Objective This study aims to investigate the selection intention of nursing interns and their influencing fac-tors,providing a scientific basis for nursing human resource management in hospitals and departments.Methods A convenience sampling method was used to conduct a questionnaire survey A questionnaire survey was conducted concerning the selection inten-tion on departments and influencing factors of intern nurses from several tertiary hospitals affiliated to three medical universities from July 2022 to December 2023.General data investigation and self-developed scales were employed,and descriptive analysis,chi-square test and other statistical methods were used to analyze the differences in department selection and related influencing factors among nursing interns.Results Analysis of 652 valid questionnaires revealed that surgery(65.80％)and operating room(38.84％)were the most preferred departments for nursing interns.The primary influencing factors included the working environment and equipment of the department(54.60％),as well as its cohesion and cultural atmosphere(51.53％).Pediat-rics(51.23％)and infectious medicine(48.77％)were found to be less favored by nursing interns.Their main concerns re-volved around work-related risks and population characteristics of patients(67.02％),along with work pressure and labor intensi-ty(65.49％).Epidemic factors have an impact on the attitudes and expectations of nursing interns towards their future practice(P＜0.01).Conclusion The choice of departments by nursing interns is influenced by various environmental,societal and personal factors;primarily based on departmental environment quality and team culture atmosphere considerations.During the in-ternship,nursing interns require more professional education guidance from both hospital administration and individual depart-ments in order to make informed career choices and plans.

Objective This study aims to investigate the selection intention of nursing interns and their influencing fac-tors,providing a scientific basis for nursing human resource management in hospitals and departments.Methods A convenience sampling method was used to conduct a questionnaire survey A questionnaire survey was conducted concerning the selection inten-tion on departments and influencing factors of intern nurses from several tertiary hospitals affiliated to three medical universities from July 2022 to December 2023.General data investigation and self-developed scales were employed,and descriptive analysis,chi-square test and other statistical methods were used to analyze the differences in department selection and related influencing factors among nursing interns.Results Analysis of 652 valid questionnaires revealed that surgery(65.80％)and operating room(38.84％)were the most preferred departments for nursing interns.The primary influencing factors included the working environment and equipment of the department(54.60％),as well as its cohesion and cultural atmosphere(51.53％).Pediat-rics(51.23％)and infectious medicine(48.77％)were found to be less favored by nursing interns.Their main concerns re-volved around work-related risks and population characteristics of patients(67.02％),along with work pressure and labor intensi-ty(65.49％).Epidemic factors have an impact on the attitudes and expectations of nursing interns towards their future practice(P＜0.01).Conclusion The choice of departments by nursing interns is influenced by various environmental,societal and personal factors;primarily based on departmental environment quality and team culture atmosphere considerations.During the in-ternship,nursing interns require more professional education guidance from both hospital administration and individual depart-ments in order to make informed career choices and plans.

Objective:To analyze and evaluate the decrease of anticoagulant effect of warfarin by herbal and dietary supplements (HDS) based on case report literature.Methods:The case reports on decrease of anticoagulant effect of warfarin by HDS were selected by searching the relevant databases at home and abroad (up to June 24, 2023). The degree of decrease of anticoagulant effect of warfarin by HDS was evaluated according to the reduction degree of international normalized ratio and the occurrence of thrombotic events in patients in the case reports. The reliability scoring criteria of HDS-warfarin interaction was established according to the causality of the interaction between HDS and warfarin, the number of case reports, and the other evidences (warnings issued by relevant national institutions, clinical studies, pharmacokinetic/pharmacodynamic studies, animal studies, etc.). It was evaluated as highly, relatively, possibly, and suspiciously reliable if the total score was ≥9, 6-8, 3-5, and ≤2 points, respectively.Results:A total of 17 case reports were enrolled in the analysis, involving 25 patients and 11 kinds of HDS. Two kinds of HDS reduced the anticoagulant effect of warfarin severely, including ginseng ( Radix Ginseng)[(American ginseng ( Radix Panacis Quinquefolii), red ginseng, etc.] and Myrrh; 5 kinds of HDS reduced the anticoagulant effect of warfarin moderately, including St. John′s wort ( Hypericum perforatum L.), tea [green tea ( Camellia sinensis), black tea], peppermint ( Herba Menthae), coenzyme Q 10, and chitosan; 4 kinds of HDS reduced the anticoagulant effect of warfarin slightly, including milkvetch root ( Radix Astragali seu Hedysari), avocado, seaweed ( Sargassum), and soya ( Glycine max). The reliability of anticoagulant effect reduction of warfarin was evaluated as highly reliable in 1 kind of HDS, namely St. John′s wort (10 points), relatively reliable in 2 kinds of HDS, including ginseng and tea (8 and 6 points, respectively), possibly reliable in 7 kinds of HDS, including Myrrh, peppermint, coenzyme Q 10, chitosan, milkvetch root, avocado, and seaweed (5, 5, 5, 4, 4, 4, and 3 points, respectively), and suspiciously reliable in 1 kind of HDS, namely soya (2 points). Conclusion:The degree and reliability of anticoagulant effect reduction of warfarin by ginseng (American ginseng, red ginseng, etc.), St. John′s wort, and tea (green tea, black tea), are higher, which should be paid attention to by clinicians and clinical pharmacists.

Objective:To analyze and evaluate the decrease of anticoagulant effect of warfarin by herbal and dietary supplements (HDS) based on case report literature.Methods:The case reports on decrease of anticoagulant effect of warfarin by HDS were selected by searching the relevant databases at home and abroad (up to June 24, 2023). The degree of decrease of anticoagulant effect of warfarin by HDS was evaluated according to the reduction degree of international normalized ratio and the occurrence of thrombotic events in patients in the case reports. The reliability scoring criteria of HDS-warfarin interaction was established according to the causality of the interaction between HDS and warfarin, the number of case reports, and the other evidences (warnings issued by relevant national institutions, clinical studies, pharmacokinetic/pharmacodynamic studies, animal studies, etc.). It was evaluated as highly, relatively, possibly, and suspiciously reliable if the total score was ≥9, 6-8, 3-5, and ≤2 points, respectively.Results:A total of 17 case reports were enrolled in the analysis, involving 25 patients and 11 kinds of HDS. Two kinds of HDS reduced the anticoagulant effect of warfarin severely, including ginseng ( Radix Ginseng)[(American ginseng ( Radix Panacis Quinquefolii), red ginseng, etc.] and Myrrh; 5 kinds of HDS reduced the anticoagulant effect of warfarin moderately, including St. John′s wort ( Hypericum perforatum L.), tea [green tea ( Camellia sinensis), black tea], peppermint ( Herba Menthae), coenzyme Q 10, and chitosan; 4 kinds of HDS reduced the anticoagulant effect of warfarin slightly, including milkvetch root ( Radix Astragali seu Hedysari), avocado, seaweed ( Sargassum), and soya ( Glycine max). The reliability of anticoagulant effect reduction of warfarin was evaluated as highly reliable in 1 kind of HDS, namely St. John′s wort (10 points), relatively reliable in 2 kinds of HDS, including ginseng and tea (8 and 6 points, respectively), possibly reliable in 7 kinds of HDS, including Myrrh, peppermint, coenzyme Q 10, chitosan, milkvetch root, avocado, and seaweed (5, 5, 5, 4, 4, 4, and 3 points, respectively), and suspiciously reliable in 1 kind of HDS, namely soya (2 points). Conclusion:The degree and reliability of anticoagulant effect reduction of warfarin by ginseng (American ginseng, red ginseng, etc.), St. John′s wort, and tea (green tea, black tea), are higher, which should be paid attention to by clinicians and clinical pharmacists.

Objective:To analyze the incidence and epidemiological characteristics of traumatic spinal cord injury in China in 2018.Methods:Multi-stage stratified cluster sampling was used to randomly select hospitals capable of treating patients with spinal cord injury from 3 regions，9 provinces and 27 cities in China to retrospectively investigate eligible patients with traumatic spinal cord injury admitted in 2018. National and regional incidence rates were calculated. The data of cause of injury，injury level，severity of injury，segment and type of fracture，complications，death and other data were collected by medical record questionnaire，and analyzed according to geographical region，age and gender.Results:Medical records of 4，134 patients were included in this study，with a male-to-female ratio of 2.99∶1. The incidence of traumatic spinal cord injury in China in 2018 was 50.484 / 1 million （95% CI 50.122-50.846）. The highest incidence in the Eastern region was 53.791 / 1 million （95% CI 53.217-54.365）. In the whole country，the main causes of injury were high falls （29.58%），as well as in the Western region （40.68%），while the main causes of injury in the Eastern and Central regions were traffic injuries （31.22%，30.10%）. The main injury level was cervical spinal cord in the whole country （64.49%），and the proportion of cervical spinal cord injury in the Central region was the highest （74.68%），and the proportion of lumbosacral spinal cord injury in the Western region was the highest （32.30%）. The highest proportion of degree of injury was incomplete quadriplegia （55.20%），and the distribution pattern was the same in each region. A total of 65.87% of the patients were complicated with fracture or dislocation，77.95% in the Western region and only 54.77% in the Central region. In the whole country，the head was the main combined injury （37.87%），as well as in the Eastern and Central regions，while the proportion of chest combined injury in the Western region was the highest （38.57%）. A total of 32.90% of the patients were complicated with respiratory complications. There were 23 patients （0.56%） died in hospital，of which 17（73.91%） died of respiratory dysfunction. Conclusions:The Eastern region of China has a high incidence of traumatic spinal cord injury. Other epidemiological features include high fall as the main cause of injury cervical spinal cord injury as the main injury level，incomplete quadriplegia as the main degree of injury，head as the main combined injury，and respiratory complications as the main complication.

Objective:To assess the efficacy and safety of 100 units of botulinum toxin A (BTX-A) intradetrusor injection in patients with overactive bladder.Methods:From April 2016 to December 2018, 17 tertiary hospitals were selected to participate in this prospective, multicenter, randomized, double-blind, placebo-controlled study. Two phases of study were conducted: the primary phase and the extended phase. This study enrolled patients aged 18 to 75 years who had been inadequately managed by anticholinergic therapy (insufficient efficacy or intolerable side effects) and had spontaneous voiding with overactive bladder. Exclusion criteria included patients with severe cardiac, renal and hepatic disorders, patients with previous botulinum toxin treatment for 6 months or allergic to BTX-A, patients with urinary tract infections, patients with urinary stones, urinary tract tumors, diabetes mellitus, and bleeding tendency. Eligible patients were randomly assigned to BTX-A group and placebo control group in a ratio of 2∶1. Two groups of patients received 20 intradetrusor injections of BTX-A 100U or placebo at the depth of the submucosal muscle layer respectively under cystoscope, including 5 injections at the base of the bladder, 3 injections to the bladder triangle, 5 injections each to the left and right walls and 2 injections to the top, sparing the bladder neck. As a placebo control group, patients received same volume of placebo containing no BTX-A and only adjuvant freeze-dried preparations for injection with the same method. A combination of gelatin, sucrose, and dextran served as adjuvants. Average micturition times per 24 hours, urinary incontinence (UI) episodes per day, average micturition volume per day, OAB symptom score(OABSS), and quality of life (QOL) score were recorded at baseline and the 2nd, 6th and 12th week after treatment. The primary efficacy endpoint was the change from baseline in the average micturition times per 24 hours at the 6th week after treatment. The secondary efficacy endpoints included the change from baseline in the average micturition times per 24 hours at 2nd and 12th week, as well as the change from baseline in the OABSS, QOL score, average frequency of urgency and UI episodes per day, urgency score, average micturition volume per day at 2nd, 6th and 12th week after treatment. Patients were followed for 12 weeks to assess adverse events (AEs). After assessed at week 12, if the micturition times has decreased less than 50% compared to baseline and the patient is willing to receive retreatment, then patients could enter the extended trial phase. In that phase, patients in both groups were injected with 100 units BTX-A from 12th week onwards and then followed up the same indicators for 12 weeks.Results:216 patients were enrolled in this trial (144 cases in the BTX-A group and 72 cases in the placebo control group). Baseline characteristics such as age (47.75±14.20 in the BTX-A group and 46.39±15.55 in the control group), sex (25 male/117 female in the BTX-A group and 10/61 in the control group), and disease duration (0.51 years in the BTX-A group and 0.60 years in the control group) were balanced between the two groups( P>0.05). A marked reduction from baseline in average micturition times per 24 hours was observed in all treatment groups at the 6th week and the reduction of the two groups was statistically different ( P<0.001 and P=0.008 respectively). Compared with the baseline, the average micturition times per 24 hours at the 6th week decreased from baseline by 2.40(0.70, 4.60)times for the BTX-A group and 0.70(-1.00, 3.30) times for the placebo control group respectively, and the difference between the two groups was considered to be statistically significant ( P=0.003). The change rates of average micturition times per 24 hours from baseline at the 6th week of the two groups were (16±22)% and (8±25)% respectively, and the difference between the two groups was statistically significant ( P=0.014). Compared with the baseline, the average micturition times per 24 hours at 2nd and 12th week decreased by 2.00(0.00, 4.00)and 3.30(0.60, 5.03)for the BTX-A group, 1.00(-1.00, 3.00)and 1.70(-1.45, 3.85)for the placebo control group respectively. The difference between two groups was considered to be statistically significant ( P=0.038 and P=0.012); the changes of average urgency times per day for the BTX-A group and the control group at the 2nd, 6th and 12th week were 2.00(0.00, 4.30)and 2.40(0.30, 5.00), 3.00(0.30, 5.70)and 0.70(-1.30, 2.70), 0.70(-1.30, 3.00) and 1.35(-1.15, 3.50), respectively. There were significant differences between two groups at the 2nd, 6th and 12th week, ( P=0.010, P=0.003 and P=0.025, respectively). The OABSS of the BTX-A group and the control group at the 6th week decreased by 1.00(0.00, 4.00)and 0.50(-1.00, 2.00) compared with the baseline, and the difference between the two groups was statistically significant ( P=0.003). 47 cases of BTX-A group and 34 cases of placebo control group entered the extended trial phase, and 40 and 28 cases completed the extended trial phase, respectively. The average micturition volume per 24 hours changed by -16.60(-41.60, -0.60)ml and -6.40(-22.40, 13.30)ml, (-35.67±54.41)ml and(-1.76±48.69)ml, (-36.14±41.51)ml and (-9.28±44.59)ml, (-35.85±43.35)ml and(-10.41±40.29)ml for two groups at the 12th, 14th, 18th and 24th week, and the difference between two groups was statistically significant at each follow-up time ( P=0.01, 0.006, 0.012 and 0.016, respectively). There was no significant difference in other parameters( P>0.05). However, adverse reactions after intradetrusor injection included increased residual urine volume (27 in the BTX-A group and 3 in the control group), dysuria (21 in the BTX-A group and 6 in the control group), urinary infection (19 in the BTX-A group and 6 in the control group), bladder neck obstruction (3 in the BTX-A group and 0 in the control group), hematuria (3 in the BTX-A group and 1 in the control group), elevated alanine aminotransferase (3 in the BTX-A group and 0 in the control group), etc. During the follow-up period, there was no significant difference in the other adverse events between two groups except the increase of residual urine volume( P<0.05). In the primary trial phase, among the 27 cases with increased residual urine volume in BTA group, only 1 case (3.70%) with PVR more than 300 ml; the PVR of 3 patients in the placebo group was less than 100 ml. The increase of residual urine volume caused by the injection could be improved or disappeared with the passage of time. Conclusions:Intradetrusor injection of Chinese BTX-A improved the average micturition times per 24 hours, the average daily urgent micturition times, OABSS, and average micturition volume per time, and reduced the adverse effects in patients with overactive bladder.Chinese BTX-A at dose of 100U demonstrated durable efficacy and safety in the management of overactive bladder.

Objective:To explore the effects of tenofovir alafenamide fumarate (TAF) and tenofovir disoproxil fumarate (TDF) on blood lipid.Methods:The relevant databases (up to August 31, 2021) were searched. The data of dyslipidemia in treatment of hepatitis B virus (HBV) or human immunodeficiency virus (HIV) infection with TAF (trial group) and TDF (control group) in randomized controlled trials (RCTs) were collected. Methodological quality was evaluated by bias risk assessment tool of Cochrane collaborative network, and the meta-analysis was conducted using RevMan 5.3 software. The effect value was the risk ratio ( RR) and its 95% confidence interval ( CI). Results:A total of 11 RCTs were enrolled in the analysis, including 4 on the treatment of hepatitis B (HBV subgroup) and 7 on the treatment of AIDS (HIV subgroup), and the methodological quality evaluation results showed low risk of bias for all. Eleven thousand eight hundred and eighty-eight patients were involved in the 11 RCTs, of which 6 273 were in the trial group and 5 615 in the control group. The results of meta-analysis showed that the incidences of increased low density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglyceride (TG) with the severity of ≥3 grade were higher in the trial group than those in the control group and the differences of incidences in LDL-C and TC increase were significant between the 2 groups [LDL-C: 2.9% (157/5 347) vs. 0.8% (37/4 727), RR=3.39, 95 %CI: 2.35-4.89, P=0.001; TC: 0.7% (36/4 880) vs. 0.1% (6/4 397), RR=4.25, 95 %CI: 1.91-9.45, P<0.001; TG: 0.5% (16/3 157) vs. 0.3% (8/3 102) , RR=1.83, 95 %CI: 0.81-4.15, P=0.140]. The changes of blood lipid after treatment were compared and the results showed that the increase of LDL-C was higher in the trial group (14.00 mg/dl) than that in the control group (4.00 mg/dl), and the difference was statistically significant ( P=0.004). Conclusion:TAF can significantly increase the levels of LDL-C and TC in patients.

Objective:To explore the effects of tenofovir alafenamide fumarate (TAF) and tenofovir disoproxil fumarate (TDF) on blood lipid.Methods:The relevant databases (up to August 31, 2021) were searched. The data of dyslipidemia in treatment of hepatitis B virus (HBV) or human immunodeficiency virus (HIV) infection with TAF (trial group) and TDF (control group) in randomized controlled trials (RCTs) were collected. Methodological quality was evaluated by bias risk assessment tool of Cochrane collaborative network, and the meta-analysis was conducted using RevMan 5.3 software. The effect value was the risk ratio ( RR) and its 95% confidence interval ( CI). Results:A total of 11 RCTs were enrolled in the analysis, including 4 on the treatment of hepatitis B (HBV subgroup) and 7 on the treatment of AIDS (HIV subgroup), and the methodological quality evaluation results showed low risk of bias for all. Eleven thousand eight hundred and eighty-eight patients were involved in the 11 RCTs, of which 6 273 were in the trial group and 5 615 in the control group. The results of meta-analysis showed that the incidences of increased low density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglyceride (TG) with the severity of ≥3 grade were higher in the trial group than those in the control group and the differences of incidences in LDL-C and TC increase were significant between the 2 groups [LDL-C: 2.9% (157/5 347) vs. 0.8% (37/4 727), RR=3.39, 95 %CI: 2.35-4.89, P=0.001; TC: 0.7% (36/4 880) vs. 0.1% (6/4 397), RR=4.25, 95 %CI: 1.91-9.45, P<0.001; TG: 0.5% (16/3 157) vs. 0.3% (8/3 102) , RR=1.83, 95 %CI: 0.81-4.15, P=0.140]. The changes of blood lipid after treatment were compared and the results showed that the increase of LDL-C was higher in the trial group (14.00 mg/dl) than that in the control group (4.00 mg/dl), and the difference was statistically significant ( P=0.004). Conclusion:TAF can significantly increase the levels of LDL-C and TC in patients.

Objective:To construct a rat model of hypothalamic obesity by two point electrical damage to the ventromedial hypothalamus and arcuate nucleus.Methods:Twenty adult male SD rats of SPF grade were randomly divided into experimental group and sham operation group.A 25GA (0.45 mm) solid iron needle was used, the needle was coated with an insulating layer, and the tip exposed a 0.5 mm conductive area.With reference to The Rat Brain in Stereotaxic Coordinates and using the stereotactic instrument (AP: -2.6 mm, ML: ± 0.6 mm, DV: -9.6 mm) as the coordinate, 1.5 mA current was continuously applied for 25 s, the ventromedial nucleus (VMH) and arcuate nucleus (ARC) of bilateral brain in SD rats was damaged.During the experiment, the body weight(BW), food intake(FI) and water intake(WI) of the two groups were recorded regularly.The rats were sacrificed on the 28th day after the operation, and the changes of periprenal fat mass and body length were measured.The changes of liver and adipose tissue were detected by HE staining method, leptin by ELISA, leptin receptor(LEPR) by Western blot.Results:(1) The body weight of rats in the experimental group ((427.5±17.7)g) and weight gain ((208.5±14.8)g) were significantly increased compared with the rats in the control group((349.2±17.7)g), ((136.2±21.4)g)on the 28th day after operation ( t=7.661, 6.806, both P<0.001). (2) The daily food intake of rats in the experimental group ((44.2±6.6)g) on the 28th day after surgery was significantly higher than that in the control group ((23.0±3.6)g) ( t=6.918, P<0.001). There was no significant difference of the daily drinking water of rats between experimental group((37.5±12.1)ml) and the control group ((35.0±11.8)ml) ( t=0.361, P=0.726). (3) Perikidney fat mass of experimental group rats ((13.4±2.7)g) significantly increased 28 days after operation compared with control group rats((6.3±0.9)g)( t=4.250, P<0.05). The naso-anal length of experimental group((21.8±0.4)cm) was significantly decreased compared with the control group ((23.4±0.2)cm) ( t=-6.788, P<0.01). The Lee index of the experimental group (348.9±8.5) was significantly higher than that of the control group(305.5±4.3)( t=7.898, P<0.01). (4) The serum leptin content ((8 324.10±159.00)μg/L) of the experimental group rats at 28 days after surgery was significantly higher than that of the control group((2 705.31±407.10)μg/L) ( t=25.712, P<0.001). The lateral hypothalamus area (LHA) LEPR protein expression (1.3±0.1) in the experimental group was significantly higher than that in the control group (0.9±0.1) ( t=4.932, P<0.01). Conclusion:Two-point electrical damage to bilateral VMH and ARC of rats can establish hypothalamic obese rat model.