Objective To explore the changes and influencing factors in patients' gastrointestinal symptoms and food tolerance before and after laparoscopic sleeve gastrectomy(LSG),and to provide a reference for the development of targeted gastrointestinal symptoms management program.Methods A convenience sampling method was used to select 125 patients who underwent LSG in the bariatric and metabolic surgery department of a tertiary-level hospital in Xuzhou City from June to November 2023 for a prospective observational study.The general information questionnaire,food tolerance questionnaire and Gastrointestinal Symptom Rating Scale(GSRS)were used to investigate at preoperative,3 months after surgery,and 6 months after surgery.Two-factor repeated measures variance analysis and generalized linear mixed model(GLMM)was used to analyze the influencing factors of gastrointestinal symptoms.Results 116 valid questionnaires were collected,and the GSRS scores of LSG patients at 3 time points were 21.67±5.80,23.28±4.33,and 21.22±3.18 respectively;the incidence rates of food intolerance were 0,32.75％,and 28.45％respectively.The patients' symptoms of bowel sounds,dysphagia,constipation,and dry stool were worse after surgery than before surgery(all P＜0.05),and the symptoms of bad breath,diarrhea,loose stools,and the need to defecate immediately were alleviated compared with symptoms before surgery(all P＜0.05).GLMM results showed that short meal times,poor food tolerance,and high school/technical secondary school education were risk factors for increasing gastrointestinal symptoms(all P＜0.05).Conclusion LSG could increase the prevalence of gastrointestinal symptoms such as dysphagia,dyspepsia,constipation and food intolerance.Medical staff should pay attention to the assessment of gastrointestinal symptoms in LSG patients,especially for patients with short meal time and poor food tolerance,strengthen postoperative follow-up,build targeted treatment and care plan,and prevent and reduce such uncomfortable symptoms.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Objective To explore the relationships of vitamin D and oxidized low-density lipoprotein(ox-LDL)with infertility in patients with polycystic ovary syndrome(PCOS)based on restricted cubic spline models.Methods A total of 150 PCOS patients were selected as the study subjects and followed up for at least 1 year.They were divided into infertile group and non-infertile group according to whether they were infertile.A Logistic regression model was used to analyze the influencing factors of infertility in PCOS patients.Furthermore,the relationships of 1,25-dihydroxyvitamin D3[1,25-(OH)2D3]and ox-LDL with infertility in PCOS patients,as well as their interactive effects on infertility in PCOS patients were analyzed.A restricted cubic spline model was used to analyze the non-linear relationships between 1,25-(OH)2D3,ox-LDL,and infertility in PCOS patients.Results Among 150 PCOS patients,78 were not pregnant,resulting in an infertility rate of 52.00％(78/150).Multivariate Logistic regression analysis showed that the severity of PCOS,body mass index,age,1,25-(OH)2D3,and ox-LDL were all independent influencing factors for infertility in PCOS patients(P＜0.05).After adjusting for confounding factors,1,25-(OH)2D3 and ox-LDL were still associated with the risk of in-fertility in PCOS patients(P＜0.05).Restricted cubic spline model analysis revealed non-linear rela-tionships between 1,25-(OH)2D3,ox-LDL,and the risk of infertility in PCOS patients(P＜0.05).When the serum 1,25-(OH)2D3 level was＜35.70 nmol/L,it was negatively correlated with the risk of infertility in PCOS patients(P＜0.05).When the serum ox-LDL level was ≥381.00 μg/L,it was positively correlated with the risk of infertility in PCOS patients(P＜0.05).Interactive effect analysis showed that 1,25-(OH)2D3 and ox-LDL had antagonistic effects on infertility in PCOS pa-tients(P＜0.05).Conclusion Decreased serum 1,25-(OH)2D3 levels and increased ox-LDL levels in PCOS patients can significantly increase the risk of infertility.Moreover,there is a non-lin-ear dose-response relationship and an antagonistic interactive effect between them,suggesting that regulating vitamin D and oxidative stress levels may be an important strategy for improving the fertili-ty outcomes of PCOS patients.

Objective To explore the changes and influencing factors in patients' gastrointestinal symptoms and food tolerance before and after laparoscopic sleeve gastrectomy(LSG),and to provide a reference for the development of targeted gastrointestinal symptoms management program.Methods A convenience sampling method was used to select 125 patients who underwent LSG in the bariatric and metabolic surgery department of a tertiary-level hospital in Xuzhou City from June to November 2023 for a prospective observational study.The general information questionnaire,food tolerance questionnaire and Gastrointestinal Symptom Rating Scale(GSRS)were used to investigate at preoperative,3 months after surgery,and 6 months after surgery.Two-factor repeated measures variance analysis and generalized linear mixed model(GLMM)was used to analyze the influencing factors of gastrointestinal symptoms.Results 116 valid questionnaires were collected,and the GSRS scores of LSG patients at 3 time points were 21.67±5.80,23.28±4.33,and 21.22±3.18 respectively;the incidence rates of food intolerance were 0,32.75％,and 28.45％respectively.The patients' symptoms of bowel sounds,dysphagia,constipation,and dry stool were worse after surgery than before surgery(all P＜0.05),and the symptoms of bad breath,diarrhea,loose stools,and the need to defecate immediately were alleviated compared with symptoms before surgery(all P＜0.05).GLMM results showed that short meal times,poor food tolerance,and high school/technical secondary school education were risk factors for increasing gastrointestinal symptoms(all P＜0.05).Conclusion LSG could increase the prevalence of gastrointestinal symptoms such as dysphagia,dyspepsia,constipation and food intolerance.Medical staff should pay attention to the assessment of gastrointestinal symptoms in LSG patients,especially for patients with short meal time and poor food tolerance,strengthen postoperative follow-up,build targeted treatment and care plan,and prevent and reduce such uncomfortable symptoms.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Objective To investigate the current status and influencing factors of physical activity (PA) among stroke survivors. Methods A total of 203 stroke survivors were selected as the research subjects using convenient sampling method. General information questionnaire, Stroke Self-efficacy Scale, Perceived Social Support Scale, Modified Rankin Scale, International Physical Activity Questionnaire-Long Form, Fatigue Severity Scale, and European Five-Dimension Health Scale were used for questionnaire survey. Based on the health ecological model, hierarchical multiple linear regression analysis was used to explore the influencing factors of PA among stroke survivors. Results Using metabolic equivalents (MET) to quantify energy expenditure, the weekly PA energy expenditure of 203 stroke survivors was 693.0 (0, 1 386.0) MET. The results of hierarchical multiple linear regression analysis showed that personal traits (stroke staging), behavioral characteristics and psychology (Modified Rankin Scale score, fatigue severity, stroke recovery self-efficacy), and interpersonal networks (perceived social support-friend support dimension) were the main influencing factors of PA among stroke survivors (P < 0.05), which could explain 55.5% of the variation in PA. Conclusion The level of PA among stroke survivors is influenced by multi-dimensional and multi-level complex factors in their health ecosystem, and it is currently at a low level. Healthcare professionals can formulate comprehensive strategies to improve PA among stroke survivors based on the health ecological model, aiming to further enhance the PA level of stroke survivors and promote physical function recovery.

Objective:To search, evaluate and integrate the best evidence for early recognition of patients with post-stroke cognitive impairment (PSCI).Methods:With"stroke""cognitive impairment"and"identif"as search terms, according to the 6S evidence resource pyramid model, a top-down systematic retrieval was conducted for literature on early identification of PSCI in UpToDate, BMJ Best Practice, the Joanna Briggs Institute (JBI), National institute for Health and Care Excellence (NICE), Medlive and other guideline websites, American Stroke Association (ASA), American Heart Association (AHA), European Stroke Organization (ESO), Heart and Stroke Foundation of Canada (HSFC), Australian Stroke Foundation (ASF), Royal College of Physicians (RCP) and other association networks, PubMed, Embase, Cochrane Library, CINAHL, Web of Science, CNKI, Wanfang Knowledge Data Service Platform, VIP database, Chinese Biomedical Database, Chinese Medical Journal Full Text Database and other databases. The search time was from the establishment of the databases to February 8, 2024. Two researchers trained in normative evidence-based methodology conducted literature screening, quality evaluation, and independent evidence extraction in accordance with the principle of evidence integration.Results:A total of 21 articles were included, including 1 clinical decision support, 8 guidelines, 3 expert consensus, and 9 systematic reviews. The best evidence summarized included 24 recommendations from 6 aspects, including screening objects, screening timing, screening practitioners, pre-screening assessment, screening tools and post-screening assessment, of which 70.8% was class 2b and above evidence, and 41.7% of the evidence was recommended with strength A.Conclusions:The literature on early identification of PSCI patients is of high quality and high level of evidence. The key to early identification of PSCI patients for medical professionals is to consider individual differences, select appropriate screening tools and conduct cognitive screening as soon as possible.

Objective:To summarize the content and effects of exercise interventions for stroke survivors, providing references for medical and nursing personnel in formulating exercise intervention plans for these patients.Methods:Literature on exercise interventions for stroke survivors was searched in databases such as China National Knowledge Infrastructure, Wanfang, VIP, China Biology Medicine disc, Cochrane Library, PubMed, Embase, and Web of Science up to May 1, 2023. Data extraction and summarization were conducted on the included literature.Results:Twenty-two articles were included in the review. The exercise types for stroke survivors primarily involved aerobic and resistance training; the intensity was mainly moderate to high; the frequency was mostly 3-5 times per week, with each session lasting 30-60 minutes; and the duration of interventions ranged from as short as two weeks to as long as one year. Exercise interventions improved stroke survivors' functional mobility, quality of life, cardiopulmonary function, mental state, cognitive function, fatigue, sleep, and compliance to varying degrees.Conclusions:Exercise interventions have achieved positive outcomes in stroke survivors. In the future, medical and nursing personnel can incorporate patient preferences into exercise intervention plans while ensuring patient safety to promote rehabilitation.

Objective To investigate the mechanism by which lectin-like oxidized low density lipoprotein receptor-1(LOX-1)regulates hyperglycemic-induced myocardial fibroblast(CFs)fibrosis through the glycogen synthase kinase-3β(GSK-3β)/signal transducer and activator of transcription 3(STAT3)pathway.Methods CFs were isolated,cultured and identified.LOX-1 RNAi lentiviral vector was constructed and infected CFs.The experimental groups were as follows:Normal control(NC)group,High glucose(HG)group,LV-LOX-1,LV-Con group,Hypertonic(HPG)group.After LV-LOX-1 and LV-Con were infected with CFs,adding 25 mmol/L glucose to culture CFs for 24 h,they were denoted as HG+LV-LOX-1 group and HG+LV-Con group.Cells in HG+LV-LOX-1 group and HG+LV-Con group were treated with 10 μ mol/L SB216763 and 10 μ mol/L STATTIC for 24 h,respectively,and then they were recorded as HG+LV-LOX-1+SB216763 group,HG+LV-Con+SB216763 group,HG+LV-LOX-1+STATTIC group and HG+LV-Con+STATTIC group.CCK-8 was used to detect the activity of CFs,and the expression levels of mRAN and protein of LOX-1,collagen type I(COL-I),thioredoxin 5(TXNDC5),GSK-3β,STAT3,p-GSK-3β and p-STAT3 were detected by qRT-PCR and Western blot.Results CFs infected with LOX-1 RNAi lentiviral vector were obtained,which showed green under fluorescence microscopy.Compared with HG and HG+LV-Con groups,the mRNA expressions of LOX-1,COL-I and TXNDC5 were decreased in HG+LV-LOX-1 group(P<0.05).Compared with HG+LV-LOX-1 group,mRNA expressions of COL-I and TXNDC5 were decreased in HG+LV-LOX-1+SB216763 and HG+LV-LOX-1+STATTIC groups(P<0.05).Compared with HG and HG+LV-Con groups,p-GSK-3β protein expression was increased in HG+LV-LOX-1 group(P<0.05),while LOX-1,p-STAT3,COL-I,TXNDC5 protein expression was decreased in HG+LV-LOX-1 group(P<0.05).Compared with HG+LV-LOX-1 group,p-GSK-3β protein expression was increased in HG+LV-LOX-1+SB216763 group(P<0.05),while the protein expressions of p-STAT3,COL-I and TXNDC5 were decreased in HG+LV-LOX-1+SB216763 and HG+LV-LOX-1+STATTIC groups(P<0.05).Conclusion LOX-1,GSK-3β,STAT3,TXNDC5,and COL-I are involved in high glucose induced CFs fibrosis.LOX-1 promotes the expression of TXNDC5 and COL-I through GSK-3β/STAT3 pathway,and inhibition of LOX-1 can inhibit high glucose induced CFs fibrosis.

Purpose To investigate the clinicopathological features,diagnosis and differential diagnosis of the primordial odontogenic tumour(POT).Methods Clinical data of 4 cases of jawbone POT were collected.Imaging examination,HE,and immunohistochemical EnVision two-step staining was used to an-alyze their clinical and pathological characteristics,and relevant literatures were reviewed.Results The age arranged from 5 years to 21 years.2 cases were male and 2 case were female.There were 2 cases in maxilla and 2 cases in mandible.The clinical presentation was a slow growing painless mass.Cut sur-face of the tumor was appeared grayish yellow and grayish white,the tumor involved the crown of an unerupted tooth.The tumour consisted of a proliferation of spindled and stellate cells in myx-oid stroma.Surfaced by cuboidal to columnar epithelium forming papillary structures and invaginations.Calcification was observed in 2 cases.Conclusion POT is a rare benign mixed odontogen-ic tumor that is more common in children and adolescents.Mas-tering its characteristic histological morphology can make a cor-rect diagnosis.Local complete resection of the tumor has a good prognosis.