ObjectiveTo systematically synthesize the illness experiences and unmet needs of patients with stroke during the rehabilitation phase. MethodsQualitative studies focusing on the illness experiences and needs of stroke patients in the rehabilitation period were retrieved from the databases of Cochrane Library, PubMed, Embase, Web of Science, CINAHL, CNKI, CBM, Wanfang data and VIP. The search timeframe was from database inception to December, 2024. Methodological quality was evaluated using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. A meta-synthesis method was adopted to categorize and integrate the findings. ResultsA total of ten studies were included. Forty-nine themes were extracted and further grouped into ten categories, which were finally integrated into three overarching themes: negative illness perceptions, multifaceted rehabilitation motivations and unmet multidimensional needs. ConclusionPatients with stroke undergo complex physical and psychological experiences during rehabilitation and present diverse and multidimensional needs.

ObjectiveTo systematically synthesize the illness experiences and unmet needs of patients with stroke during the rehabilitation phase. MethodsQualitative studies focusing on the illness experiences and needs of stroke patients in the rehabilitation period were retrieved from the databases of Cochrane Library, PubMed, Embase, Web of Science, CINAHL, CNKI, CBM, Wanfang data and VIP. The search timeframe was from database inception to December, 2024. Methodological quality was evaluated using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. A meta-synthesis method was adopted to categorize and integrate the findings. ResultsA total of ten studies were included. Forty-nine themes were extracted and further grouped into ten categories, which were finally integrated into three overarching themes: negative illness perceptions, multifaceted rehabilitation motivations and unmet multidimensional needs. ConclusionPatients with stroke undergo complex physical and psychological experiences during rehabilitation and present diverse and multidimensional needs.

ObjectiveTo systematically synthesize the illness experiences and unmet needs of patients with stroke during the rehabilitation phase. MethodsQualitative studies focusing on the illness experiences and needs of stroke patients in the rehabilitation period were retrieved from the databases of Cochrane Library, PubMed, Embase, Web of Science, CINAHL, CNKI, CBM, Wanfang data and VIP. The search timeframe was from database inception to December, 2024. Methodological quality was evaluated using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. A meta-synthesis method was adopted to categorize and integrate the findings. ResultsA total of ten studies were included. Forty-nine themes were extracted and further grouped into ten categories, which were finally integrated into three overarching themes: negative illness perceptions, multifaceted rehabilitation motivations and unmet multidimensional needs. ConclusionPatients with stroke undergo complex physical and psychological experiences during rehabilitation and present diverse and multidimensional needs.

Radiotherapy is a crucial treatment modality for head and neck tumors. However, while effectively killing tumor cells, it significantly disrupts the homeostasis of the oral microecology, which is closely associated with various complications such as radiation-induced oral mucositis. Literature review indicates that as radiotherapy doses accumulate and treatment durations extend, the richness and diversity of the oral microbiota show a declining trend, with the genus Streptococcus decreasing most markedly. In contrast, radiotherapy selectively promotes the proliferation of bacterial phyla such as Proteobacteria and Bacteroidetes, which are rich in opportunistic pathogens. Mechanistically, radiotherapy activates the nuclear factor-kappa B pathway, triggering chronic inflammation and oxidative stress, damaging the epithelial barrier, suppressing local immunity, and causing damage to organs such as the salivary glands. It can also induce systemic diseases via the oral-gut axis, forming a multi-level, interconnected pathogenic network. In terms of interventions, treatment strategies including probiotics and prebiotics have shown promising efficacy against side effects such as radiation-induced oral mucositis. Saliva-based oral microbiota transplantation is an emerging strategy that is expected to become widely utilized for restoring oral microecological balance. Existing interventions provide preliminary pathways for clinical practice, but this field still faces several key scientific questions. The association between oral microecology and systemic diseases remains largely correlative, lacking causal evidence. Furthermore, critical parameters for oral microbiota transplantation, such as donor screening criteria, transplantation protocols, and long-term safety, are not yet well-defined. Therefore, future research should focus on conducting large-scale clinical trials to establish standardized protocols and safety evaluation systems for oral microecological interventions, and explore combined treatment therapies such as probiotics, prebiotics, and microbiota transplantation to advance the development of personalized precision modulation. These will enable more effective management of radiotherapy-induced oral microecological dysbiosis and improve treatment outcomes and quality of life for patients with head and neck tumors.

Objective:To analyze the application of situational teaching method based on the OBE concept in the teaching of Emergency and Critical Care Nursing course for undergraduate nursing students,and evaluate its effect on their clinical practice and internship adaptability.Methods:The third-year nursing students from 2018 to 2021 in a university in Anhui Province were selected as the research objects.Thirty students were selected as the experimental group each academic year,and taught using situational teaching method based on the OBE concept.Another 30 students from the same academic year were selected as the control group and taught using the conventional teaching method.The course teaching evaluation and course assessment scores of the two groups were compared,and the clinical practice ability and internship adaptability were compared before and after 3 months of hospital internship.Results:There was no significant difference in the course teaching evaluation and course assessment scores between the two groups(P＞0.05).The case analysis score of the experimental group was higher than that of the control group(P＜0.01).The scores of each dimension and total score of the clinical practice ability scale after internship in the observation group were higher than those in the control group(P＜0.05),and the scores of each dimension and total score of the internship adaptability scale were also higher than those in the control group(P＜0.05).Conclusion:Based on the concept of OBE,the situational teaching method is beneficial to improving the ability of case analysis,and enhancing the clinical practice ability and internship adaptability of nursing students.

Objective:To investigate the effects of Yisui Shengxue Decoction on the regulation of Notch signaling pathway on bone marrow hematopoiesis in mice with aplastic anemia(AA).Methods:A total of 60 CByB6F1 mice were randomly divided into blank group,model group,positive control cyclosporine(CsA)group,low-dose(YSSX-L)group and high-dose(YSSX-H)group of Chinese herbal compound Yisui Shengxue Decoction,with 12 mice in each group.Except for the blank group,the mice in each group were given 5 Gy X-ray irradiation combined with tail vein infusion of lymphocytes to establish the immune-mediated AA mouse model.The low and high dose groups were given 8.6 and 17.2 g/(kg?d)of Yisui Shengxue Decoction by gavage,the model group and the blank group were given equal volume of saline by gavage,and the positive control group was given 25 mg/(kg?d)of cyclosporine by ga-vage for 14 days.The mice were tested for white blood cell count(WBC),red blood cell count(RBC),hemoglobin(Hb),platelet count(PLT)and bone marrow nucleated cell count in peripheral blood,bone marrow pathological changes and the levels of IFN-γ,IL-4 and IL-5 in peripheral serum,and T-lymphocyte transcription factors T-bet,GATA3,RORγt,FOXP3 mRNA and protein in spleen tissues,as well as the expression levels of Notch signaling pathway-related genes and protein in spleen tissues.Results:Compared with the blank group,the peripheral blood WBC,RBC,Hb,PLT,bone marrow nucleated cell count,expressions of serum IL-4,IL-5 and spleen tissue GATA3,FOXP3 mRNA and protein were significantly lower in the model group(P<0.01),and the expressions of serum IFN-γ,spleen tissue T-bet,RORγt mRNA and protein,and Notch1,Jagged1,DLL4 mRNA and protein were significantly in-creased(P<0.05).Compared with the model group,peripheral blood WBC,RBC,Hb,PLT,bone marrow nucleated cell count,ex-pressions of serum IL-4,IL-5 and spleen tissue GATA3,FOXP3 mRNA and protein were significantly higher in each intervention group(P<0.05),and the expression of serum IFN-γ and spleen tissue T-bet,RORγt mRNA and protein as well as Notch1,Jagged1,DLL4 mRNA and protein were significantly reduced(P<0.05).Conclusion:Yisui Shengxue Decoction can improve bone marrow he-matopoietic function and regulate immune disorders in AA mice,and its mechanism of action may be related to the regulation of Notch signaling pathway.

Objective To investigate the effect of atractylenolide Ⅱ regulated Yes associated protein(YAP)signaling pathway on joint function and splenic regulatory T cells(Treg)/helper T cell 17(Th17)expression in rheumatoid arthritis(RA)model rats.Methods The RA rat model was constructed,and SD rats were separated into a control group,a model group,a low-dose atractylenolide Ⅱ group(10 mg/kg/d),a high-dose atractylenolide Ⅱ group(50 mg/kg/d),and a high-dose atractylenolideⅡ+YAP activator(PY60)group.On the 1st,7th and 14th day of the dosing period,rats were weighed and the joint swelling rate was evaluated,the arthritis index was scored after administration;HE staining was applied to observe pathological changes;flow cytometry was applied to detect the proportions of Treg and Th17 cells in splenic tissue;Western blot(WB)was applied to detect the expression levels of phosphorylation(p)in metatarsal tissue-mammalian STE20-like protein kinase 1(p-MST1),MST1,phospho-large tumor suppressor gene 1(p-LATS1),LATS1,phospho-Yes associated protein(p-YAP)and YAP proteins.Results Compared with the control group,rats in the model group suffered from damage to the metatarsal cartilage tissue,resulting in weight loss and increased joint swelling rate during the administration period,during the administration period,the body weight was lower and the joint swelling rate was higher,the arthritis index score,Mankin score,proportion of spleen Th17 cells,and the expression level of metatarsal p-YAP/YAP protein were higher,the proportion of Treg cells and the expression levels of p-MST1/MST1 and p-LATS1/LATS1 proteins were lower,and the differences were statistically significant(t=4.953～38.268,all P<0.05).Compared with the model group,the cartilage tissue damage in the low and high dose atractylenolide Ⅱ groups was reduced,during the administration period,the body weight was higher and the joint swelling rate was lower,the arthritis index score,Mankin score,proportion of spleen Th17 cells,and the expression level of metatarsal p-YAP/YAP protein were lower,the proportion of Treg cells and the expression levels of p-MST1/MST1 and p-LATS1/LATS1 proteins were higher,the differences were statistically significant(tlow dose=4.050～17.013,thigh dose=6.379～32.174,all P<0.05).Compared to the high-dose atractylenolide Ⅱ group,the damage to the cartilage tissue of the metatarsal bone in the high-dose atractylenolideⅡ+PY60 group was worsened,during the administration period,the body weight was lower and the joint swelling rate was higher,the arthritis index score,Mankin score,proportion of spleen Th17 cells,and the expression level of metatarsal p-YAP/YAP protein were higher,the proportion of Treg cells and the expression levels of p-MST1/MST1 and p-LATS1/LATS1 proteins were lower,and the differences were statistically significant(t=5.084～27.703,all P<0.05).Conclusion Atractylenolide Ⅱ inhibits the activation of YAP signaling pathway,regulates splenic Treg/Th17 cell balance and ameliorates disease progression in RA rats.

Animal models of TCM syndromes are the important carriers of revealing the basic theory of traditional Chinese medicine(TCM)and promoting the clinical development of TCM,and are indispensable tools to promote the modernization and internationaliza-tion of TCM.At present,the establishment methods of TCM syndrome animal model are varied and the evaluation criteria are different.Based on the main physiological functions of the five viscera,this paper summarized and analyzed the construction and evalu-ation methods of the most commonly used animal models of TCM syndromes in recent years,represented by the common clinical heart-qi deficiency syndrome,liver stagnation syndrome,spleen-qi deficiency syndrome,lung-qi deficiency syndrome and kidney-yang de-ficiency syndrome,in order to provide reference for establishing a more scientific and objective animal model construction method and evaluation system of TCM syndromes.

Objective:To comprehensively evaluate the cost and cost-effectiveness of the colorectal cancer screening program for key populations in Zhejiang Province from 2020 to 2022, and provide reference for optimizing colorectal cancer screening strategies.Methods:Based on the colorectal cancer screening program for key populations in Zhejiang Province from 2020 to 2022, parameters such as initial screening positivity rates, colonoscopy compliance rates, and detection rates for colorectal-related lesions among residents aged 50-74 were obtained. Questionnaire surveys assessed program costs and direct medical costs associated with colorectal cancer-related lesions. From a health system perspective, the cost-effectiveness ratio was calculated using the Early Detection Cost Index (EDCI) and the cost per detected case, followed by sensitivity analysis.Results:A total of 5 881 364 screenings were completed from 2020 to 2022. The initial screening positive rate (positive for either questionnaire or fecal immunochemical testing ) was 16.83%, with a colonoscopy compliance rates of 33.96% ( n=336 150). Detection rates for non-advanced adenomas, advanced adenomas, and colorectal cancer were 24.83% ( n=83 453), 11.91% ( n=40 033), and 1.01% ( n=3 397), respectively. Initial screening positivity rates and detection rates increased with age, while colonoscopy compliance rates decreased with age. Cost analysis showed a total project investment of 378 730 457 yuan, with initial screening costing 146 633 103 yuan (38.72%) and diagnostic colonoscopy 232 097 354 yuan (61.28%). The average cost per initial screening and diagnostic colonoscopy was 24.93 and 690.46 yuan, respectively. Direct medical costs for non-advanced adenomas, advanced adenomas, and colorectal cancer at stages Ⅰ, Ⅱ, Ⅲ, and Ⅳ were 4 921, 8 380, 42 547, 62 156, 66 720, and 72 334 yuan, respectively. Cost-effectiveness analysis indicated that screening needed to detect one case of colorectal cancer required 1 731 people and cost 111 490 yuan; the cost per detected advanced adenoma was 9 460 yuan, and the EDCI was 0.09. Costs decreased with increasing age per detected colorectal lesion. Sensitivity analysis showed that increasing colonoscopy compliance could reduce the cost-effectiveness ratio. Conclusions:The colorectal cancer screening program for key populations in Zhejiang Province demonstrates cost-effectiveness. Improving colonoscopy compliance can enhance overall screening effectiveness and economic benefits.

Objective:To summarize assessment tools for taste dysfunction in patients with head and neck cancer and provide a reference for clinical evaluation by healthcare professionals.Methods:A computer-based search was conducted in PubMed, Web of Science, Embase, CINAHL, China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang Data, and VIP for literature on taste dysfunction in head and neck cancer from database inception to May 10, 2025.Results:A total of 31 articles were included: five on tool development, three on tool validation, five on cross-cultural adaptation, and 18 on tool application.A total of 16 assessment tools were identified overall: ten subjective instruments and six objective instruments. Reliability and validity were most commonly examined using internal consistency reliability and criterion-related validity.Conclusions:A wide variety of tools exist for assessing taste dysfunction in patients with head and neck cancer. Tool selection should be based on clinical context and patient characteristics. Future work should develop disease-specific, locally adapted instruments aligned with the features of head and neck cancer.