Abstract Children s emotional and behavioral problems are characterized by a relatively high incidence, concealed manifestations, and a potential correlation with an increased risk of subsequent mental disorders. These problems have a sustained impact on children s social-emotional development, learning adaptation, and peer relationships. The study reviews the main influencing factors and their mechanisms of action regarding children s emotional and behavioral problems from three levels:individual, family, and social. Under a multi-level integrated perspective, it deepens the understanding of these mechanisms and proposes that future efforts should focus on factors such as improving physical fitness, enhancing sleep, and reducing sedentary behavior. Furthermore, it suggests strengthening collaborative interventions among schools, families, and communities to promote the early prevention of childrens emotional and behavioral problems and support their healthy development.

Objective To observe the therapeutic effect of Qiwei Tangmaishu capsules on type 2 diabetes mice,and explore the mechanisms of its treatment of type 2 diabetes based on network pharmacology.Methods TCMSP,ETCM databases were used to query all components and of Qiwei Tangmaishu capsules and their targets.OMIM and DrugBank databases were used to search for targets of type 2 diabetes.The targets of type 2 diabetes and Qiwei Tangmaishu capsules were intersected by Venny 2.1.0.to perform GO and KEGG pathway enrichment analysis on those intersecting targets using the Metascape website.Then,a mouse model of type 2 diabetes was established,and Qiwei Tangmaishu capsules were given to low,medium,and high dose groups(234,468,and 936 mg/kg,respectively),and metformin(MET)group(200 mg/kg)for 2 weeks.The weight of each mouse was measured before and after treatment,and fasting blood glucose was also measured.After the 2 weeks,fasting insulin was measured;ELISA was used to detect levels of inflammatory factors IL-1β,TNF-α,IL-6,TLR4,and NF-κB in serum;Hematoxylin eosin staining was used to observe the morphology of pancreatic islets;and Caspase 3 and INS immunofluorescence were used to detect apoptosis of pancreatic islet cells and the number of pancreatic beta cells.Western Blot assay was used to detect the expression levels of pancreatic tissue proteins such as p-Akt,Akt,p-PI3K,PI3K,Bax,Bcl2.Results 1260 active ingredient targets were identified in Qiwei Tangmaishu capsules;1205 targets of type 2 diabetes were found.Of these,312 targets were intersected by Venny,with core targets involving Akt1,TNF,IL-6,TLR4,among others.Enrichment analysis identified 240 KEGG pathways,among which"insulin resistance""PI3K/Akt signaling pathway"were the key pathways enriched.The animal experiment result showed that compared with the model group,the intervention of Qiwei Tangmaishu capsules and metformin significantly improved blood glucose and insulin resistance;the content of inflammatory factors in serum decreased,and the apoptosis rate of pancreatic islet cells significantly decreased;the number of pancreatic beta cells significantly increased;the expression of pro-apoptotic protein Bax decreased,the expression of anti-apoptotic protein Bcl2 significantly increased,and the expression of p-PI3K and p-Akt was upregulated.Conclusions Qiwei Tangmaishu capsules can significantly reduce blood glucose levels,restore insulin sensitivity,and reduce islet cell apoptosis in type 2 diabetic mice.The mechanism may be related to the activation of the PI3K/Akt signaling pathway.

Objective To investigate the clinical characteristics,diagnosis and treatment of ileal injury secondary to percutaneous nephrolithotomy percutaneous nephrolithotomy(PCNL).Methods The diagnosis and treatment of a patient were reviewed,and relevant literature were retrieved.Results The patient was a 41-year-old male,who underwent stage PCNL(initial percutaneous nephrostomy,followed by secondary PCNL)due to right ureteral calculi with severe hydronephrosis.On postoperative day 1,he developed abdominal distension and pain.Abdominal X-ray revealed subdiaphragmatic free gas,and CT showed pelvic and abdominal fluid and gas accumulation,suggesting peritonitis due to intestinal perforation.Emergency exploratory laparotomy identified a 3 mm×3 mm ileal perforation approximately 30 cm from the ileocecal valve,which was repaired surgically.The patient recovered well and was discharged after one week,with no discomfort reported during a 6-month follow-up.Conclusion The clinical features of ileal injury secondary to PCNL include early postoperative abdominal distension,pain and peritonitis.Diagnosis relies on clinical manifestations,abdominal X-ray and CT,with surgical exploration if necessary.Conservative management under vigilant observation can be cautiously adopted for localized injuries,while surgical repair is required for peritonitis or failed conservative therapy.

Objective:To study the risk factors and the molecular epidemiology characteristics for Carbapenem-resistant Enterobacteriaceae(CRE) colonization in neonatal inpatients in Shenzhen region, China, which provide reference for the prevention and control of clinical CRE infection.Methods:This study is a prospective case-control study.Anal samples from inpatients between January 2023 and December 2023 at Longgang Maternity and Child Institute of Shantou University Medical College and Shenzhen Children's Hospital were collected for screening CRE strain. Drug susceptibility test, modified Carbapenem Inactivation Method (mCIM) test, drug resistance-related gene sequencing and multilocus sequence typing (MLST) were performed for isolated CRE strains.Meanwhile, the clinical data were collected for analyzing the risk factors of CRE intestinal colonization by multivariate regression analysis.Results:A total of 1 517 patients were screened, 26 CRE(1.7%, 26/1 517) were identified which including 14 Escherichia coli(53.8%, 14/26), 11 Klebsiella pneumoniae(42.3%, 11/26), 1 Enterobacter cloacae(3.9%, 1/26). The predominant carbapenemase gene was New Delhi Metallo(NDM) (92.4%, 24/26), followed by Imipenem (IMP) (3.8%, 1/26) and Guiana extended spectrum gene (GES) (3.8%, 1/26).Among the carried NDM resistance genes, New Delhi Metallo 5 (NDM5) was the main one, accounting for 84.6% (22/26).The MLST typing of Escherichia coli was mainly Sequence Type 48 (ST48) (6/14), while that of Klebsiella pneumoniae was mainly Sequence Type 35 (ST35) (10/11). All CRE isolates were resistant to penicillin, penicillinase inhibitors, cephalosporins, ertapenem and imipenem.The resistance rates of Escherichia coli to amikacin, levofloxacin was 1/14, 4/14, respectively. All isolates of Klebsiella pneumoniae were sensitive to amikacin, and the resistance rate to levofloxacin is 1/11. Risk factors for CRE colonization include the older age, length of hospital stay, tracheal intubation, invasive respiration, lumbar puncture, Apgar <7 score, and exposure to antibiotics.Conclusions:NDM5 is the predominant resistant gene in CRE isolated from neonatal patients feces in Shenzhen region.It is necessary to strengthen the screening of CRE colonization in neonate for prevention and control of CRE infection.

Objective:To explore the effect of fibroblast growth factor 2(FGF2)on ferroptosis of renal fibrotic cells and its po-tential molecular mechanisms.Methods:Rat NRK-52E cells were randomly divided into control group,renal fibrosis model group,FGF2 cytokine stimulation group,knockdown empty plasmid group,si-FGF2 group,overexpression empty plasmid group,overexpres-sion FGF2 group,Fer-1 treatment group.The model group was treated with TGF-β1 to obtain a renal fibrosis cell model.Cellular im-munofluorescence method was used to measure the level of cell fibrosis.Western blot was used to detect ferroptosis-related proteins(Nrf2,GPX4 and SLC7A11)and pathway proteins(STAT3,p-STAT3)expression level in the cells.Results:Knockdown of FGF2 could alleviate the increase in α-SMA and Collagen Ⅲ proteins caused by TGF-β1 stimulation of renal tubular cells(P<0.05).FGF2 could promote the activation of STAT3 protein into p-STAT3.The expression level of SLC7A11 protein was significantly increased after FGF2 cytokine stimulation(P<0.05).Compared with the control group,the expressions of Nrf2 and GPX4 in renal fibrotic cells in the si-FGF2 group and Fer-1 treated group were significantly reduced(P<0.05).In addition,knockdown of FGF2 significantly reduced in-terstitial fibrosis of renal tubular epithelial cells(P<0.05).Conclusion:FGF2 may mediate TGF-β1-induced renal ferroptosis through the STAT3/SLC7A11 signaling pathway,and knock down of FGF2 can improve fibrosis of renal tubular epithelial cells.

An analysis of 24 144 norovirus sequences from Asia and Russia deposited in GenBank between 1995 and 2023 was conducted,to understand the temporal and spatial variations in norovirus genotypes in these regions.Norovirus sequences from Asia and Russia were downloaded in FASTA format from GenBank for the years 1995-2023,and analyzed in Excel,R language,and GraphPad Prism for data visualization.The number of norovirus sequences submitted to GenBank increased annually from 2004 and peaked in 2015.Notably,China and Japan contributed 62.3％of all submitted norovirus sequences.These sequences encompassed 31 capsid genotypes(C-type),with GⅠ accounting for 9％and GⅡ accounting for 90％.Additionally,49 polymerase types(P-type)were identified,along with 68 combinations of CP types;among the analyzed recombinant sequences(4 460 entries in total),approxi-mately 41％belonged to three predominant recombinant strains:GⅡ.2[P16],GⅡ.4[P31],and GⅡ.4[P16].This analysis provides valuable insights into the distribution characteristics of norovirus genotypes across Asia and Russia over time,thereby supporting vac-cine design and evaluation efforts.

Objective To investigate the efficacy of ketogenic diet in the treatment of SCN2A gene-related developmental epileptic encephalopathy.Methods The clinical data of a child with developmental epileptic encephalopathy associated with SCN2A gene mutation,whose main manifestations were developmental retardancy and epileptic spasm,and treated with ketogenic diet was retrospectively analyzed.Results Epileptic spasm onset at 5 months old.The EEG showed hypsarrhythmia and the epileptic spasm was monitored.Genetic examination revealed a new heterozygous missense mutation of c.5317 G＞A(p.Ala1773Thr)in SCN2A gene.The child was not effective after treatment with a variety of anti-seizure drugs,and was effective after treatment with ketogenic diet.The follow-up for 11 months showed that the seizure of the child was completely controlled and cognitive progress was made.Conclusion The ketogenic diet can be used to treat SCN2A gene-related developmental epileptic encephalopathy,and it can also achieve better results for younger patients.

Objective:This study aims to investigate sex-specific abnormalities?? in gray matter volume (GMV) in Children with autism spectrum disorder (ASD) and their associations with gene expression.Methods:T 1-weighted brain MRI data were collected at the MRI Center of the University of Electronic Science and Technology of China between 2022 and 2023 from 100 children with ASD and 90 typically developing (TD) children. Voxel-based morphometry (VBM) was used to explore GMV differences between ASD boys and TD boys, and between ASD girls and TD girls. Partial least squares regression (PLSR) was performed based on the Allen Human Brain Atlas to identify genes associated with GMV alterations, followed by enrichment analyses. Cell-type-specific expression analyses were used to examine associations across developmental stages and brain structures. Protein-protein interaction (PPI) networks were constructed to identify hub proteins. Results:Compared to TD boys, ASD boys showed increased GMV in the right superior temporal gyrus, middle temporal gyrus, inferior temporal gyrus, temporal pole, parahippocampal gyrus, fusiform gyrus, cuneus, and precuneus, as well as in the bilateral orbital part of the superior frontal gyrus and the gyrus rectus. Decreased GMV was observed in the cerebellar vermis and bilateral cerebellar hemispheres. A total of 635 genes were associated with these GMV alterations, enriched in pathways related to DNA-templated transcription, RNA metabolism and biogenesis, and ion binding. Developmental analysis indicated strong associations with the cerebellum during early, middle-to-late childhood, and adolescence, and with the cerebral cortex in early adulthood. Protein-protein interaction (PPI) network analysis highlighted NOB1, GNL3L, ESF1, TFB2M, and WDR75 as specific hub proteins. Compared to TD girls, ASD girls exhibited increased GMV in the right middle and inferior temporal gyri, temporal pole, and fusiform gyrus, and decreased GMV in the cerebellar vermis and bilateral cerebellar hemispheres. A total of 765 genes were associated, enriched in pathways related to ion channel activity, signal transduction, and regulation of membrane potential. These genes showed strong associations with the amygdala during mid-to-late fetal development, middle-to-late childhood, adolescence, and early adulthood; with the cerebellum during late infancy, early childhood, and early adulthood; with the cerebral cortex during the mid-to-late fetal development, early neonatal period, and adolescence; with the hippocampus during middle-to-late childhood and adolescence; with the striatum during adolescence and early adulthood; and with the thalamus during early-to-mid fetal development, early neonatal period, and early adulthood. PPI network analysis identified ANK3, ANK1, SCN4B, NFKB1, and PXN as specific hub proteins. Conclusion:Both ASD boys and ASD girls exhibit GMV abnormalities compared with TD controls. The specific genes associated with GMV alterations are enriched in distinct biological pathways in boys and girls. Cell-type-specific expression analyses further revealed sex-dependent differences in developmental timing and brain structural correlations, and distinct PPI networks were constructed for each group.

Objective:To investigate the molecular epidemiological characteristics of norovirus (NoV) among infectious diarrhea patients in Linyi from 2021 to 2023, and provide the scientific evidence for norovirus control and prevention.Methods:The epidemiological information and fecal samples of patients with infectious diarrhea in Linyi from 2021 to 2023 were collected and detected by real-time fluorescent quantitative PCR. The RdRp and capsid gene VP1 region of norovirus-positive specimens were amplified and sequenced used to analyze their genotype, phylogeny and homology.Results:Among the 2 311specimens, 123 (5.32%) were positive of NoV, with GI/GII group infection accounted for 17.07% (21/123) and 77.24% (95/123), respectively, GI/GII group mixed infection accounted for 5.69% (7/123). The detection rate of <1 year age group was the highest (8.86%), followed by the 1-3 years group (7.11%, 30/422) and the over 60 years group (5.29%, 23/123). The highest NoV detection rate was 7.96% (45/565) in the urban area, and the most abundant genotypes were found in the northern mountainous area. Sequence analysis showed that 61 identified NoV strains could be divided into 12 genotypes, with 4 NoV GI and 8 NoV GII. The dominant genotype differed during the 3 years, with GII.4 Sydney [P16] in 2021, GII.4 Sydney [P31] in 2022, and GII.2[P16] in 2023.Conclusions:NoV GII group was the main NoV infection in Linyi from 2021-2023 and genotypes were diverse. Children under 3 years of age and elderly people over 60 years old as susceptible groups should be given special protection. In addition, the monitoring of NoV genotype diversification should be strengthened in northern mountainous areas.

Objective:To understand the epidemiological characteristics of severe fever with thrombocytopenia syndrome (SFTS) in Shandong province from 2010 to 2022, analyze the trends in morbidity and mortality, and provide a scientific basis for the prevention, control, diagnosis, and treatment of SFTS.Methods:The data on SFTS cases and deaths were retrospectively collected through the China Disease Control and Prevention Information System′s infectious disease surveillance system and the Shandong province all-cause mortality surveillance system. Descriptive epidemiological method was used for epidemiological analysis, and the Joinpoint regression model was applied to analyze trends in morbidity and mortality.Results:From 2010 to 2022, 6 714 SFTS cases were reported in Shandong, with an average crude incidence rate (CIR) and age-standardized incidence rate (ASIR) of 0.52/100 000 and 0.43/100 000, respectively. Among these, 1, 064 cases died within 30 days of onset, with an average crude mortality rate (CMR) and age-standardized mortality rate (ASMR) of 0.08/100, 000 and 0.06/100 000, respectively, and an average case fatality rate of 15.85%. The average incidence rates for males and females were 0.52/100 000 and 0.53/100 000, respectively, with no statistically significant difference ( P>0.05). The average annual mortality rate for males (0.09/100 000) was higher than that for females (0.08/100 000), and the average annual case fatality rate for males (17.21%) was higher than that for females (14.48%), with statistically significant differences ( P<0.05); 93.95% of the cases were over 45 years old, and 86.56% of the deaths were over 60 years old. Both cases and deaths were primarily among farmers, accounting for over 85% of the total. From 2010 to 2022, the incidence rate of SFTS in Shandong showed an overall upward trend, with an average annual percentage change (AAPC) in CIR of 23.58% and an AAPC in ASIR of 19.97%, P<0.05. The mortality rate of SFTS cases in Shandong from 2010 to 2022 showed a continuous and significant upward trend, with a CMR AAPC of 27.64% and an ASMR AAPC of 22.70%, P<0.05. SFTS incidence and mortality in Shandong exhibited clear seasonality, with high occurrence from May to October, primarily concentrated in the Jiaodong Peninsula and the hilly areas of central Shandong. The number of affected counties increased in a wave-like pattern, expanding from 6 in 2010 to 79 in 2021 for cases and from 2 in 2010 to 53 in 2022 for deaths. Conclusions:From 2010 to 2022, the incidence and mortality of SFTS in Shandong showed an upward and expanding trend, with a particularly heavy disease burden among middle-aged and elderly farmers.