ObjectiveTo introduce visual teaching into the course design of medical humanistic care based on the concept of implementation science， evaluate the teaching implementation effect and feedback， and provide references for optimizing course teaching outcomes and improving students’ humanistic care competence. MethodsA visual teaching program for medical humanistic care was designed， with key steps including clarifying teaching objectives， content， methods， and curriculum assessment. This program was implemented in the medical humanistic care course teaching involving 50 elective students. Multi-dimensional evaluation of teaching effectiveness was conducted through course grades， visual teaching evaluation， and humanistic workshop assessment， combined with inductive content analysis of students’ learning experiences in the workshops. ResultsThe 50 students achieved above-average course grades （89.60±3.41） and demonstrated high satisfaction with the overall course and visual teaching. All the 6 groups obtained relatively high scores in the medical humanistic care workshops. Four themes were extracted， namely， enhancing humanistic care competencies， deepening familial and interpersonal relationships， realizing emotional expression and self-growth， and strengthening integration of humanistic care concepts with practice. ConclusionThe teaching of medical humanistic care course has achieved favorable effects， which contributes to deepening students’ understanding of humanistic care and enhancing their humanistic care competence. Students demonstrate high levels of recognition and satisfaction with the course.

ObjectiveTo explore the driving forces for oncology nurses’ participation in palliative care work， thereby providing a theoretical basis for the improvement of education and training， incentive mechanisms， and other aspects of the palliative care nursing staff. MethodsEmploying a qualitative research method， semi-structured interviews lasting 40-60 minutes were conducted with 14 nurses who had participated in palliative care work. The interview data were analyzed using the Colaizzi seven-step analysis method. ResultsInternal positive driving forces were job interest， empathy， and a sense of professional responsibility， while the negative was low psychological resilience. External positive driving forces included high work support， professional identity， mutual benefits for nurses and patients， and positive patient attitudes， whereas negative driving forces comprised busy routine clinical work， lack of a reward and incentive system， and bland or negative patient attitudes. ConclusionIt is essential to provide a flexible platform for the enhancement of nurses’ professional capabilities in palliative care， intensify the publicity of palliative care and death education； intervene and guide nurses’ negative emotions， improve and implement relevant incentive systems， and standardize the job recognition and scope of responsibilities of palliative care nurses.

ObjectiveTo explore the impact of comprehensive vocational rehabilitation on quality of life and return-to-work outcomes for individuals with mild work-related disability. MethodsA longitudinal observational study was conducted. A total of 343 work-injured employees receiving comprehensive vocational rehabilitation intervention in Guangdong Work Injury Rehabilitation Hospital from June, 2023 to December, 2024 were selected. The 36-item Short Form Health Survey (SF-36) was adopted to assess their health-related quality of life at admission and discharge. All subjects were followed up within one year after discharge to collect their return-to-work status. The differences in each dimension score of SF-36 among patients with different return-to-work outcomes (return to original post, transfer to new post and non-return to work) were compared, and the independent influencing factors of return-to-work outcomes were identified. ResultsComprehensive vocational rehabilitation intervention significantly improved the scores of physical functioning (PF), role-physical (RP) and role-emotional (RE) among work-injured employees (P < 0.05). At discharge, compared with patients who failed to return to work, patients returning to original post obtained significantly higher scores in PF, RP, bodily pain (BP), general health (GH), vitality (VT), social functioning (SF) and mental health (MH), patients transferred to new post achieved significantly higher scores in PF, BP, GH and SF (P < 0.05). Taking non-return-to-work status as the reference category, the multinomial logistic regression model showed the adverse factors for return to original post included low educational attainment (college diploma or below), on-site placement service, increased lost workdays and low employment intention (pre-contemplation and contemplation stages); the protective factor was positive evaluation of health transition (HT); for patients transferred to new posts, adverse factors were low employment intention (pre-contemplation stage) and increased lost workdays, while protective factors covered on-site placement service and positive HT evaluation. ConclusionComprehensive vocational rehabilitation can improve the quality of life for injured workers. Better quality of life is positively associated with return-to-work outcomes. HT, education level, job placement mode, lost workdays and employment willingness are independent factors impacting return-to-work outcomes.

Objective: To analyze the epidemiological characteristics of pulmonary tuberculosis (PTB) in Jinhua City, Zhejiang Province from 2015 to 2024, so as to provide the evidence for optimizing tuberculosis control strategies. Methods: Data of PTB cases in Jinhua City from 2015 to 2024 were collected through the China Disease Prevention and Control Information System. Descriptive epidemiological methods were used to analyze the population, temporal and spatial distribution characteristics of PTB cases. Seasonal index was used to analyze temporal distribution characteristics. The average annual percent change (AAPC) was used to analyze the trends in reported incidence and etiological positivity rate of PTB from 2015 to 2024. Results: A total of 34 750 PTB cases were reported in Jinhua City from 2015 to 2024, with an average annual reported incidence of 56.35/105. There were 20 054 cases with positive etiological test results, with a positive rate of 57.71%. The reported incidence of PTB showed an overall declining trend (AAPC=-5.814%, P<0.05), while the etiological positivity rate demonstrated an overall upward trend (AAPC=6.687%, P<0.05). The average annual reported incidence of PTB was 71.29/105 in males, higher than 39.98/105 in females (P<0.05). The reported incidence in both males and females showed a downward trend (AAPC=-5.909%, -6.803%, both P<0.05). The population aged ≥60 years had a higher proportion and reported incidence, which were 40.15% and 134.05/105, respectively. The reported incidence showed downward trends in the groups aged 0-<20 years, 20-<40 years, 40-<60 years, and ≥60 years (AAPC=-11.191%, -10.849%, -6.343%, and -4.006%, all P<0.05). Farmers were the predominant occupation, with 21 584 cases, accounting for 62.11%. PTB was highly prevalent from March to September, with a higher seasonal index in May (116.37%). Lanxi City, Pujiang County and Yiwu City had higher reported incidence, which were 77.85/105, 65.89/105 and 60.77/105, respectively. Except for Pan'an County where the trend in reported incidence was not statistically significant (P>0.05), the reported incidence in other regions showed downward trends, with AAPC values ranging from -9.039% to -1.964% (all P<0.05). Conclusions From 2015 to 2024, the reported incidence of PTB in Jinhua City showed an overall declining trend, while the pathogen positivity rate showed an upward trend. PTB was highly prevalent in spring and summer. Males, the elderly and farmers were the key target population for prevention and control. Lanxi City, Pujiang County and Yiwu City were high-incidence areas.

Endometriosis （EMT） is a common disease with frequent occurrence and difficult to be cured in modern clinical practice of obstetrics and gynaecology. It is characterized by progressively worsening dysmenorrhoea， pelvic mass， and infertility. The incidence of EMT is growing and increasingly younger patients are diagnosed with this disease， which poses a serious threat to the reproductive and psychological health of women of childbearing age and adolescent females. However， the pathogenesis of EMT is still not completely clear， and the disease has a long course. Therefore， developing new therapies is an urgent clinical problem to be solved. Great progress has been achieved in the treatment of EMT with traditional Chinese medicine （TCM）， while the underlying mechanism remains in exploration. Programmed cell death （PCD） is a cell death mode mediated by a variety of bio-molecules with specific signaling cascades. The known PCD processes include apoptosis， pyroptosis， autophagy， ferroptosis， and cuproptosis， which all play a pivotal role in the development of EMT. Researchers have made achievements in the treatment of EMT with TCM， which regulates PCD via multiple pathways， routes， targets， and mechanisms. However， the progress in the regulation of PCD in the treatment of EMT with TCM remains to be reviewed. This paper reviews the research progress in the treatment of EMT with TCM from five PCD processes （apoptosis， pyroptosis， autophagy， ferroptosis， and cuproptosis）， with the aim of providing a theoretical basis for the clinical prevention and treatment of EMT.

Elderly end-of-life patients often experience distress due to being caught in dilemmas of contemplation and decision-making. Narrative wills， grounded in life values and premised on respecting individual wishes and needs， present an individual’s unique life story through narrative forms， conveying their overall experience， interpretation of meaning， and understanding of life. They are preserved and passed on in a way that meets individual expectations， thereby promoting human exploration， reflection， and growth regarding the meaning of life through interpersonal interactions that transcend space and time. This paper explored the concept of narrative wills among elderly end-of-life patients， the ethical value and ethical principles of narrative wills， and the moral and ethical risks. It also provided specific ethical interpretations， assisting in the application and development of narrative wills in elderly end-of-life patients.

Schizophrenia (SZ) stands as a severe psychiatric disorder. This study applied diffusion tensor imaging (DTI) data in conjunction with graph neural networks to distinguish SZ patients from normal controls (NCs) and showcases the superior performance of a graph neural network integrating combined fractional anisotropy and fiber number brain network features, achieving an accuracy of 73.79% in distinguishing SZ patients from NCs. Beyond mere discrimination, our study delved deeper into the advantages of utilizing white matter brain network features for identifying SZ patients through interpretable model analysis and gene expression analysis. These analyses uncovered intricate interrelationships between brain imaging markers and genetic biomarkers, providing novel insights into the neuropathological basis of SZ. In summary, our findings underscore the potential of graph neural networks applied to multimodal DTI data for enhancing SZ detection through an integrated analysis of neuroimaging and genetic features.
Humans ; Schizophrenia/pathology* ; Diffusion Tensor Imaging/methods* ; Male ; Female ; Adult ; Brain/metabolism* ; Young Adult ; Middle Aged ; White Matter/pathology* ; Gene Expression ; Nerve Net/diagnostic imaging* ; Graph Neural Networks

Cardiovascular disease (CVD) poses a serious threat to human health. Exercise plays an important role in both the prevention and treatment of CVD and is one of the key non-pharmacological interventions. Exercise can regulate the level of exerkine secreted by different tissue cells, directly affect the cardiovascular system or play a role in cardiovascular protection by improving cardiovascular risk factors. Exerkine such as meteorin-like protein (Metrnl), brain-derived neurotrophic factor (BDNF), fibroblast growth factor 21 (FGF21), and exosomal microRNA (miRNA) play an important role in regulating vascular and cardiac diseases such as atherosclerosis, heart failure, cardiac ischemia-reperfusion and myocardial infarction, as well as their risk factors. Exploring the signaling pathways and mechanisms by which Metrnl, BDNF, FGF21, and exosomal miRNAs exert cardiovascular protective effects can provide novel insights into exercise-based strategies for preventing and treating cardiovascular diseases.
Humans ; Cardiovascular Diseases/prevention & control* ; Exercise/physiology* ; Fibroblast Growth Factors/physiology* ; MicroRNAs/metabolism* ; Brain-Derived Neurotrophic Factor/physiology* ; Cardiovascular System/physiopathology* ; Exosomes/metabolism* ; Signal Transduction