Objective To explore the mediating role of occupational well-being in the relationship between professional identity and safety behavior among nurses. Methods A total of 1 006 nurses from ten tertiary general hospitals in eight provincial administrative regions were selected as the research subjects using convenient sampling method. Their safety behavior, professional identity and occupational well-being were investigated using Nurse Safety Behavior Scale, Nurse Professional Identity Scale and Occupational Well-being Scale. Structural equation modeling was performed using AMOS 26.0 to examine the mediating effect of occupational well-being in the relationship between professional identity and safety behavior among nurses. Results The scores for safety behavior, professional identity, and occupational well-being were (53.0±6.1), (123.7±21.2) and (90.8±13.1), respectively. Safety behavior was positively correlated with both professional identity and occupational well-being (correlation coefficients were 0.50 and 0.50, respectively, both P<0.01). Professional identity was positively correlated with occupational well-being (correlation coefficient was 0.51, P<0.01). The multiple linear regression analysis results showed that the higher the professional identity and occupational well-being of nurses, the higher the level of safety behavior (both P<0.05). The result of mediating effect shows that the total effect of occupational identity on safety behavior was 0.498 [95% confidence interval (CI) was 0.405-0.576], and occupational well-being played a mediating role between professional identity and safety behavior among nurses with the mediation effect of 0.156 (95%CI was 0.112-0.205), accounting for 31.33% of the total effect. Conclusion The safety behavior of nurses is at a moderate level. Both professional identity and occupational well-being can affect the safety behavior of nurses. Professional identity can increase the safety behavior of nurses by affecting occupational well-being.

Objective:To investigate the clinical characteristics of psoriasis and status quo of medical care for patients in county areas of China.Methods:This study was a cross-sectional investigation. Based on the “Qianxian Wuyin” Project (a national project for upgrating ability for psoriasis care at county level), an online questionnaire survey was conducted in the dermatology departments of 459 county hospitals in 404 pilot administrative counties across China from February to June 2023. The questionnaire included demographic information of patients (gender, ethnicity, age, place of residence, education, marital status), and clinical characteristics of psoriasis (disease course, type, comorbidities, body surface area (BSA) and previous treatment. The Dermatology Life Quality Index (DLQI) and Psoriasis Area and Severity Index (PASI) were applied for assessing the quality of life and disease severity, and completed by patients or guardian and doctors, respectively.Results:A total of 16 935 patients completed the questionnaire. The age of patients was 1-102(44.17±11.58)years, and 71.0% (12 036/16 935) were 30-59 years old. The ratio of male to female was 2.21∶1; 24.3%(4 117/16 935) of patients had high school education; there were 9 940 patients(58.7%) with previous or current smoking and/or alcohol use; 42.8%(7 218/16 855) of patients had a disease course of 1-5 years. There were 15 630 patients(92.3%) with DLQI≥10, 8 346 patients(49.7%) with PASI≥10, 15 017 patients(89.2%) with BSA≥10%. The plaque type was the most common disease type ( n=14 965, 88.7%), and spotting type ranked the second ( n=1 141, 6.8%). The most common initial site was the trunk ( n=12 309, 72.9%). Among the comorbidities, hypertension was the most common one ( n=1 681, 10.0%). There were 7 650 reports of treatment response to conventional topical drug therapy and 3 112 reports of treatment response to systemic drug therapy, with 6 269 (81.9%) and 2 493 (80.1%) reporting poor or no response, respectively. Conclusions:The survey shows that in the county areas of China, the majority of psoriasis patients are severe patients with short course of disease, plaque type is the most common type, and hypertension is the most common comorbidity; and the conventional treatment is less effective for most patients.

Objective To explore the potential categories of self-regulatory fatigue among maintenance hemodialysis patients and their relationships with self-management. Methods A total of 502 maintenance hemodialysis patients in Lanzhou were surveyed using a general information questionnaire, a Self-Regulatory Fatigue Scale, and a Self-Management Scale for Hemodialysis Patients. Potential profile analysis was conducted on self-regulatory fatigue, and its relationship with self-management was explored. Results Based on their self-regulatory fatigue status, maintenance hemodialysis patients could be categorized into four potential groups: low self-regulatory fatigue group (5.0%), moderate self-regulatory fatigue group (49.2%), high self-regulatory fatigue group (13.9%), and high cognitive regulatory fatiguegroup (31.9%). Gender, education level, and monthly per capita family income were identified as influencing factors for the potential categories of self-regulatory fatigue. Significant differences were observed in the total self-management scores among patients belonging to different potential categories of self-regulatory fatigue (F=50.617, P < 0.001). Conclusion Maintenance hemodialysis patients can be classified into four potential categories of self-regulatory fatigue, with patients in the low self-regulatory fatigue group demonstrating higher levels of self-management. Reducing the level of self-regulatory fatigue can contribute to enhancing patients'self-management capabilities.

ObjectiveTo characterize the efficacy components of Guizhi Jia Gegentang（GGT） in intervening influenza virus pneumonia by ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap high resolution mass spectrometry（UPLC-Q-Exactive Orbitrap MS）. MethodBALB/c mice were randomly divided into normal group and GGT group（36 g·kg^-1·d^-1） with six mice in each group. GGT group was continuously administered GGT extract for 5 d， while the normal group was administered an equal amount of ultrapure water. Serum and lung tissue were collected after administration， and UPLC-Q-Exactive Orbitrap MS was used to characterize the prototypical and metabolic components of GGT in serum and lung tissue of mice. The components existed simultaneously in the serum and lung tissue of mice from the GGT group were defined as its functional components， and the targets of efficacy components were searched by SwissTargetPrediction database， and GeneCards database was used to query the target of influenza virus pneumonia， and then the intersection was taken to obtain potential targets of GGT for intervening in the disease. Protein-protein interaction（PPI） network analysis of potential targets was performed by STRING database， and Kyoto Encyclopedia of Genes and Genomes（KEGG） pathway enrichment analysis on potential targets was performed by Metascape. ResultA total of 29 prototypical components and 28 metabolic components of GGT were detected in the drug-containing serum of mice， of which 11 prototypical components and 4 metabolic components were detected in the lung tissue of mice. The main metabolic pathways included reduction， hydroxylation， methylation， glucuronidation and sulfation. The results of PPI network and KEGG analysis showed that these functional components may act through their effects on targets such as albumin（ALB）， epidermal growth factor receptor（EGFR）， steroid receptor coactivator（SRC）， Toll-like receptor 4（TLR4）， nuclear transcription factor（NF）-κB and adhesion junction. ConclusionThe 11 prototypical components and 4 metabolites present simultaneously in the drug-containing serum and lung tissue of mice may be the potential therapeutic components of GGT in interfering with influenza viral pneumonia， and act through interfering with inflammatory metabolic pathways. This study can provide a reference for the mechanism study of GGT in the treatment of influenza viral pneumonia.

Objective To study the mechanism of Chaihu Guizhi Decoction(CGD)in the treatment of influenza and staphylococcus aureus co-infection.Methods The co-infection model of influenza and staphylococcus aureus was established and CGD was used to intervene.The chemical components of CGD were qualitatively analyzed by UPLC-Q-Exactive/MS technology.The potential action targets of chemical components in CGD and the related targets of influenza Staphylococcus aureus co-infection were mined by network pharmacology method.The"component target disease"network was constructed.Core targets were selected according to degree ranking.Core action pathways were enriched by KEGG analysis and GO annotation analysis.The core target was verified by RT-qPCR,and the interaction between the core component and the key target was verified by molecular docking.Results CGD could significantly improve the decrease of body weight and thymus index(P<0.05)caused by co-infection.The lung index(P<0.05),relative amount of MmRNA expression(P<0.05)and bacterial load(P<0.05)were decreased,and the survival rate was improved.51 chemical constituents were identified from CGD.Through network pharmacological analysis,107 related targets corresponding to CGD treatment of bacterial pneumonia secondary to influenza were excavated.TNF,AKT1,ALB,VEGFA,MAPK3,PTGS2,STAT3,EGFR and other targets with strong correlation,mainly involved Fc epsilon RI signal pathway,GnRH signal pathway,NF-κB signal path,etc.Molecular docking study showed that the main active component of CGD,including oroxyloside,baicalein and wogonin have strong affinity with TNF,PTGS2 and EGFR targets.Compared with co-infection model group,in CGD group TNF-α、EGFR and PTGS2 increased significantly(P<0.05).Conclusion The main active ingredient of CGD is oroxyloside,baicalein and wogonin.TNF-α,PTGS2,EGFR and other targets to played a role in the treatment of influenza staphylococcus aureus co-infection.

We report on two cases of type C insulin resistance syndrome(TCIRS) admitted to the Department of Endocrinology, Peking Union Medical College Hospital from January 2000 to December 2020. Both patients presented with persistent hyperglycemia, low immunoreactive insulin, extreme insulin resistance, high insulin autoantibodies, high total insulin, and large insulin antibody pool. TCIRS is marked by extreme insulin resistance with ketoacidosis and respond to medium to high doses glucocorticoids rather than plasmapheresis.

Objective To explore the associations of anxiety with optimism ,resilience and related demographic factors in lung cancer patients , and to provide a scientific basis for reducing the level of anxiety and improving the psychosomatic health. Methods A total of 130 lung cancer pa-tients from the department internal medicine of respiratory tumors in Liaoning Cancer Hospital&Institute were investigated by convenience sam-pling method from February 2013 to January 2014. The survey was anonymous. Finally,107 questionnaires were effective,and the effective rate was 82.307%. Results Among lung cancer patients,optimism and resilience were positively and significantly associated with anxiety. Physical ex-ercise had an effect on the anxiety symptoms. Conclusion Optimism and resilience have significant predictive value on the anxiety among lung cancer patients. It is important to encourage lung cancer patients to improve their psychological health ,so as to reduce their anxiety symptoms effec-tively.

The TNM staging system is an essential standard for cancer treatment and evaluation, and is used to assess a patient''s prog-nosis. Therefore, every update made to the system is of great significance. According to the recently released edition of the American Joint Committee on Cancer (AJCC) Staging Manual, several major changes to head and neck cancer staging have been made. In this pa-per, we analyze the advantages and disadvantages of these amendments and offer a direction for making future amendments. Our goal is to provide a brief introduction of recent research on head and neck cancers, which can be used as a reference by clinicians.

Objective To evaluate the application value of high-risk human papillomavirus (HR-HPV)DNA de-tection and ThinPrep liquid-based cytology testing(TCT)in cervical disease screening.Methods Cervical specimens of women with cervical lesions in a hospital between October 2012 and December 2013 were taken and performed hu-man papillomavirus DNA genotyping (HPV DNA)and ThinPrep liquid-based cytology testing(TCT).Positive pa-tients were performed colposcopy pathological detection.HPV DNA positive rates among different TCT groups, and different cervical lesion groups were compared,the sensitivity and specificity of TCT and HPV DNA detection, as well as differences between separate and joint detection were also compared.Results The positive rate of HPV DNA was 28.07% (1 045/3 723),most were HR-HPV (21 .57%,n=803),the major HR-HPV genotypes were HPV 16,58,52,and 18 type.HR-HPV positive rates were statistically different among different age groups(χ2 =31 .74,P <0.001 ),positive rate was highest in 20 -30 year old age group .Positive rate of TCT was 13.46%(n=501),a total of 971 patients were performed pathological detection,293 were positive.Patients were divided according to different TCT and different lesion type,χ2 testing of HR-HPV DNA positive rate showed that positive rate of HR-HPV had a increasing tendency with the increase in severity of diseases(all P <0.01).Pathological de-
tection was as a gold standard ,the sensitivity of HR-HPV DNA and TCT was 90.44%(265/293)and 85.32%(250/293)respectively,the sensitivity of joint HR-HPV DNA detection and TCT was 95.90%.In positive patho-logical group,the detection rate of TCT and HR-HPV DNA was 85.32% and 90.44%,respectively,joint detec-tion rate was 95.90%,the difference among three groups was significant (χ2 =18.185,P <0.001).Joint detection rate was higher than separate detection rate of TCT or HPV DNA.Conclusion HPV DNA detection is a useful supplement for cervical cancer screening,HPV DNA detection combined with TCT can reduce the misdiagnosis rate.

Objective To investigate the clinical efficacy of adefovir dipivoxil in antiviral treatment of chronic hepatitis B and its effect on peripheral blood T lymphocyte subsets.Methods 40 cases of patients with chronic hepatitis B were selected from The Fourth People’s Hospital of Qinghai in October 2009 to June 2012,the patients were given the antiviral treatment of adefovir dipivoxil.Before treatment,3 months,6 months and 12 months after treatment,the changes of liver function indicators of alanine transaminase(ALT),aspartate transaminase(AST)and total bilirubin(TBiL),and hepatitis B virus-DNA(HBV-DNA)were recorded;the total effective rate was observed;the peripheral blood T lymphocyte subsets changes was tested and analyzed by flow cytometry.Results The ALT,AST and TBiL of the patients all improved good,and the indicators of ALT,AST and TBiL after 12 months decreased significantly than before treatment,the HBV-DNA testing of the patients recovered negative,the difference was statistically significant (P<0.05 );the total effective rate of hepatitis B patients is 92.5%;the peripheral blood T lymphocyte subsets has no significant improvement in patients after antiviral treatment for 3 months.After the treatment for 6 months and 12 months,the CD4 +T and CD4 +/CD8 +T were significantly higher than those before treatment,there was no significant changes in CD3 +T and CD8 +T before and after treatment.Conclusion Adefovir dipivoxil has a good clinical efficacy in antiviral treatment of chronic hepatitis B,and can significantly improve the patients’liver function,improve peripheral blood T lymphocyte subsets imbalance.