OBJECTIVE To observe the clinical efficacy of Yangyin Jiedu Decoction in the prevention and treatment of acute ra-diation-induced oral mucositis(RTOM).METHODS A total of 80 inpatients who were diagnosed with head and neck tumors by pathological examination and received radiotherapy in the Department of Radiotherapy,Affiliated Hospital of Nanjing University of Chi-nese Medicine from November 2021 to September 2023 were selected and randomly divided into an observation group and a control group with 40 cases in each group.The control group was given mouthwash treatment from the onset of RTOM symptoms until the symp-toms disappeared;the observation group was given Yangyin Jiedu Decoction from the first day of radiotherapy on the basis of the treat-ment of the control group until the end of radiotherapy.During the treatment,the onset time,duration and incidence of grade Ⅱ-ⅣRTOM in the two groups were observed;the pain numerical rating scale(NRS)score,Karnofsky performance status(KPS)score,body mass index(BMI)changes were evaluated;and the levels of serum inflammatory factors[C-reactive protein(CRP),interleukin 6(IL-6),interleukin 1β(IL-1β),tumor necrosis factor α(TNF-α)]were detected.RESULTS After radiotherapy,RTOM ap-peared in both groups to varying degrees.The incidence of grade Ⅱ-Ⅳ RTOM,the onset time,duration and NRS score of RTOM in the observation group were significantly better than those in the control group(P<0.05,P<0.01).After radiotherapy,the levels of se-rum CRP,IL-6,IL-1β and TNF-α in the observation group were lower than those in the control group(P<0.05,P<0.01).After radiotherapy and 1 month of follow-up,the KPS score and BMI in the observation group were higher than those in the control group(P<0.05,P<0.01).CONCLUSION Yangyin Jiedu Decoction can decrease the incidence and severity of RTOM in patients with head and neck tumors,shorten its duration,improve the quality of life of patients,downregulate the level of inflammatory cytokines,and has a preventive effect on RTOM caused by radiotherapy in patients with head and neck tumors.

Objective:To investigate the current situation and influencing factors of clinical nurses'clinical decision-making ability,and provide a reference and evidence for improving and enhancing the correct clinical decision-making ability of clinical nurses.Methods:A total of 300 clinical nurses in Shaanxi Province were selected as the research subjects by using the convenience sampling method.The General Information Questionnaire,Clinical Decision-Making Scale,and Comprehensive Decision-Making Style Scale were used to conduct the investigation and study.The influencing factors of clinical nurses'clinical decision-making ability were analyzed by using single-factor analysis and multivariate linear regression.Results:The total score of clinical nurses'clinical decision-making ability was(163.85±13.78)points,reaching the high-level standard of clinical decision-making ability(146.68-200.00)points.The results of Spearman rank correlation analysis showed that there was a significant positive correlation between the total score and the score of each dimension of clinical decision-making ability and the score of rational decision-making style(P<0.05).The score of the dimension of searching for information or new information was only negatively correlated with the score of intuitive-impulsive decision-making style(P<0.05).Avoidant decision-making style was negatively correlated with the scores of seeking information or new information,clarifying goals and values,the total score of clinical decision-making ability,and the dimensions of finding alternative solutions(P<0.05).The results of multiple linear regression showed that rational decision-making style can positively affect clinical nurses'clinical decision-making ability,while avoidance decision-making style can negatively affect it.Conclusion:The clinical nurses'clinical decision-making ability has been maintained at a relatively constant high level,and it is greatly influenced by rational and avoidant decision-making styles.Medical managers need to organize targeted training activities and other measures to promote the construction of clinical nurses'rational decision-making style and minimize the influence of avoidant decision-making style,thus improving the clinical nurses'clinical decision-making ability.

With the deepening of the concept of enhanced recovery after surgery(ERAS),clinical techniques and applications aimed at reducing perioperative stress,reducing postoperative complications,and promoting early postoperative recovery have gradually attracted attention.Transcutaneous electrical acu-point stimulation(TEAS),as a new type of combination of transcutaneous electrical nerve stimulation and acupuncture acupoint technology,has significant effects in reducing body stress,improving the quality of postoperative recovery,and reducing postoperative complications.The purpose of this article is to review the research progress of TEAS in early postoperative recovery at home and abroad in recent years,so as to pro-vide a reference for optimizing perioperative anesthesia management.

Objective:To assess the status quo of uncertainty in illness among patients undergoing daytime ophthalmic surgeries and to identify its influencing factors.Methods:Patients who underwent surgery in the Ophthalmic Daytime Surgery Wards of Beijing Tongren Hospital, Capital Medical University, from January to June 2023, were selected by convenience sampling. Data were collected using a general demographic survey and the Medical Uncertainty Inventory Scale (MUIS/MUIS-A). Multiple linear regression analysis was employed to investigate the factors influencing the uncertainty in illness among these patients.Results:Out of 248 questionnaires distributed, 243 were effectively collected, resulting in a 97.98% response rate. The scores on the MUIS/MUIS-A ranged from 55 to 144, with a median of 102. Multiple linear regression analysis indicated that acceptance of the disease, educational level, and the number of surgeries were significant factors influencing the uncertainty in illness among these patients ( P<0.05) . Conclusions:The uncertainty in illness among patients undergoing daytime ophthalmic surgery is above the medium level. Factors such as acceptance of the disease, educational level, and the number of surgeries significantly influence this uncertainty.

Objective:To gain a deep understanding of the supportive care needs of families of children with retinoblastoma (RB) through qualitative research.Methods:From March to May 2022, a semi-structured interview was conducted using purposive sampling to select the family members of 15 RB children in the Department of Eye Tumor of Beijing Tongren Hospital affiliated to Capital Medical University. Colaizzi 7-step analysis method was used to refine, extract, and analyze interview data.Results:The supportive care needs of the families of RB children were summarized into three themes and six sub-themes, namely, psychological needs (emotional listening and psychological support), knowledge needs (disease knowledge needs, children's post discharge guidance, internet resource needs), and economic needs (social resource integration) .Conclusions:RB, as a malignant eye tumor, often brings a heavy burden to families. Family members of children generally experience negative emotions such as anxiety and depression, as well as a lack of knowledge. The economic burden on families is heavy, and there is a high demand for supportive care. The supportive care program for families of RB children is not yet perfect, and nurses should provide emotional support and professional assistance to the families, providing help and guidance in psychological counseling, knowledge needs, economic assistance, and other aspects.

Hip fracture in the elderly is characterized by high incidence, high disability rate, and high mortality and has been recognized as a public health issue threatening their health. Surgery is the preferred choice for the treatment of elderly patients with hip fracture. However, lower extremity deep venous thrombosis (DVT) has an extremely high incidence rate during the perioperative period, and may significantly increase the risk of patients′ death once it progresses to pulmonary embolism. In response to this issue, the clinical guidelines and expert consensuses all emphasize active application of comprehensive preventive measures, including basic prevention, physical prevention, and pharmacological prevention. In this prevention system, basic prevention is the basis of physical and pharmacological prevention. However,there is a lack of unified and definite recommendations for basic preventive measures in clinical practice. To this end, the Orthopedic Nursing Professional Committee of the Chinese Nursing Association and Nursing Department of the Orthopedic Branch of the China International Exchange and Promotive Association for Medical and Health Care organized relevant nursing experts to formulate Expert consensus on perioperative basic prevention for lower extremity deep venous thrombosis in elderly patients with hip fracture ( version 2024) . A total of 10 recommendations were proposed, aiming to standardize the basic preventive measures for lower extremity DVT in elderly patients with hip fractures during the perioperative period and promote their subsequent rehabilitation.

Objective:To investigate the impact of elevated glucose-induced RNA oxidation on pancreatic β-cell function, activity, and underlying molecular mechanisms.Methods:Rat pancreatic islet β-cell tumour INS-1 cells were cultured in vitro and subjected to nucleic acid oxidation assessment using isotope dilution ultra-high performance liquid tandem mass spectrometry(ID LC MS/MS)following high glucose exposure.In vitro simulation of increased RNA oxidation in INS-1 cells was achieved using 8-oxoguanosine-5'-triphosphate(8-oxoGTP).Cell proliferation was evaluated through CCK-8 assay, apoptosis was measured via flow cytometry, and gene expression of insulin(INS), pancreatic-duodenal homologous cassette 1(PDX1), cysteine-aspartate proteinase 3(Casp3), and cysteine aspartate protease 6(Casp6)was analyzed at the mRNA level.Additionally, whole transcriptome sequencing was performed to elucidate the molecular mechanisms underlying the impact of RNA oxidation on INS-1 cells.Results:Elevated glucose levels induced an increase in RNA oxidation within INS-1 cells.This heightened RNA oxidation led to the inhibition of INS-1 cell proliferation, a reduction in mRNA levels of INS and PDX1 genes, and the promotion of apoptosis-related casp3 and casp6 gene mRNA synthesis.Transcriptome sequencing analysis unveiled that the elevated RNA oxidation caused differential expression of mRNA, lncRNA, miRNA, and circRNA in INS-1 cells.This included a significant down-regulation of transcription factors such as Mafa, Pdx1, Pax6, and Mnx1, alongside an up-regulation of various miRNAs like rno-miR-124-3p, rno-miR-133a-3p, rno-miR-3120, rno-miR-212-3p, and rno-miR-7a-2-3p.These molecular changes contributed to the altered expression of associated lncRNAs, ultimately hindering insulin synthesis and secretion, as well as β-cell proliferation.Conclusions:Increased RNA oxidation down-regulates the levels of key β-cell transcription factor mRNAs, contributes to the differential expression of related non-coding RNAs(ncRNAs), particularly lncRNAs, impacts β-cell insulin synthesis and secretion, hinders cell proliferation, and serves as a significant factor in β-cell dysfunction and decreased activity in type 2 diabetes mellitus(T2DM).

ObjectiveTo compare the neuropsychological development of infants with different types of morphologic cranial deformities. MethodsA total of 954 children aged 0 to 18 months who came to Beijing Children's Hospital from January, 2020 to August, 2021 for cranial measurement and neuropsychological development measurement were selected. They were divided into brachycephaly group, plagiocephaly group, asymmetric brachycephaly group, scaphocephaly group and normal group according to the cranial measurement. The development quotient (DQ) was calculated from Children Neuropsychological Development Scale (0-6). ResultsThere were 449 cases in the normal group, 94 cases in the brachycephaly group, 201 cases in the plagiocephaly group, 82 cases in the asymmetric brachycephaly group and 128 cases in the scaphocephaly group. The detection rate of Developmental Edge and Delay (DQ < 85) for gross motor area was the most in brachycephaly group (60.6%), and it was the most for fine motor (64.6%), language (45.1%), adaption (51.2%) and social behavior areas (48.8%) in the asymmetrical brachycephaly group. The DQ was different among the five groups for all the areas except the language area (F > 14.835, P < 0.001); compared with the normal group, DQ decreased for all the four areas in all the groups except the scaphocephaly group; DQ of the areas of gross motor, fine motor and adaption was more in the plagiocephaly group than in the asymmetric brachycephaly group (P < 0.05), while DQ of the areas of gross motor and fine motor was more in the plagiocephaly group than in the brachycephaly group (P < 0.05). Linear regression analysis showed that, DQ negative linear correlated with the cephalic ratio and cranial vault asymmetry index (|B| > 0.967, P < 0.05). ConclusionAmong four kinds of cranial malformation in infants, the neuropsychological development of the scaphocephaly group is almost normal, and somehow delays for brachycephaly, plagiocephaly and asymmetric brachycephaly, especially in the aspects of gross motor, fine motor, adaption and social behavior. The more serious the cranial deformity, the greater the risk of developmental delay in each functional area.

Objective? To explore the effects of exercise-psychology-sleep nursing among esophageal cancer patients. Methods? From June 2016 to September 2018, we selected 200 esophageal cancer inpatients with intermediate and advanced stage in Surgery Department at the First Affiliated Hospital of Xi'an Jiaotong University by convenience sampling. All of the patients were divided into control group and experimental group according to admission order, 100 cases in each group. Control group carried out routine nursing. On the basis of routine nursing, experimental group implemented exercise-psychology-sleep nursing. After intervention, the intervention effects were compared with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and the Revised Piper Fatigue Scale (PFS-R) between two groups. Results? One month after intervention, the scores of function and general health of experimental group were (62.11±3.22) and (67.23±3.74) respectively higher than those of control group; the scores of symptoms and specificity of experimental group were (42.12±2.13) and (43.75±3.21) respectively lower than those of control group; the differences were all statistical (t=101.159,15.053,22.910,3.347;P＜0.01). The scores of cancer related fatigue of experimental group and control group were (3.36±1.25) and (5.14±1.04) respectively with a statistical difference (t=10.663,P＜0.01). Conclusions The application of exercise-psychology-sleep nursing in esophageal cancer patients can improve quality of life and relieve cancer related fatigue of patients which is worthy of being widely used in clinical application.

Objective To describe status of cancer-related fatigue (CRF) and its trajectory during three different time node for the operation, chemotherapy, and radiotherapy among breast cancer patients. Methods The convenience sampling method was used for 242 cases diagnosed with breast cancer which prepared for breast cancer resection, prepared to be treated with adjuvant chemotherapy and radiotherapy, and conformed to the sample standard from a tumor hospital and two affiliated hospital of medical college from February 2014 to November 2015 in a city. The follow-up survey of CRF was conducted respectively in the three different point-in-time for one week after the operation, at the end of chemotherapy and radiotherapy. Results After the operation mean rating for general fatigue was mild (2.59±2.41) points, and approximately 76.0% (184/242) patients experienced fatigue to low- grade degree; After the chemotherapy fatigue was significantly increased (6.57 ± 2.43) points, and 75.2% (182/242) patients accounted for severe fatigue; After the radiotherapy mean rating for fatigue was moderate (4.38 ± 2.46) points, and 57.0%(138/242) patients suffered to moderate fatigue. During the whole treatment period the level for general fatigue and four dimensions of fatigue were in the unstable state ofwaveof fluctuations with mild, severe, moderate, and fatigue were statistically different in three different stages of treatment ( F= 43.16,P=0.000). The age and operation method were associated with CRF in thephaseofoperation(age t=7.365, P=0.003; operation method t=5.166, P=0.009), chemotherapy (age t=9.835, P=0.000; operation method t=3.313, P=0.025) and radiotherapy (age t=9.014, P=0.000;operation method t=10.392, P=0.000). Conclusions There is a certain difference with CRF of breast cancer patients at different stage of rehabilitation treatment. There are two factors that could affect CRF such as age and operation method in the whole rehabilitation treatmentperiod.