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 explore the heterogeneity in the trajectories ofperinatal depressive symptoms and identify the related factors.Methods:A longitudinal follow-up study was conducted from January 2020 to June 2021.Baseline information,marriage satisfaction and social support status were collected at enrolment.Perinatal de-pressive symptoms were measured using the Edinburgh Postnatal Depression Scale(EPDS)at five time-points from second trimester to three-months postpartum.A Latent Class Growth Model(LCGM)was used to identify sub-groups of perinatal depressive symptoms trajectories and logistic regression was applied to examine associated risk and protective factors.Results:Two latent depression trajectory subgroups were identified A majority(72.2％,n=1 023)followed a curvilinear trajectory with low baseline scores that increased over time(curvilinear group),while 27.8％(n=393)maintained high,stable scores(linear group).Older age,higher marital satisfaction,and stronger social support were associated with a lower likelihood of belonging to the linear group(OR=0.96,0.94,0.89,re-spectively),while a personal or family history of depression increased this likelihood(OR=2.50,6.51).Conclusion:Trajectories of perinatal depressive symptoms vary significantly among individuals.The risk of persis-tent high-level symptoms is lowered by older age,stronger marital satisfaction,and greater social support,and heightened by a personal or family history of depression.

Objective To investigate the association between polymorphisms at the rs35678,rs2289274 loci of the ATPase plasma membrane Ca2+transporting 2(ATP2B2)gene and benign paroxysmal positional vertigo(BPPV).Methods 186 BPPV patients admitted to Xi'an Trade Union Hospital from January 2022 to January 2024 were selected as the BPPV group,and another 100 healthy individuals who underwent physical examination during the same period were selected as the control group.Polymerase chain reaction(PCR)was used to detect polymorphisms at the rs35678 and rs2289274 loci of the ATP2B2 gene.Allele and genotype frequencies were compared between the two groups.Unconditional Logistic regression was used to analyze the correlation with BPPV susceptibility under three genetic models(co-dominant,dominant and recessive)for the rs35678 and the rs2289274 loci.Results The distribution of genotypes at the rs35678 and rs2289274 loci of the ATP2B2 gene in the control group,and the BPPV group were all in accordance with the Hardy-Weinberg law of equilibrium(χ2=0.003～0.050,all P>0.05),and had a representativeness of the groups.Compared with the control group,the allele T frequency(56.45%vs 41.00%)and genotype TT frequency(31.87%vs 16.81%)were significantly higher in the BPPV group at the rs35678 locus,and the allele A frequency(54.30%vs 42.00%)and genotype AA frequency(29.48%vs 17.64%)at the rs2289274 locus,and the differences were statistically significant(χ2=3.936～12.290,all P<0.05).Under the codominant model(CC vs TT)for the rs35678 locus,carriers of TT genotype had an increased risk of disease compared to carriers of CC genotype(OR=1.851,95%CI:1.059～2.936);Under both the dominant model(CT+TT vs CC)and recessive model(CT+CC vs TT),the rs35678 polymorphism showed a statistically significant association with BPPV(OR=1.716,95%CI:1.074～2.936;OR=0.759,95%CI:0.517～0.837),and the differences were statistically significant(all P<0.05),reqectively.Under the codominant model(GG vs AA)for the rs2289274 locus,carriers of the AA genotype had a higher risk of disease compared to carriers of the GG genotype(OR=1.627,95%CI:1.191～2.973);in the dontinant model(AG+AA vs GG)the polymorphisms at the rs2289274 locus showed a significant association with BPPV(OR=1.941,95%CI:1.191～3.673),the differences were statistically significant(P<0.05).Conclusion The TT genotype at the rs35678 locus and the AA genotype at the rs2289274 locus of the ATP2B2 gene increase the risk of developing BPPV.

Objective:To explore the heterogeneity in the trajectories ofperinatal depressive symptoms and identify the related factors.Methods:A longitudinal follow-up study was conducted from January 2020 to June 2021.Baseline information,marriage satisfaction and social support status were collected at enrolment.Perinatal de-pressive symptoms were measured using the Edinburgh Postnatal Depression Scale(EPDS)at five time-points from second trimester to three-months postpartum.A Latent Class Growth Model(LCGM)was used to identify sub-groups of perinatal depressive symptoms trajectories and logistic regression was applied to examine associated risk and protective factors.Results:Two latent depression trajectory subgroups were identified A majority(72.2％,n=1 023)followed a curvilinear trajectory with low baseline scores that increased over time(curvilinear group),while 27.8％(n=393)maintained high,stable scores(linear group).Older age,higher marital satisfaction,and stronger social support were associated with a lower likelihood of belonging to the linear group(OR=0.96,0.94,0.89,re-spectively),while a personal or family history of depression increased this likelihood(OR=2.50,6.51).Conclusion:Trajectories of perinatal depressive symptoms vary significantly among individuals.The risk of persis-tent high-level symptoms is lowered by older age,stronger marital satisfaction,and greater social support,and heightened by a personal or family history of depression.

Objective To investigate the association between polymorphisms at the rs35678,rs2289274 loci of the ATPase plasma membrane Ca2+transporting 2(ATP2B2)gene and benign paroxysmal positional vertigo(BPPV).Methods 186 BPPV patients admitted to Xi'an Trade Union Hospital from January 2022 to January 2024 were selected as the BPPV group,and another 100 healthy individuals who underwent physical examination during the same period were selected as the control group.Polymerase chain reaction(PCR)was used to detect polymorphisms at the rs35678 and rs2289274 loci of the ATP2B2 gene.Allele and genotype frequencies were compared between the two groups.Unconditional Logistic regression was used to analyze the correlation with BPPV susceptibility under three genetic models(co-dominant,dominant and recessive)for the rs35678 and the rs2289274 loci.Results The distribution of genotypes at the rs35678 and rs2289274 loci of the ATP2B2 gene in the control group,and the BPPV group were all in accordance with the Hardy-Weinberg law of equilibrium(χ2=0.003～0.050,all P>0.05),and had a representativeness of the groups.Compared with the control group,the allele T frequency(56.45%vs 41.00%)and genotype TT frequency(31.87%vs 16.81%)were significantly higher in the BPPV group at the rs35678 locus,and the allele A frequency(54.30%vs 42.00%)and genotype AA frequency(29.48%vs 17.64%)at the rs2289274 locus,and the differences were statistically significant(χ2=3.936～12.290,all P<0.05).Under the codominant model(CC vs TT)for the rs35678 locus,carriers of TT genotype had an increased risk of disease compared to carriers of CC genotype(OR=1.851,95%CI:1.059～2.936);Under both the dominant model(CT+TT vs CC)and recessive model(CT+CC vs TT),the rs35678 polymorphism showed a statistically significant association with BPPV(OR=1.716,95%CI:1.074～2.936;OR=0.759,95%CI:0.517～0.837),and the differences were statistically significant(all P<0.05),reqectively.Under the codominant model(GG vs AA)for the rs2289274 locus,carriers of the AA genotype had a higher risk of disease compared to carriers of the GG genotype(OR=1.627,95%CI:1.191～2.973);in the dontinant model(AG+AA vs GG)the polymorphisms at the rs2289274 locus showed a significant association with BPPV(OR=1.941,95%CI:1.191～3.673),the differences were statistically significant(P<0.05).Conclusion The TT genotype at the rs35678 locus and the AA genotype at the rs2289274 locus of the ATP2B2 gene increase the risk of developing BPPV.

The irrational use of Chinese patent medicines （CPM） is becoming more and more prominent， which makes the demand for clinical practice guidelines of CPM gradually increase. In order to make domestic scholars understand the latest developments and existing problems of the CPM guidelines， and promote its development， this paper introduced the concept of CPM guidelines， summarized the characteristics of the two development modes， namely “taking CPM as the key” and “taking disease/syndrome as the key”， and analyzed the current methodological status of developing and reporting CPM guidelines. Based on the existed problems， three suggestions have been put forward to optimize the quality of CPM guidelines， which were clarifying the target users and scope of CPM guidelines， establishing an open and transparent mechanism of the personnel involvement and process steps， and formulating implementable and operable recommendations for the use of CPM.

Objective To compare the differences in lipid metabolism between platinum-resistant and platinum-sensitive ovarian cancer patients at stage Ⅲ-Ⅳ,to analyze the differential intestinal flora using 16S rRNA sequen-cing,and to explore the associations among intestinal flora,lipid metabolism characteristics and platinum resistance in ovarian cancer.Methods Patients diagnosed with ovarian cancer at stage Ⅲ-Ⅳ through surgical pathology were selected,including a platinum-resistant group(11 cases)and a platinum-sensitive group(11 cases).The differences in lipid metabolism between the two groups were compared.The differences in gut microbiota between the two groups were investigated using fecal 16S rRNA sequencing.The association among gut microbiota,lipid metabolism characteristics,and platinum resistance in ovarian cancer was analyzed.Results Significant differ-ences were observed in lipid metabolism-related indicators[total cholesterol(TC),high-density lipoprotein choles-terol(HDL-C),non-high-density lipoprotein cholesterol(n-HDL),low-density lipoprotein cholesterol(LDL-C),apolipoprotein(B)]between the two groups,with higher levels in the platinum-resistant group.The Shannon in-dex(P=0.008 3)and Simpson index(P=0.008 2)both showed higher diversity of gut microbiota in platinum-resistant ovarian cancer patients compared to the platinum-sensitive group.However,based on OTUs species clus-tering and relative abundance statistics,certain bacterial abundances differed significantly between the groups.Spe-cies such as Parabacteroides,Akkermansia,Blautia,Lachnoclostridium,Fusicatenibacter,and Megamonas had sig-nificantly higher abundances in the platinum-sensitive ovarian cancer group,and Akkermansia(a lipid metabolism-related bacterial group)was the most prevalent.Conclusion The platinum-resistant group of ovarian cancer ex-hibits significantly higher levels of lipid metabolism and gut microbiota diversity compared to the platinum-sensitive group.This suggests that the increase in lipid metabolism levels and fecal microbiota diversity may be associated with the development of platinum resistance.However,certain microbial taxa are reduced in abundance in the plat-inum-resistant group,such as the distinct Akkermansia genus(a lipid metabolism-related microbial community),which may serve as one of the factors inducing platinum-resistance in ovarian cancer.

Objective To evaluate the risk of bias and reporting quality in randomized controlled trials(RCTs)of the Chinese medicine injection for acute cerebral infarction in the last five years.Methods RCTs literature on Chinese medicine injection in the treatment of acute cerebral infarction was systematically searched in CNKI,Wanfang Data,VIP,China Biology Medicine Database(CBM),PubMed,Embase and Cochrane Library from April 20,2018 to April 20,2023.The risk of bias and reporting quality of included RCTs were evaluated using the Cochrane Risk of Bias Tool(ROB 1.0)and CONSORT-CHM Formulas 2017,respectively.Results A total of 4 301 articles were retrieved,and 408 RCTs were included according to inclusion and exclusion criteria.The ROB evaluation results showed that the the majority of studies were rated as having an unclear risk of bias due to the lack of reporting on allocation concealment,blind method,trial registration information,and funding sources.The evaluation results of CONSORT-CHM Formulas 2017 showed that the number of reported papers of 17 items was greater than or equal to 50%,and the number of reported papers of 25 items was less than 10%,and most of the RCTs did not show the characteristics of TCM syndrome differentiation and treatment.Conclusion The quality of Chinese medicine injection in the treatment of acute cerebral infarction RCTs is generally low.It is recommended that researchers refer to the methodology design of RCTs and international reporting standards,improve the trial design,standardize the trial report,and highlight the characteristics of TCM syndrome differentiation and treatment.

Objective:To screen the ultrasound markers of predictive value at 11-13 + 6 weeks for selective fetal growth restriction (sFGR) in monochorionic (MC) twins. Methods:A retrospective analysis of MC twin pregnancies collected prospectively from June 2020 to December 2021 at Beijing Obstetrics and Gynecology Hospital, Capital Medical University, with standardized ultrasound examinations performed at 11-13 + 6 weeks.According to the expert consensus on the diagnostic criteria for sFGR, collected MC twin pregnancies were divided into sFGR group and control group (normal MC twin group). Maternal age, maternal history, mode of conception, the incidence of increased nuchal translucency (NT) thickness, NT discordance, crown-rump length (CRL) discordance, abnormal ductus venous Doppler waveform and abnormal umbilical cord insertion position were compared between the two groups, and those markers that differed between groups were further analyzed for screening early ultrasound markers that could be used to predict sFGR. Results:A total of 106 cases were included in the analysis, 30 cases in sFGR group and 76 cases in control group. ①Compared with control group, sFGR group had a higher incidence of low fetal birth weight (below the 10th and 3rd percentile) in both surviving cases, large birth weight discordance and a higher incidence of birth weight inconsistency (difference >25%) ( P<0.001). ②Compared with control group, the CRL discordance was larger in sFGR group [7.8% (3.8%, 9.2%) versus 3.8% (1.5%, 7.2%)] and the incidence of abnormal cord insertion position (33.3% versus 6.6%) was higher, the differences were statistically significant ( P=0.004 and <0.001, respectively), whereas the differences of NT discordance, incidence of increased NT and abnormal ductus venous Doppler waveform were not statistically significant (all P values >0.05). ③CRL discordance was a risk factor for sFGR ( OR=1.136, 95% CI=1.021-1.264), with an area under the ROC curve of 0.682 (95% CI=0.576-0.787) for predicting sFGR, the sensitivity and specificity were 0.567 and 0.737 at a cut-off value of 6.5%. Abnormal umbilical cord insertion position was a risk factor for sFGR ( OR=7.100, 95% CI=2.176-23.167) with a sensitivity of 0.333 and specificity of 0.934 for predicting sFGR. Conclusions:CRL discordance and abnormal cord insertion position are risk factors for the development of sFGR and are of value in predicting sFGR in MC twins.

Objective:To investigate effects of bone-resorptive lesion on stress distribution of femoral head and on progression in patients with osteonecrosis of the femoral head (ONFH).Methods:From April 2014 to September 2018, a total of 155 femoral heads from 94 patients diagnosed with ARCO stage II and III ONFH were retrospectively reviewed, including 77 males and 17 females with aged 39.90±10.45 years old (ranged from 18-64 years). The hips were divided into two groups according to whether there were bone-resorptive lesions. Further, we compared whether there was statistical difference between the two groups in staging. Then, a case of ARCO II hip joint without bone-resorptive lesion was selected from the included patients. Six femoral head with different diameters of spherical bone-resorptive lesion of 5 mm, 7 mm, 10 mm, 14 mm, 18 mm, and 23 mm were simulated. The influence of bone-resorptive lesion on the stress distribution of necrotic area and a spherical shell extending 1 mm radially around the bone-resorptive lesion was investigated by finite element method in slow walking conditions.Results:Of the 155 ONFH hips, 67 hips are complicated by bone-resorptive lesions, of which 17 were ARCO II, 50 were ARCO III. A total of 88 hips did not contain bone-resorptive lesions, of which 58 were ARCO II, ARCO III 30 cases. The proportion of ARCO stage II in the group with bone-resorptive lesions was significantly higher than that in the group without bone-resorptive lesions (χ 2=25.03, P=0.000). The finite element stress distribution cloud diagram showed that there was a stress concentration area around the bone-resorptive lesions. The maximum von Mises stress around bone-resorptive lesions in the models that contained a synthetic bone-resorptive lesions were significantly higher than those reported in the matched, non-synthetic bone-resorptive lesions finite element models ( t=3.139, P=0.026). The values for maximum von Mises stress around bone-resorptive lesions were 6.94±1.78 MPa and 5.01±0.35 MPa for the group with synthetic bone-resorptive lesions and the group non-synthetic bone-resorptive lesions, respectively. There was a positive correlation between the diameter of bone-resorptive lesions and the maximum and mean von Mises stress of necrotic areas as well as the maximum von Mises stress around bone-resorptive lesions. Conclusion:Bone-resorptive lesions can increase the maximum stress and average stress in the necrotic area. The larger the bone-resorptive lesion, the more the stress increases. There is a stress concentration area around the bone-resorptive lesions, which may accelerate the collapse of the femoral head.