Objective: To explore the interrelationships between mental vulnerability, cognitive emotion regulation strategies, and positive psychological capital in medical postgraduates, so as to provide precise intervention targets for mental health services in universities. Methods: From April to June 2025, a convenience sampling method was used to select 1 461 medical postgraduates from three colleges in Hubei Province. Participants were assessed using the Mental Vulnerability Questionnaire (MVQ), the Cognitive Emotion Regulation Questionnaire-Chinese Version (CERQ-C) and the Positive Psychological Capital Questionnaire (PPQ). The network analysis model was constructed using a Gaussian graphical model. Results: The network analysis revealed that the edge connection between somatic symptoms and mental symptoms was the strongest, followed by the connection between refocus on planning and positive reappraisal within cognitive emotion regulation, with edge weights of 0.69 and 0.59, respectively. Interpersonal problems within psychological vulnerability exhibited the highest expected influence( EI =1.27), serving as the core node of the network. Rumination within cognitive emotion regulation demonstrated the highest bridge expected influence( BEI =0.33), playing a critical connecting role among psychological vulnerability, cognitive emotion regulation, and positive psychological capital. Conclusion In the mental health network of medical postgraduates, mental vulnerability, cognitive emotion regulation, and positive psychological capital interact through their respective key dimensions, jointly affect overall mental health.

目的 探究急性脑梗死（ACI）患者血清碱性螺旋-环-螺旋转录因子40（BHLHE40）、丝氨酸蛋白酶抑制剂家族E成员1（SERPINE1）、胆绿素还原酶B（BLVRB）水平与其颈动脉粥样硬化（CAS）程度、近期预后的关系。方法 选择2023年4月—2024年8月邯郸市第一医院（以下简称“本院”）收治的112例ACI患者（研究组），另选取在本院通过健康体检的110例健康人为对照组。根据患者颈动脉内膜中层的厚度（IMT）结果，将研究组患者中的22例纳入正常组，38例纳入增厚组，52例纳入斑块组。以预后评估结果为基准，将研究组患者中的68例纳入预后良好组，44例纳入预后不良组。用ELISA法测定BHLHE40、SERPINE1、BLVRB在ACI患者血清中的表达水平；多因素Logistic回归分析ACI预后不良危险因素；ROC曲线分析BHLHE40、SERPINE1、BLVRB的预测价值。结果 与对照组比较，研究组患者血清BHLHE40、SERPINE1、BLVRB水平明显升高（P<0.05）；与正常组对比，增厚组、斑块组患者血清BHLHE40、SERPINE1、BLVRB水平明显升高，且斑块组显著高于增厚组（P<0.05）；与预后良好组比较，预后不良组血清BHLHE40、SERPINE1、BLVRB水平及NIHSS评分明显提高（P<0.05）；在ACI患者中，血清BHLHE40、SERPINE1、BLVRB水平升高，NIHSS评分提高是其预后不良的危险因素（P<0.05）；BHLHE40、SERPINE1、BLVRB联用，预测ACI预后不良的AUC为0.939；联合预测AUC优于单独预测（Z值分别为3.804、3.197、3.240，P<0.05）。结论 ACI患者血清BHLHE40、SERPINE1、BLVRB水平升高，三者不仅与病情进展相关，亦是预后的影响因素；联合检测可有效提升对ACI不良预后的预测效能。

Objective: To explore the experiences of obesity among junior high school students, and reveal its core themes and essential features, so as to provide evidence for health promotion. Methods: From March to August 2025, semi structured in depth interviews were conducted with 22 obese junior high school students (15 boys,7 girls) aged 13-16 years from two junior high schools in Beijing and one junior high school in Shenyang.Each interview lasted about 40 minutes, and the outline of the interview mainly involved three dimensions: obesity experience, obesity life experience, suggestions and future expectations. Data were analyzed using Moustakas phenomenological method. Results: A total of 4 core themes and 13 sub themes were identified: health experiences (external discipline, health conflicts, perceptual tension), exercise experiences (restricted activity, weight loss expectations, psychological catharsis, physical education test pressure), emotional experiences (appearance anxiety, self soothing, generalized impact), and social experiences (social devaluation, external support, covert suppression). Conclusions Obesity is a complex experience co-constructed by body awareness, physiological indicators, and sociocultural factors. Interventions should enhance students’ body awareness, facilitate a shift from external discipline to internal motivation, and form a collaborative health promotion pathway involving families, schools, and society.

Objective: To explore the longitudinal association between weight trajectories and physical fitness test composite scores among primary school students, so as to provide empirical evidence for school based weight management and physical health promotion. Methods: A total of 2 112 students from a primary school in Beijing who participated in physical fitness assessments annually from 2008 to 2023 were included and classified into different body weight trajectory groups based on body mass index (BMI) threshold: "normal/overweight-obese". Group based trajectory model was used to identify distinct weight trajectories. Generalized estimating equation and Cox regression were used to analyze the associations between weight trajectories and changes in physical fitness test scores, as well as event risks. Robustness checks were conducted. Results: The prevalence of overweight and obesity among primary school students was 26.50%. BMI showed a significant negative correlation with physical fitness composite scores ( r=-0.19, P <0.01). Four types of weight trajectories were identified: persistent normal group (64.5%, 1 362), persistent overweight- obese group (18.2%, 385), normal to overweight-obese group (14.0%, 296), and overweight-obese to normal group (3.3%, 69). Compared to the persistent normal group, both the normal to overweight-obese and persistent overweight-obese groups showed significantly higher risks of failing the physical fitness test ( HR =4.23, 4.60), and the speed of achieving excellent was slower ( HR = 0.52, 0.40) (all P <0.05). Robustness tests confirmed the stability of the findings. Conclusions Body weight trajectories have a long term impact on physical fitness performance among primary school students. Students with persistent or progressive overweight-obese trajectories have limited score improvement and a higher risk of failure; primary school students with persistent or progressive overweight and obesity should be a key focus.

Objective: To develop and compare multiple machine learning models for identifying high-risk college students exhibiting phubbing behavior and to determine key predictive factors, so as to provide evidence for precise screening and early intervention strategies. Methods: In December 2025, 1 828 undergraduate students, selected from three universities in Wuhan by using convenience sampling method, were surveyed via online qustionnaire for sociodemographic characteristics, phubbing behavior, family cohesion index, mature happiness, fear of negative evaluation, multidimensional state boredom, and psychological vulnerability. Four machine learning algorithms, including multilayer perceptron (MLP), extreme gradient booting (XGBoost), K-nearest neighbors (KNN), and gradient boosting decision tree (GBDT), were applied. The dataset was randomly split into a training set and a test set at a ratio of 7∶3. Model performance was evaluated using accuracy, recall, F1-score, and area under the receiver operating characteristic curve (AUC). The best performing model was further interpreted using shapley additive explanation (SHAP) analysis to assess feature importance. Results: In the training set,955 participants were classified as having low level phubbing behavior, and 325 participants were classified as having high level phubbing behavior. Significant differences were observed in psychological vulnerability, multidimensional state boredom, family cohesion index, and mature happiness between groups ( Z =-10.29, -11.72, -8.17, -7.83, all P <0.05). Significant differences were also found in the detection rate of high level phubbing behavior according to family residence, family status, left behind experience,interpersonal relationships,exercise frequency,physical flexibility,and sleep status ( χ 2=12.22, 38.93, 16.90, 44.64, 58.17, 82.14, 37.89, all P <0.05). Among the four machine learning models (MLP, KNN, GBDT, XGBoost),all showed good discrimination ability, with XGBoost performing best (accuracy 79%, recall 71%, F1-score=0.70, AUC=0.78), while GBDT achieved the highest precision (78%). Feature importance analysis showed that multidimensional state boredom was the most important predictor of phubbing behavior, followed by psychological vulnerability, family cohesion, mature happiness, and fear of negative evaluation. SHAP analysis indicated that multidimensional state boredom, psychological vulnerability, and fear of negative evaluation had positive risk effects, while family cohesion and hedonic well being had protective effects for high risk of phubbing behavior. Conclusions Multidimensional state boredom is the core predictor of phubbing behavior among college students. The XGBoost model demonstrates good predictive performance and can provide a reference for identifying high risk individuals and implementing targeted interventions.

Objective:To explore the value of multiparametric ultrasonography，including grayscale ultrasound（US），color Doppler flow imaging（CDFI），and real-time shear wave elastography（SWE）in diagnosing mucosal healing（MH）in pediatric patients with Crohn's disease.Methods:This prospective study consecutively enrolled pediatric CD patients who underwent endoscopic examinations at Hunan Children's Hospital from January 2024 to August 2024. Based on the Simplified Endoscopic Score for Crohn's Disease（SES-CD），all intestinal segments were divided into two groups：the MH group and the non-mucosal healing（NMH）group. Differences in bowel wall thickness（BWT），bowel wall stratification，color Doppler grading，SWE values，and increased thickness of mesenteric fat were compared between the two groups. ROC curves were plotted to evaluate the diagnostic performance of each ultrasound parameter. Multivariate Logistic regression analysis was used to identify independent predictors of MH，and a regression model was developed based on these factors.Results:A total of 234 intestinal segments from 60 pediatric CD patients were included in the analysis，divided into the MH group（101 segments）and the NMH group（133 segments）.There were significant differences between the MH and NMH groups in terms of BWT，bowel wall stratification，color Doppler grading，SWE values，and increased thickness of mesenteric fat（all P<0.05）. The multivariate Logistic regression analysis identified BWT，color Doppler grading，and SWE values as independent predictors associated with MH（all P<0.05）.The area under the ROC curve was 0.906（95% CI = 0.867 - 0.945， P＜0.05），with a sensitivity of 0.865 and specificity of 0.851. Conclusions:Multiparametric ultrasonography can effectively assess MH in pediatric CD patients，providing critical information for accurate clinical evaluation of disease status and treatment outcomes.

Objective: To explore the relationship between school sports environment and physical activity levels of middle school students, so as to provide theoretical and empirical support for optimizing school sports environment and enhance adolescent physical activity. Methods: Using multi-stage random cluster sampling, from September to December 2023, 1 329 junior and senior high school students from Xuancheng City of Anhui Province, Lianyungang City of Jiangsu Province, Wuhan City of Hubei Province, Qiqihar City and Suihua City of Heilongjiang Province, and Shenzhen City of Guangdong Province were selected. The International Physical Activity Questionnaire-Short Form (IPAQ-SF) assessed students physical activity levels, and the questionnaire on the characteristics of school sports environment was developed to evaluate the factors of school sports environment. Multivariate ordered Logistic regression was performed to analyze the correlation between school sports environment factors and physical activity levels, and the analytic hierarchy process determined the weight of key influencing factors. Results: The results showed that weekly vigorous physical activity time was [60 (25, 90)] minutes, moderate physical activity time was [60 (30, 90)] minutes, light physical activity time was [105 (40, 200)] minutes, and sedentary behavior time was [ 3 300 (2 100, 4 500)] minutes, only 10.53% of the students met World Health Organization physical activity recommendations, and 89.69% of the students averaged >8 h daily sedentary time. Multivariate ordered Logistic regression showed that adequate sports equipment significantly promoted physical activity across all intensities and reduced sedentary time ( OR = 4.97, 11.54, 4.03, 0.11); diverse sports activities improved vigorous and moderate physical activity while reducing sedentary time ( OR =4.20, 14.06, 0.17); and peer encouragement was associated with increased low-intensity physical activities and decreased sedentary time ( OR =10.40, 0.15)( P <0.05). The analytic hierarchy process weighting analysis identified the top three influential factors related to physical activity among middle school students: sufficient sports equipment, varied physical education activities, frequent peer encouragement, the influence weight accounts for 23.55% , 14.18% and 11.77% of the total, respectively. Conclusion Key school sports environmental factors for adolescent physical activity level include ensuring adequate sports equipment and class availability, diversifying activity content, fostering peer support, and cultivating an active sports culture and a comprehensive approach encourage students participation in extracurricular physical activities.

Objective To investigate CBX2 and TIM3 in salivary adenoid cystic carcinoma(SACC)tissue and their relationship with clinical pathological features and prognosis.Methods 80 patients with SACC who underwent surgical treatment in the First Affiliated Hospital of Hebei North University from January 2016 to January 2020 were selected.Immunohistochemistry was used to measure CBX2 and TIM3 in tissues.The relationship between CBX2 and TIM3 in SACC tissue and prognosis was discussed though Kaplan-Meier method.The factors influencing the prognosis of SACC were discussed using multivariate Cox regression.Results The positive rates of CBX2 and TIM3 in SACC tissues were clearly higher than those in normal glandular tissues adjacent to cancer(χ2=11.237,8.229,P<0.05).The CBX2 and TIM3 were associated with nerve invasion and distant metastasis(P<0.05).After a 5-year follow-up,26 cases died and 54 cases survived,with an overall 5-year survival rate of 67.50%(54/80).The death group had higher positive rates of CBX2 and TIM3 in SACC tissues than the survival group(P<0.05).Patients with positive CBX2 and TIM3 in SACC tissues had clearly lower 5-year survival rate than patients with negative CBX2 and TIM3(Log Rank χ2=6.564,5.197,P<0.05).CBX2,TIM3 positivity,nerve invasion,and distant metastasis were risk factors affecting prognosis(P<0.05).Conclusion The positive expression of CBX2 and TIM3 in SACC tissues is closely related to the clinical pathological features and prognosis of patients.

Objective To analyze influencing factors of small airway dysfunction(SAD)in children with bronchial asthma,and construct a risk prediction model for SAD.Methods A total of 221 bronchial asthma children with normal pulmonary ventilation function were retrospectively selected as the modeling group.According to the presence of SAD,children were divided into the SAD group(43 cases)and the non-SAD group(178 cases).The related factors affecting the occurrence of SAD were analyzed by univariate analysis and multivariate Logistic regression analysis,and risk prediction model of SAD was constructed.In addition,74 bronchial asthma children with normal pulmonary ventilation function were collected and used as the validation group.Hosmer-Lemeshow test was adopted to evaluate the calibration of the model.Receiver operating characteristic(ROC)curve was drawn and area under the curve(AUC)was calculated to evaluate the predictive efficiency of the prediction model.Results Multivariate Logistic regression analysis showed that poor asthma control(OR=10.722,95%CI:4.044-28.428),allergic rhinitis in the attack stage(OR=4.816,95%CI:1.929-12.023)and long use of inhaled corticosteroids(ICS)or ICS/long-acting β2 receptor agonist(LABA,OR=2.903,95%CI:1.269-6.643)were independent risk factors for SAD in children(P＜0.05),and older age at first onset of suspected asthma symptoms(OR=0.599,95%CI:0.395-0.907)was a protective factor.Hosmer-Lemeshow test showed good calibration(χ2=8.301,P=0.307).The AUC,sensitivity and specificity of the model in the modeling group for predicting the occurrence of SAD in children with bronchial asthma were 0.820(95%CI:0.749-0.892),74.42%and 78.65%,and the AUC,sensitivity,specificity and accuracy of the model in the validation group were 0.849(95%CI:0.718-0.981),75.00%,94.83%and 90.54%(67/74).Conclusion Children with bronchial asthma who are younger at the time of their first suspected asthma symptoms,poor asthma control,allergic rhinitis in the exacerbation phase,and longer duration of use of ICS or ICS+LABA/LTRA are at higher risk of SAD.Therefore,SAD risk prediction model constructed on this basis has good predictive ability.

Objective The Bayesian joint model was applied to predict conversion from mild cognitive impairment(MCI)to Alzheimer's disease(AD),and to compare time effect in longitudinal outcomes,and functional forms for the longitudinal outcomes that are included in the survival model.Methods The longitudinal sub-model used generalized linear mixed models to model the trajectory of longitudinal neuropsychological tests changes pattern,and the survival sub-model adopted a Cox proportional risk model.The longitudinal sub-model utilized two forms of effects,t and t2,and the link structures of longitudinal sub-model and survival sub-model adopted three functional forms(updated value,slope,and area).The data were divided into training and validation sets according to 7∶3,the model parameters were estimated based on Bayesian algorithm,and the dynamic AUC was used to evaluate model prediction performance.Results There were 374(54.20％)of 690 patients with MCI progressed to AD during the follow-up period.In training set,the results of Bayesian joint model with a time effect of t and area effect of three longitudinal neuropsychological tests were optimal,with a mean dynamic AUC of 0.8336.The APOEε4 gene and a low functional activities questionary were risk factors for MCI conversion to AD.The dynamic AUCs of the joint model with the t time effects and area effect for longitudinal data were above 0.75 in the validation sets.Conclusion The application of multivariate Bayesian joint model to MCI risk prediction may provide a theoretical basis for individualized interventions for cognitive impairment and inform statistical methods for survival modeling of chronic diseases.