Objective: To identify the effective needs of college students for dietary nutrition health education content, so as to provide a scientific basis for optimizing the health education strategies in colleges. Methods: The literature analysis method, focus group interviews and Delphi expert consultation method were used to construct a survey questionnaire on dietary nutrition health education for college students. From January to March 2024, a total of 597 college students from six colleges in Shandong Province were selected through convenience sampling to complete the questionnaire independently by scanning the two dimensional code on questionnaire star. The Kano model was used to define the content demands of college students for dietary nutrition education, and the differences in demands were analyzed by calculating satisfied influence (SI) and dissatisfied influence (DSI). Results: The compiled questionnaire was divided into 7 dimensions and 25 items. The overall demand level analysis of college students included 3 essential attribute demands, namely, the recommended intake and various forms of dairy products (34.17%), the role of whole grains in health with their scientific intake forms and recommended amounts (31.99%), and the intake of beans (30.15%); 7 expected attribute demands included the introduction of recommended intensity of different activities (35.01%), how to achieve a healthy weight and the balance between diet and exercise (41.54%), the energy consumed by different exercises in a unit of time ( 38.36 %), the selection of healthy snacks (36.68%), the types of infectious diseases of the digestive system and how to prevent and control them (25.96%), the causes and judgments with manifestations of nutrition related diseases among college students ( 28.14 %), and the hotspots of attention on nutrition related diseases among college students (24.46%); 4 attractive attribute demands contained the introduction of the recommended activity levels for different periods such as daily and weekly (28.81%), the introduction of the importance of activities and the harm of prolonged sitting and ways to avoid it (28.64%), the nutritional value of animal foods and eating suggestions (23.45%), and the scientific intake suggestions for various processed animal foods (22.11%); the remaining were 11 attribute demands with no differences. In the quadrant diagram analysis, the demand items located in the maintenance zone, competitive advantage zone, improvement zone, and minor improvement zone were 5, 5, 8, and 7, respectively. Conclusions College students have different demands in dietary nutrition health education, and whether these demands are met affects their satisfaction in different ways. Among them, education on the intake of dairy products, whole grains, and beans has the greatest impact on satisfaction.

Neonatal diabetes mellitus （NDM） is a rare monogenic disorder primarily caused by insufficient insulin secretion resulting from mutations in the KCNJ11 and ABCC8 genes. Sulfonylureas， represented by glibenclamide， have become the standard therapy for this type of NDM by precisely closing the mutated ATP-sensitive potassium channels in pancreatic β cells， thereby restoring insulin secretion. Clinical studies confirm that sulfonylureas enable over 90% of patients to successfully transition from insulin to oral treatment， achieving long-term stable glycemic control and improving neurological outcomes to a certain extent. In terms of safety， severe hypoglycemia induced by sulfonylureas is relatively rare and gastrointestinal reactions are mild； moreover， sulfonylureas show good long-term tolerability， and have no adverse effects on child growth and development. In the future， by further refining the full-chain management pathway of “rapid genetic diagnosis-early intervention-specialized dosage forms-long-term follow-up”， the clinical application of sulfonylureas is expected to provide NDM patients with an optimized treatment regimen and maximize their health benefits.

OBJECTIVE To investigate the effects of subanesthetic dose of esketamine on postoperative anxiety and recovery in patients undergoing laparoscopic cholecystectomy. METHODS A total of 200 patients scheduled for laparoscopic cholecystectomy at Suzhou Ninth Hospital Affiliated to Soochow University from January 2023 to December 2024 were randomly assigned to control group （n＝100） and observation group （n＝100）. One minute before the initiation of anesthesia， patients in the control group received intravenous injections of Propofol emulsion injection， Sufentanil citrate injection， and Succinylcholine chloride injection. On this basis， patients in the observation group received an intravenous injection of Esketamine hydrochloride injection. The anxiety status of patients in both groups was compared， along with their general intraoperative conditions （including sufentanil dosage， duration of pneumoperitoneum， operative time， anesthesia time， and extubation time）， postoperative recovery， incidence of adverse reactions， and the need for dezocine rescue analgesia. Heart rate and mean arterial pressure， entropy index （state entropy and response entropy）， inflammatory marker levels [interleukin-6 （IL-6） and C-reactive protein （CRP）]， numerical rating scale （NRS） for pain intensity were compared between the two groups at different time points. RESULTS No significant differences were found between the two groups in pneumoperitoneum duration， operative time， anesthesia time，extubation time， incidence of postoperative dry mouth， entropy index or length of stay in the post-anesthesia care unit （P＞0.05）. Compared with the control group， the observation group showed significantly lower postoperative STAI-S scores， reduced intraoperative sufentanil consumption， decreased incidence of postoperative nausea， vomiting， and shivering， the need for dezocine rescue analgesia， as well as lower plasma IL-6 and CRP levels at 24 h after surgery， and NRS （P＜0.05）. The heart rate and mean arterial pressure of patients in the observation group at the start of surgery， end of surgery， and during extubation were all significantly higher than those in the control group （P＜0.05）. CONCLUSIONS Subanesthetic dose of esketamine can effectively alleviate postoperative anxiety， reduce intraoperative opioid consumption， suppress postoperative inflammatory response， relieve postoperative pain， and promote recovery in patients undergoing laparoscopic cholecystectomy.

ObjectiveTo establish and characterize an inducible， CD4+ T cell-specific ablation mouse model （CD4-iDTR） using the Cre-loxP and diphtheria toxin receptor （DTR） systems， and to evaluate its depletion efficacy and specificity. MethodsCD4-iDTR mice were generated through cross-breeding， with genotypes confirmed via PCR-based screening. Mice were categorized into an untreated （control） group and a diphtheria toxin （DT） induction group. Flow cytometry was employed to compare the baseline distribution of CD4⁺ T cells between untreated CD4-iDTR and wild-type C57BL/6 mice.In the DT group， CD4⁺ T cell ablation was induced by subcutaneous DT administration. The depletion efficiency in skin tissues and skin-draining lymph nodes （sdLNs） was quantified at 24 h and 1 week post-injection. Furthermore， the proportions of neutrophils， macrophages， dendritic cells， and other CD11b⁺ immune cell subsets in the skin were monitored to assess the model specificity. ResultsGenomic profiling confirmed the successful generation of the CD4-iDTR line. Under steady-state conditions， no significant differences were observed in the frequency or absolute number of CD4⁺ T cells in the skin and sdLNs between CD4-iDTR and C57BL/6 mice （P>0.05）. Following DT induction， the CD4⁺ T cell population in the skin exhibited decline within 24 h and 1 week （P<0.05）， whereas the CD4⁺ T cell counts in sdLNs remained stable. The percentages of cutaneous neutrophils， macrophages， and other CD11b⁺ myeloid populations were not significantly altered following DT treatment （P>0.05）. ConclusionThe CD4-iDTR mouse model is successfully established and bred， achieving efficient， specific， and inducible ablation of cutaneous CD4⁺ T cells without significant interference with the skin immune microenvironment. This model serves as an ideal experimental tool for investigating skin-specific immunological mechanisms.

ObjectiveTo analyze the characteristics and life loss of injury-related deaths among the registered residents in Anji County from 2015 to 2024, and to provide a reference for conducting targeted injury prevention and control efforts. MethodsData on injury-related deaths among the registered residents in Anji County from 2015 to 2024 were collected from the Chronic Disease Surveillance and Management System of Zhejiang Province. Indicators including the crude mortality rate (CMR), standardized mortality rate (SMR), proportion, potential years of life lost (PYLL), average years of life lost (AYLL) and potential years of life lost rate (PYLLR) were calculated. The annual trends in injury mortality were evaluated using average annual percent change (AAPC). ResultsFrom 2015 to 2024, a total of 3 800 injury deaths were reported in Anji County, accounting for 11.94% of all deaths and ranking as the fourth leading cause of death. The CMR was 80.65/100 000 and showed an upward trend (AAPC=3.53%, P=0.003), while the SMR was 50.68/100 000 with no significant trend (AAPC=-1.47%, P=0.196). The CMR was higher in males (95.03/100 000) than in females (66.49/100 000). The top five causes of injury-related deaths were accidental falls, traffic accidents, suicide, drowning and accidental poisoning. The top two injury-related causes of death varied by age group: for the 0‒<15 age group, they were accidental falls, traffic accidents (with drowning tied for second place); for the 15‒<45 age group, they were traffic accidents and suicide; for the 45‒<65 age group, they were traffic accidents and accidental falls; and for the 65‒105 age group, they were accidental falls and traffic accidents. From 2015 to 2024, the total PYLL due to injury deaths was 47 464.00 person-years, the AYLL was 12.49 years, and the PYLLR was 10.07‰. ConclusionFrom 2015 to 2024, the injury crude mortality rate in Anji County was relatively high and showed an upward trend. Targeted interventions based on demographic characteristics and injury types should be implemented to reduce injury mortality.

Objective:To understand the development status of maternal and child health care institutions in China from 2012 to 2022, identify the challenges they face, and provide references for further promoting the high-quality development of these institutions.Methods:Data from the China Health Statistics Yearbook (2013—2015), China Health and Family Planning Statistics Yearbook (2016—2017), and China Health and Wellness Statistics Yearbook (2018—2023) were used. Descriptive analysis was conducted on the data related to resource allocation and utilization efficiency, service provision, income and expenditure structure, and operational status of maternal and child health care institutions in China from 2012 to 2022, using methods such as fixed-base growth rate, year-on-year growth rate, and average annual growth rate. Results:From 2012 to 2022, the number of maternal and child health care institutions in China decreased from 3 044 to 3 031. In terms of resource allocation, the average annual growth rates of bed numbers and business-use floor area were 5.404% and 10.923%, respectively, while the average annual growth rate of health professionals was 7.183%. Regarding service provision, the average annual growth rates of outpatient visits and inpatient admissions were 3.954% and 1.572%, respectively. In terms of service efficiency, the bed occupancy rate decreased from 76.9% to 53.9%, and the average number of patients seen per physician per day decreased from 8.85 to 7.30. In terms of income and expenditure and operations, the income-expenditure surplus rate decreased from 9.16% to 5.41%, and the debt-to-asset ratio increased from 27.88% to 33.60%. During the same period, the average annual growth rates of bed numbers and business-use floor area in grassroots maternal and child health care institutions were 4.545% and 10.091%, respectively, lower than the national average. The number of outpatient visits increased from 89.03 million to 126.93 million, with an average annual growth rate of 3.610%, while the number of inpatient admissions decreased from 4.19 million to 3.91 million, with an average annual decline of 0.689%. The income-expenditure surplus rate of grassroots institutions decreased from 7.76% to 4.05%, 1.36 percentage points lower than the national level, and the debt-to-asset ratio increased from 27.53% to 36.37%, higher than the overall level.Conclusions:From 2012 to 2022, maternal and child health care institutions in China achieved certain developments in resource allocation and service scale. However, several challenges remain, including unbalanced resource allocation, decreased utilization efficiency, slowed growth in medical service volume, imbalanced income and expenditure structure, increased asset operation risks, and restricted development of grassroots institutions. It is recommended that relevant management departments and maternal and child health care institutions optimize resource allocation, plan for service transformation and upgrading, expand income sources, strengthen internal financial control, and reinforce the construction of high-quality and efficient maternal and child health care systems to promote the high-quality development of maternal and child health care institutions in China.

Objective To explore the differences in postoperative recovery between laparoscopic assisted distal gastrectomy(LADG)and total laparoscopic distal gastrectomy(TLDG)for gastric cancer.Methods A retrospective analysis was conducted on clinical data of 99 patients who underwent laparoscopic distal gastrectomy for gastric cancer from May 2019 to April 2024.According to patient preference,49 patients underwent TLDG and 50 patients underwent LADG.The two groups were compared regarding operation duration,intraoperative blood loss,lymph node dissection and metastasis,frequency of postoperative analgesic use,time to gas exhaustion,time to ambulation,postoperative hospital stay,self-care ability score(Barthel Index),total protein,albumin,and white blood cell count,as well as postoperative complications including anastomotic leakage,anastomotic obstruction,gastroparesis,chylous leakage,abdominal infection,incision infection,respiratory system infection and so on.Results Compared with LADG,TLDG resulted in fewer frequency of postoperative analgesic use(median,0 vs.4 times,Z=-5.810,P<0.001)and higher self-care ability scores(median,50.0 points vs.40.0 points,Z=-3.232,P=0.001)after surgery.There were no significant differences in operation duration,intraoperative blood loss,number of lymph nodes obtained,lymph node metastasis,time to gas exhaustion,time to ambulation,postoperative hospital stay,postoperative complications,postoperative total protein,albumin,and white blood cell count between the two groups(P>0.05).Conclusion LADG and TLDG are comparable in surgical efficiency and safety,but TLDG results in less postoperative pain and better self-care ability after surgery,potentially offering advantages in postoperative recovery.

Continuous care can effectively improve the quality of life, self-management ability and health outcomes of lung transplant recipients, and is important for reducing readmission rates and medical costs, but there are no standardized criteria for evaluating the quality of continuous care for lung transplant recipients. Based on the Donabedian three-dimensional quality evaluation model, this paper presents a review of the indicators for evaluating the quality of continuous care for lung transplant recipients, and analyses the current state of the art of assessing the quality of care in the current literature, in order to provide reference for the development of a multi-dimensional, highly sensitive and specific evaluation index system for lung transplant recipients′ continuous care, as well as providing a direction for future research and clinical application.

Based on the theory of"the spleen and stomach as the pivot",Professor Xiong Lei's clinical thinking of"moving the pivot and removing stale qi"to treat depression in children and adolescents is summarized.It is believed that the key mechanism of de-pression in children and adolescents is the unfavorable pivot of the spleen and stomach,and the disharmony between qi and blood of the five organs,which leads to the growth of stale qi,the clouding of the clear orifices by turbid evils,and the malfunction of the spirit.If the pivot is unfavorable,move it,and if the stale qi is endogenous,remove it.Professor Xiong,based on the concept of"treating with orchids and removing stale qi"from The Yellow Emperor's Inner Classic,utilizes aromatherapy in Chinese medicine,taking"moving the pivot and removing stale qi"as the basic treatment,and proposes Xiangzhi Shuxin Formula as the basic formula,which applies five methods of removing dampness,resolving phlegm,eliminating accumulation,removing stasis,and dispersing fire and relieving depres-sion.An experimental case is attached to explain his clinical thinking.

Breast cancer is one of the most common malignant tumors, and postoperative radiotherapy remains an essential component of its treatment. In recent years, hypofractionated radiotherapy has gradually become the recommended approach for postoperative breast cancer treatment. Compared with conventional fractionated radiotherapy, hypofractionated regimens shorten the overall treatment duration, enhance patient convenience, and reduce treatment costs, while achieving comparable long-term efficacy and maintaining good quality of life. Based on relevant domestic and international studies and clinical experience, this consensus establishes expert recommendations regarding indications, prescribed doses, dose constraints for organs at risk (OAR), implementation methods, and plan evaluation for hypofractionated radiotherapy after breast cancer surgery, with a particular focus on moderately hypofractionated (MHF) and ultrahypofractionated (UHF) regimens. MHF radiotherapy is applicable to whole-breast irradiation, chest wall irradiation, and regional nodal irradiation, and is suitable for most breast cancer patients. UHF radiotherapy, which employs a higher dose per fraction to further shorten the treatment course, is suitable for patients requiring rapid therapy or prioritizing treatment convenience. Although the short-term efficacy of UHF radiotherapyis similar to that of MHF radiotherapy, its long-term efficacy and safety require further clinical validation. Meanwhile, potential adverse effects of UHF, such as breast induration and atrophy, should be carefully assessed. Therefore, radiotherapy dose and fractionation regimen should be individualized according to patient-specific factors, particularly considering OAR dose constraints. Rational selection of radiotherapy regimens can minimize adverse effects while maintaining therapeutic efficacy, ultimately improving patient outcomes and quality of life. This consensus provides scientific guidance for the clinical and research application of hypofractionated radiotherapy in breast cancer.