Objective: To explore the effects of a classroom based transdiagnostic preventive intervention program for emotional disorders on depressive and anxiety symptoms, and resilience among junior high school students, so as to provide reference for promoting adolescent mental health. Methods: From October to December 2023, 72 students from a junior high school in Beijing were recruited as research subjects and divided into an intervention group ( n =36) and a control group ( n =36). The intervention group participated in 8 sessions (40 mins per session) of transdiagnostic prevention intervention course for emotional disorders; the control group students participated in research based learning lessons or class meetings. Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Resilience Scale-8 (RS-8) were used to evaluate junior high school students. The Wilcoxon signed rank test was used to compare the differences in depressive and anxiety symptoms, and resilience scores between the intervention group and the control group before and after the intervention. PROCESS macro was used to test the mediating effect. Results: There were no statistically significant differences in the scores of depressive and anxiety symptoms, and resilience before and after intervention in the intervention group ( Z =-1.07, 0.07, 1.43, all P >0.05). In the control group, the depressive symptoms score was higher after the intervention than before, and the resilience score was lower than before the intervention ( Z = 2.23 , -2.53, both P <0.05). After intervention, the depressive symptoms score in the intervention group was lower than that in the control group, and the resilience score in the intervention group was higher than that in the control group ( Z =-2.09, 3.33, both P < 0.05). The increase in the scores of resilience played a complete mediating role between the intervention and depressive symptoms, with the mediating effect value being -0.98 (95% CI =-2.47 to -0.11), accounting for 30.98% of the total effect. Conclusion Transdiagnostic preventive intervention program for emotional disorders based on classroom could prevent the deterioration of depressive symptom in junior high school students, and maintaining the level of resilience is an important factor for the intervention effect.

ObjectiveTo investigate the mechanisms by which Dahuang Gancaotang （DHGC） alleviates ferroptosis in chronic kidney disease （CKD） via silent information regulator 3 （SIRT3）-mediated deacetylation of tumor protein p53 （p53）. MethodsIn vivo， a CKD mouse model was established by feeding a 0.2% adenine-containing diet. Seventy-two C57BL/6 mice were randomly divided into six groups： blank group， model group， DHGC low-， medium-， and high-dose groups （0.975， 1.95， 3.90 g·kg^-1）， and valsartan group （0.025 g·kg^-1）， with 12 mice in each group. Renal function was evaluated by measuring serum blood urea nitrogen （BUN） and creatinine （SCr）. Renal pathological changes were assessed using hematoxylin-eosin （HE）， periodic acid-Schiff （PAS）， and Masson staining. Immunohistochemistry was used to detect the expression of collagen type （Col）Ⅰ， ColⅢ， and α-smooth muscle actin （α-SMA） in renal tissue to evaluate renal fibrosis. Enzyme-linked immunosorbent assay （ELISA） was used to measure serum tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and interleukin-6 （IL-6） to assess inflammatory responses. Colorimetric assays were used to determine superoxide dismutase （SOD）， malondialdehyde （MDA）， glutathione （GSH）， and renal total iron content to evaluate lipid peroxidation and iron metabolism. Western blot was used to detect the protein expression of the SIRT3/p53 signaling pathway， acetylated p53 （ac-p53）， and glutathione peroxidase 4 （GPX4） in renal tissue. In vitro， a ferroptosis model of HK-2 cells was induced using erastin. Cells were divided into six groups： blank group， model group， DHGC-containing serum low-， medium-， and high-dose groups （15 rats were randomly divided into three groups， n = 5 per group， and gavaged with 0.675， 1.35， 2.70 g·kg^-1 to prepare medicated serum）， and ferrostatin-1 （Fer-1） group （5 μmol·L^-1）. The cell counting Kit-8 （CCK-8） assay was used to determine cell viability and to screen the optimal concentrations of erastin and DHGC-containing serum. Western blot was used to detect SIRT3/p53 pathway proteins， ac-p53， and GPX4 expression. Immunofluorescence confocal microscopy was used to observe p53 nuclear translocation. ResultsIn vivo， compared with the blank group， the model group showed significantly increased BUN and SCr levels （P<0.01）. Severe renal pathological injury and aggravated renal fibrosis were observed. Lipid peroxidation and iron metabolism disorders were evident， as shown by significantly decreased SOD and GSH levels and significantly increased MDA and renal total iron levels （P<0.05， P<0.01）. Compared with the model group， all the above indices were significantly improved after DHGC intervention in a dose-dependent manner （P<0.05， P<0.01）. In vitro， compared with the blank group， HK-2 cell viability was significantly decreased in the model group. A concentration of 0.4 μmol·L^-1 erastin was identified as the optimal induction dose， and high-dose DHGC-containing serum was identified as the optimal treatment condition. Compared with the model group， cell viability was significantly increased in all DHGC-containing serum groups （P<0.05， P<0.01）. Mechanistically， compared with the blank group， protein expression of SIRT3 and GPX4 was significantly decreased in both in vivo and in vitro model groups， while p53 and ac-p53 expression and p53 nuclear translocation were significantly increased （P<0.01）. Compared with the model group， these changes were significantly reversed after DHGC intervention （P<0.05， P<0.01）. ConclusionDHGC exerts a protective effect against adenine-induced CKD in mice and erastin-induced ferroptosis in HK-2 cells. The mechanism is associated with its anti-ferroptosis effect mediated via the SIRT3/p53 signaling pathway.

Childhood bronchial asthma （hereinafter referred to as asthma） is frequently accompanied by comorbidities such as allergic rhinitis， eczema， allergic enteritis， tic disorders， and obesity. Based on the theory of "syndrome-based disease regulation"， this paper proposes that dampness， heat， and phlegm constitute the common pathological basis of asthma comorbidities in children living in cold regions. Focusing on the remission stage of asthma， this paper proposes that treatment should emphasize dispersing and draining pathogenic factors， diffusing and unblocking sanjiao （三焦）， with clearing heat， draining dampness， and resolving phlegm as the fundamental therapeutic principle. For asthma complicated by allergic rhinitis， Xiebai Wendan Decoction （泻白温胆汤） combined with Cang'erzi Powder （苍耳子散） is recommended. For asthma complicated by eczema， Baiguo Wendan Decoction （白果温胆汤） combined with Yiyi Zhuye Powder （薏苡竹叶散） is applied. For asthma complicated by allergic enteritis， Zhizhu Wendan Decoction （枳术温胆汤） is selected. For asthma complicated by tic disorders， Changyu Wendan Decoction （菖郁温胆汤） is used. And for asthma complicated by obesity， Zexie Wendan Decoction （泽泻温胆汤） is prescribed. This approach aims to achieve the therapeutic goals of "treating different diseases with the same principle" and "regulating both constitution and disease".

Objective To explore the mechanism of Shen Hong capsule in preventing and treating acute mountain sickness based on biological information platform and in vitro experiment. Methods Traditional Chinese Medicine Systems Pharmacology （TCMSP） and Traditional Chinese Medicine Information Database （TCMID） were used to obtain the active components and predicted targets of Shen Hong capsule. Therapeutic Target Database （TTD）, Disease Gene Network （DisGeNET） database and GeneCards database were used to search for the targets of acute mountain sickness related diseases, and the potential therapeutic targets were obtained. The protein-protein interaction （PPI） was analyzed by Search Tool for the Retrieval of Interacting Genes/Proteins （STRING）, the Database for Annotation, Visualization, and Integrated Discovery （DAVID） online platform was used to analyse the Gene Ontology （GO） and the Kyoto Encyclopedia of Genes and Genomes （KEGG） signal pathway enrichment. The network information was visualized by Cytoscape software, the key targets in PPI network were obtained according to the topology data, and the binding ability of main active components and key therapeutic targets were analyzed by molecular docking. The validation of the main active components was performed by liquid chromatography-mass spectrometry （LC-MS）. The hypoxia model was created by H9c2 cells, apoptosis was visualized by Hoechst33342 staining, and key target proteins were verified by Western blot. Results 91 active components, 3 main active components and 150 predicted targets were selected from Shen Hong capsule. 515 targets of altitude sickness-related diseases and 37 targets of Shen Hong capsule regulating altitude sickness-related diseases were screened out. 44 related signal pathways, such as HIF-1 signal pathway, PPAR signal pathway, drug metabolism - cytochrome P450, were enriched and analyzed. TNF, IL1B, VEGFA, NOS3, EGFR, ESR1, PPARG, NR3C1, HMOX1 and IFNG were 10 key targets. The molecular docking results showed that the docking conformations between the main active components and the key targets were stable. The three main active components of quercetin, luteolin and kaempferol were identified by LC-MS, and in vitro experiments proved that Shen Hong capsule could relieve acute hypoxia injury by regulating the expression of HIF-1α, PPARG, NOS3, and TNF. Conclusion Shen Hong capsule could regulate the body’s hypoxia response and metabolism through multi-component, multi-target and multi-channel ways, so as to prevent and treat acute mountain sickness. This study provided a direction for further exploring the mechanism of Shen Hong capsule, and also provided a theoretical basis for further development and clinical application.

Objective To analyze the influencing factors of health behaviors in stroke patients,and explore the chain mediating effects of self-efficacy and e-health literacy between the perception of stroke recurrence risk and health behaviors in stroke patients,providing a reference for strengthening the health behavior and reducing recurrence risk in stroke patients.Methods 249 stroke patients were selected as the research objects from March to September 2024 in a tertiary hospital in Shanghai,China.Patients were surveyed using General Information Questionnaire,Stroke Recurrence Risk Perception Scale,Stroke Health Behavior Scale(HBS-SP),Chronic Disease Self-Efficacy Scale(CDSES),and the e-health Literacy Scale(e-HEALS).Pearson correlation analysis was used to explore the correlations among various variables,and SPSS 26.0 software macro program Process Model 6 was used to conduct chain mediation model test.Results The scores of Recurrence Risk Perception,HBS-SP,CDSES and e-HEALS of stroke patients were(42.88±6.48)scores,(68.32±14.13)scores,(6.87±1.55)scores and(27.76±6.06)scores,and all the variables were positively correlated(P<0.01).The mediating effect model showed that self-efficacy and e-health literacy played a chain mediating role in the recurrence risk perception and health behavior in stroke patients,with an effect size of 0.488,accounting for 37.22%of the total effect.Conclusions The recurrence risk perception and health behavior of stroke patients are both at a moderate level.In the future,we can establish a mobile management platform to provide comprehensive health management for stroke patients.Further exploration of strategies to enhance stroke patients'self-efficacy and channels for online health education could be pursued to improve their health behaviors.

Objective:To compare the clinical effect of deproteinized calf blood extract (DCBE) eye drops and 0.3% sodium hyaluronate eye drops in the treatment of diabetic cataract patients with dry eye after phacoemulsification.Methods:A randomized controlled study was performed.A total of 112 patients (116 eyes) with type Ⅱ diabetes combined with cataract and dry eye who underwent phacoemulsification in the Eye Hospital of Shandong First Medical University from January 2022 to September 2022 were selected.Patients were divided into DCBE group (49 cases, 51 eyes) and sodium hyaluronate group (63 cases, 65 eyes) by the random number table method.Patients received DCBE eye drops and 0.3% sodium hyaluronate eye drops after surgery according to grouping.Preoperative and postoperative 1 week, 1 month subjective symptoms of dry eye, corneal edema grade, tear film breakup time (TBUT), corneal fluorescein staining (CFS) and Schirmer Ⅰ test (SⅠt) results were recorded and compared.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Eye Hospital of Shandong First Medical University (No.SDSYKYY202112-1).Written informed consent was obtained from each subject.Results:There were significant differences in dry eye symptom score, TBUT and SⅠt at different time points between before and after surgery ( Ftime=323.202, 102.771, 151.876; all P<0.001).Dry eye symptom score decreased and SⅠt increased in the two groups at 1 week and 1 month after surgery compared with before surgery, and the differences were statistically significant (all P<0.017).TBUT was longer at 1 week and 1 month after surgery compared with before surgery in the DCBE group, and TBUT at 1 month after surgery was longer than that before surgery in the sodium hyaluronate group, and the differences were statistically significant (all P<0.017).There were statistically significant differences in CFS scores between the two groups at different time points before and after surgery ( Fgroup=5.391, P=0.022; Ftime=142.402, P<0.001).The CFS scores of both groups at 1 week and 1 month after surgery were lower than those before surgery, and CFS scores in the DCBE group were lower than those in the sodium hyaluronate group, with statistically significant differences (all P<0.017).One week after surgery, the proportion of patients with corneal edema in the DCBE group was 5.9%(3/51), which was significantly lower than 20.0%(13/65) in the sodium hyaluronate group ( χ2=4.790, P=0.029). Conclusions:DCBE eye drops can promote corneal repair, stabilize tear film and improve dry eye discomfort in early postoperative period in diabetic cataract, and its overall effect is better than 0.3% sodium hyaluronate eye drops.

Objective:To define the concept of proactive health behavior.Methods:Literature related to proactive health behavior was retrieved from China National Knowledge Infrastructure, Wanfang Data, VIP, SinoMed, PubMed, Web of Science, Embase, and Ovid databases, with a retrieval time frame from database inception to March 1, 2025. Walker and Avant's concept analysis method was used to analyze the concept of proactive health behavior.Results:A total of 46 articles related to proactive health behavior were included. Proactive health behavior encompasses five key attributes: self-initiation, long-term persistence, multidimensional integration, future orientation, and overcoming barriers. Antecedents include individual factors, supportive factors, and environmental factors. Outcomes include promoting individual health and improving quality of life, enhancing personal health literacy, reducing disease burden, and fostering a proactive health atmosphere.Conclusions:The concept attributes of proactive health behavior were clarified through concept analysis. Future researchers may develop proactive health behavior assessment tools and construct intervention strategies based on their connotation.

Objective:To conduct a scoping review on the current status and influencing factors of adherence to lymphedema prevention behaviors among postoperative breast cancer patients, with the aim of providing a scientific basis for developing targeted interventions.Methods:A comprehensive search was conducted in both Chinese and English databases, including China National Knowledge Infrastructure, Wanfang Data, SinoMed, PubMed, Cochrane Library, Embase, CINAHL, and Web of Science, for literature published up to August 31, 2024, related to adherence to lymphedema prevention behaviors in breast cancer survivors. Eligible articles were screened, and data were extracted to analyze adherence levels. Influencing factors were mapped to the domains of the Theoretical Domains Framework to identify and analyze key behavioral determinants.Results:A total of 15 articles were included: nine quantitative and six qualitative. Overall, adherence to lymphedema prevention behaviors among postoperative breast cancer patients was found to be suboptimal. A total of 25 influencing factors were identified and categorized into eight theoretical domains: knowledge (lymphedema awareness) ; skills (coping strategies, time since surgery) ; beliefs about capabilities (self-efficacy, illness perception, unawareness of tumor stage, surgical type, symptom distress) ; beliefs about consequences (outcome expectations, attitudes) ; emotions (negative emotions, fatigue, age) ; behavior regulation (self-regulation, exercise habits, behavioral control) ; social influences (social support, family support, marital status, behavioral cues) ; environmental context and resources (healthcare access, ethnicity, professional supervision, financial status, employment situation) .Conclusions:Adherence to lymphedema prevention behaviors in postoperative breast cancer patients remains unsatisfactory, with influencing factors being multifaceted, diverse, and overlapping. Future efforts should focus on uncovering the potential interrelationships among these factors to enhance adherence and support long-term self-management in this population.

Objective:To investigate the change trend in the burden of 5 common malignant tumors of digestive system (esophageal cancer, gastric cancer, colorectal cancer, pancreatic cancer and liver cancer) in the Chinese population from 1990 to 2021.Methods:The descriptive epidemio-logic method was conducted. The number of new cases, crude incidence rate, age-standardized incidence rate, the number of deaths, crude mortality rate and age-standardized mortality rate of 5 common malignant tumors of digestive system in the Chinese population from 1990 to 2021 of the Global Burden of Disease were collected. The age-standardized rate was calculated based on the standardized demographics of the whole world in the Global Burden of Disease for the year 2021. Observation indicators: (1) The incidence of 5 common malignant tumors of digestive system in the Chinese population from 1990 to 2021; (2) the mortality of 5 common malignant tumors of digestive system in the Chinese population from 1990 to 2021; (3) the change trend of age-standardized incidence rate of 5 common malignant tumors of digestive system in the Chinese population from 1990 to 2021; (4) the change trend of age-standardized mortality rate of 5 common malignant tumors of digestive system in the Chinese population from 1990 to 2021. The Joinpoint regression model was constructed for trend analysis, specifically to calculate the annual percentage change, average annual percentage change (AAPC), and their 95% confidence interval ( CI) for age-standardized incidence and mortality rates for each cancer type at different time periods. Results:(1) The incidence of 5 common malignant tumors of digestive system in the Chinese population from 1990 to 2021. The number of new cases of esophageal cancer, gastric cancer, colorectal cancer, pancreatic cancer and liver cancer in the Chinese population changed from 207 495, 407 471, 158 389, 37 818 and 96 434 in 1990 to 320 805, 611 799, 658 321, 118 665 and 196 637 in 2021. The crude incidence rates of the above cancer types changed from 17.64/100 000, 34.64/100 000, 13.46/100 000, 3.21/100 000, 8.20/100 000 in 1990 to 22.55/100 000, 43.00/100 000, 46.27/100 000, 8.34/100 000, 13.82/100 000 in 2021. The new cases of esophageal cancer, stomach cancer, colorectal cancer, pancreatic cancer, and liver cancer all showed an increasing trend, with absolute changes of 54.61%, 50.15%, 315.64%, 213.78%, and 103.91%, respectively. (2) The mortality of 5 common malignant tumors of digestive system in the Chinese population from 1990 to 2021. The number of deaths of esophageal cancer, gastric cancer, colorectal cancer, pancreatic cancer and liver cancer in the Chinese population changed from 210 821, 374 066, 119 303, 38 883 and 94 937 in 1990 to 296 443, 445 013, 275 129, 119 602 and 172 068 in 2021. The crude death rates of the above cancer types changed from 17.92/100 000, 31.80/100 000, 10.14/100 000, 3.31/100 000, 8.07/100 000 in 1990 to 20.84/100 000, 31.28/100 000, 19.34/100 000, 8.41/100 000, 12.09/100 000 in 2021. Death cases of esophageal cancer, stomach cancer, colorectal cancer, pancreatic cancer, and liver cancer all showed an increa-sing trend, with absolute changes of 40.61%, 18.97%, 130.61%,207.59%, and 81.24%, respectively. (3) The change trend of age-standardized incidence rate of 5 common malignant tumors of digestive system in the Chinese population from 1990 to 2021. The change trends of age-standardized incidence rates of esophageal cancer, gastric cancer, colorectal cancer, pancreatic cancer, and liver cancer in the Chinese population were divided into 5, 5, 4, 5, and 5 periods, respectively, and the AAPCs of age-standardized incidence rates of the above cancer types were -1.60% (95% CI as -1.78% to -1.42%), -1.60% (95% CI as -1.78% to -1.43%), 1.66% (95% CI as 1.39% to 1.94%), 0.72% (95% CI as 0.36% to 1.08%), and -0.31% (95% CI as -0.39% to -0.23%). (4) The change trend of age-standardized mortality rate of 5 common malignant tumors of digestive system in the Chinese population from 1990 to 2021. The change trend of age-standardized mortality rates of esophageal cancer, gastric cancer, colorectal cancer, pancreatic cancer, and liver cancer in the Chinese population were divided into 5, 5, 4, 5, and 4 periods, respectively, and the AAPC of age-standardized mortality rates for each of the above mentioned cancer types were -1.96% (95% CI as -2.03% to -1.90%), -2.44% (95% CI as -2.50% to -2.38%), -0.49% (95% CI as -0.58% to -0.41%), 0.56% (95% CI as 0.48% to 0.63%), and -0.68% (95% CI as -0.89% to -0.52%). Conclusions:From 1990 to 2021, the disease burden of esophageal cancer, gastric cancer and liver cancer in the Chinese population show a downward trend. The standardized incidence of colorectal cancer shows an upward trend, and the standardized mortality rate shows a downward trend. The disease burden of pancreatic cancer shows an upward trend.

Objective:To investigate the current status of treatment delay and analyze its influencing factors in patients with breast cancer-related lymphedema.Methods:Using convenience sampling, 218 patients with breast cancer-related lymphedema from The First Affiliated Hospital of Zhengzhou University between April 2024 and January 2025 were enrolled. The General Information Questionnaire, Lymphedema Self-Management Support Scale for Breast Cancer Survivors (LSMS-BCs), Brief Illness Perception Questionnaire for Breast Cancer-related Lymphedema (BIPQ-BCRL), Perceived Barriers to Health Care-Seeking Decision-Chinese (PBHSD-C), and Health Literacy Scale for Chronic Patients (HLSCP) were used to conduct a cross-sectional survey. Logistic regression identified predictors of treatment delay, with model fit assessed by the Hosmer-Lemeshow test. Discriminative ability was evaluated using receiver operating characteristic (ROC) curve analysis.Results:The study included 218 female BCRL patients, aged (58.31 ± 10.54) years. Among 218 patients, 76 experienced treatment delay, the incidence of treatment delay was 34.8% (76/218). Independent risk factors included junior high school education or below, no regular arm circumference measurement, low self-management support scores, low illness perception scores, high perceived barriers to healthcare-seeking scores, and low health literacy scores (Wald χ2 values were 7.75-15.15, all P<0.05). The Hosmer-Lemeshow test indicated good model fit ( χ2=6.21, P>0.05). The combined predictive model demonstrated significantly better discrimination than individual factors, the area under the curve of ROC was 0.846 ( P<0.01). Conclusions:The incidence of treatment delay is relatively high among breast cancer-related lymphedema patients. Nursing staff should pay special attention to patients with a junior high school education or below, no regular arm circumference measurement, low LSMS-BCs scores, low BIPQ-BCRL scores, high PBHSD-C scores and low HLSCP scores, implement timely interventions to reduce treatment delay in lymphedema patients.