Objective: To explore the relationship between non suicidal self injury (NSSI) behavior and serum lipid levels as well as thyroid function among college students with depression. Methods: A total of 169 college students with depression in the psychiatry departments of tertiary hospitals (grade 3A and 3B) in Ningbo from December 2023 to April 2025 were selected. The Adolescent Self injury Scale (ASIS) was used to assess the presence of NSSI, and participants were accordingly divided into a NSSI group ( n =51) and a non NSSI group ( n =118). General demographic data (including gender, age, and family situation) were collected from both groups. Blood tests were performed to measure lipid profiles [triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C)] and thyroid hormones [triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH)]. Multivariate Logistic regression was employed to analyze risk factors for NSSI, and receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of serum lipid and thyroid hormone levels for NSSI occurrence in college students with depression. Results: The levels of TC, LDL-C, and TSH in the NSSI group were (4.02±0.73) mmol/L, (2.32±0.36) mmol/L, and (6.57±1.95) mU/L , which were significantly higher than those in the non NSSI group [(3.41±0.56) mmol/L, (2.00±0.27) mmol/L, and ( 4.48± 1.09) mU/L, respectively] ( t =5.32, 5.60, 7.20, all P <0.05). Logistic regression analysis revealed that college students from single parent/reconstituted families, those who had experienced school bullying, and those with higher levels of TC, LDL-C, and TSH had a significantly increased risk of engaging in NSSI ( OR =5.22, 6.12, 5.90, 83.64, 3.64, all P <0.05). ROC curve analysis demonstrated that the combined detection of TC, LDL-C, and TSH had high diagnostic efficacy for predicting NSSI in college students with depression, with a sensitivity of 86.3% and a specificity of 94.9%. Conclusions NSSI behavior in college students with depression is associated with serum lipid levels and thyroid function. These biomarkers may serve as useful reference indicators for assessing the conditions of these patients.

Objective: To explore the impact of adverse childhood experiences (ACEs) on health risk behaviors (HRBs) among college students and the mediating role of psychological symptoms, so as to provide a basis for developing intervention strategies. Methods: From March to April 2023, a convenience cluster sample of 1 801 students from 12 universities in Nanning, Liuzhou, Guilin, Wuzhou of Guangxi completed an online survey. A self designed questionnaire, Adverse Childhood Experiences-International Questionnaire (ACE-IQ) and Symptom Checklist-90 (SCL-90) were used for evaluation tools. Binary Logistic regression, structural equation modeling (SEM) and Bootstrap methods were used to analyze the associations and mediating effects. Results: Overall, 71.2% of college students experienced at least one type of ACE, with emotional neglect (40.3%) and emotional abuse ( 25.2 %) having the highest detection rates. The top three HRBs were unhealthy diet (77.8%), physical inactivity (54.1%), and smoking/alcohol use (18.5%). Logistic regression showed that poor family functioning, abuse, and extra familial violence were each associated with an increased risk of smoking/alcohol use ( OR =1.14, 1.11, 1.18) and deliberate self harm ( OR =1.26, 1.19,1.30) (all P <0.05). Experience of abuse increased the risk of high risk sexual behavior and family dysfunction increaded the risk of physical inactivity, respectively ( OR = 1.07 , 1.04, both P <0.05). Mediation analysis revealed that anxiety ( β =0.20) and depression ( β = 0.09 ) partially mediated the pathway from poor family functioning to deliberate self harm; paranoia ( β =0.02) partially mediated the pathway from abuse to high risk sexual behavior; and obsessive-compulsive symptoms ( β =0.26) and depression ( β =0.10) partially mediated the pathway from extra familial violence to deliberate self harm (all P <0.05). Conclusion Psychological symptoms play a mediating role in the association between ACEs and HRBs, and mental health interventions may reduce the risk of HRBs among college students.

Infectious bone defect,one of the complex and refractory types of bone defects,is characterized by infec-tion,inflammation and subsequent bone tissue destruction.These conditions often lead to severe consequences such as limb necrosis,dysfunction or even amputation.The previous treatment method for infectious bone defect primarily involves thorough debridement and bone grafting after infection control with antibacterial drugs.Howev-er,this method carries drawbacks,including the possibility of drug resistance and systemic toxicity due to high-dose use of antimicrobial drugs.With advancements in modern medicine and in-depth research on biomaterials,va-rious novel antibacterial materials have been increasingly applied in the treatment of infectious bone defect,demon-strating promising outcomes.This paper reviews the applications and therapeutic efficacy of novel antibacterial ma-terials in treating infectious bone defect at home and abroad,aiming to provide references for clinical management.

Objective:To investigate factors influencing 18F-FDG PET/CT SUVmax,T/MB ratio and Ki-67 expression in non-Hodgkin's lymphoma(NHL),to analyze their correlations with lymphoma aggressiveness and their potential advantages in predicting therapeutic efficacy.Methods:A retrospective analysis was conducted to investigate correlations between tumor SUVmax,T/MB ratio,and Ki-67 expression with NHL aggressiveness and clinical characteristics in 99 patients;whether SUVmax,T/MB ratio and Ki-67 served as independent prognostic factors influencing therapeutic efficacy was examined,and potential utility of ΔSUVmax and ΔT/MB as biomarkers for treatment response assessment were evaluated.Results:Aggressive NHL demonstrated significantly higher SUVmax,T/MB ratio and Ki-67 level compared to indolent NHL and aggressive/indolent NHL(P<0.05).A pretreatment SUVmax≥9.05,T/MB≥5.115 or Ki-67≥55%could predict clinical remission in NHL patients post-treatment,while post-treatment reductions of ΔSUVmax≥22.65%or ΔT/MB≥34.85%were associated with achieved clinical remission.Conclusion:SUVmax,T/MB ratio and Ki-67 are closely associated with aggressiveness of NHL,which can be predicted whether NHL will be relieved after treatment.ΔSUVmax and ΔT/MB can assess whether NHL has been relieved after treatment.

Objective::This study aimed to elucidate the effect of the lipopolysaccharides/toll-like receptor 4 (LPS/TLR4) pathway on early atherosclerosis (AS) development and its associated changes in fecal metabolites, thereby providing an experimental foundation for strategies to prevent and treat early AS.Methods::Twelve Tibetan miniature pigs aged 4-5 months were divided into normal control (NC) group and AS group (6 pigs in each). The group assignment was primarily based on body weight; Secondary criteria, including glucose, lipid profiles, and inflammatory indices, were considered to ensure balanced baseline characteristics between the 2 groups (all P > 0.05). AS group received a high-fat diet for 16 weeks to establish an AS model, while the NC group received a normal diet. Subsequently, serum levels of lipids and various inflammation and oxidative stress markers were measured. Pathological changes in the aorta and colon tissue, LPS/TLR4 pathway-associated protein expressions in the aorta, as well as occludin and zonula occludens-1 in the colon were also assessed. Proton nuclear magnetic resonance spectra technology was employed for the metabolomic analysis of fecal extracts. Results::The lipid metabolism was disrupted in AS group, with significantly higher total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol levels ((12.24 ± 5.24) mmol/L vs. (1.86 ± 0.27) mmol/L, P = 0.004,6; (2.39 ± 0.50) mmol/L vs. (0.83 ± 0.07) mmol/L, P = 0.000,5; (6.94 ± 2.87) mmol/L vs. (0.77 ± 0.18) mmol/L, P = 0.003,3), as compared to that in NC group. Serum factors, including LPS, tumor necrosis factor-α, and malondialdehyde levels of AS group were significantly higher than that of NC group ((1,230.00 ± 192.70) EU/L vs. (695.70 ± 213.70) EU/L), P = 0.001,1; (424.20 ± 176.90) ng/L vs. (51.20 ± 26.61) ng/L, P = 0.023,5; (3.60 ± 0.77) nmol/mL vs. (2.62 ± 0.21) nmol/mL, P = 0.025,4). Pathological evaluations revealed prominent lipid deposition area in the aortic arch, thoracic aorta, and abdominal aorta of the AS group compared with that of the NC group (4.17% ± 2.30% vs. 0, P = 0.006,7; 6.23% ± 2.95% vs. 0, P = 0.003,6; 3.78% ± 2.18% vs. 0, P = 0.008,1). TLR4, nuclear factor kappa-B p65, and tumor necrosis factor-α expression in the aorta tissue of the AS group were upregulated, whereas occludin and zonula occludens-1 expression in colon tissues was downregulated. Additionally, metabolomics identified significant differences in 21 metabolites in the feces of the AS group compared to the NC group, with further analysis linking these differences to amino acid metabolism. Conclusions::The Tibetan miniature pig model of early AS induced by high-fat intake displayed pronounced chronic inflammation. Preliminary findings suggest that the underlying mechanisms may be associated with the LPS/TLR4 pathway and intestinal metabolic disorders.

Objective To evaluate the effectiveness of therapeutic dentures with flat tables in edentulous patients with neuromuscular dysfunction.Methods Thirteen edentulous patients with neuromuscular dysfunction participated in this study.Initially,conventional complete dentures were fabricated using the biofunctional prosthetic system(BPS)method and delivered to the patients.The satisfaction questionnaire and oral health-related quality of life(OHRQoL)were assessed on the day of delivery and again two weeks later.The pa-tients whose grades of over-all satisfactory fewer than 8 were participated in neuromuscular training with therapeutic dentures.Subse-quently,4 mm of the occlusal surfaces of the mandibular artificial posterior teeth were removed to create flat tables.Once the mandibu-lar position was stabilized,new mandibular denture was fabricated and the same assessments were conducted on the day of delivery.Results In edentulous patients with neuromuscular dysfunction,there were no significant improvements in satisfaction,or OHRQoL on the day of delivery or two weeks later.However,significant improvements in satisfaction and OHRQoL were observed after the defin-itive dentures delivered following neuromuscular training(P＜0.05).Conclusion Thetherapeutic dentures with flat tables can improve the neuromuscular function in edentulous patients with neuromuscular dysfunction,significantly increasing their satisfaction in the den-tures,while also enhancing their quality of life.

Objective To investigate the mediating role of anxiety and depression in social sup-port and burnout among primary caregivers of stroke patients.Methods A convenience sampling method was employed to select 506 primary caregivers of stroke patients as research subjects.The Gen-eral Information Questionnaire,Caregiver Burnout Inventory for Stroke Patients,Multidimensional Scale of Perceived Social Support,and Hospital Anxiety and Depression Scale were used for data col-lection.Results The total scores for caregiver burnout,social support,anxiety,and depression a-mong primarycaregivers of stroke patients were(72.83±14.32),(47.79±7.74),(10.49±3.00),and(10.45±3.06),respectively.Correlation analysis revealed a negative correlation between caregiver burnout and social support(r=-0.245,P＜0.001),and positive correlations with anxiety and depression(r=0.178,0.216,P＜0.001).Anxiety and depression partially media-ted the relationship between social support and caregiver burnout,accounting for 7.9％and 10.7％of the total effect,respectively.Conclusion Social support,anxiety,depression,and burnout are closely interrelated.Social support can directly or indirectly influence the occurrence of burnoutthrough anxiety and depression.Medical staff should pay attention to the anxiety and depression status of primary caregivers of stroke patients and enhance social support levels to reduce the incidence of burnout by alleviating anxiety and depression.

Objective To explore correlations of expression levels of microRNA-147(miR-147),Ki-67 and carcinoembryonic antigen(CEA)with lymph node metastasis of invasive lung adenocarci-noma.Methods A total of 160 patients with invasive pulmonary adenocarcinoma were selected as study subjects.Based on presence of lymph node metastasis,patients were divided into lymph node metastasis group(n=74)and non-lymph node metastasis group(n=86).Immunohistochemistry was employed to detect the expression levels of miR-147 and Ki-67 in cancer tissues.The serum CEA level was measured using the chemiluminescence method.The correlations of the expression levels of miR-147,Ki-67 and serum CEA with the clinicopathological characteristics of patients were analyzed.The value of miR-147,Ki-67 and CEA in predicting lymph node metastasis was evaluated using the receiver operating characteristic(ROC)curve.Results The expression level of miR-147 in the lymph node metastasis group was significantly lower than that in the non-lymph node metastasis group,while the expression levels of Ki-67 and serum CEA were significantly higher in the lymph node me-tastasis group than in the non-lymph node metastasis group(P＜0.05).Patients with a tumor diameter≥3 cm or TNM stage Ⅲ to Ⅳ had significantly lower miR-147 expression levels in cancer tissues compared to those with a tumor diameter＜3 cm or TNM stage Ⅰ to Ⅱ(P＜0.05).The Ki-67 ex-pression level in cancer tissues was significantly higher in patients with a tumor diameter ≥3 cm than in those with a tumor diameter＜3 cm(P＜0.05).The serum CEA level was significantly higher in patients with TNM stage Ⅲ to Ⅳ than in those with TNM stage Ⅰ to Ⅱ(P＜0.05).The expres-sion level of miR-147 was negatively correlated with Ki-67,serum CEA and lymph node metastasis(P＜0.05);Ki-67 and serum CEA were positively correlated with lymph node metastasis(P＜0.05);Ki-67 was positively correlated with serum CEA(P＜0.05).The areas under the ROC curves for miR-147,Ki-67 and CEA in predicting lymph node metastasis were 0.785,0.835 and 0.798,respectively(P＜0.05).Conclusion The expression levels of miR-147 and Ki-67 in cancer tissues and the serum CEA level are correlated with lymph node metastasis in invasive pulmo-nary adenocarcinoma.

Objective To investigate the value of carotid ultrasonographic lesion indices in predicting coronary artery stenosis in patients with essential hypertension,and to analyze their correlation with the degree of coronary artery stenosis.Methods A total of 4 691 patients diagnosed with essential hypertension who visited our cardiac center between January 2020 and September 2023 were included in this study.All the patients underwent carotid ultrasound exam and coronary angiography.Their baseline clinical data were collected,and the severity of coronary artery stenosis was quantified using the Gensini score.Carotid ultrasound parameters,including resistance index(RI),pulsatility index(PI),intima-media thickness(IMT),intimal thickening,plaque formation and luminal stenosis,were evaluated in detail.To control for potential confounders,six multivariate Logistic regression models were constructed to analyze the stratified data on carotid artery lesions.Results Pearson correlation analysis revealed significant positive correlations of PI,RI and IMT with the Gensini score of coronary artery stenosis in hypertensive patients(left PI:r=0.041,P=0.005;right PI:r=0.035,P=0.017;left RI:r=0.119,P＜0.001;right RI:r=0.032,P=0.027;IMT:r=0.043,P=0.003).Multivariate Logistic regression analysis indicated that carotid plaque formation and stenosis were significantly associated with an increased risk of coronary artery disease(CAD)in hypertensive patients(P＜0.001),while intimal thickening was associated with a significantly decreased risk of CAD(P=0.009).Model 2 adjusted for sex,age,educational level,smoking history,systolic blood pressure,and other variables,while Model 3 further adjusted for blood parameters,including white blood cell count,creatinine,and lipid profiles.Stratified analysis of carotid artery lesions showed that intimal thickening combined with plaque formation(Model 5)and plaque formation combined with stenosis(Model 6)were significantly associated with an increased risk of CAD(P＜0.001).In contrast,the difference in patients with only intimal thickening(Model 4)was not statistically significant(P=0.127).Conclusion Carotid ultrasound lesion characteristics are strongly associated with the risk of coronary artery stenosis in patients with essential hypertension,and carotid artery lesions can be used as a useful tool to assess the risk of coronary artery disease in hypertensive patients.

Blonanserin,a second-generation atypical antipsychotic agent,acts as an antagonist for dopamine D2,D3,and serotonin 5-HT2A receptors.Clinical studies have demonstrated that blonanserin is non-inferior to other antipsychotics,such as haloperidol and risperidone,in alleviating the symptoms of schizophrenia.Moreover,it exhib-its beneficial effects on cognitive symptoms and social functioning,with a favorable safety profile,making it one of the key treatment options for schizophrenia.With extensive clinical experience accumulated in China,this expert consensus aims to provide psychiatrists with updated and localized guidance on the optimal use of blonan-serin.Based on a systematic review of the latest evidence-particularly studies in Chinese population,this paper pres-ents the updated Chinese expert recommendations for the clinical use of blonanserin in 2024.