Objective: To investigate the mental health status and related factors among primary and secondary school students in western Yunnan Province, so ao to provide scientific evidences for advancing mental health education. Methods: In June 2024, a stratified cluster sampling method was employed to select 4 584 students from 18 schools across Diqing Tibetan Autonomous Prefecture, Lincang City and Baoshan City three regions in western Yunnan Province. The Mental Health Test (MHT) was used for assessment. Latent class analysis (LCA) and Logistic regression were applied for data classification and related factor analysis respectively. Results: The overall positive detection rate of MHT was 11.81%, with a mean total score of 40.50±19.25. The predominant issues were learning anxiety (58.4%), hypersensitivity tendency (31.1%), and self blame tendency (23.1%). LCA categorized students into four groups:severe psychological problems group (74.4% detection rate), learning anxiety hypersensitivity group ( 16.4 %), learning anxiety physical symptoms group (9.2%), and healthy group (0). Logistic regression revealed that compared with the healthy group, the severe problems group showed higher risks among females ( OR =3.01), junior/senior high school students ( OR =1.88/4.02), and those with authoritarian parenting ( OR =3.54); the anxiety hypersensitivity group had higher risks for females ( OR =1.87), senior high students ( OR =1.54), boarders ( OR =1.31), and authoritarian parenting recipients ( OR = 1.85 ); the anxiety physical symptoms group demonstrated increased risks among females ( OR =2.22), senior high students ( OR =2.58), and authoritarian parenting recipients ( OR =2.74), while lower risks were observed for students with parent/grandparent guardians ( OR =0.38) and non only children ( OR =0.58) (all P <0.05). Conclusions Mental health problems are prominent among students in western Yunnan, with gender, grade level, boarding status, guardian type, and parenting style being key determinants. Recommendations include strengthening mental health education, prioritizing left behind children s psychological well being and promoting healthy development.

Objective:To explore the experience and learning curve of single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach.Methods:Clinical data of 138 patients undergoing single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via oral vestibular approach from Sep. 2019 to Dec. 2021 in the Department of Thyroid and Breast Surgery of Affiliated Hospital of North Sichuan Medical College were retrospectively analyzed. The cumulative sum (CUSUM) method and best-fit curve analysis were used to compare the differences in each index such as operative time, intraoperative bleeding, number of lymph nodes cleared in the central region and postoperative related complications at various stages of the learning curve.Results:All 138 patients underwent single-line suspension rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach, and one patient was converted to open surgery due to large intraoperative bleeding in the mass. There were 14 males and 124 females, mean age (36.07±8.49) years (20-55 years), thyroid tumor size (7.74±6.49) mm (2.4-50mm), 5 cases underwent Subtotal thyroidectomy, 129 cases underwent Unilateral lobectomy + lymph node dissection in the middle region, and 4 cases total thyroidectomy + central zone lymph node dissection. The number of surgical cases corresponding to the apex of the CUSUM learning curve was 45, and the learning curve was divided into two stages: the learning improvement stage (1-45 cases) and the mastery stage (46-138 cases). The operative time, intraoperative bleeding, postoperative hospital stay, and chin numbness were all lower in the proficiency period than in the learning and training period ( P<0.05), and the number of lymph nodes cleared in the central region was larger than that in the learning and improvement stage ( P<0.05), while the differences in other indexes between the two stages were not statistically significant ( P>0.05) . Conclusion:The single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach has clinical application value and is worth promoting, and the number of surgical cases to be accumulated to master this technique is 45.

BACKGROUND:Compared with traditional two-dimensional culture,three-dimensional microtissue culture can show greater advantages.However,more favorable cultivation methods in three-dimensional culture still need to be further explored. OBJECTIVE:To evaluate the cell behavior of microtissue and its ability to promote cartilage formation under two three-dimensional culture methods. METHODS:Cartilage-derived microcarriers were prepared by chemical decellularization and tissue crushing.DNA quantification and nuclear staining were used to verify the success of decellularization,and histological staining was used to observe the matrix retention before and after decellularization.The microcarriers were characterized by scanning electron microscopy and CCK-8 assay.Cartilage-derived microtissues were constructed by combining cartilage-derived microcarriers with human adipose mesenchymal stem cells through three-dimensional static culture and three-dimensional dynamic culture methods.The cell viability and chondrogenic ability of the two groups of microtissues were detected by scanning electron microscopy,live and dead staining,and RT-qPCR. RESULTS AND CONCLUSION:(1)Cartilage-derived microcarriers were successfully prepared.Compared with before decellularization,the DNA content significantly decreased after decellularization(P<0.001).Scanning electron microscope observation showed that the surface of the microcarrier was surrounded by collagen,maintaining the characteristics of the natural extracellular matrix of cartilage cells.CCK-8 assay indicated that microcarriers had no cytotoxicity and could promote cell proliferation.(2)Scanning electron microscopy and live and dead staining results showed that compared with the three-dimensional static group,the three-dimensional dynamic group had a more extended morphology of microtissue cells,and extensive connections between cells and cells,between cells and matrix,and between matrix.(3)The results of RT-qPCR showed that the expressions of SOX9,proteoglycan,and type Ⅱ collagen in microtissues of both groups were increased at 7 or 14 days.The relative expression levels of each gene in the three-dimensional dynamic group were significantly higher than those in the three-dimensional static group at 14 days(P<0.05).At 21 days,the three-dimensional static group had significantly higher gene expression compared with the three-diomensional dynamic group(P<0.001).(4)The results showed that compared with three-dimensional static culture microtissue,three-dimensional dynamic culture microtissue could achieve higher expression of chondrogen-related genes in a shorter time,showing better cell viability and chondrogenic ability.

Objective:To investigate the consistency of domestic F-STROKE, NeuBrainCARE MRI automatic post-processing software and RAPID MRI automatic post-processing software in the output of infarction core area volume, time-to-maximum volume and ischemic penumbra volume in patients with acute ischemic stroke.Methods:The research was cross-sectional. The clinical and imaging data of patients with acute ischemic stroke from January 2016 to March 2021 were retrospectively collected, including 149 cases from Shanghai Fourth People′s Hospital Affiliated to Tongji University (Center 1), 120 cases from Langfang Changzheng Hospital of Hebei Province (Center 2), and 45 cases from Wuzhou Workers Hospital (Center 3). All patients underwent diffusion weighted imaging (DWI) and dynamic magnetic sensitivity contrast-perfusion weighted imaging (DSC-PWI). RAPID, F-STROKE and NeuBrainCARE automatic post-processing software were used to perform automatic post-processing analysis of MRI images of all patients with acute ischemic stroke. The infarct core (apparent diffusion coefficient<620×10 -6 mm 2/s) volume, time-to-maximum (T max>6 s) volume and the ischemic penumbra (PWI-DWI mismatch) volume were output. The Wilcoxon test was used to analyze the difference between F-STROKE, NeuBrainCARE, and RAPID software outputs of infarct core volume, time to maximum peak volume, and ischemic penumbra volume. Bland-Altman and intraclass correlation coefficient ( ICC) were used to analyze the consistency of the infarct core volume, time-to-maximum volume and ischemic penumbra volume output by F-STROKE, NeuBrainCARE and RAPID software. Results:There were statistically significant differences in the core infarct volume between F-STROKE and RAPID software, NeuBrainCARE and RAPID software ( Z=-10.17, -5.43, both P<0.001). There were significant differences in the time-to-maximum volume between F-STROKE and RAPID software, NeuBrainCARE and RAPID software ( Z=-3.17, -5.51, both P<0.05). There was no significant difference in the ischemic penumbra volume between F-STROKE software and RAPID software ( Z=-1.43, P=0.153), and there was significant difference in the ischemic penumbra volume between NeuBrainCARE software and RAPID software ( Z=-6.45, P<0.05). Bland-Altman analysis showed that the values within the limits of agreement accounted for more than 93.31% of all point values. ICC analysis showed high agreement between F-STROKE, NeuBrainCARE, and RAPID software outputs of infarct core volume, time to maximum peak volume, and ischemic penumbra volume ( ICC>0.6). Conclusion:Domestic F-STROKE software, NeuBrainCARE software and RAPID software have good consistency in evaluating the infarct core volume, time-to-maximum volume and ischemic penumbra volume in patients with acute ischemic stroke, which is worthy of clinical promotion.

Objective To investigate the association of the serum levels of ischemia-modified albumin（IMA）and homocysteine（Hcy）with the onset and severity of white matter ischemic lesions（WMIL）. Methods A total of 89 patients who were diagnosed with WMIL by cranial magnetic resonance imaging（MRI）in our hospital from March 2020 to June 2022 were enrolled as WMIL group，and the volunteers with normal cranial MRI results，matched for sex and age，during the same period of time were enrolled as control group. The two groups were compared in terms of general information and laboratory markers，and the conditions of WMIL were evaluated and classified into mild and moderate-to-severe cases. A logistic regression analysis was used to investigate the influencing factors for the onset and severity of WMIL，and the receiver operating characteristic（ROC）curve was used to analyze the value of the serum levels of IMA and Hcy in the diagnosis of WMIL. Results Compared with the control group，the WMIL group had a significantly higher proportion of patients with hypertension or type 2 diabetes and significantly higher levels of uric acid（UA），IMA，and Hcy（P<0.05）. Compared with the control group，the WMIL group had a significantly higher proportion of the patients with moderate-to-severe WMIL who had hypertension or the proportion of type 2 diabetes，significantly higher levels of IMA and Hcy，and a significantly lower level of high-density lipoprotein cholesterol（P<0.05）. The logistic regression analysis showed that hypertension，elevated IMA level，and elevated Hcy level were influencing factors for the onset of WMIL（P<0.05），and hypertension，elevated IMA level，and elevated Hcy level were influencing factors for the increase in WMIL severity（P<0.05）. The ROC curve analysis showed that serum IMA and Hcy had a certain value in the diagnosis of WMIL and moderate-to-severe WMIL. Conclusion Increases in the serum levels of IMA and Hcy are associated with the onset and aggravation of WMIL，and measurement of the serum levels of IMA and Hcy has a certain value in the diagnosis of WMIL and moderate-to-severe WMIL.
Homocysteine

Objective:To learn about the genotyping of human Brucella isolated from Sichuan Province. Methods:BCSP31-PCR and AMOS-PCR were used to identify the genus and biotype of the 66 strains isolated from confirmed human brucellosis cases in Sichuan Province from 2014 to 2020, respectively. The isolated strains were genotyped by multi-locus sequence typing (MLST)-9. The sequence type (ST) was compared trough the online MLST database. A minimum spanning tree (MST) was constructed to cluster the newly discovered and known ST using the BioNumerics software version 7.6.Results:The 66 strains isolated from human cases of brucellosis in Sichuan Province from 2014 to 2020 were Brucella, and 65 of them were Brucella melitensis while one strain was Brucella abortus. The MLST method identified three known STs (ST-8, ST-39 and ST-2) and one newly type (ST-101). Among them, ST-8 was the main ST in Sichuan Province (90.91%, 60/66), another 4 strains of Brucella melitensis were ST-39, and 1 strain of Brucella abortus was ST-2. The newly type ST-101 was isolated from Leshan City in 2019, belonging to the Brucella melitensis and closely related to the evolution of ST-8. Conclusion:Brucella melitensis is the main epidemic Brucella strain in Sichuan Province, ST-8 is predominant genotype, with a small amount of ST-39, ST-101 and ST-2.

T helper 17 (Th17) cells are closely associated with the pathogenesis of several autoimmune and inflammatory diseases, and selective suppression of Th17 cell production and pathogenicity is an effective strategy for the treatment of these diseases. There is growing evidence that cellular metabolism is associated with the development of autoimmune diseases and determines the differentiation and effector functions of Th17 cells, which undergoes a metabolic reorganization during differentiation from an oxidative phosphorylation-based catabolism to a glucose-based anabolic metabolism in the initial T cells. This paper focused on reviewing recent findings regarding the importance of metabolism in T cell differentiation and autoimmune diseases, especially in Th17 cells, and discussing the regulatory mechanisms of glycolysis in Th17 cell differentiation. This review summarized the regulation of metabolism on T-cell activation and differentiation, revealed metabolic targets with specific regulation on Th17 cells, and provided reference for finding potential therapeutic targets for Th17 cell-mediated autoimmune diseases.

Objective:To retrieve and obtain evidence related to postoperative rehabilitation training of patients with lumbar disc herniation and to summarize the best evidence.Methods:The computer was used to search domestic and foreign guideline networks, evidence-based databases, original research databases and orthopedic related websites for relevant evidence on rehabilitation training for patients with lumbar disc herniation after surgery, including evidence summary, guidelines, expert consensus, systematic review and Meta-analysis. The retrieval time limit was from the establishment of the database to April 30, 2021. The literature quality evaluation, evidence extraction, classification and integration were conducted independently by two researchers, and disagreements were discussed or adjudicated by a third party.Results:A total of 14 articles were included, including 3 evidence summaries, 1 guideline, 6 expert consensuses, and 4 systematic reviews. A total of 13 best evidences of rehabilitation training for patients with lumbar disc herniation after surgery were summarized in 8 categories, including rehabilitation assessment, rehabilitation principle, rehabilitation time, rehabilitation intensity, rehabilitation mode, patient education, rehabilitation psychotherapy and follow-up monitoring.Conclusions:This study can provide evidence-based basis for nursing staff to carry out postoperative rehabilitation guidance, but in clinical practice, physical, psychological and cultural background conditions of patients should be comprehensively assessed, and individualized rehabilitation programs should be formulated for patients based on local medical level and conditions.

Objective:To investigate the diagnostic value of microRNA-29b(miR-29b)for left ventricular hypertrophy(LVH)in elderly patients with coronary heart disease(CHD).Methods:From January 2015 to December 2018, 140 elderly patients with CHD admitted in our hospital were enrolled, including 70 CHD patients without LVH(the NLVH group)and 70 CHD patients with LVH(the LVH group). Seventy healthy elderly adults without CHD who underwent heart examination at our hospital during the same period were included as the control group.The interventricular septum thickness(IVSD), left ventricular posterior wall thickness(LVPWD) and the relative expression level of microRNA-29b were detected and compared among the three groups.The correlation of microRNA-29b with IVSD and LVPWD was analyzed, and the diagnostic value of microRNA-29b for LVH in elderly CHD patients was analyzed.Results:There were significant differences in IVSD, LVPWD and the relative expression level of microRNA-29b among the three groups( F=22.838, 22.147 and 114.096, all P=0.000). The IVSD, LVPWD and the relative expression level of microRNA-29b were higher in the LVH group than in the NLVH group( t=3.479, 3.206 and 9.852, all P=0.000)and than in the control group( t=3.904, 3.553 and 10.792, all P=0.000). The relative expression level of microRNA-29b was higher in the NLVH group than in the control group( t=2.306, P=0.420). The receiver-operating characteristics(ROC)curve analysis of microRNA-29b for the diagnosis of LVH in elderly CHD patients showed that the maximum entry point of Youden index was 0.80, the optimal critical value was 3.52, the sensitivity and specificity for the diagnosis of LVH was 91.73% and 88.27%.Pearson correlation analysis showed that the expression level of microRNA-29b was positively correlated with IVSD and LVPWD( r=0.63 and 0.61, P=0.000). Conclusions:The expression level of microRNA-29b is significantly increased in elderly CHD patients with LVH, and positively correlated with IVSD and LVPWD.The expression level of microRNA-29b has high sensitivity and specificity in the diagnosis of LVH in elderly CHD patients.

Objective: To explore mechanism of how nurse managers' transformational leadership affects patient satisfaction, and to examine the mediating role of nurses' psychological empowerment. Methods: A total of 140 nurses and 310 patients in Sun Yat-sen University Cancer Center were surveyed. The Leadership Practice Inventory-other, the Psychological Empowerment Scale and two items from the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (Chinese version) were used to measure nurse-perceived nurse managers' transformational leadership behaviors, nurses' psychological empowerment and patient satisfaction. The descriptive statistics and correlation analysis were performed using the SPSS 20.0. software package, and the structure equation modeling was performed using the MPlus 7.0. Results: Higher frequencies of nurse managers adopting transformational leadership were associated with higher level of nurses' psychological empowerment (β=0.665, P < 0.05); higher level of nurses' psychological empowerment was associated with higher overall patient satisfaction (β=0.243, P < 0.05); nurses' psychological empowerment mediated the relationship between nurse managers' transformational leadership and patients' overall satisfaction (β=0.162, P=0.014); the effects of nurse managers' transformational leadership and nurses' psychological empowerment on patients' recommendation of hospital were not statistically significant (P>0.05). Conclusions Nurse managers are encouraged to adopt transformational leadership, i.e., improving clinical and leadership skills, trying to be nurses' role model, solving problems at work, empowering and motivating nurses, thus to increase nurses' senses of empowerment, and to improve patient satisfaction eventually.