Objective: To understand the dynamic temporal evolution pathways of Internet addiction among university students and to identify the core driving nodes, so as to provide theoretical evidences for the precise implementation of targeted interventions. Methods: Using a convenient cluster sampling method, a total of 1 066 full time freshmen and sophomores were recruited from three universities in Guizhou, Jiangxi, and Guangdong Provinces for a follow up survey (T1:January-March 2024; T2:January-March 2025). The Revised Chen Internet Addiction Scale (CIAS-R) was employed to assess the status of Internet addiction among university students, and cross sectional as well as cross lagged panel network models were constructed to analyze Internet addiction and its multidimensional influencing factors. Results: The T1 network comprised 19 nodes and 114 non zero edges, while the T2 network comprised 19 nodes and 126 non zero edges. Cross sectional network analysis revealed the strongest association between "insufficient sleep" and "daytime fatigue"; the core nodes were "first thought upon waking for going online" and "feeling low after disconnection" (characteristics of psychological dependence) at T1, while the core nodes shifted to "impaired health" and "excitement when online" (characteristics of functional impairment and addictive psychodynamic features) at T2. Cross lagged network analysis further indicated that "reduced leisure" directly predicted "sleep compression", and a bidirectional relationship was observed between "needing more time to achieve satisfaction" and "academic decline". Conclusions Internet addiction among university students exhibits dynamic evolutionary characteristics. Stage specific targeted interventions focusing on core driving nodes are needed, integrating behavioral regulation and academic support to break the vicious cycle and enhancing the ability to cope with real life demands.

Objective:To investigate the effect of modified thoracic nerve block on postoperative analgesia and early recovery of breast cancer patients after modified radical mastectomy.Methods:Sixty female breast cancer patients who were scheduled to undergo modified radical mastectomy in the Second Hospital of Shanxi Medical University from March 2019 to December 2019 were selected, and the patients were all American Society of Anesthesiologists (ASA) grade Ⅰ-Ⅱ. According to the random number table method, the patients were divided into three groups: improved group [third rib approach serratus anterior plane block (SAPB)+pectoralis major muscle superficial anterior cutaneous branch of intercostal nerve block combined with general anesthesia, STG group], SAPB combined with general anesthesia group (SG group) and general anesthesia+postoperative intravenous controlled analgesia pump group (GP group), with 20 cases in each group. VAS scores at 30 min, 2 h, 4 h, 12 h and 24 h after surgery, 15-item quality of recovery scale (QoR-15) scores at 1 d before and 24 h after surgery, sleep duration on the night after surgery, intraoperative opioid dosage, the time between stop medication and awakening, postoperative flurbiprofen ester dosage, nausea, vomiting, dizziness, puncture site infection, pneumothorax, infection and other adverse reactions were recorded.Results:The VAS scores at 30 min, 2 h, 4 h, 12 h, 24 h in the STG group were lower than those in the SG group and GP group, the VAS scores at 2 h, 12 h and 24 h after surgery in the SG group were lower than those in the GP group, and the differences were statistically significant (all P < 0.05). The QoR-15 score at 24 h in the STG group was higher than that in the SG group and the GP group [(137.85±2.81) points vs. (134.80± 2.72) points, (133.80±5.16) points], and the differences were statistically significant (all P < 0.05). The sleep duration on the night after surgery in the STG group and the SG group was longer than that in the GP group [(6.03±0.90) h, (5.48±1.12) h vs. (3.85±1.76) h], and the differences were statistically significant (all P < 0.05). The intraoperative opioid dosage and the time between stop medication and awakening in the STG group and the SG group were lower than those in the GP group, and the differences were statistically significant (all P < 0.05). The postoperative flurbiprofen ester dosage and the incidence rates of nausea, vomiting and dizziness in the STG group were lower than those in the SG group and the GP group, and the SG group was lower than the GP group, and the differences were statistically significant (all P < 0.05). Conclusion:The modified thoracic nerve block can relieve early postoperative pain, reduce the amount of intraoperative opioids, and improve the quality of patients' early recovery without increasing adverse reactions.