ObjectiveTo evaluate the clinical efficacy and safety of the traditional Chinese medicine （TCM） compound Chaiqin Xiaoyong Decoction （柴芩消痈饮， CXD） combined with Jinhuang Ointment （金黄膏， JO） in treating the nodular stage of acne mastitis of liver meridian heat accumulation type. MethodsA randomized， double-blind， placebo-controlled clinical trial was conducted. A total of 108 patients with liver meridian heat accumulation type acne mastitis in the nodular stage were randomly assigned to a treatment group and a control group， with 54 patients in each group. Both groups received topical application of JO once daily at a thickness of 3~5 mm for 8 hours， along with standard nursing care. On this basis， the treatment group received oral CXD granules， while the control group received placebo granules， administered twice daily， 3 sachets per dose， for 14 consecutive days. Clinical efficacy， TCM symptom scores， nodule size， visual analogue scale （VAS） pain scores， white blood cell （WBC） count， C-reactive protein （CRP） level， and systemic immune-inflammation index （SII） were compared. At the end of treatment， efficacy and safety indicators were evaluated. A 6-month follow-up was conducted to compare the proportion of patients undergoing surgical treatment. ResultsThe total clinical efficacy rate in the treatment group was 90.38% （47/52）， significantly higher than 32.00% （16/50） in the control group （P＜0.01）. The treatment group also showed significantly lower TCM symptom scores， VAS scores， nodule size， WBC count， CRP level， and SII （P＜0.05 or P＜0.01）. During follow-up， the surgical intervention rate in the treatment group was 5.77% （3/52）， lower than 14.00% （7/50） in the control group， with a statistically significant difference （P＜0.01）. No significant abnormalities were observed in safety indicators before and after treatment in either group. ConclusionCXD effectively reduces nodule size and alleviates symptoms such as redness and pain in patients with acne mastitis of liver meridian heat accumulation type， improves TCM symptom scores， enhances overall clinical efficacy， and demonstrates good safety.

Objective To compare the stress difference of the resin with different thicknesses in the screw access hole using three-dimensional finite element method.Methods A three-dimensional finite element model of the implant at the site of the mandibular first molar was established by computer aided design(CAD)software.A static load of 200 N was applied to the resin models with different thicknesses(1,2,3,4,5 mm)to analyze the effect of thickness on the von Mises stress and shear stress of the resin.Results In a certain range,the maximum von Mises stress and the maximum shear stress of the resin decreased with the increase of the thickness.At the thickness of 1mm,the maximum von Mises stress and shear stress of the resin were 23.85 MPa and 11.82 MPa,respectively.When the thickness was 2 mm,the maximum von Mises stress and shear stress of the resin were 18.75 MPa and 9.73 MPa respectively.At the thickness of 3 mm,the maximum von Mises stress and shear stress of the resin were 17.46 MPa and 9.04 MPa,respectively.When the thickness of the resin was more than 3 mm,the stress on it was in a stable level trend.When the thickness was 4 mm,the maximum von Mises stress and shear stress of the resin were 17.38 MPa and 9.04 MPa,respectively.When the thickness was 5 mm,the maxi-mum von Mises stress and maximum shear stress of the resin were 17.18 MPa and 8.85 MPa,respectively.Conclusion When the res-in reaches a certain thickness,the stress is small and stable.This study provides a new design strategy for reducing the complications after implant restoration caused by stress fatigue of the resin.

Objective To compare the differences in stress on maxillary anterior implants and labial cortical bone under varying thicknesses of palatal bone plates through three-dimensional finite element analysis.Methods Using CBCT scan data and finite ele-ment software,a three-dimensional finite element model of maxillary central incisor implant restoration was constructed.The thickness of the palatal bone plate at the cervical region of the implant was set to 0,0.5,1.0 mm,respectively.The effects of different palatal bone plate thicknesses on the equivalent stress of the implant and the minimum principal stress(compressive stress)of the labial corti-cal bone under normal occlusal conditions were simulated.Results Under normal occlusion,when the palatal cervical bone plate thickness was 0,0.5,1.0 mm,the maximum equivalent stress of the implant was consistently located at the midline of the labial cervi-cal region at the implant-abutment interface,with values of 106.8,103.5,99.71 MPa,respectively.Meanwhile,the minimum princi-pal stress of the cortical bone appeared at the alveolar crest at the junction of the implant-abutment and labial alveolar bone,measuring 107.8,103.2,95.55 MPa,respectively.The results indicated that as the palatal cervical bone plate thickness decreased,both the maximum equivalent stress of the implant and the minimum principal stress of the labial cortical bone exhibited an increasing trend,though they remained below their respective yield strengths.Conclusion From a biomechanical perspective,maxillary anterior implant restoration remains feasible even when the thickness of the palatal bone plate at the cervical region of the implant is 0 mm.

Objective To compare the differences in stress on maxillary anterior implants and labial cortical bone under varying thicknesses of palatal bone plates through three-dimensional finite element analysis.Methods Using CBCT scan data and finite ele-ment software,a three-dimensional finite element model of maxillary central incisor implant restoration was constructed.The thickness of the palatal bone plate at the cervical region of the implant was set to 0,0.5,1.0 mm,respectively.The effects of different palatal bone plate thicknesses on the equivalent stress of the implant and the minimum principal stress(compressive stress)of the labial corti-cal bone under normal occlusal conditions were simulated.Results Under normal occlusion,when the palatal cervical bone plate thickness was 0,0.5,1.0 mm,the maximum equivalent stress of the implant was consistently located at the midline of the labial cervi-cal region at the implant-abutment interface,with values of 106.8,103.5,99.71 MPa,respectively.Meanwhile,the minimum princi-pal stress of the cortical bone appeared at the alveolar crest at the junction of the implant-abutment and labial alveolar bone,measuring 107.8,103.2,95.55 MPa,respectively.The results indicated that as the palatal cervical bone plate thickness decreased,both the maximum equivalent stress of the implant and the minimum principal stress of the labial cortical bone exhibited an increasing trend,though they remained below their respective yield strengths.Conclusion From a biomechanical perspective,maxillary anterior implant restoration remains feasible even when the thickness of the palatal bone plate at the cervical region of the implant is 0 mm.

Objective To compare the stress difference of the resin with different thicknesses in the screw access hole using three-dimensional finite element method.Methods A three-dimensional finite element model of the implant at the site of the mandibular first molar was established by computer aided design(CAD)software.A static load of 200 N was applied to the resin models with different thicknesses(1,2,3,4,5 mm)to analyze the effect of thickness on the von Mises stress and shear stress of the resin.Results In a certain range,the maximum von Mises stress and the maximum shear stress of the resin decreased with the increase of the thickness.At the thickness of 1mm,the maximum von Mises stress and shear stress of the resin were 23.85 MPa and 11.82 MPa,respectively.When the thickness was 2 mm,the maximum von Mises stress and shear stress of the resin were 18.75 MPa and 9.73 MPa respectively.At the thickness of 3 mm,the maximum von Mises stress and shear stress of the resin were 17.46 MPa and 9.04 MPa,respectively.When the thickness of the resin was more than 3 mm,the stress on it was in a stable level trend.When the thickness was 4 mm,the maximum von Mises stress and shear stress of the resin were 17.38 MPa and 9.04 MPa,respectively.When the thickness was 5 mm,the maxi-mum von Mises stress and maximum shear stress of the resin were 17.18 MPa and 8.85 MPa,respectively.Conclusion When the res-in reaches a certain thickness,the stress is small and stable.This study provides a new design strategy for reducing the complications after implant restoration caused by stress fatigue of the resin.

In this study, a new in situ film of compound iodine oral spray was prepared by in situ gel technology, which was used to exert sustained-release effect for promoting the repair of oral ulcer wounds. Firstly, the formulation and process of the spray solution were optimized according to the spray state and film-forming time. The drug-liquid mixing ratio was evaluated by film-forming time and drug film adhesion. The drug content, stability, pH, and spraying effect of compound iodine oral spray prepared by the optimal formulation were investigated; and the physicochemical properties, including film formation time, solubility, hygroscopicity, moisture retention and in vitro release of drug film were evaluated. In addition, the biocompatibility of the film-forming materials and proliferation ability of drug film were investigated by cell experiment. Through the rabbit oral ulcer model, the in vivo film-forming and repair-promoting effects of compound iodine oral spray were evaluated. The results showed that the pH of liquid A and liquid B prepared were 6.21±0.02 and 6.42±0.03, respectively, which were in line with the normal pH range of oral mucosa; liquid A and liquid B had good stability and spray state; the iodine content in solution B was (1.96±0.01) mg/mL; the in situ membrane formation time in vitro and in the oral cavity were (118.3±3.6) s and (133.3±4.6) s, respectively; the 24-hour dissolution rate was (87.31±1.74)%, the moisture absorption rate was (124.17±7.13)%, and the moisture retention rate was (26.85±2.50)%; the iodine content in the oral spray was (47.42±0.39) mg/g, with good flexibility and adhesion, as well as some slow-release effect. In cell experiment, the film-forming materials showed good biocompatibility and growth promotion ability. The results of the rabbit oral ulcer experiment showed that the compound iodine oral spray could rapidly form a film in vivo and significantly promote the repair of oral ulcer. In conclusion, the compound iodine oral spray in situ film with a stable preparation process can effectively promote the repair of oral ulcer wounds, which provides a new idea for the research of novel oral mucosa formulations, with a good prospect of transfer.

Objective To explore the objective indicators of tongue and pulse manifestations in patients with endometriosis diseases by collecting the data of tongue and pulse manifestations of patients with endometriosis diseases by digital tongue and pulse diagnostic instrument. Methods The endometriosis disease group included 72 patients with endometriosis diseases who were treated in Department of Gynecology (Professor ZHANG Tingting),Yueyang Hospital of Integrated Traditional Chinese and Western Medicine from Jun. 1,2021 to Sep. 15,2022. The normal group included 35 healthy adult women recruited by the Physical Examination Center of Shuguang Hospital,Shanghai University of Traditional Chinese Medicine. Results In terms of age,there was no significant difference between the endometriotic disease group and normal group (P>0.05). In terms of tongue color,the values of zhiCon,zhiASM,zhiENT,zhiMEAN,zhiClrB,zhiClrI,zhiClrLa,zhiClrCb,and zhiClrLb in the endometriosis disease group were significantly different from those in the normal group (all P<0.05),while there were no significant differences in the values of zhiClrR,zhiClrG,zhiClrS,zhiClrL,zhiClrY,or zhiClrCr between the 2 groups (all P>0.05). In terms of tongue coating color,the values of taiClrR,taiClrB,taiClrI,taiClrS,taiClrLa,taiClrLb,taiClrCr,and taiClrCb in the endometriosis disease group were significantly different from those in the normal group (all P<0.05),while there were no significant differences in the values of taiClrG,taiClrL,or taiClrY (all P>0.05). In terms of texture and thickness of tongue coating,there were no significant differences in the values of perAll,perPart,taiCon,taiASM,taiENT,or taiMEAN between the 2 groups (all P>0.05). In terms of pulse manifestation,the values of h3,h4,h5,t4,h3/h1,and h4/h1 in the endometriosis disease group were significantly different from those in the normal group (all P<0.05),while there were no significant differences in the values of h1,t,t1,or t5 (all P>0.05). Conclusion There are significant differences in tongue and pulse indicators between patients with endometriosis diseases and healthy individuals. It can provide objective indicators for further research on the pathogenesis changes and clinical differentiation of endometriosis diseases.

Objective:To observe the clinical effect of modified orbital septum fat release in the treatment of lower eyelid relaxation with lacrimal groove deformity.Methods:From January 2019 to August 2023, 52 patients with lower eyelid relaxation and lacrimal groove deformity were treated with the procedures of modified orbital septum fat release in the First People′s Hospital of Jiande, including 5 males and 47 females. The orbicularis oculi muscle supporting ligament was sutured and fixed at the periosteum of the lower edge of the orbit to achieve anatomical reduction. Suture fixation of the free edge of the orbital septum was performed at the edge of the supporting ligament in the modified orbital septum fat release method. Following-up for 6-12 months after surgery, the complications and satisfactory rate of patients were evaluated.Results:All the incision healed well with improved skin effect, and the incision scar were almost invisible. 52 patients were followed up from 6 to 12 months; 49 patients were satisfied and 2 patients were basically satisfied with their appearance, 1 patient was not satisfied with the result. No complications such as lower eyelid ectropion, lower eyelid retraction, or eyelid ball separation occurred.Conclusions:Modified orbital septum fat release is an effective method for correction of lower eyelid relaxation with lacrimal groove deformity.

Objective:To investigate the status of clinical nurses′ professional identity, structural empowerment and psychological empowerment, analyze the correlation between professional identity and structural empowerment and psychological empowerment, and establish a multiple stepwise regression model to discuss the dependence between professional identity and structural empowerment and psychological empowerment in clinical nurses.Methods:A total of 1 008 clinical nurses from Nanjing Drum Tower Hospital, the Affiliated Hospital of Medical School of Nanjing University were selected as the subject by using the convenience sampling method. The General Information Questionnaire, Professional Identity Scale, Conditions of Work Effectiveness Scale, and Psychological Empowerment Scale were used to questionnaire.Results:The professional identity of nurses was at medium level (104.49±19.54), the total scores of structural and psychological empowerment of nurses were 60.09±13.49 and 42.59±7.31. Correlation analysis showed that the total score of professional identity of clinical nurses was positively correlated with the total score of structural empowerment, psychological empowerment and theirs dimensions ( r values were 0.436-0.715, P<0.01). Multivariate stepwise regression results showed that the nurse working years, health status self-assessment, formal empowerment, informal empowerment, work meaning, self-efficacy, work influence was the main influencing factors of nurses professional identity, which explained 60.5% of the total variation. Conclusions:Nursing managers should focus on the professional identity of clinical nurses, by optimizing the management organizational structure and pay attention to the perception of empowerment behavior to improve the comprehensive empowerment level, so as to enhance the professional identity of nurses.

Objective:To explore the incidence and degree of compassion fatigue in clinical nurses, and the effects of psychological empowerment on nurses' compassion fatigue level.Methods:A total of 1 005 clinical nurses were investigated with the general information, Chinese version of Professional Quality of Life Scale, Psychological Empowerment Scale. And the relationship between different degrees of compassion fatigue and psychological empowerment were analyzed by ordinal regression analysis.Results:The incidence of sympathetic fatigue was 93.0%,(935/1 005), mild was 53.8%(541/1 005), medium was 22.7%(228/1 005), severe was 16.5%(166/1 005). The score of Chinese version of Professional Quality of Life Scale three dimensions: compassion satisfaction, burnout, and secondary traumatic stress of clinical nurses were 34.15±5.53, 23.96±5.10, 23.73±5.92. The degree of compassion fatigue was negatively correlated with psychological empowerment score and score of each dimension( r values were 0.094-0.468, all P<0.05). The ordinal regression analysis indicated that job impact(odds ratio(OR) value was 1.095, 95% credible interval( CI) 0.094-0.236, P<0.01), self-efficacy( OR value was 0.920, 95% CI 0.250-0.054 , P<0.01) and job meaning( OR value was 0.820, 95% CI 0.431-0.240, P<0.01) were the independent risk factor of compassion fatigue level. Conclusions:The nurses mainly showed mild compassion fatigue, and main manifestation is secondary traumatic stress. The nurses who had more higher job impact scores were more likely to report higher levels of empathy fatigue, while nurses who had higher job meaning and self-efficacy scores were more likely to have low levels of empathy fatigue. Therefore, it is suggested that nursing managers should carry out timely intervention and management in accordance with the different level of compassion fatigue:improve nurses' perception of work meaning and self-efficacy, and avoid increasing workload while paying attention to the influence of work on perception level.