Objective: To understand the interrelationships of parental control, peer relationship, and aggressive behavior in junior high school students, in order to provide a theoretical basis for preventing the occurrence of adolescent aggressive behavior. Methods: During June to July, 2022, 2 564 students of grade one to grade three were selected from 6 junior high schools from each of Suzhou and Xuancheng cities in Anhui Province by using convenient cluster random sampling method, and then the questionnaire survey was administered, including the Chinese version of Parent Control Questionnaire, Chinese version of Buss & Perry Aggression Questionnaire and Adolescent Peer Relationship Questionnaire. Results: Boys scored (185.31±27.49, 21.65±7.43, 21.77 ±8.18, 69.50±11.41, 72.39±11.53) higher than girls (178.21±25.13, 20.08±7.09, 20.61±7.62, 66.56± 11.14 , 70.95± 11.84 ) in parental control, father s psychological control, mother s psychological control, father s behavioral control, and mother s behavioral control ( t =8.63, 5.47, 3.70, 6.60, 3.12), while girls scored (48.41±11.26) higher in peer relationship than boys ( 47.13 ± 10.84 ) ( t =-2.95) ( P <0.01). The scores of first grade students in parental control, father s psychological control, mother s psychological control, father s behavior control, peer relationship, and aggressive behavior (184.67±27.18, 21.83± 7.29 , 22.15±8.07, 68.81±10.95, 50.21±9.57, 80.23±17.66) were higher than those of second gradestudents (180.98±25.46, 20.16±7.82, 20.21±7.55, 68.29±11.69, 45.47±11.67, 74.08±17.70) and third grade students (179.21±26.79, 20.53±7.22, 21.17 ± 8.06 , 66.81± 11.39 , 47.54±11.43, 75.75±16.29) ( F =9.44, 12.87, 13.61, 6.84, 42.85, 30.40, P <0.01). The scores of parental control and peer relationship were positively correlated with the scores of aggressive behavior ( r=0.22, 0.47, P <0.01). Peer relationship partially mediate the relationship between parental control and aggressive behavior, with a partial mediation effect value of 0.04, accounting for 26.39% of the total effect of parental control on aggressive behavior. Conclusions High parental control and poor peer relationship are both positively correlated with the level of aggressive behavior. The peer relationship of teenagers should be improved by establishing appropriate parenting style, tackling campus violence, and maintaining good social norms, in order to reduce the occurrence of aggressive behavior among adolescents.

As a cross-field discipline,digital intervention integrates digital technology with interventional therapeutic methods.In the clinical practice of interventional radiology,the digital medicine,through using the basic tools such as electronic health records,artificial intelligence,wearable devices,remote monitoring,etc.,has been deeply integrated into the advanced imaging technology,interventional surgery planning,image-guided procedure,navigation equipment,interventional surgery robot,3D printing,remote medical education and training,and other aspects of the clinical work,which greatly optimizes the diagnostic and therapeutic processes and improves the efficiency and precision of medical services.At the same time,digital intervention also brings challenges related to data security and privacy security in medical services.Therefore,more attention should be paid to the balance between the technology and the medical ethics when planning for the future development direction of digital intervention so as to make sure that digital intervention can be continuously and safely developed.(J Intervent Radiol,2024,32:1-6)

Objective To construct SpyCatcher-mi3 nanoparticle vaccine delivery vectors,evaluate their role in enhancing the immunogenicity of the ovalbumin CD8+T-cell epitope peptide,OVA257-264,and determine its protective effect in a model which mice were immunized and subcutaneously challenged with E.G7-OVA tumor cells.Methods SpyCatcher-mi3 proteins were expressed by E.coli and purified by affinity chromatography and anion exchange chromatography sequentially.OVA257-264-SpyTag peptide was obtained by synthesis.The OVA257-264-mi3 nanoparticles were produced by the SpyTag/SpyCatcher system.The toxicity of OVA257-264-mi3 was evaluated using hemolysis assay,CCK-8 assay and mouse experiment.A total of 42 female SPF-grade C57BL/6 mice(6～8 weeks old,18～20 g)were randomly divided into OVA257-264-mi3,OVA257-264,and control groups,with 14 mice in each group.Then the mice in each group were immunized on days 0,14 and 28.In 14 d after the last immunization,the amounts of spot-forming cells(SFCs,indicating IFN-γ secreting cells in splenic lymphocytes)were determined using ELISpot assay to evaluate their immunogenicity.After the immunized mice were subcutaneously implanted with E.G7-OVA tumor cells,the antitumor effect of the vaccine in prophylactic xenograft tumor model was evaluate by observing tumor volumes with a caliper and tumor growth with MRI.Results Both SpyCatcher-mi3 and OVA257-264-mi3 could be self-assembled to form homogeneous and stable nanoparticles,with an average particle size of about 43.8 and 91.3 nm,respectively.The OVA257-264-mi3 was safe for in vitro and in vivo toxicity evaluation.The number of IFN--y secreting cells per 1 × 106 splenic lymphocytes reached 253 in the OVA257-264-mi3 group of mice,significantly higher than that in the OVA257-264 group and the Control group(P＜0.05).The tumor volume of mice in the OVA257-264-mi3 group was about 151.1 mm3 on day 22,which was significantly smaller than that of the OVA257-264 group and the Control group(P＜0.05),and the survival rate during the observation period reached 60％,which was significantly higher than that of the OVA257-264 groups(P＜0.05).Conclusion Nanoparticle vaccine OVA257-264-mi3 is successfully constructed,and it shows enhancing effect on the immunogenicity of the antigen epitope peptide,and exerts protective effect on prophylactic xenograft tumor model,providing a theoretical basis for the research of tumor neoantigen vaccines.

Objective:To investigate the surgical situations and perioperative outcome of pancreaticoduodenectomy in Jiangsu Province and the influencing factors for postoperative 90-day mortality.Methods:The retrospective case-control study was conducted. The clinicopathological data of 2 886 patients who underwent pancreaticoduodenectomy in 21 large tertiary hospitals of Jiangsu Quality Control Center for Pancreatic Diseases, including The First Affiliated Hospital of Nanjing Medical University, from March 2021 to December 2022 were collected. There were 1 732 males and 1 154 females, aged 65(57,71)years. Under the framework of the Jiangsu Provincial Pancreatic Disease Quality Control Project, the Jiangsu Quality Control Center for Pancreatic Diseases adopted a multi-center registration research method to establish a provincial electronic database for pancrea-ticoduodenectomy. Observation indicators: (1) clinical characteristics; (2) intraoperative and post-operative conditions; (3) influencing factors for 90-day mortality after pancreaticoduodenectomy. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(IQR), and comparison between groups was conducted using the Mann-Whitney U test. Count data were expressed as absolute numbers or constituent ratio, and comparison between groups was conducted using the chi-square test, continuity correction chi-square test and Fisher exact probability. Maximal Youden index method was used to determine the cutoff value of continuous variables. Univariate analysis was performed using the corresponding statistical methods based on data types. Multivariate analysis was performed using the Logistic multiple regression model. Results:(1) Clinical characteristics. Of the 2 886 patients who underwent pancreaticoduodenectomy, there were 1 175 and 1 711 cases in 2021 and 2022, respectively. Of the 21 hospitals, 8 hospitals had an average annual surgical volume of <36 cases for pancreaticoduodenectomy, 10 hospitals had an average annual surgical volume of 36-119 cases, and 3 hospitals had an average annual surgical volume of ≥120 cases. There were 2 584 cases performed pancreaticoduodenectomy in thirteen hospitals with an average annual surgical volume of ≥36 cases, accounting for 89.536%(2 584/2 886)of the total cases. There were 1 357 cases performed pancrea-ticoduodenectomy in three hospitals with an average annual surgical volume of ≥120 cases, accounting for 47.020%(1 357/2 886) of the total cases. (2) Intraoperative and postoperative conditions. Of the 2 886 patients, the surgical approach was open surgery in 2 397 cases, minimally invasive surgery in 488 cases, and it is unknown in 1 case. The pylorus was preserved in 871 cases, not preserved in 1 952 cases, and it is unknown in 63 cases. Combined organ resection was performed in 305 cases (including vascular resection in 209 cases), not combined organ resection in 2 579 cases, and it is unknown in 2 cases. The operation time of 2 885 patients was 290(115)minutes, the volume of intra-operative blood loss of 2 882 patients was 240(250)mL, and the intraoperative blood transfusion rate of 2 880 patients was 27.153%(782/2 880). Of the 2 886 patients, the invasive treatment rate was 11.342%(327/2 883), the unplanned Intensive Care Unit (ICU) treatment rate was 3.087%(89/2 883), the reoperation rate was 1.590%(45/2 830), the duration of postoperative hospital stay was 17(11)days, the hospitalization mortality rate was 0.798%(23/2 882), and the failure rate of rescue data in 2 083 cases with severe complications was 6.529%(19/291). There were 2 477 patients receiving postoperative 90-day follow-up, with the 90-day mortality of 2.705%(67/2477). The total incidence rate of complication in 2 886 patients was 58.997%(1 423/2 412). The incidence rate of severe complication was 13.970%(291/2 083). The comprehensive complication index was 8.7(22.6) in 2 078 patients. (3) Influencing factors for 90-day mortality after pancreaticoduodenectomy. Results of multivariate analysis showed that age ≥ 70 years, postoperative invasive treatment, and unplanned ICU treatment were independent risk factors for 90-day mortality after pancreaticoduodenectomy ( odds ratio=2.403, 2.609, 16.141, 95% confidence interval as 1.281-4.510, 1.298-5.244, 7.119-36.596, P<0.05). Average annual surgical volume ≥36 cases in the hospital was an independent protective factor for 90-day mortality after pancreaticoduodenectomy ( odds ratio=0.368, 95% confidence interval as 0.168-0.808, P<0.05). Conclusions:Pancreaticoduodenectomy in Jiangsu Province is highly con-centrated in some hospitals, with a high incidence of postoperative complications, and the risk of postoperative 90-day mortality is significant higher than that of hospitallization mortality. Age ≥ 70 years, postoperative invasive treatment, and unplanned ICU treatment are independent risk factors for 90-day motality after pancreaticoduodenectomy, and average annual surgical volume ≥36 cases in the hospital is an independent protective factor.

Background::Evaluating the impact of digestive system diseases is vital for devising effective prevention strategies. However, comprehensive reports on the burden of digestive system diseases in China are lacking. Our study aimed to provide an overview of the burden and trends of digestive system diseases from 1990 to 2019 in China and its provinces.Methods::This cross-sectional study utilized the Global Disease Burden Study 2019 to estimate the incidence, mortality rate, disability-adjusted life years (DALYs), years of life disability, years of life lost, and changes in the burden of digestive diseases across Chinese provinces from 1990 to 2019. The analysis of disease burden primarily examines the characteristics of sub-disease distribution, time trends, age distribution, and sex distribution. Additionally, we compared provincial age-standardized DALYs for digestive diseases with the expected rates based on the socio-demographic index (SDI).Results::In 2019, there were 499.2 million cases of digestive system diseases in China, resulting in 1,557,310 deaths. Stomach cancer, colon and rectal cancer, and esophageal cancer are the top three diseases associated with mortality and DALY related to digestive system diseases. Meanwhile, cirrhosis and other chronic liver diseases, gastroesophageal reflux disease, and gallbladder and biliary diseases are the top three kinds of diseases with the highest prevalence among digestive system diseases. The risk of gastric cancer sharply increases among men after the age of 40 years, leading to a significant disparity in burden between men and women. As the SDI increased, the DALYs associated with digestive system diseases in China and its provinces showed a downward trend.Conclusion::Our study highlights the inverse correlation between DALYs associated with digestive system diseases and the SDI.

Objective:To quantitatively analyze the primary research characteristics and keywords of international and domestic papers in the field of capsule endoscopy with bibliometric methods, and to illustrate the progression of capsule endoscopy research and offer insights for researchers in this domain.Methods:The Stork and visualized software CiteSpace were used to search and analyze the literature on "capsule endoscopy" in the English database of PubMed and the Chinese database of CNKI from 2002 to 2022.Results:A total of 6 011 English articles were identified in the PubMed database during the specified period. Both the number of publications and their citation frequencies displayed an upward trend on a global and domestic scale. The growth rates of global and domestic English publications were 5% and 15%, respectively, with major contributions coming from the United States, Japan, China, Italy and Germany. Key areas of global research interest included magnetic capsule endoscopy, colon capsule endoscopy, inflammatory bowel disease, small bowel capsule endoscopy, capsule endoscopy images, and obscure gastrointestinal bleeding, etc. A total of 2 027 articles were retrieved in the CNKI database, with top three research institutions including Department of Gastroenterology, Changhai Hospital, Naval Medical University; Department of Gastroenterology, Nanfang Hospital, Southern Medical University; School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University. Emerging research keywords encompassed artificial intelligence, deep learning, and guidelines.Conclusion:The study reveals a gradual increase in global research activities related to capsule endoscopy, with China demonstrating significant international academic influence in this field.

Objective To investigate the correlation between the Controlling Nutritional Status (CONUT) score and wound repair of diabetic foot ulcer (DFU). Methods A total of 80 DFU patients treated in the Hospital from November 20, 2019 to November 20, 2022 were randomly selected as the study objects and divided into non-wound repair group (n=47) and wound repair group (n=33) based on wound repair status. Wound repair and hospital stay were recorded; clinical characteristics and the CONUT score were compared between the wound repair group and the non-wound repair group; the influencing factors of DFU wound repair were analyzed by the multivariate Logistic regression model. Results The hospital stay of patients in the non-wound repair group was 16.00 (10.50 to 24.00) days, which was significantly shorter than 44.00 (31.00 to 61.80) days of patients in the wound repair group (P < 0.05). The total cholesterol (TC), ankle-brachial index (ABI), the CONUT score, and malnutrition rate of patients in the non-wound repair group were significantly higher than those in the wound repair group (P < 0.05). The results of multivariate Logistic regression analysis showed that the CONUT score, malnutrition, TC and ABI were the independent risk factors for wound repair of DFU (P < 0.05). Conclusion Malnutrition, ABI, TC and CONUT score in DFU patients can adversely affect wound repair, and the CONUT score can accurately predict the risk of wound repair in patients, serving as a reliable reference for clinicians in early assessment of DFU.

Objective: To understand the relationship among pubertal timing, overweight and obesity, and eating disorders among Bengbu adolescents, and to provide a reference for obesity prevention. Methods: Two nine year schools were conveniently selected in Bengbu, with 683 students from grade 5 to grade 8. Puberty Development Scale (PDS) and Eating Disorders Inventory of Children (EDI-C) subscale were used, height and weight were measured. The associations between obesity, pubertal timing and eating disorders were analyzed. Results: The prevalence of overweight and obesity was higher in boys than that in girls, and the rate of early pubertal timing, drive for thinness score, body dissatisfaction score and total eating disorder score were higher in girls than that in boys( χ 2/t =28.69, 57.99, 3.47, 2.59, 3.30, P <0.05). The differences in rate of overweight and obesity, bulimia score and total eating disorder score were statistically significant by grade( χ 2/F =28.39, 5.11, 3.95, P ＜0.01). There was a positive correlation among overweight obesity and early pubertal timing and eating disorder, and a positive correlation between early pubertal timing and eating disorder( r =0.18, 0.17, 0.14, P < 0.01 ). The mediating effect of early pubertal timing between overweiht, obesity and eating disorders partially contributed 14.25% to the total effect. Conclusion Overweight and obesity is associated with eating disorders, and early pubertal timing partially mediate the association between overweight obesity and eating disorders. Healthy lifestyle should be advocated in family and school to effectively prevent adolescents obesity, pubertal timing, and eating disorders.

Objective:To investigate the influencing factors for lymph node metastasis and prognosis in early gastric cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 1 011 patients with early gastric cancer who were admitted to the Zhejiang Cancer Hospital from January 2010 to December 2019 were collected. There were 561 males and 450 females, aged (58±11)years. All patients underwent radical resection of gastric cancer and the lymph node metastasis of each group was identified according to the pathological examination on patients' surgical specimens. Observation indicators: (1) lymph node metastasis in early gastric cancer; (2) influencing factors for lymph node metastasis in early gastric cancer; (3) influencing factors for prognosis in early gastric cancer. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was analyzed using the non‐parameter rank sum test. Univariate analysis was conducted using the Log-Rank test and Logistic regression model, and multivariate analysis was conducted using the Logistic stepwise regression model and COX step-wise regression model. The Kaplan-Meier method was used to calculate survival rate and draw survival curve, and the Log-Rank test was used for survival analysis. Results:(1) Lymph node metastasis in early gastric cancer. The lymph node metastasis rate of 1 011 patients with early gastric cancer was 23.640%(239/1 011), in which the lymph node metastasis rate of patients with T1a stage gastric cancer was 11.883%(53/446), and the lymph node metastasis rate of patients with T1b stage gastric cancer was 32.920%(186/565). There were 239 patients with lymph node metastasis mainly concentrated in the first station, including 7 cases with No.1 lymph node metastasis, 11 cases with No.2 lymph node metastasis, 135 cases with No.3 lymph node metastasis, 59 cases with No.4 lymph node metastasis, 39 cases with No.5 lymph node metastasis, 91 cases with No.6 lymph node metastasis, 6 cases with No.7 lymph node metastasis, 8 cases with No.8 lymph node metastasis, 8 cases with No.9 lymph node metastasis and 6 cases with No.10 lymph node metastasis. Multiple lymph node metastases may exist in the same patient. For lymph node metastasis in different tumor sites, there were 4 cases, 2 cases and 1 case of lymph node metastasis in the No.2, 3 and 5 lymph node in patients with upper gastric cancer. There were 3 cases, 7 cases, 36 cases, 15 cases, 3 cases and 5 cases of lymph node metastasis in the No.1, 2, 3, 4, 5 and 6 lymph node in patients with middle gastric cancer. There were 4 cases, 97 cases, 44 cases, 35 cases and 86 cases of lymph node metastasis in the No.1, 3, 4, 5 and 6 lymph node in patients with lower gastric cancer. (2) Influencing factors for lymph node metastasis in early gastric cancer. Results of multivariate analysis showed that tumor diameter, tumor location, degree of tumor invasion, vascular thrombus, degree of tumor differentiation were independent factors influencing lymph node metastasis in early gastric cancer ( odds ratio=1.80, 1.49, 2.65, 5.76, 0.60, 95% confidence interval as 1.29-2.50, 1.11-2.00, 1.81-3.88, 3.87-8.59, 0.48-0.76, P<0.05). (3) Influencing factors for prognosis in early gastric cancer. All 1 011 patients were followed up for 43(range, 0-135)months, and the 3-year overall survival rate was 97.32%. Results of multivariate analysis showed that age >60 years and lymph node metastasis were independent risk factors influencing prognosis in early gastric cancer ( hazard ratio=9.50, 2.20, 95% confidence interval as 3.31-27.29, 1.00-4.87, P<0.05). Results of further analysis showed that the 3-year overall survival rate was 99.37% and 94.66% in patient with age >60 years and ≤60 years, respectively, showing a significant difference between them ( χ2=25.33, P<0.05). The 3-year overall survival rate was 95.42% and 97.92% in patients with and without lymph node metastasis, respectively, showing a significant difference between them ( χ2=5.69, P<0.05). Conclusions:The lymph node metastasis rate of early gastric cancer can reach 23.640%. Tumor diameter, tumor location, degree of tumor invasion, vascular thrombus, degree of tumor differentia-tion are independent factors influencing lymph node metastasis in early gastric cancer, age >60 years and lymph node metastasis are independent risk factors influencing prognosis.

Objective:To analyze the difference of clinical characteristics and outcomes of infants with moderate and severe pediatric acute respiratory distress syndrome(PARDS)diagnosed according to baseline oxygenation index(OI) in pediatric intensive care unit(PICU).Methods:Second analysis of the data collected from the "Efficacy of pulmonary surfactant (PS) in the treatment of children with moderate and severe ARDS" program.Retrospectively compare of the differences in clinical data such as general condition, underlying diseases, OI, mechanical ventilation, PS administration and outcomes among infants with moderate and severe PARDS divided by baseline OI who admitted to PICUs at 14 participating tertiary hospitals from 2016 to December 2021.Results:Among the 101 cases, 55 cases (54.5%) were moderate and 46 cases (45.5%) were severe PARDS.The proportion of male in the severe group (50.0% vs.72.7%, P=0.019) and the pediatric critical illness score(PCIS)[72 (68, 78) vs.76 (70, 80), P=0.019] were significantly lower than those in the moderate group, while there was no significant difference regarding age, body weight, etiology of PARDS and underlying diseases.The utilization rate of high-frequency ventilator in the severe group was significantly higher than that in the moderate group (34.8% vs.10.9%, P=0.004), but there was no significant difference in PS use, fluid load and pulmonary complications.The 24 h OI improvement (0.26±0.33 vs.0.04±0.34, P=0.001) and the 72 h OI improvement[0.34 (-0.04, 0.62) vs.0.15 (-0.14, 0.42), P=0.029)]in the severe group were significantly better than those in the moderate group, but there was no significant difference regarding mortality, length of hospital stay and intubation duration after diagnosis of PARDS between the two groups. Conclusion:In moderate and severe(divided by baseline OI) PARDS infants with invasive mechanical ventilation, children in severe group have better oxygenation improvement in the early stage after PARDS identified and are more likely to receive high frequency ventilation compared to those in moderate group.Baseline OI can not sensitively distinguish the outcomes and is not an ideal index for PARDS grading of this kind of patient.