Objective: To explore the association between negative life events and smartphone addiction among middle school students, so as to provide theoretical support and practical guidance for prevention and intervention of smartphone addiction among middle school students. Methods: Using cluster sampling, 8 890 students were selected to survey from 27 junior high schools and 3 senior high schools in a district of Shenzhen in 2022 (baseline) and 2023 (followup). Data were collected through selfresigned questionnaires on basic information, the Smartphone Addiction Scale-Short Version, and the Adolescent Selfrating Life Events Checklist. Mixedeffects models were employed to analyze the association. Results: Compared to 2022, the punishment scores of middle school students in 2023 [1.00 (0.00, 6.00) and 1.00 (0.00, 6.00)] decreased (Z=4.27), while the scores of interpersonal stress, learning stress and adaptation [4.00(0.00, 8.00), 4.00(0.00, 8.00); 4.00(1.00, 8.00), 5.00(2.00, 9.00); 2.00 (0.00, 6.00), 3.00 (0.00, 7.00)] increased (Z=-3.04, -8.36, -6.80) (P<0.01). Mixedeffects models revealed a positive doseresponse relationship between negative life events and smartphone addiction (OR=1.08-1.17, P<0.01). Stepwise regression showed independent positive effects of interpersonal stress (OR=1.05), academic stress (OR=1.03), and adaptation stress (OR=1.11) on smartphone addiction (P<0.01). Subgroup analysis of nonaddicted students in 2022 confirmed persistent associations for academic stress (OR=1.03) and adaptation (OR=1.07) (P<0.01). Conclusion Negative life events exhibit a positive doseresponse relationship with smartphone addiction, particularly interpersonal stress, academic stress, and adaptationrelated events.

Objective: To explore the potential causal association between adolescent compulsive behaviour and smartphone addiction based on longitudinal data, so as to provide reference for the establishment of adolescent smartphone addiction interventions. Methods: A preliminary survey and follow-up were conducted on 8 907 middle and high school students in a district of Shenzhen in 2022 and 2023, respectively. Compulsive behaviours were measured by using the Mental Health Inventory for Middle School Students-60 Items (MMHI-60), smartphone addiction was assessed by using the Smartphone Addiction Scale-Short Version ( SAS- SV), and the associations between compulsive behaviours and smartphone addiction were analysed by using multilevel mixed-effects models and subgroup analyses. Results: Smartphone addiction detection rates among middle school students were significantly associated with genders, father s education level, mother s education level, study load subgroups, and whether or not they were single-parent families, and there were statistical differences ( χ 2=17.21-175.34, P <0.05). Students with compulsive behaviours were 2.98 times more likely to develop smartphone addiction than those without compulsive behaviours ( OR=2.98, 95%CI=2.77-3.22, P <0.05). Subgroup analysis of middle school students without smartphone addiction in the first year found that compulsive behaviours significantly predicted smartphone addiction ( OR= 1.76 , 95%CI=1.54-2.01, P <0.05). Conclusion There is a potential causal association between obsessive-compulsive behaviours and smartphone addiction in middle school students, and obsessive-compulsive behaviours in middle school students could significantly predicted the occurrence of smartphone addiction.

Objective:To establish a liquid chromatography tandem mass spectrometry (LC-MS/MS) method for accurate determination of plasma Lyso-GL-3 concentration.Method:Solid phase extraction technology was used to process plasma samples, and under positive ion mode and multiple reaction monitoring (MRM) conditions, LC-MS/MS was used to determine the concentration of Lyso-GL-3. The linear range, detection and quantification limits, accuracy, precision, matrix effect, carrier effect of the method, and plasma sample stability were validated. And the accuracy of Lyso-GL-3 positive patients was compared by combining enzymatic and genetic testing results.Result:Lyso-GL-3 had good linearity in the range of 1.25-400 nmol/L. The detection limit and quantification limit were 0.15 nmol/L and 0.50 nmol/L, respectively. The spiked recovery rate was 88.78%-108.96%. The coefficient of variation ( CV) for intra batch precision, inter batch precision, and matrix effect were all less than 15%, the result of carrier effect was 0.55%. Plasma samples could be stably stored for 30 days under refrigeration conditions. The clinical conformity of the patient was 100%. Conclusion:The established LC-MS/MS detection method for plasma Lyso-GL-3 concentration takes 2.5 minutes, which is simple, fast, accurate, and reliable.

Objective:To establish a liquid chromatography tandem mass spectrometry (LC-MS/MS) method for accurate determination of plasma Lyso-GL-3 concentration.Method:Solid phase extraction technology was used to process plasma samples, and under positive ion mode and multiple reaction monitoring (MRM) conditions, LC-MS/MS was used to determine the concentration of Lyso-GL-3. The linear range, detection and quantification limits, accuracy, precision, matrix effect, carrier effect of the method, and plasma sample stability were validated. And the accuracy of Lyso-GL-3 positive patients was compared by combining enzymatic and genetic testing results.Result:Lyso-GL-3 had good linearity in the range of 1.25-400 nmol/L. The detection limit and quantification limit were 0.15 nmol/L and 0.50 nmol/L, respectively. The spiked recovery rate was 88.78%-108.96%. The coefficient of variation ( CV) for intra batch precision, inter batch precision, and matrix effect were all less than 15%, the result of carrier effect was 0.55%. Plasma samples could be stably stored for 30 days under refrigeration conditions. The clinical conformity of the patient was 100%. Conclusion:The established LC-MS/MS detection method for plasma Lyso-GL-3 concentration takes 2.5 minutes, which is simple, fast, accurate, and reliable.

OBJECTIVE To investigate the effects of GSTP1， XRCC1， ABCB1， MTHFR gene polymorphisms on efficacy and toxic effect of chemotherapy regimen containing oxaliplatin in patients with stage Ⅲ and Ⅳ colorectal cancer patients. METHODS Clinical data of 76 patients with stage Ⅲ and Ⅳ colorectal cancer who received chemotherapy regimen containing oxaliplatin （XELOX，FOLFOX） were collected from the Second Affiliated Hospital of Soochow University from September 2018 to March 2020. The correlation of genotypes with progression-free survival （PFS） and toxic effect was analyzed by using univariate and multivariate COX regression model. RESULTS Carriers of the ABCB1 3435T＞C locus C allele （TC/CC） had a significantly higher risk of progression compared to TT genotype patients [HR＝2.39， 95%CI （1.05，5.50）， P＝0.038]. The risk of progression in patients at stage Ⅳ was significantly higher than those at stage Ⅲ [HR＝8.11， 95%CI（3.39，19.40）， P＜0.001]. Chemotherapy regimen， Karnofsky performance status score and tumor site had no significant effect on disease progression （P＞0.05）. Mutations in gene loci were not correlated with adverse reactions （P＞0.05）. CONCLUSIONS Patients carrying ABCB1 TC/CC and receiving chemotherapy regimen containing oxaliplatin have a higher risk of disease progression， which may be associated with longer PFS in patients （TT genotype） with stage Ⅳ colorectal cancer receiving the chemotherapy， while GSTP1， XRCC1， and MTHFR gene polymorphisms have no significant impact.

Cryoablation therapy with explicit anti-tumor mechanisms and histopathological manifestations has a long history.A large number of clinical practice has shown that cryoablation therapy is safe and effective,making it an ideal tumor treatment method in theory.Previously,its efficacy and clinical application were constrained by the limitations of refrigerants and refrigeration equipment.With the development of the new generation of cryoablation equipment represented by argon helium knives,significant progress has been made in refrigeration efficien-cy,ablation range,and precise temperature measurement,greatly promoting the progression of tumor cryoablation technology.This consensus systematically summarizes the mechanism of cryoablation technology,indications for oral mucosal melanoma(OMM)cryotherapy,clinical treatment process,adverse reactions and management,cryotherapy combination therapy,etc.,aiming to provide reference for carrying out the standardized cryoablation therapy of OMM.

Objective:To explore the utility of applying low frequency transcranial magnetic stimulation (rTMS) in the acute stage of ischemic stroke in terms of improving upper limb motor function.Methods:Eighty ischemic stroke survivors in the acute stage were randomly divided into a control group and an experimental group, with 40 in each. In addition to routine rehabilitation, the experimental group was given low frequency rTMS, while the control group was provided with sham rTMS. Before and after 4-weeks of treatment, upper limb motor function was evaluated using the Fugl-Meyer rating scale (FMA), Wolf motor function tests (WMFTs), the modified Barthel index (MBI) and in terms of motor evoked potential (MEP) latency and amplitude.Results:There were no significant differences between the two groups before the treatment. Afterward, however, the average FMA, WMFT, MBI scores had improved significantly more in the experimental group, on average, as had the average MEP amplitude.Conclusion:Low frequency rTMS in the acute phase of ischemic stroke can improve upper limb motor function and ability in the activities of daily living.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To explore the characteristics of the changes in each cognitive dimension of the elderly with normal cognitive function in different age groups over time.Methods:Individuals aged 60 and above in an urban area of Guangzhou were invited to participate in the study. Mini-mental State Examination(MMSE), Montreal Cognitive Assessment(MoCA), and the World Health Organization Complete Set of Neuropsychological Tests (WHO-BCAI) were used, a total of 281 subjects with normal cognitive function were enrolled and allocated into the senior age group (≥80 years old), the middle age group (70-79 years old) and the younger age group (60-69 years old). All of the subjects were followed up after 1 year and 5 years. Mixed linear model was used to analyze the differences and characteristics of different cognitive dimensions (including numerical breadth, auditory words, associative learning, visual recognition, language fluency, delayed recall, Wechsler mapping, and Wechsler block diagrams) in different age groups over time.Results:The differences of all cognitive assessment items between the three age groups at different survey times were statistically significant, including MMSE ( F=32.22, P<0.01), MoCA ( F=42.98, P<0.01), Digital Breadth ( F=3.62, P<0.05), Auditory Words ( F=30.21, P<0.01), Associative Learning ( F=17.97, P<0.01), Visual Recognition ( F=18.62, P<0.01), Language Fluency ( F=15.17, P<0.01), Delayed Recall ( F=33.43, P<0.01), Wechsler Mapping ( F=19.92, P<0.01), and Wechsler Block Diagram ( F=18.51, P<0.01). The results of Bonferroni multiple means comparison showed that when comparing to the baseline and the one-year follow-up timepoint, the auditory word scores of the elderly in the younger and middle-age groups were significantly increased( t=3.73, P<0.05; t=3.98, P<0.05). When comparing to the 5-year follow-up and the baseline, the MMSE scores of the elderly in the three age groups ( t=-4.64, P<0.05; t=-4.48, P<0.05; t=-4.28, P<0.05) were significantly decreased, the numerical breadth and Wechsler block diagram scores of the elderly in the younger age group were significantly decreased( t=-2.75, P<0.05; t=-2.54, P<0.05), and auditory words increased significantly( t=3.01, P<0.05); Comparing to the one-year and the five-year follow-up timepoint, the MMSE scores of the elderly in the three age groups ( t=-4.85, P<0.05; t=-2.70, P<0.05; t=-2.61, P<0.05) and MoCA ( t=-6.52, P<0.05; t=-5.67, P<0.05; t=-3.89, P<0.05) of the elderly in the three age groups were significantly decreased, the Wechsler mapping scores of the elderly in the younger and middle-age groups were significantly decreased ( t=-3.57, P<0.05; t=-2.61, P<0.05), and the Wechsler block diagram scores of the elderly in the younger age group also decreased significantly ( t=-2.79, P<0.05). Conclusions:The continuous attention, short-term memory function and recognizable, memory and comprehension ability of the elderly in the younger group decreased faster than that of the elderly in the middle and elderly groups over time, and the cognitive content mentioned above may be sensitive indicators of cognitive decline in older adults.

Objective:To explore the characteristics of the changes in each cognitive dimension of the elderly with normal cognitive function in different age groups over time.Methods:Individuals aged 60 and above in an urban area of Guangzhou were invited to participate in the study. Mini-mental State Examination(MMSE), Montreal Cognitive Assessment(MoCA), and the World Health Organization Complete Set of Neuropsychological Tests (WHO-BCAI) were used, a total of 281 subjects with normal cognitive function were enrolled and allocated into the senior age group (≥80 years old), the middle age group (70-79 years old) and the younger age group (60-69 years old). All of the subjects were followed up after 1 year and 5 years. Mixed linear model was used to analyze the differences and characteristics of different cognitive dimensions (including numerical breadth, auditory words, associative learning, visual recognition, language fluency, delayed recall, Wechsler mapping, and Wechsler block diagrams) in different age groups over time.Results:The differences of all cognitive assessment items between the three age groups at different survey times were statistically significant, including MMSE ( F=32.22, P<0.01), MoCA ( F=42.98, P<0.01), Digital Breadth ( F=3.62, P<0.05), Auditory Words ( F=30.21, P<0.01), Associative Learning ( F=17.97, P<0.01), Visual Recognition ( F=18.62, P<0.01), Language Fluency ( F=15.17, P<0.01), Delayed Recall ( F=33.43, P<0.01), Wechsler Mapping ( F=19.92, P<0.01), and Wechsler Block Diagram ( F=18.51, P<0.01). The results of Bonferroni multiple means comparison showed that when comparing to the baseline and the one-year follow-up timepoint, the auditory word scores of the elderly in the younger and middle-age groups were significantly increased( t=3.73, P<0.05; t=3.98, P<0.05). When comparing to the 5-year follow-up and the baseline, the MMSE scores of the elderly in the three age groups ( t=-4.64, P<0.05; t=-4.48, P<0.05; t=-4.28, P<0.05) were significantly decreased, the numerical breadth and Wechsler block diagram scores of the elderly in the younger age group were significantly decreased( t=-2.75, P<0.05; t=-2.54, P<0.05), and auditory words increased significantly( t=3.01, P<0.05); Comparing to the one-year and the five-year follow-up timepoint, the MMSE scores of the elderly in the three age groups ( t=-4.85, P<0.05; t=-2.70, P<0.05; t=-2.61, P<0.05) and MoCA ( t=-6.52, P<0.05; t=-5.67, P<0.05; t=-3.89, P<0.05) of the elderly in the three age groups were significantly decreased, the Wechsler mapping scores of the elderly in the younger and middle-age groups were significantly decreased ( t=-3.57, P<0.05; t=-2.61, P<0.05), and the Wechsler block diagram scores of the elderly in the younger age group also decreased significantly ( t=-2.79, P<0.05). Conclusions:The continuous attention, short-term memory function and recognizable, memory and comprehension ability of the elderly in the younger group decreased faster than that of the elderly in the middle and elderly groups over time, and the cognitive content mentioned above may be sensitive indicators of cognitive decline in older adults.