Objective: To investigate the association between screen time (ST) during leisure time and anxiety-depression symptoms among middle school students, so as to provide a basis for formulating relevant intervention measures. Methods: From November to December 2023, a stratified cluster random sampling method was used to select 2 542 students from junior and senior high school in Taiyuan City. A self designed questionnaire, the Generalized Anxiety Disorder Scale (GAD-7), and the Patient Health Questionnaire (PHQ-9) were used to investigate ST and anxiety/depression symptoms among middle school students. The Logistic regression model was used to explore the association of ST with symptoms of anxiety and depression, as well as with anxiety and depression comorbiditles (CAD). Results: The detection rates of anxiety symptoms, depression symptoms, and CAD were 13.69%, 15.77%, and 10.11%, respectively. The median ST was 2.00 h/d [interquartile range ( IQR =2.38) for weekly averages], with 0.33 h/d ( IQR =1.67) on work days and 5.00 h/d ( IQR=5.50) on rest days. Logistic regression analysis indicated that the total ST of mobile phones during rest days ( OR =1.07, 1.10, 1.11) and the averages ST of mobile phones over a week ( OR = 1.20 , 1.22, 1.29), as well as the total ST of all screen types during rest days ( OR =1.04, 1.04, 1.05) and the averages ST of all screen types over a week ( OR =1.08, 1.09, 1.21) were positively correlated with anxiety symptoms, depression symptoms, and CAD (all P <0.01). Conclusions Among middle school students in Taiyuan City, screen time is positively correlated with symptoms of anxiety or depression and the comorbidity of anxiety and depression, especially smartphone screen time and weekend screen use. Therefore, measures should be implemented to reduce unnecessary screen time among middle school students, especially the use of mobile phones, in order to mitigate the occurrence of anxiety and depression.

AIM:To investigate the impact of recombinant human CC16 protein(rhCC16)on cigarette smoke extract(CSE)-induced senescence-associated secretory phenotype(SASP)in human bronchial epithelial cells(HBECs)and in the lung tissues of chronic obstructive pulmonary disease(COPD)mice,and to explore the underlying mechanism.METHODS:HBECs were induced into cellular senescence using 5%CSE.The senescent HBECs were treated with 250 ng/mL rhCC16,and the levels of reactive oxygen species(ROS)were assessed using the 2',7'-dichlorodihydrofluorescein diacetate(DCFH-DA)method.The levels of trimethylated histone H3 at lysine 9(H3K9me3),a marker of senescence-associated heterochromatic foci(SAHF),were detected using a Western blot assay.RT-qPCR and ELISA were utilized to measure the mRNA expression and protein levels of SASP components including interleukin-1 beta(IL-1β),IL-6,IL-8,chemokine(C-X-C motif)ligand-1(CXCL-1),matrix metalloproteinase 1(MMP1)and MMP3.Passive smoking was con-ducted for six months to induce COPD in mice.RhCC16(2.5 μg/g body weight)or an equal volume of PBS(20 μL)was intranasally administered from the 16th week of smoking in the COPD+rhCC16 group or COPD+PBS group,respectively,with administration 2 hours before smoking.ROS levels in lung tissue cells were investigated using DCFH-DA staining.H3K9me3 levels in lung tissues were tested using Western blot assay.RT-qPCR and ELISA were performed to examine the mRNA expression and protein levels of IL-1β,IL-6,IL-8,CXCL-1,MMP1 and MMP3.RESULTS:DCFH-DA staining results showed that CSE stimulation increased ROS levels in HBECs,while rhCC16 treatment reduced them(P＜0.01).Western blot results indicated that CSE stimulation elevated H3K9me3 levels in HBECs,which were decreased with rhCC16 treatment(P＜0.01).RT-qPCR and ELISA assays demonstrated that CSE stimulation upregulated the mRNA and protein levels of IL-1β,IL-6,IL-8,CXCL-1,MMP1 and MMP3 in HBECs,which were reduced with rhCC16 admin-istration(P＜0.05).DCFH-DA staining results showed an increase in ROS levels in the lung tissues of COPD mice,which were decreased with rhCC16 administration(P＜0.01).Western blot data revealed an increase in H3K9me3 levels in the lung tissues of COPD mice,which were reduced with rhCC16 treatment(P＜0.01).RT-qPCR and ELISA assays demon-strated an upregulation of the mRNA and protein levels of IL-1β,IL-6,IL-8,CXCL-1,MMP1 and MMP3 in the lung tis-sues of COPD mice,which were reduced with rhCC16 treatment(P＜0.05).No statistically significant differences were ob-served in the above-mentioned indicators between the lung tissues of COPD and COPD+PBS mice(P＞0.05).CONCLU-SION:rhCC16 can effectively inhibit CSE-induced SASP in HBECs and in the lung tissues of COPD mice,with its under-lying mechanism potentially related to the inhibition of the ROS-H3K9me3 signaling pathway.

Objective:To explore the correlation between conventional ultrasound and contrast-enhanced ultrasound features and invasive histological features of T 1a clear cell renal cell carcinoma (ccRCC). Methods:A retrospective case series study was conducted. Sixty-seven T 1a ccRCC patients who were admitted to Shanxi Province Cancer Hospital from May 2018 to August 2023 were selected. According to the World Health Organization (WHO)/International Society of Urology and Pathology (ISUP) renal tumor grading system, the patients were divided into the low-grade group (WHO/ISUP grades 1-2, 53 cases) and the high-grade group (WHO/ISUP grades 3-4, 14 cases). The conventional ultrasound and contrast-enhanced ultrasound characteristics of two groups of patients were compared. Multivariate logistic regression model was used to analyze the independent factors of conventional ultrasound and contrast-enhanced ultrasound related to T 1a ccRCC with WHO/ISUP high grade. Results:There were no statistically significant differences in clinical characteristics between the two groups of patients (all P > 0.05). In conventional ultrasound examination, the proportion of patients with tumor exophytic rate <50% in the high-grade group was higher than that in the low-grade group [64.3% (9/14) vs. 34.0% (18/53)], and the difference was statistically significant ( χ2 = 4.23, P = 0.040); there were no statistically significant differences in the distribution of patients with different tumor maximum diameter, laterality, polarity, depth, echo, boundary, and shape between the two groups (all P > 0.05). In contrast-enhanced ultrasound examination, the proportion of patients lack of pseudocapsule sign in the high-grade group was higher than that in the low-grade group [57.1% (8/14) vs. 24.5% (13/53)], and the difference was statistically significant ( χ2 = 4.06, P = 0.044); there were no statistically significant differences in the distribution of patients with different perfusion mode, enhancement degree, enhancement uniformity, and regression mode between the two groups (all P > 0.05). Multivariate logistic regression analysis showed that the conventional ultrasound tumor exophytic rate < 50% (compared to exophytic rate ≥ 50%, OR = 3.732, 95% CI: 1.019-13.664, P = 0.047) and the absence of pseudocapsule sign (compared to the presence of pseudocapsule sign, OR = 4.357, 95% CI: 1.201-15.804, P = 0.025) on contrast-enhanced ultrasound were independent risk factors for high-grade T 1a ccRCC. Conclusions:T 1a ccRCC with the exophytic rate <50% and absence of pseudocapsule sign may have invasive histological features.

Objective:To apply mass spectrometry as well as bioinformatics techniques to analyze HBV peptides derived from Pol and X proteins presented by human immortalized B lymphocytes(BLCLs),and to screen for effective T-cell epitopes,which lays the foundation for the development of therapeutic vaccines.Methods:The group has constructed a genome-wide expression plasmid containing 1.2-fold HBVC2 isoforms and transfected it into BLCLs by electro-transfection,isolated and identified HBV peptides by LC-MS/MS,bioinformatically predicted peptide sequences in terms of sensitization,antigenicity,toxicity,HLA molecular affinity,and the ability of peptide HLA-class Ⅰ complex to bind to specific T cells,and retrieved reported sequences.Results:HBV peptides from lysates of five immortalized B cells(BLCLs-1 to BLCLs-5)carrying HBVC2 subtype-expressing recombinants were analyzed,and 141 peptides with sequence lengths of no less than 8 amino acid residues(≥8 aa)were successfully isolated and identified,of which 133 were derived from Pol,and 8 from X proteins.The 141 HBV peptides were analyzed for sensitization,antigenicity and toxicity,and 50 antigenic,non-toxic and sensitizing HBV peptides(47 from Pol and 3 from X protein)were screened for affinity analysis with HLA-class Ⅰ and Ⅱ molecules and for prediction of the binding ability of the peptide HLA-class Ⅰ complexes to specific T cells.Among these peptides,37 had affinity to the corresponding genotypes of HLA-class Ⅰ and Ⅱ molecules.Finally,we obtained 37 peptides with antigenic,nontoxic,and sensitizing properties with IC50<500 nmol/L to HLA-class Ⅰ and Ⅱ molecules,which have affinitied to the corresponding genotypes but have not been reported,and can be continued to be explored as potential epitopes.Finally,15 HBV peptide hotspot core regions were formed by intra-and inter-strain common,contained,overlapping or neighboring sequence analysis of 141 peptides,with 7 core region sequences with antigenic,nontoxic,and sensitizing properties restricted to the corresponding geno-types.Peptides with affinity IC50<500 nmol/L had an affinity core sequence overlap of no less than 8 amino acids,and can be priori-tized for candidate T cell epitopes for subsequent studies.Conclusion:Peptides derived from Pol and X proteins have been successfully isolated and identified,and potential T cell epitopes have been screened.

Objective:To apply mass spectrometry as well as bioinformatics techniques to analyze HBV peptides derived from Pol and X proteins presented by human immortalized B lymphocytes(BLCLs),and to screen for effective T-cell epitopes,which lays the foundation for the development of therapeutic vaccines.Methods:The group has constructed a genome-wide expression plasmid containing 1.2-fold HBVC2 isoforms and transfected it into BLCLs by electro-transfection,isolated and identified HBV peptides by LC-MS/MS,bioinformatically predicted peptide sequences in terms of sensitization,antigenicity,toxicity,HLA molecular affinity,and the ability of peptide HLA-class Ⅰ complex to bind to specific T cells,and retrieved reported sequences.Results:HBV peptides from lysates of five immortalized B cells(BLCLs-1 to BLCLs-5)carrying HBVC2 subtype-expressing recombinants were analyzed,and 141 peptides with sequence lengths of no less than 8 amino acid residues(≥8 aa)were successfully isolated and identified,of which 133 were derived from Pol,and 8 from X proteins.The 141 HBV peptides were analyzed for sensitization,antigenicity and toxicity,and 50 antigenic,non-toxic and sensitizing HBV peptides(47 from Pol and 3 from X protein)were screened for affinity analysis with HLA-class Ⅰ and Ⅱ molecules and for prediction of the binding ability of the peptide HLA-class Ⅰ complexes to specific T cells.Among these peptides,37 had affinity to the corresponding genotypes of HLA-class Ⅰ and Ⅱ molecules.Finally,we obtained 37 peptides with antigenic,nontoxic,and sensitizing properties with IC50<500 nmol/L to HLA-class Ⅰ and Ⅱ molecules,which have affinitied to the corresponding genotypes but have not been reported,and can be continued to be explored as potential epitopes.Finally,15 HBV peptide hotspot core regions were formed by intra-and inter-strain common,contained,overlapping or neighboring sequence analysis of 141 peptides,with 7 core region sequences with antigenic,nontoxic,and sensitizing properties restricted to the corresponding geno-types.Peptides with affinity IC50<500 nmol/L had an affinity core sequence overlap of no less than 8 amino acids,and can be priori-tized for candidate T cell epitopes for subsequent studies.Conclusion:Peptides derived from Pol and X proteins have been successfully isolated and identified,and potential T cell epitopes have been screened.

AIM:To investigate the impact of recombinant human CC16 protein(rhCC16)on cigarette smoke extract(CSE)-induced senescence-associated secretory phenotype(SASP)in human bronchial epithelial cells(HBECs)and in the lung tissues of chronic obstructive pulmonary disease(COPD)mice,and to explore the underlying mechanism.METHODS:HBECs were induced into cellular senescence using 5%CSE.The senescent HBECs were treated with 250 ng/mL rhCC16,and the levels of reactive oxygen species(ROS)were assessed using the 2',7'-dichlorodihydrofluorescein diacetate(DCFH-DA)method.The levels of trimethylated histone H3 at lysine 9(H3K9me3),a marker of senescence-associated heterochromatic foci(SAHF),were detected using a Western blot assay.RT-qPCR and ELISA were utilized to measure the mRNA expression and protein levels of SASP components including interleukin-1 beta(IL-1β),IL-6,IL-8,chemokine(C-X-C motif)ligand-1(CXCL-1),matrix metalloproteinase 1(MMP1)and MMP3.Passive smoking was con-ducted for six months to induce COPD in mice.RhCC16(2.5 μg/g body weight)or an equal volume of PBS(20 μL)was intranasally administered from the 16th week of smoking in the COPD+rhCC16 group or COPD+PBS group,respectively,with administration 2 hours before smoking.ROS levels in lung tissue cells were investigated using DCFH-DA staining.H3K9me3 levels in lung tissues were tested using Western blot assay.RT-qPCR and ELISA were performed to examine the mRNA expression and protein levels of IL-1β,IL-6,IL-8,CXCL-1,MMP1 and MMP3.RESULTS:DCFH-DA staining results showed that CSE stimulation increased ROS levels in HBECs,while rhCC16 treatment reduced them(P＜0.01).Western blot results indicated that CSE stimulation elevated H3K9me3 levels in HBECs,which were decreased with rhCC16 treatment(P＜0.01).RT-qPCR and ELISA assays demonstrated that CSE stimulation upregulated the mRNA and protein levels of IL-1β,IL-6,IL-8,CXCL-1,MMP1 and MMP3 in HBECs,which were reduced with rhCC16 admin-istration(P＜0.05).DCFH-DA staining results showed an increase in ROS levels in the lung tissues of COPD mice,which were decreased with rhCC16 administration(P＜0.01).Western blot data revealed an increase in H3K9me3 levels in the lung tissues of COPD mice,which were reduced with rhCC16 treatment(P＜0.01).RT-qPCR and ELISA assays demon-strated an upregulation of the mRNA and protein levels of IL-1β,IL-6,IL-8,CXCL-1,MMP1 and MMP3 in the lung tis-sues of COPD mice,which were reduced with rhCC16 treatment(P＜0.05).No statistically significant differences were ob-served in the above-mentioned indicators between the lung tissues of COPD and COPD+PBS mice(P＞0.05).CONCLU-SION:rhCC16 can effectively inhibit CSE-induced SASP in HBECs and in the lung tissues of COPD mice,with its under-lying mechanism potentially related to the inhibition of the ROS-H3K9me3 signaling pathway.

Objective:To explore the correlation between conventional ultrasound and contrast-enhanced ultrasound features and invasive histological features of T 1a clear cell renal cell carcinoma (ccRCC). Methods:A retrospective case series study was conducted. Sixty-seven T 1a ccRCC patients who were admitted to Shanxi Province Cancer Hospital from May 2018 to August 2023 were selected. According to the World Health Organization (WHO)/International Society of Urology and Pathology (ISUP) renal tumor grading system, the patients were divided into the low-grade group (WHO/ISUP grades 1-2, 53 cases) and the high-grade group (WHO/ISUP grades 3-4, 14 cases). The conventional ultrasound and contrast-enhanced ultrasound characteristics of two groups of patients were compared. Multivariate logistic regression model was used to analyze the independent factors of conventional ultrasound and contrast-enhanced ultrasound related to T 1a ccRCC with WHO/ISUP high grade. Results:There were no statistically significant differences in clinical characteristics between the two groups of patients (all P > 0.05). In conventional ultrasound examination, the proportion of patients with tumor exophytic rate <50% in the high-grade group was higher than that in the low-grade group [64.3% (9/14) vs. 34.0% (18/53)], and the difference was statistically significant ( χ2 = 4.23, P = 0.040); there were no statistically significant differences in the distribution of patients with different tumor maximum diameter, laterality, polarity, depth, echo, boundary, and shape between the two groups (all P > 0.05). In contrast-enhanced ultrasound examination, the proportion of patients lack of pseudocapsule sign in the high-grade group was higher than that in the low-grade group [57.1% (8/14) vs. 24.5% (13/53)], and the difference was statistically significant ( χ2 = 4.06, P = 0.044); there were no statistically significant differences in the distribution of patients with different perfusion mode, enhancement degree, enhancement uniformity, and regression mode between the two groups (all P > 0.05). Multivariate logistic regression analysis showed that the conventional ultrasound tumor exophytic rate < 50% (compared to exophytic rate ≥ 50%, OR = 3.732, 95% CI: 1.019-13.664, P = 0.047) and the absence of pseudocapsule sign (compared to the presence of pseudocapsule sign, OR = 4.357, 95% CI: 1.201-15.804, P = 0.025) on contrast-enhanced ultrasound were independent risk factors for high-grade T 1a ccRCC. Conclusions:T 1a ccRCC with the exophytic rate <50% and absence of pseudocapsule sign may have invasive histological features.

Purpose/Significance To construct the conceptual model of hospital intelligence index,so as to lay the foundation for the quantitative evaluation of hospital intelligence degree,and help the intelligent construction of hospital.Method/Process The paper intro-duces the connotation of intelligence,expounds the evaluation standard system of hospital informatization construction,and considers the application of intelligence in hospital from the perspective of structure-function-effect.Result/Conclusion The conceptual model of hospital intelligence index is built.That conceptual model includes 3 first-level indicators,8 second-level indicators and 33 third-level indicators of intelligence basis,intelligence capacity and intelligence effect.As a tool for continuous improvement of medical serv-ices,regular assessment of hospital intelligence level can promote the improvement of medical quality and patient experience,and help the high-quality development of hospitals.

Objective:This study aimed to assess left atrial function in adults across various age groups using 4-dimensional automated left atrial quantification(4D Auto LAQ)technology.The study also aimed to compare the differences in two-dimensional(2D)and four-dimensional(4D)strains of the left atrium among different age groups, with the goal of enhancing the clinical utility of 4D Auto LAQ.Methods:A total of 409 healthy volunteers were recruited for the research.Two-dimensional and four-dimensional images were obtained using a GE Vivid E95 ultrasound system with a 4Vc four-dimensional probe.The study examined variations in 2D and 4D ultrasound parameters across various age groups.Furthermore, the relationship between left atrial reservoir strain(LASr), Left atrial conduit strain(LAScd), left atrial contraction strain(LASct), and age was explored.Results:The study involved 409 volunteers, with 217 males and 192 females, who were categorized into three age groups: young(18-45 years, n=56), middle-aged(46-65 years, n=202), and elderly(>65 years, n=151).Conventional ultrasound measurements indicated changes in left atrial anterior-posterior diameter with age progression: (31.70±3.65)mm for the young group, (34.02±3.91)mm for the middle-aged group, and(35.2±4.37)mm for the elderly group( P<0.01).The 2D and 4D left atrial parameters across the age groups were as follows: LASr(2D)(%): 37.48±7.51, 30.95±8.23, 26.9±7.56( P<0.01); LA VImax(ml/m 2): 23.54±5.79, 26.33±7.6, 28.99±8.15( P<0.01); LASr(%): 31.2±17.07, 22.5±8.59, 19.49±7.47( P<0.01).Both 2D and 4D left atrial parameters exhibited significant associations with age.Specifically, the correlations between LASr(2D)(%), LAScd(2D)(%), LASr(%), LAScd(%), and age were -0.429, 0.580, -0.354, 0.298, respectively( P<0.01). Conclusions:The 4D Auto LAQ technology is efficient in assessing left atrial function across various age groups, with age playing a significant role in influencing left atrial parameters.When compared to other ultrasound parameters, both 2D and 4D left atrial strain parameters have the ability to detect differences at an early stage, making them suitable for the early screening, evaluation, and monitoring of age-related left atrial dysfunction, especially in the elderly population.

Objective:To investigate the influencing factors of ultrasonic missed diagnosis of kidney neoplasm.Methods:The clinical data of 2 033 patients pathologically diagnosed with kidney neoplasm after operation and with complete medical record in Shanxi Province Cancer Hospital from January 2013 to October 2021 were retrospectively analyzed. Preoperative ultrasound diagnosis, clinical data, CT/magnetic resonance imaging (MRI) were analyzed, and ultrasound missed diagnosis rate was calculated. Chi-square test and multivariate logistic regression were used to analyze the influencing factors of ultrasonic missed diagnosis of kidney neoplasm mainly based on the anatomic characteristics of neoplasm.Results:The ultrasonic missed diagnosis rate of kidney neoplasm was 1.87% (38/2 033), among which the ultrasonic missed diagnosis rate of renal parenchymal neoplasm was 1.33% (25/1 874) and the ultrasonic missed diagnosis rate of renal pelvis neoplasm was 8.18% (13/159). The results of multivariate logistic regression analysis showed that the patients' body mass index (BMI) ≥ 24 kg/m 2 ( OR = 2.805, 95% CI 1.030-7.641), the small lesion ( OR = 0.425, 95% CI 0.293-0.617), the lesion located on the left kidney ( OR = 0.307, 95% CI 0.113-0.834), the lesion located on the body ( OR = 0.344, 95% CI 0.124-0.956 compared to lesions in the upper pole of the kidney; OR = 0.239, 95% CI 0.069-0.834 compared to lesions in the lower pole of the kidney) and the lesion located on the dorsal side ( OR = 0.409, 95% CI 0.172-0.970) were independent influencing factors for ultrasound missed diagnosis of renal parenchymal neoplasms (all P < 0.05). Patients with BMI ≥ 24 kg/m 2 ( OR = 10.464, 95% CI 1.042-105.087), concurrent ureteral or (and) bladder urothelial carcinoma ( OR = 32.937, 95% CI 4.017-270.063), and small lesion size ( OR = 0.216, 95% CI 0.081-0.577) were independent influencing factors for ultrasound missed diagnosis of renal pelvis neoplasms (all P < 0.05). Conclusions:Obesity, small focus, focus on the left kidney, focus on the body, and focus on the back may be the main reasons for ultrasonic missed diagnosis of renal parenchymal neoplasms. Obesity, concurrent ureteral or/and bladder urothelial carcinoma and small lesions may be the main reasons for ultrasonic missed diagnosis of renal pelvis neoplasms.