Objective To explore the deeper understanding of the pregnancy and delivery experience of three-child pregnant and matemal women,and to provide a basis for healthcare personnel to provide more systematic,safe,and targeted perinatal healthcare services and care measures for three-child pregnant and matemal women.Methods Purposive sampling method was used to select 17 cases of three-child pregnant and matemal women who were admitted and delivered in a tertiary level-A matemal and child healthcare hospital in Nanjing from August 2022 to June 2023 for semi-structured interviews,and Colaizzi 7-step process of analyzing,summarizing,and refining the themes was used.Results A total of 4 themes were extracted,including determination of willingness to become pregnant,perceived risks of childbirth,perceived benefits to themselves and their families,diversified support needs.Conclusion The establishment of pregnancy intention of three-child pregnant women is affected by many factors.Relevant departments should actively implement the supporting measures of the three-child birth policy;healthcare workers should strengthen perinatal healthcare services for three-child mothers to reduce the risk of giving birth,actively strengthen their sense of benefits related to pregnancy,and establish a whole process of support system to promote the health of mothers and infants.

Objective To explore the influencing factors of family participation in medication safety of aged patients with multi-morbidity,and to provide references for clinical practice.Methods Based on capability,opportunity and motivation-behavior model,17 family caregivers of aged patients with multi-morbidity at 8 communities of Zhengzhou,Henan Province from September to November 2024 were selected for semi-structured interviews using purposive sampling method.The data were analyzed using directed content analysis.Results Facilitators of family participation behavior included ability factors(strong self-reflection and emotional regulation ability),opportunity factors(family and peer support,professional support from medical staff),motivational factors(par-ticipation in medication safety importance perception,high level of participation self-efficacy,strong sense of responsibility).Barriers of family participation behavior included ability factors(the family caregivers'own aging and disease limitations,and the family caregivers'medication safety management ability is insufficient),opportunity factors(the excessive physical and mental independence of the patients,the multiple role conflict of the family caregivers).Conclusion There are some facilitators and barriers in the process of family participation in medication safety of elderly patients with multi-morbidity.Medical staff should attach importance to family participation experience,adopt targeted strategies to promote family participation in medication safety of elderly patients with multi-morbidity,so as to promote disease recovery.

Objective To investigate the dynamic balance ability of healthy young adults under different obstacle-crossing strategies,thereby providing a theoretical basis for fall prevention training and public facility design.Methods Twenty healthy young adults participated in the experiment using F-scan plantar pressure analysis insoles.The subjects were required to cross three obstacles with different combinations of height and width.With their dominant foot serving as the leading foot and the non-dominant foot as the trailing foot,the subjects performed both lateral and forward crossing maneuvers,and their plantar pressure data were collected.Results Different crossing strategies significantly affected the adjustment speed of the leading foot's center of pressure in the medial-lateral direction(COP_ML),the area of the 95％confidence circle,ML amplitude,and anterior-posterior(AP)amplitude(P＜0.05).These strategies also significantly impacted the trailing foot's COP_ML adjustment speed,the area of the 95％confidence circle,and the range between the maximum and minimum swings(P＜0.05).For the leading foot,during lateral and forward crossing,the balance parameter values under different heights and widths were statistically significant(P＜0.05),increasing as the height and width increased.For the trailing foot,during forward crossing,the balance parameter values under different heights were statistically significant(P＜0.05),increasing with height,while during lateral crossing,the differences in balance parameter values were not statistically significant(P＞0.05).Conclusions Healthy young adults demonstrate better balance ability with the leading foot during forward obstacle crossing,which aligns with the movement habits of the dominant foot and daily activity patterns.The trailing foot exhibits a more stable plantar pressure distribution during lateral obstacle crossing,likely due to a larger contact area and more even center of gravity distribution.

Objective To investigate the dynamic balance ability of healthy young adults under different obstacle-crossing strategies,thereby providing a theoretical basis for fall prevention training and public facility design.Methods Twenty healthy young adults participated in the experiment using F-scan plantar pressure analysis insoles.The subjects were required to cross three obstacles with different combinations of height and width.With their dominant foot serving as the leading foot and the non-dominant foot as the trailing foot,the subjects performed both lateral and forward crossing maneuvers,and their plantar pressure data were collected.Results Different crossing strategies significantly affected the adjustment speed of the leading foot's center of pressure in the medial-lateral direction(COP_ML),the area of the 95％confidence circle,ML amplitude,and anterior-posterior(AP)amplitude(P＜0.05).These strategies also significantly impacted the trailing foot's COP_ML adjustment speed,the area of the 95％confidence circle,and the range between the maximum and minimum swings(P＜0.05).For the leading foot,during lateral and forward crossing,the balance parameter values under different heights and widths were statistically significant(P＜0.05),increasing as the height and width increased.For the trailing foot,during forward crossing,the balance parameter values under different heights were statistically significant(P＜0.05),increasing with height,while during lateral crossing,the differences in balance parameter values were not statistically significant(P＞0.05).Conclusions Healthy young adults demonstrate better balance ability with the leading foot during forward obstacle crossing,which aligns with the movement habits of the dominant foot and daily activity patterns.The trailing foot exhibits a more stable plantar pressure distribution during lateral obstacle crossing,likely due to a larger contact area and more even center of gravity distribution.

Objective To explore the deeper understanding of the pregnancy and delivery experience of three-child pregnant and matemal women,and to provide a basis for healthcare personnel to provide more systematic,safe,and targeted perinatal healthcare services and care measures for three-child pregnant and matemal women.Methods Purposive sampling method was used to select 17 cases of three-child pregnant and matemal women who were admitted and delivered in a tertiary level-A matemal and child healthcare hospital in Nanjing from August 2022 to June 2023 for semi-structured interviews,and Colaizzi 7-step process of analyzing,summarizing,and refining the themes was used.Results A total of 4 themes were extracted,including determination of willingness to become pregnant,perceived risks of childbirth,perceived benefits to themselves and their families,diversified support needs.Conclusion The establishment of pregnancy intention of three-child pregnant women is affected by many factors.Relevant departments should actively implement the supporting measures of the three-child birth policy;healthcare workers should strengthen perinatal healthcare services for three-child mothers to reduce the risk of giving birth,actively strengthen their sense of benefits related to pregnancy,and establish a whole process of support system to promote the health of mothers and infants.

Objective To explore the influencing factors of family participation in medication safety of aged patients with multi-morbidity,and to provide references for clinical practice.Methods Based on capability,opportunity and motivation-behavior model,17 family caregivers of aged patients with multi-morbidity at 8 communities of Zhengzhou,Henan Province from September to November 2024 were selected for semi-structured interviews using purposive sampling method.The data were analyzed using directed content analysis.Results Facilitators of family participation behavior included ability factors(strong self-reflection and emotional regulation ability),opportunity factors(family and peer support,professional support from medical staff),motivational factors(par-ticipation in medication safety importance perception,high level of participation self-efficacy,strong sense of responsibility).Barriers of family participation behavior included ability factors(the family caregivers'own aging and disease limitations,and the family caregivers'medication safety management ability is insufficient),opportunity factors(the excessive physical and mental independence of the patients,the multiple role conflict of the family caregivers).Conclusion There are some facilitators and barriers in the process of family participation in medication safety of elderly patients with multi-morbidity.Medical staff should attach importance to family participation experience,adopt targeted strategies to promote family participation in medication safety of elderly patients with multi-morbidity,so as to promote disease recovery.

Objective:To evaluate the effects of learning initiative on teaching effectiveness.Methods:The research subjects were the 2nd year medical students of Tongji Medical College of Huazhong University of Science and Technology. The learning initiative factor was calculated from the data of the attendance registration of the on-line learning of Physiology, and the performance of the on-line test was used as an evaluation indicator of teaching effectiveness. SPSS software was used to perform correlation analysis between the learning initiative factor and teaching effectiveness. Results:We found that learning initiative could significantly affect the teaching effectiveness, with differences among different specialties. There was a positive correlation between learning initiative and teaching effectiveness in clinical and pediatric medicine, while no correlation was observed in preventive medicine and medical imaging.Conclusion:In conclusion, learning initiative can affect teaching effectiveness, and the intensity of this effect shows difference among different specialties.

AIM:To explore the effect of dasatinib on the viability, migration, cell cycle and apoptosis of human bone marrow mesenchymal stem cells (hBMSCs), as well as the underlying signal pathway to evaluate the influence of dasatinib on hematopoietic microenvironment clinically.METHODS:The cell viability was measured by CCK-8 assay.The migration ability was detected by wound healing assay.The cell cycle and apoptosis were analyzed by flow cytometry.Acridine orange/ethidium bromide staining was also used to detected apoptosis.The secretion of transforming growth factor-β1 (TGF-β1) and tumor necrosis factor-α (TNF-α) were measured by ELISA.The protein levels of cleaved caspase-3, protein kinase B (Akt) and phosphorylated Akt were determined by Western blot.RESULTS:Compared with control group, dasatinib at 1~10 nmol/L suppressed the viability and migration ability of hBMSCs, and dasatinib at concentration of 7 nmol/L was adopted in the following assays.Dasatinib promoted apoptosis, and blocked the cell cycle in G1 phase.In addition, the secretion of TGF-β1 and TNF-α was increased markedly.The protein levels of cleaved caspase-3 was increased, but the protein levels of Akt and phosphorylated Akt were decreased.CONCLUSION:Dasatinib inhibits the viability and migration ability of hBMSCs in a dose-dependent manner, promotes the secretion TGF-β1 and TNF-α, and induces cell cycle arrest and apoptosis.Dasatinib might regulate the biological behaviors of hBMSCs observed above by modulating the expression and phosphorylation of Akt.

Objective:To investigate the effects of enteral immunonutrition on the intestinal barrier function and immune function in patients with severe pneumonia.Methods:Ninety patients with severe pneumonia were randomly divided into experimental group (n =45) and control group (n =45).All patients were received conventional therapy.In addition,patients in experimental group were given enteral immunonutrition,while patients in control group were given regular enteral nutrition.The changes of general conditions,intestinal barrier function index and immune function index were determined before treatment,on day 5 and 10 after treatment.The time of invasive mechanical ventilation,APACHE Ⅱ score and clinical effects of two groups were determined on day 10 after treatment.Results:Compared with those before treatment,in both groups,body temperature,respiration,heart rate,white blood cell count were all significantly decreased on day 5 and 10 after treatment (P ＜ 0.05).The above parameters were significantly lower in experimental group than control group on day 10 after treatment (P ＜ 0.05).The levels of serum ET,DAO were significantly decreased on day 5 and 10 after treatment in two groups compared with those before treatment (P ＜ 0.05),and these parameters were significantly lower in experimental group than control group(P ＜0.05).The number of CD3 and CD4 positive cell and the ratio of CD4 +/CD8 + were significantly increased on day 5 and 10 after treatment in two groups when compared with those before treatment (P ＜ 0.05),and these parameters were higher in experimental group than those in control group(P ＜ 0.05).The time of invasive mechanical ventilation,APACHE Ⅱ score were lower in experimental group than those in control group on day 10 after treatment (P ＜ 0.05).The rate of clinical response were higher in the experimental group than that in the control group on day 10 after treatment (P ＜ 0.05).Conclusion:Enteral immunonutrition is more effective in protecting the intestinal barrier function,improving the immune status,enhancing the immunity,reducing the time of invasive mechanical ventilation,and achieving the clinical effects of patients with severe pneumonia.

OBJECTIVEThis study aimed to investigate the expression function of substance P and the formation of osteoclasts in the periodontal tissues after the inferior alveolar nerve sectioned in rats.

METHODSThirty Wistar male rats were used in the experiment and were divided into six groups (n = 5) randomly: 0 d (normal), 3 d, 7 d, 14 d, 21 d, and 28 d. The periodontal tissues were removed from the denervation of the inferior alveolar nerve in rats. The periodontal tissues were checked by paraffin sections through immunohistochemical staining to trace the expression of substance P and through tratrate resistant acid phosphatase (TRAP) staining to detect the osteoclasts. The average optical density and osteoclast were measured, and the obtained data was statistically analyzed.

RESULTSThe expression level of substance P in the first three days decreased significantly after the inferior alveolar nerve was cut. In addition, the lowest expression level was measured after 7 d. Normal levels in the periodontal tissue were measured after 21 d. In addition, we found that osteoclasts vary proportionally with the changes in substance P.

CONCLUSIONThe changes in substance P is positively correlated with the quantity of osteoclasts after the inferior alveolar nerve section. Therefore, we deduce that substance P may regulate the differentiation of osteoclasts formation, and thereby participate in the balancing of aveular bone metabolism.