Objective:To construct and evaluate a training program for cardiovascular nurse specialists based on a core competency framework.Methods:Among 61 trainees participating in the first training class for cardiovascular nurse specialists organized by a provincial nursing society, a training program focusing on the nine core competencies for cardiovascular nurse specialists was implemented, which consisted of 4-week theoretical and 4-week practical training. The effectiveness of the training program was evaluated using the Kirkpatrick model. Data analyses were performed by using SPSS 26.0. Categorical data were presented as the number of cases; continuous variables in normal distribution were expressed as mean±standard deviation; and continuous variables in non-normal distribution were presented as median (interquartile range) and compared using non-parametric tests.Results:At the reaction level, the satisfaction rates of trainees with the theoretical and practical sections of the training program were 98.36% (60/61) and 95.08% (58/61), respectively. At the learning level, the comprehensive assessment score of the trainees was (83.01±3.39) points, and all of them successfully obtained their completion certificates, with a pass rate of 100.00% (61/61). At the behavior level, the core competencies for cardiovascular nurse specialists were significantly improved after training [the total score increased from 291.00 (254.00, 334.25) to 410.50 (354.50, 433.00), P<0.001]. At the results level, at six months after training, there were significant increases in the number of participants engaging in cardiovascular care practices, clinical nursing education and guidance, leadership roles, and research projects within their units as well as the number of individuals achieving career advancement (all P<0.05). Conclusions:The trainees are highly satisfied with the core competency-focused cardiovascular nurse training program, which can improve core competencies and cardiovascular nursing capabilities, expand the scope of cardiovascular nursing services, and foster the sustained advancement of the participants.

Objective:To investigate the current situation of nursing information ability of head nurses in different grades of hospitals in Jiaozuo City, and analyze its influencing variables based on the random forest model, so as to provide evidence-based basis for the construction of nursing information ability improvement strategies and training programs for head nurses.Methods:From August to September 2024, the head nurses of 20 hospitals of different grades were selected by cluster sampling method in Jiaozuo City as the research subjects. General Data Questionnaire and Nursing Information Ability Scale of Head Nurses were used to conduct a cross-sectional survey. Random forest model was used to evaluate the importance of variables, lasso regression analysis was applied to complete the variable screening, and the influencing factors of nursing information ability of head nurses were explored through stepwise multiple linear regression analysis.Results:A total of 305 questionnaires were ultimately collected, of which 297 were valid, the effective rate was 97.38%. Out of 297 head nurses, 6 were male and 291 were female; 49 individuals aged 20-29 years old, 127 individuals aged 30-39 years old, 92 individuals aged 40-49 years old, and 29 individuals aged ≥ 50 years old. The total score of nursing information ability was (139.06 ± 24.62). Random forest model and lasso regression analysis showed that the top 6 variables in terms of importance were the number of years serving as head nurses, participation in information function development, number of academic conferences in the past three years, hospital grade, participating in information training, and chairing or participating in scientific research in the past three years. Stepwise multiple linear regression analysis showed that the number of years serving as head nurses, participating in information training, participating in information function development and number of academic conferences in the past three years had significant effects on nursing information ability of head nurses (t values were -4.66 to 3.81, all P<0.05). Conclusions:The nursing information ability of head nurses in Jiaozuo city is in the middle level, and the nursing information ability of head nurses in different grades of hospitals is different. It is suggested to construct a stepped information ability continuing education framework and a research-information ability coupling development mechanism, and incorporate nursing information ability into the necessary conditions for the appointment of nursing management posts, so as to realize the balanced development of nursing information management ability and the continuous iteration of nursing manager information ability.

Objective:To formulate the audit standards of Chinese patent medicine prescriptions, and provide reference for rational prescriptions of Chinese patent medicine.Methods:A three-level evidence system for prescription review of Chinese patent medicine was established according to the national regulatory documents, drug labels, relevant guidelines, and expert consensuses. The catalog of Chinese patent medicines in Army Medical Center of the People′s Liberation Army was integrated and classified, preliminary review criteria including indications, drug selection, usage and dosage, and combination drugs was established and submitted to clinical experts of traditional Chinese medicine for review and revision, and finally the prescription review standard was confirmed.Results:The Chinese patent medicine catalog of the Medical Center contained 218 drugs, which were divided into 23 kinds according to efficacy and 17 kinds according to dosage forms. The prescription review standards of Chinese patent medicine were as follows. (1) Indications: both traditional Chinese medicine and Western medicine diagnosis were required. (2) Drug selection: 37 kinds of Chinese patent medicines were marked as forbidden for pregnant women in the labels, and 16 kinds were not marked but contained forbidden ingredients; 4 kinds were marked with caution for patients with liver dysfunction, and 24 kinds were not marked but contained ingredients with caution; 2 kinds of Chinese patent medicines were marked with caution for patients with renal insufficiency, and 9 kinds were not marked but contained ingredients with caution. (3) Usage and dosage: the usage and dosage rules of Chinese patent medicines for children, the elderly and patients with liver and kidney dysfunction were formulated. (4) Combined medication: 5 and 21 kinds of Chinese patent medicines were marked as "highly toxic" and "toxic" in the labels, respectively, 11 kinds of Chinese patent medicines contained incompatible ingredients of "Shibafan" (eighteen antagonisms) and "Shijiuwei (nineteen incompatibilities), and a new review scale for repeated use of Chinese patent medicine was developed.Conclusions:Based on the existing evidence-based medicine, the evidence system of prescription review of Chinese patent medicine is established, the prescription review standards of Chinese patent medicine prescription based on the pharmaceutical interaction mode is formulated and constructed.

Palliative care is recognized as an effective measure to improve the quality of life for patients with end-stage diseases， and the significance and role of such patients participating in clinical trials to conquer major diseases has also become a broad consensus. However， due to the special physical， psychological， and social conditions of terminal trial participants， the ethical problems encountered in the trial process are more serious and complex. Drawing on ethical practice experience， these seemingly common phenomena and issues were deeply analyzed. Combined with the palliative care philosophy for end-stage patients， this paper proposed a series of improvement suggestions throughout the entire life cycle of clinical trials， hoping to promote the quality improvement of clinical research in which end-stage patients participate as subjects， while effectively protecting the safety and rights of the subjects and ensuring they receive appropriate palliative care during their participation in clinical trials or clinical-related scientific research.

OBJECTIVE To investigate the efficacy of Ningmitai Capsules combined with cefoperazone/sulbactam on the treatment of type 2 diabetes mellitus(T2DM)complicated with urinary tract infections(UTIs)and its impact on soluble triggering receptor expressed on myeloid cells-1(sTREM-1),microRNA(miRNA)-34 b and Toll-like receptor-4(TLR4),so as to provide a new combined regimen for clinical treatment of such patients.METHODS From May 2022 to May 2024,122 patients with T2DM complicated with UTIs treated at the Affiliated People's Hospital of Shandong First Medical University were randomly divided into a conventional group and a combination group by the odd-even randomization method,with 61 cases in each group.The conventional group was treated with cefoperazone/sulbactam,whereas the combination group received Ningmitai capsules in combination with cef-operazone/sulbactam.The efficacy,improvement time of related symptoms,T lymphocyte subsets(CD3+,CD4+,CD4+/CD8+),sTREM-1,miRNA-34b,TLR4 levels and occurrence of adverse reactions were compared between the two groups.RESULTS The total effective rate in the combination group was higher than that in the conventional group after treatment(93.44%vs.80.33%,χ2=4.604,P=0.032).There were statistically signifi-cant differences between the two groups in the time for urine routine to return to normal,disappearance of urinary irritation symptoms,conversion of urine pathogens to negative and defervescence(P<0.05).After treatment,the levels of CD3+,CD4+and CD4+/CD8+in both groups were lower than those before treatment(P<0.05),and the levels in the combination group were higher than those in the conventional group(P<0.05).Moreover,the levels of sTREM-1,miRNA-34b and TLR4 in both groups decreased after treatment(P<0.05),and the levels in the combination group were lower than those in the conventional group(P<0.05).During the treatment period,no severe adverse reactions were observed in either group,and laboratory test results for blood routine and hepatic and renal functions showed no abnormalities.CONCLUSION The application of Ningmitai capsules combined with cef-operazone/sulbactam in the treatment of T2DM complicated with UTIs has good efficacy,can effectively control infec-tions,shorten the time for symptom relief,improve immune function and attenuate inflammation level with high safety.

Enamel demineralization, the formation of white spot lesions, is a common issue in clinical orthodontic treatment. The appearance of white spot lesions not only affects the texture and health of dental hard tissues but also impacts the health and aesthetics of teeth after orthodontic treatment. The prevention, diagnosis, and treatment of white spot lesions that occur throughout the orthodontic treatment process involve multiple dental specialties. This expert consensus will focus on providing guiding opinions on the management and prevention of white spot lesions during orthodontic treatment, advocating for proactive prevention, early detection, timely treatment, scientific follow-up, and multidisciplinary management of white spot lesions throughout the orthodontic process, thereby maintaining the dental health of patients during orthodontic treatment.
Humans ; Consensus ; Dental Caries/etiology* ; Dental Enamel/pathology* ; Tooth Demineralization/etiology* ; Tooth Remineralization

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Metastasis is the leading cause of death from cutaneous melanoma. Identifying metastasis-related targets and developing corresponding therapeutic strategies are major areas of focus. While functional genomics strategies provide powerful tools for target discovery, investigations at the protein level can directly decode the bioactive epitopes on functional proteins. Aptamers present a promising avenue as they can explore membrane proteomes and have the potential to interfere with cell function. Herein, we developed a target and epitope discovery platform, termed functional aptamer evolution-enabled target identification (FAETI), by integrating affinity aptamer acquisition with phenotype screening and target protein identification. Utilizing the aptamer XH3C, which was screened for its migration-inhibitory function, we identified the Chondroitin Sulfate Proteoglycan 4 (CSPG4), as a potential target involved in melanoma migration. Further evidence demonstrated that XH3C induces cytoskeletal rearrangement by blocking the interaction between the bioactive epitope of CSPG4 and integrin α4. Taken together, our study demonstrates the robustness of aptamer-based molecular tools for target and epitope discovery. Additionally, XH3C is an affinity and functional molecule that selectively binds to a unique epitope on CSPG4, enabling the development of innovative therapeutic strategies.

The coinfection of respiratory viruses and bacteria is a major cause of morbidity and mortality worldwide, despite the development of vaccines and powerful antibiotics. As a macromolecule that is difficult to absorb in the gastrointestinal tract, a homogeneous polysaccharide from Houttuynia cordata (HCPM) has been reported to exhibit anti-complement properties and alleviate influenza A virus (H1N1)-induced lung injury; however, the effects of HCPM without in vitro antiviral and antibacterial activities on more complicated pulmonary diseases resulting from viral-bacterial coinfection remains unclear. This study established a representative coinfection murine pneumonia model infected with H1N1 (0.2 LD₅₀) and methicillin-resistant Staphylococcus aureus (MRSA, 10⁷ CFU). HCPM significantly improved survival rate and weight loss, and ameliorated gut-lung damage and inflammatory cytokine production. Interestingly, the therapeutic effect of HCPM on intestinal damage preceded that in the lungs. Mechanistically, HCPM inhibited the overactivation of the intestinal complement (C3a and C5a) and suppressed the activation of the NLR family pyrin domain-containing 3 (NLRP3) pathway, which contributes to the regulation of the Treg/Th17 cell balance in the gut-lung axis. The results indicate the beneficial effects of an anti-complement polysaccharide against viral-bacterial coinfection pneumonia by modulating crosstalk between multiple immune regulatory networks.