Atrial functional mitral regurgitation (AFMR) is mitral regurgitation in patients with atrial fibrillation (AF), whose left atrium (LA) is enlarged, the left ventricle is not enlarged or only slightly enlarged, the left ventricular ejection fraction is preserved, and the mitral valve itself has no apparent lesion. At present, the etiology, pathophysiology and mechanism of this disease have not been completely clear yet. Existing studies have found that the causes of AFMR mainly include AF, enlargement of LA and mitral annulus, destruction of mitral annular shape, inability of mitral valve remodeling to compensate for mitral annular expansion, and hamstringing of the posterior mitral leaflet by atriogenic tethering. AFMR is demonstrated to be associated with an increased risk of mortality and readmission due to heart failure. Therefore, it serves as a primary therapeutic target for patients with heart failure and AF. However, the optimal treatment of AFMR still remains controversial. Therefore, this article will mainly expound the current definition, etiology, pathophysiological mechanism, treatment, and prognosis of AFMR.

Purpose To observation the relationship be-tween the β-catenin/Slug signal specific inhibitor FH535 and EMT,and to explore the role of LPCAT1 in regulating the inva-sion,metastasis,and growth of cervical cancer cells.Methods Hela cells were transfected with sh-NC and sh-LPCAT1,and SiHa cells were transfected with Vector group and LPCAT1 over-expression plasmid.SiHa cells were divided into control group(Con),LPCAT1 group,LPCAT1+FH535 group and FH535 group.The proliferation of cervical cancer cells was detected by CCK-8 analysis and colony formation test.The metastasis and invasion ability of cervical cancer cells were detected by wound healing test and Transwell test.Western blot was used to analyze the expression of LPCAT1,β-catenin/Slug signaling pathway and EMT-related proteins in cells.Results Compared with Vector group,the cell viability,colony number,migration and invasion number of SiHa cells in LPCAT1 group increased signif-icantly(P＜0.05).Compared with sh-NC group,the cell via-bility,colony number,migration and invasion number of Hela cells in sh-LPCAT1 group decreased significantly(P＜0.05).Compared with LPCAT1 group,the levels of Wnt4(1.18±0.05 vs 0.80±0.06),β-catenin(1.05±0.08 vs 0.77±0.05),Slug(1.13±0.06 vs 0.28±0.02),Cyclin D1(0.99±0.06 vs 0.44±0.02),N-cadherin(0.91±0.07 vs 0.46±0.03)and vimentin(0.95±0.06 vs 0.49±0.03)in SiHa cells in LPCAT1+FH535 group decreased significantly(P＜0.05),and the level of E-cadherin(0.44±0.03 vs 0.58±0.03)in-creased significantly(P＜0.05).In addition,compared with LPCAT1 group,the number of colonies(224±15 vs 146±11),migration(85±3vs51±4)and invasive(166±10 vs 90±5)cells of SiHa cells in LPCAT1+FH535 group decreased signifi-cantly(P＜0.05).Conclusion The increase of LPCAT1 ex-pression may promote the metastasis and progress of CC by acti-vating β-catenin/Slug signaling pathway,and LPCAT1 may be a potential marker for predicting CC metastasis.

Objective:To understand the use of post-exposure prophylaxis (PEP) and analyze related factors among men who have sex with men (MSM) in Qingdao, and provide a reference for the AIDS prevention and control in this population.Methods:A cross-sectional survey conducted from April 2022 to February 2023. Relying on MSM social groups in Qingdao, a snowball sampling method was applied to recruit research subjects who met the inclusion criteria of age ≥18 years old, having had homosexual anal or oral sex in the past six months, and HIV-negative or infection status unknown. The sample size was estimated at 566. Data on demographic characteristics, sexual behavior characteristics, PEP use, and others of the research subjects was collected through on-site questionnaires. The logistic regression model was used to analyze the factors associated with using PEP.Results:A total of 811 participants were recruited, mainly aged 25-34 (53.6%, 435/811), unmarried (74.7%, 606/811), with an average monthly income of ≥5 000 yuan (52.2%, 423/811), and having lived in Qingdao for ≥10 years (75.6%, 613/811). The proportion of those who knew the HIV status of their sexual partners in the last six months was 67.1% (544/811), and those with HIV-positive partners were 3.6% (29/811). In the last six months, the proportion of participants who had group sex (86.4%, 701/811), unprotected anal sex (98.2%, 796/811), and use of club drugs (80.3%, 651/811) was high. Moreover, 28.4% (230/811) had used PEP. The multivariate logistic regression analysis showed that the factors related to the use of PEP included divorced or widowed (a OR=5.46,95% CI:1.96-15.17), average monthly income ≥5 000 yuan (a OR=2.04,95% CI:1.44-2.89), same-sex sexual orientation (a OR=0.40,95% CI:0.22-0.71), having HIV-positive sexual partners in the last six months (a OR=2.54,95% CI:1.13-5.71) and having been tested for HIV ≥3 times in the last six months (a OR=1.46,95% CI:1.04-2.06). Conclusions:The prevalence of risk behaviors among MSM in Qingdao was high, and the use of PEP was low. In the future, it is essential to increase HIV/AIDS prevention education among MSM, promote MSM to know the HIV status of their sexual partners, and reduce the prevalence of risk behaviors among this population. Additionally, explore medical insurance reimbursement plans for PEP to reduce utilization costs and promote the use of PEP by MSM after HIV exposure occurs as soon as possible.

Objective:To understand and analyze the incidence of HIV infection in club drug abusers among men who have sex with men (MSM) in Qingdao and provide a reference for the prevention and intervention of this population.Methods:From March 2017 to July 2022, club drug abusers among MSM who are HIV-negative were recruited by snowball sampling of MSM social organizations in Qingdao, a prospective cohort was established, and a follow-up survey was conducted every six months, with the sample size estimated to be 436. The survey contents included demographic characteristics, sexual characteristics, AIDS knowledge awareness, club drug abuse, HIV testing, and other information. HIV infection was the outcome-dependent variable, and the interval between the recruitment into the cohort and the HIV infection was the time-dependent variable. Cox proportional hazards regression analysis was conducted to identify the related factors for HIV infection.Results:A total of 987 participants of club drug abusers among MSM were recruited during the baseline survey and 826 eligible participants were enrolled in this cohort. A total of 46 HIV infection cases were found, and the cumulative follow-up time was 1 960.68 person-years. The incidence of HIV infection was 2.35/100 person-years. The multivariate Cox regression analysis showed that <30 (a HR=3.04, 95% CI: 1.62-5.71) non-Shandong residents (a HR=2.29,95% CI:1.20-4.39) found their partners through offline (a HR=4.62,95% CI:2.05-10.41), homosexual sexual partners >4 (a HR=3.06,95% CI:1.59-5.88), condom broken during sex (a HR=2.24,95% CI:1.21-4.17) and hemorrhage sexual intercourse (a HR=2.56,95% CI:1.31-5.03) were significantly associated with HIV infection in this cohort. Conclusions:The incidence of HIV infection in club drug abusers among MSM in Qingdao is generally low, but knowledge and practice have separated, and the risk of HIV infection is high. The related factors of HIV infection included younger age, non-Shandong residents, finding their partners offline, multiple sexual partners, condom break during sex, and hemorrhage sexual intercourse; HIV-related behavioral intervention should be strengthened.

Metaverse technology, which fully combines virtual reality, augmented reality, digital twins, blockchain, Internet of Things and other technologies, enjoys promising prospects and advantages in medical care. This article reviews the types of Metaverse key technologies and their application status in medical care, proposes to develop "Metaverse + nursing" in the future, and looks forward to it, in order to promote the integration of Metaverse and nursing theory and practice and lay the foundation for subsequent research.

Objective:To establish a scientific, sensitive and practical sensitive index system for nutritional screening and nursing quality evaluation of maintenance hemodialysis patients, so as to provide reference for objective evaluation of nutritional screening and nursing quality evaluation of MHD patients.Methods:Based on Donabedian three-dimensional quality structure theory of "structure-process-result", the first draft of the index system was constructed through literature review and semi-structured interview. From September to October 2022, a total of 20 clinical nursing and nursing management experts from the field of hemodialysis in 12 Class Ⅲ Grade A hospitals were selected for two rounds of expert letter consultation to revise and confirm the indicator system.Results:The positive coefficient of the two rounds of expert correspondence were 95.00% and 100.00%, the expert authority coefficient were 0.813 and 0.818, the Kendall's harmony coefficients were 0.121-0.257 (all P<0.05), and the coefficient of variation of each index was less than 0.30. After 2 rounds of expert letter consultation, the sensitive index system for nutritional screening and evaluation of nursing quality for maintenance hemodialysis patients was finally constructed, including 1 structural index, 7 process index and 2 outcome index. Conclusions:In this study, a sensitive index system of nutritional screening and evaluation of nursing quality for maintenance hemodialysis patients with 10 indicators is established, which was scientific, practical and specialized and could be used to standardize the nutritional screening and evaluation nursing work in blood purification centers and promote the continuous improvement of nursing quality.

Objective:To establish an index system for frailty risk assessment of maintenance hemodialysis patients, and scientifically evaluate frailty risk status of maintenance hemodialysis patients.Methods:With the biopsychosocial medical model as the theoretical framework, semi-structured interview method and Delphi expert consultation method were used to establish and screen indicators and analytic hierarchy process was used to determine the weight of indicators, and an indicator system for frailty risk assessment of patients with maintenance hemodialysis was constructed.Results:The effective recovery rates of the two rounds of expert consultation questionnaires were respectively 100.00% (22/22) and 95.45% (21/22), the expert authority coefficients were respectively 0.85 and 0.84, the Kendall's harmony coefficients of the importance of expert opinions were respectively 0.149 and 0.201, and the Kendall's harmony coefficients of the feasibility of expert opinions were respectively 0.134 and 0.175. Finally, the frailty risk evaluation system for maintenance hemodialysis patients was established, including 3 primary indexes, 8 secondary indexes and 36 tertiary indexes.Conclusions:The established frailty risk evaluation index system for patients with maintenance hemodialysis is scientific and practical and comprehensive in content, which can better reflect the specialty characteristics and provide a basis for frailty risk assessment for maintenance hemodialysis patients.

Objective:To explore the effect of comprehensive nursing based on empowerment theory in patients with chronic pulmonary heart disease complicated with heart failure.Methods:From April 2018 to April 2021, convenience sampling was used to select 87 patients with chronic obstructive pulmonary disease and heart failure in Liaocheng People's Hospital as the research object. The patients were divided into the observation group (43 cases) and the control group (44 cases) by random number table method. The control group received routine nursing, and the observation group received comprehensive nursing based on empowerment theory. Before the intervention and 8 weeks after the intervention, the knowledge of heart failure and cardiopulmonary function of the two groups were evaluated.Results:The improvement of cardiopulmonary function in the observation group was better than that in the control group, and the difference was statistically significant ( P<0.05) . Before nursing and 8 weeks after nursing, the total score and of each dimension scores of the Atlanta Heart Failure Knowledge Test-V2 (AHFKT-V2) in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Comprehensive nursing based on empowerment theory can improve heart failure knowledge and cardiopulmonary function in patients with chronic pulmonary heart disease complicated with heart failure.

Objective To investigate the occupational life status and occupational related stress factors of young hospital pharmacists, and to promote the healthy development of young pharmacists. Methods Questionnaire was designed and released on-line through Wenjuan Star APP. Demographic characteristic information, occupational stress and stress management data were obtained. Data were processed with SPSS. Results About sixty percent of 289 questionnaire respondents complained of occupational stress (178 respondents). Gender, education level, hospital grade, and job position had no significant effect on occupational stress difference. However, different age group showed different occupational stress. Pharmacist at the age of 31-35 complained more stress than the other age group. Pharmacist with high title complained more stress than the lower titles. Conclusion More than half of young pharmacists suffer from the high occupational stress, and various intervention measures should be taken to relieve the stress.

Objective:To investigate the characteristics of senile neurodegenerative diseases (NDDs) inpatients in south China, especially in Guangdong province, and explore the influencing factors for their medical expenses.Methods:The medical records of 7231 patients with NDDs≥65 years were collected in the electronic health database of our hospital from January 2010 to December 2019, including gender, age, admission ways, chief complaints, length of hospital stays and medical expenses. On the basis of median of the medical expenses (21 345 yuan) of these patients, they were divided into low cost (<21 345 yuan) group and high cost (≥21 345 yuan) group. Univariate Logistic analysis and multivariate Logistic regression analysis were conducted to screen the influencing factors for medical expenses and the independent influencing factors.Results:(1) The main age group of geriatric inpatients with NDDs were 70-79 years (40.96%); the admission source was mainly outpatient (56.70%), and length of hospital stays of a large percent of patients (44.50%) were 8-14 d. (2) From 2010 to 2019, the number of hospitalized geriatric patients with NDDs showed an increasing trend year by year, the overall trend of length of hospital stays was shortened, and the medical expenses showed gradual increase; the causes of hospitalization, percentages of patients caused by infection, abnormal blood pressure and water-electrolyte metabolism disturbances showed decreased trend, percentages of patients caused by heart diseases, cerebrovascular accidents and mental-psychological diseases showed increased trend, and the proportions of patients caused by fracture/trauma/wound injuries were generally stable. The proportion of patients returning home and mortality rate after hospital discharge were declined, and the proportion of patients returning to other medical or community institutions was increased. (3) Living in ICU, length of hospital stays, diabetes, nosocomial infection, chronic kidney disease, urinary tract infection, tumble, body mass index, and anticholinergic drugs were independent risk factors influencing the medical expenses ( P<0.05). Conclusions:An aging trend is noted in patients with NDDs; the number of hospitalized patients and medical expenses increase year by year, and the length of hospital stays gradually decreases. In view of the many factors that influence the medical expenses of this disease, it is suggested to develop the corresponding standardized treatment plan for the main influencing factors in clinical practice.