Objective:To study the application of "experiential training on death education" in teaching nursing interns in the oncology department, and to explore a novel method of death education for nursing interns.Methods:From September 2019 to September 2023, a total of 120 nursing students who interned in the Department of Oncology, Nuclear Industry 416 Hospital were assigned to the control group (53 students) and the study group (67 students) based on their enrollment time. The control group received traditional theoretical teaching and experience in caring for terminally ill patients, while the study group received experiential training on death education. The Chinese death attitude profile-revised (DAP-R), coping with death scale (CDS), course satisfaction, and learning outcomes were observed after 3-month internship. A data analysis was conducted using SPSS 26.0. The differences between two groups were compared using the independent samples t-test. The differences before and after education in the same group were compared using paired t-test. The comparison of categorical data between groups was performed using the chi-square test, while ranked data were compared using the rank-sum test. Results:There were no significant differences in the DAP-R scores between the two groups before education ( P>0.05). The scores of five dimensions of DAP-R were significantly higher in the study group than in the control group after education [fear of death: (22.11±5.38) points vs. (17.14±5.23) points, P<0.05; death evasion: (14.83±4.07) points vs. (12.31±4.15) points, P<0.05; neutral acceptance: (19.95±4.44) points vs. (22.31±5.14) points, P<0.05; approaching acceptance: (32.16±6.93) points vs. (35.23±7.33) points, P<0.05; avoiding acceptance: (16.47±5.86) points vs. (18.94±5.09) points, P<0.05]. There were no significant differences in the six factors of CDS between the two groups before education ( P>0.05). The CDS scores were significantly higher in the study group than in the control group after education ( P<0.05). The scores of three dimensions (novelty of course content, course satisfaction, and self-engagement) were significantly higher in the study group than in the control group after education ( P<0.05). The scores of improvement of empathy [(2.44±0.55) points vs. (3.16±0.50) points], attention to spiritual issues [(2.61±0.49) points vs. (3.11±0.52) points], improvement of communication skills [(3.10±0.51) points vs. (4.23±0.47) points], and correct values of life [(2.29±0.44) points vs. (3.37±0.55) points] were significantly higher in the study group than in the control group after education ( P<0.05). Conclusions:Experiential training on death education can increase the experience of students, improve their attitude towards death and ability to cope with death, and enhance their initiative and enthusiasm for learning.

Type 2 diabetes mellitus(T2DM)is a chronic metabolic disorder caused by a combination of genetic and environmental factors.The epigenetic transcriptional modifications after RNA transcription can affect gene expression and glucose homeostasis.N6-methyladenine(m6A),as an RNA methylation modification,plays an important role in the pathogenesis of T2DM.This article reviews the research progress of m6A methylation in T2DM.

Objective:To analyze the predictive factors associated with late-onset sepsis(LOS) in very low birth weight infants,and to develop a risk prediction score scale applicable to these infants three days postnatal.This will provide valuable insights for early diagnosis and timely intervention.Methods:Very low birth weight infants admitted to the Children's Hospital of Fudan University from January 1,2022,to June 30,2024,were selected as research subjects.These infants were categorized into two groups:the LOS group and the non-LOS group,based on whether they developed LOS.LASSO regression analysis,alongside univariate and multivariate regression analyses,was employed to identify predictive factors for LOS in this population.A Logistic model was constructed using the optimal combination of predictive variables,and a risk assessment scale was subsequently developed.The prediction performance of the model was evaluated using the Hosmer-Lemeshow chi-square test and the receiver operating characteristic curve.Results:A total of 444 cases of very low birth weight infants were included,of which 185 had LOS and 259 did not.After screening the variables,seven independent factors were included into the model:birth weight,gestational age,tracheal intubation,abnormal skin color,abdominal distension,elevated C-reactive protein levels,and right hand perfusion index.A predictive scoring scale was developed based on the regression coefficients of each variable,with corresponding risk scores assigned as follows:1,4,3,2,1,1,and 2; a score of ≥3.5 indicated high-risk groups.The Hosmer-Lemeshow test results demonstrated that χ2 = 7.602( P = 0.473).The area under the receiver operating characteristic curve was 0.792 ( P<0.001),with a sensitivity of 73.5% and specificity of 71.0%. Conclusion:The risk score scale developed in this study exhibits significant predictive capability,providing valuable insights for clinical medical personnel to assess the risk of LOS in very low birth weight infants during the early postnatal period.

In 2025,the International Association of Pancreatology(IAP),in collaboration with the American Pancreatic Association,European Pancreatic Club,Indian Pancreas Club,and Japan Pancreas Society,released the International Association of Pancreatology revised guidelines on acute pancreatitis 2025.This edition represents a comprehensive revision of the 2013 guidelines,based on high-quality evidence accumulated over the past decade,particularly randomized controlled trials.The guidelines encompass 18 key areas-including pain management,fluid therapy,nutritional support,management of infected necrosis,complication control,discharge and follow-up,and recurrence prevention-offering a total of 96 recommendations that emphasize individualized treatment.These updates provide important guidance for standardizing clinical practice and improving outcomes in acute pancreatitis,while also indicating future research directions such as the development of targeted therapies.However,some recommendations remain limited by lower evidence quality,uncertain applicability in specific clinical settings,and insufficient consideration of economic burden and cost-effectiveness.

In 2025,the International Association of Pancreatology(IAP),in collaboration with the American Pancreatic Association,European Pancreatic Club,Indian Pancreas Club,and Japan Pancreas Society,released the International Association of Pancreatology revised guidelines on acute pancreatitis 2025.This edition represents a comprehensive revision of the 2013 guidelines,based on high-quality evidence accumulated over the past decade,particularly randomized controlled trials.The guidelines encompass 18 key areas-including pain management,fluid therapy,nutritional support,management of infected necrosis,complication control,discharge and follow-up,and recurrence prevention-offering a total of 96 recommendations that emphasize individualized treatment.These updates provide important guidance for standardizing clinical practice and improving outcomes in acute pancreatitis,while also indicating future research directions such as the development of targeted therapies.However,some recommendations remain limited by lower evidence quality,uncertain applicability in specific clinical settings,and insufficient consideration of economic burden and cost-effectiveness.

Objective:To analyze the effect of migration experiences during working age on the status of chronic disease development among rural older adults.Methods:Based on data from the China Health and Retirement Longitudinal Study(CHARLS),this study applied regression model and group-based trajectory model to examines the impact of migration experience on the status and growth trajectories of chronic diseases among rural older adults.Results:(1)Rural older adults with migration experience are more likely to develop chronic diseases and have a greater number of chronic disease in later life.(2)Rural older adults with migration experiences have a higher starting point and a faster rate of growth trajectory of chronic disease.Suggestions:It is necessary to strengthen occupational protection and health education for the rural-urban migrant population,reinforce the intervention and management of chronic diseases for the returning population,and improve the whole life-cycle medical insurance system,to break the disadvantageous cumulative effect of migration experience on health.

Objective To evaluate the comprehensive value of methicillin-resistant Staphylococcus aureus(MRSA)treatment drugs in artificial joint infections from multiple perspectives and to solve the problem of MRSA infections in artificial joints.Methods Through literature research,relevant literature was retrieved and clinical studies meeting the requirements were selected and summarized.The Analytic Hierarchy Process(AHP)was applied to collect comprehensive clinical evaluation evidence and to conduct evaluations across different dimensions according to evaluation guidelines;the Delphi method combined with AHP was used for expert anonymous questionnaire evaluation,and the data was compared and analyzed.Results A clini-cal comprehensive evaluation index model for the treatment of artificial joint infections was successfully established,and the yaahp analysis software was used to score the comprehensive clinical evaluation evidence in various directions.Treatment drugs,vancomy-cin,daptomycin,and linezolid,at various levels were calculated through the software,and it was concluded that linezolid has the highest clinical comprehensive evaluation score.Conclusion Among the treatment drugs for MRSA infections in artificial joints,linezolid has a higher clinical comprehensive value and can provide a reference for the clinical treatment of MRSA infec-tions in artificial joints.

BackgroundRumination can play a certain degree role of psychological adjustment in cancer patients. Previous studies have focused on studying the level of rumination in a single type of cancer patient， but there is a lack of comprehensive investigation and influencing factor research on rumination levels in different types of cancer patients. ObjectiveTo explore the level of rumination and its influencing factors among middle-advanced cancer inpatients， so as to provide certain guidance for targeted psychological care in clinical practice. MethodsFrom January 2021 to December 2022， a systematic sampling technique was used to recruit 346 patients with TNM stage III or above tumors hospitalized in Nuclear Industry 416 Hospital， Chengdu Sixth People's Hospital and the First People's Hospital of Yibin. All individuals were assessed using Perceived Social Support Scale （PSSS） and the Chinese version of Event-Related Ruminant Inventory （C-ERRI）， and Logistic regression analysis was utilized to identify the influencing factors of rumination. ResultsIn terms of C-ERRI， patients scored （15.59±5.61） on intrusive rumination and （14.59±5.43） on deliberate rumination. Education levels of junior high school/high school/vocational training school （OR=0.817， P<0.01） and junior college and above （OR=0.579， P<0.05） were the protective factors of intrusive rumination， whereas annual personal incomes of <10 000 yuan （OR=4.918， P<0.01） or 10 000~50 000 yuan （OR=2.076， P<0.01） and low （OR=6.882， P<0.01） or middle （OR=3.114， P<0.01） level of social support were the risk factors of intrusive rumination. For deliberate rumination， education levels of junior high school/high school/vocational training school （OR=0.574， P<0.01） and junior college and above （OR=0.449， P<0.05） were the protective factors， and low （OR=1.391， P<0.01） or middle （OR=1.161， P<0.05） levels of social support were the risk factors. ConclusionThe level of intrusive rumination of inpatients with middle-advanced cancer is related to education level， economic status and social support， furthermore， the level of deliberate rumination is related to the educational level and social support. ［Funded by Medical Research Project of Chengdu Health Commission （ number， 2020119）］

The alteration of DNA content in tumor cells is called DNA ploidy. The normal DNA content is called diploid, while the abnormal DNA content is called non-diploid, which includes polyploid and aneuploid. Non-diploid status leads to survival stress in tumor cells, including genomic stress, protein toxicity stress, metabolic stress, and immune stress, and plays a dual role by both inhibiting and promoting tumor development. In this review, the survival stress of non-diploid cells and their role in tumor cells were summarized to provide a potential target for disease intervention and provide a reference for early screening, precision prevention, and personalized treatment.

In the century-long evolution of insulin pharmaceuticals, each transformative advancement in this drug class has been closely tied to the ability to obtain new insulin isoforms for research. Despite this, the recently discovered naturally occurring isoforms of glycosylated human insulin have remained largely unattainable for proper characterization. Herein, we demonstrate for the first time that total chemical synthesis can be used to generate all isoforms. This achievement required maintaining the correct positions of the interchain disulfide bonds while effectively removing protecting groups on complex glycans. Notably, the availability of seven glycoforms reveals the important effects of natural sialylated glycans in suppressing insulin self-association and enhancing its solubility, surpassing the performance of currently employed rapid-acting insulin drugs. This work not only offers a readily adaptable platform for exploring natural O-glycosylation in other therapeutic proteins and peptides but also lays the groundwork for further research into harnessing natural glycosylation for therapeutic applications.