1.Integrated bioinformatics analysis and experimental validation of angiogenesis-related genes in diabetic retinopathy
Peng LI ; Kun LIANG ; Feng WU ; Jia LI ; Lun LIU ; Yulin TAO
Acta Universitatis Medicinalis Anhui 2026;61(5):861-871
ObjectiveTo investigate the molecular mechanisms related to angiogenesis during the development and progression of diabetic retinopathy (DR). MethodsAngiogenesis-related genes were obtained from the Gencard website and intersected with differentially expressed genes from DR datasets (GSE60436 and GSE94019). Functional enrichment and protein-protein interaction (PPI) networks were then used to screen candidate genes and evaluate their diagnostic value. Gene set enrichment analysis (GSEA) was used to explore potential pathways underlying candidate genes, and immune infiltration analysis revealed associations between candidate genes and immune cells. Cellular experiments were conducted to validate the role of fibronectin 1 (FN1) in human retinal microvascular endothelial cells (HRMECs) under high glucose (HG) conditions. ResultsA total of 237 differentially expressed genes related to angiogenesis were identified, enriched in pathways such as phosphoinositide 3-kinase/protein kinase B signaling pathway (PI3K-Akt), tumor suppressor protein 53 (P53), tumor necrosis factor (TNF), and Janus kinase (JAK)/signal transducer and activator of transcription signaling pathway (STAT). Among them, collagen type I alpha 1 chain (COL1A1), COL1A2, FN1, TNF, and tumor protein p53 (TP53) were key genes with high diagnostic value. GSEA indicated that these genes were involved in multiple signaling pathways, including P53. CIBERSORTx analysis revealed significant associations with the infiltration of multiple immune cells. HG treatment led to the upregulation of FN1. In HG-induced HRMECs, compared with the si-NC control group, si-FN1 significantly reduced cell proliferation, migration, and tube formation, while P53 protein expression was increased. ConclusionThis study reveals the important role of FN1 in angiogenesis in DR and suggests that it may be a potential diagnostic and therapeutic target.
2.Early-stage diabetes induces structural damage and functional deficits in the mouse primary visual cortex
Hanlu CHEN ; Haoqiong TANG ; Lixia FENG
Acta Universitatis Medicinalis Anhui 2026;61(5):872-879
ObjectiveTo investigate morphological and functional neural network alterations in the primary visual cortex (V1) during early-stage diabetes. Methods32 SPF male C57BL/6J mice were randomly divided into control and diabetic groups(n=16). Type 1 diabetes was induced by intraperitoneal injection of streptozotocin (STZ), with model validation via oral glucose tolerance test (OGTT) at week 4. Nissl staining was used to assess morphological changes in brain slices of the two groups. Immunohistochemistry was performed to detect the expression of calcium/calmodulin-dependent protein kinase Ⅱ (CaMKⅡ) and somatostatin (SST) in the V1 area. The co-localization density of SST-positive signals on CaMKⅡ+ neurons was then quantified by ImageJ software. In vivo electrophysiology was used for studying neuronal firing and functional connectivity. ResultsCompared with the control mice, nissl staining showed diabetic mice exhibited significant V1 thinning (P=0.02), reduced neuronal density (P=0.01). Immunohistochemistry found decreased SST integral optical density (P=0.02) and elevated mean fluorescence intensity (P=0.01), and lower SST density on CaMKⅡ+ neurons in the diabetic group than in the control group. Compared with the control mice, in vivo electrophysiology studies indicated that diabetic mice showed reduced action potential peak-to-trough ratio and the absolute values of slope (P<0.01), as well as impaired functional connectivity, including conditional firing, mutual information, and Granger causality (P<0.000 1). ConclusionEarly diabetes induces V1 structural atrophy accompanied by SSTergic system disruption and multi-level functional degradation from single neurons to neural networks.
3.Risk factors and altered functional connectivity of brain networks in end-stage renal disease complicated with frailty
Zhaohua SUN ; Dashan LI ; Nan FENG ; Zilian CHEN ; Pei ZHANG ; Yonggui WU
Acta Universitatis Medicinalis Anhui 2026;61(5):894-900
ObjectiveTo explore the risk factors and alterations in functional connectivity of brain networks in end-stage renal disease (ESRD) patients complicated by frailty. MethodsA total of 84 patients with ESRD were enrolled and divided into the frailty group (31 cases) and non-frailty group (53 cases) according to the Chinese version of the Tilburg Frailty Indicator (TFI). Cranial magnetic resonance imaging (MRI) data, neuropsychological test results and clinical data were collected for all subjects. Logistic regression analysis was used to explore risk factors for frailty in ESRD patients, and image preprocessing and independent component analysis were performed to compare differences in brain network functional connectivity between the two groups. ResultsLogistic regression analysis showed that high blood urea nitrogen level, depression, malnutrition, and sleep disturbance were risk factors for frailty in patients with ESRD (P<0.05), while a higher level of education served as a protective factor (P<0.05). Compared with the non-frailty group, the frailty group exhibited significantly weakened functional connectivity between the sensorimotor network and the visual network (P<0.05). ConclusionHigh levels of blood urea nitrogen, depression, malnutrition, and sleep disorders can increase the risk of frailty in patients with end-stage renal disease (ESRD), while a higher educational level may reduce this risk. Patients with ESRD complicated by frailty exhibit a significant decrease in functional connectivity between the sensorimotor network (SMN) and visual network (VN), which provides novel imaging evidence for exploring the central neural mechanisms underlying the development of frailty in ESRD patients.
4.Application value of deep learning reconstruction technology in enhancing the imaging efficiency and quality of HASTE and DWI sequences for liver MRI
Lulu FENG ; Zhili PAN ; Yingming ZHAO
Acta Universitatis Medicinalis Anhui 2026;61(5):937-942
ObjectiveTo explore the value of deep learning reconstruction (DLR) in liver magnetic resonance imaging (MRI) by comparing the single-shot half-fourier rapid spin-echo sequence with DLR (HASTEDLR) and diffusion-weighted imaging sequence with DLR (DWIDLR) against the conventional BLADE and conventional DWI sequences. Methods70 patients underwent MRI examinations. Two observers independently evaluated the image quality of each sequence (including liver edge, blood vessels, lesion clarity, etc.). Additionally, quantitative evaluation was conducted by measuring the signal to noise ratio (SNR) of liver parenchyma and lesions, contrast to noise ratio (CNR) of lesions, as well as apparent diffusion coefficient (ADC) values from conventional DWI and DWIDLR. Intraclass correlation coefficient (ICC) was used to evaluate the consistency between the two observers. ResultsThe inter-observer consistency was high (ICC: 0.84-0.97). The scanning time was reduced by 92.63% for HASTEDLR and 50% for DWIDLR sequences, respectively. The lesion clarity score of the HASTEDLR group was significantly better than that of the BLADE group (P<0.001), with artifacts reduced in both DLR sequences (P< 0.05). The HASTEDLR group demonstrated higher SNR and CNR, while the DWIDLR group showed higher SNR and ADC values (all P<0.05). ConclusionThe DLR technology can enhance the efficiency of liver MRI scans, improve image quality, and reduce artifacts, demonstrating promising application prospects.
5.Association of family food environment with dietary and nutrition literacy among junior and senior high school students
YANG Ge, FENG Supeng, JIANG Hua, ZHU Wenli, WANG Mengying
Chinese Journal of School Health 2026;47(6):789-794
Objective:
To assess the association of family food environment with dietary and nutrition literacy among junior and senior high school students, providing a basis for nutritional health education and adolescent nutritional improvement.
Methods:
From January 9 to February 10, 2025, a total of 1 473 junior and senior high school students aged 12-20 were recruited by using a cluster random sampling method combined with convenient sampling from 15 provinces (municipalities and autonomous regions) across China. Data on basic demographic characteristics, home food environment, and dietary and nutrition literacy were collected by using the Food and Nutritional Literacy Questionnaire for Chinese School age Children. Multiple linear regression and Logistic regression models were employed to analyze the association of the home food environment on adolescent dietary and nutrition literacy.
Results:
The total score of dietary and nutrition literacy among junior and senior high school students was (65.28±9.03). The score in the cognitive domain (67.59±10.56) was higher than that in the skill domain (60.74±9.15), and the score for food preparation skills (56.60±14.28) was the lowest. Students aged 16-20, senior high school students, those for only children, non boarding students, those with urban household registration, those from wealthier families, those whose primary caregivers were parents with higher education levels, and those who previously received nutrition and health education had significantly higher dietary and nutrition literacy scores compared to their respective counterpart groups ( t/F =-8.32, -8.14, 4.76, -2.70, 7.15, 18.29, 10.68, 11.66 , all P <0.05). Multiple linear regression analysis revealed that family food environment was associated with dietary and nutrition literacy, and the model was statistically significant ( R 2=0.20, F=20.54, P <0.05). Lower availability of fruits at home in the past month and lower frequency of family communication regarding dietary and nutrition were associated with lower dietary nutrition literacy scores among junior and senior high school students ( β =-1.35, -1.67, both P <0.01). Among junior and senior high school students, lower frequency of dining out with the family, watching videos during family meals, and being urged by parents to eat more food in the past month were associated with higher scores on dietary nutrition literacy ( β =1.35, 1.13, 0.71, all P <0.01). Logistic regression model results indicated that watching videos during family meals ( OR =1.70) and family communication regarding dietary and nutrition ( OR =0.51) were significantly associated with dietary and nutrition literacy levels (both P <0.05).
Conclusions
The score of dietary and nutrition literacy among junior and senior high school students is relatively low, and the family food environment is a key factor. It is recommended that nutrition education and improvement initiatives for junior and senior high school students prioritize attention on children and adolescents from households with less favorable food environments.
6.Correlation between parental behaviors and autistic traits in children with autism spectrum disorder
Chinese Journal of School Health 2026;47(6):818-821
Objective:
To understand the correlation between autistic traits in children with autism spectrum disorder(ASD) and their parental behaviors, so as to provide evidence for improving social behavior in children with ASD.
Methods:
A total of 62 children aged 4-7 years diagnosed with ASD at Guangdong Provincial Work Injury Rehabilitation Hospital and Guangzhou Yuexiu District Children s Hospital from October 2021 to May 2025 were selected as the ASD group. A random number table method was used to select 62 healthy children of the same age from 3 ordinary kindergartens in Guangzhou as the control (typically developing,TD) group. The Parental Behavior Inventory and Social Responsiveness Scale were used to evaluate parental behaviors and autistic traits in both groups. The t-test and multiple linear regression were used to analyze the relationship between autistic traits in children with ASD and parental behaviors.
Results:
Compared with the TD group, the ASD group had significantly higher scores in social awareness, social cognition, social communication, social motivation, autistic behavior patterns, and the total score of social responsiveness, with statistically significant differences ( t =35.83, 46.17, 64.36, 41.45, 49.46,101.15, all P <0.01). The score of parental support/participation in the ASD group (24.61±4.30) was lower than that in the TD group (31.27±4.58), while the score of parental hostility/coercion in the ASD group (25.51±2.72) was higher than that in the TD group (12.75±2.72), with statistically significant differences ( t = -8.34, 26.14, both P <0.01). The total score of the Social Responsiveness Scale was negatively correlated with the dimension score of parental support/participation behaviors, and positively correlated with the dimension score of parental hostility/coercion behaviors ( r =-0.60, 0.91,both P <0.05). After adjusting for covariates such as children s age, gender, and primary caregiver, ASD children with exclusive breastfeeding ( β =-8.79) and parental support/participation behaviors ( β = -0.79 ) had a lower risk of autistic traits, while children with parental hostility/coercion behaviors ( β =4.62) had a higher risk of autistic traits (all P <0.05).
Conclusion
Autistic traits in children with ASD may be related to their parental behaviors and early feeding mode.
7.Association of anxiety and depressive symptoms with Internet gaming disorder〖JZ〗 and emotional-behavioral problems among junior high school students
Chinese Journal of School Health 2026;47(6):828-832
Objective:
To explore the association role of anxiety and depressive symptoms with Internet gaming disorder (IGD) and emotional-behavioral problems among junior high school students, so as to provide references for preventing the occurrence and progression of emotional-behavioral problems in middle school students.
Methods:
From September to October 2024, a random cluster sampling method was adopted to select 38 069 students from 28 junior high schools in 14 counties (cities and districts) and functional areas of Jining City, Shandong Province. Surveys were conducted by Nine item Internet Gaming Disorder Scale-Short Form, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Strengths and Difficulties Questionnaire. The correlation of emotional and behavioral issues, online game addiction, anxiety and depressive symptoms among junior high school students was analyzed by Speaman correlation analysis. Mediation analysis was used to explore the role of anxiety and depressive symptoms between IGD and emotional-behavioral problems among junior high school students.
Results:
The detection rates of emotional-behavioral problems, anxiety symptoms, depressive symptoms, and IGD among junior high school students were 19.24 %, 9.48%, 16.69%, and 19.68%, respectively. The scores of emotional-behavioral problems, anxiety symptoms, depressive symptoms and IGD were 10.00 (6.00, 15.00), 3.00 (0.00, 7.00), and 4.00 (1.00, 8.00), 13.00 (10.00, 19.00), respectively. There were positive correlations between each pair of emotional-behavioral problem, IGD, anxiety symptoms, and depressive symptoms scores ( r =0.51-0.81, all P <0.01). Anxiety and depressive symptoms played mediating roles between IGD and emotional-behavioral problems among junior high school students, with mediating effect values of 0.16 (95% CI =0.15-0.17) and 0.12 (95% CI =0.11-0.14), respectively (both P <0.01).
Conclusions
Anxiety and depressive symptoms mediate the relationship between IGD and emotional-behavioral problems among junior high school students. It is necessary to identify early signs of IGD among junior high school students, strengthen intervention for anxiety and depressive symptoms, to prevent the occurrence and development of emotional and behavioral issues.
8.Intervention effects of moderate to vigorous classroom physical exercise on psychological sub health among Uyghur junior high school students
BI Cunjian, RAN Xiaokang, ZHANG Feng, YIN Xiaojian, GUO Yaru, SUN Pengwei, ZHU Yongfei
Chinese Journal of School Health 2026;47(6):837-840
Objective:
To analyze the intervention effects of moderate to vigorous classroom physical exercise on psychological sub health among Uyghur junior high school students, providing reference for mental health promotion and intervention in the ethnic group.
Methods:
From April to July 2022, 647 eighth grade Uighur junior high school students from two middle schools in the Kashgar Prefecture, Xinjiang, were selected using a random cluster digital sampling method. They were randomly assigned to a control group ( n =326) and an intervention group ( n =321). While adhering to the regular curriculum, the intervention group additionally received 12 week, 36 session (every Monday, Wednesday, and Friday afternoon) moderate to vigorous classroom physical exercise intervention (45 minutes per session, including warm up, main exercises, and cool down activities). Self administered psychological sub health was completed through Brief Instrument on Psychological Health of Youths before and after intervention, and the data were analyzed using covariance analysis.
Results:
Before intervention, there were no statistically significant differences between the control and intervention groups in the total scores for psychological sub health or in the scores for the three dimensions including emotional problems, conduct problems, and social adaptation difficulties ( t =0.76, 0.40, 0.01, 0.94 , all P >0.05). After intervention, the scores of the intervention group s junior high school students on the emotional problems, conduct problems, and social adaptation difficulties dimensions decreased by 0.50, 0.28, and 0.18, respectively, compared with the control group, and all differences were statistically significant ( t =3.35, 3.36, 2.07, all P <0.05). The main effect of the psychological sub health category was statistically significant ( F =60.66, P <0.01, partial η 2=0.09). Compared with the control group, the psychological sub health scores of junior high school students in the intervention group decreased by 0.96 ( t =3.42, P < 0.05 ).
Conclusion
The 12 week moderate to vigorous classroom physical exercise intervention has a positive effect on the psychological sub health of Uyghur junior high school students.
9.Influence of environment and genetic factors on axis length in children and adolescents
ZHENG Jie, ZHANG Jian, FENG Lixia
Chinese Journal of School Health 2026;47(6):869-872
Objective:
To investigate the heritability of axial length (AL) by comparing the consistency of AL in monozygotic (MZ) and dizygotic (DZ) twins, thereby providing data support for research on the genetic mechanisms and prevention and control practices of myopia in children and adolescents.
Methods:
A total of 137 twin pairs aged 3 to 16 years who attended the Optometry Center of the First Affiliated Hospital of Anhui Medical University from January 2021 to December 2024 were enrolled, comprising 79 DZ pairs and 58 MZ pairs. Biometry was used to measure children s axial length, and structural equation modeling within the OpenMx package was applied to calculate the heritability of axial length.
Results:
The overall mean axial length of the twin cohort was (23.7±1.5) mm. The intraclass correlation coefficient (ICC) for axial length in all twins was 0.82 (95% CI =0.76-0.87) ( P < 0.05 ). The ICC for MZ twins was 0.97 (95% CI =0.94-0.98), which was higher than that for DZ twins ( ICC =0.71, 95% CI =0.58-0.80) (both P <0.05). Maximum likelihood estimation using OpenMx revealed that the additive genetic plus unique environmental (AE) model provided the best fit. Specifically, additive genetic factors (A) accounted for 93.63% (95% CI =90.31%-95.69%) of the total variance, while unique environmental factors (E) accounted for 6.37% (95% CI =4.31%-9.69%).
Conclusion
Axial length in children is predominantly influenced by genetic factors, while unique environmental factors also play a contributory role.
10.Long-term prognosis after sublobar resection for T1a-bN0M0 non-small cell lung cancer: A propensity-score matching study
Zhao WANG ; Yanqing PAN ; Yungang SUN ; Feng SHAO
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(06):913-919
Objective To evaluate the long-term survival of patients with T1a-bN0M0 non-small cell lung cancer (NSCLC) after sublobar resection. Methods Patients with T1a-bN0M0 NSCLC who underwent sublobar resection from 2004 to 2015 were selected from the Surveillance, Epidemiology, and End Results (SEER) database, and divided into a segmentectomy group and a wedge resection group according to the resection method. After propensity-score matching at a ratio of 1:1, the overall survival (OS) and disease-specific survival (DSS) of patients were analyzed using Cox regression model, log-rank test, and restricted mean survival time (RMST). Results A total of 3262 patients were included in the study, including 1321 males and 1941 females, with a median age of 69.0 years. Among them, 2419 patients were in the wedge resection group and 843 patients were in the segmentectomy group. After matching, 843 pairs of patients were obtained. The results showed that the 10-year DSS rate (68.0% vs. 60.6%, P=0.011) and 10-year OS rate (40.8% vs. 37.0%, P=0.049) of the segmentectomy group were better than those of the wedge resection group, while there was no statistical difference in the 5-year DSS rate (82.9% vs. 79.5%, P=0.112) or 5-year OS rate (68.9% vs. 64.9%, P=0.096). Multivariate Cox regression analysis revealed that male gender [HR=1.54, 95%CI (1.28-1.86), P<0.001] and age [HR=1.02, 95%CI (1.01-1.03), P<0.001] were independent risk factors for DSS, while increased number of regional nodes dissected (RND) [HR=0.98, 95%CI (0.96-1.00), P=0.018] and segmentectomy [HR=0.82, 95%CI (0.68-0.98), P=0.030] served as protective factors. For OS, male gender [HR=1.54, 95%CI (1.35-1.75), P<0.001], age [HR=1.04, 95%CI (1.03-1.04), P<0.001], and histological subtypes of squamous cell carcinoma [HR=1.62, 95%CI (1.41-1.86), P<0.001] or large cell carcinoma [HR=1.64, 95%CI (1.07-2.52), P=0.023] were identified as independent risk factors, whereas increased RND was a protective factor [HR=0.98, 95%CI (0.97-0.99), P=0.002]. Surgical approach was not an independent prognostic factor for OS. Subgroup analysis showed that segmentectomy had a better 10-year OS-RMST in patients with adenocarcinoma (P=0.045), right lower lobe tumor (P=0.014), and tumor diameter ≤1.6 cm (P=0.006). Conclusion Increasing lymph node dissection during sublobar resection may improve prognosis. Compared with wedge resection, segmentectomy may improve the long-term DSS rate of patients with T1a-bN0M0 NSCLC.


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