ObjectiveTo investigate the intervention effects of modified Linggui Zhugan Tang （LGZGT） on patients with obstructive sleep apnea-hypopnea syndrome （OSAHS） of the spleen deficiency and dampness obstruction with blood stasis type， reveal its possible mechanisms， and provide a theoretical basis for the clinical treatment of OSAHS with traditional Chinese medicine （TCM）. MethodsEighty OSAHS patients with spleen deficiency and dampness obstruction with blood stasis were randomly assigned to a control group and an observation group （1∶1） using a random number table， with 40 patients in each group. The control group received standard basic treatment combined with oral Doxofylline tablets， while the observation group received standard basic treatment combined with modified LGZGT. Serum levels of macrophage migration inhibitory factor （MIF）， microRNA-223 （miR-223）， and interleukin-18 （IL-18） were measured by enzyme-linked immunosorbent assay （ELISA）， and the mRNA expression levels of MIF， miR-223， and IL-18 were measured by real-time quantitative polymerase chain reaction （Real-time PCR）. After two months of treatment， the total clinical efficacy， apnea-hypopnea index （AHI）， lowest nocturnal oxygen saturation （LSpO₂）， body mass index （BMI）， TCM syndrome scores， and expression levels of MIF， miR-223， and IL-18 before and after treatment were compared between the two groups. Correlations between MIF， miR-223， IL-18 and AHI and LSpO₂ were also analyzed. ResultsCompared with the control group， the observation group showed a significantly higher total clinical effective rate （P<0.01， Z=-3.49）. Within the control group， no significant changes were observed in AHI， LSpO₂， BMI， TCM syndrome scores， or MIF， miR-223， IL-18 levels and their mRNAs after treatment. In the observation group， AHI， BMI， TCM syndrome scores， and MIF and IL-18 levels and their mRNAs decreased significantly， while LSpO₂ increased significantly （P<0.01）. After treatment， compared with the control group， the observation group exhibited significantly lower AHI， BMI， TCM syndrome scores， and MIF and IL-18 levels and their mRNAs， and significantly higher LSpO₂ （P<0.01）. Correlation analysis showed that MIF and IL-18 were positively correlated with AHI （P<0.01） and negatively correlated with LSpO₂ （P<0.01）， whereas miR-223 was negatively correlated with AHI （P<0.01） and positively correlated with LSpO₂ （P<0.01）. ConclusionModified LGZGT may improve OSAHS of the spleen deficiency and dampness obstruction with blood stasis type by reducing airway inflammatory factors， alleviating airway inflammation， relieving airway edema and stenosis， and improving airway obstruction.

Objective:To explore the specialty work engagement dilemma among wound therapists in non-specialist clinics, so as to provide a reference basis for improving wound therapists' work engagement and reducing job burnout.Methods:This study was a phenomenological study. Semi-structured interviews with 12 wound therapists in non-specialist clinics from 12 hospitals were conducted between May and July 2024 using purposive sampling. Colaizzi seven-step method was used for data analysis and topic refinement.Results:A total of five themes and 13 sub-themes were extracted, including the role change dilemma (focus dispersion due to transfer of positions in clinical departments, and identity challenges due to adjustment of the field of job posting) , career development dilemma (reduced motivation due to obstacles to in-depth development in specialized fields, and limited conditions for scientific research training and implementation impeding the recognition and return of work) , support environment dilemma (insufficient medical insurance support increased job burden, lack of hospital support reduced work efficiency, lack of team support weakened work focus, poor self-support limited the depth of work engagement, lack of support from patients and their families increased the difficulty of maintaining work motivation) , pros and cons weighing dilemma (unclear delineation of risk and responsibility, difficult to weigh risk and benefit) , dilemma of whole-course management of disease (lack of communication between hospitals weakened the continuity of work, lack of home follow-up increased the uncertainty of the work) .Conclusions:Specialty work engagement dilemmas among wound therapists in non-specialist clinics are influenced by a variety of factors. It is necessary for medical institutions, healthcare workers and patients' families to work together to create a favorable working environment for wound therapists in order to promote the high-quality development of wound therapy nursing services in China.

Objective:To explore the specialty work engagement dilemma among wound therapists in non-specialist clinics, so as to provide a reference basis for improving wound therapists' work engagement and reducing job burnout.Methods:This study was a phenomenological study. Semi-structured interviews with 12 wound therapists in non-specialist clinics from 12 hospitals were conducted between May and July 2024 using purposive sampling. Colaizzi seven-step method was used for data analysis and topic refinement.Results:A total of five themes and 13 sub-themes were extracted, including the role change dilemma (focus dispersion due to transfer of positions in clinical departments, and identity challenges due to adjustment of the field of job posting) , career development dilemma (reduced motivation due to obstacles to in-depth development in specialized fields, and limited conditions for scientific research training and implementation impeding the recognition and return of work) , support environment dilemma (insufficient medical insurance support increased job burden, lack of hospital support reduced work efficiency, lack of team support weakened work focus, poor self-support limited the depth of work engagement, lack of support from patients and their families increased the difficulty of maintaining work motivation) , pros and cons weighing dilemma (unclear delineation of risk and responsibility, difficult to weigh risk and benefit) , dilemma of whole-course management of disease (lack of communication between hospitals weakened the continuity of work, lack of home follow-up increased the uncertainty of the work) .Conclusions:Specialty work engagement dilemmas among wound therapists in non-specialist clinics are influenced by a variety of factors. It is necessary for medical institutions, healthcare workers and patients' families to work together to create a favorable working environment for wound therapists in order to promote the high-quality development of wound therapy nursing services in China.

Objective:To assess the status quo of uncertainty in illness among patients undergoing daytime ophthalmic surgeries and to identify its influencing factors.Methods:Patients who underwent surgery in the Ophthalmic Daytime Surgery Wards of Beijing Tongren Hospital, Capital Medical University, from January to June 2023, were selected by convenience sampling. Data were collected using a general demographic survey and the Medical Uncertainty Inventory Scale (MUIS/MUIS-A). Multiple linear regression analysis was employed to investigate the factors influencing the uncertainty in illness among these patients.Results:Out of 248 questionnaires distributed, 243 were effectively collected, resulting in a 97.98% response rate. The scores on the MUIS/MUIS-A ranged from 55 to 144, with a median of 102. Multiple linear regression analysis indicated that acceptance of the disease, educational level, and the number of surgeries were significant factors influencing the uncertainty in illness among these patients ( P<0.05) . Conclusions:The uncertainty in illness among patients undergoing daytime ophthalmic surgery is above the medium level. Factors such as acceptance of the disease, educational level, and the number of surgeries significantly influence this uncertainty.