ObjectiveTo apply and systematically evaluate the care-need grading assessment tool for adults with disabilities in welfare institutions. MethodsFrom June to July, 2025, four disability care institutions in Shanghai were selected, and a total of 1 002 adults with disabilities were assessed using the self-developed care-need grading assessment tool for adults with disabilities in welfare institutions. The application effectiveness of the tool was evaluated by analyzing the classification results of care need grading and the reclassification in grade distribution. The application validity was assessed through score differences across functional dimensions, reduced-dimension clustering scatter plots for each grade, and external variables. The application efficiency was evaluated based on the average assessment duration and learning curves. The application utility value was assessed through the distribution characteristics and mapping relationships of service lists across different grades. ResultsThe distribution across disability levels was 84 in Level 1, 298 in Level 2, 92 in Level 3, 246 in Level 4, and 282 in Level 5, indicating a trend where individuals from higher levels in the original system shifted toward the middle and lower levels of the new system. The tool demonstrated strong discriminatory power across the four functional dimensions (P < 0.001), indicating favorable discriminant validity. The five classified levels exhibited clear clustering boundaries in the reduced-dimension space, reflecting robust structural validity. The classification results were consistent with theoretical expectations regarding external variables, including age, disability type, disability grade, number of comorbidities, and primary clinical diagnoses (P < 0.05), demonstrating sound external validity. The median assessment duration was 5.80 minutes, with a significant learning effect (P = 0.037), showcasing high efficiency. Finally, service lists tailored to different care levels were developed, where service content exhibited graded differences across care levels and accurately mapped the care-need characteristics of each grade, reflecting substantial utility value. ConclusionThis tool can classify the care needs of adults with disabilities into five levels, with sound validity and high assessment efficiency; while the resulting service lists for different care levels can be used to guide practical implementation, which can be used for the graded assessment of care needs among adults with disabilities.

By examining the records related to the Fengfu （GV 16） acupoint in BIAN Que Heart Book （《扁鹊心书》） compiled by the Song Dynasty physician DOU Cai， this study analyzed various aspects， including the differentiation of conditions treated with Fengfu （GV 16） acupoint， the theoretical foundation for selection of Fengfu （GV 16） acupoint， the application of needling manipulation， and the sensation of obtaining qi during acupuncture. The findings suggest that DOU Cai's approach to utilizing Fengfu （GV 16） acupoint differs from traditional methods， particularly emphasizing the effectiveness of achieving a sensation of heat and numbness. His unique techniques include transverse insertion at Fengfu （GV 16） acupoint and penetrated insertion to Fengchi （GB 20） and Yifeng （TE 17） acupoints. The records of Fengfu （GV 16） acupoint in BIAN Que Heart Book provide a valuable reference for its modern clinical application and further development.

Objective To develop a tool for assessing the needs for care services for adults with disabilities in welfare institutions,and formulate criteria for classifying care needs.Methods Based on the theory of the International Classification of Functioning,Disability and Health,the core contents of domestic and international care service assessment standards were analysed,and the first draft of the assess-ment tool was formed integrating with the current practice of welfare institutions.A total of eleven experts in the field of care services validated the first draft,and the assessment tool was revised according to the experts'opin-ions.From May to June,2024,340 adults with disabilities from Second Social Welfare Institute of Shanghai were graded to analyze the reliability and validity of the assessment tool.And then,1 046 subjects from Second Social Welfare Institute of Shanghai were graded using the assessment tool,and the scoring intervals for the five levels of care were determined using cluster analysis.Results The assessment tool included four first-level dimensions,eleven second-level dimensions,39 third-level dimen-sions and 43 indicators.The coefficients of variation of each dimension and indicator were less than 0.25 for ex-pert validation,while the average score of the importance of each indicator was above 4.63,with a full score rate more than 0.86.The overall Cronbach's α coefficient was 0.956,the test-retest reliability was 0.997,and the con-tent validity index of each indicator was 0.83 to 1.00.The exploratory factor analysis extracted four common fac-tors,with a cumulative variance contribution of 86.679%;the loading coefficients of indicators were 0.675 to 0.878,and the correlation coefficients among the dimensions were 0.325 to 0.476.Cluster analysis determined the level of institutional care needs as level 1(severe),level 2(medium-heavy),level 3(medium),level 4(light-moderate),and level 5(light).Conclusion The needs assessment tool for care services for adults with disabilities in welfare institutions developed in this study is good in reliability and validity,and can be used in guiding the care services provided for people with disabilities more efficient and targeted.

Objective To develop a tool for assessing the needs for care services for adults with disabilities in welfare institutions,and formulate criteria for classifying care needs.Methods Based on the theory of the International Classification of Functioning,Disability and Health,the core contents of domestic and international care service assessment standards were analysed,and the first draft of the assess-ment tool was formed integrating with the current practice of welfare institutions.A total of eleven experts in the field of care services validated the first draft,and the assessment tool was revised according to the experts'opin-ions.From May to June,2024,340 adults with disabilities from Second Social Welfare Institute of Shanghai were graded to analyze the reliability and validity of the assessment tool.And then,1 046 subjects from Second Social Welfare Institute of Shanghai were graded using the assessment tool,and the scoring intervals for the five levels of care were determined using cluster analysis.Results The assessment tool included four first-level dimensions,eleven second-level dimensions,39 third-level dimen-sions and 43 indicators.The coefficients of variation of each dimension and indicator were less than 0.25 for ex-pert validation,while the average score of the importance of each indicator was above 4.63,with a full score rate more than 0.86.The overall Cronbach's α coefficient was 0.956,the test-retest reliability was 0.997,and the con-tent validity index of each indicator was 0.83 to 1.00.The exploratory factor analysis extracted four common fac-tors,with a cumulative variance contribution of 86.679%;the loading coefficients of indicators were 0.675 to 0.878,and the correlation coefficients among the dimensions were 0.325 to 0.476.Cluster analysis determined the level of institutional care needs as level 1(severe),level 2(medium-heavy),level 3(medium),level 4(light-moderate),and level 5(light).Conclusion The needs assessment tool for care services for adults with disabilities in welfare institutions developed in this study is good in reliability and validity,and can be used in guiding the care services provided for people with disabilities more efficient and targeted.

Tumor suppressor gene p53 plays an important role in regulating cell cycle, controlling apoptosis and repairing damaged DNA. Mutation of this gene is closely related to the occurrence, development and drug resistance of various tumors. The mutant p53 protein is closely related to the growth and metastasis of triple negative breast cancer (TNBC) with higher malignancy and higher risk of metastasis. This paper expounds the mechanism of p53 protein participating in the occurrence, development and metastasis of TNBC, introduces the effect of interfering with mouse dual-microbody gene 2 (MDM2), activated T cell nuclear factor 1 (NFAT1) and other proteins on p53, as well as small molecular targeted drugs closely related to p53 protein, and provides a new direction and theoretical basis for targeted treatment of TNBC.