Objective To discuss the application of bidirectional dual loop technique in retrieving Aegisy inferior vena cava filters.Methods The clinical data of 12 patients with deep vein thrombosis in the lower limbs complicated by pulmonary embolism,who received mechanical thrombectomy and Aegisy inferior vena cava(IVC)filter implantation at the Zhoukou Municipal Central Hospital of China from January 2016 to November 2023,were retrospectively analyzed.The retrieval of Aegisy IVC filters beyond the time window was tried by standard methods,guide wire stripping,balloon dilatation,unidirectional single loop technique,unidirectional dual loop technique,etc.However,because of the difficulty in retrieval of filter,bidirectional dual loop technique had to be used.The indwelling time of the IVC filters was 30-365 days,with an average time of 105 days.Results The IVC filter was completely removed in 11 patients.Angiography showed that IVC was unobstructed,no contrast extravasation was observed,and the average operation time was 126 minutes.The retrieval of filter failed in one patient,and the patient had to receive anticoagulation therapy lifelong.No surgery-related complications occurred.Conclusion For retrieving Aegisy IVC filters beyond the time window,bidirectional dual loop technique is clinically safe and effective,and this technology is worthy of clinical promotion and application.

Objective To analyze the effect of Callicarpa nudiflora on wound healing and phos-phatidylinositol-3-kinase/protein kinase B/mammalian target of rapamycin(PI3K/AKT/mTOR)path-way by regulating M2 macrophage polarization in rats with diabetic foot ulcer.Methods A total of 40 rats were selected,with 10 rats in control group(topical application of saline),and the remaining 30 were used to establish rat model of diabetic foot ulcer.Ultimately,27 rats were successfully mod-eled and divided into model group(topical application of saline),Callicarpa nudiflora group(topi-cal application of Callicarpa nudiflora),and Callicarpa nudiflora combined with inhibitor group(topical application of Callicarpa nudiflora combined with CD206 inhibitor,a marker protein of M2 macrophages),with 9 rats in each group.The wound healing rate,levels of basic fibroblast growth factor(bFGF)and vascular endothelial growth factor(VEGF),relative expression levels of induc-ible nitric oxide synthase(iNOS),CD16/32,CD206,PI3K,AKT and mTOR as well as mRNA ex-pression levels of PI3K,AKT and mTOR were compared among groups.Results On the 3rd,7th and 14th days after intervention,compared with the control group,the wound healing rate,VEGF,bFGF,relative expression level of CD206,relative expression of PI3K,AKT and mTOR at mRNA and protein levels were significantly decreased while the relative expression levels of iNOS and CD16/32 were significantly increased in all other groups(P＜0.05);compared with the model group,the Callicarpa nudiflora group and the Callicarpa nudiflora combined with inhibitor group showed significant increased wound healing rate,VEGF,bFGF,relative expression level of CD206,and relative expression of PI3K,AKT and mTOR at mRNA and protein levels,and significant de-creased relative expression levels of iNOS and CD16/32(P＜0.05);compared with the Callicarpa nudiflora group,the Callicarpa nudiflora combined with inhibitor group showed significant decreased wound healing rate,VEGF,bFGF,relative expression level of CD206,and relative expression of PI3K,AKT and mTOR at mRNA and protein levels,and significant increased relative expression levels of iNOS and CD16/32(P＜0.05).Conclusion Callicarpa nudiflora can promote M2 mac-rophage polarization,increase wound healing rate and levels of VEGF and bFGF in rats with diabetic foot ulcer,and activate the PI3K/AKT/mTOR signaling pathway.

Objective: To investigate the tendency of obesity and depressive symptoms in middle school students in Tianjin, so as to provide a reference for exploring the clustering patterns of health risk behaviors and their effects on obesity and depressive symptoms. Methods: A stratified cluster sampling method was used to investigate the obesity, depressive symptoms and health risk behaviors of middle school students from 16 counties of Tianjin from 2019 to 2023. The latent classes analysis was used to classify health risk behaviors. The χ 2 test and Logistic regression were used to analyze the effects of different categories on obesity and depression symptoms. Results: The obesity detection rate of middle school students in Tianjin from 2019 to 2023 first increased ( 20.90% in 2019, 23.35% in 2020) and then decreased and gradually stabilized (2021-2023:22.20%-22.69%), and the detection rate of depressive symptoms showed a decreasing trend (from 21.65% to 14.92%). The detection rate of comorbidity of obesity and depressive symptoms first increased (4.62% in 2019, 4.66% in 2020) and then gradually decreased to 3.43% in 2023, and the rate was higher in boys than in girls and higher in urban areas than in suburban areas. Latent category analysis classified health risk behaviors into four categories: lack of exercise group, poor behaviors such as sleep group, poor diet group and healthy group. After adjusting for demographic characteristics,the results of Logistic regression analysis showed that the co-occurrence risk of obesity and depression symptoms among the top three groups of middle school students were 1.35( OR=1.35, 95%CI =1.15-1.58), 4.20( OR=4.20, 95%CI =3.50-5.04), and 1.84( OR=1.84, 95%CI =1.40-2.38)times, compared to the healthy group ( P <0.05). Conclusions From 2019 to 2023, the comorbidity rate of obesity and depression among middle school students in Tianjin increased first and then decreased gradually. Interventions should be made in the aspects of exercise, diet, sleep and other behaviors.

Objective: To explore the causal relationship between adolescent school connectedness and the co-occurrence with health risk behaviors among junior high school students, so as to provide the reference for reducing the occurrence of adolescents health risk behaviors among junior high school students. Methods: A total of 924 students from two junior high schools in Jishou City were selected by the convenience sampling and cluster sampling methods, and two follow up surveys were conducted at 6 month intervals in April (T1) and October (T2) of 2023 using the Adolescent Health Risk Behavior Questionnaire and the School Connection Scale. The scores of the co-occurrence of school connectedness and health risk behaviors among junior high school students were compared by different survey periods and genders using the t-test, and cross lagged analyses were performed using Mplus 8.3 software. Results: School connectedness scores among junior high school students in T1 and T2 surveys were (38.86±7.46) (37.87± 7.71 ) and co-occurrence of health risk behaviors scores were (1.64±0.68) (1.83±0.53), respectively, and the differences between the scores of the 2 surveys were statistically significant ( t=4.24, -4.14, P <0.05). The correlation between school connectedness and co-occurrence of health risk behaviors were statistically significant in both surveys ( r =-0.46 to -0.33, P <0.05). Cross lagged analyses showed that school connectedness in T1 negatively predicted the co-occurrence of health risk behaviors in T2 ( β =-0.08), and the co-occurrence of health risk behaviors in T1 negatively predicted the school connectedness in T2 ( β =-0.15) ( P <0.05). Conclusions There is a longitudinal causal relationship between school connectedness and co-occurrence of health risk behaviors among junior high school students. School connectedness should be improved through various ways to reduce the co-occurrence of health risk behaviors.

Objective: To analyze the developmental trajectories of middle school students loneliness and social support, as well as to explore the interaction between loneliness and social support, so as to provide the evidence based support for the mental health development of adolescents. Methods: A total of 989 first year students from four public middle schools in Xiangxi Tujia and Miao Autonomous Prefecture, Hunan Province were selected for three follow up surveys by a cluster random sampling method (T1:March 2023, T2:June 2023, T3:December 2023). The UCLA Loneliness Scale-20 (ULS-20) and Social Support Scale for University Students (SSSUS) were employed for questionnaire data collection. The growth mixture modeling was utilized to test the developmental trajectories of loneliness and social support among middle school students, while the cross lagged analysis was performed to investigate their mutual influence. Results: The scores for loneliness and social support in T1, T2 and T3 were (43.1±5.8, 42.5± 6.8 , 42.0±6.9; 55.9±12.0, 60.7±15.7, 60.4±16.7), respectively. Correlational analysis revealed a significant negative correlation between loneliness levels (T1, T2, T3) and social support (T1, T2, T3) ( r =-0.47 to -0.36, P <0.01). Growth mixture modeling indicated a linear declining trend of middle school students loneliness, and the developmental trajectory of social support showed a linear increasing trend, with significant individual differences in initial levels and rates of change ( P <0.05). Cross lagged analyses revealed that loneliness levels at T1 negatively predicted social support scores at T2 ( β =-0.16), and loneliness levels at T2 negatively predicted social support scores at T3 ( β =-0.12) ( P <0.05). Additionally, prior loneliness positively predicted its subsequent levels, with path coefficients of 0.58 and 0.47, respectively ( P <0.05). Social support scores at T1 negatively predicted loneliness levels at T2 ( β =-0.10), while scores at T2 negatively predicted loneliness levels at T3 ( β =-0.15) ( P <0.05). Prior loneliness also positively predicted its subsequent levels, with path coefficients of 0.43 and 0.44, respectively ( P <0.05). Conclusion The developmental trajectory of middle school students loneliness demonstrates a decreasing trend, while that of social support exhibits a linear increasing trend, indicating a longitudinal causal relationship between loneliness and social support.

Objective: To explore the current status and progress of regional school health work to provide policy reference for school health improvement. Methods: Survey data on school health work in Tianjin from 2019, 2021 and 2023 was used. School health staff allocation and expenditure of the health administrative department, CDC and education department, as well as the annual implementation of health education, prevention and control of common diseases and infectious diseases, sports activities and food nutrition in primary and secondary schools were analyzed. Statistical analysis was conducted using KruskalWallis test, Chisquare test, and Fishers exact test. Results: The number of school health staff in the health commissions and education departments from 2019, 2021 and 2023 was relatively stable. Parttime staffs were often employed by health commissions while fulltime staffs were mainly employed by education departments. The number of school health staff at CDCs increased gradually (H=12.65, P<0.01). School health expenditure of administrative departments and schools in 2021 and 2023 increased significantly compared with that in 2019 (H=22.28, 23.75, P<0.05). More than 95% of schools set up clinics or health care rooms, and about 97% of schools had school health technicians or health teachers. More than 90% of schools had health education courses over 4 hours per semester. The rate of mental health education increased by year (86.87%, 89.91%, 96.30%, Z=2.40，P<0.05). Lack of courses regarded safety emergency and risk avoidance, growth and development, and adolescent health education. The provision rate of psychological counseling services (89.00%, 97.25%, 100.00%) and psychological problem prevention and control (56.12%, 71.56%, 81.48%) also increased by year (Z=3.83, 3.96, P<0.01). The implementation rates of prevention and control of poor vision, dental caries, overweight and obesity were all higher than 80%, and the prevention and control rate of abnormal spinal curvature showed an increasing trend (38.78%, 77.06%, 72.22%, Z=4.87, P<0.01). More than 90% of schools met the standard for physical education class hours, and the proportion of schools conducting at least 30 minutes of recess physical activities every day increased year by year (65.00%, 80.73%, 85.98%, Z=3.59, P<0.01). All schools did not have shops. Conclusions School health work in Tianjin is effective and constantly developing. It is necessary to continue to increase the investment of human resources and expenditure in school health, explore the approaches of cooccurrence and prevention of common diseases, and improve the school sports and nutrition environment.

Objective: To investigate the comorbidity of myopia and scoliosis among primary and secondary school students in Tianjin, and to analyze the school environment risk factors contributing to these health issues, so as to provide a scientific basis for development effective prevention measures. Methods: A total of 41 654 primary and secondary school students from 16 districts of Tianjin were selected by stratified random cluster sampling from September to October 2023 to screen for myopia and scoliosis. Univariate analysis was performed to examine the data, followed by a bivariate multivariate Logistic regression model and cumulative effect analysis to explore the influencing factors of their comorbidity. Results: In 2023, the prevalence of comorbidity of screening positive myopia and scoliosis among primary and secondary school students in Tianjin was 2.65%. The prevalence was higher in suburban areas (3.26%) compared to urban areas (2.02%), higher among females (3.81%) compared to males (1.59%), and highest in high school students (6.17%) compared to middle school (4.19%) and primary school students (0.44%) (χ2=62.23, 198.69, 953.19, P<0.01). Logistic regression analysis showed that the number of physical education classes ≥3 per week, the number of eye health exercises at school ≥2 per day, outdoor activities between classes, teachers reminding to pay attention to reading and writing posture and strict eye standing posture were negatively correlated with the comorbidity of screening positive myopia and scoliosis (OR=0.66, 0.77, 0.71, 0.78, 0.74, P<0.05). Reading or electronic screen while lying or lying on the stomach was positively associated with the comorbidity of screening positive myopia and scoliosis (OR=1.77, P<0.05). Cumulative effect analysis showed that the cumulative score (4-7, 7-9, ≥10) was negatively correlated with the comorbidity of screening positive of myopia and scoliosis (OR=0.65, 0.55, 0.52, P<0.05). Conclusions The school environment support and students personal behavior habits in school are related to the comorbidity of comorbidity of screening positive myopia and scoliosis. Prevention and control of myopia and scoliosis should improve the environmental factors related to students health in school.

Objective To explore the mechanism of Baihu Decoction in the treatment of acute lung injury based on network pharmacology and molecular docking technology;To carry out experimental verification.Methods The active components and targets of Baihu Decoction were searched through TCMSP and BATMAN-TCM databases,and human gene searches were conducted in GeneCards,NCBI,and OMIM databases.PPI network construction and GO and KEGG pathway enrichment analysis were conducted to determine the important signaling pathways of Baihu Decoction and acute lung injury.Molecular docking of main active components and core target proteins was performed.The effects of Baihu Decoction on survival rate and inflammatory cytokine content in acute lung injury lethal model mice were observed through animal experiments.Results Totally 211 common targets for Baihu Decoction and acute lung injury were screened,and identified effective components such as quercetin,kaempferol,and stigmasterol,etc.Analysis of KEGG pathway enrichment indicated that Baihu Decoction exerted its pharmacological effects in acute lung injury through a variety of signal pathways,including Toll-like receptor signaling pathway,NOD-like receptor signaling pathway,T cell receptor signaling pathway,and MAPK signaling pathway.Molecular docking results showed that Baihu Decoction had good binding strength with MAPK14,STAT3,JUN,MAPK1,MAPK3,FOS and RELA.The results of animal experiments showed that compared with the model group,the survival rate of mice in the Baihu Decoction group was significantly increased,the degree of pathological injury in the lung tissue was reduced,and serum IL-6,TNF-α contents decreased significantly(P<0.05).Conclusion Baihu Decoction can treat acute lung injury by reducing pathological injury to lung tissue and releasing of inflammatory factors.

Objective: To understand the potential categories of health risk behaviors among adolescents in the Wuling Mountain Area and their association with school connectedness, so as to provide reference for formulating classified and effective intervention measures. Methods: From March to June 2023, 3 386 middle and high school students from eight schools in the Wuling Mountain Area were selected using the multistage stratified cluster random sampling method. A basic information questionnaire, health risk behaviors questionnaire, and school connectedness scale were utilized for the survey. The latent classes of adolescent health risk behaviors in the Wuling Mountain Area were investigated by using latent class analysis, while an multinomial Logistic regression model was employed to analyze the association between latent classes and school connectedness. Results: Adolescent health risk behaviors in the Wuling Mountains Area were classified into three latent classes: high risk class of episodic behaviors ( 5.64 %), high risk class of implicit behaviors (26.90%), and low risk class of implicit behaviors (67.45%). Gender, ethnicity, and family type revealed significant differences in the distribution of the three latent classes ( χ 2=117.91, 22.55, 21.51, P <0.05). The results of the regression model analysis showed that, with the low risk class as the reference category, high school connectedness scores were associated with the high risk class of episodic behaviors ( OR=0.89, 95%CI = 0.88- 0.91) and the high risk class of implicit behaviors ( OR=0.90, 95%CI =0.89-0.91)( P <0.05). Conclusions The characteristics of adolescent health risk behavior classes in the Wuling Mountain Area are obvious. The high risk class of episodic behaviors and the high risk class of implicit behaviors are negatively correlated with school connectedness. Corresponding measures should be taken to enhance adolescents sense of belonging in school and reduce the aggregation and co occurrence of health risk behaviors.

Objective To explore the effect of fluid shear stress on the expression of glucose regulatory protein 78(GRP78)and C/EBP homologous protein(CHOP)in human umbilical vein endothelial cells(HUVECs).Methods HUVECs were used as experimental cells,and a fluid dynamics simulation experimental system was designed and constructed.Different fluid shear stresses were applied to the experimental cells by controlling the flow rate of the perfusion fluid in the experimental system.According to the fluid shear stress experienced by the experimental cells in the experimental system,they were divided into low shear stress group(group A;0.4Pa),medium shear stress group(group B;0.8 Pa)and high shear stress group(group C;1.2 Pa).Each group of HUVECs consisted of 3 cell slides,and each slide was repeatedly circulated through the perfusion solution of the experimental system for 12 h.Western blotting was used to detect the levels of GRP78 and CHOP proteins,and real-time quantitative reverse transcription polymerase chain reaction was used to determine the levels of GRP78 and CHOP and their messenger RNA(mRNA)in each group.GraphPad Prism 8.0 software was used to statistically analyze the data.Results(1)The relative expression levels of GRP78 protein in groups A,B and C were 1.33±0.46,0.93±0.34,0.64±0.30,respectively,the difference among groups was statistically significant(F=36.17,P＜0.05).The relative expression level of GRP78 protein in group A was higher than that in group B and group C(both P＜0.01),and the relative expression level of GRP78 protein in group B was higher than that in group C(P=0.0013).The relative expression levels of CHOP protein in the three groups were 1.29±0.38 in group A,0.90±0.34 in group B,and 0.59±0.29 in group C,the difference among groups was statistically significant(F=41.27,P＜0.05).The relative expression level of CHOP protein in group A was higher than that in group B and group C(both P＜0.01),and the relative expression level of CHOP protein in group B was higher than that in group C(P=0.0 004).(2)The relative expression levels of GRP78 mRNA in groups A,B,and C were 18.3±3.4,11.3±1.8,5.4±2.2,respectively,the difference among groups was statistically significant(F=189.20,P＜0.05).The relative expression level of GRP78 mRNA in group A was higher than that in group B and group C(both P＜0.01),and the relative expression level of GRP78 mRNA in group B was higher than that in group C(P＜0.01).The relative expression levels of CHOP mRNA in the three groups were 20.4±3.8 in group A,14.2±2.1 in group B,and 7.8±1.3 in group C,the difference among groups was statistically significant(F=171.80,P＜0.05).The relative expression level of CHOP mRNA in group A was higher than that in group B and group C(both P＜0.01),and the relative expression level of CHOP mRNA in group B was higher than that in group C(P＜0.01).Conclusion Low fluid shear stress may increase the protein and mRNA expression levels of GRP78 and CHOP in HUVECs.