1.Construction of the Diagnosis and Treatment System of "Sinew Prescription Correspondence" under the Guidance of Systematic Dialectical Sphygmology
Feng ZHANG ; Baoqiang DONG ; Xingxing LIN ; Yapeng LIU ; Lujia XIAO ; Bodong XING ; Yiyun CAO ; Wenhui ZHANG ; Wenqian QI
Journal of Traditional Chinese Medicine 2026;67(10):1038-1043
"Sinew prescription correspondence" is the principle of selecting prescriptions for channel sinew diseases. On the basis of the theory of syndrome differentiation and treatment, the pulse manifestation corresponds to the channel sinew syndrome, which can improve the flexibility and standardization of clinical prescriptions. From the perspective of systematic dialectical sphygmology, this paper explains the dialectical relationship between channel sinew theory and pulse body elements, pulse wall elements, pulse elements and blood flow elements, and clarifies the internal relationship between pulse manifestation and prescriptions at the level of channel sinew disease. The prescription is derived from the method, while the method is established with the syndrome, and the prescription is unified by the method. According to the theory of "sinew prescription correspondence", the treatment ideas of channel sinew diseases were analyzed from the perspective of channel sinew distribution, functional characteristics and structural changes. On this basis, the diagnosis of channel sinew disease and the application of prescriptions are expanded, and the research on the internal treatment and diagnosis mode of "pulse manifestation-channel sinew-zang fu (脏腑)" is prospected, so as to expand the differentiation and treatment methods of channel sinew theory.
2.Influencing factors of workplace violence against nurses in Western China
Yeqiu HUANG ; Xing CHEN ; Yuexi WANG ; Xuan GONG ; Tianlan SU ; Yu CAO
China Occupational Medicine 2026;53(1):92-98
Objective To analyze the incidence and influencing factors of workplace violence (WPV) against nurses in tertiary hospitals in Western China, and to conduct a qualitative exploration based on the lived experiences of nurses who have suffered WPV. Methods A total of 1 294 nurses from 21 tertiary hospitals across 12 provinces, autonomous regions, and municipalities in western China were selected as the research subjects using a convenience sampling method. Investigation was performed among the nurses using the Hospital Workplace Violence Questionnaire and the Implementation Status of Hospital Violence Prevention Measures Questionnaire. Additionally, a total of 18 nurses who had experienced WPV were selected for semi-structured qualitative interviews. Results The overall incidence of WPV among the nurses was 47.5%, with incidences of psychological, physical, and sexual violence at 42.0%, 7.3%, and 3.5%, respectively. Binary logistic regression analysis showed that male nurses had a higher risk of experiencing WPV than female nurses (P<0.01); widowed/divorced nurses had a higher risk than unmarried nurses (P<0.05); both head nurses and department head nurses had a higher risk than general nurses (both P<0.01); and nurses with lower trust in hospitals had a higher risk than those with higher trust (P<0.01). Qualitative interviews revealed that WPV often stemmed from the accumulation of patients′ negative emotions during medical care, exacerbated by poor communication and unmet treatment expectations. Nurses tended to adopt avoidance and tolerance strategies when facing conflict, lacking effective coping skills. Following WPV incidents, nurses frequently experienced anxiety and burnout, relying mainly on self-regulation or confiding in colleagues to cope with the impact of WPV. Hospital responses to WPV are largely passive, with insufficient dedicated departments and psychological support mechanisms, indicating a need for improved institutional frameworks. Conclusion WPV among nurses in tertiary hospitals in Western China remains a serious concern. Hospital management should prioritize high-risk groups such as male and widowed/divorced nurses, and strengthen psychological support systems and standardized reporting procedures to mitigate WPV and to enhance nursing quality.
3.Semaphorin 3A promotes pathological cardiac hypertrophy: an experimental study
Lifei WU ; Jiaojiao ZHANG ; Xing ZHANG ; Donghang LI ; Hongbo WANG ; Jimin CAO
Acta Universitatis Medicinalis Anhui 2026;61(7):1215-1222
ObjectiveTo investigate the effect of Semaphorin 3A (Sema3A) on the progression of pathological cardiac hypertrophy. MethodsWild-type C57BL 6J mice, Sema3A global overexpressing (Sema3A/Cre-ERTM) mice, and their littermate controls (Cre-ERTM) were used, with 6 mice per group. A pressure-overload induced cardiac hypertrophy model was established via transverse aortic constriction (TAC), with a sham-operated group (Sham) as the control. Cardiac hypertrophy was assessed by gross morphology, heart weight/body weight ratio (HW/BW), heart weight/tibia length ratio (HW/HL), and heart weight/lung weight ratio (HW/PW). Cardiac function was evaluated by measuring ejection fraction (EF) and fractional shortening (FS) via echocardiography. In heart tissues, the mRNA level of atrial natriuretic peptide (ANP) and Sema3A were detected by RT-qPCR, Sema3A protein level was detected by western blot, morphological structure was detected by hematoxylin and eosin (HE) staining, level of fibrosis was detected by Masson’s trichrome staining, and angiogenesis was detected by immunohistochemical detection of CD31. For in vitro experiments, rat H9C2 cardiomyocytes were treated with angiotensin Ⅱ (Ang Ⅱ) to induce hypertrophy, with PBS-treated cells as the control. After 48 hours, the mRNA expression of ANP, B-type natriuretic peptide (BNP) and Sema3A were measured by RT-qPCR, and Sema3A protein level was assessed by western blot. ResultsAt the animal level, compared with the sham group, mice subjected to TAC showed significantly increased mRNA levels of ANP in cardiac tissue, as well as markedly elevated mRNA and protein levels of Sema3A (all P<0.05). Compared with the Cre-ERTM + TAC group, the Sema3A/Cre-ERTM + TAC group exhibited more pronounced cardiac hypertrophy, greater ventricular wall thickening, higher HW/BW, HW/HL, and HW/PW ratios, more significant reductions in EF and FS, more severe cardiac fibrosis, and a significant decrease in cardiac CD31 expression levels (all P<0.05). At the cellular level, compared with the control group, H9C2 cells treated with Ang Ⅱ displayed significantly increased mRNA levels of ANP and BNP, along with markedly elevated mRNA and protein levels of Sema3A (all P<0.05). ConclusionSema3A promotes the progression of pressure overload-induced cardiac hypertrophy by inhibiting angiogenesis.
4.Tengli Kangliu Prescription Inhibits Colorectal Adenoma Carcinoma Transition in Mice via Regulating STAT3 Signaling Pathway and Targeting M2 Type Macrophages
Fang LIU ; Kaiyue CHI ; Qingxiu WU ; Xing SHI ; Jiangmei ZOU ; Mingjun BAO ; Bo CAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(19):207-216
ObjectiveTo investigate the intervention effect of Tengli Kangliu prescription (TKP) on the carcinogenesis of colorectal adenoma (CRA) induced by azoxymethane (AOM)/dextran sulphate sodium salt (DSS) in C57BL/6 mice and decipher the potential mechanism through regulating the signal transducer and activator of transcription 3 (STAT3) pathway to target M2-type macrophages. MethodsA total of 55 male C57BL/6 mice were randomized into a blank group (n=10), a model group (n=15), a celecoxib (0.02 g·kg-1·d-1) group (n=15), a TKP (42.43 g·kg-1·d-1) group (n=15). The mice in the model, TKP, and celecoxib groups were modeled for CRA lesions through the AOM/DSS three-cycle protocol. The intervention in each group began one week after free access to DSS and lasted for 12 weeks, and the blank group received 20 mL·kg-1·d-1 normal saline through gavage. Throughout the study period, changes in body mass and survival rate were recorded, alongside measurements of colorectal length and spleen mass. Histological changes of the colonic tissue were observed by HE staining. Immunohistochemical (IHC) staining was performed to detect the positive expression of CD68 and CD11c in the colorectal tissue. Western blot was employed to assess the protein levels of STAT3, phosphorylated (p)-STAT3, B-cell lymphoma 2 (Bcl-2), and Bcl-2-associated X protein (Bax) in the intestinal tissue. Real-time quantitative PCR was employed to analyze the mRNA levels of arginase 1 (Arg1), CD206, and vascular endothelial growth factor (VEGF). Enzyme-linked Immunosorbent assay(ELISA) was employed to measure the serum concentrations of Th2-type cytokines interleukin (IL)-4, IL-6, and IL-13 in mice. ResultsCompared with the blank group, the model group exhibited symptoms including diarrhea, hematochezia, and body mass loss, accompanied by shortened colon length, mucosal damage, and multiple tumors. In addition, the model group showcased up-regulated protein levels of STAT3, p-STAT3, and Bcl-2, down-regulated protein level of Bax, increased positive expression of CD68 and CD11c, and up-regulated mRNA levels of Arg1, CD206, and VEGF in the colon tissue, together with elevated serum levels of IL-4, IL-13, and IL-6 (P<0.05). Compared with the model group, the above-mentioned indicators were partially reversed in both TKP group and celecoxib group, with superior effects observed in the TKP group (P<0.05). ConclusionTKP significantly improves the survival quality of the mouse model of AOM/DSS-induced CRA by reducing intestinal inflammation and decreasing colorectal tumor number and size. It may delay the progression of AOM/DSS-induced colorectal tumor-like lesions by inhibiting activation of the STAT3/p-STAT3 signaling pathway in the intestinal tissue, targeting regulation of M2-type macrophages, and improving the tumor microenvironment, thereby suppressing CRA carcinogenesis.
5.Structure and Function of GPR126/ADGRG6
Ting-Ting WU ; Si-Qi JIA ; Shu-Zhu CAO ; De-Xin ZHU ; Guo-Chao TANG ; Zhi-Hua SUN ; Xing-Mei DENG ; Hui ZHANG
Progress in Biochemistry and Biophysics 2025;52(2):299-309
GPR126, also known as ADGRG6, is one of the most deeply studied aGPCRs. Initially, GPR126 was thought to be a receptor associated with muscle development and was primarily expressed in the muscular and skeletal systems. With the deepening of research, it was found that GPR126 is expressed in multiple mammalian tissues and organs, and is involved in many biological processes such as embryonic development, nervous system development, and extracellular matrix interactions. Compared with other aGPCRs proteins, GPR126 has a longer N-terminal domain, which can bind to ligands one-to-one and one-to-many. Its N-terminus contains five domains, a CUB (complement C1r/C1s, Uegf, Bmp1) domain, a PTX (Pentraxin) domain, a SEA (Sperm protein, Enterokinase, and Agrin) domain, a hormone binding (HormR) domain, and a conserved GAIN domain. The GAIN domain has a self-shearing function, which is essential for the maturation, stability, transport and function of aGPCRs. Different SEA domains constitute different GPR126 isomers, which can regulate the activation and closure of downstream signaling pathways through conformational changes. GPR126 has a typical aGPCRs seven-transmembrane helical structure, which can be coupled to Gs and Gi, causing cAMP to up- or down-regulation, mediating transmembrane signaling and participating in the regulation of cell proliferation, differentiation and migration. GPR126 is activated in a tethered-stalk peptide agonism or orthosteric agonism, which is mainly manifested by self-proteolysis or conformational changes in the GAIN domain, which mediates the rapid activation or closure of downstream pathways by tethered agonists. In addition to the tethered short stem peptide activation mode, GPR126 also has another allosteric agonism or tunable agonism mode, which is specifically expressed as the GAIN domain does not have self-shearing function in the physiological state, NTF and CTF always maintain the binding state, and the NTF binds to the ligand to cause conformational changes of the receptor, which somehow transmits signals to the GAIN domain in a spatial structure. The GAIN domain can cause the 7TM domain to produce an activated or inhibited signal for signal transduction, For example, type IV collagen interacts with the CUB and PTX domains of GPR126 to activate GPR126 downstream signal transduction. GPR126 has homology of 51.6%-86.9% among different species, with 10 conserved regions between different species, which can be traced back to the oldest metazoans as well as unicellular animals.In terms of diseases, GPR126 dysfunction involves the pathological process of bone, myelin, embryo and other related diseases, and is also closely related to the occurrence and development of malignant tumors such as breast cancer and colon cancer. However, the biological function of GPR126 in various diseases and its potential as a therapeutic target still needs further research. This paper focuses on the structure, interspecies differences and conservatism, signal transduction and biological functions of GPR126, which provides ideas and references for future research on GPR126.
6.SR9009 combined with indolepropionic acid alleviates inflammation in C2C12 myoblasts through the nuclear factor-kappa B signaling pathway
Huihui JI ; Xu JIANG ; Zhimin ZHANG ; Yunhong XING ; Liangliang WANG ; Na LI ; Yuting SONG ; Xuguang LUO ; Huilin CUI ; Ximei CAO
Chinese Journal of Tissue Engineering Research 2025;29(6):1220-1229
BACKGROUND:Rev-erbα is involved in the regulation of inflammation,but pharmacological activation of Rev-erbα increases the risk for cardiovascular diseases.To reduce the relevant risk,an exploration on SR9009,a Rev-erbα agonist,combined with other drugs to relieve inflammation in skeletal myoblasts was conducted,laying the theoretical foundation for the treatment of inflammation-associated skeletal muscle atrophy. OBJECTIVE:To investigate the relationship of SR9009,indolepropionic acid and nuclear factor-κB signaling pathways in lipopolysaccharide-induced C2C12 myoblasts. METHODS:(1)C2C12 myoblasts were induced to differentiate in the presence of lipopolysaccharide(1 μg/mL).RNA-seq and KEGG pathway analysis were used to study signaling pathways.(2)C2C12 myoblast viability was assessed using the cell counting kit-8 assay to determine optimal concentrations of indolepropionic acid.Subsequently,cells were categorized into control group,lipopolysaccharide(1 μg/mL)group,SR9009(10 μmol/L)+lipopolysaccharide group,indolepropionic acid(80μmol/L)+lipopolysaccharide group,and SR9009+indolepropionic acid+lipopolysaccharide group.ELISA was employed to measure protein expression levels of interleukin-6 in the cultured supernatant.Real-time quantitative PCR were employed to measure mRNA expression levels of interleukin-6,tumor necrosis factor α,TLR4 and CD14.Western blot assay were employed to measure protein expression levels of NF-κB p65 and p-NF-κB p65.(3)After Rev-erbα was knocked down by siRNA,knockdown efficiency was assessed by RT-qPCR.And mRNA levels of interleukin-6 and tumor necrosis factor α were also measured. RESULTS AND CONCLUSION:Compared with the blank control group,lipopolysaccharide time-dependently inhibited myofibroblast fusion to form myotubes,the mRNA expression levels of interleukin-6 and tumor necrosis factor α were elevated,and the level of interleukin-6 in the cell supernatant was significantly increased.The results of KEGG pathway showed that the nuclear factor-κB signaling pathway was activated by lipopolysaccharide.Indolepropionic acid exhibited significant suppression of C2C12 myoblasts viability when its concentration exceeded 80 μmol/L.Indolepropionic acid and SR9009 inhibited the activation of NF-κB signaling pathway,thereby played an anti-inflammatory role,and suppressed the mRNA expression levels of interleukin-6,tumor necrosis factor α,TLR4 and CD14.Compared with the lipopolysaccharide group,the ratio of p-NF-κB p65/NF-κB p65 protein expression were downregulated.SR9009 combined with indolepropionic acid notably reduced lipopolysaccharide-induced inflammation,further downregulated the mRNA expression levels of interleukin-6,tumor necrosis factor α,TLR4 and CD14.The ratio of p-NF-κB p65/NF-κB p65 protein expression was significantly lower than that in the SR9009+lipopolysaccharide group or indolepropionic acid+lipopolysaccharide group.Rev-erbα increases time-dependently with lipopolysaccharide induction.The knockdown efficiency of Rev-erbα by siRNA reached over 58%,and lipopolysaccharide was added after Rev-erbα was successfully knocked down.Compared with the lipopolysaccharide group,the mRNA expression levels of interleukin-6 and tumor necrosis factor α were significantly up-regulated.These results conclude that Rev-erbα may act as a promising pharmacological target to reduce inflammation.SR9009 targeted activation of Rev-erbα combined with indolepropionic acid significantly inhibits the nuclear factor-κB signaling pathway and attenuates the inflammatory response of C2C12 myofibroblasts.Moreover,the combined anti-inflammatory effect is superior to that of the intervention alone.
7.Molecular Mechanisms Underlying Inhibition of LPS-induced Inflammatory Cytokine Production by Nanovesicles Derived from Rhizoma Polygonati
Teng-Hui CAO ; Xing-Wang LONG ; Lin LIU ; Gang-Lin WANG ; Wei LI
Chinese Journal of Biochemistry and Molecular Biology 2025;41(2):249-259
Plant-derived exosome-like nanovesicles refer to spherical lipid bilayer vesicles isolated from plants that contain lipids,proteins,RNAs,and various small molecules.These nanovesicles exhibit di-verse biological activities,including anti-inflammatory,anti-tumor,antioxidant,and drug delivery prop-erties.However,the functional characteristics of nanovesicles derived from rhizoma polygonati remain un-explored.In this study,exosome-like nanovesicles derived from rhizoma polygonati(referred to as RP-EVs)were successfully isolated using ultracentrifugation and density gradient centrifugation.Their physi-cochemical properties and anti-inflammatory functions were systematically characterized.Our results show that RP-EVs are predominantly negatively charged,with an average particle size of 166.5±3.3 nm,and are spherical lipid vesicles.Cellular uptake assays demonstrated that RP-EVs can be phagocytized by macrophages.qPCR and ELISA experiments revealed that RP-EVs can inhibit the elevation of interleukin 6(IL-6),interleukin 1 β(IL-1 β),and tumor necrosis factor-alpha(TNF-α)induced by lipopolysac-charide(LPS)stimulation(****P<0.0001).Additionally,reactive oxygen species(ROS)and 2,2-diphenyl-1-picrylhydrazyl(DPPH)scavenging assays confirmed that RP-EVs exhibit antioxidant proper-ties(*P<0.05).Further investigation of the underlying mechanisms through immunofluorescence and Western blotting revealed that RP-EVs inhibit the nuclear translocation(**P<0.01)and phosphoryla-tion(***P<0.001)of nuclear factor kappa-B p65(NF-κB p65)via the IκBα/NF-κB signaling path-way,thereby regulating the expression of inflammatory mediators.In animal experiments,intraperitoneal injection of RP-EVs into mice for 48 hours showed predominant localization in the liver and spleen.Fi-nally,an acute inflammatory mouse model was established via intraperitoneal injection of LPS.qPCR and ELISA analyses demonstrated that RP-EVs alleviated the expression of inflammatory factors in both the serum and spleen of LPS-treated mice(*P<0.05).In conclusion,this study isolated RP-EVs and elu-cidated their anti-inflammatory properties and potential mechanisms.These findings provide valuable in-sights into the functional exploration of nanoparticle vesicles derived from traditional Chinese medicine and suggest a novel therapeutic strategy for the treatment of inflammation-related diseases.
8.Exploring the Principles of Syndrome Differentiation and Treatment for STC Based on the Theories of"Excess Syndrome is Corresponding to Zhanyu,Deficiency Syndrome is Corresponding to Zhengsheng"and the"Brain-Gut Axis"
Haipeng LU ; Xing CHEN ; Zhijin TAN ; Renbin GONG ; Ziqin WANG ; Shuhua CAO ; Xiaoshan GUO ; Ning TIAN
World Science and Technology-Modernization of Traditional Chinese Medicine 2025;27(10):2950-2958
STC is a kind of clinically common functional gastrointestinal disease.Its pathogenesis hasn't been completely clarified,and current diagnosis and treatment norms are certainly limited.In recent years,"Brain-Gut Axis"theory has unveiled the complex bidirectional regulation mechanism between brain and intestinal tract,rendering new perspective for the research and treatment of STC.TCM theory demonstrates that there is close connection between brain and gut,has formed abundant experience in discrimination and treatment of STC and formed unique diagnosis and treatment ideas.Based on the theory of"Brain-Gut Axis"and"excess syndrome is corresponding to Zhanyu,deficiency syndrome is corresponding to Zhengsheng"in the chapter on Yangming diseases in"Treatise on Febrile Diseases",this paper elaborates on the relationship between the"Brain-Gut Axis"and STC.Meanwhile,by combining the theory of"excess syndrome is corresponding to Zhanyu,deficiency syndrome is corresponding to Zhengsheng"with the"Brain-Gut Axis"theory,it analyzes the influence of the excess and deficiency of the Yangming meridian on the mental state as well as the regulatory mechanism of the"Brain-Gut Axis",and puts forward corresponding treatment methods according to different syndromes.By integrating the relevant provisions in"Treatise on Febrile Diseases"with the"Brain-Gut Axis"theory of modern medicine,this paper makes a preliminary exploration of the laws of differentiating and treating STC,aiming to provide a theoretical basis for promoting a more comprehensive understanding of the pathogenesis of STC and developing more effective treatment strategies.
9.Construction of sulfur mustard analogue-induced skin contamina-tion models in BALB/c mice and its decontamination
Shuai GUO ; Huanchun XING ; Wenbin CAO ; Lin WANG ; Aibing CHEN ; Yongan WANG ; Jun YANG
Chinese Journal of Pharmacology and Toxicology 2025;39(4):277-284
OBJECTIVE To establish skin contamination models with sulfur mustard analogue 1-chloro-2-ethylsulfanyl ethane(CEES),and evaluate the therapeutic efficacy of reactive skin decontamination lotion kit(RSDL).METHODS ①Kunming,BALB/c,BALB/c-nu,and C57BL/6N were contaminted with CEES 75 μL·kg-1 using exposed method and covered method for 10 min on the dorsal skin.Wound healing times and areas were assessed to determine the stock of mice and exposure method.② BALB/c mice were exposed to a gradient of CEES at the doses of 75,150,250,350 and 500 μL·kg-1(10 min)using the covered method.Wound healing times,areas and Kaplan-Meier survival curves were used to determine the optimal dose.③ BALB/c mice were exposed to CEES 150 μL·kg-1 for varying durations(5,10 and 20 min)using the covered method.Wound healing times,areas and Kaplan-Meier survival curves were analyzed to determine the optimal exposure time.④ BALB/c mice were divided into four groups:control(exposed with the covered method at 150 μL·kg-1,10 min),treatment(20 μL RSDL treatment after exposure,as the control group),5 min treatment(20 μL RSDL treatment after 5 min of exposure,followed by 5 min of coverage)and immediate-treatment(exposed with the exposed method at 150 μL·kg-1,immediately treated with 20 μL RSDL,followed by 10 min of coverage).The therapeutic efficacy was evaluated based on the wound area,subcutaneous microvesicle count,epidermal thick-ness,and inflammatory cytokine(IL-6 and TNF-α)expressions.RESULTS ① The covered method caused more severe and prolonged wounds than the exposed method.BALB/c mice exhibited a high sensitivity to CEES with delayed wound healing and were therefore selected as the model animal.② Survival rates in BALB/c mice dropped below 50%at doses of 250,350 and 500 μL·kg-1,whereas an 83.3%survival rate was observed at 150 μL·kg-1.③ The mice exposed to CEES(150 μL·kg-1,20 min)died within 3 days.The wound area was consistently smaller in the 5 min covered group than in the 10 min covered group.④CEES-induced skin injury led to epidermal nuclear pyknosis,follicular disrup-tion,inflammatory infiltration,and microvesicle formation in both treatment and poisoned control groups.As more immediate treatment,the wound area significantly decreased.While the IL-6 expres-sion showed no significant intergroup difference,the TNF-α expression was significantly higher in the treatment group.CONCLUSION A CEES-induced skin contamination model has been established in BALB/c mice using the covered method(150 μL·kg-1,10 min covered).However,RSDL should be ad-ministered in 10 min post-contamination.
10.A scoping review on the current status and influencing factors of adherence to lymphedema prevention behaviors in postoperative breast cancer patients
Mengdi CAO ; Yanyan WANG ; Jing LI ; Xing LI ; Zezhao WANG
Chinese Journal of Modern Nursing 2025;31(34):4743-4749
Objective:To conduct a scoping review on the current status and influencing factors of adherence to lymphedema prevention behaviors among postoperative breast cancer patients, with the aim of providing a scientific basis for developing targeted interventions.Methods:A comprehensive search was conducted in both Chinese and English databases, including China National Knowledge Infrastructure, Wanfang Data, SinoMed, PubMed, Cochrane Library, Embase, CINAHL, and Web of Science, for literature published up to August 31, 2024, related to adherence to lymphedema prevention behaviors in breast cancer survivors. Eligible articles were screened, and data were extracted to analyze adherence levels. Influencing factors were mapped to the domains of the Theoretical Domains Framework to identify and analyze key behavioral determinants.Results:A total of 15 articles were included: nine quantitative and six qualitative. Overall, adherence to lymphedema prevention behaviors among postoperative breast cancer patients was found to be suboptimal. A total of 25 influencing factors were identified and categorized into eight theoretical domains: knowledge (lymphedema awareness) ; skills (coping strategies, time since surgery) ; beliefs about capabilities (self-efficacy, illness perception, unawareness of tumor stage, surgical type, symptom distress) ; beliefs about consequences (outcome expectations, attitudes) ; emotions (negative emotions, fatigue, age) ; behavior regulation (self-regulation, exercise habits, behavioral control) ; social influences (social support, family support, marital status, behavioral cues) ; environmental context and resources (healthcare access, ethnicity, professional supervision, financial status, employment situation) .Conclusions:Adherence to lymphedema prevention behaviors in postoperative breast cancer patients remains unsatisfactory, with influencing factors being multifaceted, diverse, and overlapping. Future efforts should focus on uncovering the potential interrelationships among these factors to enhance adherence and support long-term self-management in this population.

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