Objective: To investigate the changing trends for associations of anxiety and depressive symptoms with smartphone addiction among middle school students, so as to provide a scientific basis for preventing smartphone addiction in middle school students. Methods: From 2022 to 2023, a method of combining convenient sampling with cluster sampling was used to select 8 923 middle school students from 27 junior high schools and 3 senior high schools in a district of Shenzhen City between September 2022 (baseline, T1) and September 2023 (follow up, T2). The Smartphone Addiction Scale-Short Version (SAS-SV), Patients Health Questionnaire-9 Item (PHQ-9), and Generalized Anxiety Disorder 7-item Scale (GAD-7) were administered to assess smartphone addiction, anxiety and depressive symptoms. Mixed effects models were used to analyze the association of anxiety and depressive symptoms with smartphone addiction among middle school students. Results: From September 2022 to September 2023, the reported prevalence of smartphone addiction increased from 24.22% to 25.25% ( χ 2=45.71); and smartphone addiction scores [ 24.00 (16.00, 32.00),25.00(16.00, 33.00)], anxiety symptom scores [2.00(0.00, 7.00),3.00(0.00, 7.00)] and depressive symptom scores[3.00(0.00, 8.00),5.00(0.00, 9.00)] all significantly increased ( Z =-17.43, -42.38, -41.57) (all P <0.05). There were statistically significant difference in the distribution of anxiety and depression symptom levels among middle school students in 2022 and 2023 ( χ 2=85.15, 106.85, both P <0.05). After adjusting for covariates such as age, gender and family background, mixed effects models revealed dose response associations of anxiety and depressive symptoms with smartphone addiction among middle school students:mild anxiety symptom( OR =3.22), moderate to severe anxiety symptom ( OR =5.36), mild depressive symptom ( OR =3.32) and moderate to severe depressive symptom ( OR =6.13) were significantly associated with higher risks of smartphone addiction (all P <0.05). Interaction effect analysis found that co existing anxiety and depressive symptoms synergistically increased addiction risk by 5.60 times ( OR =5.60) compared to the asymptomatic group, with 32% of the combined risk attributable to their interaction ( S=1.64, AP =0.32)(both P < 0.05 ). Conclusions Anxiety and depressive symptoms are significantly associated with smartphone addiction, exhibiting a synergistic effect. Attention should be paid to emotional issues and smartphone addiction among middle school students.

China is a country with a high incidence of esophageal cancer.The pathological type is mainly squamous cell carcinoma.Squamous intraepithelial neoplasia is the most recognized precancerous lesion of esopha-geal squamous cell carcinoma,and its monitoring and intervention is an effective method to reduce the incidence of esophageal squamous cell carcinoma and improve the quality of life of patients.Understanding the etiology,clinical features,diagnosis and treatment of esophageal squamous cell carcinoma plays a crucial role in the prevention and early diagnosis and treatment of esophageal squamous cell carcinoma.At present,the clinical research related to esophageal squamous intraepithelial neoplasia is still insufficient,and there are some differences in clinical treat-ment.This review summarizes the risk factors,clinical features,diagnosis,prognosis and treatment of esophageal squamous intraepithelial neoplasia,hoping to provide ideas for the clinical management of esophageal squamous intraepithelial neoplasia.

OBJECTIVE: To assess the risk of aristolochic acid (AA)-associated cancer in patients with AA nephropathy (AAN). METHODS: A retrospective study was conducted on patients diagnosed with AAN at Peking University First Hospital from January 1997 to December 2014. Long-term surveillance and follow-up data were analyzed to investigate the influence of different factors on the prevalence of cancer. The primary endpoint was the incidence of liver cancer, and the secondary endpoint was the incidence of urinary cancer during 1 year after taking AA-containing medication to 2014. RESULTS: A total of 337 patients diagnosed with AAN were included in this study. From the initiation of taking AA to the termination of follow-up, 39 patients were diagnosed with cancer. No cases of liver cancer were observed throughout the entire follow-up period, with urinary cancer being the predominant type (34/39, 87.17%). Logistic regression analysis showed that age, follow-up period, and diabetes were potential risk factors, however, the dosage of the drug was not significantly associated with urinary cancer. CONCLUSIONS No cases of liver cancer were observed at the end of follow-up. However, a high prevalence of urinary cancer was observed in AAN patients. Establishing a direct causality between AA and HCC is challenging.
Humans ; Retrospective Studies ; Incidence ; Carcinoma, Hepatocellular ; Liver Neoplasms/epidemiology* ; Kidney Diseases/chemically induced* ; Aristolochic Acids/adverse effects*

Objective To explore the correlation between healthcare-associated infection(HAI)and partial inde-xes in the diagnosis-related groups(DRGs)of patients in thoracic surgery intensive care unit(ICU).Methods DRGs,case mix index(CMI),relative weight(RW),and HAI of patients in thoracic surgery ICU and four subspe-cialty departments(pulmonary surgery group,esophageal surgery group,mediastinum group[mainly thymic sur-gery],and trachea group)in a tertiary chest hospital in Shanghai from January to December 2022 were retrospec-tively analyzed and compared through DRGs index grouping.Results A total of 1 429 patients in the department of thoracic surgery ICU were analyzed,including 59 HAI cases,with a HAI rate of 4.13％.The incidences of HAI in pulmonary surgery group,esophageal surgery group,mediastinum group and trachea group were 3.74％(30/803),5.84％(25/428),1.27％(2/157)and 4.88％(2/41),respectively.There was no statistically significant differ-ence in the incidences of HAI among different subspecialty groups(P＞0.05).A total of 35 DRGs were involved,with CMI of 2.75,3.41,2.35 and 1.25 in pulmonary surgery group,esophageal surgery group,mediastinum group and trachea group,respectively,and RW ranged from 0.53 to 12.62.In the pulmonary surgery group,inci-dence of HAI in male patients was higher than that in female patients.Higher RW score level was associated with higher incidence of HAI.Differences were all statistically significant(all P 0.05).Among patients in the esophageal surgery group,the age of HAI group was higher than that of the non-HAI group(P＜0.05).Higher RW score level was associated with higher incidence of HAI(P＜0.05).Among patients in the mediastinum sur-gery group,the age of patients in the infected group was higher than that in the non-infected group(P＜0.05).Among the 59 HAI cases,31 were infected with MDROs.Conclusion Focusing on CMI and RW in the DRGs in-dex system,analyzing HAI from the perspectives of disease complexity and overall technical difficulties of medical services can provide reference for the precise management of HAI in the new era.

Objective:To explore the influencing factors of efficacy of combination therapy of nucleos（t）ide analogues（NAs）with pegylated interferon α-2a（Peg IFNα-2a）for patients with chronic hepatitis B（CHB）.Methods:The clinical data of 141 CHB patients receiving combination therapy of NAs and Peg IFNα-2a for ≥48 weeks in the First Affiliated Hospital of Zhejiang University School of Medicine from January 1，2013 to December 1，2023 was retrospectively analyzed. Patients were divided into clinical cure group（ n=45）and non-clinical cure group（ n=96）. Multivariate Logistic regression analysis was used to analyze the influencing factors of clinical cure. Results:Multivariate Logistic regression analysis showed that baseline HBsAg <1 500 IU/mL（ OR=0.160，95% CI 0.049-0.522， P=0.002），a decrease by >1 lg IU/mL in HBsAg at week 48 compared to the baseline level（ OR=0.114，95% CI 0.027-0.484， P=0.003），and sequential combination therapy（ OR=0.351，95% CI 0.128-0.960， P=0.041）were independent predicting factors for the efficacy of combination therapy of NAs and Peg IFNα-2a in CHB patients. Conclusions:The study indicates that the efficacy of the sequential combination therapy is superior to that of the treatment-na?ve therapy，and patients with baseline HBsAg<1 500 IU/mL is more likely to achieve clinical cure than those with higher baseline levels. A primary course of 48 weeks was recommended，with the possibility of an extension of the course by evaluating the degree of HBsAg decline at 48 weeks.

Non-alcoholic fatty liver disease (NAFLD) is a pathological syndrome characterized by the excessive deposition of lipids in hepatocytes but not caused by alcohol and other definite liver damage factors. The pathogenesis of NAFLD is complex. When the liver is damaged, a large amount of lipids deposited in hepatocytes will induce oxidative stress injury, endoplasmic reticulum stress and metabolic disorders in hepatocytes, and immune cells further secrete inflammatory cytokines and release them into the blood, causing systemic inflammation. In the process of NAFLD, the inflammatory response plays an important role. Macrophages are the most abundant non-parenchymal cells in the liver and play an important role in liver inflammatory injury. Hepatic macrophages include liver-native and monocyte-derived macrophages, and their activation and polarization processes are involved in the different development stages of NAFLD. Traditional Chinese medicine (TCM) compound and its active compounds have been found to regulate macrophages to participate in the process of inflammation, injury and recovery of NAFLD. Based on the existing research reports, this paper elaborates the relationship between the source, activation and polarization of macrophages and NAFLD as the breakthrough point, and systematically reviews the mechanism of TCM in the prevention and treatment of NAFLD by regulating the activation, recruitment and polarization of macrophages. This paper aims to provide new ideas for the discovery of novel NAFLD candidate drugs from TCM via targeting macrophages.

italic>Salvia apiana Jepson, commonly known as white sage, is a perennial sub-shrub of the Salvia genus in the Lamiaceae family with a long medicinal history. In this study, the complete chloroplast genome of S. apiana was sequenced using PacBio HiFi third-generation sequencing technology. The physical map of the genome was constructed, and the sequence structure features, codon preference, and repetitive sequences were analyzed. Furthermore, a comparative analysis of the chloroplast genome and phylogenetic evolution with closely related species within the same genus was conducted. The chloroplast genome of S. apiana was found to have a length of 151 701 bp (GenBank accession number: OR389048), with a typical quadripartite structure and a GC content of 38.06%. A total of 132 genes were annotated, including 87 protein-coding genes, 37 tRNA genes, and 8 rRNA genes. Among them, 17 genes contained introns, and 18 genes were present in duplicate copies. Codon preference analysis revealed a preference for codons ending with A or U. Analysis of repetitive structures in the S. apiana chloroplast genome identified 170 simple sequence repeat (SSR) sites and 65 scattered repeat sequences, with the majority of SSR sites composed of A and T. Phylogenetic analysis of the complete chloroplast genomes of 21 species within the same genus showed that S. apiana is most closely related to Salvia hispanica Ettling. ex Willk. & Lange, Salvia leucantha Cav., and Salvia tiliifolia Vahl. Comparative analysis of the chloroplast genomes revealed slight contraction and expansion of the inverted repeat (IR) boundaries in S. apiana, as well as multiple highly variable regions in the chloroplast genome sequence. This study establishes a method for de novo assembling the chloroplast genome of S. apiana using third-generation sequencing data and provides a comprehensive analysis of its chloroplast genome, which can serve as a theoretical basis for studies on chloroplast genetic engineering, genetic diversity analysis, molecular breeding, and species identification.

Objective To design a novel oxygenator to solve the existing problems of extracorporeal membrane oxygenation(ECMO)machine in high transmembrane pressure difference,low efficiency of blood oxygen exchange and susceptibility to thrombosis.Methods The main body of the oxygenator vascular access flow field was gifted with a flat cylindrical shape.The topology of the vascular access was modeled in three dimensions,and the whole flow field was cut into a blood inlet section,an inlet buffer,a heat exchange zone,a blood oxygen exchange zone,an outlet buffer and a blood outlet section.The oxygenator was compared with Quadrox oxygenator by means of ANSYS FLUENT-based simulation and prototype experiments.Results Simulation calculations showed the oxygenator designed was comparable to the clinically used ones in general,and gained advantages in transmembrane pressure difference,blood oxygen exchange and flow uniformity.Experimental results indicated that the oxygenator behaved better than Quadrox oxygenator in transmembrane pressure difference and blood oxygen exchange.Conclusion The oxygenator has advantages in transmem-brane pressure difference,temperature change,blood oxygen ex-change and low probability of thrombosis.[Chinese Medical Equipment Journal,2024,45(3):23-28]

Objective To develop a low-oxygen mixed gas generator to make up for the deficiencies of low-pressure chambers and load-resistant hypoxia trainers during pilot hypoxia tolerance testing.Methods The device prepared the low-oxygen gas with the principle of gas separation,which was composed of a Sunsource OLF1100D-220AF air compressor,a SMC IDG75SAM4-03 filter,a buffer tank,an AIR Products PA3010 integrated assembly,a control box,sensors and regulators.The sensors included the pressure sensor,flow sensor,concentration sensor and dew point temperature sensor,and the control box consisted of a main control board,a power supply module,a transmission module,a communication module,a display and a housing.The embedded control software of the device was developed with KEIL 5 and C++.Results The device developed prepared the low-oxygen gas with the volume fraction being 4％to 18％and the maximum error of volume fraction being 0.05％,and the main components of the prepared gas met the technical requirements of medical oxygen as stipulated in GB 8982-2009 Oxygen supplies for medicine and aircraft breathing.Conclusion The low-oxygen gas prepared by the device has its volume fraction precisely controlled and can be used for hypoxia tolerance testing and acclimation training for pilots.[Chinese Medical Equipment Journal,2024,45(7):24-28]

Objective To explore the mechanism of the effect of itraconazole ethanolamine tablets on the CD40/CD40L axis in children with idiopathic thrombocytopenic purpura(ITP).Methods 80 children with ITP were selected as the study subjects.They were divided into a control group(n=40)and a study group(n=40)using a digital random table method.The control group was treated with cyclosporine,while the study group was treated with itraconazole ethanolamine tablets.Both groups were treated continuously for 3 months.Compare the clinical efficacy of two groups of patients T lymphocyte subpopulation levels[CD3+CD4+and CD4+/CD8+,as well as adverse reactions.Detect CD40 on the surface of lymphocyte membrane and platelet membrane in two groups of patients CD40L level,plasma sCD40 and sCD40L levels were detected using ELISA.Results The total effective rate of the study group(92.50%)was significantly higher than that of the control group(75.00%)(P<0.05).CD3+CD4+,CD4+/CD8+,The expression levels of sCD40 in plasma were higher than before treatment,CD8+and peripheral blood CD19+CD40+The expression levels of CD3+,CD40L+cells,and plasma sCD40L were lower than before treatment;Research group CD3+CD4+,CD4+/CD8+,The expression level of sCD40 in plasma was higher than that in the control group,CD8+,And peripheral blood CD19+CD40+The expression levels of CD3+CD40L+cells and plasma sCD40L were lower than those of the control group(P<0.05).The CD40L+cells on the surface of peripheral blood platelet membranes after two treatment groups were lower than before treatment;The CD40+on the surface of peripheral blood platelet membrane in the study group was higher than that in the control group,CD40L+cells were lower than those in the control group(P<0.05).The total adverse rate of the study group(15.00%)was lower than that of the control group(22.50%),but there was no significant difference between the two groups(P>0.05).Conclusion The treatment of ITP in children with eltrombopag olamine tablets has good clinical effi-cacy,regulates the level of T lymphocyte subsets,and is safe.