Objective To analyze the potential profiles of discharge readiness in patients after 125I seed implantation and the influencing factors of different profiles.Methods A total of 221 patients who underwent 125I seed implantation in the Interventional Therapy Department,Zhejiang Cancer Hospital from October 2023 to October 2024 were selected as the research objects by convenient sampling method.The general information questionnaire,discharge readiness scale and social support rating scale were used for investigation.Mplus8.3 software was used to conduct latent profile analysis on the discharge readiness of patients after 125I seed implantation,and multivariate Logistic regression model was used to analyze the influencing factors of different discharge readiness profiles.Results The discharge readiness of patients after 125I seed implantation was divided into three potential profiles,"low discharge readiness-low self-care group"(10.41％),"medium discharge readiness-low others care group"(32.58％)and"high discharge readiness-high emotional support group"(57.01％).Logistic regression analysis showed that the number of short-term complications and the level of social support were the influencing factors of the potential profiles of discharge readiness in patients after 125I seed implantation(P＜0.05).Conclusion There is heterogeneity in the discharge readiness of patients after 125I seed implantation,and personalized intervention strategies should be formulated according to different profiles.

The majority of shift work nurses have poor sleep quality,and chronic low quality sleep can adversely affect their physical and mental health,work performance,and patient safety.Non-pharmacologic interventions have a high safety profile and can be effective in improving sleep quality.This article reviews the factors affecting sleep quality,the theoretical basis,non-pharmacological interventions,and their effects among nurses at home and abroad,and proposes an outlook for the future,aims to provide theoretical guidance for the development of well-targeted and scientifically sound intervention programmes in the future.

Objective To analyze the potential profiles of discharge readiness in patients after 125I seed implantation and the influencing factors of different profiles.Methods A total of 221 patients who underwent 125I seed implantation in the Interventional Therapy Department,Zhejiang Cancer Hospital from October 2023 to October 2024 were selected as the research objects by convenient sampling method.The general information questionnaire,discharge readiness scale and social support rating scale were used for investigation.Mplus8.3 software was used to conduct latent profile analysis on the discharge readiness of patients after 125I seed implantation,and multivariate Logistic regression model was used to analyze the influencing factors of different discharge readiness profiles.Results The discharge readiness of patients after 125I seed implantation was divided into three potential profiles,"low discharge readiness-low self-care group"(10.41％),"medium discharge readiness-low others care group"(32.58％)and"high discharge readiness-high emotional support group"(57.01％).Logistic regression analysis showed that the number of short-term complications and the level of social support were the influencing factors of the potential profiles of discharge readiness in patients after 125I seed implantation(P＜0.05).Conclusion There is heterogeneity in the discharge readiness of patients after 125I seed implantation,and personalized intervention strategies should be formulated according to different profiles.

The majority of shift work nurses have poor sleep quality,and chronic low quality sleep can adversely affect their physical and mental health,work performance,and patient safety.Non-pharmacologic interventions have a high safety profile and can be effective in improving sleep quality.This article reviews the factors affecting sleep quality,the theoretical basis,non-pharmacological interventions,and their effects among nurses at home and abroad,and proposes an outlook for the future,aims to provide theoretical guidance for the development of well-targeted and scientifically sound intervention programmes in the future.

Objectives:We aimed to compare the impact of dissection and re-entry(DR)recanalizing pattern with non-DR on the in-hospital results and prognostic outcomes of patients treated successfully by percutaneous coronary intervention(PCI)of chronic total occlusion(CTO)and examine the benefit of DR in CTO PCI. Methods:A total of 815 consecutive patients with CTO meeting the inclusion criteria in the Department of Cardiology of the First Affiliated Hospital of PLA Air Force Military Medical University from January 2018 to December 2020 were enrolled and divided into DR group(n=239)and non-DR group(n=576)according to whether DR recanalizing pattern was used in the procedure.The clinical characteristics,coronary angiographic characteristics,procedure results,and complications were collected,and the prognostic outcomes within one year after the procedure were observed.Propensity score matching by the clinical and coronary angiographic characteristics was performed and results were compared with 208 matched patients in each group.The endpoints were the major adverse cardiovascular events(MACE)consisting of all-cause death and myocardial infarction,clinically driven target vessel revascularization(TVR)one year after the procedure,and in-hospital outcomes. Results:The mean age of all patients was(60.9±10.9)years old,and 87.4%were male.As compared with the non-DR group,the proportion of blunt cap,ambiguous,calcification,angle＞45°,and diseased landing zone,as well as mean J-CTO score was higher in the DR group(all P＜0.05).The mean stent length and median procedure time were longer in the DR group,median guidewires and consumed contrast volume was also higher in the DR group(all P＜0.001).Incidence of in-hospital death,myocardial infarction,perforation,side branch loss,bleeding of BARC 3rd grade and above,and contrast-related impairment of renal function were similar between the two groups(all P＞0.05).However,peripheral vascular complications occurred more frequently in the DR group(P=0.007).One year after the procedure,the incidence of MACE(2.9%vs.2.4%,log-rank P=0.750)and clinically driven TVR(5.8%vs.3.9%,log-rank P=0.365)as well as all-cause death(2.9%vs.1.0%,log-rank P=0.154)and myocardial infarction(0.5%vs.1.9%,log-rank P=0.184)were similar between the two matched groups.Multivariate Cox regression analysis showed no significant association between DR and MACE(HR=1.129,95%CI:0.427-2.979,P=0.807)and TVR(HR=0.606,95%CI:0.213-1.722,P=0.347).LVEF≤40%(HR=2.775,95%CI:1.137-6.774,P=0.025)and elevated residual SYNTAX score(HR=1.089,95%CI:1.032-1.150,P=0.002)were risk factors for MACE,and diseased landing zone(HR=2.144,95%CI:1.019-4.513,P=0.045),rescued ADR(HR=3.479,95%CI:1.109-10.919,P=0.033),and prolonged procedure time(HR=1.007,95%CI:1.002-1.013,P=0.007)were risk factors for TVR. Conclusions:CTO lesion recanalized with PCI utilizing DR operation pattern was associated with more complex characteristics,more devices and time consumed,and longer stent length,while no significant association was observed between DR operation pattern and MACE and TVR one year after the procedure,as well as in-hospital complication..

Objective To explore the value of multi-parameter spectral CT for differentiating grade G2-3 pancreatic neuroendocrine tumor(pNET)and pancreatic neuroendocrine carcinoma(pNEC).Methods Preoperative double-layer detector spectral CT(DLCT)data of 35 patients with pNET(pNET group,including 25 cases of G2 grade and 10 cases of G3 grade)and 17 patients with pNEC(pNEC group)were retrospectively analyzed.Conventional CT and spectral CT parameters were compared between groups,and those being significant different between groups according to univariate analysis were respectively incorporated into multivariate logistic regression to select the independent predictors for identifying grade G2-3 pNET and pNEC.Conventional CT model and spectral CT model were constructed,and the combined model was constructed based on the two.The efficacy of each model for distinguishing grade G2-3 pNET and pNEC was evaluated.Results CT values of lesions during venous phase(OR=0.939,P=0.025)and vascular invasion(OR=5.049,P=0.027)shown on conventional CT were both independent predictors,and conventional CT model was constructed,its area under the curve(AUC)for distinguishing grade G2-3 pNET and pNEC was 0.808.Normalized iodine concentration during venous phase(OR=0.603)and normalized effective atomic number during venous phase(OR=0.847)on spectral CT were both independent predictors(both P＜0.05),and spectral CT model was constructed.The AUC of spectral CT model was 0.894,higher than that of conventional CT model(Z=2.127,P=0.033).The AUC of combined model was 0.924,higher than that of conventional CT model(Z=2.302,P=0.021)but not significantly different with that of spectral CT model(Z=0.827,P=0.408).Conclusion Multi-parameter spectral CT could effectively differentiate grade G2-G3 grade pNET and pNEC.

Objective:To analyze the changes in the variables of venous thromboembolism (VTE) management among inpatients after implementing clinical care classification (CCC) system, and to explore the impacts.Methods:This was a quasi experimental study. Based on the network monitoring data in Zhongshan Hospital, Fudan University, all the inpatients were included in this study from January 2022 to June 2023. According to the date of implementing CCC, we took July 2022 as the intervention cut-off point, and two phases of pre-CCC (January 2022 to June 2022) and post-CCC (July 2022 to June 2023) were defined. The interrupted time series (ITS) analysis was used to evaluate the impacts of implementing CCC system on VTE management among inpatients.Results:ITS analysis showed that in the period of post-CCC (August 2022 to June 2023), the slope of VTE evaluation rate was 0.000 415 5, with a significant upward trend ( t=2.49, P<0.05). In the month of CCC system launched (July 2022), the implementation rate of VTE preventive measures increased significantly, with a significant statistical difference ( t=3.10, P<0.05). In the post-CCC phase (August 2022 to June 2023), the slope of VTE preventive measures implementation rate was -0.012 876, with no significant statistical difference ( P>0.05). The implementation of CCC system had no significant impacts on the overall and high-risk incidence of VTE among inpatients. Conclusions:After the implementation of the CCC system, the VTE evaluation rate of inpatients increased significantly, which suggesting that the CCC system standardized the clinical VTE management among inpatients.

ObjectiveTo investigate the attenuating effect of Dioscoreae Bulbiferae Rhizoma（DBR） processed with Phaseoli Radiati Semen（PRS） juice， and explore the attenuating mechanism based on ferroptosis of the main toxic target organ. MethodSixty male ICR mice were randomly divided into blank group， DBR group， water roasted DBR group（hereinafter referred to as water group）， PRS juice-roasted DBR group 1（DBR-PRS 10∶1， stuffy moistening for 40 min， stir-fried at 130 ℃ for 18 min， hereinafter referred to as group 1）， PRS juice-roasted DBR group 2（DBR-PRS 10∶1， stuffy moistening for 80 min， stir-fried at 100 ℃ for 14 min， hereinafter referred to as group 2）， PRS juice-roasted DBR group 3（DBR-PRS=20∶3， stuffy moistening for 40 min， stir-fried at 160 ℃ for 14 min， hereinafter referred to as group 3）. The raw and processed groups of DBR were gavaged with their corresponding 95% ethanol extract at a dose of 3 g·kg^-1·d^-1， while the blank group was gavaged with an equal volume of 0.5% sodium carboxymethyl cellulose， once a day for 14 consecutive days. Hematoxylin-eosin（HE） staining was used to observe the histopathological changes of mouse liver. Alanine aminotransferase（ALT） and aspartate aminotransferase（AST） levels in serum， as well as malondialdehyde（MDA）， ferrous ions（Fe²⁺）， reduced glutathione（GSH） and superoxide dismutase（SOD） levels in liver tissue were detected by the biochemical detection. Western blot was used to detect the expression of iron key proteins such as ferritin heavy chain 1（FTH1） and glutathione peroxidase 4（GPX4）. ResultHE staining results showed that the liver tissue structure of the blank group was clear， the morphology of hepatocytes was normal， the cytoplasms of hepatocytes in the DBR group and water group were loose and vacuolar， with obvious pathological damages， and the pathologic damages of mice in the group 1-3 were significantly improved. Compared with the blank group， the levels of ALT， AST， MDA and Fe²⁺ in mice from the DBR group were significantly increased（P<0.01）， while GSH and SOD levels were significantly reduced（P<0.01）， and the protein expression levels of FTH1 and GPX4 were significantly decreased（P<0.01）. Compared with the DBR group， the ALT， AST，MDA and Fe²⁺ levels of mice in the group 1-3 were significantly reduced（P<0.05， P<0.01）， the GSH and SOD levels and the protein expression levels of FTH1 and GPX4 were significantly increased（P<0.01）. Compared with the water group， the AST and MDA levels of mice in the group 1-3 were significantly reduced（P<0.05， P<0.01）， the SOD level significantly increased（P<0.05， P<0.01）， the FTH1 protein expression significantly increased（P<0.01）， and the serum ALT level of mice in the group 2-3 significantly reduce（P<0.01）， Fe²⁺ level significantly reduced（P<0.01）， GSH level significantly increased（P<0.05， P<0.01）， and GPX4 protein expression significantly increased（P<0.05， P<0.01）. Among the group 1-3， the group 3 had the best detoxification effect. ConclutionProcessing with PRS juice can reduce the liver injury induced by DBR， and the mechanism may be related to the inhibition of ferroptosis in the liver.

The apprenticeship education of Traditional Chinese medicine(TCM)is an important pathway for the cultivation of talents in TCM education.The combination of institutional education and apprenticeship education is considered to be the most suitable educational model that aligns with the inherent characteristics of TCM education.The current status of TCM education in western medical institutions and the main challenges include the difficulty in transitioning between western and Chinese medical reasoning and limited clinical internship hours for TCM.The strengths and features of TCM apprenticeship education lie in cultural heritage,classical teachings,mentorship,practice orientation and personalized education.Therefore,integration of TCM apprenticeship education and clinical internships for western medical students represents a new educational model for medical undergraduates.

Objective To evaluate the quality of animal studies into acupuncture for glaucoma using SYRCLE's risk of bias tool,ARRIVE 2.0 guidelines,and the GSPC checklist.Methods Databases from CNKI,VIP,Wanfang,Sinomed,PubMed,Web of Science,Embase and Cochrane Library were searched to find animal research articles on acupuncture for glaucoma.Risk of bias was assessed for the included studies using the SYRCLE's tool,and reporting quality was evaluated using the ARRIVE 2.0 guidelines and GSPC checklist.Statistical analysis was performed by Excel and SPSS software.Results Thirty articles met the inclusion/exclusion criteria and were included in the final analysis.Six of the 10 items of the SYRCLE's tool had a low-risk rate of＜50％,and the non-low-risk items focused on selectivity bias,implementation bias and measurement bias.Twelve of the 22 essential sub-items of the ARRIVE 2.0 guidelines had a low-risk rate of＜50％;9 of the 16 recommended sub-items had a low-risk rate of＜50％;and 12 of the 19 subentries of the GSPC list had a low-risk rate of＜50％.Randomization,blinding,ethical statements,housing and husbandry,animal care and monitoring,and protocol registration were the non-low-risk items in the ARRIVE 2.0 guidelines and GSPC list.Conclusions The quality of the methodology and experimental reporting of animal studies into acupuncture for glaucoma are generally low,and the description of several items is not yet complete,which affects the readers'judgment on whether the result of animal studies can be translated to clinical studies.It is advisable to further promote the use of SYRCLE's tool and reporting guidelines for animal experiments to enhance the design,performance,and reporting of animal experiments;ensure the reproducibility of experiments and result;and provide reliable evidence for the translation of result to the clinic.