Objective: To analyze the developmental trajectories of clustered health risk behaviors and their association with self-esteem and lonelinesss among junior high school students, so as to provide a reference for formulating comprehensive prevention and control measures of health risk behaviors among adolescents. Methods: In October 2023, 1 165 first year junior high school students from two schools of Jishou City in Hunan Province were selected by convenient sampling method for three follow up surveys (T1:October 2023; T2:April 2024; T3:October 2024). The Adolescent Health Risk Behavior Questionnaire, Rosenberg Self esteem Scale and Loneliness Scale were used to assess health risk behaviors, self esteem and loneliness, respectively. Latent growth curve modeling and latent growth mixture modeling were applied to analyze the developmental trajectories of clustered health risk behaviors among junior high school students. Logistic regression was used to analyze the association of the developmental trajectories of clustered health risk behaviors with self esteem and loneliness among junior high school students. Results: The overall developmental trajectories among junior high school students showed a declining trend (intercept=0.15, slope=-1.65, both P <0.05), with three heterogeneous categories:low risk improvement group ( n =862, 74.0%), moderate risk stable group ( n =260, 22.3%), and high risk deterioration group ( n =43, 3.7%). After adjusting the status of the left behind individuals，using the low risk improvement group as the reference category in multinomial Logistic regression analysis, results indicated that higher loneliness scores among junior high school students increased the risks of belonging to the moderate risk stable group ( OR=1.02, 95%CI =1.00- 1.04 ) and the high risk deterioration group ( OR=1.04, 95%CI =1.00-1.08), while higher self esteem scores reduced the risks of belonging to the moderate risk stable group ( OR=0.93, 95%CI =0.91-0.96) and the high risk deterioration group ( OR=0.88, 95%CI =0.83-0.94) (all P <0.05). Conclusions The overall trend of clustered health risk behaviors among junior high school students gradually improves, and the self esteem and loneliness are significant correlative factors. Targeted intervention measures should be developed for the junior high school students, with a focus on enhancing their self esteem and alleviating loneliness.

This study aimed to localize the workplace readiness questionnaire (WRQ) and validate its applicability for assessing readiness for implementation of evidence-based practices (EBP) in primary care settings in China. The localization of the instrument will provide a practical instrument for assessing organizational readiness for change (ORC).

Objective:To introduce the research and innovations around the application of aquatic rehabilitation techniques in the treatment of lumbago, and to summarize specific methods and applications in aeromedicine. Literature resource and selection Literature on the prevention and treatment of lumbago using aquatic rehabilitation techniques as well as on the rehabilitation of lumbago in pilots was retrieved and selected. Literature quotation Sixty-one references were cited. Literature synthesis Aquatic rehabilitation techniques can be classified into shower therapy, immersion therapy, and aquatic exercise therapy according to treatment regimens. Among them, immersion therapy and aquatic exercise therapy are commonly used in the treatment of lumbago. Aquatic rehabilitation techniques can effectively alleviate patients′ lumbago, improve their functional disorders, and enhance their quality of life. Prior to aquatic therapy, patients with lumbago need to have their motor function assessed to tailor the treatment protocol based on diagnostic findings and specific therapeutic objectives. Aquatic rehabilitation techniques, when used to prevent and treat lumbago in pilots under convalescence, are not only more effective than land-based training, but also more accessible to pilots due to their comfort and compliance. Many of our military rehabilitation and convalescent centers in China have integrated modern aquatic rehabilitation techniques into rehabilitation treatment by drawing on their rich water resources so as to improve the physical and mental health, social adaptability and military adaptability of pilots. Conclusions:When used for the prevention and treatment of lumbago, aquatic rehabilitation techniques are highly effective, safe and enjoyable, so they should be made more accessible to pilots during convalescence.

Objective:To explore the effectiveness of the"full-chain"integrated medical and elderly care service model in addressing key issues in medical-nursing services such as weak medical support capacity and insufficient provision of community-and home-based medical-nursing services.Methods:The development pathway for the"full-chain"integrated medical-elderly care service standardization system,encompassing core components such as operational mechanisms,smart platforms,policy documents,and quality control systems was systematically outlined.Effectiveness based on dimensions including service coverage,quality improvement,talent development,and social benefits was evaluated.With standardization as the core driver,the'1234567'management model was innovatively implemented.Results:The model leveraged the downward allocation of high-quality resources from tertiary general hospitals to strengthen subdistrict community health service centers.By collaborating with subdistrict elderly-care service centers,it established"subdistrict medical-elderly care and wellness service centers".These centers enhanced the capabilities of"community-embedded elderly-care complexes",including community daytime care centers,established two-way referral channels between medical and elderly care services,aligned with healthcare demands to provide elderly individuals with reliable medical support.It reduced the burden on families and society,stimulated market vitality,boosted domestic demand,promoted the development of integrated medical-elderly care and wellness initiatives,thereby advancing the silver economy.With provincial government endorsement,the model had been applied to 203 communities across 37 counties by the end of 2024.Conclusion:The established"full-chain"integrated medical-elderly care service model facilitates regional high-quality development in integrated care by consolidating healthcare group resources and seamlessly connecting the service chain across hospitals,nursing homes,community institutions,and home-based settings,thereby creating a practical paradigm for comprehensive elderly care service delivery.

Objective To compare the induction effects of direct treatment with low-temperature plasma(LTP)and treatment with plasma-activated medium(PAM)on immunogenic cell death(ICD)of melanoma cells.Methods After direct treatment of melanoma cell line B16F10 with LTP and treatment of it with PAM for 24 hours,cell viability was detected by MTT assay.Flow cytometry was used to detect cell apoptosis and the expression of calreticulin(CRT)on the cell surface.The adenosine triphosphate(ATP)content in the culture medium was detected by an ATP detection kit.The content of high-mobility group box 1(HMGB1)in the cell culture medium was detected by ELISA.B16F10 cells treated with LTP were co-cultured with immature dendritic cells(DC)DC2.4 cell line,and flow cytometry was used to detect DC surface molecules CD80 and CD86.Results Compared with the control group,both direct treatment and indirect treatment could lead to a decrease in the viability of B16F10 cells,an increase in the apoptosis rate,an increase in intracellular ROS,an increase in CRT expression,and an increase in the secretion of ATP and HMGB1(P＜0.05).At the same treatment time,the expression of CRT and the release of ATP in B16F10 cells directly treated with LTP were higher than those indirectly treated with PAM(P＜0.05).Compared with the DC2.4 group,the expression proportion of the DC cell maturation marker molecule CD80 was significantly increased in LTP-120s group,LTP-180s group,PAM-120s group,and PAM-180s group.The expression proportion of the DC cell maturation marker molecule CD86 was significantly increased in LTP-120s group,LTP-180s group,and PAM-180s group,and the difference was statistically significant(P＜0.05).Conclusion Both direct treatment with LTP and indirect treatment with PAM can induce ICD in melanoma cells.The direct treatment with LTP has a better induction effect.

The success of implementation research is closely tied to the institution's pre-implementation readiness. This study aims to explore the organizational readiness for change (ORC) and its influencing factors on primary healthcare settings in the implementation of the "Shared Medical Appointment for Diabetes (SMART) in China: design of an optimization trial" and to enhance ORC and provide insights to support the effective implementation of the program.

BACKGROUND:Gradient artificial bone repair scaffolds can mimic unique anatomical features in musculoskeletal tissues,showing great potential for repairing injured musculoskeletal tissues. OBJECTIVE:To review the latest research advances in gradient artificial bone repair scaffolds for tissue engineering in the musculoskeletal system and describe their advantages and fabrication strategies. METHODS:The first author of the article searched the Web of Science and PubMed databases for articles published from 2000 to 2023 with search terms"gradient,bone regeneration,scaffold".Finally,76 papers were analyzed and summarized after the screening. RESULTS AND CONCLUSION:(1)As an important means of efficient and high-quality repair of skeletal system tissues,gradient artificial bone repair scaffolds are currently designed bionically for the natural gradient characteristics of bone tissue,bone-cartilage,and tendon-bone tissue.These scaffolds can mimic the extracellular matrix of native tissues to a certain extent in terms of structure and composition,thus promoting cell adhesion,migration,proliferation,differentiation,and regenerative recovery of damaged tissues to their native state.(2)Advanced manufacturing technology provides more possibilities for gradient artificial bone repair scaffold preparation:Gradient electrospun fiber scaffolds constructed by spatially differentiated fiber arrangement and loading of biologically active substances have been developed;gradient 3D printed scaffolds fabricated by layered stacking,graded porosity,and bio-3D printing technology;gradient hydrogel scaffolds fabricated by in-situ layered injections,simple layer-by-layer stacking,and freeze-drying method;and in addition,there are also scaffolds made by other modalities or multi-method coupling.These scaffolds have demonstrated good biocompatibility in vitro experiments,were able to accelerate tissue regeneration in small animal tests,and were observed to have significantly improved histological structure.(3)The currently developed gradient artificial bone repair scaffolds have problems such as mismatch of gradient scales,unclear material-tissue interactions,and side effects caused by degradation products,which need to be further optimized by combining the strengths of related disciplines and clinical needs in the future.

As one of the most delicate surgeries in the whole body, vitreoretinal surgery requires a high degree of refinement and stability of the surgeon's operation due to the limitation of the operating space, and the fact that any subtle surgical trauma can lead to serious visual function damage. Surgical robots can significantly improve the precision and safety of the vitreoretinal surgical procedures and have good application prospects. As an emerging technology, in recent years, scholars at home and abroad have carried out a lot of research on the surgical robot in the surgical treatment of vitreoretinal diseases, and have achieved certain research results. Starting from the development history of surgical robots, this review analyzes and summarizes the safety and stability of surgical robots assisted retinal endovascular surgery, subretinal injection, macular surgery and real-time manipulation of retinal laser photocoagulation, briefly generalized the challenges that surgical robots still faced, and aim to provide more research directions of surgical robots in the treatment of vitreoretinal diseases.

As one of the most delicate surgeries in the whole body, vitreoretinal surgery requires a high degree of refinement and stability of the surgeon's operation due to the limitation of the operating space, and the fact that any subtle surgical trauma can lead to serious visual function damage. Surgical robots can significantly improve the precision and safety of the vitreoretinal surgical procedures and have good application prospects. As an emerging technology, in recent years, scholars at home and abroad have carried out a lot of research on the surgical robot in the surgical treatment of vitreoretinal diseases, and have achieved certain research results. Starting from the development history of surgical robots, this review analyzes and summarizes the safety and stability of surgical robots assisted retinal endovascular surgery, subretinal injection, macular surgery and real-time manipulation of retinal laser photocoagulation, briefly generalized the challenges that surgical robots still faced, and aim to provide more research directions of surgical robots in the treatment of vitreoretinal diseases.

ObjectiveTo explore the pharmacological mechanism involved in the treatment of allergic cough （AC） by Xiaoer Huatan Zhike granules （XEHT） based on proteomics and network pharmacology. MethodsAfter sensitization by intraperitoneal injection of 1 mL suspension containing 2 mg ovalbumin （OVA） and 100 mg aluminum hydroxide， a guinea pig model of allergic cough was constructed by nebulization with 1% OVA. The modeled guinea pigs were randomized into the model， low-， medium- and high-dose （1， 5， 20 g·kg^-1， respectively） XEHT， and sodium montelukast （1 mg·kg^-1） groups （n=6）， and another 6 guinea pigs were selected as the blank group. The guinea pigs in drug administration groups were administrated with the corresponding drugs by gavage， and those in the blank and model groups received the same volume of normal saline by gavage， 1 time·d^-1. After 10 consecutive days of drug administration， the guinea pigs were stimulated by 1% OVA nebulization， and the coughs were observed. The pathological changes in the lung tissue were observed by hematoxylin-eosin staining. The enzyme-linked immunosorbent assay was performed to measure the levels of C-reactive protein （CRP）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， superoxide dismutase （SOD）， and malondialdehyde （MDA） in the bronchoalveolar lavage fluid （BALF） and immunoglobulin G （IgG） and immunoglobulin A （IgA） in the serum. Immunohistochemistry （IHC） was employed to observe the expression of IL-6 and TNF-α in the lung tissue. Transmission electron microscopy was employed observe the alveolar type Ⅱ epithelial cell ultrastructure. Real-time PCR was employed to determine the mRNA levels of IL-6， interleukin-1β （IL-1β）， and TNF-α in the lung tissue. Label-free proteomics was used to detect the differential proteins among groups. Network pharmacology was used to predict the targets of XEHT in treating AC. The Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analysis was performed to search for the same pathways from the results of proteomics and network pharmacology. ResultsCompared with the blank group， the model group showed increased coughs （P<0.01）， elevated levels of CRP， TNF-α， IL-6， and MDA and lowered level of SOD in the BALF （P<0.05， P<0.01）， elevated levels of IgA and IgG in the serum （P<0.05， P<0.01）， congestion of the lung tissue and infiltration of inflammatory cells， increased expression of IL-6 and TNF-α （P<0.01）， large areas of low electron density edema in type Ⅱ epithelial cells， obvious swelling and vacuolization of the organelles， karyopyknosis or sparse and dissolved chromatin， and up-regulated mRNA levels of IL-6， IL-1β， and TNF-α （P<0.01）. Compared with the model group， the drug administration groups showed reduced coughs （P<0.01）， lowered levels of CRP， TNF-α， IL-6， and MDA and elevated level of SOD in the BALF （P<0.05， P<0.01）， alleviated lung tissue congestion， inflammatory cell infiltration， and type Ⅱ epithelial cell injury， and decreased expression of IL-6 and TNF-α （P<0.01）. In addition， the medium-dose XEHT group and the montelukast sodium group showcased lowered serum levels of IgA and IgG （P<0.05， P<0.01）. The medium- and high-dose XEHT groups and the montelukast sodium showed down-regulated mRNA levels of IL-6， IL-1β， and TNF-α and the low-dose XEHT group showed down-regulated mRNA levels of IL-6 and TNF-α （P<0.05， P<0.01）. Phospholipase D， mammalian target of rapamycin （mTOR）， and epidermal growth factor receptor family of receptor tyrosine kinase （ErbB） signaling pathways were the common pathways predicted by both proteomics and network pharmacology. ConclusionProteomics combined with network pharmacology reveal that XEHT can ameliorate AC by regulating the phospholipase D， mTOR， and ErbB signaling pathways.