ObjectiveTo explore the driving forces for oncology nurses’ participation in palliative care work， thereby providing a theoretical basis for the improvement of education and training， incentive mechanisms， and other aspects of the palliative care nursing staff. MethodsEmploying a qualitative research method， semi-structured interviews lasting 40-60 minutes were conducted with 14 nurses who had participated in palliative care work. The interview data were analyzed using the Colaizzi seven-step analysis method. ResultsInternal positive driving forces were job interest， empathy， and a sense of professional responsibility， while the negative was low psychological resilience. External positive driving forces included high work support， professional identity， mutual benefits for nurses and patients， and positive patient attitudes， whereas negative driving forces comprised busy routine clinical work， lack of a reward and incentive system， and bland or negative patient attitudes. ConclusionIt is essential to provide a flexible platform for the enhancement of nurses’ professional capabilities in palliative care， intensify the publicity of palliative care and death education； intervene and guide nurses’ negative emotions， improve and implement relevant incentive systems， and standardize the job recognition and scope of responsibilities of palliative care nurses.

ObjectiveTo introduce visual teaching into the course design of medical humanistic care based on the concept of implementation science， evaluate the teaching implementation effect and feedback， and provide references for optimizing course teaching outcomes and improving students’ humanistic care competence. MethodsA visual teaching program for medical humanistic care was designed， with key steps including clarifying teaching objectives， content， methods， and curriculum assessment. This program was implemented in the medical humanistic care course teaching involving 50 elective students. Multi-dimensional evaluation of teaching effectiveness was conducted through course grades， visual teaching evaluation， and humanistic workshop assessment， combined with inductive content analysis of students’ learning experiences in the workshops. ResultsThe 50 students achieved above-average course grades （89.60±3.41） and demonstrated high satisfaction with the overall course and visual teaching. All the 6 groups obtained relatively high scores in the medical humanistic care workshops. Four themes were extracted， namely， enhancing humanistic care competencies， deepening familial and interpersonal relationships， realizing emotional expression and self-growth， and strengthening integration of humanistic care concepts with practice. ConclusionThe teaching of medical humanistic care course has achieved favorable effects， which contributes to deepening students’ understanding of humanistic care and enhancing their humanistic care competence. Students demonstrate high levels of recognition and satisfaction with the course.

Endometriosis （EMT） is a common disease with frequent occurrence and difficult to be cured in modern clinical practice of obstetrics and gynaecology. It is characterized by progressively worsening dysmenorrhoea， pelvic mass， and infertility. The incidence of EMT is growing and increasingly younger patients are diagnosed with this disease， which poses a serious threat to the reproductive and psychological health of women of childbearing age and adolescent females. However， the pathogenesis of EMT is still not completely clear， and the disease has a long course. Therefore， developing new therapies is an urgent clinical problem to be solved. Great progress has been achieved in the treatment of EMT with traditional Chinese medicine （TCM）， while the underlying mechanism remains in exploration. Programmed cell death （PCD） is a cell death mode mediated by a variety of bio-molecules with specific signaling cascades. The known PCD processes include apoptosis， pyroptosis， autophagy， ferroptosis， and cuproptosis， which all play a pivotal role in the development of EMT. Researchers have made achievements in the treatment of EMT with TCM， which regulates PCD via multiple pathways， routes， targets， and mechanisms. However， the progress in the regulation of PCD in the treatment of EMT with TCM remains to be reviewed. This paper reviews the research progress in the treatment of EMT with TCM from five PCD processes （apoptosis， pyroptosis， autophagy， ferroptosis， and cuproptosis）， with the aim of providing a theoretical basis for the clinical prevention and treatment of EMT.

Objective:To explore the influencing factors of brain injury in children with neonatal asphyxia after resuscitation.Methods:The clinical data of 180 children with neonatal asphyxia from January 2017 to January 2024 in Shijiazhuang Maternal and Child Health Hospital were retrospectively analyzed, and all children were received resuscitation treatment. The children were divided into modeling group (126 cases) and validation group (54 cases) in a 7∶3 ratio. Among the children in modeling group, 51 children combined brain injury (brain injury subgroup), and 75 children did not combine brain injury (non-brain injury subgroup). The general data were recorded, and the continuous variables were determined by the receiver operating characteristic (ROC) curve to determine the optimal cut-off value. Multivariate Logistic regression analysis was used to analyze the independent risk factors of brain injury in children with neonatal asphyxia after resuscitation. The R language software "rms" package was used to construct a nomogram model for predicting brain injury in children with neonatal asphyxia after resuscitation. The nomogram model was internally verified by the calibration curve, and the prediction efficiency of the nomogram model was evaluated by the decision curve and ROC curve.Results:There was no statistical difference in general data between modeling group and validation group ( P>0.05). The gestation age<37 weeks proportion, severe asphyxia proportion, Ⅱ to Ⅲ grade amniotic fluid contamination proportion, intrauterine distress proportion and blood lactate in brain injury subgroup were significantly higher than those in non-brain injury subgroup: 60.78% (31/51) vs. 38.67% (29/75), 37.25% (19/51) vs. 17.33% (13/75), 27.45% (14/51) vs. 10.67% (8/75), 47.06% (24/51) vs. 26.67% (20/75) and (2.64 ± 0.61) mmol/L vs. (2.21 ± 0.56) mmol/L, and there were statistical differences ( P<0.05 or <0.01); there were no statistical differences in gender composition, birth weight, maternal age, maternal history of adverse pregnancy and childbirth, mode of delivery, parity, abnormal amniotic fluid volume, abnormal fetal position, abnormal umbilical cord, abnormal placenta, systolic blood pressure, diastolic blood pressure, body temperature and blood glucose between the two groups ( P>0.05). ROC curve analysis result showed that the optimal cutoff value of blood lactate was 2.59 mmol/L. Multivariate Logistic regression analysis result showed that the young gestation age, severe asphyxia, Ⅱ to Ⅲ grade amniotic fluid contamination, intrauterine distress and high blood lactate were independent risk factors of brain injury in children with neonatal asphyxia after resuscitation ( OR = 2.854, 3.428, 3.405, 3.427 and 7.844; 95% CI 1.166 to 6.983, 1.263 to 9.305, 1.076 to 10.768, 1.358 to 8.645 and 3.080 to 19.978; P<0.05 or <0.01). The gestation age, degree of asphyxia, amniotic fluid contamination, intrauterine distress and blood lactate were used as predictors to construct a nomogram model for predicting brain injury in children with neonatal asphyxia after resuscitation. The calibration curve analysis result showed that the calibration curve of the nomogram model for predicting brain injury in children with neonatal asphyxia after resuscitation tended towards the ideal curve ( C- index = 0.824, 95% CI 0.745 to 0.903). The decision curve analysis result showed that, when the risk threshold was greater than 0.18, the clinical net benefits provided by the nomogram model were higher than those of a single independent risk factor, and it could provide significant additional clinical net benefits in predicting the high risk of brain injury in children with neonatal asphyxia after resuscitation. ROC curve of internal validation analysis result that the curve (AUC) of the nomogram model for predicting brain injury in children with neonatal asphyxia after resuscitation was 0.824 (95% CI 0.744 to 0.903). ROC curve of external validation result showed that the AUC of the nomogram model for predicting brain injury in children with neonatal asphyxia after resuscitation was 0.838 (95% CI 0.714 to 0.962). Conclusions:The gestation age, degree of asphyxia, amniotic fluid contamination, intrauterine distress and blood lactate are independent risk factors for brain injury in children with neonatal asphyxia after resuscitation. The nomogram model constructed based on these factors has a high clinical benefit in predicting brain injury in children with neonatal asphyxia after resuscitation.

Objective To investigate the predictive value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)radiomics combined with Magee equation 3(ME3)for pathological response following neoadjuvant chemotherapy(NAC)in patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative(HR+/HER2-)breast cancer.Methods A ret-rospective analysis was performed on 325 breast cancer patients diagnosed with HR+/HER2-in two hospitals.Patients from the first hospital were randomly divided into training and internal validation sets at a ratio of 7∶3.Patients from the second hospital served as external validation set.The volume of interest(VOI)of breast cancer was delineated on DCE-MRI images.Then the rele-vant radiomics features were extracted and selected,and the Radiomics score(Radscore)was calculated.The statistically significant clinical and pathological features and Radscore were incorporated into a multivariate analysis.The combined radiomics-clinical model and nomogram were established,and the prediction performance was evaluated by using the receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis(DCA).Results In the training set,seven radiomics features were selected to construct the radiomics model.ME3 score emerged as the independent factor for pathological complete response(pCR)(P＜0.001).By integrating ME3 score and Radscore,a combined radiomics-clinical model was developed.This model demonstrated robust predictive accuracy,with area under the curve(AUC)of 0.88[95％confidence interval(CI)0.80-0.95],0.90(95％CI 0.82-0.98),and 0.82(95％CI 0.70-0.93)in the training,internal validation,and external validation sets,respectively.The nomogram construc-ted from the combined model exhibited excellent discrimination and calibration,with P-values of 0.455,0.312 and 0.062 in the train-ing,internal validation,and external validation sets.Conclusion DCE-MRI radiomics combined with ME3 can be used to predict the pathological response of NAC in HR+/HER2-breast cancer.

Objective:To investigate the clinical efficacy of transcranial alternating current stimulation (tACS) combined with drug treatment in patients with bipolar Ⅰ disorder (BD Ⅰ).Methods:Forty-two patients with BD Ⅰ who were admitted to the Mental Health Center Affiliated to Anhui Medical University from March 2022 to June 2023 were included in this randomized double-blind study. These patients were randomly divided into a control group and an observation group using an Excel spreadsheet. In the control group, patients received 10 sessions of sham stimulation in addition to drug treatment, while the observation group received 10 sessions of tACS along with drug treatment. All patients were treated for 2 weeks. Each patient received stimulation for 15 minutes on each of the right and left prefrontal lobes once every working day. The Montreal Cognitive Assessment (MoCA) scores and Bech-Rafaelsen Mania Scale (BRMS) scores were compared between the two groups before and after treatment. Eighteen patients from the observation group and nineteen patients from the control group were included in the final analysis.Results:Two weeks after treatment, the MoCA score in the observation group was higher than that in the control group [(27.39 ± 1.88) vs. (24.63 ± 2.39)], and the BRMS score in the observation group was lower than that in the control group [(15.89 ± 3.18) vs. (19.00 ± 3.32)]. These differences were statistically significant ( t = -3.89, 2.91, both P < 0.05). After treatment, the MoCA score in the observation group increased, while the BRMS score decreased ( t = 5.04, -4.14, both P < 0.05). Pearson correlation analysis indicated the change in MoCA score was negatively correlated with BRMS score in both groups ( r = -0.433, P < 0.05). Conclusions:Drug treatment combined with tACS greatly improved clinical cognitive symptoms and reduced manic symptoms in patients with BD Ⅰ. The combined therapy exhibited better efficacy than monotherapy.

Stroke is characterized by a high disability rate. After stroke, patients will have different degrees of limb dysfunction, which seriously affects their quality of life. In recent years, fully immersive virtual technology has been gradually applied at home and abroad to promote limb function rehabilitation of stroke patients. This paper reviews the technical components, application forms, application effects, prospects and challenges of fully immersive virtual reality technology in limb function rehabilitation of stroke patients, in order to provide theoretical basis for the subsequent application of fully immersive virtual reality technology to improve the level of limb function rehabilitation of stroke patients.

Dyadic interviews can deeply reveal the complex interaction between dyads(eg,patients and their caregivers),and their importance in the field of nursing qualitative research has become increasingly prominent.Through a comprehensive literature review,this paper systematically combs the relevant literature of dyadic interviews,elaborates on the concept and application areas of dyadic interviews,deeply discusses 5 major forms of dyadic interviews and the analysis methods of dyadic data,illustrates with specific examples.The aim is to provide methodological guidance for Chinese nursing researchers and promote the scientific and standardized application of this method in the field of nursing qualitative research.

Dyadic interviews can deeply reveal the complex interaction between dyads(eg,patients and their caregivers),and their importance in the field of nursing qualitative research has become increasingly prominent.Through a comprehensive literature review,this paper systematically combs the relevant literature of dyadic interviews,elaborates on the concept and application areas of dyadic interviews,deeply discusses 5 major forms of dyadic interviews and the analysis methods of dyadic data,illustrates with specific examples.The aim is to provide methodological guidance for Chinese nursing researchers and promote the scientific and standardized application of this method in the field of nursing qualitative research.

OBJECTIVE To analyze the distribution of pathogens isolated from the recurrent spontaneous abortion patients complicated with genital tract infection,observe the changes of peripheral blood microribonucleic acid-155(miR-155),helper T cell 17(Th17)/regulatory T cell(Treg)cytokines and analyze the clinical significance.METHODS A total of 102 recurrent spontaneous abortion patients who were complicated with genital tract infec-tion and were treated in Xinxiang Central Hospital from Jan.2022 to Oct.2023 were assigned as the infection group,meanwhile,80 recurrent spontaneous abortion patients who were not complicated with genital tract infec-tion were chosen as the no infection group.The distribution of the pathogens isolated from the patients of the in-fection group was observed.The expression levels of peripheral blood miR-155,Th17/Treg and their cytokines[interleukin(IL)-10,IL-17]were compared between the two groups.The values of the peripheral blood miR-155,Th17/Treg,IL-10 and IL-17 in prediction of genital tract infection in the recurrent spontaneous abortion patients were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS Totally 121 strains of patho-gens were isolated from the 102 recurrent spontaneous abortion patients complicated with genital tract infection,68(56.20％)of which were gram-negative bacteria,45(37.19％)were gram-positive bacteria,and 8(6.61％)were fungi.Escherichia coli was the predominant species of gram-negative bacteria;Staphylococcus aureus was dominant among the gram-positive bacteria;Candida albicans was the predominant species of fungi.There were significant differences in the levels of peripheral blood miR-155,Th17/Treg and cytokines between the infection group and the no infection group(P＜0.05).ROC curve analysis showed that the areas under the curves(AUCs)of peripheral blood miR-155,Th17/Treg,IL-10,IL-17 and the joint detection of the above indexes were 0.891,0.909,0.877,0.869 and 0.994,respectively;the joint detection was superior to the single detection(P＜0.05).CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the recurrent sponta-neous abortion patients complicated with genital tract infection.The miR-155,Th17/Treg and their cytokines have certain values in prediction of the genital tract infection in the patients with recurrent spontaneous abortion.