Objective Emergency response to public health emergencies constitutes a vital component of the modernization of national governance systems and capacities, directly impacting national security, social stability, and public health. This study aims to analyze the key issues and research hotspots in the field of emergency response to public health emergencies, providing theoretical foundations and practical guidance for formulating scientific and effective emergency strategies and policies. Ultimately, it seeks to enhance the nation’s capability to respond to public health emergencies and safeguard public health. Methods Using core journals indexed in the China National Knowledge Infrastructure (CNKI) database as the data source, 1094 journal articles in the field of emergency response to public health emergencies in China from 2003 to September 2024 were selected as the research sample. Citespace visualization software was employed to organize and analyze the research process in the field of emergency response to public health emergencies. Results The current research in this field predominantly involves small-scale cooperation, and the research process can be divided into four stages. The research in the emerging stage mainly focuses on the themes of emergency mechanism and emergency management, the development stage mainly centers on the themes of emergency capacity improvement and system exploration, the outbreak stage emphasizes the themes of COVID-19 and epidemic prevention and control, and the sustainable development stage highlights collaborative governance and informatization. Conclusion The COVID-19 pandemic has accelerated the development of research in this field. Currently, the field shows a continuous growth, with an increasing volume of publications. The focus of current research has shifted towards collaborative governance and the study of assessment tools, aiming to enhance the efficiency and effectiveness in responding to public health emergencies. Moreover, the field is advancing toward more systematic and comprehensive research. However, there is still a need to strengthen scientific communication and collaboration.

Objective To investigate the current level of public awareness regarding nuclear emergency evacuation around a nuclear power plant, analyze the influencing factors, and propose suggestions and countermeasures based on the results. Methods In July 2024, according to the survey protocol and questionnaire developed by the National Institute for Radiological Protection, Chinese Center for Disease Control and Prevention, a field-based centralized online questionnaire was administered. A total of 854 residents living near the nuclear power plant were included as survey participants. An analysis of variance was used to compare the impact of different factors on the public knowledge of nuclear radiation and awareness of nuclear emergency evacuation, while the chi-square test was employed to compare differences between groups. Results A total of 854 questionnaires were collected in this study. The survey revealed that the levels of public knowledge about nuclear radiation and awareness of nuclear emergency evacuation around the power plant were relatively low, with average objective awareness rates of 51% and 47%, respectively. In terms of age, the 30-45 years old group had the highest average score, while the group aged 60 and above had the lowest. Regarding education level, the group with primary school education or below had the lowest average score, whereas those with junior college or undergraduate education scored the highest. The internet (73.7%) was the primary source of emergency information for the public, followed by television (61.7%). The majority of the public (85.0%) expressed trust in the government during evacuation and were willing to follow governmental evacuation arrangements. The main reason for this willingness was the belief that the government could provide sufficient emergency supplies. Conclusion The surveyed population exhibited low levels of knowledge regarding nuclear radiation and awareness of nuclear emergency evacuation, with generally low awareness rates. Awareness levels were influenced by factors such as sex, age, educational background, and distance from the nuclear power plant. To enhance public awareness, it is necessary to strengthen science communication related to nuclear radiation and public protective actions in nuclear emergencies. Targeted dissemination strategies with high communication effectiveness, accessibility, and public acceptance should be adopted to gradually enhance public awareness of nuclear radiation and nuclear emergency protective actions.

ObjectiveTo evaluate the effects of Tongnaoyin on the blood-brain barrier status and neurological impairment in acute ischemic stroke （AIS） patients with the syndrome of phlegm-stasis blocking collaterals by dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI）. MethodsA total of 63 patients diagnosed with AIS in the Jiangsu Province Hospital of Chinese Medicine from October 2022 to December 2023 were enrolled in this study. According to random number table method，the patients were assigned into a control group （32 cases） and an observation group （31 cases）. The control group received conventional Western medical treatment，and the observation group took 200 mL Tongnaoyin after meals，twice a day from day 2 of admission on the basis of the treatment in the control group. After 7 days of treatment，the patients were examined by DCE-MRI. The baseline data for two groups of patients before treatment were compared. The National Institute of Health Stroke Scale （NIHSS） score and modified Rankin Scale （mRS） score were recorded before treatment and after 90 days of treatment for both groups. The rKtrans，rKep，and rVe values were obtained from the region of interest （ROI） of the infarct zone/mirror area and compared between the two groups. ResultsThere was no significant difference in the NIHSS or mRS score between the two groups before treatment. After 90 days of treatment，the NIHSS and mRS scores declined in both groups，and the observation group had lower scores than the control group （P<0.05）. After treatment，the rKtrans and rVe in the observation group were lower than those in the control group （P<0.01）. ConclusionCompared with conventional Western medical treatment alone，conventional Western medical treatment combined with Tongnaoyin accelerates the repair of the blood-brain barrier in AIS patients，thereby ameliorating neurological impairment after AIS to improve the prognosis.

OBJECTIVES: To explore the mechanism by which astragaloside IV (AS-IV) alleviates D-galactose (D-GAL)-induced senescence in human umbilical vein endothelial cells (HUVECs). METHODS: Cultured HUVECs were treated with D-GAL (40 g/L), AS-IV (200 μmol/L), D-GAL+AS-IV, or D-GAL+AS-IV+MTK458 (a mitochondrial autophagy agonist, 25 μmol/L) for 48 h, and the changes in cell proliferation, migration, and angiogenesis capacity were evaluated. Cell apoptosis, reactive oxygen species (ROS) levels, mitochondrial membrane potential, and expressions of autophagy-related proteins (LC3-II/LC3-I) and PINK1/Parkin pathway proteins in the treated cells were detected. RESULTS: AS-IV treatment significantly reduced the inhibitory effect of D-GAL on HUVEC viability, effectively alleviated D-GAL-induced impairment of tube-forming ability, and promoted angiogenesis and migration ability of the cells. AS-IV also significantly reduced the rate of D-GAL-induced HUVECs positive for senescence-associated β-galactosidase (SA-β-Gal) staining and inhibited the expression of senescence-related genes P21 and P53. AS-IV restored mitochondrial membrane potential and reduced intracellular ROS levels in D-GAL-induced HUVECs, and inhibited the fusion of autophagosomes and lysosomes to prevent the completion of autophagic flux. In HUVECs treated with both D-GAL and AS-IV, the application MTK458 significantly increased the number of yellow spots and enhanced the expressions of P21, P53, PINK1, Parkin, LC3, and Beclin proteins. CONCLUSIONS AS-IV alleviates D-GAL-induced endothelial cell senescence by inhibiting the PINK1/Parkin pathway to regulate mitochondrial autophagy.
Humans ; Human Umbilical Vein Endothelial Cells/drug effects* ; Cellular Senescence/drug effects* ; Autophagy/drug effects* ; Saponins/pharmacology* ; Ubiquitin-Protein Ligases/metabolism* ; Mitochondria/drug effects* ; Triterpenes/pharmacology* ; Protein Kinases/metabolism* ; Galactose/pharmacology* ; Reactive Oxygen Species/metabolism* ; Signal Transduction/drug effects* ; Cells, Cultured ; Apoptosis/drug effects* ; Membrane Potential, Mitochondrial ; Cell Proliferation/drug effects*

OBJECTIVE: To investigate the predictive value of oxygenation index (PaO₂/FiO₂) at intensive care unit (ICU) admission on 30-day mortality in patients with sepsis. METHODS: A retrospective study was conducted. Patients with sepsis who were hospitalized in the ICU of the Affiliated Hospital of Jining Medical University from April 2015 to October 2023 were enrolled. The demographic information, comorbidities, sites of infection, vital signs and laboratory test indicators at the time of admission to the ICU, disease severity scores within 24 hours of admission to the ICU, treatment process and prognostic indicators were collected. According to the PaO₂/FiO₂ at ICU admission, patients were divided into Q1 group (PaO₂/FiO₂ of 4.1-16.4 cmHg, 1 cmHg ≈ 1.33 kPa), Q2 group (PaO₂/FiO₂ of 16.5-22.6 cmHg), Q3 group (PaO₂/FiO₂ of 22.7-32.9 cmHg), and Q4 group (PaO₂/FiO₂ of 33.0-94.8 cmHg). Differences in the indicators across the four groups were compared. Multifactorial Cox regression analysis was used to assess the relationship between PaO₂/FiO₂ and 30-day mortality of patients with sepsis. The predictive value of PaO₂/FiO₂, sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation II (APACHE II) on 30-day prognosis of patients with sepsis was analyzed by receiver operator characteristic curve (ROC curve). RESULTS: A total of 1 711 patients with sepsis were enrolled, including 428 patients in Q1 group, 424 patients in Q2 group, 425 patients in Q3 group, and 434 patients in Q4 group. 622 patients died at 30-day, the overall 30-day mortality was 36.35%. There were statistically significant differences in age, body mass index (BMI), history of smoking, history of alcohol consumption, admission heart rate, respiratory rate, APACHE II score, SOFA score, Glasgow coma score (GCS), site of infection, Combined chronic obstructive pulmonary disease (COPD), blood lactic acid (Lac), prothrombin time (PT), albumin (Alb), total bilirubin (TBil), pH, proportion of mechanical ventilation, duration of mechanical ventilation, proportion of vasoactive medication used, and maximal concentration, length of ICU stay, hospital stay, incidence of acute kidney injury, in-hospital mortality, 30-day mortality among the four groups. Multivariate Cox regression analysis showed that after adjusting for confounding factors, for every 1 cmHg increase in PaO₂/FiO₂ at ICU admission, the 30-day mortality risk decreased by 2% [hazard ratio (HR) = 0.98, 95% confidence interval (95%CI) was 0.98-0.99, P < 0.001]. The 30-day mortality risk in the Q4 group was reduced compared with the Q1 group by 41% (HR = 0.59, 95%CI was 0.46-0.76, P < 0.001). The fitted curve showed that a curvilinear relationship between PaO₂/FiO₂ and 30-day mortality after adjustment for confounders. In the inflection point analysis, for every 1 cmHg increase in PaO₂/FiO₂ at PaO₂/FiO₂ < 28.55 cmHg, the risk of 30-day death in sepsis patients was reduced by 5% (HR = 0.95, 95%CI was 0.94-0.97, P < 0.001); when PaO₂/FiO₂ ≥ 28.55 cmHg, there was no statistically significant association between PaO2/FiO2 and the increase in the risk of 30-day death in sepsis (HR = 1.01, 95%CI was 0.99-1.02, P = 0.512). ROC curve analysis showed that the area under the curve (AUC) for the prediction of 30-day mortality by admission PaO₂/FiO₂ in ICU sepsis patients was 0.650, which was lower than the predictive ability of the SOFA score (AUC = 0.698) and APACHE II score (AUC = 0.723). CONCLUSION In patients with sepsis, PaO₂/FiO₂ at ICU admission is strongly associated with 30-day mortality risk, alerting healthcare professionals to pay attention to patients with low PaO₂/FiO₂ for timely interventions.
Humans ; Sepsis/mortality* ; Intensive Care Units ; Retrospective Studies ; Prognosis ; Hospital Mortality ; Oxygen ; Male ; Predictive Value of Tests ; Female ; Middle Aged ; Aged

Electronic Health Records (EHRs) are digital health tools that support comprehensive care and digital services. This paper provides an overview of EHRs, summarizes their current applications in palliative care, and proposes solutions to address issues in the use of EHRs in this field. The aim is to offer reference points for promoting the application of EHRs in palliative care in China.

The Death Cafe has promoted globally, breaking the silence and taboo surrounding death, allowing the public to freely discuss topics related to death and end-of-life, raising public awareness of death, and promoting public thinking and understanding of death. This paper reviews the overview of Death Cafe and its application in palliative care, in order to provide reference for the research and practice of palliative care in China.

Objective:To systematically integrate the qualitative research on effective pain management disorders of cancer patients and caregivers, and to provide reference for patients and caregivers to safely and effectively implement cancer pain management.Methods:The qualitative studies on the experiences and obstacles of cancer patients and caregivers in cancer pain management were retrieved from electronic databases of PubMed, Web of Science, Cochrane Library, Embase, CINAHL, China National Knowledge Infrastructure, China Biology Medicine, VIP and Wanfang data from inception to September 2023. The quality of the literature was evaluated according to Joanna Briggs Institute Evidence Based Healthcare Center Critical Appraisal Tool for qualitative studies in Australia. Meta-synthesis was used to conduct the synthesis.Results:A total of 9 articles were included, and 46 research results were extracted, forming 14 categories, which were further summarized into 4 integrated results: patient-related pain management disorders, caregiver-related pain management disorders, medical staff-related pain management disorders, and health care system-related pain management disorders.Conclusions:Multiple factors cause obstacles for cancer patients and caregivers to participate in pain management. Medical staff should have a deep understanding of patients′pain problems and explore pain management plans and interventions suitable for cancer patients, so as to reduce the degree of cancer pain management obstacles.

Objective:To evaluate the influence of different teaching modes in the creativity of nursing students in China.Methods:A systematic search of PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database and VIP Database were carried out. Randomized control trials (RCTs) examining the influence of different teaching modes in the creativity of nursing students were included from inception to March 5, 2023. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies according to the Cochrane Handbook for Systematic Reviews of Interventions and combined with the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE), then network Meta-analysis with random effects was performed by using WinBugs 1.4.3 and Stata 17.0 software.Results:A total of 63 studies involving 22 teaching modes were included. The network Meta-analysis showed that Case-based Learning Mode, Evidence-based Nursing Teaching Mode, 3D Printing Model Teaching Mode, Hands-on Inquiry Based Learning, Quality Control Circle Teaching Mode, Six Thinking Hats Teaching Mode, Theory, Drill, Practice, Combine (TDPC, T:theory; D:drill; P:practice; C:combine) Teaching Mode were more effective than Lecture-based Learning Mode ( SMD values were 4.61-22.51, all P<0.05). Sensitivity analysis showed the effectiveness of TDPC Teaching Mode was the greatest in nursing theoretical teaching[surface under the cumulative ranking (SUCRA)=98.08%], the Quality Control Circle Teching Mode was the second most effective (SUCRA=83.13%). The effectiveness of Six Thinking Hats Teaching Mode was the greatest in nursing practical teaching (SUCRA=95.73%), followed by the 3D Printing Model Teching Mode (SUCRA=86.97%). Conclusions:TDPC Teaching Mode, Six Thinking Hats Teaching Mode, 3D Printing Model, Quality Control Circle Teaching Mode were superior to other teaching modes in improving creativity of nursing students.

AIM: To compare the binocular and monocular accommodation among normal group, premyopia group and mild myopia group, and to study the characteristics of accommodation in the premyopia group, thus providing clinical evidence for the delay/prevention of myopia and the effective decrease of the incidence of myopia.METHODS: Cross-sectional descriptive study. A total of 179 children who had abnormal/high-risk visual acuity indicated by the vision screening in school from October 2021 to February 2023 were selected, including 92 males and 87 females, aged from 6 to 12(mean 8.55±1.66)years old, then they were referred to the Juvenile Myopia Prevention and Control Center in Cuizu Community Health Service Center. They were divided into normal group(+0.75 D<SE≤+2.00 D), the premyopia group(-0.50 D<SE≤+0.75 D)and the mild myopia group(-3.00 D≤SE≤-0.50 D)according to the diopters after cycloplegia, and binocular myopia grouping is defined by the eye with lower diopter. Binocular positive relative accommodation(PRA), negative relative accommodation(NRA), accommodative facility(AF), and monocular AF and amplitude of accommodation(AA)were examined. The age, binocular and monocular accommodation of different groups were compared.RESULTS: There were no difference in the sex ratio of different groups(χ2=0.167, P=0.920). There was no difference in age between the normal group and the premyopia group(P=0.310), but there were differences between the mild myopia group and the normal group and premyopia group(P=0.018, <0.01); Binocular NRA, PRA, and AF had significance between the normal group and the premyopia group(P<0.01), while there was no significance between the premyopia group and the mild myopia(P>0.05). Monocular AF had significance between the normal group and the premyopia group(P<0.01), while there was no significance between the premyopia group and the mild myopia group(P>0.05); The monocular AA had significance among the three groups(P<0.05).CONCLUSION: Although the diopters was normal, binocular NRA, PRA, monocular and binocular AF had significantly decreased in the premyopia group, and there was no significant difference compared with mild myopia group; monocular AA had decreased in the premyopia group and it was also significantly different from the mild myopia group. The accommodation function should be examined in premyopic children. Recovering the abnormal visual function through visual training may be a way to prevent and control premyopia from progressing to myopia.