Objective:To explore patterns of traditional Chinese medicine (TCM) use among patients with inflammatory bowel disease (IBD) in Jiangsu Province, China from 2019 to 2023.Methods:Using data from the IBD health data platform of the National Healthcare Big Data (Eastern) Center, a retrospective cohort study was conducted. We performed descriptive analyses on hospitalised patients diagnosed with IBD between 2019 and 2023, who received TCM treatment.Results:The study included 11 095 case records from 4 760 patients, with TCM diagnoses primarily indicating diarrhoea and abdominal pain. Ulcerative colitis (UC) accounted for 4 782 hospitalizations (3 103 patients), while Crohn's disease (CD) accounted for 6 313 hospitalizations (1 657 patients). Patient demographics showed a trend towards younger age and a higher proportion of males. Treatment utilisation was highest in southern Jiangsu compared with the central and northern regions. In terms of disease burden, all treatment costs showed a downward trend. In terms of external TCM therapies, UC patients tend to prefer plasters and enemas, while CD patients are more inclined to use acupuncture. Regarding herbal medicine, licorice, white atractylodes, and white peony root are commonly used single herbs for IBD patients.Conclusions:The number of IBD patients treated with TCM in Jiangsu Province has steadily increased from 2019 to 2023. It is important to identify effective TCM treatment methods to reduce the burden of patients.

Objective:To assess the real-world triage performance of a dual-marker strategy (DMS) combining copeptin and high-sensitivity cardiac troponin T (hs-cTnT) in patients presenting with chest pain and suspected non-ST-segment elevation myocardial infarction (NSTEMI).Methods:It was conducted a prospective study of 277 consecutive chest pain patients admitted to the Emergency Department of Zhongshan Hospital, Fudan University, between July and August 2023. Admission levels of copeptin and hs-cTnT were measured. The safety, efficacy, and triage efficiency of the DMS (defined as copeptin <10 pmol/L and hs-cTnT <0.014 ng/mL) for excluding NSTEMI were evaluated based on final diagnoses and clinical outcomes.Results:Among 277 patients, 141 (50.9%) had cardiogenic diseases (51 NSTEMI, 37 unstable angina pectoris [UAP], 11 myocardial bridges, and 42 non-coronary artery disease), 29 (10.5%) had non-cardiac conditions, and 107 (38.6%) had low-risk chest pain of unknown etiology. A total of 103 patients (37.2%) were DMS-negative (copeptin and hs-cTnT both below cutoff), including 0 NSTEMI cases, 2 UAP cases, 1 myocardial bridge, 6 non-coronary artery diseases, 4 non-cardiac conditions, and 90 low-risk cases. The DMS demonstrated a negative predictive value (NPV) of 100% for excluding NSTEMI, with no major adverse cardiac events (MACE) observed in DMS-negative patients during 30-day follow-up. Real-world data revealed that only 42.2% of suspected NSTEMI patients received a second troponin test (timing: 1 hour—5.9%, 2 hours—23.9%, ≥3 hours—70.1%). The DMS enabled safe and efficient triage of 37.2% of chest pain patients at 0-hour, outperforming other strategies in applicability and feasibility ( P < 0.05). Conclusions:In real-world clinical practice, the DMS (copeptin combined with hs-cTnT) optimally complements guideline-recommended hs-cTnT algorithms. It provides a simple, rapid, and safe approach to managing acute chest pain, demonstrating superior applicability for improving emergency triage efficiency.

Objective:To explore patterns of traditional Chinese medicine (TCM) use among patients with inflammatory bowel disease (IBD) in Jiangsu Province, China from 2019 to 2023.Methods:Using data from the IBD health data platform of the National Healthcare Big Data (Eastern) Center, a retrospective cohort study was conducted. We performed descriptive analyses on hospitalised patients diagnosed with IBD between 2019 and 2023, who received TCM treatment.Results:The study included 11 095 case records from 4 760 patients, with TCM diagnoses primarily indicating diarrhoea and abdominal pain. Ulcerative colitis (UC) accounted for 4 782 hospitalizations (3 103 patients), while Crohn's disease (CD) accounted for 6 313 hospitalizations (1 657 patients). Patient demographics showed a trend towards younger age and a higher proportion of males. Treatment utilisation was highest in southern Jiangsu compared with the central and northern regions. In terms of disease burden, all treatment costs showed a downward trend. In terms of external TCM therapies, UC patients tend to prefer plasters and enemas, while CD patients are more inclined to use acupuncture. Regarding herbal medicine, licorice, white atractylodes, and white peony root are commonly used single herbs for IBD patients.Conclusions:The number of IBD patients treated with TCM in Jiangsu Province has steadily increased from 2019 to 2023. It is important to identify effective TCM treatment methods to reduce the burden of patients.

Objective:To test the validity and reliability of the Chinese version of the Cyberbullying Bystand-er Scale(CBS)in Chinese college students.Methods:Totally 722 college students were randomly divided into sample 1(n=356)and sample 2(n=366).Exploratory factor analysis was performed on sample 1,and confirma-tory factor analysis,criterion validity,and internal consistency reliability were performed on sample 2.The criterion validity was tested with the Short Form of Moral Disengagement Scale(MDS).Thirty-seven students of sample 2 were randomly selected and retested 2 week later.Results:The Chinese version of CBS contained 6 distinct factors(40 items),named passive outsider online,defender of the cybervictim online,reinforcer of the cyberbully online,passive face-to-face outsider,face to face defender of the cybervictim,face-to-face reinforcer of the cyberbully.The results of confirmatory factor analysis confirmed that the fitting index of the six-factor modelis good(x2/df=2.83,CFI=0.90,TLI=0.89,RMSEA=0.07,SRMR=0.06).The scores of passive outsider online,reinforcer of the cyberbully online,passive face-to-face outsider and face-to-face reinforcer of the cyberbully were positively correla-ted with the moral disengagement(ICC=0.11-0.28,Ps＜0.05).The internal consistency reliabilities of the scale were from 0.89 to 0.96,the retest reliabilities(ICC)of the scale were between 0.75 to 0.89.Conclusion:The Chinese version of the Cyberbullying Bystander Scale(CBS)shows good validity and reliability in Chinese college students.

Objective To analyze the correlations between platelet-related parameters and the incidence of anxiety and depression in the patients undergoing peritoneal dialysis(PD),and evaluate the efficacy of the pa-rameters in the diagnosis of anxiety and depression in PD patients.Methods A total of 245 patients undergoing PD in the First Affiliated Hospital of Hebei North University from September 2022 to February 2023 were enrolled.The gener-alized anxiety scale(GAD-7)and the patient health questionnaire(PHQ-9)were used to evaluate the anxiety and depression of the patients,respectively.The personal information and biochemical indicators of the patients were col-lected,and the platelet count(PLT),mean platelet volume(MPV),and platelet distribution width(PDW)were measured.Logistic regression was adopted to analyze the relationships of platelet-related parameters with anxiety and depression in PD patients.Results Among the 245 patients undergoing PD,the incidences of anxiety and depression were 15.9% and 38.0% ,respectively.There were differences in the dialysis period(Z=-2.358,P =0.018;Z =-3.079,P=0.002),MPV(Z=-4.953,P<0.001;Z=-7.878,P<0.001),and PDW(Z =-4.587,P<0.001;Z=-7.367,P<0.001)between the anxiety group and the non-anxiety group as well as between the de-pression group and the non-depression group.The correlation analysis showed that MPV(r =0.358,P<0.001;r =0.489,P<0.001)and PDW(r =0.340,P<0.001;r =0.447,P<0.001)were positively correlated with anxiety and depression in the patients undergoing PD.The Logistic regression model showed that MPV(P =0.022,P =0.011),PDW(P =0.041,P =0.018),and dialysis period(P =0.011,P =0.030)were independent risk factors for the anxiety and depressive state in PD patients.The areas under the receiver operating characteristic curve of MPV in the diagnosis of anxiety and depression in PD patients were 0.750 and 0.800,respectively,and those of PDW were 0.732 and 0.780,respectively.Conclusion MPV and PDW have high efficacy in the diagnosis of anxiety and depression associated with PD and can be used as objective indicators to evaluate the anxiety and depression in the patients undergoing PD.

Objective:To construct the core competence evaluation index system of general practice residents by the Delphi method.Methods:After the literature review of home and abroad and group discussion, the core competence evaluation index system of general practice residents in the outpatient environment was preliminarily developed. On this basis, the index system was determined through two rounds of expert consultation. Excel 2015 and SPSS 26.0 were used for data entry and statistical analysis.Results:The active coefficients of the two rounds of expert consultation were 95.0% (19/20) and 100.0% (19/19) respectively, and the degree of authority of the two rounds of expert consultation was 0.86. An index system consisting of 6 first-level indicators and 28 second-level indicators was determined. The 6 first-level indicators were medical services/patient care, medical knowledge, professionalism, systems-based practice, practice-based learning and improvement, interpersonal communication, and communication skills.Conclusion:This study has constructed a complete and highly reliable core competence evaluation index system of general practice residents based on the outpatient environment, which can provide reference for the cultivation of the outpatient reception ability of general practice residents in the future.

Objective:To survey the status quo of clinical teaching by specialists in general practice residents training.Methods:Thirty-four general practice residents (14 males and 20 females, aged (27.9±1.8) years) who started standardized training in 2016, 2017 and 2019 in the First Affiliated Hospital of Zhejiang University School of Medicine were selected for interview. The semi-structured and open-ended telephone interviews were conducted 6 months after their completion of residency training. The 1st round of interviews with 12 residents of 2016 and 2017 batches was conducted in March 2020 and 2021 to understand their feelings and suggestions about specialty learning. Based on the interview results, literature review, expert consultation and internal discussion, a new model for specialty teaching was developed and applied for subsequent residency training. The second round of interviews was conducted with 22 residents of 2019 batch on March 2023 to investigate the implementation of the new model.Results:In the first round of interviews, 6 participants felt that the learning of specialty knowledge was not comprehensive enough; although all respondents said that they had received simulator training for the final exam in the specialty rotation, 2 people felt that it was not comprehensive and 2 mentioned that some of the items were not practised on a real person; all 12 respondents felt that there was a certain gap between the types of diseases they encountered in the specialty learning and the real world of work; 10 respondents mentioned that there was insufficient training in the management of chronic non-chronic diseases; 7 out of 9 respondents from primary care institutions mentioned that it was difficult to apply the learned specialty knowledge to real work due to local conditions; 7 respondents mentioned that the content and methods of teaching were inconsistent among different lecturers; and respondents hoped that the surgical training, physical exam training, medication instruction, and the length of outpatient follow-up consultations would be strengthened. In the second round of interviews, the feedback of respondents was more positive than in the first round, there were still problems with the separation of teaching and examination content, and insufficient practical training of skills; 2 respondents from general hospitals mentioned that the teaching of specialties should be further deepened, and 3 respondents from the primary care institutions mentioned that the teaching of treatment and follow-up management should be further strengthened. Twenty-one respondents generally accepted the new specialty teaching model, but said that there were big differences between teachers of different specialties and there were still problems such as insufficient guidance on drug treatment and follow-up.Conclusion:In general practice, residency training specialist teaching does not fully meet the requirements of the actual work of general practitioners, and although it has improved after optimization, there is still much room for improvement.

Objective: The purpose of this study is to investigate the status of freshmen s mental health literacy and its impact on mental health and to provide a reference for probing into the effectiveness and sustainality of curriculum education as the main channel of improvement of mental health literacy. Methods: Mental health literacy questionnaire for Chinese adults and college students mental health screening scale were used to investigate 2 878 freshmen in a university in Wuhan. Mental health literacy was one of the indicators of course teaching evaluation. The curriculum intervention effect was investigated through pre-test, post-test and 10-month follow-up. Results: The mental health literacy of freshmen (40.12±6.57) was higher than the national average level(35.81±8.06), but lower than the average level in terms of self-help mental health literacy(F=28.25，P<0.01). There were gender differences and urban-rural differences in mental health literacy. The mental health literacy of freshmen without psychological problems was significantly higher than that of freshmen with psychological problems(F=374.80，P<0.01). Structured course teaching significantly improved freshmen s mental health literacy, which were still significant after 10 months. Conclusion College freshmen s mental health literacy is generally great, and the mental health curriculum improved their mental health literacy.

Objective To analyze the effects of valproic acid(VPA),a histone deacetylase(HDAC)inhibitor,on macrophage polarization in?duced by paraquat(PQ)or lipopolysaccharide(LPS). Methods Mouse RAW264.7 cells were cultured at 37℃with 5%CO2,passaged,and then given one of the following treatments:(1)PQ;(2)PQ+VPA(classⅠandⅡa HDAC inhibitor);(3)PQ+apicidin(classⅠHDAC inhibitor);(4)PQ+MC1568(classⅡa HDAC inhibitor);(5)LPS;(6)LPS+VPA;(7)LPS+apicidin;(8)LPS+MC1568. The cells and culture supernatants were harvested after 8 h of treatment. RT?PCR,ELISA,and flow cytometry were conducted to assess the expression levels of macrophage phenotyp?ic markers. Results Both PQ and LPS skewed the macrophage functional polarity toward proinflammatory phenotype. VPA,apicidin,and MC1568 all inhibited PQ?and LPS?induced macrophages polarizing toward pro?inflammatory phenotype ,but the inhibitory effects were different in some ways. Conclusion VPA inhibits the proinflammatory function of macrophages induced by PQ and LPS ,but the effect of VPA on PQ?and LPS?induced macrophages has its own characteristics.

Objective:To test curriculum management effect of graduate students'clinical practice of counseling psychology.Methods:Totally 26 students [average age (24.5 ± 1.0) years] who completed 30-day interns summer were investigated with the self-made questionnaire evaluating the quality of clinical practice.Results:All students obtained promotion in practice activities,the attendance ranged from 50.0％ to 96.2％.The overall satisfaction was (3.8 ± 0.8) and the average degree of supervisors'satisfaction was (4.0 ± 0.8).There were 92.3 ％ of the students had participated more than 224 hours' practice and completed all tasks.After the interns,the students had significantly improved in all 8 aspects of professional abilities.Conclusion:In graduate education of counseling psychology,curriculum management of clinical practice may be an effective approach to improve students' clinical skills.