Objective:To construct a scientific, systematic, and clinically applicable evaluation system of quality-sensitive indicators for nursing care of patients with tracheostomy and swallowing disorders following brain injury, providing a basis for evaluating nursing care quality in this patient population.Methods:By reviewing the literature and qualitative studies, a draft evaluation indicator was formed based on nursing issues related to patients with swallowing disorders during their hospital stay, employing the "structure-process-outcome" three-dimensional quality management model as the theoretical foundation. Between July and September 2023, two rounds of Delphi method expert consultations were conducted to add, delete, and modify indicators, and the analytic hierarchy process was used to determine indicator weights.Results:A total of 18 experts participated in two rounds of consultations, with a questionnaire return rate of 18/18. All 18 experts were female, with an average age of (47.61 ± 8.17) years. The expert authority coefficients were 0.895 and 0.910, while the Kendall concordance coefficients were 0.304 and 0.138 (all P<0.001). The average importance values assigned to each level of indicators ranged from 4.28 to 5.00. The final nursing evaluation indicators for patients with tracheostomy and swallowing disorders following brain injury included 4 first-level indicators, 21 second-level indicators, and 45 third-level indicators. Conclusions:By combining evidence-based research, current situation surveys, qualitative studies, and the Delphi method, a successful nursing quality evaluation indicator system was established for patients with tracheostomy and swallowing disorders following brain injury. These indicators are scientific, systematic, and clinically operable, playing an important role in improving the quality of nursing care for patients with tracheostomy and swallowing disorders following brain injury.

Objective:To investigate the current status and influencing factors of barriers to going out among elderly patients with chronic obstructive pulmonary disease (COPD), and to provide a reference for implementing targeted preventive measures.Methods:Elderly COPD patients from the People's Hospital of Xinjiang Uygur Autonomous Region were selected between January and May 2024 by convenience sampling. A cross-sectional survey was conducted using a general information questionnaire, Scale on Barriers to Going Out for the Elderly, Perceived Isolation Scale and COPD Assessment Test (CAT).Results:A total of 270 questionnaires were distributed, with 250 valid responses, the effective response rate was 92.6%. Among the 250 elderly COPD patients, there were 124 males and 126 females, with age distributions: 116 patients aged 60-69 years, 94 aged 70-79 years, and 40 aged ≥80 years. The total score for Scale on Barriers to Going Out for the Elderly was (20.01 ± 4.09). The score on barriers to going out in elderly COPD patients were positively correlated with the Perceived Isolation Scale and CAT scores ( r = 0.456 and 0.625, both P <0.05). Multiple linear regression analysis revealed that age, oxygen therapy, exercise habits,Perceived Isolation Scale, and CAT score classification were the main influencing factors for barriers to going out ( t values were -2.85 to 8.93, all P<0.05), explaining 63.0% of the total variance. Conclusions:The level of barriers to going out in elderly COPD patients is moderate-to-high level. Healthcare professionals should emphasize the assessment of barriers to going out, closely monitor high-risk groups, and develop and implement interventions to prevent such barriers.

OBJECTIVE: To evaluate the dynamic changes of glucocorticoid (GC) dose and the feasibility of GC discontinuation in rheumatoid arthritis (RA) patients under the background of Chinese medicine (CM). METHODS: This multicenter retrospective cohort study included 1,196 RA patients enrolled in the China Rheumatoid Arthritis Registry of Patients with Chinese Medicine (CERTAIN) from September 1, 2019 to December 4, 2023, who initiated GC therapy. Participants were divided into the Western medicine (WM) and integrative medicine (IM, combination of CM and WM) groups based on medication regimen. Follow-up was performed at least every 3 months to assess dynamic changes in GC dose. Changes in GC dose were analyzed by generalized estimator equation, the probability of GC discontinuation was assessed using Kaplan-Meier curve, and predictors of GC discontinuation were analyzed by Cox regression. Patients with <12 months of follow-up were excluded for the sensitivity analysis. RESULTS: Among 1,196 patients (85.4% female; median age 56.4 years), 880 (73.6%) received IM. Over a median 12-month follow-up, 34.3% (410 cases) discontinued GC, with significantly higher rates in the IM group (40.8% vs. 16.1% in WM; P<0.05). GC dose declined progressively, with IM patients demonstrating faster reductions (median 3.75 mg vs. 5.00 mg in WM at 12 months; P<0.05). Multivariate Cox analysis identified age <60 years [P<0.001, hazard ratios (HR)=2.142, 95% confidence interval (CI): 1.523-3.012], IM therapy (P=0.001, HR=2.175, 95% CI: 1.369-3.456), baseline GC dose ⩽7.5 mg (P=0.003, HR=1.637, 95% CI: 1.177-2.275), and absence of non-steroidal anti-inflammatory drugs use (P=0.001, HR=2.546, 95% CI: 1.432-4.527) as significant predictors of GC discontinuation. Sensitivity analysis (545 cases) confirmed these findings. CONCLUSIONS RA patients receiving CM face difficulties in following guideline-recommended GC discontinuation protocols. IM can promote GC discontinuation and is a promising strategy to reduce GC dependency in RA management. (Trial registration: ClinicalTrials.gov, No. NCT05219214).
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Arthritis, Rheumatoid/drug therapy* ; Glucocorticoids/therapeutic use* ; Medicine, Chinese Traditional ; Retrospective Studies

Functional dyspepsia (FD), characterized by persistent or recurrent dyspeptic symptoms without identifiable organic, systemic or metabolic causes, is an increasingly recognized global health issue. The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine (TCM). The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries. To address these queries, a systematic literature search was conducted across PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Database, China Biology Medicine (SinoMed) Database, Wanfang Database, Traditional Medicine Research Data Expanded (TMRDE), and the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS). The evidence from the literature was critically appraised using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts, methodologists, pharmacologists, nursing specialists, and health economists, leveraging their collective expertise and empirical knowledge. The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects, including the pathogenesis according to TCM, diagnostic approaches, therapeutic interventions, efficacy assessments, and prognostic considerations. Please cite this article as: Zhang SS, Zhao LQ, Hou XH, Bian ZX, Zheng JH, Tian HH, Yang GH, Hong WS, He YY, Liu L, Shen H, Li YP, Xie S, Shu J, Zeng BF, Li JX, Liu Z, Xiao ZH, Xiao JD, Zheng PY, Huang SG, Chen SL, Fei GJ. International clinical practice guideline on the use of traditional Chinese medicine for functional dyspepsia (2025). J Integr Med. 2025; 23(5):502-518.
Dyspepsia/drug therapy* ; Humans ; Medicine, Chinese Traditional/methods* ; Practice Guidelines as Topic ; Drugs, Chinese Herbal/therapeutic use*

OBJECTIVE: Poxviruses are zoonotic pathogens that infect humans, mammals, vertebrates, and arthropods. However, the specific role of ticks in transmission and evolution of these viruses remains unclear. METHODS: Transcriptomic and metatranscriptomic raw data from 329 sampling pools of seven tick species across five continents were mined to assess the diversity and abundance of poxviruses. Chordopoxviral sequences were assembled and subjected to phylogenetic analysis to trace the origins of the unblasted fragments within these sequences. RESULTS: Fifty-eight poxvirus species, representing two subfamilies and 20 genera, were identified, with 212 poxviral sequences assembled. A substantial proportion of AT-rich fragments were detected in the assembled poxviral genomes. These genomic sequences contained fragments originating from rodents, archaea, and arthropods. CONCLUSION Our findings indicate that ticks play a significant role in the transmission and evolution of poxviruses. These viruses demonstrate the capacity to modulate virulence and adaptability through horizontal gene transfer, gene recombination, and gene mutations, thereby promoting co-existence and co-evolution with their hosts. This study advances understanding of the ecological dynamics of poxvirus transmission and evolution and highlights the potential role of ticks as vectors and vessels in these processes.
Animals ; Poxviridae/physiology* ; Ticks/virology* ; Phylogeny ; Transcriptome ; Evolution, Molecular ; Poxviridae Infections/virology* ; Genome, Viral

Objective To preliminarily investigate the safety and efficacy of percutaneous microwave ab-lation(MWA)in patients with advanced breast cancer involving the skin or nipple-areola complex(NAC).Methods This study included breast cancer patients with skin or NAC involvement treated at the Fifth Medical Center of the Chinese PLA General Hospital from January 2011 to August 2024.Patients underwent percutaneous MWA with water isolation technique to protect surrounding tissues.Clinical data were retrospectively collected,and the technical success rate,complications,prognosis,patient satisfaction with breast aesthetics,and quality of life improvement were analyzed.Results A total of 19 patients(24 lesions)meeting the inclusion and ex-clusion criteria were analyzed.The cases included 4 with T4N0M0,2 with T4N1M0,3 with T4N2M0,1 with T4N3M0,1 with T4N2M1,and 8 with T4N3M1.The average diameter of the 24 lesions was(4.9±3.4)cm,with an average of(1.6±0.6)ablation sessions per lesion.The median ablation time was 36.9(26.1,61.7)minutes,and the median ablation energy was 84.2(45.6,149.2)kJ.The technical success rate was 100%.Postoperatively,7 patients(7/19,36.8%)experienced skin burns around the lesion or nipple shedding,all of which healed naturally.The median overall survival was 35.0(17.0,45.5)months,and the median recur-rence-free survival was 17.0(11.0,38.5)months.Patient satisfaction with post-treatment breast aesthetics was 89.5%,and all patients reported significant improvement in their quality of life.Conclusions Percutane-ous microwave ablation for breast cancer involving the skin or NAC was preliminary demonstrates to be safe and effective,suggesting its potential as a viable treatment option for patients with inoperable breast cancer.

Objective:To investigate the technical application pathways of artificial intelligence(AI)in laboratory information management systems(LIMS)and its role in promoting laboratory management efficiency and intelli-gence.Methods:Through the integration of traditional AI technologies(e.g.,machine learning,computer vision)with large language models,this study demonstrated the application of various AI technologies in scenarios such as intelligent Q&A for local knowledge bases,comprehensive review of inspection processes,intelligent data visualization,and image recognition.Results:Through the implementation of AI applications in laboratory settings,AI significantly enhanced management efficiency:the intelligent Q&A system achieved over 90％accuracy,auto-mated inspection processes reduced manual workload by 40％,and image recognition precision reached 89％-100％.Conclusion:AI provides efficient and precise solutions for laboratory management via multimodal integration and process optimization.Future efforts should focus on strengthening data security and model interpret-ability to promote comprehensive intelligent development.

Objective:To explore the correlation between palm temperature,disease activity,and traditional chinese medicine syndrome types in patients with rheumatoid arthritis(RA).Methods:80 RA patients(RA group)who were admitted to our hospital from April 2022 to June 2024 were selected,they were divided into high group(DAS28 score＞5.1 score)and low to moderate group(2.6 score ≤ DAS28 score≤5.1 score)according to the 28 joint disease activity scores(DAS28).70 healthy volunteers who underwent physical examinations during the same period(control group)were selected.The palm temperature,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),and DAS28 scores between the control group and RA group were compared.The palm temperature,ESR,and CRP levels between low to moderate group and high group were compared.The correlation between palm temperature and disease activity,ESR,and CRP levels in RA patients was analyzed by Pearson correlation.The distribution of traditional chinese medicine syndrome types in RA patients was observed,the palm temperature,ESR,and CRP levels of RA patients with different traditional chinese medicine syndrome types were compared.Results:The palm temperature,ESR,CRP levels,and DAS28 score in the RA group were higher than those in the control group(P＜0.05).The palm temperature,ESR,and CRP levels in the high group were higher than those in the low to moderate group(P＜0.05).Pearson correlation analysis results showed that,the palm temperature of RA patients was positively correlated with DAS28 score,ESR,and CRP levels(P＜0.05).Among 80 RA patients,there were 17 cases(21.25％)of liver and kidney deficiency syndrome,23 cases(29.02％)of cold and dampness obstruction syndrome,14 cases(17.86％)of qi and blood deficiency syndrome,17 cases(21.47％)of damp heat obstruction syndrome,and 9 cases(11.52％)of phlegm and blood stasis obstruction syndrome.The palm temperature,ESR,and CRP levels of patients with Qi and blood deficiency syndrome,liver and kidney deficiency syndrome,and phlegm and blood stasis obstruction syndrome increased in sequence and were higher than those of patients with damp heat obstruction syndrome and cold and dampness obstruction syndrome(P＜0.05).There was no statistical difference in palm temperature,ESR,and CRP levels between the groups of damp heat obstruction syndrome and cold and dampness obstruction syndrome(P＞0.05).Conclusion:There is a certain correlation between the palm temperature and disease activity and traditional chinese medicine syndrome types of RA patients.Regular observation of palm temperature,ESR,CRP levels,and DAS28 score is helpful for assessing the condition of RA patients.

Objective To understand the epidemiological characteristics and trends of postoperative pneumonia(POP)in tertiary general hospitals in Jiangsu Province,and provide theoretical basis for carrying out targeted pre-vention and control measures.Methods Surgery patients from 22 tertiary general hospitals in 12 cities in north,central,and south of Jiangsu Province from January 1,2022 to December 31,2023 were chosen as studied subjects,occurrence of POP was analyzed and compared.Results A total of 848 274 surgical procedures were performed in 22 hospitals,and 3 606 cases of POP occurred,with an incidence of 0.43％.The incidence in 2023 was 0.37％,which was lower than that in 2022(0.49％),with statistically significant difference(P＜0.001).The top three de-partments with high incidence of POP were neurosurgery(6.71％),cardiothoracic surgery(2.91％),and general surgery(0.77％).Among hospitals of different grades,the incidence of POP in tertiary first-class hospitals was 0.44％,which was higher than that in other tertiary hospitals(0.37％).There was no statistically significant difference in the incidence of POP between municipal and district/county hospitals(P＞0.05).The incidence of POP in hospitals with a bed:infection control full-time staff ratio＜200∶1 was lower than that in hospitals with the ratio ≥200∶1(0.39％vs 0.47％,P＜0.001),while the incidence of POP in hospitals with a proportion ≥30％of full-time staff being doctors was higher than that in hospitals with a proportion＜30％(0.45％vs 0.36％,P＜0.001).The incidence of POP in male patients was higher than that in female patients(0.62％vs 0.26％,P＜0.001).The incidence of POP in elderly patients aged≥65 was higher than that in patients aged＜65(0.73％vs 0.26％,P＜0.001).A total of 2 667 strains of infectious pathogens were detected,with the top three being Acine-tobacter baumannii,Klebsiella pneumoniae,and Pseudomonas aeruginosa,accounting for 28.95％,22.72％,and 15.45％,respectively.The detection rates of carbapenem-resistant Acinetobacter baumannii(CRAB),carba-penem-resistant Klebsiella pneumoniae(CRKP),and carbapenem-resistant Pseudomonas aeruginosa(CRPA)were 60.75％,21.45％,and 32.28％,respectively.The detection rate of CRKP decreased in 2023 compared with 2022,with statistically significant difference(P＜0.05).Conclusion The overall incidence of POP in tertiary general hos-pitals in Jiangsu Province is relatively low,but there are significant differences among different hospitals.There-fore,perioperative prevention and control measures should be carried out based on the epidemiological characteristics of patients.