Objective: To explore the impact of adverse childhood experiences (ACEs) on health risk behaviors (HRBs) among college students and the mediating role of psychological symptoms, so as to provide a basis for developing intervention strategies. Methods: From March to April 2023, a convenience cluster sample of 1 801 students from 12 universities in Nanning, Liuzhou, Guilin, Wuzhou of Guangxi completed an online survey. A self designed questionnaire, Adverse Childhood Experiences-International Questionnaire (ACE-IQ) and Symptom Checklist-90 (SCL-90) were used for evaluation tools. Binary Logistic regression, structural equation modeling (SEM) and Bootstrap methods were used to analyze the associations and mediating effects. Results: Overall, 71.2% of college students experienced at least one type of ACE, with emotional neglect (40.3%) and emotional abuse ( 25.2 %) having the highest detection rates. The top three HRBs were unhealthy diet (77.8%), physical inactivity (54.1%), and smoking/alcohol use (18.5%). Logistic regression showed that poor family functioning, abuse, and extra familial violence were each associated with an increased risk of smoking/alcohol use ( OR =1.14, 1.11, 1.18) and deliberate self harm ( OR =1.26, 1.19,1.30) (all P <0.05). Experience of abuse increased the risk of high risk sexual behavior and family dysfunction increaded the risk of physical inactivity, respectively ( OR = 1.07 , 1.04, both P <0.05). Mediation analysis revealed that anxiety ( β =0.20) and depression ( β = 0.09 ) partially mediated the pathway from poor family functioning to deliberate self harm; paranoia ( β =0.02) partially mediated the pathway from abuse to high risk sexual behavior; and obsessive-compulsive symptoms ( β =0.26) and depression ( β =0.10) partially mediated the pathway from extra familial violence to deliberate self harm (all P <0.05). Conclusion Psychological symptoms play a mediating role in the association between ACEs and HRBs, and mental health interventions may reduce the risk of HRBs among college students.

ObjectiveTo investigate the mechanism by which Wumeiwan suppresses the development and progression of colorectal cancer（CRC） through the regulation of fatty acid metabolic reprogramming， thereby providing new experimental evidence for the prevention and treatment of CRC. MethodsA total of 120 C57BL/6 mice were randomly divided into the blank group， model group， Wumeiwan high-， medium-， and low-dose groups（54， 27， 13.5 g·kg^-1）， and the mesalazine group（0.01 g·kg^-1）， with 20 mice in each group. Except for the blank group， all mice were subjected to azoxymethane（AOM）/dextran sulfate sodium（DSS） treatment to establish an inflammation-associated CRC model. One week after AOM injection， mice in the treatment groups received intragastric administration of the designated drugs， while the blank and model groups received an equal volume of purified water， continuing until 20 d after the intervention endpoint. Hematoxylin-eosin（HE） staining was used to observe colonic histopathological alterations， and immunohistochemistry for vascular endothelial growth factor（VEGF） was performed to evaluate neovascularization and tumor invasion. Metabolomics combined with Kyoto Encyclopedia of Genes and Genomes（KEGG） and metabolite set enrichment analysis（MSEA） was applied to identify key CRC-related metabolic pathways， which were further validated by transcriptomic Gene Ontology（GO） enrichment and gene heatmap analysis. Subsequently， Western blot was performed to determine the expression levels of core proteins in these pathways， and immunofluorescence was used to analyze their localization and co-expression patterns in tissues， thereby elucidating the mechanism of Wumeiwan from multiple biological dimensions. ResultsCompared with the blank group， mice in the model group exhibited a significant decrease in body weight and a significant increase in the disease activity index（DAI） score（P<0.05）， with pronounced colonic mucosal damage accompanied by aggravated tumor invasion. Compared with the model group， Wumeiwan intervention markedly improved body weight loss and reduced DAI score， attenuated mucosal injury， and significantly decreased VEGF expression level（P<0.05）. Multi-omics analysis revealed that differential metabolites and genes across groups were commonly enriched in fatty acid metabolism， fatty acid biosynthesis， and other lipid-related pathways. Relative to the blank group， the model group showed significant upregulation levels of fatty acid synthesis-related genes， including sterol regulatory element-binding protein 1（SREBP1）， fatty acid synthase（FASN）， stearoyl-CoA desaturase 1（SCD1）， as well as saturated fatty acids（P<0.05）. Compared with the model group， treatment with Wumeiwan significantly reduced the expression of key genes involved in fatty acid metabolic pathways， including SREBP1， FASN， and SCD1（P<0.05）. Western blot results further confirmed that proteins in this pathway were significantly elevated in the model group， whereas they were markedly downregulated following Wumeiwan treatment（P<0.05）. Immunofluorescence analysis demonstrated enhanced co-localization of SREBP1 with the cancer-associated fibroblast（CAF） marker α-smooth muscle actin（SMA） in the model group， whereas this co-localization signal was attenuated after Wumeiwan intervention（P<0.05）. ConclusionWumeiwan can improve survival outcomes and alleviate colonic pathological damage in CRC mice， its therapeutic mechanism may be closely associated with the regulation of fatty acid metabolic reprogramming mediated by the SREBP1/FASN/SCD1 signaling pathway.

Purpose: Erectile dysfunction (ED) is a common male sexual dysfunction. Gut microbiota plays an important role in various diseases. To investigate the effects and mechanisms of intestinal flora dysregulation induced by high-fat diet (HFD) on erectile function. Materials and Methods: Male Sprague–Dawley rats aged 8 weeks were randomly divided into the normal diet (ND) and HFD groups. After 24 weeks, a measurement of erectile function was performed. We performed 16S rRNA sequencing of stool samples. Then, we established fecal microbiota transplantation (FMT) rat models by transplanting fecal microbiota from rats of ND group and HFD group to two new groups of rats respectively. After 24 weeks, erectile function of the rats was evaluated and 16S rRNA sequencing was performed, and serum samples were collected for the untargeted metabolomics detection. Results: The erectile function of rats and the species diversity of intestinal microbiota in the HFD group was significantly lower, and the characteristics of the intestinal microbiota community structure were also significantly different between the two groups. The erectile function of rats in the HFD-FMT group was significantly lower than that of rats in the ND-FMT group. The characteristics of the intestinal microbiota community structure were significantly different. In the HFD-FMT group, 27 metabolites were significantly different and they were mainly involved in the several inflammation-related pathways. Conclusions Intestinal microbiota disorders induced by HFD can damage the intestinal barrier of rats, change the serum metabolic profile, induce low-grade inflammation and apoptosis in the corpus cavernosum of the penis, and lead to ED.

Objective:To evaluate the value of ultrasound radiomics combined with machine learning for early diagnosis of seronegative Hashimoto’s thyroiditis (SN-HT) .Methods:This retrospective study included 164 patients from Liaoning Provincial People’s Hospital , Lixin County People’s Hospital, Linghai Dalinghe Hospital, Fengcheng Phoenix Hospital, who underwent thyroidectomy for solitary nodules with normal thyroid function between Nov. 2016 and Jan. 2024. Postoperative pathology confirmed Hashimoto’s thyroiditis (HT) in some cases, who were further categorized into antibody-positive and antibody-negative groups based on serum antibody status. Patients without Hashimoto’s thyroiditis served as the control group. A total of 298 ultrasound images were analyzed. Radiomics features were extracted from hypoechoic non-nodular areas within 0.5 cm surrounding the tumor. Two senior pathologists and two senior ultrasound physicians independently assessed lymphocytic infiltration, eosinophilic changes of follicular epithelium, and the proportion of hypoechoic areas in pathology and ultrasound images, respectively. A machine learning model, CCH-NET, was developed using linear regression and t-distributed stochastic neighbor embedding (t-SNE) techniques. The dataset was divided into a training set (80%) and a validation set (20%) to compare the diagnostic accuracy of CCH-NET with that of senior ultrasound physicians. Results:In internal validation, CCH-NET achieved a diagnostic accuracy of 88.89% for both antibody-positive and antibody-negative groups, significantly higher than the 66.67% accuracy of senior ultrasound physicians ( P<0.01). In external validation, CCH-NET achieved 75.00% and 66.67% accuracy for the two groups, compared to 50.00% by senior ultrasound physicians. For the control group, both methods achieved 93.33% accuracy. The AUC of CCH-NET was 0.848, outperforming senior ultrasound physicians (0.681) ,demonstrating superior diagnostic performance. Conclusion:The radiomics-based CCH-NET model, using non-nodular hypoechoic areas as a specific indicator, can accurately identify early SN-HT in euthyroid patients. It significantly outperforms senior ultrasound physicians, improving diagnostic accuracy and reducing missed diagnoses.

Objective:To explore the diagnostic value of transvaginal color Doppler sonography (TVCDS) combined with serum allograft inflammatory factor-1 (AIF-1) and pyruvate kinase M2 type (PKM2) in cervical cancer.Methods:From Jan. 2022 to Jun. 2024, 168 patients with early cervical cancer who visited Taizhou Central Hospital were regarded as the cervical cancer group, and 96 patients with cervical precancerous lesions were regarded as the precancerous lesion group. All patients underwent TVCDS examination to obtain parameters such as peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI). ELISA method was used to detect serum AIF-1 and PKM2 levels. Kappa test was used to analyze the consistency between different diagnostic methods and pathological results. ROC curve was used to analyze the diagnostic value of serum AIF-1 and PKM2 levels for cervical cancer.Results:The cervical cancer group had manifestly higher proportions of irregular morphology, unclear boundaries, low echo ratio, and levels of PSV, EDV, AIF-1, and PKM2 than precancerous lesion group, and manifestly lower RI than precancerous lesion group ( P<0.05). The consistency analysis between TVCDS diagnosis of cervical cancer and pathological results showed a Kappa value of 0.674 ( P<0.05). The serum levels of AIF-1 and PKM2 in cervical cancer patients with a maximum tumor diameter of ≥ 4 cm, low differentiation, and vaginal infiltration were manifestly higher than those in patients with a maximum tumor diameter of < 4 cm, medium/high differentiation, and non vaginal infiltration ( P<0.05). The AUC of AIF-1 and PKM2 in the diagnosis of cervical cancer was 0.824 and 0.816, respectively, with diagnostic thresholds of 81.21 ng/L and 29.26 ng/mL. The consistency analysis of TVCDS combined with serum AIF-1 and PKM2 in the diagnosis of cervical cancer and pathological results showed a Kappa value of 0.918 ( P<0.05). The negative predictive value, accuracy, and sensitivity of TVCDS combined with serum AIF-1 and PKM2 in the diagnosis of cervical cancer were higher than those of each indicator alone, and the positive predictive value and specificity were higher than those of AIF-1 alone ( P<0.05) . Conclusion:TVCDS combined with serum AIF-1 and PKM2 has high accuracy and sensitivity in the diagnosis of cervical cancer, and their combination can serve as a potential method for clinical diagnosis of cervical cancer.

Objective:To explore more objective detection method for the performance of diagnostic equipment with ultrasound,so as to demonstrate that the subjectivity of the interpretation criteria will affect the results of resolution parameters of detection performance of ultrasonic equipment.Methods:A total of 77 conventional probes of 33 ultrasound equipment of Jiangsu Provincial Hospital were collected and sorted out.The resolution parameters of their performance were tested twice from 2022 to 2023 by the technical personnel of our institute and the tester of Jiangsu Institute of Metrology.The data was described by using the quartiles method.The resolution parameters of performances of ultrasound equipment and probes were paired to conduct Wilcoxon rank sum test,so as to compare the differences in same institute between different years,and in same year between different institute in testing the resolution parameters of performances of ultrasound equipment and probes.Results:For linear array probes,as long as the performance was tested in accordance with the standard method,there was no statistically significant difference in the resolution parameters measured between different institutes and between different times(P>0.05).For the convex array probe,in 2023,the lateral resolution[2(2,2)]of the 70mm target group,and the axial and lateral resolutions[1(1,1)and 3(3,3.25)]of the 120mm target group of our institute were different with the lateral resolution[2(1,2)]of the 70mm target group,and the axial and lateral resolutions[2(2,3)and 2(2,3)]of the 120mm target group of Jiangsu Institute of Metrology,and the differences of them between our institute and Jiangsu Institute of Metrology were significant(Z=-2.887,-2.53,-3.69,P<0.05),respectively.In our institute,the axial and lateral resolutions[1(1,2)and 2.5(2,3)]of the 70mm target group,and the axial resolution[1(1,2)]of the 120mm target group in 2022 were different with the axial and lateral resolutions[1(1,1)and 2(2,2)]of the 70mm target group,and the axial resolution[1(1,1)]of the 120mm target group in 2023,and the differences of them between two years were significant(Z=-3.317,-3.419,-2.982,P<0.05).In Jiangsu Institute of Metrology,the lateral resolutions of the 70mm target group,and the axial resolution[1(1,1)]of the 120mm target group in 2022 year were different with those in 2023 year,and the differences of them were significant(Z=-2.333,-3.051,P<0.05),respectively.Conclusion:The interpretation for lateral resolution of convex array probe in target group with high depth,the difference of subjective interpretation criteria will cause the essential difference of final results.This paper suggested that the key image should be retained when the resolution of the image of target group with high depth of the convex array probe is interpreted.At the later stage,artificial intelligence(AI)-assisted quality control can also be introduced to conduct objective interpretation by computers.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective:To analyze the clinical manifestations and fundus multimodal imaging features of patients with acute Vogt-Koyanagi-Harada (VKH) syndrome, and provide a reference for early diagnosis of VKH syndrome.Methods:Retrospective analysis was performed on the clinical data and related examinations including spectral-domain optical coherence tomography (SD-OCT), fundus fluorescein angiography (FFA), and indocyanine green angiography (ICGA) of patients diagnosed with acute VKH syndrome in the Ophthalmology Department of the Beijing Friendship Hospital from January 2017 to December 2022.Results:A total of 17 patients (34 eyes) with acute VKH syndrome were included. SD-OCT showed exudative retinal detachment in all 34 eyes with punctate hyperreflective signals; 26 eyes had choroidal folds, and 14 patients (28 eyes) had " septum-like" structures under the neuroepithelium. FFA early images showed late retinal fluorescence pooling in a multi-lake pattern in all 34 eyes. ICGA was performed in 15 patients (30 eyes), with early images showing hyperfluorescence of choroidal vessels in all 30 eyes; 26 eyes had scattered hypofluorescent lesions in the fundus. Mid-to-late images showed blurred boundaries of choroidal vessels in 28 eyes.Conclusions:Patients with acute VKH syndrome have characteristic manifestations in SD-OCT, FFA, and ICGA. Fundus multimodal imaging can provide important references for the diagnosis of VKH syndrome.

Objective To investigate the microstructural changes of white matter in patients with relapsing-remitting multiple sclerosis(RRMS)and its correlation with clinical functional scores.Methods A total of 20 patients with RRMS(RRMS group)and 20 healthy controls(HC)(HC group)were selected and underwent diffusion tensor imaging(DTI)and expanded disability status scale(EDSS)scores.Patients with RRMS were categorized into two groups based on their EDSS scores,including MS-1 group(motor dysfunction with visual impairment)and MS-2 group(motor dysfunction).Image processing was performed via tract-based spatial statistics(TBSS).Group comparisons were executed using the t-test,while correlations were analyzed utilizing Spearman correlation.Results In the RRMS group,reduced fractional anisotropy(FA)values were accompanied by increased mean diffusivity(MD)and radial diffusivity(RD)values in the forceps major,forceps minor,bilateral cingulum,bilateral uncinate fasciculus,bilateral superior longitudinal fasciculus,bilateral inferior longitudinal fasciculus,bilateral inferior fronto-occipital fasciculus,bilateral corticospinal tract and bilateral anterior thalamic radiation compared with the HC group.Additionally,In the RRMS group,increased axial diffusivity(AD)values were noted in the forceps major,forceps minor,bilateral superior longitudinal fasciculus(temporal),right inferior fronto-occipital fasciculus,bilateral corticospinal tract and right anterior thalamic radiation compared with the HC group.Compared with the MS-2 group,the MS-1 group exhibited higher FA values in the right cingulum(cingulate gyrus part)and higher AD values in the left cingulum(cingulate gyrus part).Correlation analysis revealed negative correlations between the FA values of the forceps major,right superior longitudinal fasciculus and the motor function scores in RRMS group.Conversely,positive correlations were identified between the MD values of the forceps minor,right superior longitudinal fasciculus,right inferior fronto-occipital fasciculus,left corticospinal tract and the RD values of the forceps minor,right cingulum(hip-pocampus),right superior longitudinal fasciculus,and left corticospinal tract,as well as the motor function scores.Conclusion RRMS patients exhibit microstructural damage in white matter and are associated with motor dysfunction,which provides imaging support for the pathological mechanisms underlying motor dysfunction in RRMS patients.

Objective:To explore more objective detection method for the performance of diagnostic equipment with ultrasound,so as to demonstrate that the subjectivity of the interpretation criteria will affect the results of resolution parameters of detection performance of ultrasonic equipment.Methods:A total of 77 conventional probes of 33 ultrasound equipment of Jiangsu Provincial Hospital were collected and sorted out.The resolution parameters of their performance were tested twice from 2022 to 2023 by the technical personnel of our institute and the tester of Jiangsu Institute of Metrology.The data was described by using the quartiles method.The resolution parameters of performances of ultrasound equipment and probes were paired to conduct Wilcoxon rank sum test,so as to compare the differences in same institute between different years,and in same year between different institute in testing the resolution parameters of performances of ultrasound equipment and probes.Results:For linear array probes,as long as the performance was tested in accordance with the standard method,there was no statistically significant difference in the resolution parameters measured between different institutes and between different times(P>0.05).For the convex array probe,in 2023,the lateral resolution[2(2,2)]of the 70mm target group,and the axial and lateral resolutions[1(1,1)and 3(3,3.25)]of the 120mm target group of our institute were different with the lateral resolution[2(1,2)]of the 70mm target group,and the axial and lateral resolutions[2(2,3)and 2(2,3)]of the 120mm target group of Jiangsu Institute of Metrology,and the differences of them between our institute and Jiangsu Institute of Metrology were significant(Z=-2.887,-2.53,-3.69,P<0.05),respectively.In our institute,the axial and lateral resolutions[1(1,2)and 2.5(2,3)]of the 70mm target group,and the axial resolution[1(1,2)]of the 120mm target group in 2022 were different with the axial and lateral resolutions[1(1,1)and 2(2,2)]of the 70mm target group,and the axial resolution[1(1,1)]of the 120mm target group in 2023,and the differences of them between two years were significant(Z=-3.317,-3.419,-2.982,P<0.05).In Jiangsu Institute of Metrology,the lateral resolutions of the 70mm target group,and the axial resolution[1(1,1)]of the 120mm target group in 2022 year were different with those in 2023 year,and the differences of them were significant(Z=-2.333,-3.051,P<0.05),respectively.Conclusion:The interpretation for lateral resolution of convex array probe in target group with high depth,the difference of subjective interpretation criteria will cause the essential difference of final results.This paper suggested that the key image should be retained when the resolution of the image of target group with high depth of the convex array probe is interpreted.At the later stage,artificial intelligence(AI)-assisted quality control can also be introduced to conduct objective interpretation by computers.