Objective To conduct a scoping review of studies on nurses' self-efficacy in disaster contexts,and to provide references for enhancing nurses' self-efficacy in disaster response.Methods Guided by the methodology of scoping review,we systematically searched PubMed,Web of Science,Cochrane Library,CINAHL,China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP Database,and China Biology Medicine disc(CBM)from inception to July 3,2025.Totally 2 researchers independently screened the search results,summarized them,and extracted relevant data.Results A total of 21 studies were included.Nurses' self-efficacy in disaster contexts was generally at a moderate level,influenced by multiple factors including sociodemographic characteristics,occupational background,and physical and mental health status.The main assessment tools were the General Self-Efficacy Scale and the Disaster Response Self-Efficacy Scale.Interventions included psychological first aid training,scenario simulation training,and immersive movie escape room training.Conclusion Nurses' self-efficacy in disaster contexts is generally at a moderate level with multiple influencing factors.Relevant assessment tools need further optimization,and interventions require further refinement.

Objective To conduct a scoping review of studies on nurses' self-efficacy in disaster contexts,and to provide references for enhancing nurses' self-efficacy in disaster response.Methods Guided by the methodology of scoping review,we systematically searched PubMed,Web of Science,Cochrane Library,CINAHL,China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP Database,and China Biology Medicine disc(CBM)from inception to July 3,2025.Totally 2 researchers independently screened the search results,summarized them,and extracted relevant data.Results A total of 21 studies were included.Nurses' self-efficacy in disaster contexts was generally at a moderate level,influenced by multiple factors including sociodemographic characteristics,occupational background,and physical and mental health status.The main assessment tools were the General Self-Efficacy Scale and the Disaster Response Self-Efficacy Scale.Interventions included psychological first aid training,scenario simulation training,and immersive movie escape room training.Conclusion Nurses' self-efficacy in disaster contexts is generally at a moderate level with multiple influencing factors.Relevant assessment tools need further optimization,and interventions require further refinement.

Objective To investigate the dietary patterns of rural residents in the high-incidence areas of esophageal cancer (EC), and to explore the clustering and influencing factors of risk factors associated with high-incidence characteristics. Methods A special structured questionnaire was applied to conduct a face-to-face survey on the dietary patterns of rural residents in Yanting county of Sichuan Province from July to August 2021. Univariate and multivariate logistic regression models were used to analyze the influencing factors of risk factor clustering for EC. Results There were 838 valid questionnaires in this study. A total of 90.8% of rural residents used clean water such as tap water. In the past one year, the people who ate fruits and vegetables, soybean products, onions and garlic in high frequency accounted for 69.5%, 32.8% and 74.5%, respectively; the people who ate kimchi, pickled vegetables, sauerkraut, barbecue, hot food and mildew food in low frequency accounted for 59.2%, 79.6%, 68.2%, 90.3%, 80.9% and 90.3%, respectively. The clustering of risk factors for EC was found in 73.3% of residents, and the aggregation of two risk factors was the most common mode (28.2%), among which tumor history and preserved food was the main clustering pattern (4.6%). The logistic regression model revealed that the gender, age, marital status and occupation were independent influencing factors for the risk factors clustering of EC (P<0.05). Conclusion A majority of rural residents in high-incidence areas of EC in Yanting county have good eating habits, but the clustering of some risk factors is still at a high level. Gender, age, marital status, and occupation are influencing factors of the risk factors clustering of EC.

Objective:To investigate the application value of enhanced recovery after surgery (ERAS) in perioperative period of laparoscopic sleeve gastrectomy (LSG).Method:The retrospective cohort study was conducted. The clinical data of 1 181 patients undergoing LSG in the Sir Run Run Shaw Hospital, Affiliated with the Zhejiang University School of Medicine from January 2021 to December 2023 were collected. There were 242 males and 939 females, aged (31±8)years. Of 1 181 patients, 598 cases receiving routine perioperative care were divided into the control group, and 583 cases receiving perioperative care with ERAS were divided into the ERAS group. Measurement data with normal distribution were represented as Mean± SD, and the independent sample t test was used for comparison between the groups. Measurement data with skewed distribution were represented as M( Q1, Q3), and the Mann-Whitney rank sum test was used for comparison between the groups. Count data were expressed as absolute numbers or percentages, and the chi-square test or Fisher exact probability were used for comparison between the groups. Repeated measurement data were analyzed using the repeated ANOVA, with baseline scores as covariates. Simple effects analysis was conducted in case of interaction, and multiple comparisons were adjusted using the Bonferroni method. Results:(1) Postoperative outcomes. The numerical rating scale (NRS) scores for pain at immediate return to the ward and on the third postoperative mornings changed from 5.35±0.93 to 2.57±0.83 in the control group, versus changed from 3.15±0.93 to 0.70±0.65 in the ERAS group, showing significant difference between the two groups ( Ftime=66.58, Fgroup=1 765.85, Finteraction=6.90, P<0.05). After adjusting NRS scores for pain at immediate return to the ward as the baseline, results of simple effects analysis showed that on the third postoperative mornings, the NRS scores in the ERAS group were lower by 1.89, 1.53, and 1.76 respectively compared to the control group ( P<0.05). Cases with nausea at immediate return to the ward and on the third postoperative mornings changed from 497 to 97 in the control group, versus changed from 198 to 11 in the ERAS group, showing signifi-cant difference between the two groups ( χ2=294.45, 398.76,209.39, 73.00, P<0.05). Cases with vomiting at immediate return to the ward and on the third postoperative mornings changed from 243 to 41 in the control group, versus changed from 51 to 2 in the ERAS group, showing significant difference between the two groups ( χ2=160.54, 149.37, 71.76, 35.69, P<0.05). The duration of postoperative hospital stay was (3.22±0.65)days in the control group, versus (2.17±0.49)days in the ERAS group, showing a significant difference between the two groups ( t=-11.89, P<0.05). (2) Complications. The incidence of cases with dehydration within postoperative 30 days was 0.50%(3/598) in the control group, versus 0.69%(4/583) in the ERAS group, showing no significant difference between the two groups ( P>0.05). None of patient in the control group and the ERAS group experienced bleeding, gastric leakage, intra-abdominal infection, and no patient had unplanned secondary surgery within postoperative 30 days. Conclusions:ERAS in perioperative period of LSG are safe and feasible. Compared to routine care, ERAS can significantly reduce postoperative pain, decrease the incidence of postoperative nausea and vomiting, shorten the postoperative hospital stay, and do not increase the rate of postoperative complications or unplanned secondary surgeries within postoperative 30 days.

Objective:To describe and analyze the self-care contributions of caregivers of chronic patients and provide guidance for future research on caregivers' contributions.Methods:Using the scoping review method, the computer search was conducted on PubMed, Web of Science, CINAHL, Embase, Cochrane Library, Medline, China National Knowledge Infrastructure, China Biology Medicine disc, VIP and Wanfang database. The search period was from the establishment of the databases to June 10, 2023, and the included literature was summarized and analyzed.Results:A total of 40 articles were included, of which 6 observational studies reported the significance of caregivers' self-care contributions to patients with chronic diseases. 17 articles reported measuring tools for caregivers' self-care contributions, 11 studies involved the influencing factors of caregivers' self-care contribution and 6 articles reported the intervention methods related to caregiver self-care contribution.Conclusions:Caregivers are of great significance to the health promotion behavior of patients with chronic diseases. Medical staff should accurately evaluate the self-care contributions of caregivers for chronic disease patients, implement personalized intervention measures to improve their quality of life and clinical outcomes.

Objective:To explore the real experiences of patients during the preoperative decision-making process for metabolic-bariatric surgery, providing a reference for developing targeted decision-support interventions.Methods:This descriptive phenomenological study used purposive sampling to select 21 patients who underwent metabolic-bariatric surgery at Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine, from September 2022 to February 2023. Interviews were conducted, and the data were analyzed using Colaizzi's seven-step method.Results:Four themes and 14 sub-themes were extracted: decision-making motivation (health threats, pursuit of higher quality of life, diminished self-esteem, family responsibility drive) ; pre-decision assessment (failure of other weight-loss methods, surgery as a last resort) ; decision-making dilemmas (low quality of accessible information, low social acceptance of surgery, lack of medical insurance coverage, concerns about surgical outcomes) ; and decision-making support (professional medical support, family support, peer support, self-support) .Conclusions:Patients considering metabolic-bariatric surgery have diverse decision-making motivations and face significant dilemmas. It is recommended that relevant authorities, healthcare providers, and family members work together to create a comprehensive decision-supportive environment from the patients' perspective.

Objective:To explore the real experiences of patients during the preoperative decision-making process for metabolic-bariatric surgery, providing a reference for developing targeted decision-support interventions.Methods:This descriptive phenomenological study used purposive sampling to select 21 patients who underwent metabolic-bariatric surgery at Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine, from September 2022 to February 2023. Interviews were conducted, and the data were analyzed using Colaizzi's seven-step method.Results:Four themes and 14 sub-themes were extracted: decision-making motivation (health threats, pursuit of higher quality of life, diminished self-esteem, family responsibility drive) ; pre-decision assessment (failure of other weight-loss methods, surgery as a last resort) ; decision-making dilemmas (low quality of accessible information, low social acceptance of surgery, lack of medical insurance coverage, concerns about surgical outcomes) ; and decision-making support (professional medical support, family support, peer support, self-support) .Conclusions:Patients considering metabolic-bariatric surgery have diverse decision-making motivations and face significant dilemmas. It is recommended that relevant authorities, healthcare providers, and family members work together to create a comprehensive decision-supportive environment from the patients' perspective.

Objective To investigate the relationship between serum levels of microRNA-130a(miR-130a),angiotensin Ⅱ(AngⅡ)and the degree of coronary artery lesions in patients with acute coronary syn-drome(ACS).Methods A total of 160 ACS patients admitted to the hospital from January 2021 to February 2023 were selected as the ACS group.According to total Gensini score,ACS patients were divided into mild group(57 cases),moderate group(54 cases)and severe group(49 cases).At the same time,160 healthy peo-ple were selected as the control group.The clinical data of all subjects were collected.The serum levels of miR-130a and AngⅡ were detected by real-time fluorescence quantitative PCR and enzyme-linked immunosor-bent assay,respectively.The clinical data and serum levels of miR-130a and AngⅡ were compared between control group and ACS group.The serum levels of miR-130a and AngⅡ were compared between ACS patients with different degrees of disease.Pearson correlation analysis was used to analyze the correlation between ser-um miR-130a level and AngⅡ in ACS patients.Multivariate Logistic regression was used to analyze the risk factors of ACS.Receiver operating characteristic curve was used to analyze the diagnostic value of serum miR-130a and AngⅡ levels for moderate and severe ACS.Results Compared with the control group,the ACS group had significantly higher proportions of patients with a history of hypertension and diabetes and signifi-cantly higher serum levels of miR-130a and AngⅡ(P<0.05).The serum levels of miR-130a and AngⅡ were increased sequentially in the mild group,moderate group and severe group(P<0.05).Serum miR-130a level was positively correlated with AngⅡ level in ACS patients(P<0.05).Hypertension,diabetes history and ele-vated serum levels of miR-130a and AngⅡ were independent risk factors for ACS(P<0.05).The area under the curve(AUC)of serum miR-130a,AngⅡ and their combination in the diagnosis of moderate ACS were 0.728,0.823 and 0.885,respectively,and the AUC of the combination of miR-130a and AngⅡ was higher than that of miR-130a,AngⅡ(P<0.05).The AUC of serum miR-130a,AngⅡ and their combination in the diagnosis of severe ACS were 0.731,0.730 and 0.825,respectively.The AUC of the combination of miR-130a and AngⅡ was higher than that of miR-130a and AngⅡ(P<0.05).Conclusion ACS patients serum miR-130-a,AngⅡ level is higher,and the serum miR-130a,AngⅡ levels are associated with the ACS degree of cor-onary artery lesions,the combination of the both degree of coronary artery lesions with high diagnostic value.

Total glucosides of Rhizoma Smilacis Glabrae (RSG) are selective immunosuppressants that exhibit primary efficacy in the treatment of rheumatoid arthritis through targeted inhibition of activated T cells. In this study, we aimed to investigate the potential application of RSG in the treatment of psoriasis and elucidate its mechanism of action and material basis. Our findings revealed significant improvements upon administration of RSG in an imiquimod (IMQ)-induced psoriasis model. These improvements were characterized by a remarkable increase in the number of tail scales in mice and a substantial amelioration of skin erythema, ulceration, and flaking. By transcriptome sequencing and T-cell flow sorting assay, we identified notable effects of RSG on the modulation of various cellular processes. Specifically, RSG prominently down-regulated the Th17/Treg ratio in damaged skin tissues and reduced the proportion of G₂ phase cells. Furthermore, RSG exhibited a stimulatory effect on the proliferation and differentiation of epithelial cells. Of particular interest, we discovered that β-sitosterol, sitostenone, stigmasterol, smiglanin, and cinchonain Ib displayed potent inhibitory effects on the IL-17-mediated inflammatory response in HaCaT cells. In summary, our study highlights the therapeutic potential of RSG in the treatment of psoriasis, attributed to its ability to regulate the Th17/Treg balance. These findings contribute to the development of new indications for RSG and provide a solid theoretical foundation for further exploration in this field.
Animals ; Mice ; T-Lymphocytes, Regulatory ; Psoriasis/drug therapy* ; Arthritis, Rheumatoid ; Biological Assay ; Glucosides/pharmacology*

Objective To investigate the possible mechanism of circ RNA in the pathogenesis of epilepsy.Methods In this study,circRNA expression profiles in peripheral venous blood of epileptic patients and healthy controls were studied by using circRNA gene chip technology,and differentially expressed circrnas were screened.Bioinfor-matics databases such as circPrimer,circMir and TargetScan were used to analyze its possible role in epilepsy and adenovirus vector was constructed.Thirty male adult C57BL/6 mice were randomly divided into control group,empty vector group and circ_0017178 overexpressed group(10 mice/group).Normal saline,empty plasmid ade-novirus vector and circ_0017178 overexpressed adenovirus vector were injected into the hippocampus of the three groups respectively.The change of animal behavior of mice in each group was observed after the establishment of pentetrazole epilepsy model,and the apoptosis of hippocampal tissue cells of mice in each group was analyzed by Tunel staining.Results The results of gene microarray showed that circ_0069272,circ_0033065,circ_0017178,circ_0073442,circ_0033063 and circ_0049415 in epilepsy group were up-regulated significantly compared with the control group.And circ_0083773,circ_0088262,circ_0016396 decreased significantly.Circ_0017178 might be the most associated with epilepsy.Through bioanalysis,circ_0017178 might regulate 39 epilepsy genes by combi-ning 20 miRNA and possess potential m6A,IRES and ORF1 binding sites.In the experiment of pentatetrazole epi-leptic mice,compared with the empty carrier group and the control group,the latency period of epilepsy in the circ_0017178 overexpression group was shortened(P＜0.05),the seizure time was prolonged(P＜0.05),and the seizure frequency increased(P＜0.05).There was no statistical significance between the empty carrier group and the control group(P＞0.05).In animal experiments,compared with the empty vector group and the control group,the apoptosis degree of hippocampal tissue of epileptic mice in the circ_0017178 overexpression group sig-nificantly increased(P＜0.05),but there was no statistical significance between the empty vector group and the control group(P＞0.05).Conclusion Circ_0017178 significantly increases in the expression profile of peripher-al blood mononuclear cells in patients with epilepsy,which may act as a"molecular sponge"of miRNA in epilepsy and has the potential of m6A methylation and protein translation.Circ_0017178 may increase the susceptibility and severity of epilepsy by promoting apoptosis in penetetrazole epileptic mice.