Objective: To understand the impact of childhood trauma on psychological distress among upper grade elemetary school students, and to explore the mediating role of leisure activities in the relationship, so as to provide a basis for developing mental health intervention strategies. Methods: From August to November 2024, a combination of convenience sampling and stratified cluster random sampling was employed to recruit 1 373 fourth to sixth grade students from four primary schools in Harbin. The Childhood Trauma Questionnaire(CTQ), a self designed leisure activity scale (including active and passive leisure activities), and the Kessler Psychological Distress Scale (K10) were used to assess childhood trauma experiences, leisure activities, and levels of psychological distress. Spearman correlation analysis and linear regression analysis were conducted to explore the relationships among childhood trauma, leisure types, leisure time, and psychological distress. Based on the mediation analysis framework proposed by Hayes (Model 4), the mediating role of leisure types in the relationship between childhood trauma and psychological distress was examined. Results: Totally 19.1% of the upper elemetary school students exhibited psychological distress, while 30.2% had experienced childhood trauma. During school days, 64.6% of the students were reported of having leisure time concentrated between 1 and 5 hours per day, whereas 67.4% reported leisure time exceeding 5 hours per day on weekends. After controlling for potential demographic confounders such as gender, grade, ethnicity, household registration, being an only child, parents educational level, co residence, and whether parents are first time married,linear regression analysis showed that childhood trauma experience had positive predictive effect on psychological distress in upper primary school students( β =0.20, P <0.01). Leisure time showed no statistically significant association with psychological distress, both on school days ( β =-0.58 to -0.56) and weekends ( β =0.26- 0.98 )(all P >0.05). Active leisure activities were negatively associated with psychological distress ( β =-0.20), while passive leisure activities were positively associated with psychological distress ( β =0.29)(both P <0.01). Leisure type partially mediated the relationship between childhood trauma and psychological distress, accounting for 11.7% of the indirect effect. Conclusion Childhood trauma experiences positively predict psychological distress in upper elementary school students, and affect psychological distress through active leisure and passive leisure.

Objective:To develop a training curriculum targeting the core competences of neurosurgery nurses, so as to provide a reference for standardized training of neurosurgery nurses and to strengthen their professionality.Methods:Centering on the core competences required for neurosurgery nurses, we formed the curriculum framework based on the cell structure-inspired concept proposed by the School of Nursing of The Hong Kong Polytechnic University, and determined the contents through a literature analysis and two rounds of questionnaire-based Delphi consultations with 16 experts. We increased, reduced, or modified the items and dimensions, and finally estabilished the curriculum for neurosurgery nurse training. SPSS 18.0 software was used to analyze the general information of experts, coordination coefficient, variation coefficient, full mark ratio, and mean importance value. Categorical data were described as frequencies and percentages, and continuous data were described as mean±standard deviation. Ranked data were analyzed by using the chi-square test.Results:In the two rounds of expert consultations, questionnaires were both 100.00% returned, and the coefficients of expert authority were 0.873 and 0.888, respectively. The coordination coefficient of curriculum modules and curriculum contents were 0.416 and 0.221, respectively ( P<0.001). For individual items across the curriculum modules, the mean importance value was 3.188-3.938, the variation coefficient was 0.063-0.178, and the full mark ratio was 0.250-0.875. For content items, the mean importance value was 3.250-4.000, the variation coefficient was 0-0.238, and the full mark ratio was 0.375-1.000. The established clinical practice-directed curriculum for neurosurgery nursing training included 6 course modules (anatomy and physiology of the nervous system, neurosurgery patient evaluation and monitoring, neurosurgery disease nursing, commonly used neurosurgery nursing techniques, nursing management, and scientific research basis) and 77 content items. Conclusions:The established training curriculum targeting the core competences for neurosurgery nurses is reliable, which can provide a reference for standardized training of neurosurgery nurses.

Objective:To evaluate the expression of B7-H3 and CD133 in colorectal cancer(CRC),colorectal polyps,and normal colorectal mucosa and investigate their roles in the development and prognosis of CRC.Methods:Immunohistochemistry was used to detect the ex-pression of B7-H3 and CD133 in 195 CRC,76 villous/tubulovillous adenoma,64 tubular adenoma,30 non-adenomatous polyp,and 10 nor-mal colorectal mucosa samples obtained from The Second Affiliated Hospital of Zhengzhou University between October 2012 and April 2017 and Pengan County People's Hospital between January 2017 and May 2019.Patient age,sex,and immunohistochemical staining results of B7-H3,CD133,and carcinoembryonic antigen were incorporated as risk factors to establish a CRC survival prediction model.Results:B7-H3 and CD133 expression showed an increasing trend from normal mucosa to non-adenomatous polyps,tubular adenomas,villous/tubulovil-lous adenomas,and CRC(P<0.05),and correlated with adenoma size.It was also associated with CRC metastasis and shorter survival(P<0.05).Furthermore,the expressions of B7-H3 and CD133 demonstrated a value in the CRC survival prediction model,in the training as well as validation set.Conclusions:The immune regulator B7-H3 and cancer stem cell marker CD133 are associated with poor prognosis in CRC,and their expressions may serve as predictive factors for CRC prognosis.

Objective:To evaluate the expression of B7-H3 and CD133 in colorectal cancer(CRC),colorectal polyps,and normal colorectal mucosa and investigate their roles in the development and prognosis of CRC.Methods:Immunohistochemistry was used to detect the ex-pression of B7-H3 and CD133 in 195 CRC,76 villous/tubulovillous adenoma,64 tubular adenoma,30 non-adenomatous polyp,and 10 nor-mal colorectal mucosa samples obtained from The Second Affiliated Hospital of Zhengzhou University between October 2012 and April 2017 and Pengan County People's Hospital between January 2017 and May 2019.Patient age,sex,and immunohistochemical staining results of B7-H3,CD133,and carcinoembryonic antigen were incorporated as risk factors to establish a CRC survival prediction model.Results:B7-H3 and CD133 expression showed an increasing trend from normal mucosa to non-adenomatous polyps,tubular adenomas,villous/tubulovil-lous adenomas,and CRC(P<0.05),and correlated with adenoma size.It was also associated with CRC metastasis and shorter survival(P<0.05).Furthermore,the expressions of B7-H3 and CD133 demonstrated a value in the CRC survival prediction model,in the training as well as validation set.Conclusions:The immune regulator B7-H3 and cancer stem cell marker CD133 are associated with poor prognosis in CRC,and their expressions may serve as predictive factors for CRC prognosis.

Objective To understand the experience of fall alertness in elderly patients with rheumatoid arthritis and to provide references for the development of targeted nursing intervention strategies.Methods 13 elderly patients with rheumatoid arthritis,who were admitted to the Department of Rheumatology and Immunology of a tertiary hospital in Guizhou Province from February to April 2024,were selected through purposive sampling.Phenomenological qualitative research methods were used,with semi-structured in-depth interviews.Data were analyzed using Colaizzi's seven-step method,and themes were extracted.Results 3 main themes and 9 sub-themes were identified:the process of fall risk perception(reshaping fall risk cognition,establishing emotional coping mechanism,enhancing fall alertness effect),behavioral responses to fall alertness(creating a safe living environment,regularizing daily routine plan),and needs for fall prevention support(need for fall prevention knowledge,home rehabilitation care needs,intelligent device usage needs,psychosocial support needs).Conclusion Clinical medical staff should pay attention to the transformation process of fall risk perception in elderly rheumatoid arthritis patients,accurately identify patients'fall support needs in practice,and guide patients to adopt appropriate fall alert response behaviors through innovative fall demand support interaction paths and the construction of social support network systems,in order to improve patients'fall alertness and reduce their fall risk.

Myocardial infarction(MI)is the leading cause of mortality worldwide,with heart failure(HF)af-ter MI being the main driver of this high mortality rate.Currently,no method can effectively halt the progression from MI to HF.In recent years,research on myocardial regeneration has shown promise for the treatment of HF after MI.Studies have confirmed that the regulation of myocardial amino acid metabolism can achieve myocardial regeneration,and branched-chain amino acid(BCAA)metabolism is crucial for this process.BCAA can regulate the branched-chain keto acid level through the BCAA aminotransferase(BCAT)-branched-chain keto acid dehydrogenase(BCKDH),BCKDH ki-nase(BCKDK)-BCKDH,and mitochondrial protein phosphatase 2C(PP2Cm)-BCKDH axes,thereby activating the mam-malian target of rapamycin to promote myocardial regeneration.BCAA also participates in the crosstalk between glucose and lipid metabolism,reprogramming fatty acid oxidation towards glucose metabolism and inducing cardiomyocyte prolifer-ation.However,the effects of BCAA on myocardial regeneration have not been systematically reviewed.In this review,the relationship and underlying mechanism between BCAA and myocardial regeneration are discussed extensively from the perspective of amino acid metabolic reprogramming,providing a reference for the study and treatment of post-MI HF.

Alzheimer disease(AD)and Parkinson disease(PD)are both common neurodegenerative disorders,which can manifest as cognitive impairments.AD and PD have overlapping and distinct features in cognition-related metabolic pathways,potentially reflecting different underlying mechanisms.MRI can indirectly assess structural and functional changes in metabolic pathways,while PET can evaluate cerebral metabolic activity and functional connectivity.Integration of MRI and PET may provide complementary insights into neural structure and function.This review summarized research progresses in the application of MRI and PET for neuroimaging studies of cognitive impairment in neurodegenerative diseases.

OBJECTIVE To investigate the changes of air aerosols in the digestive endoscope cleaning and disinfec-tion room under real working conditions and observe the purification effects of aerosols under different ventilation and disinfection modes.METHODS Under the real working conditions(with both the air conditioner and recircu-lating air disinfection machine under the working mode),the air samples were collected every 1 hour from 8:00 to 16:00 from the digestive endoscope cleaning and disinfection room of Ren Ji Hospital,Shanghai Jiao Tong U-niversity School of Medicine from May 2023 to Oct.2023;the contents of particulate matters(PM)and microor-ganisms in the air were detected.At the busiest moment of the cleaning and disinfection room,the air was respec-tively sampled from the cleaning and disinfection room with the working condition modes of air condition systems,recirculating air disinfection machine or natural ventilation before the starting of systems and after the work for 0.5 hour,1 hour and 2 hours.The contents of PMs and microorganisms were detected.RESULTS The PM0.5 con-centrations during various time periods met the Grade 9 ISO clean room standard(≤35,200 particles/L)under the real working conditions,and the content of airborne viable particles also conformed to the Class Ⅲ environmental requirements(≤500 CFU/m3).All of the three ventilation and disinfection methods showed certain effects on purification of the con-tents of PM0.5 and microorganisms after the ventilation for 2 hours,the contents of PMs and microorganisms of the air disinfection machine group decreased most remarkably,followed by the air conditioner group,the natural ventilation group the least.There were no significant differences in the PM concentration and the content of microorganisms among the three groups at the time points;there were only significant differences in the PM concentration and the content of mi-croorganisms of the air disinfection machine group after the ventilation for 2 hours,0.5 hour and 1 hour(P＜0.05).CONCLUSIONS Both the air conditioning systems and recirculating air disinfection machine under the working con-dition mode have certain effect on purification of the contents of PM and microorganisms,and the specific effect need to be further studied.The implementation of multicenter dynamic surveillance with the help of intelli-gent techniques may provide reference for the optimization of ventilation and disinfection strategies.

This paper highlights the specific nursing experiences in an early inflammatory bowel obstruction of a patient after the surgery for abdominal cocoon syndrome.Immediately after the surgery,the nursing care focused on prevention of postoperative metabolic disorders,including dynamic monitoring and correction of refeeding syndrome and goal-oriented sequential nutritional support management.Over the period of postoperative recovery,the nursing care shifted to prevention and treatment of early postoperative inflammatory bowel obstruction,including dynamic monitoring and identification of an early postoperative inflammatory bowel obstruction,goal-oriented early postoperative inflammatory small bowel obstruction(EPISBO)fluid therapy together with the traditional Chinese medicine to promote bowel movement and control inflammation,the auricle copper-blade Gua Sha combined with auricular point sticker compression to regulate qi and reduce bowel flatulence,as well as a goal-oriented early mobilisation to prevent a re-obstruction of bowel.The patient discharged at 28 days after surgery without an event.At the 6 months of postoperative follow-up,the patient was found in continuous improvement of relevant indicators and increase of body weight.

Chinese medicine therapy for removing gallstones is one of the methods for the treatment of cholelithiasis.In the view of Professor Liu Fengbin,attacking of external pathogens,improper diet and emotional disorders contribute to the main causes of cholelithiasis,and the pathogenesis of cholelithiasis is due to qi stagnation of both liver and gallbladder,and internal obstruction of damp-heat.The occurrence of cholelithiasis is closely related to deficiency of spleen and stomach,and is correlated with the pathological factors of turbid phlegm and blood stasis.For the Chinese medicine treatment of cholelithiasis,Professor Liu follows the principle of"treatment in accordance with three categories of etiological factors"(i.e,seasons,environment and body constitution).He advocates the integration of traditional Chinese medicine and western medicine,and is good at utilizing Lingnan herbs and distinctive herbs that can dissolve stones and remove stones.The treatment for cholelithiasis is mainly through the therapies of soothing liver and alleviating depression,clearing heat and removing dampness,and normalizing gallbladder function to remove stones,and is also supplemented by the therapies of invigorating spleen and replenishing qi,regulating qi to resolve phlegm,and activiting qi movement and blood circulation.Modified Da Chaihu Decoction plus Sijin Decoction is often used as a basic formula for treating cholelithiasis,which is mainly composed of Desmodii Styracifolii Herba,Galli Gigerii Endothelium Corneum,Bupleuri Radix,Curcumae Radix,Scutellariae Radix,Aucklandiae Radix,Aurantii Fructus Immaturus stir-fried with bran,Paeoniae Radix Rubra,Linderae Radix,and Rhei Radix et Rhizoma.