Objective: To explore the association of latent profiles of mobile phone dependence and self control with physical exercise among junior high school students, so as to provide references for the prevention of mobile phone dependence and the improvement of self control among junior high school students. Methods: From April to May 2024, a stratified random cluster sampling method was used to select a total of 2 311 students from grade 7 to grade 9 in three public junior high schools in Xiangxi Autonomous Prefecture, Hunan Province. Latent profile analysis was conducted to identify the latent profiles of mobile phone dependence and self control among junior high school students. Pearson correlation analysis was used to examine the correlation between mobile phone dependence and self control, and Chi square test was used to analyze the distribution differences of latent profiles of adolescents across different demographic characteristics. Multiple Logistic regression analysis was applied to explore the association between mobile phone dependence, self control, and physical exercise. Results: Four latent profiles of mobile phone dependence and self control were identified: low dependence-moderate self control group ( n =885, 38.3%), moderate dependence-low self control group ( n =910, 39.4%), high dependence-no self control group ( n =232, 10.0%), and no dependence-high self control group ( n =284, 12.3%). Significant differences were observed in the distribution of latent profiles across gender, grade and only child status ( χ 2=10.85, 35.72, 13.85， P <0.05). Logistic regression analysis showed that, after controlling for demographic variables, compared with the low dependence-moderate self control group, physical exercise was negatively associated with the moderate dependence-low self control group ( OR =0.79) and the high dependence-no self control group ( OR =0.81), while positively associated with the no dependence-high self control group ( OR =1.58) ( P <0.01). Conclusions The influence of physical exercise on junior high school students different potential profile types of mobile phone dependence and self control is different. Schools and families should adopt targeted physical exercise interventions based on the characteristics of different profiles to promote the physical and mental health of junior high school students.

Objective: To analyze the heterogeneity of mobile phone dependence development trajectory in middle school students and its association with loneliness and selfcontrol ability, so as to provide reference for the prevention of mobile phone dependence in middle school students. Methods: A total of 941 grade 1 students from 4 public middle schools in Xiangxi Autonomous Prefecture, Hunan Province were selected for the followup survey by random cluster sampling from October 2023 to April 2024 and October 2024. Mobile Phone Addiction Index (MPAI), University of California, Los Angeles Loneliness Scale-20 (UCLA-20) and Selfcontrol Scales (SCS) were used for questionnaire survey. The heterogeneity of the developmental trajectory of middle school students mobile phone dependence was analyzed by the latent growth curve model (LGMM), and the influencing factors of the developmental trajectory of middle school students mobile phone dependence were explored by multiple Logistic regression analysis. Results: The development trajectory of middle school students mobile phone dependence could be divided into four categories: C1 "low risk slow decline group (n=438,44.6%)", C2 "medium risk slow rise group (n=272,29.7%)", C3 "high risk rapid decline group (n=73,8.6%)" and C4 "high risk rapid rise group (n=158,17.1%)". There were significant differences in the distribution of mobile phone dependence development track heterogeneity subgroups among sex, only child, lodging, and leftbehind students (χ2=117.79, 44.88, 37.09, 130.50, P <0.01). The results of the multinomial Logistic regression model analysis showed that, with C1 group as the reference, C2, C3, and C4 were positively correlated with students loneliness [OR(95%CI)=1.04 (1.02-1.06), 1.11(1.08-1.14), 1.12(1.09-1.14)]; C2 and C4 groups were negatively correlated with students selfcontrol [OR(95%CI)=0.97(0.96-0.99), 0.95(0.93-0.97)] (P<0.01). Conclusions The development trajectory of mobile phone dependence among middle school students is heterogeneous. Reducing the loneliness of individuals and cultivating good selfcontrol ability are helpful to alleviate mobile phone dependence behavior among middle school students.

Objective: To explore the influence of social support and school connectedness on the developmental trajectory of self efficacy in adolescents and analyze its subgroup effects, so as to provide a basis for enhancing adolescents self-efficacy. Methods: Using a cluster random sampling method, 930 first year middle school students from four schools in Xiangxi Autonomous Prefecture, Hunan Province, were selected for three longitudinal surveys in October 2023 (T1), April 2024 (T2), and October 2024 (T3). The General Self-efficacy Scale (GSES), Social Support Scale (SSS), and School Connectedness Scale (SCS) were administered. Latent growth mixture modeling (LGMM) was used to identify different developmental trajectories of self-efficacy in early adolescence. Multivariate Logistic regression was employed to examine the associations of self-efficacy trajectories with social support and school connectedness in adolescents. Results: The developmental trajectory of self-efficacy in adolescents was classified into three categories:category 1 was low efficacy-rapid growth group (53 students, 6.6%), category 2 was moderate efficacy-stable growth group (793 students, 84.1%), and category 3 was high efficacy-rapid decline group (84 students, 9.3%). Using the low efficacy- rapid growth group as the reference, students with higher social support were more likely to belong to the moderate efficacy- stable growth group ( OR=1.06, 95%CI =1.03-1.08) and the high efficacy-rapid decline group ( OR=1.06, 95%CI = 1.03 -1.09), students with higher school connectedness were more likely to belong to the high efficacy-rapid decline group ( OR= 1.10 , 95%CI =1.03-1.18) (all P <0.05). Subgroup analysis revealed significant effects for boarding status (low efficacy-rapid growth group at T1, t =2.10; high efficacy-rapid decline group in social support, t =-2.15) and only child status (moderate efficacy-stable growth group at T2, t =2.05) (all P <0.05). Conclusions The developmental trajectory of self-efficacy in adolescents exhibits group heterogeneity, with boarding status and only child status showing subgroup effects. Enhancing social support and school connectedness can help improve self-efficacy in adolescents.

Objective:To summarize the practice of continuing medical education programs in tuberculosis at Beijing Chest Hospital, and to put forward suggestions and references for improving the level of education and the quality of training.Methods:This paper examined the current situation of continuing medical education programs in tuberculosis at Beijing Chest Hospital. A satisfaction survey was administered to 3 451 trainees in 30 programs using a questionnaire that assessed the four aspects of learning attitude, learning environment and conditions, learning performance, and development status. SPSS 22.0 was used for the χ 2 test and t-test. Python 3.8.1 was used for word frequency analysis. Results:Of the participants, 75.54% (2 607) were generally satisfied and 23.41% (808) were satisfied with the programs. Physicians with different titles, regions, and education levels differed significantly on satisfactory items ( P<0.05). Chief physicians (professors) demonstrated a significantly higher understanding of the training programs compared to other physicians ( P<0.001). Physicians who worked in Beijing exhibited a significantly greater learning uptake than those from regions outside Beijing ( P=0.002). Physicians with doctoral and master's degrees were significantly less satisfied with the teaching materials compared to those with undergraduate or lower degrees ( P=0.001). Conclusions:The overall satisfaction of participants in continuing medical education programs in tuberculosis is relatively high. The managerial staff should improve the programs in multiple dimensions by giving full play to the advantageous disciplines in the hospital, developing brand training programs, and establishing a full-cycle management mechanism. Additionally, it is crucial to standardize high-quality programs, actively expand online distance education, and explore verifiable self-study models.

Objective:Taking the main international collaborative innovation network management modes for clinical research as a reference, to promote the construction of a collaborative innovation network for clinical research in China.Methods:Using literature research, case study, comparative analysis, and interview methods, this study systematically studied the collaborative innovation network management modes of clinical research in the United States, the United Kingdom, Japan, South Korea, and China from the perspective of integrating and sharing clinical research resources.Results:Based on the comparative results and drawing on foreign experience, suggestions were proposed to optimize the management mode of the clinical research collaborative innovation network in China and promote the construction of clinical research collaborative innovation network.Conclusions:It is recommended to establish national medical research institutions, increase investment in clinical research funds, build a platform for integrating volunteer resources based on clinical research collaborative innovation networks, and establish a clinical sample resource service platform to further supplement and improve the structure and layout of China’s clinical research collaborative innovation network.

Objective:To explore the latent classes of doctors′ behaviors in the process of shared decision-making between doctors and patients, and analyze the influencing factors for the latent classes.Methods:From August to September 2023, doctors from 4 tertiary hospitals in Dongcheng district, Beijing were selected using convenience sampling method. The general information questionnaire, shared decision making questionnaire-physician version(SDM-Q-Doc), doctor patient relationship questionnaire, the Jefferson scale of empathy health professionals, physician trust in the patient scale were administered to the participants. Latent profile analysis was performed based on the items of SDM-Q-Doc. The ordinal logistic regression analysis was conducted to explore the influencing factors of the latent classes of shared decision making.Results:A total of 480 doctors were included in the study. The results of latent profile analysis showed that doctors could be classified into 3 subgroups by shared decision making, namely shared decision missing group(17.3%, 83/480), collective balance deficiency group(52.5%, 252/480), and shared decision making group(30.2%, 145/480). The results of ordinal logistic regression analysis showed that career development opportunity( OR=0.509, 95% CI: 0.269-0.965, P=0.038), working years( OR=1.103, 95% CI: 1.016-1.196, P=0.019), empathic ability( OR=1.096, 95% CI: 1.079-1.113, P<0.001) and doctor-patient trust( OR=1.053, 95% CI: 1.027-1.080, P<0.001) were independent influencing factors of doctors′ shared decision making. Conclusions:The shared decision making of doctors showed significant population heterogeneity. Longer working years, sufficient career opportunities, high empathy ability and strong doctor-patient trust could enhance shared decision making behavior of the doctors. Intervention can be planned based on above factors from the perspectives of hospital managers and doctors in the future.

Objective:To investigate the performance of optical surface imaging (OSI) in the postmastectomy radiotherapy setup and to assess the effects of 3D printed silicone bolus on OSI detection precision.Methods:A retrospective analysis was conducted for 16 patients treated with left-sided postmastectomy radiotherapy (PMRT) in West China Hopital, Sichuan University from January to April, 2021. The setup errors of 16 patients without bolus detected using OSI (OSI no-bolus, OSI n) were obtained before error correction was conducted using cone-beam CT (CBCT). The correlation between OSI n and CBCT was analyzed, and then the diagnostic efficacy of OSI was assessed using the receiver operating characteristic (ROC) curves. The setup errors of six patients with 3D printed silicone bolus detected using OSI (OSI bolus, OSI b) were obtained through off-line image registration, and then the detection precision of OSI n and OSI b in the translational directions was compared. Results:The setup errors in the case of OSI n were highly correlated with CBCT in the translational direction ( r ≥ 0.80), but were weakly correlated in the rotation direction ( r < 0.40). In the ROC analysis, the area under the curve (AUC) in the y direction was the lowest and was in the order of AUC 5 mm ≥AUC 3 mm > 0.75 for any translational direction. The difference in the detection precision between OSI n and OSI b was not statistically significant in the x and z directions ( P > 0.05), but was statistically significant in the y direction ( Z = -2.56, P = 0.01). In the y direction, the systematic error of detection precision in the case of OSI b was 3.11 mm higher than that in the case of OSI n, and the random error of detection precision in the case of OSI b was 1.9 mm higher than that in the case of OSI n. Conclusions:OSI cannot yet substitute CBCT in the postmastectomy radiotherapy setup, but its detection error is still within the clinically acceptable range. The performance of OSI-assisted setup is expected to be further improved by mitigating the interference of factors such as bolus in the imaging path through operational training.

Objective:To investigate the current physician title promotion satisfaction in public hospitals, and analyze the main influence factors, for references in improving their satisfaction.Methods:June to December 2018, 2 156 in-job physicians of 39 hospitals in China were surveyed with questionnaires via the medical alliances platform, in order to learn their title promotion satisfaction. General information was subject to descriptive analysis, while the main influencing factors for their satisfaction were evaluated with univariate analysis.Results:Among the 2 156 samples, the overall satisfaction scored (3.17±0.84), at a satisfaction rate of 32.88%(709/2 156), the lowest satisfaction scoring was found in the promotion ratio(2.90±1.03). The univariate analysis results indicated that such factors as teaching titles, hospital grading and their location influenced their satisfaction on title promotion with a significant difference( P<0.05), while those with medium titles presented the lowest scoring in their satisfaction. Conclusions:As the overall satisfaction rate for their professional title promotion was not high, it is necessary to take the following measures. They refer to reasonable adjustment of the proportion ratio, dynamic coordination, and proactive exploration to establish different promotion series and launch differentiated appraisal, focusing on building a scientific and reasonable promotion criteria by levels and by categories for the purpose of enhancing teambuilding of physicians.

Objective: To investigate and explore the changes of the diagnosis of Chinese children with autism spectrum disorder (ASD). Methods: The families of two groups of children aged 1-6 and 6-16 years who were diagnosed with ASD were selected from ALSOLIFE platform, and the online questionnaire was used to investigate the symptoms and its diagnosis related information. ANOVA was applied to compare the mean values, and χ 2 analysis was taken to compare the differences of two groups in the time of finding symptoms, the time of the first diagnosis, the time of treatment, and the diagnosis delayment. Results: The initial recognition age of symptoms was 26.05 months age (2.17 years) in the young group (1-6 years), and 30.76 months age (2.56 years) in the old group (6-16 years). The age of first visit doctor was 28.21 months age (2.35 years) in the young group and 34.29 months (2.86 years) in the old group, while the average delay was only 3.43 months, of which the average delay was 4.52 months in the old group and 2.78 months in the young group. The age of diagnosed as ASD was 38.01 months age (3.17 years) in the young group and 31.07 months age (2.59 years) in the old group, while the average delay from first diagnosis to last diagnosis was 3.16 months. The delay from first diagnosis to last one was 3.71 months age in old age group, and 2.83 for the younger age group, The above differences were statistically significant ( F =328.30, 535.64, 507.71, 103.03, 17.79, P <0.01). Most of the children were still in the top hospitals to get diagnosed, but the role of child care was becoming more and more important. Conclusion The diagnosis efficiency of ASD children has been greatly improved, the time of symptom identification and diagnosis is advanced, and the delay of seeing a doctor and diagnosis is shortened.