Objective: To explore the effects of personality and sleep quality with psychological distress of junior and senior high school stduents, so as to provide a reference basis for precise interventions of junior and senior high school students mental health. Methods: In October 2023, a convenience sampling method was used to select 9 034 students aged 12-17 from Shiyan City as the study subjects. The Pittsburgh Sleep Quality Index (PSQI) and Kessler Psychological Distress Scale (K10) were used to collect information on sleep quality and psychological distress of junior and senior high school stduents. Between group comparison was conducted by using t-test and Chi-square test. Generalized linear models were employed to analyze the interaction and joint effects of personality and sleep quality on psychological distress. Results: The generalized linear model analysis showed that the interaction between personality and sleep quality on psychological distress was statistically significant of junior and senior high school students(effect size=0.80, P <0.01). The general linear model analysis indicated that, after adjusting for variables such as age, gender, screen time, and daily sitting time with the extroverted and good sleep quality group as the reference, the introverted and poor sleep quality group had the largest mean difference in psychological distress scores (difference=0.51, P <0.05). When stratified by sleep quality, psychological distress scores were higher in the introverted and neutral personality groups with both poor and good sleep quality compared to the extroverted group (poor sleep quality: introverted difference=3.71, neutral difference=1.14; good sleep quality: introverted difference=2.23, neutral difference=0.57, all P < 0.05). When stratified by personality, psychological distress scores were higher in the poor sleep quality groups for introverted, neutral, and extroverted individuals compared to their good sleep quality counterparts (differences=8.66, 7.83, 7.34, all P < 0.05 ). Conclusions Personality and sleep quality have interactive and joint effects on psychological distress of junior and senior high school stduents. Personalized psychological interventions should be developed based on personality and sleep quality.

Background: High-mobility group box protein 1 (HMGB1) is a chromatin-binding protein involved in arthritis, ischemia, sepsis, atherosclerosis, neurodegenerative disorders, meningitis, and cancer. HMGB1 exhibits dual roles in cancer, acting as either a tumor suppressor or oncoprotein depending on context. Objective: This research aimed to elucidate HMGB1’s functional significance in cutaneous squamous cell carcinoma (cSCC). Methods: We overexpressed HMGB1 in cSCC cell lines using recombinant adenovirus and examined its effects on cell proliferation, colony formation, and cell migration. Results: Immunohistochemical analysis revealed elevated HMGB1 expression levels in cSCC tissue relative to normal epidermis. To assess the influence of HMGB1, we employed recombinant adenoviruses expressing HMGB1 to transduce SCC cell lines (SCC12 and SCC13). Enhanced HMGB1 expression significantly promoted cellular proliferation and colony formation capacity.Notably, HMGB1 overexpression elevated the levels of proliferation regulators, including P63, SOX2, CDK4 and CDK6. Furthermore, HMGB1 overexpression substantially enhanced tumor invasiveness, accompanied by upregulation of epithelial-mesenchymal transition (EMT) biomarkers. Mechanistically, overexpression of HMGB1 enhanced transforming growth factor-β signaling by increasing phosphorylation of SMAD2/3, the key mediators of EMT. Conclusion These data imply that HMGB1 acts as a tumor-promoting factor in cSCC.

ObjectiveHepatocellular carcinoma (HCC) represents 90% of all primary liver cancers. The main risk factors associated with HCC include viral hepatitis (B and/or C), alcohol abuse, and metabolic dysfunction-associated steatotic liver disease (MASLD), which progressively advance to liver fibrosis, cirrhosis, and ultimately evolve into HCC. Surgical resection represents the most effective treatment for HCC, while recent advances in immunotherapy, including immune checkpoint inhibitors and adoptive cell therapies, have provided improved treatment prospects for patients with unresectable HCC. However, the complex metabolic heterogeneity of HCC limits the therapeutic efficacy. Metabolic intermediates acyl-CoA not only provide energy and substrates for numerous biochemical reactions but also serve as donors for protein lysine acylation, a major class of post-translational modification (PTM). Therefore, a deeper understanding of the molecular mechanisms underlying protein lysine acylation and hepatocarcinogenesis is urgently needed. MethodsThe levels of protein lysine acylation and silence information regulator 5 (SIRT5) expression levels in clinical HCC samples were analyzed by Western blot. Quantitative malonylome and succinylome of HCC samples were analyzed by antibody-based affinity enrichment coupled with tandem mass spectrometry. The proliferation of HCC cells was analyzed with Cell Counting Kit-8 (CCK-8) assays, the apoptosis was quantified by Annexin V-FITC/propidium iodide (PI) staining coupled with flow cytometry, and the ability of cells to migrate was assayed by Transwell assays. The enzymatic activity of glutathione S-transferase Mu 1 (GSTM1) was quantified. Transgenic mice with hepatic overexpression of SIRT5 were constructed using CRISPR-Cas9, and primary hepatocarcinogenesis was induced by administration of diethylnitrosamine. ResultsWestern blot analysis indicated that the expression level of SIRT5 was elevated in clinical samples from HCC patients, and the levels of lysine malonylation, glutarylation, and succinylation were significantly reduced in HCC tissues. Knockout of SIRT5 in MHCC-97H and MHCC-97L hepatoma cells suppressed cell proliferation, and increased the percentage of apoptotic cells significantly. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses of the differentially malonylome and succinylome of HCC samples revealed significant enrichment in two major classes of biological processes: core energy metabolism (e.g., glycolysis/gluconeogenesis, tricarboxylic acid metabolic process, fatty acid beta oxidation) and detoxification and oxidative stress response (e.g., response to toxic substance, chemical carcinogenesis, reactive oxygen species (ROS)). SIRT5 removes malonylation from lysine residues in GSTM1 and restores its detoxification activity, which is crucial for the survival of hepatocytes under stressed conditions. More importantly, in vivo experiment indicated that hepatic-specific overexpression of SIRT5 in mice accelerated diethylnitrosamine-induced liver fibrosis and hepatocarcinogenesis, indicating the critical role of SIRT5 in HCC progression. ConclusionThis study highlights the previously unrecognized SIRT5-GSTM1 axis as a key regulator in hepatocarcinogenesis, and suggests a potential target for the treatment of patients with HCC.

ObjectiveStroke poses a heavy burden due to its high mortality and morbidity rates. Accurate and real-time detection of lesions is pivotal for prompt clinical intervention and favorable prognosis. Electrical impedance tomography (EIT) and microwave tomography (MWT) have emerged as compelling alternatives for stroke screening, owing to their non-ionizing, non-invasive and portable nature. EIT provides information on tissue conductivity, and MWT offers high sensitivity to changes in dielectric properties. However, single-modality imaging is inherently limited, EIT suffers from low sensitivity to deep-seated tissues and severe ill-posedness of inverse problems, whereas MWT is challenged by strong nonlinearity in inverse scattering and susceptibility to modeling errors. Consequently, the clinical utility of standalone EIT or MWT for stroke diagnosis remains constrained by poor spatial resolution and imaging artifacts. To improve the accuracy and robustness of stroke imaging, a dual-modality fusion conditional denoising diffusion probabilistic model (DM-DDPM) was proposed for high-precision dual-modality image reconstruction. MethodsA dual-encoder network with a symmetric architecture and independently trained parameters was constructed to extract heterogeneous features separately from EIT boundary voltage measurements and MWT scattered field signals. Attentional feature fusion (AFF) is employed to integrate complementary information from the two modalities adaptively, generating robust fused priors that suppress redundant noise while preserving key physical characteristics. Subsequently, the fused priors are embedded into a Transformer-based diffusion model via a cross attention mechanism to guide the reverse denoising process. This approach effectively reduces artifacts and enhances the stability of conductivity distribution reconstruction. Time step embedding is introduced to enable the network to perceive the diffusion stage and further improve the accuracy of noise prediction. ResultsSimulated experiments demonstrated that DM-DDPM significantly outperforms single-modality and multi-modality networks under various noise levels. A head model simulation dataset was constructed based on COMSOL Multiphysics, and tests were carried out under 50 dB, 40 dB and 30 dB signal-to-noise ratio levels. At 30 dB, the average relative error (RE) was below 0.20, while the structural similarity index measure (SSIM) and correlation coefficient (CC) remained above 0.90 and 0.89, respectively. Compared with single-modality and multi-modality networks, artifacts were significantly reduced, lesion edges were clearer, and localization was more accurate. The model maintains high reconstruction quality and strong robustness for single, double, and triple lesions simultaneously. Furthermore, physical experiments were conducted using a 16-electrode EIT system and a 16-antenna MWT system with asynchronous data acquisition. These experiments confirmed the feasibility of the method in real-world scenarios and demonstrated that it can robustly reconstruct simulated lesions despite environmental interference and measurement noise, validating its reliability for practical clinical applications. ConclusionThe proposed method effectively combines complementary dual-modality information with a conditional diffusion model. Low accuracy and poor noise resistance in single-modality imaging were effectively addressed, while the noise amplification issue caused by direct multimodal data fusion was avoided. The proposed algorithm exhibits strong anti-noise interference ability and high imaging stability in both simulation and physical experiments. Precise localization of stroke lesions with different quantities was achieved, providing a high-precision, and practical technical support for clinical stroke detection.

ObjectiveTo investigate the temporal trend of weight-adjusted-waist index （WWI） and its association with the risk of incident cardiovascular diseases （CVD） among middle-aged and older Chinese adults. MethodsBased on the China Health and Retirement Longitudinal Study （CHARLS）， this research enrolled participants aged 45 and above with complete physical measurement data from the 2011， 2013， and 2015 waves. Complex sampling weights were applied to calculate the mean WWI， and the Mann-Kendall test was used to analyze its trend. From the 2011 baseline survey， individuals with a history of cardiovascular disease or missing key covariates were further excluded. New-onset cardiovascular outcome events were collected during follow-up until 2020. Participants were categorized into Q1–Q4 groups based on baseline WWI quartiles. Multivariable log-binomial regression models were constructed to assess the association between WWI and CVD， while restricted cubic splines were employed to evaluate potential nonlinear relationships. Sensitivity analyses were conducted to verify the robustness of the findings. ResultsFrom 2011 to 2015， the weighted mean WWI among Chinese middle-aged and older adults remained generally stable （2011： 11.17±1.68； 2013： 11.28±1.35； 2015： 11.24±1.59； P for trend <0.05）. During the longitudinal follow-up， 1 784 incident CVD cases were documented. After multivariable adjustment， each unit increase in WWI was associated with a 17% increased risk of CVD （RR： 1.17， 95%CI： 1.10-1.24）. Compared with the Q1 group， the risk of CVD in the Q2， Q3， and Q4 groups increased by 23% （RR： 1.23， 95% CI： 1.07-1.40）， 27% （RR： 1.27， 95% CI： 1.11-1.44）， and 40% （RR： 1.40， 95% CI： 1.22-1.60）， respectively. A significant linear trend was observed between the increasing WWI and elevated CVD risk （P for trend <0.001）. Subgroup analysis revealed a stronger association in participants aged 45-60 years （P for interaction <0.05）. The results of sensitivity analysis were consistent with the main research results. ConclusionsThe overall trend of WWI level in the middle-aged and elderly population in China is stable from 2011 to 2015. The higher level of WWI is associated with an increased risk of CVD， suggesting that WWI may be used as a simple and effective indicator to evaluate the risk of cardiovascular metabolism in middle-aged and elderly people.

Objective: To explore the network structure of anxiety and depressive symptoms, and psychotic like experiences in junior and senior high school students with different sleep qualities, and to provide a reference for improving sleep quality in the population. Methods: A cross sectional online survey was conducted among 22 997 junior and senior high school students from seven junior and senior high schools in Luzhou City, Sichuan Province, using convenience sampling. The Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and the 16item Prodromal Questionnaire (PQ-16) were administered. Independent sample t-test was used to compare mental health status between adolescents with and without sleep problems. Network analysis was applied to examine the symptom association patterns across gender and school stage subgroups. Results: The prevalence of sleep problems among junior and senior high school students was 22.58%. The total anxiety symptom score (8.92± 4.02 ), total depressive symptom score (13.35±5.66), and scores for each factor of PQ-16 (perceptual and sensory abnormalities, thinking abnormalities, negative symptoms, and specific perceptual and sensory abnormalities) (3.32±3.32, 2.08±2.36, 3.36± 2.74 , 1.44±1.86) in the group with sleep problems were all significantly higher than those in the group without sleep problems ( 3.43 ±3.33, 5.03±4.73; 0.63±1.52, 0.47±1.11, 0.77±1.48, 0.25±0.79), with statistically significant differences ( t =99.60, 106.54, 82.49, 68.51, 89.09, 67.30, all P <0.01). In females with sleep problems, the anxiety-depressive symptoms edge weight was the highest (0.44). In males with sleep problems, the "sleep latency-sleep efficiency" edge weight was the highest (0.43), and the strength centrality values of "perceptual abnormalities" "medication factor" and "sleep latency" ranked the higher (1.32, 1.31 and 1.25). The network connectivity strength of the sleep problem group was higher in senior high school students than in junior high school students, and the strength centrality (1.12) and betweenness centrality (0.12) of negative symptoms were higher than those in junior high school students (1.02 and 0.11). Conclusions The network associations between sleep problems and psychological symptoms in junior and senior high school students exhibit gender and school stage specific characteristics. Differentiated intervention strategies should be tailored to specific subgroups.

Objective To observe the clinical efficacy of thumb-tack needling therapy combined with Oxycodone Hydrochloride Sustained-Release Tablets in treating patients with severe cancer pain caused by malignant tumors.Methods A total of 60 patients diagnosed with severe cancer pain who were admitted to the Traditional Chinese Medicine Department of Qingpu Branch,Zhongshan Hospital Affiliated to Fudan University between November 2023 and December 2024 were selected as study subjects.Patients were randomly divided into an observation group and a control group using a random number table,with 30 cases in each group.The control group received conventional western medicine pain management,while the observation group received additional thumb-tack needling therapy based on the control group's treatment.The treatment duration was 2 weeks.After treatment,clinical efficacy was evaluated by observing changes in European Quality of Life-5 Dimensions(EQ-5D)scores,Numerical Rating Scale(NRS)scores,Cancer Pain Self-Efficacy Scale(CPSS)scores,and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30)scores in both groups before and after treatment.Changes in serum levels of prostaglandin E2,endothelin-1,β-endorphin,and substance P were also compared.Safety and adverse reactions were assessed.Results(1)The total analgesic effective rate was 76.67％(23/30)in the observation group and 46.67％(14/30)in the control group.The total effective rate in the observation group was significantly higher than that in the control group,with a statistically significant difference(P＜0.05).(2)After treatment,serum levels of prostaglandin E2,endothelin-1,β-endorphin,and substance P were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(3)After treatment,EQ-5D scores,NRS scores,and CPSS scores were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(4)After treatment,EORTC QLQ-C30 scores were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(5)The incidence of adverse reactions was 53.33％(16/30)in the observation group and 83.33％(25/30)in the control group.The incidence of adverse reactions in the observation group was significantly lower than that in the control group,with a statistically significant difference(P＜0.05).Conclusion Thumb-tack needling therapy combined with Oxycodone Hydrochloride Sustained-Release Tablets significantly alleviates pain symptoms,improves health status and self-efficacy,and enhances the quality of life in patients with severe cancer pain caused by malignant tumors.

By reviewing the practice and current situation of the standardized training for naval surgical residents,in combination with the practice of the standardized training for resident doctors in Shanghai,this paper sums up the existing experience and explores clinical teaching,management and patterns of standardized training for naval residents based on the post competence.The aim of the study is to strengthen naval primary medical care,enhance trainees'working competence and medical support capabilities,improve the quality and level of standardized training for naval residents,so as to provide reference for the further development of the training strategy of naval officers.

Objective To explore the regulatory effect of oral probiotics as adjuvant therapy on the imbalance of helper T cell 1(Th1)/helper T cell 2(Th2),intestinal flora and lung function in children with allergic asthma and its clinical efficacy.Methods A retrospective analysis was con-ducted in the clinical data of 122 children with allergic asthma.According to different treatment regi-mens,the children were divided into control group(n=60)and observation group(n=62).The control group received conventional treatment combined with budesonide,while the observation group received oral probiotics as adjunctive therapy in addition to the treatment in the control group.The asthma control effects[Childhood Asthma Control Test(C-ACT)score],intestinal flora(Escherichia co-li,Bifidobacterium,Lactobacillus),relevant lung function indicators[peak expiratory flow as a percentage of predicted value(PEF％pred),fractional exhaled nitric oxide(FeNO),forced expiratory volume in one second as a percentage of predicted value(FEV1％pred)],respiratory mechanics parameters[work of breathing(WOB),airway resistance(Raw),peak inspiratory pressure(PIP),dynamic lung compliance(Cdyn)],levels of sputum adhesion molecules[integrin α4β1,vascular cell ad-hesion molecule-1(VCAM-1),intercellular adhesion molecule-1(ICAM-1)],levels of Th1/Th2 cytokine-related indicators[interleukin-4(IL-4),interferon--y(IFN-γ),the ratio of IFN-γ to IL-4(IFN-γ/IL-4),the ratio of Th1 to Th2(Th1/Th2)],symptom disappearance time,clinical effica-cy,and the incidence of adverse reactions were compared between the two groups.Results After treatment,the observation group demonstrated significantly higher C-ACT scores,overall clinical re-sponse rates,IFN-γ/IL-4 and Th1/Th2 ratios,along with elevated levels of Lactobacillus,Bifidobacterium,PEF％pred,FEV1％pred,Cdyn and IFN-γ compared to the control group(P＜0.05).Conversely,adverse reaction rates,and levels of Escherichia coli,FeNO,Raw,WOB,PIP,integrin α4β1,VCAM-1,ICAM-1 and IL-4 were significantly lower in the observation group(P＜0.05).Symptom resolution time was also shorter in the observation group(P＜0.05).The total Naranjo scale score was 3,indicating a"possible"causal relationship between adverse drug re-actions and probiotic use.Conclusion Oral probiotics as adjunctive therapy can effectively regulate Th1/Th2 imbalance induced by allergic asthma in children,improve clinical outcomes,pulmonary function,respiratory mechanics,intestinal microbiota composition,and sputum adhesion molecule levels.

Objective To understand the changes in self-rated health among middle-aged and elderly individuals in China and the influencing factors,providing a reference for improving health and promoting healthy aging.Methods Using data from the China Health and Aged Care Tracking Survey(CHARLS)from 2011 to 2020,this study analyzed 3595 middle-aged and elderly individuals(≥45 years old)who participated in all five rounds of the survey from 2011 to 2020.Univariate analysis and multinomial logistic regression were employed to analyze the influencing factors of self-rated health changes.Results Among the 3 595 middle-aged and elderly individuals,26.54％reported an increase in self-rated health,28.40％reported a decrease,and 45.06％reported no change.The multinomial logistic regression results indicated that compared to those with unchanged self-rated health,individuals whose self-rated health declined were more likely to have an increased number of Activities of Daily Living(ADLs),a higher number of chronic diseases,not engaging in at least 10 minutes of light physical activity per week,and a decline in life satisfaction levels.The odds ratios for these factors were 1.415(OR=1.415,95％CI:1.181～1.694),1.479(OR=1.479,95％CI:1.225～1.785),1.454(OR=1.486,95％CI:1.172～1.804),and 1.263(OR=1.237,95％CI:1.043～1.530),respectively.In contrast,individuals whose self-rated health improved,compared to those with unchanged health,were more likely to report an increase in life satisfaction levels,while an increase in ADLs and chronic diseases negatively impacted self-rated health improvement.The odds ratios for these factors were 1.698(OR=1.698,95％CI:1.425～2.023),0.769(OR=0.769,95％CI:0.646～0.915),and 0.689(OR=0.689,95％CI:0.549～0.865),respectively.Conclusion From 2011 to 2020,the self-rated health of middle-aged and elderly individuals in China has slightly declined,with a focus on improving physical health status,increasing physical activity,and addressing mental health as key areas for enhancing self-rated health among the elderly in China.