The relevant laws and regulations regarding the utilization of the deceased as medical research subjects are not yet fully developed in China nowadays. Taking the deceased as research subjects as a starting point， this paper discussed the definition of the deceased and the scope of their interest protection from multiple perspectives. It posited that the scope of interest protection for the deceased encompassed two components： spiritual personality interests and material personality interests represented by the remains. The spiritual personality interests of the deceased included identification information such as name， portrait， reputation， honor， privacy， and personal information， as well as medical and health information. The personal information of the deceased was not directly affected by the individual’s life and death status and remained relatively independent. In terms of ethical review， the research team approached from two perspectives： the remains and the personal information of the deceased. Based on the standard of whether the research subjects involve a human body， research with the remains of the deceased as the medical research subjects was classified as non-clinical research. According to the standard of whether a human body is clinically operated， research with the personal information of the deceased （including medical and health information） as the medical research subjects was recognized as clinical research without human research operation. This approach provided evidence for the application of existing laws and regulations in ethical review and record management. The ethical review of investigator-initiated clinical research conducted in medical and health institutions， as well as the regulatory conditions for exemption from ethical review， were examined. The forms， content， and acquisition of informed consent were summarized， and the risk-benefit characteristics of the research activity were evaluated， with a view to providing a basis for the smooth and compliant implementation of research activities involving the deceased as medical research subjects.

Background Staff in biosafety laboratories (BSL) are more likely to experience occupational burnout and other psychological issues due to their unique working environment and high job demands. However, current research in this field tends to focus on overall analyses, overlooking the internal differences within this group. Objective To explore latent profiles of occupational burnout among BSL workers and their influencing factors, providing a reference for targeted burnout interventions. Methods In 2022, cluster random sampling was used to select 8023 BSL workers in Xinjiang. Data were collected via a questionnaire survey, including a self-designed general information questionnaire, the Maslach Burnout Inventory-General Survey (MBI-GS), and the Effort-Reward Imbalance (ERI) scale, to analyze demographic characteristics, occupational burnout, and job stress status. After data cleaning, latent profile analysis (LPA) was applied to identify burnout profiles, followed by K-means clustering for verification. Logistic regression was used to analyze influencing factors with burnout profiles as the dependent variable. Results After excluding invalid questionnaires, 7924 valid questionnaires were retained, with an recovery rate of 98.77%. The LPA results indicated that occupational burnout among BSL staff was categorized into three latent profiles: a low burnout profile (2208 individuals, 27.86%), a moderate burnout profile (4636 individuals, 58.51%), and a high burnout profile (1080 individuals, 13.63%). A similar grouping was derived from K-means clustering analysis (28.71%, 53.37%, and 17.92%), and a Sankey diagram demonstrated significant overlap between the two classification results. Statistically significant differences were observed across the three latent profiles in all three dimensions of burnout: emotional exhaustion, cynicism, and reduced personal accomplishment. The final logistic regression model revealed that the influencing factors exhibited characteristics of partial overlap and partial differentiation. Among the common influencing factors, the shared protective factors included: age ≥50 years (OR_{moderate burnout}=0.42, OR_{high burnout}=0.45), monthly income of 4000-6000 RMB (OR_{moderate burnout}=0.83, OR_{high burnout}=0.71), good sleep quality (OR_{moderate burnout}=0.70, OR_{high burnout}=0.13) and very good sleep quality (OR_{moderate burnout}=0.51, OR_{high burnout}=0.12), and engaging in physical exercise ≥5 times per week (OR_{moderate burnout}=0.74, OR_{high burnout}=0.48). The protective effects were more pronounced for the high burnout profile. The common risk factors included: 21–30 years of service (OR_{moderate burnout}=1.38, OR_{high burnout}=3.00), ≥31 years of service (OR_{moderate burnout}=1.47, OR_{high burnout}=3.39), working in "other positions" (OR_{moderate burnout}=1.46, OR_{high burnout}=1.56), and occupational stress (ERI>1) (OR_{moderate burnout}=2.62, OR_{high burnout}=3.25), with the risk effects being more significant for the high burnout profile. Regarding differentiated influencing factors, protective factors exclusively associated with the moderate burnout profile included having an associate degree (OR=0.70) and engaging in physical exercise 3-4 times per week (OR=0.74). For the high burnout profile, exclusive protective factors included age 40-50 years (OR=0.56), while exclusive risk factors included having a senior professional title (OR=1.85), holding a managerial role (OR=1.78), a high number of night shifts per month (OR=2.66), and a very high number of night shifts per month (OR=3.93). Conclusion BSL workers exhibit three distinct latent burnout profiles. Occupational burnout requires greater attention, and targeted prevention and intervention strategies should be developed based on worker subtypes.

Objective:This study is to investigate the relationship of parental anger expression and symptoms in children with oppositional defiant disorder(ODD).Methods:Forty-six children with ODD and 46 age-gender-matched normal children participated.The Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5),guided the diagnoses.Parental anger expression and children's anger management were assessed using the State-Trait Anger Expression Inventory-2 and Children Emotion Management Scales.Results:ODD symptoms were directly predicted by maternal anger index(AI)(β=0.13,P＜0.05)and anger expression-out(AX-O)(β=0.25,P＜0.05).Children's anger cope(AC)played a mediating function to maternal AI through ODD symptoms,occupying 13％of the total effect;their AC and anger dysregulation(AD)played a mediating function to maternal AX-Othrough ODD symptoms,accounting for 29％and 18％of the total effect,respectively.Conclusion:It sug-gests that anger cope and anger dysregulation in children with oppositional defiant disordermay may play a media-ting role between maternal anger expression and oppositional defiant disorder symptoms.

Objective To systematically evaluate qualitative studies on the experience of transition from adolescent to adult medical care for patients with congenital heart disease(CHD),and to provide a reference for exploring CHD transition management options and developing intervention strategies.Methods A computerized search of PubMed,Embase,Web of Science,Cochrane Library,EBSCO,CINAHL,China Knowledge Network,Wanfang database,Vipshop database,and China Biomedical Literature Database for qualitative studies on the transition experience of CHD patients from adolescence to adult medical care was conducted for the period from the establishment of the database to April 2023.The quality of the literature was evaluated using the Joanna Briggs Institute(JBI)Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research(2016),and the results were integrated using meta-integration methods.Results A total of 9 studies were included,and 49 research results were extracted,and 11 categories were summarized.The final synthesis included 4 integrated results:①Complex attitudes towards healthcare transition,with both attachment and expectation:attachment to paediatric healthcare providers,expectation of transition to adult healthcare providers.(2)Facing multiple healthcare transition challenges:lack of adequate preparation for healthcare transition,parents withdrawing from the role of disease manager,large differences in services between paediatric and adult healthcare providers.③Expect to receive multiple supports:expect to receive comprehensive health education from healthcare personnel,expect healthcare institutions to set up healthcare transition counselling clinics and achieve handover of illness,expect to receive companionship and support from parents,expect to receive understanding and help from peers.④ Per-ceived benefits of medical transition:increased ability to manage illness,role change and personal growth.Conclusion Adolescents with CHD have a complex experience of transitioning to adult healthcare,and healthcare professionals should be attentive to their feelings,encourage them to deal with challenges positively,and provide adequate information and joint parental and peer support to facilitate a smooth transition to adult healthcare for adolescents.

This paper reviews the current status, evaluation tools, influencing factors, and intervention measures of social alienation in colorectal cancer patients with enterostomy, in order to provide reference for the research on social alienation in colorectal cancer patients with enterostomy in China.

Objective:To evaluate the methodological quality and measurement characteristics of children's needs assessment tools.Methods:Literature on children's needs assessment tools was searched in Cochrane Library, PubMed, Embase, Web of Science, CINAHL, China National Knowledge Infrastructure (CNKI), WanFang Data, VIP, and China Biology Medicine disc. The search period was from database establishment to April 2, 2023. The Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) guideline was used to evaluate the methodological quality and measurement characteristics of assessment tools, and integrate the evaluation results to form recommendations.Results:Six studies were included in total. The recommended opinions for the two evaluation tools (Needs of Children Questionnaire and Male Adolescent Health Needs-Assessment Scale) were A level. The recommended opinions for the four evaluation tools were B level. The Male Adolescent Health Needs-Assessment Scale had high cultural specificity.Conclusions:The evidence quality of the Needs of Children Questionnaire is relatively high and can be temporarily recommended for use, but other measurement characteristics still need further verification.

Objective:To develop a limb function exercise program for patients on extracorporeal membrane oxygenation (ECMO) and provide theoretical guidance for clinical nursing staff.Methods:A research team was formed to systematically review domestic and international literature on functional exercise for ECMO patients, extracting relevant evidence to form the initial version of the limb function exercise program. From June to July 2023, the Delphi method was used to conduct two rounds of expert consultations with 18 experts from three provinces and municipalities directly under the central government, including Shanghai, Jiangsu, and Shanxi. Based on the experts' feedback, the program items were revised to form the final version of the exercise program.Results:In the first round, 18 experts were consulted, with a valid response rate of 94.44% (17/18); in the second round, 17 experts participated, with a 100.00% (17/17) response rate. The expert authority coefficient was 0.859 in both rounds. The coefficient of variation for each level of indicator in the second round ranged from 0 to 0.160, and Kendall's coefficient of concordance was 0.092 to 0.130 ( P<0.01). The final ECMO patient limb function exercise program consisted of four primary indicators (preparation, assessment, exercise methods, and safety monitoring), 13 secondary indicators, and 44 tertiary indicators. Conclusions:The ECMO patient limb function exercise program developed in this study is scientifically sound and reliable, offering a reference and guidance for the implementation of limb function exercises for ECMO patients.

Objective To conduct a scoping review of virtual reality motor sensing exercise in the elderly with dementia,so as to identify the types of intervention,outcome indicators,evaluation tools and application effects of virtual reality motor sensing exercise and provide guidance for future research.Methods A literature search was performed in the PubMed,Embase,CINAHL,Web of Science,Cochrane Library,CNKI,Wanfang,VIP,and CMB databases to identify relevant studies.The search period is from the establishment of databases to October 15,2023.The included studies were summarized and analyzed.Results A total of 18 articles were included in this study,including 14 randomised controlled trials,one class-experimental study and three mixed studies involving a total of 1,054 elderly dementia patients.The types of virtual reality motor sensing exercise included motor sensing interactive games,interactive bicycle riding,remote game exercise,Wii Fit exercise and virtual reality environment exercise.The outcome indicators involve 4 aspects of physical indicators,psychological indicators,cognitive function and quality of life.Conclusion Virtual reality motor sensing exercise is feasible and effective in the elderly with dementia.However,large sample and high-quality randomized controlled trials are still needed in the future to verify the feasibility and application effect of virtual reality exercise in the elderly with dementia,so as to provide evidence-based basis for formulating the best exercise intervention program for the elderly with dementia.

Objective To evaluate and integrate the facilitators and barriers to adherence to diet or exercise interventions in patients with overweight or obesity.Methods PubMed,Web of Science,Embase,CINAHL,Cochrane Library,China National Knowledge Infrastructure,Wanfang,and VIP Chinese Biomedical Literature Database were searched by computer from the establishment of the database to October 14,2023.The 2016 edition of the Joanna Briggs Institute(JBI)evidence-based health care center qualitative research evaluation criteria was used to evaluate and integrate the included literature.Results A total of 19 studies were included,and 38 outcomes were distilled into 12 categories,and the results were consolidated into facilitators(disease threat perception,self-body perception,self-adjustment,sense of responsibility,social support)and barriers to intervention adherence(poor treatment benefit,low self-efficacy,lack of knowledge,competitive priorities,extemal environmental constraints,economic conditions,poor intervention design).Conclusion There are many facilitators and barriers of diet or exercise intervention perceived by patients.It is suggested that follow-up intervention research should be used as a reference to improve the treatment compliance of patients.

Objective:To study the effects of Jianpi Qinghua Decoction on hepatocyte apoptosis under non-alcoholic fatty liver disease (NAFLD), and to discuss its mechanism.Methods:Totally 29 C57 mice were randomly selected and fed a 60% high fat diet for 16 weeks, while the remaining 6 mice were given regular feed as the normal group. After successful modeling, 12 mice with larger body weight were divided into TCM group and model group using a random number table method, while continuing to receive high-fat feed. The TCM group was orally administered Jianpi Qinghua Decoction 20.961 g/kg. The normal group and model group were orally administered an equal volume of distilled water once a day, with continuous intervention for 4 weeks. The levels of GOT and GPT in blood were detected by ELISA, the deposition of triglyceride in liver was detected by oil red O, and the apoptosis of liver cells was detected by TUNEL fluorescence staining. Western blot was used to detect the expressions of cleaved Caspase-3, Caspase-3, Bax, Bcl-2, JNK and p-JNK.Results:Compared with the model group, the body weight and GPT in the TCM group significantly decreased ( P<0.05), TG deposition was significantly reduced, apoptosis range of liver cells was significantly reduced, and cleaved Caspase-3/Caspase-3, p-JNK/JNK and the expression of Bax significantly decreased ( P<0.05). The expression of Bcl-2 increased ( P<0.05). Conclusion:Jianpi Qinghua Decoction can inhibit JNK protein phosphorylation and effectively reduce liver cell apoptosis in NAFLD mice, which may delay the progression of NAFLD towards cirrhosis and liver cancer.