In October 2024， the 75th World Medical Association General Assembly adopted the tenth revised version of the Declaration of Helsinki. Using textual analysis， this paper systematically compared the changes between the 2024 version and the 2013 version of the Declaration of Helsinki. This study found that， while maintaining the original framework， the new version incorporated the common achievements of the values and civilizational development of human society in recent years， mainly presenting changes in three aspects. First， the core terms were updated， and new concepts such as vulnerability， structural inequality， and environmental sustainability were introduced to further emphasize human dignity， rights and interests， and autonomy in terms of values. Second， the contents of the provisions were refined， especially focusing on the vulnerability of research subjects， free and full informed consent， ethical principles in public health emergencies， and the responsibilities of the ethics committee， as well as the standardization of implementation continued to be improved in the research process. Third， mandatory expressions were strengthened， and the justice of value pursuit was further reinforced in terms of research responsibilities. The revised contents reflected the “human-oriented” fundamental principle in medical research ethics， indicating the direction for future ethical development in medical research. In the future， China should strengthen the construction of ethics committees， actively build a protection system for research participants， and continuously promote international cooperation in medical ethics， to contribute Chinese wisdom to global medical research.

【Objective】 To understand the status of COVID-19 vaccination among elderly adults in long-term care facilities and analyze the influencing factors so as to provide scientific basis for improving the policy of COVID-19 vaccination. 【Methods】 The socio-demographic characteristics, disease-related data, disability, and COVID-19 vaccination status of 575 elderly adults who resided in long-term care facilities in Shaanxi Province were collected via Sojumpin in January 2022. Factors that affected non-vaccinated elderly adults were analyzed by using the SPSS 25.0 software. 【Results】 Of the included 575 participants, 199 (34.6%) were not vaccinated against COVID-19. Univariate analysis showed that COVID-19 vaccination was associated with age, room type, length of stay, marital status, number of children, chronic diseases (i.e., diabetes, stroke, dementia), disability degree, and long-term medication use. Logistic regression analysis demonstrated that age of 90 years or above (OR=4.25), triple room (OR=6.17), moderate disability (OR=2.94), severe disability (OR=6.67), long-term medication use (OR=1.81), and stroke (OR=1.74) were independent risk factors for not injecting COVID-19 vaccine. 【Conclusion】 The COVID-19 vaccination coverage rate of elderly adults in long-term care facilities needs to be improved, and more attention should be paid to the high-risk groups (e.g., who are older, and have disability, long-term medication use, or stroke).

【Objective】 To explore the relationship between chronic comorbidity and the physical and mental health of relatives of elderly people during the nursing home confinement, and to analyze the mediating effects of perceived stress and intolerance of uncertainty in this context. 【Methods】 A total of 568 family members of elderly people in nine elderly institutions in Shaanxi Province were selected. The survey included the short version of the Perceived Stress Scale, Intolerance of Uncertainty Scale, and The World Health Organization-5 Well-being Index. The data were analyzed with Stata for correlation and mediation effects. 【Results】 ① The comorbidities of chronic diseases was positively correlated with the perceived stress (r=0.16, P<0.001) and intolerance of uncertainty (r=0.11, P=0.006) of the family members, but negatively correlated with the physical and mental health of the family members (r=-0.13, P=0.002). ② The mediating effect of perceived stress between chronic disease co-morbidity and physical and mental health of family members in older adults was -0.023, accounting for 18.8% of the total effect; the mediating effect of intolerance of uncertainty between chronic disease co-morbidity and physical and mental health of family members in older adults was -0.041, accounting for 33.5% of the total effect. 【Conclusion】 During closed management in a nursing facility, the physical and mental health of family members of older adults with chronic co-morbidities is poorer than that of family members of non-chronic co-morbidities. And it can lead to a decline in physical and mental health of family members through increased perceived stress and intolerance of uncertainty.

Anti-neurexin-3α antibody-associated encephalitis is rare in clinical practice. It often has a history of pre-infection. It is characterized by abnormal mental behavior, seizures, decreased consciousness, cognitive and sleep disorders, movement disorder, central hypoventilation and autonomic nervous dysfunction. Among them, dyskinesias are mainly involuntary movements of the mouth, face and limbs, dystonia, myoclonic seizures and other manifestations of increased movement. Parkinson′s symptoms manifested as decreased movement are rarely reported. A encephalitis patient with positive anti-neurexin-3α antibody is reported, who is a young female, mainly with parkinsonism such as slow movement, unsteady walking, difficulty in starting and turning around, and inability to hold things in both upper limbs, accompanied by abnormal mental behavior and cognitive dysfunction. After treatment with methylprednisolone and intravenous immunoglobulin, the prognosis is good.

Objective To evaluate the relation between metabolic syndrome (MetS) and gastric cancer (GC) based on a meta-analysis. Methods The case-control studies about the relation between MetS and GC were retrieved from CNKI, WanFang Data, VIP, CBM, Web of Science, The Cochrane Library and PubMed database. The retrieval time was from inception to June, 2020. Two researchers independently screened the literatures, extracted the data and evaluated the quality of the included studies. The meta-analysis of the included literatures was conducted by the Stata 12.0 software. Results A total of six literatures, involving 43617 participants, were included. The results of meta-analysis showed that there was no statistically significant difference between GC and non-GC groups in the risk of hyperglycemia (OR=1.24, 95%CI: 0.59-2.61), hypertension (OR=1.40, 95%CI: 0.60-3.25) or MetS (OR=0.79, 95%CI: 0.44-1.39), respectively. Conclusion MetS may not be related to the risk of GC.

Objective To observe and compare the effect of Cordyceps sinensis ( bailing ) capsules com-bined with weight-bearing breathing exercises, and weight-bearing breathing exercises combined with tiotropium bro-mide and seretide, on patients with stable but moderate-to-severe chronic obstructive pulmonary disease (COPD). Methods Sixty-three patients with moderate-to-severe COPD were randomly divided into an observation group and a control group. Both groups performed weight-bearing breathing exercises, supplemented in the observation group with the oral administration of bailing capsules. The control group instead inhaled tiotropium bromide and seretide. Six-mi-nute walking distance, the COPD assessment test ( CAT scores) and concentrations of interleukin-6 ( IL-6) , interleu-kin-8 ( IL-8) and tumor necrosis factor-α ( TNF-α) were observed after 1 ( T1) , 30 ( T2) and 58 ( T3) days of the treatments. Results At T1 there were no significant differences between the two groups in any of the measurements ( P≤0.05) . At T2, there were still no significant differences except that a significant decrease in IL-8 and TNF-αlevels was observed in the control group. At T3 the average CAT scores had decreased significantly in both groups compared to before the treatment but there was no significant difference between the two groups. In the observation group, the average 6MWT distance had increased significantly compared to before the treatment and compared to the control group, where there was no significant improvement. The average IL-6, IL-8 and TNF-αreadings of the control group were significantly lower than those of the observation group at T3 and compared to before the treatment. No sig-nificant changes in those indicators were observed in the observation group at T3. Conclusions Bailing capsules combined with weight-breathing exercises are more effective for relieving dyspnea symptoms and improving exercise capacity than weight-breathing exercises combined with tiotropium bromide and seretide. However, in controlling air-way inflammation and airway hyper-responsiveness, the triple inhalation combined with weight-bearing breathing exer-cises is more effective.

Objective:To investigate the uncertainty in illness of patients with systemic lupus erythematosus (SLE) and to explore the influencing factors and humanistic care strategies.Methods:The general situation questionnaire and the uncertainty in illness scale were used to investigate the influencing factors of uncertainty in illness and positive humanistic care strategies in patients with SLE.Results:Patients with SLE were at a high level of uncertainty in illness,of which the unpredictability and uncertainty scored higher but lack of information and complexity were of lower scores.Educational status,family income,and self-perceived severity of disease were the main influencing factors of uncertainty in illness (P ＜ 0.05).Conclusion:Patients with SLE were at a high level of uncertainty in illness,mainly from the unpredictable progress of disease and prognosis and unclear symptoms of the disease.Educational status,family income,and self-perceived severity of disease were the main influencing factors of uncertainty in illness.The clinical staff should pay attention to uncertainty in illness among patients with SLE and adopt positive humanistic care measures so as to reduce the sense of uncertainty in illness.

Objective To investigate the core competence of nurses in class Ⅲ grade A level hospitals in Xi′an City and its influencing factors so as to provide evidences for managers to enhance the core competence of clinical nurses and promote the quality and safety of nursing.Methods A total of 890 registered nurses from class Ⅲ grade A hospitals in Xi′an city were investigated using "the competency inventory for registered nurse scale" (CIRN) from July to September 2015. Statistical software SPSS 19.0 was used to analyze the data. Influencing factors of the core competence of nurses were analyzed using multiple linear regression analysis. Results The total score of core competences of clinical registered nurses was (159.12±33.21). The dimension with highest score was ethical/legal practice ability with an average score of (3.01±0.64). The dimension with lowest score was critical thinking/scientific research ability with an average score of (2.70±0.67). The scores of nurses from emergency and critical care were higher than those of nurses from general departments in the dimensions including clinical nursing,interpersonal relationship,ethical/legal practice, professional development and critical thinking/research ability. The differences were statistically significant (Z=-3.496, -2.688,-3.727,-2.969,-3.911;P＜0.05). Multivariate linear regression analysis showed that technical title, age, department training, and professional qualification were influencing factors of the nurses′ core competence (P＜0.05).Conclusions The core competence of registered nurses in class Ⅲ grade A hospitals in Xi′an city is at above medium level. The scores of nurses from emergency and critical care are higher than nurses from general departments in several dimensions. Age, technical title, department training and professional qualification are main influencing factors of core competence of nurses. Interventions to improve the core competency of nurses with low grade, low technical title and non-specialist qualification are necessary.

Aim To observe the physical coupling between transient receptor potential channel vanilloid type 4 (TRPV4 ) and cPLA2 in endothelial cells. Methods We investigated the physical association of TRPV4-cPLA2 coupling by immunofluorescence reso-nance energy transfer (immuno-FRET)to assess the spatial proximity between TRPV4 and cPLA2 in human microvascular endothelial cells (HMEC),primary cul-tured endothelial cells and in thoracic aortas rings from high salt-induced hypertension mice.Results At the cellular level,with high salt treatment,the physical in-teraction of TRPV4 and cPLA2 was significantly en-hanced in primary vascular endothelial cells and HMEC.Furthermore, in thoracic aortas rings from high salt-induced hypertension mice,we found an in-creases interaction between TRPV4 and cPLA2 in en-dothelial cells from arterial segments .Conclusion High-salt treatment increases the endothelial TRPV4-cPLA2 coupling,indicating that this coupling may pro-vide a new target for vascular endothelial dysfunction.

Objective To explore the group-generalization first aid modeling drilling and its effects on training of first aid skills for nurses. Methods Training scheme of group-generalization first aid modeling drilling was designed. A total of 240 nurses with 2 to 5 years of service were selected to be trained in first-aid skills for 8 months. We compared the knowledge of first aid theory, manipulative skill of first-aid, the score of group-generalization first aid modeling drilling before and after training. The score of group-generalization first aid modeling drilling included 65% for personal operation and 35% for comprehensive evaluation through group ( ability to judge the change of the condition, emergency response capability, teamwork ability, communication ability, ability of writing nursing records, accident during rescue process, other abilities including medical waste handling and so on). We also compared the score of group comprehensive evaluation, the time of simulation drilling, the problem frequencies before and after group-generalization first aid modeling drilling. T test and chi square test were used for statistical analysis according to the data type. Results After training, scores of knowledge of first aid theory, manipulative skill of first-aid and personal of group-generalization first aid modeling drilling were (83. 20 ± 4. 80), (81. 96 ± 4. 89) and (86. 95 ± 6. 06) significantly higher than those before training [(78. 10 ± 8. 46), (80. 20 ± 7. 72), (76. 37 ± 10. 79)] with statistically significant differences (t= 8. 84, 2. 59, 9. 61; P < 0. 05). The score of comprehensive evaluation through group of group-generalization first aid modeling drilling was (16. 68 ± 2. 51) before training compared (22. 06 ± 2. 81) after training with a significant difference (t=13. 22, P<0. 01). The time of simulation drilling decreased from 11 minutes to 7 minutes. There was a significant decrease in the incidence of problems with significant differences (P<0. 05). Conclusions The group-generalization first aid modeling drilling effectively improves the knowledge level of first aid theory and manipulative skill of first-aid and is helpful to comprehensively enhance the ability of comprehensive first aid so as to improve the quality of emergency treatment and nursing.