Objective: To explore the relationship between beverage dependence and sleep quality among college students, providing empirical evidence for improving their sleep quality. Methods: From December 2024 to January 2025, a convenience sampling method was used to conduct a questionnaire survey among 3 974 college students from four universities in Anhui Province. The Beverage Addiction Scale for College Students (BASCS) was used to assess beverage dependence, and the Self rating Scale of Sleep(SRSS) was used to evaluate sleep quality. A multivariate Logistic regression model was employed to analyze the relationship between beverage dependence and sleep quality, and a restricted cubic spline model was used to examine the dose response relationship between the two. Results: The positive rate of beverage dependence symptoms among college students was 7.6%, with positive rates of 9.6%, 13.8%, and 7.4% for the withdrawal symptoms, health effects, and dependence symptoms dimensions, respectively. The detection rate of sleep disorders was 23.6%. Multivariate Logistic regression analysis showed that after adjusting for covariates such as grade, gender, and body mass index, compared with the no beverage dependence group, students with positive beverage dependence symptoms had a higher risk of sleep disorders( OR =3.71, 95% CI =2.87-4.80, P <0.01). The OR (95% CI ) for sleep disorders among students with positive symptoms in the withdrawal symptoms, health effects, and dependence symptoms dimensions were 2.80(2.22-3.53), 2.38(1.95-2.91), and 2.45(1.89-3.18)(all P <0.01). Further analysis using a restricted cubic spline model revealed that the overall beverage dependence score and its three dimensional scores were approximately linearly related to the risk of sleep disorders among college students (all nonlinear P >0.05). Conclusions Beverage dependence is associated with sleep quality among college students. Schools should take multiple approaches, such as health education on beverage awareness, to improve students sleep quality.

Objective:To analyze the expression and prognosis of B-cell lymphoma 7 protein family member A (BCL7A) in hepatocellular carcinoma, as well as the effect and mechanism of BCL7A expression on the invasion and migration of hepatocellular carcinoma cells.Methods:The cancer tissues and adjacent tissues of 40 patients with hepatocellular carcinoma who underwent radical hepatobiliary resection in the Department of Hepatobiliary Surgery, Affiliated Hospital of Nantong University from November 2017 to March 2018 were prospectively collected for protein extraction, including 29 males and 11 females, aged (58.5±10.4) years. The information of 374 cases of hepatocellular carcinoma and 50 cases of adjacent tissues were downloaded from The Cancer Genome Atlas (TCGA) database, and the hepatocellular carcinoma cell lines Hep3B and SMMC-7721 were transfected with overexpressing BCL7A plasmid and empty vector plasmid (negative control), respectively. Western blotting and immunohistochemistry were used to detect the expression of BCL7A, and Western blotting was also used to detect the expression of proteins related to epithelial-mesenchymal transition (N-cadherin, E-cadherin, snail). Transwell and cell scratch assays were used to detect cell invasion and migration.Results:Compared with adjacent tissues, the mRNA expression of BCL7A in 50 patients with hepatocellular carcinoma in TCGA was significantly increased ( t=13.38, P<0.001). According to the median mRNA expression level of BCL7A, 374 patients were divided into BCL7A high expression group ( n=187) and low expression group ( n=187), and the cumulative survival rate of BCL7A high expression patients was lower than that of low expression group, and the difference was statistically significant ( χ2=6.95, P=0.009). Western blot was used to detect the relative expression of BCL7A protein in cancer tissues, and found it was higher compared to adjacent tissues. Compared with the negative control group, the number of cells invaded by the BCL7A overexpression group of hepatoma cells Hep3B and SMMC-7721 was more than the negative control group respectively, (153.7±1.3) vs (63.7±4.7) and (307.7±25.14) vs (72.3±12.5), and the differences were statistically significant ( t=7.97, 8.38, both P=0.001) .The results of the cell scratch assay were consistent with the results of the Transwell invasion assay. The expressions of N-cadherin and snail in the BCL7A overexpression group were higher than those in the negative control group, and the E-cadherin was lower, and the difference was statistically significant (all P<0.05). Conclusions:The expression of BCL7A in cancer tissues of patients with hepatocellular carcinoma is elevated and is associated with poor prognosis. BCL7A may promote hepatocellular carcinoma cell metastasis and invasion by promoting epithelial-mesenchymal transition.

Objective:To understand the real experience and needs of early exercise rehabilitation in elderly patients with total hip arthroplasty (THA), so as to provide a preliminary basis for intervention research to meet the needs of patients.Methods:Using the purposive sampling method, a total of 12 elderly patients with THA from the First Affiliated Hospital of Naval Medical University from June to September 2021 were selected as the research objects for semi-structured in-depth interviews. Colaizzi 7-step method was used to analyze, summarize and extract the data.Results:The early exercise rehabilitation experience and needs of elderly THA patients could be summarized into four themes such as postoperative exercise being a difficult journey, the need for professional support, the need for external support and internally driven needs and 14 sub themes.Conclusions:There are various problems and needs for early exercise rehabilitation in elderly patients undergoing THA. It is necessary to strengthen communication among doctors, nurses and patients, understand their true feelings and provide personalized care and rehabilitation guidance to improve their treatment experience and enhance their satisfaction.

We reported the diagnostic and therapeutic process of a young male patient with systemic lupus erythematosus (SLE) who presented with severe hyponatremia as the main manifestation upon admission, and analyzed and discussed the case. The patient was a 19-year-old young male with a subacute course of disease, fever ≥38.3 ℃ that could not be explained by other causes, acute and subacute cutaneous lupus erythematosus, oral ulcers, arthritis, leukopenia (< 4×10⁹/L), low C3+low C4, and positive anti-double-stranded DNA (anti-dsDNA). According to the 2019 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria, the score was 27 points. The patient was admitted to the hospital with SLE. After admission, further diagnosis of lupus was confirmed, excluding infection, tumor, endocrine disease, etc. Hyponatremia was the main complication of this lupus patient. Hyponatremia was a rare complication of lupus, only a few cases have been reported. In this study, the paient ' s blood osmotic pressure was significantly reduced, which was considered to be hypotonic hyponatretic, urine osmotic pressure increased, maximum urine dilution caused by excessive water intake such as primary polydipsia, hypoosmotic fluid intake, and beer drinking were excluded, and 24 h urine volume and sodium were improved. The urinary sodium concentration was close to 20 mmol/L although with severe hyponatremia, considering the possibility of isovolemic hypotonic hyponatremia, the syndrome of improper secretion of antidiuretic hormone or adrenal cortical insufficiency. The patient had no manifestations, such as hypotension, typical site pigmentation, and high potassium, and there was little possibility of adrenal cortical insufficiency, and syndrome of inappropriate antidiuretic hormone secretion (SIADH) was considered for hyponatremia in the patient. The etiological mechanism of hyponatremia in lupus patients is not clear, but it is related to acute kidney injury, drugs and systemic inflammation. In this case, we reported for the first time that SLE was associated with abnormal hypothalamic signals, suggesting a possible mechanism of lupus hyponatremia. The patient underwent water restriction, intravenous and oral sodium supplementation, and the blood sodium quickly returned to normal after pulse therapy. The abnormal signal of the head magnetic resonance imaging (MRI) fornix column was improved after 1 month of treatment, further confirming our diagnosis. SLE complicated with hyponatremia is rare, but severe hyponatremia can be life-threatening, and attention should be paid to it. The possibility of neuropsychiatric lupus should be vigilant in patients with lupus combined with hyponatremia.
Humans ; Hyponatremia/etiology* ; Lupus Erythematosus, Systemic/diagnosis* ; Male ; Young Adult

Objective: To observe the effects of tendon-regulating and stretching manipulation plus JIN's three-needle therapy for the shoulder on pain and shoulder joint function in subacromial impingement syndrome (SIS). Methods: Eighty patients with SIS were recruited and divided into a control group and a treatment group by the random number table method, with 40 cases in each group. The control group was given JIN's three-needle therapy for the shoulder, and the treatment group received additional tendon-regulating and stretching manipulation. The visual analog scale (VAS) score and constant-Murley score (CMS) were observed before and after the intervention, and the total effective rate was also observed. Results: The total effective rate was 92.5％ in the treatment group versus 70.0％ in the control group, and the difference was statistically significant (P<0.05). The VAS score and CMS changed notably after treatment in both groups (P<0.05), and the improvements were markedly greater in the treatment group than in the control group (P<0.05). Conclusion: Tendon-regulating and stretching manipulation plus JIN's three-needle therapy for the shoulder can facilitate the relief of pain and the improvement of shoulder joint function in SIS patients.

Sjögren's syndrome （SS）， a disorder of immune system， is one of the dominant diseases treated by traditional Chinese medicine （TCM）. China Association of Chinese Medicine organized experts in the field of TCM and western medicine rheumatology and pharmacology to discuss the advantages and optimal regimens of TCM for the treatment of SS. The experts generally agreed on the low early diagnosis rate of SS and the lack of targeted therapeutic drugs. In addition， autoimmune abnormality is the key factor in the occurrence of SS and deficiency of both Qi and Yin is the core pathogenesis. SS has unique tongue manifestations， which is expected to allow for the early diagnosis and treatment with integrated traditional Chinese and western medicine. TCM has advantages in treating SS in terms of alleviating clinical symptoms and systemic involvement， individualized treatment， relieving sleep and mood disorders， preventing the occurrence in the early stage， and enhancing the effectiveness and reducing toxicity in the treatment by integrated TCM and western medicine. In general， TCM has advantages in different stages of SS. Internal and external use of TCM， acupuncture， and acupotome are all available options. The optimal regimens should be determined on the basis of pattern identification， stage of disease， and the advantages of TCM. Clinical characteristics and biomarkers of SS should be studied to classify patients， so as to design precision evidence-based TCM regimens for SS. On the basis of unique tongue manifestations of SS， models for early diagnosis and poor prognosis identification of SS should also be established to achieve early prevention and treatment and to improve the prognosis. In the future， we should vigorously carry out high-quality evidence-based medical research on the treatment of SS by TCM and integrated traditional Chinese and western medicine and develop relevant guidelines to optimize and standardize current diagnosis and treatment， thereby laying a basis for clarifying and explaining the advantages of TCM in treating SS.

Objective To explore the effect of Yiqi Tongluo Anshen Recipe combined with statins on coronary blood flow and blood pressure in patients with coronary heart disease complicated with hy-pertension.Methods A total of 120 patients with coronary heart disease combined with hypertension were selected as study objects,and were divided into two groups according to treatment methods,with 60 patients in each group.The conventional group was treated with amlodipine tablets combined with atorvastatin calcium tablets,and the Anshen prescription group was treated with Yiqi Tongluo Anshen Recipe on the basis of the conventional group.The levels of Salusin-β,lipoprotein-associated phospho-lipase A2(LP-PLA2),high-sensitivity C-reactive protein(hs-CRP),pentamylin 3(PTX3),tumor necrosis factor-α(TNF-α)and blood pressure of the two groups were recorded before and after treat-ment,and the TIMI3 rate of coronary blood flow in myocardial infarction thrombolysis test(TIMI)and the adverse reaction rate during treatment were analyzed.Results The total effective rate of TCM syn-drome in the Anshen prescription group was higher than that in conventional group(P＜0.05).After treatment,systolic blood pressure(SBP)and diastolic blood pressure(DBP)in two groups were lower than before treatment,and SBP and DBP in the Anshen prescription group were lower than those in the conventional group(P＜0.05).The rate of coronary blood flow TIMI3 in the Anshen prescrip-tion group was higher than that in the conventional group(P＜0.05).After treatment,levels of Sa-lusin-β,LP-PLA2,PTX3,hs-CRP and TNF-α in two groups were decreased compared with those before treatment,and levels of Salusin-β,LP-PLA2,PTX3,hs-CRP and TNF-α levels of in the Anshen prescription group after treatment were lower than those in the conventional group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the Anshen prescription group and the conventional group(P＞0.05).Conclusion Yiqi Tongluo Anshen Recipe combined with statins in the treatment of coronary heart disease with hypertension can reduce the expression of related factors,improve coronary blood flow and the curative effect.

Objective To explore the effect of Yiqi Tongluo Anshen Recipe combined with statins on coronary blood flow and blood pressure in patients with coronary heart disease complicated with hy-pertension.Methods A total of 120 patients with coronary heart disease combined with hypertension were selected as study objects,and were divided into two groups according to treatment methods,with 60 patients in each group.The conventional group was treated with amlodipine tablets combined with atorvastatin calcium tablets,and the Anshen prescription group was treated with Yiqi Tongluo Anshen Recipe on the basis of the conventional group.The levels of Salusin-β,lipoprotein-associated phospho-lipase A2(LP-PLA2),high-sensitivity C-reactive protein(hs-CRP),pentamylin 3(PTX3),tumor necrosis factor-α(TNF-α)and blood pressure of the two groups were recorded before and after treat-ment,and the TIMI3 rate of coronary blood flow in myocardial infarction thrombolysis test(TIMI)and the adverse reaction rate during treatment were analyzed.Results The total effective rate of TCM syn-drome in the Anshen prescription group was higher than that in conventional group(P＜0.05).After treatment,systolic blood pressure(SBP)and diastolic blood pressure(DBP)in two groups were lower than before treatment,and SBP and DBP in the Anshen prescription group were lower than those in the conventional group(P＜0.05).The rate of coronary blood flow TIMI3 in the Anshen prescrip-tion group was higher than that in the conventional group(P＜0.05).After treatment,levels of Sa-lusin-β,LP-PLA2,PTX3,hs-CRP and TNF-α in two groups were decreased compared with those before treatment,and levels of Salusin-β,LP-PLA2,PTX3,hs-CRP and TNF-α levels of in the Anshen prescription group after treatment were lower than those in the conventional group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the Anshen prescription group and the conventional group(P＞0.05).Conclusion Yiqi Tongluo Anshen Recipe combined with statins in the treatment of coronary heart disease with hypertension can reduce the expression of related factors,improve coronary blood flow and the curative effect.

Objective:To investigate the efficacy and safety of apatinib combined with etoposide capsules in the treatment of patients with platinum-resistant recurrent ovarian cancer.Methods:The clinical data and follow-up data of 63 patients with platinum-resistant recurrent ovarian cancer treated in Cancer Hospital of Jilin Province from January 2017 to June 2018 were analyzed retrospectively.According to the different treatment methods, the patients were divided into single group( n=28) and combination group( n=35). The patients in the single group were treated with etoposide capsules, while the patients in the combination group were treated with apatinib and etoposide capsules.The short-term clinical efficacy, progression free survival and adverse reactions of the two groups were compared. Results:The main adverse reactions of the two groups were anemia and leukopenia.There was no statistically significant difference in adverse reactions between the two groups( P>0.05). The objective response rate(ORR) of the combined group was 54.3%(19/35), which was higher than that of the single group [25.0%(7/28)](χ 2=5.504, P<0.05). The PFS of the combined group was 8 months(95% CI: 7.4-8.6 months), which was significantly longer than that of the single group(4 months, 95% CI: 3.5-4.5 months), the difference was statistically significant(χ 2=52.400, P<0.01). Conclusion:Apatinib combined with etoposide capsules is effective in the treatment of platinum resistant recurrent ovarian cancer, which can significantly extend the median PFS, without increasing the incidence of serious adverse reactions.

The German ( Kooperation für Transoarenz und Qualit?t im Gesundheitswesen, KTQ) certification system was officially launched in Germany in December 2001. Over ten years′ development proves that the KTQ certification system as a high standard medical management system. The authors introduced its background, the update of certification content and procedures, and explained its characteristics and advantages.These insights provide valuable references for establishing a professional and efficient quality certification system, suitable for China′s social and economic development level.