Objective: To explore the network structure of anxiety and depressive symptoms, and psychotic like experiences in junior and senior high school students with different sleep qualities, and to provide a reference for improving sleep quality in the population. Methods: A cross sectional online survey was conducted among 22 997 junior and senior high school students from seven junior and senior high schools in Luzhou City, Sichuan Province, using convenience sampling. The Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and the 16item Prodromal Questionnaire (PQ-16) were administered. Independent sample t-test was used to compare mental health status between adolescents with and without sleep problems. Network analysis was applied to examine the symptom association patterns across gender and school stage subgroups. Results: The prevalence of sleep problems among junior and senior high school students was 22.58%. The total anxiety symptom score (8.92± 4.02 ), total depressive symptom score (13.35±5.66), and scores for each factor of PQ-16 (perceptual and sensory abnormalities, thinking abnormalities, negative symptoms, and specific perceptual and sensory abnormalities) (3.32±3.32, 2.08±2.36, 3.36± 2.74 , 1.44±1.86) in the group with sleep problems were all significantly higher than those in the group without sleep problems ( 3.43 ±3.33, 5.03±4.73; 0.63±1.52, 0.47±1.11, 0.77±1.48, 0.25±0.79), with statistically significant differences ( t =99.60, 106.54, 82.49, 68.51, 89.09, 67.30, all P <0.01). In females with sleep problems, the anxiety-depressive symptoms edge weight was the highest (0.44). In males with sleep problems, the "sleep latency-sleep efficiency" edge weight was the highest (0.43), and the strength centrality values of "perceptual abnormalities" "medication factor" and "sleep latency" ranked the higher (1.32, 1.31 and 1.25). The network connectivity strength of the sleep problem group was higher in senior high school students than in junior high school students, and the strength centrality (1.12) and betweenness centrality (0.12) of negative symptoms were higher than those in junior high school students (1.02 and 0.11). Conclusions The network associations between sleep problems and psychological symptoms in junior and senior high school students exhibit gender and school stage specific characteristics. Differentiated intervention strategies should be tailored to specific subgroups.

Objective To identify the main challenges in the current development of the"one hospital with multiple campuses"model in Chinese public hospitals and provide evidence for policy improvement.Methods A systematic search of literature published between 2014 and 2024 on the topic of"one hospital with multiple campuses"was conducted in the CNKI database.The severity of the problems(Pc)was comprehensively calculated through biblio-metric analysis,and the severity ranking of the problems was determined accordingly.Results Twenty-five issues were categorized into nine dimensions.Key problems included significant inter-campus disparities in medical quality hindering homogenization(Pc=1.000);outdated information systems causing data-sharing barriers(Pc=0.945);overly complex management systems increasing unified management difficulties(Pc=0.922);unclear functional posi-tioning of branch campuses and lack of integrated planning(Pc=0.772);and fragmented information systems cou-pled with workforce redundancy elevating cost-control challenges(Pc=0.772).Conclusion The development of the"one hospital with multiple campuses"model in Chinese public hospitals urgently requires unified quality control stan-dards,strengthened cross-campus quality supervision systems,integrated information platforms to eliminate data silos,optimized organizational structures,and discipline-specific layouts.These measures will establish a manage-ment system tailored to the multi-campus model,achieving a virtuous cycle of"structural optimization—pro-cess coordination—outcome homogenization".

The construction of medical ethical review is the basic guarantee for strengthening the ethical governance of medical science and technology,and mutual recognition of ethical review results serves as a pivotal approach to accelerate the construction of ethical review.This paper conducted a questionnaire survey on 30 tertiary medical and health institutions with clinical trial qualifications in Tianjin,based on the exploration of the implementation of the Notice on the Implementation of Mutual Recognition of Medical Ethics Review Results in the Beijing-Tianjin-Hebei Region jointly issued by the Health Committees of the three regions in Tianjin's tertiary medical and health institutions.By investigating and analyzing the situation of clinical trials,ethics committees,and mutual recognition from 2021 to 2023,the regular reasons affecting the promotion of mutual recognition of ethical review results in the Beijing-Tianjin-Hebei region were identified,and reasonable recommendations were proposed.These aimed to offer references for the Tianjin region in deepening the integration of Beijing-Tianjin-Hebei development and accelerating the promotion of regional ethical mutual recognition work,thereby advancing the construction and development of medical ethical review.

Objective:To evaluate the design and application of the superior thyroid artery perforator flap (STAPF) for reconstruction after head and neck oncological resection.Methods:A retrospective analysis was performed on 24 consecutive patients (22 men, 2 women; age 40-72 years) treated at Hunan Cancer Hospital between June 2018 and December 2023. Their primary tumors included buccal carcinoma ( n=7), tongue carcinoma ( n=8), oropharyngeal carcinoma ( n=2), floor-of-mouth carcinoma ( n=3), laryngeal carcinoma ( n=3), and hypopharyngeal carcinoma ( n=1). Flap design, venous drainage strategy, and postoperative outcomes were assessed. SPSS 19.0 software was used for statistical analysis. Results:Flap dimensions were length of 9.4±0.5 cm, width of 3.3±0.6 cm, thickness of 0.5±0.2 cm, and pedicle length of 7.3±0.6 cm. Fifteen flaps were based on a single perforator (diameter ≥0.5 mm), whereas, nine fascial flaps incorporated multiple perforators (capillary diameter ≤0.5 mm). Venous drainage routes were as follows: superior thyroid vein ( n=12, retrograde in 3), facial vein ( n=5, all retrograde), anterior jugular vein ( n=4, retrograde in 1), and external jugular vein ( n=3, retrograde in 2). All 24 flaps survived completely. Donor sites were closed primarily and all cervical wounds healed. No flap-related complications, inculding orocutaneous, pharyngocutaneous, laryngocutaneous fistula and wound infection, were observed. Final pathologic stages were T1N0M0 ( n=2), T2N0M0 ( n=16), T2N1M0 ( n=3), and T3N0M0 ( n=3). With follow-up of 12-46 months, aside from one patient with tongue cancer died of contralateral cervical and parapharyngeal lymph-node metastases at 6 months, others remained disease-free. Patients with laryngeal or hypopharyngeal carcinoma had their tracheostomy tubes removed within 4 weeks postoperatively. Conclusion:STAPF offers flexible design, with minimal donor-site morbidity and low functional impairment. It is particularly advantageous for reconstruction of small-to-moderate defects following head and neck tumor ablation.

Post-stroke cognitive impairment (PSCI) is a common complication of stroke, which seriously affects the quality of life of patients. Therefore, early and accurate prediction of PSCI is crucial for implementing targeted intervention measures. Quantitative electroencephalography (qEEG), as a non-invasive and objective neurophysiological technique, can provide objective basis for early prediction and targeted intervention of PSCI during the critical period of 72 hours to 1 month after stroke onset. This article reviews the current application status of qEEG in predicting PSCI, aiming to provide theoretical basis for early identification of patients with high-risk PSCI.

Objective To evaluate the diagnostic efficacy of sound touch viscoelastography(STVi)and shear wave elastography(SWE)in distinguishing between benign and malignant breast nodules.Methods A total of 104 breast nodules(52 benign and 52 malignant)from 102 patients scheduled for surgical treatment at Binzhou Medical University Hospital between October 2024 and February 2025 were prospectively enrolled.All nodules were pathologically confirmed through surgical excision or core needle biopsy.The viscosity coefficient and Young's modulus of both intranodular and perinodular tissues within a 2-mm range were measured using the Mindray Resona A20S ultrasound system.The diagnostic performance of each parameter,the correlation between elastic parameter values and the maximum nodule diameter,as well as the inter-correlation between the two parameters were systematically analyzed.Results The elasticity parameters were significantly higher in malignant nodules[maximum intranodular Viscosity coefficient(Vimax):5.93(4.33,8.47)Pa·s,maximum Young's modulus(Emax):81.18(58.31,120.33)kPa;maximum Viscosity coefficient of the surrounding 2-mm tissue(Vi2max):7.57(5.40,10.16)Pa·s,maximum Young's modulus(E2max):117.21(65.66,170.66)kPa]compared to benign nodules[Vimax:3.70(2.69,5.32)Pa·s,Emax:41.42(28.29,64.25)kPa;Vi2max:4.30(3.63,5.65)Pa·s,E2max:47.23(36.42,74.67)kPa](P<0.05).The diagnostic performance of the 2-mm perinodular tissue(Vi2max:0.78,E2max:0.81)surpassed that of intranodular tissue(Vimax:0.72,Emax:0.77)(P<0.05).The combined diagnostic model(Vi2+E2,Vi+E)achieved AUC values of 0.82 and 0.77,respectively,which outperformed STVi alone(P<0.05)and showed marginally better performance than SWE alone,although the difference was not statistically significant(P>0.05).The maximum nodule diameter showed a moderate correlation with the elasticity parameters,with E2max exhibiting the strongest correlation(r=0.510,P<0.05).Conclusions Both STVi and SWE show clinical value in distinguishing between benign and malignant breast nodules.Particularly,elasticity parameters obtained from the 2-mm perinodular tissue demonstrate better diagnostic performance than those measured within the nodule itself,and combining these parameters enhances the overall diagnostic accuracy of STVi.

Objective To identify the main challenges in the current development of the"one hospital with multiple campuses"model in Chinese public hospitals and provide evidence for policy improvement.Methods A systematic search of literature published between 2014 and 2024 on the topic of"one hospital with multiple campuses"was conducted in the CNKI database.The severity of the problems(Pc)was comprehensively calculated through biblio-metric analysis,and the severity ranking of the problems was determined accordingly.Results Twenty-five issues were categorized into nine dimensions.Key problems included significant inter-campus disparities in medical quality hindering homogenization(Pc=1.000);outdated information systems causing data-sharing barriers(Pc=0.945);overly complex management systems increasing unified management difficulties(Pc=0.922);unclear functional posi-tioning of branch campuses and lack of integrated planning(Pc=0.772);and fragmented information systems cou-pled with workforce redundancy elevating cost-control challenges(Pc=0.772).Conclusion The development of the"one hospital with multiple campuses"model in Chinese public hospitals urgently requires unified quality control stan-dards,strengthened cross-campus quality supervision systems,integrated information platforms to eliminate data silos,optimized organizational structures,and discipline-specific layouts.These measures will establish a manage-ment system tailored to the multi-campus model,achieving a virtuous cycle of"structural optimization—pro-cess coordination—outcome homogenization".

Based on the pathogenesis of erectile dysfunction (ED) from the meridian-zangfu relationship and the "brain-heart-kidney-essence chamber" axis, it proposes that dysfunction of the "brain-heart-kidney-essence chamber" axis is closely related to the occurrence of ED. Among these, brain-heart disharmony is the key pathogenic factor, kidney deficiency and essence depletion constitute an important basis, and essence chamber stasis is a critical mechanism. The treatment approach emphasizes harmonizing the brain and heart, regulating the mind, tonifying the kidney and replenishing qi, unblocking qi and blood to harmonize the essence chamber. The primary acupoints include Baihui (GV20)-Neiguan (PC6)-Shenmen (HT7), Taixi (KI3)-Guanyuan (CV4)-Sanyinjiao (SP6), and Zhongji (CV3)-Dahe (KI12)-Gongsun (SP4), with additional acupoints selected based on syndrome differentiation. This approach aims to restore the clarity of the brain and heart, replenish kidney qi, and unblock the essence chamber, thereby facilitating the restoration of normal functions of the brain, heart, kidney, and essence chamber, and alleviating ED symptoms and improving overall clinical efficacy.
Humans ; Male ; Meridians ; Erectile Dysfunction/physiopathology* ; Kidney/physiopathology* ; Brain/physiopathology* ; Acupuncture Therapy ; Acupuncture Points ; Heart/physiopathology*

Objective To evaluate the diagnostic efficacy of sound touch viscoelastography(STVi)and shear wave elastography(SWE)in distinguishing between benign and malignant breast nodules.Methods A total of 104 breast nodules(52 benign and 52 malignant)from 102 patients scheduled for surgical treatment at Binzhou Medical University Hospital between October 2024 and February 2025 were prospectively enrolled.All nodules were pathologically confirmed through surgical excision or core needle biopsy.The viscosity coefficient and Young's modulus of both intranodular and perinodular tissues within a 2-mm range were measured using the Mindray Resona A20S ultrasound system.The diagnostic performance of each parameter,the correlation between elastic parameter values and the maximum nodule diameter,as well as the inter-correlation between the two parameters were systematically analyzed.Results The elasticity parameters were significantly higher in malignant nodules[maximum intranodular Viscosity coefficient(Vimax):5.93(4.33,8.47)Pa·s,maximum Young's modulus(Emax):81.18(58.31,120.33)kPa;maximum Viscosity coefficient of the surrounding 2-mm tissue(Vi2max):7.57(5.40,10.16)Pa·s,maximum Young's modulus(E2max):117.21(65.66,170.66)kPa]compared to benign nodules[Vimax:3.70(2.69,5.32)Pa·s,Emax:41.42(28.29,64.25)kPa;Vi2max:4.30(3.63,5.65)Pa·s,E2max:47.23(36.42,74.67)kPa](P<0.05).The diagnostic performance of the 2-mm perinodular tissue(Vi2max:0.78,E2max:0.81)surpassed that of intranodular tissue(Vimax:0.72,Emax:0.77)(P<0.05).The combined diagnostic model(Vi2+E2,Vi+E)achieved AUC values of 0.82 and 0.77,respectively,which outperformed STVi alone(P<0.05)and showed marginally better performance than SWE alone,although the difference was not statistically significant(P>0.05).The maximum nodule diameter showed a moderate correlation with the elasticity parameters,with E2max exhibiting the strongest correlation(r=0.510,P<0.05).Conclusions Both STVi and SWE show clinical value in distinguishing between benign and malignant breast nodules.Particularly,elasticity parameters obtained from the 2-mm perinodular tissue demonstrate better diagnostic performance than those measured within the nodule itself,and combining these parameters enhances the overall diagnostic accuracy of STVi.

Objective:To evaluate the design and application of the superior thyroid artery perforator flap (STAPF) for reconstruction after head and neck oncological resection.Methods:A retrospective analysis was performed on 24 consecutive patients (22 men, 2 women; age 40-72 years) treated at Hunan Cancer Hospital between June 2018 and December 2023. Their primary tumors included buccal carcinoma ( n=7), tongue carcinoma ( n=8), oropharyngeal carcinoma ( n=2), floor-of-mouth carcinoma ( n=3), laryngeal carcinoma ( n=3), and hypopharyngeal carcinoma ( n=1). Flap design, venous drainage strategy, and postoperative outcomes were assessed. SPSS 19.0 software was used for statistical analysis. Results:Flap dimensions were length of 9.4±0.5 cm, width of 3.3±0.6 cm, thickness of 0.5±0.2 cm, and pedicle length of 7.3±0.6 cm. Fifteen flaps were based on a single perforator (diameter ≥0.5 mm), whereas, nine fascial flaps incorporated multiple perforators (capillary diameter ≤0.5 mm). Venous drainage routes were as follows: superior thyroid vein ( n=12, retrograde in 3), facial vein ( n=5, all retrograde), anterior jugular vein ( n=4, retrograde in 1), and external jugular vein ( n=3, retrograde in 2). All 24 flaps survived completely. Donor sites were closed primarily and all cervical wounds healed. No flap-related complications, inculding orocutaneous, pharyngocutaneous, laryngocutaneous fistula and wound infection, were observed. Final pathologic stages were T1N0M0 ( n=2), T2N0M0 ( n=16), T2N1M0 ( n=3), and T3N0M0 ( n=3). With follow-up of 12-46 months, aside from one patient with tongue cancer died of contralateral cervical and parapharyngeal lymph-node metastases at 6 months, others remained disease-free. Patients with laryngeal or hypopharyngeal carcinoma had their tracheostomy tubes removed within 4 weeks postoperatively. Conclusion:STAPF offers flexible design, with minimal donor-site morbidity and low functional impairment. It is particularly advantageous for reconstruction of small-to-moderate defects following head and neck tumor ablation.