Objective: To explore the association between the Internet usage characteristics and suicidal ideation among vocational high school students, so as to provide a theoretical basis for precise intervention of suicide among vocational high school students. Methods: A total of 1 781 students were recruited from three vocational high schools in Wuhan and Xianning in March 2023 by using the cluster random sampling method. The Columbia-Suicide Severity Rating Scale and Revised Chen Internet Addiction Scale were used to measure suicidal ideation and Internet addiction, respectively. LASSO regression model was used to select influential factors related to suicidal ideation, and the gradient boosting decision tree algorithm XGBoost was used to develop prediction models and evaluate predictive performance. By calculating the SHAP values, the contribution of each influential factor was quantified. Results: The prevalence of suicidal ideation among vocational high school students was 42.22% and prevalence of Internet addiction was 26.39%. LASSO regression results indicated that age, gender, experience of being left behind, parental relationship, holding a class cadre position, using the Internet for learning, Internet use during dawn, morning and late night, Internet addiction, and depressive symptoms were all the influential factors of suicidal ideation among vocational high school students ( β= -0.05 , 0.29, 0.09, 0.27, 0.10, -0.01, 0.09, 0.05, 0.24, 0.28, 0.78, all P <0.05). The AUC of the prediction model was 0.75. The results based on SHAP values indicated that all influential factors identified through multivariate analysis contributed positively to the model predictions ( SHAP >0). Among these, depressive symptoms and parental relationship had the greatest impact on suicidal ideation ( SHAP =0.77, 0.26), and the joint effect of features with higher contribution could improve the prediction probability. Conclusions Depressive symptoms, parental relationships, Internet addiction, and time of Internet use are most important risk factors of suicidal behaviors for vocational high school students. Thus, effective interventions should be conducted to reduce their suicidal ideation.

Objective:To investigate the mid- and long-term training effect of deliberate practice combined with intensive training in cardiopulmonary resuscitation (CPR) teaching for nurses receiving standardized training.Methods:A total of 160 nurses who received the first year of standardized training in Guangdong Provincial Hospital of Traditional Chinese Medicine from July 2020 to March 2021 were enrolled as subjects, and they were randomly divided into experimental group and control group, with 80 nurses in each group. The nurses in the control group received the mode of single deliberate practice, and those in the experimental group received deliberate practice combined with intensive training at months 0, 3, and 6. Assessment was performed for the two groups before and after training,with objective indicators and subjective evaluation as the assessment criteria. Objective score was determined by the immediate objective feedback provided by the electronic display of Resusci Anne ? QCPR, and subjective score was determined by the same group of examiners based on the evaluation of cardiopulmonary resuscitation performed by trainees,including environment evaluation, judgment of consciousness, judgment of respiration, initiation of emergency treatment system, re-evaluation after resuscitation, and overall evaluation. SPSS 18.0 was used for the independent samples t-test, the non-parametric test, and the chi-squares test. Results:After training, there were significant differences between the experimental group and the control group in the objective indicators of the percentage of correct compression (CC%) [85.500 (77.50, 93.00) vs. 81.00 (71.75, 89.00), Z=-2.49, P=0.013] and the proportion of correct ventilation (V%) [84.00 (75.00, 92.75) vs. 80.00 (64.00, 90.25), Z=-2.15, P=0.031]. Both groups had significant improvements in objective and subjective indicators after training (all P<0.05). Conclusions:Deliberate practice combined with intensive training at an interval of 3 months can effectively improve the mid- and long-term CPR skills of nurses receiving standardized training and is more suitable for high-level muscle memory training.

Objective To analyze the allocation and utilization efficiency of hospital beds from 2017-2021,and to provide a reference for the optimal allocation of hospital bed resources in Shenzhen.Methods Descriptive statistics method,bed efficiency index and bed utilization model were used to evaluate the hospital bed allocation and utilization efficiency of Shenzhen hospitals for 5 years.Results The number of beds in Shenzhen increased every year,with the highest growth rate of 21.54%,and the number of beds per 1000 resident population increased from 3.04 in 2017 to 3.25 in 2021.From the bed efficiency index,all three types of hospitals(general hospitals,specialized hospitals,traditional Chinese medicine hospitals)in Shenzhen are operating at low efficiency.Government-run hospitals are operating at high efficiency except for 2020,while socially-run hospitals are operating at low efficiency for five years,with bed efficiency indexs below 0.4.From the bed utilization model,Shenzhen general hospitals are turnover hospitals,Chinese medicine hospitals are bed-pressure hospitals for the first two years and then turn into efficiency hospitals,and specialty hospitals are idle hospitals.The government-run hospitals were efficient hospitals for 5 years,while the socially-run hospitals were idle hospitals for 5 years.Conclusion It is necessary to reasonably allocate health resources to increase the number of beds,improve the ability of hospitals to admit and absorb patients,and improve the operational efficiency of beds;the improvement and upgrading of beds in various types of hospitals should be tailored to local conditions to promote the realization of the continuity of care by integrating the concept of health care.

Sepsis is a life-threatening organ dysfunction caused by infection. Janus kinase/signal transducer and activator of transcription （JAK/STAT） signaling pathway plays a key role in the regulation of inflammatory response， oxidative stress and apoptosis. Some traditional Chinese medicine monomers， such as flavonoids （such as taxifolin）， alkaloids （such as sinomenine）， and stilbenes （such as piceatannol） can exert anti-inflammatory， anti-oxidation， and inhibition of apoptosis by regulating the JAK/ STAT signaling pathway， which is helpful to improve sepsis. Traditional Chinese medicine compounds （such as Zuojinfang） and traditional Chinese medicine injections （such as Astragalus injection， Xuebijing injection） can also inhibit inflammation， protect organ function， and reduce sepsis-related damage by regulating JAK/STAT signaling pathway. Although traditional Chinese medicine has shown great potential in the prevention and treatment of sepsis， the current research mainly focuses on in vitro and animal models， and more relative clinical researches need to be conducted.

With the development of neuroimaging technology, cerebral small vessel disease has become a hot research topic in recent years. It has been clearly related to cognitive decline, dementia and gait instability. However, recent studies have found that small cerebral vascular disease with white matter hyperintensities is the main cause of chronic dizziness in the elderly, but the pathogenesis is not completely clear, which may be related to brain neural network disconnection, visual dependence, eye movement disorder caused by abnormal brain tissue structure, oxidative stress regulation disorder, cerebral blood flow self-regulation disorder, and the interaction mechanism between vestibular system and emotional disorder.

Objective:To evaluate the quality and reporting standards of the ketogenic diet guidelines and consensuses in children with refractory epilepsy at home and abroad.Methods:A systematic search was conducted using the English and Chinese keywords for screening relevant guidelines and expert consensus on the Guidelines International Network, National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, National Institute for Health and Clinical Excellence, the Joanna Briggs Institute (JBI) Center for Evidence-Based Health Care in Australia, DynaMed Evidence-Based Medicine Database, American Academy of Neurology, American Epilepsy Society, International League Against Epilepsy, Child Neurology Society, European Paediatric Neurology Society, International Ketogenic Diet Research Group, Cochrane Library, PubMed, CNKI, Wanfang Database, VIP, China Biology Medicine disc, etc. The search period was from establishment of databases to August 13, 2021. The quality of the guidelines was evaluated using the The Appraisal of Guidelines for Research and EvaluationⅡ, and the Reporting Items for Practice Guidelines in healthcare was used to evaluate the reporting standards of guidelines. The JBI Center for Evidence-based Health Care Quality Evaluation tool was used to evaluate the quality of expert consensuses, and the National Institutes of Health Reporting Standards was used to evaluate the reporting standards of expert consensuses.Results:A total of 1 864 literatures were searched initially. According to the inclusion and exclusion criteria and reading the literature content, 13 literatures were selected, and after manual search, 1 literature was supplemented. Finally, a total of 14 literatures were obtained, including 7 guidelines and 7 expert consensuses. The quality evaluation results showed that 2 guidelines were grade A, 2 guidelines were grade B and 3 guidelines were grade C. 5 expert consensuses were rated "Yes" in the six items of quality evaluation. The results of the evaluation of reporting norms showed that the seven expert consensus reports were of poor quality; the higher the methodological quality rating of the guidelines, the better their reporting quality.Conclusions:The overall quality of the 14 guidelines and expert consensuses included is high, and attention should be paid to research quality in terms of application and participants. The reporting standards need to be further improved, and in the future, researchers can pay more attention to the reporting standards in the process of formulating guidelines and expert consensus, achieving a more rigorous research process and better applying evidence to clinical practice.

White matter hyperintensity (WMH) is one of the major imaging markers of cerebral small vascular disease, which is prevalent in the elderly. At present, the pathogenesis of WMH is not clear, most of the previous studies focused on the arterial system, but the role of the venous system in WMH is attracting more and more attention. Small venous collagen hyperplasia, downstream intracranial venous dilatation and internal jugular venous reflux may be involved in the formation and development of white matter hyperintensity.

Objective:Recently,the effects of Baduanjin (a traditional Chinese mind-body exercise) on diabetes have attracted increasing attention,and relevant systematic reviews (SRs) have emerged.However,the qualities of these SRs vary markedly,and their conclusions are inconsistent,which is not conducive to guiding decision-making.We sought to assess the quality of these SRs and provide more evidence for diabetes treatment.Methods:A literature search was conducted in 7 databases from inception to December 1st,2021.SRs of randomized controlled trials investigating the effects of Baduanjin were identified.A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) checklist,Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement,and Grading of Recommendations Assessment,Development and Evaluation (GRADE) system were applied to evaluate the quality of the SRs.Results:Ten SRs were identified.All SRs were judged as critically low methodological quality by the AMSTAR-2 checklist.The total PRISMA score of the included SRs ranged from 15 to 21,and the mean score was 18.60 (1.90),indicating that all SRs had partial reporting deficits.Sixty outcomes were reported in the included studies,of which 25 (41.67％) were judged as low quality,and 34 (56.67％) as very low quality according to the GRADE system,indicating that the overall evidence quality of outcomes was not high.Conclusion:Baduanjin seems to be an effective therapy for diabetes in improving glucose and lipid metabolism,mental health,quality of life,and waist-hip ratio (WHR).The overall quality of the SRs was less than optimal.This conclusion should be treated with caution,and researchers should conduct higher-quality clinical studies following AMSTAR-2checklist,PRISMA statement,and GRADE system in the future.

Objective:To explore the incidence and the risk factors of post-polypectomy bleeding and polyp recurrence after colonoscopic high-frequency electrocoagulation snare polypectomy.Methods:Clinical data of 1 826 children who underwent colonoscopic high-frequency electrocoagulation snare polypectomy in the Children′s Hospital, Zhejiang University School of Medicine from January 2009 to December 2020 was retrospectively analyzed. Demographic characteristics, endoscopic manifestations, pathological features, diagnosis, occurrence of post-polypectomy bleeding and polyp recurrence were collected. The associated risk factors were analyzed by Logistic regression.Results:A total of 1 826 children (1 191 males and 635 females) with 1 967 polypectomies were included. The age was 4.6 (3.2, 6.4) years at initial diagnosis. According to the initial colonoscopy, 1 611 children (88.2%) had solitary polyps, 1 707 children (93.5%) had pedicled polyps, 1 151 children (63.0%) had polyps involving the rectum, and 1 757 children (96.2%) had hamartomatous polyps. Polyposis syndromes were diagnosed in 73 children (4.0%). The post-polypectomy bleeding occurrence was 3.8% (75/1 967). Polyps recurred in 88 children (4.8%). Girls ( OR=2.01, 95% CI 1.26-3.23) and sessile polyps ( OR=2.28, 95% CI 1.15-4.49) were risk factors for post-polypectomy bleeding (both P<0.05). Multiple polyps ( OR=17.49, 95% CI 9.82-31.18), right-colon involvement ( OR=3.44, 95% CI 1.89-6.26) and non-hamartoma ( OR=2.51, 95% CI 1.04-6.07) were risk factors for polyp recurrence (all P<0.05). Conclusions:Colonoscopic high-frequency electrocoagulation snare polypectomy has low incidence of post-polypectomy bleeding and polyp recurrence. Female patients and sessile polyps have higher risk for post-polypectomy bleeding. Multiple polyps, right-colon involvement and non-hamartoma polyps increase the risk for polyp recurrence.

Objective: To study the compliance and associated factors of smartphone application (APP) usage in childhood dietary and exercise intervention. Methods: Based on one childhood intervention of diet and exercise in Beijing, Changzhi of Shanxi Province and Urumqi of Xinjiang Province, 694 children (and their primary caregivers) in the intervention group were investigated regarding usage of APP during the intervention. Compliance of APP usage was evaluated by the click times of APP, and Logistic regression models were used to analyze influencing factors of the compliance. Results: The median (inter quartile range) click times of APP in the four modules (information dissemination, behavior monitoring, homework uploading and feedback) were 10 (5，21), 20 (14，26), 7(4，10), 26 (15，53), respectively. Multivariable logistic regression analysis found that compliance of APP usage was higher among subjects in Changzhi region ( OR =1.67，95% CI =1.12-2.48), whose primary caregiver was mother ( OR =1.55，95% CI =1.09-2.22), or whose mother did not work ( OR =0.47， 95% CI =0.31-0.74). Conclusion Compliance of APP usage was generally high in the childhood intervention of diet and exercise. Some factors are associated with compliance of APP usage. Findings of the study provide a scientific basis for better implementation of APP based childhood interventions of diet and exercise in the future.