Objective:To examine the effect of a multidimensional nursing intervention based on Pender's Health Promotion Model on recovery outcomes in patients with gastrointestinal bleeding.Methods:Using convenience sampling, 200 patients with gastrointestinal bleeding who received treatment at the China-Japan Union Hospital of Jilin University from June 2023 to June 2024 were enrolled. Patients were randomly assigned by a random-number table to a control group ( n=100) receiving routine nursing or an observation group ( n=100) receiving the multidimensional nursing intervention based on Pender's Health Promotion Model in addition to routine nursing. Outcomes included bleeding control (time to melena cessation), scores on the Health-Promoting Lifestyle Profile, Generic Quality of Life Inventory, Connor-Davidson Resilience Scale 10, and the incidence of adverse events. Results:After the intervention, the time to melena cessation in the observation group was shorter than that in the control group, and the difference was statistically significant ( P<0.05). Scores on the Health-Promoting Lifestyle Profile, Generic Quality of Life Inventory, Connor-Davidson Resilience Scale 10 (all dimensions and total scores) were higher in the observation group than thoes in the control group, and the differences were statistically significant ( P<0.05). The incidence of adverse events was 3.00% (3/100) in the observation group versus 11.00% (11/100) in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:In patients with gastrointestinal bleeding, a multidimensional nursing intervention based on Pender's Health Promotion Model optimizes bleeding control, strengthens psychological resilience, improves health status and quality of life, and reduces adverse events. This approach merits wider clinical adoption.

Diabetic cardiomyopathy(DCM)is a serious complication of diabetes mellitus(DM).Recent studies have reported that the NOD-like receptor protein 3(NLRP3)inflammasome activation-mediated pyroptosis aggravates the formation and development of DCM.This review summarizes the mechanism of action of NLRP3 inflammasome in the development of DCM,and focus on the potential effects of targeted inhibition of NLRP3 inflammasome activation in the treatment of DCM.

Objective:By reviewing the experiences and challenges of assessing the value of ophthalmic gene therapy,it aimed to provide references for optimizing the reimbursement of this kind of drug.Methods:Based on case analysis,it summarized the key considerations and challenges faced by Health Technology Assessment(HTA)agencies conducting technical reviews of gene therapy for ophthalmic conditions in typical countries,including the US.,Canada,the UK.,France,and the Netherlands.Results:Disease severity and medical demand,drug safety,efficacy,cost-effectiveness,budget impact,and social value are the factors for HTA institutions to evaluate the value of ophthalmic gene therapy,patient participation and ethical fairness were taken into account by some institutions.HTA agencies generally put forward the following problems:large uncertainty of the long-term benefits,the difficulty of evaluating the value for caregivers,and the uncertainty of the discount rate.Providing methodological guidance for extrapolating clinical benefits of gene therapy,incorporating a wide range of value elements such as disease severity,and introducing innovative payment agreements are common responses.Conclusion:It is proposed to adjust the threshold for willingness to pay,consider the diversified value domains,gradually introducing finance-based or performance-based innovative payment models,and optimize value assessment and medical insurance access pathways.

Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a non-atherosclerotic, non-amyloidogenic inherited cerebral small vessel disease caused by mutations in the NOTCH3 gene, typically manifesting in middle age. The diagnosis can be confirmed through the detection of granular osmiophilic material in skin biopsies and NOTCH3 gene mutations identified by genetic testing. However, the pathogenesis of this disease remains unclear, and treatment options are limited. A major contributing factor is that currently available preclinical animal models fail to adequately recapitulate the characteristic pathological features and clinical phenotypes of the disease. Therefore, a comprehensive review of recent advances in CADASIL animal models was conducted, and the advantages and limitations of existing models were systematically analyzed, aiming to offer guidance for selecting appropriate animal models in fundamental research and to propose future directions for developing experimental models.

Cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a non-atherosclerotic, non-amyloidogenic inherited cerebral small vessel disease caused by mutations in the NOTCH3 gene, typically manifesting in middle age. The diagnosis can be confirmed through the detection of granular osmiophilic material in skin biopsies and NOTCH3 gene mutations identified by genetic testing. However, the pathogenesis of this disease remains unclear, and treatment options are limited. A major contributing factor is that currently available preclinical animal models fail to adequately recapitulate the characteristic pathological features and clinical phenotypes of the disease. Therefore, a comprehensive review of recent advances in CADASIL animal models was conducted, and the advantages and limitations of existing models were systematically analyzed, aiming to offer guidance for selecting appropriate animal models in fundamental research and to propose future directions for developing experimental models.

Objective:By reviewing the experiences and challenges of assessing the value of ophthalmic gene therapy,it aimed to provide references for optimizing the reimbursement of this kind of drug.Methods:Based on case analysis,it summarized the key considerations and challenges faced by Health Technology Assessment(HTA)agencies conducting technical reviews of gene therapy for ophthalmic conditions in typical countries,including the US.,Canada,the UK.,France,and the Netherlands.Results:Disease severity and medical demand,drug safety,efficacy,cost-effectiveness,budget impact,and social value are the factors for HTA institutions to evaluate the value of ophthalmic gene therapy,patient participation and ethical fairness were taken into account by some institutions.HTA agencies generally put forward the following problems:large uncertainty of the long-term benefits,the difficulty of evaluating the value for caregivers,and the uncertainty of the discount rate.Providing methodological guidance for extrapolating clinical benefits of gene therapy,incorporating a wide range of value elements such as disease severity,and introducing innovative payment agreements are common responses.Conclusion:It is proposed to adjust the threshold for willingness to pay,consider the diversified value domains,gradually introducing finance-based or performance-based innovative payment models,and optimize value assessment and medical insurance access pathways.

Diabetic cardiomyopathy(DCM)is a serious complication of diabetes mellitus(DM).Recent studies have reported that the NOD-like receptor protein 3(NLRP3)inflammasome activation-mediated pyroptosis aggravates the formation and development of DCM.This review summarizes the mechanism of action of NLRP3 inflammasome in the development of DCM,and focus on the potential effects of targeted inhibition of NLRP3 inflammasome activation in the treatment of DCM.

Metabolic syndrome(MetS)is a cluster of metabolic disorders with diverse clinical manifestations.Jingui Yaolue,or Synopsis of the Golden Chamber,discusses over 40 different diseases in total.This study reveals that some of these diseases,including tanyin(phlegm-dampness),xulao(consumptive disease),and xiaoke(wasting and thirst),exhibit clinical manifestations similar to those of MetS.Furthermore,there are also correspondences between these diseases and MetS in terms of the etiology and pathogenesis.For example,the pathogenesis involves multiple organs,but is centered on the spleen;the disease arises from deficiency and ultimately leads to a dual deficiency of yin and yang;the syndrome patterns are complex and predominantly characterized by phlegm-turbidity.This article summarizes targeted treatment approaches for MetS mentioned in Synopsis of the Golden Chamber,including focusing on the spleen in the treatment of diseases involving multiple organs,supporting the vital energy while dealing with excess syndrome,balancing yin and yang in a state of dual deficiency of both yin and yang,and treating phlegm and blood stasis simultaneously due to the close connection between body fluids and blood.Integrating these treatment principles into current traditional Chinese medicine treatment plans for MetS may help optimize traditional Chinese medicine treatment protocols for MetS and improve clinical outcomes.

Objective:To examine the effect of a multidimensional nursing intervention based on Pender's Health Promotion Model on recovery outcomes in patients with gastrointestinal bleeding.Methods:Using convenience sampling, 200 patients with gastrointestinal bleeding who received treatment at the China-Japan Union Hospital of Jilin University from June 2023 to June 2024 were enrolled. Patients were randomly assigned by a random-number table to a control group ( n=100) receiving routine nursing or an observation group ( n=100) receiving the multidimensional nursing intervention based on Pender's Health Promotion Model in addition to routine nursing. Outcomes included bleeding control (time to melena cessation), scores on the Health-Promoting Lifestyle Profile, Generic Quality of Life Inventory, Connor-Davidson Resilience Scale 10, and the incidence of adverse events. Results:After the intervention, the time to melena cessation in the observation group was shorter than that in the control group, and the difference was statistically significant ( P<0.05). Scores on the Health-Promoting Lifestyle Profile, Generic Quality of Life Inventory, Connor-Davidson Resilience Scale 10 (all dimensions and total scores) were higher in the observation group than thoes in the control group, and the differences were statistically significant ( P<0.05). The incidence of adverse events was 3.00% (3/100) in the observation group versus 11.00% (11/100) in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:In patients with gastrointestinal bleeding, a multidimensional nursing intervention based on Pender's Health Promotion Model optimizes bleeding control, strengthens psychological resilience, improves health status and quality of life, and reduces adverse events. This approach merits wider clinical adoption.

This study aimed to explore the relationship between comorbidity factors and in-hospital mortality related to factors in patients with carbapenem-resistant Klebsiella pneumoniae (CRKP) pneumonia. This study collected clinical data from 218 patients with CRKP pneumonia in Beijing hospital from November 2011 to December 2023, analyzed the number of comorbidities carried by CRKP pneumonia patients, comorbidity patterns, Charlson Comorbidity Index (CCI) scores, and comorbidity of underlying diseases, and explored the relationship between various indicators and comorbidity factors and in-hospital mortality in CRKP pneumonia patients. The Ward.D cluster analysis was performed on the comorbidities of patients and used to draw heatmaps. Using a multiple logistic regression model, a nomogram model was constructed to predict in-hospital mortality in patients with CRKP pneumonia. This study included 218 patients with CRKP pneumonia. The results showed that there were significant differences in the age ( P=0.003), comorbidities such as heart failure ( P<0.001), arrhythmia ( P=0.002), chronic liver disease ( P=0.003), chronic kidney disease ( P=0.002), CCI score ( P=0.007), total number of comorbidities ( P<0.001), and comorbidity patterns (respiratory/immune/psychiatric disease patterns and cardiovascular/tumor/metabolic disease patterns, P=0.003) between the survival and death groups of CRKP pneumonia patients. The multiple logistic regression showed that cardiovascular/tumor/metabolic disease patterns ( P=0.030), CCI score ( P=0.040), concomitant heart failure ( P=0.011), and concomitant arrhythmia ( P=0.025) were independent risk factors for in-hospital mortality in patients with CRKP pneumonia. The nomogram model for predicting the risk of in-hospital mortality in patients with CRKP pneumonia, constructed based on the identified risk factors, had an area under the ROC curve of 0.758. Both the ROC curve and validation curve indicated that the nomogram model had stable performance in predicting in-hospital mortality in patients with CRKP pneumonia. In summary, comorbidity factors are risk factors for predicting in-hospital mortality in patients with CRKP pneumonia, and the role of comorbidity factors in in-hospital mortality in patients with CRKP pneumonia should be taken seriously.