Objective To explore the current status of minor children parenting concerns among young and middle-aged breast cancer patients and investigate the influencing factors based on a random forest model so as to provide references for clinical interventions.Methods A convenience sampling method was used to select breast cancer patients undergoing treatment in our hospital between April and December 2023.A self-designed general information questionnaire,the Chinese version of parenting concerns questionnaire(PCQ),perceived social support scale(PSSS),concern about recurrence scale(CARS),and the brief illness perception questionnaire(BIPQ)were used for the study.A random forest model and the least absolute shrinkage and selection operator(LASSO)were employed to prioritise variables and filtered by significance.The selected variables were then incorporated into the multiple linear regression analysis.Results A total of 260 patients completed the study.The score of minor children parenting concerns of young and middle-aged breast cancer patients was 51.1±6.4.The multiple linear regression analysis,which included variables determined by random forest and LASSO regression(and sorted by the importance of influencing factors),showed that higher disease perception,lower perceived social support,greater concern about cancer recurrence,stage IV tumors,being divorced/widowed,and having more minor children were associated with higher parenting concerns among young and middle-aged breast cancer patients(all P<0.05),accounting for 57.0%of the total variance.Conclusion The minor children parenting concerns in young and middle-aged breast cancer patients are at a moderately high level and are influenced by a variety of factors.Healthcare professionals should develop targeted measures and interventions to reduce the parenting concerns among the patients.

Objective:To examine the dynamic interactive relationships between cyberbullying perpetration,anxiety,and depression in college students.Methods:A total of 4 148 college students from a comprehensive uni-versity in Guangxi Zhuang Autonomous Region completed self-report measures including Cyberbullying Scale(CS),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)at two time points,18-month a-part.Results:Correlation analysis showed significant concurrent(r=0.11-0.17,Ps＜0.001)and lagged(r=0.06-0.44,Ps＜0.001)positive associations among CS,SAS,and SDS scores.Cross-lagged analysis,controlling for gender and age,indicated that T1 CS scores were positively associated with T2 SAS and SDS scores(β=0.13,0.14,Ps＜0.001).Additionally,SAS scores at T1 and SDS scores at T1 were positively associated CS scores at T2,respectively(β=0.07,0.05,Ps＜0.001).Conclusion:Cyberbullying perpetration,anxiety,and depression in-fluence each other over time among college students,suggesting a reinforcing negative cycle.

Objective:To screen differentially expressed genes (DEGs) associated with liver cancer by bioinformatics analysis method, and to investigate the mechanism of the minichromosome maintenance protein 2 ( MCM2) and replication factor C subunit 4 ( RFC4) genes in liver cancer in vitro. Methods:Gene expression profiling data of 80 and 36 hepatocellular carcinoma tissues and 307 and 13 cirrhotic tissues were obtained from the GSE25097 and GSE98620 datasets of the gene expression analysis (GEO) database, respectively. Gene expression profiling data of 374 liver cancer tissues and 50 normal liver tissues were downloaded from the cancer genome atlas (TCGA) database. Limma and DESeqs R software were used to process the gene expression profiling data, construct protein-protein interaction networks, and analysis the relevance of these genes to survival. Weighted gene co-expression network analysis was performed to screen out the core genes. Liver cancer SMMC7721 cells were transfected with MCM2 blank plasmid (MCM2 control group), MCM2 overexpression plasmid [MCM2 WT1 group, MCM2 WT2 (2-fold WT1) group], RFC4 blank plasmid (RFC4 control group), and RFC4 overexpression plasmid [RFC4 WT1 group, RFC4 WT2 (2-fold WT1) group], respectively. The expression of MCM2 and RFC4 in liver cancer cell lines and their transfection levels were detected by real-time fluorescence quantitative reverse transcription PCR and Western blotting. The effects of MCM2 and RFC4 on the proliferation of hepatocellular carcinoma cells were detected by MTT assay and cell cloning assay, respectively. The effects of MCM2 and RFC4 on the migration of liver cancer cells were determined by the scratch assay. The effects of MCM2 and RFC4 on liver cancer cell invasion were detected by Transwell assay.Results:By bioinformatic analysis, 9 HCC DEGs were selected, including ubiquitin conjugating enzyme E2 T ( UBE2T), aurora kinase A ( AURKA), targeting protein for Xklp2 ( TPX2), MCM2, RFC4, ribonucleoside-diphosphate reductase subunit M2 ( RRM2), serine peptidase inhibitory factor Kazal type 1 ( SPINK1), collagen type XV alpha 1 chain ( COL15A1) and C-C motif chemokine 25 ( CCL25). Among the six genes associated with clinical stages, the MCM2 and RFC4 genes were found to be strongly associated with prognosis in liver cancer. The relative protein expression of MCM2 and RFC4 in HepG2 cells (1.83±0.07, 1.44±0.09) and SMMC7721 cells (1.74±0.05, 1.43±0.08) was higher than that in MIHA cells (1.00±0.02, 1.00±0.03), and all the differences were statistically significant (all P<0.05). The relative gene expression of MCM2 and RFC4 in HepG2 cells (14.30±0.12, 5.10±0.18) and SMMC7721 cells (10.60±0.11, 7.60±0.07) was higher than that in MIHA cells (1.00±0.05, 1.00±0.03), and all the differences were statistically significant (all P<0.05). Compared with the MCM2 control group, the absorbance values [(0.28±0.01 and 0.21±0.01) vs 0.18±0.03], the number of clonal cells [(717±12 and 782±29) cells vs (389±17) cells], the percentage migration [(0.43±0.02 and 0.68±0.01) vs 0.15±0.06], and the number of cellular invasions [(933±21 and 821±11) cells vs (409±16) cells] were higher in the MCM2 WT1 and MCM2 WT2 groups, and the differences were all statistically significant (all P<0.05). Compared with the RFC4 control group, the absorbance values [(0.30±0.02 and 0.21±0.01) vs 0.17±0.02], the number of cloned cells [(571±11 and 728±9) cells vs (373±23) cells], the percentage migration [(0.75±0.11 and 0.67±0.04) vs 0.34±0.07], and the number of cell invasion [(835±26 and 818±18) cells vs (629±12) cells] were higher in the RFC4 WT1 and the RFC4 WT2 groups, and the differences were statistically significant (all P<0.05). Conclusions:MCM2 and R FC4 genes play a role in promoting tumorigenesis and growth in hepatocellular carcinoma.

Objective:To investigate the clinicopathological features,treatment and prognosis of endometrial carcinoma arising in endometrial polyps(EPs).Methods:Thirty-eight cases of endometrial carcinoma arising in EPs were collected in the First Affiliated Hospital of Nanjing Medical University from January 2010 to December 2021.The clinical data,pathological characteristics,and follow-up information were retrospectively analyzed from three dimensions:tumor histological type,the menopausal status of the patients and the scope of malignant le-sions.Results:①In terms of tumor histological type,uterine endometrioid carcinoma 33 cases(86.8%)and uter-ine serous carcinoma 50 cases(13.2%),the mean age of patients with endometrioid carcinoma arising from EPs was significantly lower than that of patients with serous carcinoma arising from EPs(53.3±10.0 years vs.63.4±10.3 years,P=0.043).②In terms of menopausal status,endometrioid carcinoma progressed from atypical poly-poid adenomyoma(APA)accounted for 55.6%(10/18)and 5.0%(1/20)in the pre-and post-menopausal group,respectively(P=0.001).The rate of adjuvant therapy was significantly lower in premenopausal patients than in postmenopausal patients(16.7%vs.50.0%,P=0.043).③There were no significant differences in pa-tients age,menopausal status,BMI,comorbidities,abnormal uterine bleeding,maximum diameter of EP,tumor stage,grade,treatment or recurrence rate between cases with tumors confined and unconfined to EPs.Conclu-sions:Endometrioid and serous carcinomas progressed from EPs were more common in perimenopausal and postmenopausal patients,respectively.Malignancies derived from APA contributed to almost half of EP-arising carcinomas in premenopausal women,with a higher degree of differentiation and a low rate of postoperative adju-vant therapy.

Objective:To examine the dynamic interactive relationships between cyberbullying perpetration,anxiety,and depression in college students.Methods:A total of 4 148 college students from a comprehensive uni-versity in Guangxi Zhuang Autonomous Region completed self-report measures including Cyberbullying Scale(CS),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)at two time points,18-month a-part.Results:Correlation analysis showed significant concurrent(r=0.11-0.17,Ps＜0.001)and lagged(r=0.06-0.44,Ps＜0.001)positive associations among CS,SAS,and SDS scores.Cross-lagged analysis,controlling for gender and age,indicated that T1 CS scores were positively associated with T2 SAS and SDS scores(β=0.13,0.14,Ps＜0.001).Additionally,SAS scores at T1 and SDS scores at T1 were positively associated CS scores at T2,respectively(β=0.07,0.05,Ps＜0.001).Conclusion:Cyberbullying perpetration,anxiety,and depression in-fluence each other over time among college students,suggesting a reinforcing negative cycle.

Objective To explore the current status of minor children parenting concerns among young and middle-aged breast cancer patients and investigate the influencing factors based on a random forest model so as to provide references for clinical interventions.Methods A convenience sampling method was used to select breast cancer patients undergoing treatment in our hospital between April and December 2023.A self-designed general information questionnaire,the Chinese version of parenting concerns questionnaire(PCQ),perceived social support scale(PSSS),concern about recurrence scale(CARS),and the brief illness perception questionnaire(BIPQ)were used for the study.A random forest model and the least absolute shrinkage and selection operator(LASSO)were employed to prioritise variables and filtered by significance.The selected variables were then incorporated into the multiple linear regression analysis.Results A total of 260 patients completed the study.The score of minor children parenting concerns of young and middle-aged breast cancer patients was 51.1±6.4.The multiple linear regression analysis,which included variables determined by random forest and LASSO regression(and sorted by the importance of influencing factors),showed that higher disease perception,lower perceived social support,greater concern about cancer recurrence,stage IV tumors,being divorced/widowed,and having more minor children were associated with higher parenting concerns among young and middle-aged breast cancer patients(all P<0.05),accounting for 57.0%of the total variance.Conclusion The minor children parenting concerns in young and middle-aged breast cancer patients are at a moderately high level and are influenced by a variety of factors.Healthcare professionals should develop targeted measures and interventions to reduce the parenting concerns among the patients.

Objective:To investigate the clinicopathological features,treatment and prognosis of endometrial carcinoma arising in endometrial polyps(EPs).Methods:Thirty-eight cases of endometrial carcinoma arising in EPs were collected in the First Affiliated Hospital of Nanjing Medical University from January 2010 to December 2021.The clinical data,pathological characteristics,and follow-up information were retrospectively analyzed from three dimensions:tumor histological type,the menopausal status of the patients and the scope of malignant le-sions.Results:①In terms of tumor histological type,uterine endometrioid carcinoma 33 cases(86.8%)and uter-ine serous carcinoma 50 cases(13.2%),the mean age of patients with endometrioid carcinoma arising from EPs was significantly lower than that of patients with serous carcinoma arising from EPs(53.3±10.0 years vs.63.4±10.3 years,P=0.043).②In terms of menopausal status,endometrioid carcinoma progressed from atypical poly-poid adenomyoma(APA)accounted for 55.6%(10/18)and 5.0%(1/20)in the pre-and post-menopausal group,respectively(P=0.001).The rate of adjuvant therapy was significantly lower in premenopausal patients than in postmenopausal patients(16.7%vs.50.0%,P=0.043).③There were no significant differences in pa-tients age,menopausal status,BMI,comorbidities,abnormal uterine bleeding,maximum diameter of EP,tumor stage,grade,treatment or recurrence rate between cases with tumors confined and unconfined to EPs.Conclu-sions:Endometrioid and serous carcinomas progressed from EPs were more common in perimenopausal and postmenopausal patients,respectively.Malignancies derived from APA contributed to almost half of EP-arising carcinomas in premenopausal women,with a higher degree of differentiation and a low rate of postoperative adju-vant therapy.

Objective:To explore the expression and clinical significance of fibrinogen-like protein 2(FGL2)in gastrointesti-nal stromal tumor(GIST).Methods:Immunohistochemical EnVision two-step method was used to detect expression of FGL2 protein in 158 GIST patients,and correlation between FGL2 protein and clinicopathological parameters was analyzed,and relationship be-tween FGL2 protein and the count of CD3+T,CD8+T,CD20+T and CD68+T of tumor-infiltrating lymphocytes(TILs)in GIST was inves-tigated.Results:Expression of FGL2 protein in GIST was negatively correlated with tumor size,NIH risk grade,necrosis and mitotic image count(P<0.05),there was no significant difference in gender and tumor location(P>0.05).FGL2 expression was associated with low CD3+T cell counts in GIST(P<0.05),while there was no significantly difference with CD8+T,CD20+T and CD68+T cell counts(P>0.05).Conclusion:FGL2 protein is involved in occurrence and development of GIST,which expression level is partly pre-dictive of the malignant potential of GIST.FGL2 protein may participate in occurrence and development of GIST by regulating tumor microenvironment.

Objective:To evaluate the autogenous arteriovenous fistula(AVF) insufficiency by ultrasound monitoring of brachial artery resistance index(RI).Methods:The brachial artery RI and blood flow volume(FV) data of 828 patients who underwent color-Doppler ultrasound detection after AVF in the General Hospital of Western Theater Command from January 2019 to June 2021 were retrospectively analyzed. The patients were grouped according to the adequacy of clinical dialysis, including 668 patients in the group with normal AVF function and 160 patients in the group with insufficient AVF function. The general information and ultrasonic measurement parameters were compared between the two groups. The correlation between brachial artery FV and RI was analyzed. The evaluation of brachial artery flow RI for AVF insufficiency was analyzed by ROC curve.Results:There were statistically significant differences between the two groups in brachial artery RI and FV(both P<0.001). The results of Pearson correlation analysis showed that brachial artery FV was negatively correlated to RI ( r=-0.657, P<0.001). The area under ROC curve for assessing AVF function by brachial artery RI was 0.970, with 95% CI was 0.955-0.986, the optimal cut-off value was 0.665, and the sensitivity and specificity were 0.888 and 0.955, respectively. Conclusions:Brachial artery RI in patients with AVF insufficiency is significantly higher than that in patients with normal AVF function. The optimal cutoff value of brachial artery RI can be used as an evaluation parameter for rapid screening of AVF function.

Background: Colorectal cancer is one of the most commonly diagnosed cancer and leading causes of cancer death worldwide. Fibrinogen-like protein 2 (FGL2), a member of the fibrinogen family, has been demonstrated as a regulator of immune cell functions in tumor microenvironment and might facilitate tumor progression. Aims: To study the expression and clinical significance of FGL2 in colon cancer. Methods: One hundred and fifty colon cancer patients diagnosed from January 2018 to January 2022 at the Second Hospital of Tianjin Medical University were enrolled in this study. The paraffin-embedded tissues were collected for detection of FGL2 protein and the surface markers of tumor infiltrating immune cells (TIICs), including CD4, CD8, CD20, CD68, and CD56 by using immunohistochemistry. The correlations of FGL2 expression level with the clinicopathological parameters and TIICs counting were analyzed. Results: Expression of FGL2 was upregulated in 68.7% of the colon cancer cases. Its expression level was correlated positively with the tumor size and TNM staging (all P<0.05), while no correlations were found between FGL2 expression level and gender, age, tumor differentiation, and presence of vascular invasion (all P>0.05). Meanwhile, the expression level of FGL2 was associated with the cell counting of CD4