Objective This study aims at establishing a teaching catalog and content for breast rare dis-eases and developing the syllabus for the breast rare disease using integrated multimodality of case-/problem-/resource-based learning(CBL+PBL+RBL).Methods By conducting bibliometrics co-occurrence analysis,we collected 6291 articles on breast rare disease published from January,1975 to June,2024.Additionally,we re-trieved the Textbook on Rare Diseases,the Catalog of Chinese Rare Disease,and Second Batch of Rare Dis-ease Catalog and then decided the teaching content.Results From 16,387 keywords,1000(6.1％)keywords were identified through co-occurrence analysis,including 50(0.3％)candidate diseases.These were classified into three categories:rare primary breast diseases,rare genetic mutation-related diseases associated with breast cancer,and rare systemic multi-system diseases involving the breast.From the candidate list,20(0.1％)rare primary breast diseases were further selected for their notable clinical teaching significance,and significant multi-systemic diseases affecting the breast,whether related to gene mutations or not.Teaching plans were draf-ted using a diversified parallel teaching approaches,taking into account the characteristics of different diseases and the focus of different teaching methods.Conclusions This study initiated the development of the teaching content for breast rare diseases and developed the teaching syllabus using the CBL+PBL+RBL integrated multi teaching model and targeting each rare breast disease for the critical point for teaching.

Phosphatase and tensin-homolog deleted on chromosome 10 (PTEN) is an important cancer suppressor gene. Its pathogenic mutation leads to PTEN hamartoma tumor syndrome (PHTS), a rare syndrome also known as Cowden syndrome, which is relevant to early-onset hereditary breast cancer (BC). In this paper, we report three patients with unilateral multicentric BC and synchronous and metachronous bilateral BC who harbored PTEN gene mutations, and summarize the clinical manifestations, pathological characteristics, diagnosis, treatment and follow-up outcomes to provide reference for management of PTEN gene mutation-related BC among the Cowden syndrome population.

Objective:To examines the social health status and influencing factors affecting the elderly population in urban communities of Beijing, based on the "the Standard for Healthy Chinese Older Adults(2022)" .Methods:Using the stratified sampling method, a total of 159 elderly individuals aged 60 and above from the Lanyuan community in the Malianwa street jurisdiction of Haidian district, Beijing, were selected as research subjects.The average age of the participants was(70.7±7.9)years, comprising 74 males and 85 females.Household face-to-face interviews were conducted, utilizing self-compiled questionnaires to perform a comprehensive assessment and analysis of the social health status of the elderly.Results:In the study involving community-based elderly participants, 32.1%(51 cases)were classified as healthy.The analysis revealed statistically significant differences in the social health status among various age groups of the elderly( χ2=11.802, P=0.019), with a notable downward trend in social health status as age increases( χ2=9.626, P=0.002).Furthermore, the results of multivariate Logistic regression analysis indicated that educational level( OR=2.119, 95% CI: 1.044-4.031, P=0.038)and chronic disease status( OR=5.007, 95% CI: 1.083-23.140, P=0.039)are significant influencing factors on the social health status of older adults. Conclusions:The social health status of the elderly in urban communities in Beijing is generally low and deteriorates progressively with age.Both educational attainment and chronic disease prevalence significantly influence the social health of this demographic.For elderly individuals with lower educational levels and poor chronic disease management, it is essential to conduct social health assessments and implement targeted intervention strategies to enhance their overall social health.

Purpose: Gastric cancer (GC) is among the deadliest malignancies and the third leading cause of cancer-related deaths worldwide. Galectin-1 (Gal-1) is a primary protein secreted by cancer-associated fibroblasts (CAFs); however, its role and mechanisms of action of Gal-1 in GC remain unclear. In this study, we stimulated GC cells with exogenous human recombinant galectin-1 protein (rhGal-1) to investigate its effects on the proliferation, migration, and resistance to cisplatin. Materials and Methods: We used simulated rhGal-1 protein as a paracrine factor produced by CAFs to induce GC cells and investigated its promotional effects and mechanisms in GC progression and cisplatin resistance. Immunohistochemical (IHC) assay confirmed that Gal-1 expression was associated with clinicopathological parameters and correlated with the expression of neuropilin-1 (NRP-1), c-JUN, and Wee1. Results: Our study reveals Gal-1 expression was significantly associated with poor outcomes.Gal-1 boosts the proliferation and metastasis of GC cells by activating the NRP-1/C-JUN/ Wee1 pathway. Gal-1 notably increases GC cell resistance to cisplatin The NRP-1 inhibitor, EG00229, effectively counteracts these effects. Conclusions These findings revealed a potential mechanism by which Gal-1 promotes GC growth and contributes to chemoresistance, offering new therapeutic targets for the treatment of GC.

Objective:To retrieve, evaluate and summarize the relevant evidence of subcutaneous injection in patients to reduce pain at the injection site, so as to provide reference for clinical practice.Methods:According to the evidence pyramid "6S" model, all evidence on subcutaneous injection and injection site pain, including guidelines, expert consensus, summary of evidence, clinical decision, systematic review, etc were retrieved from domestic and international guideline networks and databases. The search period was from database establishment to October 2, 2022. The literature quality evaluation and evidence grading system of Joanna Briggs Institute (JBI) Evidence-based Health Care Center was used to evaluate the literature quality and classify the evidence level.Results:A total of 12 articles were included, including 2 expert consensus, 6 systematic reviews, 2 best evidence summaries and 2 clinical guidelines. A total of 21 pieces of best evidence were summarized from 8 aspects, including pre-subcutaneous injection assessment, injection site, injection needle, injection position, injection method, precautions, personnel training and health education.Conclusions:This study summarized a comprehensive and practical subcutaneous injection method. Clinical practitioners can use evidence to administer subcutaneous injection to patients, reduce pain and improve patients ′ comfort.

Objective:To evaluate and analyze the health status of elderly people from the physical, psychological and social aspects using the Health Criteria for Older Adults in China(2022), and to understand the impact of social demographic characteristics on the overall health status of the elderly.Methods:159 elderly people aged 60 years and over in the Lanyuan community of Malianwa Subdistrict, Haidian District, Beijing were selected by the stratified sampling method, with a mean age of(70.7±7.9)years, including 74 men and 85 women.The physical, psychological, social and overall health status of the elderly were comprehensively evaluated and analyzed from data collected through a self-designed questionnaire with face-to-face interviews at respondents' homes.Results:The percentage of participants in this community who were considered overall healthy was 30.2%(n=48). The proportions of those meeting the criteria for physical, mental and social health were 79.2%(n=126), 90.6%(n=144)and 32.1%(n=51), respectively.For participants of 3 age groups(60-69, n=89; 70-79, n=44; ≥80, n=26), differences in percentages of people who were considered not healthy, largely healthy and healthy, measured using the overall, physical, mental and social health criteria, were statistically significant( χ2=24.683, 57.096, 12.801, 11.802, all P<0.05), and results of the χ2test for trend showed that the frequency distribution of people with overall, physical, mental and social health decreased with age( χ2=16.878, 31.600, 9.626, 9.626, all P<0.05). Multivariate Logistic regression analysis showed that education level( OR=2.142, 95% CI: 1.053-4.538, P=0.035)was an influencing factor for overall health status of the elderly. Conclusions:The overall health status of community-dwelling elderly people in Beijing is relatively poor and deteriorates with age.Education level is a factor affecting their health status.Health assessment for the elderly should be strongly advocated, and targeted health education should be provided for the elderly in disease prevention and mental health care.

Objective:To explore the reliability and validity of the International Classification of Functioning, Disability and Health′s 17-item Rehabilitation Set (ICF-RS-17) when used to evaluate multidisciplinary inpatients.Methods:A total of 359 inpatients in the departments of rehabilitation, orthopedics, neurology, and neurosurgery of three hospitals in Jiangsu province were assessed with the ICF-RS-17 at admission and at discharge, and the internal consistency of the tool was calculated. Inter-rater and intra-rater reliability were quantified using interclass correlation coefficients (ICCs). Structural validity was analyzed using factor analysis.Results:The tool′s Cronbach′s α was 0.945. The overall inter-rater ICC was 0.946 with the ICCs of all of the items except b280 sensation of pain within the range from 0.630 to 0.948. The overall intra-rater ICCs ranged from 0.471 to 0.947. The factor analysis found three factors with eigenvalues greater than 1, accounting for 74% of the variation, without double-loaded items. The three influential factors were exercise ability, sleep perception communication ability and self-care ability.Conclusion:The ICF-RS-17 has good internal consistency, inter-rater and intra-rater reliability and structural validity in the evaluation of multidisciplinary inpatients.

Objective To establish the method of predicting the vertical ground reaction force (vGRF) during treadmill running based on principal component analysis and wavelet neural network (PCA-WNN). Methods Nine rearfoot strikers were selected and participated in running experiment on an instrumented treadmill at the speed of 12, 14 and 16 km/h. The kinematics data and vGRF were collected using infrared motion capture system and dynamometer treadmill. A three-layer neural network framework was constructed, in which the activation function of the hidden layers was the Morlet function. Velocities of mass center of the thigh, shank and foot as well as joint angles of the hip, knee and ankle were input into the WNN model. The prediction accuracy of the model was evaluated by the coefficient of multiple correlation (CMC) and error. The consistencies between predicted and measured peak GRF were analyzed by Bland-Altman method. Results The CMC between the predicted and measured GRF at different speeds were all greater than 0.99; the root mean square error (RMSE) between the predicted and measured vGRF was 0.18-0.28 BW; and the normalized root mean square error (NRMSE) was 6.20%-8.42%; the NRMSE between the predicted and measured impact forces and propulsive forces were all smaller than 15%. Bland-Altman results showed that the predicted peak errors of propulsive force at 12 km/h and that of impact force and propulsive force at 14 km/h were within the 95% agreement interval. Conclusions The PCA-WNN model constructed in this study can accurately predict the vGRF during treadmill running. The results provide a new method to obtain kinetic data and perform real-time monitoring on a treadmill, which is of great significance for studying running injuries and rehabilitation treatment.

Objective:To analyze the characteristics of sleep disordered breathing (SDB) in children with allergic rhinitis (AR), and improve the diagnosis and treatment at AR combined with obstructive sleep apnea (OSA).Methods:The clinical data of 120 patients with AR and OSA (AR and OSA group) admitted to the respiratory department at Shenzhen Children′s Hospital from May 2019 to December 2020 were retrospectively analyzed.A total of 120 children diagnosed with OSA and excluded AR during the same period were selected as control group.The SDB day and night symptoms, sleep structure characteristics and sleep breathing events were compared between two groups.Results:The average course of disease in children with AR and OSA was significantly longer than that in control group ( P=0.030). The main manifestations of children in AR and OSA group were mouth breathing (100.0%), snoring (99.2%), nasal obstruction (88.5%), and restless sleep (68.0%). There was no significant difference in sleep structure between two groups ( P>0.05), but the sleep efficiency of AR and OSA group was significantly lower than that of control group ( P=0.028). The respiratory events apnea hypopnea index, obstructive apnea index, obstructive apnea hypopnea index, hypopnea index and oxygen desaturation index of each sleep period in AR and OSA group were significantly higher than those in control group ( P<0.05). Among the children in AR and OSA group, moderate and severe OSA were the main manifestations, and the difference between two groups was statistically significant ( P<0.001). Conclusion:The combination of AR delayed the course of OSA in children.The main characteristics of sleep disordered breathing in children with AR are mouth opening, restless sleep, snoring and nasal obstruction.The sleep efficiency is decreased.Obstructive hypopnea and apnea are the most common respiratory events, and oxygen deficiency often occurs in rapid eye movement phase.Children with AR are more likely to have moderate or severe obstructive sleep apnea.

Objective To investigate an outbreak of norovirus GII gastroenteritis in a school, and explore the causes, transmission routes and risk factors of the outbreak, and to provide a scientific basis and experience for effective control of outbreaks of acute gastroenteritis in schools. Methods A case study of an acute gastroenteritis outbreak in a school in Wujin District, Changzhou was conducted by field epidemiological investigation. Anal swab samples of patients and controls were collected, and enterovirus nucleic acid was detected by real-time fluorescent PCR. Results From December 12 to December 17, 2019, a total of 185 cases were identified, all of them from students of the school, with an incidence rate of 3.84% (185/4,822). All of the cases were distributed in three (7^th/8^th/9^th) grades of the school, with attack rates of 5.38% (31 / 576), 18.71% (104 / 556) and 9.06% (50 / 552) in 7^th, 8^th and 9^th grade, respectively, showing a significant difference among the grades (χ²=54.47，P＜0.05). The attack rate of each floor of the teaching building from the first to fifth floor was 2.17% (5/230), 7.51% (26/346), 15.77% (53/336), 17.11% (65/380), and 6.38% (25/392), respectively, showing a statistically significant difference among different floors (χ²=55.66，P＜0.05). A total of 32 anal swabs were collected, including 12 patients, 10 control students and 10 workers in the canteen. Of them, 9 specimens of the patients and 1 specimen of the workers were positive for norovirus type GII. Conclusion The school outbreak of acute gastroenteritis was caused by norovirus GII. Close contact between students was the main mode of transmission. A hidden infection of canteen staff may be related to this outbreak. It is important to promote popular science of norovirus prevention and to enhance the awareness of the risks of the virus.