ObjectiveTo develop a nomogram-based risk prediction model for chronic obstructive pulmonary disease (COPD) incidence among the community-dwelling population aged 40 years old and above, so as to provide targeted references for the screening and prevention of COPD. MethodsBased on a natural population cohort in suburban Shanghai, a total of 3 381 randomly selected participants aged ≥40 years underwent pulmonary function tests between July and October 2021. Cox stepwise regression analysis was used to develop overall and gender-specific risk prediction models, along with the construction of corresponding risk nomograms. Model predictive performance was evaluated using the C-indice, area under the curve (AUC) values, and Brier score. Stability was assessed through 10-fold cross-validation and sensitivity analysis. ResultsA total of 3 019 participants were included, with a median follow-up duration of 4.6 years. The COPD incidence density was 17.22 per 1 000 person-years, significantly higher in males (32.04/1 000 person-years) than that in females (7.38/1 000 person-years) (P<0.001). The overall risk prediction model included the variables such as gender, age, education level, BMI, smoking, passive smoking, and respiratory comorbidities. The male-specific model incorporated the variables such as age, BMI, respiratory comorbidities, and smoking, while the female-specific model included age, marital status, respiratory comorbidities, and pulmonary tuberculosis history. The C-indices for the overall, male-specific, and female-specific models were 0.829, 0.749, and 0.807, respectively. The 5-year AUC values were 0.785, 0.658, and 0.811, with Brier scores of 0.103, 0.176, and 0.059, respectively. Both 10-fold cross-validated C-indices and sensitivity analysis (excluding participants with a follow-up duration of <6 months) yielded C-indices were above 0.740. ConclusionThis study developed concise and practical overall and gender-specific COPD risk prediction models and corresponding nomograms. The models demonstrated robust performance in predicting COPD incidence, providing a valuable reference for identifying high-risk populations and formulating targeted screening and personalized management strategies.

Neuroinflammation mediated by microglia is essential for the occurrence and development of Alzheimer’s disease (AD). Through the analysis of the GEO database, it was found that IL-27 expression decreased in both the cerebral cortex and hippocampus of AD patients. In this study, the AD cell model of BV-2 cells injured by Aβ1-42, the inflammatory cell model of BV-2 cells damaged by LPS, and the inflammatory animal model were established and the effects of IL-27 after its administration in the above models in regulating microglial phenotype and neuroinflammation were evaluated. In the animal models, the number of Iba1+ microglia in the hippocampus was detected by immunohistochemistry, the expression of pro-inflammatory factors such as TNF-α, IL-1β and IL-6 was detected by qPCR, ELISA and Western blot, and the expression of M1/M2 phenotypic markers in microglia was detected by qPCR. To further explore the action mechanism of IL-27, Western blot was used to detect the expression levels of NF-κB, p-NF-κB, IκBα and p-IκBα in microglia after administration of IL-27 and Aβ1-42. The results showed that IL-27 alleviated the abnormal activation of microglia induced by lipopolysaccharide (LPS), decreased the expression of pro-inflammatory factors such as TNF- α, IL-1β and IL-6, transformed microglia induced by LPS or Aβ1-42 from neurotoxic M1 to neuroprotective M2, and improved the abnormal phosphorylation of NF-κB and IκBα induced by Aβ1-42. The research suggested that IL-27 can regulate the M1/M2 polarization of microglia induced by Aβ1-42 or LPS, and alleviate neuroinflammation.

ObjectiveTo investigate the effects of Anmeidan （AMD） on cognitive function， cytochrome C （Cyt C） signaling pathway protein expression， and apoptosis in a geriatric sleep deprivation model. MethodSixty aged C57 mice were randomly divided into a blank group， a model group， AMD high， medium， and low dose （26.26， 13.13， 6.565 g·kg^-1·d^-1） groups， and a melatonin group （1.3 mg·kg^-1·d^-1）， with 10 mice in each group. Continuous sleep deprivation was performed for 4 weeks using a homemade sleep deprivation box. Cognitive function was assessed using the Morris water maze， and morphological changes in pyramidal cells in the CA1 area of the hippocampus were observed by hematoxylin-eosin （HE） staining and Nissl staining. Transmission electron microscopy was used to observe the mitochondrial morphology and structure of hippocampal neurons. Western blot was used to detect Cyt C， cysteine-aspartate protease-3 （Caspase-3）， cysteine-aspartate protease-9 （Caspase-9）， brain-derived neurotrophic factor （BDNF）， mitochondrial transcription factor A （TFAM）， and voltage-dependent anion channel 1 （VDAC1） protein expression. Immunohistochemistry was used to detect protein expression levels of Cyt C， Caspase-3， and Caspase-9， and immunofluorescence was used to detect the protein expression of B-cell lymphoma 2 （Bcl-2） and Bcl-2-associated X protein （Bax）. ResultCompared with the blank group， the model group showed prolonged platform latency （P<0.01）， reduced number of platform crossings， and reduced time and distance in the target quadrant （P<0.01）. The mitochondrial structure was damaged， with disappearance or breakage of cristae， and increased swelling and deformation. The protein expression levels of Cyt C， Caspase-3， Caspase-9， Bax， and VDAC1 were significantly increased （P<0.01）， while BDNF， TFAM， and Bcl-2 protein expression levels were decreased （P<0.01）. Compared with the model group， the AMD high， medium， and low dose groups improved spatial exploration and navigation abilities in geriatric sleep-deprived mice （P<0.05， P<0.01）， alleviated mitochondrial damage， and increased the number of Nissl bodies. Additionally， the expression levels of Cyt C， Caspase-3， Caspase-9， Bax， and VDAC1 proteins were significantly reduced （P<0.05， P<0.01）， while the expression levels of BDNF， TFAM， and Bcl-2 proteins were significantly increased （P<0.05， P<0.01）. ConclusionAMD improved the cognitive function of geriatric sleep-deprived mice， and its effect may be related to the reduction of apoptosis mediated by the Cyt C signaling pathway.

Objective To explore the characteristics of TCM in the treatment of asymptomatic hyperuricemia based on data mining.Methods Clinical literature on the TCM treatment of asymptomatic hyperuricemia in CNKI,Wanfang Data,VIP and SinoMed was retrieved.After screening,the prescriptions obtained were input into Excel 2019 database,and SPSS Modeler 18.0,SPSS Statistics 26.0 and Cytoscape 3.9.1 were used for frequency analysis,association rule analysis,clustering analysis and factor analysis.Results A total of 133 articles meeting the criteria were included,and 140 prescriptions were included,involving 202 kinds of Chinese materia medica,with a total frequency of 1 387 times.22 drugs,such as Smilacis Glabrae Rhizoma,Coicis Semen,Dioscoreae Spongiosae Rhizoma,Astrctylodis Rhizoma,were frequently used in the treatment of asymptomatic hyperuricemia.The commonly used drugs were drugs for urine excretion to strain off dampness,tonics,clearing heat,promoting blood circulation and removing blood stasis.The medicinal property was mainly warm,the medicinal taste was mainly sweet,and the meridians were mainly liver,spleen,stomach and kidney meridians.21 groups of medicinal combinations were obtained by high frequency drug association rule analysis,among which the core drug pairs were Coicis Semen-Astrctylodis Rhizoma,Smilacis Glabrae Rhizoma-Dioscoreae Spongiosae Rhizoma-Coicis Semen,Coicis Semen-Astrctylodis Rhizoma-Smilacis Glabrae Rhizoma,etc.Clustering analysis obtained 5 clustering methods,and factor analysis obtained 7 common factors.Conclusion In the TCM treatment of asymptomatic hyperuricemia,the main methods are urine excretion to strain off dampness,strengthening spleen and tonifying qi,and the main drugs are Smilacis Glabrae Rhizoma,Coicis Semen,Dioscoreae Spongiosae Rhizoma,Astrctylodis Rhizoma,which can provide reference for clinical treatment of asymptomatic hyperuricemia.

Anterior cruciate ligament (ACL) injury of knee is a common sports injury.The hypofunc-tion of the knee joint appears after ACL injury,which seriously affects the overall stability,coordination and balance ability of the knee joint,meanwhile also increases the risk of ACL injury again.Proprioception training can not only enhance the balance ability of the knee joint,but also enhance the control ability of the knee joint.This article reviews the changes of proprioception after ACL injury and the related contents of proprioception rehabilitation after ACL injury in order to provide reference for further improving the functional recovery of the patients with ACL injury.

Objective To quantitatively evaluate the structure and content of the long-term care policy for the older people in the 14th Five-Year Plan in China. Methods The primary indicators were constructed based on multi-source flow model,using Policy Modeling Consisten-cy(PMC)model,and the secondary indicators were constructed based on World Health Organization reports Long-term care for older people:Package for universal health coverage and Decade of healthy ageing:Plan of action.An evaluation system was formed,containing nine primary indicators and 35 secondary indicators.A total of eight policies issued by the nation between November,2021 and January,2024 were included.High-frequency words were extracted using ROSTCM 6.0,a semantic network map of keywords was created using Gephi,and the policies were analyzed using the evaluation system. Results The policies mainly focused on nursing,community,rehabilitation and nursing home,etc.The average PMC in-dex was 6.77.For the policy content coverage,one policy was perfect,five were excellent and two were accept-able.In the dimension of policy content,the indexes of three primary indicators of policy function,policy recep-tors and infrastructure construction were 0.85 or more;while the indexes of three primary indicators of caregiver assistance,support for the elderly and human resources building were 0.7 or less. Conclusion The content of long-term care policies for the older people issued in the 14th Five-Year Plan in China covers well in policy functions,policy recipients and infrastructure,and needs to be upgraded in the three dimensions of caregiver assistance,support for the elderly and human resource building.It is important to strengthen the policy content and measures in three areas,namely,the comprehensive care support network,the creation of an age-friendly environment and support for informal care.

Objective It evaluates the high-quality development policies of public hospitals at the provincial level in China,and provides theoretical basis and countermeasures for formulating and optimizing the high-quality develop-ment policies of public hospitals.Methods The ROST CM 6.0 software was used to conduct text mining for 11 sample policies,and the Policy Modeling Consistency(PMC)index model was constructed to evaluate the sample policies quantitatively.Results The average PMC index of 11 sample policies included in the study was 7.16 points,of which 8 were excellent grades and 3 were qualified grades.The first-level variables X5 service system(0.82),X8 Party leadership(0.91)and X6 organization and operation(0.94)scored higher;X2 policy timeliness(0.52),X7 cultural construction(0.68)and X4 service capability(0.71)scored low.Conclusion The content of the high-quality develop-ment policy of public hospitals at the provincial level is basically in line with the national policy,and is relatively excel-lent in the aspects of organization and operation,service system and party leadership,etc.,but there are some weaknesses in the aspects of policy timeliness,cultural construction and service capacity,etc.,which can be op-timized and improved from the aspects of improving service capacity,supplementing long-term policies and strengthening hospital cultural construction.

Objective To explore the high-quality development path of tertiary public hospitals and provide scientific reference for deepening the reform of public hospitals.Methods Based on SPO theory,it constructed an analytical framework for the high-quality development of tertiary public hospitals,collected data of a quarterly monitoring in-dex for the performance assessment and high-quality development of tertiary public hospitals in a certain province in 2023,and analysed 73 tertiary public hospitals participating in the performance assessment as the object of analy-sis,and adopted the fuzzy-set Qualitative Comparative Analysis to explore different condition sets of high-quality de-velopment of tertiary public hospitals and reveal the path of high-quality development of public hospitals.Results High-quality development is the result of multi-factor interaction.Four configurations were identified to promote the high-quality development of tertiary public hospitals:service quality-technology-driven path,service quality-driven path,comprehensive service-driven path,and service quality-benefit-driven path.Quality safety and functional orientation were found to be the core elements in promoting high-quality development of public hospitals.Conclusion Hospitals at all levels should strengthen the guidance of party building,combine with the actual functional positioning,take quality and safety as the core,and optimize the combination conditions of technical level,personnel structure,service process,and cost control.It is essential to clarify the development strategy of hospitals,implement the dynamic concept,and realize the high-quality development of public hospitals.

Objective To empirically analyze the status quo of high-quality development of public hospitals in S Province,provides reference for promoting high-quality development of public hospitals.Methods SPSS 26.0 soft-ware and text analysis method were used to process the high-quality development monitoring data of tertiary public hospitals in S Province,and the qualitative interview results obtained by field investigation were comprehensively ana-lyzed.Results In terms of capacity improvement,public hospitals actively take measures such as the construction of medical union and the reform of payment methods to improve their capacity.Specialized hospitals and maternity and child care hospitals need to be improved in some indicators.In terms of structural optimization,the quality of medi-cal services is high in all regions.The proportion of medical service revenue and the proportion of high-grade surgery still need to be increased.In terms of innovation and efficiency improvement,the application level of electronic medi-cal records has made remarkable progress in various regions.There are differences in the funding of scientific re-search projects.In terms of cultural cohesion,patient satisfaction was higher.There is improvement room in the satisfaction of medical staff.Conclusion Third-level public hospitals in S province have achieved certain results in high-quality de-velopment,but there are still problems,such as the need to further integrate party building work with hospital busi-ness work,the lack of connection between performance incentive and performance evaluation index system,and the need to improve the satisfaction of medical staff.It is necessary to solve the problem and improve the quality and efficiency of medical service.

Objective To sort out and quantitatively evaluate the policies of"Internet+Nursing Service",and provide reference for the formulation and improvement of policies.Methods It uses ROST CM 6.0 software to mine the text data of 6"Internet+Nursing service"policies,constructs Policy Modeling Consistency(PMC)index model,and uses 9 first-class variables and 43 second-class variables to quantitatively evaluate the"Internet+Nursing service"policies.Results Among the 6 policies,1 policies were of good grade,5 policies were of acceptable grade,and the mean value of PMC index was 6.40,which was at the level of qualified or above,with higher scores on the primary variables X7 policy tools(0.95),X1 policy nature(0.92)and X9 policy evaluation(0.83),and lower scores on X8 incentive methods(0.63),X2 issuing organizations(0.58),and X5 policy timeliness(0.25).Conclusion The construction of the policy framework of"Internet+Nursing Service"in China is in the exploratory stage,and there is still room for improvement.It is recommended to improve the continuity and standardization of"Internet+Nursing Service"through rational planning of policy timing,comprehensive implementation of division of labour and coordination,and adoption of diversified incentives,etc.,so as to facilitate the high-quality development of public hospitals.