Abstract Background Despite global recommendations for early antiretroviral therapy (ART) initiation and the well-established benefits of timely treatment, delayed ART initiation remains a concern in some settings. Previous studies have identified multiple barriers to ART initiation, including limited treatment knowledge, stigma, disclosure concerns, side-effect fears, and service-related barriers. Less is known, however, about how these factors become organized in everyday life into a sustained process of delay after diagnosis. This study explored how people living with HIV in southwestern China experienced delayed ART initiation, with attention to social visibility, family relationships, informal information, and changing perceptions of treatment urgency. Methods A descriptive phenomenological design was used. Semi-structured, in-depth interviews were conducted with 23 people living with HIV who had delayed ART initiation and were recruited from two HIV-designated hospitals in Yunnan Province, China. Interviews were audio-recorded, transcribed, and analyzed using Colaizzi’s seven-step method. The analysis was primarily inductive, while an HIV-related stigma framework informed the research question, interview domains, and later interpretation. Results Four themes were identified. First, delayed ART initiation often began when treatment entry was experienced as a risk of being recognized, leading to concealment, stigma-related shame, and avoidance. Second, delay was sustained through family negotiation, informal information, symptom-free periods, concerns about side effects, and the normalization of waiting. Third, treatment initiation became more likely when family or significant-other support, continued healthcare-provider contact, symptoms, or complications changed participants’ perceptions of risk. Fourth, cross-theme patterns showed that delayed ART initiation was experienced as unfolding from concealment and waiting toward treatment entry when support, symptoms, or changing perceptions of risk made continued delay less acceptable. The local context functioned primarily as a contextual condition shaping social visibility, mobility-related experience, informal information, and treatment urgency, rather than as a standalone mechanism. Conclusions Delayed ART initiation in this study was not solely attributable to insufficient knowledge or poor treatment awareness. Participants described delay as an experience shaped by social visibility concerns, stigma-related shame, family negotiation, informal information, symptom experiences, and changing perceptions of risk. Efforts to promote timely ART initiation may need to address not only treatment knowledge, but also confidentiality concerns, stigma-sensitive support, family context, and the social conditions in which treatment decisions are made.

Background The COVID-19 pandemic was occurring worldwide with over a 6.5 million deaths. It’s important to explore the instructions for the global nursing community by identifying the personal coping methods of Chinese nurses in Wuhan to deal with patient deaths. Methodology The study used a qualitative conventional content analysis with 14 Chinese Counter-marching nurses. Purposive sampling, snowball sampling, and semi-structured interviews were used for participants and data collection. To assess the quality of the findings, Guba and Lincoln’s criteria for confidence were fulfilled. Results The data analysis results in 4 main categories:(1) psychological shocks related to COVID-19 patient’s death; (2) personal psychological adjustment and demands; (3) insights on life and values; (4) Needs for relevant knowledge and skills. Conclusions During the outbreak of the epidemic or pandemic, adequate psychological care resources need to be provided to nurses when facing the death of infectious patients, to reduce the negative emotions brought by death. Effective coping strategies should also be formulated to enhance their resilience and promote their professional competence.

Objective: Digital healthcare is rapidly becoming a new model for medical development in the information society with its convenience, and personalization, and a research boom in digital healthcare has formed at home and abroad in recent years. The purpose of this study is to conduct a bibliometric analysis of the field of digital healthcare and to understand the research background and development trend in this field. Methods: A visual analysis of authors, institutions, journals and keywords was conducted using CiteSpace 5.8R3 software. Results: A total of 1646 digital healthcare-related retrieved from WoS and PubMed studies. There was an overall upward trend in the number of digital healthcare publications, with the highest number of publications in 2021 (290). The author AZIZ SHEIKH is ranked first in the number of published articles (13), while King Saud University (23) is the research institution with the most articles. Keyword clustering showed that the first cluster was data security; the common high frequency keywords that appeared were systems (85), artificial intelligence (82), mobile health (70), internet (61), and technology (57). Digital healthcare, artificial intelligence, healthcare services, machine learning and deep learning are the hotspot of current research. Conclusion: This paper summarises the state of the art in digital healthcare research. Using statistical analysis and network visualisation, it highlights the background, trends and hot topics in digital healthcare research. The paper finds that there is significant potential for artificial intelligence to help bridge the digital divide and reduce health inequalities. To understand the current state, hot trends and future directions of digital healthcare research, this paper can serve as a reference.

目的:系统评价与整合医护亲历救治流行性呼吸道传染病真实体验的质性研究.方法:计算机检索PubMed、Web of Science、Embase、The Cochrane Library、中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方(Wanfang)、维普(VIP)数据库,收集医护亲历救治流行性呼吸道传染病真实体验的质性研究.检索时限均从建库至2022 年9 月.采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准对纳入文献进行质量评价,并用汇集性整合方法进行整合.结果:共纳入 13 项研究,提炼 50个研究结果,归纳为 6 个类别,综合为 3 个整合结果,分别为:救治前——"时代重任,使命前行";救治中——"失之东隅,收之桑榆";救治后——"经一事,长一智".结论:亲历流行性呼吸道传染病救治的医护人员在不同阶段有不同的职业体验.管理者应重视医护人员的需求及体会,从而保障医护人员身心健康,提高医护人员应对能力,进一步建立健全医护应急管理机制.

Glycoprotein VI (GPVI) is the major collagen receptor on the platelet surface and is important in mediating granule secretion and atherothrombosis. Sulforaphane (SFN), a dietary isothiocyanate enriched in cruciferous vegetables, exerts multiple biological activities. This study aimed to investigate the efficacy of SFN on GPVI-mediated signaling and platelet granule secretion in vitro. We herein demonstrated that SFN greatly attenuated granule secretion in human gel-filtered platelets in response to collagen, including inhibiting CD62P and CD63 expression and PF4, CCL5, and ATP release. Mechanistically, these inhibitory effects of SFN were mainly mediated by its attenuation of cytosolic phospholipase A(2) (cPLA(2)) phosphorylation and thromboxane A(2) (TxA(2)) generation. Moreover, SFN did not further decrease the inhibitory effects of p38 MAPK inhibitor SB203580 on cPLA(2) phosphorylation, TxA(2) generation and granule secretion. Thus, SFN attenuates platelet granule secretion via down-regulating GPVI-mediated p38 MAPK/cPLA(2)/TxA(2) signaling, which may play important preventive roles in cardiovascular diseases.

Aim: To analyze the nursing publications from Mainland China (ML), Taiwan (TW), and Hong Kong (HK) with comparison to the latest global nursing scientific productivity trend. Methods: A comparative bibliometric analysis based on nursing publications cited from 2016 to 2021 in the Web of Science was conducted: the global nursing research productivity and focus were explored. The number of nursing publications, impact factors, citation report, research focus and funding support were analyzed according to the articles retrieved from ML, TW, and HK. Results: A total of 44,654 articles were published in the 122 nursing journals globally with different research focuses. USA and Australia have stayed at the top 2 during all 5 years; China firstly passed the UK to the 3rd place in 2019. Different from the results of previous studies, our study firstly discovered that the number of publications in ML has surpassed that of TW for the very first time in 2018 and arrived at 1.46 times in 2019, while it exceeded HK with 2.17 times in 2015 and reached to around 3 times since 2016. The different trends in the most used keywords and most popular journals in three Chinese regions and worldwide may indicate different research interests and phenomenon focused by nursing researchers, which may have implications for nursing policy analysis. Conclusions: Bibliometric analysis revealed embedded values of nursing scientific activity, and provided evidence for the policy changes in nursing research, education, and practices. Chinese researchers’ contribution to the global nursing field has increased significantly. The quality and quantity of nursing publications from ML firstly stayed at the 1st among Chinese three regions since 2017 and 2018 respectively. The fast development of nursing education and practice, broadened international collaboration, more funding of nursing research, higher publication requirements for career development were likely the main factors of the improvement of ML. Those trends could help China, especially the ML constructed better nursing research policy framework, and be more contributing to the global nursing scientific field.

Objective: To explore the double psychosocial threats of the COVID-19 pandemic, targeted behavior toward Chinese Americans, and the correlates to their mental health. Methods: A quantitative, cross-sectional, and descriptive design was utilized by using a purposive convenience sample of 301 Chinese Americans over the age of 18 residing in the United States. Online data collection was conducted through the social media platform WeChat from April 8-21, 2021. Descriptive statistical analysis was used for the participants' demographic charac-teristics, Multidimensional Scale of Perceived Social Support (MSPSS), Double Threat Situations, COVID-19 Racial Discrimination, and General Anxiety Disorder-7 (GAD-7). Stepwise logistic regression was conducted to verify predictors for anxiety levels by GAD-7. Results: In this sample (N = 301), 127 (42.19%) were male and 174 (57.81%) were female. The average age was 41.67 (SD = 5.89). Among MSPSS subscales, social support from family (MSPSS-Fam, 79.73%, n = 240) and social support from significant others (MSPSS-SO, 73.75%, n = 222) were high. 231 (76.74%) reported threats due to their Chinese ethnic background during the COVID-19 outbreak. Predictors for the high anxiety level by GAD-7 were COVID-19 racial discrimination from the local community (OR = 0.47, 95% CI = 0.39-0.71, p < 0.001), media/online (OR = 0.36, 95% CI = 0.26-0.53, p < 0.001), the perceived threat from the COVID-19 virus (OR = 0.33, 95% CI = 0.23-0.51, p < 0.001) and Perceived racism threat from Chinese back-ground related to COVID-19 (OR = 0.31, 95% CI = 0.21-0.49, p < 0.001). Conclusions: COVID-19 double-threats (The virus and racial discrimination) situations are significantly related to the high level of anxiety among Chinese Americans. The sense of belonging and social perceptions of Chinese immigrants is closely related to public health problems in Western societies and needs to be addressed at all levels. Our findings call for the attention of health-care workers to specific racism double-threatened situations and high mental health risks, as well as direct and indirect ethnic discrimination that Chinese Americans are experiencing during this pandemic, the long-term influ-ences and effective coping ways related to this issue should be explored in further research.

Objective Based on the literatures related to major infectious diseases in China-Myanmar border areas in three databases,CNKI,Wanfang and VIP,we visually summarized the research status,related fields and analyzed the study hotspot of targeted research,as to provide a reference for the research and prevention of infectious diseases in the China-Myanmar border area. Methods Chinese literatures related to key infectious diseases in the China-Myanmar border region from the self-built databases of CNKI, Wanfang and VIP to December 31, 2021 were searched. Citespace 5.8R3 software was used for visual analysis of authors,institutions,journals and keywords. Results Total of 534 papers were included in this study,the number of major infectious diseases published in the China-Myanmar border area showed an overall upward trend. The largest number of publications was in 2016（45）, and 78 articles were published in the journal AIDS and Venereal Diseases in China. As authors,the author DUAN Song ranked first in the number of published articles（157）,and The Center for Disease Control and Prevention of Dehong,Yunnan Province（122） was ranked as the first research institution that owned the most articles. Keywords clustering showed that the first cluster was the detection of AIDS and STD patients; The high-frequency keywords in cooccurrence were influencing factors（93）, AIDS（91）, detection（62）, dengue fever（36） and malaria（30）. The prevention and control of AIDS, dengue fever, and malaria were the research hotspots. Conclusions Research on key infectious diseases in the China-Myanmar border shows an overall upward trend of focus and author and institution leading research. In the future, multidisciplinary and interdisciplinary cooperation should be further strengthened, and emerging scientific and technological platforms such as big data can be actively used to strengthen in-depth analysis combined with statistical and epidemiological methods.

The current water conservancy model cannot realize unified access and use,and the computing efficiency of multiple users,models,and schemes is low.In addition,the ability of sharing applications deeply bound with the system is weak.Therefore,the model fails to meet the requirements of intelligent water conservancy and digital twin watershed construction.In view of this,this paper designs a water conservancy model management service platform and applies it to practice.First,different types of water conservancy models are integrated,and their service interfaces are standardized,so as to uniformly receive model calculation service parameters and data in different formats and then convert them into required formats through platform adaptation,which avoids the problem of difficult unified invocation caused by differences in the interfaces of each model.Second,model computing resources are deployed and managed in a unified manner,and model calculation requests are distributed to different servers for calculation through task scheduling,so as to improve the resource utilization rate and reduce calculation time.Finally,a water conservancy model management service platform is developed,which integrates model management,model service,and model assembly functions,so as to provide the application system with model computing service.The application of multiple projects shows that the platform can integrate and share the resources of water conservancy models,give full play to the smart function,and provide support for the construction of intelligent water conservancy and digital twin watersheds.

Under the background of a tight construction schedule and heavy tasks,this paper applies PAUT technology to the radial gate on the right bank of the Datengxia water conservancy project,so as to ensure the welding quality of the radial gate of the Datengxia water conservancy project.In addition,the conventional ultrasonic testing technology and PAUT technology are used and compared in terms of the welds in the main parts of the gate.The experimental comparison results show that PAUT technology is superior to conventional ultrasonic testing technology in defect detection rate and graphic imaging.It is proved that the defect detection rate of PAUT technology is better than that of the conventional ultrasonic wave,and log files permanently saved can be obtained.

目的:调查云南省白族老年慢性病人群健康素养现状并分析影响因素.方法:对2020年7—11月在大理白族自治州3家综合性医院住院治疗的324名白族老年慢性病患者进行问卷调查.采用t检验或单因素方差分析比较患者人口学特征上的差异,多元线性回归模型分析健康素养的独立影响因素.结果:云南省白族老年慢性病人群健康素养平均得分为(79.67±14.32)分,健康素养具备比为27.78％.多元线性回归分析结果显示年龄、生活区域、家庭月收入、居住情况、文化程度和患慢性病数量是其健康素养的独立影响因素(P<0.05).结论:云南省白族老年慢性病人群健康素养水平偏低,特别是农村地区,建议应根据影响因素并结合白族民族文化制定干预措施,从而有效提高其健康状况.

目的 探索在脊髓小脑共济失调7型(SCA7)细胞模型中,1-[1-(4-氟苯基)-2,5-二甲基-1 H-吡咯-3-基]-2-(1-吡咯烷基)乙酮(IU-1)激活泛素-蛋白酶体系(UPS)后对多聚谷氨酰胺(PolyQ)共济失调蛋白-7(ATXN7)的作用.方法 在稳定表达ATXN7突变蛋白及非突变蛋白的ATXN7-Q65和ATXN7-Q10神经细胞模型中,利用5×104μmol/L IU-1和0.2μmol/L环氧甲酮四肽分别增强和抑制UPS的降解作用,进而观察ATXN7突变蛋白对细胞的毒性作用.利用蛋白质印迹技术和斑点过滤杂交法检测ATXN7突变蛋白的表达,2-(4-磺苯)-3-(4-硝基苯)-5-(2,4-二磺基苯)-2 H-四氮唑钠盐(WST-1)法分析细胞存活率.结果 在构建的两组神经细胞模型中,ATXN7-Q65细胞表达的ATXN7蛋白及其聚合体随着诱导时间的延长而明显增加,且与ATXN7-Q10细胞相比,在诱导12 d后ATXN7-Q65细胞的存活率明显下降,细胞凋亡率增加(P<0.05);当加入Dox抑制剂后,与ATXN7-Q10细胞相比,ATXN7-Q65细胞可溶性ATXN7蛋白在24 h内降解缓慢,ATXN7聚合体水平不变.在ATXN7-Q65细胞中,加入IU-1增强UPS活性,12 d后细胞毒性降低,存活率升高;而用环氧甲酮四肽抑制UPS活性,12 d后细胞毒性增高,存活率降低,差异有统计学意义(P<0.05).结论 UPS可有效清除突变蛋白ATXN7,IU-1激活UPS活性能增强突变蛋白ATXN7的清除并降低细胞毒性.

使用Morisky药物依从性问卷对2020年7～11月在大理白族自治州3家综合性医院住院治疗的198名白族农村慢性病老人进行调查,采用描述性分析方法分析其服药依从性现状.结果显示,在接受调查的198名白族农村慢性病老人中,20人(10.11％)服药依从性好,127人(64.14％)服药依从性差.应从加强健康扶贫力度、开展健康宣教、使用智能药盒、实施互助性养老、科学看待白族文化五个方面着手,有效提高白族农村慢性病老人服药依从性,促进白族农村人口健康发展.

我国是一个传统的农业大国,农村人口众多,随着老龄化程度的加剧,我国农村的养老形势日益严峻,农村养老问题备受关注.研究目前我国农村养老情况及现型养老模式,有利于建设契合我国农村实践需求的养老模式.通过比较目前我国农村常见的五种养老模式,结合我国农村养老情况对农村养老模式进行优化分析,认为应结合现有农村养老模式以居家养老为基础,大力发展社区养老的同时融入医养结合,将机构养老作为辅助养老,形成农村多元化养老服务网,以推进我国农村养老进程.

INTRODUCTION:The World Health Organization declared the COVID-19 outbreak as a Public Health Emergency of International Concern on January 31, 2020. China was the first country to experience the challenges of controlling COVID-19. Therefore, the purpose of this study was to examine the experiences of Chinese nurses who countermarched to the outbreak city for medical support in the very first period of this global infection.METHODOLOGY:A qualitative study of phenomenological research design was used to describe the experiences of 10 Chinese nurses. Data were collected in February 2020 through in-depth interviews and analyzed by conventional content analysis methods.RESULTS:Chinese nurses experienced different psychological stages, work pressure, and challenges. New concepts of nursing also emerged during their clinical care for COVID-19 patients.DISCUSSION:The guidance synthesized from the Chinese nurse stories could give specific direction for a well-prepared global nursing workforce and high-quality patient care in the present and future epidemics. The worries about discrimination of COVID-19 patients' needs to be addressed culturally and emotionally as a priority by health care workers when they care for COVID-19 patients.

Platelet granule secretion plays a key role in atherothrombosis. Curcumin, a natural polyphenol compound derived from turmeric, exerts multiple biological activities. The current study sought to investigate the efficacy of tetrahydrocurcumin (THC, the major active metabolite of curcumin) on platelet granule secretion in vitro and thrombus formation in vivo. We found that THC significantly attenuated agonist-induced granule secretion in human gel-filtered platelets in vitro, including CD62P and CD63 expression and platelet factor 4, CCL5, and adenosine triphosphate release. These inhibitory effects of THC were partially mediated by the attenuation of cytosolic phospholipase A2 (cPLA2) phosphorylation, leading to a decrease in thromboxane A2 (TxA2) generation. Moreover, the MAPK (Erk1/2, JNK1/2, and p38 MAPK) signaling pathways were downregulated by THC treatment, resulting in reduced cPLA2 activation, TxA2 generation, and granule secretion. Additionally, THC and curcumin attenuated murine thrombus growth in a FeCl3-induced mesenteric arteriole thrombosis model in C57BL/6J mice without prolonging the tail bleeding time. THC exerted more potent inhibitory effects on thrombosis formation than curcumin. Through blocking cyclooxygenase-1 activity and thus inhibiting platelet TxA2 synthesis and granule secretion with aspirin, we found that THC did not further decrease the inhibitory effects of aspirin on thrombosis formation. Thus, through inhibiting MAPKs/cPLA2 signaling, and attenuating platelet TxA2 generation, granule secretion, and thrombus formation, THC may be a potent cardioprotective agent.

Introduction: Modern nursing was introduced into China by Western missionaries in the 19th century; since then, significant changes continued to occur, which provides beneficial areas of international collaboration based on trends in globalization. Methods and Materials: The description was developed through reviews of published literature, policy documents that inform Chinese nursing practice, education, and the firsthand working experiences between American and Chinese nurses and faculty. Results: 82 articles and 13 governmental documents were included. Chinese nursing has undergone significant changes in the organization, quality assessment, and roles requirements in education and practice. International collaboration areas include addressing the severe faculty shortage, maternal child care, elderly care, quality assessment, and educational programs evaluation. Discussion: Informative knowledge of changing Chinese nursing education and practices in the new millennium, the potential areas, and guides for international nursing collaboration would be meaningful to internationally involved faculty and nurses in China and America.

人类对高原缺氧环境的适应表现、机制及相关药理学研究一直是科研探索的热点.一个世纪以来,主要集中于青藏高原、南美洲安第斯高原和埃塞俄比亚高原的高原世居人群对于慢性缺氧所具有的独特生理适应已经得到了科学验证,而近10年来的基因研究也证实高原适应具有遗传学基础,尤其与缺氧诱导因子(hypoxia inducible factor,HIF)通路及缺氧反应基因(hypoxia response elements,HREs)具有密切关系.但有趣的是,对高原缺氧的适应表现和遗传机制在上述三大高原世居人群中却并不完全相同,其中西藏人具有更好的高原适应表现,并且HIF通路是其最关键的适应机制.同时,由于HIF通路涉及广泛,可调节数以百计的下游基因表达,并与癌症、炎症、缺血、急性脏器损伤和感染等多种疾病密切相关,因此HIF通路的激活剂和抑制剂研究也取得了很大进展.本文就三大高原世居人群对高原环境的不同适应反应、HIF及HREs在不同种族高原适应中的遗传学作用机制、HIF通路的药理学研究进展进行了综述,以期为高原低氧遗传性适应及HIF相关性疾病的进一步研究提供参考.

Purpose: To compare the surgical indicators, perioperative complications and postoperative psychological status of patients with coronary interventional therapy (CIT) by radical artery and femoral artery puncture approaches. Methods: 120 patients with CIT were divided into femoral artery group (FAG) and radial artery group (RAG) according to the operation ways. The interventional operation was performed by the same surgeon team and methods. Data of surgical indicators and perioperative complications were recorded and collected. The psychological questionare survey was made within 48 hours the after surgery by the hospital anxiety and depression scale (HAD), and the results were scored by the psychiatrist. Results: The age, sex, ethnicity, education level, disease type, and combined diseases of the two groups had homogeneity without statistical difference. There was no obvious difference in X-ray exposure time, contrast agent usage and operation time in two ways (P > 0.05). The success rate of one-time catheterization was higher in FAG than in RAG (P