Objective: To investigate the prevalence of depressive symptoms and their associated factors among students in Zhejiang Province, so as to provide evidence for targeted prevention strategies. Methods: A stratified cluster random sampling method was used to select 23 829 college students and primary and secondary school students aged 11-22 years in Zhejiang Province from December 2019 to February 2020. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Three machine learning algorithms, including Logistic regression, random forest, and eXtreme Gradient Boosting (XGBoost), were applied to construct predictive models, and key associated factors were identified by comparing model performance. Results: The detection rate of depressive symptoms among students in Zhejiang Province was 19.92%; the rates were 17.20% in boys and 22.87% in girls( χ 2=164.89, P <0.05). The CES-D total score was 9.00(4.00,13.00). Multiple Logistic regression analysis revealed that loneliness had the strongest association with depressive symptoms ( AOR =9.58, 95% CI =8.90-10.30), while bullying exposure ( AOR =4.39, 95% CI =4.02-4.80), female students( AOR =1.81, 95% CI =1.68-1.94)，never eating breakfast ( AOR = 2.34，95% CI =2.00-2.67) and overweight/obesity( AOR =1.10，95% CI =1.08-1.12) were significant associated factors of depressive symptoms among students (all P <0.05). Analysis based on the XGBoost model produced highly consistent results, identifying the above 5 factors as the core features with the highest correlation strength (all P <0.05). Conclusions Female, loneliness, bullying exposure, frequency of weekly breakfast and BMI are strongly associated with depressive symptoms among students. Mental health education for high risk groups should be strengthened, and coordinated prevention efforts between families and schools are recommended.

Objective:To explore the mediating role of psychological resilience between work stress and sleep quality in psychiatric nurses.Methods:From April to August 2023, convenience sampling was used to select 457 psychiatric nurses working in three psychiatric hospitals in Henan Province as the research subjects. The survey was conducted using the General Information Questionnaire, the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC), the Chinese Nursing Stressor Scale (CNSS), and the Pittsburgh Sleep Quality Index (PSQI). Pearson correlation was used to analyze the correlation between psychological resilience, work stress, and sleep quality among psychiatric nurses. SPSS 26.0 software was used to analyze the data, and Process macro program and Bootstrap method were used to test the mediating effect.Results:Among 457 psychiatric nurses, the total scores of the Chinese version of CD-RISC, CNSS, and PSQI were (58.89±13.27), (78.02±14.31), and (8.04±3.46), respectively. Pearson correlation showed that work stress was positively correlated with sleep quality ( r=0.703, P<0.01). In contrast, work stress was negatively correlated with psychological resilience ( r=-0.413, P<0.01), and psychological resilience was negatively correlated with sleep quality ( r=-0.712, P<0.01). Psychological resilience partially mediated the relationship between work stress and sleep quality, with a mediating effect value of 0.051, accounting for 30.0% of the total effect. Conclusions:Psychological resilience partially mediates the relationship between work stress and sleep quality in psychiatric nurses. Nursing managers should attach importance to and enhance the psychological resilience of psychiatric nurses, regularly relieve stress, improve sleep quality, and enhance the physical and mental health of nurses.

Objective:To explore the feasibility of early oral nutrition for gastric cancer patients after total gastrectomy based on propensity score matching.Methods:Using convenience sampling method, a retrospective analysis was conducted on the medical records of 755 patients who underwent total gastrectomy for gastric cancer at Jiangsu Subei People's Hospital from 2012 to 2020. A total of 454 patients who received early oral nutrition after surgery were included in the study group, while 301 patients who received conventional nutrition were included in the control group. The study group patients began eating orally on the first day after surgery, while the control group patients began eating orally after anal exhaust. The propensity score matching method was used to balance confounding factors between two groups.Results:A total of 203 pairs (406 cases) of patients were matched. After matching, there was no statistically significant difference in general data between the two groups ( P>0.05). The study group had lower dietary intake time, first anal exhaust time, hospital stay, incidence of abdominal infection, and incidence of anastomotic fistula compared to the control group, with statistically significant differences ( P<0.05) . Conclusions:Early oral nutrition for gastric cancer patients after total gastrectomy can promote intestinal function recovery, shorten hospital stay, and do not increase the risk of complications, including anastomotic fistula. It has the same acceptable tolerance as conventional nutrition, indicating that early oral nutrition after total gastrectomy is safe and feasible.

Objective To explore the application of protective restrain nicrovideo in the skill training of psychiatric low qualification nurses.Methods Totally 108 psychiatric low qualification nurses were trained with protective restrain micro video.Two microvideos were produced for theory part;for practice part,three cases of restrain were adopted and three microvideos were produced via standardized patients play and nurse scene simulation.Each microvideo was played through the platform for each week,combining periodic evaluation,which served as training for low qualification nurses.Five weeks after training,theory and practice evaluation were performed,and self-designed questionnaire was used to investigate feedbacks from nurses with regard to protective restrain training using microvideos.Clinical practicing effects were surveyed after six months.Results After the training,all the nurscs met the standard,with a good score of 95.4％.88.9％ of the nurses said the training stimulated the learning interest and initiative,94.4％ of nnrses and 93.3％ of head nurses said that training standardized the restrain behavior,90.7％ of nurses and 93.3％ of head nurses said that it could improve the ability of solving clinical emergency.After training,the injury ratc of nurses was significantly reduced,and the qualification rate of restrain nursing and restriction record and patient satisfaction were significantly improved (P＜0.05).Conclusion Protective restrain microvideo can stimulate nurse's learning interest,regulate nursiug behavior,inprove clinical nursing quality and reduce injury rate.