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.

Objective To explore the pro-inflammation resolution and protective effects of reactive oxygen species (ROS)-responsive liposomes modified with a cardiac-targeted peptide and loaded with resolvin D1 (RvD1, C-LP-RvD1) on myocardial ischemia-reperfusion (MI/R) injury. Methods The C-LP-RvD1 nanoliposomes were constructed, characterized physically and chemically, and evaluated for in vitro release. Non-targeting peptide-modified drug-loaded liposomes (LP-RvD1) were served as controls. Apoptotic adult mouse cardiomyocytes (AMCMs) were used to verify in vitro targeted binding capacity of C-LP-RvD1. In MI/R mice models, the in vivo distribution and cardiac enrichment of C-LP-RvD1 were assessed. Levels of specialized pro-resolving mediator (SPM) and inflammatory factors in cardiac tissue homogenates and cell culture supernatants were measured using enzyme-linked immunosorbent assay (ELISA). Cardiac function and fibrosis remodeling were evaluated via echocardiography and Masson staining four weeks after treatment. Biosafety was evaluated in healthy mice injected by C-LP-RvD1. Results The C-LP-RvD1 exhibited good nanoscale uniformity and stability, with ROS-triggered accelerated release characteristics. In vitro experiments showed that C-LP-RvD1 had higher binding capacity to apoptotic AMCMs than LP-RvD1, with significantly higher SPM levels (P＜0.01) and lower inflammatory factor levels (P＜0.05). In vivo experiments indicated enhanced cardiac enrichment of C-LP-RvD1 in MI/R injured hearts, with higher local myocardial SPM levels and lower inflammatory factor levels compared to LP-RvD1 (P＜0.05). Four weeks after treatment, compared with LP-RvD1, the C-LP-RvD1 mice group showed improved cardiac function indicators and reduced ventricular fibrosis remodeling ratio (P＜0.05). Safety evaluation revealed no significant systemic inflammation, immunogenicity, or coagulation abnormalities in healthy mice, with liver and kidney function and major organ histology showing no notable damage. Conclusions C-LP-RvD1 improves effective delivery of RvD1 to MI/R injured hearts through injury-targeted enrichment and ROS-responsive release, promoting inflammation resolution and suppressing excessive inflammation, thereby improving cardiac function and reducing adverse remodeling, with favorable biosafety.

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.

By integrating existing research,this paper systematically analyzes the impact of exercise training in low-temperature environments on immune regulation and infection defense,in order to explore its potential benefits and risks.Strictly following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses:2020(PRISMA 2020)guidelines,multiple databases were systematically reviewed,to include original studies on the impact of exercise training in low-temperature environments on immune regulation and infection defense,and to evaluate the quality of the studies.The 25 included literature indicated that moderate-intensity exercise training in low-temperature environments could cause an increase in white blood cell count,neutrophils and natural killer cells,changes in both pro-inflammatory and anti-inflammatory factors,and predominant upregulation of most mucosal immunity level,as well as accelerated infection recovery in several studies.High-intensity exercise training in low-temperature environments has shown an immunosuppressive trend in individual studies,and physiological indicators such as body temperature,heart rate and metabolism have also been affected to varying degrees.This suggests that moderate-intensity exercise training in a low-temperature environment is conducive to enhancing immunity and preventing infection,which is of great significance for health management and occupational protection in cold climates.Reasonable control of exercise intensity and duration in a low-temperature environment is crucial for preventing immunosuppression.

BACKGROUND:Skeletal muscle insulin resistance is the key pathological link of type 2 diabetes.The traditional Chinese medicine compound Roujishuncuiyin can effectively improve skeletal muscle insulin resistance,but its mechanism has not been clarified.OBJECTIVE:To explore the mechanism of Roujishuncuiyin on skeletal muscle insulin resistance in type 2 diabetes mice.METHODS:Forty db/db mice with type 2 diabetes mellitus were randomized into a model group,a low-dose Roujishuncuiyin group,a high-dose Roujishuncuiyin group,and a positive drug group,with 10 mice in each group.The latter three administration groups were given 157.5 mg/g and 630 mg/g Roujishuncuiyin and 200 mg/g metformin hydrochloride aqueous solution by gavage once a day,respectively.In addition,10 db/dm mice were selected as the blank control group.Mice in the model and blank control groups were given the same dose of 0.9％NaCl solution by gavage.After 12 weeks of intervention,fasting blood glucose was measured in each group of mice,and oral glucose tolerance test was performed to calculate the area under the blood glucose curve.ELISA was used to detect serum insulin level and calculate the resistance index.Mitochondrial structure of skeletal muscle tissue was observed under transmission electron microscopy.Western blot was used to detect the expression levels and phosphorylation levels of protein kinase B(AKT)and glycogen synthase kinase 3β(GSK-3β)proteins in skeletal muscle.RESULTS AND CONCLUSION:(1)Compared with the blank control group,fasting blood glucose,fasting insulin and insulin resistance index were significantly higher in the model group(P＜0.05),the area under the curve of the oral glucose tolerance test was significantly increased(P＜0.05),the expression of p-AKT and p-GSK3β proteins in tibialis anterior muscle was significantly decreased(P＜0.05),and there was a large amount of mitochondrial damage in tibialis anterior muscle and a large number of lipid droplets in the interstitium.(2)Compared with the model group,fasting blood glucose,fasting insulin,and insulin resistance index were significantly reduced in the low-and high-dose Roujishuncuiyin groups and the positive control group(P＜0.05),the area under the curve of the oral glucose tolerance test was reduced(P＜0.05),the expression of p-AKT and p-GSK3β proteins in the tibialis anterior muscle was significantly elevated(P＜0.05),and mitochondrial damage in the tibialis anterior muscle was significantly ameliorated,with decreased lipid droplets in the interstitium.(3)The above indexes were better in the high-dose Roujishuncuiyin group than the low-dose Roujishuncuiyin group(P＜0.05),while there was no significant difference between the high-dose Roujishuncuiyin group and positive control group(P＞0.05).To conclude,by upregulating the protein levels of p-AKT and p-GSK3β in skeletal muscle tissue,the traditional Chinese medicine compound Roujishuncuiyin can improve structural disorders and mitochondrial morphology in skeletal muscle tissue,reduce insulin resistance in the skeletal muscle and regulate glucose homeostasis in the body.

Objective:To investigate the effects of multimodal and multisensory stimulation training on feeding-swallowing and neurological functions in stroke patients with dysphagia.Methods:Stroke patients with dysphagia treated at Henan Provincial People's Hospital from January 2023 to October 2024 were enrolled. Patients were randomly divided into three groups according to the random number table method, with 36 patients in each group. These three groups underwent different interventions for a period of 8 weeks: multisensory stimulation intervention (stimulation group), multimodal rehabilitation training intervention (rehabilitation group), and innovative multimodal and multisensory stimulation training intervention (combined group). The Kubota water swallow test and functional oral intake scale (FOIS) were used to assess the effective improvement rate of feeding function. Differences in scores of modified Mann assessment of swallowing (MMASA), swallowing quality of life (SWAL-QOL), and National Institute of Health Stroke scale (NIHSS) among the three groups were compared before intervention, and at 4 and 8 weeks post-intervention. SPSS 27.0 software was used to analyze the data by one-way ANOVA, repeated measures ANOVA, Kruskal-Wallis H test, Mann-Whitney U test and Pearson correlation analysis. Results:(1) After 8 weeks of intervention, the effective improvement rates of feeding function were 75.00%(27/36) and 72.22%(26/36) in the stimulation group and rehabilitation group, respectively, which were both lower than that in the combined group (94.44%(34/36), both P<0.05). (2) The interaction effect between time and group was significant in MMASA scores among the three groups before and after intervention ( F=2.569, P<0.05). MMASA scores at 8 weeks post-intervention were higher than those at 4 weeks post-intervention and baseline in all groups (all P<0.05), and scores at 4 weeks post-intervention were also higher than those at baseline (all P<0.05). At 4 and 8 weeks post-intervention, MMASA scores in the combined group (85.64±11.26, 92.56±10.55) were higher than those in the stimulation group (73.52±12.65, 82.97±12.84) and rehabilitation group (72.47±11.38, 84.39±12.29) (all P<0.05). (3) The interaction effect between time and group was significant in SWAL-QOL total scores among the three groups before and after intervention ( F=18.561, P<0.05). SWAL-QOL total scores at 8 weeks post-intervention were higher than those at 4 weeks post-intervention and baseline in all groups ( P<0.05), and scores at 4 weeks post-intervention were also higher than those at baseline (all P<0.05). At 4 and 8 weeks post-intervention, SWAL-QOL total scores in the combined group (115.64±9.26, 135.68±9.55) were higher than those in the stimulation group (108.42±8.65, 113.75±8.84) and rehabilitation group (108.37±8.38, 114.39±9.29) (all P<0.05). (4) The interaction effect between time and group was significant in NIHSS scores among the three groups before and after intervention ( F=7.890, P<0.05). NIHSS scores at 8 weeks post-intervention were lower than those at 4 weeks post-intervention and baseline in all groups (all P<0.05), and scores at 4 weeks post-intervention were also lower than those at baseline (all P<0.05). At 4 and 8 weeks post-intervention, NIHSS scores in the combined group (8.36±1.35, 5.22±1.05) were lower than those in the stimulation group (11.65±2.11, 8.78±1.12) and rehabilitation group (11.32±2.03, 8.36±1.17) (all P<0.05). Conclusion:Multimodal and multisensory stimulation training can improve feeding-swallowing function and neurological impairment in stroke patients with dysphagia, with intervention effects superior to those of either approach used alone.

OBJECTIVE To investigate the therapeutic effect of Qingchang Huazhuo Formula(QCHZF)on mice with ulcerative colitis(UC)and the influences of fecal metabolites based on non-targeted metabolomics to investigate the mechanism of action of QCHZF in the treatment of UC.METHODS UC mice were induced by dextran sulfate sodium salt(DSS)and were administered with QCHZF.During the experiment,the body weight,stool characteristics and blood in stool were recorded daily,and the disease activity index(DAI)was calculated.At the end of the experiment,the length of colon was measured,colonic tissue damage in mice were ob-served by hematoxylin-eosin and alcian blue staining,mRNA expression levels of inflammatory factors,IL-6,IL-18 and IL-1β,and intestinal barrier factors,ZO-1 and Muc2,were detected in colon tissues via qPCR method,and protein expression level of intestinal barrier,Muc2,was detected with immunofluorescence.Fecal metabolite changes in mice were detected employing un-targeted metabo-lomics and analyzed by MetaboAnalyst 5.0 for metabolic pathway enrichment.RESULTS QCHZF significantly alleviated colitis symptoms,increased body weight,decreased DAI score,reversed colonic shortening,inhibited inflammatory factors expression,im-proved colonic tissue structure disorders,increased the number of goblet cells,and restored the intestinal barrier in UC mice,regulated 58 metabolites,mainly involving pathways of methionine and cysteine metabolism,purine metabolism,steroid hormone biosynthesis,vitamin B6 metabolism,tryptophan metabolism and primary bile acid pathways.CONCLUSION QCHZF can improve colitis symp-toms,repaire the intestinal barrier and modulate fecal metabolites and related metabolic pathways in UC mice.

By integrating existing research,this paper systematically analyzes the impact of exercise training in low-temperature environments on immune regulation and infection defense,in order to explore its potential benefits and risks.Strictly following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses:2020(PRISMA 2020)guidelines,multiple databases were systematically reviewed,to include original studies on the impact of exercise training in low-temperature environments on immune regulation and infection defense,and to evaluate the quality of the studies.The 25 included literature indicated that moderate-intensity exercise training in low-temperature environments could cause an increase in white blood cell count,neutrophils and natural killer cells,changes in both pro-inflammatory and anti-inflammatory factors,and predominant upregulation of most mucosal immunity level,as well as accelerated infection recovery in several studies.High-intensity exercise training in low-temperature environments has shown an immunosuppressive trend in individual studies,and physiological indicators such as body temperature,heart rate and metabolism have also been affected to varying degrees.This suggests that moderate-intensity exercise training in a low-temperature environment is conducive to enhancing immunity and preventing infection,which is of great significance for health management and occupational protection in cold climates.Reasonable control of exercise intensity and duration in a low-temperature environment is crucial for preventing immunosuppression.

Objective:To investigate the effects of multimodal and multisensory stimulation training on feeding-swallowing and neurological functions in stroke patients with dysphagia.Methods:Stroke patients with dysphagia treated at Henan Provincial People's Hospital from January 2023 to October 2024 were enrolled. Patients were randomly divided into three groups according to the random number table method, with 36 patients in each group. These three groups underwent different interventions for a period of 8 weeks: multisensory stimulation intervention (stimulation group), multimodal rehabilitation training intervention (rehabilitation group), and innovative multimodal and multisensory stimulation training intervention (combined group). The Kubota water swallow test and functional oral intake scale (FOIS) were used to assess the effective improvement rate of feeding function. Differences in scores of modified Mann assessment of swallowing (MMASA), swallowing quality of life (SWAL-QOL), and National Institute of Health Stroke scale (NIHSS) among the three groups were compared before intervention, and at 4 and 8 weeks post-intervention. SPSS 27.0 software was used to analyze the data by one-way ANOVA, repeated measures ANOVA, Kruskal-Wallis H test, Mann-Whitney U test and Pearson correlation analysis. Results:(1) After 8 weeks of intervention, the effective improvement rates of feeding function were 75.00%(27/36) and 72.22%(26/36) in the stimulation group and rehabilitation group, respectively, which were both lower than that in the combined group (94.44%(34/36), both P<0.05). (2) The interaction effect between time and group was significant in MMASA scores among the three groups before and after intervention ( F=2.569, P<0.05). MMASA scores at 8 weeks post-intervention were higher than those at 4 weeks post-intervention and baseline in all groups (all P<0.05), and scores at 4 weeks post-intervention were also higher than those at baseline (all P<0.05). At 4 and 8 weeks post-intervention, MMASA scores in the combined group (85.64±11.26, 92.56±10.55) were higher than those in the stimulation group (73.52±12.65, 82.97±12.84) and rehabilitation group (72.47±11.38, 84.39±12.29) (all P<0.05). (3) The interaction effect between time and group was significant in SWAL-QOL total scores among the three groups before and after intervention ( F=18.561, P<0.05). SWAL-QOL total scores at 8 weeks post-intervention were higher than those at 4 weeks post-intervention and baseline in all groups ( P<0.05), and scores at 4 weeks post-intervention were also higher than those at baseline (all P<0.05). At 4 and 8 weeks post-intervention, SWAL-QOL total scores in the combined group (115.64±9.26, 135.68±9.55) were higher than those in the stimulation group (108.42±8.65, 113.75±8.84) and rehabilitation group (108.37±8.38, 114.39±9.29) (all P<0.05). (4) The interaction effect between time and group was significant in NIHSS scores among the three groups before and after intervention ( F=7.890, P<0.05). NIHSS scores at 8 weeks post-intervention were lower than those at 4 weeks post-intervention and baseline in all groups (all P<0.05), and scores at 4 weeks post-intervention were also lower than those at baseline (all P<0.05). At 4 and 8 weeks post-intervention, NIHSS scores in the combined group (8.36±1.35, 5.22±1.05) were lower than those in the stimulation group (11.65±2.11, 8.78±1.12) and rehabilitation group (11.32±2.03, 8.36±1.17) (all P<0.05). Conclusion:Multimodal and multisensory stimulation training can improve feeding-swallowing function and neurological impairment in stroke patients with dysphagia, with intervention effects superior to those of either approach used alone.

Objective To understand the epidemiological characteristics and trends of postoperative pneumonia(POP)in tertiary general hospitals in Jiangsu Province,and provide theoretical basis for carrying out targeted pre-vention and control measures.Methods Surgery patients from 22 tertiary general hospitals in 12 cities in north,central,and south of Jiangsu Province from January 1,2022 to December 31,2023 were chosen as studied subjects,occurrence of POP was analyzed and compared.Results A total of 848 274 surgical procedures were performed in 22 hospitals,and 3 606 cases of POP occurred,with an incidence of 0.43％.The incidence in 2023 was 0.37％,which was lower than that in 2022(0.49％),with statistically significant difference(P＜0.001).The top three de-partments with high incidence of POP were neurosurgery(6.71％),cardiothoracic surgery(2.91％),and general surgery(0.77％).Among hospitals of different grades,the incidence of POP in tertiary first-class hospitals was 0.44％,which was higher than that in other tertiary hospitals(0.37％).There was no statistically significant difference in the incidence of POP between municipal and district/county hospitals(P＞0.05).The incidence of POP in hospitals with a bed:infection control full-time staff ratio＜200∶1 was lower than that in hospitals with the ratio ≥200∶1(0.39％vs 0.47％,P＜0.001),while the incidence of POP in hospitals with a proportion ≥30％of full-time staff being doctors was higher than that in hospitals with a proportion＜30％(0.45％vs 0.36％,P＜0.001).The incidence of POP in male patients was higher than that in female patients(0.62％vs 0.26％,P＜0.001).The incidence of POP in elderly patients aged≥65 was higher than that in patients aged＜65(0.73％vs 0.26％,P＜0.001).A total of 2 667 strains of infectious pathogens were detected,with the top three being Acine-tobacter baumannii,Klebsiella pneumoniae,and Pseudomonas aeruginosa,accounting for 28.95％,22.72％,and 15.45％,respectively.The detection rates of carbapenem-resistant Acinetobacter baumannii(CRAB),carba-penem-resistant Klebsiella pneumoniae(CRKP),and carbapenem-resistant Pseudomonas aeruginosa(CRPA)were 60.75％,21.45％,and 32.28％,respectively.The detection rate of CRKP decreased in 2023 compared with 2022,with statistically significant difference(P＜0.05).Conclusion The overall incidence of POP in tertiary general hos-pitals in Jiangsu Province is relatively low,but there are significant differences among different hospitals.There-fore,perioperative prevention and control measures should be carried out based on the epidemiological characteristics of patients.