Objective: To understand the prevalence of school bullying and the comorbidity of anxiety and depressive symptoms among middle school students and their association, so as to provide a basis for developing related intervention strategies. Methods: From September to December 2023, a multistage random cluster sampling was employed to select 107 851 middle school students across 104 counties in Anhui Province. The Center for Epidemiological Studies Depression Scale (CES-D) and the Generalized Anxiety Disorder-7 (GAD-7) Scale were used to assess depressive and anxiety symptoms. Logistic regression analysis was utilized to examine the correlations between experiences of school bullying and the comorbidity of anxiety and depressive symptoms. Results: The findings revealed that 2.80% of middle school students had experienced school bullying in the past 30 days. Additionally, 27.03% exhibited potential symptoms of depression, 8.94% showed signs of anxiety symptom, and the comorbidity rate of anxiety and depressive symptoms was 8.04%. Logistic regression analysis showed that statistically significant correlations were identified between experiences of school bullying and increased risks of depressive symptoms (OR=6.42, 95%CI=5.93-6.94, P<0.01), anxiety symptoms (OR=5.94, 95%CI=5.47-6.44, P<0.01), and their comorbidity (OR=6.38, 95%CI=5.88-6.93, P<0.01). Compared with those who did not suffer from school bullying, junior high school students, ordinary senior high school students, vocational senior high school students, boys and girls who suffered from school bullying all had increased risks of comorbidity of anxiety and depressive symptoms (OR=7.25, 5.55, 4.80, 6.42, 6.27, P＜0.01). Conclusions The study underscores the significant impact of school bullying on increasing the risk of comorbidity of anxiety and depressive symptoms among middle school students. It is important to pay attention to the psychological health of bullied students and implement timely psychological intervention measures.

Objective To establish a quantitative analysis of multi-components by single-marker(QAMS)method for the simultaneous determination of 11 components in Fazhi Banxia Qu(including Pinelliae Preparata,Fritillariae Cirrhosae Bulbus,and Exocarpium Citri Grandis),and combined with grey relational analysis(GRA)and entropy weight-technique for sequencing by approximate ideal solution or technique for order preference by similarity to ideal solution(EW-TOPSIS)analysis to comprehensive evaluate the quality of Fazhi Banxia Qu.Methods The Shimadzu C18 column was used,and the mobile phase consisted of acetonitrile-0.5%glacial acetic acid in a gradient elution manner,the flow rate was 1.0 mL·min-1,and the detection wavelength were set at 254 nm and 290 nm.Ethyl-p-methoxycinnamate was used as an internal reference substance to calculate the other ten components'relative correction factors(RCF),after which the content determination was made.The GRA combined with the EW-TOPSIS model were used to evaluate the comprehensive quality of Fazhi Banxia Qu.Results Eleven components of Fazhi Banxia Qu showed good linear relationships within their ranges,and the correlation coefficients were greater than 0.999.The average recoveries were 96.94%-100.12%(RSD<2.0%,n=9).There was no significant difference between QAMS and external standard method(ESM).The relative correlation degree of the GRA model was 0.290 3-0.618 7,and the relative proximity in the EW-TOPSIS model was 0.211 4-0.634 3.The comprehensive evaluation results of the GRA and EW-TOPSIS models were the same.Conclusion The HPLC-QAMS method is convenient and accurate,and can be used for quantitative control of multi-index components in Fazhi Banxia Qu.The GRA combined with EW-TOPSIS models can be used to evaluate the comprehensive quality of Fazhi Banxia Qu.

Objective To monitor the antifungal resistance of clinical isolates of Candida spp.in the East China region.Methods MALDI-TOF MS or molecular methods were used to re-identify the strains collected from January 2018 to December 2022.Antifungal susceptibility testing was performed using the broth microdilution method.The susceptibility test results were interpreted according to the breakpoints of 2022 Clinical and Laboratory Standards Institute(CLSI)documents M27 M44s-Ed3 and M57s-Ed4.Results A total of 3 026 strains of Candida were collected,65.33％of which were isolated from sterile body sites,mainly from blood(38.86％)and pleural effusion/ascites(10.21％).The predominant species of Candida were Candida albicans(44.51％),followed by Candida parapsilosis complex(19.46％),Candida tropicalis(13.98％),Candida glabrata(10.34％),and other Candida species(0.79％).Candida albicans showed overall high susceptibility rates to the 10 antifungal drugs tested(the lowest rate being 93.62％).Only 2.97％of the strains showed dose-dependent susceptibility(SDD)to fluconazole.Candida parapsilosis complex had a SDD rate of 2.61％and a resistance rate of 9.42％to fluconazole,and susceptibility rates above 90％to other drugs.Candida glabrata had a SDD rate of 92.01％and a resistance rate of 7.99％to fluconazole,resistance rates of 32.27％and 48.24％to posaconazole and voriconazole non-wild-type strains(NWT),respectively,and susceptibility rates above 90％to other drugs.Candida tropicalis had resistance rates of 29.55％and 26.24％to fluconazole and voriconazole,respectively,resistance rates of 76.60％and 21.99％to posaconazole and echinocandins non-wild-type strains(NWT),and a resistance rate of 2.36％to echinocandins.Conclusions The prevalence and species distribution of Candida spp.in the East China region are consistent with previous domestic and international reports.Candida glabrata exhibits certain degree of resistance to fluconazole,while Candida tropicalis demonstrates higher resistance to triazole drugs.Additionally,echinocandins resistance has emerged in Candida albicans,Candida glabrata,Candida tropicalis,and Candida parapsilosis.

Objective:To explore the prediction model of tissue chip technology for the chemotherapy response of patients with colorectal cancer.Methods:217 patients with colorectal cancer who had received standardized chemotherapy in the Affiliated People’s Hospital of Ningbo University from Jan. 2017 to Dec. 2019 were prospectively selected. The patients were randomly divided into training set (152 cases) and test set (65 cases) according to the ratio of 7:3, and were followed up for 6 months. The clinical data of the patients in the training set were compared, the expression levels of Ang-2, caspase-3 and CD147 in the patients were analyzed by tissue microarray technology, and the related factors affecting the responsiveness of colorectal cancer chemotherapy were analyzed by the Logistic regression model. R software was used based on the training set. A nomogram prediction model was built and model performance on the test set was evaluated.Results:One case was excluded from the training center, and 151 cases were finally included, including 93 cases in the chemotherapy response group and 58 cases in the chemotherapy response group. The tumor diameter, serum carcinoembryonic antigen, caspase3, Ang2 expression level, and the proportion of clinical stage IV in the poor chemotherapy group were significantly higher than those in the good chemotherapy group (all P<0.05) ; Logistic regression showed tumor diameter ( OR=2.394), serum carcinoembryonic antigen ( OR=1.878), caspase-3 ( OR=4.261), Ang-2 expression level ( OR=5.457), and clinical stage IV ( OR=5.954) were independent risk factors for adverse drug reactions in patients with colorectal cancer (all P<0.05). The consistency index (C-index) for predicting the factors related to adverse chemotherapy reactions in patients with colorectal cancer was 0.915. External verification showed that the sensitivity was 86.96%, the specificity was 92.50%, and the accuracy was 90.48% (42/65) . Conclusion:The expression levels of Ang-2 and caspase-3 are correlated with the responsiveness of colorectal cancer to chemotherapy, and can be used as predictive indicators to evaluate the responsiveness of colorectal cancer to chemotherapy.

OBJECTIVE To establish the method for simultaneous determination of 11 components as narirutin in Biantong capsules，to conduct chemical pattern recognition analysis and to screen differential markers affecting their quality . METHODS HPLC method was adopted . The separation was carried out on Venusil XBP C 18 column with mobile phase consisted of acetonitrile - 0.1％ phosphoric acid solution with gradient elution at flow rate of 1.0 mL/min. The sample size was 10 µL，and column temperature was set at 30 ℃. The detection wavelengths were set at 283，330，520，220 nm，respectively. Using verbascoside as an internal standard ，the contents were determined by quantitative analysis of mult -components by single marker （QAMS），and the results were compared with those of external standard method . Cluster analysis ，principle component analysis and orthogonal partial least squares -discriminant analysis were performed with SPSS 26.0 and SIMCA 14.1 software. The differential markers affecting the quality of Biantong capsules were screened using the variable importance in projection （VIP）value greater than 1 as the standard . RESULTS The contents of narirutin ，naringin，neohesperidin，echinacoside，tubuloside A ，isoacteoside，cyanidin-3-O-glucoside， cyanidin-3-O-rutoside，atractylolide Ⅲand atractylolide Ⅰ were 0.739-1.265，1.134-2.158，1.407-2.359，1.368-2.502，0.304-0.522， 0.257-0.521，0.423-0.727，0.375-0.733，0.130-0.283 and 0.062-0.166 mg/g，respectively. The relative average deviation of them from the external standard method was less than 2％. The results of cluster analysis showed that 15 batches of samples could be grouped into three categories ，S1-S7 as a category ，S8-S10 as a category ，and S 11-S15 as a category ，which was consistent with the classification results of principal component analysis . The results of orthogonal partial least squares -discriminant analysis showed that the VIP values of cyanidin -3-O-rutoside，atractylolide Ⅲ， naringin，neohesperidin，echinacoside and verbascoside were all greater than 1. CONCLUSIONS The method for simultaneous determination of 11 components in Biantongcapsules， including narirutin ， is successfully established . Combined with chemical pattern recognition analysis ，it can be used for the quality control of Biantong capsules . Six components such as cyanidin -3-O-rutoside may be the differential markers that affect the quality of Biantong capsules .

Artemisia annua is the main natural source of artemisinin production. In A. annua, extended drought stress severely reduces its biomass and artemisinin production while short-term water-withholding or abscisic acid (ABA) treatment can increase artemisinin biosynthesis. ABA-responsive transcription factor AabZIP1 and JA signaling AaMYC2 have been shown in separate studies to promote artemisinin production by targeting several artemisinin biosynthesis genes. Here, we found AabZIP1 promote the expression of multiple artemisinin biosynthesis genes including AaDBR2 and AaALDH1, which AabZIP1 does not directly activate. Subsequently, it was found that AabZIP1 up-regulates AaMYC2 expression through direct binding to its promoter, and that AaMYC2 binds to the promoter of AaALDH1 to activate its transcription. In addition, AabZIP1 directly transactivates wax biosynthesis genes AaCER1 and AaCYP86A1. The biosynthesis of artemisinin and cuticular wax and the tolerance of drought stress were significantly increased by AabZIP1 overexpression, whereas they were significantly decreased in RNAi-AabZIP1 plants. Collectively, we have uncovered the AabZIP1-AaMYC2 transcriptional module as a point of cross-talk between ABA and JA signaling in artemisinin biosynthesis, which may have general implications. We have also identified AabZIP1 as a promising candidate gene for the development of A. annua plants with high artemisinin content and drought tolerance in metabolic engineering breeding.

Purpose: This study was performed to investigate the association of Glasgow prognostic score (GPS), combined positive score (CPS), and clinicopathological characteristics of locally advanced rectal cancer. Methods: Between February 2012 and February 2018, 103 patients with locally advanced rectal cancer treated by neoadjuvant chemoradiotherapy and total mesorectal excision (TME) were retrospectively evaluated. Results: According to the classification of the GPS, 85 (82.5%), 13 (12.6%), and 5 patients (4.9%) were classified as a score of 0, 1, and 2, respectively. Patients were classified into the GPS-low group (GPS of 0, n = 85) and GPS-high group (GPS of 1 or 2, n = 18) with an area under the curve of 0.582 for overall survival (OS). The mean programmed death-ligand 1 (PD-L1) CPS of the whole group was 2.24 (range, 0–70). The PD-L1 CPS of the GPS-high group was higher than the GPS-low group (P < 0.001). Multivariate analysis by Cox proportional hazards model indicated that GPS was associated with OS and diseasefree survival (DFS). Furthermore, PD-L1 CPS was associated with DFS (hazard ratio, 1.050; 95% confidence interval, 1.017– 1.083; P = 0.003). Conclusion Elevated GPS was related to the PD-L1 CPS. GPS and PD-L1 CPS were associated with the prognosis of locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy followed by TME.

Objective:To investigate the efficacy of combined fluoxetine and aniracetam tablets in the treatment of senile depression and its effects on serum total bile acid (TBA) and norepinephrine (NE) levels.Methods:A total of 100 older adult patients with depression who received treatment in Heze Medical College from January 2019 to December 2019 were included in this study. They were randomly assigned to receive either fluoxetine tablets alone (control group, n = 50) or fluoxetine and aniracetam tablets (study group, n = 50). All patients received two months of treatment. Clinical efficacy, scores of the Hamilton Rating Scale for Anxiety (HAMA) and the Hamilton Rating Scale for Depression (HAMD), adverse reactions, and serum TBA and NE levels were compared between the two groups. Results:Total response rate was significantly higher in the study group than in the control group [96.0% (48/50) vs. 84.0% (42/50), χ2 = 4.00, P = 0.045]. HAMD and HAMA scores post-treatment in the study group were (5.85 ± 1.81) points and (4.81 ± 1.57) points, respectively, which were significantly lower than those in the control group [(11.65 ± 2.65) points, (10.85 ± 2.84) points, t = 10.84, P < 0.001; t = 11.16, P < 0.001). Serum NE level was significantly higher in the study group than in the control group [(138.68 ± 16.35) ng/L vs. (127.17 ± 14.34) ng/L, t = 3.17, P = 0.002]. There were no significant differences in serum TBA level [(5.85 ± 0.63) μmol/L vs. (5.91 ± 0.65) μmol/L] and the incidence of adverse reactions (8.00% vs. 6.00%) between the study and control groups ( t = 0.39, P = 0.692; χ2 = 0.15, P = 0.695). Conclusion:The combined therapy of fluoxetine and aniracetam tablets for the treatment of senile depression is safe and highly effective, does not affect metabolic function and thereby deserves clinical application.

Lateral epicondylitis is a common clinical disease with characteristics of lateral elbow pain, insidious onset and easy recurrence, which can cause forearm pain and decreased wrist strength, seriously affecting patients′ daily life and work. Although there are various treatment methods for lateral epicondylitis with different effects, standard treatments are still lacking nowadays. Platelet-rich plasma (PRP) has good effects on bone and tendon repair, and is now widely used in the treatment of lateral epicondylitis. However, there is a lack of a unified understanding of the technology and specifications of PRP in the treatment of lateral epicondylitis. Therefore, the Sports Medicine Branch of the Chinese Medical Association and Physical Medicine and Rehabilitation Branch of the Chinese Medical Association organized experts in the fields of sports medicine and rehabilitation medicine in China to formulate the "clinical expert consensus on platelet-rich plasma treatment for lateral epicondylitis (2022 version)", and proposed suggestions based on evidence-based medicine mainly from the concept, epidemiology and pathophysiology of lateral epicondylitis, symptoms, signs and imaging manifestations of lateral epicondylitis, PRP concept and application component requirements, quality control of PRP preparation technology, indications and contraindications of PRP in the treatment of lateral epicondylitis, PRP injection in the treatment of lateral epicondylitis, application of PRP in the operation of lateral epicondylitis, related problems after PRP treatment of lateral epicondylitis, evaluation of the results after PRP treatment of lateral epicondylitis, and health and economic evaluation of PRP treatment of lateral epicondylitis, so as to provide guidance for clinical diagnosis and treatment.

Objective:To explore the clinical significance of classification and grading of ovarian serous tumors (OST) and the correlation of classification and grading with expressions of p53 and Ki-67 proteins, so as to provide a basis for accurate diagnosis and reasonable treatment of OST.Methods:A total of 100 paraffin-embedded ovarian tissues were collected from Haikou Affiliated Hospital of Central South University Xiangya School of Medicine from January 2012 to November 2017. The classification and grading of OST was based on the World Health Organization (WHO) ovarian tumor tissue classification, the work conference on borderline ovarian tumors which was held in August 2013 in Maryland, United States, and the two-level tissue classification system of the United States MD Anderson Cancer Center. The 100 cases of ovarian tissues included 10 cases of normal ovarian tissues (NOT), 12 cases of ovarian serous cystadenoma (OSA), 18 cases of ovarian serous borderline tumor (OSBT), 22 cases of low-grade serous carcinoma (LGSC), and 38 cases of high-grade serous carcinoma (HGSC). The expressions of p53 and Ki-67 proteins in paraffin-embedded tissues were detected by immunohistochemistry. The clinical characteristics of patients with different types of OST and their relationships with the expression of p53 protein and Ki-67 positive index were analyzed.Results:Among OSBT, LGSC and HGSC groups, the proportion of patients with onset age > 50 years old [38.9% (7/18), 45.5% (10/22), 73.7% (28/38)], poor differentiation [0 (0/18), 0 (0/22), 100.0% (38/38)], stage Ⅲ-Ⅳ [5.6% (1/18), 27.3% (6/22), 39.5% (15/38)] increased sequentially, and the differences were statistically significant (all P < 0.05). Among NOT, OSA, OSBT, LGSC and HGSC groups, there were significant differences in the positive rate of p53 protein [20.0% (2/10), 25.0% (3/12), 27.8% (5/18), 31.8% (7/22), 57.9% (22/38)] and Ki-67 positive index [(10.40±0.00)%, (31.49±6.53)%, (42.81±6.84)%, (74.29±6.54)%, (77.04±8.88)%] (all P < 0.05). In the patients with ovarian serous carcinoma (LGSC + HGSC), there was no significant difference in the positive rate of p53 protein and Ki-67 positive index between the onset age ≤ 50 years old and > 50 years old groups (both P > 0.05), but there were significant differences between the patients with different tissue differentiation grade, clinical stage and metastasis (all P < 0.05). There was significant difference in Ki-67 positive index among NOT, OSA, OSBT, LGSC and HGSC patients with positive expression of p53 protein ( P < 0.01). Conclusions:The classification and grading of OST is related to onset age, tissue differentiation and clinical stage, which can be used to guide treatment and judge prognosis. The positive rate of p53 protein and Ki-67 positive index increase with advancing grade of breast lesions, which may be related to the occurrence and development of OST.