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.

Chronic heart failure （CHF） is an end-stage cardiac syndrome driven by multiple factors. Its pathological process involves interactions of multiple pathways such as energy metabolism dysfunction， neuroendocrine dysregulation， and myocardial fibrosis. Although current clinical medicine can alleviate symptoms through single-target approaches， significant limitations in reversing cardiac remodeling and disease progression remain. Puerarin， a major bioactive isoflavone constituent derived from Pueraria lobata， exhibits multidimensional pharmacological effects， such as vasodilatory effects， regulation of neuroendocrine balance， enhancement of metabolic homeostasis， and suppression of myocardial apoptosis. This review systematically integrated puerarin's multi-target regulatory network， elucidating its mechanisms such as improving energy metabolism by AMP-activated protein kinase/mechanistic target of rapamycin （AMPK/mTOR） pathway， inhibiting fibrosis mediated by transforming growth factor-β （TGF-β）/Smad signals， and attenuating oxidative-inflammatory cascades by regulating nuclear factor erythroid 2 （E₂）-related factor 2/nuclear transcription factor-κB（Nrf2/NF-κB） axis. Clinical research data was used to validate its efficacy in improving the left ventricular ejection function and reducing the therapeutic potential of cardiovascular events' risks. The study proposed that puerarin's "systemic regulation" characteristic breaks through the limitations of traditional single-target drugs and prospected its clinical translation pathway based on metabolomics and nano-delivery technology， offering an integrative perspective from molecular mechanisms to precise therapy for the research on modernization of traditional Chinese medicine.

Chronic heart failure （CHF） is an end-stage cardiac syndrome driven by multiple factors. Its pathological process involves interactions of multiple pathways such as energy metabolism dysfunction， neuroendocrine dysregulation， and myocardial fibrosis. Although current clinical medicine can alleviate symptoms through single-target approaches， significant limitations in reversing cardiac remodeling and disease progression remain. Puerarin， a major bioactive isoflavone constituent derived from Pueraria lobata， exhibits multidimensional pharmacological effects， such as vasodilatory effects， regulation of neuroendocrine balance， enhancement of metabolic homeostasis， and suppression of myocardial apoptosis. This review systematically integrated puerarin's multi-target regulatory network， elucidating its mechanisms such as improving energy metabolism by AMP-activated protein kinase/mechanistic target of rapamycin （AMPK/mTOR） pathway， inhibiting fibrosis mediated by transforming growth factor-β （TGF-β）/Smad signals， and attenuating oxidative-inflammatory cascades by regulating nuclear factor erythroid 2 （E₂）-related factor 2/nuclear transcription factor-κB（Nrf2/NF-κB） axis. Clinical research data was used to validate its efficacy in improving the left ventricular ejection function and reducing the therapeutic potential of cardiovascular events' risks. The study proposed that puerarin's "systemic regulation" characteristic breaks through the limitations of traditional single-target drugs and prospected its clinical translation pathway based on metabolomics and nano-delivery technology， offering an integrative perspective from molecular mechanisms to precise therapy for the research on modernization of traditional Chinese medicine.

Background Lead is a typical persistent environmental pollutant that can accumulate in bones for decades. During pregnancy, alterations in calcium metabolism promote the mobilization of bone lead, resulting in secondary exposure; however, the mechanisms by which pregnancy-associated bone lead mobilization affects maternal renal function remain unclear. Objective To investigate the role of mitochondrial dysfunction in pregnancy-related bone lead mobilization-induced renal injury. Methods Newly weaned female Wistar rats were randomly assigned to a control or a lead-exposed group administered either 0.05% sodium acetate or 0.05% lead acetate in drinking water. Following a 4-week lead exposure and a 4-week washout period, the females were co-housed with healthy age-matched males for mating. Rats were sacrificed at early (gestational day 3) and late (gestational day 17) pregnancystages, respectively. Renal histopathology was assessed using hematoxylin and eosin staining staining. Mitochondria-related indicators, including oxidative stress, inflammatory responses, and energy metabolism, were measured. Differential metabolites were identified using serum metabolomics. Results Renal injury in the lead-exposed pregnant rats progressed in a time-dependent manner, characterized by degeneration of proximal tubular epithelial cells, glomerular hyaline changes, and interstitial inflammatory cell infiltration. Repeated measures ANOVA indicated a significant interaction between the treatment factor (lead exposure) and the temporal factor (gestational stage) on renal injury (P<0.001). Further analysis of mitochondrial function-related indicators in late-pregnancy renal tissue revealed that the lead exposure group exhibited significantly increased levels of malondialdehyde (MDA) and reactive oxygen species (ROS) (P<0.05), accompanied by a reduction in superoxide dismutase (SOD) and reduced glutathione (GSH) activities (P<0.05); regarding inflammatory markers, levels of interleukin-18 (IL-18) and interleukin-1β (IL-1β) were elevated (P<0.01), whereas interleukin-33 (IL-33) was decreased in the lead-exposed group (P<0.05); energy metabolism-related indicators, including adenosine triphosphate (ATP) level, Na⁺-K⁺-ATPase and Ca²⁺-Mg²⁺-ATPase activities, and mitochondrial respiratory chain complexes I, III, and V activities, were significantly reduced (P<0.05) in the lead-exposed gorup. The typical differential metabolite N-methylisoleucine, identified through serum metabolomics analysis, was negatively correlated with blood lead levels, kidney injury scores, and IL-1β, while positively correlated with catalase (CAT) activity and Ca²⁺-Mg²⁺-ATPase. Conclusions Mitochondrial dysfunction may play a critical role in renal injury induced by bone lead mobilization during late gestation.

Objective:To construct a medical student professionalism evaluation system based on the Delphi method and provide a scientific tool for evaluation of medical education and clinical practice.Methods:Based on the Accreditation Council for Graduate Medical Education, the Canadian Medical Education Directives for Specialists, and the Chinese Resident Core Competency Framework, the indicators were selected through two rounds of Delphi consultation with 11 experts. The final medical professionalism evaluation system included 29 indicators in eight categories: professional ethics, dedication, humanistic qualities, systematic improvement ability, the process of medical professionalism, personal growth and help-seeking, patient-centered care, and teamwork. SPSS 29.0 software was used for data analysis, including descriptive statistics (mean ± standard deviation), analytic hierarchy process to determine the weights, and calculation of Cronbach's α coefficient, Spearman-Brown split-half reliability coefficient (0.929), and scale-level content validity index. The significance level was set at α=0.05. Results:The expert authority coefficients for the two rounds of consultation were 0.863 and 0.867, and the variations of Kendall coefficient of coordination were all <25.00%. The final evaluation system contained eight first-level indexes (the highest weight was 14.362% for professional ethics) and 29 second-level indicators. The system demonstrated high reliability and validity (Cronbach's α coefficient=0.912, scale-level content validity index/average=0.910). Conclusions:The professionalism evaluation system for medical students constructed in this study is scientific and practical, and can provide a reference for the quality assessment of medical education. The high reliability and validity of the evaluation system suggest that it is suitable for clinical practice and teaching feedback, though further localization to align with Chinese characteristics is necessary for further refinement.

Objective:To investigate the neurorestorative effect of basic fibroblast growth factor (bFGF) on neurological function recovery in rats with spinal cord injury and its potential mechanisms.Methods:Ninety adult SD rats were selected and randomly divided into 6 groups using a random number table: sham-operated group ( n=24), spinal cord injury group ( n=24), bFGF group ( n=24), bFGF autophagy pathway validation group ( n=6), bFGF+rapamycin group ( n=6), and bFGF+MHY1485 group ( n=6). A spinal cord injury model was established by impacting the T 10 spinal cord segment using a self-made Allen′s weight-drop impactor. The sham-operated group underwent a 3 cm midline dorsal incision without spinal cord injury; the bFGF group received immediate intrathecal injection of 100 μl bFGF solution (20 μg/L) after injury; the sham surgery group and spinal cord injury group received an equal volume of saline after injury; the bFGF autophagy pathway validation group received the identical treatment as the bFGF group; the bFGF+rapamycin group received the same treatment as the bFGF group with additional intraperitoneal injection of rapamycin (4 mg·kg -1·d -1); the bFGF+MHY1485 group received the identical bFGF treatment plus intraperitoneal injection of MHY1485 (10 mg·kg -1·d -1). At 28 days after injury, the rats were sacrificed and the spinal cord tissue was collected at 5 mm from the injury epicenter for HE staining and pathological observation. At 7, 14, 21, and 28 days after injury, BBB scoring was used to assess hindlimb motor function; P wave latency and P1-N1 wave amplitude were recorded to evaluate neuroelectrophysiological changes; Western blot analysis was performed to detect the expression levels of phosphorylated mammalian target of rapamycin (p-mTOR)/mammalian target of rapamycin (mTOR) and microtubule-associated protein light chain 3-II (LC3-II) and evaluate changes in mTOR signaling pathway and autophagy activity. At 28 days after injury, behavioral alterations, neuroelectrophysiological changes, and auctophagy-related protein expression levels were assessed in the bFGF autophagy pathyway validation group, bFGF+rapamycin group and bFGF+MHY1485 group. Results:At 28 days after injury, the sham-operated group exhibited regular nuclear morphology, while the spinal cord injury group showed disordered cell structures and the bFGF group displayed relatively normal nuclear morphology. At 7, 14, 21, and 28 days after injury, the BBB scores in both the spinal cord injury group and bFGF group were lower than those in the sham-operated group ( P<0.01), with higher scores in the bFGF group than those in the spinal cord injury group ( P<0.01). At 7, 14, 21, and 28 days after injury, P-wave latency was longer and P1-N1 wave amplitude was lower in both the spinal cord injury group and bFGF group compared to those in the sham-operated group ( P<0.01), with shorter P-wave latency and higher P1-N1 wave amplitude in the bFGF group compared to those in the spinal cord injury group ( P<0.01). Western blot results indicated that at 7, 14, 21, and 28 days after injury, in the spinal cord injury group, p-mTOR/mTOR levels were lower than those in both the sham-operated group and bFGF group ( P<0.01), while LC3-II expression levels were higher ( P<0.01); in the bFGF group, p-mTOR/mTOR levels were higher than those in the spinal cord injury group but lower than those in the sham-operated group ( P<0.01), and LC3-II expression levels were lower than those in the spinal cord injury group but higher than those in the sham-operated group ( P<0.01). At 28 days after injury, the BBB scores were higher in both the bFGF autophagy pathway validation group and bFGF+MHY1485 group than those in the bFGF+rapamycin group ( P<0.01), with higher scores in the bFGF+MHY1485 group than those in the bFGF autophagy pathway validation group ( P<0.01). P-wave latency was shorter in both the bFGF autophagy pathway validation group and bFGF+MHY1485 group than those in the bFGF+rapamycin group ( P<0.01), with shorter P-wave latency in the bFGF+MHY1485 group than that in the bFGF autophagy pathway validation group ( P<0.01). P1-N1 wave amplitude was lower in both the bFGF autophagy pathway validation group and bFGF+MHY1485 group than that in the bFGF+rapamycin group ( P<0.01), with lower P1-N1 wave amplitude in the bFGF+MHY1485 group than that in the bFGF autophagy pathway validation group ( P<0.01). The p-mTOR/mTOR levels were higher in both the bFGF autophagy pathway validation group and bFGF+MHY1485 group than those in the bFGF+rapamycin group ( P<0.01), with higher p-mTOR/mTOR levels in the bFGF+MHY1485 group than those in the bFGF autophagy pathway validation group ( P<0.01). The LC3-II expression levels were higher in both the bFGF autophagy pathway validation group and bFGF+MHY1485 group than those in the bFGF+rapamycin group ( P<0.01), with higher LC3-II expression levels in the bFGF+MHY1485 group than those in the bFGF autophagy pathway validation group ( P<0.01). Conclusion:bFGF can improve the pathological state, motor behavior, and neuroelectrophysiological function in rats with spinal cord injury, for which the mechanism of action may involve downregulating cellular autophagy function by activating the mTOR pathway, thereby inhibiting excessive autophagy to promote neuronal regeneration and repair.

Objective:To explore the evaluation method for key performance indicators of autonomous ultrasound scanning robots,so as to establish a testing scheme and conduct experiments.Methods:Based on the working principle of autonomous ultrasound scanning robots,three key performance indicators,which included scanning speed,scanning contact force,and accuracy of online adjustment,were established.The speed of the robotic arm,which execute autonomous scanning,was tested through laser rangefinders and a design of process equipment for displacement.The contact force of autonomous scanning was monitored and evaluated using a combination of ultrasound phantom and sensor with six-dimensional force.The displacement differences of phantom and robotic arm were monitored to evaluate the accuracy of online adjustment through designed a synchronization detection device for the displacements of phantom and robotic arm.Results:This research designed and provided test method and test device,which realized successful measurements for the speed,contact force,and accuracy of online adjustment in autonomous scanning of the ultrasonic scanning robot.Conclusion:The speed,contact force,and accuracy of online adjustment in scanning can be used as evaluation indicators of systematic performance of autonomous ultrasound scanning robots.The feasibility of these indicators is demonstrated through designed evaluation methods and corresponding experiments.

Objective:To construct a medical student professionalism evaluation system based on the Delphi method and provide a scientific tool for evaluation of medical education and clinical practice.Methods:Based on the Accreditation Council for Graduate Medical Education, the Canadian Medical Education Directives for Specialists, and the Chinese Resident Core Competency Framework, the indicators were selected through two rounds of Delphi consultation with 11 experts. The final medical professionalism evaluation system included 29 indicators in eight categories: professional ethics, dedication, humanistic qualities, systematic improvement ability, the process of medical professionalism, personal growth and help-seeking, patient-centered care, and teamwork. SPSS 29.0 software was used for data analysis, including descriptive statistics (mean ± standard deviation), analytic hierarchy process to determine the weights, and calculation of Cronbach's α coefficient, Spearman-Brown split-half reliability coefficient (0.929), and scale-level content validity index. The significance level was set at α=0.05. Results:The expert authority coefficients for the two rounds of consultation were 0.863 and 0.867, and the variations of Kendall coefficient of coordination were all <25.00%. The final evaluation system contained eight first-level indexes (the highest weight was 14.362% for professional ethics) and 29 second-level indicators. The system demonstrated high reliability and validity (Cronbach's α coefficient=0.912, scale-level content validity index/average=0.910). Conclusions:The professionalism evaluation system for medical students constructed in this study is scientific and practical, and can provide a reference for the quality assessment of medical education. The high reliability and validity of the evaluation system suggest that it is suitable for clinical practice and teaching feedback, though further localization to align with Chinese characteristics is necessary for further refinement.

Objective:To explore the evaluation method for key performance indicators of autonomous ultrasound scanning robots,so as to establish a testing scheme and conduct experiments.Methods:Based on the working principle of autonomous ultrasound scanning robots,three key performance indicators,which included scanning speed,scanning contact force,and accuracy of online adjustment,were established.The speed of the robotic arm,which execute autonomous scanning,was tested through laser rangefinders and a design of process equipment for displacement.The contact force of autonomous scanning was monitored and evaluated using a combination of ultrasound phantom and sensor with six-dimensional force.The displacement differences of phantom and robotic arm were monitored to evaluate the accuracy of online adjustment through designed a synchronization detection device for the displacements of phantom and robotic arm.Results:This research designed and provided test method and test device,which realized successful measurements for the speed,contact force,and accuracy of online adjustment in autonomous scanning of the ultrasonic scanning robot.Conclusion:The speed,contact force,and accuracy of online adjustment in scanning can be used as evaluation indicators of systematic performance of autonomous ultrasound scanning robots.The feasibility of these indicators is demonstrated through designed evaluation methods and corresponding experiments.

This study collected data on 9 cases of fatal head injuries caused by adjustable wrenches and analyzed 16 types of injury characteristics of head injuries caused by adjustable wrenches.The distinctive patterns of head injuries caused by adjustable wrenches were summarized.A four level scoring model and scoring criteria were constructed for head injuries caused by adjustable wrenches.From a morphological perspective,it provided a reference for the inference of injury-causing instruments in forensic practice.