Objective: To analyze the independent and interaction effects of daytime outdoor light exposure and moderate to vigorous physical activity (MVPA) duration on sleep quality of primary school students, so as to provide scientific evidence for interventions on children s sleep health. Methods: From April to June 2024, a total of 444 students from grades 3 and 4 in 2 primary schools in Jiading District, Shanghai were selected using stratified random cluster sampling method for continuous 7 day monitoring. Wearable devices "Clouclip" were used to monitor daytime outdoor activity time (represented by time with light intensity ≥ 1 000 lx ), and accelerometers were used to monitor MVPA time and sleep quality related indicators. Multiple linear regression was used to analyze the associations of daytime outdoor activity and MVPA with sleep quality. Results: Both daytime outdoor light exposure and MVPA duration(longer actual sleep duration per night,longer time in bed,fewer awakening and shorter post sleep awakening shic) were independently associated with multiple sleep indicators( β =0.52, 0.46, -0.83, -2.19, all P <0.05), with no significant interaction between the associations ( P >0.05). After controlling for MVPA, more daytime outdoor light exposure was significantly and independently associated with longer actual sleep time ( β =0.50, 95% CI =0.21-0.79, P <0.05). After controlling for light exposure, longer MVPA duration was independently associated with shorter post-sleep awakening duration ( β=-4.15, 95% CI = -6.33 to -1.96, P <0.05). Conclusion Increased daytime outdoor activity and MVPA are both associated with better sleep quality in primary school students.

OBJECTIVES: To investigate the risk factors of overall postoperative complications in elderly patients undergoing gastrointestinal surgeries. METHODS: This study was conducted among a total of 1388 elderly patients, who underwent elective gastrointestinal surgeries at 17 centers across China between April, 2020 and April, 2022. The primary outcome was the incidence of postoperative complications within 30 days, including procedure-related, neuropsychiatric, respiratory, cardiovascular, and gastrointestinal complications as well as acute kidney injury. Baseline characteristics, preoperative psychological and functional status, intraoperative anesthesia and surgical factors, intraoperative medication, use of nerve block, and postoperative analgesia methods were compared between the patients experiencing one or more postoperative complications and those without complications. Univariate and multivariate logistic regression analyses were performed to identify the independent risk factors for postoperative complications. The relationship between postoperative acute pain and each type of complication were explored. RESULTS: The incidence of overall postoperative complications was 50.8% (705/1388) in these patients. Multivariate analysis showed that age (OR: 1.026; 95% CI: 1.006-1.046), prognostic nutritional index (OR: 0.998; 95% CI: 0.997-1.000), preoperative EuroQol-5 dimensions score (OR: 0.094; 95% CI: 0.018-0.500), blood loss (OR: 1.002; 95% CI: 1.001-1.003), and acute postoperative pain (OR: 1.308; 95% CI: 1.033-1.657) were significantly associated with the occurrence of postoperative complications. Specifically, patients experiencing severe postoperative pain had a significantly higher incidence of neuropsychiatric (27.2% vs 19.8%), procedure-related (17.3% vs 10.2%), and cardiovascular complications (3.6% vs 1.7%). CONCLUSIONS An advanced age, a low preoperative nutritional index, a poor quality of life score, a greater volume of intraoperative blood loss, and acute postoperative pain are independent risk factors for postoperative complications in elderly patients undergoing gastrointestinal surgeries. There is a significant association between acute postoperative pain and multi-system complications.
Humans ; Postoperative Complications/etiology* ; Aged ; Risk Factors ; Digestive System Surgical Procedures/adverse effects* ; Male ; Female ; China/epidemiology* ; Pain, Postoperative/epidemiology* ; Incidence ; Aged, 80 and over

Non-small cell lung cancer (NSCLC), a leading cause of cancer-related deaths worldwide, remains a significant clinical challenge despite advances in immune checkpoint inhibitors therapy, with drug resistance persisting as a major obstacle. Palmitoylation, a critical post-translational modification (PTM) primarily catalyzed by palmitoyltransferases of the zinc finger DHHC-type (ZDHHC), has recently demonstrated important implications in NSCLC. This review aims to elucidate the mechanisms and clinical potential of ZDHHC-mediated protein palmitoylation in NSCLC progression and immune escape.
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Humans ; Lipoylation ; Lung Neoplasms/pathology* ; Acyltransferases/genetics* ; Carcinoma, Non-Small-Cell Lung/pathology* ; Animals

Objective To review the application of user profiles in the health management of elderly patients with chronic diseases,and to provide references for nursing staff to apply this technology to manage chronic diseases in the elderly.Methods According to the scoping review methodology,a systematic search was conducted across 9 databases including Wanfang Database,CNKI,VIP,Chinese Biomedical Abstracted Database,PubMed,Embase,Web of Science,CINAHL and Cochrane Library.The search time was from the establishment of the database to January 2024.The literature was screened according to inclusion and exclusion criteria,and the information in the literature was independently extracted and summarized by 2 researchers.Results A total of 10 pieces of the literature were included in the study.The results showed that the process of constructing user profiles mainly includes data collection,user feature extraction,and profiles generation and visualization.User profiles are widely used in the health management of chronic diseases in the elderly,commonly used in the management of diabetes,heart failure and other chronic diseases in the elderly,including the formulation of personalised intervention plans,the provision of personalised health education and information,and the adjustment of health management strategies.User profiles significantly enhanced the accuracy of health information delivery and health services,improved user experience,enhanced patients'self-management ability and quality of life.Conclusion As an emerging health information integration tool,user profiles can merge and analyze multidimensional health data to provide personalized and precise health management for elderly patients with chronic diseases.This approach enhances remote monitoring,prevents and manages complications,improves treatment outcomes,and reduces medical costs,thereby demonstrating significant potential in the health management of elderly patients with chronic conditions.

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 analyze the trajectory of dietary behaviors among middle school students in Jiading District, Shanghai, from 2021 to 2023, and longitudinally verify their association with anxiety and depression symptoms, aiming to provide scientific evidence for promoting the mental health of adolescents. Methods: The data were sourced from the National Monitoring and Intervention Project on Common Diseases and Health Impact Factors of students in Jiading District, Shanghai. A total of 1 217 middle school students who participated in at least two surveys from 2021 to 2023 were selected as the research objects, and group-based trajectory model was constructed to identify their dietary behavior scores trajectories. Modified Poisson regression was used to investigate the impact of dietary behavior scores trajectories on anxiety and depression, while Logistic regression was employed to explore the association between trajectories and changes in depression score levels. Results: The dietary behavior scores trajectories of middle school students were divided into three groups: Persistent Healthy Dietary Behavior (9.5%), Persistent Relatively Unhealthy Dietary Behavior (85.0%), and Persistent Very Unhealthy Dietary Behavior (5.5%). Students who perceived their academic performance as poor and whose parents had a cultural level of high school or below had a significantly lower proportion in the Persistent Healthy Dietary Behavior group compared to students with other characteristics ( χ 2=12.87, 8.69, 6.50, P <0.05). Compared with the Persistent Healthy Dietary Behavior group, the risk of anxiety symptoms in middle school students in the Persistent Very Unhealthy Dietary Behavior group was significantly increased ( aRR=3.04, 95%CI =1.15-8.02); Persistent Relatively Unhealthy Dietary Behavior and Persistent Very Unhealthy Dietary Behavior increased the risk of depressive symptoms ( aRR = 1.80 , 2.45, respectively), and were positively correlated with the increase in depression scores ( aOR =1.70, 2.24) ( P <0.05). Conclusions The dietary behavior of middle school students have not changed significantly in the past three years, with persistent unhealthy dietary behavior being the most common. Unhealthy dietary behaviors are positively correlated with the risk of anxiety and depressive symptoms and an increase in depression scores.

Objective:To compare the efficacy of ustekinumab (UST) and vedolizumab (VDZ) in achieving transmural healing in active Crohn′s disease (CD).Methods:From March 1, 2020 to November 30, 2024, 112 patients with active CD treated with UST or VDZ at the Department of Gastroenterology, Tenth People′s Hospital of Tongji University were retrospectively enrolled. According to the medication regimen, the 112 patients were divided into UST group (61 cases) and VDZ group (51 cases). Collected the data at baseline, such as the disease phenotype, other medication history, and clinical indicators including C-creative protein (CRP), etc. Clinical disease activity and endoscopic disease activity were assessed by Harvey-Bradshaw index (HBI) and simplified endoscopic score for Crohn′s disease (SES-CD), respectively. Transmural healing was evaluated according to the intestinal wall thickness measured by intestinal imaging examination of the affected intestinal segment. Transmural healing was defined as bowel wall thickness <0.3 cm and 110 obvious signs of inflammation, clinical remission was defined as HBI≤4, and endoscopic remission was defined as a reduction in SES-CD ≥50% or a score of ≤2. The primary endpoint was transmural healing rate within one year after treatment. The secondary endpoints were endoscopic healing rate and clinical remission rate at 13 to 24th week and 30 to 52nd week after treatment. Chi-square test or Fisher′s exact test was used to compare the efficacy of the 2 medications.Results:There was no significant difference in transmural healing rate between UST group and VDZ group within 1 year after treatment (16.4% (10/61) vs. 23.5% (12/51), χ2=0.90, P=0.344). There were no significant differences in the healing rate between UST group and VDZ group in patients with specific baseline characteristics before treatment, including CD with stenosis, with perianal disease, no history of glucocorticoid use, secondary loss of response to anti-tumor necrosis factor (TNF)-α, SES-CD 7 to 15, decreased body mass index, and increased CRP (18.2%(6/33) vs. 19.4%(7/36), 17.9%(7/39) vs. 19.4%(6/31), 17.1%(6/35) vs. 24.2%(8/33), 20.0%(8/40) vs. 3/18, 14.3%(5/35) vs. 19.2%(5/26), 15.0%(3/20) vs. 3/10, 21.4%(6/28) vs. 5/16), all P>0.05). There was no significant difference in the clinical remission rate or endoscopic remission rate between the UST group and the VDZ group from 13 to 24th week (7/14 vs. 9/18, 3/14 vs. 7/18, RR=1.000 and 0.551, 95% confidence interval: 0.497to 2.011, 0.173to 1.755, χ2=<0.01, Fisher′s exact test, both P>0.05). There was no significant difference in clinical remission rate or endoscopic remission rate between UST group and VDZ group from week 30 to week 52 after treatment (68.5% (37/54) vs. 74.4% (32/43), 27.8% (15/54) vs. 32.6% (14/43), RR=0.921 and 0.853, 95% confidence interval: 0.716 to 1.184, 0.464 to 1.568, χ2=0.41 and 0.26, both P>0.05). In UST group, the proportion of patients with normal hemoglobin after transmural healing was higher than that of patients without transmural healing (9/10 vs. 45.1% (23/51), and the difference was statistically significant ( χ2=5.08, P=0.024). However, there were no significant differences in the proportion of patients with normal body mass index, CRP, platelet count, prealbumin, albumin, interleukin-6 or TNF-α levels after treatment between those who achieved transmural healing and those who did not in either UST group or VDZ group (all P>0.05). And in VDZ group there was no significant difference in the proportion of patients with normal hemoglobin between those who achieved transmural healing and who did not (all P>0.05). Conclusion:UST and VDZ exhibit similar efficacy in transmural healing within one year of treatment in patients with active CD.

Objective:To construct and evaluate the predictive performance of a multiphase ultrasound radiomics model for microvascular invasion（MVI）in hepatocellular carcinoma（HCC）.Methods:A total of 126 patients with pathologically confirmed HCC were retrospectively enrolled from 4 medical centers between May 2018 and July 2025，including the First Hospital of Shanxi Medical University，Shanxi Province Third People's Hospital，Changzhi People's Hospital，and the Organ Transplant Center of the Affiliated Hospital of Qingdao University. A total of 630 ultrasound images of the lesions in different phases were collected，from which 1 561 radiomic features were extracted. The patients from medical institutions in Shanxi Province were chosen as the training set（ n=91），and the patients from the Organ Transplant Center of the Affiliated Hospital of Qingdao University were chosen as the validation set（ n=35）. In the training set，37.4%（34/91）patients presented MVI（+），whereas in the validation set，54.3%（19/35）patients presented MVI（+）. Radiomics features were extracted from ultrasound images，and features related to the MVI（+）were selected through dimensionality reduction analysis. Five multiple machine learning algorithms were used to construct predictive models，which were then evaluated using an external validation set. The Radscore was calculated，and a nomogram was constructed combining Radscore with ultrasound and clinical characteristics to predict MVI. Results:The model combining radiomics features from the portal venous phase and the delay phase showed the best predictive performance in both the training and validation sets，with area under curve（AUC）values of 0.835 and 0.727，respectively. The prediction model developed using radiomics Radscore and clinical indicators could be represented and presented as a nomogram.Conclusions:The radiomics model based on multi-phase ultrasound offers a novel approach for non-invasive preoperative prediction of MVI in liver cancer. Furthermore，its integration with clinical features aids in optimizing clinical treatment strategies.