BackgroundNegative effects of mobile phone addiction on undergraduate students have led to several health problems including depression， anxiety， attention deficit disorder， cognitive impairment and sleep disturbance. The undergraduate nursing students serve as an important reserve force of the clinical nursing work， and their poor psychological health would have a non-ignorable impact on the quality of the nursing work and the nurse-patient relationship in the future. ObjectiveTo investigate the relation between neuroticism and tendency of mobile phone addiction among undergraduate nursing students， and to examine the pathways through which perceived stress and self-control play a role in the relation by constructing a chain-mediated model. MethodsFrom February to March 2023， a total of 900 undergraduate nursing students across 10 universities in Xi'an， Shaanxi Province were selected through convenient sampling method. Several scales were adopted to assess undergraduate nursing students respectively， including the neuroticism subscale of Eysenck Personality Questionnaire-Revised Short Scale for Chines （EPQ-RSC）， Perceived Stress Scale （PSS）， Self-Control Scale （SCS） and Mobile Phone Addiction Tendency Scale （MPATS）. The assessment were conducted on multiple aspects of these students including neurotic personality， subjective stress， self-control and mobile phone addiction tendency. Model 6 in the SPSS Macro Process 4.1 was used to examine the mediating effect of perceived stress and self-control between neuroticism and mobile phone addiction tendency among undergraduate nursing students. Results① Among the 900 students， 314 cases （34.89%） were found to be addicted to mobile phones. ② The score of neuroticism subscale in EPQ-RSC of nursing undergraduates was positively correlated with the total scores of PSS and MPATS （r=0.400， 0.287， P<0.01）， and negatively correlated with score of SCS （r=-0.364， P<0.01）. The total score of MPATS was positively correlated with the total score of PSS （r=0.362， P<0.01）， and negatively correlated with the total score of SCS （r=-0.468， P<0.01）. The total score of SCS was negatively correlated with the total score of PSS （r=-0.515， P<0.01）. ③ Perceived stress and self-control performed partial mediation between neuroticism personality and mobile phone addiction tendency （with indirect effect values of 0.056 and 0.065， respectively， accounting for 19.72% and 22.89% of the total effect）. Perceived stress and self-control played a chain mediating role between neuroticism personality and mobile phone addiction tendency （with an indirect effect value of 0.064， accounting for 22.54% of the total effect）. ConclusionNeuroticism personality， perceived stress and self-control are confirmed to play important roles in mobile phone addiction tendency among undergraduate nursing students. Neuroticism personality not only directly affects the tendency of mobile phone addiction， but also affects their mobile phone addiction tendency through the chain mediating effect of perceived stress and self-control.［Funded by The 2020 Annual Project of the 13th Five-Year Plan of Education Science in Shaanxi Province （number， SGH20Y1386）］

Pregnant women are affected by various biological,psychological and social pressures,and the incidence of perinatal vulnerability is relatively high.The existence of perinatal vulnerability seriously affects the physical and mental health of pregnant women and infants.Attention to perinatal vulnerability can help reduce the risk of adverse matemal and infant outcomes.This paper reviews the concept,classification,assessment tools,influencing factors,intervention measures,limitations and prospects of perinatal vulnerability,providing references for formulating management programs of perinatal vulnerability.

Objective:To explore the relationship between the polymorphisms of SIRT1 and follicle-stimulating hormone receptor (FSHR) gene and ovarian function in women who underwent assisted reproductive technology (ART) and the differences between Mongolian and Han nationalities, so as to provide basis for the individualized treatment of ART assisted pregnancy. Methods:A retrospective cohort study was performed. The clinical data of 204 ART patients who visited the Reproductive Center of the Affiliated Hospital of Inner Mongolia Medical University from September 2019 to September 2021 were collected. There were 53 cases of Mongolian nationality and 151 cases of Han nationality. MassARRAY SNP genotyping technology was used to detect three sites, which were rs2236319 of SIRT1 and rs6165 and rs6166 of FSHR. SIRT1 was divided into three groups: AA group (wild type), AG group (heterozygous type) and GG group (mutant type); FSHR rs6165 was divided into TT group (wild type), AT group (heterozygous type), AA group (mutant type); FSHR rs6166 was divided into NN group (wild type), NS group (heterozygous type) and SS group (mutant type). The differences of genotype frequency and clinical and laboratory data were compared. Results:1) The allele frequencies and genotype frequencies of SIRT1 rs2236319, FSHR rs6165, and rs6166 loci were not statistically different in composition between Mongolian and Han ART female patient groups. There were no significant differences between Mongolian and Han ART women in terms of general clinical data and basal sex hormones and ovarian reserve function (all P>0.05). 2) There was a statistically significant difference in the number of eggs captured at the rs2236319 locus of the SIRT1 gene among the mutant GG group [18.5 (13.0, 32.8)], the AA group [13.0 (7.0, 20.0)] and the AG group [10.0 (5.0, 21.0), P=0.019]. 3) There was a statistically significant difference in the basal FSH levels at the rs6165 locus of the FSHR gene among the AA group [(7.45±2.73) U/L], the TT group [(5.97±2.23) U/L] and the TA group [(6.70±2.04) U/L, P=0.005]. The proportion of ovarian hyporesponsiveness among the AA group [29.6% (8/27)], the TT group [8.5% (8/94)] and the TA group [13.3% (11/83)] was statistically significant ( P=0.017). 4) The difference in basal FSH levels at the rs6166 locus of the FSHR gene among the SS group [(7.48±2.78) U/L], the NN group [(6.08±2.28) U/L] and the NS group [(6.61±1.99) U/L] was statistically significant ( P=0.016). The proportion of ovarian hyporesponsiveness among the SS group [37.0% (10/26)], the NN group [8.5% (8/99)] and the NS group [10.8% (9/79)] was statistically significant ( P=0.001). Conclusion:There were no significant differences between Mongolian and Han ART women in terms of general clinical data, basal sex hormones and ovarian reserve function. The gene polymorphism at rs2236319 of SIRT1 gene is associated with ovarian hyperresponsiveness. FSHR rs6165 and rs6166 gene polymorphisms are associated with ovarian hyporesponsiveness. There was no significant correlation between the three polymorphisms and the clinical pregnancy rate of ART.

Objective:To explore the relationship between the polymorphisms of SIRT1 and follicle-stimulating hormone receptor (FSHR) gene and ovarian function in women who underwent assisted reproductive technology (ART) and the differences between Mongolian and Han nationalities, so as to provide basis for the individualized treatment of ART assisted pregnancy. Methods:A retrospective cohort study was performed. The clinical data of 204 ART patients who visited the Reproductive Center of the Affiliated Hospital of Inner Mongolia Medical University from September 2019 to September 2021 were collected. There were 53 cases of Mongolian nationality and 151 cases of Han nationality. MassARRAY SNP genotyping technology was used to detect three sites, which were rs2236319 of SIRT1 and rs6165 and rs6166 of FSHR. SIRT1 was divided into three groups: AA group (wild type), AG group (heterozygous type) and GG group (mutant type); FSHR rs6165 was divided into TT group (wild type), AT group (heterozygous type), AA group (mutant type); FSHR rs6166 was divided into NN group (wild type), NS group (heterozygous type) and SS group (mutant type). The differences of genotype frequency and clinical and laboratory data were compared. Results:1) The allele frequencies and genotype frequencies of SIRT1 rs2236319, FSHR rs6165, and rs6166 loci were not statistically different in composition between Mongolian and Han ART female patient groups. There were no significant differences between Mongolian and Han ART women in terms of general clinical data and basal sex hormones and ovarian reserve function (all P>0.05). 2) There was a statistically significant difference in the number of eggs captured at the rs2236319 locus of the SIRT1 gene among the mutant GG group [18.5 (13.0, 32.8)], the AA group [13.0 (7.0, 20.0)] and the AG group [10.0 (5.0, 21.0), P=0.019]. 3) There was a statistically significant difference in the basal FSH levels at the rs6165 locus of the FSHR gene among the AA group [(7.45±2.73) U/L], the TT group [(5.97±2.23) U/L] and the TA group [(6.70±2.04) U/L, P=0.005]. The proportion of ovarian hyporesponsiveness among the AA group [29.6% (8/27)], the TT group [8.5% (8/94)] and the TA group [13.3% (11/83)] was statistically significant ( P=0.017). 4) The difference in basal FSH levels at the rs6166 locus of the FSHR gene among the SS group [(7.48±2.78) U/L], the NN group [(6.08±2.28) U/L] and the NS group [(6.61±1.99) U/L] was statistically significant ( P=0.016). The proportion of ovarian hyporesponsiveness among the SS group [37.0% (10/26)], the NN group [8.5% (8/99)] and the NS group [10.8% (9/79)] was statistically significant ( P=0.001). Conclusion:There were no significant differences between Mongolian and Han ART women in terms of general clinical data, basal sex hormones and ovarian reserve function. The gene polymorphism at rs2236319 of SIRT1 gene is associated with ovarian hyperresponsiveness. FSHR rs6165 and rs6166 gene polymorphisms are associated with ovarian hyporesponsiveness. There was no significant correlation between the three polymorphisms and the clinical pregnancy rate of ART.

Objective:To determine the risk factors of extubation failure and its effect on the prognosis of patients who had successfully passed a spontaneous breathing trial (SBT).Methods:The clinical data of patients with mechanical ventilation more than 24 hours who passed SBT admitted to department of intensive care unit (ICU) of First Hospital of Qinhuangdao from November 2018 to November 2019 were retrospectively analyzed. According to the outcome of weaning within 48 hours after weaning, patients were divided into weaning success group and weaning failure group. The baseline data, the presence of basic cardiopulmonary diseases, B-type natriuretic peptide (BNP), fluid balance, albumin and hemoglobin within 24 hours before weaning, the time of mechanical ventilation before weaning, rapid shallow breathing index (RSBI) during SBT, oxygenation index, cough peak flow at the end of SBT, and prognostic indicators were collected. The outcome of weaning was taken as the dependent variable, and the observation factors were taken as the independent variable for univariate analysis. The factors with statistical significance in univariate analysis were analyzed by binary Logistic regression to determine the influencing factors of weaning failure.Results:Of the 204 patients, 167 (81.9%) were successfully weaned, and 37 (18.1%) failed. Compared with the weaning success group, the total duration of mechanical ventilation and the length of ICU stay in the weaning failure group were significantly longer [days: 13.0 (7.5, 23.5) vs. 5.0 (3.0, 8.0), 17.0 (12.5, 31.0) vs. 10.0 (6.0, 15.0), both P < 0.01], and the tracheotomy rate and mortality were significantly higher (32.4% vs. 0%, 51.4% vs. 0%, both P < 0.01). Univariate analysis showed that there were significant differences in age, proportion of patients with cardiopulmonary diseases, BNP and cough peak flow between weaning failure group and weaning success group [age (years old): 70.65±15.78 vs. 62.69±15.82, cardiopulmonary diseases: 62.2% vs. 24.6%, BNP (ng/L): 416.87 (32.70, 1 225.80) vs. 45.36 (10.00, 273.60), cough peak flow (L/min): 59.89±9.06 vs. 83.84±16.52, all P < 0.01]. However, there were no significant differences in gender, acute physiology and chronic health evaluationⅡ (APACHEⅡ) at admission, mechanical ventilation time before weaning, albumin, hemoglobin, oxygenation index, RSBI and fluid balance 24 hours before weaning between weaning failure group and weaning success group [male: 51.4% vs. 68.3%, APACHEⅡ: 16.70±6.65 vs. 15.67±6.28, mechanical ventilation time before weaning (days): 6.0 (2.5, 11.0) vs. 5.0 (3.0, 8.0), albumin (g/L): 27.78±4.15 vs. 27.76±4.46, hemoglobin (g/L): 102.43±15.80 vs. 100.61±17.19, oxygenation index (mmHg, 1 mmHg = 0.133 kPa): 359.33±79.83 vs. 365.75±78.23, RSBI (times·L -1·min -1): 50.73±24.97 vs. 46.76±15.53, positive fluid balance: 70.3% vs. 69.5%, all P > 0.05]. The results of binary Logistic regression analysis showed that age ≥ 75 years old [odds ratio ( OR) = 3.099, 95% confidence interval (95% CI) was 1.003-9.574, P = 0.049], presence of cardiopulmonary diseases ( OR = 3.599, 95% CI was 1.126-11.498, P = 0.031), BNP within 24 hours before weaning ( OR = 1.002, 95% CI was 1.000-1.003, P = 0.005) were the risk factors of extubation failure, while cough peak flow at the end of SBT was the protective factor ( OR = 0.869, 95% CI was 0.823-0.917, P = 0.000). Conclusions:For patients who had successfully passed SBT, age ≥ 75 years old, the presence of cardiopulmonary diseases and an increased level of BNP within 24 hours were the risk factors of extubation failure. In addition, the higher the cough peak flow at the end of SBT, the lower the risk of weaning failure will be.

Objective:To investigate the prognostic factors associated with unresectable (stage Ⅲa-Ⅳ, according to the 7th edition of the AJCC cancer staging manual) lung squamous cell carcinoma.Methods:We retrospectively analyzed 350 patients with inoperable locally advanced, recurrent or metastatic lung squamous cell carcinoma who were admitted to the First Affiliated Hospital of Chinese Medical University from January 2005 to June 2018. The clinical pathological data, treatment and survival follow-up information of the patients were collected. Kaplan-Meier survival was used to compare the overall survival rate of different risk groups. Univariate analysis and multivariate Cox regression analysis were used to determine the independent prognostic factors.Results:A total of 350 patients were enrolled. The median overall survival (OS) of these patients was 16.7 months. Univariate analysis showed the stage, Eastern Cooperative Oncology Group(ECOG), first-line chemotherapy evaluation (RECIST version 1.1), radiation therapy, number of systemic chemotherapy lines, carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), C reactive protein (CRP), lactate dehydrogenase (LDH), whether liver, brain, boneor metastasis were associated with the OS of patients with advanced lung squamous cell carcinoma (all P<0.05). Multivariate analysis showed that ECOG score ( HR=1.855, 95% CI: 1.063-3.239, P=0.030), whether underwent lung resection ( HR=0.476, 95% CI: 0.302-0.751, P=0.001), first-line chemotherapy evaluation [stable disease (SD): HR=0.293, 95% CI: 0.159-0.540, P<0.001; complete response (CR)+ partial response (PR): HR=0.223, 95% CI: 0.120-0.413, P<0.001], CRP ( HR=1.715, 95% CI: 1.080-2.723, P=0.042), LDH ( HR=1.116, 95% CI: 0.780-1.596, P=0.002) and CEA ( HR=1.855, 95% CI: 1.361-2.528, P<0.001) before chemotherapy, liver metastasis ( HR=2.453, 95% CI: 1.461-4.120, P=0.001) are independent prognostic factors for patients with unresectable lung squamous cell carcinoma. Conclusion:The ECOG score, surgical treatment history, first-line chemotherapy, LDH, CEA and CRP before chemotherapy, liver metastasis are independent prognostic factors for patients with advanced lung squamous cell carcinoma.

Objective:To investigate the prognostic factors associated with unresectable (stage Ⅲa-Ⅳ, according to the 7th edition of the AJCC cancer staging manual) lung squamous cell carcinoma.Methods:We retrospectively analyzed 350 patients with inoperable locally advanced, recurrent or metastatic lung squamous cell carcinoma who were admitted to the First Affiliated Hospital of Chinese Medical University from January 2005 to June 2018. The clinical pathological data, treatment and survival follow-up information of the patients were collected. Kaplan-Meier survival was used to compare the overall survival rate of different risk groups. Univariate analysis and multivariate Cox regression analysis were used to determine the independent prognostic factors.Results:A total of 350 patients were enrolled. The median overall survival (OS) of these patients was 16.7 months. Univariate analysis showed the stage, Eastern Cooperative Oncology Group(ECOG), first-line chemotherapy evaluation (RECIST version 1.1), radiation therapy, number of systemic chemotherapy lines, carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), C reactive protein (CRP), lactate dehydrogenase (LDH), whether liver, brain, boneor metastasis were associated with the OS of patients with advanced lung squamous cell carcinoma (all P<0.05). Multivariate analysis showed that ECOG score ( HR=1.855, 95% CI: 1.063-3.239, P=0.030), whether underwent lung resection ( HR=0.476, 95% CI: 0.302-0.751, P=0.001), first-line chemotherapy evaluation [stable disease (SD): HR=0.293, 95% CI: 0.159-0.540, P<0.001; complete response (CR)+ partial response (PR): HR=0.223, 95% CI: 0.120-0.413, P<0.001], CRP ( HR=1.715, 95% CI: 1.080-2.723, P=0.042), LDH ( HR=1.116, 95% CI: 0.780-1.596, P=0.002) and CEA ( HR=1.855, 95% CI: 1.361-2.528, P<0.001) before chemotherapy, liver metastasis ( HR=2.453, 95% CI: 1.461-4.120, P=0.001) are independent prognostic factors for patients with unresectable lung squamous cell carcinoma. Conclusion:The ECOG score, surgical treatment history, first-line chemotherapy, LDH, CEA and CRP before chemotherapy, liver metastasis are independent prognostic factors for patients with advanced lung squamous cell carcinoma.

Objective:To construct a comprehensive, systematic and quantifiable quality evaluation index system for blood purification care in ICU.Methods:The contents of the evaluation index system for blood purification care in ICU were determined by reviewing the literature, discussion of the research group and two rounds of Delphi expert consultation.Results:The response rate of the two rounds of experts was 100%. The authoritative coefficients of the two rounds of experts were 0.908 and 0.965 respectively. The coordination coefficient of the indicators of the second round of consultation results was 0.210-0.292, P<0.05 or 0.01. The quality evaluation index system for blood purification care included 3 first-class indicators, 16 second-class indicators, and 56 third-class indicators. Conclusions:The enthusiasm, authority, concentration of opinions and degree of coordination of the consulting experts are relatively high. The constructed evaluation system for the quality of blood purification care indicators can be used for reference in the implementation, training and quality control.

Objective: To investigate the value of transrectal ultrasonography(TRUS) in the preoperative diagnosis and tumor T-staging of anorectal malignant melanoma(ARMM). Methods: The clinical and ultrasound data of 19 patients(22 lesions) with ARMM confirmed by pathology from February 2008 to Apirl 2019 in Fujian Medical University Affiliated Union Hospital were collected. TRUS was performed within one week before pathological examination. The sonographic features were summarized, ultrasonic typing was performed according to the lesion size and growth pattern, and the accuracies of preoperative ultrasound diagnosis and tumor staging were analyzed. Results: Among the 22 lesions, 63.64%(14/22) were with a distance of ≤3 cm between the anal verge and the lower margin of tumor, 68.18%(15/22) with regular shape, 81.82%(18/22) with clear boundary, and 63.64%(14/22) with Adler blood flow grading from Ⅱ to Ⅲ. The preoperative TRUS diagnostic coincidence rate was 73.68%(14/19), and the tumor T-staging accuracy was 75%(12/16), respectively. Conclusions TRUS exhibits certain sonographic characteristics, with high preoperative diagnosis rate and tumor T-staging accuracy in anorectal malignant melanoma, which is of great guiding significance for clinical diagnosis and treatment.

Objective: To analyze the risk factors related to the myocardial injury after non-cardiac surgery (MINS) in patients who underwent major abdominal surgery. Methods: The clinical data of all patients admitted in the surgical ICU of Peking University People′s Hospital from Jan 2016 to Dec 2018 were analyzed. Logistic multivariate analysis was performed to analyze the association of clinical characteristics with the incidence of MINS. Results: A total of 322 patients were included, 48.4% (156/322) were diagnosed as with MINS. 97.4% (152/156) of MINS occurred during the first 72 h of admission. Multivariate analysis showed that independent predictive factors of MINS were age >65y (OR=1.747, P=0.021), body mass index (OR=1.085, P=0.008), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ, OR=1.066; P=0.047), hypertension (OR=1.747, P=0.027), blood lactate (OR=1.393, P=0.001) and acute kidney injury (OR=2.065, P=0.047). Conclusions The incidence of MINS in patients who underwent major abdominal surgery was high. Age, body mass index, APACHE Ⅱ score, hypertension, blood lactate level and acute kidney injury after surgery were independent risk factors of MINS.