Objective: To investigate the association between different digital media usage types and depressive symptoms among junior and senior high school students, so as to provide a scientific reference for making precise mental health prevention and intervention strategies for adolescents. Methods: In October 2024, a convenience cluster sample of 3 225 students was collected from 2 junior high schools and 2 senior high schools in Shenyang City. Participants were investigated for its daily usage duration of various digital media types and depressive symptoms. Cochran-Armitage trend test was used to examine trend in depressive symptom detection rates across digital media usage types. Multivariate Logistic regression model was employed to assess associations, with stratified analyses by gender and educational stage. Results: The daily usage durations for educational/learning, social/chatting, gaming, and video/music/novel digital media were 30.0(12.1, 60.0), 22.9(9.3, 50.0), 17.1(0.0, 50.0), and 22.9(8.6, 55.7) minutes for junior and senior high school students, respectively. The detection rate of depressive symptoms was 46.1%. Among them, the detection rate of depressive symptoms of girls (49.8%) was higher than that of boys (42.3%), and that of senior high school students (53.2%) was higher than that of junior high school students (39.7%), and the differences were statistically significant ( χ 2= 18.35, 59.02, both P <0.01). Cochran-Armitage trend test revealed significant upward trends in depressive symptom detection rates with increasing usage of non educational digital media (social/chatting: Z =4.77; gaming: Z =3.24; video/music/novel: Z =7.30, all P <0.01). Logistic regression analysis showed that, compared to usage <1 h/d, using social/chatting digital media for 1-<2 h/d ( OR =1.66), 2-<3 h/d ( OR =1.80), and ≥3 h/d ( OR =2.68), gaming for 1-<2 h/d ( OR =1.48), 2-<3 h/d ( OR =1.90), and ≥3 h/d ( OR =2.93), and video/music/novel for 1-<2 h/d ( OR =1.76), 2-<3 h/d ( OR =2.00), and ≥3 h/d ( OR = 3.48) were all significantly associated with increased risks of depressive symptoms (all P <0.01). Conclusions Excessive use of non-educational digital media is a risk factor for depressive symptoms in adolescents. Regulating usage duration is beneficial for promoting adolescent mental health.

Objective: To analyze the association of mother-child interaction and screen exposure of preschool children with psychological and behavioural problems, so as to provide guidance for promoting the psychological development of preschool children. Methods: From November to December 2024, a convenience cluster sampling method was used to survey 2 977 mothers of preschool children in Daguan and Yingjiang districts of Anqing City. The Chinese Parent-Child Interaction Scale (CPCIS) was applied to evaluate the quality of mother-child interaction, and the Conners Parent Symptom Questionnaire (PSQ) was used to assess the psychological and behavioral problems of preschool children. Binary Logistic regression was applied to analyze the association of mother-child interaction, screen exposure and their combined effect on psychological and behavioral problems among preschool children. Results: The detection rate of psychological and behavioral problems among preschool children was 13.9%. Binary Logistic regression results showed that low scores of mother-child interaction ( OR=2.31, 95%CI =1.72-3.11) and high screen exposure ( OR= 1.52 , 95%CI =1.23-1.88) were higher risks for psychological and behavioral problems in preschool children; the results of the combined effect showed that preschool children in low scores of mother-child interaction and low screen exposure group ( OR=2.18, 95%CI =1.46-3.28), low scores of mother-child interaction and high screen exposure group ( OR=3.13, 95%CI =2.10- 4.65 ) had significantly higher risks of abnormal detection in psychological and behavioral problems, compared to those in the high scores of mother-child interaction and low screen exposure group respectively (all P <0.05). Conclusions Both screen exposure and mother- child interaction are associated with psychological and behavioral problems in preschool children. High quality mother-child interaction can relieve the adverse effects of screen exposure on preschool children s psychological and behavioral development.

BACKGROUND:In most species,a bone defect that is longer than 1.5 or 2 times its diameter can be considered a critical bone defect,and when the bone defect volume reaches the critical value,it cannot heal on its own.Currently,there is no uniform standard for the size of critical-sized defects in the osteoporotic femoral condyle of rabbits.OBJECTIVE:To establish a rabbit model with different sizes of bone defects in the osteoporotic femoral condyle and to determine the critical-sized defects of osteoporotic femoral condyle in rabbits.METHODS:Thirty-six 3-month-old female New Zealand white rabbits were randomly divided into ovariectomy group(n=30)and sham operation group(n=6).Rabbits in the ovariectomy group underwent bilateral ovariectomy to establish an osteoporosis model,and then femoral condyle bone defect models of different diameters(diameters were 4,5,6,and 7 mm,and depths were 8 mm)were further established;rabbits in the sham operation group did not undergo ovariectomy.At 8 and 12 weeks after modeling,3 rats were randomly selected from each group for CT scanning and three-dimensional reconstruction to evaluate the healing of bone defects.Afterwards,samples were taken for gross observation and hematoxylin-eosin staining to observe the growth of new bone in the femoral condyle bone defect area.RESULTS AND CONCLUSION:(1)All rabbits survived and moved well after modeling of osteoporosis and femoral condyle bone defect.(2)At 12 weeks after osteoporosis modeling,dual-energy X-ray absorptiometry results showed that the bone mineral density of lumbar vertebrae in ovariectomy group was significantly lower than that in sham operation group(P＜0.05).Hematoxylin-eosin staining showed that the bone trabeculae in the ovariectomy group became thinner and sparse.The proportion of bone tissue area in the ovariectomy group was significantly lower than that in the sham operation group(P=0.00).Micro-CT results showed that the bone tissue parameters of the femoral condyle in the ovariectomy group were significantly different from those in the sham operation group(P＜0.05),and the ovariectomy group showed obvious characteristics of osteoporosis.(3)CT showed that the bone defect in the 4 mm and 5 mm diameter groups was basically completely repaired at 12 weeks after surgery.There was more new bone tissue in the 6 mm diameter group,but the central part of the bone defect was not completely repaired.A small amount of new bone tissue grew in the 7 mm diameter group,and the bone defect was obvious.(4)Gross observation at 12 weeks after surgery showed that the femoral condyle bone defect in the 4 mm and 5 mm diameter groups was completely repaired.Obvious depression was seen in the bone defect area of the 6 mm and 7 mm diameter groups,and the bone defect was not completely repaired.(5)Histological observation at 12 weeks after surgery showed that the bone defect area of the 4 mm and 5 mm diameter groups was completely filled with new bone,and the trabecular structure was irregular;while there were new trabeculae in the periphery of the 6 mm and 7 mm diameter groups,and the bone defect in the central area was still obvious.(6)The results showed that during the 12-week experimental observation period of osteoporotic femoral condyle defects in rabbits,under the condition of the same defect depth of 8 mm,femoral condyle defects with a diameter ≥ 6 mm could not heal on their own,while femoral condyle defects with a diameter＜6 mm were completely repaired.A diameter of 6 mm and a depth of 8 mm can be used as the critical bone defect value of osteoporotic femoral condyle in rabbits.

Objective:To investigate the effect of aucubin(AU)on mitochondrial autophagy in the hippocampus of ischemic stroke(IS)rats by regulating the pten-induced kinase protein 1(PINK1)/cytoplasmic E3-ubiquitin ligase(Parkin)signaling pathway.Methods:The IS rat model was established by middle cerebral artery occlusion(MCAO),and was randomly divided into IS group,low-dose AU group(AU-L),medium-dose AU group(AU-M),high-dose AU group(AU-H),and high-dose AU combined with 3-MA group(AU-H+3-MA).The rats without liga-tion were used as the Sham surgery group.Zea Longa score was used to evaluate the neurological function of rats.TTC staining was used to detect the percentage of cerebral infarction volume.The microstructures of mitochondria were observed by transmission electron microscopy,and the changes of autophagy protein-microtubule associated protein light chain 3B(LC3B)and p62 were detected by immunohistochemistry.Hippocampal apoptosis was detected by TUNEL.PINK1/Parkin-related protein expression in hippocampus was detected by Western blot.Results:Neurological function score of IS rats was increased(P＜0.05),cerebral infarction was observed by TTC staining,the expression of mito-chondrial autophagy protein p62 in hippocampus was up-regulated(P＜0.05),the expression of LC3B was down-regu-lated(P＜0.05),the number of autophagosomes was decreased(P＜0.05),and apoptosis in hippocampus was in-creased(P＜0.05),the expression of PINK1 and ARKIN protein in hippocampus was down-regulated(P＜0.05).After AU intervention,the neural function score of rats was decreased,the percentage of cerebral infarction volume was reduced,the positive expression of p62 in hippocampus was down-regulated(P＜0.05),the positive expression of LC3B was up-regulated(P＜0.05),and the number of autophagosomes was increased(P＜0.05),the apoptosis of hippocampus was decreased(P＜0.05),and the expression of PINK1 and ARKIN protein in hippocampus was in-creased(P＜0.05).3-MA blocked the therapeutic effect of AU and aggravated the nerve injury in rats.Conclusion:AU promotes hippocampal mitochondrial autophagy and improves neurological damage in IS rats by activating the PINK1/Parkin signaling pathway.

Objective To investigate the changes of brain deep gray matter nucleus volume and iron content in patients with type 2 dia-betes mellitus(T2DM)based on quantitative MR technology,and their correlation and mediating effect with cognitive impairment.Methods A total of 60 T2DM patients(T2DM group)and 61 healthy controls(HC)(HC group)were prospectively selected.The volume of brain deep gray matter nucleus of 3D-T1 sequence map was measured by artificial intelligence(AI)automatic segmentation technique,the corresponding region of interest(ROI)was manually drawn and quantitative susceptibility mapping(QSM)value was measured on QSM,the cognitive score,QSM value and volume of nucleus were compared by independent sample t test and rank sum test,and the correlation analysis of imaging indexes with differences between the two groups was made.The mediating effect between fasting blood glucose(FBG)and Montreal cognitive assessment(MoCA)score was analyzed.Results The MoCA and mini-mental state examination(MMSE)scores in the T2DM group were lower than those in the HC group(P＜0.05),the volumes of bilateral caudate nucleus,putamen,globus pallidus,thalamus,and right hippocampus in the T2DM group were lower than those in the HC group(P＜0.05),and the QSM values of left caudate nucleus,thalamus and bilateral globus pallidus in the T2DM group were higher than those in the HC group(P＜0.05).In the T2DM group,the volumes of bilateral thalamus and right hippocampus were positively correlated with MoCA score(left thalamus:r=0.326,P=0.012;right thalamus:r=0.373,P=0.004;right hippocampus:r=0.509,P＜0.001),and the QSM value of left thalamus was negatively correlated with MoCA score(r=-0.263,P=0.044).The mediating effect of right hippocampus volume and left thalamus QSM value was significant(P＜0.05),and the direct effect of FBG on cog-nitive score was significant(P＜0.05).Conclusion Brain deep gray matter nucleus atrophy and brain iron deposition are closely related to T2DM and cognitive impairment,and there is a mediating effect.Brain iron deposition will increase the risk of cognitive impairment in T2DM.

Objective:In order to effectively educate students on tooth defect diseases and restoration techniques, the teaching and research team at the School of Stomatology of Qingdao University developed an integrated course operative dentistry. This course is specifically designed to align with the undergraduate curriculum reform requirements of "Three Early, Two Multiple and One Integration".Methods:The teaching practice of operative dentistry was conducted with the stomatology undergraduates of grade 2020 and 2021. The course group redesigned the curriculum by reorganizing teaching content, rebuilding teaching resources, reconstructing teaching mode, and reshaping the evaluation system. Evaluation of the curriculum design included test scores, satisfaction questionnaires, and teacher self-evaluation. Statistical analysis was performed using SPSS 27.0 software, including independent sample t-tests for numerical variables and Fisher's exact test or Wilcoxon rank sum test for categorical variables. Results:Through the integrated course learning, 92.68% (38/41) of the students of grade 2020 and 97.44% (38/39) of the students of grade 2021 can basically or completely master various dental defect repair schemes and understand the importance of preserving natural tooth. 82.93% (34/41) of the students of grade 2020 and 100.00% (39/39) of the students of grade 2021 could basically or completely master the key points of various dental defect restorations.Conclusions:Through the practice of teaching, it has been confirmed that the integrated course of operative dentistry is beneficial to students' mastering the knowledge and skills of dental defect diseases and their restoration in a more comprehensive way, and is conducive to the cultivation of clinical thinking, hands-on ability and the patient-centered, comprehensive problem-solving thinking, which is in line with the guidance on the innovation and development of medical education.

Objective To develop an evaluation system for quality palliative care and provide an evaluation tool for quality palliative care service.Methods A preliminary evaluation system was drafted by using literature review and group discussion,aligning with the U.S.National Consensus Project for Quality Palliative Care(NCP).The system was revised and refined by two rounds of Delphi consultation with 15 palliative care experts(including specialists in clinical practice,nursing management,nursing research and education)from Tier-IIIA hospitals in Guangdong Province.Indicator weights were determined via consensus.Results Both rounds of expert consultation achieved 100.00%response rates.Expert authority coefficient(Cr)was 0.855.The importance scores of the level-1,level-2 and level-3 indicators of the second round of expert consultation were 4.90-5.00,4.80-5.00 and 4.37-5.00,respectively.Coefficients of variation were 0-0.06,0-0.1 and 0-0.19,respectively.The full score ratio ranged between 0.93 and 1.00,0.8 and 1.00,and 0.67 and 1.00.Kendall's W coefficients were 0.214,0.287 and 0.245,respectively(all P<0.01).The nine level-1 indicators were identified as care structure and process,physiological care,psychological care,social care,mental care,cultural care,end-of-life care,ethical care and quality improvement,with the weight coefficients of 0.123,0.153,0.110,0.106,0.098,0.082,0.119,0.092 and 0.117,respectively.The final evaluation system for quality palliative care included 9 indicators in level-1,22 in level-2 and 69 in level-3.Conclusion The evaluation system for quality palliative care developed on the basis of NCP is scientifically innovative and valid in content.Further studies are required to evaluate its validity..

Objective To develop an evaluation system for quality palliative care and provide an evaluation tool for quality palliative care service.Methods A preliminary evaluation system was drafted by using literature review and group discussion,aligning with the U.S.National Consensus Project for Quality Palliative Care(NCP).The system was revised and refined by two rounds of Delphi consultation with 15 palliative care experts(including specialists in clinical practice,nursing management,nursing research and education)from Tier-IIIA hospitals in Guangdong Province.Indicator weights were determined via consensus.Results Both rounds of expert consultation achieved 100.00%response rates.Expert authority coefficient(Cr)was 0.855.The importance scores of the level-1,level-2 and level-3 indicators of the second round of expert consultation were 4.90-5.00,4.80-5.00 and 4.37-5.00,respectively.Coefficients of variation were 0-0.06,0-0.1 and 0-0.19,respectively.The full score ratio ranged between 0.93 and 1.00,0.8 and 1.00,and 0.67 and 1.00.Kendall's W coefficients were 0.214,0.287 and 0.245,respectively(all P<0.01).The nine level-1 indicators were identified as care structure and process,physiological care,psychological care,social care,mental care,cultural care,end-of-life care,ethical care and quality improvement,with the weight coefficients of 0.123,0.153,0.110,0.106,0.098,0.082,0.119,0.092 and 0.117,respectively.The final evaluation system for quality palliative care included 9 indicators in level-1,22 in level-2 and 69 in level-3.Conclusion The evaluation system for quality palliative care developed on the basis of NCP is scientifically innovative and valid in content.Further studies are required to evaluate its validity..

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.

Aim To explore the safety and efficacy of simple drug-coated balloon(DCB)compared with provi-sional stenting(PS)in the treatment of pseudo-left main(pseudo-LM)bifurcation lesions.Methods A retrospective analysis was performed on 175 patients who underwent coronary angiography for pseudo-LM bifurcation lesions and interven-tional treatment at the Second Affiliated Hospital of Zhengzhou University from January 2018 to January 2023.According to the treatment strategy,they were divided into drug-eluting stent(DES)group(99 cases)and DCB group(76 cases).Preoperative and immediate postoperative quantitative coronary angiography(QCA)data were recorded,and patients were followed up.The follow-up endpoints included the occurrence of major adverse cardiovascular events(MACE)and hospi-tal re-admission.Coronary angiography and QCA data during follow-up were also recorded.Results The immediate postoperative minimum lumen diameter and lumen gain in the left main(LM),left anterior descending(LAD),and left circumflex(LCX)arteries of the DCB group were smaller than those of the DES group(P＜0.05),while the degree of re-sidual lumen stenosis immediately after surgery was greater than that of the DES group(P＜0.05).QCA was performed on the coronary angiography results of follow-up patients.The minimum lumen diameter in LM,LAD,and LCX was smaller in the DCB group than in the DES group during follow-up(P＜0.05).The degree of residual lumen stenosis dur-ing follow-up was greater in the DCB group than in the DES group(P＜0.05),but the late lumen loss in LM,LAD,and LCX was smaller in the DCB group than that in the DES group,with statistically significant differences(P＜0.05).There was no significant difference in the incidence of postoperative MACE between the two groups during the follow-up period(P＞0.05).Cox regression analysis showed that the choice of interventional treatment(DCB vs.PS)had no significant impact on the risk of MACE(P＞0.05).Conclusion Compared with PS,DCB alone demonstrates relatively satisfac-tory efficacy and safety in the treatment of pseudo-LM bifurcation lesions and can be considered as an alternative treatment strategy for interventional therapy of such lesions.