The introduction of national dementia action plans will further drive the development of service systems for the continuum of care for cognitive disorders. However， current healthcare delivery models are often plagued by resource wastage and inefficiency. Grounded in the medical service chain theory， integrating healthcare and social resources through service teams to build a more efficient service system centered on patients' needs holds promise for improving both the quality and efficiency of care. This article reviews the construction of the continuum of care service chain for cognitive disorders， analyzes the potential value of social prescribing as an innovative service model， and explores the role of digital platforms in optimizing care process coordination and enabling information sharing， with the aim of providing a practical reference for the coordinated operation of the continuum of care for cognitive disorders.

Objective:To summarize domestic and foreign transitional readiness assessment tools for adolescents with chronic diseases and analyze the current status of their application in the clinic, so as to provide references for healthcare professionals to select appropriate tools.Methods:China National Knowledge Infrastructure, Wanfang Data, VIP and China Biomedical Literature Database, PubMed, Web of Science, Embase, Medline, CINAHL, Cochrane Library and scholar.google.com were searched for literature related to the assessment tools of transition readiness in adolescents with chronic illnesses from inception to March 29, 2024. Two researchers independently screened the literature and extracted the data.Results:A total of 491 articles were initially retrieved and 24 were included, involving a total of 8 transitional readiness assessment tools for adolescents with chronic diseases, including the Transition Readiness Assessment questionnaire, the University of North Carolina TRxANSITION Scale, Am I ON TRAC for adult care? Questionnaire, Transition Questionnaire, Self-Management and Transition to Adulthood with Rx=Treatment Questionnaire, Good 2 Go Questionnaire, State Assessment Questionnaire for Transition, and Self-assessment Scale of Transition Readiness for Adolescents. The Transition Readiness Assessment questionnaire and Self-Management and Transition to Adulthood with Rx=Treatment Questionnaire have good reliability and validity, comprehensive evaluation, wide applicability, simple use, and are suitable for clinical use.Conclusions:The quality of existing tools for assessing transitional readiness of adolescents with chronic diseases is mixed. The Transition Readiness Assessment questionnaire and Self-Management and Transition to Adulthood with Rx=Treatment Questionnaire are more appropriate options in the clinic, but they still need to be improved. Future studies need to continue to introduce tools to assess transitional readiness for chronic diseases in adolescents and develop localized assessment tools.

Objective:To deeply understand the psychological experiences and needs of ward nurses caring for elderly patients with postoperative delirium, providing insights for improving their care capabilities.Methods:A descriptive qualitative study was conducted using purposive sampling to select nurses from the surgical wards of the Second Affiliated Hospital of Zhejiang University School of Medicine who had cared for elderly patients with postoperative delirium between January and March 2024. Semi-structured interviews were conducted, and traditional content analysis was used to extract themes.Results:Sixteen surgical ward nurses, aged 26-48 years old and all female, were interviewed. Four themes and nine sub-themes were identified: internal stress in caring for elderly patients with postoperative delirium (concerns about failing to recognize changes in condition, leading to delayed treatment; physical and psychological stress overwhelming nursing work); external challenges in caring for elderly patients with postoperative delirium (uncontrollable patient behavior; lack of close collaboration between medical staff; lack of awareness among patient families about postoperative delirium); lack of knowledge about postoperative delirium (difficulty in identifying subtypes of postoperative delirium; lack of knowledge about postoperative delirium management); and a desire for systematic professional support (urgent need for operational guidelines on postoperative delirium management in elderly patients; expectation for the establishment of a multidisciplinary team for postoperative delirium management in elderly patients).Conclusions:Nursing managers should pay attention to the physical and mental health of ward nurses, provide multifaceted support, strengthen their knowledge about postoperative delirium in elderly patients, optimize postoperative delirium management, and improve their care capabilities.

Objective To explore the value of shear wave elastography(SWE)combined with carbohydrate antigen 15-3(CA15-3)in differentiating benign and malignant breast imaging and reporting data system(BI-RADS)category 4 breast masses.Methods Ninety patients with breast tumors confirmed by surgical pathology at the Affiliated Hospital of Yunnan University from December 2021 to June 2024 were enrolled,all with BI-RADS category 4 breast masses.The patients were divided into a benign group(n=42)and a malignant group(n=48)according to whether the breast masses were benign or malignant.All of them underwent SWE examination,and serum CA15-3 levels were determined using electrochemiluminescence method.Serum CA15-3 levels and SWE parameters[elasticity standard deviation(ESD),mean elasticity value(Emean),maximum elasticity value(Emax)and the ratio of breast mass elasticity to same-layer low fat elasticity(Eratio)]were compared between the two groups.The area under the receiver operating characteristic curve(AUC)was used to evaluate the diagnostic performance of serum CA15-3 levels,SWE parameters,and their combination for benign and malignant BI-RADS category 4 breast masses.Results The SWE parameters(ESD,Emean,Emax,and Eratio)and serum CA15-3 levels in the malignant group were significantly higher than those in the benign group(P<0.05).The AUC values of ESD,Emean,Emax,Eratio,and serum CA15-3 levels for the diagnosis of benign and malignant BI-RADS category 4 breast masses were 0.718(95%CI:0.613-0.824),0.791(95%CI:0.701-0.881),0.721(95%CI:0.615-0.826),0.721(95%CI:0.613-0.830)and 0.793(95%CI:0.702-0.885),respectively.Notably,SWE parameters combined with serum CA15-3 levels achieved an AUC value of 0.953(95%CI:0.917-0.992).Conclusion The combination of CA15-3 and SWE exhibits high efficiency in diagnosing the benign and malignant nature of BI-RADS category 4 breast masses.

BACKGROUND:U937 cells can be used as a cell model for studying the biological characteristics,signaling pathways,and therapeutic targets of acute myeloid leukemia.Although it has been reported that long non-coding RNA KIAA0125 is highly expressed in acute myeloid leukemia,its biological function in U937 cells remains unclear,and its mechanism of action in the occurrence and development of acute myeloid leukemia needs to be further clarified. OBJECTIVE:To investigate the expression level of long non-coding RNA KIAA0125 in peripheral blood of patients with acute myeloid leukemia and its effect on the proliferation and apoptosis of U937 cells. METHODS:RNA-sequencing was used to analyze the bone marrow monocyte samples from acute myeloid leukemia patients,and the differentially expressed gene long non-coding RNA KIAA0125 was screened.The expression of long non-coding RNA KIAA0125 in peripheral blood of patients with acute myeloid leukemia was detected by qRT-PCR.The relationship between long non-coding RNA KIAA0125 mRNA expression and prognosis in bone marrow cells of 173 acute myeloid leukemia patients and 70 healthy people was statistically analyzed by GEPIA database.Subsequently,recombinant lentivirus technology and CRISPR/Cas9-SAM technology were used to construct U937 cell lines with knockdown/overexpression of long non-coding RNA KIAA0125.qRT-PCR was used to detect the knockdown/overexpression efficiency of long non-coding RNA KIAA0125.Next,CCK-8 assay,flow cytometry,and western blot assay were used to detect the effects of knockdown/overexpression of long non-coding RNA KIAA0125 on the proliferation and apoptosis of U937 cells.Finally,western blot assay was used to detect the effect of knockdown/overexpressed long non-coding RNA KIAA0125 on Wnt/β-catenin signaling pathway-related proteins. RESULTS AND CONCLUSION:(1)The results of qRT-PCR showed that long non-coding RNA KIAA0125 was highly expressed in peripheral blood of acute myeloid leukemia patients.The results of GEPIA database showed that long non-coding RNA KIAA0125 was highly expressed in bone marrow cells of acute myeloid leukemia patients,and the high expression group had worse overall survival.(2)The knockdown efficiency of long non-coding RNA KIAA0125 in knockdown group was 70%,and the U937 cells that stably down-regulated long non-coding RNA KIAA0125 expression were successfully constructed.The expression of long non-coding RNA KIAA0125 in overexpression group was four times that of vector group,and stable U937 cells were successfully constructed.(3)Knockdown of long non-coding RNA KIAA0125 inhibited the proliferation of U937 cells and promoted their apoptosis.Overexpression of long non-coding RNA KIAA0125 promoted the proliferation of U937 cells but had no significant effect on the apoptosis of U937 cells.(4)Knockdown of long non-coding RNA KIAA0125 inhibited the activity of Wnt/β-catenin signaling pathway,while overexpression of long non-coding RNA KIAA0125 activated Wnt/β-catenin signaling pathway.These results confirm that long non-coding RNA KIAA0125 is highly expressed in acute myeloid leukemia peripheral blood.Long non-coding RNA KIAA0125 may affect the proliferation and apoptosis of U937 cells by regulating the Wnt/β-catenin signaling pathway,and may be a potential prognostic marker for acute myeloid leukemia.

Elemene is widely recognized as an effective anti-cancer compound and is routinely administered in Chinese clinical settings for the management of several solid tumors, including non-small cell lung cancer (NSCLC). However, its detailed molecular mechanism has not been adequately demonstrated. In this research, it was demonstrated that elemene effectively curtailed NSCLC growth in the patient-derived xenograft (PDX) model. Mechanistically, employing high-throughput screening techniques and subsequent biochemical validations such as microscale thermophoresis (MST), microRNA-145-5p (miR-145-5p) was pinpointed as a critical target through which elemene exerts its anti-tumor effects. Interestingly, elemene serves as a binding stabilizer for miR-145-5p, demonstrating a strong binding affinity (dissociation constant (K _D) = 0.39 ± 0.17 μg/mL) and preventing its degradation both in vitro and in vivo, while not interfering with the synthesis of the primary microRNA transcripts (pri-miRNAs) and precursor miRNAs (pre-miRNAs). The stabilization of miR-145-5p by elemene resulted in an increased level of this miRNA, subsequently suppressing NSCLC progression through the miR-145-5p/mitogen-activated protein kinase kinase kinase 3 (MAP3K3)/nuclear factor kappaB (NF-κB) pathway. Our findings provide a new perspective on revealing the interaction patterns between clinical anti-tumor drugs and miRNAs.

The rapid screening of bioactive constituents within traditional Chinese medicine (TCM) presents a significant challenge to researchers. Prevailing strategies for the screening of active components in TCM often overlook trace components owing to their concealment by more abundant constituents. To address this limitation, a fishing strategy based on offline two-dimensional liquid chromatography (2D-LC) combined with surface plasmon resonance (SPR) was utilized to screen bioactive trace components targeting peroxiredoxin 3 (PRDX3), using Uncaria alkaloids (UAs) as a case study. Initially, an orthogonal preparative offline 2D-LC system combining a positively charged C₁₈ column and a conventional C₁₈ column under disparate mobile phase conditions was constructed. To fully reveal the trace alkaloids, 13 2D fractions of UAs were prepared, and their components were characterized using mass spectrometry (MS). Subsequently, employing PRDX3 as the targeting protein, a SPR-based screening approach was established and rigorously validated with geissoschizine methyl ether (GSM) serving as a positive control for binding. Employing this refined strategy, 29 candidate binding alkaloids were fished from the 13 2D fractions. Notably, combining offline 2D-LC with SPR increased the yield of candidate binding components from 10 to 29 when compared to SPR-based screening alone. Subsequent binding affinity assays confirmed that PRDX3 was a direct binding target for the 12 fished alkaloids, with isovallesiachotamine (IV), corynoxeine N-oxide (CO-N), and cadambine (CAD) demonstrating the highest affinity for PRDX3. Their interactions were further validated through molecular docking analysis. Subsequent intracellular H₂O₂ measurement assays and transfection experiments confirmed that these three trace alkaloids enhanced PRDX3-mediated H₂O₂ clearance. In conclusion, this study introduced an innovative strategy for the identification of active trace components in TCM. This approach holds promise for accelerating research on medicinal components within this field.

Objective To explore the value of shear wave elastography(SWE)combined with carbohydrate antigen 15-3(CA15-3)in differentiating benign and malignant breast imaging and reporting data system(BI-RADS)category 4 breast masses.Methods Ninety patients with breast tumors confirmed by surgical pathology at the Affiliated Hospital of Yunnan University from December 2021 to June 2024 were enrolled,all with BI-RADS category 4 breast masses.The patients were divided into a benign group(n=42)and a malignant group(n=48)according to whether the breast masses were benign or malignant.All of them underwent SWE examination,and serum CA15-3 levels were determined using electrochemiluminescence method.Serum CA15-3 levels and SWE parameters[elasticity standard deviation(ESD),mean elasticity value(Emean),maximum elasticity value(Emax)and the ratio of breast mass elasticity to same-layer low fat elasticity(Eratio)]were compared between the two groups.The area under the receiver operating characteristic curve(AUC)was used to evaluate the diagnostic performance of serum CA15-3 levels,SWE parameters,and their combination for benign and malignant BI-RADS category 4 breast masses.Results The SWE parameters(ESD,Emean,Emax,and Eratio)and serum CA15-3 levels in the malignant group were significantly higher than those in the benign group(P<0.05).The AUC values of ESD,Emean,Emax,Eratio,and serum CA15-3 levels for the diagnosis of benign and malignant BI-RADS category 4 breast masses were 0.718(95%CI:0.613-0.824),0.791(95%CI:0.701-0.881),0.721(95%CI:0.615-0.826),0.721(95%CI:0.613-0.830)and 0.793(95%CI:0.702-0.885),respectively.Notably,SWE parameters combined with serum CA15-3 levels achieved an AUC value of 0.953(95%CI:0.917-0.992).Conclusion The combination of CA15-3 and SWE exhibits high efficiency in diagnosing the benign and malignant nature of BI-RADS category 4 breast masses.