This paper explored the significance and value of building a doctor-patient narrative community in clinical practice.It was clarified that clinical practice guided by evidence-based medicine thinking is essentially a"narrative"process:patients narrate their illness stories,and doctors,through a series of humanistic narrative practices,strengthen trust and empathy between patients and doctors on an emotional and ethical level,while bridging cognitive gaps,enhancing diagnostic and treatment outcomes,and ultimately fostering a harmonious and efficient doctor-patient narrative community relationship.The realization of a doctor-patient narrative community not only optimizes the treatment process but also enhances patients'self-efficacy and doctors'professional satisfaction,which is conducive to saving medical costs,optimizing public health governance,and highlighting a harmonious social atmosphere.

The operation assistant work team of public hospitals is an important bridge and link to realize the integration of industry and finance,and an important practitioner to promote the realization of lean operation management.It examines the service model of the operation assistant team engaged in Similar Multi-disciplinary Treatment,focusing on organizational structure,job responsibilities,and service mechanisms.Build a four-tiered lean operational management system and set up an operation assistant work team that combines production,university and research.Based on specific management matters,establish an operation assistant service mechanism such as problem assessment and classification management mechanism,project standardization management mechanism,reward and punishment assessment mechanism,etc.,to promote the optimization and integration of hospital medical education,research,prevention and management and core elements such as human,talent,material and technology resources.Help public hospitals to continuously improve their lean operation management level.

Objective:To explore the relationship between trait anger and depression among college students, as well as the mediating roles of perceived stress and emotion-oriented coping strategies.Methods:From March to April 2022, a total of 2 037 college students were surveyed by the trait anger scale, the perceived stress scale, the coping inventory for stressful situations, and the 9-item patient health questionnaire.The collected data were analyzed by SPSS 27.0 software and AMOS 24.0 statistical software packages.Results:The score of trait anger among college students was (14.78±3.56), the score of perceived stress was (10.02±4.77), the score of emotion-oriented coping was (14.43±3.38), and the score of depression was 2.00(0, 9.00). Correlation analysis showed that depression was significantly and positively correlated with temperamental anger, reactive anger, perceived stress, and emotion-oriented coping ( r=0.303-0.467, all P<0.01). Temperamental anger and reactive anger were significantly and positively correlated with both perceived stress and emotion-oriented coping ( r=0.279-0.332, all P<0.01). Emotion-oriented coping was significantly and positively correlated with perceived stress ( r=0.397, P<0.01). Mediation effect analysis showed that the total effect of trait anger on depression was 0.420. The direct effect of trait anger on depression was 0.241, accounting for 57.38% of the total effect. The mediating effects of perceived stress and emotion-oriented coping were 0.145 and 0.024, accounting for 34.52% and 5.72% of the total effect, respectively. The chain mediating effect of perceived stress and emotion-oriented coping was 0.010, accounting for 2.38% of the total effect. Conclusion:Trait anger can significantly and positively predict depression among college students, and it can also positively predict the level of depression among college students through the chain mediation effect of perceived stress and emotion orientation.

Objective To investigate the association between polymorphisms at rs1044122 of the metalloprotease12(ADAM12)gene and rs1553005 of the calcitionin related peptide alpha(CALCA)gene and disease susceptibility in patients with knee osteoarthritisc(KOA).Methods A total of 188 KOA patients admitted to the First Hospital of Qinhuangdao from January 2022 to January 2024 were selected as the study objects.Another 100 healthy subjects in the same hospital during the same period were selected as the control group.The polymorphisms of ADAM12 rs1044122 and CALCA rs1553005 were analyzed by PCR+gel imaging system.The frequency distribution of alleles and genotypes was compared between control group and KOA group.Logistic regression model was used to analyze the relationship between ADAM12 rs1044122 and CALCA rs1553005 and susceptibility to KOA under three genetic models(co-dominant,dominant and recessive).Results The genotypes of ADAM12 rs1044122 and CALCA rs1553005 in control group and KOA group were consistent with Hardy-Weinberg equilibrium law(all P>0.05),indicating population representation.Compared with the control group,the allele C frequency(41.49%vs 32.00%)of ADAM12 rs1044122 and the allele C(42.55%vs 30.00%)and genotype CC(18.08%vs 9.00%)frequencies of CALCA rs1553005 in KOA group were significantly increased,with statistical significance(χ2=4.980,8.715,8.631,all P<0.05).Logistic regression model showed that in the co-dominant model(AA vs CC)of ADAM12 rs1044122,the risk of KOA occurrence in CC genotype was significantly higher than that in AA genotype(OR=1.656,P<0.05).In the dominant model(AC+CC vs AA),the risk of developing KOA was higher in patients with C allele than in patients with A allele(OR=1.458,P<0.05).Under the codominant model(GG vs CC)of CALCA rs1553005,the risk of KOA in CC genotype was significantly higher than that in GG genotype(OR=1.643,P<0.05).Under the dominant model(GC+CC vs GG)and recessive model(GC+GG vs CC),the risk of developing KOA with C allele was significantly higher than that with G allele(OR=1.491,0.795,all P<0.05).Conclusion ADAM12 gene rs1044122 allele C and CALCA gene rs1553005 allele C and genotype CC increased the risk of KOA.

Objective To investigate the association between polymorphisms at rs1044122 of the metalloprotease12(ADAM12)gene and rs1553005 of the calcitionin related peptide alpha(CALCA)gene and disease susceptibility in patients with knee osteoarthritisc(KOA).Methods A total of 188 KOA patients admitted to the First Hospital of Qinhuangdao from January 2022 to January 2024 were selected as the study objects.Another 100 healthy subjects in the same hospital during the same period were selected as the control group.The polymorphisms of ADAM12 rs1044122 and CALCA rs1553005 were analyzed by PCR+gel imaging system.The frequency distribution of alleles and genotypes was compared between control group and KOA group.Logistic regression model was used to analyze the relationship between ADAM12 rs1044122 and CALCA rs1553005 and susceptibility to KOA under three genetic models(co-dominant,dominant and recessive).Results The genotypes of ADAM12 rs1044122 and CALCA rs1553005 in control group and KOA group were consistent with Hardy-Weinberg equilibrium law(all P>0.05),indicating population representation.Compared with the control group,the allele C frequency(41.49%vs 32.00%)of ADAM12 rs1044122 and the allele C(42.55%vs 30.00%)and genotype CC(18.08%vs 9.00%)frequencies of CALCA rs1553005 in KOA group were significantly increased,with statistical significance(χ2=4.980,8.715,8.631,all P<0.05).Logistic regression model showed that in the co-dominant model(AA vs CC)of ADAM12 rs1044122,the risk of KOA occurrence in CC genotype was significantly higher than that in AA genotype(OR=1.656,P<0.05).In the dominant model(AC+CC vs AA),the risk of developing KOA was higher in patients with C allele than in patients with A allele(OR=1.458,P<0.05).Under the codominant model(GG vs CC)of CALCA rs1553005,the risk of KOA in CC genotype was significantly higher than that in GG genotype(OR=1.643,P<0.05).Under the dominant model(GC+CC vs GG)and recessive model(GC+GG vs CC),the risk of developing KOA with C allele was significantly higher than that with G allele(OR=1.491,0.795,all P<0.05).Conclusion ADAM12 gene rs1044122 allele C and CALCA gene rs1553005 allele C and genotype CC increased the risk of KOA.

Objective:To explore the relationship between trait anger and depression among college students, as well as the mediating roles of perceived stress and emotion-oriented coping strategies.Methods:From March to April 2022, a total of 2 037 college students were surveyed by the trait anger scale, the perceived stress scale, the coping inventory for stressful situations, and the 9-item patient health questionnaire.The collected data were analyzed by SPSS 27.0 software and AMOS 24.0 statistical software packages.Results:The score of trait anger among college students was (14.78±3.56), the score of perceived stress was (10.02±4.77), the score of emotion-oriented coping was (14.43±3.38), and the score of depression was 2.00(0, 9.00). Correlation analysis showed that depression was significantly and positively correlated with temperamental anger, reactive anger, perceived stress, and emotion-oriented coping ( r=0.303-0.467, all P<0.01). Temperamental anger and reactive anger were significantly and positively correlated with both perceived stress and emotion-oriented coping ( r=0.279-0.332, all P<0.01). Emotion-oriented coping was significantly and positively correlated with perceived stress ( r=0.397, P<0.01). Mediation effect analysis showed that the total effect of trait anger on depression was 0.420. The direct effect of trait anger on depression was 0.241, accounting for 57.38% of the total effect. The mediating effects of perceived stress and emotion-oriented coping were 0.145 and 0.024, accounting for 34.52% and 5.72% of the total effect, respectively. The chain mediating effect of perceived stress and emotion-oriented coping was 0.010, accounting for 2.38% of the total effect. Conclusion:Trait anger can significantly and positively predict depression among college students, and it can also positively predict the level of depression among college students through the chain mediation effect of perceived stress and emotion orientation.

This paper explored the significance and value of building a doctor-patient narrative community in clinical practice.It was clarified that clinical practice guided by evidence-based medicine thinking is essentially a"narrative"process:patients narrate their illness stories,and doctors,through a series of humanistic narrative practices,strengthen trust and empathy between patients and doctors on an emotional and ethical level,while bridging cognitive gaps,enhancing diagnostic and treatment outcomes,and ultimately fostering a harmonious and efficient doctor-patient narrative community relationship.The realization of a doctor-patient narrative community not only optimizes the treatment process but also enhances patients'self-efficacy and doctors'professional satisfaction,which is conducive to saving medical costs,optimizing public health governance,and highlighting a harmonious social atmosphere.

The operation assistant work team of public hospitals is an important bridge and link to realize the integration of industry and finance,and an important practitioner to promote the realization of lean operation management.It examines the service model of the operation assistant team engaged in Similar Multi-disciplinary Treatment,focusing on organizational structure,job responsibilities,and service mechanisms.Build a four-tiered lean operational management system and set up an operation assistant work team that combines production,university and research.Based on specific management matters,establish an operation assistant service mechanism such as problem assessment and classification management mechanism,project standardization management mechanism,reward and punishment assessment mechanism,etc.,to promote the optimization and integration of hospital medical education,research,prevention and management and core elements such as human,talent,material and technology resources.Help public hospitals to continuously improve their lean operation management level.

Objective:To analyze the effect of birth parity on life expectancy (LE) and healthy life expectancy (HLE) among rural women.Method:A total of 15 304 women aged 40 to 79 years who participated in baseline and follow-up surveys were selected from a rural cohort in Henan province. The LE and HLE of women with different birth parity were calculated by using multi-state life table.Results:There were 1 195 (7.8%), 7 782 (50.8%), 3 867 (25.3%) and 2 460 (16.1%) women with 1, 2, 3 and 4 birth parities, respectively, and the M ( Q1 and Q3) of age were 50.3 (47.3, 53.4) and 53.3 (48.8, 60.7), 62.6 (55.4, 66.9) and 69.5 (64.7, 73.4) years old, respectively. LE at 40 years old was 44.5, 44.8, 45.1 and 45.4 years old, and HLE was 17.7, 18.3, 18.8 and 19.3 years old, respectively. LE at age 40 increased by 0.3, 0.6, and 0.9 years in women with 2, 3, and 4 birth parities or more and HLE increased by 0.5, 1.1, and 1.6 years, respectively, compared with women with 1 birth parity. For women with higher and lower socioeconomic status who had 4 birth parities or more, the LE at age 40 was 47.1 and 43.9 years, respectively, an increase of 0.2 and 0.1 years over women with 1 birth parity, respectively; and the HLE was 20.4 and 18.7 years, respectively, an increase of 1.4 and 1.3 years over women with 1 birth parity, respectively. Conclusion:LE and HLE show an upward trend with the increase of birth parity among rural women.

Objective:To select the differential prognostic lactic acid metabolism-related genes(LRGs)of the head and neck squamous cell carcinoma(HNSCC)to construct the LRGs prognostic model of HNSCC,and to clarify the potential mechanism.Methods:The HNSCC gene expression and clinical data were obtained from The Cancer Genome Atlas(TCGA)and Gene Expression Omnibus(GEO)Databases,the LRGs were identified through GeneCards Database,and R software was used to screen out the LRGs of HNSCC;univariate Cox regression analysis was used to identify prognosis-related genes;two different subtypes were identified based on the prognostis-related LRGs;Kaplan-Meier(K-M)curve analysis was used to compare the prognosis of the patients between two groups;CIBERSORT algorithm was used to perform the immuno-correlation analysis between two groups;multivariate Cox regression analysis and LASSO regression analysis were used to construct the prognostic model;receiver operating characteristic curve(ROC)and K-M survival curve were used to assess the relationship between LRGs and survival and prognosis of the HNSCC patients.The prognostic model was validated by GSE27020,GSE41613,and GSE65858 datasets.The experiment were grouped based on risk score,and immune-related analysis and tumor score analysis were performed.Results:The TCGA Database differential analysis results showed that 1 196 LRGs were identified from HNSCC samples;univariate Cox regression analysis selected 27 differentially expressed genes(DEGs)associated with the prognosis of the HNSCC patients.Two different LRGs subtypes(Group 1 and Group 2)were identified according to the prognosis-related genes.The K-M survival curves results showed that the overall survival(OS)of the patients in Group 2 was significantly higher than that in Group 1,and the immune cell expression amount of the patients in Group 2 was also higher than that in group 1.The multivariate Cox regression and LASSO regression analysis results screened out 9 LRGs,including hypoxanthine phosphoribosyltransferase 1(HPRT1),amyloid precursor protein(APP),glycogen phosphorylase L(PYGL),urokinase-type plasminogen activator(PLAU),cannabinoid receptor 2(CNR2),stanniocalcin 2(STC2),nucleotide binding oligomerization domain-like receptor protein 1(NLRP1),integrin-linked kinase(ILK),and forkhead box B1(FOXB1);the prognostic model was constructed.The K-M and ROC curve results indicated that the expression levels of above 9 genes were associated with the survival and prognosis of the HNSCC patients,providing good 1-year,2-year,and 3-year survival prediction effect,and the area under ROC curve(AUC)values were all greater than 0.650.Furthermore,the predictive ability of the prognosis model was validated in GSE27020,GSE41613,and GSE65858 datasets.The patients classified based on the risk scores had distinguishable immune statuses.Conclusion:The differentially expressed LRGs of HNSCC screened by bioinformatics methods are related to the survival and prognosis of the HNSCC patients;the prognostic model constructed by 9 LRGs can predict the survival status and treatment response of the HNSCC patients.