Objective: To evaluate the efficacy and prognosis of loop cutaneous ureterostomy (LCU) in the treatment of primary obstructive megaureter (POM) with severe hydroureteronephrosis (HUN) in infants under 1 year of age，so as to provide reference for infants unsuitable for stage-Ⅰ ureteral reimplantation. Methods: A retrospective analysis was conducted on 12 infants with POM and severe HUN treated with LCU in our hospital during Jan.2019 and Dec.2023.The clinical characteristics，surgical techniques，indications，postoperative complications，stage-Ⅱ surgical approaches，and follow-up outcomes were summarized. Results: All operations were successful，with an average operation time of (37.08±7.53) min (6 left-sided LCU and 6 right-sided LCU).During the mean follow-up of (10.12±2.70) months，all infants showed clinical improvement，with complete resolution or significant alleviation of hydronephrosis，reduced ureteral diameter，and increased renal cortical thickness.Complications included asymptomatic bacteriuria in 3 cases (25%) and urinary tract infection (UTI) in 1 case，all resolved with oral antibiotics.Four cases developed peristomal rashes，which improved with topical treatment.Eleven infants underwent stage-Ⅱ Cohen ureterovesical reimplantation at a mean age of (15.20±2.07) months.Notably，27.3%(3/11) required ureteral tailoring or plication during reimplantation，which reduced the risk of ischemic necrosis from excessive trimming.During the follow-up of (22.17±13.93) months，hydronephrosis and renal function improved，and no febrile UTI or bladder dysfunction occurred. Conclusion: LCU is a safe and effective method，which can provide adequate urinary drainage，relieve obstruction，stabilize renal function，and allow time for ureteral maturation and renal parenchymal recovery.LCU also facilitates subsequent stage-Ⅱ surgery by reducing ureteral dilation.

Abstract The application of artificial intelligence (AI) technology in the field of mental health is becoming increasingly extensive and in depth. As digital natives, children and adolescents are experiencing a significant shift in the prevention, identification, and intervention of their mental health issues:transitioning from traditional models to intelligent and digital approaches. At present, the mental health status of children and adolescents in China is not optimistic, with emotional disorders such as depression and anxiety showing a trend toward younger onset. However, the traditional mental health service model faces multiple challenges, including a shortage of professionals, low service accessibility, and difficulties in early identification. The study systematically reviews the current application status of AI technology in the mental health field of children and adolescents, including the latest progress in screening, assessment, intervention, and treatment; deeply analyzes the key challenges currently faced; and proposes suggestions for promoting the deep integration of AI technology and mental health services for children and adolescents, providing theoretical support and practical guidance for the intelligent, precise, and inclusive development of mental health services.

Objective To assess the exposure levels of heavy metals,including lead,arsenic,mercury,and cadmium,in the local population in Sichuan and Chongqing,China,to compare and analyze the differences in reference intervals(RIs)obtained from direct and indirect sampling methods,and to explore the interchangeability and limitations of these two sampling methods.Methods RIs were obtained by the direct sampling method and the indirect sampling method.In the direct sample method,the levels of blood arsenic,urinary cadmium,urinary mercury,and blood lead levels of 5562 healthy participants aged 22-50 years in Sichuan and Chongqing,China were measured by atomic absorption spectrometry and inductively coupled plasma-mass spectrometry.Using the human biomonitoring(HBM)data,we established RIs for the population by a nonparametric method.On the other hand,in the indirect sampling method,RIs were established via a nonparametric method based on data from the laboratory information system(LIS)of a local hospital after stratifying healthy individuals using a Gaussian mixture model(GMM).Comparative analysis of the RIs derived from the two sampling methods were then conducted.Results The RI for blood arsenic was 0.11-1.3 μmol/L.The RI for urinary cadmium was 0.51-2.80 μmol/mol creatine for adults aged 22 to under 43 years and 0.66-2.96 μmol/mol creatine for adults aged 43-50 years.The RI for urinary mercury was 0.12-1.10 μmol/mol creatine.The RI for blood lead was 14.00-47.00 pg/L for adults aged 22 to under 41 year,16.00-53.38 pg/L for males aged 41-50 year,and 15.00-51.02 pg/L for females aged 41-50 year.Most of the RIs established by the direct sampling method had a narrower range compared to those established by the indirect sampling method,and the RIs established by both sampling methods were partially biased.Conclusions The RIs for blood arsenic,urine cadmium,urine mercury,and blood lead in healthy individuals aged 22-50 years in Sichuan and Chongqing,China were established using both direct and indirect sampling methods,which contributes to a better understanding of environmental exposure to metals in the general population and provides a reference for metal poisoning.For data from the same lab,the GMM-based indirect sampling method demonstrated relatively consistent performance in establishing RIs compared with the direct sampling method.

From October 2021 to February 2023, we retrospectively analyzed the clinical and laboratory data of six patients (three male and three female, median age: 54 years, age range: 29-73 years) with mast cell leukemia (MCL) diagnosed in the First Affiliated Hospital of Soochow University (The Mastocytosis Collaborative Network of China). All patients had acute MCL, with at least one C-finding present. The main clinical presentations were hypoalbuminemia ( n=4), fatigue ( n=3), fever ( n=2), abdominal discomfort ( n=2), osteolytic lesions ( n=2), dizziness ( n=1), skin flushing ( n=1), and weight loss ( n=1). Splenomegaly and lymphadenopathy were noted in six and three patients, respectively. Six patients were strongly positive for CD117, five were positive for CD30 and CD25, and four were positive for CD2. Four patients had a normal karyotype and two patients had an abnormal karyotype. Gene mutations were detected in 4/6 cases. The median serum tryptase level was 24.9 (range: 20.1-171.9) μg/L. Two patients were treated with venetoclax and azacitidine for induction (one patient achieved partial remission by combination with afatinib, while there was no remission after combination with dasatinib in the other patient). Two patients did not achieve complete remission despite treatment with cladribine and imatinib, respectively. One patient treated with interferon combined with glucocorticoids was lost to follow-up, and one patient abandoned treatment. The follow-up time ranged from 1.1 to 21.7 months. Three patients died and two survived. Overall, MCL is a rare subtype of systemic mastocytosis with heterogeneous clinical course, and these patients have poor outcome. A better understanding of the clinical characteristics, treatment, and prognosis of MCL is urgently needed.

Objective To explore the risk factors for developing chronic pulmonary heart disease in patients with pneumoconiosis.Methods The medical records of pneumoconiosis patients admitted to an occupational disease hospital in Sichuan Province between January 2012 and November 2021 were collected.Kaplan-Meier(K-M)method,or product-limit method,was used to plot the incidence curves of pulmonary heart disease in the pneumoconiosis patients.Cox proportional hazard regression model was used to analyze the influencing factors associated with chronic pulmonary heart disease in patients with pneumoconiosis.Results A total of 885 pneumoconiosis patients were included in this study.The follow-up time was 12 to 115 months and the median follow-up time was 43 months.A total of 138 patients developed chronic pulmonary heart disease and the incidence density of pulmonary heart disease was 38.50/1000 person-years.Multivariate Cox proportional hazard regression analysis showed that the influencing factors of pneumoconiosis inpatients developing chronic pulmonary heart disease included the following,being 50 and older(hazard ratio[HR]=1.85,95%confidence interval[CI]:1.25-2.74),stage Ⅲ pneumoconiosis(HR=2.43,95%CI:1.48-4.01),resting heart rate≥100 beats/min(HR=2.62,95%CI:1.63-4.21),the complication of chronic obstructive pulmonary disease(COPD)(HR=4.52,95%CI:2.12-9.63),underweight(HR=2.40,95%CI:1.48-3.87),overweight and obesity(HR=0.54,95%CI:0.34-0.86),and triacylglycerol(TG)(HR=0.69,95%CI:0.49-0.99).Conclusion Old age,stage Ⅲ pneumoconiosis,high resting heart rate,low BMI,and the complication of COPD are risk factors for chronic pulmonary heart disease in pneumoconiosis patients,while overweight and obesity and TG are protective factors.Early identification of the risk factors and the adoption of the corresponding prevention measures are the key to preventing chronic pulmonary heart disease in patients with pneumoconiosis.

Objective:To understand the characteristics of type D personality in patients with ischemic stroke, and to explore the correlation between type D personality and carotid plaque vulnerability in patients with ischemic stroke.Methods:From November 2019 to December 2020, convenience sampling was used to select 125 patients with ischemic stroke who underwent carotid color Doppler ultrasound examination in the Department of Neurology, Affiliated Hospital of Jining Medical University as the research subject. Carotid plaques were measured by color Doppler ultrasound in patients with ischemic stroke to determine whether they were vulnerable plaques. The patients were investigated using the Type D Personality Scale.Results:The proportion of type D personality in ischemic stroke patients was 52.8% (66/125) . Logistic regression analysis showed that type D personality and the social inhibition dimension of type D personality were the influencing factors of carotid plaque vulnerability in patients with ischemic stroke ( P<0.05) . Conclusions:Type D personality is closely associated with carotid plaque vulnerability in ischemic stroke patients. Medical and nursing staff should strengthen the screening of type D personality in patients with ischemic stroke and implement early intervention.

Ras-associated domain family 1A (RASSF1A) genes are members of the RASSF family, which bind to Ras in a guanosine triphosphate(GTP)-dependent manner and then induce Ras-mediated apoptosis. The protein encoded by the RASSF1A gene is similar to the Ras effector protein, which can interact with DNA repair protein XPA, and can also inhibit the accumulation of cyclin D1, thereby inducing cell cycle arrest. The deletion or abnormal expression of RASSF1A gene is related to the pathogenesis of various malignant tumors, indicating that it has tumor suppressor function. RASSF1A gene methylation has been found in at least 37 tumors, and RASSF1A gene may be the most frequently described methylated gene in human cancers. In this paper, the abnormal methylation of RASSF1A gene in different malignant tumors was introduced, and the research progress of its related effects and mechanisms in malignant tumors of the respiratory system, digestive system, genitourinary system, and nervous system in recent years was reviewed, with a view to malignant tumors early diagnosis, individual molecular targeted therapy and prognostic evaluation provide important guidance.

Objective To quantitatively analyze the mRNA expression level of lymphoid enhance factor 1 (LEF-1) in bone marrow mononuclear cells of patients with acute myeloid leukemia (AML) at intermediate-risk after initial diagnosis and chemotherapy, and to analyze its clinical significance. Methods The real-time fluorescence quantitative polymerase chain reaction (RT-PCR) was used to measure the expression level of LEF-1 gene in AML patients at intermediate-risk after initial diagnosis and chemotherapy, and its relationship with effectiveness and survival were analyzed. Results The LEF-1 mRNA level in preliminarily diagnosed patients with AML was significantly higher than that in control arm [0.00519 (0.00015-0.09207) vs. 0.00101 (0.00009-0.00233)], and the difference was statistically significant (u=134.50, P<0.01). The LEF-1 mRNA level in patients after chemotherapy was significantly declines as compared to that in patients before chemotherapy [0.00107 (0.00008 - 0.00744) vs. 0.00519 (0.00015 - 0.09207)], and the difference was statistically significant (u= 317.00, P< 0.01) and LEF-1 mRNA expression level before chemotherapy in complete remission (CR) patients was significantly higher than that in non-CR patients [(0.01108 (0.00164 - 0.09207) vs. 0.00110 (0.00015 - 0.00916)], and the difference was statistically significant (u=19.00, P<0.01). High LEF-1 expression predicted a significantly better overall survival in AML patients with intermediate-risk cytogenetics (χ2= 4.549, P= 0.033). Conclusions LEF-1 may be involved in the development and progression of AML at intermediate-risk patients and is closely related to tumor burden and treatment efficacy. LEF-1 may be a good predictor of better prognosis and a novel target for therapeutic effect.

Objective To investigate the relationship between serum vitamin B12 level and arsenic methylation and the risk of arsenic poisoning in the arsenic exposed population.Methods Three villages in Midu County,Dali City,Yunnan Province were investigated.Cross-sectional study was used to select 103 subjects.The population was divided into three groups according to drinking water arsenic exposure situation and whether arsenic poisoning patients:28 cases of control group (not exposed to high arsenic),30 cases of arsenic patient group and 45 cases of non patient group.Instant peripheral blood samples and urine samples were collected.The content of arsenic in urine was determined by hydride generation cold trap and atomic absorption spectrophotometry.The levels of vitamin B12 in serum were determined by chemiluminescence immunoassay.The urine arsenic and serum vitamin B12 contents in different groups were compared,the arsenic poisoning prevalence rate in people with different levels of serum vitamin B12 was investigated,and the correlation between serum vitamin B12 level and the metabolism of arsenic methylation was analyzed.Results The level of urinary inorganic arsenic (iAs),monomethylated arsenic (MMA) and dimethylated arsenic (DMA),total arsenic (tAs) were significantly different between groups (F =13.032,20.778,21.978,22.155,all P ＜ 0.05).The levels of urine arsenic in patients with arsenic exposure [(94.56 ± 107.62),(75.76 ± 54.31),(270.19 ± 185.10),(444.02 ± 323.28) μg/g Cr] and non patient with arsenic exposure [(40.05 ± 47.47),(45.11 ± 46.06),(183.91± 151.45),(270.84 ± 231.45) μg/g Cr] were significantly higher than those in control group [(7.58 ± 4.82),(4.27 ± 2.01),(26.89 ± 11.45),(38.91 ± 13.34) μg/g Cr,all P ＜ 0.05].The serum levels of vitamin B12 were significantly different between groups (F =6.650,P ＜ 0.05),patients exposed to arsenic [(366.05 ± 120.03) ng/L] was significantly lower than the control group [(533.70 ± 180.12) ng/L,P ＜ 0.05].There were significant differences in the detection rate of arsenic poisoning among different levels of serum vitamin B12 (x2=8.13,P ＜ 0.05),the lower dose of vitamin B12,the more serious the incidence of arsenic poisoning.The content of vitamin B12 was negatively correlated with MMA％ (r =-0.21,P ＜ 0.05),and positively correlated with SMR (r =0.21,P ＜ 0.05).Conclusion Low levels of vitamin B12 in serum may increase the risk of arsenic poisoning.

Objective To analyze the mRNA expression level of lymphoid enhance factor 1 (LEF-1), and to investigate its clinical significance in bone marrow mononuclear cells of patients with chronic myeloid leukemia chronic-phase (CML-CP) after initial diagnosis and chemotherapy, and to analyze its clinical significance. Methods The real-time fluorescence quantitative polymerase chain reaction was used to measure the expression level of LEF-1 gene in 38 CML-CP patients after initial diagnosis and chemotherapy and 20 persons without blood system diseases and neoplastic diseases as normal control. The difference of LEF-1 expression level between the patients and healthy control was compared, and the effect of imatinib on the main molecular response (MMR) was analyzed. Results The expression of LEF-1 mRNA in 38 newly diagnosed patients [0.00214 (0.00020 - 0.02120)] was significantly higher than that in normal controls [0.00101 (0.00009 - 0.00233)] (U= 163.0, P< 0.01). The expression of LEF-1 mRNA in MMR group [0.00107 (0.00010 - 0.00519)] was significantly lower than that in non-MMR group [0.01015 (0.00091 -0.03615)] (U= 25.0, P< 0.01). There was no significant difference in LEF-1 mRNA expression between the normal control group and the MMR group after imatinib treatment (U= 201.0, P> 0.05). The level of LEF-1 mRNA expression of non-MMR group was also higher than that of the normal control group (U= 14.0, P<0.01). The rate of acquiring MMR was significantly higher in high LEF-1 mRNA expression group [84.2 %(16/19)] than that in low expression group [47.4%(9/19)] (χ2=4.209, P<0.01). The time of acquiring MMR was significantly shorter in the high LEF-1 mRNA expression group [(10.0 ± 4.5) months] than that in the low expression group [(14.6 ± 3.8) months] (t= 2.705, P< 0.01). Conclusions LEF-1 may be involved in the occurrence and development of CML, and reflects the tumor burden. It may be one of the indicators to predict the efficacy of imatinib.