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 analyze serum anti-Müllerian hormone (AMH) level and its influencing factors among female undergoing premarital and preconception examinations, so as to provide the evidence for optimizing reproductive health management measures. Methods: Female who received free premarital and preconception examinations and voluntarily underwent serum AMH testing at Women and Children's Health Center of Gongshu District, Hangzhou City from January 2022 to April 2025 were selected as study subjects. Demographic information and reproductive history were collected through questionnaire survey. Venous blood was collected to detect thyroid-stimulating hormone (TSH), alanine aminotransferase, hemoglobin (Hb), and AMH levels. The original AMH values did not follow a normal distribution, but followed a normal distribution after natural logarithm transformation, recorded as ln (AMH). Pearson correlation analysis was used to analyze the correlation between variables, and multiple linear regression model was used to analyze the influencing factors for ln (AMH) levels among female undergoing premarital and preconception examinations. Results: A total of 1 073 females undergoing premarital and preconception examinations were surveyed, with a mean age of (29.43±3.30) years. There were 959 females without pregnancy (89.38%) and 1 042 females without full-term live birth history (97.11%). The median AMH level was 3.85 (interquartile range, 3.63) ng/mL, and the mean ln (AMH) level was 1.27±0.75. The ln (AMH) levels were higher in females without pregnancy and without full-term live birth history (both P<0.05). The ln (AMH) level was negatively correlated with age (r=-0.260) and TSH (r=-0.093), and positively correlated with Hb (r=-0.260, -0.093, and 0.073, all P<0.05). Multiple linear regression analysis showed that age (β′=-0.253) and TSH (β′=-0.103) were statistically associated with ln (AMH) levels among female undergoing premarital and preconception examinations (both P<0.05). The associations of other variables with ln (AMH) levels were not statistically significant (all P>0.05). Conclusions Age and TSH level are influencing factors for AMH levels among female undergoing premarital and preconception examinations. AMH levels among female undergoing premarital and preconception examinations decrease with increasing age and increasing TSH level.

OBJECTIVE To establish a nomogram model based on clinical and biochemical parameters in elderly patients with p16-negative nasopharyngeal carcinoma and to identify patients who may benefit from concurrent chemoradiotherapy(CCRT)combined with induction chemotherapy(IC).METHODS A total of 142 nasopharyngeal carcinoma patients who received CCRT in Huanggang Central Hospital between June 2021 and May 2024 were retrospectively included for analysis,and the patients were divided into a training set(n=99)and a validation set(n=43)in a ratio of 7:3.Before treatment,all patients underwent a complete physical examination,fiberoptic nasopharyngeal endoscopy,laboratory tests,and plasma Epstein-Barr virus deoxyribonucleic acid(EBV-DNA)level detection.The study endpoint was disease-specific survival(DSS),defined as the time from initial treatment to cancer-related death or the last follow-up date.RESULTS EBV-DNA level,T stage,N stage,albumin(ALB),and lactate dehydrogenase(LDH)were screened by COX and LASSO regression analysis to establish a nomogram model for predicting DSS in nasopharyngeal carcinoma patients.The nomogram model had good discrimination ability[C-index value:0.947(95%CI:0.905-0.990)vs.0.930(95%CI:0.862-0.998)]and accuracy in both the training set and the validation set.The nomogram model was divided into low-risk group,medium-risk group and high-risk group according to risk.There were statistical differences in DSS among the three groups in the training set and validation set(χ2=7.153,9.266,P=0.028,0.010).In the training set and validation set,only the patients in the high-risk group who received IC+CCRT had a longer DSS than those who received CCRT.CONCLUSION The nomogram model of pre-treatment EBV-DNA level,T stage,N stage,ALB,and LDH was used to distinguish high-risk elderly p16-negative nasopharyngeal carcinoma patients,suggesting that this population may be the beneficiary of IC+CCRT in clinical practice.

Objective:Based on gene expression omnibus(GEO),differential expressed genes,gene set enrichment analysis(GSEA)and immune cell infiltration analysis were performed on microarray data of chronic spontaneous urticaria(CSU)expression profile,to gain more insight into the pathogenesis of CSU.Methods:The GSE72541 raw data were obtained from the GEO.Differential expressed genes were screened using R software.String database were used to construct the the protein-protein interaction(PPI)net-work.Gene ontology(GO)and Kyoto encyclopedia of gene and genomes(KEGG)enrichment analysis were performed using GSEA software.The ssGSEA method was used to analyze the infiltration of immune cells in the expression profile.Results:Genes closely related to platelet activation and its function were up-regulated in CSU serum,while genes related to Th1 cell chemotaxis were down-regulated in CSU serum.Biological processes and signal pathways related to coagulation cascade reaction,regulation of vascular per-meability,immune and inflammatory reactions,and mood-modulating were up-regulated in CSU group.Immunized cell infiltration analysis showed that activated B cells,immature B cells,follicular helper T cells,and Th2 cells were down-regulated in the CSU serum.Conclusion:Platelet activation,coagulation cascade reaction and the imbalance of Th1/Th2 immunity play important roles in the pathogenesis of CSU.

OBJECTIVE To study the anti-inflammatory immune response effects of lactoferrin in the treatment of periodontitis and its mechanism. METHODS One hundred SD rats were randomly divided into blank control group, model group, lactoferrin administration group low, medium, high dose group(1, 2, 3 g·kg-1), metronidazole positive control group (0.02 g·kg-1), PDTC group(200 mg·kg-1), lactoferrin+PDTC group(2 g·kg-1, 200 mg·kg-1), MCC950 group(1 mg·kg-1) and lactoferrin+MCC950 group(2 g·kg-1, 1 mg·kg-1), 10 rats in each group. Silk thread ligation combined with 10% sucrose drinking water was used to establish the model, and then the drug was administered orally once a day. The blank control group and the model group were administered orally with 0.9% NaCl. The rats in each group were sacrificed after one month of continuous administration. The contents of IL-1b, IL-8 and IL-10 were detected by ELISA kit, and the expressions of TLR2-NF-κB pathway and NLRP3 inflammasome related proteins were detected by Western blotting. HE staining was used to observe the pathological changes of the periodontal tissues of the rats in each group. RESULTS Compared with the model group, the symptoms of periodontitis in each dose group of lactoferrin were significantly improved. HE staining showed that the infiltration of inflammatory cells was reduced, and the proliferation of fibroblasts was active. The protein expressions of TLR2, NF-κB, NLRP3, Caspase-1 p20 and GSDMD-N decreased, the content of pro-inflammatory factor IL-8 and IL-1b decreased, and the content of anti-inflammatory factor IL-10 increased. CONCLUSION Lactoferrin may play a role in the regulation of inflammatory immune response in the treatment of periodontitis by down-regulating the protein expression of TLR2-NF-κB-NLRP3 pathway, reducing the initiation of inflammatory response and the release of inflammatory factors, so as to achieve the purpose of anti-inflammatory.

Objective:To search, evaluate and summarize the evidence related to the maintenance of peripheral arterial duct flushing systems in children for clinical reference.Methods:Up To Date, BMJ, Nathional Institute for Health and Care Excellence(NICE), Chinese Medlive, Cochrane Library, Joanna Briggs Institute(JBI), CINAHL, METSTR, PubMed, Wanfang, CNKI, VIP were used to collect secondary evidence resources about management and maintenance of peripheral arterial duct flushing systems in children. After the quality evaluation of each type of literature, the evidence was extracted and summarized.Results:A total of 9 articles were included in the research. The 22 pieces of best evidence were obtained from 7 aspects, including basic requirements of children′s peripheral arterial duct flushing systems, arterial flushing method, flushing rate of injection pump system, flushing pressure of pressurized bag pump system, arterial flushing fluid, replacement and maintenance of children′s arterial catheter flushing system, and continuous improvement of arterial catheter maintenance.Conclusions:The best evidence for the establishment and maintenance of pediatric peripheral arterial duct flushing systems provides a basis for clinical decision, but practice testing is still needed.

OBJECTIVETo explore clinicopathologic characteristics, surgical features and prognostic factors in patients with primary gastrointestinal lymphoma(PGIL) in order to provide evidence for optimizing surgical treatment.

METHODSClinicopathological data of 57 PGIL patients undergoing abdominal surgery in Sun Yat-sen University Cancer Center between October 1990 and January 2015 were retrospectively collected. The survival rates were compared among patients with different clinicopathologic characteristics by Kaplan-Meier method, while Cox regression model was employed to analyze the prognostic factors.

RESULTSAmong 57 patients, 43 were male and 14 were female, with a median age of 48 (range 16 to 80) years. Seventeen (29.8%) cases were classified as Musshoff I( stage, 19 (33.3%) cases as II( stage, 9 (15.8%) cases as III( stage, and 12(21.1%) cases as IIII( stage. Forty-four (77.2%) cases underwent selective operation, 13(22.8%) cases underwent emergent operation due to acute abdomen. Thirty-two(56.1%) cases had radical resection, 18 (31.6%) cases had partial resection and the rest 7(12.3%) cases failed to perform resection. Four (7.0%) cases received simple surgical operation, and 53 (93.0%) cases received comprehensive treatment, including 5(8.8%) cases with preoperative chemotherapy and surgery, 40 (70.2%) cases with surgery and postoperative chemotherapy, and 8 (14.0%) cases with surgery and perioperative chemotherapy. Stage III( and IIII( accounted for 76.9%(10/13) in patients undergoing emergent operation and accounted for 25.0%(11/44) in patients undergoing selective operation, whose difference was statistically significant (χ=9.503, P=0.002). Univariate prognostic analysis showed that T lymphocyte source pathological cell phenotype (P=0.000), clinical Musshoff stage III( and IIII((P=0.001), emergent operation (P=0.000) and incomplete tumor resection(P=0.007) had worse 5-year overall survival. Multivariate Cox regression analysis indicated that tumor pathological cell phenotype (HR=13.75, 95%CI:3.546-53.308, P=0.000) and surgical timing (HR=7.497, 95%CI:1.163-48.313, P=0.034) were independent prognostic risk factors of patients with stage I( and II(.

CONCLUSIONSSurgical operation is an important part of comprehensive treatment for PGIL. T lymphocyte source and ulcerative lymphoma indicates poorer prognosis.

Background: The prognostic nutritional index (PNI) has been widely applied for predicting survival outcomes of patients with various malignant tumors. Although a low PNI predicts poor prognosis in patients with colorectal cancer after tumor resection, the prognostic value remains unknown in patients with stage Ⅲ colon cancer undergoing cura-tive tumor resection followed by adjuvant chemotherapy. This study aimed to investigate the prognostic value of PNI in patients with stageⅢ colon cancer. Methods: Medical records of 274 consecutive patients with stage Ⅲ colon cancer undergoing curative tumor resec-tion followed by adjuvant chemotherapy with oxaliplatin and capecitabine between December 2007 and December 2013 were reviewed. The optimal PNI cutoff value was determined using receiver operating characteristic (ROC) curve analysis. The associations of PNI with systemic inflammatory response markers, including lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP) level, and clinicopathologic characteristics were assessed using the Chi square or Fisher's exact test. Correlation analysis was performed using Spearman's correlation confficient. Disease-free survival (DFS) and overall survival (OS) stratified by PNI were analyzed using Kaplan–Meier method and log-rank test, and prognostic factors were identified by Cox regression analyses. Results: The preoperative PNI was positively correlated with LMR (r= 0.483,P < 0.001) and negatively correlated with NLR (r=? 0.441,P < 0.001), PLR (r=? 0.607,P < 0.001), and CRP level (r=? 0.333,P < 0.001). A low PNI (≤ 49.22) was significantly associated with short OS and DFS in patients with stage IIIC colon cancer but not in patients with stage IIIA/IIIB colon cancer. In addition, patients with a low PNI achieved a longer OS and DFS after being treated with 6–8 cycles of adjuvant chemotherapy than did those with < 6 cycles. Multivariate analyses revealed that PNI was inde-pendently associated with DFS (hazard ratios 2.001; 95％ confidence interval 1.157–3.462;P= 0.013). Conclusion: The present study identified preoperative PNI as a valuable predictor for survival outcomes in patients with stage Ⅲ colon cancer receiving curative tumor resection followed by adjuvant chemotherapy.

Background: Voltage-gated sodium channel 1.5 (Nav1.5) potentially promotes the migratory and invasive behaviors of colon cancer cells. Hitherto, the prognostic significance of Nav1.5 expression remains undetermined. The present study aimed to explore the associations of Nav1.5 expression with clinical outcomes and estrogen receptor-β (ER-β) expression in non-metastatic colon cancer patients receiving radical resection. Methods: A total of 269 consecutive patients with pathologically confirmed stages Ⅰ–Ⅲ colon cancer who under-went radical resection were selected. Nav1.5 and ER-β expression was detected by using immunohistochemistry (IHC) on tissue microarray constructed from paraffin-embedded specimens. IHC score was determined according to the percentage and intensity of positively stained cells. Statistical analysis was performed with the X-tile method, k coef-ficient, Chi square test or Fisher's exact test, logistic regression, log-rank test, and Cox proportional hazards models. Results: We found that Nav1.5 was commonly expressed in tumor tissues with higher mean IHC score as compared with matched tumor-adjacent normal tissues (5.1 ± 3.5 vs. 3.5 ± 2.7, P < 0.001). The high expression of Nav1.5 in colon cancer tissues was associated with high preoperative carcinoembryonic antigen level [odds ratio (OR) = 2.980;95% confidential interval (CI) 1.163–7.632; P = 0.023] and high ER-β expression (OR = 2.808; 95% CI 1.243–6.343;P = 0.013). Log-rank test results showed that high Nav1.5 expression contributed to a low 5-year disease-free survival (DFS) rate in colon cancer patients (77.2% vs. 92.1%, P = 0.048), especially in patients with high ER-β expression tumor (76.2% vs. 91.3%, P = 0.032). Analysis with Cox proportional hazards model demonstrated that high Nav1.5 expression [hazard ratio (HR) = 2.738; 95% CI 1.100–6.819; P = 0.030] and lymph node metastasis (HR = 2.633; 95% CI 1.632–4.248; P < 0.001) were prognostic factors for unfavorable DFS in colon cancer patients. Conclusions: High expression of Nav1.5 was associated with high expression of ER-β and indicated unfavorable oncologic prognosis in patients with non-metastatic colon cancer.

ObjectiveTo explore the efficacy and safety of bevacizumab combined with preoperative chemotherapy for colorectal cancer patients with liver metastases.MethodsClinical data of 89 colorectal cancer patients with liver metastases admitted and treated in Sun Yat-sen University Cancer Center between May 2009 and August 2013 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. According to the first-line chemotherapy regimens, the patients were divided into the bevacizumab combined with preoperative chemotherapy group (bevacizumab group,n=32) and the simple preoperative chemotherapy group (the chemotherapy group,n=57). Among the patients in the bevacizumab group, 24 were males and 8 were females with the age ranging from 29 to 74 years old and the median of 59 years old, 22 were with colon cancer and 10 were with rectal cancer. Among the patients in the chemotherapy group, 42 were males and 15 were females with the age ranging from 28 to 74 years old and the median of 57 years old, 42 were with colon cancer and 15 were with rectal cancer. The progression-free survival, response rate, resection rate and conversion rate of liver metastases and adverse effect incidence of preoperative therapy in two groups were observed and compared. The rates were compared using Chi-square test, and the survival analysis was conducted using Kaplan-Meier method and Log-rank test.ResultsThe median progression-free survival was 16 months in the bevacizumab group and 13 months in the chemotherapy group, and no significant difference was observed in the progression-free survival rate between two groups (χ2=0.030,P>0.05). The response rate, resection rate and conversion rate of liver metastases were respectively 59%(19/32), 69%(22/32) and 53%(17/32) in the bevacizumab group and 39%(22/57), 54%(31/57) and 40%(23/57) in the chemotherapy group, and no signiifcant differences were observed (χ2=3.561, 1.755, 0.983;P>0.05). The overall incidence of adverse events was 12%(4/32) in the bevacizumab group with 2 cases of neutropenia, 1 case of hand-foot syndrome and 1 case of gradeⅢ gums bleeding, while the overall incidence of adverse events was 9%(5/57) in the chemotherapy group with 3 cases of thrombocytopenia, 1 case of neutropenia and 1 case of liver function impairment. And no signiifcant difference was observed between two groups (χ2=0.313, P>0.05).ConclusionsBevacizumab combined with preoperative chemotherapy is safe and has potential curative effect to prolong the disease-free survival for colorectal cancer patients with liver metastases.