The statement"Blood is the material carrier of spirit and qi"indicates that the generation of blood relies on the coordinated governance of spirit and qi,while simultaneously serving as their material foundation.Based on the physiological connection among"blood-spirit-qi",this article explores the pathogenesis of premature ovarian insufficiency(POI)accompanied by anxiety and depression.It proposes that essence and blood deficiency,premature exhaustion of Tian Gui(reproductive essence),and failure of blood to nourish the spirit form a pathological chain:"blood deficiency-spirit disturbance-POI with anxiety and depression".Blood stasis obstructing the uterine chamber,disorder of the chong and ren meridians,and failure of blood to carry the spirit give rise to the transformation:"blood stasis-spirit depression-POI with anxiety and depression".Liver qi stagnation and disruption of qi and blood further exacerbate the imbalance between blood and spirit,aggravating the disease progression.Based on this pathological analysis,the general treatment principle of"regulating blood,harmonizing spirit,and rectifying qi"is established.For patients with blood deficiency syndrome,treatment should focus on tonifying essence and blood,replenishing reproductive essence,and nourishing the spirit,selecting Guanyuan(CV4),Zusanli(ST36),and Sanyinjiao(SP6)as main acupoints.For patients with blood stasis syndrome,treatment should aim to regulate the chong and ren meridians,promote blood circulation,and calm the spirit,selecting Qichong(ST30),Zhongji(CV3),and Xuehai(SP10)as main acupoints.Simultaneously,the method of regulating the liver should be applied throughout the entire treatment process to soothe the liver,regulate qi,relieve depression,and calm the spirit,selecting Baihui(GV20),Taichong(LR3),and Ganshu(BL18)as main acupoints.Appropriate acupuncture techniques and methods should be chosen according to the patient's constitution and condition,providing new therapeutic ideas and approaches for clinical practice.

Developing and implementing biosafety standards for pathogenic microbiology laboratories is essential to achieving scientific, efficient, and standardized management and operation. This article analyzes the current standardization construction in biosafety in pathogenic microbiology laboratories domestically and internationally. It proposes a framework for the biosafety standard system of pathogenic microbiology laboratories, which mainly includes four parts: basic standards, management standards, technical standards, and industry applications. It provides a reference for the standardization work of pathogenic microbiology laboratories and helps to standardize the biosafety industry in China.

Objective:To explore the feasibility of bibliometric analysis of research papers on human metapneumovirus based on Web of Science database.Methods:The human metapneumovirus (HMPV) causes a serious disease burden worldwide. This article used bibliometric analysis method to search for papers using the keyword " metapneumovirus" , and searched for HMPV papers published from 2001 to 2023 in the Web of Science database. Statistical analysis of the distribution of papers on HMPV by year, country, journal, research institution, author, etc., in order to understand the current research status and development trends of HMPV in the international community.Results:A total of 3 282 papers were retrieved, of which 97% were in English. HMPV was first reported in 2001, and since then, research papers have been increasing year by year. The United States has the highest number of published papers, with China, the United Kingdom, France, and the Netherlands ranked 2nd, 3rd, 4th, and 5th respectively. The field of virology-general had the highest number of papers. In terms of research institution distribution, Vanderbilt University in the United States has published 135 papers, ranked the first. The journal which had the highest number of published papers was JOURNAL OF MEDICAL VIROLOGY, with a total of 143 papers. The author Williams JV of Vanderbilt University in the United States has published 92 papers, indicating its high international status in the field of HMPV research.Conclusions:Among the retrieved HMPV related papers, research institutions and universities in European and American countries have published more papers.

Positive pressure bio-protective equipment is a key protective equipment for high-level biosafety laboratories, which provides comprehensive protection for professionals working in pathogenic microorganisms or other biological contamination environments. This paper summarizes the development status of positive pressure bio-protective equipment at home and abroad, analyzes the existing problems of the current positive pressure bio-protective equipment, and puts forward suggestions, to provide reference for the development and application of positive pressure bio-protective equipment in our country.

Dark circles refer to a cosmetic issue characterized by relatively darker skin color between the brow arch and the cheekbones. It has a high incidence rate and significantly affects patients’ quality of life and mental health. This article provides an overview of the periocular anatomical structures and the clinical classification of dark circles. It delves into the pathogenesis and etiologies of structural, pigmented, and vascular dark circles, summarizing and differentiating the clinical manifestations of these three types. This article also discusses selection of the appropriate diagnostic and therapeutic approaches based on the etiology and types, offering valuable insights for clinical practice.

Dark circles refer to a cosmetic issue characterized by relatively darker skin color between the brow arch and the cheekbones. It has a high incidence rate and significantly affects patients’ quality of life and mental health. This article provides an overview of the periocular anatomical structures and the clinical classification of dark circles. It delves into the pathogenesis and etiologies of structural, pigmented, and vascular dark circles, summarizing and differentiating the clinical manifestations of these three types. This article also discusses selection of the appropriate diagnostic and therapeutic approaches based on the etiology and types, offering valuable insights for clinical practice.

Objective The aim of this study is to evaluate the effect of the payment reform of basic medical insurance on cost,medical behavior and patients′ burden.So as to provide a reference for improving the payment reform in Changsha.Methods Interrupted time-series method was used to analyze the changes of the same-day readmission rate,average hospitalization cost per time and the out-of-pocket proportion before and after the payment reform.Stakeholder interviews were used to investigate suggestions and possible reasons for the change.Results The average hospitalization cost per time and the out-of-pocket proportion of insured patients decreased significantly in early stage of the reform,and then showed an increasing trend.The growth rate of the total number of inpatients and the decrease of same-day readmission rate declined.The results of interrupted time-series analysis showed that the growth rate of total inpatients decreased from 600 per month to 20 per month after the payment reform.The same-day readmission rate increased by 0.237%in the short term after the reform,but showed a downward trend in the long term,with the rate decreasing from 0.014%per month before the reform to 0.003%per month.In the short term after the reform,the average hospitalization cost per time fell by 786.360,and the proportion of out-of-pocket decreased by 2.089%.Conclusion The effects of controlling cost and alleviating patients′ burden were obvious in the initial reform of the basic medical insurance for urban employees in Changsha,but the long-term supervision needs to be strengthened,especially for decomposition of hospitalization and patients′burden relief.

Objective:To investigate the application effect of the Living Lab concept combined with the teaching model of case-based study (CBS) and reference-induced self-education (RISE) in thoracic surgery nursing teaching.Methods:A total of 132 nursing students who participated in 11 rounds of training (12 nursing students per round) in Department of Thoracic Surgery, The Affiliated Hospital of Inner Mongolia Medical University were included in the study, and according to the teaching method, they were divided into control group and observation group, with 66 nursing students in each group. The students in the control group received routine teaching, and those in the observation group received the Living Lab concept combined with CBS-RISE teaching. Assessment results were compared between the two groups, and the critical thinking ability and degree of satisfaction with teaching were evaluated for both groups. SPSS 22.0 was used to perform the t test. Results:Compared with the control group, the observation group had significantly higher objective question score (48.82±4.21 vs. 46.73±4.54, P<0.05), subjective question score (33.12±3.86 vs. 31.59±3.47, P<0.05), and total score (81.02±7.57 vs. 76.34±7.91, P<0.05). After training, compared with the control group, the observation group had significantly higher total score and scores of the dimensions such as truth seeking, open mindedness, analyticity, systematicity, self-confidence, inquisitiveness, and cognitive maturity ( P<0.05). The observation group also had a higher degree of satisfaction with teaching methods, teaching contents, and teachers compared with the control group ( P<0.05). Conclusion:In thoracic surgery nursing teaching, the application of the Living Lab concept and CBS-RISE can improve the assessment results of nursing students and enhance their critical thinking ability, with a high degree of teaching satisfaction among nursing students.

Nasopharyngeal carcinoma (NPC) is a malignant tumor that mainly occurs in East and Southeast Asia. Although patients benefit from the main NPC treatments (e.g., radiotherapy and concurrent chemotherapy), persistent and recurrent diseases still occur in some NPC patients. Therefore, investigating the pathogenesis of NPC is of great clinical significance. In the present study, replication factor c subunit 4 (RFC4) is a key potential target involved in NPC progression via bioinformatics analysis. Furthermore, the expression and mechanism of RFC4 in NPC were investigated in vitro and in vivo. Our results revealed that RFC4 was more elevated in NPC tumor tissues than in normal tissues. RFC4 knockdown induced G2/M cell cycle arrest and inhibited NPC cell proliferation in vitro and in vivo. Interestingly, HOXA10 was confirmed as a downstream target of RFC4, and the overexpression of HOXA10 attenuated the silencing of RFC4-induced cell proliferation, colony formation inhibition, and cell cycle arrest. For the first time, this study reveals that RFC4 is required for NPC cell proliferation and may play a pivotal role in NPC tumorigenesis.
Humans ; Nasopharyngeal Carcinoma/pathology* ; Carcinoma/pathology* ; Replication Protein C/metabolism* ; Nasopharyngeal Neoplasms/pathology* ; Cell Line, Tumor ; Cell Proliferation ; Gene Expression Regulation, Neoplastic ; Cell Movement

Background The risks of unhealthy working mood and physical and mental health problems are high in the workers of petrochemical enterprises. Resilience is a positive psychological factor, which can provide positive ability to manage stress and job burnout, relieve tension, depression, anxiety, and other psychological discomfort. Objective To explore the moderating or mediating effect of resilience on the association between job burnout and sleep disorders in workers of petrochemical enterprises. Methods A survey with questionnaire of general information, resilience, job burnout (including exhaustion, cynicism, and professional efficacy), and sleep disorders was conducted among 1087 workers who were selected by cluster sampling from a petrochemical enterprise in Henan Province in April 2022. Mann-Whitney U test and Kruskal-Wallis H test were used to test the differences of scores among different demographic groups. Resilience, job burnout (including exhaustion, cynicism, and professional efficacy), and sleep disorder scores were analyzed by partial correlation analysis. The moderating effect of resilience was examined by linear regression analysis, and the mediating effect of resilience by Bootstrap method. Results A total of 861 questionnaires were collected, of which 857 were effective, and the effective rate was 99.5%. The M (P₂₅, P₇₅) of job burnout score was 1.24 (0.65, 2.22) and the incidence of job burnout was 36.4% (312/857); the scores [M (P₂₅, P₇₅)] of exhaustion, cynicism, and professional efficacy were 1.40 (0.80, 3.00), 1.00 (0.20, 1.60), and 5.50 (4.00, 6.00), respectively. The M (P₂₅, P₇₅) of resilience score was 36.00 (30.00, 41.00). The M (P₂₅, P₇₅) of sleep disorder score was 11.00 (7.00, 15.00). The partial correlation analysis results showed that job burnout, exhaustion, and cynicism were negatively correlated with resilience (r=−0.387, −0.248, −0.247, P<0.01), and positively correlated with sleep disorders (r=0.455, 0.445, 0.357, P<0.01); professional efficacy was positively correlated with resilience (r=0.366, P<0.01) and negatively correlated with sleep disorders (r=−0.184, P<0.01); resilience was negatively correlated with sleep disorders (r=−0.349, P<0.01). The linear regression analysis results found that job burnout, exhaustion, and cynicism elevated the risk of sleep disorders (P<0.01), resilience lowered the risk of sleep disorders (P<0.01); but the relationship between job burnout (exhaustion, cynicism, and professional efficacy) and sleep disorders was not moderated by resilience (P＞0.05). The mediating effect test showed that resilience played a partial mediating role in the associations of job burnout, exhaustion, cynicism, and professional efficacy with sleep disorders, the mediating effects were 0.522 (95%CI: 0.283-0.777), 0.310 (95%CI: 0.188-0.453), 0.364 (95%CI: 0.228-0.524), −0.542 (95%CI: −0.741-−0.366) and the mediating effects accounted for 17.31%, 14.12%, 19.24%, and 64.72% of the total effects, respectively. Conclusion The relationship between job burnout and sleep disorders is partially mediated by resilience among workers in the selected petrochemical company, but no moderating effect is found.