Objective: To explore the association of vegetables and fruits intake with depressive symptoms among multi ethnic first year junior high school students in Yunnan Province, so as to provide data support for preventing and reducing depressive symptoms among first year junior high school students. Methods: From October to December 2022, a cluster random sampling method was used to select 8 500 first year junior high school students from 11 ethnic minority areas in Yunnan Province (Fugong County, Longling County, Longyang District, Luchun County, Mojiang County, Nanjian County, Qiaojia County, Shuangjiang County, Tengchong City, Yuanmou County, Zhenyuan County), to investigate with a questionnaire. The Dietary Frequency Questionnaire was used to collect dietary behavior datas, and the Chinese version of Depression Anxiety Stress Scale-21 (DASS-21) was used to assess depressive symptoms. The generalized linear model was used to analyze the association of vegetable and fruit intake with depressive symptoms in students, and stratified analysis was performed according to ethnicity. Results: The detection rate of depressive symptoms among first year junior high school students in Yunnan Province was 29.5%. The detection rates of depressive symptoms in Han and minority first year junior high school students were 26.9% and 31.6%. After controlling for demographic variables such as gender, age, family residence and other confounding factors, the generalized linear model analysis results showed that the intake of leafy vegetables ( β= -0.07 , 95%CI =-0.12 to -0.01), flat fruits ( β=-0.06, 95%CI =-0.12 to -0.00) and hot natured fruits ( β=0.11, 95%CI = 0.04- 0.17) were associated with depressive symptoms in Han first year junior high school students (all P <0.05). The intake of melon and fruit vegetables ( β=-0.06, 95%CI =-0.11 to -0.01) and hot natured fruits ( β=0.06, 95%CI =0.01-0.12) were associated with depressive symptoms in ethnic minority first year junior high school students (both P <0.05). Conclusions The intake of vegetables and fruits among multi ethnic first year junior high school students in Yunnan Province is related to the risk of depressive symptoms. It is suggested to strengthen the consumption guidance and education of vegetables and fruits to prevent depressive symptoms among first year junior high school students.

The frequent extreme climatic events post multifaceted impacts on the distribution of Oncomelania hupensis, the intermediate host of Schistosoma japonicum in the context of global climate change. This article systematically reviews the effects of four types of extreme climatic events, including floods, droughts, heat waves, and cold waves, on the survival, reproduction, and distribution of Oncomelania hupensis. Floods may expand suitable snail habitats, and increase both emerging and re-emerging snail habitats; however, the impact of floods on O. hupensis density is characterized by a lag effect of a decline followed by a rise. Droughts may cause fragmentation of suitable O. hupensis snail habitats, reduced O. hupensis snail egg production rates, and increased O. hupensis snail mortality, and heat waves may cause an increase in O. hupensis snail mortality, a reduction in numbers of O. hupensis snail populations and shrinking of O. hupensis snail distribution, while cold waves may cause a reduction in O. hupensis snail density and a rise in O. hupensis snail mortality. Extreme climate events pose both shortand long-term effects on the distribution of O. hupensis. Intensified surveillance of O. hupensis snails is required in high-risk environments.

Objective To assess the survival vulnerability of Oncomelania hupensis in Jiangxi Province under future climate scenarios, and to identify low-vulnerability areas for its survival in this province. Methods Village-level O. hupensis snail survey and O. hupensis snail control with chemical treatments in Jiangxi Province from 2016 to 2024 were captured from the Parasitic Disease Prevention and Control Information Management System of China Disease Prevention and Control Information System. Climatic data were primarily sourced from the Resource and Environmental Science Data Platform, Chinese Academy of Sciences (http://www.resdc.cn/), including annual average temperature, annual average precipitation, annual accumulated temperature above 10 °C, annual accumulated temperature above 0 °C, annual maximum temperature, annual minimum temperature, and annual average relative humidity, and nineteen bioclimatic variables were downloaded from the WorldClim website (https://www.worldclim.org/), including mean diurnal range, isothermality, temperature seasonality, and so on. Elevation and normalized difference vegetation index were catprued from the Resource and Environmental Science Data Platform, Chinese Academy of Sciences (http://www.resdc.cn/), and distance to rivers was downloaded from the WorldPop website (http://www.worldpop.org), and land use and land cover (LULC) data were downloaded from the Big Earth Data Center, Chinese Academy of Sciences (https://data.casearth.cn/), and nature reserve data were obtained from the China Nature Reserve Specimen Resource Sharing Platform (http://www.papc.cn/). Three Shared Socioeconomic Pathways (SSPs) from the Beijing Climate Center-Climate System Model version 2-Medium Resolution (BCC-CSM2-MR) global climate model were employed as future climate scenarios, including SSP126, SSP245, SSP585, and the biomod2 ensemble model in R package was used to simulate suitable habitats for O. hupensis snails in Jiangxi Province in 2050 and 2070 under these scenarios. A snail survival vulnerability index was constructed based on the area of suitable snail habitats, area covered by snail control through chemical treatment, area covered by nature reserves, and changes in snail habitat fragmentation, and a map of snail survival vulnerability distribution was plotted. Results The real area of snail habitats ranged from 78 486.76 to 85 309.47 hm², and the area of snail control with chemical treatment ranged from 10 138.98 to 13 240.16 hm² in Jiangxi Province from 2016 to 2024. There were 429 to 531 villages detected with snails during the nine-year period, and the number of actually snail-infested villages ranged from 645 to 686. A total of 818 snail-present points and 1 996 snail-absent points were obtained from snail survey records. The best performance of the biomod2 ensemble model was achieved if a weighted mean approach was used as the ensemble strategy, with a true skill statistic value of 0.799 and an area under the receiver operating characteristic curve of 0.957, and modeling identified annual average relative humidity and annual average precipitation as two most influencing climatic variables for snail distribution. Relative to the current areas of suitable snail habitats under present climate conditions, the area of suitable snail habitats was projected to expand by 24.49% to 46.28% in Jiangxi Province under future climate scenarios, and the proportion of nature reserves areas in the areas of suitable snail habitats was projected to decrease slightly from the current 2.77% to approximately 2.52%, while the proportion of areas of snail control through chemical treatment in areas of suitable snail habitats varied from 0.64% to 19.57%, and the percentage of changes in snail habitat fragmentation ranged from 3.86% to 12.23%. Based on these four indicators, the snail survival vulnerability index was estimated to range from –1.96 to 0.62 in Jiangxi Province. The arithmetic mean of the snail survival vulnerability index differed under three SSP scenarios (SSP126, SSP245 and SSP585), with the highest mean value (–0.69) in 2070 under SSP126, and the lowest mean value (–0.78) in 2070 under SSP585. Conclusions The snail survival vulnerability index ranges from –1.96 to 0.62 in Jiangxi Province under future climate scenarios, and the suitable habitats for O. hupensis snails appear an overall tendency towards expansion. Low-vulnerability snail habitats are mainly distributed along the shores of Poyang Lake and the Yangtze River in Jiangxi Province, partially overlapping with nature reserves. Intensified surveillance of O. hupensis snails is recommended in these areas in the future.

Myelodysplastic syndrome (MDS), a myeloid tumor derived from the malignant clones of hematopoietic stem cells, has an annually increasing incidence. The contemporary research direction has shifted to analyzing the synergistic effect of immune surveillance collapse and abnormal bone marrow microenvironment in the pathological process of MDS. Against this backdrop, the immune checkpoint molecule TIM3 has emerged as a key target because of its persistently high expression on the surface of important immune cells such as T and NK cells. The abnormal activation of the TIM3 pathway is the mechanism by which solid tumors and hematological malignancies achieve immune escape and is a key hub in the formation of immune exhaustion phenotypes. This work integrates the original discoveries of our team with the latest international progress, systematically demonstrating the bidirectional regulatory network of TIM3 between the malignant clone proliferation of MDS and the immunosuppressive microenvironment. Integrating the evidence from emerging clinical trials allows us to consider the clinical significance of TIM3-targeted blocking for MDS, providing a transformative path to overcome the resistance of traditional treatments and marking a new chapter in the active immune reconstitution of MDS treatment.

On August 31， 2025， the Asian Pacific Association for the Study of the Liver （APASL） updated and released management of acute variceal bleeding： updated APASL guidelines （2025 edition）， which systematically elaborates on the definition， diagnosis， assessment， and treatment of acute variceal bleeding. This article gives an excerpt of the recommendations in this guideline.

OBJECTIVE To explore the effects of meropenem exposure and degradation levels on clinical efficacy in patients with purulent meningitis （PM）. METHODS A total of 131 PM patients treated with meropenem at the Affiliated Suzhou Hospital of Nanjing Medical University from January 2022 to June 2025 were prospectively included. Relevant data were collected and divided into a cured group （91 cases） and a non-cured group （40 cases） based on the efficacy. High-performance liquid chromatography-tandem mass spectrometry was used to determine the concentration of meropenem and its open-loop metabolites. Risk factors that affect efficacy were screened， and their predictive power and correlation were evaluated by univariate analysis， and multivariate Logistic regression analysis， receiver operating characteristic （ROC） curves， and correlation analysis. RESULTS Univariate analysis showed that serum creatinine， creatinine clearance rate， minimum inhibitory concentration of meropenem ≥16 μg/mL， cerebrospinal fluid red blood cell count， cerebrospinal fluid white blood cell count， cerebrospinal fluid glucose content， blood trough concentration， blood open-loop metabolite concentration/trough concentration ratio， and intrathecal injection were all correlated with efficacy （P＜0.05）. The results of multiple Logistic regression analysis showed that serum creatinine blood open-loop metabolite concentration/trough concentration ratio， intrathecal injection， and cerebrospinal fluid glucose content were influencing factors for suboptimal anti-infective ltt efficacy （P＜0.05）. ROC curve analysis showed that when the blood open-loop metabolite concentration/trough concentration ratio was greater than 2.854 （AUC＝0.647）， serum creatinine was less than 59.5 μmol/L （AUC＝0.647）， and cerebrospinal fluid glucose content was less than 3.37 mmol/L （AUC＝0.709）， the risk of treatment failure significantly increased （P＜0.05）. Correlation analysis showed that the blood trough concentration of meropenem was positively correlated with the concentration of its open-loop metabolites （R 2＝0.134 5， P＜0.000 1）. CONCLUSIONS Insufficient exposure level and rapid degradation of meropenem are key mechanisms affecting the anti-infective efficacy of PM. Elevated blood open-loop metabolite concentration/ trough concentration ratio， low serum creatinine level， lack of intrathecal injection， and low cerebrospinal fluid glucose content are independent risk factors for poor efficacy.

Objective:To explore the prognostic factors of patients with AML1::ETO-positive acute myeloid leukemia (AML).Methods:A retrospective cohort study was conducted. The clinical data of 42 AML1::ETO-positive AML patients diagnosed in the General Hospital of Ningxia Medical University from November 2012 to December 2023 were collected. The general clinical characteristics and short-term efficacy of patients were summarized, and the Kaplan-Meier method was used to analyze the overall survival (OS) and recurrence-free survival (RFS) of stratified patients based on factors such as age, gender, blood cell count, immunophenotype, treatment plan, and efficacy, and the log-rank test was used for inter-group comparison. Cox proportional hazards model was used for univariate and multivariate analyses on OS and RFS.Results:Among the 42 patients, there were 22 males (52.4%) and 20 females (47.6%), with a median age of 35 years, ranged from 14 to 66 years. The common initial symptoms included fatigue, fever and bleeding. The proportions of patients with CD19 or CD56 positivity were both 54.8% (23/42). Twenty-two cases (52.4%) received IA (idarubicin+cytarabine) regimen, 8 cases (19.1%) received HAA (homoharringtonine+cytarabine+aclarubicin) regimen, and 12 cases (28.6%) received induction chemotherapy with other regimens. Seven patients (16.7%) received hematopoietic stem cell transplantation (HSCT) during subsequent treatment. After one course of induction therapy, 29 cases (69.1%) achieved complete remission (CR). The proportions of patients in the CR group with initial platelet count > 10×10 9/L [86.2% (25/29) vs. 53.8% (7/13)], CD19 positivity [65.5% (19/29) vs. 30.8% (4/13)], CD56 negativity [58.6% (17/29) vs. 15.4% (2/13)], CD34 positivity [96.7% (28/29) vs. 76.9% (10/13)], and IA regimen treatment [58.6% (17/29) vs. 38.5% (5/13)] were higher than those in the non-CR group, and the differences were statistically significant (all P < 0.05). There were no statistically significant differences in the proportions of patients stratified by gender, age, hemoglobin, chromosomal karyotype, and with or without c-kit mutation (all P > 0.05). The median follow-up time was 19.5 months, ranged from 0.9 to 133.0 months. Kaplan-Meier analysis showed that patients with initial platelet count > 10×10 9/L, CD19 positivity, CD56 negativity, non-c-kit mutation, CR after one course of treatment, and subsequent HSCT had good OS and RFS (all P < 0.05). Multivariate Cox regression analysis showed that platelet count (> 10×10 9/L vs. ≤ 10×10 9/L, HR = 0.046, 95% CI: 0.007-0.314, P = 0.002), CD19 expression (positivity vs. negativity, HR = 0.069, 95% CI: 0.010-0.495, P = 0.008), CD56 expression (positivity vs. negativity, HR = 6.478, 95% CI: 1.178-35.631, P = 0.032), CD34 expression (positivity vs. negativity, HR = 38.300, 95% CI: 2.061-711.647, P = 0.014) and CR after one course of treatment (yes vs. no, HR = 0.076, 95% CI: 0.011-0.518, P = 0.008) were independent influencing factors for OS in AML1::ETO-positive AML patients. Platelet count (> 10×10 9/L vs. ≤ 10×10 9/L, HR = 0.101, 95% CI: 0.019-0.540, P = 0.007), CD19 expression (positivity vs. negativity, HR = 0.056, 95% CI: 0.007-0.462, P = 0.007) and CD56 expression (positivity vs. negativity, HR = 7.287, 95% CI: 1.096-48.457, P = 0.040) were independent influencing factors for RFS in AML1:: ETO-positive AML patients. Conclusions:Platelet count > 10×10 9/L and CD19 positivity may indicate a good prognosis for AML patients with AML1::ETO fusion gene, while CD56 positivity may indicate a poor prognosis.

Objective:To explore the effect of thymol on improving the core symptoms of autism through regulating scinderin expres-sion in autism spectrum disorder(ASD)rats by constructing valproic acid-induced ASD rat model and intervening with thymol.Methods:The ASD-like behaviors of rats were observed using three box social experiment,open field experiment,and youth social ex-periment.RNA-seq was used to detect the expression of RNA in the prefrontal cortex of rats.The protein level of scinderin in the pre-frontal cortex of rats was measured by Western blot.Results:Compared with the rats in the control group,the rats in the model group showed ASD-like behaviors,including decreased social ability,impaired social preference,decreased exploration ability,and repeated stereotyped behavior.Compared with the control group,the model group showed reduced standing times(P<0.001)and increased self combing time(P=0.003).Moreover,the expression level of scinderin in the prefrontal cortex increased in model rats.After thymol treat-ment,the ASD-like behaviors in the model group were significantly improved.Compared with the model group,the number of standing times in the intervention group increased(P<0.001)and the self grooming time decreased(P=0.004).The expression of scinderin basi-cally returned to the normal level.Conclusion:The abnormal expression of scinderin in the prefrontal cortex of ASD model rats can lead to ASD-like behaviors.Thymol intervention can reduce the expression of scinderin and improve the core symptoms of ASD.

Allergic rhinitis (AR), a globally prevalent immune-mediated inflammatory condition, is still an incurable disease. In the present study, we have validated the impact of the Kelch-like ECH associated protein 1 (Keap1)-related oxidative stress and inflammatory response in clinical AR patient peripheral blood and nasal swab samples, emphasizing the biological relevance of Keap1 and AR. Targeting Keap1 -nuclear factor erythroid 2-related factor 2 (Nrf2) related anti-oxidative stress may be effective for AR intervention. Drawing inspiration from the Keap1 homodimerization and the E3 ligase characteristics, we herein present a design of novel bivalent molecules for chemical knockdown of Keap1. For the first time, we characterized ternary complexes of Keap1 dimer and one molecule of bivalent compounds. The best bivalent molecule 8 encompasses robust capacity to degrade Keap1 as a homoPROTAC^KEAP1. It efficaciously suppresses inflammatory cytokines in extensively different cells, including human nasal epithelial cells. Moreover, in an AR mouse model, we confirmed that the chemical degradation induced by homoPROTAC^KEAP1 led to therapeutic benefits in managing AR symptoms, oxidative stress and inflammation. In summary, our findings underscore the efficacy of targeting the Keap1 system through the homoPROTAC-ing technology as an innovative and promising treatment strategy for the incurable allergic disorders.

Objective To assess the application value of mycoplasma pneumonia(MP)real-time fluorescence of RNA simultaneous amplification and testing(SAT)and MP antibody(MP-Ab)in the diagnosis of MP pneumonia(MPP)in children.Methods A total of 242 children with community-acquired pneumonia hospitalized at Beijing Haidian Hospital from September 2023 to October 2024 were enrolled as subjects.The children were divided into MPP group(n=193)and non-MPP group(n=49)based on MPP diagnosis.All children underwent simultaneous MP-SAT testing and initial MP-Ab detection within 24h of admission.MP-SAT results were monitored until they turned negative,with retesting for MP-Ab on 5-7d post-hospitalization in negative cases.The study compared diagnostic accuracy between MP-SAT and MP-Ab methods,while analyzing correlations between MP-SAT negative conversion time and clinical cure duration.Results For children with disease duration ≤ 7 days,MP-SAT demonstrated higher sensitivity than MP-Ab,with statistically significant difference(P＜0.001).The concordance between MP-SAT and initial MP-Ab test results was weak(Kappa=0.072),while the consistency between MP-SAT and follow-up MP-Ab test results was moderate(Kappa=0.614,P＜0.00 1).Both the clinical cure time and SAT seroconversion time were shorter with doxycycline treatment compared to azithromycin therapy.Conclusion The results of MP-SAT can be used to evaluate the condition of MPP children and guide the timely discontinuation of antibiotics.