[摘 要] 目的：探讨Shc SH2结构域结合蛋白1（SHCBP1）基因在结直肠癌（CRC）中的表达及其调控CRC细胞（Caco-2）增殖、迁移和侵袭的机制。方法：将Caco-2细胞分为4个实验组：Con组（空白对照）、sh-NC组（转染阴性对照sh-NC）、sh-SHCBP1组（转染sh-SHCBP1）、sh-SHCBP1 + 740Y-P组（转染sh-SHCBP1后用30 μmol/L PI3K激活剂740Y-P处理1 h）。采用CCK-8法、细胞划痕和Transwell实验检测细胞增殖、迁移和侵袭能力，基于Matrigel进行三维培养实验检测SHCBP1对Caco-2细胞血管生成拟态（VM）形成能力的影响，qRT-PCR检测SHCBP1的mRNA表达情况，WB法检测SHCBP1、VM相关蛋白以及PI3K/AKT/mTOR信号通路相关蛋白的表达。结果：SHCBP1在CRC组织和细胞中呈高表达（P < 0.05）。与Con组和sh-NC组相比，sh-SHCBP1组的SHCBP1的mRNA和蛋白表达水平、细胞增殖活性、划痕修复率、穿膜细胞数和形成的小管数均显著降低（均P < 0.05）；低氧诱导因子1α（HIF-1α）、Ephrin A型受体2（EPHA2）、VEGFA、p-PI3K、p-AKT和p-mTOR蛋白表达水平均显著降低（均P < 0.05）。对比sh-SHCBP1组，sh-SHCBP1 + 740Y-P组的细胞增殖活性、划痕修复率、穿膜细胞数和形成的拟态血管数均显著增加（均P < 0.05）；HIF-1α、EPHA2、VEGFA、p-PI3K、p-AKT和p-mTOR蛋白表达水平均显著增加（均P < 0.05）。结论：SHCBP1在Caco-2细胞中表达显著上调，促进Caco-2细胞的增殖、迁移和侵袭，其机制可能与激活PI3K/AKT/mTOR信号通路促进VM过程有关。

Objective: To investigate the prevalence of undernutrition and its associated factors among left behind and non left behind primary and secondary school students in the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) areas of central and western China, so as to provide evidence for improving the nutritional status of children and adolescents. Methods: A survey was conducted among 123 782 students selected by random cluster sampling method in grades 3-9 from NIPRCES in central (Hebei, Shanxi, Heilongjiang, Jilin, Anhui, Jiangxi, Henan, Hunan, Hubei, and Hainan) and western (Gansu, Guangxi, Inner Mongolia, Ningxia, Tibet, Shaanxi, Guizhou, Sichuan, Xinjiang, the Xinjiang Production and Construction Corps, Yunnan, Qinghai, and Chongqing) China in 2023. Anthropometric measurements and questionnaires were used to assess nutritional and dietary status. The prevalence of undernutrition was compared between left behind and non left behind students by Chi square test, and associated factors were analyzed by three level Logistic mixed effects model. Results: The prevalence of undernutrition was 8.5% (4 326) in left behind students and 8.1% (5 905) in non left behind students. Three level Logistic mixed effect model analysis showed that whether left behind or non left behind, the undernutrition rates of primary and secondary students in western regions were higher than those of students in central regions [ OR (95% CI )=1.72(1.57-1.87),2.25(2.07- 2.43 )]; the undernutrition risk was lower for those whose fathers had a cultural level of high school or above [ OR (95% CI )=0.69(0.62-0.77),0.90(0.82-0.98)] or junior high school [ OR (95% CI )=0.72(0.66-0.79),0.92(0.85-0.99)] compared to those with primary school or below; picky eating or selective eating increased the risk of undernutrition [ OR (95% CI )=2.36(2.07-2.68),2.28(2.04-2.55)], and primary and secondary school students without nutritional content in health education classes had higher rates of undernutrition [ OR (95% CI )=1.12(1.03-1.23),1.09(1.01-1.17)](all P <0.05). Conclusion The prevalence of undernutrition is slightly higher in left behind primary and secondary students than in non left behind primary and secondary students in central and western NIPRCES areas, with variations across different characteristics.

OBJECTIVE Healthcare-associated infection(HAI)surveillance is a crucial tool for healthcare manage-ment and public health prevention,the World Health Organization(WHO)released simplified technical guidelines of HAI surveillance to enhance the HAI surveillance in areas with limited medical resources.This study explores the applicability and implementation pathways of the WHO's simplified standards for HAI surveillance in China.METHODS This study used text analysis and qualitative interviews to compare the differences of HAI sur-veillance criteria between China and WHO.Interviews were conducted with professionals of infection prevention and control(IPC)to explore the opportunities and challenges of implementing WHO simplified standards in China.RESULTS Twenty-two IPC professionals with long-term experiences participated in the interviews.Main themes derived from the interview were:WHO simplified standards could enhance the sensitivity of HAI surveil-lance,this approach provided insights for a risk early warning surveillance and improved surveillance in primary healthcare institutions.It also increased the international comparability of Chinese HAI surveillance results.How-ever,the implementation of the WHO simplified standards required further pilot validation,higher levels of infor-matic surveillance and clinical diagnostic capabilities.CONCLUSION This study explores the feasibility and accept-ability of the WHO's simplified HAI surveillance in China,provides references for the transformation of China's HAI surveillance models and systems.

Objective: To understand the prevalence and related factors of depressive symptoms among primary and secondary school students in the in depth monitoring counties of China s Rural Compulsory Education Nutrition Improvement Program, so as to provide a basis for prevention and psychological intervention of depressive symptoms among children and adolescents in rural areas. Methods: In November 2022, a stratified random sampling method was adopted to collect height and weight data, basic personal and family information of 7 949 primary and secondary school students from grade three to grade nine through physical measurements and questionnaires in 56 key monitoring schools implementing the Student Nutrition Improvement Program in 7 in depth monitoring counties (Jalaid Banner in Inner Mongolia, Jinzhai County in Anhui, Mao Xian in Sichuan, Tiandeng County in Guangxi, Mian County in Shaanxi, Zhaozhou County in Heilongjiang and Youxi County in Fujian), and to obtain the information related to their depressive symptoms through the self assessment questionnaire on depression. Multivariate Logistic regression analysis was conducted to analyze the prevalence of depressive symptoms among primary and secondary school students, as well as their related factors. Results: The detection rate of depressive symptoms among primary and secondary school students in the in depth monitored counties was 23.5%. Logistic regression analysis showed that the probability of detecting depressive symptoms was higher among female students, middle school students, students whose video screen duration per day was >2 h, and students whose parents marital status was divorced or widowed ( OR =1.40, 1.64, 1.60, 1.24), and students whose sleep duration reached the recommended standard, whose parents usually accompanied them daily for time was 60-<120 min and ≥120 min, and students whose mothers literacy level was middle school graduation had lower probability of detecting depressive symptoms ( OR =0.85, 0.84, 0.71, 0.76) ( P < 0.05 ). Conclusion The detection rate of depressive symptoms among students in the in depth monitoring area is high, and targeted interventions need to be developed for students to reduce the risk of mental health problems.

Objective: To analyze the features of unhealthy lifestyle patterns among primary and secondary school students in the nutrition improvement program for rural compulsory education students (NIPRCES) areas in China in 2021 and 2023, so as to provide data support for lifestyle promotion and healthy development among primary and secondary school students. Methods: Adopting a cluster random sampling method, data on primary and secondary students aged 7-15 years from nutrition and health surveillance of China NIPRCES in 2021 and 2023 were collected. The prevalence of unhealthy lifestyles among primary and secondary students such as physical inactivity, outdoor inactivity, excessive screen time, and sleep deprivation by gender, school section, urban/rural, and region were analyzed. The reporting rates of the above indicators among primary and secondary students were compared by Chi-square test. Results: In 2021 and 2023, the rates of moderate to vigorous physical inactivity among primary and secondary school students were 79.2% and 80.4%, the rates of outdoor inactivity were 42.8% and 49.3%, the rates of excessive video time were 2.6% and 2.9%, the rates of sleep deprivation were 32.9% and 22.6%, and the differences were statistically significant( χ 2=51.86,1 071.48,18.36,3 296.99, P <0.05). In 2023, the rate of outdoor inactivity for primary and secondary students increased by 6.5 percentage points compared with 2021, and the rate of sleep deprivation decreased by 10.3 percentage points compared with that in 2021. In 2021 and 2023, the reporting rates of moderate to vigorous physical inactivity, outdoor inactivity, and sleep deprivation among girls and junior high school students were higher than those among boys ( χ 2=174.41,180.11; 175.75, 85.46 ;92.22,151.35) and elementary school students ( χ 2=136.64,5.75; 40.55,4.71;162.80,3 291.61); the reporting rates of moderate to vigorous physical inactivity( χ 2=194.43,118.60) and sleep deprivation ( χ 2=969.66,983.72) among urban students were higher than those among rural students; the reporting rates of excessive video time for boys and junior high school students were higher than those for girls ( χ 2=103.62,84.85) and elementary school students ( χ 2=810.09,626.51)( P <0.05). From a regional distribution perspective, the reporting rates of moderato to vigorous physical inactivity, outdoor inactivity, and excessive video time among primary and seconday school students in the central and western regions were lower than those in the eastern region ( χ 2= 663.44,302.78; 356.97,82.10;50.89,81.83) ( P <0.05). Conclusions Unhealthy lifestyles remain prevalent among primary and secondary students in NIPRCES areas of China. These findings underscore the need to strengthen policy implementation for promoting healthy lifestyles among primary and secondary school students.

Objective: To develop a modified calculation formula for renal tumor volume and tumor contact surface area (CSA) based on the modeling results of 3D Slicer software, and to create a webpage of the calculation formula for use. Methods: The general information and tumor anatomical data of 98 patients who underwent partial nephrectomy during Jan.2021 and Jul.2023 in the Second Affiliated Hospital of Xi'an Jiaotong University were retrospectively analyzed.The imaging data were input into 3D Slicer software in the form of Dicom files for tumor and ipsilateral kidney modeling to obtain tumor anatomical data.The relationship between tumor anatomical parameters and tumor volume and CSA was analyzed using multifactorial linear regression.The initial modified formulas (V2, C2) and the optimized modified formulas (V3, C3) for tumor volume over CSA were established, respectively, after insignificant variables were eliminated.The mean square error (MSE) and Akaike information criterion (AIC) of the modified and traditional formulas (V1, C1) were compared, and the formula with the smallest MSE and AIC was selected as the optimal tumor volume and CSA calculation formula.The median tumor volume and CSA obtained from 3D modeling were used as the cutoff values.The optimal formula and conventional formula were applied to calculate tumor volume and CSA for all patients, and risk stratification was performed for all patients based on these cutoff values, and the perioperative indicators of patients in the upper and lower groups were compared.Finally, an online calculation tool was developed based on HTML. Results: Based on multifactorial linear regression analysis, we obtained the modified tumor volume calculation formula: V=0.382abc+2.488a+2.372b－4.146c+1.948（V2）, V=0.469abc－4.586c+13.816（V3）; the modified tumor CSA calculation formula CSA=2.469a －2.262L －19.23a+6.206b+1.212c+18.017L+1.616h－3.97h －2.185h/h －0.388（C2）, CSA=2.376a －2.144L －20.157a+5.024b+1.128c+17.578L+2.525h－2.634（C3）.Both of the modified volume formula (MSE=151.298 vs. 127.807 vs. 104.106) and modified CSA formula (MSE=309.878 vs.23.556 vs.30.388) had smaller errors compared to the conventional formula.The modified volume calculation formula showed that bleeding was more and thermal ischemia time was longer in patients with larger tumor volumes than in patients with smaller tumor volumes (P<0.05); and the modified CSA calculation formula showed that bleeding was more, surgery and thermal ischemia time were longer in patients with high CSA than in patients with low CSA (P＜0.05).Finally, V3 and C3 are selected as the best calculation formula, and a web page (https://lizihao-bot.github.io/RCC-Calculate/) was established for easy use. Conclusion: This study combined data from a medical information technology platform with numerical modeling methods to provide a faster and more accurate method to calculate the renal tumor volume and CSA.Meanwhile, a webpage version of the tool was developed to enhance its practicability.

OBJECTIVE Healthcare-associated infection(HAI)surveillance is a crucial tool for healthcare manage-ment and public health prevention,the World Health Organization(WHO)released simplified technical guidelines of HAI surveillance to enhance the HAI surveillance in areas with limited medical resources.This study explores the applicability and implementation pathways of the WHO's simplified standards for HAI surveillance in China.METHODS This study used text analysis and qualitative interviews to compare the differences of HAI sur-veillance criteria between China and WHO.Interviews were conducted with professionals of infection prevention and control(IPC)to explore the opportunities and challenges of implementing WHO simplified standards in China.RESULTS Twenty-two IPC professionals with long-term experiences participated in the interviews.Main themes derived from the interview were:WHO simplified standards could enhance the sensitivity of HAI surveil-lance,this approach provided insights for a risk early warning surveillance and improved surveillance in primary healthcare institutions.It also increased the international comparability of Chinese HAI surveillance results.How-ever,the implementation of the WHO simplified standards required further pilot validation,higher levels of infor-matic surveillance and clinical diagnostic capabilities.CONCLUSION This study explores the feasibility and accept-ability of the WHO's simplified HAI surveillance in China,provides references for the transformation of China's HAI surveillance models and systems.

[Objective] To investigate the clinical application of microscope-assisted subinguinal hierarchical dissection in the treatment of varicocele (VC), so as to provide reference for clinicians. [Methods] The clinical data of 113 VC patients admitted to our hospital during Jul.2021 and Jun.2022 were retrospectively analyzed.All patients were treated with microscope-assisted hierarchical anatomical spermatic vein ligation under the external ring, with layered isolation.The number of intraoperative ligations of the internal spermatic veins and external spermatic vein, preserved arteries as well as the number of lymphatic vessels were recorded. [Results] Among the 13 patients with a mean age of (28.7±6.0) years, 98 had left-side lesion and 15 had bilateral lesion.The degree of varicocele: degree Ⅱ in 44 cases and degree Ⅲ in 69 cases.Intraoperative ligation of the internal spermatic veins: (9.18±3.21) on the left side and (9.02±3.39) on the right side.Intraoperative ligation of the external spermatic veins: (1.47±0.93) on the left side and (1.41±1.10) on the right side.Preservation of the internal spermatic arteries: (2.03±1.07) on the left side, (1.97±0.99) on the right side.Preservation of the external spermatic arteries: (1.42±0.50) on the left side and (1.40±0.50) on the right side.Preservation of lymphatics: (3.87±2.07) on the left and (3.89±1.99) on the right. [Conclusion] Hierarchical dissection ensures the integrity of the vas deferens and its vascular system, and tubular isolation aids in intraoperative reference identification, avoid omission of tiny veins and injury to lymphatic vessels, which helps to improve the surgical skills of beginners or less experienced surgeons.

OBJECTIVE To identify the key genes associated with lymph node metastasis in head and neck squamous carcinoma(HNSCC)and construct a prognostic model based on The Cancer Genome Atlas(TCGA)database.METHODS Differentially expressed genes(DEGs)between tumor tissues and normal tissues in the HNSCC dataset in the TCGA database were screened by R software,and gene modules related to lymph node metastasis were screened by weighted gene co-expression network(weighted gene co-expression network analysis,WGCNA).Prognostic risk models were constructed by univariate cox regression and Lasso regression analyses.Survival analyses and ROC curves were performed to verify the Reliability of prognostic models.CIBERSORT,TIMER and ESTIMATE algorithms analysed the differences in the tumor micro environment(TME)of different risk groups.RESULTS There were 2 565 DEGs screened,and a set of gene modules highly correlated with disease prognosis and lymph node metastasis were obtained by WGCNA analysis,and correlation analysis verified that the expression of genes in this gene module was highly correlated with lymph node metastasis.Univariate cox regression and Lasso regression were used to identify 6 key prognostic genes:CDKN2A,CCNE2,KNSTRN,AURKA,KPNA2,and ORC1.A prognostic model was constructed based on the 6 genes,and survival analysis showed that the prognosis of the high-risk group was significantly worse than that of the low-risk group(P<0.0001).The ROC curves demonstrated the good predictive performance of this prognostic model.CIBERSORT analyses revealed differences in the immune microenvironment of tumors in different risk groups.CONCLUSION The 6 key prognostic genes screened were helpful in predicting the prognosis of HNSCC patients and were closely associated with the immune microenvironment of HNSCC,suggesting that they may serve as potential therapeutic targets.

[摘 要] 目的：探索RAD18影响结直肠癌细胞增殖及调节NK细胞对结直肠细胞的杀伤作用及其可能的机制。方法：采用生物信息学技术分析结直肠癌组织中RAD18和miR-145-5p的表达及两者之间的调控关系、分析RAD18富集通路。采用qPCR法验证RAD18和miR-145-5p在结直肠癌细胞中的表达，双荧光素酶报告基因实验验证miR-145-5p与RAD18的调控关系。按转染物的不同将SW480、HCT-15细胞分为将si-RAD18组、si-NC组，另向SW480细胞分别转染inhibitor-NC+si-NC、miR-145-5p inhibitor+si-NC或miR-145-5p inhibitor+si-RAD18，采用CCK-8法、克隆形成实验分别检测敲降miR-145-5p和/或RAD18对细胞增殖、克隆形成的影响；将各组细胞分别与经IL-2激活的NK92细胞共培养，采用乳酸脱氢酶释放法、ELISA和免疫荧光染色法分别检测NK细胞的细胞毒性、细胞因子分泌及细胞表面穿孔素和颗粒酶B表达的影响。结果：RAD18在结直肠癌组织和细胞中呈高表达（均P<0.01）。敲降RAD18可以抑制结直肠癌细胞增殖能力（P<0.05）和促进NK细胞活力、细胞毒性、IFN-γ、TNF-α、GM-CSF分泌及穿孔素和颗粒酶B的表达（均P<0.05）。双荧光素酶报告实验验证了RAD18-3’UTR与miR-145-5p的结合关系，miR-145-5p在结直肠癌组织和细胞中低表达（P<0.05或P<0.01）。miR-145-5p可以靶向下调RAD18的表达（P<0.05），过表达RAD18可以逆转miR-145-5p过表达对NK细胞杀伤效应的促进作用（均P<0.05）。结论：miR-145-5p可靶向下调RAD18的表达，miR-145-5p/RAD18轴能够影响结直肠癌细胞的增殖和NK细胞对其的细胞毒作用。