Objective: To analyze the association between insufficient sleep and score of depressive symptoms among junior and senior high school students, so as to provide a scientific reference for targeted early intervention measures of adolescents depressive symptoms. Methods: From September to November 2023, a stratified cluster random sampling method was used to select 96 080 junior and senior high school students from 409 schools in 113 districts and counties in Shaanxi Province. A questionnaire survey was conducted using the 2023 Shaanxi Provincial Common Student Diseases and Health Influencing Factors Survey Form, and their height and weight were measured. Propensity score (PS) matched (1∶1) analysis was used to match participants with insufficient sleep to those sufficient sleep students. Through the gradual correction of the confounders, three multilevel linear models were established to analyze the association between insufficient sleep and depressive symptoms score, and subgroup analysis was conducted afterward. Results: A total of 70 135 (73.00%) students had insufficient sleep. After PS matching, 25 894 pairs were matched. Before PS matching, after adjusting for gender, educational stage, region, adolescent characteristics, boarding status, smoking, alcohol consumption, outdoor activities and body mass index grouping, linear regression analysis results showed that compared with students who got adequate sleep, students who lacked sleep had an increase of 1.39 scores ( B=1.39, 95%CI =1.28-1.51) in depressive symptoms; after PS matching, students with insufficient sleep got an increase of 1.32 scores ( B=1.32, 95%CI =1.17- 1.45 ) in depressive symptoms score compared with those who had adequate sleep (both P <0.05). Conclusions The insufficient sleep is associated with the increase of the depressive symptoms score of junior and senior high school students. It is recommended that junior and senior high school students should keep a good sleeping habit, so as to reduce the prevalence of depressive symptoms.

Objective To evaluate the diagnostic efficacy of sound touch viscoelastography(STVi)and shear wave elastography(SWE)in distinguishing between benign and malignant breast nodules.Methods A total of 104 breast nodules(52 benign and 52 malignant)from 102 patients scheduled for surgical treatment at Binzhou Medical University Hospital between October 2024 and February 2025 were prospectively enrolled.All nodules were pathologically confirmed through surgical excision or core needle biopsy.The viscosity coefficient and Young's modulus of both intranodular and perinodular tissues within a 2-mm range were measured using the Mindray Resona A20S ultrasound system.The diagnostic performance of each parameter,the correlation between elastic parameter values and the maximum nodule diameter,as well as the inter-correlation between the two parameters were systematically analyzed.Results The elasticity parameters were significantly higher in malignant nodules[maximum intranodular Viscosity coefficient(Vimax):5.93(4.33,8.47)Pa·s,maximum Young's modulus(Emax):81.18(58.31,120.33)kPa;maximum Viscosity coefficient of the surrounding 2-mm tissue(Vi2max):7.57(5.40,10.16)Pa·s,maximum Young's modulus(E2max):117.21(65.66,170.66)kPa]compared to benign nodules[Vimax:3.70(2.69,5.32)Pa·s,Emax:41.42(28.29,64.25)kPa;Vi2max:4.30(3.63,5.65)Pa·s,E2max:47.23(36.42,74.67)kPa](P<0.05).The diagnostic performance of the 2-mm perinodular tissue(Vi2max:0.78,E2max:0.81)surpassed that of intranodular tissue(Vimax:0.72,Emax:0.77)(P<0.05).The combined diagnostic model(Vi2+E2,Vi+E)achieved AUC values of 0.82 and 0.77,respectively,which outperformed STVi alone(P<0.05)and showed marginally better performance than SWE alone,although the difference was not statistically significant(P>0.05).The maximum nodule diameter showed a moderate correlation with the elasticity parameters,with E2max exhibiting the strongest correlation(r=0.510,P<0.05).Conclusions Both STVi and SWE show clinical value in distinguishing between benign and malignant breast nodules.Particularly,elasticity parameters obtained from the 2-mm perinodular tissue demonstrate better diagnostic performance than those measured within the nodule itself,and combining these parameters enhances the overall diagnostic accuracy of STVi.

Objective:To analyze the current situation and influencing factors of information need for cardiac rehabilitation of urban and rural patients with coronary heart disease, and explore the inequality of information need for cardiac rehabilitation among urban and rural patients with coronary heart disease and its influencing factors, so as to provide a scientific reference for formulating targeted cardiac rehabilitation programs.Methods:From June to July 2024, hospitalized patients with coronary heart disease from a Class A tertiary hospital in Suzhou City were selected by convenience sampling as the study subjects. A General Information Questionnaire, Information Need in Cardiac Rehabilitation Hospital Anxiety and Depression Scale, Health Literacy Management Scale, and Coronary Artery Disease Self-Management Scale were used to conduct a questionnaire survey. Multiple linear regression was used to analyze the influencing factors of the cardiac rehabilitation information needs and the oaxaca-blinder model was used to analyze the causes of unequal information needs in urban and rural patients.Results:A total of 254 hospitalized patients with coronary heart disease who met the inclusion and exclusion criteria were surveyed, included 127 males and 127 females, 182 of them were aged 60 years or older. The total cardiac rehabilitation information needs score of rural and urban patients with coronary heart disease were 168.00 (115.50, 255.00) and 213.00 (132.00, 255.00), respectively, the difference was significant ( U = 5 389.50, P<0.05). Multiple regression analysis showed that health literacy ( β = 0.871, P<0.05) was the influencing factor of cardiac rehabilitation information needs of rural coronary heart disease patients, and depression ( β = 0.719, P<0.05) and living status ( β = -0.186, P<0.05) was the influencing factor of cardiac rehabilitation information needs of urban coronary heart disease patients. Average monthly household income per capita (C = 14.50%) and health literacy (C = 88.30%) were the main causes of the difference in cardiac rehabilitation information needs between urban and rural patients with coronary heart disease. Conclusions:The information demand for cardiac rehabilitation of patients with coronary heart disease in rural area is lower than that in urban areas in Suzhou, mainly due to health literacy and monthly income. It is recommended to narrow the urban-rural gap by improving rural health literacy, optimizing medical insurance policies, and promoting a multi-level rehabilitation service network.

The left maxilla of a patient was resected because of tumor,and the defect was reconstruted with fibular transplantation.The autonomous dental implant robot technology was used to achieve precise implantation of multiple implants and immediate denture restoration within the limited left maxilla.The surgery was minimally invasive and efficient,and significantly reducing patient post-operative discomfort.The final restoration was completed 6 months after surgery.

OBJECTIVE To analyze the distribution and drug resistance of pathogenic bacteria in hospital-associat-ed infections for patients after renal transplantation,and to provide a reference for the rational selection of antibac-terial drugs for anti-infective treatment in such patients.METHODS Clinical data were collected from 89 hospital-ized patients who underwent renal transplantation and developed hospital-associated infection at Beidaihe Rehabili-tation and Recuperation Center(formerly known as 281 Hospital)from 2017 to 2021.The pathogenic bacteria de-tected in different types of hospital-associated infections and the drug resistance of the main pathogenic bacteria were analyzed.RESULTS A total of 89 pathogenic bacterial strains were isolated from the 89 patients with hospi-tal-associated infection,including 74 gram-negative bacterial strains(83.15％)and 15 gram-positive bacterial strains(16.85％).The predominant pathogenic bacterial strains were Klebsiella pneumoniae,Escherichia coli and Pseudomonas aeruginosa.Respiratory tract infection was the most common.E.coli showed severe drug re-sistance,with high drug resistance rates to various antibacterial drugs(complete drug resistance to piperacillin and ampicillin).K.pneumoniae was generally drug resistant to ampicillin.Enterobacter cloacae showed high sensitivi-ty to carbapenems,amikacin and enzyme inhibitor combinations.P.aeruginosa had low drug resistance rates to imipenem and meropenem.Staphylococcus aureus was completely drug resistant to antibacterial drugs such as penicillin,erythromycin and gentamicin,and no drug-resistant strains to vancomycin and linezolid were found.CONCLUSIONS The gram-negative bacteria are dominant among the bacteria isolated from the renal trans-planted patients with postoperative hospital-associated infections,with a high detection rate of E.coli and a severe drug resistance situation.Therefore,it is necessary to strengthen the monitoring of drug resistance in renal trans-plant recipients and make rational choices of antibacterial drugs.

Objective To investigate the effects of safflower polysaccharide on tumor growth and the Phos-phoinositide 3-kinase(PI3K)/Protein Kinase B(Akt)/Mammalian Target of Rapamycin(mTOR)signaling pathway in colorectal cancer mice.Methods The mouse model of colorectal cancer was established by inoculating SW480 colorectal cancer cells.The successfully modeled mice were divided into five groups:the control group,the low-dose safflower polysaccharide group 15 mg/(kg·day),the medium-dose safflower polysaccharide group 45 mg/(kg·day),and the high-dose safflower polysaccharide group 135 mg/(kg·day).After treatment,tumor volume,mass,and tumor inhibition rate were measured.Immunohistochemistry was used to detect the expression of Proliferating Cell Nuclear Antigen(PCNA)protein.Apoptosis was assessed using the Terminal deoxynucleotidyl Transferase-Mediated Nick End Labeling(TUNEL)method.Hematoxylin-Eosin(HE)staining was performed to observe the morphology of tumor tissues.Real-time polymerase chain reaction(RT-PCR)was employed to measure the expression levels of PI3K,Akt,and mTOR in tumor tissues from each group.Western blot analysis was conducted to evaluate the expres-sion levels of c-Myc,Bcl-2-associated X protein(Bax),and proteins related to the PI3K/Akt/mTOR pathway.Results Compared with the model group,the safflower polysaccharide(low,medium,and high)dose groups exhibited significantly decreased tumor mass and volume,as well as reduced mRNA levels of PI3K,Akt,and mTOR.Additionally,the expression ratios of p-PI3K/PI3K,p-Akt/Akt,p-mTOR/mTOR,and c-Myc protein were notably decreased,while the expression of Bax protein was significantly increased(P<0.05).As the concentration of safflower polysaccharide increased,the tumor inhibition rate also increased(P<0.05).In the model group,tumor tissue from mice showed a higher number of PCNA-positive cells;TUNEL staining revealed minimal green fluores-cence,indicating low apoptosis rates.The tumor cells were closely packed,large in size,and poorly differentiated.Conversely,in the different dosage safflower polysaccharide groups,the expression of PCNA in tumor tissues was markedly reduced,and TUNEL staining positive cells(green)were significantly increased,leading to higher apopto-sis rates(P<0.05).The tumor tissue cells were loosely arranged,with shrunken nuclei and numerous necrotic cells.Conclusion Safflower polysaccharide potentially inhibits the growth of colorectal cancer in mice through suppression of the PI3K/Akt/mTOR signaling pathway.

Objective To develop a combined model integrating radiomics and 3D deep learning features for improving the predictive efficacy of overall survival in non-small cell lung cancer(NSCLC)patients undergoing radiotherapy,thereby providing a foundation for optimizing individualized radiotherapy strategies.Methods A retrospective analysis was conducted on 522 NSCLC patients from 3 centers.Radiomics features were extracted from the tumor region of interest on radiotherapy planning CT scans,and a 3D-SE-ResNet was constructed to extract deep learning features.Following feature extraction,features were selected via univariate Cox analysis and Lasso-Cox regression,and a combined model was established by fusing the two feature types through principal component analysis.The discriminative ability of the model was evaluated using the concordance index(C-index)and the area under the receiver operating characteristic curve(AUC),while the risk stratification efficacy was verified by Kaplan-Meier survival analysis.Results The predictive performance of deep learning features was significantly superior to that of radiomics features(C-index:0.73 vs 0.65).The combined model achieved the highest predictive performance in the training set,internal test set,and external test set(C-index:0.74,0.69,0.72 respectively),with higher AUC values for predicting 1-year,2-year,and 3-year OS than either single model.Kaplan-Meier analysis showed significant differences in survival between the high-and low-risk groups(Log-rank test,P<0.001),and calibration curves indicated good consistency between predicted and actual survival outcomes.Conclusion The combined model integrating radiomics and 3D deep learning features can accurately predict survival outcomes in NSCLC patients undergoing radiotherapy.The multi-center validation results support its potential application in prognosis stratification for individualized radiotherapy.

Objective To investigate the effects of safflower polysaccharide on tumor growth and the Phos-phoinositide 3-kinase(PI3K)/Protein Kinase B(Akt)/Mammalian Target of Rapamycin(mTOR)signaling pathway in colorectal cancer mice.Methods The mouse model of colorectal cancer was established by inoculating SW480 colorectal cancer cells.The successfully modeled mice were divided into five groups:the control group,the low-dose safflower polysaccharide group 15 mg/(kg·day),the medium-dose safflower polysaccharide group 45 mg/(kg·day),and the high-dose safflower polysaccharide group 135 mg/(kg·day).After treatment,tumor volume,mass,and tumor inhibition rate were measured.Immunohistochemistry was used to detect the expression of Proliferating Cell Nuclear Antigen(PCNA)protein.Apoptosis was assessed using the Terminal deoxynucleotidyl Transferase-Mediated Nick End Labeling(TUNEL)method.Hematoxylin-Eosin(HE)staining was performed to observe the morphology of tumor tissues.Real-time polymerase chain reaction(RT-PCR)was employed to measure the expression levels of PI3K,Akt,and mTOR in tumor tissues from each group.Western blot analysis was conducted to evaluate the expres-sion levels of c-Myc,Bcl-2-associated X protein(Bax),and proteins related to the PI3K/Akt/mTOR pathway.Results Compared with the model group,the safflower polysaccharide(low,medium,and high)dose groups exhibited significantly decreased tumor mass and volume,as well as reduced mRNA levels of PI3K,Akt,and mTOR.Additionally,the expression ratios of p-PI3K/PI3K,p-Akt/Akt,p-mTOR/mTOR,and c-Myc protein were notably decreased,while the expression of Bax protein was significantly increased(P<0.05).As the concentration of safflower polysaccharide increased,the tumor inhibition rate also increased(P<0.05).In the model group,tumor tissue from mice showed a higher number of PCNA-positive cells;TUNEL staining revealed minimal green fluores-cence,indicating low apoptosis rates.The tumor cells were closely packed,large in size,and poorly differentiated.Conversely,in the different dosage safflower polysaccharide groups,the expression of PCNA in tumor tissues was markedly reduced,and TUNEL staining positive cells(green)were significantly increased,leading to higher apopto-sis rates(P<0.05).The tumor tissue cells were loosely arranged,with shrunken nuclei and numerous necrotic cells.Conclusion Safflower polysaccharide potentially inhibits the growth of colorectal cancer in mice through suppression of the PI3K/Akt/mTOR signaling pathway.

Objective To construct a global model of cardiac surface motion based on average intensity projection(AIP)image.Methods The cine magnetic resonance imaging data were divided into training set and test set for model construction and validation.The datum points were obtained on the AIP surface point cloud,and the corresponding points of each cardiac phase surface point cloud were found based on surface features.Principal component analysis was used to extract feature information,establish the mapping relationship between the datum points and the corresponding points,and construct a model for predicting each temporal phase surface point cloud from the AIP surface point cloud.Results The RMSE of the model on test set for corresponding point prediction ranged from(0.209±0.020)mm to(0.841±0.074)mm,while the Euclidean distance for each time phase surface point cloud prediction ranged from(1.399±0.029)mm to(1.658±0.100)mm.Conclusion The proposed global model exhibit high accuracy and can provide a reference for image segmentation and clinical treatments.

China is a high-incidence region for gastric cancer globally. The disease is characterized by a high morbidity rate, low early diagnostic rate, and poor long-term outcomes, imposing a significant burden on both patients and society. Therefore, exploring the pathogenesis of gastric cancer, developing novel therapeutic strategies, and identifying new drug targets is of great importance. Telomerase expression is broadly associated with cancer cell targeting, and its up-regulation is one of the key factors driving the initiation and progression of gastric cancer. Additionally, telomerase is intricately involved in the regulation of autophagy and autophagy-associated cell death. While autophagy can induce chemoresistance, excessive autophagy may lead to cell death, which also constitutes one of the mechanisms of chemotherapy. Telomerase not only directly contributes to gastric cancer pathogenesis but also indirectly influences its development and treatment by modulating autophagy and autophagic cell death. Therefore, telomerase holds promise as a novel therapeutic target in gastric cancer.
Humans ; Stomach Neoplasms/genetics* ; Telomerase/genetics* ; Autophagy/physiology*