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 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.

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.

Objective: To analyze the epidemiological characteristics of pulmonary tuberculosis (PTB) among migrant population in Jinhua City, Zhejiang Province from 2016 to 2025, so as to provide evidence for optimizing PTB prevention and control strategies among migrant population. Methods: The registration information of PTB cases in Jinhua City was extracted from the Tuberculosis Management Information System of China Disease Prevention and Control Information System, including gender, occupation, household registration, and case detection approach. A descriptive epidemiological method was used to analyze the temporal, regional, and population distribution characteristics of PTB cases among the migrant population. Results: A total of 9 639 PTB cases among migrant population were registered in Jinhua City from 2016 to 2025, accounting for 28.95% of all PTB cases, with the proportion showing an overall downward trend (P<0.05). The number of PTB cases among the migrant population was relatively high from March to September, with 6 504 cases (67.48%). The proportions of migrant PTB cases relative to all PTB cases were higher in May and June, at 11.03% and 10.26%, respectively. Yiwu City and Yongkang City had the highest number of cases among migrant population, with 4 357 and 1 877 cases, accounting for 45.20% and 19.47%, respectively. There were 5 984 male cases (62.08%) and 3 655 female cases (37.92%). The predominant group was aged 20-<35 years, with 4 934 cases (51.19%). The majority of cases were migrant workers, with 4 041 cases (41.92%). Cases were mainly detected through referral and follow-up, with 6 906 (71.65%) and 1 080 (11.20%) cases. Conclusions The proportion of PTB cases among migrant population in Jinhua City showed an overall downward trend from 2016 to 2025, with an epidemic peaking in May and June. Yiwu City and Yongkang City were key areas for prevention and control. Males, young and middle-aged adults, and migrant workers were high-risk groups. Cases were mainly detected through referral and follow-up.

Objective: To analyze the epidemiological characteristics of gonorrhea in Jinhua City, Zhejiang Province, from 2015 to 2024, so as to provide reference for formulating and optimizing regionalized sexually transmitted disease prevention and control strategies, thereby reducing the risk of infection and transmission. Methods: Data on gonorrhea cases in Jinhua City from 2015 to 2024 were collected through the Infectious Disease Surveillance System of the China Disease Prevention and Control Information System, including information on gender, age, region, and time of onset. A descriptive epidemiological method was used to analyze the epidemiological characteristics of gonorrhea in Jinhua City, and the annual percentage change (APC) was used to analyze the trend of incidence of gonorrhea from 2015 to 2024. Results: From 2015 to 2024, a total of 18 851 gonorrhea cases were reported in Jinhua City , with an average annual reported incidence of 30.57/105. The reported incidence of gonorrhea decreased from 44.99/105 in 2015 to 15.54/105 in 2024, showing a downward trend (APC=-14.775%, P<0.05). Yongkang City, Yiwu City, and Dongyang City had higher average annual reported incidences, 45.60/105, 36.38/105, and 35.54/105, respectively. From 2015 to 2024, the reported incidence of gonorrhea in Wucheng District, Jindong District, Pujiang County, Pan'an County, Yiwu City, Dongyang City, and Yongkang City showed downward trends (APC=-9.063%, -14.791%, -9.142%, -10.219%, -22.402%, -14.665%, and -15.278%, all P<0.05). The average annual reported incidence was higher in males than in females (45.73/105 vs. 13.96/105, P<0.05). The predominant age group was aged 20-<50 years, with 14 793 cases (78.47%). From 2015 to 2024, the reported incidence of gonorrhea in the age groups of 0-<15, 20-<30, 30-<40, 40-<50, 50-<60, and 60-<70 years showed declining trends (APC=-21.896%, -13.268%, -15.288%, -11.896%, -14.276%, and -11.954%, all P<0.05). The predominant occupational group was farmers, with 8 761 cases (46.47%). Conclusions From 2015 to 2024, the overall incidence of gonorrhea in Jinhua City showed a downward trend, but the incidence level remained relatively high. Yongkang City, Yiwu City, and Dongyang City were high-incidence areas. Males, young and middle-aged adults, and farmers were high-risk populations.

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.

Objective To explore the efficacy of Yishen Yangyin Gujing Prescription[derived from Zuogui Wan(Bolus for Replenishing Kidney-Yin)]for the treatment of diabetic nephropathy in type 2 diabetes mellitus(T2DM)with qi and yin deficiency syndrome,and to observe its effects on inflammatory responses,pancreatic β-cell function and renal function.Methods A total of 162 T2DM patients with diabetic nephropathy of qi and yin deficiency syndrome who admitted to the Affiliated Hospital of Shaanxi University of Chinese Medicine from May 2020 to July 2023 were randomly divided into an observation group and a control group according to the random number table method,with 81 cases in each group.The control group was given conventional western medicine treatment for lowering blood pressure and renal protection,while the observation group was treated with Yishen Yangyin Gujing Prescription on the basis of treatment for the control group.The course of treatment for the two groups covered 12 weeks.Before and after the treatment,the changes in the outcomes of the two groups were observed,and the outcomes included the total scores of traditional Chinese medicine(TCM)syndrome,insulin sensitivity index,insulin secretion index,24-h urine total protein quantification(24hUTP),and serum levels of glycosylated hemoglobin(HbA1c),fasting insulin(FINS),fasting blood glucose(FBG),serum creatinine(SCr),blood urea nitrogen(BUN),transforming growth factor β1(TGF-β1),NLRP3 inflammasome,interleukin 6(IL-6),superoxide dismutase(SOD)and sphingosine-1-phosphate(S1P).After treatment,the clinical efficacy of the two groups of patients was compared.Results(1)After 12-week treatment,the total effective rate of the observation group was 93.83%(76/81),and that of the control group was 83.95%(68/81).The intergroup comparison showed that the efficacy of the observation group was significantly superior to that of the control group(χ2=9.163,P<0.05).(2)After treatment,the insulin sensitivity index and insulin secretion index in the two groups of patients were increased(P<0.05)and the total scores of TCM syndromes were decreased(P<0.05)when compared with those before treatment,and the increase of insulin sensitivity index and insulin secretion index as well as the decrease of the total scores of TCM syndrome in the observation group was significantly superior to that in the control group(P<0.05).(3)After treatment,the serum levels of HbA1c,FINS,FBG,SCr,BUN and 24hUTP in the two groups of patients were decreased when compared with those before treatment(P<0.05),and the decrease of the above indicators in the observation group was significantly superior to that in the control group(P<0.05).(4)After treatment,the serum TGF-β1,IL-6,and NLRP3 inflammasome levels in the two groups of patients were decreased(P<0.05)and the serum S1P and SOD levels were increased(P<0.05)when compared with those before treatment,and the decrease of serum TGF-β1,IL-6,and NLRP3 inflammasome levels as well as the increase of serum S1P and SOD levels in the observation group was significantly superior to that in the control group(P<0.05).Conclusion For T2DM patients with diabetic nephropathy of qi and yin deficiency syndrome,the combined use of western medicine and Yishen Yangyin Gujing Prescription treatment is helpful to alleviate inflammatory response,improve the function of pancreatic β-cells,regulate the blood glucose level,improve renal function,and enhance the clinical efficacy.

Public health laboratory testing involves a wide range of sample types,complex matrices,diverse target analytes with varying concentrations,and multiple application contexts with different analytical requirements.As a critical step in public health laboratory analysis and testing,sample pretreatment plays a decisive role in ensuring the reproducibility and efficiency of the analytical methods.It directly affects the accuracy,sensitivity,and reliability of testing results,as well as the feasibility of downstream analyses.Traditional sample pretreatment techniques face persistent challenges,including low efficiency,limited throughput,restricted universal applicability,high organic solvent consumption,and poor compatibility with downstream analytical procedures.These limitations constrain their capacity to meet the evolving demands of research and practice in public health and preventive medicine.In recent years,technological advances have focused on improving efficiency and automation,enhancing selectivity and sensitivity,facilitating online testing capabilities,and promoting environmental sustainability.Sample pretreatment techniques in public health laboratory testing have been undergoing progressive upgrades,and numerous novel technologies have emerged.The paper provides a comprehensive review of new technologies and applications in the field.We focused on the development of new materials,the application of artificial intelligence,connections for online processing,and the approaches tailored to the demands of specific testing settings.We also discussed sample processing for omics analyses and mass spectrometry imaging methods relevant to public health laboratory testing.These advances are expected to support the development of greener and higher-throughput sample pretreatment and foster innovation in the public health laboratory testing system.

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

Objective: To evaluate the clinical efficacy of digitally guided precision crown lengthening in secondary aesthetic rehabilitation cases, and to provide a clinical reference for digitally guided crown lengthening procedures and secondary aesthetic restorations. Methods: We present a case of a patient with tetracycline-stained teeth, partial detachment of anterior resin veneers, and gingival margin discrepancies. The patient underwent digitally guided precision crown lengthening followed by secondary aesthetic rehabilitation. Multimodal data, including intraoral, facial, and CBCT scans, were integrated to construct a four-dimensional virtual patient model (incorporating teeth, face, bone, and occlusion) for surgical planning and 3D-printed guide fabrication. Secondary aesthetic restoration was performed after achieving stable post-surgical outcomes. Based on this case, we conducted a detailed analysis and reviewed relevant literature on crown lengthening in secondary aesthetic rehabilitation. Results: The gingival contour of the anterior teeth exhibited significant improvement, with enhanced symmetry and stable gingival margin positioning that closely matched the preoperative design. The crown lengthening procedure demonstrated high precision, and the final outcome was aesthetic and functional. Literature review indicated that secondary restorations frequently present challenges such as gingival contour discrepancies and inflammation. Aesthetic crown lengthening in the anterior region should optimize both soft and hard tissue morphology to meet aesthetic standards, with digital technology improving procedural accuracy. Conclusion Precision crown lengthening effectively addresses gingival margin discrepancies in secondary aesthetic rehabilitation, ensuring stable gingival positioning and superior aesthetic outcomes. This approach is particularly suitable for cases with high aesthetic demands.