Objective: To explore the interrelationships between mental vulnerability, cognitive emotion regulation strategies, and positive psychological capital in medical postgraduates, so as to provide precise intervention targets for mental health services in universities. Methods: From April to June 2025, a convenience sampling method was used to select 1 461 medical postgraduates from three colleges in Hubei Province. Participants were assessed using the Mental Vulnerability Questionnaire (MVQ), the Cognitive Emotion Regulation Questionnaire-Chinese Version (CERQ-C) and the Positive Psychological Capital Questionnaire (PPQ). The network analysis model was constructed using a Gaussian graphical model. Results: The network analysis revealed that the edge connection between somatic symptoms and mental symptoms was the strongest, followed by the connection between refocus on planning and positive reappraisal within cognitive emotion regulation, with edge weights of 0.69 and 0.59, respectively. Interpersonal problems within psychological vulnerability exhibited the highest expected influence( EI =1.27), serving as the core node of the network. Rumination within cognitive emotion regulation demonstrated the highest bridge expected influence( BEI =0.33), playing a critical connecting role among psychological vulnerability, cognitive emotion regulation, and positive psychological capital. Conclusion In the mental health network of medical postgraduates, mental vulnerability, cognitive emotion regulation, and positive psychological capital interact through their respective key dimensions, jointly affect overall mental health.

This paper aims to discuss the construction and promotion strategy of medical care capacity framework based on the core literacy of palliative care， combining domestic and foreign research and clinical status. The research results show that it is particularly important to construct a framework of medical care competence based on palliative care. The core competencies required for palliative care include the ability to comprehensively evaluate and formulate personalized programs， effective communication skills， interdisciplinary teamwork skills， and the ability to continuously learn and improve themselves. The quality of care can be further improved if the above abilities are incorporated into the framework of medical care ability based on palliative care. However， there are a series of problems in the process of constructing the framework of palliative medical care capacity， such as difficult implementation of policy support， poor professionalism of talent team， single and irregular service model， low social acceptance， and difficult interdisciplinary cooperation and resource integration. After a detailed analysis of the problems， this paper puts forward the countermeasures to construct the framework of caring ability literacy based on palliative care. Effective countermeasures such as increasing policy support， cultivating comprehensive talents， developing diversified palliative care models， improving social recognition， and strengthening interdisciplinary cooperation and resource integration can effectively improve the core literacy and professional ability of medical care personnel， and then promote the development and improvement of palliative care services. In-depth discussion of the above contents can provide scientific reference for building a care model and literacy framework with palliative care as the core.

Objective: To analyze the influencing factors of aggressive behaviors in high school students, rank the importance of relevant variables with visual presentation, so as to provide new references for developing intervention strategies. Methods: In December 2024, a convenience sampling method was used to select 5 330 students from 5 high schools in Wuhan for an online questionnaire survey. The survey included the Buss-Perry Aggression Questionnaire (BPAQ), Interaction Anxiety Scale (IAS), Emotion Regulation Ability Scale, Inventory of Parent and Peer Attachment (IPPA), and a self designed general information questionnaire. Variables were screened using LASSO regression, followed by multivariate Logistic regression analysis. The Random Forest model was then employed to rank and visualize variable importance. Results: Univariate analysis and LASSO regression results indicated that gender, emotion regulation capability, paternal attachment quality, maternal attachment quality, maternal parenting style, paternal parenting style, parenting consistency, monthly household income per capita, school climate, relationship with classmates, interaction anxiety, and academic ranking were all significant variables (all P <0.01). Multivariate Logistic regression analysis identified the following as influencing factors of aggressive behaviors in high school students: emotional management ability ( OR=0.38, 95%CI =0.34-0.43), gender ( OR=0.83, 95%CI =0.75-0.93), mother attachment quality ( OR=0.89, 95%CI = 0.74 -1.07), father attachment quality ( OR=0.76, 95%CI = 0.66- 0.87), interaction anxiousness ( OR=1.58, 95%CI =1.40- 1.78 ), consistency of parenting styles of parents ( OR=1.40, 95%CI =1.21-1.62), school atmosphere ( OR=1.50, 95%CI =1.14-1.98), academic performance ranking (upper middle: OR=0.76, 95%CI =0.61-0.93; middle: OR=0.70, 95%CI =0.57-0.86) were the influencing factors of aggressive behavior in high school students (all P <0.05). The results of Random Forest showed that emotional management ability was the most important factor affecting aggressive behavior in high school students. Conclusion Emotion regulation capability is identified as the core predictor of adolescent aggressive behaviors, which can significantly reduce the incidence of aggressive behaviors through enhanced emotion management.

Objective: To investigate the association between 24 hour activity behavior and body composition among primary and secondary school students using compositional data analysis method, so as to provide scientific guidance for optimizing daily activity allocation and improving physical health. Methods: In June 2021, following the principle of random cluster sampling, 349 primary and middle school students were selected by lottery method from Taiyuan City, Shanxi Province. Compositional multiple regression analysis was conducted to examine the relationship between different 24 hour activity behaviors and body composition indicators. The isotemporal substitution model was adopted to examine the quantitative effects of substituting 10 or 20 minutes among activity behaviors on body composition. Results: In girls, sedentary behavior (SB) time was negatively correlated with fat free mass (FFM) ( β =-4.81); in boys, moderate to vigorous physical activity (MVPA) time was positively correlated with FFM ( β =7.01), while light physical activity (LPA) time was negatively correlated with FFM ( β =-9.26) and positively correlated with body fat percentage (FAT%) ( β =0.09) (all P <0.01). Isocaloric substitution analysis revealed that replacing the same duration of MVPA with SB, sleep (SL), or LPA for 10 or 20 minutes produced significantly greater adverse effects compared to the beneficial effects of MVPA substitution. Replacing MVPA with LPA for 10 minutes resulted in 1.01% increase in FAT% and 0.91% decrease in reverse substitution for boys; replacing MVPA with SB or SL for 10 minutes resulted in a decrease of 1.10 kg and 1.16 kg in FFM for boys, 0.81 kg and 0.74 kg for girls, and reverse substitution increased by 0.92 and 0.97 kg, 0.65 and 0.58 kg, respectively (all P < 0.05 ). When LPA, SB or SL were replaced with MVPA for 20 minutes, the trend of change were basically consistent (all P <0.05). Conclusions Activity behaviors of 24 hour are associated with body composition among primary and secondary school students. MVPA is the primary influential component.

Objective: To analyze the factors associated with high level fear of negative evaluation (FNE) among junior high school students and to construct a nomogram risk prediction model, so as to provide scientific tools for psychological health intervention for junior high school students. Methods: A convenience sampling combined with cluster random sampling method was used to select 5 485 junior high school students from 4 cities (Wuhan, Huanggang, Xianning and Xiaogan) for an online questionnaire survey in March 2025. The total sample was randomly split into a training set ( n =3 839) and a validation set ( n =1 646). Univariate analysis was performed in the training set using Chi-square test and t-test. Variables with statistical significance were subsequently included in multivariate Logistic regression to identify independent predictors and to construct a nomogram based risk prediction model. The discriminative ability and clinical utility of the model were evaluated in the validation set using the area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA). Results: There were 1 649 junior high school students with low level FNE and 2 190 with high level FNE in the training set. The self control ability of junior high school students with lowlevel and high level FNE showed a statistically significant difference (23.96±3.96, 21.48±3.37, t=25.15, P < 0.01 ). Statistically significant differences in the detection rate of high level FNE were observed among junior high school students with different genders, family types, parenting styles, academic rankings, psychological flexibility, mobile phone addiction tendencies, emotional management training, exercise frequency, left behind experiences, and places of origin ( χ 2=82.01- 1 126.68 , all P <0.01). The results of Logistic regression analysis revealed that, the following factors were identified as significant factors influencing high level FNE among junior high school students:exercise frequency ( OR=0.21, 95%CI =0.17-0.26); parenting style ( OR=0.48, 95%CI =0.40-0.58); left behind experience ( OR=3.88, 95%CI =3.27-4.61); smartphone addiction proneness ( OR=2.19, 95%CI =0.89-0.93); self-control ability ( OR=0.91, 95%CI =0.89-0.93); and psychological flexibility ( OR=0.16, 95%CI =0.10-0.28) (all P <0.05). The AUC for the training and validation set were 0.88 (95% CI =0.87-0.89) and 0.87 (95% CI =0.85-0.89), respectively. The Hosmer-Lemeshow goodness of fit test yielded χ 2=8.57, 15.20 (both P >0.05). Conclusion The risk prediction model with high level FNE demonstrates good accuracy and can assist educators and parents in timely screening of junior high school students with high level FNE, thereby providing a basis for implementing targeted interventions.

Objective: To explore the relationship between school sports environment and physical activity levels of middle school students, so as to provide theoretical and empirical support for optimizing school sports environment and enhance adolescent physical activity. Methods: Using multi-stage random cluster sampling, from September to December 2023, 1 329 junior and senior high school students from Xuancheng City of Anhui Province, Lianyungang City of Jiangsu Province, Wuhan City of Hubei Province, Qiqihar City and Suihua City of Heilongjiang Province, and Shenzhen City of Guangdong Province were selected. The International Physical Activity Questionnaire-Short Form (IPAQ-SF) assessed students physical activity levels, and the questionnaire on the characteristics of school sports environment was developed to evaluate the factors of school sports environment. Multivariate ordered Logistic regression was performed to analyze the correlation between school sports environment factors and physical activity levels, and the analytic hierarchy process determined the weight of key influencing factors. Results: The results showed that weekly vigorous physical activity time was [60 (25, 90)] minutes, moderate physical activity time was [60 (30, 90)] minutes, light physical activity time was [105 (40, 200)] minutes, and sedentary behavior time was [ 3 300 (2 100, 4 500)] minutes, only 10.53% of the students met World Health Organization physical activity recommendations, and 89.69% of the students averaged >8 h daily sedentary time. Multivariate ordered Logistic regression showed that adequate sports equipment significantly promoted physical activity across all intensities and reduced sedentary time ( OR = 4.97, 11.54, 4.03, 0.11); diverse sports activities improved vigorous and moderate physical activity while reducing sedentary time ( OR =4.20, 14.06, 0.17); and peer encouragement was associated with increased low-intensity physical activities and decreased sedentary time ( OR =10.40, 0.15)( P <0.05). The analytic hierarchy process weighting analysis identified the top three influential factors related to physical activity among middle school students: sufficient sports equipment, varied physical education activities, frequent peer encouragement, the influence weight accounts for 23.55% , 14.18% and 11.77% of the total, respectively. Conclusion Key school sports environmental factors for adolescent physical activity level include ensuring adequate sports equipment and class availability, diversifying activity content, fostering peer support, and cultivating an active sports culture and a comprehensive approach encourage students participation in extracurricular physical activities.

Objective To investigate the current status of quality of life and its influencing factors in elderly patients with minor amputations of the diabetic foot,providing a basis for medical staff to formulate intervention strategies.Methods A convergent mixed study design was used.A single-centre cross-sectional survey research method was used to select 168 elderly patients with minor amputation of the diabetic foot admitted to the Department of Wound Repair of a tertiary-level hospital in Beijing from May 2022 to May 2024 for questionnaire surveys and multivariate linear regression analyses of factors affecting the quality of life.During the same period,15 patients were selected for semi-structured interviews using purposive sampling based on ternary interaction determinism.Results Quantitative findings:A total of 167 valid questionnaires were retrieved,and the recovery rate of valid questionnaires was 99.4％.the total quality of life score of 167 respondents was(84.22±12.49)scores;the results of multivariate linear regression analyses showed that age and self-care ability were the independent risk factors affecting the quality of life of patients with minor amputation of the diabetic foot(P＜0.05).Qualitative findings:a total of 3 themes were extracted based on the triadic interactive determinism,including subject level,environmental level and behavioural level.Mixed findings:age and amputation affect the physical and mental state of patients and hinders quality of life improvement;limited work and life,and scarce external resources;the level of self-care ability restricts self-management behaviours and makes it difficult to improve quality of life.Conclusion Elderly patients with minor amputations of the diabetic foot have impaired physiological and psychological health to some degree,and healthcare professionals should be concerned about the negative impact of minor amputations on elderly diabetic foot patients,while also focusing on their individual needs and providing support.

Osteosarcoma is a primary bone tumor originating from mesenchymal tissues,highly aggressive and metastatic,and is one of the causes of orthopedic disorders in children and adolescents.The establishment of an osteosarcoma model is useful for studying the changes in the physiology and pathology of the organism after the occurrence of osteosarcoma.The establishment methods of osteosarcoma models not only differ in terms of difficulty,tumorigenicity,tumor-formation time,tumor survival time,tumor metastasis,and safety,but also in terms of simulating human osteosarcoma biological characteristics and histological features.In addition,the wide application of tissue engineering in tumor modeling is conducive to better study the role of the osteosarcoma microenvironment in osteosarcoma genesis and development.In this paper,we summarize the roles of different osteosarcoma animal models and their tissue engineering models in different experiments,in order to provide help for the study of osteosarcoma pathogenesis and drug intervention mechanism.

Stem cells are a kind of cells with the ability of self-renewal and differentiation, which can differentiate into melanocytes to fill the areas of pigment loss in damaged skin, fight against the apoptosis of melanocytes caused by autoimmunity and oxidative stress damage, and improve repigmentation rates in combination with traditional therapies. Studies have shown significant efficacy of stem cell therapy in the repigmentation of vitiligo. This review summarizes the latest advances in the basic and clinical research on the application of stem cells in the treatment of vitiligo.

Objective:To investigate the effect of 308-nm light-emitting diode (LED) phototherapy at escalating doses after autologous melanocyte transplantation on the repigmentation in patients with refractory stable vitiligo.Methods:A prospective, randomized, self-controlled trial was conducted. Twelve patients with refractory stable vitiligo (a total of 17 skin lesions) were collected from the Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region from November 2023 to September 2024. Autologous cultured melanocyte transplantation was performed. One week after the inner layer of petrolatum gauze had fallen off, each white patch was bisected by the midline and randomly divided into a test group and a control group; both groups received 308-nm LED light irradiation at an initial dose of 50 mJ/cm 2; then, the test group received a slow (5%) dose escalation, while the control group received a quick (10%) dose escalation. The repigmentation outcomes, clinical efficacy and safety were observed at 1, 3, and 6 months after the start of phototherapy. Results:A total of 12 patients with refractory stable vitiligo were collected, including 3 males and 9 females, aged 5 to 59 (29.4 ± 19.6) years. At 1 month after phototherapy, there was no significant difference in the vitiligo repigmentation area score between the test group and the control group ( P = 0.666) ; at 3 months after phototherapy, the vitiligo repigmentation area score was significantly higher in the test group (54.45 [5.17, 85.50] points) than in the control group (39.75 [4.52, 65.05] points, Z = -2.51, P = 0.012) ; at 6 months after phototherapy, no significant difference in the vitiligo repigmentation area score was observed between the two groups ( P = 0.11). In the test group, the marked response rate increased from 41.18% (7/17) at 1 month to 58.82% (10/17) and 58.82% (10/17) at 3 and 6 months after treatment, respectively; in the control group, it increased from 29.41% (5/17) at 1 month to 35.29% (6/17) and 47.06% (8/17) at 3 and 6 months after treatment, respectively. At 1 month after treatment, the response rate was 58.82% (10/17) in the test group, and 64.71% (11/17) in the control group, which both increased to 70.59% (12/17) at 3 and 6 months after treatment. There were no significant differences in the marked response rates or response rates between the two groups at different time points after treatment (all P > 0.05). The maximum dose of 308-nm LED light was 106.0 (87.0, 152.5) mJ/cm 2 in the test group, and 219.0 (200.5, 268.5) mJ/cm 2 in the control group; the total accumulated dose of 308-nm LED light was 2 101.0 (1 865.0, 2 270.5) mJ/cm 2 in the test group, and 3 411.0 (2 683.5, 4 016.5) mJ/cm 2 in the control group. Blisters occurred in 3 lesions (17.6%) in the control group, while no adverse reactions were observed in the test group. Seven patients (58.3%) preferred the low-dose escalation irradiation protocol in the test group. Conclusion:Autologous melanocyte transplantation combined with 308-nm LED phototherapy initiated at a minimum dose and followed by a 5% dose-escalation irradiation protocol exhibited comparable efficacy but superior safety profiles compared with a conventional 10% dose-escalation irradiation protocol in the treatment of refractory stable vitiligo.