ObjectiveTo explore the effect of cluster scalp acupuncture combined with Taijiquan training on depressive symptom, motor function, activities of daily living, serum markers, as well as brain functional connectivity (FC) and network topological properties in patients with post-stroke depression (PSD). MethodsA total of 40 PSD patients in the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from September, 2022 to September, 2023 were enrolled and randomly divided into control group (n = 20) and experimental group (n = 20). The control group received cluster scalp acupuncture alone, while the experimental group underwent Taijiquan training in addition, for four weeks. They were assessed with Hamilton Depression Scale-17 (HAMD-17), Fugl-Meyer Assessment (FMA) and Barthel Index (BI) before and after treatment, while the serum levels of dopamine (DA), 5-hydroxytryptamine (5-HT), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected with enzyme-linked immunosorbent assay. Resting-state functional magnetic resonance imaging (rs-fMRI) was applied to assess brain FC, as well as the global efficiency (Eg) and small-world property (σ) of brain networks. ResultsThe scores of HAMD-17, FMA and BI improved in both groups (t > 2.922, P < 0.01) after treatment, and improved more in the experimental group than in the control group (t > 2.517, P < 0.05). The serum levels of DA and 5-HT increased in both groups (t > 2.637, P < 0.05), and increased more in the experimental group (t > 2.192, P < 0.05). The serum levels of IL-6 and TNF-α decreased in the experimental group after treatment (t > 4.059, P < 0.001), and they were less than those in the control group (t > 2.154, P < 0.05). FC between left middle frontal gyrus and right anterior cingulate gyrus, as well as between left hippocampus and right precuneus were higher in the experimental group than in the control group after treatment (t > 3.867, P < 0.001), while Eg and σ increased in both groups (t > 2.828, P < 0.05), and they were higher in the experimental group (t > 2.675, P < 0.05). ConclusionCombination of Taijiquan training is more effective on depressive symptoms, motor function and activities of daily living in PSD patients, which may be related to up-regulation of serum DA and 5-HT, reduction of inflammatory factors, enhancement of prefrontal-limbic system functional connectivity and optimization of brain network topological properties.

Purpose To evaluate the value of tumors invasion in the central airway(TICA)in predicting the severe immune checkpoint inhibitor-related pneumonitis(S-CIP)in lung cancer patients using propensity score matching(PSM).Materials and Methods The intact data of 162 consecutive lung cancer patients who received treatment with immune checkpoint inhibitors in Xi'an International Medical Center Hospital from September 2019 to March 2022 were retrospectively collected.Patients were divided into S-CIP group(23 cases)and non-S-CIP group(139 cases)according to the presence of S-CIP.The demographic information of the patients,including gender,age,history of smoking,thoracic radiotherapy histology,baseline lung diseases,classification,TNM stage,tumor location as well as TICA were collected.A binary Logistic regression was used to analyze the confounding factors and independent risk factors of S-CIP and to predict the development of S-CIP.A 1:1 matching was performed by the nearest neighbor method for PSM.The PSM was used to pair the two groups,and the value of TICA in predicting S-CIP before and after PSM was compared.The receiver operating characteristic curve and the area under the curve were used for model performance based on TICA.Results Before PSM,the proportion of baseline lung diseases(78.3%vs.32.4%,OR=6.802,P=0.001),thoracic radiotherapy history(69.6%vs.30.2%,OR=5.300,P=0.002)and TICA(65.2%vs.27.3%,OR=5.882,P=0.001)in the S-CIP group was higher than those in the non-S-CIP group,and were independent risk factor for predicting S-CIP.After PSM,20 patients were included in each group.The presence of TICA was higher in S-CIP group than that in the non-S-CIP group(60.0%vs.20.0%,OR=6.000,P=0.013).The area under the curves of Logistic regression model based on TICA was 0.700(95%CI 0.534-0.866).Conclusion TICA is an independent risk factor for development of S-CIP,which has moderate degree of accuracy in predicting S-CIP,can be used for risk prediction and early intervention to reduce the poor prognosis of S-CIP patients.

Objective To investigate the clinical influencing factors for the occurrence of intracranial hemorrhage(ICH)in the elderly patients with massive ischemic stroke after endovascular therapy(EVT).Methods A retrospective study was conducted on 103 elderly hospitalized patients who underwent EVT due to anterior circulation acute arterial occlusion in our department from March 2021 to December 2023.All of them were diagnosed with massive ischemic stroke before treat-ment.Multivariate logistic regression analysis was used to identify the influencing factors for ICH after EVT treatment.Then based on the obtained factors,a nomogram model was constructed,and its performance efficiency was evaluated.Results After EVT treatment,95 patients had success-ful vascular recanalization,26(25.24％)experienced ICH,10 had symptomatic cerebral hemor-rhage,and 32(31.07％)obtained good functional outcomes after 90 d of follow-up.Multivariate logistic regression analysis that history of alcohol consumption(OR=3.795,95％CI:1.381-10.427,P=0.010),coronary heart disease(OR=2.969,95％CI:1.094-8.059,P=0.033)and bridging thrombolysis(OR=0.284,95％CI:0.091-0.884,P=0.030)were independently influen-cing factors for ICH occurrence in acute ischemic stroke patients after EVT.Our nomogram model based on these three factors had an AUC value of 0.759(95％CI:0.662-0.856).Conclusion Alcohol consumption,bridging thrombolysis,and history of coronary heart disease can predict adverse outcomes in elderly patients with massive ischemic stroke after EVT.

Objective To investigate the clinical influencing factors for the occurrence of intracranial hemorrhage(ICH)in the elderly patients with massive ischemic stroke after endovascular therapy(EVT).Methods A retrospective study was conducted on 103 elderly hospitalized patients who underwent EVT due to anterior circulation acute arterial occlusion in our department from March 2021 to December 2023.All of them were diagnosed with massive ischemic stroke before treat-ment.Multivariate logistic regression analysis was used to identify the influencing factors for ICH after EVT treatment.Then based on the obtained factors,a nomogram model was constructed,and its performance efficiency was evaluated.Results After EVT treatment,95 patients had success-ful vascular recanalization,26(25.24％)experienced ICH,10 had symptomatic cerebral hemor-rhage,and 32(31.07％)obtained good functional outcomes after 90 d of follow-up.Multivariate logistic regression analysis that history of alcohol consumption(OR=3.795,95％CI:1.381-10.427,P=0.010),coronary heart disease(OR=2.969,95％CI:1.094-8.059,P=0.033)and bridging thrombolysis(OR=0.284,95％CI:0.091-0.884,P=0.030)were independently influen-cing factors for ICH occurrence in acute ischemic stroke patients after EVT.Our nomogram model based on these three factors had an AUC value of 0.759(95％CI:0.662-0.856).Conclusion Alcohol consumption,bridging thrombolysis,and history of coronary heart disease can predict adverse outcomes in elderly patients with massive ischemic stroke after EVT.

Indwelling urinary catheterization is one of the most widely used invasive procedures in clinical practice, playing a critical role in disease diagnosis, treatment, and monitoring. In 2024, the European Association of Urology Nurses (EAUN) released the Best Practice Guidelines for Indwelling Urinary Catheterization in Adults-Transurethral and Suprapubic Catheterization (hereinafter referred to as the Guideline), aiming to provide evidence-based clinical guidance and health education information for healthcare professionals. This article interprets the section on "Nursing Principles" within the Guideline, which spans the entire process of catheter management. Key aspects covered include pre-insertion preparation, catheter insertion procedure, catheter maintenance and securement, observation of urine color, prevention of constipation, and catheter removal. The aim is to help urology nurses and related healthcare personnel gain an in-depth understanding of the recommendations in the Guideline, promote its standardized application in clinical practice, improve the quality of indwelling catheter care, and ensure patient safety.

Objective:To translate the Clinical Leadership Needs Analysis Instrument (CLeeNA) into Chinese and to test its reliability and validity.Methods:The source scale was translated based on the Beaton translation model, and cultural debugging was completed through expert consultation and pre-surveys to form the Chinese version of CLeeNA. Convenience sampling was used to select 536 nurses from three Class Ⅲ Grade A hospitals in Anhui Province from August to December 2023 to conduct the survey and to verify the reliability and validity of the scale. A total of 536 questionnaires were distributed and 495 valid questionnaires were recovered, with an effective recovery rate of 92.351% (495/536) .Results:The Chinese version of CLeeNA contained 43 entries in 7 dimensions of self and team development, staff and care delivery, technology and care initiatives, financial and service management, leadership and clinical practice, patient safety and risk management, and standards of care. The content validity index at the item level ranged from 0.800 to 1.000, and the content validity index at the scale level was 0.953. Exploratory factor analysis extracted 7 common factors with a cumulative variance contribution rate of 82.098%. Confirmatory factor analysis showed that the model fit was acceptable. The total Cronbach's ɑ coefficient for the scale was 0.958, the folding coefficient was 0.898, and the retest reliability coefficient was 0.928.Conclusions:The Chinese version of CLeeNA has good reliability and validity, and can be used for measuring the clinical leadership needs of nurses.

BACKGROUND:Osteosarcoma has a complex pathogenesis and a poor prognosis.While advancements in medical technology have led to some improvements in the 5-year survival rate,substantial progress in its treatment has not yet been achieved. OBJECTIVE:To screen key molecular markers in osteosarcoma,analyze their relationship with osteosarcoma treatment drugs,and explore the potential disease mechanisms of osteosarcoma at the molecular level. METHODS:GSE99671 and GSE284259(miRNA)datasets were obtained from the Gene Expression Omnibus database.Differential gene expression analysis and Weighted Gene Co-expression Network Analysis(WGCNA)on GSE99671 were performed.Functional enrichment analysis was conducted using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes separately for the differentially expressed genes and the module genes with the highest positive correlation to the disease.The intersection of these module genes and differentially expressed genes was taken as key genes.A Protein-Protein Interaction network was constructed,and correlation analysis on the key genes was performed using CytoScape software,and hub genes were identified.Hub genes were externally validated using the GSE28425 dataset and text validation was conducted.The drug sensitivity of hub genes was analyzed using the CellMiner database,with a threshold of absolute value of correlation coefficient|R|>0.3 and P<0.05. RESULTS AND CONCLUSION:(1)Differential gene expression analysis identified 529 differentially expressed genes,comprising 177 upregulated and 352 downregulated genes.WGCNA analysis yielded a total of 592 genes with the highest correlation to osteosarcoma.(2)Gene Ontology enrichment results indicated that the development of osteosarcoma may be associated with extracellular matrix,bone cell differentiation and development,human immune regulation,and collagen synthesis and degradation.Kyoto Encyclopedia of Genes and Genomes enrichment results showed the involvement of pathways such as PI3K-Akt signaling pathway,focal adhesion signaling pathway,and immune response in the onset of osteosarcoma.(3)The intersection analysis revealed a total of 59 key genes.Through Protein-Protein Interaction network analysis,8 hub genes were selected,which were LUM,PLOD1,PLOD2,MMP14,COL11A1,THBS2,LEPRE1,and TGFB1,all of which were upregulated.(4)External validation revealed significantly downregulated miRNAs that regulate the hub genes,with hsa-miR-144-3p and hsa-miR-150-5p showing the most significant downregulation.Text validation results demonstrated that the expression of hub genes was consistent with previous research.(5)Drug sensitivity analysis indicated a negative correlation between the activity of methotrexate,6-mercaptopurine,and pazopanib with the mRNA expression of PLOD1,PLOD2,and MMP14.Moreover,zoledronic acid and lapatinib showed a positive correlation with the mRNA expression of PLOD1,LUM,MMP14,PLOD2,and TGFB1.This suggests that zoledronic acid and lapatinib may be potential therapeutic drugs for osteosarcoma,but further validation is required through additional basic experiments and clinical studies.

Objective To construct a visual imaging decision model for evaluating the prognosis of hepatocellular carcinoma(HCC)patients treated with interventional therapy based on MRI features.Methods A total of 130 HCC patients were selected.All of them underwent MRI examination upon admission,and then the interventional therapy was implemented after clinical evaluation.The patients were followed up for 2 years after the last interventional therapy,and then were divided into poor prognosis group(50 cases)and good prognosis group(80 cases)according to the follow-up results.The risk factors affecting the poor prognosis of HCC patients treated with interventional therapy were screened.A nomogram model was constructed based on the risk factors,and its prediction efficiency was then evaluated.Results The incomplete capsule,unsmooth tumor margin,portal vein tumor thrombus,cirrhosis,apparent diffusion coefficient(ADC)value,red blood cell distribution width within 24 h after admission,and aspartate aminotransferase were significantly different between the poor prognosis group and the good prognosis group(P＜0.05),and these indicators were the risk factors affecting the poor prognosis of HCC patients treated with interventional therapy(P＜0.05).Based on the above risk factors,a nomogram model of poor prognosis risk for the HCC patients treated with interventional therapy was constructed,and the sensitivity,specificity,and area under the curve(AUC)for predicting poor prognosis of HCC patients treated with interventional therapy were 90.00％,81.80％and 0.899[95％confidence interval(CI)0.827-0.972],respectively.Conclusion The risk nomogram model of poor prognosis of HCC patients treated with interventional therapy based on incomplete capsule,unsmooth tumor margin,portal vein tumor thrombus,cirrhosis,ADC value,red blood cell distribution width,and aspartate aminotransferase has good predictive efficacy.

As a third major discipline on par with internal medicine and surgery,interventional radiology is one of the key branches of modern medicine.The unique practicality and innovation of interventional radiology make it play an irreplaceable role in the diagnosis and treatment of diseases.In recent years,with the rapid development of technology and the updating of educational concepts,the teaching mode of interventional radiology is facing new challenges and opportunities.This article combines the clinical training methods adopted by interventional physicians in Europe and Germany,integrates imaging,anatomy and pathology teaching,strengthens the foundation,uses virtual reality(VR),augmented reality(AR)technology,and simulation training to enhance the practical ability of medical students.At the same time,with the help of online education platforms,the innovative methods and optimization strategies such as personalized learning program are implemented,which can greatly improve the teaching effectiveness of interventional radiology and provide useful references for teaching reform in this field.

Objective To construct a visual imaging decision model for evaluating the prognosis of hepatocellular carcinoma(HCC)patients treated with interventional therapy based on MRI features.Methods A total of 130 HCC patients were selected.All of them underwent MRI examination upon admission,and then the interventional therapy was implemented after clinical evaluation.The patients were followed up for 2 years after the last interventional therapy,and then were divided into poor prognosis group(50 cases)and good prognosis group(80 cases)according to the follow-up results.The risk factors affecting the poor prognosis of HCC patients treated with interventional therapy were screened.A nomogram model was constructed based on the risk factors,and its prediction efficiency was then evaluated.Results The incomplete capsule,unsmooth tumor margin,portal vein tumor thrombus,cirrhosis,apparent diffusion coefficient(ADC)value,red blood cell distribution width within 24 h after admission,and aspartate aminotransferase were significantly different between the poor prognosis group and the good prognosis group(P＜0.05),and these indicators were the risk factors affecting the poor prognosis of HCC patients treated with interventional therapy(P＜0.05).Based on the above risk factors,a nomogram model of poor prognosis risk for the HCC patients treated with interventional therapy was constructed,and the sensitivity,specificity,and area under the curve(AUC)for predicting poor prognosis of HCC patients treated with interventional therapy were 90.00％,81.80％and 0.899[95％confidence interval(CI)0.827-0.972],respectively.Conclusion The risk nomogram model of poor prognosis of HCC patients treated with interventional therapy based on incomplete capsule,unsmooth tumor margin,portal vein tumor thrombus,cirrhosis,ADC value,red blood cell distribution width,and aspartate aminotransferase has good predictive efficacy.