OBJECTIVE:Neuromuscular exercise is a new comprehensive rehabilitation therapy in recent years,but its effect on knee osteoarthritis is still controversial.The purpose of this paper is to systematically evaluate the efficacy of neuromuscular exercise on knee osteoarthritis pain and function. METHODS:The randomized controlled trials addressing neuromuscular exercise in the treatment of knee osteoarthritis pain and function were retrieved from PubMed,Cochrane Library,Embase,EBSCO,CNKI,Web of Science,China Biomedical Database(CBM),VIP,and WanFang Database.The retrieval time ranged from database inception to October 2023.The neuromuscular training group(experimental group)was given neuromuscular training or neuromuscular training as the main intervention;the control group was a blank group or given conventional rehabilitation.Outcome indicators included the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score,walking time,knee stability,and the maximum number of knee flexion in 30 seconds.The risk of bias was evaluated by the Cochrane Collaboration tool and the Physiotherapy Evidence Database.Meta-analysis was performed using RevMan 5.4 software. RESULTS:A total of 11 randomized controlled trials were included,and 628 samples were extracted.The results of Meta-analysis showed that the experimental group was superior to the control group in terms of WOMAC pain score[standardized mean difference(SMD)=0.38,95%confidence interval(CI):0.08-0.69,P=0.01],knee stability(SMD=0.57,95%CI:0.23-0.92,P=0.001),the maximum number of knee joint flexion in 30 seconds(SMD=0.35,95%CI:0.05-0.65,P=0.02),and WOMAC physical function score(SMD=-0.79,95%CI:-1.30 to-0.28,P=0.002).In both groups,walking speed was increased and walking ability was improved in patients with knee osteoarthritis,but there was no significant difference(walking time:SMD=-0.22,95%CI:-0.48-0.03,P=0.09). CONCLUSION:Neuromuscular exercise can effectively improve knee joint pain,enhance the stability of the knee joint,and promote functional recovery in patients with knee osteoarthritis.However,more high-quality randomized controlled trials are still needed to further confirm the research.

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 investigate the status quo of mobile phone addiction, social anxiety, sleep quality, safe behavior and the influence of mobile phone addiction on safe behavior of nursing students in practice, so as to provide evidence for improving the safety behavior of nursing students in practice.Methods:A total of 700 nursing students from The First Affiliated Hospital of Zhengzhou University from March 1 to 20, 2023 were selected by cluster sampling method. A cross-sectional investigation was conducted using the general data questionnaire, the Smartphone Addiction Scale-Short Version, the Nurse Safety Behavior Scale, the Social Anxiety Scale and the Pittsburgh Sleep Quality Index.Results:A total of 678 valid questionnaires were collected, with an effective recovery rate of 96.9%. Among the 678 nursing students in practice, 87 were male and 591 were female, aged (21.25±1.16) years old. The scores of safety behavior, mobile phone addiction, social anxiety and sleep quality of 678 nursing students were (52.33±7.31), (28.21±9.86), (41.92±7.64) and (4.56±2.79) respectively. Mobile phone addiction had a statistically significant effect on the prediction of safety behavior ( β = - 0.178, P<0.01). Social anxiety had an intermediate effect between mobile phone addiction and safety behavior, and the indirect effect accounted for 25.5%. Sleep quality could buffer the influence of social anxiety on safety behavior ( β = 0.022, P<0.05). Conclusions:The safety behaviors of student nurses are good, and there are phenomena of mobile phone addiction and social anxiety. Nursing managers and educators can effectively manage the mobile phones of nursing studentsin practice, reduce their social anxiety and improve their sleep quality, so as to improve the safety behaviors of nursing students in practice and ensure the safety of patients.

Objective:To investigate the influencing factors of constipation in patients with cerebral hemorrhage, construct a risk prediction model, and verify the predictive effect of the model to scientifically guide subsequent treatment and nursing.Methods:A total of 254 patients with cerebral hemorrhage hospitalized in Affiliated Hospital of Binzhou Medical Collegefrom May 2022 to November 2022 were selected in a prospective cohort study, and they were divided into constipation group ( n = 150) and non-constipation group ( n = 104) according to whether constipation occurred. Univariate analysis and logistic regression were used to analyze the influencing factors of constipation in patients with cerebral hemorrhage, and a risk prediction model was established and a nomogram was drawn. A total of 110 patients with cerebral hemorrhage hospitalized in the same hospital from December 2022 to March 2023 were selected as the validation group, and the Hosmer-Lemeshow test and ROC curve were used to verify the model. Results:In this study, four risk factors of hospital stay, Koubmwater swallowing test score, nutrition and diuretics were finally included to construct a risk prediction model, and the area under the ROC curve of the modeling group was 0.918, the 95% CI was 0.848 to 0.963, the optimal cut-off value was 0.7225, the sensitivity was 0.885, and the specificity was 0.837. External verification results showed a sensitivity of 0.926 and specificity of 0.611. Conclusions:The risk prediction model constructed in this study has good effect and can provide reference for clinical assessment of whether patients with cerebral hemorrhage have the risk of constipation.

Objective To investigate the effect and mechanism of salidroside on1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)-induced Parkinson's disease(PD)in mice.Methods C57BL/6J mice were induced by MPTP to establish a PD mouse model and the movement track of mice was re-corded by open field experiment.The expression of tyrosine hydroxylase(TH),α-synuclein(α-syn),nuclear factor E2 associated factor 2(Nrf2)and quinone oxidoreductase 1(NQO1)were detected by immunohistochemistry in brain tissue of mice.SN4741 cells were stimulated by MPTP to establish a PD cell model in vitro.MPTP stimulation of SN4741 cells to establish an in vitro cell mod-el of PD.After pretreatment with salidroside,TUNEL was used to detect cell apoptosis in each group.The expressions of TH,α-syn,Nrf2 and NQO1 were detected by immunofluorescence.Nrf2 expres-sion was knocked down by being transfected with si-RNA,and apoptosis condition was detected by TUNEL assay.The expression levels of interleukin-1β(IL-1β)and interleukin-18(IL-18)protein in brain tissue extract and cell culture were detected by enzyme-linked immunosorbent assay(ELISA).Results The open field experiment results showed that salidroside could improve 3 min total distance of activity,average speed and activity track of PD mice(P＜0.05).Compared with the PD model mice,the salidroside treated mice showed significantly increased expression of TH,Nrf2 and NQO1 in the brain,and reduced expression of IL-18,α-Syn,IL-1β.Compared with the MPTP stimulated cells,the salidroside pretreatment group showed a decrease in cell apoptosis and an increase in the expressions of TH,Nrf2 and NQO1,but reduced expressions in α-Syn,IL-1β and IL-18.After si-RNA knockdown of Nrf2 expression,the protective effect of salidroside on MPTP stimulated cells weakened or even disappeared.Conclusion Salidroside may alleviate neuronal apoptosis by activating Nrf2-ARE signaling pathway,which is expected to be a new drug for PD treatment.

Objective To investigate the effect and mechanism of salidroside on1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)-induced Parkinson's disease(PD)in mice.Methods C57BL/6J mice were induced by MPTP to establish a PD mouse model and the movement track of mice was re-corded by open field experiment.The expression of tyrosine hydroxylase(TH),α-synuclein(α-syn),nuclear factor E2 associated factor 2(Nrf2)and quinone oxidoreductase 1(NQO1)were detected by immunohistochemistry in brain tissue of mice.SN4741 cells were stimulated by MPTP to establish a PD cell model in vitro.MPTP stimulation of SN4741 cells to establish an in vitro cell mod-el of PD.After pretreatment with salidroside,TUNEL was used to detect cell apoptosis in each group.The expressions of TH,α-syn,Nrf2 and NQO1 were detected by immunofluorescence.Nrf2 expres-sion was knocked down by being transfected with si-RNA,and apoptosis condition was detected by TUNEL assay.The expression levels of interleukin-1β(IL-1β)and interleukin-18(IL-18)protein in brain tissue extract and cell culture were detected by enzyme-linked immunosorbent assay(ELISA).Results The open field experiment results showed that salidroside could improve 3 min total distance of activity,average speed and activity track of PD mice(P＜0.05).Compared with the PD model mice,the salidroside treated mice showed significantly increased expression of TH,Nrf2 and NQO1 in the brain,and reduced expression of IL-18,α-Syn,IL-1β.Compared with the MPTP stimulated cells,the salidroside pretreatment group showed a decrease in cell apoptosis and an increase in the expressions of TH,Nrf2 and NQO1,but reduced expressions in α-Syn,IL-1β and IL-18.After si-RNA knockdown of Nrf2 expression,the protective effect of salidroside on MPTP stimulated cells weakened or even disappeared.Conclusion Salidroside may alleviate neuronal apoptosis by activating Nrf2-ARE signaling pathway,which is expected to be a new drug for PD treatment.

Objective:To explore the relationship between pathogens in the olfactory cleft area and olfactory disorders in patients with upper respiratory inflammation (URI) during the prevention and control of 2019 novel coronavirus disease (COVID-19).Methods:A total of 234 URI patients including acute upper respiratory infection, chronic rhinosinusitis (CRS), allergic rhinitis (AR) were continuously selected from September 2020 to March 2021 in Beijing Anzhen Hospital and 98 healthy adults were enrolled as controls. The secretions from the olfactory cleft of all subjects were collected with nasal swabs under nasal endoscopy. Multiple real-time fluorescent quantitative polymerase chain reaction detection method was used to detect nucleic acids of 33 types of respiratory pathogenic microorganism. Sniffin′ Sticks olfactory test was performed on all patients with URI. URI patients with olfactory dysfunction were followed up for 9 (8, 10) months ( M ( Q1, Q3)). SPSS 20.0 software was used for statistical analysis. Results:Among the 98 controls, 9 (9.18%) were positive for pathogenic microorganisms, including 1 (1.02%) rhinovirus, 1 (1.02%) parainfluenza virus type 3, 3 (3.06%) enterovirus, 1 (1.02%) staphylococcus aureus and 3 (3.06%) Moraxella catarrhalis. Among the 234 URI patients, 111 (47.44%) had olfactory disorders and 123 (52.56%) had normal sense of smell. In the olfactory disorder group (111 cases), 38 cases (34.23%) were positive for pathogenic microorganisms, and 4 cases (3.60%) were mixed infection, including 11 cases of rhinovirus (9.91%), 5 cases of coronavirus 229E (4.50%), 2 cases of coronavirus OC43/NL63 (1.80%), 3 cases of parainfluenza virus type 1 (2.70%), 2 cases of enterovirus (1.80%), 1 case of influenza B virus type BV (0.90%), 11 cases of Staphylococcus aureus (9.91%), 7 cases of Moraxella catarrhalis (6.31%), and 1 case of Klebsiella pneumoniae (0.90%). In the normal smell group (123 cases), 18 cases (14.63%) were positive for pathogenic microorganisms, and 1 case (0.81%) was mixed infection, including 3 cases of rhinovirus (2.44%), 4 cases of coronavirus 229E (3.25%), 1 case of Influenza virus type 3 (0.81%), 3 cases of enterovirus (2.44%), 3 cases of Staphylococcus aureus (2.44%), 4 cases of Moraxella catarrhalis (3.25%), and 1 case of Klebsiella pneumoniae (0.81%). Univariate analysis between the two groups found that there were significant differences in the detection rate of pathogenic microorganisms, rhinovirus and Staphylococcus aureus between the groups (all P<0.05). The detection rate of parainfluenza virus type 1, Staphylococcus aureus, and rhinovirus were different between the patients with olfactory disorder and normal olfactory function in the three subgroups of acute upper respiratory tract infection, CRS and AR, respectively (χ 2 value was 3.88, 4.53 and 4.73, respectively, all P<0.05). During the follow-up period, among the 111 patients with olfactory disorder, 71 (63.96%) patients′ olfactory function returned to normal, 32 (28.83%) patients′ olfactory function improved but not completely returned to normal, 8 (7.21%) patients′ olfactory function did not improve. Conclusions:During the prevention and control of COVID-19, rhinovirus or Staphylococcus aureus infection or colonization of URI patients is closely related to olfactory disorders. Parainfluenza virus type 1 infection can cause relatively persistent olfactory disorders in patients with acute upper respiratory tract infection. Staphylococcus aureus and rhinovirus colonization are related to the occurrence of olfactory dysfunction in CRS and AR patients respectively.

Objective:To construct a prediction model for the prognosis of breast cancer patients with long non-coding RNA expression characteristics.Methods:To construct a long non-coding RNA(LncRNA) model for predicting the prognosis of breast cancer patients.Methods Analyzing LncRNA expression profiles and clinical characteristics of 1 081 breast cancer patients in the cancer genome atlas (TCGA) database.Performing differential expression analysis and univariate analysis on 112 paired breast cancer and normal breast tissues′ transcriptome sequencing data in the TCGA database, and screened for differentially expressed (DELncRNAs) that significantly correlated with the prognosis of BRCA (To reduce batch effects, sequencing data has been normalized using the DESeq function). One thousand eighty-one breast cancer patients were randomly divided into two groups: training set (541) and validation set (540). Performing Cox proportional hazard regression using DELncRNAs and establishing a multi-LncRNA prognosis model in the training set, followed by proportional hazards assumption test(PH assumption test). Patients were divided into high-risk and low-risk groups based on calculated risk score.Kaplan-Meier method was used for survival analysis, and 540 patients′ data were used for validation.To evaluate the prognostic value of the model in patients with squamous cell carcinoma of the lung and hepatocarcinoma in TCGA database.Gene Set Enrichment Analysis (GSEA) was used to analyze the specific mechanism of lncrna affecting the survival of patients.Results:There were 2815 differentially expressed genes screened by transcriptome sequencing, 91 of which were significantly related to the prognosis of breast cancer patients ( P<0.05). Based on the Cox regression analysis of 91 delncrna expression data from 541 breast cancer patients in training set, a Cox proportional risk regression model was constructed based on 5 LncRNA (training set AUC=0.746, validation set AUC=0.650): AC004551.1, MTOR-AS1, KCNAB1-AS2, FAM230G and LINC01283, and PH assumption test( P=0.388). K-M survival analysis showed that the survival time of high-risk group was significantly worse than that of low-risk group (median survival time: 7.049 and 12.21 years, HR 0.367, 95% CI0.228-0.597, P<0.001), and the survival time of high-risk group was significantly shorter than that of low-risk group (median survival time: 7.57 and 10.85 years, HR 0.412, 95% CI0.214-0.793, P<0.001). Similar prediction results were also obtained in other cancer species of TCGA: lung squamous cell carcinoma ( HR 0.604, 95% CI0.383-0.951, P=0.007) and liver cell carcinoma ( HR 0.551, 95% CI0.307-0.987, P=0.011). GSEA results suggested that the expression patterns of the above five LncRNA were related to the cell cycle regulation of tumor cells. Conclusion:The prognostic model constructed based on expression profile of AC004551.1, MTOR-AS1, KCNAB1-AS2, FAM230G and LINC01283 can be used to predict the prognosis of breast cancer patients, which is helpful to further guide clinical treatment.

Objective To evaluate the relationship between the degree of brain injury during the perioperative period of liver transplantation and postoperative cognitive dysfunction (POCD).Methods Thirtythree patients,undergoing elective liver transplantation,were enrolled in this study.Before induction of anesthesia (T0),at 5 min before blocking the portal vein (T1),5 min after opening the portal vein (T2),5 min after opening the hepatic artery (T3),and at 24 h after surgery (T4),blood samples were collected from the central vein for determination of the serum concentrations of S1O0β protein and neuron-specific enolase (NSE) by enzyme-linked immunosorbent assay.Patients were divided into POCD group and control group (group C) according to whether POCD happened within 7 days after surgery.Results Compared with the baseline value at T0,the serum concentrations of S100β protein were significantly increased at T2 and T3,and the serum concentrations of NSE was increased at T3 (P＜0.05).There was no significant difference in serum concentrations of S100β and NSE at each time point between group POCD and group C (P＞0.05).Conclusion The degree of brain injury during the perioperative period of liver transplantation is not the dominant factor for the development of POCD in the patients.

Objective To formulate and standardized the procedure of bowl preparation before transrectal ultrasound-guided prostate biopsy. Methods The standardized transrectal ultrasound-guided prostate biopsy flowchart were formulated based on the best evidences and recommendations. One hundred and forty patients selected with suspected of prostate cancer and scheduled for transrectal ultrasound-guided prostate biopsy was equally assigned to two groups, the control group was given routine hospital practice before biopsy, and the observation group followed the formulated flowchart. Monitoring two groups for complications, time cost for bowl preparation, medical billing and the average day of hospitalization. Results The incidence of complications and the number of hospitalization days between two groups were comparable, the observation group in bowl preparation time was (3.75 ± 0.78) min, the control group in bowl preparation time was (11.88 ± 1.93) min, the difference of two groups showed statistical significance (t=15.643, P<0.01). The observation group in medical bill was￥(81.62±15.62), the control group in medical bill was ￥(427.78 ± 76.87), the difference of two groups showed statistical significance (t=-36.964, P<0.01). Conclusions Application of evidence-based practice to formalize bowl preparation and antibiotic use in transrectal ultrasound-guided prostate biopsy patient can facilitate the clinical nurses to provide homogenized care to prostate biopsy patients as well as improve the efficiency of nursing work.