Objective: To explore the causal relationship between academic procrastination, negative emotions, self control, and smartphone addiction among college students, so as to provide theoretical reference for promoting their mental health and academic achievement. Methods: A multi stage cluster random sampling method was used to select 452 first year students from a university in Guangzhou as the research subjects. Procrastination Assessment Scale- Student (PASS), The Depression Anxiety Stress Scale (DASS-21), Self Control Scale, and Short Version of the Smartphone Addiction Scale (SAS-SV) were used as measurement tools. Three questionnaire surveys were completed in October 2024 (T1), February 2025 (T2), and May 2025 (T3). Coss lagged models were utilized to analyze the causal relationship between academic procrastination, negative emotions, self control, and smartphone addiction. Results: The SAS-SV scale for college students showed an average score of (40.52±1.96), with 43.1% of freshmen exhibiting smartphone addiction.Positive correlations were observed between academic procrastination, negative emotions, and smartphone addiction across different time points, while self control exhibited negative correlations with these three variables ( r = 0.30 -0.62, -0.72 to -0.34, all P <0.05). Cross lagged model results indicated that academic procrastination and negative emotions at T1 and T2 positively predicted smartphone addiction at T2 and T3 (T1→T2, β =0.22, 0.35; T2→T3, β =0.21, 0.24; all P < 0.05 ). Self control negatively predicted smartphone addiction (T1→T2, β =-0.32; T2→T3, β =-0.26; both P <0.05). In reverse causality regression models, smartphone addiction at T1 and T2 positively predicted academic procrastination and negative emotions at T2 and T3 (T1→T2, β =0.09, 0.24; T2→T3, β =0.10, 0.35; all P <0.05), but no statistically significant predictions were found for self control (T1→T2, β =-0.04; T2→T3, β =-0.03; both P >0.05). Conclusion Academic procrastination and negative emotions exhibit bidirectional causality with smartphone addiction among college students, while self control unidirectionally predicts smartphone addiction.

Palliative and hospice care is an emerging medical care model for the development of modern medicine,and its emergence is not only a sign of social demand and the development of human civilization,but also an important manifestation of the change in the modern medical model.Hospice care is the final stage of palliative care,which is of great significance for the end-of-life treatment of incurable diseases.Palliative and hospice care has become an independent discipline in many countries,and its development has been rapid.However,the develop-ment of hospice and palliative care in China is not satisfactory,and the lack of money and human resources are the main reasons limiting its development.Many scholars have carried out a lot of useful practices in this regard.How to explore a road of hospice and palliative care development suitable for China′s national conditions is an urgent problem to be solved.By reviewing domestic and foreign literature,this paper summarizes the development mode and payment method of palliative and hospice care abroad,identifies the challenges encountered in the practice of hospice care in China,and draws on the development experience of palliative and hospice care in foreign countries.We aimed to identify pain points and difficulties faced in developing palliative and hospice care in China,so as to better serve patients at the end of life,gradually promote the concept of palliative and hospice care,and contribute to the sustainable development of palliative and hospice care in China.

Objective To investigate the protective effects of Sulforaphane(SFN)against high glucose(HG)-induced human platelet apoptosis and elucidate the underlying mechanisms in vitro.Methods Purified platelets obtained from healthy individuals were pre-incubated with various concentrations of SFN(5,10,or 20 μmol/L)or a vehicle control(0.05%DMSO)for 40 minutes at 37℃.Subsequently,the platelets were stimulated with normal glucose(NG,5 mmol/L)or high glucose(HG,25 mmol/L)for an additional duration of 90 minutes.Flow cytometry was employed to assess platelet mitochondrial membrane potential depolarization(Δψm),exposure of phosphatidylserine(PS),and generation of total intraplatelet reactive oxygen species(ROS).Phosphorylation levels of PI3K and Akt were determined using Western blot.Results Compared to NG-treated human platelets,HG significantly induced depolarization of platelet Δψm and exposure of PS(P＜0.001).These effects of HG were markedly attenuated by various concentrations of SFN(P＜0.001).Mechanistically,SFN down-regulated the phosphorylation levels of PI3K(P＜0.01)and Akt(P＜0.05),which were increased by HG when compared to the vehicle control,and substantially reduced total intracellular ROS levels(P＜0.001).The inhibitory effects of SFN on HG-induced phosphorylation of PI3K and Akt,as well as its efficacy on total intracellular ROS generation,Δψm depolarization,and PS exposure in HG-stimulated human platelets were completely reversed by a specific agonist for PI3K,740 Y-P.Conclusions The current study demonstrates that SFN exerts a protective effect on platelet apoptosis induced by HG,potentially through the down-regulation of the PI3K/Akt-mediated pathway in human platelets in vitro.These findings suggest that SFN may hold promise for improving thrombosis in diabetes mellitus and related chronic metabolic diseases.

Objective:To investigate the differences in clinical and electrocardiographic characteristics between carriers of SCN5A mutations and non-SCN5A mutations in fever-induced Brugada syndrome.Methods:This study is a retrospective cohort study. A total of 263 patients with fever-induced Brugada syndrome who were admitted to Renmin Hospital of Wuhan University from January 2000 to December 2023 were selected. Their clinical manifestations, electrocardiographic characteristics, and major adverse cardiovascular events (MACE) at the time of diagnosis and during the follow-up period were collected. Among them, 200 patients underwent next-generation sequencing. Based on the genetic variation results, after excluding other mutations, they were divided into SCN5A mutation group, non-SCN5A sodium-related mutation group, potassium/calcium mutation group, and no mutation group. Comparisons were made among these groups in terms of their clinical and electrocardiographic characteristics.Results:Among the 263 patients with fever-induced Brugada syndrome, the mean age was (41.9±17.6) years, with 80.6% (212/263) being male. The median follow-up duration was 53.0 months, and 13.7% (36/263) of the patients experienced MACE. The rate of SCN5A mutation was 34.5% (69/200), while the rates of non-SCN5A sodium-related mutations and potassium/calcium-related mutations were 4.5% (9/200) and 3.5% (7/200), respectively. The SCN5A mutation group was younger than the non-SCN5A sodium-related mutation group and the no mutation group (ages were (33.8±14.7), (49.8±11.6), (44.6±15.7) years, respectively, P<0.001). The SCN5A mutation group also had a longer PR interval than the no mutation group ((176.8±32.3) ms vs. (163.9±28.6) ms, P=0.034). The incidence of MACE was higher in the non-SCN5A sodium-related mutation group than that in the no mutation group (55.6% (5/9) vs. 9.1% (9/99), P=0.002). Conclusions:Fever-induced Brugada syndrome patients carrying non-SCN5A mutations exhibit distinct clinical and electrocardiographic characteristics compared to those with SCN5A mutations. These differences warrant attention in clinical practice.

Background::Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography (ERCP), the benefits and safety of high-carbohydrate fluid diet (CFD) intake 2 h before ERCP remain unclear. This study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’ recovery.Methods::This prospective, multicenter, randomized controlled trial involved 15 tertiary ERCP centers. A total of 1330 patients were randomized into CFD group ( n = 665) and fasting group ( n = 665). The CFD group received 400 mL of maltodextrin orally 2 h before ERCP, while the control group abstained from food/water overnight (>6 h) before ERCP. All ERCP procedures were performed using deep sedation with intravenous propofol. The investigators were blinded but not the patients. The primary outcomes included postoperative fatigue and abdominal pain score, and the secondary outcomes included complications and changes in metabolic indicators. The outcomes were analyzed according to a modified intention-to-treat principle. Results::The post-ERCP fatigue scores were significantly lower at 4 h (4.1 ± 2.6 vs. 4.8 ± 2.8, t = 4.23, P <0.001) and 20 h (2.4 ± 2.1 vs. 3.4 ± 2.4, t= 7.94, P <0.001) in the CFD group, with least-squares mean differences of 0.48 (95% confidence interval [CI]: 0.26–0.71, P <0.001) and 0.76 (95% CI: 0.57–0.95, P <0.001), respectively. The 4-h pain scores (2.1 ± 1.7 vs. 2.2 ± 1.7, t = 2.60, P = 0.009, with a least-squares mean difference of 0.21 [95% CI: 0.05–0.37]) and positive urine ketone levels (7.7% [39/509] vs. 15.4% [82/533], χ2 = 15.13, P <0.001) were lower in the CFD group. The CFD group had significantly less cholangitis (2.1% [13/634] vs. 4.0% [26/658], χ2 = 3.99, P = 0.046) but not pancreatitis (5.5% [35/634] vs. 6.5% [43/658], χ2 = 0.59, P = 0.444). Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla (odds ratio [OR]: 0.61, 95% CI: 0.39–0.95, P = 0.028) in the multivariable models. Conclusion::Ingesting 400 mL of CFD 2 h before ERCP is safe, with a reduction in post-ERCP fatigue, abdominal pain, and cholangitis during recovery.Trail Registration::ClinicalTrials.gov, No. NCT03075280.

Objective To investigate the effects of dexmedetomidine(DEX)combined with sufentanil for patient-controlled intravenous analgesia(PCIA)on postoperative immune function and respiratory function recovery in patients undergoing thoracoscopic radical resection of lung cancer.Method From October 2020 to June 2022,92 ASA Ⅰ or Ⅱ patients scheduled for thoracoscopic radical resection of lung cancer were selected in our hospital,and they were randomly divided into sufentanil group(Group S)and DEX group(Group D)with 46 cases in each group.There was one case of postoperative bleeding in group S and one case of intraoperative bleeding in group D withdrew from the experiment.the group S postoperative PCIA with sufentanil injection 1.0 μg/kg pre day and tropisetron hydrochloride 20 mg/150 ml,Group D was treated with dexmedetomidine 1.0 μg/kg pre day and sufentanil injection 1.0 μg/kg pre day and tropisetron hydrochloride 20 mg/150 ml.At the four time points in preoperative day(T0),24 h(T1),48h(T2)and 72 h(T3)after operation.Rest and cough NRS scores and SAS scores were recorded and venous blood samples were taken to detected CD3+,CD4+,CD8+,CRP and PCT,Arterial blood gas analysis was detected to calculate OI;clinical pulmonary infection score(CPIS),the incidence of hypoxemia and pulmonary edema and adverse reactions including nausea and vomiting,drowsiness,bradycardia,respiratory depression and shivers were recorded at T2.Results Compared with S group,NRS score of resting or cough,SAS score,CRP and PCT of group D were significantly decreased at T,to T3(P＜0.05),while CD3+,CD4+,CD4+/CD8+and OI value was increased,CD8+was only lower in T1(P＜0.05).There were no significant differences in rest and cough NRS scores、SAS scores、CD3+、CD4+、CD8+、CD4+/CD8+、CRP,PCT and OI between the two groups at T0(P＞0.05).Compared with T0,Rest and cough NRS scores、CRP and PCT were significantly increased,CD3+、CD4+、CD4+/CD8+、OI and SAS scores were decreased in the two groups at T1-T3,CD8+increased only at T1 and T2(P＜0.05).Compared with group S[8(17.8％),(3.5±1.3)],the proportion of nausea and vomiting and CPIS score in group D[1(2.2％),(1.2±1.1)]was decreased(P＜0.05).There was no significant difference in the proportion of hypoxemia,pulmonary edema,drowsiness,bradycardia,respiratory depression and shivers(P＞0.05).Conclusion Dexmedetomidine combined with sufentanil patient-controlled analgesia has better analgesic and sedative effects,which can not only reduce the degree of immunosuppression caused by surgical trauma,but also reduce the adverse reactions of opioids,and is conducive to the recovery of postoperative respiratory function.It is a safer PCIA method after thoracoscopic radical resection of lung cancer.

Objective Investigate the expression level and clinical significance of microRNA-223-3p(miR-223-3p)in the serum of pregnant women with preterm premature rupture of membranes(PPROM).Methods A total of 91 pregnant women who underwent cesarean delivery at the Xuzhou Maternal and Child Health Hospital affiliated with Xuzhou Medical University between April and September 2023 were selected for the study.This included 60 cases of PPROM and 31 cases of term normal pregnant women as the research subjects.The study group was divided based on the pathological results of the membranes into:PPROM group without histological chorioamnionitis(HCA)(PPROM group,n = 37),and PPROM group with HCA(PPROM+HCA group,n = 23).Serum samples from pregnant women were collected before hospital treatment,and the expression level of miR-223-3p in the serum was detected by quantitative real-time PCR(qRT-PCR).The levels of inflammatory factors such as IL-1β,IL-6,IL-8,and TNF-α in the serum were measured by enzyme-linked immunosorbent assay(ELISA).Results The expression level of miR-223-3p in the serum of the PPROM+HCA group was significantly higher than that of the PPROM group and the normal group(P＜0.05).The expression levels of IL-1β,IL-6,IL-8,and TNF-α in the serum of the PPROM+HCA group were also significantly higher than those of the PPROM group and the normal group(P＜0.05).There was a positive correlation between the expression level of miR-223-3p in the serum of the PPROM+HCA group and the expression levels of IL-1β,IL-6,IL-8,and TNF-α(r = 0.553,0.505,0438,0.656,P＜0.05).Conclusion The upregulation of miR-223-3p in the serum of pregnant women with PPROM+HCA is associated with the severity of inflammation in PPROM.

Objective:To assess the efficacy and prognosis of gastrointestinal stromal tumors(GIST)after preoperative targeted therapy us-ing the Choi criteria compared to pathological effects,and to observe the consistency between them.Methods:The clinicopathological data of 37 patients,who underwent preoperative treatment with targeted imatinib therapy for GIST,were retrospectively analyzed.Survival ana-lysis of the Choi criteria and pathological effects was conducted using the Kaplan-Meier method and Log-rank test.The consistency between the Choi criteria and the pathological effects was assessed using Spearman's correlation and Kappa tests.Results:The median preoperative treatment duration for the 37 patients was 10 months(range,2-36 months).According to the Choi criteria,there were no cases of complete response(CR),26 cases of partial response(PR),five cases of stable disease(SD),and six progressive disease(PD)cases.The difference in overall survival(OS)between the effective group(CR+PR)and the ineffective group(SD+PD)was statistically significant(P<0.01).Pathologic-al effects were evaluated as one complete effect,11 high effects,18 partial effects,and seven zero effect cases.The OS significantly differed between the effective(full effect+high effect+partial effect)and ineffective(zero effect)groups was statistically significant(P<0.01).The Choi showed moderate consistency with the pathological effects(r=0.592,P<0.01)with a(κappa=0.566).Conclusions:The Choi criteria were moderately correlated and consistent with the pathological effects.Both can be used to evaluate the efficacy and prognosis of preoperative targeted therapy for GIST.The combined use of these two criteria has better clinical application value than that of either alone.

Carotenoids are secondary metabolite responsible for colored pigments in plants and microbes (Li et al., 2022). They are a class of C₄₀ tetraterpenoids consisting of eight isoprenoid units, and can be classified into carotenes and xanthophylls on the basis of their functional groups (Saini et al., 2015). Carotenes can be linear (phytoene, phytofluene, and ζ‍-carotene) or branched (β‍-carotene and α‍-carotene). Xanthophylls comprise β,β‍-xanthophylls (β‍-cryptoxanthin, zeaxanthin, violaxanthins, and neoxanthin) and β,ε‍-xanthophylls (α-cryptoxanthin, α-carotene, and lutein). Citrus fruits are complex sources of carotenoids, which are the principal pigments responsible for the typical orange color of most types (Chen, 2020). The difference in total carotenoid content and the diversity of carotenoid isomer proportion also accounts for other colors of citrus fruits, such as yellow, red, and pink (Chen, 2020).
Citrus/metabolism* ; Carotenoids ; Xanthophylls ; Lutein/metabolism* ; Zeaxanthins/metabolism* ; Fruit

Objective To investigate the distribution and clinical characteristics of pathogens in children with acute respiratory infection (ARI). Methods A total of 85 children with ARI in our hospital from January 2018 to May 2019 were enrolled. The distribution of pathogens, clinical characteristics, and the detection rate among different, ages, and seasons were observed. Results Among 85 children, 35 cases (41.18%) were positive for serum IgM. The total positive rate of IgM among children aged between 20d and 28d was higher than those aged less than 20d (χ²=10.365，P=0.001). MP, RSV, INFB and PIV showed significant difference between two age groups (P<0.05). The total positive rates of IgM in spring, summer, autumn and winter were 57.69% (15/26)、80.00% (20/25)、55.56% (10/18) and 12.50% (2/16), respectively (χ²=17.775，P=0.001). The clinical characteristics of 85 cases of ARI included 50 cases (58.85%) of dry cough, 84 cases (98.82%) of pharyngeal congestion, 56 cases (71.76%) of body temperature > 38.5°C (65.88%), 61 cases of pulmonary texture disorder with spot shadow and 65 cases (76.47%) of white blood cells > 10.0×109/L. Conclusion MP is the main pathogen in ARI children. age and season are important factors for respiratory tract pathogen infection, and summer is the peak period of infection.