Objective: To investigate the association characteristics between psychological resilience and Internet gaming addiction among primary and secondary school students across different educational stages, so as to provide evidence for stage specific intervention strategies. Methods: A total of 30 719 students from primary schools, junior high schools, and senior high schools in Guangzhou, were selected using a cluster random sampling method from October to December 2025. The 10 item Connor- Davidson Resilience Scale (CD-RISC-10) and the Internet Gaming Disorder Scale-Short Form (IGDS9-SF) were used to assess students phychological resilience and Internet gaming addication levels. One way analysis of variance was used for group comparisons. Network analysis was conducted to construct joint networks of psychological resilience and Internet gaming addiction across different educational stages, with a focus on identifying bridge nodes between the two domains. Results: Significant differences were observed in psychological resilience points (24.9±8.0, 24.3±8.2, 24.8±7.8) across priamry school, junior high school and senior high school ( F=18.91, P <0.01). There was a statistically significant difference in the scores of Internet game addiction points ( 17.7 ±7.6, 18.6±7.3, 19.2±7.0) among students across priamry school, junior high school and senior high school ( F=85.68, P <0.01). Psychological resilience was negatively correlated with Internet gaming addiction scores among primary school, junior high school, and senior high school students ( r =-0.27, -0.28, -0.19, all P <0.01). Network analysis revealed relatively close associations between psychological resilience and Internet gaming addiction across all educational stages. The bridge nodes were "withdrawal symptoms" for primary school, "toughness" for junior high school, and "loss of interest" for senior high school, with bridge expected influence values of 1.37, 1.31, and 1.18, respectively. The expected influence and bridge expected influence demonstrated good stability across the three educational stages, with correlation stability coefficients of 0.75. Conclusions The cross-community connections between psychological resilience and Internet gaming addiction differ across educational stages. Prevention and control of Internet gaming addiction should incorporate targeted interventions based on key bridge symptoms identified at each specific educational stage.

Objective To investigate the effect of deoxyelephantopin(Deo)on regulation of cell apoptosis pathway by reactive oxygen species(ROS)in human non-small cell lung cancer A549 cells.Methods A549 cells were treated with different concentrations of Deo.Cell counting kit 8(CCK-8)assay was used to detect the cell viability,2',7'-dichlorodihydrofluorescein diacetate(DCFH-DA)staining was used to measure cellular ROS content,and Hoechst 33342 staining was used to detect apoptotic bodies.Cell apoptosis and mitochondrial membrane potential were examined by flow cytometry.Quantitative polymerase chain reaction and Western blotting were used to detect the expression of apoptosis-related proteins.A549 xenograft tumor model in nude mice was used to evaluate the anti-tumor effect of Deo in vivo.Hematoxylin-eosin staining and TUNEL assay were used to observe the necrosis and cell apoptosis in tumor tissues.Results With the increase of Deo concentration(1,2,4,8,16,32 μmol/L),the viability of A549 cells showed a decreasing trend.Deo at 10 μmol/L could increase the ROS content in A549 cells,reduce mitochondrial membrane potential and promote cell apoptosis.Deo at 10 and 20 μmol/L promoted the mRNA and protein expression of Bax and caspase-3 and inhibited the mRNA and protein expression of Bcl-2,accompanied by significantly increased protein expression of cytochrome C in the cytoplasm.The volume and weight of transplanted tumor in nude mice were significantly inhibited after 17 d of administration of Deo of 10 and 20 mg·kg-1·d-1,and the necrotic area and the number of apoptotic cells in the tumor tissue were increased.Conclusion Deo can induce intracellular ROS production,and then activate the mitochondrial apoptosis pathway and consequently promote the apoptosis of A549 cells.

ObjectiveTo analyze the genomic characteristics of Streptococcus pyogenes (GAS) isolated from children with respiratory tract infections in a tertiary hospital in Jinshan District of Shanghai during 2013‒2024, to compare the changes in trend for genomic characteristics before and after 2000, and to provide scientific data for the prevention and control of GAS infections. MethodsGAS strains isolated from children with respiratory tract infections in this hospital were collected from 2013 to 2024. Antimicrobial susceptibility of the isolated strains to 12 antibiotics, including penicillin, cefotaxime, cefepime, linezolid, vancomycin, meropenem, chloramphenicol, ofloxacin, levofloxacin, erythromycin, clindamycin, and tetracycline, was determined using broth microdilution plate method. Besides, whole genome sequencing (WGS) was used to analyze multilocus sequence type (MLST), emm typing, carriage of superantigen genes, mobile genetic element (MGE), carriage of virulence gene, and genomic phylogenetic tree of the isolated strains. ResultsA total of 50 GAS strains were collected and identified from children with respiratory tract infections aged 4‒14 years old, and the resistance rates of those isolates to erythromycin, clindamycin, and tetracycline were 100.00%, 100.00%, and 86.00%, respectively. There were two emm types in the GAS isolates; the emm12 type accounted for 76.00% (38/50), corresponding to ST36 type, and the emm1 type accounted for 24.00% (12/50), corresponding to ST28, ST1274, and new-1 types. There was a statistically significant difference in the constitution of the MLST before and after 2020 (P=0.015). All the isolates carried the superantigen genes speC, speG, ssa, and smeZ. The predominant emm12 isolates belonged to the Clade Ⅱ, carrying the mobile elements ICE-emm12 (harboring erythromycin-resistance gene ermB and tetracycline-resistance gene tetM) and ΦHKU.vir (carrying virulence genes speC and ssa). The emm1 isolates carried the mobile elements ICE-HKU488 (harboring erythromycin-resistance gene ermB and tetracycline-resistance gene tetM) and ΦHKU488.vir (carrying virulence genes speC and ssa), and had close phylogenetical relationships with isolates from Hong Kong, China. No M1_UK new clone strains were found. The ST1274 isolates of emm1 were newly discovered in 2020‒2024, and belonged to a separate phylogenetic clade. ConclusionGAS strains isolated from children with respiratory tract infections in a tertiary hospital in Jinshan District of Shanghai exhibit a high resistance to erythromycin, clindamycin, and tetracycline. It is recommended that the clinical treatments change to use other antimicrobial drugs, such as penicillin, third-generation cephalosporins, and fluoroquinolones. During 2020‒2024, a new ST1274 clone strain is discovered in emm1 GAS isolates, without M1_UK new clone strains being found. It is essential to continuously concern locally prevalent GAS strains and perform early identification of MLST types to promptly monitor the internal changes of the bacterial population and potential prevalence of new clones.

Objective:To exploring the application effect of doctors-nurses-patients theory of goal attainment combined with StMarys cluster intervention mode in patients with tracheotomy after stroke.Methods:Using convenient sampling method, a total of 130 stroke patients with tracheostomy who were admitted to Shangqiu First People's Hospital from August 2020 to February 2022 were selected as the research objects. The patients were divided into the control group and the observation group using the random number table method, with 65 cases in each group. The control group received routine nursing care, while the observation group applied doctors-nurses-patients theory of goal attainment combined with StMarys cluster nursing intervention mode on the basis of the control group. After intervention, scores of Self Rating Anxiety Scale (SAS) and Self Rating Depression Scale (SDS) and patient nursing satisfaction were compared between the two groups.Results:After intervention, the SAS and SDS scores of the observation group were lower than those of the control group, and the nursing satisfaction was higher than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The doctors-nurses-patients theory of goal attainment combined with StMarys cluster intervention mode can help improve the psychological state of patients and increase nursing satisfaction.

Objective? To explore the effect of WeChat-based information support in patients with bronchial asthma. Methods? Using convenient sampling method, 100 cases of bronchial asthma patients admitted to Shangqiu First People's Hospital from June 2014 to December 2016 were selected as the research objects. The selected patients were divided into observation group and control group by random number table method, 50 cases in each group. The control group was given routine out-of-hospital guidance when discharged, on the basis of that, the observation group was given transitional nursing based on WeChat information support. The control of asthma at discharge and 6 months after intervention [assessed by Asthma Control Test Table (ACT)], quality of life (assessed by Asthma Quality of Life Questionnaire (AQLQ)], total compliance rate of medication during 6 months of intervention, recurrence rate, number of acute episode and number of hospitalizations were compared between the two groups. Results? There was no significant difference in ACT score and AQLQ score between the two groups at discharge (P＞0.05). After intervention for 6 months, the ACT and AQLQ scores of the two groups increased compared with those at discharge,the differences were statistical (P＜ 0.05). The scores of ACT and AQLQ in the observation group were (22.98±3.11) and (133.14±12.35) respectively, higher than those in the control group, which were (20.50±3.05) and (116.24±11.87), respectively, and the differences were statistical (P＜0.01). The total compliance rate of the observation group was 86% during the 6-month intervention period, which was higher than 68% of the control group with statistical difference (P＜ 0.05). The recurrence rate, the number of acute episodes and the number of hospitalizations in the observation group [10%, (0.45±0.20) and (0.30±0.14)times ]were lower than those in the control group [26.00%, (1.04±0.38) times and (0.89±0.33) times], and the differences between the two groups were statistical (P＜0.05). Conclusions? Information support based on WeChat can provide comprehensive guidance for the work and life of patients with tracheal asthma after discharge, effectively control their condition, improve their quality of life and medication compliance, and reduce the recurrence rate.

Objective? To explore the application value of trajectory nursing of chronic diseases in patients with chronic obstructive pulmonary disease (COPD). Methods? By convenience sampling, a total of 69 COPD patients at the stable stage after treatment in Shangqiu First People's Hospital from January 2016 to January 2018 were selected as research objects, and a total of 66 patients completed the research. According to the communities they belonged to, they were divided into the observation group(n=31) and control group (n=35). BODE index(B: body mass index; O: airway obstruction; D: dyspnea; E: exercise endurance) was counted in both groups. The patients' COPD disease trajectory in the observation group were evaluated by their scores in BODE and were divided into different stages: 1-2 points were stage I, 3-4 points were stage Ⅱ, 5-7 points were stage Ⅲ, 8-10 points were stage Ⅳ and for those at different stages were given different nursing care with different focus and the control group was given conventional continuous nursing care. The intervention lasted for 3 months, the two groups were compared in their score change status in COPD Assessment Tes(t CAT), BODE index, Zarit Burden Interview(ZBI). Results? Before intervention, there was no statistical difference in the two groups' CAT scores, BODE index, and ZBI scores (P＞0.05). After intervention, the CAT score and BODE index, ZBI score in the observation group were lower than the control group with statistical significance (P＜ 0.05). Conclusions? Chronic disease trajectory model is conducive to reducing COPD patients' clinical symptoms and the main caregivers' burden.

Objective To strengthen the voluntary blood donation publicity through the analysis of the voluntary blood donation.Methods The ratio of voluntary blood donation was statistically analyzed between staffs in some Medical institutions in Hangzhou and Ordinary people.Results The ratio of voluntary blood donation in ordinary people is 1.82％,which is higher than the national data (1.05％).The ratio of medical institutions in Hangzhou is 9.54％,which is far higher than ordinary people.The data of provincial,civic and private medical institutions are 10.20％,6.11％ and 15.42％,respectively.Conclusion The ratio of voluntary blood donation is different between different level hospitals,and the staffs in medical institutions are more willing to donate blood than ordinary people.

Objective To standardize the job training and improve the basic professional quality and induction ability of practitioners in Blood Services by setting up job training assessment standardized model.Methods Using the standardize model to carry out the application of standardized model of job training assessment for the practitioners in Blood Services.July 2016-June 2017,focusing on the standardize training materials and training standards to carry out the centralized training,establishing a unified teacher library of the province and the centralized training will be taught by those teachers,evaluating result by standardize theoretical test and the conformity standard,then evaluating and supervising the assessment results.Results 356 practitioners participated in centralized training,379 practitioners participated in the theoretical test,and 339 practitioners were qualified of the actual operation during these two years.The total qualified rate is 89.4％.There was no significant difference in the qualified rate between two years (P＞0.05).Among them,the qualified rate of category Ⅰ personnel was 85.1％,category Ⅱ personnel was 98.7％,category Ⅲ personnel was 94.8％,and the qualified rate of category Ⅱand Ⅲ was higher than that of category Ⅰ (P＜0.05).Conclusion Through the application of the standardized model to promote the standardization of education and training resource standard,and carry on standardized training evaluation as well as strictly grasp the examination and evaluation standards,it will be conducive to improving the quality of education and training,will also be conducive to improving the professional quality of employees and supply institutions.

Objective To explore the application effect of interactive health education in insulin injections of aged patients with type 2 diabetes in the incipient stage of diagnosis and treatment. Methods 100 cases of aged patients with type 2 diabetes were hospitalized into endocrinology department from January 2014 to December 2014, the pen insulin injections were conducted for them at the beginning. They were equally divided into experimental group and control group through random number method. And, the general education guidance was conducted in control group. Meanwhile, the diabetes health education team was established in observation group on the basis of control group. Then, it was educated through the interactive lectures, interviews, teaching, repeated teaching, psychological intervention and individual assessment. Before and after education, the KAP survey of standard insulin injections were used for the patients in two groups to evaluate their degree of proficiency in the knowledge and skills about insulin injections, and the incidence of glucose metabolism level and low blood sugar. Results After intervention, the insulin injection skill in observation group was better than that of in the control group, (64.6%,31/48 vs. 24.5%, 12/149,χ2=16.441, P<0.01), while the level of glycosylated hemoglobin was reduced from (7.95±0.65)%to (6.58±0.62)%(t=7.85, P<0.01). Conclusions In the incipient stage of diagnosis and treatment, the ability of aged patients with type 2 diabetes in learning new knowledge and technology was improved through interactive health education mode. Besides, the insulin injections were standardized. Also, the glucose metabolism was improved, and the incidence of hypoglycemia was significantly reduced to ensure the patients′safety when the insulin was injected outside hospital, which was worth being clinically applied and promoted.

Objective To discuss the application effect of peer support education in improving theself-management ability of old patients with diabetes. Methods A total of 160 cases of old patients with type 2 diabetes who were treated and hospitalized from June 2014 to August 2015 were selected, then equally divided into observation group and control group through using random number method.Finally, 76 cases were studiedin observation group, while 75 cases in control group. The health education guidance of conventional diabetes had been used in two groups for six months, and the peer support education was also conducted for the patients in observation group on the basis of conventional education. The self-management ability, insulin standard injection knowledge-belief and attitude-behavior/practice (KAP) and glycosylated hemoglobin (HbA1c) value of old patients with diabetes were observed before intervention, 3 months and 6 months later, respectively. Also,the hypoglycemia frequency in two groups was compared during intervention. Results After three months of intervention, the score of diet, exercise management, glucose monitoring, foot care, pharmaceutical administration and smoke for self-management ability in observation group was 4.63 ± 0.92, 4.18 ± 0.97, 2.86 ± 0.96, 2.35 ± 0.59, 4.01 ± 1.43 and 0.62 ± 0.29, respectively, while that of these indicators in control group was 3.69 ± 0.83, 3.52 ± 0.67, 1.75 ± 0.67, 1.63 ± 0.72, 3.05 ± 1.39 and 0.59 ± 0.38. Except smoke (P > 0.05), the differences between two groups were statistically significant (t=2.987-5.965, P < 0.05). After six months of intervention, the score of diet, exercise management, glucose monitoring, foot care, pharmaceutical administration and smoke for self-management ability in observation group was 5.86±0.93, 5.37±0.61, 3.97±0.94, 5.06±0.92, 5.81±0.73 and 0.89 ± 0.31, respectively, while that of these indicators in control group was 3.68 ± 0.96, 3.65 ± 0.95, 1.86 ± 0.88, 2.65±0.88, 3.21±1.13 and 0.81±0.39. The difference was statistically significant (t=9.336-15.633, P<0.01), except smoke (P>0.05). Then, the insulin was normally injected in observation group after six months of intervention, the score of knowledge, attitude and behavior was 5.63 ± 1.87, 43.17 ± 6.03 and 16.57 ± 1.59, while that in control group was 3.76 ± 0.83, 23.71 ± 0.59 and 10.16 ± 0.95. The differences between two groups were statistically significant (t= 8.569, 15.623, 6.751, P<0.01). Also, the level of glycosylated hemoglobin was decreased from (8.17 ± 0.32) % to (7.16 ± 0.41) %, and the difference was statistically significant (t=-3.560, P=0.000). Conclusions Peer support education couldenhance the self-management consciousness of old patients with diabetes, standardize the insulin injection, improve the ability of self-management and improve glucose metabolism index so that it is worthy of being clinically popularized and applied.