and their volatile components were detected by headspace gas chromatography-mass spectrometry（HS-GC-MS）， and the relative mass fractions of these components were determined by peak area normalization method. Principal component analysis（PCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA） were performed on the obtained sample data by SIMCA 14.1 software， and the differential components of LSCR， wine-washed and wine-fried LSCR were screened according to the variable importance in the projection（VIP） value>1. Pearson correlation analysis was used to explore the relationship between volatile differential flavor components and electronic nose sensors. ResultsElectronic nose detection results showed that there were significant differences in the odors of LSCR， wine-washed and wine-fried LSCR， mainly reflected in the sensors S2， S4， S5， S6， S11， S12， S13. And a total of 62 compounds were identified from LSCR and its wine-processed products， among which 46， 50 and 51 compounds were identified from LSCR， wine-fried and wine-washed LSCR， respectively. There were 21 differential components between the raw products and wine-fried products， of which 10 components were increased and 11 were decreased after processing. There were 20 differential components between the raw products and wine-washed products， of which 11 constituents increased and 9 decreased after processing. There were 17 differential components between the wine-wash products and wine-fried products. Compared with the wine-washed products， the contents of 13 components in the wine-fried products increased， and the contents of 4 components decreased. The increasing trend of the content of phthalides in the wine-washed products was more obvious than that in the wine-fried products， but the content of total volatile components was higher in the wine-fried products than the wine-washed products. Correlation analysis showed that there were different degrees of correlation between the 7 differential sensors of electronic nose and 24 differential volatile components， mainly phthalides and olefins. ConclusionThe odor and the content of volatile components in LSCR changed obviously after wine processing， and n-butylphthalide， Z-butylidenephthalide and E-ligustilide can be used as the candidate differential markers of volatile components in LSCR before and after wine processing.

Objective To analyze the clinical characteristics and treatment strategies for Nocardia brasiliensis infection.Methods A clinical pharmacist participated in the clinical diagnosis and treatment plan for a case of a membranous nephropa-thy patient infected with Nocardia brasiliensis,resulting in multiple infections in the lungs,eyes,and nervous system.They were involved in assessing the patient's infection symptoms and severity,as well as reviewing the literature to participate in developing and optimizing the clinical drug therapy regimen.Results Following infection with Nocardia brasiliensis,the patient developed lung,eye,and nervous system infections.The patient showed significant improvement after targeted treatment by clinical doctors and clinical pharmacists.At the 3-month outpatient follow-up,the patient's lung,eye,and lower limb nervous system had re-turned to normal.Conclusions Nocardia brasiliensis can colonize in various environments,and immunocompromised individu-als are at risk of infection.Clinical diagnosis relies on metagenomic sequencing methods for identification.For mild to moderate in-fections,a combination of sulfamethoxazole/trimethoprim(TMP-SMX)can be used as monotherapy.Severe infections often re-quire a combination of two or three antibiotic drugs(such as TMP-SMX,imipenem cilastatin,amikacin)for intravenous treatment for 3-6 weeks,and followed by oral therapy.The entire course of treatment typically lasts 3-6 months.Patients with timely and ef-fective treatment usually have a better prognosis.

BACKGROUND:Osteonecrosis is an orthopedic disease that severely limits joint function,with complex pathogenesis involving multiple risk factors.Cathepsins,as a class of enzymes that play a key role in bone metabolism,are closely related to the proliferation,differentiation of bone cells,and remodeling of the bone matrix.However,previous studies have mostly focused on descriptive analyses,lacking direct evidence of causal relationships.OBJECTIVE:To clarify the potential causal relationship between cathepsins and osteonecrosis and to explore their possible mechanisms by analyzing large-scale sample data from the FinnGen database.METHODS:We obtained osteonecrosis-related data from the FinnGen database,including R9(a total of 359 399 samples:1 385 cases and 358 014 controls)and R10 versions(a total of 392 580 samples:1 543 cases and 391 037 controls).Single nucleotide polymorphisms associated with nine cathepsins(cathepsin B,E,F,G,H,O,S,L2,and Z)were acquired from a previous study(3 301 individuals).Univariate Mendelian randomization,reverse univariate Mendelian randomization,and multivariate Mendelian randomization analyses were conducted using the inverse variance weighted method,MR-Egger method,weighted median method,simple mode method,and weighted mode method.Initially,Mendelian randomization analysis was performed using osteonecrosis data from R9.Additionally,sensitivity analyses were conducted using Cochran's Q test,MR-Egger intercept,MR-PRESSO global test,and leave-one-out analysis to check for horizontal pleiotropy and heterogeneity.Subsequently,a validation analysis study was carried out on the R10 dataset,and a meta-analysis was conducted to combine the two datasets to explore the joint effect.RESULTS AND CONCLUSION:Univariate Mendelian randomization analysis results showed that higher levels of cathepsin B were significantly associated with a reduced risk of osteonecrosis(inverse variance weighted:odds ratio(OR)=0.865,95％confidence interval(CI):0.762-0.982,P=0.025),and no reverse causal relationship was found between the nine cathepsins and osteonecrosis(P＞0.05).These associations were validated by meta-analysis.Multivariate analysis,using the nine cathepsins as covariates,revealed a reverse causal relationship between the levels of cathepsin Band the risk of osteonecrosis(inverse variance weighted:OR=0.8710,95％CI:0.761-0.997,P=0.045),consistent with the results before adjustment.Sensitivity analyses based on heterogeneity and horizontal pleiotropy suggested that the results were relatively robust.This study suggests that there is a causal relationship between high levels of cathepsin B and the reduced risk of osteonecrosis,and it may serve as a biomarker for osteonecrosis,providing new directions and insights for the diagnosis and treatment of osteonecrosis.Although this study is based on data analysis of European populations,these findings have important implications for Chinese biomedical research,especially in understanding disease mechanisms,developing biomarkers,and formulating treatment strategies.They also encourage similar studies conducted on Chinese populations to explore the impact of racial and genetic background differences on the occurrence of osteonecrosis.

Objective To evaluate the efficacy of uterine artery embolization(UAE)for the treatment of adenomyosis(AM)and to discuss the factors predicting efficacy.Methods The clinical data of 44 patients with AM,who received UAE at The Second Affiliated Hospital of Soochow University from January 2020 to August 2022,were retrospectively analyzed.Based on the MRI findings,serum CA125 levels and follow-up dysmenorrhea scores,the efficacy of UAE and the factors predicting efficacy were analyzed.Results A single UAE treatment was performed in all 44 patients with AM.Follow-up check with MRI at 12 months after treatment showed that the mean uterine volume decreased from preoperative(299.60±182.42)cm3 to postoperative(173.14±104.00)cm3,with a volume reduction of 36.64％(P＜0.05).The dysmenorrhea score decreased from preoperative(7.70±2.60)points to postoperative(2.20+2.37)points,with a relief rate of 88.64％(P＜0.05),and no severe adverse reactions occurred.Enhanced MRI demonstrated that in 30 patients(68.18％)the AM lesions presented as complete necrosis foci.In the patients whose preoperative lesions were completely necrotic,the mean preoperative serum CA125 level was(101.97±60.30)U/mL,the mean ADC value was(1.012+0.271)mm2/s,which were obviously lower than those in the patients whose preoperative lesions were incompletely necrotic(P＜0.05).The mean T2 signal ratio(T2SR)value in the patients whose preoperative lesions were completely necrotic was(0.582±0.198),which was significantly higher than that in the patients whose preoperative lesions were incompletely necrotic(P＜0.05).The analysis of receiver operating characteristic(ROC)curve showed that the preoperative area under the curve(AUC),sensitivity,and specificity for preoperative CA125 were 0.844,60％and 80％respectively;the AUC,sensitivity,and specificity for preoperative ADC were 0.760,80％and 65％respectively;and the AUC,sensitivity,and specificity for preoperative T2SR were 0.760,80％and 70％respectively.ADC＜1.116 × 10-3 mm2/s,T2SR＞0.479,and CA125＜109.10 U/mL could be used as the reliable predictive factors for the efficacy of UAE treatment for AM.Conclusion UAE can effectively alleviate dysmenorrhea symptoms in patients with AM,and it is clinically safe and effective.ADC,T2SR,and CA125 can be used as the reliable predictive factors for the efficacy of UAE treatment for AM,which are helpful in predicting the lesion response and selecting the reasonable therapeutic options for patients.

Objective To analyze the clinical characteristics and treatment strategies for Nocardia brasiliensis infection.Methods A clinical pharmacist participated in the clinical diagnosis and treatment plan for a case of a membranous nephropa-thy patient infected with Nocardia brasiliensis,resulting in multiple infections in the lungs,eyes,and nervous system.They were involved in assessing the patient's infection symptoms and severity,as well as reviewing the literature to participate in developing and optimizing the clinical drug therapy regimen.Results Following infection with Nocardia brasiliensis,the patient developed lung,eye,and nervous system infections.The patient showed significant improvement after targeted treatment by clinical doctors and clinical pharmacists.At the 3-month outpatient follow-up,the patient's lung,eye,and lower limb nervous system had re-turned to normal.Conclusions Nocardia brasiliensis can colonize in various environments,and immunocompromised individu-als are at risk of infection.Clinical diagnosis relies on metagenomic sequencing methods for identification.For mild to moderate in-fections,a combination of sulfamethoxazole/trimethoprim(TMP-SMX)can be used as monotherapy.Severe infections often re-quire a combination of two or three antibiotic drugs(such as TMP-SMX,imipenem cilastatin,amikacin)for intravenous treatment for 3-6 weeks,and followed by oral therapy.The entire course of treatment typically lasts 3-6 months.Patients with timely and ef-fective treatment usually have a better prognosis.

BACKGROUND:Previous studies by the research group have shown that core proteoglycan in Cornus Cervi Col la can enter the bone,promote the proliferation and osteogenic differentiation of bone marrow mesenchymal stem cells,and has a good repair effect on steroid-induced osteonecrosis of the femoral head.OBJECTIVE:To investigate the therapeutic effect and potential mechanism of Cornus Cervi Colla on steroid-induced osteonecrosis of the femoral head in rats by fecal non-targeted fecal metabolomics.METHODS:Thirty SD rats were randomly divided into three groups using a random number table method:the control group(n=10)was injected with normal saline into the right gluteal muscle(injected on the first 3 days of each week for 3 consecutive weeks),and was given pure water gavage(once a day for 6 consecutive weeks).The model group(n=10)was injected with methylprednisolone sodium succinate into the right gluteal muscle(injected on the first 3 days of each week for 3 consecutive weeks)to establish a steroid-induced osteonecrosis of the femoral head model,and was given pure water gavage(once a day for 6 consecutive weeks).The Cornus Cervi Co I la group(n=10)was also established with a steroid-induced osteonecrosis of the femoral head model,and was given Cornus Cervi Col la gavage(once a day for 6 consecutive weeks).After gavage,cecal feces and femoral heads were collected for fecal metabolomics analysis and bone tissue Micro-CT and hematoxylin-eosin staining,respectively.RESULTS AND CONCLUSION:(1)Metabolomics analysis results showed that there were 233 differential metabolites between the Cornus Cervi Col la and model groups,with 65 significantly differing and clearly annotated metabolites.Lipid and amino acid metabolites were significantly increased,with bile acids,sulfated steroids,ephedrine,hypoxanthine,betaine,L-carnitine,B-mouse bile acid,cytidine,4-pyridoxic acid,taurine,N-acetyl-d-glucosamine,and butyric acid being the most impacted(variable weight value VIP＞5).The metabolic pathways of taurine and hypotaurine were crucial in the metabolic regulatory network(pathway impact=0.428 57).(2)Micro-CT scanning results of bone tissue showed that the femoral heads of rats in the model group and the Cornus Cervi Col la group had different degrees of damage;the femoral head contour was irregular;the trabeculae in the subchondral bone of the femoral head were missing and disordered,and some cystic structures were visible.Compared with the model group,the degree of trabecular damage in the rats of the Cornus Cervi Colla group was milder.Hematoxylin-eosin staining results showed that the trabeculae in the subchondral bone of the femoral heads of rats in the model group and the Cornus Cervi Colla group were sparse or interrupted,and the empty bone lacuna rate and adipocyte invasion were increased.Compared with the model group,the empty bone lacuna rate and adipocyte invasion in the subchondral bone of the femoral heads of rats in the Cornus Cervi Colla group were reduced.(3)These results conclude that Cornus Cervi Colla potentially mitigates steroid-induced osteonecrosis of the femoral head through the metabolic processes involving taurine and associated pathways.

Objective To explore the significance of mitoxantrone hydrochloride injection and carbon nanoparticles suspension injection in endoscopic radical thyroid cancer surgery.Methods A retrospective analysis was carried out on patients who underwent endoscopic radical surgery for unilateral thyroid cancer at the Depart-ment of General Surgery,Gansu Provincial Central Hospital,from December 2022 to February 2024.The patients were classified into two groups according to the intraoperative tracer employed:the mitoxantrone group and the nanocarbon group.After a 6-month postoperative follow-up,the baseline data of the two patient groups were compared.The intraoperative visualization of lymph nodes and parathyroid glands in both groups was observed.Additionally,the hospitalization costs and the incidence of postoperative complications were compared between the two groups.Results In this study,110 cases were included in the Mitoxantrone group and 126 cases in the nanocarbon group.The staining time of the central lymph nodes was significantly shorter in the nanocarbon group compared to the mitoxantrone group(P<0.05).The blue staining rate of MHI reached 97.5%,while the black staining rate of CNSI was 98.3%.The difference between them was not statistically significant(P>0.05).Regarding the number of central lymph nodes dissected,it was 9.34±0.22 in the Mitoxantrone group and 9.88±0.24 in the nanocarbon group,with no statistically significant difference(P>0.05).Similarly,the parathyroid misdissection rates were 1.8%and 0.8%in the two groups respectively,and no significant statistical difference was observed(P>0.05).Postoperative blood calcium and PTH levels measured at 1 day,1 month,and 6 months did not show any statistically significant differences between the two groups(P>0.05).The incidence of transient hypoparathy-roidism and hypocalcemia was comparable in both groups(P>0.05),and no patients developed permanent hypo-parathyroidism or permanent hoarseness.None of the patients in one Mitoxantrone group experienced postoperative hemorrhage,coeliac leakage,or skin staining.In contrast,in the nanocarbon group,there was one case of postop-erative hemorrhage and one case of coeliac leakage,and two case of skin staining.Conclusions In laparoscopic unilateral thyroid cancer radical surgery,when it comes to lymph node tracing and parathyroid gland protection,no significant disparities were detected between MHI and CNSI.Nevertheless,CNSI exhibits a shorter staining time for central lymph nodes.In contrast,MHI is more manageable,features a faster metabolic rate,and has been demonstrated to be more cost-effective.