Objective To analyse the distribution characteristics and drug resistance of multidrug-resistant bacteria infections in patients with diabetic foot ulcers, and to investigate the relevant risk factors affecting the infection of multidrug-resistant bacteria in patients with diabetic foot ulcers. Methods We selected 352 patients with diabetic foot ulcers admitted to our hospital from January 2021 to December 2023, and retrospectively collated and analysed the clinical data of all patients, collected the ulcer wound specimens of all patients, analysed the infection of multidrug-resistant bacteria and bacterial resistance, compared the differences in the relevant data of patients with different infections, and analysed the risk factors affecting the patients with diabetic foot ulcers by using multivariate logistic regression model. Multiple logistic regression model was used to analyse the risk factors affecting patients with diabetic foot ulcers infected with multi-drug resistant bacteria. Results A total of 352 patients with diabetic foot ulcers, 20.45% developed multidrug-resistant bacterial infections, and a total of 91 strains of bacteria were detected, with the predominant strains being Staphylococcus aureus (41.76%), Pseudomonas aeruginosa (24.18%) and Enterobacteriaceae (21.98%).Compared with uninfected patients, patients with MDRI had a longer duration of diabetes, longer duration of ulcers, a higher proportion of Wagner grade 3-5, ischaemic ulcers, multiple hospitalisations, combined osteomyelitis, larger ulcers, and a longer duration of antibiotic use (P < 0.05).Multifactorial analysis showed that long duration of diabetes mellitus, high Wagner grading, long duration of ulcer, large ulcer size, multiple hospitalisations, prolonged antibiotic use, and comorbid osteomyelitis were all risk factors for MDRI (P < 0.05). Conclusion Patients with diabetic foot ulcers are at risk of multi-resistant bacterial infections, and longer duration of diabetes mellitus, Wagner grade 3-5, longer duration of ulcers prior to hospitalisation, larger ulcer size, hospitalisation for the same wound >2 times/year, prolonged use of antibiotics prior to hospitalisation, and comorbidity with osteomyelitis can increase the risk of multi-resistant bacterial infections in patients with diabetic foot ulcers, therefore, controlling and reducing multi-resistant bacterial infections is the key to improving the prognosis of patients with diabetic foot ulcers.

Objective: To explore the association between peer victimization and psychotic like experiences (PLEs) among junior high school students, so as to provide a scientific basis for preventing adolescent PLEs. Methods: In January 2024, a method of combining convenient sampling with cluster sampling was used to survey 2 760 students from two ordinary junior high schools in southern Anhui Province (Susong Country,Anqing City). The Community Assessment of Psychic Experiences (CAPE) and the Adolescent Peer Bullying Scale were employed to assess PLEs with different symptoms and peer victimization (verbal, physical, relational, and cyberbullying). Multivariate Logistic regression models analyzed the associations of different types peer victimization and PLEs with different symptoms. Results: The prevalence of PLEs was 17.5%, with delusional (15.4%) and hallucinatory (7.4%) symptoms being most common. Peer victimization was reported by 51.3% of students (49.6% victims, 19.5% perpetrators), with verbal victimization being most frequent (42.4% victims, 15.5% perpetrators) and cyberbullying least frequent (6.0% victims, 1.9 % perpetrators). Compared to students without bullying,students exposed to bullying showed significantly higher rates of delusional ( χ 2=29.09-127.22), hallucinatory ( χ 2=27.23-72.29), and overall PLEs ( χ 2=34.32-127.25) (all P <0.01). After adjusting for relevant confounding factors,the multiple Logistic regression model revealed verbal victimization increased risks of delusions ( OR=1.59, 95%CI =1.22-2.09), hallucinations ( OR=1.94, 95%CI =1.33-2.84), and overall PLEs ( OR=1.62, 95%CI = 1.26- 2.09); relational victimization was associated with delusions ( OR=1.83, 95%CI =1.40-2.39) and PLEs ( OR=1.65, 95% CI = 1.28-2.13); physical victimization correlated with hallucinations ( OR=1.64, 95%CI =1.12-2.40) and PLEs ( OR=1.41, 95%CI =1.06-1.87) (all P <0.05). Conclusion Specific types of peer victimization are differentially associated with PLEs, with relational victimization demonstrating the strongest association.

Objective:To explore the correlation between subclavian artery stenosis disease (SASD) classification and posterior circulation ischemia.Methods:A retrospective study was performed; the clinical data, and Doppler vascular ultrasound and vascular imaging results of 81 SASD patients, admitted to Cerebrovascular Stenosis Diagnosis and Treatment Center, Second Affiliated Hospital of Qiqihar Medical College and Department of Neurology, Rocket Force Specialty Medical Center from May 2018 to August 2023, were collected. SASD was categorized into 2 types (single type and concurrent type) based on the presence or absence of other posterior circulation artery (basilar artery, vertebral artery, or subclavian artery distal segment) stenosis/occlusion, and into 3 groups (non-posterior circulation ischemia group, posterior circulation transient ischemic attack group and posterior circulation cerebral infarction group) based on the presence or absence of posterior circulation ischemia. Blood stealing pathways in different SASD classifications were analyzed, and correlation of SASD classification with posterior circulation ischemia was discussed.Results:Single-type SASD was noted in 44 patients (54.3%), mainly initiating blood stealing through the vertebral artery to the vertebral artery and then to the subclavian artery ( n=26); concurrent-type SASD was noted in 37 patients (45.7%), mainly initiating blood stealing through the occipital artery to the costocervical trunk and then to the subclavian artery ( n=10). Sixty-five patients (80.2%) were into the non-posterior circulation ischemia group, 4 (4.9%) into the posterior circulation transient ischemic attack group and 12 (14.8%) into the posterior circulation cerebral infarction group. Among the 44 patients with single-type SASD, 39 did not have posterior circulation ischemia, and 3 had posterior circulation cerebral infarction. Among the 37 patients with concurrent-type SASD, 26 did not have posterior circulation ischemia, and 9 had posterior circulation cerebral infarction. Conclusion:Initiation of blood stealing in SASD patients is related to SASD classification, and concurrent-type SASD patients trend to have posterior circulation ischemia.

Objective: To explore the association between acute stress response during the outbreak of COVID 19 and peer bullying behaviors during the normalized management of COVID 19 among middle school students, and to provide a basis for developing relevant measures for peer bullying prevention. Methods: In December 2020, a total of 2 219 students from two junior middle schools in South Anhui(Xuancheng City) and North Anhui(Huaibei City), were selected to participate in this study by using the cluster sampling method. The occurrence of verbal bullying, relational bullying, physical bullying and cyberbullying behaviors among victims and perpetrators of bullying, and self rated acute stress response during the outbreak of COVID 19 (social isolation) were investigated. Multiple Logistic regression models were conducted to explore the relationship between different levels of acute stress response during the COVID 19 outbreak and peer bullying behaviors among middle school students. Results: The reported rate of peer bullying, being bullied by others and bullying others during the COVID19 normalized management were 65.8%, 63.8% and 27.1%, respectively. The reporting rate of verbal bullying victimization was the highest (54.8%) and cyberbullying others was the lowest (4.6%). The mean score of acute stress response among middle school students during the COVID 19 outbreak was (6.50±1.67). Except for physically bullying others, the reported rate of other bullying behaviors was the highest in the high level acute stress response group ( P <0.05). Multiple Logistic regression models showed that high levels of acute stress response were associated with high risk of verbal bullying victimization ( OR =1.38), relational bullying victimization ( OR =2.28), physical bullying victimization ( OR =1.87) and cyberbullying victimization ( OR =2.30) after adjusting for related confounders. In the high level acute stress response group, verbal bullying ( OR =1.80), relational bullying ( OR =1.99), physical bullying ( OR =1.76) and cyberbullying ( OR =2.32) had higher risks of bullying others than in the low level acute stress response group ( P <0.05). Conclusion High levels of acute stress response are associated with different peer bullying behaviors, with stronger associations with cyberbullying.

Objective: To explore the relationship between different types of bullying behavior and depressive symptoms among adolescents, and to provide scientific basis for further prevention of peer bullying. Methods: Based on the follow up data of 1 687 adolescents from Huaibei City, Anhui Province in September 2019 (T1) and September 2020 (T2), the autoregressive cross lagged analysis was employed to explore the relationship between different types of peer bullying and depressive symptoms. Results: The scores of bullying behaviors (physical bullying, verbal bullying, relational bullying and cyber bullying) and depressive symptoms at T2 were lower than those at T1,and the differences were statistically significant ( t =13.60, 8.61,7.24,3.76,8.29, P <0.01). There was a positive correlation between bullying behavior and depressive symptoms ( P <0.01). The results from cross lagged regression analysis showed that physical, verbal, relational and cyber bullying at T1 could positively predict depressive symptoms at T2 ( β = 0.06 , 0.04, 0.12, 0.05), and physical, verbal, relational and cyber bullying at T1 could positively predict depressive symptoms at T2 ( β =0.07, 0.10, 0.13, 0.10) ( P <0.05). Conclusion There were bidirectional associations between adolescent peer bullying and depressive symptoms.

Objective:To investigate the effect of Spautin-1 (an inhibitor of autophagy) on improving anxiety-like behaviors and its mechanism in mice after traumatic brain injury (TBI).Methods:Thirty-six C57BL/6 mice were randomly divided into sham-operated group, TBI group, and TBI+Spautin-1 group ( n=12); TBI models in the latter two groups were established by modified Feeney free fall epidural impingement method. Mice in TBI+Spautin-1 group were administered with Spautin-1 (2 μL, 10 mmol/L) into the lateral ventricle 10 min after modeling, but mice in the other two groups were only injected with same volume of solvent. Neuropathy Symptom Score (NSS) was used to evaluate the functions of motor, sensory and reflexes of mice on 1 st, 7 th and 14 th d of modeling. On 15 th and 16 th d of modeling, open field test and elevated plus maze test were used to evaluate the anxiety-like behaviors in mice. The number of Nissl bodies in the amygdala of mice was calculated by Nissl staining 16 d after modeling. The numbers of neuron specific nucleoprotein (NeuN) positive cells, interleukin (IL)-18 and IL-1β positive astrocytes in the amygdala were detected by immunofluorescent staining. Western blotting was used to detect the autophagy-and pyrotopic-associated protein expressions in the amygdala region of mice. Results:(1) As compared with the sham-operated group, the TBI group and TBI+Spautin-1 group had significantly increased NSS scores on 1 st and 7 th d of modeling ( P<0.05). (2) Open field test showed that as compared with the sham-operated group, the TBI group and TBI+Spautin-1 group had significantly smaller number of crossing grids, significantly decreased percentage of time spending in the central zone ([central area residence time/total time] × 100%), significantly decreased percentage of frequencies entering into opening arm (OE) (OE/[OE+frequencies of entering closing arm]×100%) and opening arm time (OT) percentage (OT/[OT+time of closing arm]×100%); as compared with the TBI group, TBI+Spautin-1 group had significantly larger number of crossing grids, and significantly increased time percentage spending in the central zone, OE percentage, and OT percentage ( P<0.05). (3) As compared with sham-operated group, the TBI group and TBI+Spautin-1 group had significantly smaller numbers of Nissl bodies and NeuN positive cells in the amygdala of mice ( P<0.05); as compared with TBI group, TBI+Spautin-1 group had significantly larger numbers of Nissl bodies and NeuN positive cells in the amygdala of mice ( P<0.05). (4) As compared with the sham-operated group, the TBI group and TBI+Spautin-1 group had significantly increased percentages of IL-1β and IL-18 positive astrocytes in amygdala of mice ( P<0.05); as compared with the TBI group, the TBI+Spautin-1 group had significantly decreased percentages of IL-1β and IL-18 positive astrocytes in amygdala of mice ( P<0.05). (5) As compared with sham-operated group, the TBI group and TBI+Spautin-1 group had significantly higher protein expressions of NOD-like receptor family protein 3 (NLRP3), activated cysteine aspartate protease-1 (Caspase-1), pore-forming protein D-N terminal fragment (GSDMD-N), ubiquitin specific peptidase (USP) 13 and B-lymphocytoma-2 interacting protein (Beclin1), and statistically higher ratio of microtubule-associated protein 1 light chain (LC)3 II/LC3 I ( P<0.05); as compared with TBI group, the TBI+Spautin-1 group had significantly decreased protein expressions of NLRP3, activated Caspase-1, GSDMD-N, USP13 and Beclin1 in the amygdala, and statistically lower ratio of LC3 II/LC3 I ( P<0.05). Conclusion:Spautin-1 improves the anxiety-like behaviors in mice after TBI, whose mechanism may be associated with the inhibition of astrocytic pyroptosis in the amygdala.

Objective: This study aimed to explore the relationship between childhood sexual abuse (CSA) and sexual orientation among college students, and to explore possible sex difference. Methods: By using multi-stage stratified cluster sampling method, 4 034 students were selected from 4 college schools. Self-made questionnaire was used to collect the demographic information, CSA experiences and sexual orientation. Logistic regression models were conducted to examine sex differences in the relationship between different types and timing of CSA and sexual orientation. Results: The reporting rates of heterosexual, homosexual, bisexual and asexual orientation of college students were 93.2%, 0.7%, 3.7% and 2.4%, respectively. For males, contact CSA (OR=14.70, 95%CI=5.73-37.72), both contact and noncontact CSA (OR=4.33,95%CI=1.91-9.84) in elementary school or earlier were associated with sexual orientaion. non-contact CSA (OR=4.20, 95%CI=2.21-7.98), both contact and noncontact CSA (OR=3.57, 95%CI=1.65-7.70) in middle school were related to sexual orientation. However, for females, non-contact CSA (OR=1.78, 95%CI=1.02-3.13) and both contact and non-contact CSA (OR=3.13, 95%CI=1.35-7.23) in elementary school or earlier were associated with sexual orientation. Conclusion CSA experiences are associated with sexual orientation in sex-specific manner, with significant stronger association among males.

Objective:To investigate the prognostic factors that influence Barcelona (Barcelona clinical liver cancer staging system, BCLC)stage B hepatocellular carcinoma patients after hepatectomy.Methods:Retrospective analysis was made on clinical and pathological data of 50 standardized hemihepatectomy in Barcelona stage B hepatocellular carcinoma from 2013 to 2017.Results:Single-factor results showed that high expression of tumor microvascular invasion (MVI) and proliferation of nuclear antigen (Ki-67) were the prognostic factors ( respectively χ 2 =8.411, 10.939, all P<0.05). Multivariate analysis showed that the difference of high expression of Ki-67 and survival rate was statistically significant (respectively F=5.710, 8.254, all P<0.05). Ki-67 expression level and tumor differentiation were statistically significant (χ 2=0.497, P<0.05). There was a statistically significant difference in survival between the high-risk group and the low-risk group according to the risk factors (χ 2=12.152, P<0.05). Conclusions:MVI and high expression of Ki-67 were high risk factors affecting the overall survival rate of liver cancer after hemihepatectomy.

Disulfiram (DSF) has been widely used in clinical treatment of alcoholism.To date,in vivo and in vitro experiments have demonstrated that DSF has strong anti-cancer activity and could improve patient's survival,and the underlying mechanism has been elaborated.In addition,it was reported that,during radiotherapy,DSF could protect normal tissue and cells meanwhile enhance the radiosensitivity of tumor cells by forming complexes with copper ions,suppressing cancer stem cells and inhibiting ubiquitin-proteasome system activity in cancer cells.This review summarizes the completed and ongoing clinical trials of disulfiram,and its anti-tumor mechanisms and advances in radiation biology.

Objective To investigate whether prolonged the interval of tumor necrosis factor (TNF)-α inhibitors (TNF-i) injection could continuously improve inflammatory biomarkers and imaging changes of sacroiliac joint and spine in spondyloarthritis (SpA).Methods A total of 154 SpA patients were included and 95 of them received TNF-α inhibitor therapy.TNF-i used in this study included etanercept,infliximab and adalimumab.The dose of etanercept was gradually reduced from 50 mg per week to every two weeks,every three weeks and then per month.The infusion of Infliximab was reduced from 4 mg/kg at 0,2,6 week to every 8 weeks,every 12 weeks and then every 16 weeks.The interval of Adalimumub injection was changed from 40 mg every two weeks to 3 weeks to 4 weeks and then to two months.The levels of inflammatory parameters,bath ankylosing spondylitis disease activity index (BASDAI),bath ankylosing spondylitis functional index (BASFI),ankylosing spondylitis disease activity score (ASDAS),spondyloarthritis research consortium of canada (SPARCC) scores of sacroiliac joint and fat metaplasia,bone erosion,sclerosis and ankylosis changes on magnetic resonance imaging (MRI) were investigated every 3 to 6 months.Radiograhs of spine were assessed by modified stoke ankylosing spondylitis spinal score (mSASSS) scores at baseline and 2 years.Analyses were performed by Paired t-test,Wilcoxon test,Mann-Whitney U test,Kruskal-Wallis and Chi-square test.Results After 3 months of treatment,erythrocyte sedimentation rate (ESR),c reactive protein (CRP),immunoglobulin A (IgA),BASDAI,BASFI,ASDAS and SPARCC scores were significantly lower than those of the baseline [13.00(6.00,31.00) mm/1 h vs 3.00 (2.00,6.00) mm/1 h,Z=-5.61;7.39(2.52,17.90) mg/L vs 1.88(1.21,3.75) mg/L,Z=-5.57;2.89(2.52,17.90) g/L vs 2.27(1.60,2.85) g/L,Z=-4.69;(2.57±1.43) vs (1.17±0.92),t=9.81;17.50(5.00,27.00) vs 4.00(0,11.00),Z=-6.69;2.62(2.02,3.52) vs 1.22(0.92,1.59),Z=-6.96;25.00(10.00,37.00) vs 12.00 (6.00,20.25),Z=-6.68;all P＜0.05].Compared to 3-6 months,SPARCC scores were significantly reduced during 2-3 years in the TNF-i group [12.00 (6.00,20.25) vs 7.00 (3.25,14.75),P=0.02].There were no significant progresses in fat metaplaisa,bone erosions,sclerosis or ankylosis during the follow-up period (61％,57％,x2=0.07,P=1.00;53％,43％,x2=0.40,P=0.75;31％,57％,x2=3.02,P=0.11;14％,7％,x2=0.43,P=0.66).The mSASSS scores were not different between TNF-i group and TNF-i group after 2 years of treatment [2.50 (0,8.00) vs 3.00 (0,8.00),Z=-0.30,P=0.76].Conclusion Prolonged the interval of TNF-i treatment could continuously improve bone marrow edema in SPA,whereas structural damages of sacroiliac joints and spine are not deteriorated.