Neuropathic pain is frequently comorbidity with cognitive deficits. Neuralized1 (Neurl1)-mediated ubiquitination of CPEB3 in the hippocampus is critical in learning and memory. However, the role of Neurl1 in the cognitive impairment in neuropathic pain remains elusive. Herein, we found that lumbar 5 spinal nerve ligation (SNL) in male rat-induced neuropathic pain was followed by learning and memory deficits and LTP impairment in the hippocampus. The Neurl1 expression in the hippocampal CA1 was decreased after SNL. And this decrease paralleled the reduction of ubiquitinated-CPEB3 level and reduced production of GluA1 and GluA2. Overexpression of Neurl1 in the CA1 rescued cognitive deficits and LTP impairment, and reversed the reduction of ubiquitinated-CPEB3 level and the decrease of GluA1 and GluA2 production following SNL. Specific knockdown of Neurl1 or CPEB3 in bilateral hippocampal CA1 in naïve rats resulted in cognitive deficits and impairment of synaptic plasticity. The rescued cognitive function and synaptic plasticity by the treatment of overexpression of Neurl1 before SNL were counteracted by the knockdown of CPEB3 in the CA1. Collectively, the above results suggest that the downregulation of Neurl1 through reducing CPEB3 ubiquitination and, in turn, repressing GluA1 and GluA2 production and mediating synaptic plasticity impairment in hippocampal CA1 leads to the genesis of cognitive deficits in neuropathic pain.
Animals ; Male ; Neuralgia/metabolism* ; Rats ; Down-Regulation/physiology* ; Ubiquitination/physiology* ; Neuronal Plasticity/physiology* ; Rats, Sprague-Dawley ; CA1 Region, Hippocampal/metabolism* ; Cognitive Dysfunction/metabolism* ; RNA-Binding Proteins/metabolism* ; Receptors, AMPA/metabolism*

Objective To compare six existing Chinese standards related to visual disability,including Disability Assessment and Code for Life Insurance(Insurance Standard),Specification for Ability Assessment of Older Adults(Elderly Stan-dard),Grading of Disability due to Human Body Injury(Judicial Standard),Standard for Identify Work Ability—Gradation of Disability Caused by Work-related Injuries and Occupational Diseases(Work Injury Standard),Standard for Assessment of Disability Grades of Military Personnel(Military Standard),and Classification and Grading Criteria of Disability(Disability Classification Standard).Methods Based on the theoretical framework of International Classification of Functioning,Disability and Health(ICF)and International Classification of Diseases,the 11th Revision(ICD-11),and with reference to World Report on Vision(WRV),this study analyzed and compared five key dimensions of visual disability across the six stan-dards:definition,classification,grading,assessment methods and coding systems.Results In terms of definition,the insurance,work injury,military,and disability classification standards emphasized vi-sual structure and function,focusing on visual acuity and visual field;the insurance and elderly standards incor-porated activities and participation,reflecting the concept of functional vision;the judicial standard lacked a dedi-cated definition of visual disability.In terms of grading,each standard graded visual disability into different lev-els acoording to different functional indicators.In terms of coding,only the insurance standard adopted the ICF framework,while others used non-ICF numeric codes or lacked standardized coding.In terms of assessment tools,the elderly standard employed a customized perceptual and participation scoring system,while others re-lied primarily on vision charts.Conclusion Most current Chinese standards focus on impairments in visual function,with limited attention to activity limitations and participation restrictions.It is needed for incorporating the concept of functional vision,aligned with ICF and WRV,to establish a unified conceptual framework,terminology,coding system for visual disability,and comprehensive assessments that reflect not only impairments but also the impact on daily functioning and en-vironmental interaction.

Objective:To explore and evaluate the optimization and application of case-based learning (CBL) in the reform practice for integrated curriculum of the digestive system.Methods:The 174 undergraduate students majoring in eight-year clinical medicine enrolled in 2019 at the Peking University Health Science Center were selected as research objects. CBL was used in the integration and optimization of the digestive system curriculum. These included increasing class hours, selecting disease modules, lesson preparation involving multi-disciplinary teachers, and joint teaching. Upon completion of teaching, a comprehensive evaluation of teaching effectiveness was conducted through questionnaires administrated to teachers and students, feedback from supervision experts, and scores of students. SPSS 21.0 was used for the t-test and a reliability analysis was conducted on the questionnaire results. Results:Teachers, students, and supervision experts were highly satisfied with CBL. More than 95% of teachers believed that joint teaching facilitated the sharing of diverse professional knowledge among teachers, enhanced the in-depth instruction of imaging knowledge, promoted the transformation of teaching ideas, and improved teaching ability. More than 70% of students agreed that joint teaching deepened their understanding of diseases, stimulated learning interest, and established a theoretical foundation for clinical practice. The average score of class performance was (47.60±2.41) points (a total score of 50 points). The answers of students to case-based questions in final exams were satisfactory. The average score of final evaluation was (82.24±8.82) points.Conclusions:The optimization and application of CBL in the integrated curriculum of the digestive system is highly accepted by teachers and students. This method improves the interest of learning and facilitates the establishment of overall medical thinking and clinical thinking in students.

Objective To compare six existing Chinese standards related to visual disability,including Disability Assessment and Code for Life Insurance(Insurance Standard),Specification for Ability Assessment of Older Adults(Elderly Stan-dard),Grading of Disability due to Human Body Injury(Judicial Standard),Standard for Identify Work Ability—Gradation of Disability Caused by Work-related Injuries and Occupational Diseases(Work Injury Standard),Standard for Assessment of Disability Grades of Military Personnel(Military Standard),and Classification and Grading Criteria of Disability(Disability Classification Standard).Methods Based on the theoretical framework of International Classification of Functioning,Disability and Health(ICF)and International Classification of Diseases,the 11th Revision(ICD-11),and with reference to World Report on Vision(WRV),this study analyzed and compared five key dimensions of visual disability across the six stan-dards:definition,classification,grading,assessment methods and coding systems.Results In terms of definition,the insurance,work injury,military,and disability classification standards emphasized vi-sual structure and function,focusing on visual acuity and visual field;the insurance and elderly standards incor-porated activities and participation,reflecting the concept of functional vision;the judicial standard lacked a dedi-cated definition of visual disability.In terms of grading,each standard graded visual disability into different lev-els acoording to different functional indicators.In terms of coding,only the insurance standard adopted the ICF framework,while others used non-ICF numeric codes or lacked standardized coding.In terms of assessment tools,the elderly standard employed a customized perceptual and participation scoring system,while others re-lied primarily on vision charts.Conclusion Most current Chinese standards focus on impairments in visual function,with limited attention to activity limitations and participation restrictions.It is needed for incorporating the concept of functional vision,aligned with ICF and WRV,to establish a unified conceptual framework,terminology,coding system for visual disability,and comprehensive assessments that reflect not only impairments but also the impact on daily functioning and en-vironmental interaction.

Objective:To explore and evaluate the optimization and application of case-based learning (CBL) in the reform practice for integrated curriculum of the digestive system.Methods:The 174 undergraduate students majoring in eight-year clinical medicine enrolled in 2019 at the Peking University Health Science Center were selected as research objects. CBL was used in the integration and optimization of the digestive system curriculum. These included increasing class hours, selecting disease modules, lesson preparation involving multi-disciplinary teachers, and joint teaching. Upon completion of teaching, a comprehensive evaluation of teaching effectiveness was conducted through questionnaires administrated to teachers and students, feedback from supervision experts, and scores of students. SPSS 21.0 was used for the t-test and a reliability analysis was conducted on the questionnaire results. Results:Teachers, students, and supervision experts were highly satisfied with CBL. More than 95% of teachers believed that joint teaching facilitated the sharing of diverse professional knowledge among teachers, enhanced the in-depth instruction of imaging knowledge, promoted the transformation of teaching ideas, and improved teaching ability. More than 70% of students agreed that joint teaching deepened their understanding of diseases, stimulated learning interest, and established a theoretical foundation for clinical practice. The average score of class performance was (47.60±2.41) points (a total score of 50 points). The answers of students to case-based questions in final exams were satisfactory. The average score of final evaluation was (82.24±8.82) points.Conclusions:The optimization and application of CBL in the integrated curriculum of the digestive system is highly accepted by teachers and students. This method improves the interest of learning and facilitates the establishment of overall medical thinking and clinical thinking in students.

Objective:To investigate the association of malnutrition based on Global Leadership Initiative on Malnutrition (GLIM) criteria with the disease activity and clinical outcomes in hospitalized ulcerative colitis (UC) patients.Methods:Clinical data of 115 patients with UC hospitalized in the Affiliated Hospital of Qingdao University from September 2019 to March 2023 were prospectively analyzed. GLIM and European Society for Clinical Nutrition and Metabolism (ESPEN) 2015 criteria were used for the diagnosis of malnutrition, allowing the analysis of consistency between two diagnostic criteria for malnutrition. The relationship between malnutrition based on GLIM criteria and disease activity and clinical outcome was further investigated. The risk factors of adverse clinical outcomes in UC patients were analyzed using binary logistic regression.Results:GLIM and ESPEN 2015 diagnostic criteria showed high correlation and consistency (AUC=0.875, P<0.001; K=0.809, P<0.001). According to GLIM criteria, the prevalence of malnutrition among hospitalized UC patients was 32.17% (37 cases). Compared with non-malnourished UC patients, the modified Mayo score and C-reactive protein level of malnutrition patients were higher ( P<0.005), and the proportion of patients with severe disease activity was higher ( P=0.005). UC patients in the malnourished group had longer hospital stay ( P<0.001), higher hospitalization costs ( P<0.001), and higher rates of drug escalation/conversion therapy, re-admission and surgery at 12 weeks and 54 weeks ( P<0.05). Binary logistic regression analysis showed that a high Mayo score ( OR=3.606, P=0.016), a high modified Mayo score ( OR=1.346, P=0.009) and malnutrition ( OR=1.430, P=0.012) were independent risk factors for adverse clinical outcomes of hospitalized UC patients at 12 weeks. A high modified Mayo score ( OR=6.491, P=0.011) and malnutrition as per GLIM criteria ( OR=6.693, P=0.033) were independent risk factors for adverse clinical outcomes of hospitalized UC patients at 54 weeks. Conclusions:GLIM and ESPEN 2015 diagnostic criteria show high consistency in the diagnosis of malnutrition in hospitalized UC inpatients. Malnutrition may imply adverse clinical outcomes of hospitalized UC patients, which is an independent risk factor for the adverse clinical outcome of hospitalized UC patients.

‍ ObjectiveTo investigate the serum level of HBV RNA in untreated or treatment-experienced patients with chronic hepatitis B （CHB） and the correlation between serum HBV RNA level and the duration of antiviral therapy with nucleos（t）ide analogues （NAs）. MethodsA total of 300 patients with CHB who attended Department of Infectious Diseases in The First Affiliated Hospital of Shihezi University School of Medicine from February to July， 2022， were enrolled as subjects. Related clinical data were collected， and according to the duration of antiviral therapy， they were divided into untreated group with 73 patients， treatment duration ≤1 year group with 91 patients， and treatment duration >1 year group with 136 patients. Serum HBV RNA load， HBV DNA load， and HBsAg concentration were measured for all patients. The Mann-Whitney U test was used for comparison of continuous data between two groups， and the Kruskal-Wallis H test was used for comparison between multiple groups， further pairwise comparison using Bonferroni method； the chi-square test was used for comparison of categorical data； a Spearman correlation analysis was used to investigate the degree of correlation between various indicators. ResultsThe positive rate of HBeAg was 18.3%， and among the patients with negative HBV DNA， the patients with positive HBV RNA accounted for 44.1% （86/195）. There was a significant difference in the distribution of the serum levels of HBV RNA， HBV DNA， and HBsAg between the positive HBeAg group and the negative HBeAg group （Z=10.740， 6.300， and 7.280， all P<0.05）. There was a significant difference in the distribution of DNA level between the untreated group and the treatment duration ≤1 year group （P<0.05）； there was a significant difference in the distribution of HBV RNA and HBV DNA levels between the untreated group and the treatment duration >1 year group （P<0.05）； there was a significant difference in the distribution of HBV RNA， HBV DNA， and HBsAg levels between the treatment duration ≤1 year group and the treatment duration >1 year group （P<0.05）. The correlation analysis between the duration of antiviral therapy and the levels of HBV RNA， HBV DNA， and HBsAg showed that the duration of antiviral therapy had an extremely weak negative correlation with the levels of HBV RNA and HBsAg （r=-0.247 and -0.138， both P<0.05） and a strong negative correlation with the level of HBV DNA （r=-0.771， P<0.001）. There was a low degree of correlation between the serum level of HBV RNA and the serum levels of HBV DNA and HBsAg （r=0.360 and 0.442， both P<0.001）. Further stratified analysis showed that in the untreated group， there was a strong positive correlation between HBV RNA and HBV DNA （r=0.752， P<0.001） and a moderate positive correlation between HBV RNA and HBsAg （r=0.559， P<0.001）； in the treatment duration ≤1 year group， there was a low degree of positive correlation between HBV RNA and HBV DNA/HBsAg （r=0.396 and r=0.388， both P<0.001）； in the treatment duration >1 year group， there was a low degree of positive correlation between HBV RNA and HBsAg （r=0.352， P<0.001）. ConclusionSerum HBV RNA is negatively correlated with the duration of treatment with NAs， and the correlation of HBV RNA with HBV DNA and HBsAg gradually decreases with the increase in the duration of treatment. Therefore， it can be used as a supplementary indicator for monitoring the level of virologic response in CHB patients to a certain extent， with a relatively high accuracy in reflecting the level of viral replication in untreated patients.

Objective To construct the theoretical framework of rehabilitation big data based on International Classification of Func-tioning,Disability and Health(ICF). Methods Drawing upon international rehabilitation policy documents,such as the World Health Organization's Rehabili-tation in health systems;Rehabilitation in health systems:guide for action;Rehabilitation indicator menu:a tool accompanying the Framework for Rehabilitation Monitoring and Evaluation(FRAME);Template for Rehabilita-tion Information Collection(TRIC):a tool accompanying the Systematic Assessment of Rehabilitation Situation(STARS);and Framework and Standards for Country Health Information Systems;this study examined the com-position and function of rehabilitation big data.The content structure of the rehabilitation big data domain was an-alyzed using the World Health Organization Family of International Classifications(WHO-FICs).Furthermore,the generation patterns of rehabilitation big data was constructed drawing on the Health Metrics Network and big data hierarchical classification. Results Within the six primary elements of the health service system,the information system element was particularly significant,encompassing a substantial branch known as rehabilitation big data.There were three components of rehabilitation big data:health condition,health-related factors and health services.The content framework for this data was derived from the WHO-FICs framework,which covered three dimensions:health and function,dis-ease and function,and disease,function and intervention.A comprehensive model for generating and applying re-habilitation big data in rehabilitation services was developed in line with the requirements for constructing big da-ta architectures.The sources of this data included population censuses,social registration information,population surveys,resources,services and personal records.The result chain of rehabilitation big data encompassed five major processes:input,process,output,outcome and impact.The processing and utilization of this data involved collection,storage,management,analysis and application. Conclusion A theoretical framework for rehabilitation big data has been constructed based on the ICF theory.

Objective To explore and organize the standards of rehabilitation big data. Methods The connotation and extension of rehabilitation big data were discussed based on International Classification of Functioning,Disability and Health(ICF)framework.Referring to the documents of Guidance on the analysis and use of routine health information systems rehabilitation module,Rehabilitation in health systems:guide for action,Rehabilitation indicator menu:a tool accompanying the Framework for Rehabilitation Monitoring and Evaluation(FRAME),and Data quality assurance.Module 1.Framework and metrics,the sources,patterns,clas-sification systems and coding standards were discussed under the ICF theory,and the metadata standards were ex-plored.The application and management of rehabilitation big data standards were discussed according to Nation-al Health Medical Big Data Standards,Security and Service Management Measures(Trial). Results The rehabilitation big data included rehabilitation service data and personal health data,coming from population-based and institution-based data,covering macro,meso and micro levels.The pattern of rehabilitation data flow corresponded to the interaction and source of the entire process of rehabilitation service,to organize and manage rehabilitation big data.The classification system included object classes,object feature classes,participant role classes,relationship classes,and activity and event classes,each of which was further subdivided into subcatego-ries to cover the entities,features,roles,relationships and activities involved in the rehabilitation process.The metadata standards included three levels:core,general and specialized metadata,ensuring standardized manage-ment,sharing and interoperability of rehabilitation data. Conclusion This study delves into the standardization of rehabilitation big data based on the ICF framework,encompass-ing multiple dimensions such as the connotation and extension of rehabilitation big data,data sources,data mod-els,classification systems,coding standards,and metadata standards.The construction of a rehabilitation big data standard system involves standardization efforts in various aspects,including data content,data structure,data coding,and metadata.These standards not only adhere to the norms of data flow,but also take into account the complexity of data composition.This system aligns with health big data standards,ensuring data consistency,ac-curacy,and interoperability,thus providing a foundation for effective exchange and comparison between different data sources.The establishment of a rehabilitation big data standard system not only ensures the standardized pro-cessing of rehabilitation big data,but also lays a solid foundation for effective exchange between rehabilitation big data and other health data,as well as for the widespread application of rehabilitation big data.This provides crucial support for improving the quality and efficiency of rehabilitation services,ensuring that patients receive appropriate care,rehabilitation and support.It holds significant theoretical and practical implications for promot-ing the development of the rehabilitation field.

ObjectiveTo systematically analyze international disability data policies and standards, as well as the application of disability data in policymaking, service optimization and inclusive social development, and to clarify the importance of international disability data policies, standard systems and disability data application for the development of disability-related services. MethodsThrough the analysis of policy content and research on the data standard system, this study explored the disability data policy framework, standard system and technical path of data interoperability and integration of international organizations including the United Nations (United Nations Statistics Division and United Nations Children's Fund), World Health Orgnization, United Nations Educational Scientific and Cultural Organization, and International Labour Organization. ResultsInternational organizations established disability data policy frameworks based on their respective mandates, involving data and service development, data standards, data governance, and data application. The international community established a disability data standard system for disability data collection, coding, exchange, interoperability, statistical analysis, data fusion and application. Building a standardized disability data standard system based on the framework of international health classification standards such as International Classification of Functioning, Disability and Health, and International Classification of Diseases, Eleventh Revision would ensure the consistency of cross-national disability data policies, and the interoperability and comparability of disability data, promoting the development of data-driven disability-related services, accurately identifying the service needs of people with disabilities, and optimizing service provision, thereby improving the quality of life and social participation of people with disabilities. ConclusionThe construction and implementation of international disability data policies and data standards have promoted the standardization and interoperability of disability data. With the application of big data, artificial intelligence and blockchain technologies in disability data, international cooperation and cross-industry data fusion in the field of disability data have been promoted, further promoting the development of data-driven disability services, ensuring equal opportunities for people with disabilities to enjoy service resources, and improving the coverage and quality of disability services.