Objective To explore the mediating role of eating disorders in the relationship between body image satisfaction and anxiety symptoms among college students,and further examine the moderating effect of mindfulness on this mediating pathway.Methods By using convenience sampling,we conducted baseline and follow-up surveys among freshmen and sophomores at two universities in Xizang Autonomous Region from September to December 2021.Measurements included the Generalized Anxiety Disorder Scale,the body image satisfaction subscale of the Multidimensional Body-Self Relations Questionnaire,the Eating Attitudes Test,and the Mindful Attention Awareness Scale.Data analyses performed using SPSS 23.0 included Pearson correlation analysis,mediation(model 4),and moderation(model 58)effect analysis.Results A total of 2 993 students participated in both the baseline and follow-up surveys,including 1 007 males(34.3％)and 1,666 Tibetan and other ethnic minorities(56.8％),with an average age of 19.8(SD=1.3)years.Body image satisfaction significantly predicted anxiety symptoms,and this relationship was partially mediated by disordered eating.The presence of mindfulness moderated the impact of body image satisfaction on disordered eating and the influence of disordered eating on anxiety symptoms,indicating varying strengths of these relationships at different levels of mindfulness.Conclusion This study demonstrates that body image satisfaction can significantly predict anxiety symptoms,with disordered eating playing a mediating role in this relationship.The moderating effect of mindfulness further reveals that students with high levels of mindfulness are less likely to experience eating disorders influenced by body image dissatisfaction.Interventions for college students'mental health should consider including management of body image and eating behaviors,as well as mindfulness training.

Diabetic kidney disease(DKD)is a chronic kidney disease caused by diabetes,influenced by genetic and environmental factors and their interaction.It is the primary cause of chronic kidney disease and end-stage renal disease.Recent studies have found,as a natural isoquinoline alkaloid,berberine(BBR)has hypoglycemic,hypolipidemic,antiox-idant,anti-inflammatory and anti-fibrotic properties,thus protects against kidney injury in DKD.The mechanisms of action of BBR may involve improving glucolipid metabolism,reducing oxidative stress,alleviating inflammatory responses,mitigat-ing renal fibrosis,regulating DNA methylation,promoting mitochondrial function and modulating the gut microbiota to enhance gut metabolism and clearance.This article systematically reviews the current status of research on the mechanisms of BBR in the treatment of DKD and provides reference for future clinical application of BBR in the treatment of DKD.

Objective:To investigate the midterm and long-term efficacy of flow-diverter device in treating intracranial aneurysms (IAs) and analyze its clinical outcomes in anterior circulation aneurysms and posterior circulation aneurysms.Methods:This is a retrospective case series study. The data of 566 intracranial aneurysm patients (681 aneurysms) treated with the flow-diverter device at Department of Neurosurgery, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University from January 2018 to January 2021 were retrospectively analyzed. There were 205 males and 361 females, with an age ( M(IQR)) of 55 (14) years (range:18 to 77 years). Twelve patients (12 aneurysms) had ruptured aneurysms before surgery, and 75 patients (172 aneurysms) had multiple aneurysms. Preoperative modified Rankin scale (mRS) >2 points in 16 patients.There were 444 patients (552 aneurysms) in the anterior circulation group and 122 patients (129 aneurysms) in the posterior circulation group. Postoperative follow-up was conducted via outpatient visits or telephone calls at 3 to 12 months after the procedure. Baseline aneurysm parameters, surgical information, and imaging and clinical outcomes were collected. Univariate and multivariate Logistic regression analyses were used to identify independent factors associated with long-term incomplete aneurysm occlusion. Results:Intraoperative use of flow diverter-assisted coil embolization was performed in 221 patients (226 aneurysms), and balloon assistance was used in 20 patients (22 aneurysms).The intraoperative rupture rate was 0.5% (3/566), and the intraoperative thrombosis rate was 0.7% (4/566). The in-hospital mortality rate was 1.2% (7/566). Postoperative complications included subarachnoid hemorrhage in 5 patients (0.9%), intracerebral hemorrhage in 2 patients (0.4%), ischemic stroke in 19 patients (3.6%), and transient ischemic attack in 16 patients (3.0%). Imaging follow-up was available for 447 patients (548 aneurysms) with a follow-up duration of (16.7±6.7) months (range:3 to 45 months). Incomplete aneurysm occlusion occurred in 79 patients (95 aneurysms), accounting for 17.3% (95/548). Parent artery stenosis was observed in 63 patients (72 aneurysms), accounting for 13.1% (72/548). Clinical follow-up was available for 530 patients (644 aneurysms) with a follow-up duration of (29.4±11.3) months (range:3 to 54 months). One case of mRS score >2 points was observed in 18 patients, accounting for 3.4% (18/530). Among them, the rate of incomplete occlusion in the anterior and posterior circulation group was 16.9% (76/450) and 19.4% (19/98), respectively, and the rate of parent artery stenosis was 10.9% (49/450) and 23.5% (23/98), respectively; the rate of mRS score>2 points was 2.4% (10/415) and 7.0% (8/115), respectively. Univariate and multivariate Logistic regression analysis showed that aneurysm neck size ( β=0.075, OR=1.08, P=0.028) and coil use ( β=-1.070, OR=0.034, P=0.001) were independent factors influencing long-term aneurysm occlusion. Conclusions:The flow-diverter device demonstrates good safety and efficacy in the midterm and long-term treatment of overall IAs. However, further research is needed to focus on the midterm and long-term treatment outcomes of aneurysms with relatively wide neck and posterior circulation aneurysms.

Objective:To investigate the midterm and long-term efficacy of flow-diverter device in treating intracranial aneurysms (IAs) and analyze its clinical outcomes in anterior circulation aneurysms and posterior circulation aneurysms.Methods:This is a retrospective case series study. The data of 566 intracranial aneurysm patients (681 aneurysms) treated with the flow-diverter device at Department of Neurosurgery, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University from January 2018 to January 2021 were retrospectively analyzed. There were 205 males and 361 females, with an age ( M(IQR)) of 55 (14) years (range:18 to 77 years). Twelve patients (12 aneurysms) had ruptured aneurysms before surgery, and 75 patients (172 aneurysms) had multiple aneurysms. Preoperative modified Rankin scale (mRS) >2 points in 16 patients.There were 444 patients (552 aneurysms) in the anterior circulation group and 122 patients (129 aneurysms) in the posterior circulation group. Postoperative follow-up was conducted via outpatient visits or telephone calls at 3 to 12 months after the procedure. Baseline aneurysm parameters, surgical information, and imaging and clinical outcomes were collected. Univariate and multivariate Logistic regression analyses were used to identify independent factors associated with long-term incomplete aneurysm occlusion. Results:Intraoperative use of flow diverter-assisted coil embolization was performed in 221 patients (226 aneurysms), and balloon assistance was used in 20 patients (22 aneurysms).The intraoperative rupture rate was 0.5% (3/566), and the intraoperative thrombosis rate was 0.7% (4/566). The in-hospital mortality rate was 1.2% (7/566). Postoperative complications included subarachnoid hemorrhage in 5 patients (0.9%), intracerebral hemorrhage in 2 patients (0.4%), ischemic stroke in 19 patients (3.6%), and transient ischemic attack in 16 patients (3.0%). Imaging follow-up was available for 447 patients (548 aneurysms) with a follow-up duration of (16.7±6.7) months (range:3 to 45 months). Incomplete aneurysm occlusion occurred in 79 patients (95 aneurysms), accounting for 17.3% (95/548). Parent artery stenosis was observed in 63 patients (72 aneurysms), accounting for 13.1% (72/548). Clinical follow-up was available for 530 patients (644 aneurysms) with a follow-up duration of (29.4±11.3) months (range:3 to 54 months). One case of mRS score >2 points was observed in 18 patients, accounting for 3.4% (18/530). Among them, the rate of incomplete occlusion in the anterior and posterior circulation group was 16.9% (76/450) and 19.4% (19/98), respectively, and the rate of parent artery stenosis was 10.9% (49/450) and 23.5% (23/98), respectively; the rate of mRS score>2 points was 2.4% (10/415) and 7.0% (8/115), respectively. Univariate and multivariate Logistic regression analysis showed that aneurysm neck size ( β=0.075, OR=1.08, P=0.028) and coil use ( β=-1.070, OR=0.034, P=0.001) were independent factors influencing long-term aneurysm occlusion. Conclusions:The flow-diverter device demonstrates good safety and efficacy in the midterm and long-term treatment of overall IAs. However, further research is needed to focus on the midterm and long-term treatment outcomes of aneurysms with relatively wide neck and posterior circulation aneurysms.

Objective:To explore the effectiveness of applying the ADDIE (analysis, design, develop, implement, evaluate) Model in clinical teaching for nursing interns in spine surgery department.Methods:Using a convenience sampling method, 44 nursing interns in the Department of Orthopedics at Peking Union Medical College Hospital were selected as the control group from July 2021 to May 2022, and were taught using traditional methods. From July 2022 to May 2023, 45 nursing interns were selected as the observation group, and a teaching team was formed to design a training program based on the five stages of the ADDIE instructional design model. This program was tailored to improve the overall clinical competence of the spinal surgery nursing interns. After training, the teaching effects were evaluated based on knowledge test scores, skills test scores, overall clinical competence, and teaching satisfaction.Results:After the training, the skills test scores in specialized nursing for the observation group were (94.87±1.10) points, higher than the control group's (93.98±1.41) points, with a statistically significant difference ( P<0.01). The observation group also scored higher than the control group in clinical judgment, organizational effectiveness, overall performance, and total score in the Mini-Clinical Evaluation Exercise, with statistically significant differences ( P<0.01). Additionally, the observation group reported higher satisfaction with the teaching plan and methods compared to the control group ( P<0.05) . Conclusions:Clinical teaching for spinal surgery nursing interns based on the ADDIE instructional design model can improve their specialized practical skills and overall clinical competence. The interns also expressed a high level of acceptance for this teaching design model.

Objective:Proximal femur tumor resection often leads to hip joint instability and functional loss.Various methods have been clinically applied to repair hip joint soft tissue function,but deficiencies remain.This study aims to evaluate the advantages and disadvantages of the ligament advanced reinforcement system(LARS)tumor tube in assisting soft tissue function reconstruction in patients undergoing tumor type artificial hip replacement surgery. Methods:This study included 85 patients(41 males,44 females)with proximal femoral tumors treated at the Xiangya Bone Tumor Treatment Center from January 2012 to January 2022,aged 10 to 79(38.5±18.2)years.Among them,13 cases had benign aggressive tumors,45 had primary malignant bone tumors,and 27 had bone metastases.Clinical data,imaging data,and intraoperative photos were collected.Patients were followed up and postoperative functional evaluations were conducted using the Musculoskeletal Tumor Society(MSTS)scoring system and Harris hip joint scoring system to assess limb function and hip joint function. Results:Preoperative pathological fractures were present in 37 cases(43.5％),with a lesion length of(9.4±2.9)cm.Among non-metastatic tumor patients,7 experienced postoperative recurrence,including 6 cases of osteosarcoma and 1 case of fibrosarcoma.Pulmonary metastases occurred in 9 osteosarcoma patients.Five patients required reoperation due to postoperative complications,including 3 cases of deep vein thrombosis,1 case of giant cell granuloma,and 1 case of prosthesis infection.Postoperatively,5 patients exhibited Trendelenburg gait,and 6 had leg length discrepancies.The postoperative MSTS score was 26.7±1.4,and the Harris score was 89.6±5.3. Conclusion:The LARS tumor tube can effectively assist in reconstructing the soft tissue function of the hip joint and greatly reduce postoperative complications,making it an effective technical improvement in joint function reconstruction in tumor type artificial hip replacement surgery.

Alzheimer's disease (AD) is associated with the impairment of white matter (WM) tracts. The current study aimed to verify the utility of WM as the neuroimaging marker of AD with multisite diffusion tensor imaging datasets [321 patients with AD, 265 patients with mild cognitive impairment (MCI), 279 normal controls (NC)], a unified pipeline, and independent site cross-validation. Automated fiber quantification was used to extract diffusion profiles along tracts. Random-effects meta-analyses showed a reproducible degeneration pattern in which fractional anisotropy significantly decreased in the AD and MCI groups compared with NC. Machine learning models using tract-based features showed good generalizability among independent site cross-validation. The diffusion metrics of the altered regions and the AD probability predicted by the models were highly correlated with cognitive ability in the AD and MCI groups. We highlighted the reproducibility and generalizability of the degeneration pattern of WM tracts in AD.
Humans ; White Matter/diagnostic imaging* ; Diffusion Tensor Imaging/methods* ; Alzheimer Disease/complications* ; Reproducibility of Results ; Cognition ; Cognitive Dysfunction/complications* ; Brain/diagnostic imaging*

Objective:To analyze the distribution of blood lipids and apolipoprotein E ( ApoE) gene in patients with cardiovascular and cerebrovascular diseases in Honghe Hani and Yi Autonomous Prefecture of Yunnan Province, and their relationship with ethnicity, gender, and age. Methods:A total of 102 patients with cardiovascular and cerebrovascular diseases who received treatment in Southern Central Hospital of Yunnan Province (The First People's Hospital of Honghe State) from May 2019 to June 2020 were included in this study. Their blood lipid and ApoE gene distributions were analyzed. The correlations between blood lipid and ApoE gene distribution and ethnicity, gender, and age were analyzed. Results:There was a significant difference in total cholesterol level between male and female patients with cardiovascular and cerebrovascular diseases in Honghe Hani and Yi Autonomous Prefecture of Yunnan Province [(4.10 ± 1.27) mmol/L vs. (4.70 ± 1.83) mmol/L, t = 1.87, P = 0.048]. There was no significant difference in total cholesterol level among different ethnic groups and different ages ( P = 0.343, 1.000). There were no significant differences in low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride levels among different ethnic groups, different sexes, and different ages ( P = 0.562, 0.125, 0.158; 0.884, 0.068, 0.681; 0.262, 0.367, 0.965). There were no significant differences in blood lipid levels among different ethnic groups, different sexes, and different ages ( P = 0.890, 0.336, 0.142). No E2/E4 gene was found in all patients. E2/E2 and E2/E3 genes of ApoE accounted for 16.67%, E3/E3 gene accounted for 70.59%, and E3/E4 and E4/E4 genes accounted for 12.74%. There was no significant difference in the distribution of ApoE gene among different ethnic groups, different sexes, and different ages ( χ2 = 0.13, 0.69, 0.44, P = 0.936, 0.429, 0.804). Conclusion:Female patients with cardiovascular and cerebrovascular diseases in Honghe Hani and Yi Autonomous Prefecture of Yunnan Province have higher total cholesterol levels than male patients. Low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride levels are not significantly correlated with ethnicity, sex, and age. Blood lipid abnormalities mainly manifest as low high-density lipoprotein cholesterol levels and high triglyceride levels. The E2/E4 gene has not been found in this region so far.

Objective:To construct the core competence indicator system of newly recruited nurses based on the concept of safety and quality improvement, so as to provide a reference for the construction of the training system of the core competence and the formulation of evaluation standards of newly recruited nurses.Methods:Through literature retrieval and analysis, a framework of core competency indicator system of newly recruited nurses guided by the concept of safety and quality improvement was initially constructed. From November 2020 to March 2021, 15 nursing education and nursing practice experts across the country were consulted for 3 rounds through the Delphi expert consultation, and the expert opinions were collected to finally determine the indicator system.Results:Among 3 rounds of expert consultation, the response rates of the questionnaires were all 100%, and the expert authority coefficient was 0.90, and the Kendall coordination coefficient of the three-level indicators was from 0.14 to 0.20 ( P<0.05) . The finalized core competence indicator system of newly recruited nurses included 7 first-level indicators (professional knowledge and ability, patient-centered nursing, cooperative communication, quality promotion, safety, nursing information ability, professional development) , 18 second-level indicators and 103 third-level indicators. Conclusions:The indicators of the core competence indicator system of newly recruited nurses are good, which can provide a reference for optimizing the training courses for newly recruited nurses and improving the evaluation standards.

Objective:To analyze the distribution of solute carrier organic anion transporter family member 1b1 ( SLCO1B1) and apolipoprotein E ( ApoE) genes in a population from southern Yunnan. Methods:The data of 104 patients who received treatment in Southern Central Hospital of Yunnan Province (The First People's Hospital of Honghe State) between May 2019 and June 2020 were collected. The distribution of SLCO1B1 and ApoE genes and their relationship with nationality, sex, and age were analyzed and compared between different regions. Results:The percentage of patients carrying *1a/*1a, *1a/*1b, *1b/*1b, *1a/*15, *1b/*15, five phenotypes of SLCO1B1 gene, in the population from southern Yunnan was 4.81%, 32.69%, 42.31%, 12.50% and 7.69% respectively. Phenotypes *1a/*5, *5/*5, *5/*15 and *15/*15 were not detected. Normal metabolic phenotype of SLCO1B1 accounted for 79.81%, and intermediate metabolic phenotype of SLCO1B1 accounted for 20.19%. Weak metabolic phenotype was not detected. The percentage of patients carrying E2/E2, E2/E3, E3/E3, E3/E4, E4/E4, five phenotypes of ApoE gene in the population from southern Yunnan was 0.96%, 16.35%, 70.19%, 11.54% and 0.96% respectively. E2/E4 phenotype was not detected. The percentage of patients with ApoE protective phenotype, ApoE normal phenotype, and ApoE risk phenotype was 17.31%, 70.19% and 12.50% respectively. The observed polymorphism mutation frequency of SLCO1B1 and ApoE genes was consistent with the Hardy-Weinberg equilibrium ( P > 0.05), suggesting constancy and a population representation. The Fisher test showed that SLCO1B1 gene distribution differed significantly between ethnic minorities and Han nationality in southern Yunnan ( P = 0.013). There was no significant difference in SLCO1B1 gene distribution between different sexes and between different ages (all P > 0.05). There was no significant difference in ApoE gene distribution between ethnic minorities and Han nationality, between different sexes, and between different ages in the population from southern Yunnan (all P > 0.05). Conclusion:SLCO1B1 gene distribution is related to nationality in the population from southern Yunnan, but it is unrelated to sex and age. ApoE gene distribution is unrelated to nationality, sex and age.