In the contemporary medical context of alienated interpersonal relationships， narrative constitutes an important carrier for doctors to realize caring ethics for patients. Narrative nursing represents an emerging nursing research and practice paradigm that complements evidence-based nursing. It is a comprehensive thinking utilizing narrative concepts to resolve multidimensional narrative crises that occur between nurses and patients in the medical context. Focusing on the empowerment mechanism of narrative nursing， this paper elaborated the relationship between the maturity of narrative self in the nursing workplace and the regulation of occupational stress as well as the prevention of occupational burnout. It also discussed the critical role of nursing professional narrative competence in facilitating the leapfrog growth of patients’ narrative self and improving their medical experience. Furthermore， drawing on the three principles of care ethics （acceptance， relationship， and response） proposed by educational philosopher Noddings， it also elucidated the implications of caring ethics corresponding to narrative nursing， aiming to promote the high-quality development of the nursing industry.

Entrustable professional activities (EPAs) serve as a critical instrument bridging competency frameworks and clinical practice, and have garnered widespread attention in medical education both domestically and internationally. This article systematically reviews the origin, theoretical framework, and operational mechanisms of EPAs, summarizes their current application status and developmental trajectory in medical education across China and other countries, and provides an in-depth analysis of the core challenges confronting the localization of EPAs in China, including insufficient multi-center validation, lack of unified evaluation standards, poor articulation across training stages, and incomplete implementation conditions. On this basis, and in consideration of China′s medical education policy environment and practical needs, this article proposes strategic pathways for future localization efforts, with the aim of providing a reference for further research and practical promotion of EPAs in China.

Objective:To observe the efficacy of transcutaneous electrical acupoint stimulation (TEAS) when it is combined with warm moxibustion scraping therapy (WMST) in the treatment of myofascial pain syndrome (MPS) in the lumbodorsal region.Methods:A total of 112 patients with lumbodorsal MPS were randomly divided into a control group and a combination group, each of 56. All of the patients received TEAS, but those in the combined group additionally received warm moxibustion scraping therapy. The treatment consisted of 3 consecutive courses, with each course lasting 2 weeks and a 1-day rest interval between courses. Before the treatment and after completing 3 courses (post-treatment), the therapeutic effects were evaluated using traditional Chinese medicine (TCM) syndrome scores, visual analogue scale (VAS) ratings for pain, a pain rating index (PRI), present pain intensity (PPI), the Oswestry Disability Index (ODI), and the Pittsburgh Sleep Quality Index (PSQI).Results:After the treatment, significant decreases were observed in the average TCM syndrome, VAS pain, PRI, PPI, ODI and PSQI scores of both groups, but the combination group′s averages were all significantly lower than those of the control group. Efficacy among the combination group (92.9%) was significantly higher than among the controls (62.5%).Conclusions:Supplementing TEAS with warm moxibustion scraping can more effectively relieve lumbodorsal pain and dysfunction among patients with lumbodorsal MPS, and improve their sleep quality.

In the YY 0989.3-2023 standard, clause 27.106 specifies the protection test against electromagnetic interference, but it only briefly describes the test level for electromagnetic exposure, and does not detail the parameters of the torso. This study aims to explore the internal field distribution for different torso parameters under electromagnetic exposure, and explore the patterns of field distribution through modeling and simulation. The results indicate that the parameters of the torso significantly affect the internal field distribution. The findings of this study provide a basis and reference for the electromagnetic compatibility test for implantable neurostimulator products.
Electromagnetic Fields ; Implantable Neurostimulators ; Computer Simulation

OBJECTIVE To observe the effects of measures dominated by intensifying link quality on prevention and control of carbapenem-resistant Klebsiella pneumoniae(CRKP)among general ICU patients.METHODS The conventional intervention measures were taken from Jan.2016 to Oct.2020,which was assigned as the pre-inter-vention period;the intervention measures dominated by enhancement of link quality were taken for the general ICU patients(the study group)from Nov.2020 to Oct.2021,which was set as the intervention period,the inter-vention measures were taken for the neurosurgery ICU patients and the surgery ICU patients(the control group).A two-group interrupted time series of a quasi-experimental study was analyzed,and whether or not the intervention measures could reduce the incidence of CRKP hospital-associated infection among the general ICU patients was evaluated.RESULTS A total of 23 713 case-times of patients from three ICU wards were enrolled in the study.The incidence of CRKP hospital-associated infection among the general ICU patients was 4.49 cases per thousand patient-days during intervention period,3.71 cases per thousand patient-days during pre-intervention pe-riod,and there was no significant difference(u=-1.412,P=0.079);it was lower than 7.06 cases per thousand patient-days during nearly one year before the intervention period(from Nov.2019 to Oct.2020),and there was significant difference(u=3.128,P=0.002).The result of analysis of the interrupted time series showed that there was significant difference in the slope change between the study group and the control group after the inter-vention(P=0.035),indicating that the intervention measures could reduce the incidence of CRKP hospital-associ-ated infection in the study group,and there was significant difference in the changing trend between the study group and the control group.CONCLUSIONS The prevention and control measures for CRKP dominated by the link quality management can effectively reduce the incidence of CRKP hospital-associated infection among the gen-eral ICU patients.The prevention and control strategies may provide reference for prevention and control of CRKP in ICUs of other medical institutions.

Clinical teaching managers are the designers, implementers, and supervisors of clinical medical education. Their competence level directly affects the quality of hospital teaching management and clinical medical education. The competence evaluation systems for medical education managers in countries such as the United States and the United Kingdom are well-established, which provides a reference for the competence evaluation of clinical teaching managers in China. This research systematically reviews the construction process and current situation of the competence evaluation systems for medical education managers in the world, and summarizes the basis, methods, and dimensions of competence evaluation. According to the actual situation of clinical teaching management, suggestions were put forward, including developing systematic scientific evaluation tools, carrying out competence-oriented training and assessment, focusing on student-centered education, and creating a career path of sustainable development.

Objective To explore the technical characteristics and clinical application value of Endosize intelligent surgical planning software in guiding the treatment of Stanford type B aortic dissection(TBAD)with single-branch Castor stent.Methods A retrospective analysis was conducted on the clinical data of 37 patients with TBAD who were manually measured to have insufficient proximal anchoring zones.Preoperative computed tomography angiography(CTA)images of the patients were analyzed using Endosize software for precise endovascular measurements and three-dimensional visual reconstruction of the aortic anatomy in the interventional treatment area.The C-arm angle was preset,and the stent type,size,and surgical pathway were precisely planned.Intraoperatively,digital subtraction angiography(DSA)was used to verify the consistency between the preoperative plan and the actual surgical plan,and the postoperative outcomes and perioperative complications were analyzed.Comprehensive evaluation was performed in combination with early follow-up results.Results The measurement results of the Endosize software were highly consistent with DSA results.Among the 37 patients,3 had sufficient proximal anchoring zones,and 34 had insufficient proximal anchoring zones.The consistency rate between manual measurements and software measurements was 91.89%.All 34 patients with insufficient proximal anchoring zones successfully underwent treatment with single-branch Castor stent.The stent type and size planned preoperatively were completely consistent with those actu-ally used,and the technical success rate was 100%.No adverse events occurred during the perioperative period.The mean follow-up duration was(6.09±4.42)months,with no deaths during this period.All branch stents remained patent,no endoleaks occurred,thrombosis occurred in all of the dissection false lumen,and aortic morphology was remodeled.Conclusion Endosize intelligent surgical planning software can provide detailed preoperative information for endovascular treatment,and it demonstrates significant clinical application value in guiding the treatment of TBAD with insuffi-cient proximal anchoring zones using single-branch Castor stent.

OBJECTIVE To observe the effects of measures dominated by intensifying link quality on prevention and control of carbapenem-resistant Klebsiella pneumoniae(CRKP)among general ICU patients.METHODS The conventional intervention measures were taken from Jan.2016 to Oct.2020,which was assigned as the pre-inter-vention period;the intervention measures dominated by enhancement of link quality were taken for the general ICU patients(the study group)from Nov.2020 to Oct.2021,which was set as the intervention period,the inter-vention measures were taken for the neurosurgery ICU patients and the surgery ICU patients(the control group).A two-group interrupted time series of a quasi-experimental study was analyzed,and whether or not the intervention measures could reduce the incidence of CRKP hospital-associated infection among the general ICU patients was evaluated.RESULTS A total of 23 713 case-times of patients from three ICU wards were enrolled in the study.The incidence of CRKP hospital-associated infection among the general ICU patients was 4.49 cases per thousand patient-days during intervention period,3.71 cases per thousand patient-days during pre-intervention pe-riod,and there was no significant difference(u=-1.412,P=0.079);it was lower than 7.06 cases per thousand patient-days during nearly one year before the intervention period(from Nov.2019 to Oct.2020),and there was significant difference(u=3.128,P=0.002).The result of analysis of the interrupted time series showed that there was significant difference in the slope change between the study group and the control group after the inter-vention(P=0.035),indicating that the intervention measures could reduce the incidence of CRKP hospital-associ-ated infection in the study group,and there was significant difference in the changing trend between the study group and the control group.CONCLUSIONS The prevention and control measures for CRKP dominated by the link quality management can effectively reduce the incidence of CRKP hospital-associated infection among the gen-eral ICU patients.The prevention and control strategies may provide reference for prevention and control of CRKP in ICUs of other medical institutions.

Clinical teaching managers are the designers, implementers, and supervisors of clinical medical education. Their competence level directly affects the quality of hospital teaching management and clinical medical education. The competence evaluation systems for medical education managers in countries such as the United States and the United Kingdom are well-established, which provides a reference for the competence evaluation of clinical teaching managers in China. This research systematically reviews the construction process and current situation of the competence evaluation systems for medical education managers in the world, and summarizes the basis, methods, and dimensions of competence evaluation. According to the actual situation of clinical teaching management, suggestions were put forward, including developing systematic scientific evaluation tools, carrying out competence-oriented training and assessment, focusing on student-centered education, and creating a career path of sustainable development.

Objective To explore the technical characteristics and clinical application value of Endosize intelligent surgical planning software in guiding the treatment of Stanford type B aortic dissection(TBAD)with single-branch Castor stent.Methods A retrospective analysis was conducted on the clinical data of 37 patients with TBAD who were manually measured to have insufficient proximal anchoring zones.Preoperative computed tomography angiography(CTA)images of the patients were analyzed using Endosize software for precise endovascular measurements and three-dimensional visual reconstruction of the aortic anatomy in the interventional treatment area.The C-arm angle was preset,and the stent type,size,and surgical pathway were precisely planned.Intraoperatively,digital subtraction angiography(DSA)was used to verify the consistency between the preoperative plan and the actual surgical plan,and the postoperative outcomes and perioperative complications were analyzed.Comprehensive evaluation was performed in combination with early follow-up results.Results The measurement results of the Endosize software were highly consistent with DSA results.Among the 37 patients,3 had sufficient proximal anchoring zones,and 34 had insufficient proximal anchoring zones.The consistency rate between manual measurements and software measurements was 91.89%.All 34 patients with insufficient proximal anchoring zones successfully underwent treatment with single-branch Castor stent.The stent type and size planned preoperatively were completely consistent with those actu-ally used,and the technical success rate was 100%.No adverse events occurred during the perioperative period.The mean follow-up duration was(6.09±4.42)months,with no deaths during this period.All branch stents remained patent,no endoleaks occurred,thrombosis occurred in all of the dissection false lumen,and aortic morphology was remodeled.Conclusion Endosize intelligent surgical planning software can provide detailed preoperative information for endovascular treatment,and it demonstrates significant clinical application value in guiding the treatment of TBAD with insuffi-cient proximal anchoring zones using single-branch Castor stent.