Objective: To explore the latent profile characteristics of regulatory emotional self-efficacy and its relationship with non-suicidal self-injurious (NSSI) behavior among junior and senior high school students, so as to provide a basis for effectively reducing NSSI behaviors. Methods: From April to October 2023, a total of 1 217 junior and senior high school students were selected from Tongren City, Zunyi City and Qiannan Prefecture of Guizhou Province by stratified cluster random sampling method. The Scale of Regulatory Emotional Self-efficacy and the Adolescent Self-injury Scale were administered. Latent profile analysis (LPA) was employed to explore distinct profiles of regulatory emotional self-efficacy, and the Lanza, Tan, and Bray s method (LTB) was used to analyze the relationship between these profiles and NSSI behavior. Results: The prevalence rate of NSSI behavior among junior and senior high school students was 28.6%. Among males, regulatory emotional self-efficacy was categorized into two types: moderate positive expression-low negative management group (59.1%, n =353) and high efficacy group (40.9%, n =244); among females, regulatory emotional self-efficacy was classified into three categories: low efficacy group (18.4%, n =114), high positive expression-low negative management group (56.3%, n =349), and high efficacy group (25.3%, n =157). There were statistically significant differences in total NSSI scores across different potential categories of regulatory emotional self-efficacy within both males and females ( Z/H = -5.75 , 57.58, both P <0.01). The differences in NSSI prevalence rates across the potential categories of regulatory emotional self-efficacy were statistically significant for both males and females ( χ 2=38.00, 69.14, both P <0.01), and among females, the differences in NSSI prevalence rates between the high efficacy group and the low efficacy group ( χ 2=60.01) and between the high efficacy group and the high positive expression-low negative management group ( χ 2=31.34) were also statistically significant (both P < 0.016 7 ). Binary Logistic regression analysis revealed that, compared with the high efficacy group within each gender, the moderate positive expression-low negative management group among males ( OR =2.36), and both the low efficacy group and the high positive expression-low negative management group among females ( OR =6.19, 2.97), were at an increased risk of engaging in NSSI (all P <0.01). Conclusion Different latent profiles of regulatory emotional self efficacy among junior and senior high school students are associated with NSSI behavior.

Background/Aims: Cholangiocarcinoma (CCA) is a primary malignant neoplasm with an extremely poor prognosis. While combined chemoradiotherapy has been demonstrated to delay CCA progression to a certain extent, the absence of specific molecular biomarkers or targets significantly hinders the diagnosis and treatment of CCA. Methods: Through cross-analysis of proteomics and ADMA modificationomics, we identified DDX1 overexpressed in CCA with elevated R602-ADMA modifications. HPLC-MS/MS identified PRMT1 as the methyltransferase and USP10 as the deubiquitinating enzyme for DDX1. Immunofluorescence and nuclear-cytoplasmic partitioning experiments confirmed DDX1’s nuclear localization. GO and KEGG analyses clarify the biological functions of DDX1 in response to hypoxia. RNA-seq transcriptomics analyzed key pathways influenced by DDX1. A hydrodynamic in situ CCA mouse model was established to validate the chemopreventive effects of the PRMT1-specific inhibitor GSK715 on CCA development. Results: DDX1 promotes CCA progression both in vivo and in vitro and can be inhibited by GSK715. Mechanistically, PRMT1 mediates ADMA modification at position R602 of DDX1. This modification promotes DDX1 nuclear localization by recruiting USP10 to deubiquitinate DDX1, while simultaneously inhibiting PRMT1 degradation. DDX1 promotes the transcription of PRMT1 and USP10 by binding to the mRNA 3’UTR region, establishing a positive feedback regulatory pathway. This mechanism promotes the occurrence and development of CCA and can serve as a target for the inhibitor GSK715 to suppress CCA progression. Conclusions Our study identified DDX1-R602-ADMA modification as a novel ADMA modification in CCA. It further confirmed its pivotal role in CCA progression. Targeting the USP10-PRMT1-DDX1 axis may represent a significant therapeutic approach for CCA.

Objective: To investigate the visual acuity and correction conditions of children and adolescents in Shanghai, so as to provide a scientific basis for developing intervention measures to prevent myopia and protect vision among children and adolescents. Methods: From October to December 2022, a stratified cluster random sampling survey was conducted, involving 47 034 students from 16 municipal districts in Shanghai, covering kindergartens (≥5 years), primary schools, middle schools, general high schools and vocational high schools. According to the Guidelines for Screening Refractive Errors in Primary and Secondary School Students, the Standard Logarithmic Visual acuity Chart was used to examine naked vision and corrected vision of students, and general information was collected. The distribution and severity of visual impairment in different age groups were analyzed, and χ 2 tests and multivariate Logistic regression were used to explore factors associated with visual impairment. Results: The detection rate of visual impairment among children and adolescents was 76.2%, with a higher rate among females (78.8%) than males ( 73.8 %), higher among Han ethic students ( 76.2 %) than minority students (71.2%), and higher among urban students (76.7%) than suburban students (75.8%), all with statistically significant differences ( χ 2=162.6, 10.4, 5.5, P <0.05). The rate of visual impairment initially decreased and then increased with age, reaching its lowest at age 7 (53.8%) and peaking at age 17 (89.6%) ( χ 2 trend = 3 467.0 , P <0.05). Severe visual impairment accounted for the majority, at 56.6%, and there was a positive correlation between the severity of visual impairment and age among children and adolescents ( r =0.45, P <0.05). Multivariate Logistic regression showed that age, BMI, gender, ethnicity and urban suburban status were associated with visual impairment ( OR =1.18, 1.01, 1.38 , 0.79, 0.88, P <0.05). Among those with moderate to severe visual impairment, the rate of spectacle lens usage was 62.8%, yet only 44.8 % of those who used spectacle lens had fully corrected visual acuity. Females (64.9%) had higher spectacle lens usage rates than males (60.6%), and general high school students had the highest spectacle lens usage (83.9%), and there were statistically significant differences in gender and academic stages ( χ 2=57.7, 4 592.8, P <0.05). Conclusions The rate of spectacle lens usage among students with moderate to severe visual impairment is relatively low, and even after using spectacle lens, some students still do not achieve adequate corrected visual acuity. Efforts should focus on enhancing public awareness of eye health and refractive correction and improving the accessibility of related health services.

Objective:To study the correlation between osteoporosis and the joint of small articular process of lumbar vertebra,and the correlation between bone mineral density(BMD)and various parameters of small joint based on quantitative computed tomography(QCT),so as to provide scientific basis for formulating clinically treatment strategies.Methods:This study included 63 patients who admitted to orthopedics of The Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from December 2023 to March 2024 due to waist discomfort and lower limb pain.According to BMD standard of CT examination for lumbar vertebra,these patients were divided into normal BMD group(31 cases),osteopenia group(21 cases)and osteoporosis group(11 cases).All patients underwent CT scan on lumbar vertebra.The mode with body membrane were adopted to measure BMD,the area of left and right articular process,CT value,height after the scan was completed.Whether existed osteophytes,endplate inflammation and intervertebral disc herniation in each group were checked.Univariate Analysis of Variance(ANOVA)was employed to assess the differences among different BMD groups in age,gender,area of articular process,CT value and height.The Pathria grading system was adopted to assess the degeneration degree of intervertebral joint,and the Fisher's exact test was used to analyze the differences in degeneration scores of articular process among three groups.At the same time,the pairwise comparison between groups also was conducted.Spearman's rank correlation analysis was conducted to explore the correlation between BMD and the degeneration degree of intervertebral joint.Results:The BMD value of normal BMD group was(165.14±30.11)mg/cm3,and that of osteopenia group was(98.98±10.14)mg/cm3,and that of osteoporosis group was(58.62±18.73)mg/cm3.There was a statistically significant difference in BMD value among three groups(F=103.121,P＜0.001),and there was a statistically significant difference in BMD value between normal BMD group and osteopenia group as the result of pairwise comparison between groups(t=10.018,P＜0.001).There was statistically significant difference in BMD value between normal BMD group and osteoporosis group(t=12.989,P＜0.001),and there was statistically significant difference in BMD value between osteopenia group and osteoporosis group(t=4.641,P＜0.001).The areas of left and right upper articular process of normal BMD group were less than that of other two groups,and the differences of CT value and height of left and right upper articular process among three groups were significant(F=27.350,24.458,P＜0.05),respectively.The CT value of normal BMD group was higher than that of other two groups,and CT values of right upper articular process of osteopenia group was significantly lower than that of osteoporosis group,and the difference was statistical significance(t=2.191,P＜0.05).The heights of left and right upper articular processes of normal BMD group were lower than those of osteoporosis group,and the height of right upper articular process was lower than that of osteopenia group(t=2.331,-2.798,-2.618,P＜0.05).There was a negative correlation between osteoporosis degree and the degeneration of articular process joints(r=-0.745,P＜0.001).With the decreasing of BMD value,the degeneration of articular process joint gradually aggravated,and the ratios of osteophytes,endplate inflammation and intervertebral discs increased.Conclusion:There is a certain correlation between the osteoporosis and the degeneration of articular process joints of lumbar intervertebral disc.The ratios of osteophytes,endplate inflammation and intervertebral disc herniation increase,and both the area and height of the left and right articular process increase when the reduction of bone mass reaches to a serious degree.

Objective:The aims of this study were to compare the clinical effectiveness of an immunosuppressant(sintilimab)combined with different chemotherapy regimens(two-and three-drug regimens)in the neoadjuvant treatment of advanced gastric cancer and to explore the efficacy-associated clinical features.Methods:A retrospective analysis was conducted on patients with advanced gastric cancer who re-ceived treatment at Lanzhou University Second Hospital between August 2020 and February 2024.Overall,133 patients were included in the study and assigned into groups A(three-drug regimens)and B(two-drug regimens),according to the treatment regimen received.Recent ef-ficacy outcomes,including the pathological complete response rate(pCR),major pathological response rate(MPR),objective response rate(ORR),and disease control rate(DCR),as well as long-term efficacy outcomes,including overall survival(OS)and disease-free survival(DFS),were compared.Subgroup analyses were performed to identify clinical features associated with treatment efficacy.Results:The recent effic-acy outcomes were similar between groups A(two-drug regimen)and B(three-drug regimen),with pCRs of 18.46%and 27.94%,MPRs of 52.31%and 58.82%,ORRs of 76.92%and 76.47%,and DCRs of 87.69%and 95.59%,respectively.However,the three-drug regimen led to significantly improved OS and DFS,compared with the two-drug regimen(P<0.05).Subgroup analysis revealed that male patients and those with gastric antrum cancer,an ECOG score of 0,a T4 stage tumor,and no vascular or nerve invasion benefited more from the three-drug re-gimen.Conclusions:Sintilimab combined with the three-drug chemotherapy regimen demonstrated superior long-term efficacy in the neo-adjuvant treatment of advanced gastric cancer,compared with the combination with the two-drug regimen.Certain clinical features may predict greater benefit from the three-drug regimen.

Objective:To explore the effect of hyperbaric oxygen (HBO) combined with Saccharomyces boulardii in ulcerative colitis (UC) and effect of serum asymmetric dimethylarginine (ADMA). Methods:A total of 100 patients with UC admitted to the First Hospital of Yulin from August 2021 to August 2023 were prospectively selected as the study objects and divided into control group and observation group according to random number table method, with 50 cases in each group. The control group was treated with mesalazine + Saccharomyces boulardii sachets, and the observation group was treated with mesalazine + Saccharomyces boulardii sachets + HBO, and both groups were treated for 60 d. The clinical efficacy and the levels of intestinal flora, ADMA, intestinal mucosal barrier function indexes, inflammatory factors and immune function indexes before and after treatment were compared between the two groups, and the occurrence of adverse reactions were compared between the two groups. Results:After treatment, the total effective rate in the observation group was higher than that in the control group: 74.00%(37/52) vs. 50.00%(26/52), there was statistical difference ( χ2 = 5.19, P<0.05). After treatment, the number of Enterococcus and Escherichia coli in the observation group were lower than those in the control group: (4.37 ± 0.91) lgcfu/g vs. (7.95 ± 1.32) lgcfu/g, (6.17 ± 0.92) lgcfu/g vs. (9.36 ± 1.35) lgcfu/g; and the number of Lactobacillus and Bifidobacterium were higher than those in the control group: (10.24 ± 2.57) lgcfu/g vs. (8.38 ± 1.48) lgcfu/g, (10.72 ± 3.15) lgcfu/g vs. (8.69 ± 2.64) lgcfu/g, there were statistical differences ( P<0.05). After treatment, the level of ADMA in the observation group was lower than that in control group: (0.51 ± 0.08) μmol/L vs. (0.85 ± 0.12) μmol/L; and the intestinal mucosal barrier function indexes of diamine oxidase, D-lactic acid and endotoxin were lower than those in the control group: (5.82 ± 1.13) U/L vs. (7.13 ± 1.89) U/L, (3.96 ± 0.42) mmol/L vs. (4.38 ± 0.85)mmol/L, (0.18 ± 0.02) kEU/L vs. (0.23 ± 0.04) kEU/L, there were statistical differences ( P<0.05). After treatment, the inflammatory factor C-reactive protein (CRP), interleukin (IL)-6 and tumor necrosis factor-α (TNF-α) in the observation group were lower than those in the control group: (4.84 ± 0.68) mg/L vs. (7.16 ± 0.82) mg/L, (13.24 ± 1.98) ng/L vs. (17.61 ± 2.25) ng/L, (22.13 ± 4.16) μg/L vs. (29.36 ± 5.37) μg/L; and IL-10 was higher than that in the control group:(15.35 ± 2.98) ng/L vs. (11.27 ± 3.26) ng/L, there were statistical differences ( P<0.05). After treatment, the immune function indexes CD 3+, CD 4+, CD 4+/CD 8+ in the observation group were higher than those in the control group: 0.563 ± 0.063 vs. 0.459 ± 0.052, 0.420 ± 0.049 vs. 0.383 ± 0.053, 1.35 ± 0.32 vs. 1.16 ± 0.26, there werestatistical differences ( P<0.05). The incidence of adverse reactions between the two groups had no statistical difference ( P>0.05). Conclusions:HBO combined with Saccharomyces boulardii can significantly improve clinical symptoms, reduce intestinal mucosal damage and improve intestinal microenvironment in UC patients.

To investigate the feasibility and advantages of "Axis Coordinate Localization Method" combined with total endoscopic technique for parotid surgery. A total of 31 patients with parotid gland tumors who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2022 to August 2024 were included in this study. The cohort comprised 11 males and 20 females, with age of (38.9±13.9) years and a maximum tumor diameter of (19.34±6.89) mm. Among these cases, 93.5% (29/31) involved the superficial lobe and 6.5%(2/31) the deep lobe of the parotid gland. The "axial" localization method was utilized to plan the surgical approach: establishing a coordinate system with the earlobe as the origin, the surface projection of the parotid duct as the x-axis, and a perpendicular line through the origin as the y-axis. The incision type-pre-tragal, retroauricular groove, or postauricular hairline-was selected according to the position of the tumor′s surface projection center within this coordinate system. All operations were performed using a complete endoscopic technique for tumor and glandular tissue resection. Postoperative facial nerve function was assessed with the House-Brackmann grading scale, while patient incision satisfaction, impact on work and daily life, and facial symmetry were quantitatively evaluated using a Numerical Rating Scale (10-point system).　All 31 patients successfully underwent the procedure. Short-term postoperative complications included temporary facial paralysis in 1 case (3.2%), periauricular numbness in 1 case (3.2%), surgical site effusion in 1 case (3.2%), and subcutaneous hematoma in 1 case (3.2%). All complications resolved after appropriate management. During follow-up, there were no instances of sialocele, Frey syndrome, incision infection, or tumor recurrence. Patient ratings were as follows: incision satisfaction (9.42±0.78), impact of surgery on daily life (1.32±0.60), and facial symmetry (9.29±0.78). The one case of temporary facial paralysis recovered 3 months after surgery. The combination of the "Axial" localization method and fully endoscopic technique demonstrates clear clinical feasibility in parotid tumor resection. This approach enables rapid and personalized incision selection based on tumor location, while the endoscopic minimally invasive technique reduces tissue trauma, improves cosmetic outcomes, and enhances surgical safety. It provides a new minimally invasive treatment pathway for patients with benign parotid tumors.

Objective:To evaluate the clinical equivalence between a domestic calcipotriol/betamethasone dipropionate ointment and the originator product in the treatment of stable plaque psoriasis.Methods:A multicenter, randomized, double-blind, three-arm, parallel-group, active- and placebo-controlled study was conducted, and 449 patients aged 18 - 65 years with stable plaque psoriasis were enrolled from 25 hospitals (such as the First Affiliated Hospital of China Medical University). Eligible patients had a baseline physician's global assessment (PGA) score of ≥ 3 points, baseline body surface area (BSA) involvement of 5% - 30%, and a target lesion psoriasis area and severity index (TL-PASI) for plaque elevation of ≥ 3 points. Participants were randomly assigned in a 2:2:1 ratio to the test group ( n = 179), reference group ( n = 180), and placebo group ( n = 90), and applied the domestic calcipotriol/betamethasone dipropionate ointment, originator product, and ointment base respectively, once daily in the evening for 4 weeks. Efficacy and safety were assessed at weeks 1, 2, and 4. The primary efficacy endpoints were the treatment success rates and clinical success rates in each group at week 4. The per-protocol set (PPS) was used for the primary efficacy analysis, and the intention-to-treat (ITT) set for supplementary efficacy analysis. Equivalence between the test and reference preparations was tested using the Cochran-Mantel-Haenszel method adjusted for randomization strata. Superiority of the test and reference preparations over the placebo was also tested. Measurement data were compared among the 3 groups using analysis of variance or non-parametric tests, while treatment success rates, clinical success rates, and incidence rates of adverse reactions were compared using the chi-square test. Results:The ITT, PPS, and safety sets included 447, 420, and 448 patients, respectively. In the ITT set, patients were aged 43.6 ± 12.8 years, including 320 (71.6%) males and 127 (28.4%) females, and the disease duration was 11.21 ± 9.05 years; 316 (70.7%) had a PGA score of 3 points and 131 (29.3%) had a PGA score of 4 - 5 points. No significant differences in the baseline characteristics (including age, sex, disease duration and disease severity) were observed among the 3 groups (all P > 0.05). Based on the PPS analysis, the treatment success rates were 57.9% (99/171) in the test group, 50.3% (86/171) in the reference group, and 7.7% (6/78) in the placebo group, and the clinical success rates were 57.9% (99/171), 50.3% (86/171), and 10.3% (8/78), respectively; both the test and reference groups were superior to the placebo group in both treatment and clinical success rates (all P < 0.001) ; the rate differences for treatment success (90% confidence interval [ CI]: -1.3% - 16.4%) and clinical success (90% CI: -1.3% - 16.3%) between the test and reference groups were entirely within the pre-defined equivalence margin (-20% - 20%). Subgroup analyses by baseline PGA scores: for patients with a baseline PGA score of 3 points, the treatment success rates in the test, reference, and placebo groups were 60.8% (73/120), 52.1% (62/119), and 11.1% (6/54), respectively, and the corresponding clinical success rates were 61.7% (74/120), 53.8% (64/119), and 13% (7/54), respectively; the test and reference groups did not differ significantly in treatment or clinical success rates (both P > 0.05), but both showed higher success rates than the placebo group (all P < 0.001) ; the results of statistical comparisons among the 3 groups in patients with a baseline PGA score of 4 - 5 points were consistent with those observed in patients with a baseline PGA score of 3 points. The percentage reductions in PGA and TL-PASI scores from baseline to weeks 1, 2, and 4 showed significant differences among the 3 groups, which were significantly higher in the test and reference groups than in the placebo group (all P < 0.001), but did not differ between the test and reference groups (all P > 0.05). The primary adverse reactions were local skin reactions, such as pruritus, pain, and erythema. The incidence rates of adverse reactions were 8.9% (16/179) in the test group, 7.3% (13/179) in the reference group, and 7.8% (7/90) in the placebo group, with no significant difference among the 3 groups ( P > 0.05) . Conclusions:The domestic calcipotriol/betamethasone dipropionate ointment demonstrated clinical equivalence to the originator product in the treatment of stable plaque psoriasis, and the two agents exhibited comparable efficacy for patients with varying degrees of disease severity, and were comparable in the speed and degree of clinical improvement, with similar favorable safety profiles.

Objective:To evaluate the influence of different positive end-expiratory pressure on the ventilation of laryngeal mask airway in pediatric patients undergoing laparoscopic surgery through ultrasound assessment.Methods:In this randomized controlled trial, 90 pediatric patients of both sexes, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, aged 2-10 yr, with a body mass index of 12-22 kg/m 2, scheduled for elective laparoscopic surgery, were divided into 3 groups ( n=30 each) by a random number table method: group P0, group P3, and group P5. Each group adopted the pressure-controlled mode with an inspiration/expiration ratio of 1∶2, a flow rate of 2 L/min, and a respiratory rate of 16-26 breaths/min. The positive end-expiratory pressure was set at 0, 3 and 5 cmH 2O(1 cmH 2O=0.098 kPa) in P0, P3 and P5 groups respectively. The ultrasonic scores and misalignment rate of the laryngeal mask airway were recorded every 5 min following the pneumoperitoneum, and the occurrence of intraoperative hypoxemia (SpO 2 < 92%) and P ETCO 2 ≥ 45 mmHg(1 mmHg=0.133 kPa) was recorded. The development of hypoxemia, blood staining on the laryngeal mask airway and hoarseness after laryngeal mask airway removal were also recorded. Results:Compared with P0 group, the ultrasound scores were significantly increased at 15 min of pneumoperitoneum in P3 group ( P<0.05), and the ultrasound scores and the laryngeal mask airway misplacement rate were significantly increased, and no significant change was found in the other parameters in P5 group ( P<0.05). There were no statistically significant differences in each parameter between P5 group and P3 group ( P>0.05). There was no statistically significant difference in the incidence of postoperative complications among the three groups ( P>0.05). Conclusions:The laryngeal mask airway provides better ventilatory effect in pediatric patients undergoing laparoscopic surgery when the PEEP is set at 3 cmH 2O.

Objective:To investigate the association between anti-rituximab antibodies (ARA) and relapse after rituximab (RTX) therapy in children with frequently relapsing or steroid-dependent nephrotic syndrome (FRNS or SDNS).Methods:A retrospective cohort study was conducted. Clinical and laboratory data were collected from 48 FRNS or SDNS children treated with RTX in the Department of Pediatrics, General Hospital of Eastern Theater Command, between April 2024 and October 2024. Data included RTX dosing frequency, relapse events, peripheral CD20? B-cell counts, and ARA levels. With a 6-month observation period after the last RTX therapy, the children were divided into an ARA-positive group and an ARA-negative group based on ARA test results. Chi-square test, independent sample t-test, or Mann-Whitney U test were used to compare relapse rates and laboratory indicators between the two groups. The predictive value of ARA levels for relapse was evaluated using univariate receiver operating characteristic (ROC) curve analysis. Results:Among the 48 children (36 males, 12 females), the age of disease onset was 3.5 (2.0, 6.0) years, the ages at the first and last RTX treatments were 7.0 (5.0, 12.0) years and 9.5 (7.0, 13.0) years, respectively. The overall ARA positive rate was 29% (14/48). The relapse rate in the ARA-positive group was significantly higher than that in the negative group ( P<0.05). The ARA level was 0.01 (0.01, 5.88) μg/L, and all 12 children with ARA levels >5.88 μg/L relapsed. ROC curve analysis showed that ARA levels predicted relapse after RTX treatment in FRNS or SDNS children with an area under the curve (AUC) of 0.73, sensitivity of 0.50, specificity of 1.00, and an optimal cut-off value of 5.02 μg/L. All children received single-dose RTX therapy, with no significant difference in treatment frequency between the two groups ( P>0.05). At 3 months after the last rituximab therapy, CD20? B cell counts were significantly higher in the ARA-positive group ( P<0.05). During follow-up, 15% (7/48) of the children experienced infusion-related adverse reactions, with no significant difference in incidence between the two groups ( P>0.05). Conclusion:ARA is significantly associated with relapse in FRNS or SDNS children after RTX therapy.