Objective: To explore the micro associations and key bridge nodes between physical fitness indicators and anxiety/depressive symptoms among college students using network analysis, so as to provide a theoretical foundation for promoting physical and mental health of college students. Methods: From September to October 2025, a combination of purposive sampling and cluster sampling was employed to select 2 158 college students from three universities in Xuzhou City. Seven physical fitness indicators were measured and standardized according to the National Student Physical Health Standard. The Generalized Anxiety Disorder Scale-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9) were used to assess anxiety and depressive symptoms. Independent samples t-test was used for intergroup comparisons of physical fitness indicators and psychological symptom scores. A gaussian graphical model (GGM) was constructed to calculate node and bridge strength, followed by stability analyses. Results: The detection rates of anxiety and depressive symptoms among college students were 21.3% and 24.5%, respectively. Male participants demonstrated superior performance in physical fitness indicators such as vital capacity, 50 meter sprint, and standing long jump compared to female participants, whereas females exhibited better results in the sit and reach test ( t =48.35, -44.82 , 70.21, -16.51, all P <0.01). Regarding psychological indicators, female participants showed higher scores of anxiety and depressive symptoms than males ( t =-4.15, -4.46, both P <0.01). Physical fitness and psychological symptoms were predominantly negatively correlated. "feeling tired" and "not being able to stop or control worrying" were the symptoms with the highest centrality in the network of physical fitness and phychological symptoms among college students (standardized strengths were 2.15 and 1.98, respectively). Among the bridge indicators, the "1 000 m (male)/800 m (female) run" exhibited the highest strength (0.85), outperforming "vital capacity" (0.35); it was linked to the symptom cluster primarily by negatively predicting "feeling tired" (edge weight=-0.38). The network stability was excellent of physical fitness and phychological symptoms among college students (correlation stability coefficient= 0.60 ). Conclusions Endurance capacity serves as the most critical bridge connecting physical and mental health, and its decline is closely related to intensified feelings of fatigue. Colleges should prioritize endurance training as a core target for promoting college students mental health.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To investigate the follow-up colonoscopy of patients after colorectal adenoma (CRA) resection, so as to improve colonoscopy quality and reduce missed CRA diagnosis.Methods:A total of 189 patients after CRA resection who underwent follow-up colonoscopy from October 2020 to October 2021 were consecutively recruited. The effect of bowel preparation was evaluated by the Boston bowel preparation scale (BBPS). The location, the number, and gross morphology of adenomas during CRA resection and two colonoscopies during 1 year follow-up after the resection were recorded, and their correlation with major clinicopathologic features were analyzed, and the missed CRA in follow-up colonoscopy were also analyzed.Results:The BBPS scores of the right colon, transverse colon, left colon and total colon in 189 patients who underwent CRA resection were 1.93±0.42, 2.53±0.52, 2.77±0.45, and 7.22±1.03 points at the 1-year follow-up colonoscopy and 2.08±0.35, 2.70±0.46, 2.81±0.40, and 7.57±0.84 points at the time of CRA resection. Except for the left colon segment ( χ 2=0.98, P>0.05), the differences in other colon segments were significantly different ( P<0.05). At the time of CRA resection, 62, 66, 210 and 338 CRAs were detected in the right colon, transverse colon, left colon and total colon segments, respectively. At the 1-year follow-up colonoscopy, 21, 38, 49 and 108 CRAs were missed in the corresponding colon segments and total colon, respectively. CRA missed diagnosis was related to patient age (≥60 years accounting for 54.2%), gender (males accounting for 81.9%), adenoma location (predominantly in the left colon comprising 36.2%) and gross morphology (flat types representing 72.3%) ( P<0.05), but not related to being vegetarian, history of cholecystectomy or appendectomy, smoking or alcohol consumption, number of adenomas or pathological type ( P>0.05). Conclusion:The missed diagnosis of CRA in patients after CRA resection primarily involves the flat type adenomas, which is associated with the age, gender, adenoma location within the colon and the gross morphology.

Aim To investigate the intervention effect of Rehmannia radix water extract on bleomycin(BLM)-induced pulmonary fibrosis in mice combined with metabolomics and to reveal the potential mechanism,in order to provide new ideas for clinical treatment of pul-monary fibrosis.Methods Male C57BL/6N mice were randomly divided into the control group,model group,pirfenidone group(positive control,PFD,270 mg·kg-1),and low dose(DH-L,4.55 g·kg-1)group,medium dose(DH-M,9.1 g·kg-1)group and high dose(DH-H,18.2 g·kg-1)group of Rehman-nia.Except for the control group,BLM(5 mg·kg-1)was instilled into the trachea to establish the model of pulmonary fibrosis in the other groups.The survival rate,lung index and blood oxygen saturation of mice in each group were evaluated.HE and Masson staining were used to observe the pathological changes of lung tissue.WBP was used to detect lung function.Flow cytometry was used to detect the apoptosis of primary lung cells,ROS and immune cells.ELISA was used to detect the levels of fibrosis markers and inflammatory factors(α-SMA,collagen Ⅰ,collagen Ⅲ,TGF-β1,TNF-α,IL-1 β,and IL-6).Biochemical method was employed to detect the contents of GSH-Px,T-SOD and MDA.Liquid chromatograph mass spectrometer(LC-MS)metabolomics was used to analyze the changes of serum metabolic profile.Results Water extract of Re-hmannia significantly increased the survival rate,oxy-gen saturation and lung function of mice with pulmona-ry fibrosis,reduced the lung coefficient,ameliorated pathological damage and collagen deposition in lung tissue,reduced the levels of apoptosis and oxidative stress,and down-regulated the levels of inflammatory factors in lung tissue.It regulated the levels of metabo-lites such as bile acid metabolism,sphingolipid metabo-lism,and unsaturated fatty acid metabolism.Conclu-sions Water extract of Rehmannia inhibits lung injury and collagen deposition in mice with pulmonary fibrosis by inhibiting inflammatory response,which may be a-chieved by regulating the levels of inflammatory factors through the metabolic pathways of bile acid and sphin-golipid.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To evaluate the clinical characteristics, pathology, treatment and prognosis of blastic plasmacytoid dendritic cell neoplasm (BPDCN) in children.Methods:Clinical data (including gender, age of disease onset, affected sites, treatment, timing of allogeneic hematopoietic stem cell transplantation (allo-HSCT), etc.) of 7 children with BPDCN who were admitted to Beijing Children′s Hospital, Capital Medical University from December 2018 to December 2023 were analyzed retrospectively. Clinical outcomes were also assessed, with patients followed up until December 2024.Results:Among 7 patients, there were 3 males and 4 females. Age at disease onset ranged from 3.2 to 12.9 years. Initial presentations included subcutaneous nodules in 5 cases, rash in 1 case, and ankle pain in 1 case. Extra-cutaneous involvement was seen in the bone marrow, lymph nodes, and central nervous system. Six patients received induction chemotherapy using a modified lymphoblastic lymphoma regimen, 1 patient received the high-risk protocol for pediatric lymphoblastic lymphoma/leukemia and salvage therapy regimens. Allo-HSCT was performed soon after chemotherapy remission. The time to bridge allo-HSCT was 3.5 to 6.5 months. The follow-up time was 1.6 to 6.0 years. Six patients were in disease-free survival, while 1 patient survived with disease after recurrence following transplantation.Conclusions:BPDCN is rare in children and presents diverse clinical manifestations, with skin involvement being the predominant feature. Early allo-HSCT following complete remission with chemotherapy can improve prognosis.

Objective To explore the efficacy of magnetic resonance angiography(MRA)combined with CXC motif chemokine ligand 12(CXCL12)in predicting ischemic stroke in patients with transient ischemic attack(TIA).Methods A total of 225 patients with TIA were selected,and all patients underwent MRA and CXCL12 examination before treatment.The occurrence of ischemic stroke in TIA patients was counted within 1 week of treatment,the factors influencing the occurrence of ischemic stroke in TIA patients were analyzed,and the value of MRA combined with CXCL12 in predicting the occurrence of ischemic stroke in TIA patients was ana-lyzed.Results Among the 225 patients,21 of them had ischemic stroke.Multivariate logistic regression analysis showed that Essen stroke risk scale(ESRS)score,lesion site stenosis,and CXCL12 level were the factors influencing the occurrence of ischemic stroke in TIA patients(P<0.05).The receiver operating characteristic(ROC)curve showed that the sensitivity of lesion site stenosis,CXCL12 and their combination in predicting the occurrence of ischemic stroke in TIA patients was 76.19%,71.43%,and 85.71%,respectively,the specificity was 80.39%,70.10%,and 88.73%,respectively,and the area under the curve(AUC)was 0.798,0.733,and 0.895,respectively.Conclusion MRA combined with CXCL12 has good efficacy in predicting the occurrence of ischemic stroke in TIA patients.

Objective To compare the hemodynamic effects of anesthesia induction with remimazolam tosylate and etomidate in elderly frail patients.Methods This study was a single-center,prospective,randomized,single-blind trial.From January to April 2024,96 elderly frail patients undergoing elective surgery in Fuyang People's Hospital were recruited.After excluding 6 cases(3 refused to participate,1 had tracheal intubation time＞30 s,and 2 had missing data),90 patients were finally included.They were randomly divided into remimazolam tosylate group(intravenous injection of 0.2 mg/kg remimazolam tosylate for anesthesia induction,n=45)and etomidate group(intravenous injection of 0.3 mg/kg etomidate for anesthesia induction,n=45)by the random number table method.The area under the curve for mean arterial pressure(MAP)below or above baseline values(AUCMAP-and AUCMAP+),the heart rate(HR)below or above baseline values by 10％(AUCHR-and AUCHR+)within 10 minutes of anesthesia induction,the time to loss of consciousness,the time from the start of anesthesia induction to a bispectral index(BIS)＜60,the incidence of drug-related adverse reactions,the incidence of cardiovascular adverse events,and the usage of vasoactive drug administrations were compared between the two groups.Results Compared with the etomidate group,the AUCMAP-(145.10±35.75 vs.178.52±39.78)and AUCHR-[43.20(26.58,56.35)vs.54.99(43.01,65.85)]in remimazolam tosylate group were significantly reduced(P＜0.001,P=0.001).The time to loss of consciousness and the time from the start of anesthesia induction to BIS＜60 were prolonged(P＜0.001).The incidence of drug-related adverse reactions was significantly decreased(P＜0.05),and the number of norepinephrine administrations was significantly reduced(P＜0.05)in remimazolam tosylate group.However,there were no statistically significant differences in AUCMAP+,AUCHR+,the incidence of cardiovascular adverse events,and the usages of atropine,urapidil,and esmolol between the two groups(P＞0.05).Conclusion The use of remimazolam tosylate during anesthesia induction in elderly frail patients can provide more stable hemodynamic parameters and results in fewer adverse reactions than etomidate.

Objective To explore the traditional Chinese medicine(TCM)syndrome character-istics and medication patterns of cerebral small vessel disease(CSVD)using data mining techniques.Methods Clinical research literature on TCM treatment of CSVD,published from the establishment of the database to September 1,2024,was retrieved from the China National Knowledge Infrastructure(CNKI),Wanfang,and VIP databases.Analyses were conducted on syndromes,drug frequencies,properties,flavors,and meridian tropisms.Data mining was performed using R4.4.1 software to ex-plore associations,correlations,and clustering of TCM herbs,aiming to elucidate medication patterns in CSVD treatment.Results A total of 60 prescription formulas for treating CSVD were screened,involving 142 TCM herbs with a total usage frequency of 1,312 times.The top five most frequently used herbs were Chuanxiong,Danggui,Dilong,Huangqi,and Chishao.Herb properties were pre-dominantly warm and cold;flavors were mainly pungent,bitter,and sweet;and meridian tropisms were primarily to the liver,spleen,and heart meridians.Twenty-nine strong association rules were identified,and association analysis revealed core herbal combinations centered around Chuanxiong,Chishao,and Danggui.Clustering analysis yielded five herbal combinations.Conclusion CSVD is characterized by a deficiency in essence and excess in superficiality.Treatment should focus on tonify-ing deficiencies and eliminating excesses,combining both tonification and purgation methods.Medication patterns predominantly involve herbs for promoting blood circulation and removing blood stasis,often combined with herbs for nourishing the kidney and marrow,calming the liver and suppressing wind,and awakening the mind and opening the orifices.

OBJECTIVE: This study aimed to investigate the impact of glycemic control and diabetes duration on subsequent myocardial infarction (MI) in patients with both coronary heart disease (CHD) and type 2 diabetes (T2D). METHODS: We conducted a retrospective cohort study of 33,238 patients with both CHD and T2D in Shenzhen, China. Patients were categorized into 6 groups based on baseline fasting plasma glucose (FPG) levels and diabetes duration (from the date of diabetes diagnosis to the baseline date) to examine their combined effects on subsequent MI. Cox proportional hazards regression models were used, with further stratification by age, sex, and comorbidities to assess potential interactions. RESULTS: Over a median follow-up of 2.4 years, 2,110 patients experienced MI. Compared to those with optimal glycemic control (FPG < 6.1 mmol/L) and shorter diabetes duration (< 10 years), the fully-adjusted hazard ratio ( HR) (95% Confidence Interval [95% CI]) for those with a diabetes duration of ≥ 10 years and FPG > 8.0 mmol/L was 1.93 (95% CI: 1.59, 2.36). The combined effects of FPG and diabetes duration on MI were largely similar across different age, sex, and comorbidity groups, although the excess risk of MI associated with long-term diabetes appeared to be more pronounced among those with atrial fibrillation. CONCLUSION Our study indicates that glycemic control and diabetes duration significant influence the subsequent occurrence of MI in patients with both CHD and T2D. Tailored management strategies emphasizing strict glycemic control may be particularly beneficial for patients with longer diabetes duration and atrial fibrillation.
Humans ; Diabetes Mellitus, Type 2/blood* ; Male ; Female ; Middle Aged ; Aged ; Coronary Disease/complications* ; Myocardial Infarction/etiology* ; Retrospective Studies ; China/epidemiology* ; Glycemic Control ; Blood Glucose ; Adult ; Risk Factors ; Time Factors