Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Objective:To investigate the extent and characteristics of parenting stress experienced by fathers of children aged 0-6 in three provinces of Eastern China, and to compare the quality of their marital relationships within each latent class, in order to provide reference for developing intervention strategies for different categories of fathers.Methods:Using cross-sectional survey methods, fathers with children aged 0-6 years were recruited using convenience sampling from December 2020 to March 2021 from Anhui province, Zhejiang province and Jiangsu province in Eastern China. Data were collected through a general information questionnaire, the Parenting Stress Index-Short Form, and the Locke-Wallace Marital Adjustment Scale.Latent profile analysis was used to determine the classification, Kruskal-Wallis H test was used to compare the difference of marital quality. Results:A total of 657 questionnaires were distributed and 604 valid questionnaires were recovered. The age of 604 fathers was (32.50 ± 6.26) years, the score of parenting stress was (89.70 ± 17.87) and the score of marriage quality was (108.36 ± 22.28). The characteristics of parenting stress among fathers of young children were categorized into three latent profile types: "high stress-negative parenting group" (88 people accounting for 14.6%), " medium stress- poor interaction group" (329 people accounting for 54.5%), and " low stress-positive parenting group" (187 people accounting for 30.9%). The scores of marriage quality were (99.94 ± 23.81), (106.52 ± 19.84), (115.56 ± 23.70) points among these three latent classes with significant differences ( H=35.89, P<0.05). Conclusions:The study identifies three latent classes of parenting stress among fathers of children aged 0-6, each associated with varying levels of marriage quality. Therefore, targeted interventions aimed at improving fathers′ parenting stress and marriage quality, and helping create family environments where children can grow up healthy.

In observational research,a primary objective is to accurately and reliably assess the causal impact of exposure on outcomes.Identifying and properly adjusting for confounding factors is a key prerequisite and central challenge to achieving this goal.Ineffective management of confounders,whether by neglecting significant ones,(leading to residual confounding),or by over-adjusting for irrelevant factors,(introducing collider bias),can distort effect estimates and lead to erroneous scientific conclusions and clinical decisions.Therefore,it is essential to develop and implement systematic,transparent,and reproducible methods for identifying and selecting confounding factors to enhance the validity and reliability of causal inferences in observational studies.This paper provides a systematic review of directed acyclic graphs(DAGs),a robust visual causal modeling tool,and offers a detailed examination of three prominent criteria for selecting confounding factors based on DAGs:the Pre-exposure criterion,the Common cause criterion,and the Modified disjunctive cause criterion.The aim is to equip researchers with a structured and theoretically grounded framework for identifying and selecting confounding factors,thereby improving the process of estimating causal effects in observational studies.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Objective:To explore the effect of non-invasive intervention on preventing maternal breast tenderness, and to provide references for clinicians to select the optimal non-invasive intervention for the prevention of maternal breast tenderness.Methods:Literature focused on the effect of different non-invasive interventions to prevent maternal breast tenderness by randomized controlled trials design was searched in the databases, including China National Knowledge Infrastructure, VIP, Wanfang, SinoMed, PubMed, Web of Science, Embase and Cochrane Library, from inception to April 8, 2024. Two researchers independently screened the literature, extracted the data and evaluated the quality of the literature. Stata 16.0 was used to conduct a network Meta-analysis.Results:A total of 21 studies involving 2 298 women, covering 5 non-invasive interventions (low-frequency pulse electrotherapy, breast massage combined with low-frequency pulse electrotherapy, breast massage and acupoint massage, breast massage and acupoint massage combined with ear point pressure bean, breast massage and acupoint massage combined with external application of Chinese medicine). The network meta-analysis results showed that, compared with routine care, five non-invasive interventions had statistically significant differences in reducing the incidence of maternal breast tenderness ( OR values ranging from 0.20 to 0.39, all P<0.05). Breast massage combined with low-frequency pulse electrotherapy ranked first in terms of effectiveness on preventing of breast tenderness. Conclusions:All five non-invasive interventions are effective on preventing maternal breast tenderness, with breast massage combined with low-frequency pulse electrotherapy being the most effective.

[Objective]To evaluate the efficacy of different acupuncture therapies in treating patients with insomnia with heart and spleen deficiency,thereby providing evidence-based guidance for clinical practice in selecting optimal treatment regimens.[Methods]A systematic search was performed across China National Knowledge Infrastructure(CNKI),WanFang,China Biomedical Literature Database(SinoMed),China Science and Technology Journal Database(VIP),PubMed,the Cochrane Library,Web of Science and Embase for randomized controlled trials assessing different acupuncture interventions for heart-spleen deficiency insomnia.The retrieval time limit was from the establishment date of the databases to August 2024.Data were analyzed by using Review Manager 5.3 and Stata 17.0 software.[Results]Ultimately,28 studies were included,encompassing 10 distinct acupuncture modalities and involving a total of 2 117 patients.According to the network Meta-analysis,moxibustion,warm acupuncture,acupuncture plus moxibustion,ear acupuncture with moxibustion,as well as ear acupressure beads combined with acupuncture demonstrated superior effectiveness compared with conventional sedative-hypnotic medications in enhancing Pittsburgh sleep quality index(PSQI)scores,and the ranking from high to low was warm acupuncture,ear acupoint pressure bead plus acupuncture,ear acupoint pressure bead plus moxibustion,moxibustion,acupuncture plus moxibustion,electroacupuncture,simple acupuncture,acupoint catgut embedding.Regarding clinical efficacy rates,warm acupuncture,acupuncture plus moxibustion,ear acupoint pressure bead plus acupuncture,pure acupuncture,electroacupuncture,and acupoint catgut embedding exhibited greater efficacy than conventional sedative-hypnotic medications.And the ranking in terms of clinical efficacy was electroacupuncture,warm acupuncture,acupoint catgut embedding,ear acupoint pressure bead plus acupuncture,simple acupuncture,acupuncture plus acupoint injection,acupoint injection,acupuncture plus moxibustion,ear acupoint pressure bead plus moxibustion.[Conclusion]Electroacupuncture can effectively increase the total clinical effective rate of insomnia treatment,warming moxibustion can effectively improve the PSQI score of patients.In clinical practice,an appropriate treatment plan can be selected based on the patient's own condition.

BACKGROUND:The imbalance between proliferation and apoptosis of chondrocytes plays an important role in the occurrence and development of osteoarthritis. Previous studies have found that hsa-miR-3202 is involved in regulating the proliferation and apoptosis of various cells. However,no studies have explored the correlation between hsa-miR-3202 and osteoarthritis.OBJECTIVE:To investigate the expression of hsa-miR-3202 in osteoarthritic chondrocytes and its effect on the proliferation and apoptosis of chondrocytes. METHODS:(1) MicroRNAs differentially expressed in osteoarthritic chondrocytes were screened by biogenic analysis. Based on the current research situation at home and abroad,hsa-miR-3202 was selected for follow-up studies,and its target genes were predicted by gene ontology (GO) functional enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. (2) Human normal chondrocyte cell lines C28/I2 in logarithmic growth phase were selected and randomly divided into four groups for culture:in normal group,cells were cultured in normal medium for 24 hours,the medium was then changed to normal medium for another 6 hours of culture,and changed to normal medium for subsequent culture;in lipopolysaccharide group,cells were cultured in lipopolysaccharide-containing medium for 24 hours,the medium was then changed to normal medium for another 6 hours,and changed to normal medium for subsequent culture;in lipopolysaccharide+NC group,cells were cultured in lipopolysaccharide-containing medium for 24 hours,and then transfected with has-miR-3202 mimics control for 6 hours,and the medium was change to normal medium for subsequent culture;in lipopolysaccharide+hsa-miR-3202 mimics group,cells were cultured in lipopolysaccharide-containing medium for 24 hours and then transfected with has-miR-3202 mimics for 6 hours,and the medium was changed to normal medium for subsequent culture. After further 48 hours of culture,the expression level of hsa-miR-3202 was detected by fluorescence quantitative PCR and cell apoptosis was detected by flow cytometry. After further culture of 0-72 hours,cell proliferation activity was detected by cell counting kit-8. RESULTS AND CONCLUSION:Bioinformatics analysis results indicated that hsa-miR-3202 was significantly down-regulated in osteoarthritic chondrocytes. GO functional enrichment and KEGG pathway enrichment showed that the function of hsa-miR-3202 target gene was closely related to cell growth and apoptosis. The results of in vitro cell experiments showed that compared with the normal group,the expression level of hsa-miR-3202 and proliferation ability of chondrocytes were significantly decreased in the lipopolysaccharide group (P<0.05),while the apoptotic rate was significantly increased (P<0.05). Compared with the lipopolysaccharide group,the expression level of hsa-miR-3202 and proliferation ability of chondrocytes were significantly increased in the lipopolysaccharide+hsa-miR-3202 mimics group (P<0.05),while the apoptotic rate was significantly decreased (P<0.05). To conclude,the expression of hsa-miR-3202 is down-regulated in osteoarthritic chondrocytes to inhibit cell proliferation and promote cell apoptosis,thus affecting the occurrence and development of osteoarthritis.

Objective To investigate the clinical characteristics of hepatitis-associated aplastic anemia(HAAA)in pediatric patients.Methods A retrospective study was conducted on 212 children with aplastic anemia(AA)who were hospitalized at Henan Children's Hospital from September 2014 to February 2023.The patients were categorized into two groups based on etiology:the HAAA group and the non-HAAA group.The study group consisted of 23 patients in the HAAA group,while a control group of 115 children without HAAA was matched in a 1∶5 ratio based on age,sex,and severity of aplastic anemia.The clinical characteristics,treatment regimens,and outcomes of the 23 patients with HAAA were analyzed and compared with those of the control group comprising 115 patients.Results Among the 23 children with HAAA,there were 11 males and 12 females,with a median age of 6 years and 3 months(ranging from 1 year and 4 months to 12 years old).The onset of aplastic anemia in all HAAA children occurred after the initial presentation of acute hepatitis.Following gradual improvement in liver function,peripheral blood images showed a progressive decline by two or three lines,including platelets.Among these cases,very severe aplastic anemia was observed in 14 patients(60.9%),severe aplastic anemia in 7 patients(30.4%),and non-severe aplastic anemia in 2 patients(8.7%).The median interval between hepatitis onset and diagnosis of aplastic anemia was found to be 56 days(range:10～157 days).All 23 pediatric patients with HAAA presented with acute icteric hepatitis,accounting for 100%of the cohort.One patient(4.3%)was genetically diagnosed with X-linked lymphoproliferative disease type 2,while liver biopsy revealed drug-induced hepatitis/chemical liver injury in five patients(21.7%).Compared to the control group,HAAA patients exhibited significantly lower levels of CD4+cells[(1.2±0.3)vs.(1.5±0.1)]and CD4+/CD8+ratios[(-0.2±0.4)vs.(0.1±0.2)](P<0.05).Three patients received immunosuppressive therapy(IST),18 underwent hematopoietic stem cell transplantation(HSCT),and two non-severe cases were treated with methylprednisolone sodium succinate and compound Zapoan pill;all patients survived.Conclusions Children with HAAA present a critical condition and exhibit a poor prognosis,predominantly manifesting as severe or extremely severe aplastic anemia during the recovery phase of hepatitis.Reduction in CD4+cell count and inversion of CD4+/CD8+ratio may serve as early warning indicators for HAAA.Effective improvement in prognosis can be achieved through immunosuppressive therapy and hematopoietic stem cell transplantation.

Objective To evaluate the reporting quality and influencing factors of patient-reported outcome (PRO) data in randomized controlled trials (RCTs) of lung cancer. Methods RCTs of lung cancer with PRO as either primary or secondary endpoints were searched from PubMed, EMbase, Medline, CNKI, Wanfang Data, and VIP databases between January 1, 2010 and April 20, 2024. Reporting quality of included RCTs were assessed based on the CONSORT-PRO extension. Descriptive statistics and bivariate regression analysis were used to describe the reporting quality and analyze the factors influencing the reporting quality. Results A total of 740 articles were retrieved. After screening, 53 eligible RCTs of lung cancer with 22 780 patients were included. The patients were mainly with non-small cell lung cancer (84.91%), with the median sample size of the included studies was 364.0 (160.5, 599.5) patients. The primary PRO tool used was the EORTC QLQ-C30 (60.38%). There were 52 (98.11%) studies whose PRO measured the domain of "symptom management of cough, dyspnea, fatigue, pain, etc.", and 45 (84.91%) studies measured "health-related quality of life". Multicenter studies accounted for 84.91%, and randomized non-blind trials accounted for 62.26%. PRO was used as the primary endpoint in 33.96% of the studies and as secondary endpoints in 66.04%. The reliability and validity of the PRO tools were explicitly mentioned in 11.32% and 7.55% of the studies, respectively. The average completeness of reporting according to the CONSORT-PRO guidelines was 60.00%, ranging from 25.00% to 93.00%. The main factors affecting the completeness of CONSORT-PRO reporting included sample size and publication year. For every increment in sample size, the completeness of reporting increased by 27.5% (SE=0.00, t=2.040, P=0.046). Additionally, studies published after 2018 had a 67.2% higher completeness of reporting compared to those published in or before 2018 (SE=17.8, t=–3.273, P=0.006). Conclusion The study reveals that the overall reporting quality of PRO in lung cancer RCTs is poor. Particularly, the reporting of PRO measures reliability and validity, PRO assumptions, applicability, and handling of missing data need further improvement. Future research should emphasize comprehensive adherence to the CONSORT-PRO guidelines.

This comprehensive review systematically explores the multifaceted applications, inherent challenges, and promising future directions of artificial intelligence (AI) within the medical domain. It meticulously examines AI's specific contributions to basic medical research, disease prevention, intelligent diagnosis, treatment, rehabilitation, nursing, and health management. Furthermore, the review delves into AI's innovative practices and pivotal roles in clinical trials, hospital administration, medical education, as well as the realms of medical ethics and policy formulation. Notably, the review identifies several key challenges confronting AI in healthcare, encompassing issues such as inadequate algorithm transparency, data privacy concerns, absent regulatory standards, and incomplete risk assessment frameworks. Looking ahead, the future trajectory of AI in healthcare encompasses enhancing algorithm interpretability, propelling generative AI applications, establishing robust data-sharing mechanisms, refining regulatory policies and standards, nurturing interdisciplinary talent, fostering collaboration among industry, academia, and medical institutions, and advancing inclusive, personalized precision medicine. Emphasizing the synergy between AI and emerging technologies like 5G, big data, and cloud computing, this review anticipates a new era of intelligent collaboration and inclusive sharing in healthcare. Through a multidimensional analysis, it presents a holistic overview of AI's medical applications and development prospects, catering to researchers, practitioners, and policymakers in the healthcare sector. Ultimately, this review aims to catalyze the deep integration and innovative deployment of AI technology in healthcare, thereby driving the sustainable advancement of smart healthcare.