Objective: To analyze the association between drinking behaviors and anxiety symptoms, with the mediating role of insomnia symptoms among college freshmen, so as to provide a reference basis for reducing the occurrence of anxiety symptoms in college freshmen. Methods: From October to December 2021, 31 856 freshmen were selected by the purposive sampling method in 22 colleges across 11 provinces (Fujian, Jiangsu, Guangdong, Henan, Anhui, Hubei, Shanxi, Jiangxi, Shaanxi, Yunnan, Chongqing) in China. The Semi quantitative Food Frequency Questionnaire was used to investigate college freshmen drinking behaviors. The Depression Anxiety Stress Scale 21 and the Insomnia Severity Index were used to assess anxiety symptoms and insomnia symptoms in college freshmen. The generalized linear model was employed to analyze the association between drinking behaviors and anxiety symptoms in college freshmen, and the structural equation modeling was used to assess the mediating effect of insomnia symptoms on the association. Results: The detection rate of anxiety symptoms among college freshmen was 28.2%, the detection rates of the mild, moderate, severe and extremely severe were 6.6%, 15.9%, 3.2% and 2.6%, respectively. While 23.6% of college freshmen reported drinking in the past month, the rates were 39.8% among boys and 15.9% among girls. After adjusting for demographic variables (ethnicity, education, major, etc.) and confounding variables (self evaluation of learning burden, number of close friends, screen time, etc.), the results of generalized linear model analysis showed that beer consumption was associated with anxiety symptoms in college freshmen( β =0.09, 95% CI =0.04-0.14), girls( β =0.14, 95% CI =0.07-0.21) and those aged 19-20 years ( β =0.12, 95% CI =0.05-0.19)(all P <0.05). Red wine consumption was associated with anxiety symptoms in male students ( β =0.13, 95% CI =0.02-0.24, P <0.05). Alcohol and beer consumption were associated with insomnia in college freshmen[ β (95% CI ) =0.22(0.08-0.36),0.31(0.23-0.39),both P <0.01]. Insomnia symptoms partially mediated the association between drinking behaviors and anxiety symptoms among college freshmen with a mediating effect value of 0.05, accounting for 50.49% of the total effect. Conclusions Insomnia symptoms partially mediates the association between drinking behaviors and anxiety symptoms in college freshmen. Measures should be taken to simultaneously intervene in the drinking behaviors and insomnia symptoms of college freshmen to prevent the occurrence of their anxiety symptoms.

Objective: To explore the association between takeout fast foods and sugar sweetened beverage consumption with co-occurrence of anxiety and depressive symptoms among first year junior high school students in Yunnan Province, so as to provide theoretical basis for the prevention of anxiety and depressive symptoms co-occurrence among adolescents. Methods: A random cluster sampling involving 8 500 first year junior high school students in 11 counties in Yunnan Province was conducted by a questionnaire survey from October to December 2022. The Depression Anxiety Stress Scale-21 (DASS-21) was applied to assess anxiety and depressive symptoms in first year junior high school students. Chi-square test was used to compare the anxiety-depression co-occurrence symptoms of first year junior high school students with different demographic characteristics. The association between takeout fast foods and sugar sweetened beverage consumption with co-occurrence of anxiety and depressive symptoms of adolescents was analyzed by binary Logistic regression models. Results: The detection rate of co-occurrence of anxiety and depression symptoms among first year junior high school students in Yunnan Province was 26.92%. After controlling for demographic variables and other confounders, takeout fast foods and sugar sweetened beverage consumption( OR=1.50, 95%CI =1.27-1.77) was associated with anxiety-depression co-occurrence symptoms among first year junior high school students in Yunnan Province ( P <0.01). Stratified analysis showed that both Han ( OR=1.37, 95%CI =1.07-1.77) and ethnic minorities ( OR=1.60, 95%CI =1.29-2.00) exhibited statistically significant associations between takeout fast foods and sugar sweetened beverage consumption with co-occurrence of anxiety and depressive symptoms(both P <0.05). Conclusions Takeout fast foods and sugar sweetened beverage consumption increases the risk of co-occurrence of anxiety and depressive symptoms among first year junior high school students in Yunnan Province. It is recommended to strengthen guidance on the consumption of such products among junior high school students to prevent co-occurrence of anxiety and depressive symptoms.

Objective To compare the curative efficacy of balloon stent kissing technique and jailed wire technique in treating coronary bifurcation lesions(CBL)in the elderly patients.Methods A total of 104 elderly patients with CBL,who received interventional surgery from January 2023 to December 2023 in the First Hospital of Hebei University and Hebei Provincial Hospital of Traditional Chinese Medicine were enrolled in this study.The patients were divided into balloon stent group(n=51,using balloon stent kissing technique)and jailed wire group(n=53,using jailed wire technique).The postoperative changes in diseased vessels,myocardial and endothelial function injuries were compared between the two groups,and the incidence of postoperative major adverse cardiovascular event(MACE)was calculated.Results Half a year after surgery,in both groups the minimum internal diameters of the arterial main branch and lateral branches were larger than their preoperative values(P＜0.05),and the stenosis ratio of the lesion segment was smaller than the preoperative value(P＜0.05).In balloon stent group,the minimum internal diameter of lateral branches was larger than that in jailed wire group(P＜0.05),and the stenosis ratio of the lesion segment was smaller than that in jailed wire group(P＜0.05).Seven days after surgery,in both groups the levels of serum BNP,hs-cTnI,CK-MB,ET-1 and vWF were lower than their preoperative values,while the level of serum NO was higher than its preoperative value.The changes in the above indicators in balloon stent group were more obvious than in jailed wire group.No statistically significant difference in the incidence of MACE existed between the two groups(x2=1.605,P=0.205).Conclusion In treating elderly patients with CBL,both balloon stent kissing technique and jailed wire technique can improve the stenosis degree of the arterial main branch and lateral branches,but balloon stent kissing technique is superior to jailed wire technique in improving postoperative short-term myocardial function and endothelial function.

OBJECTIVE To explore the distribution and pathogens isolated from the acute respiratory distress syn-drome(ARDS)patients with pulmonary infection and analyze the values of serum endothelial cell-specific mole-cule-1(ESM-1),soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and macrophage inflamma-tory protein-1α(MIP-1α)in diagnosis of pulmonary infection.METHODS A total of 98 ARDS patients complicated with pulmonary infection who were treated in Hebei Provincial People's Hospital from Oct.2021 to Oct.2023 were assigned to the infection group,and 102 ARDS patients who were not complicated with pulmonary infection were chosen as the non-infection group.The distribution and drug resistance of the pathogens were analyzed.The levels of serum ESM-1,sTREM-1 and MIP-1α were compared between the two groups,and the values of the three inde-xes in diagnosis of pulmonary infection in the ARDS patients were analyzed.RESULTS Totally 112 strains of pathogens were isolated from the patients of the infection group,among which Klebsiella pneumoniae and Staph-ylococcus aureus were dominant.The drug resistance rates of K.pneumoniae strains to ceftriaxone and cefazolin were 56.52％and 52.17％,respectively;the drug resistance rates of the S.aureus strains to sulfamethoxazole-tri-methoprim,clindamycin and oxacillin were 75.00％,75.00％and 70.00％,respectively.The levels of serum ESM-1,sTREM-1 and MIP-1α of the infection group were higher than those of the non-infection group(P＜0.05);the area under the curve(AUC)value of the joint detection of the three indexes was higher than that of the single detection in diagnosis of the pulmonary infection in the ARDS patients(P＜0.05),and the sensitivity of the joint detection was 93.88％,with the specificity 84.31％.CONCLUSIONS K.pneumoniae and S.aureus are the predominant species of pathogens isolated from the ARDS patients complicated with pulmonary infection.The pa-tients show the high expressions of serum ESM-1,sTREM-1 and MIP-1α.The joint detection of the three indexes has high value in diagnosis of pulmonary infection in the ARDS patients.

OBJECTIVE To explore the distribution and pathogens isolated from the acute respiratory distress syn-drome(ARDS)patients with pulmonary infection and analyze the values of serum endothelial cell-specific mole-cule-1(ESM-1),soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and macrophage inflamma-tory protein-1α(MIP-1α)in diagnosis of pulmonary infection.METHODS A total of 98 ARDS patients complicated with pulmonary infection who were treated in Hebei Provincial People's Hospital from Oct.2021 to Oct.2023 were assigned to the infection group,and 102 ARDS patients who were not complicated with pulmonary infection were chosen as the non-infection group.The distribution and drug resistance of the pathogens were analyzed.The levels of serum ESM-1,sTREM-1 and MIP-1α were compared between the two groups,and the values of the three inde-xes in diagnosis of pulmonary infection in the ARDS patients were analyzed.RESULTS Totally 112 strains of pathogens were isolated from the patients of the infection group,among which Klebsiella pneumoniae and Staph-ylococcus aureus were dominant.The drug resistance rates of K.pneumoniae strains to ceftriaxone and cefazolin were 56.52％and 52.17％,respectively;the drug resistance rates of the S.aureus strains to sulfamethoxazole-tri-methoprim,clindamycin and oxacillin were 75.00％,75.00％and 70.00％,respectively.The levels of serum ESM-1,sTREM-1 and MIP-1α of the infection group were higher than those of the non-infection group(P＜0.05);the area under the curve(AUC)value of the joint detection of the three indexes was higher than that of the single detection in diagnosis of the pulmonary infection in the ARDS patients(P＜0.05),and the sensitivity of the joint detection was 93.88％,with the specificity 84.31％.CONCLUSIONS K.pneumoniae and S.aureus are the predominant species of pathogens isolated from the ARDS patients complicated with pulmonary infection.The pa-tients show the high expressions of serum ESM-1,sTREM-1 and MIP-1α.The joint detection of the three indexes has high value in diagnosis of pulmonary infection in the ARDS patients.

Objective To analyze the correlation of serum creatinine(Cr)/cystatin C(Cys C)ratio and monocyte/high-density lipoprotein-cholesterol(HDL-C)ratio with hypertension complicated with coronary heart disease(CHD).Methods A total of 200 hypertension patients with concomi-tant CHD admitted in our hospital from August 2021 to August 2023 were recruited and served as the observation group,and another 100 patients with hypertension during the same period served as the control group.Based on the number of vascular lesions,the patients in the observation group were divided into single-,double-and multi-vessel disease subgroups(104,75 and 21 cases).According to their Gensini score(＜30,30-90,＞90),they were also assigned into mild,moderate and severe stenosis subgroup(98,78 and 24 cases).After the fasting venous blood sam-ples were harvested from all subjects,the serum levels of Cys C,Cr and HDL-C were measured,and monocyte count was calculated,and Spearman correlation analysis was used to determine the correlation of serum Cr/Cys C ratio and monocyte/HDL-C ratio with number and severity of cor-onary artery lesions.Results The observation group had significantly higher Cr and Cys C levels,monocyte count and monocyte/HDL-C ratio,while lower Cr/Cys C ratio and HDL-C level than the control group(P＜0.01).The conditions of above indicators were more severe in the multi-vessel lesion subgroup than the single-and double-vessel lesion subgroups(P＜0.05).Similar re-sults were observed in the severe stenosis subgroup when compared with the mild and moderate stenosis subgroups(P＜0.05).Spearman correlation analysis showed that the Cr/Cys C ratio was negatively correlated with the number of coronary artery lesions and the severity of coronary ar-tery stenosis(r=-0.743,P＜0.05;r=-0.673,P＜0.05),and the monocyte/HDL-C ratio was positively correlated with the number of coronary artery lesions and the degree of coronary artery stenosis(r=0.692,P＜0.05;r=0.611,P＜0.05).Conclusion The serum Cr/Cys C ratio and monocyte/HDL-C ratio are closely associated with hypertension combined with concomitant CHD.And the Cr/Cys C ratio is negatively correlated with the severity of the disease,and the monocyte/HDL-C ratio is positively correlated with the severity of the disease in the patients.

Objective:To investigate the mechanism by which curcumin activates the PINK1/Parkin pathway to enhance mitophagy and ameliorate endothelial cell damage induced by oxygen-glucose deprivation/reperfusion(OGD/R).Methods:An OGD/R injury model was established in mouse brain microvascular endothelial cells(BMECs).En-dothelial cells were treated with different concentrations of curcumin.The effects of curcumin on mitophagy in BMECs were assessed using immunofluorescence and transmission electron microscopy.Cell proliferation,injury,and barrier integrity were evaluated using a Cell Counting Kit-8(CCK-8),lactate dehydrogenase(LDH)assay,and transendothe-lial electrical resistance(TEER)measurement,respectively.Western Blot was used to detect the effects of curcumin on the expression of PINK1/Parkin pathway proteins(LC-3 Ⅱ/Ⅰ,PINK1,Parkin and p62).Additionally,cells were co-treated with Mdivi-1 to further confirm the role of mitophagy in curcumin's protective effects against OGD/R injury.Results:Curcumin treatment significantly promoted mitophagy,increased the expression of LC-3 Ⅱ/Ⅰ,PINK1,and Par-kin proteins(P＜0.001),and decreased the expression of p62 protein(P＜0.001).In the OGD/R model,curcumin significantly enhanced cell proliferation rates(P＜0.001),reduced LDH release(P＜0.001),and improved TEER values(P＜0.001).However,these protective effects of curcumin were reversed by the mitophagy inhibitor Mdivi-1.Conclusion:Curcumin effectively alleviates cell damage in BMECs under OGD/R conditions by enhancing mitophagy through the activation of the PINK1/Parkin pathway.

Objective:To investigate the mechanism by which curcumin activates the PINK1/Parkin pathway to enhance mitophagy and ameliorate endothelial cell damage induced by oxygen-glucose deprivation/reperfusion(OGD/R).Methods:An OGD/R injury model was established in mouse brain microvascular endothelial cells(BMECs).En-dothelial cells were treated with different concentrations of curcumin.The effects of curcumin on mitophagy in BMECs were assessed using immunofluorescence and transmission electron microscopy.Cell proliferation,injury,and barrier integrity were evaluated using a Cell Counting Kit-8(CCK-8),lactate dehydrogenase(LDH)assay,and transendothe-lial electrical resistance(TEER)measurement,respectively.Western Blot was used to detect the effects of curcumin on the expression of PINK1/Parkin pathway proteins(LC-3 Ⅱ/Ⅰ,PINK1,Parkin and p62).Additionally,cells were co-treated with Mdivi-1 to further confirm the role of mitophagy in curcumin's protective effects against OGD/R injury.Results:Curcumin treatment significantly promoted mitophagy,increased the expression of LC-3 Ⅱ/Ⅰ,PINK1,and Par-kin proteins(P＜0.001),and decreased the expression of p62 protein(P＜0.001).In the OGD/R model,curcumin significantly enhanced cell proliferation rates(P＜0.001),reduced LDH release(P＜0.001),and improved TEER values(P＜0.001).However,these protective effects of curcumin were reversed by the mitophagy inhibitor Mdivi-1.Conclusion:Curcumin effectively alleviates cell damage in BMECs under OGD/R conditions by enhancing mitophagy through the activation of the PINK1/Parkin pathway.

【Objective】 To investigate the effect of optimized preoperative hemoglobin (Hb) level on clinical outcome in patients undergoing coronary artery bypass grafting (CABG). 【Methods】 Retrospective analysis was performed on patients who were selected to receive CABG from April 2020 to August 2021 in our hospital. Preoperative basic data, perioperative blood transfusion volume, blood transfusion rate, acute liver function impairment, renal function impairment (AKI), ICU stay, length of hospital stay, and in-hospital mortality of patients, meeting the inclusion criteria, were collected. According to the perioperative red blood cell transfusion, the optimal preoperative Hb threshold was calculated by receiver operating characteristic curve (ROC). According to the threshold, all patients were divided into two groups, and the blood transfusion volume and clinical outcomes of the two groups were compared to evaluate the predictive value of the optimal threshold of Hb. 【Results】 A total of 915 patients who met the inclusion criteria were enrolled in the study. The optimal threshold for predicting red blood cell transfusion rate by calculating preoperative Hb value by ROC curve was 118 g/L for males and 116g/L for females. Group A: Hb≤ threshold (n=293) was divided into the red blood cell transfusion group A1 and the red blood cell non-transfusion group A2. Group B: Hb>threshold (n=622) was divided into the red blood cell non-transfusion group B1 and no red blood cell non-transfusion group B2. The risk factors for perioperative red blood cell transfusion were age (OR=1.033 874, 95%CI 1.000 4-1.068 3, P<0.01), gender (female) (OR=3.268 5, 95%CI 2.353 1-4.540 0, P<0.01), BMI (OR=0.927 8, 95%CI 0.883 3-0.974 4, P<0.01), chronic renal insufficiency (CKD) (OR=2.041 1, 95%CI 1.347 8-3.091 0, P<0.01). Preoperative Hb≤ threshold (OR=3.517 4, 95%CI 2.502 1-4.944 7, P<0.01) was an independent risk factor for perioperative red blood cell transfusion. Perioperative red blood cell transfusion in patients with preoperative anemia further increases the incidence of postoperative complications (acute liver injury, AKI) and length of ICU stay. 【Conclusion】 Preoperative Hb≤ threshold can effectively predict perioperative red blood cell transfusion in patients with CABG, and increase the risk of postoperative acute liver injury, AKI, prolonged ICU stay and hospital stay. Optimizing the preoperative Hb level in CABG patients, increasing the Hb level to 118 g/L in males and 116 g/L in females can reduce the incidence of perioperative red blood cell transfusion and postoperative complications.

Objective:To explore the prolonged therapeutic regimen for patients with plaque psoriasis, who showed a positive response to 4-week treatment with tazarotene/betamethasone dipropionate cream, but were not completely cured.Methods:A multicenter, randomized, open-labelled, parallel-controlled clinical study was conducted. A total of 232 patients with plaque psoriasis were collected, who showed a positive response to previous 4-week treatment with 0.05%/0.05% tazarotene/betamethasone dipropionate cream, but were not completely cured with the psoriasis area and severity index[PASI] improvement rate being 50%-90%. At week 5, they were randomly and equally divided into 2 groups: test group receiving treatment with 0.05%/0.05% tazarotene/betamethasone dipropionate cream once a day, and control group receiving a sequential regimen of 0.05% tazarotene gel on weekdays once a day followed by 0.05%/0.05% tazarotene/betamethasone dipropionate cream on weekends once a day. After 2-and 4-week prolonged treatment, the efficacy and safety of the 2 therapeutic regimens were evaluated and compared. Measurement data were compared between 2 groups by using covariance analysis or t test, and enumeration data were compared by using chi-square test. Results:From the 5th to the 8th week, 200 out of the 232 patients completed the treatment. Data collected from 110 patients in the test group and 112 in the control group were enrolled into the full analysis set, and those from both 113 patients in the test group and control group were enrolled into safety analysis set. After consecutive 6-and 8-week treatment, the decline rates of the PASI score were 73.05% ± 16.69% and 78.46% ± 15.40% respectively in the test group, which were significantly higher than those in the control group (66.73% ± 21.77%, 67.02% ± 34.19%, respectively, both P < 0.05) . After 6-week treatment, the proportion of subjects who achieved PASI90 was significantly higher in the test group (14 cases, 12.7%) than in the control group (5 cases, 4.5%, χ2=4.842, P=0.028) ; After 8-week treatment, the proportions of subjects who achieved PASI75 and PASI90 (61.8%, 23.6%, respectively) were significantly higher in the test group than in the control group (48.2%, 12.5%, respectively, both P < 0.05) . During the consecutive 8-week treatment, there was no significant difference in the incidence rate of adverse reactions between the test group (15.0%) and control group (23.9%, χ2=2.822, P=0.093) . Conclusion:For patients who showed a positive response to 4-week treatment with 0.05%/0.05% tazarotene/betamethasone dipropionate cream, but were not completely cured, the continuous use of 0.05%/0.05% tazarotene/betamethasone dipropionate cream for 4 weeks is a superior therapeutic regimen compared with the sequential regimen of 0.05% tazarotene gel followed by 0.05%/0.05% tazarotene/betamethasone dipropionate cream.