Objective:This study was aimed to explore the preference and heterogeneity in community health management service model selection among older patients with multiple chronic diseases,and to provide scientific evidence for optimizing the model.Methods:A multi-stage stratified and convenience sampling approach was adopted.A discrete choice experiment was conducted with 360 elderly patients with multiple chronic diseases from six regions in Jiangsu Province.The Mixed Logit Model was used to analyze service selection preferences and willingness to pay,while the Latent Class Logit Model was applied to explore heterogeneity among patient groups.Results:Patients showed a stronger preference for a service model featuring"twice-monthly visits,medication guidance+lifestyle counseling,and face-to-face consultations,"with willingness to pay values of 170.18 CNY,162.90 CNY,and 112.70 CNY,respectively.Willingness to pay decreased as out-of-pocket costs increased.Heterogeneity analysis identified three distinct preference groups,with statistically significant differences in urban-rural distribution,income levels,and health insurance types.Conclusions and suggestions:Medication and lifestyle guidance are the most valued components of community health management services among older patients with multiple chronic diseases.Patients'demographic and socioeconomic characteristics have a structural influence on their service preferences,highlighting the need to tailor service provision to different population groups.It is recommended to enhance medication guidance capacity at the primary care level,especially in rural areas;promote physical medicine integration to improve the accuracy and effectiveness of lifestyle guidance provided by primary healthcare personnel;strengthen digital infrastructure and streamline service processes to moderately increase the frequency of face-to-face consultations;and improve the integration of medical insurance and public health funding mechanisms to enhance service accessibility and equity.

Objective To investigate the effects of ischemia time and storage periods on RNA quality in fresh-frozen breast cancer(BC)and esophageal cancer(EC)tissue samples in order to establish evidence-based protocols for biobank sample management.Methods The tumor(T)and paired normal(N)tissue samples from 6 cases of BC and 6 cases of EC were collected and cryopreserved in Biobank,Shantou Central Hospital.Mirror paraffin-embedded tissues were simultaneously prepared into sections for morphological analysis.The samples were divided into two groups of<15 min and 15-30 min according to ischemia time,and RNA quality was analyzed at 4 storage periods of 8-10 months(T1),14-16 months(T2),26-28 months(T3)and 38-40 months(T4).Results In 96 analyzed samples,93.8%(90/96)exhibited high quality(RIN≥6),with 89.6%(43/48)in BC and 97.9%(47/48)in EC.Significant differences in RIN were observed between BC group and EC group(8.050 vs.8.600,P=0.009).In EC group,RIN value was significantly negatively correlated with RNA yield(P<0.001).Moreover,RIN values of tumor-normal pairs exhibited markedly significant differences(7.550 vs.9.000,P<0.001).In contrast,no significant difference was detected in BC group(8.200 vs.7.700,P=0.348).Statistical analysis showed that RIN value was positively correlated with 28S/18S(P<0.001),but had no correlation with tumor content(P=0.676)and necrotic content(P=0.055).Neither ischemia time(<15 min vs.15-30 min:8.200 vs.8.300,P=0.932)nor storage periods(T1-T4:8.400,7.700,8.450,8.600,P=0.163)compromised RNA quality.Conclusion Organ origin and tissue type could influence RNA quality of fresh-frozen tissue samples.However,limited ischemia time(≤30 min)and long-term storage period(38-40 months)do not adversely affect RNA quality in fresh-frozen breast cancer and esophageal cancer tissue samples.

Abstract Alzheimer′s disease(AD) is a common neurodegenerative disease. It has been found that AD is related to various pathogenic factors such as genetics, cardiovascular and cerebrovascular disease, and excessive phosphorylation of tau protein. However, no definitive conclusions on its pathogenesis have been reached. In this paper, the research progress on the pathogenesis of AD inC.elegansmodel and the therapeutic effects of traditional Chinese medicine extracts on AD are reviewed, providing a basis for further research on the alleviating effects of Chinese medicine extracts on AD.

Objective To summarize the perioperative nursing experience of a child with Angelman syndrome(AS)complicated with moderate scoliosis undergoing posterior 3-dimensional osteotomy correction,fusion,and internal fixation under general anesthesia.Methods The clinical data of the child with AS and moderate scoliosis who underwent surgical treatment in our hospital on Aug.4,2023,were analyzed.A multidisciplinary team was established upon admission.Relevant literatures and evidences were reviewed to develop and implement a"1+X"nursing plan,which included 2 components:"1"(core perioperative nursing priorities for scoliosis)and"X"(multiple AS-related nursing issues and corresponding strategies).Results The surgery was successful,with stable postoperative conditions and significant improvement in spinal curvature.The child's height increased by 7 cm.Discharge occurred on postoperative day 10,with 100%follow-up compliance.The child regained preoperative independent walking ability during follow-up.Conclusion The"1+X"nursing protocol for AS complicated with scoliosis can effectively ensure perioperative safety and promote recovery,which providing insights for perioperative nursing care of other rare diseases complicated with scoliosis.

With the acceleration of the global aging process and the widespread use of electronic devices,eye health problems have gradually become a focus of public concern.Presbyopia is a physiological phenomenon and an inevitable vis-ual problem that is prevalent among middle-aged and elderly individuals.It is noteworthy that the traditional term"presbyo-pia"has now been renamed as"close-range eye strain".This change more accurately reflects the visual fatigue caused by the decline in the eye's accommodative function and illustrates the widespread nature of the phenomenon and its trend to-wards younger populations.The timely identification of close-range eye strain,along with the adoption of effective treat-ment measures,is of great significance for slowing the progression of the condition,protecting the near vision of middle-aged and elderly individuals,and improving their quality of life.To promote the application and popularization of the new term"close-range eye strain"and to update its knowledge structure and cognitive system,this article interprets the key as-pects of the current understanding of close-range eve strain.

Dry eye is a common ocular condition characterized by symptoms such as eye dryness,irritation,and blurred vision.The main treatment of dry eye has been for a long time to supplement tear components,including the use of artificial tears,punctal occlusion,and meibomian gland expression.However,these methods have proven ineffective for some patients,making the exploration of new treatment mechanisms particularly important.In recent years,neurostimula-tion therapy has emerged as a novel treatment approach and received widespread attention in the field of dry eye treatment.In this article,the current applications of neurostimulation in the treatment of dry eye and its potential future applications were thoroughly investigated,aiming to provide a reference for further research on neurostimulation therapy in the treat-ment of dry eye.

An imbalance between oxidative and antioxidant defense mechanisms in the body triggers oxidative stress,which causes a series of damages to the body,tissues and cells.The eye is particularly susceptible to oxidative stress due to its prolonged exposure to light and its anatomical characteristics of high metabolism and oxygen consumption.In addi-tion,inflammation,aging,genetic and environmental factors can promote the production of reactive oxygen species and weaken antioxidant defense mechanisms,which are all risk factors for oxidative stress that can lead to a variety of ocular diseases.The aim of this paper is to review the mechanisms of oxidative stress in ocular diseases such as ocular surface diseases,glaucoma,cataract,and retinopathy.At the same time,the potential therapeutic approaches to these diseases by regulating oxidative stress are discussed,so as to provide new ideas and directions for the diagnosis and treatment of ocular diseases.

Ophthalmic surgery is characterized by limited operational space and high precision requirements,and tradi-tional surgical methods find it difficult to satisfy increasingly growing surgical needs.With the rapid advancement of medical technology,microsurgical robots have gained widespread attention and application in the field of ophthalmology due to their high precision,flexibility,and repeatability.This paper provides a comprehensive overview of the latest research progress in ophthalmic microsurgical robots,covering the current development,technological advancements,current application status,and challenges faced in the field.It also offers a forward-looking discussion on future trends in development.