Objective: To explore the impact of adverse childhood experiences (ACEs) on health risk behaviors (HRBs) among college students and the mediating role of psychological symptoms, so as to provide a basis for developing intervention strategies. Methods: From March to April 2023, a convenience cluster sample of 1 801 students from 12 universities in Nanning, Liuzhou, Guilin, Wuzhou of Guangxi completed an online survey. A self designed questionnaire, Adverse Childhood Experiences-International Questionnaire (ACE-IQ) and Symptom Checklist-90 (SCL-90) were used for evaluation tools. Binary Logistic regression, structural equation modeling (SEM) and Bootstrap methods were used to analyze the associations and mediating effects. Results: Overall, 71.2% of college students experienced at least one type of ACE, with emotional neglect (40.3%) and emotional abuse ( 25.2 %) having the highest detection rates. The top three HRBs were unhealthy diet (77.8%), physical inactivity (54.1%), and smoking/alcohol use (18.5%). Logistic regression showed that poor family functioning, abuse, and extra familial violence were each associated with an increased risk of smoking/alcohol use ( OR =1.14, 1.11, 1.18) and deliberate self harm ( OR =1.26, 1.19,1.30) (all P <0.05). Experience of abuse increased the risk of high risk sexual behavior and family dysfunction increaded the risk of physical inactivity, respectively ( OR = 1.07 , 1.04, both P <0.05). Mediation analysis revealed that anxiety ( β =0.20) and depression ( β = 0.09 ) partially mediated the pathway from poor family functioning to deliberate self harm; paranoia ( β =0.02) partially mediated the pathway from abuse to high risk sexual behavior; and obsessive-compulsive symptoms ( β =0.26) and depression ( β =0.10) partially mediated the pathway from extra familial violence to deliberate self harm (all P <0.05). Conclusion Psychological symptoms play a mediating role in the association between ACEs and HRBs, and mental health interventions may reduce the risk of HRBs among college students.

Purpose: The aim of this study was to investigate the feasibility of an intelligent handheld ultrasound (US) device for assisting non-expert general practitioners (GPs) in detecting carotid plaques (CPs) in community populations. Methods: This prospective parallel controlled trial recruited 111 consecutive community residents. All of them underwent examinations by non-expert GPs and specialist doctors using handheld US devices (setting A, setting B, and setting C). The results of setting C with specialist doctors were considered the gold standard. Carotid intima-media thickness (CIMT) and the features of CPs were measured and recorded. The diagnostic performance of GPs in distinguishing CPs was evaluated using a receiver operating characteristic curve. Inter-observer agreement was compared using the intragroup correlation coefficient (ICC). Questionnaires were completed to evaluate clinical benefits. Results: Among the 111 community residents, 80, 96, and 112 CPs were detected in settings A, B, and C, respectively. Setting B exhibited better diagnostic performance than setting A for detecting CPs (area under the curve, 0.856 vs. 0.749; P<0.01). Setting B had better consistency with setting C than setting A in CIMT measurement and the assessment of CPs (ICC, 0.731 to 0.923). Moreover, measurements in setting B required less time than the other two settings (44.59 seconds vs. 108.87 seconds vs. 126.13 seconds, both P<0.01). Conclusion Using an intelligent handheld US device, GPs can perform CP screening and achieve a diagnostic capability comparable to that of specialist doctors.

Objective To investigate the effects of Sini Powder on serum hypothalamic-pituitary-adrenal(HPA)axis-related hormones and inflammatory factors in liver cancer mice with comorbid depression,and to evaluate its effect on depressive behavior and tumor proliferation activity.Methods Forty-eight specific pathogen-free female C57BL/6 mice were randomly assigned to either a blank(n=8)or model group(n=40).The modeling group was subjected to chronic unpredictable mild stress(CUMS)for six weeks.Both groups underwent orthotopically transplanted liver tumor surgery at the end of the fourth week of CUMS treatment.At the end of the sixth week of CUMS treatment,color Doppler ultrasonography was used to observe tumor formation in the orthotopic transplantation liver tumors,and the tail suspension test was used to assess depressive behavior.Non-tumor-bearing and deceased mice were excluded.The remaining model group mice were stratified by tail suspension immobility time and randomly assigned to the following groups:model group(distilled water),Fluoxetine group(5.0 mg/kg),and Sini Powder low-dose,medium-dose,and high-dose groups(5.2,10.4,and 20.8 g/kg,respectively),with six mice per group.The treatments were administered once daily for 21 consecutive days.After treatment,depressive behaviors were assessed using the open field,tail suspension,and forced swimming tests.The proliferation status of the orthotopic liver transplantation tumor was evaluated by measuring the size of the tumor,observing pathological changes in the tumor tissue through hematoxylin and eosin staining,and detecting the positive cell rate of proliferating cell nuclear antigen(Ki-67)in the tumor tissue using immunohistochemistry.The levels of HPA axis-related hormones in serum,such as corticotropin-releasing hormone(CRH),adrenocorticotropic hormone(ACTH),corticosterone(CORT),as well as inflammatory factors such as tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and interleukin-6(IL-6)were measured using an enzyme-linked immunosorbent assay.Western blotting was used to assess mitogen-activated protein kinase(MAPKs)phosphorylation and the expression of nuclear factor-κB(NF-κB),NOD-like receptor family pyrin domain-containing receptor 3(NLRP3),and cysteine aspartic protease-1(Caspase-1)in orthotopic tumors.Results Compared with the blank group,the model group showed reduced total distance traveled in open field test,prolonged immobility times in the tail suspension and forced swimming tests(P<0.05,P<0.01),indicating successful establishment of the liver cancer with comorbid depression mice model.Also,the model group showed increased orthotopic tumor volume(P<0.01),and elevated serum CRH,ACTH,CORT,TNF-α,IL-1β,and IL-6 levels(P<0.01).The phosphorylation of MAPKs in tumor tissues was suppressed(P<0.01),while NF-κB,NLRP3,and Caspase-1 expression levels were downregulated(P<0.01).Compared with the model group,Sini Powder medium-and high-dose groups exhibited increased total distance traveled in the open field test(P<0.05),reduced forced swimming test and prolonged total distance traveled in open field test(P<0.01),while Sini Powder high-dose group showed reduced immobility times in the tail suspension test(P<0.05).Also,Sini Powder low-dose,medium-dose,and high-dose groups showed slower tumor growth,histological changes,including vacuolization and necrosis,decreased Ki-67 positive cell rate(P<0.01),and reduced serum CRH,ACTH,CORT,TNF-α,IL-1β,and IL-6 levels(P<0.05).Additionally,the phosphorylation of MAPKs in tumor tissues was suppressed(P<0.01),and NF-κB,NLRP3,and caspase-1 expression levels were downregulated(P<0.01).Conclusion Sini Powder may alleviate depressive behaviors and suppress tumor proliferation activity in liver cancer mice with comorbid depression by modulating MAPKs activation,inhibiting NF-κB,NLRP3,and Caspase-1 expressions,and reducing serum inflammatory factors and HPA axis-related hormones levels.

Objective:To validate the effectiveness of the leaf position data of multi-leaf collimator (MLC) recorded in the Infinity medical linear accelerator log file (LF).Methods:In this study, the establishment of the film dose calibration curve involved two steps. Initially, the pixel values obtained from scanning the film were converted into net optical density values. Subsequently, a sixth-order polynomial fit was performed on the net optical density and dose data. The picket fence (PF) tests were performed on the electronic portal imaging device (EPID) and film, and the corresponding acquired PF test images were analyzed using the relative leaf travel distance, relative leaf position, relative leaf pair full-width half -maximum (FWHM), and relative leaf pair neighbor region width analysis index, and compared with the relevant results in LF. In addition, to investigate the effect of gravity on the recorded leaf position data by the Infinity medical linear accelerator LF, the above PF tests were executed at 0°, 90°, 180°, and 270° gantry angles, respectively. Intergroup differences were assessed with the Wilcoxon rank-sum test.Results:The film dose calibration curve demonstrated high goodness-of-fit, with a correlation coefficient ( R2) of 0.9994. Across all gantry angles, the dispersion of overall leaf position data for EBT3 film, EPID, and LF followed a consistent pattern based on four analysis metrics: EBT3 film > EPID > LF. Moreover, for each analysis metric, inter-tool differences in standard deviations of results were consistently below 0.1 mm, and this pattern was invariant to gantry angle. Conclusions:The leaf position data recorded in the Infinity medical linear accelerator LF have a high degree of accuracy, and can be used as reference for the actual position of the MLC leaf. Furthermore, gravitational forces exhibit negligible impact on leaf position data acquired via LF.

Objective:To discuss the efficacy of temporomandibular joint disc anchoring(TMJDA)in the treatment of anterior disc displacement without reduction(ADDWoR)from clinical and imaging perspectives,in order to improve the clinicians'understanding of this surgical approach.Methods:Twenty-one ADDWoR patients who underwent TMJDA were retrospectively collected,involving a total of 25 temporomandibular joints(TMJs).The maximum mouth opening,visual analogue scale(VAS)score for pain,and Helkimo index were measured preoperatively,1 month postoperatively,and 6 months postoperatively in all the patients.Postoperative complications and satisfaction questionnaires were designed for the patients to self-evaluate the efficacy,and their magnetic resonance imaging(MRI)findings were assessed.Results:Compared with preoperative period,the maximum mouth opening at 1 month and 6 months postoperatively was significantly increased(P<0.05);compared with 1 month postoperatively,the maximum mouth opening at 6 months postoperatively was significantly increased(P<0.05).Compared with preoperative period,the VAS scores at 1 month and 6 months postoperatively were significantly decreased(P<0.05);compared with 1 month postoperatively,the VAS score at 6 months postoperatively was significantly decreased(P<0.05).Compared with preoperative period,the percentages of the patients with Di 0 and DiⅠ scores were significantly increased(P<0.05),while those with DiⅡand DiⅢ scores were significantly decreased(P<0.05),indicating significant improvement in TMJ function after surgery.Among the 21 ADDWoR patients,14(66.67%)were satisfied and 7(33.33%)were basically satisfied.Compared with preoperative period,the disc length was significantly increased postoperatively(P<0.01),while no significant difference was observed in condylar height(P>0.05);all displaced discs were repositioned postoperatively;among the 25 joints,23(92.00%)were evaluated as"excellent"and 2(8.00%)were evaluated as"good".No patients experienced postoperative facial nerve injury,local alopecia,surgical area depression,salivary fistula,or Frey syndrome;3 patients(3 joints)developed numbness in the preauricular area within 24 hours postoperatively,which resolved by the 6-month follow-up.Conclusion:TMJDA for the treatment of ADDWoR can stably reposition the disc,significantly improve mouth opening and pain levels,with a low incidence of postoperative complications.

The inference of tissue origin of body fluid stains is crucial for case investigation and court proceedings.However,traditional methods for identification of body fluid stains,such as morpho-logical,chemical,and immunoassay identifications have certain limitations,and there is an urgent need for more efficient methods for confirmatory experiments.In recent years,the rapid development of tran-scriptomics technology has provided new means for the identification of tissue origin of body fluid stains.Different types of RNA in the transcriptome have their own advantages.This paper elaborates in detail on the application of different types of RNA,such as mRNA,miRNA,circRNA,lncRNA,piRNA and microbial transcriptomics in body fluid identification,and summarizes their respective ad-vantages and limitations,in order to provide a reference for related research.

Objective:To analyze the epidemiological characteristics of cases involving monkey injuries at medical institutions surrounding Qianlingshan Park in Guiyang City, and to provide a reference basis for preventive measures to reduce monkey injuries and standardized post-exposure treatment.Methods:A retrospective cross-sectional study was conducted, collecting 1 900 cases of monkey-induced injuries in Qianlingshan Park treated at the outpatient clinic of Guizhou Provincial Center for Disease Control and Prevention and the Department of Surgery at Qianling Hospital, Guiyang City, from 2021 to 2024. Statistical analysis was performed using Pearson′s chi-square test.Results:Total of 1 900 cases of monkey-related injuries in Qianlingshan Park were collected from 2021 to 2024. The exposure time distribution exhibited significant seasonality, with 48.58% of cases occurring during July and August, totaling 923 cases, indicating a peak in the summer. There were 774 male patients and 1 126 female patients, with a ratio of 1∶1.45.and significant differences were observed between different age groups and genders (χ2=195.00, P<0.001), with the highest number of cases occurring in the 0-9 and 20-29 age groups, accounting for 22.05%(419 cases) and 21.79%(414 cases), respectively. The upper limbs were the most common injury site, accounting for 50.84% of the total cases(966 cases in total), with significant differences between gender and injury location (χ2=22.00, P<0.001), Among females, the proportion of injuries to the upper and lower limbs (30.11% and 16.47%, respectively) was higher than that among males (20.74% and 8.63%, respectively). The majority of injuries were classified as Grade Ⅲ, making up 57.38% of cases(1 069 cases in total). Self-treatment after exposure was the most common approach(60.44%), with significant differences observed between wound severity and treatment method (χ2=6.90, P=0.032), Patients with Grade Ⅱ and Grade Ⅲ wounds were more likely to choose self-management (26.84% and 33.23%, respectively) than outpatient management (15.14% and 24.15%). Approximately 98.05% (1 863 cases) of monkey-injured patients had received rabies vaccinations. Conclusions:This study analyzes monkey-related injuries in Qianlingshan Park from 2021 to 2024, clarifying the temporal distribution of injuries, demographic characteristics, injury sites, and treatment methods. The findings provide references for optimizing human-monkey conflict management and the prevention and control of zoonotic diseases in urban ecological parks.

Objective:To investigate the efficacy of compression fixation with cross-locking Kirschner wires in the treatment of bicondylar fractures of the phalangeal neck in fingers (toes).Methods:A retrospective study was conducted to analyze the clinical data of 15 patients with bicondylar fractures of the phalangeal neck in fingers (toes) who had been treated from February 2019 to August 2023 at Department of Hand and Foot Surgery, Taizhou Hospital. The patients were all treated by compression fixation with cross-locking Kirschner wires. They were 13 males and 2 females with an age of (43.4±11.0) years and with 9 hands and 6 feet involved. In 2 of them, the fracture line of the bone block was completely located far from the insertion point of the lateral collateral ligament (condylar lateral recess). After surgery, no additional external fixation was used for all but 2 patients whose bone fold line was fixed with plaster for 3 to 4 weeks at a distance from the lateral collateral ligament insertion point. Follow-up records included fracture healing time, visual analogue scale (VAS) pain score at postoperative 3 months, total active motion (TAM) of the finger for hand patients at the final follow-up, and surgical complications.Results:All patients were followed up for (5.4±3.0) months. The VAS pain score for all patients was 0 (0, 0) point at postoperative 3 months. Only 2 patients reported mild pain in the hand at 3 months postoperatively (their VAS pain score was 1 or 2 respectively). At 12-month follow-up, 1 foot patient reported mild pain (1 point of VAS) and the other 5 foot patients experienced no pain while they were carrying weights and walking normally. X-ray evaluations at postoperative 4, 6, and 8 weeks showed nonunion of a middle phalanx intra-articular fracture of the ring finger in 1 case, complicated by bone resorption and joint stiffness which were not further treated. The other cases achieved bony union after an average healing time of (7.1±1.9) weeks. Of the 8 hand patients whose total active motion was measured at the final follow-up using the TAM scoring system, 6 were rated as excellent and 2 as good. No fracture displacement, loosening or withdrawal of Kirschner wires, or no needle tunnel infection occurred.Conclusion:In the treatment of bicondylar fractures of the phalangeal neck in fingers (toes), compression fixation with cross-locking Kirschner wires offers advantages of simplicity in operation, minimal invasiveness, good stability, and facilitation of early postoperative rehabilitation.

Objective:To evaluate the diagnostic efficacy of B-type natriuretic peptide(BNP)combined with the Evaluation of Guidelines in Syncope Study(EGSYS)score for cardiogenic syncope(CS), and to provide evidence for rapid clinical identification of high-risk patients.Methods:We retrospectively analyzed 366 patients with syncope hospitalized in the department of cardiovascular medicine of Beijing Hospital from January 1, 2016, to December 31, 2022.Based on the international guideline diagnostic criteria, the patients were categorized into four groups: neutrally mediated reflex syncope(NMS)group, orthostatic hypotension(OH)group, cardiogenic syncope(CS)group, and syncope of unknown origin(US)group.BNP levels were measured at admission and EGSYS scores were calculated.Receiver operating characteristic(ROC)curve analysis was performed to assess the diagnostic efficacy of individual and combined indices for CS.Results:A total of 366 syncope patients were included, among which 70 patients(19.1%)were diagnosed with NMS, 25 patients(6.8%)with OH, 44 patients(12.0%)with CS, and 227 patients(62.0%)with US.Patients in the CS group had significantly higher BNP levels and EGSYS scores compared to those in the NMS, OH, and US groups(all P<0.001). The AUC of EGSYS score for diagnosing CS was 0.783(95% CI: 0.711-0.855), while the AUC of BNP level for diagnosing CS was 0.805(95% CI: 0.727-0.884). When BNP level was combined with EGSYS score, diagnostic performance was significantly improved, with the AUC increasing to 0.855(95% CI: 0.792-0.918). Conclusions:The combination of BNP and EGSYS score significantly can improve the diagnostic accuracy of cardiogenic syncope, providing a practical diagnostic strategy for the early identification of high-risk syncope patients in clinical practice.

Objective To investigate the relationship between abnormal expression of angiotensin-converting enzyme(ACE)and lipoprotein(a)[Lp(a)]with hypertension-diabetes comorbidity.Methods A case-control analysis was conducted on 342 patients with metabolic diseases admitted in our hospital between January 2021 and May 2024,and they were divided into in a diabetes-hypertension comorbidity group(114 cases),a diabetes group(114 cases)and a hypertension group(114 cases).Another 114 matched healthy individuals who taking physical examination in our hospital during the same period were subjected and served as the control group.Clinical data were collected and serum levels of ACE and Lp(a)were measured in all the groups.Multivariate logistic regression analysis was applied to analyze the independent risk factors for hypertension-diabetes comorbidity,and ROC curve analysis was performed to evaluate and predict the efficacy.Results The serum levels of ACE and Lp(a)were significantly higher in the comorbidity group than the control,hypertension and diabetes groups(P＜0.01),and in the hypertension and diabe-tes groups than the control group(P＜0.01).After adjusting for waist-to-hip ratio,alanine amin-otransferase and triglyceride,multivariate logistic regression analysis revealed that serum ACE and Lp(a)still were risk factors for the occurrence of hypertension-diabetes comorbidity(P＜0.01).ROC curve analysis demonstrated that when the cut-off value was 39.01 pg/L,ACE had an AUC value of 0.884(95％CI:0.789-0.980),a sensitivity of 76.67％and a specificity of 75.28％in predicting the comorbidity,and when the cut-off value for Lp(a)was 254.33 mg/L,the AUC value was 0.899(95％CI:0.799-0.919),the sensitivity was 85.83％,and the specificity was 82.22％.Their combination improved the AUC value to 0.993(95％CI:0.979-1.000),with a sensitivity of 95.00％and a specificity of 95.28％in the prediction.Conclusion Serum ACE and Lp(a)are independent risk factors for hypertension-diabetes comorbidity,and can be combined together and regarded as biomarkers for early identification of the comorbidity.