Objective: To explore the association of vegetables and fruits intake with depressive symptoms among multi ethnic first year junior high school students in Yunnan Province, so as to provide data support for preventing and reducing depressive symptoms among first year junior high school students. Methods: From October to December 2022, a cluster random sampling method was used to select 8 500 first year junior high school students from 11 ethnic minority areas in Yunnan Province (Fugong County, Longling County, Longyang District, Luchun County, Mojiang County, Nanjian County, Qiaojia County, Shuangjiang County, Tengchong City, Yuanmou County, Zhenyuan County), to investigate with a questionnaire. The Dietary Frequency Questionnaire was used to collect dietary behavior datas, and the Chinese version of Depression Anxiety Stress Scale-21 (DASS-21) was used to assess depressive symptoms. The generalized linear model was used to analyze the association of vegetable and fruit intake with depressive symptoms in students, and stratified analysis was performed according to ethnicity. Results: The detection rate of depressive symptoms among first year junior high school students in Yunnan Province was 29.5%. The detection rates of depressive symptoms in Han and minority first year junior high school students were 26.9% and 31.6%. After controlling for demographic variables such as gender, age, family residence and other confounding factors, the generalized linear model analysis results showed that the intake of leafy vegetables ( β= -0.07 , 95%CI =-0.12 to -0.01), flat fruits ( β=-0.06, 95%CI =-0.12 to -0.00) and hot natured fruits ( β=0.11, 95%CI = 0.04- 0.17) were associated with depressive symptoms in Han first year junior high school students (all P <0.05). The intake of melon and fruit vegetables ( β=-0.06, 95%CI =-0.11 to -0.01) and hot natured fruits ( β=0.06, 95%CI =0.01-0.12) were associated with depressive symptoms in ethnic minority first year junior high school students (both P <0.05). Conclusions The intake of vegetables and fruits among multi ethnic first year junior high school students in Yunnan Province is related to the risk of depressive symptoms. It is suggested to strengthen the consumption guidance and education of vegetables and fruits to prevent depressive symptoms among first year junior high school students.

Objective:To explore the lived experiences of family members of terminal ICU patients regarding their humanistic care needs and provide theoretical foundations for developing nursing care plans tailored to their needs.Methods:This study was a descriptive qualitative study. From April to December 2023, 16 family members of terminally ill ICU patients in Shanghai East Hospital, Tongji University were selected for semi-structured interviews using purposive sampling method, and the interview data were qualitatively analyzed using Colaizzi 7-step analysis.Results:The humanistic care needs of family members of terminally ill ICU patients can be categorized into five themes, namely, the need to know the condition at the first time; the need to participate in treatment and decision-making; the need to respect the wishes of terminally ill patients; the need for psychological care; and the need for social support.Conclusions:The humanistic care needs of family members of terminal ICU patients remain largely unmet. Nursing professionals should consider these needs and preferences and provide family members with professional guidance to help them establish positive coping mechanisms.

Objective:To explore the current status and influencing factors of non-verbal communication needs in mechanically ventilated patients in ICU using an interpretive sequential mixed research design to inform the future development of targeted non-verbal communication strategies for mechanically ventilated patients in the ICU.Methods:Convenience sampling was used to select 262 mechanically ventilated patients from the general ICUs of two Class Ⅲ Grade A hospitals in Shanghai, from January to June 2023 for the study. Patients were surveyed using the General Information Questionnaire and the Surgical ICU Tracheal Intubation Patient Communication Needs Scale. Multiple linear regression was used to analyze the factors influencing the non-verbal communication needs of mechanically ventilated patients in the ICU. A total of 262 questionnaires were distributed in the quantitative study, and 256 valid questionnaires were recovered, with a valid recovery rate of 97.71% (256/262) . Purposive sampling was used to select 16 ICU mechanically ventilated patients for semi-structured in-depth interviews. The information was analyzed using the Colaizzi 7-step analysis method.Results:In 256 mechanically ventilated patients, the total non-verbal communication needs score was (144.33±12.82) , and the items average scores of physiological needs, safety needs, love and belongingness needs, and self-esteem needs were (3.39±1.83) , (3.35±0.98) , (3.32±1.21) , and (3.29±1.32) , respectively. Multiple linear regression analysis showed that the duration of mechanical ventilation, history of intubation, and education level were the factors influencing the non-verbal communication needs of mechanically ventilated patients in the ICU ( P<0.05) . Five themes were distilled from the qualitative study, including communication needs for shared decision-making about disease trajectories, communication needs for accurate management of disease symptoms, communication needs for psychological stress adjustment, communication needs for social system support, and communication needs for dignity preservation. Integrating and analyzing the quantitative and qualitative results revealed that they complemented each other in explaining and validating ideas in elaborating the current status and intrinsic relationship of non-verbal communication needs of mechanically ventilated patients in ICU. Conclusions:The non-verbal communication needs of mechanically ventilated patients in the ICU are prevalent and influenced by a variety of factors. It is recommended that hospital administrators construct an effective non-verbal communication support system based on the status quo of patients' non-verbal communication needs in order to promote the whole process and multidimensional health management services for ICU mechanically ventilated patients and to improve patients' quality of life.

ObjectiveTo analyze the temporal trend of knockdown resistance (kdr) gene mutations highly correlated with pyrethroid resistance in field populations of Aedes aegypti in Jinghong City of Yunnan Province, and to provide a scientific basis for formulating rational insecticide use strategies. MethodsAdult mosquito samples of Aedes aegypti from 2016 to 2023 and larvae mosquito samples from July 2022 to June 2023 were collected in Jinghong City of Yunnan Province. Allele specific PCR (AS-PCR) was used to measure kdr mutations at amino acid positions 989, 1016 and 1534 of the voltage-gated sodium ion channel (VGSC) gene. Data such as mutation rate and mutation allele frequency were calculated, SPSS software was used to perform trend chi square tests on mutation rate and mutation allele frequency with year and month, as well as comparison of mutation allele frequencies and genotype distributions between the dry and rainy seasons, thereby delineating the temporal trend of kdr gene mutations. ResultsAmong the 173 samples collected from 2016 to 2023, the mutation rates of S989P and V1016G were 100.00% for each year, while the mutation rate of F1534C ranged from 62.50% to 100.00%. The mutation rate and mutation allele frequency of F1534C were increased over the years (χ²=22.079, P<0.001; χ²=42.971, P<0.001). Concurrently, the proportion of the PPGGCC genotype was increased annually (χ²=60.790, P<0.001). Among the 288 samples collected from July 2022 to June 2023, the monthly mutation rates for S989P, V1016G, and F1534C were consistently 100.00%. There was only one type of mutation present, namely S989P+V1016G+F1534C. In the combinations of the three genotypes, the SPGGCC genotype accounted for 1.39% (4/288), the PPGGFC accounted for 2.78% (8/288), and the PPGGCC had the highest proportion at 95.83% (276/288). After tesiting the samples collected in August 2023, the mutation rates of 989, 1016 and 1534 sites of VGSC in females, males, and larvae of the same generation were all 100.00%. ConclusionSince 2016, the gene mutations at S989P and V1016G loci in the VGSC gene of wild Aedes aegypti in Jinghong City have remained consistently at 100.00%, while the mutation rate and mutant allele frequency of F1534C have increased year by year during the testing period. By 2023, the mutation rates at three loci in the VGSC gene of Aedes aegypti in Jinghong City had all reached 100.00%, and neither changes in insect developmental stage nor gender differences during transmission exerted a detectable impact on the mutation rates. In the control of Aedes aegypti in Jinghong City, the use of pyrethroid insecticides should be stopped or reduced, and regular monitoring of kdr genes should be carried out to promptly detect new mutations.

Objective : To explore the therapeutic effect of extracellular vesicles(EVs) of Aspergillus flavus(A. flavus) on A. flavus infection. Methods: The EVs of A. flavus were isolated using ultracentrifugation and detected/identified by nanoparticle tracking analysis(NTA). Quantitative real-time PCR(qRT-PCR) and enzyme-linked immunosorbent assay(ELISA) kits were used to assess the effect of A. flavus EVs on the polarization of bone marrowderived macrophages(BMDMs) and the expression levels of several cytokines,including tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),interleukin-6(IL-6),and interleukin-10(IL-10). The Galleria mellonella(G.mellonella) infection model was constructed. Three concentration groups of A. flavus EVs(0. 2,2,and 20 μg/larvae) were set as the experimental groups,and PBS was used as the control group for the infection model.Meanwhile,three forms of negative control groups were established,including the PBS group,the pierced controlgroup, and the negative control group. The therapeutic effect of A. flavus EVs on A. flavus infection was evaluated by the survival rate of the G. mellonella infection models. Results: The particle size of A. flavus EVs ranged from 20 to550 nm. A. flavus EVs could polarize BMDMs into both M1 and M2 phenotypes and induce the production of cytokines,including TNF-α,IFN-γ,IL-6,and IL-10. The results of the G. mellonella infection model showed that A.flavus EVs could improve the survival rate of G. mellonella after A. flavus infection. Conclusion The EVs produced by A. flavus can promote the expression of both pro-inflammatory and anti-inflammatory cytokines in BMDMs,induce M1 polarization and M2 polarization of BMDMs,and increase the survival rate of G. mellonella after A. flavus infection.

With the popularization of 5G communication technology and the continuous upgrade of robot-assisted surgery system,telesurgery has developed rapidly.However,there are few of reports about this technique in single-port laparoscopic gynecological surgery.On April 19,2024,the surgeons at the Second Affiliated Hospital of Naval Medical University in Shanghai successfully implemented robot-assisted single-port laparoscopic bilateral adnexectomy for a patient who was admitted to the Naval Hospital of the Eastern Theater Command in Zhoushan,Zhejiang Province through 5G communication technology.The operation time was 90 min,intraoperative bleeding was 20 ml,and no intraoperative complications occurred.There were no adverse events caused by robots such as robot system failure and instrument failure,or adverse events caused by remote communication such as network interruption and network attack.Intraoperative user datagram protocol(UDP)real-time monitoring data showed an average delay of 108 ms(range,105-111 ms)and a packet loss rate of 0.04%.The surgeons had a slight sense of delay when the operation amplitude was too large.There was no obvious stalling which affected the process of the operation.The patient was able to move around on the first day after surgery,and the catheter was removed.No postoperative complications occurred.The patient was discharged from the hospital on the second day after surgery.Postoperative pathological results revealed left fallopian tube ovarian serous cystadenofibroma,fallopian tubal tissue;right fallopian tube ovarian,sent for examination as ovarian and fallopian tube tissue.There were no complaints of discomfort during reexamination one month after surgery,and the umbilical incision healed well.This case is an attempt of telesurgery in the field of gynecology,and provides experiences for the further development of this technique.

Objective:To explore the lived experiences of family members of terminal ICU patients regarding their humanistic care needs and provide theoretical foundations for developing nursing care plans tailored to their needs.Methods:This study was a descriptive qualitative study. From April to December 2023, 16 family members of terminally ill ICU patients in Shanghai East Hospital, Tongji University were selected for semi-structured interviews using purposive sampling method, and the interview data were qualitatively analyzed using Colaizzi 7-step analysis.Results:The humanistic care needs of family members of terminally ill ICU patients can be categorized into five themes, namely, the need to know the condition at the first time; the need to participate in treatment and decision-making; the need to respect the wishes of terminally ill patients; the need for psychological care; and the need for social support.Conclusions:The humanistic care needs of family members of terminal ICU patients remain largely unmet. Nursing professionals should consider these needs and preferences and provide family members with professional guidance to help them establish positive coping mechanisms.

Objective:To explore the current status and influencing factors of non-verbal communication needs in mechanically ventilated patients in ICU using an interpretive sequential mixed research design to inform the future development of targeted non-verbal communication strategies for mechanically ventilated patients in the ICU.Methods:Convenience sampling was used to select 262 mechanically ventilated patients from the general ICUs of two Class Ⅲ Grade A hospitals in Shanghai, from January to June 2023 for the study. Patients were surveyed using the General Information Questionnaire and the Surgical ICU Tracheal Intubation Patient Communication Needs Scale. Multiple linear regression was used to analyze the factors influencing the non-verbal communication needs of mechanically ventilated patients in the ICU. A total of 262 questionnaires were distributed in the quantitative study, and 256 valid questionnaires were recovered, with a valid recovery rate of 97.71% (256/262) . Purposive sampling was used to select 16 ICU mechanically ventilated patients for semi-structured in-depth interviews. The information was analyzed using the Colaizzi 7-step analysis method.Results:In 256 mechanically ventilated patients, the total non-verbal communication needs score was (144.33±12.82) , and the items average scores of physiological needs, safety needs, love and belongingness needs, and self-esteem needs were (3.39±1.83) , (3.35±0.98) , (3.32±1.21) , and (3.29±1.32) , respectively. Multiple linear regression analysis showed that the duration of mechanical ventilation, history of intubation, and education level were the factors influencing the non-verbal communication needs of mechanically ventilated patients in the ICU ( P<0.05) . Five themes were distilled from the qualitative study, including communication needs for shared decision-making about disease trajectories, communication needs for accurate management of disease symptoms, communication needs for psychological stress adjustment, communication needs for social system support, and communication needs for dignity preservation. Integrating and analyzing the quantitative and qualitative results revealed that they complemented each other in explaining and validating ideas in elaborating the current status and intrinsic relationship of non-verbal communication needs of mechanically ventilated patients in ICU. Conclusions:The non-verbal communication needs of mechanically ventilated patients in the ICU are prevalent and influenced by a variety of factors. It is recommended that hospital administrators construct an effective non-verbal communication support system based on the status quo of patients' non-verbal communication needs in order to promote the whole process and multidimensional health management services for ICU mechanically ventilated patients and to improve patients' quality of life.

Objective To investigate the effect of long non-coding RNA(lncRNA)lung cancer-related transcript 1(LUCAT1)on the pathogenesis of intrauterine adhesion by regulating the expression of amphiregulin(AREG),to provide a new molecular target for the prevention and treatment of intrauterine adhesions.Methods Real-time quantitative polymerase chain reaction(RTqPCR)was used to determine the mRNA expression levels of lncRNA LUCAT1,fibrotic markers of α-smooth muscle actin(α-SMA)and collagen type Ⅰ alpha 1 chain protein(COL1A1)in samples of intrauterine adhesion tissue and endometrial stromal cell treated with transforming growth factor-β1.Western blot was used to determine the protein expression levels of AREG,α-SMA,COL1A1.Then,si-LUCAT1,pcDNA LUCAT1,si-AREG were transfected into ESC and RT-qPCR was used to detect the mRNA expression levels of lncRNA LUC-AT1 and AREG.Next,si-LUCAT1 and pcDNA LUCAT1 were transfected into ESC and treated these cells with TGF-β1 for 48h,re-spectively.Western blot was used to further detect the protein expression levels of AREG,α-SMA and COL1A1,and cell proliferation and apoptosis were detected by cell proliferation assay and cell apoptosis assay.Results The expression levels of lncRNA LUC AT1,AR-EG and fibrosis markers α-SMA and COL1A1 were upregulated in endometrial tissues from patients with intrauterine adhesion and in ESC that had been treated with TGF-β1.AREG changed with the change of lncRNA LUCAT1,and the expression of lncRNA LUC-AT1did not change significantly after downregulation of AREG,and AREG was positively regulated by lncRNA LUCAT1.During the process of the transformation of ESC into fibroblasts,si-LUCAT1 significantly inhibited the protein expression levels of AREG,α-SMA and COL1A1(P＜0.01),significantly reduced cell proliferation and significantly induced cell apoptosis,the difference was statistically significant(P＜0.001).pcDNA LUCAT1 significantly induced the protein expression levels of AREG,α-SMA and COL1A1,and the difference was statistically significant(P＜0.01).Conclusion LncRNA LUCAT1 promotes the pathogenesis of intrauterine adhesion by up-regulating the expression of AREG.LncRNA LUCAT1/AREG axis may provide novel molecular target for the prevention and treat-ment of intrauterine adhesion.

Objective To evaluate the current situation of blood glucose management of inpatients with diabetes mellitus (DM) in non-endocrinological department,and to find the existing problems in blood glucose management. Methods Adults with a diagnosis of DM who were discharged from the First Hospital of Jiaxing from January 1 to December 31,2022 were included. The first page of medical records,doctor's advices,and blood glucose monitoring data were collected. The detection rate of DM patients and the process indexes of blood glucose management were calculated. Population model,individual model and person-day model were used to evaluate the outcome of blood glucose management. The differences between surgical and non-surgical patients in terms of process and outcome indicators were compared. Results A total of 11629 DM patients were included,of which 10620 (91.32％) were distributed in non-endocrinology department. The detection rate of DM patients in non-endocrinological department was 11.83％,the detection rate of glycosylated hemoglobin (HbA1c) was 60.29％,and the detection rate of fasting blood glucose (FBG) was 89.91％. The rate of peripheral blood glucose monitoring was 88.85％,the rate of DM diet prescription was 85.59％,and the rate of endocrinology consultation was 31.21％. The HbA1c detection rate in surgical group was lower than that in non-surgical group,the FBG detection rate and the DM diet prescription rate were higher than those in non-surgical group (P<0.001). There were statistically significant differents in the target range of blood glucose,severe hyperglycemia and hypoglycemia among three models (P<0.001). In both the population model and the person-day model,the target range blood glucose ratio in surgical group was higher than that in non-surgical group,and the incidence of severe hyperglycemia was lower than that in non-surgical group (P<0.001). Conclusion The detection rate of DM in non-endocrinology department is high,and there are differences in blood glucose management quality indexes between surgical and non-surgical patients. It is necessary to carry out blood glucose management in the whole hospital to improve the quality and homogeneity of blood glucose management in non-endocrinology department.