ObjectiveTo explore the effectiveness of health information dissemination and its influencing factors using the "Shanghai CDC" WeChat public account as a case study, providing references for public health institutions to optimize the use of official new media platforms for effective publicity. MethodsA total of 1 030 headline articles published on the "Shanghai CDC" WeChat public account between 2016 and 2019 were analyzed using content analysis and non-parametric tests to examine the impact of factors such as titles and content categories. ResultsFrom 2016 to 2019, the number of WeChat public account followers increased by 280 000, with the articles accumulating over 8.8 million views. The median (P₂₅, P₇₅) open rate of articles was 5.90% (3.69%, 10.31%), and the median (P₂₅, P₇₅) sharing and forwarding rate was 6.60% (4.25%, 9.17%). Factors such as the use of first- and second-person pronouns, degree adverbs, negative adverbs, explicit viewpoints, and title length all significantly affected the open rate of articles, with OR (95%CI) values of 0.175 (0.041‒0.756), 32.606 (2.350‒452.432), 4.079 (1.093‒15.230), 0.106 (0.028‒0.409), and 1.184 (1.063‒1.319),respectively (all P<0.05). In terms of content, statistical significant differences in dissemination effectiveness were observed across article categories and themes (P<0.05). In terms of article categories, articles related to news hotspots and service information had higher open rates of 9.58% and 14.00%, respectively. These two types of articles also obtained higher sharing and forwarding rates of 7.65% and 9.16%, respectively. In terms of article topics, compared with healthy life and health products, among the top four topics in terms of publication volume, the open rates of articles about infectious diseases and disease-causing biology and immunization programs were higher, accounting for 7.88% and 6.88%, respectively, with no significant difference in sharing and forwarding rates. ConclusionThe "Shanghai CDC" WeChat public account demonstrated good dissemination effectiveness. Enhancing article titles by increasing informational content and degree adverbs (e.g., "highly," "most," and "extremely") and negative adverbs (e.g., "no") can improve dissemination reach. Public health WeChat accounts should incorporate news hotspots or service information in their articles. While maintaining their strengths in disseminating knowledge on infectious diseases and immunization programs, they should also enhance public education in other professional fields within their scope of responsibility to improve the overall dissemination impact of health information.

ObjectiveTo study the effects of applying different microbial fertilizers on the growth and rhizosphere soil environment of Codonopsis pilosula and provide a theoretical basis for ecological cultivation of this medicinal plant. MethodsSeven groups were designed， including CK （no application of microbial fertilizer）， T1 （Trichoderma longibrachiatum fertilizer）， T2 （Bacillus subtilis fertilizer）， T3 （Trichoderma viride fertilizer）， T4 （compound microbial fertilizer）， T5 （C. pilosula stems and leaves fermented with compound microbial fertilizer）， and T6 （Scutellaria baicalensis stems and leaves fermented with T. viride fertilizer）. The physiological indicators， yield， and quality of C. pilosula and the physicochemical properties， enzyme activities， and microbial diversity in the rhizosphere soil of different fertilizer treatments were measured. ResultsGroup T1 showed slight decreases in soluble protein content （SPC） and superoxide dismutase （SOD）. Groups T2-T6 showed increases in physiological indicators such as proline （Pro）， soluble solids content （SSC）， SPC， catalase （CAT）， and peroxidase （POD） and a decrease in malondialdehyde （MDA） in C. pilosula leaves. All the fertilizer treatments increased the yield of C. pilosula and the total polysaccharide content in the roots. T1， T2， T3， T4， and T5 increased the total flavonoid content in the roots. Meanwhile， T4 increased the total saponin content in the roots. All the fertilizer treatments reduced the pH and increased the electric conductivity （EC）， soil organic matter （SOM）， and alkaline nitrogen （AN） in the soil. T2 and T5 increased the available phosphorus （AP）， and T3， T4， T5， and T6 increased the available potassium （AK） in the soil. All the fertilizer treatments increased the activities of urease， sucrase， and CAT in the soil. Except that T1 decreased the bacterial diversity in the soil， other fertilizer treatments significantly increased bacterial and fungal diversity in the soil. Different fertilizer treatments significantly affected the composition of bacterial and fungal communities in the soil. At the phylum level， the dominant bacterial phyla included Proteobacteria， Acidobacteriota， and Bacteroideta， and the dominant fungal phyla were Ascomycota， Mortierellomycota， and unclassified_fungi in the rhizosphere soil of C. pilosula after bacterial fertilizer treatment. At the genus level， unclassified Gemmatimonadaceae， Sphingomonas， and unclassified Vicinamibacteraceae were the dominant bacterial genera， while unidentified， unclassified Fungi， and unclassified Sordariomycetes were the dominant fungal genera in the rhizosphere soil. The results of redundancy analysis indicated that the main physicochemical factors affecting changes of microbial communities in the rhizosphere soil of C. pilosula were pH， EC， AK， AN， AP， and soil organic matter （SOM） in the soil. The correlation heatmap showed that Bryobacter had significantly positive correlations with EC， AK， and AN. There was a significantly negative correlation between Fusarium and SOM. In summary， applying an appropriate amount of microbial fertilizer can promote the growth and improve the rhizosphere soil environment of C. pilosula. ConclusionThe compound microbial fertilizer and the C. pilosula stems and leaves fermented with compound microbial fertilizer can improve the soil nutrients， growth， development， yield， and quality of C. pilosula， and thus they can be applied to the artificial cultivation of C. pilosula.

ObjectiveTo study the effects of applying different microbial fertilizers on the growth and rhizosphere soil environment of Codonopsis pilosula and provide a theoretical basis for ecological cultivation of this medicinal plant. MethodsSeven groups were designed， including CK （no application of microbial fertilizer）， T1 （Trichoderma longibrachiatum fertilizer）， T2 （Bacillus subtilis fertilizer）， T3 （Trichoderma viride fertilizer）， T4 （compound microbial fertilizer）， T5 （C. pilosula stems and leaves fermented with compound microbial fertilizer）， and T6 （Scutellaria baicalensis stems and leaves fermented with T. viride fertilizer）. The physiological indicators， yield， and quality of C. pilosula and the physicochemical properties， enzyme activities， and microbial diversity in the rhizosphere soil of different fertilizer treatments were measured. ResultsGroup T1 showed slight decreases in soluble protein content （SPC） and superoxide dismutase （SOD）. Groups T2-T6 showed increases in physiological indicators such as proline （Pro）， soluble solids content （SSC）， SPC， catalase （CAT）， and peroxidase （POD） and a decrease in malondialdehyde （MDA） in C. pilosula leaves. All the fertilizer treatments increased the yield of C. pilosula and the total polysaccharide content in the roots. T1， T2， T3， T4， and T5 increased the total flavonoid content in the roots. Meanwhile， T4 increased the total saponin content in the roots. All the fertilizer treatments reduced the pH and increased the electric conductivity （EC）， soil organic matter （SOM）， and alkaline nitrogen （AN） in the soil. T2 and T5 increased the available phosphorus （AP）， and T3， T4， T5， and T6 increased the available potassium （AK） in the soil. All the fertilizer treatments increased the activities of urease， sucrase， and CAT in the soil. Except that T1 decreased the bacterial diversity in the soil， other fertilizer treatments significantly increased bacterial and fungal diversity in the soil. Different fertilizer treatments significantly affected the composition of bacterial and fungal communities in the soil. At the phylum level， the dominant bacterial phyla included Proteobacteria， Acidobacteriota， and Bacteroideta， and the dominant fungal phyla were Ascomycota， Mortierellomycota， and unclassified_fungi in the rhizosphere soil of C. pilosula after bacterial fertilizer treatment. At the genus level， unclassified Gemmatimonadaceae， Sphingomonas， and unclassified Vicinamibacteraceae were the dominant bacterial genera， while unidentified， unclassified Fungi， and unclassified Sordariomycetes were the dominant fungal genera in the rhizosphere soil. The results of redundancy analysis indicated that the main physicochemical factors affecting changes of microbial communities in the rhizosphere soil of C. pilosula were pH， EC， AK， AN， AP， and soil organic matter （SOM） in the soil. The correlation heatmap showed that Bryobacter had significantly positive correlations with EC， AK， and AN. There was a significantly negative correlation between Fusarium and SOM. In summary， applying an appropriate amount of microbial fertilizer can promote the growth and improve the rhizosphere soil environment of C. pilosula. ConclusionThe compound microbial fertilizer and the C. pilosula stems and leaves fermented with compound microbial fertilizer can improve the soil nutrients， growth， development， yield， and quality of C. pilosula， and thus they can be applied to the artificial cultivation of C. pilosula.

Objective:To summarize the best evidence for non-pharmacological interventions for postoperative pain in patients undergoing abdominal surgery, so as to provide reference for alleviating postoperative pain in patients.Methods:UpToDate, BMJ Best Practice, PubMed, Embase, Web of Science, Guidelines International Network and other databases and professional association websites were searched for guidelines, clinical decisions, evidence summaries, systematic reviews, expert consensus and randomized controlled trials on non-pharmacological interventions for postoperative pain in patients undergoing abdominal surgery. The search period was from the establishment of the databases to December 30, 2022.Results:A total of 17 articles were included, including three clinical decision-making, four guidelines, six systematic evaluations, two expert consensus, one randomized controlled trial and one quasi-randomized cotrolled trial. A total of 30 pieces of evidence were summarized from six aspects, such as basic principles of non-pharmacological intervention, evaluation and planning, physical intervention, psychological intervention, other forms of intervention, health education and follow-up.Conclusions:The best evidence for non-pharmacological intervention in postoperative pain in patients undergoing abdominal surgery can provide a basis for clinical medical staff to conduct non-pharmacological intervention.

Objective:To explore the behavioral intention of nurses for pain management after abdominal surgery based on the planned behavior theory.Methods:According to the framework of planned behavior theory, an interview outline was developed. Using the purposive sampling method, a total of 11 General Surgical Department nurses from the First Affiliated Hospital of Wenzhou Medical University from July to November 2022 were selected as the interview subjects for semi-structured interviews to understand their behavioral intentions regarding postoperative pain management in abdominal surgery. Colaizzi 7-step analysis was used to analyze the original data. Two researchers repeatedly compared, verified, analyzed and summarized the interview data. When different opinions were generated, the group members discussed and decided together to ultimately determine the code and theme.Results:Based on the three dimensions of behavioral attitude, subjective norms and perceived behavioral control in the theoretical framework of planned behavior, three themes and seven sub-themes were extracted, such as behavioral attitude (positive attitude, negative attitude), pressure sources (group pressure, leadership pressure, patient and family pressure), subjective perception and behavior (imprisonment of comfort zone, insufficient support from external resources) .Conclusions:Most nurses hold a positive attitude towards pain management behavior after abdominal surgery, and the behavioral intention of postoperative pain management is affected by colleagues, leaders, patients and their families. At the same time, there are also obstacles such as insufficient personal ability and insufficient support from external resources.

Objective To systematically analyze influencing factors of migration stress of patients'families transferred out of intensive care unit(ICU)in China,and provide evidence-based guidance for alleviating migration stress level of families of transferred patients.Methods Computer searches were conducted on China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,VIP,China Biomedical Literature Database,Web of Science,PubMed,the Cochrane Library and Embase for observational studies such as cohort studies,case-control studies and cross-sectional studies on factors influencing migration stress among family members of ICU patients.Search deadline was from database establishment to October 2023.Literature screening,quality assessment and data extraction were conducted independently by two researchers in accordance with the inclusion and exclusion criteria.RevMan5.4 software was used to conduct a Meta-analysis of the data results.Results Fifteen studies were finally included,with a total sample size of 2558 and 12 influencing factors were extracted.Fifteen articles were divided into positive scoring group(higher scores,higher levels of migration stress,nine articles)and negative scoring group(higher scores,lower levels of migration stress,six articles)based on instruments used to measure outcome indicators.When analyzing each group,only factors mentioned in the group more than twice were included in Meta analysis.Meta analysis showed that within positive scoring group,family member education level,family member gender,patient awareness,ICU treatment time and family member uncertainty about the disease were factors affecting migration stress of ICU transfer patients'families(P<0.05);In reverse calculation group,educational level of family member,gender of family member,age of patient and ICU treatment time were influencing factors of migration stress of family members of ICU transfer patients(P<0.05).Sensitivity analysis result showed that result of each factor was relatively stable.Conclusion Educational level of family member,gender of family member,age of patient,ICU treatment time,uncertainty of family member's illness are influencing factors of migration stress of family members of patients transferred out of ICU in China.Influence of family member's religious beliefs and patient's consciousness needs further demonstration.

Deficiency of natural killer (NK) cells shows a significant impact on tumor progression and failure of immunotherapy. It is highly desirable to boost NK cell immunity by upregulating active receptors and relieving the immunosuppressive tumor microenvironment. Unfortunately, mobilization of NK cells is hampered by poor accumulation and short retention of drugs in tumors, thus declining antitumor efficiency. Herein, we develop an acid-switchable nanoparticle with self-adaptive aggregation property for co-delivering galunisertib and interleukin 15 (IL-15). The nanoparticles induce morphology switch by a decomposition-metal coordination cascade reaction, which provides a new methodology to trigger aggregation. It shows self-adaptive size-enlargement upon acidity, thus improving drug retention in tumor to over 120 h. The diameter of agglomerates is increased and drug release is effectively promoted following reduced pH values. The nanoparticles activate both NK cell and CD8⁺ T cell immunity in vivo. It significantly suppresses CT26 tumor in immune-deficient BALB/c mice, and the efficiency is further improved in immunocompetent mice, indicating that the nanoparticles can not only boost innate NK cell immunity but also adaptive T cell immunity. The approach reported here provides an innovative strategy to improve drug retention in tumors, which will enhance cancer immunotherapy by boosting NK cells.

Objective:To construct a health education program for patients with permanent enterostomy based on the information motivation behavioral skills model, and to test its effectiveness in improving patient readiness for discharge and reducing the incidence of early ostomy complications after discharge.Methods:From February 2021 to January 2022, convenience sampling was used to select 68 patients with low rectal cancer who were diagnosed by the Colorectal Surgery Department at the First Affiliated Hospital of Wenzhou Medical University and underwent abdominal perineal combined radical resection of rectal cancer (Miles) as research subjects. Randomized number series were generated using the digital table method, and the subjects were randomly divided into control group (33 cases) and intervention group (35 cases) using the envelope method. The control group was housed in the first ward, while the intervention group was housed in the second ward. The control group implemented the conventional health education, while the intervention group carried out the health education based on the information motivation behavioral skills model. The discharge readiness scores, ostomy self-efficacy and ostomy complications were compared between the two groups on the day of discharge and one month after discharge.Results:Patients in the intervention group had higher discharge readiness scores and higher discharge readiness levels than those in the control group, with statistical differences ( P<0.01) . The intervention group had higher levels of ostomy self-efficacy than the control group one month after discharge, with statistically significant difference ( P<0.01) . At the time of discharge for one month, the overall incidence of ostomy complications in the intervention group was 11.43% (4/35) , lower than 42.42% (14/33) in the control group, with a statistically significant difference ( P<0.01) . Conclusions:The health education program based on the information motivation behavioral skills model can effectively increase the readiness of patients with permanent enterostomy for discharge, reduce the incidence of complications of the ostomy and surrounding skin, improve the ostomy self-efficacy and promote patient rehabilitation.

【Objective】 To investigate HBV infection with low level of HBsAg and nucleic acid testing(NAT) non-reactive results in blood donors, and analyze molecular characteristics. 【Methods】 Low level HBsAg but NAT-nonreactive samples were collected and tested for HBsAg by Abbott chemiluminescent microparticle immunoassay (CMIA)., HBsAg, anti-HBs, HBeAg, anti-HBe and anti-HBc were further detected by Roche electrochemiluminescence immunoassay(ECLI). BCP/PC and S regions were also amplified by Nested-PCRs and qPCR for HBV DNA quantity were adopted simultaneously. 【Results】 Of 100 363 donations, 60(0.054%) low level HBsAg and NAT-nonreactive blood samples were enrolled the study. In which, 54/60(90%) and 57/60(95%) were WanTai HBsAg ELISA and DiaSorin HBsAg ELISA reactive respectively. Of 33 cases genotyped, genotype B were 87.9%( 29/33), including adw2 96.6%(28/29) and adw1 3.4%(1/29), C was observed in 4(12.1%) with sero-type adrq+. Mutations in S gene of genotype B such as Q101R, Q129H, T131I, M133L/T, F134L, G145R, V168A, L175S and V177A were observed as notable mutations, which can affect HBsAg diagnosis. A high frequency mutation C1799G(87.5%, 21/24)were detected in BCP/PC and would reduce the replication of virus. The median viral load measured by qPCR was 49.6(0~628)IU/mL. 【Conclusion】 A small part of donations with low-level HBsAg and NAT-nonreactive can not be deferred by one isolated ELISA screening assay. It is necessary to apply more sensitive and specific HBsAg assays and NAT in blood screening, and improve the ability to detected mutants.

Objective To investigate the correlation between the quality of life and joint health status of adult hemophilia patients. Methods Forty-nine adult hemophilia patients were selected.The quality of life and joint health status of patients were evaluated by hemophilia-specific health related quality of life questionnaire for adults (Hemo-QOL-A) and hemophilia joint health score (HJHS). Results The Hemo-QOL-A score of adult hemophilia patients was (39.34 ± 18.97) scores, and HJHS score was(33.16 ± 13.17)scores.The Pearson correlation analysis result showed that Hemo-QOL-A score was positively related with HJHS score (r = 0.490, P<0.05), and Hemo-QOL-A score was positively correlated with muscular condition,joint activity and joint friction sound score of HJHS score(r=0.469, 0.396 and 0.290; P<0.05). Hemo-QOL-A score was not correlated with swelling, swelling duration, arthralgia and gait of HJHS score (P>0.05). In 294 joints of 49 patients, the total abnormal rate of the joint was 82.7%(243/294),the abnormal rate of the elbow joint was 72.4%(71/98),the abnormal rate of the knee joint was 90.8%(89/98),and the abnormal rate of ankle joint was 84.7%(83/98).Conclusions Decreased joint health status, mainly including the surrounding muscle condition and joint mobility, results in lower quality of life in patients with hemophilia.