This article reviews the concept and significance of death literacy, assessment tools, current status domestically and internationally, influencing factors, and intervention measures. The aim is to provide insights for effective strategies to enhance residents' death literacy, thereby offering a new perspective for improving palliative care practices and research in China and ensuring quality of death.

Objective:To investigate COVID-19 vaccination status and relevant adverse reactions in patients with psoriasis treated with biological agents, and to explore the effect of COVID-19 vaccination on psoriatic lesions.Methods:Clinical data were collected from 572 psoriasis patients aged 18 - 60 years, who were registered in the management system of psoriasis patients treated with biological agents in the University of Hong Kong-Shenzhen Hospital from May 2019 to June 2021. The COVID-19 vaccination status was investigated by telephone interviews, and the vaccination-related information was obtained by fixed healthcare workers during a fixed time period according to a predesigned questionnaire. Measurement data were compared between two groups by using t test, and enumeration data were compared by using chi-square test or Fisher′s exact test. Results:The COVID-19 vaccination coverage rate was 43.13% (226 cases) among the 524 patients who completed the telephone interview, and was significantly lower in the biological agent treatment group (30.79%, 105/341) than in the traditional drug treatment group (66.12%, 121/183; χ2 = 60.60, P < 0.001) . The main reason for not being vaccinated was patients′ fear of vaccine safety (49.66%, 148/298) , followed by doctors′ not recommending (26.51%, 79/298) . In the biological agent treatment group after vaccination, the exacerbation of psoriatic lesions was more common in patients receiving prolonged-interval treatment (42.86%, 6/14) compared with those receiving regular treatment (4.40%, 4/91; Fisher′s exact test, P < 0.001) . Skin lesions were severely aggravated in two patients after COVID-19 vaccination, who ever experienced allergic reactions and whose skin lesions did not completely subside after the treatment with biological agents. Conclusions:The COVID-19 vaccination coverage rate was relatively low in the psoriasis patients treated with biological agents, and no serious adverse reaction was observed after vaccination. Prolonged-interval treatment due to COVID-19 vaccination ran the risk of exacerbation of skin lesions.

ObjectiveTo analyze the quality changes of Platycladi Semen before and after the deterioration of moth-eaten and rancidity during storage. MethodFour types samples of Platycladi Semen， including normal， moth-eaten， oxidative rancidity and hydrolytic rancidity， were determined for volatile components， odor， and taste based on headspace solid phase microextraction/gas chromatography-mass spectrometry （HS-SPME/GC-MS） and electronic sensory techniques such as electronic nose and electronic tongue. Volatile components were identified by searching the database and manual comparison， the odor and taste were determined by the response values of the electronic nose and electronic tongue sensors， and the difference between samples before and after deterioration was studied by multivariate statistical analysis. ResultA total of 85 compounds were identified in Platycladi Semen samples. Compared with the normal samples， the number of volatile compounds in samples after hydrolytic rancidity decreased by 5， the number of volatile compounds in samples after moth-eaten and oxidative rancidity increased by 1 and 21， respectively. Aldehydes and acids accounted for majority of types. Among them， the contents of N-hexanoic acid， hexanal and propionic acid in the samples of oxidative rancidity reached 11.49%， 10.21% and 7.52%， which became the key indicators of rancidity. There was significant variance among the odor components corresponding to W1W， W2W and W1S sensors by electronic nose analysis. It was indicated that the value of sourness in deteriorated samples generally increased by mean of electronic tongue analysis. Compared with normal samples， the moth-eaten samples had changed slightly and rancidity samples had changed significantly especially oxidative rancidity samples of volatile components， odor and taste by multivariate statistical analysis. ConclusionIn terms of Platycladi Semen， the oxidative rancidity caused by nature storage for 12 months has the greatest impact on the quality. Therefore， it should be mainly to prevent oxidative rancidity to ensure the quality of Platycladi Semen.

Objective:To evaluate the effects of different densities of rat cardiac fibroblasts (RCF) subjected to hypothermic hypoxia-reoxygenation on cardiomyocyte injury and intercellular coupling.Methods:RCF was cultured in vitro and divided into 3 groups ( n=12 each) using a random number table method: RCF density 0.5×10 5 cells/ml group (T 0.5 group), RCF density 1.0×10 5 cells/ml group (T 1.0 group), and RCF density 2.0×10 5 cells/ml group (T 2.0 group). The three groups were placed in an anoxic device, into which 95% N 2 + 5% CO 2 was continuously blown at the speed of 5 L/min for 15 min, and then placed in a 4 ℃ refrigerator for 1 h for low temperature treatment.After completion of culture, cells were placed in a incubator containing 95% air + 5% CO 2 at 37 ℃ for 4 h of reoxygenation.After the end of culture, RCF in three groups were indirectly co-cultured with cardiomyocytes of the same density (1.0×10 5 cells/ml) in a Transwell chamber for 16 h, cardiomyocytes were seeded in the lower chamber of Transwell, and RCF were seeded in the upper chamber of Transwell.After the end of co-culture, cardiomyocytes were collected for determination of the cell viability (by CCK8 method), apoptosis rate (by flow cytometry), expression of connexin 43 (Cx43) mRNA (by real-time fluorescence quantitative polymerase chain reaction), and expression of Cx43 and phosphorylated Cx43 (p-Cx43) (by Western blot). Results:Compared with T 0.5 group, the cell viability, apoptosis rate and expression of Cx43, p-Cx43 and Cx43 mRNA were significantly decreased in T 1.0 and T 2.0 groups ( P<0.01). Compared with T 1.0 group, the cell viability, apoptosis rate and expression of Cx43 and p-Cx43 were significantly decreased ( P<0.01), and no significant change was found in expression of Cx43 mRNA in cardiomyocytes in T 2.0 group ( P>0.05). Conclusions:RCF subjected to hypothermic hypoxia-reoxygenation induces cardiomyocyte injury in a density-dependent manner in a certain range, and the mechanism may be related to down-regulation of the expression of Cx43 and reduction of the activity of Cx43.

Objective:To compare the predictive performance of the Norton Pressure Ulcer Risk Assessment Scale and the OH Pressure Sore Assessment Scale on pressure injury in elderly stroke patients.Methods:From January to December 2021, convenience sampling was used to select 168 elderly stroke patients admitted to the Department of Neurology, Wuxi Second People's Hospital as the research subject. The Norton Pressure Ulcer Risk Assessment Scale and the OH Pressure Sore Assessment Scale were used to assess the risk of pressure injury in elderly stroke patients. The sensitivity, specificity, positive predictive value, negative predictive value, Youden index, and area under the receiver operating characteristic curve ( AUC) of each scale were calculated. The Kappa value was used to evaluate the consistency. Results:A total of 168 questionnaires were distributed, 160 valid questionnaires were recovered, and the valid recovery rate was 95.24%. The incidence of pressure injury in 160 elderly stroke patients was 9.38% (15/160) . The AUC of the Norton Pressure Ulcer Risk Assessment Scale was 0.805. When the total score was 12.5, the sensitivity, specificity, and Youden index of pressure ulcer prediction were 0.933, 0.559, and 0.492, respectively, with the highest predictive performance. The AUC of the OH Pressure Sore Assessment Scale was 0.803. When the total score was 5.5, the sensitivity, specificity and Youden index of pressure ulcer prediction were 0.933, 0.379, and 0.312, respectively, with the highest predictive performance. The Kappa value between the two scales was 0.588, and the difference was statistically significant ( P<0.05) . Conclusions:The Norton Pressure Ulcer Risk Assessment Scale was superior to the OH Pressure Sore Assessment Scale in predicting pressure injury in elderly stroke patients.

Objective : To analyze the accuracy of the infiltrating depth of tongue squamous cell carcinoma measured by magnetic resonance imaging (MRI) using pathological sections under a light microscope to provide a clinical reference. Methods : Seventy-three patients with tongue squamous cell carcinoma who visited the Department of Stomatology of the First Hospital of Shanxi Medical University and Xiangya Stomatological Hospital from January 2018 to September 2020 were selected. Preoperative MRI was performed to evaluate the infiltration depth of tongue squamous cell carcinoma, and intraoperative frozen pathological sections were used to confirm the infiltration depth of tongue squamous cell carcinoma measurement. Results : The infiltration depth of tongue squamous cell carcinoma measured by T1-weighted imaging was 1.11 mm (95% CI=0.51-1.70; t=3.72; P < 0.001), and the correlation coefficient r was 0.95. The T2-weighted average overestimation was 2.17 mm (95% CI=1.32-3.02; t=5.10; P < 0.001), and the correlation coefficient was 0.92. The Bland-Altman plot showed good consistency between T1- and T2-weighted images and pathologic measurements. Conclusion The infiltration depth of tongue squamous cell carcinoma measured by MRI is more accurate, with an average overestimation of 1-2 mm compared with pathological measurements, and T1-weighted images are better than T2-weighted images.

Objective:To evaluate the effects of different density rat fibroblasts on the expression of conjunctin 43 (Cx43) in cardiomyocytes and cell viability.Methods:Cardiomyocytes and fibroblasts were co-cultured using Transwell, cardiomyocytes were inoculated into the lower chamber of Transwell and fibroblasts into the upper chamber of Transwell.The cells were divided into 3 groups ( n=12 each) by a random number table method: fibroblast density 0.5×10 5 cells/ml group (group C 0.5), fibroblast density 1×10 5 cells/ml group (group C 1), and fibroblast density 2×10 5 cells/ml group (group C 2), with the density of cardiomyocytes 1×10 5 cells/ml in three groups.Cardiomyocytes and fibroblasts were co-cultured for 20 h in three groups.Cardiomyocytes were collected after co-culture for determination of cell viability (by CCK8 method), apoptosis rate (by flow cytometry), and expression of Cx43 mRNA (by quantitative real-time polymerase chain reaction) and expression of Cx43 and phosphorylated Cx43 (p-Cx43) (by Western blot). Results:There was no significant difference in the apoptosis rate of cardiomyocytes among the three groups ( P>0.05). Compared with group C 0.5, the expression of Cx43 protein and mRNA and p-Cx43 was significantly up-regulated in group C 1, the cardiomyocyte viability was significantly increased, and the expression of Cx43 protein and mRNA and p-Cx43 was up-regulated in group C 2 ( P<0.05). Compared with group C 1, the cardiomyocyte viability was significantly increased, and the expression of Cx43 protein and mRNA and p-Cx43 was up-regulated in group C 2 ( P<0.05). Conclusion:Rat fibroblasts up-regulate the expression of Cx43 and enhance the activity of Cx43 in cardiomyocytes and enhance cell viability in a density-dependent manner in a certain range.

With the development of science and technology and the improvement of living standards, people's understanding of "health" has also changed. The patients with chronic diseases and the people who do not have obvious symptoms of disease all hope to further improve the quality of life as well as the sense of happiness, gain and security. Disabled people and the elderly people with degraded physical functions are in need of corresponding rehabilitation devices. These needs determine that the research scope of biomedical engineering should be expanded, so as to use modern scientific technology and medical methods to study related issues and improve the health of the people. As a result, the concept of "healthcare medical engineering" emerged. In this paper, the definition of healthcare medical engineering were proposed, its significance, characteristics, content, and outlook for the future were introduced. This paper is expected to broaden the horizons and inspire ideas of researchers engaged in biomedical engineering research for future research in finding solutions to many problems in the field of medical and health care, thereby improving the quality of medical services and management, and promoting the development of the national health industry.

Objetive:To investigate whether the methylation patterns of the interleukin-4 (IL-4) gene promoter changed and whether environmental factors affected the methylation level of IL-4 gene in the peripheral blood of patients with recurrent aphthous ulcer (RAU).Methods:Totally 20 patients, who were diagnosed with RAU, were recruited from May 2018 to May 2019 in the Department of Stomatology， First Hospital of Shanxi Medical University in the study (RAU group), including 12 females and 8 males, with mean age of 16-35 years. During the same period, 20 healthy volunteers matching the age and gender of the RAU group were selected from the medical personnel of the same hospital as the healty control group, including 11 females and 9 males, with mean age of 15-35 years. Peripheral blood samples of two groups were collected and the methylation levels of the IL-4 promoter were detected by bisulfite sequencing PCR (BSP). The IL-4 promoter methylation level of each sample was analyzed by direct sequencing and the IL-4 mRNA level was detected by real-time quantitative PCR. The data obtained were statistically analyzed.Results:The IL-4 gene promoter fragment contained 10 CPG sites from -1400 to -1625 bp. The methylation rates of CPG -1556, CPG -1483, CPG -1479and 10 CPG sites were significantly higher in RAU group ［(32.0±19.9)%, (53.0±13.4)%, (46.0±19.8)% and (39.3±12.4)%］ than in healthy control group ［(20.0±3.2)%, (35.5±12.3)%, (28.0±14.4)% and (32.6±5.8)%］, with statistically significant differences ( P<0.05). The relative expression of IL-4 mRNA in the peripheral blood of RAU patients (1.0±0.1) was significantly lower than that of the healthy control group (1.5±0.2) ( P<0.01). There was a significant negative correlation between the overall methylation rate of IL-4 gene promoter and the relative expression level of IL-4 mRNA in RAU group ( r=-0.494, P<0.05). In the multivariate analysis, smoking, vitamin B12 and folic acid in the RAU group were significantly correlated with the overall methylation rate of the IL-4 gene promoter ( P<0.01). Conclusions:The hypermethylation of IL-4 promoter in RAU patients may be related to the reduction of IL-4 gene transcription. Vitamin B12, folic acid and smoking may affect IL-4 gene methylation in peripheral blood of RAU patients.

Objective: To explore the potential genetic target of Stephania terandra in the therapy for hypertension based on inte-grated pharmacology platform to study the molecular mechanism of Chinese medicines in treating hypertension. Methods: Using the functional prediction modules of integrated pharmacology platform and the functional modules of network construction, the component-target network of Stephania terandra was calculated, and the target network of anti-hypertension was further calculated, and the target molecules related to hypertension were explored. Results: A total of 198 targets related to hypertension were obtained from the hyper-tension prevention. Among them, there were 59 potential action nodes and 20 known action nodes. The nodes with direct action were type-2 angiotensin Ⅱ receptor ( AGTR2), type-1 angiotensin Ⅱ receptor ( AGTR1), prostacyclin receptor ( PTGIR), solute carrier family 12 member 3 (SLC12A3) and endothelin-1 (EDN1). The GO enrichment and KEGG pathway enrichment of Stephania terandra chemical components showed a close correlation with hypertension, and the molecular mechanism of the target was clear. Conclusion:Through the integration of pharmacology platform, the targets of Stephania terandra-disease are deeply explored, and its potential mo-lecular mechanism as well as potential factors is studied.