ObjectiveTo investigate the epidemiological characteristics and influencing factors of depressive symptoms among middle school (junior, senior, and vocational high school) students in Yunnan Province, China, and to inform evidence-based intervention strategies for adolescent mental health. MethodsA cross-sectional survey was conducted between October and November 2023 using stratified random cluster sampling. Students from eight counties (districts) across four prefectures (cities) in Yunnan Province were included. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Multivariate logistic regression analysis was performed to examine factors associated with depressive symptoms, with stratified analyses conducted by gender, educational stage, and ethnicity. ResultsA total of 4 672 questionnaires were distributed, with 4 670 valid questionnaires retrieved, yielding a valid response rate of 99.96%. The surveyed participants were predominantly female students (50.81%), junior high school students (49.13%), ethnic minorities (52.78%), and urban residents (79.29%). The mean CES-D score for middle school students in Yunnan Province was (15.31±10.83). Female students had a significantly higher mean score (16.63±11.41) than male students (13.95±10.02) (P<0.001). Senior high school students had a significantly higher mean score (16.61±10.61) compared to both junior high school students (14.74±11.45) and vocational high school students (13.10±7.71) (all pairwise comparisons P<0.001). The prevalence of depressive symptoms among middle school students in Yunnan Province was 28.18%. The prevalence was significantly higher in females (34.09%) than in males (22.07%). By school type, the detection rate was highest among senior high school students (33.39%), followed by junior high school students (26.29%) and vocational high school students (17.27%) (P<0.05). Multivariate logistic regression analysis showed that female gender (OR=2.16, 95%CI: 1.86‒2.50), being in junior high school (OR=2.43, 95%CI: 1.84‒3.20) or senior high school (OR=2.27, 95%CI: 1.73‒2.98), not living with parents (OR=1.24, 95%CI: 1.07‒1.44), irregular breakfast consumption (OR=1.52, 95%CI: 1.33‒1.75), lack of moderate-to-vigorous physical activity (MVPA) (OR=1.69, 95%CI: 1.37‒2.09), sleep duration ≤5 h per night (OR=2.52, 95%CI: 2.02‒3.14) or 6‒7 h per night (OR=1.47, 95%CI: 1.25‒1.73), smoking (OR=1.86, 95%CI: 1.56‒2.23), and alcohol consumption (OR=1.81, 95%CI: 1.54‒2.13) were positively associated with depressive symptoms. In contrast, screen time ≤1 h (OR=0.71, 95%CI: 0.59‒0.86) was negatively associated with depressive symptoms. Stratified analyses showed that female students not living with parents (OR=1.29, 95%CI: 1.06‒1.58), senior high school students (OR=1.51, 95%CI: 1.21‒1.88), and Han Chinese students (OR=1.37, 95%CI: 1.11‒1.69) were more likely to experience depressive symptoms. Han Chinese students who smoked were also more likely to have depressive symptoms (OR=1.72, 95%CI: 1.34‒2.21). In contrast, male students with screen time ≤1 h (OR=0.71, 95%CI: 0.53‒0.95) and ethnic minority students (OR=0.74, 95%CI: 0.58‒0.95) were less likely to experience depressive symptoms. Regardless of gender, irregular breakfast consumption, lack of MVPA, sleep duration less than 8 h per night, smoking, and alcohol consumption were all positively associated with depressive symptoms (P<0.05). Among both junior and senior high school students, irregular breakfast consumption, lack of MVPA, smoking, and alcohol consumption were positively associated with depressive symptoms (all P<0.05), while screen time ≤1 h was negatively associated with depressive symptoms (all P<0.05). For junior high school students, engaging in 1‒2 days of MVPA per week, screen time more than 2 h per day, and sleep duration 6‒7 h per night were all positively associated with depressive symptoms (all P<0.05). Among junior high, senior high, and vocational high school students, sleep duration ≤5 h per night was positively associated with depressive symptoms (P<0.05). For both Han Chinese and ethnic minority students, irregular breakfast consumption, lack of MVPA, sleep duration less than 8 h per night, and alcohol consumption were all positively associated with depressive symptoms (all P<0.05). ConclusionThe prevalence of depressive symptoms among middle school students in Yunnan Province is comparable to that in central China and higher than that in northern regions. Prevention and control efforts should prioritize female students and those in junior and senior high school stages. Universal improvements in lifestyle behaviors among middle school students, such as regular breakfast consumption, MVPA, sufficient sleep (≥8 h), and abstinence from smoking and alcohol. Particular attention should be given to limiting excessive screen time among junior high school students and addressing the mental health needs of females not living with their parents, senior high school students, and Han Chinese students.

Objective To verify the accuracy of a Non-Contact Sleep Monitoring Mattress(NCSMM)based on body movement during sleep in assessing sleep quality of patients before neurosurgery in order to provide a more portable and efficient assessment tool for clinical staff.Methods A single-arm trial was conducted on 114 inpatients admitted in our department selected with convenience sampling.Sleep quality data of 1 night were collected through 5 sleep quality assessment tools,including NCSMM,polysomnography(PSG),Patient-Reported Outcome Measurement Information System(PROMIS)Sleep Disturbance scale,Richards-Campbell Sleep Scale(RCSQ),and a wearable device(smart watch for body movements and sleep quality monitoring).The sleep efficiency(≤85%)obtained by PSG was used as the diagnostic standard for sleep disorders.The area under the receiver operating characteristic curve(AUC),sensitivity,specificity,positive predictive value,negative predictive value,and Youden index were calculated for the other 4 tools to evaluate and compare their diagnostic effectiveness.Results The AUC value for NCSMM,PROMIS,RCSQ and smart watch was 0.788(95%CI:0.687～0.888,P<0.001),0.664(95%CI:0.543～0.784,P=0.02),0.723(95%CI:0.600～0.846,P=0.001)and 0.750(95%CI:0.654～0.846,P<0.001),respectively.The diagnostic accuracy rate was 0.774,0.559,0.742 and 0.602,with corresponding Youden index value of 0.488,0.321,0.456,and 0.459.NCSMM demonstrated the best AUC value,sensitivity and Youden index when compared with the other 3 tools.Conclusion NCSMM shows high accuracy in assessing sleep quality in pre-neurosurgery inpatients,and it is a viable portable and efficient assessment tool in clinical practice.

Neurosurgery is considered as one of the most difficult areas in the field of medicine, and the complexity of nervous system is a leading cause. Therefore, it demands neurosurgeons possess basic knowledge, spatial thinking, and practical experiences. Here, we introduce a rapid developing technique applying multi-modal neuroimaging reconstruction and virtual reality, which constitutes a novel learning model for boosting the growth of neurosurgeons. The incorporation of multi-modal neuroimaging and virtual reality builds a bridge from two-dimensional image to actual surgical view. Neurosurgeons are able to perform surgical planning and simulation with naked eyes under the constructed three-dimensional hologram. The technique also provides evidence of accurate localization and guidance for operation. Therefore, multi-modal neuroimaging reconstruction and virtual reality are expected to tremendously promote the progress of young trainees, and can further enhance their all-round abilities. In short, this revolutionary learning model would impact the neurosurgical specialists training profoundly.

Objective To explore the value of 3D time-of-flight MRI ( MRI 3D-TOF) combined with 3D reconstruction technique for the diagnosis and treatment of vascular compression of trigeminal neuralgia by magnetic resonance angiography combined with three-dimen-sional reconstruction technique.Methods A total of 80 patients with vascular compression of the trigeminal neuralgia in our hospital from January 2012 to February 2014 were diagnosed by axial MRI 3D-TOF,combined with 3D vascular and nerve reconstruction in the anatomy Department for further diagnosis and treatment.Results The patients were diagnosed according to the trigeminal nerve and the typings of pe-ripheral vascular compression.The diagnosis results for 29 cases of typeⅠ,19 cases of typeⅡ,32 cases of typeⅢfrom physician 1,the di-agnosis results for 48 cases of typeⅠ,21 cases of typeⅡand typeⅢin 11 cases from physician 2,the difference of the diagnosis bwtween two physicians was statistical significance (P=0.00).Compared with intraoperative diagnosis,the diagnosis of 3D reconstruction results was similar to the intraoperative diagnosis,and the difference was no statistical significance (P=0.98).Conclusion MRI 3D-TOF combined with three-dimensional reconstruction technique in the diagnosis of vascular trigeminal neuralgia shows clear images of the nerve and its sur-rounding vessels,which can be applied to the diagnosis of trigeminal neuralgia.

Objective To observe the therapeutic effect and mechanism of the aqueous extract of ephedra sinica on brain damage after subarachnoid hemorrhage(SAH)in rats.Methods Totally 50 rats of Sprague-Dawley were randomly divided into control group,model group and three groups treated with different concentrations(4,12,36 mg/kg).The changes of the cerebral water content,malondialdehyde(MDA),glutathione peroxidase(GSH-Px)and hydroxy radical of brain tissue were recorded,and he-matoxylin-eosin(HE)staining was used to test the subarachnoid haemorrhagia and oedema,and immunohistochemistry and western blot were carried out to assay the expression of complement C3 in brains of different animal in different group 3d after operation. Results On the postoperative 3 days,compared with the model group,the content of MDA、GSH-Px activity and hydroxyl radical of 12、36 mg/kg treatment groups significantly reduced(P <0.01 ),the content of MDA of 4 mg/kg treatment group not change (P >0.05),but GSH-Px activity and inhibition of hydroxyl radical significantly reduced(P <0.01),and the cerebral water content of 12,36 mg/kg groups were obviously lower compared with model group.The expression of complement C3 was significantly lower on 36 mg/kg treatment group and edema reduced.Conclusion The aqueous extract of ephedra could significantly inhibit the activity of complement C3,prevent the production of MDA、GSH-Px and hydroxyl radical,reduce the severity of cerebral edema and the in-flammatory response,which has a better therapeutic effect SAH animals.

OBJECTIVETo investigate the prognostic value of the size of primary tumor (T staging) and international prognostic index (IPI) for patients with non-Hodgkin's lymphoma (NHL) of the tonsil, and to recommend the treatment strategy for early stage patients.

METHODS306 patients with untreated NHL of the tonsil were reviewed. According to Ann Arbor staging classification, 35 patients had stage I, 178 stage II, 49 stage III and 44 stage IV disease. According to 1997' AJCC staging system, 29 patients had T1, 142 T2, 117 T3 and 18 T4 disease. Twelve stage I patients were given radiotherapy alone and 23 stage II patients were given combined modality therapy (CMT). For patients with stage II lesion, 57 were given radiotherapy alone, 2 chemotherapy alone and 119 CMT. Chemotherapy was the main treatment in patients with stage III or IV lesions.

RESULTSThe 5-year cancer specific survival (CSS) was 74% for patients with T(1), 59% for T(2), 56% for T(3) and 26% for T(4), respectively (P = 0.000). The 5-year CSS was 70% for patients with 0 risk factor, 49% for 1 risk factor, 25% for 2 or 3 risk factor, respectively (P = 0.000). CMT significantly improved disease free survival (DFS) from 46% (radiotherapy alone) to 60% (CMT) for stage II patients (P = 0.046). Multivariate analysis showed that performance status, Ann Arbor staging, T staging, B symptom, and IPI were independent prognostic factors.

CONCLUSIONThe T staging of the primary tumor and IPI are the important prognostic factors of patients with NHL of the tonsil. Combined modality therapy significantly improves the disease free survival of stage II patients.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Lymphoma, Non-Hodgkin ; diagnosis ; mortality ; therapy ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Survival Analysis ; Tonsillar Neoplasms ; diagnosis ; mortality ; therapy