Objective: To investigate the prevalence and associated factors of depressive symptoms among junior and senior high school students in Beijing from 2019 to 2023, in order to provide a scientific basis for interventions targeting high risk groups. Methods: From 2019 to 2023, a stratified cluster random sampling method was used to select 88 927 junior and senior high school students from 16 districts in Beijing. The Center for Epidemiologic Studies Depression Scale(CES-D) was conducted to assess depressive symptoms. The Chi square test was used to compare the detection rates of depressive symptoms among different student groups, and the trend Chi square test was employed for trend analysis of detection rates across the years. Multivariate Logistic regression analysis was applied to examine the association between the detection of depressive symptoms and related factors among junior and senior high school students. Results: From 2019 to 2023, the prevalence rates of depressive symptoms among junior and senior high school students in Beijing were 20.45%, 18.19%, 16.64%, 17.89% and 18.17%, respectively, with an overall downward trend ( χ 2 trend =27.51, P <0.01). Multivariate Logistic regression analysis revealed that after adjusting for gender, monitoring year, educational stage,family structure,boarding status and has taken a medical leave of absence in the past year unhealthy dietary behaviors ( OR=1.80, 95%CI =1.73-1.87), physical inactivity ( OR=1.24, 95%CI =1.19-1.29), try smoking ( OR=1.46, 95%CI =1.35-1.58), try alcohol( OR=1.96, 95%CI =1.88-2.05), Internet addiction ( OR=3.88, 95%CI =3.57-4.22), and adverse ear related behavior ( OR=1.82, 95%CI =1.71-1.93) were all associated with an increased risk of depressive symptoms among junior and senior high school students (all P <0.05). Conclusions The prevalence depression symptoms among middle school students in Beijing showed a fluctuating downward trend from 2019 to 2023. Targeted interventions should be adopted to reduce the occurrence of depression symptoms among junior and senior high school students.

Objective: To understand the trends of classroom lighting and illumination of primary and secondary schools in Beijing from 2016 to 2023, so as to provide a scientific basis for targeted improvement measures. Methods: A sampling survey was conducted on the lighting and illumination indicators of 8 390 classrooms in primary and secondary schools in Beijing from 2016 to 2023. The survey included classroom daylight factor, window to floor area ratio, average illuminance and illuminance uniformity on the desks, average illuminance and illuminance uniformity on blackboards, as well as classroom lighting and blackboard illumination sources. Intergroup comparisons were performed using the Kruskal-Wallis H test and the Chi square test, and Spearman correlation analysis was used to examine the trend of classroom lighting and illumination changes. Results: Except the window to floor area ratio, the measured values and compliance rates of all lighting and illumination indicators showed an overall upward trend from 2016 to 2023 (daylight factor r = 0.27, χ 2 trend =206.80, average illuminance on the desk surface r =0.30, χ 2 trend =87.97, illuminance uniformity on the desk surface r =0.14, χ 2 trend =73.59, average illuminance on the blackboard r =0.33, χ 2 trend =477.43, illuminance uniformity on the blackboard r = 0.09, χ 2 trend =50.76) (all P ＜0.01). The lighting and illumination indicators of classrooms (included classroom daylight factor, average illuminance and illuminance uniformity on the desks, average illuminance and illuminance uniformity on blackboards) in urban schools, primary schools, and secondary schools from 2016 to 2023 showed an upward trend (urban r =0.23-0.40, χ 2 trend =88.66-392.18; primary school r =0.12-0.36, χ 2 trend =39.50-281.44; secondary schools r =0.06-0.31, χ 2 trend =11.79-213.73) (all P ＜ 0.01 ). The illuminance uniformity on the blackboard in suburban schools showed a downward trend ( r = -0.09, χ 2 trend =31.53, both P ＜0.01). The illuminance uniformity on the desk surface in suburban schools showed no significant change ( r =0.03, χ 2 trend =1.23, both P ＞0.05). The other indicators showed an upward trend (daylight factor r =0.28, χ 2 trend =40.69, average illuminance on the desk surface r =0.24, χ 2 trend =16.35, average illuminance on the blackboard r =0.25, χ 2 trend =118.05, all P ＜0.01). The trends of classroom and blackboard illumination sources were that fluorescent lamps decreased year by year and LED lamps increased by year (classroom illumination sources χ 2 trend =1 059.82, blackboard illumination sources χ 2 trend =1 070.25, both P ＜0.01). Conclusions The classroom lighting and illumination in primary and secondary schools in Beijing has shown an overall improving trend from 2016 to 2023. However, problems remain, such as limited improvement of illuminance uniformity indicators, late start and poor effect of reconstruction in suburban schools. Further improvements are still needed.

Objective To investigatethe relationship between gastroesophageal reflux disease (GERD) symptoms and clinicopathological characteristics, p53 expression, and survival of Chinese patients with esophageal adenocarcinoma. Methods A total of 3882 patients with esophageal adenocarcinoma, 970 matched patients with esophageal squamous cell carcinoma, and 970 matched patients with gastric cardia adenocarcinoma were included to compare the incidence of GERD symptoms. Patients with esophageal adenocarcinoma were divided into two groups according to the presence and absence of GERD symptoms. The differences in clinicopathological characteristics and p53 expression between the two groups were compared by chi-square test, and the differences in survival between the two groups were compared by landmark analysis. Results The incidence of GERD symptoms increased successively in esophageal squamous cell carcinoma, esophageal adenocarcinoma, and gastric cardia adenocarcinoma. In patients with esophageal adenocarcinoma, the proportions of male, less than 65 years old, lower thoracic tumors, tumors without squamous cell carcinoma, poorly differentiation, early tumors (stage 0-I), and p53-positive tumors in the group with GERD symptoms were higher than those in the group without GERD symptoms; moreover, the long-term survival (≥15 years) was better. Conclusion GERD symptom is an important clinical sign of esophageal adenocarcinoma. It is closely related to specific clinicopathological characteristics, p53 overexpression, and good long-term prognosis.

BACKGROUND:The biomechanical stability of basal femoral neck fracture is poor,and the treatment plan is different from the traditional femoral neck fracture. At present,there is still no consensus on the surgical plan for the treatment of basal femoral neck fracture in young adults. OBJECTIVE:To compare the biomechanical characteristics of proximal femoral nail antirotation and femoral neck system in the treatment of basal femoral neck fractures by finite element analysis.METHODS:First,Mimics Medical 21.0 software was used to extract the right femur CT data of healthy young female volunteers to establish a preliminary model. Secondly,the model was imported into Geomagic Wrap 2021 software for further smoothing. SOLIDWORKS 2021 software was used to establish and assemble the femoral neck base fracture model,proximal femoral nail antirotation model,and femoral neck system model. Finally,the assembled model was imported into Workbench 2021 R1 software for biomechanical analysis.RESULTS AND CONCLUSION:(1) Stress distribution:the stress distribution of the proximal femoral nail antirotation group was mainly near the fracture line and the medial side of the femur,and the peak stress was 151.90 Mpa. In the femoral neck system group,the stress distribution of the femoral model was mainly near the fracture line,and the peak stress was 290.74 Mpa. The proximal femoral nail antirotation internal fixation stress was mainly distributed at the proximal end of the helical blade and the main nail,and the peak stress was 102.95 Mpa. The stress distribution of internal fixation in femoral neck system mainly extended to both sides of the support rod,and the peak stress was 184.69 Mpa. (2) Total displacement:the maximum displacement of the femoral model in the proximal femoral nail antirotation group was 4.0323 mm,and the maximum displacement of the femoral model in the femoral neck system group was 4.6489 mm. The maximum displacement was located in the femoral head. The peak displacement of internal fixation in the proximal femoral nail antirotation group and the femoral neck system group was 2.7094 mm and 3.1303 mm,respectively. The displacement of internal fixation in the two groups was mainly concentrated in the proximal end of internal fixation,and gradually decreased to the distal end. (3) It is concluded that in the femoral neck base fracture model,whether it is the femoral model or the internal fixation model,the proximal femoral nail antirotation group has more dispersed stress distribution,lower stress peak,smaller femoral head displacement,and better biomechanical stability than the femoral neck system group.

BACKGROUND:The treatment of Pauwels type Ⅲ femoral neck fractures in young adults is extremely difficult.When treating Pauwels type Ⅲ femoral neck fractures with internal fixation,it is not only necessary to ensure the mechanical stability of the internal fixation,but also to ensure that it can resist the impact of shear,compression and tension,so as to prevent the internal fixation from breaking or loosening due to fatigue during the fracture healing process.However,existing internal fixation methods do not fully meet our requirements for the treatment of this fracture.OBJECTIVE:To provide a more reasonable and effective choice of internal fixation mode for clinicians in the treatment of young adults with Pauwels type Ⅲfemoral neck fracture,so as to optimize the treatment effect,reduce the occurrence of complications,and improve the recovery speed and quality of life of patients.METHODS:A femoral neck fracture model with Pauwels angle of 70° was constructed using CT data extracted from volunteers,and three placement modes were set up:(1)femoral neck system group:the main nail of femoral neck system was located in the center of the femoral neck axis.(2)Combination group:The main nail of femoral neck system was located in the lower third of the femoral neck axis,and a cannulated compression screw was located in the upper third of the femoral neck axis.(3)Cannulated compression screw group:The arrangement of three cannulated compression screws was arranged in the classic inverted triangle shape to ensure the maximum fixed effect.Stress distribution and displacement of proximal femoral fracture fragments and internal fixation devices were analyzed under three different internal fixation methods.RESULTS AND CONCLUSION:(1)The stress of the proximal femur models in the three groups was concentrated near the fracture line:combination group(201.10 MPa)＜femoral neck system group(222.25 MPa)＜cannulated compression screw group(271.25 MPa).(2)The peak value of proximal femur displacement was located at the top:combination group(6.33 mm)＜femoral neck system group(9.37 mm)＜cannulated compression screw group(9.92 mm).(3)The internal fixation stress was concentrated on the screw surface at the broken end of the fracture and gradually extended from there to both sides;cannulated compression screw group(136.67 MPa)＜combination group(201.10 MPa)＜femoral neck system group(222.25 MPa).(4)The maximum displacement of the internal fixation device model was located at the very top of the internal fixation.The three groups gradually decreased from the top to the far end.The peak displacement values of combination group(6.21 mm)＜femoral neck system group(9.19 mm)＜cannulated compression screw group(9.51 mm).(5)The stress of proximal bone mass in the three models was mainly concentrated in the fracture end,especially in the lower part of the fracture end.This indicates that these regions were subjected to greater stress and strain during mechanical transfer;combination group(24.96 MPa)＜femoral neck system group(39.69 MPa)＜cannulated compression screw group(44.47 MPa).(6)The results indicate that the internal fixation strategy of femoral neck system combined with cannulated compression screw arranged in parallel coronal surface shows higher biomechanical stability than single femoral neck system fixation or cannulated compression screw in inverted triangle arrangement fixation,and provides a more reliable and effective solution for the treatment of Pauwels type Ⅲ femoral neck fracture in young adults.

Purpose To investigate the clinical and imaging features and diagnostic points of hemophilic pseudotumor(HPT).Materials and Methods A total of 50 HPT patients in Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2015 to August 2023 were selected.Gender,haemophilia category,site of disease and X-ray,CT and MRI manifestations of HPT were retrospectively analyzed.Results A total of 50 patients with HPT were collected,49 male patients and one female patient.There were 48 cases of haemophilia A,one case of haemophilia B and one case of vascular haemophilia.Imaging manifestations were single bone and adjacent soft tissue involvement in 22 cases;multi-bone and single joint in four cases;multi-bone and multi-joint in ten cases;simple skeletal muscle and soft tissue involvement in six cases;abdominopelvic cavity and retroperitoneal space in six cases;and small intestinal wall in two cases.X-ray and CT mainly showed that the bone was destroyed by expansion,partially combined with osteolysis of the bone destruction,residual coarse bone ridge could be seen in the damaged area,and the sclerotic edge could be seen in the edge of the bone destruction.The main body of the lesion showed mixed density,and the enhancement scanning of the bone destruction area and soft tissue mass did not see the exact enhancement.MRI showed bone destruction area,soft tissue mass formation,which could better reflect its pathological characteristics,i.e.,the haematoma signals in different periods.Conclusion HPT commonly affect the femur and pelvic bones,and can involve multiple bones,joints,the abdominal and pelvic cavities,the retroperitoneum and the intestinal wall.The primary manifestation is the formation of massive hematomas within soft tissues,with varying stages of hemorrhage.When bone is involved,it typically presents as expansive bone destruction accompanied by the formation of large pseudotumors.The edges of the destruction area may show bone sclerosis.The pseudotumors exhibit characteristics of hematomas at different stages.A definitive diagnosis can be made by integrating imaging findings,clinical data and laboratory tests.

The C 2-C 7 sagittal vertical axis (SVA) is an essential biomechanical parameter for evaluating cervical spine alignment, and it is integral to the pathogenesis, progression, and prognosis of cervical spine disorders. This parameter is widely used in evaluating cervical sagittal balance and functional status. Internationally, a C 2-C 7 SVA of less than 25 mm is considered within the cervical range for sagittal balance, while values exceeding 40 mm indicate cervical sagittal imbalance or deformity. An increased C 2-C 7 SVA disrupts cervical spine biomechanics, leading to heightened static and dynamic loads on the cervical musculature. This, in turn, results in muscle fatigue and discomfort. In the short term, patients may experience axial neck symptoms, while a sustained elevation in SVA over time significantly raises the risk of cervical disc degeneration, radiculopathy, and myelopathy. Additionally, a higher C 2-C 7 SVA postoperatively places excessive stress on adjacent spinal segments, which can accelerate degeneration of intervertebral discs and facet joints, contributing to adjacent segment degeneration. Both short-term and long-term postoperative evaluations have shown that an increase in C 2-C 7 SVA is typically associated with poorer surgical outcomes, whereas effective control of SVA values is closely linked to better functional recovery. Therefore, in clinical practice, maintaining C 2-C 7 SVA within the normal range (<25 mm) is critical not only for optimizing treatment results but also for significantly reducing postoperative complications and improving overall patient quality of life.

Objective:To describe the prevalence of myopia and pre-myopia among preschool children aged 5-6 years in ten provinces or municipalities(hereinafter referred to as province)of China,and to provide a reference for the prevention and control of myopia,and the allocation of related health re-sources.Methods:Convenience sampling was used to select preschool children aged 5-6 years from 21 cities in 10 provinces(including 8 provinces and 2 municipalities)in China.Cycloplegic autorefraction was conducted.The distribution of myopia and pre-myopia was described using frequencies and percenta-ges.The Chi-square test was used to compare the differences in the prevalence of myopia and pre-myopia between regions with different varying economic development levels and between boys and girls,with a significance level of α=0.05.Results:A total of 12 926 preschool children aged 5-6 years were sur-veyed.The myopia prevalence was 5.5％,and the overall prevalence of myopia and pre-myopia was 43.4％.Boys had higher rates of myopia and overall prevalence of myopia and pre-myopia than girls(5.7％vs.5.2％,46.4％vs.40.1％),though the difference in myopia prevalence was not statistical-ly significant.Stratified analysis by the province,there was no statistically significant differences in the prevalence of myopia between boys and girls in any province(P＞0.05),but in 8 provinces,the preva-lence of myopia in boys was slightly higher than in girls.The overall prevalence of myopia and pre-myopia in boys was higher than in girls across all the 10 provinces,with 5 provinces showing statistically signifi-cant differences(P＜0.05).The investigated areas were divided into two categories,relatively more-developed areas and relatively less-developed areas,based on per capita gross domestic product(GDP).In 6 provinces,there was no statistically significant difference in the prevalence of myopia between the two categories of areas.In 2 provinces,the prevalence was higher in relatively more-developed areas,and in 2 provinces,it was higher in relatively less-developed areas.In 4 provinces,there was no statisti-cally significant difference in the overall prevalence of myopia and pre-myopia between the two categories of areas with relatively more-developed and relatively less-developed areas.In 3 provinces,the preva-lence was higher in relatively more-developed areas,and in 3 provinces,it was higher in relatively less-developed areas.Conclusion:The prevalence of myopia and pre-myopia among preschool children aged 5-6 years is relatively high.Boys show higher overall prevalence of myopia and pre-myopia than girls,but there is no significant difference in the prevalence of myopia.There is no consistent association be-tween the level of economic development and the incidence of myopia and pre-myopia in each province.

Objective: To analyze the factors related to dual use of traditional cigarettes and e-cigarettes among middle school students in Beijing, in order to provide a scientific basis for adapting to the new situation and carrying out tobacco control among adolescents. Methods: A multi stage cluster random sampling method was used to select 15 688 and 13 607 junior and senior middle school students from 16 districts in Beijing from April to June in 2019 and 2023, respectively. Online self administered questionnaires among middle school students in Beijing were completed, including use of traditional cigarettes and e-cigarettes, exposure to second hand smoke, attitudes and perceptions towards tobacco, etc. The Chi-square test was used to compare rates, and a multiple factors Logistic regression model was used to analyze related factors of traditional cigarettes and e-cigarettes dual use among middle school students. Results: The dual use rate of traditional cigarettes and e-cigarettes in 2023 had decreased to 2.46% from 4.88% in 2019 among middle school students in Beijing. The results of the multiple Logistic regression model analysis showed that among middle school students, tobacco control anywhere at home (boys: OR =0.47, girls: OR =0.34), without anyone smoking on campus in the past month (boys: OR =0.43, girls: OR =0.26) had lower risks of dual use ( P <0.05); and middle school students strongly or slightly agreeing that smoking could bring happiness (boys: OR =4.11, 2.22, girls: OR =5.32, 3.87), believing that smoking could increase attractiveness of young people (boys: OR =3.13, girls: OR =5.81), smoking cigarettes handed over by good friends (boys: OR =4.24, girls: OR =7.21), thinking smoking in the next year (boys: OR =5.77, girls: OR =7.74) had higher risks of dual use ( P <0.05).Among boys, junior middle school students ( OR =0.50), excellent academic performance ( OR =0.36), no acceptance of free tobacco products from tobacco companies ( OR =0.38), believing that smoking couldn t refresh oneself ( OR =0.37) and smoking still could pose a health hazard though not yet addictive ( OR =0.32) had lower risks of dual use ( P <0.05);and boys with a history of secondhand smoke exposure indoor outside home ( OR =2.19), believing that quitting smoking without difficulty ( OR =2.57),smoking e-cigarettes handed over by good friends ( OR =11.27) had higher risks of dual use ( P <0.05). Among girls, no acceptance of using tobacco product labeled items ( OR =0.28) had lower risks of dual use ( P <0.05); and girls whose parents both smoke ( OR =5.53), believing that quitting smoking might not be difficult ( OR =4.44) had higher risks of dual use ( P < 0.05 ). Conclusions The dual use rate of traditional cigarettes and e-cigarettes among middle school students in Beijing has decreased. It is recommended to take the construction of smoke free families as the starting point, so as to reduce indoor second hand smoke exposure and control tobacco promotions, and promote the formation of correct tobacco control culture and moral constraints among secondary school students.

Extensive epigenetic reprogramming involves in memory CD8+ T-cell differentiation. The elaborate epigenetic rewiring underlying the heterogeneous functional states of CD8+ T cells remains hidden. Here, we profile single-cell chromatin accessibility and map enhancer-promoter interactomes to characterize the differentiation trajectory of memory CD8+ T cells. We reveal that under distinct epigenetic regulations, the early activated CD8+ T cells divergently originated for short-lived effector and memory precursor effector cells. We also uncover a defined epigenetic rewiring leading to the conversion from effector memory to central memory cells during memory formation. Additionally, we illustrate chromatin regulatory mechanisms underlying long-lasting versus transient transcription regulation during memory differentiation. Finally, we confirm the essential roles of Sox4 and Nrf2 in developing memory precursor effector and effector memory cells, respectively, and validate cell state-specific enhancers in regulating Il7r using CRISPR-Cas9. Our data pave the way for understanding the mechanism underlying epigenetic memory formation in CD8+ T-cell differentiation.
CD8-Positive T-Lymphocytes/metabolism* ; Cell Differentiation ; Chromatin/immunology* ; Animals ; Mice ; Immunologic Memory ; Epigenesis, Genetic ; SOXC Transcription Factors/immunology* ; NF-E2-Related Factor 2/immunology* ; Mice, Inbred C57BL ; Gene Regulatory Networks ; Enhancer Elements, Genetic