BackgroundAnxiety exhibits a rising prevalence among college students. Investigating the mechanisms through which family function relates to anxiety and examining the moderating role of emotion regulation strategies within this context hold substantial implications for promoting mental health among college students. However， existing research has not sufficiently elucidated the complex interplay among family function， emotion regulation， and anxiety among college students. Further research is warranted to clarify the underlying mechanisms linking family function to anxiety outcomes and to examine the potential moderating role of emotion regulation strategies in this causal pathway. ObjectiveTo explore the relationship between family function and anxiety among lower-grade college students， and to validate the moderating role of emotion regulation strategies in this relationship， thereby offering evidence-based insights for anxiety reduction interventions in this population. MethodsIn March 2023， a total of 1 980 first- and second-year students from a comprehensive university in Shanghai were selected using the cluster sampling method. A self-designed demographic questionnaire， the Emotion Regulation Questionnaire （ERQ）， the Family Adaptability and Cohesion Evaluation Scale Ⅱ-Chinese Version （FACES Ⅱ-CV）， and the Symptom Checklist-90 （SCL-90） were utilized for assessment. Pearson correlation analysis and Spearman correlation analysis were employed to test the correlations of each variable. Hierarchical linear regression analysis was conducted to certify the moderating role of emotion regulation strategies in the relationship between family function and anxiety. ResultsCompared with female students， male students scored significantly lower on ERQ cognitive reappraisal （t=-5.793， P<0.01） but significantly higher on ERQ expressive suppression （t=8.359， P<0.01）. For lower-grade college students， scores on adaptability and cohesion subscales of FACES Ⅱ-CV showed a positive association with cognitive reappraisal in ERQ （r=0.251， 0.302， P<0.01）， while simultaneously displaying negative correlations with both expressive suppression in ERQ （r=-0.113， -0.154， P<0.01） and anxiety in SCL-90 （r=-0.243， -0.202， P<0.01）. Notably， anxiety scores in SCL-90 were inversely related to cognitive reappraisal scores in ERQ （r=-0.159， P<0.01） but directly associated with expressive suppression scores in ERQ （r=0.171， P<0.01）. Hierarchical regression analysis indicated that cognitive reappraisal significantly moderated the relationship between family cohesion and anxiety （β=-0.421， P<0.01）. ConclusionThe cognitive reappraisal strategy serves as a moderator in the relationship between family cohesion and anxiety， potentially mitigating the escalation of anxiety levels associated with family dysfunction. ［Funded by Science and Technology Development Fund of Shanghai Pudong New Area （number， PKJ2023-Y21）］

Parkinson's disease （PD） is a chronic progressive neurodegenerative disorder primarily characterized by motor dysfunction. The main pathological features include the loss of dopaminergic neurons in the substantia nigra， abnormal aggregation of alpha-Synuclein （α-Syn）， and the formation of Lewy bodies. However， the exact mechanisms remain unclear. In recent years， the PD incidence has gradually increased， while current treatment methods are limited to symptom alleviation， incapable of halting disease progression， and prone to adverse effects， thus making it urgent to search for medicines effective for PD. Modern research indicates that the Kelch-like ECH-associated protein 1 （Keap1）/nuclear factor E₂ related factor 2 （Nrf2）/antioxidant response element （ARE） signaling pathway is closely related to oxidative stress， neuroinflammation， apoptosis， ferroptosis， and mitochondrial dysfunction， playing a crucial role in the pathophysiological development of PD. A large number of studies have further confirmed that traditional Chinese medicine （TCM） can regulate diseases through a holistic view of Syndrome differentiation and microscopic molecular pathways. With unique advantages， such as multiple targets， multiple pathways， and fewer adverse reactions， TCM provides a new strategy for PD treatment. This article elucidates the mechanism of the Keap1/Nrf2/ARE signaling pathway in the occurrence and development of PD， while summarizing the latest research on PD intervention by TCM monomers， active ingredients， and compounds， as well as acupuncture via the precise targeted regulation of the Keap1/Nrf2/ARE pathway， aiming to provide a reference for clinical medicine development to prevent and treat PD.

AIM: To investigate the influence of pterygium thickness and area on corneal refractive status.METHODS: Prospective longitudinal study. A total of 60 cases(60 eyes)of pterygium patients admitted to our hospital from January 2024 to September 2024 were randomly selected. All patients underwent pterygium excision combined with pedicle conjunctival flap transplantation for treatment. Optical coherence tomography(OCT)was used to measure the preoperative thickness of patient's pterygium, and a digital slit lamp microscope was used to measure the area of pterygium. The corneal refractive status(degree of corneal astigmatism and average curvature)and changes in uncorrected visual acuity of patients before surgery, 1 d, 1, and 3 mo after surgery were compared. The relationship between preoperative thickness and area of pterygium in patients and corneal refractive status indicators at different postoperative time points were analyzed, and Logistic regression was used to analyze the impact of pterygium thickness and area on postoperative visual improvement in patients.RESULTS: All patients completed follow-up after surgery for 3 mo. At 3 mo after surgery, visual acuity improved in 21 eyes(35%). The results of bivariate Pearson correlation analysis showed that the thickness and area of pterygium positively correlated with the degree of corneal astigmatism and uncorrected visual acuity before surgery and 1 d, 1, and 3 mo after surgery(all P<0.05), and negatively correlated with the average corneal curvature before surgery and 1 d, 1, and 3 mo after surgery(all P<0.05). Logistic regression analysis showed that the thickness and area of pterygium before surgery, high degree of corneal astigmatism, and low uncorrected visual acuity(large LogMAR value)were all risk factors for poor postoperative visual improvement in patients(OR>1, P<0.05). The large average corneal curvature before surgery was a protective factor for poor postoperative visual improvement in patients(OR<1, P<0.05).CONCLUSION: The increase in thickness and area of pterygium can, to some extent, improve corneal astigmatism, reduce the average curvature of the cornea, and affect postoperative visual recovery.

Minimally conscious state （MCS） is at the edge between closed and open consciousness， but it still belongs to the category of "wind-strike block" syndrome. The basic pathogenesis of MCS is the obstruction of pathogenic qi， orifices closed and spirit hidden， with pathological factors including phlegm， fire， and blood stasis. Wind movement and water retention may also be present， and often leading to deficiency syndrome due to the exhaustion of qi， blood， yin， and yang at later stages. Treatment chooses Shexiang （Moschus） as the chief medicinal， emphasizing combination of medicinals and urgency of medication administration； the key therapeutic method is to open the orifices， with focuses on expelling pathogens and reinforcing healthy qi. For patients with severe phlegm or fire， use Xiaochengqi Decoction （小承气汤） to open the lower orifices， discharge heat and unblock the bowels， combined with Shexiang （Moschus） and Niuhuang （Bovis Calculus） to open the upper orifices， awaken the spirit and guide qi. For patients with turbid phlegm as the predominant， temporarily replace Shexiang （Moschus） with Baizhi （Angelicae dahuricae radix）， using Ditan Decoction （涤痰汤） to eliminate phlegm to open the orifices， when turbid phlegm gradually subsided， Shexiang （Moschus） could be added. For patients with blood stasis as the predominant， Tongqiao Huoxue Decoction （通窍活血汤） will be used to activate blood and open orifice， if the blood circulates， the endogenous wind will be calmed， the water will be induced， the orifices will open and the consciousness will restore. For patients with closed orifices and body deficiency， the treatment should open the orifices and reinforce healthy qi， and consider the root and branch simultaneously； qi deficiency syndrome can be addressed with Buyang Huanwu Decoction （补阳还五汤） to boost qi and reinforce healthy qi； yin deficiency syndrome can be treated with Shaoyao Gancao Decoction （芍药甘草汤） combined with Fengsui Pill （封髓丹） to nourish yin， soften sinews， and secure kidney essence； yang deficiency can be managed by using Dihuang Yinzi Decoction （地黄饮子） to enrich yin， supplement yang， and open the orifices.

Objective We apply a class imbalance treatment method that can solve the between-class imbalance problem and the within-class imbalance problem of the minority class and the majority class at the same time.And combining it with RF classifier to achieve early recurrence prediction in DLBLC patients,which provided a reference for the treatment of DLBLC patients.Methods Firstly,we apply a class imbalance processing method based on Gaussian mixture model bi-directional clustering resampling to process the data.And compared with ROS,SMOTE,Borderline-1 SMOTE,Borderline-2 SMOTE,GMM oversampling,GMM undersampling,SMOTE+RUS,SMOTE+GMM and GMM+RUS.Afterwards,in order to verify the performance of RF,we use logistic regression and decision tree models as controls.Finally,the evaluation of the model is carried out in terms of discrimination and calibration.Results The RF model with GMM-GMM resampling achieved relatively optimal classification performance(accuracy=0.79,AUC=0.87,sensitivity=0.71,specificity=0.87,G-means=0.79,MSE=0.21).Conclusion GMM-GMM is superior to other traditional resampling methods,and combining it with the RF model for the prediction of early recurrence in DLBCL patients has achieved relatively good classification results,which can well realize the prediction of early recurrence in DLBCL patients.

Objective:The study aimed to validate the Neuroception of Psychological Safety Scale (NPSS) in terms of reliability and validity among individuals with mental disorders in China.Methods:The Study followed Brislin′s translation principles to adapt the scale into Chinese. From February to June 2023, a total of 638 hospitalized patients with mental disorders (477 with schizophrenia and 161 with mood disorders) were selected through gender-stratified simple random sampling from the Shanghai Pudong New Area Mental Health Center and the Shanghai Baoshan Mental Health Center. The Chinese version of the NPSS and the Security Questionnaire (SQ) were administered. The reliability of the scale was measured using split-half reliability and test-retest reliability. Validity was assessed through content validity, structural validity, convergent validity, and discriminative validity analyses. In addition, SQ was used as a criterion tool to test the validity of the criterion through Pearson correlation analysis.Results:The Chinese version of the NPSS contained 29 items, with total scores ranging from 29 to 145. Higher total scores indicated greater psychological safety. Item analysis showed a decider value of 10.58 to 20.80 (>3), and the correlation between items and total scores ranged from 0.579 to 0.749 (all P<0.05). The item-level content validity index (I-CVI) for the items ranged from 0.86 to 1.00, while the average scale-level content validity index (S-CVI/Ave) was 0.99. Exploratory factor analysis extracted three common factors: social participation, empathy, and bodily sensations, which is consistent with the structure of the original scale, explaining a cumulative variance contribution rate of 62.551%. Confirmatory analysis revealed a satisfactory model fit, with average variance extracted (AVE) values for the three dimensions ranging from 0.523 to 0.645, and composite reliability(CR) ranging from 0.905 to 0.938. The standard loading coefficients for the items ranged from 0.608 to 0.859, and inter-factor correlation coefficients were all smaller than the square roots of their respective AVE values. Pearson correlation analysis indicated significant positive relationships between the Chinese NPSS and SQ ( r=0.822-0.846, P<0.01). Reliability analysis showed Cronbach′s alpha coefficients of 0.903-0.959 for the total scale and subscales. After a 3-week interval, test-retest reliability (70 patients) ranged from 0.874 to 0.983, and split-half reliability was 0.869-0.969. All model fit indices met established criteria. Conclusions:The Chinese version of the NPSS demonstrates good reliability and validity, making it suitable for both research and clinical applications in assessing psychological security among individuals with schizophrenia and mood disorders.

Objective:To investigate the status of sedentary behavior and its influencing factors among inpatients with stable schizophrenia, providing empirical evidence for developing interventions to reduce sedentary behavior.Methods:A cross-sectional survey design was used to prospectively collect clinical data from 166 inpatients with stable schizophrenia (97 males, 69 females, mean age 56.4±8.4 years) hospitalized at the Shanghai Mental Health Center affiliated with Shanghai Jiao Tong University School of Medicine from February 2024 to May 2024. Sedentary behavior time was assessed using the Sedentary Behavior Questionnaire (SBQ), daily step count was measured via pedometers, and negative schizophrenic symptoms were evaluated using the Scale for the Assessment of Negative Symptoms (SANS). Patients were divided into a non-sedentary behavior group (≥5 000 steps/day, 66 cases) and a sedentary behavior group (<5 000 steps/day, 100 cases). Clinical variables were compared between the two groups, and binary logistic regression was used to identify influencing factors of sedentary behavior.Results:Stable inpatients with schizophrenia exhibited high levels of sedentary behavior, with an average daily sedentary time of (8.03±2.33) hours and a median daily step count of 3 352 (1 258-5 506) steps. Significant differences were observed between sedentary and non-sedentary behavior groups in Age ( t=-2.38),hospitalization duration ( Z=-1.53),blunted affect ( t=-8.37),poverty of thought ( t=-2.45),avolition ( t=-2.45),impoverished interests/social engagement ( t=-2.41),abdominal obesity ( χ2=9.18),and open vs. restricted hospital/wards environment ( χ2=8.88)(all P<0.05). Binary logistic regression analysis identified that hospital/wards environment ( OR=0.314, 95 %CI: 0.125-0.787),hospitalization duration ( OR=1.001, 95 %CI: 1.000-1.001),and the negative symptom of blunted affect ( OR=3.256, 95 %CI: 1.960-5.407)(all P<0.05) were significantly influencing factors for sedentary behavior in patients with stable schizophrenia. Conclusion:Hospitalized patients with stable schizophrenia exhibit high levels of sedentary behavior. Hospital/wards environment and blunted affect are significant factors influencing sedentary behavior.

Objective To explore the effect of esculin(ESCL)on hypoxia/reoxygenation(H/R)-induced myocardial cell injury by regulating high mobility group B1(HMGB1)/receptor of advanced glycation endproducts(RAGE)signaling pathway.Methods H9c2 cells were divided into the control group,the H/R group,the ESCL-low group,the ESCL-medium group and the ESCL-high group(ESCL-L,M,H,0.4,0.8,1.6 mmol/L),the ESCL-H+pcDNA-NC group and the ESCL-H+pcDNA-HMGB1 group.The AnnexinV FITC staining method was used to detect the apoptosis rate of H9c2 cells.Enzyme linked immunosorbent assay was used to measure interleukin(IL)-18,IL-1β,tumor necrosis factor(TNF)-α,the malondialdehyde(MDA),lactate dehydrogenase(LDH)contents and the superoxide dismutase(SOD)activity.The DCHF-DA fluorescent probe was performed to detect active oxygen(ROS)fluorescence intensity.Immunoblotting was performed to detect B-cell lymphoma-2(Bcl-2),Bcl-2 associated X protein(Bax),HMGB1 and RAGE proteins.Results Compared with the control group,the H/R group showed conspicuously higher apoptosis rate,IL-18,IL-1β,TNF-α,MDA,LDH,ROS fluorescence intensity,Bax,HMGB1 and RAGE proteins in H9c2 cells,and conspicuously lower Bcl-2 protein and SOD activity(P＜0.05).Compared with the H/R group,the ESCL-L,ESCL-M and ESCL-H groups showed a gradual decrease in cell apoptosis rate,IL-18,IL-1β,TNF-α,MDA,LDH and ROS fluorescence intensity,Bax,HMGB1 and RAGE proteins with increasing ESCL concentration,and a gradual increase in Bcl-2 protein and SOD activity(P＜0.05).Overexpression of HMGB1 reversed the protective effect of ESCL on H/R induced cardiomyocyte injury.Conclusion ESCL may reduce H/R induced cardiomyocyte injury by inhibiting HMGB1/RAGE pathway.

Infectious diseases continue to pose a threat to global public health. Successive global shocks caused by emerging and re-emerging pathogens have continuously challenged existing surveillance systems, highlighting the urgent need to build efficient and precise pathogen surveillance networks. Pathogen genomic databases have been developed rapidly in recent two decades, significantly improving the molecular identification, evolutionary analysis, and transmission tracking of pathogens, and changing disease surveillance strategies and patterns. This paper summarizes the developmental history and current state of pathogen genomic databases, and discusses their applications in public health, including pathogen variation surveillance, emerging or suspected pathogen identification, and epidemiological tracing. Furthermore, this paper systematically analyzes the limitations and key challenges faced by current global health prevention and control system, and suggests the focus of the development of online pathogen databases to address existing shortcomings, ultimately improve global infectious disease surveillance and early warning

Hepatic osteodystrophy is a common complication in patients with chronic liver disease and is influenced by various risk factors， and it has become one of the important influencing factors for the prognosis of liver transplantation. By analyzing the influencing factors for bone health and bone metabolism during the perioperative period of liver transplantation， this article emphasizes the importance of a comprehensive assessment of bone health and necessary interventions at this stage， with an aim to reduce the risk of postoperative complications and improve the long-term prognosis of patients. A deeper exploration of the association between hepatic osteodystrophy and the prognosis of liver transplantation can help to reveal the key influencing factors for postoperative outcomes， thus providing a theoretical basis for optimizing postoperative management strategies. Furthermore， advances in this research field will offer new insights into the treatment of patients receiving liver transplantation， and it is expected to further improve quality of life and long-term survival rate.