Objective To explore the expression of epidermal growth factor and nuclear transcrip-tion factor kappa B(NF-κB)in elderly gliomas and their roles in malignant progression of the dis-ease.Methods A total of 240 elderly glioma patients undergoing surgical resection in our hospital from January 2020 to January 2023 were enrolled and served as an observation group.Another 100 patients receiving surgical treatment due to traumatic brain injury in our hospital during the same period were recruited and served as the control group.Immunohistochemical assay was used to detect the expression of epidermal growth factor and NF-κB in brain tissue.Cox regression analy-sis was employed to determine the independent influencing factors of malignant progression in the elderly glioma patients.Results The observation group had significantly higher epidermal growth factor expression score and NF-κB expression score than the control group(7.44±1.16 vs 3.68±0.51,6.49±1.02 vs 3.56±0.64,P＜0.01).The age,tumor pathological grade,surgical approach,postoperative radiotherapy,and epidermal growth factor and NF-κB expression levels were inde-pendent factors affecting the progression of elderly glioma patients(P＜0.05,P＜0.01).Conclusion The epidermal growth factor and NF-κB expression levels are independent influen-cing factors of progressive disease in elderly glioma patients,and can serve as evaluation indicators for postoperative progression in the patients.

Objective:To screen bile acid-related characteristic genes in IgA nephropathy (IgAN) based on the feature gene selection algorithm in the machine learning method, aiming to exploring the molecular biological mechanisms and biomarkers of IgAN.Methods:The gene expression data and sample grouping information of GSE93798, GSE116626 and GSE35487 were downloaded from the Gene Expression Omnibus (GEO). Bile acid-related gene sequences were obtained from the Molecular Signatures Database (MSigDB). R language was used to identify differentially expressed genes between IgAN samples and healthy control samples. Candidate genes were obtained by intersecting differentially expressed genes and bile acid-related genes. The least absolute shrinkage and selection operator (LASSO) algorithm in machine learning was used to screen the feature genes in the candidate genes as biomarkers, and the feature genes in the training set and validation set were analyzed by the rate of change index. Receiver operating characteristic curve (ROC) method was used to evaluate the diagnostic value of identified bile acid related characteristic genes for IgAN. Gene set enrichment analysis (GSEA) was used to analyze the Spearman correlation between the characteristic genes and all other genes and their related metabolic pathways. The expression of disease-characteristic genes in the kidney tissues of IgAN rats was validated by real-time PCR.Results:Gene expression information from kidney tissue samples of 20 IgAN cases and 22 healthy controls were obtained from GEO database. A total of 204 bile acid-related genes including 24 pathways were obtained from MSigDB. The results of gene differential expression analysis showed that 333 genes in the kidney tissues of IgAN patients were differentially expressed compared with those of healthy controls, including 102 up-regulated genes and 231 down-regulated genes, among which 12 differentially expressed genes were related to bile acid genes, as follows: NR1H4,SLC23A1, ALDH8A1, FABP1, ALB, SLC27A2, DIO1, CYP8B1, BBOX1, PIPOX, AKR1C1 and SLC10A2. Five characteristic genes ( NR1H4, SLC23A1, FABP1, ALB and AKR1C1) were screened by LASSO regression algorithm.ROC analysis results showed that in GSE93798 cohort genes, the AUC of NR1H4, SLC23A1, FABP1 and ALB genes with differential expression was >0.95 respectively in diagnosing IgAN, and that of AKR1C1 genes with differential expression was >0.85 in diagnosing IgAN. The gene expression data of SLC23A1 in GSE35487 cohort was missing. ROC analysis results of other four genes showed that the AUC of differential expression of ALB gene for IgAN was >0.95 respectively, that of NR1H4 gene was >0.70, and that of both FABP1 and AKR1C1 gene was >0.60. In the GSE116626 cohort genes, the AUC of five disease characteristic genes ( NR1H4, SLC23A1, FABP1, ALB, AKR1C1) for diagnosing IgAN was >0.60, respectively. These results suggested that 5 characteristic genes have certain distinguishing ability between IgAN group and control group. GSEA results were displayed that the characteristic genes were related to butyric acid metabolism, propionic acid metabolism, arginine and proline metabolism, valine leucine and isoleucine degradation, fatty acid metabolism, etc. These results suggested that five characteristic genes might be related to IgAN through the above metabolic mechanisms. The verification results of five bile acid characteristic genes in the rat model of IgAN in the kidney tissue showed that the expressions of four genes, NR1H4, SLC23A1, FABP1 and ALB, were higher than those of the control group, and there was no statistical significance in the expression of AKR1C1 gene between the two groups. Conclusions:The expression of bile acid-related characteristic genes is abnormal in the kidney tissue of IgAN patients. Four bile acid-related differentially expressed genes, NR1H4, SLC23A1, FABP1 and ALB, are expected to be biomarkers for non-invasive diagnosis and therapeutic targets .

Objective:To investigate the training needs of general practitioners in community health center in health care and management of older patients for developing a curriculum for the Extension for Community Health Outcomes (ECHO) project accordingly.Methods:This was a qualitative study. The semi-structured interviews were conducted with 20 community health center general practitioners (GPs) using focus groups between March 2024 and April 2024. The interview data were collated using Nvivo12 software and coded using thematic analysis. The focus of the interviews was on the challenges GPs face in health care of older people in the community and relevant training needs.Results:Three male and 17 female GPs took part in the interviews. The interviews showed that GPs in comminity health service centers faced multiple challenges in the helth management of older patients, including implementation of holistic treatment plans, time-consuming comprehensive patient assessment, lack of standardized medication selection, unclear referral processes and difficulties in establishing a trusting doctor-patient relationship. The study suggested that the design and development of training programs should encompass eight core components: differentiated end-of-life care for patients, nutritional advice, positive psychological intervention, software data-based health assessment, systematic geriatric medicine, updated clinical research findings, medication selection and treatment guidelines, and insulin resistance management.Conclusion:Through qualitative investigation, this study explored the challenges faced by general practitioners in providing health care for older patients and relevant training needs, which provids evidence for designing and developing corresponding curricula for ECHO projects.

Objective To investigate the effects of sufentanil on proliferation,invasion,migration,and apoptosis of thyroid cancer cells,and analyze whether its mechanism is related to the AMP-activated protein kinase(AMPK)-silent information regulator 1(SIRT1)-peroxisome proliferat or activator receptor gamma coactivator 1α(PGC-1α)signaling pathway.Methods The human thyroid cancer cell line(TPC-1)was separated into a control group,L,M,H-sufentanil groups,and H-sufentanil+AICAR group.TPC-1 cell activity,apoptosis,invasion,migration,and expression of proteins were detected using CCK-8 assay,flow cytometry,Transwell assay,scratch assay,and Western blot,respectively.Results Compared with the control group,the absorbance value,invasion number,scratch healing rate,cleaved-Caspase-3,programmed cell death 1 ligand 1,B lymphoblastoma-2,p-AMPK/AMPK,SIRT1,and PGC-1αprotein levels in L,M,and H-sufentanil groups were reduced;the apoptosis rate and Bax protein level were increased(P＜0.05).AICAR treatment reversed the effect of H-sufentanil on the above indicators(P＜0.05).Conclusion Sufentanil may inhibit the AMPK-SIRT1-PGC-1α signaling pathway,thereby inhibiting the proliferation and invasion migration of thyroid cancer cells,and promoting cell apoptosis.

Objective To explore the effect of combining case-based teaching method with micro teaching method in the teaching of rehabilitation nurses.Methods A total of 60 students from the rehabilitation department of a hospital were selected from January 2021 to December 2022 and divided into control group and observation group by drawing lots,with 30 cases in each group.The control group adopted the traditional teaching and case teaching mode,and the observation group adopted the Semi-nar-case teaching mode and microteaching mode.The results of operation examination,basic theory and independent learning a-bility were compared between the two groups.Results After two months of study,the observation group had higher scores in the operation exam and basic theory than the control group(P＜0.05);The observation group scored higher in self-directed learning ability than the control group(P＜0.05).Conclusion The combination of case teaching method and microteaching method in the teaching process of rehabilitation nurses is conducive to the students'learning of clinical theoretical knowledge and practical operation,and improving their self-learning ability in the learning process.

Objective To compare the effect of transcranial direct current stimulation(tDCS)combined with seated Taijiquan Yun-shou in different sequences on brain functional activation in healthy youths.Methods From September to December,2024,14 healthy young medical interns or probationers were recruited from the Fifth Hospital of Xiamen.They randomly completed three interventions in a crossover design:Yunshou training followed immediately by tDCS(Y-S group),tDCS intervention followed immediately by Yunshou training(S-Y group),and simultaneous implementation of tDCS intervention and Yunshou training(Sim group).Yunshou was practiced in a seated position.For tDCS,the anode was placed over the left primary motor cortex(M1),and the cathode over the right M1.Changes in oxyhemoglobin(HbO2)concentration in the regions of interest were mea-sured using functional near-infrared spectroscopy.Results Three cases dropped down.The brain regions with significant differences before and after intervention included:CH3,CH7 and CH23 of right prefrontal cortex(PFC)in Y-S group;CH12 of left PFC in S-Y group;and CH9,CH10 and CH25 of the left PFC,CH13 and CH14 of the left sensorimotor cortex(SMC),CH15 of the right pre-motor and supplementary motor cortex(PMC),and CH16 of the right SMC in Sim group(P<0.05).After inter-vention,HbO2 concentration was the highest in the bilateral PFC,bilateral PMC and left SMC in the Y-S group(P<0.05);and it was almost the same between Sim group and S-Y group(P>0.05),except that of the right PFC decreased in Sim group.Conclusion The sequential combination of brain-limb integrated regulation is a key factor influencing the immediate cor-tical activation pattern.

Objective To compare the effect of transcranial direct current stimulation(tDCS)combined with seated Taijiquan Yun-shou in different sequences on brain functional activation in healthy youths.Methods From September to December,2024,14 healthy young medical interns or probationers were recruited from the Fifth Hospital of Xiamen.They randomly completed three interventions in a crossover design:Yunshou training followed immediately by tDCS(Y-S group),tDCS intervention followed immediately by Yunshou training(S-Y group),and simultaneous implementation of tDCS intervention and Yunshou training(Sim group).Yunshou was practiced in a seated position.For tDCS,the anode was placed over the left primary motor cortex(M1),and the cathode over the right M1.Changes in oxyhemoglobin(HbO2)concentration in the regions of interest were mea-sured using functional near-infrared spectroscopy.Results Three cases dropped down.The brain regions with significant differences before and after intervention included:CH3,CH7 and CH23 of right prefrontal cortex(PFC)in Y-S group;CH12 of left PFC in S-Y group;and CH9,CH10 and CH25 of the left PFC,CH13 and CH14 of the left sensorimotor cortex(SMC),CH15 of the right pre-motor and supplementary motor cortex(PMC),and CH16 of the right SMC in Sim group(P<0.05).After inter-vention,HbO2 concentration was the highest in the bilateral PFC,bilateral PMC and left SMC in the Y-S group(P<0.05);and it was almost the same between Sim group and S-Y group(P>0.05),except that of the right PFC decreased in Sim group.Conclusion The sequential combination of brain-limb integrated regulation is a key factor influencing the immediate cor-tical activation pattern.

Objective To explore the effect of combining case-based teaching method with micro teaching method in the teaching of rehabilitation nurses.Methods A total of 60 students from the rehabilitation department of a hospital were selected from January 2021 to December 2022 and divided into control group and observation group by drawing lots,with 30 cases in each group.The control group adopted the traditional teaching and case teaching mode,and the observation group adopted the Semi-nar-case teaching mode and microteaching mode.The results of operation examination,basic theory and independent learning a-bility were compared between the two groups.Results After two months of study,the observation group had higher scores in the operation exam and basic theory than the control group(P＜0.05);The observation group scored higher in self-directed learning ability than the control group(P＜0.05).Conclusion The combination of case teaching method and microteaching method in the teaching process of rehabilitation nurses is conducive to the students'learning of clinical theoretical knowledge and practical operation,and improving their self-learning ability in the learning process.

Objective To investigate the effects of sufentanil on proliferation,invasion,migration,and apoptosis of thyroid cancer cells,and analyze whether its mechanism is related to the AMP-activated protein kinase(AMPK)-silent information regulator 1(SIRT1)-peroxisome proliferat or activator receptor gamma coactivator 1α(PGC-1α)signaling pathway.Methods The human thyroid cancer cell line(TPC-1)was separated into a control group,L,M,H-sufentanil groups,and H-sufentanil+AICAR group.TPC-1 cell activity,apoptosis,invasion,migration,and expression of proteins were detected using CCK-8 assay,flow cytometry,Transwell assay,scratch assay,and Western blot,respectively.Results Compared with the control group,the absorbance value,invasion number,scratch healing rate,cleaved-Caspase-3,programmed cell death 1 ligand 1,B lymphoblastoma-2,p-AMPK/AMPK,SIRT1,and PGC-1αprotein levels in L,M,and H-sufentanil groups were reduced;the apoptosis rate and Bax protein level were increased(P＜0.05).AICAR treatment reversed the effect of H-sufentanil on the above indicators(P＜0.05).Conclusion Sufentanil may inhibit the AMPK-SIRT1-PGC-1α signaling pathway,thereby inhibiting the proliferation and invasion migration of thyroid cancer cells,and promoting cell apoptosis.

Objective To explore the expression of epidermal growth factor and nuclear transcrip-tion factor kappa B(NF-κB)in elderly gliomas and their roles in malignant progression of the dis-ease.Methods A total of 240 elderly glioma patients undergoing surgical resection in our hospital from January 2020 to January 2023 were enrolled and served as an observation group.Another 100 patients receiving surgical treatment due to traumatic brain injury in our hospital during the same period were recruited and served as the control group.Immunohistochemical assay was used to detect the expression of epidermal growth factor and NF-κB in brain tissue.Cox regression analy-sis was employed to determine the independent influencing factors of malignant progression in the elderly glioma patients.Results The observation group had significantly higher epidermal growth factor expression score and NF-κB expression score than the control group(7.44±1.16 vs 3.68±0.51,6.49±1.02 vs 3.56±0.64,P＜0.01).The age,tumor pathological grade,surgical approach,postoperative radiotherapy,and epidermal growth factor and NF-κB expression levels were inde-pendent factors affecting the progression of elderly glioma patients(P＜0.05,P＜0.01).Conclusion The epidermal growth factor and NF-κB expression levels are independent influen-cing factors of progressive disease in elderly glioma patients,and can serve as evaluation indicators for postoperative progression in the patients.