Objective: To examine the associations of pet ownership and daily outdoor activity duration with depressive symptoms in middle school students, so as to provide evidence for targeted prevention strategies of depressive symptoms in middle school students. Methods: Using a stratified cluster random sampling method, 83 601 middle and high school students from 103 districts and counties in Inner Mongolia Autonomous Region were selected in 2024. A questionnaire survey was conducted to collect demographic data, household pet ownership, outdoor activity duration, and depressive symptoms of the research subjects. The comparison of reporting rates of depressive symptoms among different groups of middle school students was conducted using a χ 2 test. The association between pet ownership and outdoor activity duration and depressive symptoms among middle school students was evaluated using a Logistic regression model, and stratified analysis was conducted among different genders and regions to control for potential confounding factors and evaluate the stability of the association. Results: The prevalence of depressive symptoms among middleschool students in Inner Mongolia was 17.2%. Significant differences in depressive symptom reporting rates were observed across sex, grade, ethnicity, surveillance site, parental education, menarche/spermarche status, boarding status, smoking and alcohol use, daily breakfast consumption, school bullying, continuous 30 minute headphone use in a noisy environment, and often use the Internet ( χ 2=8.07-2 672.57, all P <0.01). Both pet ownership ( OR =0.78, 95% CI =0.75-0.81) and ≥2 h/d of outdoor activity( OR =0.81, 95% CI =0.78-0.84) were inversely associated with depressive symptoms;compared to the without owning pets and < 2 h of outdoor activity daily group, students who both owned pets and engaged in ≥2 h of outdoor activity daily had an even lower risk ( OR =0.83, 95% CI =0.78-0.87)(all P <0.05). Conclusion Pet ownership and increased daily outdoor activity duration may help mitigate depressive symptoms among middle school students.

Objective: To analyze the prevalence trends of different types of elevated blood pressure and their association with nutritional status among primary and secondary school students in Inner Mongolia from 2019 to 2024, providing references for targeted prevention strategies. Methods: From September 2019 to 2024, a stratified random cluster sampling method was used to select 12 primary and secondary schools from each league city in Inner Mongolia Autonomous Region. A total of 177 108, 137 758, 190 182, 180 084 , 188 056, 180 351 primary and secondary school students (excluding grades one to three of primary school) were included for physical examination. The correlation between their nutritional status and high blood pressure was analyzed based on the basic situation of 129 821 primary and secondary school students who completed a questionnaire survey at the same time in 2024. Statistical analysis was conducted using a Chi-square test and multiple Logistic regression model. Results: From 2019 to 2024, the detection rates of elevated blood pressure were 13.60%, 13.68%, 17.60%, 17.24%, 14.77% and 15.96%, respectively. The rates for isolated systolic hypertension were 4.24%, 5.83%, 7.26%, 7.19%, 6.24% and 6.93%; isolated diastolic hypertension rates were 6.38%, 4.99%, 6.23 %, 6.41%, 5.39% and 5.66%; and combined systolic and diastolic hypertension rates were 2.97%, 2.86%, 4.11%, 3.65%, 3.14 % and 3.36%. Multivariate Logistic regression analysis showed that girls, junior high school, senior high school, overweight, and obesity were positively associated with elevated blood pressure risk ( OR =1.27, 1.25, 1.32, 1.66, 3.07, all P <0.05); conversely, county residence, Mongolian ethnicity, and other ethnicities showed negative associations ( OR =0.90, 0.93, 0.90, all P <0.05). Conclusions Overweight and obesity among children and adolescents are closely related to various types of elevated blood pressure. Prevention strategies should prioritize effectively controlling weight issues among children and adolescents, thereby effectively reducing the incidence of elevated blood pressure.

OBJECTIVE To investigate the effect and mechanism of gracillin from Reineckia carnea on autophagy in non- small cell lung cancer A549 cells. METHODS Using A549 cells as subjects， the effects of different concentrations of gracillin （0.25， 0.5， 1， 2， 4 μmol/L） on the proliferation of cells were detected by CCK-8 after being treated for different time （12， 24， 48 h）. Compared with the control group without medication， the effect of gracillin （2 μmol/L） on the formation of autophagosomes in cells was observed by transmission electron microscope after 24 h of exposure. The aggregation of GFP-LC3 on autophagosome membrane was detected by GFP-LC3 plasmid transfection after being treated with gracillin （0.25， 0.5， 1， 2 μmol/L） for 24 h. Quantitative real-time PCR and Western blot assay were used to detect the mRNA and protein expressions of family with sequence similarity 102 member A（FAM102A）， the expressions of autophagy-related proteins [p62， Beclin-1， microtubule-associated protein 1 light chain 3B （LC3B）]， and the expressions of phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway-related proteins in A549 cells after being treated with gracillin （0.25， 0.5， 1 and 2 μmol/L） for 24 h. RESULTS Gracillin significantly inhibited the proliferation of A549 cells in a concentration- and time-dependent manner. The IC50 was 2.55 μmol/L at 24 h. After 24 h of gracillin treatment， autophagosomes with bilayer membrane structure were found in the cell cytoplasm， and GFP-LC3 green fluorescent spots on autophagosome membrane were obvious， representing an increasing trend as drug concentration. Compared with the control group， mRNA and protein expressions of FAM102A （0.5， 1， 2 μmol/L groups）， protein expression of Beclin-1 （1， 2 μmol/L groups） and LC3B-Ⅱ/LC3B-Ⅰ ratio （2 μmol/L group） were significantly increased in different concentrations of gracillin groups， while the protein expression of p62 （1， 2 μmol/L groups）， and the protein phosphorylations of Akt （1， 2 μmol/L groups） and PI3K （2 μmol/L group） were all decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS Gracillin can promote excessive autophagy in A549 cells by up-regulating mRNA and protein expressions of FAM102A and inhibiting PI3K/Akt signaling pathway， thus inhibiting cell proliferation.

Objective: To understand smoking behavior and related factors among college and middle school students in Inner Mongolia Autonomous Region, so as to provide a technical basis for targeted tobacco control interventions. Methods: In September 2023, a total of 93 647 students in Inner Mongolia Autonomous Region were randomly selected by stratified cluster sampling from 12 league cities and 103 banner counties (cities districts) to conduct a questionnaire survey. The χ2 test and binary Logistic regression analyses were used to explore the current situation of adolescent smoking and its related factors. Results: The prevalence of college and middle school students who tried smoking was 10.2%, and the prevalence of current smokers was 4.4%. The binary Logistic regression model showed that students in high school, vocational high school, university, males, those from unstable family, boarders, individuals who sew someone smoking at home, at school, in public places, drinking alcohol, inhaling volatile solvents for pleasure, using cough suppressant except for coughing, using sedative without a doctors permission, being scolded by parents, experiencing school bullying, being addicted to the Internet, having depressive symptoms, anxiety symptoms, and low selfesteem were more likely to attempt smoking and currently smoke (attempt smoking:OR=1.38, 2.59, 1.75, 3.24, 1.18, 1.43, 1.25, 1.43, 1.43, 0.79, 9.18, 1.42, 1.17, 1.65, 1.52, 1.31, 1.58, 1.41, 1.11, 1.17； current smoking:OR=1.61, 4.76, 3.76, 4.45, 1.17, 1.44, 1.27, 1.58, 1.69, 0.68, 7.99, 1.64, 1.12, 2.31, 1.48, 1.37, 1.26, 1.31, 1.35, P<0.05). Teenagers with parents who had graduated from high school and eat breakfast every day had a relatively low risk of trying and current smoking (OR=0.78, 0.83, 0.79, 0.84, 0.78, 0.68, P<0.05). Conclusions Adolescent smoking behaviours in Inner Mongolia Autonomous Region exhibit obvious clustering pattern in the school setting. Associated factors includes demographic characteristics, secondhand smoke exposure, daily behaviours and substance abuse, and psychological behaviours. Schools, families and society should work together to create a smokefree environment to protect adolescents from the harms of tobacco.

Objective: To analyse the correlation between unhealthy lifestyles and anxiety symptoms among high school students in Inner Mongolia Region, so as to provide a scientific basis for the prevention of anxiety symptoms among high school students. Methods: From September to November 2023, 35 362 high school students were selected by stratified cluster random sampling method from 12 cities (103 counties) in Inner Mongolia Region, and the survey was conducted by using the questionnaire on student health status and influencing factors. The χ2 test and multivariate Logistic regression analyses were used to determine the influencing factors of anxiety symptoms. Results: The total number of students with anxiety symptoms was 2 747, and the detection rate of anxiety symptoms was 7.77%. The results of multivariate Logistic regression analyses showed that female students, father having higher education background, never eating breakfast, being overweight and obese, sleeping <8 h/d, being scolded by parents in the past 30 days, and depressive symptoms were positively correlated with the anxiety symptoms of the high school students (OR=1.31, 1.23, 1.53, 1.14, 1.22, 1.51,28.92); nonsmoking, having no alcohol consumption, no Internet addiction and no use of sedatives without doctors permission were all negatively correlated with anxiety symptoms of high school students (OR=0.84, 0.73, 0.57,0.40) (P<0.05). Conclusions Anxiety symptoms of high school students are closely related to unhealthy lifestyle. Measures should be taken to improve unhealthy lifestyle, so as to reduce the occurrence of anxiety symptoms in high school students.

Objective: To investigate the value of left ventricular global longitudinal strain( LVGLS) in predicting early chemotherapy related cardiotoxicity in breast cancer patients after chemotherapy． Methods : Eighty-six breast cancer patients were enrolled in this study and received 6 cycles of doxorubicin + cyclophosphamide．Conventional echocardiography parameters were measured before chemotherapy ( T0 ) ，immediately after chemotherapy ( T1 ) ，6 months(T2) and 12 months after chemotherapy ( T3 ) ． LVGLS was obtained by 2D speck tracing imaging (2DSTI) ，and the relative change of LVGLS( △LVGLS) was calculated at T1．With the occurrence of cardiotoxicity as the clinical outcome，receiver operating characteristic ( ROC) curve was plotted．The parameters were analyzed at T1 to evaluate the value of △LVGLS in predicting cardiotoxicity. Results: ① Although the change in LVEF was not different between T0 and T1 (P ＞0. 05) ，LVEF decreased significantly at T2 and T3 (P ＜0. 05) . ② Compared with T0，LVGLS decreased at T1，which was further damaged at T2 and T3 (P＜0. 05) . ③ Seven patients (8. 1% ) developed chemotherapy-related cardiotoxicity．LVGLS and △LVGLS were correlated with cardiotoxicity at T1 stage ，and △LVGLS was more significant ( r = 0. 64，P ＜0. 001 ) . ROC curve analysis showed that a △LVGLS ＞12% at T1 predicted cardiotoxicity，with sensitivity of 92. 2% ，specificity of 76% ，and area under the curve was 0. 88. Conclusion The LVGLS decreased earlier than LVEF in breast cancer patients after doxorubicin treatment. △LVGLS ＞12% is a good predictor of cardiotoxicity in patients with breast cancer.

Objective: To investigate the incidence and associated factors of spinal curvature disorders among primary and middle school students in Hohhot, so as to provide reference for relevant prevention strategies. Methods: According to the monitoring and intervention work of students common diseases in Inner Mongolia Autonomous, 13 586 primary and middle school students in Hohhot were selected by random sampling method to carry out scoliosis examination in September 2021. Results: A total of 538( 4.0% ) students were found to have spinal curvature disorder. Multivariate Logistic regression analysis showed that monitoring site, phases of studying, and persistent back pain in the past 1 month were associated of spinal curvature disorder in primary and middle school students ( OR =0.33, 1.74, 1.28, 1.51, P <0.05). Conclusion Spinal curvature disorder is relatively common in primary and middle school students in Hohhot. Effective measures should be taken to reduce the burden of spinal curvature disorders in primary and middle school students.

Hypertension is the leading risk factor for global mortality and morbidity and those with hypertension are more likely to develop severe symptoms in cardiovascular and cerebrovascular system, which is closely related to abnormal renin-angiotensin system and elabela/apelin-apelin receptor (APJ) axis. The elabela/apelin-APJ axis exerts essential roles in regulating blood pressure levels, vascular tone, and cardiovascular dysfunction in hypertension by counterbalancing the action of the angiotensin II/angiotensin II type 1 receptor axis and enhancing the endothelial nitric oxide (NO) synthase/NO signaling. Furthermore, the elabela/apelin-APJ axis demonstrates beneficial effects in cardiovascular physiology and pathophysiology, including angiogenesis, cellular proliferation, fibrosis, apoptosis, oxidative stress, and cardiovascular remodeling and dysfunction during hypertension. More importantly, effects of the elabela/apelin-APJ axis on vascular tone may depend upon blood vessel type or various pathological conditions. Intriguingly, the broad distribution of elabela/apelin and alternative isoforms implicates its distinct functions in diverse cardiac and vascular cells and tissue types. Finally, both loss-of-function and gain-of-function approaches have defined critical roles of the elabela/apelin-APJ axis in reducing the development and severity of hypertensive diseases. Thus, targeting the elabela/apelin-APJ axis has emerged as a pre-warning biomarker and a novel therapeutic approach against progression of hypertension, and an increased understanding of cardiovascular actions of the elabela/apelin-APJ axis will help to develop effective interventions for hypertension. In this review, we focus on the physiology and biochemistry, diverse actions, and underlying mechanisms of the elabela/apelin-APJ axis, highlighting its role in hypertension and hypertensive cardiovascular injury and dysfunction, with a view to provide a prospective strategy for hypertensive disease therapy.

Objective: To investigate the feasibility of GE11 peptide targeting to brain metastases from epidermal growth factor receptor (EGFR)-positive breast cancer and thereby explore the potential for the construction of specific targeting molecular probe. Methods: The EGFR expression level of triple negative breast cancer cell line (MDA-MB-231-BR) was detected using Western blot and flow cytometry. GE11 peptide targeting property was tested using immunofluorescence staining and flow cytometry in MDA-MB-231-BR cells and in the subcutaneous tumor model. GK-13 peptide was selected as the control peptide. Two-sample t test was used for data analysis. Results: Western blot and flow cytometry showed that EGFR expression in MDA-MB-231-BR cells was 88.60%, significantly higher than those in other cells. Flow cytometry results indicated that the cell binding rate of MDA-MB-231-BR with GE11 peptide (10 μmol/L) was significantly higher than that with control peptide (38.4% vs 0.6%; t=16.941, P<0.01). Cell immunofluorescence staining results showed GE11 peptides were detected with stronger signal after being incubated with cells, and the combination was concentration- and temperature-dependent. In vivo experiment results showed that the signal of GE11 peptide was stronger in tumor site than that in other organs or tissues. Conclusion GE11 peptide may specifically target the brain metastases of EGFR-positive breast cancer.

Objective To investigate the pathological escalation after cervical cone resection in postmenopausal women, and analyze the related influencing factors. Methods A retrospective cohort study was conducted at the Sir Run Run Shaw Hospital,School of Medicine, Zhejiang University between July 2013 and January 2015. Seven hundred and fifty cases of cervical cone-cut were enrolled in this study, 129 cases of them were postmenopausal women, and 621 were premenopausal women. All results of patients'liquid-based thin-layer cytology(TCT), HPV test, colposcopy and biopsy pathology, cervical cone resection and postoperative pathological examination were collected. Then the compliance with the pathological examination results after colposcopic cervical biopsy and cervical cone resection, and the related factors affecting the pathological escalation after cervical cone resection were analyzed. The pathological escalation of patients with different menopausal conditions after cervical cone resection was also analyzed. Results (1)Of the 750 patients, there were 329 patients had the same pathological examination results after colposcopic cervical biopsy and cervical cone resection, which accounted for 43.9％(329/750). And 216 cases demonstrated pathological escalation after cervical cone resection, which accounted for 28.8％(216 / 750). The results of TCT examination and menopause were significantly correlated with the pathological escalation after cervical cone resection(P<0.05). However, the condition of HPV infection was unrelated to pathological escalation after cervical cone resection(P>0.05).(2)Compared with the different results of TCT examination [including non-intrusive load monitoring(NILM), atypical squamous cell of undetermined signification (ASCUS), low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion(HSIL)], the ratio of pathological escalation after cervical cone resection was not statistically significant difference between postmenopausal and non-menopausal patients(P>0.05). The proportion of pathological escalation of patients with >5 years of menopause was significantly higher than that of patients with menopause time ≤5 years(40.3％ vs 27.7％, OR=1.8, 95％CI: 1.1-2.8, P=0.029). Among them, when the result of TCT examination was LSIL, the rate of pathological escalation in patients >5 years of menopause was significantly higher than that in menopause time ≤5 years(6/10 vs 26.3％, OR=4.2, 95％CI: 1.1-15.8, P=0.033). While the results of TCT examination were NILM, ASCUS or HSIL showed there was no statistically significant difference between two groups(P>0.05).(3)Among the 143 cases, of which the result of TCT examination was LSIL, 9 cases of the pathological examination results after cervical resection were escalated to cervical cancer, which accounted for 6.3％ (9 / 143). Among 10 cases of menopause time >5 years, 2 cases(2 / 10)of the pathological examination results after cervical cone resection were escalated to cervical cancer. Among 133 cases with menopause time ≤ 5 years, 7 cases (5.3％)were upgraded to cervical cancer after cervical cone resection. The ratio of pathological escalation to cancer in postmenopausal patients with >5 years was higher than that of menopause time ≤5 years. Due to the data volume limitation, the comparison was not statistically significant difference(χ2=0.460, P>0.05). Conclusions In postmenopausal women, especially when menopausal time is > 5 years, the proportion of pathological escalation after cervical cone resection following colposcopic cervical biopsy is increased. And the pathological escalation after cervical cone resection is significantly correlated with the results of TCT examination and menopausal status. Therefore, doctors should treat the colposcopic biopsy pathological results with caution during clinic. Depending on TCT results, loop electrosurgical excision procedure (LEEP) sampling could be administrated directly in case of avoid missing diagnosis.