Objective Logistic regression model was used to analyze the risk factors of liver cancer in patients with hepatitis B virus-related cirrhosis. Methods A retrospective analysis was performed on 504 patients with hepatitis B cirrhosis who were treated in a hospital from April 2021 to April 2024. The occurrence of liver cancer was counted. The risk factors of liver cancer in patients with HBV-related cirrhosis were analyzed by logistic regression analysis. Results Among the 504 patients with hepatitis B cirrhosis, 101 patients developed liver cancer and 403 patients did not develop liver cancer, which were included in the liver cancer group (n=101) and the non-liver cancer group (n=403).. Among hepatitis B cirrhosis, the incidence rate of liver cancer was 20.04%. Compared with the non-liver cancer group, the proportion of patients with long-term drinking history, family history of liver cancer, history of diabetes mellitus, antiviral therapy, and HBV-DNA load>104 were higher in the liver cancer group (P<0.05). logistic regression analysis found that long-term drinking history (OR=3.077, 95%CI: 1.130-8.378, P=0.028), history of diabetes mellitus (OR=3.747, 95%CI: 1.765-7.954, P=0.001), no antiviral therapy (OR=3.466, 95%CI: 1.337-8.985, P=0.011) and HBV-DNA load>104 (OR=3.149, 95%CI: 1.353-7.328, P=0.008) could independently affect the occurrence of liver cancer in patients with hepatitis B cirrhosis. Conclusion According to logistic regression analysis, long-term drinking history, history of diabetes mellitus, no antiviral therapy, and HBV-DNA load>104 are risk factors for liver cancer in patients with HBV-related cirrhosis.

Objective To investigate the effectiveness of intravenous thrombolytic therapy mode led by fast-track specialist nurses on patients with acute ischemic stroke(AIS).Methods This study involved 124 AIS patients who underwent intravenous thrombolytic therapy in the Department of Emergency of our hospital from March 2021 to February 2023.Among the patients,61 admitted between March 2021 and February 2022 received conventional AIS thrombolytic therapy were assigned to a control group.While the 63 patients who received AIS thrombolytic therapy under the specialist nurse-led intravenous thrombolytic therapy mode between March 2022 and February 2023 were assigned to an observation group.The two groups were compared in terms of the time from admission to completion of CT examination,time for signing the informed consent for thrombolytic therapy,door to needle time and percentage of DTN<60 minutes,as well as the post-thrombolysis scores according to the National Institute of Health Stroke Scale(NIHSS)and satisfaction to medical consultation.Results The observation group exhibited a significantly shorter time from admission to completion of CT examination,a shorter time for signing an informed consent for thrombolytic therapy,a shorter door to needle time and a higher percentage of DTN<60 minutes,all with significant difference in comparison with those in the control group.After thrombolysis,the NIHSS score of the observation group decreased more than that of the control group(P<0.05).The patients and their families in the observation group reported significantly higher satisfaction compared to those in the control group(both P<0.05).Conclusion The fast-track specialist nurse-led intravenous thrombolytic therapy mode demonstrates the superiority in reduction of the time from admission to completion of CT examination,time for signing an informed consent for thrombolytic therapy,door to needle time and the NIHSS scores,higher percentage of DTN<60 minutes as well as improvement of patient satisfaction.

Objective To observe the drainage pathways of interstitial fluid(ISF)and substance clearance pattern in rat brain with fluorescence tracing imaging and treacer-based MRI.Methods Thirty-three male SD rats were randomly divided into fluorescence tracing group(F group,n=18)and treacer-based MRI group(MRI group,n=15),then further divided into thalamic,hippocampal and caudate nucleus subgroups,respectively.Evans blue was injected to rats in F group,and cardiac perfusion was performed after injection,then brain tissue was harvested,and frozen sections were made to observe the drainage pathways of IFS in different subgroups.MRI was performed on rats in MRI group before and after injection of gadolinium-diethylenetriamine pentaacetic acid(Gd-DTPA)to observe signal intensity in ROI of brain regions in different subgroups,the signal unit ratio was calculated,and the changing trend was explored.Results ISF in thalamus,hippocampus and caudate nucleus had different dominant drainage pathways,and the time of tracer reached to adjacent brain regions and whole brain in F group were different.In MRI group,within 4 h after injection of Gd-DTPA,there were differences in direction and clearance rate among tracer in thalamus,hippocampus and caudate nucleus,mainly manifesting as the tracer in thalamus and hippocampus drained to the ipsilateral cortex and lateral ventricle,while the tracer in the caudate nucleus diffused to the cortex and midbrain,and there were differences of the peak time of tracer signal among adjacent drainage brain regions.Conclusion Fluorescence and MR dual-mode imaging showed that there were differences in the dominant drainage pathways of IFS and clearance rates of small molecule substances among hypothalamus,hippocampus and caudate nucleus of rats.

Objective: To describe the association of different sleep characteristics and cardiometabolic risk among college students, so as to provide reference for health promotion of college students. Methods: By random cluster sampling method, a questionnaire survey and physical examination including blood pressure, waist circumference and blood lipid indicators, which were conducted in April and May of 2019 among a total of 1 179 college students from the first grade in two universities in Hefei City of Anhui Province and Shangrao City of Jiangxi Province. A total of 729 college students with valid questionnaires were included into analysis. The Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were used to investigate sleep behavior, and the Morning And Evening Questionnaire-5 (MEQ-5) was used to investigate sleep characteristics. The cardiometabolic risk score was derived using the sum of the standardized sex specific Z scores of waist circumference, mean arterial pressure, HDL cholesterol (multiplied by -1), triglycerides, and insulin resistance index. The rank sum tests were used to compare differences in cardiometabolic risk scores across demographic characteristics. Generalized linear models were used to compare the association of different sleep characteristics with cardiometabolic risk scores among college students. Results: The average cardiovascular metabolic risk score of college students was -0.32(-2.03, 1.58). There were statistically significant differences in cardiovascular metabolic risk scores among college students in variables such as smoking, health status, and physical activity levels ( t/F=-3.41, 12.88, 51.07, P <0.01). The results of the generalized linear model showed that nighttime preference ( B=1.89, 95%CI =1.02-3.49), insomnia symptoms ( B=3.25, 95%CI =1.79-5.90), and short or long sleep duration ( B=1.92, 95%CI =1.21-3.05) were positively correlated with the cardiovascular metabolic risk score of college students ( P <0.05). Conclusions Poor sleep patterns among college students are positively correlated with the risk of cardiovascular metabolism. The sleep behavior of college students should be actively changed to reduce the risk of cardiovascular disease.

Objective: To describe the prevalence and the association of sleep quality trajectory, social jetlag and comorbid symptoms of anxiety and depression among college students, in order to provide a theoretical basis for improving the comorbid symptoms of anxiety and depression in college students. Methods: A questionnaire survey was conducted among 1 135 college students from two universities in Shangrao, Jiangxi Province and Hefei, Anhui Province from April to May 2019, and were followed up once every one year for a total of three times, with a valid sample size of 1 034 individuals after matching with the baseline survey. A selfassessment questionnaire was used to investigate the social jetlag of college students, the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire 9 (PHQ-9) were used to evaluate anxiety and depression symptoms, respectively, while the Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. College students with GAD-7 score ≥5 and PHQ-9 score ≥5 were defined as having comorbid anxiety and depression symptoms. Latent class growth model (LCGM) was employed to analyze the sleep quality trajectory of college students, and binary Logistic regression was used to analyze the relationship between social jetlag, sleep quality trajectory and comorbid symptoms of anxiety and depression. Results: The detection rate of comorbid symptoms of anxiety and depression among college students was 16.9%, and the detection rate of social jetlag ≥2 h was 13.8%. The sleep quality showed an overall improvement trend, and the two trajectories were good sleep quality (81.6%) and poor sleep quality (18.4%). Binary Logistic regression model showed that poor sleep quality and social jetlag ≥2 h were positively correlated with comorbid symptoms of anxiety and depression (OR=5.94, 1.84, P<0.05). Conclusions Poor sleep quality and social jetlag ≥2 h in college students increase the risk of comorbid symptoms of anxiety and depression. Early screening and intervention of sleep quality and reduction of social jetlag are crucial for enhancing the mental health of college students.

In the process of promoting the implementation and transformation of the Q3D guideline of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) in China, the risk assessment of elemental impurities in naturally sourced excipients often faces challenges such as multiple types of elemental impurities and insufficient detection methods. In this paper, an inductively coupled plasma mass spectrometry (ICP-MS) method for screening 12 elemental impurities in titanium dioxide was established using the optimized acid extraction pre-treatment method. The accuracy and repeatability of the method were good. The recoveries of cadmium, lead, mercury, cobalt, nickel, lithium, barium, molybdenum, copper, chromium and iron were 83.6%−101.6%, the recovery of antimony was 54.1%, and the RSD was 1.1%−10.2% (n=6). The evaluation results of elemental impurities showed that the risk of cadmium, mercury, cobalt, nickel, lithium, barium, molybdenum, copper, chromium and antimony was low, while the risk of lead was high, and it is recommended that a lead salt test be added to the pharmacopoeia standard for this product. Based on the statistical data, the differences in the control levels of elemental impurities and whiteness of 29 batches of titanium dioxide samples from 10 domestic and foreign manufacturers were compared and analyzed. The Pearson correlation coefficient method was used to analyze the correlation between residual elemental impurities and whiteness, and a heat map was used to visualize the results. The results showed that whiteness was significantly negatively correlated with the amount of residual barium and the sum of residual elemental impurities. It is suggested that the manufactures should include whiteness as an internally controlled indicator to further improve the quality of titanium dioxide used as a pharmaceutical excipient.

Objective: The study aimed to describe the prevalence of mobile phone use and depressive symptoms and to examine the bidirectional associations between the two among college students, providinb evidence for mental health promotion among college students. Methods: A longitudinal study with follow up at 6 month intervals was conducted in 1 135 students from 2 universities in Hefei, Anhui Province and Shangrao, Jiangxi Province who were selected between April and May 2019. The last follow up was conducted between April and May 2021 based on questionnaire survey, and 999 valid participants were obtained after matching. The self designed questionnaire was used to investigate the duration of cellular phone use and use of cellular phone functions among college students. The Self rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU) and the Patient Health Questionnaire-9 (PHQ-9) were used to assess cellular phone dependence and depressive symptoms among college students. Pearson correlation analysis was used to examine the correlation between cellular phone use behavior and depressive symptoms at baseline and 2 years later; linear regression model was used to analyze the linear association between cellular phone use behavior and depressive symptoms scores; autoregressive cross lagged model was used to analyze the bidirectional associations between cellular phone use behaviors and depressive symptoms among college students over time. Results: The prevalence of mobile phone dependence and depressive symptoms among college students at baseline were 24.3% and 42.4%, respectively. The mean duration of mobile phone use among college students at baseline and the 2 year follow up were (2.84±0.90)h/d and (2.02±1.05)h/d, respectively; the mean scores of mobile phone dependence were (23.30±9.00) and (23.29±10.45), respectively; the mean scores of mobile phone function use were (30.12±6.66) and (29.12±7.27), respectively; and the mean scores of depressive symptoms were (4.51±4.76) and (2.61±4.40), respectively. Pearson correlation analysis showed there were significant positive correlations between duration of cellular phone use, cellular phone dependence, use of cellular phone functions at baseline or 2 years later and depressive symptoms 2 years later( r =0.08-0.50, P <0.05). Linear regression models showed a significant positive association between cellular phone dependence at baseline and depressive symptoms ( β=0.26, 95%CI =0.23-0.29) at baseline and 2 years later ( β=0.12, 95%CI =0.09-0.15). Autoregressive cross lagged models showed that cellular phone dependence at baseline positively predicted depressive symptoms 2 years later ( β =0.04) and depressive symptoms at baseline positively predicted cellular phone dependence 2 years later( β =0.23)( P <0.05). Conclusion There was a bidirectional association between cellular phone dependence and depressive symptoms among college students. Reducing cellular phone dependence is of positive significance for improving college students mental health.

Objective: To describe the prevalence and association of sleep quality and anxiety-depression co-morbid symptoms among nursing students, in order to provide a reference basis for promoting the development of nursing students mental health. Methods: Using a prospective study design, baseline survey was conducted in January 2019 among a random cluster sample of 1 716 individuals in three medical universities in Hefei, Anhui Province, and a follow-up survey was conducted in October 2019, with a valid number of 1 573 individuals after matching with the baseline survey. The Pittsburgh Sleep Quality Index (PSQI) was used to assess nursing students sleep quality, and the Depression Anxiety Stress Scale (DASS-21) to assess the anxiety-depression comorbid symptoms. Results: The detection rates of anxiety-depression co-morbidities among nursing students at baseline and follow-up survey were 16.9% and 18.2%, respectively, and the detection rates of poor sleep quality among nursing students at baseline and follow-up survey were 10.1% and 10.3%, respectively. The results of the binary Logistic regression model showed that baseline PSQI score were positively associated with the risk of anxiety-depression co-morbid symptoms among nursing students at baseline ( OR=1.49, 95%CI =1.40-1.59) and after nine months of follow-up ( OR=1.22, 95%CI =1.16-1.28). Furthermore, the influence of baseline sleep quality on the risk of anxiety-depression co-morbid symptoms were mainly concentrated in the five dimensions of sleep time, sleep efficiency, sleep disorders, hypnotic drugs and daytime dysfunction, and such effects of sleep time, sleep disorders and daytime dysfunction still existed in the follow-up investigation. Conclusion Poor sleep quality of nursing students can increase the risk of anxiety-depression co-morbidities. Improving sleep quality of nursing students has a positive effect on improving their mental health.

Objective: To describe the cross sectional and longitudinal associations of dietary patterns and depressive symptoms among college students, so as to provide a reference for improving college students mental and physical health. Methods: From April to May 2019, 1 110 college students were randomly sampled in Hefei City, Anhui Province and Shangrao City, Jiangxi Province, and a follow up survey was conducted from September to October 2019. The depression subscale of Depression Anxiety Stress Scale-21 (DASS-21) was used to investigate depressive symptoms in college students. The Semi Quantitative Food Frequency Questionnaire (SQFFQ) was used to investigate the eating behaviors of college students. Diet patterns were analyzed by principal component analysis and exploratory factor analysis, and the scores were classified T1, T2 and T3. Multivariate Logistic regression models were used to analyze the association of baseline dietary patterns and depressive symptoms at baseline and follow up. Results: The detection rates of mild, moderate and above depressive symptoms among baseline college students were 7.03% and 14.23% , respectively. The results of principal component analysis and exploratory factor analysis showed that the dietary patterns of college students were divided into four patterns: sugary drinks, meat, fast food and healthy food. At baseline and follow up surveys, the detection rate of depressive symptoms in sugary drinks, meat and fast food was the highest ( χ 2=21.51, 32.25, 22.21； 23.54, 13.91, 19.98, P ＜0.05). The results of multivariate Logistic regression model showed that the meat and fast food T3 showed positive association with baseline and moderate follow up, and the fast food T3 showed positive association with mild depressive symptoms at follow up ( P ＜0.05). Conclusion Meat and fast food diet patterns can increase the risk of depressive symptoms, suggesting that improving their eating patterns has a positive effect on promoting the mental health of college students.

Objective: To analyze the current status and equity of mental health resources allocation in Shanghai Municipality, so as to provide data supports to formulate mental health action plans and relevant policies. . Methods: The data pertaining to mental health institutions, actual beds opened, certified or assistant psychiatrists and registered nurses was collected from the Survey of the Current Status on Mental Health Resources in Shanghai Municipality in 2020. The equity of mental health resources allocated by population and geographical area in Shanghai Municipality was evaluated with Lorenz curve and Gini coefficient Results: There were 96 mental health institutions, 15 060 actual beds opened, 257 certified or assistant psychiatrists and 2 887 registered nurses in Shanghai Municipality in 2020, with a physician-to-nurse ratio of 1∶2.30. The greatest numbers of actual beds opened in the department of psychiatrics, the number of certified or assistant psychiatrists and the number of registered nurses per 10 000 residents and per km2 were all found the central urban areas. The numbers of actual beds opened in the department of psychiatrics, the number of certified or assistant psychiatrists and the number of registered nurses per 10 000 residents were 6.06 beds, 0.51 physicians and 1.16 nurses, with Gini coefficients of 0.36, 0.42 and 0.44, respectively, and the numbers of actual beds opened in the department of psychiatrics, the number of certified or assistant psychiatrists and the number of registered nurses per km2 were 2.38 beds, 0.20 physicians and 0.46 nurses, with Gini coefficients of 0.72, 0.76 and 0.75, respectively. Conclusions There was a gross equity in mental health resources allocated by population and geographical area in Shanghai Municipality in 2020, which showed an improvement as compared to 2015. The equity in mental health resources allocated by geographical area was lower than that by population in Shanghai Municipality.