Background: The surgical neck of the humerus is located approximately 2–3 cm distal to the anatomical neck (collum anatomicum) at the junction of the greater and lesser tubercles and the humeral shaft. Owing to the transition between cortical and cancellous bones, this region is biomechanically vulnerable and prone to fractures, particularly in older adults. Fractures of the surgical neck of the humerus are classified under the International Classification of Diseases, 10th Revision (ICD-10), with diagnostic codes S42.21.3, S42.22, and S42.23. National statistics indicate that 210,763 new trauma cases were reported in Mongolia in 2023, representing an 11.6% increase compared to the previous year, of which 11,452 cases (5.4%) involved shoulder and humeral injuries. Aim: This study aimed to compare the clinical effects of traditional Mongolian bone-setting therapy and surgical treatment on pain intensity, shoulder function, range of motion, and activities of daily living in patients with surgical neck of the humerus fractures. Materials and Methods: Based on the Department of Traditional Therapies of the Mongolian National University of Medical Sciences (MNUMS) and the Department of Orthopedic Trauma of the Inner Mongolia International Hospital, Inner Mongolia Autonomous Region, China, a total of 60 patients diagnosed with surgical neck fractures of the humerus were enrolled in this study between January 2024 and December 2025. The patients were randomly assigned into two groups: a Mongolian traditional bone-setting therapy group (n=30) and a surgical treatment group (n=30). Assessments were conducted before treatment and at 1 month and 3 months after treatment. Shoulder joint range of motion, activities of daily living, and muscle strength were evaluated using the Constant–Murley score, while pain intensity was assessed using the Visual Analog Scale (VAS). The collected data were systematically analyzed, and the therapeutic outcomes of the two treatment modalities were comprehensively compared and summarized. Result: The baseline demographic and clinical characteristics were comparable between the groups. In the traditional bone-setting group, VAS scores decreased significantly, whereas Constant–Murley scores improved markedly at both follow-up points. The overall outcomes in the traditional bone-setting group were significantly better than those in the surgical group (P<0.05). Conclusion Traditional Mongolian bone-setting therapy offers rapid pain relief, superior long-term functional recovery, and fewer complications, making it a valuable treatment option, particularly for elderly patients and those unsuitable for surgery.

Objective:To explore the longitudinal effect of learning stress on learning burnout in vocational college students, and the mediating role of academic procrastination.Methods:A total of 1 212 vocational college students were selected, and two follow-up surveys were conducted at 12-week intervals in September (T1) and November (T2) of 2024 using the basic situation questionnaire, the burnout inventory-student survey, the learning pressure questionnaire and the brief academic procrastination scale. SPSS 26.0 software was used to compare the demographic characteristics of students' depersonalization using t test and single factor analysis of variance. Bootstrap was used to analyze the relationship among learning stress, academic procrastination and learning burnout. Results:The scores of learning stress at T1 and T2 for vocational college students were 14.47±3.52 and 14.52 ±3.50, the scores of academic procrastination at T1 and T2 were 27.14±9.07 and 27.21±9.04, and the scores of learning burnout T1 and T2 were 39.38±8.76 and 39.69±8.79.The t-test showed that the score of learning burnout at T1 of students aged 18 and below (36.70±8.72) was lower than students aged 18 above (40.15±8.63, t=-5.81, P<0.01). The score of learning burnout for liberal arts students at T1(40.82±8.54) was higher than that of science students (37.68±8.72, t=6.31, P<0.01). Single factor analysis of variance showed that the score of learning burnout for grade 1 students at T1(35.19±8.45) was lower than that of grade 2 students (41.33±7.98) and grade 3 students (38.92±9.88), and learning burnout score of grade 2 students at T1 was higher than that of grades 3 students ( F=61.59, P<0.01). The score of learning burnout for high-achieving students at T1(36.23±8.34) was lower than that of middle-achieving students (39.82±8.52) and low-achieving students (45.42±9.14), and the score of learning burnout for middle-achieving students at T1 were lower than that of low-achieving students ( F=36.53, P<0.01). Bootstrap test showed that academic procrastination T2 played a partial mediating role in the relationship between learning stress T1 and learning burnout T2 (effect size=0.04, 95% CI=0.03-0.07). Academic procrastination T1 played a partial mediating role in the relationship between learning stress T1 and learning burnout T2 (effect size=0.05, 95% CI=0.04-0.07). Conclusion:Learning stress can directly affect learning burnout in vocational college students, and also can indirectly affect learning burnout through the mediating effect of academic procrastination.

Objective:To investigate the differential expression of Nuclear Factor Kappa B(NF-κB)and Tumor Necrosis Factor-Alpha(TNF-α)in endometrial polyp tissues,polyp-adjacent endometrium,and normal endometrium,and to analyze their correlation with local inflammatory responses,thereby elucidating the pathogenesis of endometrial polyps.Methods:Thirty-six patients with hysteroscopically confirmed endometrial polyps at Qingdao University Affiliated Hospital(September 2023-December 2024)were enrolled.Polyp tissues and adjacent endometrial tissues(0.5 cm-1 cm from polyps)were collected during surgery.Twenty-six patients undergoing hysterectomy for uterine fibroids,with pathologically confirmed normal endometrium,served as controls.The expression of NF-κB and TNF-α proteins was assessed using immunohistochemistry(IHC).Real-time quantitative PCR(RT-qPCR)was employed to detect the mRNA expression levels of NF-κB and TNF-α,and Western blot analysis was used to measure their protein expression.Differences among the three groups were compared.Results:Immunohistochemical analysis demonstrated:NF-κB p65 was predominantly localized to the cytoplasm and/or nucleus;TNF-α-positive expression was principally observed in the cytoplasmic compartment and/or cell membrane,manifesting as brown-yellow to brownish granules.The positive expression rate of NF-κB protein was significantly elevated in endometrial polyp tissues compared to both adjacent endometrial tissues and normal endometrial tissues(P＜0.05),whereas no statistically significant difference was observed between adjacent and normal endometrial tissues(P＞0.05).TNF-α protein expression exhibited a gradient pattern:Endometrial polyp tissues＞Adjacent endometrial tissues＞Normal endometrial tissues(with all inter-group comparisons demonstrating statistically significant differences,P＜0.05).Real-time quantitative PCR analysis revealed a significant gradient trend in the mRNA expression of NF-κB and TNF-α in endometrial polyp tissues:NF-κB mRNA:Polyp group(7.15±3.15)＞parapolyp group(4.38±2.01)＞normal group(1.03±0.30),with significant intergroup differences(all P＜0.05).TNF-α mRNA:Polyp tissue(17.66±9.25)＞parapolyp tissue(9.35±5.75)＞normal endometrium(1.16±0.58),with statistically significant differences among all groups(all P＜0.05).Western blot quantification further confirmed this trend:NF-κB protein:Expression in the polyp group(0.87±0.11)was 2.23-fold higher than in the normal group(0.39±0.02)(P=0.0007),while the parapolyp group(0.59±0.07)showed a 51％increase compared to the normal group(P=0.0435).TNF-α protein:Expression in the polyp group(1.13±0.21)was elevated by 94.8％versus the parapolyp group(0.58±0.03,P=0.0036)and by 494.7％versus the normal group(0.19±0.03,P=0.0002).One-way ANOVA indicated significant intergroup differences(F=43.56,P＜0.05).Conclusion:The TNF-α-mediated NF-κB signaling pathway is abnormally activated in endometrial polyps,exhibiting its highest expression at the polyp site.This suggests that the localized chronic inflammatory microenvironment may promote polyp formation through persistent stimulation of the NF-κB pathway.Targeted regulation of this pathway offers a novel strategy for preventing polyp recurrence.

A mounting body of research suggests that circRNAs significantly contribute to the develop-ment of myocardial fibrosis.The microarray results of human circular RNA expression profile indicated that circHERC4_041 expression increased in the myocardium of patients with heart failure,RT-qPCR a-nalysis confirmed that the myocardial expression level of circHERC4_041 in individuals with heart failure were considerably elevated compared to that in healthy organ donors.Fluorescence in situ hybridization(FISH)confirmed that circHERC4_041 was abundant in the cytoplasm of human cardiomyocyte AC16.Overexpression of circHERC4_041 in mouse myocardial fibroblasts(mCFs)mediated by adenovirus in-hibited the expression of fibrosis-related proteins in mCFs.Experiments involving cell proliferation,wound healing,and Transwell assays demonstrated that overexpression of circHERC4_041 suppressed the growth and mobility of mCFs(P＜0.001).Sequence analysis results suggested that circHERC4_041 con-tains potential ribosome entry sequence(IRES)and open reading frame(ORF).Western blot confirmed that circHERC4_041 could translate the 516 amino acid HERC4-516aa protein,which was mainly located in the cytoplasm of the cell.Cell functional experiments confirmed that circHERC4_041 inhibited the fi-brotic phenotype of mCFs by specifically translating HERC4-516aa(P＜0.05).The specific interaction between HERC4-516aa and transglutaminase 2(TGM2)was confirmed by IP-MS screening and Co-IP i-dentification.Further results found that the degradation of TGM2 was promoted through proteasome path-way.The overexpression of TGM2 in mCFs facilitated by adenoviral vectors could counteract the suppres-sive effects of HERC4-516aa on the fibrotic phenotype of mCFs.Therefore,this study confirmed that the HERC4-516aa protein translated by circHERC4_041 can specifically bind to TGM2 to inhibit the fibrotic phenotype of myocardial fibroblasts.

Objective:To explore the longitudinal effect of learning stress on learning burnout in vocational college students, and the mediating role of academic procrastination.Methods:A total of 1 212 vocational college students were selected, and two follow-up surveys were conducted at 12-week intervals in September (T1) and November (T2) of 2024 using the basic situation questionnaire, the burnout inventory-student survey, the learning pressure questionnaire and the brief academic procrastination scale. SPSS 26.0 software was used to compare the demographic characteristics of students' depersonalization using t test and single factor analysis of variance. Bootstrap was used to analyze the relationship among learning stress, academic procrastination and learning burnout. Results:The scores of learning stress at T1 and T2 for vocational college students were 14.47±3.52 and 14.52 ±3.50, the scores of academic procrastination at T1 and T2 were 27.14±9.07 and 27.21±9.04, and the scores of learning burnout T1 and T2 were 39.38±8.76 and 39.69±8.79.The t-test showed that the score of learning burnout at T1 of students aged 18 and below (36.70±8.72) was lower than students aged 18 above (40.15±8.63, t=-5.81, P<0.01). The score of learning burnout for liberal arts students at T1(40.82±8.54) was higher than that of science students (37.68±8.72, t=6.31, P<0.01). Single factor analysis of variance showed that the score of learning burnout for grade 1 students at T1(35.19±8.45) was lower than that of grade 2 students (41.33±7.98) and grade 3 students (38.92±9.88), and learning burnout score of grade 2 students at T1 was higher than that of grades 3 students ( F=61.59, P<0.01). The score of learning burnout for high-achieving students at T1(36.23±8.34) was lower than that of middle-achieving students (39.82±8.52) and low-achieving students (45.42±9.14), and the score of learning burnout for middle-achieving students at T1 were lower than that of low-achieving students ( F=36.53, P<0.01). Bootstrap test showed that academic procrastination T2 played a partial mediating role in the relationship between learning stress T1 and learning burnout T2 (effect size=0.04, 95% CI=0.03-0.07). Academic procrastination T1 played a partial mediating role in the relationship between learning stress T1 and learning burnout T2 (effect size=0.05, 95% CI=0.04-0.07). Conclusion:Learning stress can directly affect learning burnout in vocational college students, and also can indirectly affect learning burnout through the mediating effect of academic procrastination.

The active ingredient of WINREVAIR,sotatercept-csrk,is a recombinant activin receptor ⅡA-Fc(ActRⅡA-Fc)fusion protein that improves pro-proliferation(ActRⅡA/Smad2/3-mediated)and anti-proliferation(BMPRⅡ/Smad 1/5/8-mediated)signals,thereby regulating vascular proliferation.In March 2024,WINREVAIR was approved by the U.S.Food and Drug Administration for the treatment of pulmonary arterial hypertension(PAH)in adults.Clinical studies have shown that WINREVAIR can improve exercise capacity and reduce the incidence of all-cause death or clinical worsening of PAH by 84％.Common adverse drugreactions include headache,epistaxis,rash,etc.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

Objective To summarize the changing prevalence of carbapenem resistance in Enterobacterales based on the data of CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021 for improving antimicrobial treatment in clinical practice.Methods Antimicrobial susceptibility testing was performed using a commercial automated susceptibility testing system according to the unified CHINET protocol.The results were interpreted according to the breakpoints of the Clinical & Laboratory Standards Institute(CLSI)M100 31st ed in 2021.Results Over the seven-year period(2015-2021),the overall prevalence of carbapenem-resistant Enterobacterales(CRE)was 9.43％(62 342/661 235).The prevalence of CRE strains in Klebsiella pneumoniae,Citrobacter freundii,and Enterobacter cloacae was 22.38％,9.73％,and 8.47％,respectively.The prevalence of CRE strains in Escherichia coli was 1.99％.A few CRE strains were also identified in Salmonella and Shigella.The CRE strains were mainly isolated from respiratory specimens(44.23±2.80)％,followed by blood(20.88±3.40)％and urine(18.40±3.45)％.Intensive care units(ICUs)were the major source of the CRE strains(27.43±5.20)％.CRE strains were resistant to all the β-lactam antibiotics tested and most non-β-lactam antimicrobial agents.The CRE strains were relatively susceptible to tigecycline and polymyxins with low resistance rates.Conclusions The prevalence of CRE strains was increasing from 2015 to 2021.CRE strains were highly resistant to most of the antibacterial drugs used in clinical practice.Clinicians should prescribe antimicrobial agents rationally.Hospitals should strengthen antibiotic stewardship in key clinical settings such as ICUs,and take effective infection control measures to curb CRE outbreak and epidemic in hospitals.

Objective To characterize the changing species distribution and antibiotic resistance profiles of respiratory isolates in hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Methods Commercial automated antimicrobial susceptibility testing systems and disk diffusion method were used to test the susceptibility of respiratory bacterial isolates to antimicrobial agents following the standardized technical protocol established by the CHINET program.Results A total of 589 746 respiratory isolates were collected from 2015 to 2021.Overall,82.6％of the isolates were Gram-negative bacteria and 17.4％were Gram-positive bacteria.The bacterial isolates from outpatients and inpatients accounted for(6.0±0.9)％and(94.0±0.1)％,respectively.The top microorganisms were Klebsiella spp.,Acinetobacter spp.,Pseudomonas aeruginosa,Staphylococcus aureus,Haemophilus spp.,Stenotrophomonas maltophilia,Escherichia coli,and Streptococcus pneumoniae.Each microorganism was isolated from significantly more males than from females(P＜0.05).The overall prevalence of methicillin-resistant S.aureus(MRSA)was 39.9％.The prevalence of penicillin-resistant S.pneumoniae was 1.4％.The prevalence of extended-spectrum β-lactamase(ESBL)-producing E.coli and K.pneumoniae was 67.8％and 41.3％,respectively.The overall prevalence of carbapenem-resistant E.coli,K.pneumoniae,Enterobacter cloacae,Pseudomonas aeruginosa,and Acinetobacter baumannii was 3.7％,20.8％,9.4％,29.8％,and 73.3％,respectively.The prevalence of β-lactamase was 96.1％in Moraxella catarrhalis and 60.0％in Haemophilus influenzae.The H.influenzae isolates from children(＜18 years)showed significantly higher resistance rates to β-lactam antibiotics than the isolates from adults(P＜0.05).Conclusions Gram-negative bacteria are still predominant in respiratory isolates associated with serious antibiotic resistance.Antimicrobial resistance surveillance should be strengthened in clinical practice to support accurate etiological diagnosis and appropriate antimicrobial therapy based on antimicrobial susceptibility testing results.