Objective: To explore the effects of personality and sleep quality with psychological distress of junior and senior high school stduents, so as to provide a reference basis for precise interventions of junior and senior high school students mental health. Methods: In October 2023, a convenience sampling method was used to select 9 034 students aged 12-17 from Shiyan City as the study subjects. The Pittsburgh Sleep Quality Index (PSQI) and Kessler Psychological Distress Scale (K10) were used to collect information on sleep quality and psychological distress of junior and senior high school stduents. Between group comparison was conducted by using t-test and Chi-square test. Generalized linear models were employed to analyze the interaction and joint effects of personality and sleep quality on psychological distress. Results: The generalized linear model analysis showed that the interaction between personality and sleep quality on psychological distress was statistically significant of junior and senior high school students(effect size=0.80, P <0.01). The general linear model analysis indicated that, after adjusting for variables such as age, gender, screen time, and daily sitting time with the extroverted and good sleep quality group as the reference, the introverted and poor sleep quality group had the largest mean difference in psychological distress scores (difference=0.51, P <0.05). When stratified by sleep quality, psychological distress scores were higher in the introverted and neutral personality groups with both poor and good sleep quality compared to the extroverted group (poor sleep quality: introverted difference=3.71, neutral difference=1.14; good sleep quality: introverted difference=2.23, neutral difference=0.57, all P < 0.05). When stratified by personality, psychological distress scores were higher in the poor sleep quality groups for introverted, neutral, and extroverted individuals compared to their good sleep quality counterparts (differences=8.66, 7.83, 7.34, all P < 0.05 ). Conclusions Personality and sleep quality have interactive and joint effects on psychological distress of junior and senior high school stduents. Personalized psychological interventions should be developed based on personality and sleep quality.

Objective To identify factors affecting and key environmental factors of the Oncomelania hupensis snail density in the Yangtze River Delta region using machine learning methods. Methods Administrative village-level O. hupensis snail survey data in the Yangtze River Delta (including Shanghai Municipality, Jiangsu Province, Zhejiang Province and Anhui Province) from 2011 to 2021 were retrieved from the Information Management System for Parasitic Disease Control of Chinese Center for Disease Control and Prevention. Environmental factor data were captured from the Google Earth Engine platform, including elevation, slope, terrain, normalized difference vegetation index (NDVI), vegetation type, soil type, total petroleum hydrocarbon (TPH), ammonium nitrogen, inorganic nitrogen, dissolved oxygen, pH of water, chemical oxygen demand (COD) and inorganic phosphorus, and climatic factor data in the study region were retrieved from the Copernicus Climate Data Store, including annual precipitation, aridity index and annual mean temperature (AMT). O. hupensis snail survey data in the Yangtze River Delta region from 2011 to 2021 were randomly divided into a training set (70%) and a test set (30%), and five machine learning models were selected for machine learning model construction and comparative analysis of the O. hupensis snail density using the software R 4.3.0, including random forest (RF), eXtreme gradient boosting (XGBoost), support vector machine (SVM), gradient boosting machine (GBM) and neural network (NN). The XGBoost model was employed to construct a predictive model for the O. hupensis snail density, and the impact of each environmental factor on O. hupensis snail distribution was quantified. The SHapley Additive exPlanations (SHAPs) values were calculated to estimate the average contribution of each variable to the model prediction, and the core environmental factors affecting the O. hupensis snail population density were screened. Results Among the five machine learning models, the XGBoost model exhibited the optimal comprehensive performance, with the coefficient of determination (R²) of 0.855, mean squared error (MSE) of 0.188, root mean squared error (RMSE) of 0.434 and mean absolute error (MAE) of 0.155, respectively. Analysis of factors affecting the O. hupensis snail density with the XGBoost model showed that among the 16 environmental factors, the top four high-impact factors ranked by SHAPs values included annual precipitation, elevation, aridity index and NDVI, with cumulative SHAPs contributions of 75%, which was higher than that of other environmental factors. If NDVI was higher than 0.6, the O. hupensis snail density increased with NDVI and peaked if NDVI was 0.8 (1.60 snails/0.1 m²). The O. hupensis snail density increased with elevation if the elevation ranged from 14 to 40 m, and slowly rose if the annual precipitation ranged from 900 to 1 300 mm, and then increased rapidly to the peak (1.52 snails/0.1 m²) if the annual precipitation ranged from 1 300 to 1 500 mm. In addition, the O. hupensis snail density increased rapidly to the maximum (1.60 snails/0.1 m²) if the aridity index ranged from 0.8 to 1.1, and decreased gradually if the aridity index exceeded 1.1. Conclusions The XGBoost model shows excellent performance in prediction of the O. hupensis snail density and identification of key environmental factors in the Yangtze River Delta region. Annual precipitation, elevation, aridity index and NDVI are key environmental factors affecting the distribution and density of O. hupensis snails in the Yangtze River Delta region.

The frequent extreme climatic events post multifaceted impacts on the distribution of Oncomelania hupensis, the intermediate host of Schistosoma japonicum in the context of global climate change. This article systematically reviews the effects of four types of extreme climatic events, including floods, droughts, heat waves, and cold waves, on the survival, reproduction, and distribution of Oncomelania hupensis. Floods may expand suitable snail habitats, and increase both emerging and re-emerging snail habitats; however, the impact of floods on O. hupensis density is characterized by a lag effect of a decline followed by a rise. Droughts may cause fragmentation of suitable O. hupensis snail habitats, reduced O. hupensis snail egg production rates, and increased O. hupensis snail mortality, and heat waves may cause an increase in O. hupensis snail mortality, a reduction in numbers of O. hupensis snail populations and shrinking of O. hupensis snail distribution, while cold waves may cause a reduction in O. hupensis snail density and a rise in O. hupensis snail mortality. Extreme climate events pose both shortand long-term effects on the distribution of O. hupensis. Intensified surveillance of O. hupensis snails is required in high-risk environments.

Bicornuate uterus can cause miscarriage, premature birth, abnormal delivery or infertility. Strassman metroplasty may improve pregnancy outcomes for patients, but uterine rupture, placental implantation, premature birth, and postpartum hemorrhage may occur. The paper presents a case of a complete bicornuate uterus with spontaneous conception after Strassman metroplasty. However, complications such as cervical insufficiency, placenta implantation and premature birth occurred, and the relevant literatures were reviewed. Strassman metroplasty by laparoscopy combined with hysteroscopy for complete bicornuate uterus with adverse pregnancy outcomes is safe and feasible, and may improve reproductive outcomes. However, potential pregnancy and labor complications cannot be ignored.

Objective:To investigate effect of LncRNA C-terminal binding protein 1 antisense RNA 2(CTBP1-AS2)on malig-nant biological behavior of acute myeloid leukemia(AML)cells by regulating miR-433-3p/dipeptidyl peptidase 8(DPP8)signaling axis.Methods:AML cells HL-60 were randomly separated into si-NC group,si-CTBP1-AS2 group,si-CTBP1-AS2+anti-NC group,and si-CTBP1-AS2+anti-miR-433-3p group.CCK-8 method and EdU staining were applied to detect HL-60 cell proliferation.Flow cytometry was applied to detect HL-60 cells apoptosis.Transwell was applied to detect migration and invasion of HL-60 cells.Western blot was applied to detect expressions of PCNA,Bax,MMP-9 and DPP8 proteins in HL-60 cells.ELISA was applied to detect expres-sions of IFN-γ and IL-1β.Dual luciferase reporter gene experiment was applied to analyze interaction between LncRNA CTBP1-AS2 and miR-433-3p,and between miR-433-3p and DPP8.Results:Expressions of LncRNA CTBP1-AS2,DPP8 mRNA,A450,EdU posi-tive cells,number of migrating cells,number of invading cells,PCNA protein,MMP-9 protein,DPP8 protein and IL-1β protein ex-pressions of HL-60 cells in si-CTBP1-AS2 group were lower than si-NC group,miR-433-3p expression,apoptosis rate,Bax protein and IFN-γ protein expressions were higher than si-NC group(P<0.05).Compared with si-CTBP1-AS2 group and si-CTBP1-AS2+anti-NC group,miR-433-3p expression,apoptosis rate,and expressions of Bax protein and IFN-γ protein in si-CTBP1-AS2+anti-miR-433-3p group were decreased,DPP8 mRNA,A450,EdU positive cells,number of migrating cells,number of invading cells,PCNA protein,MMP-9 protein,DPP8 protein and IL-1β protein expressions were increased(P<0.05).LncRNA CTBP1-AS2 targeted negative regula-tion of miR-433-3p,while miR-433-3p targeted negative regulation of DPP8.Conclusion:Knocking down LncRNA CTBP1-AS2 may inhibit malignant biological behavior of AML cells,whose mechanism may be achieved by regulating miR-433-3p/DPP8 signaling axis.

Objective:To investigate the application of Galectin-9 and Pentraxin3 in cardiotoxicity assessment during anthracycline chemotherapy in breast cancer patients.Methods:A total of 143 breast cancer patients who received anthracycline chemotherapy in Department of Breast, Shanxi Provincial People’s Hospital from Oct. 2021 to Oct. 2023 were separated into cardiotoxic group ( n=47) and non-cardiotoxic group ( n=96) according to whether cardiotoxicity occurred. Clinical data of patients were collected and the risk factors of cardiotoxicity were analyzed by univariate and multivariate Logistic regression. The predictive efficacy of serum Galectin-9 and Pentraxin3 levels on cardiotoxicity was evaluated by receiver operating characteristic curve (ROC) . Results:There was no statistically significant difference in age, body mass index, total cholesterol, triglycerides, low density lipoprotein, high density lipoprotein, smoking history, drinking history, underlying disease (hypertension, diabetes, hyperlipidemia) , tumor stage, pathological type, tumor size, anthracycline type, or dose between the two groups ( t=1.07, 1.22, 0.96, 0.43, 1.07, 0.50; χ 2=0.12, 1.20, 0.14, 0.01, 0.47, 0.14, 3.32, 3.83, 1.91, 3.18, P > 0.05) ; The levels of troponin and B-type brain natriuretic peptide in cardiotoxicity group were higher than those in non-cardiotoxicity group ( t=13.48, 10.28, P < 0.05) , and serum Galectin-9 and Pentraxin3 levels were also higher ( t=22.53, 17.92, P < 0.05) . Multivariate Logistic regression analysis showed that high levels of troponin, B-type brain natriuretic peptide, Galectin-9 and Pentraxin3 were all influential factors in the occurrence of cardiotoxicity ( OR=2.221, 2.050, 1.925, 1.976, P < 0.05) . ROC curve analysis showed that the area under curve of serum Galectin-9 for predicting cardiotoxicity was 0.722, the predictive sensitivity was 68.09%, and the specificity was 77.08%; The area under the curve of miR-135 for predicting cardiotoxicity was 0.636, the predictive sensitivity was 44.68%, and the specificity was 82.29%. Conclusion:Serum Galectin-9 and Pentraxin3 have high expression levels in breast cancer patients treated with anthracyclines, which are influential factors for the occurrence of cardiotoxicity after chemotherapy, and have high predictive value for the occurrence of cardiotoxicity in patients.

Objective:To explore the correlation of bone metabolism with vitamin D and vitamin K levels in children with glucocorticoid-induced osteoporosis (GIOP) .Methods:A total of 120 GIOP children admitted to Neonatal Department of the First People’s Hospital of Chenzhou City, Hunan Province from Oct. 2022 to Dec. 2024 (GIOP group) and children without osteoporosis who received glucocorticoid therapy during the same period (the control group) were studied. Bone mineral density (BMD), biochemical indexes of bone metabolism and serum 25-hydroxyvitamin D (25 (OH) D), vitamin K1 (VitK1) and VitK2 were determined. BMD and bone metabolism indexes of GIOP children with different levels of 25 (OH) D, VitK1 and VitK2 were compared and their correlation was analyzed. Multiple linear regression analysis was conducted to analyze the independent factors affecting low BMD in GIOP children.Results:GIOP group had lower BMD, serum 25 (OH) D, VitK1 and VitK2 levels ( t=33.03, 42.22, 65.30, 86.16, P<0.05), while higher PINP, β-CTX and N-MID levels ( t=17.98, 34.78, 2.58, P<0.05); The levels of VitK1, VitK2, BMD, PINP, β-CTX and N-MID in GIOP children with different vitamin D and K levels were statistically significant ( F =54.31, 36.77, 82.32, 32.40, 22.80, 5.23), among which BMD was the lowest and PINP, β-CTX and N-MID levels were the highest ( P<0.05); The levels of 25 (OH) D, VitK1 and VitK2 were positively correlated with BMD ( r=0.54, 0.39, 0.47, P<0.05), but negatively correlated with PINP, β-CTX and N-MID ( r = -0.43, -0.34, -0.38, -0.39, -0.45, -0.44, -0.29, -0.32, -0.51, P<0.05); 25 (OH) D, VitK1 and VitK2 were protective factors for low BMD ( t=-2.76, -2.55, -3.51, P<0.05), while PINP, β-CTX, N-MID and hormone use time were risk factors ( t=2.48, 2.19, 2.22, 2.06, P<0.05) . Conclusions:The level of bone metabolism in children with GIOP is closely related to the levels of vitamin D and vitamin K. With the decrease of vitamin D and vitamin K levels, the decrease of BMD is more obvious. Therefore, vitamin D and vitamin K should be supplemented in a timely and reasonable manner for such children.

Objective:To elucidate the correlation between phase angle and malnutrition and to determine the cut-off value for phase angle to predict malnutrition in pancreatic cancer patients.Methods:This prospective cross-sectional study enrolled patients with pancreatic cancer hospitalized in the Department of Hepato-pancreato biliary Surgery at Beijing Hospital between December 2021 and March 2024. Baseline data, diet survey results, and body composition of these patients were recorded. Phase angle was measured with the InBody 720(Biospace, Korea). The Global Leadership Initiative on Malnutrition (GLIM) criteria were used to diagnose malnutrition.Results:A total of 110 cases (75 males and 35 females) aged 29-87(63.00±12.37) years were included. The prevalence of malnutrition was 63.6% (70/111) among the patients. Patients were divided into malnutrition ( n=77) and non-malnutrition ( n=33) groups as per the GLIM criteria. Phase angle was significantly lower in the malnutrition group than in the non-malnutrition group ( t=-3.808, P<0.001). Positive correlations were found between phase angle and body mass index, appendicular skeletal muscle mass index, fat-free mass index , fat-free mass, total energy intake, total protein, albumin, and prealbumin (all P<0.05).After adjusting for sex and age, low phase Angle remained an independent risk factor for malnutrition ( OR=3.809, 95% CI: 1.150-12.612, P=0.029). The cut-off values of phase angle for predicting malnutrition were 4.43 for males (with a sensitivity of 0.955, specificity of 0.585, area under the curve of 0.636; 95% CI: 0.508-0.763, P=0.037) and 4.54 for females (with a sensitivity of 1.000, specificity of 0.708, area under the curve of 0.799; 95% CI: 0.653-0.946, P<0.001). Conclusion:Phase angle may serve as a valid and simple indicator of malnutrition in pancreatic cancer patients.

Objective To develop a reminiscence therapy program with Montessori educational philosophy in treatment of elderly people with mild cognitive impairment(MCI)in nursing homes and evaluate its effect.Methods On the basis of Montessori education principles,a reminiscence therapy program was drafted through literature review and had it finalised with expert consultations and a pilot study.Between February and May 2022,70 elderly with MCI were recruited from a nursing home in Liaoning Province using convenience sampling.The recruited elderly were randomly divided into a control group(n=35)and an intervention group(n=35)using a random number table.The elderly in control group received conventional cognitive training only while the elderly in the intervention group received reminiscence therapy in addition to the conventional cognitive training.Cognitive function and ability of daily living(ADL)were compared between the two groups after a 6-week intervention.Results The elderly in intervention group demonstrated statistically significant improvements in both cognitive function and dimensions(visuospatial/executive function,naming ability,delayed recall and orientation,as well as in ADL after a 6-week intervention(all P<0.05).Conclusion The Montessori philosophy based on reminiscence therapy improves cognitive function and activities of daily living in the elderly with MCI,particularly from the perspectives of visuospatial/executive function,naming ability,delayed recall and orientation.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.