CEP162, a 162-kDa centrosome protein, is a crucial centrosomal adapter, mediating cell differentiation and polarization. CEP162 maintains mitosis by dynamically stabilizing microtubules. CEP162 promotes the transition zone (TZ) assembly in the basal body through interaction with CEP131, CEP290, and axoneme microtubules as well as the distal centriole. TZ ensures the normal distribution of soluble proteins between the cytoplasm and cilia. It also facilitates retinal development and sperm flagellar motility. However, fluctuations in TZ permeability caused by abnormal expression of CEP162, including truncated mutations and naturally occurring mutations, lead to cilia abnormality and dysfunction in ciliogenesis through the regulation of intraflagellar transport, resulting in retinal degeneration and infertility. LncRNAs can induce SNP events in the CEP162 transcript by altering alternative splicing. Naturally occurring mutations are closely linked to retinal ciliopathy and diabetic retinopathy. This review summarizes the latest research progress to better understand the biology and pathophysiology of CEP162 and the clinical manifestations caused by CEP162 variants.

Transcriptional co-activator with PDZ-binding motif (TAZ) plays a critical role in the repair process following lung injury by enhancing the proliferation of alveolar epithelial cells (AECs) and exerting anti-inflammatory effects post-injury. Hypoxia is a significant factor in inducing lung injury. However, whether and how TAZ regulates transcription of target genes involved in hypoxia-induced lung injury remains unclear. In this study, we discovered that M2 macrophages protected against hypoxic condition-induced lung injury, coinciding with increased TAZ expression in hypoxic AECs. Experimental verification confirmed that the up-regulation of TAZ promoted AEC proliferation. Furthermore, we found that TAZ interacted with H2A.Z, a histone H2A variant. CUT&Tag sequencing verified that TAZ was essential for maintaining the enrichment of H2A.Z at the promoters of their shared target genes in hypoxic AECs. Gene Ontology analysis revealed a significant predominance of pathways associated with IL-6 mediation, indicating that this pathway is the most enriched in our dataset. Importantly, IL-6 secreted by AECs under hypoxia stimulates the polarization of macrophages towards the M2 phenotype, thereby promoting lung tissue repair after hypoxia exposure. In summary, our findings demonstrate that TAZ facilitates the deposition of H2A.Z at the IL-6 gene promoter, thereby enhancing IL-6 expression in hypoxic AECs. This, in turn, induces M2 macrophage polarization and PD-L1 expression, ultimately mitigating hypoxic condition-induced lung injury.

Background In the context of aging and digitalization, the development and application of digital health can help meet the growing health needs of older adults. Improving digital health literacy of older adults may be an effective way to alleviate the shortage of public health resources and improve their health-related quality of life (HRQoL). However, the impact of digital health literacy on HRQoL in older adults and the underlying mechanism remain unclear. This study intends to explore whether digital health literacy has an effect on HRQoL in community-dwelling older adults, and whether health-promoting lifestyle plays a mediating role between digital health literacy and HRQoL, while providing a theoretical basis for the scientific construction of HRQoL intervention programs for older adults. Methods The cross-sectional study was conducted in Chongqing, China from September 2020 to April 2021. 572 community-dwelling older adults were surveyed by stratified sampling. Data on sociodemographic characteristics, digital health literacy, health-promoting lifestyle and HRQoL were collected. Univariate analysis was used to compare the differences in HRQoL among community-dwelling older adults with different sociodemographic characteristics. Pearson correlation analysis was used to explore the correlation between digital health literacy, health-promoting lifestyle and HRQoL. SPSS PROCESS macro was used to examine the mediating effect of health-promoting lifestyle between digital health literacy and HRQoL. Results The mean score of HRQoL was 97.97 (SD 11.45). Univariate analysis showed that there were statistically significant differences in HRQoL among community-dwelling older adults with different gender, age, educational level, marital status, and monthly household income per capita ( p < 0.05). There were positive correlations between digital health literacy, health-promoting lifestyle and HRQoL, with correlation coefficients ranging from 0.416 to 0.706 ( p < 0.001). Digital health literacy was positively associated with HRQoL ( β = 0.210, p < 0.001), and health-promoting lifestyle mediated the relationship between digital health literacy and HRQoL, with an indirect effect of 0.175 (95% Bootstrap CI 0.135–0.214). Conclusion Digital health literacy can affect HRQoL through the mediating effect of health-promoting lifestyle. It is suggested that relevant management institutions, communities and families should strengthen the cultivation of the digital health literacy of older adults, promote their development of health-promoting lifestyle, and ultimately improve HRQoL.

Background Accumulating evidence supports the implication of circular RNAs (circRNAs) in systemic lupus erythematosus (SLE). However, little is known about the detailed mechanisms and roles of circRNAs in the pathogenesis of SLE. Methods Quantitative real-time PCR was used to determine the levels of circLOC101928570 and miR-150-5p in peripheral blood mononuclear cells of SLE. Overexpression and knockdown experiments were conducted to assess the effects of circLOC101928570. Fluorescence in situ hybridization, RNA immunoprecipitation, luciferase reporter assays, Western blot, flow cytometry analysis and enzyme-linked immunosorbent assay were used to investigate the molecular mechanisms underlying the function of circLOC101928570. Results The results showed that the level of circLOC101928570 was significantly downregulated in SLE and correlated with the systemic lupus erythematosus disease activity index. Functionally, circLOC101928570 acted as a miR-150-5p sponge to relieve the repressive effect on its target c-myb, which modulates the activation of immune inflammatory responses. CircLOC101928570 knockdown enhanced apoptosis. Moreover, circLOC101928570 promoted the transcriptional level of IL2RA by directly regulating the miR-150-5p/c-myb axis. Conclusion Overall, our findings demonstrated that circLOC101928570 played a critical role in SLE. The downregulation of circLOC101928570 suppressed SLE progression through the miR-150-5p/c-myb/IL2RA axis. Our findings identified that circLOC101928570 serves as a potential biomarker for the diagnosis and therapy of SLE.

目的 研究火针联合银离子治疗感染性压力性损伤的临床效果,为临床治疗提供理论依据.方法 选取广州中医药大学第一附属医院治疗的46例感染性压力性损伤患者为研究对象,分为对照组和观察组,每组23例.对照组采用外科清创+含银离子敷料负压治疗的方法,观察组在对照组治疗基础上联合火针治疗,每2天1次,记录治疗前和治疗后7、14、21 d两组伤口 pH值、伤口愈合情况、肉芽组织生长情况及不良反应发生情况.结果 与对照组比较,观察组7、14、21 d伤口 pH值更低,14、21 d压疮愈合计分量表(PUSH)评分、肉芽组织评分更低,差异有统计学意义(P＜0.05),两组均无不良反应发生.结论 火针联合含银离子敷料能加快感染性压力性损伤的愈合.

Systemic lupus erythematosus (SLE) is a prototypical systemic autoimmune disease of unknown etiology. The epigenetic regulation of N6-methyladenosine (m6A) modification in immunity is emerging. However, few studies have focused on SLE and m6A immune regulation. In this study, we aimed to explore a potential integrated model of m6A immunity in SLE. The models were constructed based on RNA-seq data of SLE. A consensus clustering algorithm was applied to reveal the m6A-immune signature using principal component analysis (PCA). Univariate and multivariate Cox regression analyses and Kaplan–Meier analysis were used to evaluate diagnostic differences between groups. The effects of m6A immune-related characteristics were investigated, including risk evaluation of m6A immune phenotype-related characteristics, immune cell infiltration profiles, diagnostic value, and enrichment pathways. CIBERSORT, ESTIMATE, and single-sample gene set enrichment analysis (ssGSEA) were used to evaluate the relative immune cell infiltrations (ICIs) of the samples. Conventional bioinformatics methods were used to identify key m6A regulators, pathways, gene modules, and the coexpression network of SLE. In summary, our study revealed that IGFBP3 (as a key m6A regulator) and two pivotal immune genes (CD14 and IDO1) may aid in the diagnosis and treatment of SLE. The potential integrated models of m6A immunity that we developed could guide clinical management and may contribute to the development of personalized immunotherapy strategies.

借助生命价值理论,围绕突发重大公共卫生事件下医务人员风险作业的意外赔偿,通过收益法来测算他/她们的生命物质价值,估算其精神价值.结果显示医务人员生命总价值与现行补偿标准相差太大,建议调整参与突发公共卫生事件处置的医务人员的现行工伤死亡补偿标准,估算风险作业意外的精神补偿,购买专项意外保险,提供其家人在就医、入学和就业等方面优惠保障政策.

目的:探讨药零差改革对重庆市公立医院人力价值补偿的政策效应,为深化医改提供政策参考.方法:利用重庆市22家公立医院成本核算数据,比较分析药零差改革前(2015年、2016年)与改革后(2018年、2019年)公立医院人力成本水平及其补偿度.结果:改革后重庆市全市公立医院人力成本占比、技术劳务收入占比均值为36.92％和26.14％,较改革前增加了2.74和4.78百分点,变化均具有统计学意义;人力成本补偿度均值为70.80,较改革前增加了8.31,变化具有统计学意义;改革后重庆市全市公立医院人员薪酬倍差均值为2.25,较改革前下降了0.15;变化无统计学意义.结论:药零差改革显著提升了重庆市公立医院的人力价值补偿水平,但政策效应存在异质性.应厘清公立医院人力价值回归的机理与路径,推动公立医院高质量发展.

通过国内外对"食育"的定义阐述,提出食育的内容:通过各种饮食观念、营养知识、饮食安全、饮食文化等知识进行教育,一方面获得有关"食"的知识和选择食的能力;另一方面培养出有人与自然、环境和谐相处的意识,,有传统食文化理解力、有良好饮食习惯、能过健康食生活的人.我国食育尚处于起步阶段,在政策制定、理论探索、实践尝试等方面均未形成体系,除借鉴国外食育经验,还需考虑地域、文化、传统、宗教等因素影响,提出符合我国国情,具有中国特色的食育养生的建议与对策,以提升全民健康素养,帮助社区居民树立科学合理的食育健康观.

目的 探讨表没食子儿茶素没食子酸酯(EGCG)对人子宫肌瘤细胞增殖的影响及其机制.方法 获取人子宫肌瘤组织后提取人子宫肌瘤细胞.将细胞分为对照组、50μmol/L EGCG组、100μmol/L EGCG组、200μmol/L EGCG组,各EGCG剂量组分别加入相应浓度的EGCG,对照组加入等体积的磷酸缓冲盐溶液.干预24 h、48 h、72 h后,检测细胞存活率;干预48 h后观察细胞形态,并检测Wnt5 b、β-连环蛋白(β-Catenin)、上皮生长因子受体(EGFR)蛋白的表达情况.结果 干预48 h、72 h后,对照组、50μmol/L EGCG组、100μmol/L EGCG组、200μmol/L EGCG组人子宫肌瘤细胞存活率依次降低;随着干预时间的延长,各干预组细胞存活率有下降趋势(均P<0.05);免疫组化检测结果显示,各浓度EGCG干预组Wnt5 b、β-Catenin蛋白表达水平均低于对照组;200μmol/L EGCG组Wnt5 b蛋白表达水平低于其他两个浓度干预组,50μmol/L EGCG组、100μmol/L EGCG组、200μmol/L EGCG组β-Catenin蛋白表达水平依次降低(均P<0.05).免疫印迹试验结果显示,各浓度EGCG干预组EGFR、β-Catenin蛋白表达水平均低于对照组,100、200μmol/L EGCG组Wnt5 b蛋白表达水平低于对照组;200μmol/L EGCG组的EGFR、Wnt5 b蛋白表达水平均低于其他两个干预组(均P<0.05).结论 EGCG可抑制人子宫肌瘤细胞增殖,其机制可能与抑制Wnt/β-Catenin信号通路和EGFR的表达有关.

目的 了解重庆市三甲医院心内科护士对心脏康复的认知情况.方法 采用横断面调查研究,以重庆市11所三级甲等医院心内科护士作为调查对象进行问卷调查,内容包括护士一般资料、护士的专科工作经历;护士对心脏康复相关知识的认知情况和对心脏康复工作开展的意见和建议.结果 2019年2月共234名心内科护士完成问卷,在调查对象中仅有23.93％的护士熟悉心脏康复的内容,参与过心脏康复相关的培训和实践的仅有17.52％.结论 重庆市三甲医院心内科护士对心脏康复认知情况亟待加强,心脏康复的普及是心脏康复推广和实施的前提和重要保证,需要从多层面开展心脏康复相关知识和技能的教育与培训,本文结合调研结果提出"心脏康复护理团队组建模型设想及实施路径"的设想,以期为在相关政策和指南的支持和引导下,组建适宜的心脏康复团队做出有益的尝试.

党建工作是抓好各项工作的根本.陆军军医大学在党建工作中深入挖掘自身红色军医文化资源.介绍了红色军医文化的形成历史及其精神价值,概括为:"革命理想高于天"的理想信念是文化自信的基础;"听党指挥"的不变军魂是我军永葆红色的政治要求;"一不怕苦、二不怕死"的战斗精神是攻坚克难的重要保证;"解放思想、实事求是"的探索创新是红色文化的活力之源;"为人民服务"是红色军医文化的根基.指出,全面提升陆军军医大学党建工作的科学化水平,传承独特的红色军医文化,可以促进军校大学生对理想信念的文化认同,强化红色军医文化记忆,扩大红色军医文化的外化感染力,升华红色军医文化的群体性认可.

住院医师规范化培训旨在培养能独立、规范承担常见多发疾病诊疗工作的临床医师,是医学教育培养体系的重要一环.为推进医学教育改革,大力发展住院医师高阶思维能力,才能更好地医疗卫生服务.笔者立足心内科住院医师规范化培训,运用行动学习方法,围绕心内科的临床实践教学设计、组织和效果评价,探索了如何有效地提升住院医师的高阶思维能力,并提高住院医师的临床诊疗能力,并就存在的问题提出了相应的改进建议.

目的:考察医务人员人力价值提升的控费效应.方法:利用2010—2019年31个省份的面板数据,采用固定效应面板模型进行实证分析.结果:新医改来我国人员经费占比和人员经费倍差年均增长率分别为4.23％和2.69％.人员经费占比每增加1％,医疗机构收入和支出均将下降0.80％,门诊次均费用将下降0.45％;人员经费倍差每增加1％,医疗机构收入和支出均将下降0.19％,门诊和住院次均费用将分别下降0.13％和0.11％.结论:医务人员人力价值提升具有显著的控费效应,但在费用和人力价值结局指标上出现分化:人力价值提升对供方费用的控费效应大于次均医疗费用,人员经费占比的控费效应大于人员经费倍差.基于此,应厘清医务人员人力价值回归的内在机理和协同路径,建立健全医疗费用增长的分类治理机制.

随着我军深化改革不断推进和新时代军事教育方针的提出,"立德树人、为战育人"成为军队院校教育的核心[1],我军历来十分重视军官的教育培训与职业发展,要求制定岗位职责任务清单,明确各级各类岗位职责任务,根据岗位任职、能力要求和职业发展需要,把军事职业教育贯穿整个职业生涯[2-31.近年来文职护士成为了军队医院护理队伍的重要组成部分,承担着临床护理、教学与科研、卫勤保障等多领域的任务.然而,文职人员为军队面向地方公开招聘的人员,对于军事护理的内涵与外延缺乏系统认识,同时各单位对于军事护理所要具备的理论与技能尚缺乏较系统、规范的培训.笔者所在单位自2018年承担护理文职人员专业培训班任职教育教学任务以来,采用CBE模式构建教学培训体系,取得了良好的教学效果,为军队同类或同专业任职教育改革提供一定参考,现报道如下.

目的 调查重庆市某主城区失独家庭慢性病老人居家护理服务直接成本,为社区护理服务成本管理提供参考.方法 采用案例调查法和访谈法,以重庆市某主城区3个社区382名失独家庭老人和3个社区卫生服务中心124名护理人员为研究对象,确定失独家庭慢性病老人居家护理服务项目和成本构成要素,核算护理服务项目直接成本.结果 共确定了22项护理服务项目,其中,糖尿病8项、高血压4项、冠心病5项、其他疾病5项;生命体征测量项目直接成本最低(1.5元),糖尿病伤口换药项目直接成本最高,在22.8元～57.0元之间.失独家庭慢性病老人居家护理服务项目中血糖监测、PICC维护及引流管护理盈利,其他项目处于亏损状态.结论 护理服务项目计价标准较低,未能体现社区护理人员劳动价值;失独家庭扶助金标准较低,难以减轻居民经济负担;社区护理人员学历、职称不高,难以满足失独家庭慢性病老人心理需求.建议动态调整居家护理服务项目物价标准,提高失独家庭老人救助金标准,加强"互联网+社区护理"体系建设,完善人才队伍结构,有效利用社会资源.

Burns are one of the most common injuries in daily life for all ages of population. This study was to investigate the epidemiology and outcomes among burn patients in one of the largest burn centers in the southwest of China. The study was performed at the Institute of Burn Research in the first affiliated with the Army Medical University (AMU). A total of 17,939 burn patients were included in this retrospective study. Information regarding burn epidemiology and outcomes in 17 years were collected, calculated and compared. The age ranged from 257 days to 95 years old. Scalding and flame were the two most common causes to burn injuries, comprising of 91.96% in total. Limbs, head/face/neck, and trunk were the most frequently occurred burn sites, with the number and the percent of 12,324 (68.70%), 7989 (44.53%), and 7771 (43.32%), respectively. The average total body surface area (TBSA) was 13.64 ± 16.83% (median 8%) with a range of 0.1–100%. A total of 874 (4.9%) patients had TBSA > 50%. The presence of a burn with an inhalation injury was confirmed in 543 patients (3.03%). The average LOS was 32.11 ± 65.72 days (median: 17 days). Eventually, the retrospective analysis resulted in the development of a burn management continuum used for developing strategies to prevent and manage severe burns. The annual number of burn injuries has kept decreasing, which was partially attributed to the increased awareness and education of burn prevention and the improved burn-preventative circumstances. However, the burn severity and the economic burden were still in a high level. And the gender difference and age difference should be considered when making individualized interventions and rehabilitative treatments.

OBJECTIVE:This study examined the association between iron status and a set of breast cancer risk factors among U.S. adult women aged 20-80 years.METHODS:Data from National Health and Nutrition Examination Survey (2017-2018) were used to examine the relation between serum ferritin, serum iron and transferrin saturation with a set of breast cancer risk factors [body mass index (BMI), waist circumference, glycosylated hemoglobin (HbA1c), fasting plasma glucose, insulin and HOMA-IR]. The multivariable linear regressions were used controlling for age, race/ethnicity, menopause status, education level, smoking status, alcohol consumption, physical activity, high-sensitivity C-reactive protein (hsCRP) and total energy intake.RESULTS:HbA1c, BMI and waist circumference data were available for 1902 women with a fasting sample (n = 913) for fasting plasma glucose, insulin and HOMA-IR. Transferrin saturation had significant, inverse associations with BMI, waist circumference and HbA1c. The size of difference observed were that participants in the fourth quartile of transferrin saturation had a 4.50 kg/m2 smaller BMI, a 9.36 cm smaller waist circumference and a 0.1 % lower HbA1c level than participants in the first quartile. Similarly, serum iron concentrations were inversely associated with BMI and waist circumference. In addition, serum iron had significant, inverse associations with insulin and HOMA-IR. Sensitivity analyses among men gave similar results. For serum ferritin, there was a trend towards a positive association between waist circumference, HbA1c and fasting plasma glucose with serum ferritin. However, the associations did not reach statistical significance among women.CONCLUSIONS:Iron status may impact breast cancer risk via effects on adiposity or glucose metabolism. The findings should be confirmed with further prospective data.

目的 探讨改良限盐DASH饮食联合氨氯地平对原发性高血压患者心血管功能的保护作用.方法 选取陆军军医大学附属第一医院2018年10月至2019年8月收治的原发性高血压患者106例,按治疗方式的不同分为观察组(58例)和对照组(48例).两组患者均予氨氯地平片口服,观察组患者加用改良限盐DASH饮食治疗.两组均持续治疗6个月.结果 治疗后,观察组患者的收缩压、收缩压变异性、舒张压变异性及颈动脉内膜中膜厚度(IMT)均显著低于对照组(P<0.05),需要增加剂量或联合用药例数均显著少于对照组(P<0.05);观察组与对照组不良心血管事件发生率相当(1.72％比6.25％,P>0.05).结论 改良限盐DASH饮食联合氨氯地平可降低原发性高血压患者的收缩压及其变异性与舒张压,保护脏器功能,减少降压药物用量.

目的 调查重庆市失独家庭中糖尿病患者膳食营养状况.方法 随机抽取重庆市失独家庭中糖尿病患者 100 例作为观察组, 同时选取 100 例正常家庭中的健康人群作为对照组, 调查 2 组人群膳食营养状况.结果 重庆市失独家庭中糖尿病患者身体体重指数明显高于健康人群[(26.95±3.02) vs. (25.26±3.39) kg/m2, P<0.01]; 肥胖比例显著高于健康人群(32.00% vs. 18.00%,P<0.05).重庆市失独家庭中糖尿病患者谷物、油脂类、禽肉类、豆类、盐摄入量较正常人群增高(P<0.05), 而乳类、蔬菜类、鱼虾类、蛋类、水果摄入量较正常人群降低(P<0.05).通过对比糖尿病患者推荐摄入量发现重庆市失独家庭中糖尿病患者谷物、油脂类、禽肉类、豆类、盐摄入量超量, 而乳类、蔬菜类、鱼虾类、蛋类、水果摄入量不足.重庆市失独家庭中糖尿病患者热量、碳水化合物和脂肪摄入量高于正常人群, 而蛋白质摄入量低于正常人群(P<0.05).重庆市失独家庭中糖尿病患者焦虑自我评分、抑郁自我评分高于正常人群(P<0.05).焦虑自我评分、抑郁自我评分与热量、碳水化合物、脂肪摄入正相关, 与蛋白质摄入负相关(P<0.05).结论 重庆市失独家庭中糖尿病患者热量摄入较多, 其中碳水化合物、脂肪、盐摄入较多, 而蛋白质摄入偏少, 与心理健康状况有关, 应加强对这类人群的饮食教育和心理健康建设.