Objective: To explore the effects of personality and sleep quality with psychological distress of junior and senior high school stduents, so as to provide a reference basis for precise interventions of junior and senior high school students mental health. Methods: In October 2023, a convenience sampling method was used to select 9 034 students aged 12-17 from Shiyan City as the study subjects. The Pittsburgh Sleep Quality Index (PSQI) and Kessler Psychological Distress Scale (K10) were used to collect information on sleep quality and psychological distress of junior and senior high school stduents. Between group comparison was conducted by using t-test and Chi-square test. Generalized linear models were employed to analyze the interaction and joint effects of personality and sleep quality on psychological distress. Results: The generalized linear model analysis showed that the interaction between personality and sleep quality on psychological distress was statistically significant of junior and senior high school students(effect size=0.80, P <0.01). The general linear model analysis indicated that, after adjusting for variables such as age, gender, screen time, and daily sitting time with the extroverted and good sleep quality group as the reference, the introverted and poor sleep quality group had the largest mean difference in psychological distress scores (difference=0.51, P <0.05). When stratified by sleep quality, psychological distress scores were higher in the introverted and neutral personality groups with both poor and good sleep quality compared to the extroverted group (poor sleep quality: introverted difference=3.71, neutral difference=1.14; good sleep quality: introverted difference=2.23, neutral difference=0.57, all P < 0.05). When stratified by personality, psychological distress scores were higher in the poor sleep quality groups for introverted, neutral, and extroverted individuals compared to their good sleep quality counterparts (differences=8.66, 7.83, 7.34, all P < 0.05 ). Conclusions Personality and sleep quality have interactive and joint effects on psychological distress of junior and senior high school stduents. Personalized psychological interventions should be developed based on personality and sleep quality.

Based on the theory of diseased collaterals and the progression pattern of diabetic kidney disease （DKD）， this paper proposes a staged treatment system based on the "three states of kidney collaterals" including collateral distention， collateral bi （痹） and collateral accumulation. In the collateral distention stage， the primary pathogenesis is heat damaging the kidney collaterals and collateral vessel dilation， corresponding to the early state of DKD characterized by hyperfiltration and microalbuminuria； the clearing method is suggested， and Shenling Jiangtang Formula （参苓降糖方） can be used to promote the remission of proteinuria by ameliorating insulin resistance and regulating intestinal microecology. In the collateral bi stage， the core pathogenesis lies in the binding of phlegm and stasis， and the formation of concretions and conglomerations in the kidney collaterals， corresponding to massive proteinuria and the decline of renal function， for which the unblocking method should be taken， using Jinchan Yishen Tongluo Formula （金蝉益肾通络方） and Qingre Xiaozheng Formula （清热消癥方） to alleviate renal pathological damage by regulating the autophagy-lysosome pathway and repairing mitochondrial energy metabolism. The collateral accumulation stage is characterized by the internal retention of turbid toxins and accumulations of concretions in the kidney collaterals， corresponding to renal fibrosis and end-stage renal disease （ESRD）； the dispersion method is suggested， and Yiqi Tongluo Xiezhuo Formula （益气通络泄浊方） and Shenyan Fangshuai Fluid （肾炎防衰液） can be used to inhibit extracellular matrix accumulation and delay the progressive loss of renal function. Collateral deficiency runs through the entire course of the disease and is closely related to cellular senescence and the imbalance of the ubiquitin-proteasome/autophagy system. The concept of the "three states of kidney collaterals" integrates the evolution of traditional Chinese medicine pathogenesis with modern pathological staging， forming a whole-course intervention system of "staging-syndrome differentiation-target-formula"， thereby providing novel insights for prevention and treatment of DKD using integrated traditional Chinese and western medicine.

Objective To provide relevant suggestions for ethical considerations in clinical research by searching literature related to ethics in clinical research using the visualization analysis software CiteSpace,and to analyze and compare the current research status of clinical research ethics at home and abroad.Methods The papers on the application of medical ethics in clinical trials from the core collection of CNKI and Web of Science databases were collected and the bibliometric software CiteSpace was used to draw a knowledge map of domestic and foreign literature.The research hotspots and development trends of medical ethics in clinical trials were analyzed.Results In terms of the process of informed consent,risk minimization,fair selection,and protection on the rights and interests of vulnerable groups,the focus of medical ethics research in China were basically consistent with foreign literature.The difference was that foreign research focused more on ethical education,the quality of life of research participants,and ethical counseling.Otherwise,domestic research focused more on the quality management of clinical trials and the specificity of traditional Chinese medicine research,with research on vulnerable groups mostly focused on children.Conclusion Chinese researchers should strengthen multi-dimensional research on medical ethics in China,and gradually expand their view from ethical review points and management research to applied research solved clinical problems and the specificity of research participants,and increasing the number and dimensions of research.

Objective To provide relevant suggestions for ethical considerations in clinical research by searching literature related to ethics in clinical research using the visualization analysis software CiteSpace,and to analyze and compare the current research status of clinical research ethics at home and abroad.Methods The papers on the application of medical ethics in clinical trials from the core collection of CNKI and Web of Science databases were collected and the bibliometric software CiteSpace was used to draw a knowledge map of domestic and foreign literature.The research hotspots and development trends of medical ethics in clinical trials were analyzed.Results In terms of the process of informed consent,risk minimization,fair selection,and protection on the rights and interests of vulnerable groups,the focus of medical ethics research in China were basically consistent with foreign literature.The difference was that foreign research focused more on ethical education,the quality of life of research participants,and ethical counseling.Otherwise,domestic research focused more on the quality management of clinical trials and the specificity of traditional Chinese medicine research,with research on vulnerable groups mostly focused on children.Conclusion Chinese researchers should strengthen multi-dimensional research on medical ethics in China,and gradually expand their view from ethical review points and management research to applied research solved clinical problems and the specificity of research participants,and increasing the number and dimensions of research.

Objective:To document any effect of repeated high-frequency repetitive transcranial magnetic stimulation (rTMS) using double-cone coils on the lower limb motor function of stroke survivors.Methods:A total of 40 stroke survivors were randomly divided into an rTMS group and a sham stimulation group, each of 20. The rTMS group received rTMS at 10Hz with a double-cone coil, while a coil that produced sound but no magnetic stimulation was used with the sham group. The treatments were administered daily, five times a week, for three weeks. Before as well as after 1, 2 and 3 weeks of treatment, lower limb motor function, balance, and the root mean square (RMS) and median frequency (MF) of the rectus femoris and tibialis anterior muscles were evaluated using the Fugl-Meyer lower extremity assessment (FMA-LE), the Berg Balance Scale (BBS), the Modified Barthel Index (MBI), Brunnstrom staging, the TecnoBody balance assessment system, and surface electromyography.Results:Compared with the sham stimulation group, the BBS score of the rTMS group was significantly higher after 2 weeks of treatment, and both the FMA-LE and BBS scores were significantly higher after 3 weeks. The average Brunnstrom stage in the sham group had increased significantly after 3 weeks, but in the rTMS group it had increased after 2 weeks. By 3 weeks there were no significant differences between the two groups. In terms of movement control, the average motion ellipse area in the rTMS group was significantly smaller than among the sham group after 2 weeks, and after 3 weeks the average motion trajectory length was significantly shorter than in the sham group. The average RMS of the rectus femoris in the rTMS group was significantly higher than the sham group′s average after 3 weeks of treatment, indicating improved muscle activation.Conclusions:High-frequency rTMS using a conical coil can effectively improve the lower limb motor function and balance ability of stroke survivors, demonstrating promising clinical application potential.

Objective:To evaluate the effect of cognitive behavioral therapy (CBT) on reducing anxiety and promoting rapid postoperative recovery in patients undergoing induced abortion surgery.Methods:Non-randomized controlled trials were adopted, a total of 480 patients scheduled for induced abortion between January 2024 and January 2025 were consecutively enrolled and allocated to the intervention group ( n=240) or control group ( n=240). The control group received conventional education, whereas the intervention group implemented cognitive behavioral therapy on the basis of control group. The Hamilton anxiety scale (HAMA), the self-rating anxiety scale (SAS) and the 36-item short-form health survey (SF-36) were the main observed outcome measures. The anxiety, pain degree 24 h after the intervention, postoperative recovery, postoperative complications and changes in quality of life after the intervention were compared between the two groups of patients. Taking the baseline characteristics of the patients as independent variables and the scores of HAMA, SAS and SF-36 as dependent variables, multiple linear regression analysis was conducted. Results:After the intervention, the scores of HAMA and SAS in the intervention group were 5.76±1.13 and 40.98±3.76 respectively, which were lower than those in control group (7.08±1.42; 46.42±4.14), and the differences were statistically significant (all P<0.001). The score of the visual analogue scale 24 h after the operation was lower than that in control group (1.64±0.48 vs. 2.83±0.76), and the difference was statistically significant ( P<0.001). The duration of vaginal bleeding, the time of menstrual resumption and the recovery time of daily activities in the intervention group were all shorter than those in control group [(8.23±2.36) d vs. (10.87±2.16) d; (28.34±3.65) d vs. (33.47±4.18) d; (18.98±5.24) d vs. (25.42±4.16) d], and the differences were statistically significant (all P<0.001). Six weeks after the operation, the total incidence of complications in the intervention group was 5.0% (12/240), which was lower than that in control group [12.9% (31/240)], and the difference was statistically significant ( P=0.002). After the intervention, the total score of each dimension of SF-36 was higher than that in control group (334.68±5.79 vs. 305.46±5.93), and the difference was statistically significant ( P<0.001). Multiple linear regression analysis showed that higher educational attainment (bachelor's degree and above compared with junior high school and below HAMA β=-0.52, 95% CI: -0.85--0.19, P=0.002; SAS β=-0.75, 95% CI: -1.31--0.19, P=0.008) and higher household income (HAMA β=-0.15, 95% CI: -0.22--0.08, P<0.001; SAS β=-0.18, 95% CI: -0.28--0.08, P<0.001) were protective factors for reducing anxiety levels. Married was the protection factor in SAS scores ( β=-0.68, 95% CI: -1.22--0.14, P=0.013), and higher number of pregnancies was a risk factor for SAS scores ( β=0.19, 95% CI: 0.07-0.31, P=0.002). Age increase was a protective factor for HAMA score ( β=-0.03, 95% CI: -0.05--0.01, P=0.001). Higher educational attainment (junior college: β=3.25, 95% CI: 0.60-5.90, P=0.016; bachelor's degree and above: β=5.02, 95% CI: 2.33-7.71, P<0.001), higher household income ( β=1.25, 95% CI: 0.55-1.95, P<0.001), and married status ( β=2.81, 95% CI:0.28-5.34, P=0.030) were all significant positive predictors of quality of life. Conclusion:Cognitive-behavioral therapy effectively alleviates anxiety, reduces post-operative complications, accelerates recovery, and improves the quality of life in women undergoing induced abortion.

Objective:To explore the effects of happy PERMA intervention on resilience, stigma and quality of life in colostomy patients with colorectal cancer.Methods:According to convenience sampling method, 120 patients with colorectal cancer who underwent permanent colostomy in the hospital were enrolled from September 2021 to August 2023. According to admission order, they were divided into control group (60 cases, September 2021-August 2022) and study group (60 cases, September 2022-August 2023). The control group was given routine nursing, while the study group was additionally given happy PERMA mode nursing intervention for 8 weeks. The scores of Connor-Davidson resilience scale (CD-RISC), social impact scale (SIS), ostomy adjustment inventory-20 (OAI-20), quality of life questionnaire core 30(QLQ-C30), general well-being schedule(GWB) and self-care ability before and after 8 weeks of intervention were compared between the two groups using SPSS 22.0 software.Results:After the intervention, the scores of resilience (45.28±2.59), strength (26.34±2.47), optimism (11.05±0.78), and the total CD-RISC score (80.95±3.47) in the study group were significantly higher than those in the control group (37.46±2.08, 18.55±1.96, 8.96±0.63, 65.11±2.32) ( t=18.235, 19.137, 16.146, 29.394, all P<0.05). The scores of internalized stigma (13.09±1.97), economic discrimination (6.85±0.78), social isolation (14.15±1.98), social exclusion (16.93±2.54), and the total SIS score (50.17±2.35) in the study group were significantly lower than those in the control group (13.97±2.44, 7.36±0.95, 16.94±2.37, 19.55±3.42, 58.69±2.83)( t=2.174, 3.214, 6.998, 4.764, 13.756, all P<0.05). The score of persistent worry (11.95±2.16) in the study group was significantly lower than that in the control group (16.57±1.92) ( t=12.383, P<0.05), while the score of acceptance (15.28±1.16), positive life attitude (17.38±2.31), and the total OAI-20 score (58.64±2.08) in the study group were significantly higher than those in the control group (12.19±0.97, 14.55±1.94, 46.30±1.57) ( t=15.829, 7.267, 36.679, all P<0.05). The scores of role function (86.27±3.15), emotional function (81.25±4.33), social function (79.63±3.16), cognitive function (83.55±3.97), general health (83.15±3.16), and the total QLQ-C30 score (407.13±15.92) in the study group were significantly higher than those in the control group (77.62±4.38, 73.85±4.96, 71.80±3.98, 79.42±4.31, 75.34±3.62, 372.65±11.58)( t=12.419, 8.706, 11.935, 5.459, 12.590, 13.567, all P<0.05). The GWB score (86.95±3.57) and self-care ability score (91.13±3.45) in the study group were significantly higher than those in the control group (73.82±4.06, 87.55±4.68)( t=18.812, 4.769, both P<0.05). Conclusion:Happy PERMA mode intervention can effectively improve resilience, reduce stigma and improve quality of life in colostomy patients with colorectal cancer.

Breast cancer is the leading cause of cancer-related mortality among women worldwide and has drawn extensive research attention.Owing to its molecular heterogeneity,drug resistance,and low therapeutic response,single-modality treatments often fail to achieve satisfactory efficacy or broad applicability.Combination therapy,designed based on the pathophysiological characteristics,related signaling pathways,and biomarkers of breast cancer,has emerged as a promising approach for improving therapeutic outcomes.With the advancement of research on combination strategies,the understanding of their molecular mechanisms—particularly key signaling pathways and biomarkers—has become increasingly important.However,comprehensive reviews addressing these molecular mechanisms and synergistic strategies remain scarce.This article summarizes recent advances in combination therapy for breast cancer,providing a comprehensive review of recent combination therapies for breast cancer and their underlying molecular mechanisms,and focusing on key signaling pathways involved in combination therapy and synergistic strategies,thereby providing theoretical insights and reference for researchers,graduate students,and clinicians engaged in the development of novel combination therapeutic strategies for breast cancer and related malignancies.

Objective:To explore the effects of happy PERMA intervention on resilience, stigma and quality of life in colostomy patients with colorectal cancer.Methods:According to convenience sampling method, 120 patients with colorectal cancer who underwent permanent colostomy in the hospital were enrolled from September 2021 to August 2023. According to admission order, they were divided into control group (60 cases, September 2021-August 2022) and study group (60 cases, September 2022-August 2023). The control group was given routine nursing, while the study group was additionally given happy PERMA mode nursing intervention for 8 weeks. The scores of Connor-Davidson resilience scale (CD-RISC), social impact scale (SIS), ostomy adjustment inventory-20 (OAI-20), quality of life questionnaire core 30(QLQ-C30), general well-being schedule(GWB) and self-care ability before and after 8 weeks of intervention were compared between the two groups using SPSS 22.0 software.Results:After the intervention, the scores of resilience (45.28±2.59), strength (26.34±2.47), optimism (11.05±0.78), and the total CD-RISC score (80.95±3.47) in the study group were significantly higher than those in the control group (37.46±2.08, 18.55±1.96, 8.96±0.63, 65.11±2.32) ( t=18.235, 19.137, 16.146, 29.394, all P<0.05). The scores of internalized stigma (13.09±1.97), economic discrimination (6.85±0.78), social isolation (14.15±1.98), social exclusion (16.93±2.54), and the total SIS score (50.17±2.35) in the study group were significantly lower than those in the control group (13.97±2.44, 7.36±0.95, 16.94±2.37, 19.55±3.42, 58.69±2.83)( t=2.174, 3.214, 6.998, 4.764, 13.756, all P<0.05). The score of persistent worry (11.95±2.16) in the study group was significantly lower than that in the control group (16.57±1.92) ( t=12.383, P<0.05), while the score of acceptance (15.28±1.16), positive life attitude (17.38±2.31), and the total OAI-20 score (58.64±2.08) in the study group were significantly higher than those in the control group (12.19±0.97, 14.55±1.94, 46.30±1.57) ( t=15.829, 7.267, 36.679, all P<0.05). The scores of role function (86.27±3.15), emotional function (81.25±4.33), social function (79.63±3.16), cognitive function (83.55±3.97), general health (83.15±3.16), and the total QLQ-C30 score (407.13±15.92) in the study group were significantly higher than those in the control group (77.62±4.38, 73.85±4.96, 71.80±3.98, 79.42±4.31, 75.34±3.62, 372.65±11.58)( t=12.419, 8.706, 11.935, 5.459, 12.590, 13.567, all P<0.05). The GWB score (86.95±3.57) and self-care ability score (91.13±3.45) in the study group were significantly higher than those in the control group (73.82±4.06, 87.55±4.68)( t=18.812, 4.769, both P<0.05). Conclusion:Happy PERMA mode intervention can effectively improve resilience, reduce stigma and improve quality of life in colostomy patients with colorectal cancer.

Objective:To investigate the changes in the expression of miR-146a-5p and steroidogenic acute regulatory protein (StAR) in the blood vessels of rats with hypertension complicated with sepsis, and to preliminarily evaluate the underlying mechanisms of vascular lesions in hypertension complicated with sepsis.Methods:Twenty-four clean-grade healthy male Wistar rats, aged 12 weeks, weighing 250-270 g, were divided into 4 groups ( n=6 each) using the random number table method: sham operation group, sepsis group, hypertension group, and hypertension complicated with sepsis group. In sham operation group, laparotomy was performed, and sterile normal saline was subcutaneously infused using a micro-osmotic pump for 4 weeks. The sepsis model was established by cecal ligation and perforation after anesthesia in sepsis group. The hypertension model was established by subcutaneously infusing angiotensin Ⅱ at a rate of 500 ng·kg -1·min -1 for 4 weeks using a micro-osmotic pump in hypertension group. In hypertension complicated with sepsis group, angiotensin Ⅱ was subcutaneously infused, and 4 weeks later the sepsis model was established by cecal ligation and perforation. Blood pressure was measured at the end of establishing the model in each group, and blood samples of the abdominal aorta and specimens of aorta were obtained under deep anesthesia, and the serum tumor necrosis factor-alpha (TNF-α) concentration was determined by enzyme-linked immunosorbent assay. The systolic and diastolic functions of the aorta were detected using the aortic vascular ring assay. The collagen volume fraction (CVF) was calculated after Masson staining. The expression of α-smooth muscle actin (α-SMA) and StAR was detected using the immunohistochemical staining assay, and the thickness of the aortic wall was measured. The expression of StAR mRNA and miR-146a-5p was detected using quantitative real-time polymerase chain reaction. Results:Compared with sham operation group, the aortic contraction rate was significantly decreased, the expression of StAR protein and mRNA was up-regulated, the expression of miR-146a-5p was down-regulated, and the serum TNF-α concentration was increased in the other three groups, and the systolic blood pressure and CVF were significantly increased, the thickness of the aortic wall was increased, the expression of α-SMA was up-regulated, and the thickness of the aortic wall was increased in hypertension and hypertension complicated with sepsis groups ( P<0.05). Compared with sepsis group, the systolic pressure was significantly increased, the aortic contraction rate was decreased, CVF was increased, the expression of α-SMA was up-regulated, the thickness of the aortic wall was increased, the expression of StAR protein and mRNA was up-regulated, the expression of miR-146a-5p was down-regulated, and the serum TNF-α concentration was increased in hypertension complicated with sepsis group ( P<0.05). Compared with hypertension group, the aortic contraction rate was significantly decreased, the diastolic rate was increased, the expression of StAR protein and mRNA was up-regulated, the expression of miR-146a-5p was down-regulated, and the serum TNF-α concentration was increased in hypertension complicated with sepsis group ( P<0.05). Conclusions:Down-regulation of miR-146a-5p and up-regulation of StAR in the blood vessels of rats with hypertension complicated with sepsis may be associated with the vascular lesions caused by hypertension complicated with sepsis.