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 investigate the management of cancer pain and the clinical practices of hospice care across 11 cities in Zhejiang Province.Methods:From May 22 to 29, 2023, the Zhejiang Provincial Health Commission conducted a survey to assess the current status of hospice care practitioners regarding cancer pain management, the practices employed by medical staff in managing cancer pain, and the understanding of medical personnel concerning self-controlled analgesia for cancer pain treatment in Zhejiang Province.Results:A total of 505 questionnaires were collected from 198 hospitals across 11 cities in the province.Among the medical staff in secondary and tertiary medical institutions, 85.71%(198 out of 231)participated in the management of cancer pain in patients.Oral analgesics emerged as the most commonly used treatment for pain outbreaks, accounting for 38.53%(89 out of 231)of cases.Additionally, 37.66%(87 out of 231)of medical personnel were involved in the development of self-controlled analgesia devices within their institutions.Conclusions:In the management of cancer pain within hospice care, it is essential to enhance the theoretical training of medical staff, ensure the availability of basic analgesic medications, and establish standardized management protocols for the entire process as promptly as possible.

Objective To observe the correlations of metabolite levels in medial prefrontal cortex(mPFC)and cancer-related depression(CRD)in patients with non-small cell lung cancer(NSCLC).Methods Totally 38 NSCLC patients were prospectively enrolled and divided into CRD group(n=23)and non CRD group(n=15)based on Hamilton depression scale(HAMD-17).Meanwhile,22 healthy individuals were taken as control group.1 H-MR spectroscopy was performed using Meshcher-Garwood point resolved spectroscopy sequence,then metabolite levels of mPFC were measured,and their correlations with HAMD-17 score were analyzed.Results Significant differences of gamma-aminobutyric acid(GABA)+/Water and glutamate/glutamine complex(Glx)/Water in mPFC were found among 3 groups.GABA+/Water in mPFC of CRD group was significantly lower than that of the other 2 groups(both P＜0.05),and Glx/Water in mPFC of CRD group was significantly lower than that of control group(P=0.034).In NSCLC patients,GABA+/Water in mPFC was negatively correlated with HAMD-17 score(r=-0.491,P=0.002).Conclusion GABA+/Water in mPFC was negatively correlated with HAMD-17 score in NSCLC patients.

Objective: To investigate the characteristics of malignant tumor incidence and mortality in cancer registration areas of Zhejiang Province in 2021. Methods: Based on the 2021 cancer registration data from 22 national cancer registries in Zhejiang Province, the crude incidence, crude mortality, and cumulative rate for 0 to 74 years were calculated. Age standardized was performed using the age composition of the standard population from the Fifth National Population Census in 2000 and Segi's world standard population. The incidence and mortality characteristics of malignant tumor in different genders, urban/rural areas and ages were described. The order of crude incidence and mortality of malignant tumor were analyzed. Results: In 2021, there were 116 639 new malignant tumor cases in Zhejiang Province. The crude, Chinese population standardized, and world population-standardized incidences were 530.93/100 000, 304.83/100 000, and 288.20/100 000, respectively. The cumulative incidence for 0 to 74 years was 31.92%. There were 40 475 death cases. The crude, Chinese population-standardized, and world population-standardized mortalities were 184.24/100 000, 79.40/100 000, and 78.97/100 000, respectively. The cumulative mortality for 0 to 74 years was 8.37%. The Chinese population-standardized incidence for males and females were 286.34/100 000 and 323.45/100 000, respectively, and the Chinese population-standardized mortality were 106.25/100 000 and 54.17/100 000, respectively. The Chinese population-standardized incidence for urban and rural were 316.85/100 000 and 285.11/100 000, respectively, and the Chinese population-standardized mortality were 75.59/100 000 and 85.48/100 000, respectively. The crude incidence and crude mortality of malignant tumor both increased with age, peaking in the groups aged 80-<80 and ≥85 years at 1 845.06/100 000 and 1 656.88/100 000, respectively. The top ten malignant tumors with the highest crude incidence were, in descending order: lung cancer, thyroid cancer, breast cancer, prostate cancer, colorectal cancer, gastric cancer, liver cancer, cervical cancer, lymphoma, and brain tumors. These accounted for 80.34% of all new malignant tumor cases. The top ten malignant tumors with the highest crude mortality were, in descending order: lung cancer, liver cancer, colorectal cancer, gastric cancer, pancreatic cancer, prostate cancer, breast cancer, esophageal cancer, lymphoma, and gallbladder cancer. These accounted for 82.26% of all malignant tumor deaths. Conclusions In 2021, the cancer registration areas of Zhejiang Province were characterized by a relatively high malignant tumor incidence and a comparatively low mortality compared to national data. Males and the elderly emerged as key populations for targeted prevention and control. It is recommended to enhance screening, early diagnosis, and early treatment for lung cancer, thyroid cancer, prostate cancer, breast cancer, and gastric cancer malignancies.

Objective:To investigate the management of cancer pain and the clinical practices of hospice care across 11 cities in Zhejiang Province.Methods:From May 22 to 29, 2023, the Zhejiang Provincial Health Commission conducted a survey to assess the current status of hospice care practitioners regarding cancer pain management, the practices employed by medical staff in managing cancer pain, and the understanding of medical personnel concerning self-controlled analgesia for cancer pain treatment in Zhejiang Province.Results:A total of 505 questionnaires were collected from 198 hospitals across 11 cities in the province.Among the medical staff in secondary and tertiary medical institutions, 85.71%(198 out of 231)participated in the management of cancer pain in patients.Oral analgesics emerged as the most commonly used treatment for pain outbreaks, accounting for 38.53%(89 out of 231)of cases.Additionally, 37.66%(87 out of 231)of medical personnel were involved in the development of self-controlled analgesia devices within their institutions.Conclusions:In the management of cancer pain within hospice care, it is essential to enhance the theoretical training of medical staff, ensure the availability of basic analgesic medications, and establish standardized management protocols for the entire process as promptly as possible.

Objective:To investigate the prevalence and risk factors of the 4 most common functional gastrointestinal disorders (FGID) among school-aged children in Shanghai.Methods:A cross-sectional questionnaire survey was conducted from January to December 2019. Using stratified cluster sampling, 26 097 students in grades 1-12 from Huangpu and Jiading District, Shanghai were enrolled. The questionnaire of pediatric gastrointestinal symptoms-Rome Ⅳ (QPGS-Ⅳ) and the pediatric quality of life inventory (PedsQL) were used to assess the prevalence and health-related quality of life (HRQoL) of functional dyspepsia (FD), irritable bowel syndrome (IBS), functional abdominal pain-not otherwise specified (FAP-NOS), and functional constipation (FC). Multivariate Logistic regression analysis was performed to identify correlations between sociodemographic factors, lifestyle habits, comorbidities and 4 major FGID. A trend chi-square test was used to explore the relationship between HRQoL scores and FGID prevalence.Results:A total of 26 097 valid participants (26 097/27 036, 96.5%) were included in the study, with the age of (10.8±3.1) years and 12 441 cases (47.7%) were female. The prevalence of FC was found to be the highest (5 537 cases, 21.2%), followed by IBS (797 cases, 3.1%), FAP-NOS (267 cases, 1.0%) and FD (218 cases, 0.8%). Multivariate Logistic regression analysis revealed the following findings: junior high school (FD: OR=1.88 (95% CI 1.35-2.61); IBS: OR=1.42 (95% CI 1.18-1.71); FAP-NOS: OR=1.39 (95% CI 1.02-1.90)), senior high school (FD: OR=2.67 (95% CI 1.84-3.86);IBS: OR=2.36 (95% CI 1.93-2.89) ;FAP-NOS: OR=2.20 (95% CI 1.56-3.11)) and frequent respiratory infections (FD: OR=2.15 (95% CI 1.45-3.18); IBS: OR=2.59 (95% CI 2.12-3.16); FAP-NOS: OR=1.49 (95% CI 1.00-2.21)) were common risk factors for FD, IBS and FAP-NOS. Allergic symptoms (FD: OR=2.21 (95% CI 1.56-3.14); IBS: OR=2.30 (95% CI 1.04-1.51); FAP-NOS: OR=2.54 (95% CI 1.85-3.50); FC: OR=1.09 (95% CI 1.01-1.17)) was a common risk factor for FD, IBS, FAP-NOS and FC. Family history of allergy was a risk factor for IBS ( OR=1.41 (95% CI 1.20-1.65)) and FAP-NOS ( OR=1.33 (95% CI 1.01-1.74)). Female exhibited increased risks for FD ( OR=1.49 (95% CI 1.13-1.96)), IBS ( OR=1.50 (95% CI 1.30-1.74)) and FC ( OR=1.10 (95% CI 1.03-1.17)). The presence of dietary bias was associated with of IBS ( OR=1.46 (95% CI 1.26-1.69)) and FC ( OR=1.26 (95% CI 1.19-1.34)); late bedtime ( OR=1.32 (95% CI 1.06-1.64)) and allergen exposure ( OR=1.25 (95% CI 1.04-1.51)) were risk factors for IBS. Insufficient sleep ( OR=1.11 (95% CI 1.02-1.21)), insufficient outdoor time ( OR=1.20 (95% CI 1.01-1.43)) and severe lack of outdoor time ( OR=1.48 (95% CI 1.23-1.76)) were significant risk factors for FC. Pet ownership ( OR=1.39 (95% CI 1.07-1.81)) was a risk factor for FAP-NOS. HRQoL scores were significantly lower in children with FD, IBS, or FAP-NOS compared to non-FGID peers (all P<0.05). χ2 trend test analysis showed that the Pearson correlation coefficients between the prevalence of FD, IBS, FAP-NOS, FC and HRQoL scores were -0.93, -0.93, -0.97 and -0.84, respectively. Conclusions:The prevalence of FGID among school-aged children in Shanghai varies by sub-type. FC was the most prevalence. Junior and senior high school, female sex, allergic symptoms and frequent respiratory infections were major risk factors. Meanwhile, dietary bias, late bedtime, insufficient outdoor time and pet ownership were associated with specific subtypes. The HRQoL is significantly reduced in children with FD, IBS and FAP-NOS.

Objective To explore the value of spectral CT quantitative parameters combined with clinical and CT features for predicting lymphovascular invasion(LVI)of colorectal cancer.Methods Clinical,pathological and preoperative abdominal spectral CT data of 98 colorectal cancer patients were retrospectively analyzed.According to pathological results,the patients were divided into LVI group(n=36)and non-LVI group(n=62).Univariate and multivariate logistic regression were used to compared clinical,pathological,conventional CT manifestations and spectral CT quantitative parameters between groups to screen independent predictors for LVI of colorectal cancer,and then a regression model was constructed.Receiver operating characteristic(ROC)curves were drawn,and the area under the curves(AUC)were calculated to evaluate the predictive efficacy of each single independent predictor and regression model for predicting LVI of colorectal cancer.Results Serum carbohydrate antigen 724,CT showed periintestinal fat infiltration and effective atomic number(Zeff)at venous phase were all independent predictors of LVI of colorectal cancer(OR=4.723,7.301 and 18.912,all P＜0.05).AUC of the above independent predictors was 0.582,0.723 and 0.691,respectively,while of the regression model was 0.837.Conclusion Spectral CT quantitative parameters combined with clinical and CT features could effectively predict LVI of colorectal cancer.

The aim of this study is to establish an gene editing method of Mesomycoplasma hyo-pneumoniae(Mhp)based on the homologous recombination principle.The restriction enzyme di-gestion and ligation method combined with gene synthesis were used to construct a shuttle plasmid to achieve replication in both Mhp and Escherichia coli(E.coli).The pGEM?-T vector was used as the skeleton.The oriC sequence of Mhp which can achieve the replication of the plasmid in Mhp was inserted into the vector.Sequences of the Spiroplasma promoter and puromycin resistance gene were then inserted into the above constructed plasmid to screen recombinant clones.The up-stream and downstream homologous arms of p97 were constructed to initiate homologous recombination.The recA gene of E.coli is inserted to improve the efficiency of homologous recom-bination.The obtained shuttle plasmid was then delivered into Mhp by electro-transformation or chemical transformation.A shuttle plasmid,pGEM?-Mhp-oriC-p 97,which can replicate in both Mhp and E.coli was constructed.With the transformation of this plasmid,the carried puromycin gene and recA gene can be expressed,the p97 gene can be edited.Finally,the genetically unstable p97 gene mutant was initially obtained.In this study,a tool for Mhp gene editing based on the principle of homologous recombination was established,which laid a foundation for the develop-ment of tools for studying the pathogenesis of Mhp.

Objective To explore the value of spectral CT quantitative parameters combined with clinical and CT features for predicting lymphovascular invasion(LVI)of colorectal cancer.Methods Clinical,pathological and preoperative abdominal spectral CT data of 98 colorectal cancer patients were retrospectively analyzed.According to pathological results,the patients were divided into LVI group(n=36)and non-LVI group(n=62).Univariate and multivariate logistic regression were used to compared clinical,pathological,conventional CT manifestations and spectral CT quantitative parameters between groups to screen independent predictors for LVI of colorectal cancer,and then a regression model was constructed.Receiver operating characteristic(ROC)curves were drawn,and the area under the curves(AUC)were calculated to evaluate the predictive efficacy of each single independent predictor and regression model for predicting LVI of colorectal cancer.Results Serum carbohydrate antigen 724,CT showed periintestinal fat infiltration and effective atomic number(Zeff)at venous phase were all independent predictors of LVI of colorectal cancer(OR=4.723,7.301 and 18.912,all P＜0.05).AUC of the above independent predictors was 0.582,0.723 and 0.691,respectively,while of the regression model was 0.837.Conclusion Spectral CT quantitative parameters combined with clinical and CT features could effectively predict LVI of colorectal cancer.

Objective To observe the correlations of metabolite levels in medial prefrontal cortex(mPFC)and cancer-related depression(CRD)in patients with non-small cell lung cancer(NSCLC).Methods Totally 38 NSCLC patients were prospectively enrolled and divided into CRD group(n=23)and non CRD group(n=15)based on Hamilton depression scale(HAMD-17).Meanwhile,22 healthy individuals were taken as control group.1 H-MR spectroscopy was performed using Meshcher-Garwood point resolved spectroscopy sequence,then metabolite levels of mPFC were measured,and their correlations with HAMD-17 score were analyzed.Results Significant differences of gamma-aminobutyric acid(GABA)+/Water and glutamate/glutamine complex(Glx)/Water in mPFC were found among 3 groups.GABA+/Water in mPFC of CRD group was significantly lower than that of the other 2 groups(both P＜0.05),and Glx/Water in mPFC of CRD group was significantly lower than that of control group(P=0.034).In NSCLC patients,GABA+/Water in mPFC was negatively correlated with HAMD-17 score(r=-0.491,P=0.002).Conclusion GABA+/Water in mPFC was negatively correlated with HAMD-17 score in NSCLC patients.