Objective To explore the relationship between circadian rhythm genes and the occurrence, development, prognosis, and tumor microenvironment (TME) of lung adenocarcinoma (LUAD). Methods The Cancer Genome Atlas data were used to evaluate the expression, copy number variation, and somatic mutation frequency of circadian gene sets in LUAD. Gene ontology, Kyoto encyclopedia of genes and genomes, and gene set enrichment analysis were used to explore the potential mechanisms by which circadian rhythm genes affected LUAD progression. Cox regression, least absolute shrinkage and selection operator regression, support vector machine recursive feature elimination, and random forest screened circadian genes and established prognostic models, and on this basis constructed nomogram to predict patients’ 1-, 3-, and 5-year survival rates. Kaplan-Meier survival curves, receiver operating characteristic (ROC) curves, and time-dependent ROC curves were drawn to evaluate the predictive ability of the model, and the external dataset of GEO further verified the prognostic value of the prediction model. In addition, we evaluated the association of the prognostic model with immune cells and immune checkpoint genes. Single cell RNA sequencing (scRNA-seq) analysis was used to explore the molecular characteristics between prognostically relevant circadian genes and different immune cell populations in TME. Results Differentially expressed circadian rhythm genes were mainly enriched in biological processes related to cGMP-PKG signaling pathway, lipid and atherosclerosis, and JAK-STAT signaling pathway. Seven circadian rhythm genes: LGR4, CDK1, KLF10, ARNTL2, RORA, NPAS2, PTGDS were screened out, and a RiskScore model was established. According to the median RiskScore, samples were divided into a high-risk group and a low-risk group. Compared with patients in the low-risk group, patients in the high-risk group showed a poorer prognosis (P<0.001). Immunological characterization analysis showed that there were differences in the infiltration of multiple immune cells between the low-risk group and high-risk group. Most immune checkpoint genes had higher expression levels in the high-risk group than those in the low-risk group, and RiskScore was positively correlated with the expression of CD276, TNFSF4, PDCD1LG2, CD274, and TNFRSF9, and negatively correlated with the expression of CD40LG and TNFSF15. The scRNA-seq analysis showed that RORA and KLF10 were mainly expressed in natural killer cells. Conclusion The prognostic model based on seven feature circadian rhythm genes has certain predictive value for predicting survival of LUAD patients. Dysregulated expression of circadian genes may regulate the occurrence, progression as well as prognosis of LUAD through affecting TME, which provides a possible direction for finding potential strategies for treating LUAD from the perspective of mechanism by which circadian disorder affects immune cells.

Diabetic retinopathy(DR)remains the leading cause of vision loss in patients with diabetes. Current anti-vascular endothelial growth factor(VEGF)therapies are limited by inadequate response in some patients and the necessity for repeated intravitreal injections, underscoring the urgent need for novel therapeutic targets. Angiopoietin-like protein 4(ANGPTL4), a multifunctional secreted protein, has emerged as a critical regulator in the pathogenesis and progression of DR, positioning it as a promising interventional target. This review systematically elaborates the biological characteristics of ANGPTL4, with a focus on its expression dynamics, molecular mechanisms, and regulatory networks rolesin the development of DR. Furthermore, the prospects of ANGPTL4-targeted therapeutic strategies are discussed, aiming to offer new insights and directions for understanding DR pathogenesis, advancing multi-target drug development, and improving clinical management.

Objective To determine the prognostic biomarkers and new therapeutic targets of the lung adenocarcinoma (LUAD), based on which to establish a prediction model for the survival of LUAD patients. Methods An integrative analysis was conducted on gene expression and clinicopathologic data of LUAD, which were obtained from the UCSC database. Subsequently, various methods, including screening of differentially expressed genes (DEGs), Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis and Gene Set Enrichment Analysis (GSEA), were employed to analyze the data. Cox regression and least absolute shrinkage and selection operator (LASSO) regression were used to establish an assessment model. Based on this model, we constructed a nomogram to predict the probable survival of LUAD patients at different time points (1-year, 2-year, 3-year, 5-year, and 10-year). Finally, we evaluated the predictive ability of our model using Kaplan-Meier survival curves, receiver operating characteristic (ROC) curves, and time-dependent ROC curves. The validation group further verified the prognostic value of the model. Results The different-grade pathological subtypes' DEGs were mainly enriched in biological processes such as metabolism of xenobiotics by cytochrome P450, natural killer cell-mediated cytotoxicity, antigen processing and presentation, and regulation of enzyme activity, which were closely related to tumor development. Through Cox regression and LASSO regression, we constructed a reliable prediction model consisting of a five-gene panel (MELTF, MAGEA1, FGF19, DKK4, C14ORF105). The model demonstrated excellent specificity and sensitivity in ROC curves, with an area under the curve (AUC) of 0.675. The time-dependent ROC analysis revealed AUC values of 0.893, 0.713, and 0.632 for 1-year, 3-year, and 5-year survival, respectively. The advantage of the model was also verified in the validation group. Additionally, we developed a nomogram that accurately predicted survival, as demonstrated by calibration curves and C-index. Conclusion We have developed a prognostic prediction model for LUAD consisting of five genes. This novel approach offers clinical practitioners a personalized tool for making informed decisions regarding the prognosis of their patients.

Objective:To investigate the effect of up-regulation of microRNA-31(miRNA-31)on the osteogenic differentiation of dental pulp stem cells(DPSCs),and to elucidate its possible mechanism.Methods:The DPSCs in logarithmic growth phase were divided into control group(no treatment),NC group(transfected with random sequence control),Agomir group(transfected withmiR-31 mimic agomiR-31),and combination group(transfected with miR-31 mimic agomiR-31 and added with XAV939).After 48 h of transfection,real-time fluorescence quantitative PCR(RT-qPCR)was used to detect the expression levels of miR-31 in the DPSCs in various groups.MTT assay was used to detect the proliferation abilities of the DPSCs in various groups.Alizarin red staining was used to detect calcium deposition in the DPSCs in various groups.Alkaline phosphatase(ALP)staining was used to detect the degree of osteogenic differentiation of the DPSCs in various groups.Western blotting method was used to detect the expression levels of proteins related to the wingless-type MMTV integration site family(Wnt)/β-catenin signaling pathway in the DPSCs in various groups.Results:There were no significant differences in the miR-31 expression level,the cell proliferation abilities at 24,48 and 72 h,the ratio of calcified region,and the ALP ability between control group and NC group(P＞0.05).Compared with control group and NC group,the expression level of miR-31,the cell proliferation abilities at 24,48 and 72 h,the ratio of calcified region,and the ALP activity in the DPSCs in Agomir group were increased(P＜0.05).Compared with Agomir group,the expression level of miR-31,the cell proliferation abilities at 24,48 and 72 h,the ratio of calcified region,and the ALP activity in the DPSCs in combination group were decreased(P＜0.05).There were no significant difference in the expression levels of glycogen synthase kinase 3β(GSK-3β),β-catenin and Runt-associated transcription factor 2(Runx2)in the DPSCs between control group and NC group(P＞0.05).Compared with control group and NC group,the expression level of GSK-3β protein in the DPSCs in Agomir group was decreased(P＜0.05),and the expression levels of β-catenin and Runx2 proteins in the DPSCs were increased(P＜0.05).Compared with Agomir group,the expression level of GSK-3β protein in the DPSCs in combination group was increased(P＜0.05),while the expression levels of β-catenin and Runx2 proteins were decreased(P＜0.05).Conclusion:Up-regulation of miR-31 can promote the proliferation and osteogenic differentiation of DPSCs,and its mechanism may be related to the activation of Wnt/β-catenin signaling pathway.

Objective To understand the prevalence and risk factors of hyperuricemia in electronics factory workers in Wuhan, and to provide evidence for the health protection of electronics factory workers. Methods A total of 1 415 employees in an electronics factory in Wuhan were selected as the research subjects, and the physical examination and determination of various biochemical indicators, as well as questionnaire survey were carried out. Results The detection rate of hyperuricemia among workers in the electronics factory in Wuhan was 32.43%, with 36.33% for men and 14.11% for women, and the difference was statistically significant ( χ²＝46.077，P＜0.001). The detection rate of hyperuricemia was the highest (33.77%) among those with university or college education, followed by graduate students and above (31.50%). Compared with subjects with good lifestyle habits, people with drinking habits had higher hyperuricemia detection rate (49.38%), and the difference was statistically significant (P =0.001). The detection rates of hyperuricemia in those with central obesity and elevated alanine aminotransferase were 48.23% and 61.29%, respectively, which were significantly higher than those in the subjects without the above diseases (26.91% and 27.21%, respectively), and the differences were statistically significant (P <0.001). Obese people had the highest detection rate of hyperuricemia (66.95%), followed by overweight people (43.75%), and the difference was statistically significant (P <0.001). Multivariate logistic analysis showed that alcohol drinking (OR=1.836, 95% CI=1.139-2.961, P =0.013) and body mass index ≥ 24 kg/m² (OR=2.175, 95% CI=1.686 -2.806, P <0.001) were risk factors for hyperuricemia in electronic factory workers. Elevated alanine aminotransferase (ALT) was significantly correlated with hyperuricemia (OR=2.964, 95%CI=2.146-4.095 , P <0.001). Female gender was a protective factor for hyperuricemia in workers in the electronics factory (OR=0.441, 95%CI=0.297-0.653 , P <0.001). Conclusion The detection rate of hyperuricemia among workers in an electronics factory in Wuhan is high, and the detection rate of hyperuricemia in men is higher than that in women. Alcohol consumption, overweight and obesity will increase the risk of hyperuricemia. Elevated ALT is associated with hyperuricemia. Maintaining an ideal body mass index and establishing a good lifestyle play an important role in preventing hyperuricemia.

Objective It constructs a new culture index system for high-quality development of public hospitals to provide scientific tool for evaluating the level of new culture construction of public hospitals and promoting high-quali-ty development.Methods A pool of indicators was established based on policy combing and literature research.Then,an indicator system was formed through Delphi expert consultation and demonstration,and weighting coefficients were assigned using the hierarchical analysis method.Results The indicator system of the new culture in public hospi-tals contains four primary indicators,eight secondary indicators and 23 specific entries.The four primary indicators are hospital culture system construction,strengthening the orientation of patients'needs,caring for medical staff and distinctive hospital culture.The effectiveness of implementation as an additional dimension contains two secondary indicators and eight specific entries.The weights of the primary indicators are balanced.Among the sec-ondary indicators,institutional planning(0.250),staff care(0.170),medical services(0.130),discipline branding(0.125)and professionalism(0.125)have higher weights.Conclusion The new culture index system for high-quality development of public hospitals is in line with Xi Jinping's cultural thought and the requirements of the new culture for high-quality development of public hospitals.It needs to pay attention to the planning of the cultural system,em-phasises the care of employees and the cultivation of professionalism,and focuses on the construction of medical services and disciplinary brands,so as to promote the construction of the new culture in public hospitals in line with the requirements of the national strategies.

Objective Using the indicator system to objectively evaluate the content and effectiveness of the new culture construction in typical public hospitals,so as to identify problems and put forward suggestions for improve-ment.Methods Applying the new culture index system for the high-quality development of public hospitals con-structed by the research group,it quantitatively evaluated the practice of new culture construction in a tertiary hospi-tal in Shanghai.Results It found that the main body of the hospital's new culture construction scored 98.9 points.The 2 dimensions of hospital culture system construction and carrying out effectiveness(additional indicators)were all full scores.In addition,the dimension of caring for medical staff was 24.8 points,the dimension of strengthening pa-tient demand orientation was 24.6 points,and the dimension of distinctive hospital culture was 24.5 points.There are still deficiencies in the dimensions of the post-diagnosis experience of patients,the cultivation of health habits of staff,and the transformation of scientific research.Conclusion The hospital has taken advantage of the top-level de-sign of cultural construction under the leadership of the Party Committee and has improved the relevant systems.The hospital also focuses on several special cultural projects such as cultural heritage,employee care,optimization of ac-cess to medical care,and popularisation of scientific brands.It propose to promote the high-quality development of the hospital's new culture by carrying out Internet medical care,organizing special staff activities,strengthening the guidance of scientific research policies,and increasing the financial support for projects.

Objective It developed and tested the reliability and validity of the Hospital Culture Perception and Experi-ence Scale for medical staff to provide a scientific tool for assessing medical staff's perceptions and experiences of hospital culture.Methods The scale was constructed with reference to the Dennison model of organisational culture and refined based on policy documents,literature and expert consultation.A hospital was selected to conduct the questionnaire survey.It used item analysis,factor analysis,and Cronbach's α to test scale reliability and validity.Results The total scale contains 43 entries in 4 subscales:institutional initiatives,practitioner perception,manage-ment training and mission commitment.Item analysis results showed that the scale had good differentiation;the Cronbach's αof the total scale was 0.992,and the Spearman-Brown was 0.979,with good reliability.Exploratory factor analysis results suggested that the institutional initiative,practitioner perception,and management training sub-scales had only 1 dimension,with a variance contribution rate of 77.12％,76.33％,and 85.75％,respectively.For the mission subscale,2 male factors were extracted,with a cumulative variance contribution rate of 91.34％.The factor loadings were all greater than 0.4.The validation factor analysis results shows that the model fit is good.The AVE of each subscale and dimension is greater than 0.5,and the CR is greater than 0.7,which indicates that the convergent validity is good.Conclusion The scale has good reliability and validity,and can be used to quantitatively as-sess the medical staff's perception and sense of experience of hospital culture.

Objective It investigates medical staff's perception and experience sense of hospital culture,and analy-ses its influencing factors.This can further play the role of hospital culture construction on medical staff's motiva-tion,and improve medical staff's work motivation to provide reference basis.Methods The Medical Staff's Percep-tion and Experience of Hospital Culture scale developed by the research team was used to conduct a questionnaire survey with on medical staff in the sample hospital.Descriptive analysis,single factor analysis and multiple linear re-gression analysis were used to study the medical staff's perception and experience of hospital culture and its influ-encing factors.Results A total of 629 valid questionnaires were collected.The overall score rate of medical staff's per-ception and experience of hospital culture was over 90%.Among them,the highest scoring rate of the mission bearing subscale,and the dimension with higher scores was vision and goals.However,the experience of work environ-ment,promotion system and research environment is relatively low.The results of the one-way test showed that the differences in the scores of hospital culture perception and experience among medical staff with different educa-tion levels,titles and job positions were statistically significant(P＜0.05).Conclusion Medical staff generally support the construction of hospital culture.It is suggested that the hospital culture development strategy should be formulated from the perspective of the staff and according to their goals,problems and needs.It is also recommended to con-tinuously improve the medical staff's perception and experience of the hospital culture according to their needs,so as to play a positive role in the high-quality development of the hospital by culture construction.

Objective It developed a hospital culture awareness and experience scale for patients and their families and its reliability and validity were verified.The scale provides a tool for investigating patients'and families'experiences of hospital culture and promoting hospital culture building.Methods A scale that meets policy requirements and practice needs was designed with reference to a theoretical framework of hospital customers satisfaction index and it was refined through expert consultation.Patients and family members of a sample hospital were selected for the survey,and the reliability and validity of the scale were tested by item analysis,factor analysis and Cronbach's α.Results The scale contains 29 items in 3 dimensions of service perception,value recognition and cultural knowledge.Item analysis results showed that the scale had good differentiation.The Cronbach's αof the total scale was 0.975,and the Spearman-Brown was 0.934,with good reliability.Exploratory factor analysis extracted three male factors,with a cumulative variance contribution rate of 76.61%,and the factor loadings of each factor were all greater than 0.4.Validation factor analysis results suggests a better model fit.The CR is greater than 0.7 and the AVE of each dimension is greater than 0.5,which proves that convergent validity is good.Conclusion The scale has good reliability and validity,and can be used to quantitatively assess patients'and their families'sense of knowing and experiencing the hospital culture.It can provide scientific tool for evaluating the status of cultural leadership in helping public hospitals to develop high quality from the patient's perspective.