Objective: To analyze the heterogeneity of mobile phone dependence development trajectory in middle school students and its association with loneliness and selfcontrol ability, so as to provide reference for the prevention of mobile phone dependence in middle school students. Methods: A total of 941 grade 1 students from 4 public middle schools in Xiangxi Autonomous Prefecture, Hunan Province were selected for the followup survey by random cluster sampling from October 2023 to April 2024 and October 2024. Mobile Phone Addiction Index (MPAI), University of California, Los Angeles Loneliness Scale-20 (UCLA-20) and Selfcontrol Scales (SCS) were used for questionnaire survey. The heterogeneity of the developmental trajectory of middle school students mobile phone dependence was analyzed by the latent growth curve model (LGMM), and the influencing factors of the developmental trajectory of middle school students mobile phone dependence were explored by multiple Logistic regression analysis. Results: The development trajectory of middle school students mobile phone dependence could be divided into four categories: C1 "low risk slow decline group (n=438,44.6%)", C2 "medium risk slow rise group (n=272,29.7%)", C3 "high risk rapid decline group (n=73,8.6%)" and C4 "high risk rapid rise group (n=158,17.1%)". There were significant differences in the distribution of mobile phone dependence development track heterogeneity subgroups among sex, only child, lodging, and leftbehind students (χ2=117.79, 44.88, 37.09, 130.50, P <0.01). The results of the multinomial Logistic regression model analysis showed that, with C1 group as the reference, C2, C3, and C4 were positively correlated with students loneliness [OR(95%CI)=1.04 (1.02-1.06), 1.11(1.08-1.14), 1.12(1.09-1.14)]; C2 and C4 groups were negatively correlated with students selfcontrol [OR(95%CI)=0.97(0.96-0.99), 0.95(0.93-0.97)] (P<0.01). Conclusions The development trajectory of mobile phone dependence among middle school students is heterogeneous. Reducing the loneliness of individuals and cultivating good selfcontrol ability are helpful to alleviate mobile phone dependence behavior among middle school students.

Objective To study its effect and mechanism of epigallocatechin-3-gallate(EGCG)on the generation of Aβ42 in N2a/APP695swe cells.Methods The N2a/APP695swe cells were cultured in vitro and treated with different concentrations of EGCG(or in combination with LXRβ antagonist GSK2033).The DM-SO group and wild type N2a/wt group were set.The cellular survival rate was detected by the MTT assay;ELISA was used to detect the Aβ42 level;Western blot was used to detect the expression levels of LXRβ,RXRα,ABCA1,caveolin-1 and BACE1 proteins.Results The cellular survival rate and Aβ42 level in the 20,40 μmol/L EGCG cells groups were significantly improved compared with the other groups(P＜0.05),more-over which showed the concentration dependence(P＜0.05).After 20 μmol/L EGCG action,the expression levels of LXRβ,RXRα and ABCA1 protein were increased,the expression levels of caveolin-1 and BACE1 pro-tein were significantly decreased,and the differences were statistically significant(P＜0.05);after treating the cells by combining with GSK2033,the expression levels of LXRβ,RXRα and ABCA1 protein were significantly decreased and caveolin-1 and BACE1 protein expression levels were significantly increased(P＜0.05).Conclu-sion The generation of Aβ42 in N2a/APP695swe cells could be inhibited by EGCG,thus which inhibits the cellular proliferation,and its mechanism may be related to EGCG activating the LXRβ-RXRα-ABCA1 path-way,and then inhibiting the expression of caveolin-1 and BACE1.

Objective: To analyze the developmental trajectories of middle school students loneliness and social support, as well as to explore the interaction between loneliness and social support, so as to provide the evidence based support for the mental health development of adolescents. Methods: A total of 989 first year students from four public middle schools in Xiangxi Tujia and Miao Autonomous Prefecture, Hunan Province were selected for three follow up surveys by a cluster random sampling method (T1:March 2023, T2:June 2023, T3:December 2023). The UCLA Loneliness Scale-20 (ULS-20) and Social Support Scale for University Students (SSSUS) were employed for questionnaire data collection. The growth mixture modeling was utilized to test the developmental trajectories of loneliness and social support among middle school students, while the cross lagged analysis was performed to investigate their mutual influence. Results: The scores for loneliness and social support in T1, T2 and T3 were (43.1±5.8, 42.5± 6.8 , 42.0±6.9; 55.9±12.0, 60.7±15.7, 60.4±16.7), respectively. Correlational analysis revealed a significant negative correlation between loneliness levels (T1, T2, T3) and social support (T1, T2, T3) ( r =-0.47 to -0.36, P <0.01). Growth mixture modeling indicated a linear declining trend of middle school students loneliness, and the developmental trajectory of social support showed a linear increasing trend, with significant individual differences in initial levels and rates of change ( P <0.05). Cross lagged analyses revealed that loneliness levels at T1 negatively predicted social support scores at T2 ( β =-0.16), and loneliness levels at T2 negatively predicted social support scores at T3 ( β =-0.12) ( P <0.05). Additionally, prior loneliness positively predicted its subsequent levels, with path coefficients of 0.58 and 0.47, respectively ( P <0.05). Social support scores at T1 negatively predicted loneliness levels at T2 ( β =-0.10), while scores at T2 negatively predicted loneliness levels at T3 ( β =-0.15) ( P <0.05). Prior loneliness also positively predicted its subsequent levels, with path coefficients of 0.43 and 0.44, respectively ( P <0.05). Conclusion The developmental trajectory of middle school students loneliness demonstrates a decreasing trend, while that of social support exhibits a linear increasing trend, indicating a longitudinal causal relationship between loneliness and social support.

ObjectiveTo investigate the satisfaction of both service providers and users in community health service centers through questionnaires， and to analyze the reasons， so as to put forward suggestions for improving satisfaction. MethodsSampling was conducted in 247 community health service centers in 16 districts of Shanghai， and data were collected from employees and patients through on-site questionnaires. ResultsA total of 10 334 eligible questionnaires were collected from community health service centers， of which 7 712 were from patients and 2 622 were from employees. In 2021， the public's satisfaction with community health service centers was 96.51 points， and the satisfaction of employees was 94.08 points. The public expressed lower satisfaction with the availability of essential drugs for outpatient services， while the staff were less satisfied with their salary and benefits， work recognition， and career development. Regarding family doctor services， 73.38% of the public had signed up for family doctor services， while 23.57% of the public did not know about the family doctor services， and 16.18% believed it was necessary to improve the publicity of basic public health services. ConclusionThe public's overall satisfaction with the service of community health services is gradually increased. The basic medical services of community health are recognized by residents. Drug allocation needs to be improved urgently， and publicity and promotion need to be further strengthened. The overall satisfaction of employees is high， but further improvement is needed in terms of salary and benefits， work recognition， and career development.

Neonatal hyperbilirubinaemia, clinically presenting as jaundice, is a ubiquitous and commonly a benign metabolic condition in newborn infants.It is a leading cause of hospitalization of neonates in the first week of life.Serum bilirubin has been considered as the most potent superoxide with the peroxyl radical scavenger activity.However, uncontrolled hyperbilirubinaemia or rapidly rising bilirubin can reach a neurotoxic concentration, potentially leading to central nervous system sequelae.Thus, the health status of jaundiced newborn infants is dependent on striking an appropriate balance between the protective effects of serum bilirubin and the risk of bilirubin neurotoxicity.In order to standardize the management of neonatal hyperbilirubinemia (jaundice), many countries have developed clinical practice management guidelines.This review sorted out and briefly interpreted the main contents of clinical management guidelines for neonatal hyperbilirubinemia drafted by the American Academy of Pediatrics and other countries, aiming to provide references of clinical diagnosis and treatment practice to domestic pediatrician.

Objective To evaluate the clinical experience of extracorporeal membrane oxygenation (ECMO) treatment on two cases of infection with the critical Corona Virus Disease 2019 (COVID-19) complicated by fulminant myocarditis (FM) . Methods This study selects two COVID-19 cases comorbid with fulminant myocarditis and had been treated with ECMO in Shenzhen Third People's Hospital from January 2020 to February 2020. We compare the index of inflammation, immunization, D-dimer and lactic acid before and after ECMO treatment in 24 and 96 hours, cardiopulmonary function before and after ECMO treatment in 24, 48, 72, 96 hours,. We also analyze the complications and clinical outcomes of the two cases during the ECMO treatment. Results Both patients were elderly obese men with chronic cardiopulmonary disease. Comparing the laboratory test results and imaging data of the two patients, the acute lung injury score, oxygenation index, albumin level, hypersensitive C-reactive protein, lactate and lactate dehydrogenase levels in 2 patients after ECMO treatment were improved as compared with those before ECMO treatment. Finally, case 1 died of multiple organ failure and his cardiac function continued to deteriorate, while, case 2 successfully withdrew and his cardiac function gradually improved. Conclusions For critical COVID-19 patients with fulminant myocarditis, ECMO treatment can improve pulmonary function in the short term, provide valuable time for rescuing COVID-19 patients with fulminant myocarditis.

Purpose To investigate the clinicopathologic features of desmoplastic fibroma of bone (DF).Methods The clinical and pathologic profiles of 7 cases were retrospectively analyzed.Results Desmoplastic fibroma of bone was a rare neoplasm of bone,which typically occurred in young children and adolescents.The tumor showed infiltrative and locally aggressive nature,the most common sites were long tubular bones and mandible.Microscopically,the tumor was composed of sparse fibroblasts in a rich background of collagen fibers.Immunohistochemically,the tumor cells were positive for vimentin and SMA.Conclusion Desmoplastic fibroma is a rare,locally aggressive fibroblasticlesion of bone.It can make an accurate diagnosis by integrating the clinical location with histopathological features.Trauma,hormone and horomosome aberration may be related with its pathogenesis.

Objective To discuss the application form, method and effect of blending learning based on MOOC in Obstetrics and Gynecology Nursing Course, so as to improve learning quality and com-prehensive qualities of students. Methods Randomly selected a nursing undergraduate class as experi-mental group (n=190) and another as control group (n=189);blending learning and traditional teaching model were adopted, respectively. T test and chi-square test were used to compare scores of final exam in two groups, and Rating Scale of Self-directed Learning Competence for Nurses and Scale of Clinical Commu-nication Competence for Nursing Students were used to evaluate two groups before and after the course. Results The average score (76.30±7.08) and excellent rate (35.79％) in the experimental group were higher than those in the control group of (74.78 ±7.18) and 25.93％, with significance differences (P<0.05);Surveys showed that after the course, the autonomous learning ability and the clinical communication ability of students in the experimental group were better than before, and were better than those in the control group. Conclusion Blending learning can be applied to Obstetrics and Gynecology Nursing Course, which can effectively improve learning quality and enhance students' ability of independent study and clinical com-munication, with satisfactory teaching effects to both teachers and students.

Objective To explore the methods and results of the application of formative assessment in gynecology and obstetrics nursing teaching.Methods In the gynecology and obstetrics nursing teaching practice,556 undergraduate students in Grade 2011 were set as experimental group while 339 students in Grade 2010 as control group.Based on the teaching syllabus,in the experimental group,traditional lecture and bilingual teaching method were applied in theory courses and PBL or PBL combined with Scene simulation were applied in practice lessons.And after the teaching,formative assessment was applied in the experimental group,which included setting up small study groups and learning files,giving evaluation to students' participation in class activities,written assignments,operation exams,attendance to classes and their in-class test results.In the evaluation of a student,the results of formative assessment took a proportion of 50％ and the final exam result took the other half.While in the control group,traditional summative assessment was applied,namely,results of the final exams were the terminal results of students.Results Gynecology and obstetrics nursing got the first prize in the Final-term Assessment of Teaching Efficiency of the Nursing School.When comparing the results of the final exam of the students in the experimental group and the control group,there was statistically difference(P=0.000),and 86％ of the students in the experimental group were in favor of formative assessment.Conclusion When applied in gynecology and obstetrics nursing teaching in undergraduate students,formative assessment can help teachers adjust teaching methods to improve the effectiveness of teaching; it can also make students more motivated in learning and help students form good learning habits and improve their learning strategies,which can improve students' comprehensive quality.

Objective To investigate the protective effects of hypereapnia on acute lung injury(ALI)in an model of rabbits in vivo,and to observe its effect on oxygen free radicals in the lung tissue in order to uncover the potential mechanisms.Method In the laboratory of pharmacology,China Medical Univereity,twenty-two healthy New Zealand white rabbits were randomly assigned to control group(Group C,n=6)with the injection of normal saline(0.1 ml/kg),and sixteen rabbits were injected with oleic acid(0.1ml/kg)intravenously,and then were randomly dirided into normocapnia group(Group N,n=8)and hypercapnia group(Group H,n=8,FiCO2=8%).Then tracheostomy was performed,and the experimental animals were ventilated for 3 hours after oleic acid or sterile normal saline administration.Lung mechanics,hemodynamics,blood-gas analysis were monitored.The rabbits were exsangninated.and the lungs and heart were taken out from the thorax.The concentration of superoxide dismutase(SOD)and malondialdehyde(MDA)in the lung tissue were assayed.Lung tissue wet/dry ratio and pulmonary permeability index were measured and histologic damage was assessed after three hours'mechanical ventilation.Results Peak airway pressure in Group H was significantly lower than that in Group N and the dynamic lung comphance Was significantly higher than that in Group N(P＜0.05).PaO2 in Group H was significantly higher than that in Group N(P＜0.05).The concentration of MDA in the lung tissue in group H was significantly lower than that in Group N(P＜0.05),and SOD in group H was significantly higher than that in Group N(P＜O.05).Lung tissue wet/dry ratio and pulmonary permeability in group H were significantly lower than that in Group N(P＜0.05).Histological tissus damage in Group N wassignificantly severer than that in Group H.Conclusions Hypercapnia induced by inhalation of high concentration of carbon dioxide(8%)plays protective role in this in vivo model of ALI.The mechanisms may be associated with enhanced SOD activity and the attenuation of lipid peroxidation in the lung tissue.