Mechanism of Guangdong Shenqu in regulating intestinal flora in mice with food stagnation and internal heat based on 16S rDNA sequencing

Objective:To investigate the effect of Guangdong Shenqu(GSQ)on intestinal flora structure in mice with food stagnation through 16S rDNA sequencing.Methods: Mice were randomly assigned to control,model,GSQ low-dose(GSQL),GSQ medium-dose(GSQM),GSQ high-dose(GSQH),and lacidophilin tablets(LAB)groups,with each group containing 10 mice.A food stagnation and internal heat mouse model was established through intragastric administration of a mixture of beeswax and olive oil(1:15).The control group was administered normal saline,and the model group was administered beeswax and olive oil to maintain a state.The GSQL(2 g/kg),GSQM(4 g/kg),GSQH(8 g/kg),and LAB groups(0.625 g/kg)were administered corresponding drugs for 5 d.After administration,16S rDNA sequencing was performed to assess gut microbiota in mouse fecal samples.Results: The model group exhibited significant intestinal flora changes.Following GSQ administration,the abundance and diversity index of the intestinal flora increased significantly,the number of bacterial species was regulated,andαandβdiversity were improved.GSQ administration increased the abundance of probiotics,including Clostridia,Lachnospirales,and Lactobacillus,whereas the abundance of conditional pathogenic bacteria,such as Allobaculum,Erysipelotrichaceae,and Bacteroides decreased.Functional prediction analysis indicated that the pathogenesis of food stagnation and GSQ intervention were primarily associated with carbohydrate,lipid,and amino acid metabolism,among other metabolic pathways.Conclusion: The digestive mechanism of GSQ may be attributed to its role in restoring diversity and abundance within the intestinal flora,thereby improving the composition and structure of the intestinal flora in mice and subsequently influencing the regulation of metabolic pathways.

Study on the Application Effect of Enhanced Recovery After Surgery (ERAS) in Patients Undergoing Spinal Fracture Surgery

Objective:To study the application effect of the Enhanced Recovery After Surgery(ERAS)model in patients undergoing spinal fracture surgery.Methods:A randomized controlled trial was designed,and 86 patients undergoing spinal fracture surgery were randomly divided into the ERAS group and the conventional care group.Postoperative recovery outcomes of the two groups were compared.Results:The ERAS group showed better outcomes in terms of postoperative pain scores,activities of daily living,length of hospital stay,and adherence to rehabilitation training compared to the conventional care group,with shorter hospital stays and lower medical expenses(P<0.05).Conclusion:The ERAS model significantly improves the postoperative recovery quality of patients undergoing spinal fracture surgery,reduces hospital stay and medical costs,and increases patient satisfaction.

Performances of a Stinger PDC cutter breaking granite: Cutting force and mechanical specific energy in single cutter tests

The Stinger PDC cutter has high rock-breaking efficiency and excellent impact and wear resistance, which can significantly increase the rate of penetration (ROP) and extend PDC bit life for drilling hard and abrasive formation. The knowledge of force response and mechanical specific energy (MSE) for the Stinger PDC cutter is of great importance for improving the cutter's performance and optimizing the hybrid PDC bit design. In this paper, 87 single cutter tests were conducted on the granite. A new method for precisely obtaining the rock broken volume was proposed. The influences of cutting depth, cutting angle, and cutting speed on cutting force and MSE were analyzed. Besides, a phenomenological cutting force model of the Stinger PDC cutter was established by regression of experimental data. Moreover, the surface topography and fracture morphology of the cutting groove and large size cuttings were measured by a 3D profilometer and a scanning electron microscope (SEM). Finally, the rock-breaking mechanism of the Stinger PDC cutter was illustrated. The results indicated that the cutting depth has the greatest influence on the cutting force and MSE, while the cutting speed has no obvious effects, especially at low cutting speeds. As the increase of cutting depth, the cutting force increases linearly, and MSE reduces with a quadratic polynomial relationship. When the cutting angle raises from 10° to 30°, the cutting force increases linearly, and the MSE firstly decreases and then increases. The optimal cutting angle for breaking rock is approximately 20°. The Stinger PDC cutter breaks granite mainly by high concentrated point loading and tensile failure, which can observably improve the rock breaking efficiency. The key findings of this work will help to reveal the rock-breaking mechanisms and optimize the cutter arrangement for the Stinger PDC cutter.

快速高效区分黄檀属黑酸枝木的方法-GC/MS指纹图谱

采用气相色谱-质谱指纹图谱分别鉴定阔叶黄檀、卢氏黑黄檀、东非黑黄檀和伯利兹黄檀木材。以二氯甲烷提取样品中的特定化合物,采用气相色谱-质谱法分析提取物,建立目标物色谱图。采用二氯甲烷溶剂提取阔叶黄檀、卢氏黑黄檀、东非黑黄檀和伯利兹黄檀4种黄檀属黑酸枝木,其提取液用气相色谱质谱联用仪分析,结果显示该4种树种的特征色谱峰不同。阔叶黄檀的色谱峰在14.6min、14.8min出现双子色谱峰,强度相似;卢氏黑黄檀分别在11.9min、12.5min、12.9min有3个强度相似的色谱峰;东非黑黄檀的强度大的特征峰在18.3min和18.5min;伯利兹黄檀仅有1个强度大的色谱峰,其保留时间在17.1min。分析这4种木材的GC/MS指纹图谱,色谱峰的保留时间不同。该方法可以有效区分鉴别这4种黑酸枝木。

服役损伤对制动盘疲劳裂纹扩展行为的影响

制动盘是高速列车制动系统的重要元件,其复杂的服役工况会使制动盘出现多种形式的服役损伤,影响制动盘后续的可维修性和服役安全性。选取未服役制动盘和产生翘曲变形且摩擦面出现疲劳裂纹的服役后制动盘为研究对象,通过测试服役前后制动盘材料在不同温度下的拉伸力学性能,构建了受摩擦面深度和温度双参数影响的力学性能衰退模型来表征制动盘的材料损伤。通过构建不同制动工况下制动盘三维瞬态仿真模型,得到了服役后制动盘的结构变形和残余应力状态来表征制动盘的结构损伤。基于Paris理论进行制动盘疲劳裂纹扩展寿命分析,评估了服役损伤对制动盘疲劳裂纹扩展能力的影响。结果表明:长期服役后制动盘本体材料力学性能会发生衰退,从摩擦面表层至心部呈现梯度分布,近表层材料强度下降约20%,制动盘残余应力释放后会使盘体产生碟形翘曲变形。服役后制动盘的力学性能衰退使裂纹前缘的应力强度因子水平显著高于服役前制动盘,摩擦面中部裂纹沿制动盘径向的扩展速率大于沿深度方向,使裂纹深长比不断减小。与服役前制动盘相比,服役后制动盘摩擦面中部裂纹从0.5 mm扩展至70 mm的扩展寿命降低了48%。螺栓孔处疲劳裂纹扩展初期主要沿深度方向扩展,随着裂纹尺寸增加沿制动盘径向与深度扩展速率逐渐一致,服役后制动盘螺栓孔裂纹从0.5 mm扩展至50 mm的扩展寿命与服役前相比降低了29%。本文的研究方法可用于不同损伤程度的制动盘本体性能表征与失效分析,对服役后制动盘的检修维护、保障制动盘的安全运用具有工程参考价值。

Changes in snow parameterization over typical vegetation in the Northern Hemisphere

季节性降雪对气候变化很敏感,常被当作气候变化的信号.由于其局地特征差异显著,不同下垫面类型的积雪过程也不尽相同.北半球中高纬度的典型下垫面(开阔灌丛,常绿针叶林和混交林)在积雪覆盖率和雪深之间有着独特的关系曲线,这种关系不仅代表了积雪过程和融雪过程的特征变化,更能用于模式进行积雪预测.研究发现,北半球中高纬度的增温改变了积雪参数化关系,进一步影响了局地能量和水循环,造成开阔灌丛的北缩和常绿针叶林及混交林的扩张.然而,目前模式中的积雪参数化并不能很好地再现全球变暖影响下融雪阶段出现的加速融化过程,并且进一步影响对春季融雪的生态影响的理解.

孕晚期血清尿酸及血清尿酸/肌酐水平与不良妊娠结局的关系研究

背景孕期血清尿酸代谢紊乱与不良妊娠结局相关,但目前分析并比较血清尿酸及血清尿酸/肌酐水平在孕期不良妊娠结局中的关系研究较少。目的分析孕妇孕晚期血清尿酸及血清尿酸/肌酐水平与不良妊娠结局的关系。方法选取2015—2022年于南京大学医学院附属鼓楼医院常规产检及生产的单胎活产孕妇743例为研究对象。根据是否发生不良妊娠结局,将孕妇分为正常组344例和不良结局组399例。分别以四分位数将血清尿酸及血清尿酸/肌酐分为3个水平:Q1(血清尿酸<257μmol/L)、Q2(血清尿酸257~359μmol/L)、Q3(血清尿酸>359μmol/L)和q1(血清尿酸/肌酐<5.88)、q2(血清尿酸/肌酐5.88~7.94)、q3(血清尿酸/肌酐>7.94)。根据孕妇中位年龄,将孕妇分为年龄<30岁亚组(341例)及年龄≥30岁亚组(402例)。根据既往孕产次情况,将孕妇分为初产妇亚组(539例)及经产妇亚组(194例)。采用多因素Logistic回归分析探讨血清尿酸及血清尿酸/肌酐水平与不良妊娠结局的关系。结果不良结局组孕妇年龄、BMI、血清尿酸、血清尿酸/肌酐、三酰甘油高于正常组(P<0.05)。校正混杂因素后,血清尿酸、血清尿酸/肌酐对不良妊娠结局影响的多因素Logistic回归分析结果显示,与Q1水平血清尿酸相比,Q3水平时子痫前期(AOR=4.41,95%CI=2.16~8.99)、宫内生长受限(AOR=3.59,95%CI=1.08~11.96)的发生风险增加(P<0.05);与q1水平血清尿酸/肌酐相比,q2、q3水平时子痫前期(AOR=2.33,95%CI=1.13~4.79;AOR=3.56,95%CI=1.68~7.56)的发生风险增加,q3水平时早产(AOR=2.76,95%CI=1.33~5.71)、宫内生长受限(AOR=5.15,95%CI=1.39~19.14)的发生风险增加,而q3水平时巨大儿(AOR=0.43,95%CI=0.19~0.98)、大于胎龄儿(AOR=0.38,95%CI=0.15~0.96)的发生风险降低(P<0.05)。血清尿酸、血清尿酸/肌酐在不同年龄亚组对子痫前期、早产的影响结果显示,与Q1水平血清尿酸相比,Q3水平在两个年龄亚组中子痫前期的发生风险均增加(P<0.05);与q1水平血清尿酸/肌酐相比,q2、q3水平在年龄≥30岁孕妇中子痫前期的发生风险增加(P<0.05)。血清尿酸、血清尿酸/肌酐在不同孕产次亚组对子痫前期、早产的影响结果显示,与Q1水平血清尿酸相比,Q3水平在初产妇中子痫前期的发生风险增加(P<0.05);与q1水平血清尿酸/肌酐相比,q2、q3水平在初产妇中子痫前期的发生风险增加,q3水平在初产妇中早产的发生风险增加(P<0.05)。结论高水平血清尿酸、血清尿酸/肌酐时子痫前期、宫内生长受限的发生风险均增加,其中子痫前期主要发生在年龄≥30岁的孕妇或初产妇中。高水平血清尿酸/肌酐时早产的发生风险增加,主要发生在初产妇中。血清尿酸/肌酐较血清尿酸预测的不良妊娠结局更多。

粗毛纤孔菌不同提取物对免疫抑制小鼠免疫功能的影响

采用粗毛纤孔菌(Inonotus hispidus)石油醚提取物(高、低剂量分别为12、6 mg·kg^(-1))、乙酸乙酯提取物(高、低剂量组分别为17、8.5 mg·kg^(-1))、正丁醇提取物(高、低剂量分别为45、22.5 mg·kg^(-1))、水提取物(高、低剂量分别为600、300 mg·kg^(-1))、麦角甾醇(高、低剂量分别为10、5 mg·kg^(-1))灌胃环磷酰胺所致免疫抑制小鼠,测定免疫器官指数、吞噬指数、吞噬系数、耳肿胀度、耳肿胀率和血清细胞因子、免疫球蛋白含量,采用苏木素-伊红染色小鼠脾脏、胸腺、胰腺、回肠后观察组织形态,研究粗毛纤孔菌不同提取物对免疫抑制小鼠免疫功能的影响。结果表明:与模型组相比,石油醚、水提取物高剂量组和麦角甾醇高、低剂量组的胸腺指数显著升高;麦角甾醇高、低剂量组的吞噬指数和吞噬系数均显著升高,水提取物高、低剂量组的吞噬系数显著升高;水提取物和麦角甾醇高、低剂量组的耳肿胀度和耳肿胀率均极显著升高;石油醚、水提取物和麦角甾醇高、低剂量组,乙酸乙酯提取物高剂量组的IL-1β含量显著增加;石油醚、乙酸乙酯、水提取物高、低剂量组和麦角甾醇高、低剂量组的IL-2含量极显著增加;除正丁醇提取物低剂量组外,其余提取物组和麦角甾醇高、低剂量组的IFN-γ和IL-10含量均极显著增加;石油醚、水提取物和麦角甾醇高、低剂量组,乙酸乙酯提取物高剂量组的IL-4含量极显著增加;石油醚、水提取物和麦角甾醇高、低剂量组的IgG含量显著增加。研究结果表明,粗毛纤孔菌提取物对环磷酰胺所致免疫抑制小鼠具有良好的免疫保护作用,可为粗毛纤孔菌进一步开发提供参考。

含不同初始织构的Mg−Gd−Y−Zn−Zr合金热轧板材的显微组织和力学性能

通过光学显微镜、扫描电子显微镜、电子背散射衍射、透射电子显微镜和拉伸试验研究含不同初始织构的Mg−4.7Gd−3.4Y−1.2Zn−0.5Zr(质量分数,%)合金热轧板材的显微组织和力学性能。结果表明,初始织构为0001//RD(板材轧向)的板材获得相对较粗的晶粒和双峰基面织构;而初始织构为0001//TD(板材横向)的板材动态再结晶程度更高,因此,获得更细的晶粒尺寸和较强的0001//ND基面织构。此外,在两种板材中均发现沿RD拉长的不规则形状LPSO相,这种LPSO相导致各向异性的承载强化行为,并进一步引起板材的屈服各向异性。对强化机理的分析表明,晶界强化对轧制板材的强化效果最好。由于具有较小的晶粒尺寸和LPSO相带来的承载强化效果,初始织构为0001//TD的板材在RD方向上获得最高的屈服强度。

三峡库区降雨特征和林草覆被格局对坡面水沙产出的影响

[目的]为探析三峡库区降雨特征和林草覆被格局对坡面水沙产出的影响,适应人地矛盾突出和乡村特色产业发展对林下土地资源优化利用提出的新需求。[方法]以三峡库区典型退耕林地为研究对象,设置林下全坡草本覆盖格局(QF)、上坡裸地+下坡草本覆盖格局(XF)、等高横坡草本条带覆盖格局(TF)、全坡无草本覆盖格局(WF)4种林草覆被的径流小区,开展24场侵蚀性降雨事件的坡面产流产沙野外观测,辨识降雨特征和林草覆被格局对坡面产水产沙的影响。[结果](1)24场侵蚀性降雨分为A雨型(雨量小、强度较大、历时短)、B雨型(雨量大、强度大、历时短)和C雨型(雨量小、强度小、历时长)3类。A雨型发生频率最高,为45.83%,B雨型累积降雨量最大,占总降雨量的63.44%。(2)4种林草覆被格局的累积径流深和累积侵蚀量总体呈现QF<XF<TF<WF;径流深和侵蚀量峰值均发生于B雨型,其产流量相比于A雨型增加337.74%~410.32%,产沙量增加283.47%~504.58%。(3)WF径流深和侵蚀量占比为75.75%和98.51%,XF、TF分别占12.20%和1.08%,7.28%和0.34%。与WF相比,XF和TF的径流减少84.18%和75.85%,产沙减少96.99%和93.30%。[结论]对比不同林草覆被格局的坡面水沙产出,上坡耕种+下坡草本覆盖、条带耕种+等高植物篱的林下适度利用可兼顾林地调水保土和林下生态种植的功能,为三峡库区生态修复与林下土地资源优化利用提供理论依据。

气相色谱-质谱法快速测定塑料制品中28种高关注物质

建立了气相色谱-质谱法测定塑料制品中28种高度关注物质含量,包括10种硅氧烷类、6种烷基酚类、9种UV抗氧化剂和3种磷酸酯类。样品经超声提取,提取液经气相色谱-质谱联用仪测定,质谱图及保留时间定性,外标法定量。试验结果表明,28种高度关注物质的质量浓度在0.5~10 mg/L范围内的线性相关系数均大于0.995,检出限为0.39~2.99 mg/kg,定量限为1.29~9.87 mg/kg。加标回收率为80.4%~118%,测定结果的相对标准偏差为1.8%~14%(n=6)。该方法可用于塑料制品中28种高度关注物质的测定。

使用Aspen Plus协助实现化工仿真实训课程的学习目标

化工仿真实训课程是一门主要面向化工专业的实践课程,其学习的主要目标是使学生初步掌握化工设备的基本操作,提高学生对化工过程的分析和决策能力,提高学生工程实践能力和创新能力,培养良好的职业规范和职业道德。本文结合我校化工仿真实训课程的教学现状,采用Aspen Plus软件作为工具,贯穿化工仿真实训课程的全过程,协助实现化工仿真实训课程的学习目标,解决目前存在的教学问题,提高课程的教学效果。

不同填充介质对储能换热器传热强化影响的数值模拟

本文以含熔融盐颗粒储能胶囊的换热器为对象,采用数值模拟方法探究了填充介质在换热器内部的强化换热传热过程,分析了其物性对传热过程的影响。研究结果表明,石蜡等介质的填充显著提升了胶囊的传热速率。本研究为储能换热器优化提供了范例。

阳离子田菁胶助染剂对纸张浆外染色效果的影响

本研究通过醚化反应制备了阳离子田菁胶(CSG)助染剂,并通过浆外浸渍染色法,探究了其对直接耐晒翠蓝GL染色效果的影响,并确定了最佳染色工艺。适度提高醚化剂用量,能获得更高取代度的CSG;CSG的热稳定性比未改性田菁胶(SG)较差。加入CSG后,染料分子和CSG可通过静电吸附作用,稳固地附着在纸张表面,染色效果显著。选用取代度0.22、N含量0.63%的CSG作为助染剂,染色时间30 s、染液pH值6、CSG用量0.8%、染液温度70℃时,CSG染色效果最佳,相比SG组染色效果提升168.9%。染纸水洗前后Δb^(*)值变化不大,说明CSG同时具有较好的固色效果。

Identification of hub genes associated with Helicobacter pylori infection and type 2 diabetes mellitus:A pilot bioinformatics study

BACKGROUND Helicobacter pylori(H.pylori)infection is related to various extragastric diseases including type 2 diabetes mellitus(T2DM).However,the possible mechanisms connecting H.pylori infection and T2DM remain unknown.AIM To explore potential molecular connections between H.pylori infection and T2DM.METHODS We extracted gene expression arrays from three online datasets(GSE60427,GSE27411 and GSE115601).Differentially expressed genes(DEGs)commonly present in patients with H.pylori infection and T2DM were identified.Hub genes were validated using human gastric biopsy samples.Correlations between hub genes and immune cell infiltration,miRNAs,and transcription factors(TFs)were further analyzed.RESULTS A total of 67 DEGs were commonly presented in patients with H.pylori infection and T2DM.Five significantly upregulated hub genes,including TLR4,ITGAM,C5AR1,FCER1G,and FCGR2A,were finally identified,all of which are closely related to immune cell infiltration.The gene-miRNA analysis detected 13 miRNAs with at least two gene cross-links.TF-gene interaction networks showed that TLR4 was coregulated by 26 TFs,the largest number of TFs among the 5 hub genes.CONCLUSION We identified five hub genes that may have molecular connections between H.pylori infection and T2DM.This study provides new insights into the pathogenesis of H.pylori-induced onset of T2DM.

有机余辉材料的类别及其在生物分析成像中的研究进展

有机余辉材料是一类具有余辉特性的光学材料,可在光照结束后进行长时间发光,从而延长成像时间,并提高成像灵敏度。有机余辉材料凭借其灵活的可设计性与良好的生物相容性已被广泛应用于生物分析成像中。此外,余辉成像由于不需要实时激发光源,因而可有效消除生物组织自身荧光信号的干扰。因此,余辉成像在活体成像信背比和分析灵敏度方面具有明显的优势。基于此,作者综述了近年来有机余辉材料的最新进展,对已报道的有机余辉材料在生物分析和余辉成像中的医学应用进行了总结,讨论了有机余辉材料在分子构建及临床成像中的应用前景及存在的挑战。

Joint User Association and Satellite Selection for Satellite-Terrestrial Integrated networks

In this paper, we investigate a cooperation mechanism for satellite-terrestrial integrated networks. The terrestrial relays act as the supplement of traditional small cells and cooperatively provide seamless coverage for users in the densely populated areas.To deal with the dynamic satellite backhaul links and backhaul capacity caused by the satellite mobility, severe co-channel interference in both satellite backhaul links and user links introduced by spectrum sharing,and the difference demands of users as well as heterogeneous characteristics of terrestrial backhaul and satellite backhaul, we propose a joint user association and satellite selection scheme to maximize the total sum rate. The optimization problem is formulated via jointly considering the influence of dynamic backhaul links, individual requirements and targeted interference management strategies, which is decomposed into two subproblems: user association and satellite selection. The user association is formulated as a nonconvex optimization problem, and solved through a low-complexity heuristic scheme to find the most suitable access point serving each user. Then, the satellite selection is resolved based on the cooperation among terrestrial relays to maximize the total backhaul capacity with the minimum date rate constraints. Finally,simulation results show the effectiveness of the proposed scheme in terms of total sum rate and power efficiency of TRs' backhaul.

试论综合灾害风险管理:思想、目标与路径

面对系统和复杂的灾害问题,综合灾害风险管理成为灾害应对的必然选择。但综合灾害风险管理涉及管理学、地理学、经济学、统计学和信息学等众学科。回答何为综合,为何综合,如何综合,构建综合框架下的多学科对灾害管理的共同理解,仍然是该领域的核心挑战。该文试图直面挑战,以“综合风险为核心的综合灾害的综合管理”的观点解释“何为综合”,以“问题导向的研究,综合自然而然”的视角解释“为何综合”,提出“渐进式综合途径”和“以风险曲线为中心的综合灾害风险管理方法”回答“如何综合”的问题。同时展现研究案例,以期为综合灾害风险管理的研究和实践提供参考。

子宫内膜样腺癌组织中TIM3、PD-1、PD-L1的表达及意义

目的:探讨T细胞免疫球蛋白黏蛋白3(TIM3)、程序性死亡受体1(PD-1)与程序性死亡受体配体1(PD-L1)在子宫内膜样腺癌组织中的表达及意义。方法:选取2021年1月至2022年12月行手术切除的50例子宫内膜样腺癌患者的癌、癌旁子宫内膜非典型增生和正常子宫内膜组织。采用免疫组化检测TIM3、PD-1和PD-L1蛋白的表达,qRT-PCR法检测TIM3、PD-1和PD-L1 mRNA的表达,分析子宫内膜样腺癌组织中TIM3、PD-1和PD-L1 mRNA表达的相关性。比较不同临床特征的子宫内膜样腺癌患者癌组织中TIM3、PD-1和PD-L1表达的差异。结果:3种组织中TIM3、PD-1、PD-L1蛋白和mRNA表达的差异有统计学意义,子宫内膜非典型增生和子宫内膜样腺癌组织高于正常子宫内膜组织,子宫内膜样腺癌组织高于子宫内膜非典型增生组织(P<0.05);TIM3 mRNA与PD-1、PD-L1 mRNA的表达呈正相关(r P=0.471和0.512,P<0.001);有淋巴结转移,TNM分期Ⅲ期和中、低分化程度的子宫内膜样腺癌患者癌组织中TIM3、PD-1蛋白表达的阳性率较高(P<0.05)。结论:TIM3、PD-1、PD-L1可能与子宫内膜样腺癌的发生发展有关。

Trajectories of depressive symptoms and risk of cardiovascular disease,cancer and mortality:a prospective cohort study

Background Depressive symptoms are established risk factors for various health outcomes.However,previous studies assessed depressive symptoms at a single time point,neglecting individual variations over time.Aims To identify depressive symptoms trajectories through repeated measures and examine their associations with cardiovascular disease(CVD),cancer and mortality.Methods This study included 20634 UK Biobank participants free of CVD and cancer at baseline with two or more assessments of depressive symptoms during 2006-2016.Group-based trajectory modelling identified depressive symptoms trajectories.Incident CVD,cancer and mortality were followed up until 2021 through linked registries.Results Six depressive symptoms trajectories were identified:no symptoms(n=6407),mild-stable(n=11539),moderate-stable(n=2183),severe-decreasing(n=206),moderate-increasing(n=177)and severe-stable(n=122).During a median follow-up of 5.5 years,1471 CVD cases,1275 cancer cases and 503 deaths were documented.Compared with the no symptoms trajectory,the mildstable,moderate-stable and severe-stable trajectories exhibited higher CVD risk,with hazard ratios(HRs)(95%CIs)of 1.19(1.06 to 1.34),1.32(1.08 to 1.34)and 2.99(1.85 to 4.84),respectively.Moderate-increasing and severe-stable trajectories were associated with higher mortality risks,with HRs(95%CIs)of 2.27(1.04 to 4.93)and 3.26(1.55 to 6.88),respectively.However,the severedecreasing trajectory was not associated with higher risks of adverse outcomes.We did not find significant associations between any trajectory and cancer.Conclusions Trajectories related to stable and increasing depressive symptoms,but not the trajectory associated with severe depressive symptoms at the initial assessment but decreasing at the follow-up,were associated with higher risks of CVD and mortality.Alleviating severe depressive symptoms at the initial onset may mitigate CVD and mortality risks.