Objective To analyze the epidemiological distribution characteristics and influencing factors of treat-ment outcome of pulmonary tuberculosis(PTB)patients complicated with diabetes mellitus(DM)in Bijie City from 2017 to 2022,and provide reference for formulating prevention and control measures of PTB-DM.Methods The registered management cases of PTB patients combined with DM from the tuberculosis surveillance report informa-tion management system in Bijie City in 2017-2022 were collected.Changing trends in annual registration rates and successful treatment rates were analyzed with Joint-point regression models.Different characteristics between pa-tients with PTB-DM and PTB alone were conducted comparative analysis;the influencing factors of treatment out-come were analyzed by x2 test and binary logistic regression analysis.Results A total of 679 PTB-DM patients were registered in Bijie City from 2017 to 2022,accounting for 1.53％of total PTB patients,the annual registration rate increased from 1.11/100 000 in 2017 to 3.08/100 000 in 2022,with an increasing trend in the annual percentage change(APC=26.67％,95％CI:5.36％-52.29％,t=3.564,P=0.024).In the analysis on characteristics,the proportion of PTB-DM male patients,age ≥45 years and farmers,the ratio of direct consultation to transfer treat-ment,the pathogenicity positive rate,the proportion re-treatment,and rate of delay in consultation were all higher than those of PTB alone;successful treatment rate and proportion of floating population were all lower than PTB alone,difference were all statistically significant(all P＜0.05).The successful treatment rate of PTB-DM patients in Bijie City from 2017 to 2022 was 87.80％.Age,occupation,pathogenicity diagnosis results were influencing fac-tors for treatment outcome in patients with PTB-DM,with farmers(OR=3.68,95％CI:1.22-11.09),with pathogenicity positivity(OR=2.84,95％CI:1.24-6.50),and without pathogenic detection result+tuberculous pleurisy(OR=11.35,95％CI:2.16-59.74)being risk factors for successful treatment.Conclusion Although the proportion of PTB-DM in the total PTB patients in Bijie City from 2017 to 2022 was not high,it showed an up-ward trend;it is necessary to attach great importance to male,re-treated,farmer,and pathogenicity positivity co-morbid patients in Bijie City,and strengthen the two-way screening of PTB-DM in high-risk populations.

With the aim of establishing a clear and effective financial and accounting supervision mechanism for hospitals,it unscrambled the connotation of the financial and accounting supervision in hospital.It analyzed the subjects,the objects,and the methods of the financial and accounting,compared and contrasted the financial and accounting supervision with internal controls,and explored functional positioning within the subject of internal financial and accounting supervision.An organizational structure has been formed with the finance department as the leading department and multiple departments collaborating horizontally.The implementation path and management practice of the finance department of the case hospital in building a network system of financial and accounting internal supervision by integrating the functions of the departments were shared,with a view to providing a theoretical basis and practical exploration for the promotion of the effective implementation of financial and accounting supervision in hospitals.

Objective:To explore the mediating role of activity of daily living between social support and cognitive function of rural elderly.Methods:A face-to-face questionnaire survey was conducted from July to August 2019 among 1 626 rural elderly people selected by multi-stage cluster random method in Guiyang City and Qiannan Prefecture, Guizhou Province.The contents include general situation, social support rate scale (SSRS), activity of daily living scale (ADL) and mini-mental state examination (MMSE). Partial correlation analysis and multiple linear regression analysis were used to analyze the relationship among social support, activity of daily living and cognitive function in the elderly by SPSS 23.0 software. AMOS 28.0 software was used to construct structural equation models, and Bootstrap method was used to test the mediating role of activity of daily living.Results:The scores of cognitive function, social support and activity of daily living of the rural elderly were (20.83±5.47), (34.96±6.42) and (16.51±3.29), respectively.There were statistically significant differences in the cognitive function scores among rural elderly with different levels of social support and activity of daily living( F=33.418, t=25.533, P<0.01). The partial correlation analysis showed that the social support score was positively correlated with the cognitive function score ( r=0.161, P<0.01), and the activity of daily living score was negatively correlated with scores of social support and cognitive function ( r=-0.083, -0.453, both P<0.01). Multiple linear stepwise regression analysis showed that social support, objective support dimensions, activity of daily living and instrumental activity of daily living were influencing factors of cognitive function of rural elderly( P<0.001).The results of structural equation model showed that the activity of daily living played a partial mediating role between social support and cognitive function in rural elderly, with the mediating effect of 0.046 (95% CI=0.025-0.075), accounting for 13.18% of total effect (effect value=0.349, 95% CI=0.277-0.415). Conclusion:The activity of daily living of rural elderly plays a partial mediating effect between social support and cognitive functioning.

Objective:To explore the mediating role of activity of daily living between social support and cognitive function of rural elderly.Methods:A face-to-face questionnaire survey was conducted from July to August 2019 among 1 626 rural elderly people selected by multi-stage cluster random method in Guiyang City and Qiannan Prefecture, Guizhou Province.The contents include general situation, social support rate scale (SSRS), activity of daily living scale (ADL) and mini-mental state examination (MMSE). Partial correlation analysis and multiple linear regression analysis were used to analyze the relationship among social support, activity of daily living and cognitive function in the elderly by SPSS 23.0 software. AMOS 28.0 software was used to construct structural equation models, and Bootstrap method was used to test the mediating role of activity of daily living.Results:The scores of cognitive function, social support and activity of daily living of the rural elderly were (20.83±5.47), (34.96±6.42) and (16.51±3.29), respectively.There were statistically significant differences in the cognitive function scores among rural elderly with different levels of social support and activity of daily living( F=33.418, t=25.533, P<0.01). The partial correlation analysis showed that the social support score was positively correlated with the cognitive function score ( r=0.161, P<0.01), and the activity of daily living score was negatively correlated with scores of social support and cognitive function ( r=-0.083, -0.453, both P<0.01). Multiple linear stepwise regression analysis showed that social support, objective support dimensions, activity of daily living and instrumental activity of daily living were influencing factors of cognitive function of rural elderly( P<0.001).The results of structural equation model showed that the activity of daily living played a partial mediating role between social support and cognitive function in rural elderly, with the mediating effect of 0.046 (95% CI=0.025-0.075), accounting for 13.18% of total effect (effect value=0.349, 95% CI=0.277-0.415). Conclusion:The activity of daily living of rural elderly plays a partial mediating effect between social support and cognitive functioning.

Objective:To assess the disease burden of lung cancer associated with occupational exposure to polycyclic aromatic hydrocarbons (PAHs) in China from 1990 to 2021 using the 2021 Global Burden of Disease (GBD) data.Methods:In July 2024, data on occupational PAHs exposure-associated lung cancer from 1990 to 2021 were extracted from the GBD database, including mortality rates, age-standardized mortality rates, number of deaths, disability-adjusted life years (DALYs) rates, age-standardized DALYs rates, and number of DALYs for different genders and ages. Descriptive statistics were used to analyze trends in lung cancer mortality rates, age-standardized mortality rates, DALYs rates, and age-standardized DALYs rates over different years, genders, and ages. Joinpoint regression models were used to calculate the annual percent change (APC) and average annual percent change (AAPC), and to identify change points and trends in different periods within the data.Results:From 1990 to 2021, the mortality rate of lung cancer associated with occupational PAHs exposure increased from 0.085 per 100000 to 0.259 per 100000, and the age-standardized mortality rate increased from 0.107 per 100000 to 0.162 per 100000. The DALYs rate increased from 2.746 per 100000 to 7.389 per 100000, and the age-standardized DALYs rate increased from 3.330 per 100000 to 4.679 per 100000. The number of lung cancer deaths and DALYs both peaked in the 65-69 age group. Joinpoint regression analysis showed significant upward trends in mortality, age-standardized mortality, DALYs rate, and age-standardized DALYs rate from 1990 to 2021, with AAPCs of 3.655%, 1.382%, 3.256%, and 1.108%, respectively (all P<0.001). From 2016 to 2021, both the mortality rate and age-standardized mortality rate increased, with APCs of 4.163% and 1.735%, respectively. From 2015 to 2021, the DALYs rate increased (APC: 3.137%), and from 2016 to 2021, the age-standardized DALYs rate also rose (APC: 1.578%). For females, both mortality and DALYs rates increased from 2015 to 2021 (APCs: 6.269% and 5.426%, respectively). Among males, the mortality rate increased from 2018 to 2021 (APC: 3.477%) . Conclusion:From 1990 to 2021, the disease burden of lung cancer related to occupational PAHs exposure in China has significantly increased, particularly among the elderly population. Public health policies should enhance screening and prevention efforts targeting the high-risk populations.

Objective:To systematically and comprehensively retrieve studies on urethra care for patients with urinary catheter at home and abroad, so as to provide a reference for removing low-value care measures in the future.Methods:Arksey and O'?Malley scoping review method was used to systematically search the China National Knowledge Infrastructure, China Biology Medicine disc, WanFang Data, VIP, PubMed, Cochrane Library, CINAHL, Embase, and Web of Science. The search period was from database establishment to January 1, 2024. Literature was screened based on inclusion and exclusion criteria, and catheter care site, disinfection/cleaner type, frequency, institutional norms, and determinants were independently extracted by two researchers, where determinants were framed based on the theoretical domains framework.Results:A total of 21 papers were included. Urethra low-value care measures were reflected in the selection of nursing solutions that differed significantly from guideline recommendations and were inconsistently standardized across hospitals. Thirteen strategies were proposed to remove urethra low-value care measures. Factors that influenced the removal of low-value care behaviors included knowledge, reinforcement, environment and resources, social influences, personal roles and identities, outcome beliefs and memories, and attention and decision-making processes.Conclusions:Future researchers should further refine the evidence on urethra care and develop contextualized care for complex, multilevel healthcare settings to achieve continuous improvement and high quality care at low cost.

AIM:To construct and breed infertility model mice with ATP/GTP binding carboxypeptidase 1(Agtpbp1)gene knockout homozygote(Agtpbp1-/-)by CRISPR/Cas9 technology,so as to provide an animal model for the subsequent exploration of the pathogenesis of Agtpbp1 gene in male sterility.METHODS:The CRISPR/Cas9 technology was used to obtain Agtpbp1 gene knockout heterozygote(Agtpbp1+/-)mice according to the data of the main protein functional region of Agtpbp1 gene and combined with Cas9 nuclease.The obtained Agtpbp1+/-mice were mated,and their offspring were genotyped by PCR and agarose gel electrophoresis.The expression of Agtpbp1 at different levels was detected by RT-PCR,Western blot and immunohistochemical staining to support the identification results.The HE staining was used to observe the mouse cerebellum and eyeball structure to analyze the effect of Agtpbp1 gene knockout on Purkinje cells and photoreceptor cells.The symptoms of ataxia in mice were observed in combination with behavioral tests.The growth of mice was observed,and the changes of testicular tissue volume and weight of male mice were analyzed.The HE staining was used to observe the changes of testicular structure,and PAS staining was used to observe the changes of testicular germ cell cycle.Finally,sperm analyzer was used to analyze the sperm motility,so as to analyze the growth and develop-ment of the mice.RESULTS:The male and female Agtpbp1+/-mice could continue to mate,and three genotypes,Agtpbp1 wild-type(Agtpbp1+/+),Agtpbp1+/-and Agtpbp1-/-,were obtained.The genotypes of the offspring mice were successfully identified by PCR.The results of RT-PCR,Western blot and immunohistochemical staining verified the successful con-struction of Agtpbp1-/-mouse model at different levels(P<0.05).The results of HE staining showed that Purkinje cells were lost in the cerebellum of Agtpbp1-/-mice and the number of photoreceptor cells in the eyeball was reduced.Behavioral tests confirmed that Agtpbp1-/-mice had ataxia symptoms such as motor dysfunction and uncoordinated movements.Com-pared with control group,the testicular volume and weight of Agtpbp1-/-mice were significantly reduced.The results of HE staining showed a very small amount of sperm in the testis of Agtpbp1-/-mice.Combined with the sperm analyzer,it was ob-served that the sperm motility,vitality and movement rate of Agtpbp1-/-mice were significantly lower than those of the con-trol mice.Testicular sections with PAS staining showed cell cycle arrest of the sperm from Agtpbp1-/-mice.CONCLU-SION:In this study,Agtpbp1 knockout mice were successfully bred.The deletion of Agtpbp1 caused the arrest of sper-matogenic cell differentiation and the decrease in sperm motility in adult male mice,resulting in infertility.At the same time,it provides a new experimental tool for further exploring the molecular mechanism of Agtpbp1-induced male sterility.

Objective : To investigate the antidepressant effects and the underlying mechanisms of tetrahydrocurcumin(THC) and its nanoparticle formulation(THCN). Methods : Forty-six male ICR mice were randomly divided into Con group, LPS group, THC group, THCN group and SER group. A mouse depression model was established by intraperitoneal administration of LPS. The anxiety and depression-like behaviors of mice were evaluated by open field test(OFT) and forced swimming test(FST). Myelin staining was applied to assess the extent of demyelination in the prefrontal cortex of the mice. The prefrontal cortex and hippocampus were further examined for the expression levels of glial fibrillary acidic protein(GFAP) and Toll-like receptor 4(TLR4) through quantitative immunofluorescence assays. Results : Compared with the Con group, the LPS group showed increased anxiety-like and depressive-like behaviors in both the long-term and short-term experiments(P<0.05); the degree of demyelination increased in the LPS group of the long-term experiment(P<0.01); the expression of GFAP was reduced in the LPS group of the short-term experiment(P<0.01), while the expression of TLR4 increased(P<0.05); the expression of TLR4 decreased in the THC group(P<0.01); the expression of GFAP in the prefrontal cortex of the THCN group was reduced(P<0.01), while the expression of TLR4 increased(P<0.05). Compared with the LPS group, the THC group showed reduced depressive-like behaviors in the long-term experiment(P<0.05), while the anxiety-like and depressive-like behaviors of the THCN group and the SER group were reduced(P<0.05), and the anxiety-like and depressive-like behaviors of the THC group and the THCN group were reduced in the short-term experiment(P<0.05); the degree of demyelination was reduced in the THC group, THCN group and SER group in the long-term experiment(P<0.05); the expression of GFAP increased in the THC group of the short-term experiment(P<0.05), while the expression of TLR4 was reduced(P<0.05), and the expression of GFAP increased in the THCN group(P<0.05). Compared with the THC group, the THCN group and the SER group showed reduced anxiety-like behaviors in the long-term experiment(P<0.05); the expression of GFAP in the prefrontal cortex of the THCN group was reduced in the short-term experiment(P<0.05), while the expression of TLR4 in the hippocampal DG area increased in the short-term experiment(P<0.01). Conclusion Tetrahydrocurcumin and its nanoparticle formulation both exert significant ameliorative effects on depression-like behaviors and demyelination in mice induced by lipopolysaccharide. The antidepressant mechanism of THC appears to be mediated through the down-regulation of TLR4 and the up-regulation of GFAP. The mechanism underlying the antidepressant action of THCN seems predominantly focused on the enhancement of GFAP expression.

Objective To explore the association between the relative expression level of SNORD55 in peripheral blood and the outcomes of all-cause mortality and stroke in patients with atrial fibrillation(AF),and to evaluate the predictive value of SNORD55 for prognosis.Methods A total of 133 patients with non-valvular AF admitted in Department of Cardiology of the First Affiliated Hospital of Army Medical University from January 2014 to December 2017 were enrolled in this study.Their baseline information was collected,and the relative expression level of plasma SNORD55 was detected.Cox proportional hazards model was used to explore the association between the relative expression level of SNORD55 in peripheral blood and all-cause mortality as well as stroke in the patients.The predictive performance of CHA2DS2-VASc score for all-cause mortality and stroke was compared with the score combined with the relative expression level of SNORD55 in the AF patients.The area under the receiver operating characteristic curve(AUC)was utilized to evaluate the discrimination,and the net reclassification index(NRI)and comprehensive discriminant improvement index(IDI)were calculated to evaluate the improvement of reclassification ability.Decision curve analysis(DCA)was applied to analyze the change in clinical net benefit.Results The results of multivariate Cox regression showed that high expression of SNORD55 in peripheral blood was an independent risk factor for all-cause mortality and stroke in the AF patients.In predicting the outcomes of all-cause mortality and stroke,the addition of relative expression SNORD55 level with the CHA2DS2-VASc score obtained higher AUC value[0.80(95％CI:0.67～0.93)vs 0.67(95％CI:0.53～0.81),P＜0.05].In predicting the outcome of all-cause death and stroke,combination of the relative expression level of SNORD55 with CHA2DS2-VASc score increased both NRI[54.3(95％CI:10.6～61.9)vs 31.9(95％CI:2.8～47.5),P＜0.05]and IDI[16.1(95％CI:2.4～27.0)vs 7.9(95％CI:0.5～14.8),P＜0.05].The results of DCA showed that our combination of CHA2DS2-VASc score relative expression level of SNORD55 had higher clinical net benefits than the foreign ABC score in the prediction of the outcomes.Conclusion Peripheral blood SNORD55 level is an independent risk factor for all-cause mortality and stroke in AF patients,and has good predictive performance for all-cause mortality and stroke in the patients.

Objectives To explore the association of peripheral blood PIWI-interacting RNA,piR-hsa-2700592,with all-cause mortality and stroke outcomes in patients with atrial fibrillation(AF),and to determine whether piR-hsa-2700592 has the potential to be an AF biomarker.Methods A total of 127 patients with non-valvular AF were enrolled,and the relative expression level of plasma piR-hsa-2700592 was detected.Cox proportional hazard regression was used to analyze the correlation between the expression of piR-hsa-2700592 and all-cause death as well as stroke outcome in the patients.Then the molecule expression level was combined with CHA2DS2-VASc score and ABC stroke(or death)score to establish 2 new prediction models,the improvement of the predictive performance was compared and analyzed.Receiver operating characteristic(ROC)curve analysis(area under the curve,AUC),net reclassification index(NRI),and comprehensive discriminant improvement index(IDI)were used to evaluate the predictive performance,and decision curve analysis(DCA)was employed to assess the clinical benefit.Results Multivariate Cox regression analysis showed that the patients with higher expression level of piR-hsa-2700592 in peripheral blood had a higher risk of stroke(HR:2.203,95%CI:1.120～4.332;P=0.022).In the stroke outcome,combination of plasma piR-hsa-2700592 expression level with CHA2DS2-VASc score and ABC stroke score obtained an AUC of 0.70(95%CI:0.55～0.85,P＜0.001)and 0.84(95%CI:0.73～0.96,P=0.02),respectively.But,no significant association was observed between high plasma piR-hsa-2700592 level and all-cause mortality in the AF patients(HR:1.997;95%CI:0.884～4.509;P=0.096).Combination of plasma piR-hsa-2700592 level improved the discriminative capability than the single CHA2DS2-VASc score and ABC stroke score models,with an NRI and IDI value of 44.20%(95%CI:3.40～59.90,P＜0.001)and 8.20%(95%CI:0.60～15.40,P＜0.001),respectively for the new CHA2DS2-VASc score model,and an NRI and IDI value of 44.20%(95%CI:9.80～58.90,P＜0.001)and 10.40%(95%CI:0.70～21.40,P＜0.001),respectively for the new ABC stroke score model.The DCA curve showed that both new prediction models obtained better net clinical benefits.Conclusion High peripheral blood expression of piR-hsa-2700592 is an independent risk factor for stroke in the AF patients,and the indicator has a good predictive value for prognosis of the patients.piR-hsa-2700592 might be used as a potential biomarker in the diagnosis and prevention of cardiovascular diseases.