Objective:To explore the dynamic change trajectory and influencing factors of postoperative fatigue (POF) in patients with early digestive tract cancer undergoing endoscopic submucosal dissection (ESD), so as to provide theoretical basis for individualized management of such patients.Methods:Using cross-sectional survey and convenient sampling method, the patients who underwent ESD for early cancer of digestive tract in the endoscopic center of the Second Affiliated Hospital of Zhejiang University School of Medicine from January to June 2024 were selected as the research objects. The questionnaires were conducted at 30 min, 24 h, 3 days, 5 days, 7 days after ESD with Christensen's postoperative fatigue score. Spearman test was used to analyze the correlation between pain, insomnia and POF. The latent variable growth model was used to identify the potential categories of POF trajectory, and the influencing factors were analyzed by Logistic regression.Results:A total of 232 patients were finally induded, with ages of 19-94(59.53 ± 13.29) years, including 120 males and 112 femalss. The POF level of patients with early cancer of digestive tract showed a downward trend one week after operation. Three postoperative fatigue trajectories were fitted, 9.05% in moderate or severe fatigue low-speed smooth descent group (C1 group); 32.76% in moderate fatigue first decreased quickly and then slowly group (C2 group) and 58.19% in mild fatigue continuous decline group (C3 group). The result of Logistic regression analysis showed that, compared with C1 group, people without religious beliefs were morelikely to enter C2 group [ β = 1.572, OR = 4.818(1.033 - 22.465), P<0.05]; compared with C3 group, patients with high pain level and severe insomnia degree were likely to enter C1 [ β = 2.621, 0.663, OR were 13.754(2.692 - 70.283) and 1.942(1.429 - 2.638), both P<0.05] and C2 [ β = 2.010, 0.491, OR were 7.464(1.890 - 29.482) and 1.634(1.348 - 1.982), both P<0.05] group. Conclusions:There were three potential types of POF in patients with early digestive tract cancer ESD. Medical staff should pay attention to patients with severe insomnia, intense pain and religious beliefs, and give staged fatigue assessment and individualized intervention, so as to reduce the level of POF and promote rapid recovery.

Objective To understand the experience of fall alertness in elderly patients with rheumatoid arthritis and to provide references for the development of targeted nursing intervention strategies.Methods 13 elderly patients with rheumatoid arthritis,who were admitted to the Department of Rheumatology and Immunology of a tertiary hospital in Guizhou Province from February to April 2024,were selected through purposive sampling.Phenomenological qualitative research methods were used,with semi-structured in-depth interviews.Data were analyzed using Colaizzi's seven-step method,and themes were extracted.Results 3 main themes and 9 sub-themes were identified:the process of fall risk perception(reshaping fall risk cognition,establishing emotional coping mechanism,enhancing fall alertness effect),behavioral responses to fall alertness(creating a safe living environment,regularizing daily routine plan),and needs for fall prevention support(need for fall prevention knowledge,home rehabilitation care needs,intelligent device usage needs,psychosocial support needs).Conclusion Clinical medical staff should pay attention to the transformation process of fall risk perception in elderly rheumatoid arthritis patients,accurately identify patients'fall support needs in practice,and guide patients to adopt appropriate fall alert response behaviors through innovative fall demand support interaction paths and the construction of social support network systems,in order to improve patients'fall alertness and reduce their fall risk.

Talent gather is a process of talent flow and aggregation caused by various factors.Talent gather can not only promote the high-quality development of public hospitals and the aggregation of medical resources but also enhance hospital international competitiveness to form good groups promotion effect.Besides,talent gather can also lead to decrease in management efficiency,an increase in the siphon effect of large hospitals on talents and patients,and existing systems hindering the agglomeration effect.Therefore,it is necessary to strengthen management functions and improve efficiency,to seize the opportunities and breakthroughs in institutional and mechanism reform,and solve the problem of siphoning.Enhance the adaptability of personnel management and promote the advantages of talent aggregation,and establish a talent highland in the field of life and health.

Objective To investigate the proportions of myeloid-derived suppressor cells(MDSCs)and their subsets,including poly-morphonuclear MDSCs(PMN-MDSCs),early-stage MDSCs(e-MDSCs),monocytic MDSCs(M-MDSCs),and lectin-like oxidized low-density lipoprotein receptor-1(LOX-1)positive PMN-MDSCs,in the peripheral blood of ovarian cancer(OC)patients and ana-lyze their correlations with clinicopathological parameters of the patients.Methods The proportions of MDSCs and their subsets in the peripheral blood of 38 OC patients(OC group)and 46 healthy individuals(healthy control group)were detected by flow cytometry.The levels of serum IL-10 and TGF-β were detected using ELISA.The OC group was further divided into LOX-1 high and low expres-sion subgroups based on the median proportion of LOX-1+PMN-MDSCs in MDSCs.Results The proportions of MDSCs,PMN-MDSCs,and LOX-1+PMN-MDSCs in the peripheral blood mononuclear cells(PBMCs)of the OC group were significantly higher than those in the healthy control group(U=492,P＜0.001;t=8.741,P＜0.000 1;U=223,P＜0.000 1).The proportions of M-MDSCs and e-MDSCs in the OC group were significantly lower than those in the healthy control group(t=4.366,P＜0.000 1;t=6.927,P＜0.000 1).The proportion of LOX-1+PMN-MDSCs in the lymph node metastasis group of OC patients was significantly higher than that in the non-metastasis group(t=2.249,P＜0.05).The levels of serum IL-10 and TGF-β in the OC group were significantly higher than those in the healthy control group(P＜0.05).In addition,the level of serum TGF-β in the LOX-1 high expression group was significantly higher than that in the LOX-1 low expression group(t=2.302,P＜0.05).Conclusion The proportion of LOX-1+PMN-MDSCs in the peripheral blood of OC patients is significantly increased and closely related to lymph node metastasis.

Objective:To investigate effect of hyperbaric oxygen chamber therapy at postoperative early period and its impact on the prognosis of patients with traumatic intracranial hematoma.Methods:A total of 86 patients with traumatic intracranial hematoma who admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2022 to January 2024 were retrospectively selected,and they were divided into observation group and control group according to random number table,with 43 cases in each group.All patients underwent surgery for treatment,and control group received conventional medicine treatment after surgery,while observation group received hyperbaric oxygen chamber therapy at postoperative early period on the basis of conventional medicine treatment after surgery.The clinically curative effect,cerebral hemodynamics,markers of brain injury,prognostic quality scores,and treatment safety of the two groups were assessed.Results:The total effective rate of the observation group was 93.02%,which was higher than that of the control group(x2=5.460,P<0.05).After treatment,the blood flow velocity(Vd),blood flow volume(BF)and pulsatility index(PI)of cranial arteries of the observation group were higher than those of the control group,and the resistance index(RI)of the observation group was lower than that of the control group(t=5.419,3.459,2.905,4.182,P<0.05).The levels of glial fibrillary acidic protein(GFAP),central nervous system specific protein(S100β)and neuron-specific enolase(NSE)of the observation group were lower than those of the control group after treatment(t=3.865,4.315,5.177,P<0.05).In addition,the scores of national institute of health stroke scale(NIHSS)and modified Rankin scale(mRS)of the observation group were lower than those of the control group,and the score of the comprehensive assessment questionnaire for quality of life(GQOLI-74)of the observation group were higher than those of the control group(t=4.524,5.323,3.676,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The postoperative early treatment with hyperbaric oxygen chamber for traumatic intracranial hematoma has a favorable effect,which can enhance the cerebral hemodynamics,and reduce the markers'level of brain injury,and improve the prognostic quality of life of patients.Its safety in treatment is favorable.

Objective:To explore the dual mediating effects of health belief and depression among health knowledge, social support, and health behaviors based on the capacity, opportunity, motivation-behavior (COM-B) model, and analyze the influencing factors of health behaviors in patients with ischemic stroke.Methods:This multi-center cluster sampling research recruited ischemic stroke patients ( n=1 696) who were hospitalized in neurology departments of five tertiary hospitals in Henan Province from October 2023 to October 2024. A cross-sectional investigation was conducted using the general information questionnaire, social support rating scale (SSRS), stroke prevention knowledge questionnaire(SPKQ), short form health belief model scale(SF-HBMS), health promoting lifestyle profile-Ⅱ (HPLP-Ⅱ), and patient health questionnaire-9(PHQ-9) to ultimately reveal the pathways and effect sizes among variables. Partial correlation analysis and multiple linear stepwise regression analysis were conducted to examine the relationships among social support, health knowledge, health belief, health behaviors, and depression in stroke patients by SPSS 26.0 software. Structural equation modeling was constructed using AMOS 28.0 software, and the mediating effect was tested using the Bootstrap method. Results:The scores of social support, health knowledge, health belief, and health behaviors among ischemic stroke patients were (37.46±9.94), (26.56±6.84), (75.62±12.62) and (130.79±26.27), respectively. The score of depression was 5.00 (2.00, 8.00). Health behaviors were positively correlated with health knowledge, social support, and health belief( r=0.333, 0.246, 0.267, all P<0.05), while negatively correlated with depression ( r=-0.146, P<0.05). Multiple linear stepwise regression analysis showed that health knowledge, social support, health belief, and depression were all influencing factors of health behaviors in ischemic stroke patients (all P<0.05). Health belief (effect value=0.068, 95% CI=0.048-0.093) and depression (effect value=0.009, 95% CI=0.003-0.018) both played partial mediating roles between health knowledge and health behaviors, accounting for 17.3%(0.077/0.446) of the total effect. Meanwhile, health belief (effect value=0.045, 95% CI=0.029-0.063) and depression (effect value=0.016, 95% CI=0.008-0.027) both played partial mediating roles between social support and health behaviors, accounting for 26.5%(0.061/0.230) of the total effect. Conclusion:Health knowledge and social support can not only directly influence health behaviors but also indirectly affect them through health belief and depression in patients with ischemic stroke.

BACKGROUND:Numerous clinical trials have demonstrated that hypertonic glucose prolotherapy promotes tendon injury healing,yet the underlying mechanisms remain unclear.OBJECTIVE:To investigate the effects of different concentrations of hypertonic glucose on rat behavior,cellular morphology,tendon extracellular matrix components,and growth factors.METHODS:Fifty male Sprague-Dawley rats were randomly assigned into five groups:control blank,model,5%glucose,15%glucose,and 25%glucose groups,with 10 rats in each group.(1)Modeling:Except for the control blank group,all groups received an Achilles tendon injection of type I collagenase.(2)Intervention:The control blank and model groups received no treatment.The 5%,15%,and 25%glucose groups received injections of 30 μL of 5%,15%,and 25%glucose,respectively,into the right Achilles tendon once a week for 3 weeks.(3)Assessments:Behavioral assessments,hematoxylin-eosin staining,western blot,and RT-qPCR were conducted to assess type I collagen,type III collagen,transforming growth factor β1,vascular endothelial growth factor,and SCX expression levels in tendon tissue.RESULTS AND CONCLUSION:(1)Behavioral analysis:Compared with the control blank group,the model group showed a significant reduction in 5-minute running distance(P<0.05).Compared with the model group,the 25%glucose group exhibited a significant increase in 5-minute running distance(P<0.05).(2)Compared with the control blank group,tendon tissue in the other groups showed varying degrees of collagen disarray,increased number of blood vessels,and increased number of cells.However,glucose-treated groups exhibited more orderly collagen alignment than the model group.(3)Compared with the control blank group,the mRNA expression of type I collagen α1 was reduced,and the mRNA expression of type III collagen was increased in the model group(P<0.05).Compared with the model group,the 25%glucose group exhibited increased mRNA expression of type I collagen α1,while both the 15%and 25%glucose groups showed significantly decreased mRNA expression of type III collagen and increased SCX mRNA expression(P<0.05).(4)Compared with the control group,the model group displayed reduced protein expression of type I collagen and increased protein expression of type III collagen and vascular endothelial growth factor(P<0.05).Compared with the model group,the glucose intervention groups had decreased protein expression of type III collagen,with the 25%glucose group showing increased protein expression of type I collagen and the 15%glucose group exhibiting elevated protein expression of vascular endothelial growth factor and transforming growth factor β1(P<0.05).To conclude,hypertonic glucose promotes vascular endothelial growth factor and transforming growth factor β1 expression,modulates collagen synthesis,increases the content of type I collagen,and accelerates tendon healing.Furthermore,25%hypertonic glucose concentration has the optimal intervention effect.

Objective:To explore the effectiveness of the interactive nursing guided by the Noddings' care theory in children with mycoplasma pneumonia.Methods:Convenience sampling was used to select 150 children with mycoplasma pneumonia admitted to the China-Japan Union Hospital of Jilin University from February 2020 to June 2023 and their families for the study. The simple random number table method was used to divide the research subjects into intervention group and control group of 75 cases each. Control group was treated with conventional nursing, and intervention group was given interactive nursing guided by the Noddings' care theory on the basis of control group. Treatment adherence and family care satisfaction after the intervention, quality of life and negative emotions of the children before and after the intervention were compared between the two groups.Results:After intervention, the treatment compliance and family care satisfaction of the children in intervention group were higher than those in control group, and the differences were statistically significant ( P<0.05). After intervention, the scores of the five dimensions of generalized anxiety, school anxiety, social fear, separation anxiety and somatization in the Screen for Child Anxiety Related Emotional Disorders were lower than those before intervention in both groups, the scores of the dimensions in intervention group were lower than those in control group, and the differences were statistically significant ( P<0.05). After intervention, the scores in the four domains of psychosocial functioning, physical and mental health, living environment, and life satisfaction in the Children and Adolescents' Quality of Life Scale were higher than those before intervention, the scores of all domains of the children in intervention group were higher than those in control group, and the differences were statistically significant ( P<0.05) . Conclusions:Interactive nursing guided by the Noddings' care theory in children with mycoplasma pneumonia can effectively increase treatment adherence, alleviate negative emotions and improve quality of life, and enhance the family's satisfaction with nursing care, which is worthy of clinical promotion and application.

Objective:To systematically review and evaluate prediction models for aspiration risk in enteral nutrition patients, providing a reference for the development and application of future models.Methods:Literature related to prediction models for aspiration risk in enteral nutrition patients was searched in China National Knowledge Infrastructure, Wanfang Data, China Biology Medicine disc, Web of Science, Cochrane Library, Embase, and PubMed, with the search period covering from the inception of the databases to August 30, 2024. Two researchers independently conducted literature screening and data extraction, and the PROBAST tool was used to assess the risk of bias and applicability of the included studies.Results:A total of 18 studies were included, involving 24 prediction models, with sample sizes ranging from 103 to 512 and an event rate of 9.46% to 49.87%. The top six predictive variables reported most frequently were baseline age, history of aspiration, length of nasogastric tube insertion, nutritional risk, impaired consciousness, and Acute Physiology and Chronic Health Evaluation-Ⅱscore. The area under the receiver operating characteristic curve of the models ranged from 0.756 to 0.992. Twelve studies reported model calibration, six studies conducted internal validation only, one study conducted external validation only, and four studies performed both internal and external validation. The overall applicability of the 18 studies was good, but the risk of bias was high, mainly due to improper handling of continuous variables and missing data.Conclusions:The aspiration risk prediction models developed in various studies for enteral nutrition patients show good applicability but carry a high risk of bias. Future efforts should focus on further optimizing the model construction process, internal and external validation, and result analysis to provide more reliable and scientific tools for clinical aspiration risk assessment.

Objective:To investigate influences of tetrandrine(Tet)on proliferation,apoptosis and immune escape of melanoma cells by regulating cyclic GMP-AMP synthase(cGAS)-stimulator of interferon gene(STING)signal pathway.Methods:MV3 cells were divided into NC group,Tet-L group(5 μmol/L),Tet-M group(10 μmol/L),Tet-H group(15 μmol/L),RU.521(cGAS inhibi-tor)group(1 μmol/L),Tet-H+RU.521 group(15 μmol/L+1 μmol/L).Proliferation of MV3 cells was detected by CCK-8 and plate cloning test;apoptosis of MV3 cells was detected by flow cytometry;Western blot was used to detect expressions of proliferating cell nuclear antigen(PCNA),Bcl-2-associated X protein(Bax),TGF-β,cGAS,STING proteins in MV3 cells.Cells in above groups were co-cultured with NK cells for 48 h through Transwell chamber,and named NC co-culture group,Tet-L co-culture group,Tet-M co-culture group,Tet-H co-culture group,RU.521 co-culture group,Tet-H+RU.521 co-culture group,respectively.ELISA was used to detect levels of IFN-γ and Granzyme B in supernatant of co-cultured cells;change of NK cell killing activity was detected.Results:Compared with NC group,A450,cloning rate,PCNA and TGF-β protein expressions of MV3 cells in Tet-L group,Tet-M group and Tet-H group were decreased,apoptosis rate,Bax,cGAS,STING protein expressions were increased,which was in a dose dependent man-ner,change trend of corresponding indexes in RU.521 group was contrary to the above(P<0.05);compared with NC co-culture group,levels of IFN-γ,Granzyme B and NK cell killing activity in supernatant of Tet-L co-culture group,Tet-M co-culture group and Tet-H co-culture group were increased,which was in a dose-dependent manner,change trend of corresponding indexes in RU.521 co-culture group was opposite to the above(P<0.05);RU.521 attenuated inhibition of high-dose Tet on MV3 cell proliferation,immune escape and its promotion on apoptosis.Conclusion:Tet may inhibit melanoma cell proliferation,immune escape and promote cell apoptosis by activating cGAS-STING signal pathway.