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Lin Zheng, Rong Ge, Xiaoying Weng, Liang Lin Medical Centre of Maternity and Child Health, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fuzhou, Fujian, People’s Republic of ChinaCorrespondence: Liang Lin, Director of the Medical Centre of Maternity and Child Health, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fuzhou, Fujian, People’s Republic of China, Tel +86-13799348286, Email kitty342@163.comBackground: Thrombophilia combined with pregnancy poses significant risks for adverse pregnancy outcomes. Unfortunately, there are no indicators at high risk for predicting adverse pregnancy outcomes. This study investigates the predictive efficiency of serum immune-inflammatory markers on adverse pregnancy outcomes.Methods: This retrospective cohort study includes 223 pregnant women diagnosed with thrombophilia who delivered at the Fujian Provincial Hospital South Branch from January 2022 to April 2024. Clinical information and pregnancy outcomes were collected. The systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and lactate dehydrogenase (LDH) were calculated using blood samples. The relationship and predictive accuracy between immune-inflammatory markers and adverse pregnancy outcomes were analyzed.Results: In this study, 50 (22.4%) patients had adverse pregnancy outcomes. Significant differences were observed in neutrophils counts, monocytes counts, LDH, SII, and SIRI levels between the adverse pregnancy outcome groups (APOs) and the control groups (P< 0.05). The area under the receiver operating characteristic (ROC) curve analysis revealed that SII (AUC=0.762), SIRI (AUC=0.764), and LDH (AUC=0.732) had high predictive values for adverse pregnancy outcomes. Notably, the combined model had the highest AUC of 0.805. Multivariate logistic regression identified SII had the highest odd ratio (OR) (OR=8.512; 95% CI(3.068– 23.614)), followed by LDH (OR=4.905; 95% CI (1.167– 11.101)), SIRI (OR=3.549; 95% CI(0.847– 8.669)), and neutrophils count (OR=1.726; 95% CI (0.563– 2.938)) as independent risk factors for adverse outcomes.Conclusion: Elevated levels of immune-inflammatory markers such as SII, SIRI, and LDH level are strong predictors of adverse pregnancy outcomes in thrombophilia-complicated pregnancies. These markers are significantly associated with maternal-neonatal outcomes. Our findings underscore the importance of monitoring immune-inflammatory markers in pregnant women with thrombophilia to improve maternal and neonatal outcomes.Keywords: Thrombophilia, Maternal-neonatal Outcomes, Immune, Inflammatory

Cuiyu Lan,1 Tianshu Zhou,2,3 Yuchang Bao,4 Ruizhe Wang,5 Xinying Weng,6 Jie Su,7 Yinlin Li,8 Peijing Qiao,9 Danfeng Guo2 1Faculty of Law, Qingdao University, Qingdao, Shandong, People’s Republic of China; 2Department of Political Science, Suzhou University of Science and Technology, Suzhou, Jiangsu, People’s Republic of China; 3Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, SAR, People’s Republic of China; 4Faculty of Education, University of Macau, Macau, SAR, People’s Republic of China; 5GEC-Advanced Studies Institute, Beijing, People’s Republic of China; 6Ip Ying To Lee Yu Yee School of Humanities and Languages, Caritas Institute of Higher Education, Hong Kong, SAR, People’s Republic of China; 7Department of Public and International Affairs, City University of Hong Kong, Hong Kong, SAR, People’s Republic of China; 8Department of History, Hong Kong Shue Yan University, Hong Kong, SAR, People’s Republic of China; 9Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong, SAR, People’s Republic of ChinaCorrespondence: Danfeng Guo, Email guodanfeng@usts.edu.cnPurpose: This study aims to translate and validate the Learned Helplessness Scale (LHS) for use in the educational context and specifically among Chinese law school students. Understanding learned helplessness in the context of Chinese law students can provide unique insights into the interaction of legal education, psychological health, and cultural influences, thereby contributing to a more nuanced understanding of learned helplessness.Methods: A total of 711 Chinese college students from two law schools participated in this study. The Learned Helplessness Scale (LHS) was translated into Chinese using forward and backward translation. Exploratory and confirmatory factor analysis, and construct validity were conducted to assess the dimensionality of the Chinese version of the LHS (Chinese LHS).Results: The exploratory factor analysis indicated that the Chinese LHS has a four-factor structure consisting of 14 items, which accounted for 50% of the total variance. The subsequent confirmatory factor analysis further supported this four-factor structure. The internal consistency of the Chinese LHS was found to be medium to high, with Cronbach’s α values ranging from 0.63 to 0.87 for the subfactors, and 0.79 for the total scale. In addition, concurrent validity is also confirmed.Conclusion: The 14-item version of the Chinese LHS is a psychometric sound instrument for assessing learned helplessness among Chinese law school students.Keywords: learned helplessness scale, Chinese, adaptation, validation

Yang Zhao,1 Ruizhe Wang,2 Hebin Li,3 Chong Chen,4 Bowen Zhou,5 Xinying Weng,3 Yidi Hua,6 Yaqi Jia,7 Yajun Wu,8 Ying Li9 1Faculty of Law, Qingdao University, Qingdao, People’s Republic of China; 2HeXie Management Research Center, Xi’an Jiaotong-Liverpool University, Suzhou, People’s Republic of China; 3Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, People’s Republic of China; 4CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, People’s Republic of China; 5Department of Social Work, Hong Kong Baptist University, Hong Kong, People’s Republic of China; 6School of Humanities and Social Science, The Hong Kong University of Science and Technology, Hong Kong, People’s Republic of China; 7Entrepreneurs College, Xi’an Jiaotong-Liverpool University, Suzhou, People’s Republic of China; 8Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou, People’s Republic of China; 9School of Urban Governance and Public Affairs, Suzhou City University, Suzhou, People’s Republic of ChinaCorrespondence: Ying Li, Email yingli.szcityu@gmail.comIntroduction: This longitudinal study aims to investigate the relationship between fear of COVID-19, support-seeking behaviors, and perceived social support among Chinese college students during two distinct periods of the COVID-19 pandemic: the period of strict control (time 1) and the period following a relaxation of restrictions (time 2).Methods: A total of 408 Chinese college students participated in this study. Data collection included demographic information, measures of fear of COVID-19, support-seeking behaviors, and perceived social support.Results: Fear of COVID-19 at time 1 showed a significant positive association with fear of COVID-19 at time 2. The relationship between support-seeking behavior at time 1 and fear of COVID-19 at time 2 was significantly mediated through a chain mediation effect of support-seeking behavior at time 1 and perceived social support at time 2.Discussion: This study contributes to the growing body of evidence on the psychological impacts of the COVID-19 pandemic and underscores the significance of social support in mitigating fear of COVID-19. It calls for a re-evaluation of public health policies considering their potential psychological effects and introduces new opportunities for developing psychosocial interventions.Keywords: fear of COVID-19, social support, Chinese students, COVID-19 policy, longitudinal study

MinChao Feng,1,&ast; Fang Luo,1,&ast; HuiMin Wu,1 Yushan Chen,1 Jinjin Zuo,1 Xueying Weng,1 Guozhong Chen,2 Jian Zhong3 1The First Clinical Medical College, Guangxi University of Traditional Chinese Medicine, Nannig, People’s Republic of China; 2Department of Gastroenterology, the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine, Nanning, People’s Republic of China; 3Department of Nephrology, the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine, Nanning, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jian Zhong, Department of Nephrology, the First Affiliated Hospital of Guangxi University of traditional Chinese Medicine, No. 89-9, Dong Ge Lu, Xixiangtang District, Nanning, 530023, People’s Republic of China, Tel +86-18677920877, Email 18922005825@163.comPurpose: YiShen HuoXue decoction (YSHXD) is a formulation that has been used clinically for the treatment of renal fibrosis (RF) for many years. We aimed to clarify therapeutic effects of YSHXD against RF and potential pharmacological mechanisms.Materials and Methods: We used network pharmacology analysis and machine-learning to screen the core components and core targets of YSHXD against RF, followed by molecular docking and molecular dynamics simulations to confirm the reliability of the results. Finally, we validated the network pharmacology analysis experimentally in HK-2 cells and a rat model of RF established by unilateral ureteral ligation (UUO).Results: Quercetin, kaempferol, luteolin, beta-sitosterol, wogonin, stigmasterol, isorhamnetin, baicalein, and dihydrotanshinlactone progesterone were identified as the main active components of YSHXD in the treatment of unilateral ureteral ligation-induced RF, with IL-6, IL1β, TNF, AR, and PTGS2 as core target proteins. Molecular docking and molecular dynamics simulations further confirmed the relationship between compounds and target proteins. The potential molecular mechanism of YSHXD predicted by network pharmacology analysis was confirmed in HK-2 cells and UUO rats. YSHXD downregulated NLRP3, ASC, NF-κBp65, Caspase-1, GSDMD, PTGS2, IL-1β, IL-6, IL-18, TNF-α, α-SMA and upregulated HGF, effectively alleviating the RF process.Conclusion: YSHXD exerts important anti-inflammatory and anti-cellular inflammatory necrosis effects by inhibiting the NLRP3/caspase-1/GSDMD-mediated pyroptosis pathway, indicating that YSHXD represents a new strategy and complementary approach to RF therapy.Graphical Abstract: Keywords: pyroptosis, YiShen HuoXue decoction, renal fibrosis, molecular docking simulation, machine-learning

Lijuan Zhuang,&ast; Xiaoyan Xie,&ast; Lihua Wang, Xiulan Weng, Yingling Xiu, Dabin Liu, Liying Zhong Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350001, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Liying Zhong; Dabin Liu, Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, 18 Daoshan Road, Fuzhou, 350001, People’s Republic of China, Tel +86-13860610354 ; +86-13489997701, Fax +86-591-87551247, Email zhongliying@fjmu.edu.cn; 15968250@qq.comBackground: The characteristics of high-risk human papillomavirus (HR-HPV) infection in different pathological types of cervical cancer in China are unclear. The aim of this study was to evaluate HR-HPV genotypes and age stratification with cervical squamous cell carcinoma (SCC) and adenocarcinoma (ADC) in China.Materials and Methods: Patients diagnosed with cervical cancer by histopathology in Fujian Maternity and Child Health Hospital from January 1, 2014, to December 31, 2017, were included in this study. The HR-HPV genotype was analyzed in cervical specimens. Logistic regression was used to calculate odds ratios (ORs). All tests of statistical significance were two-sided, and the P value< 0.05.Results: A total of 1,590,476 women were screened for cervical cancer, and 688 cervical cancers were detected, including 554 SCC and 93 ADC. The overall HR-HPV infection rate in SCC was higher than that in ADC (91.2% vs 81.7%, P=0.005). HPV-16 was the most prevalent genotype in SCC (70.0%) but was only 31.2% in ADC (P< 0.001). However, the prevalence of HPV-18 in ADC was significantly higher than that in SCC (45.2% vs 7.0%; P< 0.001). In SCC, the prevalence of HPV-16 was consistently much higher than that of HPV-18 regardless of age group. Among ADC, the prevalence of HPV-18 was higher than that of HPV-16 in women aged ≥ 45 years. Interestingly, in those aged < 35 years, the highest prevalence was observed for HPV-16. HPV-18 infection has the highest risk of ADC (OR= 12.109; P< 0.001), and HPV-45 and HPV-51 were also found to be associated with the occurrence of ADC. However, HPV-16 infection greatly increased the risk of having histological SCC.Conclusion: HPV-16 and HPV-18 infections are key risk factors for SCC and ADC. The use of HR-HPV genotyping tests in cervical cancer screening and vaccination against major HPV genotypes could reduce the incidence of cervical cancer.Keywords: cervical squamous cell carcinoma, cervical adenocarcinoma, high-risk human papillomavirus

Lijuan Zhuang &ast;, Xiulan Weng &ast;, Lihua Wang, Xiaoyan Xie, Liying Zhong, Dabin Liu, Yingling Xiu Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yingling Xiu; Dabin Liu, Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, 18 Daoshan Road, Fuzhou, People’s Republic of China, Tel +86-13860610354 ; +86-13489997701, Fax +86-591-87551247, Email xiuyingling@fjmu.edu.cn; xiuyingling1985@163.com; 15968250@qq.comPurpose: A high-risk human papillomavirus E6/E7 mRNA (HR-HPV mRNA) assay is widely used in cervical cancer screening in China. However, it is still unclear whether stand-alone HR-HPV mRNA testing is sufficient for primary screening. The purpose of this study was to investigate the feasibility of a stand-alone HR-HPV mRNA assay for primary screening of cervical cancer.Methods: Women aged 21 and older were recruited in Fujian Province, China, from January 2020 to January 2022. Cervical exfoliated cells were collected for cervical cytology and HR-HPV mRNA assays, and women with positive results on either assay were referred for colposcopy. The screening effectiveness of the assay was calculated based on the cervical histology. When comparing the efficacy of the different screening strategies, only women aged 25 and older were included.Results: A total of 9927 women were recruited. This study identified 217 cases of high-grade squamous intraepithelial disease or worse (HSIL+). The overall age-specific HR-HPV infection rate showed a U-shaped distribution. The sensitivity of the HR-HPV mRNA assay to identify CIN2+ and CIN3+ was 97.2% and 97.9%, respectively, which was significantly higher than that of cytology (82.9% and 88.6%, P< 0.001 and 0.002). The sensitivity of the HR-HPV mRNA primary screening strategy to identify CIN2+ and CIN3+ was 92.2% and 94.3%, respectively, which was similar to the co-testing strategy (P=0.336 and 0.394) and higher than the cytology primary screening (P=0.002 and 0.048). In addition, the HR-HPV primary screening strategy had a lower referral rate for colposcopy than cytology primary screening (5.4% vs 6.6%, P< 0.001), and the screening cost was lower than co-testing (&dollar;29,594.3 per 1000 screened women vs &dollar;55,140 per 1000 screened women, P< 0.001).Conclusion: In conclusion, the detection of CIN2+/CIN3+ by HR-HPV mRNA is both specific and sensitive. It may be suitable for primary screening of cervical cancer in China.Keywords: cervical cancer, HR-HPV, E6/E7 mRNA, primary screening, cervical intraepithelial neoplasia

Jie Li, Qi He, Xiu Yu, Khalid Khan, Xuanwen Weng, Minjie Guan Department of Respiratory Diseases, Second Clinical Medical College Shenzhen People’s Hospital, Jinan University, Shenzhen 518020, China Purpose: The purposes of this study were to investigate whether the use of immune checkpoint inhibitors (ICIs) in advanced non-small-cell lung cancer (NSCLC) would increase the possibility of archiving complete response (CR) and assess the surrogate end points for overall survival (OS). Methods: We calculated the incidence and relative risk (RR) of CR events in patients assigned to ICIs compared to that in controls. Simple linear regression models were fitted for median OS and each surrogate (median progression-free survival [PFS], CRs, and objective response rate [ORR]). Results: A total of 4,803 NSCLC patients from nine randomized controlled trials (RCTs) were included for analysis. The incidence of CR in NSCLC patients treated with ICIs was 1.5% (95% CI: 0.8–3.0) compared to 0.7% (95% CI: 0.4–1.2) in chemotherapy (CT) groups. The use of ICIs in advanced NSCLC significantly improved the possibility of archiving CR (RR 2.89, 95% CI: 1.44–5.81, P=0.003) compared to CT. Subgroup analysis according to ICIs showed that the use of atezolizumab (RR 3.26, P=0.01) and nivolumab (RR 4.83, P=0.042) in advanced NSCLC significantly improved the CR rate in comparison with CT alone, but not pembrolizumab and ipilimumab. We also found that the use of ICIs as first-line (RR 2.39, 95% CI: 1.08–5.3, P=0.032) or second-line (RR 4.99, 95% CI: 1.10–22.66, P=0.038) therapy significantly increased the change in obtaining a CR. In addition, correlation analysis indicates that PFS was strongly correlated with OS in NSCLC patients who received ICIs (r=0.89 for PFS, P=0.017). No marked correlation was found between OS and CR (r=0.19, P=0.75) and OS and ORR (r=0.52, P=0.28). Conclusion: The CR is a rate event in advanced NSCLC, but the use of ICIs significantly increases the possibility of archiving CR in comparison with CT. PFS is significantly correlated with OS and could be used as a surrogate end point, but not for CRs and ORRs. Keywords: immune checkpoint inhibitors, non-small-cell lung cancer, complete response, randomized controlled trials, meta-analysis, immunotherapy therapy, systematic review

BACKGROUND: Congenital scoliosis is a common type of vertebral malformation. Genetic susceptibility has been implicated in congenital scoliosis. METHODS: We evaluated 161 Han Chinese persons with sporadic congenital scoliosis, 166 Han Chinese controls, and 2 pedigrees, family members of which had a 16p11.2 deletion, using comparative genomic hybridization, quantitative polymerase-chain-reaction analysis, and DNA sequencing. We carried out tests of replication using an additional series of 76 Han Chinese persons with congenital scoliosis and a multicenter series of 42 persons with 16p11.2 deletions. RESULTS: We identified a total of 17 heterozygous TBX6 null mutations in the 161 persons with sporadic congenital scoliosis (11%); we did not observe any null mutations in TBX6 in 166 controls (P

Obstructive sleep apnea and chronic airway inflammatory diseases, such as chronic obstructive pulmonary disease (COPD) and asthma, are prevalent respiratory conditions, particularly among the elderly. These diseases significantly impact the health and quality of life of the general population. The coexistence of two or more of these conditions, known as overlap syndrome, exacerbates their impact and is frequently encountered in clinical practice. This article provides a comprehensive review of the progress in understanding overlap syndromes, focusing on their distinctive disease features, risk factors, pathophysiological mechanisms, symptoms, diagnostic approaches, and corresponding treatment strategies.

The feasibility of underground gasification of Yan 9 coal seam of the middle-lower Jurassic Yan ′an Formation in J148 area of Dongsheng gas field is systematically studied from the perspectives of geological structure, hydrogeology and coal gasification characteristics, and the prospects of carbon sequestration by using the pore layer, aquifer layer and tight gas layer in the deep coal gasification cavity are discussed.The results show that the coal seam of Yan 9 in this area is stable when the buried depth is 1 264~1 285 m and the dip angle is less than 1°.In the interior of the gasification target constituency, the structural faults are not developed, the joint cracks are not developed, there are occasional cracks but the section is fresh and closed, and the cavity of the coal seam after gasification has a good tightness, which has little influence on the construction and expansion of coal gasification furnace, and can meet the implementation of large-scale coal gasification projects.There is a continuous water barrier layer on the top and bottom of Yan 9 coal seam, which can prevent the influence of groundwater on the direct water filling of coal seam, and is conducive to the layout of underground gasifier.The thickness of the roof water-barrier layer is less than the height of the water-conducting fissure zone, there is a risk of indirect water filling through the roof aquifer, but the roof aquifer is a weak water-rich aquifer, and the risk of small water inflow is controllable.The thickness of the floor water barrier layer is greater than the safe thickness of the floor water barrier layer, which can effectively prevent the risk of direct water filling to the coal seam.In general, Yan 9 coal seam has moderate thickness, little waste, low ash, low sulfur, high calorific value non-stick coal, high coke reactivity, and has a good development prospect.In view of the large amount of CO2 emission from large-scale gasification mining of deep coal seam, the feasibility of CO2 safe geological storage by using coal seam burning and caving area, top and bottom aquifer and lower tight natural gas layer was discussed.The analysis shows that 60.8 % ~88.2 % of CO2 produced by coal seam gasification can be stored in the pore layer and the top and bottom aquifer in the gas-burning and air-burning zone of Yan 9 coal seam.Combined with the development of tight natural gas in the Upper Paleozoic of Dongsheng gas field, it is expected to achieve near-zero carbon emissions in the process of deep coal seam gasification mining by using CO2 generated by coal gasification for natural gas displacement and storage.