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 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 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.

This paper aims to discuss the construction and promotion strategy of medical care capacity framework based on the core literacy of palliative care， combining domestic and foreign research and clinical status. The research results show that it is particularly important to construct a framework of medical care competence based on palliative care. The core competencies required for palliative care include the ability to comprehensively evaluate and formulate personalized programs， effective communication skills， interdisciplinary teamwork skills， and the ability to continuously learn and improve themselves. The quality of care can be further improved if the above abilities are incorporated into the framework of medical care ability based on palliative care. However， there are a series of problems in the process of constructing the framework of palliative medical care capacity， such as difficult implementation of policy support， poor professionalism of talent team， single and irregular service model， low social acceptance， and difficult interdisciplinary cooperation and resource integration. After a detailed analysis of the problems， this paper puts forward the countermeasures to construct the framework of caring ability literacy based on palliative care. Effective countermeasures such as increasing policy support， cultivating comprehensive talents， developing diversified palliative care models， improving social recognition， and strengthening interdisciplinary cooperation and resource integration can effectively improve the core literacy and professional ability of medical care personnel， and then promote the development and improvement of palliative care services. In-depth discussion of the above contents can provide scientific reference for building a care model and literacy framework with palliative care as the core.

AIM: To investigate the changes in serum levels of trefoil factor 1(Tff1)and bone morphogenetic protein 4(BMP4)in patients with diabetic retinopathy, and to evaluate their diagnostic value for diabetic retinopathy.METHODS: From January 2022 to January 2024, 186 patients with type 2 diabetes were selected as the study group and divided into a retinopathy subgroup(52 cases)and a non-retinopathy subgroup(134 cases)based on the presence of retinopathy. Another 186 healthy volunteers who underwent physical examinations during the same period were chosen as the control group. Serum Tff1 and BMP4 levels were measured using the enzyme-linked immunosorbent assay(ELISA). Pearson analysis was used to assess the correlation between serum Tff1, BMP4 levels, and clinical data. Multivariate Logistic regression analysis was performed to identify factors influencing the development of retinopathy in type 2 diabetic patients. Receiver operating characteristic(ROC)curve analysis was conducted to evaluate the diagnostic value of serum Tff1 and BMP4 levels for retinopathy in type 2 diabetic patients.RESULTS: Compared to the control group, serum Tff1 levels were lower and BMP4 levels were higher in both retinopathy and non-retinopathy subgroups(all P<0.05). Specifically, serum Tff1 levels were lower and BMP4 levels were higher in the retinopathy subgroup than in the non-retinopathy subgroup(all P<0.05). Pearson analysis revealed that Tff1 levels in type 2 diabetes patients were negatively correlated with disease duration, glycated hemoglobin levels, and triglyceride levels, while BMP4 levels were positively correlated(all P<0.05). Multivariate Logistic regression analysis identified type 2 diabetes duration, glycated hemoglobin, triglycerides, Tff1, and BMP4 as influencing factors for retinopathy development in type 2 diabetes patients(all P<0.05). ROC curve analysis showed that the combined diagnosis of serum Tff1 and BMP4 had an area under the curve(AUC)of 0.901, which was significantly higher than that of Tff1 alone(Z=2.069, P=0.039)and BMP4 alone(Z=2.072, P=0.038).CONCLUSION: Serum Tff1 levels are decreased and BMP4 levels are increased in patients with diabetic retinopathy, and the combined detection of these two markers offers high diagnostic value for diabetic retinopathy.

Objective To investigate the current status of quality of life and its influencing factors in elderly patients with minor amputations of the diabetic foot,providing a basis for medical staff to formulate intervention strategies.Methods A convergent mixed study design was used.A single-centre cross-sectional survey research method was used to select 168 elderly patients with minor amputation of the diabetic foot admitted to the Department of Wound Repair of a tertiary-level hospital in Beijing from May 2022 to May 2024 for questionnaire surveys and multivariate linear regression analyses of factors affecting the quality of life.During the same period,15 patients were selected for semi-structured interviews using purposive sampling based on ternary interaction determinism.Results Quantitative findings:A total of 167 valid questionnaires were retrieved,and the recovery rate of valid questionnaires was 99.4％.the total quality of life score of 167 respondents was(84.22±12.49)scores;the results of multivariate linear regression analyses showed that age and self-care ability were the independent risk factors affecting the quality of life of patients with minor amputation of the diabetic foot(P＜0.05).Qualitative findings:a total of 3 themes were extracted based on the triadic interactive determinism,including subject level,environmental level and behavioural level.Mixed findings:age and amputation affect the physical and mental state of patients and hinders quality of life improvement;limited work and life,and scarce external resources;the level of self-care ability restricts self-management behaviours and makes it difficult to improve quality of life.Conclusion Elderly patients with minor amputations of the diabetic foot have impaired physiological and psychological health to some degree,and healthcare professionals should be concerned about the negative impact of minor amputations on elderly diabetic foot patients,while also focusing on their individual needs and providing support.

Osteosarcoma is a primary bone tumor originating from mesenchymal tissues,highly aggressive and metastatic,and is one of the causes of orthopedic disorders in children and adolescents.The establishment of an osteosarcoma model is useful for studying the changes in the physiology and pathology of the organism after the occurrence of osteosarcoma.The establishment methods of osteosarcoma models not only differ in terms of difficulty,tumorigenicity,tumor-formation time,tumor survival time,tumor metastasis,and safety,but also in terms of simulating human osteosarcoma biological characteristics and histological features.In addition,the wide application of tissue engineering in tumor modeling is conducive to better study the role of the osteosarcoma microenvironment in osteosarcoma genesis and development.In this paper,we summarize the roles of different osteosarcoma animal models and their tissue engineering models in different experiments,in order to provide help for the study of osteosarcoma pathogenesis and drug intervention mechanism.

Stem cells are a kind of cells with the ability of self-renewal and differentiation, which can differentiate into melanocytes to fill the areas of pigment loss in damaged skin, fight against the apoptosis of melanocytes caused by autoimmunity and oxidative stress damage, and improve repigmentation rates in combination with traditional therapies. Studies have shown significant efficacy of stem cell therapy in the repigmentation of vitiligo. This review summarizes the latest advances in the basic and clinical research on the application of stem cells in the treatment of vitiligo.