Objective To investigate the desire and demand for the retraining of specialist nurses medical institutions in China,and to provide references for the further work of the re-certification of specialist nurses.Methods Convenient sampling method was used to select the head nurses in the nursing departments of 5 030 medical institutions in 30 provinces,autonomous regions and municipalities as the survey subjects in May 2023.The questionnaire was self-designed,and the survey was conducted by anonymous electronic questionnaire.Results 4 563 valid questionnaires were collected.Among the 4 563 medical institutions,the training of specialized nurses was carried out in various fields,among which 46.31％of the medical institutions have carried out the training of intensive care specialized nurses.82.29％of the medical institutions considered it necessary to retrain specialized nurses;60.86％of the medical institutions suggested that the training cycle should be once every 5 years;68.05％of the medical institutions suggested that the training method should be online;47.97％of the medical institutions thought that the conditions could be applied without limitation.More than 80％of medical institutions believe that specialized knowledge and clinical practice ability should be the main training and assessment content.Conclusion Most medical institutions have the need for retraining of specialist nurses,and there are differentiated needs for the implementation of retraining.Retraining can be carried out on a pilot basis in the field of intensive care.The retraining and assessment of specialist nurses should mainly focus on specialist knowledge and clinical practice ability.

Objective To investigate the desire and demand for the retraining of specialist nurses medical institutions in China,and to provide references for the further work of the re-certification of specialist nurses.Methods Convenient sampling method was used to select the head nurses in the nursing departments of 5 030 medical institutions in 30 provinces,autonomous regions and municipalities as the survey subjects in May 2023.The questionnaire was self-designed,and the survey was conducted by anonymous electronic questionnaire.Results 4 563 valid questionnaires were collected.Among the 4 563 medical institutions,the training of specialized nurses was carried out in various fields,among which 46.31％of the medical institutions have carried out the training of intensive care specialized nurses.82.29％of the medical institutions considered it necessary to retrain specialized nurses;60.86％of the medical institutions suggested that the training cycle should be once every 5 years;68.05％of the medical institutions suggested that the training method should be online;47.97％of the medical institutions thought that the conditions could be applied without limitation.More than 80％of medical institutions believe that specialized knowledge and clinical practice ability should be the main training and assessment content.Conclusion Most medical institutions have the need for retraining of specialist nurses,and there are differentiated needs for the implementation of retraining.Retraining can be carried out on a pilot basis in the field of intensive care.The retraining and assessment of specialist nurses should mainly focus on specialist knowledge and clinical practice ability.

The phrase"wood element characterized by spreading harmony"from the Huangdi Neijing five-phase theory summarizes the fundamental nature and functions of the wood element,emphasizing the crucial significance of the harmonious virtue of wood in promoting the generation and transformation of all things.In human physiology,"wood element characterized by spreading harmony"corresponds to the harmonious spreading of liver-gallbladder qi,ensuring smooth liver qi regulation and proper functioning of the ascending-descending movement mechanisms.Bipolar disorder,categorized in traditional Chinese medicine as"depression"or"manic depressive psychosis,"primarily arises from hepatic wood dysfunction.Insufficient wood qi dispersion typically manifests as a depressive phase,whereas excessive dispersion leads to a manic phase,with alternating manic-depressive phase indicating qi movement disorder.By integrating wood qi characteristics,disease pathogenesis of bipolar disorder,and our team's clinical experience in treating emotional disorders,this study developed an integrated acupuncture and moxibustion diagnosis and treatment approach for bipolar disorder,focusing on soothing the liver and regulating spirit,structured as"acupuncture-moxibustion-consolidation."Based on the physiological characteristics of"wood element characterized by spreading harmony,"from liver failing to controll conveyance and dispersion:depressive phase should apply warm-nourishing growth method,manic phase should suppress hyperactive liver for tranquillizing mind method,and alternating manic-depressive phase should apply harmonized rigidity-flexibility method.These methods aim to regulate the spirit of the heart and brain,harmonize the qi movement of the spleen and stomach,and replenish the essence and blood of the liver and kidney.Clinical application through syndrome differentiation has demonstrated satisfactory therapeutic outcomes.

ObjectiveTo explore the potential mechanism of acupuncture with the method of soothing the liver and regulating the mind in improving depressive disorder. MethodsEighteen C57BL/6J mice were randomly divided into blank group， model group， and acupuncture group， with 6 mice in each group. The model group and the acupuncture group were subjected to depression induction by intraperitoneal injection of lipopolysaccharide （LPS）， while the blank group received an equal volume of normal saline once daily for seven consecutive days. Concurrently， the acupuncture group received "soothing the liver and regulating the mind" acupuncture intervention starting from the first day of modeling， once daily for 14 days； whereas the blank group and the model group were only restrained without acupuncture. The sucrose preference test was used to assess sucrose preference rate， the open-field test to measure center stay time and total travel distance， and the forced swim test to evaluate immobility time. Hematoxylin-eosin （HE） staining was performed to observe hippocampal morphological changes. Enzyme-linked immunosorbent assay （ELISA） was used to detect levels of interleukin-1β （IL-1β）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α） in hippocampal tissue. Western blot analysis was conducted to examine the protein expression levels of Toll-like receptor 4 （TLR4） and nuclear factor-κB （NF-κB） in the hippocampus. ResultsCompared to the blank group， the model group showed a significant reduction in sucrose preference rate， center stay time， and total travel distance， along with a significant increase in immobility time in the forced swim test， hippocampal IL-1β， IL-6， and TNF-α levels， as well as TLR4 and NF-κB protein expression （P＜0.01）， and the histological examination revealed blurred hippocampal neuronal boundaries， loose arrangement， and some neurons exhibiting nuclear pyknosis and deep staining. Compared to the model group， the acupuncture group demonstrated a significant increase in sucrose preference rate， center stay time， and total travel distance， along with a significant reduction in immobility time in the forced swim test， hippocampal IL-1β， IL-6， and TNF-α levels， and TLR4 and NF-κB protein expression （P＜0.01）， and the histological analysis showed that hippocampal neurons in the acupuncture group were more tightly arranged， with reduced nuclear pyknosis and deep staining. ConclusionAcupuncture with the "soothing the liver and regulating the mind" method can significantly improve depression-like behavior， potentially by inhibiting the hippocampal TLR4/NF-κB signaling pathway and alleviating inflammatory responses.

The phrase"wood element characterized by spreading harmony"from the Huangdi Neijing five-phase theory summarizes the fundamental nature and functions of the wood element,emphasizing the crucial significance of the harmonious virtue of wood in promoting the generation and transformation of all things.In human physiology,"wood element characterized by spreading harmony"corresponds to the harmonious spreading of liver-gallbladder qi,ensuring smooth liver qi regulation and proper functioning of the ascending-descending movement mechanisms.Bipolar disorder,categorized in traditional Chinese medicine as"depression"or"manic depressive psychosis,"primarily arises from hepatic wood dysfunction.Insufficient wood qi dispersion typically manifests as a depressive phase,whereas excessive dispersion leads to a manic phase,with alternating manic-depressive phase indicating qi movement disorder.By integrating wood qi characteristics,disease pathogenesis of bipolar disorder,and our team's clinical experience in treating emotional disorders,this study developed an integrated acupuncture and moxibustion diagnosis and treatment approach for bipolar disorder,focusing on soothing the liver and regulating spirit,structured as"acupuncture-moxibustion-consolidation."Based on the physiological characteristics of"wood element characterized by spreading harmony,"from liver failing to controll conveyance and dispersion:depressive phase should apply warm-nourishing growth method,manic phase should suppress hyperactive liver for tranquillizing mind method,and alternating manic-depressive phase should apply harmonized rigidity-flexibility method.These methods aim to regulate the spirit of the heart and brain,harmonize the qi movement of the spleen and stomach,and replenish the essence and blood of the liver and kidney.Clinical application through syndrome differentiation has demonstrated satisfactory therapeutic outcomes.

To provide scientific guidance and standardization for perioperative clinical nursing practice in patients undergoing percutaneous renal biopsy, relevant evidence on percutaneous renal biopsy nursing care was systematically retrieved and synthesized through an evidence-based approach. After two rounds of Delphi expert consultation and expert panel discussions, expert consensus on perioperative clinical nursing standards for patients undergoing percutaneous renal biopsy (hereinafter referred to as the "Consensus") was developed. The Consensus includes three primary themes: preoperative care, intraoperative care, and postoperative care, encompassing 21 secondary themes. It is characterized by scientific rigor, practical applicability, and comprehensiveness, and serves as a valuable reference and guide for clinical nursing professionals across medical institutions.

To provide scientific guidance and standardization for perioperative clinical nursing practice in patients undergoing percutaneous renal biopsy, relevant evidence on percutaneous renal biopsy nursing care was systematically retrieved and synthesized through an evidence-based approach. After two rounds of Delphi expert consultation and expert panel discussions, expert consensus on perioperative clinical nursing standards for patients undergoing percutaneous renal biopsy (hereinafter referred to as the "Consensus") was developed. The Consensus includes three primary themes: preoperative care, intraoperative care, and postoperative care, encompassing 21 secondary themes. It is characterized by scientific rigor, practical applicability, and comprehensiveness, and serves as a valuable reference and guide for clinical nursing professionals across medical institutions.

Objective To analyze the therapeutic effect of self-adhesive absorbent fiber dressing on su-perficial ulcer of stage 2 pressure injury.Methods Sixty patients with stage 2 pressure injury superficial ul-cers(71 sites)in the thoracic surgery ICU of this hospital from October 2020 to October 2023 were selected and divided into the control group(30 cases,36 sites)and experimental group(30 cases,35 sites)according to the random number table method.The control group was added with the exudation absorption dressing on the basis of conventional pressure injury therapy,while the experimental group was added the self-adhesive ab-sorbent fiber on the basis of conventional pressure injury therapy.After 3 weeks,the clinical efficacy,healing time,dressing change times and pain score were observed and compared between the two groups.Results The total effective rate of clinical treatment in the experimental group was 100.0％(30/30),which was significant-ly higher than 90.0％(27/30)in the control group.The cure time of the experimental group was(17.35±4.17)d,which was significantly shorter than(30.58±4.65)d of the control group.The number of dressing changes in the experimental group was(15.43±1.21)times,which was significantly lower than(53.24±3.43)times in the control group.The pain score of the experimental group was(2.33±1.45)points,which was significantly lower than(8.71±0.52)points of the control group.The above indicators had statistical differences between the two groups(P＜0.05).Conclusion The effect of self-adhesive absorbent fiber in the treatment of stage 2 pressure injury superficial ulcer is obvious,which could increase the clinical curative effect,shorten the healing time,reduce the times of dressing change and relieve the pain of the patients,it has good clinical application value.

Objective To analyze the relationship between serum a proliferation inducing ligand(APRIL)and galactin-1(Gal-1)levels with clinical features and prognosis in patients with epithelial ovarian cancer(EOC).Methods EOC patients(n=132)who admitted in Handan Hangang Hospital of Hebei Province from January 2018 to June 2020 were selected as the cancer group,and were grouped into a survival group(n=56)and a death group(n=76)based on their three-year survival after discharge.Meanwhile,healthy in-dividuals(n=68)who underwent physical examination were regarded as the healthy group.Enzyme linked immunosorbent assay was applied to detect serum APRIL and Gal-1 levels in all subjects.Clinical data of all patients were collected and their relationship with serum APRIL,Gal-1 levels and prognosis was analyzed.Ka-plan-Meier method was applied to analyze the relationship between serum APRIL and Gal-1 levels and the prognosis of EOC patients.Cox regression was applied to analyze the relevant factors affecting the prognostic death of EOC patients.The prognostic value of serum APRIL in patients with EOC was analyzed by receiver operating characteristic(ROC)curve.Results The serum APRIL and Gal-1 expression levels in the cancer group were greatly higher than those in the healthy group,and the differences were statistically significant(P＜0.05).The serum APRIL and Gal-1 levels in the death group were greatly higher than those in the sur-vival group,and the differences were statistically significant(P＜0.05).Clinical data analysis showed that se-rum APRIL and Gal-1 levels were not related to the age of EOC patients(P＞0.05),but were related to tumor location,tumor diameter,The International Febderation of Gynecology and Obstetrics(FIGO)staging,differentiation degree,lymph node metastasis,histological classification,and levels of cancer antigen 125(CA125)and human epididymis protein 4(HE4),and FIGO staging,differentiation degree,lymph node me-tastasis,histological classification,and levels of CA125 and HE4 also significantly affected the prognosis of pa-tients(P＜0.05).FIGO stage Ⅲ+Ⅳ,low differentiation,lymph node metastasis,serous tissue classification,CA125≥200 U/mL,HE4≥200 pmol/L,and high expression of APRIL and Gal-1 were all risk factors for prognostic death in EOC patients(P＜0.05).The three-year survival rate of APRIL high expression patients(25.37％)was greatly lower than that of APRIL low expression patients(60.00％),and the three-year sur-vival rate of Gal-1 high expression patients(27.94％)was greatly lower than that of Gal-1 low expression pa-tients(57.81％),,and the differences were statistically significant(P＜0.05).ROC curve showed that the ar-ea under the curve(AUC)of the combination of APRIL and Gal-1 for predicting the prognosis was 0.925,which was significantly higher than that of the diagnosis of the two alone,(Zcombined-APRIL=4.061,P＜0.001,Zcombined-Gal-1=3.424,P＜0.001),with a sensitivity and specificity of 86.84％and 83.93％,respectively.Conclu-sion The expression levels of serum APRIL and Gal-1 are greatly elevated in EOC patients,and their levels are related to tumor location,tumor diameter,FIGO staging,lymph node metastasis,histological classifica-tion,CA1 25,HE4,and differentiation degree.The expression levels of both have great application value in the prognosis evaluation of EOC patients.

Purpose/Significance The internet consultation user portrait is constructed to explore the consultation topic,improve the consultation service quality,reduce the communication barriers between doctors and patients,and provide targeted treatment in an online and offline manner.Method/Process Python crawler is used to obtain the autism diagnosis data of a medical platform,and the combined model of LDA and TF-TFIDF is used to divide the data,and the user group classification is realized after dimensionality reduction clus-tering.Finally,the characteristic sets of different user groups are calculated and output by logistic regression model to construct the por-trait.Result/Conclusion The consultation content of users mainly focuses on 11 topics.The platform can optimize the consultation filling template based on the typical characteristics of the subject content to improve the accuracy of the disease description,consultation effi-ciency and satisfaction of patients.