Objective To explore the value of high-frequency ultrasound in the detection of metastatic hepatocellular carcinoma and displaying lesion characteristics. Methods A total of 38 paitients with hepatocellular carcinoma satellite lesions within 40 mm of subcutaneous tissue were underwent low-frequency (1-5 MHz) and high-frequency (6-9 MHz) ultrasound. Detection rates and ultrasonic features were compared. Results High-frequency grayscale ultrasound had a higher detection rate (71.1% vs. 36.8%, P＜0.001). Subgroup analysis showed higher detection rates with chemotherapy history (88.9% vs. 33.3%, P＝0.002), fatty liver (71.9% vs 31.3%, P＜0.001) or superficial lesion (within 20 mm, 76.5% vs 41.2%, P＝0.031). High-frequency ultrasound also showed clearer margins (P＝0.004) and more arterial-phase rim enhancement (P＝0.007). Conclusions 6-9 MHz ultrasound detects metastatic hepatocellular carcinoma, especially superficial lesions, more effectively than 1-5 MHz ultrasound and better visualizes characteristics.

Objective: To investigate treatment strategies for chronic periapical periodontitis in prematurely erupted premolars and provide guidance for managing pulp and periapical diseases in young permanent teeth with immature roots. Methods: A regenerative endodontic procedure (REP) was performed on a prematurely erupted maxillary left first premolar (tooth 24) at Nolla stage Ⅶ with chronic apical periodontitis, following standardized protocols including root canal irrigation, disinfection, and coronal sealing. The case was followed up, and a literature review was conducted. Results: Clinical resolution of symptoms was observed on tooth 24, with sustained root development. After a 20-month follow-up, the tooth had restored biological function. Literature synthesis revealed that periapical infections in prematurely erupted permanent teeth predominently arise from pulp exposure and bacterial infection, with retrograde infection being rare. For young permanent teeth with necrotic pulp, regenerative endodontic procedures has been established as the treatment of choice to promote apical closure and root maturation. The critical steps of regenerative endodontic procedures include thorough disinfection, induced bleeding to form a fibrin scaffold, and coronal sealing to facilitate stem cell recruitment and differentiation. Conclusion Regenerative endodontic procedures represents an effective and viable treatment option for prematurely erupted young permanent teeth with chronic periapical periodontitis.

Objective: To explore the independent effects and gender differences of different types of adverse childhood experiences (ACEs) on the co-occurrence of non-suicidal self-injury (NSSI) and suicide attempts (SA), so as to provide a reference for the precise prevention and control of self-harm in junior high school students. Methods: From May to June 2023, a total of 7 360 junior high school students were selected from 12 schools in three districts/counties of Chongqing using a combination of stratified cluster sampling and convenience sampling methods. Information on NSSI, SA, ACEs, and depressive symptom, as well as other related data were collected through the Adolescent Non-suicidal Self-injury Assessment Questionnaire (ANSAQ), suicide related section of the Chinese Adolescent Health related Behavior Questionnaire (Junior High School Version), Childhood Trauma Questionnaire-Short Form ( CTQ- SF), and Center for Epidemiologic Studies-Depression Scale (CES-D). Statistical analyses of the data were performed using the Chi-square test and multiple Logistic regression. Results: The detection rates of NSSI, SA, NSSI+SA and ACEs in junior high school students were 19.2%, 4.6%, 3.5% and 57.9% respectively. After controlling for factors such as gender, grade, family type, self rated family economic status, self rated academic performance, self rated academic pressure, number of close friends, and depressive symptom scores, results from the multiple Logistic regression analysis showed that junior high school students with physical abuse ( OR = 1.98, 95% CI =1.23-3.18), emotional abuse ( OR =2.83, 95% CI =1.92-4.19), sexual abuse ( OR = 1.70, 95% CI =1.07- 2.69 ), physical neglect ( OR =1.67, 95% CI =1.20-2.33) and witnessing domestic violence ( OR =2.10, 95% CI =1.41-2.87) in childhood had higher risks for the occurrence of NSSI+SA (all P <0.05). After stratification by gender, boys with sexual abuse in childhood had a high risk for the occurrence of NSSI+SA ( OR =2.17, 95% CI =1.06-4.43), whereas girls with emotional abuse ( OR =3.69, 95% CI =2.29-5.94), physical neglect ( OR =1.62, 95% CI =1.07-2.45) and witnessing domestic violence ( OR =2.17, 95% CI =1.41-3.34) in childhood had hgih risks for the occurrence of NSSI+SA (all P <0.05). Conclusions Different types of ACEs have different effects on the co-occurrence of self-harm in junior high school students and there are gender differences. When family interventions are conducted for the combined model, emphasis should be placed on aspects of emotional abuse and domestic violence while optimizing the interventions based on gender differences.

Objective: To understand the current situation and influencing factors of comorbidity of depressive and anxiety symptoms among middle school students in Chongqing, so as to provide a scientific basis for formulating a comprehensive strategy for the co prevention of multiple diseases among middle school students. Methods: From September to December 2024, 12 327 middle school students were selected from 6 districts and counties in Chongqing by the combination of stratified cluster sampling and convenience sampling method. The current status of depressive and anxiety symptoms was investigated by using the Center for Epidemiological Survey-Depression Scale (CES-D) and the Generalized Anxiety Disorder-7 (GAD-7). The Chi-squared test was used to compare the differences between groups with comorbidity of depressive and anxiety symptoms, multivariate Logistic regression analysis was used to analyze its related factors, and a nomogram prediction model was drawn. Results: The detection rates of depressive symptoms, anxiety symptoms and comorbidity among middle school students in Chongqing were 26.34%, 34.55% and 21.16%, respectively. Among them, the detection rates of the three types of symptoms in girls (29.80%, 40.99%, 25.15%) were all higher than those in boys (23.22%, 28.73%, 17.55%) ( χ 2=68.61, 204.23, 106.51, all P <0.01). Statistical significance was observed in the distribution of depressive and anxious symptoms among middle school students across different gender, academic stage, school district, family type, physical activity levels, parental discipline, smoking, alcohol consumption, sleep deprivation, excessive screen time, Internet addiction, and bullying ( χ 2=14.49-991.46, all P <0.01). Multivariate Logistic regression analysis showed that compared with junior high school students, ordinary high school students had a higher risk of comorbidity ( OR=2.71, 95% CI = 2.41-3.05); girls ( OR=2.17, 95%CI =1.95-2.40), non-core family ( OR=1.20, 95%CI =1.08-1.32), and good neighborhood ( OR=1.16, 95%CI =1.02-1.30), campus bullying ( OR=4.88, 95%CI =4.32-5.50), Internet addiction ( OR=4.77, 95%CI = 3.41 -6.68), parental beating and scolding ( OR=3.18, 95%CI =2.72-3.71), alcohol consumption ( OR=2.10, 95%CI =1.86- 2.37 ), and insufficient sleep ( OR=1.73, 95%CI =1.54-1.95) had higher risks with comorbidity of depression and anxiety symptoms (all P <0.05). A nomogram prediction model was constructed based on significant variables shows that C-index=0.75 (AUC= 0.75 , 95% CI=0.74-0.76, P <0.05), and the model had good predictive performance. Conclusions The current situation of comorbidity of depressive and anxiety symptoms among middle school students in Chongqing is not optimistic. The nomograms can be used to effectively predict the risk of comorbidity of depressive and anxiety symptoms in middle school students.

Tracheobronchial adenoid cystic carcinoma （TACC） is a low-grade malignant tumor originating from the airway mucosa. Despite its slow progression，it is characterized by high invasiveness，frequent recurrence，and a strong tendency for metastasis. Preclinical studies have shown that vascular-targeted therapy holds significant potential. However，an effective systemic treatment for TACC has not been established yet. This study explored TACC from the perspective of "Feiji" in traditional Chinese medicine （TCM） as the starting point. It deeply investigated the mechanisms of abnormal collaterals and tumor vascular recruitment and further elaborated on the theoretical connection between abnormal collaterals and tumor vascular recruitment. Firstly，collateral hyperactivity led to disordered and erratic pulmonary collaterals. Their abnormal structures were similar to the disorderly and tortuous nature of tumor （pseudo）angiogenesis. This resulted in imbalances in the functions of circulation，perfusion，and reverse injection of the pulmonary collaterals，and then led to unrestrained collateral dysfunction and the accumulation of pathogenic factors. Secondly，the remodeling of the extracellular matrix （ECM） and epithelial-mesenchymal transition （EMT） in TACC were critical processes in vascular co-option （VCO），representing the micro-level manifestation of the displacement of nutrient and defense. During this process，ECM remodeling made TACC cells more likely to hijack normal blood vessels，creating a complex vascular microenvironment conducive to tumor growth. In terms of treatment，this study proposed a TCM strategy of "regulating collaterals to expel pathogenic factors and nourishing collaterals to strengthen the healthy Qi"，and listed potential TCM. These were intended to regulate the Qi and blood in the collaterals，repair the functions of abnormal collaterals，and intervene in the vascular recruitment process of TACC. Future research should focus on improving the TCM clinical syndrome characteristics of TACC. Through modern molecular biology techniques，it is necessary to deeply analyze the micro-level pattern of vascular recruitment in TACC. This would enrich the understanding of the profound connection between abnormal collaterals and tumor vascular recruitment，providing empirical evidence for TCM-targeted therapies for vascular recruitment in TACC.

OBJECTIVE: Epidemiological studies have shown that vitamin D status affects glycemic control in individuals with type 2 diabetes mellitus (T2DM). However, findings from intervention studies remain inconsistent. Therefore, a network meta-analysis was conducted to evaluate the comparative efficacy of various vitamin D supplementation strategies on glucose indicators in adults with T2DM. METHODS: Eligible studies published before September 12, 2024, were retrieved from PubMed, EMBASE, Cochrane Library, and Web of Science. A network meta-analysis of multiple dosage strategies-low (< 1,000 IU/day, LDS), medium (1,000-2,000 IU/day, MDS), high (2,000-4,000 IU/day, HDS), and extremely high (≥ 4,000 IU/day, EHDS)-was performed. RESULTS: The network meta-analysis of 40 RCTs indicated that, compared with placebo, vitamin D ₃ supplementation increased 25-hydroxyvitamin D [25-(OH)-D] levels, with pooled mean difference ( MD) showing a stepwise increase from LDS to EHDS. Ranking probabilities showed a corresponding rise in 25-(OH)-D levels from LDS (46.7%) to EHDS (91.2%). EHDS reduced fasting blood glucose (FBG) relative to no treatment. LDS significantly decreased hemoglobin A1c (HbA1c), and vitamin D ₂ significantly affected FBG levels. MDS led to a significant change in fasting insulin (FIN) compared to both placebo ( MD: -4.76; 95% CI -8.91 to -0.61) and no treatment ( MD: -7.30; 95% CI -14.44 to -0.17). CONCLUSION The findings suggest that vitamin D supplementation may be a viable approach for improving glycemic control in adults with T2DM, with lower doses potentially offering benefit. The analysis also showed a dose-dependent increase in 25-(OH)-D levels.
Humans ; Administration, Oral ; Blood Glucose/drug effects* ; Diabetes Mellitus, Type 2/blood* ; Dietary Supplements ; Vitamin D/analogs & derivatives* ; Vitamins/administration & dosage*

Wastewater-based epidemiology has emerged as a transformative surveillance tool for estimating substance consumption and monitoring disease prevalence, particularly during the COVID-19 pandemic. It enables the population-level monitoring of illicit drug use, pathogen prevalence, and environmental pollutant exposure. In this perspective, we summarize the key challenges specific to the Chinese context: (1) Sampling inconsistencies, necessitating standardized 24-hour composite protocols with high-frequency autosamplers (≤ 15 min/event) to improve the representativeness of samples; (2) Biomarker validation, requiring rigorous assessment of excretion profiles and in-sewer stability; (3) Analytical method disparities, demanding inter-laboratory proficiency testing and the development of automated pretreatment instruments; (4) Catchment population dynamics, reducing estimation uncertainties through mobile phone data, flow-based models, or hydrochemical parameters; and (5) Ethical and data management concerns, including privacy risks for small communities, mitigated through data de-identification and tiered reporting platforms. To address these challenges, we propose an integrated framework that features adaptive sampling networks, multi-scale wastewater sample banks, biomarker databases with multidimensional metadata, and intelligent data dashboards. In summary, wastewater-based epidemiology offers unparalleled scalability for equitable health surveillance and can improve the health of the entire population by providing timely and objective information to guide the development of targeted policies.
China/epidemiology* ; Humans ; Wastewater/analysis* ; COVID-19/epidemiology* ; Public Health ; Wastewater-Based Epidemiological Monitoring ; SARS-CoV-2

Objective: To detect the different proteomic characteristics of microvesicles (MVs) and exosomes (EXOs) released from apheresis platelets during storage, and to explore their role in mediating platelet storage damage lesion (PSL). Methods: Apheresis platelets were collected from the retention bag on the third day of storage. MVs and EXOs were isolated using differential centrifugation. Platelet, MVs and EXOs protein samples were extracted respectively, and the differentially expressed proteins were detected by quantitative proteomics technology. Further, the co-incubation model of MVs, EXOs and fresh platelets was adopted to evaluate the effect of extracellular vesicles on PSL. The aggregation response of platelets to collagen agonizers and the changes in ATP release rate were evaluated by optical turbidimetry. Flow cytometry was used to evaluate the changes of platelet early activation indicators (P-selectin and PAC-1) and mitochondrial membrane potentia. Western blot was used to detect the changes in the expression of key proteins for platelet activation and apoptosis (P-selectin, Integrin β3 and Bcl-xl). Results: Proteomic analysis revealed a significantly separation in protein expression profiles of platelet, MVs and EXOs samples within the latent variable space. Energy metabolization-related proteins such as mitochondrial respiratory chain complex and oxidative phosphorylation were enriched specifically, in MVs while EXOs were enriched with inflammation-related proteins. Co-incubation experiments confirmed that extracellular vesicles could significantly induce platelet responses to agonists (the maximum aggregation rate in the MVs group increased by 187.36%, P<0.001; 71.26%, in the EXOs group P=0.002). The maximum ATP release rate of platelets also increased (275.44% in the MVs group, P<0.001; 70.18% in the EXOs group, P=0.015). The expression of P-selectin increased (119.33% in the MVs group, P<0.001; 25.61% in the EXOs group, P=0.013), as detected by flow cytometry. The binding rate of PAC-1 increased (132.18% in MVs group, P<0.001; 21.41% in EXOs group, P=0.043), and the mitochondrial membrane potential decreased (20.49% in MVs group, P<0.001; 9.73% in EXOs group, P=0.044). In the MVs group, platelet P-selectin and Integrin β3 expression were significantly increased (100.83% and 395.64%, P<0.001), while Bcl-xl expression was lower than that in the control group (83.94%, P<0.001). Compared with the control group, P-selectin and Integrin β3 expression were also increased (27.89% and 181.91%, P=0.007和P=0.002), while Bcl-xl was decreased in the EXOs group (36.52%, P<0.001). Conclusion: MVs and EXOs derived from stored platelets show different proteomic characteristics. Compared with EXOs, MVs exhibits a stronger effect in inducing mitochondrial dysfunction. Mvs also promots PSL responses including platelet activation and apoptosis.

Objective: To explore the association between various components of sleep quality and the co-occurrence of non-suicidal self-injury (NSSI) behaviors and depressive symptoms among junior high school students, so as to provide evidence for targeted prevention strategies of NSSI and depression. Methods: From May to June 2024, a total of 5 008 junior high school students from 8 schools in 2 districts/counties of Chongqing were selected through a stratified cluster sampling method. The Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiological Studies Depression Scale (CES-D), and the Adolescent Non suicidal Self injury Assessment Questionnaire (ANSAQ) were used to assess sleep quality, depressive symptoms, and NSSI, respectively. Data were analyzed by using the Chi-square test, Bonferroni correction, and multivariate Logistic regression. Results: Non-NSSI group and depressive symptoms group accounted for 68.11% among junior high school students, NSSI-only group accounted for 4.71%, only depressive symptoms group accounted for 14.94%, and co-occurrence of NSSI and depressive symptoms group accounted for 12.24%. The prevalence of the co-occurrence group was higher in girls (16.39%) than in boys (7.85%) ( χ 2=84.89, P <0.01). After controlling for gender, grade, and boarding status etc., multivariate Logistic regression analysis revealed that five sleep components, including subjective sleep quality, sleep latency, sleep duration, sleep disturbances, and daytime dysfunction, were significantly and positively associated with the co-occurrence of NSSI and depressive symptoms ( OR =1.30-3.86, all P <0.05). The strength of association between these components and the co-occurrence group, in descending order, was: daytime dysfunction ( OR = 2.52), sleep disturbances ( OR =2.36), subjective sleep quality ( OR =1.76), sleep latency ( OR =1.44), and sleep duration ( OR =1.22) (all P <0.01). Conclusions The co-occurrence of NSSI and depressive symptoms is prevalent among junior high school students, with girls being more significantly affected. Sleep disturbances and daytime dysfunction may represent particularly important risk factors. Targeted and prioritized intervention strategies addressing specific sleep components should be developed and implemented to reduce the co-occurrence of NSSI and depressive symptoms in junior high school students.

Fe/Mn/Gd polymetallic nanooxide(FMGN)were prepared by one-step solvent thermal reaction by using Fe(acac)3,Mn(acac)2 and Gd(acac)3 as reaction precursors.Next,hyaluronic acid(HA)was used to modify FMGN to fabricate tumor-targeting T 1-T 2 dual-mode magnetic resonance imaging(MRI)contrast agent(HA-FMGN)for accurate diagnosis of prostate cancer.The structure and morphology of FMGN were observed by transmission electron microscope(TEM).It was found that FMGN exhibited a uniform nanocluster spherical structure when the feeding ratio of iron acetylacetonate,manganese acetylacetonate,and gadolinium acetylacetonate was 3:2:1.X-ray diffraction(XRD)analysis showed that FMGN had a typical inverse spinel structure of Mn doped Fe 3O 4,with Gd existing in the form of amorphous gadolinium oxide.The longitudinal relaxivity(r 1)and transverse relaxivity(r 2)of FMGN were 13.395 and 428.535 L/(mmol·s),respectively,measured by 0.5 T MRI analyzer,which proved that FMGN had excellent T 1-T 2 dual-mode MRI contrast capability.The cytotoxicity and hemolysis test found that HA-FMGN didn't damage red cells and induce toxicity for normal cells,indicating that HA-FMGN had excellent cell biocompatibility.The internalization efficacy of HA-FMGN was observed by CLSM,and the results showed that HA-FMGN possessed excellent prostate tumor-targeting ability.In vivo MRI experiment showed that HA-FMGN significantly enhanced T 1 and T 2 weighted MRI signal to noise ratio(SNR)of prostate tumor,which promoted the accurate diagnosis of orthotopic prostate cancer.