Objective: To explore the dynamic developmental trajectories of college students class belongingness during their college years and its longitudinal predictive effects on depressive symptoms, so as to provide targeted insights for precise campus psychological interventions. Methods: In October 2021 (T1), a total of 4 720 college students from a university in Shandong Province were selected by cluster sampling method and followed up for 3 years. Surveys were conducted annually (T2: October 2022, T3: October 2023, T4: October 2024). The Class Belongingness Scale and Patient Health Questionnaire-9 (PHQ-9) were used to assess students class belongingness and depressive symptoms. Latent growth mixture modeling was employed to identify trajectories of class belonging, and multinomial Logistic regression analysis was used to examine the predictive effects of these trajectory classes on depressive symptoms. Results: Mean scores of class belongingness across T1-T4 were (73.24±11.95, 74.76±12.25, 75.25±12.38, 77.64±11.63), and the scores of depressive symptoms were [1.00 (0, 5.00), 0 (0, 3.00), 0 (0, 2.00), 0 (0, 2.00)]. The developmental trajectories of class belongingness were categorized into three types: the high-starting ascending group ( 56.61 %), the low-starting descending group (11.91%), and the medium-starting stable group (31.48%). Multinomial Logistic regression analysis showed that, compared to the medium-starting stable group, the high-starting ascending group had a lower probability of developing mild depressive symptoms ( OR=0.27, 95%CI =0.15-0.47) and moderate or above depressive symptoms ( OR=0.29, 95% CI = 0.14-0.60) (both P <0.05). Conversely, the low-starting descending group had a higher probability of developing mild depressive symptoms ( OR=2.31, 95%CI =1.65-3.22) and moderate or above depressive symptoms ( OR=7.49, 95%CI = 3.82-14.69) (both P <0.05). Conclusion Declining trajectory of class belongingness is a risk factor for depressive symptoms, while sustained upward trend may mitigate such risks.

Purpose: Metastatic rectal cancer (mRC) is a highly lethal and complex disease that demands a multidisciplinary treatment approach. However, the clinical effectiveness of radiotherapy (RT) for de novo mRC remains controversial and uncertain. Methods: This retrospective cohort study examined medical records from Kaohsiung Chang Gung Memorial Hospital for patients with histologically confirmed de novo mRC diagnosed between January 2015 and December 2020. All patients received standard systemic therapy and radical surgery when feasible. The primary outcome, overall survival (OS), was assessed using the Kaplan-Meier method. Multivariable analysis was performed using a Cox regression model. Results: Among 271 patients included in the analysis, 117 received RT and 154 did not. The median OS was significantly longer in the RT group compared with the non-RT group (27.8 months vs. 21.9 months; P=0.046). Multivariate analysis identified several independent predictors of OS: age ≥65 years (hazard ratio [HR], 1.69; 95% confidence interval [CI], 1.26–2.27; P=0.001), primary tumor resection (HR, 2.62; 95% CI, 1.90–3.61; P<0.001), M1b or M1c disease (HR, 1.97; 95% CI, 1.44–2.69; P<0.001), and receipt of RT (HR, 1.41; 95% CI, 1.02–1.94; P=0.036). Conclusion RT significantly improves OS in patients with mRC, underscoring its role in treatment strategies. These findings support its inclusion in therapeutic protocols and highlight the need for larger, multicenter trials to confirm and extend these results.

Objective: Executive function correlates with the parasympathetic nervous system (PNS) based on static heart rate variability (HRV) measurements. Our study advances this understanding by employing dynamic assessments of the PNS to explore and quantify its relationship with inhibitory control (IC). Methods: We recruited 31 men aged 20–35 years. We monitored their electrocardiogram (ECG) signals during the administration of the Conners’ Continuous Performance Test-II (CCPT-II) on a weekly basis over 2 weeks. HRV analysis was performed on ECG-derived RR intervals using 5-minute windows, each overlapping for the next 4 minutes to establish 1-minute intervals. For each time window, the HRV metrics extracted were: mean RR intervals, standard deviation of NN intervals (SDNN), low-frequency power with logarithm (lnLF), and high-frequency power with logarithm (lnHF). Each value was correlated with detectability and compared to the corresponding baseline value at t0. Results: Compared with the baseline level, SDNN and lnLF showed marked decreases during CCPT-II. The mean values of HRV showed significant correlation with d’, including mean SDNN (R=0.474, p=0.012), mean lnLF (R=0.390, p=0.045), and mean lnHF (R=0.400, p=0.032). In the 14th time window, the significant correlations included SDNN (R=0.578, p=0.002), lnLF (R=0.493, p=0.012), and lnHF (R=0.432, p=0.031). Significant correlation between d’ and HRV parameters emerged only during the initial CCPT-II. Conclusion A significant correlation between PNS and IC was observed in the first session alone. The IC in the repeated CCPT-II needs to consider the broader neural network.

Objective:To analyze the learning curve of TiRobot-assisted lumbar pedicle screw fixation (LPSF) by cumulative sum (CUSUM) test method.Methods:The clinical data of 50 patients who underwent TiRobot-assisted LPSF from January 2020 to December 2022 in Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed. CUSUM analysis and learning curve fitting were performed with robot usage time as the main indicator with the time for each step refined (robot registration time, path planning time and guide wire placement time), to select the best learning curve fitting model with the R2 value closest to 1. Using the turning point of the learning curve as the boundary, the learning curve was divided into two stages as learning stage and maturity stage, and then the observation indexes were compared between the two stages. Results:All 50 patients successfully completed the surgery without perioperative complications, with a total of 244 pedicle screws implanted. The total robot usage time and robot registration time showed a gradually decreasing trend with the increase of case number, and the learning curves were successfully fitted and reached their peaks at the seventeenth and thirteenth cases respectively. The entire learning process was divided into learning stage (17 cases) and maturity stage (33 cases) based on the turning point of the learning curve of total robot usage time. The path planning time and guide wire placement time did not show significant changes with the increase in the case number. The total robot usage time, robot registration time and the intraoperative blood loss in the learning stage were significantly higher than those in the maturity stage: (35.35 ± 1.58) min vs. (30.61 ± 0.43) min, (20.83 ± 1.56) min vs. (14.94 ± 0.29) min and 400 (150, 500) ml vs. 200 (110, 300) ml, the guide wire placement time of per screw was significantly lower than that in the maturity stage: 2.00 (1.83, 2.34) min/screw vs. 2.33 (2.13, 2.69) min/screw, and there were statistical differences ( P<0.05 or <0.01). There were no statistical difference in the path planning time, path planning time of per screw, guide wire placement time and the accuracy of screw placement between two stages ( P>0.05). Conclusions:TiRobot-assisted LPSF is a new technology with safety and effectiveness, and it has a relatively short learning curve. To achieve technological maturity, at least 17 surgeries are required with accumulated experience, and the robot registration is the main step of the learning process. After reaching maturity stage, the robot usage time is significantly shortened and intraoperative trauma is significantly reduced while the relatively high screw placement accuracy is ensured.

Objective:To evaluate the role of NOD-like receptor protein 3 (NLRP3) inflammasome-mediated microglia activation in myocardial ischaemia-reperfusion-induced brain injury in mice.Methods:Fifty-two SPF healthy male wild-type C57BL/6 mice and 52 NLRP3 -/- mice, aged 8-10 weeks, were divided into 4 groups ( n=26 each) using a random number table method: wild type sham operation group (W-S group), wild type myocardial ischemia-reperfusion group (W-IR group), NLRP3 -/- sham operation group (NLRP3 -/--S group), and NLRP3 -/- myocardial ischemia-reperfusion group (NLRP3 -/--IR group). The myocardial ischemia-reperfusion-induced brain injury model was established by ligating the left anterior descending coronary artery for 45 min followed by 24 h of reperfusion in anesthetized mice. The cognitive function was evaluated using the modified Morris water maze test at 24 h of reperfusion. The mice were sacrificed after blood specimens were collected, and brain tissues were obtained for measurement of the blood-brain barrier permeability and water content, for microscopic examination of the pathological changes of brain tissues, and for determination of serum S-100β protein and neuron-specific enolase (NSE) concentrations, contents of interleukin-1 beta (IL-1β), IL-6 and tumor necrosis factor-alpha (TNF-α) in hippocampal tissues (by enzyme-linked immunosorbent assay), expression of NLRP3, apoptosis-associated speck-like protein (ASC), cleaved cysteine aspartate protease 1 (cleaved-caspase-1), gasdermin D (GSDMD), ionized calcium-binding adapter molecule 1 (Iba-1), and occludin in hippocampal tissues (by immunofluorescence and/or Western blot). The apoptosis rate of neurons and density of dendritic spine were calculated. Results:Compared with sham operation group, the escape latency was significantly prolonged, the number of crossing the original platform was decreased, and the time spent in the target quadrant was shortened, the concentrations of serum S-100β protein and NSE were increased, the blood-brain barrier permeability and brain water content were increased, the dendritic spine density in the hippocampal CA1 area was decreased, the contents of IL-1β, IL-6 and TNF-α were increased, the expression of NLRP3, ASC, cleaved-caspase-1, GSDMD and Iba-1 was up-regulated, and the expression of occludin was down-regulated ( P<0.05), and the pathological injury to brain tissues was found in ischemia-reperfusion group. Compared with W-IR group, the escape latency was significantly shortened, the number of crossing the original platform was increased, and the time spent in the target quadrant was prolonged, the concentrations of serum S-100β protein and NSE were decreased, the blood-brain barrier permeability and brain water content were decreased, the dendritic spine density in the hippocampal CA1 area was increased, the contents of IL-1β, IL-6 and TNF-α were decreased, the expression of NLRP3, ASC, cleaved-caspase-1, GSDMD and Iba-1 was down-regulated, and the expression of occludin was up-regulated ( P<0.05), and the pathological injury to brain tissues was alleviated in NLRP3 -/--IR group. Conclusions:NLRP3 inflammasome-mediated microglia activation is involved in myocardial ischaemia-reperfusion-induced brain injury in mice.

Objectives:To evaluate the impact of hemoglobin concentration on 5-year cardiovascular mortality in patients with hypertrophic obstructive cardiomyopathy(HOCM).Methods:This study retrospectively analyzed 325 non-surgically treated HOCM patients hospitalized at Fuwai Hospital from October 2009 to December 2014.Baseline information was compared between patients with or without cardiac death.The impact of hemoglobin concentration on 5-year cardiovascular mortality in HOCM patients was analyzed.Results:The median follow-up time was(43.55±19.70)months.During the follow-up period,a total of 29 patients(8.9%)experienced cardiac death.Univariate Cox regression analysis demonstrated that hemoglobin concentration was significantly associated with 5-year cardiac mortality in HOCM patients(P<0.001).After adjusting for potential cardiovascular risk factors in multivariate Cox regression analysis,hemoglobin concentration(P=0.011)remained negatively associated with 5-year cardiac mortality in HOCM patient.HOCM patients with decreased hemoglobin level faced a 3.118-fold increase in 5-year cardiac mortality(HR=4.118,95%CI:1.114-14.822,P=0.030).Kaplan-Meier survival analysis showed that HOCM patients with decreased hemoglobin levels had a significantly higher risk of 5-year cardiac mortality(log-rank test,χ2=24.38,P<0.001).Conclusions:Lower hemoglobin concentration is an independent risk factor for 5-year cardiac mortality in patients with HOCM.Compared to patients with normal hemoglobin levels,HOCM patients with decreased hemoglobin level face a 3-fold increase in 5-year cardiac mortality.

Objective To establish and evaluate a mouse model of acute myocardial infarction(AMI)with coronary heart disease(CHD)that integrates syndrome differentiation with disease diagnosis,based on the"deficiency-stagnation-toxicity"pathogenesis.Methods Forty-eight ICR mice were randomly divided into four groups using a random number table:sham-operated,normal diet,high-choline,and trimethylamine N-oxide(TMAO).From weeks 1 to 8,each group received corresponding dietary and water interventions.From the 9th week,the normal diet,high-choline,and TMAO groups underwent coronary artery ligation(left anterior descending artery,LAD).In contrast,the sham-operated group only had suture placement without ligation,maintaining the same dietary and water interventions.Data on general signs,body weight,food and water intake,urine and feces,auricle and paw conditions,and behavioral patterns were collected and compared macroscopically and microscopically to determine the syndrome type of the high-choline-induced AMI mouse model and observe changes in the"deficiency-stagnation-toxicity"syndrome indicators.After 12 weeks,echocardiography,hematoxylin-eosin(HE)staining,and Masson′s trichrome staining were used to assess cardiac function,myocardial tissue cellular morphology changes,and myocardial fibrosis levels,respectively.The stability and reliability of the model were evaluated by observing the fluorescence intensity of inflammatory cytokines in the myocardial tissues of each group using immunofluorescence.Results Mice in all groups post-AMI surgery exhibited significant weight loss,dull fur,lethargy,and reduced activity.Mice in the high-choline and TMAO groups showed more sluggish responses to stimuli.The high-choline and TMAO groups displayed increased food intake but slow weight gain from weeks 1 to 4,developing into a trend of"increased food and water intake with weight loss"from 5 to 8 weeks,accompanied by yellowish urine and dry stools(P<0.01).Postoperatively(9-12 weeks),body weight significantly decreased,with the most prominent weight loss observed in the high-choline group.The high-choline and TMAO groups exhibited abnormal RGB values in auricles and paws(P<0.01),and behavioral tests showed a significant decline in open-field activity(P<0.01).Cardiac function and pathological examinations revealed that,compared with the sham-operated and normal diet groups,mice in the high-choline and TMAO groups had increased left ventricular end-diastolic and end-systolic volumes(P<0.01),decreased left ventricular ejection fraction and fractional shortening(P<0.01),and elevated heart indices(P<0.05).HE staining of myocardial tissues indicated more pyknotic nuclei and inflammatory cell infiltration in the high-choline and TMAO groups.Masson′s trichrome staining showed extensive blue-stained collagen fiber distribution in the infarct border zones of the high-choline and TMAO groups,with aggravated fibrosis(P<0.05).Immunofluorescence revealed elevated interleukin-1 beta and tumor necrosis factor-alpha levels in the high-choline and TMAO groups compared with the sham-operated and normal diet groups(P<0.01).Conclusion A high-choline diet combined with LAD ligation successfully established an animal model of AMI with CHD that integrates syndrome differentiation with disease diagnosis,based on the"deficiency-stagnation-toxicity"pathogenesis.This model not only embodies the traditional Chinese medicine theory′s understanding of the pathogenic features of"deficiency-stagnation-toxicity",but also serves as a reference for assessing the interventional effects of Chinese herbal compound prescriptions and facilitating research on syndrome patterns in traditional Chinese medicine.

Objective:To evaluate the safety and efficacy of the TiRobot assisted screw placement in patients with lumbar degenerative diseases.Methods:The clinical data of 165 patients with lumbar degenerative diseases from January 2020 to December 2022 in Beijing Friendship Hospital, Capital Medical University were retrospectively analyze, and all patients were treated with posterior lumbar decompression and instrumentation. Among them, 46 patients were used the TiRobot assisted screw placement during surgery (robotic-assisted group), and 119 patients underwent freehand screw placement by C-arm X-ray machine fluoroscopy (freehand group). The operation time, intraoperative blood loss, complication and skelalgia visual analogue scale (VAS), Oswestry disability index (ODI) before and after operation were recorded. The accuracy of screw placement and rate of proximal facet joint violation were compared between two groups.Results:There were no statistical difference in operation time, intraoperative blood loss and incidence of complication between two groups ( P>0.05). In the two groups, the 3 d VAS and ODI after operation were significantly lower than those before operation, robot-assisted group: (3.33 ± 1.40) scores vs. (6.54 ± 2.00) scores and (16.96 ± 8.03) scores vs. (43.09 ± 5.48) scores; freehand group: (3.56 ± 1.29) scores vs. (6.55 ± 1.65) scores and (18.89 ± 6.74) scores vs. (44.91 ± 4.96) scores, and there were statistical differences ( P<0.01); there were no statistical difference in VAS and ODI before operation and 3 d after operation between two groups ( P>0.05). A total of 234 screws were implanted in robot-assisted group, and 590 screws were implanted in freehand group. The accuracy of screw placement in robot-assisted group was significantly higher than that in freehand group: 80.77% (189/234) vs. 74.58% (440/590), the rate of proximal facet joint violation was significantly lower than that in freehand group: 2.56% (6/234) vs. 7.29% (43/590), and there were statistical differences ( χ2 = 3.56 and 6.68, P<0.05). Conclusions:The TiRobot assisted screw placement for lumbar degenerative diseases is safe and effective. Compared to freehand technique, the TiRobot assisted method demonstrates higher screw placement accuracy and a lower rate of proximal facet joint violation.

Objective: Executive function correlates with the parasympathetic nervous system (PNS) based on static heart rate variability (HRV) measurements. Our study advances this understanding by employing dynamic assessments of the PNS to explore and quantify its relationship with inhibitory control (IC). Methods: We recruited 31 men aged 20–35 years. We monitored their electrocardiogram (ECG) signals during the administration of the Conners’ Continuous Performance Test-II (CCPT-II) on a weekly basis over 2 weeks. HRV analysis was performed on ECG-derived RR intervals using 5-minute windows, each overlapping for the next 4 minutes to establish 1-minute intervals. For each time window, the HRV metrics extracted were: mean RR intervals, standard deviation of NN intervals (SDNN), low-frequency power with logarithm (lnLF), and high-frequency power with logarithm (lnHF). Each value was correlated with detectability and compared to the corresponding baseline value at t0. Results: Compared with the baseline level, SDNN and lnLF showed marked decreases during CCPT-II. The mean values of HRV showed significant correlation with d’, including mean SDNN (R=0.474, p=0.012), mean lnLF (R=0.390, p=0.045), and mean lnHF (R=0.400, p=0.032). In the 14th time window, the significant correlations included SDNN (R=0.578, p=0.002), lnLF (R=0.493, p=0.012), and lnHF (R=0.432, p=0.031). Significant correlation between d’ and HRV parameters emerged only during the initial CCPT-II. Conclusion A significant correlation between PNS and IC was observed in the first session alone. The IC in the repeated CCPT-II needs to consider the broader neural network.

Objective: To investigate the role and mechanism of the heat-clearing and detoxifying drug Laggerae Herba in regulating the nuclear factor-erythroid 2-related factor-2(Nrf2)/solute carrier family 7 member 11 (SLC7A11)/glutathione peroxidase 4 (GPX4) signaling pathway to inhibit ferroptosis and improve chronic heart failure induced by transverse aortic arch constriction in mice. Methods: Twenty-four male ICR mice were divided into the sham (n=6) and transverse aortic arch constriction groups (n=18) according to the random number table method. The transverse aortic arch constriction group underwent transverse aortic constriction surgery to establish models. After modeling, the transverse aortic arch constriction group was further divided into the model, captopril, and Laggerae Herba groups according to the random number table method, with six mice per group. The captopril (15 mg/kg) and Laggerae Herba groups (1.95 g/kg) received the corresponding drugs by gavage, whereas the sham operation and model groups were administered the same volume of ultrapure water by gavage once a day for four consecutive weeks. After treatment, the cardiac function indexes of mice in each group were detected using ultrasound. The heart mass and tibia length were measured to calculate the ratio of heart weight to tibia length. Hematoxylin and eosin staining were used to observe the pathological changes in myocardial tissue. Masson staining was used to observe the degree of myocardial fibrosis. Wheat germ agglutinin staining was used to observe the degree of myocardial cell hypertrophy. Prussian blue staining was used to observe the iron deposition in myocardial tissue. An enzyme-linked immunosorbent assay was used to detect the amino-terminal pro-brain natriuretic peptide (NT-proBNP) and glutathione (GSH) contents in mice serum. Colorimetry was used to detect the malondialdehyde (MDA) content in mice serum. Western blotting was used to detect the Nrf2, GPX4, SLC7A11, and ferritin heavy chain 1 (FTH1) protein expressions in mice cardiac tissue. Results: Compared with the sham group, in the model group, the ejection fraction (EF) and fractional shortening (FS) of mice decreased, the left ventricular end-systolic volume (LVESV) and left ventricular end-systolic diameter (LVESD) increased, the left ventricular anterior wall end-systolic thickness (LVAWs) and left ventricular posterior wall end-systolic thickness (LVPWs) decreased, the ratio of heart weight to tibia length increased, the myocardial tissue morphology changed, myocardial fibrosis increased, the cross-sectional area of myocardial cells increased, iron deposition appeared in myocardial tissue, the serum NT-proBNP and MDA levels increased, the GSH level decreased, and Nrf2, GPX4, SLC7A11, and FTH1 protein expressions in cardiac tissue decreased (P<0.05). Compared with the model group, in the captopril and Laggerae Herba groups, the EF, FS, and LVAWs increased, the LVESV and LVESD decreased, the ratio of heart weight to tibia length decreased, the myocardial cells were arranged neatly, the degree of myocardial fibrosis decreased, the cross-sectional area of myocardial cells decreased, the serum NT-proBNP level decreased, and the GSH level increased. Compared with the model group, the LVPWs increased, the iron deposition in myocardial tissue decreased, the serum MDA level decreased, and Nrf2, GPX4, SLC7A11, and FTH1 protein expressions in cardiac tissue increased (P<0.05) in the Laggerae Herba group. Conclusion Laggerae Herba improves the cardiac function of mice with chronic heart failure caused by transverse aortic arch constriction, reduces the pathological remodeling of the heart, and reduces fibrosis. Its mechanism may be related to Nrf2/SLC7A11/GPX4 pathway-mediated ferroptosis.