Objective To explore the efficacy of goal management training(GMT)on core symptoms and mental status in college students with attention deficit hyperactivity disorder(ADHD)inattentive type.Methods Delphi method was used to construct a GMT program for college students with inattentive ADHD.Then,totally 68 college students with inattentive ADHD were recruited through advertisements published by hospitals and universities(Second Affiliated Hospital of Army Medical University,and 3 universities in Chongqing from March to June 2024.The subjects were randomly divided into an intervention group(n=34)and a control group(n=34).The intervention group received GMT for 2 h,once a week,for 7 weeks,and the control group did not receive training for the time being.The 2 groups were evaluated within 1 week before and in 7 weeks after intervention by using Adult ADHD Self-Report Scale(ASRS),Dysregulation of Emotions Rating Scale(DERS),Generalized Anxiety Disorde-7(GAD-7),Patient Health Questionnaire-9(PHQ-9),Self-Compassion Scale(SCS),and Satisfaction with Life Scale(SWLS).Results ① The expert authority coefficient(Cr)of 2 rounds of expert consultation was 0.83,with a questionnaire recovery rate of 100%and 95%,respectively,the Kendall's coordination coefficient was 0.081(P<0.01)and 0.226(P<0.01),and the coefficient of variation was<0.3,indicating the results of the expert consultation were reliable.The constructed GMT program includes 1 first-level indicator,7 second-level indicators,and 20 third-level indicators.② After 7 weeks of GMT intervention,the interaction between the 2 groups and time showed that the experimental group obtained significant improvements than the control group in terms of inattention symptoms(Wald Chi-square=28.35,P<0.001),dysregulation of emotions(Wald Chi-square=23.81,P<0.001),anxiety(Wald Chi-square=22.79,P<0.001),depression(Wald Chi-square=20.52,P<0.001),self-compassion(Wald Chi-square=9.36,P<0.01),and life satisfaction(Wald Chi-square=3.97,P<0.05).Conclusion GMT intervention can significantly improve the core symptoms of college students with inattentive ADHD,reduce anxiety and depression levels,enhance their emotion regulation and self-compassion abilities,and improve their life satisfaction.

Objective:To evaluate the perioperative application effect of enhanced recovery after surgery (ERAS) clinical pathway in percutaneous vertebro plasty (PVP).Methods:The clinical data of 274 patients who underwent PVP treatment for osteoporotic vertebral compression fracture (OVCF) in Beijing Friendship Hospital, Capital Medical University from May 2023 to August 2024 were retrospectively analyzed. The patients were divided into two groups according to the different numbers of surgical segments: the single-segment group ( n=211) and the multisegment group ( n=63). Patients in the single-segment group underwent single-segment surgery, while patients in the multisegment group underwent surgery on ≥2 segments. The core points of the ERAS clinical pathway adopted in this study include perioperative education, pain management, early mobilization, application of "outfast", and joint guidance from the departments of nutrition and rehabilitation. Comparison was made between the two groups of patients in terms of visual analog scale (VAS) scores for low back pain at preoperative, 2 h, 6 h, 24 h postoperatively, and on the day of discharge; Oswestry disability index (ODI) scores preoperatively and on the day of discharge; time to first ambulation postoperatively, total length of hospital stay, postoperative length of stay, perioperative complications, and perioperative application of Opioid consumption. Measurement data were expressed as mean±standard deviation ( ± s), and the independent sample t-test was used for comparison between groups; count data were expressed as cases and percentage, and the Chi-square test was used for comparison between groups. The VAS pain scores at each stage of the perioperative period were evaluated using repeated measures analysis of variance or generalized estimating equations. Results:Compared with that before the operation [(6.17±0.93) points, (6.29±0.83) points], the VAS scores of low back pain of patients in the single-segment group and the multisegment group at 2 hours after surgery [(3.09±0.82) points, (3.27±0.65) points], 6 hours after surgery [(2.60±0.79) points, (2.62±0.55) points], and 24 hours after surgery [(1.89±0.77) points, (1.97±0.72) points] and on the day of discharge [(1.72±0.71) points, (1.81±0.64) points] were significantly decreased, and the differences were statistically significant ( P<0.05). At the same stage, the VAS scores of low back pain in both groups were not statistically significant ( P>0.05). The ODI scores of patients in the single-segment group and the multisegment group on the day of discharge [(24.21±2.35) points, (24.63±3.31) points] were significantly lower than those before the operation [(64.50±4.81) points, (65.52±4.08) points], and the differences were statistically significant ( P<0.05). There were no statistically significant differences in perioperative complications and the proportion of Opioid drug application between the two groups of patients ( P>0.05). Conclusion:For patients with single-segment or multisegment OVCF, PVP surgical treatment under ERAS clinical pathway management can achieve immediate pain relief, early ambulation exercise, and satisfactory perioperative efficacy.

Objective To assess the prevalence and clinical features of nonalcoholic fatty liver disease(NAFLD)and its risk factors in patients with CHF,so as to provide the reference for early identification of NAFLD.Methods The data from 1120 CHF patients aged 14～89 was collected,including the general demographic information(age,gender,smoking status,height,weight,BMI,etc.),clinical diagnosis and treatment data(blood pressure,NYHA heart function classification,blood biochemical indicators,etc.),and medication use status.SPSS 27.0 was applied to analyze the clinical characteristics of CHF combined with NAFLD,and binary multivariate logistic regression was used to analyze the independent risk factors of CHF combined with NAFLD.Results Among the 1120 patients,634(56.6%)were male and 486(43.4%)were female.The prevalence of CHF patients with NAFLD was 25.0%.The results of univariate analysis showed that the weight of NAFLD patients BMI,systolic blood pressure,diastolic blood pressure,FPG,UA,left room expansion ratio,ALT,CHO,TG,obesity rate,hyperuricemia rate and β-blocker usage rate were all higher than those of non NAFLD patients.The age,BNP,HDL and ACEI/ARB/ARNI usage rate of NAFLD patients were lower than those of non NAFLD patients(all P<0.05).Logistic regression analysis showed that age(OR=0.988),FPG(OR=1.099),overweight(OR=3.497)and obesity(OR=9.193)were independent risk factors for CHF patients with NAFLD.Conclusion NAFLD may be a common complication in CHF patients,especially those who are young,have high FPG,overweight and obese.In the clinical practice,NAFLD screening,evaluation and management should be focused on CHF patients who are young,have high fasting blood sugar,overweight,and obese.

Objectives To identify key clinical factors influencing recurrence in osteosarcoma patients,to construct and validate a Nomogram-based recurrence risk prediction model,thereby providing a quantitative tool for clinical decision-making and recurrence prevention/control.Methods Clinical data of 469 osteosarcoma patients admitted to Yunnan Cancer Hospital between 2013～2022 were retrospectively collected.Statistical analysis was performed using R software(version 4.3.2).Potential influencing factors were initially screened via univariate analysis and LASSO regression analysis.Independent predictors of osteosarcoma recurrence were then identified using multivariate logistic regression analysis.Based on the identified independent factors,a Nomogram prediction model for recurrence risk was constructed.The area under the receiver operating characteristic curve(AUC)was used to evaluate the model's discriminative ability.Results Among the entire cohort,68 patients experienced recurrence,yielding a recurrence rate of 14.50%.Multivariate analysis identified the following as independent predictors of recurrence:Primary Tumor Location:Tibial lesions(P=0.009)were associated with a significantly lower recurrence risk compared to femoral lesions(OR=0.297),while lesions in"Other Bones"(P=0.008)carried a significantly higher risk(OR=3.294).Biopsy Method:Needle biopsy(P=0.033)was associated with a significantly lower recurrence risk compared to open biopsy(OR=0.461).Lung Metastasis Status:Patients with lung metastasis(P<0.001)had a significantly higher recurrence risk than those without(OR=11.873).Lymphocyte Count:A higher lymphocyte count(P=0.001)was a protective factor,associated with a lower recurrence risk(OR=0.450).The constructed Nomogram prediction model demonstrated excellent performance:Validation results showed an AUC=0.842(95%CI:0.806～0.875),indicating outstanding discriminative ability.Conclusions This study successfully constructed and validated a Nomogram prediction model for osteosarcoma recurrence risk integrating key clinical factors.The model demonstrates superior discriminative ability and can accurately and quantitatively assess the recurrence risk for individual patients.This tool thus provides critical reference for guiding clinical treatment decisions.

Objective:To study the relationship between adult fluoride exposure and grip strength in rural areas of China with fluorosis, as well as the roles of basal metabolic rate (BMR) and body fat percentage (BFP) in the association between fluoride exposure and grip strength.Methods:From April to May 2017, a cluster sampling method was used to conduct a questionnaire survey, physical examination, and biological sample collection on residents aged 18 - 60 in Tongxu County, Kaifeng City, Henan Province (epidemic areas of drinking-water-borne fluorosis). A total of 1 168 subjects were included in the study, including 427 males and 741 females. The fluoride ion selective electrode method and the picric acid method were used to determine the concentrations of urine fluoride and urine creatinine, and the adjusted urine fluoride concentration (CUF) was calculated. BMR and BFP were measured by a bioelectrical impendence method, and the grip strength was measured by a Jamar grip dynamometer. The relationship between CUF, BMR, BFP and grip strength were analyzed using a generalized linear model regression. The mediation effect model was used to assess the mediating effect of BMR and BFP on the association between CUF and grip strength.Results:Female grip strength decreased by 0.28 kg ( P = 0.043) for every 1.00 mg/L increment in CUF. No similar association was found between the two in males ( P = 0.744). Regardless of gender stratification, BMR was positively correlated with grip strength ( P < 0.001). For every 1.00% increase in BFP, female grip strength decreased by 0.18 kg ( P = 0.043). The mediation effect model analysis results showed that the mediation effect ratios of BMR and BFP in the association between CUF and grip strength in female were 65.1% ( P < 0.001) and 8.4% ( P = 0.111), respectively. Conclusion:Fluoride exposure is associated with changes in female grip strength, and BMR changes play a partial mediating role in the association between fluoride exposure and female grip strength.

Objective To investigate the value of multiparametric magnetic resonance imaging(MRI)texture analysis based on T2 weighted image(T2WI),diffusion weighted imaging(DWI),and dynamic contrast enhanced-MRI(DCE-MRI)in predicting the axillary lymph node status of small-sized invasive ductal carcinoma(IDC)of the breast.Methods A retrospective analysis was conducted on the medical records of 139 patients with newly diagnosed IDC,who were treated at Taizhou Central Hospital from January 2018 to June 2023.Based on the postoperative pathological results,the patients were divided into two groups:85 cases without axillary lymph node metastasis and 54 cases with axillary lymph node metastasis.All patients underwent preoperative MRI examination,including sequences such as T2WI,DWI,and DCE-MRI.After delineating the region of interest(ROI)on the slice with the largest tumor diameter in each sequence,texture analysis was performed using Firevoxel software,which yielded five major parameters,including mean,standard deviation,skewness,kurtosis,and entropy.Univariate analysis was employed to evaluate the effectiveness of each parameter in distinguishing the axillary lymph node status.Variables that showed significant results in the univariate analysis were then included in binary Logistic regression analysis to explore the relationship between these parameters and lymph node metastasis status.Receiver operating characteristic(ROC)curves were plotted,and the area under the curve(AUC)was calculated.Results Significant differences were observed between the two groups in the entropy and mean values of the ROI delineated on the DCE-MRI sequence,as well as the skewness of the T2WI(P<0.001).Among these texture parameters,the entropy of the DCE-MRI sequence showed the highest AUC value of 0.719 in the univariate analysis.Multivariate analysis of the selected parameters yielded an optimal diagnostic model,with an AUC of 0.769 in differentiating lymph node metastasis from non-metastasis.Conclusion Texture analysis of small-sized breast cancer based on multiparametric MRI can effectively predict the preoperative axillary lymph node status of breast cancer.

Objective:To explore the predictive value of the prognostic nutritional index (PNI) in concurrently infected patients with acute-on-chronic liver failure (ACLF).Methods:220 cases with ACLF diagnosed and treated at the First Affiliated Hospital of Xi'an Jiaotong University from January 2011 to December 2016 were selected. Patients were divided into an infection and non-infection group according to whether they had co-infections during the course of the disease. Clinical data differences were compared between the two groups of patients. Binary logistic regression analysis was used to screen out influencing factors related to co-infection. The receiver operating characteristic curve was used to evaluate the predictive value of PNI for ACLF co-infection. The measurement data between groups were compared using the independent sample t-test and the Mann-Whitney U rank sum test. The enumeration data were analyzed using the Fisher exact probability test or the Pearson χ2 test. The Pearson method was performed for correlation analysis. The independent risk factors for liver failure associated with co-infection were analyzed by multivariate logistic analysis. Results:There were statistically significant differences in ascites, hepatorenal syndrome, PNI score, and albumin between the infection and the non-infection group ( P ?

In recent years, group psychological training has become one of the most important skills that must be mastered by psychological workers in colleges and universities. However, there are problems with its teaching models, such as unreasonable course content, insufficient autonomous practice, and the lack of teaching competency assessment. Based on the theory of modules of employable skills (MES), we have constructed the core modules of group psychological training on teaching course content and skills, and in accordance with the BOPPPS teaching model, we have achieved satisfying teaching effects though the teaching practice of "bridge-in-theory and discussion-teaching practice and supervision-effectiveness assessment and summarization", in which the trainees have made objective progress in theory application, scheme design, and skill practice, with a high degree of subjective self-satisfaction. According to the problems found in the teaching practice, we will further improve the model by optimizing the modules, innovating teaching implementation methods, refining competency assessment standards, and strengthen the overall integration with medical education in order to better meet the needs of the development of psychological service in colleges and universities.

Objective To explore the correlation of CPNE3 expression with long-term prognosis of patients with gastric cancer(GC)and the possible mechanism.Methods We retrospectively collected the data of 104 GC patients undergoing radical surgery in our hospital from February,2013 to October,2017.TCGA database and immunohistochemistry were used to analyze CPNE3 expression level in GC tissues and its effects on tumor progression and long-term prognosis of the patients.GO analysis was performed to predict the biological role of CPNE3 in GC.We also conducted cell experiments with MGC803 cells and observed the effects of CPNE3 knockdown,CPNE3 overexpression and LY294002(a PI3K/AKT inhibitor)treatment on cell apoptosis and cellular expressions of apoptotic proteins using flow cytometry and Western blotting.Results TCGA analysis and immunohistochemistry both showed high expressions of CPNE3 in GC(P<0.05).The patients with high CPNE3 expressions had a reduced 5-year survival(P<0.01),and a high CPNE3 expression,CEA level≥5 μg/L,CA19-9 level≥37 kU/L,T3-T4 stage,and N2-N3 stage were all independent risk factors for a lowered 5-year survival rate after surgery.The sensitivity and specificity of CPNE3 for predicting 5-year mortality was 79.59%and 74.55%,respectively(P<0.05).GO analysis predicted that CPNE3 negatively regulated GC cell apoptosis.In MGC803 cells,CPNE3 knockdown significantly increased cell apoptosis,enhanced Bax and Cleaved Caspase-3 expressions and decreased Bcl-2 expression,while CPNE3 overexpression produced the opposite results(P<0.05).The cellular expressions of p-PI3K and p-AKT were significantly decreased following CPNE3 knockdown and increased following CPNE3 overexpression(P<0.05).Treatment with LY294002 obviously attenuated the inhibitory effect of CPNE3 overexpression on apoptosis of MGC803 cells(P<0.05).Conclusion CPNE3 is highly expressed in GC tissues and affects the long-term prognosis of the patients possibly by inhibiting GC cell apoptosis through activation of PI3K/AKT signaling.

Objective To construct a group psychological training for junior officers based on competency model and explore its intervention effect on competency and mental health of junior officers.Methods Delphi method was used to construct a group psychological training program for junior officers based on competency model.A total of 63 junior officers were subjected with convenience sampling during October and November 2023.According to the principle of randomized controlled experimental design,the participants were divided into experimental group(n=30)and control group(n=33).The experimental group was given our group psychological training program for totally 8 sessions,90～120 min per session,2 sessions per week,while the control group received no such training.Competency scale,12-item general health questionnaire(GHQ-12),Chinese perceived stress scale(CPSS),and Neuroticism Extraversion Openness Five-Factor Inventory(NEO-FFI)were used to assess the 2 groups before and at the end of intervention.Results ① The results of the 2 rounds of expert consultation showed that the total recovery rate was 100％,the expert authority coefficient was 0.87,the Kendall's coordination coefficients(ω)of the 2 rounds of expert consultation were 0.102(P＜0.001)and 0.410(P＜0.001),respectively,with a coefficients of variation of＜0.3,indicating reliable expert consultation.(2)The results of post-intervention time main effect indicated that the total score of competence(P＜0.001),extroversion score(P＜0.05)and responsibility score(P＜0.01)were significantly higher,but the total score of GHQ-12 was obviously lower in the experimental group than the control group(P＜0.001).(3)The results of post-intervention group main effects revealed that the extraversion score of the experimental group was significantly higher than that of the control group(P＜0.01).(4)The results of the post-intervention time × group interaction displayed that the experimental group had notably higher total competency score(P＜0.01),job performance score(P＜0.05),extraversion score(P＜0.05),agreeableness score(P＜0.001)and responsibility score(P＜0.01),but lower total GHQ-12 score(P＜0.01)than the control group.Conclusion Competency-based modeling group psychological training for junior officers can significantly enhance the competency,strengthen the extroversion,agreeableness and responsibility in personality traits,and thus improve job performance for them.