ObjectiveTo systematically evaluate the application of narrative education in undergraduate nursing teaching， to understand the current application status of narrative education， and to provide a theoretical basis for the subsequent establishment of a sound narrative education system. MethodsA systematic search was conducted for studies published in Chinese and English databases on applying narrative education to undergraduate nursing teaching， with the search period ranging from database inception to February 23， 2025. Literature was screened， and relevant information was extracted. A rigorous quality evaluation was conducted on the included studies， and a descriptive analysis was performed on their content. ResultsA total of 20 papers were included， involving 3，180 research subjects， all of whom were undergraduate nursing students. The results of descriptive analysis showed that the teaching model of narrative education primarily encompassed reading narrative works， watching films and videos， performing narrative scenarios， and writing reflective journals. The course setting and content covered pre-teaching preparation and in-teaching implementation. The evaluation of teaching effectiveness included the evaluation of teachers’ teaching methods （student evaluation/self-evaluation） and the evaluation of students’ learning effectiveness （course grade evaluation/humanistic care scale/empathy scale assessment， and others）. ConclusionNarrative education combines abstract concepts with concrete clinical situations， which not only enriches students’ learning experiences but also enhances their humanistic literacy. Meanwhile， it provides teachers with opportunities to develop their narrative teaching skills， which requires them to possess profound professional knowledge and employ narrative techniques to guide students in reflection and critical thinking， thereby improving teaching quality and learning outcomes. Future efforts should consistently deepen the connotation research of narrative education and build a systematic nursing education system.

Objective:To explore the correlations between the monocytes/high-density lipoprotein ratio (MHR), alkaline phosphatase (ALP), and all-cause mortality in patients undergoing maintenance peritoneal dialysis (PD), and to provide references for clinical prevention and treatment strategies.Methods:A retrospective analysis was conducted on the clinical data of 336 PD patients who were treated in the Affiliated Hospital of Jining Medical University from June 2014 to August 2023. According to the survival status of the patients during the follow-up period, they were divided into the death group ( n=55) and the survival group ( n=281). The differences in clinical data, blood routine, laboratory biochemical indicators, monocyte count, high-density lipoprotein cholesterol, and ALP indicators between the two groups were collected and compared. Multivariate Cox regression analysis was used to screen the risk factors for all-cause mortality in PD patients, and Pearson correlation analysis was used to evaluate the correlation between the survival time of patients and related indicators. Results:In this study, there were 55 patients who died of all causes. The causes of death were cardiovascular events in 26 cases (47.27%), gastrointestinal bleeding in 3 cases (5.45%), infection in 7 cases (12.73%), multiple organ failure in 8 cases (14.55%), and unexplained death in 11 cases (20.00%). There was no statistically significant difference in gender, age, weight, serum parathyroid hormone (PTH), and total cholesterol (TC) between the death group and the survival group (all P>0.05). The treatment time, neutrophil count, red blood cell volume distribution width (RDW), ALP, blood uric acid (UA), blood calcium, MHR and creatinine in the death group were all higher than those in the survival group (all P<0.05), while the lymphocyte count was lower than that in the survival group ( P<0.05). The Cox risk model showed that MHR, ALP, treatment duration, neutrophil count, lymphocyte count, RDW, UA, and creatinine were independent risk factors for all-cause mortality in PD patients ( OR=1.578, 2.881, 1.021, 1.122, 1.476, 2.231, 1.018, 1.008, all P<0.05); Pearson correlation analysis revealed that the survival time of PD patients was negatively correlated with MHR and ALP ( r=-0.305, -0.246, all P<0.05). Conclusions:The levels of MHR and ALP are closely related to the risk of all-cause mortality in PD patients and are independent risk factors for all-cause mortality in patients.

Objective:To explore the safety and short-term efficacy of single-port robotic transanal total mesorectal excision (SPr-taTME).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of six patients who underwent SPr-taTME at Daping Hospital of Army Medical University from October to November 2024 were collected. There were 3 males and 3 females, aged (65±5)years. Observation indicators: (1) intraoperative situations; (2) postoperative situations; (3) follow-up. Measurement data with normal distribution were represen-ted as Mean± SD, measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Intraoperative situations. All patients successfully underwent SPr-taTME without conversion to laparotomy or blood transfusion. There was no intraoperative complication such as accidental hemorrhage or adjacent organ injury. No intra-operative adverse events or mortality occurred. The operation time of the 6 patients was 286(range, 240?400)minutes. The time of transanal platform setup and robotic docking was (21±10)minutes, transanal dissection time was (97±45)minutes, and transabdominal dissection time was (90±35)minutes. The volume of intraoperative blood loss was (47±14)mL. Among the six patients, 1 case underwent synchronous transanal and transabdominal surgery, while 5 cases underwent non-synchronous procedures. Specimens were extracted transanally in 5 cases and via an auxiliary abdominal incision in 1 case. The single-port robotic platform was utilized for the abdominal surgery in 3 cases, while laparoscopy was used in 3 cases. Splenic flexure mobilization was performed in 3 cases and omitted in the other 3 cases. Three patients underwent hand-sewn sigmoid colon-anal anastomosis, 1 case underwent modified Bacon pull-through anastomosis, 1 case received stapled sigmoidorectal anastomosis, 1 case underwent sigmoid colostomy without anastomosis due to significant bowel edema. Two cases didn′t undergo intestinal stoma, 2 cases underwent virtual ileostomy, 1 case underwent ileostomy, and 1 case underwent sigmoid colostomy. (2) Postoperative situations. All patients started water drinking and out‐of‐bed activities on postoperative day 1 and liquid diet intake on postoperative day 2. The time to postoperative first flatus was 1(range, 1?3)days, and duration of postoperative hospital stay was (8±2)days.The total number of lymph nodes dissected was 13±2, with the number of positive lymph nodes as 0(range, 0?3) and the distance of distal resection margin as (23±8)mm. Pathological examination of 6 patients showed 1 case in stage T1N0, 2 cases in stage ypT0N0, 1 case in ypT1N0, 1 case in ypT3N1, and 1 case in ypT0N1. The degree of mesorectal integrity was complete in 5 patients and nearly complete in 1 patient. The surgical specimens of 6 patients showed negative in distal, proximal and circumferential margin. (3) Follow-up. All 6 patients completed the 30-day postoperative follow-up. None of the patients experienced postoperative complication such as bleeding, intestinal obstruction or anastomotic leakage. There was no readmission within 30 days after surgery. Digital rectal examination or colonoscopy on postoperative 30 day confirmed no anastomosis-related complications, including stenosis, dehiscence or anastomotic leakage. All 6 patients survived.Conclusion:The SPr-taTME is safe and feasible, with satisfactory short-term efficacy.

This study aims to explore protective effects of Lycium barbarum polysaccharides(LBP)on intestinal damage caused by lipopolysaccharide(LPS)-induced inflammatory bowel disease(IBD)in chicks.Network pharmacology was initially employed to determine the target proteins of wolfberry in the prevention and treatment of IBD.Following this,protein-protein interaction analy-sis,GO and KEGG pathway enrichment analysis,and molecular docking studies were conducted.Subsequently,an animal study was conducted:a total of 100 one-day-old male Hy-line brown lay-ing hens were randomly divided into five groups:a blank control group(CON),an LPS treatment group(LPS),a low-dose LBP group(LPS+LBP 0.25 g/L,L-LBP),a medium-dose LBP group(LPS+LBP 0.5 g/L,M-LBP),and a high-dose LBP group(LPS+LBP 1 g/L,H-LBP).Upon reac-hing 21 days old,duodenal,jejunal,ileal,and cecal tissues were collected to determine SOD and GSH-Px levels.Furthermore,the mRNA expression levels of TNF-α,AKT1,IL-6,IL-1β and TP53 in the intestinal tissues were measured using quantitative real-time PCR.The results demonstrated that network pharmacology identified 45 active ingredients in wolfberry that target 116 key protein sites,including TNF,AKT1 and IL6.The primary objectives focus on signaling pathways including AGE-RAGE,IL-17,TNF,HIF-1,and NF-κB.Molecular docking showed excellent ligand-receptor docking scores,with stable binding facilitated by hydrogen bonds and hydrophobic interactions.Compared to the LPS group,the 0.5 g/L LBP exhibited notably higher levels of SOD and T-AOC.In comparison with the LPS group,the medium and high-dose LBP experimental groups showed notably decreased the mRNA expressions of TNF-α,AKT1,IL-6,and IL-1β,while TP53 mRNA expression was significantly upregulated(P＜0.01).In summary,wolfberry exerts preventive and therapeutic effects on IBD through a multi-component,multi-target,and multi-pathway mecha-nism.

Objective:To explore the correlations between the monocytes/high-density lipoprotein ratio (MHR), alkaline phosphatase (ALP), and all-cause mortality in patients undergoing maintenance peritoneal dialysis (PD), and to provide references for clinical prevention and treatment strategies.Methods:A retrospective analysis was conducted on the clinical data of 336 PD patients who were treated in the Affiliated Hospital of Jining Medical University from June 2014 to August 2023. According to the survival status of the patients during the follow-up period, they were divided into the death group ( n=55) and the survival group ( n=281). The differences in clinical data, blood routine, laboratory biochemical indicators, monocyte count, high-density lipoprotein cholesterol, and ALP indicators between the two groups were collected and compared. Multivariate Cox regression analysis was used to screen the risk factors for all-cause mortality in PD patients, and Pearson correlation analysis was used to evaluate the correlation between the survival time of patients and related indicators. Results:In this study, there were 55 patients who died of all causes. The causes of death were cardiovascular events in 26 cases (47.27%), gastrointestinal bleeding in 3 cases (5.45%), infection in 7 cases (12.73%), multiple organ failure in 8 cases (14.55%), and unexplained death in 11 cases (20.00%). There was no statistically significant difference in gender, age, weight, serum parathyroid hormone (PTH), and total cholesterol (TC) between the death group and the survival group (all P>0.05). The treatment time, neutrophil count, red blood cell volume distribution width (RDW), ALP, blood uric acid (UA), blood calcium, MHR and creatinine in the death group were all higher than those in the survival group (all P<0.05), while the lymphocyte count was lower than that in the survival group ( P<0.05). The Cox risk model showed that MHR, ALP, treatment duration, neutrophil count, lymphocyte count, RDW, UA, and creatinine were independent risk factors for all-cause mortality in PD patients ( OR=1.578, 2.881, 1.021, 1.122, 1.476, 2.231, 1.018, 1.008, all P<0.05); Pearson correlation analysis revealed that the survival time of PD patients was negatively correlated with MHR and ALP ( r=-0.305, -0.246, all P<0.05). Conclusions:The levels of MHR and ALP are closely related to the risk of all-cause mortality in PD patients and are independent risk factors for all-cause mortality in patients.

This study aims to explore protective effects of Lycium barbarum polysaccharides(LBP)on intestinal damage caused by lipopolysaccharide(LPS)-induced inflammatory bowel disease(IBD)in chicks.Network pharmacology was initially employed to determine the target proteins of wolfberry in the prevention and treatment of IBD.Following this,protein-protein interaction analy-sis,GO and KEGG pathway enrichment analysis,and molecular docking studies were conducted.Subsequently,an animal study was conducted:a total of 100 one-day-old male Hy-line brown lay-ing hens were randomly divided into five groups:a blank control group(CON),an LPS treatment group(LPS),a low-dose LBP group(LPS+LBP 0.25 g/L,L-LBP),a medium-dose LBP group(LPS+LBP 0.5 g/L,M-LBP),and a high-dose LBP group(LPS+LBP 1 g/L,H-LBP).Upon reac-hing 21 days old,duodenal,jejunal,ileal,and cecal tissues were collected to determine SOD and GSH-Px levels.Furthermore,the mRNA expression levels of TNF-α,AKT1,IL-6,IL-1β and TP53 in the intestinal tissues were measured using quantitative real-time PCR.The results demonstrated that network pharmacology identified 45 active ingredients in wolfberry that target 116 key protein sites,including TNF,AKT1 and IL6.The primary objectives focus on signaling pathways including AGE-RAGE,IL-17,TNF,HIF-1,and NF-κB.Molecular docking showed excellent ligand-receptor docking scores,with stable binding facilitated by hydrogen bonds and hydrophobic interactions.Compared to the LPS group,the 0.5 g/L LBP exhibited notably higher levels of SOD and T-AOC.In comparison with the LPS group,the medium and high-dose LBP experimental groups showed notably decreased the mRNA expressions of TNF-α,AKT1,IL-6,and IL-1β,while TP53 mRNA expression was significantly upregulated(P＜0.01).In summary,wolfberry exerts preventive and therapeutic effects on IBD through a multi-component,multi-target,and multi-pathway mecha-nism.

Objective To investigate the effect of programmed cell death-ligand 1(PD-L1)monoclonal antibody and paclitaxel(PTX)combined with lentinan(LNT)on human breast cancer MDA-MB-231 cells in vitro.Methods MDA-MB-231 cells,human peripheral blood mononuclear cells(PBMCs),and MDA-MB-231+PBMCs co-culture were randomly divided into control group,PTX group,LNT group,MPDL3280A(PD-L1 monoclonal antibody)group,PTX+LNT group,and PTX+LNT+MPDL3280A group.The cell activity was detected by CCK8.The expressions of MHC-I and PD-L1 were detected by flow cytometry.The levels of IFN-γ and TNF-α were detected by ELISA kits.Results Compared with control group,the activity of MDA-MB-231 cells was significant inhibited in PTX group,MPDL3280A group,PTX+LNT group,and PTX+LNT+MPDL3280A group(P＜0.01).LNT group and PTX+LNT+MPDL3280A group significantly promoted the immune effect of PBMCs(P＜0.05,P＜0.01).PTX+LNT+MPDL3280A group significantly inhibited the activity of MDA-MB-231cells co-cultured with PBMCs(0.56±0.16 vs.0.39±0.13,P＜0.05).Compared with the negative control,LNT significantly promoted the expression of PD-L1 in MDA-MB-231 and the secretion of IFN-γ by PBMCs(P＜0.05).Conclusion By blocking the effect between PD-L1 and PD-1,PD-L1 monoclonal antibody can improve immunity and promote the antitumor effect of PTX combined with LNT in vitro.

Based on teaching concept of outcomes-based education(OBE),teaching of immunology was reformed.In terms of theoretical teaching,author adopts diversified teaching method including generative AI-assisted differentiation pedagogy,mind map-ping combined with verbal memorization method,combination of reading literature and experimental teaching and combination of case-based learning(CBL)and problem-based learning(PBL)method.It aims to stimulate students'learning interest and promote stu-dents'active thinking.In practical teaching,validation experiment is reshaped,and practical training is connected with production line,so as to realize deep integration of theory and practice under background of intelligent animal husbandry.Results showed that stu-dents'understanding and application ability of immunology knowledge had been comprehensively improved,which greatly promoted students'subjective initiative and laid a solid foundation for training new veterinary talents with quality and high ability.

Objective:To investigate the outcomes of natural cycle (NC) and modified natural cycle (MNC) assisted reproductive technology (ART) in patients with diminished ovarian reserve (DOR), and to provide a scientific basis for individualized treatment strategies for DOR patients.Methods:A retrospective cohort analysis was performed on the clinical data of DOR patients who underwent ART at the Center for Reproductive Medicine of the Department of Obstetrics and Gynecology, Peking University Third Hospital from January 1, 2015 to December 31, 2023. Patients were divided into the NC group ( n=801) and the MNC group ( n=385) based on their treatment protocol. The primary outcomes were cycle cancellation rate and oocyte retrieval rate. Secondary outcomes included clinical pregnancy rate and live birth rate per fresh embryo transfer cycle and frozen-thawed embryo transfer cycle, cumulative pregnancy rate and cumulative live birth rate per started cycle and per transfer cycle, as well as laboratory parameters such as the number of retrieved oocytes, the number of two pronuclei (2PN) fertilized oocytes, the number of transferable embryos, and transferable embryo formation rate. Further, multivariate logistic regression was used to analyze the impact of the treatment protocol on pregnancy and live birth outcomes. Results:There were no statistically significant differences between the NC and MNC groups in terms of general characteristics such as age, body mass index, and baseline hormone levels (all P>0.05). The cycle cancellation rate was significantly higher in the NC group [19.10% (153/801)] than in the MNC group [10.65% (41/385), P<0.001], and the oocyte retrieval rate was significantly lower in the NC group [66.31% (431/650)] than in the MNC group [74.86% (259/346), P=0.005]. The number of retrieved oocytes [1 (0,1)], the number of 2PN fertilized oocytes [1 (0,1)], and the number of transferable embryos [0 (0, 1)] were also significantly lower in the NC group than in the MNC group [1 (1, 2), P<0.001; 1 (1, 1), P<0.001; 0 (0, 1), P<0.001]. However, there were no statistically significant differences in 2PN fertilization rate and transferable embryo formation rate between the NC and MNC groups (all P>0.05). In both fresh embryo transfer cycles and frozen-thawed embryo transfer cycles, there were no statistically significant differences in clinical pregnancy rate and live birth rate between the NC and MNC groups (all P>0.05). The cumulative pregnancy rate per started cycle and transfer cycle, the cumulative live birth rate per started cycle and per transfer cycle were also not significantly different between the NC and MNC groups (all P>0.05). Multivariate logistic analysis showed no significant association between NC and clinical pregnancy or live birth compared with MNC. Conclusion:While MNC to some extent reduced the cycle cancellation rate and improved oocyte retrieval rates compared with NC, it did not ultimately improve pregnancy outcomes in DOR patients.

Objective The aim of this study is to understand the quality of the medical records front page,analyze the reasons,and propose targeted measures to continuously improve the quality of medical records front page,providing accurate and reliable data assurance for the DIP model.Methods A stratified sampling method was used to select 15 020 discharged medical records from a tertiary hospital in Guangzhou from 2022 to 2023.Senior coders performed quality control on the selected medical records front page using a double-person double-quality control mode.Data collection was conducted using Microsoft Excel 2007,and statistical description was performed using SPSS 26.0.Results The defect rate of the medical records front page in the stud-ied tertiary hospital in Guangzhou was 19.91％.The defect rates for non-surgical departments and surgical departments were 17.26％and 23.40％,respectively.There were 4,121 cases(49.28％)with information system transmission errors.The main defects affecting DIP inclusion in the medical records front page were the primary surgical or operative procedure name(903 ca-ses,10.80％)and the primary diagnosis(828 cases,9.90％).Conclusion The defect rate of the medical records front page in the studied tertiary hospital in Guangzhou is at a medium-to-high level,with prominent issues of information system transmis-sion errors and defects affecting DIP inclusion.Measures such as strengthening information construction,enhancing training and communication,and organizing medical records front page knowledge competitions should be implemented to improve the quality of medical records front page.