Objective: To investigate the emotional and behavioral problems among preschool children and the correlations with maternal parenting competence and family rearing environment, so as to provide a scientific basis and practical guidance for the physical and mental health development of preschool children. Methods: In June 2025, 660 preschool children aged 3-6 years old were selected from 10 kindergartens in Hefei, Anqing, and Tongling in Anhui Province by using a stratified cluster random sampling method. A questionnaire survey was conducted among all parents of preschool children using the Parent version of the Strengths and Difficulties Questionnaire, the Child Family Rearing Environment Scale, and the Chinese version of the Parenting Sense of Competence Scale. Pearson correlation analysis and multiple linear regression analysis were used to analyze the related factors of emotional and behavioral problems among preschool children. SPSS macro program Process 4.1 and Bootstrap method were used to test the mediating effect of family parenting environment between emotional and behavioral problems among preschool children and maternal parenting competence. Results: The detection rate of emotional and behavioral problems among preschool children was 20.15%. The total scores of family rearing environment and maternal parenting competence were negatively correlated with emotional and behavioral problems among preschool children ( r =-0.45,-0.79), and the total score of family rearing environment was positively correlated with the total score of maternal parenting competence ( r =0.43) (all P <0.01). Multiple linear regression showed that, after controlling whether being only child, parents educational level, registered residence location and other variables, family rearing environment, self efficacy and satisfaction were all negative predictors of emotional and behavioral problems among preschool children ( B =-0.07, -0.42, -0.42, all P <0.01). The mediation effect results showed that maternal parenting competence could positively predict the family rearing environment ( B =0.75), while maternal parenting competence and family rearing environment could both negatively predict emotional and behavioral problems among preschool children ( B =-0.49, -0.06 ) (all P <0.05). The Bootstrap sampling method test results showed that the effect value of the indirect effect of maternal parenting competence on emotional and behavioral problems through the family rearing environment was -0.04, and the effect proportion was 8.21 %. Conclusion Preschool children with a better family rearing environment and stronger maternal parenting competence are less likely to have emotional and behavioral problems, among which the family rearing environment has a mediating effect.

BACKGROUND: Recent studies have shown that sodium-glucose cotransporters-2 (SGLT2) inhibitors significantly improve major adverse cardiovascular events in heart failure with preserved ejection fraction (HFpEF) patients, but the exact mechanism is unknown. Ferritinophagy is a special form of selective autophagy that participates in ferroptosis. In this study, we aimed to investigate whether ferritinophagy was activated during the occurrence of HFpEF, and whether canagliflozin (CANA) could inhibite ferritinophagy. METHODS: We reared Dahl salt-sensitive (DSS) rats on a high-salt diet to construct a hypertensive HFpEF model, and simultaneously administered CANA intervention. Then we detected indicators related to ferritinophagy. RESULTS: The expression of nuclear receptor coactivator 4 (NCOA4), as well as microtubule-associated proteins light chain 3 (LC3), Bcl-2 interacting protein 1 (Beclin-1) and p62, were upregulated in HFpEF rats, accompanied by the downregulation of ferritin heavy chain 1 (FTH1), upregulation of mitochondrial iron transporter sideroflexin1 (SFXN1) and increased reactive oxygen species (ROS) production. Above changes were diminished by CANA. CONCLUSION Ferritinophagy is activated in HFpEF rats and then inhibited by CANA, leading to HFpEF benefits. The inhibition of ferritinophagy could provide new prospective targets for the prevention and treatment of HFpEF, and provide new ideas for investigating the mechanism of cardiovascular benefit of SGLT2 inhibitors.

Myocardial infarction (MI) is the leading cause of cardiovascular disease-related death worldwide. Nonetheless, existing therapeutic approaches for MI are hampered by issues such as reliance on pharmacological agents and suboptimal patient adherence. Caffeic acid (CA) is a bioactive polyphenolic compound with important anti-inflammatory, anti-bacterial and anti-oxidant functions. Still, its specific role and mechanism in treating cardiovascular disease remain to be further studied. In recent years, a large number of studies have shown that the kelch-like ECH-associated protein 1/nuclear factor erythroid 2 related factor 2 (Keap1/Nrf2) pathway is a key factor in the occurrence and development of cardiovascular diseases. In this study, H₂O₂-induced oxidative stress model of H9c2 cells and left anterior descending branch (LAD) conjunctival induced acute myocardial infarction reperfusion (AMI/R) model were used to evaluate the protective effect of CA on the heart. The interaction between CA and Keap1 was analyzed by CA-labeled fluorescence probe, target fishing, isothermal titration calorimetry (ITC), protein crystallography and surface plasmon resonance (SPR). Our results suggested that CA binds Keap1 and degrades Keap1 in a p62-dependent manner, further promoting nuclear transcription of Nrf2 and thus effectively reducing oxidative stress. In addition, based on the three-dimensional eutectic structure, it was confirmed that CA directly targets Keap1 protein by interacting with residues M550 and N532, inducing conformation changes in Keap1 protein. We also found that the CA analog chlorogenic acid (GCA) can bind Keap1. In conclusion, this study elucidates a novel molecular mechanism and structural basis for the protective effects of CA against oxidative damage via the Keap1-Nrf2 pathway.

As a new type of production factor that can empower the development of new quality productivity, the data element is an important engine to promote the high quality development of the industry. Traditional Chinese medicine(TCM) dispensing is the most basic work of TCM clinical pharmacy, and its quality directly affects the clinical efficacy of TCM. The integration of data elements and TCM dispensing can stimulate the innovation and vitality of the TCM dispensing industry and promote the high-quality and sustainable development of the industry. A large-scale, detailed, and systematic study on TCM dispensing was conducted. The innovative practice path of data fusion construction in the whole process of TCM dispensing was investigated by integrating the digital resources "nine full activities" of TCM dispensing, creating the digital dictionary of "TCM clinical information data elements", and exploring innovative applications of TCM dispensing driven by data and technology, so as to promote the standardized, digital, and intelligent development of TCM dispensing in medical health services. The research content of this project was successfully selected as the second batch of "Data element×" typical cases of National Data Administration in 2024, which is the only selected case in the field of TCM.
Medicine, Chinese Traditional/methods* ; Drugs, Chinese Herbal ; Humans

Objective:To investigate the short-term efficacy and safety of rituximab (RTX) in children with calcineurin inhibitor (CNI) resistant steroid resistant nephrotic syndrome (SRNS).Methods:A retrospective case analysis was conducted. Thirteen children with CNI resistant SRNS who were regularly treated with RTX (375 mg/m 2 per dose (maximum dose 500 mg), 1 dose per week, a total of 4 doses) in Department of Nephrology, Children′s Hospital of Fudan University from January 2016 to December 2023 were enrolled. The general data, disease related information, urinary protein/creatinine, serum albumin, blood creatinine before RTX treatment, immunosuppressants, adverse events, and monthly urinary protein/creatinine, serum albumin, and blood creatinine indexes within 6 months after RTX treatment were collected. The changes of urinary protein/creatinine, serum albumin and estimated glomerular filtration rate (eGFR) before and after RTX at 3 and 6 months were analyzed by using paired sample t test and Wilcoxon signed-rank test. Results:Among the 13 patients, 8 were male and 5 were female. The age of disease onset was 4.0 (2.9, 6.8) years and the age of RTX treatment was 9.8 (5.9, 13.6) years. There were 8 cases of focal segmental glomerulosclerosis, 3 cases of minimal change disease and 2 cases of mesangial proliferative glomerulonephritis. No clinically significant gene variation was detected in 12 cases and the other one did not receive gene test. Before RTX treatment, 11 cases were in chronic kidney disease stage G1, and 1 case each was in stage G2 and stage G3. Ten children completed 4 doses of RTX treatment, 1 patient completed 3 doses, and 2 patients completed 2 doses. Urinary protein/creatinine in 13 children at 3 and 6 months after RTX treatment was significantly lower than baseline (0.60 (0.13, 2.04), 0.49 (0.28, 1.10) vs. 1.44 (0.76, 4.11) mg/mg, Z=-2.34, -2.34, both P<0.05), and serum albumin was significantly higher than baseline ((35±8), (34±7) vs. (30±6) g/L, t=2.30, 2.60, both P<0.05). The eGFR at 6 months after RTX treatment was not significantly different from the baseline ((110±32) vs. (113±35) ml/(min·1.73 m 2), t=-0.76, P>0.05)). No serious adverse reactions occurred in this study. Conclusion:RTX could reduce urinary protein and increase serum albumin in short-term treatment in children with CNI resistant SRNS without significant side effects.

Objective:To investigate the current status of occupational internal exposure of nuclear medicine staff performing 131I treatment, and explore the related influence factors, so as to provide a basis for protection against internal exposures. Methods:A survey was conducted using cluster random sampling method to ascertain all the nuclear medicine staff involved in 131I treatment in nuclear medicine hospitals in Hubei province for the years 2021 to 2023. The in vitro monitoring mesurement was made of the 131I activity in thyroid by using portable gamma spectrometer, and the committed effective dose was estimated. Results:The positive detection rate of 131I in treatment staff was between 18.75% and 21.12%, with an average of 20.08%. The highest value found in cleaning and nursing staff in iodine therapy workplaces. The detection rate found in two hospitals were up to 75.61% and 64.71%, respectively. The detection rate was positive for the three consecutive years. There was no statistically significant difference in the committed effective dose between different treatment positions, and the level of internal exposure was lower than the external exposure arising from nuclear medicine practice. Factors affecting detection rate of 131I in thyroid included the amount of 131I used for treatment, and disorder type for treatment, 131I dose, use or otherwise of automated radiopharmaceutical dispenser, and ventilation in treatment rooms. Conclusions:Continuous attention should be paid to the internal exposure of nuclear medicine staff for use of 131I for treatment. Ventilation should be provided regularly, as required, to the 131I treatment rooms and active rooms and the staff should wear masks during the relevant working processes.

OBJECTIVE T o explore the clinical characteristics and risk factors for plastic bronchitis(PB)in the chil-dren with Mycoplasma pneumoniae pneumonia(MPP).METHODS A retrospective case-control study was con-ducted for the medical data of the children with MPP who hospitalized in pediatrics department of Affiliated Hos-pital of Jining Medical College and underwent bronchoscopy and bronchoalveolar lavage from Jan.2023 to Dec.2024.The enrolled children were divided into the PB group and the non-PB group according to the status of complication with PB.The baseline data,clinical characteristics,laboratory test indexes,imaging features,bron-choscopy findings and treatment outcomes were observed and compared between the two groups of children.RESULTS A total of 734 children with MPP were included in the study,131 of whom were assigned as the PB group,and 603 were assigned as the non-PB group.The children were younger[4.83(1.88,7.00)years],the du-ration of fever was longer,the peak temperature was higher[39.50(39.20,39.80)℃],the percentage of compli-cation with pleural effusion was higher(33.59％),the percentage of extrapulmonary organs involved was higher(27.48％),the levels of white blood cells,neutrophils percentage,C-reactive protein(CRP),lactic dehydrogen-ase(LDH),D-dimer(DD)and alanine aminotransferase(ALT)were higher in the PB group than in the non-PB group,and there were significant differences(P＜0.05).There were significant differences in the percentage of mucosal necrosis under bronchoscopy,number of times of treatments assisted by bronchoscopy and length of hospital stay between the two groups(P＜0.05).CONCLUSIONS The MPP children with PB are characterized by younger rage,longer duration of fever,higher peak temperature,higher percentage of complication with pleural effusion,extrapulmonary organs more likely to be involved,more intensive inflammatory reactions and higher percentage of mucosal necrosis under bronchoscopy.Some of the children need to be treated repeatedly with assis-tance of bronchoscopy,and the length of hospital stay is long.

Objective: To explore the relationship between beverage dependence and sleep quality among college students, providing empirical evidence for improving their sleep quality. Methods: From December 2024 to January 2025, a convenience sampling method was used to conduct a questionnaire survey among 3 974 college students from four universities in Anhui Province. The Beverage Addiction Scale for College Students (BASCS) was used to assess beverage dependence, and the Self rating Scale of Sleep(SRSS) was used to evaluate sleep quality. A multivariate Logistic regression model was employed to analyze the relationship between beverage dependence and sleep quality, and a restricted cubic spline model was used to examine the dose response relationship between the two. Results: The positive rate of beverage dependence symptoms among college students was 7.6%, with positive rates of 9.6%, 13.8%, and 7.4% for the withdrawal symptoms, health effects, and dependence symptoms dimensions, respectively. The detection rate of sleep disorders was 23.6%. Multivariate Logistic regression analysis showed that after adjusting for covariates such as grade, gender, and body mass index, compared with the no beverage dependence group, students with positive beverage dependence symptoms had a higher risk of sleep disorders( OR =3.71, 95% CI =2.87-4.80, P <0.01). The OR (95% CI ) for sleep disorders among students with positive symptoms in the withdrawal symptoms, health effects, and dependence symptoms dimensions were 2.80(2.22-3.53), 2.38(1.95-2.91), and 2.45(1.89-3.18)(all P <0.01). Further analysis using a restricted cubic spline model revealed that the overall beverage dependence score and its three dimensional scores were approximately linearly related to the risk of sleep disorders among college students (all nonlinear P >0.05). Conclusions Beverage dependence is associated with sleep quality among college students. Schools should take multiple approaches, such as health education on beverage awareness, to improve students sleep quality.

Mental state is an important part of the normal life activities of the human body, and it is also the most external expression and the most easily obtained information of the physical condition. The normal activities of the mind depend on the normal operation of the viscera, qi, and blood, and are a unified whole that prospers together and suffers together. The theory of the five-spirit-viscera in the Yellow Emperor’s Inner Classic revealed that the normal mental activities of the human body were dominated by the five internal organs, that is, the five internal organs were the body and the five spirits were the function. And it highlighted the viewpoint that the five internal organs store the spirits and are actually one. The heart governs the spirit and belongs to the four internal organs. On this basis, Synopsis of Golden Chamber used the internal organs to diagnose and treat mental diseases, integrating the theory of the five spirits into it, forming a unique method of diagnosis and treatment with the heart as the leading factor and regulating the qi and blood of the four internal organs. It identified the pathogenesis of diseases such as pathogenic crying, lily disease, and hysteria from five levels: heart deficiency and weak qi, heart-lung disharmony, heart-liver disharmony, the heart of the loss of the spleen nourishment, and disharmony between heart and kidney. The treatment was mainly to replenish the deficiency of the viscera and eliminate the pathogens, reflecting the characteristics of regulating the mind and calming the four internal organs. This unique view on diagnosis and treatment has profoundly influenced the diagnosis and treatment theories of mental illnesses by later doctors, and is of great significance to the current clinical treatment of such illnesses.

Objective: To investigate the association between dietary behaviors and overweight and obesity among middle school students, so as to provide the evidence for developing dietary intervention strategies for them. Methods: From October to December 2023, a total of 7 063 middle school students from six counties (districts) in Ma'anshan City, Anhui Province were selected through stratified cluster random sampling method. Demographic information, physical activity, sleep, and dietary behaviors over the past year were collected through questionnaire surveys. Height and weight were measured to calculate body mass index (BMI), with overweight and obesity determined based on gender- and age-specific BMI cut-off points. The association between dietary behaviors and overweight and obesity was analyzed using a multivariable logistic regression model. Results: Totally 7 063 questionnaires were allocated, and 7 045 valid questionnaires were recovered, with an effective recovery rate of 99.75%. There were 3 925 males (55.71%) and 3 120 females (44.29%). A total of 2 326 students were overweight and obesity, with the prevalence of 33.02%. There were significant differences in the prevalence of overweight and obesity among middle school students with different genders, whether they were the only child or not, different intake frequency of sugar-sweetened beverages, and different intake frequency of beans and soy products (all P<0.05). After adjusting for factors such as gender, education stage, whether the only child, whether living on school, physical activity and sleep, multivariable logistic regression analysis showed that the frequency of snack consumption (1-2 times/week, OR=0.803, 95%CI: 0.669-0.963; 3-6 times/week, OR=0.759, 95%CI: 0.623-0.926; daily, OR=0.758, 95%CI: 0.595-0.964), sugar-sweetened beverages consumption (1-2 times/week, OR=1.166, 95%CI: 1.012-1.343; daily, OR=1.891, 95%CI: 1.302-2.746) and beans and soy products consumption (1-2 times/week, OR=0.787, 95%CI: 0.628-0.987) were the influencing factors of overweight and obesity among middle school students. Conclusions The frequencies of snack, beans and soy products and sugar-sweetened beverage consumption are associated with overweight and obesity among middle school students. Targeted interventions should be strengthened to reduce the risk of overweight and obesity.