This study examines the effects of zearalenone(ZEA)on the survival and function of lu-teinized granulosa cells,and studies the role of activating transcription factor 6(ATF6)in regula-ting apoptosis and functional abnormalities of luteinized granulosa cells induced by ZEA.An in vitro model of luteinized granulosa cells was utilized to examine the effects of ZEA treatment on apoptosis,hormone secretion,and the expression of relevant proteins.Furthermore,the expression of ATF6 was manipulated using siRNA to elucidate its regulatory function in the ZEA-induced damage of luteinized granulosa cells in mice.Our findings revealed that ZEA inhibited the activity of luteinized granulosa cells and reduced the secretion of estradiol(E2)and progesterone(P4)in a dose-dependent manner.The expression levels of p-IRE1,ATF6 and StAR in both low(20 pmol/L)and high(40 μmol/L)ZEA groups were significantly increased after 24 h(P＜0.05).GRP78 had no significant change at low concentration treatment(P＞0.05),but significantly increased at high concentration treatment(P＜0.05).Similarly,ATF4 and p-EIF2α had no significant change at low concentration treatment(P＞0.05),but significantly decreased at high concentration treat-ment(P＜0.05).HSD3B2 and CYP19A1 were significantly decreased in both low and high concentration treatments(P＜0.05).After 48 h of treatment,ATF6 and GRP78 were significantly increased in both low and high concentration treatments(P＜0.05).p-IRE1 was significantly de-creased at low concentration treatment(P＜0.05),but remained unchanged at high concentration treatment(P＞0.05).ATF4,p-EIF2α,HSD3B2 and CYP19A1 were significantly decreased in both low and high concentration treatments(P＜0.05).St AR was significantly increased in both low and high concentration treatments(P＜0.05).Interference with the expression of ATF6 could sig-nificantly reduce the apoptosis induced by low concentration group(P＜0.05),and enhanced the hormone secretion in both high and low concentration groups(P＜0.05).In conclusion,ZEA can cause damage to luteinized granulosa cells and activate ATF6 signaling pathway.Interference with ATF6 can alleviate apoptosis and hormone secretion disturbance induced by low concentration ZEA,but has limited effect on damage caused by high concentration ZEA.

This study examines the effects of zearalenone(ZEA)on the survival and function of lu-teinized granulosa cells,and studies the role of activating transcription factor 6(ATF6)in regula-ting apoptosis and functional abnormalities of luteinized granulosa cells induced by ZEA.An in vitro model of luteinized granulosa cells was utilized to examine the effects of ZEA treatment on apoptosis,hormone secretion,and the expression of relevant proteins.Furthermore,the expression of ATF6 was manipulated using siRNA to elucidate its regulatory function in the ZEA-induced damage of luteinized granulosa cells in mice.Our findings revealed that ZEA inhibited the activity of luteinized granulosa cells and reduced the secretion of estradiol(E2)and progesterone(P4)in a dose-dependent manner.The expression levels of p-IRE1,ATF6 and StAR in both low(20 pmol/L)and high(40 μmol/L)ZEA groups were significantly increased after 24 h(P＜0.05).GRP78 had no significant change at low concentration treatment(P＞0.05),but significantly increased at high concentration treatment(P＜0.05).Similarly,ATF4 and p-EIF2α had no significant change at low concentration treatment(P＞0.05),but significantly decreased at high concentration treat-ment(P＜0.05).HSD3B2 and CYP19A1 were significantly decreased in both low and high concentration treatments(P＜0.05).After 48 h of treatment,ATF6 and GRP78 were significantly increased in both low and high concentration treatments(P＜0.05).p-IRE1 was significantly de-creased at low concentration treatment(P＜0.05),but remained unchanged at high concentration treatment(P＞0.05).ATF4,p-EIF2α,HSD3B2 and CYP19A1 were significantly decreased in both low and high concentration treatments(P＜0.05).St AR was significantly increased in both low and high concentration treatments(P＜0.05).Interference with the expression of ATF6 could sig-nificantly reduce the apoptosis induced by low concentration group(P＜0.05),and enhanced the hormone secretion in both high and low concentration groups(P＜0.05).In conclusion,ZEA can cause damage to luteinized granulosa cells and activate ATF6 signaling pathway.Interference with ATF6 can alleviate apoptosis and hormone secretion disturbance induced by low concentration ZEA,but has limited effect on damage caused by high concentration ZEA.

Objective:To examine the effect of social support on benefit finding in patients with advanced gastrointestinal cancer and the mediating role of spirituality in this relationship, providing insights for promoting psychological well-being in gastrointestinal cancer patients.Methods:A convenience sampling method was used to select 300 inpatients with advanced gastrointestinal cancer admitted to the Department of Integrated Traditional Chinese Medicine, Sun Yat-sen University Cancer Center, from February 2022 to December 2023. Patients were surveyed using the General Information Questionnaire, Benefit Finding Scale (BFS), Perceived Social Support Scale (PSSS), and Spiritual Attitude and Involvement List (SAIL). Pearson correlation analysis was used to assess correlations between social support, spirituality, and benefit finding. Mediation analysis was conducted using model 4 in the PROCESS macro in SPSS 24.0.Results:A total of 300 questionnaires were distributed, with 295 valid responses (effective response rate of 98.33%). The mean scores for BFS, PSSS, and SAIL among 295 patients were (72.62±6.30), (62.31±10.41), and (100.17±17.34), respectively. Both social support and spirituality were positively correlated with benefit finding ( r=0.540 and 0.529, P<0.05), and social support was positively correlated with spirituality ( r=0.611, P<0.05). Social support positively predicted benefit finding directly, and the mediating effect of spirituality between social support and benefit finding was 0.194, accounting for 35.79% of the total effect. Conclusions:Providing strong social support while fostering patients' spirituality can significantly enhance their benefit finding.

Objective:To examine the effect of social support on benefit finding in patients with advanced gastrointestinal cancer and the mediating role of spirituality in this relationship, providing insights for promoting psychological well-being in gastrointestinal cancer patients.Methods:A convenience sampling method was used to select 300 inpatients with advanced gastrointestinal cancer admitted to the Department of Integrated Traditional Chinese Medicine, Sun Yat-sen University Cancer Center, from February 2022 to December 2023. Patients were surveyed using the General Information Questionnaire, Benefit Finding Scale (BFS), Perceived Social Support Scale (PSSS), and Spiritual Attitude and Involvement List (SAIL). Pearson correlation analysis was used to assess correlations between social support, spirituality, and benefit finding. Mediation analysis was conducted using model 4 in the PROCESS macro in SPSS 24.0.Results:A total of 300 questionnaires were distributed, with 295 valid responses (effective response rate of 98.33%). The mean scores for BFS, PSSS, and SAIL among 295 patients were (72.62±6.30), (62.31±10.41), and (100.17±17.34), respectively. Both social support and spirituality were positively correlated with benefit finding ( r=0.540 and 0.529, P<0.05), and social support was positively correlated with spirituality ( r=0.611, P<0.05). Social support positively predicted benefit finding directly, and the mediating effect of spirituality between social support and benefit finding was 0.194, accounting for 35.79% of the total effect. Conclusions:Providing strong social support while fostering patients' spirituality can significantly enhance their benefit finding.

Objective:To understand the current management status of chronic obstructive pulmonary disease (COPD) in county-level hospitals in China from 2020 to 2021.Methods:This survey was led by the China Association of County Hospital President. In 2021, a questionnaire survey was conducted on 633 secondary and tertiary hospitals from 24 provinces, and the questionnaire was filled out according to the actual situation of the hospital in 2020, including diagnosis, treatment, rehabilitation and comprehensive management of COPD. The nature of the hospital was divided into public or private. The type of hospital was divided into general or specialist. The economic zones was divided into eastern, central or western. Through the content of the questionnaire, the influencing factors of the diagnosis, treatment and management capabilities of COPD in county-level hospitals were explored.Results:A total of 633 questionnaires were collected in this survey, and 26 were removed due to the incorrect information or information loss. Thus, a total of 607 questionnaires were finally included in this survey, including 425 secondary hospitals and 182 tertiary hospitals; 591 public hospitals and 16 private hospitals. For the capabilities of diagnosis and treatment, the tertiary hospital was significantly better than the secondary hospital on the availability of respiratory outpatient clinics, COPD outpatient clinics, outpatient comprehensive clinics, respiratory ward and intensive care unit (ICU) (94.5% and 78.4%, 51.1% and 32.7%, 79.7% and 67.3 %, 84.6% and 59.8%, 78.6% and 61.9%, respectively) (all P<0.01). In terms of lung function test and bronchodilation test, tertiary hospitals performed significantly better than secondary hospitals ( P<0.05). There was no difference in availability of inhaled bronchodilators and expectorant drugs among different hospital levels, nature, type, and economic zones ( P>0.05). However, the proportion of hospitals with available triple inhalation drugs was lower in secondary hospitals than tertiary hospitals. For the non-drug treatment, the proportion of general hospitals carrying out vaccination was significantly higher than that of specialized hospitals (52.7% and 28.1%, P=0.010). The tertiary hospitals performed significantly better than secondary hospitals in smoking cessation guidance (98.4% and 94.4%, P=0.031). In terms of rehabilitation, tertiary hospitals also performed significantly better than secondary hospitals (79.7% and 61.9%, P<0.001). The proportion of hospitals carrying out long-term management of COPD in tertiary hospitals was significantly higher than secondary hospitals, and the proportion in public hospitals was significantly higher than private hospitals (80.2% and 61.2%, 68.2% and 18.8%, both P<0.001). Conclusions:County hospitals in China have a good overall performance in the diagnosis and drug treatment of COPD, but need to be further improved in non-drug treatment, rehabilitation, and comprehensive management. The hospital level is the main factor affecting the management ability of COPD. The nature and type of hospital mainly affect the construction of departments and comprehensive management of COPD.

Objective:To explore the effect of nursing services under the Internet platform in cancer patients.Methods:From July 2019 to July 2021, convenience sampling was used to select patients who were diagnosed with cancer for the first time in the Department of Comprehensive Diseases of the Sun Yat-Sen University Cancer Center. The patients were randomly divided into the intervention group and the control group by random number table. The control group was given routine nursing during hospitalization. On the basis of routine nursing, the intervention group implemented the intervention using the hospital's WeChat public platform, mobile APP and WeChat group as the main media. Adherence and self-efficacy were compared between the two groups.Results:There was no significant difference in the adherence between the two groups one month after discharge ( P>0.05) . Three and six months after discharge, the adherence of the intervention group was higher than that of the control group, and the difference was statistically significant ( P<0.05) . There was no significant difference in the scores of total self-efficacy, self-decompression, self-decision-making and positive attitude between the two groups before intervention ( P>0.05) . After the intervention, the total score and each dimension score of self-efficacy in the intervention group were higher than those in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Nursing services based on the Internet platform can improve the adherence of newly diagnosed tumor patients and enhance patients' self-efficacy, which is worthy of clinical promotion.