Abstract Mental health problems in adolescents often emerge alongside incidents of peer bullying, negatively affecting their development. In order to develop intervention measures for peer bullying among Chinese adolescents, the article elaborates on the current research progress in the theoretical basis, evidence based approaches, and practical models of peer bullying intervention, summarizes strengths and limitations of existing approaches, and proposes future research directions for intervention, with the aim of preventing and reducing peer bullying and creating a favorable environment for the healthy adolescent develpment.

Acute esophagogastric variceal bleeding （AEGVB） is one of the life-threatening complications of decompensated cirrhosis. Endoscopy is the main method for the diagnosis and treatment of AEGVB， and endoscopic treatment can effectively control acute bleeding and alleviate or eliminate varices. However， there is still a lack of consistent recommendations for the timing of endoscopic examination and intervention for AEGVB in related guidelines in China and globally. Existing studies in China and globally have low quality of evidence， with significant variations in the definition of “early endoscopy” and inconsistent conclusions. This article reviews the research advances in the timing of endoscopic treatment for AEGVB in liver cirrhosis， points out the controversies over the optimal timing of treatment， and discusses future research directions in this field.

Objective:To analyze the current status and trend of the mortality burden of cardiovascular disease in China from 2010 to 2021.Methods:Data related to cardiovascular disease mortality and disability-adjusted life year (DALY) were extracted from the Global Burden of Disease Study 2021 (GBD2021) database. The age-standardized mortality rate and DALY rate were calculated, using the 2021 world standard population estimated by GBD2021. Joinpoint 5.2.0 software was used to calculate the mortality rate, standardized mortality rate, DALY rate, standardized DALY rate, annual percent change (APC), average annual percent change (AAPC), and 95% CI of cardiovascular disease in China from 2010 to 2021. Results:The mortality rate of cardiovascular disease was 357.44/100 000, and the age-standardized mortality rate was 280.11/100 000 in China in 2021. The DALY rate was 7 043.33/100 000, and the age-standardized DALY rate was 5 120.06/100 000. From 2010 to 2021, the mortality rate and DALY rate of cardiovascular disease in China showed an upward trend (AAPC was 1.58% and 0.83%, respectively, both P<0.05), and the standardized mortality rate and standardized DALY rate showed a downward trend (AAPC was -2.13% and -2.02%, respectively, both P<0.05). The mortality burden of cardiovascular disease was higher in males (mortality rate 392.80/100 000, DALY rate 8 156.19/100 000) than in females (mortality rate 320.38/100 000, DALY rate 5 876.87/100 000). With the increase older in age, the mortality burden of cardiovascular disease in China decreased first and then increased. China ranked high in the mortality burden of cardiovascular disease among G20 member countries. Conclusions:The death burden of cardiovascular disease is serious in China. The mortality rate and DALY rate of cardiovascular disease in China showed an increasing trend from 2010 to 2021, and the standardized mortality rate and standardized DALY rate of cardiovascular disease ranked high in G20 member countries. The death burden of cardiovascular disease was more serious in men and the elderly. It is necessary to develop more comprehensive prevention, treatment, and rehabilitation measures for men and the elderly to reduce mortality and disability rates, decrease the disease burden, and improve the quality of life.

Objective:To investigate the status quo of the salary status of Guangxi's village doctors under the background of the implementation of"Employed by Townships and Work in the Villages"Policy.Methods:A total of 142 village doctors'salary data were obtained and sorted out through field investigation.Village doctors'salary level was analyzed with Chi-square test,rank test and correlation analysis.Results:More than 70%of village doctors'annual salary in the surveyed counties exceeded 50 000 yuan.Performance allowance is the main component of village doctors'annual salary.There are differences between the implementation number of"Employed by Townships and Work in the Villages"Policy and village doctors'annual salary level in different urban areas(P＜0.05).The village doctors'service population was positively correlated with the allowance of basic public health service,the general medical service population and the annual salary level(P＜0.05).Conclusion:Under the"Employed by Townships and Work in the Villages"Policy,the salary level of Guangxi's village doctors has been improved,and the salary component could be further optimized.It is suggest that the"Employed by Townships and Work in the Villages"Policy should be promoted in accordance with the economic development conditions of different urban areas,the income standards that match village doctors'academic,professional ranks,professional qualifications and working years,and the performance evaluation standards linked to village doctors'subsidy standards should be improved.

Objective:To analyze the current status and trend of the mortality burden of cardiovascular disease in China from 2010 to 2021.Methods:Data related to cardiovascular disease mortality and disability-adjusted life year (DALY) were extracted from the Global Burden of Disease Study 2021 (GBD2021) database. The age-standardized mortality rate and DALY rate were calculated, using the 2021 world standard population estimated by GBD2021. Joinpoint 5.2.0 software was used to calculate the mortality rate, standardized mortality rate, DALY rate, standardized DALY rate, annual percent change (APC), average annual percent change (AAPC), and 95% CI of cardiovascular disease in China from 2010 to 2021. Results:The mortality rate of cardiovascular disease was 357.44/100 000, and the age-standardized mortality rate was 280.11/100 000 in China in 2021. The DALY rate was 7 043.33/100 000, and the age-standardized DALY rate was 5 120.06/100 000. From 2010 to 2021, the mortality rate and DALY rate of cardiovascular disease in China showed an upward trend (AAPC was 1.58% and 0.83%, respectively, both P<0.05), and the standardized mortality rate and standardized DALY rate showed a downward trend (AAPC was -2.13% and -2.02%, respectively, both P<0.05). The mortality burden of cardiovascular disease was higher in males (mortality rate 392.80/100 000, DALY rate 8 156.19/100 000) than in females (mortality rate 320.38/100 000, DALY rate 5 876.87/100 000). With the increase older in age, the mortality burden of cardiovascular disease in China decreased first and then increased. China ranked high in the mortality burden of cardiovascular disease among G20 member countries. Conclusions:The death burden of cardiovascular disease is serious in China. The mortality rate and DALY rate of cardiovascular disease in China showed an increasing trend from 2010 to 2021, and the standardized mortality rate and standardized DALY rate of cardiovascular disease ranked high in G20 member countries. The death burden of cardiovascular disease was more serious in men and the elderly. It is necessary to develop more comprehensive prevention, treatment, and rehabilitation measures for men and the elderly to reduce mortality and disability rates, decrease the disease burden, and improve the quality of life.

Objective:To analyze the application of antitoxin therapy in severe infant botulism.Methods:A retrospective analysis was conducted on 14 cases of severe infant botulism treated at 3 pediatric medical centers from July 2020 to August 2024. This study investigated antitoxin dosage, treatment duration, discontinuation criteria and adverse reactions.Results:A total of 14 cases (12 males and 2 females) were included, with an age of 5.0 (3.8, 7.0) months. Botulinum toxin typing revealed 10 cases of Type B, 2 cases of Type A and 2 untyped cases. The interval from symptom onset to antitoxin administration was 9.0 (6.0, 11.5) d. The initial dosage of type A antitoxin was 12 500 (10 000, 22 500) U, while type B was 5 000 (5 000, 5 000) U. The dosage was tapered in some cases after symptom improvement, the duration of treatment was 16.5 (9.8, 25.3) d. In total, 11 infants discontinued medications after improvement in muscle strength, while 3 infants discontinued treatment after obtaining negative results from fecal mouse bioassays. Adverse events were reported in 2 cases, both of which resulted in rash, and 1 case was complicated with anaphylactic shock. All the patients survived upon discharge with a follow-up period of 11 d to 3 years and 8 months. Totally 12 infants had fully recovered, while 2 infants were still recovering after discharge.Conclusion:Antitoxin therapy is a feasible and safe approach which showed favorable prognosis in severe infant botulism.

Objective To observe the effects of Yitangkang on brown fat thermogenesis and mitochondrial biogenesis of PGC1α-NRF1/2-TFAM pathway in db/db mice;To explore its mechanism of regulating glucose and lipid metabolism.Methods Totally 27 six-week-old db/db mice were randomly divided into model group,Yitangkang group(30 g/kg)and liraglutide group(200 μg/kg),another 9 db/m mice of the same age were set as normal group.All groups received intervention with drugs or saline for 6 weeks.The body mass and FBG were measured weekly.After intervention,oral glucose tolerance test(OGTT)was carried out,the contents of serum TC,TG,LDL-C and HDL-C were detected by biochemical analyzer,HE staining was used to observe the morphology of brown adipose tissue(BAT)in scapular region,RT-qPCR and Western blot were used to detect the expressions of UCP1,PRDM16,PGC1α related to BAT thermogenesis and NRF1,Nrf2,TFAM related to mitochondrial biogenesis.Results Compared with the normal group,the body mass,FBG,area under the curve of OGTT and serum TG,TC,LDL-C content of model group significantly increased(P<0.01),the content of HDL-C significantly decreased(P<0.01);the diameter of BAT cells in scapular region was larger,white vacuoles appeared,lipid droplets increased,and the mRNA and protein expressions of UCP1,PRDM16,PGC-1α,NRF1,NRF2 and TFAM in BAT decreased significantly(P<0.01).Compared with the model group,the body mass,FBG,area under the curve of OGTT and serum TG,TC,LDL-C contents of Yitangkang group and liraglutide group significantly decreased(P<0.01),the content of HDL-C increased(P<0.01);BAT cells were smaller in diameter,more closely arranged,more regular in shape,and more abundant in capillary,the mRNA and protein expressions of UCP1,PRDM16,PGC-1α,NRF1,NRF2 and TFAM in BAT increased significantly(P<0.01).Conclusion Yitangkang can regulate mitochondrial biogenesis through PGC1α-NRF1/2-TFAM pathway to activate brown fat in db/db mice and improve glucose and lipid metabolism in db/db mice.

Objective To observe the effects of Yitangkang on brown fat thermogenesis and mitochondrial biogenesis of PGC1α-NRF1/2-TFAM pathway in db/db mice;To explore its mechanism of regulating glucose and lipid metabolism.Methods Totally 27 six-week-old db/db mice were randomly divided into model group,Yitangkang group(30 g/kg)and liraglutide group(200 μg/kg),another 9 db/m mice of the same age were set as normal group.All groups received intervention with drugs or saline for 6 weeks.The body mass and FBG were measured weekly.After intervention,oral glucose tolerance test(OGTT)was carried out,the contents of serum TC,TG,LDL-C and HDL-C were detected by biochemical analyzer,HE staining was used to observe the morphology of brown adipose tissue(BAT)in scapular region,RT-qPCR and Western blot were used to detect the expressions of UCP1,PRDM16,PGC1α related to BAT thermogenesis and NRF1,Nrf2,TFAM related to mitochondrial biogenesis.Results Compared with the normal group,the body mass,FBG,area under the curve of OGTT and serum TG,TC,LDL-C content of model group significantly increased(P<0.01),the content of HDL-C significantly decreased(P<0.01);the diameter of BAT cells in scapular region was larger,white vacuoles appeared,lipid droplets increased,and the mRNA and protein expressions of UCP1,PRDM16,PGC-1α,NRF1,NRF2 and TFAM in BAT decreased significantly(P<0.01).Compared with the model group,the body mass,FBG,area under the curve of OGTT and serum TG,TC,LDL-C contents of Yitangkang group and liraglutide group significantly decreased(P<0.01),the content of HDL-C increased(P<0.01);BAT cells were smaller in diameter,more closely arranged,more regular in shape,and more abundant in capillary,the mRNA and protein expressions of UCP1,PRDM16,PGC-1α,NRF1,NRF2 and TFAM in BAT increased significantly(P<0.01).Conclusion Yitangkang can regulate mitochondrial biogenesis through PGC1α-NRF1/2-TFAM pathway to activate brown fat in db/db mice and improve glucose and lipid metabolism in db/db mice.

Objective To evaluate the application of high-resolution magnetic resonance vessel wall imaging(HRMR-VWI)in identifying high-risk features of intracranial atherosclerotic plaques,and to analyze the correlation between plaque characteristics and stroke recurrence under varying degrees of stenosis.Methods The data from 368 patients with intracranial atherosclerotic stenosis(ICAS)across two centers were retrospectively analyzed.Based on the degree of stenosis,all patients were categorized into mild-to-moderate stenosis group(luminal stenosis<70%,n=155)and severe stenosis group(luminal stenosis≥70%,n=213).HRMR-VWI images and clinical information of the patients were collected and analyzed,and the culprit plaques were quantitatively analyzed.Univariate and multivariate logistic regression analyses were employed to identify the risk factors for stroke recurrence,and the predictive performance was evaluated using the area under the curve(AUC)of the receiver operating characteristic(ROC)curve.Results Higher normalized wall index(NWI)[odds ratio(OR)=1.082,95%confidence interval(CI)1.050-1.118,P<0.05]and the presence of intraplaque hemorrhage(IPH)(OR=1.843,95%CI 1.120-3.036,P<0.05)were risk factors for stroke recurrence in all patients.And these two factors were also significant in the mild-to-moderate stenosis group(NWI:OR=1.088,95%CI 1.009-1.186,P<0.05;IPH:OR=4.049,95%CI 1.227-16.065,P<0.05).A predictive model for stroke recurrence was constructed using the combination of IPH and NWI,with the best performance in the mild-to-moderate stenosis group(AUC=0.813,95%CI 0.723-0.906).Conclusion In patients with luminal stenosis<70%,the increase of NWI and the presence of IPH have been validated as significant and effective indicators for predicting stroke recurrence,demonstrating notable predictive performance.In contrast,among patients with luminal stenosis≥70%,the utility of plaque characteristics in predicting stroke recurrence is relatively lower,indicating that the correlation between plaque characteristics and stroke recurrence varies across different degrees of stenosis.

Objective:To understand the changes in the experience of dietary behavior compliance management in middle-aged and young adults with newly diagnosed type 2 diabetes (T2DM) and provide strategies for healthcare professionals to manage patients' long-term dietary compliance.Methods:A longitudinal qualitative study design was used. Purposeful sampling was conducted to select 16 middle-aged and young adult patients diagnosed with T2DM at the Department of Endocrinology, the Affiliated Huaian No. 1 Hospital of Nanjing Medical University, from January to May 2024. Semi-structured interviews were conducted, and data was analyzed cross-sectionally and longitudinally.Results:A total of 3 main themes and nine sub-themes were identified: emotional changes in dietary compliance (negative emotional experiences, positive emotional coping, and emotional fluctuations transformation) ; management experience of dietary compliance (gradual adaptation to dietary management, disruption of daily eating routine, and lack of family decision-making support) ; diverse support needs for dietary compliance (needs for knowledge and information support, peer and decision-making support, and continuity of care management system) .Conclusions:The experience of dietary behavior compliance management in middle-aged and young adults with T2DM is a continuous, dynamic, and fluctuating process. Healthcare professionals can develop targeted interventions based on patients' real situations and management experiences to improve their compliance levels.