Objective:To evaluate the effectiveness of an integrated management model involving the Centers for Disease Control and Prevention (CDC), general hospitals, and community health service centers in improving outcomes for community-dwelling patients with chronic obstructive pulmonary disease (COPD), with the aim of optimizing existing COPD management strategies.Methods:This study was a cluster randomized controlled trial. From January to March 2022, a total of 236 patients with COPD were recruited from four communities in Chibi City, Hubei Province. Ultimately, 223 patients completed follow-up and participated in the intervention evaluation. The participants were cluster-randomized into an intervention group ( n=121) and a control group ( n=102). The intervention group received a one-year "trinity" integrated community management model, while the control group received only basic follow-up. Face-to-face questionnaires were administered before and after the intervention to collect data on demographics, disease awareness, risk factors, respiratory symptoms, medication use, and disease management. Quality of life scores and pulmonary function tests were also assessed. Pre-and post-intervention outcomes were compared using t-tests or chi-square tests. Results:The intervention group demonstrated significantly higher rates of COPD awareness and disease-related knowledge compared to the control group (94.12% vs 77.78% and 78.15% vs 49.49%; both P<0.05), along with lower overall smoking rate and current smoking rate (57.14% vs 70.71% and 29.41% vs 47.47%; both P<0.05). The intervention group showed reduced household polluting fuel use for heating (17.65% vs 28.93%; P<0.05), while the control group exhibited no significant change. Significant improvements were observed in the intervention group for inhaler medication usage (14.05% vs 2.94%), exercise training, and respiratory muscle training (22.31% vs 2.94% and 26.45% vs 0.98%)(all P<0.05). Additionally, the intervention group reported lower prevalence of chronic sputum production, wheezing, and dyspnea (12.40%, 0.83%, 27.27% vs 24.51%, 9.80%, 41.18%; all P<0.05) compared to controls. Pulmonary function tests revealed that the percentage of forced expiratory volume in one second (FEV 1%predicted) was significantly higher in the intervention group than in the control group [(69.53±18.01)% vs (54.90±12.39)%; both P<0.05]. Conclusions:The "trinity" integrated management model effectively enhances health literacy, self-management capabilities, and quality of life among COPD patients, while reducing behavioral risk factors. This model aligns with the long-term and individualized management needs of COPD patients.

OBJECTIVE To explore the efficacy and safety of different doses of bupivacaine liposome （referred to as “LB”） in posterior quadratus lumborum block （QLB） for postoperative analgesia in patients undergoing cesarean section （CS）. METHODS In prospective research method， a total of 168 patients undergoing CS admitted to Chongzhou Maternal and Child Health Hospital from June to December 2024 were randomly divided into LB1 group， LB2 group， and LB3 group （LB of 199， 133 and 67 mg， respectively） according to the random number sorting method， with 56 cases in each group. All patients underwent CS after combined spinal-epidural anesthesia， and received patient-controlled intravenous analgesia and bilateral posterior QLB with different doses of LB after the operation. Visual analogue scale score， Ramsay sedation score， the presence of postoperative block planes and muscle strength classification were observed in the three groups of patients at 6， 12， 24， 48 and 72 hours after the operation. The time of the first compression of the analgesic pump， the dosage of sufentanil and butorphanol within 72 hours after surgery， the number of compressions of the analgesic pump， the analgesic rescue rate， the time of initiating lactation， the score of neonatal behavioral neurological assessment （NBNA）， the time of postoperative exhaust， the indwelling time of urinary catheter， the length of hospital stay， and the total satisfaction at 72 hours after surgery were compared. The occurrence of adverse reactions within 72 hours after the operation was recorded. RESULTS The resting and motor pain scores， the dosage of sufentanil and butorphanol within 72 hours after surgery， the number of compressions of the analgesic pump， the analgesic rescue rate， and the time of initiating lactation at 6， 12， 24， 48 and 72 hours after surgery in the LB1 group and the LB2 group were significantly lower or shorter than those in the LB3 group（P＜0.05）. The proportion of postoperative block planes at 24， 48 and 72 hours after surgery， the time of the first compression of the analgesic pump and the total satisfaction in the LB1 group and the LB2 group were significantly higher or longer than those in the LB3 group（P＜0.05）. The proportion of patients with muscle strength≤grade 3 at 6 hours after surgery in the LB1 group was significantly higher than that in the LB2 and the LB3 groups （P＜0.05）. There were no statistically significant differences in the Ramsay sedation scores at each time point after surgery， NBNA scores， postoperative exhaust time， urinary catheter indwelling time， the length of hospital stay， as well as the occurrence of adverse reactions among the 3 groups （P＞0.05）. CONCLUSIONS Compared with 67 mg of LB， 199 mg and 133 mg of LB can improve the postoperative analgesic effect and total satisfaction of CS patients undergoing posterior QLB， reduce the use of postoperative analgesic drugs， and shorten the time to start lactation. Compared with 199 mg and 133 mg of LB， 67 mg of LB has a smaller impact on the motor function of CS patients. All three doses of LB had no significant effect on the neurobehavioral abilities of newborns, and demonstrated comparable sedative efficacy and safety.

Objective:To explore the impact of group interpersonal psychotherapy (IPT-G) on depressive symptoms and social cognitive function of adolescents with depression.Methods:From June 2021 to December 2023, a total of 75 adolescent inpatients diagnosed with depression were recruited from Hangzhou Seventh People’s Hospital. They were divided into intervention group and control group according to the general information matching principle.Finally, 30 patients in each group completed the study.The patients in control group received antidepressant medication, psychiatric care, and general recreational activities.While the patients in intervention group received IPT-G based on the treatment of control group. Children's depression inventory (CDI), interpersonal trust scale (ITS), self-esteem scale (SES) and the adolescent cognitive style questionnaire (ACSQ) were adopted to assess the depressive symptoms and social cognitive function of adolescent inpatients before and after the intervention and at 3 and 6 months of follow-up, respectively. SPSS 25.0 software was used for statistical analysis. Chi-square test, independent sample t-test and repeated measure ANOVA were used for inter or intra group comparisons. Results:1.Comparison of depression: The time and group interaction effect of CDI scores between the two groups was significant ( F=6.405, P<0.01). Inter group comparison showed that the CDI scores of the intervention group at 3 and 6 months (12.10±5.20, 7.93±2.98) were lower than those of the control group(18.13±7.28, 15.77±5.52) (both P<0.05), and the scores of both groups at the end of the intervention, 3 months after the intervention, and 6 months after the intervention were lower than that before intervention (all P<0.05).2.Comparison of social cognitive function: (1)There were significant time and group interaction effect of ITS score and SES score( F=5.871, 6.594, both P<0.01).Inter group comparison showed that the ITS score(78.97±7.63, 83.03±7.42) and the SES score(28.00±4.00, 30.30±3.21) of intervention group at 3 months and 6 months after intervention were all higher than those of control group(ITS: (71.70±12.29, 73.90±12.79); SES: (24.37±5.08, 25.80±4.10)(all P<0.05).Intra group comparison showed that the ITS and the SES scores of the intervention group at 3 months and 6 months after intervention were all higher than before intervention( P<0.05).The ITS score of the control group at 6 months after intervention was higher than before intervention( P<0.05).The SES scores of the control group at three time points after intervention were all higher than those before intervention(all P<0.05).(2)Comparison of ACSQ scores: There were significant time and group interaction effects for the scores of academic stability, academic specificity, interpersonal introversion and extroversion, and interpersonal stability, interpersonal specificity( F=5.414, 9.294, 3.440, 8.231, 10.669, all P<0.05). Inter group comparison showed that the academic stability, academic specificity, interpersonal stability, and interpersonal specificity scores of the intervention group were lower than those of the control group at 3 and 6 months after intervention (all P<0.05).Intra group comparison showed that the academic stability, academic specificity, interpersonal introversion and extroversion, interpersonal stability, and interpersonal specificity scores of the intervention group at 3 months and 6 months after the intervention were lower than those before the intervention (all P<0.05).After 3 and 6 months of intervention, the academic stability, academic specificity, interpersonal introversion and extroversion, interpersonal stability, and interpersonal specificity scores of the control group were all lower than those before intervention (all P<0.05). Conclusion:IPT-G can not only alleviate depressive symtoms, but also improve social cognitive function.

Non-small cell lung cancer (NSCLC), a leading cause of cancer-related deaths worldwide, remains a significant clinical challenge despite advances in immune checkpoint inhibitors therapy, with drug resistance persisting as a major obstacle. Palmitoylation, a critical post-translational modification (PTM) primarily catalyzed by palmitoyltransferases of the zinc finger DHHC-type (ZDHHC), has recently demonstrated important implications in NSCLC. This review aims to elucidate the mechanisms and clinical potential of ZDHHC-mediated protein palmitoylation in NSCLC progression and immune escape.
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Humans ; Lipoylation ; Lung Neoplasms/pathology* ; Acyltransferases/genetics* ; Carcinoma, Non-Small-Cell Lung/pathology* ; Animals

Objective:To explore the impact of group interpersonal psychotherapy (IPT-G) on depressive symptoms and social cognitive function of adolescents with depression.Methods:From June 2021 to December 2023, a total of 75 adolescent inpatients diagnosed with depression were recruited from Hangzhou Seventh People’s Hospital. They were divided into intervention group and control group according to the general information matching principle.Finally, 30 patients in each group completed the study.The patients in control group received antidepressant medication, psychiatric care, and general recreational activities.While the patients in intervention group received IPT-G based on the treatment of control group. Children's depression inventory (CDI), interpersonal trust scale (ITS), self-esteem scale (SES) and the adolescent cognitive style questionnaire (ACSQ) were adopted to assess the depressive symptoms and social cognitive function of adolescent inpatients before and after the intervention and at 3 and 6 months of follow-up, respectively. SPSS 25.0 software was used for statistical analysis. Chi-square test, independent sample t-test and repeated measure ANOVA were used for inter or intra group comparisons. Results:1.Comparison of depression: The time and group interaction effect of CDI scores between the two groups was significant ( F=6.405, P<0.01). Inter group comparison showed that the CDI scores of the intervention group at 3 and 6 months (12.10±5.20, 7.93±2.98) were lower than those of the control group(18.13±7.28, 15.77±5.52) (both P<0.05), and the scores of both groups at the end of the intervention, 3 months after the intervention, and 6 months after the intervention were lower than that before intervention (all P<0.05).2.Comparison of social cognitive function: (1)There were significant time and group interaction effect of ITS score and SES score( F=5.871, 6.594, both P<0.01).Inter group comparison showed that the ITS score(78.97±7.63, 83.03±7.42) and the SES score(28.00±4.00, 30.30±3.21) of intervention group at 3 months and 6 months after intervention were all higher than those of control group(ITS: (71.70±12.29, 73.90±12.79); SES: (24.37±5.08, 25.80±4.10)(all P<0.05).Intra group comparison showed that the ITS and the SES scores of the intervention group at 3 months and 6 months after intervention were all higher than before intervention( P<0.05).The ITS score of the control group at 6 months after intervention was higher than before intervention( P<0.05).The SES scores of the control group at three time points after intervention were all higher than those before intervention(all P<0.05).(2)Comparison of ACSQ scores: There were significant time and group interaction effects for the scores of academic stability, academic specificity, interpersonal introversion and extroversion, and interpersonal stability, interpersonal specificity( F=5.414, 9.294, 3.440, 8.231, 10.669, all P<0.05). Inter group comparison showed that the academic stability, academic specificity, interpersonal stability, and interpersonal specificity scores of the intervention group were lower than those of the control group at 3 and 6 months after intervention (all P<0.05).Intra group comparison showed that the academic stability, academic specificity, interpersonal introversion and extroversion, interpersonal stability, and interpersonal specificity scores of the intervention group at 3 months and 6 months after the intervention were lower than those before the intervention (all P<0.05).After 3 and 6 months of intervention, the academic stability, academic specificity, interpersonal introversion and extroversion, interpersonal stability, and interpersonal specificity scores of the control group were all lower than those before intervention (all P<0.05). Conclusion:IPT-G can not only alleviate depressive symtoms, but also improve social cognitive function.

Objective:To evaluate the effectiveness of an integrated management model involving the Centers for Disease Control and Prevention (CDC), general hospitals, and community health service centers in improving outcomes for community-dwelling patients with chronic obstructive pulmonary disease (COPD), with the aim of optimizing existing COPD management strategies.Methods:This study was a cluster randomized controlled trial. From January to March 2022, a total of 236 patients with COPD were recruited from four communities in Chibi City, Hubei Province. Ultimately, 223 patients completed follow-up and participated in the intervention evaluation. The participants were cluster-randomized into an intervention group ( n=121) and a control group ( n=102). The intervention group received a one-year "trinity" integrated community management model, while the control group received only basic follow-up. Face-to-face questionnaires were administered before and after the intervention to collect data on demographics, disease awareness, risk factors, respiratory symptoms, medication use, and disease management. Quality of life scores and pulmonary function tests were also assessed. Pre-and post-intervention outcomes were compared using t-tests or chi-square tests. Results:The intervention group demonstrated significantly higher rates of COPD awareness and disease-related knowledge compared to the control group (94.12% vs 77.78% and 78.15% vs 49.49%; both P<0.05), along with lower overall smoking rate and current smoking rate (57.14% vs 70.71% and 29.41% vs 47.47%; both P<0.05). The intervention group showed reduced household polluting fuel use for heating (17.65% vs 28.93%; P<0.05), while the control group exhibited no significant change. Significant improvements were observed in the intervention group for inhaler medication usage (14.05% vs 2.94%), exercise training, and respiratory muscle training (22.31% vs 2.94% and 26.45% vs 0.98%)(all P<0.05). Additionally, the intervention group reported lower prevalence of chronic sputum production, wheezing, and dyspnea (12.40%, 0.83%, 27.27% vs 24.51%, 9.80%, 41.18%; all P<0.05) compared to controls. Pulmonary function tests revealed that the percentage of forced expiratory volume in one second (FEV 1%predicted) was significantly higher in the intervention group than in the control group [(69.53±18.01)% vs (54.90±12.39)%; both P<0.05]. Conclusions:The "trinity" integrated management model effectively enhances health literacy, self-management capabilities, and quality of life among COPD patients, while reducing behavioral risk factors. This model aligns with the long-term and individualized management needs of COPD patients.

Objective:To explore the factors that promote and hinder exercise adherence in long dialysis duration hemodialysis patients, and to provide a reference for improving their exercise levels.Methods:From March to May 2023, a qualitative research method using phenomenon approach was conducted and 15 patients with peritoneal dialysis for at least 10 years at the People′s Liberation Army Central Command Headquarters Hospital (Hankou Hospital) were selected for in-depth interviews using purposive sampling method. The data were analyzed using Colaizzi 7-step method and the main themes were extracted.Results:Among the 15 interviewers, there were 5 males and 10 females, aged 39-76 years old.Conclusions:The exercise level of long dialysis duration hemodialysis patients is influenced by multiple factors. Medical staff should correct their cognitive biases and change their behavioral attitudes, strengthen external supportive environments and reduce subjective normative pressures, gradually provide more objective support, thereby promoting the exercise training of long dialysis duration hemodialysis patients.

Objective:To detect the cystic fibrosis transmembrane transduction regulator(CFTR)gene mutations and congenital bilateral absence of vas deferens(CBAVD)susceptibility gene mutations in pa-tients with CBAVD,and to explore their association with the risk of CBAVD.Methods:Whole-exome sequencing and Sanger sequencing validation were conducted on the pathogenic genes CFTR,adhesion G protein-coupled receptor G2(ADGRG2),sodium channel epithelial 1 subunit beta(SCNN1B),carbonic anhydrase 12(CA12),and solute carrier family 9 member A3(SLC9A3)in thirteen cases of isolated CBAVD patients.The polymorphic loci,intron and flanking sequences of CFTR gene were amplified by polymerase chain reaction(PCR)followed by Sanger sequencing.Bioinformatics methods were employed for conservative analysis and deleterious prediction of novel susceptibility gene mutations in CBAVD.Ge-netic analysis was performed on the pedigree of one out of thirteen patients with CBAVD to evaluate the risk of inheritance in offspring.Results:Exome sequencing revealed CFTR gene exon mutations in only six of the thirteen CBAVD patients,with six missense mutations c.2684G＞A(p.Ser895Asn),c.4056G＞C(p.Gln1352His),c.2812G＞(p.Val938Leu),c.3068T＞G(p.Ile1023Arg),c.374T＞C(p.Ile125Thr),c.1666A＞G(p.Ile556Val)),and one nonsense mutation(c.1657C＞T(p.Arg553Ter).Among these six patients,two also had the CFTR homozygous p.V470 site,additional-ly,mutations in CFTR gene exon regions were not detected in the remaining seven patients.Within the thirteen CBAVD patients,three carried the homozygous p.V470 polymorphic site,four carried the 5T al-lele,two carried the TG13 allele,and ten carried the c.-966T＞G site.Four CBAVD patients simulta-neously carried 2-3 of the aforementioned CFTR gene mutation sites.Susceptibility gene mutations in CBAVD among the thirteen patients included one ADGRG2 missense mutation c.2312A＞G(p.Asn771Ser),two SLC9A3 missense mutations c.2395T＞C(p.Cys799Arg),c.493G＞A(p.Val165Ile),one SCNN1B missense mutation c.1514G＞A(p.Arg505His),and one CA12 missense mutation c.1061C＞T(p.Ala354Val).Notably,the SLC9A3 gene c.493 G＞A(p.Val165Ile)mutation site was first identi-fied in CBAVD patients.The five mutations exhibited an extremely low population mutation frequency in the gnomAD database,classifying them as rare mutations.Predictions from Mutation Taster and Poly-phen-2 software indicated that the harmfulness level of the SLC9A3 gene c.493G＞A(p.Val165Ile)site and the SCNN1B gene c.1514G＞A(p.Arg505His)site were disease causing and probably damaging.The genetic analysis of one pedigree revealed that the c.1657C＞T(p.Arg553Ter)mutation in the proband was a de novo mutation,as neither the proband's father nor mother carried this mutation.The proband and his spouse conceived a daughter through assisted reproductive technology,and the daughter inherited the proband's pathogenic mutation c.1657C＞T(p.Arg553Ter).Conclusion:CFTR gene mutations remain the leading cause of CBAVD in Chinese patients;however,the distribution and fre-quency of mutations differ from data reported in other domestic and international studies,highlighting the need to expand the CFTR mutation spectrum in Chinese CBAVD patients.The susceptibility genes ADGRG2,SLC9A3,SCNN1B,and CA12 may explain some cases of CBAVD without CFTR mutations.Given the lack of specific clinical manifestations in CBAVD patients,it is recommended that clinicians conduct further physical examinations and consider scrotal or transrectal ultrasound before making a defi-nitive diagnosis.It is advisable to employ CFTR gene mutation testing in preconception genetic screening to reduce the risk of CBAVD and cystic fibrosis in offspring.

Background and Objectives: The goal of this study was to investigate the mechanism of mesenchymal stem cell (MSC)-derived microRNA (miR)-150-5p-expressing exosomes in promoting skin wound healing through activating PI3K/AKT pathway by PTEN. Methods: and Results: Human umbilical cord (HUC)-MSCs were infected with miR-150-5p overexpression and its con-trol lentivirus, and HUC-MSCs-derived exosomes (MSCs-Exos) with stable expression of miR-150-5p were obtained. HaCaT cells were induced by H2O2 to establish a cellular model of skin injury, in which the expression of miR-150-5p and PTEN and the phosphorylation of PI3K and AKT were evaluated. HaCaT cells were transfected with pcDNA3.1-PTEN or pcDNA3.1 and then cultured with normal exosomes or exosomes stably expressing miR-150-5p. Cell proliferation was inspected by CCK-8. Cell migration was detected by scratch test and cell apoptosis by flow cytometry. The starBase tool was used to predict the binding site of miR-150-5p to PTEN. Dual-luciferase reporter assay and RIP assay were applied to assess the interaction between miR-150-5p and PTEN. In H2O2 -induced HaCaT cells, the miR-150-5p expression decreased, and PTEN expression increased in a concentration-dependent manner. MSCs-Exos promoted the growth and migration of H2O2 -induced HaCaT cells and inhibited their apoptosis. In addition, overexpression of exosomal miR-150-5p enhanced the protective effect of MSCs-Exos on H2O2 -induced HaCaT cells; PTEN overexpression in HaCaT cells partially restrained miR-150-5p-mediated inhibition on H2O2 -induced injury in HaCaT cells. PTEN was a target gene of miR-150-5p. MiR-150-5p regulated PI3K/AKT pathway through PTEN. Conclusions MSCs-derived miR-150-5p-expressing exosomes promote skin wound healing by activating PI3K/AKTpathway through PTEN.

Objective:To investigate the distribution and antimicrobial resistance profile of clinical bacteria isolated from blood culture in China.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2018 to December 2019. Antibiotic susceptibility tests were conducted with agar dilution or broth dilution methods recommended by US Clinical and Laboratory Standards Institute (CLSI). WHONET 5.6 was used to analyze data.Results:During the study period, 14 778 bacterial strains were collected from 50 hospitals, of which 4 117 (27.9%) were Gram-positive bacteria and 10 661(72.1%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (37.2%), Klebsiella pneumoniae (17.0%), Staphylococcus aureus (9.7%), coagulase-negative Staphylococci (8.7%), Pseudomonas aeruginosa (3.7%), Enterococcus faecium (3.4%), Acinetobacter baumannii(3.4%), Enterobacter cloacae (2.9%), Streptococci(2.8%) and Enterococcus faecalis (2.3%). The the prevalence of methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus were 27.4% (394/1 438) and 70.4% (905/1 285), respectively. No glycopeptide-resistant Staphylococcus was detected. More than 95% of S. aureus were sensitive to amikacin, rifampicin and SMZco. The resistance rate of E. faecium to vancomycin was 0.4% (2/504), and no vancomycin-resistant E. faecalis was detected. The ESBLs-producing rates in no carbapenem-resistance E. coli, carbapenem sensitive K. pneumoniae and Proteus were 50.4% (2 731/5 415), 24.6% (493/2001) and 35.2% (31/88), respectively. The prevalence of carbapenem-resistance in E. coli and K. pneumoniae were 1.5% (85/5 500), 20.6% (518/2 519), respectively. 8.3% (27/325) of carbapenem-resistance K. pneumoniae was resistant to ceftazidime/avibactam combination. The resistance rates of A. baumannii to polymyxin and tigecycline were 2.8% (14/501) and 3.4% (17/501) respectively, and that of P. aeruginosa to carbapenem were 18.9% (103/546). Conclusions:The surveillance results from 2018 to 2019 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while E. coli was the most common pathogen, and ESBLs-producing strains were in majority; the MRSA incidence is getting lower in China; carbapenem-resistant E. coli keeps at a low level, while carbapenem-resistant K. pneumoniae is on the rise obviously.