To further standardize the management of vaccination units, the Specifications for Vaccination (2023 version) proposes hierarchical management. However, guidelines for establishing, implementing, and evaluating such a framework remain underdeveloped. This paper systematically reviews the current status of hierarchical management in vaccination units, clarifies its feasibility and necessity, and proposes an implementation scheme.

Objective To design and manufacture a stoma bag changer,and explore its application effect in patients with high displacement stoma.Methods The stoma bag changer consists of a communicating tube,an air bag,a collecting bag,an air pressure valve and a tube body.The convenience sampling method was used to select 2023.From December to March 2024,patients with ileal high-displacement stoma who were treated or hospitalized in the outpatient clinics of 15 tertiary hospitals in Zhejiang Province were used as research subjects.The subjects were randomly divided into an experimental group and a control group,with 35 cases in each group.The experimental group used the stoma bag changer to assist bag change,and the control group used the routine method.Data were collected continuously for 1 week through the questionnaire star platform,and differences of the single ostomy bag replacement time,the number of perioral skin cleaning treatments,and effective wearing time of ostomy bag were compared.Results In the end,all 70 patients completed the trial without stoma complications.In the experimental group,the time of single ostomy bag replacement,around the stoma number of skin cleaning treatments were significantly lower than those of the control group,and the effective wearing time of ostomy bag was significantly longer than that of the control group.In the control group,the differences were statistically significant(all P＜0.05).Conclusion The stoma bag changer is used in patients with high ileal displacement stoma,which can effectively shorten the single stoma bag replacement time and reduce the number of skin cleaning around the stoma,and prolong the use of a stoma bag.

Objective To give references for future study,the current state of research and identify key areas of interest,and development trends in the field of Chinese Materia Medica interventions for PD were examined.Methods Literature on Chinese Materia Medica treatment of PD published between 2004 and 2024 was retrieved from the China National Knowledge Infrastructure(CNKI)and Web of Science(WOS)databases.After screening,689 articles were included(412 in Chinese,277 in English).CiteSpace software was used for bibliometric and knowledge graph analysis,generating author collaboration networks,institutional collaboration networks,keyword clustering,timeline maps,and keyword burst analysis.Results Over the past two decades,the number of publications has continued to grow globally.Chinese-language studies focused primarily on clinical research,with core authors such as Yi Liu,Jiancheng He,and Jianfen Liang,and institutions like Guangxi University of Chinese Medicine making significant contributions.English-language literature emphasized mechanistic studies,with Kyung Hee University and Beijing University of Chinese Medicine as leading research teams.High-frequency keywords included"Parkinson's disease"(346 occurrences),"traditional Chinese medicine(TCM)"(60 occurrences),and"oxidative stress"(11 occurrences).Keyword clustering revealed research hotspots in TCM formulas(e.g.,Zhichan decoction),mechanisms(e.g.,oxidative stress),and integrated TCM-Western medicine therapies(e.g.,Madopar).Burst analysis indicated emerging frontiers in the gut-brain axis,iron metabolism,molecular docking,gut microbiota,and signaling pathways.Conclusions Although there is a lot of potential for treating PD in TCM,there are also a lot of challenges.In order to realize the transformation of TCM from a supportive to a mainstream treatment for PD,and to bring better efficacy to patients in the future,it is necessary to strengthen evidence-based research,deepen the research of mechanisms,promote the construction of standards,explore the integration of Chinese and Western medicine,and improve the evaluation system.

To further standardize the management of vaccination units, the Specifications for Vaccination (2023 version) proposes hierarchical management. However, guidelines for establishing, implementing, and evaluating such a framework remain underdeveloped. This paper systematically reviews the current status of hierarchical management in vaccination units, clarifies its feasibility and necessity, and proposes an implementation scheme.

Objective To design and manufacture a stoma bag changer,and explore its application effect in patients with high displacement stoma.Methods The stoma bag changer consists of a communicating tube,an air bag,a collecting bag,an air pressure valve and a tube body.The convenience sampling method was used to select 2023.From December to March 2024,patients with ileal high-displacement stoma who were treated or hospitalized in the outpatient clinics of 15 tertiary hospitals in Zhejiang Province were used as research subjects.The subjects were randomly divided into an experimental group and a control group,with 35 cases in each group.The experimental group used the stoma bag changer to assist bag change,and the control group used the routine method.Data were collected continuously for 1 week through the questionnaire star platform,and differences of the single ostomy bag replacement time,the number of perioral skin cleaning treatments,and effective wearing time of ostomy bag were compared.Results In the end,all 70 patients completed the trial without stoma complications.In the experimental group,the time of single ostomy bag replacement,around the stoma number of skin cleaning treatments were significantly lower than those of the control group,and the effective wearing time of ostomy bag was significantly longer than that of the control group.In the control group,the differences were statistically significant(all P＜0.05).Conclusion The stoma bag changer is used in patients with high ileal displacement stoma,which can effectively shorten the single stoma bag replacement time and reduce the number of skin cleaning around the stoma,and prolong the use of a stoma bag.

Objective To give references for future study,the current state of research and identify key areas of interest,and development trends in the field of Chinese Materia Medica interventions for PD were examined.Methods Literature on Chinese Materia Medica treatment of PD published between 2004 and 2024 was retrieved from the China National Knowledge Infrastructure(CNKI)and Web of Science(WOS)databases.After screening,689 articles were included(412 in Chinese,277 in English).CiteSpace software was used for bibliometric and knowledge graph analysis,generating author collaboration networks,institutional collaboration networks,keyword clustering,timeline maps,and keyword burst analysis.Results Over the past two decades,the number of publications has continued to grow globally.Chinese-language studies focused primarily on clinical research,with core authors such as Yi Liu,Jiancheng He,and Jianfen Liang,and institutions like Guangxi University of Chinese Medicine making significant contributions.English-language literature emphasized mechanistic studies,with Kyung Hee University and Beijing University of Chinese Medicine as leading research teams.High-frequency keywords included"Parkinson's disease"(346 occurrences),"traditional Chinese medicine(TCM)"(60 occurrences),and"oxidative stress"(11 occurrences).Keyword clustering revealed research hotspots in TCM formulas(e.g.,Zhichan decoction),mechanisms(e.g.,oxidative stress),and integrated TCM-Western medicine therapies(e.g.,Madopar).Burst analysis indicated emerging frontiers in the gut-brain axis,iron metabolism,molecular docking,gut microbiota,and signaling pathways.Conclusions Although there is a lot of potential for treating PD in TCM,there are also a lot of challenges.In order to realize the transformation of TCM from a supportive to a mainstream treatment for PD,and to bring better efficacy to patients in the future,it is necessary to strengthen evidence-based research,deepen the research of mechanisms,promote the construction of standards,explore the integration of Chinese and Western medicine,and improve the evaluation system.

Objective:To explore the moderating effect of associative stigma on the relationship between personality and professional identity among students majoring in psychiatry.Methods:The Chinese version of the 10-item Big Five Personality Inventory(TIPI-C10),the Chinese version of the Clinician Associative Stigma Scale(CASS-C),and the College Students'Professional Identity Questionnaire were used to investigate the personality traits,levels of associative stigma,and levels of professional identity among 342 psychiatric students.The main statistical analyses used were correlation analysis and moderation effect testing.Results:When the level of associative stigma was high,extraversion positively predicted professional identity(simple slope=1.047,t=3.018,P<0.01).When the level of associative stigma was low,extraversion positively predicted professional identity(simple slope=2.094,t=6.091,P<0.001).When the level of associative stigma was high,conscientiousness positively predicted professional identity(simple slope=1.781,t=3.986,P<0.001);When the level of associative stigma was low,conscientiousness positively predicted professional identity(simple slope=3.684,t=8.681,P<0.001).When the level of associative stigma was high,emotional stability positively predicted professional identity(simple slope=0.965,t=2.388,P<0.05).When the level of associative stigma was low,emotional stability positively predicted professional identity(simple slope=2.998,t=7.175,P<0.001).Conclusion:Associative stigma played the moderating effect between extraversion,conscientiousness,emotional stability,and the professional identity of psychiatric students.Colleges and universities should carry out targeted education and publicity work based on the personality traits of different students.

Objective: To investigate the mechanism of electroacupuncture (EA) for treating depression and to explore the role of brevican in the medial prefrontal cortex (mPFC) in modulating stress susceptibility and the antidepressant effects of EA in rats. Methods: Twenty-four Sprague–Dawley (SD) rats were equally divided into three groups: green fluorescent protein (GFP) + control, GFP + chronic unpredicted mild stress (CUMS), and short-hairpin RNA targeting on brevican (shBcan) + CUMS. Another 24 SD rats were equally divided into CUMS + GFP, CUMS + GFP + EA, and CUMS + shBcan + EA groups. Behavioral tests were conducted to assess depression-like behavior. Western blot analysis was used to evaluate the expression of brevican, aggrecan, GLuA1, and PSD95 in mPFC subregions. Results: Behavioral parameter evaluation show that rats in the shBcan + CUMS group exhibited a significantly reduced sucrose preference (P = .0002) and increased immobility time (P = .0011) compared to those in rats in the GFP + CUMS group. Western blotting showed that brevican expression was significantly downregulated in the PrL of the shBcan + CUMS group compared with that in the GFP + CUMS group (P = .0192). Furthermore, compared to the CUMS + GFP + EA group, the CUMS + shBcan + EA group exhibited a significantly decreased sucrose preference (P = .0334), increased immobility time (P = .0465), and increased latency to food (P = .0261). In the CUMS + shBcan + EA group, the EA-induced brevican and PSD95 overexpression was reversed, compared with that in the CUMS + GFP + EA group (P = .0454 and P = .0198, respectively). Conclusion EA exerts its antidepressant effects through the modulation of brevican expression in rats. Our findings highlight the important role for brevican in stress susceptibility, which could be a potential target for treating depression.

Objective To explore the effects of electroacupuncture on motor function in Parkinson's disease(PD)model mice and NLRP3 inflammasome-related proteins in the midbrain substantia nigra(SN).Methods C57BL/6 mice were assigned to three groups according to the random number table method:control group,model group,and electroacupuncture(EA)group,12 mice per group.The PD model was reproduced by intragastric administration of rotenone solution 10 mg/(kg·d).EA group was administered at the three selected points,"Fengfu"(GV16),"Taichong"(LR3),and"Zusanli"(ST36),with a treatment cycle of 2 weeks.The control and model groups took the same time synchronous fixation operation for the control variable.Behavioral scores and open field tests were used to detect the exercise ability of mice in each group.Tyrosine hydroxylase(TH)and α-synuclein(α-syn)in the midbrain SN of mice in all groups were measured with an immunohistochemistry test.NLRP3 and cysteinyl aspartate specific proteinase-1(Caspase-1)protein expression levels in the midbrain SN of mice in the three groups were measured using Western blotting,and interleukin-1β(IL-1β)content was determined with an enzyme-linked immunosorbent assay.Results Compared to the control group,the behavioral scores of the mice in the model group were higher(P<0.01).Compared to the model group,the behavioral scores of the mice in the EA group were lower(P<0.01).Compared to the control group,the time ratio of the relative rest state of the mice in the model group(<100 mm/s)increased significantly(P<0.01),while the time ratio of the slow motion(100～200 mm/s)and time ratio of the fast motion(>200 mm/s)state decreased significantly(P<0.01).Compared to the model group,the time ratio spent in the relative rest state of mice in the EA group decreased significantly(P<0.01),while the time ratio of the slow motion state and time ratio of the fast motion state and movement rate increased significantly(P<0.01).Compared to the control group,the TH expression level decreased in the SN in the model group(P<0.01),while α-syn increased(P<0.01).Compared to the model group,the TH expression level in the EA group increased(P<0.05),while α-syn decreased(P<0.05).Compared to the control group,the protein expressions of NLRP3 and Caspase-1 in the SN of the model group increased(P<0.01);compared to the model group,the expressions of NLRP3 and Caspase-1 in the SN of the midbrain of mice decreased after EA treatment(P<0.01).Compared to the control group,IL-1β in the SN of the mouse midbrain increased in the model group(P<0.01).Compared to the model group,IL-1β decreased in the EA group(P<0.05).Conclusion This experiment shows that stimulation of EA in"Fengfu","Taichong",and"Zusanli"can effectively reduce abnormal aggregation of the PD marker α-syn,increase TH expression,and enhance the motor dysfunction of PD model mice.The molecular mechanism is related to the regulation of the expression of NLRP3,Caspase-1,and IL-1β of inflammasome-related pathways.

Objective To establish a simple model for arteriosclerosis(AS)screening to provide a viable tool for the timely identification of AS risk among residents aged 40～65 years.Methods Data were obtained from the Sleep and Chronic Diseases Program in Fuquan City.The original dataset was divided into a training subset and a validation subset(80%:20%).LASSO and logistic regression models were used to screen variables,perform multivariate regression analyses.Internal validation was performed using the Bootstrap method.Nomogram Plot was constructed,and risk score thresholds were determined based on ROC curves to classify high-risk populations.Results RS Model was established to include age,gender,napping,sleep efficiency,sleep disorders,hyperten-sion and diabetes,with AUC=74.80%and a model risk score threshold=84.20.PHC Model was established to include age,gender,napping,sleep efficiency,systolic blood pressure,fasting blood glucose,and pulse variables,with AUC=82.80%and a risk score threshold of 78.00.Decision curves showed that both models performed well in terms of calibration and actual benefits for health management.Conclusion The two AS screening models exhibit acceptable accuracy and differentiation.Therefore,it can be applied in residents'self-health management and in primary care organizations'screening work in a large scale.