Objective To establish a competency evaluation indicator system for school physicians. Methods A preliminary pool of competency indicators for school physicians was established through systematic literature review and policy document analysis. The Delphi method was used to conduct two rounds of expert consultations with 16 experts who involve in educational administration, clinical medicine, public health management, and school healthcare. Based on the opinions of the experts, the indicator system was screened, revised, and refined to establish the final competency evaluation indicator system for school physicians. Results The questionnaire recovery rates of the two rounds of expert consultations were both 100.0%. The expert authority coefficient were 0.93 and 0.94, and Kendall′s coefficients of concordance were 0.21 and 0.26, respectively (both P<0.01). The final competency evaluation indicator system for school physicians consisted of five primary indicators, including basic medical service capacity, school health service capacity, health education and communication capacity, professional ethics and competency, and self-improvement capacity, as well as 35 secondary indicators (items). All indicators received relatively high importance scores. The system demonstrated a reasonable structure, good scientific validity, and practical applicability. Conclusion The competency evaluation indicator system for school physicians developed in this study demonstrates high scientific validity and practicality. It can serve as an important tool for school physician management, competency development, and performance evaluation, providing references for improving school health service quality and strengthening the construction of school physician teams.

Objective:To analyze the regional differences in health resource allocation in Guangdong Province and provide references for optimizing health resource allocation in Guangdong Province. Methods:The health resource density index,entropy weight-TOPSIS method,and RSR method were used to comprehensively evaluate the allocation of health resources in Guangdong Province from 2018 to 2022. Results:The results of the entropy weight-TOPSIS analysis showed that the average levels of comprehensive evaluation in the Pearl River Delta,Western Wing (West Guangdong),Eastern Wing (East Guangdong),and mountainous areas (North Guangdong) from 2018 to 2022 were 0.4452,0.1338,0.2144 and 0.0566,respectively. The RSR grading results show that Zhuhai,Dongguan,Guangzhou and Shenzhen had better allocation of health resources,with a"good"grading result;Shaoguan,Yunfu and Heyuan are worse. Conclusion:There is an obvious regional difference in the allocation of health resources in Guangdong Province. The allocation level of health resources in the Pearl River Delta and the Eastern Wing (East Guangdong) is relatively high,while the allocation level of health resources in the western wing (West Guangdong) and the mountainous areas (North Guangdong) is relatively low. In the future,Guangdong Province should pay attention to the areas with poor allocation of health resources,develop regional characteristic economy,strengthen the training of health talents,optimize the allocation of health resources,and realize that all people in the province can enjoy high-quality,convenient and equal medical and health services. At the same time,it is also necessary to strengthen cooperation and exchanges among regions to jointly promote the comprehensive development of health undertakings in Guangdong Province.

Objective:To explore the association between self-perception of aging and physical activity in elderly colorectal cancer patients, so as to provide reference for clinical physical activity intervention programs.Methods:From July 2022 to March 2023, convenience sampling was used to select 234 colorectal cancer patients in three Class Ⅲ Grade A hospitals in Jinan, Shandong Province as participants. Cross-sectional survey was conducted using the General Information Questionnaire, Brief Ageing Perceptions Questionnaire (B-APQ), and Physical Activity Measurement Scale for Cancer Patients. Multiple linear regression was used to explore the influencing factors of physical activity in elderly patients with colorectal cancer.Results:A total of 234 questionnaires were distributed, and 221 valid questionnaires were collected, with a valid response rate of 94.44% (221/234). Among 221 elderly patients with colorectal cancer, the score of B-APQ was (46.28±11.89), and physical activity was 52.50 (30.00, 77.75) hours per week. Multiple linear regression showed that self-perception of aging, regular physical activity before illness, self-evaluation of physical health, and disease stage were the influencing factors of physical activity in elderly colorectal cancer patients ( P<0.05) . Conclusions:Elderly patients with colorectal cancer tend to have a negative perception of aging and low levels of physical activity. Medical and nursing staff should attach importance to the assessment and intervention of patients' self-perception of aging to improve their physical activity.

Objective:To analyze the regional differences in health resource allocation in Guangdong Province and provide references for optimizing health resource allocation in Guangdong Province. Methods:The health resource density index,entropy weight-TOPSIS method,and RSR method were used to comprehensively evaluate the allocation of health resources in Guangdong Province from 2018 to 2022. Results:The results of the entropy weight-TOPSIS analysis showed that the average levels of comprehensive evaluation in the Pearl River Delta,Western Wing (West Guangdong),Eastern Wing (East Guangdong),and mountainous areas (North Guangdong) from 2018 to 2022 were 0.4452,0.1338,0.2144 and 0.0566,respectively. The RSR grading results show that Zhuhai,Dongguan,Guangzhou and Shenzhen had better allocation of health resources,with a"good"grading result;Shaoguan,Yunfu and Heyuan are worse. Conclusion:There is an obvious regional difference in the allocation of health resources in Guangdong Province. The allocation level of health resources in the Pearl River Delta and the Eastern Wing (East Guangdong) is relatively high,while the allocation level of health resources in the western wing (West Guangdong) and the mountainous areas (North Guangdong) is relatively low. In the future,Guangdong Province should pay attention to the areas with poor allocation of health resources,develop regional characteristic economy,strengthen the training of health talents,optimize the allocation of health resources,and realize that all people in the province can enjoy high-quality,convenient and equal medical and health services. At the same time,it is also necessary to strengthen cooperation and exchanges among regions to jointly promote the comprehensive development of health undertakings in Guangdong Province.

Objective:To explore the association between self-perception of aging and physical activity in elderly colorectal cancer patients, so as to provide reference for clinical physical activity intervention programs.Methods:From July 2022 to March 2023, convenience sampling was used to select 234 colorectal cancer patients in three Class Ⅲ Grade A hospitals in Jinan, Shandong Province as participants. Cross-sectional survey was conducted using the General Information Questionnaire, Brief Ageing Perceptions Questionnaire (B-APQ), and Physical Activity Measurement Scale for Cancer Patients. Multiple linear regression was used to explore the influencing factors of physical activity in elderly patients with colorectal cancer.Results:A total of 234 questionnaires were distributed, and 221 valid questionnaires were collected, with a valid response rate of 94.44% (221/234). Among 221 elderly patients with colorectal cancer, the score of B-APQ was (46.28±11.89), and physical activity was 52.50 (30.00, 77.75) hours per week. Multiple linear regression showed that self-perception of aging, regular physical activity before illness, self-evaluation of physical health, and disease stage were the influencing factors of physical activity in elderly colorectal cancer patients ( P<0.05) . Conclusions:Elderly patients with colorectal cancer tend to have a negative perception of aging and low levels of physical activity. Medical and nursing staff should attach importance to the assessment and intervention of patients' self-perception of aging to improve their physical activity.

Objective To explore the potential impact pathways of self-management behavior based on COM-B model,in maintenance hemodialysis(MHD)patients,and provide reference for the intervention of self-manage-ment behavior.Methods Judgment sampling was used to select 350 MHD patients undergoing dialysis at the hospital in a certain district of Guangzhou,and a questionnaire survey was conducted among them.Smart PLS software was used to construct a partial least squares structural equation model and perform path analysis.Results Self-manage-ment behavior score of MHD patients was(57.06±13.28).Univariate analysis showed that age,education back-ground,employment status,occupational classification,per capita monthly income of families,and the number of comorbidities could directly affect self-management behavior of MHD patients(P<0.05).PLS-SEM model showed that self-efficacy(β = 0.246),family care level(β = 0.124)and social support(β = 0.140)positively impacted patients' self-management behavior,while disease perception negatively affected self-management behavior(β =-0.097).Self-efficacy can mediate the impact of disease perception and social support on self-management behavior of MHD patients(P<0.05).Conclusions Self-management behavior of MHD patients is currently at a low level.Therefore,when devising intervention plans for these patients,it is crucial to consider the combined effects of disease knowledge education,disease perception reconstruction,opportunity provision,and motivation.The primary focus should be on enhancing patients' self-efficacy,which will ultimately elevate their overall level of self-management.

Objective:To investigate the effect of 125I-RSOAds-hTERT/PSA oncolytic adenovirus on targeted therapy of prostate cancer and its effect on tumor microenvironment. Methods:125I-RSOAds-hTERT/PSA ( 125I-virus complex) oncolytic adenovirus was constructed by PCR amplification and double restriction enzyme ligation. TUNEL staining, flow cytometry and Caspase-3 immunoblotting assay were used to detect the killing effect of 125I-RSOAds-hTERT/PSA oncolytic adenovirus on prostate cancer cells in vitro and in vivo, respectively. To explore the effect of 125I-virus complex on tumor tissue cytokine secretion levels, interleukin 2 (IL-2), IL-10, tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) in the culture supernatant of human prostate cancer cell line PC3, mouse prostate adenocarcinoma cell line RM-1, and mice serum were detected by ELISA. We explored the regulation of 125I-virus complex on the expression of CD24, CD44 and prostate stem cell antigen (PSCA) in prostate tumor tissues and tumor cells through immunohistochemistry. Meanwhile, the expression levels of CD32 and vascular endothelial growth factor (VEGF), as well as CD4+ , CD8+ and macrophage infiltration in tumor tissue were detected through immunofluorescence experiments. Results:125I-virus complex oncolytic adenovirus significantly increased tumor cell apoptosis in vitro and in vivo that was significantly higher than that of 125I group and virus complex group. Meanwhile, IL-2 ( t=-183.30, -38.20, P<0.05), IL-10 ( t=113.80, 92.71, P<0.05), TNF-α ( t=-73.20, -73.91, P<0.05), IFN-γ ( t=-65.37, -139.70, P<0.05) increased in vitro and in vivo. 125I-virus complex reduced the expression of CD24, CD44 and PSCA in tumor cells and tumor tissue, reduced the weight of tumor tissue, inhibited angiogenesis of tumor tissue ( t=8.55, P<0.05), and regulated the immune response in tumor tissue. Conclusions:125I-virus complex targeting prostate cancer can significantly kill cancer cells, reduce the weight and angiogenesis of tumor, and improve tumor microenvironment.

Objective: To investigate the clinical value of the serum new molecular markers, soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and soluble hemoglobin scavenger receptor(sCD163), in the diagnosis of sepsis in elderly patients with burns. Methods: A total of 58 inpatients with burns from Jun 2017 to June 2018 were enrolled in the study.Patients were divided into three groups: the sepsis group(n=12), the localized infection group(n=21)and the non-infection group(n=29). The levels of sTREM-1 and sCD163 were determined by enzyme-linked immunosorbent assays(ELISAs). The clinical diagnostic value of sTREM-1 and sCD163 was assessed by receiver operating characteristic(ROC)curve analysis. Results: There was a statistically significant difference in the levels of sTREM-1 and sCD163 at day 1 between the three groups(F=20.994 and 38.363, P<0.01). Serum levels of sTREM-1 and sCD163 were higher in the sepsis group than in the localized infection group and the non-infection group.Serum levels of sTREM-1 and sCD163 were higher in the localized infection group than in the non-infection group.Serum levels of sTREM-1 and sCD163 were lower at day 7 than those at day 1 in all groups(F=21.242 and 41.035, P<0.01). Serum sTREM-1 levels were positively correlated with serum sCD163 levels(r=0.609, P=0.000). The AUC of sTREM-1 and sCD163 for the diagnosis of sepsis was 0.880(95%CI: 0.816~0.926). Conclusions Serum levels of sTREM-1 and sCD163 are elevated with increasing degrees of infection.Monitoring serum sTREM-1 and sCD163 levels is helpful for the diagnosis of sepsis in elderly patients with burns.

Objective To investigate the effect of ERH gene knockdown on the proliferation and apoptosis of human bladder cancer T24 cells. Methods T24 cells infected by lentivirus with interference on ERH gene sequence were cloned to establish stable T24 cells clone in ERH gene suppression. The expression of ERH mRNA gene in bladder cancer was detected by using quantitative real time polymerase chain reaction (qPCR). The effects of ERH knockout on the cell proliferation and apoptosis were examined by using methylthiazolyl tetrazolium (MTT) assay, colony formation assay and flow cytometry. The effect of ERH knockout on the tumorigenic effect of T24 cells in vivo was verified by subcutaneous tumor formation in nude mice. Results After lentiviral transfection, qPCR results showed that the knockdown effect of ERH mRNA in ERH normal group (untreated T24 cells) was better than that in ERH gene knockdown group, and the difference was statistically significant [(1.006±0.126) vs. (0.079±0.007); t=12.72, P=0.0002]. After knocking out ERH gene, MTT assay showed that the proliferation ability of T24 cells in ERH gene knockdown group was weakened compared with ERH normal group, and the difference was statistically significant [A490 value: (0.13±0.00) vs. (0.66±0.01);t=104.61, P<0.0001]. Colony formation assay indicated that the ability of clone in ERH normal group was weakened compared with ERH gene knockdown group [(10.5 ±1.2) vs. (196.4 ±4.0); t= 73.63, P< 0.0001]. Flow cytometry showed that the cell apoptosis rate in ERH gene knockdown group was higher than that in ERH normal group [(11.0 ±0.5) ％ vs. (4.2 ±0.5) ％; t= 16.06, P<0.0001]. Imaging results of subcutaneous tumor formation in nude mice showed that the total fluorescence intensity of the tumor area in ERH gene knockdown group was (4.67 ±0.59) × 1010 μW/cm2, and the corresponding part in ERH normal group was (9.54±4.20) × 1010μW/cm2 (t=3.64, P=0.0051);tumor weight in ERH gene knockdown group was (0.80±0.62) g, and in ERH normal group was (1.79±0.71) g (t=3.33, P=0.0037). Conclusion ERH gene knockout can inhibit the proliferation of human bladder cancer T24 cells, and promote the cell apoptosis.