Objective: To develop and compare multiple machine learning models for identifying high-risk college students exhibiting phubbing behavior and to determine key predictive factors, so as to provide evidence for precise screening and early intervention strategies. Methods: In December 2025, 1 828 undergraduate students, selected from three universities in Wuhan by using convenience sampling method, were surveyed via online qustionnaire for sociodemographic characteristics, phubbing behavior, family cohesion index, mature happiness, fear of negative evaluation, multidimensional state boredom, and psychological vulnerability. Four machine learning algorithms, including multilayer perceptron (MLP), extreme gradient booting (XGBoost), K-nearest neighbors (KNN), and gradient boosting decision tree (GBDT), were applied. The dataset was randomly split into a training set and a test set at a ratio of 7∶3. Model performance was evaluated using accuracy, recall, F1-score, and area under the receiver operating characteristic curve (AUC). The best performing model was further interpreted using shapley additive explanation (SHAP) analysis to assess feature importance. Results: In the training set,955 participants were classified as having low level phubbing behavior, and 325 participants were classified as having high level phubbing behavior. Significant differences were observed in psychological vulnerability, multidimensional state boredom, family cohesion index, and mature happiness between groups ( Z =-10.29, -11.72, -8.17, -7.83, all P <0.05). Significant differences were also found in the detection rate of high level phubbing behavior according to family residence, family status, left behind experience,interpersonal relationships,exercise frequency,physical flexibility,and sleep status ( χ 2=12.22, 38.93, 16.90, 44.64, 58.17, 82.14, 37.89, all P <0.05). Among the four machine learning models (MLP, KNN, GBDT, XGBoost),all showed good discrimination ability, with XGBoost performing best (accuracy 79%, recall 71%, F1-score=0.70, AUC=0.78), while GBDT achieved the highest precision (78%). Feature importance analysis showed that multidimensional state boredom was the most important predictor of phubbing behavior, followed by psychological vulnerability, family cohesion, mature happiness, and fear of negative evaluation. SHAP analysis indicated that multidimensional state boredom, psychological vulnerability, and fear of negative evaluation had positive risk effects, while family cohesion and hedonic well being had protective effects for high risk of phubbing behavior. Conclusions Multidimensional state boredom is the core predictor of phubbing behavior among college students. The XGBoost model demonstrates good predictive performance and can provide a reference for identifying high risk individuals and implementing targeted interventions.

ObjectiveThis research focused on examining the distinctive characteristics of nutrient intake and dietary patterns among long-lived elderly individuals. Additionally， the study was aimed to explore the specific dietary components that may impact the skeletal muscle mass in this particular group. MethodsThis study was conducted in the Chongming area of Shanghai， China. A total of 206 long-lived elderly individuals aged 90 or above were recruited. The 3-day 24-hour dietary recall method was used to collect dietary information and general demographic data through face-to-face interviews with professional nutritionists. The skeletal muscle mass index（SMI） was measured by bioelectrical impedance analysis（BIA）， and low skeletal muscle mass was diagnosed based on the 2019 Asian Working Group for Sarcopenia criteria. T-test analysis， chi-square test， and logistic regression were used to analyze the relationship between dietary nutrient intake and skeletal muscle mass. ResultsIn terms of food intake categories， compared with the long-lived elderly people with normal muscle mass， the intake of cereals containing miscellaneous beans and vegetables in the long-lived elderly people with low muscle mass was significantly lower（P<0.05）. In terms of the nutrient intake， compared with the long-lived elderly people with normal muscle mass， the intake of total energy， carbohydrate， dietary fiber， vitamin D， folic acid， phosphorus， potassium， magnesium， iron， and manganese in the long-lived elderly people with low muscle mass was significantly lower（P<0.05）. After continuous adjustment for the covariates， multivariate logistic regression analysis found that the intake levels of folic acid and dietary fiber were important factors influencing skeletal muscle mass， Individuals with lower intake levels of folic acid and dietary fiber are at a higher risk of low muscle mass in long-lived elderly individuals ［OR_{folic acid T1}， _{dietary fiber T1} （95%CI）： 2.90 （1.11‒7.61）； 4.09 （1.53‒10.91）］. ConclusionThe consumption of cereals that include a variety of beans and vegetables was noticeably lower in the long-lived elderly individuals with lower muscle mass when compared to those with normal muscle mass. Furthermore， low levels of folic acid and dietary fiber intake are associated with an increased risk of low skeletal muscle mass.

The mild-natured and bitter-flavored traditional Chinese medicines (MB-TCMs) are an important class of TCMs that have been widely used in clinical practice and recognized as safe long-term treatments for chronic diseases. However, as an important class of TCMs, the panorama of pharmacological effects and the mechanisms of MB-TCMs have not been systemically reviewed. Compelling studies have shown that gut microbiota can mediate the therapeutic activity of TCMs and help to elucidate the core principles of TCM medicinal theory. In this systematic review, we found that MB-TCMs commonly participated in the modulation of metabolic syndrome, intestinal inflammation, nervous system disease and cardiovascular system disease in association with promoting the growth of beneficial bacteria Bacteroides, Akkermansia, Lactobacillus, Bifidobacterium, Roseburia as well as inhibiting the proliferation of harmful bacteria Helicobacter, Enterococcus, Desulfovibrio and Escherichia-Shigella. These alterations, correspondingly, enhance the generation of protective metabolites, mainly including short-chain fatty acids (SCFAs), bile acid (BAs), 5-hydroxytryptamine (5-HT), indole and gamma-aminobutyric acid (GABA), and inhibit the generation of harmful metabolites, such as proinflammatory factors trimethylamine oxide (TAMO) and lipopolysaccharide (LPS), to further exert multiplicative effects for the maintenance of human health through several different signaling pathways. Altogether, this present review has attempted to comprehensively summarize the relationship between MB-TCMs and gut microbiota by establishing the TCMs-gut microbiota-metabolite-signaling pathway-diseases axis, which may provide new insight into the study of TCM medicinal theories and their clinical applications.

The comparison between traditional Chinese medicine Jinzhen oral liquid (JZOL) and Western medicine in treating children with acute bronchitis (AB) showed encouraging outcomes. This trial evaluated the efficacy and safety of the JZOL for improving cough and expectoration in children with AB. 480 children were randomly assigned to take JZOL or ambroxol hydrochloride and clenbuterol hydrochloride oral solution for 7 days. The primary outcome was time-to-cough resolution. The median time-to-cough resolution in both groups was 5.0 days and the antitussive onset median time was only 1 day. This randomized controlled trial showed that JZOL was not inferior to cough suppressant and phlegm resolving western medicine in treating cough and sputum and could comprehensively treat respiratory and systemic discomfort symptoms. Combined with clinical trials, the mechanism of JZOL against AB was uncovered by network target analysis, it was found that the pathways in TRP channels like IL-1β/IL1R/TRPV1/TRPA1, NGF/TrkA/TRPV1/TRPA1, and PGE2/EP/PKA/TRPV1/TRPA1 might play important roles. Animal experiments further confirmed that inflammation and the immune regulatory effect of JZOL in the treatment of AB were of vital importance and TRP channels were the key mechanism of action.

Objective To investigate the effect of resveratrol on endoplasmic reticulum stress and apoptosis in thyroid follicular cells induced by high iodine. Methods The thyroid follicular cell line Nthy-ori 3-1 was cultured in vitro and divided into four groups based on different culture methods: normal culture group (Normal group), high iodine group (HI group), resveratrol group (RES group), and high iodine combined with resveratrol group (HI+RES group). Cell proliferation activity was detected by CCK-8 assay, cell apoptosis was detected by TUNEL assay, and the BIP, CHOP, IRE1 mRNA expressions were detected by real-time quantitative polymerase chain reaction (PCR). Western blot was used to detect the protein expressions of BIP, CHOP, and IRE1. Results Compared with the Normal group, the proliferation activity of cells in the HI group decreased after 72 hours of culture, the proportion of apoptotic cells increased, the proportion of TUNEL staining positive cells increased, and the relative expressions of BIP, CHOP, IRE1 mRNA, as well as BIP and CHOP proteins were significantly elevated (P < 0.001 or P < 0.05). Compared with the HI group, the proliferation activity of cells in the HI+RES group increased after 72 hours of culture, the proportion of apoptotic cells decreased, the proportion of TUNEL staining positive cells decreased, and the relative expressions of BIP, CHOP mRNA, as well as BIP and CHOP proteins, were significantly reduced(P < 0.001 or P < 0.01). Conclusion Resveratrol exerts a protective effect on thyroid follicular cells induced by high iodine, significantly inhibiting endoplasmic reticulum stress and apoptosis caused by excessive iodine intake.

Objective To investigate the therapeutic effect of different debridement approaches combined with internal fixation with bone grafting in Brucellar spondylitis.Methods A retrospective study was conducted on 68 patients with Brucellar spondylitis.The 34 patients receiving one-stage posterior debridement+bone graft fusion+pedicle screw rod internal fixation were included in group A,while the other 34 patients treated with one-stage anterior debridement+bone graft fusion+pedicle screw rod internal fixation were included in group B.After 1 year of follow-up,3 cases in group B and 1 case in group A fell off.The two groups were compared for biomechanical indexes,clinical indexes,blind imaging scores and complications.Results The operation time,the first time of getting out of bed,the length of hospitalization and the intraoperative blood loss were shorter/less in group A than in group B(P<0.05).The differences in blind imaging score,Cobb angle and anterior vertebral body height ratio before operation and 1,6 and 12 months after operation,as well as the visual analogue scale score for low back pain before operation and 6 and 12 months after operation between two groups were trivial(P>0.05).One month after operation,the visual analogue scale score for low back pain in group A was lower than that in group B(P<0.05).Significant difference between two groups was found in ASIA grades at 12 months after operation(P<0.05)but not at 6 months after operation(P>0.05).No serious complications occurred in both groups,and patients'condition improved after active intervention.Conclusion Both debridement approaches can effectively improve clinical symptoms,maintain spinal stability,facilitate graft fusion,and control postoperative inflammation.However,the posterior approach can shorten the operation time,reduce the trauma to the body,and significantly alleviate pain at 1 month after operation,especially improving the symptoms of spinal cord nerve compression in the spinal canal,so it can be preferred if patient's condition permits.

Objective To investigate the therapeutic effect of different debridement approaches combined with internal fixation with bone grafting in Brucellar spondylitis.Methods A retrospective study was conducted on 68 patients with Brucellar spondylitis.The 34 patients receiving one-stage posterior debridement+bone graft fusion+pedicle screw rod internal fixation were included in group A,while the other 34 patients treated with one-stage anterior debridement+bone graft fusion+pedicle screw rod internal fixation were included in group B.After 1 year of follow-up,3 cases in group B and 1 case in group A fell off.The two groups were compared for biomechanical indexes,clinical indexes,blind imaging scores and complications.Results The operation time,the first time of getting out of bed,the length of hospitalization and the intraoperative blood loss were shorter/less in group A than in group B(P<0.05).The differences in blind imaging score,Cobb angle and anterior vertebral body height ratio before operation and 1,6 and 12 months after operation,as well as the visual analogue scale score for low back pain before operation and 6 and 12 months after operation between two groups were trivial(P>0.05).One month after operation,the visual analogue scale score for low back pain in group A was lower than that in group B(P<0.05).Significant difference between two groups was found in ASIA grades at 12 months after operation(P<0.05)but not at 6 months after operation(P>0.05).No serious complications occurred in both groups,and patients'condition improved after active intervention.Conclusion Both debridement approaches can effectively improve clinical symptoms,maintain spinal stability,facilitate graft fusion,and control postoperative inflammation.However,the posterior approach can shorten the operation time,reduce the trauma to the body,and significantly alleviate pain at 1 month after operation,especially improving the symptoms of spinal cord nerve compression in the spinal canal,so it can be preferred if patient's condition permits.

ObjectiveTo describe the incidence and distribution characteristics of congenital heart disease in newborns， and to analyze the trend of the notification rate from 2009 to 2018 in Chongming District， Shanghai. MethodsBased on the shanghai birth defects surveillance system， newborns delivered in all medical institutions in Chongming District from 2009 to 2018 were examined for congenital heart disease at birth and followed up to 42 days. The notification rate and trends of various congenital heart diseases were described. ResultsThere were 548 cases of neonatal congenital heart disease in Chongming District from 2009 to 2018， and the notification rate was 20.11‰ （95%CI： 18.47‰-21.85‰）， with statistically significant differences between years during the study period （Z=10.616， P<0.001）. The four most common types of congenital heart disease were patent ductus arteriosus （313， 11.49%）， patent foramen ovale （312， 11.45%）， atrial septal defect （88， 3.64%） and ventricular septal defect （73， 2.68%）. Majority of the congenital heart disease cases were patent ductus arteriosus and patent foramen ovale that could be further closed during growth and development. Isolated patent ductus arteriosus and isolated patent foramen ovale accounted for 18.61% and 23.18% respectively of the total cases. ConclusionThe notification rate of congenital heart disease in Chongming District shows a trend of fluctuating decline followed by an increase. Community follow-up and outcome tracking should be strengthened for children with congenital heart disease， especially those with patent ductus arteriosus or patent foramen ovale.

ObjectiveTo observe the effects of specific exercise therapy on spinal deformity and joint hypermobility of idiopathic scoliosis. MethodsFrom April to October, 2021, 100 children with idiopathic scoliosis in the Scoliosis Rehabilitation Center of Xinhua Hospital were divided into control group (n = 50) and experimental group (n = 50), who accepted routine exercise therapy or scoliosis-specific exercise therapy in accordance with their wishes, for six months. The maximum Cobb angle and bone mineral density were measured, and they were assessed with Beighton Scale and Chinese version of the Scoliosis Research Society-22 Questionnaire Scores (SRS-22) before and after treatment. ResultsThe change of the maximum Cobb angle was more in the experimental group than in the control group (Z = -2.202, P < 0.05) after treatment, and the incidence of respondent was more (χ² = -2.405, P < 0.05). The bone mineral density decreased in the experimental group after treatment (|Z| > 2.127, P < 0.05). For SRS-22, the total scores increased in both groups after treatment (F_time = 106.57, P < 0.001), and increased more in the experimental group than in the control group (F = 4.969, P < 0.05); the scores of function domain and self-image domain increased in the experimental group (|Z| > 2.149, P < 0.05), while the mental health domain score decreased in the control group (Z = -2.096, P < 0.05); and the mental health domain score was more in the experimental group than in the control group (Z = -2.260, P < 0.05). ConclusionThe scoliosis-specific exercise therapy is effective on spinal deformity and quality of life for children with idiopathic scoliosis, but less helpful for joint hypermobility and bone mineral density, which need to further improve.

Objective To evaluate the quality of the clinical trial literatures published on the treatment of COVID-19 with TCM, find out the shortcomings and put forward corresponding suggestions, in order to promote TCM against COVID-19. Methods "COVID-19", "New Coronavirus Pneumonia", "TCM", "Chinese Medicine", "Clinical Trial", "Lianhua Qingwen", "Huoxiang Zhengqi", "Jinhua Qinggan", and other keywords were used to search relevant literatures in CNKI and PubMed database. Among the all the screened relevant literatures on the treatment of COVID-19 with TCM, the literature quality was assessed according to evaluation criteria of clinical trial literatures. Results A total of 463 papers related to the treatment of COVID-19 with TCM were obtained. 440 papers on theoretical research on the network pharmacology mechanism of Chinese medicine treatment of COVID-19 were excluded. Among the 23 articles included in the quality analysis, there are 3 randomized controlled studies, 1 multi-center prospective randomized controlled trial, 2 disease case report trials, and 5 uncontrolled single arm studies, 5 controlled trials and 7 retrospective studies. In the period of more than half a year, although many clinical trial documents of TCM for the treatment of COVID-19 have been published, the clinical trial design reflected in most TCM clinical trials were not standardized. There are problems in "randomness and rationality", such as no control group, no randomization design, only case studies, no blinding method in controlling bias, and insufficient objectivity in the evaluation criteria of efficacy. All of these need to be improved. Conclusion The treatment of new coronavirus pneumonia with TCM still requires more and standardized clinical trial verifications and publications to generate strong evidence-based results, such as adding control groups, increasing sample size, and using blinding methods to increase the credibility of clinical trials.