Objective:To explore the longitudinal predictive relationship between self-neglect and frailty among older adults.Methods:Data were drawn from the Chinese Longitudinal Healthy Longevity Survey conducted in 2011 (T1), 2014 (T2), and 2018 (T3). A total of 1 495 older adults aged≥65 years at T1 who participated in three consecutive surveys and had no missing key variables were included. General demographic information, self-neglect scores, and frailty status were extracted. Spearman correlation analysis was used to examine the association between self-neglect and frailty. Cross-lagged analysis was employed to investigate the potential causal relationship between the two variables.Results:The self-neglect scores for 1 495 older adults at T1, T2, and T3 were (2.84±1.39), (2.47±1.30), and (2.41±1.20), respectively, showing a declining trend. The frailty scores at T1, T2, and T3 were 0 (0, 1.00), 0 (0, 2.00), and 1.00 (0, 2.00), respectively, indicating an increasing trend. Cross-lagged analysis revealed that self-neglect at T1 positively predicted frailty at T2 (β=0.076, P=0.004). Frailty at both T1 and T2 positively predicted self-neglect at T2 (β=0.057, P=0.044) and T3 (β=0.058, P=0.029), respectively. Conclusions:Frailty among older adults positively predicts self-neglect, and self-neglect also has a certain predictive effect on frailty. Medical staff should strengthen early screening and intervention for frailty in older adults to delay the occurrence and progression of self-neglect.

Aim To investigate the association of triglyceride-glucose(TyG)index with microvascular obstruction(MVO)after percutaneous coronary intervention(PCI)in patients with ST-segment elevated myocardial infarction(STEMI).Methods Individual patient-data were pooled from 310 patients with STEMI underwent emergency PCI in Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School from June 2018 to June 2021 for a prospective analysis.A week following the operation,cardiac magnetic resonance imaging was used to evaluate the MVO region and the patients were divided into two groups based on whether MVO occured after PCI:the MVO group(n=183)and the non-MVO group(n=127).The clinical data of the two groups were compared,and the linear relationship between TyG index and MVO was described using restricted cubic splines(RCS).Univariate and multivariate Logistic regression analysis were used to correct for confounding factors and identify independent risk factors for MVO occurrence.Results After adjustment for confounding factors,TyG index was an independent risk factor for MVO after emergency PCI in STEMI patients,and every 1-unit increased in TyG index,the risk of MVO increased by 1.24 times(OR=2.24,95％CI:1.07～4.71,P=0.033).The RCS curve analysis results showed that there was a linear re-lationship between the TyG index and the occurrence of MVO after emergency PCI(non-linear correlation test P=0.47).When the TyG index was greater than 9.5,the risk of MVO after emergency PCI significantly increased.Conclusion An increased TyG index is postively associated with the incidence of MVO in STEMI patients who have undergone PCI,and has clinical significantce for early prevention and risk stratification of MVO in STEMI patients.

Objective:To evaluate the short-term and long-term effects of different incentive strategies on attracting physicians from secondary and higher-level hospitals to work in primary health institutions, and to analyze the influencing factors in depth.Methods:Based on the preference probabilities of physicians from secondary and higher-level hospitals to work in primary health institutions, as measured by a discrete choice experiment model, a Markov model was constructed to simulate physician mobility between different types of health institutions. The model was used to assess the long-term attractiveness of various intervention strategies and to identify key factors affecting physicians′ decisions to work in primary health institutions.Results:Increasing salary by 10% and providing permanent positions (bianzhi) were found to be the most effective strategies for attracting physicians from secondary and higher-level hospitals to primary health institutions, increasing physicians′ preference probabilities by 54.5% and 58.5%, respectively. The 20-year Markov model simulation of physician mobility showed that, without intervention, the number of physicians in primary health institutions would decline from 171 to 33, while the gap with secondary and higher-level hospitals would continue to widen. Simulations examining the effects of different job attributes revealed that 9 factors, including working in township hospitals or community health service centers, maintaining or increasing current salary, having record-based tenure or bianzhi, working 40-60 hours or>40 h per week, and receiving higher local recognition and respect, could effectively attract physicians to primary health institutions. Among these, a 10% salary increase and bianzhi provision could increase the number of physicians in primary institutions to 361 and 364, respectively. Moreover, greater local recognition and respect for physicians could help sustain long-term growth in the number of primary healthcare physicians.Conclusions:Strategies of increasing annual salary and offering bianzhi can effectively attract a large number of high-quality physicians to primary health institutions in the short term; however, their effectiveness gradually diminishes over time. To achieve sustainable long-term in the number of physicians in primary health institutions, further research is needed to evaluate the effectiveness of other incentive strategies and to develop a comprehensive incentive strategy combination.

Lacking therapeutic targets highlights the crucial roles of chemotherapy and radiotherapy in the clinical management of triple-negative breast cancer (TNBC). To relieve the side effects of the chemoradiotherapy combination regimen, we design and develop a self-assembled micelle nanosystem consisting of perfluorocarbon chain-modified cisplatin prodrug. By incorporating perfluorodecalin, this nanosystem can effectively carry ozone and promote irradiation-derived reactive oxygen species (ROS) production. By leveraging the perfluorocarbon sidechain, the nanosystem exhibits efficient internalization by TNBC cells and effectively escapes from lysosomal entrapment. Under X-ray irradiation, ozone-generated ROS disrupts the intracellular redox balance, thereby facilitating the release of cisplatin in a reduction-responsive manner mediated by reduced glutathione. Moreover, oxygen derived from ozone decomposition enhances the efficacy of radiotherapy by alleviating tumor hypoxia. Notably, the combination of irradiation with ozone-loaded cisplatin prodrug nano system synergistically prompts antitumor efficacy and reduces cellular/systemic toxicity in vitro and in vivo. Furthermore, the combo regimen remodels the tumor microenvironment into an immune-favored state by triggering immunogenic cell death and relieving hypoxia, which provides a promising foundation for a combination regimen of immunotherapy. In conclusion, our nanosystem presents a novel strategy for integrating chemotherapy and radiotherapy to optimize the efficacy and safety of TNBC clinical treatment.

Objective:To explore the mediating effect of dyadic coping between perceived social support and family cohesion and adaptability and happiness in spouses of patients with post-stroke motor impairments.Methods:From December 2023 to May 2024, a total of 366 spouses of patients with post-stroke motor impairments who received treatment at the First Affiliated Hospital of Zhengzhou University were recruited as study participants. Data were collected using the general information, perceived social support scale, dyadic coping inventory, Chinese version of the family cohesion and adaptability scale(FACESⅡ-CV), and memorial University of Newfoundland scale of happiness. The AMOS 21.0 software was utilized to construct a structural equation model to examine the mediating effect of dyadic coping between perceived social support, family cohesion and adaptability and happiness.Results:The spouses of patients with post-stroke motor impairments reported overall scores for perceived social support (62.80±12.80), dyadic coping (117.07±20.78), family cohesion and adaptability (115.96±19.51), and happiness (22.27±7.29). Family cohesion and adaptability was positively correlated with dyadic coping and perceived social support ( r=0.614, 0.520, both P<0.01).Spousal happiness was positively correlated with dyadic coping and perceived social support ( r=0.296, 0.202, both P<0.01).The spouses recognized that perceived social support had a positive correlation with dyadic coping ( r=0.479, P<0.01).Dyadic coping played a partial mediating effect between perceived social support and family cohesion and adaptability as well as happiness, accounting for 32.41% (0.211/0.651) and 44.39% (0.190/0.428) of the total effect, respectively. Conclusion:Dyadic coping is the mediating variable of family cohesion, adaptability and happiness of spouses of patients with post-stroke motor impairments. Medical staff should try to construct a dyadic coping intervention plan to improve the dyadic coping level of spouses of patients with post-stroke motor impairments, so as to improve their family happiness index.

Objective:To explore the mediating effect of dyadic coping between perceived social support and family cohesion and adaptability and happiness in spouses of patients with post-stroke motor impairments.Methods:From December 2023 to May 2024, a total of 366 spouses of patients with post-stroke motor impairments who received treatment at the First Affiliated Hospital of Zhengzhou University were recruited as study participants. Data were collected using the general information, perceived social support scale, dyadic coping inventory, Chinese version of the family cohesion and adaptability scale(FACESⅡ-CV), and memorial University of Newfoundland scale of happiness. The AMOS 21.0 software was utilized to construct a structural equation model to examine the mediating effect of dyadic coping between perceived social support, family cohesion and adaptability and happiness.Results:The spouses of patients with post-stroke motor impairments reported overall scores for perceived social support (62.80±12.80), dyadic coping (117.07±20.78), family cohesion and adaptability (115.96±19.51), and happiness (22.27±7.29). Family cohesion and adaptability was positively correlated with dyadic coping and perceived social support ( r=0.614, 0.520, both P<0.01).Spousal happiness was positively correlated with dyadic coping and perceived social support ( r=0.296, 0.202, both P<0.01).The spouses recognized that perceived social support had a positive correlation with dyadic coping ( r=0.479, P<0.01).Dyadic coping played a partial mediating effect between perceived social support and family cohesion and adaptability as well as happiness, accounting for 32.41% (0.211/0.651) and 44.39% (0.190/0.428) of the total effect, respectively. Conclusion:Dyadic coping is the mediating variable of family cohesion, adaptability and happiness of spouses of patients with post-stroke motor impairments. Medical staff should try to construct a dyadic coping intervention plan to improve the dyadic coping level of spouses of patients with post-stroke motor impairments, so as to improve their family happiness index.

Objective:To explore the longitudinal predictive relationship between self-neglect and frailty among older adults.Methods:Data were drawn from the Chinese Longitudinal Healthy Longevity Survey conducted in 2011 (T1), 2014 (T2), and 2018 (T3). A total of 1 495 older adults aged≥65 years at T1 who participated in three consecutive surveys and had no missing key variables were included. General demographic information, self-neglect scores, and frailty status were extracted. Spearman correlation analysis was used to examine the association between self-neglect and frailty. Cross-lagged analysis was employed to investigate the potential causal relationship between the two variables.Results:The self-neglect scores for 1 495 older adults at T1, T2, and T3 were (2.84±1.39), (2.47±1.30), and (2.41±1.20), respectively, showing a declining trend. The frailty scores at T1, T2, and T3 were 0 (0, 1.00), 0 (0, 2.00), and 1.00 (0, 2.00), respectively, indicating an increasing trend. Cross-lagged analysis revealed that self-neglect at T1 positively predicted frailty at T2 (β=0.076, P=0.004). Frailty at both T1 and T2 positively predicted self-neglect at T2 (β=0.057, P=0.044) and T3 (β=0.058, P=0.029), respectively. Conclusions:Frailty among older adults positively predicts self-neglect, and self-neglect also has a certain predictive effect on frailty. Medical staff should strengthen early screening and intervention for frailty in older adults to delay the occurrence and progression of self-neglect.

Aim To investigate the association of triglyceride-glucose(TyG)index with microvascular obstruction(MVO)after percutaneous coronary intervention(PCI)in patients with ST-segment elevated myocardial infarction(STEMI).Methods Individual patient-data were pooled from 310 patients with STEMI underwent emergency PCI in Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School from June 2018 to June 2021 for a prospective analysis.A week following the operation,cardiac magnetic resonance imaging was used to evaluate the MVO region and the patients were divided into two groups based on whether MVO occured after PCI:the MVO group(n=183)and the non-MVO group(n=127).The clinical data of the two groups were compared,and the linear relationship between TyG index and MVO was described using restricted cubic splines(RCS).Univariate and multivariate Logistic regression analysis were used to correct for confounding factors and identify independent risk factors for MVO occurrence.Results After adjustment for confounding factors,TyG index was an independent risk factor for MVO after emergency PCI in STEMI patients,and every 1-unit increased in TyG index,the risk of MVO increased by 1.24 times(OR=2.24,95％CI:1.07～4.71,P=0.033).The RCS curve analysis results showed that there was a linear re-lationship between the TyG index and the occurrence of MVO after emergency PCI(non-linear correlation test P=0.47).When the TyG index was greater than 9.5,the risk of MVO after emergency PCI significantly increased.Conclusion An increased TyG index is postively associated with the incidence of MVO in STEMI patients who have undergone PCI,and has clinical significantce for early prevention and risk stratification of MVO in STEMI patients.

Objective:To evaluate the short-term and long-term effects of different incentive strategies on attracting physicians from secondary and higher-level hospitals to work in primary health institutions, and to analyze the influencing factors in depth.Methods:Based on the preference probabilities of physicians from secondary and higher-level hospitals to work in primary health institutions, as measured by a discrete choice experiment model, a Markov model was constructed to simulate physician mobility between different types of health institutions. The model was used to assess the long-term attractiveness of various intervention strategies and to identify key factors affecting physicians′ decisions to work in primary health institutions.Results:Increasing salary by 10% and providing permanent positions (bianzhi) were found to be the most effective strategies for attracting physicians from secondary and higher-level hospitals to primary health institutions, increasing physicians′ preference probabilities by 54.5% and 58.5%, respectively. The 20-year Markov model simulation of physician mobility showed that, without intervention, the number of physicians in primary health institutions would decline from 171 to 33, while the gap with secondary and higher-level hospitals would continue to widen. Simulations examining the effects of different job attributes revealed that 9 factors, including working in township hospitals or community health service centers, maintaining or increasing current salary, having record-based tenure or bianzhi, working 40-60 hours or>40 h per week, and receiving higher local recognition and respect, could effectively attract physicians to primary health institutions. Among these, a 10% salary increase and bianzhi provision could increase the number of physicians in primary institutions to 361 and 364, respectively. Moreover, greater local recognition and respect for physicians could help sustain long-term growth in the number of primary healthcare physicians.Conclusions:Strategies of increasing annual salary and offering bianzhi can effectively attract a large number of high-quality physicians to primary health institutions in the short term; however, their effectiveness gradually diminishes over time. To achieve sustainable long-term in the number of physicians in primary health institutions, further research is needed to evaluate the effectiveness of other incentive strategies and to develop a comprehensive incentive strategy combination.

Fibroblast activation protein inhibitors(FAPI)can specifically bind to fibroblast activation protein,which is highly expressed in tumor stroma,and 68Ga-FAPI do not get involved into the procedure of glucose metabolism in tumor cells.68Ga-FAPI PET/CT and PET/MR can be used for displaying malignant tumors at various sites and play a unique role for diagnosis and differential diagnosis.The research progresses of 68 Ga-FAPI-based PET/CT and PET/MR for diagnosing malignant tumors were reviewed in this article.