BackgroundAddictive non-suicidal self-injury （NSSI） behaviors among adolescents have become increasingly prominent， although previous studies have identified multiple related risk factors and have examined the association between screen time and NSSI behaviors， the impact of screen time on NSSI behaviors addiction， as well as the mediating role of family dysfunction in this relationship， remain to be further clarified. ObjectiveTo investigate the mediating role of family dysfunction in the relationship between screen time and NSSI behaviors addiction among adolescent female patients with depression disorder， with the aim of providing references for reducing NSSI behaviors addiction. MethodsFrom September 2024 to November 2025， a total of 652 adolescent female patients with depression disorder were enrolled from both outpatient and inpatient departments of Xiamen Xian-yue Hospital， all of whom met the diagnostic criteria for depressive episode （F32） or recurrent depressive disorder （F33） according to the International Classification of Diseases， tenth edition （ICD-10）. Assessments included a self-developed demographic questionnaire， screen use questionnaire， Chinese Family Assessment Instrument （C-FAI）， and Ottawa Self-injury Inventory Chinese Revised version （OSIC）. Among participants with NSSI behaviors， Spearman correlation analysis was used to examine the correlation between screen time and scale scores. Model 4 of the Process 4.1 for SPSS 26.0 was then applied to test the mediating role， and Bootstrapping procedure involving 5 000 replicates was employed to confirm the statistical significance. ResultsAmong the 652 patients， 569 （87.27%） exhibited NSSI behaviors. Among them， 398 cases （69.95%） belonged to the addictive NSSI group， and 171 cases （30.05%） belonged to the non-addictive NSSI group. The OSIC addiction dimension score was positively correlated with screen time and C-FAI scores （r_s=0.114， 0.224， P<0.01）. Family dysfunction mediated the relationship between screen time and NSSI addiction， with an indirect effect value of 0.036 （95% CI： 0.016–0.062）， accounting for 35.88% of the total effect. ConclusionScreen time may affect the NSSI behaviors addiction in adolescent female patients with depression disorder through family dysfunction. ［Funded by Joint Funds for the Innovation of Science and Technology， Fujian Province （number， 2025Y9762）］

ObjectiveTo construct an actor-network for integrating physical activity into rehabilitation services based on the World Health Organization Rehabilitation in Health Service System framework and actor-network theory (ANT). MethodsContent analysis was employed using the six building blocks of health service systems as the theoretical framework. Actors related to rehabilitation services were extracted and categorized into a rehabilitation actor pool, while a physical activity actor pool was formed based on four major physical activity scenarios. Actors from both pools were integrated, deduplicated and classified to form a final list of integrated actors. Using ANT, the construction process of the actor network integrating physical activity into rehabilitation was analyzed through the four stages of translation: problematization, interessment, enrollment and mobilization. ResultsA dynamic integration network was constructed, comprising human actors (patients, rehabilitation professionals, researchers, sports coaches, government departments, medical institutions, community organizations and industry media, etc.) and non-human actors (assistive devices, sports infrastructure, smart equipment, information systems, online exercise guidance systems, laws and regulations, strategic documents, and exercise prescriptions, etc.). The study identified maximizing rehabilitation outcomes as the mandatory passage point and elaborated on the critical role of government departments as focal actors in coordinating various stakeholders. ConclusionThe integration of physical activity into rehabilitation services is a dynamic network constructed by diverse actors through a process of translation. ANT provides an operational theoretical framework for cross-departmental governance of rehabilitation policies in China, promotes the spatial expansion of the rehabilitation field, and drives its transformation toward a networked and ecological system. The government needs to play a leading role in facilitating role reconstruction and synergy among heterogeneous actors in both the sports and rehabilitation sectors through mechanism design, to create a bidirectional empowerment mechanism that fosters mutual progress and ensures the sustainable development of integrated services.

The biological nitrogen removal technology utilizing heterotrophic nitrification-aerobic denitrification (HN-AD) bacteria has shown effectiveness in wastewater treatment. However, the nitrogen removal efficiency of HN-AD bacteria significantly decreases as the salinity increases. To tackle the challenge of treating high-salt and high-nitrogen wastewater, we isolated a moderately halophilic HN-AD strain 5505 from a salt lake in Xinjiang. The strain was identified based on morphological, physiological, and biochemical characteristics and the 16S rRNA gene sequence. Single-factor experiments were carried out with NH₄⁺-N, NO₃^--N, and NO₂^--N as sole or mixed nitrogen sources to study the nitrifying effect, denitrifying effect, and nitrogen metabolism pathway of the strain. The strain was identified as Halomonas sp.. It can grow in the presence of 1%-25% (W/V) NaCl and exhibited efficient nitrogen removal ability in the presence of 3%-8% NaCl. At the optimal NaCl concentration (8%), the strain showed the NH₄⁺-N, NO₃^--N and NO₂^--N removal rates of 100.0%, 94.11% and 74.43%, respectively. Strain 5505 removed inorganic nitrogen mainly by assimilation, which accounted for over 62.68% of total nitrogen removal. In the presence of mixed nitrogen sources, strain 5505 showed a preference for utilizing ammonia, with a potential HN-AD pathway of NH₄⁺→NH₂OH→NO₂^-→NO₃^-→NO₂^-→NO/N₂O/N₂. The findings provide efficient salt-tolerant bacterial resources, enhance our understanding of biological nitrogen removal, and contribute to the nitrogen removal efficiency improvement in the treatment of high-salt and high-nitrogen wastewater.
Halomonas/classification* ; Nitrogen/isolation & purification* ; Denitrification ; Nitrification ; Wastewater/microbiology* ; Aerobiosis ; Biodegradation, Environmental ; Salinity

As an inevitable trend of social development, aging has generated a wide and far-reaching impact on every aspect of society, especially posing severe challenges for the heath system of all countries and regions around the world. Facing the objective reality of humans co-existing with diseases in a long term and people’s ever-growing demand for healthcare, the successful development of vaccine products can provide people with effective preventive measures to combat infectious diseases. This article summarizes the development and use of 4 vaccines that are suitable for the elder population, i.e., influenza vaccine, pneumococcal vaccine, varicella-zoster virus vaccine and respiratory syncytial virus vaccine, aiming to provide some reference for the development and popularization of these vaccines and to improve the well-being of the senior citizens.

Objective To investigate the needs of the main caregivers of patients with spinal cord injury following neurogenic bowel dysfunction to participate in the whole process of intestinal management.Methods Nine main caregivers of patients with spinal cord injury in Jiangsu Province Hospital from January to Decem-ber,2024 were selected with objective sampling method.They were investigated face-to-face semi-structured in-depth interviews,and the data were analyzed,summarized and extracted by Colaizzi 7-step analysis method.Results Three themes and eight sub-themes were extracted:the needs of professional knowledge and skills standards in intestinal management(lack of intestinal training knowledge,lack of ability to acquire knowledge and different standards of medical institutions);the needs of physical ability and decision making ability participating in intesti-nal training(lack of participation,single decision-making behavior,excessive dependence on medical personnel);the desire for therapeutic benefits and the needs for building psychological confidence(concerns about the pa-tient's prognosis,overdependence on medication).Conclusion Clinical medical staff should pay attention to the actual needs and difficulties faced by the main caregivers of patients with neurogenic bowel dysfunction to participate in the entire intestinal management,and construct targeted training programs,strengthen the skills and knowledge training,to enhance their autonomy and responsi-bility,to achieve the rehabilitation goal better.

This study aims to investigate the effects of aflatoxin B1(AFB1)on the infection and replication of porcine delta coronavirus(PDCoV).Porcine small intestinal epithelial cells(IPEC-J2),porcine kidney cells(LLC-PK)and swine testis cells(ST)were used as models,and CCK-8 method was used to detect the safe mass concentration range of AFB1 on the three cell lines.Each cell line was divided into the blank control group,AFB1 treatment group,PDCoV treatment group and AFB1 and the PDCoV co-treatment group.The cells were treated with safe mass concentration of AFB1 for 12 h,and then treated with PDCoV for 20 h.Total RNA and total protein were extrac-ted from the cells.The effects of AFB1 on PDCoV infection and replication were detected by qPCR,Western blot and cell immunofluorescence tests.The results showed that compared with the PDCoV treatment group,the mRNA and N protein of viral S protein in the AFB1 and PDCoV co-treatment group were significantly increased(P＜0.05),and a significantly higher fluorescence of PDCoV N protein is also visibly present in the co-treatment group,and there was a significant difference between the two groups.The results showed that AFB1 could promote the infection and replication of PDCoV.It provides important data that AFB1 can promote the infection replication of PDCoV and provides a new idea for the prevention and treatment of PDCoV.

Objective:To investigate the clinical efficacy of intraoperative regional lymph-adenectomy and extended lymphadenectomy in resectable hilar cholangiocarcinoma.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 187 patients of hilar cholangiocarcinoma who were admitted to Henan University People′s Hospital from January 2014 to January 2018 were collected. There were 105 males and 82 females, aged (57±9)years. Of the 187 patients, 62 patients undergoing hilar cholangiocarcinoma resection with extended lymphadenectomy were divided into the extended group, and 125 patients under-going hilar cholangiocarcinoma resection with regional lymphadenectomy were divided into the regional group. Observation indicators:(1) propensity score matching status and comparison of clinical data of patients between the two groups after matching; (2) intraoperative and postoperative conditions; (3) follow-up. Comparison of measurement data with normal distribu-tion between groups was conducted using the independent sample t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test. Comparison of count data between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the rank sum test. The Kaplan-Meier method was used to plot calculate survival rate and survival curve. The Log-rank test was used for survival analysis. Propen-sity score matching was performed using the 1∶1 nearest neighbor matching method, with the caliper value of 0.1. Results:(1) Propen-sity score matching status and comparison of clinical data of patients between the two groups after matching. Of the 187 patients, 104 patients were success-fully matched, with 52 cases in each of the extended group and the regional group. After propensity score matching, the elimination of tumor diameter, neural invasion, Bismuth classification, and TNM staging confounding bias ensured comparability. (2) Intraoperative and postoperative conditions. After pro-pensity score matching, the operation time of the extended group was (341±83)minutes, the number of lymph node dissected was 12.3±4.5, the number of positive lymph node dissected was 2.2±0.7, cases of postoperative new lymphadenectasis was 17. The above indicators of the regional group were (311±73)minutes, 9.2±3.4, 1.5±0.5, 44, respectively. There were significant differences in the above indica-tors between patients of the two groups ( t=-1.99, -3.92, -5.57, χ2=31.18, P<0.05). (3) Follow-up. After propensity score matching, all 104 patients were followed up after surgery, with the follow-up time of 29(range, 3-49)months. The postoperative 3-year overall survival rate was 44.2% of the extended group, versus 30.8% of the regional group, showing a significant difference between the two groups ( χ2=4.41, P<0.05). Conclusions:The perioperative safety of regional lymphadenec-tomy and extended lymphadenectomy in the radical resection of hilar cholangiocarcinoma are com-parable. Extended lymphadenectomy can increase the number of positive lymph node detected and improve the postoperative survival rate of patients.

Objective To explore the mediating effect of adversity quotient(AQ)in the relationship between organizational support and professional identity among nurses undergoing standard nursing training and to provide theoretical guidance for enhancing professional identity.Methods A total of 1,031 nurses receiving standardized training from 12 tertiary general hospitals in Jiangsu Province,were recruited using a convenience sampling.Data were collected using the self-rating scale for nurses'adversity,nurses'organizational support perception scale,and nurse professional identity assessment scale.Pearson correlation analysis was performed to examine associations among organizational support,AQ,and professional identity.Structural equation modeling(SEM)was used to test the mediating role of AQ.Results A total of 930 nurses undergoing standardized training completed the survey.The total scores for AQ,organizational support,and professional identity were 132.44±29.78,45.51±9.60,and 100.88±19.52,respectively.Organizational support was positively correlated with professional identity(r=0.753,P<0.01),but negatively with AQ(r=-0.720,P<0.01).AQ was also negatively associated with professional identity(r=-0.772,P<0.01).SEM analysis revealed that AQ partially mediated the relationship between organizational support and professional identity,accounting for 49.20%of the total effect(effect size=0.392).Conclusion Nurses undergoing standardized nursing training exhibit moderate professional identity.AQ serves as a key mediator between organizational support and professional identity.It indicates that improving organizational support and adversity quotient can strengthen their professional identity.

Objective To investigate the relationship between the ratio of C-reactive protein(CRP)/preal-bumin(PAB)and severity of illness and onset in patients with primary knee osteoarthritis(KOA).Methods A total of 102 patients with primary KOA admitted to a hospital from October 2018 to October 2023 were selected as the study group,and 100 healthy people in a hospital during the same period were select-ed as the control group.According to the Kelgren-Lawrence(K-L)grading criteria,102 patients with primary KOA were divided into K-L grade Ⅰ group(n=21),K-L grade Ⅱ group(n=27),K-L grade Ⅲ group(n=34),and K-L grade Ⅳ group(n=20).The levels of CRP and PAB were measured by automatic biochemical analyzer,and the ratio of CRP/PAB was calculated.The predictive value of CRP,PAB and CRP/PAB ratio to the incidence of primary KOA was analyzed by receiver operating characteristic curve,and the influencing fac-tors of the incidence of primary KOA patients were analyzed by multivariate Logistic regression.Results There were significant differences in CRP,PAB and CRP/PAB ratio among primary KOA patients with different K-L grades(P＜0.05).The total score of Western Ontario and McMaster Universities Osteoar-thritis Index(WOMAC)for primary KOA patients from K-L group Ⅰ to K-L group Ⅳ were(40.91±5.18),(46.08±9.21),(51.24±7.46),(65.83±12.93)points,respectively.The difference was statistically signifi-cant(P＜0.05).In patients with primary KOA,CRP and CRP/PAB ratio were positively correlated with K-L grade and WOMAC total score,while PAB was negatively correlated with K-L grade and WOMAC total score(P＜0.05).CRP and CRP/PAB ratio in study group were higher than those in control group,and PAB level was lower than those in control group,the differences were statistically significant(P＜0.05).The area under the curve(AUC)and 95％CI of CRP and PAB levels were 0.781(0.736-0.831)and 0.853(0.781-0.876),respectively,and the AUC of CRP/PAB ratio was 0.937(0.892-0.987).Conclusion CRP and CRP/PAB ratio are highly expressed in patients with primary KOA,and PAB is low expressed in patients with pri-mary KOA,which is related to the severity of illness and onset in patients,and can be used as a potential marker to predict the severity of illness and onset in patients with primary KOA.

Objective:To investigate the diagnostic potential of serum Dickkopf-related protein 3(Dkk3)as a novel biomarker for sarcopenia in an elderly Chinese population by examining its correlation with muscle mass, muscle strength, and physical function.Methods:The study included elderly individuals aged ≥60 years from the Health Examination Center of Jiangsu Provincial Hospital between 2021 and 2022, who had independent mobility and were free from acute diseases.Fat and muscle mass were measured using Dual-energy X-ray Absorptiometry(DXA). Grip strength and chair stand test times were employed to assess upper and lower limb muscle strength, respectively.Physical function was evaluated using the Short Physical Performance Battery(SPPB). Serum Dkk3 concentration was measured using a human Dkk3 enzyme-linked immunosorbent assay(ELISA)kit.Results:A total of 108 elderly participants(83 males)were included in the study, with an age range of 60 to 97 years(mean age: 70.6±10.8). Serum Dkk3 concentration was found to be negatively correlated with the skeletal muscle mass index(SMI)( R=-0.292, P=0.002), lower limb muscle mass( R=-0.320, P<0.001), upper limb muscle mass( R=-0.222, P=0.020), and hip muscle mass( R=-0.261, P=0.006). Functional assessments revealed negative correlations with grip strength( R=-0.204, P=0.035), 4-meter walking speed( R=-0.195, P=0.043), the three-position balance test( R=-0.245, P=0.011), and the SPPB score( R=-0.196, P=0.043). Regression analysis indicated that, after adjusting for age, sex, body mass index(BMI), and comorbidities, Dkk3 remained negatively associated with lower limb muscle mass( β=-0.197, P=0.012), hip muscle mass( β=-0.156, P=0.029), and the SPPB score( β=-0.001, P=0.013). The sarcopenia group exhibited a 55.6% higher serum Dkk3 level compared to the control group(76.68±37.62 ng/ml vs.49.27±25.88 ng/ml, P<0.001). Receiver Operating Characteristic(ROC)curve analysis determined the optimal diagnostic threshold to be 80.08 ng/ml, with an area under the curve of 0.726, a sensitivity of 41.98%, and a specificity of 96.30% for detecting sarcopenia. Conclusions:Serum Dkk3 is closely associated with reduced muscle mass in the lower limbs and hips, as well as a decline in physical function, in elderly individuals with sarcopenia.Given its cost-effectiveness and clinical utility, serum Dkk3 shows potential as a meaningful biomarker for diagnosing sarcopenia in the elderly.