Objective: To investigate the relationship between night-time noise exposure and depressive symptoms among junior and senior high school students, so as to provide evidence to support strategies for promoting their physical and mental health. Methods: From September 2024 to December 2025, 2 900 junior and senior high school students were selected using stratified cluster random sampling in the three cities of Nanning, Lhasa, and Yanji. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depressive symptoms in junior and senior high school students, and a noise exposure survey was conducted. Chi-square test was used to compare the prevalence of depressive symptoms among junior and senior high school students with different types of night-time noise exposure, and Logistic regression models were employed to examine the association between night-time noise exposure and depressive symptoms among junior and senior high school students. Results: The prevalence of depressive symptoms among junior and senior high school students without night-time noise exposure was 33.0%, while that among junior and senior high school students with night-time noise exposure was 49.0%; the difference was statistically significant ( χ 2= 45.85 , P <0.01) . After adjusting for gender, age and region, Logistic regression analysis showed that exposure to night-time traffic noise, neighborhood noise, air conditioner noise, and other types of noise showed increased risk of detecting depressive symptoms in junior and senior high school students ( OR =2.22, 1.84, 2.41, 2.17, all P <0.05). Conclusion Night-time noise exposure is associated with an increased risk of depressive symptoms among junior and senior high school students.

Objective:To explore the influencing factors for pathological upgrading in prostate cancer patients with a Gleason score of 3 + 3 undergoing targeted biopsy，and to establish a nomogram prediction model.Methods:A retrospective analysis was conducted on 191 patients with localized prostate cancer diagnosed with a Gleason score of 3 + 3 through targeted biopsies at the First Affiliated Hospital of Nanjing Medical University from January 2020 to June 2024. The age of the patients was 67（61，73）years，with prostate-specific antigen（PSA）level of 7.44（5.53，10.19）ng/ml，prostate volume of 35.64（26.59，48.97）ml，and PSA density（PSAD）of 0.20（0.14，0.31）ng/ml 2. Among them，61 cases（31.94%）had a Prostate Imaging Reporting and Data System（PI-RADS）score of 3，104 cases（54.45%）had a score of 4，and 26 cases（13.61%）had a score of 5. The diameter of the main lesion was 10.75（7.86，14.00）mm. The lesions were located in the peripheral zone in 78 cases（40.84%），the transition zone in 99 cases（51.83%），and the anterior fibromuscular stroma in 14 cases（7.33%）. The lesions were found at the apex in 56 cases（29.32%），in the body in 120 cases（62.83%），and at the base in 15 cases（7.85%）. MRI revealed only one lesion with a PI-RADS score ≥ 3 in 131 cases，two suspected lesions in 43 cases，three suspected lesions in 12 cases，and four suspected lesions in 5 cases. Systematic biopsy was positive in 121 cases（63.4%）and negative in 70 cases（36.6%）. The lesions were confined to the left lobe in 63 cases（32.98%），right lobe in 68 cases（35.60%），and involved both lobes in 60 cases（31.41%）. The interval between biopsy and surgery was 9.0（7.0，14.0）days. Univariate analyses were performed using Mann-Whitney U tests or χ2 tests，and multivariate logistic regression was used to identify independent predictors of pathological upgrading. A nomogram model was constructed based on these independent predictors. The model’s discriminative ability was assessed using the area under the receiver operating characteristic（ROC）curve（AUC），and internal validation of the model’s consistency was conducted using the bootstrap resampling method. Decision curve analysis（DCA）was performed to assess clinical utility. Results:Among the 191 cases，60（31.4%）had no pathological upgrading after surgery，while 131（68.6%）showed upgrading. Univariate analysis showed that the maximum diameter of the main lesion［9.0（6.0，13.2）mm vs. 11.0（8.4，14.0）mm］，number of suspicious lesions on MRI［1.0（1.0，1.0）vs. 1.0（1.0，2.0）］，number of positive systematic biopsy cores［1.0（0，2.0）vs. 1.0（0，3.0）］，percentage of positive systematic biopsy cores［0.08（0，0.17）vs. 0.12（0，0.25）］，number of positive targeted biopsy cores［2.0（1.0，3.0）vs. 3.0（1.0，4.0）］，percentage of positive targeted biopsy cores［0.37（0.24，0.75）vs. 0.50（0.38，0.85）］，level of the index lesion，location of the index lesion，and PI-RADS score were associated with pathological upgrading（ P < 0.05）. Multivariate logistic regression analysis showed that PI-RADS score 4（ OR = 5.88，95% CI 2.41 - 14.35），number of suspicious lesions on MRI（ OR = 4.15，95% CI 1.88 - 9.17），location of the index lesion in the transition zone（ OR = 6.86，95% CI 2.81 - 16.73），and percentage of positive targeted biopsy cores（ OR = 4.37，95% CI 1.38 - 14.90）were independent risk factors for pathological upgrading（ P < 0.05）. The nomogram model constructed using these predictors had an AUC of 0.845. Internal validation using the Bootstrap method yielded an AUC value of 0.812，indicating high predictive accuracy of the model. The calibration curve indicated good calibration. Decision curve analysis showed that the threshold range for net benefit in the model was between 12% - 100%. Conclusions:The PI-RADS score 4，the number of lesions with PI-RADS ≥ 3，the location of the main lesion in the transition zone，and the percentage of positive needles in targeted biopsy are independent risk factors for pathological upgrading from Gleason score 3 + 3. The nomogram model constructed from these factors demonstrates good predictive performance and provides a reference for clinical decision-making.

Objective:To explore the influencing factors for pathological upgrading in prostate cancer patients with a Gleason score of 3 + 3 undergoing targeted biopsy，and to establish a nomogram prediction model.Methods:A retrospective analysis was conducted on 191 patients with localized prostate cancer diagnosed with a Gleason score of 3 + 3 through targeted biopsies at the First Affiliated Hospital of Nanjing Medical University from January 2020 to June 2024. The age of the patients was 67（61，73）years，with prostate-specific antigen（PSA）level of 7.44（5.53，10.19）ng/ml，prostate volume of 35.64（26.59，48.97）ml，and PSA density（PSAD）of 0.20（0.14，0.31）ng/ml 2. Among them，61 cases（31.94%）had a Prostate Imaging Reporting and Data System（PI-RADS）score of 3，104 cases（54.45%）had a score of 4，and 26 cases（13.61%）had a score of 5. The diameter of the main lesion was 10.75（7.86，14.00）mm. The lesions were located in the peripheral zone in 78 cases（40.84%），the transition zone in 99 cases（51.83%），and the anterior fibromuscular stroma in 14 cases（7.33%）. The lesions were found at the apex in 56 cases（29.32%），in the body in 120 cases（62.83%），and at the base in 15 cases（7.85%）. MRI revealed only one lesion with a PI-RADS score ≥ 3 in 131 cases，two suspected lesions in 43 cases，three suspected lesions in 12 cases，and four suspected lesions in 5 cases. Systematic biopsy was positive in 121 cases（63.4%）and negative in 70 cases（36.6%）. The lesions were confined to the left lobe in 63 cases（32.98%），right lobe in 68 cases（35.60%），and involved both lobes in 60 cases（31.41%）. The interval between biopsy and surgery was 9.0（7.0，14.0）days. Univariate analyses were performed using Mann-Whitney U tests or χ2 tests，and multivariate logistic regression was used to identify independent predictors of pathological upgrading. A nomogram model was constructed based on these independent predictors. The model’s discriminative ability was assessed using the area under the receiver operating characteristic（ROC）curve（AUC），and internal validation of the model’s consistency was conducted using the bootstrap resampling method. Decision curve analysis（DCA）was performed to assess clinical utility. Results:Among the 191 cases，60（31.4%）had no pathological upgrading after surgery，while 131（68.6%）showed upgrading. Univariate analysis showed that the maximum diameter of the main lesion［9.0（6.0，13.2）mm vs. 11.0（8.4，14.0）mm］，number of suspicious lesions on MRI［1.0（1.0，1.0）vs. 1.0（1.0，2.0）］，number of positive systematic biopsy cores［1.0（0，2.0）vs. 1.0（0，3.0）］，percentage of positive systematic biopsy cores［0.08（0，0.17）vs. 0.12（0，0.25）］，number of positive targeted biopsy cores［2.0（1.0，3.0）vs. 3.0（1.0，4.0）］，percentage of positive targeted biopsy cores［0.37（0.24，0.75）vs. 0.50（0.38，0.85）］，level of the index lesion，location of the index lesion，and PI-RADS score were associated with pathological upgrading（ P < 0.05）. Multivariate logistic regression analysis showed that PI-RADS score 4（ OR = 5.88，95% CI 2.41 - 14.35），number of suspicious lesions on MRI（ OR = 4.15，95% CI 1.88 - 9.17），location of the index lesion in the transition zone（ OR = 6.86，95% CI 2.81 - 16.73），and percentage of positive targeted biopsy cores（ OR = 4.37，95% CI 1.38 - 14.90）were independent risk factors for pathological upgrading（ P < 0.05）. The nomogram model constructed using these predictors had an AUC of 0.845. Internal validation using the Bootstrap method yielded an AUC value of 0.812，indicating high predictive accuracy of the model. The calibration curve indicated good calibration. Decision curve analysis showed that the threshold range for net benefit in the model was between 12% - 100%. Conclusions:The PI-RADS score 4，the number of lesions with PI-RADS ≥ 3，the location of the main lesion in the transition zone，and the percentage of positive needles in targeted biopsy are independent risk factors for pathological upgrading from Gleason score 3 + 3. The nomogram model constructed from these factors demonstrates good predictive performance and provides a reference for clinical decision-making.

AIM: To compare the efficacy of different intraocular lens(IOL)fixation in aphakic patients lacking capsule support.METHODS:Retrospective study. Totally 120 cases(120 eyes)of aphakia patients who lacked capsule support admitted to our hospital from June 2019 to June 2024 were selected as the study subjects and randomly assigned into group A and group B, with 60 cases in each group. Group A underwent subcapsular IOL deep scleral fixation, while group B underwent IOL suture suspension fixation in the ciliary groove. The surgery time, uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), intraocular pressure(IOP), corneal endothelial cell density(CECD), corneal endothelial cell loss rate, and postoperative complications were compared between the two groups before and at 1, 3, 6 mo after surgery.RESULTS:The operation time of the group A was lower than that of the group B(24.69±2.69 vs. 32.75±3.75 min, t=11.937, P<0.05). The UCVA and BCVA in both groups were better than those before operation, and the group A was better than the group B(all P<0.05). The loss rates of corneal endothelial cells in the group A were lower than those in the group B at 1, 3 and 6 mo after surgery, the IOP in the group A was lower than that in the group B at 1 mo after surgery, and the CECD in the group A was higher than the group B(all P<0.05). The 3 eyes(5.0%)of the postoperative IOL ectopic in the group A were less than 11 eyes in the group B(18.3%, P=0.023).CONCLUSION:Subcapsular IOL deep scleral fixation has prominent curative effects on aphakic patients who lack capsule support. It helps improve vision, with less operation time, and fewer postoperative complications.

Objective To investigate the effects of transcranial magnetic stimulation(TMS)combined with human umbilical cord mesen-chymal stem cells(hUC-MSCs)on ferroptosis following spinal cord injury(SCI)in rats.Methods Allen percussion was used to estab-lish the SCI model.A total of 60 SD rats were randomly divided into sham,SCI,TMS,hUC-MSC,and TMS+hUC-MSC groups,with 12 rats in each group.Motor function was evaluated using the Basso-Beattie-Bresnahan(BBB)score.Spinal cord tissues were sampled and stained with hematoxylin and eosin(HE)as well as Nissl to observe tissue damage as well as the changes in neurons and Nissl bodies,respectively.The colorimetric method was used to detect the contents of ferrous ions(Fe2+)and reduced glutathione(GSH).Transmission electron microscopy was applied to observe the ultrastructure of the mitochondria.Western blotting was performed to detect the expres-sion levels of SLC7A11,GPX4,and ACSL4.Results The SCI group had lower BBB scores,higher Fe2+and ACSL4 protein expression levels,and lower GSH,SLC7A11,and GPX4 protein expression levels than the sham group(P<0.05).The mitochondrial cristae reduced with membrane shrinkage,neuronal damage was severe,and Nissl bodies were absent in the SCI group.The TMS,hUC-MSC,and TMS+hUC-MSC groups had higher BBB scores,lower Fe2+and ACSL4 protein expression levels,and higher GSH,SLC7A11,and GPX4 protein expression levels than the SCI group(P<0.05).The mitochondrial cristae increased with an intact membrane structure,the pathological damage was attenuated,neuronal morphology was restored,and Nissl bodies were clearly visible in TMS,hUC-MSC,and TMS+hUC-MSC groups.Conclusion TMS combined with hUC-MSC inhibits ferroptosis through activating the SLC7A11/GSH/GPX4 pathway,alleviates secondary injury after SCI,and promotes functional recovery and neural remodeling in rats.

Objective To investigate the effects of transcranial magnetic stimulation(TMS)combined with human umbilical cord mesen-chymal stem cells(hUC-MSCs)on ferroptosis following spinal cord injury(SCI)in rats.Methods Allen percussion was used to estab-lish the SCI model.A total of 60 SD rats were randomly divided into sham,SCI,TMS,hUC-MSC,and TMS+hUC-MSC groups,with 12 rats in each group.Motor function was evaluated using the Basso-Beattie-Bresnahan(BBB)score.Spinal cord tissues were sampled and stained with hematoxylin and eosin(HE)as well as Nissl to observe tissue damage as well as the changes in neurons and Nissl bodies,respectively.The colorimetric method was used to detect the contents of ferrous ions(Fe2+)and reduced glutathione(GSH).Transmission electron microscopy was applied to observe the ultrastructure of the mitochondria.Western blotting was performed to detect the expres-sion levels of SLC7A11,GPX4,and ACSL4.Results The SCI group had lower BBB scores,higher Fe2+and ACSL4 protein expression levels,and lower GSH,SLC7A11,and GPX4 protein expression levels than the sham group(P<0.05).The mitochondrial cristae reduced with membrane shrinkage,neuronal damage was severe,and Nissl bodies were absent in the SCI group.The TMS,hUC-MSC,and TMS+hUC-MSC groups had higher BBB scores,lower Fe2+and ACSL4 protein expression levels,and higher GSH,SLC7A11,and GPX4 protein expression levels than the SCI group(P<0.05).The mitochondrial cristae increased with an intact membrane structure,the pathological damage was attenuated,neuronal morphology was restored,and Nissl bodies were clearly visible in TMS,hUC-MSC,and TMS+hUC-MSC groups.Conclusion TMS combined with hUC-MSC inhibits ferroptosis through activating the SLC7A11/GSH/GPX4 pathway,alleviates secondary injury after SCI,and promotes functional recovery and neural remodeling in rats.

A retrospective analysis was conducted on 5 516 patients diagnosed with prostate cancer(PCa) at our hospital. Among these, 52 patients aged ≤ 50 years were defined as the early-onset group.For the control group, 228 patients aged >50 years were randomly selected at a ratio of 1∶4.4. The early-onset group predominantly presented with elevated PSA levels at diagnosis and had a lower positive rate of digital rectal examination. There were no significant differences in clinical and pathological characteristics between the early-onset group and the control group. Young PCa patients in the low to intermediate risk categories had similar survival prognosis to older patients. However, young patients with high-risk prostate cancer had 5-year progression-free survival rate of 38.4% compared to 55.6% for older patients, and 5-year cancer-specific survival rate of 70.1% compared to 84.1% for older patients, indicating that high-risk young patients exhibited poorer oncological outcomes.

A valid, novel, and comprehensive evaluation method for assessing the quality of Magnolia officinalis leaves (MOLs) from different origins has been established based on multiwavelength fusion fingerprint, quantitative analysis, and antioxidant activity screening. The four wavelength fingerprints for MOL samples at 258, 266, 290, and 327 nm were collected by high performance liquid chromatography, and then data fusion was conducted. In addition, the content of multiple components was determined by high performance liquid chromatography at four wavelengths. 1, 1-Diphenyl-2-pyridyl hydrazine scavenging assay was applied to study in vitro antioxidant activity. The effective distinction of 18 batches of MOLs was realized based on hierarchical cluster analysis, principal component analysis, and orthogonal partial least squares discriminant analysis combined with multiwavelength fusion fingerprint. The orthogonal partial least squares discriminant analysis model exhibited huge advantages in distinguishing among different samples and screening three quality markers of the tested samples, including rutin, isoquercitrin, and chlorogenic acid. This established method of multitechnology fusion is simple, reliable, and efficient for the qualitative and quantitative bioactivity evaluation of MOLs. This study aims to investigate the development of new medicinal parts of traditional Chinese medicines (TCMs), so as to enhance the efficiency of utilizing TCM resources and promote the high-quality development of the TCM industry.

Objective:To investigate the value of bi-parameter magnetic resonance imaging (bpMRI) in diagnosis and treatment of hematospermia.Methods:The clinical data and bpMRI of 182 patients with hematospermia (hematospermia group) and 51 patients without urinary system diseases (control group) were retrospectively analyzed. Both the control group and the hematospermia group underwent semen quality analysis, blood routine, urine routine, coagulation function, serum PSA test, and bpMRI examination before treatment. There were no significant differences in age [40(33, 50)years vs. 39(31, 53) years, Z=-0.77, P=0.43], body mass index [23.9(22.0, 25.7)kg/m2 vs. 24.5(22.3, 26.1) kg/m 2, Z=-0.50, P=0.62], smoking rate [24.7%(45/182) vs. 27.5%(14/51), χ2=0.16, P=0.69], alcohol consumption rate [29.1%(53/182) vs. 29.4%(15/51), χ2=0.002, P=0.97], and comorbid hypertension [20.9%(38/182) vs. 17.6%(9/51), χ2=0.26, P=0.61] between the hematospermia group and the control group. There was a statistically significant difference in PSA levels between the hematospermia group and the control group [2.82(2.08, 3.68)ng/ml vs 1.59(0.88, 2.28) ng/ml, Z=6.08, P=0.03].The median duration of illness in the hematospermia group was 10(5, 15) months, the median number of red blood cells reported in semen analysis was 17(10, 23)/HP, 59(32.4%) cases had infections in urine routine results, 15(8.2%) cases had infections in blood routine results, and 19(10.4%) cases had coagulation abnormalities. Hematospermia patients can be divided into five categories based on their causes: 105 cases of infection and inflammation, 42 cases of obstruction, 19 cases of tumors, 8 cases of systemic diseases, and 8 cases of iatrogenic factors and trauma. The treatment option was based on etiology: ①Infections, Inflammation, Systemic Diseases, Iatrogenic Factors, and Trauma: Remove the underlying cause and observe or watchful waiting. ②Recurrence of Systemic Diseases, Infections, and Inflammation: Treat the underlying cause with appropriate medication, including nonsteroidal anti-inflammatory drugs (NSAIDs), α-receptor blockers, etc. If there is an infection, administer oral antibiotics for 1-2 weeks. ③Obstruction and Tumors: Perform seminal vesiculoscopy surgery or radical prostatectomy. The efficacy evaluation was porfeomed after 12 months of treatment. Cure: Hematospermia symptoms disappear, with no recurrence. Effective: Symptoms significantly improve, no visible hematospermia, semen analysis shows marked improvement in red blood cells, and neither clinical symptoms nor semen analysis worsen. Not Cured: Visible hematospermia persists, and semen analysis shows no change in red blood cells compared to before treatment. Recurrence: Clinical symptoms improve but significant visible hematospermia reappears, and semen analysis shows red blood cell count >5/HP. Results:The proportion of patients with PI-RADS scores ≥ 3 in the hematospermia group was higher than that in the control group [29.1%(53/182)vs. 13.7%(7/51), χ2=4.94, P=0.03], and the difference was statistically significant. Comparing the imaging characteristics and related parameters of two groups of bpMRI, the results showed that the length and width of the left and right seminal vesicles in the hematospermia group were greater than those in the control group. The length of the left seminal vesicle was [29.9(25.9, 33.4)mm vs. 23.0(21.2, 25.4)mm, Z=7.30, P<0.01], the width of the left seminal vesicle was[20.4(17.8, 23.5)mm vs. 17.2(15.1, 18.5)mm, Z=5.85, P<0.01], the length of the right seminal vesicle was [28.9(24.8, 32.4)mm vs. 23.4(21.5, 28.1)mm, Z=4.68, P<0.01], and the width of the right seminal vesicle was[19.8(17.7, 23.1)mm vs. 17.2(15.1, 18.6)mm, Z=5.45, P<0.01]. The differences were statistically significant. After 12 months of follow-up, 152(83.5%) cases were cured, 21(11.5%) cases were defined as effective, 4(2.2%) cases were not cured, and 5(2.7%) cases had recurrence. Conclusions:The bpMRI examination can clearly identify the location of the hematospermia lesion and the timing of the bleeding. Based on the results of bpMRI, determining the cause and selecting the appropriate treatment strategy is reliable, convenient, and effective.

A retrospective analysis was conducted on 5 516 patients diagnosed with prostate cancer(PCa) at our hospital. Among these, 52 patients aged ≤ 50 years were defined as the early-onset group.For the control group, 228 patients aged >50 years were randomly selected at a ratio of 1∶4.4. The early-onset group predominantly presented with elevated PSA levels at diagnosis and had a lower positive rate of digital rectal examination. There were no significant differences in clinical and pathological characteristics between the early-onset group and the control group. Young PCa patients in the low to intermediate risk categories had similar survival prognosis to older patients. However, young patients with high-risk prostate cancer had 5-year progression-free survival rate of 38.4% compared to 55.6% for older patients, and 5-year cancer-specific survival rate of 70.1% compared to 84.1% for older patients, indicating that high-risk young patients exhibited poorer oncological outcomes.