Objective: To explore the impact of adverse childhood experiences (ACEs) on health risk behaviors (HRBs) among college students and the mediating role of psychological symptoms, so as to provide a basis for developing intervention strategies. Methods: From March to April 2023, a convenience cluster sample of 1 801 students from 12 universities in Nanning, Liuzhou, Guilin, Wuzhou of Guangxi completed an online survey. A self designed questionnaire, Adverse Childhood Experiences-International Questionnaire (ACE-IQ) and Symptom Checklist-90 (SCL-90) were used for evaluation tools. Binary Logistic regression, structural equation modeling (SEM) and Bootstrap methods were used to analyze the associations and mediating effects. Results: Overall, 71.2% of college students experienced at least one type of ACE, with emotional neglect (40.3%) and emotional abuse ( 25.2 %) having the highest detection rates. The top three HRBs were unhealthy diet (77.8%), physical inactivity (54.1%), and smoking/alcohol use (18.5%). Logistic regression showed that poor family functioning, abuse, and extra familial violence were each associated with an increased risk of smoking/alcohol use ( OR =1.14, 1.11, 1.18) and deliberate self harm ( OR =1.26, 1.19,1.30) (all P <0.05). Experience of abuse increased the risk of high risk sexual behavior and family dysfunction increaded the risk of physical inactivity, respectively ( OR = 1.07 , 1.04, both P <0.05). Mediation analysis revealed that anxiety ( β =0.20) and depression ( β = 0.09 ) partially mediated the pathway from poor family functioning to deliberate self harm; paranoia ( β =0.02) partially mediated the pathway from abuse to high risk sexual behavior; and obsessive-compulsive symptoms ( β =0.26) and depression ( β =0.10) partially mediated the pathway from extra familial violence to deliberate self harm (all P <0.05). Conclusion Psychological symptoms play a mediating role in the association between ACEs and HRBs, and mental health interventions may reduce the risk of HRBs among college students.

OBJECTIVE To construct a predictive model for evaluating the efficacy of a triple antiemetic regimen （neurokinin- 1 receptor antagonist+5-hydroxytryptamine 3 receptor antagonist+dexamethasone） for preventing nausea and vomiting induced by highly emetogenic chemotherapy （HEC） based on interpretable deep learning algorithms. METHODS Clinical data of cancer patients who received HEC and were treated with the standard triple antiemetic regimen in the oncology department of Tianjin Medical University General Hospital from January 2018 to December 2022 were collected retrospectively. Demographic， clinical and metabolism-related variables were integrated. After data pre-processing， two deep learning algorithms （deep random forest and dense neural network） and four machine learning algorithms （support vector machine， categorical boosting， random forest and decision tree） were used to build predictive models. Subsequently， model performance evaluation and model interpretability analysis were conducted. RESULTS Among the six candidate models， the deep random forest model demonstrated the best predictive performance on the test set， with an area under the receiver operating characteristic curve of 0.850， an accuracy of 0.911， a precision of 0.805， a recall of 0.783， an F1 score of 0.793， and a Brier score of 0.075. Interpretability analysis revealed that creatinine clearance rate （Ccr） was the key predictive factor， and low Ccr levels， female gender， younger age， highly emetogenic drugs （particularly cisplatin-containing chemotherapy regimens）， and anticipatory nausea and vomiting were positively correlated with the risk of HEC-related nausea and vomiting. CONCLUSIONS The deep random forest model exhibits the best performance in predicting the efficacy of triple antiemetic regimen for preventing HEC-related nausea and vomiting. The key predictors in this model primarily include Ccr，anticipatory nausea and vomiting， gender， age， and highly emetogenic drugs.

To understand the background of Escherichia coli(E.coli)carried by artificially bred sika deer and the biological characteristics of the isolated strains,such as drug resistance and pathogenicity,in April 2024,we collected 184 fresh deer fecal samples from four deer farms in Luxiang Township,Shuangyang District,Changchun City,Jilin Province,for isolation and cultivation of E.coli.The isolates were tested for drug resistance and biochemical identification with a BD PhoenixTM-100 Automated Microbiology System.The virulence genes were detected with PCR,and the strains were molecularly typed with ERIC-PCR.A total of 165 E.coli strains were isolated from 184 samples of deer feces,with an isolation rate of 89.67%.Twenty strains had a drug resistance phenotype,and the drug resistance rate was 12.12%;these strains included 15 strains of multi-drug resistant bacteria and 11 strains of ESBL-producing bacteria.Virulence gene detection indicated that the sika deer isolates carried multiple diarrhea-associated virulence genes,such as EAST-1(12.12%),eae(1.21%),stx1(7.88%),stx2(7.27%),and STa(1.82%).ERIC-PCR demonstrated that the isolates showed high polymorphism.The ESBL-producing E.coli carried by sika deer are likely to spread drug resistance in the community and livestock population.Some isolates carried multiple diarrhea-associated virulence genes,thus posing a human transmission risk.Therefore,monitoring of drug resistance and virulence genes must be strengthened,and antibiotics must be used reasonably during the breeding process to avoid excessive use and misuse.

Complex liver resection (CLR) is a collective term for surgical procedures addre-ssing complex invasion of intrahepatic vasculobiliary structures that cannot be radically resected through conventional methods. The ex vivo liver resection and autotransplantation (ELRA) and its modified techniques have significantly enhanced the technical feasibility of CLR implementation. In recent years, advancements in modified ELRA techniques and derivative procedures, including conversion resection, in-situ hypothermic perfusion, and auxiliary liver transplantation, have further diversified CLR methodologies, offering more personalized treatment options for CLR candidates. Given the complexity of such cases and substantial variations in surgical approach selection, improving procedural safety and scalability remains a critical challenge in CLR practice. The authors review the current application of modified techniques based on ELRA in CLR, evaluate the clinical significance based on institutional experiences, and propose future directions and individual selection for advancing the safe implementation of CLR.

Objective:To investigate the feasibility and safety of endoscopic surgery in the treatment of fibro-adipose vascular anomaly (FAVA).Methods:Clinical data of FAVA patients who underwent endoscopic treatment admitted to Xi’an International Medical Center Hospital from October 1, 2019 to April 1, 2024 were retrospectively analyzed, including gender, age of onset, age of diagnosis, lesion location, operation time, intraoperative blood loss, hospital stays, incision complications, etc. Before endoscopy, magnetic resonance imaging and ultrasound were routinely used to locate the lesion range, and the surgical position and Trocar location were selected according to different lesion sites.Descriptive statistical analysis was conducted using SPSS version 26.0.Results:40 cases of FAVA patients were admitted during the period, all of whom underwent endoscopic radical resection, including 15 males and 25 females. The age of onset was 8 (6, 12.5) years. The age of diagnosis was 11 (8, 22.5) years. There were 31 patients with stage Ⅰ and 9 patients with stage Ⅱ. 31 cases involved the calf, of which 21 involved the calf triceps (gastrocnemius, soleus) and 9 involved the thigh, of which 1 patient had lesions originating from the fascia around the sciatic neurovascular bundle. 11 cases (27.5%) were converted to open surgery. The operative time was 192.5 (107, 292.5) min. The intraoperative blood loss was 35 (10, 87.5) ml. The length of hospital stay for endoscopic surgery was 9 (7, 11) d. The postoperative follow-up time was 11.5 (3.5, 13.5) months. Of the 40 patients, 39 were cured completely without residual pain or joint movement disorder after operation. Postoperative dorsiflexion function of the ankle joint was mildly limited in one patient classified as stage Ⅱ. There was no incision complication and recurrence.Conclusion:For patients with stage Ⅰ and Ⅱ FAVA, endoscopic surgery has concealed incisions, indistinct scars, definite therapeutic effects and high safety.

Objective:To investigate the feasibility and safety of endoscopic surgery in the treatment of fibro-adipose vascular anomaly (FAVA).Methods:Clinical data of FAVA patients who underwent endoscopic treatment admitted to Xi’an International Medical Center Hospital from October 1, 2019 to April 1, 2024 were retrospectively analyzed, including gender, age of onset, age of diagnosis, lesion location, operation time, intraoperative blood loss, hospital stays, incision complications, etc. Before endoscopy, magnetic resonance imaging and ultrasound were routinely used to locate the lesion range, and the surgical position and Trocar location were selected according to different lesion sites.Descriptive statistical analysis was conducted using SPSS version 26.0.Results:40 cases of FAVA patients were admitted during the period, all of whom underwent endoscopic radical resection, including 15 males and 25 females. The age of onset was 8 (6, 12.5) years. The age of diagnosis was 11 (8, 22.5) years. There were 31 patients with stage Ⅰ and 9 patients with stage Ⅱ. 31 cases involved the calf, of which 21 involved the calf triceps (gastrocnemius, soleus) and 9 involved the thigh, of which 1 patient had lesions originating from the fascia around the sciatic neurovascular bundle. 11 cases (27.5%) were converted to open surgery. The operative time was 192.5 (107, 292.5) min. The intraoperative blood loss was 35 (10, 87.5) ml. The length of hospital stay for endoscopic surgery was 9 (7, 11) d. The postoperative follow-up time was 11.5 (3.5, 13.5) months. Of the 40 patients, 39 were cured completely without residual pain or joint movement disorder after operation. Postoperative dorsiflexion function of the ankle joint was mildly limited in one patient classified as stage Ⅱ. There was no incision complication and recurrence.Conclusion:For patients with stage Ⅰ and Ⅱ FAVA, endoscopic surgery has concealed incisions, indistinct scars, definite therapeutic effects and high safety.

Objective:To prospectively analyze and evaluate the clinical efficacy of fire needle acupuncture selection based on CT localization in the treatment of lung cancer-related cough.Methods:A total of 36 patients with lung cancer-related cough who were admitted to the Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine from January 2020 to December 2023 were prospectively included as research samples.According to the random number table method,they were divided into control group(18 cases)and observation group(18 cases).The control group was treated with routine etiological treatment and symptomatic treatment,while the observation group was treated with fire needle acupuncture selection based on CT localization on the basis of the control group.The course of treatment was 28 days.The efficacy improvement rate after 28 days of treatment,visual analogue scale(VAS),le icester cough questionnaire in mandarin-Chinese(LCQ-MC)and levels of peripheral serum cytokines interleukin-6(IL-6)and interleukin-8(IL-8)before and after 28 days of treatment were compared between the two groups.Results:After 28 days of treatment,the efficacy improvement rate of curative effect,VAS score and LCQ-MC score in the observation group were significantly higher than those in the control group(P＜0.05).The levels of IL-6 and IL-8 in the two groups were significantly lower than those before treatment(P＜0.05),but there was no significant difference between the two groups(P＞0.05).Conclusion:The treatment of fire needle acupuncture selection guided by CT localization can significantly improve the therapeutic effect of patients with lung cancer-related cough,effectively reduce the cough symptoms of patients,improve the quality of life of patients,and alleviate the inflammatory response in the body.

Complex liver resection (CLR) is a collective term for surgical procedures addre-ssing complex invasion of intrahepatic vasculobiliary structures that cannot be radically resected through conventional methods. The ex vivo liver resection and autotransplantation (ELRA) and its modified techniques have significantly enhanced the technical feasibility of CLR implementation. In recent years, advancements in modified ELRA techniques and derivative procedures, including conversion resection, in-situ hypothermic perfusion, and auxiliary liver transplantation, have further diversified CLR methodologies, offering more personalized treatment options for CLR candidates. Given the complexity of such cases and substantial variations in surgical approach selection, improving procedural safety and scalability remains a critical challenge in CLR practice. The authors review the current application of modified techniques based on ELRA in CLR, evaluate the clinical significance based on institutional experiences, and propose future directions and individual selection for advancing the safe implementation of CLR.

The integration of science and education is not only an important strategy for promoting social progress and technological development,but also a modern form of higher education aiming at cultivating innovative talents.Conducting scientific research training for undergraduate medical students is one of the important ways to cultivate their innovative abilities and comprehensive qualities.Our team proposed a"teaching,science,and ideology trinity"teaching model to comprehensively cultivate students' scientific research comprehensive abilities under the value orientation of ideological and political education by or-ganically integrating molecular biology experimental teaching with the scientific research training of under-graduate medical students.In this teaching activity,taking the experiment of gene polymorphism as an example,our team selected students with research potential from the whole grade and divided them into 4 project groups that were instructed by 4 teachers.The students were trained in the whole process of scien-tific research,including topic selection,project writing,experimental designing,application for research ethics,and project summary.Our team has always adhered to student-contentedness of educational con-cepts to stimulate students' intrinsic motivation throughout the teaching process.Students are the design-ers and implementers of the project,and teachers are only guides and promoters of learning.After this training,students not only became familiar with the writing and implementation of scientific research pro-jects,but also improved their literature reading,experimental designing,experimental skills,and prob-lem-solving abilities.More importantly,this teaching activity also cultivated students' awareness of re-search ethics and academic moral standards.

Objective To observe the clinical efficacy of mind-regulating and meridians-dredging acupuncture combined with rehabilitation training in treating limb dysfunction in recovery period of cerebral infarction(CI).Methods A total of 110 cases of patients with limb dysfunction in recovery period of CI were randomly divided into observation group and control group,55 cases in each group,the control group was given routine rehabilitation training,and the observation group was treated with mind-regulating and meridians-dredging acupuncture on the basis of intervention of the control group,the course of treatment covered two consecutive weeks.After two weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes of scores of traditional Chinese medicine(TCM)syndrome,Fugl-Meyer Assessment(FMA),Berg Balance Scale(BBS)and Modified Barthel Index(MBI)before and after treatment of patients in the two groups were observed.The changes of electromyographic signal before and after treatment were compared between the two groups.And the safety and the occurrence of adverse reactions in the two groups were evaluated.Results(1)The total effective rate was 98.18%(54/55)in the observation group and 87.27%(48/55)in the control group.The efficacy of the observation group was superior to that of the control group,the difference being statistically significant(P<0.05).(2)After treatment,the TCM syndrome scores of patients in the two groups were significantly improved(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,with a statistically significant difference(P<0.05).(3)After treatment,the FMA scores of patients in the two groups improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(4)After treatment,the BBS scores and MBI scores of the patients in the two groups improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(5)After treatment,the root mean square value(RMS)of biceps brachii muscle elbow flexion and triceps brachii muscle elbow extention of the two groups of patients improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(6)During the treatment,there were no obvious adverse reactions occurred in both groups.Conclusion Mind-regulating and meridians-dredging acupuncture combined with rehabilitation training in treating limb dysfunction in recovery period of CI can significantly improve the motor ability of patients,and adjust the electromyographic signals of the affected limbs,with high safety.