Diabetic peripheral neuropathy （DPN） is one of the common complications of diabetes. The disease has a long course with nerve pain and other symptoms， seriously affecting the quality of life of patients. DPN is related to high glucose in vivo， inflammation， oxidative stress， apoptosis， and autophagy， involving phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt）， Janus kinase （JAK）/signal transducer and activator of transcription （STAT）， nuclear factor-κB （NF-κB）， mitogen-activated protein kinase （MAPK）， and other signaling pathways. At present， the treatment of DPN mainly focuses on symptomatic treatments such as blood glucose control and neurotrophic therapy， but the effect is not ideal. Therefore， it is particularly important to select a reasonable and effective drug to prevent and treat DPN. In recent years， Chinese medicine has played an important role in the treatment of DPN. Many studies have explored the mechanism of Chinese medicine in the treatment of DPN， and it has been found that some Chinese medicine monomers and compounds can regulate signaling pathways to prevent and treat DPN. This paper reviewed the research results of signaling pathways involved in DPN and the regulation of related pathways by Chinese medicine， aiming to provide references for the clinical treatment of DPN.

In order to assist in the standardization and maturity evaluation of national hospital information interconnection, and further standardize the application and management of hospital medical record data, a hospital carried out the practice of design of structured medical records and the corresponding quality management from April 2021. Based on the six sigma quality management method, the hospital had developed universal templates for electronic medical records and a list of candidate electronic medical record templates. The problems faced by medical record data had been analyzed, and improvement strategies had been proposed from three levels: template design, software functionality and management services. The clinical departments were guided to design and develop various structured electronic medical record templates for specialties and specialized diseases, and established a medical record template design and quality management method. The hospital had ultimately designed a total of 614 structured electronic medical record templates that met the actual needs of the hospital. This practice enhanced the scalability of structured templates and quality of the data, and achieved localization and specialization of medical record templates while meeting the requirements of information interconnection and sharing, providing reference for promoting the interconnection and sharing of electronic medical records of hospitals in China.

Knee osteoarthritis （KOA） is a common degenerative joint disease in the middle-aged and elderly. The incidence of KOA is rising as the population aging aggravates and the obese population grows. KOA seriously affects the health and daily life of the patients. The commonly used drugs for the symptomatic treatment of KOA include non-steroidal anti-inflammatory drugs， cartilage protective drugs， and opioid analgesics， which have limited therapeutic effects and induce obvious adverse drug reactions. Eucommiae Cortex is one of the commonly used Chinese herbal medicines for the treatment of KOA， while its pharmacological material basis and mechanism remain unclear， which limits its clinical application. The active ingredients of Eucommiae Cortex for treating KOA mainly include iridoids （geniposide， aucubin）， lignans （pinoresinol diglucoside）， flavonoids （quercetin， astragaloside， baicalein， hyperoside， and kaempferol）， phenylpropanoids （chlorogenic acid）， and polysaccharides. These compounds regulate the levels of inflammatory cytokines， inhibit oxidative stress， protect chondrocytes， balance the synthesis and degradation of extracellular matrix， and control the progression of KOA via the mitogen-activated protein kinase， nuclear factor-κB， phosphatidylinositol-3-kinase/protein kinase B， and Janus kinase 1/signal transducer and activator of transcription 3 signaling pathways. This paper introduces the mechanisms of Eucommiae Cortex and its active components in the treatment of KOA， aiming to provide a theoretical basis for the development of new drugs for KOA.

Objective:To examine the roles of the threat to self-moderator (intolerance of uncertainty) and the motivational moderator (meaning in life) in the relationship between triggering variables (thwarted belongingness and fear of negative evaluation) and outcome variables (suicidal ideation and suicidal behavior) based on the integrated motivational-volitional model of suicidal behavior.Methods:A total of 1 325 university freshmen were investigated with the thwarted belongingness questionnaire, the brief fear of negative evaluation scale, the intolerance of uncertainty scale, the meaning in life questionnaire, the positive and negative suicide ideation inventory and the suicidal behaviors questionnaire-revised.SPSS 24.0 software was used for descriptive statistics, independent sample t-test, Pearson correlation analysis, and moderating effect analysis. AMOS 20.0 software was used for mediating effect analysis. Results:(1) Female students had more fear of negative evaluation than males ((41.89±9.96), (40.31±10.68), t=2.03, P<0.05). Students from rural areas experienced more thwarted belongingness than students from urban areas ((23.83±8.87), (22.49±9.17), t=2.51, P<0.05). (2) Thwarted belongingness, fear of negative evaluation, and intolerance of uncertainty were positively related to suicidal ideation and suicidal behavior ( r=0.24-0.59, all P<0.001), while meaning in life was negatively related to suicidal ideation and suicidal behavior ( r=-0.43, r=-0.22, both P<0.001). (3) Suicidal ideation mediated the relationship between thwarted belongingness and suicidal behavior ( β=0.34, P<0.001) and mediated the relationship between fear of negative evaluation and suicidal behavior ( β=0.11, P<0.001). (4) Compared to the students with lower levels of intolerance of uncertainty, for those who had higher levels of intolerance of uncertainty, thwarted belongingness had a stronger predictive power on suicidal ideation ( β=0.27, P<0.001; β=0.41, P<0.001) and fear of negative evaluation also had a stronger predictive power on suicidal ideation ( β=0.08, P<0.001; β=0.14, P<0.001). Compared to the students with lower levels of meaning in life, for those who had higher levels of meaning in life, fear of negative evaluation had a weaker predictive power on suicidal ideation ( β=0.20, P<0.001; β=0.12, P<0.001). Conclusion:This study provides empirical evidence to the integrated motivational-volitional model of suicidal behavior. Results indicate that effects of perceived stress from interpersonal relations on suicidal ideation are moderated by meaning in life and intolerance of uncertainty. Reducing the perceived stress from interpersonal relations, lessening the level of intolerable of uncertainty, and carrying out intervention programs aiming at meaning in life are potential intervention ways to reduce the suicide risks of university freshmen.

Objective:To investigate the acceptance of advance care planning and its influencing factors in heart failure patients.Methods:A total of 208 patients with heart failure were surveyed by general data questionnaires and advance care planning acceptance questionnaires.Results:The total score of advance care planning acceptance of heart failure patients was (44.26 ± 11.73), the score of feeling dimension was (13.67 ± 5.72), the score of attitude dimension was (30.59 ± 6.33). 53.4%(111/208) of patients were willing to accept the talking about advance care planning. Regression analysis results showed that education level, New York Heart Association (NYHA) classification, communication status with medical staff and whether they had received life-sustaining treatment were important factors influencing of the acceptance of advance care planning in patients with heart failure.Conclusion:Patients with heart failure had higher acceptance of advance care planning. In clinical work, it is necessary to strengthen the scientific popularization of advance care planning in patients with low education level, low NYHA grade and no exposure to life-sustaining treatment. And strengthen the daily communication with patients to prepare for the follow-up advance care planning related communication.

Objective:To establish a 10-year comparison table of cerebrovascular function score and first stroke risk, and to provide a new method for screening of high-risk population of stroke.Methods:In the beginning of 2003, a cohort for studing stroke risk factors in those aged 40 years and over was established in a community of Shanghai by cluster sampling. The common risk factors of stroke were investigated with a unified questionnaire, and the cerebrovascular function (cerebral vascular hemodynamic indexes, CVHI) was measured. The baseline study was completed from April to June 2003 and December 2004 to January 2005, respectively. The incident of first stroke and all cause of death were followed up year by year. The follow-up period was up to December 31, 2014. The 10-year incidence of first stroke was calculated according to the baseline score of cerebrovascular function, and the score-risk control table was established to estimate 10-year first stroke risk in each score group. The role of cerebrovascular function score in stroke was also estimated.Results:The follow-up term of 10 565 participants was (10.26±2.00) years, and 350 patients had first stroke during the follow-up. The trend 10-year incidence of first stroke both in men and women was significantly increased with the decrease of the score of cerebrovascular function (trend χ2=296.125, P<0.01). As the 10-year risk of first stroke was higher than 5% and higher than 10%, the corresponding CVHI score was lower than 70 and 40 points in males and lower than 30 and 20 points in females. When the scores of cerebral vascular function were divided by every 25 points, incidence of first stroke in each group from top to bottom was 1.9%, 4.7%, 10.8%, 15.2% in males and 1.6%, 4.4%, 4.8%, 11.4% in females, respectively. As compared to the top, the relative risk (95% CI) of first stroke in the lower groups was 2.61(1.67-4.07), 6.46(4.22-9.89), 9.74(6.53-14.52) for males and 2.82(1.93-4.12), 3.15(1.99-4.99), 8.12(5.65-11.68) for females, respectively. Multivariate analysis showed that the factors being selected into the regression equation were cerebrovascular function score, age, hypertension history, stroke family history and smoking history, among which the role of cerebrovascular function score was the strongest. Conclusion:The risk of first stroke increases significantly with the decrease of cerebrovascular function score, which can be used to assess the 10-year risk of first stroke.

Objective To explore the association between serum amyloid A (SAA) and carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitus(T2DM).Methods A total of 148 diabetic subjects were divided into three groups according to C1MT:normal IMT group,IMT incrassation group and arteriosclerosis group.Levels of SAA,25-hydroxyvitamin D [25 (OH) D],brachial-ankle artery pulse wave velocity (baPWV),high density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),fasting plasma glucose (FPG),glycosylated hemoglobin (HbA1 c),triglyceride (TG),total cholesterol (TC),body mass index (BMI) and blood presure were measured in all groups.The relationship between SAA,CIMT,25 (OH)D,baPWV and other factors was also analyzed.Results Compared to the normal IMT group,levels of FPG,HbA1 c,TC,BMI,SAA and ba-PWV were significantly higher in IMT incrassation group and arteriosclerosis group,while HDL-C and 25 (OH)D were lower.In arteriosclerosis group,levels of BMI,FPG,HbA1 c,SAA and ba-PWV were higher than those in IMT incrassation group,while 25 (OH) D was lower.Pearson correlation analysis showed that the level of SAA was positively correlated with baPWV,BMI,TC,course of disease and IMT,while it was negatively correlated with HDL-C and 25 (OH)D.Logistic regression analysis of IMT showed that smoking,obesity,high levels of HbAlc,FPG,TC,SAA,low levels of HDL-C and 25 (OH)D may contribute to higher levels of IMT.Conclusions SAA was closely related to carotid atherosclerosis.Further prospective studies will be helpful to explore the influence of SAA on diabetic macroangiopathy.

Objective To investigate the relationships between mindfulness,anxiety and depression in surface warship soldiers and the mediating role of attentional control.Methods Chinese versions of State-Trait Anxiety Inventory ( STAI ) , Center for Epidemiologic Studies Depression Scale ( CES-D ) , Attentional Control Scale ( ACS) and the Five Facet Mindfulness Questionnaire ( FFMQ) were used to survey 475 sur-face warship soldiers. Single factor analysis of variance,correlation analysis and path analysis were conducted by SPSS 20.0 and Amos18.0. Results ①The scores of the state anxiety,trait anxiety and depression in the soldiers and noncommissioned officers were significantly higher than that of commissioned officers (P<0.05) . As for the state anxiety,trait anxiety,depression and attentional focusing,there were statistically significant differences among different educational levels (P<0.05) . Specifically,the lower educational level,the higher anxiety and depression,the lower control focusing. ② There were significant positive correlations among at-tentional focusing (27.12±4.43),attentional shifting (29.43±3.78) and mindfulness (120.27±11.16,r=0.49-0.51,P<0.01). State anxiety (38.65±10.07) was negatively correlated with attentional focusing,atten-tional shifting and mindfulness (r=-0.32--0.54, P<0.01). Similar results were observed for trait anxiety (41.28±8.79) and depression (9.97±10.13). ③Attentional focusing partially mediated the relationships be-tween state anxiety,trait anxiety,depression and mindfulness. Conclusion Anxiety and depression of sol-diers have obvious relationships with kinds of soldiers' rank and education level. Mindfulness and attentional control are vital protective factors for marine army's mental health. This study indicates that mindfulness may improve individuals' attentional focusing and attentional shifting,and ameliorate negative moods such as anx-iety and depression.

Objective To analyze psychological stress level and features of recruits in training camp.Methods Psychological stress self-evaluation test (PSET) was applied to 1 600 recruits in training camp.Results ①There were 64 recruits(64/1600,4％) who had high level of psychological stress(T score ≥70).②The psychological stress symptoms of recruits in training camp mainly manifested as increased alertness (87.7％),sleep deprivation (57.6％),mental and physical fatigue (48.7％) and nervous irritability (45.2％).③Psychological stress levels of recruits with different ages and different levels of self-feeling in camp had significant differences(P＜0.05).Conclusion Recruits in training camp have partly excessive psychological stress responses,targeted emergency decompression trainings should be carried out in recruits.

Objective:To translate the Attention to Positive and Negative Inventory(APNI)and analyze the validity and reliability in Chinese undergraduates sample,to offer a convenient and reliable tool of measuring the cognitive bias for national researchers. Methods:The English-version APNI went through translation into Chinese, retroversion into English,translation into Chinese again,and revision several stages. Two parts of samples (1450 Chinese college students)were surveyed. Sample one (n=1000)was used for item analysis,exploratory factor a-nalysis (EFA),concurrent validity and reliability analysis,while sample 2 (n=450)was used for confirmatory fac-tor analysis (CFA). Totally 68 subjects of sample 1 were randomly chosen and resurveyed with an interval of one week. Beck depression inventory (BDI-II)and patient health questionnaire (PHQ-9)was used for concurrent validi-ty. Results:Item analysis indicated that the 22 items of Chinese APNI had good discriminability. EFA focused onattention to positive information(API)and attention to negative information(ANI)two factors. CFA showed good model fit (χ2 =1376,RMESA=0. 09,CFI=0. 94). Concurrent validity result showed that the total scores of BDI-II and PHQ-9 was negatively correlated with total scores of API (r=-0. 24,-0. 29,Ps<0. 01 ),and posi-tively correlated with total scores of ANI (r=0. 36,0. 31,Ps<0. 01). The Cronbach'αcoefficients of API and ANI sub-scale were 0. 86 and 0. 82,while the retest reliability coefficients were 0. 79 and 0. 62. Conclusion:It suggests that the Chinese APNI has good validity and reliability in a sample of college students,which could be used to eval-uate the cognitive bias of Chinese college students.