Objective:To investigate the effects of moxibustion,filiform needle acupuncture,and electroacupuncture on synovial hypoxia and expression of synovial fibrosis markers[transforming growth factor(TGF)-β and collagen alpha-1(Ⅰ)chain(COL1A1)]in knee osteoarthritis(KOA)rats.Methods:Fifty Sprague-Dawley rats were randomly divided into a normal group,a model group,a moxibustion group,an acupuncture group,and an electroacupuncture group,with 10 rats in each group.Except for the normal group,rats in the other four groups were injected with sodium iodoacetate into the right knee joint cavity to establish KOA models.The right Futu(ST32)and Zusanli(ST36)were selected in the moxibustion,acupuncture,and electroacupuncture groups to perform the mild moxibustion with moxa sticks,filiform needle acupuncture,or electroacupuncture,respectively.Each intervention lasted 15 min,once every other day,and continued for 4 weeks,with a total of 14 interventions.The Lequesne score was used to evaluate the degree of knee dysfunction before and after intervention,and the rat's right knee joint diameter was measured to evaluate the degree of knee swelling.Morphological changes of the right knee joint synovial tissue were observed using hematoxylin-eosin staining.Hypoxia probe immunofluorescence staining was used to observe the degree of synovial hypoxia in rats.Western blotting was used to detect the protein expression levels of hypoxia-inducible factor(HIF)-1α,TGF-β,and COL1A1 in the synovial tissue of the right knee joints.Results:Before intervention,the Lequesne score and the right knee joint diameter in the other four groups increased significantly compared to the normal group(P<0.01).After intervention,the Lequesne score and the right knee joint diameter increased significantly in the model group compared to the normal group(P<0.01)together with worsened cartilage deformation and osteophytes,inflammatory cell infiltration and fibrosis in synovial tissue,and hypoxia degree,and the expression levels of HIF-1α,TGF-β,and COL1A1 proteins in the knee joint synovial tissue of rats increased(P<0.01).The Lequesne score and the right knee joint diameter decreased significantly(P<0.01 or P<0.05),the cartilage morphology was normal without obvious osteophytes,and the hypoxia degree reduced in the three intervention groups compared to the model group.Among them,the moxibustion group had the most notable improvement in hypoxia,synovial tissue fibrosis,angiogenesis,and inflammatory cell infiltration.The expression levels of HIF-1α,TGF-β,and COL1A1 proteins decreased in the moxibustion and electroacupuncture groups(P<0.01),and the expression levels of HIF-1α and TGF-β proteins were decreased in the acupuncture group(P<0.01).Conclusion:Moxibustion,filiform needle acupuncture,and electroacupuncture improve knee joint function and reduce knee joint swelling in KOA rats.The mechanism may be to improve synovial fibrosis of the knee joint by regulating HIF-1α;moxibustion has the best effect on improving hypoxia among the three interventions,but the effect of filiform needle acupuncture on COL1A1 is not significant.

[Purpose]To analyze the incidence and mortality of gastric cancer in Zhejiang cancer registration areas in 2021,and trends from 2000 to 2021.[Methods]The data of gastric cancer were obtained from Zhejiang cancer registration areas.The crude incidence/mortality rates,age-specific rates,and age-standardized incidence/mortality rates by Chinese standard population(ASRC)and the world standard population(ASRW)were calculated.The temporal trends were ana-lyzed by calculating annual percentage change(APC)and average annual percentage change(AAPC).[Results]A total of 7 602 new cases and 4 178 deaths of gastric cancer were reported in 2021.The incidence and mortality rates of gastric cancer in men were significantly higher than those in women;the incidence rate in urban areas was significantly higher than that in rural areas,while the mortality was slightly lower than that in rural areas.From 2000 to 2021,the ASRC of inci-dence rate decreased from 16.80/105 to 16.08/105(without statistical significance):an upward trend was observed from 2000 to 2009,whereas a downward trend became apparent from 2009 to 2021.From 2000 to 2021 the ASRC of mortality rate decreased from 13.59/105 to 8.02/105 with an AAPC of-2.62％(P＜0.001).The decline rate of female mortality rate(AAPC=-2.68％,95％CI:-3.61％～-1.68％,P＜0.001)was slightly higher than that of male(AAPC=-2.44％,95％CI:-3.06％～-1.61％,P＜0.001).[Conclusion]In 2021,both the incidence and mortality rates of gastric can-cer in Zhejiang Province were lower than the national average in China,which ranked 6th and 4th among all types of cancer.From 2000 to 2021,the overall burden of gastric cancer in Zhejiang Province showed a downward trend.

Objective To design a practice courses and competency-oriented training in rehabilitation psychology,in response to the demands of team-based and interprofessional practices for professionals,based on World Health Organization re-habilitation competency framework(RCF).Methods Using the five core domains of RCF(practice,professionalism,learning and development,management and leadership,and research),this study analyzed the competencies and role positioning of undergraduate rehabilita-tion psychology students within team-based and interprofessional rehabilitation settings.It identifies the core competencies needed in these contexts and corresponding practical teaching approaches,to enhance students'ability to translate disciplinary knowledge into team-based and interprofessional practice competencies in real-world rehabilitation scenarios.Results The study yielded a competency-oriented practical curriculum structured around the teamwork and interprofes-sional practice requirements for rehabilitation psychology professionals.Based on RCF,we defined specific core competencies and developed a curricular framework incorporating pedagogical methods such as integrated as-sessments based on International Classification of Functioning,Disability and Health,motivational interviewing,case study analysis,and standardized patient simulations.These methods are designed to build student proficien-cy in team communication,collaborative decision-making,case management and evidence-based practice.Conclusion In undergraduate rehabilitation psychology education,developing competency-based practical courses tar-geting team-based and interprofessional service competencies,which grounded in RCF,can enhance the quality and efficiency of talent cultivation in the field.It also helps improve students'capabilities in collaborative and in-terprofessional practice.RCF provides a theoretical foundation,practical tools,and reference frameworks for building competency-oriented curricula and instructional methods in rehabilitation psychology.

[This corrects the article DOI: 10.1016/j.apsb.2019.01.013.].

Objective To analyze the distribution characteristics and trends of occupational exposure types of medical radiation workers in Gansu Province, China, and to provide a basis for administrative departments to formulate and adjust radiation protection policies. Methods According to the radiation health information platform, the data of occupational exposure types of radiation workers in Gansu Province from 2014 to 2023 were obtained. The proportions of occupational exposure types in each physical examination year was statistically analyzed. Results From 2014 to 2023, the number of medical radiation workers accounted for more than 70% of the total number of radiation workers. The proportion of X-ray imaging diagnostic radiation workers in the total number of medical radiation workers gradually decreased but remained the highest, exceeding 68% annually. The proportion of interventional radiology workers in the total number of medical radiation workers increased from 13.8% to 25.5%. The proportions of radiation therapy and nuclear medicine workers in the total number of medical radiation workers increased slowly. The numbers of interventional radiology and radiotherapy workers in tertiary hospitals both accounted for more than 70% of the total number of such workers in the province. The proportion of interventional radiology workers increased and then decreased. The proportion of radiotherapy workers increased significantly from 70.5% to 93.0%. The number of nuclear medicine workers in tertiary hospitals accounted for more than 80% of such workers in the province. Conclusion Radiation protection policies and measures should be adjusted according to the changes in the types of occupational exposure. The focus of these policies and measures should differ depending on the level of healthcare institutions, the type of radiological diagnostic and therapeutic services, and the characteristics of various occupational exposure types .

Objective To design a practice courses and competency-oriented training in rehabilitation psychology,in response to the demands of team-based and interprofessional practices for professionals,based on World Health Organization re-habilitation competency framework(RCF).Methods Using the five core domains of RCF(practice,professionalism,learning and development,management and leadership,and research),this study analyzed the competencies and role positioning of undergraduate rehabilita-tion psychology students within team-based and interprofessional rehabilitation settings.It identifies the core competencies needed in these contexts and corresponding practical teaching approaches,to enhance students'ability to translate disciplinary knowledge into team-based and interprofessional practice competencies in real-world rehabilitation scenarios.Results The study yielded a competency-oriented practical curriculum structured around the teamwork and interprofes-sional practice requirements for rehabilitation psychology professionals.Based on RCF,we defined specific core competencies and developed a curricular framework incorporating pedagogical methods such as integrated as-sessments based on International Classification of Functioning,Disability and Health,motivational interviewing,case study analysis,and standardized patient simulations.These methods are designed to build student proficien-cy in team communication,collaborative decision-making,case management and evidence-based practice.Conclusion In undergraduate rehabilitation psychology education,developing competency-based practical courses tar-geting team-based and interprofessional service competencies,which grounded in RCF,can enhance the quality and efficiency of talent cultivation in the field.It also helps improve students'capabilities in collaborative and in-terprofessional practice.RCF provides a theoretical foundation,practical tools,and reference frameworks for building competency-oriented curricula and instructional methods in rehabilitation psychology.

Objective:To investigate the effects of moxibustion,filiform needle acupuncture,and electroacupuncture on synovial hypoxia and expression of synovial fibrosis markers[transforming growth factor(TGF)-β and collagen alpha-1(Ⅰ)chain(COL1A1)]in knee osteoarthritis(KOA)rats.Methods:Fifty Sprague-Dawley rats were randomly divided into a normal group,a model group,a moxibustion group,an acupuncture group,and an electroacupuncture group,with 10 rats in each group.Except for the normal group,rats in the other four groups were injected with sodium iodoacetate into the right knee joint cavity to establish KOA models.The right Futu(ST32)and Zusanli(ST36)were selected in the moxibustion,acupuncture,and electroacupuncture groups to perform the mild moxibustion with moxa sticks,filiform needle acupuncture,or electroacupuncture,respectively.Each intervention lasted 15 min,once every other day,and continued for 4 weeks,with a total of 14 interventions.The Lequesne score was used to evaluate the degree of knee dysfunction before and after intervention,and the rat's right knee joint diameter was measured to evaluate the degree of knee swelling.Morphological changes of the right knee joint synovial tissue were observed using hematoxylin-eosin staining.Hypoxia probe immunofluorescence staining was used to observe the degree of synovial hypoxia in rats.Western blotting was used to detect the protein expression levels of hypoxia-inducible factor(HIF)-1α,TGF-β,and COL1A1 in the synovial tissue of the right knee joints.Results:Before intervention,the Lequesne score and the right knee joint diameter in the other four groups increased significantly compared to the normal group(P<0.01).After intervention,the Lequesne score and the right knee joint diameter increased significantly in the model group compared to the normal group(P<0.01)together with worsened cartilage deformation and osteophytes,inflammatory cell infiltration and fibrosis in synovial tissue,and hypoxia degree,and the expression levels of HIF-1α,TGF-β,and COL1A1 proteins in the knee joint synovial tissue of rats increased(P<0.01).The Lequesne score and the right knee joint diameter decreased significantly(P<0.01 or P<0.05),the cartilage morphology was normal without obvious osteophytes,and the hypoxia degree reduced in the three intervention groups compared to the model group.Among them,the moxibustion group had the most notable improvement in hypoxia,synovial tissue fibrosis,angiogenesis,and inflammatory cell infiltration.The expression levels of HIF-1α,TGF-β,and COL1A1 proteins decreased in the moxibustion and electroacupuncture groups(P<0.01),and the expression levels of HIF-1α and TGF-β proteins were decreased in the acupuncture group(P<0.01).Conclusion:Moxibustion,filiform needle acupuncture,and electroacupuncture improve knee joint function and reduce knee joint swelling in KOA rats.The mechanism may be to improve synovial fibrosis of the knee joint by regulating HIF-1α;moxibustion has the best effect on improving hypoxia among the three interventions,but the effect of filiform needle acupuncture on COL1A1 is not significant.

[Purpose]To analyze the incidence and mortality of gastric cancer in Zhejiang cancer registration areas in 2021,and trends from 2000 to 2021.[Methods]The data of gastric cancer were obtained from Zhejiang cancer registration areas.The crude incidence/mortality rates,age-specific rates,and age-standardized incidence/mortality rates by Chinese standard population(ASRC)and the world standard population(ASRW)were calculated.The temporal trends were ana-lyzed by calculating annual percentage change(APC)and average annual percentage change(AAPC).[Results]A total of 7 602 new cases and 4 178 deaths of gastric cancer were reported in 2021.The incidence and mortality rates of gastric cancer in men were significantly higher than those in women;the incidence rate in urban areas was significantly higher than that in rural areas,while the mortality was slightly lower than that in rural areas.From 2000 to 2021,the ASRC of inci-dence rate decreased from 16.80/105 to 16.08/105(without statistical significance):an upward trend was observed from 2000 to 2009,whereas a downward trend became apparent from 2009 to 2021.From 2000 to 2021 the ASRC of mortality rate decreased from 13.59/105 to 8.02/105 with an AAPC of-2.62％(P＜0.001).The decline rate of female mortality rate(AAPC=-2.68％,95％CI:-3.61％～-1.68％,P＜0.001)was slightly higher than that of male(AAPC=-2.44％,95％CI:-3.06％～-1.61％,P＜0.001).[Conclusion]In 2021,both the incidence and mortality rates of gastric can-cer in Zhejiang Province were lower than the national average in China,which ranked 6th and 4th among all types of cancer.From 2000 to 2021,the overall burden of gastric cancer in Zhejiang Province showed a downward trend.

Objective To investigate the clinical value of extracellular volume(ECV)based on CT delayed phase in combination with pathologic indicators in predicting early recurrence of gastric mesenchymal tumors after surgery.Methods A retrospective case-control trial was conducted on the imaging,clinical and pathological data of 110 patients with gastric mesenchymal tumors who were surgically resected at the First Affiliated Hospital of Army Medical University from January 2011 to August 2022.They were 60 males and 50 females,at a mean age of 58±10 years.All of them received preoperative multiphase dynamic CT enhancement examination of the abdomen,and ECV value was calculated with the formula:ECV=(1-hematocrit)×(△HU tumor/△HU aorta).According to the postoperative recurrence within 24 months after surgery,they were divided into early recurrence group and non early recurrence group.Statistical indexes:① Consistency analysis.② The factors affecting early recurrence after resection of gastric mesenchymal stromal tumors were analyzed and a prediction model was conducted.Delong test was used to assess the predictive value of the model.Then a nomogram was plotted based on the combines model,and calibration curves were drawn to assess the efficacy of the column charts,and decision curve analysis(DCA)was adopted to assess the value of the model for clinical application.Results ① Consistency analysis.After 2 radiologists outlined the region of interest and obtained ECV value according to the above formula,The intraclass correlation coefficient(ICC)was 0.806.② For the 110 subjected patients,21 cases of them had early recurrence,and 89 one did not.Multivariate analysis showed that ECV value,risk degree,and tumor length were independent influencing factors for predicting early recurrence.Receiver operating characteristic(ROC)curve analysis indicated that the area under the curve(AUC)value of ECV,hazard degree,and tumor length diameter in predicting early recurrence was 0.838(95％CI 0.758～0.918),0.774(95％CI 0.656～0.892),and 0.700(95％CI 0.589～0.810),respectively,and the value of their combined model was 0.899(95％CI 0.811～0.987),which was higher than that of each independent model.The sensitivity and specificity of the combined model was 85.71％and 86.52％,respectively,and the optimal cutoff value was 0.19.Delong test revealed that there was statistical difference between the combined model and the clinical model established by the hazard level(Z=6.548,P＜0.001,95％CI 0.140～0.259).Calibration curve analysis suggested that the combined model had a better fit,and DCA displayed that the combined model had a better net benefit.Conclusion The model established by ECV combined with pathological indicators has good predictive performance and can be used as a more effective predictor of early recurrence of gastric mesenchymal tumors after surgery.

Objective:To analyze the epidemiological characteristics and risk factors of brucellosis in Yan'an City, and to provide a theoretical basis for scientifically formulating prevention and control measures for brucellosis.Methods:A descriptive analysis method was used to analyze the general information, epidemiological characteristics of confirmed brucellosis cases at General Hospital of Yan'an Second Medical Group from 2019 to 2023. Univariate and multivariate logistic regression models were used to analyze the risk factors for brucellosis infection in the population.Results:From 2019 to 2023, a total of 301 cases of brucellosis were confirmed, and the number of cases in each year was 1, 7, 85, 85 and 123 cases, respectively. There were 231 males and 70 females, with a gender ratio of 3.3 ∶ 1.0. The patients were mainly aged between 15 and 64 years old (88.70%, 267/301), with a higher incidence in summer and autumn (36.55%, 110/301; 30.23%, 91/301). The occupation was dominated by farmers (62.98%, 182/289). The area with the highest number of cases was Ansai District (20.67%, 62/300), followed by Baota District (19.33%, 58/300) and Zhidan County (17.67%, 53/300). The results of multivariate logistic analysis showed that contact with livestock and unprotected contact were risk factors for brucellosis infection ( OR = 2.81, 6.75, 95% CI: 1.14 - 5.98, 1.23 - 15.72, P < 0.05). Conclusions:From 2019 to 2023, the number of brucellosis cases in Yan'an has been increasing year by year, with a higher incidence among young and middle-aged people. Summer and autumn are the high incidence seasons for the disease, and Ansai District, Baota District, and Zhidan County are key areas for brucellosis prevention and control in Yan'an City. Failure to take protective measures when in contact with livestock can increase the probability of brucellosis infection.