Objective: To explore the correlation between adverse childhood experiences (ACEs) and digital self harm behavior among college students, so as to provide scientific evidence for preventing and intervening digital self harm behavior. Methods: A total of 5 917 college students from five provinces (Anhui, Guangdong, Hebei, Jilin, and Sichuan) were selected by using a method combining stratified cluster random sampling with convenient sampling to complete an electronic questionnaire survey, from May to June 2024. The survey was conducted to assesse digital self harm behavior and ten dimensions of ACEs, including peer bullying, emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, adverse family events, adverse school or social events, adverse life experiences, and personal adverse problems. A multivariable Logistic regression model was used to analyze the association between ACEs and digital selfharm among college students. Results: The reporting rate of digital self harm behavior among college students was 11.5%. There were statistically significant differences in the reporting rates of digital self harm behaviors among college students with different household registration location and the numbers of close friends ( χ 2=3.91, 8.09 , both P <0.05). Univariate analyses showed that the prevalence of digital self harm behavior was significantly higher among students who reported any type of ACEs compared with those without such experiences ( χ 2=7.99-27.63, all P <0.01). After controlling for demographic variables, each type of ACE was separately included in multivariable Logistic regression models as an independent variable, and all types of ACEs were significantly associated with digital self harm behavior among college students ( OR =1.27-1.91, all P <0.01). Notably, the OR values for sexual abuse and personal adverse problems were relatively high, being 1.91 and 1.83 respectively. Moreover, the risk of reporting digital self harm increased with the number of types of ACEs ( OR= 1.17 , P <0.01). Conclusions ACEs are related factors for digital self harm behavior among college students. Early psychological intervention should be strengthened, particularly for college students who have experienced sexual abuse and personal adverse problems during childhood.

Objective To investigate the effects of low, mid, and high flux smoothness modes on plan quality, treatment efficiency, equipment loss, and clinical economic benefits in fixed-field intensity-modulated radiotherapy for cervical cancer, and establish a decision-making model for parameter optimization and economic benefits. Methods Fifteen patients with cervical cancer undergoing radiotherapy were selected. Using the Monaco system and adjusting only the flux smoothness parameter, low, mid, and high plans were designed for each patient. Dosimetric differences were compared for the target volume (D₂, D₉₈, D_mean, homogeneity index, conformity index) and organs at risk (small intestine, rectum, colon, bladder, femoral head). The number of segments, monitor units, and their correlations with treatment efficiency and equipment loss were analyzed, as well as the potential impact on clinical costs. Results There were statistically significant differences in the three groups' planned target areas D₂, D₉₈, D_mean, CI, HI, and the dose parameters of organs at risk (P<0.001), but the absolute differences were all lower than the clinical tolerance limits in the ICRU 83 report (±3% – ±5%), with an effect size d<0.5 (except for the small intestine with d = 0.51). There was no clinical significance. Compared with the mid mode, the high mode had a 13.3% reduction in the number of subfields (effect size d = 0.85), a 11.6% reduction in machine jumps (d = 1.0), and a 13.0% reduction in treatment time. Based on the mid mode, the relative loss rate of the accelerating tube in the high mode was 11.6%, the theoretical risk change rate of equipment failure was 12.7%, and the accelerating tube lifespan was extended by approximately 1.2 years. Comprehensive economic benefits: Calculated based on 1,200 treatments per year, the annual cost savings are approximately 920,000 yuan. Conclusion Adoption of the high flux smoothness mode in fixed-field intensity-modulated radiotherapy for cervical cancer using the Monaco system can significantly enhance treatment efficiency and reduce operating costs while ensuring dosimetric quality. It is recommended for routine clinical use.

Objective To explore the effect of follow-up management based on the digital information platform on the compliance of early screening and follow-up of liver cancer in patients with chronic liver diseases,and to provide a management method for clinical practice.Methods Convenience sampling was adopted to include 3,959 patients who had chronic liver diseases and visited the outpatient clinic of the Department of Infectious Liver Diseases in our hospital from January 2022 to December 2023.Before the application of the digital information platform for management,it was the medical staff of the Infectious Liver Disease Department who conducted telephone follow-ups and handwritten registrations for patients with chronic liver diseases within one week after their visits.After management,A liver cancer prediction model installed in the digital information platform of the hospital automatically collected data of the patients,including information about the diseases and results of examinations for intelligent risk stratification of liver cancer.The nurses who were in charge of the follow-up performed individualised follow-up reviews based on the levels of risk.Follow-up re-visit rate of the patients in very high-and high-risks were calculated.Scores of chronic disease self-efficacy and medication compliance were compared before and at 3 months after the follow-up management.Results A total of 3,860 patients completed the study.After the follow-up management,the total follow-up re-visit rate of the patients was 88.2%(1,818/2,062)and that of the high-risk patients was 95.3%(246/258)in 2022,while those in 2023 were 94.0%(1,691/1,798)and 98.3%(232/236),respectively.After 3 months of follow-up management,scores for medication compliance and chronic disease self-efficacy showed significant improvement in comparison with those before the implementation of follow-up management(P<0.001).Conclusion The follow-up management based on a digital information platform is suitable for screening of early liver cancer in the patients with chronic liver diseases,as it improves the re-visit rate of patients for follow-up,medication compliance and self-efficacy.

Objective To investigate the effects of acteoside in a rat model on of diabetic nephropathy(DN)and high-glucose-induced glomerular mesangial cells(GMCs),focusing on the role of acteoside in the silent information regulator 1(SIRT1)/nuclear factor eryth-roid 2-related factor 2(Nrf2)signaling pathway.Methods GMCs were cultured under normal glucose conditions or stimulated with high glucose.Fibrosis,oxidative stress,SIRT1 and Nrf2 protein expression,and mitochondrial structure were assessed in four groups:normal glucose,high glucose,high glucose+acteoside,and high glucose+acteoside+SIRT1 inhibitor(hsa62).DN was induced in rats via intraperitoneal streptozotocin injection,and animals were divided into control,model,and acteoside-treated groups.Pathological kidney changes,blood glucose changes,renal function indices,and protein expression of SIRT1 and Nrf2 were evaluated.Results Compared with controls,DN model rats showed significantly elevated fasting blood glucose,serum creatinine,blood urea nitrogen,and 24-h urinary protein levels of rats in the model group were significantly increased(P＜0.01).GMCs exhibited increased fibrosis,oxidative stress,and mitochondrial damage.Acteoside treatment significantly improved all measured parameters(P＜0.01);and mitigated mitochondrial injury.In vitro,acteoside reduced high-glucose-induced fibrosis and oxidative stress in GMCs,effects that were reversed by SIRT1 inhibition.Western blotting confirmed upregulation of SIRT1 and Nrf2 expression in both treated rat kidney tissues and GMCs(P＜0.01).Conclusion Acteoside alleviates glomerular fibrosis and oxidative stress in DN by activating the SIRT1/Nrf2 signaling pathway,suggesting its potential therapeutic agent for DN.

Objective:To observe the effect of point injection at Zusanli(ST36)plus abdominal point application on gastrointestinal dysfunction after laparoscopic surgery.Methods:A total of 204 patients with gastrointestinal dysfunction after laparoscopic surgery were recruited and divided into four groups using the random number table method,with 51 cases in each group.The control group received conventional postoperative intervention.In addition to the treatment in the control group,the point injection group was given point injection at Zusanli(ST36),the application group was offered abdominal point application,and the integrated group received point injection at Zusanli(ST36)and abdominal point application.The treatment lasted 3 consecutive days in all four groups.The recovery time of gastrointestinal function indicators and the incidence rate of postoperative nausea and vomiting(PONV)were observed and recorded.Before and after treatment,the visual analog scale(VAS)was used to assess abdominal pain intensity,the venous blood type 1 helper T cells/type 2 helper T cells(Th1/Th2)was determined,the serum levels of interleukin(IL)-6 and interferon(IFN)-γ were detected using the enzyme-linked immunosorbent assay,and the plasma levels of motilin and gastrin were measured using radioimmunoassay.Results:Compared to the control group,the first exhaust time,the first defecation time,and the time of restoring fluid diet came earlier in the other three groups(P<0.05)and were earlier in the integrated group than in the point injection and application groups(P<0.05).The point injection,application,and integrated groups had a lower PONV incidence rate than the control group,and the integrated group was lower than the point injection and application groups(P<0.05).The intra-group comparisons showed that the VAS score and the levels of IL-6 and INF-γ decreased after treatment in all four groups(P<0.05);the point injection,application,and integrated groups were lower than the control group(P<0.05),and the integrated group was lower than the point injection and application groups(P<0.05).The intra-group comparisons also demonstrated that the levels of Th1/Th2,motilin,and gastrin increased after the intervention in the four groups(P<0.05);the point injection,application,and integrated groups were higher than the control group(P<0.05),and the integrated group was higher than the point injection and application groups(P<0.05).Conclusion:Point injection at Zusanli(ST36)plus abdominal point application can encourage postoperative exhaust,defecation,and the recovery of diet fluid,alleviate postoperative abdominal pain,reduce PONV,balance Th1/Th2,and regulate the secretion of motilin and gastrin in patients with gastrointestinal dysfunction after laparoscopic surgery.

AIM:To explore the mechanism of berberine on breast cancer cells based on network pharmacology and in vitro cell experiments.METH-ODS:Firstly,berberine and breast cancer were tak-en as the research objects,the intersection targets of the two were screened by VEEN diagram,GO function and KEGG enrichment analysis were per-formed by R language,and molecular docking and visualization were carried out by Autodock Vina and Pymol software.Then,berberine treated breast cancer MCF-7 cells for 24 h,and then in vi-tro cell experiments were performed.CCK-8 was used to detect cell viability,Edu and plate cloning were used to detect cell proliferation and cloning,and apoptosis was detected by An-nexin V-FITC/PI double staining and Western blot.Laser confocal and CETSA were used to verify the binding effect of berberine and AKT1 protein.RESULTS:The results of network pharmacology showed that berberine had a good binding to the core targets AKT1,AKT2 and MAPK3.Berberine(20,40,80 μmol/L)signifi-cantly inhibited the proliferation and cloning ability of MCF-7 cells in a concentration-dependent man-ner(P＜0.05,P＜0.01).The results of laser confocal and CETSA experiments showed that berberine and AKT1 had a binding effect,and the stability of the two was enhanced after the combination.CONCLU-SION:Berberine inhibits MCF-7 cell proliferation and induces apoptosis in human breast cancer cells by targeting binding to AKT1 protein.

OBJECTIVE To explore the effect of Astragali Radix-Curcuma Zedoaria-Paridis Rhizoma(Qi-Zhu-Zao)combina-tion on inhibiting the growth and metastasis of colon cancer based on the PINK1/Parkin/EMT signaling pathway.METHODS Thirty male BALB/c mice were randomly assigned to five groups:sham operation group,model group,positive control group,high-dose Qi-Zhu-Zao group(5.85 g·kg-1),and low-dose Qi-Zhu-Zao group(2.925 g·kg-1),with six mice in each group.An orthotopic colon cancer model was established in the mice using CT26.WT cells.After 15 days of treatment,tumor and liver tissues were collected from each group.Hematoxylin and eosin(HE)staining was performed to assess tumor metastasis,and transmission electron microscopy was used to observe mitochondrial autophagy in tumor tissues.The expression of mitochondrial autophagy-related proteins PINK1,Parkin,p62,and LC3-Ⅱ/LC3-Ⅰ was analyzed using Western blot and immunohistochemistry(IHC).Additionally,the expression levels of epithelial-mesenchymal transition(EMT)-related proteins and mRNA,including E-cadherin,N-cadherin,Vimentin,and Snail,were detected using Western blot,qPCR,and IHC staining.RESULTS Compared to the model group,mice in the treatment groups exhibited significantly reduced tumor volumes and fewer metastatic foci.Additionally,liver tissues showed pathological changes,and the overall growth condition of the mice was markedly improved;the tumor tissues in the treatment groups displayed selective mitochon-drial autophagy,accompanied by the formation of autophagosomes.The treatment influenced the PINK1/Parkin pathway-mediated mi-tochondrial autophagy biological process,with PINK1,Parkin,p62,and LC3-Ⅱ/LC3-Ⅰ levels being significantly upregulated(P<0.05,P<0.01),the high-dose group exhibited a more significant impact than the low-dose group(P<0.05,P<0.01).Furthermore,the treatment groups also showed significant reductions in the protein and mRNA levels of N-cadherin,Vimentin,and Snail(P<0.05,P<0.01),along with significant increases in the protein and mRNA levels of E-cadherin(P<0.05,P<0.01),these effects were more pronounced in the high-dose group compared to the low-dose group(P<0.05,P<0.01).CONCLUSION The herbal combination of Qi-Zhu-Zao inhibits tumor growth and metastasis to a certain extent in a mouse model of orthotopic transplantation of colon cancer.The underlying mechanism may involve the restoration of mitochondrial function through the PINK1/Parkin signaling pathway and the inhibition of the epithelial-mesenchymal transition(EMT)process,thereby achieving a therapeutic effect on colon cancer.

Objective To compare and find an optimal model for predicting the risk of DKD occurrence in patients with type 2 diabetes mellitus(T2DM).Methods A total of 2005 patients with T2DM were enrolled in this study from The Second Hospital of Shijiazhuang City during December 2017 to December 2022.All the subjects were divided into a training set(n=1403)and a validation set(n=602)according to the ratio of 3∶1 by simple random sampling.With the occurrence of DKD as the outcome variablein the training set,important feature variables were screened by LASSO regression.Six different machine learning models were established according to the feature variables,thenthe optimal model was determined by comparison,and anonlinerisk predictor for DKD occurrence was constructed in patients with T2DM.Results Taking the occurrence of DKD as the outcome variable in the training set,the results of LASSO regression analysis showed that the optimal value of the model was 10-fold cross validation lambda.1se=0.01662473,and 15 characteristic variables with nonzero coefficient were screened out to be related to the occurrence of DKD.The data included sex,age,family history of DM,DM duration,LDL-C,HbA1c,WBC,PDW,Scr,urine α1-microglobulin,urine β2-microglobulin,urine microalbumin,hypertension,hypokalemia,and DR.In the training set and validation set,the prediction performance of XGBoost model was better than that of other models(AUC=0.872,0.893,95%CI 0.853～0.891,0.865～0.921),the sensitivity was 0.779,0.863,and the specificity was 0.721,0.758,respectively.The F1 scores were 0.774 and 0.787.DCA analysis showed that the XGBoost model had a greater net benefit and threshold probability.According to the XGBoost model,the online predictor of DKD risk in T2DM patients was laid out,and two patients were selected for application,the results showed that the predictive value of the model was 0.185 in non-DKD patients,and the predictive value was 0.510 in DKD patients.Conclusions The XGBoost model is the best model for predicting the occurrence of DKD in T2DM patients,and an online predictor was successfully built.

Retinopathy caused by myopia is the first cause of irreversible blinding eye disease in China.The TCM methods to prevent and control myopia mainly include Chinese materia medica and TCM appropriate techniques,which have the advantages of good efficacy,simple operation,and few adverse reactions.This paper believed that internal and external pathogenic factors act on the brain and eyes,breaking their homeostasis,leading to rhythmic disorders,and imbalance of essence,qi and blood is the main pathogenesis of myopia.Based on the idea of"nature and human in the same rhythm"and"the same treatment for common diseases",targeting the above pathogenesis,the method of"brain-eye synchronization"was proposed to restore the homeostasis of the brain and eyes to prevent and control myopia in children and adolescents,and the treatment rules were to regulate the rhythms of the time,harmonize the qi and blood,nourish the blood to soften the tendons,and replenish the essence and blood,so as to achieve the effect of brain-eye synchronization and the treatment of the spirit and the body together.This article summarized the theoretical basis of"brain-eye synchronization"and its clinical application in traditional Chinese and Western medicine,with a view to providing new ideas for the prevention and control of myopia in children and adolescents.

Objective To explore influencing factors of subsequent fracture among elderly osteoporotic patients and provide a basis for improving the management and early intervention after osteoporotic fracture.Methods A total of 14 349 elderly patients with osteoporotic fracture in 594 hospitals across 31 provinces(autonomous regions and municipalities)were selected by convenience sampling method from September to December 2023.A general information questionnaire and a clinical characteristics of fracture questionnaire were used.The univariate analysis and logistic regression were used to clarify the influencing factors and gender differences.Results A total of 11364 valid questionnaires were collected,with a valid questionnaire recovery rate of 79.20％.Gender,age,occupation,education,marital status,family history of osteoporosis,comorbid osteoarthropathies/rheumatism/ophthalmopathies,bone mineral density,risk of fall,risk of fracture grade,reasons and site for first fracture,whether to use walking aid and receive home rehabilitation guidance were associated with the occurrence of subsequent fracture.Gender comparisons found that widowhood,family history of osteoporosis,comorbid rheumatism,vertebral fracture,alcohol consumption,fall or no causative factor triggering the fracture,and educational level,home rehabilitation instruction were associated with the risk of subsequent fracture only in women(P＜0.05).Smoking was associated with the risk of subsequent fracture only in men(P＜0.05).Conclusion Osteoporotic subsequent fracture in the elderly is affected by multidimensional factors,with significant gender differences.The surveillance of key populations should be strengthened in prevention,control and intervention.