Objective: To explore the longitudinal relationship between bullying victimization and sleep quality among rural boarding junior high school students in Hebei Province, and to investigate the chain mediated role of loneliness and rumination, so as to provide evidence for promoting sleep health in the population. Methods: A baseline survey was conducted in May, 2023 (T1) by convenient sampling method, and two rounds of longitudinal surveys were conducted in November, 2023 (T2) and May, 2024 (T3) among students in two rural boarding junior high schools in Hebei Province, and a sample of 601 students who completed all the surveys was finally obtained. Students completed questionnaires, including the Delaware Bullying Victimization Scale Student (DBVS-S), the University of California at Los Angeles Loneliness Scale (UCLA), the Ruminative Responses Scale, and the Pittsburgh Sleep Quality Index (PSQI). Group differences were examined by using t-test or ANOVA, correlations between variables were analyzed by using Pearson correlation coefficients, and a serial mediation structural equation model was constructed, with mediation effects tested via the Bootstrap method. Results: Female students scored higher on sleep quality than male students (7.47±2.70, 6.47 ±2.46, t =4.74, P <0.01). Pearson correlation analysis indicated that bullying victimization was positively correlated with loneliness, rumination, and sleep quality; loneliness was positively correlated with rumination and sleep quality; and rumination was positively correlated with sleep quality ( r =0.26, 0.33, 0.23; 0.39, 0.38; 0.54, all P <0.01). Mediation analysis showed that T2 loneliness had an independent mediating effect of 0.70 (95% CI =0.36-1.35) between T1 bullying victimization and T3 sleep quality, T2 rumination had an independent mediating effect of 1.34 (95% CI =0.71-2.45), and the serial mediation effect of T2 loneliness and T2 rumination was 0.64 (95% CI =0.37-1.13), accounting for 22.11% of the total effect (all P <0.01). Conclusions Bullying victimization adversely affects sleep quality among rural boarding junior high school students through a longitudinal chain mediating pathway involving loneliness and rumination. Psychological interventions should be strengthened for students who experience bullying to alleviate their loneliness and reduce rumination, thereby improving sleep quality.

Objective In the clinical teaching of neurosurgery,the traditional Problem-Based Learning(PBL)teaching model faces systematic challenges such as the disconnection between the training cycle of specialized talents and technological iteration,the limitation of practical opportunities due to hospital infections,and the inefficient allocation of teaching resources.It provides a new path for teaching reform based on the deep integration of Artificial Intelligence and PBL,but it still needs to address issues such as differences in intern participation,insufficient technical adaptability of instructors,and fragmented resource allocation.Based on these problems,a collaborative mechanism of"technology development-talent cultivation"and a multi-dimensional optimization path of"intern participation-instructor training-hospital resource input"are proposed.On this basis,through collaborative strategies such as strengthening the incentive mechanism for autonomous learning,establishing a standardized instructor training system,and building a dynamic resource allocation platform,the management of neurosurgery clinical teaching is promoted towards intelligence,personalization,and systematization.

Objective To distinguish Cremastra appendiculata(D.Don)Makino,Pleione yunnanensis Rolfe and Pleione bulbocodioides,and its easily confusing products Oreorchis patens and Iphigenia indica Kunth using the ITS sequence in DNA barcodes;To explore the genetic diversity of Cremastra appendiculata germplasm resources.Methods Three different original Cremastra appendiculata,Pleione yunnanensis Rolfe and Pleione bulbocodioides,and their easily confusing products Cremastrae Pseudobulbus of Oreorchis patens and Iphigenia indica Kunth were selected as the research objects,and the genomic DNA of the above samples were extracted by the modified CTAB method,and then the ITS sequences were amplified,sequenced and spliced by PCR technology.The Kimura 2-Parameter(K2P)model was used to calculate the genetic distance,and the phylogenetic tree was constructed with the help of neighbour joining method(NJ)for genetic relationship analysis.Results Except for the Iphigenia indica Kunth species that were not found during the BLAST search,the BLAST comparison results of the other samples were higher than 95%.At the same time,the results of phylogenetic tree showed that Cremastra appendiculata,Pleione yunnanensis Rolfe and Pleione bulbocodioides were clustered into one branch,respectively,and the easily confusing products were also respectively clustered into one branch.Conclusion The ITS sequence in DNA barcodes can be used to accurately distinguish Cremastra appendiculata,Pleione yunnanensis Rolfe and Pleione bulbocodioides,and its easily confusing products Oreorchis patens and Iphigenia indica Kunth.

Objective:To explore the moderating effect of social support on the effect of occupational stress affecting job burnout, and to provide a theoretical basis for effectively reducing job burnout of medical workers.Methods:In April 2021, a cluster sampling method was adopted. Two units were randomly selected from the tertiary, secondary and primary medical institutions in Shanghai to carry out the survey. The survey was conducted by distributing electronic questionnaires online, and a total of 1963 valid questionnaires were collected. The questionnaire employed Maslach Burnout Inventory-General Survey (MBI-GS) to measure job burnout, and Job Content Questionnaire to measure occupational stress and social support. The questionnaire also collected demographic characteristics and work-related information. Mann-Whitney U test and Kruskal-Wallis H test were used for one-way analysis to test whether there was any difference in the distribution of occupational stress, job burnout, and social support on different demographic characteristics. Spearman's rank correlation coefficient was used to analyze the correlation between occupational stress, job burnout, and social support. Bootstrap method was used to analyze the moderating effect of social support on occupational stress affecting job burnout. Results:The occupational stress score was 1.232 (1.039, 1.530) , the job burnout score was 2.480 (1.560, 3.240) , and the social support score was 3.500 (3.125, 4.000) . Occupational stress, job burnout and social support were distributed differently on sex, job position, hospital level, monthly income, daily working hours, break duration per shift, and break duration between shifts ( P<0.05) . Occupational stress was positively associated with job burnout ( rs=0.49, P<0.001) , and social support was negatively associated with both occupational stress ( rs=-0.44, P<0.001) and job burnout ( rs=-0.48, P<0.001) . Social support played a moderating role in the influence of occupational stress on job burnout ( B=0.321, 95% CI: 0.216~0.426) . Conclusion:The problem of job burnout is more prominent among medical workers. In the context of enhanced social support, improving job stress condition can lead to a greater decrease in job burnout.

Objective The mouse autologous tumor model H22 is more valuable for tumor immunological-related research.This paper aims to establish mouse hepatic tumor cell line(H22-luc2-tdT)that stably express the tan-dem-dimer tomato(tdTomato)and luciferase genes.Establish an in vivo imaging model of cell line derived trans-planted tumors.Methods Using transplanted H22 tumor tissue,primary culture and continuous passage in vitro were performed to establish a continuous cell line.Cell proliferation,chromosome analysis,organoid culture,tumorigenicity,HE and ICH of aFP,CK7,CK15 were performed to charaterize the cell line.Then the luc2-tdT plasmid was transfected into H22 cells of P22,flow cytometry and in vitro/in vivo imaging were employed to screen and verify fluorescence expression.Mycoplasma detection and species verification of the established cell lines were performed.Results The H22 cells had been continuously passaged over 50 times.The cells of passsge 22(P22)were transplanted subcutaneously and intraperitoneally into C57 and Kunming mice,with a 100%tumor formation.The HE morphology of subcutaneous transplanted tumor were consistent with the original tumor.CK+/AFP+proved that it was of liver cancer origin.The H22 cells were hypo-triploid with a modal number of 40-44 chromosomes and telocentromeres,verifing its mouse origin.The latent phase for in vitro growth of H22 lasted from d0 to d3,while the exponential phaes d3 to d5,and reach plateou at d6.Successful transfection of H22 cells with the luc2-tdT were observed with in vitro/in vivo 100%fluorescence positivity,thus named H22-luc2-tdT.The transplanted tumor tissue of H22 cells could be primarily cultured to form organoids.The detection of Mycoplasma was negative,and its mouse origin confirmed by PCR.Conclusions H22 and H22-luc2-tdT cell lines are established and characterized,which can be used for the establishment and application of in vitro and in vivo liver cancer research and metastatic cell tracking.These cell lines are deposited at and can obtain from the National Biomedical Cell Resource Center(http://www.cellresource.cn).

Objective: To identify ferroptosis-related genes associated with gastric cancer prognosis and investigate their potential molecular functions. Methods: Gene expression profiles and clinical information of gastric cancer tissues and adjacent normal tissues were obtained from TCGA database. Differential expression analysis of ferroptosis-related genes was performed using the "DESeq2" package in R software. Key genes were identified and a prognostic model for gastric cancer was constructed through Cox regression analysis based on the LASSO algorithm. Patients were stratified into high-risk and low-risk groups according to the median risk score. The accuracy of the model was evaluated using Kaplan-Meier survival analysis and ROC curve analysis. Immune cell infiltration in gastric cancer patients was assessed with the "CIBERSORT" package. The mRNA expression of differentially expressed genes(DEGs) with prognostic significance was examined in both gastric cancer and adjacent normal tissue samples. In vitro experiments were conducted to validate the impact of hydroxycarboxylic acid receptor 1(HCAR1) on the malignant biological behavior of gastric cancer. Results: Based on ferroptosis-related genes from the TCGA database, a novel prognostic model was constructed. It demonstrated robust predictive power for survival in both training and validation cohorts. RT-qPCR analysis of 8 pairs of gastric cancer and normal tissues revealed that the expression patterns of 6 prognostic DEGs in cancer tissues were consistent with those predicted by the model. In vitro experiments confirmed that downregulation of the key gene HCAR1 could inhibit the proliferation, invasion, and metastasis of gastric cancer cells. Conclusion The ferroptosis-related gene based prognostic model exhibits robust predictive capability, allowing for accurate determination of prognosis and survival in individuals with gastric cancer.

Objective:To explore the incidence of delirium in patients of advanced age hospitalized in internal medicine departments and analyze its influencing factors.Methods:A retrospective analysis was conducted on the medical records of 586 patients of advanced age hospitalized in internal medicine departments at the Beijing University of Chinese Medicine Third Affiliated Hospital from May 2023 to May 2024. Patients were divided into a delirium group and a non-delirium group based on whether delirium occurred. Univariate analysis and binary Logistic regression analysis were used to explore the factors influencing delirium in patients of advanced age hospitalized in internal medicine departments.Results:Among 586 patients of advanced age hospitalized in internal medicine departments, the incidence of delirium was 21.2% (124/586). Binary Logistic regression analysis showed that age, activities of daily living (Barthel Index), folate deficiency, sleep disorders, and indwelling catheters were factors influencing delirium in patients of advanced age hospitalized in internal medicine departments ( P<0.05) . Conclusions:The incidence of delirium is high among patients of advanced age hospitalized in internal medicine departments. Healthcare professionals should pay particular attention to elderly patients with advanced age, limited activities of daily living, folate deficiency, sleep disorders, and indwelling catheters, and should implement targeted preventive strategies as early as possible.

Objective:To explore the moderating effect of social support on the effect of occupational stress affecting job burnout, and to provide a theoretical basis for effectively reducing job burnout of medical workers.Methods:In April 2021, a cluster sampling method was adopted. Two units were randomly selected from the tertiary, secondary and primary medical institutions in Shanghai to carry out the survey. The survey was conducted by distributing electronic questionnaires online, and a total of 1963 valid questionnaires were collected. The questionnaire employed Maslach Burnout Inventory-General Survey (MBI-GS) to measure job burnout, and Job Content Questionnaire to measure occupational stress and social support. The questionnaire also collected demographic characteristics and work-related information. Mann-Whitney U test and Kruskal-Wallis H test were used for one-way analysis to test whether there was any difference in the distribution of occupational stress, job burnout, and social support on different demographic characteristics. Spearman's rank correlation coefficient was used to analyze the correlation between occupational stress, job burnout, and social support. Bootstrap method was used to analyze the moderating effect of social support on occupational stress affecting job burnout. Results:The occupational stress score was 1.232 (1.039, 1.530) , the job burnout score was 2.480 (1.560, 3.240) , and the social support score was 3.500 (3.125, 4.000) . Occupational stress, job burnout and social support were distributed differently on sex, job position, hospital level, monthly income, daily working hours, break duration per shift, and break duration between shifts ( P<0.05) . Occupational stress was positively associated with job burnout ( rs=0.49, P<0.001) , and social support was negatively associated with both occupational stress ( rs=-0.44, P<0.001) and job burnout ( rs=-0.48, P<0.001) . Social support played a moderating role in the influence of occupational stress on job burnout ( B=0.321, 95% CI: 0.216~0.426) . Conclusion:The problem of job burnout is more prominent among medical workers. In the context of enhanced social support, improving job stress condition can lead to a greater decrease in job burnout.

Objective:To analyze the total amount,institutional flow and development trend of total Traditional Chinese Medicine(TCM)costs in China from 2018 to 2022,and to study the changes of total TCM costs in different primary healthcare institutions.Methods:The total TCM costs were accounted for using the institutional flow method and the case-base aggregation method.Results:From 2018 to 2022,the total TCM costs of primary healthcare organizations in China accounted for a rising proportion,with a stable growth trend,in which the total flow to community and township health centers accounted for a higher proportion,the proportion of total TCM costs of primary institutions in rural areas declined,and there was a negative growth in the village clinics;the growth rate of primary drug costs slowed down,and the growth rate of medical costs showed a wave-like change,with an overall increase in the amount of financial subsidies and subsidies from the higher level.Conclusion:The TCM service capacity of primary healthcare institutions nationwide has been developing steadily,and should continue to expand the existing advantages and build up a solid position for grassroots TCM service in China;the TCM service capacity of China's rural areas still needs to be improved;it is needed to continue to enhance the capacity of primary technical services of Chinese medicine practitioners and rationalizing the role of pharmaceutical services,and the percentage of financial and higher-level subsidies for primary healthcare institutions has been rising fluctuatingly.

Objective To investigate the effect of 3D technology combined with smartphones in problem-based learning(PBL)for neuroendoscopy.Methods 82 trainees who were enrolled from January 2021 to January 2023 were selected as the research subjects.A randomized controlled trial was conducted,and the subjects were divided into a control group and an experimental group.PBL and 3D technology combined with smartphone-assisted PBL were implemented respectively for two groups of students.The data were analyzed using t-test.Teaching satisfac-tion is evaluated by 2 test.Results The results of the in-operation examination and theoretical examination of the ex-perimental group students were found to be higher than those of the control group students(t=8.630,6.087,P＜0.001),the satisfaction scores of students and teachers showing that the satisfaction of the experimental group was higher than that of the control group(x2=4.213,6.301,7.026,P＜0.01).Conclusion In the PBL of neuroendosco-py,the use of 3D technology combined with smart phones as an auxiliary teaching system can effectively improve students'sense of participation,reduce the difficulty of skull base anatomy learning,and improve students'theo-retical and surgical assessment scores and teaching satisfaction.