Objective: To analyze the developmental trajectories of clustered health risk behaviors and their association with self-esteem and lonelinesss among junior high school students, so as to provide a reference for formulating comprehensive prevention and control measures of health risk behaviors among adolescents. Methods: In October 2023, 1 165 first year junior high school students from two schools of Jishou City in Hunan Province were selected by convenient sampling method for three follow up surveys (T1:October 2023; T2:April 2024; T3:October 2024). The Adolescent Health Risk Behavior Questionnaire, Rosenberg Self esteem Scale and Loneliness Scale were used to assess health risk behaviors, self esteem and loneliness, respectively. Latent growth curve modeling and latent growth mixture modeling were applied to analyze the developmental trajectories of clustered health risk behaviors among junior high school students. Logistic regression was used to analyze the association of the developmental trajectories of clustered health risk behaviors with self esteem and loneliness among junior high school students. Results: The overall developmental trajectories among junior high school students showed a declining trend (intercept=0.15, slope=-1.65, both P <0.05), with three heterogeneous categories:low risk improvement group ( n =862, 74.0%), moderate risk stable group ( n =260, 22.3%), and high risk deterioration group ( n =43, 3.7%). After adjusting the status of the left behind individuals，using the low risk improvement group as the reference category in multinomial Logistic regression analysis, results indicated that higher loneliness scores among junior high school students increased the risks of belonging to the moderate risk stable group ( OR=1.02, 95%CI =1.00- 1.04 ) and the high risk deterioration group ( OR=1.04, 95%CI =1.00-1.08), while higher self esteem scores reduced the risks of belonging to the moderate risk stable group ( OR=0.93, 95%CI =0.91-0.96) and the high risk deterioration group ( OR=0.88, 95%CI =0.83-0.94) (all P <0.05). Conclusions The overall trend of clustered health risk behaviors among junior high school students gradually improves, and the self esteem and loneliness are significant correlative factors. Targeted intervention measures should be developed for the junior high school students, with a focus on enhancing their self esteem and alleviating loneliness.

OBJECTIVE To provide direction and reference for the adjustment of the discount rate （DR） in China’s pharmacoeconomic guidelines. METHODS Search was conducted on the official websites of the International Society for Pharmacoeconomics and Outcomes Research， health technology assessment agencies in various countries/regions， as well as relevant websites of other upper-middle-income or high-income countries/regions. The recommended DR， adjustment trends， and setting rationales in pharmacoeconomic evaluation guidelines across different countries/regions were then summarized and compared. Based on theoretical derivation and literature analysis， the effects of different DR on the incremental cost-effectiveness ratio （ICER） were examined. RESULTS & CONCLUSIONS Among the 40 included guidelines， the base-case DR ranged from 1.5% to 5%， with 5% being the most common value； the range for sensitivity analysis was 0 to 12%. Thirty-six countries/regions applied the same DR to both costs and health outcomes， while in the Netherlands， Belgium， Poland and Czech Republic， DR for costs was higher than for health outcomes. In recent years， Korea， France and Ireland had lowered their DR in response to economic changes， whereas the Netherlands and Czech Republic had raised their DR for cost. The setting of the DR was primarily based on the public project investment interest rate or referred to recommendations from internationally authoritative institutions and other relevant guidelines. The direction and magnitude of the impact of different DR on the ICER largely depended on the distribution of costs and health outcomes between the intervention and reference measure. The setting and adjustment of DR were closely associated with the economic environment. Based on international experience, the DR in China can be lowered by 0.5% to 1.5%， and localized empirical research can be conducted using internationally common estimation methods.

Objective To explore the effect of virtual reality technology combined with self-made spe-cial masks on preoperative anxiety and general anesthesia induction in children.Methods A total of 180 chil-dren with adenoid hypertrophy who underwent surgical treatment in this hospital from 2021 to 2023 were se-lected as the research subjects and divided into the control group,the experiment group 1 and 2 according to the random number table method,with 60 cases in each group.After the children entered the anesthesia induc-tion room,the control group was accompanied by one nurse to play with toys and read books to relieve anxie-ty.The experiment group 1 and 2 wore the PICO 4 VR all-in-one machine.In the control group and the experi-ment group 1,the masks were connected to the anesthesia machine for inhalation of sevoflurane.The children lost consciousness and completed the peripheral venous puncture operation and were sent to the operating room.They were assisted with intravenous anesthetics and tracheal intubation was completed.The experiment group 2 completed anesthesia induction by connecting a special mask to an anesthesia machine and a negative pressure suction tube on the basis of the experiment group 1.The simplified Modified Yale Preoperative Anxi-ety Scale(mYPAS-SF)scores of the three groups were compared at the time of entering the anesthesia induc-tion room(T0),10 min after entering the anesthesia induction room(T1),before the start of anesthesia induc-tion(T2),as well as the anesthesia induction time and the incidence of postoperative anesthesia adverse reac-tions.Results The comparison results among the three groups of mYPAS-SF scores showed that at T1 and T2,the scores of the experiment group 1 and 2 were decreased compared with the control group(P<0.05).The mYPAS-SF scores in the three groups showed that the scores at T0,T1,and T2 were significantly higher than those at admission(P<0.05).The levels in the experiment group 1 and 2 gradually were decreased over time(P<0.05),while there was no significant change in the control group(P>0.05).There was a statisti-cally significant difference in the anesthesia induction time among the three groups(P<0.05),and it was gradually decreased(P<0.05).There was a statistically significant difference in the incidence of choking cough,stridor and restlessness among the three groups(P<0.05),both the experiment group 1 and 2 were lower than the control group(P<0.05),and the incidence of choking cough in the experiment group 2 was lower than that in the experiment group 1(P<0.05).Conclusion Virtual reality technology combined with special masks for the induction of general anesthesia can reduce preoperative anxiety in children,shorten the induction time of anesthesia,and reduce adverse reactions of anesthesia.

Although cancer immunotherapy has made great strides in the clinic, it is still hindered by the tumor immunosuppressive microenvironment (TIME). The stimulator of interferon genes (STING) pathway which can modulate TIME effectively has emerged as a promising therapeutic recently. However, the delivery of most STING agonists, specifically cyclic dinucleotides (CDNs), is performed intratumorally due to their insufficient pharmacological properties, such as weak permeability across cell membranes and vulnerability to nuclease degradation. To expand the clinical applicability of CDNs, a novel pH-sensitive polycationic polymer-modified lipid nanoparticle (LNP-B) system was developed for intravenous delivery of CDNs. LNP-B significantly extended the circulation of CDNs and enhanced the accumulation of CDNs within the tumor, spleen, and tumor-draining lymph nodes compared with free CDNs thereby triggering the STING pathway of dendritic cells and repolarizing pro-tumor macrophages. These events subsequently gave rise to potent anti-tumor immune reactions and substantial inhibition of tumors in CT26 colon cancer-bearing mouse models. In addition, due to the acid-sensitive property of the polycationic polymer, the delivery system of LNP-B was more biocompatible and safer compared with lipid nanoparticles formulated with an indissociable cationic DOTAP (LNP-D). These findings suggest that LNP-B has great potential in the intravenous delivery of CDNs for tumor immunotherapy.

Cold tumors have a poor response to tumor immunotherapy due to low immune cell infiltration and the ability to evade immune attacks. Converting cold tumors into hot tumors can enhance the clinical effectiveness of anti-tumor immunotherapy. High-intensity focused ultrasound (HIFU) as a non-invasive treatment can damage tumors through mechanical effects, but there is a lack of research on its cytotoxic mechanisms at the cellular level and its role in inducing anti-immune responses. In this study, the role of HIFU in triggering tumor ferroptosis by disrupting the GSH/GSSG balance through mechanochemical action and the associated anti-tumor immune priming effect were investigated. The use of a nano-enhancer loaded with PFOB combined with HIFU could enhance ferroptosis in triple-negative breast cancer at a specific stage of tumor growth (UTGR = 0) while promoting the conversion of a cold tumor into a hot tumor, thereby improving the immune response. Overall, this provides valuable guidance for the clinical application of HIFU in tumor immunotherapy.

Alzheimer's disease （AD）， a degenerative disease of the central nervous system， is characterized by progressive degradation of learning， memory， and cognitive functions. Currently， few drugs are available for treating AD， and their effects are limited. Berberine （BBR） is a natural isoquinoline （quaternary ammonium-like） with a wide range of pharmacological effects. Studies have proven that BBR has good potential in the treatment of AD. Specifically， BBR can inhibit the generation， aggregation， and neurotoxicity of amyloid-β and the hyperphosphorylation of Tau protein， promote the clearance of phosphorylated Tau protein， reduce the cholinesterase activity， neuroinflammation， and oxidative stress， regulate neuronal apoptosis， improve the mitochondrial function and glucose and lipid metabolism， suppress the monoamine oxidase activity， and modulate gut microbiota. In addition， researchers have ameliorated the low bioavailability of BBR. Probing into the potential targets is hoped to provide a reference for further research on the prevention and treatment of AD by BBR.

Objective:To analyze and compare differences in cortical functioning between patients with post-stroke dysphagia (PSD) following a left hemisphere stroke and healthy individuals using functional near-infrared spectroscopy (fNIRS).Methods:Twenty-six patients recovering from post-stroke dysphagia following a left hemisphere stroke formed the study′s PSD group, and 26 age-matched healthy subjects serves as the HC group. A 41-channel infrared spectroscope was used to record any changes in oxyhemoglobin (HbO) concentration while swallowing and at rest. The fNIRS data were statistically analyzed using Nirspark software. The β-values, reflecting the level of cortical activation, and the swallowing-related specific functional connectivity (FC) strength values (ΔFCs), representing task-specific FC strength, were extracted. The β-values and ΔFCs of the two groups were compared.Results:Compared with the HC group, the PSD group showed significantly reduced activation in Brodmann area (BA) 3/4/6/43 and BA4/6 of the left hemisphere during swallowing. Those areas correspond to the left primary motor cortex (M1), primary somatosensory cortex (S1), premotor cortex, and supplementary motor area (PM). Significantly reduced activation was observed in the PSD group in the right hemisphere at BA45/46/47, BA45/38/48, and BA10, corresponding to the right prefrontal cortex (PFC). The ΔFC values between the left PM-left M1, left PM-left S1, left M1-right S1, and left S1-right M1 in the PSD group were significantly lower than those in the HC group.Conclusions:Left hemispheric PSD is associated not only with decreased activation in the ipsilesional sensorimotor cortex (M1, S1, PM) but also with functional decline in the contra-lesional PFC. During swallowing, persons with left hemispheric PSD exhibit extensive impairment in inter-cortical network connectivity, with particularly marked reductions in connectivity between their ipsilesional and contra-lesional sensorimotor cortices.

Objective:To investigate whether the rs612529 C/T and rs11669663 G/A in VSTM1 gene are associated with leukocyte signaling inhibitory receptor-1(SIRL-1)expression and an increased risk for systemic lupus erythematosus(SLE)in a Han Chinese cohort.Methods:A total of 200 patients with SLE and 218 healthy controls(HC)were enrolled.Relevant laboratory characteris-tics of patients with SLE were also collected.Genotyping of rs612529 C/T and rs11669663 G/A were performed by Sanger sequencing technology.SIRL-1 expression was assessed in peripheral blood neutrophils and monocytes was detected by flow cytometry.Levels of autoantibodies associated with SLE were detected by ELISA.Results:In both SLE group and HC,the C allele of rs612529 was asso-ciated with a decreased expression level of SIRL-1 on monocytes,with a gradual increased in SIRL-1 protein level from the CC over the CT to the TT genotype.C allele of rs612529 was associated with higher serum anti-dsDNA antibody titers in patients with SLE(P<0.05).In the case of rs11669663 G/A,no significant association of genotypes with SLE susceptibility was detected.Conclusion:VSTM1 rs612529 C/T may contribute to SLE disease activity and regulate SIRL-1 expression on monocytes in the Han Chinese cohort.

Objective:To explore the relationship between autistic trait and pain empathy among college students, as well as the mediating role of personal pain perception.Methods:From October to December 2023, a cross-sectional survey was conducted among 1 195 college students using the autism spectrum quotient, pain sensitivity questionnaire, fear of pain questionnaire, pain catastrophizing scale and empathy for pain scale.SPSS 27.0 software was used for descriptive statistics and correlation analysis.A structural equation model was constructed using Mplus 8.3 to examine the mediating effect of personal pain perception, which was composed of pain sensitivity, fear and catastrophizing cognition.Results:Autistic trait(22.00(18.00, 26.00))was significantly positively correlated with pain sensitivity (55.00(43.00, 70.00)), fair of pain (69.00(60.00, 78.00)), and pain catastrophizing cognition (16.00(8.00, 23.00)) ( r=0.112, 0.154, 0.204, all P<0.001).Autistic trait was also significantly positively correlated with affective distress(62.00(46.00, 80.00), r=0.162, P<0.001) and vicarious pain (14.00(8.00, 20.00), r=0.096, P<0.001) of pain empathy.Pain sensitivity, fear of pain and pain catastrophizing cognition were significantly positively correlated with affective distress( r=0.244, 0.332, 0.375, all P<0.001) and vicarious pain ( r=0.210, 0.232, 0.285, all P<0.001) of pain empathy.The effects of autistic trait on affective distress and vicarious pain dimensions of pain empathy were fully mediated by personal pain perception, with the mediating effects of 0.115( P<0.001, 95% CI=0.073-0.165) and 0.085( P<0.001, 95% CI=0.053-0.124). Conclusions:The autistic trait of college students can predict the affective distress and vicarious pain of pain empathy indirectly through personal pain perception.

Objective To explore the characteritics of spontaneous brain functional activities for patients with hand dysfunction after ischemic stroke using resting state functional magnetic resonance imaging(rs-fMRI).Methods From August,2024 to June,2025,23 patients with hand dysfunction after ischemic stroke were as patients group,and ten age-matched healthy adults were recruited as healthy control group.The patients group was as-sessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE),Wolf Motor Function Test(WMFT)and modified Lindmark Scale.All subjects underwent rs-fMRI examinations,and the amplitude of low frequency fluctuations(ALFF),fractional amplitude of low frequency fluctuations(fALFF)and regional homogeneity(Re-Ho)were compared between two groups.The resting state functional network was constructed based on indepen-dent component analysis,and the functional connectivity(FC)were analyzed.The rs-fMRI indicators of the pa-tients and the clinical scale scores were analyzed.Results Compared with the healthy control group,the zALFF value decreased in the precentral gyrus(P<0.05,FWE corrected)in the patient group,as well as the values of zfALFF in Cerebelum-Crus2-R(P<0.05,FWE correct-ed),and ReHo values in the putamen(P<0.05,corrected by Alpha Sim).FC of the inferior frontal gyrus(IF-Goperc.R)in the executive control network enhanced(P<0.05,Alpha Sim corrected),while FC of the middle oc-cipital gyrus(MOG.L)in the dorsal attention network(DAN)weakened(P<0.05,Alpha Sim corrected).There was a positive correlation between FC of MOG.L in the patient's DAN and the scores of FMA-UE(r=0.439,P=0.036),WMFT(r=0.516,P=0.012),and modified Lindmark Scales(r=0.425,P=0.043).Conclusion The resting state spontaneous activity of some brain areas of the cerebrum,cerebellum and basal ganglia is reduced in patients with hand dysfunction after ischemic stroke,and some brain network connections are abnor-mal.FC of MOG.L may serve as an objective imaging marker for evaluating hand dysfunction.