Endovascular interventional therapy is currently the main treatment for acute ischemic stroke，but some patients still have not achieved neurological function independence. Analysis of the predictive value of various factors for postoperative neurological function changes can provide more reference for selecting appropriate patient groups and treatment plans.

Objective: To understand the current situation of college students emotional regulation and its correlation with perceived social support, so as to provide a reference for improving emotional regulation ability among college students. Methods: From September 15 to October 15, 2022, a total of 15 560 students from 27 colleges and universities in Guangdong, Jiangsu, Shandong, Shanghai, Anhui, Hebei, Yunnan, Shanxi and Gansu were enrolled by stratified random sampling method. The Perceived Social Support Scale (PSSS) and the Emotion Regulation Questionnaire (ERQ) were used to investigate, and multiple stepwise regression was used to explore the relationship between perceived social support and emotion regulation of college students. Results: The scores of emotion regulation, cognitive reappraisal and expression inhibition were 44(40, 50), 24(20, 28) and 20(19, 24) respectively. There were significant differences in the scores of emotion regulation, cognitive reappraisal and expression inhibition by age, grade, household registration, only child status,cost of living, and sleep ( H/Z =77.72, 49.73, -5.10, -9.77, 7.68, 168.27 ; 204.55, 317.32, -5.96, -7.60, 131.20, 968.08; 82.18, 148.04, -2.30, -8.03, 64.82, 188.08, P <0.05). In addition, the multiple stepwise regression found that family support, friend support, and other support in perceived social support all had a positive impact on the emotional regulation state of college students ( β =0.137,0.207,0.090), and family support and friend support had a significant positive effect on expression inhibition( β =0.079,0.053) and cognitive reappraisal( β =0.153,0.296)( P <0.01). Conclusion The perceived social support can directly affect the emotional regulation of college students, and improving the emotional regulation ability has a positive significance to promote the mental health level among college students.

Objective:To evaluate the relationship between red blood cell distribution width (RDW) and prognosis of patients with hepatocellular carcinoma (HCC) andergoing transcatheter arterial chemoembolization (TACE).Methods:Clinical data of 212 patients with HCC andergoing TACE for the first time in Department of Interventional Radiology, the Affiliated Hospital of Xuzhou Medical University from January 2011 to May 2018 were retrospectively analyzed, including 184 males and 28 females, aged (56.8±11.2) years. Follow-up for survival. X-tile software was used to determine 13.1% as the optimal threshold for preoperative RDW prediction of prognosis, and enrolled patients were divided into a low level group (RDW<13.1%, n=70) and a high level group (RDW≥13.1%, n=142). Aspartate aminotransferase, total bilirubin, albumin, hemoglobin and lipoprotein a, Barcelona clinical liver cancer (BCLC) stage and other indexes were compared between the two groups. Survival analysis was performed by Kaplan-Meier method, survival rate was compared by log-rank test, and the effect of RDW on prognosis was analyzed by Cox regression. Results:The 1-year, 2-year and 3-year cumulative survival rates in RDW high level group were 34.5%, 14.1% and 6.3%, respectively, while those in RDW low level group were 64.3%, 38.6% and 21.4%, respectively, with significant difference ( χ2=23.09, P<0.001). Compared with the low level group, the levels of aspartate aminotransferase and total bilirubin were higher, the levels of albumin, hemoglobin and lipoprotein a were lower, the proportion of portal vein cancer thrombin was higher, and the stage of BCLC was later, with statistical significance (all P<0.05). Cox regression analysis showed that HCC patients with RDW≥13.1%( HR=1.732, 95% CI: 1.223-2.452, P=0.002) had poor survival prognosis after TACE. Conclusion:Preoperative RDW≥13.1% is an independent risk factor for survival after TACE in patients with HCC. RDW has potential predictive value for prognosis of patients with HCC.

Generative artificial intelligence (GAI) refers to AI technology capable of generating new content such as text, images, or audio from training data. GAI tools not only demonstrate rapid and efficient potential in literature screening, data extraction, and literature appraisal in systematic reviews, but can also be used for guideline evaluation and dissemination, enhancing the readability and promotion efficiency of guidelines. However, the accuracy of content generated by GAI tools, the rationality of cited evidence, the level of evidence, and the reliability of data still need verification. Additionally, data privacy protection and ethical issues are challenges that need to be addressed. This article aims to overview the current status of GAI tools in the formulation, evaluation, dissemination, and implementation of guidelines, explore the feasibility and new models of GAI tools in the field of guidelines, and improve the efficiency and quality of guideline formulation to better serve guideline developers and users.

Objective:Exploring gene-age interactions associated with breast cancer prognosis based on epigenomic data.Methods:Differential expression analysis of DNA methylation was conducted using multiple independent epigenomic datasets of breast cancer from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO). The false discovery rate (FDR) method was used for multiple corrections, retaining differentially methylated sites with q-FDR≤0.05. A three-stage analytic strategy was implemented, using a multivariable Cox proportional hazards regression model to examine gene-age interactions. In the discovery phase, signals with q-FDR ≤ 0.05 were screened out using TCGA-BRCA database. In validation phaseⅠ, the interaction was validated using GSE72245 data, with criteria of P≤0.05 and consistent effect direction. In validation phaseⅡ, the signals were further validated using GSE37754 and GSE75067 data. A prognostic prediction model was constructed by incorporating clinical indicators and interaction signals. Results:The three-stage analytic strategy identified a methylation site (cg16126280 EBF1), which interacted with age to jointly affect the overall survival time of patients (interaction HR= 1.001 1,95% CI:1.000 7-1.001 5, P<0.001). Stratified analysis by age showed that the effect of hypermethylation of cg16126280 EBF1 was completely opposite in younger patients ( HR=0.550 5, 95% CI: 0.383 8-0.789 6, P=0.001) and older patients ( HR=2.166 5, 95% CI: 1.285 2-3.652 2, P=0.004). Conclusions:The DNA methylation site cg16126280 EBF1 exhibits an interaction with age, jointly influencing the prognosis of breast cancer in a complex association pattern. This finding contributes new population-based evidence for the development of age-specific targeted drugs.

Objective:To systematically evaluate the qualitative research on the practical experience of hospice care among medical staff in nursing homes, and to provide a reference basis for the implementation of hospice care services in nursing homes.Methods:The qualitative research on the practical experience of hospice care among medical staff in nursing homes was searched from databases including the Web of Science, PubMed, Cochrane Library, Embase, CINAHL, China National Knowledge Infrastructure, China Biology Medicine disc, Wanfang Data and VIP Database. The retrieval period was from the establishment of the database to March 21, 2024. The quality evaluation standards for qualitative research of the Australian Joanna Briggs Institute Evidence-Based Health Care Center were used to evaluate the quality of the literature. The results were integrated by the method of aggregative integration.Results:A total of 15 studies were included, and 47 clear research results were extracted, summarized into 11 categories, and 4 integrated results were obtained: the palliative care work responsibilities of medical staff; the emotional experience of medical staff in practice; coping with negative experience and gaining personal growth;the practical dilemmas faced by nursing homes when implementing hospice care.Conclusions:Nursing homes face multiple obstacles and challenges in the process of providing hospice care services. It is recommended that future research should focus on improving the policy system of hospice care in nursing homes, building a support system for hospice care services, and promoting the development and practice of death literacy among the public, so as to promote the healthy and long-term development of hospice care services in nursing homes.

Objective:Studying the effect of PRDX4 on esophageal squamous cell carcinoma cells(esophageal carcinoma,ESCC)proliferation and apoptosis as well as its potential mechanism.Methods:The University of Alabama at Birmingham cancer data analysis portal(UALCAN),gene expression profiling interactive analysis(GEPIA)and the Cancer Genome Atlas(TCGA)databases were used to predict PRDX4 expres-sion in ESCC and its relationship with pathological features and prognosis.The cancer and adjacent tissues of 60 patients with ESCC who un-derwent radical resection in the Affiliated Hospital of Weifang Medical College from August 2010 to August 2023 were selected as research samples.The expression level of PRDX4 in the patients was detected by immunohistochemistry(IHC).The extracted cancer and adjacent tis-sues were homogenized to analyze its mRNA expression.The expression levels of PRDX4 mRNA and related signaling proteins in ESCC cells were analyzed by real-time quantitative PCR and Western blot.Cell Counting Kit-8(CCK-8)assay and flow cytometry were used to analyze the effect of PRDX4 on cell proliferation and apoptosis.Finally,a subcutaneous tumor model in nude mice was constructed to validate the in vitro experimental results.Results:The data from the GEPIA and UALCAN showed that PRDX4 expression was abnormally increased and re-lated to the pathology stage,grade,and survival rate of patients.After knockdown and overexpression of PRDX4 in an ESCC cell line,the ex-pression of PRDX4,phos-phosphatidylinositol 3-kinase(p-PI3K),phos-protein kinase B(p-AKT),cyclinD1,and survivin protein decreased and increased,respectively;cell proliferation and apoptosis were positively regulated.Compared with the sh-NC group,tumor volume and weight in the sh-PRDX4 group were decreased.Conclusions:PRDX4 regulates the proliferation and apoptosis of ESCC cells by activating the PI3K/AKT signaling pathway.

This article introduced Professor Wang Xingkuan's academic thoughts and clinical experience in diagnosing and treating burning mouth syndrome(BMS)in perimenopausal women based on the theory of"yin injury and internal dryness".Professor Wang advocates the principle of"treating the root cause of the disease and harmonizing multiple organs".Starting from the unique physiological characteristics of perimenopausal women,he believes that the BMS in perimenopausal women should be attributed to the kidneys,liver,heart,and small intestine.The fundamental cause of the disease is the deficiency of kidney essence and the gradual decline of liver blood,and the key to the onset is the dryness of the kidney,liver,heart,and small intestine.In treatment,the overall strategy is to take"yin injury and internal dryness"as the main guideline,focusing on the liver and kidney,with nourishing and replenishing the liver and kidney as the main approach and clearing heat and moistening as auxiliary methods.The basic formula for treating BMS is a combination of Erdong Decoction and Baihe Dihuang Decoction,which has shown significant clinical efficacy.

Objective To evaluate the clinical efficacy of kissing-stent implantation in the treatment of chronic iliac-vena cava occlusion.Methods The clinical data of 22 patients with chronic iliac-vena cava occlusion,who received kissing-stent implantation,were retrospectively analyzed.The surgical success rate and the procedure-related complications were recorded,the postoperative 3-,6-and 12-month stent patency rates were calculated,and the postoperative 6-month Villalta score was compared with its preoperative value.Results The technical success rate of kissing-stent implantation was 100％.No procedure-related surgical complications occurred.The postoperative 3-,6-and 12-month stent patency rates were 95.5％,90.9％and 86.1％respectively.The postoperative 6-month Villalta score was(12.14±2.80)points,which was remarkably lower than preoperative(20.91±3.16)points,the difference was statistically significant(P＜0.05).Conclusion The implantation of kissing-stent can successfully reconstruct iliac-vena cava with satisfactory short-term efficacy for chronic iliac-vena cava occlusion.

Objective To explore the effects of metformin on the proliferation,migration,and epithelial-mesenchy-mal transition(EMT)of human lens epithelial cells(LEC)induced by transforming growth factor-β2(TGF-β2).Methods Immortalized human LEC(HLEB-3 cells)was selected as the cell source.Human LEC with a cell fusion degree of 80％was cultured in DMEM low-glucose medium containing 10 mg·L-1 TGF-β2 for 24 hours as the control group.The cells treated with TGF-β2 and then further treated with different concentrations of metformin were used as the experimental group.After treatment,the morphological changes of cells in each group were observed under an inverted microscope.The cytotoxicity was detected by CCK-8 assay,and the cell survival rate was calculated.The expression levels of Yes-associated protein 1(YAP1),large tumor suppressor 1(LATS1),and Vimentin in cells were detected by Western blot.The mRNA ex-pression levels of YAP1,LATS1,mammalian STE20-like kinase 1(MST1),Vimentin,and E-cadherin were detected by re-al-time quantitative polymerase chain reaction.Results The cytotoxicity test of metformin showed that when the concen-tration of metformin was greater than 15 mmol·L-1,the survival rate of human LEC significantly decreased,indicating that the concentration of metformin had a significant impact on the survival of LEC.Therefore,15 mmol·L-1 was selected for subsequent experiments.Metformin significantly inhibited the proliferation of human LEC induced by TGF-β2 in a dose-dependent manner(P＜0.001).After 24 hours of treatment with 15 mmol·L-1 metformin,the relative expression levels of YAP1 and Vimentin proteins in human LEC were lower than those in the control group(both P＜0.05),while the relative expression level of LATS1 protein was higher than that in the control group(P＜0.05).After 24 hours of treatment with 15 mmol·L-1 metformin,the relative expression levels of YAP1 and Vimentin mRNA in human LEC were lower than those in the control group,while the relative expression levels of LATS1,MST1,and E-cadherin mRNA were higher than those in the control group,with statistically significant differences(all P＜0.05).Conclusion Metformin can inhibit the prolifer-ation,migration and EMT of human LEC induced by TGF-β2 in vitro,downregulate the expression of YAP1 and Vimentin mRNA,and upregulate the expression of LATS1,MST 1 and E-cadherin.The mechanism of action may be related to its ac-tivation of the Hippo signaling pathway.