Objective To explore the role of resilience and stress in childhood maltreatment and adolescent depression and anxiety symptoms, and to provide a basis for adolescent psychological intervention. Methods From September to October 2022, a total of 11 217 students from four middle schools in Changsha were selected by multistage stratified sampling, and the Childhood Trauma Questionnaire, Depression–Anxiety–Stress Scales and the Resilience Scale for Chinese Adolescents were used to carry out online questionnaire survey. Results The detection rate of depressive symptoms and anxiety symptoms in adolescent was 19.43% (2 179) and 28.7% (3 224). The direct effect of childhood maltreatment on depressive symptoms was significant (β =0.09), Childhood maltreatment is a negative prediction of resilience (β = -0.57) and a positive prediction of pressure (β =0.06); Resilience can negatively predict stress (β = -0.61) and depressive symptoms (β = -0.25) (all P values <0.001); The direct effect of childhood maltreatment on anxiety symptoms was significant (β =0.03), resilience negatively predicts anxiety symptoms (β = -0.08) (all P values <0.01). Resilience and stress have a partially mediating role between childhood maltreatment and depressive symptoms, the mediation effect value was 0.39, accounting for 81.25% of the total effect. The effect values of the three pathways accounted for 29.17%, 8.33% and 43.75% of the total effect, respectively. Resilience and stress have a partial mediating effect between childhood abuse and anxiety symptoms, and the mediating effect was 0.36, accounting for 92.31% of the total effect, and the effect values of the three pathways accounted for 12.82%, 10.26% and 69.23% of the total effect, respectively. Conclusion Childhood maltreatment could affect adolescents’ depression and anxiety through the chain mediating effect of resilience and stress.

Objective To explore the clinical efficacy and safety of endoscopic endonasal dorsum sellae and posterior clinoid process resection combined with pituitary hemi-transposition in the treatment of pan-sellar area lesions. Methods Clinical data from 57 patients with pan sellar diseases who underwent endoscopic transnasal resection of the posterior clinoid process combined with lateral pituitary displacement surgery in the neurosurgery department of Zhongshan Hospital, Fudan University from January 2019 to January 2025 were collected, and their clinical surgical characteristics and prognosis were analyed. Results A total of 57 patients with pan-sellar area lesions were included in this study, comprising 27 craniopharyngiomas, 7 giant suprasellar pituitary adenomas, 7 chordomas, 6 chondrosarcomas, 5 diaphragma sellae/dorsum sellae meningiomas, and 5 rare lesions. All procedures were completed successfully, and gross total or near-total resection was achieved in all patients. No new neurovascular complications occurred intraoperatively. The follow-up duration ranged from 3 to 24 months. New postoperative anterior pituitary insufficiency occurred in 3 patients (5.3%), and new posterior pituitary insufficiency requiring long-term hormone replacement therapy occurred in 4 patients (7.0%). No additional pituitary dysfunction was observed in the remaining patients. Cerebrospinal fluid rhinorrhea occurred in 1 patient (1.8%) and was successfully repaired. Intracranial infection occurred in 3 patients (5.3%) and resolved after medical treatment. Conclusion Endoscopic resection of the posterior clinoid process combined with lateral displacement of the pituitary gland can effectively expand the surgical space, while repositioning the pituitary gland can reduce the extent of skull base defects. In addition, the risk of pituitary dysfunction caused by lateral displacement of the pituitary gland is relatively low.

Objective To analyze the characteristics of stroke incidence among residents in Changsha City from 2022 to 2023, and to provide a scientific basis for formulating stroke prevention and control measures. Methods The data were obtained from routine cardiovascular and cerebrovascular event monitoring data. The incidence rate, constituent ratio, standardized incidence rate, age incidence rate and other indicators were calculated using SPSS21.0 software. The incidence rate between different genders and between urban and rural areas was compared by χ² tests. Results From 2022 to 2023, a total of 67 400 stroke cases were reported in 9 districts and counties (cities) of Changsha. The incidence rate and the age standardized rate were 327.40/10⁵ and 374.68/10⁵, respectively. The incidence rate of stroke in men was higher than that in women (χ²=2501.312, P<0.001). The incidence rate of stroke in rural areas was higher than that in urban areas (χ²=2501.312, P<0.001). Among the four subtypes of stroke, cerebral infarction was the most common (62 278 cases, 92.40%). With the increase of age, the incidence rate of stroke generally showed an upward trend, with a low incidence in those aged under 40 years old, and a significant upward trend in those aged 40 years and older. The incidence rate of stroke among residents above 85 years old was the highest, reaching 3414.25/10⁵. Conclusion The incidence of stroke in Changsha residents is higher in men than in women, higher in rural areas than in urban areas, and higher with age. Therefore, targeted stroke prevention and control efforts should be carried out in key areas and populations.

Objective: To analyze the effects of overweight and obesity or central obesity comorbid with hyperuricemia on dyslipidemia among the elderly, so as to provide evidence for early identification, high-risk population screening and precise intervention of dyslipidemia among the elderly. Methods: Based on the National Basic Public Health Service Program, the elderly aged ≥65 years in Changsha City were selected as study participants. Data on gender, age, body mass index, waist circumference, total cholesterol, triglycerides and serum uric acid were collected through the Hunan Provincial Primary Health Information System. A multivariable logistic regression model was used to analyze the effects of overweight and obesity or central obesity comorbid with hyperuricemia on dyslipidemia among the elderly. The Excel sheet compiled by Andersson et al. was used to calculate the relative excess risk due to interaction (RERI), the attributable proportion due to interaction (AP) and the synergy index (SI). Results: A total of 1 755 participants were included, including 833 males (47.46%) and 922 females (52.54%). The median age was 73.00 (interquartile range, 9.00) years. A total of 597 participants had overweight and obesity (34.02%), 583 had central obesity (33.22%), and 323 had hyperuricemia (18.40%). Dyslipidemia was detected in 663 participants, with a detection rate of 37.78%. Multivariable logistic regression analysis showed that overweight and obesity (OR=2.734, 95%CI: 2.207-3.386), central obesity (OR=2.665, 95%CI: 2.152-3.301), hyperuricemia (OR=2.459, 95%CI: 1.910-3.165), overweight and obesity combined with hyperuricemia (OR=5.417, 95%CI: 3.741-7.843) and central obesity combined with hyperuricemia (OR=5.307, 95%CI: 3.633-7.751) were statistically associated with a higher risk of dyslipidemia among the elderly. Interaction analysis showed that there was an additive interaction between overweight and obesity and hyperuricemia on dyslipidemia among the elderly (RERI=1.568, 95%CI: 0.371-2.765; AP=0.289, 95%CI: 0.068-0.510; SI=1.550, 95%CI: 1.135-2.116), and an additive interaction between central obesity and hyperuricemia on dyslipidemia among the elderly (RERI=1.303, 95%CI: 0.115-2.491; AP=0.246, 95%CI: 0.022-0.470; SI=1.434, 95%CI: 1.045-1.968). Conclusion Interaction effects of overweight and obesity or central obesity comorbid with hyperuricemia on dyslipidemia among the elderly were observed and may increase the risk of dyslipidemia.

Objective: To explore the relative importance of different food attributes and levels in food decision making of school aged children, and to understand their meal preferences, so as to provide the evidence for formulating precise intervention strategies for dietary behaviours of school aged children. Methods: From May to June 2024, a total of 854 children aged 11 to 15 years old were selected from 2 middle schools (each school in urban and rural areas) in both Hubei Province and Anhui Province by stratified cluster random sampling method to conduct a D-optimal discrete choice experiment. The mixed Logit model was used to analyze children s preference for meal attributes and different levels, and to calculate the relative importance (RI) of attributes and willingness to pay (WTP) in meal choices. Results: The included five food attributes had statistical significance on meal choice of school aged children ( P <0.05). The relative importance of food attributes affecting the meal choices of school aged children in descending order were dining mode ( RI =31.26%), food varieties ( RI =30.56%), cooking method( RI =23.84%), taste( RI =8.06%) and price ( RI =6.27%). Among them, school aged children preferred home cooked meals ( β =0.74) (WTP=86.3 yuan),varied foods(grain/tubers+vegetables+fish, meat, eggs and beans) ( β =0.61) (WTP=71.9 yuan), fried/roasted cooking ( β =0.51) and spicy taste ( β =0.33).Price was negatively correlated with meal choices( β =-0.01) ( P <0.05). Based on residential area and body mass index (BMI), the stratified analysis showed that dining mode was highest in the relative importance for rural children with overweight and obese children ( RI =31.28%,34.17%), both of whom preferred home cooked meals ( β =0.76, 0.91), and meals containing fish, meat, eggs and beans with grain/tubers or grain/tubers and vegetables in terms of food choice (area: β =0.53, 0.53 ; BMI: β =0.55, 0.56) ( P <0.05). Conclusions School aged children have different preferences for different attributes of meals. The quality of school meals should be improved,the cost of buying healthy meals should be reduced,targeted family health education should be carried out,and healthy cooking methods should be advocated.

To summarize the clinical experience of Professor LIU Shangyi in treating pruritus vulvae. It is believed that women have the physiological characteristics of liver and kidney as the root， and their pubic area is easily attacked by wind-dampness pathogenic qi， so the core mechanism of pruritus vulvae is proposed as wind-dampness accumulation and deficiency of liver and kidney. The core treatment method is to dispel wind-dampness and nourish the liver and kidneys， and modify the Danggui Decoction （当归饮子） to form a self-prescribed Yinyang Formula （阴痒方） as the basic prescription to treat pruritus vulvaen.

Progressive pulmonary fibrosis (PPF) is a progressive and lethal condition with few effective treatment options. Improvements in quality of life for patients with PPF remain limited even while receiving treatment with approved antifibrotic drugs. Traditional Chinese medicine (TCM) has the potential to improve cough, dyspnea and fatigue symptoms of patients with PPF. TCM treatments are typically diverse and individualized, requiring urgent development of efficient and precise design strategies to identify effective treatment options. We designed an innovative Bayesian adaptive two-stage trial, hoping to provide new ideas for the rapid evaluation of the effectiveness of TCM in PPF. An open-label, two-stage, adaptive Bayesian randomized controlled trial will be conducted in China. Based on Bayesian methods, the trial will employ response-adaptive randomization to allocate patients to study groups based on data collected over the course of the trial. The adaptive Bayesian trial design will employ a Bayesian hierarchical model with "stopping" and "continuation" criteria once a predetermined posterior probability of superiority or futility and a decision threshold are reached. The trial can be implemented more efficiently by sharing the master protocol and organizational management mechanisms of the sub-trial we have implemented. The primary patient-reported outcome is a change in the Leicester Cough Questionnaire score, reflecting an improvement in cough-specific quality of life. The adaptive Bayesian trial design may be a promising method to facilitate the rapid clinical evaluation of TCM effectiveness for PPF, and will provide an example for how to evaluate TCM effectiveness in rare and refractory diseases. However, due to the complexity of the trial implementation, sufficient simulation analysis by professional statistical analysts is required to construct a Bayesian response-adaptive randomization procedure for timely response. Moreover, detailed standard operating procedures need to be developed to ensure the feasibility of the trial implementation. Please cite this article as: Zhang C, Nie YS, Zhang CT, Yang HJ, Zhang HR, Xiao W, Cui GF, Li J, Li SJ, Huang QS, Yan SY. An adaptive Bayesian randomized controlled trial of traditional Chinese medicine in progressive pulmonary fibrosis: Rationale and study design. J Integr Med. 2025; 23(2): 138-145.
Female ; Humans ; Male ; Bayes Theorem ; Disease Progression ; Drugs, Chinese Herbal/therapeutic use* ; Medicine, Chinese Traditional/methods* ; Pulmonary Fibrosis/therapy* ; Quality of Life ; Randomized Controlled Trials as Topic ; Research Design ; Adaptive Clinical Trials as Topic

Ovarian cancer is one of the three major malignant tumors in the female reproductive system,and its development and pro-gression involves multiple genes and stages.Circular RNA is a special type of non-coding RNA with a closed circular structure and plays an important regulatory role in cancer.The article comprehensively introduces the role of circular RNA in the proliferation,migra-tion,and invasion of ovarian cancer cells and summarizes the potential value of circular RNA.The article reviews the use of circular RNA as a liquid marker to monitor cancer progression and summarizes the situation of regulating chemotherapy resistance.This article provides a new idea for the diagnosis and treatment of ovarian cancer.

In February 2024,the European Society of Cardiology(ESC)Working Group on Aortic and Peripheral Vascular Diseases,in collaboration with the European Society for Vascular Medicine(ESVM)and the European Society for Vascular Surgery(ESVS),published the Consensus on Exercise Therapy for Chronic Symptomatic Peripheral Artery Disease.This document provides evidence-based recommendations for estab-lishing comprehensive exercise programs,offering optimal therapeutic strategies for symptomatic chronic pe-ripheral artery disease(PAD)patients.Specifically,it proposes different exercise training regimens.This re-view interprets the consensus core components to inform evidence-based exercise therapy recommendations for PAD management in China.