Objective: To explore the relationship between parenting styles and depressive symptoms in adolescents with nightmare disorder, so as to provide a scientific basis for formulating effective family intervention measures and psychological counseling. Methods: From January 2023 to August 2024, 90 adolescents diagnosed with nightmare disorder and admitted to Hangzhou Seventh Peoples Hospital, along with 176 healthy controls from the urban areas of Hangzhou, were recruited as participants in the study. All participants were assessed using the Nightmare Experience Questionnaire (NEQ), Family Relationship Questionnaire (FRQ), and Plutchik-van Praag Selfreport Depression Scale (PVP). The ttest and Chisquare test were conducted to compare two groups. Pearson correlation and stepwise multiple linear regression were employed to explore the correlations between PVP and NEQ or FRQ. The Process model was used to testing the mediating effects among NEQ/FRQ/PVP. Results: The nightmare disorder group had higher scores in nightmare frequency, the four factors of NEQ (physical effect, negative emotion, meaning interpretation, horrible stimulation), and PVP than the healthy control group (24.86±18.89, 10.12±3.67, 19.01±3.51, 17.02±3.31, 15.14±3.26, 14.02±4.38; 2.34±1.04, 6.49±2.18, 17.63±4.76, 13.91±4.24, 12.40±4.49, 9.39±3.28)(t=15.79, 10.11, 2.43, 6.09, 5.14, 27.46, P<0.05). The nightmare disorder group reported significantly lower scores in FRQ general attachment and maternal encouragement than the healthy control group (7.22±2.81, 16.39±3.28) (t=-5.53, -4.95). In contrast, they exhibited significantly higher scores in maternal abuse, maternal dominance, paternal freedom release, and paternal dominance than the healthy control group (8.23±1.80, 13.11±3.73, 18.36±3.37, 12.04±3.29; 6.07±1.85, 8.48±3.80, 15.15±2.51, 9.47±3.03) (t=6.70, 8.96, 5.90, 7.04, P<0.01). The results of Pearson correlation analysis showed that, in the nightmare disorder group, the PVP score was positively correlated with negative emotion, nightmare frequency, maternal abuse, and maternal dominance score (r=0.14, 0.63, 0.26, 0.51, P<0.05). The results of multiple linear regression analysis showed that when using FRQ score to predict NEQ score, the adjusted R2 in the nightmare disorder group was 0.01-0.59. Mother abuse could prediced physical effect (β=0.33); maternal dominance significantly predicted negative emotion, horrible stimulation, and nightmare frequency (β=0.29, 0.30, 0.79); paternal freedom release could predict negative emotion (β=0.26), paternal dominance predicted both negative emotion and nightmare frequency (β=0.22, 0.45) (P<0.05). Mediation analysis further revealed that, in the nightmare disorder group, PVP scores served as a mediating variable between FRQ and NEQ. Conclusion Abusive, controlling, and neglectful family upbringing styles as well as depression maybe are key factors that may contribute to the development of nightmare disorder among adolescents.

A method for determination and targeted screening of diflorasone components in health products using ultra performance liquid chromatography-quadrupole time of flight mass spectrometry(UPLC-Q-TOF/MS)was established.Four representative diflorasone and esters(diflorasone,diflorasone diacetate,diflorasone-17-propionate,and diflorasone-21-propionate)were selected to optimize the pretreatment conditions,and 10 mL of extraction solvent dosage,15 min of extraction time and 5 g of salting-out agent as the optimal conditions were selected by response surface methodology.The results showed that the four analytes exhibited good linearity within the concentration range of 2.0?100 μg/L with the chromatographic peak area,and the correlation coefficients(R2)were all greater than 0.9990,while the results of recovery and relative standard deviation could satisfy the requirements of determination.The common characteristic ions of diflorasone and esters werem/z121 andm/z335,and their specific structures were obtained by analyzing the cleavage pathway based on the optimized determination conditions.A targeted screening method for other esters of diflorasone based on characteristic ions guidance strategy was established.This method had many advantages such as high efficiency,high sensitivity and good reproducibility,and could be used for targeted screening of diflorasone and esters in health products.The developed characteristic ion guided strategy could be employed to construct mass spectral databases for various glucocorticoids,enabling comprehensive targeted screening across a broad range of compounds.

Osteoporotic fractures(OPF) refer to the fractures caused by minor violence in the state of osteoporosis, seriously threatening the life and health of elderly patients. Drug and surgical therapies have limitations such as single targets, diverse adverse reactions, and poor prognosis. Kidney-tonifying traditional Chinese medicine(TCM) has good potential in the treatment of OPF. TCM can promote the healing of OPF by promoting angiogenesis in the early stage of bone healing, promoting osteogenic differentiation of bone marrow mesenchymal stem cells in the stage of bone repair, maintaining the balance of osteogenic and osteoclastic system in the stage of bone remodeling, and regulating the oxidative stress responses throughout the process of OPF healing. TCM can alleviate the pathological state of osteoporosis and promote fracture healing in OPF patients via multiple pathways and targets, demonstrating the advantages and potential of biphasic regulation.
Humans ; Drugs, Chinese Herbal/therapeutic use* ; Osteoporotic Fractures/metabolism* ; Animals ; Fracture Healing/drug effects* ; Medicine, Chinese Traditional ; Kidney/metabolism* ; Osteogenesis/drug effects*

OBJECTIVE: Previous studies have shown that insomnia is closely related to erectile dysfunction（ED）. However, the causal relationship between them is still unclear. Mendelian randomization (MR) provides a new method for studying the relationship between the two, and the theory of heart-kidney interaction in TCM provides a new idea for exploring the causal relationship between them. METHODS: Based on the statistical data collected by genome-wide association studies (GWAS), the causal relationship between insomnia and ED was discussed by MR. Inverse variance weighted (IVW) is the main analysis method, and weighted median (WME), simple mode (SM), weighted mode (WM) and MR Egger method were the supplementary analysis to evaluate the causal effect. MR-Egger intercept test, Cochran Q test and leave-one-out method were used in sensitivity analysis to verify the reliability of MR results. RESULTS: Thirty-nine SNPs significantly related to insomnia were finally included for MR analysis. The results of IVW method in MR analysis showed that insomnia had a significant causal relationship with the increased risk of ED (OR = 3.111，95% CI= 1.566－6.181，P=1.193×10－3). The results obtained by MR-Egger method, WME method, WM method and SM method were consistent with IVW method in the direction of effect. The sensitivity results suggested that the results of this study were robust. CONCLUSION Our study reveals the causal relationship between insomnia and ED, which provides a new basis for future clinical practice and prevention and treatment of ED.
Causality ; Sleep Initiation and Maintenance Disorders/genetics* ; Erectile Dysfunction/genetics* ; Mendelian Randomization Analysis ; Genome-Wide Association Study ; Humans ; Male ; Heart/physiology* ; Kidney/physiology* ; Polymorphism, Single Nucleotide ; Data Interpretation, Statistical

In the context of medical insurance payment reform,the sample hospital has implemented performance management optimization to effectively address the challenges posed by diagnosis-intervention packet(DIP)payment.Reform measures focused on disease quality,rational diagnosis and treatment,operational management,medical technological value,and policy orientation,and they have significantly optimized service ability and performance evaluation indexes of the hospital.Main achievements included a reduction in the cost consumption index and an increase in the clinical performance index,with the overall DIP payment rate increasing from 88.86%to 103.23%and a marked improvement in operational management.The quality control and operational efficiency of the hospital have been effectively enhanced by choosing proper DIP payment evaluation indexes and improving performance management,and provided strong support for the high-quality development of the hospital.

Naval hospitals,the backbone of naval health service system,are the key to build a world-class naval health service system.On the basis of the requirements of military transformation and high-quality development of public hospitals,this paper summarized five aspects of high-quality development of naval hospitals,including directions and regulations,support and contribution of combats,efficiency,sustainable development momentum,and the expansion of service functions.It is very important to strengthen the top-level design and policy support for naval hospitals,to improve the level of governance and innovation,and to find the right target for the naval hospital construction in naval health service system reform.

Objective:To evaluate the efficacy and safety of induction therapy with first-line chidamide plus chemotherapy and sequential chidamide maintenance therapy for peripheral T-cell lymphoma (PTCL) to provide evidence for clinical medication.Methods:The relevant literature in the databases of Cochrane Library, PubMed, EMbase, Web of Science, Chinese Biomedical Database, China National Knowledge Infrastructure Database, Wanfang, and VIP from December 2014 to November 2023 were retrieved. Meta-analysis and comparison were conducted on the objective response rate (ORR), complete remission (CR) rate, progression-free survival (PFS), and overall survival (OS) of patients receiving induction therapy with first-line chidamide plus chemotherapy and sequential chidamide maintenance therapy (chidamide combined with chemotherapy group) and those receiving chemotherapy alone (control group). A systematic descriptive analysis was performed on the occurrence of adverse events.Results:A total of 5 relevant literature on the induction therapy with first-line chidamide plus CHOP/CHOP-like regimens and sequential chidamide maintenance therapy for PTCL was included, including 350 initial-treated PTCL patients. Among them, there were 176 cases in the chidamide combined with chemotherapy group and 174 cases in the control group. The CR rate of the chidamide combined with chemotherapy group was higher than that of the control group [59.6% (90/151) (95% CI: 51.9%-67.5%) vs. 41.6% (62/149) (95% CI: 27.8%-51.7%)], and the difference was statistically significant ( P < 0.01); the ORR of the chidamide combined with chemotherapy group was 83.4% (126/151) (95% CI: 73.3%-94.1%), while the control group was 69.1% (103/149) (95% CI: 58.4%-79.2%), and the difference was not statistically significant ( P = 0.051). The 2-year PFS rate of the chidamide combined with chemotherapy group was higher than that of the control group [60.2% (106/176) (95% CI: 47.1%-74.6%) vs. 31.6% (55/174) (95% CI: 17.8%-45.7%)], and the difference was statistically significant ( P < 0.01); the 2-year OS rate of the chidamide combined with chemotherapy group was higher than that of the control group [83.2% (114/137) (95% CI: 66.8%-100.0%) vs. 53.4% (93/174) (95% CI: 42.1%-67.9%)], and the difference was statistically significant ( P < 0.01). There was no statistically significant difference between the chidamide combined with chemotherapy group and the control group in the incidence of grade 3-4 neutropenia [60.6% (20/33) and 57.6% (19/33)], anemia [17.9% (20/112) and 16.0% (17/106)] and thrombocytopenia [22.3% (25/112) and 22.6% (24/106)] (all P > 0.05); during the maintenance therapy with chidamide, the incidence of grade 3-4 neutropenia, anemia and thrombocytopenia was 28.1% (9/32), 12.5% (4/32) and 15.6% (5/32), respectively; the hematological adverse events mostly occured within 6 weeks of initial administration and were relieved after symptomatic treatment. Conclusions:Compared with only receiving chemotherapy, the first-line combination therapy with chidamide and CHOP/CHOP-like regimens can improve the CR rate of PTCL patients, and the maintenance therapy with chidamide alone after remission can improve PFS and OS and the hematological adverse reactions are tolerable.

AIM To explore the ameliorative effects of Ziyin Mingmu Pills on mouse retinitis pigmentosa(RP)and the possible mechanism.METHODS The RP transgenic mice(rd10)were randomly divided into the model group,the Leding group(0.15 g/kg)and the low and high dose Ziyin Mingmu Pills groups(4.50,9.00 g/kg),in contrast to the C57BL/6 mice of the normal group,with 12 mice in each group.The mice had their retinal pathological changes detected by HE staining;their visual function detected by electroretinogram(ERG);their fundus conditions and retinal thickness detected by optical coherence tomography(OCT);their retinal blood perfusion detected by laser speckle blood flow technique;their mRNA expressions of Shh,Ptc,Smo,Gli1,N-myc and Cyclin mRNA detected by digital PCR;and their protein expressions of Shh,Ptc,Smo,Gli1,N-myc and Cyclin detected by immunofluorescence staining.RESULTS Compared with the normal group,the model group displayed pathological changes in the fundus and retina and decreased amplitudes of ERG a wave and b wave(P＜0.01);decreased retinal thickness(P＜0.01);decreased retinal blood perfusion(P＜0.01);and decreased retinal expressions of Shh,Ptc,Smo,Gli1,N-myc,Cyclin mRNA and protein(P＜0.01).Compared with the model group,the groups intervened with Ziyin Mingmu Pills or Leding shared improved pathological changes in the fundus and retina tissue,and increased retinal thickness(P＜0.01);increased retinal blood flow(P＜0.01);increased amplitudes of ERG a wave and b wave(P＜0.01);and increased retinal Shh,Ptc,Smo,Gli1,N-myc and Cyclin mRNA and protein expressions(P＜0.01).CONCLUSION Ziyin Mingmu Pills can improve the fundus pathological changes and visual function to delay RP in mice because of their efficacy in ameliorating retinal thickness and blood flow possibly by activating Shh signaling pathway.

Objective To observe the effects of methylenedioxygenase(TET2)expression on the proliferation ability,apoptosis rate,cell cycle,migration,and invasion of non-small cell lung cancer cells.Methods Detect the expression of TET2 gene and protein in different non-small cell lung cancer cells through RT-PCR and Western blot.Knock down the gene expression of the highest TET2 expressing cells(shRNA1)and overexpress the gene in the most low TET2 expressing cells(OE-TET2).Detect the effect of TET2 expression on cell proliferation through CCK-8,observe the effect of TET2 expression on cell apoptosis and cell cycle through flow cytometry,and observe the effect of TET2 expression on cell migration and invasion ability through migration and invasion experiments.Results The expression levels of TET2 gene and protein in H1299 cells were the highest,while A549 cells had the lowest expression levels(P＜0.05).The proliferation ability of OE-TET2 group cells was significantly lower than that of normal A549,while the proliferation ability of shRNA1 group cells was significantly higher than that of normal H1299 cells(P＜0.05).The apoptosis rate of OE-TET2 group was significantly higher than that of normal A549 cells,while the apoptosis rate of shRNA1 group was significantly lower than that of normal H1299 cells(P＜0.05).The number of migration and invasion cells in the OE-TET2 group was significantly lower than that of normal A549 cells,while the migration and invasion cells in the shRNA1 group were significantly higher than those in normal H1299 cells(P＜0.05).Conclusion TET2 can reduce the proliferation ability,increase its apoptosis rate,and slow down its migration and invasion ability of non-small cell lung cancer cells.

Objective To investigate the relevancy between diet and colostrum nutrition in pregnant women in the second and third trimesters.Methods A total of 378 pregnant women who met the inclusion and exclusion criteria and were registered in the Obstetrics and Gynecology Hospital,Fudan University from Jun 2022 to Apr 2023 were included in the study by continuous sampling method.General information,diet in the second trimester,diet in the third trimester and colostrum data 48-72 h after delivery were collected.The relevancy between daily dietary nutrient intake and colostrum quality in pregnant women during the second and third trimesters was analyzed.Results All of the 378 subjects met the colostrum collecting criteria.We found that dietary fat intake during the second trimester was positively correlated with colostrum quality(OR=2.408,95%CI:1.086-5.338),and energy was negatively correlated with colostrum quality(OR=0.319,95%CI:0.157-0.651).Dietary protein intake in the third trimester was positively correlated with colostrum quality(OR=5.905,95%CI:1.757-19.842).Conclusion There is a certain relevancy between diet and colostrum nutrition.A reasonable diet during pregnancy is recommended to promote the quality of colostrum.