Objective: To analyze the factors associated with high level fear of negative evaluation (FNE) among junior high school students and to construct a nomogram risk prediction model, so as to provide scientific tools for psychological health intervention for junior high school students. Methods: A convenience sampling combined with cluster random sampling method was used to select 5 485 junior high school students from 4 cities (Wuhan, Huanggang, Xianning and Xiaogan) for an online questionnaire survey in March 2025. The total sample was randomly split into a training set ( n =3 839) and a validation set ( n =1 646). Univariate analysis was performed in the training set using Chi-square test and t-test. Variables with statistical significance were subsequently included in multivariate Logistic regression to identify independent predictors and to construct a nomogram based risk prediction model. The discriminative ability and clinical utility of the model were evaluated in the validation set using the area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA). Results: There were 1 649 junior high school students with low level FNE and 2 190 with high level FNE in the training set. The self control ability of junior high school students with lowlevel and high level FNE showed a statistically significant difference (23.96±3.96, 21.48±3.37, t=25.15, P < 0.01 ). Statistically significant differences in the detection rate of high level FNE were observed among junior high school students with different genders, family types, parenting styles, academic rankings, psychological flexibility, mobile phone addiction tendencies, emotional management training, exercise frequency, left behind experiences, and places of origin ( χ 2=82.01- 1 126.68 , all P <0.01). The results of Logistic regression analysis revealed that, the following factors were identified as significant factors influencing high level FNE among junior high school students:exercise frequency ( OR=0.21, 95%CI =0.17-0.26); parenting style ( OR=0.48, 95%CI =0.40-0.58); left behind experience ( OR=3.88, 95%CI =3.27-4.61); smartphone addiction proneness ( OR=2.19, 95%CI =0.89-0.93); self-control ability ( OR=0.91, 95%CI =0.89-0.93); and psychological flexibility ( OR=0.16, 95%CI =0.10-0.28) (all P <0.05). The AUC for the training and validation set were 0.88 (95% CI =0.87-0.89) and 0.87 (95% CI =0.85-0.89), respectively. The Hosmer-Lemeshow goodness of fit test yielded χ 2=8.57, 15.20 (both P >0.05). Conclusion The risk prediction model with high level FNE demonstrates good accuracy and can assist educators and parents in timely screening of junior high school students with high level FNE, thereby providing a basis for implementing targeted interventions.

Fusion variations of neurotrophic receptor tyrosine kinase (NTRK) are oncogenic drivers in various solid tumors such as breast cancer, salivary gland carcinoma, infant fibrosarcoma, etc. Gene rearrangements involving NTRK1/2/3 lead to constitutive activation of the tropomyosin receptor kinase (TRK) domain, and the expressed fusion proteins drive tumor growth and survival. NTRK fusions are estimated to occur at a frequency of approximately 0.1% to 1% in non-small cell lung cancer (NSCLC). Epidermal growth factor receptor (EGFR) mutations are prevalent in NSCLC, but the frequency of EGFR G719A mutation is relatively low (about 2%), and EGFR mutations are typically mutually exclusive with NTRK fusion variants. The study presented the first documented case of lung adenocarcinoma harboring both EGFR G719A mutation and LMNA-NTRK1 fusion. A review of the literature was conducted to elucidate the role of NTRK fusion mutations in NSCLC and their relationship with EGFR mutations, aiming to enhance the understanding of NTRK fusion mutations in NSCLC.
.
Humans ; Adenocarcinoma/genetics* ; Adenocarcinoma of Lung ; ErbB Receptors/genetics* ; Lamin Type A/genetics* ; Lung Neoplasms/genetics* ; Mutation ; Oncogene Proteins, Fusion/genetics* ; Receptor, trkA/metabolism*

Objective To investigate the effect of acute cold stimulation on the staufen1-mediated mRNA decay(SMD)pathway in brown adipose tissue of mice and the downstream regulated target genes.Methods Mice were subjected to acute cold stimulation(CS)at 4℃.After 48 hours,the brown adipose tissue of mice was extracted to detect the expression of genes including as Stau1,Ucp1 and Pparγ,and compared with mice in room temperature control group(RT).Transcriptomic sequencing was performed on the brown adipose tissue of mice in the CS group and in the RT group,and the functional enrichment analysis of differential genes was performed on the sequencing re-sults.The Stau1 gene was knocked out in the brown adipocytes of mice using CRISPR-Cas9 technology,and the ex-pression of thermogenic genes after knockout was analyzed.Results Acute cold stimulation induced the expression of Stau1 gene and promoted the degradation of downstream target genes Serpineb1,Klf2 and c-Jun in the SMD pathway(P＜0.05).After Stau1 knockout,the glycolipid metabolism pathway of brown adipocytes in mice was significantly up-regulated,and the expression of thermogenesis-related genes Ucp1,Prdm16,ATP5o,Dio2 and Pgc1α was up-regulated(P＜0.05).Conclusions Acute cold stimulation promotes the SMD pathway in brown adipose tissue of mice,and SMD pathway mainly regulates the metabolic and thermogenic pathways in brown adipocytes.

Objective:To investigate the clinical characteristics of sepsis-induced myocardial injury and microbial distribution.Methods:It was a retrospective observational study conducted from Jan 2023 to Dec 2023 in the Department of Emergency Intensive Care Medicine, Changshu Hospital Affiliated to Soochow University. Patients meeting the sepsis 3.0 criteria were included, excluding those with underlying cardiovascular diseases or incomplete data. Patients were categorized into myocardial injury (SIMI) and non-myocardial injury (Non-SIMI) groups based on troponin levels. General patient information, laboratory results, microbial findings, and prognostic indicators were collected. Differences in clinical parameters between the two groups were compared. Factors showing statistical differences in univariate analysis were further analyzed using multivariable logistic regression to identify risk factors for SIMI. Conduct propensity score matching among Pulmonary infection patients who underwent bronchoalveolar lavage high-throughput sequencing to compare microbial distribution between groups. Bracken was used to estimate species-level abundance from Kraken2 results, and α and β diversity analyses were conducted on the metagenomic samples.Results:A total of 179 patients were included in the study, with 98 (54.4%) in the Non-SIMI group and 81 (45.5%) in the SIMI group. There were 69 deaths overall (38.5%), with 23 (23.7%) in the Non-SIMI group and 46 (56.8%) in the SIMI group (χ 2=20.347, P<0.01). The 28-day survival curve indicated survival rates in the SIMI group were significantly lower compared to the Non-SIMI group (Log Rank χ 2=21.270, P<0.01). Univariate analysis revealed that fungal infection rate ( P=0.007), C-reactive protein ( P=0.021), procalcitonin, blood urea nitrogen, creatinine, alanine transaminase, and lactate levels were higher in the SIMI group compared to the Non-SIMI group (all P<0.01), prothrombin time was prolonger ( P<0.01) and APACHEⅡ scores were higher ( P<0.01), while serum albumin, base excess, and platelet levels were lower (all P<0.01). Multivariable logistic regression analysis indicated that fungal infection ( OR=3.441, P=0.015) was a risk factor for SIMI, whereas base excess and platelets were protective factors ( OR=0.845, 0.988, both P<0.01). Comparison of bronchoalveolar lavage high-throughput sequencing results in the pulmonary infection subgroup showed the relative abundance of Haemophilus paraininfluenzae in Non-SIMI group was higher than SIMI group among the top 20 species ( P=0.013). There were no statistically significant differences in microbial αand β-diversity between the two groups. Conclusions:The incidence of SIMI is relatively highamong sepsis patients and it affects their prognosis. Risk factors for SIMI include fungal infection, decreased platelet count, and reduced base excess levels. Among patients with pulmonary infections, there is a lower risk of SIMI associated with Haemophilus influenzae infection.

Objective:To examine the burden and trends of acute viral hepatitis in Guangdong Province from 1990 to 2019, and provide reference evidences for hepatitis prevention and control in the province.Methods:Data on acute viral hepatitis (hepatitis A, B, C, and E) in Guangdong from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019 database. The incidence, prevalence, mortality, and disability-adjusted life years (DALY) data were analyzed by age and gender, and the estimated annual percentage change (EAPC) was calculated to describe the changing trends in disease burden.Results:From 1999 to 2019, the standardized incidence, prevalence, mortality, and DALY of acute viral hepatitis in Guangdong were higher than the national averages. In 2019, 51.43% (2 245 087/4 365 221) of acute viral hepatitis cases in Guangdong Province were mainly attributed to hepatitis B, and 77.18% (106/138) of deaths were due to acute hepatitis B. In different age groups, except for acute hepatitis B, which was more common in adults, the incidence rates of other types of viral hepatitis such as hepatitis A, B, and E showed an overall decreasing trend with age. The mortality rates of different types of acute viral hepatitis, except for the <5 age group, increased with age. The overall incidence and mortality rates of acute viral hepatitis were higher in men than in women.Conclusions:The overall burden of acute viral hepatitis in Guangdong declined in 2019, but remained higher than the national level. Further efforts are needed to strengthen hepatitis prevention and screening in different population in Guangdong Province, especially in children and the elderly.

Objective:To explore the clinical characteristics of pregnancy complicated by primary Sj?gren's syndrome (pSS) and the related factors of adverse outcomes in pregnant women with pSS.Methods:A retrospective analysis was conducted on the clinical data of 32 pregnancies complicated by pSS treated in the Department of Obstetrics at the Third Affiliated Hospital of Guangzhou Medical University from February 2017 to August 2022. The patients were divided into two groups according to whether they had perinatal adverse outcomes: an adverse outcome group ( n=20) and a favorable outcome group ( n=12). The clinical characteristics of the two groups were compared with two independant sample t-test, Mann-Whitney U test, and Fisher's exact test, and multivariate logistic regression analysis was used to analyze the related factors of adverse outcomes in pregnant women with pSS. Results:(1) The average maternal age of the 32 pSS pregnancies was (32.9±4.6) years, the pre-pregnancy body mass index was (21.1±3.8) kg/m 2, and the median gestational age at delivery was 37.8 (35.4-38.5) weeks. There were 18 women (56.3%, 18/32) were diagnosed before pregnancy and 14 women (43.7%, 14/32) during pregnancy. Out of the 32 pregnancies, 25 (79.1%, 25/32) received therapy with glucocorticoids and/or hydroxychloroquine during pregnancy, whereas seven (21.9%, 7/32) had no medication during pregnancy. (2) The main adverse maternal outcomes included oligohydramnios (25%, 8/32), hypertensive disorder of pregnancy (18.8%, 6/32), preterm birth (18.8%, 6/32), fetal growth restriction (15.6%, 5/32), miscarriage (12.5%, 4/32), gestational diabetes mellitus (9.4%, 3/32), and postpartum hemorrhage (3.1%, 1/32). (3) Adverse neonatal outcomes included low birth weight infants in seven cases (25.0%, 7/28), neonatal asphyxia in seven cases (25.0%, 7/28), and two cases of congenital heart block (7.1%, 2/28). (4) The rate of diagnosis before pregnancy in the favorable outcome group was higher than the adverse outcome group [10/12 vs. 40.0%(8/20), Fisher's exact test, P=0.028]. There were no significant differences between the two groups concerning maternal age, pre-pregnancy BMI, weight gain during pregnancy, parity, rates of positivity for autoantibodies (antinuclear antibody, Sj?gren-specific antibody A, Sj?gren-specific antibody B, anti-Ro-52), and proportion of drug treatment (glucocorticoids, hydroxychloroquine) (all P>0.05). (5) Multivariate logistic regression analysis showed that diagnosis before pregnancy ( OR=0.02, 95% CI: 0.00-0.62, P=0.024) and positive Sj?gren-specific antibody B ( OR=0.01,95% CI: 0.00-0.75, P=0.038) were the protective factors. Conclusions:The clinical manifestations of pSS among pregnant women are varied and atypical,often with insidious onset. For pregnant women with pSS, being diagnosed before pregnancy, positive Sj?gren-specific antibody B may reduce adverse outcomes. It is important to address pre-pregnancy examination, early diagnosis and timely intervention to reduce the occurrence of adverse outcomes in pregnant women with pSS.

Objective: To investigate the impact of COVID-19 infection and health related behaviors on the health related quality of life of children and adolescents aged 8-15 years in Nanjing, so as to provide a theoretical basis for improving HRQoL in children and adolescents. Methods: From December 2022 to January 2023, a total of 2 398 students aged 8-15 years from the third grade of primary school to junior middle school in Nanjing were selected by multistage random cluster sampling. The 3 level EuroQol 5 dimension Questionnaire Youth Vension (EQ-5D-Y-3L) was completed by the respondents on their own, and the parents assisted in completing the rest of the questionnaire. Results: The EuroQol-index(EQ-index) and Visual Analogue Scale (VAS) scores of being infected individuals were lower than those of uninfected and previously infected ( P <0.05). The proportion of being infected individuals reporting difficulty on "Pain/Discomfort" was higher than that of uninfected and previously infected individuals, and the proportion of reporting difficulty on "Mobility" was also higher than that of uninfected individuals ( P <0.05). Lack of parental companionship( OR=10.19, 95%CI =3.12-33.22), irregular breakfast consumption ( OR=10.63, 95%CI =3.20-35.25), and excessive screen time ( OR=8.24, 95%CI =3.02-22.51) increased the risk of difficulty on "Mobility" in being infected individuals ( P <0.05). Irregular breakfast consumption ( OR=1.93, 95%CI =1.31-2.84) and consumption of sweetened beverages and snacks (OR=1.56, 95%CI =1.17-2.10) increased the risk of having lower EQ index in previously infected individuals compared to uninfected individuals. Furthermore, consumption of sweetened beverages and snacks ( OR=1.57, 95%CI =1.21-2.05) and excessive screen time ( OR=1.49, 95%CI =1.12-1.98) also increased the risk of VAS scores being lower in previously infected individuals compared to uninfected individuals ( P <0.05). Conclusion The COVID-19 infection impairs HRQoL, and unhealthy behaviors deteriorate its negative impact. Healthy behaviors and lifestyles should be advocated to reduce the impact of COVID-19 infection on HRQoL.

{L-End}Objective To explore the status of quality control assessment of pure tone audiometry (PTA) and to analyze its influencing factors in occupational medical examination (OME) institutions in Guangzhou City. {L-End}Methods A total of 41 OME institutions in Guangzhou City were selected as the research subjects from 2021 to 2022 using random sampling method, and its status of on-site quality and PTA quality for individuals exposed to noise were assessed. {L-End}Results A total of 205 rectification items were identified among the 41 OME institutions from 2021 to 2022. Among them, 19, 28, 30, and 28 OME institutions did not meet the requirements of organizational structure, quality management system, quality control of OME, and health examination information reporting, respectively. A total of 1 095 OME reports for individuals exposed to noise were assessed, with 820 reports having correct results and conclusions, resulting in an accuracy rate of 74.9%. The results of the multiple logistic regression analysis showed that OME institutions without meeting the requirements for the quality management system had a higher risk of failing the PTA quality control assessment and having inaccurate hearing test results compared with those meeting the requirements (all P<0.05). OME institutions with a filing period less than one year had a higher risk of having inaccurate hearing test results than those with a filing period of one year or more (P<0.05). OME institutions not meeting the requirements for quality control of OME had a higher risk of having abnormal OME conclusions than those meeting the requirements (P<0.05). OME institutions not meeting the requirements for health examination information reporting had a higher risk of having abnormal conclusions in suspected occupational disease than those meeting the requirements (P<0.05). OME institutions not meeting the requirements for the quality management system had a higher risk of having abnormal conclusions of occupational contraindications than those meeting the requirements (P<0.05). {L-End}Conclusion The quality of PTA in OME institutions in Guangzhou City needs to be improved. And a well-established quality management system for OME is beneficial for improving the quality of PTA.

Objective To explore the correlation between six characteristics of perioperative hypothermia and allogeneic red blood cell(RBC)transfusions in patients who underwent abdominal surgeries.Methods Patients who underwent abdominal surgeries at West China Hospital,Sichuan University between October 2019 and July 2021 were retrospectively enrolled.A wearable wireless temperature sensor was used to continuously monitor the core body temperature of patients throughout the perioperative period.The perioperative temperature nadir,maximum temperature loss,percentage of time with hypothermia,time-weigh ted average temperature,area under the curve(AUC)at 36 ℃,and AUC at 37 ℃ were calculated for the period from entering the operation room to 24 hours after the end of anesthesia.The restricted cubic spline(RCS)and multiple logistic regression models were used to explore the correlation between these temperature characteristics and perioperative allogeneic RBC transfusions.Results A total of 3119 patients were included in the study,with an allogeneic RBC transfusion rate of 2.8％.The RCS model showed that allogeneic RBC transfusion was associated with the perioperative temperature nadir(Poverall=0.048)and AUC at 36 ℃(Poverall=0.026)and no statistical significance was found in the nonlinear test.The association between allogeneic RBC transfusions and other temperature characteristics was not statistically significant.According to the RCS model results,cut-off points were taken to form groups based on the body temperature characteristics.Multivariate logistic regression showed that the perioperative temperature nadir＜35.5 ℃(odds ratio[OR]=2.47,95％confidence interval[CI]:1.21-5.03)and AUC at 36 ℃≥100 ℃·min(OR=2.24,95％CI:1.09-4.58)were associated with increased demand for allogeneic RBC transfusion.Conclusion Hypothermia is associated with an increased need for perioperative allogeneic RBC transfusions and has a cumulative effect over time.For patients at high risk of bleeding,attention should be paid to the prevention of perioperative hypothermia and reduction in the cumulative exposure to hypothermia,thereby reducing the need for blood transfusion.

Objective    To analyze the relationship between preoperative pulmonary function indexes and postoperative pneumonia (POP) in patients undergoing upper gastrointestinal surgery. Methods    The clinical data of 303 patients who underwent lung function examination and upper gastrointestinal surgery in West China Hospital, Sichuan University from September 2020 to January 2021 were prospectively collected and analyzed. There were 217 males and 86 females, with an average age of 61.61±10.42 years. Pulmonary function was evaluated from four aspects including ventilatory function, pulmonary volume, diffusion function and airway resistance. Relevant pulmonary function indicators were displayed as the percentage of actual measured value to predicted value (%pred). The outcome index was pneumonia within 30 days after the surgery. Logistic regression was used to analyze the relationship between preoperative pulmonary function indicators and POP. Results    A total of 196 patients with gastric cancer and 107 patients with esophageal cancer were included, and the incidence of POP in patients undergoing upper gastrointestinal surgery was 26.7% (81/303). Patients with preoperative low peak expiratory flow (PEF%pred) had a 3.094 times higher risk of developing POP than those with normal PEF%pred [OR=3.094, 95%CI (1.362, 7.032), P=0.007]. The incidence of POP had no correlation with the other preoperative indicators. Conclusion    Preoperative PEF%pred may be an important indicator for predicting the occurrence of POP in patients undergoing upper gastrointestinal surgery.