OBJECTIVE To investigate the effects of peiminine B （PEI） on Streptococcus pneumoniae （SP）-induced alveolar epithelial cell injury by regulating the Ras-related C3 botulinum toxin substrate 1 in nucleus accumbens （Rac1）/protein kinase B （Akt）/nuclear factor κB （NF-κB） signaling pathway. METHODS Human alveolar epithelial cells （HPAEpiC） were taken and randomly divided into the Control group， SP group （1×108 cfu/mL SP bacterial solution）， low-， medium-， and high-concentration PEI groups （1×108 cfu/mL SP bacterial solution+0.05， 0.10， 0.20 mmol/L PEI）， and high-concentration PEI+Akt activator group （P-H+SC79 group， 1×108 cfu/mL SP bacterial solution+0.20 mmol/L PEI+10 μmol/L SC79）. Except for the Control group， the other groups of cells were treated with SP bacterial solution and/or corresponding drug solution. After 24 h of treatment， the levels of inflammatory factors （interleukin-6， -18， -1β） in the supernatant solution， the contents of oxidative stress indexes [lactate dehydrogenase （LDH）， reactive oxygen species （ROS） and superoxide dismutase （SOD）]， apoptosis rate， as well as the expressions of proliferation/apoptosis-related proteins [cyclin-dependent kinase 1 （CDK1）， B cell lymphoma-2 related X protein （Bax）] and pathway-related proteins （Rac1， Akt， phosphorylated Akt， NF-κB and phosphorylated NF-κB） were detected in each group. RESULTS Compared with the Control group， the levels of inflammatory factors in supernatant solution， LDH and ROS contents， apoptosis rate， the protein expressions of Bax and Rac1 and the phosphorylation levels of Akt and NF-κB in the SP group were significantly increased or up-regulated， while SOD content and the protein expression of CDK1 were significantly decreased or down-regulated （P＜0.05）. Compared with the SP group， the above indexes in PEI groups were significantly improved in a concentration-dependent manner （P＜0.05）. SC79 could significantly reverse the improvement effect of the high concentration of PEI （P＜0.05）. CONCLUSIONS PEI can alleviate SP-induced inflammation and oxidative stress damage of alveolar epithelial cells and inhibit apoptosis， which may be achieved by inhibiting Rac1/Akt/NF-κB signaling pathway.

Objective:To understand the current status of knowledge of brucellosis prevention and control among occupational groups at high-risk of brucellosis, and to provide a scientific basis for assessing the effectiveness of brucellosis prevention and control in China.Methods:A total of four counties in Shanxi Province and Xinjiang Uygur Autonomous Region were selected as survey counties from 2019 to 2020, and 600 people from the occupational groups at high-risk of brucellosis in each survey county were selected as survey respondents, and basic information and knowledge of prevention and treatment were collected through questionnaires. Single-factor and multi-factor logistic regression models were used to analyze the factors affecting the population's knowledge of prevention and treatment.Results:A total of 2 411 people participated in the survey and 2 384 valid questionnaires were obtained, including 1 405 males and 979 females, with the youngest age being 18 years old, the oldest being 91 years old, and the median being 57 years old. The overall knowledge of brucellosis prevention and control was 17.74% (423/2 384). The knowledge rate was lower among people over 60 years old, farmers, and people with less than elementary school education (13.99%, 14.50%, and 13.78%), and higher among women, herders, and people with elementary school education (20.02%, 36.33%, and 19.58%); the knowledge rate was lower in Hunyuan County (0.51%), and the differences in overall knowledge rates by age, occupation, education level, and region were statistically significant (χ 2 = 18.25, 87.18, 11.05, 197.43, P < 0.001). Multi-factor logistic regression analysis showed that gender, occupation, literacy and region were associated with knowledge of prevention and treatment ( P < 0.05). Conclusions:The overall knowledge of prevention and treatment among high-risk occupational groups in the key areas of China's brucellosis prevention and treatment program is low, with a large gap with the goals of the national brucellosis prevention and treatment program, and gender, occupation, literacy level, and region are the influencing factors of the knowledge of prevention and treatment. There is an urgent need to carry out a variety of health education activities for high-risk occupational groups and to strengthen the exchange of experience on brucellosis prevention and treatment between regions.

Objective:To investigate the association between congenital hypothyroidism (CH) and the adverse outcomes during hospitalization in very low birth weight infants (VLBWI).Methods:This prospective, multicenter observational cohort study was conducted based on the data from the Sino-northern Neonatal Network (SNN). Data of 5 818 VLBWI with birth weight <1 500 g and gestational age between 24-<37 weeks that were admitted to the 37 neonatal intensive care units from January 1 st, 2019 to December 31 st, 2022 were collected and analyzed. Thyroid function was first screened at 7 to 10 days after birth, followed by weekly tests within the first 4 weeks, and retested at 36 weeks of corrected gestational age or before discharge. The VLBWI were assigned to the CH group or non-CH group. Chi-square test, Fisher exact probability method, Wilcoxon rank sum test, univariate and multivariate Logistic regression were used to analyze the relationship between CH and poor prognosis during hospitalization in VLBWI. Results:A total of 5 818 eligible VLBWI were enrolled, with 2 982 (51.3%) males and the gestational age of 30 (29, 31) weeks. The incidence of CH was 5.5% (319 VLBWI). Among the CH group, only 121 VLBWI (37.9%) were diagnosed at the first screening. Univariate Logistic regression analysis showed that CH was associated with increased incidence of extrauterine growth retardation (EUGR) ( OR=1.31(1.04-1.64), P<0.05) and retinopathy of prematurity (ROP) of stage Ⅲ and above ( OR=1.74(1.11-2.75), P<0.05). However, multivariate Logistic regression analysis showed no significant correlation between CH and EUGR, moderate to severe bronchopulmonary dysplasia, grade Ⅲ to Ⅳ intraventricular hemorrhage, neonatal necrotizing enterocolitis in stage Ⅱ or above, and ROP in stage Ⅲ or above ( OR=1.04 (0.81-1.33), 0.79 (0.54-1.15), 1.15 (0.58-2.26), 1.43 (0.81-2.53), 1.12 (0.70-1.80), all P>0.05). Conclusion:There is no significant correlation between CH and in-hospital adverse outcomes, possibly due to timely diagnosis and active replacement therapy.

Objective:To analyze the correlation between different grades of sarcopenia and 10-year atherosclerotic cardio-vascular disease risk,and provide the scientific evidence for prevention of sarcopenia and cardiovascular disease. Method:The study included 1,072 elderly individuals who completed physical examination program for seniors 65 years and older at Beijing Zhongguancun Hospital from January 2021 to June 2022,consisting of 408 men and 664 women.The investigation was performed with the questionnaires,physical examination,biochemical,body composition and physical performance test.According to handgrip strength,5-time chair stand test and ASMI,the subjects were divided into control,possible sarcopenia,pre-sarcopenia and sarcopenia group.Bina-ry logistic regression method was used to analyze the data. Result:The prevalence of disease for sarcopenia was 10.6％,with the detection rates of possible sarcopenia and pre-sarcopenia being 16.1％and 15.1％,respectively.In male,pre-sarcopenia[OR:95％Cl=3.63(1.03-12.78),P=0.04]and sarcopenia[OR:95％C1=8.90(1.15-68.86),P=0.04]were correlated with a high 10-year risk of atherosclerotic cardiovascular disease.In female,sarcopenia[OR:95％Cl=5.05(1.49-17.13),P=0.009]was significantly correlated with a high 10-year risk of atherosclerotic cardiovascular disease. Conclusion:Both male and female elderly sarcopenia patients,as well as males with reduced muscle mass,have a higher 10-year risk of developing ASCVD.The severity of sarcopenia is positively correlated with the risk of ASCVD,underscoring the importance of early prevention of cardiovascular disease.

Objective:To understand the current status of personal protection in occupational population at high risk for brucellosis in China and provide evidence for the evaluation of implementation of National Brucellosis Prevention and Control Plan (2016-2020).Methods:Four counties in Shanxi Province and Xinjiang Uygur Autonomous Region were selected to conduct a questionnaire survey in occupational population at high risk for brucellosis from December 2019 to July 2020 by using cross-sectional survey methods.Results:A total of 2 384 persons at high risk for brucellosis were surveyed, and the standardized utilization rate of personal protective equipment (PPE) was 20.13% (480/2 384). The utilization rate of glove, mask, rubber shoe, and work cloth were 38.26% (912/2 384), 31.80% (758/2 384), 32.01% (763/2 384) and 30.87% (736/2 384),respectively. There were significant differences in the utilization rate and standardized utilization rate of the four types of PPE among populations in different age, occupation, educational level and area groups (all P<0.001). The utilization rate and standardized utilization rate of PPE were lower in people over 60 years old, women, farmers, and those with lower educational level. The results of multivariate analysis showed that occupation and area were the influencing factors for the standardized utilization of PPE, the standardized utilization rates of PPE were higher in herdsmen and veterinarians. The standardized utilization rate of PPE in Yanggao County and Huocheng County was significantly higher than that in Zuoyun County and Hunyuan County. Conclusions:The utilization rate of the four types of PPE in occupational population at high risk for brucellosis was not high in China, and the standardized utilization rate was low, lower than the requirement in National Brucellosis Prevention and Control Plan, and there were significant differences among different areas. It is urgent to distribute PPE to occupational population at high risk for brucellosis and carry out health education about PPE utilization. Meanwhile, it is necessary to strengthen information exchange or sharing among different areas.

Objective To explore the application effect of"personalized"video propaganda and educa-tion combined with AI technology in hyperbaric oxygen therapy of the patients.Methods A total of 208 new-ly admitted patients with hyperbaric oxygen therapy in this hospital from June to September 2023 were select-ed as the control group,and 215 newly admitted patients from October 2023 to January 2024 were selected as the experimental group.The control group adopted the oral propaganda and education combined with paper propaganda and education to explain the principle and function of hyperbaric oxygen,informed that electronic products and flammable and explosive materials should not be brought into the cabin,and reminded the items needing to be prepared during treatment and the precautions in the treatment process.On the basis of the con-trol group,the experimental group combined with AI to make the"personalized"propaganda and education video and the patient's signature confirmation method,and the plan-do-check-action(PDCA)cycle mode was used to continuously improve the quality of hyperbaric oxygen health propaganda and education.The correct answer situation of relevant knowledge,carrying prohibited items into the cabin,the implementation of pre-cautions,satisfaction and anxiety self-rating scale(SAS)scores were compared between the two groups Re-sults The experimental group had better answers to hyperbaric oxygen related knowledge than the control group,and the difference was statistically significant(P＜0.05).Before entering the cabin,the proportion of carrying the prohibited items in the control group was 6.3％(13/208),which was higher than 0.9％(2/215)in the experimental group,and the difference was statistically significant(P＜0.05).During the whole process of hyperbaric oxygen therapy,the complete implementation rate of precautions in the experimental group was better than that in the control group(68.8％vs.44.2％),and the difference was statistically significant(P＜0.05).The satisfaction rate of the experimental group was 93.4％,which was higher than 46.6％of the con-trol group,and the difference was statistically significant(P＜0.05).The mild and moderate anxiety scores of the experimental group were lower than those of the control group,and the difference was statistically signifi-cant(P＜0.05).The severe anxiety score had no statistical difference between the two groups(P＞0.05).Conclusion The application of"personalized"video propaganda and education combined with AI technology has a good effect in the treatment of hyperbaric oxygen patients,which could reduce the patients'anxiety,in-crease the patients'confidence,and improve the patients'knowledge awareness rate,treatment compliance and satisfaction on nursing work.

ObjectiveTo observe the lower limb muscle activation strategy of healthy middle-aged and old women during stair ascent and descent with surface electromyography. MethodsFrom August, 2021 to February, 2022, 20 healthy middle-aged and old women were measured the surface electromyography root mean square (RMS) and integrated electromyography (iEMG) of bilateral vastus lateral, rectus femoris, vastus medialis, biceps femoris and semitendinosus during stair ascent and descent, and co-contraction ratio was calculated. ResultsDuring stair ascent, the RMS of bilateral vastus lateral, rectus femoris and vastus medialis was higher at starting stage than at following stage (|t| > 6.650, P < 0.001), while the RMS of biceps femoris and semitendinosus was lower (t > 3.559, P < 0.01); and the co-contraction ratio of hamstrings/quadriceps was lower at starting stage than at following stage (t > 8.185, P < 0.001). During stair descent, the RMS of bilateral vastus lateral, vastus medialis, biceps femoris and semitendinosus was higher at following stage than at starting stage (t > 2.345, P < 0.05), as well as the co-contraction ratio of hamstrings/quadriceps (t > 2.405, P < 0.05). ConclusionThe activities of the muscles around the knees are almost symmetrical during stair ascent and descent for healthy middle-aged and old women. The activation and co-contraction ratio of quadriceps and hamstring are various at starting/following stages.

Objective To systematically evaluate the rehabilitation experience of patients after total knee arthroplasty,and to provide references for improving the effect of rehabilitation treatment and formulating related clinical nursing strategies.Methods We searched PubMed,Web of Science,the Cochrane Library,Embase,CINAHL,Scopus,ProQuest,CNKI,Wanfang database,VIP database and Chinese biomedical literature database.A qualitative study on the experiences,feelings,and needs of patients undergoing rehabilitation after total knee arthroplasty was retrieved from the database until April 2023.The quality of literature was evaluated using the Quality Evaluation Criteria of Evidence-Based Health Care Center(2016)of Joanna Briggs Institute in Australia,and the results were summarized and integrated by the aggregation integration method.Results A total of 25 studies were included;82 topics were summarized into 12 categories;4 integrated results were finally formed:rehabilitation treatment was faced with multiple difficulties,and patients lost confidence and needed professional guidance and supervision;unsatisfactory experience in rehabilitation;the perception of the benefits of rehabilitation therapy and the encouragement of medical staff,and firm faith in rehabilitation;seeking understanding and social support can promote the effect of rehabilitation therapy.Conclusion Healthcare professionals should pay attention to and reflect on the challenges and unsatisfactory experiences that patients may face during rehabilitation,and provide them with professional guidance and supervision,as well as personalized rehabilitation treatment.

BackgroundThe major depressive disorder has high prevalence among adolescents， and non-suicidal self-injury （NSSI） behaviors frequently occur among patients， therefore， major depressive disorder in adolescents has become the researching focus. ObjectiveTo explore the effect of mentalization-based family therapy （MBFT） on depressive symptoms and NSSI behavior in adolescents with major depressive disorder， and to provide references for the rehabilitation of major depressive disorder in adolescents. MethodsA total of 90 adolescent patients with major depression disorder who met the diagnostic criteria of International Classification of Diseases， 10th edition （ICD-10） for depressive disorders and attended Wuhan Mental Health Center from January to December 2022 were selected， and were assigned into study group （n=44） and control group （n=46） using random number table method. All participants received routine intervention， based on this， study group added a 60-minute MBFT intervention once a week for 8 weeks. Before the intervention and at the end of 1^st， 2^nd，4^th and 8^th week，the two groups were assessed using Hamilton Depression Scale-24 item （HAMD-24）， General Self-Efficacy Scale （GSES）， Pittsburgh Sleep Quality Index （PSQI） and Ottawa Self-injury Inventory （OSI）. ResultsThe repeated measures analysis of variance reported a statistical main effect of time， main effect of group， and interaction effect between time and group at the baseline and the end of 1^st， 2^nd， 4^th and 8^th week of treatment in HAMD-24 score （F=69.621， 15.428， 29.623， P˂0.05）， OSI score （F=176.642， 37.682， 21.873， P˂0.05）， GSES score （F=215.236， 57.421， 27.857， P˂0.05） and PSQI score （F=268.541， 61.863， 33.867， P˂0.05）. Individual effect analysis discovered a statistical difference between study group and control group at the end of 2^nd， 4^th and 8^th week of treatment in HAMD-24 score （t=5.567， 8.645， 6.233， P˂0.01）， OSI score （t=3.675， 11.817， 9.632， P˂0.01）， GSES score （t=23.462， 31.709， 12.750， P˂0.01） and PSQI score （t=9.664， 22.457， 9.333， P˂0.01）. ConclusionMBFT may improve depressive symptoms， NSSI behavior， sleep quality and self-efficacy in adolescents with major depressive disorder. ［Funded by 2022 Natural Science Foundation Project of Hubei Province （number， 2022CFB483）］

Objective:To deeply explore the real work of primary, secondary and tertiary prevention of stroke in general hospitals, rehabilitation and pension institutions and community health service centers (stations), and to provide reference for improving the level of comprehensive prevention of stroke in the medical system.Methods:From July to November 2022, face-to-face semi-structured interviews with 18 medical staff in general hospitals, 10 medical staff in rehabilitation and pension institutions, and 8 medical staff in community health service centers (stations) were conducted by phenomenological research methods. Colaizzi 7-step analysis method was used to analyze the interview data, and Nvivo12 software was used to code the interview data.Results:Four themes were extracted: hospitals, institutions and communities all played an important role in the comprehensive prevention of stroke and actively cooperated with each other; the public was still lack of comprehensive prevention awareness and correct cognition of stroke; lack of professional medical resources hindered the development of comprehensive stroke prevention; incomplete collaborative mechanism of comprehensive prevention of stroke in hospitals, institutions and communities.Conclusions:In the current comprehensive prevention of stroke, there are still problems such as weak public awareness of prevention, insufficient professional medical resources, and imperfect coordination mechanism. In view of the advantages of medical institutions at all levels, it is necessary to clarify the responsibilities of the system at all levels and explore efficient and sustainable coordination mechanism, so as to improve the comprehensive prevention level of stroke in the medical system.