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 explore the current situation of nurses′growth mindset ability and study its related influencing factors, so as to serve as a reference for improving nurses′ growth mindset ability.Methods:This was a cross-sectional survey, and 310 nurses from 5 tertiary hospitals in Shandong Province, Shanghai City, and Guangdong Province were selected as the survey subjects from April to June 2022 using convenience sampling method. The General Information Questionnaire, the Nurses′ Growth Mindset Assessment Scale, the Psychological Adaptability Self-Assessment Scale, the Chinese Big Five Personality Inventory Brief Version and the Team Psychological Safety Atmosphere Scale were used to investigate the growth mindset ability of nurses and its influencing factors.Results:Finally, 307 valid questionnaires were collected. There were 46 males and 261 females, aged 20-50 years old. The scores of the Nurses′ Growth Mindset Assessment Scale were (108.89 ± 29.32) points, the scores of the Psychological Adaptability Self-Assessment Questionnaire were 10.0(0.0, 20.0) points, the scores of the Chinese Big Five Personality Inventory Brief Scale were (162.37±43.82) points, and the scores of the Team Psychological Safety Atmosphere Scale were (55.84 ± 15.12) points. The highest education level ( B = 0.028, P = 0.040), professional title ( B = 0.033, P = 0.032), family economic support ( B = 0.025, P = 0.048), Chinese big five personality ( B = 0.039, P = 0.037), team psychological safety atmosphere ( B = 0.600, P<0.001) and psychological adaptability ( B = 0.313, P<0.001) had a significant effect on nurses′ growth mindset ability. Conclusions:The growth mindset ability of nurses is at the upper middle level, and the educational background, professional title, family economic support, personality characteristics, team psychological safety atmosphere and psychological adaptability of nurses are the significant influencing factors. Hospitals, social and health education systems can combine influencing factors to provide a harmonious working atmosphere for nurses, focusing on the improvement of nurses′ academic qualifications and the promotion of professional titles, cultivating nurses′ psychological adaptability, improving nurses′growth mindset ability, and improving the overall quality of the nursing service team.

Objective:To conduct a nationwide physician survey to better understand clinicians’ disease awareness, treatment patterns, and experience of Waldenstr?m macroglobulinemia (WM) in China.Methods:This cross-sectional study was conducted from February 2022 to July 2022 by recruiting clinicians with WM treatment experience from hematology, hematology-oncology, and oncology departments throughout China. Quantitative surveys were designed based on the qualitative interviews.Results:The study included 415 clinicians from 219 hospitals spread across thirty-three cities and twenty-two provinces. As for diagnosis, the laboratory tests prescribed by physicians for suspected WM patients were relatively consistent (92% -99% recommendation for laboratory, 79% -95% recommendation for pathology, 96% recommendation for gene testing, and 63% -83% recommendation for imaging examination). However, from a physician's perspective, there was 22% misdiagnosis occurred in clinical practice. The rate of misdiagnosis was higher in lower-level hospitals than in tertiary grade A hospitals (29% vs 21%, P<0.001). The main reasons for misdiagnosis were that WM was easily confused with other diseases, and physicians lacked the necessary knowledge to make an accurate diagnosis. In terms of gene testing in clinical practice, 96% of participating physicians believed that WM patients would require gene testing for MYD88 and CXCR4 mutations because the results of gene testing would aid in confirming diagnosis and treatment options. In terms of treatment, 55% of physicians thought that the most important goal was to achieve remission, while 54% and 51% of physicians wanted to improve laboratory and/or examination results and extend overall survival time, respectively. Among patients with treatment indications, physicians estimated that approximately 21% of them refused to receive treatment, mainly owing to a lack of affordable care and disease awareness. When selecting the most appropriate treatment regimens, physicians would consider patient affordability (63% ), comorbidity (61% ), and risk level (54% ). Regimens containing Bruton tyrosine kinase inhibitor (BTKi) were most widely recommended for both treatment-na?ve and relapsed/refractory patients (94% for all patients, 95% for treatment-na?ve patients, and 75% for relapsed/refractory patients), and most physicians recommended Ibrutinib (84% ). For those patients who received treatment, physicians reported that approximately 23% of patients did not comply with the treatment regimen due to a lack of affordability and disease awareness. Furthermore, 66% of physicians believe that in the future, increasing disease awareness and improving diagnosis rates is critical. Conclusions:This study is the first national physician survey of WM conducted in China. It systematically describes the issues that exist in WM diagnosis and treatment in China, such as a high rate of misdiagnosis, limited access to gene testing and new drugs, and poor patient adherence to treatment. Chinese doctors believe that improving doctors’ and patients’ understanding of WM is one of the most urgent issues that must be addressed right now.

Objective:To explore the role of arginine metabolism in the inflammatory response to influenza A virus (FluA) infection.Methods:Eighteen-month-old mice were infected with FluA via nasal drip, with samples collected on the 6th day post-infection. The concentration of cytokines was determined by the Luminex multifactor assay, while the metabolites in bronchoalveolar lavage fluid (BALF) were analyzed using targeted metabolomic method. Correlation analysis was employed to examine the correlation between cytokines and metabolites. Macrophages were infected with FluA at a multiplicity of infection (MOI) of 1 and cultured with different concentrations of arginine for 24 h. The mRNA and protein expression levels of interleukin (IL)-1β, IL-6, tumor necrosis factor α (TNF-α) and IL-10 were detected by real time fluorescence quantitative RT-PCR (qRT-PCR) and Cytometric Bead Array (CBA).Results:In comparison to the control group, the levels of surfactant protein D (SP-D), TNF-α, monocyte chemotactic protein-1 (MCP-1), IL-1α, IL-6, IL-10, recombinant S100 calcium binding protein (S100) A9, interferon inducible protein 10 (IP-10), macrophage inflammatory protein-1α (MIP-1α), matrix metalloprotein-9 (MMP-9), and Complement Factor D in BALF of FluA infection exhibited a significant elevation. The concentrations of arginine, aspartate, citrulline, glutamic acid, ornithine, proline, creatine, and sarcosine in arginine metabolism were up-regulated, which was correlated with most of elevated cytokine levels. The supplementation of arginine after FluA infection significantly decreased the levels of IL-1β, IL-6, and TNF-α, but increased the level of IL-10 in macrophages.Conclusions:Arginine reduces the inflammatory response induced by FluA infection in macrophages, suggesting that it may be a potential intervention target for severe pulmonary inflammation following FluA infection.

Objective To study the effect of temperature on microleakage of Beautifil Flow Plus F00,FiltekTM Z350 XT,SDR,Tet-ric?N-Flow and Constic,and to provide reference for clinical selection of ideal fluid resins.Methods A total of 60 adult detached premolars removed for orthodontic extraction were divided into 10 groups(n=12),which were divided into F00A group,Z350A group,SDRA group,TetricA group and ConsticA group according to whether they had undergone cold and hot cycle aging test,and F00B group,Z350B group,SDRB group,TetricB group,ConsticB group,a total of 10 groups.The occlusal surface of each isolated tooth was prepared into a type Ⅰhole with the width of 2 mm,length of 4 mm and depth of 2 mm,which was filled with the corresponding fluid resin respectively.Methylene blue staining experiment was performed on specimens in group A,and methylene blue staining experiment was performed on specimens in group B after 5 000 times of cold and hot cycling aging experiment.The crowns of all specimens were dissected longitudinally along the long axis of the tooth body from the direction of buccal tongue(palate).The degree of microleakage in each group was observed under stereomicroscope,and the data were recorded and analyzed statistically.Results ①There was no sig-nificant difference in the degree of microleakage between the F00A group,the Z350A group,the SDRA group,the TetricA group and the ConsticA group(P>0.05).②The degree of microleakage in the SDRB group and TetricB group was significantly higher than that in the F00B group and Z350B group(P<0.05).③Temperature had a significant effect on the microleakage degree of Beautifil Flow Plus F00,FiltekTM Z350 XT,SDR,Tetric? N-Flow and Constic(P<0.05).Conclusion ①There was no significant difference in the de-gree of immediate microleakage of Beautifil Flow Plus F00,FiltekTM Z350 XT,SDR,Tetric?N-Flow,and Constic without cold and hot cycle aging experiments.②After the cold and hot cycle aging experiments,the microleakage degree of SDR fluid resin and Tetric? N-Flow fluid resin was high,and the edge tightness was poor.Beautifil Flow Plus F00 fluid resin and FiltekTM Z350 XT fluid resin had a low degree of microleakage and better edge tightness.③The micro-leakage degree of Beautifil Flow Plus F00，FiltekTM Z350 XT，SDR，Tetric? N-Flow and Constic was aggravated by the cold and hot cycle aging ex-periments.

Objective:To investigate the interaction of platelet factor 4(PF4)with tumor necrosis factor-α(TNF-α)in the pathoge-nesis of chronic periodontitis(Ⅲ-C).Methods:22 patients with chronic periodontitis(Ⅲ-C)and 22 subjects with periodontal health were recruited.Before and after periodontal treatment,the concentration of PF4 and TNF-α in gingival crevicular fluid(GCF)and ser-um,the amount of PF4 released by platelets after lipopolysaccharide(LPS)stimulated peripheral blood platelets were measured by ELISA.Flow cytometry was used to calculate the number of platelets in GCF before and after treatment.Results:The concentrations of PF4 and TNF-α in the GCF and serum of the patients were higher than those in the periodontal healthy group(P＜0.05).After treat-ment,the concentrations of PF4 and TNF-α in the GCF were significantly lower than those before treatment(P＜0.05),and the con-centrations of PF4 and TNF-α in the serum were unchanged(P＞0.05).After LPS stimulation of the platelets in blood before and after treatment,the concentration of PF4 released by the platelets was much higher in the patients than that in the healthy controls(P＜0.01),and the concentration was significantly lower after periodontal treatment than before treatment(P＜0.01).The number of CD41/CD61 double positive platelets and CD45 negative cells in GCF before periodontal treatment were 85 times and 87 times higher than those in periodontal healthy subjects,respectively(P＜0.01).Conclusion:PF4 and TNF-α have synergistic effect in the patho-genesis of chronic periodontitis.

Objective:To explore the effect of paeoniflorin on LPS-induced bronchial epithelial cell inflammatory response by regulating NF-κB pathway.Methods:BEAS-2B cells were cultured in vitro for paeoniflorin toxicity assay and concentration screening.BEAS-2B cells were divided into control group,LPS group,LPS+CAPE group,LPS+PF group and LPS+CAPE+PF group.Inflammatory responses were induced in BEAS-2B cells using LPS(1 μg/ml),and cell viability was detected by CCK-8 assay after administration of paeoniflorin or CAPE interventions.Apoptosis and cell cycle were detected by flow cytometry.The levels of IFN-γ,IL-4,IL-17C and IL-10 were detected by ELISA.The protein expression levels of p53,Bcl-2,Bax,Cyclin1,NF-κB and p-p65 were detected by Western blot.Results:Paeoniflorin increased cell viability,inhibited apoptosis,increased IFN-γ and IL-10 levels(P<0.01),de-creased IL-4 and IL-17C levels(P<0.01),down-regulated the protein expression levels of p53,Bax,NF-κB and p-p65(P<0.01),and up-regulated the protein expression levels of Bcl-2 and Cyclin1(P<0.01).The effect of paeoniflorin was more significant after the intervention of NF-κB inhibitor CAPE.Conclusion:Paeoniflorin reduces LPS-induced inflammatory factor levels in bronchial epithelial cells by regulating the NF-κB pathway,thereby suppressing the asthmatic inflammatory response.

Objective:To explore the status quo and influencing factors of death anxiety among middle-aged and young adult patients with chronic heart failure (CHF) .Methods:Totally 176 middle-aged and young adult CHF patients treated at Fuwai Central China Cardiovascular Hospital between January 2021 and February 2023 were selected by convenience sampling and investigated with a general information questionnaire, the Medical Coping Modes Questionnaire (MCMQ), and the Death Anxiety Scale.Results:A total of 176 questionnaires were distributed, with 170 valid responses, yielding an effective response rate of 96.59%. Among the 170 middle-aged and young adult CHF patients, 136 had low death anxiety, while 34 had high death anxiety. Multiple linear regression analysis showed that educational level, per capita monthly family income, duration of illness, cardiac function classification, physical exercise, and coping style (yielding) were influencing factors of death anxiety in middle-aged and young adult CHF patients ( P<0.05) . Conclusions:Death anxiety in middle-aged and young adult CHF patients is primarily associated with educational level, per capita monthly family income, duration of illness, cardiac function classification, physical exercise, and coping style (yielding). Clinical assessments should focus on these factors to provide timely and targeted psychological interventions.

Objective:To explore influencing factors of the self-reported brief life quality satisfaction score(Brief-QoL) in patients with acromegaly and understand the persistent low Brief-QoL scores in cases achieving biochemical remission.Methods:This study included 836 acromegaly patients who were hospitalized at Peking Union Medical College Hospital between January 2012 and December 2020. We retrospectively examined how clinical characteristics, biochemical parameters, comorbidities, and symptoms influenced Brief-QoL. Among patients who achieved biochemical remission, differences in clinical symptoms and comorbidities were analyzed between the high and low quality of life groups.Results:Patients with well-controlled biochemical indicators at the last follow-up had generally high Brief-QoL. However, patients with symptoms such as headaches (47.8% in the low-score group vs 14.9% in the high-score group, P<0.001) and joint pain (69.6% in the low-score group vs 19.0% in the high-score group, P<0.001) had low Brief-QoL despite biochemical remission. Receiving combined treatment(52.4% in the low-score group vs 27.5% in the high-score group, P=0.030) and having comorbid diabetes or hyperlipidemia were significant factors leading to decreased quality of life. Conclusion:Brief-QoL is suitable for follow-up of outpatient patients. Early identification of factors affecting quality of life and timely intervention can facilitate the realization of standardized management.

Objective To study the changes in intestinal structure and function of Parkinson's dis-ease(PD)model in cynomolgus monkeys so as to provide scientific basis for exploring the mecha-nism and intervention of constipation and other intestinal symptoms in PD patients.Methods Six male cynomolgus monkeys were subjected,and three of them received intracarotid injection of MPTP for manifestations of typical PD motor symptoms.The monkeys with the Kurlan score reached 10 and persisting for over 3 months without abrogation were identified as PD model(PD group).The other three monkeys served as control group.The brain and ileum tissue samples were collected from the two groups of monkeys.Immunohistochemical staining with tyrosine hydroxy-lase(TH)was used to determine the number of dopaminergic neurons in the substantia nigra of the brain and the changes in peripheral TH of the intestine.HE staining was employed to observe the structure of the intestine.Intestinal permeability was evaluated by atresia occlusive zone pro-tein 1(ZO-1),and intestinal peristalsis function was assessed with intestinal pacemaker cell bio-markers oncogene c-kit and protein gene product 9.5(PGP9.5).Results When compared with the control group,the PD group had significantly less number of nigrostriatal dopaminergic neurons in the left and right sides(133.13±108.63 vs 957.21±225.56,t=5.705,P=0.005;155.74±62.48 vs 917.52±161.14,t=7.611,P=0.002),lower expression of TH in the ileal intermuscular plexus(0.79±0.01 vs 0.73±0.01,t=5.149,P=0.007),reduced villus density with irregular arrange-ment,scattered structure,and detachment of goblet cells,and increased expression of ZO-1(0.28± 0.01 vs 0.22±0.02,P=0.006)and c-kit(0.21±0.01 vs 0.18±0.01,P=0.007)in the ileum muco-sa,but there was no such difference in the expression of PGP9.5 between the two groups(0.31± 0.08 vs 0.38±0.06,P=0.322).Conclusion Intestinal barrier integrity is damaged in PD mon-keys,with damaged villi,increased intestinal permeability and decreased peristalsis,and peristaltic function related intermuscular neurons are not involved.