Patients with rare disease are a vulnerable group in healthcare who urgently need more attention from the government and society. Despite their overall number, they face challenges such as limited diagnosis and treatment options, poor access to medications, and heavy financial burdens. Providing better protection for this group is not only essential for public well-being, but also an important indicator of societal progress. This paper analyzes the current status and challenges of rare disease protection in China, with a focus on building diagnostic and treatment networks, optimizing the multitiered social security system, and improving pharmaceutical access mechanisms. It highlights issues such as incomplete health insurance coverage, unequal resource allocation, and insufficient incentives for drug development. To address these challenges, we suggest strengthening policies, improving the multitiered social security system, encouraging social support, and promoting medical and pharmaceutical innovation to provide comprehensive care for rare disease patients.

Background: Condyloma acuminatum (CA) is a common sexually transmitted disease caused by human papillomavirus (HPV). In recent years, research on anal CA has primarily focused on treatment rather than underlying mechanisms. The mechanism of HPV persistence and recurrence in CA require further exploration. It needs multiple researches in mechanisms to focalize treatment targets. Objective: To investigate the relationship between intestinal mucosal immunity and the relapse of anal CA and persistent infection. Methods: Levels of interferon gamma (IFN-γ) and secretory immunoglobulin A (sIgA) were measured using enzyme-linked immunosorbnent assay in anal mucosal cells obtained from patients treated at Tianjin Union Medical Center from September 2022 to December 2024. All the participants signed Informed Consent and the whole plan was approved by Institutional Review Board in Tianjin Union Medical Center (No. B155). Results: The levels of IFN-γ and sIgA significantly decreased after infection, and persistent infection exhibited even lower levels. These two factors increased following treatment, reaching peak concentrations at 4 weeks before decreasing again. Conclusion These findings demonstrate a significant association between persistent anal CA infection and dysregulation of intestinal mucosal immunity.

Objective:To assess the efficacy and safety of skin care products containing mandelic acid and niacinamide in the management of mild to moderate acne.Methods:A total of 50 patients with mild to moderate acne were prospectively enrolled at Xijing Hospital, Air Force Military Medical University, from June to October 2020. Participants were randomly assigned into an observation group and a control group using a random number table method, with each group comprising 25 individuals. The observation group consisted of 3 males and 22 females, with a mean age of (22.5±3.2) years; the control group also included 3 males and 22 females, with a mean age of (22.9±2.8) years. The control group received conventional acne treatment without any additional skin care interventions apart from daily facial cleaning; conversely, the observation group was treated with skin care products containing mandelic acid and niacinamide alongside standard treatment protocols. At weeks 2, 4, and 8 post-treatment, objective assessments utilizing skin property system and VISIA complexion analysis system were conducted to evaluate changes in lesion count as well as recovery of skin barrier function between both groups; additionally, patients completed adverse reaction record forms.Results:No significant differences were observed regarding gender distribution, age demographics, disease duration or severity between the two groups ( P>0.05). After 8 weeks of treatment, the rates of effective improvement for skin lesions and acne were observed to be 84.0% (21/25) in the observation group compared to 56.0% (14/25) in the control group for lesion improvement, and 84.0% (21/25) versus 44.0% (11/25) for acne improvement, respectively. When compared to the control group, the observation group demonstrated significantly higher rates of effective improvement in both skin lesions and acne ( P<0.001).VISIA analysis revealed that pore size scores as well as violet scores decreased significantly after eight weeks in comparison to controls ( P=0.035; P=0.027). CK results indicated reduced transepidermal water loss along with diminished sebum levels within the observation cohort relative to controls ( P=0.009; P=0.042). Skin erythema along with symptoms such as dryness or burning sensations occurred among five patients (three from the observation cohort while two belonged to controls) with no serious adverse reactions reported across either study arm. Conclusions:Skin care products incorporating mandelic acid and niacinamide can serve effectively as adjunctive treatments for mild-to-moderate acne with enhancing clinical outcomes accompanied by minimal adverse effects.

Objective:To explore the effects of depressive symptoms on sleep quality in adolescents with depressive disorder, and the mediating roles of cognitive fusion and sleep belief.Methods:A sample of 210 adolescents with first episode depressive disorder aged 12-18 years were recruited to complete 17-item Hamilton depression scale (HAMD-17), Pittsburgh sleep quality index (PSQI), cognitive fusion questionnaire (CFQ), and dysfunctional beliefs and attitudes about sleep scale (DBAS-16) from November 2021 to July 2022. SPSS 26.0 software was used to perform descriptive analysis and correlation analysis. The mediating effect was tested by Bootstrap analysis using PROCESS V 3.4 Macro program.Results:The incidence of low sleep quality in adolescents with depressive disorder was 69.0%(145/210). HAMD-17 score was (22.4±7.9), PSQI score was (9.7±3.7), CFQ score was (51.6±7.8), DBAS-16 score was (43.5±8.4).PSQI was positively correlated with the scores of HAMD-17 and CFQ( r=0.613, 0.463, both P<0.001).HAMD-17 was positively correlated with CFQ score ( r=0.488, P<0.001).DBAS-16 was negatively correlated with scores of PSQI, HAMD-17 and CFQ( r=-0.326, -0.284, -0.354, all P<0.001). The direct effect of depression on sleep quality was 0.230(95% CI=0.169-0.293). The indirect effect of depression on sleep quality through two pathways, the separate mediating effect value of cognitive fusion was 0.041 (95% CI=0.011-0.074), and the chain mediating effect value of cognitive fusion and sleep beliefs was 0.008(95% CI=0.001-0.020). Conclusion:Depressive symptoms can directly affect sleep quality of depressive disorder adolescents and indirectly through cognitive fusion and sleep beliefs.

Urban traffic is closely related to the daily life of the public,and air pollution in the traffic microenvironment has become a public health problem that cannot be ignored.This paper reviews the comparative studies of air pollutant exposure levels among different modes of transportation in multiple cities in China.By com-paring the exposure levels of pollutants among different modes of transportation,this paper provides a reference for protecting the health of the public in daily transportation and selecting targeted control measures.

Objective:To understand the interaction effect of general obesity, central obesity, and dyslipidemia on the risk of hypertension to provide scientific evidence for the early prevention and control of hypertension.Methods:From 2019 to 2023, 10 of the 16 districts in Tianjin were selected as project sites. A community and a natural village were selected as monitoring sites in each project site using a multi-stage cluster random sampling method. A questionnaire, physical, and biochemical examination were conducted on permanent residents aged 35-75 who had lived in the surveillance sites for more than half a year. The chi-square test univariate and multivariate logistic regression were used for statistical analysis. The multiplicative and additive models were used to calculate the interaction between general obesity and dyslipidemia, as well as central obesity and dyslipidemia, respectively.Results:A total of 177 160 subjects were included in the study, with an age of (56.44±8.62) years old. There were 29 535 (16.67%) patients with general obesity, 67 338 (38.01%) patients with central obesity, 64 906 (36.64%) patients with dyslipidemia, and 90 266 (50.95%) patients with hypertension. Multiplication interaction analysis results showed that, after adjusting for gender, age, culture level, marriage status, drinking, smoking, and diabetes, the multiplicative interactions between general obesity and dyslipidemia, and central obesity and dyslipidemia on hypertension were statistically significant (all P<0.001), and the adjusted OR and 95% CI were 2.57 (2.47-2.68) and 2.14 (2.08-2.20), respectively. The results of the additive interaction analysis demonstrated that after adjusting for relevant variables, the relative excess risk of interaction ( RERI), the attributable proportion of interaction ( API), and the synergy index ( SI) of the interaction between generalized obesity and dyslipidemia were 0.48 (95% CI: 0.33-0.63), 0.15 (95% CI: 0.11-0.19), and 1.27 (95% CI: 1.18-1.36), respectively; the RERI, API, and SI of the interaction between central obesity and dyslipidemia were 0.37 (95% CI: 0.28-0.46), 0.13 (95% CI: 0.10-0.16), and 1.25 (95% CI: 1.18-1.32), respectively. Conclusions:There might be multiplicative and additive interactions between general obesity, central obesity, and dyslipidemia on the risk of hypertension. Simultaneous control of BMI, waist circumference, and blood lipid levels may effectively reduce the risk of hypertension.

Objective:To explore the latent classes of health behavior and explore the predictive factors among stroke patients.Methods:A total of 1 250 participants were recruited using cluster random sampling in September 2022. The general information, the modified Rankin scale(mRS), stroke prevention knowledge questionnaire(SPKQ), health behavior scale for stroke patients (HBS-SP), and short form-health belief model scale (SF-HBMS) were administered in the cross-sectional survey. Mplus 8.3 software was used to conduct a latent class analysis (LCA) on the health behavior of stroke patients, and SPSS 27.0 software was used to carry out multinomial Logistic regression to analyze the predictive factors of different latent classes of health behavior of stroke patients.Results:The health behavior of stroke patients obtained three latent classes: low health behaviors-lack of health responsibility group (66.9%, n=794), moderate health behaviors-poor compliance group (11.9%, n=141), and good health behaviors-insufficient exercise group (21.2%, n=251). Compared with good health behaviors-insufficient exercise group, stroke patients with shorter duration education time ( B=-0.589, OR=0.555, P=0.036), hemorrhagic stroke ( B=0.082, OR=1.086, P<0.001), fewer comorbidities ( B=-0.022, OR=0.978, P=0.026), higher mRS score ( B=-0.046, OR=1.047, P=0.004), lower SPKQ score ( B=-0.055, OR=0.947, P=0.016), and lower SF-HBMS score ( B=-0.085, OR=0.919, P<0.001) were more likely to be included in moderate health behaviors-poor compliance group. However, stroke patients with shorter duration education time ( B=-0.026, OR=0.974, P=0.003), rural areas dwelling ( B=0.800, OR=2.225, P=0.004), fewer comorbidities ( B=-0.056, OR=0.945, P<0.001), lower SPKQ score ( B=-0.101, OR=0.904, P<0.001), and lower SF-HBMS score ( B=-0.071, OR=0.931, P<0.001) were more likely to be included in low health behaviors-lack of health responsibility group. Conclusion:The health behavior of stroke patients has three latent classes. A targeted intervention should be carried out according to the characteristics of different classes to improve their health behavior levels.

Objective:To explore the potential facilitators and barriers to healthy behavior among stroke patients.Methods:Semi-structured interviews were conducted among 16 stroke patients from September 2022 to March 2023 using an objective sampling method.The interview guide was developed using the theoretical domain framework(TDF). Interviews were transcribed and refined the theme using directed content and induction analysis.Using the TDF as the initial coding framework, the themes were then merged into the most relevant domains.Finally, the correspondence between theoretical domains and the healthy behavior of stroke patients was determined based on the frequency and relationship between themes.Results:This study identified nine theoretical domains that affected the healthy behavior of stroke patients: knowledge, skills, motivation and goals, social influences, social/professional role and identity, environment context and resources, belief about capability, consequence belief and behavioral regulation.Conclusion:The healthy behavior of stroke patients is complex and influenced by several factors.The nine theoretical domains identified in this study will provide recommendations for future healthy behavior interventions for stroke patients.

Objective:To explore the latent profile types of capability-opportunity-motivation-behavior in stroke patients and analyze the influencing factors of different latent profiles.Methods:From January to October 2023, totally 596 stroke patients from the Neurology Department of five ClassⅢ Grade A hospitals in Henan Province were selected by stratified random sampling. The patients were surveyed using a general information questionnaire, the Stroke Prevention Knowledge Questionnaire (SPKQ), the Social Support Rating Scale (SSRS), the WHO's Quality of Life Questionnaire- Brief Version (WHOQOL-BREF), the Short Form Health Belief Model Scale (SF-HBMS), and the Health Promoting Lifestyle ProfileⅡ (HPLPⅡ). Latent profile analysis was used to classify the capability-opportunity-motivation-behavior characteristics of stroke patients, and multiple logistic regression was conducted to explore the influencing factors of different latent profiles.Results:Three latent profiles of capability-opportunity-motivation-behavior in stroke patients were identified, including low capability-opportunity-motivation-behavior with high health beliefs (32.4%, 193/596), moderate capability-opportunity-motivation-behavior with insufficient health beliefs (47.5%, 283/596), and high capability-opportunity-motivation-behavior with lack of social support (20.1%, 120/596). Multiple logistic regression analysis showed that educational level, smoking history, family history, body mass index, and Charlson Comorbidity Index score were influencing factors of different latent profiles ( P<0.05) . Conclusions:Stroke patients exhibit distinct classifications of capability-opportunity-motivation-behavior. Targeted interventions should be conducted based on the characteristics of each category to improve health behavior management outcomes in patients.

Objective:To explore the mediating effect of rumination between self-perceived burden (SPB) and stigma in stroke patients, so as to provide theoretical basis for the development of targeted nursing interventions in clinical practice.Methods:In September 2022, cluster sampling was used to select 1 126 stroke patients admitted to Department of Neurology of five ClassⅢ Grade A hospitals in Henan Province as subjects. General Information Questionnaire, Self-Perceived Burden Scale (SPBS), Stroke Stigma Scale (SSS), and Chinese Version of Event Related Rumination Inventory (C-ERRI) were used to investigate stroke patients. Pearson correlation analysis was used to explore the correlation between SPB, rumination, and stigma. AMOS 28.0 software was used to establish the structural equation model, and Bootstrap method was used to test the mediating effect.Results:A total of 1 126 questionnaires were distributed, and 1 026 valid questionnaires were collected, with a valid response rate of 91.12% (1 026/1 126). SPBS score of 1 026 stroke patients was (28.68±8.32), the SSS score was (40.53±9.48) and the C-ERRI score was (25.43±12.62). Pearson correlation analysis showed that SPB in stroke patients was positively correlated with stigma and rumination ( P<0.01), and rumination was positively correlated with stigma ( P<0.01). Bootstrap mediating effect test showed that rumination partially mediated the relationship between SPB and stigma in stroke patients, accounting for 55.15% of the total effect. Conclusions:SPB of stroke patients both directly affect stigma and indirectly affect stigma through rumination. Clinical nursing workers should promptly evaluate patients' SPB, pay attention to the mediating role of rumination, develop effective psychological intervention programs, implement personalized and targeted nursing measures, relieve patients' stigma, and improve treatment and rehabilitation compliance.