Objective: To investigate the prevalence and influencing factors of depression among middle school students in Jiading District, Shanghai Municipality, so as to provide the evidence for developing mental health intervention strategies among middle school students. Methods: Students from 3 junior high schools and 3 senior high schools in Jiading District were selected from June 2022 to June 2023 using a stratified random cluster sampling method. Basic information including gender and educational stage was collected through questionnaire surveys. Depression, mental health literacy, cognitive emotion regulation, family cohesion, school climate, stress, and life satisfaction were assessed using the Children's Depression Inventory, the Mental Health Literacy Assessment Scale, the Chinese version of the Cognitive Emotion Regulation Questionnaire, the Family Adaptability and Cohesion Scale, the Perceived School Climate Scale, Depression-Anxiety-Stress Scale, and the Life Satisfaction Scale, respectively. Factors affecting depression among middle school students were analyzed using a multivariable logistic regression model. Results: There were 1 117 boys (53.94%) and 954 girls (46.06%), with a mean age of (15.20±1.77) years. There were 1 193 (57.61%) junior high school students and 878 (42.39%) senior high school students. Depression was detected in 577 students, with a prevalence of 27.86%. Multivariable logistic regression analysis identified gender (boy, OR=0.652, 95%CI: 0.512-0.832), educational stage (senior high school, OR=2.519, 95%CI: 1.584-4.008), mental health literacy (OR=0.958, 95%CI: 0.951-0.966), cognitive emotion regulation (adaptive cognitive emotion regulation strategies, OR=0.970, 95%CI: 0.958-0.982; maladaptive cognitive emotion regulation strategies, OR=1.103, 95%CI: 1.084-1.123), family cohesion (OR=0.910, 95%CI: 0.899-0.921), school climate (OR=0.720, 95%CI: 0.694-0.747), stress (OR=1.127, 95%CI: 1.104-1.150), life satisfaction (OR=0.817, 95%CI: 0.799-0.836) as factors affecting depression among middle school students. Conclusions Depression among middle school students in Jiading District is associated with gender, educational stage, mental health literacy, cognitive emotion regulation, family cohesion, school climate, stress, and life satisfaction. It is recommended that targeted measures be taken from the perspectives of individuals, families, schools, and society to promote the mental health of middle school students.

BACKGROUND: Telesurgery has the potential to overcome spatial limitations for surgeons, which depends on surgical robot and the quality of network communication. However, the influence of network latency and bandwidth on telesurgery is not well understood. METHODS: A telesurgery system capable of dynamically adjusting image compression ratios in response to bandwidth changes was established between Beijing and Sanya (Hainan province), covering a distance of 3000 km. In total, 108 animal operations, including 12 surgical procedures, were performed. Total latency ranging from 170 ms to 320 ms and bandwidth from 15-20 Mbps to less than 1 Mbps were explored using designed surgical tasks and hemostasis models for renal vein and internal iliac artery rupture bleeding. Network latency, jitter, frame loss, and bit rate code were systemically measured during these operations. National Aeronautics and Space Administration Task Load Index (NASA-TLX) and a self-designed scale measured the workload and subjective perception of surgeons. RESULTS: All 108 animal telesurgeries, conducted from January 2023 to June 2023, were performed effectively over a total duration of 3866 min. The operations were completed with latency up to 320 ms and bandwidths as low as 1-5 Mbps. Hemostasis for vein and artery rupture bleeding models was effectively achieved under these low bandwidth conditions. The NASA-TLX results indicated that latency significantly impacted surgical performance more than bandwidth and image clarity reductions. CONCLUSIONS This telesurgery system demonstrated safety and reliability. A total of 320 ms latency is acceptable for telesurgery operations. Reducing image clarity can effectively mitigate the potential latency increase caused by decreased bandwidth, offering a new method to reduce the impact of latency on telesurgery.
Animals ; Robotic Surgical Procedures/methods* ; Laparoscopy/methods*

Objective:To explore the effect of combining transcranial magnetic stimulation (rTMS) with acupuncture in the treatment of patients with vascular cognitive impairment (VCI).Methods:A total of 40 VCI patients were randomly assigned to either the control group or the experimental group ( n=20 per group) using a random number table. Both groups received routine treatment and rTMS, while the experimental group was additionally provided with acupuncture for four weeks. The rTMS was at 10Hz at 90% of the motor threshold. Before and after the treatment, both groups′ cognition was evaluated using the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). Ability in the activities of daily living (ADL) was quantified using the modified Barthel Index (MBI). Serum levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were measured using enzyme-linked immunosorbent assays. Results:Significant improvement was observed in both groups′ average MoCA, MMSE, and MBI scores, along with reductions in peripheral serum IL-6 and TNF-α levels. The experimental group exhibited significantly higher MoCA subdomain scores in the visuospatial and executive function, attention, and delayed recall subdomains, as well as a higher total MoCA score compared to the control group. The average MMSE and MBI scores were significantly higher in the experimental group than the control group, and that group′s serum IL-6 and TNF-α levels were significantly lower, on average. Pearson correlation analysis demonstrated a positive correlation between the improvements in MoCA and MMSE scores and the reductions in IL-6 and TNF-α levels in both groups.Conclusions:rTMS combined with acupuncture effectively improves cognition and ADL ability among VCI patients. The underlying mechanism may be associated with the reduction of neuroinflammatory factors IL-6 and TNF-α.

Objective:To explore the effect of combining transcranial magnetic stimulation (rTMS) with acupuncture in the treatment of patients with vascular cognitive impairment (VCI).Methods:A total of 40 VCI patients were randomly assigned to either the control group or the experimental group ( n=20 per group) using a random number table. Both groups received routine treatment and rTMS, while the experimental group was additionally provided with acupuncture for four weeks. The rTMS was at 10Hz at 90% of the motor threshold. Before and after the treatment, both groups′ cognition was evaluated using the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). Ability in the activities of daily living (ADL) was quantified using the modified Barthel Index (MBI). Serum levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were measured using enzyme-linked immunosorbent assays. Results:Significant improvement was observed in both groups′ average MoCA, MMSE, and MBI scores, along with reductions in peripheral serum IL-6 and TNF-α levels. The experimental group exhibited significantly higher MoCA subdomain scores in the visuospatial and executive function, attention, and delayed recall subdomains, as well as a higher total MoCA score compared to the control group. The average MMSE and MBI scores were significantly higher in the experimental group than the control group, and that group′s serum IL-6 and TNF-α levels were significantly lower, on average. Pearson correlation analysis demonstrated a positive correlation between the improvements in MoCA and MMSE scores and the reductions in IL-6 and TNF-α levels in both groups.Conclusions:rTMS combined with acupuncture effectively improves cognition and ADL ability among VCI patients. The underlying mechanism may be associated with the reduction of neuroinflammatory factors IL-6 and TNF-α.

ObjectiveTo understand the utilization of preconception healthcare services and the influencing factors among the women expecting additional childbirth in Jiading District， Shanghai， and to provide references for promoting the utilization of preconception healthcare services under the new population policy. MethodsA questionnaire survey on the utilization of preconception healthcare services and related influencing factors was carried out among 682 women expecting additional childbirth across six subdistricts in Jiading District， Shanghai. The results were statistically analyzed. ResultsThe average age of the women was （31.7±4.5） years， 30.2% of whom were ≥35 years old. The proportion of women having their third or subsequent children was low， at 16.4%. A significant majority， 92.4%， were found to have various risk factors during initial pregnancy screening. The utilization rate of preconception healthcare services among women seeking additional childbirth was relatively low at 26.7%. Awareness of the free preconception check-up program in Jiading District was also low at 28.6%， and the utilization rate for these services was even lower at 7.69%. Unplanned pregnancies were the primary reason for not utilizing preconception healthcare services， accounting for 63.6%. The results of multifactorial binary logistic regression analysis showed that the utilization rate of preconception healthcare services before the current pregnancy was higher for women aged between 35 and 39 compared to women aged ≤29 years old （OR=1.789， 95%CI： 1.033‒3.099）. Women with planned pregnancies had a higher utilization of preconception healthcare services prior to this pregnancy （OR=4.164， 95%CI： 2.627‒6.602）. Women who had received preconception care prior to their first birth had a higher utilization rate of preconception care prior to the current pregnancy （OR=7.534， 95%CI： 4.954‒11.456）. Women without a family history of chronic diseases had a higher utilization rate of preconception healthcare services （OR=1.903， 95%CI： 1.083‒3.345）. ConclusionUnder the context of three-child policy， the proportion of women seeking three or more children in Jiading District is low. Most of these women have risk factors identified during initial pregnancy screenings. The utilization rate of preconception healthcare services and the awareness of the free preconception screening program in Jiading District are both low. Unplanned pregnancies remain the primary reason for failing to receive timely preconception healthcare services. Age， whether the pregnancy was planned， whether the women had received preconception healthcare services before their first baby and family history of chronic diseases are the main factors affecting the utilization of preconception healthcare services. Relevant departments should enhance the promotion of preconception healthcare service programs， especially for women of childbearing age who have not yet given birth， so as to improve the utilization rate of preconception health care services.

Plant-derived nanovesicles have gained attention given their similarity to mammalian exosomes and advantages such as low cost,sustainability,and tissue targeting.Thus,they hold promise for disease treatment and drug delivery.In this study,we proposed a time-efficient method,PEG 8000 combined with sucrose density gradient centrifugation to prepare ginger-derived nanovesicles(GDNVs).Subse-quently,curcumin(CUR)was loaded onto GDNV by ultrasonic incubation.The optimum conditions for ginger-derived nanovesicles loaded with curcumin(CG)were ultrasound time of 3 min,a carrier-to-drug ratio(GDNV:CUR)of 1∶1.The study achieved a high loading capacity(94.027％±0.094％)and encapsu-lation efficiency(89.300％±0.344％).Finally,the drugs'in vivo distribution and anti-colitis activity were investigated in mice.CG was primarily distributed in the colon after oral administration.Compared to CUR and GDNV,CG was superior in improving disease activity,colon length,liver and spleen coefficients,myeloperoxidase activity,and biochemical factor levels in ulcerative colitis(UC)mice.In addition,CG plays a protective role against UC by modulating serum metabolite levels and gut flora.In summary,our study demonstrated that GDNV can be used for CUR delivery with enhanced therapeutic potential.

Plant-derived nanovesicles have gained attention given their similarity to mammalian exosomes and advantages such as low cost, sustainability, and tissue targeting. Thus, they hold promise for disease treatment and drug delivery. In this study, we proposed a time-efficient method, PEG 8000 combined with sucrose density gradient centrifugation to prepare ginger-derived nanovesicles (GDNVs). Subsequently, curcumin (CUR) was loaded onto GDNV by ultrasonic incubation. The optimum conditions for ginger-derived nanovesicles loaded with curcumin (CG) were ultrasound time of 3 min, a carrier-to-drug ratio (GDNV:CUR) of 1:1. The study achieved a high loading capacity (94.027% ± 0.094%) and encapsulation efficiency (89.300% ± 0.344%). Finally, the drugs' in vivo distribution and anti-colitis activity were investigated in mice. CG was primarily distributed in the colon after oral administration. Compared to CUR and GDNV, CG was superior in improving disease activity, colon length, liver and spleen coefficients, myeloperoxidase activity, and biochemical factor levels in ulcerative colitis (UC) mice. In addition, CG plays a protective role against UC by modulating serum metabolite levels and gut flora. In summary, our study demonstrated that GDNV can be used for CUR delivery with enhanced therapeutic potential.

ObjectiveTo understand the influencing factors of women’s intention to utilize preconception health care services， so as to promote the utilization of preconception care among women with future pregnancy plan. MethodsThe study was conducted at 8 outpatient health clinics of medical institutions providing perinatal health care in Jiading District of Shanghai. Women who had fertility intention for another child were invited to complete an electronic questionnaire from November 2020 to February 2021. ResultsWomen with better pregnancy and birth care behaviors during the last periconception were more likely to utilize preconception care service before the next conception than those with previous poorer behaviors （OR=1.980， 95%CI= 1.061‒3.694， P=0.032）. Women with higher preconception care knowledge scores had better pregnancy and birth care behaviors during the last periconception than those with lower knowledge scores （OR=1.362， 95%C1= 1.004‒1.846， P=0.047）. ConclusionsIn order to improve the utilization of preconception care among the population with future pregnancy plan， it is necessary to further strengthen health education and social mobilization to promote the preconception eugenic knowledge， planned pregnancy and pregnancy and birth care behaviors.

Objective:To evaluate the safety and clinical efficacy of Neuroform EZ stent in the treatment of severe intracranial atherosclerotic stenosis (ICAS).Methods:A total of 36 patients with severe ICAS receiving Neuroform EZ stent angioplasty were retrospectively analyzed at Beijing Anzhen Hospital from July 2018 to January 2020. Digital subtraction angiography (DSA) before endovascular intervention confirmed the diagnosis. Follow-up information was reviewed by neurologists at 30 days and 6 months after the procedure. The primary endpoints were transient ischemic attack (TIA), ischemic or hemorrhagic stroke and death caused by any reason within 30 days.Results:The overall technical success rate was 100%. The median stenosis rate was reduced from 93.6%±4.5% to 18.8%±11.2% ( t=37.36, P<0.001).Primary endpoint event was not reported. During follow-up, one patient developed TIA and no death or ischemic stroke was observed. No in-stent restenosis at six months occurred. Conclusion:Neuroform EZ stent is safe and effective in patients with severe ICAS. However, perspective studies need to be operated for further validation via long-term follow-up.