Objective: To investigate the prevalence and associated factors of depressive symptoms among junior and senior high school students in Beijing from 2019 to 2023, in order to provide a scientific basis for interventions targeting high risk groups. Methods: From 2019 to 2023, a stratified cluster random sampling method was used to select 88 927 junior and senior high school students from 16 districts in Beijing. The Center for Epidemiologic Studies Depression Scale(CES-D) was conducted to assess depressive symptoms. The Chi square test was used to compare the detection rates of depressive symptoms among different student groups, and the trend Chi square test was employed for trend analysis of detection rates across the years. Multivariate Logistic regression analysis was applied to examine the association between the detection of depressive symptoms and related factors among junior and senior high school students. Results: From 2019 to 2023, the prevalence rates of depressive symptoms among junior and senior high school students in Beijing were 20.45%, 18.19%, 16.64%, 17.89% and 18.17%, respectively, with an overall downward trend ( χ 2 trend =27.51, P <0.01). Multivariate Logistic regression analysis revealed that after adjusting for gender, monitoring year, educational stage,family structure,boarding status and has taken a medical leave of absence in the past year unhealthy dietary behaviors ( OR=1.80, 95%CI =1.73-1.87), physical inactivity ( OR=1.24, 95%CI =1.19-1.29), try smoking ( OR=1.46, 95%CI =1.35-1.58), try alcohol( OR=1.96, 95%CI =1.88-2.05), Internet addiction ( OR=3.88, 95%CI =3.57-4.22), and adverse ear related behavior ( OR=1.82, 95%CI =1.71-1.93) were all associated with an increased risk of depressive symptoms among junior and senior high school students (all P <0.05). Conclusions The prevalence depression symptoms among middle school students in Beijing showed a fluctuating downward trend from 2019 to 2023. Targeted interventions should be adopted to reduce the occurrence of depression symptoms among junior and senior high school students.

Objective: To understand the trends of classroom lighting and illumination of primary and secondary schools in Beijing from 2016 to 2023, so as to provide a scientific basis for targeted improvement measures. Methods: A sampling survey was conducted on the lighting and illumination indicators of 8 390 classrooms in primary and secondary schools in Beijing from 2016 to 2023. The survey included classroom daylight factor, window to floor area ratio, average illuminance and illuminance uniformity on the desks, average illuminance and illuminance uniformity on blackboards, as well as classroom lighting and blackboard illumination sources. Intergroup comparisons were performed using the Kruskal-Wallis H test and the Chi square test, and Spearman correlation analysis was used to examine the trend of classroom lighting and illumination changes. Results: Except the window to floor area ratio, the measured values and compliance rates of all lighting and illumination indicators showed an overall upward trend from 2016 to 2023 (daylight factor r = 0.27, χ 2 trend =206.80, average illuminance on the desk surface r =0.30, χ 2 trend =87.97, illuminance uniformity on the desk surface r =0.14, χ 2 trend =73.59, average illuminance on the blackboard r =0.33, χ 2 trend =477.43, illuminance uniformity on the blackboard r = 0.09, χ 2 trend =50.76) (all P ＜0.01). The lighting and illumination indicators of classrooms (included classroom daylight factor, average illuminance and illuminance uniformity on the desks, average illuminance and illuminance uniformity on blackboards) in urban schools, primary schools, and secondary schools from 2016 to 2023 showed an upward trend (urban r =0.23-0.40, χ 2 trend =88.66-392.18; primary school r =0.12-0.36, χ 2 trend =39.50-281.44; secondary schools r =0.06-0.31, χ 2 trend =11.79-213.73) (all P ＜ 0.01 ). The illuminance uniformity on the blackboard in suburban schools showed a downward trend ( r = -0.09, χ 2 trend =31.53, both P ＜0.01). The illuminance uniformity on the desk surface in suburban schools showed no significant change ( r =0.03, χ 2 trend =1.23, both P ＞0.05). The other indicators showed an upward trend (daylight factor r =0.28, χ 2 trend =40.69, average illuminance on the desk surface r =0.24, χ 2 trend =16.35, average illuminance on the blackboard r =0.25, χ 2 trend =118.05, all P ＜0.01). The trends of classroom and blackboard illumination sources were that fluorescent lamps decreased year by year and LED lamps increased by year (classroom illumination sources χ 2 trend =1 059.82, blackboard illumination sources χ 2 trend =1 070.25, both P ＜0.01). Conclusions The classroom lighting and illumination in primary and secondary schools in Beijing has shown an overall improving trend from 2016 to 2023. However, problems remain, such as limited improvement of illuminance uniformity indicators, late start and poor effect of reconstruction in suburban schools. Further improvements are still needed.

Purpose To investigate the clinical and imaging features and diagnostic points of hemophilic pseudotumor(HPT).Materials and Methods A total of 50 HPT patients in Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2015 to August 2023 were selected.Gender,haemophilia category,site of disease and X-ray,CT and MRI manifestations of HPT were retrospectively analyzed.Results A total of 50 patients with HPT were collected,49 male patients and one female patient.There were 48 cases of haemophilia A,one case of haemophilia B and one case of vascular haemophilia.Imaging manifestations were single bone and adjacent soft tissue involvement in 22 cases;multi-bone and single joint in four cases;multi-bone and multi-joint in ten cases;simple skeletal muscle and soft tissue involvement in six cases;abdominopelvic cavity and retroperitoneal space in six cases;and small intestinal wall in two cases.X-ray and CT mainly showed that the bone was destroyed by expansion,partially combined with osteolysis of the bone destruction,residual coarse bone ridge could be seen in the damaged area,and the sclerotic edge could be seen in the edge of the bone destruction.The main body of the lesion showed mixed density,and the enhancement scanning of the bone destruction area and soft tissue mass did not see the exact enhancement.MRI showed bone destruction area,soft tissue mass formation,which could better reflect its pathological characteristics,i.e.,the haematoma signals in different periods.Conclusion HPT commonly affect the femur and pelvic bones,and can involve multiple bones,joints,the abdominal and pelvic cavities,the retroperitoneum and the intestinal wall.The primary manifestation is the formation of massive hematomas within soft tissues,with varying stages of hemorrhage.When bone is involved,it typically presents as expansive bone destruction accompanied by the formation of large pseudotumors.The edges of the destruction area may show bone sclerosis.The pseudotumors exhibit characteristics of hematomas at different stages.A definitive diagnosis can be made by integrating imaging findings,clinical data and laboratory tests.

BACKGROUND:The biomechanical stability of basal femoral neck fracture is poor,and the treatment plan is different from the traditional femoral neck fracture. At present,there is still no consensus on the surgical plan for the treatment of basal femoral neck fracture in young adults. OBJECTIVE:To compare the biomechanical characteristics of proximal femoral nail antirotation and femoral neck system in the treatment of basal femoral neck fractures by finite element analysis.METHODS:First,Mimics Medical 21.0 software was used to extract the right femur CT data of healthy young female volunteers to establish a preliminary model. Secondly,the model was imported into Geomagic Wrap 2021 software for further smoothing. SOLIDWORKS 2021 software was used to establish and assemble the femoral neck base fracture model,proximal femoral nail antirotation model,and femoral neck system model. Finally,the assembled model was imported into Workbench 2021 R1 software for biomechanical analysis.RESULTS AND CONCLUSION:(1) Stress distribution:the stress distribution of the proximal femoral nail antirotation group was mainly near the fracture line and the medial side of the femur,and the peak stress was 151.90 Mpa. In the femoral neck system group,the stress distribution of the femoral model was mainly near the fracture line,and the peak stress was 290.74 Mpa. The proximal femoral nail antirotation internal fixation stress was mainly distributed at the proximal end of the helical blade and the main nail,and the peak stress was 102.95 Mpa. The stress distribution of internal fixation in femoral neck system mainly extended to both sides of the support rod,and the peak stress was 184.69 Mpa. (2) Total displacement:the maximum displacement of the femoral model in the proximal femoral nail antirotation group was 4.0323 mm,and the maximum displacement of the femoral model in the femoral neck system group was 4.6489 mm. The maximum displacement was located in the femoral head. The peak displacement of internal fixation in the proximal femoral nail antirotation group and the femoral neck system group was 2.7094 mm and 3.1303 mm,respectively. The displacement of internal fixation in the two groups was mainly concentrated in the proximal end of internal fixation,and gradually decreased to the distal end. (3) It is concluded that in the femoral neck base fracture model,whether it is the femoral model or the internal fixation model,the proximal femoral nail antirotation group has more dispersed stress distribution,lower stress peak,smaller femoral head displacement,and better biomechanical stability than the femoral neck system group.

BACKGROUND:The treatment of Pauwels type Ⅲ femoral neck fractures in young adults is extremely difficult.When treating Pauwels type Ⅲ femoral neck fractures with internal fixation,it is not only necessary to ensure the mechanical stability of the internal fixation,but also to ensure that it can resist the impact of shear,compression and tension,so as to prevent the internal fixation from breaking or loosening due to fatigue during the fracture healing process.However,existing internal fixation methods do not fully meet our requirements for the treatment of this fracture.OBJECTIVE:To provide a more reasonable and effective choice of internal fixation mode for clinicians in the treatment of young adults with Pauwels type Ⅲfemoral neck fracture,so as to optimize the treatment effect,reduce the occurrence of complications,and improve the recovery speed and quality of life of patients.METHODS:A femoral neck fracture model with Pauwels angle of 70° was constructed using CT data extracted from volunteers,and three placement modes were set up:(1)femoral neck system group:the main nail of femoral neck system was located in the center of the femoral neck axis.(2)Combination group:The main nail of femoral neck system was located in the lower third of the femoral neck axis,and a cannulated compression screw was located in the upper third of the femoral neck axis.(3)Cannulated compression screw group:The arrangement of three cannulated compression screws was arranged in the classic inverted triangle shape to ensure the maximum fixed effect.Stress distribution and displacement of proximal femoral fracture fragments and internal fixation devices were analyzed under three different internal fixation methods.RESULTS AND CONCLUSION:(1)The stress of the proximal femur models in the three groups was concentrated near the fracture line:combination group(201.10 MPa)＜femoral neck system group(222.25 MPa)＜cannulated compression screw group(271.25 MPa).(2)The peak value of proximal femur displacement was located at the top:combination group(6.33 mm)＜femoral neck system group(9.37 mm)＜cannulated compression screw group(9.92 mm).(3)The internal fixation stress was concentrated on the screw surface at the broken end of the fracture and gradually extended from there to both sides;cannulated compression screw group(136.67 MPa)＜combination group(201.10 MPa)＜femoral neck system group(222.25 MPa).(4)The maximum displacement of the internal fixation device model was located at the very top of the internal fixation.The three groups gradually decreased from the top to the far end.The peak displacement values of combination group(6.21 mm)＜femoral neck system group(9.19 mm)＜cannulated compression screw group(9.51 mm).(5)The stress of proximal bone mass in the three models was mainly concentrated in the fracture end,especially in the lower part of the fracture end.This indicates that these regions were subjected to greater stress and strain during mechanical transfer;combination group(24.96 MPa)＜femoral neck system group(39.69 MPa)＜cannulated compression screw group(44.47 MPa).(6)The results indicate that the internal fixation strategy of femoral neck system combined with cannulated compression screw arranged in parallel coronal surface shows higher biomechanical stability than single femoral neck system fixation or cannulated compression screw in inverted triangle arrangement fixation,and provides a more reliable and effective solution for the treatment of Pauwels type Ⅲ femoral neck fracture in young adults.

BACKGROUND:The treatment of Pauwels type Ⅲ femoral neck fractures in young adults is extremely difficult.When treating Pauwels type Ⅲ femoral neck fractures with internal fixation,it is not only necessary to ensure the mechanical stability of the internal fixation,but also to ensure that it can resist the impact of shear,compression and tension,so as to prevent the internal fixation from breaking or loosening due to fatigue during the fracture healing process.However,existing internal fixation methods do not fully meet our requirements for the treatment of this fracture.OBJECTIVE:To provide a more reasonable and effective choice of internal fixation mode for clinicians in the treatment of young adults with Pauwels type Ⅲfemoral neck fracture,so as to optimize the treatment effect,reduce the occurrence of complications,and improve the recovery speed and quality of life of patients.METHODS:A femoral neck fracture model with Pauwels angle of 70° was constructed using CT data extracted from volunteers,and three placement modes were set up:(1)femoral neck system group:the main nail of femoral neck system was located in the center of the femoral neck axis.(2)Combination group:The main nail of femoral neck system was located in the lower third of the femoral neck axis,and a cannulated compression screw was located in the upper third of the femoral neck axis.(3)Cannulated compression screw group:The arrangement of three cannulated compression screws was arranged in the classic inverted triangle shape to ensure the maximum fixed effect.Stress distribution and displacement of proximal femoral fracture fragments and internal fixation devices were analyzed under three different internal fixation methods.RESULTS AND CONCLUSION:(1)The stress of the proximal femur models in the three groups was concentrated near the fracture line:combination group(201.10 MPa)＜femoral neck system group(222.25 MPa)＜cannulated compression screw group(271.25 MPa).(2)The peak value of proximal femur displacement was located at the top:combination group(6.33 mm)＜femoral neck system group(9.37 mm)＜cannulated compression screw group(9.92 mm).(3)The internal fixation stress was concentrated on the screw surface at the broken end of the fracture and gradually extended from there to both sides;cannulated compression screw group(136.67 MPa)＜combination group(201.10 MPa)＜femoral neck system group(222.25 MPa).(4)The maximum displacement of the internal fixation device model was located at the very top of the internal fixation.The three groups gradually decreased from the top to the far end.The peak displacement values of combination group(6.21 mm)＜femoral neck system group(9.19 mm)＜cannulated compression screw group(9.51 mm).(5)The stress of proximal bone mass in the three models was mainly concentrated in the fracture end,especially in the lower part of the fracture end.This indicates that these regions were subjected to greater stress and strain during mechanical transfer;combination group(24.96 MPa)＜femoral neck system group(39.69 MPa)＜cannulated compression screw group(44.47 MPa).(6)The results indicate that the internal fixation strategy of femoral neck system combined with cannulated compression screw arranged in parallel coronal surface shows higher biomechanical stability than single femoral neck system fixation or cannulated compression screw in inverted triangle arrangement fixation,and provides a more reliable and effective solution for the treatment of Pauwels type Ⅲ femoral neck fracture in young adults.

Objective:To investigate the association of the interaction and combined effect of renal function and body mass index (BMI) with the risk for all-cause death in patients with type 2 diabetes mellitus (T2DM) in communities of Jiangsu Province.Methods:The study subjects were from the Comprehensive Research Project of Diabetes Prevention and Control conducted in Jiangsu from December 2013 to January 2014, and follow up was conducted for them until September 30, 2023. A total of 20 025 subjects were included in the study. Cox proportional hazards regression model was used to analyze the association of renal function with risk for death in T2DM patients, and the association of interaction between renal function and BMI and their combined effect with all-cause death risk in T2DM patients.Results:In the follow up for 198 370 person-years, a total of 4 459 deaths were recorded. Cox proportional hazards regression model analysis showed that renal dysfunction was associated with 71% risk of all-cause mortality in all T2DM patients [hazard ratio ( HR) =1.71, 95% CI: 1.59-1.84], as well as in all BMI subgroups. Likelihood ratio test indicated an interaction between renal function and BMI (interaction for P=0.030). Compared with patients with normal renal function and normal BMI, those with normal renal function and over weight or obesity had a lower risk of all-cause mortality, and those with renal dysfunction and low weight had the highest risk for death ( HR=2.78, 95% CI: 1.87-4.14). Conclusions:There is association of interaction between renal function and BMI with all-cause mortality in T2DM patients. T2DM patients with renal dysfunction and low body weight had significant higher risk for death.

The C 2-C 7 sagittal vertical axis (SVA) is an essential biomechanical parameter for evaluating cervical spine alignment, and it is integral to the pathogenesis, progression, and prognosis of cervical spine disorders. This parameter is widely used in evaluating cervical sagittal balance and functional status. Internationally, a C 2-C 7 SVA of less than 25 mm is considered within the cervical range for sagittal balance, while values exceeding 40 mm indicate cervical sagittal imbalance or deformity. An increased C 2-C 7 SVA disrupts cervical spine biomechanics, leading to heightened static and dynamic loads on the cervical musculature. This, in turn, results in muscle fatigue and discomfort. In the short term, patients may experience axial neck symptoms, while a sustained elevation in SVA over time significantly raises the risk of cervical disc degeneration, radiculopathy, and myelopathy. Additionally, a higher C 2-C 7 SVA postoperatively places excessive stress on adjacent spinal segments, which can accelerate degeneration of intervertebral discs and facet joints, contributing to adjacent segment degeneration. Both short-term and long-term postoperative evaluations have shown that an increase in C 2-C 7 SVA is typically associated with poorer surgical outcomes, whereas effective control of SVA values is closely linked to better functional recovery. Therefore, in clinical practice, maintaining C 2-C 7 SVA within the normal range (<25 mm) is critical not only for optimizing treatment results but also for significantly reducing postoperative complications and improving overall patient quality of life.

Objective: To analyze the factors related to dual use of traditional cigarettes and e-cigarettes among middle school students in Beijing, in order to provide a scientific basis for adapting to the new situation and carrying out tobacco control among adolescents. Methods: A multi stage cluster random sampling method was used to select 15 688 and 13 607 junior and senior middle school students from 16 districts in Beijing from April to June in 2019 and 2023, respectively. Online self administered questionnaires among middle school students in Beijing were completed, including use of traditional cigarettes and e-cigarettes, exposure to second hand smoke, attitudes and perceptions towards tobacco, etc. The Chi-square test was used to compare rates, and a multiple factors Logistic regression model was used to analyze related factors of traditional cigarettes and e-cigarettes dual use among middle school students. Results: The dual use rate of traditional cigarettes and e-cigarettes in 2023 had decreased to 2.46% from 4.88% in 2019 among middle school students in Beijing. The results of the multiple Logistic regression model analysis showed that among middle school students, tobacco control anywhere at home (boys: OR =0.47, girls: OR =0.34), without anyone smoking on campus in the past month (boys: OR =0.43, girls: OR =0.26) had lower risks of dual use ( P <0.05); and middle school students strongly or slightly agreeing that smoking could bring happiness (boys: OR =4.11, 2.22, girls: OR =5.32, 3.87), believing that smoking could increase attractiveness of young people (boys: OR =3.13, girls: OR =5.81), smoking cigarettes handed over by good friends (boys: OR =4.24, girls: OR =7.21), thinking smoking in the next year (boys: OR =5.77, girls: OR =7.74) had higher risks of dual use ( P <0.05).Among boys, junior middle school students ( OR =0.50), excellent academic performance ( OR =0.36), no acceptance of free tobacco products from tobacco companies ( OR =0.38), believing that smoking couldn t refresh oneself ( OR =0.37) and smoking still could pose a health hazard though not yet addictive ( OR =0.32) had lower risks of dual use ( P <0.05);and boys with a history of secondhand smoke exposure indoor outside home ( OR =2.19), believing that quitting smoking without difficulty ( OR =2.57),smoking e-cigarettes handed over by good friends ( OR =11.27) had higher risks of dual use ( P <0.05). Among girls, no acceptance of using tobacco product labeled items ( OR =0.28) had lower risks of dual use ( P <0.05); and girls whose parents both smoke ( OR =5.53), believing that quitting smoking might not be difficult ( OR =4.44) had higher risks of dual use ( P < 0.05 ). Conclusions The dual use rate of traditional cigarettes and e-cigarettes among middle school students in Beijing has decreased. It is recommended to take the construction of smoke free families as the starting point, so as to reduce indoor second hand smoke exposure and control tobacco promotions, and promote the formation of correct tobacco control culture and moral constraints among secondary school students.

ObjectiveTo investigate the influence of histone deacetylase 3 (HDAC3) on the occurrence, development of psoriasis-like inflammation in mice, and the relative immune mechanisms. MethodsHealthy C57BL/6 mice aged 6-8 weeks were selected and randomly divided into 3 groups: control group (Control), psoriasis model group (IMQ), and HDAC3 inhibitor RGFP966-treated psoriasis model group (IMQ+RGFP966). One day prior to the experiment, the back hair of the mice was shaved. After a one-day stabilization period, the mice in Control group was treated with an equal amount of vaseline, while the mice in IMQ group was treated with imiquimod (62.5 mg/d) applied topically on the back to establish a psoriasis-like inflammation model. The mice in IMQ+RGFP966 group received intervention with a high dose of the HDAC3-selective inhibitor RGFP966 (30 mg/kg) based on the psoriasis-like model. All groups were treated continuously for 5 d, during which psoriasis-like inflammation symptoms (scaling, erythema, skin thickness), body weight, and mental status were observed and recorded, with photographs taken for documentation. After euthanasia, hematoxylin-eosin (HE) staining was used to assess the effect of RGFP966 on the skin tissue structure of the mice, and skin thickness was measured. The mRNA and protein expression levels of HDAC3 in skin tissues were detected using reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR) and Western blot (WB), respectively. Flow cytometry was employed to analyze neutrophils in peripheral blood and lymph nodes, CD4⁺ T lymphocytes, CD8⁺ T lymphocytes in peripheral blood, and IL-17A secretion by peripheral blood CD4⁺ T lymphocytes. Additionally, spleen CD4⁺ T lymphocyte expression of HDAC3, CCR6, CCR8, and IL-17A secretion levels were analyzed. Immunohistochemistry was used to detect the localization and expression levels of HDAC3, IL-17A, and IL-10 in skin tissues. ResultsCompared with the Control group, the IMQ group exhibited significant psoriasis-like inflammation, characterized by erythema, scaling, and skin wrinkling. Compared with the IMQ group, RGFP966 exacerbated psoriasis-like inflammatory symptoms, leading to increased hyperkeratosis. The psoriasis area and severity index (PASI) skin symptom scores were higher in the IMQ group than those in the Control group, and the scores were further elevated in the IMQ+RGFP966 group compared to the IMQ group. Skin thickness measurements showed a trend of IMQ+RGFP966>IMQ>Control. The numbers of neutrophils in the blood and lymph nodes increased sequentially in the Control, IMQ, and IMQ+RGFP966 groups, with a similar trend observed for CD4⁺ and CD8⁺ T lymphocytes in the blood. In skin tissues, compared with the Control group, the mRNA and protein levels of HDAC3 decreased in the IMQ group, but RGFP966 did not further reduce these expressions. HDAC3 was primarily located in the nucleus. Compared with the Control group, the nuclear HDAC3 content decreased in the skin tissues of the IMQ group, and RGFP966 further reduced nuclear HDAC3. Compared with the Control and IMQ groups, RGFP966 treatment decreased HDAC3 expression in splenic CD4⁺ and CD8⁺ T cells. RGFP966 treatment increased the expression of CCR6 and CCR8 in splenic CD4⁺ T cells and enhanced IL-17A secretion by peripheral blood and splenic CD4⁺ T lymphocytes. Additionally, compared with the IMQ group, RGFP966 reduced IL-10 protein levels and upregulated IL-17A expression in skin tissues. ConclusionRGFP966 exacerbates psoriatic-like inflammatory responses by inhibiting HDAC3, increasing the secretion of the cytokine IL-17A, and upregulating the expression of chemokines CCR8 and CCR6.