Purpose To detect the expression of peroxiso-mal membrane protein 4(PXMP4)in breast cancer tissues and to explore the effect of PXMP4 on the proliferation,invasion,and epithelial-mesenchymal transition(EMT)of breast cancer cells.Methods Bioinformatics and immunohistochemistry(IHC)were used to detect the expression of PXMP4 in breast cancer tissues.In breast cancer cells,Western blot was used to detect the expression of Cyclin D1,E-cadherin,vimentin and N-cadherin after knockdown and overexpression of PMXP4.The proliferation ability of breast cancer cells was analyzed by CCK-8 and plate cloning assay.Scratch healing and Transwell assay an-alyzed the migration and invasion ability of breast cancer cells.Lentivirus was used to construct a PXMP4-silenced MCF-7 cell line,and the PXMP4-silenced MCF-7 cells were injected into the subcutaneous or tail vein of mice to observe lung metastasis and the number of subcutaneous tumors.Results Bioinformat-ics and IHC showed that the expression of PXMP4 in breast cancer tissues was significantly increased(P＜0.05),and the prognosis of breast cancer patients with high expression of PXMP4 was poor(P＜0.05).The clinicopathological analysis showed that the expression of PXMP4 was correlated with tumor grade and lymph node metastasis(P＜0.05).In vitro knock-down of PMXP4 inhibited the proliferation,invasion and EMT process of breast cancer cells(P＜0.05).Conversely,overex-pression of PXMP4 promoted the proliferation,invasion and EMT process of breast cancer cells(P＜0.05).In vivo,the number of lung metastases,the size of subcutaneous tumor,and the expression of Ki67 in tumor tissue were significantly de-creased after silenced PXMP4(P＜0.05).Conclusion PXMP4 is related to tumor grading and lymph node metastasis.PXMP4 promotes proliferation,invasion and EMT process of breast cancer cells.

Objective:To analyze the causal relationship between lifestyle-based factors and the occurrence and development of hepatobiliary malignancies by Mendelian randomization study method,and to provide the potential clinical evidence for the prevention and treatment of hepatobiliary malignancies.Methods:The data from large-scale,independent genome-wide association studies(GWAS)were selected,and seven-step inclusion criteria for the instrumental variable screening were set up.The exposure lifestyles included the percentage of carbohydrate intake,percentage of fat intake,percentage of protein intake in the diet,coffee intake,weekly alcohol consumption times,leisure electronic screen exposure time,moderate to vigorous intensity physical activity(MVPA)during leisure time,sedentary behavior at work,age at first smoking,daily smoking quantity,current smoking status,and past smoking status,totaling 12 phenotypes.The primary analysis method used was the random effect model of the inverse variance weighted(IVW)method,and the heterogeneity was detected by Cochrane's Q test and the horizontal pleiotropy was detected by MR-Egger intercept method.Results:The current smoking status was significantly positively correlated with the increasing risk of extrahepatic cholangiocarcinoma(OR=1.607,95%CI:1.113-2.322,P=0.011).Higher coffee intake was causally linked to a higher risk of liver cancer and intrahepatic cholangiocarcinoma(OR=1.000,95%CI:0.999-1.000,P=0.012).In the physical activity,more MVPA was associated with the lower risk of liver cancer and intrahepatic cholangiocarcinoma(OR=0.998,95%CI:0.996-0.999,P=0.002).The Cochrane's Q test results showed that there was mild heterogeneity between MVPA and extrahepatic cholangiocarcinoma(Q=18.354,P=0.049)as well as the percentage of protein intake and intraphepatic cholangiocarainoma(Q=12.715,P=0.026),and the MR-Egger intercept method results showed there was no horizontal pleiotropy.Conclusion:There is a causal relationship between current smoking status and extrahepatic cholangiocarcinoma,and there is a causal relationship between more MVPA and the lower risk of liver cancer and intrahepatic cholangiocarcinoma.Education on smoking and physical activity for the patients may offer potential benefits for the prevention of hepatobiliary malignancies.

Objective To analyze the prevalence,burden and risk factors of mental disorders in Chinese population from 1990 to 2019.Methods Data on disease burden of mental disorders in China from 1990 to 2019 was obtained from the Global Burden of Disease(GBD)in 2019.The prevalence,disability adjusted of life years(DALY)and burden attributable to risk factors of mental disorders were analyzed.Joinpoint was used to estimate the annual percent change average(APC)and the annual percent change(AAPC)of DALY rate of mental disorders and analyze the trend of disease burden.Results In 2019,the prevalence of mental disorders was 11260.42/100000.Among mental disorders,depressive disorder(3519.26/100000)and anxiety disorder(3363.60/100000)had the highest prevalence.In 2019,the DALY rate of females(1564.22/100000)was higher than that of males(1294.51/100000).Depressive disorder(531.65/100000),anxiety disorder(321.60/100000)and schizophrenia(250.99/100000)had the highest DALY rates,accounting for 37.26%,22.54%and 17.59%of the total DALY rates of mental disorders respectively.From 1990 to 2019,the DALY rate of mental disorders in China increased from 1321.15/100000 to 1426.78/100000,the age-standardized DALY rate decreased with an average annual decrease of 0.19%(95%CI:-0.22%～-0.15%),and the age-standardized DALY rate of eating disorders increased the most(AAPC=1.94%,95%CI:1.85%～2.02%).The DALY rate of depressive disorder attributable to intimate partner violence was the highest in China in 2019(26.72/100000).The DALY rate of male depression attributed to childhood sexual abuse increased significantly from 1990 to 2019(AAPC=0.68%,95%CI:0.26%～1.09%).Conclusion Attention should be paid to the prevention and treatment of mental disorders,screening and intervention measures should be carried out among high risk populations,and etiological prevention should be carried out according to risk factors to reduce the burden of mental disorders.

Objective To distinguish Khat from its similar plants,such as white tea and Houttuynia cordata,so as to identity Khat and its camouflage and confusing products in smuggling crime and public security anti-drug work.Methods FTIR is used to collect the infrared spectral data of plant samples,and the data are analyzed by chemometrics.The original data were preprocessed by three data processing methods,namely,SG smoothing,baseline and normalization,then the processed data were classified and reduced by PCA,finally the mathematical model was constructed by three methods:KNN,RF and SVM for classification and prediction.Results The results were expressed by confusion matrix,and the accuracy of the RF model is 96.51%.The accuracy of the SVM model is 98.84%;The accuracy of the KNN model is 93.02%.Conclusion In this experiment,FTIR was used to establish a model for rapid identification of Khat grass,the SVM model has the highest correct recognition rate and good parameters,which can be used to distinguish dry khat from its similar plants.

Objective:To develop clinical physicians′ health education competency assessment tool, so as to provide reference for competency-based capability enhancement management.Methods:Conduct a literature search using keywords such as " clinical physicians" " competency" " hospital health education" " health education competency" and " health education ability" to retrieve articles published between 2003 and 2023 in the China National Knowledge Infrastructure (CNKI) and PubMed databases. Through literature review, combined with the competency onion model, construct an initial pool of items for the clinical physicians′ health education competency scale (PHECS). From May to September 2023, expert consultation was used to screen items and form a test version of the scale. From November 2023 to January 2024, a purposive sampling method was used to recruit doctors from 2 comprehensive hospitals in Nanjing and 5 community health service centers in each district. A questionnaire survey was conducted using the test version of the scale, and scale validation was performed based on questionnaire data using item analysis and factor analysis, among other methods.Results:The constructed PHECS included three domains: knowledge, skills, and comprehensive quality, as well as ten dimensions: health education knowledge, clinical-related knowledge, health education program development, health education program implementation, health education program evaluation, organization and coordination, communication, personal traits and self-efficacy, motivation, and professional values, totaling 36 items. Confirmatory factor analysis indicated that the model fits well ( χ2/ df=2.438, RMSEA=0.078, CFI=0.937, TLI=0.928), and the PHECS had acceptable internal consistency (Cronbach′s α values range from 0.89 to 0.98) and good convergent validity ( AVE for each factor range from 0.71 to 0.94, and composite reliability ranges from 0.88 to 0.98). Conclusions:The PHECS developed in this study has good reliability, validity, and scientific merit, and can be used for competency-based management to enhance the health education capabilities of clinical physicians.

Objective:To develop clinical physicians′ health education competency assessment tool, so as to provide reference for competency-based capability enhancement management.Methods:Conduct a literature search using keywords such as " clinical physicians" " competency" " hospital health education" " health education competency" and " health education ability" to retrieve articles published between 2003 and 2023 in the China National Knowledge Infrastructure (CNKI) and PubMed databases. Through literature review, combined with the competency onion model, construct an initial pool of items for the clinical physicians′ health education competency scale (PHECS). From May to September 2023, expert consultation was used to screen items and form a test version of the scale. From November 2023 to January 2024, a purposive sampling method was used to recruit doctors from 2 comprehensive hospitals in Nanjing and 5 community health service centers in each district. A questionnaire survey was conducted using the test version of the scale, and scale validation was performed based on questionnaire data using item analysis and factor analysis, among other methods.Results:The constructed PHECS included three domains: knowledge, skills, and comprehensive quality, as well as ten dimensions: health education knowledge, clinical-related knowledge, health education program development, health education program implementation, health education program evaluation, organization and coordination, communication, personal traits and self-efficacy, motivation, and professional values, totaling 36 items. Confirmatory factor analysis indicated that the model fits well ( χ2/ df=2.438, RMSEA=0.078, CFI=0.937, TLI=0.928), and the PHECS had acceptable internal consistency (Cronbach′s α values range from 0.89 to 0.98) and good convergent validity ( AVE for each factor range from 0.71 to 0.94, and composite reliability ranges from 0.88 to 0.98). Conclusions:The PHECS developed in this study has good reliability, validity, and scientific merit, and can be used for competency-based management to enhance the health education capabilities of clinical physicians.

Objective:To investigate the association of lipoprotein a (Lpa) in early pregnancy with gestational diabetes mellitus (GDM) risk.Methods:A total of 445 pregnant women in 12-14 gestational weeks from "Maternal Key Nutritional Factors and Offspring's Atopic Dermatitis" cohort were included in this study. The demographic characteristics of participants were collected by using questionnaires, and the fasting glucose and lipids levels in early pregnancy were measured. The results of oral glucose tolerance test (OGTT) between 24-28 gestational weeks were recorded. Multivariate logistic regression model was applied to analyze the association of Lpa with GDM by calculating the OR and 95% CI after adjustment for covariates. Results:The incidence number of GDM was 78 (17.5%). The Lpa level in pregnant women with GDM was significantly higher than that in pregnant women without GDM [105.5 (92.0, 122.0) vs. 97.0 (87.0, 109.0) mg/L], P<0.05. Lpa was significantly associated with GDM risk [ OR (95% CI) =1.21(1.08-1.36) per 10 mg/L], P<0.05. The association was still significant after adjustment for covariates including age, gestational weeks et al, the adjusted OR was 1.14 (95% CI: 1.01-1.30), P=0.03. Conclusions:The elevation of Lpa in early pregnancy is one of risk factor for GDM. Maintaining normal Lpa level during early pregnancy can benefit early prevention of GDM and offspring health.

Objective:To evaluate the effect of VX-765 on cognitive function in acute rapid eye movement (REM) sleep-deprived juvenile rats.Methods:Thirty-six clean-grade healthy male Sprague-Dawley rats, aged 3-4 weeks, weighing 52-101 g, were divided into 3 groups ( n=12 each) using a random number table method: control group (group C), acute REM group (group AREM) and VX-765 group (group V). Sleep deprivation model was established by modified multi-platform water environment method.In group V, VX-765 solution 10 mg/kg was intravenously injected via the tail vein at 9: 00 a. m.every day for 4 consecutive days.The equal volume of normal saline was given instead in C and AREM groups.Morris water maze and novel object recognition tests were performed for 4 consecutive days during sleep deprivation.The rats were then sacrificed after the end of Morris water maze and novel object recognition tests on 5th day, and hippocampi were removed for determination of the expression of interleukin-1beta (IL-1β) and IL-18 by Western blot. Results:Compared with group C, the latency of novel object recognition was significantly prolonged, the percentage of novel object exploration was shortened, and the number of head exploration was decreased, the percentage of novel object exploration and discrimination index were decreased, the number of crossing the original platform in Morris water maze test was reduced, the time of staying at the target quadrant was shortened, and the expression of IL-1β and IL-18 was up-regulated in AREM and V groups ( P<0.05). Compared with group AREME, the latency of novel object recognition was significantly shortened, the percentage of novel object exploration was prolonged, and the number of head exploration was increased, the percentage of novel object exploration and discrimination index were increased, the number of crossing the original platform in Morris water maze test was increased, the time of staying at the target quadrant was prolonged, and the expression of IL-1β and IL-18 was down-regulated ( P<0.05). Conclusion:VX-765 can improve the cognitive function in acute REM sleep-deprived juvenile rats, which is related to inhibiting hippocampal inflammatory responses.

Objective To evaluate the effectiveness of a chronic disease self-management program (CDSMP) in the Nanjing community. Methods From April to June 2016, the volunteer patients with chronic diseases from National Basic Public Health Services Plan were recruited and agreed to enter the CDSMP. A total of 42 self-management groups were established. The Nanjing CDSMP was based on the model of the Shanghai CDSMP developed by Stanford University. Questionnaire surveys, anthropometric measurements, and laboratory examinations were collected at 3 measurement moments (baseline, after 6 months, and after 12 months). Qualitative data were obtained from 1-2 participants in each self-management group. Paired t-tests, paired Chi-square tests, generalized estimating equation, and content analysis were used to evaluate the effectiveness of the CDSMP. Results Among 562 eligible patients, 548 completed 3 questionnaire surveys, physical measurements, and laboratory examinations. Sixty-six interviewees completed qualitative evaluations. Compared with baseline, the time of stretching or strengthening exercise and aerobic exercise; the scores on communication with the medical doctor; self-efficacy to manage symptoms and manage disease in general; quality of life in physical component summary and mental component summary; and rate of glucose control were all higher after 6 months and after 12 months interventions, whereas the score of fatigue; pain, health distress; social/role activities limitation; and the value of body weight, systolic blood pressure, and triglyceride were all decreased (all P values<0.01). The satisfaction rate of CDSMP in general, and content were 87.9%, 90.9%, and 83.3%, respectively. Conclusion Overall, the Nanjing CDSMP was successful in improving knowledge and self-management skills, increasing self-management behaviors, self-efficacy, health status, and quality of life, and decreasing body weight, blood pressures, and lipids. It is suggested that CDSMP may be widely used in Nanjing communities.

Objective To evaluate the diabetes self-management program based on Chinese local patients in Nanjing community. Methods From April 2014 to June 2014, diabetes patients were recruited through health records system screening in the community health service centers, letter invitation, poster announcements at communities, and telephone notification. A total of 53 self-management groups were established. Nanjing diabetes self-management program included six 1-1.5 hours sessions scheduled on consecutive weeks, based on the blueprint of Shanghai Chronic Disease Self-Management Program (CDSMP) developed at Stanford University. Baseline and three-month later interviews were conducted respectively. Results A total of 636 patients were recruited and agreed to enter CDSMP; 603 completed the 6-session activities, with the response rate being 94.8%. Compared to baseline, nine of the patients' the awareness rate of diabetes-related knowledge, six of self-management behaviors, the scores of quality of life in physical component summary [(47.51 ± 9.47) vs. (49.10 ± 8.27) points, t=6.170, P=0.000] and mental component summary [(47.09±11.95) vs. (49.13±10.74) points, t=5.157, P=0.000] were all higher after three months (all P values<0.05). Three months after implementation, the level of systolic blood pressure, diastolic blood pressure, fasting plasma glucose and total cholesterol decreased respectively by (1.42±0.52) mmHg (1 mmHg=0.133 kPa), (0.98 ± 0.34) mmHg, (0.66 ± 0.16) mmol/L, (0.15 ± 0.56) mmol/L,the differences were statistically significant (tpaired values were 3.935, 2.030, 4.889, 4.899, all P values<0.05). Conclusion The diabetes self-management program based on Chinese local patients for Nanjing may improve patients' awareness rate of diabetes-related knowledge, self-management behavior, the quality of life, and health status. CDSMP could be applied effectively in Nanjing.