Objective:To investigate the effects of Xiaomudan Granules on PERK/eIF2α/ATF4 pathway and lipid metabolism in NAFLD mice.Methods:Totally 60 mice were divided into a normal group of 10 mice and a high-fat diet group of 50 mice. The high-fat diet group was given a high-fat diet to establish a NAFLD mouse model. The high-fat feed group was divided into model group, metformin group, and Xiaomudan Granules low-, medium-, and high-dosage groups according to the random number table method. Xiaomudan Granules low-, medium-, and high-dosage groups were orally administered with concentrated Xiaomudan Granules at dosages of 11.7, 23.4, and 46.8 g/kg, respectively. The metformin group was orally administered with metformin solution at a dose of 0.2 g/kg, while the normal group and model group were orally administered with distilled water of equal volume once a day for 8 consecutive weeks. The liver oil red O staining of mice was observed in each group. The protein expressions of p-PERK, p-eIF2α, ATF4, C/EBP homologous protein (CHOP), CCAAT enhancer binding protein alpha (C/EBPα), C/EBPβ, and steroid regulatory element binding protein 2 (SREBP2) were detected by Western blot. Fluorescence quantitative PCR was used to detect the mRNA expressions of ATF4, CHOP, C/EBPα, C/EBPβ, and SREBP2.Results:The liver tissue structure and steatosis of mice were improved in Xiaomudan Granules groups. Compared with the model group, the expressions of p-PERK/PERK, ATF4, C/EBPα, C/EBPβ, and SREBP2 proteins decreased in Xiaomudan Granules groups and the metformin group ( P<0.01 or P<0.05). The expressions of p-eIF2α/eIF2α and CHOP proteins decreased in the Xiaomudan Granules medium- and high-dosage groups and the metformin group ( P<0.01); compared with the model group, the levels of ATF4, CHOP, C/EBPα, and C/EBPβ mRNA in Xiaomudan Granules groups and the metformin group decreased ( P<0.01), while the levels of SREBP2 mRNA in the Xiaomudan Granules medium- and high-dosage groups and the metformin group decreased ( P<0.01). Conclusion:Xiaomudan Granules may improve liver lipid metabolism and reduce liver fat deposition in NAFLD mice by regulating the PERK/eIF2α/ATF4 pathway.

ObjectiveTo study the relationship between qi stagnation constitution and suboptimal health status (SHS) or lifestyle.MethodsFrom 2012 to 2013, we conducted a cross-sectional survey of 24 159 Chinese individuals aged 12–80 years. The qi stagnation constitution was assessed using the Constitution in Chinese Medicine Questionnaire. Health status was evaluated through medical records and the Subhealth Measurement Scale V1.0 (SHMS V1.0). Health-promoting lifestyles were measured using the Health-Promoting Lifestyle Profile II (HPLP-II).ResultsOf the 24 159 participants, 16.1% and 15.2% were classified as “always” and “sometimes” having the qi stagnation constitution, respectively. Those classified as “rarely” having the qi stagnation constitution scored higher on both the HPLP-II and SHMS V1.0. The participants classified as “always” having the qi stagnation constitution showed a significant association with SHS or disease compared to other imbalanced constitutions. Those in the “always” category were approximately 21 times more likely to be classified as having SHS (odds ratio [OR]: 21.17, 95% confidence interval [CI]: 15.74–28.45), whereas those in the “sometimes” category were approximately six times more likely (OR: 5.89, 95% CI: 5.04–6.90). Accordingly, the qi stagnation constitution score was significantly associated with the diagnosis of SHS, with an area under the curve of 0.77 (P .001). A score of 18.75 yielded the highest Youden Index (0.407), with a sensitivity of 60.5% and a specificity of 80.3%. Significant associations were observed between health-promoting lifestyles and qi stagnation constitution severity in an ordinal regression analysis (P .001). Protective factors included stress management (OR: 1.59), self-actualization (OR: 1.57), and exercise (OR: 1.36). In contrast, poorer interpersonal relationships (OR: 0.79), greater health responsibilities (OR: 0.86), and poorer nutrition (OR: 0.91) were associated with increased severity.ConclusionModulating the qi stagnation constitution through lifestyle interventions may help prevent the progression of SHS to disease, which aligns with core preventive principles in traditional Chinese medicine.

Objective To establish and verify the microscopic review rules of Dirui GMD-S600 gynecologi-cal secretion analysis system.Methods A total of 2 619 samples of vaginal secretions were collected and test-ed for tangible components and dry chemistry items using the Dirui GMD-S600 gynecological secretions analy-sis system.All samples were subjected to manual microscope examination using a double blind method,and the results of instrument testing,manual image review of instrument testing,and manual microscope examina-tion were recorded separately.Using the results of manual microscope examination as the standard,the false negative rates and the false positive rates of instrument testing results and tangible component results after manual image review of instrument testing were analyzed.At the same time,the false negative rates and the false positive rates of instrument detection dry chemistry items and their corresponding tangible components were analyzed,and the review rules were derived based on this.Subsequently,344 samples were selected to verify the effectiveness of the review rules.Results The false positive rates of white blood cells,fungi,trichomonas and clue cells detected by the instrument were 28.77%,14.71%,20.09%and 2.30%,and the false negative rates were 0.28%,15.06%,4.35%and 10.34%.After manual image review and correction,the false positive rates of white blood cells,fungi,trichomonas and clue cells were 28.77%,7.06%,8.67%,0.66%,and the false negative rates were 0.28%,3.35%,4.35%and 10.34%.The false positive rates of white blood cell esterase(LE)for white blood cells,N-acetylhexylglucosidase(NAG)for fungi,NAG for trichomonas,hydrogen peroxide(H2O2)for bacteria,lactic acid(LA)for bacteria,sialidase(SNA)for clue cells,and proline aminopeptidase(PIP)for clue cells were 13.83%,22.47%,24.10%,95.52%,2.52%,12.92%and 5.54%,and the false negative rates were 28.17%,48.12%,0.00%,23.55%,78.82%,0.00%and 74.14%.The false positive rate of 260 validation samples was 1.68%,the false negative rate was 4.22%,and the review rate was 45.38%.Conclusion The review rules of the Dirui GMD-S600 gynecological secretion analysis system are as follows(1)All specimens need to be reviewed with images,and the following rules are based on this rule.(2)When the result of white blood cell shows positive,then the microscopic exam-ination is required.(3)When the result of fungi shows positivity,then the microscopic examination is re-quired.(4)When the result of trichomonas shows positive,then the microscopic examination is required.(5)When the result of SNA does not match the positive result of clue cells,then the microscopic examination is required.

Objective:To evaluate the fetal adrenal gland volume (AGV) and corrected adrenal gland volume (cAGV) in intrauterine growth restriction (IUGR) fetuses and observe their associations with the adverse perinatal outcomes.Methods:From February 2021 to August 2022, 32 IUGR fetuses who underwent fetal ultrasound examination in the Second Xiangya Hospital of Central South University were prospectively selected as the IUGR group, and 32 normal fetuses matched for gestational age during the same period were selected as the control group. Three-dimensional ultrasound was used to obtain fetal adrenal volume images, and the virtual organ computer-aided analysis (VOCAL) was used to measure AGV, then the cAGV was calculated. The values of AGV and cAGV were appropriately compared between the IUGR and the control groups. The pregnancy outcomes were noted. Multiple logistic regression analysis was employed to evaluate the relationship between the cAGV and adverse perinatal outcomes in IUGR fetus, with maternal age and the CPR included as covariates to control for confounding factors.Results:A total of 32 fetuses with IUGR and 32 controls were involved in this prospective study. There was no significant difference in the AGV between these two groups ( P=0.417). The cAGV of the IUGR fetus was substantially larger than that of the normal fetus ( P=0.034). In the multivariate logistic regression analysis, after adjusting for maternal age and fetal CPR, the fetal cAGV was noticeably associated with the fetal distress (adjusted OR=0.005, 95% CI=0.000-0.587, P=0.029) and the total adverse perinatal outcomes (adjusted OR=0.014, 95% CI=0.000-0.475, P=0.018). Conclusions:The value of cAGV is increased in the IUGR fetuses and associated with adverse perinatal outcomes. The evaluation of fetal AGV could be beneficial to monitoring and managing IUGR fetuses.

With the development of medical technology, the survival rate of cancer patients continues to improve, and the number of stoma patients is increasing day by day. Self-management refers to patients monitoring and managing their own diseases to maintain and improve physical health. Good self-management ability can enhance patient treatment compliance, reduce the incidence of stoma and surrounding complications, improve health outcomes, and raise patient quality of life. This article reviews the research progress on self-management of stoma patients, with the aim of providing reference for research on self-management of stoma patients.

The symptoms of prostate cancer and the complications caused by treatment have a serious impact on the quality of life of prostate cancer patients. Conducting symptom assessment on patients is beneficial for judging disease progression and prognosis, and can provide a basis for symptom management and subsequent treatment, thereby improving their quality of life. This article reviews the symptom assessment tools for prostate cancer, including their evaluation content, reliability and validity, scoring methods, application status, and evaluation. The aim is to provide reference for the selection and development of symptom assessment tools for prostate cancer patients.

Objective:To investigate the construction of ostomy nurse-led clinics in tertiary hospitals in China.Methods:Using the convenient method, managers of ostomy nurse-led clinics in tertiary hospitals in 31 provinces, autonomous regions and municipalities in China in August 2020 were selected as the survey objects. Questionnaire for Survey on Status Quo of Ostomy nurse-led clinics in ClassⅢ Grade A hospital in China was used to investigate. A total of 367 questionnaires were recovered in this survey, 313 valid questionnaires were recovered, and the effective recovery rate was 85.29%.Results:A total of 313 tertiary hospitals have set up ostomy nurse-led clinics. Among the ostomy nurse-led clinics, 86.58% (271/313) of the ostomy specialist nursing outpatient visits were independent visits by nurses. The opening period of stoma clinic was (6.27±4.08) years and the weekly opening time was (5.30±3.93) half-days. The average monthly outpatient number was 100, with a minimum of 4 and a maximum of 3 000. In terms of job management, 50.48% (158/313) of the stoma specialist nursing outpatient jobs were part-time, managers were mostly undergraduates (74.44%, 233/313) , the professional title of managers was mostly nurse in charge (48.24%, 151/313) , 38.98% (122/313) of hospitals had promotion system and 36.74% (115/313) of hospitals had performance management system. There were large differences in environmental layout, facilities and equipment, goods management and specialist management and there was no unified standard.Conclusions:There are great differences in the construction of ostomy nurse-led clinics in tertiary hospitals in China, which need to be further standardized and unified. It is suggested that relevant departments should introduce relevant policies to encourage the establishment of full-time nurse posts in ostomy nurse-led clinics, guarantee the training, promotion and performance reward of visiting nurses and fully encourage the subjective initiative of ostomy specialist nurses to promote their career development.

Objective:To compile the post quality standard scale for wound, ostomy and continence nurses in China and to test the reliability and validity of the scale.Methods:The first draft of the scale was formed through literature review, semi-structured interview and Delphi expert letter consultation. Using the purposive sampling method, a total of 796 wound, ostomy and continence nurses from 31 provinces, municipalities and autonomous regions of China were selected from April to May 2019 to test the reliability and validity of the scale. A total of 796 questionnaires were sent out and 693 were effectively received, with effective recovery of 87.1%.Results:The post quality standard scale for wound, ostomy and continence nurses included 3 first-level items and 77 second-level items. Three common factors were extracted from exploratory factor analysis and the cumulative variance contribution rate was 72.466%. The correlation coefficient between the first-level items was 0.709-0.898 and the correlation coefficient between the first-level item and the total scale was 0.859-0.937. The Cronbach's α coefficient of the total amount table was 0.992 and the half-fold reliability coefficient was 0.917 ( P<0.01) . Conclusions:The post quality standard scale for wound, ostomy and continence nurses has good reliability and validity, which can be used to evaluate the post quality of wound, ostomy and continence nurses.

Objective:To retrieve, evaluate and summarize the relevant evidence of mechanical prevention of venous thromboembolism (VTE) in adult patients undergoing abdominal and pelvic surgery, so as to provide a scientific basis for clinical practice.Methods:We systematically retrieved and screened the guide network and database for evidence on mechanical prevention of VTE in adult patients undergoing abdominal and pelvic surgery, including guidelines, evidence summary, clinical decision-making, systematic review, and expert consensus. The search time limit was to build the database until January 19, 2020. Two researchers who had undergone evidence-based training selected appropriate evaluation tools according to different types of literature to evaluate the quality of the literature, and to extract, translate and integrate recommendations.Results:A total of 24 articles were included, including 7 guidelines, 2 evidence summaries, 1 recommended practice, 12 systematic reviews, and 2 expert consensus. The evidence was summarized from 6 aspects, namely admission assessment, contraindications, applicable population, starting time, duration and patient education, and a total of 10 recommendations were formed.Conclusions:This study summarizes the best evidence for mechanical prevention of VTE in adult patients undergoing abdominal and pelvic surgery, and provides evidence-based evidence for standardizing clinical mechanical prevention.

Objective:To construct a position responsibilities index system of wound, ostomy and continence nurses (WOCN) based on the Delphi method.Methods:Through literature review, semi-structured interviews, and investigation and research on the current working situation of WOCN, the expert inquiry questionnaire was self-designed with reference to opinions of the expert coordination group. From January to April 2019, a total of 45 senior experts including professional doctors, WOCN representatives, representatives of international Enterostomal Therapist Training Program (ETNEP) and chairmen of various provincial professional committees in China were invited to conduct 3 rounds of Delphi expert consultation, and construct the position responsibilities index system of WOCN.Results:The positive coefficients of the 3 rounds of expert consultation were respectively 100.0% (45/45) , 93.3% (42/45) and 100.0% (42/42) , and the authority coefficient of the experts was (0.92±0.16) . The final position responsibilities index system of WOCN included 5 first-level indexes such as clinical practice, education, research, coordinated management and professional promotion and 33 second-level indexes.Conclusions:The index system constructed in the study clarifies the position responsibilities of WOCN, which helps to provide a certain theoretical basis for the work, performance and classification of specialist nurses.