Objectives:To explore the relationship between insomnia symptoms and neuroticism in patients with COVID-19,and to explore the role of anxiety and psychological capital in the relationship.Methods:Totally 687 patients with COVID-19 were recruited from Shanghai Fangcang Hospital.The Athens Insomnia Scale(AIS),Eysenck Personality Questionnaire-Revised Short Scale for Chinese Neuroticism Subscale(EPQ-RSC-N),Self-Rat-ing Anxiety Scale(SAS)and Psychological Capital Questionnaire(PCQ)were used to measure insomnia symp-toms,neuroticism personality trait,anxiety symptoms and psychological capital levels.The deviation-corrected per-centile Bootstrap method was used to test the mediating effect,and the PROCESS program was used to test the moderated effect.Results:The detection rate of insomnia symptoms was 49.93％.The AIS scores were lower in male patients than in female patients(P＜0.01).The SAS scores partly mediated the relationship between neuroti-cism scores and AIS scores,with an effect size of 0.03,accounting for 18.29％of the total effect.With the im-provement of PCQ scores,the predictive effect of SAS scores on AIS scores gradually decreased(β=-0.01,t=-4.41,P＜0.001).Conclusions:Anxiety symptoms in patients with COVID-19 play a partial mediating role in the positive relationship between insomnia symptoms and neuroticism.The psychological capital moderates the relation-ship between insomnia and anxiety symptoms.

Objective:To explore the relationship between the perceived stress and the independent learning ability of nursing undergraduates, to establish a chain mediation model to investigate the role of psychological capital and self-control in the relationship between the two, aiming to provide a new direction for nursing educators to improve the independent learning ability of nursing undergraduates.Methods:Using the convenient sampling method, a total of 913 nursing undergraduates from 10 universities in Shaanxi Province were selected as research objects from February to March 2023. Perceived Stress Scale (PSS), Positive Psychological Capital Questionnaire (PPQ), Self-control Scale (SCS) and Self-directed Learning Ability Scale (SLAS) were used to investigate the nursing undergraduates.Results:A total of 913 questionnaires were sent out in this study, and 900 were effectively collected, with an effective recovery rate of 98.58% (900/913). The total SLAS score of 900 nursing undergraduates was (87.12±9.20). The perception of stress among undergraduate nursing students could directly predict their self-directed learning ability negatively ( P<0.01), or indirectly affected their self-learning ability through psychological capital and self-control ( P<0.05). Psychological capital (indirect effect value=-0.160) and self-control (indirect effect value=-0.106) played a mediating role between stress perception and self-directed learning ability, and the mediating effect accounted for 38.55% and 25.54%, respectively. Moreover, psychological capital and self-control also played a chain mediating role (indirect effect value=-0.053), and the proportion of chain mediated effect was 12.77%. Conclusions:Perceived stress, psychological capital and self-control are important influencing factors on the self-directed learning ability of nursing undergraduate students. Perceived stress not only directly affects the self-directed learning ability of nursing undergraduate students, but also indirectly affects their self-directed learning ability through the chain mediation effect of psychological capital and self-control.

【Objective:】 To explore the effect of metacognition on self-directed learning ability of undergraduate nursing students, and the role of interpersonal communication ability and sense of self-worth between them. 【Methods:】 A total of 905 undergraduate nursing students from six colleges and universities in Shaanxi were selected as the survey subjects by convenient sampling method during August to November 2022. Metacognitive Assessment Inventory, Self-Directed Learning Ability Measurement Scale for Nursing Students, Adolescent Sense of Total Self-Worth Scale, and Supportive Communication Scale were used to conduct a questionnaire survey on undergraduate nursing students. SPSS 25.0 software was used for statistical analysis of the data. 【Results:】 Finally, 854 valid questionnaires (94.36%) were collected, and the results showed that: a) Metacognition of undergraduate nursing students significantly positively predicted self-directed learning ability (β=0.172, P<0.001). b) Interpersonal communication ability played a partial mediating role between metacognition and self-directed learning ability [β=0.019, 95%CI: 0.004~0.034)] . c) The predictive effect of metacognition on self-directed learning ability was regulated by the level of self-worth (R²=0.314, P<0.001). 【Conclusion:】 This paper indicated that the metacognition of undergraduate nursing students indirectly affects their self-learning ability through interpersonal communication ability, and their sense of self-worth plays a moderating role. It is recommended to improve the metacognitive level of undergraduate nursing students, strengthen their interpersonal communication skills, and focus on the cultivation of self-worth, so as to improve their self-directed learning ability.

ObjectiveTo explore the relationship between occupational stress， psychological capital and insomnia among nurses， and to test the mediating effect of psychological capital on the relationship between nurses' occupational stress and insomnia. MethodsStratified random sampling method was utilized in selecting 810 nurses from a tertiary A-level hospital from March to May 2021. The Effort-Reward Imbalance questionnaire （ERI）， Psychological Capital Questionnaire （PCQ） and Athens Insomnia Scale （AIS） were used to evaluate the occupational stress， psychological capital and insomnia of nurses， respectively. Then the mediation effect of psychological capital on the relationship between occupational stress and insomnia in nurses was tested by PROCESS macro program. ResultsA total of 658 （81.23%） questionnaires were effectively collected. Analysis found that nurses' effort-reward ratio was positively correlated with AIS score （r=0.379， P<0.01）， and negatively correlated with PCQ score （r=-0.275， P<0.01）. Nurses' PCQ score was negatively correlated with AIS score （r=-0.402， P<0.01）. Nurses' occupational stress could negatively predict psychological capital （β=-11.024， t=-7.324， P<0.01）， and positively predict insomnia （β=4.117， t=10.478， P<0.01）. Psychological capital could negatively predict insomnia （β=-0.087， t=-9.083， P<0.01）. The predictive effect of occupational stress on insomnia was statistically significant with psychological capital introduced as a mediating variable （β=3.158， t=8.185， P<0.01）. ConclusionPsychological capital plays a partial mediating role in the relationship between occupational stress and insomnia in nurses.

Objective:To explore the status and influencing factors of stress disorder in different periods of postpartum women.Methods:From October 2019 to April 2021, convenience sampling was used to select 332 puerperae from 8 community health service stations in Xi'an as the research object. The Posttraumatic Stress Checklist-Civilian version (PCL-C) was used to investigate the puerperae in T1 (1 to 3 months postpartum) , T2 (4 to 6 months postpartum) , T3 (7 to 12 months postpartum) .Results:Among 332 puerperae, there were no significant differences in the posttraumatic stress disorder (PTSD) positive rate, PTSD total score and symptom cluster scores in T1, T2 and T3 ( P>0.05) . From 1 to 3 months postpartum, occupation, husband participation, sleep, delivery mode, neonatal gender coincidence and initial delivery were the influencing factors of postpartum PTSD ( P<0.05) . From 4 to 6 months postpartum, pregnancy complications was the factor affecting postpartum PTSD ( P<0.05) . From 7 to 12 months, sleep was the influencing factor of postpartum PTSD ( P<0.05) . Conclusions:PTSD was relatively stable within one year in postpartum women. Targeted intervention measures should be taken according to the influencing factors of PTSD in different postpartum periods.

[摘 要] 目的：探讨miR-206对雌激素诱导的ER-α36阳性胃癌（gastric cancer, GC）细胞BGC-823增殖和侵袭的影响及其相关机制。方法: 用不同浓度（1、10和100 pmol/L）的雌二醇（estradiol，E2）刺激ER-α36阳性BGC-823细胞后，用qPCR法检测miR-206表达水平，MTT法和Transwell实验分别检测细胞的增殖和侵袭能力，WB法检测细胞中CDK14的表达。将miR-206 mimic、miR-NC、pcDNA-CDK14、pcDNA-vector等转染ER-α36阳性BGC-823细胞，并给予100 pmol/L的E2处理后，用MTT法和Transwell小室法分别检测细胞的增殖和侵袭能力，WB法检测细胞中CDK14的表达。用双荧光素酶报告基因实验验证miR-206与CDK14之间的靶向关系。结果: E2能显著降低ER-α36阳性BGC-823细胞中miR-206表达水平（P<0.05或P<0.01）、增强细胞的增殖和侵袭能力（P<0.05或P<0.01）、上调细胞中CDK14的表达水平（P<0.01）。过表达miR-206能显著降低E2诱导的ER-α36阳性BGC-823细胞的增殖和侵袭能力（均P<0.01）。miR-206通过直接结合CDK14 mRNA的3'-UTR发挥抑制作用，从而负向调节CDK14的表达，进而抑制ER-α阳性BGC-823细胞的增殖和侵袭能力（均P<0.01）。结论: miR-206通过靶向CDK14从而抑制雌激素诱导的ER-α36阳性GC细胞的增殖和侵袭。

Objective: To evaluate the relationship between the offset of a laser-assisted flap using the WaveLight FS200 femtosecond laser and the clinical results after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK). Methods: In this prospective cohort study, 125 patients who underwent FS-LASIK for myopia by WaveLight FS200 femtosecond laser from June 2017 to July 2018 at the Tungwah Ophthalmic Center were divided into two groups according to the offset of the corneal flap from the pupil center: the no-offset group (57 eyes) and the certain-offset group (68 eyes); the baseline data, including age, sex, uncorrected visual acuity(UCVA), spherical degree, and central corneal thickness were matched in the two groups.UCVA, residual astigmatism, spherical degree, corneal curvature and aberration were observed 1 week and 1 month after surgery.The study protocol was approved by the Ethics Committee of Tungwah Hospital of Sun Yat-Sen University (No.2017DHLL004). Written informed consent was obtained from each subject prior to entering the study cohort. Results: UCVA, corneal curvature, spherical degree, spherical and corneal aberration between the two groups were not significantly different (all at P>0.05). One week after surgery, the residual astigmatism was ≤-0.50 D in 50 eyes (87.7%, 50/57)and >-0.50 D in 7 eyes (12.3%, 7/57) in the no-offset group; the residual astigmatism was ≤-0.50 D in 50 eyes (73.5%, 50/68) and >-0.50 D in 18 eyes (26.5%, 18/68) in the no-offset group.The residual astigmatism between the two groups 1 week after surgery was significantly different (χ²=3.902, P=0.048), and there was no significant difference in residual astigmatism 1 month after surgery (χ²=2.031, P=0.068). The trefoil of the no-offset group was statistically less than of the certain-offset group at 1 week and 1 month after surgery (0.05[0.04, 0.08]vs.0.06[0.04, 0.10]; 0.05[0.03, 0.07]vs.0.06[0.05, 0.09])(Z=-2.245, P=0.022; Z=-2.370, P=0.018). The spherical aberration and coma were not significantly different between the two groups at 1 week and 1 month after surgery (both at P>0.05). Conclusions The offset from femtosecond laser-assisted flap by WaveLight FS200 has no effect on long-term visual acuity or residual astigmatism.Some patients may have different visual experiences because of the residual astigmatism and higher order aberration during the early postoperative stage.

Objective To explore the relationship between the level of plasma ADAMTS4 and the vulnerability of carotid atherosclerotic plaque in patients with carotid artery stenosis and the clinical value of evaluating the vulnerability of the carotid atherosclerotic plaque.Methods 60 patients with carotid artery stenosis were divided into stable plaque group and vulnerable plaque group according to the histopathological typing after carotid endarterectomy (CEA).30 patients who had atherosclerosis but no carotid plaque formation served as control.Using ELISA to measure the level of plasma ADAMTS4.Results The level of plasma ADAMTS4 was significantly higher in the vulnerable-plaque group (112.74 ± 17.47) ng/ml compared with the stable plaque group (56.67 ± 22.14)ng/ml and the control group (56.67 ± 22.14)ng/ ml,P ＜ 0.001.Logistic analysis showed that high level of plasma ADAMTS4 was risk factor for vulnerability of carotid atherosclerotic plaque (P ＜ 0.05,OR =8.240,95 ％ CI:1.512-22.915).ROC curve showed that ADAMTS4 =100.935 ng/ml could accurately predict significant vulnerability with accuracy of 94.3％.Conclusion ADAMTS4 is an effective,sensitive and non-invasive biomarker to evaluate the vulnerability of carotid atherosclerotic plaque.