Objective To explore the optimization effect of the nursing pathway driven by the theory of planned behavior(TPB)on postoperative rehabilitation in patients with senile cataract.Methods A total of 100 patients with senile cataract were selected as the research subjects and ran-domly divided into control group and study group using the random number table method,with 50 ca-ses in each group.The control group received routine nursing care,while the study group received TPB-driven nursing pathway intervention in addition to routine care.The postoperative recovery sta-tus,hospitalization expenses,visual quality[Visual Function Index Questionnaire(VF-14)score],self-care ability[Exercise of Self-care Agency Scale(ESC A)score],postoperative complications,and behavioral change intention were compared between the two groups.Results The postoperative visual acuity in the study group was higher,while the intraocular pressure and hospitalization expen-ses were lower than that in the control group.The visual acuity recovery time and hospitalization dura-tion were shorter in the study group than those in the control group,with statistically significant differ-ences(P＜0.05).After the intervention,the VF-14 score and ESC A score in the study group were higher than those in the control group;the overall incidence of postoperative complications in the study group was 4.00％,which was lower than 16.00％in the control group;the scores of each di-mension of behavioral change intention after the intervention in the study group were higher than those in the control group,with statistically significant differences(P＜0.05).Conclusion The TPB-driv-en nursing pathway can effectively optimize the postoperative rehabilitation effect in patients with senile cataract,improve their postoperative visual acuity,visual quality,and self-care ability,thereby enhancing the quality of rehabilitation.

Objective: Data on syncopal donation-related vasovagal reaction (DRVR) collected from 74 blood centers between 2020 and 2023 was statistically analyzed to provide a reference for developing preventive strategies against syncopal DRVR. Methods: Data on blood donation adverse reactions and basic information of donors from 2020 to 2023 were collected through the information management system at monitoring sentinel sites. Statistical analysis was performed on the following aspects of syncopal DRVR: characteristics of donors who experienced syncope, reported incidence, triggers, duration, presence and occurrence time of syncope-related trauma, clinical management including outpatient and inpatient treatment, and severity grading. Results: From 2020 to 2023, 45 966 donation-related adverse reactions were recorded. Of these, 1 665 (3.72%) cases were syncopal DRVR. The incidence of syncopal DRVR decreased with age, being the highest in the 18-22 age group. Incidence was significantly higher in female donors than male donors, in first-time donors than repeat donors, and in university and individual donors than group donors (all P<0.05). There was no statistically significant difference among different blood donation locations (P>0.05). The top three triggers were tension, fatigue, and needle phobia or fear of blood. Among syncopal DRVR cases, 60.36% occurred during blood collection, 87.63% lasted for less than 60 seconds, and 5.05% were accompanied by trauma. Notably, 57.14% of these traumas occurred after donor had left the blood collection site. Syncope severity was graded based on required treatment: grade 1 (fully recovered without treatment, 95.50%); grade 2 (recovered after outpatient treatment, 4.02%); and grade 3 (recovered after inpatient treatment, 0.48%). Conclusion: By analyzing the data of syncopal DRVR cases, it is possible to provide a reference for formulating blood donor safety policies.

Objective:To investigate the effect of advanced glycation end products (AGEs) on ferroptosis in human retinal pigment epithelium (RPE) cell cultured in vitro. Methods:ARPE-19 cell lines were cultured in DMEM medium containing 10% fetal bovine serum (FBS), and the 3rd to 6th generations of cells were used for further study.Cell activity was detected by using the cell counting kit 8 after ARPE-19 were cultured with AGEs at 0, 50, 100, 200, 400 μg/ml for 48 hours.The cells were cultured with 200 μg/ml AGEs for 48 hours.Cell lipid peroxidation level was measured by Lipid Peroxidation Assay Kit (Bodipy 581/591 C11) combined with flow cytometry.The relative mRNA and protein expression levels of solute carrier family 7 member 11 (SLC7A11) and glutathione peroxidase 4 (GPX4) were determined by quantitative real-time PCR (qRT-PCR) and Western blot.The morphology of mitochondria was observed by transmission electron microscope.Results:The activity of ARPE-19 cells decreased with increasing AGEs concentration, and the overall difference of ARPE-19 activity among 0, 50, 100, 200, 400 μg/ml AGEs groups was statistically significant ( F=6.21, P<0.01).The cell activity of ARPE-19 cells in 200 and 400 μg/ml AGEs groups was lower than that in control group (both P<0.05).Flow cytometry showed that the fluorescence intensity in AGEs group was 622.0±11.3, which was significantly higher than 487.7±12.8 in control group ( t=6.809, P=0.002).qRT-PCR showed that the mRNA and protein relative expression levels of SLC7A11 and GPX4 were lower in AGEs group than those in control group (mRNA: t=3.72, 7.14, both P<0.05; protein: t=6.20, 5.15, both P<0.05).Transmission electron microscopy showed that mitochondria in AGEs group shrank with significantly reduced volume, decreased mitochondrial cristae, and increased mitochondrial membrane density. Conclusions:AGEs can induce ferroptosis in ARPE-19 cultured in vitro.

Objective:To understand the hindrance and promoting factors of colonoscopy compliance in high-risk adenoma patients 3 months after resection, and to provide reference for formulating targeted nursing intervention strategies.Methods:An interview outline was formulated based on the health action process approach theory. A descriptive qualitative research method was used to select 13 patients with high-risk adenoma after resection in Guilin Integrated Traditional Chinese and Western Medicine Hospital from April to May 2024 for semi-structured interviews according to the purposive sampling method. Content analysis was used to analyze the data and refine the themes.Results:Among the 13 patients, there were 8 males and 5 females, aged 42-70 years old.A total of 2 themes and 8 sub-themes were extracted, including hindering factors (fear of disease outcome, risk perception barriers, low self-efficacy and lack of behavior plan) and promoting factors (establishing correct health beliefs, perceiving the benefits of health behavior, enhancing personal efficacy and advocating health behavior plan).Conclusions:The compliance of colonoscopy in patients with high-risk adenoma after resection is affected by a series of obstacles and promoting factors. In the future, targeted intervention strategies can be formulated based on the health action process approach theory to improve their compliance with colonoscopy.

Objective:To investigate the clinical efficacy of insulin combined with zoledronic acid in the treatment of type 2 diabetes mellitus (T2DM) complicated by osteoporosis and its effects on bone metabolism and pancreatic β-cell function.Methods:A retrospective analysis was conducted on the clinical data of 68 patients with T2DM complicated by osteoporosis who were treated at Wenling Hospital of Traditional Chinese Medicine from January 2021 to December 2023. The patients were divided into a control group and a study group, with 34 cases in each group. The control group received treatment with zoledronic acid combined with acarbose, while the study group received insulin combined with zoledronic acid. The clinical efficacy and improvements in bone metabolism (bone-specific alkaline phosphatase, alkaline phosphatase, osteoprotegerin), bone density, and pancreatic β-cell function (homeostasis model assessment of beta-cell function and homeostasis model assessment of insulin resistance) were evaluated and compared between the two groups. Additionally, the incidence of adverse reactions was also compared between the two groups.Results:The clinical overall effective rate in the study group was significantly higher than that in the control group [91.18% (31/34) vs. 67.65% (23/34), χ2 = 5.76, P < 0.05]. The levels of bone-specific alkaline phosphatase [(44.92 ± 5.92) μg/L], alkaline phosphatase [(109.12 ± 9.46) U/L], and osteoprotegerin [(331.42 ± 13.92) ng/L]in the study group were significantly higher than those in the control group [(38.25 ± 4.78) μg/L, (102.95 ± 9.23) U/L, (312.26 ± 13.11) ng/L, t = -5.11, -2.72, -5.84, all P < 0.05]. After treatment, the bone density indicators in the study group [(0.80 ± 0.12) g/cm2, (0.84 ± 0.13) g/cm2, (0.82 ± 0.10) g/cm2, (0.83 ± 0.11) g/cm2]were significantly higher than those in the control group [(0.72 ± 0.11) g/cm2, (0.73 ± 0.09) g/cm2, (0.71 ± 0.12) g/cm2, (0.74 ± 0.09) g/cm2, t = -2.87, -7.38, -4.11, -3.69, all P < 0.05]. The homeostasis model assessment of beta-cell function and homeostasis model assessment of insulin resistance in the study group were (54.97 ± 5.42) and (1.61 ± 0.89), respectively, which were significantly different from those in the control group [(43.11 ± 5.23), (2.46 ± 0.96), t = -25.97, 3.79, both P < 0.05]. There was no statistically significant difference in the incidence of adverse reactions between the two groups ( χ2 = 0.36, P > 0.05). Conclusions:Insulin combined with zoledronic acid can enhance clinical efficacy in patients with T2DM complicated by osteoporosis, improve bone metabolism, boost pancreatic β-cell function, and demonstrate good safety.

Objective:To investigate the effect of advanced glycation end products (AGEs) on ferroptosis in human retinal pigment epithelium (RPE) cell cultured in vitro. Methods:ARPE-19 cell lines were cultured in DMEM medium containing 10% fetal bovine serum (FBS), and the 3rd to 6th generations of cells were used for further study.Cell activity was detected by using the cell counting kit 8 after ARPE-19 were cultured with AGEs at 0, 50, 100, 200, 400 μg/ml for 48 hours.The cells were cultured with 200 μg/ml AGEs for 48 hours.Cell lipid peroxidation level was measured by Lipid Peroxidation Assay Kit (Bodipy 581/591 C11) combined with flow cytometry.The relative mRNA and protein expression levels of solute carrier family 7 member 11 (SLC7A11) and glutathione peroxidase 4 (GPX4) were determined by quantitative real-time PCR (qRT-PCR) and Western blot.The morphology of mitochondria was observed by transmission electron microscope.Results:The activity of ARPE-19 cells decreased with increasing AGEs concentration, and the overall difference of ARPE-19 activity among 0, 50, 100, 200, 400 μg/ml AGEs groups was statistically significant ( F=6.21, P<0.01).The cell activity of ARPE-19 cells in 200 and 400 μg/ml AGEs groups was lower than that in control group (both P<0.05).Flow cytometry showed that the fluorescence intensity in AGEs group was 622.0±11.3, which was significantly higher than 487.7±12.8 in control group ( t=6.809, P=0.002).qRT-PCR showed that the mRNA and protein relative expression levels of SLC7A11 and GPX4 were lower in AGEs group than those in control group (mRNA: t=3.72, 7.14, both P<0.05; protein: t=6.20, 5.15, both P<0.05).Transmission electron microscopy showed that mitochondria in AGEs group shrank with significantly reduced volume, decreased mitochondrial cristae, and increased mitochondrial membrane density. Conclusions:AGEs can induce ferroptosis in ARPE-19 cultured in vitro.

Objective:To understand the hindrance and promoting factors of colonoscopy compliance in high-risk adenoma patients 3 months after resection, and to provide reference for formulating targeted nursing intervention strategies.Methods:An interview outline was formulated based on the health action process approach theory. A descriptive qualitative research method was used to select 13 patients with high-risk adenoma after resection in Guilin Integrated Traditional Chinese and Western Medicine Hospital from April to May 2024 for semi-structured interviews according to the purposive sampling method. Content analysis was used to analyze the data and refine the themes.Results:Among the 13 patients, there were 8 males and 5 females, aged 42-70 years old.A total of 2 themes and 8 sub-themes were extracted, including hindering factors (fear of disease outcome, risk perception barriers, low self-efficacy and lack of behavior plan) and promoting factors (establishing correct health beliefs, perceiving the benefits of health behavior, enhancing personal efficacy and advocating health behavior plan).Conclusions:The compliance of colonoscopy in patients with high-risk adenoma after resection is affected by a series of obstacles and promoting factors. In the future, targeted intervention strategies can be formulated based on the health action process approach theory to improve their compliance with colonoscopy.

Objective:To investigate the clinical efficacy of insulin combined with zoledronic acid in the treatment of type 2 diabetes mellitus (T2DM) complicated by osteoporosis and its effects on bone metabolism and pancreatic β-cell function.Methods:A retrospective analysis was conducted on the clinical data of 68 patients with T2DM complicated by osteoporosis who were treated at Wenling Hospital of Traditional Chinese Medicine from January 2021 to December 2023. The patients were divided into a control group and a study group, with 34 cases in each group. The control group received treatment with zoledronic acid combined with acarbose, while the study group received insulin combined with zoledronic acid. The clinical efficacy and improvements in bone metabolism (bone-specific alkaline phosphatase, alkaline phosphatase, osteoprotegerin), bone density, and pancreatic β-cell function (homeostasis model assessment of beta-cell function and homeostasis model assessment of insulin resistance) were evaluated and compared between the two groups. Additionally, the incidence of adverse reactions was also compared between the two groups.Results:The clinical overall effective rate in the study group was significantly higher than that in the control group [91.18% (31/34) vs. 67.65% (23/34), χ2 = 5.76, P < 0.05]. The levels of bone-specific alkaline phosphatase [(44.92 ± 5.92) μg/L], alkaline phosphatase [(109.12 ± 9.46) U/L], and osteoprotegerin [(331.42 ± 13.92) ng/L]in the study group were significantly higher than those in the control group [(38.25 ± 4.78) μg/L, (102.95 ± 9.23) U/L, (312.26 ± 13.11) ng/L, t = -5.11, -2.72, -5.84, all P < 0.05]. After treatment, the bone density indicators in the study group [(0.80 ± 0.12) g/cm2, (0.84 ± 0.13) g/cm2, (0.82 ± 0.10) g/cm2, (0.83 ± 0.11) g/cm2]were significantly higher than those in the control group [(0.72 ± 0.11) g/cm2, (0.73 ± 0.09) g/cm2, (0.71 ± 0.12) g/cm2, (0.74 ± 0.09) g/cm2, t = -2.87, -7.38, -4.11, -3.69, all P < 0.05]. The homeostasis model assessment of beta-cell function and homeostasis model assessment of insulin resistance in the study group were (54.97 ± 5.42) and (1.61 ± 0.89), respectively, which were significantly different from those in the control group [(43.11 ± 5.23), (2.46 ± 0.96), t = -25.97, 3.79, both P < 0.05]. There was no statistically significant difference in the incidence of adverse reactions between the two groups ( χ2 = 0.36, P > 0.05). Conclusions:Insulin combined with zoledronic acid can enhance clinical efficacy in patients with T2DM complicated by osteoporosis, improve bone metabolism, boost pancreatic β-cell function, and demonstrate good safety.

Objective:To investigate the association between hyperuricemia and the risk for stroke occurrence, as well as the mediating effect of hypertension on this association.Methods:In this study, the China Chronic Diseases and Nutrition Surveillance system in 2015 was used as baseline data. We identified hospital admissions for stroke using the electronic homepage of inpatient medical records from 2013-2020, and death data were obtained from the 2015-2020 National Mortality Surveillance System. A retrospective cohort was established after matching and linking the database. The Cox proportional hazard regression model was used to analyze the relationship between hyperuricemia and the risk of stroke and its subtypes. Restricted cubic spline analysis was conducted to examine the dose-response relationship between serum uric acid levels and the risk for stroke. Mediation analysis was performed to investigate the mediating effect of hypertension on the association between hyperuricemia and the risk for stroke and its subtypes. Subgroup analyses were conducted based on gender and age groups.Results:A total of 124 352 study subjects were included, with an accumulative follow-up time of 612 911.36 person-years. During the follow-up period, 4 638 cases of stroke were found, including 3 919 cases of ischemic stroke and 689 cases of hemorrhagic stroke. The incidence density of stroke was 756.72 per 100 000 person-years, 641.37 per 100 000 person-years for ischemic stroke, and 114.60 per 100 000 person-years for hemorrhagic stroke. Multivariable Cox proportional hazards regression models showed that after adjusting for covariates, compared to those without hyperuricemia, individuals with hyperuricemia had a 16% higher risk for stroke [hazard ratio ( HR)=1.16, 95% CI: 1.06-1.27], a 12% higher risk of ischemic stroke ( HR=1.12, 95% CI: 1.01-1.24), and a 39% higher risk of hemorrhagic stroke ( HR=1.39, 95% CI: 1.11-1.75). Mediation analysis showed that hypertension partially mediated the associations between hyperuricemia and the risk for stroke, ischemic stroke, and hemorrhagic stroke, with mediation proportions of 36.07%, 39.98%, and 25.34%, respectively. The mediating effect is pronounced in the male population and individuals below 65. Conclusion:Hyperuricemia is a risk factor for stroke, and hypertension partially mediates the effect of hyperuricemia on stroke.

AIM: To analyze the correlation between ocular surface status and serum lipids in patients with meibomian gland dysfunction(MGD)during pregnancy, and to provide new ideas for the management and treatment of MGD during pregnancy.METHODS: Totally 120 pregnant women(240 eyes)treated in our hospital from May 2021 to May 2022 were selected and they were divided into MGD group(60 cases, 120 eyes)and control group(60 cases, 120 eyes)according to the presence or absence of MGD. All subjects received the ocular surface disease index scores(OSDI)and underwent examinations of meibomian gland morphology and function, tear film and blood lipid.RESULTS: The scores of OSDI, the related indexes of meibomian gland, corneal fluorescein staining(FL)scores, total cholesterol(TC), triglyceride(TG)and low density lipoprotein-cholesterol(LDL-C)in the MGD group were significantly higher than those in the control group(P<0.05). The scores of fluorescein breakup time(FBUT), Schirmer Ⅰ test(SIt)and high-density lipoprotein cholesterol(HDL-C)in the MGD group were significantly lower than those in the control group(P<0.05). Correlation analysis showed that the scores of TG, TC, LDL-C were negatively correlated with the values of FBUT(rs =-0.702, -0.647, -0.710, all P<0.001).CONCLUSION: The level of blood lipids in pregnant patients with MGD is significantly increased, and the levels of TC, TG and LDL-C may be related to the stability of tear film.