Objective: To explore the relationship between socio ecological risk factors (SERF), physical activity (PA) developmental trajectories, and depressive symptoms among junior and senior high school students in Tianjin, in order to provide theoretical support for comprehensive interventions for adolescent depression. Methods: A longitudinal follow up design was adopted. In September 2022, a baseline survey was conducted using a stratified cluster random sampling method in two junior high schools and two senior high schools in Tianjin, collecting data on students basic information, SERF, PA, and depressive symptoms. Two follow up surveys were conducted in September 2023 and 2024, yielding 588 valid participants. Latent class growth analysis (LCGA) was used to identify PA developmental trajectory categories among junior and senior high school students. Logistic regression was applied to examine the associations between depressive symptoms and SERF as well as PA trajectories. Results: The detection rates of depressive symptoms among Tianjin junior and senior high school students over the three years were 26.53%, 20.24%, and 21.26 %, respectively. Depressive symptoms were positively correlated with SERF ( OR=1.04, 95%CI=1.03-1.05, P <0.05). The highest risks were observed in the individual dimension and family dimension ( OR =1.28, 1.21, both P <0.05). LCGA identified three PA trajectory groups:persistently low level (80.65%), persistently high level (4.58%), and slowly increasing group ( 14.77 %). Multivariate regression analysis showed that compared with the persistently low level PA, the slowly increasing PA significantly reduced the risk of depressive symptoms ( OR=0.44, 95%CI =0.20-0.88), while SERF still increased the risk of depressive symptoms ( OR=1.04, 95%CI =1.03-1.05) (both P <0.05). Conclusion SERF are risk factors for depression symptoms among junior and senior high school students, whereas slowly increasing PA development trajectory demonstrates a protective effect.

OBJECTIVE To understand the healthcare-seeking behavior of patients with AIDS co-infected with tu-berculosis and analyze the factors influencing delayed consultation and diagnosis,and to provide a theoretical basis for the implementation of interventional tuberculosis control measures.METHODS Two hundred and two patients with AIDS complicated with tuberculosis who were first admitted to Yunnan Infectious Diseases Hospital from Jan.2020 to Dec.2023 were selected,and their clinical data were collected through the inpatient medical record system.Multivariate logistic regression model was used to analyze the factors influencing delayed consultation and diagnosis.RESULTS Time of admission,place of residence,presence of lung cavities,distribution of lung lesions,intermediate hospital visited,sputum culture results,etiological situation,CD4+/CD8+cell ratio,and CD8+cell counts were the factors influencing delayed consultation(P<0.05).The initial diagnosis and Gene-Xpert results were the factors influencing delayed diagnosis(P<0.05).Multivariate logistic regression analysis showed that ad-mission in 2021(OR=3.842,95%CI:1.651-8.966),and presence of lung cavity(OR=8.007,95%CI:1.381-6.436),single lung lesion accumulation(OR=0.637,95%CI:0.049-8.267)were risk factors for delayed consultation.A 10%reduction in body mass(OR=2.070,95%CI:1.056-4.059)and negative Gene-Xpert re-sults(OR=1.667,95%CI:0.688-4.038)were risk factors for delayed diagnosis.CONCLUSIONS The issues of delayed medical consultation and diagnosis in patients with AIDS complicated with tuberculosis remain severe,with different factors influencing the delay.Special attention should be paid to the screening for latent tuberculosis infection in people infected with HIV.When experiencing suspicious symptoms,patients should go be encouraged to take exams at designated tuberculosis hospitals,repeatedly collect sputum samples and monitor changes in body mass,all of which are positively significant in reducing delays.

A 58-year-old female patient presented with erythema on the right shoulder and chest for 8 years. The appearance of erythema was concurrent with numbness and weakness in both lower limbs, elevated peripheral blood M protein levels, thyroid dysfunction, and multiple enlarged lymph nodes in the right axilla, leading to a diagnosis of POEMS syndrome. After autologous hematopoietic stem cell transplantation, erythema subsided but recurred 1 year prior to this visit. Physical examination revealed a pigeon egg-sized swollen lymph node on the right side of the neck. Skin examination showed patchy erythema on the right shoulder and chest, with clear boundaries and a hard texture. Serum protein electrophoresis revealed an elevated M protein level, and serum immunofixation electrophoresis showed a restricted IgG λ band. In addition, peripheral blood levels of vascular endothelial growth factor were elevated. Computed tomography scan images showed an irregular flaky bone destruction area at the acromion end of the right scapula, which was consistent with the manifestations of bone plasmacytoma. Histopathological examination of the skin tissue in the right shoulder revealed a large number of dilated and proliferative vessels between dermal collagen fibers, and the patient was diagnosed with AESOP syndrome. Lenalidomide combined with dexamethasone chemotherapy was administered. After three cycles of treatment, M protein turned negative, and erythema became darker in color, and decreased in size compared with the skin lesion before treatment.

Objective To explore the diagnostic value of 18F-fluorodeoxyglucose(FDG)PET/CT in primary pulmonary enteric adenocarcinoma.Methods The clinical and imaging data of 9 patients with primary pulmonary enteric adenocarcinoma who under-went 18F-FDG PET/CT examination were retrospectively analyzed,including lesion distribution,morphology,maximum standardized uptake value(SUVmax),clinical symptoms and signs,gastroscopy finding,puncture pathological results,and serum tumor markers[carbohydrate antigen 72-4(CA72-4),cytokeratin 19 fragment antigen 21-1(CYFRA21-1),carcinoembryonic antigen(CEA),carbo-hydrate antigen 199(CA199)].Results Pathological examination confirmed a diagnosis of primary pulmonary enteric adenocarcinoma after excluding gastrointestinal primary tumors through clinical evaluation.In all nine patients,18F-FDG PET/CT examination did not reveal any evidence of digestive system malignancies,and gastrointestinal microscopy was negative.Primary lesions were observed as masses or nodular types in 6 cases(5 in the left lung and 1 in the right lung),while 3 cases exhibited diffuse bilateral pulmonary involvement(manifested as multiple patchy opacities,nodules,ground-glass opacities,and consolidations).All pulmonary primary lesions showed increased 18F-FDG uptake,with SUVmax ranging from 2.7 to 12.8,mean 8.6±3.7.The six masses-or nodular-type primary lesions showed maximum diameters ranging from 2.1 to 10.5 cm,mean(5.23±3.06)cm.Four cases demonstrated hilar and mediastinal lymph node metastases,intrapulmonary metastases,and distant metastases,while 1 case showed only distant metastasis.Elevated levels of serum tumor markers were observed as follows:CA72-4 in 7 cases(10-273.3 U/mL),CEA in 7 cases(5-147.4 ng/mL),CA199 in 6 cases(31.22-4 364 U/mL),and CYFRA21-1 in 5 cases(8.31-99.7 ng/mL).Conclusion When pathological biopsy of a pulmonary lesion suggests primary pulmonary enteric adenocarcinoma after excluding gastrointestinal primary tumors,and 18F-FDG PET/CT shows no gastrointestinal masses,this may support the diagnosis of primary pulmonary enteric adenocarcinoma.

A 58-year-old female patient presented with erythema on the right shoulder and chest for 8 years. The appearance of erythema was concurrent with numbness and weakness in both lower limbs, elevated peripheral blood M protein levels, thyroid dysfunction, and multiple enlarged lymph nodes in the right axilla, leading to a diagnosis of POEMS syndrome. After autologous hematopoietic stem cell transplantation, erythema subsided but recurred 1 year prior to this visit. Physical examination revealed a pigeon egg-sized swollen lymph node on the right side of the neck. Skin examination showed patchy erythema on the right shoulder and chest, with clear boundaries and a hard texture. Serum protein electrophoresis revealed an elevated M protein level, and serum immunofixation electrophoresis showed a restricted IgG λ band. In addition, peripheral blood levels of vascular endothelial growth factor were elevated. Computed tomography scan images showed an irregular flaky bone destruction area at the acromion end of the right scapula, which was consistent with the manifestations of bone plasmacytoma. Histopathological examination of the skin tissue in the right shoulder revealed a large number of dilated and proliferative vessels between dermal collagen fibers, and the patient was diagnosed with AESOP syndrome. Lenalidomide combined with dexamethasone chemotherapy was administered. After three cycles of treatment, M protein turned negative, and erythema became darker in color, and decreased in size compared with the skin lesion before treatment.

Objective:To investigate the efficacy of preoperative ultrasound-guided injection of carbon nanoparticle suspension in cervical lymph node dissection for thyroid cancer reoperation.Methods:Ninety-four patients undergoing reoperation for thyroid cancer admitted by the same physician team of the Department of Thyroid and Breast Surgery of the Ninety-sixty Hospital of the People’s Liberation Army (PLA) from Jan. 2019 to Sep. 2024 were retrospectively analyzed. According to the different scope of the initial surgery, they were divided into the re-specification clearance group, the regional lymph node clearance group, and the metastatic lymph node dissection group, and the groups were subdivided into the carbon nanoparticle group and the control group according to whether they were injected with carbon nanoparticle before the surgery or not. The t-test, χ2-test, and non-parametric test were used to compare the age, gender, surgical method, duration of surgery, total number of lymph nodes detected, and positive lymph node detection rate between the nano-charcoal group and the control group in the three groups. Results:There was no statistically significant difference between the three groups in terms of age, gender, surgical methods, or the total number of lymph nodes detected (all P>0.05) , and the difference between the surgical time of the carbon nanoparticle group in the re-regulation clearance group and the control group was not statistically significant ( P>0.05) ; the surgical time of the carbon nanoparticle group was shorter than that of the control group in both the regional lymph node clearance and the metastatic lymph node dissection groups, and the difference was statistically significant (all P<0.05) ; the positive detection rate of lymph nodes in the carbon nanoparticle group was higher than that in the control group among the three groups, and the difference was statistically significant (all P<0.05) . Conclusion:In the operation of cervical lymph node dissection for papillary thyroid cancer, preoperative ultrasound-guided injection of carbon nanoparticle can accurately localize the lymph nodes, increase the positive detection rate of lymph nodes, reduce the difficulty of surgical operation, and shorten the operation time.

Objective To explore the relationship between the level of Caveolin-1 and high mobility group protein B1(HMGB-1)in cerebrospinal fluid and the severity of sepsis and their predictive value.Methods A total of 102 children with sepsis were selected in a hospital from June 2021 to December 2023.According to neonatal critical case scoring criteria,the children were divided into mild group(n=41)and severe group(n=61).According to the diagnostic criteria of purulent meningitis and the results of cerebrospinal fluid examina-tion,the children were divided into sepsis complicated with purulent meningitis group(n=16)and simple sepsis group(n=86).The clinical data of the children were collected,and the levels of Caveolin-1,HMGB-1 and inflammatory factors[hypersensitive C-reactive protein(hs-CRP),procalcitonin(PCT)and tumor necro-sis factor-α(TNF-α)]in cerebrospinal fluid of the children were detected by enzyme-linked immunosorbent assay.Multivariate Logistic regression analysis was conducted to analyze the factors affecting the severity of sepsis,and the receiver operating characteristic curve was drawn to analyze the diagnostic value of Caveolin-1 and HMGB-1 in the severity of sepsis and the prediction value of purulent meningitis in the children.Results Compared with mild group,cerebrospinal fluid levels of Caveolin-1 and HMGB-1 in severe group were signifi-cantly increased,and the difference was statistically significant(P<0.05).The levels of PCT,hs-CRP and TNF-α in severe group were significantly higher than those in mild group,and the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that PCT,hs-CRP,TNF-α,Caveolin-1 and HMGB-1 levels were all risk factors for the severity of sepsis in children(P<0.05).The combined diag-nosis of Caveolin-1 and HMGB-1 was significantly better than that of Caveolin-1(Z=2.109,P=0.035),HMGB-1(Z=2.099,P=0.036),PCT(Z=2.487,P=0.013),hs-CRP(Z=2.419,P=0.016)and TNF-α(Z=3.441,P=0.001)were diagnosed alone.Compared with simple sepsis group,cerebrospinal fluid Caveo-lin-1 and HMGB-1 levels in sepsis complicated with purulent meningitis group were significantly increased,and the difference was statistically significant(P<0.05).The combined prediction of Caveolin-1 and HMGB-1 was significantly better than that of Caveolin-1(Z=2.621,P=0.009)and HMGB-1(Z=1.997,P=0.046)alone.Conclusion There are significant increases in the levels of Caveolin-1 and HMGB-1 in chil-dren with severe sepsis or sepsis complicated with purulent meningitis.Caveolin-1 and HMGB-1 have a certain clinical value in evaluating the severity of sepsis in children and predicting whether they are complicated with purulent meningitis.

Objective: To understand the subjective and objective comfort evaluations of students from different age groups on desks and chairs, so as to provide reference for standardized allocation and use of desks and chairs. Methods: From January to April 2024, a total of 2 446 students were selected from 26 schools in 13 districts (counties/cities) in Shanghai, Tianjin, and Wuxi from Jiangsu Province by using cluster random method, including students in kindergartens, primary schools, junior high schools,senior high schools, colleges and universities. Standardized procedures were used to measure the height and weight of participants, and the matching desks and chairs models were selected according to the height. The subjective comfort of students on matching desks and chairs was investigated, and their objective comfort was evaluated by using a self designed questionnaire. The χ 2 test was used to analyze the differences of subjective perception and objective evaluation in comfort between different types of desks and chairs. Results: About 84.1% of the students subjectively thought that large desks and small chairs were very comfortable or relatively comfortable, followed by large desks and chairs (75.7%), and the proportion of small desks and chairs was the lowest among the three types (46.2%), and the difference was statistically significant ( χ 2=722.46, P <0.01). The reporting rates of primary school, junior high school and senior high school students who subjectively considered large desks and chairs to be very comfortable/relatively comfortable were higher than that of other types of desks and chairs, and the differences were statistically significant ( χ 2=297.49, 252.82, 343.67, P <0.01). However, there was no significant difference in the subjective comfort evaluation of different types of desks and chairs among kindergarten children ( χ 2=3.21, P >0.05), and 66.3% of the students in colleges and universities felt very comfortable/relatively comfortable when they used the matching standard desks and chairs. The objective evaluation results of the comfort for the three types of desks and chairs were consistent with the subjective evaluation, but the proportions of the objective evaluation as very comfortable/relatively comfortable were higher than that of the subjective evaluation ( χ 2=20.76- 813.47, P <0.01). Conclusions Large desks and chairs, as well as large desks with small chairs are perceived comfortable, while small desks and chairs are perceived less comfortable. It is recommended to match the large desks and chairs or large desks and small chairs that are suitable for them according to the "standard", to promote physical and mental health of students.

Objective: To investigate the differences in the comfort of desks and chairs furniture among students with different body types according to the standard, so as to provide a reference for guiding students with overweight and obesity to choose the correct study furniture and revising the standards. Methods: From January to April 2024, 2 443 students from 26 schools in 13 districts (counties/cities) in Shanghai, Tianjin, and Jiangsu Province were selected by the cluster random sampling method to conduct physical examination. The subjective and objective evaluations of the comfort of height matched desks and chairs were investigated. The students were divided into non overweight, overweight, and obesity groups according to relevant criteria, and stratified analysis was performed. The χ 2 test was used to analyze differences in the comfort evaluations of desks and chairs among students with different body types. Results: Among the 2 443 students surveyed, 16.7% and 12.6% were respectively classified as overweight and obese. All students assigned the highest comfort ratings to large desks and small chairs (84.1%), and consistency was observed between students subjective and objective evaluations. The reporting rate of samll desks and chairs of obesity students subjective evaluation was lower (36.8%) than that of overweight and non overweight/obesity students (52.1%, 48.0%) ( χ 2=14.63, P <0.01). The overweight and obese group of primary school students had a worse evaluation of the comfort of large desks and chairs and small desks and chairs than those of the non overweight and obese groups( χ 2=15.78, 7.63, P <0.05). Among high school students, the overweight and obese group had worse evaluation of the comfort of large desks and chairs, as well as large desks and small chairs, than those of the non-overweight and obese groups( χ 2=9.62, 11.77, P <0.05). The objective evaluations revealed low compliance ratings on the posture of the thighs and calves for naturally forming an angle greater than 90° (55.6%), and headroom height under the table (50.3%) with small desks and chairs ( χ 2=94.05, 166.47, P <0.05). Conclusions Compared with non overweight/obese students, students with overweight and obese students report poor comfort evaluations of height matched desks and chairs. Revision of the standard should consider the body types of students, and evaluations of the comfort of desks and chairs furniture by students with overweight and obesity should be improved.

Extensive epigenetic reprogramming involves in memory CD8+ T-cell differentiation. The elaborate epigenetic rewiring underlying the heterogeneous functional states of CD8+ T cells remains hidden. Here, we profile single-cell chromatin accessibility and map enhancer-promoter interactomes to characterize the differentiation trajectory of memory CD8+ T cells. We reveal that under distinct epigenetic regulations, the early activated CD8+ T cells divergently originated for short-lived effector and memory precursor effector cells. We also uncover a defined epigenetic rewiring leading to the conversion from effector memory to central memory cells during memory formation. Additionally, we illustrate chromatin regulatory mechanisms underlying long-lasting versus transient transcription regulation during memory differentiation. Finally, we confirm the essential roles of Sox4 and Nrf2 in developing memory precursor effector and effector memory cells, respectively, and validate cell state-specific enhancers in regulating Il7r using CRISPR-Cas9. Our data pave the way for understanding the mechanism underlying epigenetic memory formation in CD8+ T-cell differentiation.
CD8-Positive T-Lymphocytes/metabolism* ; Cell Differentiation ; Chromatin/immunology* ; Animals ; Mice ; Immunologic Memory ; Epigenesis, Genetic ; SOXC Transcription Factors/immunology* ; NF-E2-Related Factor 2/immunology* ; Mice, Inbred C57BL ; Gene Regulatory Networks ; Enhancer Elements, Genetic