Objective This study aims to construct and evaluate a clinical decision support system for individualized frequency repositioning in ICU patients using big data and modern information technology,with the goal of improving ICU nursing quality.Methods From February to August 2023,a dedicated research team was established to construct a data model based on real-world data from 3,988 ICU patients,assessing the impact of different position change frequencies on the incidence of pressure injuries.Based on this model,a decision support system was designed and developed,incorporating modules for personalized patient characteristics input,data analysis and result queries,decision recording,and patient file management.From September to November 2023,ICU nurses at a tertiary hospital in Qingdao city was selected to use the system.A usability survey was conducted using the System Usability Scale(SUS)to evaluate the system's usability.Results The constructed decision support system can display the outcomes for patients under 7 different position change frequencies based on the input of personalized patient characteristics and the calculation results from the data model,providing precise decision support for nurses.A total of 85 nurses participated in the system usability evaluation,with the SUS score of 64.22±13.9.Conclusion The constructed individualized frequency of repositioning decision support system for ICU patients demonstrates good scientific validity and usability,providing clinical nurses with a valuable reference for implementing personalized position change frequencies for patients.

The application of genetic testing technologies in assisted reproduction, such as preimplantation genetic testing (PGT) and carrier screening for monogenic diseases, has provided infertile couples with more reproductive options and played a crucial role in the prevention of genetic disorders, significantly improving reproductive health. However, the widespread use of these technologies has also raised various ethical challenges, including the uncertainty of mosaic embryo transfer and its implications for reproductive rights, the cost-effectiveness debate surrounding PGT for structural rearrangement for chromosomal inversion carriers, the predictive accuracy and ethical boundaries of polygenic embryo screening, and the ethical concerns related to extensive carrier screening, such as information overload, restricted informed choice, disputes over screening scope, and disparities in healthcare access. The reproductive medicine ethics committee plays a central role in addressing these challenges by overseeing ethical reviews of technological applications, ensuring patients' informed consent, balancing technological innovation with ethical responsibility, and promoting social equity. This article explores the ethical challenges brought by the application of technologies such as PGT and carrier screening in assisted reproduction, and proposes corresponding suggestions based on ethical principles framework, in order to promote the standardized application of genetic testing technology in reproductive medicine.

The application of genetic testing technologies in assisted reproduction, such as preimplantation genetic testing (PGT) and carrier screening for monogenic diseases, has provided infertile couples with more reproductive options and played a crucial role in the prevention of genetic disorders, significantly improving reproductive health. However, the widespread use of these technologies has also raised various ethical challenges, including the uncertainty of mosaic embryo transfer and its implications for reproductive rights, the cost-effectiveness debate surrounding PGT for structural rearrangement for chromosomal inversion carriers, the predictive accuracy and ethical boundaries of polygenic embryo screening, and the ethical concerns related to extensive carrier screening, such as information overload, restricted informed choice, disputes over screening scope, and disparities in healthcare access. The reproductive medicine ethics committee plays a central role in addressing these challenges by overseeing ethical reviews of technological applications, ensuring patients' informed consent, balancing technological innovation with ethical responsibility, and promoting social equity. This article explores the ethical challenges brought by the application of technologies such as PGT and carrier screening in assisted reproduction, and proposes corresponding suggestions based on ethical principles framework, in order to promote the standardized application of genetic testing technology in reproductive medicine.

Objective This study aims to construct and evaluate a clinical decision support system for individualized frequency repositioning in ICU patients using big data and modern information technology,with the goal of improving ICU nursing quality.Methods From February to August 2023,a dedicated research team was established to construct a data model based on real-world data from 3,988 ICU patients,assessing the impact of different position change frequencies on the incidence of pressure injuries.Based on this model,a decision support system was designed and developed,incorporating modules for personalized patient characteristics input,data analysis and result queries,decision recording,and patient file management.From September to November 2023,ICU nurses at a tertiary hospital in Qingdao city was selected to use the system.A usability survey was conducted using the System Usability Scale(SUS)to evaluate the system's usability.Results The constructed decision support system can display the outcomes for patients under 7 different position change frequencies based on the input of personalized patient characteristics and the calculation results from the data model,providing precise decision support for nurses.A total of 85 nurses participated in the system usability evaluation,with the SUS score of 64.22±13.9.Conclusion The constructed individualized frequency of repositioning decision support system for ICU patients demonstrates good scientific validity and usability,providing clinical nurses with a valuable reference for implementing personalized position change frequencies for patients.

As a medicinal and edible fungus, Inonotus obliquus has a long history of folk application in Russia, Japan, and Northeast China. It is rich in terpenoids, steroids, polysaccharides, phenols, alkaloids, etc, and exhibits pharmacological activities including anti-tumor, hypoglycemic, anti-inflammatory, antioxidant, and lipid-lowering effects. Among these, lanostane-type tetracyclic triterpenes represent its characteristic constituents. This review systematically summarizes the research progress on the chemical components isolated and identified from I. obliquus and their pharmacological activities in recent years. The structures of terpenoids, steroids, and phenolic compounds are compiled and illustrated, with a particular focus on the skeletal types and structural characteristics of lanostane-type tetracyclic triterpenes. This work aims to provide some reference for the further investigation and comprehensive development and utilization of I. obliquus.

A qualitative analysis by high-performance liquid chromatography coupled with time-of-flight mass spectrometry (HPLC-QTOF-MS/MS) was performed for the identification of main constituents in Gentiana veitchiorum. High-performance liquid chromatography (HPLC) was developed for the quantification of seven major components, including loganic acid (1), swertiamarin (2), gentiopicroside (3), sweroside (4), isoorientin (5), isoscoparin (6), and gentiournoside A (7). A total of 42 compounds, including 31 flavonoids, and 11 Iridoids, were identified based on their retention behaviors, and MS fragment information. Furthermore, regression equations for these seven chemical components were established, with good linear relationships (r2 > 0.9999), and the sample recovery rate was 97.02%-103.08%. This method was successfully applied for simultaneous determination of seven components in 7 batches of G. veitchiorum samples by HPLC-UV method. The method established in this study is simple and reliable, capable of qualitatively and quantitatively analyzing the main chemical components of G. veitchiorum, and is applicable to its quality evaluation.

Objective To investigate the correlation between physical examination results and age of submariners,so as to provide scientific guidance for the health management of submariners.Methods A total of 331 submariners who underwent physical examination at a naval hospital in 2022 were selected for this research.There were 174 submariners aged≤26 years and 157 submariners aged>26 years.Physical examination results were statistically analyzed.Results Body mass index,basophil count,alanine aminotransferase,fasting blood glucose,total cholesterol,triglycerides,systolic blood pressure and diastolic blood pressure were positively correlated with age,while erythrocyte count and direct bilirubin were negatively correlated with age.The proportions of submariners aged>26 years with overweight,gallbladder polyps,elevated total cholesterol and elevated triglycerides were significantly higher than those aged≤26 years(P<0.05).The proportion of submariners aged>26 years with erythrocytosis was significantly lower than that of submariners aged≤26 years(P<0.05).Conclusion Some physical indicators of submariners are age-dependent,with older crews having higher incidences of overweight,gallbladder polyps and hyperlipidaemia.Individual health management measures should be developed for submariners with different ages.

Objective To search and summarize the de-implementation strategy of low-value care and describe the specific elements of de-implementation strategies.Methods PubMed,ProQuest,CINAHL,China Biomedical Literature Service System database,CNKI,Wanfang and VIP database were searched until May 10,2023.Literature of de-implementation strategies was screened.Specific elements of the de-implementation strategies(i.e.,actors,actions,temporality,dose,action target,affected implementation outcome and justification)were extracted.Results A total of 20 pieces of the literature were included,of which 18 used multiple strategies and 2 used single strategy.A total of 65 strategies were extracted,and the education strategy was applied 15 times,the assessment and feedback strategy were applied 14 times,and the specific elements of only 3 strategies were fully described.Conclusion Education,assessment and feedback strategies are commonly used in de-implementation of low-value care studies.Future studies should clearly describe the specific elements of de-implementation strategies,in order to promote replication,improvement,and clinical application of strategies.

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Objective To further update the evidence-based medicine evidence of clinical efficacy and safety of butylphthalide soft capsules in the treatment of Parkinson disease(PD). Methods Randomized controlled trials(RCT) on Butylphthalide soft capsules for PD was collected from PubMed,Embase,Cochrane Library,CNKI,Wanfang and CBM,the retrieval time was from inception to August 2021.The literature selection,data collection were conducted. Meta-analysis was performed by RevMan 5.3 software. Results A total of 28 studies were included and 2463 patients were included. Compared with control group,butylphthalide soft capsules could reduce UPDRS score (MD=-9.52,95%CI -11.23~-7.82,P<0.05),increase MMSE score (MD=3.40,95%CI 2.74~4.06,P<0.05) and MoCA score (MD=3.31,95%CI 3.04~3.57,P<0.05). It also could reduce CRP levels (MD=-2.37,95%CI -2.49~-2.24,P<0.05) and PARK-7 level (MD=-9.39,95%Cl -10.56~-8.22,P<0.05),increase NT-3 levels (MD=8.04,95%CI 7.01~9.07,P<0.05). However,there was no statistical difference in the number of adverse events between the treatment and control groups (RR=1.21,95%CI 0.75~1.94,P=0.43). Conclusion Butylphthalide soft capsules can improve cognitive dysfunction and other complications in Parkinson's patients,by reducing PARK-7,CRP levels and increase NT-3 levels,No serious adverse events have been observed.