BackgroundDepression is a prevalent emotional problem in adolescents， and parental psychological control is an important predictor of adolescent depression. However， existing research on the acting mechanism between the two is not adequate. ObjectiveTo explore the pathway of negative perfectionism and academic stress between parental psychological control and depressive symptoms among secondary school students， so as to provide references for reducing the incidence risk of depression in such population. MethodsFrom February to April 2023， 1 100 students across 2 middle schools and 2 high schools in Zhongshan city were selected as subjects. The survey was conducted adopting Parental Psychological Control Questionnaire， Chinese Frost Multidimensional Perfectionism Scale （CFMPS）， sense of academic stress subscale in Mental Health Inventory of Middle School Student （MMHI-60） and Center for Epidemiological Studies-Depression Scale （CES-D）. Spearman correlation analysis was adopted to examine the correlation between scores of all scales above， and Amos 24.0 was used to test the mediating path of negative perfectionism and academic stress between parental psychological control and depressive symptoms among secondary school students. ResultsAmong the 1 009 valid questionnaires withdrew （91.73% of the total）， 261 students were detected to have depressive symptoms （25.87%）. As the results of Spearman correlation analysis showed， the scores of the Parental Psychological Control Questionnaire， score of negative perfectionism dimension in CFMPS， score of sense of academic stress subscale in MMHI-60 and CES-D score were positively correlated with each other （r=0.323~0.644， P<0.05 or 0.01）. The direct effect value of parental psychological control on depressive symptoms in secondary school students was 0.128 （95% CI： 0.061~0.201）， accounting for 31.37% of the total effect. Negative perfectionism and academic stress played independently as intermediatory roles between parental psychological control and depressive symptoms in secondary school students， and the indirect effect values were 0.099 （95% CI： 0.068~0.133） and 0.100 （95% CI： 0.060~0.143）， accounting for 24.27% and 24.51% of the total effect， respectively. Negative perfectionism and academic stress acted combinedly as the chain effect pathway between parental psychological control and depressve symptoms in secondary school students， with the indirect effect value of 0.081 （95% CI： 0.060~0.106） accounting for 19.85% of the total effect. ConclusionParental psychological control can affect the depressive symptoms among secondary school students directly， and through independent or chain paths of negative perfectionism and academic stress indirectly. ［Funded by Zhongshan Social Welfare Technology Research Project （number， 2022B1060）］

More and more evidence shows that there is a close relationship between the inflammatory state and coronary heart disease. Inflammatory state triggers the damage of vascular endothelium in the early stage of coronary heart disease and ultimately mediates the formation of atherosclerotic plaque. The mechanism of occurrence and development of heart disease is of great significance. Phlegm is a pathological product formed by the subtle imbalance of the spleen and stomach in the transportation and transformation of water and grain. It is the general summary of a series of abnormally accumulated inflammatory substances， such as low density lipoprotein， inflammatory cells， and inflammatory factors. The nature of Phlegm determines the invasiveness and turbidity of Phlegm. Phlegm invades the meridians， causing damage to the meridians and gradually accumulating， which eventually causes the local meridian damage to aggravate. This process is similar to the persistent damage of the vascular endothelium caused by inflammation. Phlegm blocks the meridians， affects the operation of Qi and blood， causes Qi stagnation and blood stasis， and finally forms the outcome of heart and blood stasis. This process is similar to the mechanism of atherosclerotic plaques formed by continuous inflammatory damage. Heart blood stasis， depression and heat， heat toxin endogenous， forming the syndrome of heat toxin stasis， which is similar to the process of atherosclerotic plaque rupture and thrombosis causing acute cardiovascular events.The formation of Phlegm is rooted in the deficiency of spleen. Based on the ''phlegm，stasis，toxin'' theory， spleen deficiency is the intrinsic pathogenesis of the inflammatory state of coronary heart disease， and the invasion of phlegm， blood stasis of heart， heat and blood stasis are the evolution of inflammatory damage of coronary heart disease. Traditional Chinese medicine differentiation and treatment is based on strengthening the spleen and nourishing Qi to treat the root and removing phlegm and blood stasis， and clearing heat and detoxifying to treat symptoms. The related Chinese medicine compounds， Chinese patent medicines， and single Chinese medicines can reduce the inflammatory indicators of coronary heart disease， thereby improving the prognosis of coronary heart disease.

Bipolar disorder （BD） is a serious chronic emotional disorder with a high suicide rate and a common psychiatric disease. Traditional Chinese medicine （TCM） treatment based on syndrome differentiation of BD has unique advantages and good safety， which is expected to become a breakthrough in the treatment. Based on Expert Consensus on TCM Syndrome Differentiation Criteria for Bipolar Disorder by Professor Yin Dongqing and Professor Jia Hongxiao， this study collated the treatment protocols of BD with various syndrome types according to Meta-analysis of the existing literature in the database and evaluated the evidence level according to the evidence evaluation standard issued by the US Agency for Healthcare Research and Quality （AHRQ）. （1） Depression attack. ① Liver depression and spleen deficiency syndrome： Xiaoyaosan pills or Shugan Jieyu capsules， ② Phlegm dampness and spleen stagnation syndrome： Wendantang modified with Tianwang Buxindan， ③ Heart and spleen deficiency syndrome： Jiuwei Zhenxin Granules or DANG's Ganmai Dazhaotang， ④ Fire heat and internal depression syndrome： Danzhi Xiaoyaosan Granules or Chaihu Longgu Mulitang， ⑤ Liver and kidney deficiency syndrome： JIANG's Buganshen Decoction. （2） Mania episode. ① Heart and liver fire hyperactivity syndrome： Zhengan Ningshen Formula， ② Phlegm heat harassing spirit syndrome： Huatan Xiehuo Dingshen decoction， Lianzhi Tongqiao Anshen decoction， Qingshen Dingkuang decoction or Qingshen Xingnao decoction， ③ Liver and gallbladder dampness-heat syndrome： Longdan Xiegantang. （3） Other syndrome types. ① Liver qi stagnation syndrome： modified Tongqiao Huoxue decoction， Shengyang Yiwei Acupuncture， ② Deficiency of kidney yang syndrome： Jingui Shenqitang， ③ Phlegm accumulation and blood stasis syndrome： modified Tongqiao Huoxue decoction， ④ Qi and Yin deficiency， stagnation of blood stasis syndrome： Xinnaoxin pills， ⑤ Syndrome of blood deficiency generating wind and fire heat harassing spirit： Fangji Dihuangtang.

Autophagy is a lysosome-dependent intracellular degradation process，and it is a key mechanism of diabetic cardiomyopathy （DCM）. Autophagy has dual regulatory effects on DCM. Under physiological conditions，normal autophagy can promote the decomposition of damaged cardiomyocytes and metabolites，so as to reduce the damage of harmful substances to the body and provide energy for cardiomyocytes. Under pathological conditions，the inhibited autophagy of cardiomyocytes will cause the accumulation of damaged cells and metabolites，which will cause damage to cardiomyocytes and eventually aggravate cardiac dysfunction in the patients with DCM. However，the over autophagy of cardiomyocytes will lead to autophagic death of a large number of cardiomyocytes and result in pathological myocardial remodeling and cardiac dysfunction，thus promoting the progression of DCM. Therefore，the restoration of a normal autophagy level is the key means to protect cardiomyocytes and improve the prognosis of DCM. Chinese medicine can regulate autophagy to treat DCM. Specifically，it can promote autophagy （making up for deficiency） or inhibit autophagy （removing excess） to restore the balance of autophagy，thereby alleviating DCM.

Atherosclerotic cardiovascular disease is a common disease with high incidence rate and mortality worldwide. Atherosclerosis is an important pathological basis for the formation of ischemic cardiovascular diseases such as cardiovascular disease， which is related to inflammation， oxidative stress， apoptosis， vascular endothelial damage， foam cell formation， platelet activation， and so on， involving mitogen-activated protein kinase （MAPK）， phosphoinositide 3-kinase/protein kinase B （PI3K/Akt）， cyclic adenosine monophosphate/protein kinase A （cAMP/PKA）， Ras homolog gene family member A （RhoA）/Rho-associated coiled-coil containing protein kinase （ROCK）， nuclear factor-kappa B （NF-κB）， and other signaling pathways. In the past few decades， high-intensity statins were mainly used to treat atherosclerosis by reducing blood lipid levels， which usually caused obvious side effects. Therefore， the development of safer and more effective drugs and treatment modes is the focus of research at this stage. In recent years， Chinese medicine has been playing an increasingly important role in the prevention and treatment of cardiovascular diseases in China. There are many studies on the mechanism of Chinese medicine in the prevention and treatment of atherosclerosis， and it is found that a variety of single Chinese medicine regulate the formation process of atherosclerosis by regulating targeted signal molecules. This paper reviewed the research results of related signaling pathways involved in the pathological formation of atherosclerosis and the mechanism of Chinese medicine in the prevention and treatment of cardiovascular diseases， thereby providing references for the clinical treatment of cardiovascular diseases.

Objective: To explore the influence of adverse childhood experiences (ACEs) on pubertal development of boys and girls and to provide a reference for the development of intervention measures. Methods: A stratified cluster sampling method was used to select a total of 1 156 students in grades three and four in the boarding school system and public primary schools in Huangshan City and surrounding towns in September 2018, using the Childhood Trauma Questionnaire (CTQ) and the Pubertal Development Scale (PDS). For the baseline self-assessment survey, according to different dimensions, abuse children score no exposure groups. Children were divided into an exposure group and a high exposure level group, according to their childhood experiences. PDS self-report questionnaire was administered two years later, and an analysis of ACE type and severity of the continuous impact of youth development was conducted. Results: In the baseline survey, there were 53 girls (11.32%) and 51 boys (7.41%) who developed earlier. The rate of early development in girls was higher than that of boys, and the difference was statistically significant(χ 2=5.21, P<0.05). Univariate analysis showed gender differences in the effects of type and severity of ACEs and abuse on adolescent development at both baseline and follow-up. There were gender differences in the rate of early development between boys and girls at baseline and at follow-up between the exposure groups. Regression analysis showed that the higher the degree of emotional abuse, emotional neglect, and sexual abuse in girls, the higher the PDS score(B=0.22, 0.15, 0.08, P<0.05). In boys, the more severe the emotional abuse experienced, the higher the PDS score, and the more severe the physical abuse experienced, the lower the PDS score(B=0.20, 0.04, P<0.05). Conclusion Attention should be paid to the influence of ACEs and gender differences during youth development among male and female students, and more longterm studies should also be carried out.

Objective To compare the agreement of central vault measurements between anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM) in the eyes with posterior chamber phakic intraocular lens implantation and analyze the association sculus to sculus (STS) diameter and white-to-white (WTW) diameter of cornea with central vault.Methods A cross-sectional study was carried out.Medical records of 150 phakic eyes of 75 myopic patients who underwent implantable collamer lens (ICL) surgery for the correction of myopia were collected in Chongqing Aier Eye Hospital from December 2017 to March 2018.The postoperative central vault were measured with AS-OCT and UBM.Intraclass correlation coefficient (ICC) and Bland-Altman plot were used to evaluate the repeatability and agreement of the measurements between two devices.The affecting factors of central vault measurements were assessed.Results Mean central vault in the 150 phakic eyes after ICL surgery was (0.73±0.25)mm by AS-OCT and (0.76-±0.31)mm by UBM,respectively with the ICC of 0.91 for the measurements of AS-OCT and UBM.Bland-Altman analysis showed that the 95％ limits of agreement of central vault measurements were-0.38-0.31 mm between the two devices.Five values were beyond the 95％ consistency interval,and the maximum absolute value of the difference was is 0.31 mm,which was beyond the clinical acceptable range,showing an non-interchangeable difference in the central vault measurements between the devices in ICL implanted eyes.WTW was a affecting factor for vault with a regression equation of Y=0.145 3X-0.960 1 (t =2.272,P＜0.05).Horizontal and vertical STS were the indirect affecting factors for vault by the association with WTW with the regression equation of Y=0.524 1X+5.362 4 and Y=0.613 4X+4.658 3,respectively.Conclusions Central vault measured by UBM is higher that than AS-OCT after ICL surgery,and the measurements are uninterchangeable between the two devices.Accurate measurement of STS distance is essential for the selection of appropriate lens before operation.

ObjectiveTo investigate the clinical feature, management, outcome and prognosis of chest pain during pregnancy.MethodsClinical data of 13 gravidas with chest pain admitted to the Fujian Medical University Union Hospital from January, 2013 to December, 2017 were analyzed retrospectively.Results Among the 13 cases, nine had acute chest pain (happen within 72 hours); two had chronic chest pain lasting over one month, and the other two had paroxysmal subacute chest pain (72 h to less than 30 d). Seven cases were complicated by cardiogenic disease/death including six with aortic dissection (patients No.1-6) and one with myocardial infarction (patient No.7). The remaining six cases were complicated by a variety of different non-cardiac conditions including transverse colon cancer (patient No.8), spontaneous pneumothorax (patient No.9), reflux esophagitis (patient No.11), intercostal neuralgia (patient No.12), acute leukemia (patient No.13) and idiopathic disease (patient No.10). Eight women underwent cesarean section, three delivered vaginally (patients No.8, No.10 and No.12), and two (patients No.7 and No.13) were aborted in the first trimester. Patient No.7 chose abortion in early pregnancy, 12 days after stent implantation, and was lost to follow up after discharge. Patient No.13 underwent induced abortion following two courses of chemotherapy against acute leukemia and was also lost to follow up. Patient No.2 died due to the septic shock and subsequent multi-organ dysfunction syndrome after cesarean section and aortic surgery. The remaining ten cases did not report any abnormalities during follow-up. Among the 11 neonates, seven were preterm infants. All of the 11 babies were normal in follow-ups except one preterm infant (case 8) showed growth retardation at 11 months old.ConclusionsChest pain during pregnancy may be caused by various reasons, and the severity varies greatly, and may even result in maternal and infant deaths in some circumstances. Early identification diagnosis and timely intervention are required to improve maternal and fetal outcomes.

Objective To explore the clinical efficacy of knee osteoarthritis treated by abdominal acupuncture combined with sodium hyaluronate injected in intraarticular.Methods 120 patients with knee osteoarthritis were randomly divided into observation group and control group,60 patients in each group.The observation group was treated by abdominal acupuncture combined with sodium hyaluronate injected in intraarticular.The control group was treated with intraarticular injection of sodium hyaluronate alone.Results After a follow up of 6 months, the total effective rate of the treatment group was 95.00%,which was higher than 78.33% of the control group, the difference was statistically significant (x2=7.21,P<0.01).Conclusion Abdominal acupuncture combined with intraarticular injection of sodium hyaluronate is a good way to treat middle and old age patients with knee osteoarthritis.

Objective To explore the effects of exercise instruction during the whole course of pregnancy by mobile phone APP on master of pregnancy motor knowledge, body movement during pregnancy and gestation related index. Methods Totals of 186 pregnant women who received prenatal examination during early pregnancy were selected. They were divided into intervention group (n=96) and control group (n=90) according to random number table. Patients in the intervention group received exercise instruction during the whole course by mobile phone APP involving pushing pregnancy motor knowledge at regular intervals, sharing authoritative movement method, reminding the time of further consultation and arranging experts for response to messages of pregnant women and so on. Patients in the control group accepted routine exercise instruction with the existing model of pregnancy movement. The master of pregnancy motor knowledge, body movement during pregnancy and gestation related index were compared. Results The total scores of the master of pregnancy motor knowledge in the intervention group and the control group were (77.22±7.07) and (63.31±5.91) with a significant difference (t=14.592, P< 0.001). There was a statistically significant difference in the average total energy consumed per week between the intervention group (154.62±20.74) MET-hours and the control group (105.48±15.81) MET-hours (t=18.240, P< 0.001). Besides, the differences in pregnancy weight gain, antenatal weight, postpartum BMI and pelvic floor muscle strength between two groups were significant (t=-7.715, -4.438, -9.805, 13.988; P< 0.001). The amount of vaginal bleeding, cesarean section rate, perineotomy rate with spontaneous labor during the second stage, total stage of labor and two hours after delivery in the intervention group were lower than those in the control group with significant differences (P< 0.05). Conclusions The exercise instruction during the whole course of pregnancy by mobile phone APP can improve the master of pregnancy motor knowledge and increase the energy consumed during pregnancy, so as to improve the gestation related index, reduce the cesarean section rate and perineotomy rate with spontaneous labor. It is better than the existing model of pregnancy movement.