Objective: To analyze factors impacting mental health status of medical students based on ecological systems theory, so as to provide reference for the mental health promotion system for medical students. Methods: In June 2024, 1 760 medical school students randomly selected from 19 different kinds of medical colleges in eastern China by stratified cluster were surveyed using questionnaires and expert interviews. Descriptive statistics, cross analysis, hierarchical linear regression analysis, structural equation models were used for data analysis. Results: Medical school students had higher satisfaction with the school (65.85%) and a great sense of perceived social support (57.16%). Furthermore, 91.14% of the students had normal interpersonal relationships. However, 44.89% reported that their mental health was impacted by high level of depression. The hierarchical linear regression analysis showed that the mental health outcomes of the medical students were positively predicted by higher perceived social support scores ( β =-11.40), institutional satisfaction ( β =-4.85 ), and lower help seeking stigma scores ( β =9.31) ( P <0.05). The structural equation modeling showed that the status of both perceived social support and self help seeking stigma had significant impacts on depression severity ( β =-0.32, -0.53) and interpersonal relationship sensitivity ( β =-0.31, 0.58) among medical students ( P <0.01).Through expert interviews, collaborations between the school and the tripartite organization (families, universities and society) was of growing importance. Conclusions Perceived social support and self stigma have a significant impact on the mental health status of medical students. The problem of self stigma of medical students should be paid attention to. Therefore, families, universities and society should work together to improve the mental health of medical students.

This study summarizes the application of automatic recognition technologies for patient-ventilator asynchrony(PVA)during mechanical ventilation.In the early stages,the method of setting rules and thresholds relied on manual interpretation of ventilator parameters and waveforms.While these methods were intuitive and easy to operate,they were relatively sensitive in threshold setting and rule selection and could not adapt well to minor changes in patient status.Subsequently,machine learning and deep learning technologies began to emerge and develop.These technologies automatically extract and learn data characteristics through algorithms,making PVA detection more robust and universal.Among them,logistic regression,support vector machines,random forest,hidden Markov models,convolutional autoencoders,long short-term memory networks,one-dimensional convolutional neural networks,etc.,have all been successfully used for PVA recognition.Despite the significant advancements in feature extraction through deep learning methods,their demand for labelled data is high,potentially consuming significant medical resources.Therefore,the combination of reinforcement learning and self-supervised learning may be a viable solution.In addition,most algorithm validations are based on a single dataset,so the need for cross-dataset validation in the future will be an important and challenging direction for development.

AIM: To observe the effect ofacacia honey (AH) on serum uric acid level and renal function in potassium oxonate modelrats after drinking AH aqueous solution. METHODS: Sixty male SD rats were selected and randomly divided into control group (CON group), potassium oxonate model group (OA model group), 10% fructose group (10% F group) and different concentration honey groups (25%, 12.5% and 6.25% AH groups). All rats were fed with normal diet.The rats in CON group were subcutaneously injected with 5% sodium carboxymethyl cellulose (CMC-Na) solution and drunk sterile water every day, while rats in other groups were injected with 100 mg / kg OA solution suspended with 5% CMC-Na subcutaneouslyand drunksterile water orfructose solution or AH solution of different concentrations every day. Before and during the 4-week test, rats were weighed and blood was taken once a week. At the end of test, urine and feces specimens or kidney tissues were collected and blood was taken from the abdominal aorta. The uric acid content in blood, urine, and feces and the levels of serum creatinine (Cre) and blood urea nitrogen (BUN) or inflammatory factors in kidney tissues were measured. Renal function and histology were evaluated. RESULTS: Compared with CON group, AH could significantly reduce the body weight of rats (P<0.05), increase the kidney organ coefficient, the levels of serum uric acid, and uric acid in urine or feces, and reduce the level of fecal uric acid (FUA) in rats. AH can down regulate the level of tumor necrosis factor alpha (TNF-a) (P< 0.05) and up regulate the expression of monocyte chemoattractant protein 1 (MCP-1) and transforming growth factor β - 1 (TGF - β1) in rats kidneys; AH can cause slight to mild dilatation of renal tubules and mild to moderate basophilic lesions of renal rubules in rat kidney in a dose dependent manner. CONCLUSION: In the doses rang of present study, AH can cause hyperuricemia, renal tubular dilatation and basophilic lesions, and lead to renal function damage in rats.

Objective:To summarize the clinical manifestations and gene mutation features of patients with nucleotide excision repair (NER) disorders.Methods:A retrospective analysis was made on clinical data of patients with NER disorders who were admitted to the Chinese People′s Liberation Army General Hospital from October 2008 to February 2022 and diagnosed in the Outpatient Department of Beijing Children′s Hospital, Capital Medical University from October 2015 to February 2022.Literature on previously reported Chinese patients with NER disorders was reviewed.Results:(1)A total of 16 patients with NER disorders were enrolled, including 6 males and 10 females.The onset age was 7.5 (4.0, 12.0) months and the age at diagnosis was 42.0 (21.5, 77.0) months.There were 3 types of NER disorders: Cockayne syndrome (CS) in 13 cases, Xeroderma Pigmentosum (XP) in 2 cases and Cerebro-Oculo-Facio-Skeletal syndrome (COFS) in 1 case.Four disease-causing genes were detected: CSA gene in 11 cases, CSB gene in 3 cases, XPG gene in 1 case, and XPD gene in 1 case.The first symptoms of the 16 patients were photosensitivity and developmental delay, and neurological symptoms were observed in all the 3 NER disorder types.XP and CS patients had skin symptoms.CS patients presented typical facial features, visual and auditory impairment, microcephaly and changes in neuroimaging features.COFS patients showed intrauterine growth retardation.(2)Results of literature review: a total of 96 Chinese patients reported were retrieved, involving 6 disease types, including CS in 45 cases, XP in 44 cases, trichothiodystrophy in 4 cases, COFS in 1 case, XP-CS in 1 case, and ultraviolet sensitive syndrome in 1 case.Nine mutated genes were identified: CSA in 33 cases, XPA in 15 cases, CSB in 13 cases, XPV in 10 cases, XPC in 9 cases, XPG in 7 cases, XPD in 7 cases, XPF in 1 case, and MPLKIP in 1 case.The common symptoms were growth failure (62 cases), skin photosensitivity (61 cases), typical facial features (52 cases), mental retardation (49 cases) and microcephaly (48 cases). Among 36 cases had imaging data 33 cases(91.7%)had calcification of basal nucleus or globus pallidus.Three cases had intrauterine growth retardation and microcephaly during pregnancy. Conclusions:Patients with such prenatal manifestations as intrauterine growth retardation and microcephaly or with typical symptoms like skin photosensitivity, typical facial features, growth failure, mental retardation, hypertonia, and calcifications of basal ganglia should be suspected of NER disorders.Early genetic testing is recommended to confirm the diagnosis.

Many human genetic diseases, including Hutchinson-Gilford progeria syndrome (HGPS), are caused by single point mutations. HGPS is a rare disorder that causes premature aging and is usually caused by a de novo point mutation in the LMNA gene. Base editors (BEs) composed of a cytidine deaminase fused to CRISPR/Cas9 nickase are highly efficient at inducing C to T base conversions in a programmable manner and can be used to generate animal disease models with single amino-acid substitutions. Here, we generated the first HGPS monkey model by delivering a BE mRNA and guide RNA (gRNA) targeting the LMNA gene via microinjection into monkey zygotes. Five out of six newborn monkeys carried the mutation specifically at the target site. HGPS monkeys expressed the toxic form of lamin A, progerin, and recapitulated the typical HGPS phenotypes including growth retardation, bone alterations, and vascular abnormalities. Thus, this monkey model genetically and clinically mimics HGPS in humans, demonstrating that the BE system can efficiently and accurately generate patient-specific disease models in non-human primates.
Animals ; Disease Models, Animal ; Female ; Gene Editing ; Humans ; Lamin Type A/metabolism* ; Macaca fascicularis ; Progeria/pathology*

OBJECTIVE: To determine the composition and distribution of beta-thalassemia-associated genotypes in Liuzhou area of Guangxi, China. METHODS: From January to December 2017, 13 847 individuals who came for premarital examination, maternity examination or health check were recruited with informed consent. The subjects were analyzed by reverse dot blotting (RDB) for 17 common beta-thalassemia-associated variants among the Chinese population. Individuals with inconsistent results by blood test, electrophoresis, and RDB were subjected to Sanger sequencing to detect rare variants of the beta globin gene. RESULTS: In total 2098 individuals were found to harbor beta-thalassemia-associated variants, which included 2075 heterozygotes (98.90%), 12 compound heterozygotes (0.57%) and 11 homozygotes (0.52%). CD41-42 (48.43%) and CD17 (31.45%) were the most common variants. Three hundred and thirty eight-individuals were found to also carry heterozygous variants of the alpha globin gene, with the most common types being --SEA/aa, -a3.7/aa, aCSa/aa, -a4.2/aa. Through Sanger sequencing, rare genotypes such as beta-32/betaN, betaCD41-42/betaIVS-II-5 and betaCD30/betaN were detected. CONCLUSION Liuzhou area has a high incidence of beta-thalassemia, but with a complex variant spectrum and clinical phenotypes different from other regions. Genetic counseling and prenatal diagnosis for the carrier population is crucial for the reduction of the related birth defects. Our result may provide valuable information for the prevention and control of beta-thalassemia in this area.
China ; Female ; Genetic Counseling ; Genetic Variation ; Genotype ; Humans ; Mutation ; Pregnancy ; Prenatal Diagnosis ; alpha-Globins ; genetics ; beta-Globins ; genetics ; beta-Thalassemia ; diagnosis ; genetics

ObjectiveTo investigate the mechanism of action of Sini powder in the treatment of liver cancer based on network pharmacology and molecular docking. MethodsTraditional Chinese Medicine Systems Pharmacology Database and Analysis Platform was used to obtain the compound and target of Sini powder, and the corresponding gene Symbol was obtained through Uniprot. The disease genes of liver cancer were obtained from Human Genome Database, and the genes with intersection with the target genes of Sini powder were screened out. Cytoscape3.7.1 software was used to draw the map of “traditional Chinese medicine (TCM)-compound-target” network. STRING was used to construct a protein-protein interaction (PPI) network, R studio software was used to conduct gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses on therapeutic targets, and then the results were visualized. The active component with the highest number of targets was selected as the ligand, and the target with the highest degree in the PPI network was selected as the receptor, so as to predict the structure of receptor-ligand complex and the amino acid residues that bind to each other. ResultsIn this study, 91 core targets and 141 relevant active components of Sini powder were screened out, among which quercetin and kaempferol were the main active components in the treatment of liver cancer. TP53 and HSP90AA1 were the main therapeutic targets. The GO enrichment analysis obtained 1007 items which met the screening criteria, which were mainly involved in the biological processes of antioxidation reaction, activity regulation of protein serine and threonine kinase, and cellular stress response. The KEGG enrichment analysis obtained 102 pathways, which mainly regulated the hepatitis B pathway and the PI3K-Akt signaling pathway in the prevention and treatment of liver cancer. The results of molecular docking showed a synergistic antitumor effect between the crystal structure domains VAL147, CYS220, GLU221, and PRO222 of quercetin-TP53. ConclusionThis study reveals the mechanism of action of Sini powder in the treatment of liver cancer by acting on multiple targets and signaling pathways, which provides a theoretical basis for biological experiments.

BACKGROUND:Three dimensional finite element analysis is widely used in orthopedics, but research in the knee flexion movement is not much. OBJECTIVE:To analyze biomechanical properties of knee flexion using finite element analysis.METHODS:Three dimensional finite element models and models of knee flexion at 30 degrees, 60 degrees and 120 degrees were established. Femoral forward movement, femur inward movement, tibia internal rotation and tibia vara were analyzed at different flexion angles. RESULTS AND CONCLUSION:(1) When knee flexion was at 30 degrees, 60 degrees and 120 degrees, the femur had backward movement. The backward movement value was larger at 60 degrees than at 30 and 120 degrees (P<0.05). The backward movement value was larger at 120 degrees than at 30 degrees (P>0.05). (2) The femur had outward movement at 30 degrees, and inward movement at 120 degrees. The inward movement value was significantly larger at 120 degrees than at 30 and 60 degrees (P<0.05). No significant difference in outward movement was determined between the 30 and 60 degrees (P>0.05). (3) Tibia internal rotation was not significantly different at 30, 60 and 120 degrees of flexion (P>0.05). (4) Tibia vara was found at 30, 60 and 120 degrees of flexion, but the tibia vara was not obvious at 120 degrees. The tibia vara was maximum at 60 degrees, and significantly higher than that at 120 degrees (P<0.05). The tibia vara was larger at 30 degrees than at 120 degrees (P>0.05). (5) These findings verify that backward movement was most obvious at 60 degrees. Femur inward movement was most large at 120 degrees. Tibia internal rotation was noticeable at 30 and 120 degrees. Tibia vara was remarkable at 60 degrees.

Objective This study aimed to estimate the impact of the threshold of Autocapture algorithm on the pacemaker's service life.Methods Seventy-four patients implanted with VVI pacemaker were retrospectively evaluated.Among them,48 were implanted with pacemaker of autocapture function.Diagnostic data were retrieved from device memory.Pacemaker's service life was estimated according to the working flow and voltage.Results (1) The average working voltage of the control group and the observation group was (2.8 ± 0.4) V and (1.1 ± 0.4)V respectively.The difference was statistically significant;(2) The battery life in the observation group was (12.59 ± 0.55) a,significantly longer than that in the control group (6.74 ± 1.12) a,with an 86.8％ increase of the device's estimated service life (P＜0.05).Conclusion The Autocapture function results in a significant service life of cardiac pacemaker and represents valuable clinical technology.

Objective To observe the effect of Zusan Li acupoint injection with Chuankezhi injection ( CI) combined with chemotherapy on the quality of life in the stage III or IV senile patients with non-small cell lung cancer (NSCLC) . Methods We adopted research methods for the prospective, randomized, and controlled trial. A total of 62 qualified patients completed the treatment program, and were randomly divided into two groups. Thirty-two patients in the test group received CI combined with chemotherapy and syndrome differentiation treatment, and 30 patients in the control group were given chemotherapy and syndrome differentiation treatment. We used the WHO Quality of Life Older Module Scale ( WHOQOL-OLD) , Functional Assessment of Cancer Therapy-Lung ( FACT-L V4.0) and the Brief Fatigue Inventory ( BFI) to evaluate and analyze the quality of life before and after treatment. Results (1) In the WHOQOL-OLD evaluation, the total scores and the scores of dimensions of sensory abilities, autonomy, social participation, and past, present and future behavior were much improved in the test group after treatment ( P﹤0.01 compared with those before treatment) , while the control group only had statistically significant difference ( P﹤0.01) in the improvement of social participation and the total scores. The test group had higher scores difference in autonomy than the control group (P<0.01) . (2) In the FACT-L V4.0 evaluation, the total scores and the scores of domains of physiological condition, emotional status, functional status, and additional attention were much improved in the test group ( P﹤0.01 compared with those before treatment) , and the control group had an improvement in the total scores and scores of emotional status and additional attention after treatment ( P<0.01) . The test group had higher scores difference in physiological condition, functional status, and additional attention than the control group (P<0.01) . (3) In BFI evaluation, the degree of fatigue and fatigue influence were improved in both group after treatment ( P﹤0.01 compared with those before treatment) , and the improvement in the test group was superior to that in the control group ( P<0.05) . Conclusion Zusan Li acupoint injection with CI can improve the quality of life of senile NSCLC patients treated with chemotherapy in dimensions of sensory abilities, autonomy, social participation, and past, present and future behavior, and in domains of physiological conditions, functional status, additional concern, and it can also improve the degree of fatigue and fatigue influence.