ObjectiveTo systematically evaluate the application of narrative education in undergraduate nursing teaching， to understand the current application status of narrative education， and to provide a theoretical basis for the subsequent establishment of a sound narrative education system. MethodsA systematic search was conducted for studies published in Chinese and English databases on applying narrative education to undergraduate nursing teaching， with the search period ranging from database inception to February 23， 2025. Literature was screened， and relevant information was extracted. A rigorous quality evaluation was conducted on the included studies， and a descriptive analysis was performed on their content. ResultsA total of 20 papers were included， involving 3，180 research subjects， all of whom were undergraduate nursing students. The results of descriptive analysis showed that the teaching model of narrative education primarily encompassed reading narrative works， watching films and videos， performing narrative scenarios， and writing reflective journals. The course setting and content covered pre-teaching preparation and in-teaching implementation. The evaluation of teaching effectiveness included the evaluation of teachers’ teaching methods （student evaluation/self-evaluation） and the evaluation of students’ learning effectiveness （course grade evaluation/humanistic care scale/empathy scale assessment， and others）. ConclusionNarrative education combines abstract concepts with concrete clinical situations， which not only enriches students’ learning experiences but also enhances their humanistic literacy. Meanwhile， it provides teachers with opportunities to develop their narrative teaching skills， which requires them to possess profound professional knowledge and employ narrative techniques to guide students in reflection and critical thinking， thereby improving teaching quality and learning outcomes. Future efforts should consistently deepen the connotation research of narrative education and build a systematic nursing education system.

Objective:To explore the predictive value of models based on clinical parameters, deep learning radiomics (DLR) from CT images, and traditional handcrafted radiomics (HCR) in assessing pathological complete response (pCR) after neoadjuvant radiotherapy combined with medical therapy in patients with esophageal cancer.Methods:A retrospective study was conducted on 130 patients with locally advanced esophageal cancer who underwent neoadjuvant radiotherapy combined with medical therapy followed by surgery at the First Affiliated Hospital of the University of Science and Technology of China from August 1, 2018, to August 31, 2024. Patients were randomly divided into a training set ( n=91) and a validation set ( n=39) at a ratio of 7:3. Logistic regression analysis was performed to identify clinical independent risk factors associated with pCR. DLR and HCR features were extracted from the tumor and the 5 mm peritumoral region on planning CT images. Features for modeling were selected using t-test, Mann-Whitney U test or Fisher exact probability method, least absolute shrinkage and selection operator (LASSO) regression to calculate the radiomics score (Rad-score). A nomogram was then constructed by integrating the clinical risk factors. The predictive performance of each model was evaluated using the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, and decision curve analysis (DCA) to assess clinical benefits. Results:Multivariate logistic regression analysis identified body weight ( OR=1.101, 95% CI: 1.029-1.177, P=0.005) and lymph node positivity ( OR=0.100, 95% CI: 0.014-0.727, P=0.023) as independent predictors of pCR. The peritumoral DLR-HCR model showed superior predictive performance, with AUCs of 0.870 (95% CI: 0.799-0.942) in the training set and 0.866 (95% CI: 0.750-0.982) in the validation set. The combined model incorporating clinical parameters achieved the best performance, with AUCs of 0.903 (95% CI: 0.845-0.962) and 0.888 (95% CI: 0.782-0.994) in the training and validation sets, respectively. Conclusions:The combined model integrating peritumoral DLR-HCR features with clinical parameters provides excellent predictive value for pCR after neoadjuvant radiotherapy combined with medical therapy in esophageal cancer and offers valuable guidance for personalized treatment strategies.

To improve the consistency of outcome documentation and address the potential for outcome reporting bias in clinical trials involving integrative Chinese and Western medicine (ICWM) for ulcerative colitis (UC), we aim to develop a customized core outcome set (COS) that incorporates input from various stakeholders. The study design of this COS has been informed by the Core Outcome Measures in Effectiveness Trials Initiative Handbook, with adherence to the guidelines from the Core Outcome Set-STAndards for Reporting statement and Core Outcome Set-STAndardised Protocol Items recommendations. Five groups of stakeholders will be invited to participate in the development of COS for clinical trials with ICWM for UC, including healthcare professionals, patients, COS developers, COS users, and methodologists. The process will involve five stages: (1) conducting a systematic review of outcomes reported in clinical trials and protocols to develop a list of potential outcome domains; (2) conducting semi-structured interviews to obtain important outcomes; (3) choosing the most important outcomes by conducting three-round Delphi surveys; (4) achieving a consensus in a face-to-face meeting to discuss the final COS; and (5) publication, dissemination and implementation of COS. Consequently, this specialized COS will be applicable to clinical trials involving both traditional Chinese medicine (TCM) and ICWM interventions. Please cite this article as: Zhang X, Zhang L, Wang J, Lau CT, Wang N, Zhang X, Wang P, Li J, Han F, Bian Z. A protocol for developing, disseminating and implementing a core outcome set for clinical trials of integrative Chinese and Western medicine for ulcerative colitis. J Integr Med. 2025; 23(6):654-659.
Colitis, Ulcerative/therapy* ; Humans ; Medicine, Chinese Traditional ; Clinical Trials as Topic ; Integrative Medicine ; Research Design ; Outcome Assessment, Health Care ; Delphi Technique

Objective To explore the clinical application value of modified and optimized en-hanced recovery after surgery(ERAS)management in the perioperative period of patients undergoing robot-assisted laparoscopic radical prostatectomy(RLRP).Methods A total of 100 RLRP patients were selected as the research subjects and randomly divided into conventional group(receiving con-ventional ERAS management)and research group(receiving modified and optimized ERAS manage-ment)using the random number table method,with 50 cases in each group.Perioperative indicators,the use of anesthetic drugs,and the levels of physiological stress indicators[cortisol(Cor),norepi-nephrine(NE),plasma renin activity(PRA)]and coagulation function indicators[prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT)]before and after surgery were compared between the two groups.The incidence of postoperative complications and the readmis-sion rate within 30 days after surgery were also statistically analyzed.Results The intraoperative fluid infusion volume in the research group was less than that in the conventional group.The postoperative time to get out of bed,time to first flatus,pelvic drainage tube retention time,and hospital stay in the research group were horter than those in the conventional group(P＜0.05).The incidence of intraoperative hypothermia in the research group was lower than that in the conventional group,with statistically significant differences(P＜0.05).The doses of propofol and cisatracurium in the re-search group were less than those in the conventional group,with statistically significant differences(P＜0.05).After surgery,the levels of Cor,NE and PRA in both groups were higher than those before surgery,but they were lower in the research group than those in the conventional group,with statistically significant differences(P＜0.05).After surgery,the TT,PT and APTT in both groups were longer than those before surgery,but they were shorter in the research group than those in the conventional group,with statistically significant differences(P＜0.05).The overall incidence of complications in the research group was lower than that in the conventional group,with a statistically significant difference(P＜0.05).There was no statistically significant difference in the readmission rate within 30 days after surgery between the two groups(P＞0.05).Conclusion Modified and optimized ERAS management can effectively promote rapid postoperative recovery in RLRP patients,reduce the doses of anesthetic drugs and fluid infusion volume,alleviate physiological stress respon-ses,improve the body's coagulation function,and reduce the risk of complications.

Objective:To explore the relationship between general demographic characteristics,inflammatory indicators,nutritional indicators,pathological data and lymph node metastasis in endometrial cancer(EC)pa-tients,and to construct and validate a model for preoperative prediction of lymph node status in endometrial canc-er patients.Methods:The preoperative clinical data of 473 patients with EC who underwent surgical treatment in the Zhu Jiang Hospital of Southern Medical University from January 2010 to April 2024 were retrospectively ana-lyzed.The independent risk factors of lymph node metastasis of endometrial cancer were screened by univariate and multivariate Logistic regression analyses,and the nomogram prediction model was constructed by R soft-ware.The performance of the model was evaluated by the receiver operating characteristic(ROC)curve,calibra-tion curve and clinical decision curve.Results:Menopausal status,high grade biopsy pathology,CA125 ≥24.47U/ml,systemic immune inflammatory index(SII)≥710.91,and prognostic nutritional index(PNI)＜52.90 were in-dependent risk factors for lymph node metastasis in endometrial cancer(OR＞1,P＜0.05).The nomogram model constructed based on these five factors had an AUC of 0.853 in the training set and 0.871 in the test set.The cali-bration curve fitted well,and the clinical decision curve shows a positive benefit.Conclusions:The endometrial cancer lymph node metastasis prediction model constructed based on menopausal status,biopsy pathology,CA125,SII,and PNI has good accuracy and fit,with certain clinical application value.

Objective:To explore the relationship between general demographic characteristics,inflammatory indicators,nutritional indicators,pathological data and lymph node metastasis in endometrial cancer(EC)pa-tients,and to construct and validate a model for preoperative prediction of lymph node status in endometrial canc-er patients.Methods:The preoperative clinical data of 473 patients with EC who underwent surgical treatment in the Zhu Jiang Hospital of Southern Medical University from January 2010 to April 2024 were retrospectively ana-lyzed.The independent risk factors of lymph node metastasis of endometrial cancer were screened by univariate and multivariate Logistic regression analyses,and the nomogram prediction model was constructed by R soft-ware.The performance of the model was evaluated by the receiver operating characteristic(ROC)curve,calibra-tion curve and clinical decision curve.Results:Menopausal status,high grade biopsy pathology,CA125 ≥24.47U/ml,systemic immune inflammatory index(SII)≥710.91,and prognostic nutritional index(PNI)＜52.90 were in-dependent risk factors for lymph node metastasis in endometrial cancer(OR＞1,P＜0.05).The nomogram model constructed based on these five factors had an AUC of 0.853 in the training set and 0.871 in the test set.The cali-bration curve fitted well,and the clinical decision curve shows a positive benefit.Conclusions:The endometrial cancer lymph node metastasis prediction model constructed based on menopausal status,biopsy pathology,CA125,SII,and PNI has good accuracy and fit,with certain clinical application value.

Objective:To explore the predictive value of models based on clinical parameters, deep learning radiomics (DLR) from CT images, and traditional handcrafted radiomics (HCR) in assessing pathological complete response (pCR) after neoadjuvant radiotherapy combined with medical therapy in patients with esophageal cancer.Methods:A retrospective study was conducted on 130 patients with locally advanced esophageal cancer who underwent neoadjuvant radiotherapy combined with medical therapy followed by surgery at the First Affiliated Hospital of the University of Science and Technology of China from August 1, 2018, to August 31, 2024. Patients were randomly divided into a training set ( n=91) and a validation set ( n=39) at a ratio of 7:3. Logistic regression analysis was performed to identify clinical independent risk factors associated with pCR. DLR and HCR features were extracted from the tumor and the 5 mm peritumoral region on planning CT images. Features for modeling were selected using t-test, Mann-Whitney U test or Fisher exact probability method, least absolute shrinkage and selection operator (LASSO) regression to calculate the radiomics score (Rad-score). A nomogram was then constructed by integrating the clinical risk factors. The predictive performance of each model was evaluated using the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, and decision curve analysis (DCA) to assess clinical benefits. Results:Multivariate logistic regression analysis identified body weight ( OR=1.101, 95% CI: 1.029-1.177, P=0.005) and lymph node positivity ( OR=0.100, 95% CI: 0.014-0.727, P=0.023) as independent predictors of pCR. The peritumoral DLR-HCR model showed superior predictive performance, with AUCs of 0.870 (95% CI: 0.799-0.942) in the training set and 0.866 (95% CI: 0.750-0.982) in the validation set. The combined model incorporating clinical parameters achieved the best performance, with AUCs of 0.903 (95% CI: 0.845-0.962) and 0.888 (95% CI: 0.782-0.994) in the training and validation sets, respectively. Conclusions:The combined model integrating peritumoral DLR-HCR features with clinical parameters provides excellent predictive value for pCR after neoadjuvant radiotherapy combined with medical therapy in esophageal cancer and offers valuable guidance for personalized treatment strategies.

ObjectiveTo explore the mechanism of Bushen Huoxue enema in treating the rat model of kidney deficiency and blood stasis-thin endometrium （KDBS-TE） by transcriptome sequencing. MethodThe rat model of KDBS-TE was established by administration of tripterygium polyglycosides tablets combined with subcutaneous injection of adrenaline. The pathological changes of rat endometrium in each group were then observed. Three uterine tissue specimens from each of the blank group， model group， and Bushen Huoxue enema group were randomly selected for transcriptome sequencing. The differentially expressed circRNAs， lncRNAs， and miRNAs were screened， and the disease-related specific competitive endogenous RNA （ceRNA） regulatory network was constructed. Furthermore， the gene ontology （GO） functional annotation and the Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment were performed for the mRNAs in the network. ResultCompared with the blank group， the model group showed endometrial dysplasia， decreased endometrial thickness and endometrial/total uterine wall thickness ratio （P<0.01）， and differential expression of 18 circRNAs， 410 lncRNAs， and 7 miRNAs. Compared with the model group， the enema and estradiol valerate groups showed improved endometrial morphology and increased endometrial thickness and ratio of endometrial to total uterine wall thickness （P<0.05）. In addition， 21 circRNAs， 518 lncRNAs， and 17 miRNAs were differentially expressed in the enema group. The disease-related specific circRNA-miRNA-mRNA regulatory network composed of 629 nodes and 664 edges contained 2 circRNAs， 34 miRNAs， and 593 mRNAs. The lncRNA-miRNA-mRNA regulatory network composed of 180 nodes and 212 edges contained 5 lncRNAs， 10 miRNAs， and 164 mRNAs. The mNRAs were mainly enriched in Hippo signaling pathway， autophagy-animal， axon guidance， etc. ConclusionBushen Huoxue enema can treat KDBS-TE in rats by regulating specific circRNAs， lncRNAs， and miRNAs in the uterus and the ceRNA network.

High-voltage pulsed electric field(HV-PEF)ablation technology has demonstrated promising applications in the clinical treatment of chronic obstructive pulmonary disease(COPD).However,its use has been limited to exploratory applications in a small number of cases,and the underlying mechanisms remain largely undefined.To facilitate broader clinical implementation,comprehensive molecular mechanism studies via extensive animal experimentation are essential.Rats,due to their ease of modeling COPD and the availability of comprehensive molecular reagents,serve as an optimal model for such studies.Consequently,the development of electrodes specifically designed for HV-PEF respiratory ablation in SD rats is of significant importance.In this study,we meticulously examined the anatomical structure of rat airways and investigated various equipment parameters,including material composition,rigidity,diameter,electrode ring dimensions,spacing between positive and negative poles,insulation coating for the catheters,welding techniques between the guidewire and electrode ring,and the design of vent holes in the catheter.Based on these considerations,we fabricated PVC ablation electrode catheters with integrated ventilation functionality.Subsequently,we employed finite element simulation to estimate the field strengths that could be applied by these electrodes.The simulation results were then validated in normal rats to assess the electrical safety and efficacy of the electrodes.These findings laid the groundwork for further investigation into the mechanisms of HV-PEF treatment for COPD.

Objective:To explore the economic applicability and safetyof the novel uterovaginal pubic comb suspension(UPCS)surgery with Mersilene tape in the treatment of pelvic organ prolapse(POP).Methods:A ret-rospective analysis was conducted on the clinical data of patients who underwent UPCS surgery due to POP from January 1st,2021 to February 28,2023.They were divided to the UPCS surgery with Mersilene tape group(group A)and suspension surgery with Y-shaped mesh group(group B)respectively.The POP-Q indication points,sus-pension surgery duration,intraoperative bleeding volume,material expense,postoperative catheter retention time,anal exhaust time and hospitalization duration were recorded for both groupbefore and after surgery.Evaluate the severity of POP related symptoms in patients before and after surgery using the pelvic Floor Distress Invento-ry-short Form 20(PFDI-20)and Pelvic Organ Prolapsed/Urinary Incontinence Sexual Questionnaire-12(PISQ-12),and follow up and observe the patients and analyze the complications.Results:A total of 17 POP patients were included in the study.There were 12 patients in group A while 5 patients in group B.The suspension material expense of group A was considerably lower than that of group B(P＜0.05).There was no significant difference between the two groups in preoperative PFDI-20 score,preoperative PISQ-12 score,UPCS surgery duration,intr-aoperative bleeding volume,postoperative urinary catheter retention time,postoperative anal exhaust time and hospitalization duration.All patients showed stable vital signs during the surgery and no severe complications were reported.Compared with the preoperative status,the positions of the Aa,Ba,and C indicatorpoint in group A and group B were all increased significantly(P＜0.05).The PFDl-20 and PISQ-12 scores of the two groups at the last follow-up after surgery showed significant improvement compared to those before surgery(P＜0.05).No signifi-cant difference was found in the PFDI-20 and PISQ-12 scores between the two groups after surgery(P＞0.05).There were no significant differences in the postoperative complications between the two groups(P＞0.05).Con-clusions:Compared with suspension surgery with Y-shaped mesh,UPCS surgery with Mersilene tape is safe and effective in the treatment of POP.The UPCS surgery with Mersilene tape showed better cost-effectiveness in the treatment of POP,and the surgical steps are relatively simple.Therefore,UPCS surgery with Mersilene tape was worthy of promotion in clinical practice.