Objective:To explore the key influencing factors and combined action pathways of self-management behaviors of young and middle-aged patients with type 2 diabetes mellitus (T2DM), so as to provide reference for improving self-management behaviors of young and middle-aged patients with T2DM.Methods:Between August 2024 and January 2025, young and middle-aged patients with T2DM in the Department of Endocrinology of three ClassⅢ Grade A hospitals in Jiangsu Province were selected by convenience sampling method. A framework for configuration path analysis of self-management behaviors in young and middle-aged patients with T2DM was constructed based on the capability, opportunity, motivation-behavior (COM-B) model. Fuzzy-set qualitative comparative analysis (fsQCA) was used to explore different conditional configurations of self-management behaviors in young and middle-aged people with T2DM.Results:Based on five conditional variables (risk perception, health literacy, self-efficacy, social support, and family care) of self-management behaviors of young and middle-aged patients with T2DM, three configuration pathways (ability-driven, motivation-driven, and integrative-driven) were derived, with an overall consistency of 0.86 and a total coverage of 0.54. Self-efficacy was a core condition of self-management behavior in young and middle-aged people with T2DM.Conclusions:Self-management behaviors of young and middle-aged patients with T2DM are influenced by a combination of multiple factors, of which self-efficacy is the core influencing factor. Healthcare professionals should develop targeted interventions based on the groups represented by the different pathways to improve self-management behaviors and enhance patients' quality of life.

The incidence of cancer continues to rise, and improving treatment outcomes and quality of life for cancer patients has become a major goal. Death anxiety is prevalent throughout the entire disease trajectory of cancer patients. It not only severely impairs their psychological well-being and quality of life but also undermines treatment confidence and rational decision-making. Therefore, it warrants significant clinical attention. This paper reviews the current status of assessment, influencing factors, and intervention strategies for death anxiety in cancer patients, aiming to provide a reference for healthcare professionals.

Breast cancer is the leading cause of cancer-related mortality among women worldwide and has drawn extensive research attention.Owing to its molecular heterogeneity,drug resistance,and low therapeutic response,single-modality treatments often fail to achieve satisfactory efficacy or broad applicability.Combination therapy,designed based on the pathophysiological characteristics,related signaling pathways,and biomarkers of breast cancer,has emerged as a promising approach for improving therapeutic outcomes.With the advancement of research on combination strategies,the understanding of their molecular mechanisms—particularly key signaling pathways and biomarkers—has become increasingly important.However,comprehensive reviews addressing these molecular mechanisms and synergistic strategies remain scarce.This article summarizes recent advances in combination therapy for breast cancer,providing a comprehensive review of recent combination therapies for breast cancer and their underlying molecular mechanisms,and focusing on key signaling pathways involved in combination therapy and synergistic strategies,thereby providing theoretical insights and reference for researchers,graduate students,and clinicians engaged in the development of novel combination therapeutic strategies for breast cancer and related malignancies.

Objective This study aims to explore the influence of social support on depressive symptoms and its threshold effect in elderly patients undergoing maintenance hemodialysis(MHD),thereby providing a basis for improving patients' depressive conditions.Methods A convenience sample of 440 elderly MHD patients was recruited from the hemodialysis centers of 3 general hospitals in Kunshan between October 2024 and February 2025.Data collection involved the use of a general information questionnaire,the Social Support Rating Scale(SSRS),and the Short Form Geriatric Depression Scale(GDS-15).Logistic regression and threshold effect analyses were conducted to identify influencing factors and assess their impact.Results A total of 432 valid questionnaires were recovered,yielding a response rate of 98.18％.The prevalence of depressive symptoms among elderly MHD patients was 27.8％,with an average social support score of 32.53±5.58,indicating a moderate level of social support.Logistic regression analysis revealed that the use of assistive devices,dialysis modality,marital status,social support,and type of vascular access were significant factors influencing depressive symptoms(P＜0.05).Restricted cubic spline analysis indicated a non-linear relationship between social support and depressive symptoms(P＜0.001).Threshold effect analysis showed that when the social support score was≥ 23,depressive symptoms decreased as the social support score increased(P＜0.05).Conclusion The impact of social support on depressive symptoms in elderly MHD patients has a critical threshold.This finding suggests that clinical healthcare providers should prioritize interventions for patients with low social support to improve their physical and mental health and quality of life by enhancing social support levels.

Objective:To analyze and clarify the conceptual connotation of help-seeking delay in diabetic foot, with the aim of providing reference for clinical nursing practice.Methods:A systematic literature search was conducted in China National Knowledge Infrastructure, VIP, Wanfang Data, Web of Science, PubMed, and Embase databases, covering all available publications up to October 10, 2024. Rodgers' evolutionary concept analysis method was employed for analysis.Results:A total of 53 articles were included. Three defining attributes of help-seeking delay in diabetic foot were identified: delay in seeking medical care, perceived risk of complications, and irrational help-seeking behaviors. Five antecedents were extracted: sociodemographic factors, disease-related factors, social factors, level of diabetes knowledge, and coping styles. Three consequences were summarized: poor clinical outcomes, increased hospitalization duration and costs, and decreased prognosis and quality of life.Conclusions:Systematic analysis of the concept of help-seeking delay in diabetic foot is beneficial for medical staff to develop specific assessment tools and implement individualized intervention strategies, thereby reducing the occurrence of help-seeking delay and improving patient outcomes.

Objective:To explore the key influencing factors and combined action pathways of self-management behaviors of young and middle-aged patients with type 2 diabetes mellitus (T2DM), so as to provide reference for improving self-management behaviors of young and middle-aged patients with T2DM.Methods:Between August 2024 and January 2025, young and middle-aged patients with T2DM in the Department of Endocrinology of three ClassⅢ Grade A hospitals in Jiangsu Province were selected by convenience sampling method. A framework for configuration path analysis of self-management behaviors in young and middle-aged patients with T2DM was constructed based on the capability, opportunity, motivation-behavior (COM-B) model. Fuzzy-set qualitative comparative analysis (fsQCA) was used to explore different conditional configurations of self-management behaviors in young and middle-aged people with T2DM.Results:Based on five conditional variables (risk perception, health literacy, self-efficacy, social support, and family care) of self-management behaviors of young and middle-aged patients with T2DM, three configuration pathways (ability-driven, motivation-driven, and integrative-driven) were derived, with an overall consistency of 0.86 and a total coverage of 0.54. Self-efficacy was a core condition of self-management behavior in young and middle-aged people with T2DM.Conclusions:Self-management behaviors of young and middle-aged patients with T2DM are influenced by a combination of multiple factors, of which self-efficacy is the core influencing factor. Healthcare professionals should develop targeted interventions based on the groups represented by the different pathways to improve self-management behaviors and enhance patients' quality of life.

The incidence of cancer continues to rise, and improving treatment outcomes and quality of life for cancer patients has become a major goal. Death anxiety is prevalent throughout the entire disease trajectory of cancer patients. It not only severely impairs their psychological well-being and quality of life but also undermines treatment confidence and rational decision-making. Therefore, it warrants significant clinical attention. This paper reviews the current status of assessment, influencing factors, and intervention strategies for death anxiety in cancer patients, aiming to provide a reference for healthcare professionals.

Rapid and ultrasensitive detection of pathogen-associated biomarkers is vital for the early diagnosis and therapy of bacterial infections.Herein,we developed a close-packed and ordered Au@AgPt array coupled with a cascade triggering strategy for surface-enhanced Raman scattering(SERS)and colorimetric identification of the Staphylococcus aureus biomarker micrococcal nuclease(MNase)in serum samples.The trimetallic Au@AgPt nanozymes can catalyze the oxidation of 3,3',5,5'-tetramethylbenzidine(TMB)molecules to SERS-enhanced oxidized TMB(oxTMB),accompanied by the color change from colorless to blue.In the presence of S.aureus,the secreted MNase preferentially cut the nucleobase AT-rich regions of DNA sequences on magnetic beads(MBs)to release alkaline phosphatase(ALP),which subsequently mediated the oxTMB reduction for inducing the colorimetric/SERS signal fade away.Using this"on-to-off"triggering strategy,the target S.aureus can be recorded in a wide linear range with a limit of detection of 38 CFU/mL in the colorimetric mode and 6 CFU/mL in the SERS mode.Meanwhile,the MNase-mediated strategy characterized by high specificity and sensitivity successfully discriminated between patients with sepsis(n=7)and healthy participants(n=3),as well as monitored the prog-nostic progression of the disease(n=2).Overall,benefiting from highly active and dense"hot spot"substrate,MNase-mediated cascade response strategy,and colorimetric/SERS dual-signal output,this methodology will offer a promising avenue for the early diagnosis of S.aureus infection.

Rapid and ultrasensitive detection of pathogen-associated biomarkers is vital for the early diagnosis and therapy of bacterial infections. Herein, we developed a close-packed and ordered Au@AgPt array coupled with a cascade triggering strategy for surface-enhanced Raman scattering (SERS) and colorimetric identification of the Staphylococcus aureus biomarker micrococcal nuclease (MNase) in serum samples. The trimetallic Au@AgPt nanozymes can catalyze the oxidation of 3,3',5,5'-tetramethylbenzidine (TMB) molecules to SERS-enhanced oxidized TMB (oxTMB), accompanied by the color change from colorless to blue. In the presence of S. aureus, the secreted MNase preferentially cut the nucleobase AT-rich regions of DNA sequences on magnetic beads (MBs) to release alkaline phosphatase (ALP), which subsequently mediated the oxTMB reduction for inducing the colorimetric/SERS signal fade away. Using this "on-to-off" triggering strategy, the target S. aureus can be recorded in a wide linear range with a limit of detection of 38 CFU/mL in the colorimetric mode and 6 CFU/mL in the SERS mode. Meanwhile, the MNase-mediated strategy characterized by high specificity and sensitivity successfully discriminated between patients with sepsis (n = 7) and healthy participants (n = 3), as well as monitored the prognostic progression of the disease (n = 2). Overall, benefiting from highly active and dense "hot spot" substrate, MNase-mediated cascade response strategy, and colorimetric/SERS dual-signal output, this methodology will offer a promising avenue for the early diagnosis of S. aureus infection.

BACKGROUND: Generalized pustular psoriasis (GPP), a rare and recurrent autoinflammatory disease, imposes a substantial burden on patients and society. Awareness of GPP in China remains limited. METHODS: This cross-sectional survey, conducted between September 2021 and May 2023 across 14 hospitals in China, included GPP patients of all ages and disease phases. Data collected encompassed demographics, clinical characteristics, economic impact, disease severity, quality of life, and treatment-related complications. Risk factors for GPP recurrence were analyzed. RESULTS: Among 127 patients (female/male ratio = 1.35:1), the mean age of disease onset was 25 years (1st quartile [Q1]-3rd quartile [Q3]: 11-44 years); 29.2% had experienced GPP for more than 10 years. Recurrence occurred in 75.6% of patients, and nearly half reported no identifiable triggers. Younger age at disease onset ( P  = 0.021) and transitioning to plaque psoriasis ( P  = 0.022) were associated with higher recurrence rates. The median diagnostic delay was 8 months (Q1-Q3: 2-41 months), and 32.3% of patients reported misdiagnoses. Comorbidities were present in 53.5% of patients, whereas 51.1% experienced systemic complications during treatment. Depression and anxiety affected 84.5% and 95.6% of patients, respectively. During GPP flares, the median Dermatology Life Quality Index score was 19.0 (Q1-Q3: 13.0-23.5). This score showed significant differences between patients with and without systemic symptoms; it demonstrated correlations with both depression and anxiety scores. Treatment costs caused financial hardship in 55.9% of patients, underscoring the burden associated with GPP. CONCLUSIONS The substantial disease and economic burdens among Chinese GPP patients warrant increased attention. Patients with early onset disease and those transitioning to plaque psoriasis require targeted interventions to mitigate the high recurrence risk.
Humans ; Male ; Female ; Psoriasis/pathology* ; Adult ; Cross-Sectional Studies ; Adolescent ; Child ; Young Adult ; Quality of Life ; Middle Aged ; China/epidemiology* ; Recurrence ; Risk Factors ; Surveys and Questionnaires ; East Asian People