Objective Summarize and analyze the core issues in the process of the"three medics"linkage reform in China,and provide optimized paths and countermeasure suggestions for the coordinated development and governance of the"three medics".Methods The problem list of the"three medics"linkage reform in China was summarized through literature analysis and boundary analysis method.The problem system was constructed based on the macro model of the health system,and the prob-lem evaluation was conducted by using the social network analysis method and the entropy weight Topsis method.Results The problem list can be summarized into 4 major categories,with a total of 45 problem topics.Among them,there are 5 items in the external submodule category,18 items in the structure category,17 items in the process category,and 5 items in the result cate-gory.The total frequency proportions are 16.22％,27.15％,43.68％,and 12.95％ respectively.Among the process-related problem themes,"excessive medical treatment"has the highest attention,the entropy weight Topsis comprehensive evaluation value of"lagging information system construction"is the highest,and"insufficient cross-departmental collaboration"is closest to the centrality value and has the greatest correlation.Conclusion Guided by the framework of the theory of holistic governance,it is urgently necessary to construct an information system for the coordinated development of the"three medics",reshape the mechanisms of leadership decision-making,data linkage and information collaboration,and enhance the synergy among depart-ments.Taking the reform of medical service prices as the starting point,by improving the value-oriented medical insurance pay-ment mechanism,the compensation mechanism of public hospitals,the salary system,etc.,we promote the compatibility of in-centives among multiple subjects and form a closed loop of coordinated development of the"three medics"sectors.

Objective Summarize and analyze the core issues in the process of the"three medics"linkage reform in China,and provide optimized paths and countermeasure suggestions for the coordinated development and governance of the"three medics".Methods The problem list of the"three medics"linkage reform in China was summarized through literature analysis and boundary analysis method.The problem system was constructed based on the macro model of the health system,and the prob-lem evaluation was conducted by using the social network analysis method and the entropy weight Topsis method.Results The problem list can be summarized into 4 major categories,with a total of 45 problem topics.Among them,there are 5 items in the external submodule category,18 items in the structure category,17 items in the process category,and 5 items in the result cate-gory.The total frequency proportions are 16.22％,27.15％,43.68％,and 12.95％ respectively.Among the process-related problem themes,"excessive medical treatment"has the highest attention,the entropy weight Topsis comprehensive evaluation value of"lagging information system construction"is the highest,and"insufficient cross-departmental collaboration"is closest to the centrality value and has the greatest correlation.Conclusion Guided by the framework of the theory of holistic governance,it is urgently necessary to construct an information system for the coordinated development of the"three medics",reshape the mechanisms of leadership decision-making,data linkage and information collaboration,and enhance the synergy among depart-ments.Taking the reform of medical service prices as the starting point,by improving the value-oriented medical insurance pay-ment mechanism,the compensation mechanism of public hospitals,the salary system,etc.,we promote the compatibility of in-centives among multiple subjects and form a closed loop of coordinated development of the"three medics"sectors.

Objective To investigate the influencing factors of lactational insufficiency in 72 hours postpartum and to construct a nomogram model. Methods A total of 345 puerperae who were hospitalized for delivery were selected as research subjects. According to a ratio of 7 to 3, they were divided into modeling group (242 cases) and validation group (103 cases). Based on the lactation situation at 72 hours postpartum, the modeling group was further divided into lactational insufficiency group (69 cases) and normal lactation group (173 cases). The clinical data of the puerperae were collected. Multivariate Logistic regression model was used to analyze the influencing factors of lactational insufficiency at 72 hours postpartum. R 3.6.3 software was used to construct a nomogram model for predicting lactational insufficiency at 72 hours postpartum. The receiver operating characteristic (ROC) curve and calibration curve were plotted to evaluate the discrimination and consistency of the nomogram model in predicting lactational insufficiency at 72 hours postpartum. Results There were no significant differences in age, parity, delivery mode, nipple type, and other factors between the modeling group and the validation group (P>0.05). The proportions of primipara, cesarean section, time from delivery to milk expression >1 hour, the number of breastfeeding ≤6 times in 24 hours, and absence of breast massage in the lactational insufficiency group were higher than those in the normal lactation group (P < 0.05). Multivariate Logistic regression model analysis showed that parity, delivery mode, time from delivery to milk expression, and the number of breastfeeding in 24 hours were influencing factors of lactational insufficiency at 72 hours postpartum (OR=3.488, 2.381, 2.442, 2.223, P < 0.05). The ROC curve showed that the area under the curve of the nomogram model in the modeling group and the validation group was 0.844 (95%CI, 0.792 to 0.897) and 0.863 (95%CI, 0.791 to 0.935), respectively. The slope of calibration curve was close to 1, and the Hosmer-Lemeshow goodness-of-fit test showed that the model fitted well (χ²=7.002, 4.560, P=0.429, 0.714). Conclusion Parity, delivery mode, time from delivery to milk expression, and the number of breastfeeding in 24 hours are influencing factors of lactational insufficiency at 72 hours postpartum. The nomogram prediction model constructed based on these factors has good discrimination and consistency.

Liver disease is one of the most burdensome diseases in the world. Therefore, new technologies are needed to study its pathogenesis in depth; however, because of its complex pathogenesis, there are relatively limited treatment options. Single-cell sequencing (SCS), as an emerging sequencing method, reflects the heterogeneity between cells by sequencing the genome, transcriptome, and epigenome of a single cell, thereby revealing the complex mechanisms of disease occurrence and development. The application of SCS in the study of liver diseases will enrich our understanding of the pathogenesis of liver diseases and provide a new direction for exploring the diagnosis and treatment. This article mainly reviews the research progress of SCS technology in liver diseases.

Background/Aims: To investigate the autoantibody against fumarate hydratase (FH), which is a specific liver failure-associated antigen (LFAA) and determine whether it can be used as a biomarker to evaluate the prognosis of acute-on-chronic liver failure (ACLF). Methods: An immunoproteomic approach was applied to screen specific LFAAs related to differential prognosis of ACLF (n=60). Enzyme-linked immunosorbent assay (ELISA) technology was employed for the validation of the frequency and titer of autoantibodies against FH in ACLF patients with different prognoses (n=82). Moreover, we clarified the expression of autoantibodies against FH in patients with chronic hepatitis B (n=60) and hepatitis B virus-related liver cirrhosis (n=60). The dynamic changes in the titers of autoantibodies against FH were analyzed by sample collection at multiple time points during the clinical course of eight ACLF patients with different prognoses. Results: Ultimately, 15 LFAAs were screened and identified by the immunoproteomic approach.Based on ELISA-based verification, anti-FH/Fumarate hydratase protein autoantibody was chosen to verify its expression in ACLF patients. ACLF patients had a much higher anti-FH autoantibody frequency (76.8%) than patients with liver cirrhosis (10%, p=0.000), patients with chronic hepatitis B (6.7%, p=0.022), and normal humans (0%, p=0.000). More importantly, the frequency and titer of anti-FH protein autoantibodies in the serum of ACLF patients with a good prognosis were much higher than that of patients with a poor prognosis (83.9% vs 61.5%, p=0.019; 1.41±0.85 vs 0.94±0.56, p=0.017, respectively). The titer of anti-FH autoantibodies showed dynamic changes in the clinical course of ACLF. Conclusions The anti-FH autoantibody in serum may be a potential biomarker for predicting the prognosis of ACLF.

ObjectiveTo investigate epidemiological characteristics and influencing factors of non-suicidal self-injury （NSSI） behaviors among middle school students in Jiangmen. MethodsA total of 1 220 middle school students in Jiangmen were selected for the study through stratified random sampling from November to December 2020. The self-compiled general demographic questionnaire， Coping Style Scale for Middle School Students， Olweus Bully/Victim Questionnaire （BVQ）， Social Support Scale for Adolescents， and Center for Epidemiologic Studies-Depression Scale （CES-D） were used for the assessment. Then binary Logistic regression analysis was performed to screen the factors influencing NSSI behaviors in students. ResultsA total of 204 middle school students （16.72%） were found to be engaged in NSSI behaviors， of whom 67 were male and 137 were female. There were statistically significant differences between the NSSI group and the non-NSSI group in terms of gender， school period， lodging， peer relationship and academic performance （χ²=22.162， 7.247， 6.541， 45.787， 25.097， P<0.05 or 0.01）. Compared with the non-NSSI group， the NSSI group scored higher on CES-D （t=-14.240） and BVQ （t=-5.952）， lower on Social Support Scale for Adolescents （t=9.238）. Within the Coping Style Scale for Middle School Students， NSSI group had lower problem-focused coping score （t=7.148） and higher emotion-focused coping score （t=-7.038） than those of non-NSSI group. The detection rates of school bullying， verbal and relational bullying were higher in NSSI group compared with non-NSSI group （χ²=34.215， 29.785，16.465）. The differences were statistically significant （P<0.01）. Binary Logistic regression showed that depression （OR=1.090， P<0.01） and school bullying （OR=1.492， P<0.05） entered into the regression model. ConclusionThe situation of NSSI behaviors of middle school students in Jiangmen is serious， and depression and school bullying are risk factors affecting NSSI behaviors in students.

The outbreak of coronavirus disease (COVID-19) caused by SARS-CoV-2 virus continually lead to worldwide human infections and deaths. Currently, there is no specific viral protein-targeted therapeutics. Viral nucleocapsid protein is a potential antiviral drug target, serving multiple critical functions during the viral life cycle. However, the structural information of SARS-CoV-2 nucleocapsid protein remains unclear. Herein, we have determined the 2.7 Å crystal structure of the N-terminal RNA binding domain of SARS-CoV-2 nucleocapsid protein. Although the overall structure is similar as other reported coronavirus nucleocapsid protein N-terminal domain, the surface electrostatic potential characteristics between them are distinct. Further comparison with mild virus type HCoV-OC43 equivalent domain demonstrates a unique potential RNA binding pocket alongside the -sheet core. Complemented by binding studies, our data provide several atomic resolution features of SARS-CoV-2 nucleocapsid protein N-terminal domain, guiding the design of novel antiviral agents specific targeting to SARS-CoV-2.

Objective To carry out health education nursing intervention mode for patients with hemodialy-sis,and to study and analyze the clinical nursing effect.Methods 112 cases of hemodialysis patients were randomlydivided into the observation group and the control group according to random number table,56 cases in each group. The patients of the control group were given conventional nursing model,and the patients of the observation group were given nursing intervention model on the basis of health education.The blood pressure,the internal fistula blockage, indwelling catheter caused by the incidence of infection and blood phosphorus level of compliance rate were compared in the two groups.Results After nursing intervention,diastolic blood pressure(76.17 ±7.02)mmHg and systolic blood pressure (131.17 ±8.77)mmHg of the observation group were significantly better than the control group [(90.91 ±8.44)mmHg,(141.29 ±7.08)mmHg],there were statistically significant differences(t =10.49,13.75, all P <0.05).The incidence rate of fistula obstruction (1.79%)and the catheter infection incidence rate(1.79%) of the observation group were significantly lower than the control group (28.57%,26.79%),there were statistically significant differences(χ2 =8.22,9.17,all P <0.05).The blood phosphorus level standard rate(60.71%)of the observation group was significantly higher than the control group(33.93%),there was statistically significant differ-ence (χ2 =11.45,P <0.05).Conclusion The incidence of complications is significantly decreased after nursing intervention of health education in patients with hemodialysis,and the indexes are improved significantly,and there is no obvious conflict of interest.