Objective:To systematically integrate the work experience of medical and nursing staff in the remote home palliative care model, so as to provide a reference for improving remote home palliative care services.Methods:Qualitative studies on medical and nursing staff providing remote home palliative care were electronically searched in PubMed, Web of Science, Embase, ProQuest, CINAHL, PsycINFO, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc. The search period was from database establishment to April 30, 2024. Literature quality evaluation was conducted using the Joanna Briggs Institute Center for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research. The aggregative integration method was used to synthesize the findings.Results:Researchers repeatedly read, analyzed, and interpreted the 17 included literature, extracting 56 themes and summarizing eight new categories, and further synthesized three integrated results, namely, remote home palliative care provided patients with comprehensive physical, psychological, and mental care, as well as guidance and support for family members; remote home care helped to achieve full coverage of palliative care services; equipment limitations, information security risks, and incomplete processes restricted the development of remote palliative care.Conclusions:Remote home palliative care has improved patient care and family support capabilities, expanded service coverage, and promoted interdisciplinary collaboration. However, there are still issues such as equipment limitations, information security risks, and incomplete processes. Optimizing processes, improving safety mechanisms, and strengthening collaboration platforms will contribute to sustainable development.

Objective:To systematically integrate the work experience of medical and nursing staff in the remote home palliative care model, so as to provide a reference for improving remote home palliative care services.Methods:Qualitative studies on medical and nursing staff providing remote home palliative care were electronically searched in PubMed, Web of Science, Embase, ProQuest, CINAHL, PsycINFO, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc. The search period was from database establishment to April 30, 2024. Literature quality evaluation was conducted using the Joanna Briggs Institute Center for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research. The aggregative integration method was used to synthesize the findings.Results:Researchers repeatedly read, analyzed, and interpreted the 17 included literature, extracting 56 themes and summarizing eight new categories, and further synthesized three integrated results, namely, remote home palliative care provided patients with comprehensive physical, psychological, and mental care, as well as guidance and support for family members; remote home care helped to achieve full coverage of palliative care services; equipment limitations, information security risks, and incomplete processes restricted the development of remote palliative care.Conclusions:Remote home palliative care has improved patient care and family support capabilities, expanded service coverage, and promoted interdisciplinary collaboration. However, there are still issues such as equipment limitations, information security risks, and incomplete processes. Optimizing processes, improving safety mechanisms, and strengthening collaboration platforms will contribute to sustainable development.

Objective:To explore the independent association between handgrip strength and chronic kidney disease (CKD) in adult residents in Anhui Province using data from the China Adult Chronic Disease and Risk Factor Surveillance (2023).Methods:A multi-stage stratified cluster random sampling method was used to select residents aged ≥18 years for surveys, physical measurements, and laboratory tests. Relevant covariates were adjusted, and a multivariable logistic regression model was established to infer the association between handgrip strength and CKD, followed by subgroup analysis.Results:A total of 7 295 participants were included in the study, with age of (61.5±13.2) years, and 55.6% of the study participants were women. The results of the multivariate logistic regression analysis showed that with each 1.0 kg increase in handgrip strength, the risk for CKD decreased by 1.3% ( OR=0.987, 95% CI: 0.978-0.997). Compared with those with low handgrip strength, the people with moderate hasdgrip strength ( OR=0.818, 95% CI: 0.694-0.964) and high handgrip strength ( OR=0.729, 95% CI: 0.598-0.989) had lower risk for CKD. In the subgroup analysis, the association between handgrip strength and risk for CKD remained unchanged regardless age, sex, smoking status, and alcohol consumption statuys, and the prevalence of hypertension and hyperlipidemia (interaction P>0.05), except BMI and diabetes. Conclusion:The decline in handgrip strength is associated with an increased risk for CKD in adult residents in Anhui.

Objective:To explore the independent association between handgrip strength and chronic kidney disease (CKD) in adult residents in Anhui Province using data from the China Adult Chronic Disease and Risk Factor Surveillance (2023).Methods:A multi-stage stratified cluster random sampling method was used to select residents aged ≥18 years for surveys, physical measurements, and laboratory tests. Relevant covariates were adjusted, and a multivariable logistic regression model was established to infer the association between handgrip strength and CKD, followed by subgroup analysis.Results:A total of 7 295 participants were included in the study, with age of (61.5±13.2) years, and 55.6% of the study participants were women. The results of the multivariate logistic regression analysis showed that with each 1.0 kg increase in handgrip strength, the risk for CKD decreased by 1.3% ( OR=0.987, 95% CI: 0.978-0.997). Compared with those with low handgrip strength, the people with moderate hasdgrip strength ( OR=0.818, 95% CI: 0.694-0.964) and high handgrip strength ( OR=0.729, 95% CI: 0.598-0.989) had lower risk for CKD. In the subgroup analysis, the association between handgrip strength and risk for CKD remained unchanged regardless age, sex, smoking status, and alcohol consumption statuys, and the prevalence of hypertension and hyperlipidemia (interaction P>0.05), except BMI and diabetes. Conclusion:The decline in handgrip strength is associated with an increased risk for CKD in adult residents in Anhui.

Eleven compounds were isolated and purified from the ethyl acetate part of 80% ethanol extract of Ferula feruloides root by a combination of normal-phase silica gel column chromatography, Sephadex LH-20 dextran gel column chromatography and semi-preparative liquid chromatography and then modern wave spectrometry methods (NMR, MS, UV, IR) were used to identify the structures of the compounds, which were identified as baigene D (1), baigene E (2), baigene F (3), β-kirialovin (4), α-kirialovin (5), falcarindiol (6), ammoresinol (7), dshamirone (8), 2,3-dihydro-7-hydroxy-2S*,3R*-dimethyl-3-[4-methyl-5-(4-methy1-2-furyl)-3(E)-pentenyl]-furo[3,2-c]coumarin (9), 2,3-dihydro-7-hydroxy-2S*,3R*-dimethyl-2-[4,8-dimethyl-3(E),7-nonadi-enyl]-furo[3,2-c]coumarin (10), and baigene C (11). Compounds 1-3 are new coumarin analogues, and compounds 4-6 are firstly isolated from F. feruloides. The anti-proliferative activity of compounds 5, 7-11 against human gastric cancer (MKN-45) cells was evaluated using MTT assay, which showed that compounds 7-11 exhibited strong inhibitory activity, and compound 5 exhibited weak inhibitory activity.

【Objective】 To understand the obesity status of Kazakh children and adolescents in the agricultural and pastoral areas of Xinjiang and its association with lifestyle, so as to provide reference and help for maintaining good body shape and health intervention for Kazakh children and adolescents in agricultural and pastoral areas. 【Methods】 From April to June 2022, 6 242 Kazakh children and adolescents aged 10 - 20 years were tested for obesity and surveyed by lifestyle questionnaires using stratified whole-group sampling in the farming and herding areas of Yili Kazakh Autonomous Prefecture and Altay Region, Xinjiang. χ² test and Logistic regression analysis were used to analyze data. 【Results】 The obesity detection rate of Kazakh children and adolescents in Xinjiang farming and herding areas was 18.71%, with higher rates in boys (22.24%) compared to girls (15.12%), and the difference was statistically significant (χ² =52.04, P<0.01). Significant differences were observed in the obesity rates based on grade level, fruit consumption frequency, screen time of television, feeling hopeful for the future, fatigue, loneliness, and sadness (χ² =24.29, 4.61, 694.51, 7.15, 10.33, 6.51, 8.07, P<0.01). Logistic regression analysis showed that female students (OR=0.63, 95%CI: 0.56 - 0.69) and students who felt hopeful about the future (OR=0.96, 95%CI: 0.94 - 0.99) were protective factors against obesity (P<0.05); while high school and lower grades (senior high school OR=1.38, 95%CI: 1.24 - 1.57; junior high school OR=1.82, 95%CI: 1.58 - 2.06; primary school OR=2.67, 95%CI: 2.33 - 2.99), fruit consumption ≥1time/d (OR=1.07, 95%CI: 1.03 - 1.16), watching TV ≥2h/d (OR=1.07, 95%CI: 1.02 - 1.17), frequent feeling of fatigue (OR=1.07, 95%CI: 1.03 - 1.12), loneliness (OR=1.08, 95%CI: 1.02~1.19) and sadness (OR= 1.09, 95%CI: 1.04 - 1.14) of students were risk factors for the development of obesity (P<0.05). 【Conclusions】 The obesity rate of Kazakh children and adolescents in the agricultural and pastoral areas of Xinjiang is high and closely associated with lifestyle. Therefore, it is crucial to improve unhealthy lifestyles in order to reduce obesity and promote the physical and mental well-being of this population.

Objective To explore the causal complexity between individual digital literacy and innovative behaviors by focusing on medical students,and to provide scientific references for empowering their innovative behaviors.Methods A questionnaire survey was conducted to collect relevant data from students currently enrolled in a medical school in Anhui Province.Fuzzy-set qualitative comparative analysis(fsQCA)was performed to examine the different combination paths for empowering innovative behaviors in medical students.Results A total of 922 valid questionnaires were collected.Based on six conditional variables of digital literacy,namely information and data literacy,communication and collaboration literacy,digital content creation literacy,security literacy,problem solving literacy,and career-related literacy,there were five configurations for high-level innovation behaviors of medical students,with the overall consistency being 0.816 and the overall coverage being 0.664.On the other hand,there were three configurations for their low-level innovation behaviors,with the overall consistency being 0.901 and the total coverage being 0.585.Conclusion There is a causal complexity between medical students'digital literacy and their innovative behaviors.Different dimensions of digital literacy act synergistically to produce multiple paths to empower medical students'innovative behaviors.Among them,a high level of competence in digital content creation is the core condition that empowers innovative behaviors in medical students,while a low level of problem-solving competence is the key barrier to their innovative behaviors.

Although NPM1 mutations are frequently found in acute myeloid leukemia patients, therapeutic strategies are scarce and unsuitable for those who cannot tolerate intensive chemotherapy. Here we demonstrated that heliangin, a natural sesquiterpene lactone, exerts favorable therapeutic responses in NPM1 mutant acute myeloid leukemia cells, with no apparent toxicity to normal hematogenous cells, by inhibiting their proliferation, inducing apoptosis, causing cell cycle arrest, and promoting differentiation. In-depth studies on its mode of action using quantitative thiol reactivity platform screening and subsequent molecular biology validation showed that the ribosomal protein S2 (RPS2) is the main target of heliangin in treating NPM1 mutant AML. Upon covalent binding to the C222 site of RPS2, the electrophilic moieties of heliangin disrupt pre-rRNA metabolic processes, leading to nucleolar stress, which in turn regulates the ribosomal proteins-MDM2-p53 pathway and stabilizes p53. Clinical data shows that the pre-rRNA metabolic pathway is dysregulated in acute myeloid leukemia patients with the NPM1 mutation, leading to a poor prognosis. We found that RPS2 plays a critical role in regulating this pathway and may be a novel treatment target. Our findings suggest a novel treatment strategy and lead compound for acute myeloid leukemia patients, especially those with NPM1 mutations.

Objective: To evaluate the effect of Triangle hierarchical management among community patients with hypertension, so as to provide insights into the improvements of standardized hypertension management. Methods: Patients with newly diagnosed hypertension from 2 community health service centers in Qiantang District of Hangzhou City by the end of 2020 were randomly assigned to the conventional group and the Triangle group. Patients in the conventional group were given health management services according to the requirements of basic public health service standard for one year, while patients in the Triangle group were given Triangle hierarchical management. The blood pressure, self-management behaviors, treatment compliance, smoking, alcohol consumption and exercise were collected using the self-management behavior scale, treatment compliance scale and self-designed questionnaires, and were compared before and after intervention with analysis of covariance and generalized estimation equations. Results: Totally 200 patients with hypertension were recruited, including 100 patients in the conventional group and 100 patients in the Triangle group. There were no significant differences between the two groups before implementation of interventions in terms of gender, age, educational level or occupation (P>0.05). The reduction in blood pressure, increase in the score of treatment, diet, exercise and living habitat management and the total score of self-management behaviors, increase in the score of adherence to medication regimens, daily living management behaviors, smoking and alcohol consumption preference and the total score of treatment compliance, and increase in the number of patients with normal standard of quitting smoking, quitting alcohol consumption, exercise and blood pressure were significantly higher in the Triangle group than in the conventional group after intervention (P<0.05). Conclusions Triangle hierarchical management may increase the treatment compliance, improve the self-management behavior and facilitate hypertension control among hypertensive patients, which may be popularized for health management among community patients with hypertension.