Objective:To analyze the burden and trends of noncommunicable chronic disease(NCD) attributable to metabolic factors in China from 1990 to 2021.Methods:Data from the Global Burden of Diseases(GBD) 2021 database were utilized to describe changes in mortality and disability-adjusted life years(DALYs) of NCD in China from 1990 to 2021. Stratified analyses were conducted by age, sex, sociodemographic index(SDI), and related risk factors. Statistical analyses and predictions were conducted using the age-period-cohort model and the Nordpred model.Results:In 2021, the age-standardized mortality rate and age-standardized DALYs rate of NCD attributable to metabolic factors in China were 227.56 per 100 000 and 4 829.39 per 100 000, respectively. Their average annual percentage changes were -0.76%( P<0.001) and -0.77%( P<0.001). Overall, the burden decreased progressively with higher SDI levels. Analysis using the age-period-cohort model indicated reduced birth cohort and period effects for metabolic factor-attributable NCD, while age effects rose significantly. The minimum relative risk( RR) value was observed in the 15-19 age group( RR=0.01), and the maximum RR value occurred in the 95-99 age group( RR=996.86). The overall rising mortality trend indicated that age effects are the predominant driver at present. Projections estimate that by 2046, deaths from metabolic factor-attributable NCD in China will reach 8 189 563, with an age-standardized mortality rate of 236.95 per 100 000. Conclusions:China continues to face a substantial burden of NCD linked to metabolic factors, with older adults, males, and individuals with hypertension, diabetes, and prediabetes identified as key populations requiring targeted interventions.

Objective:To analyze the burden and trends of noncommunicable chronic disease(NCD) attributable to metabolic factors in China from 1990 to 2021.Methods:Data from the Global Burden of Diseases(GBD) 2021 database were utilized to describe changes in mortality and disability-adjusted life years(DALYs) of NCD in China from 1990 to 2021. Stratified analyses were conducted by age, sex, sociodemographic index(SDI), and related risk factors. Statistical analyses and predictions were conducted using the age-period-cohort model and the Nordpred model.Results:In 2021, the age-standardized mortality rate and age-standardized DALYs rate of NCD attributable to metabolic factors in China were 227.56 per 100 000 and 4 829.39 per 100 000, respectively. Their average annual percentage changes were -0.76%( P<0.001) and -0.77%( P<0.001). Overall, the burden decreased progressively with higher SDI levels. Analysis using the age-period-cohort model indicated reduced birth cohort and period effects for metabolic factor-attributable NCD, while age effects rose significantly. The minimum relative risk( RR) value was observed in the 15-19 age group( RR=0.01), and the maximum RR value occurred in the 95-99 age group( RR=996.86). The overall rising mortality trend indicated that age effects are the predominant driver at present. Projections estimate that by 2046, deaths from metabolic factor-attributable NCD in China will reach 8 189 563, with an age-standardized mortality rate of 236.95 per 100 000. Conclusions:China continues to face a substantial burden of NCD linked to metabolic factors, with older adults, males, and individuals with hypertension, diabetes, and prediabetes identified as key populations requiring targeted interventions.

Modulating Tankyrases (TNKS), interactions with USP25 to promote TNKS degradation, rather than inhibiting their enzymatic activities, is emerging as an alternative/specific approach to inhibit the Wnt/β-catenin pathway. Here, we identified UAT-B, a novel neoantimycin analog isolated from Streptomyces conglobatus, as a small-molecule inhibitor of TNKS-USP25 protein-protein interaction (PPI) to overcome multi-drug resistance in colorectal cancer (CRC). The disruption of TNKS-USP25 complex formation by UAT-B led to a significant decrease in TNKS levels, triggering cell apoptosis through modulation of the Wnt/β-catenin pathway. Importantly, UAT-B successfully inhibited the CRC cells growth that harbored high TNKS levels, as demonstrated in various in vitro and in vivo studies utilizing cell line-based and patient-derived xenografts, as well as APC^min/+ spontaneous CRC models. Collectively, these findings suggest that targeting the TNKS-USP25 PPI using a small-molecule inhibitor represents a compelling therapeutic strategy for CRC treatment, and UAT-B emerges as a promising candidate for further preclinical and clinical investigations.

Objective:To construct an evaluation indicator system for the efficiency of nursing human resources in integrated medical and elderly care institutions using Data Envelopment Analysis (DEA) and subsequently evaluate its effectiveness.Methods:This cross-sectional survey utilized literature review and investigative methods to initially establish a library of evaluation indicators for nursing human resource efficiency. The Delphi method was employed in two rounds of consultations with 17 experts from various fields, including nursing management, elderly care institution management, integrated medical and elderly care institution management, health economics management, and public health. The reliability of the indicator system was assessed based on factors such as expert enthusiasm, authority, concentration of opinions, and coordination. Adjustments, modifications, and improvements were made to the indicators based on expert opinions to establish the final indicator system. From August to December 2022, the DEA model was applied to evaluate the efficiency of 12 integrated medical and elderly care institutions in Haikou city based on this indicator system.Results:The constructed evaluation indicator system comprised 68 items divided into three levels: 9 primary indicators, 19 secondary indicators, and 40 tertiary indicators. The positive coefficients of the two rounds of expert consultations were 100% and 94.1%, with authority coefficients of 0.88 and 0.92, Kendall harmony coefficients of 0.471 and 0.348, and mean coefficients of variation of 0.16 and 0.12 ( P<0.001). DEA evaluation results for the 12 integrated medical and elderly care institutions showed that 5 were DEA effective institutions with comprehensive efficiency (OE), technical efficiency (TE), and scale efficiency (SE) values all equal to 1.000, while 7 were non-DEA effective institutions, including 4 with SE <1.000 but TE=1.000 and 3 with both SE and TE<1.000. Conclusions:The constructed evaluation indicator system demonstrates high enthusiasm, authority coefficients, and coordination in expert consultations, indicating high acceptability and comprehensive content with distinct levels and strong specialty characteristics. The DEA model′s evaluation results objectively and effectively reflect the efficiency of nursing human resources in integrated medical and elderly care institutions, demonstrating practical utility.

This study aims at elucidating on the concept, strategy and implementation effect of constructing medical English teaching resource based on multi-online medium in medical colleges and universities. The medical English teaching resource based on multi-online medium breaks through the limitations of traditional paper-based teaching materials, optimizes the existing teaching resources and forms a multi-dimensional medical English teaching system with multi-modal interactions. It not only transforms the teaching organization of medical English course, but also innovates the teaching concept, teaching mode as well as teaching methodology. It has important practical significance for improving the medical English learning environment of medical college students and improving the teaching quality and efficiency of medical English course.

Objective:To retrieve and obtain evidence related to postoperative rehabilitation training of patients with lumbar disc herniation and to summarize the best evidence.Methods:The computer was used to search domestic and foreign guideline networks, evidence-based databases, original research databases and orthopedic related websites for relevant evidence on rehabilitation training for patients with lumbar disc herniation after surgery, including evidence summary, guidelines, expert consensus, systematic review and Meta-analysis. The retrieval time limit was from the establishment of the database to April 30, 2021. The literature quality evaluation, evidence extraction, classification and integration were conducted independently by two researchers, and disagreements were discussed or adjudicated by a third party.Results:A total of 14 articles were included, including 3 evidence summaries, 1 guideline, 6 expert consensuses, and 4 systematic reviews. A total of 13 best evidences of rehabilitation training for patients with lumbar disc herniation after surgery were summarized in 8 categories, including rehabilitation assessment, rehabilitation principle, rehabilitation time, rehabilitation intensity, rehabilitation mode, patient education, rehabilitation psychotherapy and follow-up monitoring.Conclusions:This study can provide evidence-based basis for nursing staff to carry out postoperative rehabilitation guidance, but in clinical practice, physical, psychological and cultural background conditions of patients should be comprehensively assessed, and individualized rehabilitation programs should be formulated for patients based on local medical level and conditions.

Objective To analyze the economic burden and its influencing factors of brucellosis for providing scientific basis to targeted epidemic prevention and control in Gansu Province.Methods A total of 226 outpatients and inpatients treated at different levels of medical institutions in Jingyuan County of Gansu Province during 2013 to 2016 were selected as research subjects.The basic information (sex,age,education level,family income,etc.) of the subjects was collected according to the questionnaire.By consulting the patient's hospital billing settlement list,outpatient billing invoices,and related bills,the information about the cost of visiting the patient due to brucellosis,cost information of the paramedics and the visiting staff was obtained.A Kruskal-Wallis rank-sum test was used for univariate analysis to analyze the direct medical costs and total costs of patients with various diseases,including gender,occupation,age,education level,per capita income,misdiagnosis,medical institution level,different stages,and different types of disease.The generalized multiple linear regression model was used to analyze the relationship between misdiagnosis,different stages,different types of brucellosis,medical institution levels,and the direct medical expenses and total costs of ill patients.Results Of the 226 patients with brucellosis,each person was hospitalized twice a year and stayed in hospital for 28 days.Direct medical expenses of 115 cases with acute brucellosis and 111 cases of chronic patients,direct non-medical expenses,indirect economic losses and total expenses were 11 835,1 850,2 475,16 396 and 16 733,3 240,4 748,24 188 Yuan RMB,respectively.The western medicine fee of direct medical treatment of acute brucellosis was 67.95％ (8 042/11 835),the inspection fee was 16.92％ (2 002/11 835) and the examination fee was 9.02％ (1 068/11 835).The cost of western medicine for chronic and complications was 39.82％ (6 663/16 733),37.50％ (6 339/16 904),the inspection fee was 27.37％ (4 580/16 733),24.30％ (4 108/16 904),the examination fee was 13.32％ (2 229/16 733),15.46％ (2 613/16 904),and the traditional Chinese medicine cost was 9.34％ (1 563/16 733) and 10.11％ (1 709/16 904).The results of univariate analysis showed that there were significant differences in the direct medical expenses and total costs of patients with misdiagnosis,medical institution level,different stages,and different types of brucellosis (P ＜ 0.05).The results of multivariate analysis showed that there was a positive correlation between misdiagnosis and provincial medical institutions and patients' direct medical expenses and total expenses (P ＜ 0.05).Conclusions It should give rise to enough attention that the burden of different types of brucellosis is heavy.Local medical institutions should refer to "Guidelines for the Diagnosis and Treatment of Brucellosis" (2012) to carry out standardized diagnosis and treatment,reduce the complications of brucellosis and chronic brucellosis.Therefore,strengthening the training of medical personnel,standardize diagnosis and treatment of brucellosis in hospitals at all levels is very urgent.

Objective To explore the Hobiletin improving cognitive function and the possible mechanism to protect the hippocampal neurons.Methods Eight of Wistar rats,SPF,12 weeks of age,male,were set to the normal group;Eight of GK male rats,SPF,12 weeks of age,only for diabetes group;Both of the two groups were given the normal feed.6 of GK male rats,12 weeks of age,to feed Hobiletin of orange peel 10 mg/kg and lavage for 8 weeks,were set to the NOB group.After 22 weeks the rats were tested by Morris water maze behavior experiment for test the ability of learning and memory;the expression of Nrf-2 was detected by immunohistochemistry and Western Blot.Results Compared with the normal group,the incubation period of diabetes group was longer (P＜0.05),and theescape latency of NOB group was shorter than that of diabetes group (P＜0.05).Compared with the normal group,the residence time in the target quadrant was shorter in the diabetes group (P＜0.05),and prolonged in the NOB group than in the diabetes model group (P＜0.05).The expression of Nrf-2 in diabetes group was significantly higher than that in diabetes group (P＜0.05).The expression of NH-2 in NOB group was significantly higher than that in diabetes group (P＜0.05).Conclusion NOB can increase the expression of Nrf-2 in hippocampus and improve the cognitive function of diabetic rats,which may be related to the enhancement of Nrf-2 activity and the activation of anti-oxidative stress pathway.

Objective To analyze the knowledge and perceptions of brucellosis and human behavior in different populations in Jingyuan County Gansu Province,and to provide a scientific basis for carrying out health education and prevention accurately on brucellosis.Methods In 2015,using two-stage cluster sampling method,nine towns with more accumulative incidence of brucellosis in the past 3 years in Jingyuan Country were selected,5 villages were selected from each town,occupational exposure and patients with brucellosis were selected in each village as respondents.A questionnaire survey was carried out to collect basic information,brucellosis related knowledge,population's behavio.Results The overall awareness rate of prevention and control knowledge on brucellosis was 44.10％ (12 943/29 348),included 809 people with the occupation exposure population and 203 patients with brucellosis,among them,the rate of patients with brucellosis knowledge was 50.40％ (2 967/5 887),occupational exposure population was 42.52％ (9 976/23 461);There were significant differences in the awareness rate of knowledge on prevention and control of brucellosis in population of different gender,age,education and years of work experience (x2 =84.413,166.100,207.200,16.822,P ＜ 0.01);of the following parameters:shared water,peel dead lamb,How to deal with flow products,treatment of abortion without gloves,masks,not wearing gloves,masks when lambing ,to give livestock vaccines and drugs,eat dead cow,lamb,and sale of diseased,dead livestock,slaughter livestock,there were statistical significant differences between patients with brucellosis and exposure people (x2 =13.940,27.965,30.031,19.575,22.597,21.139,14.524,436.450,8.482,P ＜ 0.05).Conclusions The occupational exposure population has a low knowledge awareness rate;high risk behaviors have higher risk of brucellosis infection in Jingyuan County.We should carry out health education and high-risk behavior intervention in targeted population.

Objective To explore the impact of the systematic social skills training on recovery of in -patients with chronic schizophrenia.Methods A total of 78 cases of long -term hospitalized patients with chronic schizophrenia were randomly divided into intervention group and control group on the basis of random number table. The two groups received psychiatric routine therapy and nursing,and general entertainment therapy,and the patients in the intervention group received group social skills training for 12 weeks.IPROS and SSSI were respectively used to evaluate two groups before the intervention,trained for 12 weeks.Results After 12 weeks'of systematic social skills training,social function defect levels SSSI score in the intervention group was apparently higher than that in the control group,and the difference was significant (χ2 =8.952,P <0.05 ).Compared with the control group (19.4 ± 4.5)points,(16.5 ±4.7 )points,(13.6 ±4.1 )points,(5.5 ±3.1 )points,(18.2 ±4.2 )points,(73.2 ± 16.3)points,in the intervention group public medical situation (10.3 ±5.5)points,life ability(12.1 ±5.7)points, social ability(6.2 ±3.5)points,antiseptic ability (3.3 ±3.3)points,concern and interest (9.6 ±4.5)points as well as the total score of IPROS (44.6 ±20.4),the differences were significant(t =7.760,6,188,8.165,2.568, 6.632,8.259,all P <0.05).Compared with before intervention,each factor in IPROS and the total score in the inter-vention group had statistically significant differences (t =8.890,7.923,8.321,3.195,8.21,9.852,all P <0.01). Conclusion The systematic social skills training can greatly promote the recovery of in -patients with chronic schiz-ophrenia,improve their social skills and life qualities.Compared with control group,the social function of patients in the intervention group has recovered positively.