ObjectiveTo investigate the current situation of mutual recognition for ethical review outcomes in multicenter clinical research across 10 contracting medical institutions in Guangdong Province， analyze existing issues and propose improvement recommendations， thereby promoting the standardized management of mutual recognition for ethical review outcomes in medical institutions. MethodsData from 381 multicenter clinical studies conducted in these 10 medical institutions from January 24 to October 31， 2024， were collected. Text visualization was performed using Python and the WordCloud library， and statistical analyses were conducted with SPSS 25.0. ResultsOf the 381 studies investigated， industry-sponsored clinical trials （ISTs） accounted for 51.71%， while investigator-initiated clinical trials （IITs） constituted 48.29%. The proportions of ethical committees serving as primary reviewers and collaborative reviewers were 33.33% and 66.67%， respectively. The confirmation methods of mutual recognition outcomes were primarily expedited reviews （50.66%） and meeting reviews （49.34%）， and no cases of “direct confirmation” were found. The Chi-square test revealed statistically significant differences in review confirmation methods based on project type （χ²=14.851， P<0.001） and ethics committee role （χ²= 69.435， P<0.001）. The frequency distribution trend of the contingency table showed that IST projects and primary ethics committees preferred to employ meeting review （58.88% and 79.53% respectively， both higher than the average level of 49.34%）， while IIT projects and the collaborative ethics committees more frequently utilized expedited review （60.87% and 65.75% respectively， both higher than the average level of 50.66%）. ConclusionThe confirmation methods of mutual recognition for ethical review outcomes in multicenter clinical research are significantly associated with the role of the ethics committee and the type of project. It is recommended to improve management systems， enhance information construction and personnel training， as well as clarify mutual recognition responsibilities and strengthen supervision. This aims to ensure review quality while improving mutual recognition efficiency， thereby safeguarding the rights and interests of research participants.

Background/Aims: Non-pharmacological treatments are crucial for managing irritable bowel syndrome (IBS), yet patient engagement remains a challenge. Understanding patients' knowledge, attitudes, and practices regarding these treatments is essential for improving care. Methods: A cross-sectional study was conducted across 5 hospitals, from October 2023 to February 2024. A self-designed knowledge, attitudes, and practices questionnaire along with the IBS quality of life and IBS severity scoring system was administered, and 496 valid responses were analyzed. Statistical analyses included correlation tests, multivariate linear regression, and mediation effect analysis. Results: The median scores for knowledge, attitude, and practice were 28, 25.5, and 21, respectively. Significant positive correlations were found between knowledge-attitude (r = 0.195), knowledge-practice (r = 0.364), and attitude-practice (r = 0.151). The multivariate linear regression analysis further indicated that knowledge (β = 0.399, P < 0.001) and attitude (β = 0.219, P = 0.022) positively correlated with the practical performance. SEM revealed that knowledge had a significant direct effect on both attitude (β = 0.186, P = 0.013) and practice (β = 0.356, P = 0.006). However, the direct effect of attitude on practice was not significant, and attitude did not mediate the relationship between knowledge and practice. Conclusions IBS patients exhibit a significant gap between their positive attitudes and their actual practices concerning non-pharmacological treatments. Knowledge is a direct driver of practice, but positive attitudes alone are insufficient to translate into behavior. Healthcare providers must move beyond simply fostering positive attitudes and focus on targeted educational interventions that provide actionable knowledge and skills to improve patient outcomes.

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.

Objective To investigate the role and mechanism of ubiquitin-specific protease 46 (USP46) in hypoxia/reoxygenation (H/R)-induced pyroptosis of renal tubular epithelial cells. Methods Renal tubular epithelial cells were divided into negative control siRNA group (si-CTL group), USP46 knockdown group (si-USP46 group), negative control siRNA + H/R treatment group (si-CTL+H/R group), and USP46 knockdown + H/R treatment group (si-USP46+H/R group). Flow cytometry was used to detect cell apoptosis in each group. Real-time quantitative polymerase chain reaction (RT-qPCR) was employed to measure the messenger RNA (mRNA) expression of USP46, NOD-like receptor protein 3 (NLRP3), gasdermin D (GSDMD), interleukin (IL)-18, and IL-1β. Western blotting was used to detect the protein expression of USP46, NLRP3, GSDMD, and cleaved cysteinyl aspartate specific proteinase (C-Caspase)-1. The levels of inflammatory factors and lactate dehydrogenase (LDH) in the cell supernatants were detected, and the levels of reactive oxygen species (ROS) and malondialdehyde (MDA) in the cells were detected. Co-immunoprecipitation was used to verify the interaction between USP46 and NLRP3. Results Compared with the si-CTL group, the si-CTL+H/R group exhibited increased cell apoptosis, elevated protein expression of USP46, NLRP3, GSDMD-N and C-Caspase-1, increased mRNA expression of USP46, NLRP3, GSDMD, IL-18 and IL-1β, higher levels of IL-18, IL-1β, TNF-α and LDH, and increased ROS and MDA levels (all P < 0.05). Compared with the si-CTL+H/R group, the si-USP46+H/R group showed decreased cell apoptosis, reduced protein expression of USP46, NLRP3, GSDMD-N and C-Caspase-1, decreased mRNA expression of USP46, GSDMD and IL-18, lower levels of IL-18, IL-1β, TNF-α and LDH, and decreased ROS and MDA levels (all P < 0.05). Co-immunoprecipitation results indicated that USP46 could bind to NLRP3. Conclusions Downregulation of USP46 alleviates H/R-induced pyroptosis in renal tubular epithelial cells, possibly by inhibiting USP46-dependent NLRP3 deubiquitination and promoting NLRP3 ubiquitination and degradation.

Objective To understand the situation of dental cone beam computed tomography (CBCT) quality control testing phantoms in radiation health technical service institutions in Guangdong province, analyze the differences among different phantoms, and provide a reference for dental CBCT quality control testing. Methods The testing phantoms of 49 radiation health technical service institutions were used as the research objects. The designated CBCT equipment was used for scanning and imaging. The Z-score method was used to evaluate the high-contrast resolution, low-contrast resolution, and distance measurement deviation of each phantom. Results The satisfaction rates of various items for the phantoms in 49 institutions ranged from 85.7% to 100%. The distance measurement deviations of four institutions were “suspicious”, and the high-contrast resolution of four institutions and the distance measurement deviation of one institution were “unsatisfactory”. Conclusion The overall performance of dental CBCT quality control testing phantoms in radiological health technical service institutions in Guangdong province is satisfactory. However, there are still some phantoms with poor results in items such as distance measurement deviation and high-contrast resolution. The structural design, material selection, and manufacturing process of the phantom may all affect the results of quality control testing. Therefore, appropriate phantoms, optimized exposure conditions, and suitable reconstruction algorithms should be used in CBCT quality control testing to ensure accurate and reliable measurements.

Objective:To investigate the effect of Knowledge-Attitude-Practice and Health Belief Model(KAP-HBM)combined with evidence-based intervention mode on cardiopulmonary function,coagulation function,quali-ty of life and adverse events in patients with acute heart failure(AHF)during rehabilitation.Methods:This ran-domized controlled study enrolled 110 AHF patients admitted in the Second Affiliated Hospital of Chinese PLA Air Force Military Medical University between February 2020 and March 2023.They were divided into control group(n=55,single evidence-based intervention)and intervention group(n=55,additional KAP-HBM intervention).After 1-month intervention,cardiopulmonary function,coagulation function,quality of life and incidence of ad-verse events were compared between two groups.Results:After 1-month intervention,compared with patients in control group,those in intervention group had significant lower interventricular septal thickness(IVST)[(9.34±0.14)mm vs.(10.28±0.28)mm],left ventricular end-systolic volume index(LVESVI)[(35.47±1.16)ml/m2 vs.(39.81±1.87)ml/m2],left ventricular end-diastolic volume index(LVED VI)[(45.30±1.29)ml/m2 vs.(56.69±2.25)ml/m2],D dimer(D-D)[(365.56±25.38)g/L vs.(491.16±25.86)g/L],fibrinogen(Fg)[(2.79±0.37)mg/dl vs.(3.85±0.51)mg/dl]and score of Minnesota Living with Heart Failure Questionnaire(MLHFQ)[(34.32±2.59)points vs.(39.64±3.18)points],and significant higher forced vital capacity(FVC)[(2.55±0.14)L vs.(2.18±0.22)L],forced expiratory volume in one second(FEV1)[(3.38±0.14)L vs.(2.63±0.14)L],FEV1/FVC[(1.49±0.07)vs.(1.22±0.09)]and prothrombin time(PT)[(16.90±2.96)s vs.(14.10±3.37)s](P＜0.001 all).Intervention group had significant lower incidence of adverse events com-paring to control group(3.64％vs.18.18％,P=0.014).Conclusion:KAP-HBM combined evidence-based intervention mode could significantly improve the cardiopulmonary function,coagulation function and quality of life in AHF patients with high safety.

BACKGROUND:Current treatment strategies for chronic non-healing wounds have shown unsatisfactory results,necessitating the exploration of novel therapeutic approaches.Concentrated growth factors,rich in high-concentration growth factors and possessing a stable natural three-dimensional structure,have demonstrated significant application value in the treatment of chronic non-healing wounds.OBJECTIVE:To review the current status of concentrated growth factor application in chronic non-healing wounds,analyze the shortcomings of concentrated growth factor in clinical applications,and propose constructive suggestions and prospects.METHODS:CNKI,WanFang,and VIP databases were searched with the key words of"concentrated growth factor,platelet concentrate products,chronic wound,chronic ulcer,wound healing,platelet-rich plasma,platelet-rich fibrin"in Chinese.PubMed was searched with the key words of"CGF,concentrated growth factor,platelet concentrate products,chronic wound,chronic ulcer,wound healing,PRP,PRF,platelet-rich plasma,platelet-rich fibrin"in English.The articles published from 2000 to 2024 were searched and further analyzed and summarized after screening.RESULTS AND CONCLUSION:Concentrated growth factor,with its diverse application forms,high concentration of growth factors,natural three-dimensional structure,compatibility with various material technologies,relatively low cost,and ease of operation,has demonstrated significant clinical value in the treatment of chronic wounds.Numerous researchers have validated its positive effects in chronic wound therapy through clinical applications.However,there is currently no clear consensus on standardized concentrated growth factor application protocols,and certain deficiencies have been revealed in practical applications,including issues with dosage,centrifugation settngs,identification schemes,and preparation methods for different forms of concentrated growth factor.There is substantial room for research on concentrated growth factor,and it is believed that with a clear consensus on its application in the future,concentrated growth factor could play a significant role in clinical practice.

Object·To explore the effects of comorbid obsessive-compulsive personality disorder(OCPD)on the behavioral inhibition system(BIS)/behavioral activation system(BAS)in patients with obsessive-compulsive disorder(OCD).Methods·A total of 247 patients with unmedicated OCD diagnosed in the Mental Health Center,Shanghai Jiao Tong University School of Medicine from 2014 to 2018 were included and divided into an OCD group(n=202),and an OCD+OCPD group(n=45),and 107 healthy controls were recruited as a comparison group.Yale-Brown Obsessive-Compulsion Scale(YBOCS),BIS/BAS Scale,Hamilton Depression Scale(HAMD),and Hamilton Anxiety Scale(HAMA)were used to assess psychopathological features.Gender differences among the three groups were analyzed using the x2 test.One-way analysis of variance(ANOVA)was used to compare differences in demographic characteristics,psychopathological features,and BIS/BAS scores,followed by the least significant difference(LSD)test for pairwise comparisons.Regression analysis was conducted to explore the relationships between psychopathological features and BIS/BAS scores.Results·There were no significant differences in gender,age,and years of education among the three groups.The scores of YBOCS(t=2.925,P=0.004),HAMD(t=2.130,P=0.034)and HAMA(t=2.568,P=0.011)in the OCD+OCPD group were significantly higher than those in the OCD group.There were statistically significant differences in BIS and BAS scores among the three groups(BIS:F=39.573,P＜0.001;BAS:F=3.915,P=0.021).The results showed that for BIS,there were statistically significant differences in pairwise comparisons among the three groups(OCD+OCPD vs OCD:P=0.002;OCD+OCPD vs HC:P＜0.001;OCD vs HC:P＜0.001),and the scores were OCD+OCPD＜OCD＜HC from low to high.For BAS,the OCD group scored significantly higher than the OCD+OCPD and HC groups(OCD+OCPD vs OCD:P=0.018;OCD vs HC:P=0.043),but there was no significant difference between the OCD+OCPD and HC groups.Regression models of BIS and BAS were constructed for OCD patients with OCPD,and the results showed that the overall prediction effect of the model was significant for BIS total scores(F=2.599,P=0.013).Only the severity of OCPD symptoms can significantly predict BIS scores(t=-2.282,P=0.023).For BAS total scores,the overall prediction effect of the model was not significant(F=1.438,P=0.191).Conclusion·Comorbid OCPD may be an adverse factor for abnormal BIS and a protective factor for abnormal BAS in patients with OCD.

Objective:To explore the impact of adverse childhood experiences on psychosomatic symptoms and job burnout in the nursing population.Methods:Utilizing a multistage stratified cluster random sampling meth-od,1 661 nurses were selected.Through a 1∶2 propensity score matching approach,demographic and work-related characteristics were balanced between the positive and negative groups of adverse childhood experiences.Finally,880 cases were successfully matched(positive group:300 cases,negative group:580 cases).Linear regression was employed to explore the relationship between nurses'adverse childhood experiences and psychosomatic symptoms(anxiety,depression,physical symptoms),as well as job burnout.The average treatment effect among the treated(ATT)was calculated.Results:Linear regression results revealed a significant positive association between adverse childhood experiences and scores for anxiety symptoms,depression symptoms,physical symptoms,and job burnout(B=1.68,2.67,2.89,5.90;ATT=1.64,2.58,2.82,5.96,Ps＜0.001).However,there was no statistically signif-icant association with scores for a sense of inadequacy in individual achievements(P＞0.05).Conclusion:Nurses who have experienced childhood adverse experiences may exhibit more severe psychosomatic symptoms and job burnout compared to those who have not experienced such adversities during childhood.

microRNA(miRNA),as a short non-coding RNA molecule,regulates bone-immune signal and stress response through transcription,translation as well as the combination of shear process,exerting the effect of promoting angiogenesis and repairing damage bone;type H vessels play a role in the cou-pling of angiogenesis and osteogenesis in the formation of new bone and promoting bone regeneration at the defect site.In re-cent years,miRNA regulates hypoxia inducible factor 1α(HIF-1 α)/vascular endothelial growth factor(VEGF),Notch,plate-let-derived growth factor-BB(PDGF-BB),Wnt/glycogen syn-thase kinase-3 β(GSK3 β)to affect the migration,recruitment,proliferation and differentiation of endothelial cells(ECs)and osteoblast(OB),promote the coupling of H-type vessels and os-teoblasts to improve bone homeostasis,and then prevent and treat bone metabolic diseases.This article explains the role of miRNA in regulating H-type vascular osteogenic coupling to provide tar-gets and pathways for improving bone homeostasis.In addition,the active ingredients of traditional Chinese medicine affect the differential expression of miRNA to promote H-type angiogenesis and provide strategies for clinical prevention and treatment of bone metabolic diseases.