Objective: To examine the association between academic stress and anxiety-depression comorbidity among college students and the potential moderating effect of physical activity, so as to provide a theoretical basis for the development of evidence based mental health promotion frameworks in higher education institutions. Methods: From October 2022 to June 2024, a total of 7 980 students from 21 universities across five provinces/municipalities in China, including Shanghai, Jiangsu, Zhejiang, Shandong, and Anhui, using a combination of convenience sampling and stratified random cluster sampling. Physical activity, academic stress, anxiety, and depression were assessed by using the 24 hour Movement Behaviors Questionnaire, the Chinese College Students Mental Health Screening Scale, the Generalized Anxiety Disorder-7, and the Center for Epidemiologic Studies Depression Scale, respectively. Binary Logistic regression was used to examine the associations between academic stress and anxiety, depression, and their comorbidity. The PROCESS macro was employed to test the moderating effect of physical activity. Results: The prevalence of anxiety-depression comorbidity among college students was relatively high (11.53%), with significant differences observed across grades and body mass index (BMI) categories ( χ 2=70.30, 24.63, both P <0.01). Binary Logistic regression revealed that, compared with low academic stress, moderate academic stress among male students was significantly associated with greater odds of anxiety ( OR =2.78), depression ( OR =2.75), and anxiety-depression comorbidity ( OR =2.89) (all P <0.01). High academic stress was associated with elevated odds of anxiety ( OR =6.66), depression ( OR =12.81), and anxiety-depression comorbidity ( OR =13.65) (all P <0.01). Among female students, moderate academic stress was associated with anxiety ( OR =2.58), depression ( OR =1.52), and anxiety-depression comorbidity ( OR =1.70) (all P <0.01). High academic stress increased the risk of anxiety ( OR =6.77), depression ( OR =6.81), and anxiety-depression comorbidity ( OR =7.48) (all P <0.05). The moderation analysis indicated that the interaction between total physical activity duration and academic stress had a significant netative moderating effect on anxiety-depression comorbidity among college students ( β =-0.03, P <0.01). Conclusions Academic stress increases the risk of anxiety, depression, and anxiety-depression comorbidity among college students. Physical activity may attenuate the adverse effects of academic stress on anxiety-depression comorbidity.

The Expert Consensus on Clinical Application of Qinbaohong Zhike Oral Liquid in Treatment of Acute Bronchitis and Acute Attack of Chronic Bronchitis （GS/CACM 337-2023） was released by the China Association of Chinese Medicine on December 13^th， 2023. This expert consensus was developed by experts in methodology， pharmacy， and Chinese medicine in strict accordance with the development requirements of the China Association of Chinese Medicine （CACM） and based on the latest medical evidence and the clinical medication experience of well-known experts in the fields of respiratory medicine （pulmonary diseases） and pediatrics. This expert consensus defines the application of Qinbaohong Zhike oral liquid in the treatment of cough and excessive sputum caused by phlegm-heat obstructing lung， acute bronchitis， and acute attack of chronic bronchitis from the aspects of applicable populations， efficacy evaluation， usage， dosage， drug combination， and safety. It is expected to guide the rational drug use in medical and health institutions， give full play to the unique value of Qinbaohong Zhike oral liquid， and vigorously promote the inheritance and innovation of Chinese patent medicines.

Purpose To explore the expression of SHIP2 in esophageal squamous cell carcinoma and its effect on the malignant biological behavior of ESCC cells.Methods The UALCAN database was used to analyze the expression of SHIP2 in esophageal cancer.qRT-PCR and immunohistochemistry SP method were used to measure the expression of SHIP2 in tumor tissues of ESCC patients.SHIP2 mRNA and protein were examined by qRT-PCR and Western blot in human normal esophageal epithelial cells(HEEC)and ESCC cells(KYSE150 and EC109).KYSE150 and EC109 were divided into the NC group and the si-SHIP2 group respectively.Cell proliferation,migration,and invasion were observed by CCK-8 assay,EdU assay,scratch assay,and Transwell assay.The expression of epithelial-mesenchymal transition-related proteins(E-cadherin,N-cadherin,and vimentin)was detected by Western blot.Results The UAL-CAN database showed that SHIP2 expression was higher in esophageal cancer than in normal tissues(P＜0.05).SHIP2 had higher mRNA(2.19±3.20)expression and staining scores(5.33±3.83)in ESCC tumor tissues than in paracarcinoma tissues(1.00±0.80;0.87±1.07,all P＜0.05).SHIP2 had higher mRNA(KYSE150,EC109:1.91±0.22,3.73±1.06)and protein(KYSE150,EC109:0.93±0.12,1.05±0.13)expression in ESCC cells than in HEEC(1.06±0.40;0.31±0.04,all P＜0.05).Cell function experiments showed that compared with the NC group(CCK-8 assay:KYSE150,EC109:2.44±0.12,3.56±0.07;EdU assay:KYSE150,EC109:44.46±4.74,38.82±3.79;scratch assay:KYSE150,EC109:0.85±0.07,0.70±0.06;Transwell migration assay:KYSE150,EC109:130.30±9.53,39.25±3.30;Transwell invasion assay:KYSE150,EC109:121.00±9.54、88.67±6.66);cell proliferation(CCK-8 assay:KYSE150,EC109:1.56±0.03,2.85±0.02,EdU assay:KYSE150,EC109:19.34±6.24,17.39±1.14);migration(scratch assay:KYSE150,EC109:0.51±0.09,0.36±0.02;Transwell migration assay:KYSE150,EC109:71.50±12.07,20.75±2.99),and invasion(Transwell in-vasion assay:KYSE150,EC109:73.33±4.04,12.67±2.31)ability in the si-SHIP2 group was significantly re-duced(all P＜0.05).Western blot results showed that compared with the NC group(0.48±0.21,0.42±0.24;1.00±0.04,1.17±0.18;1.34±0.10,1.00±0.13),the expression of E-cadherin protein(1.10±0.22,1.02±0.20)in the si-SHIP2 group was increased(P＜0.05),while the expression of N-cadherin protein(0.59±0.20,0.84±0.08)and vimentin protein(0.41±0.06,0.338±0.19)was decreased(P＜0.05).Conclusion SHIP2 is overexpressed in ESCC,and the down-regulation of SHIP2 can inhibit the proliferation,migration,and invasion of ES-CC cells.

Objective·To investigate the efficacy and safety of a dose-reduced,all-oral lenalidomide/melphalan/prednisone acetate(RMP)regimen in elderly and frail patients with newly diagnosed multiple myeloma(NDMM).Methods·Elderly and frail NDMM patients who visited the Department of Hematology of Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,and the Third People's Hospital of Kunshan from April 2018 to March 2024 were retrospectively included.Clinical data and laboratory indicators were collected,and all patients were treated with the RMP regimen.SPSS 27.0 and R software were used for statistical analysis.Independent t-test was applied to normally distributed quantitative data,Mann-Whitney U test to non-normally distributed quantitative data,and x2 test and Fisher's exact probability method to qualitative data.Kaplan-Meier survival curves and Log-rank test were used for survival analysis.Results·Among the 22 elderly and frail NDMM patients treated with RMP,the median age was 76.3(68.4,95.0)years,and the median follow-up time was 25.5 months.The overall response rate(ORR)was 68.2%,and the rate of≥very good partial response(VGPR)was 36.4%.The median progression-free survival(PFS)was 20.53 months.The median PFS in the≤75-year-old group was 25.23(95%CI 12.95?37.52)months,while in the>75-year-old group it was 18.23(95%CI 14.86?21.61)months.There was no significant difference between the two groups.The median PFS in the≥partial response(PR)group was 20.67(95%CI 13.57?27.76)months,and in the

Objective To identify determinants of subtherapeutic voriconazole(VRCZ)concentrations in allogeneic hematopoietic stem cell transplantation(allo-HSCT)recipients and to develop/validate a nomogram-based risk prediction model.Methods This study retrospectively analyzed 310 VRCZ therapeutic drug monitoring(TDM)measurements from allo-HSCT recipients at 310 patients who under went allo-HSCT surgery at Hebei Yanda Ludaopei Hospital from October 2022 to October 2024 and received VRCZ for the prevention and treatment of invasive fungal infections before transplantion were selected as the study subjects.Cases were stratified into target-concentration group(0.5～5.0μg/ml)and subtherapeutic group(<0.5μg/ml).Through single factor and multiple factor Logistic regression analysis,indeipendent predictive factors forvecz plasma concentration non-compliance were screened,and a column chart prediction model(NPM)was constructed.The performance of the model was evaluateding area under the receiver operating characteristic curve(AUC),Hosmer-Lemeshow(H-L)goodness-of-fit test,and decision curve analysis(DCA).Results Among 310 VRCZ-TDM measurements,71.61%(222/310)achieved target concentrations.Multivariate analysis showed that CYP2C19 intermediate metabolite,daily dose of cyclosporine A(CSA),daily dose of VRCZ,creatinine(Cr)>97 μmol/L,albumin(Alb)and C-reactive protein(CRP)were independent influencing factors for VRCZ blood drug concentration non-compliance(Wald χ2=4.046～13.221,all P＜0.05).The nomogram demonstrated excellent discrimination,calibration(H-L goodness of fit test χ2=2.663,P=0.954),and clinical utility with net benefit across 0.05～0.96 risk thresholds.Conclusion The nomogram incorporating CYP2C19 gene phenotype,daily CSA dosing,daily VRCZ dosing,Cr levels,Alb and CRP provides a validated tool for optimizing VRCZ therapy in allo-HSCT recipients,enabling precision dosing strategies.

Objective To explore the experiences of master degree nursing students and their supervisors under the dual-supervisor system.Methods A phenomenological research was adopted in this study eighteen master degree nursing students,five principle supervisors and four assistant supervisors from our university were selected through purposive sampling for semi-structured interviews between July and September 2023.Data acquired from the interviews was analysed using Colaizzi's method to summarise and extract the themes.Results Three main themes and eleven sub-themes were extracted,including the collaborative framework of the dual-mentor system(discrepancies in the perception of the dual-mentor system between faculty and students,the selection and matching process for associate mentors,the division of responsibilities and collaborative dynamics between primary and associate mentors,student-centered personalized training strategies,context-specific guidance provided by associate mentors,and the extent to which inter-role communication relies on student initiative),the benefits of the dual-mentor system(encompassing diversified academic and professional guidance,as well as integrated theoretical and practical support)and the expectations held by faculty and students regarding the dual-mentor system(refining institutional design and reinforcing accountability,enhancing the support infrastructure for associate mentors,and improving the tripartite communication mechanism among faculty,students,and associate mentors).Conclusion In nursing postgraduate education,the roles and responsibilities within the dual-mentor system can be more clearly delineated,and inter-mentor collaboration should be further strengthened.It is recommended to enhance tripartite communication among faculty,students,and associate mentors to foster the effective implementation and development of the dual-mentor system.

Objective·To investigate the efficacy and safety of a dose-reduced,all-oral lenalidomide/melphalan/prednisone acetate(RMP)regimen in elderly and frail patients with newly diagnosed multiple myeloma(NDMM).Methods·Elderly and frail NDMM patients who visited the Department of Hematology of Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,and the Third People's Hospital of Kunshan from April 2018 to March 2024 were retrospectively included.Clinical data and laboratory indicators were collected,and all patients were treated with the RMP regimen.SPSS 27.0 and R software were used for statistical analysis.Independent t-test was applied to normally distributed quantitative data,Mann-Whitney U test to non-normally distributed quantitative data,and x2 test and Fisher's exact probability method to qualitative data.Kaplan-Meier survival curves and Log-rank test were used for survival analysis.Results·Among the 22 elderly and frail NDMM patients treated with RMP,the median age was 76.3(68.4,95.0)years,and the median follow-up time was 25.5 months.The overall response rate(ORR)was 68.2%,and the rate of≥very good partial response(VGPR)was 36.4%.The median progression-free survival(PFS)was 20.53 months.The median PFS in the≤75-year-old group was 25.23(95%CI 12.95?37.52)months,while in the>75-year-old group it was 18.23(95%CI 14.86?21.61)months.There was no significant difference between the two groups.The median PFS in the≥partial response(PR)group was 20.67(95%CI 13.57?27.76)months,and in the

Purpose To explore the expression of SHIP2 in esophageal squamous cell carcinoma and its effect on the malignant biological behavior of ESCC cells.Methods The UALCAN database was used to analyze the expression of SHIP2 in esophageal cancer.qRT-PCR and immunohistochemistry SP method were used to measure the expression of SHIP2 in tumor tissues of ESCC patients.SHIP2 mRNA and protein were examined by qRT-PCR and Western blot in human normal esophageal epithelial cells(HEEC)and ESCC cells(KYSE150 and EC109).KYSE150 and EC109 were divided into the NC group and the si-SHIP2 group respectively.Cell proliferation,migration,and invasion were observed by CCK-8 assay,EdU assay,scratch assay,and Transwell assay.The expression of epithelial-mesenchymal transition-related proteins(E-cadherin,N-cadherin,and vimentin)was detected by Western blot.Results The UAL-CAN database showed that SHIP2 expression was higher in esophageal cancer than in normal tissues(P＜0.05).SHIP2 had higher mRNA(2.19±3.20)expression and staining scores(5.33±3.83)in ESCC tumor tissues than in paracarcinoma tissues(1.00±0.80;0.87±1.07,all P＜0.05).SHIP2 had higher mRNA(KYSE150,EC109:1.91±0.22,3.73±1.06)and protein(KYSE150,EC109:0.93±0.12,1.05±0.13)expression in ESCC cells than in HEEC(1.06±0.40;0.31±0.04,all P＜0.05).Cell function experiments showed that compared with the NC group(CCK-8 assay:KYSE150,EC109:2.44±0.12,3.56±0.07;EdU assay:KYSE150,EC109:44.46±4.74,38.82±3.79;scratch assay:KYSE150,EC109:0.85±0.07,0.70±0.06;Transwell migration assay:KYSE150,EC109:130.30±9.53,39.25±3.30;Transwell invasion assay:KYSE150,EC109:121.00±9.54、88.67±6.66);cell proliferation(CCK-8 assay:KYSE150,EC109:1.56±0.03,2.85±0.02,EdU assay:KYSE150,EC109:19.34±6.24,17.39±1.14);migration(scratch assay:KYSE150,EC109:0.51±0.09,0.36±0.02;Transwell migration assay:KYSE150,EC109:71.50±12.07,20.75±2.99),and invasion(Transwell in-vasion assay:KYSE150,EC109:73.33±4.04,12.67±2.31)ability in the si-SHIP2 group was significantly re-duced(all P＜0.05).Western blot results showed that compared with the NC group(0.48±0.21,0.42±0.24;1.00±0.04,1.17±0.18;1.34±0.10,1.00±0.13),the expression of E-cadherin protein(1.10±0.22,1.02±0.20)in the si-SHIP2 group was increased(P＜0.05),while the expression of N-cadherin protein(0.59±0.20,0.84±0.08)and vimentin protein(0.41±0.06,0.338±0.19)was decreased(P＜0.05).Conclusion SHIP2 is overexpressed in ESCC,and the down-regulation of SHIP2 can inhibit the proliferation,migration,and invasion of ES-CC cells.

Objective To identify determinants of subtherapeutic voriconazole(VRCZ)concentrations in allogeneic hematopoietic stem cell transplantation(allo-HSCT)recipients and to develop/validate a nomogram-based risk prediction model.Methods This study retrospectively analyzed 310 VRCZ therapeutic drug monitoring(TDM)measurements from allo-HSCT recipients at 310 patients who under went allo-HSCT surgery at Hebei Yanda Ludaopei Hospital from October 2022 to October 2024 and received VRCZ for the prevention and treatment of invasive fungal infections before transplantion were selected as the study subjects.Cases were stratified into target-concentration group(0.5～5.0μg/ml)and subtherapeutic group(<0.5μg/ml).Through single factor and multiple factor Logistic regression analysis,indeipendent predictive factors forvecz plasma concentration non-compliance were screened,and a column chart prediction model(NPM)was constructed.The performance of the model was evaluateding area under the receiver operating characteristic curve(AUC),Hosmer-Lemeshow(H-L)goodness-of-fit test,and decision curve analysis(DCA).Results Among 310 VRCZ-TDM measurements,71.61%(222/310)achieved target concentrations.Multivariate analysis showed that CYP2C19 intermediate metabolite,daily dose of cyclosporine A(CSA),daily dose of VRCZ,creatinine(Cr)>97 μmol/L,albumin(Alb)and C-reactive protein(CRP)were independent influencing factors for VRCZ blood drug concentration non-compliance(Wald χ2=4.046～13.221,all P＜0.05).The nomogram demonstrated excellent discrimination,calibration(H-L goodness of fit test χ2=2.663,P=0.954),and clinical utility with net benefit across 0.05～0.96 risk thresholds.Conclusion The nomogram incorporating CYP2C19 gene phenotype,daily CSA dosing,daily VRCZ dosing,Cr levels,Alb and CRP provides a validated tool for optimizing VRCZ therapy in allo-HSCT recipients,enabling precision dosing strategies.

Objective To explore the experiences of master degree nursing students and their supervisors under the dual-supervisor system.Methods A phenomenological research was adopted in this study eighteen master degree nursing students,five principle supervisors and four assistant supervisors from our university were selected through purposive sampling for semi-structured interviews between July and September 2023.Data acquired from the interviews was analysed using Colaizzi's method to summarise and extract the themes.Results Three main themes and eleven sub-themes were extracted,including the collaborative framework of the dual-mentor system(discrepancies in the perception of the dual-mentor system between faculty and students,the selection and matching process for associate mentors,the division of responsibilities and collaborative dynamics between primary and associate mentors,student-centered personalized training strategies,context-specific guidance provided by associate mentors,and the extent to which inter-role communication relies on student initiative),the benefits of the dual-mentor system(encompassing diversified academic and professional guidance,as well as integrated theoretical and practical support)and the expectations held by faculty and students regarding the dual-mentor system(refining institutional design and reinforcing accountability,enhancing the support infrastructure for associate mentors,and improving the tripartite communication mechanism among faculty,students,and associate mentors).Conclusion In nursing postgraduate education,the roles and responsibilities within the dual-mentor system can be more clearly delineated,and inter-mentor collaboration should be further strengthened.It is recommended to enhance tripartite communication among faculty,students,and associate mentors to foster the effective implementation and development of the dual-mentor system.