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.

Ochratoxin A (OTA) is ubiquitous in the food and feed fields. It has strong hepatotoxicity and nephrotoxicity, seriously threatening the health of humans and animals. Enzymatic degradation of mycotoxins is considered to be a promising method to control mycotoxin contaminations. In this study, a new ochratoxin A amidohydrolase from Microbulbifer thermotolerans (MiADH) was obtained. After heterologous expression in Escherichia coli and purification, the recombinant protein was studied regarding the hydrolysis activity, hydrolysis products, enzymatic properties, and substrate binding mode. MiADH can degrade OTA into ochratoxin α (OTα) and phenylalanine, demonstrating a detoxifying ability. It demonstrated the best performance at 70 ℃ and pH 8.0, and Cu²⁺ had the strongest inhibitory effect on the activity of MiADH. MiADH with good thermal stability exhibited huge potential for industrial application. Rational design guided by three-dimensional structural models and substrate docking analysis revealed the important amino acids affecting substrate binding and obtained multiple mutants with improved activity. Among these mutants, V324A had the highest activity, which was 4.2-fold that of the wild type. The identification of MiADH enriches the ochratoxin A degradation enzyme library and provides a new candidate enzyme for the biological detoxification of ochratoxin A in the food and feed industry.
Amidohydrolases/chemistry* ; Ochratoxins/metabolism* ; Substrate Specificity ; Escherichia coli/metabolism* ; Recombinant Proteins/metabolism* ; Actinomycetales/genetics*

Objective: To evaluate the feasibility and effectiveness of dual fluorescence laparoscopy in the localization of ureteral stricture and its blood supply，and to provide a new idea for the treatment of complex ureteral stenosis，thus helping doctors to improve the efficiency of ureteral reconstruction surgery. Methods: Our team developed a dual fluorescence laparoscopic system，which could simultaneously identify the ureter stricture by intra-ureteral injection of methylene blue (MB) and assess the blood supply of the ureteral stumps by intravenous injection of indocyanine green (ICG). Results: The clinical data of 3 patients who underwent lingual mucosa ureteroplasty using dual fluorescence laparoscopy in Zhongnan Hospital of Wuhan University were retrospectively analyzed.All operations were successful，without conversion to open surgery.The operation time was 144，132 and 163 minutes，respectively.The length of harvested lingual mucosa graft was 2.0，2.8 and 3.5 cm，respectively.No intraoperative or postoperative complications occurred.Eight weeks after operation，ureterography showed that the ureter was unobstructed. Conclusion: Dual fluorescence laparoscopy is safe and feasible in the repair of complex ureteral stricture with lingual mucosa graft，which provides a new idea for complex ureteral reconstruction.

Objective:To investigate the effect of Smac mimetic compound SM-164 on the radiosensitivity of cervical cancer cells and its underlying mechanisms.Methods:Human cervical cancer cell lines HeLa and SiHa were treated with different concentrations of SM-164 (0.05, 0.1, 0.2, 0.4 μmol/L) for 24 hours, followed by irradiation with 6 MV X rays at different doses (0, 2, 4, 6, 8 Gy). Clone formation assay was used to detect the survival fraction of HeLa and SiHa cells. The cells were divided into the negative control (NC) group, 4 Gy ionizing radiation (IR) group, 4 Gy combined with 0.2 μmol/L SM-164 treatment (IR+SM-164) group, and Caspases (Casp) broad-spectrum inhibitor Z-VAD blocking (IR+SM-164+Z-VAD) group. CCK-8 assay was adopted to assess cell proliferation, flow cytometry was used to detect cell apoptosis, and Western blot was employed to assess the changes in apoptosis-related proteins cleaved (C)-Casp9/Casp9, C-Casp3/Casp3, C-poly(ADP ribose) polymerase (PARP)/PARP, and DNA damage marker phosphorylated-histone H2A family member X (γH2AX)/H2AX ratios. One-way ANOVA was used for the comparison of means among multiple groups, and the SNK- q test was used for pairwise comparisons between two groups. Results:Compared with the NC group, the survival rates of HeLa and SiHa cells were significantly decreased after the combined treatment of IR and SM-164 (both P<0.01), and different concentrations of SM-164 enhanced cell radiosensitivity (all P<0.05). Compared with the NC group, cell proliferation activity was significantly decreased in the IR, IR+SM-164 and IR+SM-164+Z-VAD groups (all P<0.01), while apoptosis rate and the ratios of C-Casp9/Casp9, C-Casp3/Casp3, C-PARP/PARP, and γH2AX/H2AX were significantly increased (all P<0.01). Compared with the IR group, the proliferation activity in the IR+SM-164 group was significantly decreased ( P<0.05), whereas apoptosis rate and related protein ratios were significantly increased (all P<0.05). The γH2AX/H2AX ratio was increased in the IR+SM-164+Z-VAD group ( P<0.05). Compared with the IR+SM-164 group, the proliferation activity in the IR+SM-164+Z-VAD group was increased ( P<0.05), while the apoptosis rate and related protein ratios were significantly decreased (all P<0.05). Conclusion:SM-164 enhances the radiosensitivity of cervical cancer cells by inducing Casp activation.

Objective:To investigate the effect of Smac mimetic compound SM-164 on the radiosensitivity of cervical cancer cells and its underlying mechanisms.Methods:Human cervical cancer cell lines HeLa and SiHa were treated with different concentrations of SM-164 (0.05, 0.1, 0.2, 0.4 μmol/L) for 24 hours, followed by irradiation with 6 MV X rays at different doses (0, 2, 4, 6, 8 Gy). Clone formation assay was used to detect the survival fraction of HeLa and SiHa cells. The cells were divided into the negative control (NC) group, 4 Gy ionizing radiation (IR) group, 4 Gy combined with 0.2 μmol/L SM-164 treatment (IR+SM-164) group, and Caspases (Casp) broad-spectrum inhibitor Z-VAD blocking (IR+SM-164+Z-VAD) group. CCK-8 assay was adopted to assess cell proliferation, flow cytometry was used to detect cell apoptosis, and Western blot was employed to assess the changes in apoptosis-related proteins cleaved (C)-Casp9/Casp9, C-Casp3/Casp3, C-poly(ADP ribose) polymerase (PARP)/PARP, and DNA damage marker phosphorylated-histone H2A family member X (γH2AX)/H2AX ratios. One-way ANOVA was used for the comparison of means among multiple groups, and the SNK- q test was used for pairwise comparisons between two groups. Results:Compared with the NC group, the survival rates of HeLa and SiHa cells were significantly decreased after the combined treatment of IR and SM-164 (both P<0.01), and different concentrations of SM-164 enhanced cell radiosensitivity (all P<0.05). Compared with the NC group, cell proliferation activity was significantly decreased in the IR, IR+SM-164 and IR+SM-164+Z-VAD groups (all P<0.01), while apoptosis rate and the ratios of C-Casp9/Casp9, C-Casp3/Casp3, C-PARP/PARP, and γH2AX/H2AX were significantly increased (all P<0.01). Compared with the IR group, the proliferation activity in the IR+SM-164 group was significantly decreased ( P<0.05), whereas apoptosis rate and related protein ratios were significantly increased (all P<0.05). The γH2AX/H2AX ratio was increased in the IR+SM-164+Z-VAD group ( P<0.05). Compared with the IR+SM-164 group, the proliferation activity in the IR+SM-164+Z-VAD group was increased ( P<0.05), while the apoptosis rate and related protein ratios were significantly decreased (all P<0.05). Conclusion:SM-164 enhances the radiosensitivity of cervical cancer cells by inducing Casp activation.

Objective:To explore the potential categories of psychological distress in spousal caregivers of stroke patients and differences in quality of life between categories, in order to provide a theoretical basis for early clinical identification and provision of individualized and targeted interventions for psychological distress in spousal caregivers of stroke patients and improvement of their quality of life.Methods:A total of 207 spouse caregivers of stroke patients hospitalized in three class 1-Grade A hospitals in Yinchuan city of Ningxia Hui Autonomous Region, who met the inclusion and exclusion criteria were selected from December 2020 to July 2021 by convenience sampling method as study subjects. The general information questionnaire, Kessler Psychological Distress Scale, and the Mos 36-Item Short from Health Survey were used for a cross-sectional survey.Results:A total of 203 spousal caregivers of stroke patients were finally investigated, 46 males and 157 females with a age of (58.65 ± 9.66) years. Psychological distress among spousal caregivers of stroke patients was categorized into 3 potential categories:no distress group (40%, 81/203), listlessness group (45%, 91/203) and helplessness and restlessness group (15%, 31/203). The psychological distress subgroup was a factor influencing the quality of life of spousal caregivers of stroke patients ( t=-10.03, P<0.05), explaining 33.0% of the variance in quality of life. Conclusions:Psychological distress in spousal caregivers of stroke patients is significantly heterogeneous. Those in the helplessness and restlessness group have the lowest quality of life and should be given focused attention and early intervention.

Objective:To explore the relationship between psychological distress and intimacy in stroke patients and the mediating effect of different dyadic coping style, to provide theoretical guidance for improving the intimate relationship of stroke patients.Methods:A convenient sampling method was used to select 203 patients with stroke who visited the General Hospital of Ningxia Medical University, the People's Hospital of Ningxia Hui Autonomous Region and the Department of Neurology of Yinchuan First People's Hospital from December 2020 to July 2021 as the survey objects. The general information questionnaire, Kessler Psychological Distress Scale, Quality of Relationship Index and Dyadic Coping Inventory were used to investigate patients.Results:The scores of psychological distress, intimate relationship, positive dyadic coping and negative dyadic coping were 19.33 ± 7.46, 32.75 ± 6.79, 86.25 ± 13.22, and 16.46 ± 4.08, respectively. Correlation analysis showed that psychological distress was negatively correlated with intimate relationship and positive dyadic coping ( r=-0.195, -0.204, both P<0.01), psychological distress was positively correlated with negative dyadic coping ( r=0.229, P<0.01). The mediating effect of positive dyadic coping and negative dyadic coping on psychological distress and intimate relationship was 35.87% and 53.26%, respectively. Conclusions:The psychological distress indirectly affects the intimate relationship of stroke patients through positive dyadic coping and negative dyadic coping. Health care workers can guide patients to actively cope with the disease and encourage couples to strengthen communication, so as to enhance the intimacy of couples and promote their physical and mental health development.

Objective:To explore the potential categories of resourcefulness in primary caregivers of stroke patients and analyze the differences in the characteristics of different types of caregivers, so as to provide basis for clinical construction of effective intervention plans.Methods:The 308 primary caregivers of stroke patients who met the research standards in the Department of Neurology of General Hospital of Ningxia Medical University, People′s Hospital of Ningxia Hui Autonomous Region, the First People′s Hospital of Yinchuan from December 2020 to August 2021 were selected as the research objects by convenient sampling method.The general information questionnaire, Resourcefulness Scale and Social Support Revalued Scale were used for cross-sectional investigation.Results:The resourcefulness of the primary caregivers of stroke patients were divided into 2 potential categories: low resourcefulness group (62.7%, 193/308) and high resourcefulness group (37.3%, 115/308). Uni-variate analysis showed that there were differences between potential categories: age and education level of stroke patients, whether there was long-term medication history, number of other chronic diseases, had there been any complications due to illness, age, education level and occupation of caregivers, average daily care duration, family relations, and social support ( χ2 values were -3.34 - 23.62, all P<0.05). Logistic regression analysis showed that social support and education level of caregivers were the influencing factors of caregiver resourcefulness ( P<0.05). Conclusions:The resourcefulness in the primary caregivers of stroke patients has certain characteristics. Clinically, targeted intervention measures should be formulated according to the different types of caregiver resourcefulness characteristics of caregivers and their influencing factors to improve the caregiver resourcefulness of stroke patients.

Objective:To construct a conceptual framework of burnout among primary caregivers of stroke patients based on grounded theory.Methods:According to the characteristics of age, gender, relationship with patients, length of care and other characteristics of purpose sampling method, from December 2021 to March 2022, 31 primary caregivers of stroke patients were selected for semi-structured interviews in two second-class hospitals, a first-class hospitals and a community health service station in Wuzhong city and Yinchuan city. The data were analyzed in procedural grounded theory method.Results:A total of 29 primary categories and 9 secondary categories were formed. The conceptual framework of burnout among primary caregivers of stroke patients was finally established, which consisted of four main categories (role burnout, physical burnout, psychological burnout and social burnout) and a core category (burnout of primary caregivers of stroke patients).Conclusions:The conceptual framework of burnout among primary caregivers of stroke patients constructed in this study elaborates the connotation of burnout of primary caregivers of stroke patients from four aspects, which can provide a basis for the development of assessment tools and the formulation of intervention measures in the future.

Objective:To investigate the safety and feasibility of Ivor-Lewis procedure under uniportal video-assisted thoracoscopy(VATS) for esophageal cancer and Siewert type I esophago-gastric junction carcinoma.Methods:The patients with middle-lower segment esophageal cancer or Siewert type I esophago-gastric junction carcinoma received minimally invasive esophagectomy between October 2020 and June 2021, and the clinical data was collected and analyzed.Results:26 patients received Ivor-Lewis procedure underwent uniportal VATS, while 45 patients underwent McKeown surgery under multiport VATS. The average operation time of patients in the two groups were(265±110)min and (235±94)min, and the average intraoperative blood loss were(80±57)ml and(105±60)ml. The mean number of lymph nodes removed in the surgery were (19.3±2.9) and 18.6±2.7 respectively in two groups, and the mean length of hospital stay was(7.5±3.5)days and(8.3±2.7)days. The incidence of perioperative complications were not significantly different in two groups. The VAS score of patients received Ivor-Lewis procedure underwent uniportal VATS was lower than that of patients received McKeown surgery in ostoperative day 1, day 3, day 7 and 1 month. The difference was statistically significant in two groups( P<0.05). Conclusion:The Ivor-Lewis procedure under uniportal VATS for esophageal cancer and Siewert type I esophago-gastric junction carcinoma has the advantage of less postoperative pain, and the procedure is feasible in clinical practice.