Objective:To develop an efficient and robust method based on three dimensional facial landmarks for evaluating chin region asymmetry at the soft tissue level and to compare it with the tradi-tional mirror-overlap analysis method in order to test its availability.Methods:Standard symmetrical face was used for mental tubercle coordinate transformation so as to filter soft tissue three dimensional spatial angle and construct corresponding three dimensional spatial angle wireframe template.Ten patients aged 12-32 years with clinical chin region asymmetry diagnosis at the Department of Orthodontics of Peking University Hospital of Stomatology from November 2020 to November 2021 were randomly selected.Three dimensional soft tissue face scan data of the patients were collected by three dimensional face scanner and the landmark points were automatically determined by the Meshmonk non-rigid registration algorithm pro-gram,and in this way,the asymmetric three dimensional spatial angle wireframe template and corre-sponding spatial angle parameters were generated.Mirror-overlap analysis of face scan data was also per-formed in Geomagic Studio 2015 software and deviation color maps were generated.This study took mirror-overlap analysis as the gold standard method,the response rate of chin region asymmetry was eva-luated by the outcomes of the mirror-overlap analysis and three dimensional spatial angle wireframe tem-plate analysis.Results:Nine three dimensional spatial angle indicators were selected through coordinate transformation,and the response rate was calculated using mirror-overlap analysis as the gold standard method.Among these ten selected patients,the response rate of the total chin region asymmetry was 90％(9/10).Using the deviation value of mirror-overlap analysis as a reference,the response rate of chin region asymmetry in the X dimension was 86％,the response rate of chin region asymmetry in the Y dimension was 89％,and the response rate of chin region asymmetry in the Z dimension was 100％.Conclusion:The three dimensional soft tissue spatial angle wireframe template proposed in this study has some feasibility in evaluating chin region asymmetry at the soft tissue level,and its ability to recognize asymmetry separately in the three dimensional direction is better than the mirror-overlap analysis method,and the indicators recognition rate still needs to be further improved.

Objective To investigate the expression of allograft inflammatory factor-1(AIF-1)in the testicular model of diabetes mellitus(DM)rats as well as its significance.Methods The rat model of DM testis(DMT)was established,which were randomly divided into the DM testis 4-week group(DMT4W),DM testis s 8-week group(DMT8W)and the DM testis 12-week group(DMT12W).The normal control group(NC group)was randomly divided into three subgroups:NC 4-week(NC4W),NC 8-week(NC8W)and NC 12-week(NC12W).The morphologic changes of testis in the different groups was detected by histopathology.The expression of AIF-1 protein was detected by immunohistochemistry.The expression of AIF-1 and NF-κB p65 protein was observed by immunofluorescence.Results The histopathological results suggested that the numbers of spermatogenic cells,sertoli cells,interstitial cells and sperms in the DMT group were significantly decreased,as compared with the NC group.The immunohistochemistry results showed that the expression of AIF-1 protein was significantly increased in the DMT group,as compared with the NC group(P<0.05).The intensity of AIF-1 and NF-κB p65 in the DMT group was significantly increased by immunofluorescence,as compared with the NC group.Conclusion The over expression of AIF-1 protein in DMT tissue suggests that it may play an important role in the pathological process of DMT and may become a new therapeutic target and diagnostic marker in the future.

Objective:To investigate the current situation of narrative literacy among medical students in different majors in a university and analyze its reasons,providing data for effective implementation of narrative medicine literacy training.Methods:Using the convenience sampling method,a total of 1,274 students from the Medicine College and the School of Nursing of a university were selected from January to March 2023.A questionnaire survey was conducted using the General Information Questionnaire,the Interpersonal Reactivity Index,the Social Self-efficacy Scale,the Interpersonal Communication Skills Assessment Scale,and the Communication Skills Assessment for Medical Students.SPSS 26.0 software was used for statistical analysis to compare whether there were differences in empathy ability,social self-efficacy,interpersonal communication skills,and doctor-patient communication skills between medical and nursing students and their possible reasons.Results:In terms of empathy ability,medical students scored higher than nursing students in the perspective-taking dimension.In terms of interpersonal communication skills,medical students scored higher than nursing students in the dimensions of proactive communication,appropriate rejection,conficet management,and emotional support,and the differences were statistically significant(P＜0.05);In terms of doctor-patient communication skills,medical students scored higher than nursing students in terms of attitude and service ability,transmission and collection ability,interaction and consensus reaching ability,expression ability,information confirmation ability,experience and feedback ability,and the differences were statistically significant(P＜0.05).With regards to social self-efficacy scores,females scored higher than males,and the difference was statistically significant(P＜0.05).Regarding the scores of interpersonal communication skills,medical students and first-choice students scored higher than those nursing students and non-first-choice students,and the difference was statistically significant(P＜0.05).There were statistical differences in the scores of doctor-patient communication skills in terms of gender,ethnicity,major,first choice,and place of origin(P＜0.05).There was a positive correlation between empathy,social self-efficacy,interpersonal communication skills,and doctor-patient communication skills(P＜0.05).Conclusion:Medical students have higher empathy,interpersonal communition and doctor-patient communication skills than nursing students.Whether they receive medical humanities education,their place of origin,and whether they are only children may be influencing factors.The dimensions of narrative literacy are positively correlated,and they are influenced by college students'gender,major,first choice,and place of origin.

Objective To conduct a visual analysis of the current status, hotspots, and frontiers of research on renal cell carcinoma targeted therapy using VOSviewer software. Methods Literature related to renal cell carcinoma targeted therapy published between January 1, 2006 and December 31, 2023, from the Web of Science (WOS) Core Collection database were retrieved. Eligible articles were screened and subjected to bibliometric and visual analysis using VOSviewer software. Results A total of 1, 009 articles were selected, with an overall increasing trend in annual publication volume. The top three countries in terms of publication output were the United States, China, and Italy, while the top three institutions were Harvard University, The University of Texas, and France Uni-cancer Institute. The analysis of the core author collaboration network revealed close collaboration among researchers in the United States and the United Kingdom, whereas collaboration between China and foreign countries was limited, resulting in a relatively loose collaboration network. Through co-occurrence clustering analysis of high-frequency author keywords, nine clusters were generated, with hotspots focusing on targeted and immune combination therapy, efficacy, prognosis, drug resistance, targets, and biomarkers. Conclusion Remarkable progress has been made in renal cell carcinoma targeted therapy research over the past decade; however, drug resistance and adverse reactions to targeted therapies remain challenges in clinical treatment. Research related to targeted drug resistance mechanisms, novel targeted drugs, and effective predictive biomarkers has significantly increased. Grasping the developmental trends in this fieldis crucial, and VOSviewer's visual analysis can offer an intuitive representation of the current status, hotspots, and frontiers, thereby providing researchers with a valuable reference.

[摘 要] 目的：分析干扰素基因刺激因子（STING）在肺腺癌中的表达及其与肺腺癌患者临床特征间的关系，探讨STING与内质网应激的相关性及其在调控肺腺癌进展中的作用机制。方法：利用TIMER数据库分析STING基因在泛癌水平的表达情况，利用UALCAN和HPA数据库分析STING在肺腺癌组织中的表达及其与肺腺癌患者临床特征间的关系，利用Kaplan-Meier生存函数分析STING表达与肺腺癌患者OS率间的关系。利用LinkedOmics数据库对肺腺癌表达谱数据进行STING基因共表达分析，对STING相关差异表达基因（DEG）进行GO功能与KEGG通路富集分析，通过GSEA筛选STING调控肺腺癌的潜在通路。使用STING激动剂diABZI及内质网应激抑制剂TUDCA对肺腺癌A549与H460细胞进行处理，通过qPCR、WB法检测STING及内质网应激相关分子的表达，通过CCK-8法检测细胞增殖活力。结果：肺腺癌组织和细胞中STING的表达水平均显著低于正常肺组织（均P<0.01），STING高表达肺腺癌患者5年OS率显著高于低表达患者（P<0.01），STING的表达与肺腺癌患者的年龄、性别等临床特征密切相关（均P<0.01）。STING高表达在肺腺癌外源性抗原处理及提呈等通路上存在富集（均P<0.01）。使用STING激动剂可显著诱导肺腺癌细胞发生内质网应激（P<0.05），STING诱导活化后肺腺癌细胞增殖活力显著下降（均P<0.01），内质网应激抑制剂能部分恢复STING活化诱导后下降的细胞活力（P<0.05）。结论：STING基因在肺腺癌中低表达，其表达下调与肺腺癌患者预后不良相关，其机制可能是STING通过诱导内质网应激而抑制肺腺癌细胞活力。

Objective To analyze the effect of different environments risks on the prognosis of patients with chronic obstructive pulmonary disease (COPD). Methods A total of 231 patients diagnosed with COPD who visited Mianyang Hospital of Traditional Chinese Medicine from April 2018 to January 2021 were selected as the study subjects and divided into two groups according to whether the residence was changed after discharge, that is, Mianyang Environmental Living Suzhou Environmental Living Group. The follow-up time was 2019 December to September 2021. The contents include relative humidity, temperature, PM_2.5, PM₁₀, air quality index, exposure to household smoking environment, and open windows for ventilation. The regional environment was mainly measured three times, namely October to February (expressed as cold period), June to August (expressed as warm period), March to May and September to October (expressed as suitable period). The family environment was followed up every 2 months by means of questionnaires and interviews, and detailed records were recorded. After the follow-up, the COPD Assessment Test (CAT) and Modified Dyspnea Rating Score (mMRC) were analyzed. Concentration-response curves were used to analyze the influence of living environment exposure on the prognosis of COPD patients. The generalized additive model with semi-Poisson distribution as the connection function was used to study the influence of univariate and multifactor environmental factors on COPD. Results The air quality index of Mianyang was higher than that of Suzhou during the cold period, while that of Mianyang was lower than that of Suzhou during the suitable period. Meanwhile, the average relative humidity of Suzhou was higher than that of Mianyang during the warm period. The comparison of CAT and mMRC scores of COPD patients in the two regions in different quarters showed that the CAT and mMRC scores of COPD patients in Mianyang City were lower than those in Suzhou City during the cold period, and the difference between groups was statistically significant (P<0.01). PM_2.5 (warm period), PM₁₀ (warm period) and NO2 (suitable period) increased by 10μg/m³, 8μg/m³, 12μg/m³ and CO (suitable period) increased by 0.3mg/m³ respectively caused COPD function The scores of indicators CAT and mMRC increased. After adjusting for other pollutants, PM_2.5, CO were still related to the prognosis of COPD. Concentration-response curve results showed that the risk of increasing CAT score decreased with increasing daily windowing time; conversely, the risk of increasing CAT score was increasing with increasing environmental exposure to smoking. Conclusion Pollutant exposure and living environment factors have a significant impact on the prognosis of COPD, and improving the environment is of great significance for the recovery of COPD pulmonary function.

ObjectiveTo analyze the microbial diversity in the rhizosphere soil of Gastrodia elata with different yields and explore the influence of soil microorganisms on the yield of G. elata. MethodThe experiment adopted the 16S DNA and ITS high-throughput sequencing technologies to study the diversity of the bacterial and fungal community in the rhizosphere soil of G. elata with high yield （GC） and low yield （DC）. ResultProteobacteria， Firmicutes， and other unidentified Bacteria were dominant in the rhizosphere soil of G. elata. The dominant rhizosphere fungi were Ascomycota， Basidiomycota， and Mortierellomycota. There was no significant difference in microbial community abundance in the high-yield and low-yield rhizosphere soil of G. elata， but there was a significant difference in species composition. Thirty-eight microbes such as Bradyrhizobium， Schleiferilactobacillus， and Archaeorhizomyces were gathered in large numbers in the high-yield rhizosphere soil， and thirty microbes such as Fusarium， Coprinellus， and Nitrosotalea were gathered in large numbers in the low-yield rhizosphere soil. At the level of genus and species， there were six different species in the high-yield and low-yield rhizosphere soil of G. elata， among which Russula mariae， Archeaeorhizomyces， and Ilyonectria were gathered in the high-yield rhizosphere soil of G. elata， while Nitrosotalea， Coprinellus disserminatus， and Fusarium were gathered in the low-yield rhizosphere soil of G. elata. ConclusionThere are different microorganisms in the rhizosphere soil of G. elata with different yields， and it is speculated that these microorganisms are related to the yields of G. elata. The research results are expected to provide a vital theoretical basis for the follow-up study of the high yield of G. elata.

Objective: To investigate the burden of caregivers of elderly patients with chronic diseases and its influencing factors, so as to provide the evidence for reducing the burden of caregivers. Methods: The caregivers of patients with chronic diseases at ages of 65 years and older were selected using convenience sampling method from Jinqiu Hospital during 2020 and 2021. The burden of caregivers was estimated using Chinese version of Caregiver Burden Scale (CBI), the basic information of patients and caregivers was collected, and the influencing factors of caregivers' burden were identified using multivariable linear regression analysis. Results: Totally 276 questionnaires were distributed, and 261 were valid, with an effective rate of 94.57%. There were 48 men (18.39%) and 213 women (81.16%), 166 (63.60%) subjects aged 45 to 59 years and 354 (82.38%) subjects participating in training on COVID-19 prevention. The mean score of caregivers' burden was 26.27±14.93, and the mean scores of social burden and emotional burden were 11.08±5.23 and 7.81±6.24, respectively. The patients with chronic diseases included 183 men (70.11%), had a mean age of (89.97±8.26) years, had a mean score of activities of daily living of 20.00 (interquartile range, 50.00) and had a mean geriatric syndrome number of 4.10±1.57. Multivariable linear regression analysis identified caregivers' participating in training on COVID-19 prevention (β'=0.175), patients' activities of daily living (β'=-0.144), patients' geriatric syndrome number (β'=0.138) and patients' age (β'=0.162) as factors affecting the burden of caregivers. Conclusions The social and mental burden of the caregivers of elderly patients with chronic diseases is heavy, and patients' activities of daily living, number of geriatric syndromes and age, as well as caregivers' training on COVID-19 prevention may be associated.

OBJECTIVE：To study the improvement effects and mechanism of Polygonum orientale flower extract on hypoxia- reoxygenation injury of H 9c2 cardiomyocytes. METHODS ：H9c2 cardiomyocytes were divided into normal control group ，model group and low- ，medium- and high-concentrations groups of P. orientale flower extract （20，40，80 μg/mL）. Except for normal control group ，other groups were given 800 μmol/L CoCl2 to induce hypoxia-reoxygenation injury model. Cell apoptosis was observed. The levels of Ca 2+（in cytoplasm ），mitochondrial membrane potential （MMP），ATP enzyme （Na+-K+-ATP enzyme ，Ca2+-Mg2+-ATP enzyme） activities， the ratio of cytochrome c （Cyto c ）， protein in cytosol to mitochondria ，phosphorylation levels of reperfusion injury salvage kinase （RISK） signaling pathwayrelated protein [protein kinase B （Akt）and extracellular signal regulated kinase 1/2（ERK1/2）] as well as protein expression of HIF- 1 α were detected respectively. In addition，the cells were divided into normal control group ，model group and P. orientale flower extract group （80 μ g/mL），PI3K inhibitor LY294002+CoCl2 group（15 μmol/L LY294002+80 μmol/L ，LY294002+P. orientale flower extract group （15 μmol/L LY294002+80 μg/mL P. orientale flower extract ），MEK inhibitor PD98059+CoCl2 group（25 μmol/L PD98059+800 μmol/L CoCl2），PD98059+P. orientale flower extract group （25 μmol/L PD98059+80 μg/mL P. orientale flower extract ）. After cultured by the same method ，the phosphorylation levels of Akt protein and ERK1/2 protein in the cells were measured to verify the activation of P. orientale flower extract to RISK signaling pathway. RESULTS：Compared with model group ，nuclear pyknosis and the number of apoptotic bodies were reduced in different concentrations groups of P. orientale flower extract. ROS level ，Ca2+ level（except for low-concentration group ），MMP，ratio of Cyto c in cytoplasm to Cyto c in mitochondria ，protein expression of HIF- 1α were decreased significantly（P＜0.05 or P＜0.01）； the activity of ATP enzyme （except for the low-concentration group ），Akt protein and ERK 1/2 protein phosphorylation level were significantly increased （P＜0.01）. After treated with PI 3K inhibitor LY 294002 and MEK inhibitor PD 98059，Akt protein and ERK 1/2 protein phosphorylation level in cadiomyocyte were decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ：P. orientale flower extract can improve hypoxia-reoxygenation injury of H 9c2 cardiomyocytes，the mechanism of which may be associated with inhibiting cardiomyocyte apoptosis ，improving ATPase activity ，protecting mitochondria ，regulating RISK signaling pathway related proteins and HIF- 1α protein expression.

ObjectiveTo investigate the current status of knowledge， attitude and practice of nurses in mental health hospitals on the prevention and control of nosocomial infections， and to analyze the influencing factors. MethodsFrom June to August 2020， 402 clinical nurses from 8 mental health hospitals in a city were enrolled using simple random sampling method， and were assessed using a self-compiled knowledge-attitude-practice questionnaire related to the nosocomial infection prevention and control， thereafter， the influencing factors were screened. ResultsThe scores of knowledge， attitude and practice dimensions in relation to the nosocomial infection prevention and control among the nurses were （8.43±1.84）， （76.01±5.70） and （57.42±3.75）， respectively. Univariate analysis showed that the knowledge dimension score demonstrated significant difference among nurses of different types of hospital， grades of hospital， professional titles， education levels， and emphasis degrees of hospital and individual on nosocomial infection （P<0.05 or 0.01）. The attitude dimension scores yielded significant difference among nurses of different types of hospital， position， grades of hospital， and emphasis degrees of hospital and individual on nosocomial infection （P<0.05 or 0.01）. The practice dimension scores manifested significant difference among nurses of different types of hospital， grades of hospital， professional titles， emphasis degrees of hospital and individual on nosocomial infection， and training frequency （P<0.05 or 0.01）. Multiple linear regression analysis showed that professional titles and individual emphasis on nosocomial infection entered the regression model of nurses' knowledge dimension of nosocomial infection prevention and control （P<0.05 or 0.01）. Individual emphasis on nosocomial infection， hospital types and position entered the regression model of attitude dimension （P<0.05 or 0.01）. Individual emphasis on nosocomial infection， hospital types， professional titles， and hospital emphasis on nosocomial infection entered the regression model of practice dimension （P<0.05 or 0.01）. ConclusionNurses in mental health hospital have a positive attitude towards nosocomial infection prevention and control， but their knowledge base needs to be strengthened.