Objective To translate the English version of Heart Continuity of Care Questionnaire (HCCQ) into Chinese and to test the reliability and validity of the Chinese version of HCCQ in congestive heart failure (CHF) patients and atrial fibrillation (AF).Methods Totally 339 patients with CHF (n=170) and AF (n=169) were recruited and were investigated by the Chinese version of HCCQ.Results The internal consistency coefficient of the Chinese version of HCCQ ranged from 0.821 to 0.913,both above 0.7.The split half coefficient was 0.649,and test-retest reliability was 0.812,which demonstrated better internal consistency.The content validity index was 0.940.Factor analysis got three factors,which explain 47.059％ of the total variance.Conclusions The Chinese version of HCCQ has been proved to be reliable and valid.It can be used as a valid tool for the measurement of heart continuity in cardiac patients.

Designing of natural product-like compounds using natural products as template structures is an important strategy for the discovery of new drugs. Gambogic acid (GA), which is a Garcinia natural product with a unique caged xanthone scaffold, inhibits potent antitumor activity both in vitro and in vivo. This review summarized the researches on the identification of the antitumor pharmacophore of GA, and the design, structural optimization and structure-activity relationship (SAR) of natural product-like caged xanthones based on it.

To investigate the role of Egr-1 in the carcinogcnestic process of hepatocellular carcinoma (H-CC). Methods Expression of Egr-1 gene in HCC tissues were detected by in situ hybridization and immunohistochemistry. Human breast andmouse liver and brain tissues were used for control. ResultsLittle or no Egr-1 transcription was detected both in HCC tissues and in their normal counterparts. High transcription of Egr-1 was detected in the LCD and atrophic-like liver plate of HCC tissues. Protein expression of Egr-1 gene was consistent with mRNA transcription. High expression of Egr-1 protein was also detected in normal breast and mouse brain tissues. ConclusionsLittle or no expression of Egr-1 may play a role in the deregulation of normal growth in the carcinogenestic process of HCC. The differences of Egr-1 expression among liver cells, breast epithelia and mouse brain tissues might be associated with their different ways of proliferation and differentiation in different cell types.

Objective:To investigate the knowledge, attitude and practice status of ophthalmic nurses on prevention and control of intraocular infection in grade Ⅲ class A hospitals.Methods:A self-made questionnaire was used to investigate the knowledge, attitude and practice of 236 nurses on prevention and control of intraocular infection in the ophthalmology department of 8 grade Ⅲ class A hospitals in Zhengzhou from January to June 2020. The correlation between the knowledge, attitude and practice were analyzed by Pearson correlation analysis and the influencing factors of each term were analyzed by multivariate Logistic regression.Results:The scores of knowledge, attitude, practice of all nurses were (26.08 ± 2.46), (67.45 ± 8.48), (50.31 ± 6.67) points, and the scoring rate were (87.0 ± 8.2)%, (84.3 ± 10.1)%, (83.9 ± 9.8)%, respectively. The scores of each dimension of knowledge, attitude and practice were significantly positively correlated ( r values were 0.26-0.42, all P<0.05), respectively. Multivariate Logistic regression analysis showed that education background, professional title and training experience of infection were the influencing factors of knowledge score ( P<0.05), education background, professional title, training experience of infection and demand were the influencing factors of attitude score ( P<0.05), and nursing age and work post were the influencing factors of practice score ( P<0.05). Conclusions:The level of knowledge, attitude and practice of ophthalmic nurses in grade Ⅲ class A hospitals on prevention and control of intraocular infection is overall good. Hospital management department still needs to make reasonable management countermeasures according to personnel characteristics to improve the knowledge, attitude and practice level of ophthalmic nurses and to reduce post-operative intraocular infection.

Objective This study aims to investigate possible hub genes,associated pathways,and transcription fac-tors between chronic periodontitis(CP)and Parkinson's disease(PD).Methods Gene expression profiles of CP(GSE16134,GSE23586,and GSE10334)and PD(GSE20141 and GSE49036)were downloaded from the gene expres-sion omnibus(GEO)database for differential expression analysis and functional clustering analysis.The protein-protein interaction(PPI)network was constructed,and hub genes were screened by four topological analysis algorithms and modular segmentation.Functional clustering analysis was performed.The hub genes were validated by external datasets of CP and PD,and causal relation was further assessed by Mendelian randomization(MR).Results After merging the data,1 211 differentially expressed genes(DEGs)were screened in the CP datasets;of which,551 were upregulated and 660 were downregulated.A total of 2 407 DEGs were screened in the PD dataset,of which,1 438 were upregulated and 969 were downregulated.The PPI network included 145 nodes and 126 edges.Four hub genes(FCGR3B,PRF1,IL18,and CD33)and three transcription factors(HSF1,HSF2,and HSF4)were finally screened.The relevant pathway was pre-dominantly natural killer(NK)cell-mediated toxic effects.The MR results suggest a possible positive causal relationship between CP and the risk of developing PD.Conclusion This study indicated the probably shared pathophysiology and possible causal relationship between CP and PD and may offer novel concepts and therapeutic targets for future mecha-nistic investigations.

Objective:To retrieve, extract, evaluate and integrate relevant evidence on the prevention and management of exposure corneal injury in critically ill patients, so as to provide a reference for clinical practice.Methods:Based on the "6S" pyramid model of evidence resources, the database and relevant society websites were systematically searched from top to bottom for evidence on the prevention and management of exposure corneal injury in critically ill patients, including guidelines, expert consensus, evidence summaries, and systematic reviews. The retrieval time limit was from the establishment of the database to October 31, 2021. Two researchers independently assessed the quality of the article, extracted evidence from the article that met the quality standards, and adopted the Joanna Briggs Institute (JBI) evidence pre-grading and evidence recommendation system (2014 edition) to grade the evidence.Results:A total of 15 articles were included, including 2 guidelines, 2 evidence summaries, 6 systematic reviews, and 5 randomized controlled trials. A total of 42 pieces of the best evidence on the prevention and management of exposure corneal injury in critically ill patients were summarized, including five aspects, namely, assessment, daily management, risk management, drug management and procedure management.Conclusions:This study summarizes the best evidence for the prevention and management of exposure corneal injury in critically ill patients. When medical and nursing staff carry out clinical transformation, they should fully consider the actual situation of patients and select evidence in a targeted manner to reduce the incidence of ocular complications in critically ill patients.

Objective:To study the efficiency and difference of the artificial intelligence (AI) system based on fundus-reading in community and hospital scenarios in screening/diagnosing diabetic retinopathy (DR) among aged population, and further evaluate its application value.Methods:A combination of retrospective and prospective study. The clinical data of 1 608 elderly patients with diabetes were continuously treated in Henan Eye Hospital & Henan Eye Institute from July 2018 to March 2021, were collected. Among them, there were 659 males and 949 females; median age was 64 years old. From December 2018 to April 2019, 496 elderly diabetes patients were prospectively recruited in the community. Among them, there were 202 males and 294 female; median age was 62 years old. An ophthalmologist or a trained endocrinologist performed a non-mydriatic fundus color photographic examination in both eyes, and a 45° frontal radiograph was taken with the central fovea as the central posterior pole. The AI system was developed based on the deep learning YOLO source code, AI system based on the deep learning algorithm was applied in final diagnosis reporting by the"AI+manual-check" method. The diagnosis of DR were classified into 0-4 stage. The 2-4 stage patients were classified into referral DR group.Results:A total of 1 989 cases (94.5%, 1 989/2 104) were read by AI, of which 437 (88.1%, 437/496) and 1 552 (96.5%, 1 552/1 608) from the community and hospital, respectively. The reading rate of AI films from community sources was lower than that from hospital sources, and the difference was statistically significant ( χ2=51.612, P<0.001). The main reasons for poor image quality in the community were small pupil (47.1%, 24/51), cataract (19.6%, 10/51), and cataract combined with small pupil (21.6%, 11/51). The total negative rate of DR was 62.4% (1 241/1 989); among them, the community and hospital sources were 84.2% and 56.3%, respectively, and the AI diagnosis negative rate of community source was higher than that of hospital, and the difference was statistically significant ( χ2=113.108, P<0.001). AI diagnosis required referral to DR 20.2% (401/1 989). Among them, community and hospital sources were 6.4% and 24.0%, respectively. The rate of referral for DR for AI diagnosis from community sources was lower than that of hospitals, and the difference was statistically significant ( χ2=65.655, P<0.001). There was a statistically significant difference in the composition ratio of patients with different stages of DR diagnosed by AI from different sources ( χ2=13.435, P=0.001). Among them, community-derived patients were mainly DR without referral (52.2%, 36/69); hospital-derived patients were mainly DR requiring referral (54.9%, 373/679), and the detection rate of treated DR was higher (14.3%). The first rank of the order of the fundus lesions number automatically identified by AI was drusen (68.4%) and intraretinal hemorrhage (48.5%) in the communities and hospitals respectively. Conclusions:It is more suitable for early and negative DR screening for its high non-referral DR detection rate in the community. Whilst referral DR were mainly found in hospital scenario.

Shared decision-making is a medical model developed in the 1970s where physicians and patients jointly participate in making healthcare decisions. It has been widely adopted in developed countries in Europe and the United States. In recent years, more and more studies have explored the localization of shared decision-making in China, but the clinical application model in Chinese context has not yet been established. This article reviews the basic concept, clinical application, advantages and disadvantages, and future development of the shared decision-making between doctor and patient, in hope of providing ideas for the construction of a shared decision-making model in China.

Objective:To observe the presence or absence of necroptosis in PC12 cells after radiation injury, and to detect the expression of receptor-interacting protein 3(RIP3) and evaluate its regulatory effect on necroptosis.Methods:PC12 cells were treated with different doses of irradiation and their necroptosis was detected by lactate dehydrogenase (LDH) release at different time points. After pretreatment with necroptosis inhibitor Necrostatin-1(Nec-1), the changes of cell necroptosis were detected by LDH. The expression level of RIP3 after irradiation intervention was detected by Western blot (WB). After pretreatment with the RIP3-specific inhibitor GSK′872, the changes of cell necroptosis were detected by LDH. The best transfection sequence of RIP3 knockout was screened by WB. The cells were divided into the control group, irradiation group, solvent control group, no-load control group and pretreatment group. WB, immunofluorescence staining, MTT, LDH and Annex V-fluorescein Isothiocyanate/Propidium Iodide (AnnexV-FITC/PI) flow cytometry were used for detection and analysis.Results:After 4 Gy irradiation, the degree of cell necrosis was the highest after 3 hours of culture, and the expression level of RIP3 protein was up-regulated. The cell necrosis was decreased after Nec-1, GSK′872 and RIP3 gene knockdown pretreatment.Conclusions:The radiation injury of 4 Gy can induce the necroptosis of PC12 cells, and the most significant effect can be observed when cultured for 3 hours after irradiation. RIP3 is involved in the process of necroptosis of PC12 cells induced by radiation injury, and plays a pivotal positive regulatory role.

Objective:To investigate the current status and quality and safety of radiation therapy resources in medical institutions in Hunan province.Methods:The basic situation questionnaire, quality and safety self-assessment form were designed according to the content of the survey, distributed and recovered through the network, and the survey was conducted on all medical institutions (excluding military hospitals) conducting radiotherapy in Hunan province in 2022, and the quality and safety evaluation was checked by the Hunan Radiotherapy Quality Control Center using stratified sampling field inspection. The differences between the self-evaluation scores of radiotherapy quality and safety and the on-site inspection scores of each unit was compared using Wilcoxon test.Results:By the end of 2022, there were 76 medical institutions (excluding military hospitals) conducting radiotherapy in Hunan province, including 62 tertiary hospitals and 14 secondary hospitals, with a total of 44 253 radiotherapy patients admitted annually. The total number of personnel engaged in radiotherapy was 1 381, including 746 physicians, 205 physicists, 397 technicians and 33 maintenance engineers. There were a total of 88 accelerators (including 3 tomotherapy units), 10 gamma knives, and 28 rear-loading machines, with 1.33 gas pedals per million population. There were 36 units that were carrying out three-dimensional conformal technology, 60 static intensity modulation technology, 20 volumetric rotational intensity modulation, 27 stereotactic radiotherapy, 44 image-guided radiotherapy, 33 respiratory motion management, and 27 rear-loading radiotherapy. In the quality and safety evaluation situation, the basic requirements of radiotherapy specialty scored high, with 2 units achieving full marks and no failing units. Radiotherapy personnel and organization, radiotherapy process, documentation record score and other aspects of no full-score units, the score was concentrated in 60~＜80 points, and all have part of the unit failed.Conclusions:The radiotherapy industry in Hunan province has been developed steadily in recent years in general, and the structure of radiotherapy personnel tends to be reasonable, but there still exists uneven distribution of radiotherapy resources, poor utilization of equipment in some areas, and inadequate development of technology. The overall quality and safety evaluation are good, but there are still many deficiencies in the organizational requirements of radiotherapy personnel, process requirements and documentation, which need to be continuously optimized and improved in the future, and at the same time, field inspections will be intensified to ensure the quality and safety of radiotherapy.