Objective: To explore the consistency between self perceived body size and body mass index (BMI) evaluation among medical students, and analyze their association with depressive symptoms, so as to provide scientific evidence for psychological intervention targeting medical students. Methods: From September to November 2022, a convenient cluster sampling method was employed to select 1 850 college students from two universities in Hefei, Anhui Province, and Nanjing, Jiangsu Province. The Patient Health Questionnaire-9 (PHQ-9) was used to assess their depressive symptoms. Chi-square test was applied to compare the rates of depressive symptoms among medical students with different demographic characteristics. Kappa consistency test was performed to evaluate the consistency between self-perceived body size and BMI evaluation. Generalized linear models with binomial distribution and Logit link were constructed to analyze the associations of self-perceived body size and consistency between self-rated and BMI evaluation with depressive symptoms, as well as gender differences in these associations. Results: A total of 40.7 % of medical students overestimated or underestimated their body size. Specifically, the underestimation rate was 20.5% in males and 4.9 % in females, while the overestimation rate was 12.7% in males and 40.5% in females, the distribution of consistency in the misclassification rate of body self-perception between males and females was statistically significant ( χ 2=221.54, P ＜0.01). The overall consistency between self perceived body size and BMI evaluation was low for both males and females, with Kappa values of 0.518 and 0.281 respectively (both P <0.01). After adjusting for confounding variables, generalized linear model analyses showed that medical students with self perceived obesity and body size overestimation had higher risks of depressive symptoms ( OR =1.62, 1.26, both P ＜0.05). Stratified analyses by gender revealed that girls with self perceived overweight and obesity had higher risks of depressive symptoms in female students ( OR =1.43, 1.66, both P <0.05), whereas no statistically significant associations among boys ( OR =0.84, 1.86, both P >0.05). Girls with body size overestimation had a higher risk of depressive symptoms ( OR=1.20, P ＜ 0.05), with no significant association in boys ( OR=1.00, P >0.05). Conclusions Differences exist related between self perceived body size and BMI evaluation among medical students. Self perceived obesity and body size overestimation are related factors to depressive symptoms.

Objective To investigate the protective effect and regulatory mechanism of ciprofol on Parkinson's disease(PD)rats based on the adenosine monophosphate-activated protein kinase(AMPK)/silent information regulator 1(SIRT1)/peroxisome proliferator-activated receptor gamma coactivator 1α(PGC1α)signaling pathway.Methods Wistar rats were divided into blank control group,model group,ciprofol group,and ciprofol+AMPK inhibitor dorsomorphin group(ciprofol+Dor group),with 10 rats in each group.Except for the blank control group,PD models were estab-lished in the other three groups.Behavioral experiments were used to assess the motor and cognitive functions of rats in each group.Enzyme-linked immunosorbent assay(ELISA)was employed to de-tect the levels of dopamine(DA)and 5-hydroxytryptamine(5-HT)in the rat brain striatum.Immu-nofluorescence staining was conducted to measure the level of tyrosine hydroxylase(TH)in the rat brain substantia nigra.Real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)was applied to detect the relative mRNA expression levels of ULK1,beclin1,LC3,Bcl-2,and Bax in the rat brain striatum.Western blot was used to determine the relative protein expression levels of ULK1,beclin1,Bcl-2,Bax,phosphorylated(p)-AMPK,SIRT1,PGC1α,and the ratio of LC3 Ⅱ to LC3 Ⅰ(LC3 Ⅱ/LC3 Ⅰ)in the rat brain striatum.Results Compared with the blank control group,the motor and cognitive functions of rats in the model group were reduced,the levels of DA and 5-HT in the brain striatum decreased,the fluorescence intensity of TH in the brain substantia nigra weakened,and the relative mRNA expression levels of ULK1,beclin1,LC3,Bcl-2,as well as the relative protein expression levels of ULK1,beclin1,Bcl-2,p-AMPK,SIRT1,PGC1α,and LC3 Ⅱ/LC3 Ⅰ in the brain striatum were reduced.In contrast,the relative mRNA expression level of Bax and the relative protein expression level of Bax increased,with statistically significant differ-ences(P＜0.05).Compared with the model group,the motor and cognitive functions of rats in the ciprofol group were improved,the levels of DA and 5-HT in the brain striatum increased,the fluo-rescence intensity of TH in the brain substantia nigra strengthened,and the relative mRNA expres-sion levels of ULK1,beclin1,LC3,Bcl-2,as well as the relative protein expression levels of ULK1,beclin1,Bcl-2,p-AMPK,SIRT1,PGC1α,and LC3 Ⅱ/LC3 Ⅰ in the brain striatum were elevated.Meanwhile,the relative mRNA expression level of Bax and the relative protein expression level of Bax decreased,with statistically significant differences(P＜0.05).The comparison between the ciprofol+Dor group and the ciprofol group revealed that the AMPK inhibitor dorsomorphin could re-verse the effects of ciprofol(P＜0.05).Conclusion Ciprofol may exert neuroprotective effects for PD rats by promoting autophagy through activating the AMPK/SIRT1/PGC1α signaling pathway.

Objective To investigate the effects and related molecular mechanisms of esket-amine on the proliferation,epithelial-mesenchymal transition(EMT),and stem cell properties of colorectal cancer(CRC)cells.Methods CRC cell line SW480 was cultured with varying concentra-tions of esketamine,and the cells were divided into blank group(0 μmol/L),low-concentration group(1 μmol/L),medium-concentration group(5 μmol/L)and high-concentration group(10 μmol/L).Cell proliferation activity was assessed using the EdU proliferation assay,cell spheroid-forming ability was evaluated via the spheroid formation assay,cell migration capacity was measured using the scratch assay,cell invasion ability was determined through the transwell assay,and the expression levels of tumor stem cell property markers[NANOG homeobox(NANOG),SRY-box transcription fac-tor(SOX)2,SOX4],the neurogenic locus Notch homolog protein 1(Notch1)receptor and the Notch1 intracellular domain(Notch1 ICD)were detected by western blot.A recovery test was con-ducted by adding the Notch1 receptor agonist Jagged1 to the culture groups with different concentra-tions of esketamine.Results Compared with the blank group,esketamine significantly inhibited the proliferation activity,spheroid-forming ability,migration ability,and invasion ability of CRC cells in a concentration-dependent manner.The intracellular expression levels of SOX2,SOX4,NANOG,and Notch1 ICD proteins were significantly decreased,while the expression level of the Notch1 recep-tor was significantly increased in the esketamine groups(P＜0.05).After the addition of Jagged1,the inhibitory effects of esketamine on the proliferation activity,metastatic ability,and stem cell properties of CRC cells were alleviated.Conclusion Esketamine inhibits CRC cell proliferation,metastasis,EMT,and stem cell properties by reducing the activation level of the Notch1 receptor,demonstrating a potential for clinical anti-tumor applications.

To summarize the postoperative nursing experience for a child with Uhl's anomaly undergoing complex heart surgery.Nursing key points include implementing goal-oriented liquid negative balance management to promote the recovery of cardiac function;carrying out pressure load management and closely monitoring the heart rate and rhythm to maintain the stability of the circulatory system;closely monitoring the central venous pressure in the upper chamber and paying attention to the changes of the pulmonary artery pressure in real time;adopting a refined integrated management to avoid an abnormal rise in the pulmonary artery pressure;withdrawing invasive mechanical ventilation as early as possible and carrying out the non-invasive ventilator deconditioning training in an orderly manner;the synergistic management of bleeding and anticoagulation;the adoption of various measures to actively prevent complications;the prevention and control of infections in an all-round and multi-angle manner;the formulation of individualized cardiac rehabilitation training and nutritional intervention programs.The child was transferred from the pediatric intensive care unit back to the pediatric ward on postoperative day 9,transferred back to the pediatric intensive care unit on postoperative day 11 for 13 d for right atrial thrombus,stabilized and transferred back to the pediatric ward,and discharged after 10 d for recovery.The prognosis showed good recovery after 1 month and 3 months.

The Janus kinase/signal transducers and activators of transcription (JAK-STAT) control natural killer (NK) cells development and cytotoxic functions, however, whether long non-coding RNAs (lncRNAs) are involved in this pathway remains unknown. We found that miR155HG was elevated in activated NK cells and promoted their proliferation and effector functions in both NK92 and induced-pluripotent stem cells (iPSCs)-derived NK (iPSC-NK) cells, without reliance on its derived miR-155 and micropeptide P155. Mechanistically, miR155HG bound to miR-6756 and relieved its repression of JAK3 expression, thereby promoting the JAK-STAT pathway and enhancing NK cell proliferation and function. Further investigations disclosed that upon cytokine stimulation, STAT3 directly interacts with miR155HG promoter and induces miR155HG transcription. Collectively, we identify a miR155HG-mediated positive feedback loop of the JAK-STAT signaling. Our study will also provide a power target regarding miR155HG for improving NK cell generation and effector function in the field of NK cell adoptive transfer therapy against cancer, especially iPSC-derived NK cells.

This study aims to establish a high-performance size-exclusion chromatography (HPSEC) method for determining the content of the classical swine fever virus (CSFV) E2 protein and screen the optimal stabilizer to enhance the stability of this protein. The optimal detection conditions were determined by optimizing the composition of the mobile phase, and characteristic chromatographic peaks were identified by SDS-PAGE and Western blotting. The specificity, repeatability, precision, linearity, limit of detection (LOD), and limit of quantitation (LOQ) of the method were assessed. The method established was used to determine the content of CSFV E2 protein antigen and vaccine. Differential scanning fluorimetry (DSF) was employed to screen the buffer system, pH, and salt ion concentrations, and sugar, amino acid, and alcohol stabilizers were further screened. The results showed that using a 200 mmol/L phosphate buffer provided the best column efficiency. An antigen-specific chromatographic peak appeared at the retention time of 18 min, which was identified as the CSFV E2 protein by SDS-PAGE and Western blotting. The method exhibited high specificity for detecting the CSFV E2 protein, with no absorbance peak observed in the blank control. The relative standard deviation (RSD) of the peak area for six repeated injections of the CSFV E2 protein was 0.74%, indicating good repeatability of the method. The RSD for repeated detection of two different concentrations of CSFV E2 protein samples by different operators at different time points was less than 2%, suggesting good intermediate precision of the method. The peak area of the CSFV E2 protein was linearly related to its concentration, with the regression equation showing R² of 1.000. The LOD and LOQ of the method were 14.88 μg/mL and 29.75 μg/mL, respectively. Application of the developed method in the detection of three batches of CSFV E2 protein antigen and three batches of vaccine demonstrated results consistent with those from the bicinchoninic acid (BCA) assay, which meant that the method could accurately determine the content of CSFV E2 protein antigen and vaccine. The DSF method identified 50 mmol/L Tris-HCl at pH 8.0 as the optimal buffer, and the addition of sugar and alcohol stabilizers further improved the stability of the CSFV E2 protein. The HPSEC method established in this study is simple, fast, and exhibits good accuracy and repeatability, enabling precise measurement of the CSFV E2 protein content. It is expected to play a crucial role in the quality control of the CSFV E2 vaccine. Furthermore, the strategy for improving the CSFV E2 protein stability, identified through DSF screening, has significant implications for enhancing the stability of the CSFV E2 vaccine.
Classical Swine Fever Virus/chemistry* ; Chromatography, Gel/methods* ; Animals ; Swine ; Viral Envelope Proteins/immunology*

Objective To investigate the mechanism by which cancer-associated fibroblast(CAF)in the tumor microenvironment regulate key pathways in prostate cancer stem cells(PCSCs).Methods An in vitro co-culture system of CAF and PCSC was established to observe the effects of CAF on PCSC proliferation and sphere formation.Prostate cancer stem cells were treated with CAF conditioned medium pre-treated with Wnt inhibitor DKK-1 and SDF-1 neutralizing anti-body(MAB310).Western blot was used to detect the expression of β-catenin,CXCR4,CD133 and CD44 in PCSCs.And PCR was used to detect the expression of β-catenin,CXCR4,TCF,and LEF mRNA.TOPflash/FOPflash dual-luciferase reporter assays were conducted to detect the effects of SDF-1 on Wnt/β-catenin signaling activity in PCSCs.Results ELISA results showed that the secretion of Wnt3a and SDF-1 in CAF supernatant was significantly higher than that in WPMY-1 cells(P＜0.05).The A value of PCSCs co-cultured with CAF at a 1∶6 ratio was significantly higher than that of the PCSC-only group(P＜0.0 1),and CAF promoted sphere formation in PCSCs(P＜0.05).Western blot results showed that CAF-CM significantly increased the relative expression of β-catenin,CXCR4,CD133 and CD44 in PCSCs(P＜0.01).Compared to CAF-CM,CAFanti-Wnt-CM significantly reduced the expression of β-catenin,CD133 and CD44(P＜0.01).CAFanti-SDF-1-CM also significantly inhibited the expression of CXCR4,β-catenin,CD133 and CD44(P＜0.01).PCR results showed that CAFanti-SDF-1-CM inhibited the expression of β-catenin,CXCR4 and downstream Wnt signaling effectors TCF and LEF(P＜0.01).Dual-luciferase reporter assay results showed that luciferase activity in the CAFanti-SDF-1-CM group was significantly lower than that in the CAF-CM group(P＜0.05).Conclusion CAF reg-ulates the stemness of PCSCs through the Wnt/β-catenin and SDF-1/CXCR4 pathways.CXCR4 may enhance the mainte-nance of stemness by activating β-catenin.

With the latest development of information and communication technology, mobile applications for health care have attracted much attention to help cancer patients better manage their diseases. Digital therapeutics is an evidence-based intervention driven by high-quality software programs that prevent, manage, or treat medical disorders or diseases. This paper summarizes the origin, concept and characteristics of digital therapeutics and the application form, effect, challenge and opportunity of symptom management in cancer patients, in order to provide reference for the scientific and efficient application of Digital therapeutics to cancer patients.

Objective To explore the expert consensus on perinatal care management of infants with congenital heart disease(hereinafter referred to as"Consensus")in order to promote the standardization of integrated nursing.Methods The literature was systematically searched and several discussions were organized within the group to compile the first draft of the Consensus.From January to March 2024,20 experts in the clinical nursing,nursing management,clinical medicine and other fields of congenital heart disease were solicited through 2 rounds of Delphi,and 8 experts were invited to conduct a validation to revise the items to form the final Consensus.Results The recovery rates of the 2 rounds of questionnaires were 100％;the experts'authority coefficient was 0.89;the Kendall's W were 0.172,0.211,with statistical significance(P＜0.05).The Consensus included 8 first-level subjects,namely prenatal examination and consultation,postpartum screening,standardized referral,preoperative nursing,intraoperative nursing,postoperative nursing,other disease screening,health education and discharge follow-up.Conclusion The Consensus is scientific and rigorous,and it can provide a reference basis for clinical nursing staff to carry out the care and management of newborns with congenital heart disease.

Objective To examine the changing prevalence and antimicrobial resistance profiles of Burkholderia cepacia in 52 hospitals across China from 2015 to 2021.Methods A total of 9 261 strains of B.cepacia were collected from 52 hospitals between January 1,2015 and December 31,2021.Antimicrobial susceptibility of the strains was tested using Kirby-Bauer method or automated antimicrobial susceptibility testing systems according to a unified protocol.The results were interpreted according to the breakpoints released in the Clinical & Laboratory Standards Institute(CLSI)guidelines(2023 edition).Results A total of 9 261 strains of B.cepacia were isolated from all age groups,especially elderly patients.The proportion was 11.1％(1 032 strains)in children,significantly lower than the proportion in adults.About half(46.5％,4 310/9 261)of the strains were isolated from patients at least 60 years old and 42.3％(3 919/9 261)of the strains were isolated from young adults.Most isolates(71.1％)were isolated from sputum and respiratory secretions,followed by urine(10.7％)and blood samples(8.1％).B.cepacia isolates were highly susceptible to the five antimicrobial agents recommended in the CLSI M100 document(33rd edition,2023).B.cepacia isolates showed relatively higher resistance rates to meropenem and levofloxacin.However,the resistance rates to ceftazidime,trimethoprim-sulfamethoxazole,and minocycline remained below 8.1％.The percentage of B.cepacia strains resistant to levofloxacin was the highest compared to other antibiotics in any of the three age groups(from 12.4％in the patients＜18 years old to 20.6％in the patients aged 60 years or older).Conclusions B.cepacia is one of the clinically important non-fermenting gram-negative bacteria.Accurate and timely reporting of antimicrobial susceptibility test results and ongoing antimicrobial resistance surveillance are helpful for rational prescription of antimicrobial agents and proper prevention and control of nosocomial infections.