Objective To translate the Context Assessment for Community Health(COACH)scale into Chinese,thereby providing a standardized measurement tool for context assessment in clinical evidence-based practice.Methods The scale was translated following the Brislin translation model,ultimately forming the Chinese version of the COACH scale.Using convenience sampling,584 healthcare professionals were recruited from 3 tertiary hospitals in Jiangxi,Henan,and Liaoning provinces and 2 community hospitals in Liaoning province from May to September 2024 to evaluate the reliability and validity of the scale.In October 2024,the Chinese version of COACH was applied to 44 healthcare professionals in a hypertension specialist ward of a provincial tertiary hospital.Results Of the 584 distributed questionnaires,519 valid questionnaires were collected(the effective response rate of 88.87％).The Chinese version consists of 7 dimensions with 42 items.The overall Cronbach's α coefficient was 0.975;the McDonald's omega coefficient was 0.979;split-half reliability was 0.808,and the test-retest reliability was 0.917.The scale-content validity index/average was 0.950,and the scale-content validity index/universal agreement was 0.980,with item-content validity index ranging from 0.775 to 1.000.Exploratory factor analysis extracted 7 factors,accounting for 79.260％of the cumulative variance,with factor loadings ranging from 0.569 to 0.954.Confirmatory factor analysis showed good model fit.The preliminary application results showed that the total score of the scale was 185.18±17.82.The correlation coefficients between dimensions and total score ranged from 0.116 to 0.905.Conclusion The Chinese version of the COACH scale demonstrates good reliability and validity,making it suitable as a context measurement tool for implementation research at different stages in clinical and public health settings.

Objective To translate the Context Assessment for Community Health(COACH)scale into Chinese,thereby providing a standardized measurement tool for context assessment in clinical evidence-based practice.Methods The scale was translated following the Brislin translation model,ultimately forming the Chinese version of the COACH scale.Using convenience sampling,584 healthcare professionals were recruited from 3 tertiary hospitals in Jiangxi,Henan,and Liaoning provinces and 2 community hospitals in Liaoning province from May to September 2024 to evaluate the reliability and validity of the scale.In October 2024,the Chinese version of COACH was applied to 44 healthcare professionals in a hypertension specialist ward of a provincial tertiary hospital.Results Of the 584 distributed questionnaires,519 valid questionnaires were collected(the effective response rate of 88.87％).The Chinese version consists of 7 dimensions with 42 items.The overall Cronbach's α coefficient was 0.975;the McDonald's omega coefficient was 0.979;split-half reliability was 0.808,and the test-retest reliability was 0.917.The scale-content validity index/average was 0.950,and the scale-content validity index/universal agreement was 0.980,with item-content validity index ranging from 0.775 to 1.000.Exploratory factor analysis extracted 7 factors,accounting for 79.260％of the cumulative variance,with factor loadings ranging from 0.569 to 0.954.Confirmatory factor analysis showed good model fit.The preliminary application results showed that the total score of the scale was 185.18±17.82.The correlation coefficients between dimensions and total score ranged from 0.116 to 0.905.Conclusion The Chinese version of the COACH scale demonstrates good reliability and validity,making it suitable as a context measurement tool for implementation research at different stages in clinical and public health settings.

Background Environmental noise pollution is serious, and there are few studies on the effects of long-term noise exposure during sleep on cognitive function and possible biological clock mechanism. Objective To explore the cognitive impairment induced by noise exposure during sleep in mice and possible biological clock mechanism, and to provide a theoretical basis for the protection against noise exposure. Methods Twenty male C57BL/6J mice were randomly divided into a control group and a noise-exposed group, 10 mice in each group. The noise-exposed group was exposed to sleep-period noise using a noise generator for 12 h (08:00–20:00) per day for a total of 30 d. The calibrated noise intensity was set at 90 dB. No intervention was imposed on the control group. At the end of the noise exposure, cognitive function of mice was examined using the new object recognition experiment and the open field test, and the hippocampal tissue damage of mice were evaluated by Nissl staining, ionized calcium binding adaptor molecule 1 (Iba1) immunofluorescence staining, and real-time fluorescence quantitative PCR for inflammatory factors and biological clock genes. Oxidative stress indicators in the hippocampus of mice were also detected by assay kit. Results After noise exposure during sleep period, the results of new object recognition experiment showed that the discrimination index of mice in the noise-exposed group was 0.06±0.04, which was significantly lower than that of the control group (0.65±0.13) (P<0.05). The results of open field test showed that the central activity distance of the noise-exposed group was (242.20±176.10) mm, which was significantly lower than that of the control group, (1548.00±790.30) mm (P < 0.05), and the central activity time of the noise-exposed group was (0.87±0.64) s, which was significantly lower than that of the control group, (6.00±2.86) s (P < 0.05). The Nissl staining results showed that compared with the control group, neurons in the hippocampus of the noise-exposed mice were shrunken, deeply stained, disorganized, and loosely connected. The immunofluorescence results showed that microglia in the hippocampus of the noise-exposed mice were activated and the expression of Iba1 was significantly increased compared with those of the control group (P<0.05). The real-time PCR results of showed that the mRNA levels of the biological clock genes Clock, Per2, and Rev-erbα were significantly increased compared with those of the control group (P<0.05), and the mRNA level of Per1 was significantly decreased compared with that of the control group (P<0.05); and the mRNA levels of IL-18, IL-6, iNOS, and NLRP3 in the hippocampal tissues of mice were significantly increased compared with those of the control group (P<0.05). The results of oxidative stress evaluation showed that compared with the control group, reduced glutathione content was significantly reduced in the noise-exposed group (P<0.001). Conclusion Noise exposure during sleep period can lead to the destabilization of biological clock genes in hippocampal tissues and trigger hippocampal neuroinflammation, which can lead to the activation of microglia and cause cognitive impairment in mice.

Objective:To explore the effects of graded nutritional nursing based on Prognostic Nutritional Index (PNI) in patients with cervical cancer undergoing concurrent chemoradiotherapy.Methods:Totally 414 patients with cervical cancer who were treated in Henan Cancer Hospital from December 2020 to December 2021 were selected by convenience sampling, and they were randomly divided into the study group and the control group according to the random number table, with 207 patients in each group. All patients received the same concurrent chemoradiotherapy. Patients in the control group were given nutritional nursing under the guidance of NRS2002, while patients in the study group were given graded nutritional nursing based on PNI. The PNI, levels of albumin (ALB) , prealbumin (PA) , transferrin (TRF) , immunoglobulin A (IgA) , immunoglobulin G (IgG) and adverse reactions were compared between the two groups.Results:Finally, 197 patients were included in the study group, and 195 patients were included in the control group. At the eighth week of treatment, the PNI of the study group was better than that of the control group, and the difference was statistically significant ( P<0.05) . In the first and third weeks of treatment, the levels of ALB, PA, TRF, IgA and IgG in the two groups gradually decreased, but the levels of ALB, PA, TRF, IgA and IgG in the study group were higher than those in the control group, and the difference was statistically significant ( P<0.01) . During concurrent chemoradiotherapy, the incidences of nausea and vomiting, enteral nutrition intolerance, bone marrow suppression, and cancer-related fatigue in the study group were lower than those in the control group, with statistically significant differences ( P<0.05) . Conclusions:PNI-based graded nutritional nursing to cervical cancer patients undergoing concurrent chemoradiotherapy can improve the nutritional status and immune level of patients and reduce the incidence of related complications.

Objective:To compare the effect of modified postauricular transverse incision and traditional vertical incision for microvascular decompression in the treatment of hemifacial spasm.Methods:Prospective study method was used. A total of 116 patients with hemifacial spasm in Handan Central Hospital from January 1, 2019 to January 1, 2020 were selected, and divided into two groups according to the admission order. Both groups underwent microvascular decompression; control group (57 cases) received traditional vertical incision, while treatment group (59 cases) received modified postauricular transverse incision. The brainstem auditory evoked potential (BAEP), pain degree, surgical indicators, facial aesthetic satisfaction and complications were compared between two groups.Results:After treatment, the BAEP of latency, wave interval and wave amplitude in the two groups increased compared with that before treatment, and the BAEP of latency, wave interval and wave amplitude in the treatment group were higher than those in the control group: (1.89 ± 0.15) ms vs. (1.62 ± 0.21) ms, (7.89 ± 0.15) ms vs. (6.25 ± 0.41) ms, (1.79 ± 0.19) ms vs. (1.54 ± 0.11) ms ( P<0.05). After treatment, the visual analogue score (VAS) of patients in the two groups decreased compared with that before treatment, and the VAS of patients in the treatment group was lower than that in the control group: (1.15 ± 0.27) points vs. (2.18 ± 0.24) points ( P<0.05). The operation time, intraoperative bleeding volume and postoperative scar length of patients in the treatment group were less than those in the control group: (60.41 ± 3.81) h vs. (76.87 ± 3.87) h, (30.18 ± 4.19) ml vs. (56.87 ± 4.15) ml and (4.18 ± 1.07) cm vs. (6.87 ± 1.05) cm ( P<0.05). The satisfaction rate of patients in the treatment group was higher than that in the control group: 91.53% (54/59) vs. 71.93% (41/57) ( P<0.05). The complication rate of patients in the treatment group was lower than that in the control group: 5.08% (3/59) vs. 21.05% (12/57) ( P<0.05). Conclusions:Compared with traditional vertical incision, the modified transverse incision for microvascular decompression in the treatment of hemifacial spasm can reduce intraoperative blood loss and postoperative scar area, enhance brainstem auditory evoked potential, and improve facial aesthetics, which is worthy of recommendation.

Objective:To prepare 99Tc m-hydrazinonicotinamide(HYNIC)-αCD8/Fab ( 99Tc m-αCD8/Fab), and explore the predictive value of 99Tc m-αCD8/Fab SPECT/CT imaging for the efficacy of anti-programmed death-1 (PD-1) immunotherapy. Methods:The αCD8/Fab was modified with HYNIC- N-hydroxysuccinimide (NHS) and IRDye800-NHS to form HYNIC-αCD8/Fab and IRDye800-αCD8/Fab (Dye-αCD8/Fab), respectively. 99Tc m-αCD8/Fab was prepared in sodium bicarbonate buffer (pH=8.5), with SnCl 2 being used as the reducing agent. The labeling yield and radiochemical purity of 99Tc m-αCD8/Fab and its stability in PBS and fetal bovine serum (FBS) were tested in vitro. The mouse spleen and human peripheral blood lymphocytes were isolated for cell-specific binding and blocking experiments of 99Tc m-αCD8/Fab in vitro. SPECT/CT imaging was used to analyze the specific binding ability of the 99Tc m-αCD8/Fab probe in CT26 colon cancer mouse models (BALB/c). The near infrared fluorescence imaging and SPECT/CT imaging were performed to detect the intra-tumoral CD8 + T cell infiltration after anti-PD-1 therapy in tumor bearing mice, and the results were further verified by HE and immunofluorescence staining. CD8 + T cell depletion study was performed to determine the role of CD8 + T cells in the tumor responses to anti-PD-1 therapy. Two-way analysis of variance was used to compare the data difference. Results:The labeling yield of 99Tc m-αCD8/Fab was 90% with a high radiochemical purity (95%) and good stability in vitro (radiochemical purity still more than 80% after 720 min in PBS and FBS). 99Tc m-αCD8/Fab could specifically bind to mouse CD8 + T cells ((10.30±0.81) percent added radioactive dose (%AD)/10 6 cells), compared with the binding ability in human peripheral blood lymphocytes group and CD8 antibody blocking group ((1.78±0.61) and (1.59±0.25) %AD/10 6 cells; F=10.07, P<0.001). SPECT/CT imaging showed that 99Tc m-αCD8/Fab had markedly higher tumor uptake in the CT26 colon cancer mouse models. Near-infrared fluorescence imaging showed that the tumor uptake of 99Tc m-αCD8/Fab in the responsive group was significantly higher than in the nonresponsive group after anti-PD-1 treatment ((8.9±1.1)% vs (7.1±0.8)%; F=4.69, P=0.024), and SPECT/CT imaging found the similar result. HE and immunofluorescence staining of tumor and lymph nodes showed that the proportion of lymphocyte infiltration was higher in the responsive group. Furthermore, CD8 + T cell depletion significantly reversed the therapeutic effect of anti-PD-1 immunotherapy in tumor-bearing mice. Conclusions:In this study, 99Tc m-αCD8/Fab was successfully obtained. CD8-specific SPECT imaging could sensitively visualize the tumor-infiltrating CD8 + T cells, suggesting the potential application value to predict and evaluate the efficacy of immunotherapy in the clinical settings.

BACKGROUND: Chronic noise exposure is one environmental hazard that is associated with genetic susceptibility factors that increase Alzheimer's disease (AD) pathogenesis. However, the comprehensive understanding of the link between chronic noise stress and AD is limited. Herein, we investigated the effects of chronic noise exposure on AD-like changes in senescence-accelerated mouse prone 8 (SAMP8). METHODS: A total of 30 male SAMP8 mice were randomly divided into the noise-exposed group, the control group, and aging group (positive controls), and mice in the exposure group were exposed to 98 dB SPL white noise for 30 consecutive days. Transcriptome analysis and AD-like neuropathology of hippocampus were examined by RNA sequencing and immunoblotting. Enzyme-linked immunosorbent assay and real-time PCR were used to further determine the differential gene expression and explore the underlying mechanisms of chronic noise exposure in relation to AD at the genome level. RESULTS: Chronic noise exposure led to amyloid beta accumulation and increased the hyperphosphorylation of tau at the Ser202 and Ser404 sites in young SAMP8 mice; similar observations were noted in aging SAMP8 mice. We identified 21 protein-coding transcripts that were differentially expressed: 6 were downregulated and 15 were upregulated after chronic noise exposure; 8 genes were related to AD. qPCR results indicated that the expression of Arc, Egr1, Egr2, Fos, Nauk1, and Per2 were significantly high in the noise exposure group. These outcomes mirrored the results of the RNA sequencing data. CONCLUSIONS These findings further revealed that chronic noise exposure exacerbated aging-like impairment in the hippocampus of the SAMP8 mice and that the protein-coding transcripts discovered in the study may be key candidate regulators involved in environment-gene interactions.

Objective: To study the effects of different holding gun methods and gun weight on health when standing guard, and propose a way to support the health of long-term standing guard soldiers. Methods: We created different percentile mannequins by Classic JACK, and adjusted the standing guard posture based on its standards for soldiers. The pressure on lumbar L4/L5 and moment on ankles and knees were analysied for different holding gun methods and gun weight. Then the mathematical models of joint load, gun weight and body mass index were studied by multiple regression analysis. Results: Holding gun methods and gun weight influence the force characteristics on ankles, knees and lumbar L4/L5. Holding gun with a brace and hands applying downward force -2 kgf could significantly reduce lumbar L4/L5 pressure. When the hand force is -5, -3, -4, -3, -2, -1, 0, 1, 2 kgf, and the weight of the gun is 0, Lumbar vertebrae L4/L5 joint pressure of people with different body mass index(P₁, P₅, P₅₅, P₉₅, P₉₉) are the smallest, respectively 269, 281, 321, 408, 444 N, and the same change trend occurs when the weight of the gun is 2, 4, and 8 kg.The moment on ankles and knees were less with the same holding gun method and the hands downward force ranged from 0 to -4 kgf, and the higher the body mass index is, the more the hands downward force needed to make the moment on ankles and knees zero. That is, the moment on ankles could be zero when the hands downward force ranged from -1 to -3 kgf, the moment on knees could be zero when the hands downward force ranged from -1.1 to -3.7 kgf. Conclusion To reduce the pressure on lumbar L4/L5 and moment on ankles and knees, so as to cut down occupational risk of long-standing operation, we advise the long-term standing guard soldiers holding gun with a brace and hands applying downward force -2 kgf.

Objective : To analyze the initial displacement of the upper central incisor and stress distribution of periodontal ligament under different torque values of upper incisors under the action of a four-curved auxiliary arch to provide a reliable basis for the safety of clinical application of four-curved auxiliary arches. Methods : A three-dimensional finite element model for torque control of upper anterior teeth with a homemade quadrilateral auxiliary arch was established. Four different states were analyzed: molar ligation without extraction space (group A), microimplant ligation without extraction space (group B), molar recovery with extraction space closure (group C) (the adductive traction force was set at 115 g) and microimplant recovery with extraction space closure (group D) (the adductive traction force was set at 115 g). When four types of torque (0.5 N, 1.0 N, 1.5 N, and 2.0 N) were applied. The initial displacement of upper central incisors and the stress distribution of periodontal ligament in 16 groups (A1-A4, B1-B4, C1-C4, D1-D4) were observed. Results : Under different conditions, as the strength of the four-curve auxiliary arch increases, the maxillary anterior teeth has crown labial inclination and a root lingual inclination. The displacement of the incisor tip increases with the increase in the loading force of the torque auxiliary arch, and the displacement of the incisor root apex increases as the force increases. The difference in incisor-apex displacement distance in A1-A4, B1-B4, C1-C4, D2 and D4 groups increased as the torque force increases, while the difference between the D3 group and D1 and D2 groups decreased slightly. The stress of the cervical periodontal ligament of the upper central incisor did not exceed the stress of the periodontal ligament in the following groups: A1, A2, B1, B2, B3, C1, C2, D1, and D2. The stress of the lip side of the upper central incisor did exceed the stress of the periodontal ligament in the following groups: A3, A4, B4, C3, C4, D3, and D4. In other words, when using the four-curved auxiliary arch as an implant anchorage, the force applied in the absence of extraction space should not exceed 1.5 N, and the force applied in the adduction of extraction space should not exceed 1.0 N. When using the nonimplant anchorage, the force applied in the absence of extraction space and the adduction of extraction space should not exceed 1.0 N. In addition, the range of force should not exceed the maximum stress of the periodontal ligament in the cervical region such that the effective and safe torque movement can be achieved. Under other stress conditions, the stress of the labial and cervical periodontal ligament of the upper central incisor exceeded the stress value (2.6 × 10-2MPa). The stress value of periodontal ligament was 2.6 × 10-2MPa in all groups. Conclusion A four-curved auxiliary arch has a significant effect on the upper anterior teeth, and the use of microimplants can better control root movement such that the crown of upper central incisors cannot be excessively lip inclined.

The normal torque angle of the maxillary anterior teeth is an important factor in the aesthetics and function of the anterior teeth, and torque control of the front teeth is an extremely important aspect of the correction process. At present, the normal torque angle of the front teeth is among the phase Ⅲ clinical test items recognized by the American orthodontic professional committee; consequently, good control of front teeth torque is of great significance to the aesthetics of the upper anterior teeth. In this paper, the influence of a lip appliance on the bad torque of upper anterior teeth and the associated methods of control are reviewed in detail. The advantages and disadvantages of various control methods for the anterior teeth and the significance of correct anterior teeth torque angle are summarized. The existing research results indicate that the torsion of a straight arch wire applied directly to individual teeth is too great, making it difficult to enter the groove. Although the bending of the arch wire overcomes these shortcomings, the procedure is cumbersome; it stimulates the soft tissue of the vestibular groove and increases the patient’s discomfort. The bending mechanism of the rocking chair is more complicated; it is greatly affected by the friction between the arch wire and the bracket and is not conducive to closing the tooth extraction gap using the sliding method. The portal auxiliary arch and the single bending torque are suitable for correcting the torque angle of a single tooth. Auxiliary arch torque can be used to correct the upright upper anterior teeth during the process of closing the extraction space and after adduction; therefore, this procedure is worth popularizing. However, the accuracy of orthodontic control of anterior teeth torque requires further study.