BackgroundCurrently， the incidence of depression among teenagers is on the rise， and the related academic problems are becoming increasingly serious. Short video addiction has a negative impact on teenagers' emotional issues and academic achievements. However， few studies have explored the relationship between this addiction and the learning burnout of teenagers with depression， and even fewer have focused on the role paths of impulsivity and coping disposition in this process. ObjectiveTo explore the relationship between short video addiction and learning burnout in adolescent patients with depression， as well as the pathway of impulsivity and coping disposition， so as to provide references for the intervention of learning burnout in adolescent patients with depression. MethodsA total of 191 adolescent patients who were hospitalized at The Affiliated Brain Hospital of Guangzhou Medical University from December 2024 to April 2025 and met the diagnostic criteria for depression according to the International Classification of Diseases， tenth edition （ICD-10） were selected consecutively. The Short Video Addiction Measurement Scale （SVAMS）， the Brief Barratt Impulsiveness Scale （BBIS）， the Simplified Coping Style Questionnaire （SCSQ）， and the Adolescent Student Burnout Inventory （ASBI） were used for assessment. Pearson correlation analysis was employed to examine the correlations of the scores of each scale. Model 6 of the SPSS macro Process 4.2 was employed to analyze the chained mediation pathway of impulsivity and coping disposition between short video addiction and learning burnout. ResultsA total of 173 cases （90.58%） of adolescent patients with depression completed the valid questionnaire survey. Correlation analysis showed that SCSQ coping disposition score was negatively correlated with the SVAMS score， the BBIS score， and the ASBI score （r=-0.282， -0.341， -0.431， P<0.01）， the SVAMS score was positively correlated with the BBIS score and the ASBI score （r=0.339， 0.262， P<0.01）， and the BBIS score was positively correlated with the ASBI score （r=0.486， P<0.01）. The pathway analysis showed that the direct effect of short video addiction on learning burnout was not statistically significant， but the total effect and the indirect effect were statistically significant. The effect values were 0.275 （95% CI： 0.207–0.343） and 0.193 （95% CI： 0.143–0.246）， respectively， with the indirect effect accounting for 70.18%. Impulsivity and coping disposition both played independent mediating roles between short video addiction and learning burnout， with effect values of 0.122 （95% CI： 0.090–0.156） and 0.054 （95% CI： 0.032–0.079）， accounting for 44.36% and 19.64% of the total effect， respectively. The chained mediation effect of impulsivity and coping disposition was significant， with an effect value of 0.017 （95% CI： 0.011–0.026）， accounting for 6.18% of the total effect. ConclusionAlthough short video addiction does not directly affect learning burnout in adolescent patients with depression， it may indirectly influence learning burnout through independent and chain paths of impulsivity and coping disposition. ［Funded by Guangzhou Key Clinical Specialty （Clinical Medical Research Institute）］

Objective : To analyze the epidemiological characteristics of tuberculosis in Urumqi and assess the im⁃pact of the national health examination policy , as well as COVID⁃19 prevention and control measures , on tuberculo⁃sis incidence in Xinjiang. Methods: The seasonal patterns of pulmonary tuberculosis were examined using the seasonal index method and circular distribution analysis. An Interrupted Time Series (ITS , Interrupted Time Series) model was employed to investigate how the national health examination policy and COVID_19 interventions influenced trends in tuberculosis incidence in Urumqi. Results: From 2013 to 2021 , a total of 19 ,049 cases of tuberculosis were reported in Urumqi. The peak incidence day occurred on May 25th , indicating a consistently high rate throughout the year, particularly during spring and summer months. The results of the interrupted time series model indicated that the initial monthly incidence rate of pulmonary tuberculosis in Urumqi was 5. 05 per 100 ,000. From January 2013 to September 2016 , the incidence rate of pulmonary tuberculosis showed a slow upward trend , and the upward trend was significant (β1 = 0. 039 ,P < 0. 05) . After the implementation of the universal health checkup policy , the incidence rate of pulmonary tuberculosis showed a slow downward trend , and the downward trend was significant(β3 = - 0. 109 ,P < 0. 05) . After the outbreak of the COVID_19 epidemic in January 2020 , the incidence rate of pulmonary tuberculosis in Urumqi first dropped rapidly and then entered a slow upward stage , and the upward trend was significant(β5 = 0. 082 , P < 0. 05) . Conclusion It is recommended that public health authorities prioritize timely identification of potential TB patients during periods with elevated incidence rates observed in spring and summer months. While significant progress has been made through implementing national health examinations policies , attention must be directed towards understanding how ongoing epidemics affect TB patient detection. Thus , enhancing surveillance efforts and intervention strategies are essential in adapting to this new normal. Key words tuberculosis ; seasonal index method ; circular distribution method ; national health examination ; COVID_19 ; interruption time series

As an independent first-level discipline,an appropriate classification of nursing science is significant.In China,each nursing degree-granting institution has developed its own secondary-level discipline directions based on its research characteristics and strengths,with varying names and research scopes.Furthermore,there is no unified global classification system.This paper,based on the characteristics of nursing as a discipline and combined with China's discipline classification principles,used literature analysis,comprehensive classification,philosophical reflection,logical reasoning,and expert consultation methods to explore the connotation of nursing,its unique research objects and scope,and to construct a secondary-level discipline classification system for nursing science that is suitable for China's national conditions.The paper also discussed the challenges faced by the nursing discipline and its future development directions,providing theoretical and practical guidance for the development of the nursing discipline.

Objective Based on a clinical cohort study of repeated ketamine infusions for treatment-resistant depression(TRD),this study aimed to examine differences in brain-derived neurotrophic factor(BDNF)methylation among patients with varying therapeutic responses and explore its potential role in predicting treatment efficacy.Methods A retrospective analysis was conducted on peripheral plasma BDNF levels in 83 patients with TRD before and after a 2-week course of ketamine treatment(6 injections total).The Montgomery-Asberg depression rating scale(MADRS)was used to assess treatment efficacy.BDNF methylation levels were compared between responder group and non-responder group.The effect of methylation of the target CpG site on transcriptional activity was verified by using the dual luciferase reporter gene system.Results In patients with TRD who completed six repeated ketamine infusions,the responder group showed significant improvements compared to baseline levels in both MADRS scores(25.20±7.54 vs.8.10±5.32,P<0.01)and plasma BDNF concentrations[8.74(5.26,13.46)ng/mL vs.16.59(7.41,24.46)ng/mL,P<0.01].At baseline,35 CpG sites within the BDNF gene displayed significant methylation differences between response groups(P<0.05).Two CpG sites(rs1240718851 and cg06260077)located in the BDNF promoter region demonstrated a hypermethylation-low expression correlation,and dual-luciferase reporter assays confirmed that one of these sites functionally modulates BDNF expression.Conclusions The plasma BDNF concentration in TRD patients increases with the remission of depressive symptoms.The regulation of BDNF gene expression by methylation can predict the antidepressant efficacy of repeated intravenous ketamine.

Objective To stratify the estrogen receptor(ER)positive while human epidermal growth factor receptor 2(HER2)negative breast cancer patients by the expression level of ER,providing new evidence for prognostic prediction and guiding precision endocrine therapy(ET)for those with different ER expression levels.Methods A retrospective cohort study was conducted on 1 962 ER-positive/HER2-negative breast cancer patients treated in our department from January 1,2013 to December 31,2018.X-tile was used to calculate the optimal cutoff point of ER expression level,and then based on the results,they were divided into low(1%～10%),moderate(11%～30%),and high expression(31%～100%)groups.After propensity score matching(PSM)was performed to balance baseline characteristics,their prognostic outcomes were compared and the responses to ET were analyzed in the groups.Cox proportional risk regression model was applied to analyze the prognostic factors,and subgroup analysis was further performed.Results After PAM,129(11.5%)were assigned into a low ER expression group,151(13.5%)and 840(75%)into moderate and high ER expression groups,respectively.Statistical differences were observed in disease-free survival(DFS)and overall survival(OS)among the 3 groups(P=8e-6,P=8e-14).In the low ER expression group,the patients treated with selective estrogen receptor modulators(SERMs)showed no significant differences in DFS and OS than those treated with aromatase inhibitors(AIs)(P>0.05).However,the patients from the moderate and high ER expression groups demonstrated significantly better DFS when treated with AI than with SERM(P=0.02,P=0.03).Multivariate analysis showed that compared with the moderate ER expression group,the high ER expression group exhibited significantly lower risk of disease recurrence/metastasis(HR=0.62,95%CI:0.43～0.88,P=0.009)and risk of death(HR=0.49,95%CI:0.26～0.93,P=0.03).Subgroup analysis revealed that when compared with the high ER expression group,the moderate ER expression group exhibited notably worse DFS in the following subgroups:oral SERM,non-breast-conserving surgery,lymph node metastasis,TNM stage Ⅱ,and chemotherapy,and shorter OS in the subgroups of oral SERM,non-breast-conserving surgery,lymph node metastasis,TNM stage Ⅱ subgroup,and chemotherapy.Conclusion Taking ER expression of 11%～30%as an independent stratification criterion can guide more accurate prognostic assessment and more rational ET selection in ER-positive/HER2-negative breast cancer patients.

OBJECTIVE To observe the current status and influencing factors for the water contamination of humid-ification tanks of ventilators of the patients undergoing invasive mechanical ventilation.METHODS Totally 139 hu-midified water samples were collected from the patients who received invasive mechanical ventilation in The First Medical Center of Chinese PLA General Hospital from Jul.2024 to Nov.2024.The humidified water samples were collected,cultured and identified on Day 1,3,5 and 7 after humidification tanks replacement.RESULTS Among the 139 samples,25 were tested positive for pathogens,with the positive test rate 17.99％;the positive test rate was highest(33.33％,8/24)in respiratory intensive care unit.The positive test rate was 12.90％on Day 1,18.42％on Day 3,15.00％on Day 5 and 26.67％on Day 7,showing an upward trend.The result of bacterial culture showed that the percentage of isolated Burkholderia cepacia was highest(36.00％).The result of analysis of the related factors for positive test of humidified water samples showed that the sample adding pattern was as-sociated with the isolation rate(P＜0.05).Only 1 case was diagnosed with ventilator-associated pneumonia(VAP)after the humidified water was detected with pathogens and varied in the pathogens.CONCLUSIONS There is an association between the status of water contamination of the ventilator humidification tanks and usage duration of humidification tank.It is necessary to attach great importance to the contamination of humidification tanks,carry out standard management,and implement the prevention and control measures in an all-round way.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective:To identify the relevant factors for the first-course remission of acute myeloid leukemia (AML) and to develop a predictive model as well as assess its predictive capability.Methods:Clinical data of 749 patients newly diagnosed with AML admitted to the Department of Hematology, the First Affiliated Hospital, Zhejiang University, School of Medicine from January 1, 2019, to April 30, 2023, were collected and randomly divided into training and validation sets. Multivariate logistic regression analysis was conducted to determine variables associated with complete remission in the first course of induction therapy, and a predictive model was established based on these variables. The receiver operating characteristic (ROC) curve of the predictive model was plotted, and the area under the curve (AUC) was calculated.Results:The indicators predicting the first remission course included peripheral blood white blood cell count during onset, CBF::MYH11 fusion gene, CEBPA bZIP region mutation, myelodysplastic syndrome-related gene mutation, and induction chemotherapy regimen selection as independent factors for the first remission course. The model’s area under the training and validation curves was 0.738 (95% CI: 0.696-0.780) and 0.726 (95% CI: 0.650-0.801), respectively. The Hosmer-Lemeshow test results yielded P-values of 0.993 and 0.335, respectively. Conclusion:In this study, the developed model demonstrates a strong predictive capability for the efficacy of the first course of patients with AML, providing valuable guidance to clinicians in assessing patient prognosis and selecting appropriate treatment strategies.

Matrix Gla protein (MGP) is a vitamin K-dependent protein secreted by chondrocytes and vascular smooth muscle cells. It is mainly distributed in cartilage, bone marrow, and arterial walls, and participates in osteogenic differentiation and vascular calcification processes in vascular smooth muscle. Previous studies have suggested that MGP only has inhibitory effects on physiological and ectopic calcification. A new study has found that MGP is highly expressed in various tumor tissues, but the relationship between its expression level and the malignant biological behavior of tumors is not completely consistent in different tumors. The differential expression of MGP may be a result of tumor heterogeneity. This article reviews the research progress of MGP in multi-system malignant tumors, in order to provide new ideas for the diagnosis and treatment of clinical malignant tumors.

Objective: The CT/MRI Liver Imaging Reporting and Data System (LI-RADS) demonstrates high specificity with relatively limited sensitivity for diagnosing hepatocellular carcinoma (HCC) in high-risk patients. This study aimed to explore the possibility of improving sensitivity by combining CT/MRI LI-RADS v2018 with second-line contrast-enhanced ultrasound (CEUS) LI-RADS v2017 using sulfur hexafluoride (SHF) or perfluorobutane (PFB). Materials and Methods: This retrospective analysis of prospectively collected multicenter data included high-risk patients with treatment-naive hepatic observations. The reference standard was pathological confirmation or a composite reference standard (only for benign lesions). Each participant underwent concurrent CT/MRI, SHF-enhanced US, and PFB-enhanced US examinations. The diagnostic performances for HCC of CT/MRI LI-RADS alone and three combination strategies (combining CT/ MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or a modified algorithm incorporating the Kupffer-phase findings for PFB [modified PFB]) were evaluated. For the three combination strategies, apart from the CT/MRI LR-5 criteria, HCC was diagnosed if CT/MRI LR-3 or LR-4 observations met the LR-5 criteria using LI-RADS SHF, LI-RADS PFB, or modified PFB. Results: In total, 281 participants (237 males; mean age, 55 ± 11 years) with 306 observations (227 HCCs, 40 non-HCC malignancies, and 39 benign lesions) were included. Using LI-RADS SHF, LI-RADS PFB, and modified PFB, 20, 23, and 31 CT/MRI LR-3/4 observations, respectively, were reclassified as LR-5, and all were pathologically confirmed as HCCs. Compared to CT/MRI LI-RADS alone (74%, 95% confidence interval [CI]: 68%–79%), the three combination strategies combining CT/MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or modified PFB increased sensitivity (83% [95% CI: 77%–87%], 84% [95% CI: 79%–89%], 88% [95% CI: 83%–92%], respectively; all P < 0.001), while maintaining the specificity at 92% (95% CI: 84%–97%). Conclusion The combination of CT/MRI LI-RADS with second-line CEUS using SHF or PFB improved the sensitivity of HCC diagnosis without compromising specificity.