Abstract The global prevalence of non-suicidal self-harm (NSSI) among adolescents is becoming increasingly severe. Traditional mental health services are struggling to meet the growing social demand due to limited resource allocation and service accessibility. The rapid development of artificial intelligence (AI) technology provides a new technological path. The article systematically reviews the research progress of AI technology in adolescent NSSI, demonstrating key technologies such as machine learning, natural language processing, and deep learning in predicting NSSI risk prediction, emotion recognition and online intervention for adolescents. However, challenges remain, including algorithm bias, data privacy protection, model interpretability and ethical decision making. Future research should focus on multi disciplinary collaborative cooperation based on artificial intelligence to build a safe, effective and sustainable digital psychological intervention system, so as to provide innovative strategies and technical support for the early warning and intervention of NSSI behavior in adolescents.

Objective To investigate the plaque characteristics evaluated by intravascular ultrasound(IVUS)in perimenopausal women with coronary artery disease(CAD)and their impacts on the outcomes of stent implantation.Methods A total of 169 female CAD patients who were admitted to the Fourth People's Hospital of Langfang City from March 2021 to March 2023 were selected as research objects.All the patients underwent coronary angiography(CAG)and IVUS to identify plaque characteristics.Based on the plaque stability,the patients were assigned to stable plaque group(n=105)or unstable plaque group(n=64).Clinical data,IVUS parameters,coronary stent placement,and the incidence of major adverse cardiac events(MACE)were compared between the two groups.Results The plaque burden in the unstable plaque group was higher than that in the stable plaque group,while the minimal lumen area in the unstable plaque group was lower than that in the stable plaque group(P<0.05).The incidences of thrombosis,plaque rupture,and calcification in the unstable plaque group were higher than those in the stable plaque group(P<0.05).The stent placement rate and achievement rate in the unstable plaque group were higher than those in the stable plaque group(P<0.05).Kaplan-Meier survival analysis showed that the incidence of MACE in the unstable plaque group was significantly higher than that in the stable plaque group(HR=2.257,95%CI:1.184-4.303,log-rank P=0.007).Conclusion IVUS shows high value in evaluating plaque characteristics in perimenopausal women with CAD.It can be used as an important tool to optimize treatment strategies.

To summarize the perioperative nursing experience of a patient with thoracic and abdominal aortic dissection aneurysm after Stanford type A aortic dissection surgery,who underwent intra-abdominal aortic aneurysm endovascular isolation,in situ fenestration branch covered stent placement,and artificial blood vessel bypass.The nursing points include regular evaluation of the intra-abdominal pressure of the patient,being on guard against the rupture of the dissection;specialist nurses participated in the preoperative multidisciplinary discussion;establishing an emergency plan for the rescue of ruptured aortic dissection;monitoring the vital signs of patients closely to prevent critical complications during surgery.After multidisciplinary treatment and meticulous care,the patient's surgery went smoothly and the postoperative recovery was good.The patient was discharged 8 days later.

Objective:To investigate the application effect of web-based problem-based learning (WPBL) versus traditional teaching in the teaching of geriatric medicine courses.Methods:PubMed, Embase, the Cochrane Library, Web of Science, CNKI, CBMdisc, and Wanfang Data were searched for clinical studies on the application of WPBL in the teaching of geriatric medicine courses in China and globally published up to October 1, 2023. After literature screening, data extraction, and quality assessment, RevMan5.4.1 was used to perform a systematic review.Results:A total of 14 eligible articles were included in this study, with 1 436 medical students as the subjects and geriatric medicine as the content of teaching. The Meta-analysis showed that WPBL teaching had a better effect than traditional problem-based learning or lecture-based learning in the teaching of geriatric medicine courses and could improve the theoretical examination score [mean difference (MD)=3.53, 95% confidence interval (CI)=1.77-5.29, P<0.001], operational skills (MD=5.92, 95%CI=2.67-9.18, P<0.001), critical thinking ability (MD=9.30, 95%CI=5.43-13.18, P<0.001), and teaching satisfaction (MD=1.75, 95%CI=1.49-2.01, P<0.001) among medical students. Conclusions:WPBL in the teaching of geriatric medicine courses can improve the theoretical examination score, operational skills, critical thinking skills, and teaching satisfaction among medical students.

Objective:To investigate the application effect of web-based problem-based learning (WPBL) versus traditional teaching in the teaching of geriatric medicine courses.Methods:PubMed, Embase, the Cochrane Library, Web of Science, CNKI, CBMdisc, and Wanfang Data were searched for clinical studies on the application of WPBL in the teaching of geriatric medicine courses in China and globally published up to October 1, 2023. After literature screening, data extraction, and quality assessment, RevMan5.4.1 was used to perform a systematic review.Results:A total of 14 eligible articles were included in this study, with 1 436 medical students as the subjects and geriatric medicine as the content of teaching. The Meta-analysis showed that WPBL teaching had a better effect than traditional problem-based learning or lecture-based learning in the teaching of geriatric medicine courses and could improve the theoretical examination score [mean difference (MD)=3.53, 95% confidence interval (CI)=1.77-5.29, P<0.001], operational skills (MD=5.92, 95%CI=2.67-9.18, P<0.001), critical thinking ability (MD=9.30, 95%CI=5.43-13.18, P<0.001), and teaching satisfaction (MD=1.75, 95%CI=1.49-2.01, P<0.001) among medical students. Conclusions:WPBL in the teaching of geriatric medicine courses can improve the theoretical examination score, operational skills, critical thinking skills, and teaching satisfaction among medical students.

To summarize the perioperative nursing experience of a patient with thoracic and abdominal aortic dissection aneurysm after Stanford type A aortic dissection surgery,who underwent intra-abdominal aortic aneurysm endovascular isolation,in situ fenestration branch covered stent placement,and artificial blood vessel bypass.The nursing points include regular evaluation of the intra-abdominal pressure of the patient,being on guard against the rupture of the dissection;specialist nurses participated in the preoperative multidisciplinary discussion;establishing an emergency plan for the rescue of ruptured aortic dissection;monitoring the vital signs of patients closely to prevent critical complications during surgery.After multidisciplinary treatment and meticulous care,the patient's surgery went smoothly and the postoperative recovery was good.The patient was discharged 8 days later.

Objective To compare the cleaning abilities of ProTaper Gold(PTG)and TF-Adaptive(TFA).Methods Forty single-abstracted premolars were randomly divided into PTG and TFA groups.The debris and smear layer of the root coronal 1/3,middle 1/3 and apical 1/3 in the two groups were observed using scanning electron microscope(SEM).The cleaning abilities of the PTG and TFA rotary systems were scored according to the scoring standard developed by YAMASHITA.The scores of the two groups were compared and then analyzed.Results There was no significant difference found in the scores of the smear layer and debris at the root coronal 1/3 and the middle 1/3.The scores of the debris and smear layer at the apical 1/3 in the group PTG were higher than those in the TFA group(P<0.05).Conclusion PTG and TFA can effectively remove the root canal smear layer and debris at the root coronal 1/3,and the middle 1/3.However,at the apical 1/3,the cleaning efficiency of TFA is better than that of PTG.

To understand the survival stress of community-dwelling people with mental disorder. Fifteen cases were selected by purposive sampling and received semi-structured individualized interviews.The data were analyzed by Colaizzi framework and themes were extracted. Four themes were extracted:physiological stress due to psychiatric symptoms and side effects of drugs;psychological stress due to the outcome of mental illness and to conflict of roles in daily life;social and environmental stress such as social discrimination,lack of job opportunities,and difficulty in obtaining social welfare resources;and interpersonal stress caused by discrimination and deteriorating family relations. Community-dwelling people with mental illness have a higher level survival stress after returning to their families and society,with the stressors including symptoms of illness,social discrimination,and interpersonal relationship.Eliminating self-discrimination of the patients,improving social support and social welfare system,and increasing individualized community mental rehabilitation activities may reduce the survival stress of these patients and promote their rehabilitation.
Humans ; Independent Living ; Mental Disorders ; Qualitative Research ; Social Support

Objective To investigate the effect of anterior artificial vertebral body reconstruction and internal fixation after the failed posterior thoracolumbar fracture surgery.Methods A retrospective case series study was conducted to analyze the clinical data of 14 patients whose posterior thoracolumbar fracture surgery failed admitted to Sir Run Run Shaw Hospital School of Medicine affiliated to Zhejiang University from January 2014 to June 2017,There were eight males and six females,aged 29-69 years[(43.6±11 .9)years].The involved segments included T11 in one patient,T12 in two patients,L1 in five patients,L2 in four patients and L3 in two patients.According to AO classification,there were four patients with type A2,six with type A3,two with type B1 and two with type B2.The thoracolumbar injury severity scores(TLICS)ranged from 4 to 8 points[(5.3±1.1)points].There were six patients with nonunion,three with nonunion following screw loosening,three with nonunion following breakage,and two with neurological dysfunction.Revision plan:for patients with internal fixation loosening or rupture or long nail placement,the posterior internal fixation would be removed first,and then the stage I anterior revision would be performed after changing the position;for patients with complete internal fixation,only anterior revision would be performed.The operation time,intraoperative blood loss,intraoperative and postoperative complications,pain visual analogue score(VAS),Oswestry dysfunction index(ODI)score and kyphosis angle changes before and after operation were recorded.Results All patients were followed up for 12-54 months[(25.9±13.0)months].The anterior operation time ranged from 100 to 180 minutes[(137.9±23.6)minutes].The intraoperative blood loss ranged from 280 to 750 ml[(452.9±145.4)ml].There were no intraoperative or postoperative complications such as spinal nerve injury,cerebrospinal fluid leakage,vascular injury,abdominal organ injury,incision infection and hemorrhage.VAS decreased from preoperative(6.1±0.9)points to(1.9±0.7)points 3 months after operation and to(1.4±0.5)points at the last follow-up;ODI increased from preoperative(30.4±7.1)points to(7.9±6.4)points 3 months after operation and to(8.1±4.3)points at the last follow-up;kyphosis degree decreased from preoperative(-20.1±6.5)° to(5.6±6.4)° 3 months after operation and to(5.4±6.8)0 at the last follow-up.The VAS,ODI score and kyphosis degree were significantly improved at the last follow-up compared with those before operation(P＜ 0.01).Conclusions For patients with failed thoracolumbar fracture posterior surgery,anterior artificial vertebral body reconstruction and internal fixation can significantly relieve back pain,improve function and kyphosis deformity,with satisfactory clinical effect,which can be an ideal treatment option for the revision of thoracolumbar fracture.

Objectives: To study the significance of SATB2 expression in colon adenocarcinoma and its differential diagnosis function for ovarian metastatic adenocarcinoma. Methods: Immunohistochemistry was used to detect the expression level of SATB2 in 130 cases of colon adenocarcinoma. The relationship between the positive rate of SATB2 expression in colon cancer and clinicopathological factors was studied. Forty-seven cases of pancreatic ductal adenocarcinoma, 22 cases of cholangiocarcinoma, 46 cases of gastric adenocarcinoma, and 53 cases of ovarian mucinous adenocarcinoma were studied respectively. Results: The positive expression rate of SATB2 in 130 cases of colon adenocarcinoma is 73.8%. The SATB2 expression bears no correlation with gender, age, tumor size, location, histology type, lymph node metastasis, staging, local recurrence, distant metastasis, survival, Kras mutation, and microsatellite stability. The expression rate of SATB2 is significantly higher in well differentiated and moderately differentiated colon adenocarcinoma than that in poorly differentiated adenocarcinoma (χ²=12.804, P=0.002); the expression rate in the cases without tumor deposit is significantly higher than in cases with tumor deposit (χ²=6.485, P=0.011). There was no positive expression in all cases of pancreatic adenocarcinoma, cholangiocarcinoma, gastric adenocarcinoma, nor in ovarian mucinous adenocarcinoma. Conclusion The expression of SATB2 is associated with the differentiation of colon adenocarcinoma and the formation of tumor deposit. SATB2 can be used as an effective tumor marker for identifying colorectal cancer ovarian metastases.