Objective: To investigate the status of heat illness, knowledge awareness and adaptive behaviors of heat wave knowledge among food delivery riders, so as to provide a basis for optimizing heat wave response measures for food delivery riders. Methods: In November 2022, food delivery riders from a large food delivery platform in Ningbo City, Zhejiang Province were selected as survey subjects using a cluster sampling method. A self-designed electronic questionnaire was used to select demographic information, work status, lifestyle behaviors and disease history, heat illness status, knowledge awareness and adaptive behaviors of heatwave. Results: A total of 911 questionnaires were distributed, and 830 valid questionnaires were recovered, resulting in a valid response rate of 91.11%. Among the respondents, 796 (95.90%) were male, and 818 (98.55%) worked full-time. The mean age was (27.75±8.00) years. A total of 470 respondents (56.63%) had a work tenure of less than 1 year. The primary working hours were 8-<12 hours, with 504 people accounting for 60.72%. There were 108 cases of heatstroke, with an occurrence rate of 13.01%. And 286 people reported heat-related symptoms, with an occurrence rate of 34.46%. The overall awareness rate of heat wave knowledge was 73.22%, while the awareness rate of heat warning signal classification was relatively low at 9.04%. The heat wave cognition score was (5.86±1.31) points. There were statistically significant differences in heat wave cognition scores among food delivery riders of different ages, educational levels, family annual income, work tenures, and work durations (all P<0.05). Regarding positive adaptive behaviors, the number of riders paying attention to weather forecasts and actively learning about preventive measures was higher (734 people each, accounting for 88.43%). Regarding negative adaptive behaviors, the number of riders who often drank ice-cold beverages was higher (509 people, accounting for 61.33%). The heat wave adaptive behavior score was (6.88±1.77) points. There were statistically significant differences in adaptive behavior scores among riders with different educational levels, family annual income, work tenures, and smoking frequency (all P<0.05). Conclusions The occurrence rates of heatstroke and heat-related symptoms among food delivery riders are relatively high. The knowledge awareness and adaptive behaviors regarding heat wave are at a moderate level. It is suggested to strengthen health education, reinforce risk cognition of heat wave, and promote positive adaptive behaviors among food delivery riders.

Objective:To explore the influence of Stat1 on Foxp3 expression and production of Treg.Methods:C57BL/6 mice were used and separated into normal control group and Stat1 specific inhibitor Fludarabine(Flud)treatment group.Ratio of CD4+Foxp3+Treg and expression of Foxp3 in spleen,lymph nodes and peripheral blood of mice in each group were detected by flow cy-tometry.Human Stat1 overexpression plasmid was constructed and transfected into human breast cancer MCF-7 cells,and expression changes of Foxp3 was detected by RT-qPCR and Western blot.Results:Compared with mice in normal control group,proportion of Treg and expression of Foxp3 in lymph nodes and peripheral blood of mice in Flud treatment group were increased,while Stat1 overex-pression resulted in decreased Foxp3 mRNA and protein expression in MCF-7 cells.Conclusion:Stat1 inhibits expression of Foxp3 and production of Tregs.

Objective To construct a competency-based and functioning-oriented training curriculum system for inclusive education teachers in primary and secondary schools based on World Health Organization International Classification of Functioning,Disability and Health(ICF)and rehabilitation competency framework(RCF).Methods Based on the policy documents of inclusive education from United Nations Educational,Scientific and Cultur-al Organization and the European Union,and aligning with China's national policies such as the 14th Five-Year Plan for Special Education Development and Improvement,this study systematically analyzed the core competen-cies required for primary and secondary inclusive education teachers using ICF and RCF,and developed a compe-tency-based and functioning-oriented training curriculum system.Results The core competencies for primary and secondary school teachers encompassed four dimensions under the con-text of inclusive education.In the dimension of professional identity and ethics,teachers needed to establish in-clusive education values and be able to use ICF to comprehensively understand students'functioning perfor-mance and developmental needs.In the dimension of inclusive teaching and support practices,it was emphasized the ability for inclusive instructional design based on functioning assessment,including applying universal design for learning,creating barrier-free learning environments and implementing multiple assessments.In the dimen-sion of collaboration and communication,it was needed to build home-school-community support networks and possess communication skills for interprofessional teamwork.In the dimension of continuous reflection and pro-fessional development,it was focused on teachers'continuous learning and professional growth.A curriculum system comprising four major modules including concepts and foundations,core skills for teaching and support,collaboration and expansion,and practical reflection and research were constructed based on this competency model.Conclusion Based on ICF and RCF,a competency-based and functioning-oriented training curriculum system has been established,providing a theoretical framework and practical pathway for improving the quality of inclusive edu-cation teachers in China.

Objective:To observe the clinical effect of urokinase along the pipeline under offline status to dissolve dialyzer microthrombus in patients undergoing continuous renal replacement therapy (CRRT).Methods:A prospective research method was adopted. A total of 248 CRRT patients with dialyzer microthrombus in Sinopharm-Gezhouba Central Hospital from January 2017 to December 2021 were selected. The patients were divided into experimental group (continued CRRT treatment after urokinase along the pipeline under offline status to dissolve dialyzer microthrombus) and control group (continued CRRT treatment after dialyzer replacement) by random number table method with 124 cases in each group. The baseline data were recorded, including gender, age, primary disease, hemoglobin, platelet count, hematocrit, plasma albumin, D-dimer, fibrinogen, anticoagulant method and symptoms associated with dialyzer microthrombus. The blood indexes were detected before and after treatment of microthrombus, and the symptom scores were performed. The blood indexes included creatinine, urea nitrogen, β 2 microglobulin (β 2-MG), international normalized ratio (INR), hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α); and the symptom scores included acute physiology and chronic health status score Ⅱ (APACHE Ⅱ) and (APACHE Ⅱ) and sequential organ failure score. The initial transmembrane pressure, transmembrane pressure before disembarkation, CRRT treatment extension time and coagulation classification were recorded. In experimental group, the blood coagulation function indexes before and after treatment were detected, including prothrombin time (PT), activated partial prothrombin time (APTT), thrombin time (TT) and fibrinogen (Fib). The adverse reactions were recorded, including black stools, arrhythmias and wound bleeding. Results:There were no statistical differences in baseline data, initial transmembrane pressure, transmembrane pressure before disembarkation, CRRT treatment extension time and coagulation classification between two groups ( P>0.05). There were no statistical differences in creatinine, urea nitrogen, β 2-MG, INR, hs-CRP, IL-6, TNF-α, APACHE Ⅱ and SOFA before treatment between two groups ( P>0.05); after treatment, the indexes in both groups were significantly lower than before treatment, and the indexes in experimental group were significantly lower than those in control group: (179.1 ± 41.2) μmol/L vs. (187.1 ± 53.9) μmol/L, (7.3 ± 2.8) mmol/L vs. (9.3 ± 2.5) mmol/L, (2.5 ± 0.6) mg/L vs. (4.2 ± 0.7) mg/L, 1.0 ± 0.3 vs. 1.8 ± 0.5, (8.7 ± 1.1) mg/L vs. (10.6 ± 2.4) mg/L, (21.5 ± 12.7) ng/L vs. (29.5 ± 10.3) ng/L, (20.2 ± 6.1) ng/L vs. (26.6 ± 7.2) ng/L, (12.1 ± 6.9) scores vs. (17.2 ± 5.2) scores and (5.9 ± 1.8) scores vs. (6.8 ± 1.9) scores, and there were statistical differences ( P<0.05). In experimental group, there were no statistical differences in PT, APTT, TT and Fib between before treatment and after treatment ( P>0.05). The incidence of adverse reactions in experimental group was significantly lower than that in control group: 4.03%(5/124) vs. 12.90%(16/124), and there was statistical difference ( χ2 = 6.30, P<0.05). Conclusions:The urokinase along the pipeline under offline status to dissolve dialyzer microthrombus in patients undergoing CRRT is safer, cheaper and more efficient. It can improve the biocompatibility of tissue with dialyzer and pipe, prolong the use time of the dialyzer, and complete renal replacement therapy.

Objective To explore the latent profile analysis of oral frailty in elderly patients with multiple chronic conditions and to analyze the influencing factors of different potential profiles in order to provide a theoretical basis for constructing clinical intervention programs.Methods Convenience sampling method was used to select elderly patients with multiple chronic conditions in a tertiary hospital in Hefei City from July to December 2024 as the survey subjects.General information questionnaire,the Chinese version of the Oral Frailty Index-8,Mini-Nutritional Assessment Short-Form,Consumer Health Activation Index and Family APGAR Index Questionnaire were used to conduct the survey,and multivariate logistic regression was used to analyze the influencing factors.Results A total of 418 elderly patients with multiple chronic conditions were included,with a total oral frailty score of(7.21±2.83).Oral frailty in elderly patients with multiple chronic conditions can be classified into 3 potential profiles,namely severe oral frailty-low oral functioning group(60.53％),moderate oral frailty-high social behaviors group(8.85％),mild oral frailty-high oral health behavior group(30.62％).Age,family care,type of chronic disease,type of oral medication,and consumer health activation index were influential factors for different potential profiles(P＜0.05).Conclusion The oral frailty in elderly patients with multiple chronic conditions was heterogeneous.Caregivers should focus on the severe oral frailty-low oral functioning group and the moderate oral frailty-high social behavior group,and develop targeted interventions according to the patients'different profile characteristics and influencing factors to prevent and delay the occurrence of oral frailty.

Objective To systematically evaluate the level of proteus mirabilis(PM)infection in patients with rheumatoid arthritis(RA)and to investigate its potential association with the development of RA.Methods Based on Meta-analysis of observational studies in epidemiology and preferred reporting items for systematic review and Meta-analysis guide,a comprehensive search of PubMed,Web of Science and Embase databases was conducted to screen relevant literature published up to December 2024 for studies comparing the levels of anti-PM antibodies between RA patients and healthy populations,and the quality of the included studies was assessed by using the Newcastle-Ottawa scale.Heterogeneity among studies was assessed by Q-test and I2-test,and accordingly,fixed-effects or random-effects models were selected,and the robustness of the results was assessed by sensitivity analyses,Begg's test,and clipping and patching method.Results Finally,18 eligible articles were included,involving 753 RA patients and 716 healthy controls.The total antibody levels[weighted mean difference(WMD)=0.86,95％CI:0.38-1.34,I2=98.3％,P=0.000]and IgA antibody levels(WMD=0.17,95％CI:0.06-0.28,I2=96.7％,P=0.000)of RA patients were higher than those of healthy controls,and subgroup analyses revealed significant heterogeneity among geographic regions and testing methods.Conclusion Prevention and treatment of PM infections may be a complementary strategy for RA management and provide evidence-based support for the"PM antigen-genitourinary tract mucosa-autoimmunity"pathology hypothesis.

Objective To explore and analyze the current situation of consumer health activation index and its influencing factors in hospitalized elderly patients with multiple chronic conditions,and to provide reference basis for clinical intervention.Methods Convenience sampling method was used to select 332 hospitalized elderly patients with multiple chronic conditions from a tertiary hospital in Hefei City from July to December 2024 as the study subjects,and general information questionnaire,Consumer Health Activation Index,Health Literacy Management Scale,Scale of the Elderly Self-neglcet(Rural),and Perceived Social Support Scale were used to investigate the current situation of consumer health activation index of hospitalized elderly patients with multiple chronic conditions.Univariate analysis and multiple linear regression analysis were employed to explore the influencing factors of consumer health activation index in patients with multiple chronic conditions.Results A total of 332 questionnaires were distributed,and 325 valid questionnaires were retrieved.The score of the consumer health activation index of hospitalized elderly patients with multiple chronic conditions was(61.68±15.12).The results of multiple linear regression showed that literacy,average monthly household income,number of chronic diseases,medication frequency,self-care ability,health literacy management,perceived social support and self-neglect were the influencing factors for the positivity of hospitalized elderly patients with multiple chronic conditions(P＜0.05),which could explain 59.9％of the variance of the consumer health activation index of hospitalized elderly patients with multiple chronic conditions.Conclusion The consumer health activation index of hospitalized elderly patients with multiple chronic conditions is at a low level.In the future,precise and systematic intervention measures for enhancing positive health status can be formulated by taking into account relevant influencing factors,in order to promote the transformation of patients from passive health to active health,and thereby facilitating positive aging.

Objective To systematically evaluate the level of proteus mirabilis(PM)infection in patients with rheumatoid arthritis(RA)and to investigate its potential association with the development of RA.Methods Based on Meta-analysis of observational studies in epidemiology and preferred reporting items for systematic review and Meta-analysis guide,a comprehensive search of PubMed,Web of Science and Embase databases was conducted to screen relevant literature published up to December 2024 for studies comparing the levels of anti-PM antibodies between RA patients and healthy populations,and the quality of the included studies was assessed by using the Newcastle-Ottawa scale.Heterogeneity among studies was assessed by Q-test and I2-test,and accordingly,fixed-effects or random-effects models were selected,and the robustness of the results was assessed by sensitivity analyses,Begg's test,and clipping and patching method.Results Finally,18 eligible articles were included,involving 753 RA patients and 716 healthy controls.The total antibody levels[weighted mean difference(WMD)=0.86,95％CI:0.38-1.34,I2=98.3％,P=0.000]and IgA antibody levels(WMD=0.17,95％CI:0.06-0.28,I2=96.7％,P=0.000)of RA patients were higher than those of healthy controls,and subgroup analyses revealed significant heterogeneity among geographic regions and testing methods.Conclusion Prevention and treatment of PM infections may be a complementary strategy for RA management and provide evidence-based support for the"PM antigen-genitourinary tract mucosa-autoimmunity"pathology hypothesis.

Objective To explore and analyze the current situation of consumer health activation index and its influencing factors in hospitalized elderly patients with multiple chronic conditions,and to provide reference basis for clinical intervention.Methods Convenience sampling method was used to select 332 hospitalized elderly patients with multiple chronic conditions from a tertiary hospital in Hefei City from July to December 2024 as the study subjects,and general information questionnaire,Consumer Health Activation Index,Health Literacy Management Scale,Scale of the Elderly Self-neglcet(Rural),and Perceived Social Support Scale were used to investigate the current situation of consumer health activation index of hospitalized elderly patients with multiple chronic conditions.Univariate analysis and multiple linear regression analysis were employed to explore the influencing factors of consumer health activation index in patients with multiple chronic conditions.Results A total of 332 questionnaires were distributed,and 325 valid questionnaires were retrieved.The score of the consumer health activation index of hospitalized elderly patients with multiple chronic conditions was(61.68±15.12).The results of multiple linear regression showed that literacy,average monthly household income,number of chronic diseases,medication frequency,self-care ability,health literacy management,perceived social support and self-neglect were the influencing factors for the positivity of hospitalized elderly patients with multiple chronic conditions(P＜0.05),which could explain 59.9％of the variance of the consumer health activation index of hospitalized elderly patients with multiple chronic conditions.Conclusion The consumer health activation index of hospitalized elderly patients with multiple chronic conditions is at a low level.In the future,precise and systematic intervention measures for enhancing positive health status can be formulated by taking into account relevant influencing factors,in order to promote the transformation of patients from passive health to active health,and thereby facilitating positive aging.

Objective:To observe the clinical effect of urokinase along the pipeline under offline status to dissolve dialyzer microthrombus in patients undergoing continuous renal replacement therapy (CRRT).Methods:A prospective research method was adopted. A total of 248 CRRT patients with dialyzer microthrombus in Sinopharm-Gezhouba Central Hospital from January 2017 to December 2021 were selected. The patients were divided into experimental group (continued CRRT treatment after urokinase along the pipeline under offline status to dissolve dialyzer microthrombus) and control group (continued CRRT treatment after dialyzer replacement) by random number table method with 124 cases in each group. The baseline data were recorded, including gender, age, primary disease, hemoglobin, platelet count, hematocrit, plasma albumin, D-dimer, fibrinogen, anticoagulant method and symptoms associated with dialyzer microthrombus. The blood indexes were detected before and after treatment of microthrombus, and the symptom scores were performed. The blood indexes included creatinine, urea nitrogen, β 2 microglobulin (β 2-MG), international normalized ratio (INR), hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α); and the symptom scores included acute physiology and chronic health status score Ⅱ (APACHE Ⅱ) and (APACHE Ⅱ) and sequential organ failure score. The initial transmembrane pressure, transmembrane pressure before disembarkation, CRRT treatment extension time and coagulation classification were recorded. In experimental group, the blood coagulation function indexes before and after treatment were detected, including prothrombin time (PT), activated partial prothrombin time (APTT), thrombin time (TT) and fibrinogen (Fib). The adverse reactions were recorded, including black stools, arrhythmias and wound bleeding. Results:There were no statistical differences in baseline data, initial transmembrane pressure, transmembrane pressure before disembarkation, CRRT treatment extension time and coagulation classification between two groups ( P>0.05). There were no statistical differences in creatinine, urea nitrogen, β 2-MG, INR, hs-CRP, IL-6, TNF-α, APACHE Ⅱ and SOFA before treatment between two groups ( P>0.05); after treatment, the indexes in both groups were significantly lower than before treatment, and the indexes in experimental group were significantly lower than those in control group: (179.1 ± 41.2) μmol/L vs. (187.1 ± 53.9) μmol/L, (7.3 ± 2.8) mmol/L vs. (9.3 ± 2.5) mmol/L, (2.5 ± 0.6) mg/L vs. (4.2 ± 0.7) mg/L, 1.0 ± 0.3 vs. 1.8 ± 0.5, (8.7 ± 1.1) mg/L vs. (10.6 ± 2.4) mg/L, (21.5 ± 12.7) ng/L vs. (29.5 ± 10.3) ng/L, (20.2 ± 6.1) ng/L vs. (26.6 ± 7.2) ng/L, (12.1 ± 6.9) scores vs. (17.2 ± 5.2) scores and (5.9 ± 1.8) scores vs. (6.8 ± 1.9) scores, and there were statistical differences ( P<0.05). In experimental group, there were no statistical differences in PT, APTT, TT and Fib between before treatment and after treatment ( P>0.05). The incidence of adverse reactions in experimental group was significantly lower than that in control group: 4.03%(5/124) vs. 12.90%(16/124), and there was statistical difference ( χ2 = 6.30, P<0.05). Conclusions:The urokinase along the pipeline under offline status to dissolve dialyzer microthrombus in patients undergoing CRRT is safer, cheaper and more efficient. It can improve the biocompatibility of tissue with dialyzer and pipe, prolong the use time of the dialyzer, and complete renal replacement therapy.