ObjectiveTo explore the current situation of forensic ethics practice and education by designing a questionnaire on forensic ethics， with a view to exploring the path of forensic ethics education construction. MethodsA total of 667 valid questionnaires were collected using the online survey method， basically covering various regions across the country and all sub-specialties of forensic medicine. Descriptive analysis was used to analyze the relevant data. ResultsMost practitioners had relevant ethical reflections in the process of forensic practice. 69.12% of the respondents indicated that they had studied the relevant rules， but approximately half stated that there were no corresponding ethical norms or standard operating manuals. The specific behaviors violating ethics in different units were diverse. 23.04% of the respondents reported that they had encountered unethical behaviors， but only 4.9% of them reported such violations. In terms of forensic ethics education， 87.75% of the respondents believed that there were issues with the current model of forensic ethics education. Meanwhile， the respondents showed a high degree of recognition for receiving forensic ethics education， with 84.15% of respondents expressing willingness to participate in relevant courses. More than half of respondents were willing to participate in forensic ethics education during undergraduate studies， new employee training， and regular post-employment training. ConclusionCurrently， there is a problem of ethical neglect in forensic work in China. Combining ethics courses with professional courses at the practitioner training stage and providing regular training at the practice stage are effective measures to popularize forensic ethics knowledge， enhance ethical awareness， and improve the quality of practice.

BACKGROUND:With the development of computer-aided design and computer-aided manufacturing technology,zirconia abutments with a titanium base are widely used in clinic due to its good application advantages,but there are still some problems and a lack of consensus design standards. OBJECTIVE:To review the fabrication methods of Ti-base zirconia abutment,and the effect of abutment connection,emergence design,abutment angle,and bonding on mechanical properties of Ti-base zirconia abutment. METHODS:Relevant literature published from 2010 to 2023 was searched in CNKI and PubMed databases with the search terms"zirconia abutment,titanium base"in Chinese and English,respectively.The search time limit was extended for some classical literature.The relevant literature was obtained through inclusion and exclusion criteria,and 57 eligible documents were included for review. RESULTS AND CONCLUSION:It is recommended that clinicians try to select antirotational titanium bases or rotational titanium bases with a Morse taper connection.Implants should be placed in the correct axial angulation of not more than 15° or with an inclination to the palatal side when using angled zirconia abutments.When a≥30° labial inclination is followed for implant placement,the bite force must be decreased effectively to reduce the risk of mechanical and biological complications of implants,abutments,and prostheses.Ti-base zirconia abutments with a higher gingival height should be selected,and its restorative angle should not exceed 40°.Multilink Hybrid Abutment could be the first choice for extraoral bonding of zirconia abutment to titanium bases.

Purpose/Significance To study and develop an intervention plan for the utilization barriers of health information services for empty nest elderly,in order to provide a basis for improving their knowledge,attitude,and action abilities in health information serv-ices.Method/Process Selecting residents of Yan'an community in Bengbu as research subjects,who are randomly divided into a control group and an intervention group.The intervention group use a pre-constructed intervention plan.After the intervention study,the con-trol group is provided with the same health education content as the intervention group.Result/Conclusion The intervention programs can improve the knowledge level and behavioral ability of empty nest elderly in utilizing information services.

Purpose/Significance To understand the influencing factors of health information literacy of elderly discharged patients receiving continuous nursing services,and to provide theoretical basis for related health education and health promotion.Method/Process The selective quota sampling method is used to conduct a questionnaire survey on elderly discharged patients aged 60 and above receiving continuous nursing services in Bengbu city,and a structural equation model is constructed to analyze the effect pathway of influencing fac-tors.Result/Conclusion The level of health information literacy of the discharged elderly patients receiving continuous nursing services is average.Healthy lifestyle has direct influence on health information literacy of them,and social support and psychological status have in-direct influence on them through self-efficacy and healthy lifestyle.It is suggested that family members and medical staffs should pay positive attention to patients,help patients maintain a good psychological state,promote the recovery of diseases,and improve the level of health information literacy.

AIM:To investigate the effects of sodium hydrosulfide(NaHS)on hexokinase 2(HK2)-nucleo-tide-binding oligomerization domain-like receptor protein 3(NLRP3)-gasdermin D(GSDMD)pathway and pyroptosis in-duced by lung ischemia/reperfusion(I/R)in rats.METHODS:Male Sprague-Dawley rats were divided into 6 groups:control group,control+NaHS group,I/R group,low-dose NaHS+I/R(L+I/R)group,medium-dose NaHS+I/R(M+I/R)group,and high-dose NaHS+I/R(H+I/R)group,with 6 rats in each group.The NaHS was administered via intraperi-toneal injection at 1.5 mL,30 min before modeling.The left lung tissues were collected 30 min after ischemia and 1 h af-ter reperfusion,and the wet/dry weight ratio and total lung water content were recorded.Hematoxylin-eosin(HE)staining was used to examine lung tissue morphological changes.The levels of malondialdehyde(MDA),myeloperoxidase(MPO)and lactate in lung tissues were measured with test kits.ELISA was employed to determine the levels of interleukin-1β(IL-1β)and IL-18.The expression of glycolysis-and pyroptosis-related indicators was analyzed by Western blot,qRT-PCR and immunofluorescence staining.RESULTS:Compared with control group,the rats in NaHS group showed no signifi-cant differences in all laboratory tests(P>0.05).The rats in I/R group exhibited significant lung injury,oxidative stress,increased lactate level,and up-regulated glycolysis and pyroptosis(P<0.05 or P<0.01).Compared with I/R group,the indicators in L+I/R group showed a downward trend(P<0.01)or no difference(P>0.05),while those in M+I/R group dis-played a significant reduction(P<0.05 or P<0.01).However,the indexes in H+I/R group exhibited no significant dif-ferences in these tests(all P>0.05).CONCLUSION:A moderate dose(56 μmol·L-1·kg-1)of NaHS mitigated the oc-currence of pyroptosis by inhibiting the HK2-NLRP3-GSDMD pathway,thus contributing to the attenuation of lung I/R in-jury in rats.

Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.

Objective To explore the underlying mechanism of β2 adrenergic receptor(ADRB2)in fibrogenesis during wound healing.Methods Non-specific ADRB2 gene knockdown adeno-associated virus(AAV-ADRB2 group,6 mice)and control virus(AAV-NC group,6 mice)was injected randomly into the back skin of 12 mice for 21 days,a full-thickness skin defected wound healing murine model was established.Wound healing rates were recorded at the 1st,3rd,5th,and 7th day after operation.Histological examinations by H-E staining,Masson staining,and immunohistochemistry were conducted to observe wounded skin tissue structure,fibrosis,and α-SMA protein expression;quantitative PCR was employed to analyze ADRB2 and matrix metalloproteinase(MMP)mRNA levels;Western blotting was utilized to assess the protein expression levels of COL1A1,COL3A1,TGF-β1,and Smad3.Results On postoperative day 5 and 7,the wound healing rate of the AAV-ADRB2 group significantly decreased(P＜0.05),accompanied by a series pathological changes,including thickened epidermis,exaggerated inflammation,reduced fibroblast count,and inhibited collagen deposition;the α-SMA expression showed a significant decrease(P＜0.05),and the ratio of COL1A1 to COL3A1 decreased(P＜0.05);ADRB2 mRNA levels significantly decreased(P＜0.01),while MMP-1 and MMP-8 mRNA levels increased(P＜0.01);the protein levels of TGF-β1 and Smad3 exhibited a significant decrease(P＜0.05).Conclusions ADRB2 knockdown reduced fibrosis during wound healing and degenerated connective tissue content around the wound bed by inhibiting the TGF-β1/Smad3 signaling pathway,which leads to an increase in MMP mRNA levels and a decrease in the ratio of type Ⅰ to type Ⅲ collagen.

Objectives:To explore the risk factors of major adverse cardiovascular events (MACEs) in immune checkpoint inhibitor (ICI) related myocarditis and establish a predictive model.Methods:This was a retrospective case-control study. Tumor patients diagnosed with ICI related myocarditis in the First Affiliated Hospital of Guangzhou Medical University from May 2019 to August 2023 were selected and divided into non-MACE group and MACE group based on whether MACE occurred. Clinical and imaging data of the two groups were collected. Univariate and multivariate logistic regression models were used to analyze the risk factors for MACE in patients with ICI related myocarditis. According to the results of multivariate logistic regression analysis, R 4.1.0 software was used to construct the MACE risk prediction model for these patients and draw a nomogram. The receiver operating characteristic curve was used to evaluate the prediction ability of the prediction model.Results:A total of 35 patients with ICI related myocarditis, aged (63.9±8.2) years, were included, including 28 males (80%). There were 18 patients in the non-MACE group and 17 patients in the MACE group. Multivariate logistic regression analysis showed that elevated neutrophil to lymphocyte ratio ( OR=1.115, 95% CI 1.007-1.235, P=0.036) and ST-T segment changes ( OR=24.942, 95% CI 1.239-502.194, P=0.036) were risk factors for MACE in patients with ICI related myocarditis. The receiver operating characteristic curve indicated that the area under the curve of the prediction model was 0.967 (95% CI 0.916-1.000, P<0.001), with a sensitivity of 88.2% and specificity of 100%, demonstrating good predictive ability. Conclusion:Elevated neutrophil to lymphocyte ratio and ST-T segment change are independent risk factors for MACE in patients with ICI related myocarditis. Risk prediction model based on the above two indicators can assist in the early identification and individualized intervention of ICI related myocarditis patients.

Objective:To understand the molecular epidemiological characteristics of unique recombinant forms (URFs) in newly reported HIV-1 patients in Hangzhou, and provide theoretical support for prevention and control of AIDS.Methods:The blood samples of newly-diagnosed HIV-1 infected cases who received no antiviral therapy from 2019 to 2023 were collected, pol gene was amplified by RT-PCR and nested PCR, followed by sequencing. The URFs were screened using phylogenetic tree, followed by recombinant analysis. Genetic distances between URFs sequences were calculated and molecular transmission networks were constructed. The calibrated population resistance program (CPR) was used to analyze transmissible drug-resistant mutations. Results:A total of 222(5.0%, 222/4 471) URFs pol gene sequence were obtained, and the recombination types were CRF01_AE/CRF07_BC (60.4%, 134/222), CRF01_AE/C (11.7%, 26/222), CRF01_AE/B (9.5%, 21/222), CRF01_AE/B/C (8.1%, 18/222), B/C (7.6%, 17/222) and CRF55_01B/CRF07_BC (2.7%, 6/222), respectively. 78.8% (175/222) were infected by men who have sex with man(MSM), whoes mean age was 31.3±10.5. The proportion of URFs increased from 4.0% (34/843) to 7.4% (60/807) from 2019 to 2023. Under the optimal gene distance threshold of 1.5%, the molecular network access rate was 49.5% (110/222), included 23 clusters. We found a large active transmission cluster with 39 cases mixed homosexual and heterosexual, the recombination types was CRF01_AE/CRF07_BC, and the average gene distance was 0.005. Prevalence of URFs transmissible resistance was 3.2% (7/222). Conclusions:URFs are mainly produced and transmitted in young MSM, which shows an increasing trend year by year. There is a large active transmission cluster required major attention and effective intervention to prevent further expansion. At the same time, the occurrence and transmission of URFs should be continuously monitored to understand the clusters and drug resistance dynamics.

AIM: To explore the risk factors of retinal detachment after stage II vitrectomy in patients with open ocular trauma.METHODS: Retrospective analysis. Totally 278 patients(278 eyes)with open ocular trauma who received stage II vitrectomy in the hospital were included from April 2020 to July 2023. According to the postoperative retinal detachment status, they were divided into detachment group(48 eyes)and non-detachment group(230 eyes). The basic clinical conditions of the two groups of patients were compared, and the factors affecting retinal detachment were analyzed.RESULTS: Univariate analysis revealed that there were statistical differences in wound length, injured area, surgical time after injury, and history of retinal detachment/lesion between the two groups(all P<0.05). Logistics multivariate regression analysis showed that wound length greater than 10 mm, surgical time after injury more than 1 wk, and history of retinal detachment/lesion were risk factors for retinal detachment in patients with open ocular trauma after stage II vitrectomy(all P<0.05).CONCLUSION: The occurrence of retinal detachment in patients with open ocular trauma after stage II vitrectomy is mainly related to the severity of trauma, surgical time after injury and history of ocular retinopathy. It is necessary to perform surgical treatment for patients as soon as possible.