Objective Under the background of national centralized procurement,to understand the problems and needs faced by nurses in the drug identification process,and to provide a basis for formulating targeted intervention measures.Methods Nurses from a tertiary hospital in Hubei province were selected as interviewees using purposive sampling from June to September in 2024.Semi-structured interviews method were conducted with the respondents on a one-on-one basis,and the interview data were analyzed using Colaizzi's phenomenological analysis method.Results The experience of nurses in drug identification could be summarized into two themes:increased risk of drug identification errors,and bearing complex psychological burdens.The demands of nurses for drug identification could be summarized into three themes:enhancing the ability of safe identification;innovation-driven drug identification management;and optimizing the environment for medication safety.Conclusion Under the background of centralized procurement,the update pace of clinically used drugs has accelerated,which has increased the difficulty for nurses in identifying drugs,and there is a negative psychological experience during the drug identification.Nursing managers should pay attention to the experiences and needs of nurses,and start from multiple dimensions such as theoretical knowledge training,improvement of professional ethics,innovation driven drug identification and management,and optimization of drug safety environment,to help clinical nurses obtain positive experiences in drug identification,reduce the risk of drug identification errors,and enhance the safety guarantee of drug identification.

Objective:This study implemented a pulmonary rehabilitation integrated care management model based on an Internet of things platform for patients with chronic obstructive pulmonary disease (COPD) and evaluated its effectiveness to provide evidence for clinical respiratory rehabilitation practices.Methods:A quasi-experimental design was adopted. Patients from the Department of Respiratory and Critical Care Medicine at Changsha Central Hospital Affiliated to University of South China between May and December 2023 were selected via purposive sampling. Sixty COPD patients from May to August 2023 were assigned to the control group, while 60 patients from September to December 2023 were assigned to the comprehensive management group. The control group adopted routine respiratory rehabilitation management, the comprehensive management group adopted a pulmonary rehabilitation integarted care management mode based on Internet of things platform respiratory rehabilitation. Before and after 6 months of intervention, patients were assessed for respiratory rehabilitation compliance, lung function (including the percentage of forced expiratory volume in the first second to the expected value (FEV 1% pred) and the ratio of forced expiratory volume in the first second to forced vital capacity (FEV 1/FVC), 6-minute walk test (6MWT) and COPD Assessment Test (CAT). Results:Finally, 55 cases were included in the control group and 59 cases were included in the comprehensive management group. The control group included 32 males and 23 females, aged (67.31 ± 7.14) years. The comprehensive management group included 39 males and 20 females, aged (68.15 ± 6.34) years. The respiratory rehabilitation compliance score, FEV 1% pred, FEV 1/FVC, 6MWT, and CAT score of the full management group after intervention were as follows: (26.45 ± 1.51) points, (59.21 ± 6.68)%, (78.35 ± 8.01)%, (479.63 ± 54.70) m, and (12.35 ± 4.01) points, which were all better than the control group′s (15.68 ± 1.56) points, (44.09 ± 6.31)%, (68.38 ± 6.43)%, (429.82 ± 60.50) m, and (17.03 ± 4.23) points. The difference between two groups were significant ( t values were 1.83-5.24, all P<0.05). Conclusions:The pulmonary rehabilitation integarted care management model based on Internet of things platform improves patient compliance, enhances pulmonary function, enhance their activity endurance, and improve their quality of life. It is worth promoting and using in clinical practice.

Objective Under the background of national centralized procurement,to understand the problems and needs faced by nurses in the drug identification process,and to provide a basis for formulating targeted intervention measures.Methods Nurses from a tertiary hospital in Hubei province were selected as interviewees using purposive sampling from June to September in 2024.Semi-structured interviews method were conducted with the respondents on a one-on-one basis,and the interview data were analyzed using Colaizzi's phenomenological analysis method.Results The experience of nurses in drug identification could be summarized into two themes:increased risk of drug identification errors,and bearing complex psychological burdens.The demands of nurses for drug identification could be summarized into three themes:enhancing the ability of safe identification;innovation-driven drug identification management;and optimizing the environment for medication safety.Conclusion Under the background of centralized procurement,the update pace of clinically used drugs has accelerated,which has increased the difficulty for nurses in identifying drugs,and there is a negative psychological experience during the drug identification.Nursing managers should pay attention to the experiences and needs of nurses,and start from multiple dimensions such as theoretical knowledge training,improvement of professional ethics,innovation driven drug identification and management,and optimization of drug safety environment,to help clinical nurses obtain positive experiences in drug identification,reduce the risk of drug identification errors,and enhance the safety guarantee of drug identification.

Objective To investigate the influence of helical tomographic radiotherapy plans with different combinations of lead gate width,pitch and algorithms on threading effects.Methods A target model was established with a Cheese Phantom used as the simulated human body,then three lead gate widths(1.0,2.5,and 5.0 cm),six screw pitches(0.143,0.172,0.215,0.287,0.430,and 0.500)and two computational grids(Fine algorithm and Normal algorithm)were respectively combined for designing the helical tomography radiotherapy plans.The radiotherapy plans with a pitch of 0.143,0.172,0.215,0.287 or 0.430 were enrolled into an experimental group,and the plans with a pitch of 0.500 were divided into a control group.The dosimetric parameters including maximum dose(Dmax),minimum dose(Dmin)and mean dose(Dmean)of the target area PTV1 and PTV2 were evaluated by the dose volume histogram(DVH).The dose homogeneity index(HI)of the target area was calculated,and the single rotation time and total treatment time of each plan were recorded and counted.SPSS 27.0 software was used for statistical analysis.Results No significant threading effect appeared regardless of the pitch value when the lead gate width was 1.0 cm.The threading effects in the experimental group were weaker than those in the control group when the lead gate width was 2.5 or 5.0 cm.The threading effect gradually rose with the pitch increased when the lead gate width was 5.0 cm.The most significant difference was found between the threading effect in case of the screw pitch being 0.500 and that with the screw pitch being 0.143,with the differenes being statistically obvious(P<0.05).The lead gate width had significant effects on the Dmax,Dmin,Dmean and HI of PTV1 and PTV2.When the lead gate width was 5.0 cm,high HI value and uneven dose distribution were detected and lowered screw pitch weakened the threading effect.The single rotation time first remained constant and then increased with the screw pitch was enlarged,with the changing points occurring in case of the screw pitches of 0.287 and 0.430.With a certain lead gate width,the treatment time for plans was shortened with the decrease of the pitches in case of the pritches lower than 0.287,and tended to be constant after the screw pitches reached 0.287.The changes of the computational grid had no significant effects on the results of radiotherapy plans when the lead gate width and screw pitch were kept constant.Conclusion When designing a spiral tomotherapy plan with conventional doses,a lead gate width of 1.0 or 2.5 cm and a screw pitch of 0.287 or 0.430 should be selected in order to minimize the threading effect while ensuring the efficiency of plan implementation.[Chinese Medical Equipment Journal,2025,46(8):58-66]

Objective To investigate the efficacy and safety of domestic RECO flow restoration device in endovascular treatment of acute ischemic stroke(AIS)patients in a real-world setting.Methods From January 2019 to June 2021,consecutive patients with acute intracranial vessel occlusion treated with RECO device from 8 stroke centers in Jiangsu Province were analyzed retrospectively.Baseline and clinical data were collected,including age,gender,baseline modified Rankin scale(mRS)scores,National Institutes of Health stroke scale(NIHSS)score on admission,trial of Org 10172 in acute stroke treatment(TOAST)classification,responsible location of occlusion,wake-up stroke,and medical history(hypertension,diabetes mellitus,hyperlipidemia,atrial fibrillation,coronary heart disease,peripheral arterial disease),smoking,and alcohol consumption.Furthermore,surgical parameters were collected,including time indicators(intervals between symptom onset,admission,puncture and recanalization),preoperative intravenous thrombolysis,general anesthesia,combination of aspiration,number of passes,first pass effect(modified thrombolysis in cerebral infarction[mTICI]grade 3 achieved with s single stent-based thrombectomy),rescue therapy(including thrombectomy with other stents,intra-arterial urokinase thrombolysis,intra-arterial application of tirofiban,emergency angioplasty[stent implantation,balloon dilatation,balloon dilatation combined with stent implantation]),balloon guided catheter and NIHSS score at discharge.The effectiveness indicators included immediate successful recanalization after the operation(mTICI grade ≥ 2b),complete recanalization(mTICI grade 3),and a good prognosis at 90 d after the operation(mRS score ≤2).The safety indicators included symptomatic intracranial hemorrhage(sICH)within 24 h after the operation,device-related intraoperative complications(such as thrombus escape,iatrogenic dissection,bleeding at the surgical site),and all-cause mortality within 90 days after the operation.All patients were divided into the anterior circulation occlusion group and the posterior circulation occlusion group according to the location of the responsible occluded vessel,and the effectiveness and safety indexes were analyzed.Results A total of 366 patients with AIS caused by intracranial vessel occlusion who underwent mechanical thrombectomy with the domestic RECO thrombectomy stent were included.The average age was(69±11)years,with 54 patients(14.8％)over 80 years old and 221 patients(60.4％)male.There were 296 patients in the anterior circulation occlusion group and 70 patients in the posterior circulation occlusion group.(1)Immediate successful recanalization(mTICI grade≥2b)was achieved in 337 patients(92.1％),and complete recanalization was achieved in 282 patients(77.0％)immediately after the operation.The average number of thrombectomies was(1.9±1.0)times,and 141 patients(38.5％)achieved recanalization on the first attempt.9 patients(2.5％)used other stents during the operation,and 65 patients(17.8％)underwent emergency angioplasty.The incidence of sICH within 24 h after the operation was 10.9％(40/366),the good prognosis rate at 90 d after the operation was 53.6％(196/366),and the all-cause mortality rate at 90 d after the operation was 23.0％(84/366).The incidence of device-related intraoperative complications was 3.6％(13/366).The median time from arterial puncture to recanalization was 75(52,110)min,and the median time from onset to recanalization was 370(280,488)min.(2)The good prognosis rates at 90 d after the operation in the anterior and posterior circulation occlusion groups were 55.1％(163/296)and 47.1％(33/70),respectively.The immediate successful recanalization rates were 93.2％(276/296)and 87.1％(61/70),respectively.The immediate complete recanalization rates were 79.1％(234/296)and 68.6％(48/70),respectively.The incidence of sICH within 24h after the operation was 12.2％(36/296)and 5.7％(4/70),respectively.The incidence of device-related intraoperative complications was 3.7％(11/296)and 2.9％(2/70),respectively.The all-cause mortality rate within 90 d after the operation was 21.6％(64/296)and 28.6％(20/70),respectively.There were no statistically significant differences between the two groups in the above aspects(all P＞0.05).Conclusions The application of the domestic RECO thrombectomy stent in the treatment of AIS caused by intracranial vessel occlusion can effectively and safely achieve vascular recanalization.The results of this study still need to be further verified by prospective controlled studies.

Objective To investigate the impact of osteotomy mode on the callus morphology in the ex-tension area of tibial bone transfer and its efficacy.Methods The information of the patients with bone defect treated in 910 Hospital of Joint Logistics and Security Force of Chinese People's Liberation Army from May 2016 to June 2022 was collected.By comparing the general data of the patients with different osteotomy meth-ods(minimally invasive osteotomy group,subperiosteal osteotomy group and extraperiosteal osteotomy group),callus morphology in the extension area(sunken type,uniform type and protruding type),healing in-dex,Ilizarov Method Research and Application Society(ASAMI)bone healing and functional evaluation and other information,the curative effect differences of different osteotomy methods on tibial bone transfer were investigated.Results The incidence rate of sunken type of callus in the extension area was 15.8%in the mini-mally invasive osteotomy group,18.9%in the subperiosteal osteotomy group,and 14.3%in the extraperioste-al osteotomy group,with statistically significant differences among the three groups(P<0.05);in which,the incidence of sunken type of callus in the minimally invasive osteotomy group was lower than that in the subpe-riosteal osteotomy group(χ2=10.178,P=0.005),but there was no statistically significant difference when compared to the extraperiosteal osteotomy group(χ2=0.102,P=0.814),the difference betrrween the extra-periosteal osteotomy group and subperiosteal osteotomy group also had no statistical difference(χ2=0.084,P=0.772).The incidence rate of uniform type of callus in the minimally invasive osteotomy group was lower than that in the subperiosteal osteotomy group(χ2=6.579,P=0.013),but there was no statistically signifi-cant difference when compared to the extraperiosteal osteotomy group(χ2=0.443,P=0.506).The difference in the subperiosteal osteotomy group and extraperiosteal osteotomy group also had no statistically significant(χ2=2.602,P=0.107).The incidence rate of protruding type of callus in the minimally invasive osteotomy group was higher than that in the subperiosteal osteotomy group(χ2=9.795,P=0.002),and the incidence rate of protruding type of callus in the extraperiosteal osteotomy group was higher than that in the subperios-teal osteotomy group(χ2=5.170,P=0.023),however,there was no statistically significant difference be-tween the minimally invasive osteotomy group and the extraperiosteal osteotomy group(χ2=0.308,P=0.579).There were no statistically significant differences in healing index,ASAMI scores,contact point non-union,pin tract infection and refracture incidence rate rates among the three groups(P>0.05).Conclusion Sub-periosteal osteotomy in the single plane tibial bone moving does not show the expected results in favor of the extension area mineralization,on the contrary,extraperiosteal osteotomy has the similar clinical efficacy to minimally invasive osteotomy.

Objective To investigate the influence of helical tomographic radiotherapy plans with different combinations of lead gate width,pitch and algorithms on threading effects.Methods A target model was established with a Cheese Phantom used as the simulated human body,then three lead gate widths(1.0,2.5,and 5.0 cm),six screw pitches(0.143,0.172,0.215,0.287,0.430,and 0.500)and two computational grids(Fine algorithm and Normal algorithm)were respectively combined for designing the helical tomography radiotherapy plans.The radiotherapy plans with a pitch of 0.143,0.172,0.215,0.287 or 0.430 were enrolled into an experimental group,and the plans with a pitch of 0.500 were divided into a control group.The dosimetric parameters including maximum dose(Dmax),minimum dose(Dmin)and mean dose(Dmean)of the target area PTV1 and PTV2 were evaluated by the dose volume histogram(DVH).The dose homogeneity index(HI)of the target area was calculated,and the single rotation time and total treatment time of each plan were recorded and counted.SPSS 27.0 software was used for statistical analysis.Results No significant threading effect appeared regardless of the pitch value when the lead gate width was 1.0 cm.The threading effects in the experimental group were weaker than those in the control group when the lead gate width was 2.5 or 5.0 cm.The threading effect gradually rose with the pitch increased when the lead gate width was 5.0 cm.The most significant difference was found between the threading effect in case of the screw pitch being 0.500 and that with the screw pitch being 0.143,with the differenes being statistically obvious(P<0.05).The lead gate width had significant effects on the Dmax,Dmin,Dmean and HI of PTV1 and PTV2.When the lead gate width was 5.0 cm,high HI value and uneven dose distribution were detected and lowered screw pitch weakened the threading effect.The single rotation time first remained constant and then increased with the screw pitch was enlarged,with the changing points occurring in case of the screw pitches of 0.287 and 0.430.With a certain lead gate width,the treatment time for plans was shortened with the decrease of the pitches in case of the pritches lower than 0.287,and tended to be constant after the screw pitches reached 0.287.The changes of the computational grid had no significant effects on the results of radiotherapy plans when the lead gate width and screw pitch were kept constant.Conclusion When designing a spiral tomotherapy plan with conventional doses,a lead gate width of 1.0 or 2.5 cm and a screw pitch of 0.287 or 0.430 should be selected in order to minimize the threading effect while ensuring the efficiency of plan implementation.[Chinese Medical Equipment Journal,2025,46(8):58-66]

Objective: To examine the causal relationship between gut microbiota and noninfectious gastroenteritis using bidirectional Mendelian randomization (MR) approach, so as to provide the basis for the prevention and treatment of noninfectious gastroenteritis. Methods: Genome-wide association study (GWAS) data of gut microbiota were obtained from the MiBioGen database, comprising 18 340 participants. GWAS data of noninfectious gastroenteritis were obtained from the IEU OpenGWAS database, including 416 adult cases and 7 235 adult controls. The bidirectional MR analysis between gut microbiota and noninfectious gastroenteritis was conducted using inverse-variance weighted method. Sensitivity analyses were conducted using Cochran's Q test, MR-Egger regression, and the MR-PRESSO test. Results: Forward MR analyses demonstrated statistically significant associations between a higher risk of noninfectious gastroenteritis and Clostridium gangrenexotoxin genus (OR=2.201, 95%CI: 1.295-3.740) and Ruminococcaceae UCG-013 genus (OR=2.683, 95%CI: 1.258-5.720). Conversely, statistically significant associations were observed between a lower risk of noninfectious gastroenteritis and Eubacterium hallii group (OR=0.534, 95%CI: 0.307-0.927), Lachnospiraceae NK4A136 group (OR=0.490, 95%CI: 0.252-0.953), and Oxalobacter formigenes group (OR=0.561, 95%CI: 0.348-0.903). Reverse MR analysis showed no evidence for the causal association between the aforementioned five types of gut microbiota and noninfectious gastroenteritis (all P>0.05). Sensitivity analyses revealed no evidence of heterogeneity or horizontal pleiotropy (all P>0.05). Conclusion Clostridium gangrenexotoxin genus and Ruminococcaceae UCG-013 genus were risk factors for the noninfectious gastroenteritis, while Eubacterium hallii group, Lachnospiraceae NK4A136 group and Oxalobacter formigenes group were protective factors for the noninfectious gastroenteritis.

Yinyang Gongji Pills have the effects of strengthening the body resistance to eliminate pathogenic factors, removing stasis, and reducing swelling, which is a commonly used traditional Chinese medicine(TCM) formula for treating intestinal accumulation. A real-world, registered, and single-arm clinical trial was conducted to observe the clinical efficacy and safety of Yinyang Gongji Pills combined with capecitabine in the treatment of advanced colorectal cancer and analyze the clinical characteristics of the patients. A total of 60 patients with advanced colorectal cancer who refused or could not tolerate standard treatment of western medicine were included in the study. They were treated with Yinyang Gongji Pills combined with capecitabine until disease progression or intolerable adverse events occurred. The main observation indicators were progression-free survival(PFS) and safety. The treatment effects of the patients under different baseline characteristics were analyzed. The clinical trial has found that the median PFS of all enrolled patients was 7.3 months, with 30.1% of patients having a PFS exceeding 12.0 months. Layered analysis showed that the median PFS of patients with the onset site being the colon and rectum were respectively 8.4 and 4.7 months. The median PFS of patients with high, medium, and low tumor burden were respectively 7.0, 4.7, and 10.8 months. The median PFS of patients with wild-type and mutant-type RAS/BRAF were respectively 7.9 and 6.9 months. The median PFS of patients with KPS scores ≥80 and ≤70 were respectively 7.9 and 6.5 months. The median PFS of patients treated with Yinyang Gongji Pills for ≥6, 3-6, and ≤3 months were respectively 8.0, 5.2, and 4.2 months. The median PFS of patients with spleen, kidney, liver, and lung syndrome differentiation in TCM were respectively 8.3, 6.7, 7.3, and 5.6 months. The median PFS of patients with TCM pathological factors including phlegm, dampness, and blood stasis were respectively 7.0, 7.3, and 6.5 months. Common adverse reactions include anemia, decreased white blood cells, decreased appetite, fatigue, and hand foot syndrome, with incidence rates being respectively 44.2%, 34.6%, 42.3%, 32.7%, and 17.3%. The results showed that the combination of Yinyang Gongji Pills and capecitabine demonstrated potential clinical efficacy and good safety in this study. The patients have clinical characteristics such as low tumor burden, onset site at the colon, KPS scores ≥ 80, long duration of oral TCM, and TCM syndrome differentiation including spleen or liver.
Humans ; Capecitabine/adverse effects* ; Colorectal Neoplasms/mortality* ; Drugs, Chinese Herbal/adverse effects* ; Male ; Middle Aged ; Female ; Aged ; Adult ; Treatment Outcome

Colorectal cancer(CRC) is a common malignant tumor worldwide. Due to the treatment intolerance and side effects, CRC rank the top among various cancers regarding the incidence and mortality rates. Therefore, exploring new therapies is of great significance for the treatment of CRC. Aerobic glycolysis(AEG) plays an important role in the microenvironment formation, proliferation, metastasis, and recurrence of CRC and other tumor cells. It has been confirmed that intervening in the AEG pathway can effectively curb CRC. The active ingredients and compound prescriptions of traditional Chinese medicine(TCM) can effectively inhibit the proliferation, metastasis, and drug resistance and regulate the apoptosis of tumor cells by modulating AEG-associated transport proteins [eg, glucose transporters(GLUT)], key enzymes [hexokinase(HK) and phosphofructokinase(PFK)], key genes [hypoxia-inducible factor 1(HIF-1) and oncogene(c-Myc)], and signaling pathways(MET/PI3K/Akt/mTOR). Accordingly, they can treat CRC, reduce the recurrence, and improve the prognosis of CRC. Although AEG plays a key role in the development and progression of CRC, the specific mechanisms are not yet fully understood. Therefore, this article delves into the intrinsic connection of the targets and mechanisms of the AEG pathway with CRC from the perspective of tumor cell glycolysis and explores how active ingredients(oxymatrine, kaempferol, and dioscin) and compound prescriptions(Quxie Capsules, Jiedu Sangen Decoction, and Xianlian Jiedu Prescription) of TCM treat CRC by intervening in the AEG pathway. Additionally, this article explores the shortcomings in the current research, aiming to provide reliable targets and a theoretical basis for treating CRC with TCM.
Humans ; Colorectal Neoplasms/genetics* ; Drugs, Chinese Herbal/therapeutic use* ; Glycolysis/drug effects* ; Animals ; Medicine, Chinese Traditional ; Signal Transduction/drug effects*