ObjectiveTo clarify the expression of TRIM28 in non-M3 acute myeloid leukemia （AML） and its correlation with clinical indicators and prognosis， and to further explore the effect of TRIM28 expression levels on the proliferation and apoptosis of AML cells using small interfering RNA. MethodsThe GSE34577 dataset was analyzed using R software to compare TRIM28 expression between healthy controls and non-M3 acute myeloid leukemia （AML） patients. Clinical samples from non-M3 AML patients were collected， with TRIM28 expression levels measured using real-time quantitative PCR （qPCR）. The analysis focused on correlations between TRIM28 expression and various clinical indicators， treatment efficacy， and patient prognosis. Furthermore， small interfering RNA （siRNA） technology was employed to downregulate TRIM28 expression in human primary AML cells （HL60 cell line）. The effects on cell proliferation and apoptosis were then assessed through CCK-8 assays and flow cytometry， respectively. ResultsThe results showed that TRIM28 was up-regulated in non-M3 AML of both online database GSE34577 and clinical samples （P<0.000 1）， TRIM28 expression of new diagnosis group and relapsed refractory group was higher than iron deficiency anemia group （P<0.01）， and there was no significance between different French-American-British classification systems subtype. TRIM28 expression was higher in non-M3 AML patients with a poor genetic prognosis stratified as moderate than in the good prognosis group， and TRIM28 expression was associated with NPM1 combined with the FLT3-ITD mutation， positively correlated with age， bone marrow blast， peripheral blood blast and white blood cell， negatively correlated with hemoglobin. In addition， interference TRIM28 greatly inhibited cell proliferation and promoted cell apoptosis. ConclusionThis study reveals that TRIM28 is highly expressed in non-M3 AML and associated with prognosis， and plays a key role in the proliferation and apoptosis of AML cells， suggesting that TRIM28 may serve as a novel therapeutic target for non-M3 AML.

Objective: To evaluate the feasibility of dynamic contrast-enhanced MRI (DCE-MRI) in differentiating tumor deposits (TDs) from metastatic lymph nodes (MLNs) in rectal cancer. Materials and Methods: A retrospective analysis was conducted on 70 patients with rectal cancer, including 168 lesions (70 TDs and 98 MLNs confirmed by histopathology), who underwent pretreatment MRI and subsequent surgery between March 2019 and December 2022. The morphological characteristics of TDs and MLNs, along with quantitative parameters derived from DCE-MRI (K trans , kep, and v e) and DWI (ADCmin, ADCmax, and ADCmean), were analyzed and compared between the two groups.Multivariable binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of significant individual quantitative parameters and combined parameters in distinguishing TDs from MLNs. Results: All morphological features, including size, shape, border, and signal intensity, as well as all DCE-MRI parameters showed significant differences between TDs and MLNs (all P < 0.05). However, ADC values did not demonstrate significant differences (all P > 0.05). Among the single quantitative parameters, v e had the highest diagnostic accuracy, with an area under the ROC curve (AUC) of 0.772 for distinguishing TDs from MLNs. A multivariable logistic regression model incorporating short axis, border, v e, and ADC mean improved diagnostic performance, achieving an AUC of 0.833 (P = 0.027). Conclusion The combination of morphological features, DCE-MRI parameters, and ADC values can effectively aid in the preoperative differentiation of TDs from MLNs in rectal cancer.

Objective To investigate the biomechanical effects of implant-anchored retraction and intrusion of maxillary anterior teeth under different force systems using three-dimensional finite element analysis(3D-FEA),by constructing models simulating both normal periodontium and mild alveolar bone resorption.Methods Cone-beam computed tomography(CBCT)data from a patient with skeletal protrusion and gummy smile was utilized.3D finite element models integrating micro-implants anchorage(MIA)and a straight-wire ap-pliance for en-mass retraction of maxillary anterior teeth were established using Mimics,Geomagic,SolidWorks,and Ansys software.Six experimental groups were designed based on alveolar bone height and vertical positioning of posterior MIA.Groups A1,A2,A3:Normal alveolar bone height.Groups B1,B2,B3:Mild alveolar bone resorption.Posterior MIA were placed between the first molar and second premolar at vertical heights of 4,6,and 8 mm(relative to the cementoenamel junction),respectively,each loaded with 200 g retraction force.Anterior MIA between the central and lateral incisors delivered 50 g intrusion force.Stress distribution,anterior tooth displacement patterns,and torque changes were analyzed and compared across all groups.Results Under varying force conditions,greater torque loss was observed in the anterior teeth of the mild alveolar bone resorption group compared to the periodontally healthy group.Differential displacement patterns emerged among central incisors,lateral incisors,and canines when posterior MIA were placed at different vertical heights.The center of resistance in the resorption group shifted apically,resulting in undesirable extrusion and com-promised torque control during intrusion-retraction of maxillary anterior teeth.Conclusion Anterior torque control is more challenging in the alveolar bone resorption group than in the periodontally normal group.Elevating posterior MIA height promotes bodily movement of central incisors,thereby mitigating the ＂bowing effect＂ to a clinically relevant extent.

Objectives:To investigate the epidemiological characteristics and ethnic differences of cardiovascular-kidney-metabolic syndrome(CKM)among the Hani,Dai,Bai,and Lisu populations in Yunnan Province,and to provide evidence for developing effective prevention and control strategies for CKM.Methods:A cross-sectional survey was conducted among four ethnic minority groups.A total of 3 906 permanent residents aged 18 years and older were enrolled using a multistage cluster random sampling method.CKM stages(0-4)were defined based on the 2023 American Heart Association criteria,stages 3-4 were classified as advanced CKM.Descriptive statistics and chi-square tests were used to compare the prevalence of CKM stages across ethnic groups.Modified Poisson regression was applied to estimate relative risk(RR)and 95%confidence intervals(CI)for factors associated with advanced CKM.Results:The prevalence rates of CKM stage 1 and above among the Hani,Dai,Bai and Lisu ethnic groups were 80.1%,87.3%,84.8%and 67.8%,respectively.The prevalence of CKM was generally higher in males than in females,and the prevalence of CKM increased significantly with age.The Dai ethnic group had the highest prevalence of advanced CKM(24.7%,95%CI:22.1%-27.4%),while the Lisu ethnic group had the lowest prevalence of advanced CKM(13.7%,95%CI:11.5%-15.9%).Modified Poisson regression analysis showed that older age and higher body mass index were common risk factors for advanced CKM across all four ethnic groups.Additionally,except for the Lisu ethnic group,the other three ethnic groups had specific individual risk factors:among the Hani ethnic group,low educational attainment(RR=2.18,95%CI:1.12-4.25)and low income(RR=1.47,95%CI:1.00-2.18)were the primary risk factors of CKM.Among the Dai ethnic group,smoking(RR=1.60,95%CI:1.07-2.37)and a family history of cardiovascular disease(RR=1.61,95%CI:1.14-2.27)are the primary risk factors of CKM.Among the Bai ethnic group,male gender(RR=0.48,95%CI:0.29-0.79)was the primary risk factor of CKM.Conclusions:The prevalence of CKM stage 1 or higher is relatively high among the four minority ethnic groups in Yunnan province.There are significant differences in staging characteristics and primary risk factors across ethnic groups,necessitating the development of stratified,differentiated intervention strategies to achieve precise prevention and control and ethnic health equity in terms of CKM.

Inflammatory response,immunosuppression,and drug sensitivity have been reported to have a significant correlation with the disulfidptosis levels in cancer patients.However,the value of disulfidpto-sis in colorectal cancer therapy remains unclear.Therefore,we classified the CRC cells into different cell types using single-cell sequencing data and cell-specific markers and analyzed their relationship with the cell disulfidptosis level.We found that the high disulfidptosis regions were concentrated in epithelial-like CRC cells.Further exploration using the disulfidptosis and programmed cell death 1 inhibitor therapy treated differential expression genes indicated that CRC patients with high disulfidptosis levels exhibited a lower risk profile and increased sensitivity to immunotherapy.By using the spatial transcriptomic analy-sis,we found that ubiquinol-cytochrome c reductase core protein 1(UQCRC1),a disulfidptosis-related gene,is highly expressed in epithelial-like CRC cells and co-localized with immune-infiltrated tumor re-gions.Additional bioinformatic analyses and experimental validation further confirmed that UQCRC1 was downregulated in CRC tissues.Overexpression of UQCRC1 suppressed CRC cell proliferation and migra-tion.These findings indicate that UQCRC1 is a potential target for CRC diagnosis and treatment.

Aim To explore the therapeutic effects of resveratrol(Res)on hepatic inflammation and oxida-tive stress in rheumatoid arthritis(RA),and to eluci-date the relationship of the regulatory mechanism of the Nrf2/Keap1 signaling pathway in it.Methods A mouse model of arthritis was induced using chicken type Ⅱ collagen in combination with complete Freund's adjuvant,and Res was administered by tube feeding for treatment.Serum liver function indices and levels of hepatic inflammation and oxidative stress were detected in mice.An in vitro cellular model of hepatic inflam-mation and oxidative stress was established by treating mouse primary hepatocytes(MPHs)with TNF-α(5μg·L-1),cell proliferation inhibition was detected by CCK-8,and inflammation and oxidative stress-relat-ed indices were detected by protein blotting.The in-trinsic mechanisms by which Res attenuated hepatic in-flammation and oxidative stress in rheumatoid arthritis were explored by treating MPHs with Nrf2 inhibitor and Keap1 overexpression plasmid.Results Res signifi-cantly reduced the levels of inflammation and oxidative stress in hepatic tissues of collagen-induced arthritis mice as well as TNF-α-treated MPHs,and activated the Nrf2/Keap1 signaling pathway.Inflammation and oxidative stress levels in MPHs were exacerbated by the use of Nrf2 inhibitors and Keap1 overexpression,which promoted apoptosis.Conclusion Res attenuates he-patic inflammation and oxidative stress in rheumatoid arthritis via the Nrf2/Keap1 pathway.

Objective:To develop a Pain Management Nursing Competency Evaluation Index System for surgical nurses, providing a framework for assessing their pain management competency and guiding in-service training programs.Methods:From December 2023 to July 2024, a research team employed literature analysis, semi-structured interviews, expert consultations, and the analytic hierarchy process (AHP) to determine the content and weight of the competency evaluation index system. A cross-sectional survey was subsequently conducted using convenience sampling on 788 surgical nurses to test the internal consistency, test-retest reliability, and content validity of the index system.Results:The response rates for the two rounds of expert consultations were both 100% (46/46), with an expert authority coefficient of 0.921; the Kendall′s coefficients of expert opinions for the primary indicators were 0.106 and 0.245, respectively. The final index system included seven primary indicators (routine pain assessment, assessment and management of active and unexpected pain, pharmacological pain management, patient-controlled analgesia nursing, non-pharmacological pain management, pain related education for patients and their families, and professional development), 23 secondary indicators, and 78 tertiary indicators. The overall Cronbach α was 0.991, the test-retest reliability was 0.493, the item-level content validity index ranged from 0.96 to 1.00, and the scale-level content validity index was 0.98.Conclusions:The pain management nursing competency evaluation index system for surgical nurses is scientifically valid, reliable, and practical. It offers a solid foundation for evaluating the pain management competencies of surgical nurses and designing targeted in-service training programs.

Objective:To clarify the complex network structure between self-management levels and supportive care needs of patients undergoing maintenance hemodialysis, utilizing network analysis methods to identify the core and bridging nodes among the variables, thereby defining targets for nursing interventions to implement more precise care strategies.Methods:A cross-sectional survey was conducted from May to November 2023 among 302 outpatient maintenance hemodialysis patients at the hemodialysis centers of two healthcare institutions in Harbin (the Second Affiliated Hospital of Harbin Medical University and Heilongjiang Changjiang Nephrology Specialist Hospital). This involved the use of general information questionnaires, the Hemodialysis Patient Self-Management Scale, and the Supportive Care Needs Scale for Hemodialysis Patients. R language was employed for the network analysis.Results:A total of 300 valid questionnaires were collected, including 186 males and 114 females, with an age range of 23 to 88 years (mean age 55.00 ± 13.78 years). The scores for the dimensions of self-management among dialysis patients were as follows: problem-solving (3.38 ± 0.63), execution of self-care (3.16 ± 0.52), partnership (2.56 ± 0.69), and emotional processing (1.89 ± 0.63). The scores for the dimensions of supportive care needs among dialysis patients were: physiological needs (2.82 ± 1.08), psychological needs (1.51 ± 1.02), social needs (1.97 ± 1.07), emotional needs (1.67 ± 1.12), spiritual needs (2.22 ± 0.77), informational needs (2.83 ± 1.08), and practical needs (2.82 ± 1.03). In network analysis, the strongest intensity was found in the execution of self-care (1.753), and the highest closeness was in psychological needs (0.017). The top three dimensions ranked by bridge strength were social needs (1.463), partnership (1.462), and execution of self-care (1.384). The root mean square error was lowest for psychological needs (0.518) and emotional needs (0.538). The stability and accuracy of the network structure were found to be good.Conclusions:The key intervention targets for nursing care in maintenance hemodialysis patients were identified as executing self-care, psychological needs, emotional needs, and social needs. Among these, executing self-care served as the core intervention focus, while psychological and emotional needs had dominant influences, and social needs exhibited the strongest bridging role. Nursing staff should prioritize these key targets and tailor personalized comprehensive nursing intervention plans to enhance patients′self-management levels and fully meet their care needs.

Objective To explore the characteristics of the potential categories of traumatic psychological reactions in ICU patients and analyze the influencing factors of different potential categories,in order to provide ideas for the implementation of scientific and effective personalized intervention in the future.Methods A convenience sample of 300 patients treated in the ICU of a hospital from May 2023 to February 2024 was surveyed.The used instruments included a general information questionnaire,the Social Support Rating Scale,the Brief Resilience Scale,the Acute Stress Disorder Scale,and the Simplified Chinese version of the Post-Traumatic Growth Inventory.Data were analyzed using multivariate Logistic regression.Additionally,a purposive sampling method was used to conduct semi-structured interviews with 12 ICU patients,and the interview data were analyzed by interpretative phenomenological analysis.Results Quantitative research results showed that the traumatic psychological responses of ICU patients were categorized into 4 latent classes,including Trauma-Dependent Type(17.3％),Smooth-Transition Type(36.0％),External-Support Growth Type(25.3％),and Internal-Rooted Growth Type(21.3％).Factors influencing these responses included age,educational level,social support,psychological resilience,household income,and the number of used hormone medications(P＜0.05).Qualitative research results showed that 4 core themes were identified,including immersion in psychological trauma,rational cognition and acceptance of reality,seeking external support for personal growth,and independent exploration of inner self.Influencing factors included age,income level,history of major illness or ICU treatment,level of disease awareness,presence of underage children,and individual capacity for rumination.The quantitative and qualitative results were mutually corroborative and complemented each other.Conclusion The acute stress response of ICU patients is obvious,and there are multiple characteristics in the potential categories of traumatic psychological response,suggesting that medical and nursing staff can identify the characteristics of various types and influencing factors early,formulate personalized intervention programs,and promote their post-traumatic growth.

Objective:To conduct a study on pricing by service unit to address the problems of hospice and palliative care pricing and fee system in China.Methods:Combining theoretical research and empirical evidence,this study organized the pricing mechanism of initiative hospice and palliative care services and established a graded and categorized pricing strategy.Empirical research was conducted based on real-world data from 36 pilot institutions in typical areas.Results:This study developed a comprehensive pricing framework for value-based classification price standard of initiative hospice and palliative care services from the perspective of incentive regulation.We proposed a pricing plan based on service units,with inpatient bed fee ranging from 459 to 606 yuan or 459 to 1 102 yuan,and home visit fee ranging from 89 to 264 yuan.Conclusions and suggestions:This study proposes a pricing scheme based on the technique and service value with a gradient fluctuation by service unit,and forms a set of price standards with high economic and technical feasibility,which can provide scientific evidences for solving the pricing problem of hospice care.In addition,there is still a need to establish a multi-level incentive compensation mechanism to motivate all levels and types of organisations and healthcare provider,and to promote the high-quality and sustainable development of hospice and palliative care.