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 evaluate the effect of augmented reality (AR) technology on improving the teaching quality of cardiac magnetic resonance (MR).Methods:A total of 36 postgraduate students of Tongji University majoring in medical imaging of 2018 and 2019 who received standardized residency training in Tongji Hospital affiliated to Tongji University from September 2019 to January 2022 were prospectively enrolled and randomly divided into experimental group and control group in average. In cardiac MR teaching, the experimental group combined with AR technology on the basis of the traditional electronic courseware teaching mode, and the control group adopted the traditional electronic courseware teaching mode. In order to evaluate the role of AR technology in cardiac MR teaching, theoretical examination, practical examination and satisfaction survey were conducted among the two groups of students after the completion of the teaching content. SPSS Statistics 24 analysis software was used to conduct exploratory analysis and mean comparison (independent-samples t-test) on the theoretical examination, practical examination and satisfaction survey of the two groups of students. All statistical analyses were conducted at 95% confidence level. Results:The average scores of theoretical examination of the two groups were (87.56±5.07) points and (75.22±4.04) points, respectively, and the difference was statistically significant ( t=10.36, P<0.001). The scores of knowledge points in basic concepts and technical characteristics, normal anatomy and hemodynamics of cardiac MR, basic cardiac lesions and MR manifestations of the two groups of students were as follows: (15.72±2.08) points, (27.00±2.09) points, (44.83±2.60) points vs. (13.28±1.74) points, (21.89±1.78) points, (40.06±2.67) points. The average scores of the practical examination for the students in the experimental group and the control group were (80.83±7.33) points and (71.11±6.98) points, respectively, with statistical significance ( t =35.00, P<0.001). In the satisfaction questionnaire, the scores of the experimental group were higher than those of the control group in five aspects: learning motivation, classroom atmosphere, teaching role of the course, mastery of key and difficult points and examination arrangement. The difference between the two groups was statistically significant (all P<0.05). Conclusions:In the teaching of cardiac MR, the application of AR technology has achieved good teaching results, improved the ability of students to diagnose and differentiate heart diseases, and improved the teaching effect and quality.

This article analyzes the characteristics and current status of orthopedic surgery teaching, as well as the advantages of mixed reality technology. We explore the application of mixed reality technology in the clinical surgery teaching of orthopedics from the perspective of different diseases in orthopedics. Additionally, we analyze its limitations in teaching practice, providing reference for the practical application of mixed reality technology in clinical teaching of orthopedics.

Objective:To explore the association of gait speed and cognitive function of the community-dwelling elderly.Methods:From March to December 2021, a total of 1 172 Xinxiang community-dwelling elderly people were investigated by general information questionnaire, mini-mental state examination(MMSE), patient health questionnaire depression scale and 4.6 m gait test. The elderly were divided into five groups based on the quintile grouping of gait speed values, with Q1 group (≤0.76 m/s), Q2 group (0.77-0.88 m/s), Q3 group (0.89-0.98 m/s), Q4 group (0.99-1.11 m/s) and Q5 group (≥1.12 m/s). SPSS 25.0 statistical software was used for descriptive statistics, and binary Logistic regression was used to analyze the influence of gait speed and depression on cognitive impairment of the elderly.Results:The gait speed of community-dwelling elderly people was (0.92±0.22) m/s. The scores of MMSE in Q1-Q5 groups were (24.72±3.67), (26.63±2.90), (26.58±2.66), (27.01±2.45) and (27.18±2.35), respectively, and the cognitive function was significantly different among the five gait speed groups( F=27.92, P<0.05). The results of binary Logistics regression showed that compared with Q1 group, the OR value (95% CI) of cognitive impairment in Q2-Q5 group were 0.475 (0.253-0.893), 0.426 (0.219-0.828), 0.421(0.212-0.826) and 0.371(0.179-0.766), respectively, which indicated that fast walking speed was a protective factor for cognitive function. Old age ( OR=1.096, 95% CI=1.053-1.140) and depression ( OR=14.441, 95% CI=12.670-19.829) were risk factors of cognitive impairment. Conclusion:The gait speed is associated with cognitive function among community-dwelling elderly people, and faster gait speed is a protective factor for cognitive function.

Objective: To evaluate the degeneration patterns of paraspinal muscles in double-level degenerative lumbar spondylolisthesis (dl-DLS) versus single-level degenerative lumbar spondylolisthesis (sl-DLS). Methods: A total of 67 dl-DLS and 73 sl-DLS patients were included. Multifidus (MF), erector spinae (ES), and psoas major (PM)’s fatty infiltration (FI) and relative cross-sectional area (rCSA) were measured. Sagittal parameters such as lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS) were also assessed. Comparisons and correlation analysis were performed between the 2 groups. Results: MF atrophy is worse in dl-DLS patients from L3–4 to L5–S1, with higher FI from L1–2 to L5–S1 compared to sl-DLS patients. ES atrophy and FI are more pronounced in dl-DLS patients from L1–2 to L5–S1. PM atrophy is more significant in dl-DLS patients at L2–3 to L5–S1, with heavier FI from L1–2 to L3–4, though no difference in FI from L4–5 to L5–S1. The rCSA and FI of MF and ES show significant differences between adjacent segments in both groups, except for MF rCSA between L3–4 and L4–5 in dl-DLS. In dl-DLS, PM rCSA negatively correlates with PT from L4–5 to L2–3, while FI of MF and ES in L5–S1 positively correlates with LL. In sl-DLS, PM FI in L4–5 and L5–S1 negatively correlates with LL. Conclusion Degeneration of MF, ES, and PM is more severe in dl-DLS patients, particularly at the spondylolisthesis level. Severe paraspinal muscle degeneration can lead to spinal force imbalance and progression from sl-DLS to dl-DLS. The degradation of PM and ES correlates negatively with PT and SVA, indicating a link to pelvic decompensation and SVA abnormalities, potentially causing disproportionate degenerative changes in dl-DLS patients.

Objective To investigate the impact of hemoglobin(Hb)level on the risk of all-cause mortality in elderly patients with stable coronary artery disease(SCAD)treated by percutaneous coronary intervention(PCI).Methods A retrospective cohort study was conducted on 195 elderly SCAD patients treated by PCI in our hospital from June 2016 to December 2017,a total of 180 case were followed up.They were divided into four groups based on quartiles of Hb levels:Q1 group[≤122(108.28±12.53)g/L,n=47],Q2 group[122＜Hb≤137(130.07±4.33)g/L,n=43],Q3 group[137＜Hb≤148(142.67±3.10)g/L,n=46],and Q4 group[＞148(158.36±8.50)g/L,n=44].Their clinical data were collected and compared among the groups.All patients were followed up,with all-cause mortality as endpoint.Cox regression analysis was used to evaluate the impact of Hb level on all-cause mortality in elderly SCAD patients treated by PCI.Results For the 180 patients with complete follow-up,the median follow-up time was 703(415,1121)d,and the incidence of all-cause mortality was 10.00％(totally 18 deaths).And the incidence was 25.50％(12 deaths),7.00％(3 death),4.30％(2 deaths)and 2.30％(1 death)in Q1,Q2,Q3,and Q4 groups,respectively,with statistically significant differences(P＜0.01).Univariate Cox regression analysis showed age was a risk factor for all-cause death(P＜0.01),while Hb level,BMI,smoking history,dyslipidemia,and aspirin use were a risk facotr for all-cause death(P＜0.05,P＜0.01).Further multivariate Cox regression analysis revealed Hb level was a risk facotr for all-cause death(HR=0.96,95％CI:0.93-0.99,P＜0.01).The risk of all-cause mortality was 3.68 times higher in the Q1 group than the Q2 group(HR=3.68,95％CI:1.01-13.45,P＜0.05),and there was no correlation in the incidence between the Q3 and Q4 groups(P＞0.05).Conclusion Low Hb level is an independent predictor for all-cause mortality in elderly SCAD pa-tients after PCI.

Objective:To detect the 3′-terminal 2′- O-methylation (2′Ome) modified microRNA-486-5p (miR-486-5p) levels in the serum of patients with coronary heart disease (CHD), and evaluate its clinical application value as a biomarker to assist the diagnosis of CHD. Methods:Seventy patients with CHD diagnosed at the Eastern Theater General Hospital from January 2021 to December 2022 and 60 age-and sex-matched healthy people undergoing health examination during the same period were selected for this retrospective case-control study. The Gensini score was calculated based on coronary angiography results, and patients in the coronary artery disease group was categorized into mild-to-moderate stenosis (40 cases) and severe stenosis subgroups (30 cases); Serum biochemical indexes, miR-486-5p and 2′Ome-miR-486-5p expression levels were compared between the CHD group and the healthy control group; correlation of biochemical indices, Gensini score and serum miR-486-5p and 2′Ome-miR-486-5p levels was assessed by using Spearman correlation analysis; and multifactorial logistic regression was used to analyze the impact of serum miR-486-5p and 2′Ome-miR-486-5p levels on CHD and the degree of coronary artery stenosis; evaluation of the diagnostic value of 2′Ome-miR-486-5p levels on the degree of coronary artery disease and coronary artery stenosis was achieved by using ROC curve.Results:Serum miR-486-5p and 2′Ome-miR-486-5p levels were significantly higher in CHD group than in the healthy control group [0.31 (0.17, 0.84) vs 0.21 (0.11, 0.49), Z=2.055, P<0.05; 2.30 (1.32, 5.40) vs 0.86 (0.55, 1.72), Z=5.840, P<0.05]; Serum 2′Ome-miR-486-5p expression levels were higher in both mild-moderate and severe stenosis subgroups than in healthy controls ( P<0.05), and serum 2′Ome-miR-486-5p levels were higher in the severe stenosis subgroup than in the mild-moderate stenosis subgroup [3.54(1.78, 5.44) vs 1.63(1.25, 4.07), Z=-2.053, P<0.05]. Both serum miR-486-5p and 2′Ome-miR-486-5p levels were positively correlated with the Gensini score ( r=0.277 and 0.479, respectively, P<0.05); multifactorial logistic regression analysis showed that serum 2′Ome-miR-486-5p level was an independent influence factor of the degree of coronary stenosis after adjustig for the effects of confounding factors such as age and sex ( OR=1.025, 95% CI 1.002-1.049, P<0.05). ROC curve analysis showed that the area under the ROC curve of serum 2′Ome-miR-486-5p levels for the diagnosis of CHD patients, mild to moderate and severe stenosis were 0.798, 0.752 and 0.859, with sensitivities of 91.4%, 92.5%, and 73.3%, and specificities of 56.7%, 51.7% and 81.7%, respectively, at the optimal cut-off (0.912, 0.863, 2.209). Conclusion:Serum 2′Ome-miR-486-5p level is increased in CHD patients and is an independent predictor of the severity of coronary artery stenosis, which can be used as a biomarker for the diagnosis of patients with CHD.

Objective:To detect the changes in the levels of miR-21-5p and miR-125a-5p modified with 3′-terminal 2′-O-methylation (3′t-2′Ome) in serum extracellular vesicles (EV) of non-small cell lung cancer (NSCLC) patients, and evaluate their value as auxiliary screening molecular markers for NSCLC patients.Method:A retrospective analysis was conducted on the data of 69 NSCLC patients diagnosed at the Eastern Theater Command General Hospital from May 1st to October 31st,2023, as well as 65 age and gender matched healthy controls during the same period. Two real-time fluorescence quantitative PCR (RT-qPCR) techniques, namely stem-loop method and poly (A) tailed method, were used to detect the levels of 3′t-2′Ome-miR-21-5p and 3′t-2′-Ome miR-125a-5p in serum EV of NSCLC patients and controls.Analyze the correlation between the levels of two types of 3′t-2 ′Ome miRNAs and the differences in clinical stage, pathological classification, and other tumor indicators in patients. Receiver operating characteristic (receiveroperating curve, ROC) curves were used to analyze the efficacy of 3′t-2 ′Ome miR-21-5p and 3′t-2′ Ome miR-125a-5p in serum EV, as well as their combination, in diagnosing NSCLC.Result:Compared with the control group, the levels of 3′t-2′Ome-miR-21-5p in serum EV of NSCLC patients increased [(0.30±0.05) vs (0.35±0.09), t=3.32, P=0.001], while the levels of 3′t-2′Ome-miR-125a-5p decreased [(0.33±0.06 vs 0.25±0.06, t=7.45, P<0.001]. The differences were statistically significant. The expression levels of 2′Ome-miR-21-5p in EV were also significantly elevated in the NSCLC patients at 0-Ⅱ stage, adenocarcinoma patients, and squamous cell carcinoma patients, respectively. Notably, the levels of EV 3′t-2′Ome-miR-21-5p was also statistically significant between the adenocarcinoma patients and squamous cell carcinoma patients [(0.34±0.85) vs (0.40±0.12), P<0.05]. ROC curve analysis showed that the levels of 3′t-2 ′Ome miR-21-5p and 3′t-2′ Ome miR-125a-5p in serum EV, as well as their combined AUC for discriminating NSCLC patients, were 0.647(95% CI 0.550-0.743), 0.825(95% CI 0.756-0.894) and 0.860(95% CI 0.797-0.923), respectively. The sensitivity was 92.3%, 80.0%, 89.2%, and the specificity was 46.4%, 73.9%, and 78.3%, respectively. Conclusion:There are changes in the levels of 2 ′Ome miR-21-5p and 2′ Ome miR-125a-5p in the serum EV of NSCLC patients, and the combined detaction has the potential as an auxiliary screening molecular marker of NSCLC patients.

Objective:To explore the clinical value of CT identification of vascular variations in the dorsal side of right middle segmental bronchus before thoracoscopic lobectomy.Methods:A retrospective analysis was conducted on the clinical data of 3 patients who underwent thoracoscopic lobectomy at Shanxi Province Cancer Hospital from July 2022 to March 2024 and had a variant blood vessel on the dorsal side of the right middle segmental bronchus. Relevant literature was also reviewed.Results:Among the 3 patients, 2 were female and 1 was male, with ages of 66, 50 and 69 years old, respectively. Prior to admission, imaging examinations revealed space-occupying lesions or nodes in the right lung, and all patients underwent thoracoscopic right lobectomy and systematic lymph node dissection. Postoperative pathology diagnosed adenocarcinoma in the lower lobe of the right lung, cystic adenoma in the upper lobe of the right lung and invasive adenocarcinoma in the lower lobe of the right lung. Preoperative chest CT scans revealed an abnormal blood vessel on the dorsal side of the right middle segmental bronchus, and its direction and confluence with the right lower pulmonary vein or left atrium were observed on the downward CT imaging. This was confirmed and treated accordingly during surgery. All 3 patients had no postoperative complications and recovered smoothly. Follow-up showed good health status.Conclusions:The vascular variation on the dorsal side of the right middle segmental bronchus has obvious characteristic manifestations on chest CT. Identifying the variation by CT before thoracoscopic lobectomy can effectively ensure surgical safety and reduce the occurrence of postoperative complications.

Behavioral activation therapy is a short-term psychological treatment for depression.It has achieved positive results in the treatment of depression due to its simplicity and low treatment cost.Driven by the development of information technology and the aging of population,behavioral activation therapy is constantly innovated to meet the needs of depression treatment.This article reviews the application of behavioral activation therapy in depression treatment,and focuses on the innovative application progress based on the analysis of the connotation and current status of behavioral activation therapy.