Objective: To explore the relationship between beverage dependence and sleep quality among college students, providing empirical evidence for improving their sleep quality. Methods: From December 2024 to January 2025, a convenience sampling method was used to conduct a questionnaire survey among 3 974 college students from four universities in Anhui Province. The Beverage Addiction Scale for College Students (BASCS) was used to assess beverage dependence, and the Self rating Scale of Sleep(SRSS) was used to evaluate sleep quality. A multivariate Logistic regression model was employed to analyze the relationship between beverage dependence and sleep quality, and a restricted cubic spline model was used to examine the dose response relationship between the two. Results: The positive rate of beverage dependence symptoms among college students was 7.6%, with positive rates of 9.6%, 13.8%, and 7.4% for the withdrawal symptoms, health effects, and dependence symptoms dimensions, respectively. The detection rate of sleep disorders was 23.6%. Multivariate Logistic regression analysis showed that after adjusting for covariates such as grade, gender, and body mass index, compared with the no beverage dependence group, students with positive beverage dependence symptoms had a higher risk of sleep disorders( OR =3.71, 95% CI =2.87-4.80, P <0.01). The OR (95% CI ) for sleep disorders among students with positive symptoms in the withdrawal symptoms, health effects, and dependence symptoms dimensions were 2.80(2.22-3.53), 2.38(1.95-2.91), and 2.45(1.89-3.18)(all P <0.01). Further analysis using a restricted cubic spline model revealed that the overall beverage dependence score and its three dimensional scores were approximately linearly related to the risk of sleep disorders among college students (all nonlinear P >0.05). Conclusions Beverage dependence is associated with sleep quality among college students. Schools should take multiple approaches, such as health education on beverage awareness, to improve students sleep quality.

Objective: To explore effects of cumulative family risk in university students on individuals internalizing problems, to elucidate the mediating roles of perceived social support and self esteem in the relationship, so as to provide a basis for promoting university student s mental health. Methods: Using longitudinal design, 1 207 freshmen from a university in Tianjin were randomly selected and surveyed in November 2023 (T1) and November 2024 (T2). The instruments included the Cumulative Family Risk Scale, the Perceived Social Support Scale, the Self esteem Scale, and the College Student Mental Health Screening Scale. Structural equation modeling (SEM) was constructed, with Bootstrap method used to test mediating effects and to examine gender differences. Results: The results showed that cumulative family risk at T1 with internalizing problems at T1( r =0.30) and internalizing problems at T2 ( r =0.32) were significantly positively correlated (both P <0.01). Mediation analysis indicated that the independent mediating effect of perceived social support at T1，cumulative family risk at T1 and internalizing problems at T2 was 0.03 (95% CI =0.02-0.05), and the independent mediating effect of self esteem at T1 was 0.08 (95% CI = 0.06 -0.10) (both P <0.05). The chain mediating effect of perceived social support and self esteem at T1 was 0.02 (95% CI =0.02-0.03) ( P <0.05). Significant gender differences were observed in the path from cumulative family risk to self esteem ( β male =-0.24, β female =-0.35) and in the path from perceived social support to self esteem ( β male =0.41, β female =0.25) (all P <0.05). Conclusion Cumulative family risk reduces internalizing behaviors in university students via internal and external development resources, with gender specific mechanisms.

Mental state is an important part of the normal life activities of the human body, and it is also the most external expression and the most easily obtained information of the physical condition. The normal activities of the mind depend on the normal operation of the viscera, qi, and blood, and are a unified whole that prospers together and suffers together. The theory of the five-spirit-viscera in the Yellow Emperor’s Inner Classic revealed that the normal mental activities of the human body were dominated by the five internal organs, that is, the five internal organs were the body and the five spirits were the function. And it highlighted the viewpoint that the five internal organs store the spirits and are actually one. The heart governs the spirit and belongs to the four internal organs. On this basis, Synopsis of Golden Chamber used the internal organs to diagnose and treat mental diseases, integrating the theory of the five spirits into it, forming a unique method of diagnosis and treatment with the heart as the leading factor and regulating the qi and blood of the four internal organs. It identified the pathogenesis of diseases such as pathogenic crying, lily disease, and hysteria from five levels: heart deficiency and weak qi, heart-lung disharmony, heart-liver disharmony, the heart of the loss of the spleen nourishment, and disharmony between heart and kidney. The treatment was mainly to replenish the deficiency of the viscera and eliminate the pathogens, reflecting the characteristics of regulating the mind and calming the four internal organs. This unique view on diagnosis and treatment has profoundly influenced the diagnosis and treatment theories of mental illnesses by later doctors, and is of great significance to the current clinical treatment of such illnesses.

Objective: To investigate the association between dietary behaviors and overweight and obesity among middle school students, so as to provide the evidence for developing dietary intervention strategies for them. Methods: From October to December 2023, a total of 7 063 middle school students from six counties (districts) in Ma'anshan City, Anhui Province were selected through stratified cluster random sampling method. Demographic information, physical activity, sleep, and dietary behaviors over the past year were collected through questionnaire surveys. Height and weight were measured to calculate body mass index (BMI), with overweight and obesity determined based on gender- and age-specific BMI cut-off points. The association between dietary behaviors and overweight and obesity was analyzed using a multivariable logistic regression model. Results: Totally 7 063 questionnaires were allocated, and 7 045 valid questionnaires were recovered, with an effective recovery rate of 99.75%. There were 3 925 males (55.71%) and 3 120 females (44.29%). A total of 2 326 students were overweight and obesity, with the prevalence of 33.02%. There were significant differences in the prevalence of overweight and obesity among middle school students with different genders, whether they were the only child or not, different intake frequency of sugar-sweetened beverages, and different intake frequency of beans and soy products (all P<0.05). After adjusting for factors such as gender, education stage, whether the only child, whether living on school, physical activity and sleep, multivariable logistic regression analysis showed that the frequency of snack consumption (1-2 times/week, OR=0.803, 95%CI: 0.669-0.963; 3-6 times/week, OR=0.759, 95%CI: 0.623-0.926; daily, OR=0.758, 95%CI: 0.595-0.964), sugar-sweetened beverages consumption (1-2 times/week, OR=1.166, 95%CI: 1.012-1.343; daily, OR=1.891, 95%CI: 1.302-2.746) and beans and soy products consumption (1-2 times/week, OR=0.787, 95%CI: 0.628-0.987) were the influencing factors of overweight and obesity among middle school students. Conclusions The frequencies of snack, beans and soy products and sugar-sweetened beverage consumption are associated with overweight and obesity among middle school students. Targeted interventions should be strengthened to reduce the risk of overweight and obesity.

Surgical methods for varicocele remain controversial. This study intends to evaluate the efficacy and safety of different surgical approaches for treating varicocele through a network meta-analysis (NMA). PubMed, Embase, Cochrane, and Web of Science databases were thoroughly searched. In total, 13 randomized controlled trials (RCTs) and 24 cohort studies were included, covering 9 different surgical methods. Pairwise meta-analysis and NMA were performed by means of random-effects models, and interventions were ranked based on the surface under the cumulative ranking curve (SUCRA). According to the SUCRA, microsurgical subinguinal varicocelectomy (MSV; 91.6%), microsurgical retroperitoneal varicocelectomy (MRV; 78.2%), and microsurgical inguinal varicocelectomy (MIV; 76.7%) demonstrated the highest effectiveness in reducing postoperative recurrence rates. In this study, sclerotherapy embolization (SE; 87.2%), MSV (77.9%), and MIV (67.7%) showed the best results in lowering the risk of hydrocele occurrence. MIV (82.9%), MSV (75.9%), and coil embolization (CE; 58.7%) were notably effective in increasing sperm motility. Moreover, CE (76.7%), subinguinal approach varicocelectomy (SV; 69.2%), and SE (55.7%) were the most effective in increasing sperm count. SE (82.5%), transabdominal laparoscopic varicocelectomy (TLV; 76.5%), and MRV (52.7%) were superior in shortening the length of hospital stay. The incidence rates of adverse events for MRV (0), SE (3.3%), and MIV (4.1%) were notably low. Cluster analyses indicated that MSV was the most effective in the treatment of varicocele. Based on the existing evidence, MSV may represent the optimal choice for varicocele surgery. However, selecting clinical surgical strategies requires consideration of various factors, including patient needs, surgeon experience, and the learning curve.
Humans ; Male ; Embolization, Therapeutic/methods* ; Microsurgery/methods* ; Randomized Controlled Trials as Topic ; Sclerotherapy/methods* ; Treatment Outcome ; Urologic Surgical Procedures, Male/methods* ; Varicocele/surgery*

Mycophenolic acid (MPA), the active moiety of both mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS), serves as a primary immunosuppressant for maintaining solid organ transplants. Therapeutic drug monitoring (TDM) enhances treatment outcomes through tailored approaches. This study aimed to develop an evidence-based guideline for MPA TDM, facilitating its rational application in clinical settings. The guideline plan was drawn from the Institute of Medicine and World Health Organization (WHO) guidelines. Using the Delphi method, clinical questions and outcome indicators were generated. Systematic reviews, Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence quality evaluations, expert opinions, and patient values guided evidence-based suggestions for the guideline. External reviews further refined the recommendations. The guideline for the TDM of MPA (IPGRP-2020CN099) consists of four sections and 16 recommendations encompassing target populations, monitoring strategies, dosage regimens, and influencing factors. High-risk populations, timing of TDM, area under the curve (AUC) versus trough concentration (C₀), target concentration ranges, monitoring frequency, and analytical methods are addressed. Formulation-specific recommendations, initial dosage regimens, populations with unique considerations, pharmacokinetic-informed dosing, body weight factors, pharmacogenetics, and drug‍-‍drug interactions are covered. The evidence-based guideline offers a comprehensive recommendation for solid organ transplant recipients undergoing MPA therapy, promoting standardization of MPA TDM, and enhancing treatment efficacy and safety.
Mycophenolic Acid/administration & dosage* ; Drug Monitoring/methods* ; Humans ; Organ Transplantation ; Immunosuppressive Agents/administration & dosage* ; Delphi Technique

In recent decades, the prevalence of hyperuricemia and gout has increased dramatically due to lifestyle changes. The drugs currently recommended for hyperuricemia are associated with adverse reactions that limit their clinical use. In this study, we report that berberine (BBR) is an effective drug candidate for the treatment of hyperuricemia, with its mechanism potentially involving the modulation of gut microbiota and its metabolite, succinic acid. BBR has demonstrated good therapeutic effects in both acute and chronic animal models of hyperuricemia. In a clinical trial, oral administration of BBR for 6 months reduced blood uric acid levels in 22 participants by modulating the gut microbiota, which led to an increase in the abundance of Bacteroides and a decrease in Clostridium sensu stricto_1. Furthermore, Bacteroides fragilis was transplanted into ICR mice, and the results showed that Bacteroides fragilis exerted a therapeutic effect on uric acid similar to that of BBR. Notably, succinic acid, a metabolite of Bacteroides, significantly reduced uric acid levels. Subsequent cell and animal experiments revealed that the intestinal metabolite, succinic acid, regulated the upstream uric acid synthesis pathway in the liver by inhibiting adenosine monophosphate deaminase 2 (AMPD2), an enzyme responsible for converting adenosine monophosphate (AMP) to inosine monophosphate (IMP). This inhibition resulted in a decrease in IMP levels and an increase in phosphate levels. The reduction in IMP led to a decreased downstream production of hypoxanthine, xanthine, and uric acid. BBR also demonstrated excellent renoprotective effects, improving nephropathy associated with hyperuricemia. In summary, BBR has the potential to be an effective treatment for hyperuricemia through the gut-liver axis.

Ventriculostomy drainage is one of the commonly used surgical techniques in neurocritical care, which can relieve intracranial hypertension and facilitate postoperative cerebrospinal fluid and intracranial pressure monitoring. By placing a drainage tube in the ventricle, blood and fluid accumulation within the ventricle are drained out of the brain, reducing intracranial pressure and preventing brain tissue damage. Clinically, the speed of ventriculostomy drainage is often controlled by measuring the height difference between the drainage opening and the plane of the ventricle, ensuring the safe and effective reduction of intracranial pressure, facilitating the implementation of clinical management plans, and preventing complications. However, how to easily, safely, and effectively measure the height difference between the drainage opening and the ventricular plane remains a challenge in nursing management. Currently, clinical practice often uses a tape measure to measure the height of the ventriculostomy drainage, a process that is cumbersome and time-consuming and susceptible to human error, leading to inaccurate measurements. However, the challenge of easily, safely, and effectively detecting the height difference between the drainage opening and the ventricular plane remains a difficult problem in nursing management. To address this issue, the medical and nursing staff of the intensive care unit (ICU) at Zhongda Hospital, Southeast University, jointly designed a novel ventriculostomy drainage height measurement device, which has been granted a national utility model patent (patent number: ZL 2022 2 1400920.9). This device can be easily and securely fixed to an infusion stand. Using a level within the horizontal measuring part and a rotational structure, the vertical measuring part of the device is adjusted to be perpendicular to the ground. After opening the limit clip, the horizontal part is manually guided down to the appropriate height. The front end of the horizontal measuring part is then extended towards the patient's head, and after confirming the position, the limit clip is closed. At this point, the horizontal height difference between the drainage opening and the ventricular plane can be accurately measured. When temporarily finishing the height measurement of the drainage tube, the device can be folded and stored by retracting the horizontal measuring part and rotating components. This measuring device has a simple operation process, which can improve the accuracy and reliability of the drainage height measurement, enhance treatment outcomes and patient safety, reduce the workload of nursing staff, and has certain clinical promotion and practical value.
Humans ; Ventriculostomy/methods* ; Drainage/instrumentation* ; Equipment Design ; Cerebral Ventricles

OBJECTIVE To explore the expression of trefoil factor family peptide(TFF3)in chronic rhinosinusitis with nasal polyps(CRSwNP)and its regulation on mucin 5AC(MUC5AC)expression.METHODS The nasal polyp tissues of 16 patients in the CRSwNP group and the nasal mucosal tissues of 16 patients in the control group were selected,and the expressions of TFF3 and MUC5AC were detected by quantitative real-time polymerase chain reaction(RT-qPCR)and Western blot,and the correlation between them was analyzed.The human nasal epithelial cell(HNEpC)line with TFF3 knockdown was constructed,and the expression of MUC5AC in KD-TFF3 HNEpC was detected by RT-qPCR and immunofluorescence.RESULTS The expression level of TFF3 in nasal polyps was significantly lower than that of control group,and the expression level of MUC5AC was increased,and the expression level of both was negatively correlated(r=-0.556,P<0.05).The expression of MUC5AC in KD-TFF3 HNEpC was significantly higher than that in control group.CONCLUSION The expression of TFF3 decreases in CRSwNP and negatively regulates the expression of MUC5AC.This study provides a new idea for the treatment of abnormal hypersecretion of mucous in chronic nasal inflammatory diseases represented by CRSwNP.

The incidence of cancer is closely correlated with age,as 75％of non-small cell lung cancer(NSCLC)patients are aged at least 65 years.The availability of immune checkpoint inhibitors(ICIs)has altered the available NSCLC therapeutic pattern.Limited studies on elderly patients have demonstrated that ICIs as monotherapy provide substantial ben-efits for patients aged 65-75 years,showing no significant difference compared to younger patients.This benefit is also observed in combination with immune-combined chemotherapy or radiotherapy.For individuals older than 75 years,the survival effect was not evident,though.Immune-related adverse events(irAEs)with ICIs alone were similar in incidence across age catego-ries.Immune-combination chemotherapy resulted in a higher incidence of irAEs than chemotherapy alone,and patients ≥75 years of age were more likely to experience higher-grade irAEs.Besides the fact that immunosenescence in older patients influ-ences the immune milieu in a multifaceted manner,which in turn impacts the effectiveness of immunotherapy,the prognosis is also influenced by the Eastern Cooperative Oncology Group performance status(ECOG PS)score,among other factors.For certain individuals aged ≥75 years or in poor physical health,immunotherapy combined with low-intensity chemotherapy has emerged as a viable treatment option.However,there are fewer related studies,so there should be a conscious effort to increase the number of elderly patients enrolled in the trial and a comprehensive assessment to explore individualized treatment op-tions.To provide additional references and guidance for immunotherapy in elderly NSCLC patients and to propose new thera-peutic perspectives in combination with their characteristics,this review aims to summarize and analyze the pertinent studies on the application of programmed cell death protein 1(PD-1)/programmed cell death ligand 1(PD-L1)inhibitors in these patients.