Objective To investigate the causal relationship between serum total bile acid (TBA) levels and gastric cancer (GC) using regression discontinuity design (RDD). Methods A total of 1244 GC patients and 1333 healthy controls were included in the study. Demographic characteristics, gallbladder disease history, tumor markers, and serum TBA levels were collected from both groups. Logistic regression was used to construct a risk prediction model to estimate the risk of GC. RDD was employed with serum TBA as the grouping variable and the individual risk of developing GC as the outcome variable. Results The predictive factors in the GC risk prediction model included age, sex, body mass index(BMI), serum TBA, carcinoembryoniv antigen(CEA), alpha fetoprotein(AFP), carbohydrate antigen 199(CA199), and CA125. Serum TBA was identified as an independent risk factor for GC (OR=1.054, 95% CI: 1.030 to 1.079). RDD analysis indicated that when serum TBA levels reached 8 μmol/L, the probability of developing GC increased sharply by 23.7%. The breakpoint remained statistically significant following validity and robustness assessments. Conclusion The study demonstrates a positive causal relationship between serum TBA levels and GC, when the serum TBA level reaches 8 μmol/L, the risk of an individual developing GC increases sharply.
Humans ; Stomach Neoplasms/etiology* ; Male ; Female ; Middle Aged ; Bile Acids and Salts/blood* ; Aged ; Adult ; Risk Factors ; Case-Control Studies ; Biomarkers, Tumor/blood* ; Logistic Models

BACKGROUND: High temperatures are known to be associated with an increased risk of self-harm, but the influence of demographic changes and country-level indicators on the burden of heat-related self-harm remains unclear. This study examined the key factors driving changes in self-harm mortality linked to high temperatures and explored their impact at the country level. METHODS: This is an ecological study that analyzes data from the 2021 Global Burden of Disease (GBD) study, the World Bank, and the Climate Research Unit (CRU) were analyzed. Decomposition analyses were used to identify key factors driving changes in high temperature-related self-harm mortality between 1990 and 2021. A panel data model assessed the impact of national indicators on heat-related self-harm mortality. RESULTS: In 2021, 14,885 deaths globally were attributed to heat-related self-harm, a 41.94% increase from 1990, with low-middle SDI regions accounting for 47.84% of these deaths. While the global death rate from heat-related self-harm declined slightly over this period, South Asia and low-middle SDI regions contributed most to the decline. However, population aging exacerbated mortality rates. Demographic and meteorological factors were also linked to heat-related self-harm. CONCLUSION The global decline in heat-related self-harm mortality is largely driven by reductions in females, low-middle SDI regions, and South Asia. However, population aging and growth in these regions have added to the mortality burden, slowing the overall decline. Factors such as population density are also associated with heat-related self-harm. Targeted measures are needed to mitigate heat-induced self-harm more effectively in future.
Humans ; Self-Injurious Behavior/etiology* ; Hot Temperature/adverse effects* ; Global Health/statistics & numerical data* ; Female ; Male ; Adult ; Middle Aged ; Aged ; Young Adult ; Adolescent

Palliative care has become an important medical measure to provide professional healthcare and alleviate patients' suffering. Nurse-led palliative care models enable patients to access palliative care services in a timely manner and can be applied across various healthcare settings. This paper reviews the current status of nurse-led palliative care models in China and internationally, summarizes the summarizes the intervention settings, care forms, implementation contents, and effects of nurse-led palliative care models, and expounds on the existing barriers and improvement strategies of nurse-led palliative care models in China. The aim is to provide a reference for the implementation and development of palliative care.

BACKGROUND: Bile acids (BAs) facilitate the progression of gastric intestinal metaplasia (GIM). Long non-coding RNAs (lncRNAs) dysregulation was observed along with the initiation of gastric cancer. However, how lncRNAs function in GIM remains unclear. This study aimed to explore the role and mechanism of lncRNA PVT1 in GIM, and provide a potential therapeutic target for GIM treatment. METHODS: We employed RNA sequencing (RNA-seq) to screen dysregulated lncRNAs in gastric epithelial cells after BA treatment. Bioinformatics analysis was conducted to reveal the regulatory mechanism. PVT1 expression was detected in 21 paired biopsies obtained under endoscopy. Overexpressed and knockdown cell models were established to explore gene functions in GIM. Molecular interactions were validated by dual-luciferase reporter assay, RNA immunoprecipitation (RIP), and chromatin immunoprecipitation (Ch-IP). The levels of relative molecular expression were detected in GIM tissues. RESULTS: We confirmed that lncRNA PVT1 was upregulated in BA-induced GIM model. PVT1 promoted the expression of intestinal markers such as CDX2 , KLF4 , and HNF4α . Bioinformatics analysis revealed that miR-34b-5p was a putative target of PVT1 . miR-34b-5p mimics increased CDX2 , KLF4 , and HNF4α levels. Restoration of miR-34b-5p decreased the pro-metaplastic effect of PVT1 . The interactions between PVT1 , miR-34b-5p, and the downstream target HNF4α were validated. Moreover, HNF4α could transcriptionally activated PVT1 , sustaining the GIM phenotype. Finally, the activation of the PVT1 /miR-34b-5p/ HNF4α loop was detected in GIM tissues. CONCLUSIONS BAs facilitate GIM partially via a PVT1/miR-34b-5p/HNF4α positive feedback loop. PVT1 may become a novel target for blocking the continuous development of GIM and preventing the initiation of gastric cancer in patients with bile reflux.
Humans ; RNA, Long Noncoding/metabolism* ; MicroRNAs/metabolism* ; Hepatocyte Nuclear Factor 4/genetics* ; Bile Acids and Salts ; Kruppel-Like Factor 4 ; Metaplasia/metabolism*

Palliative care has become an important medical measure to provide professional healthcare and alleviate patients' suffering. Nurse-led palliative care models enable patients to access palliative care services in a timely manner and can be applied across various healthcare settings. This paper reviews the current status of nurse-led palliative care models in China and internationally, summarizes the summarizes the intervention settings, care forms, implementation contents, and effects of nurse-led palliative care models, and expounds on the existing barriers and improvement strategies of nurse-led palliative care models in China. The aim is to provide a reference for the implementation and development of palliative care.

Objective The present study aims to explore the mediating role of rumination and coping styles in social support and post-traumatic stress disorder(PTSD)in young and middle-aged spinal cord injury(SCI)patients.The study will provide a basis for developing targeted interventions.Methods Two hundred and forty young and middle-aged SCI patients hospitalized for treatment were selected by convenience sampling and questionnaires were administered using the General Information Questionnaire,the Perceived Social Support Scale(PSSS),the Simplified Coping Style Questionnaire(SCSQ),the Event Related Rumination Inventory(ERRI),and the Post-traumatic Stress Disorder Self-assessment Scale(PCL-C),Mediation analysis using Model-6 with Process4.1 plugin in SPSS 25.0.Results The mean scores for PTSD,social support,rumination,positive coping,and negative coping in young and middle-aged SCI patients were 29.00(26.00,35.75),67.00(62.00,70.00),and 37.00(34.00,4 1.00),and 36.00(33.00,42.00),respectively.PTSD demonstrated a negative correlation(r=-0.553,r=-0.484,P＜0.001)and a negative correlation with positive coping and rumination(r=0.499,r=0.472,P＜0.001).The mediation modelling test demonstrated that rumination and positive and negative coping mediated significantly between social support and PTSD,with effect values of-0.078 1,-0.097 0 and-0.049 6,accounting for 17.81％,22.12％and 11.31％of the total effect,respectively.Furthermore,the chain mediation effects of rumination and positive coping and negative coping were also significant,with effect values of-0.026 3 and-0.026 2,accounting for 5.99％and 5.97％of the total effect,respectively.Conclusions The present study hypothesises that rumination,thinking and coping styles play a simple and chain-mediating role between social sup-port and PTSD in young and middle-aged SCI patients.Medical professionals should focus on the mediating role of rumination and coping styles when developing interventions related to improving and preventing PTSD in patients,which can be done by increasing the level of social support for patients,decreasing the level of rumination,and guiding patients to positively cope with their illness.

Objective To investigate the clinical significance and potential mechanism of NAT10 in hepatocellular carcinoma.Meth-ods A total of 50 normal and 374 tumor samples were obtained based on The Cancer Genome Atlas(TCGA),and the data were pro-cessed by R 4.2.1.Results The expression of NAT10 in tumor samples was significantly higher than that in normal samples(P＜0.001).Compared with patients with low expression of NAT10,patients with high expression of NAT10had worse prognosis(P＜0.001).Logistic regression analysis showed that high NAT10 expression was associated with adverse clinical prognostic factors,and pa-tients with high NAT10 expression were more likely to progress to the advanced stage.Gene set enrichment analysis(GSEA)results showed that the genes related to heterobiotic metabolism,blood coagulation and fatty acid metabolism were differentially enriched in the samples with high expression of NAT10.The protein interaction analysis results showed that NAT10may interact with genes such as IGF2,SST,MUC2,CHGA,AGR2,etc.Conclusion NAT10 is highly expressed in hepatocellular carcinoma,and the expression level is cor-related with the clinical characteristics and survival rate of patients with hepatocellular carcinoma.NAT10may be a potential molecular bio-marker for hepatocellular carcinoma prognosis.

Objective The present study aims to explore the mediating role of rumination and coping styles in social support and post-traumatic stress disorder(PTSD)in young and middle-aged spinal cord injury(SCI)patients.The study will provide a basis for developing targeted interventions.Methods Two hundred and forty young and middle-aged SCI patients hospitalized for treatment were selected by convenience sampling and questionnaires were administered using the General Information Questionnaire,the Perceived Social Support Scale(PSSS),the Simplified Coping Style Questionnaire(SCSQ),the Event Related Rumination Inventory(ERRI),and the Post-traumatic Stress Disorder Self-assessment Scale(PCL-C),Mediation analysis using Model-6 with Process4.1 plugin in SPSS 25.0.Results The mean scores for PTSD,social support,rumination,positive coping,and negative coping in young and middle-aged SCI patients were 29.00(26.00,35.75),67.00(62.00,70.00),and 37.00(34.00,4 1.00),and 36.00(33.00,42.00),respectively.PTSD demonstrated a negative correlation(r=-0.553,r=-0.484,P＜0.001)and a negative correlation with positive coping and rumination(r=0.499,r=0.472,P＜0.001).The mediation modelling test demonstrated that rumination and positive and negative coping mediated significantly between social support and PTSD,with effect values of-0.078 1,-0.097 0 and-0.049 6,accounting for 17.81％,22.12％and 11.31％of the total effect,respectively.Furthermore,the chain mediation effects of rumination and positive coping and negative coping were also significant,with effect values of-0.026 3 and-0.026 2,accounting for 5.99％and 5.97％of the total effect,respectively.Conclusions The present study hypothesises that rumination,thinking and coping styles play a simple and chain-mediating role between social sup-port and PTSD in young and middle-aged SCI patients.Medical professionals should focus on the mediating role of rumination and coping styles when developing interventions related to improving and preventing PTSD in patients,which can be done by increasing the level of social support for patients,decreasing the level of rumination,and guiding patients to positively cope with their illness.

Objective To investigate the clinical significance and potential mechanism of NAT10 in hepatocellular carcinoma.Meth-ods A total of 50 normal and 374 tumor samples were obtained based on The Cancer Genome Atlas(TCGA),and the data were pro-cessed by R 4.2.1.Results The expression of NAT10 in tumor samples was significantly higher than that in normal samples(P＜0.001).Compared with patients with low expression of NAT10,patients with high expression of NAT10had worse prognosis(P＜0.001).Logistic regression analysis showed that high NAT10 expression was associated with adverse clinical prognostic factors,and pa-tients with high NAT10 expression were more likely to progress to the advanced stage.Gene set enrichment analysis(GSEA)results showed that the genes related to heterobiotic metabolism,blood coagulation and fatty acid metabolism were differentially enriched in the samples with high expression of NAT10.The protein interaction analysis results showed that NAT10may interact with genes such as IGF2,SST,MUC2,CHGA,AGR2,etc.Conclusion NAT10 is highly expressed in hepatocellular carcinoma,and the expression level is cor-related with the clinical characteristics and survival rate of patients with hepatocellular carcinoma.NAT10may be a potential molecular bio-marker for hepatocellular carcinoma prognosis.

Objective To investigate the effects of the Pingan qushi prescription on traditional Chinese medicine syndrome,adverse events,and compliance in young and middle-aged hypertensive patients.Methods One hundred thirty-two young and middle-aged patients with hypertension were selected and randomly divided into two groups.After elimination,64 cases were included in each group.For 2 months,the control group was treated with irbesartan tablets,and the observation group underwent the Pingan qushi prescription based on the control group.The blood pressure,curative effect,traditional Chinese medicine syndrome score,safety,adverse events,and prognosis-related indicators were compared between the two groups.Results The total effective rate of the observation group(96.88%,92.19%)was higher than that of the control group(82.52%,78.13%),and the difference was statistically significant(P = 0.005,P = 0.025).After 1 and 2 months of treatment,the blood pressure,syndrome scores,ALD,PRA,AngⅡ,and ET-1 in the observation group were lower than those in the control group,and the differences were statistically significant(all P<0.05).There was no sig-nificant difference in the incidence of adverse reactions between the two groups(P>0.05).There was no statistically significant difference(P>0.05)in the incidence of adverse events during treatment between the observation group(1.56%)and control group(10.94%).Conclusion The treatment of young and middle-aged community patients with hypertension undergoing the Pingan qushi pre-scription can further improve patients'symptoms,increase blood pressure control,promote prognosis improvement.