Objective: To explore the relationship between related factors of non-suicidal self-injury behavior (NSSI) among middle school students in Guizhou Province, so as to provide the evidence for preventing high risk behaviors in adolescents. Methods: A stratified cluster random sampling method was used to select 1 034 junior and senior middle school students from Zunyi City, Qiannan Prefecture and Tongren City in Guizhou Province from April to October in 2023. Questionnaire survey was conducted to collect information including Adolescent Self injury Scale and Family Assessment Device. The R 4.4.1 software was employed for network analysis visualization, centrality indicators, and result stability assessment. Results: The detection rate of NSSI behavior among middle school students in Guizhou province was 29.6%, with a detection rate of 25.5% for boys and 33.1% for girls, showing a statistically significant difference ( χ 2=7.07, P <0.05). There were statistically significant differences in scores of emotional communication, egoism, family rules, positive communication, problem solving, expression of positive emotions and management of negative emotions self-efficacy, and bullying victimization in various dimensions between middle school students with and without NSSI ( Z =-13.66 to -7.05, P <0.01). NSSI among middle school students was positively correlated with social/relational bullying, depression and anxiety, and there were relatively close connections in the network ( r =0.35, 0.43, 0.42, P <0.01). Centrality indicators showed that the highest in strength and closeness centrality were stress ( Z =1.29, 1.58), the highest in betweenness centrality was for emotional communication ( Z =1.91), and the highest in expected influence index was for physical bullying ( Z =1.44)( P < 0.05). Conclusions Stress, emotional communication and physical bullying have significant impacts in the network of factors related to NSSI. Social/relational bullying, depression and anxiety have strong direct correlations with NSSI behavior among middle school students.

Epileptogenesis is a dynamic process of gradual progression from normal developing brain to pathological epileptic brain， which is the latent and budding stage of epilepsy. Combining the understanding of epileptogenesis in children from Western medicine and traditional Chinese medicine （TCM）， we proposed that the viewpoints of constitutional transformation， phlegm pathogen inducing epilepsy， and brain collateral damage， which correspond to key pathological mechanisms， namely gene polymorphism， immunoinflammation， and microvascular dysfunction of the blood-brain barrier， respectively. Based on these insights， strategies for prevention and treatment of epileptogenesis in children， as well as potential research directions are explored.

Objective To explore the potential causal relationship between occupational pneumoconiosis (hereinafter referred to as "pneumoconiosis") and five mental disorders (depression, bipolar disorder, schizophrenia, insomnia and anxiety) using the two-sample Mendelian randomization (MR) method. Methods Single nucleotide polymorphisms (SNPs) loci associated with pneumoconiosis and five mental disorders were screened from Genome-Wide Association Studies. Inverse variance weighting (IVW), weighted median (WM) and MR-Egger regression methods were used to evaluate the significance of the causal relationship between pneumoconiosis and five mental disorders. Sensitivity analysis was used to evaluate the accuracy and reliability of the research results. Results After matching data of pneumoconiosis and the five mental disorders, 16 SNPs were ultimately included as instrumental variables in this study. The result of MR analysis revealed a positive causal relationship between pneumoconiosis and both depression [IVW: odds ratio (OR) and 95% confidence interval (CI) was 1.017 (1.000-1.035), P<0.05] and bipolar disorder [IVW: OR(95%CI)was 1.046(1.009-1.083), P<0.05; WM: OR (95%CI) was 1.055(1.007-1.105), P<0.05]. Result of sensitivity analysis indicated there was no heterogeneity and horizontal pleiotropy in the above results. There was no causal association observed between pneumoconiosis and schizophrenia, insomnia, or anxiety disorders (all P>0.05). Conclusion This study provides genetic evidence supporting a positive causal relationship between pneumoconiosis and both depression and bipolar disorder.

Sepsis-associated acute kidney injury （SA-AKI） is an acute kidney injury caused by sepsis， characterized by acute onset， severe progression and high mortality. The abnormal activation of the nuclear factor-κB （NF-κB） signaling pathway can lead to pathological processes such as renal inflammatory cascade reactions， oxidative stress， apoptosis and pyroptosis， and microcirculatory dysfunction， thereby promoting the development of SA-AKI. In recent years， the basic research on the prevention and treatment of SA-AKI with traditional Chinese medicine （TCM） has made significant progress， among which NF-κB plays an important role as a key factor. This article summarizes the research findings over the past few years on active ingredients and compound formula of TCM interventions for SA-AKI via the NF-κB signaling pathway. It elaborates on various active ingredients of TCM， such as flavonoids， phenols， glycosides， terpenoids， quinones and alkaloids， as well as TCM compound formulations including Qihuang jiedu huayu decoction， Huangqi jiuni decoction， and Xuebijing injection， etc. These interventions significantly inhibit renal inflammatory responses， oxidative stress， apoptosis， pyroptosis and microcirculatory dysfunction by regulating multiple NF-κB-mediated signaling pathways， such as Toll-like receptor 4/myeloid differentiation primary response protein 88/NF- κB， sirtuin 1/NF- κB， NF- κB/NOD-like receptor family pyrin domain-containing protein 3， thereby alleviating SA-AKI and improving renal function.

Objective:To construct a model of nursing teaching rounds in dental clinics, and to provide a reference for the implementation of nursing teaching activities in dental clinics.Methods:Using the constructivism learning theory framework, we developed a preliminary draft of a teaching rounds model for dental outpatient nursing according to literature review, cross-sectional survey, and brainstorming results. Two rounds of Delphi consultation with 21 experts from across China were conducted to determine the teaching rounds model for dental outpatient nursing. Data entry and statistical analysis were performed with Excel 2016 and SPSS 26.0 software.Results:In the two rounds of expert consultation, the questionnaire response rates were both 100%; the expert authority coefficients were 0.865 and 0.873, respectively; and the Kendall's coefficients of concordance were 0.116 and 0.164, respectively. The established dental outpatient nursing teaching rounds model included 7 first-level items and 22 second-level items.Conclusions:The dental outpatient nursing teaching rounds model constructed in this study is scientific, reliable, and practical, which can provide guidance for conducting nursing teaching rounds in dental clinics.

Objective To compare the effects of different axillary lymph node surgical procedures on complications following immediate two-stage breast reconstruction after mastectomy.Methods A retrospective analysis was performed on 232 patients who underwent mas-tectomy with immediate two-stage breast reconstruction in the Department of Breast Surgery at the First Hospital of China Medical Uni-versity between January 2018 and December 2021.Patients were divided into two groups based on the type of axillary lymph node surgery performed:the sentinel lymph node biopsy group(SLNB group,n=84)and the axillary lymph node dissection group(ALND group,n=148).We compared baseline characteristics,surgical procedures,and postoperative complications between the two groups.Results The ALND group had a higher prevalence of advanced T and N stages,received neoadjuvant chemotherapy more frequently,and underwent chemotherapy and radiotherapy at a higher rate compared to the SLNB group.Additionally,the ALND group experienced greater drainage volume and a significantly higher complication rate(all P<0.05).Postoperative infection was the most common complication observed in the ALND group.Importantly,no significant differences were found in long-term outcomes(local/regional recurrence,distant metastasis,and disease-free survival)between the two groups(all P>0.05).Conclusion In patients undergoing immediate two-stage breast recon-struction after mastectomy,axillary lymph node dissection is associated with a higher rate of reconstruction complications compared to sentinel lymph node biopsy.

Gastric ulcer is a common digestive system disease,and the long-term use of non-steroidal anti-inflammatory drugs(NSAIDs)is the second most important cause.NSAID-induced gastric ulcer animal models are key experimental tools for studying the pathogenesis,corresponding treatment method,and effective mechanisms of NSAID-induced gastrointestinal injury.However,there are currently a lack of reviews on NSAID-induced gastric ulcer animal models.This review summarizes and compares the relevant literature on animal research into indomethacin-and aspirin-induced gastric ulcers in the past 10 years,including the selection of experimental animals,drug solvents,and specific modeling method.The limitations of current models,such as the cumbersome modeling method,incomplete modeling details,inadequate models for clinical use,and lack of comparative drug research,are discussed.Feasible solutions are proposed with the aim of providing an effective reference for research in this field.

Objective:To analyze the impact of cecal ligation and puncture (CLP)-induced sepsis on the proliferation and differentiation of intestinal epithelial cells.Methods:① Animal experiment: sixteen male C57BL/6 mice were divided into sham operation group (Sham group) and CLP-induced sepsis model group (CLP group) by random number table method, with 8 mice in each group. After 5 days of operation, the jejunal tissues were taken for determination of leucine-rich-repeat-containing G-protein-coupled receptor 5 (LGR5) and intestinal alkaline phosphatase (IAP) by polymerase chain reaction (PCR). The translation of LGR5 was detected by Western blotting. The expression of proliferating cell nuclear antigen (Ki67) was analyzed by immunohistochemistry. IAP level was detected by modified calcium cobalt staining and colorimetry. Immunofluorescence staining was used to detect the expression of Paneth cell marker molecule lysozyme 1 (LYZ1) and goblet cell marker molecule mucin 2 (MUC2). ② Cell experiment: IEC6 cells in logarithmic growth stage were divided into blank control group and lipopolysaccharide (LPS) group (LPS 5 μg/mL). Twenty-four hours after treatment, PCR and Western blotting were used to analyze the transcription and translation of LGR5. The proliferation of IEC6 cells were detected by 5-ethynyl-2'-deoxyuridine (EdU) staining. The transcription and translation of IAP were detected by PCR and colorimetric method respectively.Results:① Animal experiment: the immunohistochemical results showed that the positive rate of Ki67 staining in the jejunal tissue of CLP group was lower than that of Sham group [(41.7±2.5)% vs. (48.7±1.4)%, P = 0.01]. PCR and Western blotting results showed that there were no statistical differences in the mRNA and protein expressions of LGR5 in the jejunal tissue between the CLP group and Sham group (Lgr5 mRNA: 0.7±0.1 vs. 1.0±0.2, P = 0.11; LGR5/β-actin: 0.83±0.17 vs. 0.68±0.19, P = 0.24). The mRNA (0.4±0.1 vs. 1.0±0.1, P < 0.01) and protein (U/g: 47.3±6.0 vs. 73.1±15.3, P < 0.01) levels of IAP in the jejunal tissue were lower in CLP group. Immunofluorescence saining analysis showed that the expressions of LYZ1 and MUC2 in the CLP group were lower than those in the Sham group. ②Cell experiment: PCR and Western blotting results showed that there was no significant difference in the expression of LGR5 between the LPS group and the blank control group (Lgr5 mRNA: 0.9±0.1 vs. 1.0±0.2, P = 0.33; LGR5/β-actin: 0.71±0.18 vs. 0.69±0.04, P = 0.81). The proliferation rate of IEC6 cells in the LPS group was lower than that in the blank control group, but there was no significant difference [positivity rate of EdU: (40.5±3.8)% vs. (46.5±3.6)%, P = 0.11]. The mRNA (0.5±0.1 vs. 1.0±0.2, P < 0.01) and protein (U/g: 15.0±4.0 vs. 41.2±10.4, P < 0.01) of IAP in the LPS group were lower than those in the blank control group. Conclusion:CLP-induced sepsis inhibits the proliferation and differentiation of intestinal epithelial cells, impairing the self-renewal ability of intestinal epithelium.

Objective To analyze medication patterns and the targets and pathways of core drug combinations in treatment of palpitation.Methods The prescriptions of Li Yaping for treatment of palpitation from March 2023 to March 2024 were collected,and frequency counts of drugs'nature and flavour,channel tropism,and efficacy were performed.Apriori algorithm,association rules,and clustering analysis were carried out using SPSS Modeler 18.0 and SPSS 26.0.The core drugs and disease targets were searched,and gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis were performed on the targets of their therapeutic action for palpitation.Results A total of 220 prescriptions were collected,involving 192 flavors of traditional Chinese medicines,with a cumulative medication frequency of 3978 times,and 18 flavors of high-frequency medicines.The medicines were mainly tonics,sedative,and promoting blood circulation for removing blood stasis.The distribution of medicinal properties were mainly warm,cold and flat.The medicinal flavors were mainly sweet,bitter and pungent,and channel tropism were mostly heart,liver and spleen channel.Association rule analysis showed that Radix Angelicae Sinensis,Radix et Rhizoma Salviae Miltiorrhizae,Radix et Rhizoma Glycyrrhizae,Radix Ophiopogonis,and Radix Astragali were the core drugs.Cluster analysis showed that there was 3 cluster combinations.In the network pharmacology part,there were 181 targets intersected by drug combinations and diseases.KEGG analysis showed that the core drugs for palpitation mainly involved signaling pathways such as phosphoinositide 3-kinase/protein kinase B,hypoxia-inducible factor-1,mitogen-activated protein kinase,interleukin-17,etc.GO analysis obtained 1000 GO pathways,of which 760 were biological processes,93 were cellular components,and 147 were molecular functions.Conclusion In the treatment of palpitation,Li Yaping advocates benefiting qi and promoting yang,removing blood stasis and eliminating turbidity,and tranquilizing the mind,emphasizing the"two hearts in the same adjustment",and treating the heart and liver at the same time,taking into account the spleen and stomach,and the combination of core medicines can intervene in the course of palpitation through multi-components,multi-targets,and multi-pathways,which is of great significance for the treatment of palpitation in the clinical setting.

Objective to explore the use of performance management as a lever in public hospitals to achieve quality improvement,efficiency enhancement,and high-quality development under the dual influences of na-tional civil service examination and Diagnosis-Related Groups(DRGs)payment policy reform.Methods A questionnaire survey was conducted to summarize the current situation and problems of performance assessment in public hospitals in China.Based on the identified problems,an upgraded performance management system was proposed,and key indicators were selected through a case study in a specific hospital.Results An empirical study in a specific hospital demonstrated the positive effects of the upgraded performance management system on hospital management improvement.Conclusion Public hospitals should establish a long-term mechanism for performance management,focusing on organizational positioning,indicator design,management levers,and talent development,to continuously support high-quality development.