The Occupational Classification Dictionary of the People's Republic of China (2015 Edition) has added a new occupation type, Medical Nursing Assistants, aiming to meet the strong demand for medical care in the context of the aging population in China.In order to standardize the services of medical nursing assistants for the elderly in home and community settings and contribute to healthy aging, the National Health Commission issued the " Service Standards for Medical Nursing Assistants of Older Adults in Home and Community" ( WS/ T 803—2022) on September 28, 2022.The standards regulate the service processes, service items and requirements, as well as service evaluation and improvement for elderly medical nursing assistants.The interpretation of the standard's formulation background, the compilation process, and the standard's content are as follows.

Objective:To screen the key genetic,diagnostic and therapeutic targets of chronic obstructive pulmonary disease(COPD)patients by using microarray datasets and Mendelian randomization(MR)method,and to provide the evidence for clinical diagnosis and treatment of COPD.Methods:Four COPD gene expression profile datasets were obtained from the Gene Expression Omnibus(GEO)database.The data were processed and normalized using R software,and differentially expressed genes(DEGs)were screened.MR analysis was performed to explore the causal relationship between COPD and expression quantitative trait loci(eQTL),intersection with DEGs was taken to identify potential key targets.Gene Set Enrichment Analysis(GSEA),Gene Ontology(GO)functional enrichment analysis,and Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling pathway enrichment analysis were conducted to investigate the functional roles and pathways of the key targets,external datasets were used to validate their expression.Results:A total of 1 571 DEGs were screened,including 820 upregulated genes and 751 downregulated genes.MR analysis identified 286 COPD-related genes,and intersection with DEGs revealed 3 upregulated genes:diacylglycerol kinase gamma(DGKG),neurofilament heavy polypeptide(NEFH),and Fc receptor like B(FCRLB);and 6 downregulated genes:STEAP4 metalloreductase(STEAP4),pleckstrin homology domain containing family F member 2(PLEKHF2),CD3d molecule(CD3D),transgelin 2(TAGLN2),tripartite motif containing 22(TRIM22),and ribosomal protein L9(RPL9).The biological function analysis results indicated that these genes were mainly involved in pathways such as iron ion transport into the cells,oxidoreductase activity,primary immunodeficiency,and Th1 and Th2 cell differentiation.The MR analysis results confirmed the causal relationship between these targets and COPD.The external validation results showed that compared with healthy controls,the expression level of FCRLB in COPD samples was significantly increased(P<0.01),while the expression levels of CD3D and RPL9 were significantly decreased(P<0.05 or P<0.01),which was consistent with the MR analysis results,highlighting the reliability of this study.Conclusion:DGKG,NEFH,FCRLB,STEAP4,PLEKHF2,CD3D,TAGLN2,TRIM22,and RPL9 may serve as important regulatory factors and clinical diagnostic/therapeutic targets in the pathogenesis of COPD,providing clues for early screening,diagnosis,and targeted treatment of COPD.

The Occupational Classification Dictionary of the People's Republic of China (2015 Edition) has added a new occupation type, Medical Nursing Assistants, aiming to meet the strong demand for medical care in the context of the aging population in China.In order to standardize the services of medical nursing assistants for the elderly in home and community settings and contribute to healthy aging, the National Health Commission issued the " Service Standards for Medical Nursing Assistants of Older Adults in Home and Community" ( WS/ T 803—2022) on September 28, 2022.The standards regulate the service processes, service items and requirements, as well as service evaluation and improvement for elderly medical nursing assistants.The interpretation of the standard's formulation background, the compilation process, and the standard's content are as follows.

Objective·To analyze the epidemiological characteristics of risk factors for cardiovascular diseases and malignant tumors based on the Shanghai community elderly cohort.Methods·The study subjects were selected from the Shanghai community elderly cohort established from February to August 2019,with a total of 17 948 people.The study subjects were divided into 4 groups according to self-reported presence or absence of tumors and/or cardiovascular diseases during the baseline survey:tumor-free and non-cardiovascular disease group,single cardiovascular disease group,single tumor group and tumor cardiovascular disease co-occurrence group.The differences among the four groups of subjects were collected and compared in terms of demographic characteristics and physiological indicators,daily living habits(smoking,drinking tea,drinking coffee,drinking carbonated drink,drinking alcohol,sedentary time,physical activity level and sleep quality),past medical history,psychological status(depression and anxiety)and dietary compliance.Results·Among the study subjects,60.1%of tumor patients were complicated with cardiovascular diseases.The differences among the four groups of subjects in age,gender,educational level,pre-retirement occupation,waist circumference,hip circumference and body mass index were statistically significant(all P<0.05).Compared with the tumor-free and non-cardiovascular disease group,the single cardiovascular disease group,single tumor group and tumor cardiovascular disease co-occurrence group all exhibited lower proportions of smoking and high physical activity levels(all P<0.05),and higher proportion of sedentary time exceeding 4 h/d and poor sleep quality(all P<0.05);the proportion of subjects with past medical histories including hyperlipidemia,peripheral vascular disease,endocrine system disease,respiratory system disease,urinary system disease and digestive system disease of the single cardiovascular disease group and the tumor cardiovascular disease co-occurrence group was higher(all P<0.05),and the proportion of subjects with depression and anxiety was also higher(all P<0.05).Furthermore,compared with the tumor-free and non-cardiovascular disease group,the single cardiovascular disease group had lower compliance rates of poultry,fish,fruit and liquid milk(all P<0.05).Among the four groups,only the compliance rate of vegetable intake exceeded 50%,while the compliance rates of poultry,fish,fruit,liquid milk and tubers were all below 20%.Conclusion·In the elderly population of Shanghai communities,over half of malignant tumor patients are concomitant with cardiovascular diseases.Unhealthy daily habits are prevalent among those with cardiovascular diseases,tumors and tumor-cardiovascular disease co-occurrence.The intake of many foods in the elderly of the community do not reach the levels recommended by Chinese Dietary Guidelines.

Objective·To compare the physical activities of stroke population and non-stroke population based on the baseline survey of the elderly population cohort in Shanghai communities,and explore the participation in different types of physical activities of stroke population.Methods·The subjects were screened from Shanghai Community Elderly Cohort constructed from February to August,2019 according to the admission criteria.The subjects were divided into non-stroke group and stroke group according to whether they had reported a history of stroke by themselves,and the two groups were matched 2 to 1 by controlling age and sex with propensity score matching.The baseline characteristics of the two groups were collected,and the physical activities related to sports,transportation and housework in the last week were investigated with the International Physical Activity Questionnaire(IPAQ).Pittsburgh Sleep Quality Index(PSQ1)was used to evaluate the sleep quality of the subjects.Generalized Anxiety Disorder(GAD-7)and Patient Health Questionnaire-9(PHQ-9)were used to evaluate anxiety and depression of the subjects,respectively.The above characteristics were compared between the stroke group and non-stroke group,and the participation of different types of physical activities were compared between the two groups by multivariate Logistic regression model.Results·Among the 17 948 people included,there were 993(5.5％)in the stroke group and 16 955(94.5％)in the non-stroke group.After propensity score matching,there were 1 984 people(66.7％)in the non-stroke group and 992 people(33.3％)in the stroke group.There were significant differences in education level,pre-retirement occupation,waist circumference,body mass index,sleep status,anxiety symptoms,depression symptoms and disease history between the two groups(all P＜0.05).In terms of physical activities,the female stroke group had shorter daily moderate exercises time,fewer riding and walking days in one week,and shorter daily riding time,compared with the non-stroke people,with statistical significance(all P＜0.05).Compared with the non-stroke people,the weekly housework days and daily housework time in the male and female stroke groups were lower than those in the non-stroke group,while the daily sedentary time was longer,with statistical significance(all P=0.000).In terms of physical activity level,the proportions of men and women in the stroke group who reached medium or high level were lower than those in the non-stroke group,and the differences were statistically significant(all P=0.000).After adjusting for gender,age,occupation,anxiety symptoms,history of hyperlipidemia,history of atrial fibrillation,history of chronic gastritis and history of hip fracture by multivariate Logistic regression model,the level of vigorous exercise participation in the stroke group was lower,the proportions of no housework in the last week and sedentary time greater than 180 min per day were higher,and the proportion at medium and high activity levels was lower(all P＜0.05).Conclusion·The frequency and duration of housework participation and the physical activity level of elderly people with a history of stroke in Shanghai communities are at a lower level than those without stroke,and they also have a longer sedentary time.

ObjectiveTo observe the effect of Danshen injection （DAN） on platelet （PLT）-induced metastasis of breast cancer cells in vitro. MethodThe 3-（4，5-dimethylthiazol-2-yl）-2，5-diphenyltetrazolium bromide （MTT） assay was used to observe the effect of DAN on the growth of MDA-MB-231 cells in vitro. Oris™ migration assay was used to determine the effect of DAN （final mass concentrations 4， 8， 16 g·L^-1） on PLT （1.5×10¹⁰ cells/L）-induced migration of breast cancer cells in vitro. The effect of DAN on PLT-induced cell invasion was detected by Transwell assay. Immunofluorescence and Western blot were used to detect the effect of DAN on the protein expression associated with PLT-induced epithelial-mesenchymal transition （EMT）. In addition， enzyme-linked immune-sorbent assay （ELISA） was used to determine the effect of DAN （final mass concentrations 4， 8， 16， 32， 64 g·L^-1） on the secretion of transforming growth factor-β₁ （TGF-β₁）. Western blot was used to observe the effect of DAN on the expression of podoplanin （PDPN） protein in MDA-MB-231 cells induced by PLT. ResultCompared with the blank group， the DAN groups （32 and 64 g·L^-1） showed decreased A₅₇₀ （P<0.05， P<0.01）， and there was no significant difference in A₅₇₀ between DAN groups （4， 8， 16 g·L^-1）. Compared with the blank group， the PLT group showed increased cell migration and invasion， while DAN groups significantly inhibited PLT-induced cell migration and invasion. Compared with the blank group， the PLT group showed decreased expression of E-cadherin， while DAN could significantly reverse this effect of PLT. Compared with the blank group， the PLT group showed increased Slug and Snail protein expression （P<0.05， P<0.01）， while DAN significantly reversed Snail protein expression induced by PLT （P<0.05， P<0.01）. The content of TGF-β₁ in the PLT group increased （P<0.01）， while the secretion of TGF-β₁ induced by PLT decreased in the DAN groups （16， 32， and 64 g·L^-1） （P<0.05， P<0.01）， and the secretion of TGF-β₁ was not significantly affected in other DAN groups. PDPN protein expression in the PLT group increased （P<0.01）， while DAN could significantly inhibit PLT-induced PDPN expression （P<0.01）. ConclusionDAN can inhibit PLT-induced migration， invasion， and EMT of breast cancer cells. The mechanism may be related to the direct action between breast cancer cells and tumor cells by down-regulating PDPN expression and interfering with PLT and has nothing to do with the effect of TGF-β₁ secretion of PLT.

OBJECTIVE： To study the effects of glycyrrhizic acid on the pharmacokinetics of nifedipine in rats. METHODS： Rats were randomly divided into experimental group and control group， with 10 rats in each group. Experimental group was given glycyrrhizic acid 5 mg/kg and control group was given 0.5％ CMC-Na （sodium carboxymethylcellulose） solution， once a day， for 14 consecutive days. On 14th day after 30 min of intragastric administration， both groups were given nifedipine 3 mg/kg intragastrically. Blood samples 0.5 mL were collected from intraocular vein plexus before and at 0.25， 0.5， 0.75， 1， 1.5， 2， 3， 4， 6， 8， 12 and 24 h after intragastric administration. The concentration of nifedipine was determined by HPLC using diazepam as internal standard. The determination was performed on ODS-C18 column with mobile phase consisted of methanol-water （62 ∶ 38，     V/V，pH adjusted to 4.5 with acetic acid） at the flow rate of 1.0 mL/min. The column temperature was 30 ℃. The detection wavelength was set at 238 nm， and sample size was 20 μL. The pharmacokinetic parameters were calculated with Winonlin 6.0 software， and statistical analysis was performed by t-test. RESULTS： The main pharmacokinetic parameters of the experimental group and the control group were as follows as tmax was （1.40±0.15）， （1.50±0.01） h； cmax was （0.15±0.03）， （0.29±0.09）      mg/L； t1/2 was （4.70±1.17）， （5.20±1.38） h； AUC0-24 h were （1.00±0.10）， （1.89±0.37） mg·h/L； AUC0-∞ was （1.00±0.16）， （1.98±0.32） mg·h/L； MRT was （6.76±0.64）， （6.60±1.36） h， respectively. Compared with control group， cmax， AUC0-24 h and AUC0-∞ of nifedipine were decreased significantly in experimental group， with statistical significance （P＜0.05）. CONCLUSIONS： Glycyrrhizic acid can reduce the bioavailability of nifedipine in rats. It is suggested that the dosage of nifedipine should be increased in order to achieve effective blood concentration.

Objective:To optimize the preparation technology of rutin nanoemulsion. Methods:The pseudoternary phase diagram of rutin nanoemulsion under the condition of different Kmwas drawn. With the drug loading and the particle size as the independent var-iables,and the percent of oil and the weight ratio of surfactant to cosurfactant as the dependent variables, the blank formula of rutin nanoemulsion was optimized by central composite design-response surface method. Results:The optimal formula was as follows:the ra-tio of ethyl oleate, cremopher RH40,1,2-propanediol and water was 7: 13: 5: 25. The average particle size of the prepared rutin nanoemulsion was 26.51 nm,and the drug loading was 8.97 mg·ml-1. Conclusion:The central composite design-response surface method can obtain a good formula of rutin nanoemulison,and the model has a good predictive function.

With the rapid development of cell biology and biological materials, the dentine-pulp complex regeneration research has gone further. Scaffolds play important roles in the construction of tissue engineered dentine-pulp complex. At present, scaffolds used in dentine-pulp complex regeneration include not only natural biological materials and synthetic biomaterials, but also various composite materials and cell- or body-based carrier materials. In this paper, the latest research status of various scaffolds for dentine-pulp complex regeneration were reviewed. The advantages and problems of these scaffolds were analyzed. The future development direction was predicted.

Objective To explore the effect of the Internet technology′s application on the hand hygiene compliance of medical staff. Methods Establishing Internet+hand hygiene management model to implement Internet based hand hygiene supervisory and reminding, Internet based hand hygiene publicity and education, and Internet based hand hygiene feedback and communication. This model was applied in Guangdong Provincial Dermatology Hospital to intervene the hand hygiene related activities. Before and after the intervention, the hand hygiene compliance of medical staff in the trial hospital was observed with WHO hand hygiene monitoring table by directly manual observation. Thereafter, the changes of hand hygiene compliance before and after the intervention were compared based on the statistical analysis of test results. Results With the application of Internet+hand hygiene management model, the hand hygiene compliance of medical staff increased from 41.75% (324/776) before the intervention to 72.14% (554/768) after the intervention, and the difference was statistically significant (χ2=145.264, P<0.01). The hand hygiene compliance of both doctors and nurses was significantly increased (doctors: χ2=94.784, P<0.01;nurses:χ2=58.798, P<0.01). In all the five indications, i.e., before patient care, before an aseptic task, after exposure to blood/body fluids, after patient care, and after environmental contact, the hand hygiene compliance was 35.42%(68/192), 63.33%(38/60), 84.38%(54/64), 44.83%(130/290), and 20.00%(34/170) respectively before the intervention;it was 65.38%(102/156), 83.33%(120/144), 95.45%(105/110), 68.52%(148/216), and 55.63%(79/142) after the intervention; and the difference before and after the intervention was statistically significant (χ2=6.305-42.529;P<0.01 or 0.05). Most of the medical staff of the trial department supported this model. Conclusions Internet+ hand hygiene management model could significantly improve the hand hygiene compliance of medical staff and were very popular. And, the model is worth of application in more hospitals.