Objective: To investigate the association between the physical fitness index (PFI) and symptoms of depressive, anxiety and stress symptoms among college students, providing a reference for mental health interventions. Methods: From June to September 2025, combined convenience and cluster random sampling approach was used to administer questionnaire surveys and perform physical fitness tests on 2 712 college students from Zhejiang Chinese Medical University. The Depression Anxiety Stress Scales-21 Items (DASS-21) was used to assess mental health status. Chi square test and multivariate Logistic regression analysis were used to determine the associations between the PFI and the PFI component indicators with depressive, anxiety and stress symptoms. Results: The prevalence of depressive, anxiety and stress among college students were 24.26%, 33.22% and 13.68%, respectively. Statistically significant differences in the prevalence of these symptoms were detected across groups differing in sleep quality, physical activity, weekly breakfast frequency, and history of low back or neck pain ( χ 2=9.33-151.83, all P <0.05). After adjusting for confounding factors, Logistic regression revealed that the moderate and high PFI groups had significantly reduced risks of depressive and anxiety compared to the low PFI group ( OR =0.73, 0.63; 0.61, 0.72, all P <0.05). Poor speed (50 m run) and lower body strength (standing long jump) emerged as common risk factors affecting anxiety and depressive symptoms in both male and female college students (all P <0.05). Increased muscle strength (sit up for 1 min) in female students reduced the risk of depressive ( OR =0.81), anxiety ( OR =0.85), and stress symptoms ( OR =0.79) (all P <0.05). Enhanced lung capacity in male students decreased the risk of depressive ( OR =0.84) and anxiety symptoms ( OR =0.85) (both P <0.05). Conclusions The PFI is negatively correlated with depressive and anxiety symptoms among college students with notable gender differences. Insufficient speed and lower body explosive power represent common risk factors for mental health among male and female college students.

Objective To explore the clinical value of laparoscopic radical cystectomy based on fascia anatomy for bladder cancer treatment.Methods The clinical data of 51 patients with bladder cancer who underwent 3D laparoscopic radical cystectomy during Jan.2015 and Jun.2022 were retrospectively analyzed.The surgery was performed based on membrane anatomy technology along four longitudinal and two transverse planes to complete the radical cystectomy.The pelvic plexus was preserved for patients with normal preoperative sexual function.Results All surgeries were completed without conversion to open operation.The mean operation time was(502.52±108.99)min,mean intraoperative blood loss was(275.96±155.18)mL,mean postoperative drainage time was(4.14±2.41)d,and the mean postoperative hospital stay was(16.37±4.85)d.The mean number of lymph nodes removed was(17.98±11.48).The mean postoperative follow-up was(30.27±19.39)months.At the last follow-up,no Clavien ≥grade 3 complications were observed.The estimated overall survival(OS),tumor-specific survival(TSS),and recurrence-free survival(RFS)were 82.4％,92.2％,and 88.2％,respectively.The lymph node positive patients had shorter OS and RFS(60.0％,60.0％)than the lymph node negative patients(84.8％,91.3％).Among the 19 male patients who underwent radical cystectomy with pre-exposure and preservation of pelvic plexus,daytime and nocturnal continence rate were 83.3％and 72.2％,respectively,and 17 patients recovered potency within 6 months postoperatively.Conclusion Laparoscopic radical cystectomy based on fascia anatomy is safe and effective in laparoscopic radical cystectomy,with standardized surgical procedure,satisfactory oncological outcomes,little hemorrhage,few complications and fast recovery.

Objective To explore the clinical features,treatment and prognosis of glioblastomas(GBM)in adults.Methods A retrospective cohort study was performed on 176 adult GBM patients admitted to our department from January 2015 to December 2021.Chi-square test was used to investigate the clinical differences between isocitrate dehydrogenase(IDH)mutant and wild-type GBM.Kaplan-Meier and Log-Rank tests were employed to plot survival curve and compute the survival analysis.Multivariate Cox regression model was applied to identify the independent prognostic factors.Results IDH wild-type GBM account for 89.2％and had significantly differences from the IDH-mutant GBM in terms of age of onset,Karnofsky(KPS)score at admission,symptoms of neurological deficit,and methylation status of O6-methylguanine-DNA-methyltransferase(MGMT)promoter(P＜0.05).For the IDH wild-type GBM patients receiving conventional therapy,univariate Cox hazard analysis showed gross total resection,methylation of MGMT promoter,initiation of radiation within the 5th to 6th week after surgery,and adjuvant temozolomide(TMZ)chemotherapy ≥6 cycles were favorable prognostic factors for overall survival(OS);GBMs in the left hemisphere,involvement of single lobe,methylation of MGMT promoter,and initiation of radiation within the 5th to 6th week after surgery were favorable prognostic factors for progression free survival(PFS)(all P＜0.05).Moreover,multivariate Cox hazard regression analysis indicated that methylation of MGMT promoter,and initiation of radiation within the 5th to 6th week after surgery,and adjuvant TMZ chemotherapy ≥6 cycles were independent protective factors for OS,and GBMs in the left hemisphere,involvement of single lobe and methylation of MGMT promoter were independent protective factors for PFS in the GBM patients(all P＜0.05).Conclusion The clinical and prognostic features are totally different between IDH mutant and wild-type GBM,and molecular detections are needed for the further pathological classification.Methylation of MGMT promoter is a primary marker of favorite prognosis for IDH wild-type GBM,and slightly delay in radiotherapy(the 5th to 6th week after surgery)can effectively improve the survival prognosis of IDH wild-type GBM.

Objective:To investigate the efficacy of a trauma-integrated treatment program for severe traumatic brain injury and its effect on patients' coagulation and neurological functions.Methods:A total of 114 patients with severe traumatic brain injury who received treatment at the Department of Trauma Surgery at the Jinhua Municipal Central Hospital from April 2020 to October 2022 were retrospectively included in this study. The patients were divided into two groups based on different treatment protocols: Group A ( n = 57 patients) received the conventional emergency treatment protocol, while Group B ( n = 57 patients) received the trauma-integrated treatment protocol. The emergency treatment efficiency (including emergency room stay time, waiting time for auxiliary examinations, waiting time for multidisciplinary consultations, and time from emergency to surgery), coagulation function (prothrombin time, thrombin time, activated partial thromboplastin time), neurological function (National Institutes of Health Stroke Scale), incidence of complications (stress ulcers, pulmonary infections, hypernatremia, and cerebral salt-wasting syndrome), and prognosis were compared between the two groups. Results:The emergency room stay time, waiting time for auxiliary examinations, waiting time for multidisciplinary consultations, and time from emergency to surgery in Group B [(21.94 ± 6.21) minutes, (5.78 ± 1.12) minutes, (10.58 ± 2.47) minutes, and (8.57 ± 2.01) minutes] were significantly shorter than those in Group A [(32.59 ± 6.83) minutes, (9.46 ± 2.57) minutes, (17.36 ± 3.71) minutes, (15.36 ± 4.49) minutes, t = 8.71, 9.91, 11.48, 10.42, all P < 0.001]. After treatment, the prothrombin time, thrombin time, and activated partial thromboplastin time in Group B [(19.78 ± 2.32) seconds, (21.16 ± 2.60) seconds, (39.35 ± 4.60) seconds] were significantly shorter than those in Group A [(21.83 ± 2.63) seconds, (23.28 ± 2.95) seconds, (42.16 ± 5.52) seconds, t = 4.41, P < 0.001, t = 4.07, P < 0.001, t = 2.95, P = 0.002]. The National Institutes of Health Stroke Scale score after treatment in Group B [(13.55 ± 3.17) points] was significantly lower than that in Group A [(18.36 ± 3.83) points, t = 7.30, P < 0.001]. The incidence of complications in Group B [7.02% (4/57)] was significantly lower than that in Group A [22.81% (13/57), χ2 = 5.60, P = 0.018]. The rate of good prognosis in Group B [66.67% (38/57)] was significantly higher than that in Group A [47.37% (27/57), χ2 = 4.33, P = 0.037]. Conclusion:The trauma-integrated treatment protocol is effective for severe traumatic brain injury, as it improves emergency treatment efficiency, enhances coagulation and neurological functions, reduces the incidence of complications, and is beneficial for prognosis.

As a common psychiatric disorder, the etiology and pathogenesis of depression are complex and not yet fully elucidated.The diagnosis of depression mainly depends on the patients’ medical history, clinical symptoms and related examinations.Identification of biomarkers will provide important clues for the specific diagnosis and targeted treatment of depression.In addition to the widely recognized neurotransmitter dysregulation, hypothalamus-pituitary-adrenal axis hyperactivity, neuroplasticity, and neuro-inflammation theory, oxidative stress is also involved in the pathogenesis of depression in multiple ways.Many studies showed that the heat shock protein 70(HSP70)levels will increase in early stage to cope with the stress in patients with depression.However, lower HSP70 levels are often correlated with more severe depressive symptoms.HSP70 may be involved in depression through multiple pathways of oxidative stress, glucocorticoid receptors, neuroinflammation and neuroplasticity.Furthermore, increasing HSP70 expression results in significant improvement in depression-like behavior in animals.Thus, HSP70 possesses potential value as an early warning marker for depression as well as a therapeutic target.

Objective:To explore the feasibility and clinical efficacy of oblique lateral interbody fusion (OLIF) in the treatment of adjacent segment disease (ASDis).Methods:Retrospective analysis was conducted on the data of 31 patients with ASDis treated by OLIF in four medical centers from June 2015 to December 2018. There were 17 males and 14 females. The average age was (65.7±3.4) years (range, 59 to 75 years). 19 cases received single-segment fixed fusion, 11 cases received double-segment fixed fusion and 1 case received three-segment fixed fusion. Original fixed fusion site: 1 case of L 1, 2, 3 cases of L 3, 4, 11 cases of L 4, 5, 4 cases of L 5S 1, 6 cases of L 3-L 5, 5 cases of L 4-S 1, and 1 case of L 3-S 1. The time from the initial fixation and fusion to this admission was 82.5±45.5 months (rang, 24 to 180 months). ASDis occurred at the proximal end of the fixed fusion segment in 28 cases and at the distal end in 3 cases. The types of ASDis: degenerative disc disease in 11 cases, lumbar spinal stenosis in 15 cases, degenerative spondylolisthesis in 2 cases, and degenerative scoliosis in 3 cases. The location of ASDis: 6 cases of L 2, 3, 12 cases of L 3, 4, 6 cases of L 4, 5, 3 cases of L 1-L 3, 1 case of L 2-L 4, and 3 cases of L 1-L 4. At admission, 3 cases of lumbar internal fixation had been removed and 28 cases of internal fixation remained. Stand-alone OLIF was performed in 19 cases, OLIF combined with pedicle screw fixation in 8 cases, and OLIF combined with cortical screw fixation in 4 cases. Visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate the low back pain and lumbar function before operation and at the last follow-up, and the imaging results and complications were observed. Results:All patients were followed up. The follow-up time was 23.6±9.6 months (range, 12 to 60 months). The operation time was 73.8±25.3 mins (range, 40 to 180 min), and the intraoperative blood loss was 86.2±67.4 ml (range, 20 to 310 ml). The average blood loss in each segment was 24.8 ml. During the operation, there were 1 case of segmental vein injury, 7 cases of endplate injury, 2 cases of transient iliopsoas muscle weakness, 1 case of thigh pain and numbness, and 1 case of incomplete intestinal obstruction. There was no incision necrosis and infection. The VAS score of low back pain decreased from 5.9±1.9 before operation to 1.4±0.6 at the last follow-up, with a statistically significant difference ( t=8.47, P<0.001). The ODI index recovered from 45.2%±5.7% before operation to 13.8%±4.7% at the last follow-up, with a statistically significant difference ( t=7.92, P<0.001). The height of intervertebral space increased from 8.7±1.6 mm before operation to 11.4±1.9 mm after operation and 9.9±1.8 mm at the last follow-up. There was a statistically significant difference between postoperative and preoperative height of intervertebral space ( F=4.15, P=0.007). There was a statistically significant difference between the last follow-up and postoperative height of intervertebral space ( P=0.011). During the follow-up, there were 13 cases of fusion cage subsidence, 1 case of fusion cage displacement, and no case of internal fixation loosening or fracture. The intervertebral fusion rate was 94%(29/31) and the complication rate was 42%(13/31). Conclusion:ASDis is a common complication after lumbar fixation and fusion, and requires surgical treatment. OLIF is a reliable method to treat ASDis as it has advantages of small trauma, high fusion rate and low complication rate.

Objective To investigate the effect of microRNA-1180 transfection on the growth of renal cell carcinoma lines 786-O and ACHN.Methods The renal carcinoma cells were divided into the two groups:control group (transfecting dsControl) and experimental group (transfecting miR-1180).The expression change of p21 mRNA was detected by qRT-PCR.Western blot was conducted to analyze the expression changes of p21,CDK4,CDK6 and CyclinD1 proteins.Flow cytometry (FCM) was used to detect the cell cycle change.The MTS assay was conducted to detect the cell viability and the colony forming assay was performed to examine the cell proliferation ability.Results The qRT-PCR results showed that compared with the negative control dsControl group,after miR-1180 transfection,the expression level of·p21 mRNA in 786-O and ACHN cells was up-regulated to 2.54-fold and 2.49-fold respectively(P＜0.01).The expression trend of p21 protein was consistent with qRT-PCR results.The expression of CDK4,CDK6 and CyclinD1 proteins were significantly down-regulated.The FCM results showed that the proportion of cells in G0/ G1 phase was significantly increased after transfection of miR-1180,but the proportion of cells in S phase and G2/M phase was decreased significantly,indicating that the cell cycle was arrested in G0/G1 phase.The MTS assay results showed that compared with the dsControl group,the viability of the two kinds of renal carcinoma cells was significantly decreased.The colony formation assay showed that the number of colonies formed in the miR-1180 group was smaller,indicating the proliferation ability of miR-1180 transfected cells was decreased.Conclusion miR-1180 can significantly activate the p21 protein expression and inhibit the growth of renal carcinoma cell lines 786-O and ACHN.

Objective: To study the effects of microRNA-1180-5p (miR-1180-5p) on malignant biological behaviors of prostate cancer VCAP and LNCaP cells and the possible mechanisms. Methods: dsControl (dsControl group) and miR-1180-5p (miR-1180-5p group) were constructed and then transfected into two prostate cancer cell lines VCAPand LNCaP. qPCR and Western blotting were used to analyze the changes in mRNA and protein expressions of CDKN1A, Cyclin D1 and CDK6 after transfection. Cell cycle distribution, proliferation activity, clone formation capacity, cell migration and invasion ability were detected by flow cytometry, MTT assay, colony culture assay and Transwell assay, respectively. Results: qPCR results showed that compared with dsControl, CDKN1A mRNA levels in VCAP and LNCaP cells transfected with miR-1180-5p were up-regulated significantly, while the mRNA expressions of Cyclin D1 and CDK6 were significantly down-regulated (all P<0.01). Western blotting result was consistent with that of qPCR. The percentage of cells in G0/G1 phase was increased after transfection of miR-1180-5p (P<0.05), but the proportion of cells in S phase and G2/M phase was decreased and the cell cycle was arrested at G0/G1 phase (P<0.05). The proliferation activity of the two prostate cancer cells was significantly lower than that of the dsControl group after miR-1180-5p transfection (P<0.05), and the number of colonies in the miR-1180-5p group was significantly lower than that in the dsControl group (P<0.01). In the meanwhile, the cell migration and invasion ability in miR-1180-5p group was decreased (P<0.01). Conclusion: miR-1180-5p can significantly activate CDKN1A gene expression in prostate cancer cells and further inhibit the proliferation, migration and invasion of prostate cancer cells.

Objective To screen the risk factors for blood coagulation abnormality in patients undergoing off-pump coronary artery bypass grafting (OPCABG).Methods A total of 140 patients undergoing elective OPCABG were included in this study,and combined intravenous-inhalational anesthesia was performed during operation.The patients were divided into normal group and abnormal group according to whether or not blood coagulation abnormality developed during operation and within 48 h after operation.The data such as gender,age,body mass index,American Society of Anesthesiologists physical status,the number of operation per year for surgeons,comorbidities (hypertension and diabetes mellitus),preoperative hematocrit (Hct),left ventricular ejection fraction,arterial oxygen pressure,liver function,operation time and requirement for intraoperative continuous cardiac output monitoring,positive end expiratory pressure,tranexamic acid,ulinastatin and hydroxyethyl starch,postoperative acidosis and hypothermia were recorded.Results Blood coagulation abnormality was found in 43 patients,and the incidence was 31％.The results of logistic regression analysis showed that the number of operation per year for surgeons＜ 50,preoperative abnormal liver function,preoperative Hct＜35％,surgery time≥240 min,no use of continuous cardiac output monitoring during operation and postoperative hypothermia were risk factors for blood coagulation abnormality in patients undergoing OPCABG.Conclusion The number of operation per year for surgeons＜50,preoperative abnormal liver function,preoperative Hct ＜ 35％,operation time ≥ 240 min,no use of continuous cardiac output monitoring during operation and postoperative hypothermia are risk factors for blood coagulation abnormality in patients undergoing OPCABG.

Objective To investigate the effect of exogenous small RNA (dsP21-397) transfection on growth of human renal clear cell carcinoma cell lines A-498 and Caki-1. Methods The dsControl(control group) and dsP21-397(experimental group)were transfected into A-498 and Caki-1,respectively. The expression of p21 mRNA was analyzed by qRT-PCR. The expression of p21 protein,CDK4 and Cyclin D1 proteins were detected by Western blot. The cell cycle distribution was examined by flow cytometry(FCM). MTS assay and colony formation assay were used to analyze cell viability and proliferation ability. Results Compared with dsControl,p21 mRNA levels in A-498 and Caki-1 cells increased to 2.55-fold(P<0.01)and 2.18-fold(P<0.01),respectively,after transfection with dsP21-397. The expression of p21 protein was up-regulated while the expression of CDK4 and CyclinD1 were down-regulated. The percentage of cells in G0/G1 phase significantly increased after transfection of dsP21-397,and the proportion of cells in S phase and G2/M phase significantly decreased. The activity of A-498 and Caki-1 cells significantly decreased and the number of colonies in the dsP21-397 group was significantly lower. Conclusions dsP21-397 can significantly activate p21 protein expression,down-regulate the cell cycle-associated proteins,and inhibit the growth of renal clear cell carcinoma cells.