To develop and validate a model for predicting intensive care unit (ICU) mortality risk in patients with malignant tumors complicated by acute respiratory failure (ARF) based on an explainable machine learning framework.

Ulcerative colitis(UC)is a recurrent,chronic,nonspecific inflammatory bowel disease.Shaoyao Decoction has shown good efficacy in the treatment of UC,which mainly regulates the balance of cytokines to achieve the purpose of treating UC.This article reviewed the research progress in the mechanism of Shaoyao Decoction in the treatment of UC from two aspects of pro-inflammatory cytokines and anti-inflammatory cytokines.Research has shown that Shaoyao Decoction can regulate the body's immune response,alleviate intestinal inflammation,protect the intestinal mucosal barrier,restore normal structure and function of the colon mucosa through pro-inflammatory cytokines such as tumor necrosis factor-α,interferon-γ,interleukin(IL)-1β,IL-6,IL-8,IL-17,and anti-inflammatory cytokines such as transforming growth factor-β,IL-4,IL-10,IL-13,which can provide reference for UC related mechanism research and clinical treatment.

[Objective]To explore the effects of ZHANG's empirical formula directional drug delivery combined with auricular acupressure in treatment for postoperative pain in hand trauma due to Qi stagnation and blood stasis.[Methods]A total of 152 postoperative patients with hand trauma with Qi stagnation and blood stasis who were hospitalized in the Department of Hand and Foot Surgery at Hangzhou Fuyang Hospital of Orthopedics of Traditional Chinese Medicine from September 2023 to January 2024 were selected.The patients were randomly divided into control group,directed group,acupressure group and combined group,with 38 cases in each group.The control group received routine nursing care;the directed group received ZHANG's empirical formula for directed transdermal medication in addition to the regular care;the acupressure group received auricular acupressure treatment in addition to the regular care;and the combined group received both ZHANG's empirical formula for directed transdermal medication and auricular acupressure treatment in addition to the regular care.The numerical rating scale(NRS)pain scores,peripheral blood circulation levels of the affected limb at different time points before and after intervention,clinical efficacy,cumulative use of analgesics within 72 hours post-surgery and the occurrence of adverse reactions were compared among the four groups.[Results]Thirty minutes after intervention,the NRS scores of both combined group and acupressure group were lower than those of the other groups(P<0.05).From 12 to 72 hours after intervention,the NRS scores of combined group remained significantly lower than those of the other groups(P<0.05).The effective rates were 80.6%in control group,85.7%in directed group,88.9%in acupressure group and 91.4%in combined group,with statistically significant differences among the four groups(P<0.05).After intervention,statistically significant differences were observed in peripheral blood circulation of the affected limbs among the four groups(P<0.05),and combined group demonstrated superior outcomes compared with the others.Additionally,significant differences were found in cumulative analgesic consumption within 72 hours of post-surgery(P<0.05),where the control group showed the highest usage while the acupressure group and combined group exhibited the lowest.No adverse reactions were observed in any enrolled patients.[Conclusion]ZHANG's empirical formula directional drug delivery combined with auricular acupressure can effectively alleviate post-operative pain due to Qi stagnation and blood stasis in hand trauma,reduce the cumulative analgesic consumption within 72 hours post-surgery,and improve peripheral blood circulation in the affected limb,making it worthy of further promotion and application in clinical practice.

Objective To explore the current situation and influencing factors of post-intensive care syndrome(PICS)in critically ill patients a month after their transfer out,and to provide a basis for formulating individualized intervention measures.Methods By the convenience sampling method,550 patients who were transferred out of the ICU of a tertiary A hospital in Guizhou Province for a month from April to November 2024 were selected as the survey subjects.The general information of the patients was collected and sorted out.During their stay in the ICU,the Barthel Index,the Richards Campbell Sleep Scale,and the Perceived Social Support Scale were employed for evaluation.A month after the patients were transferred out of the ICU,the assessment was completed through telephone follow-up using the Chinese version of the Brain Care Monitoring Questionnaire for Healthy Aging.According to the assessment a month after the patients were transferred out,they were divided into a PICS group and a non-PICS group.Univariate analysis and binary Logistic regression analysis were completed based on the data of the 2 groups.Results A total of 550 questionnaires were distributed,and 442 valid questionnaires were ultimately collected,with a valid questionnaire collection rate of 80.3％.Among them,194 cases(43.9％)were high-risk patients with PICS.Binary logistic regression analysis showed that advanced age,pulmonary infection,total hospitalization time＞15 days,and internal environment disorder were the risk factors for PICS in ICU patients(P＜0.05).Conclusion The risk of PICS is relatively high in critically ill patients a month after the transfer.Medical staff need to pay attention to patients who are older,have pulmonary infections and internal environment disorders,and formulate personalized intervention measures for different disease types to improve the long-term health prognosis of patients.

Objective To evaluate the methodological quality and measurement attribute quality of the evaluation tool for pediatric palliative care quality assessment tools,and to provide references for medical staff to select the best assessment tools.Methods The PubMed,Embase,Cochrane Library,Web of Science,CINAHL,Scopus,China National Knowledge Infrastructure(CNKI),Wanfang Database,VIP Database,Chinese Biomedical Literature Database,GIN,NGC,NICE,NRAO,medlive,WHO,AAHPM,WHPCA,APHN were searched from inception to March 28,2024.Data were screened and extracted independently by 2 researchers.The consensus-based standards for the selection of health measurement instruments(COSMIN)checklist and quality criteria were employed to evaluate the methodological quality and psychometric properties of the included pediatric palliative care quality assessment tools.Finally,recommendations were formulated based on these evaluations.Results A total of 13 articles were included,involving 9 pediatric palliative care quality assessment tools.Among them,the PICU-QODD,PaPEQu and QCPCI demonstrated good content validity and internal consistency,and are recommended as Grade A.The remaining assessment tools are recommended as Grade B or C.Conclusion The PICU-QODD,PaPEQu and QCPCI are recommended for use,but further validation of their psychometric properties is still needed.

[Objective]To explore the effects of ZHANG's empirical formula directional drug delivery combined with auricular acupressure in treatment for postoperative pain in hand trauma due to Qi stagnation and blood stasis.[Methods]A total of 152 postoperative patients with hand trauma with Qi stagnation and blood stasis who were hospitalized in the Department of Hand and Foot Surgery at Hangzhou Fuyang Hospital of Orthopedics of Traditional Chinese Medicine from September 2023 to January 2024 were selected.The patients were randomly divided into control group,directed group,acupressure group and combined group,with 38 cases in each group.The control group received routine nursing care;the directed group received ZHANG's empirical formula for directed transdermal medication in addition to the regular care;the acupressure group received auricular acupressure treatment in addition to the regular care;and the combined group received both ZHANG's empirical formula for directed transdermal medication and auricular acupressure treatment in addition to the regular care.The numerical rating scale(NRS)pain scores,peripheral blood circulation levels of the affected limb at different time points before and after intervention,clinical efficacy,cumulative use of analgesics within 72 hours post-surgery and the occurrence of adverse reactions were compared among the four groups.[Results]Thirty minutes after intervention,the NRS scores of both combined group and acupressure group were lower than those of the other groups(P<0.05).From 12 to 72 hours after intervention,the NRS scores of combined group remained significantly lower than those of the other groups(P<0.05).The effective rates were 80.6%in control group,85.7%in directed group,88.9%in acupressure group and 91.4%in combined group,with statistically significant differences among the four groups(P<0.05).After intervention,statistically significant differences were observed in peripheral blood circulation of the affected limbs among the four groups(P<0.05),and combined group demonstrated superior outcomes compared with the others.Additionally,significant differences were found in cumulative analgesic consumption within 72 hours of post-surgery(P<0.05),where the control group showed the highest usage while the acupressure group and combined group exhibited the lowest.No adverse reactions were observed in any enrolled patients.[Conclusion]ZHANG's empirical formula directional drug delivery combined with auricular acupressure can effectively alleviate post-operative pain due to Qi stagnation and blood stasis in hand trauma,reduce the cumulative analgesic consumption within 72 hours post-surgery,and improve peripheral blood circulation in the affected limb,making it worthy of further promotion and application in clinical practice.

Objective:To explore the latent categories of barriers to PhaseⅡ cardiac rehabilitation in patients after coronary artery bypass grafting (CABG), and to analyze the influencing factors of different latent classes.Methods:A total of 340 CABG patients in PhaseⅡ cardiac rehabilitation were recruited by convenience sampling from two Class Ⅲ Grade A hospitals in Shanghai between January and August 2024. Data were collected using a general information questionnaire, the Cardiac Rehabilitation Barriers Scale (CRBS), and the Fear of Exercise Scale for Cardiac Patients. Latent profile analysis was used to classify the cardiac rehabilitation barriers, and multinomial Logistic regression was conducted to identify influencing factors for different latent classes.Results:Of the 340 questionnaires distributed, 319 valid responses were obtained after excluding incomplete or patterned questionnaires, with a valid response rate of 93.82% (319/340). The cardiac rehabilitation barriers among the 319 CABG patients were classified into three latent profiles: low-barrier, active rehabilitation type; moderate-barrier, poor-functioning type; and moderate-barrier, insufficient-perception type. Multinomial logistic regression analysis indicated that smoking, comorbidities, age, educational level, and fear of exercise were statistically significant influencing factors for different barrier profiles ( P<0.05) . Conclusions:Cardiac rehabilitation barriers in CABG patients exhibit heterogeneity. Medical staff should adopt targeted intervention strategies based on the specific barrier profiles, reduce patients' fear of exercise, and thereby improve rehabilitation outcomes.

Sneddon syndrome is a rare neurocutaneous disorder that primarily affects small-and medium-sized arteries.Its clinical manifestations include livedo racemosa and recurrent cerebral ischemic events,and it may also involve multiple organs such as the heart,spleen,and kidneys.This disease can lead to early-onset stroke,making it a rare cause of stroke in young adults.This article reported a case of a young female patient who experienced two cerebral infarctions within one month.Genetic testing identified a homozygous mutation in the adenosine deaminase 2 gene,confirming the diagnosis of Sneddon syndrome.This case serves as a reference to improve clinical recognition of this disease.

Objective:Analysis of the composition of pathogen spectrum and prevalence characteristics in throat swabs of patients with acute respiratory infections (ARI) in Yucheng city, Henan province, from March to June 2023.Methods:After 1 153 throat swabs were collected from ARI patients in Yucheng, 18 respiratory pathogens were tested using a real-time fluorescence quantitative polymerase chain reaction (qPCR) method. The characterization of pathogens spectrum was analyzed.Results:A total of 1 153 throat swabs from ARI patients were collected from March to June 2023 in Yucheng, including 171 outpatients and 982 hospitalized patients. A total of 244 positive samples for common respiratory pathogens were detected (at least one pathogen per sample was detected). The total detection rate of respiratory pathogens was 21.16%, and the top three detection rates were, in descending order, human bocavirus (HBoV), enterovirus (EV), and human parainfluenza virus (HPIV). The main detection month for pathogens was May, with a detection rate of 42.3% (60/142). The main respiratory pathogens detected are HBoV, EV, and HPIV. The detection rate of the age group under 1 year old was the highest, at 25.1% (49/195), mainly consisting of HBoV, respiratory syncytial virus (RSV), and HPIV. The main clinical manifestations of respiratory pathogen-positive patients were fever and cough, and the clinical diagnosis was mainly lower respiratory tract infection, all of which were hospitalized patients.Conclusions:The respiratory pathogens in ARI patients were mainly HBoV, EV, and HPIV from March to June, 2023 in Yucheng. The peak of the epidemic was in May, mainly infecting children under 5 years of age.

Objective:To analyze the clinical characteristics and cytokines expression characteristics in infants with mild and severe respiratory syncytial virus (RSV) infection.Methods:From May 2023 to December 2023, plasma samples and clinical information were collected from 16 infants with RSV infection and 14 control infants. Cytek Aurora flow cytometry (Cytek, America) and Enzyme linked immunosorbent assay (ELISA) were used to detect the expression levels of 25 cytokines after mild and severe RSV infection.Results:Cough and nasal obstruction were the main clinical manifestations in infants with mild RSV infection, accompanied by polypnea, wheezing and other symptoms. The main symptoms of severe RSV infection were cough and rales, accompanied by fever and polypnea. In comparison with the control group, the expression levels of IL-2, IL-4, IL-5, IL-6, IL-9, IL-13, IL-22, TNF-α, IFN-α, IFN-β, MIP-1β, I-TAC, ENA-78, GROα, Eotaxin, and MCP-1 in the RSV infection group all exhibited an upregulation trend. Both IP-10 and MIP-3α demonstrated a downward trend in the RSV infection group; however, there was no statistically significant difference ( P>0.05). The levels of IL-10, IFN-γ, MIP-1α, and IL-8 in the RSV infection group were significantly higher than those in the control group, whereas the levels of MIG, TARC, and RANTES in the RSV infection group were significantly lower than those in the control group ( P<0.05). The levels of IL-2, IL-4, IL-5, IL-6, IL-9, IL-10, IL-13, IL-22, IFN-β, IFN-γ, TNF-α, IL-8, I-TAC, MIP-1β, Eotaxin, and MCP-1 in the mild RSV infection group were significantly higher than those in the severe RSV infection group ( P>0.05). Among these, the levels of MIG, RANTES, TARC, MIP-3α, and ENA-78 in the mild infection group were all lower than those in the severe infection group. The expressions of ENA-78 and MIP-1α in the severe infection group were significantly higher than those in the mild infection group and also higher than those in the control group. There was no significant difference in IP-10 and GROα between the mild and severe RSV infection groups ( P>0.05). Conclusions:The differences in clinical features and cytokines between infants with mild and severe RSV infection provide important data support for the prevention and treatment of RSV infection in infants.