Objective To analyze the nutritional status and risk factors of disease condition grading in patients with chronic obstructive pulmonary disease (COPD), and to provide the reference for clinical diagnosis and treatment.. Methods A total of 518 patients with COPD who were admitted to the hospital from February 2020 to February 2023 were selected as the study subjects (COPD group). Among the 520 cases of non-COPD patients in respiratory and critical care wards were included in control group . The patients with COPD were divided into 265 cases in malnutrition group and 253 cases in normal nutrition group according to the nutritional status. The nutritional status of patients with different disease condition grades was observed . The basic information and clinical examination status were compared between both groups, and multivariate logistic regression analysis was used to explore the risk factors of malnutrition in patients with COPD. Results The nutritional indicators of BMI, IBM and ALB in COPD group were lower than those in control group (P<0.05). The higher the disease condition grade , the lower the levels of nutritional indicators (P<0.05). The proportions of smoking history, number of acute exacerbations ≥twice a year, comorbidity types≥4, ALB<35 g/L, CRP≥60 mg/L, CAT score≥10 points and FEV1/FVC<50% in malnutrition group were higher than those in normal nutrition group while the proportion of ventilator use was lower than that in normal nutrition group (P<0.05) . Multivariate Logistic regression analysis showed that the number of acute exacerbations≥ twice a year, comorbidity types≥4, CRP≥60 mg/L and FEV1/FVC<50% were independent risk factors of malnutrition in patients with COPD, and ventilator use was a protective factor (P<0.05). Conclusion The nutritional status of COPD patients is poor , and the more serious the disease condition grade , the worse the nutritional status . The number of acute exacerbations , types of concurrent diseases , CRP , FEV1/FVC are all influencing factors of malnutrition in COPD patients.

Objective:To explore the ideological and political education elements and methods in the introduction to nursing course, so as to enhance its ideological educational effectiveness. Methods:In February 2024, based on a "three-stage" teaching model (pre-class, in-class, and post-class), this study reformed the ideological and political education plan for the introduction to nursing course by integrating online and offline case studies and resources, expanding educational materials, and organizing teaching assessments and effectiveness surveys. A semester-long ideological and political education practice was implemented for 237 first-year nursing students from four classes in Medical College of Xinjiang University of Science and Technology. The effectiveness was evaluated by exam scores and a self-designed Introduction to Nursing Teaching Effectiveness Evaluation Scale under the ideological and political education framework. Results:Among the 237 students, there were 107 males and 130 females, aged (18.50 ± 1.12) years old, 63 achieved a passing grade, 149 achieved a good grade, and 18 achieved an excellent grade, with a pass rate of 97.05% (230/237). The scores of the six dimensions of interest stimulation in teaching methods, acceptance of teaching methods, knowledge review and application, knowledge comprehension and retention, self-challenge and improvement, and satisfaction with learning outcomes within 1 week after the end of the course scores were (3.92 ± 1.11), (4.21 ± 0.82), (4.05 ± 0.97), (4.05 ± 0.89), (4.11 ± 0.94), (4.03 ± 0.90) points, which were significantly higher than 1 week before the start of the course (3.43 ± 1.00), (3.54 ± 1.03), (3.48 ± 1.08), (3.47 ± 1.04), (3.52 ± 1.05), (3.47 ± 1.01) points. The differences were statistically significant ( t values were -19.38- -13.22, all P < 0.01). Conclusions:The "three-stage" teaching model in the introduction to nursing course effectively integrates professional education with ideological and political education, improves students′ academic performance, enhances learning effectiveness in nursing practice, and strengthens the overall impact of ideological and political education.

Objective:To explore the ideological and political education elements and methods in the introduction to nursing course, so as to enhance its ideological educational effectiveness. Methods:In February 2024, based on a "three-stage" teaching model (pre-class, in-class, and post-class), this study reformed the ideological and political education plan for the introduction to nursing course by integrating online and offline case studies and resources, expanding educational materials, and organizing teaching assessments and effectiveness surveys. A semester-long ideological and political education practice was implemented for 237 first-year nursing students from four classes in Medical College of Xinjiang University of Science and Technology. The effectiveness was evaluated by exam scores and a self-designed Introduction to Nursing Teaching Effectiveness Evaluation Scale under the ideological and political education framework. Results:Among the 237 students, there were 107 males and 130 females, aged (18.50 ± 1.12) years old, 63 achieved a passing grade, 149 achieved a good grade, and 18 achieved an excellent grade, with a pass rate of 97.05% (230/237). The scores of the six dimensions of interest stimulation in teaching methods, acceptance of teaching methods, knowledge review and application, knowledge comprehension and retention, self-challenge and improvement, and satisfaction with learning outcomes within 1 week after the end of the course scores were (3.92 ± 1.11), (4.21 ± 0.82), (4.05 ± 0.97), (4.05 ± 0.89), (4.11 ± 0.94), (4.03 ± 0.90) points, which were significantly higher than 1 week before the start of the course (3.43 ± 1.00), (3.54 ± 1.03), (3.48 ± 1.08), (3.47 ± 1.04), (3.52 ± 1.05), (3.47 ± 1.01) points. The differences were statistically significant ( t values were -19.38- -13.22, all P < 0.01). Conclusions:The "three-stage" teaching model in the introduction to nursing course effectively integrates professional education with ideological and political education, improves students′ academic performance, enhances learning effectiveness in nursing practice, and strengthens the overall impact of ideological and political education.

Chronic obstructive pulmonary disease (COPD) is a common respiratory system disease, with high incidence rate and mortality. So far, the pathogenesis of COPD has not been clearly determined. Microinflammatory state refers to the growth and reproduction of certain pathogens in the body due to bacteria, viruses and fungi infections, which causes inflammatory response of local tissues and the whole body, it is manifested by a slight and continuous increase of inflammatory marker proteins and inflammatory cytokines in systemic circulation. This article reviewed the literature on microinflammatory state and COPD. It is concluded that microinflammatory state will lead to the imbalance of proinflammatory and anti-inflammatory mechanisms, which can cause ischemic and hypoxic destruction and injury of lung tissue cells, and further aggravate lung injury. The common inflammatory factors such as C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin (IL) in microinflammatory state are closely related to the severity of COPD, which may promote disease progression, continuously affect lung function, arterial blood gas and nutritional status of patients.

Spinal surgical site infection (SSI), especially deep SSI after internal fixation is difficult in treatment, with long course of disease and poor prognosis. At present, there are many controversies in the diagnosis and treatment of spinal SSI, with unsatisfactory overall efficacy of its diagnosis and treatment. Besides, no diagnosis and treatment guideline based on evidence-based medicine has been in existence. To this end, the Spinal Infection Group of the Orthopedic Branch of the Chinese Medical Doctor Association and the Spinal Infection Group of the Spinal Surgery Branch of the Chinese Rehabilitation Medicine Association jointly organized relevant experts to formulate Evidence-based clinical guideline for the diagnosis and treatment of surgical site infection in spinal trauma ( version 2024) based on an evidence-based approach. A total of 10 recommendations were proposed on the diagnosis and treatment of spinal SSI, so as to provide a clinical reference for the diagnosis and treatment of spinal SSI.

Objective:To determine the median effective dose (ED 50) of oliceridine combined with propofol for analgesia during induced abortion in patients with different labor histories. Methods:This was a prospective study. American Society of Anesthesiologists Physical Status classification I or Ⅱ patients, aged 18-45 yr, with a body mass index of 20-28 kg/m 2, scheduled for elective induced abortion at Henan Provincial People′s Hospital (Zhengzhou University People′s Hospital) from July 1, 2024 to August 20, 2024, were selected. Patients were divided into a delivery group (group D) and a non-delivery group (group N) based on their histories of vaginal delivery. The modified Dixon′s up and down method was used to conduct the trial. Oliceridine was intravenously injected at a dose of 0.015 mg/kg in the first patient in each group, and the dose was determined based on the intraoperative body movement. The positive response was defined as the body movement of grade 2 or higher during induced abortion. If the response was positive, the next patient received a higher dose of oliceridine, or conversely, a lower dose was given. The ratio between the two successive concentrations was 1.2, and the trial was terminated until 7 turning points were achieved. The ED 50 and 95% confidence interval were calculated using the Dixon sequential method formula. The occurrence of adverse reactions was recorded. Results:A total of 54 patients were included in this study, with 25 in group D and 29 in group N. The ED 50 and 95% confidence interval of oliceridine for painless abortion were 0.019 (0.014-0.031) mg/kg and 0.026 (0.020-0.044) mg/kg in group D and group N, respectively. Compared with group D, the ED 50 of oliceridine for analgesia during induced abortion was significantly increased when combined with propofol in group N ( P<0.05). Patients in both groups experienced dizziness after intravenous oliceridine injection, and no other adverse reactions such as injection pain were observed. Conclusions:When combined with propofol, the ED 50 of oliceridine for analgesia is 0.019 mg/kg and 0.026 mg/kg during induced abortion in patients with and without vaginal delivery history, respectively. The analgesic potency of oliceridine is decreased in patients without a history of vaginal delivery compared to patients with a history of vaginal delivery.

Chronic obstructive pulmonary disease (COPD) is characterized by progressive and incomplete reversible airflow limitation, and COPD is mainly caused by small airway lesions and seriously endangers human health due to its high incidence rate and mortality rate. At present, the occurrence of COPD can be effectively prevented by detecting the characteristics of small airway lesions, so the study of small airway lesions has positive significance in the prevention and early intervention of COPD. This paper reviews the research progress on characteristics, detection methods and diagnosis and treatment methods of small airway lesions in COPD, so as to provide a theoretical basis for clinical research.

Objective To explore the application of the"learning by doing"learning theory and methods in the teaching of Obstetrics and Gynecology Nursing for undergraduate nursing students.Method By setting up an experimental group of 151 students and a control group of 152 students in the teaching of Obstetrics and Gynecology Nursing for undergraduate nursing students,practicing"learning by doing"and evaluating the teaching effect.Result The experimental group students held a positive attitude towards the implementation of"learning by doing"in the teaching of Obstetrics and Gynecology Nursing for undergraduate nursing students,with higher scores in both theoretical and skill exams than the control group(P＜0.05),and achieved good practical results.Conclusion By comparing the theoretical and skill exam scores of the experimental group and the control group,the experimental group had a higher average score than the control group(P＜0.05).The application of"learning by doing"in the teaching of Obstetrics and Gynecology Nursing for undergraduate nursing has improved students'self-learning ability and empowered their innovative and collaborative growth.

ObjectiveTo explore the improving effects and its synergistic mechanism of Olibanum before and after processing with vinegar on glycodesoxycholic acid（GDCA） intervention in mice with ulcerative colitis（UC） based on the perspective of intestinal flora. MethodC57BL/6J male mice were randomly divided into the normal group， model group， GDCA group， Olibanum group（1.5 g·kg^-1） and vinegar-processed Olibanum（1.5 g·kg^-1） group， with 6 mice in each group. Mice in the normal group drank water freely， and mice in the other groups were given 2% dextran sulfate sodium（DSS） periodically to establish a UC mouse model. During the modeling， GDCA group， Olibanum group and vinegar-processed Olibanum group were intervened by intraperitoneally injection of GDCA（0.05 g·kg^-1）. From the 13^th day after modeling， Olibanum group and vinegar-processed Olibanum group were given the corresponding doses of drugs by gavage， once a day， for 36 d. During this period， the body mass of mice was recorded and the disease activity index（DAI） was assessed. On day 48， faeces were collected for 16S rRNA and metagenomic sequencing to analyse changes in intestinal flora. On the 49^th day， hematoxylin-eosion（HE） staining was used to observe the colon histological lesions， enzyme-linked immunosorbent assay（ELISA） was used to determine serum levels of tumour necrosis factor-α（TNF-α）， interleukin（IL）-1β and IL-6， and Spearman correlation analysis was used to explore the correlation between differential bacterial species and inflammatory factor levels. ResultCompared with the normal group， the model group showed a significant decrease in body weight（P<0.01）， a significant increase in DAI（P<0.05）， and a significant increase in TNF-α， IL-1β and IL-6 levels（P<0.01）， and there was partial infiltration of inflammatory cells in the colon. Compared with the model group， mice in the GDCA group showed a significant decrease in body weight， a significant increase in DAI and levels of TNF-α， IL-1β and IL-6（P<0.01）， and severe disruption of colonic crypt structure， extensive infiltration of inflammatory cells， and a significant decrease in goblet cells. Compared with the GDCA group， both the Olibanum and vinegar-processed Olibanum groups showed a significant recovery in body weight， a significant decrease in DAI and levels of TNF-α， IL-6 and IL-1β（P<0.05， P<0.01）， and the modulating effect of vinegar-processed Olibanum was significantly better than that of Olibanum. Alpha diversity showed that Chao1 index of UC mice significantly increased（P<0.01） and Shannon index decreased significantly（P<0.05） in UC mice after GDCA intervention. Beta diversity showed that the microbial community structure of the 5 groups had significant changes， Olibanum and vinegar-processed Olibanum could modulate the changes in the structure of the intestinal flora in UC mice after GDCA intervention. Microbial sequencing results indicated that， compared with the normal group， the Firmicutes/Bacteroidetes ratio in the model group was significantly higher（P<0.05）， and the relative abundance of 3 genera and 5 species of flora changed significantly（P<0.05， P<0.01）. Compared with the model group， the Firmicutes/Bacteroidetes ratio in the GDCA group was significantly higher（P<0.05）， the relative abundance of 7 pathogenic bacterial genera and four species was significantly increased（P<0.05， P<0.01）， and the relative abundance of three beneficial bacterial genera and Bacteroides_intestinalis was significantly decreased（P<0.05， P<0.01）. Olibanum group and vinegar-processed Olibanum group could modulate the Firmicutes/Bacteroidetes ratio， the relative abundance of pathogenic bacteria and beneficial bacteria， and the vinegar-processed Olibanum group was significantly superior to Olibanum group in terms of modulating the Firmicutes/Bacteroidetes ratio， the relative abundance of the three genera and five species of bacteria（P<0.01， P<0.05）. Correlation analysis showed that the relative abundance of Bacteroides_intestinalis was negatively correlated with the levels of TNF-α， IL-6 and IL-1β， the relative abundance of Prevotella_sp_CAG873， Bacteroides_sp_CAG927， Bacteroidales_bacterium_52_46 and Bacteroidales_bacterium was positively correlated with TNF-α， IL-6 and IL-1β levels. ConclusionGDCA can exacerbate UC colonic inflammation， and Olibanum and vinegar-processed Olibanum have an ameliorative effect on GDCA-mediated UC， with the vinegar-processed Olibanum showing a stronger ameliorative effect， the mechanism may be related to the regulation the abundance and structure of intestinal beneficial and pathogenic bacteria， and the reduction of inflammatory factor levels.

Objective:To determine the median effective dose (ED 50) of oliceridine combined with propofol for analgesia during induced abortion in patients with different labor histories. Methods:This was a prospective study. American Society of Anesthesiologists Physical Status classification I or Ⅱ patients, aged 18-45 yr, with a body mass index of 20-28 kg/m 2, scheduled for elective induced abortion at Henan Provincial People′s Hospital (Zhengzhou University People′s Hospital) from July 1, 2024 to August 20, 2024, were selected. Patients were divided into a delivery group (group D) and a non-delivery group (group N) based on their histories of vaginal delivery. The modified Dixon′s up and down method was used to conduct the trial. Oliceridine was intravenously injected at a dose of 0.015 mg/kg in the first patient in each group, and the dose was determined based on the intraoperative body movement. The positive response was defined as the body movement of grade 2 or higher during induced abortion. If the response was positive, the next patient received a higher dose of oliceridine, or conversely, a lower dose was given. The ratio between the two successive concentrations was 1.2, and the trial was terminated until 7 turning points were achieved. The ED 50 and 95% confidence interval were calculated using the Dixon sequential method formula. The occurrence of adverse reactions was recorded. Results:A total of 54 patients were included in this study, with 25 in group D and 29 in group N. The ED 50 and 95% confidence interval of oliceridine for painless abortion were 0.019 (0.014-0.031) mg/kg and 0.026 (0.020-0.044) mg/kg in group D and group N, respectively. Compared with group D, the ED 50 of oliceridine for analgesia during induced abortion was significantly increased when combined with propofol in group N ( P<0.05). Patients in both groups experienced dizziness after intravenous oliceridine injection, and no other adverse reactions such as injection pain were observed. Conclusions:When combined with propofol, the ED 50 of oliceridine for analgesia is 0.019 mg/kg and 0.026 mg/kg during induced abortion in patients with and without vaginal delivery history, respectively. The analgesic potency of oliceridine is decreased in patients without a history of vaginal delivery compared to patients with a history of vaginal delivery.