AIM:This study aims to examine the ependymin-related protein 1(EPDR1)expression in various tissues from wild-type C57BL/6 mice and type 2 diabetes(db/db)mice.The impact of EPDR1 on lipid accumulation in al-pha mouse liver 12(AML12)hepatocytes was also investigated.METHODS:Western blot was used to detect EPDR1 protein expression in the heart,liver,spleen,lung,kidney,gastrocnemius,brown adipose and brain tissues of C57BL/6 mice.Western blot and immunohistochemical(IHC)staining were also used to compare EPDR1 protein expression in the liver,gastrocnemius muscle,heart and kidney tissues of db/db and C57BL/6 mice.To develop an AML12 cell lipid deposi-tion model,palmitic acid(PA)+oleic acid(OA)was used,and the cells were transfected with adenovirus overexpressing EPDR1 or treated with exogenous recombinant EPDR1 protein(rEPDR1).ELISA was conducted to determine intracellu-lar triglyceride(TG)content,and oil red O staining was employed to assess the effect of EPDR1 on lipid accumulation in AML12 cells.RESULTS:Western blot and IHC staining results revealed that EPDR1 was widely expressed in various tis-sues of wild-type mice,with the liver exhibiting the highest protein expression level.However,EPDR1 expression was down-regulated in the liver,gastrocnemius muscle,heart and kidney tissues in diabetic db/db mice compared with wild-type mice.Oil red O staining revealed that overexpression of EPDR1 in AML12 liver cells or rEPDR1 treatment led to re-duced lipid accumulation.Furthermore,the TG content significantly decreased compared with the model group(P<0.05).CONCLUSION:EPDR1 is expressed in various tissues of wild-type mice,but showed diminished expression in the liver tissues of diabetic mice.Nevertheless,enhancing the expression of EPDR1 can aid in reducing lipid accumula-tion in hepatocytes.These findings provide an experimental foundation for further exploration of the role of EPDR1 in the development of fatty liver in diabetic liver tissue.

Objective:To retrieve, evaluate and summarize the best evidence of exercise reversal intervention in the elderly with cognitive frailty, and to provide evidence for guiding exercise in elderly patients.Methods:This study was a summary of evidence-based nursing evidence. Based on the PIPOST (P: Population; I: Intervention; P: Professional; O: Outcome; S: Setting; T: Type of evidence) mode, the evidence of exercise reversal intervention in the elderly with cognitive frailty in 25 relevant guideline network and association websites, Chinese and foreign language comprehensive databases such as PubMed, CINAHL, Web of Science, Embase, Chinese Biomedical Database, China National Knowledge Internet and others were searched, extracted and integrated. The retrieval time was from January 1, 2013 to February 14, 2022.Results:A total of 22 articles were included, including 3 guidelines, 2 expert consensuses, 1 clinical decision-making, 1 evidence summary, 9 Meta analysis, and 6 randomized controlled trials. Finally, 28 pieces of the best evidence including 7 dimensions were namely formulate principles,overall assessment, exercise mode, exercise intensity, exercise time and frequency, exercise management, health guidance.Conclusions:This study summarized the best evidence of exercise intervention in the elderly with cognitive frailty, which are systematic, comprehensive, rigorous, and reliable. It can provide references for healthcare administrators to dynamically evaluate patients′cognitive frailty status, formulate personalized exercise programs, and standardize exercise guidance for patients, so as to delay or even reverse cognitive frailty.

Objective To analyze the influencing factors and principal components of care needs outside hospital for acute leukemia patients with chemotherapy.Methods A total of 240 acute leu-kemia patients with chemotherapy in authors'hospital from January 2021 to December 2022 were se-lected as research objects,and the patients were divided into no demand group and unsatisfied group according to score of the Supportive Care Needs Questionnaire.The survey questionnaire was used to collect the related materials of patients;the influencing factors were analyzed by Logistic regression coefficient;the principal component analysis(PCA)was used to extract the principal components of influencing factors.Results A total of 240 patients completed the Supportive Care Needs Questionnaire assessment,of which 132 cases(55.00％)had a need for health information,121 cases(50.42％)had a need for care and support,101 cases(42.08％)had a need for psychology,86 cases(35.83％)had a need for physiology and daily life,and 31 cases(12.92％)had a need for sexual support.There were significant differences in gender,age,educational level,average household income and payment method between the two groups(P＜0.05);there were significant differences in the course of dis-ease,patterns of activity and comorbidity of symptoms between the two groups(P＜0.05).Univari-ate Logistic regression analysis showed that gender,age,education level,payment method,average household income,course of disease,patterns of activity and comorbidity of symptoms were the influencing factors of care needs(P＜0.05).Principal component analysis extracted three principal components:payment method,syndrome merging status,anddisease course,with a cumulative con-tribution rate of 63.556％.Conclusion Acute leukemia patients have the highest proportion of health information needs and the lowest proportion of sexual support needs.Payment methods,comor-bidity of symptoms and the course of disease show significant impacts on the care needs of patients.

Objective To analyze the influencing factors and principal components of care needs outside hospital for acute leukemia patients with chemotherapy.Methods A total of 240 acute leu-kemia patients with chemotherapy in authors'hospital from January 2021 to December 2022 were se-lected as research objects,and the patients were divided into no demand group and unsatisfied group according to score of the Supportive Care Needs Questionnaire.The survey questionnaire was used to collect the related materials of patients;the influencing factors were analyzed by Logistic regression coefficient;the principal component analysis(PCA)was used to extract the principal components of influencing factors.Results A total of 240 patients completed the Supportive Care Needs Questionnaire assessment,of which 132 cases(55.00％)had a need for health information,121 cases(50.42％)had a need for care and support,101 cases(42.08％)had a need for psychology,86 cases(35.83％)had a need for physiology and daily life,and 31 cases(12.92％)had a need for sexual support.There were significant differences in gender,age,educational level,average household income and payment method between the two groups(P＜0.05);there were significant differences in the course of dis-ease,patterns of activity and comorbidity of symptoms between the two groups(P＜0.05).Univari-ate Logistic regression analysis showed that gender,age,education level,payment method,average household income,course of disease,patterns of activity and comorbidity of symptoms were the influencing factors of care needs(P＜0.05).Principal component analysis extracted three principal components:payment method,syndrome merging status,anddisease course,with a cumulative con-tribution rate of 63.556％.Conclusion Acute leukemia patients have the highest proportion of health information needs and the lowest proportion of sexual support needs.Payment methods,comor-bidity of symptoms and the course of disease show significant impacts on the care needs of patients.

【Objective】 To study the role and mechanism of sinomenine in the macrophage polarization induced by gastric cancer cells. 【Methods】 Sinomenine was added to gastric cancer cells BGC-823 and MKN-45， cell viability was measured by CCK-8， cell proliferation was measured by colony formation experiment， Co-culture and Transwell cell migration experiments were used to evaluate the recruitment and polarization of macrophages by sinomenine， flow cytometry was used to evaluate the polarization of macrophages， and qRT-PCR and Western blot were used to detect the expression of gene RNA and protein levels. 【Results】 Sinomenine could inhibit the proliferation of gastric cancer cells and the recruitment of gastric cancer cells to macrophages， thus promoting macrophage M2 polarization. It simultaneously inhibited the expression of STAT6 as well as the expression and phosphorylation of C/EBPβ. When STAT6 is overexpressed， it could reduce these inhibitory effects of sinomenine on gastric cancer cells. Further research found that STAT6 mediated the secretion of IL-6 by gastric cancer cells， which was the cause of sinomenine-mediated macrophage recruitment and M2 polarization. 【Conclusion】 The natural drug sinomenine has a good tumor-suppressing ability against gastric cancer， directly inhibits the survival and migration of gastric cancer cells， and inhibits the expression of IL-6 and the M2 phenotype in the tumor microenvironment， reshapes the tumor environment， and reduces the risk of M2 type macrophages for gastric cancer tumors.

Objective:To understand the oral health and frailty status of the elderly in the community in Beijing and analyze the correlation between the two, so as to provide a reference for the frailty management of the elderly in the community.Methods:This study was a cross-sectional study. Using the multi-stage stratified sampling method, a total of 241 community elderly people in 9 communities in Beijing from July to December 2021 were selected as the research objects. They were investigated using the general information questionnaire, Mini-Nutritional Assessment (MNA) and the Fried Frailty Phenotype. Univariate analysis and ordinal logistic regression analysis were used to explore the influencing factors of frailty among the elderly in the community. A total of 260 questionnaires were distributed in this study and 241 valid questionnaires were recovered, with an effective recovery rate of 92.6%.Results:Among the 241 community elders, 115 (47.7%) were not frail, 92 (38.2%) were pre-frail and 34 (14.1%) were frail. Ordinal Logistic regression analysis showed that the number of teeth of 0-9, 10-19, dry mouth and incomplete or unrepaired restoration of missing teeth were risk factors for frailty among the elderly in the community ( P<0.05) . Conclusions:From the perspective of oral health, this study further analyzes the risk factors of frailty in the elderly in the community. Medical institutions and elderly care institutions at all levels can use oral health status as a screening item for the frailty risk of the elderly in the community, providing new ideas for the prevention and intervention of frailty in the community.

Objective:To explore the application effect of scenario simulation exercise in standardized training of newly recruited nurses.Methods:Using the convenient sampling method, the newly recruited nurses in Henan Provincial People's Hospital from 2019 to 2020 were selected as the research objects. A total of 50 newly recruited nurses in 2019 were set as the control group, while 50 newly recruited nurses in 2020 were set as the observation group. The newly recruited nurses in the control group adopted traditional training methods, while the observation group added scenario simulation exercise teaching on the basis of the control group. The theoretical assessment and practical operation scores and Critical Thinking Disposition Inventory-Chinese Version (CTDI-CV) scores of the two groups were compared, and the training satisfaction was evaluated.Results:The theoretical assessment and practical operation scores, all dimensions scores of CTDI-CV and total satisfaction of training of the newly recruited nurses in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:In the standardized training of newly recruited nurses, the use of scenario simulation exercise can improve the theoretical and practical mastery of new nurses, promote the improvement of critical thinking ability of nurses and improve training satisfaction.

Objective:To explore the expression of polypyrimidine tract-binding protein 1 (PTBP1) in gastric cancer (GC) tissues and GC cell lines, and the role of PTBP1 in the proliferation and metastasis of GC cells.Methods:From January to June in 2019 at The First Affiliated Hospital of Xi′an Jiaotong University, the cancer tissues and corresponding para-cancer tissues of GC patients underwent surgical resection were collected. The Kaplan-Meier Plotter database was used to analyze the survival of GC patients. The expression of PTBP1 was down-regulated by transfecting small interfering RNA (siRNA) in human GC cell lines SGC7901 and AGS with relatively high expression of PTBP1. The cells were divided into blank control group, negative control group, and PTBP1 knockdown group. The expression of PTBP1 at mRNA and protein level were detected by real-time fluorescence quantification polymerase chain reaction (RT-qPCR) and Western blotting. At 24, 48, 72 and 96-hour after transfection, the effect of PTBP1 on the proliferation of GC cells was observed by 3-(4, 5 dimethylthiazol)-2, 5 diphenyltetrazolium bromide (MTT) experiment. The changes of invasion and migration of GC cells after down-regulation of PTBP1 were detected by transwell assay. The expression changes of epithelial-mesenchymal transition (EMT) markers E-cadherin, N-cadherin and vimentin after down-regulation of PTBP1 in GC cells were determined by Western blotting. Indenpendent samples t test, analysis of variance and rank sum test were used for statistical analysis. Results:The Kaplan-Meier Plotter prognostic analysis showed that the overall survival of GC patients with high PTBP1 expression was shorter than that of GC patients with low PTBP1 expression (9.2 months, 6.2 months to 17.2 months vs. 19.0 months, 14.5 months to 28.4 months), and the difference was statistically significant ( Z=5.31, P<0.05). The results of RT-qPCR showed that in GC cell lines SGC7901 and AGS, the expression of PTBP1 at mRNA level of PTBP1 knockdown group was lower than that of blank control group and negative control group (SGC7901: 0.78±0.11 vs.3.10±0.19 and 2.99±0.23; AGS: 0.80±0.09 vs. 3.55±0.24 and 3.50±0.18), and the differences were statistically significant ( tSGC7901=10.57 and 8.08, tAGS=10.91 and 13.42; all P<0.01). The results of Western blotting indicated that in GC cell lines SGC7901 and AGS, the expression of PTBP1 at protein level of PTBP1 knockdown group was lower than those of blank control group and negative control group (SGC7901: 0.38±0.04 vs. 1.42±0.05 and 1.35±0.09; AGS: 0.17±0.02 vs. 1.52±0.08 and 1.38±0.45), and the differences were statistically significant ( tSGC7901=15.94 and 10.57, tAGS=16.60 and 20.80; all P<0.01). The results of MTT showed that at 48, 72 and 96-hour after transfection the absorbance values of PTBP1 knockdown group decreased by 0.25±0.01, 0.38±0.02, and 0.84±0.04 as compared with those of negative control group, and the decrease was the most significant at 96-hour after transfection, and the differences were statistically significant ( t=10.21、14.32, both P<0.01). The results of transwell experiment demonstrated that the number of invasion and migration cells of PTBP1 knockdown group were both less than that of the blank control group and the negative control group (SGC7901: 42.00±5.91 vs. 116.40±10.23 and 114.40±10.43; 39.60±6.77 vs. 125.80±11.51 and 122.40±5.90; AGS: 40.20±7.25 vs. 115.60±14.63 and 117.40±9.12; 36.00±5.20 vs. 122.40±12.10 and 125.40±12.74), and the differences were statistically significant ( tSGC7901=14.07, 13.50, 14.43 and 20.62; tAGS=10.27, 14.75, 14.68 and 16.76; all P<0.01). The results of Western blotting showed that the expression of E-cadherin of PTBP1 knockdown group was higher than that of the blank control group and the negative control group (SGC7901: 1.42±0.05 vs. 0.53±0.05 and 0.57±0.03; AGS: 1.34±0.04 vs. 0.54±0.03 and 0.61±0.01), however the expression levels of N-cadherin and vimentin were both lower than those of the blank control group and the negative control group (SGC7901: 0.50±0.03 vs. 1.64±0.05 and 1.46±0.07; 0.32±0.07 vs. 1.42±0.07 and 1.33±0.07; AGS: 0.37±0.06 vs. 1.47±0.04 and 1.36±0.04; 0.41±0.04 vs. 1.53±0.06 and 1.37±0.04), and the differences were statistically significant ( tSGC7901=11.63, 13.19, 18.83, 11.68, 11.43 and 10.43; tAGS= 15.02, 16.23, 14.67, 12.97, 14.45 and 17.18; all P<0.01). Conclusions:The expression levels of PTBP1 increase in GC tissues and cells, which may be involved in regulating the proliferation, metastasis and EMT of GC cells.

Objective: To explore the current status of village doctors′ vulnerability in Shandong province in the context of ongoing healthcare reform. Methods: A cross-section study was conducted from October 2015 to November 2015 based on a self-designed questionnaire for village doctors. The questionnaire included 6 parts: fundamental state, disturbance from surroundings, disturbance from job, emotional support, instrumental support and self-ability of village doctors. Mean and standard deviation were adopted to describe the level of disturbance and support. Quadrant analysis was adopted to analyze village doctors′ vulnerability. The set pair analysis was adopted to calculate the vulnerability index and sample cluster analysis was adopted to classify village doctors based on the vulnerability index. Results: The total disturbance score was 3.39±0.46, and contribution from professional risk was the biggest(19.95%). The self-ability score was 3.33±0.40, and contribution from financial support was the smallest(4.09%). According to the set pair analysis, village doctors′ vulnerability total score was 0.49±0.06, ranging in a medium category. According to the sample cluster analysis, 27.2%(277/1 018)of the village doctors stayed at the upper category, as 30.3%(309/1 018) was defined as a medium category. According to the quadrant analysis, 35.5%(361/1 018)of the village doctors were found as in crisis vulnerability. Conclusions In general, village doctors′ vulnerability stays in the medium category. They have to fight against high disturbance from surroundings, with more emotional support and less financial support expected.

Objective: To explore the formation mechanism of the weakening of village clinic′s medical service capacity in the context of new medical reform. Methods: Purposive sampling method was used to enroll 38 rural doctors and managers of rural health centers and health offices in the interview from October 2015 to November 2015. And grounded theory was adopted to analyze reasons and their mechanism of the weakening of village clinic′ s medical service capacity. Results: 29 first-grade categories and 7 second-grade categories were worked out in text encoding. With the implementation of the ongoing healthcare reform, support from financial, policy and technology increased significantly, but due to the synthetic action of unexpected negative effects of the reform, superposition and accumulation of disturbance and ineffective support, village clinic′ s medical service capacity began to weaken. Conclusions The weakened village clinic′ s medical service capacity is a result of the synthetic action of 3 reasons. The persistence of this status will intensify the vulnerability of rural health service system and be bad for the implementation of hierarchical medical policy and the strategy of rural vitalization. Measures should be taken to optimization the essential medicine system, establish a comprehensive assessment mechanism for basic medical service and basic public health service of village clinic, strength the strategic purchasing of medical insurance, improve the financial compensation mechanism, and complete training system of village doctors, aims to promoting sustainable development of village clinic.