Objective:To explore the factors influencing the recovery of swallowing function after a brainstem hemorrhage and to construct a prediction model.Methods:Clinical data on 134 persons with dysphagia after a brainstem hemorrhage were collected retrospectively. According to their swallowing ability at discharge, the patients were divided into a swallowing recovery group and a non-recovery group. Univariate correlation analysis and multivariate logistic regression analysis were used to explore the independent factors influencing the recovery of swallowing function and to construct a prediction nomogram. The receiver operating characteristics (ROC) curves were evaluated to analyze the nomogram′s predictive value and those of the relevant influencing factors.Results:Sixty-two of the patients (46%) had recovered their swallowing function at discharge, while 72 (54%) had not. Univariate correlation analysis showed that there had been significant differences in tracheal intubation, NIHSS score, FOIS score, Barthel index and Glasgow coma scale (GCS )score between the two groups, on average. The multivariate logistic regressions showed that a low NIHSS score, a high FOIS score and a high GCS score were independent predictors of swallowing function recovery, so they were used in the prediction model. ROC curve analysis showed that the area under the curve (AUC) of the prediction model was 0.953 (95% CI: 0.902~0.982) with a sensitivity of 87% and a specificity of 93%. The model′s predictions were thus better than using an NIHSS score, GCS score or FOIS score alone. Conclusions:NIHSS score, GCS score and FOIS score can independently predict the recovery of swallowing function after a brainstem hemorrhage. A prediction model constructed using all three has good predictive power.

Objective To develop and validate a deep learning model based on chest CT images to accurately distinguish between drug-resistant(DR-TB)and-sensitive tuberculosis(DS-TB).Methods A retrospective study was conducted on 722 cases of confirmed secondary tuberculosis admitted in our center from January 2019 to December 2022.According to the results of antimicrobial susceptibility test,they were divided into 357 DS-TB cases and 365 DR-TB cases.Pre-existing U-Net segmentation model was employed to segment the lung parenchyma regions in CT images.The dataset was randomly partitioned into a training set and a testing set in an 8:2 ratio.Six 3D deep learning architectures(3D Swin Transformer,3D ShuffleNet v2,3D ViT,3D MobileNet v2,3D DenseNet,and 3D ResNet18)were employed to evaluate the discriminative efficiency between DS-TB and DR-TB.Hyperparameters were optimized by five-fold cross-validation on the training set to construct the optimal model.The performance of the constructed model was assessed using area under the curve(AUC),sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and F1-score.Six radiologists independently evaluated DR-TB identification on the test set,and their performance was compared with the best-performing deep learning model.Results The AUC value in DR-TB prediction was 0.583,0.704,0.698,0.758,0.736,and 0.841,respectively,for 3D Swin Transformer,3D ShuffleNet v2,3D ViT,3D MobileNet v2,3D DenseNet,and 3D ResNet18.The 3D ResNet18 model demonstrated optimal performance,achieving a sensitivity of 0.935(95%CI:0.880～0.987),a specificity of 0.642(95%CI:0.492～0.757),a PPV of 0.750(95%CI:0.663～0.835),an NPV of 0.896(95%CI:0.809～0.976),an AUC value of 0.841,and a F1-score of 0.832.The radiologists got a F1-score of 0.571,0.450,0.675,0.623,0.617 and 0.635,respectively,and the F1-score of the 3D ResNet18 model is all higher than that of the radiologists.The highest-performing radiologist achieved sensitivity,specificity,PPV and NPV of 0.701(95%CI:0.605～0.802),0.567(95%CI:0.447～0.684),0.651(95%CI:0.549～0.757),and 0.623(95%CI:0.500～0.754),with all these values lower than those of the 3D ResNet18 model(P<0.05).Class activation mapping showed that the 3D ResNet18 model could focus on key lesion areas.The class activation mapping demonstrated that the 3D ResNet18 model could effectively focus on critical lesion regions.Conclusion Our 3D ResNet18 model shows the best predictive performance in identifying DR-TB,and is expected to assist clinical diagnosis for DR-TB.

Objective This study aims to investigate the work fatigue risks of clinical nursing staff in a tertiary hospital in Xingguo County and analyze the influencing factors,providing a reference for formulating scientific work processes and systems and improving nursing quality.Methods A convenience sampling was conducted to select 179 clinical nurses from a tertiary hos-pital in Xingguo County from March to April 2025.A self-designed general information questionnaire,a clinical nursing staff work fatigue risk assessment questionnaire,and the nurse work stressor scale were used for the investigation.Univariate and multiple linear regression analyses were conducted to identify the influencing factors of work fatigue risks.Results A total of 186 ques-tionnaires were distributed,with 7 excluded as invalid and 179 valid responses(96.24％).The work fatigue risk assessment score of the 179 clinical nurses was(84.39±10.26),indicating a relatively high level of fatigue.There were significant differ-ences in work fatigue risk scores across genders,weekly working hours,years of work experience,contract types,and work stress levels(P＜0.05).Multiple linear regression analysis showed that gender(B=0.624,95％CI=0.194～1.054),weekly work-ing hours(B=0.037,95％CI=0.067～0.007),years of work experience(B=0.028,95％CI=0.010～0.046),contract type(B=-0.517,95％CI=-0.997～-0.037),and work stress(B=0.127,95％CI=0.050～0.204)were the influen-cing factors of work fatigue risks(P＜0.05).Conclusion The work fatigue risks of clinical nursing staff in a tertiary hospital in Xingguo County are at a relatively high level.Gender,weekly working hours,years of work experience,contract type,and work stress are the main influencing factors.Nursing managers should pay attention to these factors and take targeted measures to inter-vene and reduce the work fatigue risks of nursing staff.

Objective:To investigate the effects and mechanisms of dendrobium officinale polysaccharides(DOP)on neural function and sleep in a rat model of ischemic stroke.Methods:Rats with ischemic stroke were modeled using middle cerebral artery occlusion(MCAO).The neurological function was assessed using the Longa scale.Sleep was monitored by electroencephalography.The hippocampal tissue damage was evaluated by TTC staining,HE staining,Nissl staining and TUNEL staining.The kits were used to detect reactive oxygen species(ROS),malondialdehyde(MDA),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),IL-1β,and IL-18 in the hippocampal tissue.West-ern blot analysis was conducted to detect the expression of microtubule-associated protein light chain 3(LC3)and Bec-lin1,NLRP3,apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),cleaved caspase-1(C-caspase-1),GSDMD-N-terminal domain(GSDMD-N),nuclear factor erythroid 2-related factor 2(Nrf2),and heme oxygenase-1(HO-1)in the hippocampal tissue.Results:DOP can improve sleep quality and neurological func-tion in rats with ischemic stroke,alleviate hippocampal tissue damage,inhibit oxidative stress and inflammation in the hippocampus,decrease the expression of Beclin1,NLRP3,ASC,C-caspase-1,GSDMD-N,cytosolic Nrf2 protein,and the LC3-Ⅱ/LC3-Ⅰ ratio in the hippocampus,while increasing the expression of HO-1 and nuclear Nrf2 protein.The Nrf2 inhibitor ML385 partially reversed the ameliorative effects of DOP.Conclusion:DOP may improve neurological function and sleep in rats with ischemic stroke by inhibiting autophagy and NLRP3 inflammasome-mediated pyroptosis through the activation of the Nrf2/HO-1 pathway,thereby alleviating oxidative stress and neuroinflammation.

BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

Objective:To develop an exercise rehabilitation program based on the Temporal Self-regulation Theory and evaluate its effectiveness in elderly patients with hip fractures.Methods:A total of 84 elderly patients with hip fractures admitted to the Department of Trauma Orthopedics at the First Affiliated Hospital of University of South China from May to August 2024 were enrolled using convenience sampling. Participants were randomly assigned to an experimental group ( n=42) and a control group ( n=42) using a random number table. The control group received routine exercise rehabilitation, while the experimental group received an exercise rehabilitation program constructed based on the Temporal Self-regulation Theory. The program included components such as establishing a unified concept of "exercise-rehabilitation", enhancing time-limited efficacy, achieving behavioral advantages, and improving self-regulation of active movement. Both groups received interventions for 12 weeks. Functional exercise adherence, activities of daily living, and hip joint function were assessed using the Orthopedic Exercise Adherence Scale, Modified Barthel Index, and Harris Hip Score at four time points: before intervention, on the day of discharge, and at 4 and 12 weeks postoperatively. Results:During the study, two patients from each group dropped out. Results of the generalized estimating equations showed group effects, time effects, and interaction effects in adherence scores with statistically significant differences ( P<0.01). On the day of discharge, and at 4 and 12 weeks postoperatively, the adherence scores in the experimental group were significantly higher than those in the control group, and the differences were statistically significant ( P<0.05). Repeated measures ANOVA indicated that group effects, time effects, and interaction effects were also statistically significant in scores for daily living ability and hip joint function ( P<0.05). The experimental group scored higher than the control group at each time point with statistically significant differences ( P<0.05) . Conclusions:The exercise rehabilitation program based on the Temporal Self-regulation Theory is scientifically sound and practical. It can effectively improve functional exercise adherence, enhance daily living ability, and promote postoperative recovery of hip joint function in elderly patients with hip fractures.

Objective:To investigate the effects and mechanisms of dendrobium officinale polysaccharides(DOP)on neural function and sleep in a rat model of ischemic stroke.Methods:Rats with ischemic stroke were modeled using middle cerebral artery occlusion(MCAO).The neurological function was assessed using the Longa scale.Sleep was monitored by electroencephalography.The hippocampal tissue damage was evaluated by TTC staining,HE staining,Nissl staining and TUNEL staining.The kits were used to detect reactive oxygen species(ROS),malondialdehyde(MDA),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),IL-1β,and IL-18 in the hippocampal tissue.West-ern blot analysis was conducted to detect the expression of microtubule-associated protein light chain 3(LC3)and Bec-lin1,NLRP3,apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),cleaved caspase-1(C-caspase-1),GSDMD-N-terminal domain(GSDMD-N),nuclear factor erythroid 2-related factor 2(Nrf2),and heme oxygenase-1(HO-1)in the hippocampal tissue.Results:DOP can improve sleep quality and neurological func-tion in rats with ischemic stroke,alleviate hippocampal tissue damage,inhibit oxidative stress and inflammation in the hippocampus,decrease the expression of Beclin1,NLRP3,ASC,C-caspase-1,GSDMD-N,cytosolic Nrf2 protein,and the LC3-Ⅱ/LC3-Ⅰ ratio in the hippocampus,while increasing the expression of HO-1 and nuclear Nrf2 protein.The Nrf2 inhibitor ML385 partially reversed the ameliorative effects of DOP.Conclusion:DOP may improve neurological function and sleep in rats with ischemic stroke by inhibiting autophagy and NLRP3 inflammasome-mediated pyroptosis through the activation of the Nrf2/HO-1 pathway,thereby alleviating oxidative stress and neuroinflammation.

Objective This study aims to investigate the work fatigue risks of clinical nursing staff in a tertiary hospital in Xingguo County and analyze the influencing factors,providing a reference for formulating scientific work processes and systems and improving nursing quality.Methods A convenience sampling was conducted to select 179 clinical nurses from a tertiary hos-pital in Xingguo County from March to April 2025.A self-designed general information questionnaire,a clinical nursing staff work fatigue risk assessment questionnaire,and the nurse work stressor scale were used for the investigation.Univariate and multiple linear regression analyses were conducted to identify the influencing factors of work fatigue risks.Results A total of 186 ques-tionnaires were distributed,with 7 excluded as invalid and 179 valid responses(96.24％).The work fatigue risk assessment score of the 179 clinical nurses was(84.39±10.26),indicating a relatively high level of fatigue.There were significant differ-ences in work fatigue risk scores across genders,weekly working hours,years of work experience,contract types,and work stress levels(P＜0.05).Multiple linear regression analysis showed that gender(B=0.624,95％CI=0.194～1.054),weekly work-ing hours(B=0.037,95％CI=0.067～0.007),years of work experience(B=0.028,95％CI=0.010～0.046),contract type(B=-0.517,95％CI=-0.997～-0.037),and work stress(B=0.127,95％CI=0.050～0.204)were the influen-cing factors of work fatigue risks(P＜0.05).Conclusion The work fatigue risks of clinical nursing staff in a tertiary hospital in Xingguo County are at a relatively high level.Gender,weekly working hours,years of work experience,contract type,and work stress are the main influencing factors.Nursing managers should pay attention to these factors and take targeted measures to inter-vene and reduce the work fatigue risks of nursing staff.

Objective:To develop an exercise rehabilitation program based on the Temporal Self-regulation Theory and evaluate its effectiveness in elderly patients with hip fractures.Methods:A total of 84 elderly patients with hip fractures admitted to the Department of Trauma Orthopedics at the First Affiliated Hospital of University of South China from May to August 2024 were enrolled using convenience sampling. Participants were randomly assigned to an experimental group ( n=42) and a control group ( n=42) using a random number table. The control group received routine exercise rehabilitation, while the experimental group received an exercise rehabilitation program constructed based on the Temporal Self-regulation Theory. The program included components such as establishing a unified concept of "exercise-rehabilitation", enhancing time-limited efficacy, achieving behavioral advantages, and improving self-regulation of active movement. Both groups received interventions for 12 weeks. Functional exercise adherence, activities of daily living, and hip joint function were assessed using the Orthopedic Exercise Adherence Scale, Modified Barthel Index, and Harris Hip Score at four time points: before intervention, on the day of discharge, and at 4 and 12 weeks postoperatively. Results:During the study, two patients from each group dropped out. Results of the generalized estimating equations showed group effects, time effects, and interaction effects in adherence scores with statistically significant differences ( P<0.01). On the day of discharge, and at 4 and 12 weeks postoperatively, the adherence scores in the experimental group were significantly higher than those in the control group, and the differences were statistically significant ( P<0.05). Repeated measures ANOVA indicated that group effects, time effects, and interaction effects were also statistically significant in scores for daily living ability and hip joint function ( P<0.05). The experimental group scored higher than the control group at each time point with statistically significant differences ( P<0.05) . Conclusions:The exercise rehabilitation program based on the Temporal Self-regulation Theory is scientifically sound and practical. It can effectively improve functional exercise adherence, enhance daily living ability, and promote postoperative recovery of hip joint function in elderly patients with hip fractures.

Objective:To explore the factors influencing the recovery of swallowing function after a brainstem hemorrhage and to construct a prediction model.Methods:Clinical data on 134 persons with dysphagia after a brainstem hemorrhage were collected retrospectively. According to their swallowing ability at discharge, the patients were divided into a swallowing recovery group and a non-recovery group. Univariate correlation analysis and multivariate logistic regression analysis were used to explore the independent factors influencing the recovery of swallowing function and to construct a prediction nomogram. The receiver operating characteristics (ROC) curves were evaluated to analyze the nomogram′s predictive value and those of the relevant influencing factors.Results:Sixty-two of the patients (46%) had recovered their swallowing function at discharge, while 72 (54%) had not. Univariate correlation analysis showed that there had been significant differences in tracheal intubation, NIHSS score, FOIS score, Barthel index and Glasgow coma scale (GCS )score between the two groups, on average. The multivariate logistic regressions showed that a low NIHSS score, a high FOIS score and a high GCS score were independent predictors of swallowing function recovery, so they were used in the prediction model. ROC curve analysis showed that the area under the curve (AUC) of the prediction model was 0.953 (95% CI: 0.902~0.982) with a sensitivity of 87% and a specificity of 93%. The model′s predictions were thus better than using an NIHSS score, GCS score or FOIS score alone. Conclusions:NIHSS score, GCS score and FOIS score can independently predict the recovery of swallowing function after a brainstem hemorrhage. A prediction model constructed using all three has good predictive power.