Driven by the"Big Health"concept,chronic disease management has gradually shifted from single-treatment approaches to comprehensive health maintenance.This paper analyzes the challenges in the development of community-based re-habilitation for chronic diseases in China,including workforce shortages,policy support gaps,funding constraints,and health ed-ucation deficiencies.Implementation pathways are proposed,such as strengthening rehabilitation teams,improving community re-habilitation management systems,diversifying funding sources,and promoting health education.Future directions include con-structing a multimodal collaborative"hospital-community-pharmacy"network,advancing integrated healthcare and prevention models,emphasizing scientific multi-morbidity management,and adopting AI-driven medical technologies.These strategies aim to optimize service models,enhance the overall effectiveness of community-based chronic disease rehabilitation,and support the implementation of the Healthy China initiative.

Driven by the"Big Health"concept,chronic disease management has gradually shifted from single-treatment approaches to comprehensive health maintenance.This paper analyzes the challenges in the development of community-based re-habilitation for chronic diseases in China,including workforce shortages,policy support gaps,funding constraints,and health ed-ucation deficiencies.Implementation pathways are proposed,such as strengthening rehabilitation teams,improving community re-habilitation management systems,diversifying funding sources,and promoting health education.Future directions include con-structing a multimodal collaborative"hospital-community-pharmacy"network,advancing integrated healthcare and prevention models,emphasizing scientific multi-morbidity management,and adopting AI-driven medical technologies.These strategies aim to optimize service models,enhance the overall effectiveness of community-based chronic disease rehabilitation,and support the implementation of the Healthy China initiative.

Landfill is one of the important sources of carbon tetrachloride (CT) pollution, and it is important to understand the degradation mechanism of CT in landfill cover for better control. In this study, a simulated landfill cover system was set up, and the biotransformation mechanism of CT and the associated micro-ecology were investigated. The results showed that three stable functional zones along the depth, i.e., aerobic zone (0-15 cm), anoxic zone (15-45 cm) and anaerobic zone (> 45 cm), were generated because of long-term biological oxidation in landfill cover. There were significant differences in redox condition and microbial community structure in each zone, which provided microbial resources and favorable conditions for CT degradation. The results of biodegradation indicated that dechlorination of CT produced chloroform (CF), dichloromethane (DCM) and Cl^- in anaerobic and anoxic zones. The highest concentration of dechlorination products occurred at 30 cm, which were degraded rapidly in aerobic zone. In addition, CT degradation rate was 13.2-103.6 μg/(m²·d), which decreased with the increase of landfill gas flux. The analysis of diversity sequencing revealed that Mesorhizobium, Thiobacillus and Intrasporangium were potential CT-degraders in aerobic, anaerobic and anoxic zone, respectively. Moreover, six species of dechlorination bacteria and eighteen species of methanotrophs were also responsible for anaerobic transformation of CT and aerobic degradation of CF and DCM, respectively. Interestingly, anaerobic dechlorination and aerobic transformation occurred simultaneously in the anoxic zone in landfill cover. Furthermore, analysis of degradation mechanism suggested that generation of stable anaerobic-anoxic-aerobic zone by regulation was very important for the harmless removal of full halogenated hydrocarbon in vadose zone, and the increase of anoxic zone scale enhanced their removal. These results provide theoretical guidance for the removal of chlorinated pollutants in landfills.
Bacteria/metabolism* ; Biodegradation, Environmental ; Carbon Tetrachloride/metabolism* ; Methane/metabolism* ; Waste Disposal Facilities

Objective? To understand the work experience of PICC nurse specialists in using intracavitary electrocardiogram for PICC placement, so as to provide a reference for further promoting and standardizing of the intracavitary electrocardiogram method. Methods? From October 2018 to February 2019, the PICC nurse specialists from 5 Class Two and 16 Class Three hospitals which developed intracavitary electrocardiogram guided PICC in Shandong Province were selected by purposive sampling method as interveiwees. A qualitative phenomenological study was used to conduct semi-structured interviews with 21 PICC specialist nurses. Colaizzi's seven-step analysis method was used to analyze the data. Results? Three themes were identified:a method that "makes your mind at rest", difficulties met in work, growth and learn. The intracavitary electrocardiogram method effectively promoted PICC placement and released pressure of nurse specialists. Nurse practitioners will experience hardship at the beginning of using the intracavitary electrocardiogram method. As they gradually became skilled and came across difficulties, they would experience development personally and professionally. Conclusions? The intracavitary electrocardiogram method can benefit PICC nurse specialists both in their profession and career identity. However, the PICC nurse will face difficulties from different aspects while using this method. It is necessary to support better training courses and standardized management for the extension of intracavitary electrocardiogram method, promoting the promotion and application of new technologies.

Objective To investigate the effects of B lymphocyte-induced maturation protein-1 ( Blimp-1) on the number and function of splenic lymphocytes.Methods The mice with defective Blimp-1 in T cells were generated by cross-breeding B6.Blimp-1flox/flox mice with B6.Lck-Cre mice.The mononuclear lymphocytes isolated from spleen of T cell conditional Blimp-1 knockout (Blimp-1CKO) mice and wild type ( WT) C57/B6 mice were comparatively analyzed.Alterations of CD4+T and CD8+T cell subsets, the secre-tion of cytokines as well as the expression of C-C chemokine receptor type 7 ( CCR7 ) and Sphingosine-1-phosphate receptor 1 (S1P1) in mice from the two groups were analyzed by flow cytometry.The changes of CD19+B cell subsets were also detected.Results Compared with WT mice, the total numbers of mononu-clear cells, T and B lymphocytes were all significantly increased in Blimp-1CKO mice ( P<0.05) .The ab-solute numbers of CD4+T, CD8+T and CD19+CD5+CD1d+B cells in mice form Blimp-1CKO group were higher than those of the control group (P<0.05), however, no significant differences with the percentages of these cell populations were observed between two groups.Higher numbers and percentages of CD19+CD5+B cells were detected in mice from Blimp-1CKO group (P<0.01).The Blimp-1CKO mice showed increased secretion of IFN-γ, TNF-α, IL-17 and IL-2, but decreased expression of CCR7 on CD8+T cells as com-pared with WT mice (P<0.05).No significant differences with the changes of S1P1 were found between the two groups.Conclusion Blimp-1 played an important role in the maintenance of number, phenotype and function of T cells.Furthermore, not only T cells but also B cell subsets in mice were affected by the dele-tion of Blimp-1 in T cells.