The diagnosis and treatment resources for rare diseases in China are highly imbalanced. The basic diagnosis and treatment capabilities are weak, the diagnosis period for patients is long, and the rates of missed diagnosis and misdiagnosis are relatively high. The establishment of a hierarchical diagnosis and treatment system is the inevitable approach to enhancing the diagnosis and treatment standards of rare diseases. Currently, the implementation of the domestic hierarchical diagnosis and treatment system for rare diseases still confronts numerous challenges, such as ambiguous referral standards and processes of primary medical institutions, and ineffective information interaction among institutions at all levels. Thus, it is essential to facilitate high-level information construction for the hierarchical diagnosis and treatment of rare diseases. This paper explores the process of constructing a multidisciplinary joint remote diagnosis and treatment platform and a health management platform through informatization, with the hope of establishing two closed loops of digital diagnosis and treatment services and health follow-up management for patients with rare diseases, as well as achieving timely diagnosis and lifelong health management for patients. It integrates and optimizes auxiliary diagnostic tools, promotes the rapid dissemination of rare disease diagnosis and treatment experiences to the grassroots, enhances the information construction level of the hierarchical diagnosis and treatment system, and endeavors to address the practical predicament of weak diagnosis and treatment capabilities of rare diseases in grassroots medical institutions. Additionally, this paper proposes an essential approach for multi-dimensional independent innovation to guide the popularization of efficient and high-quality rare disease diagnosis and treatment services. By encompassing innovating the rare disease diagnosis and treatment collaboration network and multidisciplinary diagnosis and treatment model, facilitating the application of the latest biomedical and informatics technologies to the grassroots, and constructing a national intelligent data platform for rare disease innovation, a new model for rare disease services with Chinese characteristics will be established. This will significantly enhance the medical treatment level of rare diseases in China and strive for more benefits for patients.

Peptidylarginine deiminases 2(PADI2)is an enzyme that catalyzes the conversion of arginine residues to citrulline on protein peptides.Aberrant activation of PADI2 can induce excessive tissue inflammation and immune responses,thereby exacerbating the progression of autoimmune diseases(ADs).Through citrullination,PADI2 modifies protein structure and immunogenicity,influencing the production of autoantibodies and regulating the activity of immune cells such as neutrophils and macrophages.This review provides an overview of PADI2's functions and its pivotal role in ADs,with the objective of elucidating the mechanisms underlying ADs pathogenesis and identifying novel therapeutic targets and strategies for related diseases.

Peptidylarginine deiminases 2(PADI2)is an enzyme that catalyzes the conversion of arginine residues to citrulline on protein peptides.Aberrant activation of PADI2 can induce excessive tissue inflammation and immune responses,thereby exacerbating the progression of autoimmune diseases(ADs).Through citrullination,PADI2 modifies protein structure and immunogenicity,influencing the production of autoantibodies and regulating the activity of immune cells such as neutrophils and macrophages.This review provides an overview of PADI2's functions and its pivotal role in ADs,with the objective of elucidating the mechanisms underlying ADs pathogenesis and identifying novel therapeutic targets and strategies for related diseases.

Objective:To explore the effect of hyperbaric oxygen（HBO）combined with paclitaxel（PTX）on the proliferation，level of reactive oxygen species（ROS），and cell cycle of human gastric cancer AGS cell line cultured in vitro. Methods:After the completion of in vitro culture，the AGS cells were divided into four groups，including control group，PTX group，HBO group，and HBO+PTX group. Cell Counting Kit-8（CCK-8）assay was used to detect the inhibitory effect of HBO combined with PTX on the proliferation of AGS cells. Flow cytometry was adopted to detect the intracellular ROS level and cell cycle arrest. Western blotting was used to assess the expression levels of cell cycle-related proteins. Results:The survival rate of AGS cells in the HBO+PTX group was significantly lower than those in the control group and the HBO group（ P<0.01），and also lower than that in the PTX group（ P<0.05）. The ROS level of AGS cells in the HBO+PTX group was significantly higher than those in the control group and the HBO group（ P<0.01），and also higher than that in the PTX group（ P<0.05）. PTX blocked the AGS cell cycle in S phase（ P<0.05），and the percentage of cells at S phase in the HBO+PTX group was found slightly higher than that in the PTX group（ P>0.05）. The expression level of Cyclin A1 in the HBO+PTX group was significantly lower than those in the other three groups（ P<0.05 or P<0.01）；the expression level of CDK2 in the HBO+PTX group was lower than those in the control group and the HBO group（ P<0.05），and also slightly lower than that in the PTX group（ P>0.05）. Conclusion:HBO can effectively enhance the inhibitory effect of PTX on the proliferation of AGS cells，increase the intracellular ROS level in AGS cells，and block the cell cycle，thereby inhibiting the differentiation and proliferation of AGS cells.

Objective:To investigate the effect of hyperbaric oxygen（HBO）on the resistance of gastric cancer AGS cells to irinotecan（ITC）and its related regulatory mechanisms.Methods:Gastric cancer AGS cells were cultured in vitro，and the cells were divided into four groups according to the experimental design：control group，ITC group，HBO group，and HBO + ITC group. The effect of ITC combined with HBO on the proliferation rate of gastric cancer cells was detected by Cell Counting Kit-8（CCK-8）；the changes of apoptosis rate after ITC combined with HBO treatment of AGS cells were detected by flow cytometry；and the changes in the expression of apoptosis-related and drug resistance-related proteins in AGS cells were detected by Western blotting assay. Results:Compared with control group and HBO group，the proliferation of AGS cells in the HBO + ITC group was further inhibited，and its proliferation rate was significantly lower than those of the control group and HBO group（ P<0.01），and also lower than that of the ITC group（ P<0.05）. Compared with those in the control group and the HBO group，the apoptosis rate of AGS cells in the HBO+ITC group was significantly higher than those in the control group and the HBO group（ P<0.01），and also higher than that in the ITC group（ P < 0.05）. In the ITC group and HBO+ITC group，the expression of apoptosis-related and drug resistance-related proteins，including Bcl-2，caspase-9 and P-gp，were significantly decreased，while the expression of Bad，caspase-3 and PARP were significantly increased，and the differences were statistically significant（ P<0.05 or P<0.01）. Compared with the control group and HBO group，p-JNK expression was increased and STAT3 expression was decreased in the ITC group（ P<0.01）；compared with the ITC group，p-JNK expression was increased and STAT3 expression was decreased in the HBO+ITC group（ P<0.05 or P<0.01）. Conclusion:HBO combined with ITC can effectively inhibit the proliferation of gastric cancer AGS cells，affect the apoptosis of AGS cells by regulating the JNK/STAT3 signaling pathway，and improve the cells’ drug resistance to a certain extent.

Objective:To investigate the effect of hyperbaric oxygen（HBO）on the resistance of gastric cancer AGS cells to irinotecan（ITC）and its related regulatory mechanisms.Methods:Gastric cancer AGS cells were cultured in vitro，and the cells were divided into four groups according to the experimental design：control group，ITC group，HBO group，and HBO + ITC group. The effect of ITC combined with HBO on the proliferation rate of gastric cancer cells was detected by Cell Counting Kit-8（CCK-8）；the changes of apoptosis rate after ITC combined with HBO treatment of AGS cells were detected by flow cytometry；and the changes in the expression of apoptosis-related and drug resistance-related proteins in AGS cells were detected by Western blotting assay. Results:Compared with control group and HBO group，the proliferation of AGS cells in the HBO + ITC group was further inhibited，and its proliferation rate was significantly lower than those of the control group and HBO group（ P<0.01），and also lower than that of the ITC group（ P<0.05）. Compared with those in the control group and the HBO group，the apoptosis rate of AGS cells in the HBO+ITC group was significantly higher than those in the control group and the HBO group（ P<0.01），and also higher than that in the ITC group（ P < 0.05）. In the ITC group and HBO+ITC group，the expression of apoptosis-related and drug resistance-related proteins，including Bcl-2，caspase-9 and P-gp，were significantly decreased，while the expression of Bad，caspase-3 and PARP were significantly increased，and the differences were statistically significant（ P<0.05 or P<0.01）. Compared with the control group and HBO group，p-JNK expression was increased and STAT3 expression was decreased in the ITC group（ P<0.01）；compared with the ITC group，p-JNK expression was increased and STAT3 expression was decreased in the HBO+ITC group（ P<0.05 or P<0.01）. Conclusion:HBO combined with ITC can effectively inhibit the proliferation of gastric cancer AGS cells，affect the apoptosis of AGS cells by regulating the JNK/STAT3 signaling pathway，and improve the cells’ drug resistance to a certain extent.

Objective:To explore the effect of hyperbaric oxygen（HBO）combined with paclitaxel（PTX）on the proliferation，level of reactive oxygen species（ROS），and cell cycle of human gastric cancer AGS cell line cultured in vitro. Methods:After the completion of in vitro culture，the AGS cells were divided into four groups，including control group，PTX group，HBO group，and HBO+PTX group. Cell Counting Kit-8（CCK-8）assay was used to detect the inhibitory effect of HBO combined with PTX on the proliferation of AGS cells. Flow cytometry was adopted to detect the intracellular ROS level and cell cycle arrest. Western blotting was used to assess the expression levels of cell cycle-related proteins. Results:The survival rate of AGS cells in the HBO+PTX group was significantly lower than those in the control group and the HBO group（ P<0.01），and also lower than that in the PTX group（ P<0.05）. The ROS level of AGS cells in the HBO+PTX group was significantly higher than those in the control group and the HBO group（ P<0.01），and also higher than that in the PTX group（ P<0.05）. PTX blocked the AGS cell cycle in S phase（ P<0.05），and the percentage of cells at S phase in the HBO+PTX group was found slightly higher than that in the PTX group（ P>0.05）. The expression level of Cyclin A1 in the HBO+PTX group was significantly lower than those in the other three groups（ P<0.05 or P<0.01）；the expression level of CDK2 in the HBO+PTX group was lower than those in the control group and the HBO group（ P<0.05），and also slightly lower than that in the PTX group（ P>0.05）. Conclusion:HBO can effectively enhance the inhibitory effect of PTX on the proliferation of AGS cells，increase the intracellular ROS level in AGS cells，and block the cell cycle，thereby inhibiting the differentiation and proliferation of AGS cells.

Objective:To study the clinical value of the ISBAR communication model based on nursing priorities in nursing ward rounds.Methods:Using a quasi-experiment method, 104 patients who received secondary and tertiary care from April to June 2020 were set as the control group, and 122 patients who received secondary and tertiary care from July to September 2020 were set up as the experimental group, with non-randomized method. The experimental group used the ISBAR communication model based on nursing priorities for nursing ward rounds, and the control group used the traditional method for nursing ward rounds. The abilities of bedside nurses collecting the patients′condition, the bedside nurses′ condition observation and the nurses′ critical thinking were compared between the two groups, and the patients' nursing quality and satisfaction were also compared.Results:The scores of the bedside nurses′ knowledge of the patients′ condition were 81.14±3.09 in the test group and 75.90±2.84 in the control group, with statistically significant difference ( t value was -12.88, P<0.01). The scores of the bedside nurses′ ability in observing patients′ condition were 140.50 (137.00, 144.50) in the experimental group and 135.50 (128.75, 139.00) in the control group, with statistically significant difference ( Z value was -3.399, P<0.01). The scores of the Critical Thinking Disposition Inventory Chinese-version (CTDI-CV) were 309.82±36.33 in the experimental group and 286.86±33.54 in the control group, with statistically significant difference ( t value was -2.177, P<0.05). The scores of patient care quality evaluation were 62.50 (60.00, 64.00) in the experimental group and 59.00 (55.00, 61.50) in the control group, with statistically significant difference ( Z value was -6.47, P<0.01). The patient discharge satisfaction score of the experimental group was 53.00 (48.75, 55.00), and that of the control group was 51.00 (44.00, 54.00), with statistically significant difference ( Z value was -3.56, P<0.01). Conclusions:The application of ISBAR communication model based on nursing priorities in nursing ward rounds had a significant promotion effect on the improvement of nurses' abilities of collecting the patients′ condition, observing patients′ condition, and critical thinking, and can effectively improve nursing care quality and patients′ satisfaction.

Objective To analyze the clinical characteristics of pseudohypoparathyroidism ( PHP ) inpatients in our hospital from January 2008 to December 2017 and to gain a better understanding of this disorder. Methods 18 inpatients diagnosed as sporadic PHP in our hospital were analyzed retrospectively, as regarding the clinical manifestation, laboratory examination and imaging data. Results 18 inpatients were diagnosed sporadic PHP consisting of 12 males and 6 females, with 13 adults and 5 child participants respectively. The medium age of onset was 14 (6-57), and the average age at diagnosis was (24.9± 14.7) years old. Initial onset of symptoms reported were: 12 patients complained of tetany, 3 reported convulsions, 1 reported numbness, 1 reported dysnoesia, and 1 were asymptomatic. Among them: 3 patients were found to have short distal phalanx, 7 displayed a round face, and 3 out of 15 adults were less than 155 cm in height. 12 patients had a positive Trousseau sign, 1 had an ectopic calcification. 11 were found to have intercranial massive calcifications by head computed tomography. Serum calcium was reported at (1.58 ± 0.11) mmol/ L and parathyroid hormone was (359.5 ± 146.6) pg/ ml. 3 patients were discovered to have hypothyroidism, 2 had been misdiagnosed with epilepsy, and 1 with encephalitis. Conclusions Tetany and intracranial calcifications were the most common signs of PHP patients. A number of the PHP cases in this study lacked typical Albright's Hereditary Osteodystrophy ( AHO) appearance. The age of onset and or duration of the disease varied somewhat in the different patient populations. The heterogeneity nature of the clinical manifestations of PHP makes it difficult to diagnose. It is therefore important to make accurate differential diagnosis of PHP to avoid misdiagnosis of the condition.

Objective To evaluate the clinical value and effect of biofeedback training therapy for functional constipation in elderly patients.Methods A total of 78 elderly patients with functional constipation were treated at the People's Hospital of Pudong New Area,and were divided randomly into two groups.The control group (n =39) received routine treatment plus oral polyethylene glycol,while the experimental group (n=39) received biofeedback training treatment in addition to what was offered to the control group.After treatment,constipation symptom scores,anorectal dynamic parameters and clinical effects were compared between the two groups.Results The scores on excrement characteristics,defecation difficulty,and time and frequency of defecation were better in the experimental group than those in the control group (t=5.670,4.740,4.170,5.530;P=0.016,0.034,0.039,0.022,respectively).The overall effectiveness rate was 94.9 ％ (37/39) in the experimental group,which was higher than that (71.8 ％,2 8/3 9) in the control group (x2 =4.493,P=0.030).Meanwhile,the levels of 3 SC and 10 SC in the two groups were higher than those before treatment,but the level of 10SR was lower than that before treatment (all P＜0.05).Moreover,improvement in 3SC,10SC and 10SR were more significant in the experiment group than in the control group (all P＜ 0.05).Conclusions Biofeedback training therapy is safe and effective for elderly patients with constipation to relieve constipation symptoms,enhance control of defecation and promote defecation.