Objective: To explore the network structure of middle school students basic psychological needs and psychological behavioral problems, and identify the core nodes within the network, as well as examine demographic subgroup differences, so as to provide support for targeted mental health interventions for adolescents. Methods: In September and October of 2023, a total of 2 000 junior and senior high school students were selected with multistage cluster random sampling from 8 schools in Jiaojiang District and Tiantai County, Taizhou City. An online self administered questionnaire was used to assess emotional and behavioral problems, perceived autonomy, self awareness, loneliness, and social support. The instruments included the Strengths and Difficulties Questionnaire (SDQ), Perceived Choice and Awareness of Self Scale (PCASS), Mental Health Literacy Questionnaire (MHLQ), University of California,Los Angeles Loneliness Scale (UCLA-LS), and the Multidimensional Scale of Perceived Social Support (MSPSS). A network analysis approach was employed to construct a network representing adolescents basic psychological needs and psychological behavioral problems, focusing on centrality measures and demographic subgroup differences. Results: A total of 418 students (20.9%) reported abnormal emotional and behavioral problems. Perceived autonomy and competence were negatively correlated with emotional problems (weights: 0.12, 0.14) and hyperactivity (weights: 0.10, 0.16). Social support showed negative correlation with peer relationship issues, hyperactivity, and conduct problems (weights: 0.16, 0.13, 0.10). Loneliness was positively correlated with emotional symptoms and peer relationship problems (weights: 0.28, 0.18). In the overall network, perceived relationships (social support and loneliness), emotional symptoms, and hyperactivity emerged as central nodes. Significant differences in network structure were observed between gender subgroups ( P =0.02). Girls internalizing issues were more influenced by loneliness and perceived autonomy frustration, while social support exhibited higher centrality in boys. Conclusions Perceived relationships, emotional problems, and hyperactivity are key nodes in the network of adolescents basic psychological needs and psychological behavioral problems. Loneliness demonstrates a prominent influence within the network, and the overall network exhibits gender differences.

It has been 131 years since Halsted reported radical mastectomy to treat breast cancer in 1894. The concept of “R0 resection” as the most important treatment strategy has significantly contributed to improving the survival rate of patients with breast cancer. With deep understanding of the mechanism of tumorigenesis and advancements in systematic treatment since the 20th century,modified radical mastectomy proposed by Patey and Auchincloss,aimed to improve quality of life,replaced radical mastectomy and became the mainstream surgery for breast cancer. Based on NSABP-B06 trial,the 2025 St. Gallen consensus persisted in the principle of preserving breast-conserving surgery whenever possible. Additionally,the guidelines recommend axillary lymph node dissection can be omitted in patients with negative sentinel lymph nodes,supported by high-level evidence. The AJCC Cancer Staging System (8th Edition) showed the evaluation of breast cancer burden has transcended TNM stage,leading to the level of detecting microscopic tumor burden. Pathological test is no longer limited to pathomorphology, instead,immunohistochemistry,molecular pathology testing,and next-generation sequencing technologies have laid a scientific foundation for categorized treatment of breast cancer. The evolution of breast cancer surgery is undergoing a shift from “maximal resection” to “minimal effective treatment” de-escalation. On this basis,promoting the standardization and homogenization of breast surgery suited to China′s national conditions is the common goal of breast surgeons at this stage.

It has been 131 years since Halsted reported radical mastectomy to treat breast cancer in 1894. The concept of “R0 resection” as the most important treatment strategy has significantly contributed to improving the survival rate of patients with breast cancer. With deep understanding of the mechanism of tumorigenesis and advancements in systematic treatment since the 20th century,modified radical mastectomy proposed by Patey and Auchincloss,aimed to improve quality of life,replaced radical mastectomy and became the mainstream surgery for breast cancer. Based on NSABP-B06 trial,the 2025 St. Gallen consensus persisted in the principle of preserving breast-conserving surgery whenever possible. Additionally,the guidelines recommend axillary lymph node dissection can be omitted in patients with negative sentinel lymph nodes,supported by high-level evidence. The AJCC Cancer Staging System (8th Edition) showed the evaluation of breast cancer burden has transcended TNM stage,leading to the level of detecting microscopic tumor burden. Pathological test is no longer limited to pathomorphology, instead,immunohistochemistry,molecular pathology testing,and next-generation sequencing technologies have laid a scientific foundation for categorized treatment of breast cancer. The evolution of breast cancer surgery is undergoing a shift from “maximal resection” to “minimal effective treatment” de-escalation. On this basis,promoting the standardization and homogenization of breast surgery suited to China′s national conditions is the common goal of breast surgeons at this stage.

AIM: To investigate the potential inhibitory effect of pterostilbene on the endothelial-to-mesenchymal transition(EndMT)induced by high glucose conditions in human retinal microvascular endothelial cells(HRMECs).METHODS: The optimal concentration of pterostilbene for treating HRMECs was determined using the CCK-8 assay, with 12.5 and 25 μmol/L concentrations selected for subsequent experiments. Four experimental groups were established: control group, high glucose group, high glucose combined with 12.5 μmol/L pterostilbene treatment group, and high glucose combined with 25 μmol/L pterostilbene treatment group. The expression levels of HDAC7 and EndMT-associated markers were detected via Western blot analysis. Cell migration ability was assessed using Transwell migration assays and scratch wound healing tests, while vasculogenic capability was evaluated through tube formation assays.RESULTS: The CCK-8 assay revealed that pterostilbene at a concentration of 22.07 μmol/L inhibited 50% of cell viability in HRMECs. Western blot analysis demonstrated that compared with the control group, the expression levels of HDAC7, ZEB1, Vimentin, and Snail were significantly upregulated in HRMECs cultured in high glucose(all P<0.01), while the expressions of VE-cadherin and CD31 were significantly reduced(all P<0.01). Compared to the high glucose group, the treatment with 12.5 and 25 μmol/L pterostilbene significantly reduced the expression of HDAC7, ZEB1, Vimentin, and Snail under high glucose conditions(all P<0.01). Notably, 25 μmol/L pterostilbene enhanced the expression of VE-cadherin and CD31(all P<0.01). Scratch wound healing tests revealed that HRMECs treated with high glucose exhibited a significantly increased cell migration rate compared to the control group(P<0.05), while the application of 25 μmol/L pterostilbene significantly suppressed HRMECs migration under high glucose conditions(P<0.01). Transwell migration assays demonstrated that the cell migration rate in the high glucose group was significantly higher than that in the control group(P<0.01), with cell migration rate markedly reduced following treatment with both of 12.5 and 25 μmol/L pterostilbene(all P<0.01). The tube formation assay revealed that the ability of HRMECs to form tubular structures was significantly enhanced under high glucose conditions(P<0.01), and both 12.5 and 25 μmol/L of pterostilbene effectively inhibited this effect(all P<0.01).CONCLUSION: Pterostilbene can inhibit HDAC7 expression, suppress EndMT-mediated migration of HRMECs, and impair tube formation under high-glucose conditions.

AIM: To investigate the potential inhibitory effect of pterostilbene on the endothelial-to-mesenchymal transition(EndMT)induced by high glucose conditions in human retinal microvascular endothelial cells(HRMECs).METHODS: The optimal concentration of pterostilbene for treating HRMECs was determined using the CCK-8 assay, with 12.5 and 25 μmol/L concentrations selected for subsequent experiments. Four experimental groups were established: control group, high glucose group, high glucose combined with 12.5 μmol/L pterostilbene treatment group, and high glucose combined with 25 μmol/L pterostilbene treatment group. The expression levels of HDAC7 and EndMT-associated markers were detected via Western blot analysis. Cell migration ability was assessed using Transwell migration assays and scratch wound healing tests, while vasculogenic capability was evaluated through tube formation assays.RESULTS: The CCK-8 assay revealed that pterostilbene at a concentration of 22.07 μmol/L inhibited 50% of cell viability in HRMECs. Western blot analysis demonstrated that compared with the control group, the expression levels of HDAC7, ZEB1, Vimentin, and Snail were significantly upregulated in HRMECs cultured in high glucose(all P<0.01), while the expressions of VE-cadherin and CD31 were significantly reduced(all P<0.01). Compared to the high glucose group, the treatment with 12.5 and 25 μmol/L pterostilbene significantly reduced the expression of HDAC7, ZEB1, Vimentin, and Snail under high glucose conditions(all P<0.01). Notably, 25 μmol/L pterostilbene enhanced the expression of VE-cadherin and CD31(all P<0.01). Scratch wound healing tests revealed that HRMECs treated with high glucose exhibited a significantly increased cell migration rate compared to the control group(P<0.05), while the application of 25 μmol/L pterostilbene significantly suppressed HRMECs migration under high glucose conditions(P<0.01). Transwell migration assays demonstrated that the cell migration rate in the high glucose group was significantly higher than that in the control group(P<0.01), with cell migration rate markedly reduced following treatment with both of 12.5 and 25 μmol/L pterostilbene(all P<0.01). The tube formation assay revealed that the ability of HRMECs to form tubular structures was significantly enhanced under high glucose conditions(P<0.01), and both 12.5 and 25 μmol/L of pterostilbene effectively inhibited this effect(all P<0.01).CONCLUSION: Pterostilbene can inhibit HDAC7 expression, suppress EndMT-mediated migration of HRMECs, and impair tube formation under high-glucose conditions.

Objective To investigate the effects of Fuzheng Touxie Prescription on pulmonary injury of Pseudomonas aeruginosa pneumonia(PAP)in rats;To discuss its possible mechanism.Methods A total of 36 SD rats were divided into blank group,model group,piperacillin group and Fuzheng Touxie Prescription low-,medium-and high-dosage groups according to random number table method,with 6 rats in each group.Except for the blank group,0.1 mL of Pseudomonas aeruginosa suspension with a concentration of 3×109 CFU/mL was injected through oral catheterization.In the blank group,0.1 mL sterile saline was injected by oral catheterization.Fuzheng Touxie Prescription low-,medium-and high-dosage groups were gavaged 1.6 mL of Fuzheng Touxie Prescription solution with the concentration of 0.43,0.86 and 1.73 g/mL respectively,the blank group and model group were gavaged equal volume of distilled water,piperacillin group was intraperitoneal injected 0.53 mL piperacillin tazobactam sodium solution with a concentration of 0.11 g/mL,once a day,for consecutive 3 days.HE staining was used to observe the pathological changes of lung tissue,lung injury score was performed and bronchial wall thickness was measured,flow cytometry was used to detect Th17/Treg ratio in peripheral blood,the serum contents of RORγt,FoxP3,TGF-β and inflammatory factors TNF-α,IL-6 and IL-10 were detected by ELISA,the mRNA expression of RORγt,FoxP3 and inflammatory factors in lung tissue were detected by RT-qPCR,the protein expressions of RORγt,FoxP3 and inflammatory factors in lung tissue were detected by Western blot.Results Compared with the blank group,a large amount of inflammatory cell infiltration was observed in lung tissue of the model group rats,accompanied by bronchial wall hyperplasia,alveolar dilation,interstitial edema,and a significant increase in lung injury score and bronchial wall thickness(P<0.01),the proportion of Th17 in peripheral blood increased(P<0.01),the proportion of Treg decreased(P<0.01),and the Th17/Treg ratio increased(P<0.05),the contents of serum RORγt,TNF-α,TGF-β and IL-6 significantly increased(P<0.01),the contents of FoxP3 and IL-10 significantly decreased(P<0.01),the mRNA and protein expressions of RORγt,TNF-α,TGF-β and IL-6 in lung tissue significantly increased(P<0.01),while the mRNA and protein expressions of FoxP3 and IL-10 significantly decreased(P<0.01).Compared with the model group,the alveoli of rats in each treatment group were relatively intact and the structure was clearer,inflammatory cell infiltration,pulmonary interstitial edema and congestion were reduced,and lung injury scores and bronchial wall thickness were reduced(P<0.05,P<0.01),the proportion of Th17 in peripheral blood decreased(P<0.05),the proportion of Treg increased(P<0.05),and the Th17/Treg ratio decreased(P<0.05)in Fuzheng Touxie Prescription high-dosage group and piperacillin group,the contents of serum RORγt,TNF-α,TGF-β and IL-6 significantly decreased in Fuzheng Touxie Prescription medium-and high-dosage groups and piperacillin group(P<0.05,P<0.01),the contents of FoxP3 and IL-10 significantly increased(P<0.05,P<0.01),the mRNA and protein expressions of RORγt,TNF-α,TGF-β and IL-6 in lung tissue significantly decreased(P<0.05,P<0.01),the mRNA and protein expressions of FoxP3 and IL-10 significantly increased(P<0.05,P<0.01).Conclusion Fuzheng Touxie Prescription can improve pulmonary inflammatory symptoms,reduce the level of inflammatory factors and increase the level of anti-inflammatory factors in PAP rats.The mechanism may be through the TGF-β/RORγt/FoxP3 pathway to regulate immune balance.

Objective:To investigate the impact of tumor origin (ventral pancreatic origin and dorsal pancreatic origin) on prognosis in patients with pancreatic head cancer.Methods:A retrospective analysis was performed on the clinical data of 150 patients with pancreatic head cancer who received surgical treatment at the First Affiliated Hospital of the Naval Medical University from October 2014 to December 2017. Among these patients, 92 were male and 58 were female, aged (61.2±8.8) years. The 150 patients were divided into two groups based on tumor origin: the ventral pancreatic cancer group ( n=72) and the dorsal pancreatic cancer group ( n=78). A comparative analysis of clinical, pathological, and imaging charac-teristics was conducted between the two groups. Univariate and multivariable Cox proportional hazards models were used to analyze the association between pancreatic head cancer origin and overall survival (OS). Results:Patients with pancreatic head carcinoma arising from the ventral and dorsal pancreas accounted for 48%(72/150) and 52%(78/150) of the study cohort, respectively. Pancreatic head carcinoma arising from the dorsal pancreas were more likely to show pathological features of pancreatic parenchymal atrophy [73.1%(57/78) vs. 47.2%(34/72), χ2=10.49, P=0.001] and pancreatitis [44.9%(35/78) vs. 29.2%(21/72), χ2=3.95, P=0.047]. In contrast, patients with pancreatic head carcinoma arising from the ventral pancreas was more frequently associated with contact with the superior mesenteric artery [25.0%(18/72) vs. 1.3%(1/78), χ2=19.04, P<0.001], perineural invasion [100%(72/72) vs. 88.5%(69/78), χ2=8.84, P=0.003], and positive surgical margins [15.3%(11/72) vs. 2.6%(2/78), χ2=7.65, P=0.006], with all differences statistically significant. The ventral pancreatic cancer group demonstrated cumulative survival rates of 33.2% and 0 at 1-year and 2-year postoperative intervals, respectively, while the dorsal pancreatic cancer group exhibited rates of 56.7% and 24.8% at the corresponding timepoints. Comparison of Kaplan-Meier survival curves between the two groups showed a statistically significant difference ( χ2=6.00, P=0.014). Multivariable Cox proportional hazards analysis identified dorsal pancreatic origin pancreatic head cancer as an independent predictor of increased mortality risk compared to ventral origin tumors ( HR=2.75, 95% CI: 1.52-4.98, P=0.001). Conclusion:The embryonic origin of pancreatic head cancer determines its clinical, pathological, and imaging heterogeneity, and pancreatic head cancer arising from the ventral pancreas demonstrates significantly worse prognostic outcomes compared to dorsal pancreatic origin.

[Objective]To explore the medicinal qualities and background of CHEN Xiuyuan in treating gynecological disorders.[Methods]By reading CHEN Xiuyuan's book Gynaecological Essentials and analyzing its theoretical aspects,treatment concepts and medicinal aspects in relation to regulating women's menstruation,preparing for pregnancy,the perinatal and postnatal periods,etc.[Results]Gynaecological Essentials points out,in terms of diagnostic and therapeutic features,the gynecological disorders are always leukorrheal diseases;it emphasizes the importance of pulse diagnosis,advocates that regulating menstruation should be preceded by stabilizing the spleen and stomach,highlights that four essentials should support preparing for pregnancy,emphasizes spleen and kidney preservation for the fetus and that postpartum illnesses should not be limited in course of disease.In the drug characteristics,Ligusticum chuanxiong Hort(Chuan xiong)and Angelica sinensis(Danggui)are the first choice to replenish Qi and blood,Atractylodes macrocephalae(Baizhu)is an essential part of a prescription for calming the fetus,and the use of blood,flesh and sentimental products is preferred,while the use of medicines during pregnancy is advised to be within a reasonable range.[Conclusion]CHEN Xiuyuan learned the ancients but didn't stick stubbornly in treating gynecological diseases,emphasized the importance of pulse diagnosis,paid attention to the spleen and stomach,used medication to replenish Qi and blood,and the principle-method-recipe-medicines was very distinctive,which was of great significance to the differentiation and treatment of gynecological diseases in later generations.

Objective:To investigate the epidemiological characteristics and morbidity trends of hypertensive disorders of pregnancy (HDP) in Shenzhen, China.Methods:This study was a cross-sectional study. Data were based on the Shenzhen Birth Cohort. Pregnant women who gave birth from January 1, 2018 to March 31, 2023 were included. Incidence and change trends of HDP and its different pathological types were analyzed. The enrolled pregnant women were divided into the HDP group and the non-HDP group according to whether HDP occurred. General clinical data and pregnancy outcomes were collected from both groups. The incidence of adverse pregnancy outcomes among pregnant women with different pathological types of HDP was analyzed, and subgroup analyses were performed based on age and body mass index (BMI).Results:A total of 90 117 pregnant women were enrolled, aged (31.6±4.4) years. There were 4 117 cases in the HDP group and 86 000 in the non-HDP group. The overall incidence of HDP in the whole study population was 4.57% (4 117/90 117). From 2018—2023, the incidence of HDP in Shenzhen showed an increasing trend year by year, from 2.88% (523/18 155) to 7.04% (271/3 851). Specifically, the incidence of gestational hypertension increased from 0.93% (168/18 155) to 3.09% (119/3 851), the incidence of preeclampsia-eclampsia increased from 1.78% (323/18 155) to 3.17% (122/3 851), the incidence of chronic hypertension increased from 0.01% (1/18 155) to 0.42% (16/3 851), and the incidence of chronic hypertension with superimposed preeclampsia increased from 0.17% (31/18 155) to 0.36% (14/3 851). The age ((32.8±4.8) years vs. (31.5±4.3) years, P<0.05) and BMI in the first trimester ((23.37±3.77) kg/m 2 vs. (21.35±2.91) kg/m 2, P<0.05) of HDP group were higher than those of the non-HDP group. Subgroup analysis showed that the incidence of HDP in pregnant women aged≥50.0 years was the highest in all age subgroups (42.86% (6/14)). The incidence of HDP in pregnant women with BMI≥30.0 kg/m 2 in the first trimester was the highest among all BMI subgroups (20.44% (241/1 179)). The proportions of preterm birth, gestational diabetes, fetal growth restriction, small for gestational age, placental abruption, and late abortion in HDP group were 30.82% (1 269/4 117), 30.46% (1 254/4 117), 6.80% (280/4 117), 4.86% (200/4 117), 3.59% (148/4 117), and 0.80% (33/4 117), respectively. Conclusions:The incidence of HDP among pregnant women has been increased year by year in Shenzhen, China. With the increase in age and BMI during early pregnancy, the incidence of HDP showed an overall upward trend.

Aim To investigate the relationship between sleep deprivation and vascular aging,as well as the un-derlying mechanisms.Methods Male Sprague-Dawley rats were divided into control group,senescence group,sleep deprivation group,and sleep deprivation+senescence group,with 6 rats in each group.The modified level table method deprived rats of sleep duration.Senescence-associated β-galactosidase(SA-β-Gal)staining was used to detect the senes-cence status of rat vascular tissue.The mRNA and protein expression of tumor suppressor protein p53,silent information regulator 1(SIRT1)and clock gene cryptochrome 1(CRY1)was detected by real-time fluorescence quantification PCR(RT-qPCR),Western blot and immunohistochemistry.Results Compared with the control group,the intensity of SA-β-Gal staining was increased in the vascular tissues of the senescence group rats,the expression level of p53 was elevat-ed,the expression level of SIRT1 was decreased.Similar changes were observed in the sleep deprivation group and the sleep deprivation+senescence group,including intensified SA-β-Gal staining,elevated p53 levels,and reduced SIRT1 lev-els in vascular tissues.Additionally,compared with the control group,the sleep deprivation group showed reduced CRY1 levels in vascular tissues,while only CRY1 mRNA levels were reduced in the sleep deprivation+senescence group.Fur-thermore,compared with the senescence group,the sleep deprivation+senescence group exhibited intensified SA-β-Gal staining,increased p53 level,decreased SIRT1 level,and reduced CRY1 mRNA level in vascular tissues.Conclusion Sleep deprivation may promote the expression of vascular aging-related factors,potentially through the inhibition of CRY1 expression in vascular tissues.