Objective: To analyze the epidemiological characteristics and changing trends of non suicidal self injury (NSSI) behaviors among middle school students in Jiading District of Shanghai, from 2015 to 2023, so as to provide a basis for the development of NSSI prevention and control measures among students. Methods: Using a stratified cluster random sampling method, a total of five times for Shanghai Adolescent Health Risk Behavior Surveys were conducted for every two years in Jiading District of Shanghai from 2015 to 2023. A total of 5 231 middle school students from junior high schools and senior high schools were selected for questionnaire surveys. Intergroup comparisons were performed using the x 2 test or the χ 2 trend test, and the JointPoint 5.0 software was used to analyze the changing trends, with the annual percent change (APC) used for evaluation. A binary Logistic regression model was employed to analyze the related factors of NSSI behavior among middle school students. Results: In 2023, the reported NSSI rate among middle school students in Jiading District was 14.2%. The rate was significantly higher among junior high school students (17.1%) than that among senior high school students (11.1%), and higher among females (19.2%) than that among males (10.0%) ( χ 2=10.04, 23.21, both P <0.01). From 2015 to 2023, the overall reported NSSI rate showed an increasing trend, rising from 8.6% in 2015 to 14.2% in 2023 ( χ 2 trend =22.25), with an APC of 6.64% ( t =3.49), and the APC for girls was 9.79 % ( t =3.20) (all P <0.05). Among students reporting NSSI, the proportion experiencing ≥6 episodes increased from 10.8% in 2015 to 19.2% in 2023 ( χ 2 trend =6.57, P <0.05). Multivariate Logistic regression analysis indicated that girls, junior high school students, those with insomnia, depressive emotion and drinkers had higher risks of NSSI, compared to boys, senior high school students, those without insomnia, non depressive emotion students and non drinkers ( OR =1.71, 1.96, 3.44, 4.76, 1.77, all P < 0.05 ). Conclusions The reported rate of NSSI among middle school students in Jiading District of Shanghai, increased annually from 2015 to 2023, and the proportion of repeated NSSI also showed an upward trend. Early intervention measures targeting middle school students, especially junior high school students and females, should be implemented to prevent and control its occurrence and development.

Mitochondrial dysfunction in chondrocytes is a key pathogenic factor in osteoarthritis (OA), but directly modulating mitochondria in vivo remains a significant challenge. This study is the first to verify a correlation between mitochondrial dysfunction and the downregulation of the FOXO3 gene in the cartilage of OA patients, highlighting the potential for regulating mitophagy via FOXO3 gene modulation to alleviate OA. Consequently, we developed a chondrocyte-targeting CRISPR/Cas9-based FOXO3 gene-editing tool (FoxO3) and integrated it within a nanoengineered 'truck' (NETT, FoxO3-NETT). This was further encapsulated in injectable hydrogel microspheres (FoxO3-NETT@SMs) to harness the antioxidant properties of sodium alginate and the enhanced lubrication of hybrid exosomes. Collectively, these FoxO3-NETT@SMs successfully activate mitophagy and rebalance mitochondrial function in OA chondrocytes through the Foxo3 gene-modulated PINK1/Parkin pathway. As a result, FoxO3-NETT@SMs stimulate chondrocytes proliferation, migration, and ECM production in vitro, and effectively alleviate OA progression in vivo, demonstrating significant potential for clinical applications.

Myocardial fibrosis is a serious cause of heart failure and even sudden cardiac death. However, the mechanisms underlying myocardial ischemia-induced cardiac fibrosis remain unclear. Here, we identified that the expression of sterile alpha and TIR motif containing 1 (SARM1), was increased significantly in the ischemic cardiomyopathy patients, dilated cardiomyopathy patients (GSE116250) and fibrotic heart tissues of mice. Additionally, inhibition or knockdown of SARM1 can improve myocardial fibrosis and cardiac function of myocardial infarction (MI) mice. Moreover, SARM1 fibroblasts-specific knock-in mice had increased deposition of extracellular matrix and impaired cardiac function. Mechanically, elevated expression of SARM1 promotes the deposition of extracellular matrix by directly modulating P4HA1. Notably, by using the Click-iT reaction, we identified that the increased expression of ZDHHC17 promotes the palmitoylation levels of SARM1, thereby accelerating the fibrosis process. Based on the fibrosis-promoting effect of SARM1, we screened several drugs with anti-myocardial fibrosis activity. In conclusion, we have unveiled that palmitoylated SARM1 targeting P4HA1 promotes collagen deposition and myocardial fibrosis. Inhibition of SARM1 is a potential strategy for the treatment of myocardial fibrosis. The sites where SARM1 interacts with P4HA1 and the palmitoylation modification sites of SARM1 may be the active targets for anti-fibrosis drugs.

Objective To evaluate the diagnostic efficacy of metagenomic next-generation sequencing(mNGS)in detecting pathogens causing secondary infections in maintenance hemodialysis(MHD)patients,providing evidence for clinical implementation.Methods Sixty-five MHD patients with suspected secondary infections admitted to the blood purification treatment center of Tianjin University Tianjin Hospital from October 2022 to March 2024 were selected as the research subjects.All enrolled patients underwent routine laboratory examinations and imaging tests,the peripheral blood,sputum,bronchoalveolar lavage fluid(BALF),urine,feces,pleural effusion,and peritoneal effusion were collected for mNGS and traditional isolation and culture respectively.The infection status of MHD patients was analyzed.Compare the sensitivity,specificity,diagnostic accuracy,positive predictive value,negative predictive value,pathogen detection rate,and detection cycle across the two etiological diagnostic methods.Results Among the enrolled patients,11 were excluded from infection after comprehensive analysis and diagnostic treatment,and 54 were definitively diagnosed with MHD-associated secondary infections,including 20 cases of respiratory system infection(accounting for 37.04%),18 cases of bloodstream infection(33.33%),13 cases of urinary system infection(24.07%),2 cases of pleurisy(3.71%),and 1 case of peritonitis(1.85%).Among these infected cases,there were 12 cases of single bacterial infection,6 cases of single fungal infection,3 cases of atypical pathogen infection,and 33 cases of overlapping infections detected.The most common pathogens in respiratory infections,bloodstream infections,and urinary tract infections were Klebsiella pneumoniae,Staphylococcus aureus,and Escherichia coli respectively.Through mNGS,6 additional cases of Pneumocystispneumonia,3 cases of pulmonary Aspergillosis,3 cases of pulmonary tuberculosis,and 1 case of fungal pleurisy were successfully detected.A total of 25 patients had their medication adjusted based on the mNGS results,among whom 18 were discharged after improvement with treatment.The most common pattern of mixed infection was bacteria+fungi(16 cases),followed by bacteria+bacteria(9 cases),bacteria+fungi+atypical pathogens(4 cases),bacteria+atypical pathogens(3 cases),and fungi+fungi(1 case)in overlapping infections.The positive detection rate of overlapping infections by mNGS was significantly higher than that by traditional isolation and culture[78.79%(26/33)vs.12.12%(4/33),P<0.05].The sensitivity of mNGS in diagnosing pathogenic infections was significantly higher than that of traditional isolation and culture(overall diagnostic efficacy:96.30%vs.59.26%,precise diagnostic efficacy:95.35%vs.35.29%,both P<0.05).However,the specificity of the overall diagnostic efficacy of traditional isolation and culture was significantly higher than that of mNGS(100.00%vs.81.82%,P<0.05),the diagnostic coincidence rate,accuracy rate of single pathogen detection,and accuracy rate of overlapping pathogen detection of mNGS were all significantly higher than those of traditional isolation and culture(diagnostic coincidence rate of overall diagnostic efficacy:93.85%vs.66.15%,diagnostic coincidence rate of precise diagnostic efficacy:76.92%vs.35.38%,accuracy rate of single pathogen detection:80.95%vs.52.38%,accuracy rate of overlapping pathogen detection:66.67%vs.0,all P<0.05).The detection cycle of mNGS was significantly shorter than that of traditional isolation and culture[hours:27(26,29)vs.70(28,114),P<0.05].Conclusion mNGS can provide accurate and rapid etiological diagnosis for secondary infections in MHD patients,bringing benefits to precise diagnosis and targeted drug therapy.

Objective:To evaluate the changes in left ventricular structure and function in pregnant women with different severities of hypertensive disorders of pregnancy（HDP）using conventional echocardiographic parameters，strain，and tissue-tracking mitral annulus displacement（TMAD）parameters，and to validate and compare the application value of strain and TMAD parameters.Methods:A total of 148 singleton pregnant women with HDP and 100 healthy pregnant women（HP group）who attended the Third Affiliated Hospital of Zhengzhou University from October 2023 to July 2024 were selected. Conventional echocardiographic parameters，strain，and TMAD parameters were collected. Based on the severity of the disease，HDP patients were divided into the gestational hypertension group（GH group， n=49），non-severe preeclampsia group（NSPE group， n=35），and severe preeclampsia group（SPE group， n=64）. The differences in various parameters between the HP，GH，NSPE，and SPE groups were compared. The correlation between the displacement ratio of the midpoint of the mitral valve annulus in the apical 4-chamber（AP4 Midpt%），the displacement ratio of the midpoint of the mitral valve annulus in the apical 2-chamber（AP2 Midpt%）and left ventricular global longitudinal strain（LVGLS）were analyzed，and ROC curves were plotted to analyze and compare the diagnostic efficacies of LVGLS，AP4 Midpt% and AP2 Midpt% for left ventricular function changes in HDP pregnant women. Results:① The analysis revealed no statistically significant differences in maternal age and height between the HP group and the HDP subgroups（all P>0.05）. In contrast，statistically significant differences were observed in gestational age，systolic blood pressure，diastolic blood pressure，body mass index，and body surface area（all P<0.05）. Additionally，significant differences were noted in left ventricular mass，left ventricular interventricular septum thickness at end-diastole，left ventricular posterior wall thickness at end-diastole，left ventricular end-diastolic dimension，left ventricular end-systolic dimension，left ventricular end-diastolic volume，left ventricular end-systolic volume，and stroke volume between the HP group and the HDP subgroups（all P<0.05），while the difference in left ventricular ejection fraction was not statistically significant（ P>0.05）. ② Significant differences were identified in strain and TMAD parameters between the HP group and the HDP subgroups（all P<0.05），with LVGLS，AP4 Midpt% and AP2 Midpt% exhibited the largest effect sizes（ η p2=0.457，0.453，0.351）. A progressive decline in strain and TMAD parameters was observed as the severity of HDP increased. ③ There were strong positive correlations between AP4 Midpt%，AP2 Midpt% and LVGLS（ r=0.752，0.747；all P<0.001）. ④ LVGLS，AP4 Midpt% and AP2 Midpt% all demonstrated significant diagnostic efficacies for changes in left ventricular function in HDP（AUC=0.840，0.847，0.791），and the differences in AUC among the 3 curves were not statistically significant（all P>0.05）.⑤ The success rate of collecting TMAD parameters was significantly higher than that of strain parameters（99.24% vs. 93.58%， P<0.001）. Conclusions:As the severity of the disease worsens，the changes of left ventricular structure and function in pregnant women with HDP become more and more significant. Both strain and TMAD parameters can early and sensitively identify the subclinical damage of left ventricular systolic function in HDP pregnant women，and both of them have the same diagnostic value. TMAD parameters can be used as a reliable substitute parameter of LVGLS in HDP pregnant women.

Objective:To investigate the effect of oxidized-low density lipoprotein (ox-LDL) on contrast-induced renal tubular epithelial cell apoptosis and its mechanism.Methods:Human renal proximal tubular epithelial HK-2 cells were cultured in vitro and divided into four groups using the random number table method, including a control group, an ox-LDL group (50 μg/ml ox-LDL), an iohexol group (100 mg I/ml iohexol) and an ox-LDL+iohexol group (50 μg/ml ox-LDL+100 mg I/ml iohexol). Apoptosis rates were detected using the in situ terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay. Western blotting was used to detect the level of apoptosis by evaluating the presence of cleaved cysteine aspartic acid specific protease-3 (cleaved Caspase-3) protein. Mitochondrial membrane potential was detected using the JC-1 method. Mitochondrial/cytoplasmic cytochrome C (Cyt C) levels were detected by Western blotting to assess mitochondrial damage. Western blotting was used to detect the levels of the mitochondrial fission-related dynamin-related protein 1 (Drp1) and the mitochondrial fusion-related optic atrophy protein 1 (OPA1) to evaluate mitochondrial fusion/fission. Independent sample t test and one-way analysis of variance were used for data analysis. Results:The apoptosis rate [(30.12±3.19)%] and the relative expression of cleaved Caspase-3 protein (0.34±0.07) in the iohexol group were higher than those in the control group [(4.77±1.68)%, 0.23±0.05] ( P<0.05, 0.01). The apoptosis rate [(48.81±4.96)%] and the relative expression of cleaved Caspase-3 protein (0.53±0.05) in the ox-LDL+iohexol group were higher than those in the iohexol group (both P<0.01). The mitochondrial membrane potential (1.61±0.15) and mitochondrial/cytoplasmic Cyt C ratio (1.09±0.14) in the iohexol group were lower than those in the control group (6.15±0.52 and 3.09±0.45) (both P<0.01). The mitochondrial membrane potential (0.27±0.01) and the mitochondrial/cytoplasmic Cyt C ratio (0.24±0.04) in the ox-LDL+iohexol group were lower than those in the iohexol group (both P<0.01). The relative expression of Drp1 protein in the iohexol group (0.49±0.05) was higher than that in the control group (0.29±0.03), the relative expression of long OPA1 protein (0.24±0.03) was lower than that of the control group (0.40±0.03) (both P<0.01). The relative expression of Drp1 protein in the ox-LDL+iohexol group (0.64±0.02) was higher than that in the iohexol group, the relative expression of long OPA1 protein (0.07±0.02) was lower than that in the iohexol group (both P<0.01). Conclusions:ox-LDL can exacerbate contrast-induced renal tubular epithelial cell apoptosis, and its mechanism may be due to an imbalance in mitochondrial fusion and division caused by the contrast agent, leading to the increase mitochondrial damage.

Objective: To study the effects and potential mechanisms of the aquaporin 1(AQP1) inhibitor acetazolamide(AZ) on the proliferation, apoptosis, and inflammatory response of rheumatoid arthritis(RA) fibroblast-like synoviocytes(FLS). Methods: TNF-α-induced RA-FLS was served as in vitro RA model. MTT assay, IF staining, and EdU incorporation assay were applied to study AZ′s effects on RA-FLS proliferation. Hoechst staining, flow cytometry analysis of Annexin V-FITC/PI-stained cells, and mitochondrial membrane potential detection experiments were used to detect cell apoptosis. ELISA and quantitative real-time PCR methods were used to measure pro-inflammatory cytokine production. Cell autophagy was evaluated using IF staining and mCherry-GFP-LC3B puncta assay. Western blot was performed to detect the levels of autophagy, apoptosis, and proliferation-related proteins. Moreover, the role of autophagy inhibition in AZ′s effects on RA-FLS was examined by co-treating with the autophagy activator rapamycin(RAPA) or the autophagy inhibitor 3-methyladenine(3-MA). Results: AZ dose⁃dependently inhibited cell proliferation , promoted apoptosis , and reduced the production of pro⁃inflammatory cytokines in RA⁃FLS. Furthermore , AZ suppressed cytoprotective autophagy in these cells , as evidenced by decreased LC3B levels ( P < 0. 05 ) , increased p62 expression ( P < 0. 05 ) , and reduced autophagic flux ( P <0. 01) . Particularly , AZ ′s beneficial effects were reversed by RAPA⁃induced autophagy activation and enhanced by 3 ⁃MA⁃induced autophagy inhibition. Conclusion This study provides the first evidence that AZ hinders cytoprotective autophagy , thereby alleviating the hyperproliferation , apoptosis resistance , and aberrant inflammatory response of RA⁃FLS , revealing the core role of autophagy inhibition in AZ ′s anti⁃RA effects.

Subjective visual gravity detection includes subjective visual vertical(SVV)detection and subjec-tive visual horizontal(SVH)detection,which refers to the detection of the angle between patients' perceived gravity vertical line and gravity horizontal line and the actual gravity vertical line and horizontal line when people exclude vis-ual reference and in dark environment.The results are used to evaluate the function of the utricle of the subjects,and then provide the basis for diagnosing vestibular system diseases.With the continuous improvement of SVV &SVH examination technology and the understanding of the mechanism,SVV & SVH examination has been widely applied to clinical work.At present,there are some progresses of srvesvit SVV & SVH in the diagnosis,evaluation and treatment of diseases of the vestibular system such as vestibular neuronitis,Meniere disease and benign paroxys-mal positional vertigo(BPPV),and this article reviews these progresses.

Objective:To evaluate the effect of value orientation brief therapy(VBT)combined with selective serotonin reuptake inhibitors(SSRIs)on clinical symptoms,rumination,decision-making ability,and cognitive func-tion in patients with mild to moderate depression.Methods:Eighty patients meeting the DSM-5 diagnostic criteria for mild to moderate depression were randomly assigned to either a medication(SSRIs)group(36 completed)or a VBT combined group(38 completed)for a 6-week intervention.Baseline and post-intervention assessments includ-ed the Hamilton Depression Scale(HAMD),Hamilton Anxious Scale(HAMA),Ruminative Response Scale-Chi-nese Version(RRS-CV),Iowa Gambling Test(IGT),number of eye fixation(NEF),responsive search score(RSS)in exploratory eye trajectory movement were used to evaluate patients'anxiety and depression symptoms,ru-minative thinking,decision-making function,and cognitive function.Results:The VBT combined group showed sig-nificantly better therapeutic effects than the medication group(P＜0.05).Compared to baseline and the medication group,the VBT combined group had significantly lower post-intervention scores in HAMD,HAMA,symptom rumi-nation,introspective reflection,compulsive meditation,and RRS-CV total scores after intervention(Ps＜0.05),and significantly higher scores in IGT net profit scores,NEF,and RSS scores(Ps＜0.05).Compared with the medica-tion group,the VBT combined group demonstrated a greater reduction in HAMD,HAMA,symptom rumination,in-trospective reflection,compulsive meditation,and RRS-CV total scores before and after intervention(Ps＜0.05),and a larger increase in IGT net profit scores,NEF,and RSS scores(Ps＜0.05).Conclusion:VBT combined with SSRIs effectively improves the symptoms of depression,anxiety,decision-making ability,rumination thinking,and cognitive function in patients with mild to moderate depression.

Objective:To translate the Clinical Leadership Needs Analysis Instrument (CLeeNA) into Chinese and to test its reliability and validity.Methods:The source scale was translated based on the Beaton translation model, and cultural debugging was completed through expert consultation and pre-surveys to form the Chinese version of CLeeNA. Convenience sampling was used to select 536 nurses from three Class Ⅲ Grade A hospitals in Anhui Province from August to December 2023 to conduct the survey and to verify the reliability and validity of the scale. A total of 536 questionnaires were distributed and 495 valid questionnaires were recovered, with an effective recovery rate of 92.351% (495/536) .Results:The Chinese version of CLeeNA contained 43 entries in 7 dimensions of self and team development, staff and care delivery, technology and care initiatives, financial and service management, leadership and clinical practice, patient safety and risk management, and standards of care. The content validity index at the item level ranged from 0.800 to 1.000, and the content validity index at the scale level was 0.953. Exploratory factor analysis extracted 7 common factors with a cumulative variance contribution rate of 82.098%. Confirmatory factor analysis showed that the model fit was acceptable. The total Cronbach's ɑ coefficient for the scale was 0.958, the folding coefficient was 0.898, and the retest reliability coefficient was 0.928.Conclusions:The Chinese version of CLeeNA has good reliability and validity, and can be used for measuring the clinical leadership needs of nurses.