Objective To establish an expert consensus on the management of low anterior resection syndrome(LARS)in patients with rectal cancer post-surgery(hereinafter referred to as"consensus"),aiming to standardize the related work of medical institutions in the context of post-operative LARS.Methods A comprehensive search of domestic and international databases was conducted to collect guidelines,expert consensuses,systematic reviews,evidence summaries,and original research related to post-operative LARS in rectal cancer published from the establishment of the databases until August 2024.Based on clinical practice experience,a preliminary draft of the"consensus"was formed.From September to November 2024,22 experts were invited to participate in 2 rounds of expert consultations,during which the draft content was revised and improved,and the final version of the"consensus"was determined through expert validation.Results A total of 22 experts responded,achieving a response rate of 100％.The effective recovery rate of the consultation questionnaires in both rounds was 100％,with an expert authority coefficient of 0.89,a judgment coefficient of 0.97,and a familiarity degree of 0.84.The Kendall harmony coefficients for the 2 rounds of expert consultations were 0.122 and 0.136,respectively(P＜0.001).This consensus covers 5 main aspects:definition,assessment,prevention,treatment,and follow-up management of LARS.Conclusion This consensus demonstrates a high level of scientific rigor and can provide a strong reference for clinical nursing personnel in the specialized care of rectal cancer patients with post-operative LARS.

Objective To investigate differential patterns of oxygenated hemoglobin concentration in prefron-tal cortical regions between major depressive disorder patients with or without psychotic symptoms during verbal flu-ency task(VFT)performance using functional near-infrared spectroscopy(fNIRS).Methods A total of 108 pa-tients with major depression who were hospitalized in the psychiatric department of the hospital from July 2023 to April 2024 were selected as the study objects.They were divided into two groups(n=60)with or without psychotic symptoms(n=48).fNIRS devices were used to measure and compare the changes in the relative concentration of cerebral hemoglobin in 52 brain channels between the two groups during VFT.Re-sults Compared with the unaccompanied group,the relative concentration of cerebral oxygenated hemoglobin in channel 13 was higher(0.003±0.001 vs.0.002±0.001),and the relative concentration of cerebral oxygen-ated hemoglobin in channel 33 was lower(0.003±0.001 vs.0.007±0.002),the difference was statistically significant(P＜0.05).There was no significant difference in the relative concentration of oxygenated hemo-globin in other brain areas between the two groups(P＞0.05).Conclusion There are abnormal oxygen activ-ity in brain functional areas associated with psychotic symptoms,and fNIRS technique is helpful for early as-sessment of cerebral aerobic function in depressed patients with psychotic symptoms.

Objective Utilizing patient journey mapping to decipher disease management behaviors,barriers,and needs in young and middle-aged liver transplant recipients,providing implications for self-management optimization and quality of life improvement.Methods Using purposive sampling,12 young and middle-aged liver transplant patients who attended outpatient clinics or were hospitalized in liver transplant center of a tertiary hospital in Qingdao were selected for semi-structured interviews from September to November 2024.Thematic extraction and analysis were performed using Colaizzi's 7-step analysis,ultimately resulting in the development of a patient journey map.Results The journey stages were divided into transplantation decision-making period,transplantation waiting period,perioperative period,and post-discharge management period,and the journey key elements were designed as behaviors,barriers,and needs.A total of 25 themes were extracted,including behaviors(such as referrals to higher-level hospitals,verification of treatment options),barriers(such as lack of decision-making autonomy,health information-seeking barriers),and needs(such as shared decision-making,financial assistance).Ultimately,resulting in a map of the disease management journey for young and middle-aged liver transplant recipients.Conclusion The behaviors,barriers,and needs in disease management among young and middle-aged liver transplant recipients demonstrate distinct phase-specific patterns.Healthcare providers should deliver precise and dynamic interventions tailored to each clinical phase,aiming to foster optimal self-management behaviors,address phase-specific banriers,and meet evolving patient needs throughout the transplant continuum.

Objective:To study the application of Internet+ follow-up model based on nutrition support team (NST) cooperation in enteral nutrition therapy for patients with inflammatory bowel disease (IBD).Methods:From November 2021 to April 2023, 98 IBD patients admitted to the First Affiliated Hospital of Anhui Medical University were prospectively enrolled and were divided into the observation and control groups (49 cases in each group) using a random number table. The observation group received the intervention of Internet+ follow-up based on NST cooperation and the control group was given routine telephone follow-up. The nutritional indicators, IBD quality of life score, and patient satisfaction with care were compared between the two groups before and 3 months after the intervention.Results:After intervention, the serum albumin, hemoglobin, and pre-albumin levels in the observation group were significantly higher than those in the control group (all P<0.05). After intervention, the IBD quality of life scores of patients in the observation group were significantly higher than those in the control group, in the domains including daily activities, bowel function, social function, and emotional ability (all P<0.05). The patient satisfaction with care in the observation group was 93.62% (44/47), which was significantly higher than that (76.60%, 36/47) in the control group ( P<0.05). Conclusion:The Internet+ follow-up model based on NST cooperation favors the enteral nutrition therapy for patients with IBD as it improves the nutritional status, quality of life, and patient satisfaction with care.

Objective:To learn about the distribution characteristics of marmot in Qinghai-Tibet Plateau Himalayan marmot plague foci, and to study the spatial-temporal patterns and variation characteristics of Himalayan marmot density in the Yarlung Zangbo River, Lhasa River and Nyangqu River Region. Methods:The density survey data of Himalayan marmot from 2001 to 2019 in the Qinghai-Tibet Plateau were collected from the Tibet Autonomous Region Center for Disease Control and Prevention, and the habitat characteristic data of Himalayan marmot were collected from the database of the Resource and Environmental Science Data Platform of Chinese Academy of Sciences and other relevant institutions. Based on the density survey data of Himalayan marmot and its habitat characteristics, five regression models were constructed. The best regression model was selected by comparing the accuracy indicators [root-mean-square error ( RMSE), coefficient of determination ( R 2), mean absolute error ( MAE), and mean bias error ( MBE)]. The habitat characteristics of Himalayan marmot at the basin scale from 2001 to 2019 were included in the best regression model to analyze the spatial-temporal pattern of the density of Himalayan marmot, and the hotspot analysis was used to analyze the aggregation pattern of the density of Himalayan marmot. Results:In the constructed regression models, the random forest regression model had high accuracy, with RMSE of 0.05, R 2 of 0.65, MAE of 0.02, and MBE of 0.01. Among the characteristics of various habitats, the contribution of average temperature was the highest, at 0.85. The prediction results of the random forest regression model showed that the density distribution of Himalayan marmot at the basin scale was basically similar in different years, and the overall spatial distribution characteristics were "high in the north, low in the south" and "high in the east and west, low in the middle". The northwest of Xietongmen County, the northeast of Maizhokunggar County, and the north of Namling County were hotspot area. Conclusions:The distribution of Himalayan marmot in the Yarlung Zangbo River, Lhasa River and Nyangqu River Region has obvious spatial aggregation, and the high-density aggregation areas of Himalayan marmot in different years are basically similar. It is necessary to continue to monitor the density of Himalayan marmot and strengthen the prevention and control of plague.

Objective:To explore the clinical characteristics and the treatment strategies of surgery and post-operative chemotherapy of ovarian Sertoli-Leydig cell tumors.Methods:A total of 18 patients who underwent sur-gical treatment in Department of Gynecology,Peking University Third Hospital from January 2003 to June 2022 and were pathologically diagnosed with ovarian Sertoli-Leydig cell tumors were selected as the research subjects.The clinical manifestations,auxiliary examinations,surgical and pathological diagnoses,adjuvant treatments and fol-low-up of the included patients were retrospectively analyzed.Results:The age of onset ranged from 19 to 59 years old,with a median age of 24 years old.Among them,12 cases(66.7％)were under40 years old.11 cases(61.1％)showed abnormal symptoms of sex hormones,such as hyperandrogenism and menstrual disorders,and 6 cases(33.3％)sought medical attention for acute abdomen.Preoperative ultrasound indicated a single non-sim-ple mass in the pelvic cavity in 17 cases,during the operation,all tumors were found to originate from one ovary,and all patients under the age of 40(12 cases)underwent adnexectomy on the affected side to preserve fertility.The accuracy of intraoperative frozen pathology was 31.3％(5/16).Among the 18 patients,11 cases were in stage ⅠA and 7 in stage ⅠC,1 case was of well-differentiated type,10 cases of moderate differentiation and 7 ca-ses of poorly differentiated type,3 cases had heterogeneous components.12 cases received adjuvant chemother-apy after surgery.After initial treatment,follow-up was conducted for 4 to 230 months,with a median time of 70.5 months.One case of high-grade sarcoma with heterologous components experienced multiple recurrences,the others had no recurrence.Conclusions:Most cases of ovarian Sertoli-Leydig cell tumors are diagnosed as stageⅠ.For young patients,adnexectomy on the affected side can be performed to preserve fertility and have a good prognosis.But if the tumor contains heterologous components as high-grade sarcoma,it indicates a poor prognosis.

Objective:To study the application of Internet+ follow-up model based on nutrition support team (NST) cooperation in enteral nutrition therapy for patients with inflammatory bowel disease (IBD).Methods:From November 2021 to April 2023, 98 IBD patients admitted to the First Affiliated Hospital of Anhui Medical University were prospectively enrolled and were divided into the observation and control groups (49 cases in each group) using a random number table. The observation group received the intervention of Internet+ follow-up based on NST cooperation and the control group was given routine telephone follow-up. The nutritional indicators, IBD quality of life score, and patient satisfaction with care were compared between the two groups before and 3 months after the intervention.Results:After intervention, the serum albumin, hemoglobin, and pre-albumin levels in the observation group were significantly higher than those in the control group (all P<0.05). After intervention, the IBD quality of life scores of patients in the observation group were significantly higher than those in the control group, in the domains including daily activities, bowel function, social function, and emotional ability (all P<0.05). The patient satisfaction with care in the observation group was 93.62% (44/47), which was significantly higher than that (76.60%, 36/47) in the control group ( P<0.05). Conclusion:The Internet+ follow-up model based on NST cooperation favors the enteral nutrition therapy for patients with IBD as it improves the nutritional status, quality of life, and patient satisfaction with care.

Objective:To explore the clinical characteristics and the treatment strategies of surgery and post-operative chemotherapy of ovarian Sertoli-Leydig cell tumors.Methods:A total of 18 patients who underwent sur-gical treatment in Department of Gynecology,Peking University Third Hospital from January 2003 to June 2022 and were pathologically diagnosed with ovarian Sertoli-Leydig cell tumors were selected as the research subjects.The clinical manifestations,auxiliary examinations,surgical and pathological diagnoses,adjuvant treatments and fol-low-up of the included patients were retrospectively analyzed.Results:The age of onset ranged from 19 to 59 years old,with a median age of 24 years old.Among them,12 cases(66.7％)were under40 years old.11 cases(61.1％)showed abnormal symptoms of sex hormones,such as hyperandrogenism and menstrual disorders,and 6 cases(33.3％)sought medical attention for acute abdomen.Preoperative ultrasound indicated a single non-sim-ple mass in the pelvic cavity in 17 cases,during the operation,all tumors were found to originate from one ovary,and all patients under the age of 40(12 cases)underwent adnexectomy on the affected side to preserve fertility.The accuracy of intraoperative frozen pathology was 31.3％(5/16).Among the 18 patients,11 cases were in stage ⅠA and 7 in stage ⅠC,1 case was of well-differentiated type,10 cases of moderate differentiation and 7 ca-ses of poorly differentiated type,3 cases had heterogeneous components.12 cases received adjuvant chemother-apy after surgery.After initial treatment,follow-up was conducted for 4 to 230 months,with a median time of 70.5 months.One case of high-grade sarcoma with heterologous components experienced multiple recurrences,the others had no recurrence.Conclusions:Most cases of ovarian Sertoli-Leydig cell tumors are diagnosed as stageⅠ.For young patients,adnexectomy on the affected side can be performed to preserve fertility and have a good prognosis.But if the tumor contains heterologous components as high-grade sarcoma,it indicates a poor prognosis.

Objective To construct a perioperative blood pressure management plan for patients undergoing carotid artery stenting(CAS)and evaluate its application effectiveness,and to provide references for clinical practice.Methods The relevant literature on perioperative blood pressure management for CAS patients was retrieved from domestic and foreign databases,and a preliminary draft of a perioperative blood pressure management plan for CAS patients was constructed.The preliminary draft was discussed and modified through expert meetings,and 2 rounds of expert inquiries were conducted using the Delphi method from June 2023 to August 2023 to determine the final plan.32 patients who received CAS in the neurology department of a tertiary comprehensive hospital in Zhejiang Province were selected from May to July 2024 as an experimental group,and 33 patients who received CAS in the same ward from January to March 2024 as a control group.The experimental group applied the constructed CAS patient perioperative blood pressure management plan,while the control group applied routine perioperative nursing measures.The incidence of postoperative hypertension,postoperative hypotension,and postoperative adverse events was compared between 2 groups.Results A total of 13 experts completed 2 rounds of inquiries.The effective questionnaire response rate for the second round of inquiry was 100％,with an authority coefficient of 0.897.The coefficients of variation for the importance and feasibility scores of each item were 0～0.19 and 0～0.18,respectively,and the Kendall harmony coefficients were 0.224 and 0.201,respectively(P＜0.05).The final construction plan includes 3 primary indicators,15 secondary indicators,and 40 tertiary indicators.Ultimately,32 cases were included in the experimental group and 33 cases in the control group.The incidence of postoperative hypertension,postoperative hypotension,and adverse events in the experimental group was lower than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion The perioperative blood pressure management plan for CAS patients constructed in this study has good scientificity and practicality,which can improve the stability of patients'perioperative blood pressure and reduce the occurrence of adverse events.

Objective To construct a perioperative blood pressure management plan for patients undergoing carotid artery stenting(CAS)and evaluate its application effectiveness,and to provide references for clinical practice.Methods The relevant literature on perioperative blood pressure management for CAS patients was retrieved from domestic and foreign databases,and a preliminary draft of a perioperative blood pressure management plan for CAS patients was constructed.The preliminary draft was discussed and modified through expert meetings,and 2 rounds of expert inquiries were conducted using the Delphi method from June 2023 to August 2023 to determine the final plan.32 patients who received CAS in the neurology department of a tertiary comprehensive hospital in Zhejiang Province were selected from May to July 2024 as an experimental group,and 33 patients who received CAS in the same ward from January to March 2024 as a control group.The experimental group applied the constructed CAS patient perioperative blood pressure management plan,while the control group applied routine perioperative nursing measures.The incidence of postoperative hypertension,postoperative hypotension,and postoperative adverse events was compared between 2 groups.Results A total of 13 experts completed 2 rounds of inquiries.The effective questionnaire response rate for the second round of inquiry was 100％,with an authority coefficient of 0.897.The coefficients of variation for the importance and feasibility scores of each item were 0～0.19 and 0～0.18,respectively,and the Kendall harmony coefficients were 0.224 and 0.201,respectively(P＜0.05).The final construction plan includes 3 primary indicators,15 secondary indicators,and 40 tertiary indicators.Ultimately,32 cases were included in the experimental group and 33 cases in the control group.The incidence of postoperative hypertension,postoperative hypotension,and adverse events in the experimental group was lower than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion The perioperative blood pressure management plan for CAS patients constructed in this study has good scientificity and practicality,which can improve the stability of patients'perioperative blood pressure and reduce the occurrence of adverse events.