Objective:To analyze the multimorbidity trends and influencing factors of internet addiction and depressive symptoms among middle school students in Zhejiang Province.Methods:From 2018 to 2023, a multistage stratified random cluster sampling method was used to select middle school students aged 12 to 18 in Zhejiang Province. Internet addiction and depression status were measured by the Internet Addiction Scale and the Center for Epidemiologic Studies Depression Scale. When both symptoms were present, it was defined as multimorbidity.The multivariate logistic regression model was used to analyze the influencing factors of multimorbidity among middle school students, and a trend Chi-square test was used to analyze the changing trends of internet addiction, depression and multimorbidity prevalence. Results:A total of 193 505 students were included in the study. From 2018 to 2023, the prevalence of multimorbidity of internet addiction and depressive symptoms among middle school students ranged from 2.7% to 3.5%. The prevalence of internet addiction ranged from 4.7% to 6.0%, while the prevalence of depressive symptoms ranged from 18.7% to 25.1%. Multivariate logistic regression showed that boarding students ( OR=1.34 , 95% CI: 1.26-1.42), low-frequency ( OR=1.59, 95% CI: 1.46-1.73), and high-frequency sugary drink consumption ( OR=3.91, 95% CI: 3.55-4.31) increased the risk of multimorbidity among middle school students. In contrast, higher frequencies of moderate-to-high-intensity exercise (medium: OR=0.54, 95% CI: 0.50-0.58; high: OR=0.49, 95% CI: 0.44-0.55) and sufficient sleep ( OR=0.52, 95% CI: 0.49-0.56) were protective factors. From 2018 to 2023, there was no significant change in the trend of multimorbidity prevalence among middle school students ( χ2trend=3.82, P=0.051). The prevalence of internet addiction showed an upward trend ( χ2trend=20.54, P<0.001), while depressive symptoms showed a downward trend ( χ2trend=181.41, P<0.001). Conclusion:The prevalence of internet addiction and depression symptoms among middle school students in Zhejiang Province remains stable from 2018 to 2023. The prevalence of internet addiction shows an upward trend, while the prevalence of depression symptoms shows a downward trend. The risk of multimorbidity is related to students′ boarding, consumption of sugary drinks, lack of exercise, and insufficient sleep.

Objective This study examined changes in serum growth hormone(GH)and insulin-like growth factor 1(IGF-1)levels,as well as insulin resistance,in patients with type 2 diabetes mellitus(T2DM)across different stages of diabetic kidney disease(DKD).It explored the relationship between these factors and the occurrence and progression of DKD,with the aim of identifying new targets for the prevention and treatment of DKD.Methods In this cross-sectional study,T2DM patients aged 18-80 years were selected from the Department of Endocrinology,The Second Affiliated Hospital of Xi'an Jiaotong University,from November 30,2019 to March 30,2021.Their serum GH and IGF-1 levels were tested.Results The serum GH level increased gradually in the groups,and the difference was statistically significant(P＜0.05).The level of serum IGF-1 decreased first and then increased among the groups,but with no significant difference(P＞0.05).HOMA-IR showed no significant correlation among the groups(P＞0.05),but HOMA-β gradually decreased among the groups,with statistically significant difference(P＜0.05).Multivariate Logistic regression analysis showed that the increase of serum GH level was closely related to the progression of T2DM to early DKD,and that the increase of serum IGF-1 level might be related to the deterioration of renal function in patients with T2DM at DKD stage.HOMA-IR and HOMA-β were not found to have correlation with the occurrence or development of DKD in T2DM patients.Conclusion In patients with T2DM,elevated serum GH level is closely associated with the occurrence and progression of early DKD.The increase of serum GH level may promote the occurrence of early DKD in T2DM,and the increase of serum IGF-1 level may be related to the deterioration of renal function in clinical DKD stage.In this study,we did not find correlation of HOMA-IR and HOMA-β with the occurrence or development of DKD in T2DM patients.

This study investigated the therapeutic effects of a low-dose phage cocktail combined with antibiotics on burn wounds in-fected with multidrug resistant Pseudomonas aeruginosa.Given the risk of sepsis caused by drug-resistant bacteria infection after burns and the limitations of antibiotic monotherapy,we constructed a mouse model of burns combined with Pseudomonas aeruginosa infection.A saline control group,phage cocktail monotherapy group,antibiotic monotherapy group,and combined treatment group were examined.The combined treatment group showed a synergistic effect on the 7th day after infection:this group of mice had a sig-nificantly lower pathogenic bacterial load in the skin and liver tissues than observed in the single drug treatment group,and showed the strongest bacterial clearance effect.Histopathological analysis indicated improved structural integrity of the skin tissue,as well as decreased infiltration of inflammatory cells,and no obvious tissue damage,in the combined treatment group.Detection of serum in-flammatory factors indicated that the levels of the pro-inflammatory factors IL-6 and TNF-α significantly decreased,whereas the level of anti-inflammatory factor IL-10 significantly increased.The combination of low-dose phage cocktail and antibiotics synergistically en-hanced antibacterial activity and ameliorated infection through a dual mechanism of direct removal of pathogens and regulation of the host immune response.Our findings provide an experimental basis for the optimal treatment of wounds infected with multidrug-resistant bacteria.

This study investigated the therapeutic effects of a low-dose phage cocktail combined with antibiotics on burn wounds in-fected with multidrug resistant Pseudomonas aeruginosa.Given the risk of sepsis caused by drug-resistant bacteria infection after burns and the limitations of antibiotic monotherapy,we constructed a mouse model of burns combined with Pseudomonas aeruginosa infection.A saline control group,phage cocktail monotherapy group,antibiotic monotherapy group,and combined treatment group were examined.The combined treatment group showed a synergistic effect on the 7th day after infection:this group of mice had a sig-nificantly lower pathogenic bacterial load in the skin and liver tissues than observed in the single drug treatment group,and showed the strongest bacterial clearance effect.Histopathological analysis indicated improved structural integrity of the skin tissue,as well as decreased infiltration of inflammatory cells,and no obvious tissue damage,in the combined treatment group.Detection of serum in-flammatory factors indicated that the levels of the pro-inflammatory factors IL-6 and TNF-α significantly decreased,whereas the level of anti-inflammatory factor IL-10 significantly increased.The combination of low-dose phage cocktail and antibiotics synergistically en-hanced antibacterial activity and ameliorated infection through a dual mechanism of direct removal of pathogens and regulation of the host immune response.Our findings provide an experimental basis for the optimal treatment of wounds infected with multidrug-resistant bacteria.

Objective:To analyze the multimorbidity trends and influencing factors of internet addiction and depressive symptoms among middle school students in Zhejiang Province.Methods:From 2018 to 2023, a multistage stratified random cluster sampling method was used to select middle school students aged 12 to 18 in Zhejiang Province. Internet addiction and depression status were measured by the Internet Addiction Scale and the Center for Epidemiologic Studies Depression Scale. When both symptoms were present, it was defined as multimorbidity.The multivariate logistic regression model was used to analyze the influencing factors of multimorbidity among middle school students, and a trend Chi-square test was used to analyze the changing trends of internet addiction, depression and multimorbidity prevalence. Results:A total of 193 505 students were included in the study. From 2018 to 2023, the prevalence of multimorbidity of internet addiction and depressive symptoms among middle school students ranged from 2.7% to 3.5%. The prevalence of internet addiction ranged from 4.7% to 6.0%, while the prevalence of depressive symptoms ranged from 18.7% to 25.1%. Multivariate logistic regression showed that boarding students ( OR=1.34 , 95% CI: 1.26-1.42), low-frequency ( OR=1.59, 95% CI: 1.46-1.73), and high-frequency sugary drink consumption ( OR=3.91, 95% CI: 3.55-4.31) increased the risk of multimorbidity among middle school students. In contrast, higher frequencies of moderate-to-high-intensity exercise (medium: OR=0.54, 95% CI: 0.50-0.58; high: OR=0.49, 95% CI: 0.44-0.55) and sufficient sleep ( OR=0.52, 95% CI: 0.49-0.56) were protective factors. From 2018 to 2023, there was no significant change in the trend of multimorbidity prevalence among middle school students ( χ2trend=3.82, P=0.051). The prevalence of internet addiction showed an upward trend ( χ2trend=20.54, P<0.001), while depressive symptoms showed a downward trend ( χ2trend=181.41, P<0.001). Conclusion:The prevalence of internet addiction and depression symptoms among middle school students in Zhejiang Province remains stable from 2018 to 2023. The prevalence of internet addiction shows an upward trend, while the prevalence of depression symptoms shows a downward trend. The risk of multimorbidity is related to students′ boarding, consumption of sugary drinks, lack of exercise, and insufficient sleep.

Objective This study examined changes in serum growth hormone(GH)and insulin-like growth factor 1(IGF-1)levels,as well as insulin resistance,in patients with type 2 diabetes mellitus(T2DM)across different stages of diabetic kidney disease(DKD).It explored the relationship between these factors and the occurrence and progression of DKD,with the aim of identifying new targets for the prevention and treatment of DKD.Methods In this cross-sectional study,T2DM patients aged 18-80 years were selected from the Department of Endocrinology,The Second Affiliated Hospital of Xi'an Jiaotong University,from November 30,2019 to March 30,2021.Their serum GH and IGF-1 levels were tested.Results The serum GH level increased gradually in the groups,and the difference was statistically significant(P＜0.05).The level of serum IGF-1 decreased first and then increased among the groups,but with no significant difference(P＞0.05).HOMA-IR showed no significant correlation among the groups(P＞0.05),but HOMA-β gradually decreased among the groups,with statistically significant difference(P＜0.05).Multivariate Logistic regression analysis showed that the increase of serum GH level was closely related to the progression of T2DM to early DKD,and that the increase of serum IGF-1 level might be related to the deterioration of renal function in patients with T2DM at DKD stage.HOMA-IR and HOMA-β were not found to have correlation with the occurrence or development of DKD in T2DM patients.Conclusion In patients with T2DM,elevated serum GH level is closely associated with the occurrence and progression of early DKD.The increase of serum GH level may promote the occurrence of early DKD in T2DM,and the increase of serum IGF-1 level may be related to the deterioration of renal function in clinical DKD stage.In this study,we did not find correlation of HOMA-IR and HOMA-β with the occurrence or development of DKD in T2DM patients.

Objective To understand the prognosis of patients with bone metastases from first-treatment non-small cell lung cancer(NSCLC)of different pathological types after different first-line treatment regimens,in order to provide clinical prediction of disease progression,guidance of treatment,and improvement of prognosis.Methods 403 NSCLC patients with bone metastases who received primary treatment with bone metastases from Chaohu Hospital of Anhui Medical University from 1 January 2019 to 31 December 2023 were selected for univariate analysis using survival analysis(Log-rank test)and multifactorial analysis with Cox regression,and it was found that histopathological subtyping was an independent factor affecting the prognosis of patients(P=0.001,HR=1.952),after which the effect of this factor on prognosis was removed,and the total number of patients was divided into two groups according to histopathological classification:adenocarcinoma group(316)and squamous carcinoma group(87),and then multifactorial analysis was performed again using Cox regression model to analyse the factors affecting survival prognosis.Results In this data analysis,patients with the pathological type of squamous carcinoma had a median overall survival(mOS)of 15 months(95%CI:12.85～17.15)and a median progression-free survival(mPFS)of 9 months(95%CI:7.34～10.67),whereas patients in the adenocarcinoma group had a mOS of 25 months(95%CI:23.26～26.74)and mPFS was 16 months(95%CI:14.43～17.57),a statistically significant difference.The OS of the overall group was affected by multiple factors,including Eastern Cooperative Oncology Group(ECOG)score status(1/＞1)at the time of initial diagnosis,bone metastases to Trunk+limb bones+cranium,number of bone metastases≥4,mutation of ALK target genes,and the use of chemotherapy+targeted therapy as the first line of treatment.therapy;similarly,PFS was also affected by the above factors.In addition,in the adenocarcinoma and squamous carcinoma models based on histopathological classification,chemotherapy+targeted therapy and chemotherapy+immunotherapy were found to be the protective factors for the two groups,and ALK target gene mutation was only a protective factor for the adenocarcinoma group.Conclusion This study further confirmed the prognostic factors influencing the prognosis of patients with bone metastases from primary NSCLC,which provides an important reference for clinical treatment.

Objective To investigate the current situation of knowledge,belief,and practice of grass-root health workers during war injury rescue in marine corps,so as to provide a basis for targeted training of war injury rescue.Methods From March to May 2023,382 grass-root health workers were selected by convenience sampling method as research subjects,and a self-designed questionnaire was used for the survey.Results The average scores of knowledge,attitude,and behavior items related to war injury rescue were 3.78±0.94,4.55±0.64,and 3.50±1.08,respectively.Multiple linear regression analysis showed that military rank,workplace,and training experience were the main influence factors for the knowledge,belief,and practice of health workers in war injury rescue(P<0.05).Conclusion Grass-root health workers in the marine corps have a positive attitude towards war injury rescue,but their knowledge and practice are relatively weak.It is necessary to carry out targeted and graded training for them.

The clinical translation of stem cells and their extracellular vesicles (EVs)-based therapy for central nervous system (CNS) diseases is booming. Nevertheless, the insufficient CNS delivery and retention together with the invasiveness of current administration routes prevent stem cells or EVs from fully exerting their clinical therapeutic potential. Intranasal (IN) delivery is a possible strategy to solve problems as IN route could circumvent the brain‒blood barrier non-invasively and fit repeated dosage regimens. Herein, we gave an overview of studies and clinical trials involved with IN route and discussed the possibility of employing IN delivery to solve problems in stem cells or EVs-based therapy. We reviewed relevant researches that combining stem cells or EVs-based therapy with IN administration and analyzed benefits brought by IN route. Finally, we proposed possible suggestions to facilitate the development of IN delivery of stem cells or EVs.

Background::To date, there is no effective medicine to treat coronavirus disease 2019 (COVID-19), and the antiviral efficacy of arbidol in the treatment for COVID-19 remained equivocal and controversial. The purpose of this study was to evaluate the efficacy and safety of arbidol tablets in the treatment of COVID-19.Methods::This was a prospective, open-label, controlled and multicenter investigator-initiated trial involving adult patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Patients were stratified 1:2 to either standard-of-care (SOC) or SOC plus arbidol tablets (oral administration of 200 mg per time, three times a day for 14 days). The primary endpoint was negative conversion of SARS-CoV-2 within the first week. The rates and 95% confidential intervals were calculated for each variable.Results::A total of 99 patients with laboratory-confirmed SARS-CoV-2 infection were enrolled; 66 were assigned to the SOC plus arbidol tablets group, and 33 to the SOC group. The negative conversion rate of SARS-CoV-2 within the first week in patients receiving arbidol tablets was significantly higher than that of the SOC group (70.3% [45/64] vs. 42.4% [14/33]; difference of conversion rate 27.9%; 95% confidence interval [CI], 7.7%-48.1%; P = 0.008). Compared to those in the SOC group, patients receiving arbidol tablets had a shorter duration of clinical recovery (median 7.0 days vs. 12.0 days; hazard ratio [HR]: 1.877, 95% CI: 1.151-3.060, P = 0.006), symptom of fever (median 3.0 days vs. 12.0 days; HR: 18.990, 95% CI: 5.350-67.410, P < 0.001), as well as hospitalization (median 12.5 days vs. 20.0 days; P < 0.001). Moreover, the addition of arbidol tablets to SOC led to more rapid normalization of declined blood lymphocytes (median 10.0 days vs. 14.5 days; P > 0.05). The most common adverse event in the arbidol tablets group was the elevation of transaminase (5/200, 2.5%), and no one withdrew from the study due to adverse events or disease progression. Conclusions::SOC plus arbidol tablets significantly increase the negative conversion rate of SARS-CoV-2 within the first week and accelerate the recovery of COVID-19 patients. During the treatment with arbidol tablets, we find no significant serious adverse events.Trial registration::Chinese Clinical Trial Registry, NCT04260594, www.clinicaltrials.gov/ct2/show/NCT04260594?term= NCT04260594&draw=2&rank=1