Objective: To investigate the subclinical eating disorders among college students and to analyze associated factors, so as to provide a basis for the prevention and treatment of eating disorders among adolescents. Methods: From November to December 2023, a total of 5 201 college students were selected by stratified random cluster sampling from one undergraduate college and one specialized college in Yangzhou City, Jiangsu Province. Data on general information, subclinical eating disorders, body image perception, depressive symptoms, anxiety symptoms, and mental health literacy were collected using questionnaires. The Chisquare test was used to compare the detection rates of subclinical eating disorders between groups, and binary Logistic regression was employed to analyze associated factors. Results: The detection rate of subclinical eating disorders among college students was 16.0%. Binary Logistic regression analysis showed that the prevalence of subclinical eating disorders among college students was higher in the following categories:being in a relationship (OR=1.22, 95%CI=1.04-1.44), being overweight and obese (OR=2.75, 3.82, 95%CI=2.24-3.38, 2.89-5.06), overestimation of body shape (OR=2.04, 95%CI=1.68-2.49), being in a depressive state (OR=2.53, 95%CI=1.99-3.21), experiencing anxiety (OR=2.63, 95%CI=2.16-3.20), and having substandard mental health literacy (OR=1.37, 95%CI=1.11-1.70). Conversely, low body weight (OR=0.15, 95%CI=0.10-0.22) and underestimation of body shape (OR=0.37, 95%CI=0.27-0.51) were associated with a lower risk (P<0.05). Conclusions The detection rate of subclinical eating disorders among college students is high, and it is associated with relationship status, body mass index classification, body shape perception, depressive and anxiety symptoms, and mental health literacy. Comprehensive interventions should be implemented to improve the subclinical eating disorders and promote the physical and mental health of college students.

Objective To evaluate early outcomes of transthoracic pulmonary valve implantation for the treatment of moderate and severe pulmonary regurgitation by using homemade self-expanding valve (SalusTM). Methods Patients with severe pulmonary regurgitation who underwent transthoracic pulmonary valve implantation in Guangdong Provincial People’s Hospital from September 2, 2021 to November 25, 2022 were prospectively enrolled. The early postoperative complications and improvement of valve and heart function were summarized and analyzed. Results A total of 25 patients were enrolled, including 16 males and 9 females, with an average age of 24.5±1.5 years and an average weight of 57.0±3.0 kg. The mean systolic diameters of the bifurcation near the main pulmonary artery, the stenosis of the middle segment of the aorta and near the valve of the right ventricular outflow tract of the patients were 31.8±7.4 mm, 30.6±5.9 mm and 38.4±8.0 mm, respectively. All patients were successfully implanted with valves, and there were no serious complications such as death, coronary compression, stent fracture, valve displacement and infective endocarditis in the early postoperative period. The indexed left atrial longitudinal diameter, indexed right atrial longitudinal diameter, and indexed right ventricular outflow tract anteroposterior diameter decreased significantly after the operation. The degree of tricuspid and pulmonary valve regurgitation and the indexed regurgitation area decreased significantly. The above differences were statistically significant (P<0.05). Conclusion The early outcomes of transthoracic pulmonary valve implantation with homemade self-expanding pulmonary valve (SalusTM) in the treatment of severe pulmonary regurgitation is relatively good, and the long-term outcomes need to be verified by the long-term follow-up studies with large samples.

In order to further standardize the diagnosis and treatment of long-term systemic complications in kidney transplant recipients,Branch of Organ Transplantation of Chinese Medical Association initiated the formulation of"Clinical Diagnosis and Treatment Guidelines for Long-term Systemic Complications in Kidney Transplant Recipients in China".Experts on organ transplantation were organized to summarize and integrate the latest progress in this field based on existing clinical guidelines,systematic evaluations,case studies,expert consensus.The guideline was formed after multiple rounds of discussion and reaching a consensus which included complications of hematological system,central nervous system,cardiovascular system,ocular,cutaneous and osteoporosis disorders.The full text focuses on 27 clinical problems and forms 40 recommendations,mainly involving the risk factors,classification,diagnosis,treatment and prevention of various complications.This guideline graded the quality of evidence and the strength of recommendation for each clinical issue using 2009 Oxford Centre for Evidence-Based Medicine(OCEBM)Grading and Strength of Recommendation criteria,so as to provide reference for the diagnosis and treatment of late complications,comprehensively improve the management capacity of clinicians to benefit kidney transplant recipients.

The diagnosis and treatment of digestive system complications of kidney transplant recipients is related to the long-term survival and quality of life of patients,which needs great attention.In order to further standardize its diagnosis and treatment,Branch of Organ Transplantation of Chinese Medical Association initiated the formulation of"Clinical Diagnosis and Treatment Guidelines for Digestive System Complications in Kidney Transplant Recipients in China",and organized experts in organ transplantation and related disciplines to summarize the new progress in diagnosis and treatment of digestive system complications of kidney transplant recipients at home and abroad in recent years based on existing clinical research,systematic evaluation,case study,expert consensus and existing guidelines,and reached a consensus after many discussions.This paper focuses on 11 clinical problems,forming 16 recommendations,and grading the evidence quality and recommendation strength of each clinical problem by the evidence grading and recommendation strength standard of Oxford University Evidence-based Medicine Center in 2009,in order to provide reference for the diagnosis and treatment of digestive system complications of kidney transplant recipients,comprehensively improve the management ability of digestive system complications of clinicians in an all-round way and benefit transplant recipients.

Objective To study the intervention effect of Jianpi Zhidong Decoction on the expressions of Cx43 and Cx30 in the cortex,corpus striatum,hypothalamus,and hippocampus of tic disorder mice.Methods According to the random number table method,60 male ICR mice were divided into the blank control group(n=15)and modeling group(n=45).The mice in the modeling group were intraperitoneally injected with iminodipropanitrile(350 mg/kg,once a day for 7 days)to establish a tic disorder model,and the mice in the blank control group were intraperitoneally injected with equal volume of normal saline.The stereotyped behavior score was calculated to evaluate the success of modeling.According to the random number table method,the mice in the modeling group were divided into the model group,tiapride group(29.5 mg/kg)and Jianpi Zhidong Decoction group(17.8 g/kg),with 15 mice in each group.The drug was administered by gavage for 4 weeks.After administration,stereotyped behavior score was calculated.The positive protein expression,protein expression,and mRNA expression of Cx43 and Cx30 in the cortex,corpus striatum,hypothalamus and hippocampus were determined by immunohistochemistry,Western blotting and real-time PCR.Results Compared with the blank control group,the stereotyped behavior score of mice in the model group was increased(P＜0.05).Compared with the model group,the stereotyped behavior scores of mice in the tiapride group and the Jianpi Zhidong Decoction group were decreased(P＜0.05).Compared with the blank control group,the average optical densities of Cx43 in the cortex,corpus striatum,hypothalamus,and hippocampus of mice in model group were decreased(P＜0.05).Compared with the model group,the average optical densities of Cx43 in the cortex and hippocampus in the tiapride group were increased,and the average optical densities of Cx43 in the cortex,corpus striatum,and hippocampus in the Jianpi Zhidong Decoction group were increased(P＜0.05).Compared with the tiapride group,the average optical density of Cx43 in the cortex in the Jianpi Zhidong Decoction group was increased(P＜0.05).Compared with the blank control group,the average optical densities of Cx30 in the cortex,corpus striatum,hypothalamus,and hippocampus of mice in model group were decreased(P＜0.05).Compared with the model group,the average optical densities of Cx30 in the corpus striatum and hypothalamus in the tiapride group were increased,and the average optical densities of Cx30 in the cortex,corpus striatum,and hippocampus in the Jianpi Zhidong Decoction group were increased(P＜0.05).Compared with the tiapride group,the average optical density of Cx30 in the hippocampus in the Jianpi Zhidong Decoction group was increased(P＜0.05).Compared with the blank control group,the protein expressions of Cx43 in the cortex,corpus striatum,and hippocampus of mice in the model group were decreased(P＜0.05).Compared with the model group,the protein expression of Cx43 in the cortex in the tiapride group was increased,and the protein expressions of Cx43 in the cortex,corpus striatum,and hippocampus in the Jianpi Zhidong Decoction group were increased(P＜0.05).Compared with the blank control group,the protein expressions of Cx30 in the cortex and hippocampus of mice in the model group were decreased(P＜0.05).Compared with the model group,the protein expressions of Cx30 in the cortex and hippocampus in the tiapride group and the Jianpi Zhidong Decoction group were increased(P＜0.05).Compared with the blank control group,the mRNA expressions of Cx43 in the cortex,corpus striatum and hippocampus in the model group were decreased(P＜0.05).Compared with the model group,the mRNA expressions of Cx43 in the cortex,corpus striatum,and hippocampus in the tiapride group and the Jianpi Zhidong Decoction group were increased(P＜0.05).Compared with the blank control group,the mRNA expressions of Cx30 in the cortex and hippocampus in the model group were decreased(P＜0.01).Compared with the model group,the mRNA expressions of Cx30 in the cortex and hippocampus in the tiapride group and the Jianpi Zhidong Decoction group were increased(P＜0.05).Conclusion The decreased expression of Cx43 and Cx30 in the cortex,corpus striatum,hypothalamus,and hippocampus may be involved in the occurrence of stereotyped behavior in tic disorder mice.The intervention mechanism of Jianpi Zhidong Decoction may be related to the increased expression of Cx43 and Cx30 in various brain regions.

Objective:To investigate the factors for serious complications within 30 days after surgery in elderly patients with advanced epithelial ovarian cancer(EOC)who undertook primary debulking surgery(PDS).Methods:The clinical data of International Federation of Gynecology and Obstetrics(FIGO)stage ⅢC/Ⅳ EOC patients aged≥60 years who received PDS in gynecological department of National Cancer Center and National Center of Gerontology between January 2014 and December 2018 were retrospectively analyzed.Clavien-Dindo scoring system was applied to grade the complications within 30 days after surgery.The serious early postoperative complications were those of grade Ⅲ or above occurred within 30 days after surgery.Multivariate Logistic regression analysis was used to screen the independent risk factors of serious complications within 30 days after surgery.Results:A total of 133 patients were included in this study and serious complications rated 11.3%(15/133). The mean age of patients in severe complication group was significantly higher than that in the control group[(69.80±6.56) vs.(65.87±5.14), t=2.699, P=0.008]. The proportion of patients with preoperative ECOG score≥2 was significantly higher in the severe complication group than that in the control group[26.7%(4/15) vs.5.9%(7/118), χ2=4.985, P=0.026], and the proportion of preoperative hypoalbuminemia(<35 g/L)was significantly higher in the severe complication group[20.0%(3/15) vs.3.4%(4/118), χ2=4.897, P=0.027]. However, there was no significant difference in intraoperative bleeding, R0 resection rate as well as surgical complexity( χ2=1.964, 0.330, 4.637, all P>0.05)between the two groups.Multivariate Logistic regression analysis showed that the independent factors for serious early postoperative complications were age≥70 years( OR=4.345, P=0.028), ECOG score≥2( OR=25.619, P=0.008)and preoperative albumin <35 g/L( OR=6.733, P=0.040). Conclusions:In the elderly ovarian cancer patients, individualized perioperative management should be strengthened for the patients with factors associated with serious early postoperative complications, in order to reduce severe complications and improve the prognosis.

Objective:To investigate clinical phenotypes of type Ⅳ hereditary hemochromatosis caused by c. 430A>G heterozygous mutation of SLC40A1 gene and the correlation between genotype and phenotype, exploring ferritin cutoff value for screening.Methods:One case of type Ⅳ hereditary hemochromatosis with c. 430A>G heterozygous mutation in the SLC40A1 gene and 5 generations of their family lineage with a total of 47 members who were seen at the First Affiliated Hospital of Nanjing Medical University in July 2020 were studied for systematic clinical investigation. Thirty-nine surviving individuals were tested for ferritin, liver function, fasting plasma glucose (FPG), and sex hormones, and Sanger sequencing was performed to verify the mutation loci and to map the family tree. Spearman correlation analysis was used to explore the relationship between ferritin and other indicators, and receiver operating characteristic curves were used to calculate the ferritin cutoff value for screening for this genotype of hemochromatosis.Results:Ten patients with c. 430A>G heterozygous mutation in the SLC40A1 gene were identified among 39 family members, and five of them were diagnosed with hemochromatosis, presenting incomplete penetrance. The differences in levels of ferritin, aspartate aminotransferase (AST; both P<0.01) and FPG, as well as incidences of hypogonadotropic hypogonadism and arthritis (all P<0.05) between group of mutation positive and group negative were statistically significant, while the difference in alanine aminotransferase (ALT) was not. Spearman correlation analysis showed that, ferritin levels were significantly associated with ALT ( r=0.903), AST ( r=0.879), FPG ( r=0.782), and the incidences of hypogonadotropic hypogonadism ( r=0.798) and arthritis ( r=0.798; all P<0.01) in those with the c. 430A>G heterozygous mutation in the SLC40A1 gene. The ferritin cutoff value for screening of hereditary hemochromatosis with c. 430A>G heterozygous mutation in the SLC40A1 gene was 1 036.7 μg/L, with a sensitivity and specificity of 100% and 94.3%, respectively. Conclusion:The SLC40A1 gene c. 430A>G heterozygous mutation is closely associated with elevated levels of AST and FPG, increased incidences of hypogonadotropic hypogonadism and arthritis, and the ferritin cutoff value is a useful screening parameter.

Objective:To explore the research trends, research advances and future orientations in the field of inflammatory bowel disease (IBD), so as to inform future researches.Methods:Web of Science database was searched from 2000 to 2021. CiteSpace software was used for visual and quantitative analysis.Results:A total of 3 582 articles were included. Publications on nutrition science in IBD showed a rising trend. The United States ranked first according to number of publications by country, the University of Toronto ranked first by institution, Inflammatory Bowel Diseases ranked first by journal and Li J from Nanjing University was the very author with the highest number of relevant publications. Research hotspots mainly focused on risk, gut microbiota and pediatric population. Research fronts mainly focused on the gut microbiota. Conclusion:Visual analysis shows the research trend in the field of nutrition in IBD, with gut microbiota as the research hotspots in the future.

Objective:To compare the optimal gridpercutaneous vertebroplasty (PVP) and conventional PVP in the treatment of osteoporotic vertebral compression fractures (OVCFs).Methods:A retrospective cohort study was conducted of 102 patients with OVCFs who had underwent PVP between May 2016 and May 2019 at department of spine surgery, General Hospital of Northern Theater Command. According to the different surgical methods, they were divided into the optimalgrid PVP group (102 cases) and conventional PVP group (94 cases). In the optimal grid PVP group, there were 38 males and 64 females with an average age of 67.3±8.5 years old, and the course of disease was 2.3±1.2 days; the injured sites were lumbar vertebra, including 59 cases of L 1 vertebra, 31 cases of L 2 vertebra, 8 cases of L 3 vertebra, 3 cases of L 4 vertebra and 1 case of L 5 vertebra. In the conventional PVP group, there were 26 males and 68 females with an average age of 71.5±5.6 years old, and the course of disease was 2.1±1.1 days; the injured sites were lumbar vertebra, including 52 cases of L 1 vertebra, 33 cases of L 2 vertebra, 7 cases of L 3 vertebra and 2 cases of L 4 vertebra. The patients were prepared before operation. Then the best puncture point was selected, and the guide wire and working channel were inserted. Finally the bone cement was pushed. The operation time, intraoperative fluoroscopy times, bone cement dosage and bone cement leakage were compared between the two groups. Visual analogue scale (VAS), anterior heights and median heights of injured vertebra were compared between the two groups at postoperative 3 days, 3 months and the final follow-up. Results:There were no significant differences in the general clinical data between the two groups before operation ( P>0.05). All patients had no complications such as wound infection,pulmonary embolism,spinal cord embolism or death. The operation time, fluoroscopy times, bone cement dosage and bone cement permeability of the two groups were statistically significant different ( P<0.05), and the optimal grid group was better than the conventional group. VAS at 3 days, 3 months and the final follow-up was statistically significantlower in the optimal grid group than the conventional group ( P<0.05). There was no significant difference in the recovery of the anterior and middle edge heights of injured vertebra in the two groups 3 days after operation ( P>0.05), but there were statistical significant difference between the two groups3 months after operation and at the last follow-up ( P<0.05), whilethe optimal grid group was better than the conventional group. Conclusion:Compared with conventional PVP, the optimal grid PVP is safer and more effective in the treatment of osteoporotic vertebral compression fractures.

Ischemic stroke is a severe disorder resulting from acute cerebral thrombosis. Here we demonstrated that post-ischemic treatment with ciclopirox olamine (CPX), a potent antifungal clinical drug, alleviated brain infarction, neurological deficits and brain edema in a classic rat model of ischemic stroke. Single dose post-ischemic administration of CPX provided a long-lasting neuroprotective effect, which can be further enhanced by multiple doses administration of CPX. CPX also effectively reversed ischemia-induced neuronal loss, glial activation as well as blood-brain barrier (BBB) damage. Employing quantitative phosphoproteomic analysis, 130 phosphosites in 122 proteins were identified to be significantly regulated by CPX treatment in oxygen glucose deprivation (OGD)-exposed SH-SY5Y cells, which revealed that phosphokinases and cell cycle-related phosphoproteins were largely influenced. Subsequently, we demonstrated that CPX markedly enhanced the AKT (protein kinase B, PKB/AKT) and GSK3 (glycogen synthase kinase 3) phosphorylation in OGD-exposed SH-SY5Y cells, and regulated the cell cycle progression and nitric oxide (NO) release in lipopolysaccharide (LPS)-induced BV-2 cells, which may contribute to its ameliorative effects against ischemia-associated neuronal death and microglial inflammation. Our study suggests that CPX could be a promising compound to reduce multiple ischemic injuries; however, further studies will be needed to clarify the molecular mechanisms involved.