Objective: To examine the changing trajectories of sleep problems and teacher support among first year middle school students and their covariant relationship,so as to provide theoretical basis for the prevention strategy of sleep problems for the first year junior high school students. Methods: In September 2020, a multistage cluster random sampling method was used to select 1 027 first year junior high school students from two schools of Anshun and Guiyang cities in Guizhou Province for survey and follow up assessments (T1:September 2020, T2:October 2020, T3:November 2020, T4:December 2020). The Student Perceived Teacher Support Behavior Questionnaire and Pittsburgh Sleep Quality Index Scale were administered to assess sleep problems and teacher support among first year junior high school students. Spearman correlation analysis was used to examine the relationship between sleep problems and teacher support. A multivariate latent growth curve model was employed to analyze the changing trajectories and covariant relationship between teacher support and sleep problems, followed by a multi group analysis. Results: For first year junior high school students, teacher support scores at T1-T4 were 4.00 (3.47, 4.53), 4.00 (3.47, 4.58), 3.95 (3.47, 4.61) and 4.00 (3.48, 4.67), respectively; sleep problem scores were 0.83 (0.50, 1.17), 0.67 (0.50, 1.17), 0.83 (0.50, 1.17) and 0.67 (0.33, 1.17), respectively. Spearman correlation analysis revealed that teacher support and sleep problems were negatively correlated across all four period ( r =-0.28 to -0.14, all P <0.01). Teacher support perceived by students showed a linear increasing trend (intercept=3.98, slope=0.02), while sleep problems showed a linear decreasing trend (intercept=0.86, slope= -0.02 ) (all P <0.05). The multivariate latent growth model indicated that the rate of increase in teacher support after enrollment effectively predicted the rate of decrease in sleep problem levels ( β=-0.34, P <0.01). Multigroup analysis showed that the covariant relationship was not moderated by gender or boarding status (both P >0.05). Conclusions The increase in teacher support experienced by first year junior high school students during the transition period after enrollment, accompanied by a reduction in sleep problems, constitutes a dynamic protective process. The process is not moderated by gender or boarding status.

Gastrointestinal stromal tumors(GISTs)are the most common mesenchymal neoplasms of the gastrointestinal tract,and early diagnosis and accurate evaluation are of great significance for clinical treatment.Ultrasound examination plays an important role in the preliminary detection,hemodynamic monitoring,and prognostic assessment of GISTs,but the complex and diverse manifestations of GISTs have increased the difficulties in diagnosis.Radiomics and artificial intelligence(AI)have significantly improved the effi-ciency of medical imaging analysis,and they are expected to enhance diagnostic accuracy and provide a scientific basis for prognostic evaluation.This article systematically reviews the latest research advances in ultrasound-based radiomics and AI in the diagnosis and prognostic evaluation of GISTs,with a focus on their application value in early diagnosis and risk assessment,in order to provide theo-retical support for optimizing clinical decision-making.

Objective To analyze the characteristics of HIV-1 pretreatment drug resistance(PDR)and molecular transmission networks in Yubei District,Chongqing,providing evidence for targeted interventions.Methods Using a cross-sectional design,plasma samples were collected from HIV/AIDS patients receiving antiretroviral therapy(ART)in Yubei District from January 2022 to December 2023.Pol gene fragments were extracted and amplified for HIV-1 genotyping and drug resistance analysis.Molecular transmission networks were constructed based on genetic distance calculations.Results Among 478 HIV-1 pol sequences,eight geno-types were identified:with CRF07_BC(60.4%,289/478),CRF08_BC(15.5%,74/478),CRF01_AE(11.7%,56/478),and CRF85_BC(5.9%,28/478).The overall PDR rate was 6.3%(30/478),with resistance to nucleoside reverse transcriptase inhibitors(NRTIs)and non-nucleoside reverse transcriptase inhibitors(NNRTIs)at 1.7%(8/478)and 5.2%(25/478),respectively.No protease inhibitor(PI)resistance was de-tected.The molecular network included 177 cases(37.0%network entry rate),forming 53 clusters with 198 connections.Cluster sizes ranged from 2 to 17 nodes,and 75.3%(149/198)of connections were associated with five subdistricts/towns:Shuanglonghu Street,Huixing Street,Luoqi Town,Gulu Town,and Baoshenghu Street.Conclusion HIV-1 genotypes in Yubei District exhibit diversity and complexity,with moderate PDR prevalence.Regional clustering of transmission networks suggests the need for enhanced molecular surveil-lance and targeted interventions based on analytical findings.

Objective To evaluate the effect of dapagliflozin on myocardial function in early spontaneously hypertensive rats(SHR)with layer-specific global longitudinal strain(GLS).Methods A total of 45 male SHR aged 6 weeks were randomly divided into control group(normal saline),dapagliflozin group[1 mg/(kg·day)],and losartan group[10 mg/(kg·day)].Fifteen male Wistar-Kyoto(WKY)rats at same age with normal blood pressure were subjected and served as blank control group.During 8 weeks of intervention,systolic blood pressure(SBP)was measured,and conventional echocardiography and two-dimensional speckle tracking echocardiography(2DSTE)were performed and the results were collected to acquire the longitudinal strain of each layer of left ventricular(LV)myocardium.The parameters were compared among the groups.The pathological changes of myocardium were observed in each group of rats.Results Compared with the WKY group,LV ejection fraction(LVEF)and LV fraction shortening(LVFS)at week 8 were decreased in the control group(P＜0.05),but no such decreases were observed in the dapagliflozin group and the losartan group.The GLS of endo-myocardium(GLSendo)at the 6th week was decreased,and GLSendo,GLSmid and GLSepi at the 8th week were all decreased in the control group than the WKY group(all P＜0.05).But there were no statistical differences in the above 3 indicators in the dapagliflozin and losartan groups when compared with the WKY group(all P＞0.05).The pathological results showed that myocardial interstitial fibrosis was observed in the control group at the 6th week.Conclusion Dapagliflozin can effectively improve myocardial function in early SHR.

Objective To develop a preoperative question prompt list(QPL)for older patients with benign prostatic hyperplasia(BPH)and evaluate its effectiveness in application.Methods This trial adopted a randomized controlled design.The QPL was developed by literature review,expert discussions,and Delphi consultation.Convenience sampling was used to subject 76 older BPH inpatients treated in our department,and then they were randomly divided into control(routine communication,n=38)and intervention(QPL-assisted communication,n=38)groups.Number of the questions patient asking,communication duration,information recall,and communication quality were compared between the 2 groups.Results In the 2 rounds of expert consultation,the response rate of questionnaire was 94.44%and 100%,the authority coefficient was 0.89 and 0.93,the coefficient of variation was 0.05～0.22 and 0～0.11,and Kendall's coefficients was 0.645(Chi-square=87.782,P<0.001)and 0.733(Chi-square=74.789,P<0.001),respectively.The final QPL included 3 themes and 7 questions.The intervention group asked more questions(4.03±1.89 vs 2.11±1.27,P<0.05)but spent similar time for communication(8.18±2.11 vs 7.67±1.72 min,P>0.05).At 1 d before discharge,better information recall(8.74±1.12 vs 6.49±1.68,P<0.001)and communication quality(60.06±6.25 vs 54.86±7.98,P<0.05)were observed in the intervention group when compared with the control group.Conclusion Our developed preoperative communication QPL is of scientificalness and effectiveness for elderly BPH patients.This tool can not only encourage question-asking behavior,but also improve information recall and communication quality in the patients.

Objective To investigate the role and mechanism of ginsenoside Rk3 in alleviating the senescence of retinal pigment epithelial(RPE)cells and in treating neovascular age-related macular degeneration(nAMD).Methods An ARPE-19 cell senescence model induced by hydrogen peroxide and an nAMD mouse model were subjected to validate the pharmacological activity of ginsenoside Rk3 in reducing RPE cell senescence and shrinking choroidal neovascularization(CNV)area.Transcriptome sequencing was performed to analyze the changes in differential gene expression profiles.Western blotting was used to detect the expression levels of mTOR,S6K1,p-S6K1,4EBP1,p-4EBP1,p62,and LC3A/B.Molecular docking and dynamics simulations were conducted to analyze the binding affinity of ginsenoside Rk3 with mTOR protein.Results ① Cell experiments showed that ginsenoside Rk3 significantly alleviated the senescence in ARPE-19 cells(P<0.05).② Animal experiments confirmed that ginsenoside Rk3 significantly reduced the retinal CNV area in nAMD mice(P<0.01),and its efficacy was comparable to the first-line clinical drug aflibercept(P>0.05).③ Transcriptome sequencing suggested that ginsenoside Rk3 led to enrichment of the PI3K-Akt signaling pathway.Western blotting showed that ginsenoside Rk3 inhibited the overactivation of mTORC1 signaling(P<0.05)and simultaneously enhanced cellular autophagy(P<0.05).④ Molecular docking and dynamics simulations further validated that ginsenoside Rk3 probably targets mTOR to alleviate RPE cell senescence.Conclusion Ginsenoside Rk3 alleviates RPE cell senescence and reduces retinal CNV area in nAMD mice by enhancing autophagy through inhibition of mTOR.

To explore the immunomodulatory effects of a new vegetable oil adjuvant(named E515)containing vitamin E(VE)and ginsenosides(GS)on rabbit peripheral blood lymphocytes and Bordetella of rabbit inactivated vaccine.E515,Bordetella bronchiseptica(Bb)and LPS were co-cultured with rabbit peripheral blood lymphocytes in vitro,and the lymphocyte conversion rate was detected by CCK8 method,and the content of lymphocyte supernatant cytokines was detected by ELISA method.After rabbits were immunized with E515-Bb vaccine,the antibody level was detec-ted by indirect ELISA,the serum cytokine content was detected by ELISA,and the protective effect of E515-Bb vaccine on rabbits was observed by challenge test.In vitro cell experiments showed that E515 could significantly increase lymphocyte proliferation and TH1/TH2 cytokine se-cretion in rabbit peripheral blood.In vivo animal experiments showed that E515 adjuvant could sig-nificantly enhance the level of Bb specific antibody induced by Bordetella vaccine in rabbits.In-crease the secretion level of TH1/TH2 cytokines and decrease the secretion level of TNF-α;It can effectively protect rabbits against Bordetella infection with a protection rate of 91.67％.Therefore,E515 as a new vegetable oil adjuvant deserves further study.

Objective To analyze the research status,hotspots and trends for the mental health of parents of children with autism spectrum disorder(ASD).Methods Literatures from January 1st,2016 to March 26th,2025 in CNKI and Web of Science core databases were re-trieved.CiteSpace 6.4.R1 advanced version was used for bibliometric analysis in terms of publication trends,countries/authors/institutions collaboration networks,keywords and bursting words.Results A total of 216 Chinese and 1 258 English articles were included.The annual publication volume increased in English articles by an average of 20.1%a year,and the United States,Netherlands and China were the countries with the most publication.However,Chinese publication volume decreased after 2023.The keywords formed nine and eight clusters in Chinese and English literatures,respectively,which were integrated into four core ar-eas:mental health and comorbid disorders,neurodevelopmental and behavioral disorders,education and social function,and research methods and intervention.Chinese researches focused on optimizing the family-social sup-port system and intervention models,while English researches focused on the mechanism of neurodevelopmental comorbidities and evidence-based practice.Conclusion The researches on the mental health of parents of children with ASD tend to interdisciplinary integration.There is a significant divergence in the main topics between Chinese and English researches.

Objective To explore the clinical efficacy of Xingqi Tongjiang tablets in treating postprandial distress syndrome(PDS)of liver-stomach disharmony syndrome and its impact on electrogastrogram indicators.Methods A total of 300 patients with PDS were prospectively selected and randomly divided into the control group(treated with mosapride citrate+placebo of Xingqi Tongjiang tablets,n=151)and the observation group(treated with mosapride citrate+Xingqi Tongjiang tablets,n=149)according to the random number table method.The levels of traditional Chinese medicine(TCM)syndrome scores,clinical efficacy,electrogastrography indicators,negative emotion scores,quality of life scores and adverse reactions were compared between the two groups.Results After treatment,the TCM syndrome scores of both groups decreased,and the scores of the observation group were lower than those of the control group(P＜0.05).The total effective rate of the observation group was higher than that of the control group(P＜0.05).After treatment,the percentages of normal gastric slow waves(NGSW)in the overall stomach and gastric antrum before and after meals of both groups increased,and the proportion of slow waves(SR)decreased.Moreover,the increased NGSW and the decreased SR in the observation group were more significant(P＜0.05).The scores of the Hamilton Anxiety Scale(HAMA)and the Hamilton Depression Scale(HAMD)decreased after treatment in both groups,and the scores of the observation group were lower(P＜0.05).The scores of the Nepean Dyspepsia Quality of Life Index(NDLQI)increased after treatment in both groups,and the scores of the observation group were higher(P＜0.05).There were no significant differences in adverse reactions between the two groups.Conclusion Xingqi Tongjiang tablets can effectively improve the electrogastrogram indicators of patients with postprandial distress syndrome of liver-stomach disharmony syndrome,and enhance clinical efficacy.

Objective:To develop the Home-based Self-management Efficacy Questionnaire for Stable Chronic Obstructive Pulmonary Disease (COPD) Patients and test its reliability and validity.Methods:Guided by the individual and family self-management theory and self-management efficacy theory, a preliminary questionnaire was developed through literature analysis, semi-structured interviews, and expert inquiries. From September to November 2022, convenience sampling was used to select stable COPD patients of the Respiratory Department of Tongji University Shanghai Pulmonary Hospital as participants for investigation for project analysis and exploratory factor analysis of the questionnaire. From December 2022 to January 2023, a survey was conducted on stable COPD patients who visited the Respiratory Department of Tongji University Shanghai Pulmonary Hospital and Yancheng Third People's Hospital to conduct confirmatory factor analysis and reliability testing on the questionnaire.Results:A total of 220 and 290 questionnaires were distributed respectively, and 214 and 280 valid questionnaires were collected, with effective response rates of 97.27% (214/220) and 96.55% (280/290), respectively. The Home-based Self-management Efficacy Questionnaire for COPD Patients included six dimensions and 28 items. The questionnaire's total Cronbach's α coefficient was 0.910, and the half-confidence coefficient was 0.806. The content validity index at the questionnaire level was 0.928, and the content validity index at the item level was 0.800 to 1.000. The exploratory factor analysis showed that a total of six common factors were extracted, with a cumulative variance contribution rate of 63.943%. Confirmatory factor analysis showed that the model fitted well and the questionnaire factor structure was stable.Conclusions:The the Home-based Self-management Efficacy Questionnaire for Stable COPD has been developed with good reliability and validity, providing a reference for medical and nursing staff to evaluate the home self-management efficacy of stable COPD patients.