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Background In 2010, China began to implement a free training program for rural order-oriented medical students (the "program") , which has played an important role in improving the construction of grass-roots health personnel and upgrading the level of grass-roots medical and health services. As the program has progressed, despite certain successes, there are many problems that remain to be solved, and it is not yet known which are the urgent and important core issues. Objective Sorting out the problems with the program to provide lessons learned for moving the program forward. Methods In May 2023, Chinese databases were searched using the literature analysis method to sort out the problems of the project documented in the literature; the problems resulting from the sorting out were analyzed using the social network analysis method, and the results calculated based on the social network analysis method were comprehensively evaluated using the TOPSIS method. Results The relevant problems in the literature were organized and counted. The top-ranked problems in order of frequency were low salary and treatment at the grassroots level for oriented medical students (14 times) , limited space for career development at the grassroots level for oriented medical students (10 times) , imperfect relevant supporting policies (10 times) , poor working conditions at the grassroots level (7 times) , and lack of motivation and initiative in learning for oriented medical students (7 times) ; and the results of the social network analysis were synthesized and evaluated by the TOPSIS method. The results of the social network analysis method were comprehensively evaluated by the TOPSIS method, and the top four rankings were imperfect relevant supporting policies (Ci=0.867) , limited space for grassroots career development of oriented medical students (Ci=0.800) , low grassroots salary and treatment of oriented medical students (Ci=0.786) , and poor grassroots working conditions (Ci=0.621) in the order of ranking. Conclusion Guangxi's free training program for rural order-oriented medical students still has major problems in the process of promoting the program. It is recommended that the program be optimized in the following ways to ensure its high-quality development: improve relevant supporting policies and strengthen supervision and evaluation; smooth career promotion channels and establish a long-term incentive mechanism; improve the remuneration system and raise the level of treatment; and improve the grass-roots working environment to enhance the quality of grass-roots work and increase efficiency.

Sepsis is a life-threatening condition manifested by concurrent inflammation and immunosuppression. Ubiquitin-specific peptidase 9, X-linked (USP9x), is a USP domain-containing deubiquitinase which is required in T-cell development. In the present study, we investigate whether USP9x plays a role in hepatic CD8 + T-cell dysfunction in septic mice. We find that CD8 + T cells are decreased in the blood of septic patients with liver injury compared with those without liver injury, the CD4/CD8 ratio is increased, and the levels of cytolytic factors, granzyme B and perforin are downregulated. The number of hepatic CD8 + T cells and USP9x expression are both increased 24 h after cecal ligation and puncture-induced sepsis in a mouse model, a pattern similar to liver injury. The mechanism involves promotion of CD8 + T-cell dysfunction by USP9x associated with suppression of cell cytolytic activity via autophagy inhibition, which is reversed by the USP9x inhibitor WP1130. In the in vivo studies, autophagy is significantly increased in hepatic CD8 + T cells of septic mice with conditional knockout of mammalian target of rapamycin. This study shows that USP9x has the potential to be used as a therapeutic target in septic liver injury.

According to the change of air quality in the Beijing-Tianjin-Hebei region, this paper analyzes the pollution characteristics of the air environment in this region, constructs the air quality evaluation model, and finds that the main pollution sources affecting the air quality in Beijing-Tianjin-Hebei region are coal combustion and automobile exhaust. By using the flow-diffusion equation, the air pollution concentration gradients of the Second Ring Road, the Fourth Ring Road, and the Sixth Ring Road in Beijing are given. Finally, this paper also puts forward specific countermeasures for the prevention and control of air pollution.

This paper discusses the reasonable collocation of natural casings. Through the analysis and research of the problems, the optimal model of the bundle number of assembled products is established. For this multi-objective optimization problem, the finished products are sorted according to the length from long to short, and then the method of hierarchical optimization algorithm is used to solve the problem. Finally, the empirical analysis of the given actual data is carried out. It provides an important idea for the formulation of the collocation scheme, and the solution of this problem can be extended to other aspects of production.