ObjectiveTo investigate the imaging features of calcium salt deposition and serological markers in patients with alveolar echinococcosis through a retrospective analysis， as well as independent risk factors for the degree of calcium salt deposition in lesions， and to provide a basis for assessing disease process. MethodsA retrospective analysis was performed for the imaging and clinical data of 107 patients with alveolar echinococcosis who were admitted to The First Affiliated Hospital of Shihezi University from December 2023 to June 2025， and according to the volume of calcium salt deposition， they were divided into non-deposition group with 16 patients， mild deposition group with 52 patients， moderate deposition group with 16 patients， and severe deposition group with 23 patients. A one-way analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between groups， and the χ² test or Fisher’s exact test was used for comparison of categorical data between groups. The four groups were further combined into the low deposition group （no/mild deposition） and the high deposition group （moderate/severe deposition）. A binary logistic regression analysis was used to investigate the independent influencing factors for calcium salt deposition， and a predictive model was established. The receiver operating characteristic （ROC） curve was used to assess the predictive performance of the model， and the Bootstrap method was used for internal validation. ResultsThere were significant differences between the four groups in sex distribution， involvement of other sites， white blood cell count， lymphocyte percentage， fibrinogen， uric acid， sodium ion， chloride ion， and calcium ion （all P<0.05）. The univariate analysis showed that there were significant differences between the four groups in sex， involvement of other sites， white blood cell count， lymphocyte percentage， fibrinogen， alanine aminotransferase， albumin， creatinine， uric acid， sodium ion， chloride ion， and calcium ion （all P<0.1）. The multi-collinearity diagnosis showed that the VIF values for all continuous variables ranged from 1.104 to 1.760， suggesting that collinearity did not affect modeling. An ordinal logistic regression model was established based on sex， involvement of other sites， calcium ion， lymphocyte percentage， and uric acid. The multivariate analysis showed that lymphocyte percentage （odds ratio ［OR］=1.106， 95% confidence interval ［CI］： 1.041 — 1.174， P=0.001） and blood calcium level （OR=0.005， 95%CI： 0.000 —0.230， P=0.007） were independent influencing factors for the degree of calcium salt deposition. The regression equation was established as Logit（P）=8.231 + 0.100 × lymphocyte percentage -5.344 × calcium ion. The ROC curve analysis showed that the model had an area under the ROC curve of 0.716， with a Youden index of 0.353， a sensitivity of 1.000， and a specificity of 0.353. The Hosmer-Lemeshow test showed that the model had poor calibration （χ²=20.688， P=0.008）. The Bootstrap method with 1000 repeated samples showed that the estimated values of lymphocyte percentage （OR=1.106， 95%CI： 1.049 — 1.186， P=0.002） and calcium ion （OR=0.005， 95%CI： 0.000 — 0.214， P=0.010） were consistent with the original model， and the confidence intervals did not include 1， which further supported the reliability of the model. ConclusionBoth lymphocyte percentage and blood calcium level are independent influencing factors for calcium salt deposition in alveolar echinococcosis， and the degree of calcium salt deposition in alveolar echinococcosis lesions increases with the reduction in blood calcium level and the increase in lymphocyte percentage.

Objective: To explore the association between nap duration with anxiety and depressive symptoms among junior high school students, in order to provide evidence for mental health interventions for adolescents. Methods: From May to June 2022, a combination of convenience sampling and cluster sampling was used to select 2 491 students from 2 junior high schools in Haizhu District, Guangzhou City for questionnaire survey and physical examination. The questionnaire collected nap duration, night time sleep duration, bedtime, physical activity, and sedentary behavior. Anxiety and depressive symptoms were assessed using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. Log-binomial regression model was used to analyze the association of nap duration with anxiety and depressive symptoms, as well as comorbidity among junior high school students, and a restricted cubic spline (RCS) Log-binomial regression model was employed to analyze the non linear relationship after adjusting for covariates. Results: The detection rates of anxiety symptoms, depressive symptoms and comorbidity among junior high school students were 13.29%,14.65%,9.19%. After adjusting for covariates such as age, gender and nighttime sleep duration, compared with a school day nap duration of <30 min/d, a nap duration of 30-<60 min/d was associated with a reduced risk of anxiety symptoms ( APR =0.68, 95% CI =0.49-0.98) and comorbidity ( APR =0.56, 95% CI =0.39-0.87)(both P < 0.05 ). Compared with no napping on weekends, a nap duration of 30-<60 min/d was associated with a reduced risk of anxiety symptoms ( APR =0.62, 95% CI =0.41-0.88), depressive symptoms ( APR =0.52, 95% CI =0.34-0.75) and comorbidity ( APR = 0.52 , 95% CI =0.30-0.83)(all P <0.05). RCS curves showed a nonlinear relationship between weekend nap duration and the prevalence of anxiety, depressive symptoms and comorbidity among junior high school students(all P non linear <0.05); weekend nap duration of <120 min was associated with a lower risk of anxiety and depressive symptoms, and weekend nap duration of >180 min was associated with an increased risk. Conclusions Appropriate nap duration can help reduce the risk of anxiety, depressive symptoms, and the comorbidity among junior high school students. Adolescents should be guided to reasonably arrange nap duration for promoting physical and mental health.

Background Platelet parameters are important indicators of cardiovascular risk, and environmental pollutants such as polychlorinated biphenyls (PCBs) may impair platelet function through oxidative stress. Objective To investigate the differential effects of single and mixed exposure to PCBs on platelet parameters among individuals with normal glucose tolerance (NGT), impaired fasting glucose (IFG), and type 2 diabetes mellitus (T2DM), and to evaluate the potential modifying role of a healthy lifestyle. Methods This study included 2249 participants (including 707 with NGT, 759 with IFG, and 783 with T2DM). Plasma PCB concentrations were measured using triple quadrupole gaschromatography-tandem mass spectrometry. Generalized linear regression was used to assess the associations between individual PCB congeners and platelet parameters. Quantile g-computation (QGC) and Bayesian kernel machine regression (BKMR) models were used to evaluate the overall effects of PCBs mixture exposure on platelet parameters across different glycemic states, as well as its interaction with healthy lifestyle score (HLS). Results Generalized linear regression analyses showed significant differences in the effects of PCBs on platelet parameters across different glycemic states (P<0.05). After adjusting for confounders, PCBs mixture exposure was significantly associated with lower platelet counts (PLT) in individuals with NGT (b=−10.60, 95%CI: −16.48, −4.71) and IFG (b=−12.91, 95%CI: −18.90, −6.92), whereas no significant association was observed in individuals with T2DM (P=0.051). Mean platelet volume (MPV) and platelet-large cell ratio (P-LCR) increased significantly with higher PCBs exposure levels across all three groups (P<0.05). BKMR analysis showed a positive association between PCBs mixture exposure and P-LCR, with the strongest association observed in the NGT group. Furthermore, a significant interaction was observed between HLS and PCBs mixture exposure, and a higher HLS attenuated the effects of PCBs on P-LCR. Conclusion Glycemic glycemic states may modify the effects of PCBs on platelets. Individuals with NGT appear more sensitive to PCBs exposure, whereas the T2DM state may attenuate this effect. Moreover, healthy lifestyles, including not smoking, moderate alcohol consumption, maintaining moderate-to-high physical activity, a healthy diet, and an appropriate body mass index (BMI), may mitigate the adverse effects of most PCBs on platelet parameters.

Background Platelet parameters are important indicators of cardiovascular risk, and environmental pollutants such as polychlorinated biphenyls (PCBs) may impair platelet function through oxidative stress. Objective To investigate the differential effects of single and mixed exposure to PCBs on platelet parameters among individuals with normal glucose tolerance (NGT), impaired fasting glucose (IFG), and type 2 diabetes mellitus (T2DM), and to evaluate the potential modifying role of a healthy lifestyle. Methods This study included 2249 participants (including 707 with NGT, 759 with IFG, and 783 with T2DM). Plasma PCB concentrations were measured using triple quadrupole gaschromatography-tandem mass spectrometry. Generalized linear regression was used to assess the associations between individual PCB congeners and platelet parameters. Quantile g-computation (QGC) and Bayesian kernel machine regression (BKMR) models were used to evaluate the overall effects of PCBs mixture exposure on platelet parameters across different glycemic states, as well as its interaction with healthy lifestyle score (HLS). Results Generalized linear regression analyses showed significant differences in the effects of PCBs on platelet parameters across different glycemic states (P<0.05). After adjusting for confounders, PCBs mixture exposure was significantly associated with lower platelet counts (PLT) in individuals with NGT (b=−10.60, 95%CI: −16.48, −4.71) and IFG (b=−12.91, 95%CI: −18.90, −6.92), whereas no significant association was observed in individuals with T2DM (P=0.051). Mean platelet volume (MPV) and platelet-large cell ratio (P-LCR) increased significantly with higher PCBs exposure levels across all three groups (P<0.05). BKMR analysis showed a positive association between PCBs mixture exposure and P-LCR, with the strongest association observed in the NGT group. Furthermore, a significant interaction was observed between HLS and PCBs mixture exposure, and a higher HLS attenuated the effects of PCBs on P-LCR. Conclusion Glycemic glycemic states may modify the effects of PCBs on platelets. Individuals with NGT appear more sensitive to PCBs exposure, whereas the T2DM state may attenuate this effect. Moreover, healthy lifestyles, including not smoking, moderate alcohol consumption, maintaining moderate-to-high physical activity, a healthy diet, and an appropriate body mass index (BMI), may mitigate the adverse effects of most PCBs on platelet parameters.

[摘 要] 目的：探讨m6A调控因子在宫颈癌预后评估、免疫微环境特征及治疗反应中的作用，构建基于m6A调控因子的预后风险模型，并分析其与免疫浸润、药物敏感性及细胞间通信的关系。方法：基于TCGA和GEO数据库中宫颈鳞癌及腺癌（CESC）转录组数据，分析22个m6A调控因子的表达与突变情况；采用LASSO‑Cox回归构建m6A相关预后风险模型，并依据风险评分将患者分为高、低风险组。利用CIBERSORT和ESTIMATE算法评估两组免疫细胞浸润及微环境特征；通过oncoPredict预测抗肿瘤药物敏感性。整合单细胞转录组数据（E-MTAB-12305），采用CellChat分析细胞间通信网络。结果：共鉴定出12个在宫颈癌中差异表达的m6A调控因子。高风险组患者总生存期缩短（P < 0.05），免疫评分降低，且对紫杉醇、氟尿嘧啶、多柔比星等抗肿瘤药物敏感性较差（IC50较高）。单细胞分析显示宫颈癌组织中细胞间通信网络发生改变，其中T细胞与内皮/上皮细胞间的相互作用可能主要由CCL5‑ACKR1和MIF‑（CD74 + CXCR4）配体‑受体介导。在临床样本中，对关键的m6A调控因子进行mRNA和蛋白水平的验证，结果显示部分调控因子在宫颈癌组织中的表达水平高于正常宫颈组织（P < 0.05）。结论：m6A调控因子特征可有效预测宫颈癌患者预后，其风险评分与肿瘤免疫浸润、药物敏感性及细胞通信密切相关，为宫颈癌的预后分层及个体化治疗提供了新的分子依据。

Lung cancer constitutes the most prevalent and lethal malignant tumor in China. Approximately 85% of lung cancer diagnoses correspond to the non-small cell histological subtype [non-small cell lung cancer (NSCLC)]. Despite surgery being the mainstay for early-stage disease, postoperative recurrence remains high and adjuvant chemotherapy offers limited benefit. In recent years, targeted therapy has demonstrated substantial advantages in driver mutation-positive NSCLC. To this end, the Lung Cancer Medical Education Committee of the Chinese Medical Education Association developed guidelines based on a systematic review of evidence through November 2025, using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach and a modified Delphi method. Focusing on epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), and addressing ROS proto-oncogene 1 (ROS1), B-Raf proto-oncogene serine/threonine kinase (BRAF) V600E mutation, and mesenchymal-epithelial transition factor (MET) exon 14 (METex14) skipping, the guideline covers molecular testing, neoadjuvant/adjuvant therapy, perioperative strategies, minimal residual disease monitoring, and postoperative surveillance. It defines testing requirements, specifies stage-directed and subtype-specific treatments, and standardizes minimal residual disease monitoring. These recommendations emphasize precision and feasibility to improve survival and quality of life.

Objective: To analyze the factors affecting direct-acting antiviral (DAA) therapy among cases with hepatitis C virus (HCV) infection in Zhejiang Province, so as to provide evidence for optimizing local HCV prevention and treatment strategies and improving DAA treatment coverage. Methods: Eight counties (cities, districts) in Zhejiang Province were selected as survey sites. Consecutive sampling was used to enroll HCV cases reported from November 2022 to June 2024. Demographic information, diagnosis and treatment status, DAA therapy, and awareness of relevant medical insurance policies were collected through questionnaire surveys. Factors affecting DAA therapy among cases with HCV infection were analyzed using a multivariable logistic regression model. Results: A total of 412 questionnaires were distributed, and 404 valid questionnaires were collected, with an effective rate of 98.06%. There were 291 males (72.03%) and 113 females (27.97%). The median age was 49.00 (interquartile range, 11.00) years. A total of 303 cases received DAA therapy, with a proportion of 75.00%. Multivariable logistic regression analysis showed that HCV cases aged 40-<50 years (OR=3.469, 95%CI: 1.228-9.345) and with per capita monthly household income >3 000 yuan (>3 000-5 000 yuan, OR=3.198, 95%CI: 1.597-6.403; >5 000 yuan, OR=5.391, 95%CI: 2.230-13.033) had higher likelihood of receiving DAA therapy. HCV cases diagnosed in non-infectious disease departments (OR=0.334, 95%CI: 0.173-0.643), concerned about economic burden of DAA therapy (OR=0.309, 95%CI: 0.160-0.599), and unaware of HCV payment policy by disease type (OR=0.262, 95%CI: 0.111-0.622) had lower likelihood of receiving DAA therapy. Conclusions The proportion of DAA therapy among cases with HCV infection in Zhejiang Province is relatively high. Age, per capita monthly household income, department of diagnosis, concerns about DAA therapy, and medical insurance/payment policies are factors influencing DAA therapy among cases with HCV infection.

Objective:To investigate the dynamic changes of plasma high-mobility group box 1 (HMGB1) and its correlation with functional outcome and symptomatic intracranial hemorrhage (sICH) after endovascular treatment (EVT) in patients with acute large vessel occlusion stroke (ALVOS).Methods:Patients with ALVOS admitted to the Department of Neurology, Zengcheng District, Nanfang Hospital, Southern Medical University from June 2021 to April 2023 were included retrospectively. Plasma HMGB1 before EVT and at 6, 24, and 48 hours after procedure was detected, and the dynamic changes of plasma HMGB1 were compared and analyzed. The primary endpoint was the functional outcome evaluated using the modified Rankin Scale at 90 days of onset. A score of 0-2 was defined as good outcome and >2 was defined as poor outcome. The secondary endpoint was sICH, which was defined as the occurrence of hemorrhagic infarction after EVT and an increase of ≥4 in the National Institutes of Health Stroke Scale (NIHSS) score from baseline. Multivariate logistic regression analysis was used to evaluate the predictive value of HMGB1 for poor outcome and sICH. Results:A total of 73 patients with ALVOS received EVT were included. There were 54 males (74.0%), aged 62±12 years. The median time from onset to door was 90 minutes (interquartile range, 40-180 minutes), and the median time from onset to femoral artery puncture was 181 minutes (interquartile range, 140-280 minutes). Twenty-nine patients (39.7%) underwent bridging intravenous thrombolysis (IVT). At 90 days after onset, 37 patients (50.7%) had poor outcome, and 12 (16.4%) died during follow-up. Eleven patients (15.1%) developed sICH. After EVT, plasma HMGB1 showed a temporal increase, reaching its peak at 48 hours (median, 102.57 μg/L). Subgroup analysis showed that HMGB1 in the bridging IVT group at 6 hours ( P<0.05) and 24 hours ( P<0.05) after procedure were significantly higher than that at baseline. The non-bridging IVT group showed a significant increase at 6 hours after procedure ( P<0.05). There was no statistically significant difference in HMGB1 between the bridging IVT group and the non-bridging IVT group at the same time point. Multivariate logistic regression analysis showed that after adjusting for age, ischemic heart disease, triglycerides, uric acid, baseline NIHSS score, and sICH, the third quartile (adjusted odds ratio 7.087, 95% confidence interval 1.243-40.419; P=0.027) and fourth quartile (adjusted odds ratio 7.544, 95% confidence interval 1.260-45.172; P=0.027) of plasma HMGB1 were independent risk factors for poor outcome at 6 hours after procedure. The postoperative plasma HMGB1 in the sICH group was significantly higher than that in the non-sICH group ( P<0.05), but multivariate analysis showed no independent correlation between plasma HMGB1 and sICH. Conclusion:The elevation of plasma HMGB1 in patients with ALVOS at 6 hours after EVT is independently associated with poor outcome at 90 days after onset, but not with sICH.

Background and aims:Metabolic dysfunction-associated fatty liver disease(MAFLD)is a common chronic condition that can lead to cancer due to its complex pathogenesis.Therapeutic agents targeting AMP-activated protein kinase(AMPK)activation have been suggested as potential treatments for metabolic disorders such as metabolic dysfunction-associated steatohepatitis(MASH).Rhizoma Atractylodis Mac-rocephalae(RAM)has been clinically used to treat obesity-related health problems,but its therapeutic effects on MAFLD and the underlying mechanism remain unclear.Therefore,this study was conducted to evaluate the function and underlying mechanism of RAM in the treatment of MAFLD.Methods:The effect of RAM decoction on MAFLD was evaluated using a high-fat diet(HFD)-induced MAFLD mouse model.In vitro studies were conducted using a palmitic acid/oleic acid-induced lipid accumulation model in the alpha mouse liver 12 cells and RAM-containing serum.The underlying mechanisms were elucidated through a combination of network pharmacology analysis,immunohis-tochemistry,western blotting,and polymerase chain reaction analysis.Results:Administration of RAM decoction significantly reduced body weight gain in MAFLD mice without changing food intake.The weights of the liver and inguinal adipose tissues were also reduced after RAM treatment.Additionally,RAM administration decreased serum levels of alanine aminotrans-ferase,aspartate transaminase,total cholesterol,triglyceride,low-density lipoprotein cholesterol,and glucose,while reducing lipid droplet accumulation in the liver tissues of MAFLD mice.The underlying mechanisms included the activation of the phosphorylation of AMPK and acetyl-CoA carboxylase(ACC),and inhibition of the expression of sterol regulatory element binding protein 1(SREBP1).However,RAM did not alter the protein expression levels of peroxisome proliferator-activated receptor α and carnitine palmitoyltransferase-1α.Furthermore,the RAM-induced upregulation of phosphorylated AMPK,phos-phorylated ACC,and SREBP1 expression,as well as the downregulation of fatty acid synthase expression,were reversed by using an AMPK inhibitor.Conclusions:Through a combination of network pharmacology and experimental validation,we demonstrated that RAM may exert therapeutic effects on MAFLD by inhibiting lipid synthesis and activating phosphorylated AMPK pathways.

Objective To investigate whether transcutaneous electrical acupoint stimulation(TEAS)can improve the muscle strength,endurance and work efficiency of calf muscles in healthy young men,aiming to explore a new method for preventing and combating microgravity-induced muscle atrophy in space environments.Methods 40 healthy young men aged 18-35 years were randomly divided into a Control group(Pseudo Transcutaneous Electrical Acupoint Stimulation)and a Experimental group(Transcutaneous Electrical Acupoint Stimulation)in a 1∶1 ratio,with 20 participants in each group.In the Control group,the indicator light of the stimulator was covered,and the device was turned on,but the electrodes did not contact the skin,The device automatically turned offafter 3 seconds.In the Experimental group,the TEAS device was connected to the current and TEAS intervention was performed.The electrical stimulation waveform was a sperse-dense wave with a frequency of 4/20 Hz,and the intensity was determined by patient tolerance.The acupoints selected for electrical stimulation in both groups were bilateral Zusanli(ST36)、Liangqiu(ST34),Taixi(KI3),and Fuliu(KI7).Zusanli and Liangqiu were paired,and Taixi and Fuliu were paired.The intervention frequency was 30 min/time,1 time/day,6 days/week,for 2 weeks.The relative peak torque at 60°/s,relative peak torque at 180°/s,and average power at 180°/s of the bilateral calf muscles were measured using an isokinetic dynamometer at 0th,7th,and 14d day of the experiment.Results After 1 week of TEAS,compared with Control group,there were no significant changes in the relative peak torque at 60°/s,relative peak torque at 180°/s and average power at 180°/s of the bilateral anterior calf muscles in the Experimental group(all P>0.05);however,compared with Control group,the relative peak torque at 60°/s and the relative peak torque at 180°/s of the bilateral posterior calf muscles in the Experimental group were significantly increased(all P<0.05).After 2 weeks TEAS;compared with the Control group,there were no significant changes in the relative peak torque at 60°/s,relative peak torque at 180°/s and average power at 180°/s of the bilateral anterior calf muscles in the Experimental group(all P>0.05);however,the relative peak torque at 60°/s,relative peak torque at 180°/s,and average power at 180°/s of the bilateral posterior calf muscles were significantly increased in the Experimental group(all P<0.05).Conclusion TEAS of Zusanli,Liangqiu,Fuliu and Taixi acupoints on the lower limbs for 2 weeks can effectively improve the maximum muscle strength,endurance and work efficiency of the posterior calf muscles in healthy young men.