Chronic obstructive pulmonary disease (COPD) is the most common chronic respiratory disease around the world, and pharmacotherapy is the foremost treatment method currently. In recent decades, with the rapid development of bronchoscopic interventional therapy, endoscopic physical ablation technology presents a therapeutic effect in treating COPD, with few treatment-related side effects, showing excellent application prospects in treating COPD. Since ablation techniques in this field are emerging technologies with low patient acceptance, they are not widely used in the clinical treatment of COPD. This article reviews the development process of physical ablation techniques. Moreover, their current application status and the prospects in the field of COPD treatment are also summarized and analyzed. We hope to promote the application of physical ablation in the clinical treatment of COPD and provide practical references and a theoretical basis for the clinical treatment of COPD.

Objective To analyze the epidemiological characteristics of statutory infectious diseases in Yichang City from 2015 to 2023 and evaluate the effectiveness of non-pharmaceutical interventions (NPIs) in infectious disease prevention and control, and to provide a basis for formulating prevention and control strategies. Methods Descriptive epidemiological methods were used to analyze annual incidence rates. SARIMA and SARIMA intervention models were constructed to predict the incidence rates of infectious diseases. Interrupted time series analysis (ITS) was applied to assess the control effectiveness. Results The average annual incidence rate from 2015 to 2023 was 787.47/100 000, with the top five diseases being influenza, hand-foot-and-mouth disease, hepatitis B, tuberculosis, and diarrheal diseases. The average incidence rate from 2015 to 2019 (654.31/100 000) was significantly higher than that from 2020 to 2022 (489.01/100 000) (χ²= 3 499.6, P < 0.05). The total incidence rate in 2023 (2 396.51/100 000) was significantly higher than the average annual incidence rates from 2015-2019 (χ²= 108 186.1, P < 0.05) and 2020-2022 (χ²= 112 869.4, P < 0.05). SARIMA model results indicated that the actual incidence rate from 2020 to 2022 decreased by 73.49% compared to the predicted rate without intervention, with the highest decline observed in respiratory infectious diseases (79.57%). The SARIMA-intervention model showed a 55.48% relative decrease in the total incidence rate for 2023, with the largest reduction in respiratory infectious diseases (63.28%) and a slight increase in intestinal infectious diseases (5.48%). Conclusion NPIs effectively reduce the incidence of statutory infectious diseases in the short term, especially for acute respiratory and intestinal infectious diseases. However, long-term effectiveness faces challenges, necessitating the development of differentiated prevention and control strategies.

ObjectiveTo investigate the mechanism by which Notoginsenoside R1 （NGR1） ameliorates hypoxia/reoxygenation （H/R）-induced injury in AC16 human cardiomyocyte cell lines through the regulation of mitophagy. MethodsCommon genes linked to hypoxia/reoxygenation injury and mitophagy were identified by intersecting data from GeneCards and MitoCarta databases. AC16 cell viability was assessed via CCK-8 assay under varying NGR1 concentrations （0， 6.25， 12.5， 25， 50， 100， 200， 300， 400， 500 μmol/L）. AC16 cells were divided into the following groups： control group （Control）， model group （H/R）， and treatment groups （H/R + NGR1 at 100， 200 and 300 μmol/L）. Mitochondrial membrane potential （ΔΨm） was measured using 5，5'，6，6'-tetrachloro-1，1'，3，3'-tetraethylbenzimidazolylcarbocyanine iodide （JC-1） staining. Transcriptional levels of mitophagy-related genes （Parkin， Pink1， P62） were quantified by reverse transcription-quantitative PCR （RT-qPCR）. Protein expression of mitophagy-related markers （Parkin， Pink1， P62， and LC3BⅡ） was evaluated via Western blot analysis. Mitochondrial ultrastructure was visualized by transmission electron microscopy （TEM）. ResultsCompared to the control group， cell viability in the H/R group significantly decreased （P<0.01）. Treatment with NGR1 at concentrations above 100 μmol/L significantly enhanced the cell viability of AC16 cells compared to the H/R group （P<0.01）. H/R induced a significant decrease in mitochondrial membrane potential （P<0.01）， which was restored by NGR1 treatment （P<0.01）. The mRNA levels of Parkin， Pink1， and P62 in the H/R group were upregulated compared to the control group （P<0.05）， while NGR1 intervention downregulated their expression （P<0.05）. Protein expression levels of Parkin， Pink1， and LC3BⅡ in the H/R group significantly increased， while P62 expression decreased compared to the control group （P<0.01）. In contrast， different doses of NGR1 treatment significantly reduced the expression of Parkin， Pink1， and LC3BⅡ while increasing P62 expression （P<0.05）. TEM revealed that the mitochondrial structure in the H/R group was severely disrupted， with fragmented and disorganized cristae， which was alleviated by NGR1. ConclusionNGR1 ameliorates H/R-induced AC16 cell injury， and its mechanism may be associated with modulating the Pink1/Parkin pathway to suppress excessive mitophagy.

ObjectiveTo investigate the characteristics of gray matter structure and clinical symptoms in patients with Alzheimer's disease （AD） comorbid with apathy （AD-A）. MethodsThe study included 30 patients with AD-A， 30 AD disease patients without apathy （AD without apathy， AD-NA）， and 30 healthy controls （HCs） matched in gender， age， and years of education. All participants underwent a comprehensive neuropsychological assessment and magnetic resonance imaging （MRI） scans. Voxel-based morphometry （VBM） was used to analyze changes in gray matter volume among the three groups. Additionally， the correlation between the identified abnormal brain regions and apathy scale scores was analyzed. ResultsThere were no statistically significant differences among the three groups in terms of age， gender， years of education， or total intracranial volume. Compared with the HCs group， both the AD-A and AD-NA groups showed significantly lower scores in cognitive function （P<0.001）. The AD-A group exhibited significantly higher apathy scale scores compared with the AD-NA group （P<0.001）. Compared with the AD-NA group， the AD-A group showed reduced gray matter volume in the bilateral caudate nucleus， left orbitofrontal cortex， lingual gyrus， inferior frontal gyrus， superior frontal gyrus， entorhinal cortex， right middle frontal gyrus and posterior cingulate cortex （FWE-corrected， P<0.05 for all）. Compared with the HCs group， the AD-A group exhibited reduced gray matter volume in the bilateral middle temporal gyrus， left fusiform gyrus， calcarine sulcus， postcentral gyrus， right inferior frontal gyrus and supramarginal gyrus （FWE-corrected， P<0.05 for all）. Compared with the HCs group， the AD-NA group showed reduced gray matter volume in the left precuneus， inferior temporal gyrus， and right inferior temporal gyrus （FWE-corrected， P<0.05 for all）. In the AD-A group， changes in the gray matter volume of the left caudate nucleus （r= -0.557， P=0.002） and right middle frontal gyrus （r=-0.620， P=0.001） were negatively correlated with the apathy evaluation scale （AES） scores. ConclusionPatients in the AD-A group exhibited significant atrophy in the frontal-temporal-basal ganglia circuit， and the degree of gray matter atrophy was correlated with the severity of apathy.

Objective To establish a competency evaluation indicator system for school physicians. Methods A preliminary pool of competency indicators for school physicians was established through systematic literature review and policy document analysis. The Delphi method was used to conduct two rounds of expert consultations with 16 experts who involve in educational administration, clinical medicine, public health management, and school healthcare. Based on the opinions of the experts, the indicator system was screened, revised, and refined to establish the final competency evaluation indicator system for school physicians. Results The questionnaire recovery rates of the two rounds of expert consultations were both 100.0%. The expert authority coefficient were 0.93 and 0.94, and Kendall′s coefficients of concordance were 0.21 and 0.26, respectively (both P<0.01). The final competency evaluation indicator system for school physicians consisted of five primary indicators, including basic medical service capacity, school health service capacity, health education and communication capacity, professional ethics and competency, and self-improvement capacity, as well as 35 secondary indicators (items). All indicators received relatively high importance scores. The system demonstrated a reasonable structure, good scientific validity, and practical applicability. Conclusion The competency evaluation indicator system for school physicians developed in this study demonstrates high scientific validity and practicality. It can serve as an important tool for school physician management, competency development, and performance evaluation, providing references for improving school health service quality and strengthening the construction of school physician teams.

Lumbar spinal stenosis (LSS) is a common disabling condition in the elderly, and its clinical assessment relies not only on imaging and neurofunctional indicators but also on traditional Chinese medicine (TCM) syndrome differentiation. To evaluate the concordance between existing LSS animal models and clinical characteristics of TCM and Western medicine, clarify their advantages and limitations, and explore their translational potential, Chinese and English databases, including CNKI, Wanfang Data, PubMed, and Web of Science, are searched using combinations of the terms "lumbar spinal stenosis," "model," "guideline," "consensus," and "norm" from inception to the end of June 2025. After screening, a total of 21 publications are included, of which 15 report animal experimental studies, and 6 are guidelines, consensus statements, or normative documents. Based on these, the existing modeling methods are summarized, diagnostic indicators are extracted from clinical guidelines and expert consensus, and clinical concordance is evaluated using an assessment system proposed in the relevant literature. The results show that the existing animal models are categorized into three concordance levels: high (laminectomy/spinous process removal with filling; laminectomy/spinous process + ligament/muscle removal with filling; autologous bone backfilling), moderate (nylon tape dural binding method, adjustable screws, fixation combined with removal of ligament/muscle), and low (balloon compression method, adjustable balloon compression method, bipedal standing, ligament/muscle resection, steel wire cerclage method). Overall, current animal models of LSS generally perform well in terms of structural construction but show clear limitations in replicating clinical diagnostic logic and TCM syndromes. Future research should enhance syndrome phenotype collection and enrich TCM-based evaluation systems based on existing models. Additionally, multifactorial integrated modeling strategies should be introduced to extend the depth of syndrome-level simulation. This study aims to analyze LSS animal models that can faithfully recapitulate disease pathogenesis, conform to clinical realities of both Western medicine and TCM clinical practice, and have broad application potential, so as to narrow the translational gap between experimental findings and clinical practice.

Objective To explore the mechanism of electroacupuncture in inhibiting peripheral sensitization of visceral pain in mice with irritable bowel syndrome(IBS)based on TRPV1/Ras/p38MAPK signaling pathway.Methods Totally 28 male SPF-grade C57BL/6 mice were randomly divided into normal group,model group,electroacupuncture group and inhibitor group.The IBS visceral hypersensitivity model was induced by trinitrobenzene sulfonic acid enema.Four weeks post-modeling,electroacupuncture group and inhibitor group were given electroacupuncture at bilateral"Zusanli"and intraperitoneal injection of the TRPV1 receptor inhibitor respectively for consecutive 7 d.Abdominal withdrawal reflex(AWR)score was used to evaluate visceral pain in mice,HE staining was used to observe the morphology of colonic tissue,Western blot was used to detect the protein expressions of TRPV1,p-p38,tumor necrosis factor(TNF)-α and interleukin(IL)-6 in colonic tissue,ELISA was used to detect the Ras-GTP content in colonic tissue,and RT-qPCR was used to detect the mRNA expression of TRPV1 and p38 in colonic tissue.Results Compared with the normal group,AWR score under different pressure were significantly increased in the model group(P<0.05,P<0.01),the expression of TRPV1,p-p38,TNF-α and IL-6 protein in colonic tissue significantly increased(P<0.05,P<0.01,P<0.001),the content of Ras-GTP significantly increased(P<0.001),the expression of TRPV1 and p38 mRNA significantly increased(P<0.001).Compared with the model group,AWR score under different pressure were significantly decreased in electroacupuncture group and inhibitor group(P<0.05,P<0.01),the expression of TRPV1,p-p38,TNF-α and IL-6 protein in colonic tissue significantly decreased(P<0.05,P<0.01,P<0.001),the content of Ras-GTP significantly decreased(P<0.01,P<0.001),and the expressions of TRPV1 and p38 mRNA significantly decreased(P<0.05,P<0.01,P<0.001).There was no significant change in the morphology of colonic tissue in each group of mice.Conclusion Electroacupuncture can effectively alleviate visceral hypersensitivity in IBS mice,and its analgesic effect may be related to the inhibition of the TRPV1/Ras/p38MAPK signaling pathway in colonic tissue.

The cultivation of top innovative nursing talents with Chinese characteristics in the new era lends critical support to the accomplishment of the strategic goal of the Healthy China Initiative.Herein,we reviewed the historical development of nursing science in China,clarified the conceptual framework of nursing science with Chinese characteristics in the new era,and identified the essential qualities and competencies required for top innovative nursing talents.Furthermore,we analyzed the mission and challenges in cultivating these nursing talents,and put forward new approaches,including formulating new ethics and political education theories specific to nursing science with Chinese characteristics,establishing a cross-disciplinary educational model of Nursing+X,and creating a new nursing talent cultivation ecosystem adapted to the era of human-machine symbiosis.This study provides theoretical insights into the cultivation of top innovative nursing talents who align their development well with national strategic needs,embody patriotism,and possess a strong sense of contemporary responsibility.

This article reports a first case of combined infection with severe fever with thrombocytopenia syndrome(SFTS)and scrub typhus in Dalian City.The patient was admitted to the hospital due to recurrent fever for 7 days and loss of consciousness for 1 day.Pathogen metagenomic sequencing(mNGS),SFTSV quantitative PCR,and enzyme-linked immunosorbent assay(ELISA)IgM tests were performed,showing positive results for Orientia tsutsugamushi and SFTSV nucleic acids.Based on clinical manifestations and epidemiological history,the patient was diagnosed with combined infections.

Objective To evaluate the efficacy of the enzyme-linked immunosorbent assay(ELISA),polymerase chain reaction(PCR),and gold chromatographic strip assay(GICA)in diagnosing clonorchiasis through a meta-analysis of diagnostic tests.Methods Relevant databases,including CNKI,the Wan Fang Database,VIP,and PubMed,were searched according to inclusion and exclusion criteria.Literature quality was assessed using RevMan 5.4 and Stata 18,and funnel plots,forest plots,and SROC curves were generated.Results A total of 50 articles met the inclusion criteria.Deeks'funnel plot analysis indicated no significant publication bias among the three methods.The combined effect size analysis revealed that the sensitivity and specificity of ELISA for detecting clonorchiasis were 0.93(0.89-0.95)and 0.94(0.92-0.96),respectively,with an area under the SROC curve of 0.98.For PCR,the sensitivity and specificity were 0.93(0.84-0.97)and 0.92(0.80-0.97),respectively,yielding an area under the SROC curve of 0.97.The sensitivity and specificity of the GICA method for detecting clonorchiasis were 0.91(0.83-0.96)and 0.95(0.87-0.98),respectively,with an area under the SROC curve of 0.97.Conclusions In the diagnosis of clonorchiasis,ELISA,PCR and GICA have high diagnostic value,but their ranges differ from each other.