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 observe the clinical efficacy and safety of acupuncture combined with blade needle therapy for knee osteoarthritis (KOA). METHODS: A total of 60 patients with KOA were randomly divided into an observation group and a control group, 30 cases each group. The control group received acupuncture at Neixiyan (EX-LE4)，Dubi (ST35), Yinlingquan (SP9), Liangqiu (ST34), Xuehai (SP10), Yanglingquan (GB34) and Zusanli (ST36) on the affected side, once every other day, 3 times a week. The observation group received blade needle therapy on the basis of the treatment in the control group, once every 3 days, 2 times a week. Both groups were treated for 4 weeks. Before treatment, after 2, 4 weeks of treatment, and after 1 month of treatment completion (in follow-up), the scores of pain visual analogue scale (VAS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and Lequesne index were observed in the two groups, and the clinical efficacy and safety were evaluated. RESULTS: After 2, 4 weeks of treatment and in follow-up, the pain VAS scores, Lequesne index scores, and pain, stiffness, function scores of WOMAC in both groups were decreased compared with those before treatment (P<0.05), and the VAS scores, Lequesne index scores and pain, function scores of WOMAC in the observation group were lower than those in the control group (P<0.05). The effective response rate in the observation group was 76.7% (23/30), while that in the control group was 70.0% (21/30), there was no statistically significant difference in the effective response rates between the two groups (P>0.05). No adverse reactions were observed in either group. CONCLUSION Acupuncture combined with blade needle therapy could alleviate pain and promote functional recovery in KOA patients, and achieve long-lasting improvements.
Humans ; Osteoarthritis, Knee/physiopathology* ; Acupuncture Therapy/instrumentation* ; Male ; Female ; Middle Aged ; Aged ; Acupuncture Points ; Treatment Outcome ; Adult ; Needles ; Combined Modality Therapy

Taxifolin (TAX) is a natural compound known for its liver protection effect, but the mechanism remains unknown. Phosphorylated proteomics analyses discovered that the phosphorylation level of NDRG1 at T328 was a key event of TAX-improved liver fibrosis. We established models with NDRG1 knockout (KO) in vivo and in vitro, demonstrating that NDRG1 KO attenuated the development of hepatocyte injury, and combining NDRG1 KO and TAX administration did not result in a reduction in protection against liver injury. Cellular thermal shift assay and surface plasma resonance analysis showed that TAX directly binds to NDRG1 rather than its upstream kinase, subsequently demonstrating that TAX regulated phosphorylation of NDRG1 at T328 through binding to its C289 site. NDRG1 T328A (phosphorylated mutation) and T328E (mimic phosphorylation) in vivo and in vitro confirmed that pNDRG1_T328 exacerbates hepatocyte injury along with DNA damage, inflammatory response, and apoptosis, thereby contributing to hepatic stellate cells (HSCs) activation. In contrast, TAX can inhibit the above pathological abnormalities and block hepatocyte injury-triggered HSCs activation and fibrosis. Overall, TAX is a potent liver protection drug primarily targeting NDRG1 and inhibiting pNDRG1_T328 in hepatocytes.

Objective To investigate the awareness of radon exposure hazards among non-uranium miners in Chongqing, China. Methods A survey was conducted among 177 male miners from eight non-uranium metal mines in Chongqing to collect data on basic information, personal habits, and the rate of radon awareness. Factors affecting radon awareness were analyzed using chi-square test and logistic regression model. Results The awareness rate of radon among miners was 23.73%. The chi-square test indicated significant difference in the radon awareness rate among miners with different levels of education (χ² = 10.28, P < 0.05), while there was no significant difference across different ages, years of work, labor relations, job categories, and types of miners (P > 0.05). Binary logistic regression analysis showed that a college (junior college) or higher level of education, a high school level of education, and working in mines were factors affecting the radon awareness among miners (χ² = 4.030, 9.150, 11.776, P < 0.05). Conclusion Miners lack awareness of radon, and there is an urgent need to strengthen education and propaganda regarding the hazards of radon.

Objective To systematically evaluate the level of proteus mirabilis(PM)infection in patients with rheumatoid arthritis(RA)and to investigate its potential association with the development of RA.Methods Based on Meta-analysis of observational studies in epidemiology and preferred reporting items for systematic review and Meta-analysis guide,a comprehensive search of PubMed,Web of Science and Embase databases was conducted to screen relevant literature published up to December 2024 for studies comparing the levels of anti-PM antibodies between RA patients and healthy populations,and the quality of the included studies was assessed by using the Newcastle-Ottawa scale.Heterogeneity among studies was assessed by Q-test and I2-test,and accordingly,fixed-effects or random-effects models were selected,and the robustness of the results was assessed by sensitivity analyses,Begg's test,and clipping and patching method.Results Finally,18 eligible articles were included,involving 753 RA patients and 716 healthy controls.The total antibody levels[weighted mean difference(WMD)=0.86,95％CI:0.38-1.34,I2=98.3％,P=0.000]and IgA antibody levels(WMD=0.17,95％CI:0.06-0.28,I2=96.7％,P=0.000)of RA patients were higher than those of healthy controls,and subgroup analyses revealed significant heterogeneity among geographic regions and testing methods.Conclusion Prevention and treatment of PM infections may be a complementary strategy for RA management and provide evidence-based support for the"PM antigen-genitourinary tract mucosa-autoimmunity"pathology hypothesis.

Objective:To investigate the radon exposure levels and health effects among non-uranium miners in Chongqing.Methods:From June 2022 to December 2023, a survey was carried out on basic information, radon exposure and occupational health status of 110 male miners with good cooperation attitudes in 6 non-uranium metal mines in normal operation in Chongqing. The logistic regression model was utilized to statistically analyze the impact of miners′ individual radon doses on abnormalities in chromosomal aberration analysis, micronucleus examination, tumor marker tests, and pulmonary CT imaging.Results:Monitoring results from passive integrated radon personal dosimeters indicated that three miners had an annual dose exceeding 2 mSv. Logistic regression analysis revealed that abnormalities in pulmonary CT imaging were associated with miners′ age, tenure, and alcohol consumption ( χ2=12.18, 9.63, 4.87, P<0.05), with no significant correlation with smoking or individual radon dose. There was a significant correlation between individual radon dose and abnormalities in tumor markers; for every additional 1 mSv of effective dose from radon and its progeny, the risk of abnormality increased by 2.25 times ( χ2=4.57, P < 0.05). Conclusions:Some miners in Chongqing are exposed to an annual dose exceeding 2 mSv, and there is a correlation between individual radon doses and abnormalities in lung cancer serum tumor markers. It is necessary to focus on monitoring the radon exposure risks for miners, carry out regular health checks, and enhance the health protection for the miner population.

Objective:To compare the therapeutic efficacy of the dual anteromedial and anterolateral approaches versus that of the anterior midline approach in the treatment of Wahlquist type C medial tibial plateau fractures accompanied by posterior column collapse.Methods:A retrospective study was conducted to analyze the 21 patients who had been treated for Wahlquist type C medial tibial plateau fractures plus posterior column collapse at The Fourth Orthopedic Ward, The 72nd Group Army Hospital of PLA between January 2019 and August 2023. The cohort included 13 males and 8 females, with an age of (43.3±6.7) years. The left side was involved in 14 fractures and the right side in 7 ones. The patients were divided into 2 groups based on their surgical approaches: a dual-approach group ( n=13) undergoing fixation via the dual anteromedial and anterolateral approaches, and a single-approach group ( n=8) undergoing fixation via the anterior midline approach. Comparative parameters included operative time, intraoperative blood loss, fracture healing time, quality of fracture reduction, medial proximal tibial angle (MPTA), incision complications, postoperative bone mass reduction quality (evaluated according to the Rasmussen anatomical criteria for tibial condyle fracture reduction), lateral tibial plateau instability, incidence of genu varum, and post-traumatic arthritis. Functional recovery of the lower limb joints was assessed at the final follow-up using the Merchant criteria. Results:No statistically significant differences were observed in the baseline characteristics between the 2 groups preoperatively, indicating comparability ( P>0.05). All patients were followed up for a mean duration of (38.1±11.3) months. The postoperative MPTA in the dual-approach group (86.8°±0.8°) was significantly larger than that in the single-approach group (85.5°±0.9°) ( P<0.05). Genu varum occurred in 1 patient in the dual-approach group and in 4 patients in the single-approach group, while lateral tibial plateau instability was observed in 1 patient in the dual-approach group and in 4 patients in the single-approach group, showing statistically significant differences between the 2 groups ( P<0.05). No statistically significant differences were found between the 2 groups regarding operative time, intraoperative blood loss, fracture healing time, quality of fracture reduction, incidence of incision complications, or incidence of post-traumatic arthritis ( P>0.05). At the final follow-up, no statistically significant difference was observed in the functional recovery of the lower limb joints assessed by the Merchant criteria between the 2 groups ( P>0.05). Conclusion:In the treatment of Wahlquist type C medial tibial plateau fractures accompanied by posterior column collapse, compared with the single anterior midline approach, the dual anteromedial and anterolateral approaches can restore more effectively the MPTA, and reduce the incidences of genu varum and lateral tibial plateau instability.

Objective:To explore screening pathways and practical implementation strategies for primary care disease groups un-der the Diagnosis-Intervention Packet(DIP)payment.Methods:Matching and expert consultation methods were used to select primary care conditions,and experts included DIP National Steering Group experts,DIP experts from a sample municipal health-care security bureau,health policy researchers,coders from a tertiary hospital in Beijing,and big data engineers.Results:The DIP primary disease of"conservative treatment groups"in primary and secondary medical institutions were 104 and 105,repective-ly.The DIP primary disease of"primary can be completed groups"were 74 and 171,respectively.The final number of primary diseases in primary and secondary hospital was determined to be 178 and 276,respectively.Conclusions:The number of primary care disease groups varies from place to place,but it still needs to be dynamically adjusted and optimized in conjunction with big data methods and expert consultation,evaluated and corrected in a timely manner to ensure scientificity and effectiveness.The pri-mary care disease groups implement"same price for the same disease"across different levels of medical institutions,eliminating the differentiation of medical institution grade coefficients to promote hierarchical diagnosis and treatment.Cost-value measurement of disease group,scientific development of payment criteria for disease group,lack of regulatory tools for big data,and high sets of codes are key barriers to primary care implementation.

Objective:To explore screening pathways and practical implementation strategies for primary care disease groups un-der the Diagnosis-Intervention Packet(DIP)payment.Methods:Matching and expert consultation methods were used to select primary care conditions,and experts included DIP National Steering Group experts,DIP experts from a sample municipal health-care security bureau,health policy researchers,coders from a tertiary hospital in Beijing,and big data engineers.Results:The DIP primary disease of"conservative treatment groups"in primary and secondary medical institutions were 104 and 105,repective-ly.The DIP primary disease of"primary can be completed groups"were 74 and 171,respectively.The final number of primary diseases in primary and secondary hospital was determined to be 178 and 276,respectively.Conclusions:The number of primary care disease groups varies from place to place,but it still needs to be dynamically adjusted and optimized in conjunction with big data methods and expert consultation,evaluated and corrected in a timely manner to ensure scientificity and effectiveness.The pri-mary care disease groups implement"same price for the same disease"across different levels of medical institutions,eliminating the differentiation of medical institution grade coefficients to promote hierarchical diagnosis and treatment.Cost-value measurement of disease group,scientific development of payment criteria for disease group,lack of regulatory tools for big data,and high sets of codes are key barriers to primary care implementation.

Objective:To investigate the radon exposure levels and health effects among non-uranium miners in Chongqing.Methods:From June 2022 to December 2023, a survey was carried out on basic information, radon exposure and occupational health status of 110 male miners with good cooperation attitudes in 6 non-uranium metal mines in normal operation in Chongqing. The logistic regression model was utilized to statistically analyze the impact of miners′ individual radon doses on abnormalities in chromosomal aberration analysis, micronucleus examination, tumor marker tests, and pulmonary CT imaging.Results:Monitoring results from passive integrated radon personal dosimeters indicated that three miners had an annual dose exceeding 2 mSv. Logistic regression analysis revealed that abnormalities in pulmonary CT imaging were associated with miners′ age, tenure, and alcohol consumption ( χ2=12.18, 9.63, 4.87, P<0.05), with no significant correlation with smoking or individual radon dose. There was a significant correlation between individual radon dose and abnormalities in tumor markers; for every additional 1 mSv of effective dose from radon and its progeny, the risk of abnormality increased by 2.25 times ( χ2=4.57, P < 0.05). Conclusions:Some miners in Chongqing are exposed to an annual dose exceeding 2 mSv, and there is a correlation between individual radon doses and abnormalities in lung cancer serum tumor markers. It is necessary to focus on monitoring the radon exposure risks for miners, carry out regular health checks, and enhance the health protection for the miner population.