Objective: To explore the early effects of birth weight at different gestational ages on blood pressure trajectory among primary school students, so as to provide evidence for incorporating gestational age birth weight into individualized early warning and intervention strategies for childhood hypertension. Methods: From May to November 2023, a purposeful sampling method was used to recruit 1 676 students in grade 1-3 from three primary schools in a certain urban district of Chongqing. Follow up assessments were conducted in May 2024(T1), November 2024(T2), and May 2025(T3). General demographic and birth related information were collected via self administered questionnaires, while height, weight and blood pressure were obtained through physical examinations. Linear mixed effects model was used to analyze the associations between birth weight at different gestational ages and blood pressure trajectories. Results: During the T1-T3 period, the systolic blood pressure of boys were 98.5 (93.0, 104.5 ),98.5 (93.5, 105.0), and 97.5 (92.5, 103.5)mmHg, respectively, while the diastolic blood pressure were 60.5 (56.5, 65.0), 61.5 ( 57.0 , 65.5), and 60.0 (56.0, 64.0)mmHg, respectively. For girls, the systolic blood pressure were 95.5 (90.0, 102.0),95.5 (90.5, 101.5), and 96.0 (90.5, 101.5)mmHg, respectively, and the diastolic blood pressure were 60.5 (56.0, 64.5 ),61.5 (57.5, 65.5), and 59.5 (56.0, 63.0)mmHg, respectively. Through Friedman test within both boys and girls, diostolic blood pressure were statistically significant across three measurements( χ 2=48.85，81.54，both P <0.01). The proportion of normal blood pressure increased , and the proportion of prehypertension and hypertension decreased with time( χ 2=39.72，25.62，both P < 0.01 ). Linear mixed effects model analysis revealed that after adjusting for age, sex, household income monthly, parental education, family history of hypertension and maternal pregnancy complications, large for gestational age had significantly higher trajectories of systolic ( β = 1.50) and diastolic( β =0.94) blood pressure compared to appropriate for gestational age(both P <0.01). Conclusion Large for gestational age is associated with elevated blood pressure trajectories during school age, and it may be considered as an early indicator for individualized screening and intervention for childhood hypertension.

Objective: To analyze the epidemiological characteristics and changing trends of non suicidal self injury (NSSI) behaviors among middle school students in Jiading District of Shanghai, from 2015 to 2023, so as to provide a basis for the development of NSSI prevention and control measures among students. Methods: Using a stratified cluster random sampling method, a total of five times for Shanghai Adolescent Health Risk Behavior Surveys were conducted for every two years in Jiading District of Shanghai from 2015 to 2023. A total of 5 231 middle school students from junior high schools and senior high schools were selected for questionnaire surveys. Intergroup comparisons were performed using the x 2 test or the χ 2 trend test, and the JointPoint 5.0 software was used to analyze the changing trends, with the annual percent change (APC) used for evaluation. A binary Logistic regression model was employed to analyze the related factors of NSSI behavior among middle school students. Results: In 2023, the reported NSSI rate among middle school students in Jiading District was 14.2%. The rate was significantly higher among junior high school students (17.1%) than that among senior high school students (11.1%), and higher among females (19.2%) than that among males (10.0%) ( χ 2=10.04, 23.21, both P <0.01). From 2015 to 2023, the overall reported NSSI rate showed an increasing trend, rising from 8.6% in 2015 to 14.2% in 2023 ( χ 2 trend =22.25), with an APC of 6.64% ( t =3.49), and the APC for girls was 9.79 % ( t =3.20) (all P <0.05). Among students reporting NSSI, the proportion experiencing ≥6 episodes increased from 10.8% in 2015 to 19.2% in 2023 ( χ 2 trend =6.57, P <0.05). Multivariate Logistic regression analysis indicated that girls, junior high school students, those with insomnia, depressive emotion and drinkers had higher risks of NSSI, compared to boys, senior high school students, those without insomnia, non depressive emotion students and non drinkers ( OR =1.71, 1.96, 3.44, 4.76, 1.77, all P < 0.05 ). Conclusions The reported rate of NSSI among middle school students in Jiading District of Shanghai, increased annually from 2015 to 2023, and the proportion of repeated NSSI also showed an upward trend. Early intervention measures targeting middle school students, especially junior high school students and females, should be implemented to prevent and control its occurrence and development.

Objective:To explore the HIV-1 drug resistance in patients with HIV/AIDS in Guilin city following the failure of antiretroviral treatment (ART).Methods:Plasma samples were collected from patients in Guilin who had received ART for more than 1 year and had a HIV viral load greater than or equal to 1 000 copies/ml from January 2019 to December 2023, and demographic information was also collected for HIV-1 genotype subtype analysis and drug resistance testing to determine the resistance mutation loci and the susceptibility of the strains to drugs.Results:A total of 766 patient samples with failed ART collection and successful amplification were collected, of which 536 (69.97%, 536/766) were male, with an average age of 53 years; a total of 8 HIV-1 subtypes were detected, with CRF01_AE (80.55%, 617/766), CRF07_BC (11.10%, 85/766) and CRF08_BC (6.92%, 53/766) predominated. The drug resistance analysis showed that the HIV-1 drug resistance rate was 34.86% (267/766), including nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitor (PI), with dual resistance to NRTIs/NNRTIs (48.31%, 129/267) and NNRTIs resistance (43.07%, 115/267) predominantly. A total of 37 resistance mutation sites were detected, 14 NRTIs-associated mutation sites mainly included M184V/I (47.57%, 127/267), K65R (18.73%, 50/267), K70E/N/T/G/R (13.11%, 35/267), etc., and 18 NNRTIs-associated mutation sites mainly included K103 N/R (56.93%, 152/267), V179 D/E/T (21.72%, 58/267), G190C/S/Q (17.23%, 46/267), and V106I/M (16.85%, 45/267), etc.; and 5 PIs-associated mutation sites was the highest with L10V/I mutation rate (3.00%, 8/267).Conclusions:HIV/AIDS patients in Guilin have shown favorable outcomes in antiviral therapy, with a relatively low overall incidence of drug resistance. However, it is essential to enhance surveillance to reduce the spread of drug-resistant strains in the future.

Objective:To observe the effects of hyperbaric oxygen combined with Xingnaojing injection on serum nerve injury，serum factors，and cognitive function in patients with acute carbon monoxide poisoning delayed encephalopathy（ACMPDE）.Methods:A total of 106 cases with ACMPDE who were admitted to the First People’s Hospital of Nanning from July 2018 to July 2020 were selected as the research subjects and divided into control group and research group according to the random number table method，with 53 cases in each group. The control group was given hyperbaric oxygen treatment for 20 days，while the research group was given Xingnaojing injection on the basis of the treatment in the control group for 20 days. The levels of hypersensitive C-reactive protein（hs-CRP），interleukin-6（IL-6），interleukin-10（IL-10），tumor necrosis factor - α（TNF - α），neuron specific enolase（NSE），5-hydroxytryptamine（5-HT），angiopoietin-2（Ang-2），inducible nitric oxide synthase（iNOS），malondialdehyde（MDA），superoxide dismutase（SOD）in the two groups were detected before and after treatment. The Montreal Cognitive Assessment Scale（MoCA），Mini-Mental State Examination（MMSE）and 36-Item Short Form Health Survey（SF-36）were used to evaluate the cognitive function and quality of life of the two groups of patients and to compare the clinical efficacy of the two groups after treatment.Results:The levels of hs CRP，TNF - α and IL-6 in the research group were lower than those in the control group（ P < 0.01），the level of IL-10 in the research group was higher than that in the control group（ P < 0.01），the level of 5-HT in the research group was higher than that in the control group（ P < 0.01），the levels of NSE，Ang-2，and iNOS in the research group were lower than those in the control group（ P < 0.01），the level of SOD in the research group was higher than that in the control group（ P < 0.01），and the level of MDA in the research group was lower than that in the control group（ P < 0.01）.The MMSE，MOCA and SF-36 scores of the research group were higher than those of the control group（ P < 0.01）. After treatment，the total effective rate of the research group（98.11%）was significantly higher than that of the control group（84.91%），and the difference was statistically significant（χ 2 = 4.371， P = 0.037）. Conclusion:Hyperbaric oxygen combined with Xingnaojing injection can improve the level of serum factors in patients with ACMPDE，inhibit inflammatory response，alleviate nerve injury，reduce oxidative stress response，and improve the cognitive function and the quality of life of patients，which is worthy of clinical application.

Objective:To observe the effects of hyperbaric oxygen combined with Xingnaojing injection on serum nerve injury，serum factors，and cognitive function in patients with acute carbon monoxide poisoning delayed encephalopathy（ACMPDE）.Methods:A total of 106 cases with ACMPDE who were admitted to the First People’s Hospital of Nanning from July 2018 to July 2020 were selected as the research subjects and divided into control group and research group according to the random number table method，with 53 cases in each group. The control group was given hyperbaric oxygen treatment for 20 days，while the research group was given Xingnaojing injection on the basis of the treatment in the control group for 20 days. The levels of hypersensitive C-reactive protein（hs-CRP），interleukin-6（IL-6），interleukin-10（IL-10），tumor necrosis factor - α（TNF - α），neuron specific enolase（NSE），5-hydroxytryptamine（5-HT），angiopoietin-2（Ang-2），inducible nitric oxide synthase（iNOS），malondialdehyde（MDA），superoxide dismutase（SOD）in the two groups were detected before and after treatment. The Montreal Cognitive Assessment Scale（MoCA），Mini-Mental State Examination（MMSE）and 36-Item Short Form Health Survey（SF-36）were used to evaluate the cognitive function and quality of life of the two groups of patients and to compare the clinical efficacy of the two groups after treatment.Results:The levels of hs CRP，TNF - α and IL-6 in the research group were lower than those in the control group（ P < 0.01），the level of IL-10 in the research group was higher than that in the control group（ P < 0.01），the level of 5-HT in the research group was higher than that in the control group（ P < 0.01），the levels of NSE，Ang-2，and iNOS in the research group were lower than those in the control group（ P < 0.01），the level of SOD in the research group was higher than that in the control group（ P < 0.01），and the level of MDA in the research group was lower than that in the control group（ P < 0.01）.The MMSE，MOCA and SF-36 scores of the research group were higher than those of the control group（ P < 0.01）. After treatment，the total effective rate of the research group（98.11%）was significantly higher than that of the control group（84.91%），and the difference was statistically significant（χ 2 = 4.371， P = 0.037）. Conclusion:Hyperbaric oxygen combined with Xingnaojing injection can improve the level of serum factors in patients with ACMPDE，inhibit inflammatory response，alleviate nerve injury，reduce oxidative stress response，and improve the cognitive function and the quality of life of patients，which is worthy of clinical application.

Objective: To study the effect of low-to-moderate dose glucocorticoid therapy on viral clearance time in patients with COVID-19. Methods: A total of 72 patients diagnosed with COVID-19 from January 19 to February 17, 2020 at the First Affiliated Hospital, School of Medicine, Zhejiang University were recruited. All patients received oral abidol and/or combined lopinavir/ritonavir, darunavir antiviral, and symptomatic supportive care. Among them, 51 patients received methylprednisolone (0.75-1.50 mg·kg^-1·d^-1) (glucocorticoid treatment group), and 21 patients who did not use glucocorticoid were the control group. The time of stable virologic conversion insputumand the time of radiologic recovery in lungsince onset were compared between the two groups and among the normal patients.The Kruskal-Wallis test or Fisher exact test was used to compare the difference between groups. Results: The median ages of the glucocorticoid group and the control group were 52 [interquartile range (IQR):45, 62] years and 46 (IQR: 32, 56)years, and the differences were significant (P<0.05). The clinical conditions at hospital admission were different between the two groups (P<0.01). There were 52.0% critical ill patients in the glucocorticoid treatment group, compared to that of 71.4% normal patients in the control group. The median times from the onset tostable virologic conversion to negative in the two groups were 15 (IQR:13,20) days and 14 (IQR:12,20) days (P>0.05), and the difference was no statistically significant. The median times from onset to radiologic recovery were 13 (IQR: 11,15) days and 13 (IQR:12,17) days in the two groups, and there was no difference (P>0.05). In ordinary patients, the median timesfrom the onset tostable virologic conversion insputum were no difference (P>0.05), with 13 (IQR:11,18) days in the glucocorticoid group and 13 (IQR:12,15) days in the control group; The median times from onset to radiologic recovery in lungwere also no difference (P>0.05), with 12 (IQR: 10,15)days in the glucocorticoid group and 13 (IQR: 12,17) days inthe control group. Conclusions Low-to-moderate glucocorticoid treatment has no effect on the time of virus clearance in patients with different clinical types of COVID-19. The glucocorticoid is not recommended since no effectiveness on accelerating the improvement of radiologic recovery in lung has been observed.

Objective:To study the effect of low-to-moderate dose glucocorticoid therapy on viral clearance in patients with COVID-19.Methods:A total of 72 patients diagnosed with COVID-19 from January 19 to February 17, 2020 at the First Affiliated Hospital, Zhejiang University School of Medicine were recruited. All patients received oral arbidol and combination of lopinavir/ritonavir or darunavir/cobistitat for antiviral therapy, and symptomatic supportive care. Among them, 51 patients received methylprednisolone (0.75-1.50 mg·kg -1·d -1) (glucocorticoid treatment group), and 21 patients did not use glucocorticoid (control group). The time of virologic negative conversion in sputum and the time of radiologic recovery in lung since onset were compared between the two groups. The Kruskal-Wallis test or Fisher exact test was used to compare the difference between groups. Results:The median ages of the glucocorticoid group and the control group were 52 (45, 62) and 46 (32, 56) years ( χ2=4.365, P<0.05). The clinical conditions at hospital admission were different between the two groups ( P<0.01). The severe cases accounted for 52.0%, while moderate cases in the control group accounted for 71.4%. The median times from the onset to virologic negative conversion in the two groups were 15 (13, 20) and 14 (12, 20) days ( P>0.05). The median times from onset to radiologic recovery were 13 (11, 15) and 13 (12, 17) days in the two groups ( P>0.05). In moderate cases, the median times from the onset to virologic conversion in sputum were 13 (11, 18) days in the glucocorticoid group and 13 (12, 15) days in the control group ( P>0.05). The median times from onset to radiologic recovery in lung were 12 (10, 15) and 13 (12, 17) days, respectively ( P>0.05). Conclusions:Low-to-moderate glucocorticoid treatment has no effect on the time of virus clearance in patients with different clinical types of COVID-19, and also no effect on accelerating radiologic recovery in lung, so it is not recommended.

Objective: To understand the homosexual behavior and related factors among married MSM in Mianyang city. Methods: Between January and October in 2017, a snowball sampling method was adopted to carry out cross-sectional survey through questionnaires plus HIV testing among those MSM in Mianyang city. Logistic regression model was used to analyze homosexual behaviors and related factors among married MSM under study. Statistical analysis was used by EpiData 3.1 and SPSS 19.0 software. Results: A total of 234 MSM participated in this survey. The overall rate of homosexual behavior in these married MSM appeared as 94.9% (222/234). Rate of having anal sex behavior was 94.4% (221/234) in the past 6 months, with rate of condom use as 57.9% (128/221). HIV positive rate was 8.1% (18/222). As for the motives for homosexual behavior after marriage, 87.8% (195/222) were driven by feelings of love, 12.2% (27/222) due to 'releasing pressure’. Proportion of male sex partners would include occasional sex partners (62.2%, 138/222), stable male sex partners (26.1%, 58/222) and stable boyfriends (11.7%, 26/222). Factors from logistic regression analysis showed that homosexual behaviors were related to the factors including education level of senior high school or above vs. education level of junior middle school or below (OR=3.65, 95%CI: 1.33-9.98); local residency over one year vs. the ones having local residency less than one year (OR=23.28, 95%CI:1.67-324.89); having 10 or more friends in the MSM community vs. having below 10 friends in MSM community (OR=4.15, 95%CI: 1.28-13.43); without sex pleasure with spouse vs. having sex pleasure with spouse (OR=3.25, 95%CI: 1.22-8.62); having 2 or more anal sex partners in the past 6 months vs. having less than 2 anal sex partners in the past 6 months (OR=0.28,95%CI: 0.09-0.81). Conclusions The rate of homosexual behavior and HIV positive rate were high among MSM in Mianyang city. Homosexual behaviors after marriage were influenced by multiple factors among MSM. The motives of homosexual behavior after marriage were driven by feelings of love, the related factors were education level of senior high school or above, local residency over one year, having 10 or more friends in the MSM community and without sex pleasure with spouse. As for the motives of these behaviors was caused by releasing pressure, the related factors was having more than 2 anal sex partners.

Psychological suboptimal health status is an intermediate state between mental health and mental disease.Without timely intervention,psychological suboptimal health may develop into serious diseases that pose a threat to human physical and mental health,such as depression,anxiety disorders and high blood pressure.This review summarizes the scientific concepts,diagnostic Criteria,intervention and pharmacological research of psychological suboptimal health from the perspective of both modern medicine and traditional Chinese medicine and proposes possible solutions to existing problems in order to contribute to the identification,diagnosis,prevention and treatment of psychological suboptimal health.

Objective To investigate the effects of congenital ptosis on refractive power of the corneal surface.Methods Forty-five patients (90 eyes) with congenital ptosis in the First Affiliated Hospital of Kunming Medical University were examined from October 2013 to June 2015.Corneal topographic analysis was performed in both the ptosis and the normal eyes.The comparison between the ptotic eye and the normal eye was done according to the topographic results.Results Among 90 eyes,55 were ptotic and 35 were normal.Amblyopia was detected in 21 ptotic eyes (38.2％).No correlation was found between amblyopia and the severity of ptosis (x 2=2.617,P＞0.05).Ptotic eye showed an asymmetrical bow tie pattern (23 eyes) and an irregular pattern (32 eyes) on corneal photography and the maximum refractive power occurred at the inferior quadrant of the corneal horizontal axis.Difference value of the average refractive power of the cornea between lower side and upper side in ptotic eyes was higher than that of the normal eyes at 5mm and 7mm diameter areas (P＜0.01) except for 3mm diameter area (P＞ 0.05).Conclusion Congenital ptosis may lead to the change of refractive power of the local corneal surface.Amblyopia has no correlation with the severity of ptosis.