Objective: To explore the independent effects and gender differences of different types of adverse childhood experiences (ACEs) on the co-occurrence of non-suicidal self-injury (NSSI) and suicide attempts (SA), so as to provide a reference for the precise prevention and control of self-harm in junior high school students. Methods: From May to June 2023, a total of 7 360 junior high school students were selected from 12 schools in three districts/counties of Chongqing using a combination of stratified cluster sampling and convenience sampling methods. Information on NSSI, SA, ACEs, and depressive symptom, as well as other related data were collected through the Adolescent Non-suicidal Self-injury Assessment Questionnaire (ANSAQ), suicide related section of the Chinese Adolescent Health related Behavior Questionnaire (Junior High School Version), Childhood Trauma Questionnaire-Short Form ( CTQ- SF), and Center for Epidemiologic Studies-Depression Scale (CES-D). Statistical analyses of the data were performed using the Chi-square test and multiple Logistic regression. Results: The detection rates of NSSI, SA, NSSI+SA and ACEs in junior high school students were 19.2%, 4.6%, 3.5% and 57.9% respectively. After controlling for factors such as gender, grade, family type, self rated family economic status, self rated academic performance, self rated academic pressure, number of close friends, and depressive symptom scores, results from the multiple Logistic regression analysis showed that junior high school students with physical abuse ( OR = 1.98, 95% CI =1.23-3.18), emotional abuse ( OR =2.83, 95% CI =1.92-4.19), sexual abuse ( OR = 1.70, 95% CI =1.07- 2.69 ), physical neglect ( OR =1.67, 95% CI =1.20-2.33) and witnessing domestic violence ( OR =2.10, 95% CI =1.41-2.87) in childhood had higher risks for the occurrence of NSSI+SA (all P <0.05). After stratification by gender, boys with sexual abuse in childhood had a high risk for the occurrence of NSSI+SA ( OR =2.17, 95% CI =1.06-4.43), whereas girls with emotional abuse ( OR =3.69, 95% CI =2.29-5.94), physical neglect ( OR =1.62, 95% CI =1.07-2.45) and witnessing domestic violence ( OR =2.17, 95% CI =1.41-3.34) in childhood had hgih risks for the occurrence of NSSI+SA (all P <0.05). Conclusions Different types of ACEs have different effects on the co-occurrence of self-harm in junior high school students and there are gender differences. When family interventions are conducted for the combined model, emphasis should be placed on aspects of emotional abuse and domestic violence while optimizing the interventions based on gender differences.

Objective To investigate the expression of lymphoid enhancer binding factor 1(LEF1)in B cell chronic lymphoproliferative disorders(B-CLPD)and estimate its value in the differential diagnosis of the subtype of B-CLPD.Methods A retrospective study was conducted on 58 patients diagnosed with B-CLPD by using bone marrow biopsy samples or lymphnode biopsy samples from Hematology Department of The Second People′s Hospital of Wuhu from September 2018 to June 2023,as well as 20 bone marrow biopsy samples which were diagnosis as non-hematologic malignancy in the control group.Immunohistochemical method was used to detect the expression of LEF1 in 78 samples,and statistical analysis was conducted.Results In all 78 cases,16 of 20 chronic lymphocytic leukemia(CLL)patients were LEF1 positive,the positive rate was 80%;mantle cell lymphoma 1/12;Follicular lymphoma 1/5;marginal zone cell lymphoma 0/11;Lymphoplasmacyticlymphom 0/8;hairy cell leukemia 0/2;in Control group no patient was LEF1 positive(P = 0.000).The expression of LEF1 is correlated with CD200 and CLL score(P<0.05).In the LEF1 negative group with 4 CLL patients,2 were detected with +12 chromosomal abnormality,the detective rate was higher than that of the LEF1 positive group(P>0.05).Conclusion LEF1 was a sensitive and specific diagnosis marker in CLL and B-CLPD subtype.

ObjectiveTo investigate the effect of Rehmanniae Radix Praeparata on neurological function injury in ischemic stroke rats and explore its mechanism. MethodMale SD rats were randomized into sham operation， model， low- and high -dose （3.5 g·kg^-1 and 7 g·kg^-1） Rehmannia Radix Praeparata， and nimodipine （0.01 g·kg^-1） groups. The rat model of middle cerebral artery occlusion （MCAO） was established with the modified suture occlusion method. Zea-Longa 5-point scoring was employed to evaluate the neurological function of rats. The cerebral infarction volume was detected by 2，3，5-triphenyltetrazolium chloride （TTC） staining. Hematoxylin-eosin staining and Nissl staining were employed to observe the morphology and damage of the brain tissue. Meanwhile， the serum levels of lactate dehydrogenase （LDH）， oxidative stress-related indicators superoxide dismutase （SOD）， glutathione peroxidase 4 （GPX4）， and malondialdehyde （MDA）， and the iron （Fe） content in the brain tissue were determined. To explore the mechanism of Rehmanniae Radix Preparata in mitigating the neurological damage in ischemic stroke rats， Western blotting was employed to determine the expression levels of proteins in the ischemic brain tissue. The autophagy-associated proteins included autophagy effector （beclin-1）， microtubule-associated protein light chain 3 （LC3B）， and ubiquitin-binding protein p62 （p62）. The ferroptosis-associated proteins included transferrin （TF）， transferrin receptor 1 （TFR1）， ferritin heavy chain 1 （FTH1）， and ferropotin （FPN1）. The neurological function injury-associated proteins included brain-derived neurotrophic factor （BDNF） and tyrosine kinase receptor B （TrkB）. ResultCompared with the sham operation group， the model group showed increased neurological function score， cerebral infarction volume， and appearance of nuclear pyknosis and vacuole of cells in the cerebral cortex. In addition， the model group presented elevated levels of LDH， MDA， and Fe （P<0.01） and lowered levels of SOD and GPX4 （P<0.01）. Compared with the model group， Rehmanniae Radix Praeparata decreased the content of LDH， MDA， and Fe （P<0.05， P<0.01） and elevated the levels of SOD and GPX4 （P<0.05， P<0.01）. Compared with the sham operation group， the modeling promoted the expression of beclin-1，LC3B Ⅱ/Ⅰ， TF， and TFR1 and inhibited the expression of p62， FTH1， FPN1， BDNF， and TrkB （P<0.01）. The expression levels of these proteins were recovered after the treatment with Rehmanniae Radix Praeparata. ConclusionRehmanniae Radix Praeparata may inhibit ferroptosis and improve the neurological function in ischemic stroke rats by down-regulating the autophagy level in the brain tissue.

African swine fever(ASF)is a virulent,hemorrhagic disease of swine caused by African swine fever virus(ASFV),which seriously affects the healthy development of Chinese pig indus-try.The genome of ASFV is large and encodes more than 165 proteins.Among them,the p54 pro-tein is encoded by the E183L gene,which has various functions such as participating in viral as-sembly,inducing apoptosis and inducing immune response.The conventional Chinese vaccine(C-strain)is a safe and effective attenuated vaccine developed by Chinese scientists.It can efficiently protect against attacks from various genotypes of classical swine fever virus(CSFV).The aim of this study was to investigate whether C-strain can express ASFV p54 protein serve as a delivery vector for ASF genetically engineered vaccines.An infectious clone of pHCLV-p54 was constructed by homologous recombination,the recombinant virus rHCLV-p54 was rescued by transfecting it into SK6 cells by blind passaging.Its genetic stability and growth curve were determined in vitro,while rabbits were immunized to evaluate its immunity effect.The results showed that the E183L gene remained genetically stable in the recombinant virus,indicating that the E183L gene could be stably inherited in recombinant viruses,but the inserted exogenous gene affected the replication of the C-strain.The results of the rabbit immunization test showed that the recombinant virus rHCLV-p54 was able to induce ASFV-specific antibodies.The above results indicated that we have successfully constructed a recombinant C-strain that stably expresses the ASFV p54 protein.In summary,the recombinant virus rHCLV-p54 has a good immunogenicity and is warranted for fur-ther evaluation as a vaccine candidate.

Objective To summarize the clinical characteristics,treatment regimen and clinical outcomes of infantile hepatic hemangioma(IHH)with high-output heart failure(HHF).Methods A retrospective analysis was conducted on 3 IHH infants with concomitant HHF admitted to the Children's Hospital of Chongqing Medical University during October 2020 and October 2023.The characteristics,treatment plans and efficacy were analyzed in the 3 cases.CNKI,WANFANG DATA,Chinese Medical Association Journal Full-text Database,and PubMed databases were retrieved to search domestic and foreign literature concerning the diseases,and the enrolled cases were analyzed and reviewed.Results Among the 3 infants,they were 1 male and 2 females,and aged 1 d,19 d and 80 d,respectively.The main clinical symptoms were dyspnea and respiratory distress.All 3 patients rapidly progressed to respiratory failure,pulmonary hypertension and heart failure after admission.Diffuse IHH was diagnosed in 2 cases and focal IHH in 1 case.One case of diffuse IHH underwent percutaneous hepatic artery embolization,and the cardiopulmonary function recovered on the day of surgery,and the ventilator was removed.In the other 2 cases,propranolol combined with steroid medication was used,and the estimated right ventricular systolic pressure and E wave to A wave mitral flow ratio(E/A)were the most sensitive indicators in echocardiographic monitoring.There were 24 cases included in literature review,with 4 cases of treatment failure and death,3 cases of remission,and 17 cases of complete recovery.Conclusion Propranolol combined with steroid medication and percutaneous hepatic artery embolization are effective in treating IHH complicated with HHF.Right ventricular systolic pressure and E/A during drug therapy might be early sensitive marker for the early evaluation of potential therapeutic effects of drugs.

Gastroesophageal reflux disease （GERD） is a frequently and commonly occurring disease in clinic. In recent decades， with the development in pathophysiology and drug researches， modern medicine has achieved remarkable progress and results in diagnosis and treatment. However， the treatments for non-erosive reflux disease， refractory gastroesophageal reflux disease， proton pump inhibitor resistance， overlap of disease symptoms， and extraesophageal symptoms are limited and ineffective. Traditional Chinese medicine （TCM） was widely used in clinical practice， which has been proved effective in relieving symptoms and improving the quality of life. Sponsored by China Association of Chinese Medicine （CACM） and undertaken by the Spleen and Stomach Disease Branch of CACM， "the 12^th Youth Salon of Clinical Predominance Disease Series （GERD）" invited 18 authoritative digestive experts of TCM and western medicine to discuss "the difficulties of clinical diagnosis and treatment of GERD and TCM advantages". The focus issues such as modern medical diagnosis and treatment achievements and contributions， improvement and maintenance of symptoms， response to overlapping disease symptoms， reduction and withdrawal of acid suppressors， and treatment of extra-esophageal symptoms were discussed in depth. TCM and western medicine exchanged and complemented each other's strengths， combing the difficulties of modern medical diagnosis and treatment， which clarified the positioning and advantages of TCM and provided guidance for clinical and scientific research.

Objective:To screen and diagnose cervical lesions in middle-aged and elderly postmenopausal women and analyze the characteristics of cervical lesions in middle-aged and elderly women.Methods:A retrospective analysis was conducted on the screening data of 1 337 postmenopausal women aged between 50 and 86 years who visited the outpatient clinics of the gynecology department of Beijing Hospital between January, 2015 and December, 2019.Participants were divided into groups based on age, with 787 in the 50-59 years old group, 483 in the 60-69 years old group, 60 in the 70-79 years old group, and 7 in the 80-89 years old group.Exfoliated cervical cells were collected, and high-risk human papillomavirus(HPV)detection and liquid-based cervical cytology examination were performed to confirm the diagnosis based on the pathological results of cervical biopsy.Cervical lesions were analyzed.Results:53.0%(708)of the 1 337 enrolled patients made their hospital visits because of symptoms.There were 666 patients(49.8%)with cervical lesions, including 357 with low-grade squamous intraepithelial lesions(LSIL), 252 with high-grade squamous intraepithelial lesions(HSIL)and 57(4.3%)with cervical cancer.The 70-79 group showed the highest incidence of HSIL at 30.0%(18/60), while the 50~59 group had the highest incidence of LSIL at 30.6%(241/787), and there were significant differences in different types of cervical lesions between different age groups( χ2=28.919, P<0.01). Liquid-based cervical cytology examination revealed a positive rate of 51.6%(166/322)for LSIL, a positive rate of 70.8%(143/202)for HSIL, and a rate of 71.4%(25/35)for cervical cancer.There were significant differences in LSIL, HSIL and other above-mentioned positive rates of lesions( P<0.05). In the cervical malignancy group, cytological high-grade squamous epithelial lesions made up 51.4%(18/35). Intraepithelial lesions or cancerous lesions represented 29.2%(59/202)in the HSIL group.The rate of intraepithelial lesions or cancerous lesions in the LSIL group was 48.4%(156/322), with statistically significance in these differences( χ2=118.806, P<0.01). Chronic cervicitis was found in 52.9%(109)of 206 patients with atypical squamous cells and positive HPV, and in 76.2%(16)of 21 patients without HPV.HPV examination was completed in 1 301 patients, with 69.4%(903)having infections by one HPV strain and 30.6%(398)having infections by mixed HPV strains.Biopsy results showed that the rates of HPV infections in LSIL, HSIL and cancer patients were 84.6%(302/357), 95.9(185/193)and 100%(54/54), respectively, and the differences in these pathological results were statistically significant( P<0.01). HPV16 was the most common subtype in single HPV strain infections.The most common subtypes of HPV infections in cervical lesions with HSIL and above were HPV16 and HPV18.The agreement rate was 52.4%(187/357)for LSIL, 60.7%(153/252)for HSIL, and 64.9%(37/57)for cervical cancer between diagnoses based on cervical biopsy and those based on colposcopy.As the severity of lesions increased, the accuracy of colposcopy also increased.Differences between colposcopic diagnosis and pathological diagnosis on different types of cervical lesions were statistically significant( χ2=550.382, P<0.01).1 310 patients underwent endocervical curettage, identifying 120 cases of HSIL and 39 cases of cervical cancer, with a detection rate of 55.8%(159/285). Conclusions:The incidence of cervical cancer is high in elderly women.The incidences of high-grade lesions and cervical cancer in patients with atypical squamous cells plus HPV infections in the cervix are also high.Postmenopausal patients with cervical lesions are mainly infected by a single HPV subtype, with subtype 16 being the most common one.With increasing severity of lesions, the accuracy of colposcopy-based diagnosis increases and the rate of missed diagnosis decreases.Cervical curettage is an important means to reduce missed diagnosis with colposcopy.

Objective:To investigate short-term safety, efficacy and the learning curve of this self-developed novel transcatheter valve repair system (Neonova?) in patients with mitral regurgitation, and explore the role of perioperative echocardiography.Methods:Ten patients who visited the Union Hospital of Tongji Medical College, Huazhong University of Science and Technology from June 2021 to March 2022 and met the inclusive criteria were prospectively enrolled. All the patients were at high risk of surgery with moderate to severe or severe mitral regurgitation (MR). Clamps of Neonova? were implanted under guidance of transesophageal echocardiography and digital subtraction angiography. Clinical outcomes, echocardiography indexes and learning curves of this technique were evaluated immediately after intervention, 7 d, 1 month and 3 months post-intervention.Results:The technical success rate was 100% with MR relieved in all patients immediately after intervention. The device and procedural success rates were both 90.0% with 1 patient received surgical replacement at 37 days post-intervention while the others′ reduced to mild (8/9) and moderate (1/9) MR. New York Heart Association class and the Kansas City Cardiomyopathy Questionnaire improved significantly (all P<0.001). Mean mitral valve pressure gradient didn′t increase significantly after intervention when compared with that before intervention( P=0.324), and no mitral stenosis was observed. Left ventricular end-diastolic diameter decreased significantly ( P=0.008) during follow up.Procedure duration ranged from 60 to 300 (175.8±75.2)minutes. The simple linear regression model between procedure volume and duration showed that procedure duration decreased significantly with the increase of procedure volume ( F=15.857, P=0.004). Conclusions:Neonova? implantation can improve MR severity and clinical symptoms safely and effectively. Transthoracic echocardiography and transesophageal echocardiography are essential for perioperative management of transcatheter mitral valve repair.

Objective : To investigate the clinical application value of chemokine ligand (CCL)21 and its receptor chemokine(CCR)7 in patients with anti⁃neutrophil cytoplasmic antibody associated vasculitis. Methods : The ser⁃ um levels of CCL21 and its receptor CCR7 were measured by ELISA methods in 102 patients with AASV and 70 healthy controls. At the same time , the correlation among the CCL21 , CCR7 , MPO , PR3 and general laboratory index of TNF⁃α , IL⁃6 , BUN , CRE , C3 , C4 ESR , CRP , BVAS in AASV patients was analyzed. Results : The serum levels of the CCL21 and CCR7 were significantly higher in AASV patients than that in healthy controls[(276. 95 ± 57. 34) vs ( 179. 91 ± 19. 45) ; (85. 85 ± 18. 77) vs (54. 83 ± 18. 18) pg/ml](P < 0. 05) . The serum levels of the CCL21 and CCR7 in MPO positive patients were higher than those in MPO negative patients[(294. 94 ± 58. 15) vs (244. 35 ± 46. 76) ; (90. 64 ± 18. 38) vs (78. 37 ± 13. 44) pg/ml] ( P < 0. 05 ) . Moreover, The levels of the CCL21 and CCR7 were similar to those of TNF⁃α , IL⁃6 , CRE , BUN , CRP , BVAS and MPO in AASV patients, the levels of the CCL21 and CCR7 in AASV patients were positively correlated. The serum levels of the CCL21 and CCR7 were found to be predictive of AASV activity with ROC. Conclusion The serum level of CCL21 and CCR7 in AASV patients increased significantly , especially in MPO positive patients , and related to patients with renal function index and related inflammation index. Serum CCL21 and CCR7 are the influencing factors of BVAS in AASV patients , and have important significance in the diagnosis and judgment of AASV disease.

OBJECTIVE To co mpare the difference of liposoluble constitue nts in different processed products of Huaizhong No.1 Rehmannia glutionsa （fresh R. glutionsa ，R. glutionsa and prepared R. glutionsa ），and to evaluate its in vitro antioxidant activity preliminarily. METHODS Liposoluble extracts were extracted from 3 processed products of R. glutionsa by Soxhlet extraction. Their constituents were analyzed by gas chromatography-mass spectrometry. The spectral library of NIST 98 system was used to automatically retrieve the mass spectrum information of components ，and the structures of compounds were identified in combination with relevant literature and by comparing with eight peak index and EPA/NIH library. Relative contents of the components were calculated by using peak area normalization method with Hewlett Packard software. The antioxidant activities of liposoluble constituents in 3 processed products of R. glutionsa were investigated by 1，1-diphenyl-2-picrylhydrazyl（DPPH）free radical scavenging. RESULTS A total of 79 liposoluble components were identified from different processed products of R. glutionsa，and 48，52 and 37 liposoluble compounds were identified from fresh R. glutionsa ，R. glutionsa and prepared R. glutionsa，respectively；their relative contents accounted for 92.69％，86.29％，92.89％ of the total components respectively. Among them ，there were 20 liposoluble compounds totally ，and their relative contents accounted for 88.73％，80.89％ and 85.87％ of liposoluble components in each processed product respectively ；they were mainly composed of fatty acids such as methyl linoleate，methyl palmitate and methyl oleate. In addition ，there were 18 unique liposoluble components in fresh R. glutionsa ， mostly terpenoids ；there were 17 and 6 unique liposoluble components in R. glutionsa and prepared R. glutionsa ，mostly alkanes. The results of antioxidant experiment showed that median scavenging concentrations of liposoluble components to DPPH limeng free radical were 0.756，0.660，0.758 mg/mL，respectively. CONCLUSIONS The common liposoluble components in different processed products of R. glutionsa are mostly acids；the unique liposoluble components in fresh R. glutionsa are mostly terpenoids ，and those of R. glutionsa and prepared R. glutionsa are mostly alkanes ；the liposoluble constituents possess in vitro antioxidant activities.