Objective:To explore the application effects of mind map-based health education in improving rehabilitation of patients with traumatic cervical spinal cord injury after surgery.Methods:A retrospective cohort study was conducted to analyze the clinical data of 64 patients with traumatic cervical spinal cord injury admitted to Zhengzhou Orthopedic Hospital from August 2019 to September 2023, including 51 males and 13 females, aged 20-75 years [(52.7±12.5)years]. The injured segments were located at C 3/4 in 8 patients, at C 4/5 in 18, at C 5/6 in 22, and at C 6/7 in 16. The American Spinal Injury Association (ASIA) Scale was grade A in 3 patieats, grade B in 15, grade C in 18, and grade D in 28. All the patients underwent cervical decompression and fusion with internal fixation. Thirty-two patients received conventional nursing health education after surgery (conventional education group), while the other 32 patients received mind map-based nursing health education (mind map education group). Readiness for hospital discharge scale (RHDS) and quality of discharge teaching scale (QDTS) were used to compare the discharge readiness and quality of discharge instruction between the two groups at 4 hours before discharge. Self-rating anxiety scale (SAS), self-rating depression scale (SDS), and post-traumatic growth inventory (PTGI) were used to compare the anxiety, depression, and post-traumatic growth levels between the two groups before the health education, at discharge, and at 6 months after discharge. The incidence of complications was also compared between the two groups at 6 months after discharge. Results:All the patients were followed up for 6 months. At 4 hours before discharge, the total scores of RHDS and QDTS were (86.5±7.8)points and (142.9±2.7)points in the mind map education group, which were higher than (75.2±5.3)points and (125.3±2.3)points in the conventional education group ( P<0.01). Before the health education, no statistically significant differences were found in SAS scores, SDS scores, or PTGI total scores between the two groups ( P>0.05). At discharge, the SAS and SDS scores were (41.6±0.9)points and (41.4±1.1)points in the mind map education group, which were lower than (47.2±0.8)points and (47.0±0.7)points in the conventional education group ( P<0.01); the PTGI total score was (72.4±4.3)points, which was higher than (53.8±2.3)points in the conventional education group ( P<0.01). At 6 months after discharge, the SAS and SDS scores were (31.2±0.8)points and (31.0±1.0)points in the mind map education group, which were lower than (44.6±1.1)points and (42.4±0.9)points in the conventional education group ( P<0.01); the PTGI total score was (85.8±1.9)points, which was higher than (68.0±1.6)points in the conventional education group ( P<0.01); the complication rate was 6% (2/32) in the mind map education group, which was lower than 34% (11/32) in the conventional education group ( P<0.05). Conclusion:Compared with conventional nursing health education, mind map-based nursing health education can improve the discharge readiness and quality of discharge instruction for patients with traumatic cervical spinal cord injury after surgery, alleviate negative emotions such as anxiety and depression, improve their psychological status, promote post-traumatic growth, and reduce the incidence of complications.

Objective:To explore the effects of umbilical moxibustion combined with a multi-component exercise program on perioperative rehabilitation in frail elderly patients with intertrochanteric fractures so as to provide evidence-based basis for optimizing clinical rehabilitation nursing pathways.Methods:A quasi-experimental study design was used. Convenience sampling was applied to frail select elderly patients with intertrochanteric femoral fractures, who were admitted to Zhengzhou Orthopedic Hospital from January to October 2024. According to their admission time, the patients were divided into four groups: conventional nursing group, umbilical moxibustion group (conventional nursing+umbilical moxibustion), exercise group (conventional nursing+multicomponent exercise), and combination group (conventional nursing+umbilical moxibustion combined with multicomponent exercise), with 31 patients in each group. All the patients underwent internal fixation with proximal femoral nail antirotation under anesthesia. The umbilical moxibustion protocol focused on Shenque acupoint, combined with liver-kidney-nourishing Chinese herbal powder, with each session lasting 20 minutes. The multi-component exercise program was designed in phases, including resistance, balance, and aerobic training. The Harris hip score (HHS), Tilburg frailty indicator (TFI), falls efficacy scale-international (FES-I), and Chinese version of the short form-36 health survey (SF-36) scores were compared among the four groups preoperatively, at 1 month, 3 months postoperatively, and at the last follow-up.Results:A total of 124 elderly patients were involved, including 50 males and 74 females, aged 60-80 years [(71.8±5.0)years]. All the patients were followed up for 6 months. The results of generalized estimating equation showed that the HHS, TFI, FES-I, and SF-36 scores differed significantly in terms of group effect, time effect, and interaction effect among the four groups across all the time points ( P<0.05). Simple effect analysis indicated no significant differences in preoperative HHS, TFI, FES-I, or SF-36 scores among the four groups ( P>0.05). The HHS scores at 1 and 3 months postoperatively were (54.3±5.1)points and (65.7±6.3)points in the umbilical moxibustion group, (61.3±5.3)points and (74.5±6.8)points in the exercise group, and (66.5±5.2)points and (86.3±6.7)points in the combination group, which were all significantly higher than (50.2±4.5)points and (60.7±5.1)points in the conventional nursing group ( P<0.05), with the combination group showing higher scores than the umbilical moxibustion group and exercise group ( P<0.05). At the last follow-up, the HHS score was (77.3±6.0)points in the conventional nursing group and (77.0±5.9)points in the umbilical moxibustion group ( P>0.05); the score was (83.8±4.7)points in the exercise group and (91.4±3.5)points in the combination group, which were significantly higher than that in the conventional nursing group ( P<0.05), with the combination group showing higher score than those in the umbilical moxibustion group and exercise group ( P<0.05). At 1 month, 3 months postoperatively, and at the last follow-up, the TFI total scores were 5.0(3.0, 7.0)points, 3.0(1.0, 5.0)points, and 3.0(0.0, 4.0)points in the umbilical moxibustion group, 4.0(1.0, 6.0)points, 2.0(0.0, 5.0)points, and 2.0(0.0, 3.0)points in the exercise group, and 2.0(0.0, 5.0)points, 1.0(0.0, 2.0)points, and 0.0(0.0, 1.0)points in the combination group, which were all significantly lower than those in the conventional nursing group [7.0(5.0, 10.0)points, 7.0(5.0, 9.0)points, and 6.0(5.0, 8.0)points, respectively] ( P<0.05), with the combination group showing lower scores than the umbilical moxibustion group and exercise group ( P<0.05). The physical and social dimension scores of TFI at 1 month, 3 months postoperatively, and at the last follow-up were significantly lower in the umbilical moxibustion group, exercise group, and combination group than those in the conventional nursing group ( P<0.05), with the combination group showing the lower scores than those in the umbilical moxibustion group and exercise group ( P<0.05). At 1 month postoperatively, no statistically significant difference was observed among the four groups in the psychological dimension scores of TFI ( P>0.05). At 3 months postoperatively and at the last follow-up, the psychological dimension scores of TFI in the umbilical moxibustion group, exercise group, and combination group were all lower than those in the conventional nursing group ( P<0.05), with the combination group showing the lower scores than those in the umbilical moxibustion group and exercise group ( P<0.05). At 1 month, 3 months postoperatively, and at the last follow-up, the FES-I scores were (45.3±4.3)points, (40.9±3.9)points, and (33.9±2.8)points, respectively in the umbilical moxibustion group, (38.7±3.8)points, (32.9±3.6)points, and (30.3±2.2)points, respectively in the exercise group, and (34.2±3.6)points, (30.2±2.6)points, and (27.9±1.3)points, respectively in the combination group, which were all significantly lower than those in the conventional nursing group [(50.9±4.9)points, (50.0±4.9)points, and (40.7±4.2)points] ( P<0.05), with the combination group showing lower scores than those in the umbilical moxibustion group and exercise group ( P<0.05). At 1 month, 3 months postoperatively, and at the last follow-up, the SF-36 physical health scores were (60.6±3.7)points, (76.1±3.5)points, and (78.4±2.6)points, respectively in the umbilical moxibustion group, (57.6±3.7)points, (78.4±3.7)points, and (80.4±3.1)points, respectively in the exercise group, and (65.7±3.1)points, (85.9±2.9)points, and (87.4±2.2)points, respectively in the combination group, which were all significantly higher than those in the conventional nursing group [(47.5±4.6)points, (65.9±4.6)points, and (68.3±4.4)points] ( P<0.05), with the combination group showing higher scores than those in the umbilical moxibustion group and exercise group ( P<0.05). At 1 month, 3 months postoperatively, and at the last follow-up, the SF-36 mental health scores were (59.7±4.1)points, (74.5±3.6)points, and (76.2±3.0)points, respectively in the umbilical moxibustion group, (59.4±4.6)points, (74.1±3.8)points, and (74.4±3.9)points, respectively in the exercise group, and (66.9±4.1)points, (81.6±3.3)points, and (79.9±3.7)points, respectively in the combination group, which were all significantly higher than those in the conventional nursing group [(52.8±5.2)points, (64.0±4.9)points, and (65.3±5.1)points] ( P<0.05), with the combination group showing higher scores than those in the umbilical moxibustion group and exercise group ( P<0.05). Conclusion:For elderly patients with intertrochanteric femoral fracture combined with frailty, umbilical moxibustion combined with a multi-component exercise program can significantly improve hip function, reduce frailty and fall risk, and enhance quality of life.

Objective To explore the mechanism of action of Neiyi Soft Extract in the treatment of endometriosis(EMS)based on network pharmacology and transcriptomics.Methods A model of SD rat with EMS was replicated by autotransplantation method.After successful modeling,the rats were randomly divided into model group,Neiyi Soft Extract low-,medium-and high-dose groups and dienogest group,with 10 rats in each group.Another sham-operated group(10 rats)was set up.After four consecutive weeks of intervention,the volume size of the endometriotic lesions was measured,and its pathological changes were detected by hematoxylin-eosin(HE)staining.RNA was extracted from the rat lesions for transcriptomic sequencing,and Gene Ontology(GO)enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)functional enrichment analysis were performed on the differential genes among various groups.The main active ingredients and their targets of Neiyi Soft Extract were collected and screened in databases such as TCMSP,the disease targets of EMS were collected through databases such as OMIM,the intersection targets between the drug ingredient targets and the diseases were obtained by using Venn diagrams,GO enrichment analysis and KEGG pathway enrichment analysis of genes in the intersection targets of the drug ingredients and the diseases were performed by using gene enrichment analysis online tool(Metascape).The network pharmacology enrichment pathway and transcriptomics enrichment pathway were taken for intersection,the mRNA and protein expression levels of the key targets on the intersection pathway were correspondingly detected by real-time quantitative polymerase chain reaction(qPCR)and Western Blot,respectively.Results The volume of lesions in the model group was significantly increased compared with that of the sham-operated group(P<0.01);the volume of lesions in rats in the drug-administered groups was significantly reduced compared with that of the model group(P<0.05).A total of 341 active ingredients were obtained from Neiyi Soft Extract,and there were 2 178 disease-related targets of EMS,and 278 intersections between drug targets and disease targets;189 differential genes were screened in the sham-operated group and the model group;255 differential genes were screened in the model group and Neiyi Soft Extract high-dose group;and 740 differential genes were screened in the sham-operated group and the Neiyi Soft Extract high-dose group,including 390 up-regulated genes and 350 down-regulated genes.The result of intersection of KEGG enrichment pathways between the network pharmacology and transcriptomics showed that the distriution mainly included P53 signaling pathway,FOXO signaling pathway,cell cycle,etc.The qPCR and Western Blot validation results showed that Neiyi Soft Extract could inhibit the proliferation of endometrial stromal cells and up-regulated the mRNA and protein expression levels of BAX,Caspase3 in EMS rats(P<0.05 or P<0.01),and down-regulated BCL-2 mRNA and protein expression levels(P<0.05 or P<0.01).Conclusion Neiyi Soft Extract may play a therapeutic role in the treatment of EMS by regulating the P53 signaling pathway.

Objective To explore the expression level of zinc finger CCCH-type containing 13 (ZC3H13)in gastric cancer based on bioinformatics techniques,along with clinicopathological stag-ing,prognostic survival,immune infiltration,correlation analysis,protein-protein interactions,and enrichment analysis.Methods Using the UALCAN database and the Gene Expression Profiling Inter-active Analysis(GEPIA)databases,the expression differences of ZC3H13 between normal gastric tis-sues and gastric cancer tissues,as well as the significance of clinical pathological data were compared.The correlation between ZC3H13 expression levels in gastric cancer tissues and patient survival progno-sis was assessed using univariate survival analysis through the Kaplan-Meier Plotter website and the GEPIA database.The relationship between ZC3H13 expression and immune infiltration levels in gastric cancer was explored using the Tumor Immune Estimation Resource(TIMER)database.Co-expression genes significantly correlated with ZC3H13 expression in gastric cancer were identified through the Linkedomics database.The protein-protein interaction network of ZC3H13 and its common target genes in gastric cancer was constructed using the STRING website,followed by Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses.Results Compared to normal gastric tissues,ZC3H13 was significantly upregulated in gastric cancer,and its high ex-pression was closely associated with patient age,ethnicity,tissue subtype,and other factors.Pa-tients with high ZC3H13 expression showed no statistically significant difference in overall survival(OS)or progression-free survival(PFS)time compared to patients with low expression(P＞0.05).Immune analysis revealed a significant negative correlation between ZC3H13 expression and the infiltration density of CD8+T cells,macrophages,neutrophils,and dendritic immune cells in gastric cancer(P＜0.05).Correlation analysis showed that ZC3H13 expression in gastric cancer was significantly positively correlated with the gene expression of DAK,DDK1,and BCL7C,and negatively correlated with the expression of FAM10A4,SLC6A7,and TAC1(P＜0.05).The pro-tein interaction network indicated that proteins interacting with ZC3H13 in gastric cancer included VIRMA,WTAP,METTL3,METTL14,RBM15,and others.Enrichment analysis revealed that dif-ferentially expressed genes in gastric cancer were mainly enriched in RNA polymerase,nucleotide excision repair,thyroid hormone signaling pathway,and other pathways.Conclusion ZC3H13 is overexpressed in gastric cancer,and its elevated expression is linked to the clinicopathological stage,patient survival time,and immune cell infiltration levels.Additionally,ZC3H13 may partici-pate in the initiation and progression of gastric cancer through interactions with key molecules such as VIRMA and METTL3.These findings suggest that ZC3H13 could serve as a potential biomarker and therapeutic target for gastric cancer prognosis.

Purpose To investigate the relationship between FN1 expression and clinical and pathologic features of laryngeal squamous cell carcinoma(LSCC)and the expression of tumor-associated macrophages(TAMs).Methods LSCC datasets GSE33232 and GSE84957 were analyzed and screened the differentially expressed gene FN1,and draw the receiver operating characteristic(ROC)curve.Bioinformatics analysis of FN1 expression,and prognosis in LSCC was performed.To investigate the effect of down-regulating FN1 expression in TU177 cells on the malignant bio-logical behavior of LSCC,we performed a scratch wound healing assay and a Transwell chamber assay to assess the effect of FN1 on cell proliferation,migration,and invasion in vitro.Immunohistochemical(IHC)staining was per-formed to detect the expression of FN1 and CD 163 in LSCC tissues.Results Analysis of the GSE33232 and GSE84957 datasets and online databases showed that FN1 was significantly overexpressed in LSCC tissues(P＜0.05),and patients with high FN1 expression had a significantly lower recurrence-free survival rate(HR=1.6,P=0.017).After transfection with si-FN1,the expression of FN1 in TU177 cells was significantly reduced(0.34±0.02 vs 1.00±0.03,P＜0.01).Compared with the control group,the down-regulation of FN1 expression inhibited the in vitro migra-tion(56.1±3.1 vs 19.23±1.0)and invasion(480±23 vs 288±20)ability of TU177 cells(both P＜0.01).Im-munohistochemistry findings showed that FN1 was highly expressed in both the tumor parenchyma(nest)and stromal cells of LSCC tissue,with a statistically significant difference[52.1％(24/46)vs 71.7％(33/46),P＜0.001].It was found that high expression of N-FN1 was associated with patients' pathological grade and lymph node metastasis(P＜0.05),while high expression of S-FN1 was associated with patients' age,lymph node metastasis,and TNM stage(P＜0.05).In addition,the co-expression of FN1 and CD163 was correlated with patients' pathological grad-ing,lymph node metastasis,and TNM stage(all P＜0.05).Conclusion FN1 and CD163 exhibit high expression levels in LSCC patients,which are closely associated with malignant progression,including invasion and metastasis.Notably,during LSCC progression,there may be a potential synergistic interaction between FN1 and CD 163-positive macrophages in the tumor microenvironment.

Objective To analyze the prevalence of latent tuberculosis infection(LTBI)among relevant healthcare workers(HCWs)in designated tuberculosis medical institutions(MIs)in Yantai City,and explore its influencing factors.Methods The cluster random sampling method was adopted to select two county-and district-level desig-nated tuberculosis MIs.All HCWs underwent questionnaire survey and creation tuberculin skin test(C-TST)at the same time,and the influencing factors for LTBI were analyzed.Results A total of 215 HCWs from designated tu-berculosis MIs were included for analysis,37 were diagnosed with LTBI,with an infection rate of 17.21％(95％CI:12.42％-22.93％).Multivariate logistic regression analysis showed that clinicians(OR=3.19,95％CI:1.05-9.69),laboratory technician(OR=5.90,95％CI:1.21-28.77),working years≥10 years(OR=3.31,95％CI:1.39-7.90),and tuberculosis history of family members(OR=6.49,95％CI:1.01-41.46)were independent risk factors for LTBI.Conclusion The infection risk of clinicians and laboratory technicians who directly contact with tuberculosis patients or Mycobacterium tuberculosis is higher than that of other HCWs,and is related to the length of working years.It is suggested that healthcare-associated infection control measures should be streng-thened,and tuberculosis active screening should be carried out regularly for HCWs in key departments.

Background: Intraoperative hypercapnia reduces the time to emergence from volatile anesthetics, but few clinical studies have explored the effect of hypercapnia on the emergence time from intravenous (IV) anesthesia. We investigated the effect of inducing mild hypercapnia during the recovery period on the emergence time after total IV anesthesia (TIVA). Methods: Adult patients undergoing transurethral lithotripsy under TIVA were randomly allocated to normocapnia group (end-tidal carbon dioxide [ETCO2] 35–40 mmHg) or mild hypercapnia group (ETCO2 50-55 mmHg) during the recovery period. The primary outcome was the extubation time. The spontaneous breathing-onset time, voluntary eye-opening time, and hemodynamic data were collected. Changes in the cerebral blood flow velocity in the middle cerebral artery were assessed using transcranial Doppler ultrasound. Results: In total, 164 patients completed the study. The extubation time was significantly shorter in the mild hypercapnia (13.9 ± 5.9 min, P = 0.024) than in the normocapnia group (16.3 ± 7.6 min). A similar reduction was observed in spontaneous breathing-onset time (P = 0.021) and voluntary eye-opening time (P = 0.008). Multiple linear regression analysis revealed that the adjusted ETCO2 level was a negative predictor of extubation time. Middle cerebral artery blood flow velocity was significantly increased after ETCO2 adjustment for mild hypercapnia, which rapidly returned to baseline, without any adverse reactions, within 20 min after extubation. Conclusions Mild hypercapnia during the recovery period significantly reduces the extubation time after TIVA. Increased ETCO2 levels can potentially enhance rapid recovery from IV anesthesia.

Background: Intraoperative hypercapnia reduces the time to emergence from volatile anesthetics, but few clinical studies have explored the effect of hypercapnia on the emergence time from intravenous (IV) anesthesia. We investigated the effect of inducing mild hypercapnia during the recovery period on the emergence time after total IV anesthesia (TIVA). Methods: Adult patients undergoing transurethral lithotripsy under TIVA were randomly allocated to normocapnia group (end-tidal carbon dioxide [ETCO2] 35–40 mmHg) or mild hypercapnia group (ETCO2 50-55 mmHg) during the recovery period. The primary outcome was the extubation time. The spontaneous breathing-onset time, voluntary eye-opening time, and hemodynamic data were collected. Changes in the cerebral blood flow velocity in the middle cerebral artery were assessed using transcranial Doppler ultrasound. Results: In total, 164 patients completed the study. The extubation time was significantly shorter in the mild hypercapnia (13.9 ± 5.9 min, P = 0.024) than in the normocapnia group (16.3 ± 7.6 min). A similar reduction was observed in spontaneous breathing-onset time (P = 0.021) and voluntary eye-opening time (P = 0.008). Multiple linear regression analysis revealed that the adjusted ETCO2 level was a negative predictor of extubation time. Middle cerebral artery blood flow velocity was significantly increased after ETCO2 adjustment for mild hypercapnia, which rapidly returned to baseline, without any adverse reactions, within 20 min after extubation. Conclusions Mild hypercapnia during the recovery period significantly reduces the extubation time after TIVA. Increased ETCO2 levels can potentially enhance rapid recovery from IV anesthesia.

Background: Intraoperative hypercapnia reduces the time to emergence from volatile anesthetics, but few clinical studies have explored the effect of hypercapnia on the emergence time from intravenous (IV) anesthesia. We investigated the effect of inducing mild hypercapnia during the recovery period on the emergence time after total IV anesthesia (TIVA). Methods: Adult patients undergoing transurethral lithotripsy under TIVA were randomly allocated to normocapnia group (end-tidal carbon dioxide [ETCO2] 35–40 mmHg) or mild hypercapnia group (ETCO2 50-55 mmHg) during the recovery period. The primary outcome was the extubation time. The spontaneous breathing-onset time, voluntary eye-opening time, and hemodynamic data were collected. Changes in the cerebral blood flow velocity in the middle cerebral artery were assessed using transcranial Doppler ultrasound. Results: In total, 164 patients completed the study. The extubation time was significantly shorter in the mild hypercapnia (13.9 ± 5.9 min, P = 0.024) than in the normocapnia group (16.3 ± 7.6 min). A similar reduction was observed in spontaneous breathing-onset time (P = 0.021) and voluntary eye-opening time (P = 0.008). Multiple linear regression analysis revealed that the adjusted ETCO2 level was a negative predictor of extubation time. Middle cerebral artery blood flow velocity was significantly increased after ETCO2 adjustment for mild hypercapnia, which rapidly returned to baseline, without any adverse reactions, within 20 min after extubation. Conclusions Mild hypercapnia during the recovery period significantly reduces the extubation time after TIVA. Increased ETCO2 levels can potentially enhance rapid recovery from IV anesthesia.

Purpose To investigate the relationship between FN1 expression and clinical and pathologic features of laryngeal squamous cell carcinoma(LSCC)and the expression of tumor-associated macrophages(TAMs).Methods LSCC datasets GSE33232 and GSE84957 were analyzed and screened the differentially expressed gene FN1,and draw the receiver operating characteristic(ROC)curve.Bioinformatics analysis of FN1 expression,and prognosis in LSCC was performed.To investigate the effect of down-regulating FN1 expression in TU177 cells on the malignant bio-logical behavior of LSCC,we performed a scratch wound healing assay and a Transwell chamber assay to assess the effect of FN1 on cell proliferation,migration,and invasion in vitro.Immunohistochemical(IHC)staining was per-formed to detect the expression of FN1 and CD 163 in LSCC tissues.Results Analysis of the GSE33232 and GSE84957 datasets and online databases showed that FN1 was significantly overexpressed in LSCC tissues(P＜0.05),and patients with high FN1 expression had a significantly lower recurrence-free survival rate(HR=1.6,P=0.017).After transfection with si-FN1,the expression of FN1 in TU177 cells was significantly reduced(0.34±0.02 vs 1.00±0.03,P＜0.01).Compared with the control group,the down-regulation of FN1 expression inhibited the in vitro migra-tion(56.1±3.1 vs 19.23±1.0)and invasion(480±23 vs 288±20)ability of TU177 cells(both P＜0.01).Im-munohistochemistry findings showed that FN1 was highly expressed in both the tumor parenchyma(nest)and stromal cells of LSCC tissue,with a statistically significant difference[52.1％(24/46)vs 71.7％(33/46),P＜0.001].It was found that high expression of N-FN1 was associated with patients' pathological grade and lymph node metastasis(P＜0.05),while high expression of S-FN1 was associated with patients' age,lymph node metastasis,and TNM stage(P＜0.05).In addition,the co-expression of FN1 and CD163 was correlated with patients' pathological grad-ing,lymph node metastasis,and TNM stage(all P＜0.05).Conclusion FN1 and CD163 exhibit high expression levels in LSCC patients,which are closely associated with malignant progression,including invasion and metastasis.Notably,during LSCC progression,there may be a potential synergistic interaction between FN1 and CD 163-positive macrophages in the tumor microenvironment.