Objective: To investigate the prevalence of depressive symptoms and their associated factors among students in Zhejiang Province, so as to provide evidence for targeted prevention strategies. Methods: A stratified cluster random sampling method was used to select 23 829 college students and primary and secondary school students aged 11-22 years in Zhejiang Province from December 2019 to February 2020. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Three machine learning algorithms, including Logistic regression, random forest, and eXtreme Gradient Boosting (XGBoost), were applied to construct predictive models, and key associated factors were identified by comparing model performance. Results: The detection rate of depressive symptoms among students in Zhejiang Province was 19.92%; the rates were 17.20% in boys and 22.87% in girls( χ 2=164.89, P <0.05). The CES-D total score was 9.00(4.00,13.00). Multiple Logistic regression analysis revealed that loneliness had the strongest association with depressive symptoms ( AOR =9.58, 95% CI =8.90-10.30), while bullying exposure ( AOR =4.39, 95% CI =4.02-4.80), female students( AOR =1.81, 95% CI =1.68-1.94)，never eating breakfast ( AOR = 2.34，95% CI =2.00-2.67) and overweight/obesity( AOR =1.10，95% CI =1.08-1.12) were significant associated factors of depressive symptoms among students (all P <0.05). Analysis based on the XGBoost model produced highly consistent results, identifying the above 5 factors as the core features with the highest correlation strength (all P <0.05). Conclusions Female, loneliness, bullying exposure, frequency of weekly breakfast and BMI are strongly associated with depressive symptoms among students. Mental health education for high risk groups should be strengthened, and coordinated prevention efforts between families and schools are recommended.

OBJECTIVE: By analyzing the hormone secretion of the adenohypophysis, thyroid glands, gonads, and adrenal cortex in patients with hematological diseases before and after hematopoietic stem cell transplantation (HSCT), this study aims to preliminarily explore the effect of HSCT on patients' hormone secretion and glandular damage. METHODS: The baseline data of 209 hematological disease patients who underwent HSCT in our hospital from January 2019 to December 2023, as well as the data on the levels of hormones secreted by the adenohypophysis, thyroid glands, gonads and adrenal cortex before and after HSCT were collected, and the changes in hormone levels before and after transplantation were analyzed. RESULTS: After allogeneic HSCT, the levels of thyroid-stimulating hormone (TSH), triiodothyronine (T3), free triiodothyronine (FT3) and estradiol (E2) decreased, while the levels of luteinizing hormone (LH) and follicle- stimulating hormone (FSH) increased. The T3 level of patients with decreased TSH after transplantation was lower than that of those with increased TSH after transplantation. In female patients, the levels of prolactin (PRL), progesterone (Prog), and testosterone (Testo) decreased after HSCT. Testo and PRL decreased when there was a donor-recipient sex mismatch, and the levels of adrenocorticotropic hormone (ACTH) and cortisol (COR) decreased when the HLA matching was haploidentical. The levels of T3, FT3, and PRL decreased after autologous HSCT. In allogeneic HSCT patients, the levels of TSH, T4, T3, FT3, and ACTH in the group with graft-versus-host disease (GVHD) were significantly lower than those in the group without GVHD. Logistic regression analysis showed the changes in hormone levels after transplantation were not correlated with factors such as the patient's sex, age, or whether the blood types of the donor and the recipient are the same. CONCLUSION HSCT can affect the endocrine function of patients with hematological diseases, mainly affecting target glandular organs such as the thyroid, gonads, and adrenal glands, while the secretory function of the adenohypophysis is less affected.
Humans ; Hematopoietic Stem Cell Transplantation ; Female ; Male ; Hematologic Diseases/blood* ; Follicle Stimulating Hormone/blood* ; Triiodothyronine/blood* ; Luteinizing Hormone/blood* ; Thyroid Gland/metabolism* ; Estradiol/blood* ; Thyrotropin/blood* ; Gonads/metabolism* ; Adult ; Middle Aged ; Adrenocorticotropic Hormone/blood* ; Hormones/metabolism* ; Adrenal Cortex/metabolism* ; Prolactin

Objective To summarize the treatment of cervical cancer patients diagnosed before 34 weeks of gestation who chose to continue pregnancy,and to provide clinical experience for improving maternal and fetal outcomes.Methods Clinical data of pregnant women with cervical cancer admitted to the Obstetrics and Gynecology Hospital,Fudan University from Jan 2013 to Feb 2024 were collected and analyzed.Treatment of patients diagnosed before 34 weeks of gestation and chose to continue pregnancy was summarized.Outcomes of patients and newborn were followed up.Results A total of 15 patients were enrolled with a median age of 34 years old.Nine cases(9/15)represented clinical symptom of abnormal vaginal bleeding,14 cases(14/15)of patients were diagnosed in the middle or late stages of pregnancy,12 cases(12/15)diagnosed with tumor size of more than 2 cm,13 patients(13/15)infected HPV type 16 or 18.The main pathological type was squamous cell carcinoma(9/15).Regarding therapy,one patient with stage Ⅰa1 was under observation and underwent a caesarean section and total hysterectomy at 35 weeks of gestation due to premature rupture of membrane and a scarred uterus.For the other patients with 14 stage Ⅰb,lymph node metastasis was excluded by pelvic lymphadenectomy or MRI,and then neoadjuvant chemotherapy was administered.Termination of pregnancy and standardized treatment for cervical cancer were provided after 34 weeks of gestation.One patient's pathology was upgraded to stage Ⅱa1 after surgery.Up to follow-up,13 out of 15 patients had survived without tumors.The average gestational age of newborns was(35.0±1.5)weeks,and the average birth weight was(2 345.33±431.44)g.Blood tests conducted one day after delivery of the newborns revealed that:8 newborns(8/15)had hypoleukocyte and one newborn(1/15)had anemia.After short-term hospitalization and supportive treatment,all newborns'progress was favorable.Conclusion For pregnant patients with stage Ⅰb cervical cancer diagnosed before 34 weeks of gestation,postponing termination to after 34 weeks of gestation through neoadjuvant chemotherapy and then giving standardized treatment for cervical cancer was safe with favorable maternal and fetal prognosis.

Ferroptosis is an iron-dependent form of programmed cell death triggered by the excessive accumulation of lipid peroxides on the cell membrane.Recent studies have found that ferroptosis can be induced by exposure of the testis tissue and germ cells to some high-risk factors,accompanied by various characteristic reproductive system injuries,including changes in cell morphology,ferroptosis-related physico-chemical indicators and gene expressions.This review focuses on the association of ferroptosis with male reproductive system diseases from three key aspects:iron metabolism abnormalities,Cystine/GSH/GPX4 axis imbalance,and lipid peroxidation.

Objective To investigate the factors affecting survival of dilated cardiomyopathy(DCM)after treatment with decreased left ventricular ejection fraction(LVEF).Methods A total of 158 DCM patients with decreased LVEF treated in Huzhou First People's Hospital from June 2020 to June 2023 were selected and divided into death group(n=40)and survival group(n=1 18)according to their survival status.The clinical data of two groups were analyzed by Cox proportional risk regression model to analyze the factors affecting the survival of DCM with decreased LVEF after treatment.Results The age of patients in death group was significantly higher than that in survival group,and the combination of hypertension,New York Heart Association(NYHA)cardiac function grade Ⅳ,ventricular arrhythmia and left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),and brain natriuretic peptide(BNP)were significantly higher than those in survival group,global longitudinal strain(GLS),standard deviation of RR interval(SDNN),standard deviation of the average RR interval(SDANN),the average standard deviation of RR interval(SDNNindex),root mean square of RR interval difference(rMSSD),the percentage of total number of adjacent RR intervals＞50ms to total heart rate(pNN50),end diastolic interventricular septal thickness(IVSd),left ventricular posterior wall diastolic thickness(LVPWD),stroke volume(SV),and cardiac output(CO)were significantly lower than those in survival group(P＜0.05).Cox regression analysis showed that age,combined hypertension,NYHA cardiac function grade,ventricular arrhythmia,GLS,SDNN,SDANN,SDNNindex,rMSSD,pNN50,LVEDD,LVESD and BNP were risk factors affecting the survival rate of DCM patients with decreased LVEF after treatment,IVSd and LVPWD were protective factors(P＜0.05).Conclusion DCM patients with decreased LVEF had a higher mortality rate,which was affected by multiple factors such as age,hypertension,NYHA cardiac function grade,ventricular arrhythmia,GLS,heart rate variability,LVEDD,LVESD,BNP,IVSd,LVPWD,etc.Targeted intervention should be given early to improve the survival rate of patients after treatment.

OBJECTIVE: Diffuse large B-cell lymphoma (DLBCL) is often associated with bone marrow infiltration, and 2-deoxy-2-(18F) fluorodeoxyglucose positron emission tomography/computed tomography ( ¹⁸F-FDG PET/CT) has potential diagnostic significance for bone marrow infiltration in DLBCL. METHODS: A total of 102 patients diagnosed with DLBCL between September 2019 and August 2022 were included. Bone marrow biopsy and ¹⁸F-FDG PET/CT examinations were performed at the time of initial diagnosis. Kappa tests were used to evaluate the agreement of ¹⁸F-FDG PET/CT with the gold standard, and the imaging features of DLBCL bone marrow infiltration on PET/CT were described. RESULTS: The total detection rate of bone marrow infiltration was not significantly different between PET/CT and primary bone marrow biopsy ( P = 0.302) or between the two bone marrow biopsies ( P = 0.826). The sensitivity, specificity, and Youden index of PET/CT for the diagnosis of DLBCL bone marrow infiltration were 0.923 (95% CI, 0.759-0.979), 0.934 (95% CI, 0.855-0.972), and 0.857, respectively. CONCLUSION ¹⁸F-FDG PET/CT has a comparable efficiency in the diagnosis of DLBCL bone marrow infiltration. PET/CT-guided bone marrow biopsy can reduce the misdiagnosis of DLBCL bone marrow infiltration.
Humans ; Positron Emission Tomography Computed Tomography/methods* ; Fluorodeoxyglucose F18 ; Bone Marrow/pathology* ; Retrospective Studies ; Positron-Emission Tomography/methods* ; Lymphoma, Large B-Cell, Diffuse/pathology*

We reported the discovery of six novel coumarins, toddasirins A-F (1-6), each endowed with modified isoprenyl or geranyl side chains, derived from the roots of Toddalia asiatica. Comprehensive structural elucidation was achieved through multispectroscopic analyses, single-crystal X-ray diffraction experiments, and advanced quantum mechanical electronic circular dichroism (ECD) calculations. Furthermore, the anti-inflammatory activity of these compounds was assessed. Notably, compounds 1-3 and 6 demonstrated notable inhibitory effects on nitric oxide (NO) production in lipopolysaccharide (LPS)-induced RAW 264.7 cells, with 50% inhibitory concentration (IC₅₀) values of 3.22, 4.78, 8.90, and 4.31 μmol·L^-1, respectively.
Mice ; Animals ; Coumarins/chemistry* ; Rutaceae/chemistry* ; Anti-Inflammatory Agents/pharmacology* ; Plant Extracts/chemistry* ; RAW 264.7 Cells ; Nitric Oxide ; Molecular Structure

Drug discrimination is a behavioral pharmacological technique to study the discriminative stimulus effects of drug. Currently drug discrimination has been widely used in preclinical drug development of CNS drugs, the most extensive of which is psychodependent research in the field of drug abuse. This review describes in general the basic principles of drug discrimination, preliminarily elaborates on the relevant characteristics and applications of the subjective effects, time-course effect, stereo specificity, individual differences, and receptor mechanisms, and its development prospects for hallucinogens and cannabis drugs are also presented.

Aim To prepare prostate cancer exosomes containing melittin and observe their uptake by prostate cancer cells. Methods Cells treated with starvation for different time were screened for exosome extraction. Exosomes from PC-3 cells were extracted by ultracentrifugation, and the extracted particles were examined by transmission electron microscopy, nanoparticle tracking analyzer(NTA), and Western blot. Melittin exosome system was prepared by repeated freeze-thaw method, incubation at room temperature as well as electroporation, and the size of encapsulation efficiency was measured by centrifugation. A high-performance liquid chromatography(HPLC)method was applied to assay the content of melittin exosomes(exo-mel). Fluorescence inverted microscopy was employed to evaluate the uptake of melittin exosomes by PC-3 cells, DU145 cells as well as LNCaP cells. Results The results of starvation treatment showed that 24 h starvation treatment was the optimal time point. TEM results showed that the exosomes were round or oval in shape with a distinct membranous structure, and the diameter was around 100 nm. The reagent protein concentration for NTA analysis of exosomes was 0.222 g·L-1. The results of Western blot for the marker proteins of exosomes showed that Alix and CD63 were positively expressed, which indicated that the exosomes could be obtained by starvation culture of PC-3 cells and ultracentrifugation. The results of entrapment efficiency showed that the entrapment efficiency of electroporation method was 17.51% ± 2.39%, that of repeated freeze-thaw method was 11.46% ± 1.02%, and that of room temperature incubation method was 3.93% ± 2.44%. The encapsulation efficiency of electroporation was the highest with significant difference(P<0.05). The uptake assay showed that PC-3 cells could efficiently take up exo-mel in a time-dependent manner, and DU145 cells and LNCaP cells also could take up exo-mel over time. Conclusions Exosomes can be accessed by starvation treatment and high-speed centrifugation, and the prostate cancer melittin exosome system prepared by electroporation method could be taken up by prostate cancer cells.

Objective To evaluate the effect of virtual reality(VR)on alleviation of fatigue in patients undergoing chemotherapy for non-small cell cancer so as to enhance the quality of life of the patients.Methods This study was conducted with a quasi-randomised controlled trial.Sixty patients with non-small cell cancer treated under initial chemotherapy in a general hospital in Shanghai were enrolled in the study between January 2020 and January 2021.The patients in Ward-Ⅰ were assigned as the control group and those in Ward-Ⅱ as the trial group,with 30 patients per group.The patients in control group was treated with routine nursing strategy and those in the trial group with VR intervention in addition to routine nursing.An interactive immersion with six 3-D switching relaxation-oriented scenes was introduced in the VR intervention including travel,starry sky,four seasons,globe,parks and ocean world.Patients received a 20-minute VR intervention before chemotherapy at two times per week during the intermittent periods of chemotherapy.The revised piper fatigue scale in Chinese version(RPFS-CV)was used to assess the patients on admission and early,middle and late phases referring the third,fifth and seventh courses of the chemotherapy,respectively.Scores of the assessments were compared between the groups.Results All of the 60 patients had smoothly completed the 7 courses of chemotherapy.With repeated measures analysis of variance,the differences were found to be statistically significant in the scores of RPFS-CV,time,and interaction across different time points(all P<0.001).The scores of RPFS-CV taken at the fifth and seventh courses of chemotherapy in the trial group were significantly lower than that of the control group(P<0.001).There were no significant differences in the scores of RPFS-CV within the control group at the fifth and seventh courses of chemotherapy,but the differences were statistically significant in the other courses of chemotherapy(P<0.008 or P<0.001),showing a trend that the later the treatment course,the higher the score of RPFS-CV would be,and ultimately it went steady.In the trial group,there was no significant difference between the third course of chemotherapy and the fifth and seventh courses,as well as between the fifth and seventh courses(P>0.05);but the score taken before the chemotherapy was significantly lower as compared to those taken at the third,fifth and seventh courses(all P<0.001).Conclusion VR intervention with deep relaxation immersive interactive experience could inhibit fatigue by activating the hypothalamic-pituitary-adrenal axis and facilitating the secretion of cortisol via enhancing visual stimulation,thus alleviating cancer fatigue in patients undergoing chemotherapy for non-small cell cancer.