Objective To construct a quality evaluation index system for non-medical technical services in public hospitals,aiming to provide a more scientific and feasible basis for evaluating patient service quality.Methods Based on literature research,the SERVQUAL theory was used to preliminarily formulate a comprehensive and full-cycle evaluation index for patient service quality.The final evaluation index system was determined through expert consultation,and the Analytic Hierarchy Process was used to determine the weights of the evaluation indices.Results The questionnaire response rates for the two rounds of expert consultation were both 100％.The authority coefficients of the experts were 0.82 and 0.80,respectively,indicating a high level of expert authority.The Kendall's W coefficient increased from 0.088 to 0.107 between the two rounds,and the difference was statistically significant (P<0.001),indicating good consistency of expert opinions.The consistency results of each judgment matrix were less than 0.1,passing the consistency test.The final evaluation index system consisted of six primary indicators (tangibility,reliability,responsiveness,assurance,empathy,and continuity) and 33 secondary indicators.Conclusion The selection of evaluation indicators revolves around the core service processes of outpatient,inpatient,and other hospital services,focusing on key elements at various critical junctures that influence patient experience.The evaluation indicators aim to guide hospitals to improve not only essential needs but also desired improvements in service quality,thus promoting the continuous enhancement of hospital services.

Objective:To explore the application of three-level task-driven teaching based on motivational regulation strategy in training nurse interns in the Department of Clinical Psychology.Methods:This study included 80 nurse interns in the Department of Clinical Psychology at Zhejiang Provincial People's Hospital between June 2021 and May 2024 as research subjects. They were divided into a control group ( n=40) and an experimental group ( n=40). The control group received traditional teaching, while the experimental group received three-level task-driven teaching based on motivational regulation strategy, covering basic knowledge mastery, practical operation improvement, and comprehensive ability enhancement. Through scenario guidance and simulation exercises, the intrinsic motivation of nurse interns was stimulated. The assessment scores, self-learning ability, teaching quality, and recognition of teaching were compared between the two groups of nurse interns. Results:After teaching, the experimental group scored higher than the control group on theoretical assessment [(86.05±5.86) vs. (74.35±4.72)] and operational skill assessment [(88.18±5.67) vs. (82.65±6.09)] ( P<0.001). The total score and scores of various dimensions of teaching quality were higher in the experimental group compared to those in the control group ( P<0.001). After teaching, the total score and scores of various dimensions of self-learning ability of both groups were higher than those before teaching, and the scores were higher in the experimental group than in the control group ( P<0.05). Conclusions:The three-level task-driven teaching based on motivational regulation strategy can significantly improve the assessment scores, self-learning abilities, and teaching quality of nurse interns in the Department of Clinical Psychology. Additionally, this method can enhance their recognition of nursing internship teaching. This teaching method is worth promoting.

Objective:To investigate the application effect of a rehabilitation diary combined with self-identity psychological nursing in adolescent patients with major depressive disorder (MDD), and to provide a reference for optimizing intervention strategies for adolescent MDD.Methods:A prospective randomized controlled trial was conducted. A total of 110 adolescent patients with MDD admitted to Zhejiang Provincial People's Hospital from July 1, 2024, to January 31, 2025 were selected as research subjects by continuous sampling method. Fifty-five patients who received routine nursing care from July 1, 2024, to September 30, 2024, were assigned to the control group. Fifty-five patients who received a rehabilitation diary combined with self-identity psychological nursing from October 1, 2024, to January 31, 2025, were assigned to the combined group. The improvement status of MDD symptoms (Montgomery-Asberg Depression Rating Scale), interpersonal relationship (Interpersonal Relationship Assessment Scale), social function (Social Disability Screening Schedule), et al, were compared between groups.Results:A total of 110 patients were included. In the control group, there were 29 males and 26 females, aged (15.38 ± 1.35) years old. In the combined group, there were 28 males and 27 females, aged (15.17 ± 1.36) years old. Before the intervention, there were no statistically significant differences in the improvement of MDD symptoms, interpersonal relationships, and social functions between the two groups of patients (all P>0.05). After 4 and 8 weeks of intervention, the scores of the Montgomery-Asberg Depression Rating Scale and the Social Disability Screening Schedule in the combined group were 25.47 ± 4.12, 22.35 ± 4.29, 12.41 ± 1.68, 11.02 ± 1.32, respectively, which were lower than those of the control group 30.16 ± 5.32, 27.29 ± 4.61, 14.18 ± 1.32, 12.45 ± 2.27, the differences were statistically significant ( t values were 4.04-6.49, all P<0.05). After 8 weeks of intervention, the scores of interpersonal communication, interpersonal friendship, dealing with people and matters, opposite-sex interaction of the Interpersonal Relationship Assessment Scale in the combined group were 4.62 ± 0.53, 4.28 ± 0.38, 4.35 ± 0.61, 3.97 ± 0.28 respectively, which were lower than those of the control group 5.37 ± 0.41, 5.32 ± 0.79, 5.28 ± 0.53, 4.86 ± 0.64, and the differences were statistically significant ( t values were 8.30-9.45, all P<0.05). Conclusions:Rehabilitation diary combined with self-identity psychological nursing intervention for adolescent MDD patients can improve the depression symptoms, interpersonal relationship and social function, and enhance the treatment compliance and quality of life.

Objective To construct a quality evaluation index system for non-medical technical services in public hospitals,aiming to provide a more scientific and feasible basis for evaluating patient service quality.Methods Based on literature research,the SERVQUAL theory was used to preliminarily formulate a comprehensive and full-cycle evaluation index for patient service quality.The final evaluation index system was determined through expert consultation,and the Analytic Hierarchy Process was used to determine the weights of the evaluation indices.Results The questionnaire response rates for the two rounds of expert consultation were both 100％.The authority coefficients of the experts were 0.82 and 0.80,respectively,indicating a high level of expert authority.The Kendall's W coefficient increased from 0.088 to 0.107 between the two rounds,and the difference was statistically significant (P<0.001),indicating good consistency of expert opinions.The consistency results of each judgment matrix were less than 0.1,passing the consistency test.The final evaluation index system consisted of six primary indicators (tangibility,reliability,responsiveness,assurance,empathy,and continuity) and 33 secondary indicators.Conclusion The selection of evaluation indicators revolves around the core service processes of outpatient,inpatient,and other hospital services,focusing on key elements at various critical junctures that influence patient experience.The evaluation indicators aim to guide hospitals to improve not only essential needs but also desired improvements in service quality,thus promoting the continuous enhancement of hospital services.

OBJECTIVE: Exposure to polycyclic aromatic hydrocarbons (PAHs) or metal(loid)s individually has been associated with neural tube defects (NTDs). However, the impacts of PAH and metal(loid) co-exposure and potential interaction effects on NTD risk remain unclear. We conducted a case-control study in China among population with a high prevalence of NTDs to investigate the combined effects of PAH and metal(loid) exposures on the risk of NTD. METHODS: Cases included 80 women who gave birth to offspring with NTDs, whereas controls were 50 women who delivered infants with no congenital malformations. We analyzed the levels of placental PAHs using gas chromatography and mass spectrometry, PAH-DNA adducts with ³²P-post-labeling method, and metal(loid)s with an inductively coupled plasma mass spectrometer. Unconditional logistic regression was employed to estimate the associations between individual exposures and NTDs. Least absolute shrinkage and selection operator (LASSO) penalized regression models were used to select a subset of exposures, while additive interaction models were used to identify interaction effects. RESULTS: In the single-exposure models, we found that eight PAHs, PAH-DNA adducts, and 28 metal(loid)s were associated with NTDs. Pyrene, selenium, molybdenum, cadmium, uranium, and rubidium were selected through LASSO regression and were statistically associated with NTDs in the multiple-exposure models. Women with high levels of pyrene and molybdenum or pyrene and selenium exhibited significantly increased risk of having offspring with NTDs, indicating that these combinations may have synergistic effects on the risk of NTDs. CONCLUSION Our findings suggest that individual PAHs and metal(loid)s, as well as their interactions, may be associated with the risk of NTDs, which warrants further investigation.
Humans ; Neural Tube Defects/chemically induced* ; Polycyclic Aromatic Hydrocarbons/adverse effects* ; Female ; Case-Control Studies ; China/epidemiology* ; Adult ; Pregnancy ; Environmental Pollutants ; Maternal Exposure/adverse effects* ; Metals/toxicity* ; Young Adult ; Risk Factors

Objective:To explore the application of three-level task-driven teaching based on motivational regulation strategy in training nurse interns in the Department of Clinical Psychology.Methods:This study included 80 nurse interns in the Department of Clinical Psychology at Zhejiang Provincial People's Hospital between June 2021 and May 2024 as research subjects. They were divided into a control group ( n=40) and an experimental group ( n=40). The control group received traditional teaching, while the experimental group received three-level task-driven teaching based on motivational regulation strategy, covering basic knowledge mastery, practical operation improvement, and comprehensive ability enhancement. Through scenario guidance and simulation exercises, the intrinsic motivation of nurse interns was stimulated. The assessment scores, self-learning ability, teaching quality, and recognition of teaching were compared between the two groups of nurse interns. Results:After teaching, the experimental group scored higher than the control group on theoretical assessment [(86.05±5.86) vs. (74.35±4.72)] and operational skill assessment [(88.18±5.67) vs. (82.65±6.09)] ( P<0.001). The total score and scores of various dimensions of teaching quality were higher in the experimental group compared to those in the control group ( P<0.001). After teaching, the total score and scores of various dimensions of self-learning ability of both groups were higher than those before teaching, and the scores were higher in the experimental group than in the control group ( P<0.05). Conclusions:The three-level task-driven teaching based on motivational regulation strategy can significantly improve the assessment scores, self-learning abilities, and teaching quality of nurse interns in the Department of Clinical Psychology. Additionally, this method can enhance their recognition of nursing internship teaching. This teaching method is worth promoting.

Objective:To investigate the application effect of a rehabilitation diary combined with self-identity psychological nursing in adolescent patients with major depressive disorder (MDD), and to provide a reference for optimizing intervention strategies for adolescent MDD.Methods:A prospective randomized controlled trial was conducted. A total of 110 adolescent patients with MDD admitted to Zhejiang Provincial People's Hospital from July 1, 2024, to January 31, 2025 were selected as research subjects by continuous sampling method. Fifty-five patients who received routine nursing care from July 1, 2024, to September 30, 2024, were assigned to the control group. Fifty-five patients who received a rehabilitation diary combined with self-identity psychological nursing from October 1, 2024, to January 31, 2025, were assigned to the combined group. The improvement status of MDD symptoms (Montgomery-Asberg Depression Rating Scale), interpersonal relationship (Interpersonal Relationship Assessment Scale), social function (Social Disability Screening Schedule), et al, were compared between groups.Results:A total of 110 patients were included. In the control group, there were 29 males and 26 females, aged (15.38 ± 1.35) years old. In the combined group, there were 28 males and 27 females, aged (15.17 ± 1.36) years old. Before the intervention, there were no statistically significant differences in the improvement of MDD symptoms, interpersonal relationships, and social functions between the two groups of patients (all P>0.05). After 4 and 8 weeks of intervention, the scores of the Montgomery-Asberg Depression Rating Scale and the Social Disability Screening Schedule in the combined group were 25.47 ± 4.12, 22.35 ± 4.29, 12.41 ± 1.68, 11.02 ± 1.32, respectively, which were lower than those of the control group 30.16 ± 5.32, 27.29 ± 4.61, 14.18 ± 1.32, 12.45 ± 2.27, the differences were statistically significant ( t values were 4.04-6.49, all P<0.05). After 8 weeks of intervention, the scores of interpersonal communication, interpersonal friendship, dealing with people and matters, opposite-sex interaction of the Interpersonal Relationship Assessment Scale in the combined group were 4.62 ± 0.53, 4.28 ± 0.38, 4.35 ± 0.61, 3.97 ± 0.28 respectively, which were lower than those of the control group 5.37 ± 0.41, 5.32 ± 0.79, 5.28 ± 0.53, 4.86 ± 0.64, and the differences were statistically significant ( t values were 8.30-9.45, all P<0.05). Conclusions:Rehabilitation diary combined with self-identity psychological nursing intervention for adolescent MDD patients can improve the depression symptoms, interpersonal relationship and social function, and enhance the treatment compliance and quality of life.

Objective:To compare the characteristics of background mucosa, lesion features, and the efficiency of endoscopic submucosal dissection(ESD)between elderly and non-elderly patients with early gastric cancer(EGC).Methods:This study retrospectively collected data on patients with EGC who underwent ESD treatment at Beijing Hospital from April 2020 to December 2022.The clinical characteristics, background mucosa, lesion features, ESD outcomes, and pathological results of the patients were analyzed to compare the differences between elderly and non-elderly patients.Results:A total of 100 patients with EGC were selected, comprising 57 patients in the elderly group and 43 patients in the non-elderly group, with a total of 111 lesions identified(64 lesions in the elderly group and 47 lesions in the non-elderly group).The proportion of patients with a history of chronic atrophic gastritis was significantly higher in the elderly group(89.5%、51/57)compared to the non-elderly group(74.4%、32/43), with a statistically significant difference( P=0.047).Additionally, the difference in the extent of atrophy between elderly patients with EGC and their non-elderly counterparts was statistically significant( P=0.022).Among these patients, the proportion of those classified as Kimura-Takemoto C0 to C1 in the elderly group(15.6%、10/64)was lower than that in the non-elderly group(40.4%、19/47).In contrast, the proportion of patients classified as C2 to C3 in the elderly group(65.6%、42/64)was higher than that in the non-elderly group(51.1%、24/47), and the proportion of those classified as O1 to O3 in elderly patients(12.5%、8/64)was also higher than in the non-elderly group(4.3%、2/47).Furthermore, the difference in the extent of intestinal metaplasia between elderly and non-elderly patients with early gastric cancer was statistically significant( P=0.007).The overall proportion of total intestinal metaplasia in elderly patients(85.9%、55/64)was significantly higher than that in non-elderly patients(61.7%、29/47).Notably, the proportion of patients exhibiting extensive intestinal metaplasia(intestinal metaplasia present in both the gastric antrum and gastric body)was greater in the elderly group(43.8%、28/64)compared to the non-elderly group(23.4%、11/47).The Kyoto gastric cancer risk endoscopic score for elderly patients with EGC was(2.43±1.28)points, significantly higher than that of the non-elderly group(1.72±1.41)points, with a statistically significant difference observed( t=2.778, P=0.006).No statistically significant differences were observed in the proportions of total resection rates, R0 resections, curative resections, or postoperative complications following ESD when comparing elderly patients with EGC to their non-elderly counterparts. Conclusions:The proportion of extensive atrophy and intestinal metaplasia was higher in the background mucosa of elderly patients with EGC, and correspondingly, the Kyoto endoscopic gastric cancer risk score was elevated.Therefore, endoscopic examinations for elderly patients with chronic atrophic gastritis should be conducted with greater care and comprehensiveness.

Acidosis, regardless of hypoxia involvement, is recognized as a chronic and harsh tumor microenvironment (TME) that educates malignant cells to thrive and metastasize. Although overwhelming evidence supports an acidic environment as a driver or ubiquitous hallmark of cancer progression, the unrevealed core mechanisms underlying the direct effect of acidification on tumorigenesis have hindered the discovery of novel therapeutic targets and clinical therapy. Here, chemical-induced and transgenic mouse models for colon, liver and lung cancer were established, respectively. miR-7 and TGF-β2 expressions were examined in clinical tissues (n = 184). RNA-seq, miRNA-seq, proteomics, biosynthesis analyses and functional studies were performed to validate the mechanisms involved in the acidic TME-induced lung cancer metastasis. Our data show that lung cancer is sensitive to the increased acidification of TME, and acidic TME-induced lung cancer metastasis via inhibition of miR-7-5p. TGF-β2 is a direct target of miR-7-5p. The reduced expression of miR-7-5p subsequently increases the expression of TGF-β2 which enhances the metastatic potential of the lung cancer. Indeed, overexpression of miR-7-5p reduces the acidic pH-enhanced lung cancer metastasis. Furthermore, the human lung tumor samples also show a reduced miR-7-5p expression but an elevated level of activated TGF-β2; the expressions of both miR-7-5p and TGF-β2 are correlated with patients' survival. We are the first to identify the role of the miR-7/TGF-β2 axis in acidic pH-enhanced lung cancer metastasis. Our study not only delineates how acidification directly affects tumorigenesis, but also suggests miR-7 is a novel reliable biomarker for acidic TME and a novel therapeutic target for non-small cell lung cancer (NSCLC) treatment. Our study opens an avenue to explore the pH-sensitive subcellular components as novel therapeutic targets for cancer treatment.

Inhibitor of nuclear factor kappa-B kinase subunit beta (IKKβ) is one of important kinases in inflammation to phosphorylate inhibitor of nuclear factor kappa-B (IκBα) and then activate nuclear factor kappa-B (NF-κB). Inhibition of IKKβ has been a therapeutic strategy for inflammatory and autoimmune diseases. Here we report that IKKβ is constitutively activated in healthy donors and healthy Ikkβ ^C46A (cysteine 46 mutated to alanine) knock-in mice although they possess intensive IKKβ-IκBα-NF-κB signaling activation. These indicate that IKKβ activation probably plays homeostatic role instead of causing inflammation. Compared to Ikkβ ^WT littermates, lipopolysaccharides (LPS) could induce high mortality rate in Ikkβ ^C46A mice which is correlated to breaking the homeostasis by intensively activating p-IκBα-NF-κB signaling and inhibiting phosphorylation of 5' adenosine monophosphate-activated protein kinase (p-AMPK) expression. We then demonstrated that IKKβ kinase domain (KD) phosphorylates AMPKα1 via interacting with residues Thr183, Ser184, and Thr388, while IKKβ helix-loop-helix motifs is essential to phosphorylate IκBα according to the previous reports. Kinase assay further demonstrated that IKKβ simultaneously catalyzes phosphorylation of AMPK and IκBα to mediate homeostasis. Accordingly, activation of AMPK rather than inhibition of IKKβ could substantially rescue LPS-induced mortality in Ikkβ ^C46A mice by rebuilding the homeostasis. We conclude that IKKβ activates AMPK to restrict inflammation and IKKβ mediates homeostatic function in inflammation via competitively phosphorylating AMPK and IκBα.