Objective This study aimed to assess the clinical utility of combining the Controlling Nutri-tional Status(CONUT)score with the Prognostic Nutritional Index(PNI)for evaluating anemia risk in elderly colorectal cancer patients and to establish a risk prediction model.Methods A total of 661 elderly colorectal cancer patients treated at Xinjiang Uygur Autonomous Region People's Hospital from July 2018 to March 2025 were included in this retrospective study.Patients were categorized into anemic and non-anemic groups and randomly assigned to a training set and validation set at a 7:3 ratio.The XGBoost algorithm was applied to develop a predictive model for anemia risk,and its performance was assessed using the receiver operating characteristic(ROC)curve.SHAP value visualization,and other methods.Results Among the 661 patients,257(38.9％)were diagnosed with anemia.Compared with the non-anemic group,patients in the anemic group had significantly lower levels of PNI and albumin,but higher CONUT scores and blood urea nitrogen levels.Additionally,the anemic group had higher proportions of tumor diameter≥5 cm,poorly differentiated tumors,and stage Ⅲ-Ⅳ disease(all P<0.05).The XGBoost model demonstrated good discriminatory ability,with an AUC of 0.897(95％CI:0.868～0.925).SHAP value analysis identified PNI,CONUT score,albumin,blood urea nitrogen,TNM stage,tumor differentiation,and tumor size as major contributing variables.PNI and albumin were protective factors,whereas CONUT score,blood urea nitrogen,and tumor-related features were risk factors.Conclusion Nutritional indicators such as PNI and CONUT score,along with tumor characteristics,can effectively predict the risk of anemia in elderly patients with colorectal cancer.The XGBoost-based predictive model demonstrates high discriminatory power and good inter-pretability,providing valuable support for early screening of high-risk patients and guiding individualized nutri-tional interventions and anemia management.

Objective:To culturally adapt the eHealth Literacy Questionnaire (eHLQ) into Chinese and validate its reliability and validity in stroke patients, so as to provide a basis for comprehensive evaluation of electronic health literacy in stroke patients.Methods:From May to September 2024, the Brislin translation model was adopted for translation, and the expert consultation was used for cultural adaptation. Followed by preliminary testing to finalize the Chinese version of eHLQ. A convenience sample of the stroke patients was recruited from Beijing Tiantan Hospital, Capital Medical University and Tianjin Huanhu Hospital between October 2024 to February 2025 to conduct a cross-sectional study and evaluate the scale's reliability and validity.Results:Finally, 415 stroke patients were included, with 284 males and 131 females, aged (61.26 ± 9.75) years. The Chinese eHLQ comprised 7 dimensions and 35 items. The item-level content validity index ranged from 0.875 to 1.000, and the scale-level content validity index of universal agreement was 0.857. Exploratory factor analysis revealed KMO value of 0.922, with a cumulative variance contribution rate of 68.90% and factor loading ranging from 0.515 to 0.803. Confirmatory factor analysis demonstrated satisfactory model fit indices: χ2/ df was 1.639, incremental fit index was 0.913, Tucker-Lewis index was 0.902, comparative fit index was 0.912, goodness-of-fit index was 0.812, and root mean square error of approximation was 0.056. The overall Cronbach α coefficient was 0.941, with subscale Cronbach α ranging from 0.825 to 0.894. The test-retest reliability was 0.954. Conclusions:The Chinese version of the eHLQ exhibits excellent reliability and validity, serving as an effective tool for assessing eHealth literacy among stroke patients in China.

Objective This study aimed to assess the clinical utility of combining the Controlling Nutri-tional Status(CONUT)score with the Prognostic Nutritional Index(PNI)for evaluating anemia risk in elderly colorectal cancer patients and to establish a risk prediction model.Methods A total of 661 elderly colorectal cancer patients treated at Xinjiang Uygur Autonomous Region People's Hospital from July 2018 to March 2025 were included in this retrospective study.Patients were categorized into anemic and non-anemic groups and randomly assigned to a training set and validation set at a 7:3 ratio.The XGBoost algorithm was applied to develop a predictive model for anemia risk,and its performance was assessed using the receiver operating characteristic(ROC)curve.SHAP value visualization,and other methods.Results Among the 661 patients,257(38.9％)were diagnosed with anemia.Compared with the non-anemic group,patients in the anemic group had significantly lower levels of PNI and albumin,but higher CONUT scores and blood urea nitrogen levels.Additionally,the anemic group had higher proportions of tumor diameter≥5 cm,poorly differentiated tumors,and stage Ⅲ-Ⅳ disease(all P<0.05).The XGBoost model demonstrated good discriminatory ability,with an AUC of 0.897(95％CI:0.868～0.925).SHAP value analysis identified PNI,CONUT score,albumin,blood urea nitrogen,TNM stage,tumor differentiation,and tumor size as major contributing variables.PNI and albumin were protective factors,whereas CONUT score,blood urea nitrogen,and tumor-related features were risk factors.Conclusion Nutritional indicators such as PNI and CONUT score,along with tumor characteristics,can effectively predict the risk of anemia in elderly patients with colorectal cancer.The XGBoost-based predictive model demonstrates high discriminatory power and good inter-pretability,providing valuable support for early screening of high-risk patients and guiding individualized nutri-tional interventions and anemia management.

Objective:To culturally adapt the eHealth Literacy Questionnaire (eHLQ) into Chinese and validate its reliability and validity in stroke patients, so as to provide a basis for comprehensive evaluation of electronic health literacy in stroke patients.Methods:From May to September 2024, the Brislin translation model was adopted for translation, and the expert consultation was used for cultural adaptation. Followed by preliminary testing to finalize the Chinese version of eHLQ. A convenience sample of the stroke patients was recruited from Beijing Tiantan Hospital, Capital Medical University and Tianjin Huanhu Hospital between October 2024 to February 2025 to conduct a cross-sectional study and evaluate the scale's reliability and validity.Results:Finally, 415 stroke patients were included, with 284 males and 131 females, aged (61.26 ± 9.75) years. The Chinese eHLQ comprised 7 dimensions and 35 items. The item-level content validity index ranged from 0.875 to 1.000, and the scale-level content validity index of universal agreement was 0.857. Exploratory factor analysis revealed KMO value of 0.922, with a cumulative variance contribution rate of 68.90% and factor loading ranging from 0.515 to 0.803. Confirmatory factor analysis demonstrated satisfactory model fit indices: χ2/ df was 1.639, incremental fit index was 0.913, Tucker-Lewis index was 0.902, comparative fit index was 0.912, goodness-of-fit index was 0.812, and root mean square error of approximation was 0.056. The overall Cronbach α coefficient was 0.941, with subscale Cronbach α ranging from 0.825 to 0.894. The test-retest reliability was 0.954. Conclusions:The Chinese version of the eHLQ exhibits excellent reliability and validity, serving as an effective tool for assessing eHealth literacy among stroke patients in China.

BackgroundSibling relationships play a critical role in shaping anxiety symptoms in firstborn children. Anxiety symptoms often originate in early childhood and can persist into adolescence and adulthood. However， there is insufficient research on anxiety symptoms in preschool children， especially firstborn preschool children. ObjectiveTo explore the influencing factors of anxiety symptoms among firstborn preschool children， so as to provide references for the intervention of anxiety symptom for children in families with multiple children. MethodsFrom October to December 2021， a total of 8 449 children from 234 kindergartens in Longhua District of Shenzhen were included using a cluster sampling method. Sibling Inventory of Behavior （SIB） and Spence Preschool Anxiety Scale （SPAS） were used to investigate. Logistic regression analysis was used to identify influencing factors of anxiety symptoms in firstborn preschool children. ResultsA total of 8 419 （99.64%） valid questionnaires were collected. Anxiety symptoms were detected in 344（4.09%） firstborn preschool children. Statistically significant differences were observed between anxiety group and non-anxiety group in terms of household registration， monthly family income， maternal age， maternal education level， paternal education level， family living conditions and whether they are left-behind children （χ²/t=9.906， 33.490， 5.136， 13.485， 9.690， 17.332， 21.975， P<0.05 or 0.01）. Compared with non-anxiety group， children in the anxiety group scored higher on the SIB dimensions of rivalry， aggression and avoidance （t=165.322， 74.471， 286.419， P<0.01）， and lower on companionship， empathy and teaching （t=59.133， 42.417， 39.112， P<0.01）. Risk factors for anxiety symptoms in firstborn preschool children included left-behind children， as well as negative sibling relationships characterized by rivalry and avoidance （OR=1.195， 1.143， 1.260， P<0.05 or 0.01）. ConclusionFirstborn preschool children who are left-behind are more susceptible to anxiety symptoms. Negative sibling relationships， characterized by competition and avoidance， may also contribute to the emergence of anxiety symptoms in firstborn preschool children.

Objective To detect the expression level of 4-aminobutyrate aminotransferase(ABAT)in bone marrow of patients with myelodysplastic syndrome(MDS),and analyze its influence on clinicopathological features and prognosis of patients.Methods From January 2016 to March 2020,92 patients with MDS and 30 patients with acute myeloid leukemia(AML)from the First Affiliated Hospital of Xingtai Medical College were retrospectively collected.Meanwhile,30 patients with immunothrombocytopenia who did not develop MDS or other clonal diseases of the blood system during a 3-year follow-up were collected as control group.Real-time quantitative fluorescent PCR(qRT-PCR)was used to detect the relative expression level and methylation level of ABAT mRNA of all patients,and the relative expression level and methylation level of ABAT mRNA among different clinical characteristics of MDS patients were compared.Multivariate logistic regression analysis was used to analyze the risk factors affecting the adverse prognosis of MDS.The clinical value of detecting ABAT methylation level in predicting poor prognosis of MDS patients was analyzed by receiver operating characteristic(ROC)curve.Kaplan-Meier method was used to calculate the 3-year survival rate between groups with different ABAT mRNA relative expression levels and methylation levels,and log-rank test was used for their comparison.Results The expression level of ABAT mRNA in MDS group(0.42±0.08)was lower than that in control group(0.56±0.15)and AML group(0.52±0.10),while the methylation level of ABAT(32.51±5.32)was higher than that of AML group(26.21±4.58)and control group(10.25±4.31),and the differences were significant(t=4.251,4.562;10.415,8.326,all P<0.001).The methylation level of ABAT in high-risk patients(42.65±5.32)was higher than that in low-risk patients(25.63±4.16),intermediate-risk-1 patients(30.59±2.51)and intermediate-risk-2 patients(33.25±3.69)by IPSS risk grade,and the differences were significant(t=8.329,7.077,15.874,all P<0.001).Poor Karyotype analysis result[OR(95%CI):4.973(1.524～8.581),P=0.004],high IPSS risk grade[OR(95%CI):8.542(2.365～14.521),P<0.001]and ABAT hypermethylation level[OR(95%CI):6.178(1.589～13.021),P<0.001]were the risk factors affecting the poor prognosis of MDS.The cut-offvalue of ABAT methylation level to predict the poor prognosis of MDS were 30.54,and the area under the curve(AUC),the sensitivity and specificity were 0.92,0.874 and 0.851,respectively.The 3-year survival rate of the high ABAT methylation group(>30.54)was 66.67%,which was lower than that of the low ABAT methylation group(≤30.54)was 93.18%,with significant difference(Log-rank x2=9.814,P=0.002).Conclusion The ABAT methylation levels in MDS bone marrow increase,which is a risk factor affecting the poor prognosis of patients.ABAT basal level>30.54 is expected to become a factors predicting the poor prognosis of patients.

Objective:To investigate the dosimetric effects of complex cardiac-respiratory motion in cardiac stereotactic body radiotherapy (CSBRT).Methods:A cardiac motion phantom was employed to simulate patient-specific cardiac-respiratory motion in 10 cases. The measured doses obtained under the phantom motion state were compared with the calculated doses in radiotherapy treatment planning for clinical patients. Moreover, 18 groups of design-based cardiac-respiratory motion were simulated. The radiation doses under the phantom motion state were measured using radiochromic films and compared with those under the resting state.Results:In the patient-specific cardiac-respiratory motion group, the gamma passing rate (GPR) under the 3%/2 mm standard between the measured and the calculated doses was 90.0% ± 7.0%. The correlation coefficient of the respiratory motion amplitude in the superior-inferior (SI) dimension with the GPR was -0.86 ( P=0.01). In the design-based cardiac-respiratory motion groups, the increase in the amplitude of cardiac-respiratory motion reduced the consistency between the dynamic dose and the static reference dose. Especially, the increase in the respiratory motion amplitude produced the most pronounced effect, reducing the width of the 90% isodose line in the respiratory motion direction, with a mean slope of -1.6. Additionally, the increase in the penumbra corresponds to a mean slope of 1.4. Conclusions:The respiratory motion amplitude serves as a primary factor influencing the dose accuracy of CBSRT. The characteristics and dosimetric effects of cardiac-respiratory motion are patient-specific, thus necessitating the assessment of cardiac-respiratory motion characteristics before CBSRT to individualize the application of motion management techniques for enhanced treatment accuracy.

Objective:To explore the effect of continuous large-volume hemofiltration combined with somatostatin on the prognosis of patients with acute severe pancreatitis.Methods:A total of 106 patients with acute severe pancreatitis who were treated in the People′s Hospital of Xinjiang Uygur Autonomous Region from October 2019 to October 2021 were enrolled retrospectively and they were divided into drug group (53 cases) and filtration group (53 cases) according to different treatment methods. The patients in the drug group were given somatostatin instillation on the basis of routine treatment, and the patients in the filtration group were given continuous large-volume hemofiltration therapy on the basis of the drug group. The serum amylase level, clinical efficacy, clinical indicators and prognosis were compared between the two groups.Results:After treatment for 3 d and 1 week, the levels of serum amylase in the drug group were lower than those in the filtration group: (385.62 ± 15.57) U/L vs.(426.83 ± 18.21) U/L, (110.75 ± 7.68) U/L vs. (162.74 ± 9.12) U/L, there were statistical differences ( P<0.05). The total effective rate in the filtration group was higher than that in the drug group: 90.57%(48/53) vs. 75.47%(40/53), χ2 = 4.28, P<0.05. The hospitalization time, gastrointestinal decompression time and recovery time of bowel sounds in the filtration group were shorter than those in the drug group: (17.21 ± 4.01) d vs. (20.56 ± 4.57) d, (5.46 ± 1.56) d vs. (7.98 ± 1.79) d, (5.43 ± 2.11) d vs. (6.78 ± 2.54) d, there were statistical differences ( P<0.05). After treatment for 3 d and 1 week, the scores of gastrointestinal function and acute physiology and chronic health assessment (APACHE) Ⅱ in the filtration group were lower than those in the drug group: after treatment for 3 d: (1.64 ± 0.35) scores vs. (1.89 ± 0.41) scores, (23.42 ± 2.71) scores vs. (27.62 ± 3.01) scores; after treatment for 1 week: (0.67 ± 0.21) scores vs. (1.01 ± 0.32) scores, (9.78 ± 1.21) scores vs. (15.62 ± 1.58) scores, there were statistical differences ( P<0.05). After treatment for 28 d, the fatality rate in the filtration group was lower than that in the drug group: 5.66%(3/53) vs. 20.75%(11/53), χ2 = 5.27, P<0.05. Conclusions:Bedside continuous bulk hemofiltration with somatostatin in the treatment of severe acute pancreatitis can effectively reduce the serum amylase level, promote the recovery of gastrointestinal function, improve the clinical symptoms and prognosis.

Objective:To explore the effect of methylphenidate (MPH) sustained-release tablets on the sleep characteristics of children with attention deficit hyperactivity disorder (ADHD).Methods:A total of 23 children with ADHD were included in the MPH group, and treated with sustained variable doses of methylphenidate sustained-release tablets, and overnight polysomnograms (PSG) were performed at baseline, 2 weeks of treatment, and 6 weeks of treatment.At the same time, 21 matched normal children were recruited as control group for PSG.SPSS 22.0 was used for statistical analysis, and the mean ± standard deviation, M( P25, P75) and percentage were used for statistical description according to the type of data.Paired t test or analysis of variance was used for comparison of sleep parameters. Results:At baseline, children in MPH group had lower sleep efficiency (SE (%)) ((86.7±12.4)%, (90.9±7.5)%), longer sleep latency (SOL) ((21.1±12.4) min, (18.1 ±13.0) min), shorter rapid eye movement onset latency (ROL) ((145.2±35.2)min, (155.6±57.7)min), and the differences were statistically significant (all P<0.05). Compared with baseline, children in MPH group after 2 weeks of treatment had prolonged SOL ((27.2±6.4)min, (21.1±12.4) min), shortened ROL((127.2±32.1) min, (145.2±35.2) min) and REM phase time((70.5±13.8) min, (79.8±15.3)min) and significantly lower SE (%) ((83.1±15.4)%, (86.7±12.4)%), and the differences were statistically significant (all P<0.05). There was no significant difference in the SOL, ROL, REM phase time, and SE (%) sleep parameters of children in the MPH group after 6 weeks of treatment and baseline (all P>0.05). The sleep parameters such as %TST, number of awakenings and time of awakening of WASO in N1, N2, N3 and R phase of MPH group were not statistically significant among baseline, 2 weeks of treatment and 6 weeks of treatment (all P> 0.05). Conclusion:Children with ADHD present lower sleep efficiency, more difficulty to fall asleep, and shortened REM latency.MPH has a certain negative effect on the sleep of ADHD children in the first 2 weeks, which worsens the sleep problems of ADHD children.After 6 weeks of continuous treatment, the effect of MPH on sleep gradually improved.

Objective To investigate the prevalence and related factors of musculoskeletal diseases in nurses by means of qualitative and quantitative research, and to have a discussion on the inner experiences of nurses. Methods 1 012 clinical nurses, from one hospital during March 2019 to May 2019, were selected as research objects by convenience sampling method. The Nordic musculoskeletal disease questionnaire was used for investigation,and SPSS 21.0 was used for statistical analysis. In the qualitative study,5 ICU nurses were selected by objective sampling method. Data were collected by semi-structured interview method,and analyzed by content analysis method. Results The annual prevalence rate of musculoskeletal diseases in clinical nurses was mainly in the neck (53.2%, 538/1 012), followed by the waist and back (48.5%, 491/1 012), hip and leg (45.2%, 457/1 012). Logistic regression analysis of neck related factors showed that BMI (P=0.039), repeated operation for one minute (P=0.007), and staff shortage in the Department (P=0.027) were the influencing factors of musculoskeletal diseases. Qualitative research extracted the following two themes:negative psychological experience of nurses under high workload and positive psychological experience of nurses. Conclusion The prevalence of neck is the highest among those of other musculoskeletal diseases in clinical nurses, which is related to many related factors. In the professional environment of nurses, nurses have high self-protection willingness and ability. It is suggested to strengthen support from hospital, family and other aspects, reduce the prevalence rate, and improve the quality of work and family life of nurses.