ObjectiveTo investigate the influence of histone deacetylase 3 (HDAC3) on the occurrence, development of psoriasis-like inflammation in mice, and the relative immune mechanisms. MethodsHealthy C57BL/6 mice aged 6-8 weeks were selected and randomly divided into 3 groups: control group (Control), psoriasis model group (IMQ), and HDAC3 inhibitor RGFP966-treated psoriasis model group (IMQ+RGFP966). One day prior to the experiment, the back hair of the mice was shaved. After a one-day stabilization period, the mice in Control group was treated with an equal amount of vaseline, while the mice in IMQ group was treated with imiquimod (62.5 mg/d) applied topically on the back to establish a psoriasis-like inflammation model. The mice in IMQ+RGFP966 group received intervention with a high dose of the HDAC3-selective inhibitor RGFP966 (30 mg/kg) based on the psoriasis-like model. All groups were treated continuously for 5 d, during which psoriasis-like inflammation symptoms (scaling, erythema, skin thickness), body weight, and mental status were observed and recorded, with photographs taken for documentation. After euthanasia, hematoxylin-eosin (HE) staining was used to assess the effect of RGFP966 on the skin tissue structure of the mice, and skin thickness was measured. The mRNA and protein expression levels of HDAC3 in skin tissues were detected using reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR) and Western blot (WB), respectively. Flow cytometry was employed to analyze neutrophils in peripheral blood and lymph nodes, CD4⁺ T lymphocytes, CD8⁺ T lymphocytes in peripheral blood, and IL-17A secretion by peripheral blood CD4⁺ T lymphocytes. Additionally, spleen CD4⁺ T lymphocyte expression of HDAC3, CCR6, CCR8, and IL-17A secretion levels were analyzed. Immunohistochemistry was used to detect the localization and expression levels of HDAC3, IL-17A, and IL-10 in skin tissues. ResultsCompared with the Control group, the IMQ group exhibited significant psoriasis-like inflammation, characterized by erythema, scaling, and skin wrinkling. Compared with the IMQ group, RGFP966 exacerbated psoriasis-like inflammatory symptoms, leading to increased hyperkeratosis. The psoriasis area and severity index (PASI) skin symptom scores were higher in the IMQ group than those in the Control group, and the scores were further elevated in the IMQ+RGFP966 group compared to the IMQ group. Skin thickness measurements showed a trend of IMQ+RGFP966>IMQ>Control. The numbers of neutrophils in the blood and lymph nodes increased sequentially in the Control, IMQ, and IMQ+RGFP966 groups, with a similar trend observed for CD4⁺ and CD8⁺ T lymphocytes in the blood. In skin tissues, compared with the Control group, the mRNA and protein levels of HDAC3 decreased in the IMQ group, but RGFP966 did not further reduce these expressions. HDAC3 was primarily located in the nucleus. Compared with the Control group, the nuclear HDAC3 content decreased in the skin tissues of the IMQ group, and RGFP966 further reduced nuclear HDAC3. Compared with the Control and IMQ groups, RGFP966 treatment decreased HDAC3 expression in splenic CD4⁺ and CD8⁺ T cells. RGFP966 treatment increased the expression of CCR6 and CCR8 in splenic CD4⁺ T cells and enhanced IL-17A secretion by peripheral blood and splenic CD4⁺ T lymphocytes. Additionally, compared with the IMQ group, RGFP966 reduced IL-10 protein levels and upregulated IL-17A expression in skin tissues. ConclusionRGFP966 exacerbates psoriatic-like inflammatory responses by inhibiting HDAC3, increasing the secretion of the cytokine IL-17A, and upregulating the expression of chemokines CCR8 and CCR6.

Objective: To explore the intervention effect of schoolbased horticultural activities combined with fancy rope skipping on the health behaviour of fourthgrade primary school students, so as to provide a reference method for childrens health promotion. Methods: Eightyfive primary school students in grade 4 of a primary school in Changsha City were selected in March 2023 by using multistage cluster random sampling method and randomly divided into an intervention group (43 students) and a control group (42 students). The intervention group implemented a 12week comprehensive intervention of "schoolbased gardening combined with pattern skipping, once a week 90 min/time including routine practice (weeks 1-5,7-11; the contents were vegetable and plant management, theoretical knowledge learning of pattern skipping practice, etc.) and parent-child activities (weeks 6 and 12; vegetable salad making, synchronized jumping rope competition, etc.), and the control group maintained the regular curriculum. Moderate to vigorous physical activity (MVPA) and sleep duration were monitored by accelerometers in grade 4 primary school students, combined with questionnaires to assess fruit and vegetable intake and video screen behaviour, and generalised estimating equations were used to analyse the data. Results: After the intervention, there were interaction effect for school day MVPA time (Wald χ2group×time=8.27), vegetable intake (Wald χ2group×time=4.35), and video screen time (Wald χ2group×time=13.27) in both groups (P<0.01). After the intervention, the MVPA time in the intervention group increased from 30.00 (20.00,60.00) min to 40.00 (30.00, 60.00) min from school day; vegetable intake increased from 99.85 (33.95, 229.48) g to 190.15 (131.05, 279.48) g; and video screen time increased from 225.00 (110.00, 313.75) min to 60.00 (30.00, 142.50) min (Z=-4.51, -2.00, -3.84, P<0.05). However, there were no statistical differences in MVPA time, fruit intake and sleep time before and after intervention in the intervention group on weekends (Z=-1.35, -0.85, -0.24, P>0.05). Conclusion Schoolbased horticultural activities combined with an integrated intervention of fancy rope skipping can significantly improve physical activity, vegetable intake and video screen behaviours on weekdays in grade 4 primary school children, in order to provide a basis for multidimensional health promotion.

Aim To investigate the effect and role of neuronal restriction silencing factor(REST/NRSF)in epilepsy disorder.Methods Immunohistochemistry,immunofluorescence,Western blot and qPCR tech-niques were used to detect REST/NRSF expression levels in hippocampal tissues of mice induced by kainic acid and human brain tissue.Viral injections,EEG re-cordings and behavioral methods were used to test the effects on epileptic mice after knockdown and overex-pression of REST/NRSF in the hippocampal CA1 re-gion,respectively.Results The positive rate of REST/NRSF in the lesions of epileptic patients was significantly higher compared with that in the control group.The levels of REST/NRSF protein and mRNA in the CA1 region of the hippocampus of mice in the KA model group were significantly higher.Kv7.2 and Kv7.3 potassium channel mRNA expression levels were significantly down-regulated.Significant up-regu-lation of REST/NRSF expression levels was observed in mouse hippocampus after NMDA injection.Knock-down of REST/NRSF in the CA1 region of hippocam-pus significantly elevated the expression levels of Kv7.2 and Kv7.3 potassium channel mRNAs.The fre-quency of EEG spiking and sharp-wave issuance and epileptic seizure grade were significantly lower.Over-expression of REST/NRSF in the CA1 region of hippo-campus significantly reduced the mRNA expression lev-els of Kv7.2 and Kv7.3 potassium channels.The fre-quency of EEG spiking and sharp-wave issuance was significantly higher and epileptic symptoms were exac-erbated.Conclusion REST/NRSF in mouse hipp-ocampal brain regions is involved in epileptic disease development through transcriptional regulation of Kv7.2 and Kv7.3 potassium channels.

Objective To evaluate the clinical effect of a new three-phase Chinese medicine(CM)external treatment for acute lateral ankle ligament injuries.Methods From July to December 2023,64 patients with acute lateral ankle ligament in-juries were randomly assigned to receive either the new three-phase CM external treatment combined with the POLICE(pro-tect,optimal loading,ice,compression,elevation)treatment(observation group)or the POLICE treatment(control group),with 32 cases in each group.The observation group consisted of 17 males and 15 females,with an average age of(30.59±3.10)years old ranging from 25 to 36 years old,while the control group included 14 males and 18 females,with an average age of(30.03±3.19)years old ranging from 24 to 37 years old.Visual analogue scale(VAS)evaluation and Figure of 8 measurement were used to evaluate the degree of ankle joint pain and swelling of the subjects at the initial enrollment and after 1 week and sixth weeks of treatment.At the same time,the American Orthopaedic Foot and Ankle Society(AOFAS)and Karlsson Ankle Function Score System were used to evaluate the improvement of ankle joint function in patients at all stages.MRI imaging was employed to observe the degree of biological healing of the anterior talofibular ligament,with the signal to noise ratio(SNR)in-dicating the level of healing.A lower SNR suggests better ligament healing,as it represents lower water content in the ligament.Results All patients completed a 6-week follow-up.There was no significant difference in VAS,AOFAS score and Karlsson score between the two groups before treatment(P＞0.05).After 1 week and 6 weeks of treatment,the VAS,AOFAS score and Karlsson score of the two groups were significantly improved(P＜0.05).After 1 week of treatment,the VAS score of the obser-vation group(3.21±0.87)was lower than that of the control group(4.21±1.50),and the difference was statistically significant(P＜0.05).After 1 weeks of treatment,the AOFAS and Karlsson scores[(50.84±4.70)points,(49.97±4.00)points]of the ob-servation group were higher than those[(46.91±5.56)points,(46.66±5.36)points]of the control group(P＜0.05).MRI images showed that after 6 weeks of treatment,the SNR value of the observation group was significantly lower than that of the control group,and the difference was statistically significant(SNR of the observation group was 75.25±16.59,the contral gruop was 85.81±15.55),(P＜0.05).Conclusion Compared with the control group,the new three-phase CM external treatment is signifi-cantly effective in reducing pain and swelling,enhancing ligament repair quality,and promoting functional recovery of the an-kle joint in patients with acute lateral malleolar ligament injuries.

Objective To compare the effects of transumbilical single-incision appendectomy and laparoscopic appendectomy in the treatment of acute appendicitis in pediatric patients.Methods The clinical data of 162 pediatric patients under 14 years old with acute appendicitis admitted to our department were retrospectively analyzed,and the pediatric patients were divided into the transumbilical single-incision surgery group(n=59)and the laparoscopic group(n=103)according to their surgeries.The completion of the operation was recorded,and the operation time,intraoperative blood loss,gastrointestinal function recovery time,hospitalization cost,hospital stay and complications were compared between the two groups.The postoperative wound healing was observed.The wound infection,abdominal pain,abdominal distension,vomiting and abnormal stool were observed during the 6-month follow-up after operation.Results The operations of pediatric patients in the laparoscopic group were successfully completed without conversion to open surgery.The appendixes of 2 cases in the transumbilical single-incision surgery group were found by transumbilical laparoscopy during the operation due to the difficulty in finding the appendixes.The operation time and hospital stay in the transumbilical single-incision surgery group were shorter than those in the laparoscopic group(P<0.05).There was no significant difference in the hospitalization cost,intraoperative blood loss,gastrointestinal function recovery time,or incidence of complications between the two groups(P>0.05).The incision healing in the transumbilical single-incision surgery group was more beautiful.During the follow-up period,the incision of the pediatric patients in the two groups healed well,and there was no abdominal pain,abdominal distension,vomiting or abnormal stool.Conclusion Compared with the traditional laparoscopic appendectomy,transumbilical single-incision appendectomy has the advantages of simple operation,short operation time and hospital stay,and more beautiful incision healing.

Objective:To explore effect of oleanolic acid on allergic rhinitis(AR)and its potential mechanism.Methods:Peripheral blood mononuclear cells(PBMCs)were isolated by density gradient centrifugation.Real-time quantitative PCR was used to detect expressions of Foxp3,IL-17A,Beclin1,and RORγt mRNA in nasal mucosa;flow cytometry was employed to assess proportion of Treg and Th17 cells in PBMCs;Western blot was utilized to determine expressions of RORγt,LC3-Ⅰ,LC3-Ⅱ,Beclin1,and P62 proteins in nasal mucosal.Mice were randomly divided into Control,ovalbumin(OVA),L-oleanolic acid,H-oleanolic acid,DSGC,3-MA and H-oleanolic acid+Rapa groups.Histological changes were observed by HE staining and Periodate Schiff(PAS)staining.Serological changes,expressions of IL-17A,IL-10,eosinophilic cationic protein(ECP)and anti-OVA-specific antibodies were detected by ELISA.Results:AR patients had Th17/Treg imbalance and activated autophagy.Oleanolic acid restored Th17/Treg balance and inhibited autophagy in vitro.In vivo experiments demonstrated that oleanolic acid inhibited OVA-induced allergic nasal symptoms and activation of autophagy pathway,which was same as regulation of 3-MA,while Rapa could weaken effects of high dose of oleanolic acid.Moreover,oleanolic acid reduced infiltration of different inflammatory cells of nasal lavage fluid,prevented damages to epithelial cells,and improved nasal mucosal thickness and mucus secretion.Oleanolic acid regulated balance of mouse Th17/Treg-associated cytokines expressions.Conclusion:Oleanolic acid can be used to treat AR,whose effect is realized through inhibiting autophagy to regulate Th17/Treg balance.

This is the first reported case of a female with monkeypox infection in Kunming City,Yunnan Province.An epi-demiological investigation was conducted to provide a scientific basis for the prevention and control of monkeypox epidemics in China,especially for early detection in females in accordance with the"Monkeypox prevention and control program(2023 ver-sion)".Diagnosis was performed as described in the"Monkeypox Diagnosis and Treatment Guidelines(2022 version)".Speci-mens were collected for laboratory testing.The epidemiological investigation determined that the female patient had sexual in-tercourse with her newly married husband once before disease onset and the husband hid his history of male homosexual sex.The laboratory test results of the woman and her husband were positive for the nucleic acid of the monkeypox virus.Both had typical clinical symptoms,including rash.The epidemiological investigation,clinical symptoms,laboratory test results,and previous epidemic data of monkeypox in Yunnan province confirmed the woman as the first female infected with monkeypox in Yunnan Province and her husband was the presumed source of infection.

Objective:This study aims to explore the synergistic effects of DIP and other medical insurance supply-side policies.Method:City A that has piloted DIP reform was set as the treatment group,and City B without reform was set as the control group.A total of 1 120 public medical institution samples from 2019 to 2022 were collected.The total medical expenses during hospitalization and some structural expenses were analyzed using DID method.Result:DIP had a significant inhibitory effect on the medical expenses,and the expenses of checkups and examinations during hospitalization in city A,but had no impact on the drug and the material expenses during hospitalization.Conclusion:DIP played a significant cost control role and effectively controlled the total medical expenses during hospitalization.The synergistic effects of price adjustment of medical services policy and national centralized drug/material procurement policy on cost control were insufficient.DIP synergized with other supply-side policies to promote rational medical cost structure.It is suggested that medical insurance departments should focus on the synergistic effects of medical insurance supply-side policies to jointly improve the efficiency of medical insurance fund utilization.

Objective:This study aims to develop a validated instrument for assessing the degree of integration perceived by patients in the services provided by general practitioner(GP)teams,and to evaluate the current state of integrated medical-prevention services.Methods:The survey tool was initially created through a review of existing literature and semi-structured interviews.It was subsequently refined and enhanced following consultations with experts.The utility of the instrument was confirmed through empirical research,which also facilitated an analysis of the status quo regarding the integration of medical and prevention services.Results:The devised instrument encompasses 18 items distributed across six dimensions:service comprehensiveness,service continuity,depth of service,continuity of relationship,patient-centricity,and service coordination.The cumulative score reflecting patients'perception of the integration level in GP teams'medical-prevention services was 54.30±12.45.Conclusion:The survey instrument developed in this research is characterized by its rationality,novelty,and practical relevance.It offers a patient-centered perspective for assessing the quality of integrated medical and prevention services for primary chronic diseases.While the overall perception of integration among patients is positive,there is a notable deficiency in the depth of services provided.There is a need for optimization of the service process,clarification of the service path,refinement of service management,and development of an integrated incentive mechanism for medical and preventive care,aiming for a deeper integration between medical services and preventive care.

Objective:To collate the progress of innovative medical technology payment mechanism under DRG/DIP payment in China,and raise suggestions for policy improvement.Methods:The study analysed policy documents on DRG/DIP payment reform in provinces and municipalities up to April 2024 and conducted in-depth interviews with relevant heads of healthcare security departments in some pilot cities.Results:A total of 45 national reform pilot cities and 19 provincial expansion cities included innovative technology payment mechanisms in the reform documents.The innovative technology payment mechanism for DRG-paying cities includes eight types of practices such as adjusting subgroup weights/institutional coefficients,separate payment,etc.The DIP-paying cities are classified into six types of practices such as determining the additive scores after expert deliberation,and determining the scores by adopting different computation rules.The practices of Shanghai,Hangzhou and Nanjing are more typical,namely tilting towards new technologies in supporting industrial development,setting up regressive incentives and precise compensation under a multi-dimensional adjustment mechanism.Conclusion:It is necessary to give a harmonised definition of innovative technologies at the national or provincial level and to complete its access and exit mechanism;using the rebate incentive mechanism helps promote the transition from short-term to long-term payments;adherence to the total amount of control payment and improvement of the regulation are important.