Objective: To explore the longitudinal relationship between bullying victimization and sleep quality among rural boarding junior high school students in Hebei Province, and to investigate the chain mediated role of loneliness and rumination, so as to provide evidence for promoting sleep health in the population. Methods: A baseline survey was conducted in May, 2023 (T1) by convenient sampling method, and two rounds of longitudinal surveys were conducted in November, 2023 (T2) and May, 2024 (T3) among students in two rural boarding junior high schools in Hebei Province, and a sample of 601 students who completed all the surveys was finally obtained. Students completed questionnaires, including the Delaware Bullying Victimization Scale Student (DBVS-S), the University of California at Los Angeles Loneliness Scale (UCLA), the Ruminative Responses Scale, and the Pittsburgh Sleep Quality Index (PSQI). Group differences were examined by using t-test or ANOVA, correlations between variables were analyzed by using Pearson correlation coefficients, and a serial mediation structural equation model was constructed, with mediation effects tested via the Bootstrap method. Results: Female students scored higher on sleep quality than male students (7.47±2.70, 6.47 ±2.46, t =4.74, P <0.01). Pearson correlation analysis indicated that bullying victimization was positively correlated with loneliness, rumination, and sleep quality; loneliness was positively correlated with rumination and sleep quality; and rumination was positively correlated with sleep quality ( r =0.26, 0.33, 0.23; 0.39, 0.38; 0.54, all P <0.01). Mediation analysis showed that T2 loneliness had an independent mediating effect of 0.70 (95% CI =0.36-1.35) between T1 bullying victimization and T3 sleep quality, T2 rumination had an independent mediating effect of 1.34 (95% CI =0.71-2.45), and the serial mediation effect of T2 loneliness and T2 rumination was 0.64 (95% CI =0.37-1.13), accounting for 22.11% of the total effect (all P <0.01). Conclusions Bullying victimization adversely affects sleep quality among rural boarding junior high school students through a longitudinal chain mediating pathway involving loneliness and rumination. Psychological interventions should be strengthened for students who experience bullying to alleviate their loneliness and reduce rumination, thereby improving sleep quality.

Objective To establish quality evaluation method of Andrographis paniculata standard decoction by UPLC. Methods 21 batches of Andrographis paniculata standard decoctions were prepared according to the standardization method of TCM decoction pieces. The UPLC characteristic chromatograms analysis method was established. With andrographolide as a reference, quantitative analysis of multi-components by single marker （QAMS） was established for new neoandrographolide, 14 deoxyandrographolide and dehydrated andrographolide. The results were compared with the external standard method （ESM） to determine the accuracy of the method. Results Similarity Evaluation System for Chromatographic Fingerprint of TCM （2012 edition） was used to analyze and compare the characteristic chromatograms, and seven common peaks were determined and five were identified including luteolin-7-O-β-D-glucuronide, andrographolide, neoandrographolide, 14-deoxyandrographolide and dehydroandrographolide. The RSDs of content results of each component by QAMS and ESM were all within 3%. Conclusion The determination method was reliable and accurate, which could be used to reflect the intrinsic quality of Andrographis paniculata standard decoction comprehensively and provide the basis for the quality evaluation of Andrographis paniculata formula granules and other preparations.

Objective:To systematically evaluate studies validating the performance of the Global Leadership Initiative on Malnutrition (GLIM) in diagnosing malnutrition.Methods:Seven Chinese and English databases including Embase, Web of Science (WOS), PubMed, CINAHL, Cochrane Library, SinoMed, CNKI, Wanfang Data, and VIP Database were searched for articles on the validation of GLIM criteria published between September 2018 and September 2024. Two researchers independently performed literature screening and data extraction. The concurrent and predictive validity of the criteria was analyzed.Results:A total of 136 papers were included for analysis. The GLIM criteria for diagnosing malnutrition had a sensitivity of 77%, a specificity of 87%, and an area under the curve (AUC) of 0.90. Malnutrition diagnosed by the GLIM criteria predicted prolonged hospital and intensive care unit (ICU) stays, increased readmission and complication rates (both overall and infectious), reduced survivals (median, overall, and disease-free), and increased in-hospital and follow-up mortalities. Both moderate and severe malnutrition predicted decreased overall survival. However, only three studies analyzed the impact of nutritional therapy on the clinical outcomes of malnourished patients.Conclusions:The GLIM criteria accurately differentiate malnutrition and are a valid predictive tool of clinical outcomes. However, the validity criteria in these validation studies were questionable, along with high methodological heterogeneity. Furthermore, there is a lack of studies validating the role of nutritional therapy in improving the clinical outcomes of malnourished patients.

Home rehabilitation is the main rehabilitation model for elderly patients with hip fractures in China, and the application of digital health technology shows great potential in improving the quality of home rehabilitation for this population. This paper describes the concept of digital health technology, the current application status of different types of digital health technology in home rehabilitation for elderly patients with hip fractures, and discusses existing issues and future prospects, aiming to provide a reference for digital home rehabilitation nursing for elderly hip fracture patients.

Strengthening the cultivation of innovation ability is the new requirement put forward by the state for higher educa-tion.High-quality curriculum design is the primary means of achieving high-quality talent cultivation.By constructing the"disease case library"and"problem graph"of immune system and related diseases,and adopting the teaching method of"combining large and small cases and integrating online and offline",this study not only consolidates students'basic knowledge,but also builds a bridge for students from theory to practice,from knowledge accumulation to creation and application.It further exercises students'ability to dis-cover,analyze and solve problems,and enhances students'innovation awareness and ability.

Objective:To systematically evaluate studies validating the performance of the Global Leadership Initiative on Malnutrition (GLIM) in diagnosing malnutrition.Methods:Seven Chinese and English databases including Embase, Web of Science (WOS), PubMed, CINAHL, Cochrane Library, SinoMed, CNKI, Wanfang Data, and VIP Database were searched for articles on the validation of GLIM criteria published between September 2018 and September 2024. Two researchers independently performed literature screening and data extraction. The concurrent and predictive validity of the criteria was analyzed.Results:A total of 136 papers were included for analysis. The GLIM criteria for diagnosing malnutrition had a sensitivity of 77%, a specificity of 87%, and an area under the curve (AUC) of 0.90. Malnutrition diagnosed by the GLIM criteria predicted prolonged hospital and intensive care unit (ICU) stays, increased readmission and complication rates (both overall and infectious), reduced survivals (median, overall, and disease-free), and increased in-hospital and follow-up mortalities. Both moderate and severe malnutrition predicted decreased overall survival. However, only three studies analyzed the impact of nutritional therapy on the clinical outcomes of malnourished patients.Conclusions:The GLIM criteria accurately differentiate malnutrition and are a valid predictive tool of clinical outcomes. However, the validity criteria in these validation studies were questionable, along with high methodological heterogeneity. Furthermore, there is a lack of studies validating the role of nutritional therapy in improving the clinical outcomes of malnourished patients.

Objective:To investigate the expression of miR-1243 and long non-coding RNA (lncRNA) HULC in papillary thyroid carcinoma (PTC) tissues, and their relationships with clinicopathological features and postoperative prognosis of patients.Methods:A total of 116 PTC patients treated in the Second Hospital of Nanjing from August 2021 to August 2023 were selected. The expression levels of miR-1243 and lncRNA HULC in PTC tissues and adjacent normal tissues were detected by real-time fluorescent quantitative polymerase chain reaction (PCR). The differences in the expression levels of miR-1243 and lncRNA HULC between PTC tissues and adjacent normal tissues, as well as among PTC tissues with different clinical features and different prognoses, were analyzed. Receiver operating characteristic (ROC) curve was used to analyze the value of miR-1243 in predicting postoperative recurrence of PTC patients.Results:The relative expression level of miR-1243 in PTC tissues was significantly lower than that in adjacent normal tissues ( P<0.05), while the relative expression level of lncRNA HULC was higher than that in adjacent normal tissues ( P<0.05). The relative expression level of lncRNA HULC in PTC tissues of patients with tumor diameter ≥2 cm, tumor node metastasis (TNM) stage Ⅲ-Ⅳ, and lymph node metastasis was higher than that in patients with tumor diameter <2 cm, TNM stage Ⅰ-Ⅱ, and no lymph node metastasis (all P<0.05). The relative expression level of miR-1243 in PTC tissues of patients with TNM stage Ⅲ-Ⅳ and lymph node metastasis was lower than that in patients with TNM stage Ⅰ-Ⅱ and no lymph node metastasis (all P<0.05). There was no significant correlation between the expression of miR-1243 and lncRNA HULC in PTC tissues ( r=0.129, P=0.167). All patients were followed up for 12 months, and 20 patients had postoperative recurrence. The proportion of TNM stage Ⅲ-Ⅳ in recurrent patients was 70.00%(14/20), which was higher than that in non-recurrent patients [29.17%(28/96), P<0.05], and the relative expression level of miR-1243 was lower than that in non-recurrent patients ( P<0.05). There was no significant difference in the relative expression level of lncRNA HULC between recurrent and non-recurrent patients ( P>0.05). The area under the ROC curve of miR-1243 relative expression level in predicting postoperative recurrence of PTC patients was 0.809(95% CI: 0.711-0.907, P<0.05), with a cut-off value of 1.17, sensitivity of 65.00% and specificity of 87.50%. Conclusions:The expression of miR-1243 is down-regulated and lncRNA HULC is up-regulated in PTC tissues, and both are related to clinicopathological features such as lymph node metastasis and TNM stage. Among them, the expression of miR-1243 is related to postoperative recurrence.

Objective:To investigate the feasibility and clinical effects of ultra early enteral nutrition (≤24 h) in critically ill children supported by extracorporeal membrane oxygenation (ECMO).Methods:A retrospective cohort study was conducted. Clinical data of 43 critically ill children who received ECMO support in the pediatric intensive care unit (PICU) of Shanghai Children′s Hospital from January 2016 to December 2023 were collected, including general information, nutritional support modalities, and enteral nutrition tolerance. Based on the timing of enteral nutrition initiation, patients were divided into the within 24 h enteral nutrition group and the after 24 h enteral nutrition group. Nutritive indicators, nutritional intake, duration of ECMO support, duration of mechanical ventilation duration, and mortality rates were compared between the 2 groups using the two independent sample t test, Mann-Whitney U test, χ2 test and Fisher′s exact test. Results:Among the 43 children, 25 were male and 18 were female, with an age of 47 (18, 97) months. There were no statistically significant differences between the within 24 h enteral nutrition group (21 cases) and the after 24 h enteral nutrition group (22 cases) in terms of age, body mass index Z score, total protein, albumin, hemoglobin levels before ECMO support, duration of ECMO support, duration of mechanical ventilation, length of PICU stay, number of enteral nutrition intolerance events, number of enteral nutrition interruption, or mortality rate (all P>0.05). The protein intake adequacy rate during ECMO support was higher in the within 24 h enteral nutrition group than in the after 24 h enteral nutrition group (0 (0, 21%) vs. 0 (0, 0), U=175.00, P<0.05). Conclusions:Ultra early enteral nutrition is safe for children supported by ECMO. Initiating enteral nutrition within 24 h can increase the proportion of days with adequate protein intake in ECMO children without increasing the occurance of enteral nutrition intolerance or interruptions.

Strengthening the cultivation of innovation ability is the new requirement put forward by the state for higher educa-tion.High-quality curriculum design is the primary means of achieving high-quality talent cultivation.By constructing the"disease case library"and"problem graph"of immune system and related diseases,and adopting the teaching method of"combining large and small cases and integrating online and offline",this study not only consolidates students'basic knowledge,but also builds a bridge for students from theory to practice,from knowledge accumulation to creation and application.It further exercises students'ability to dis-cover,analyze and solve problems,and enhances students'innovation awareness and ability.

Home rehabilitation is the main rehabilitation model for elderly patients with hip fractures in China, and the application of digital health technology shows great potential in improving the quality of home rehabilitation for this population. This paper describes the concept of digital health technology, the current application status of different types of digital health technology in home rehabilitation for elderly patients with hip fractures, and discusses existing issues and future prospects, aiming to provide a reference for digital home rehabilitation nursing for elderly hip fracture patients.