Objective:To investigate the current status of peripherally inserted central catheter (PICC) -associated thrombosis prevention nursing practices among surgical nurses, and to provide a scientific basis for targeted future interventions.Methods:A convenience sampling method was used to select 3 151 surgical nurses from tertiary hospitals in 11 provinces and municipalities who attended the Surgical Nursing Academic Symposium of the Chinese Nursing Association between April and May 2023. The survey utilized a standardized questionnaire assessing current practices in PICC-associated thrombosis prevention among clinical nurses.Results:A total of 3 151 questionnaires were distributed, and 2 341 valid responses were collected, yielding a valid response rate of 74.29% (2 341/3 151) . Among the respondents, the training rate on PICC-associated thrombosis prevention was only 62.45% (1 462/2 341) , and just 1.28% (30/2 341) had received full-time (off-duty) training. The usage rate of standardized procedures for PICC-related thrombosis prevention was 92.40% (2 163/2 341) , and the risk assessment rate was 79.79% (1 868/2 341) . Compared to urology and cardiothoracic surgery departments, breast surgery departments had significantly higher rates of thrombosis risk assessment ( P<0.05) . Additionally, 56.69% (1 327/2 341) of surgical nurses used risk assessment tools specific to PICC-associated thrombosis. Among non-pharmacological prevention measures, the implementation rate of encouraging patients to perform grip strength exercises was only 68.26% (1 598/2 341) . Conclusions:The current level of PICC-associated thrombosis prevention nursing among surgical nurses needs further improvement. Efforts should be strengthened in professional training, implementation of standardized protocols, risk assessment, and non-pharmacological interventions.

It is believed that psoriasis with anxiety and depression presents the pathogenesis of "depression-blood-spirit"， with qi depression as the initiating factor， and that the disease mechanism is understood from three aspects， including "qi depression transforming into fire， blood stasis disturbing the spirit"， "depressed fire consuming yin， causing blood dryness and spirit agitation"， "qi stagnation leading to blood stasis， resulting in obstructed channels and spirit depression". The treatment proposes three methods， firstly， cooling blood and resolving depression， secondly， nourishing blood and soothing depression， and thirdly， activating blood and regulating depression， which applies prescriptions as modified Liangxue Huoxue Decoction （凉血活血汤） combined with Zhiqiao （Poncirus trifoliata）， Foshou （Citrus medica）， and Lianqiaoxin （Forsythia suspensa） for cooling blood and resolving depression； modified Yangxue Jiedu Decoction （养血解毒汤） combined with Baishao （Paeonia lactiflora Pall）， Zhenzhumu （Margaritifera Concha）， and calcined Muli （Ostreidae） for nourishing blood and soothing depression； and modified Huoxue Sanyu Decoction （活血散瘀汤） combined with Yujin （Curcuma aromatica） and Hehuanpi （Albiziae Cortex） for activating blood and regulating depression. These three methods integrate the "depression-blood-spirit" pathogenesis to achieve harmony of body and spirit by clearing blood heat， nourishing yin and blood， and removing blood stasis， complemented with medicinals that soothing the liver， calming the spirit， and regulating depression.

Objective:To investigate the current status of peripherally inserted central catheter (PICC) -associated thrombosis prevention nursing practices among surgical nurses, and to provide a scientific basis for targeted future interventions.Methods:A convenience sampling method was used to select 3 151 surgical nurses from tertiary hospitals in 11 provinces and municipalities who attended the Surgical Nursing Academic Symposium of the Chinese Nursing Association between April and May 2023. The survey utilized a standardized questionnaire assessing current practices in PICC-associated thrombosis prevention among clinical nurses.Results:A total of 3 151 questionnaires were distributed, and 2 341 valid responses were collected, yielding a valid response rate of 74.29% (2 341/3 151) . Among the respondents, the training rate on PICC-associated thrombosis prevention was only 62.45% (1 462/2 341) , and just 1.28% (30/2 341) had received full-time (off-duty) training. The usage rate of standardized procedures for PICC-related thrombosis prevention was 92.40% (2 163/2 341) , and the risk assessment rate was 79.79% (1 868/2 341) . Compared to urology and cardiothoracic surgery departments, breast surgery departments had significantly higher rates of thrombosis risk assessment ( P<0.05) . Additionally, 56.69% (1 327/2 341) of surgical nurses used risk assessment tools specific to PICC-associated thrombosis. Among non-pharmacological prevention measures, the implementation rate of encouraging patients to perform grip strength exercises was only 68.26% (1 598/2 341) . Conclusions:The current level of PICC-associated thrombosis prevention nursing among surgical nurses needs further improvement. Efforts should be strengthened in professional training, implementation of standardized protocols, risk assessment, and non-pharmacological interventions.

Objective:To investigate the effect of mild moxibustion on transient receptor potential vanilloid type 1(TRPV1)channel expression in primary dysmenorrhea(PD)rats and explore its mechanism in alleviating central pain sensitization.Methods:Thirty-two female non-pregnant Wistar rats were randomized into a blank group,a model group,a mild moxibustion group,and a capsazepine group,with 8 rats in each group.Except for the blank group,the other three groups used estradiol benzoate,ice-water bath,and oxytocin to establish the rat PD model of cold-dampness stagnation pattern.The interventions began on day 1 of modeling,once a day,and lasted 10 d.The mild moxibustion group received mild moxibustion at Shenque(CV8)and Guanyuan(CV4),20 min/time;in the capsazepine group,capsazepine was injected at a dose of 2 mg/(kg·bw).The abdominal pain threshold was measured 10-30 min after oxytocin injection on day 11;enzyme-linked immunosorbent assay was used to detect serum prostaglandin F2α(PGF2α)level;the expression of TRPV1,cluster of differentiation 11B(CD11B),and proto-oncogene c-Fos in the spinal dorsal horn and hypothalamus was detected by immunofluorescence and Western blotting.Results:Compared to the blank group,the model group showed a decreased pain threshold(P<0.05)and an increased serum PGF2α level with elevated TRPV1,CD11B,and c-Fos protein expression in the spinal dorsal horn and hypothalamus(P<0.05).Compared to the model group,both the mild moxibustion group and capsazepine group showed significantly increased pain thresholds(P<0.05),along with decreased serum PGF2α levels and reduced protein expression levels of TRPV1,CD11B,and c-Fos in the spinal dorsal horn and hypothalamus(P<0.05).Rat pain threshold in the capsazepine group was higher than that in the mild moxibustion group(P<0.05).Serum PGF2α level,the expression levels of CD11B and c-Fos proteins in the spinal dorsal horn,as well as TRPV1,CD11B,and c-Fos proteins in the hypothalamus of the capsazepine group were lower than those in the mild moxibustion group(P<0.05).Conclusion:Mild moxibustion at Shenque(CV8)and Guanyuan(CV4)may alleviate the central pain sensitization in PD rats by down-regulating TRPV1 channel expression in the spinal dorsal horn and hypothalamus,thus playing an analgesic effect.

Objective:To describe the current status and research methods of external validation studies of risk prediction models conducted by nursing scholars in China.Methods:Using the search terms "predictive model, external validation, nursing, risk prediction, external validation, nursing" this study searched eight databases (China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang Data, VIP, Embase, PubMed, CINAHL, and Web of Science) for studies published up to June 2023. Literature was imported into EndNote software for organization and deduplication. Two researchers independently conducted initial and secondary screenings by reading the titles, abstracts, and full texts of studies according to inclusion and exclusion criteria. Descriptive analysis was conducted on the included studies under the framework of the Joanna Briggs Institute (JBI) scoping review methodology.Results:A total of 70 studies (15 dissertations and 55 journal articles), primarily published from 2021 to 2023, were included. Among 246 risk prediction models constructed by nurses, 28.5% (70/246) underwent external validation. The models focused on issues such as infection, cognitive impairment, skin injury, thrombosis, and malnutrition. Most studies were conducted in single-center settings (71.4%, 50/70), with temporal validation being the most common type (67.1%, 47/70). The majority of models were presented as nomograms, though some studies had methodological issues in validation.Conclusions:In recent years, new prediction models for specific diseases or endpoints have continued to emerge from nursing research in China, yet few have undergone external validation for clinical application, and the quality and methods of validation require improvement. Future researchers should standardize and strengthen the external validation and optimization of risk prediction models, focusing on clinical applicability to enhance the practical value of these models.

Objective:To investigate the effect of mild moxibustion on transient receptor potential vanilloid type 1(TRPV1)channel expression in primary dysmenorrhea(PD)rats and explore its mechanism in alleviating central pain sensitization.Methods:Thirty-two female non-pregnant Wistar rats were randomized into a blank group,a model group,a mild moxibustion group,and a capsazepine group,with 8 rats in each group.Except for the blank group,the other three groups used estradiol benzoate,ice-water bath,and oxytocin to establish the rat PD model of cold-dampness stagnation pattern.The interventions began on day 1 of modeling,once a day,and lasted 10 d.The mild moxibustion group received mild moxibustion at Shenque(CV8)and Guanyuan(CV4),20 min/time;in the capsazepine group,capsazepine was injected at a dose of 2 mg/(kg·bw).The abdominal pain threshold was measured 10-30 min after oxytocin injection on day 11;enzyme-linked immunosorbent assay was used to detect serum prostaglandin F2α(PGF2α)level;the expression of TRPV1,cluster of differentiation 11B(CD11B),and proto-oncogene c-Fos in the spinal dorsal horn and hypothalamus was detected by immunofluorescence and Western blotting.Results:Compared to the blank group,the model group showed a decreased pain threshold(P<0.05)and an increased serum PGF2α level with elevated TRPV1,CD11B,and c-Fos protein expression in the spinal dorsal horn and hypothalamus(P<0.05).Compared to the model group,both the mild moxibustion group and capsazepine group showed significantly increased pain thresholds(P<0.05),along with decreased serum PGF2α levels and reduced protein expression levels of TRPV1,CD11B,and c-Fos in the spinal dorsal horn and hypothalamus(P<0.05).Rat pain threshold in the capsazepine group was higher than that in the mild moxibustion group(P<0.05).Serum PGF2α level,the expression levels of CD11B and c-Fos proteins in the spinal dorsal horn,as well as TRPV1,CD11B,and c-Fos proteins in the hypothalamus of the capsazepine group were lower than those in the mild moxibustion group(P<0.05).Conclusion:Mild moxibustion at Shenque(CV8)and Guanyuan(CV4)may alleviate the central pain sensitization in PD rats by down-regulating TRPV1 channel expression in the spinal dorsal horn and hypothalamus,thus playing an analgesic effect.

Objective:To describe the current status and research methods of external validation studies of risk prediction models conducted by nursing scholars in China.Methods:Using the search terms "predictive model, external validation, nursing, risk prediction, external validation, nursing" this study searched eight databases (China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang Data, VIP, Embase, PubMed, CINAHL, and Web of Science) for studies published up to June 2023. Literature was imported into EndNote software for organization and deduplication. Two researchers independently conducted initial and secondary screenings by reading the titles, abstracts, and full texts of studies according to inclusion and exclusion criteria. Descriptive analysis was conducted on the included studies under the framework of the Joanna Briggs Institute (JBI) scoping review methodology.Results:A total of 70 studies (15 dissertations and 55 journal articles), primarily published from 2021 to 2023, were included. Among 246 risk prediction models constructed by nurses, 28.5% (70/246) underwent external validation. The models focused on issues such as infection, cognitive impairment, skin injury, thrombosis, and malnutrition. Most studies were conducted in single-center settings (71.4%, 50/70), with temporal validation being the most common type (67.1%, 47/70). The majority of models were presented as nomograms, though some studies had methodological issues in validation.Conclusions:In recent years, new prediction models for specific diseases or endpoints have continued to emerge from nursing research in China, yet few have undergone external validation for clinical application, and the quality and methods of validation require improvement. Future researchers should standardize and strengthen the external validation and optimization of risk prediction models, focusing on clinical applicability to enhance the practical value of these models.

Background and purpose:Thyroid dysfunction can frequently be discovered in breast cancer patients during long-term follow-up after receiving post-operative radiation therapy(PORT).This study aimed to compare serum levels of thyroid transcription factors(TTFs)TTF-1 and paired box 8(PAX-8)before and after PORT in breast cancer patients,combined with the results of serological thyroid indicators tests,and to analyze the relationship between the changes in serum levels of these two kinds of TTFs and thyroid dysfunction after breast cancer PORT.Methods:Female breast cancer patients without thyroid disease records who received PORT in Department of Radiation Oncology,Shanghai Ninth People's Hospital Huangpu Branch,Shanghai Jiao Tong University School of Medicine from Jan.2022 to Jun.2022 were prospectively selected,and were divided into two groups according to being with or without supraclavicular radiation field.All the patients had given informed consent before joining the study.The study design was approved by the ethic committee of our hospital(Ethic Approval No.2021-KY-2).Serum levels of TTF-1 and PAX-8,serological thyroid indicators[triiodothyronine(T3),tetraiodothyronine(T4),free triiodothyronine(FT3),free tetraiodothyronine(FT4),thyroid stimulating hormone(TSH)and thyroid peroxidase antibody(TPO-Ab)]were recorded before PORT,at the end of PORT,6,12 and 24 months after the end of PORT,respectively.The Strengthening the Reporting of Observational Studies in Epidemiology(STROBE)checklist was followed for this study.Results:Eighty patients were enrolled in this study(40 in each group).A total of 19 patients who had hypothyroidism were divided in two groups,15 in supraclavicular field group(SC group)and 4 in non-supraclavicular field group(NSC group),respectively(P=0.004).Levels of TTF-1[5.70(5.11,7.13)vs 6.68(5.15,7.57),P=0.296]and PAX-8(5.26±1.01 vs 5.66±1.37,P=0.149)did not show statistically significant deference between two groups before PORT.In SC group,levels of TTF-1 and PAX-8 gradually rose in 12 months after the end of PORT.In NCS group,levels of TTF-1 and PAX-8 did not change significantly during 24 months after the end of PORT.Test results of serum TTF-1 between two groups were statistically different at 6 months[6.99(4.73,13.94)vs 5.79(5.01,6.28),P=0.049],12 months[7.65(5.02,17.85)vs 5.43(4.52,6.22),P=0.005]after the end of PORT,while test results of serum PAX-8 between two groups were statistically different at 12 months[6.79(4.86,14.30)vs 5.81(4.70,7.25),P=0.042]after the end of PORT.The median values of TTF-1 and PAX-8 test results at 12 months after the end of PORT in SC group which were both significantly higher compared with NSC group were selected as the referent thresholds.Patients in SC group whose test results were higher than referent thresholds were defined as TTF-1/PAX-8 elevating subgroups,and patients whose test results under the threshold defined as TTF-1/PAX-8 normal subgroups.The incidences of hypothyroidism were higher in elevation subgroups than in normal subgroups(65.0%vs 10.0%,60.0%vs 15.0%,respectively,P=0.001,P=0.008,respectively).Positive correlations were observed between the elevation of TTF-1/PAX-8 at 12 months after the end of PORT and hypothyroidism after breast cancer supraclavicular field radiation(OR=9.702,3.930,and P=0.020,0.046,respectively)according to multivariate analysis.Conclusion:Thyroid dysfunction after breast cancer PORT was mainly manifested with hypothyroidism;supraclavicular field radiation may significantly increase the incidence of hypothyroidism;serum levels of TTF-1 and PAX-8 elevated obviously in breast cancer PORT patients who had hypothyroidism after receiving supraclavicular field radiation.

Background and purpose:Thyroid dysfunction can frequently be discovered in breast cancer patients during long-term follow-up after receiving post-operative radiation therapy(PORT).This study aimed to compare serum levels of thyroid transcription factors(TTFs)TTF-1 and paired box 8(PAX-8)before and after PORT in breast cancer patients,combined with the results of serological thyroid indicators tests,and to analyze the relationship between the changes in serum levels of these two kinds of TTFs and thyroid dysfunction after breast cancer PORT.Methods:Female breast cancer patients without thyroid disease records who received PORT in Department of Radiation Oncology,Shanghai Ninth People's Hospital Huangpu Branch,Shanghai Jiao Tong University School of Medicine from Jan.2022 to Jun.2022 were prospectively selected,and were divided into two groups according to being with or without supraclavicular radiation field.All the patients had given informed consent before joining the study.The study design was approved by the ethic committee of our hospital(Ethic Approval No.2021-KY-2).Serum levels of TTF-1 and PAX-8,serological thyroid indicators[triiodothyronine(T3),tetraiodothyronine(T4),free triiodothyronine(FT3),free tetraiodothyronine(FT4),thyroid stimulating hormone(TSH)and thyroid peroxidase antibody(TPO-Ab)]were recorded before PORT,at the end of PORT,6,12 and 24 months after the end of PORT,respectively.The Strengthening the Reporting of Observational Studies in Epidemiology(STROBE)checklist was followed for this study.Results:Eighty patients were enrolled in this study(40 in each group).A total of 19 patients who had hypothyroidism were divided in two groups,15 in supraclavicular field group(SC group)and 4 in non-supraclavicular field group(NSC group),respectively(P=0.004).Levels of TTF-1[5.70(5.11,7.13)vs 6.68(5.15,7.57),P=0.296]and PAX-8(5.26±1.01 vs 5.66±1.37,P=0.149)did not show statistically significant deference between two groups before PORT.In SC group,levels of TTF-1 and PAX-8 gradually rose in 12 months after the end of PORT.In NCS group,levels of TTF-1 and PAX-8 did not change significantly during 24 months after the end of PORT.Test results of serum TTF-1 between two groups were statistically different at 6 months[6.99(4.73,13.94)vs 5.79(5.01,6.28),P=0.049],12 months[7.65(5.02,17.85)vs 5.43(4.52,6.22),P=0.005]after the end of PORT,while test results of serum PAX-8 between two groups were statistically different at 12 months[6.79(4.86,14.30)vs 5.81(4.70,7.25),P=0.042]after the end of PORT.The median values of TTF-1 and PAX-8 test results at 12 months after the end of PORT in SC group which were both significantly higher compared with NSC group were selected as the referent thresholds.Patients in SC group whose test results were higher than referent thresholds were defined as TTF-1/PAX-8 elevating subgroups,and patients whose test results under the threshold defined as TTF-1/PAX-8 normal subgroups.The incidences of hypothyroidism were higher in elevation subgroups than in normal subgroups(65.0%vs 10.0%,60.0%vs 15.0%,respectively,P=0.001,P=0.008,respectively).Positive correlations were observed between the elevation of TTF-1/PAX-8 at 12 months after the end of PORT and hypothyroidism after breast cancer supraclavicular field radiation(OR=9.702,3.930,and P=0.020,0.046,respectively)according to multivariate analysis.Conclusion:Thyroid dysfunction after breast cancer PORT was mainly manifested with hypothyroidism;supraclavicular field radiation may significantly increase the incidence of hypothyroidism;serum levels of TTF-1 and PAX-8 elevated obviously in breast cancer PORT patients who had hypothyroidism after receiving supraclavicular field radiation.

Objective To investigate the effects of esketamine on hypoxic-ischemic myocardial injury in neonatal rats based on glycogen synthase kinase-3β/NOD-like receptor thermal protein domain-containing protein 3 (GSK-3β/NLRP3) pathway. Methods Thirty neonatal rats were randomly divided into sham operation group, model group and esketamine group, with 10 rats in each group. The rats in the sham operation group underwent a median incision in the neck to expose the bilateral common carotid arteries; the rats in the model group and the esketamine group underwent ligation of the common carotid arteries combined with a hypoxic environment to establish a model ofischemia and hypoxia; the rats in the esketamine group were given esketamine intervention (50 mg/kg). Left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), serum creatine kinase isoenzyme (CK-MB), cardiac troponin I (cTnI), lactate dehydrogenase (LDH), tumor necrosis factor-α (TNF-α), interleukin (IL)-6 and IL-1β levels, myocardial injury, myocardial cell apoptosis and apoptosis protein caspase 1/3/9 levels, neutrophil infiltration in myocardial tissue, and changes in GSK-3β and NLRP3 protein levels in myocardial tissue were detected in each group. Results Compared with the sham operation group, the LVEF and LVFS were significantly decreased and the LVEDD and LVESD were significantly increased in the model group, while the LVEF and LVFS were significantly higher and the LVEDD and LVESD were significantly lower in the esketamine group than in the model group (P < 0.05). The serum levels of CK-MB, cTnI, LDH, TNF-α, IL-6, IL-1β, myocardial injury and apoptosis, caspase 1/3/9 protein levels in myocardial tissue sections, neutrophil counts, and GSK-3β and NLRP3 protein levels were significantly increased in the model group, and these indicators were significantly lower in the esketamine group than in the model group (P < 0.05). Conclusion Esketamine improves hypoxic-ischemic myocardial injury in neonatal rats by inhibiting inflammation, and its mechanism of action is related to the GSK-3β/NLRP3 pathway.