With the deepening of population aging and the rising prevalence of chronic diseases among the elderly in China， the traditional elderly care models are facing challenges. This paper proposed a community-integrated medical-nursing-rehabilitation-care service model， characterized by “integration， flexibility， community orientation， and demand orientation.” This model optimizes and combines various service resources such as healthcare， elderly care， rehabilitation， and nursing at the community level， providing more comprehensive and targeted services for the elderly with chronic diseases in the community. However， a series of challenges existed in dimensions such as the service integration， benefit distribution， resources and funds， as well as policies and systems， hindering the sustainable development of the community-integrated medical-nursing-rehabilitation-care service model. Future efforts should focus on constructing a more standardized collaborative system， clarifying standards for resource investment and benefit distribution， as well as strengthening policy guidance， financial support， and talent team development.

Objective: To explore the longitudinal associations between non-restorative sleep (NRS) and non-suicidal self-injury (NSSI) among college freshmen, so as to provide a reference framework for intervention targeting adolescent NSSI behaviors. Methods: Utilizing a combination of convenience sampling and cluster randomized sampling, a 1 year longitudinal assessment across three time points (T1, T2, and T3) was conducted from October 2023 to October 2024 among 967 college freshmen recruited from a provincial university in Guangdong. The survey was administered using the Non restorative Sleep Scale (NRSS) and the Adolescent Non suicidal Self injury Assessment Questionnaire (ANSAQ). Data analysis was performed using unconditional latent growth curve modeling (LGCM), cross lagged panel modeling (CLPM), and parallel latent growth modeling. Results: The detection rates of NSSI behaviors in college students at T1, T2, and T3 were 18.20%, 11.89%, and 7.55%, respectively. From T1 to T3, NRSS scores showed a linear increasing trend ( β =0.67), while ANSAQ scores showed a linear downward trend ( β =-0.17) (both P < 0.05 ). Cross lagged analysis showed that NRSS scores negatively predicted ANSAQ scores (T1 NRSS scores → T2 ANSAQ scores: β =-0.10; T2 NRSS scores → T3 ANSAQ scores: β =-0.09; both P <0.01). However, in the reverse pathways, the predictive effects of ANSAQ scores on subsequent NRSS scores were not statistically significant ( β =-0.02, -0.02, both P >0.05). Parallel latent growth modeling indicated that both the initial level ( β =-0.49) and the rate of change ( β =-0.29) of NRSS scores predicted the developmental trajectory of ANSAQ scores (both P <0.05). Conclusions NRS is a risk factor for NSSI behaviors among college freshmen. Early assessment of and targeted interventions for NRS could potentially help mitigate the risk of NSSI occurrence.

Pancreatic cancer （PC）， a highly malignant tumor of the digestive system， is characterized by extremely high incidence and mortality rates， imposing a severe burden on the healthcare system. Despite significant advancements in comprehensive therapeutic strategies for PC， clinical benefits for patients remain limited due to the high heterogeneity and unique microenvironment of the tumor. Therefore， further elucidating the molecular mechanisms underlying PC progression and developing novel， effective therapeutic strategies have become an urgent necessity in the current research. Programmed cell death （PCD） is a genetically orchestrated process of autonomous cell demise that is crucial for maintaining cellular homeostasis. Recent studies have demonstrated that tumor cells can remodel the tumor microenvironment by modulating various PCD pathways—including apoptosis， autophagy， pyroptosis， and ferroptosis—thereby driving tumor proliferation， invasion， and drug resistance. Traditional Chinese medicine （TCM） possesses unique advantages in anti-tumor therapy， characterized by multi-component， multi-target， and multi-pathway regulation. Accumulating evidence suggests that TCM formulas and their natural active compounds can effectively delay the malignant progression of PC by modulating PCD in tumor cells. This article systematically summarizes the molecular mechanisms of PCD in PC progression and reviews the mechanisms by which TCM formulas and natural active compounds intervene in PC through PCD modulation. This review aims to provide theoretical support and future research directions for the prevention and treatment of PC with TCM.

ObjectiveTo investigate the effects of Dihuang Yinzi on the cognitive function in the mouse model of learning and memory impairments induced by scopolamine （SCOP） and explore the treatment mechanism. MethodsA mouse model of learning and memory impairment was induced by intraperitoneal injection of SCOP. Sixty male C57BL/6J mice were randomized into six groups： control （0.9% NaCl， n=10）， model （SCOP 1 mg·kg^-1·d^-1， n=10）， low-， medium-， and high-dose Dihuang Yinzi （SCOP 1 mg·kg^-1·d^-1 + Dihuang Yinzi 5.5， 11.0， and 22.0 g·kg^-1·d^-1， n=10）， and donepezil （SCOP 1 mg·kg^-1·d^-1 + donepezil 0.84 mg·kg^-1·d^-1， n=10）. Mice were administrated with corresponding drugs for 6 weeks. Modeling started in the 4th week， and mice in other groups except the control group were injected with SCOP intraperitoneally 40 min after daily gavage. Behavioral testing began in the 5th week， 30 min after modeling each day. The Morris water maze and novel object recognition tests were carried out to evaluate the spatial learning and memory function of mice. Nissl staining was employed to observe the survival of neurons and Nissl bodies in the hippocampal CA1 region. Western blot was employed to determine the protein levels of silent information regulator 2 （SIRT2）， α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid （AMPA） receptor 1 （GluA1）， protein kinase A （PKA）， cAMP response element-binding protein （CREB）， phosphorylated-CREB （p-CREB）， postsynaptic density protein 95 （PSD95）， growth-associated protein-43 （GAP-43）， and synaptophysin （SYN） in the hippocampus. Immunofluorescence was used to detect the expression of doublecortin （DCX） in the hippocampal dentate gyrus （DG） region. ResultsCompared with the control group， the model group showed impaired learning and memory （P<0.01）， obvious neuronal damage in the hippocampal CA1 region， a reduction in neuron survival （P<0.01）， a decrease in DCX expression in the hippocampal DG region （P<0.01）， down-regulated proteins levels of GluA1， PKA， p-CREB/CREB， PSD95， SYN， and GAP-43 in the hippocampal tissue （P<0.05， P<0.01）， and an up-regulated protein level of SIRT2 （P<0.01）. Compared with the model group， the medium- and high-dose Dihuang Yinzi groups and the donepezil group showed improvements in learning and memory （P<0.05， P<0.01）， while the low-， medium-， and high-dose Dihuang Yinzi groups and the donepezil group had increased neuron survival （P<0.05， P<0.01）. The medium-dose Dihuang Yinzi group and the donepezil group showed increased DCX expression （P<0.05， P<0.01）. The medium- and high-dose Dihuang Yinzi groups and the donepezil group showed up-regulation in the protein levels of GluA1， PKA， p-CREB/CREB， PSD95， SYN， and GAP-43 （P<0.05， P<0.01） and down-regulation in the protein level of SIRT2 （P<0.01）. ConclusionDihuang Yinzi can improve the cognitive function in the mouse model of learning and memory impairments induced by SCOP by inhibiting the upregulation of SIRT2， activating the PKA/CREB signaling pathway， improving synaptic plasticity， and reducing hippocampal neuronal damage.

Objective: To investigate whether armillariella tabescens polysaccharides (ATPS) alleviates inflamma- tory responses and tissue damage in 5-fluorouracil ( 5-FU ) -induced chemotherapy-induced intestinal mucositis ( CIM) by inhibiting the TLR4 /MyD88 /NF-κB signaling pathway． Methods: Thirty 8-weeks-old male C57BL/6J mice were randomly divided into five groups ( n = 6 per group) : control group，model group ，and ATPS-treated groups (low，medium，high dose : 100，200，400 mg / kg) ．Body weight changes were recorded ; Disease activity in- dex (DAI) scores were evaluated ; small intestinal length and histopathology were measured ; HE staining and his- topathological scoring were performed ; immunohistochemistry was used to detect the expression of tight junction pro- teins (ZO-1，Occludin) in the small intestine ; serum levels of inflammatory cytokines interleukin-6 ( IL-6 ) and tumor necrosis factor-alpha (TNF-α) were analyzed by enzyme-linked immunosorbent assay (ELISA) kit ; Western blot was employed to quantify ZO-1，Occludin，and TLR4 /MyD88 /NF-κB pathway-related protein TLR4，MyD88，NF-κB p65，IκBα , p-NF-κB p65，p-IκBα protein expression． Results : Compared with the control group，mice in the model group exhibited significant reductions in body weight ，elevated DAI scores ，shortened small intestinal length，increased histopathological scores，marked downregulation of ZO-1 and Occludin expression，and elevated levels of inflammatory cytokines TNF-α and IL-6．Additionally，protein expression levels of TLR4，MyD88，p-NF- κB p65，and p-IκBα were significantly upregulated ( all P ＜0. 01 ) ． In contrast ，mice in ATPS-treated groups showed dose-dependent improvements，attenuated weight loss，reduced DAI scores，restored intestinal length，de- creased histopathological scores，upregulated ZO-1 and Occludin expression，reduced TNF-α and IL-6 levels，and downregulated TLR4，MyD88，p-NF-κB p65，and p-IκBα protein expression (all P＜0. 01) ． Conclusion ATPS alleviates 5-FU-induced CIM by inhibiting the TLR4 /MyD88 /NF-κB signaling pathway．

Objective: To explore the longitudinal relationships between sleep problems and non suicidal self injury (NSSI) behaviors in college students, so as to provide a theoretical basis for the prevention and intervention of NSSI. Methods: In October 2023 (T1), a total of 1 009 college students from two provincial colleges in Guangdong were selected by using a combination of convenience sampling and stratified cluster random sampling for a 1 year follow up survey (October 2024, T2). The students were assessed by using the Insomnia Severity Index(ISI), Non restorative Sleep Scale(NRSS), Epworth Sleepiness Scale (ESS), and Adolescent Non suicidal Self injury Assessment Questionnaire(ANSAQ). Data analysis was performed using McNemar’s test and Logistic regression. Results: The detection rate of NSSI behaviors was 18.83% at T1 and decreased to 7.73% at T2, with a statistically significant difference ( χ 2=66.24, P <0.01). The trajectories of NSSI behaviors were divided into persistent group (4.06%), new onset group (3.67%), remission group (14.77%), and resistance group (77.50%). Logistic regression analysis showed that sleep less than 7 hours per day at night, insomnia (mild, moderate to severe), non restorative sleep (moderate, severe), daytime sleepiness, and weekly nightmare frequency (1-2, ≥3 times) were associated with NSSI behaviors at T1 ( OR =5.02, 2.39, 5.51, 3.47, 9.70, 2.36, 2.63, 4.74, all P <0.01). Insomnia (mild, moderate to severe), severe non restorative sleep, daytime sleepiness, and weekly nightmares ≥3 times at T1 all increased the risk of NSSI behaviors at T2 ( OR =1.76, 4.15, 4.05, 1.88, 5.63, all P < 0.05 ). Moderate to severe insomnia, severe non restorative sleep, daytime sleepiness, and weekly nightmares ≥3 times at T1 increased the risk of belong to the new onset NSSI group ( OR =5.05, 3.37, 2.08, 5.86, all P <0.05). Conclusions Insomnia, non restorative sleep, daytime sleepiness, and frequent nightmares are important risk factors for NSSI behaviors among college students. Early assessment and intervention of sleep problems may be an important strategy for the prevention and treatment of NSSI.

Porcine reproductive and respiratory syndrome virus(PRRSV)mainly causes sow abor-tion,stillbirth,mummified fetus and respiratory symptoms in piglets.Since first reported in China in 1996,the virus complexity has increased significantly in more than 20 years of genetic evolution,bringing huge economic losses to the pig industry.In recent years,with the emergence of various PRRSV recombinant virus strains,preventing and controlling this epidemic became increasingly difficult.The purpose of this article is to comprehensively review the genome structure and func-tion of PRRSV,RNA virus recombination mechanism,main types of recombination,and the epi-demic status and recombination for the dominant epidemic PRRSV strains,in order to provide clues for in-depth research on gene recombination of PRRSV,thus providing the theoretical sup-port for formulating scientific prevention and control strategies.

Objective:To investigate the role of calcium-binding protein S100A9 in acute lung injury induced by hepatic ischemia-reperfusion (HIR) in mice, and to explore its relationship with nuclear factor erythroid 2-related factor 2 (Nrf2).Methods:A total of 12 specific pathogen-free (SPF) male wild-type (WT) and 12 S100A9 knockout (S100A9 KO) C57BL/6J mice aged 6~8 weeks and weighing 20-25 g were randomly divided into four groups using a random number table: WT+Sham group, S100A9 KO+Sham group, WT+HIR group, and S100A9 KO+HIR group ( n=6 per group). The HIR model was established by clamping the portal vein and hepatic artery of the left and median liver lobes for 60 minutes followed by reperfusion. At 6 hours post-reperfusion, mice were anesthetized again, and blood samples were collected from the inferior vena cava. Both lungs were harvested. The lung wet-to-dry (W/D) weight ratio was measured. Hematoxylin and eosin (HE) staining was used to assess histopathological changes and calculate lung injury scores. The levels of inflammatory markers—S100A9, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) —as well as oxidative stress indicators including myeloperoxidase (MPO), reactive oxygen species (ROS), malondialdehyde (MDA), and superoxide dismutase (SOD) in serum and lung tissue were measured. Western blotting was used to assess the expression levels of nuclear and cytoplasmic Nrf2, and cytoplasmic HO-1. Results:Compared with the WT+Sham group, both the WT+HIR and S100A9 KO+HIR groups showed significantly increased lung injury scores, W/D ratio, TNF-α, IL-6, ROS, MPO, and MDA levels (all P<0.05). Compared with the WT+HIR group, the S100A9 KO+HIR group exhibited significantly reduced levels of these indicators (all P<0.05). Moreover, the S100A9 KO+HIR group showed elevated nuclear Nrf2 expression and decreased cytoplasmic Nrf2 expression, accompanied by increased expression of HO-1, Gclm, Gclc, and Nqo1 (all P<0.05). Conclusion:Upregulation of S100A9 is involved in the development of HIR-induced acute lung injury, possibly through inhibition of Nrf2 nuclear translocation.

BACKGROUND:Irisin plays a crucial role in the physiological regulation of the body,advancing the browning process of white adipose tissue cells and exerting significant effects on the regulation of energy metabolism,thermogenesis,reduction of oxidative stress,and body mass loss.OBJECTIVE:To summarize the latest research progress in irisin and related diseases.METHODS:A computerized search of PubMed,MedReading,Web of Science,CNKI,WanFang,and VIP was performed to collect studies on the effect of irisin on relevant diseases.The search time was from January 1,2011 to April 13,2024.The search terms were"irisin,physical exercise,FNDC5,disease"in Chinese and English.According to the inclusion and exclusion criteria,71 papers were finally included for review.RESULTS AND CONCLUSION:Irisin has important roles in anti-inflammation,fat metabolism,bone metabolism,brain health,cancer,diabetes,cardiovascular disease and kidney disease.Moreover,exercise can promote the expression of irisin,and different forms of exercises have different effects on irisin levels.Acute exercise,long-term exercise,resistance exercise and high-intensity exercise can all enhance irisin levels.The discovery of irisin provides a new potential basis for exercise therapy,which is a promising therapeutic target due to the multiple biological functions of irisin,and shows potential therapeutic value in the treatment of human metabolic diseases and their complications,obesity,and cancer.Irisin has a promising application as a potential target for the treatment of obesity,cognitive function,cardiovascular,cancer and other diseases in clinical practice.However,its specific mechanism of action still needs to be studied in depth,and there may be side effects.In the future,an in-depth understanding of the mechanism of irisin is needed to provide a more adequate basis for the treatment of obesity,cognitive dysfunction,cardiovascular disease,and cancer.

Background Polycyclic aromatic hydrocarbons (PAHs) are widely known atmospheric pollutants, which can cause serious harm to human body and ecological environment. Objective To analyze the concentrations and sources of PAHs in atmospheric PM_2.5 in Zhifu District and Longkou City during the heating period in Yantai. Methods Two monitoring sites in Zhifu District and Longkou City of Yantai were selected, and PM_2.5 sample collection was carried out from April 2023 to March 2024. Gas chromatography-mass spectrometry was applied to analyze the concentrations of PAHs in atmospheric PM_2.5 during the heating period (from November 2023 to March 2024) and the non-heating period (from April to October 2023). The concentrations of PAHs in the two periods were compared and the sources of PAHs during the heating period were analyzed by characteristic ratio method. Results During the heating period, the total concentration ranges of PAHs in atmospheric PM_2.5 at the monitoring sites in Zhifu District and Longkou City of Yantai were (1.59-23.70) ng·m⁻³ and (2.08-149.72) ng·m⁻³ respectively, and the medians (M) and the 25th and 75th percentiles (P₂₅, P₇₅) were 4.99 (2.61, 8.09) ng·m⁻³ and 15.46 (8.15, 29.05) ng·m⁻³ respectively. The PAHs concentrations in Longkou City were significantly higher than those in Zhifu District in all months (P<0.05). The highest median total concentrations of PAHs in both sites were reported in January (8.14 ng·m⁻³ and 81.56 ng·m⁻³ respectively). In the non-heating period, the M (P₂₅, P₇₅) of the total PAHs concentrations at the two sites were 1.59 (1.59, 2.78) ng·m⁻³ and 4.11 (2.94, 7.97) ng·m⁻³ respectively, much lower than those in the heating period (P<0.01). The order of composition of PAHs by ring number in PM_2.5 at both sites was 4-ring> 5-ring> 6-ring, with the 4-ring contributing the largest proportion (65.33% and 46.39% respectively). Fluoranthene had the highest concentration among PAHs at both sites, with concentrations M (P₂₅, P₇₅) of 1.29 (0.51, 1.78) ng·m⁻³ and 2.32 (1.30, 3.82) ng·m⁻³ respectively. The characteristic ratios of fluoranthene/(fluoranthene + pyrene), fluoranthene/pyrene, benzo[a]anthracene/(benzo[a]anthracene + chrysene), pyrene/benzo[a]pyrene, benzo[a]pyrene/(benzo[a]pyrene + chrysene), benzo[a]pyrene/benzo[g,h,i]pyrene, and indeno[1,2,3-c,d]pyrene/(indeno[1,2,3-c,d]pyrene + benzo[g,h,i]pyrene) in Zhifu District were 0.62, 1.65, 0.41, 4.48, 0.50, 0.93 and 0.47 respectively, and those in Longkou were 0.57, 1.35, 0.40, 2.89, 0.29, 0.79 and 0.47 respectively. The results showed that PAHs pollutants were generated by combination of coal combustion, vehicle exhaust emissions and gasoline combustion. Conclusion During the heating period in Yantai area, the total concentration of PAHs in atmospheric PM_2.5 is significantly higher than that in the non-heating period. Among them, during the heating period, the pollution level in Longkou City is significantly higher than that in Zhifu District. The local PAHs may be sourced from mixed pollution, and the main sources include gasoline, and coal combustion and vehicle exhaust emissions.