Objective:To analyze the preferences of medical staff in TCM hospitals in Beijing regarding the achievements transformation of hospital traditional Chinese medicine preparations,and to provide a reference for formulating incentive policies.Methods:233 medical staff from five TCM hospitals in Beijing were taken as the research objects,and surveyed with a questionnaire designed based on the discrete choice experiment(DCE).Mixed logit models and latent class models were then used to analyze their transformation preferences.Results:The mixed Logit model revealed that seven key attributes significantly influenced medical staff's preferences for the achievements transformation of traditional Chinese medicine preparations(P<0.05).Latent class analysis identified three distinct preference groups among respondents:an organization-dependent group(27.0%),a pro-transformation group(61.4%),and a conservative group(11.6%).Conclusions:Medical Staff preferred transformation conditions that increased monthly income;utilized"human use+re-experimentation";involved the hospital's achievements transformation department as the entity;were funded by the hospital;offered a 70%profit share;enabled promotion three years earlier,and assigned patents to the hospital.The study recommends implementing diverse incentive measures and developing differentiated strategies tailored to the distinct Medical Staff categories to facilitate the transformation of hospital traditional Chinese medicine preparations into new drugs.

Objective:To study the role of cadherin 1 (CDH1) gene DNA methylation in autoimmune thyroiditis (AIT) in population from different water-iodine regions.Methods:From May to June 2019, the information of AIT cases and healthy individuals in Shandong Province were collected in three types of water-iodine regions: iodine-fortification (IF) region, iodine-adequate (IA) region and iodine-excess (IE) region. A case-control study design was applied to match 176 AIT cases (case group) with age, gender, body mass index, and place of residence in a 1 ∶ 1 ratio to 176 healthy individuals (control group). Fasting urine and whole blood samples were collected to test the contents of urinary iodine, thyroid function indicators [serum free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid stimulating hormone (TSH)], and serum iodine. The DNA methylation levels of the target region of the CDH1 gene and its four CpG sites in whole blood were determined using methylation sequencing technology for target regions (MethylTarget TM). Results:The DNA methylation level of the target region of CDH1 gene in the case group was 0.832 ± 0.044, and that in the control group was 0.828 ± 0.049, there was no statistically significant difference between the two groups ( t = 0.76, P = 0.448). There was no statistically significant difference in DNA methylation levels of the four CpG sites in the target region of CDH1 gene between the case group and the control group ( P > 0.05). There was no statistically significant difference in the DNA methylation level of the CDH1 gene target region between the case group and the control group in IF, IA and IE regions ( P > 0.05). The detection results of DNA methylation levels at CpG sites in the target region of CDH1 gene in different water iodine regions showed that the DNA methylation level at site 83 in case group in IF region was higher than that in the control group ( t = 2.30, P = 0.023). However, there was no statistically significant difference in the DNA methylation levels of the four CpG sites between the case group and the control group in IA and IE regions ( P > 0.05). The DNA methylation level of CDH1 gene target region in AIT patients was not significantly correlated with urinary iodine, serum iodine, and serum FT 3, FT 4, and TSH contents ( P > 0.05), but was significantly negatively correlated with age ( r =-0.19, P = 0.014). Conclusions:The DNA methylation level at CpG site 83 of CDH1 gene in AIT patients in IF region is significantly higher than that in control population, indicating that DNA methylation at this locus may be involved in the occurrence and development of AIT after iodine fortification. The DNA methylation level of CDH1 gene is negatively correlated with age.

The purpose of this study was to establish a luciferase immunosorbent assay(LISA)using the Crimean-Congo hemorrhagic fever virus(CCHFV)glycoprotein C(Gc),a specific antigen,for the detection of CCHFV IgG antibodies.Three antigenic fragments based on CCHFV glycoprotein C were designed,and three recombinant plasmids were constructed by liga-tion with the NanoLuc luciferase(NLuc)expression vector pNLF1-N through molecular cloning.The accuracy of the sequences in the recombinant plasmids was confirmed through sequencing.The recombinant plasmids were transfected into eukaryotic cells to obtain fusion proteins containing specific antigens and luciferase,and the expression of the fusion proteins was verified by western blotting,thereby facilitating the establishment of the CCHFV-LISA detection technique.The assay's sensitivity,specificity,and stability were evaluated and compared with those of a commercial CCHFV IgG antibody test kit.Three recom-binant antigen fragments of CCHFV Gc—NLuc-Gc-Full,NLuc-Gc-C1,and NLuc-Gc-C2—were expressed,with molecular weights of 80.1 kDa,62.8 kDa,and 53.9 kDa,respectively.The optimal fragment for CCHFV detection was NLuc-Gc-C2.The sensitivity of the CCHFV-LISA was 90.9％,and the specificity was 100％;the findings were highly concordant with those for the commercial CCHFV enzyme-linked immunosorbent assay kit.Repeatability tests indicated no statistically significant differ-ences in inter-and intra-assay variability within the same batch.The LISA was highly specific,sensitive,and user-friendly in detecting IgG antibodies against the CCHFV.Therefore,this method may facilitate serological diagnosis and epidemiological studies in endemic regions,and provide essential technical support for disease surveillance and early warning.

The purpose of this study was to establish a luciferase immunosorbent assay(LISA)using the Crimean-Congo hemorrhagic fever virus(CCHFV)glycoprotein C(Gc),a specific antigen,for the detection of CCHFV IgG antibodies.Three antigenic fragments based on CCHFV glycoprotein C were designed,and three recombinant plasmids were constructed by liga-tion with the NanoLuc luciferase(NLuc)expression vector pNLF1-N through molecular cloning.The accuracy of the sequences in the recombinant plasmids was confirmed through sequencing.The recombinant plasmids were transfected into eukaryotic cells to obtain fusion proteins containing specific antigens and luciferase,and the expression of the fusion proteins was verified by western blotting,thereby facilitating the establishment of the CCHFV-LISA detection technique.The assay's sensitivity,specificity,and stability were evaluated and compared with those of a commercial CCHFV IgG antibody test kit.Three recom-binant antigen fragments of CCHFV Gc—NLuc-Gc-Full,NLuc-Gc-C1,and NLuc-Gc-C2—were expressed,with molecular weights of 80.1 kDa,62.8 kDa,and 53.9 kDa,respectively.The optimal fragment for CCHFV detection was NLuc-Gc-C2.The sensitivity of the CCHFV-LISA was 90.9％,and the specificity was 100％;the findings were highly concordant with those for the commercial CCHFV enzyme-linked immunosorbent assay kit.Repeatability tests indicated no statistically significant differ-ences in inter-and intra-assay variability within the same batch.The LISA was highly specific,sensitive,and user-friendly in detecting IgG antibodies against the CCHFV.Therefore,this method may facilitate serological diagnosis and epidemiological studies in endemic regions,and provide essential technical support for disease surveillance and early warning.

Objective To investigate the experience of ICU nurses in communication with the patients under mechanical ventilation,therefore to provide a reference for establishing and improving effective strategies in communication with the patients.Methods Using qualitative research,semi-structured interviews were conducted on 14 ICU nurses in a Tire-IIIA hospital.Data were analysed using Colaizzi's seven-step method to extract themes.Results A total of 4 themes were extracted with 11 sub-themes,they were:emotional stress in non-verbal communication(frustration and feeling of defeat,emotional exhaustion and burnout),difficulty and challenge in ineffective communication(difficulty in establishing an equal and trusting communication quickly,difficulty in accurately understanding communication requirement of patients,and difficulty in achieving effective communication and cooperation),active promotion of effective communication(use of assistive communication tools,actively seek external collaboration,early assessment and prevention of delirium),and enhancement of communication skills and a sense of professional benefit(improvement of professional communication skills and enhancement of cultural communication literacy).Conclusion ICU nurses face various emotional pressures and communication challenges.It is important to actively provide psychological support to the nurses and optimise the communication environment in order to reduce the work stress and enhance the sense of achievement and values.

Objective:To develop a scale to measure the sense of gain of the elderly, and to evaluate its reliability and validity.Methods:According to the content of the sense of gain, combined with the literature research method and interview method, the scale entry pool was established.After the expert consistency evaluation and the optimal test assembly method (OTA) analysis, the formal version of the scale was formed.The stratified sampling method was used to select 1 043 community-dwelling elders for the survey, and the reliability and validity of the scale were evaluated by methods based on classical test theory.Results:The scale of elderly sense of gain, which was screened by OTA method, included four dimensions: health status, relationship and communication, social security, and ideal expectation, with a total of 17 items. The Cronbach's α value of the formal version of the scale was 0. 850, and the Cronbach's α coefficients of the four dimensions were 0.721, 0.772, 0.779, and 0.930, respectively. The CR values of the combined reliabilities of each dimension were all above 0.7. In terms of AVE values, except for the health status dimension was acceptable, the other three dimensions were all above 0.36. The correlation coefficient between the sense of health acquisition and life satisfaction of the elderly was 0.531 ( P<0.01). Conclusion:The developed scale for measuring the sense of gain of the elderly has good reliability and validity, which can be used as an effective tool for measuring the sense of gain of the elderly.

Objective:To analyze the preferences of medical staff in TCM hospitals in Beijing regarding the achievements transformation of hospital traditional Chinese medicine preparations,and to provide a reference for formulating incentive policies.Methods:233 medical staff from five TCM hospitals in Beijing were taken as the research objects,and surveyed with a questionnaire designed based on the discrete choice experiment(DCE).Mixed logit models and latent class models were then used to analyze their transformation preferences.Results:The mixed Logit model revealed that seven key attributes significantly influenced medical staff's preferences for the achievements transformation of traditional Chinese medicine preparations(P<0.05).Latent class analysis identified three distinct preference groups among respondents:an organization-dependent group(27.0%),a pro-transformation group(61.4%),and a conservative group(11.6%).Conclusions:Medical Staff preferred transformation conditions that increased monthly income;utilized"human use+re-experimentation";involved the hospital's achievements transformation department as the entity;were funded by the hospital;offered a 70%profit share;enabled promotion three years earlier,and assigned patents to the hospital.The study recommends implementing diverse incentive measures and developing differentiated strategies tailored to the distinct Medical Staff categories to facilitate the transformation of hospital traditional Chinese medicine preparations into new drugs.

Objective:To analyze the coupling coordination relationship and spatial correlation among the service demand,resource allocation and utilization efficiency of Traditional Chinese Medicine(TCM),aiming to provide theoretical support and optimization strategies for achieving the coordinated operation of the TCM systems in various provinces and promoting the coordinated development of TCM in different provinces.Methods:The data were collected from the China Health and Family Planning Statistical Yearbook(2013-2017)and the China Health Statistics Yearbook(2018-2023),the entropy method was employed to determine the weight of each evaluation index within the subsystems.A coupling coordination degree model and spatial econometric model were applied to assess the coupling coordination values and spatial correlations of the TCM system across various provinces in China.Results:In 2022,the national average coupling coordination degree was 0.603,with values of 0.648,0.577,and 0.563 for the eastern,central,and western regions,respectively.The western region had the highest number of provinces classified as"disordered type".A spatial clustering effect of the coupling coordination degree across 30 provinces.Conclusions:While the allocation of TCM resources has shown steady improvement,the demand for TCM services and utilization efficiency have exhibited a declining trend.The coupling coordination degree follows a decreasing gradient from east to west and exhibits significant spatial effects,a regional collaborative development mechanism for TCM should be established.

Objective:To investigate the clinical efficacy of transcranial alternating current stimulation (tACS) combined with drug treatment in patients with bipolar Ⅰ disorder (BD Ⅰ).Methods:Forty-two patients with BD Ⅰ who were admitted to the Mental Health Center Affiliated to Anhui Medical University from March 2022 to June 2023 were included in this randomized double-blind study. These patients were randomly divided into a control group and an observation group using an Excel spreadsheet. In the control group, patients received 10 sessions of sham stimulation in addition to drug treatment, while the observation group received 10 sessions of tACS along with drug treatment. All patients were treated for 2 weeks. Each patient received stimulation for 15 minutes on each of the right and left prefrontal lobes once every working day. The Montreal Cognitive Assessment (MoCA) scores and Bech-Rafaelsen Mania Scale (BRMS) scores were compared between the two groups before and after treatment. Eighteen patients from the observation group and nineteen patients from the control group were included in the final analysis.Results:Two weeks after treatment, the MoCA score in the observation group was higher than that in the control group [(27.39 ± 1.88) vs. (24.63 ± 2.39)], and the BRMS score in the observation group was lower than that in the control group [(15.89 ± 3.18) vs. (19.00 ± 3.32)]. These differences were statistically significant ( t = -3.89, 2.91, both P < 0.05). After treatment, the MoCA score in the observation group increased, while the BRMS score decreased ( t = 5.04, -4.14, both P < 0.05). Pearson correlation analysis indicated the change in MoCA score was negatively correlated with BRMS score in both groups ( r = -0.433, P < 0.05). Conclusions:Drug treatment combined with tACS greatly improved clinical cognitive symptoms and reduced manic symptoms in patients with BD Ⅰ. The combined therapy exhibited better efficacy than monotherapy.

Objective:To develop a scale to measure the sense of gain of the elderly, and to evaluate its reliability and validity.Methods:According to the content of the sense of gain, combined with the literature research method and interview method, the scale entry pool was established.After the expert consistency evaluation and the optimal test assembly method (OTA) analysis, the formal version of the scale was formed.The stratified sampling method was used to select 1 043 community-dwelling elders for the survey, and the reliability and validity of the scale were evaluated by methods based on classical test theory.Results:The scale of elderly sense of gain, which was screened by OTA method, included four dimensions: health status, relationship and communication, social security, and ideal expectation, with a total of 17 items. The Cronbach's α value of the formal version of the scale was 0. 850, and the Cronbach's α coefficients of the four dimensions were 0.721, 0.772, 0.779, and 0.930, respectively. The CR values of the combined reliabilities of each dimension were all above 0.7. In terms of AVE values, except for the health status dimension was acceptable, the other three dimensions were all above 0.36. The correlation coefficient between the sense of health acquisition and life satisfaction of the elderly was 0.531 ( P<0.01). Conclusion:The developed scale for measuring the sense of gain of the elderly has good reliability and validity, which can be used as an effective tool for measuring the sense of gain of the elderly.