Objective:To investigate the association of blood lipids and body mass index (BMI) with hyperuricemia (HUA) in the elderly.Methods:It was a cross-sectional study. A total of 114 391 elderly individuals received health examinations at primary healthcare institutions in Wujin District from January to December in 2022. The health examination included questionnaire survey, physical examination and laboratory examination. The multivariate logistic regression and restricted cubic spline (RCS) plots were used to analyze the association and dose-response relationship of blood lipid and BMI with HUA. The mediating effect model was used to explore the mediation effect of BMI on the association between blood lipid and HUA.Results:Among the 112 415 subjects, 18 506 (16.46%) were checked with HUA. After adjusting for relevant confounders, total cholesterol (TC) ( OR=1.20, 95% CI: 1.16-1.23), triglyceride (TG) ( OR=1.46, 95% CI: 1.44-1.49), high density lipoprotein cholesterol (HDL-C) ( OR=0.74, 95% CI: 0.73-0.76), low density lipoprotein cholesterol (LDL-C) ( OR=1.14, 95% CI: 1.12-1.15) and BMI ( OR=1.42, 95% CI: 1.39-1.44) were all associated with HUA (all P0.05). The RCS analysis revealed that TG, HDL-C, and LDL-C each exhibited a nonlinear dose-response relationship with HUA, the inflection points was 3.00 mmol/L, 1.57 mmol/L and 2.50 mmol/L, respectively (all P-nonlinear0.001). The results of interaction showed that there were additive interaction between high TC( S=1.27 , 95% CI: 1.17-1.37), high TG( S=1.32 , 95% CI: 1.25-1.40), high LDL-C( S=1.23 , 95% CI: 1.14-1.34) and overweight/obesity with HUA (all P0.05). The results of mediation effect analysis showed that the mediation effect of BMI on the association between blood lipids (HDL-C, LDL-C, TG and TC) and HUA, from high to low, were as follows: 22.5% (95% CI: 20.8%-24.2%), 13.9% (95% CI: 12.0%-16.2%), 13.5% (95% CI: 12.7%-14.4%) and-3.9% (95% CI:-6.6%--1.8%). Conclusion:The blood lipid levels and BMI are positively correlated with HUA in the elderly.

Objective:To explore the potential profile characteristics of cancer-related worries in patients after surgery for early-stage lung cancer, and the influencing factors of different categories, provide reference for patients to formulate individualized rehabilitation programs and psychological intervention measures.Methods:A cross-sectional survey method was used to conveniently select patients who received outpatient follow-up after lung cancer surgery at Shanghai Pulmonary Hospital Affiliated to Tongji University from October 2022 to October 2023 as the survey subjects. The general information questionnaire, the Chinese version of Brief Cancer-related Worry Inventory, the Chinese version of the MD Anderson Symptom Inventory, Brief Illness Perception Questionnaire, 10-item Connor Davidson Resilience Scale and Medical Coping Modes Questionnaire were examined. Latent profile analysis was performed on the cancer-related worry scores of lung cancer surgery patients, and its influencing factors were explored by binary Logistic regression analysis.Results:A total of 302 patients after lung cancer surgery were included, including 111 males and 191 females, aged 18-83(52.73 ± 13.07) years, and the Chinese version of the Brief Cancer-related Worry Inventory scored 380.00 (130.00, 720.00) points. The cancer-related worry of patients after lung cancer surgery could be divided into two potential profile categories: "high worry type" (138 patients accounted for 45.70%) and "low worry type" (164 patients accounted for 54.30%). Symptom burden ( OR=1.055, 95% CI 1.039-1.072), illness perception ( OR=1.190, 95% CI 1.127-1.256), resilience ( OR=0.933, 95% CI 0.886-0.983), and coping modes of confrontation ( OR=0.857, 95% CI 0.757-0.971) and acceptance-resignation ( OR=1.247, 95% CI 1.050-1.481) were influencing factors for grouping cancer related worry profiles (all P<0.05). Conclusions:There was significant heterogeneity in the level of cancer-related worries among patients after surgery for early-stage lung cancer. It is recommended that medical staff provide targeted continuity care measures based on the characteristics of worries of different categories of patients to improve patients' postoperative mental health and quality of life.

Objective:To explore the potential profile characteristics of cancer-related worries in patients after surgery for early-stage lung cancer, and the influencing factors of different categories, provide reference for patients to formulate individualized rehabilitation programs and psychological intervention measures.Methods:A cross-sectional survey method was used to conveniently select patients who received outpatient follow-up after lung cancer surgery at Shanghai Pulmonary Hospital Affiliated to Tongji University from October 2022 to October 2023 as the survey subjects. The general information questionnaire, the Chinese version of Brief Cancer-related Worry Inventory, the Chinese version of the MD Anderson Symptom Inventory, Brief Illness Perception Questionnaire, 10-item Connor Davidson Resilience Scale and Medical Coping Modes Questionnaire were examined. Latent profile analysis was performed on the cancer-related worry scores of lung cancer surgery patients, and its influencing factors were explored by binary Logistic regression analysis.Results:A total of 302 patients after lung cancer surgery were included, including 111 males and 191 females, aged 18-83(52.73 ± 13.07) years, and the Chinese version of the Brief Cancer-related Worry Inventory scored 380.00 (130.00, 720.00) points. The cancer-related worry of patients after lung cancer surgery could be divided into two potential profile categories: "high worry type" (138 patients accounted for 45.70%) and "low worry type" (164 patients accounted for 54.30%). Symptom burden ( OR=1.055, 95% CI 1.039-1.072), illness perception ( OR=1.190, 95% CI 1.127-1.256), resilience ( OR=0.933, 95% CI 0.886-0.983), and coping modes of confrontation ( OR=0.857, 95% CI 0.757-0.971) and acceptance-resignation ( OR=1.247, 95% CI 1.050-1.481) were influencing factors for grouping cancer related worry profiles (all P<0.05). Conclusions:There was significant heterogeneity in the level of cancer-related worries among patients after surgery for early-stage lung cancer. It is recommended that medical staff provide targeted continuity care measures based on the characteristics of worries of different categories of patients to improve patients' postoperative mental health and quality of life.

Objective:To investigate the association of blood lipids and body mass index (BMI) with hyperuricemia (HUA) in the elderly.Methods:It was a cross-sectional study. A total of 114 391 elderly individuals received health examinations at primary healthcare institutions in Wujin District from January to December in 2022. The health examination included questionnaire survey, physical examination and laboratory examination. The multivariate logistic regression and restricted cubic spline (RCS) plots were used to analyze the association and dose-response relationship of blood lipid and BMI with HUA. The mediating effect model was used to explore the mediation effect of BMI on the association between blood lipid and HUA.Results:Among the 112 415 subjects, 18 506 (16.46%) were checked with HUA. After adjusting for relevant confounders, total cholesterol (TC) ( OR=1.20, 95% CI: 1.16-1.23), triglyceride (TG) ( OR=1.46, 95% CI: 1.44-1.49), high density lipoprotein cholesterol (HDL-C) ( OR=0.74, 95% CI: 0.73-0.76), low density lipoprotein cholesterol (LDL-C) ( OR=1.14, 95% CI: 1.12-1.15) and BMI ( OR=1.42, 95% CI: 1.39-1.44) were all associated with HUA (all P0.05). The RCS analysis revealed that TG, HDL-C, and LDL-C each exhibited a nonlinear dose-response relationship with HUA, the inflection points was 3.00 mmol/L, 1.57 mmol/L and 2.50 mmol/L, respectively (all P-nonlinear0.001). The results of interaction showed that there were additive interaction between high TC( S=1.27 , 95% CI: 1.17-1.37), high TG( S=1.32 , 95% CI: 1.25-1.40), high LDL-C( S=1.23 , 95% CI: 1.14-1.34) and overweight/obesity with HUA (all P0.05). The results of mediation effect analysis showed that the mediation effect of BMI on the association between blood lipids (HDL-C, LDL-C, TG and TC) and HUA, from high to low, were as follows: 22.5% (95% CI: 20.8%-24.2%), 13.9% (95% CI: 12.0%-16.2%), 13.5% (95% CI: 12.7%-14.4%) and-3.9% (95% CI:-6.6%--1.8%). Conclusion:The blood lipid levels and BMI are positively correlated with HUA in the elderly.

Objective This study aims at establishing a teaching catalog and content for breast rare dis-eases and developing the syllabus for the breast rare disease using integrated multimodality of case-/problem-/resource-based learning(CBL+PBL+RBL).Methods By conducting bibliometrics co-occurrence analysis,we collected 6291 articles on breast rare disease published from January,1975 to June,2024.Additionally,we re-trieved the Textbook on Rare Diseases,the Catalog of Chinese Rare Disease,and Second Batch of Rare Dis-ease Catalog and then decided the teaching content.Results From 16,387 keywords,1000(6.1％)keywords were identified through co-occurrence analysis,including 50(0.3％)candidate diseases.These were classified into three categories:rare primary breast diseases,rare genetic mutation-related diseases associated with breast cancer,and rare systemic multi-system diseases involving the breast.From the candidate list,20(0.1％)rare primary breast diseases were further selected for their notable clinical teaching significance,and significant multi-systemic diseases affecting the breast,whether related to gene mutations or not.Teaching plans were draf-ted using a diversified parallel teaching approaches,taking into account the characteristics of different diseases and the focus of different teaching methods.Conclusions This study initiated the development of the teaching content for breast rare diseases and developed the teaching syllabus using the CBL+PBL+RBL integrated multi teaching model and targeting each rare breast disease for the critical point for teaching.

Radiotherapy, as a common modality for the treatment of head and neck cancer (HNC), frequently induces oral and maxillofacial complications. However, the complex tissues and diverse pathogeneses of these regions lead to limited treatment protocols and research progress currently. This paper systematically summarizes radiation-induced oral mucositis, salivary gland injury, and dental caries in radiotherapy for HNC and reviews existing pathogenetic hypotheses, treatment, and research progress. The purpose is to provide some reference for further research on relevant pathological mechanisms and the development of new preventive and treatment methods.

Objective:To understand the status quo of challenge-hindrance stressors in nurses of ClassⅢ general hospitals and their effects on work engagement, so as to provide guidance for nursing managers to formulate stressor coping strategies.Methods:This study was a cross-sectional survey. From October to December 2020, the convenience sampling method was used to select 1 ClassⅢ general hospital in Shanghai, Anhui Province, and Zhejiang Province, respectively. Cluster sampling was performed by department, and a total of 1 257 nurses were selected. Nurses were surveyed using general information, Challenge-Hindrance Stressor Scale (CHSS) , Recovery Experience Questionnaire (REQ) , Calling Questionnaire and Utrecht Work Engagement Scale-9 (UWES-9) . A total of 1 133 valid questionnaires were recovered, with an effective recovery rate of 90.14%.Results:The total score of challenging stressors of 1 133 nurses was (22.51±4.08) , the total score of hindrance stressors was (19.46±4.33) and the total score of UWES-9 was (42.24±10.54) . The results of path analysis showed that job mission completely mediated the relationship between challenging stressors and job engagement. Hindering stressors directly negatively predicted job engagement and recovery experience and occupational mission played a partial mediating role between them. The recovery experience had a higher mediating effect than occupational mission ( P<0.05) . Conclusions:The challenging stressors for nurses in tertiary general hospitals are at an upper-middle level and the hindrance stressors were at a moderate level. Managers should distinguish the attributes of stressors and improve work engagement of nurses according to different action paths.

Objective To investigate an outbreak of norovirus GII gastroenteritis in a school, and explore the causes, transmission routes and risk factors of the outbreak, and to provide a scientific basis and experience for effective control of outbreaks of acute gastroenteritis in schools. Methods A case study of an acute gastroenteritis outbreak in a school in Wujin District, Changzhou was conducted by field epidemiological investigation. Anal swab samples of patients and controls were collected, and enterovirus nucleic acid was detected by real-time fluorescent PCR. Results From December 12 to December 17, 2019, a total of 185 cases were identified, all of them from students of the school, with an incidence rate of 3.84% (185/4,822). All of the cases were distributed in three (7^th/8^th/9^th) grades of the school, with attack rates of 5.38% (31 / 576), 18.71% (104 / 556) and 9.06% (50 / 552) in 7^th, 8^th and 9^th grade, respectively, showing a significant difference among the grades (χ²=54.47，P＜0.05). The attack rate of each floor of the teaching building from the first to fifth floor was 2.17% (5/230), 7.51% (26/346), 15.77% (53/336), 17.11% (65/380), and 6.38% (25/392), respectively, showing a statistically significant difference among different floors (χ²=55.66，P＜0.05). A total of 32 anal swabs were collected, including 12 patients, 10 control students and 10 workers in the canteen. Of them, 9 specimens of the patients and 1 specimen of the workers were positive for norovirus type GII. Conclusion The school outbreak of acute gastroenteritis was caused by norovirus GII. Close contact between students was the main mode of transmission. A hidden infection of canteen staff may be related to this outbreak. It is important to promote popular science of norovirus prevention and to enhance the awareness of the risks of the virus.

Objective To evaluate the effect and cost-benefit of influenza vaccination for patients with chronic diseases in Wujin district of Changzhou City. Methods An epidemiological quasi-experiment was employed in this study. A total of 441 patients with chronic diseases were recruited as the vaccine group and inoculated with trivalent influenza virus vaccine, while 467 patients with chronic diseases matched with the age, gender and health status of the vaccine group were selected as the control group for both baseline and follow-up investigations. Results A total of 431 subjects in the vaccine group and 460 subjects in the control group completed baseline and 1-year follow-up investigations. The incidence of influenza-like illness was 7.42% (32/431) and 14.13% (65/460) in the vaccine group and the control group, respectively, with a statistically significant difference (χ²=9.634, P=0.002). The protective rate was 47.46%, and the effect index was 1.90. The incidence of common cold was 16.94% (73/431) and 25.43% (117/460), respectively, and the difference was statistically significant (χ²=9.077, P=0.003), with a protective rate of 33.41%, and an effect index of 1.50. The incidence of chronic disease was 5.57% (24/431) and 9.35% (43/460), respectively. The difference was statistically significant (χ²=4.043, P=0.044), with a protective rate of 40.43% and an effect index of 1.68. The per capita benefit of inoculation was 675.86 yuan, and the benefit-cost ratio was 10.09:1. Conclusion Influenza vaccination for patients with chronic diseases effectively prevented the occurrence of influenza-like illness and reduced the incidence of related chronic diseases.

Objective:To provide a preliminary theoretical basis for gout and hyperuricemia of Deoxyribonucleic acid (DNA) methylation.Methods:Breast cancer anti-resistance 1(BCAR1), phospho-diesterase 1C (PDE1C), opioid receptor delta 1(OPRD1) and neurexin 1(NRXN1) methylation levels were measured by bisulfite pyrosequencing in 50 gout patients, 30 hyperuricemia patients and 50 matched healthy controls. Comparisons between groups were evaluated by F-test and Nonparametric tests. Results:Receiver operating characteristic showed that the methylation of PDE1C(pos4, pos5, pos6)(AUC: 0.712, 0.772, 0.775; all P values<0.05) had higher accuracy for diagnosis of gout, and OPRD1 pos4 (AUC=0.733, P<0.05) had higher accuracy for hyperuricemia. Conclusion:DNA methylation may play a role in the development of gout and hyperuricemia, however, further studies are needed.