Objective: To explore the interactive mechanisms of middle school students lifestyle with depressive and anxiety symptoms, so as to provide a basis for constructing a precise prevention system of middle school students mental health. Methods: From October to December in 2024, a stratified cluster random sampling method was used to select 6 251 middle school students from Guangxi. The Lifestyle Questionnaire, Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 ( GAD- 7) were used to investigate middle school students lifestyle, depressive symptoms and anxiety symptoms. The relationship of adolescent lifestyle with depressive and anxiety symptoms was analyzed through binary Logistic regression. The network analysis method was used to construct the network of middle school students lifestyle with depressive and anxiety symptoms. Results: A total of 1 690 individuals (27.0%) exhibited depressive symptoms, and 1 071 individuals (17.1%) exhibited anxiety symptoms. Binary Logistic regression analysis revealed that smoking, alcohol consumption, excessive intake of sugary drinks, insufficient vegetable intake, not eating breakfast daily, frequent consumption of fast food, prolonged sedentary time on both weekdays and weekends, insufficient sleep duration on weekdays and weekends, and excessive screen time on weekdays were all associated with depressive symptom ( OR =1.19-2.07) and anxiety symptom ( OR =1.20-1.91) in middle school students(all P ＜0.05). Additionally, excessive screen time on weekends was associated only with depressive symptoms ( OR =1.35, P <0.05). The connection between the lifestyle-depressive symptom cluster was mainly through "breakfast" and "suicidal ideation" (weight=0.31); the connection between the lifestyle-anxiety symptom cluster was mainly through "sedentary time on weekdays" and "uncontrollable worry" (weight=0.34). In the depressive symptom network, "depressed mood" had the highest node strength; in the anxiety symptom network, "uncontrollable worry" had the highest node strength. "Suicidal ideation" was a key bridge node between lifestyle and depressive and anxiety symptoms. Conclusions Unhealthy lifestyles are significant modifiable risk factors for depressive and anxiety symptoms among middle school students. Regular breakfast intake and management of sedentary behavior should be prioritized as important intervention entry points.

Objective:To compare the occurrence and clinical characteristics of hypersensitivity reactions induced by 3 non-ionic iodine contrast media (NICMs) during percutaneous coronary intervention (PCI).Methods:The patients who developed hypersensitivity reactions in iopromide, iohexol, and iodixanol application during PCI were screened out from adverse drug reaction reports of Beijing Anzhen Hospital from January 1, 2013 to December 31, 2018 and the total number of patients who underwent the PCI during that period and received the above NICMs was obtained by searching the hospital information system. The overall incidences of hypersensitivity reactions and severe hypersensitivity reactions and incidences of those induced by each of the 3 NICMs were calculated and their clinical characteristics were analyzed.Results:The overall incidences of hypersensitivity reactions and severe hypersensitivity reactions induced by the 3 NICMs were 0.603% (422/69 955) and 0.024% (17/69 955). The incidences of hypersensitivity reactions induced by iohexol, iopromide, and iodixanol were 0.418% (109/26 097), 0.364% (83/22 787), and 1.092% (230/ 21 071), respectively; the incidences of severe hypersensitivity reactions were 0.023% (6/26 097), 0.039% (9/22 787), and 0.009% (2/21 071), respectively. Iodixanol had a higher incidence of hypersensitivity reactions than iopromide and iohexol (both P<0.001) but the lowest incidence of severe hypersensitivity reactions, which was significantly different from that of iopromide ( P=0.047). Of the 422 patients who developed hypersensitivity reactions, 327 were male and 95 were female with an average age of 59 years (range: 27-101 years). The time of hypersensitivity reactions occurrence was recorded in 373 patients and time from NICMs injection to hypersensitivity reactions occurrence were 30 minutes to 90 hours with the median time of 5 hours; hypersensitivity reactions were immediate type (latency ≤1 hour) in 127 patients (34.0%) and delayed type (latency>1 hour) in 246 patients (66.0%). The hypersensitivity reactions induced by iopromide were mainly immediate type (79.5%, 62/78), while those induced by ioxamol were mainly delayed type (87.7%, 193/220). The proportion of patients with a previous history of allergy in the immediate type patients was significantly higher than that in the delayed type patients [15.0% (15/100) vs. 7.1% (14/197), P=0.030]. The most common clinical manifestation of hypersensitivity reactions was rash [78.0% (329/422)]. Among 17 cases of severe hypersensitivity reactions, 15 (88.2%) were anaphylactic shock, 1 was laryngeal edema, and 1 was dyspnea, all of which were immediate type. Hypersensitivity reactions were all improved after treatments, but PCI failed to be fully performed in 6 patients due to severe hypersensitivity reactions. Conclusions:The safety of 3 NICMs for PCI was good and the incidence of hypersensitivity reactions was low; the incidence of severe hypersensitivity reactions due to iopromide was the highest. Severe hypersensitivity reactions such as anaphylactic shock might affect the performance of PCI and caution should be given.

Objective:To compare the occurrence and clinical characteristics of hypersensitivity reactions induced by 3 non-ionic iodine contrast media (NICMs) during percutaneous coronary intervention (PCI).Methods:The patients who developed hypersensitivity reactions in iopromide, iohexol, and iodixanol application during PCI were screened out from adverse drug reaction reports of Beijing Anzhen Hospital from January 1, 2013 to December 31, 2018 and the total number of patients who underwent the PCI during that period and received the above NICMs was obtained by searching the hospital information system. The overall incidences of hypersensitivity reactions and severe hypersensitivity reactions and incidences of those induced by each of the 3 NICMs were calculated and their clinical characteristics were analyzed.Results:The overall incidences of hypersensitivity reactions and severe hypersensitivity reactions induced by the 3 NICMs were 0.603% (422/69 955) and 0.024% (17/69 955). The incidences of hypersensitivity reactions induced by iohexol, iopromide, and iodixanol were 0.418% (109/26 097), 0.364% (83/22 787), and 1.092% (230/ 21 071), respectively; the incidences of severe hypersensitivity reactions were 0.023% (6/26 097), 0.039% (9/22 787), and 0.009% (2/21 071), respectively. Iodixanol had a higher incidence of hypersensitivity reactions than iopromide and iohexol (both P<0.001) but the lowest incidence of severe hypersensitivity reactions, which was significantly different from that of iopromide ( P=0.047). Of the 422 patients who developed hypersensitivity reactions, 327 were male and 95 were female with an average age of 59 years (range: 27-101 years). The time of hypersensitivity reactions occurrence was recorded in 373 patients and time from NICMs injection to hypersensitivity reactions occurrence were 30 minutes to 90 hours with the median time of 5 hours; hypersensitivity reactions were immediate type (latency ≤1 hour) in 127 patients (34.0%) and delayed type (latency>1 hour) in 246 patients (66.0%). The hypersensitivity reactions induced by iopromide were mainly immediate type (79.5%, 62/78), while those induced by ioxamol were mainly delayed type (87.7%, 193/220). The proportion of patients with a previous history of allergy in the immediate type patients was significantly higher than that in the delayed type patients [15.0% (15/100) vs. 7.1% (14/197), P=0.030]. The most common clinical manifestation of hypersensitivity reactions was rash [78.0% (329/422)]. Among 17 cases of severe hypersensitivity reactions, 15 (88.2%) were anaphylactic shock, 1 was laryngeal edema, and 1 was dyspnea, all of which were immediate type. Hypersensitivity reactions were all improved after treatments, but PCI failed to be fully performed in 6 patients due to severe hypersensitivity reactions. Conclusions:The safety of 3 NICMs for PCI was good and the incidence of hypersensitivity reactions was low; the incidence of severe hypersensitivity reactions due to iopromide was the highest. Severe hypersensitivity reactions such as anaphylactic shock might affect the performance of PCI and caution should be given.

Under the background of deepening the medical and health system reform, it is necessary to explore the measures of fine and rational drug use management and strengthen the rational drug use. Through giving full play to the management functions of pharmacy administration and pharmacotherapeutics committee, formulating the performance evaluation index system of pharmacy affairs in the hospital, adhering to the prescription doctor′s advice review and prescription pre audit, continuing to carry out drug dynamic monitoring, implementing standardized-path antimicrobial drug management, the hospital implemented refined and rational drug use management. Before and after the management, the average drug cost, prescription unqualified rate, auxiliary drug amount and antibacterial drugs related indicators were significantly improved, suggesting that fine pharmacy management could promote the rational use of drugs in the whole hospital, promote the transformation of pharmacists′ work, and control the unreasonable growth of drug costs.

Objective: To explore the relationship between parents’ unstable marital status and offspring’s suicide attempts and the possible mediating factors, and to provide reference for suicide prevention among off spring grom unst able families. Methods: From 2017 to 2018, 2 766 valid questionnaires were collected from freshmen in a university in Hunan province. Students completed questionnaires of childhood trauma and depression traits,and reported their parents’ marital status and suicide attempts etc. Results: Compared to college students with parents of stable marital status,students with parents of unstable marital status showed higher reported rate of suicide attempts and higher scores of depression trait and childhood trauma (t/χ2=2.78, 5.83, 20.30, P<0.05). Controlling possible confounding factors,unconditional Logistic regression showed that childhood trauma,unstable marital status of parents and depressive traits were positively correlated with suicide attempt(OR=1.05, 1.45, 1.08, P<0.05). The 95% confidence interval of the Bootstrapping method with four mediation pathways (parental marital status→childhood trauma→depressive trait,childhood trauma→depressive trait→suicide attempt,parental marital status→childhood trauma→suicide attempt and parental marital status→childhood trauma→depressive trait→suicide attempt) does not include zero. Conclusion Childhood trauma and depressive traits mediate the relationship between parental instable marriage and suicide attempts in off spring.

Objective:To explore the occurrence and risk factors of bleeding events in acute coronary syndromes (ACS) patients treated with ticagrelor combined with aspirin.Methods:The study subjects were selected from ACS patients who were admitted to Beijing Anzhen Hospital, Capital Medical University from January to December 2017 and treated with ticagrelor and aspirin (aspirin 100 mg/d, ticagrelor 180 mg/d). Medical records of the patients who met the inclusion criteria(at age>18 years, with medication duration ≥ 1 year, and with complete follow-up records) were collected and retrospectively analyzed. The patients were divided into bleeding group and non-bleeding group according to whether there were bleeding events within 1 year. Baseline clinical characteristics such as gender, age, type of ACS, comorbidities, combined drugs, history of percutaneous coronary intervention, routine blood parameters, liver and kidney function, and etc. in patients between 2 groups were compared. The risk factors of bleeding events were analyzed using logistic regression method and the odds ratio ( OR) and its 95% confidence interval ( CI) were calculated. Results:A total of 180 patients were entered in the analysis, including 135 males and 58 females, aged (57±10) years, with the range of 31 to 81 years. There were 39 patients in the bleeding group and 141 patients in the non-bleeding group, and the incidence of bleeding events was 21.7%. None of the differences in gender distribution, age, comorbidities, history of percutaneous coronary intervention or combined drugs in patients between the 2 groups were statistically significant (all P>0.05). The platelet count of patients in the bleeding group was significantly lower than that in the non-bleeding group [(197±49) ×10 9/L vs. (220±60) ×10 9/L, t=2.254, P=0.025]. The shortest time from medication to the onset of bleeding of the 39 patients in the bleeding group was 14 days and the longest one was 12 months. The cumulative incidences of bleeding events at 3, 6, and 12 months of medication were 12.2% (22/180), 18.3% (33/180), and 21.7% (39/180), respectively. All bleeding events were minor bleeding, and the skin mucous ecchymosis had the highest incidence, which was 15.0% (27/180), followed by gingival bleeding or nosebleed, which was 7.2% (13/180). The incidence of fundus hemorrhage was 1.7% (3/180) and incidences of gastrointestinal bleeding and hematuria were both 0.6% (1/180). Multivariate logistic regression analysis showed that low platelet count was an independent risk factor for bleeding events [ OR=0.991, 95 %CI: 0.984-0.999, P=0.020]. Conclusions:ACS patients have a relative high risk of bleeding events when treated with ticagrelor combined with aspirin, but most of them were minor. For ACS patients with low platelet counts, this anti-platelet regimen should be used with caution and drug monitoring should be done in the whole course.

Objective:To explore the occurrence and risk factors of bleeding events in acute coronary syndromes (ACS) patients treated with ticagrelor combined with aspirin.Methods:The study subjects were selected from ACS patients who were admitted to Beijing Anzhen Hospital, Capital Medical University from January to December 2017 and treated with ticagrelor and aspirin (aspirin 100 mg/d, ticagrelor 180 mg/d). Medical records of the patients who met the inclusion criteria(at age>18 years, with medication duration ≥ 1 year, and with complete follow-up records) were collected and retrospectively analyzed. The patients were divided into bleeding group and non-bleeding group according to whether there were bleeding events within 1 year. Baseline clinical characteristics such as gender, age, type of ACS, comorbidities, combined drugs, history of percutaneous coronary intervention, routine blood parameters, liver and kidney function, and etc. in patients between 2 groups were compared. The risk factors of bleeding events were analyzed using logistic regression method and the odds ratio ( OR) and its 95% confidence interval ( CI) were calculated. Results:A total of 180 patients were entered in the analysis, including 135 males and 58 females, aged (57±10) years, with the range of 31 to 81 years. There were 39 patients in the bleeding group and 141 patients in the non-bleeding group, and the incidence of bleeding events was 21.7%. None of the differences in gender distribution, age, comorbidities, history of percutaneous coronary intervention or combined drugs in patients between the 2 groups were statistically significant (all P>0.05). The platelet count of patients in the bleeding group was significantly lower than that in the non-bleeding group [(197±49) ×10 9/L vs. (220±60) ×10 9/L, t=2.254, P=0.025]. The shortest time from medication to the onset of bleeding of the 39 patients in the bleeding group was 14 days and the longest one was 12 months. The cumulative incidences of bleeding events at 3, 6, and 12 months of medication were 12.2% (22/180), 18.3% (33/180), and 21.7% (39/180), respectively. All bleeding events were minor bleeding, and the skin mucous ecchymosis had the highest incidence, which was 15.0% (27/180), followed by gingival bleeding or nosebleed, which was 7.2% (13/180). The incidence of fundus hemorrhage was 1.7% (3/180) and incidences of gastrointestinal bleeding and hematuria were both 0.6% (1/180). Multivariate logistic regression analysis showed that low platelet count was an independent risk factor for bleeding events [ OR=0.991, 95 %CI: 0.984-0.999, P=0.020]. Conclusions:ACS patients have a relative high risk of bleeding events when treated with ticagrelor combined with aspirin, but most of them were minor. For ACS patients with low platelet counts, this anti-platelet regimen should be used with caution and drug monitoring should be done in the whole course.

Objective To evaluate the risk of acute kidney injury (AKI) induced by sodium glucose co-transporter 2 (SGLT2) inhibitors (canagliflozin,dapagliflozin,empagliflozin,and ertugliflozin).Methods Reports of AKI events induced by SGLT2 inhibitors and non-SGLT2 inhibitors received from January 1,2013 to September 30,2018 in the US Food and Drug Administration Adverse Event Reporting System (FAERS) database were collected.The relationship between the drugs mentioned above and the AKI events in all patients and especially in patients with diabetes mellitus,respectively,were analyzed by the method of reporting odds ratio (ROR).Results A total of 2 949 reports of SGLT2 inhibitors-induced AKI (2.50％ of 117 843 AKI event reports in the database during the study period),and 114 894 reports of non-SGLT2 inhibitors-induced AKI were retrieved from the database.The ROR values of AKI events induced by overall SGLT2 inhibitors,canagliflozin,dapagliflozin,and empagliflozin in all patients were 4.14 (95％ CI:3.98-4.30),5.58 (95％ CI:5.35-5.83),2.62 (95％ CI:2.35-2.92),and 1.96 (95％ CI:1.76-2.19),respectively,and in patients with diabetes mellitus were 2.84 (95 ％ CI:2.71-2.98),3.90 (95 ％ CI:3.69-4.12),1.70 (95％CI:1.48-1.94),and 1.30 (95％CI:1.15-1.48),respectively.Due to the short time to market,less than 3 reports of AKI events induced by ertugliflozin were reported,thus ROR analysis was not conducted for ertugliflozin.The analyses of combined medication showed that in all patients,the ROR value of AKI events induced by SGLT2 inhibitors was 8.05 (95％ CI:7.10-9.13) when SGLT2 inhibitors were combined with diuretics,which increased by 80.90％ compared with that when SGLT2 inhibitors were given alone and in patients with diabetes mellitus,it was 6.07 (95％ CI:5.27-7.00),which increased by 92.09％;in all patients,the ROR value of AKI events induced by SGLT2 inhibitors was 5.87 (95％CI:4.89-7.04) when SGLT2 inhibitors were combined with non-steroidal anti-inflammatory drugs (NSAID),which increased by 39.43％ compared with that when SGLT2 inhibitors were given alone and in patients with diabetes mellitus,it was 4.66 (95％ CI:3.79-5.74),which increased by 61.25％;in all patients,the ROR value of AKI events induced by SGLT2 inhibitors was 5.60 (95％ CI:5.12-6.14) when SGLT2 inhibitors were combined with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers,which increased by 25.56％ compared with that when SGLT2 inhibitors were given alone and in patients with diabetes mellitus,it was 4.05 (95％ CI:3.66-4.48),which increased by 27.36％.Conclusions SGLT2 inhibitors might increase the risk of AKI and this risk was mainly from canagliflozin,suggesting that dapagliflozin and empagliflozin were relatively safe to patients.The risk of AKI might increase when SGLT2 inhibitors were combined with diuretics or NSAID.

Objective To evaluate the risk of acute kidney injury (AKI) induced by sodium glucose co-transporter 2 (SGLT2) inhibitors (canagliflozin,dapagliflozin,empagliflozin,and ertugliflozin).Methods Reports of AKI events induced by SGLT2 inhibitors and non-SGLT2 inhibitors received from January 1,2013 to September 30,2018 in the US Food and Drug Administration Adverse Event Reporting System (FAERS) database were collected.The relationship between the drugs mentioned above and the AKI events in all patients and especially in patients with diabetes mellitus,respectively,were analyzed by the method of reporting odds ratio (ROR).Results A total of 2 949 reports of SGLT2 inhibitors-induced AKI (2.50％ of 117 843 AKI event reports in the database during the study period),and 114 894 reports of non-SGLT2 inhibitors-induced AKI were retrieved from the database.The ROR values of AKI events induced by overall SGLT2 inhibitors,canagliflozin,dapagliflozin,and empagliflozin in all patients were 4.14 (95％ CI:3.98-4.30),5.58 (95％ CI:5.35-5.83),2.62 (95％ CI:2.35-2.92),and 1.96 (95％ CI:1.76-2.19),respectively,and in patients with diabetes mellitus were 2.84 (95 ％ CI:2.71-2.98),3.90 (95 ％ CI:3.69-4.12),1.70 (95％CI:1.48-1.94),and 1.30 (95％CI:1.15-1.48),respectively.Due to the short time to market,less than 3 reports of AKI events induced by ertugliflozin were reported,thus ROR analysis was not conducted for ertugliflozin.The analyses of combined medication showed that in all patients,the ROR value of AKI events induced by SGLT2 inhibitors was 8.05 (95％ CI:7.10-9.13) when SGLT2 inhibitors were combined with diuretics,which increased by 80.90％ compared with that when SGLT2 inhibitors were given alone and in patients with diabetes mellitus,it was 6.07 (95％ CI:5.27-7.00),which increased by 92.09％;in all patients,the ROR value of AKI events induced by SGLT2 inhibitors was 5.87 (95％CI:4.89-7.04) when SGLT2 inhibitors were combined with non-steroidal anti-inflammatory drugs (NSAID),which increased by 39.43％ compared with that when SGLT2 inhibitors were given alone and in patients with diabetes mellitus,it was 4.66 (95％ CI:3.79-5.74),which increased by 61.25％;in all patients,the ROR value of AKI events induced by SGLT2 inhibitors was 5.60 (95％ CI:5.12-6.14) when SGLT2 inhibitors were combined with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers,which increased by 25.56％ compared with that when SGLT2 inhibitors were given alone and in patients with diabetes mellitus,it was 4.05 (95％ CI:3.66-4.48),which increased by 27.36％.Conclusions SGLT2 inhibitors might increase the risk of AKI and this risk was mainly from canagliflozin,suggesting that dapagliflozin and empagliflozin were relatively safe to patients.The risk of AKI might increase when SGLT2 inhibitors were combined with diuretics or NSAID.

Objective To explore the mediating effects of neuropeptide S receptor 1 and negative coping in chronic stress induced emotional responses. Methods A survey of 366 local residents who were chosen from County of Nandan in Guangxi Province by stratified random sampling method. Questionnaires of the life events scale (LES),the simplified symptom checklist and the Simplified Coping Style Questionnaire (SCSQ) were used. The level of NPSR1 was measured by Elisa. Data was analyzed by SPSS 21 and AMOS 21 statistical software for statistical analysis. Results The level of chronic psychological stress was (25. 24± 29. 26) and score of negative coping was(14. 84±4. 35). Somatic factor,anxiety factor,depressive factor and hostile factor were (1. 58±0. 58),(1. 43±0. 56),(1. 44±0. 55),(1. 23±0. 37). The total score of life e-vents was positively correlated with negative coping,somatic factor score,anxiety factor score,depression fac-tor score(r=0. 23-0. 46,P<0. 05),while negatively correlated with the expression level of detection of NPSR1 in plasma(r=-0. 26,P<0. 05). NPSR1 level was negatively correlated with body factor score,anxiety factor score,depression factor score and hostility factor score(r=-0. 18--0. 61,P<0. 05). Negative coping was positively correlated with body factor score,anxiety factor score,depression factor score and hostility fac-tor score(r=0. 12- 0. 27,P<0. 05). Both neuropeptide S receptor 1 and negative response had significant me- diating effects on emotional responses induced by chronic psychological stress (P<0. 05),and the effect val-ues were -0. 08 and 0. 05,respectively. According to the Bootstrapping method,the results of the mediation model showed that Bias-Corrected of 95% CI of the total standardization effect,the indirect standardization effect,the direct standardization effect were not including 0. Conclusion NPSR1 and negative coping plays a dual mediating effect on stress induced emotional responses.