ObjectiveTo observe the effects of Xiaoyaosan on glucagon-like peptide-1 （GLP-1）/GLP-1 receptor （GLP-1r） and protein kinase A （PKA）/cAMP response element binding protein （CREB）/brain-derived neurotrophic factor （BDNF） signaling pathways in the hippocampal CA1 region of rats under chronic restraint stress （CRS），and to explore the mechanism of this formula to alleviate anxiety and depression-like behaviors. Methods40 specific pathogen-free male Sprague-Dawley （SD） rats were randomly divided into normal，model，Xiaoyaosan，and fluoxetine groups，with 10 rats in each group. CRS was used to induce anxiety and depression-like behaviors. The rats in the Xiaoyaosan group were gavaged with aqueous solution of traditional Chinese medicine formula granules （7.36 g·kg^-1·d^-1），while those in the fluoxetine group were gavaged with aqueous solution of fluoxetine （2 mg·kg^-1·d^-1）. Body weight was measured on days 0，7，14，and 21 of the experiment. On days 0 and 22 of the experiment，the sucrose preference test （SPT），forced swimming test （FST），and open field test （OFT） were performed. The pathological morphology of the hippocampal CA1 region was observed by Nissl staining. The relative mRNA expression of post-synaptic density protein-95 （PSD95） and synapsin （SYP） was detected by reverse transcription quantitative real-time polymerase chain reaction. Immunohistochemistry and Western blot were used to detect expression of proteins in the GLP-1/GLP-1r and PKA/CREB/BDNF pathways in the hippocampal CA1 region. ResultsAfter CRS modeling，compared with the normal group，the rats of the model group had anxiety and depression-like behavioral manifestations，neuronal damage in the hippocampal CA1 region，significantly downregulated expression of synaptic plasticity markers PSD95 and SYP genes （P<0.01），and inhibition of GLP-1/GLP-1r and PKA/CREB/BDNF signaling pathways （P<0.05，P<0.01）. Compared with the model group，the Xiaoyaosan group exhibited alleviated anxiety and depression-like behaviors，reduced neuronal damage in the hippocampal CA1 region， significantly increased expression of PSD95 and SYP genes （P<0.01），and the activation of the GLP-1/GLP-1r and PKA/CREB/BDNF signaling pathways （P<0.05，P<0.01）. ConclusionXiaoyaosan can alleviate anxiety and depression-like behaviors in CRS rats by improving synaptic plasticity in the hippocampal CA1 region. The mechanisms may be related to the activation of the GLP-1/GLP-1r pathway and its mediated PKA/CREB/BDNF signaling pathway by the formula.

Objective: To understand the impact of childhood trauma on psychological distress among upper grade elemetary school students, and to explore the mediating role of leisure activities in the relationship, so as to provide a basis for developing mental health intervention strategies. Methods: From August to November 2024, a combination of convenience sampling and stratified cluster random sampling was employed to recruit 1 373 fourth to sixth grade students from four primary schools in Harbin. The Childhood Trauma Questionnaire(CTQ), a self designed leisure activity scale (including active and passive leisure activities), and the Kessler Psychological Distress Scale (K10) were used to assess childhood trauma experiences, leisure activities, and levels of psychological distress. Spearman correlation analysis and linear regression analysis were conducted to explore the relationships among childhood trauma, leisure types, leisure time, and psychological distress. Based on the mediation analysis framework proposed by Hayes (Model 4), the mediating role of leisure types in the relationship between childhood trauma and psychological distress was examined. Results: Totally 19.1% of the upper elemetary school students exhibited psychological distress, while 30.2% had experienced childhood trauma. During school days, 64.6% of the students were reported of having leisure time concentrated between 1 and 5 hours per day, whereas 67.4% reported leisure time exceeding 5 hours per day on weekends. After controlling for potential demographic confounders such as gender, grade, ethnicity, household registration, being an only child, parents educational level, co residence, and whether parents are first time married,linear regression analysis showed that childhood trauma experience had positive predictive effect on psychological distress in upper primary school students( β =0.20, P <0.01). Leisure time showed no statistically significant association with psychological distress, both on school days ( β =-0.58 to -0.56) and weekends ( β =0.26- 0.98 )(all P >0.05). Active leisure activities were negatively associated with psychological distress ( β =-0.20), while passive leisure activities were positively associated with psychological distress ( β =0.29)(both P <0.01). Leisure type partially mediated the relationship between childhood trauma and psychological distress, accounting for 11.7% of the indirect effect. Conclusion Childhood trauma experiences positively predict psychological distress in upper elementary school students, and affect psychological distress through active leisure and passive leisure.

The surgical management of colorectal cancer has evolved from conventional multiport laparoscopic surgery toward more minimally invasive and individualized approaches. Among these, single-incision laparoscopic surgery (SILS) or reduced-port laparoscopic surgery (RPLS) has gained increasing attention from clinicians. Single-incision plus one port laparoscopic surgery (SILS+1) combines the advantages of both SILS and RPLS. Recent studies have demonstrated that compared with conventional multiport laparoscopic surgery, SILS+1 could yield comparable safety, feasibility and oncologic outcomes in treating colorectal cancer while offering additional benefits in enhanced recovery and better cosmesis.The development of SILS+1 relies heavily on innovations in single-port platforms and specialized instruments. By strictly adhering to its indica-tions, skillfully employing string and traction techniques during surgery, and the appropriate mana-gement of complications such as hemorrhage, the procedure can be performed safely and smoothly. The authors review relevant domestic and international studies and integrate the practical experi-ence to provide an in-depth discussion on the application and exploration of SILS+1 in radical colorectal cancer surgery, aiming to provide valuable insights for broader adoption of this approach.

Objective To construct a prediction model for the risk of peripherally inserted central venous catheter(PICC)-related bloodstream infection(CRBSI)in preterm infants,and evaluate the effect of the model.Methods 1 295 preterm infants admitted to the neonatal intensive care unit(NICU)in a hospital and received PICC intrave-nous infusion from January 2019 to October 2023 were selected as the study subjects,including 1 080 preterm in-fants from January 2019 to December 2022 in the modeling set and 215 premature infants from January to October 2023 in the validation set.Risk factors of cases were analyzed based on 24 clinical characteristics,optimized charac-teristics was selected by LASSO regression,independent risk factors for CRBSI of preterm infants during PICC in-dwelling period were identified by multiple logistic regression analysis,and nomogram model was constructed with R software.Discrimination and fitting of the model were evaluated by the area under the curve(AUC)of the receiver operating characteristic(ROC)as well as Hosmer-Lemeshow test and calibration curve,and clinical practicality of the model was evaluated by decision curve analysis(DCA).Results Multivariate logistic analysis showed that birth weight ≥1 500 g,sterile protection during catheter maintenance,and sterile cloth wrapped joints were protective factors for CRBSI during PICC indwelling period in preterm infants(OR=0.172,0.187,0.063,respectively,all P＜0.05),while puncture frequency＞2 times,catheter indwelling period＞14 days,and use of tees were inde-pendent risk factors for CRBSI during PICC indwelling period in premature infants(OR=2.533,14.128,13.256,respectively,all P＜0.05).The AUC of ROC of the modeling set was 0.953(95％CI:0.936-0.969),and that of the validation set was 0.930(95％CI:0.885-0.974),indicating good discriminability of the model.The calibra-tion curve and Hosmer-Lemeshow goodness of fit test showed that the model had good accuracy and consistency,with high net profit value,indicating that the predictive value of the model was high and with good clinical practica-lity.The statistical test result in the rationality analysis of the model was P＜0.001.Conclusion The nomogram model based on the general clinical characteristics of preterm infants as well as the basic prevention and control measures of the catheter can provide a visual and simple evaluation tool for early identification of high risk factors for CRBSI in preterm infants.

AIM:To investigate the mechanism of Luotong-Xianrong Yin(LTXRY)in regulating endoplasmic reticulum stress(ERS)to improve lung function of rats with idiopathic pulmonary fibrosis(IPF).METHODS:Forty-eight SPF male SD rats were randomly divided into sham group,model group,LTXRY group and nintedanib group,with 12 rats in each group.The IPF rat model was prepared by intratracheal infusion of bleomycin.The rats in LTXRY group were gavaged with aqueous solution of Chinese medicine formula granules,while the rats in nintedanib group were gavaged with aqueous solution of nintedanib.Lung function was detected by awake and unrestrained animal lung function test sys-tem.The pathomorphologic change in lung tissue was observed by HE and Masson staining.The expression of α-smooth muscle actin(α-SMA)was observed by immunohistochemical(IHC)staining,and the expression of vimentin was detect-ed by Western blot.The expressions of Bax,Bcl2,cleaved caspase-3,and PERK/eIF2α signal pathway related proteins were detected by Western blot.RESULTS:Abnormal lung function and fibrotic-like changes in lung tissue were present in rats in the IPF state.After the intervention of LTXRY,the lung function of IPF rats was significantly improved(P<0.01),the degree of lung tissue damage was significantly reduced(P<0.01),the expressions of apoptosis-related pro-teins,Bax and cleaved caspase-3,were significantly decreased(P<0.05 or P<0.01),while the expression of Bcl2 was significantly increased(P<0.05).Moreover,the ERS signal pathway,PERK/eIF2α,was significantly inhibited(P<0.05 or P<0.01).CONCLUSION:LTXRY could improve lung function in IPF rats by regulating cell apoptosis,and the mechanism may be related to inhibit endoplasmic reticulum stress.

Objective To construct a prediction model for the risk of peripherally inserted central venous catheter(PICC)-related bloodstream infection(CRBSI)in preterm infants,and evaluate the effect of the model.Methods 1 295 preterm infants admitted to the neonatal intensive care unit(NICU)in a hospital and received PICC intrave-nous infusion from January 2019 to October 2023 were selected as the study subjects,including 1 080 preterm in-fants from January 2019 to December 2022 in the modeling set and 215 premature infants from January to October 2023 in the validation set.Risk factors of cases were analyzed based on 24 clinical characteristics,optimized charac-teristics was selected by LASSO regression,independent risk factors for CRBSI of preterm infants during PICC in-dwelling period were identified by multiple logistic regression analysis,and nomogram model was constructed with R software.Discrimination and fitting of the model were evaluated by the area under the curve(AUC)of the receiver operating characteristic(ROC)as well as Hosmer-Lemeshow test and calibration curve,and clinical practicality of the model was evaluated by decision curve analysis(DCA).Results Multivariate logistic analysis showed that birth weight ≥1 500 g,sterile protection during catheter maintenance,and sterile cloth wrapped joints were protective factors for CRBSI during PICC indwelling period in preterm infants(OR=0.172,0.187,0.063,respectively,all P＜0.05),while puncture frequency＞2 times,catheter indwelling period＞14 days,and use of tees were inde-pendent risk factors for CRBSI during PICC indwelling period in premature infants(OR=2.533,14.128,13.256,respectively,all P＜0.05).The AUC of ROC of the modeling set was 0.953(95％CI:0.936-0.969),and that of the validation set was 0.930(95％CI:0.885-0.974),indicating good discriminability of the model.The calibra-tion curve and Hosmer-Lemeshow goodness of fit test showed that the model had good accuracy and consistency,with high net profit value,indicating that the predictive value of the model was high and with good clinical practica-lity.The statistical test result in the rationality analysis of the model was P＜0.001.Conclusion The nomogram model based on the general clinical characteristics of preterm infants as well as the basic prevention and control measures of the catheter can provide a visual and simple evaluation tool for early identification of high risk factors for CRBSI in preterm infants.

Objective:To investigate and analyze the thyroid examination results and influencing factors of interventional radiation workers in Tianjin.Methods:In February 2023, A convenient sampling method was used to select the staff engaged in interventional radiation work in an occupational health inspection institution in Tianjin from 2020 to 2022 as the study object. After excluding the incomplete data, 1080 people were included, and 363 medical staff with non-radiological work during the same period were included as the control group. To analyze the individual doses and occupational health examination data of interventional radiation workers, and to analyze the possible influencing factors of thyroid abnormalities.Results:The cumulative dose M ( Q1, Q3) of interventional radiation workers was 1.039 (0.528, 1.905) mSv. The levels of FT 3 and FT 4 in the intervention group were higher than those in the control group, while TSH levels were lower than those in the control group ( Z=4.84、6.03、-5.82, P<0.05). The levels of FT 3 and FT 4 in female interventional radiation workers were lower than those in males, while the levels of TSH were higher than those in males ( Z= -17.54、-6.65、3.61, P<0.05). There were statistically significant differences in FT 3 levels among different ages, differen tradiation exposure years, different initial age of exposure to radiation, and different cumulative doses ( H=47.22、11.33、16.70, Z=-2.48, P<0.05). There were statistically significant differences in thyroid ultrasound abnormalities among different genders, different ages, different initial age of exposure to radiation, and different cumulative doses ( χ2=28.02、61.12、17.87、11.30, P<0.05). The results of logistic regression analysis showed that the influencing factors of FT 3 distributed in the low-level group were female ( OR=10.53, 95% CI: 7.66-14.47, P<0.05), and age 40-49, ≥50 years old ( OR=2.40, 95% CI: 1.12-5.14 OR=3.79, 95% CI: 1.59-9.03, P<0.05). The influencing factors of thyroid ultrasound abnormalities were female ( OR=1.92, 95% CI: 1.48-2.50, P<0.05) and age ≥50 years old ( OR=3.93, 95% CI: 1.91-8.09, P<0.05) . Conclusion:Long term low dose ionizing radiation has a certain effect on FT 3, FT 4 and TSH levels of interventional radiation workers. Gender and increased age are possible influencing factors of the decreased FT 3 levels and thyroid ultrasound abnormalities.

Objective:To explore the related risk factors of neonatal necrotizing enterocolitis (NEC) by constructing and comparing nine regression models.Methods:All NEC patients admitted to the neonatal internal medicine department, neonatal surgery department, and neonatal intensive care unit of Shanxi Provincial Children's Hospital (Shanxi Provincial Maternity and Child Health Center) from 2020 to 2022 were included as the case group. A control group consisted of children admitted during the same period based on the inclusion and exclusion criteria. The NEC data collected were used for feature selection by using the Boruta algorithm. Logistic regression, multi-decision tree gradient boosting, efficient gradient one-sided sampling, random forest, decision tree, gradient boosting decision tree (GBDT), neural network, support vector machine, and K-nearest neighbor models were constructed. The optimal model was selected through rigorous comparison and Shap explainable analysis was performed on the GBDT model.Results:Thirteen key factors were identified through screening for nine regression models construction. After strict comparison and analysis, the GBDT model showed higher stability compared with other eight regression models. In the validation set, the area under the receiver operating characteristic curve of the GBDT model was 0.958, with an accuracy of 0.925, and sensitivity and specificity of 0.827 and 0.950, respectively. Shap explainable analysis on the GBDT model revealed that suffering from anemia, non-invasive ventilator use, procalcitonin use, premature birth, and low birth weight increased the risk for NEC, while breastfeeding and probiotics decreased the risk for NEC.Conclusion:This study identified the risk factors and protective factors for NEC by using the GBDT model, which provided evidnce for the prevention and treatment of NEC.

AIM:To investigate the mechanism of Luotong-Xianrong Yin(LTXRY)in regulating endoplasmic reticulum stress(ERS)to improve lung function of rats with idiopathic pulmonary fibrosis(IPF).METHODS:Forty-eight SPF male SD rats were randomly divided into sham group,model group,LTXRY group and nintedanib group,with 12 rats in each group.The IPF rat model was prepared by intratracheal infusion of bleomycin.The rats in LTXRY group were gavaged with aqueous solution of Chinese medicine formula granules,while the rats in nintedanib group were gavaged with aqueous solution of nintedanib.Lung function was detected by awake and unrestrained animal lung function test sys-tem.The pathomorphologic change in lung tissue was observed by HE and Masson staining.The expression of α-smooth muscle actin(α-SMA)was observed by immunohistochemical(IHC)staining,and the expression of vimentin was detect-ed by Western blot.The expressions of Bax,Bcl2,cleaved caspase-3,and PERK/eIF2α signal pathway related proteins were detected by Western blot.RESULTS:Abnormal lung function and fibrotic-like changes in lung tissue were present in rats in the IPF state.After the intervention of LTXRY,the lung function of IPF rats was significantly improved(P<0.01),the degree of lung tissue damage was significantly reduced(P<0.01),the expressions of apoptosis-related pro-teins,Bax and cleaved caspase-3,were significantly decreased(P<0.05 or P<0.01),while the expression of Bcl2 was significantly increased(P<0.05).Moreover,the ERS signal pathway,PERK/eIF2α,was significantly inhibited(P<0.05 or P<0.01).CONCLUSION:LTXRY could improve lung function in IPF rats by regulating cell apoptosis,and the mechanism may be related to inhibit endoplasmic reticulum stress.

OBJECTIVE To investigate the effects of alirocumab combined with atorvastatin on clinical efficacy and safety of patients with acute coronary syndrome （ACS） who underwent percutaneous coronary intervention （PCI）. METHODS A total of 207 patients with ACS who underwent PCI in our hospital from January 2021 to December 2023 were randomly divided into alirocumab group， ezetimibe group and control group， with 69 cases in each group. All patients received routine thrombosis prevention and antihypertensive treatment after PCI. On this basis， patients in the control group were treated with atorvastatin （20 mg/time， once a day）； patients in the ezetimibe group were treated with ezetimibe （10 mg/time， once a day） + atorvastatin （20 mg/time， once a day）； patients in the alirocumab group were treated with alirocumab （75 mg/time， once every 2 weeks） + atorvastatin （20 mg/time， once a day）. All patients in the three groups were treated for 8 weeks and followed up for another 6 months after treatment. The levels of cardiac function and lipid metabolism indices before and after treatment， as well as the occurrence of major adverse cardiovascular event （MACE） and other adverse drug reaction （ADR） during the follow-up period were compared among the three groups. RESULTS After treatment for 8 weeks， the levels of cardiac function and lipid metabolism indices in the three groups were significantly improved compared with those before treatment （P＜0.05）. Compared with the control group and ezetimibe group， the left ventricular ejection fraction in the alirocumab group was significantly increased， and the left ventricular end-diastolic diameter （LVEDD） was significantly shortened （P＜0.05）. Compared with control group， LVEDD of ezetimibe group was significantly shortened （P＜0.05）， the levels of total cholesterol， triglyceride and low-density lipoprotein cholesterol in the alirocumab group and ezetimibe group were significantly decreased （P＜0.05）. During the follow-up period， there was no significant difference in the total incidence of MACE and the total incidence of other ADR such as headache and abdominal pain among the three groups （P＞0.05）. CONCLUSIONS Alirocumab combined with atorvastatin can significantly improve cardiac function and regulate lipid metabolism indices in patients with ACS after PCI without increasing the risk of MACE or other ADR.