Objective: To analyze the current status and influencing factors of psychological crisis among college students, so as to provide a scientific basis for the formulation of psychological crisis intervention plans in colleges and universities. Methods: From September to December 2024, 645 college students from a medical undergraduate university in Heilongjiang Province were selected with a convenience sampling method. A convergent mixed analysis design was used. Quantitative analysis was conducted using College Students Psychological Crisis Screening Scale, Emotion Regulation Questionnaire, Short-Egna Minnen av Barndoms Uppfostran and Perceived School Climate Scale. Binary Logistic regression analysis was used to explore the related factors of psychological crisis among college students. Qualitative research was conducted on 15 college students with psychological crisis identified in the quantitative analysis by a purposive sampling method. The interview data were organized and analyzed using the thematic framework analysis method. Results: Among the surveyed college students, 92 (14.3%) had psychological crisis. Binary Logistic regression analysis results showed that positive parenting style ( OR=0.97,95%CI =0.95-0.99), negative parenting style ( OR=1.01,95%CI =1.00-1.02), cognitive reappraisal ( OR=0.88, 95%CI =0.83-0.92), expressive suppression ( OR=1.08, 95%CI =1.02-1.15), and perceived campus atmosphere ( OR=0.97, 95%CI =0.95-0.98) were all related factors of psychological crisis among college students ( P <0.05). The qualitative analysis results showed that there were three themes for the influencing factors of college students psychological crisis, including differential impact of emotion regulation strategies on psychological state, shaping of psychological state of college students by family and bidirectional effect of perceived campus atmosphere on psychological state. Mixed analysis results showed that the influencing factors of college students psychological crisis were consistent in terms of emotion regulation strategies, and were expansive in terms of parenting style and perceived campus atmosphere. Conclusion Schools and mental health service departments can reduce the risk of psychological crisis by optimizing cognitive reappraisal and reducing expressive suppression, improve the level of psychological crisis by strengthening positive family interaction and blocking negative parenting style, and maintain the mental health level of college students by building a supportive campus environment and alleviating high pressure.

Objective To construct a swallowing dynamic model for simulating dysphagia caused by reduced tongue movement am-plitude.Methods A swallowing dynamic model was established based on medical imaging data from CT and videofluoroscopic swallowing study(VFSS).The finite element method was used to simulate soft tissues,while the smoothed parti-cle hydrodynamics method(SPH)was used to simulate bolus.The model's posture at each time point was com-pared with the imaging data of VFSS from twelve patients with dysphagia,and a normalization method was used for quantitative evaluation of the model's validity.By adjusting the tongue movement amplitude under different viscosity conditions,the role of tongue movement in the swallowing process was investigated,and the swallow-ing safety and efficiency were assessed.Results The tongue posture and bolus trajectory presented by the swallowing dynamic model were consistent with the VFSS imaging.The brightness in the epiglottis area in VFSS images correlated with the equivalent brightness of SPH particles in the simulation results(r=0.97).As the tongue movement amplitude reducing by 20%,the num-ber of aspirated particles,swallowing efficiency and the average velocity of bolus particles in the oropharyngeal cavity all performed well.Pudding-like fluids exhibited favorable swallowing characteristics even when tongue movement amplitude reducing significantly.Conclusion The swallowing dynamic model can simulate the human swallowing process,providing good support for re-habilitation training of patients with dysphagia and the development of specialized medical foods,demonstrating significant potential for clinical applications.

Objective To evaluate the relationship between triglyceride-glucose index(TyG)and intensive care unit(ICU)mor-tality in patients with non-diabetic sepsis.Methods The retrospective cohort study analyzed the data from sepsis patients admitted to the Second Hospital & Clinical Medical School,Lanzhou University between January 2018 and December 2023.The patients were divided into three groups based on the terartiles of the TyG index:group T1,group T2 and group T3,with ICU mortality as the primary endpoint.Multivariate COX regression analysis and restricted cubic spline(RCS)modeling were performed to investigate the potential non-linear relationship between the TyG index and ICU mortality of patients with sepsis,and subgroup analysis were conducted to further explore these relationships.Results This study included 578sepsis patients,with an ICU mortality of 16.96％.The Kaplan-Meier survival curve analysis indicated that the ICU mortality in the group T3 was significantly higher than that in the group T1.The RCS analysis re-vealed a linear relationship between the TyG index and ICU mortality,for every 1-unit increase in the TyG index,the risk of ICU mortal-ity increased by approximately 54％.Subgroup analysis demonstrated consistent effect directions across different subgroups,with no sub-group-specific effects,indicating the robustness of the results.Conclusion TyG index may serve as a potential biomarker for predicting ICU mortality in non-diabetic sepsis patients.

With the increasing aging population in China and rising incidence rates of diseases such as cancer and cardiovascular conditions, the demand for palliative care services continues to grow. In recent years, the integration of artificial intelligence and medical disciplines has advanced significantly, with machine learning research and applications in the palliative care field progressing steadily. This paper reviews the overview of machine learning, its applications in palliative care, and effectiveness evaluations. It also discusses existing limitations in current research and provides recommendations for future studies. The aim is to assist healthcare professionals in improving palliative care services and offer valuable insights for the development of palliative care in China.

Objective To construct a swallowing dynamic model for simulating dysphagia caused by reduced tongue movement am-plitude.Methods A swallowing dynamic model was established based on medical imaging data from CT and videofluoroscopic swallowing study(VFSS).The finite element method was used to simulate soft tissues,while the smoothed parti-cle hydrodynamics method(SPH)was used to simulate bolus.The model's posture at each time point was com-pared with the imaging data of VFSS from twelve patients with dysphagia,and a normalization method was used for quantitative evaluation of the model's validity.By adjusting the tongue movement amplitude under different viscosity conditions,the role of tongue movement in the swallowing process was investigated,and the swallow-ing safety and efficiency were assessed.Results The tongue posture and bolus trajectory presented by the swallowing dynamic model were consistent with the VFSS imaging.The brightness in the epiglottis area in VFSS images correlated with the equivalent brightness of SPH particles in the simulation results(r=0.97).As the tongue movement amplitude reducing by 20%,the num-ber of aspirated particles,swallowing efficiency and the average velocity of bolus particles in the oropharyngeal cavity all performed well.Pudding-like fluids exhibited favorable swallowing characteristics even when tongue movement amplitude reducing significantly.Conclusion The swallowing dynamic model can simulate the human swallowing process,providing good support for re-habilitation training of patients with dysphagia and the development of specialized medical foods,demonstrating significant potential for clinical applications.

Objective To evaluate the relationship between triglyceride-glucose index(TyG)and intensive care unit(ICU)mor-tality in patients with non-diabetic sepsis.Methods The retrospective cohort study analyzed the data from sepsis patients admitted to the Second Hospital & Clinical Medical School,Lanzhou University between January 2018 and December 2023.The patients were divided into three groups based on the terartiles of the TyG index:group T1,group T2 and group T3,with ICU mortality as the primary endpoint.Multivariate COX regression analysis and restricted cubic spline(RCS)modeling were performed to investigate the potential non-linear relationship between the TyG index and ICU mortality of patients with sepsis,and subgroup analysis were conducted to further explore these relationships.Results This study included 578sepsis patients,with an ICU mortality of 16.96％.The Kaplan-Meier survival curve analysis indicated that the ICU mortality in the group T3 was significantly higher than that in the group T1.The RCS analysis re-vealed a linear relationship between the TyG index and ICU mortality,for every 1-unit increase in the TyG index,the risk of ICU mortal-ity increased by approximately 54％.Subgroup analysis demonstrated consistent effect directions across different subgroups,with no sub-group-specific effects,indicating the robustness of the results.Conclusion TyG index may serve as a potential biomarker for predicting ICU mortality in non-diabetic sepsis patients.

With the increasing aging population in China and rising incidence rates of diseases such as cancer and cardiovascular conditions, the demand for palliative care services continues to grow. In recent years, the integration of artificial intelligence and medical disciplines has advanced significantly, with machine learning research and applications in the palliative care field progressing steadily. This paper reviews the overview of machine learning, its applications in palliative care, and effectiveness evaluations. It also discusses existing limitations in current research and provides recommendations for future studies. The aim is to assist healthcare professionals in improving palliative care services and offer valuable insights for the development of palliative care in China.

The irrational use of Chinese patent medicines （CPM） is becoming more and more prominent， which makes the demand for clinical practice guidelines of CPM gradually increase. In order to make domestic scholars understand the latest developments and existing problems of the CPM guidelines， and promote its development， this paper introduced the concept of CPM guidelines， summarized the characteristics of the two development modes， namely “taking CPM as the key” and “taking disease/syndrome as the key”， and analyzed the current methodological status of developing and reporting CPM guidelines. Based on the existed problems， three suggestions have been put forward to optimize the quality of CPM guidelines， which were clarifying the target users and scope of CPM guidelines， establishing an open and transparent mechanism of the personnel involvement and process steps， and formulating implementable and operable recommendations for the use of CPM.

The identification of clinical questions for clinical practice guidelines of Chinese patent medicine （CPM） is important for subsequent evidence retrieval， evaluation of evidence quality， formation of recommendations. This paper described a methodological proposal for the identification of clinical questions for CPM guidelines to highlight the characteristics of Chinese patent medicine and reflect its effect in specific stage of the disease. Considering four aspects， namely， the drug of Chinese patent medicine （D）， the specific disease stage （S）， comparison （C）， and specific outcome （O）， DSCO framework has been proposed to formulate the clinical questions. Multi-source information through scientific research， policy or standard documents， and clinical data are suggested for collecting clinical questions， and clear selection criteria should be set to finalize the clinical questions to be addressed by the guideline. In addition， the above process needs to be transparently and publicly reported in order to ensure the clarity and completeness of the guidelines.

Objective To evaluate the risk of bias and reporting quality in randomized controlled trials(RCTs)of the Chinese medicine injection for acute cerebral infarction in the last five years.Methods RCTs literature on Chinese medicine injection in the treatment of acute cerebral infarction was systematically searched in CNKI,Wanfang Data,VIP,China Biology Medicine Database(CBM),PubMed,Embase and Cochrane Library from April 20,2018 to April 20,2023.The risk of bias and reporting quality of included RCTs were evaluated using the Cochrane Risk of Bias Tool(ROB 1.0)and CONSORT-CHM Formulas 2017,respectively.Results A total of 4 301 articles were retrieved,and 408 RCTs were included according to inclusion and exclusion criteria.The ROB evaluation results showed that the the majority of studies were rated as having an unclear risk of bias due to the lack of reporting on allocation concealment,blind method,trial registration information,and funding sources.The evaluation results of CONSORT-CHM Formulas 2017 showed that the number of reported papers of 17 items was greater than or equal to 50%,and the number of reported papers of 25 items was less than 10%,and most of the RCTs did not show the characteristics of TCM syndrome differentiation and treatment.Conclusion The quality of Chinese medicine injection in the treatment of acute cerebral infarction RCTs is generally low.It is recommended that researchers refer to the methodology design of RCTs and international reporting standards,improve the trial design,standardize the trial report,and highlight the characteristics of TCM syndrome differentiation and treatment.