Objective:It aimed to provide a review on health insurance literacy,including its definition,measurement tools,influencing factors,and its effects on insurance enrollment and the healthcare utilization.Methods:A literature review was conducted by searching for the keywords"health insurance literacy"(Chinese/English)in the CNKI and PubMed databases.Results:The findings indicated that international research had developed a relatively mature definition of health insurance literacy and measurement tools,while domestic research remained in early stage.Health insurance literacy was significantly effected by age,gender,education level,and income.Conclusion:It is suggested to enhance health insurance literacy,develop localized measurement tools,implement targeted educational programs,and promote broader public understanding of health insurance.

AIM:To compare the efficacy and safety of early combination therapy with ranibizumab and dexamethasone intravitreal implants versus ranibizumab monotherapy for the treatment of macular edema secondary to retinal vein occlusion(RVO-ME).METHODS: A retrospective cohort study was conducted on a total of 62 cases(64 eyes)of patients who were first diagnosed with RVO-ME at the Eye Centre of the Affiliated Hospital of Shandong Second Medical University between February 2022 and February 2023. The subjects were divided into two groups according to the different treatment regimens: 32 cases(34 eyes)in the monotherapy group received only ranibizumab [3+pro re nata(PRN)regimen], and 30 cases(30 eyes)in the combination therapy group were injected with ranibizumab once first, followed by dexamethasone intravitreal implant 3 wk later(1+DEX regimen). The best corrected visual acuity(BCVA), central retina thickness(CRT), foveal avascular zone(FAZ)area, macular vascular density(MVD)at the level of the deep vascular complex(DVC)of the retina, the incidence of ocular adverse effects, the number of drug injections, and the total cost between the two groups were compared before and after treatment.RESULTS: At 3 wk, 3 and 6 mo, and at the final follow-up of the two groups of patients, the improvement in BCVA, CRT, and MVD in the DVC layer was significantly better than that before treatment(all P<0.05); there were differences in the comparisons of BCVA and CRT between the two groups at 6 mo and the final follow-up(all P<0.05), and the increase in the number of letters of BCVA was the most pronounced in the combination therapy group at 6 mo of treatment. Statistical significant difference was observed in the comparison of MVD in the DVC layer between the two groups at 3 and 6 mo after treatment and at the final follow-up(all P<0.05). However, no significant change in FAZ area was evident before and after treatment in both groups(P>0.05). The combination therapy group exhibited a reduced number of injections and total cost in comparison to the monotherapy group. The combination therapy group exhibited a slightly higher incidence of high intraocular pressure and cataract progression compared to the monotherapy group, with no statistical significant difference(all P>0.05). Furthermore, no serious adverse events were observed in either group following treatment.CONCLUSION:Compared with ranibizumab alone, ranibizumab combined with dexamethasone intravitreal implant significantly improved vision, reduced macular edema, and lowered the frequency of injections and total treatment cost in patients with RVO-ME. CRT and MVD in the DVC layer are reliable prognostic indicators for patients with RVO-ME.

To prepare a recombinant adeno-associated virus(rAAV9-ZsGreen1-EsASP)capable of expressing the aspartic protease protein of Eimeria stiedai(E.stiedai),and explore its in vitro ac-tivity.The EsASP gene was amplified by PCR,and recombinant adeno-associated viral vector pAAV-IRES-ZsGreen1 was combined with the EsASP gene using homologous recombination to construct the pAAV-ZsGreen1-EsASP expression plasmid;pAAV-ZsGreen1-EsASP expression plasmid,pHelper,and pAAV-RC9 plasmids were cotransfected into HEK-293T cells by liposomal transfection to package and produce recombinant adeno-associated virus rAAV9-ZsGreen1-EsASP capable of expressing EsASP protein.rAAV9-ZsGreen1-EsASP was purified using chloroform treatment-PEG/NaCl precipitation-chloroform extraction method,the purity of the virus was iden-tified by silver staining,the virus morphology was observed by TEM,and virus titer was detected by qRT-PCR;the purified recombinant virus was further infected into HEK-293T cells,and EsASP expression was detected by observing green fluorescent protein ZsGreen1 and Western blot method.The results indicated that double enzyme digestion and DNA sequencing confirmed that the EsASP gene had been successfully constructed into the pAAV-IRES-ZsGreen1 expression plas-mid.The expression of green fluorescent protein in HEK-293T cells suggested that co-transfection was successful.Western blot results of cell protein preparation showed that EsASP protein was successfully expressed;The purified recombinant viral capsid proteins show three distinct bands(VP1-3).The purified rAAV9-ZsGreen1-EsASP was uniform in size,around 20 nm,and had a titer higher than 1.0 × 1012 vg/mL;Green fluorescent protein expression was observed after infection of HEK-293T cells with the recombinant virus,and EsASP expression was detected by Western blot.The results suggest that rAAV9-ZsGreen1-EsASP with in vitro infectious activity was suc-cessfully obtained,providing a material basis for the development of a novel vaccine against Eimer-ia stiedai.

Objective To investigate the predicting value of cardiac magnetic resonance feature tracking(CMR-FT)for adverse left ventricular remodeling(ALVR)in patients with acute anterior wall ST-segment elevation myocardial infarction(STEMI).Methods The clinical data and cardiac magnetic resonance(CMR)images of 161 acute anterior wall STEMI patients within 1 week and 6 months after emergency percutaneous coronary intervention(PCI)were retrospectively analyzed.ALVR was defined as an increase of left ventricular end-diastolic volume(LVEDV)over 20％at the second CMR examination compared to the baseline.The CMR parame-ters were analyzed by CVI42 post-processing software.The logistic regression analysis was used to screen the independent predictors of ALVR,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive efficiency of ALVR.Results The incidence of ALVR at 6 months was 21.7％(35/161).The logistic regression analysis showed that the left ventricular global circumferential strain(LVGCS)and right ventricular global longitudinal strain(RVGLS)at baseline were independent predictors for ALVR(P＜0.001).When LVGCS was-13.89％and RVGLS was-15.07％at baseline,the sensitivity of predicting ALVR was 0.714 and 0.743,the specificity was 0.833 and 0.810,and the area under the curve(AUC)was 0.806 and 0.835,respectively.The sensitivity of LVGCS combined with RVGLS in predicting ALVR was 0.802,the specificity was 0.952,and the AUC was 0.888.The DeLong test showed that the AUC of LVGCS com-bined with RVGLS in predicting ALVR was significantly higher than that of individuals,and the difference was statistically significant(P＜0.05).Conclusion The LVGCS and RVGLS at baseline are independent predictors for ALVR in patients with acute anterior wall STEMI,their combination can significantly improve the pre-dictive efficiency of ALVR in these patients.

Objective To construct mice hepatocellular carcinoma models with different tumor immune microenvironments(TIME)and explore the differences.Methods H22 and hepa1-6 were used to construct subcutaneous transplantation tumor model of C57 mice as homologous hepatocellular carcinoma cell lines(denoted as H22 group and hepal-6 group,each n=8),and the differences of TIME were evaluated.Immunohistochemistry was used to detect and quantify the infiltration of T cells,CD4+T cells,CD8+T cells,regulatory T cells and B cells in TIME.Flow cytometry was performed to detect the differences of composition of immune cell subpopulations in peripheral blood and tumor parenchyma.Gene expression profile characteristics of tumor tissue were analyzed based on high-throughput transcriptome sequencing technology,and enrichment analyses of immune-related signaling pathways were evaluated combined with gene ontology(GO)and Kyoto encyclopedia of genes and genomes(KEGG).Results H22 group showed cold and hepa1-6 group showed hot TIME characteristics.The number of T cells,CD4+T cells and CD8+T cells in tumor tissue of H22 group were all lower,while the proportion of T cells,CD4+T cells and CD8+T cells in peripheral blood were all higher than those of hepa1-6 group(all P＜0.05).Compared with H22 group,up-regulated genes of tumor tissue in hepa1-6 group expressed significantly enriched in tumor immune activation-related signaling pathways.Conclusion H22 and hepa1-6 hepatocellular carcinoma models showed distinct TIME characteristics of cold and hot tumors,respectively,and the amount of immune cells in tumor tissue of the former were significantly lower than those in the latter.

Objective To construct mice hepatocellular carcinoma models with different tumor immune microenvironments(TIME)and explore the differences.Methods H22 and hepa1-6 were used to construct subcutaneous transplantation tumor model of C57 mice as homologous hepatocellular carcinoma cell lines(denoted as H22 group and hepal-6 group,each n=8),and the differences of TIME were evaluated.Immunohistochemistry was used to detect and quantify the infiltration of T cells,CD4+T cells,CD8+T cells,regulatory T cells and B cells in TIME.Flow cytometry was performed to detect the differences of composition of immune cell subpopulations in peripheral blood and tumor parenchyma.Gene expression profile characteristics of tumor tissue were analyzed based on high-throughput transcriptome sequencing technology,and enrichment analyses of immune-related signaling pathways were evaluated combined with gene ontology(GO)and Kyoto encyclopedia of genes and genomes(KEGG).Results H22 group showed cold and hepa1-6 group showed hot TIME characteristics.The number of T cells,CD4+T cells and CD8+T cells in tumor tissue of H22 group were all lower,while the proportion of T cells,CD4+T cells and CD8+T cells in peripheral blood were all higher than those of hepa1-6 group(all P＜0.05).Compared with H22 group,up-regulated genes of tumor tissue in hepa1-6 group expressed significantly enriched in tumor immune activation-related signaling pathways.Conclusion H22 and hepa1-6 hepatocellular carcinoma models showed distinct TIME characteristics of cold and hot tumors,respectively,and the amount of immune cells in tumor tissue of the former were significantly lower than those in the latter.

To prepare a recombinant adeno-associated virus(rAAV9-ZsGreen1-EsASP)capable of expressing the aspartic protease protein of Eimeria stiedai(E.stiedai),and explore its in vitro ac-tivity.The EsASP gene was amplified by PCR,and recombinant adeno-associated viral vector pAAV-IRES-ZsGreen1 was combined with the EsASP gene using homologous recombination to construct the pAAV-ZsGreen1-EsASP expression plasmid;pAAV-ZsGreen1-EsASP expression plasmid,pHelper,and pAAV-RC9 plasmids were cotransfected into HEK-293T cells by liposomal transfection to package and produce recombinant adeno-associated virus rAAV9-ZsGreen1-EsASP capable of expressing EsASP protein.rAAV9-ZsGreen1-EsASP was purified using chloroform treatment-PEG/NaCl precipitation-chloroform extraction method,the purity of the virus was iden-tified by silver staining,the virus morphology was observed by TEM,and virus titer was detected by qRT-PCR;the purified recombinant virus was further infected into HEK-293T cells,and EsASP expression was detected by observing green fluorescent protein ZsGreen1 and Western blot method.The results indicated that double enzyme digestion and DNA sequencing confirmed that the EsASP gene had been successfully constructed into the pAAV-IRES-ZsGreen1 expression plas-mid.The expression of green fluorescent protein in HEK-293T cells suggested that co-transfection was successful.Western blot results of cell protein preparation showed that EsASP protein was successfully expressed;The purified recombinant viral capsid proteins show three distinct bands(VP1-3).The purified rAAV9-ZsGreen1-EsASP was uniform in size,around 20 nm,and had a titer higher than 1.0 × 1012 vg/mL;Green fluorescent protein expression was observed after infection of HEK-293T cells with the recombinant virus,and EsASP expression was detected by Western blot.The results suggest that rAAV9-ZsGreen1-EsASP with in vitro infectious activity was suc-cessfully obtained,providing a material basis for the development of a novel vaccine against Eimer-ia stiedai.

Objective:It aimed to provide a review on health insurance literacy,including its definition,measurement tools,influencing factors,and its effects on insurance enrollment and the healthcare utilization.Methods:A literature review was conducted by searching for the keywords"health insurance literacy"(Chinese/English)in the CNKI and PubMed databases.Results:The findings indicated that international research had developed a relatively mature definition of health insurance literacy and measurement tools,while domestic research remained in early stage.Health insurance literacy was significantly effected by age,gender,education level,and income.Conclusion:It is suggested to enhance health insurance literacy,develop localized measurement tools,implement targeted educational programs,and promote broader public understanding of health insurance.

Objective To investigate the predicting value of cardiac magnetic resonance feature tracking(CMR-FT)for adverse left ventricular remodeling(ALVR)in patients with acute anterior wall ST-segment elevation myocardial infarction(STEMI).Methods The clinical data and cardiac magnetic resonance(CMR)images of 161 acute anterior wall STEMI patients within 1 week and 6 months after emergency percutaneous coronary intervention(PCI)were retrospectively analyzed.ALVR was defined as an increase of left ventricular end-diastolic volume(LVEDV)over 20％at the second CMR examination compared to the baseline.The CMR parame-ters were analyzed by CVI42 post-processing software.The logistic regression analysis was used to screen the independent predictors of ALVR,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive efficiency of ALVR.Results The incidence of ALVR at 6 months was 21.7％(35/161).The logistic regression analysis showed that the left ventricular global circumferential strain(LVGCS)and right ventricular global longitudinal strain(RVGLS)at baseline were independent predictors for ALVR(P＜0.001).When LVGCS was-13.89％and RVGLS was-15.07％at baseline,the sensitivity of predicting ALVR was 0.714 and 0.743,the specificity was 0.833 and 0.810,and the area under the curve(AUC)was 0.806 and 0.835,respectively.The sensitivity of LVGCS combined with RVGLS in predicting ALVR was 0.802,the specificity was 0.952,and the AUC was 0.888.The DeLong test showed that the AUC of LVGCS com-bined with RVGLS in predicting ALVR was significantly higher than that of individuals,and the difference was statistically significant(P＜0.05).Conclusion The LVGCS and RVGLS at baseline are independent predictors for ALVR in patients with acute anterior wall STEMI,their combination can significantly improve the pre-dictive efficiency of ALVR in these patients.

Objective:To analyze the relationship among self-efficacy, family support and diabetes self-management behavior in rural patients with type 2 diabetes mellitus, and to explore the mediating role of self-efficacy between self-management behavior and family support in rural patients with type 2 diabetes mellitus.Methods:From June to July 2023, Jingde county in southern Anhui, Jinzhai county in central Anhui, and Mengcheng county in northern Anhui were selected by multistage stratified cluster random sampling method as investigation sites. A total of 258 patients with type 2 diabetes mellitus were investigated by face-to-face survey. The questionnaire included general situation survey from, the summary of diabetes self-care activities measure, the self-efficacy for diabetes and diabetes family behavior checklist. SPSS 25.0 and AMOS 26.0 softwares were used for descriptive analysis, correlation analysis, common method bias test and mediation analysis.Results:The self-management behavior score of rural patients with type 2 diabetes mellitus was(2.15±0.96).The self-efficacy score was(28.50±7.02).The family support score was(29.37±9.45).Self-efficacy and family support were positively correlated with self-management behavior( r=0.390, 0.333, both P<0.01), and family support was positively correlated with self-efficacy( r=0.511, P<0.01). Self-efficacy played a partial mediating role between self-management behavior and family support in rural patients with type 2 diabetes, and the mediating effect accounted for 45.2%(0.147/0.325) of the total effect. Conclusion:Family support not only has direct influence on self-management behavior of rural patients with diabetes mellitus, but also has indirect influence on self-management behavior by improving self-efficacy.