BackgroundIn recent years， the prevalence of depression among adolescents has risen steadily， alongside an increasing prominence of non-suicidal self-injury （NSSI） behaviors in this population， which may elevate suicide risk and constitute a serious public health problem. Negative emotions such as anxiety and depression are closely related to NSSI behaviors. Previous studies have predominantly relied on retrospective reports， limiting the ability to dynamically capture temporal relationships between emotional fluctuations and NSSI behaviors. Moreover， cognitive behavioral therapy （CBT） often lacks targeted design to address proximal triggers in interventions for NSSI behaviors. ObjectiveTo verify that anxiety as a proximal trigger factor for NSSI behaviors in adolescent patients with depression， and to evaluate the efficacy of modified CBT integrated with ecological momentary assessment （EMA） data in alleviating their anxiety and self-injury urges. MethodsA prospective cohort study design was adopted. A total of 132 adolescent patients with a history of NSSI behaviors who were treated at Jiujiang Fifth People's Hospital from January to December 2024 and met the diagnostic criteria for depression in the Diagnosed and Statistical Manual of Mental Disorders， fifth edition （DSM-5）. A smartphone-based EMA application to conduct natural situation emotions on participants for 14 consecutive days. The monitoring period spanned from 10∶00 to 22∶00 daily， with randomized assessments pushed every 2 hours. The assessment tools included the Self-rating Anxiety Scale （SAS） and the negative affect subscale of the Positive and Negative Affect Schedule （PANAS）， with real-time recording of NSSI behaviors and emotional states before and after their occurrence. Repeated measures analysis of variance was used to compare the dynamic changes in the scores of each scale before and after the episodes of NSSI behaviors. A modified CBT was administered to 83 participants who completed EMA data collection， with sessions conducted once weekly for 12 weeks. Anxiety levels were accessed using the SAS， and the self-injury urges was evaluated using the Ottawa Self-injury Inventory （OSI） before and after the intervention. ResultsEMA data revealed that SAS scores were significantly higher during the 1-2 hours before NSSI episodes compared to baseline periods ［（56.19±11.06）vs.（52.83±10.25），P<0.01］. SAS scores were positively correlated with the NSSI behavioral scores （r=0.460，P<0.01，95% CI：0.310-0.580）. After receiving modified CBT intervention， adolescent patients with depression demonstrated statistically significant decreases in both SAS scores ［（52.30±8.10） vs.（48.70±7.30），t（82）=4.820，P<0.01，Cohen's d=0.420］ and the OSI self-injury impulse subcale scores ［（12.80±2.70） vs.（9.60±2.50），t（82）=5.170，P<0.01，Cohen's d=0.510］ compared to their pre-intervention levels. ConclusionAnxiety may serve as a proximal trigger for NSSI behaviors in adolescent patients with depression. Modified CBT integrating EMA data could potentially alleviate their anxiety level and self-injury urges. ［Funded by Science and Technology Plan Project of Jiangxi Provincial Health Commission （number， SKJP220227629）］

Clinical research is usually aimed at and guided by therapeutic efficacy. Clarifying the placebo effect and the nocebo effect from treatment outcomes is an important issue in clinical research. This paper reviews the meaning of the placebo effect， suggesting that factors that may produce the placebo effect in clinical practice include past experience associations， patient expectations， suggestion， and doctor-patient relationships. It also summarizes the characteristics of the nocebo effect， its influencing factors， and its impact on clinical prognosis. Combining the characteristics of traditional Chinese medicine， this paper explores the design of acupuncture clinical trials that can reflect the measurement of the placebo effect， attempting to provide a clearer interpretation of the placebo effect in the evaluation of acupuncture efficacy in traditional Chinese medicine. Taking primary insomnia as an example， a prospective randomized placebo-controlled trial is designed to observe and evaluate the relationship between the treatment effects of acupuncture and the placebo effect in different patients under the treatment of the same doctor. Group comparisons will help better distinguish clinical effects in different situations. The authors also attempt to explore the responsive population to the placebo effect and the effects of placebos in different populations.

AIM:To investigate the effect of Huangqi-Danggui decoction(HQDG)on the brain tissue of rats with cerebral ischemia/reperfusion(I/R)injury for 7 d by regulating macroautophagy and chaperone-mediated autophagy(CMA),and to explore its mechanism.METHODS:Male SD rats were randomly divided into sham group,model group,HQDG group and Xuesaitong(XST)group.Determination of main chemical components of HQDG by liquid chro-matography-mass spectrometry.The model of middle cerebral artery occlusion/reperfusion in rats was established by the left modified thread embolism method,and the changes of cerebral blood flow were observed by laser speckle blood flow imager.Zea Longa score was used to observe the neurological deficit.HE staining was used to observe the degree of nerve cell injury.The changes of neurovascular unit and autophagosomes in brain tissue were observed by transmission electron microscopy.Immunohistochemical method was used to detect the expression of LC3,P62,lysosome-associated membrane protein-2A(LAMP-2A),heat shock protein 70(HSP70)and myocyte enhancer factor 2D(MEF2D)proteins.Western blot was used to detect the expression of autophagy-related proteins P62 and LC3-Ⅱ/LC3-I.RESULTS:Compared with the sham group,the neurological deficit score in model group was significantly higher(P<0.01).A large number of nerve cells showed necrosis and nuclear dissolution,with the cell arrangement being disordered.The number of autophagosomes increased.The protein expression levels of LC3,LAMP-2A,HSP70 and MEF2D in brain tissue increased,while the ex-pression level of P62 protein decreased(P<0.05 or P<0.01).Compared with the model group,the scores of neurological deficit in brain tissue in HQDG and XST groups were significantly lower(P<0.01).Cell damage was significantly re-duced.The number of autophagosomes further increased.The expression levels of LAMP-2A,HSP70,MEF2D and P62 proteins in brain tissue decreased,while the expression levels of LC3-Ⅱ/LC3-I protein increased(P<0.05 or P<0.01).CONCLUSION:HQDG can alleviate cerebral ischemia/reperfusion injury in rats and exert neuroprotective effects by ac-tivating macroautophagy and reducing CMA.

Objective To explore the mechanisms of Buyang Huanwu Decoction(BYHWD)in reducing oxidative stress levels to protect the blood-brain barrier(BBB)in cerebral ischemia/reperfusion injury(CIRI)rats.Methods A middle cerebral artery occlusion/reperfusion(MCAO/R)model in rats was established via wire embolization method.PeriCam PSI laser speckle flow imaging was applied to detect whether the model was successfully established.Neurological deficits in the rats were evaluated by Zea Longa score,and histopathological changes in the rat brain were observed by HE staining.The degree of brain edema was detected by the dry and wet weight method.BBB permeability was detected by Evans blue staining,and ultrastructural changes to the BBB were observed by transmission electron microscopy.The levels of ROS,MDA and SOD activities,which are related to oxidative stress,were detected using kits.The expression levels of matrix metalloproteinase-9(MMP-9)were detected by immunohistochemical staining and Western blot.The expression levels of Occludin,ZO-1,and Claudin-5 tight junction proteins were determined via immunofluorescence and Western blot.Results BYHWD reduced neurological deficit scores,alleviated brain histopathological damage,alleviated BBB structural disruption,prolonged the appearance of dense regions in the tight junction structure,attenuated edema of the brain on the ischemic side,and reduced BBB permeability in MCAO/R rats.BYHWD decreased the levels of ROS and MDA,increased the activity of SOD,decreased the expression levels of MMP-9,and increased the expression levels of Occludin,Claudin-5 and ZO-1.Conclusions BYHWD can increase BBB tight junction protein expression levels,reduce the permeability of the BBB,protect the ultrastructure of the BBB,and reduce brain edema,and its mechanisms may be related to its antioxidant activity and inhibition of MMP-9 activation.

Objective The scope of related research on ethical conflicts in the interprofessional collaboration in nursing was reviewed,so as to summarize the obstacles and coping strategies that lead to ethical conflicts in interprofessional collaboration and provide references for promoting nurse engagement in interprofessional collaboration.Methods Based on the methodological framework of the scope review,we systematically searched domestic and foreign databases including the Cochrane Library,CINAHL,Embase,PubMed,Web of Science,CNKI,VIP,Wanfang and SinoMed.The time limit for database retrieval was from the establishment of each database to March 2023.The selected studies were summarized and analyzed.Results Totally 13 articles published between 1991 and 2022 were included.The obstacle factors that lead to ethical conflicts in nurse engagement of interprofessional collaboration can be divided into 3 categories,including personal factors(insufficient professional knowledge,differences in professional values),interprofessional factors(imbalanced power between professions,lack of respect and collaboration between cooperators)and environmental factors(insufficient resources and staffing,high-intensity workload,and high-pressure work environment).At the same time,in view of these 3 aspects,it puts forward some countermeasures,such as enhancing professional knowledge,strengthening interprofessional education,improving understanding and cooperation among medical workers in different wards,providing medical practitioners with a team-based,ethical work environment that facilitates interprofessional collaborations and open dialogues.Conclusion It is of great significance for nurses to get involved in interprofessional collaborations,in order to ensure high-quality nursing services.Further studies are needed for the development of education and the core competency framework construction for interprofessional collaborations in nursing.More attention should be paid to develop the organizational atmosphere at the same time,so as to continuously improve nurse'capabilities in interprofessional collaborations.

Objective To understand the current status of nurses'health promotion lifestyle in tertiary comprehensive hospitals,explore the category characteristics of nurses'health promotion lifestyle,and analyze the influencing factors under different categories.Methods From March to April 2023,a multi-stage sampling method was used to select 1326 nurses from 10 tertiary comprehensive hospitals in Hunan Province as the research subjects.A cross-sectional survey was conducted by General Information Questionnaire,Health Promotion Lifestyle Profile Scale,Self-Rated Abilities for Health Practices Scale,Health Behavior Self-Efficacy Assessment Scale,and Nursing Work Environment Scale.Latent profile analysis(LPA)of nurses'health promotion lifestyle was conducted,and the influencing factors of different profiles were explored through univariate analysis and logistic regression analysis.Results A total of 1220 nurses were included,and the score of Health Promotion Lifestyle Profile Scale was(62.61±18.67)points.Nurses'health promotion lifestyle in tertiary comprehensive hospitals can be divided into 3 profiles,namely survival type(25.41％),vitality type(21.97％)and normal type(52.62％).The results of logistic regression analysis showed that coping strategies for stress,non-occupational physical activity,perceived health status,health behavior self-efficacy,and nursing work environment are the influencing factors of nurses'health promotion lifestyle in tertiary comprehensive hospitals(P＜0.05).Conclusion Nurses'health promotion lifestyle in tertiary comprehensive hospitals exhibit significant heterogeneity.It is recommended that nursing managers carry out individualized interventions based on the characteristics of nurses in different categories.Health behavior self-efficacy can be used as the core of intervention to improve nurses'health promotion lifestyles.

Background: Several risk factors have been identified that compromise the treatment outcome in patients with early-to-mid-stage cervical cancer (CC) who are primarily treated with radical surgery. However, there is no report on the impact of intraoperative frozen pathology examination of vaginal margins on the prognosis of patients with CC. This study aimed to conduct a randomized controlled trial (RCT) to determine whether selective vaginal resection can reduce the incidence of operative complications and the risk of postoperative radiotherapy. The impact of the length of the vagina removed in radical hysterectomy (RH) on prognosis and quality of life (QoL) for IB2–IIA2 CC patients will be investigated. Methods A multicenter, non-inferiority, RCT at 7 institutions in China is designed to investigate the effect of intraoperative frozen pathology exam of vaginal margin in RH on the survival outcomes for patients with IB2–IIA2 CC. Eligible patients aged 18–70 years will be randomly assigned online by one-to-one random allocation to receive intraoperative frozen pathology exam of vaginal margin or not. If frozen pathology indicates positive margin, continue resection of 1 centimeter of vaginal tissue until negative margin is achieved. The primary end point is 2-year disease-free survival (DFS). Adverse events (AEs) caused by further vagina resection, 5-year DFS, 2-year overall survival (OS), 5-year OS and AEs caused by radiotherapy and QoL are secondary end points. A total of 310 patients will be enrolled from 7 tertiary hospitals in China within 3-year period and followed up for 5 years.Trial Registration: Chinese Clinical Trial Registry Identifier: ChiCTR2000035668

Background: Several risk factors have been identified that compromise the treatment outcome in patients with early-to-mid-stage cervical cancer (CC) who are primarily treated with radical surgery. However, there is no report on the impact of intraoperative frozen pathology examination of vaginal margins on the prognosis of patients with CC. This study aimed to conduct a randomized controlled trial (RCT) to determine whether selective vaginal resection can reduce the incidence of operative complications and the risk of postoperative radiotherapy. The impact of the length of the vagina removed in radical hysterectomy (RH) on prognosis and quality of life (QoL) for IB2–IIA2 CC patients will be investigated. Methods A multicenter, non-inferiority, RCT at 7 institutions in China is designed to investigate the effect of intraoperative frozen pathology exam of vaginal margin in RH on the survival outcomes for patients with IB2–IIA2 CC. Eligible patients aged 18–70 years will be randomly assigned online by one-to-one random allocation to receive intraoperative frozen pathology exam of vaginal margin or not. If frozen pathology indicates positive margin, continue resection of 1 centimeter of vaginal tissue until negative margin is achieved. The primary end point is 2-year disease-free survival (DFS). Adverse events (AEs) caused by further vagina resection, 5-year DFS, 2-year overall survival (OS), 5-year OS and AEs caused by radiotherapy and QoL are secondary end points. A total of 310 patients will be enrolled from 7 tertiary hospitals in China within 3-year period and followed up for 5 years.Trial Registration: Chinese Clinical Trial Registry Identifier: ChiCTR2000035668

Background: Several risk factors have been identified that compromise the treatment outcome in patients with early-to-mid-stage cervical cancer (CC) who are primarily treated with radical surgery. However, there is no report on the impact of intraoperative frozen pathology examination of vaginal margins on the prognosis of patients with CC. This study aimed to conduct a randomized controlled trial (RCT) to determine whether selective vaginal resection can reduce the incidence of operative complications and the risk of postoperative radiotherapy. The impact of the length of the vagina removed in radical hysterectomy (RH) on prognosis and quality of life (QoL) for IB2–IIA2 CC patients will be investigated. Methods A multicenter, non-inferiority, RCT at 7 institutions in China is designed to investigate the effect of intraoperative frozen pathology exam of vaginal margin in RH on the survival outcomes for patients with IB2–IIA2 CC. Eligible patients aged 18–70 years will be randomly assigned online by one-to-one random allocation to receive intraoperative frozen pathology exam of vaginal margin or not. If frozen pathology indicates positive margin, continue resection of 1 centimeter of vaginal tissue until negative margin is achieved. The primary end point is 2-year disease-free survival (DFS). Adverse events (AEs) caused by further vagina resection, 5-year DFS, 2-year overall survival (OS), 5-year OS and AEs caused by radiotherapy and QoL are secondary end points. A total of 310 patients will be enrolled from 7 tertiary hospitals in China within 3-year period and followed up for 5 years.Trial Registration: Chinese Clinical Trial Registry Identifier: ChiCTR2000035668

Objective:To measure the partial parameters of the soft tissues of upper eyelid in young women with single eyelid in Shantou City, Guangdong Province, and to explore the asymmetry rate of the left and right palpebral fissure and its regularity.Methods:From March 2018 to July 2019, the Medical Cosmetology Center of the First Affiliated Hospital of Shantou University Medical College measured 108 young women with single eyelid, aged 18-35 years, with an average age of 24.6 years. Before operation, palpebral fissure width (PFW), palpebral fissure height (PFH), palpebral fissure inclination (PFI) and central eyebrow height (CEH) were measured. The resected intra-orbital septum fat pad during the procedure was weighed. Both direct measurement and the photo measurement were used to obtain the average value of the two sets of data for final analysis. We calculated out the incidence rate of asymmetry of each palpebral item.Results:The paired t-test showed that the mean value of PFW was (25.76±1.50) mm on the left and (26.04±1.55) mm on the right ( t=2.93); the mean value of PFH was (9.70±1.15) mm on the left and (9.49±1.05) mm on the right ( t=3.12); the mean value of PFI was (9.77±2.57)° on the left and (9.67±2.28)° on the right ( t=2.01); the mean value of CEH was (12.05±1.61) mm on the left and (12.32±1.69) mm on the right ( t=-2.66); the mean value of the weight of the intra-orbital septum fat pad was (0.20±0.11) g on the left and (0.22±0.12) g on the right ( t=2.29). There were significant differences between the two sets of data (all P<0.05). Conclusions:The asymmetric phenomenon of the upper eyelid is commonly found in Shantou young female undergraduates, in which the PFH in the left is higher than that in the left; the PFW, the CEH, the weight of the intra-orbital septum fat pad in the right more commonly found than that in the left.. This study provides a certain reference for the clinical evaluation of the operation.