BackgroundIn recent years， the incidence of non-suicidal self-injury （NSSI） behaviors among adolescents has been increasing annually. Self-esteem and alexithymia are strongly associated with NSSI behaviors， and alienation is closely linked to both self-esteem and alexithymia. However， there is limited research on the relationship between alienation and NSSI behaviors among adolescents in China. ObjectiveTo analyze the relationship between alienation and NSSI behaviors among adolescents， and to explore the factors influencing NSSI behaviors in this population， so as to provide insights for the prevention and treatment of NSSI behaviors in adolescents. MethodsAdolescents admitted to the Department of Psychiatry and Psychology at the 923^rd Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from September 1， 2021 to March 1， 2023， who met the diagnostic criteria for NSSI in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）， were selected as the study group （n=60）. Concurrently， middle school students from Nanning were recruited as the control group （n=60）. Participants were assessed using Adolescent Self Harm Scale （ASHS）， Rosenberg Self-Esteem Scale （RSES）， Toronto Alexithymia Scale （TAS） and Adolescent Students′ Alienation Scale （ASAS）. Pearson correlation analysis was employed to examine the relationships between scale scores in the study group， and Logistic regression analysis was used to identify the influencing factors of NSSI behaviors among adolescents. ResultsThe RSES score of the study group was significantly lower than that of the control group （t=-7.033， P<0.01）. The TAS and ASAS scores of the study group were significantly higher than those of the control group （t=5.591， 8.124， P<0.01）. The ASHS score was negatively correlated with RSES score （r=-0.410， P<0.01） and positively correlated with ASAS score （r=0.555， P<0.01）. The RSES scores of the study group were negatively correlated with TAS and ASAS scores （r=-0.317， -0.590， P<0.05 or 0.01）. Logistic regression analysis showed that being female （OR=0.714， 95% CI： 0.042~0.709） was a protective factor for NSSI behaviors among adolescents， while high alienation （OR=1.028， 95% CI： 1.013~1.043） and residing in rural areas （OR=6.692， 95% CI： 2.038~21.967） were risk factors for NSSI behaviors among adolescents. ConclusionAlienation was positively correlated with NSSI behaviors in adolescents. Female adolescents had a lower risk of NSSI behaviors， while those with higher levels of alienation or residing in rural areas were more prone to NSSI behaviors. ［Funded by Self-financed Scientific Research Project of the Health Commission of Guangxi Zhuang Autonomous Region （number， Z20210656）； Self-financed Scientific Research Project of the Health Commission of Guangxi Zhuang Autonomous Region （number， Z-A20231057）］

Objective To investigate the expression levels and prognostic value of preoperative serum exosomes micro RNA(miR)-193a and micro RNA(miR)-208b in patients with gastric cancer(GC).Methods A total of 132 patients who underwent GC radical gastrectomy in the First Affiliated Hospital of Xinjiang Medical University from March 2018 to March 2020 were regarded as the GC group,while 132 healthy individuals who underwent physical examination were selected as the control group.Their clinical and pathological data were collected and compared.The relative expression levels of miR-193a and miR-208b in serum exosomes were detected using quantitative real-time polymerase chain reaction(qRT-PCR)method.Pearson method was used to analyze the correlation between miR-193a and miR-208b.The correlation between the expression of miR-193a and miR-208b in preoperative serum exosomes of GC patients and postoperative prognosis was analyzed using Kaplan-Meier method.Univariate and multivariate COX regression were applied to analyze the influencing factors of prognosis.Results The expression level of miR-208b in the serum exosomes of the GC group was higher than that of the control group(1.77±0.14 vs 1.02±0.01),while the expression level of miR-193a was lower than that of the control group(0.52±0.06 vs 1.01±0.01),and the differences were statistically significant(t=92.551,61.392,all P<0.05).The expression levels of miR-193a and miR-208b in GC patients before surgery were negatively correlated(r=-0.409,P<0.05).The low expression rate of miR-193a and high expression rate of miR-208b in patients with TNM stage Ⅰ+Ⅱ,no lymph node metastasis,and no distant metastasis were lower than those in patients with TNM stage Ⅲ+Ⅳ,lymph node metastasis,and distant metastasis,and the differences were statistically significant(χ2=5.008,4.397;7.142,4.688;4.407,5.189,all P<0.05).The 3-year cumulative survival rate of patients with low expression of miR-193a(30.43%)was lower than that of patients with high expression(60.32%)(χ2=17.861,P<0.001),while the 3-year cumulative survival rate of patients with high expression of miR-208b(27.14%)was lower than that of patients with low expression(64.52%)(χ2=16.340,P<0.001).The independent prognostic factors included serum levels of exosomes miR-193a(HR=0.493,95%CI:0.323～0.753)and miR-208b(HR=2.697,95%CI:1.382～5.262)(all P<0.05).Conclusion The preoperative serum miR-193a level in the exosomes was decreased and miR-208b level was increased,and their expression levels were related to the prognosis of patients undergoing GC radical gastrectomy.

Objective To observe the safety and efficacy of perioperative short-duration platelet membrane glycoprotein Ⅱ b/Ⅲ a receptor antagonist(GPI)in elderly patients undergoing primary percutaneous coronary intervention(PPCI)for acute ST-segment elevation myocardial infarction(STEMI)with high thrombotic burden.Methods A total of 140 elderly patients with acute STEMI admitted to our department from October 2021 to January 2024 were recruited and ran-domly divided into experimental group(short duration)and control group(standard duration),with 70 cases in each group.The occurrence of MACE,complete rate of ST segment resolution 2 h after surgery,blood flow classification thrombolysis in myocardial infarction(TIMI),left ventric-ular ejection fraction(LVEF),N-terminal pro-B-type natriuretic peptide(NT-proBNP),inhibition of platelet aggregation(IPA)by thromboelastography(TEG),maximum amplitude of adenosine diphosphate receptor pathway(MAADP),platelet-related indicators,and incidences of thrombocy-topenia and bleeding events were observed in the 2 groups after operation.Results There were no significant differences in postoperative recurrence of angina pectoris,acute heart failure,malignant arrhythmia,rate of ST segment resolution,TIMI blood flow grade 3,no reflow,LVEF,NT-proBNP level before discharge,and incidences of severe hemorrhage and thrombocytopenia during hospi-talization between the two groups(P＞0.05).The experimental group had significantly lower IPA[(76.1±15.3)％vs(96.3+19.4)％,P=0.016]and higher MAADP(45.6±8.2 mm vs 26.7±9.7 mm,P=0.028)in 18 h after operation,and lower incidence of minor bleeding(7.1％vs 24.3％,P＜0.05)during hospitalization when compared with the control group.Conclusion Under the premise of using a novel oral purinergic receptor P2Y12 inhibitor,short-term GPI is not inferior to the standard time course in achievement of IPA,with similar efficacy and relatively better safety.

Uremic pruritus is one of the skin complications that perplex patients with end-stage renal disease undergoing hemodialysis or peritoneal dialysis. Because the specific pathogenesis is not clear, there is no unified treatment plan in the world. In August 2021, the US Food and Drug Administration approved the use of difelikefalin (under the trade name Korsuva) for the treatment of moderate to severe pruritus associated with chronic kidney disease in adult patients undergoing hemodialysis. Studies have shown that difelikefalin can remarkably reduce the intensity of pruritus and improve sleep and pruritus-related quality of life. The recommended dose of difelikefalin is 0.5 μg/kg, and difelikefalin is well tolerated and has high safety. This paper reviews the pharmacological effects, pharmacokinetics, clinical efficacy and safety of difelikefalin.

With the development of laparoscopic technology, surgeon's requirements for precise anatomy are gradually increasing. Laparoscopic system has great advantages in the selection of anatomical level, the protection of nerve and blood vessel in surgery. 4K laparoscopic system can provide high-definition vision of operative field, which is conducive to precise anatomical operation. The authors share the practical team cooperation experience of laparoscope left hemi-colectomy for colon cancer in order to provide references for surgical colleagues.

With the development of laparoscopic techniques, the requirement of fine dissection in surgeons is also growing. Laparoscopic technique has the advantages in the choice of anatomical level and nerve vascular protection for surgery. 4K laparoscopy provides more clear field of vision and more detailed anatomic prerequisites. Combined with surgical examples, the authors share experiences in protection of plant nerve during 4K laparoscopic radical resection of colorectal cancer.

Objective: To evaluate the clinical efficacy of hematoporphyrin monomethyl ether-based photodynamic (HMME-PDT) therapy for the treatment of port-wine stain (PWS) and its sonographic changes. Methods: A total of 45 patients with confirmed PWS were enrolled from the Department of Dermatology, Third Affiliated Hospital of Soochow University from March 2017 to June 2018, including 5 with pink PWS, 39 with purplish red PWS and 1 with thickened PWS. All the patients received 3 sessions of HMME-PDT therapy. The skin thickness and density were compared before and after the treatment by using high-frequency ultrasound. Ranked data were analyzed by using nonparametric test. Measurement data were expressed as mean ± standard deviation, and analyzed using ony-way analysis of variance. Multiple comparisons were performed using Student-Newman-Keuls-q (SNK-q) test. The results were considered to be statistically significant if P < 0.05. Results: Among the 45 patients with PWS who completed the treatment and follow-up, 10 were cured, 21 received marked improvement, 12 received improvement, and 1 showed no response. The total response rate was 97.78%, and the response rate in the patients with pink PWS was higher than that in the patients with purplish red PWS (U = 12.50, P < 0.001) . The difference value of the skin thickness or skin density before and after the treatment significantly differed among the cured patients, patients receiving marked improvement and those receiving improvement (skin thickness:0.65 ± 0.21, 0.56 ± 0.88, 0.37 ± 0.12 mm respectively; skin density: -8.65 ± 2.19, -6.86 ± 2.79, -4.92 ± 2.91 g/cm³ respectively; F = 14.528, 5.428 respectively, both P < 0.001) , and the difference values of the skin thickness and density were significantly higher in the cured patients than in those receiving improvement (q = 5.82, 4.63, both P < 0.05) . Erythematous swelling to different extents occurred at the laser-exposed sites in the zygomatic and cheek region in 23 patients with PWS and in the frontal-zygomatic region in 6 with PWS after the HMME-PDT therapy, but gradually regressed about 1 week later. Pale brown crusts were observed at the laser-exposed sites in 35 patients, and shed spontaneously about 3 weeks later. Post-inflammatory hyperpigmentation at the laser-exposed sites was observed in 4 patients, and gradually regressed after 2-month follow-up. Conclusions HMME-PDT therapy is effective for the treatment of PWS, with high safety and few adverse reactions. High-frequency ultrasound can be used for objectively evaluating the clinical efficacy of HMME-PDT therapy.

OBJECTIVE:To evaluate the efficacy and safety of tolvaptan in the treatment of liver cirrhosis ascites with hyponatremia systematically,in order to provide reference for clinical drug use. METHODS:Retrieved from The Cochrane Library, PubMed,CNKI and Wanfang database,etc.,randomized controlled trials(RCTs)about tolvaptan combined with routine treatment plan(trial group)versus routine treatment plan with or without placebo(control group)in the treatment of liver cirrhosis ascites with hyponatremia were collected. The qualities of included studies were evaluated according to modified Jadad scale after extracting data. Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS:A total of 16 RCTs were included, involving 1 271 patients.The results of Meta-analysis showed that serum sodium concentration[MD=6.51,95%CI(4.64,8.39),P<0.001],24 h urine volume [MD=1.36,95%CI(1.01,1.70),P<0.001],response rate of ascites and edema [RD=0.27,95%CI (0.20,0.35),P<0.001],body weight improvement[MD=-1.11,95%CI(-1.31,-0.91),P<0.001]and abdomen circumference improvement [MD=-2.13,95%CI(-2.96,-1.31),P<0.001] of trial group were significantly superior to those of control group, with statistical significance.There was no statistical significance in the levels of blood potassium,blood pressure,heart rate,TBiL,Scr or BUN between 2 groups before and after treatment(P>0.05). The level of ALT in trial group was significantly lower than control group,with statistical significance(P=0.003). Subgroup analysis showed that there was no statistical significance in 24 h urine volume when traditional diuretics were given only in control group or not used in two groups(P>0.05);the serum sodium concentration and 24 h urine volume of other subgroups were significantly higher than those of control group,with statistical significance(P<0.001). The incidence of ADR in trial group was higher than control group as dry mouth,thirst,frequent urination,insomnia,with statistical significance(P<0.05). Total incidence of ADR in trial group was slightly higher than control group,without statistical significance (P>0.05). CONCLUSIONS:Tolvaptan has good therapeutic efficacy for liver cirrhosis ascites with hyponatremia,can effectively improves serum sodium concentration,24 h urine volume,ascites and edema,body weight and abdomen circumference,but rarely affects blood potassium,heart rate,blood pressure,liver and renal function.However,ADR as thirst should be paid attention.

A 8-channel neural signal′s simultaneous transducer detection micro system was developed to research the neural loop located at the brain hippocampus zone. The components of the system contained the neural probe manufactured with the Micro-electro-mechanical-systems (MEMS) technique based on silicon-on-insulator (SOI) substrate, biological low noise chopper-stabilization amplifier, low noise and intermediate speed SAR-ADC converter, reduced and low power ASK/FSK modulation radio transmitter. The micro system was applicable with the characters of small volume, interferences free, neural electrophysiology and neurotransmitter simultaneous detection, high sensitivity, high linearity, etc. The electrode resistance was optimized to 35.0 kΩ after depositing nanometer platinum black on the 4 electrophysiological sites on the Pt electrode. With the modification enzyme technique, nanomaterial enzyme membrane (Pt-mPD-GluOx) was directly fixed on the glutamate detection locus for selectively detecting special neural neurotransmitter matter. In addition, the electrochemistry measurement results indicated that the linear range of glutamate was 6-35 μmol/L with correlation coefficient of 0.97, the sensitivity was 0.0069 pA/(μmol/L). The current response error was less than 3.0 pA, which showed that the neural needle satisfied differential selection. Also, the logic/analog mixed signal 180-nm Application specific integrated circuit (ASIC ) technique (SmicRF180 nm 1Poly6M) was used to manufacture the transducer back-end disposing IC chip, and the test results provided some key parameters such as chopper-stabilization amplifier (equivalent in putting noise voltage ≤0.7 μV rms@1 kHz, gain of 71-82 dB, CMRR/PSRR>100 dB), SAR-ADC (ENOB is 12 bits, power consumption is 1.2 mW when maxmium conversion speed is 1 Msps, signal-noise-ratio is 60.9 dB, etc), and ASK/FSK modulation radio transmitter (the PA′s outputting power of 4-5 dBm, the radiation range of 10 meters). The micro neural transducer integrated system was convenient and wireless wearable for the research of brain hippocampus region.

OBJECTIVETo investigate the expression of TMEMl6A in the colon of intractable functional constipation patients and its clinical implications.

METHODSA total of 30 patients with intractable chronic functional constipation were selected as trial group (full thickness tissue of sigmoid colon), 30 patients with colon cancer as control group (distant tissues at least 5 cm away from cancer). Tissues from two groups were collected in our hospital from February 2012 to June 2014 and confirmed by pathological diagnosis. Immunofluorescence staining, RT-PCR and Western blot were performed to detect the mRNA and protein expression of TMEM16A and c-kit in colon.

RESULTSTMEM16A and c-kit protein expressions were observed in similar sites of colon tissues in two groups. Expressions of TMEM16A and C-kit in colon tissues detected by immunofluorescence, RT-PCR, and Western blotting were significantly lower in trial group than those in control group (TMEM16A: mean A 1.84±0.25 vs. 3.65±0.32, P<0.05, gray intensity ratio 0.66±0.07 vs. 1.04±0.17, P<0.05, relative mRNA 0.41±0.05 vs. 1.00, P<0.05; c-kit: mean A 3.38±0.24 vs. 5.06±0.31, gray intensity ratio 0.64±0.06 vs. 0.98±0.09, relative mRNA 0.18±0.08 vs. 1.00, all P<0.05).

CONCLUSIONSTMEM16A expression in colon tissues of intractable functional constipation patients is significantly lower and may adjust the movement of colonic smooth muscle by regulating the c-kit expression. TMEMl6A may be used as a new candidate target for diagnosis and treatment of intractable functional constipation.

Anoctamin-1 ; Blotting, Western ; Chloride Channels ; Colon, Sigmoid ; Colonic Neoplasms ; Constipation ; Humans ; Muscle, Smooth ; Neoplasm Proteins ; Proteomics ; Proto-Oncogene Proteins c-kit ; RNA, Messenger