BackgroundNon-suicidal self-injury （NSSI） behavior has become a global public health concern affecting the physical and mental health of adolescents. The experiential avoidance model posits that childhood trauma contributes to NSSI behavior through the mediating pathway of emotional dysregulation. However， existing research has predominantly focused on isolated psychological or social factors， with limited attention to their interactive effects of emotional dysregulation and social anxiety， both of which fall within the psychosocial domain. ObjectiveTo examine the relationship between childhood trauma and NSSI among adolescents， and to analyze the mediating role of emotional dysregulation and the moderating role of social anxiety， so as to provide evidence for targeted interventions for NSSI behavior of adolescents. MethodsA total of 282 adolescent inpatients who consecutively admitted to the Department of Psychiatry of Guangdong Provincial People's Hospital from March to December 2025 and met the Diagnostic and Statistical Manual of Mental Disorders，fifth edition（DSM-5）criteria for NSSI were enrolled as study participants. Participants were assessed using the general information questionnaire， the Adolescent Self-Harm Questionnaire， the Childhood Trauma Questionnaire （CTQ）， the Difficulties in Emotion Regulation Scale （DERS）， and the Social Anxiety Scale for Adolescents （SAS-A）. Pearson correlation analysis was used to examine correlations among scale scores. model 4 and model 58 of the Process 4.1 were used to test the mediating effect of emotional dysregulation and the moderating effect of social anxiety， respectively. ResultsCTQ score was positively associated with score of the Adolescent Self-Injury Questionnaire （r=0.279， P<0.01）. Emotional dysregulation significantly partially mediated the relationship between childhood trauma and NSSI behavior， with a mediating effect of 0.112 （95% CI： 0.043–0.208）， accounting for 40.14% of the total effect. Social anxiety moderated the association between childhood trauma and emotional dysregulation，the effect value was 0.102 （95% CI： 0.008–0.196）， as well as the relationship between emotional dysregulation and NSSI behavior， the effect value was 0.130 （95% CI： 0.033–0.226）. ConclusionEmotional dysregulation may mediate the relationship between childhood trauma and NSSI behavior among hospitalized adolescents， while social anxiety moderates both the first and second paths of this mediating process. ［Funded by Guangdong Medical Science and Technology Research Fund Project （number， A2022538）］

Objective To investigate the diagnostic value of serum bromodomain-containing pro-tein 4(BRD4)combined with gastrin-17(G-17)in Helicobacter pylori(Hp)-positive early gastric cancer.Methods A total of 88 patients with Hp-positive early gastric cancer admitted to our hospital from September 2021 to September 2023 were selected as early gastric cancer group.Meanwhile,92 patients with Hp-positive precancerous lesions and 80 patients with Hp-positive gastritis admitted dur-ing the same period were selected as precancerous lesion group and gastritis group,respectively.En-zyme-linked immunosorbent assay(ELISA)was used to detect the serum levels of BRD4 and G-17.Multivariate logistic regression analysis was performed to screen the influencing factors of Hp-positive early gastric cancer.Receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic value of serum BRD4 and G-17 in Hp-positive early gastric cancer.Results Compared with the gastritis group,the levels of BRD4 and G-17 in the precancerous lesion group and early gastric cancer group were significantly increased(P＜0.05).Furthermore,compared with the precancerous le-sion group,the levels of BRD4 and G-17 in the early gastric cancer group were also significantly elevated(P＜0.05).The proportion of patients with a family history of gastric cancer,those who preferred hot food,cold food,or high-salt food,as well as the levels of PG Ⅱ,BRD4,and G-17 were signifi-cantly higher in the early gastric cancer group than in the non-gastric cancer group,while the level of pepsinogen(PG)Ⅰ was significantly lower(P＜0.05).Logistic regression analysis revealed that preference for hot food,high-salt food,PG Ⅱ,BRD4,G-17,and PG Ⅰ were all influencing factors for Hp-positive early gastric cancer(P＜0.05).The area under the curve(AUC)values for serum BRD4,G-17,and their combination in diagnosing Hp-positive early gastric cancer were 0.793,0.830,and 0.912,respectively.The diagnostic efficacy of the combined detection was superior to that of single detection(P＜0.05).Conclusion The serum levels of BRD4 and G-17 are elevated in patients with Hp-positive early gastric cancer,and both exhibit certain diagnostic value for Hp-positive early gastric cancer,suggesting their potential as serum biomarkers for the diagnosis of Hp-positive early gastric cancer.

Objective To analyze the risk factors for chronic cough following pulmonary surgery in patients with non-small cell lung cancer (NSCLC). Methods A retrospective analysis was conducted on 427 NSCLC patients who underwent pulmonary surgery in the Department of Thoracic Surgery, The First Affiliated Hospital of the University of Science and Technology of China, between January 2021 and June 2023. Patients were categorized into a chronic cough group (103 patients) and a non-chronic cough group (324 patients) based on the presence of cough at 8 weeks post-surgery. A comparative analysis was performed between the two groups, considering gender, age, smoking history, comorbidities, preoperative pulmonary function indicators, pleural adhesion, anesthesia duration, surgical site, operative techniques, lymph node dissection methods, tumor maximum diameter, and postoperative chest tube duration. Factors showing statistical significance in univariate analysis underwent multivariate logistic regression analysis. Results Among the 427 patients undergoing pulmonary surgery, there were 165 males and 262 females, with an average age of (59.93±12.11) years. The incidence of chronic cough was 24.12%. Univariate analysis revealed significant differences in smoking history, preoperative pulmonary function indicators, pleural adhesion, anesthesia duration ≥135.5 minutes, surgical site, operative techniques, lymph node dissection methods, tumor maximum diameter, and postoperative chest tube duration (P<0.05). Multivariate logistic regression analysis indicated that the surgical site (right upper lung), operative techniques (lobectomy), lymph node dissection, and anesthesia time ≥135.5 minutes were independent risk factors for chronic cough following pulmonary surgery. Conclusion Patients undergoing right upper lung surgery, lobectomy, lymph node dissection, and experiencing anesthesia duration ≥135.5 minutes are at a higher risk of developing chronic cough post-pulmonary surgery.

An 8-year-old male patient with chronic granulomatous disease received amphotericin B liposome (unknown dose) in addition to anti-infection treatments with meropenem, compound sulfamethoxazole, and voriconazole due to recurrence of secondary pulmonary infection. After 3 days, the patient developed tachycardia, edema, and worsening dyspnea. Echocardiography revealed severe right heart enlarge- ment and pulmonary hypertension. Cardiotonic, diuretic, and pulmonary antihypertensive therapies were given. After over half a month, his pulmonary infection was improved, pulmonary arterial pressure decreased, but the right heart enlargement persisted. Suspending treatment about half a month later, amphotericin B liposome was reinitiated at a gradually increased dose from 2 mg once daily, in combination with piperacillin sodium and tazobactam sodium and compound sulfamethoxazole due to aggravated cyanosis and cough. After the administration of amphotericin B liposome (50 mg once daily) on day 5, the patient experienced wheezing and facial edema. Laboratory tests showed B-type natriuretic peptide (BNP) 4 679 ng/L; echocardiography demonstrated right heart enlargement and pulmonary hypertension. Suspecting that the cardiac dilatation and heart failure were associated with amphotericin B liposome, the drug was discontinued. The anti-infection regimen was switched to biapenem, linezolid and voriconazole, along with continued cardiotonic and diuretic managements. The patient′s symptoms were improved after 10 days, the treatment regimen was changed to compound sulfamethoxazole and voriconazole. However, after 3 days, the patient′s abdominal distension and dyspnea worsened. Endotracheal intubation and mechanical ventilation were initiated along with cardiotonic and diuretic therapy; anti-infection therapy with cefoperazone sodium and sulbactam sodium combined with voriconazole was given based on bronchoalveolar lavage fluid and sputum culture results. One month later, the patient′s condition was improved, showing no right ventricular dilation and reduced pulmonary arterial pressure on echocardiography and BNP 800 ng/L.

Objective:To investigate the impact of correcting rotational subluxation through circumferential fusion and transforaminal lumbar interbody fusion (TLIF) on postoperative coronal plane imbalance in degenerative scoliosis.Methods:A retrospective analysis was conducted on the data of 108 patients with type A degenerative scoliosis in the Nanjing classification who underwent primary multi-segment posterior column osteotomy (PCO) with deformity correction and internal fixation at Nanjing Gulou Hospital from June 2017 to June 2021. Patients were divided into two groups based on the presence of preoperative rotational subluxation: the rotational subluxation group and the non-rotational subluxation group. The rotational subluxation group consisted of 60 patients, with 8 males and 52 females, aged 63.7±5.5 years (range, 56-75 years). The non-rotational subluxation group included 48 patients, with 5 males and 43 females, aged 64.4±5.2 years (range, 53-72 years). Within the rotational subluxation group, depending on whether TLIF was performed on the rotational subluxation segment, they were further categorized into the TLIF group and the PCO group. The TLIF group comprised 28 patients, while the PCO group had 32 patients. Full-spine anteroposterior and lateral X-rays were taken preoperatively, postoperatively, and at the last follow-up to measure coronal balance types and radiographic parameters. The differences in the lumbar Cobb angle, coronal balance distance (CBD), and the Cobb angle of the lumbosacral curve (Cobb-Fra angle) were compared between the rotational subluxation group and the non-rotational subluxation group, as well as between the TLIF group and the PCO group.Results:The average surgery duration ranged from 200 to 310 min, with a mean of 235±47 min. The intraoperative blood loss ranged from 700 to 2,400 ml, with an average of 950±355 ml. The number of fused segments in the rotational subluxation group was 7.6±2.1, ranging from 5 to 11 segments, while in the non-rotational subluxation group, it was 7.4±2.0, ranging from 5 to 10 segments. Postoperatively, 13%(8/60) of patients in the rotational subluxation group developed type C coronal imbalance, significantly higher than the 2%(1/48) in the non-rotational subluxation group. The immediate postoperative and final follow-up lumbar Cobb angles, CBD, and Cobb-Fra angles in the rotational subluxation group were 20.60°±10.73° and 20.33°±10.92°, 22.53±16.45 mm and 18.53±17.31 mm, 13.14°±4.40° and 11.23°±4.92°, respectively, which were higher than those in the non-rotational subluxation group (13.92°±7.02° and 12.92°±6.64°, 18.62±17.44 mm and 8.83±8.95 mm, 11.91°±3.03° and 9.52°±3.30°), with statistical significance ( P<0.05).. Among patients in the rotational subluxation group, the probability of new-onset coronal imbalance postoperatively was 4%(1/28) in the TLIF group, which was lower than the 22%(7/32) in the PCO group, with a statistically significant difference (χ 2=4.330, P=0.037). The immediate postoperative and final follow-up lumbar Cobb angles, CBD, and Cobb-Fra angles in the PCO group were 25.63°±11.00° and 25.13°±11.04°, 27.37±18.95 mm and 25.25±18.67 mm, 15.50°±3.62° and 14.08°±4.77°, respectively, which were significantly higher than those in the TLIF group (14.86°±6.96° and 14.86°±5.37°, 17.08±10.94 mm and 10.86±7.86 mm, 10.14°±3.37° and 8.46°±2.66°), with statistical significance ( P<0.05). Conclusion:For patients with Type A degenerative scoliosis combined with rotational subluxation according to the Nanjing classification, performing a 360-degree circumferential release and interbody fusion at the segment with rotatory subluxation can reduce the risk of developing new postoperative coronal imbalances.

Objective:To investigate the impact of correcting rotational subluxation through circumferential fusion and transforaminal lumbar interbody fusion (TLIF) on postoperative coronal plane imbalance in degenerative scoliosis.Methods:A retrospective analysis was conducted on the data of 108 patients with type A degenerative scoliosis in the Nanjing classification who underwent primary multi-segment posterior column osteotomy (PCO) with deformity correction and internal fixation at Nanjing Gulou Hospital from June 2017 to June 2021. Patients were divided into two groups based on the presence of preoperative rotational subluxation: the rotational subluxation group and the non-rotational subluxation group. The rotational subluxation group consisted of 60 patients, with 8 males and 52 females, aged 63.7±5.5 years (range, 56-75 years). The non-rotational subluxation group included 48 patients, with 5 males and 43 females, aged 64.4±5.2 years (range, 53-72 years). Within the rotational subluxation group, depending on whether TLIF was performed on the rotational subluxation segment, they were further categorized into the TLIF group and the PCO group. The TLIF group comprised 28 patients, while the PCO group had 32 patients. Full-spine anteroposterior and lateral X-rays were taken preoperatively, postoperatively, and at the last follow-up to measure coronal balance types and radiographic parameters. The differences in the lumbar Cobb angle, coronal balance distance (CBD), and the Cobb angle of the lumbosacral curve (Cobb-Fra angle) were compared between the rotational subluxation group and the non-rotational subluxation group, as well as between the TLIF group and the PCO group.Results:The average surgery duration ranged from 200 to 310 min, with a mean of 235±47 min. The intraoperative blood loss ranged from 700 to 2,400 ml, with an average of 950±355 ml. The number of fused segments in the rotational subluxation group was 7.6±2.1, ranging from 5 to 11 segments, while in the non-rotational subluxation group, it was 7.4±2.0, ranging from 5 to 10 segments. Postoperatively, 13%(8/60) of patients in the rotational subluxation group developed type C coronal imbalance, significantly higher than the 2%(1/48) in the non-rotational subluxation group. The immediate postoperative and final follow-up lumbar Cobb angles, CBD, and Cobb-Fra angles in the rotational subluxation group were 20.60°±10.73° and 20.33°±10.92°, 22.53±16.45 mm and 18.53±17.31 mm, 13.14°±4.40° and 11.23°±4.92°, respectively, which were higher than those in the non-rotational subluxation group (13.92°±7.02° and 12.92°±6.64°, 18.62±17.44 mm and 8.83±8.95 mm, 11.91°±3.03° and 9.52°±3.30°), with statistical significance ( P<0.05).. Among patients in the rotational subluxation group, the probability of new-onset coronal imbalance postoperatively was 4%(1/28) in the TLIF group, which was lower than the 22%(7/32) in the PCO group, with a statistically significant difference (χ 2=4.330, P=0.037). The immediate postoperative and final follow-up lumbar Cobb angles, CBD, and Cobb-Fra angles in the PCO group were 25.63°±11.00° and 25.13°±11.04°, 27.37±18.95 mm and 25.25±18.67 mm, 15.50°±3.62° and 14.08°±4.77°, respectively, which were significantly higher than those in the TLIF group (14.86°±6.96° and 14.86°±5.37°, 17.08±10.94 mm and 10.86±7.86 mm, 10.14°±3.37° and 8.46°±2.66°), with statistical significance ( P<0.05). Conclusion:For patients with Type A degenerative scoliosis combined with rotational subluxation according to the Nanjing classification, performing a 360-degree circumferential release and interbody fusion at the segment with rotatory subluxation can reduce the risk of developing new postoperative coronal imbalances.

Physical training-associated exertional heat stroke (EHS) is a highly lethal training injury in which early acute stress can lead to multiple organ damage in patients. This paper reviews the progress of research on physical training-related EHS onset and prognostic risk factors, and cooling techniques. Risk factors for the onset of physical training-associated EHS mainly include environment, body size, demographic characteristics, health status, and subject factors, and prognostic risk factors mainly involve systemic inflammatory response syndrome, central nervous system dysfunction, impaired intestinal function, coagulation disorders, rhabdomyolysis, myocardial injury, and hepatic impairment. Cooling techniques mainly include target temperature management, water bath immersion, ice sheet cooling, continuous renal replacement therapy and so on, which need to be applied comprehensively according to site conditions and patient characteristics.

An 8-year-old male patient with chronic granulomatous disease received amphotericin B liposome (unknown dose) in addition to anti-infection treatments with meropenem, compound sulfamethoxazole, and voriconazole due to recurrence of secondary pulmonary infection. After 3 days, the patient developed tachycardia, edema, and worsening dyspnea. Echocardiography revealed severe right heart enlarge- ment and pulmonary hypertension. Cardiotonic, diuretic, and pulmonary antihypertensive therapies were given. After over half a month, his pulmonary infection was improved, pulmonary arterial pressure decreased, but the right heart enlargement persisted. Suspending treatment about half a month later, amphotericin B liposome was reinitiated at a gradually increased dose from 2 mg once daily, in combination with piperacillin sodium and tazobactam sodium and compound sulfamethoxazole due to aggravated cyanosis and cough. After the administration of amphotericin B liposome (50 mg once daily) on day 5, the patient experienced wheezing and facial edema. Laboratory tests showed B-type natriuretic peptide (BNP) 4 679 ng/L; echocardiography demonstrated right heart enlargement and pulmonary hypertension. Suspecting that the cardiac dilatation and heart failure were associated with amphotericin B liposome, the drug was discontinued. The anti-infection regimen was switched to biapenem, linezolid and voriconazole, along with continued cardiotonic and diuretic managements. The patient′s symptoms were improved after 10 days, the treatment regimen was changed to compound sulfamethoxazole and voriconazole. However, after 3 days, the patient′s abdominal distension and dyspnea worsened. Endotracheal intubation and mechanical ventilation were initiated along with cardiotonic and diuretic therapy; anti-infection therapy with cefoperazone sodium and sulbactam sodium combined with voriconazole was given based on bronchoalveolar lavage fluid and sputum culture results. One month later, the patient′s condition was improved, showing no right ventricular dilation and reduced pulmonary arterial pressure on echocardiography and BNP 800 ng/L.

Physical training-associated exertional heat stroke (EHS) is a highly lethal training injury in which early acute stress can lead to multiple organ damage in patients. This paper reviews the progress of research on physical training-related EHS onset and prognostic risk factors, and cooling techniques. Risk factors for the onset of physical training-associated EHS mainly include environment, body size, demographic characteristics, health status, and subject factors, and prognostic risk factors mainly involve systemic inflammatory response syndrome, central nervous system dysfunction, impaired intestinal function, coagulation disorders, rhabdomyolysis, myocardial injury, and hepatic impairment. Cooling techniques mainly include target temperature management, water bath immersion, ice sheet cooling, continuous renal replacement therapy and so on, which need to be applied comprehensively according to site conditions and patient characteristics.

Objective To investigate the effects of acute sleep deprivation on the behavior and synaptic protein expression of rats.Methods Seventy healthy male Wistar rats were randomly divided into seven groups,a Control group and sleep deprivation groups(24,48,72,96,120 and 144 hours).The sleep deprivation rat model was established by the modified multiplatform water environment sleep deprivation method.Spatial learning and memory were assessed by the Morris water maze.Anxiety was assessed by the open field test.The morphology and quantity of hippocampal neurons were observed by Nissl staining.Western blot and Real-time PCR were used to determine the expression of synaptophysin(SYN),post-synaptic density protein-95(PSD-95),and brain-derived neurotrophic factor(BDNF)in rats.Results Compared with the Control group,the numbers of standing and modification were significantly increased by prolongation of the sleep deprivation time(P＜0.05).The escape latency and path length were significantly increased in 120 and 144 h groups(P＜0.05),whereas the number of platform crossings and the percentage of the target quadrant time were significantly decreased(P＜0.01)and negatively correlated to the sleep deprivation time.The expression levels of BDNF,SYN,and PSD-95 were significantly decreased with the prolongation of sleep deprivation time(P＜0.01).Conclusions With the increase in sleep deprivation time,cognitive dysfunction and anxiety gradually deteriorated,which may be related to decreases in the expression of synaptic biomarkers.