Objective: To investigate the effectiveness of child life services in alleviating medical fear among pediatric patients in emergency care settings.
Methods: A convenience sampling method was employed to select 85 pediatric patients admitted to the Emergency Department of West China Second University Hospital, Sichuan University, between January 2022 and December 2024. A self-controlled before-and-after study design was adopted, wherein child life interventions were administered to all participants. The Children's Fear Scale was utilized to assess fear levels pre- and post-intervention, and then to compare the differences.
Results: After the child life intervention, 69 patients exhibited a score reduction > 0, yielding an intervention efficacy rate of 81.18%. The median (interquartile range) fear score decreased significantly from 3 (2-4) pre-intervention to 1 (1-2) post-intervention (Z = －7.329, P < 0.001). The proportion of participants with severe or extreme fear (≥ 3 points) declined markedly post-intervention, showing statistical significance (11.76% vs. 80.00%, χ 2 = 33.029, P < 0.001). Intervention efficacy varied significantly among subgroups with different levels of fear (P < 0.01), with better effectiveness observed in cohorts with higher levels of fear.
Conclusion: Child life services significantly reduce the levels of medical fear among pediatric patients in emergency care settings and provide comprehensive psychosocial support. It can also serve as an effective measure for establishing a humanistic emergency care environment.
Objective: To explore the effect of physical exercise intervention on mild-to-moderate depression in college students, and to provide empirical evidence for informing treatment.
Methods: A total of 108 college students with mild-to-moderate depression receiving care at the outpatient department and inpatient department of the Second Affiliated Hospital, Xinxiang Medical University between January 2022 and March 2024 were enrolled. The participants were divided into a control group (n = 54) and a physical exercise group (n = 54) according to the time of consultation. The control group received conventional drug therapy, whereas the physical exercise group was an aerobic exercise intervention regimen in addition to the routine drug therapy. Both groups were treated for 8 weeks. The primary outcome indicator (clinical efficacy) and secondary outcome indicators, including the 24-Item Hamilton Depression Rating Scale (HAMD-24) score, the Pittsburgh Sleep Quality Index (PSQI) score, the P300 component of the event-related potential (latency and amplitude), the serum levels of hypothalamic-pituitary-adrenal (HPA) axis-related indicators (adrenocorticotropic hormone [ACTH] and cortisol [Cor]), and the World Health Organization Quality of Life-Brief scale (WHOQOL-BREF) score, before and after intervention were measured and compared between the two groups.
Results: Comparison of the primary outcome indicator revealed that, after treatment, the efficacy grading in the physical exercise group was better than that in the control group (Z = 2.546, P = 0.011). Regarding secondary outcomes, both groups showed significant reductions in HAMD-24 and PSQI scores after treatment (P < 0.05), with the physical exercise group demonstrating lower scores than the control group (P < 0.05). Event-related potential P300 latency was shortened in both groups, and the reduction was greater in the physical exercise group (P < 0.05). P300 amplitude increased in both groups, with a larger increase observed in the physical exercise group (P < 0.05). Levels of ACTH and cortisol decreased across groups, with lower values in the physical exercise group compared with controls (P < 0.05). Quality-of-life scores improved in both groups, with the physical exercise group reporting higher scores than the control group (P < 0.05).
Conclusion: Physical exercise can regulate the function of the HPA axis of college students with mild-to-moderate depression, alleviate their depressive symptoms, promote the recovery of cognitive function, and improve the sleep quality and quality of life of patients.
Chronic diseases pose a major public health challenge in China. Clarifying the responsibilities of key stakeholders in chronic disease prevention and control and fostering synergy among them are essential to advancing the goals of the Healthy China 2030 Initiative. Utilizing the World Health Organization's Innovative Care for Chronic Conditions (ICCC) framework, we systematically analyzed how stakeholder responsibilities are defined in China's chronic disease prevention and control system, along with current coordination efforts and persistent challenges. We propose the following reform recommendations: strengthening governmental leadership by improving legislation and policy implementation standards, expanding health insurance coverage, and enhancing capacity building at the primary care level alongside patient education; establishing cross-departmental coordination mechanisms, encouraging social sector engagement, and improving communication, referral, incentive, and oversight mechanisms; accelerating the development of information system in central/western and rural areas, and promoting the application of big data and artificial intelligence technologies; fostering a supportive social environment through implementing incentive measures, promoting primordial prevention, and advancing healthy community initiatives. The implementation of these multifaceted measures is expected to enhance the quality and efficiency of chronic disease prevention and control, thereby contributing to the achievement of the goals of the Healthy China Initiative.
Objective: To explore the association between the value alignment with medical care and prevention integration among family doctors and the health status of patients with chronic diseases, and to analyze the mediating effect of team cohesion between them.
Methods: SA survey was conducted in 4 cities in the eastern, central and western regions of China. In each city, chronic disease patients and their contracted family doctors were enrolled in 6 randomly selected townships or neighborhoods. Self-developed scales were used to assess the value identification with medical care and prevention integration among family doctors, as well as their team cohesion. The Chinese version of the EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire was used to assess the health status of patients. A multilevel regression model was applied to analyze variables at two levels-patients and family doctors. The mediating effect was analyzed using a multilevel structural equation model.
Results: A total of 5855 patients with chronic diseases and 164 family doctors were included. The correlation between value alignment with medical care and prevention integration among family doctors and the health status of patients was statistically significant (β = 0.089, 95% CI: 0.042-0.136). Team cohesion played a mediating role between them (P = 0.030), accounting for 5.23% of the total effect, with an indirect effect value of 0.054 and a 95% bootstrap confidence interval of 0.005-0.103.
Conclusion: IIt is important to establish appropriate performance evaluation and incentive mechanisms and team collaboration mechanisms in the promotion of medical care and prevention integration, so as to improve the effect of health management for patients.
Objective: To investigate whether nuclear factor I-X (NFIX) possesses phase separation capability and to elucidate its mechanism in regulating biological functions related to craniofacial development through phase separation.
Methods: An enhanced green fluorescent protein (EGFP)-tagged full-length NFIX recombinant plasmid was transfected into U2OS cells, and its subcellular localization was observed using confocal fluorescence microscopy. The protein structure of NFIX was analyzed using the Predictor of Natural Disordered Regions (PONDR), a protein analysis instrument, with a focus on identifying intrinsically disordered regions (IDRs) associated with weak interactions required for biomolecular condensate formation. A truncated NFIX-EGFP plasmid lacking the IDR was constructed, and changes in its intracellular localization were observed. Immunoprecipitation-mass spectrometry (IP-MS) was utilized to analyze differences in protein interactions with downstream factors between full-length and truncated NFIX.
Results: In the nucleus, full-length EGFP-NFIX formed biomolecular condensates resembling membraneless organelles. PONDR analysis confirmed that NFIX contains an IDR (aa245-494) (IDR2), which is critical for biomolecular condensate formation. Truncation of IDR2 resulted in a diffuse protein distribution in the nucleus. IP-MS revealed that multiple proteins exhibited IDR2-dependent binding specificity and were significantly enriched in pathways related to craniofacial development, such as the MAPK pathway.
Conclusion: NFIX regulates bone developmental homeostasis not only through canonical transcriptional mechanisms but also through IDR-mediated phase separation. This biomolecular condensate formation mechanism provides new insights into the pathogenesis of NFIX-related craniofacial dysmorphogenesis syndromes.
The degeneration of the third molar (wisdom tooth) represents a key marker of human dental evolution. Archaeological investigations of this phenomenon provide important insights into the living environment, dietary composition, health status, and evolutionary relationships of ancient populations. In this article, we systematically reviewed archaeological evidence of third molar degeneration in China from the Paleolithic through historical periods, focusing on 3 principal manifestations-impaction, congenital absence, and morphological abnormalities. Evidence indicates that third molar impaction can be traced back to Australopithecus from approximately 2.3 million years ago, with a notable qualitative transition occurring during the Neolithic period, when frequencies increased substantially. Congenital absence has been documented in Lantian Man (Homo erectus lantianensis) and shows marked regional and temporal variations across different historical periods. Morphological abnormalities primarily manifested as peg-shaped teeth and size reduction, reflecting the ongoing evolutionary process of dental degeneration. These archeological findings not only provide crucial support for understanding the biological mechanisms underlying human adaptation to environmental changes, but also provide historical references for modern oral medicine, particularly in disease prevention and treatment strategies. Furthermore, these archeological findings lay the foundation for promoting a deeper integration of archeology with modern medicine and add new dimensions to the study of human civilization.
Objective: To investigate the factors influencing all-cause and specific cause deaths in community-dwelling patients with schizophrenia.
Methods: The data analyzed in this study were obtained from the integrated management information platform for severe mental disorders in a region in western China. The Kaplan-Meier method and log-rank test were used to estimate and compare the cumulative incidence curves of patient deaths. Risk factors for all-cause and specific cause deaths were explored using the Cox proportional hazards regression model and Fine-Gray competing risk model, respectively.
Results: A total of 207638 schizophrenia patients were included in the study, with a median follow-up period of 3.98 years and a maximum follow-up period of 12.35 years. A total of 15062 (7.3%) patients died during the follow-up period, including 8758 (4.2%) due to physical illnesses, 563 (0.3%) due to suicide, 1337 (0.6%) due to accidents, 1193 (0.6%) due to mental illness-related complications, and 3211 (1.6%) due to other causes. Multivariate Cox regression analysis revealed that age (hazard ratio [HR] = 3.65, 95% CI: 3.49-3.81), sex (HR = 0.78, 95% CI: 0.75-0.81), ethnicity (HR = 0.78, 95% CI: 0.61-0.99), marital status (HR = 1.24, 95% CI: 1.19-1.28), economic status (HR = 1.67, 95% CI: 1.61-1.74), educational attainment (HR = 0.69, 95% CI: 0.66-0.72), family history of psychiatric illness (HR = 0.90, 95% CI: 0.83-0.98), and the duration of illness (10-19 years [HR = 0.82, 95% CI: 0.79-0.85] and 20-29 years [HR = 0.79, 95% CI: 0.76-0.83]) were influencing factors for all-cause deaths in patients with schizophrenia. The results of the Fine‒Gray model indicated that older age, male sex, lower educational attainment, and poverty are common risk factors for patient deaths due to physical illnesses, accidents, mental illness-related complications, and other causes. Being single, divorced, or widowed and having a shorter duration of illness are common risk factors for mortality due to physical illnesses, accidents, and other causes. Poor medication adherence was a risk factor for patient deaths due to mental illness-related complications and other causes. Additionally, for deaths due to physical illnesses, Han ethnicity and the absence of a family history of psychiatric illness were associated with a higher mortality risk. Regarding suicide deaths, higher educational attainment, poverty, shorter duration of illness, and good medication adherence were identified as risk factors.
Conclusion: Targeted management and interventions should be implemented based on the different mortality risks in schizophrenia patients to improve their survival rates.
Objective: To explore the performance of a predictive model based on plasma multigene methylation testing in the early diagnosis of colorectal cancer (CRC).
Methods: A total of 688 patients with suspected CRC who underwent diagnostic examination at the Affiliated Hospital of Xuzhou Medical University between July 2022 and June 2024 were enrolled. The plasma methylation status of 5 genes, including SEPTIN9 (septin 9), BCAT1 (branched chain amino acid transaminase 1), IKZF1 (IKAROS family zinc finger 1), BCAN (brevican), and VAV3 (vav guanine nucleotide exchange factor 3), was assessed before pathological biopsy. The negative or positive results of the methylation testing of the 5 genes were compared with the clinical pathological diagnosis results of the same participants to construct a predictive model based on the methylation status of SEPTIN9, BCAT1, IKZF1, BCAN, and VAV3 genes, and the performance of the predictive model in the early diagnosis of CRC patients was evaluated.
Results: Of the 688 patients, 48 had a pathologically confirmed diagnosis of colorectal carcinoma. The diagnostic performance of a single-gene methylation status for CRC was as follows: SEPTIN9 showed a sensitivity of 47.92%, specificity of 96.72%, and AUC of 0.804 (95% CI: 0.672-0.899); BCAT1 showed a sensitivity of 52.08%, specificity of 96.88%, and AUC of 0.753 (95% CI: 0.702-0.864); IKZF1 showed a sensitivity of 50.00%, specificity of 98.28%, and AUC of 0.740 (95% CI: 0.635-0.881); BCAN showed a sensitivity of 33.33%, specificity of 98.75%, and AUC of 0.690 (95% CI: 0.572-0.785); VAV3 showed a sensitivity of 35.42%, specificity of 97.66%, and AUC of 0.686 (95% CI: 0.597-0.734). A diagnostic model integrating the 5 genes achieved a sensitivity of 85.42%, specificity of 93.40%, and AUC of 0.916 (95% CI: 0.835-0.972). The diagnostic sensitivities of the model for CRC of different stages were 85.71% for stage Ⅰ, 92.86% for stage Ⅱ, 78.95% for stage Ⅲ, and 87.50% for unstaged cases.
Conclusion: A diagnostic model based on the methylation levels of the SEPTIN9, BCAT1, IKZF1, BCAN, and VAV3 genes in plasma demonstrates good diagnostic performance for CRC, particularly in early-stage cases.
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