ObjectiveTo evaluate the effects of Tongnaoyin on the blood-brain barrier status and neurological impairment in acute ischemic stroke （AIS） patients with the syndrome of phlegm-stasis blocking collaterals by dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI）. MethodsA total of 63 patients diagnosed with AIS in the Jiangsu Province Hospital of Chinese Medicine from October 2022 to December 2023 were enrolled in this study. According to random number table method，the patients were assigned into a control group （32 cases） and an observation group （31 cases）. The control group received conventional Western medical treatment，and the observation group took 200 mL Tongnaoyin after meals，twice a day from day 2 of admission on the basis of the treatment in the control group. After 7 days of treatment，the patients were examined by DCE-MRI. The baseline data for two groups of patients before treatment were compared. The National Institute of Health Stroke Scale （NIHSS） score and modified Rankin Scale （mRS） score were recorded before treatment and after 90 days of treatment for both groups. The rKtrans，rKep，and rVe values were obtained from the region of interest （ROI） of the infarct zone/mirror area and compared between the two groups. ResultsThere was no significant difference in the NIHSS or mRS score between the two groups before treatment. After 90 days of treatment，the NIHSS and mRS scores declined in both groups，and the observation group had lower scores than the control group （P<0.05）. After treatment，the rKtrans and rVe in the observation group were lower than those in the control group （P<0.01）. ConclusionCompared with conventional Western medical treatment alone，conventional Western medical treatment combined with Tongnaoyin accelerates the repair of the blood-brain barrier in AIS patients，thereby ameliorating neurological impairment after AIS to improve the prognosis.

Background and Aims:Portal hypertensive colopathy(PHC)is a common complication of portal hypertension in patients with liver cirrhosis.It may lead to gastrointestinal bleeding,yet its underlying pathogenesis remains unclear,and systematic research in China is limited.This study aimed to analyze the colonoscopic features in cirrhotic patients and to explore their associations with relevant clinical factors.Methods:A retrospective analysis was conducted on 99 cirrhotic patients who underwent colonoscopy at Xingtai People's Hospital between July 2020 and December 2024.Colonoscopy,gastroscopy,and clinical data were reviewed.Differences between patients with PHC and those without were compared in terms of sex,Child-Pugh classification,platelet count,presence of ascites,and hepatic encephalopathy.Multivariate logistic regression was used to identify independent risk factors for PHC.Additionally,colorectal lesion detection rates were compared with those of a contemporaneous cohort of 444 participants undergoing national colorectal cancer(CRC)screening at the same center.Results:Among the 105 patients with cirrhosis,the detection rates of PHC,adenomatous polyps,and CRC were 32.32%,28.28%,and 3.03%,respectively,while only 37.37%had no abnormal findings.No serious colonoscopy-related complications were observed.The proportion of males in the PHC group was significantly higher than in the non-PHC group(78.13%vs.50.75%,P=0.009).The PHC group also showed significantly higher rates of Child-Pugh class B/C,and lower platelet count(all P<0.05).There was no statistically significant difference in the incidence of ascites and hepatic encephalopathy between the two groups(P>0.05).Multivariate analysis identified that male gender(OR=3.307,95%CI=1.219-8.971)and Child-Pugh class B/C(OR=2.867,95%CI=1.046-7.861)were independent risk factors for PHC.Compared to the CRC screening cohort,cirrhotic patients had a similar adenoma detection rate(28.28%vs.25.00%,P=0.499),and a slightly higher colorectal cancer detection rate that did not reach statistical significance(3.03%vs.0.68%,P=0.135).Conclusion:Colonoscopy revealed a high rate of abnormalities in cirrhotic patients,with PHC and adenomatous polyps being the most common findings.Routine colonoscopy is recommended for cirrhotic patients without contraindications,especially males,and patients with Child-Pugh class B/C,to facilitate early detection of PHC and precancerous lesions,thereby reducing the risk of lower gastrointestinal bleeding and missed diagnoses of malignancy.

Objective:To assess the level of moral distress among pediatric nurses in China and explore its influencing factors, providing a reference for future interventions.Methods:A cross-sectional survey was conducted using a convenience sampling method from May 2022 to March 2023. Pediatric nurses meeting the inclusion and exclusion criteria were selected from children′s specialized hospitals, general hospitals, and maternal and child health hospitals across 16 provinces in China. Moral distress was assessed using the Chinese version of the Moral Distress Scale-Revised (MDS-R). Data analysis included descriptive statistics, non-parametric analysis, and multiple linear regression.Results:A total of 509 pediatric nurses participated in the survey, including 10 males and 499 females. Among them, 45 were aged ≤25 years, 268 were aged 26-35 years, 172 were aged 36-45 years, and 24 were aged >45 years.The median moral distress score was 58.00 (26.00, 77.50). Factors independently associated with higher levels of moral distress included having a master′s degree ( t = 2.33), working in a ward with more than 40 beds ( t = 3.38), working in a ward without parental accompaniment ( t = 2.60), being passively assigned to the nursing profession ( t = 2.63), and considering resignation but not leaving the job ( t = 3.85) (all P<0.05). Conclusions:Pediatric nurses in China experience a moderate level of moral distress. Further research is needed to understand its underlying causes and to develop preventive and intervention strategies.

Objective:To deeply explore the thematic needs and characteristics of learners regarding course elements based on the review texts of nursing massive open online courses (MOOC), providing a reference for achieving effective alignment between digital nursing education content and learner needs.Methods:Data were collected from the review texts of 112 nursing courses on the Chinese University MOOC platform using a web crawler script written with Python′s Requests library. The collection period spanned from the course launch dates to December 31, 2023. Sentiment analysis and high-frequency words analysis were conducted using Chinese text Nature language processing library, and core themes of learners′ positive and negative reviews were extracted using the latent dirichlet allocation.Results:A corpus of 18 184 nursing MOOC review texts was constructed, with positive sentiment reviews accounting for 89.30% (16 238/18 184) and negative sentiment reviews making up 10.70% (1 946/18 184). Word frequency analysis revealed that most nursing MOOC serve as carriers for blended online and offline teaching models, with students being the primary target audience, though social participants were also involved. The reviews effectively mirrored real-world clinical nursing scenarios. The need of learners was categorized into three major themes: content design and assessment, course resources and teaching strategies, and software applications and platform functionality.Conclusions:This study, leveraging text mining technology, thoroughly investigated the three thematic characteristics of nursing MOOC needs of online learners and proposed targeted optimization recommendations. Future research could incorporate other online teaching platforms and comprehensively construct a sentiment lexicon for nursing online course reviews using big data modeling and machine learning algorithms. These would enable a holistic analysis of the digital nursing education landscape, allowing for precise improvements to address existing shortcomings.

Background and Aims:Portal hypertensive colopathy(PHC)is a common complication of portal hypertension in patients with liver cirrhosis.It may lead to gastrointestinal bleeding,yet its underlying pathogenesis remains unclear,and systematic research in China is limited.This study aimed to analyze the colonoscopic features in cirrhotic patients and to explore their associations with relevant clinical factors.Methods:A retrospective analysis was conducted on 99 cirrhotic patients who underwent colonoscopy at Xingtai People's Hospital between July 2020 and December 2024.Colonoscopy,gastroscopy,and clinical data were reviewed.Differences between patients with PHC and those without were compared in terms of sex,Child-Pugh classification,platelet count,presence of ascites,and hepatic encephalopathy.Multivariate logistic regression was used to identify independent risk factors for PHC.Additionally,colorectal lesion detection rates were compared with those of a contemporaneous cohort of 444 participants undergoing national colorectal cancer(CRC)screening at the same center.Results:Among the 105 patients with cirrhosis,the detection rates of PHC,adenomatous polyps,and CRC were 32.32%,28.28%,and 3.03%,respectively,while only 37.37%had no abnormal findings.No serious colonoscopy-related complications were observed.The proportion of males in the PHC group was significantly higher than in the non-PHC group(78.13%vs.50.75%,P=0.009).The PHC group also showed significantly higher rates of Child-Pugh class B/C,and lower platelet count(all P<0.05).There was no statistically significant difference in the incidence of ascites and hepatic encephalopathy between the two groups(P>0.05).Multivariate analysis identified that male gender(OR=3.307,95%CI=1.219-8.971)and Child-Pugh class B/C(OR=2.867,95%CI=1.046-7.861)were independent risk factors for PHC.Compared to the CRC screening cohort,cirrhotic patients had a similar adenoma detection rate(28.28%vs.25.00%,P=0.499),and a slightly higher colorectal cancer detection rate that did not reach statistical significance(3.03%vs.0.68%,P=0.135).Conclusion:Colonoscopy revealed a high rate of abnormalities in cirrhotic patients,with PHC and adenomatous polyps being the most common findings.Routine colonoscopy is recommended for cirrhotic patients without contraindications,especially males,and patients with Child-Pugh class B/C,to facilitate early detection of PHC and precancerous lesions,thereby reducing the risk of lower gastrointestinal bleeding and missed diagnoses of malignancy.

Objective To understand the epidemiological characteristics of burns and scalds in a sentinel hospital for na-tional injury surveillance in Guangzhou,and to provide a scientific basis for developing precise and effective prevention strategies.Methods Data on burn and scald cases from the outpatient and emergency departments of a sentinel injury surveillance hospital in Guangzhou from 2022 to 2024 were collected,and epidemiological characteristics were analyzed.Results A total of 19 303 burn and scald cases were reported during 2022-2024,with a male-to-female ratio of 1∶1.29.The majority of cases occurred in young and middle-aged adults(51.40％).Across all age groups,the top three locations where burns and scalds occurred were homes(60.14％),industrial and construction sites(30.74％),and public places(5.12％).Burns and scalds in preschool children predominantly occurred at home,mostly during leisure activities,while in young adults and the elderly,they were mainly associated with household chores and leisure activities.Unintentional injuries accounted for the vast majority of cases(99.45％).Analysis of age-specific outcomes of burns and scalds showed that the proportion of preschool children discharged af-ter treatment decreased(19.10％,AR=-5.08),while the proportion hospitalized increased(25.98％,AR=4.66).Conclu-sion This study indicates that homes are the primary location for burns and scalds in Guangzhou,with preschool children being particularly vulnerable during leisure activities at home.Preschool children should be the key target group for burn and scald pre-vention and control efforts.

Objective:To assess the level of moral distress among pediatric nurses in China and explore its influencing factors, providing a reference for future interventions.Methods:A cross-sectional survey was conducted using a convenience sampling method from May 2022 to March 2023. Pediatric nurses meeting the inclusion and exclusion criteria were selected from children′s specialized hospitals, general hospitals, and maternal and child health hospitals across 16 provinces in China. Moral distress was assessed using the Chinese version of the Moral Distress Scale-Revised (MDS-R). Data analysis included descriptive statistics, non-parametric analysis, and multiple linear regression.Results:A total of 509 pediatric nurses participated in the survey, including 10 males and 499 females. Among them, 45 were aged ≤25 years, 268 were aged 26-35 years, 172 were aged 36-45 years, and 24 were aged >45 years.The median moral distress score was 58.00 (26.00, 77.50). Factors independently associated with higher levels of moral distress included having a master′s degree ( t = 2.33), working in a ward with more than 40 beds ( t = 3.38), working in a ward without parental accompaniment ( t = 2.60), being passively assigned to the nursing profession ( t = 2.63), and considering resignation but not leaving the job ( t = 3.85) (all P<0.05). Conclusions:Pediatric nurses in China experience a moderate level of moral distress. Further research is needed to understand its underlying causes and to develop preventive and intervention strategies.

Objective:To deeply explore the thematic needs and characteristics of learners regarding course elements based on the review texts of nursing massive open online courses (MOOC), providing a reference for achieving effective alignment between digital nursing education content and learner needs.Methods:Data were collected from the review texts of 112 nursing courses on the Chinese University MOOC platform using a web crawler script written with Python′s Requests library. The collection period spanned from the course launch dates to December 31, 2023. Sentiment analysis and high-frequency words analysis were conducted using Chinese text Nature language processing library, and core themes of learners′ positive and negative reviews were extracted using the latent dirichlet allocation.Results:A corpus of 18 184 nursing MOOC review texts was constructed, with positive sentiment reviews accounting for 89.30% (16 238/18 184) and negative sentiment reviews making up 10.70% (1 946/18 184). Word frequency analysis revealed that most nursing MOOC serve as carriers for blended online and offline teaching models, with students being the primary target audience, though social participants were also involved. The reviews effectively mirrored real-world clinical nursing scenarios. The need of learners was categorized into three major themes: content design and assessment, course resources and teaching strategies, and software applications and platform functionality.Conclusions:This study, leveraging text mining technology, thoroughly investigated the three thematic characteristics of nursing MOOC needs of online learners and proposed targeted optimization recommendations. Future research could incorporate other online teaching platforms and comprehensively construct a sentiment lexicon for nursing online course reviews using big data modeling and machine learning algorithms. These would enable a holistic analysis of the digital nursing education landscape, allowing for precise improvements to address existing shortcomings.

Objective:To explore the effectiveness of find-organize-clarify-understand- select-plan-do-check-act (FOCUS-PDCA) cycle management in improving the accuracy of Nutritional Risk Screening 2002 (NRS 2002) scoring in inpatients.Methods:This study was a retrospective study. Data from a continuous quality improvement project, namely Improving the Accuracy of Nutritional Risk Screening for Inpatients from People's Hospital of Longhua in 2021 were selected. The NRS 2002 scores of newly admitted patients from 8 departments with relatively high nutritional risk (departments of gstroenterology, neurology, nephrology, respiratory medicine, oncology and hematology, neurosurgery, gastrointestinal surgery, and critical care medicine) from April 10, 2021 to April 29, 2021 (before intervention) were collected. The NRS 2002 scores were evaluated by a multidisciplinary nutrition support team in terms of accuracy and error types. Possible issues in the process of nutritional screening were analyzed and mitigated using the FOCUS-PDCA cycle management method. The NRS 2002 scores from July 18, 2021 to August 8, 2021 (after intervention) were collected in real time to summary the data on accuracy and error types and to evaluate the effect of FOCUS-PDCA.Results:The accuracy of NRS 2002 score in the 8 departments was increased from 52.97% (294/555) to 81.13% (473/583) after intervention, and the difference was statistically significant ( χ2=102.606, P<0.001). The accuracy of nutritional status impairment score was 64.14% before intervention, compared with 90.57% after intervention ( χ2=114.484, P<0.001). The accuracy of disease severity score was 78.56%, compared with 89.54% after intervention( χ2=25.736, P<0.001). The false-negative rate was 68.02% before intervention and 31.87% after intervention, and the difference was statistically significant ( χ2=31.501, P<0.001). Conclusion:FOCUS-PDCA can improve the accuracy of NRS 2002 scoring in inpatients, reduce the risk of failing to identify patients at nutritional risk, and contribute to further nutritional diagnosis and treatment.

Objective To understand the epidemiological characteristics of burns and scalds in a sentinel hospital for na-tional injury surveillance in Guangzhou,and to provide a scientific basis for developing precise and effective prevention strategies.Methods Data on burn and scald cases from the outpatient and emergency departments of a sentinel injury surveillance hospital in Guangzhou from 2022 to 2024 were collected,and epidemiological characteristics were analyzed.Results A total of 19 303 burn and scald cases were reported during 2022-2024,with a male-to-female ratio of 1∶1.29.The majority of cases occurred in young and middle-aged adults(51.40％).Across all age groups,the top three locations where burns and scalds occurred were homes(60.14％),industrial and construction sites(30.74％),and public places(5.12％).Burns and scalds in preschool children predominantly occurred at home,mostly during leisure activities,while in young adults and the elderly,they were mainly associated with household chores and leisure activities.Unintentional injuries accounted for the vast majority of cases(99.45％).Analysis of age-specific outcomes of burns and scalds showed that the proportion of preschool children discharged af-ter treatment decreased(19.10％,AR=-5.08),while the proportion hospitalized increased(25.98％,AR=4.66).Conclu-sion This study indicates that homes are the primary location for burns and scalds in Guangzhou,with preschool children being particularly vulnerable during leisure activities at home.Preschool children should be the key target group for burn and scald pre-vention and control efforts.