Objective To investigate the current status of pelvic floor muscle training(PFMT)adherence for preventing low anterior resection syndrome(LARS)in rectal cancer patients with prophylactic ostomy and analyze its influencing factors.Methods A total of 247 patients who underwent preventive stoma reversal surgery after sphincter-preserving rectal cancer resection between January 2024 and February 2025 at 22 tertiary hospitals in the Beijing-Tianjin-Hebei region were recruited in this study.Their clinical data were collected through a general information questionnaire,a LARS Knowledge-Attitude-Practice and Needs questionnaire,a PFMT Self-Efficacy Scale,and a PFMT Adherence Questionnaire.Univariate analysis,correlation analysis,LASSO regression,and random forest importance ranking were applied to screen the variables,and multiple linear regression analysis was conducted to analyze the significant variables.Results The overall PFMT adherence score was 14.52±4.18 among the 247 patients.The random forest algorithm identified 7 key predictors when the minimum error was achieved at a λ value of 2.293.The top 7 variables in importance ranking were PFMT self-efficacy,total knowledge-attitude-practice(KAP)score,education level,primary caregiver,tumor location,stoma reversal time,and chemoradiotherapy.Multiple linear regression analysis revealed that PFMT self-efficacy(P<0.001,β=0.007,95%CI:0.004～0.009),total KAP score(P<0.001,β=0.052,95%CI:0.035～0.070),stoma reversal time(P<0.030,β=-0.539,95%CI:-1.025～-0.053),and chemoradiotherapy(P<0.045,β=-0.451,95%CI:0.010～0.892)were significant related factors of PFMT adherence(P<0.05).Conclusion PFMT adherence for LARS prevention is at a moderate level in rectal cancer patients with prophylactic ostomy.Key factors such as PFMT self-efficacy,total KAP score,stoma reversal time,and chemoradiotherapy are significantly correlated with PFMT adherence.

Objective:To establish a prediction model for larger for gestational age(LGA)infants in pregnant women with gestational diabetes mellitus(GDM)in order to improve pregnancy outcomes.Methods:A retro-spective analysis was performed on the clinical data of 338 pregnant women with GDM who underwent routine prenatal examinations and were hospitalized for delivery in the First Affiliated Hospital of Nanjing Medical Universi-ty from January 1,2018 to December 31,2023.Pregnant women with complete HbAlc data during pregnancy were divided into a training set of 241 cases and a validation set of 97 cases.Lasso and Logistic regression analysis and variable screening combined with previous clinical experience were used to construct a nomogram model,and its degree of differentiation and calibration were evaluated.Result:①By Lasso regression analysis,age,family histo-ry of type 2 diabetes,body mass index(BMI),gestational weight gain(GWG),fasting blood glucose(FBG),postprandial 1-hour blood glucose(1h PBG),HbAlc,free triiodothyronine(FT3),free thyroxine(FT4)and insulin treatment were important predictors of LGA.②Multivariate Logistic regression analysis showed that GWG and HbAlc were independent risk factors for LGA in pregnant women with GDM(OR＞1,P＜0.05).③Combined with Lasso and Logistic regression analysis,previous literature reports and clinical experience,BMI,GWG,FBG,1h PBG,HbAlc and FT3 were selected as independent variables,and LGA as dependent variable.A nomogram pre-diction model was constructed in the training set,and the C-index of 0.71.ROC curve analysis showed that the AUC values of the training set and the validation set were 0.709 and 0.700,respectively,and the discriminative a-bility of the model was acceptable.The calibration curve of the model was close to the ideal curve,and the clinical decision curve suggested that the model showed a positive net benefit at the threshold of 10％to 50％.Conclu-sion:The predictive model has certain value in predicting the occurrence of LGA in pregnant women with GDM,and provides help for early diagnosis,treatment and clinical intervention of GDM and its complications,in order to improve perinatal and long-term adverse outcomes.

Endometriosis is a common estrogen-dependent disease in women of childbearing age,often leading to chronic pelvic pain,infertility,ovarian cancer,and other serious complications,and jeopardizing the health of women.The pathogenesis of endometriosis is complex and involves the alteration of multiple signaling pathways mediated by hormones,immunity,genetics,and the environment,and their interactions.Wnt/β-catenin signaling is involved in the regulation of embryonic development and tissue homeostasis,and it has recently been implicated in the pathogenesis of endometriosis via multiple pathways.This review considers the biological characteristics of the Wnt/β-catenin signaling pathway and summarizes the main mechanisms and signaling pathways involved in the pathogenesis of endometriosis,as well as the curr-ent research status of the regulation of this signaling pathway by traditional Chinese medicine for the treatment of endometriosis.We aim to clarify how the Wnt/β-catenin signaling pathway affects the development of endometriosis,and suggest that future studies should focus on exploring its potential role as an indicator for the clinical prediction and early diagnosis of endometriosis,thus providing theoretical support for the early diagnosis of this condition and the development of targeted drugs.

Background:To compare the efficacy and safety of monthly administrations of gonadotropin releasing hormone (GnRH) agonists LY01005 and Zoladex ? in Chinese patients with premenopausal breast cancer. Methods:From October 2020 to November 2021, 188 premenopausal breast cancer patients were enrolled in 34 hospitals and randomized 1:1 to receive either LY01005 or Zoladex ? every 28 days for a total of three injections. All patients concomitantly received oral tamoxifen (TAM). The primary efficacy endpoint was cumulative probability of maintaining menopausal level [oestradiol (E2) ≤30 pg/ml] from day 29 to day 85. The second efficacy endpoint included changes in E2, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) compared with the baseline. Pharmacokinetics (PK), pharmacodynamics (PD), and safety were analyzed. The study also evaluated the pharmacokinetic and pharmacodynamic characteristics of LY01005. Results:A total of 188 patients were randomised and 187 patients received either LY01005 or Zoladex ?. Cumulative probabilities of maintaining menopausal level (E2≤30 pg/ml) from day 29 to day 85 were 93.1% for LY01005 and 86.3% for Zoladex ?. The between-group difference was 6.8% (95% CI: -2.3%, 15.9%) and primary efficacy in the LY01005 group was not inferior to that in the Zoladex ? group. Changes in E2, LH, and FSH levels compared with the baseline were equivalent between the two groups (E2: 89.34% to 90.23% vs. 82.11% to 85.02%; LH: 88.89% to 95.52% vs. 89.70% to 97.02%; FSH: 75.36% to 80.85% vs.73.07% to 80.24%, respectively). After three consecutive doses of LY01005, the LH and FSH levels of the subjects showed a transient increase after the first dose, reached a peak on the second day and then started to decrease. The LH and FSH reached a lower level and remained at or below that level until the 85th day. Both treatments were well-tolerated. Conclusion:LY01005 is as effective as Zoladex ? in suppressing E2 to menopausal levels in Chinese patients with premenopausal breast cancer, with a similar safety profile.

Objective To understand the real-life experiences of patients with chronic obstructive pulmonary disease(COPD)in disease self-control and to inform clinical nursing practice.Methods From March to May 2024,a phenomenological research method was used to conduct semi-structured interviews with 15 patients with COPD who were either outpatients or inpatients in a tertiary hospital in Suzhou City,China,and the data were analyzed using the Colaizzi 7-step analysis method.Results Totally 3 themes and 9 sub-themes were extracted,namely self-control challenges due to cognitive deficits(lack of knowledge leads to ambiguous control direction;cognitive bias hinders control strategy formulation;negative perception leads to control avoidance),weakening trend of self-control behaviors(decision-making conflicts between immediate indulgence and delayed gratification;lack of reinforcement mechanisms leads to psycho-emotional depletion;external temptations lead the self to imitate bad behavior),urgent need for multiple supports to help with self-control(the desire for continuity and stability of family support,the need for professionalism and accuracy of healthcare guidance,and the expectation for rationality and matching of resource allocation).Conclusion Healthcare professionals should pay attention to the real experience of COPD patients in the process of disease self-control,help them effectively deal with the challenges of disease self-control,strengthen self-control behaviors,and satisfy their diversified needs by strengthening the support of families,professionals,and the community to improve poor outcomes and reduce the cost of healthcare services.

The Occupational Classification Dictionary of the People's Republic of China (2015 Edition) has added a new occupation type, Medical Nursing Assistants, aiming to meet the strong demand for medical care in the context of the aging population in China.In order to standardize the services of medical nursing assistants for the elderly in home and community settings and contribute to healthy aging, the National Health Commission issued the " Service Standards for Medical Nursing Assistants of Older Adults in Home and Community" ( WS/ T 803—2022) on September 28, 2022.The standards regulate the service processes, service items and requirements, as well as service evaluation and improvement for elderly medical nursing assistants.The interpretation of the standard's formulation background, the compilation process, and the standard's content are as follows.

Objective:To investigate the dietary iodine intake levels of residents and the dietary iodine contribution rates in Hainan Province.Methods:Using cluster random sampling method, common foods sold in 21 counties (cities, districts) markets in Hainan Province in 2023 were collected to determine iodine content. Each county (city, district) was divided into five sampling areas by east, west, south, north, and center, with one township (street) selected from each area, and 20 permanent residents over 18 years old (non same household, half male and half female) and 20 pregnant women were selected from each township (street). The "Iodine-Specific Food Frequency Questionnaire (I-FFQ)" was used to investigate the daily dietary intake of adults and pregnant woman. The average daily salt intake of the survey subjects was measured by the 3-day weighing method, and the dietary iodine intake and the dietary iodine contribution rates were calculated.Results:A total of 632 food samples were collected, and the iodine content of seaweed was relatively high (4 424.76 μg/100 g); the iodine content of seasoning was relatively low (2.41 μg/100 g). A total of 4 227 individuals in Hainan Province were surveyed for dietary iodine intake. The median dietary iodine intake level of residents was 211.6 μg/d, with the medians dietary iodine intake level of adults and pregnant women being 204.5 and 218.4 μg/d ( n = 2 120, 2 107), respectively. There was a statistically significant differences between different populations ( Z = - 8.64, P < 0.001). The medians dietary iodine intake level in the western coastal areas, central mountainous regions, and eastern coastal areas were 210.0, 207.3 and 211.6 μg/d ( n = 1 205, 1 203, 1 819), respectively, with statistically significant differences between different regions ( H = 15.33, P < 0.001). The contribution rate of dietary iodine from iodized salt was the most (59.4%), followed by kelp (8.1%). Conclusions:Under the condition of consuming iodized salt, the dietary iodine intake of adults in Hainan Province meets the recommended dietary iodine intake ( > 120 μg/d), but the dietary iodine intake of pregnant women is insufficient ( < 230 μg/d). Iodized salt is the main source of dietary iodine for residents in Hainan Province.

Objective:To describe epidemiological characteristics and their influencing factors of diabetes and pre-diabetes among adult residents in Hainan Province and provide a theoretical basis to develop epidemic prevention and control strategies for diabetes.Methods:This study used a two-stage unequal proportion cluster sampling method, and 32 857 subjects (≥18 years old) were collected from 24 cities/counties/districts in Hainan Province. All the subjects were investigated with questionnaires, physical examination, and laboratory tests from January to June 2023. The χ2 and Mantel-Haenszel trend χ2 tests were used to analyze the data. Multivariate logistic regression was used to analyze the factors influencing diabetes and pre-diabetes. SPSS 23.0 software was used to analyze the data. Results:The crude prevalence of diabetes and pre-diabetes in adult residents of Hainan Province were 18.1% and 22.8%, while the weighted rates were 13.7% and 20.7%, respectively. The results of multivariate logistic regression analysis showed that: aging (30-39 years old: OR=2.65, 95% CI: 2.06-3.41; 40-49 years old: OR=5.64, 95% CI: 4.40-7.24; 50- 59 years old: OR=9.88, 95% CI: 7.71-12.67; 60-69 years old: OR=18.34, 95% CI: 14.28-23.55; 70-79 years old: OR=21.30, 95% CI: 16.41-27.65; 80 years old and above: OR=24.13, 95% CI: 17.94-32.46), nationality (Li minority group: OR=1.50, 95% CI: 1.38-1.63; other ethnic groups: OR=1.53, 95% CI: 1.20-1.94), urban ( OR=1.12, 95% CI: 1.04-1.21), central obesity ( OR=2.14, 95% CI: 2.01-2.29), higher frequency of alcohol consumption (5-7 day/week: OR=1.24, 95% CI: 1.11-1.38), physical inactivity ( OR=1.09, 95% CI: 1.02-1.17) were risk factors for diabetes, while aging (30-39 years old: OR=1.53, 95% CI: 1.31-1.79; 40-49 years old: OR=2.36, 95% CI: 2.01-2.76; 50-59 years old: OR=3.03, 95% CI: 2.58-3.55; 60-69 years old: OR=4.22, 95% CI: 3.58-4.97; 70-79 years old: OR=5.05, 95% CI: 4.23-6.04; 80 years old and above: OR=6.08, 95% CI: 4.86-7.61), nationality: (Li minority group: OR=1.18, 95% CI: 1.10-1.28; other ethnic groups: OR=1.40, 95% CI: 1.14-1.71), urban ( OR=1.12, 95% CI: 1.04-1.19), central obesity ( OR=1.72, 95% CI: 1.62-1.83), higher frequency of alcohol consumption (1-4 day/week: OR=1.12, 95% CI: 1.01-1.23; 5-7 day/week: OR=1.35, 95% CI: 1.22-1.49) were risk factors for pre-diabetes. Conclusions:The epidemic situation of diabetes and pre-diabetes among adult residents in Hainan Province was not optimistic. In order to control the development of abnormal blood glucose, measures and targeted health education should be carried out to strengthen the screening, treatment, and management of people with abnormal blood glucose among different populations.

As an independent first-level discipline,an appropriate classification of nursing science is significant.In China,each nursing degree-granting institution has developed its own secondary-level discipline directions based on its research characteristics and strengths,with varying names and research scopes.Furthermore,there is no unified global classification system.This paper,based on the characteristics of nursing as a discipline and combined with China's discipline classification principles,used literature analysis,comprehensive classification,philosophical reflection,logical reasoning,and expert consultation methods to explore the connotation of nursing,its unique research objects and scope,and to construct a secondary-level discipline classification system for nursing science that is suitable for China's national conditions.The paper also discussed the challenges faced by the nursing discipline and its future development directions,providing theoretical and practical guidance for the development of the nursing discipline.

Objective To understand the real-life experiences of patients with chronic obstructive pulmonary disease(COPD)in disease self-control and to inform clinical nursing practice.Methods From March to May 2024,a phenomenological research method was used to conduct semi-structured interviews with 15 patients with COPD who were either outpatients or inpatients in a tertiary hospital in Suzhou City,China,and the data were analyzed using the Colaizzi 7-step analysis method.Results Totally 3 themes and 9 sub-themes were extracted,namely self-control challenges due to cognitive deficits(lack of knowledge leads to ambiguous control direction;cognitive bias hinders control strategy formulation;negative perception leads to control avoidance),weakening trend of self-control behaviors(decision-making conflicts between immediate indulgence and delayed gratification;lack of reinforcement mechanisms leads to psycho-emotional depletion;external temptations lead the self to imitate bad behavior),urgent need for multiple supports to help with self-control(the desire for continuity and stability of family support,the need for professionalism and accuracy of healthcare guidance,and the expectation for rationality and matching of resource allocation).Conclusion Healthcare professionals should pay attention to the real experience of COPD patients in the process of disease self-control,help them effectively deal with the challenges of disease self-control,strengthen self-control behaviors,and satisfy their diversified needs by strengthening the support of families,professionals,and the community to improve poor outcomes and reduce the cost of healthcare services.