Acute stress disorder (ASD) is a time-limited stress-related disorder triggered by severe traumatic events. Its core symptoms include intrusive memories, heightened arousal and reactivity, pathological avoidance, dissociation, and abnormalities in cognition and emotion. The pathophysiology of ASD involves multiple factors, including emotional-cognitive dysregulation, neural circuit remodeling, neurotransmitter imbalances, and immune-inflammatory responses. A proportion of patients may further progress to post-traumatic stress disorder (PTSD). In recent years, non-invasive neuromodulation techniques, such as transcranial magnetic stimulation (TMS), transcranial electrical stimulation (tES), and vagus nerve stimulation (VNS), have shown potential in modulating dysregulated neurotransmitter systems and reshaping neural circuits, offering new perspectives for the early treatment of ASD.

Acute stress disorder (ASD) is a time-limited stress-related disorder triggered by severe traumatic events. Its core symptoms include intrusive memories, heightened arousal and reactivity, pathological avoidance, dissociation, and abnormalities in cognition and emotion. The pathophysiology of ASD involves multiple factors, including emotional-cognitive dysregulation, neural circuit remodeling, neurotransmitter imbalances, and immune-inflammatory responses. A proportion of patients may further progress to post-traumatic stress disorder (PTSD). In recent years, non-invasive neuromodulation techniques, such as transcranial magnetic stimulation (TMS), transcranial electrical stimulation (tES), and vagus nerve stimulation (VNS), have shown potential in modulating dysregulated neurotransmitter systems and reshaping neural circuits, offering new perspectives for the early treatment of ASD.

Purpose/Significance To explore the training path of smart medical compound talents with both medical knowledge and artificial intelligence(AI)engineering technology under the background of education digital transformation.Method/Process By apply-ing the methods of educational practice and literature research,the paper analyzes the challenges faced by education digital transforma-tion,expounds the construction method of the"real-virtual"digital transformation model of smart medical education,and puts forward the training path of smart medical talents.Result/Conclusion Under the background of education digital transformation,it is necessary to reshape the concept of smart medical education and innovate the evaluation mode of smart medical education,realize the reform of"teach-ing""learning"and"management"through the smart campus system.

Objective To explore the predictive value and efficacy evaluation of plasma microRNA(miR)-132,miR-134 combined with miR-124 in patients with depression.Methods A total of 75 patients diagnosed with depression in the psychiatric department of the hospital from June 2021 to July 2023 were selected as the study group,and 75 healthy subjects who underwent physical examination in the hospital during the same pe-riod were selected as the control group.The relative expression levels of miR-132,miR-134 and miR-124 in plasma of the two groups were detected.The levels of miR-132,miR-124,miR-134,brain-derived neurotrophic factor(BDNF).inflammatory factors[interleukin(IL)-6,IL-18,tumor necrosis factor-a(TNF-a)]were com-pared between the two groups before and after 8 weeks of treatment.Multiple linear regression analysis was used to construct a joint prediction model.The application value of plasma miR-132,miR-134,miR-124 and combined prediction in the diagnosis of depression was evaluated by receiver operating characteristic(ROC)curve.Results The relative expression levels of miR-132 and miR-124 in plasma of the study group were sig-nificantly higher than those of the control group,with statistical significance(P＜0.05).The relative expres-sion level of miR-134 in the study group was significantly lower than that in the control group,and the differ-ence was statistically significant(P＜0.05).ROC curve analysis showed that the area under the curve of plas-ma miR-132,miR-134,miR-124 and combined prediction of depression were 0.858 8,0.851 9,0.763 1 and 0.971 4,respectively.Compared with 8 weeks before treatment,plasma miR-132,miR-124,IL-6,IL-18 and TNF-a levels were significantly down-regulated,while plasma miR-134 and BDNF levels were significantly up-regulated after 8 weeks of treatment.Conclusion miR-132,miR-134 and miR-124 are closely related to the oc-currence of depression,and the combination of the three can be used to predict and early diagnose depression patients and evaluate the drug efficacy of depression patients.

Objective To provide references for the plan-making of mental intervention on new recruits through the exploration of the comprehensive psychological behavior training influences on psychological stress and health and relevant factors.Methods 436 new recruits in training period were divided into comprehensive psychological behavior training group (intervention group) and non intervention group (control group).By randomly selected 2 (intervention group,control group) × 2 (Before training and after training) matching design,the questionnaire survey was carried out using stress-reaction questionnaire (SRQ),symptom checklist 90 (SCL-90),eysenck personality questionnaire(EPQ),trait coping style questionaire(TCSQ) at the 15th day and 75th day.t-test between group and matched t-test within group and multiple stepwise regression analysis were carried out.Results (1) The SCL-90 total point of new recruits in intervention group (125.26±36.52)and control group(124.92± 34.79) before the training and the difference of SRQ and TCSQ factor scores had no statistical significance(P＞ 0.05).The difference after the comprehensive psychological behavior training had no statistical significance (P＞ 0.05) as the total points of SCL-90 of intervention group(125.63±36.74) and other factors' score were compared with before.Except for the somatization and force,the total points of SCL-90 (131.21 ± 39.98)and other factor scores of the control group were all higher than what they were in the early period of the training significantly (P＜ 0.01 or P＜0.05).In the later period of group training,from the parallel controlled study among groups we found that except for the somatization and force,the total points of SCL-90 and other factor scores of the control group are all lower than the control group (P＜0.0 or P＜0.05).(2)The total points of intervention group's SCL-90 and SRQ had significant positive correlation with negative coping and stability(r=0.313-0.698,P＜0.01) while it had negative correlation with introversion and extroversion(r=-0.293--0.207,P＜0.01) as well as dissimulation at the later period of group training,however,it did not have significant correlation with positive coping method (P＞0.05).(3) The regression analysis showed that factors significantly affected the total score of SCL-90 respectively was:SRQ total score,negative coping method,stability,introversion-extroversion and psychoticism (P＜ 0.01).Five variables'coefficient of determination R 2 =0.665,F=247.82,P＜ 0.01.Conclusion The comprehensive psychological behavior training could reduce the over psychological stress of new recruits,promote their positive coping attitude and protecting their psychological health.Coping method and personality characteristics are important mediating variable between new recruits' psychological stress and mental health.

Objective To explore the mental health and its relationship with mental quality of training logistic soldiers in field.Methods Symptom Checklist 90(SCL-90) and Mental Quality Questionnaire for armymen (MQQA) were employed to evaluate the mental health and mental quality of 230 training logistic soldiers in field,and then an analysis was carried out on the characteristics of the training logistic soldiers on mental health and its relationship with mental quality.Results ①The psychological problem's ratio of training soldiers was 21.3％,and the ratio of the male(22.8％) was significantly higher than that of the female(15.2％) (x2 =8.64,P=0.00).In SCL-90,the scores of somatization (1.46 ± 0.63),hostility (1.49 ± 0.75) and psychotism (1.43 ±0.68) were all higher in training soldiers than the army norm.The factor scores of somatization (1.49 ± 0.66)and psychotism(1.46 ± 0.72) in the male training soldiers were considerably higher than those of the male soldiers norm (P ＜ 0.05),but not in the female(P ＞ 0.05).②There existed a significantly negative correlation between the factor scores of the mental quality and that of SCL-90 (P ＜ 0.05,P ＜ 0.01).③The SCL-90 scores existed clear differences in obsessive-compulsive,interpersonal sensitivity,depression,hostility and paranoid ideation among different mental quality groups (P ＜ 0.05).Conclusion The mental health of training logistic soldiers is poor.The mental health is closely related to the mental quality.Therefore,the mental health education and mental quality training should be strengthened to the training logistic soldiers.

ObjectiveTo examine the clinical features of fractures and related risk factors in patients with rheumatoid arthritis(RA) in China.MethodsSix hundred and eighty-one RA patients were randomly selected from department of rheumatology of 18 hospitals of China.Data were obtained from the questionnaire,including age,sex,disease duration,the involvement of joints,treatment regimen,features of fractures etc.The possible risk factors of fracture in patients with RA were analyzed with a multi-variate Logistic regression analysis.Results① In 681 RA patients of the survey,48 patients had 54 fractures,and the incidence of fractures was about 8％.② Fractures occurred at various sites.Foot/ankle,femur,spine and wrist were the mostfrequent sites.③ The Logistic regression analysis showed that several factors increased the risk of fracture in RA patients,including long disease duration (OR:1.245,95％CI:0.987-1.570,P=0.065),male gender(OR:0.433,95％CI:0.199-0.942,P=0.035),more deformed joints(OR:1.042,95％CI:1.006-1.079,P=0.023),family history of RA (OR:2.201,95％CI:0.984-4.923,P=0.055),and high scores of SF-36(OR:1.017,95％CI:1.002-1.033,P=0.028).④ According to the degree of correlation from strong to weak,the risk factors of fracture were disease duration,SF-36,sex,number of deformed joints and family history of rheumatoid arthritis.ConclusionThe incidence of fracture is high in patients with rheumatoid arthritis.Several factors could increase the risk of fractures in RA patients,including long disease duration,male gender,more deformed joints,and family history of RA.In order to prevent the occurrence of fractures,cautions should be taken to prevent the development of fractures and treat the disease aggressively to suppress the disease activity of RA.

Objective To describe the distribution of medication costs of rheumatoid arthritis patients, and to analyze the factors that may affect the costs. Methods Data were obtained from a 12-month retrospective investigation of patients with rheumatoid arthritis (RA) across China. Department of Rheuma-tology of 18 hospitals were randomly selected. The data about their social conditions, clinical conditions, medications associated with RA such as disease-modifying antirheumatic drugs (DMARDs), non -steroidal anti -inflammtory drugs (NSAIDs), steroids, biologic agents were collected, and the costs of drugs were calculated. A non-parameter test and multivariate logistic regression analysis were performed. Results Six hundred and forty six patients were enrolled into the study, 435 completed data were chosen for analysis. The results demonstrated that the average costs per patient for medications in the past year was 8018 . The total medication costs were further subdivided into the following parts: DMARDs, (represented 20% of the total costs), biologic drugs (49%), NSAIDs (4%), herbal drugs (22%), steroids (1%). Data analysis showed that patients with higher education and higher incomes, with medical insurance,better health function status and outpatients paid more on DMARDs. Extra-articular manifestations increased the odds of the high-cost group (OR: 2.180, 95%CI: 1.335～3.558, P=0.002), while poor health function status increased the probability of paying high costs (OR: 1.373, 95%CI: 1.012～1.863, P=0.041). Conclusion High medication costs in RA do exist in RA patients. The costs of medication is associated with health function status and the presence of extra-articular manifestations.

Objective To investigate the prevalence rate and the related risk factors of post traumatic stress disorder (PTSD) in rescue troops one year after Wenchuan earthquake as science proofs of mental interven-tion. Methods 1176 officers/soldiers from rescue troops were tested with the questionnaire composed by General state of health questionnaire, PTSD Checklist-Civilian Version (PCL-C), Symptom Checklist-90 (SCL-90), simple coping style questionnaire (SCSQ) and Eysenck Personality Questionnaire (EPQ). Students't test and correlation analysis were used to study the risk factors. Results One year after Wenehuan earthquake,the prevalence rate of PTSD was 3.45%. Compared with the norms of Chinese serviceman, some evaluative indexes' scores, including somatization(1.43±0.57),exterior(12.50±3.79)/interior and positive response factors(2.05±0.71), were higher(P<0.05), at the same time some evaluative indexes' scores, such as anxiety,depression,nervousness and negative response factor, were obviously lower(P<0.01). Correlation analysis showed total score of PLC-C was positively correlated with somatization, anxiety, depression and negative response factors, separately (P<0.01),but negatively correlated with exterior/interior and positive response factors, separately (P<0.01).Conclusion The psychological status of the earthquake-rescuers is basically normal one year after Wenchuan earthquake. The younger soldiers with less education,who have nervous,introversive character,are the emphasis crowd.

Objective To investigate the changes of trace elements score in hairs in patients with hyperthyroidism and its relationship with thyroid function. Methods The trace elements(Mg,Ca,Cr,Mn,Fe,Cu,Zn,Sr,Mo,Ba)in hairs and serum thyroid hormones(FT_3 and FT_4)were measured in control group (60 cases) and hyperthyroidism group (67 cases). Results The levels of trace elements Zn,Cu,Mg,Cr were significantly lower (P