Objective: To explore the relationship between sleep quality and mental health among middle school students, so as to provide scientific basis for improving mental health among adolescents. Methods: From September to December 2023, a stratified cluster random sampling method was employed to select 5 713 middle school students aged 13-18 from Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi, and Urumqi. Sleep quality and mental health were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Brief Adolescent Mental Health Assessment Questionnaire. Spearman correlation analysis and linear regression analysis were used to explore the relationship between sleep quality and various dimensions of mental health among middle school students. Results: There was a statistically significant difference in the total PSQI score among middle school students of different age groups ( H=226.49, P <0.01), and there was no statistically significant difference in the psychological health scores of middle school students in different age groups ( H=5.37, P >0.05). In terms of gender, the total PSQI score for girls [5.00 (3.00, 6.00)] was higher than that for boys [4.00 (2.00, 6.00)]; additionally, boys had higher mental health scores [85.00 (75.00, 90.00)] than females [83.00 (70.00, 89.00)], with statistically significant differences ( Z=-10.90, -8.16, P <0.01). Spearman correlation analysis revealed a negative correlation between total PSQI scores and mental health scores ( r=-0.51, P <0.05) among middle school students. After controlling for variables such as maximum oxygen uptake, physical activity and nutritional status, linear regression analysis further confirmed that higher PSQI scores were associated with lower mental health scores ( B=-3.76, 95%CI = -4.15 to -3.38, P <0.01). Conclusion There is a negative correlation between PSQI scores and mental health scores among middle school students, indicating that improving sleep quality may contribute to better mental health among middle school students.

Objective: To explore the relationship between sleep quality and executive function among middle school students, so as to provide theoretical support for the promotion of adolescents physical and mental health development. Methods: From September to December 2023, 5 713 junior and senior high school students aged 13 to 18 were selected by stratified cluster random sampling method from Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi, and Urumqi. Pittsburgh Sleep Quality Index was used to conduct sleep quality survey. And conduct executive function was tested on middle school students, including inhibitory function, refresh function and conversion function tests. Spearman correlation and linear regression were used to analyze the relationship between sleep quality and executive function of middle school students. Results: The total Pittsburgh Sleep Quality Index (PSQI) score of boys was [4.0(2.0,6.0)] and that of girls was [5.0(3.0,6.0)], and the difference was statistically significant ( Z=-10.90, P < 0.01 ). The total PSQI score of boys was positively correlated with both 2-back reaction time and conversion function of executive function ( r =0.04, 0.04); the total PSQI score of girls was negatively correlated with 2-back reaction time ( r =-0.04) ( P <0.05). After controlling for variables such as mental health, physical activity and nutritional status,linear regression analyses showed that PSQI total score of middle school students was positively correlated with the inhibitory function and the conversion function response time [ B (95% CI )=1.28(0.21-2.34), 7.62(2.34-12.90), P <0.05]; the associations of total PSQI scores among middle school students with both 2-back and 1-back response time were not statistically significant [ B (95% CI )=-5.88(-16.14-4.37), 8.05( -3.39 -19.50), P >0.05]. Conclusion Positive correlations are observed on sleep quality with inhibitory and conversion functions of executive function among middle school students.

Objective:To evaluate the diagnostic value of rapid on-site evaluation (ROSE) performed by endoscopists for solid pancreatic lesions requiring tissue for immunohistochemistry (IHC) staining with different approach of endoscopic ultrasound-guided tissue acquisition (EUS-TA).Methods:After screening 1 573 cases who underwent EUS-TA operation at the Endoscopy Center of Peking Union Medical College Hospital between August 2018 and October 2022, a total of 65 cases of solid pancreatic lesions whose diagnosis rely on IHC staining was collected and summarized with clinical data of each case. Among 65 cases, there were 46 cases of pancreatic neuroendocrine tumors (PNETs), 13 cases of pancreatic solid pseudo-papillary tumors (SPTs), and 6 cases of lymphomas and mesenchymal. Patients were categorized into ROSE group (36 cases) and non-ROSE group (29 cases) according to the presence or absence of endoscopists performed ROSE during EUS-TA operation. They were further divided into subgroups of FNA-ROSE (26 cases), FNB-ROSE (10 cases), FNA-non-ROSE (24 cases) and FNB-non-ROSE (5 cases) according to the type of EUS-TA. Diagnostic accuracy and IHC success rate were compared between different groups and subgroups. Binomial logistic multifactorial regression analysis was used to evaluate the influence of ROSE and EUS-TA type on diagnostic accuracy and IHC success rate.Results:There were no statistically significant differences between ROSE group and non-ROSE group in terms of age, gender, bilirubin level, CA19-9 level, lesion site, lesion size, composition ratio of diagnosis, and surgical rate. The differences in mean size of lesions, needle gauge, location of puncturation, and number of needle pass between subgroups were not statistically significant. The diagnostic accuracy was 88.9% in ROSE group and 79.3% in non-ROSE group, and the difference between the two groups was statistically significant ( P=0.023). The diagnostic accuracy of FNA-ROSE group was higher than that of FNA-non-ROSE group (88.5% vs 75.0%), but the difference was not statistically significant ( P>0.100). The differences in diagnostic accuracy and success rate of IHC between FNB-ROSE group and FNB-non-ROSE group were not statistically significant. Binomial logistic multifactorial regression analysis did not reveal any independent influences on diagnostic accuracy. Conclusions:ROSE performed by endoscopists improved diagnostic accuracy of EUS-TA in solid pancreatic lesions requiring IHC staining, and therefore is potentially valuable for improving the diagnostic efficiency of EUS-TA for such diseases.

Heart failure (HF) is a global public health problem with high morbidity and mortality. A large number of studies have shown that HF is caused by severe energy metabolism disorders, which result in an insufficient heart energy supply. This deficiency causes cardiac pump dysfunction and systemic energy metabolism failure, which determine the development of HF and recovery of heart. Current HF therapy acts by reducing heart rate and cardiac preload and afterload, treating the HF symptomatically or delaying development of the disease. Drugs aimed at cardiac energy metabolism have not yet been developed. In this review, we outline the main characteristics of cardiac energy metabolism in healthy hearts, changes in metabolism during HF, and related pathways and targets of energy metabolism. Finally, we discuss drugs that improve cardiac function

Objective:To investigate the feasibility, efficacy, and safety of CT- and bronchoscopy-guided 125I seed implantation in the treatment of central lung cancer complicated with atelectasis. Methods:Retrospective analysis was conducted on twenty-nine patients who were treated from May 2016 to Oct 2019 in the Second Hospital of Tianjin Medical University for central non-small-cell lung carcinoma complicated with pulmonary atelectasis that was inoperable due to medical reasons. 125I seeds were implanted into the trachea under the guidance of bronchoscopy first.The 125I seeds were then implanted into the hilum of the lungs by percutaneous puncture under the guidance of the CT and template.The seed activity was 18.5-29.6 MBq, and the prescription dose was 120 Gy.TPS planning and quality verification were performed before and after the operations.The rate of atelectasis recanalization, the satisfactory rate of dose verification, the improvement of dyspnea index, the survival time, and the adverse events during and after operation were observed. Results:All 29 patients with lung cancer complicated with atelectasis successfully completed the seed implantation, and the satisfactory rate of quality verification was 93.1%.The rate of atelectasis recanalization at 2, 6, 12, 18, and 24 months was 93.1%, 89.7%, 78.6%, 76.2%, and 60%, respectively.Their dyspnea and anoxia symptoms were significantly relieved in 5-28 months after treatment.The results showed that the patients′ dyspnea index was 2.8-0.8 before treatment and 1.4-0.9 after treatment.The median follow-up period was 20 months and median survival was 21 months.Adverse events associated with the radiation therapy included pneumothorax, hemoptysis, cough, fever, and particle displacement.No level-3 or more serious adverse events occurred.Conclusions:The CT- and bronchoscopy-guided 125I seed implantation is a safe and effective therapy option for the treatment of central non-small-cell lung carcinoma associated with atelectasis.It contributes to a high rate of local recanalization, and can rapidly improve clinical conditions and quality of life of the patients with few adverse reactions.

Objective:To investigate the application effect of dexmedetomidine combined with propofol and remifentanil in fiberoptic bronchoscopy in elderly patients with chronic obstructive pulmonary disease(COPD).Methods:From October 2018 to November 2019, 112 elderly patients with COPD who were examined by fiberoptic bronchoscopy in the Affiliated Hospital of Medical College of Ningbo University were divided into control group and observation group, with 56 cases in each group.Propofol and remifentanil were used for anesthesia induction in both two groups.Dexmedetomidine (0.5μg/kg) was injected intravenously into observation group, and later 0.5μg·kg -1·h -1 continuous infusion, the control group was given the same dose of 0.9% sodium chloride injection.The OAA/S scores, propofol dosage, remifentanil dosage, wake-up time, heart rate, oxygen saturation, mean arterial pressure, pulmonary function changes and adverse reactions were compared between the two groups. Results:At the fiberbronchoscope entered immediately and 10 min after examination, the OAA/S scores in the observation group were (1.03±0.35)points, (4.42±0.28)points, respectively, which in the control group were (1.22±0.22)points, (3.01±0.22)points, respectively, the differences between the two groups were statistically significant( t=3.439, 29.631, all P<0.05). The dosages of propofol and remifentanil in the observation group were (3.00±0.28)μg/kg and (1.65±0.29)μg/kg, respectively, which were less than those in the control group [(3.70±0.39)μg/kg, (2.42±0.45)μg/kg], the recovery time was (8.40±1.58)min, which was shorter than that in the control group [(13.31±2.02)min], the differences were statistically significant( t=10.911, 10.763, 14.327, all P<0.05). The heart rate, oxygen saturation, mean arterial pressure, pulmonary function(FEV 1, MVV) in the observation group were significantly better than those in the control group( t=9.757, 11.981, 11.486, 11.913, 40.189, all P<0.05). The incidence of adverse reactions in the observation group was 7.14%(4/56), which was lower than 19.64%(11/56) in the control group(χ 2=6.737, P<0.05). Conclusion:Dexmedetomidine(0.5μg/kg, followed by 0.5μg·kg -1·h -1 continuous infusion) and target controlled infusion of propofol and remifentanil are safe for elderly patients with COPD, and the use of anesthetic drugs is small, which can shorten the recovery time after operation, and will not have a great impact on respiratory circulation.

Objective:To analyze the efficacy and the adverse reactions of conventional treatment-failed advanced refractory ovarian cancer cases after treatment with apatinib.Methods:Six patients enrolled in the Second Hospital of Tianjin Medical University from June 2015 to October 2015 received treatment with apatinib. Treatment efficacy was evaluated by imaging and analysis of tumor markers,including CA125,CEA,and NSE.Results:The age range of the six patients was 48-71 years(median:55 years).Their histopath-ological subtypes included poorly differentiated serous cystadenocarcinoma(4/6),borderline papillary adenoma(1/6),and clear cell carcinoma(1/6).Clinical evaluation of patients revealed no cases with complete remission,two cases with partial response,one case with stable disease,and three cases with progressive disease.The objective response rate was 33%(2/6)and the disease control rate was 50%(3/6).In all patients,the main side effects were hypertension and hand-foot syndrome,which were controlled.Conclusions:The treatment of conventional treatment-failed advanced refractory ovarian cancer with apatinib has better exact effects,and medical toxicity can be controlled.In the future,to seek more effective treatment strategies,the mechanism of apatinib in the treatment of ad-vanced ovarian cancer should be further explored.

Objective To study the relationship between the expression level of PLK1 in castration-resistant prostate cancer (CRPC) tissues, and its relationship with pathological features. Methods Forty-four CRPC specimens including 28 samples from patients with prostate adenocarcinoma, 14 samples from patients with neuroendocrine prostate cancer (NEPC) and 2 samples from patients with other types of prostate cancer, and 10 normal prostatic hyperplasia specimens were collected from January 2010 to September 2016 in the Second Hospital of Tianjin Medical University. The expression levels of PLK1 in these tissues were detected by S-P immunohistochemistry. The relationship between PLK1 expression and pathologic factors was discussed. Results The positive expression of PLK1 was located in cytoplasm of carcinoma cells, and no express of PLK1 was found in benign prostatic hyperplasia tissues. The expression levels of PLK1 showed no significantly differences between different groups of age, local tumor invasion and regional nodal status, and the level of prostate-specific antigen (PSA, P>0.05). The expression level of PLK1 in patients with Gleason score>8 was higher than that in patients with Gleason score≤8. The PLK1 expression level was positively correlated with Gleason score (rs=0.441,P<0.05). Conclusion PLK1 protein is over-expressed in CRPC tissues, which can reflect the proliferation and differentiation of cancer cells and may be a potential marker of CRPC.

Objective To evaluate the efficacy and toxicity of pemetrexed and nedaplatin in the treatment of patients with locally advanced or metastatic urothelial cell carcinoma who failed a first-line GC regimen.Methods A total of 11 patients with locally advanced or metastatic urothelial carcinoma failed with first-line treatment of GC regimen were included in the present study.There were 6 males and 5 females,aged 56-80 years old,median age was 65 years old.Six patients' primary tumors were in bladder,4 in the renal pelvis,1 ureter.There were 7 cases with ECOG score 0 point,3 cases 1 point,1 case 2 points.Patients received pemetrexed 500 mg/m2 intravenously on the 1st day,and nedaplatin 25mg/m2 from the 1st to 3th day every 21 days.The evaluation of efficacy and adverse reactions were carried out after 2 to 3 cycles.Results Eleven patients received 1 to 6 cycles (mean 3.3 cycles) treatments.There were 2 cases (18.2％) complete remission,5 cases (45.5％) partial remission,2 cases (18.2％) no change and 2 cases (18.2％) progressed.The total effective rate was 63.6％.The main adverse events were anemia (6 cases),leukopenia (5 cases),nausea and vomiting (6 cases) and rash (5 cases),all of which were mild to moderate.No treatment-related death occurred.Conclusions Pemetrexed and nedaplatin regimen could be effective in the treatment of advanced urothelial carcinoma after first-line chemotherapy failed.The side effect is mild.

Objective To systematically evaluate the efficacy and safety of 125I seed implantation for treatment of advanced pancreatic cancer.Methods An electronic literatuire search was performed about randomized controlled trials(RCTs) of 125I implantation for treamtent of advanced pancreatic cancer in CNKI,Wanfang Data,CBM,Cochrane Library,PubMed and Embase (from the date of building the database to November 2016).Two investigators independently screened literature,extracted data and assessed the risk bias of included studies,and the Meta-analysis was performed by using Revman 5.3software.Results There were 12 RCTs (n =689) included.Meta-analysis showed that the objective respond rate(ORR) (OR =3.24,95％CI2.33-4.52,P＜0.001),the 6-month survival rate(OR =3.61,95％ CI 1.53-8.52,P =0.003),the 12-month survival rate(OR =4.80,95％ CI 2.40-9.57,P ＜ 0.001) and the relief rate of pain were higher than those in the control group.However,there were no significant differences between both groups in the 2-year survival rate and the adverse reaction rate,which were (OR=2.36,95％ CI 0.47-11.74,P =0.29) and (OR =4.94,95％ CI 1.05-23.23,P =0.04),respectively.Conclusions The limited current evidence showed that 125I implantation for treatment of advanced pancreatic cancer is effective and safety.125I implantation can improve the ORR,short-time survival rate and pain relief rate.In addition,there was no significant increase in the incidence of related adverse events except for seed malposition.Although the quality and quantity of evidences is limited,it merits further study to provide high quality evidences.