ObjectiveTo systematically assess the public health governance capacity in Zhejiang Province, to conduct an in-depth analysis of its strengths and weaknesses, so as to provide scientific basis and strategic recommendations for further enhancement. MethodsA systematic collection of policy documents, public information reports, and research literature related to public health governance capacity in Zhejiang Province from 2002 to 2023 was conducted (encompassing a total of 1 263 policy documents, 138 pieces of information reports and 631 research articles). Based on the evaluation criteria suitable for public health systems previously developed by the research team, the basic status and magnitude of change in public health governance capacity in Zhejiang Province was evaluated. Additionally, normative gap analyses were employed to identify the strengths and weaknesses. ResultsZhejiang Province ranked 4th nationwide in terms of public health governance capacity with a score of 733.4 points (1 000.0-point maximum). The province has effectively implemented the principle of health first (scoring 698.5 points in the assessment of health-first strategy implementation) and attached sufficient importance to health-related goals (scoring 658.2 points in the scientific rationality of goal setting). However, the implementation of inter-departmental coordination and incentive mechanisms only scored 178.7 points, the feasibility of management and monitoring mechanisms scored even lower at only 144.0 points, and the coverage of incentive mechanisms scored 286.0 points. ConclusionZhejiang Province has effectively implemented its health first strategy and attached great importance to health targets, but still needs to strengthen cross-departmental coordination mechanisms and health-oriented incentives.

Objective To investigate the factors affecting cerebral vasospasm in elderly patients af-ter interventional embolization of intracranial aneurysms,and to develop a nomogram prediction model.Methods A total of 307 elderly patients with intracranial aneurysms who underwent inter-ventional embolization in our hospital from May 2021 to May 2023 were recruited,and according to the occurrence of postoperative cerebral vasospasm or not,they were divided into a cerebral vasospasm group(n=63)and a non-cerebral vasospasm group(n=244).The general clinical data were compared between two groups.Univariate and multivariate logistic regression analyses were used to identify the risk factors for postoperative cerebral vasospasm in elderly patients with in-tracranial aneurysms,and then a nomogram prediction model was constructed.Results There were significant differences between the two groups in terms of age,Hunt-Hess grade,Fisher grade,and time window for surgical treatment(P＜0.01).The cerebral vasospasm group had sig-nificantly higher WBC count and IL-1β and Caspase-3 levels than the non-cerebral vasospasm group(P＜0.01).Univariate logistics regression analysis showed that seven indicators,that is,aged≥65 years,Hunt-Hess grade Ⅲ-Ⅵ,Fisher grade Ⅲ-Ⅵ,later surgical start time and in-creased WBC count and IL-1β and Caspase-3 levels were risk factors for postoperative cerebral vasospasm(P＜0.05).Multivariate logistics regression analysis indicated that above seven indica-tors were still independent risk factors for postoperative cerebral vasospasm(OR=11.372,95％CI:4.032-32.073,P=0.000;OR=12.415,95％CI:4.979-30.959,P=0.000;OR=9.568,95％CI:3.945-23.206,P=0.000;OR=2.898,95％CI:1.217-6.901,P=0.016;OR=1.762,95％CI:1.125-2.761,P=0.013;OR=1.153,95％CI:1.035-1.283,P=0.009).ROC curve analysis re-vealed that the AUC value of the nomogram model in predicting postoperative cerebral vasospasm was 0.934,with a sensitivity of 85.40％and a specificity of 90.50％.Conclusion Aged≥65 years,Hunt-Hess grade Ⅲ-Ⅵ,Fisher grade Ⅲ-Ⅵ,later surgical start time and increased WBC count and IL-1β and Caspase-3 levels have adverse effects on postoperative cerebral vasospasm in in eld-erly patients after interventional embolization of intracranial aneurysms.The nomogram model based on these factors shows certain efficacy in evaluating the occurrence of cerebral vasospasm.

Objective:To analyze the influencing factors of blood flow infection in patients with severe cerebral hemorrhage and construct a nomogram prediction model.Methods:Clinical data of 300 patients with severe cerebral hemorrhage admitted to the Hainan Provincial People′s Hospital from January 2020 to December 2022 were collected by retrospective study. According to the occurrence of bloodstream infection during hospitalization, they were divided into infected group (22 cases) and uninfected group (278 cases). Multivariate Logistic regression was used to analyze the influencing factors of the occurrence of blood flow infection in patients with severe cerebral hemorrhage, and a nomogram model was constructed to predict the occurrence of blood flow infection in patients with severe cerebral hemorrhage. The correction curve was used for internal verification, and the prediction efficiency was evaluated by decision curve.Results:The proportion of patients with diabetes, femoral vein catheterization, and catheterization time>7 d in the infected group was higher than that in the uninfected group group: 45.45% (10/22) vs. 20.14 % (56/278), 68.18% (15/22) vs. 32.37% (90/278), 63.64% (14/ 22) vs. 40.29% (112/278), and the serum albumin level was lower than that in the uninfected group: (37.20 ± 6.02) g/L vs. (42.12 ± 4.46) g/L, with statistical significant differences ( P<0.05). Multivariate Logistic regression analysis showed that diabetes, femoral vein catheterization, and catheterization time>7 d were risk factors for blood flow infection in patients with severe cerebral hemorrhage, and high serum albumin level was a protective factor for blood flow infection in patients with severe cerebral hemorrhage ( P<0.05). The nomogram model was constructed with diabetes, catheter placement site, catheter placement time, and serum albumin as predictors. The calibration curve of this model for predicting blood flow infection in patients with severe intracerebral hemorrhage approached the ideal curve (C-index: 0.865, 95% CI: 0.774 to 0.956). The result of decision curve analysis showed that when the risk threshold was > 0.08, the clinical net benefit provided by the nomogram model was higher than that of diabetes, catheter placement site, catheter placement time and serum albumin. Conclusions:Combined with diabetes, femoral vein catheterization, catheterization time>7 d, serum albumin are the influencing factors of blood flow infection in patients with severe cerebral hemorrhage. The nomogram model based on the above factors can be used to identify high-risk patients with blood flow infection.

BACKGROUND:Eupatilin,a flavonoid active component derived from Artemisia sinensis,has been reported to relieve inflammation and improve neurological scores in rats with subarachnoid hemorrhage,but its role and mechanism in learning and memory remain unclear.OBJECTIVE:To investigate the effects of eupatilin on learning and memory abilities and P38 mitogen activated protein kinase(p38 MAPK)/signal transducer and activator of transcription-3(STAT3)pathway proteins in rats with subarachnoid hemorrhage.METHODS:A total of 50 Sprague-Dawley rats were randomly divided into sham surgery group,model group,eupatilin group,hesperetin group,eupatilin+hesperetin group,with 10 rats in each group.Except for the sham surgery group,the rats in the other groups were used to construct a subarachnoid hemorrhage model through intravascular perforation.Two hours after successful modeling,the eupatilin group was injected with 10 mg/kg eupatilin via the tail vein,the hesperetin group was injected with 50 mg/kg hesperetin(p38 MAPK/STAT3 signaling pathway activator)via the tail vein,the eupatilin+hesperetin group was injected with 10 mg/kg eupatilin and 50 mg/kg hesperetin via the tail vein,and the sham surgery group and the model group were injected with 10 mL/kg saline via the tail vein.The drug treatment lasted for 24 hours.The neurologic deficit score and Morris water maze experiment were applied to detect the neurological function and learning and memory abilities of rats.Hematoxylin-eosin staining was performed to detect the histopathological changes of the hippocampus.TUNEL method was used to detect neuronal apoptosis.Immunohistochemical staining was conducted to detect the number of doublecortin-positive cells in hippocampal tissue.Western blot was applied to detect the expression of p38 MAPK/STAT3 protein in hippocampal tissue.RESULTS AND CONCLUSION:Compared with the sham surgery group,rats in the model group had lower neurological deficit scores,learning and memory abilities,and number of doublecortin-positive cells(P<0.05),and higher neuronal apoptosis rate and protein expression of p-p38 MAPK/p38 MAPK and p-STAT3/STAT3(P<0.05).Compared with the model group,rats in the eupatilin group showed higher neurological deficit scores,learning and memory abilities,and number of doublecortin-positive cells(P<0.05),and lower neuronal apoptosis rate and protein expression of p-p38 MAPK/p38 MAPK and p-STAT3/STAT3(P<0.05),while those in the nerolone group showed lower neurological deficit scores,learning and memory abilities,and number of doublecortin-positive cells(P<0.05),and higher neuronal apoptosis rate and protein expression of p-p38 MAPK/p38 MAPK and p-STAT3/STAT3(P<0.05).Compared with the eupatilin group,rats in the eupatilin+hesperetin group had lower neurological deficit scores,learning memory abilities,and number of doublecortin-positive cells(P<0.05),and higher neuronal apoptosis rate and protein expression of p-p38 MAPK/p38 MAPK and p-STAT3/STAT3(P<0.05).Hematoxylin-eosin staining showed that compared with the model group,the nerve cells were more neatly arranged in the eupatilin group,disorganized in the hesperetin group,and arranged in a similar way to the model group in the eupatilin+hesperetin group.To conclude,eupatilin may improve learning and memory abilities of rats with subarachnoid hemorrhage by inhibiting the p38 MAPK/STAT3 signaling pathway.

Objective This study aims to explore the characteristics and weight loss motivations of patients in the medi-cal nutrition weight loss clinic of a hospital in Ningxia.Methods This study is a cross-sectional study.Patients who visited the medical weight loss clinic at Ningxia Hui Autonomous Region People's Hospital from April to September 2023 were selected as the study subjects.A self-designed questionnaire was used to collect patients'demographic information,lifestyle,weight loss ex-periences,and motivations.The characteristics of weight loss patients were analyzed.Furthermore,the patients were divided into two groups,improvement of health group and improvement of body shape group,based on their weight loss motivations,in order to study the characteristics of different motivational groups.Results A total of 160 subjects were included in the study,with 97 females(60.6％)and 63 males(39.4％).The average age was 29.66±11.89 years,weight was 89.11±16.54 kg,and BM1 was 31.15±4.44 kg/m2.Most patients had comorbidities,with fatty liver being the most common(57.5％),followed by hype-ruricemia(30.6％)and hyperlipidemia(23.8％).Common problems among patients included unhealthy dietary habits,lack of physical activity,and irregular sleep patterns.72.5％of patients had attempted weight loss multiple times,and among different weight loss methods,combined interventions had a higher effectiveness rate,but rebound rates were generally high.In terms of weight loss motivations,81 patients aimed to improve health,while 79 aimed to improve body shape.There were statistically sig-nificant differences(P＜0.05)between the two groups in terms of age,education level,occupation,duration of obesity,and medical history.Conclusion Patients in the medical nutrition weight loss clinic often have comorbidities and have experienced multiple weight loss attempts and weight rebounds.Motivational interviews help patients recognize the dangers of obesity,estab-lish a belief in health,and promote the formation of a healthy lifestyle.

Objective To investigate the factors affecting cerebral vasospasm in elderly patients af-ter interventional embolization of intracranial aneurysms,and to develop a nomogram prediction model.Methods A total of 307 elderly patients with intracranial aneurysms who underwent inter-ventional embolization in our hospital from May 2021 to May 2023 were recruited,and according to the occurrence of postoperative cerebral vasospasm or not,they were divided into a cerebral vasospasm group(n=63)and a non-cerebral vasospasm group(n=244).The general clinical data were compared between two groups.Univariate and multivariate logistic regression analyses were used to identify the risk factors for postoperative cerebral vasospasm in elderly patients with in-tracranial aneurysms,and then a nomogram prediction model was constructed.Results There were significant differences between the two groups in terms of age,Hunt-Hess grade,Fisher grade,and time window for surgical treatment(P＜0.01).The cerebral vasospasm group had sig-nificantly higher WBC count and IL-1β and Caspase-3 levels than the non-cerebral vasospasm group(P＜0.01).Univariate logistics regression analysis showed that seven indicators,that is,aged≥65 years,Hunt-Hess grade Ⅲ-Ⅵ,Fisher grade Ⅲ-Ⅵ,later surgical start time and in-creased WBC count and IL-1β and Caspase-3 levels were risk factors for postoperative cerebral vasospasm(P＜0.05).Multivariate logistics regression analysis indicated that above seven indica-tors were still independent risk factors for postoperative cerebral vasospasm(OR=11.372,95％CI:4.032-32.073,P=0.000;OR=12.415,95％CI:4.979-30.959,P=0.000;OR=9.568,95％CI:3.945-23.206,P=0.000;OR=2.898,95％CI:1.217-6.901,P=0.016;OR=1.762,95％CI:1.125-2.761,P=0.013;OR=1.153,95％CI:1.035-1.283,P=0.009).ROC curve analysis re-vealed that the AUC value of the nomogram model in predicting postoperative cerebral vasospasm was 0.934,with a sensitivity of 85.40％and a specificity of 90.50％.Conclusion Aged≥65 years,Hunt-Hess grade Ⅲ-Ⅵ,Fisher grade Ⅲ-Ⅵ,later surgical start time and increased WBC count and IL-1β and Caspase-3 levels have adverse effects on postoperative cerebral vasospasm in in eld-erly patients after interventional embolization of intracranial aneurysms.The nomogram model based on these factors shows certain efficacy in evaluating the occurrence of cerebral vasospasm.

Objective:To analyze the influencing factors of blood flow infection in patients with severe cerebral hemorrhage and construct a nomogram prediction model.Methods:Clinical data of 300 patients with severe cerebral hemorrhage admitted to the Hainan Provincial People′s Hospital from January 2020 to December 2022 were collected by retrospective study. According to the occurrence of bloodstream infection during hospitalization, they were divided into infected group (22 cases) and uninfected group (278 cases). Multivariate Logistic regression was used to analyze the influencing factors of the occurrence of blood flow infection in patients with severe cerebral hemorrhage, and a nomogram model was constructed to predict the occurrence of blood flow infection in patients with severe cerebral hemorrhage. The correction curve was used for internal verification, and the prediction efficiency was evaluated by decision curve.Results:The proportion of patients with diabetes, femoral vein catheterization, and catheterization time>7 d in the infected group was higher than that in the uninfected group group: 45.45% (10/22) vs. 20.14 % (56/278), 68.18% (15/22) vs. 32.37% (90/278), 63.64% (14/ 22) vs. 40.29% (112/278), and the serum albumin level was lower than that in the uninfected group: (37.20 ± 6.02) g/L vs. (42.12 ± 4.46) g/L, with statistical significant differences ( P<0.05). Multivariate Logistic regression analysis showed that diabetes, femoral vein catheterization, and catheterization time>7 d were risk factors for blood flow infection in patients with severe cerebral hemorrhage, and high serum albumin level was a protective factor for blood flow infection in patients with severe cerebral hemorrhage ( P<0.05). The nomogram model was constructed with diabetes, catheter placement site, catheter placement time, and serum albumin as predictors. The calibration curve of this model for predicting blood flow infection in patients with severe intracerebral hemorrhage approached the ideal curve (C-index: 0.865, 95% CI: 0.774 to 0.956). The result of decision curve analysis showed that when the risk threshold was > 0.08, the clinical net benefit provided by the nomogram model was higher than that of diabetes, catheter placement site, catheter placement time and serum albumin. Conclusions:Combined with diabetes, femoral vein catheterization, catheterization time>7 d, serum albumin are the influencing factors of blood flow infection in patients with severe cerebral hemorrhage. The nomogram model based on the above factors can be used to identify high-risk patients with blood flow infection.

BACKGROUND:Eupatilin,a flavonoid active component derived from Artemisia sinensis,has been reported to relieve inflammation and improve neurological scores in rats with subarachnoid hemorrhage,but its role and mechanism in learning and memory remain unclear.OBJECTIVE:To investigate the effects of eupatilin on learning and memory abilities and P38 mitogen activated protein kinase(p38 MAPK)/signal transducer and activator of transcription-3(STAT3)pathway proteins in rats with subarachnoid hemorrhage.METHODS:A total of 50 Sprague-Dawley rats were randomly divided into sham surgery group,model group,eupatilin group,hesperetin group,eupatilin+hesperetin group,with 10 rats in each group.Except for the sham surgery group,the rats in the other groups were used to construct a subarachnoid hemorrhage model through intravascular perforation.Two hours after successful modeling,the eupatilin group was injected with 10 mg/kg eupatilin via the tail vein,the hesperetin group was injected with 50 mg/kg hesperetin(p38 MAPK/STAT3 signaling pathway activator)via the tail vein,the eupatilin+hesperetin group was injected with 10 mg/kg eupatilin and 50 mg/kg hesperetin via the tail vein,and the sham surgery group and the model group were injected with 10 mL/kg saline via the tail vein.The drug treatment lasted for 24 hours.The neurologic deficit score and Morris water maze experiment were applied to detect the neurological function and learning and memory abilities of rats.Hematoxylin-eosin staining was performed to detect the histopathological changes of the hippocampus.TUNEL method was used to detect neuronal apoptosis.Immunohistochemical staining was conducted to detect the number of doublecortin-positive cells in hippocampal tissue.Western blot was applied to detect the expression of p38 MAPK/STAT3 protein in hippocampal tissue.RESULTS AND CONCLUSION:Compared with the sham surgery group,rats in the model group had lower neurological deficit scores,learning and memory abilities,and number of doublecortin-positive cells(P<0.05),and higher neuronal apoptosis rate and protein expression of p-p38 MAPK/p38 MAPK and p-STAT3/STAT3(P<0.05).Compared with the model group,rats in the eupatilin group showed higher neurological deficit scores,learning and memory abilities,and number of doublecortin-positive cells(P<0.05),and lower neuronal apoptosis rate and protein expression of p-p38 MAPK/p38 MAPK and p-STAT3/STAT3(P<0.05),while those in the nerolone group showed lower neurological deficit scores,learning and memory abilities,and number of doublecortin-positive cells(P<0.05),and higher neuronal apoptosis rate and protein expression of p-p38 MAPK/p38 MAPK and p-STAT3/STAT3(P<0.05).Compared with the eupatilin group,rats in the eupatilin+hesperetin group had lower neurological deficit scores,learning memory abilities,and number of doublecortin-positive cells(P<0.05),and higher neuronal apoptosis rate and protein expression of p-p38 MAPK/p38 MAPK and p-STAT3/STAT3(P<0.05).Hematoxylin-eosin staining showed that compared with the model group,the nerve cells were more neatly arranged in the eupatilin group,disorganized in the hesperetin group,and arranged in a similar way to the model group in the eupatilin+hesperetin group.To conclude,eupatilin may improve learning and memory abilities of rats with subarachnoid hemorrhage by inhibiting the p38 MAPK/STAT3 signaling pathway.

Objective This study aims to explore the characteristics and weight loss motivations of patients in the medi-cal nutrition weight loss clinic of a hospital in Ningxia.Methods This study is a cross-sectional study.Patients who visited the medical weight loss clinic at Ningxia Hui Autonomous Region People's Hospital from April to September 2023 were selected as the study subjects.A self-designed questionnaire was used to collect patients'demographic information,lifestyle,weight loss ex-periences,and motivations.The characteristics of weight loss patients were analyzed.Furthermore,the patients were divided into two groups,improvement of health group and improvement of body shape group,based on their weight loss motivations,in order to study the characteristics of different motivational groups.Results A total of 160 subjects were included in the study,with 97 females(60.6％)and 63 males(39.4％).The average age was 29.66±11.89 years,weight was 89.11±16.54 kg,and BM1 was 31.15±4.44 kg/m2.Most patients had comorbidities,with fatty liver being the most common(57.5％),followed by hype-ruricemia(30.6％)and hyperlipidemia(23.8％).Common problems among patients included unhealthy dietary habits,lack of physical activity,and irregular sleep patterns.72.5％of patients had attempted weight loss multiple times,and among different weight loss methods,combined interventions had a higher effectiveness rate,but rebound rates were generally high.In terms of weight loss motivations,81 patients aimed to improve health,while 79 aimed to improve body shape.There were statistically sig-nificant differences(P＜0.05)between the two groups in terms of age,education level,occupation,duration of obesity,and medical history.Conclusion Patients in the medical nutrition weight loss clinic often have comorbidities and have experienced multiple weight loss attempts and weight rebounds.Motivational interviews help patients recognize the dangers of obesity,estab-lish a belief in health,and promote the formation of a healthy lifestyle.

AIM:To investigate the impact of aquaporin 4(AQP4)expression inhibition on autophagy and apoptosis in a mouse model of cerebral ischemia-reperfusion(I/R)injury,and to elucidate its underlying mechanism.METHODS:Cerebral I/R injury was induced in mice via transient middle cerebral artery occlusion(tMCAO).Totally 60 mice were randomly divided into sham group,I/R group,AQP4 inhibition group,and 3-methyladenine(3-MA)group,with 15 mice in each group.Among them,the mice in sham and I/R groups received intraperitoneal injections of normal saline,while those in AQP4 inhibition group and 3-MA group received intraperitoneal injections of AER-271(2 mg·kg-1·d-1)and AER-271+3-MA(2 mg·kg-1·d-1)for 3 d,respectively,once per day.Longa score was adopted to assess the neu-rological function,and to record changes in body weight.Cerebral infarction volume and histopathological alterations were evaluated using hematoxylin-eosin staining.Western blot analysis was performed to determine the levels of AQP4,LC3-Ⅱ,P62 and cleaved caspase-3,while the LC3-Ⅱ,P62,cleaved caspase-3 and NeuN(neuronal marker)colocalization and expression assessment were conducted with immunofluorescence.RESULTS:The mice in I/R and AQP4 inhibition groups exhibited extensive cerebral infarction,cerebral edema,and elevated Longa scores.However,in comparision to I/R group,the mice in AQP4 inhibition group showed significantly reduced cerebral infarct volume,cerebral edema vol-ume,and Longa score(P<0.05).Additionally,in contrast to sham group,the mice in I/R group displayed increased ex-pression of AQP4,LC3-Ⅱ and cleaved caspase-3(P<0.01),accompanied by decreased body weight and P62 expression(P<0.05 or P<0.01).Furthermore,compared with I/R group,the mice in both AQP4 inhibition group and 3-MA group demonstrated a decrease in the expression levels of AQP4,LC3-Ⅱ and cleaved caspase-3(P<0.05 or P<0.01),along with increased body weight and P62 expression(P<0.05 or P<0.01).Nonetheless,no significant differences were ob-served between AQP4 inhibition group and 3-MA group regarding Longa score,cerebral infarct volume,body weight,and the expression of AQP4,LC3-Ⅱ,cleaved caspase-3 and P62.CONCLUSION:Inhibition of AQP4 expression signifi-cantly reduces cerebral infarction area and nerve injury severity in tMCAO mice.Moreover,AQP4 expression inhibition decelerates autophagy and apoptosis after cerebral infarction,with the additional autophagy inhibitor showing no notable impact on the protective effect of AQP4 inhibition.