Objective: To investigate the current status and trends of depressive symptoms among middle school and college students in Hunan Province, and to explore the primary related factors of depressive symptoms, so as to provide a scientific basis for strengthening mental health among students. Methods: A total of 279 382 students in Hunan Province were selected through a stratified cluster random sampling method from 2021 to 2023. National Survey Questionnaire on Common Diseases and Health Influencing Factors among Students was adopted for the survey, and the Center for Epidemiological Studies Depression Scale was used to assess their depressive symptoms. The χ 2 test and trend χ 2 test were used to analyze depressive symptoms prevalence and trends, and multivariable Logistic regression was used to analyze the related factors of depressive symptoms. Results: The prevalence of depressive symptoms among students in Hunan Province from 2021 to 2023 were 19.66%, 20.17% and 21.47%, respectively, showing an upward trend ( χ 2 trend =9.07, P <0.01). In addition, the results of the multivariable Logistic regression analysis showed that students with healthy diet ( OR=0.43, 95%CI =0.40-0.45), adequate sleep ( OR=0.88, 95%CI =0.86-0.90), and acceptable screen time ( OR=0.61, 95%CI =0.60-0.62) had lower risks in depressive symptoms detection, while students with smoking ( OR= 1.95, 95%CI =1.88-2.02), secondhand smoke exposure ( OR=1.33, 95%CI =1.30-1.36) and Internet addiction ( OR= 4.19 , 95%CI =4.05-4.34) had higher risks in depressive symptoms detection, with differences in the degree of association among different genders, educational stages and urban rural groups ( OR=0.40-6.04, Z =-12.69-11.98) ( P <0.05). Conclusions There is an increasing trend of depressive symptoms among middle school and college students in Hunan Province from 2021 to 2023.Targeted depression prevention measures should be taken for students with different demographic characteristics to promote their mental health.

OBJECTIVE To explore the main factors influencing the blood concentration of duloxetine， and provide a scientific basis for the individualized use of duloxetine. METHODS Retrospective analysis was conducted on 434 inpatients with depressive disorders at the First Hospital of Hebei Medical University， who were treated with duloxetine and underwent blood concentration monitoring between January 2022 and April 2024. The study examined the impact of various factors， including gender， age， body mass index （BMI）， gene phenotypes， combined medication， drug type （original/generic）， and genotyping results of gene single nucleotide polymorphism loci， on blood concentration and the concentration-to-dose （C/D） after dose adjustment. RESULTS The blood concentration of duloxetine was 76.65 （45.57， 130.31） ng/mL， and C/D was 0.96 （0.63， 1.60） ng·d/（mL·mg）. The blood concentration of duloxetine was positively correlated with the daily dose of administration （R2＝0.253 7， P＜0.001）. Blood concentration of duloxetine in 38.94% of patients exceeded the recommended range specified in the guidelines. Gender， age， BMI， combined use of CYP2D6 enzyme inhibitors， and CYP2D6 and CYP1A2 phenotypes had significant effects on C/D of duloxetine （P＜0.05）. CONCLUSIONS The patient’s age， gender， BMI， combined medication， and genetic phenotypes are closely related to the blood concentration of duloxetine.

ObjectiveTo construct an intelligent model for literature screening， retrieval， and data extraction with a systematic review of coronary heart disease syndromes as an example， so as to improve the efficiency of evidence-based Chinese medicine research. MethodsBased on China National Knowledge Infrastructure （CNKI）， VIP and Wanfang Data Resource System， the articles related to coronary heart disease syndrome research published from January 1， 2000 to December 31， 2023 were retrieved. Automated tools were used to batch retrieve paper metadata. Using text similarity algorithms， papers were merged， deduplicated， and subjected to preliminary screening based on titles and abstracts. Further screening was performed using object detection and image processing technologies on the full texts and statistical tables. Natural language processing （NLP） techniques and pre-trained models were applied to extract information. ResultsThe initial search retrieved 56 255 coronary heart disease syndrome-related articles. By artificial intelligence-assisted preliminary and secondary screening， the manual verification scope was narrowed to 1075 articles. Ultimately， 646 coronary heart disease syndrome related studies were included manually. With accuracy verification showing over 90% consistency in semantic recognition and element decomposition processes， we achieved data extraction and standardization processing for both basic literature information and 38 syndrome element statistics. ConclusionBy incorporating natural language processing， pre-trained models， artificial intelligence image processing and other technologies， this study enabled efficient retrieval， screening and standardized data extraction of Chinese medicine research literature.

Objective To discuss the clinical efficacy and safety of bilateral internal iliac artery Fogarty balloon occlusion in uterine curettage for patients with cesarean scar pregnancy(CSP).Methods The clinical data of a total of 80 CSP patients,who were admitted to the Fuyang People's Hospital of China between January 2021 and September 2022 to receive treatment,were retrospectively analyzed.The patients were divided into the observation group(n=40)and the control group(n=40).For the patients of the observation group,the hysteroscopic uterine curettage was carried out under the situation of bilateral internal iliac artery Fogarty balloon occlusion and during the operation the internal iliac artery was intermittently blocked.The embryo was removed,and the hemostasis was accomplished by electrocoagulation or surgical suture.For the patients of the control group,the hysteroscopic uterine curettage was performed within 1-2 days after uterine artery embolization(UAE).The digital subtraction angiography(DSA)fluoroscopy time,body surface radiation dose,blood loss during uterine curettage,time spent for uterine curettage,length of hospital stay,and postoperative follow-up results were compared between the two groups.Results Successful uterine curettage was accomplished and the uterus was retained in all the patients.In the observation group,no balloon-related complications occurred.In the control group,all the 40 patients developed different degrees of fever,pain at uterine area,and other post-embolization symptoms after UAE.In the observation group and the control group,the DSA fluoroscopy time was(9.2±1.1)seconds and(1 273.6±141.1)seconds respectively,the body surface radiation dose was(7.7±0.8)mGy and(1 503.8±101.8)mGy respectively,the differences between the two groups were statistically significant(both P＜0.05);the blood loss during uterine curettage was(30.3±14.7)mL and(27.5±13.2)mL respectively,the time spent for uterine curettage was(41.6±16.2)min and(42.8±15.0)min respectively,the differences between the two groups were not statistically significant(both P＞0.05);the length of hospital stay was(6.0±0.7)days and(7.3±0.8)days respectively,the difference between the two groups was statistically significant(P＜0.05).All patients were followed up for more than 3 months,the time of β-hCG turning to negative,time of vaginal bleeding,time of menstruation returning to normal,and patient satisfaction rate in the observation group were(21.1±2.4)days,(8.2±1.1)days,(29.5±2.2)days and 95.0%(38/40)respectively,which in the control group were(24.6±3.3)days,(13.6±2.6)days,(46.7±7.3)days and 67.5%(27/40)respectively,the differences in the above indexes between the two groups were statistically significant(all P＜0.05).Conclusion In performing uterine curettage for CSP patients,both bilateral internal iliac artery Fogarty balloon occlusion and UAE can significantly reduce the intraoperative blood loss,but bilateral internal iliac artery Fogarty balloon occlusion is superior to UAE in reducing radiation dose,in shortening the patient's hospital stay,the time of β-hCG turning to negative,the time of vaginal bleeding and the time of menstruation returning to normal,and in improving the patient satisfaction rate.

Objective To evaluate the postoperative analgesia efficacy and clinical safety of hydro-morphone patients-controlled intravenous analgesia(PCIA)in patients with scar pregnancy after auxiliary uterine artery embolization(UAE).Methods A total of 116 patients with scar pregnancy,who received auxiliary UAE at the Fuyang Municipal People's Hospital of China between January 2021 and September 2022,were enrolled in this study.According to the intravenous self-controlled analgesic drugs used after UAE,the patients were randomly and equally divided into observation group(n=58)and control group(n=58).Ten minutes before the procedure,intravenous injection of 2 mg hydromorphone(observation group)or 2 μg/kg sufentanyl(control group)was performed,and the PCIA pump was connected.In the observation group,the mixed solution of 10 mg hydromorphone+100 mg flurbiprofen axetil+100 mL saline was put in the analgesic pump,while in the control group,the mixed solution of 2 μg/kg sufentanyl+flurbiprofen axetil 100 mg+100 mL saline was put in the analgesic pump.The post-UAE 0.5-h,4-h,8-h,12-h,24-h and 48-h visual analogue scale(VAS)scores,the Bruggrmann comfort scale(BCS)scores,the number of pressing analgesic pump times within postoperative 48 hours,the used dosage of analgesic drugs,the adverse reactions,and the incidence of postoperative complications were recorded.Results The difference in the post-UAE 0.5-h VAS scores between the observation group and the control group was not statistically significant(P＞0.05),while the post-UAE 4-h,8-h,12-h,24-h and 48-h VAS scores in the observation group were significantly lower than those in the control group,and the differences were statistically significant(all P＜0.05).The post-UAE 0.5-h,4-h,8-h,12-h,24-h and 48-h BCS scores in the observation group were significantly higher than those in the control group,and the differences were statistically significant(all P＜0.05).The number of pressing analgesic pump times and the used dosage of analgesic drugs within postoperative 48 hours in the observation group were lower than those in the control group,and the differences were statistically significant(all P＜0.05).No statistically significant differences in the complications such as drowsiness,skin itching,hypoxia,or respiratory depression,etc.existed between the two groups,while the difference in the incidence of adverse reactions between the two groups was statistically significant(P＜0.05).Conclusion Hydromorphone and sufentanil PCIA can relieve the pain in scar pregnancy patients after UAE.Hydromorphone is superior to sufentanil in reducing the number of pressing analgesic pump times within postoperative 48 hours,reducing the used dosage of analgesic drugs,and decreasing the incidence of adverse reactions,therefore,hydromorphone PCIA has a certain promotion value.(J Intervent Radiol,2024,33:240-244)

With the optimization of surgical technologies and postoperative management regimens, the number of lung transplantation has been significantly increased, which has become an important treatment for patients with end-stage lung disease. However, due to the impact of comprehensive factors, such as bronchial ischemia and immunosuppression, the incidence of airway stenosis after lung transplantation is relatively high, which severely affects postoperative survival and quality of life of lung transplant recipients. In recent years, with the improvement of perioperative management, organ preservation and surgical technologies, the incidence of airway stenosis after lung transplantation has been declined, but it remains at a high level. Early diagnosis and timely intervention play a significant role in enhancing clinical prognosis of patients with airway stenosis. In this article, the general conditions, diagnosis, treatment and prevention of airway stenosis after lung transplantation were reviewed, aiming to provide reference for comprehensive management of airway stenosis after lung transplantation and improving clinical prognosis of lung transplant recipients.

Objective To analyze the prevalence and genetic characteristics of influenza A(H3N2) viruses in the city of Xiangyang in 2022-2023, and to provide a scientific basis for predicting the epidemic and mutation of influenza virus. Methods Throat swab specimens of the influenza like cases were collected from national influenza monitoring sentinel hospitals in Xiangyang every week. RNA was extracted from the specimens for influenza diagnosing using real-time RT-PCR．Viruses were isolated from H3N2 positive specimens, and HA and NA genes were amplified and sequenced．3D modeling analyses were conducted. Results The gene phylogenetic tree showed that the H3N2 isolates in 2022-2023 belonged to 3C.2a1b.2a1 and 3C.2a1b.2a2 branches, respectively. The A(H3N2) influenza virus strains all had amino acid point mutation sites on important antigenic determinants of HA protein. The epitope mutations of the 2022 A(H3N2) strain mainly occurred in regions B, C, and D. The epitope mutations of the A(H3N2) strain in 2023 mainly occurred in regions C and D. Different glycosylation sites of HA gene were found in 2022-2023 strains. No variation was found in key amino acid sites associated with neuraminidase inhibitor resistance. The difference of overall structure was not obvious in the three-dimensional simulation structure diagram. Conclusion The A(H3N2) influenza strains isolated in this study have shown antigenic drift, especially the mutation of HA, which may affect the protective effect of the vaccine on the local population and lead to influenza epidemic. The variations of HA and NA suggest that close attention should be paid to the epidemic and genetic variation of H3N2 subtype influenza virus, to provide a scientific basis for the selection of influenza virus vaccine strains and the prevention and control of influenza.

Objective To explore the relationship between haptoglobin gene polymorphism and disease se-verity and susceptibility in senile vascular dementia patients.Methods A total of 80 patients with senile vas-cular dementia admitted to the hospital from February 2018 to February 2023 were selected as the vascular de-mentia group,and 80 stroke patients with non-vascular dementia admitted to the hospital during the same pe-riod were selected as the control group.The genotype distribution and allele frequency of haptoglobin gene were measured using polymerase chain reaction with sequence-specific primers,and their relationship with the severity and susceptibility of vascular dementia patients was analyzed.Results The proportion of history of hyperlipidemia and diabetes mellitus and the levels of total cholesterol and triglyceride in vascular dementia group were higher than those in control group,the differences were statistically significant(P＜0.05).The distribution of genotypes was in Hardy-Weinberg equilibrium(P＞0.05).The frequency of haptoglobin 2-2 genotype and haptoglobin 2 allele in vascular dementia group were higher than those in control group,and the differences were statistically significant(P＜0.05).There were significant differences in the scores of mini-mental state examination and hachinski ischaemic score among patients with vascular dementia with different haptoglobin genotypes(P＜0.05).Multivariate Logistic regression analysis showed that the carrier of hapto-globin 2-2 genotype and the carrier of haptoglobin 2 allele were independent risk factors for vascular dementia(P＜0.05).Conclusion Haptoglobin 2-2 genotype and haptoglobin 2 allele distribution frequency are associ-ated with the occurrence of vascular dementia after stroke,and those with high frequency of haptoglobin 2-2 genotype and haptoglobin 2 allele distribution suffer a severe disease,which can provide reference for early i-dentification and assessment of vascular dementia.

AIM:To observe the different effects of three intervention approaches on related biometric parameters in children diagnosed with latent myopia, and to investigate different control effects on children with latent myopia.METHODS:Prospective cohort concurrent controls trials. A total of 60 cases(120 eyes)of children who were initially diagnosed as latent myopia and untreated previously at ophthalmology clinic of the Affiliated Hospital of Chengde Medical University from December 2021 to May 2022 were recruited. They were randomly divided into three groups, with 20 cases(40 eyes)in group A treated with 0.01% Atropine eye drops, 20 cases(40 eyes)in group B treated with vision training with a flip chart, and 20 cases(40 eyes)in group C treated with esculin and digitalis glycosides eye drops. They were followed-up for 12 mo, and the spherical equivalent(SE), axial length(AL), corneal curvature(CC), accommodative facility(AF), and macular retinal thickness of the three groups of children were compared at 6 and 12 mo post-intervention.RESULTS:Significant statistical differences were found in AL, SE and AF of the three groups of children at 6 and 12 mo(all P<0.05), and there were significant differences between 6 and 12 mo after the intervention(all P<0.05). SE and AF in the group B and C were higher than those in the group A(all P<0.05). However, there were no significant differences in CC before and after the intervention(all P>0.05). The retinal thickness of the temporal, nasal, inferior and macular fovea of the outer ring at 6 and 12 mo after intervention in the three groups was significantly different from that at the initial diagnosis(all P<0.05), and there was significant difference between 6 mo and 12 mo after intervention(all P<0.05). There was no significant difference in the retinal thickness of the other macular areas among the three groups before and after intervention(all P>0.05).CONCLUSION:When it comes to preventing and controlling myopia, 0.01% Atropine is more effective than flip chart training and esculin and digitalis glycosides eye drops. Therefore, the administration of 0.01% atropine and the implementation of flip chart training can effectively slow down the advancement of latent myopia.

AIM:To explore the synergistic sensitization effect of human umbilical cord mesenchymal stem cell culture supernatant(hUMSC-CM)combined with temozolomide(TMZ)on various glioma cell lines,and to elucidate the underlying mechanisms.METHODS:The hUMSC-CM was harvested using two different serum deprivation tech-niques at 24 and 48 h,and was converted into freeze-dried powder,which was then given to rat malignant glioma cell line RG-2,human astrocytoma cell line U251 and human glioblastoma cell line LN-428 at 5 concentrations(0,1,3,6 and 9 g/L).The effectiveness and sensitivity of hUMSC-CM for inhibiting growth of glioma cells at 24,48 and 72 h were as-sessed using CCK-8 assay.Hematoxylin-eosin(HE)staining combined with CCK-8 assay was employed to evaluate the chemotherapy sensitivity of glioma cells after 48 h of treatment with TMZ at 6 concentrations(0,25,50,100,200 and 400 μmol/L).Two concentrations(3 and 9 g/L)of hUMSC-CM and 3 concentrations(50,100 and 200 μmol/L)of TMZ were chosen for concurrent treatment of glioma cells to assess the proliferation and pathological alterations.TUNEL staining was utilized to detect apoptosis.Flow cytometry was utilized to analyze cell cycle modifications.The expression alterations of apoptosis-inducing proteins,cleaved caspase-3,cleaved caspase-8 and cleaved PARP1,as well as autophagy-inducing proteins beclin-1 and LC3,were examined using Western blot to investigate the synergistic sensitization mechanism of hUMSC-CM combined with TMZ in vitro.RESULTS:The susceptibility of glioma cell lines to hUMSC-CM and TMZ varied,with RG-2 showing the highest sensitivity,followed by U251,and then LN-428.The inhibitory effect of hUMSC-CM(3 and 9 g/L)and TMZ(50,100 and 200 μmol/L)combined treatment on glioma cells was significantly greater than that that of single-agent treatments(P＜0.05),demonstrating a dose-and concentration-dependent enhancement.Notably,the combination of 9 g/L hUMSC-CM(C9)with 50 μmol/L TMZ(T50)effectively suppressed glioma cell growth.CCK-8 as-say indicated a significant reduction of cell viability in C9+T50 group compared with either C9 or T50 alone(P＜0.05).HE staining and TUNEL staining revealed pronounced morphological changes and significant apoptotic features in glioma cells treated with C9+T50.Flow cytometric analysis confirmed that C9+T50 induced cell cycle arrest in glioma cells.Fur-thermore,compared with control group,the levels of cleaved caspase-3,cleaved caspase-8,cleaved PARP1,beclin-1,and LC3-Ⅱ/LC3-Ⅰ were significantly elevated in the C9+T50-treated glioma cells(P＜0.01).CONCLUSION:(1)The concomitant administration of hUMSC-CM and TMZ exerts a broad inhibitory effect on glioma cells,with a synergistic sen-sitization observed across different cell lines.(2)The enhancement of glioma cell sensitivity to TMZ by hUMSC-CM may be attributed to the modulation of caspase-8/caspase-3/PARP1 signaling pathway and the induction of both apoptosis and autophagy in glioma cells.