1.Hepatitis E virus infection among blood donors in Zhengzhou
Hongna ZHAO ; Yueguang WEI ; Lumin YAN ; Tiantian TU ; Shumin WANG ; Yihui WEI ; Yifang WANG ; Lei ZHAO ; Mingjun CHEN
Chinese Journal of Blood Transfusion 2025;38(1):13-18
[Objective] To analyze the infection status of hepatitis E virus (HEV) among blood donors in Zhengzhou, so as to provide data support for formulating local blood screening strategies. [Methods] Random samples from blood donors from January to December 2022 were tested for HEV RNA using PCR technology. Reactive samples were sequenced for gene analysis, and the donors were followed up. [Results] Among 21 311 samples, 3(0.14‰) were reactive for HEV RNA, all of whom were male. Genetic sequencing results revealed that one strong positive sample was genotype 4, while sequencing failed for the other two due to low viral load. A follow-up of 25 strong positive donors showed that ALT significantly increased on day 7 after donation, anti-HEV IgM and anti-HEV IgG turned positive. On day 21, ALT returned to normal, and on day 35, HEV RNA turned negative. Notably, anti-HEV IgM and anti-HEV IgG persisted until day 482. [Conclusion] There is HEV infection among blood donors in Zhengzhou, and it is necessary to expand the screening scope to comprehensively explore the prevalence and genotype distribution of HEV among blood donors.
2.Impact of Toxoplasma gondii type I rhoptry protein 16 on programmed cell death ligand 1 expression and its binding to programmed cell death 1 in lung adenocarcinoma cells
Guangqi LI ; Yuning ZHOU ; Shaohan MA ; Mei TIAN ; Tiantian DANG ; Zhijun ZHAO
Chinese Journal of Schistosomiasis Control 2025;37(1):44-54
Objective To investigate the impact of Toxoplasma gondii type I, II and III rhoptry protein 16 (ROP16) on programmed cell death ligand 1 (PD-L1) expression in lung adenocarcinoma cells, and to examine the effects of T. gondii type I ROP16 protein on the relative PD-L1 expression, the relative PD-L1 distribution on the cell membrane surface, and the binding of programmed cell death 1 (PD-1) to PD-L1 in lung adenocarcinoma cells. Methods Lentiviral vectors overexpressing T. gondii type I, II and III ROP16 proteins were generated, and transfected into the human lung adenocarcinoma A549 cell line. A549 cells were used as a blank control group, and A549 cells transfected with an empty lentiviral expression vector were used as a negative control group, while A549 cells transfected with lentiviral vectors overexpressing T. gondii type I, II and III ROP16 proteins served as experimental groups. Stably transfected cells were selected with puromycin and verified using Western blotting, quantitative real-time PCR (RT-qPCR), and immunofluorescence assays. The PD-L1 expression was quantified at translational and transcriptional levels using Western blotting and RT-qPCR assays in A549 cells in the five groups, and the relative PD-L1 distribution was detected on the A549 cell membrane surface using flow cytometry. In addition, the effect of T. gondii type I ROP16 protein on the PD-1/PD-L1 binding was measured in A549 cells using enzyme-linked immunosorbent assay (ELISA). Results The relative ROP16 protein expression was 0, 0, 1.546 ± 0.091, 1.822 ± 0.047 and 2.334 ± 0.089 in the blank control group, negative control group, and the T. gondii type I, II and III ROP16 protein overexpression groups (F = 1 339.00,P < 0.001), and the relative ROP16 mRNA expression was 2.153 ± 0.949, 2.436 ± 1.614, 14.343 ± 0.020, 12.577 ± 0.285 and 15.090 ± 0.420 in the blank control group, negative control group and the T. gondii type I, II and III ROP16 protein overexpression groups, respectively (F = 483.50,P < 0.001). The ROP16 expression was higher in the T. gondii type I, II and III ROP16 protein overexpression groups than in the blank control group at both translational and transcriptional levels (allP values < 0.001). Immunofluorescence assay revealed that T. gondii type I, II and III ROP16 proteins were predominantly localized in A549 cell nuclei. Western blotting showed that the relative PD-L1 protein expression was 0.685 ± 0.109, 0.589 ± 0.114, 1.007 ± 0.117, 0.572 ± 0.151, and 0.426 ± 0.116 in the blank control group, negative control group, and the T. gondii type I, II and III ROP16 protein overexpression groups (F = 9.46,P < 0.05), and RT-qPCR assay quantified that the relative PD-L1 mRNA expression was 1.012 ± 0.190, 1.281 ± 0.465, 1.950 ± 0.175, 0.889 ± 0.251, and 0.230 ± 0.192 in the blank control group, negative control group, and the T. gondii type I, II and III ROP16 protein overexpression groups (F = 14.18,P < 0.05). The PD-L1 expression was higher in the T. gondii type IROP16 protein overexpression group than in the blank control group at both translational and transcriptional levels (both P values < 0.05). Flow cytometry detected that the relative distributions of PD-L1 protein were (10.83 ± 0.60)%, (11.23 ± 0.20)%, and (14.61 ± 0.50)% on the A549 cell membrane surface (F = 28.31, P < 0.05), and the relative distribution of PD-L1 protein was higher in the T. gondii type IROP16 protein overexpression group than in the blank control group and negative control group (both P values < 0.001). ELISA measured significant differences in the absorbance (A) value among the T. gondii type IROP16 protein overexpression group, the blank control group and the negative control group if the concentrations of the recombinant PD-1 protein were 0.04 (F = 10.45, P < 0.05), 0.08 μg/mL (F = 11.68, P < 0.05) and 0.12 μg/mL (F = 52.68, P < 0.05), and the A value was higher in the T. gondii type IROP16 protein overexpression group than in the blank control group and the negative control group (both P values < 0.05), indicating that T. gondii type IROP16 protein promoted the PD-L1/PD-1 binding in A549 cells in a concentration-dose manner. Conclusions T. gondii type IROP16 protein overexpression may up-regulate PD-L1 expression in A549 cells at both transcriptional and translational levels and the relative PD-L1 distribution on the A549 cell membrane surface, and affect the PD-1/PD-L1 binding in a concentration-dependent manner.
3.Effects of Toxoplasma gondii type I/II rhoptry protein 16 on the polarization and inflammatory response of mouse alveolar macrophages
Jiaming LI ; Tiantian DANG ; Zhijun ZHAO
Chinese Journal of Schistosomiasis Control 2025;37(2):127-135
Objective To investigate the effects of Toxoplasma gondii type Iand IIrhoptry protein 16 (ROP16) on the polarization and inflammatory response of mouse alveolar macrophages, so as to provide the scientific evidence for unveiling the immunoregulatory mechanisms following T. gondii infection in host cells and the clinical diagnosis and treatment of pulmonary toxoplasmosis. MethodsMouse alveolar macrophages served as blank controls, and mouse alveolar macrophages transfected with the empty lentiviral expression vector served as negative controls, and mouse alveolar macrophages transfected with lentiviral vectors overexpressing T. gondii type I and II ROP16 served as the type I and II ROP16 overexpression groups. Following puromycin selection, stably transfected cells that overexpressed type Iand IIROP16 were generated, observed for green fluorescence expression under a fluorescence microscope and verified using PCR, Western blotting and real-time quantitative reverse transcription PCR (RT-qPCR) assays. The expression of ROP16, inducible nitric oxide synthase (iNOS), arginase (Arg)-1, mannose receptor (CD206), cluster of differentiation 86 (CD86), NOD-like receptor thermal protein domain associated protein 3 (NLRP3), caspase-1, apoptosis-associated speck-like protein containing a CARD (ASC), and interleukin (IL)-1β proteins was determined in mouse alveolar macrophages using Western blotting assay, and the mRNA levels of ROP16, iNOS, IL-1β, IL-4, IL-12, IL-18, Arg-1, IL-10, IL-6, tumor necrosis factor (TNF)-α and transforming growth factor (TGF)-β were detected in mouse alveolar macrophages using RT-qPCR assay. Results Fluorescence microscopy showed 90% of mouse alveolar macrophages producing green fluorescent signals in the type Iand II ROP16 overexpression groups and the negative control group. The relative ROP16 protein expression was 1.000 ± 0.000, 1.003 ± 0.020, 1.349 ± 0.055, and 1.376 ± 0.080 in mouse alveolar macrophages in the blank control group, negative control group, and type Iand IIROP16 overexpression groups (F = 35.30, P < 0.01), and the relative ROP16 mRNA expression was 1.007 ± 0.172, 2.030 ± 0.356, 1 409.579 ± 75.960, and 1 413.581 ± 27.712 in the blank control group, negative control group, and type Iand II ROP16 overexpression groups (F = 811.00, P < 0.01). The ROP16 expression was significantly higher in the type Iand IIROP16 overexpression groups than in the blank control group at both protein and mRNA levels (all P value < 0.01). Western blotting assay detected significant differences among the four groups in terms of iNOS, Arg-1, CD86, CD206, NLRP3, caspase-1, ASC, and IL-1β protein expression (F = 124.70, 82.40, 79.82, 919.40, 84.74, 39.85, 2 354.00 and 65.96, all P values < 0.05), and the expression of Arg-1, CD206, NLRP3, caspase-1, ASC, and IL-1β proteins was significantly higher in the type I ROP16 overexpression group than in the blank control group (all P values < 0.001), while the expression of iNOS, CD86, NLRP3, caspase-1, ASC, and IL-1β proteins was significantly higher in the type II ROP16 overexpression group than in the blank control group (all P values < 0.01). RT-qPCR assay detected significant differences among the four groups in terms of iNOS, IL-1β, IL-4, IL-12, IL-18, Arg-1, IL-10, IL-6, TNF-α, and TGF-β mRNA expression (F = 407.00, 1 528.00, 833.10, 267.90, 989.80, 161.80, 461.10, 5 529.00, 849.60 and 8 836.00, all P values < 0.05), and the Arg-1, IL-4, IL-10, and TGF-β mRNA expression was significantly higher in the type I ROP16 overexpression group than in the blank control group (all P values < 0.001), while the iNOS, IL-1β, IL-12, IL-18, IL-6, and TNF-α mRNA expression was significantly higher in the type II ROP16 overexpression group than in the blank control group (all P values < 0.001). Conclusions T. gondii type IROP16 may induce M2-dominant phenotypes of mouse alveolar macrophages, and type II ROP16 may induce M1-dominant phenotypes of mouse alveolar macrophages. Both T. gondii type I and II ROP16 may activate NLRP3, and mediate the activation of ASC, caspase-1 and IL-1β to promote inflammatory responses.
5.Effectiveness comparison of anterior cervical discectomy and fusion with zero-profile three-dimensional-printed interbody fusion Cage and titanium plate fusion Cage.
Yuwei LI ; Xiuzhi LI ; Bowen LI ; Yunling GU ; Tiantian YANG ; Lei ZHAO ; Wei CUI ; Shifeng GU ; Haijiao WANG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(9):1187-1195
OBJECTIVE:
To compare the effectiveness of a zero-profile three-dimensiaonal (3D)-printed microporous titanium alloy Cage and a conventional titanium plate combined with a polyether-ether-ketone (PEEK)-Cage in the treatment of single-segment cervical spondylotic myelopathy (CSM) by anterior cervical discectomy and fusion (ACDF).
METHODS:
The clinical data of 83 patients with single-segment CSM treated with ACDF between January 2022 and January 2023 were retrospectively analyzed, and they were divided into 3D-ZP group (35 cases, using zero-profile 3D-printed microporous titanium alloy Cage) and CP group (48 cases, using titanium plate in combination with PEEK-Cage). There was no significant difference in gender, age, disease duration, surgical intervertebral space, and preoperative Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS) score, neck disability index (NDI), vertebral height at the fusion segment, Cobb angle, and other baseline data between the two groups (P>0.05). The operation time, intraoperative blood loss, hospital stay, complications, interbody fusion, and prosthesis subsidence were recorded and compared between the two groups. VAS score, NDI, and JOA score were used to evaluate the improvement of pain and function before operation, at 3 months after operation, and at last follow-up, and the vertebral height at the fusion segment and Cobb angle were measured by imaging. The degree of dysphagia was assessed by the Bazaz dysphagia scale at 1 week and at last follow-up.
RESULTS:
The operation was successfully completed in all the 83 patients. There was no significant difference in intraoperative blood loss and hospital stay between the two groups (P>0.05), but the operation time in the 3D-ZP group was significantly shorter than that in the CP group (P<0.05). Patients in both groups were followed up 24-35 months, with an average of 25.3 months, and there was no significant difference in the follow-up time between the two groups (P>0.05). The incidence and grade of dysphagia in CP group were significantly higher than those in 3D-ZP group at 1 week after operation and at last follow-up (P<0.05). There was no dysphagia in 3D-ZP group at last follow-up. There was no complication such as implant breakage or displacement in both groups. The intervertebral fusion rates of 3D-ZP group and CP group were 65.71% (23/35) and 60.42% (29/48) respectively at 3 months after operation, and there was no significant difference between the two groups [OR (95%CI)=1.256 (0.507, 3.109), P=0.622]. The JOA score, VAS score, and NDI significantly improved in the 3D-ZP group at 3 months and at last follow-up when compared with preoperative ones (P<0.05), but there was no significant difference between the two groups (P>0.05). There was no significant difference in the improvement rate of JOA between the two groups at last follow-up (P>0.05). At 3 months after operation and at last follow-up, the vertebral height at the fusion segment and Cobb angle significantly improved in both groups, and the two indexes in 3D-ZP group were significantly better than those in CP group (P<0.05). At last follow-up, the incidence of prosthesis subsidence in 3D-ZP group (8.57%) was significantly lower than that in CP group (29.16%) (P<0.05).
CONCLUSION
The application of zero-profile 3D-printed Cage and titanium plate combined with PEEK-Cage in single-segment ACDF can both reconstruct the stability of cervical spine and achieve good effectiveness. Compared with the latter, the application of the former in ACDF can shorten the operation time, reduce the incidence of prosthesis subsidence, and reduce the incidence of dysphagia.
Humans
;
Spinal Fusion/instrumentation*
;
Titanium
;
Cervical Vertebrae/surgery*
;
Diskectomy/instrumentation*
;
Bone Plates
;
Male
;
Printing, Three-Dimensional
;
Female
;
Retrospective Studies
;
Middle Aged
;
Treatment Outcome
;
Benzophenones
;
Adult
;
Spondylosis/surgery*
;
Aged
;
Polymers
;
Ketones
;
Polyethylene Glycols
6.A reporter gene assay for determining antibody-dependent cell-mediated phagocytosis activity of HER2-targeted antibody drug conjugate.
Ying CHEN ; Can WANG ; Qin ZHAO ; Mingren WANG ; Tiantian LI ; Shanshan DONG ; Hong SHAO ; Weidong XU
Chinese Journal of Biotechnology 2025;41(8):3122-3130
To develop a method for determining the antibody-dependent cell-mediated phagocytosis (ADCP) activity of human epidermal growth factor receptor 2 (HER2)-targeted antibody drug conjugate (ADC) based on the reporter gene assay, we established an ADCP activity assay with Jurkat/NFAT/FcγRIIa cells as the effector cells and BT474 as the target cells. Then, the target cell density, the ratio of effector to target cells, the target cell adhesion time, the incubation time for drug administration, and the induction time after adding effector cells were optimized by the method of design of experiment (DOE). The method showed a significant dose-response relationship, which was complied with the four-parameter equation: y=(A-D)/[1+(x/C)B]+D. The durability ranges of the target cell density, the ratio of effector to target cells, the target cell adhesion time, the incubation time for drug administration, and the induction time after adding effector cells were (2.5-4.0)×105 cells/mL, 3-5, 1.0-2.0 h, 0 h, and 5.0-6.0 h, respectively. The results of the methodological validation showed that the linear equation was y=1.106 8x-0.011 6, r=0.969 2. The established method showed the relative accuracy ranging from -6.59% to 2.98% and the geometric coefficient of variation less than 11% in the intermediate precision test. Furthermore, the method was target-specific. The method was then applied to the determination of ADCP activity of HER2-targeted ADC, demonstrating the result of (103.5±5.7)%. We developed a reporter gene assay for determining the ADCP activity of HER2-targeted ADC and the assay demonstrated high accuracy and good reproducibility, which proposes a highly efficient and approache for evaluating ADCP effect of this HER2-targeted ADC, and also provides a referable technique for characterizing the Fc effector functions of ADCs with diverse targets.
Humans
;
Receptor, ErbB-2/immunology*
;
Phagocytosis/drug effects*
;
Immunoconjugates/immunology*
;
Genes, Reporter
;
Antibody-Dependent Cell Cytotoxicity
;
Jurkat Cells
7.Analysis of the relevant contents of comprehensive sexual education in the current compulsory education curriculum standards of China
GUO Shihao, ZHU Fan, ZHU Guiyin, ZHAO Tianjie, QI Tiantian, YANG Shuang, MA Yinghua
Chinese Journal of School Health 2024;45(11):1531-1535
Objective:
To analyze and evaluate the comprehensiveness and reliability of the content related to comprehensive sexuality education in 16 subject curriculum standards in the current compulsory education system, and the feasibility and effectiveness of comprehensive sexuality education teaching practice.
Methods:
Based on the textbook analysis model, a curriculum standard analysis model was established, and the interpretive structure model was used to analyze and evaluate the content related to comprehensive sexual education in the curriculum standards of 16 subjects in the current compulsory education system, including Ethics and Rule of Law, Chinese, History, Mathematics, English, Japanese, Russian, Geography, Science, Physics, Chemistry, Biology, Information Technology, Physical Education and Health, Arts, Labor.
Results:
There were 7 subject curriculum standards including Ethics and Rule of Law, Chinese, English, Science, Biology, Information Technology, Physical Education and Health reflecting 5 core concepts and 12 themes of comprehensive sexuality education, and the most frequent core concept was Violence and Staying Safe and the Human Body and Development,as well as the most frequent theme was "Puberty". History, Mathematics, Japanese, Russian, Geography, Physics, Chemistry, Art and Labor didn t include content related to comprehensive sexuality education. The content related to comprehensive sexuality education in the curriculum standard of compulsory education presented three characteristics:it was closely related to the subject content, partial content was consistent with the teaching goal of the subject, and the content depth increased with the growth of grade. The comprehensiveness and reliability of comprehensive sexual education in the current compulsory education curriculum standards of China needed to be improved.
Conclusion
The comprehensiveness, reliability, feasibility and effectiveness of teaching practice of comprehensive sexuality education in 16 subject curriculum standards in the current compulsory education stage need to be improved.
8.Relationship between depressive symptoms, negative life events, and resilience in primary and secondary school teachers
WANG Pei, ZHU Fan, JIA Bibo, ZHU Guiyin, ZHAO Tianjie, QI Tiantian,HU Yifei, MA Yinghua
Chinese Journal of School Health 2024;45(3):411-413
Objective:
To explore the relationship between depressive symptoms, negative life events and resilience among primary and secondary school teachers, so as to provide a reference for mental health promotion in school teachers.
Methods:
During November to December 2022, a questionnaire survey was conducted using convenient cluster sampling method to select 11 332 in service teachers from 38 schools in 8 provinces (cities) including Beijing, Guangdong, Anhui, Hubei, Sichuan, Xinjiang, Liaoning, and Heilongjiang. The Patient Health Questionnaire-9 items, a self developed 21-item Adverse Life Events questionnaire, and a 10-item Conner-Davidson Resilience Scale were used to assess depressive symptoms, experiences of negative life events, and resilience levels of the teachers, respectively. The relationship between depressive symptoms, negative life events and psychological resilience were analyzed by multiple linear regression and stratified regression.
Results:
The detection rate of depressive symptoms among primary and secondary school teachers was 14.0%. Negative life events of primary and secondary school teachers were positively correlated with depressive symptoms ( r =0.35), while psychological resilience was negatively correlated with depressive symptoms ( r =-0.45) ( P <0.05). After adjusting for possible covariates including gender and marital status, negative life events were positively correlated with depressive symptoms ( β=0.22, P <0.01). Resilience played a moderating role in the association of negative life events with depressive symptoms among primary and secondary school teachers ( B=-0.15, P <0.01).
Conclusions
Negative life events experiences are associated with higher level of depressive symptoms among school teachers. However, resilience might mitigate the negative effects of negative life events on depressive symptoms, playing a protective role in teachers mental health.
9.Mechanism of Naozhenning granules in regulating mitochondrial energy metabolism in multiple cerebral concussion rats
Li GAO ; Le ZHAO ; Nannan WEI ; Liya WU ; Tiantian WANG ; Weiyi ZHANG ; Yonghui WANG
China Pharmacy 2024;35(9):1050-1056
OBJECTIVE To explore the mechanism of Naozhenning granules in regulating mitochondrial energy metabolism in hippocampal tissue of multiple cerebral concussion (MCC) model rats. METHODS SPF grade Wistar rats were used to prepare MCC models using the “free fall impact method”. The successfully modeled rats were divided into model group, piracetam group, and Naozhenning granule low-dose, medium-dose and high-dose groups, and a normal group was also set up, with 8 rats in each group. Rats in each treatment group orally administered corresponding drugs at doses of 0.324 g/kg for the piracetam group and 2.25, 4.5 and 9 g/kg for the Naozhenning granule low-dose, medium-dose and high-dose groups; the normal group and model group were given equal volumes of normal saline; once a day, for 14 consecutive days. The motor exploration ability, learning and memory ability of rats were tested; the adenosine triphosphate (ATP) content in the hippocampal tissue of rat was detected; the changes in the mitochondrial structure of hippocampal tissue was observed; the fluorescence intensity of mitochondrial dynamin- related protein 1 (Drp1), mitochondrial fission protein 1 (Fis1), mitochondrial fusion 1 (Mfn1), and optic atrophy protein 1 (Opa1) were detected in the hippocampal tissue of rat; the protein expression levels of peroxisome proliferator activated receptor gamma coactivator-1α(PGC-1α), nuclear respiratory factor-1(NRF-1),mitochondrial transcription factor A(TFAM), Wnt-3a,β-catenin in hippocampal tissue of rat were detected. RESULTS Compared with the normal group, the total exercise distance, number of central grid entries, number of upright positions, new object recognition index, mitochondrial ATP content, fluorescence intensity of Mfn1 and Opa1, the protein expression levels of PGC-1α、NRF-1、TFAM、Wnt-3a、 β-catenin in the model group were significantly reduced (P<0.01), while the rest time and fluorescence intensity of Drp1 and Fis1 in hippocampal tissue were significantly increased (P<0.01). The results of transmission electron microscopy showed that the mitochondria in the hippocampal tissue were significantly swollen, with a large number of broken and reduced cristae, and some mitochondria had myeloid changes in the membrane. Compared with the model group, the levels/contents of the above indicators in rats of each administration group showed varying degrees of reversal, and most of the differences were statistically significant (P<0.05 or P<0.01); the degree of mitochondrial swelling in the hippocampal tissue was reduced, with a small amount of broken and reduced cristae, fuzzy fractures appeared in local areas of the rough endoplasmic reticulum. CONCLUSIONS Naozhenning granules can improve the motor exploration, learning and memory abilities of MCC model rats, repair neuronal damage, and exert neuroprotective effects. Its mechanism may be related to activating Wnt/β-catenin signaling pathway,maintaining the balance of mitochondrial division and fusion,and promoting mitochondrial biosynthesis.
10.Association of healthrelated quality of life and parental companionship among middle school students
ZHAO Tianjie, ZHU Fan, ZHU Guiyin, QI Tiantian, GUO Shihao, MA Yinghua
Chinese Journal of School Health 2024;45(6):840-843
Objective:
To understand the association of healthrelated quality of life of middle school students with parental companionship, so as to provide a reference for school and family health education.
Methods:
From September to November 2023, 4 594 middle school students were selected through convenient sampling from four economic zones in China (Liaoning Province, Beijing City, Sichuan Province, Shanxi Province). Structured questionnaires were used to evaluate healthrelated quality of life among middle school students. The ttest, variance analysis and linear regression were used to analyze the relationship between healthrelated quality of life with parental companionship among middle school students.
Results:
The average score of healthrelated quality of life among middle school students was (140.99±21.38). There were statistically significant differences in the scores of healthrelated quality life among middle school students in different regions, genders, educational stages, grades, whether they live on campus and parental companionship(F/t=20.73, 8.62,16.71,105.70, -9.51, 52.29, P<0.01). Linear regression analysis showed that students who were living in eastern region, boys, with higher selfevaluation of academic performance, with higher subjective family socioeconomic status, with parental companionship (β=3.19, 4.96, 2.19, 6.11, 3.19), and older students had lower healthrelated quality of life levels (β=-2.34)(P<0.01).
Conclusions
There are significant regional differences in the healthrelated quality of life levels among middle school students. It is necessary to strengthen the popularization of school health education and focus on students who do not live with their parents on a daily basis to provide more psychological support for them.


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