ObjectiveTo introduce visual teaching into the course design of medical humanistic care based on the concept of implementation science， evaluate the teaching implementation effect and feedback， and provide references for optimizing course teaching outcomes and improving students’ humanistic care competence. MethodsA visual teaching program for medical humanistic care was designed， with key steps including clarifying teaching objectives， content， methods， and curriculum assessment. This program was implemented in the medical humanistic care course teaching involving 50 elective students. Multi-dimensional evaluation of teaching effectiveness was conducted through course grades， visual teaching evaluation， and humanistic workshop assessment， combined with inductive content analysis of students’ learning experiences in the workshops. ResultsThe 50 students achieved above-average course grades （89.60±3.41） and demonstrated high satisfaction with the overall course and visual teaching. All the 6 groups obtained relatively high scores in the medical humanistic care workshops. Four themes were extracted， namely， enhancing humanistic care competencies， deepening familial and interpersonal relationships， realizing emotional expression and self-growth， and strengthening integration of humanistic care concepts with practice. ConclusionThe teaching of medical humanistic care course has achieved favorable effects， which contributes to deepening students’ understanding of humanistic care and enhancing their humanistic care competence. Students demonstrate high levels of recognition and satisfaction with the course.

ObjectiveTo explore the driving forces for oncology nurses’ participation in palliative care work， thereby providing a theoretical basis for the improvement of education and training， incentive mechanisms， and other aspects of the palliative care nursing staff. MethodsEmploying a qualitative research method， semi-structured interviews lasting 40-60 minutes were conducted with 14 nurses who had participated in palliative care work. The interview data were analyzed using the Colaizzi seven-step analysis method. ResultsInternal positive driving forces were job interest， empathy， and a sense of professional responsibility， while the negative was low psychological resilience. External positive driving forces included high work support， professional identity， mutual benefits for nurses and patients， and positive patient attitudes， whereas negative driving forces comprised busy routine clinical work， lack of a reward and incentive system， and bland or negative patient attitudes. ConclusionIt is essential to provide a flexible platform for the enhancement of nurses’ professional capabilities in palliative care， intensify the publicity of palliative care and death education； intervene and guide nurses’ negative emotions， improve and implement relevant incentive systems， and standardize the job recognition and scope of responsibilities of palliative care nurses.

Objective:To explore the influencing factors of brain injury in children with neonatal asphyxia after resuscitation.Methods:The clinical data of 180 children with neonatal asphyxia from January 2017 to January 2024 in Shijiazhuang Maternal and Child Health Hospital were retrospectively analyzed, and all children were received resuscitation treatment. The children were divided into modeling group (126 cases) and validation group (54 cases) in a 7∶3 ratio. Among the children in modeling group, 51 children combined brain injury (brain injury subgroup), and 75 children did not combine brain injury (non-brain injury subgroup). The general data were recorded, and the continuous variables were determined by the receiver operating characteristic (ROC) curve to determine the optimal cut-off value. Multivariate Logistic regression analysis was used to analyze the independent risk factors of brain injury in children with neonatal asphyxia after resuscitation. The R language software "rms" package was used to construct a nomogram model for predicting brain injury in children with neonatal asphyxia after resuscitation. The nomogram model was internally verified by the calibration curve, and the prediction efficiency of the nomogram model was evaluated by the decision curve and ROC curve.Results:There was no statistical difference in general data between modeling group and validation group ( P>0.05). The gestation age<37 weeks proportion, severe asphyxia proportion, Ⅱ to Ⅲ grade amniotic fluid contamination proportion, intrauterine distress proportion and blood lactate in brain injury subgroup were significantly higher than those in non-brain injury subgroup: 60.78% (31/51) vs. 38.67% (29/75), 37.25% (19/51) vs. 17.33% (13/75), 27.45% (14/51) vs. 10.67% (8/75), 47.06% (24/51) vs. 26.67% (20/75) and (2.64 ± 0.61) mmol/L vs. (2.21 ± 0.56) mmol/L, and there were statistical differences ( P<0.05 or <0.01); there were no statistical differences in gender composition, birth weight, maternal age, maternal history of adverse pregnancy and childbirth, mode of delivery, parity, abnormal amniotic fluid volume, abnormal fetal position, abnormal umbilical cord, abnormal placenta, systolic blood pressure, diastolic blood pressure, body temperature and blood glucose between the two groups ( P>0.05). ROC curve analysis result showed that the optimal cutoff value of blood lactate was 2.59 mmol/L. Multivariate Logistic regression analysis result showed that the young gestation age, severe asphyxia, Ⅱ to Ⅲ grade amniotic fluid contamination, intrauterine distress and high blood lactate were independent risk factors of brain injury in children with neonatal asphyxia after resuscitation ( OR = 2.854, 3.428, 3.405, 3.427 and 7.844; 95% CI 1.166 to 6.983, 1.263 to 9.305, 1.076 to 10.768, 1.358 to 8.645 and 3.080 to 19.978; P<0.05 or <0.01). The gestation age, degree of asphyxia, amniotic fluid contamination, intrauterine distress and blood lactate were used as predictors to construct a nomogram model for predicting brain injury in children with neonatal asphyxia after resuscitation. The calibration curve analysis result showed that the calibration curve of the nomogram model for predicting brain injury in children with neonatal asphyxia after resuscitation tended towards the ideal curve ( C- index = 0.824, 95% CI 0.745 to 0.903). The decision curve analysis result showed that, when the risk threshold was greater than 0.18, the clinical net benefits provided by the nomogram model were higher than those of a single independent risk factor, and it could provide significant additional clinical net benefits in predicting the high risk of brain injury in children with neonatal asphyxia after resuscitation. ROC curve of internal validation analysis result that the curve (AUC) of the nomogram model for predicting brain injury in children with neonatal asphyxia after resuscitation was 0.824 (95% CI 0.744 to 0.903). ROC curve of external validation result showed that the AUC of the nomogram model for predicting brain injury in children with neonatal asphyxia after resuscitation was 0.838 (95% CI 0.714 to 0.962). Conclusions:The gestation age, degree of asphyxia, amniotic fluid contamination, intrauterine distress and blood lactate are independent risk factors for brain injury in children with neonatal asphyxia after resuscitation. The nomogram model constructed based on these factors has a high clinical benefit in predicting brain injury in children with neonatal asphyxia after resuscitation.

Objective To investigate the predictive value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)radiomics combined with Magee equation 3(ME3)for pathological response following neoadjuvant chemotherapy(NAC)in patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative(HR+/HER2-)breast cancer.Methods A ret-rospective analysis was performed on 325 breast cancer patients diagnosed with HR+/HER2-in two hospitals.Patients from the first hospital were randomly divided into training and internal validation sets at a ratio of 7∶3.Patients from the second hospital served as external validation set.The volume of interest(VOI)of breast cancer was delineated on DCE-MRI images.Then the rele-vant radiomics features were extracted and selected,and the Radiomics score(Radscore)was calculated.The statistically significant clinical and pathological features and Radscore were incorporated into a multivariate analysis.The combined radiomics-clinical model and nomogram were established,and the prediction performance was evaluated by using the receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis(DCA).Results In the training set,seven radiomics features were selected to construct the radiomics model.ME3 score emerged as the independent factor for pathological complete response(pCR)(P＜0.001).By integrating ME3 score and Radscore,a combined radiomics-clinical model was developed.This model demonstrated robust predictive accuracy,with area under the curve(AUC)of 0.88[95％confidence interval(CI)0.80-0.95],0.90(95％CI 0.82-0.98),and 0.82(95％CI 0.70-0.93)in the training,internal validation,and external validation sets,respectively.The nomogram construc-ted from the combined model exhibited excellent discrimination and calibration,with P-values of 0.455,0.312 and 0.062 in the train-ing,internal validation,and external validation sets.Conclusion DCE-MRI radiomics combined with ME3 can be used to predict the pathological response of NAC in HR+/HER2-breast cancer.

OBJECTIVE To analyze the distribution of pathogens isolated from the recurrent spontaneous abortion patients complicated with genital tract infection,observe the changes of peripheral blood microribonucleic acid-155(miR-155),helper T cell 17(Th17)/regulatory T cell(Treg)cytokines and analyze the clinical significance.METHODS A total of 102 recurrent spontaneous abortion patients who were complicated with genital tract infec-tion and were treated in Xinxiang Central Hospital from Jan.2022 to Oct.2023 were assigned as the infection group,meanwhile,80 recurrent spontaneous abortion patients who were not complicated with genital tract infec-tion were chosen as the no infection group.The distribution of the pathogens isolated from the patients of the in-fection group was observed.The expression levels of peripheral blood miR-155,Th17/Treg and their cytokines[interleukin(IL)-10,IL-17]were compared between the two groups.The values of the peripheral blood miR-155,Th17/Treg,IL-10 and IL-17 in prediction of genital tract infection in the recurrent spontaneous abortion patients were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS Totally 121 strains of patho-gens were isolated from the 102 recurrent spontaneous abortion patients complicated with genital tract infection,68(56.20％)of which were gram-negative bacteria,45(37.19％)were gram-positive bacteria,and 8(6.61％)were fungi.Escherichia coli was the predominant species of gram-negative bacteria;Staphylococcus aureus was dominant among the gram-positive bacteria;Candida albicans was the predominant species of fungi.There were significant differences in the levels of peripheral blood miR-155,Th17/Treg and cytokines between the infection group and the no infection group(P＜0.05).ROC curve analysis showed that the areas under the curves(AUCs)of peripheral blood miR-155,Th17/Treg,IL-10,IL-17 and the joint detection of the above indexes were 0.891,0.909,0.877,0.869 and 0.994,respectively;the joint detection was superior to the single detection(P＜0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the recurrent sponta-neous abortion patients complicated with genital tract infection.The miR-155,Th17/Treg and their cytokines have certain values in prediction of the genital tract infection in the patients with recurrent spontaneous abortion.

Objective To rapidly evaluate the efficacy,safety,and cost-effectiveness of venetoclax(Ven)in non-M3 acute myeloid leukemia(AML),and to provide an evidence-based basis for rational clinical treatment.Methods PubMed,Cochrane Library,Embase,CNKI,WanFang Data databases,and relevant health technology assessment(HTA)websites were searched to collect relevant literature and reports on Ven treatment for non-M3 AML,with a search timeframe from the establishment of the database/website to November 1st,2024.Two researchers independently screened literature,extracted data,and assessed quality,and then qualitatively described and analyzed the results.Results A total of 11 pieces of literature were included,including 5 systematic reviews/Meta-analysis,4 pharmacoeconomic studies,and 2 HTA reports.In terms of efficacy,compared with the control group,non-M3 AML patients receiving Ven treatment had a higher clinical remission rate(P<0.05),a longer event-free survival(EFS)(P<0.05)and a similar or longer overall survival(OS)(P<0.05).Regarding safety,compared to Azacitidine(Aza)monotherapy,Ven+Aza resulted in a higher likelihood of febrile neutropenia in non-M3 AML patients(P<0.05).Non-M3 AML patients receiving Ven+low-dose cytarabine(LDAC)had a higher risk of developing thrombocytopenia compared with LDAC monotherapy(P<0.05).However,the early 30-day mortality rate was lower in the Ven+chemotherapy group than that in the chemotherapy alone group(P<0.05),presenting an acceptable security profile overall.In terms of cost-effectiveness,Ven was cost-effective in non-M3 AML patients compared with the control group.Conclusion Ven has manifested remarkable efficacy and acceptable security profile among patients with non-M3 AML,thus proving to be a medium to long-term cost-effective treatment modality.

Objective To rapidly evaluate the efficacy,safety,and cost-effectiveness of venetoclax(Ven)in non-M3 acute myeloid leukemia(AML),and to provide an evidence-based basis for rational clinical treatment.Methods PubMed,Cochrane Library,Embase,CNKI,WanFang Data databases,and relevant health technology assessment(HTA)websites were searched to collect relevant literature and reports on Ven treatment for non-M3 AML,with a search timeframe from the establishment of the database/website to November 1st,2024.Two researchers independently screened literature,extracted data,and assessed quality,and then qualitatively described and analyzed the results.Results A total of 11 pieces of literature were included,including 5 systematic reviews/Meta-analysis,4 pharmacoeconomic studies,and 2 HTA reports.In terms of efficacy,compared with the control group,non-M3 AML patients receiving Ven treatment had a higher clinical remission rate(P<0.05),a longer event-free survival(EFS)(P<0.05)and a similar or longer overall survival(OS)(P<0.05).Regarding safety,compared to Azacitidine(Aza)monotherapy,Ven+Aza resulted in a higher likelihood of febrile neutropenia in non-M3 AML patients(P<0.05).Non-M3 AML patients receiving Ven+low-dose cytarabine(LDAC)had a higher risk of developing thrombocytopenia compared with LDAC monotherapy(P<0.05).However,the early 30-day mortality rate was lower in the Ven+chemotherapy group than that in the chemotherapy alone group(P<0.05),presenting an acceptable security profile overall.In terms of cost-effectiveness,Ven was cost-effective in non-M3 AML patients compared with the control group.Conclusion Ven has manifested remarkable efficacy and acceptable security profile among patients with non-M3 AML,thus proving to be a medium to long-term cost-effective treatment modality.

Objective:To explore the motivation and experience of volunteers in palliative care, so as to provide a reference for volunteer training and support.Methods:From October to November 2024, volunteers providing palliative care from one volunteer organization in Hangzhou and two volunteer organizations in Suzhou were selected using purposive sampling as research subjects for semi-structured interviews. Data analysis was performed using the Colaizzi 7-step analysis method.Results:A total of three core themes and 19 sub-themes were identified, including various motivations for palliative care volunteer services, multidimensional pressures and challenges in palliative care volunteer services, and diverse coping styles and positive attitudes of palliative care volunteers.Conclusions:Relevant institutions and organizations should conduct targeted and personalized training and support based on the motivation and experience of palliative care volunteers, provide volunteers with professional knowledge and skills training to improve the quality and level of palliative care volunteer services.

Objective In this paper,CiteSpace(V6.3.R1)was used to sort out and summarize the experimental study on the mechanism and development trend of acupuncture intervention in Alzheimer's disease(AD),so as to provide basis and suggestions for subsequent research.Methods Relevant literatures on the mechanism of acupuncture intervention in AD were retrieved from CNKI database from March 1997 to March 2024.CiteSpace(V6.3.R1)software was used to visually display keywords,draw corresponding maps,and discuss the hot spots of acupuncture intervention mechanism in AD.Results After screening,a total of 397 articles were included in this study.The mechanism of acupuncture intervention in AD mainly focuses on the regulation of synaptic plasticity,regulation of neurotransmitter release,regulation of neuroinflammation,regulation of apoptosis,influence on mitochondrial autophagy,anti-oxidative stress and so on.Conclusion Acupuncture intervention in AD has developed rapidly,involving Notch1/Hes signaling pathway,Shh signaling pathway,NF-κB signaling pathway,PI3K/Akt signaling pathway and other signaling pathways.The research heat of TCM acupuncture intervention in AD continues to rise,and various research teams have harvested rich research results,diversified research hotspots,and in-depth exploration of acupuncture treatment of AD has rich clinical value.

Objective:To explore the impact of previous cytomegalovirus (CMV), herpes simplex virus (HSV), and rubella virus (RV) infection on pregnancy outcomes in infertile women undergoing the first in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) treatment. Methods:A retrospective cohort study was conducted to analyze the clinical data of women who underwent IVF/ICSI-ET for the first time at the Reproductive Medicine Center, the First Affiliated Hospital of Zhengzhou University from December 2017 to December 2022. The patients were divided into CMV-IgG (+) group ( n=154), RV-IgG (+) group ( n=86), HSV-IgG (+) group ( n=93) and IgG all-negative group ( n=172). The pregnancy outcomes of the patients in the virus-only infection group and the IgG all-negative group were compared. Patients who were previously co-infected with CMV and HSV were classified as the CMV+HSV-IgG (+) group ( n=344), and the pregnancy outcomes of patients with previous CMV and HSV co-infection and those with infection alone were further compared. Results:The two pronuclei (2PN) fertilization rate [63.90% (1 195/1 870)], the clinical pregnancy rate [51.30% (79/154)], and the live birth rate [45.45% (70/154)] of the CMV-IgG (+) group were significantly lower than those of the IgG completely negative group [68.68% (1 469/2 139), P=0.001; 68.60% (118/172), P=0.001; 61.05% (105/172), P=0.005]. The 2PN fertilization rate [61.62% (729/1 183)], the clinical pregnancy rate [50.54% (47/93)], and the live birth rate [43.01% (40/93)] of the HSV-IgG (+) group were significantly lower than those of the IgG completely negative group [68.68% (1 469/2 139), P=0.001; 68.60% (118/172), P=0.004; 61.05% (105/172), P=0.005]. There were no statistical differences in the 2PN fertilization rate, the clinical pregnancy rate, and the live birth rate between the RV-IgG (+) group and the IgG completely negative group (all P>0.05). Compared with the IgG completely negative group, there were no significant differences in the risk of complications such as gestational diabetes, hypertensive disorders of pregnancy and neonatal outcomes in the CMV-IgG (+) group, RV-IgG (+) group, and HSV-IgG (+) group (all P>0.05). Multivariate logistic regression analysis showed that CMV-IgG (+) ( OR=0.453, 95% CI: 0.280-0.734, P=0.001; OR=0.515, 95% CI: 0.321-0.825, P=0.006), HSV-IgG (+) ( OR=0.425, 95% CI: 0.245-0.738, P=0.002; OR=0.447, 95% CI: 0.259-0.771, P=0.004) and CMV+HSV-IgG (+) ( OR=0.491, 95% CI: 0.329-0.733, P=0.001; OR=0.528, 95% CI: 0.357-0.780, P=0.001) were all independent influencing factors of patients' clinical pregnancy and live birth. There were no statistical differences in the clinical outcomes between the previous CMV and HSV co-infection group and the single infection group ( P>0.05). Conclusion:Previous CMV or HSV infection alone reduced the fertilization rate, the clinical pregnancy rate and the live birth rate of patients undergoing IVF/ICSI-ET treatment, but had no significant impact on pregnancy complications and neonatal outcomes. Pregnancy outcomes of patients with previous CMV and HSV co-infection were similar to those with infection alone.