OBJECTIVES: To investigate the changes in blood levels of calcium and bone metabolism biochemical markers in patients with primary osteoporosis receiving treatment with denosumab. METHODS: Seventy-three patients with primary osteoporosis treated in our Department between December, 2021 and December 2023 were enrolled. All the patients were treated with calcium supplements, vitamin D and calcitriol in addition to regular denosumab treatment every 6 months. Blood calcium, parathyroid hormone (PTH), osteocalcin (OC), type I procollagen amino-terminal propeptide (PINP), and type I collagen carboxy-terminal telopeptide β special sequence (β‑CTX) data before and at 3, 6, 9, and 12 months after the first treatment were collected from each patient. RESULTS: Three months after the first denosumab treatment, the bone turnover markers (BTMs) OC, PINP, and β-CTX were significantly decreased compared to their baseline levels by 39.5% (P<0.001), 56.2% (P<0.001), and 81.8% (P<0.001), respectively. At 6, 9, and 12 months of treatment, OC, PINP, and β-CTX remained significantly lower than their baseline levels (P<0.001). Blood calcium level was decreased (P<0.05) and PTH level increased (P<0.05) significantly in these patients at months of denosumab treatment, but their levels were comparable to the baseline levels at 6, 9, and 12 months of the treatment (P>0.05). CONCLUSIONS Denosumab can suppress BTMs and has a good therapeutic effect in patients with primary osteoporosis, but reduction of blood calcium and elevation of PTH levels can occur during the first 3 months in spite of calcium supplementation. Blood calcium and PTH levels can recover the baseline levels as the treatment extended, suggesting the importance of monitoring blood calcium and PTH levels during denosumab treatment.
Humans ; Denosumab/therapeutic use* ; Calcium/blood* ; Parathyroid Hormone/blood* ; Biomarkers/blood* ; Osteoporosis/blood* ; Osteocalcin/blood* ; Procollagen/blood* ; Female ; Collagen Type I/blood* ; Peptide Fragments/blood* ; Bone Density Conservation Agents/therapeutic use* ; Bone and Bones/metabolism* ; Male ; Middle Aged ; Vitamin D ; Peptides/blood* ; Aged

Objective:To explore the mediating role of mindfulness between professional identity and positive emotions among medical students.Methods:From February to April 2022, a total of 878 undergraduates from a medical school in Shandong Province were selected by cluster sampling method. The medical professional identity questionnaire, positive and negative affective scale, and mindful attention awareness scale were utilized for cross-sectional investigation. SPSS 22.0 software was used for descriptive and correlation analysis, and AMOS 25.0 software was used to test the mediating effect.Results:(1) The scores for medical students' professional identity, positive emotions, and mindfulness were 140.00 (125.00, 150.00), 30.00 (28.00, 35.00), and 52.00 (44.00, 63.00), respectively. The dimension scores of occupational cognition, occupational emotion, occupational commitment, occupational behavior, occupational expectation and occupational sense of value in the medical professional identity questionnaire were 23.00 (20.00, 25.00), 19.00 (16.00, 20.00), 19.00 (16.00, 21.00), 16.00 (13.00, 16.00), 32.00 (28.00, 36.00), and 31.00 (29.00, 34.00), respectively. (2) The total and dimension scores of professional identity, positive emotions, and mindfulness were significantly and positively correlated with each other( r=0.125-0.390, all P<0.001). (3) Mindfulness partially mediated the relationship between professional identity and positive emotions (effect size=0.02, 95% CI=0.01-0.04), and the mediating effect accounted for 4.76%(0.02/0.42) of the total effect. Conclusion:Professional identity can directly affect the positive emotions of medical students, and indirectly affect the positive emotions through the mediating role of mindfulness.

Objective:To explore the effect of SQLE on the biological characteristics of pan-cancer,using bioinformatics methods to predict and analyze the correlation between SQLE and the clinical prognosis and immunity of pan-cancer.Methods:The ex-pression level of SQLE in tumor and normal tissues and its correlation with different clinical stages of pan-cancer were analyzed,and the relationship between SQLE expression and overall survival and tumor microenvironment were evaluated.Gene enrichment analysis was conducted to study the biological functions and signaling pathways related to SQLE gene,then,calculate the correlation between SQLE gene and tumor mutation load and microsatellite instability,and analyze the correlation between SQLE gene and immunomodula-tory genes.Results:SQLE gene was highly expressed in variety of tumors,and differentially expressed in different tumor stages.High expression of SQLE was a risk factor in variety of tumors.Patients with high expression of SQLE hade a worse prognosis.SQLE was cor-related with TMB and MSI,and involved in tumor development through different pathways.Conclusion:SQLE,as a valuable prognos-tic biomarker and new therapeutic target for variety of cancers,has certain application value in basic research and clinical treatment of various cancers.

Objective:To investigate the associated factors of depressive symptoms among patients with neo-plasms.Methods:Nationwide(excluding Hong Kong,Macao,and Taiwan),30 505 residents were selected by a combination of stratified sampling and quota sampling according to the proportion of the seventh national population census.Patient Health Questionnaire-9(PHQ-9),General Anxiety Disorder-7(GAD-7),self-made questionnaire,and simplified perceived social support scale used to evaluate depressive symptoms,anxiety symptoms,behaviors,and perceived social support among patients with neoplasms.Results:Totally 359(1.2％)patients with self-repor-ted clinically diagnosed neoplasms were included,of which 151(42.1％)patients with malignant neoplasms and 208(57.9％)patients with benign neoplasms.The detection rate of depressive symptoms in patients with neo-plasms was 76.6％.Less than three days of walking for more than 10 minutes per day in the past week(OR=6.63),4-6 days of walking for more than 10 minutes per day in the past week(OR=5.00),the low(OR=4.80)or medium(OR=3.06)overall sleep quality,the lower perceived friend support(OR=4.66),and anxiety symp-toms(OR=1.74)among patients with neoplasms were risk factors for depressive symptoms.Conclusion:Patients with neoplasms generally might be at a high risk of depressive symptoms,especially for those patients with less ex-ercise,poor sleep quality,and low perceived social support.

Objective:To report the clinical manifestations, structural and functional imaging features of 3 patients with progressive supranuclear palsy with predominant cerebellar ataxia (PSP-C) assisted by florzolotau ( 18F) positron emission tomography (tau PET) imaging, and conduct a literature review, aiming to provide a basis for the diagnosis and treatment of this rare type of PSP. Methods:The clinical data, brain magnetic resonance imaging, 18F-fluorodeoxyglucose PET ( 18F-FDG PET) and tau PET head imaging features of 3 patients with PSP-C who were admitted to the Department of Neurology, Peking Union Medical College Hospital from January 2019 to December 2021 were summarized, and a systematic review of related case reports or series studies from China and abroad was conducted. Results:The age of onset of the 3 patients was 55-61 years, and the disease duration was 2-5 years at the time of diagnosis. All patients had an onset of instable walking and had repeated falls, and the duration between fall and disease onset was 0.5-3.0 years, with an average of 1.5 years. At the time of diagnosis, all patients showed gait ataxia with or without limb ataxia. The results of the brain magnetic resonance imaging showed that all patients had midbrain atrophy and midbrain-to-pons ratio<0.52. The tau PET results of all patients showed significant tau protein deposition in the midbrain and mild to moderate tau protein deposition in the cerebellum, and case 2 had concomitant mild tau protein deposition in the prefrontal lobe and decreased 18F-FDG PET metabolism in this region, supporting the diagnosis of PSP. Literature review showed that 24 patients with PSP complicated with cerebellar ataxia were reported, and 23 patients provided detailed clinical data. All patients had gait ataxia on physical examination and the clinical manifestations were consistent with those of this group. Conclusions:PSP-C is characterized by early gait ataxia and falls as the core manifestations. Structural imaging shows mesencephalic atrophy, and tau PET shows mesencephalic and cerebellar uptake. In the case of atypical PSP, head magnetic resonance imaging combined with tau PET imaging is helpful to further determine the diagnosis of PSP.

Objective:To screen the key exosomal long non-coding RNAs (lncRNAs) molecules that cause nasopharyngeal carcinoma cells to develop chemoradiotherapy resistance.Methods:In vitro, a model of concurrent chemoradiotherapy for human nasopharyngeal carcinoma cells was constructed, and the continuous shock method of high-dose concurrent chemoradiotherapy was used to induce the establishment of chemoradiotherapy-resistant nasopharyngeal carcinoma cell lines, and its resistance formation was verified. Exosomes produced by chemoradiotherapy-resistant cell lines and respective mother cell lines for nasopharyngeal carcinoma were extracted and identified. Finally, biochip technology was used to detect the differential expression levels of exosomal lncRNAs. Results:After 10 repeated treatments of concurrent chemoradiotherapy, CNE-1 CRR and CNE-2 CRR were successfully obtained. Compared with the mother cell lines, CNE-1 CRR and CNE-2 CRR had a tendency to transform from epithelial to interstitial morphology, and the number of cell clones was higher, and the values of average lethal dose (D 0), quasi-threshould dose (D q), survival fraction after 2 Gy irradiation (SF 2) and cell survival rate were higher. Nasopharyngeal carcinoma cells were detected by PCR chip of exosomal lncRNAs. Compared with their respective mother cell lines, 18 lncRNAs in CNE-1 CRR exosomes were significantly up-regulated and 31 lncRNAs were significantly down-regulated, and 15 lncRNAs were significantly up-regulated and 38 lncRNAs were significantly down-regulated in CNE-2 CRR exosomes. CNE-1 CRR also had similar expression profiles to CNE-2 CRR. Conclusion:There are significantly up-regulated and down-regulated lncRNAs in the exosomes of CNE-1 CRR and CNE-2 CRR.

Objective:To explore stigma and related factors among family members of patients with mental disorders in psychiatric hospitals.Methods:Totally 1 365 family members of inpatients with mental disorders were-surveyed,and were assessed with the Perceived Devaluation-Discrimination Scale and a self-made demographic characteristics questionnaire.Results:The screening rate of stigma among the patient's family members was 61.5％.Males(OR=2.26,95％CI:1.06-5.01),age group of 18-29 years(OR=1.91,95％CI:1.15-3.20),monthly income ≥500 yuan(P＜0.05),disease duration of 0.5-＜lyear(OR=3.14,95％CI:1.66-6.03),care for patients within＜lyear(P＜0.05),teachers(OR=2.32,95％CI:1.24-3.44),self-employed person(OR=1.63,95％CI:1.02-2.24),civil servants(OR=1.77,95％CI:1.09-2.45),schizophrenia(OR=1.87,95％CI:1.32-2.42),affective disorders(OR=1.52,95％CI:1.03-2.016)were the main riskfactors of stigma.Conclusions:Family members of patients with mental disorders generally have a severe stigma,especially of patients with schizophrenia and affective disorders.

Objective:To explore the influence of chronic rhinitis on depressive symptoms of college freshmen and the mediating effect of avoidant personality.Methods:A cluster sampling method was used to survey 8 079 college freshmen from April 2018 to October 2018 using the Beck depression inventory and the avoidant personality diagnosis questionnaire based on DSM-Ⅳ.SPSS 25.0 software was used for descriptive statistics and Spearman correlation analysis, and the macro program PROCESS version 3.3 was used for the mediating effect.Results:(1) The detection rates of chronic rhinitis, avoidant personality and depressive symptoms were 22.90% (1 850/8 079), 19.22% (1 553/8 079) and 6.28% (507/8 079). The scores for avoidant personality disorder and depressive symptoms were 1.00 (0, 3.00) and 1.00 (0, 4.00), respectively. (2) The chronic rhinitis, avoidant personality and depressive symptoms were positively correlated ( rchronic rhinitis-avoidant personality=0.094, rchronic rhinitis-depressive symptoms=0.095, ravoidant personality-depressive symptoms=0.416, all P<0.001). (3) Chronic rhinitis could positively predict depressive symptoms ( β=1.113, P<0.001). (4) Avoidant personality played a mediating role between chronic rhinitis and depressive symptoms ( β=1.094, P<0.001), and accounted for 44.92%(0.500/1.113) of the total effect. Conclusion:Chronic rhinitis directly affect the depressive symptoms of college freshmen, and indirectly affect the depressive symptoms of college freshmen through the mediating role of avoidant personality.

Objective:To investigate the status quo of nursing cognition of caregivers of patients with end-stage renal disease based on cognitive adaptation theory and explore its influencing factors.Methods:The convenient sampling method was adopted to select 150 caregivers of patients with end-stage renal disease admitted to Affiliated Hospital of Jining Medical University from June 2018 to June 2020 as the research objects. Guided by cognitive adaptation theory, a questionnaire was designed to investigate the caregivers' cognitive level of end-stage renal disease care. According to the survey results, caregivers were divided into the high cognition group and the low cognition group. Univariate analysis and Logistic regression analysis were used to analyze the influencing factors of cognitive level of caregivers.Results:There were 150 caregivers in this group, 60 of whom had high nursing cognition, accounting for 40%. There were statistically significant differences between the high cognition group and the low cognition group in knowledge training, life meaning score, internal control scale score and benefit discovery score ( P<0.05) . Logistic regression analysis showed that knowledge training, meaning of life, internal sources of control and the discovery of benefits were the influencing factors for the nursing cognition level of patients with end-stage renal disease ( P<0.05) . Conclusions:The nursing cognition level of caregivers of patients with end-stage renal disease is affected by whether they participate in knowledge training, sense of life meaning, internal control psychological control source and benefit discovery.

Objective: To investigate vitamin D levels among primary and middle school students in Xicheng District, Beijing Municipality, and to examine the association of vitamin D levels with hemoglobin (Hb) and serum ferritin (SF) levels, so as to provide insights into the prevention of anemia among primary and middle school students. Methods: The first, third and fifth grade primary school students and the first grade junior high school students were sampled from Xicheng District in 2019, using the multistage stratified cluster sampling method, and students' gender, age, height, weight and Hb levels were collected. The 25-hydroxyvitamin D [25-( OH )D] was measured using electrochemiluminescence assay, and SF was detected using immunoturbidimetry. The vitamin D deficiency was determined according to the American College of Endocrinology guidelines. The associations of 25-( OH) D levels with Hb and SF levels were examined using Pearson correlation analysis and Spearman rank correlation analysis. Results: Totally 403 primary and junior high school students were investigated, including 196 boys ( 48.64% ) and 207 girls ( 51.36% ). There were 179, 114 and 110 students at ages of 6 to 8 years ( 44.41% ), 9 to 11 years ( 28.29% ) and 12 to 13 years ( 27.30% ), respectively. The mean 25-( OH )D level was ( 14.80±5.96 ) ng/mL among the study students, and there were 90 students ( 22.33% ) with severe vitamin D deficiency, 243 students ( 60.30% ) with vitamin D deficiency, 63 students ( 15.63% ) with vitamin D inadequacy and 7 students ( 1.74% ) with vitamin D sufficiency. The mean Hb level was ( 136.28±8.33 ) g/L and the median SF level (interquartile range) was 56.80 (14.36) ng/mL among the study students, respectively. The 25-( OH )D level positively correlated with Hb ( r=0.364, P<0.001 ) and SF levels ( rs=0.374, P<0.001 ), and after adjustment for age and body mass index, the 25-( OH )D still correlated positively with Hb ( r=0.157, P=0.048 ) and SF levels ( rs=0.174, P=0.022 ) . Conclusions Vitamin D deficiency is prevalent among primary and middle school students in Xicheng District, and the 25-(OH)-D levels correlate positively with Hb and SF levels. 25-( OH )-D deficiency may contribute to the development of anemia.
vitamin D ; hemoglobin ; serum ferritin ; primary and middle school student