Objective To explore the correlation between kinesiophobia and disease uncertainty, personal mastery, cardiac discomfort symptoms in patients with acute myocardial infarction (AMI) during recovery period. Methods A total of 320 patients with AMI admitted to the hospital were enrolled between January 2020 and January 2024. According to the results of Tampa Scale for Kinesiophobia Heart (TSK-H), they were divided into AMI kinesiophobia group (n=166) and simple AMI group (n=154). The disease uncertainty was evaluated by Mishel Uncertainty in Illness Scale for Adults (MUIS-A), personal mastery was evaluated by Personal Mastery Scale (PMS), and cardiac discomfort symptoms were evaluated by cardiac discomfort symptom scale. The correlation between kinesiophobia and disease uncertainty, personal mastery, cardiac discomfort symptoms in AMI patients was analyzed by Pearson correlation analysis. Results The scores of MUIS-A and cardiac discomfort symptoms in AMI kinesiophobia group were higher than those in simple AMI group (P<0.05), and PMS scores were lower than those in simple AMI group (P<0.05). The score of kinesiophobia was significantly positively correlated with scores of disease uncertainty and cardiac discomfort symptoms (r=0.628, 0.689, P<0.05), while significantly negatively correlated with the score of personal mastery (r=-0.526, P<0.05). Conclusion Kinesiophobia is related to disease uncertainty, personal mastery and cardiac discomfort symptoms in AMI patients during recovery period. Clinical medical staffs should focus on patients with the above characteristics. The targeted intervention measures can improve kinesiophobia and promote recovery of patients.

Objective To explore the clinical characteristics and features of noninfectious fever in elderly patients with aortic dilation disease.Methods A total of 599 elderly patients diagnosed with aortic dilation disease(including 274 cases of acute disease and 325 cases of chronic disease)in the Affiliated Wuxi People's Hospital of Nanjing Medical University from January 2021 to June 2024 were recruited.According to their age,the patients with acute disease were divided into aged group 1(105 cases)and non-age group 1(169 cases),and those with chronic disease were into aged group 2(231 cases)and non-age group 2(94 cases).For the 520 patients(246 cases of acute disease and 274 cases of chronic disease)subjected for endovascular repair surgery,they were assigned into aged group 3(90 cases)and non-aged group 3(156 cases)for those with acute dis-ease,and aged group 4(206 cases)and non-aged group 4(68 cases)for those with chronic disease.For the 230 patients experiencing postoperative non-infectious fever,they were divided into acute-febrile(50 cases),acute-afebrile(20 cases),chronic-febrile(106 cases)and chronic-afebrile(54 cases)groups.Their general data was compared among the groups.Multivariate logistic regression analysis was conducted to identify the risk factors for postoperative noninfectious fever.ROC curve was plotted to analyze the predictive performance of our model for postoperative noninfec-tious fever.Results The surgical rate of endovascular repair surgery was 86.81％(520/599).The aged patients had significantly lower incidences of postoperative fever and non-infectious fever than the non-aged patients(P＜0.05,P＜0.01).There were no statistical differences in the ratio of using first and second generation cephalosporins or clindamycin and the duration of postopera-tive medication between the febrile group and afebrile group(P＞0.05).Multivariate logistic re-gression analysis showed that for acute disease,implantation of polytetrafluoroethylene stents(OR=7.931,95％CI:1.945-32.337,P=0.004)was a risk factor,while administration of statins(OR=0.160,95％CI:0.032-0.807,P=0.026)was a protective factor for non-infectious fever.ROC curve analysis indicated that showed our model based on above results of multivariate logis-tic regression analysis had an AUC value of 0.836,a sensitivity of 60.0％and a specificity of 95.0％.For chronic disease,implantation of polytetrafluoroethylene stents(OR=2.558,95％CI:1.250-5.235,P=0.010)and preoperative increased temperature(OR=4.615,95％CI:1.502-14.181,P=0.008)were risk factors for non-infectious fever.Based on these results,the construc-ted model obtained an AUC value of 0.714 in ROC curve analysis.Conclusion For elderly patients undergoing aortic repair surgery,it is unnecessary to upgrade the variety of antibiotics or extend the course of treatment due to advanced age.Individualized analysis of possible infections should be conducted to promote the rational use of antibiotics.

Objective To explore the clinical characteristics and features of noninfectious fever in elderly patients with aortic dilation disease.Methods A total of 599 elderly patients diagnosed with aortic dilation disease(including 274 cases of acute disease and 325 cases of chronic disease)in the Affiliated Wuxi People's Hospital of Nanjing Medical University from January 2021 to June 2024 were recruited.According to their age,the patients with acute disease were divided into aged group 1(105 cases)and non-age group 1(169 cases),and those with chronic disease were into aged group 2(231 cases)and non-age group 2(94 cases).For the 520 patients(246 cases of acute disease and 274 cases of chronic disease)subjected for endovascular repair surgery,they were assigned into aged group 3(90 cases)and non-aged group 3(156 cases)for those with acute dis-ease,and aged group 4(206 cases)and non-aged group 4(68 cases)for those with chronic disease.For the 230 patients experiencing postoperative non-infectious fever,they were divided into acute-febrile(50 cases),acute-afebrile(20 cases),chronic-febrile(106 cases)and chronic-afebrile(54 cases)groups.Their general data was compared among the groups.Multivariate logistic regression analysis was conducted to identify the risk factors for postoperative noninfectious fever.ROC curve was plotted to analyze the predictive performance of our model for postoperative noninfec-tious fever.Results The surgical rate of endovascular repair surgery was 86.81％(520/599).The aged patients had significantly lower incidences of postoperative fever and non-infectious fever than the non-aged patients(P＜0.05,P＜0.01).There were no statistical differences in the ratio of using first and second generation cephalosporins or clindamycin and the duration of postopera-tive medication between the febrile group and afebrile group(P＞0.05).Multivariate logistic re-gression analysis showed that for acute disease,implantation of polytetrafluoroethylene stents(OR=7.931,95％CI:1.945-32.337,P=0.004)was a risk factor,while administration of statins(OR=0.160,95％CI:0.032-0.807,P=0.026)was a protective factor for non-infectious fever.ROC curve analysis indicated that showed our model based on above results of multivariate logis-tic regression analysis had an AUC value of 0.836,a sensitivity of 60.0％and a specificity of 95.0％.For chronic disease,implantation of polytetrafluoroethylene stents(OR=2.558,95％CI:1.250-5.235,P=0.010)and preoperative increased temperature(OR=4.615,95％CI:1.502-14.181,P=0.008)were risk factors for non-infectious fever.Based on these results,the construc-ted model obtained an AUC value of 0.714 in ROC curve analysis.Conclusion For elderly patients undergoing aortic repair surgery,it is unnecessary to upgrade the variety of antibiotics or extend the course of treatment due to advanced age.Individualized analysis of possible infections should be conducted to promote the rational use of antibiotics.

Objective To explore the mechanism of Quhan Zhufeng Mixture on proliferation and apoptosis of rheumatoid arthritis fibroblast-like synoviocyte(RA-FLS)based on NDRG2/JAK2/STAT3 signaling pathway.Methods RA-FLS cells were cultured in vitro,and were divided into ① blank serum group,methotrexate group,Quhan Zhufeng Mixture low-,medium-and high-dosage groups;② blank serum group,AG490 group,Quhan Zhufeng Mixture low-,medium-and high-dosage groups.Different concentrations of drug-containing serum were used to intervene cells.Cell proliferation was detected by CCK-8 method,apoptosis was detected by flow cytometry,and mRNA expressions of Bax,Bcl-2,Caspace-3,Caspace-9,N-myc downstream regulatory gene 2(NDRG2),Janus kinase 2(JAK2)and signal transduction and transcription activator 3(STAT3)were detected by RT-qPCR,Western blot was used to detect the protein expressions of Bax,Bcl-2,Caspace-3,Caspace-9,NDRG2,JAK2,STAT3,p-JAK2 and p-STAT3 in cells.Results Compared with the blank serum group,cell survival rate in methotrexate group,Quhan Zhufeng Mixture all dosage groups significantly decreased(P<0.01),the apoptosis rate significantly increased(P<0.01),the mRNA and protein expressions of Bax and Caspase-9 significantly increased(P<0.05,P<0.01),while the mRNA and protein expression of Bcl-2 significantly decreased(P<0.01),and Caspase-3 mRNA and protein expression in methotrexate group and Quhan Zhufeng Mixture medium-and high-dosage groups significantly increased(P<0.01).Compared with the blank serum group,the mRNA and protein expression of NDRG2 significantly increased in Quhan Zhufeng Mixture all dosage groups(P<0.05,P<0.01),the mRNA and protein expressions of JAK2 and STAT3 were significantly reduced in AG490 group and Quhan Zhufeng Mixture medium-and high-dosage groups(P<0.05,P<0.01),and the expressions of p-JAK2 and p-STAT3 proteins were significantly reduced(P<0.01).Conclusion Quhan Zhufeng Mixture can regulate the proliferation and apoptosis of RA-FLS by regulating the activity of NDRG2/JAK2/STAT3 signaling pathway,playing a role in treating rheumatoid arthritis.

Objective To investigate the factors influencing global longitudinal strain(GLS)measured by cardiac magnetic resonance(CMR)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods Clinical data of 315 hospitalized patients diagnosed with acute STEMI who underwent percutaneous coronary intervention(PCI)at the First Medical Center of Chinese PLA General Hospital from June 2016 to September 2021 were retrospectively collected.After analyzing CMR images of all patients,GLS and other strain parameters were obtained,and then the patients were divided into two groups according to the median GLS.In order to balance gender and age differences,1:1 propensity score matching was performed,and 206 patients were eventually included:GLS>-11.3%group(indicating severe GLS impairment,n=103)and GLS≤-11.3%group(n=103).Baseline characteristics,laboratory indicators,coronary angiographic parameters,electrocardiogram(ECG)features,and CMR parameters were compared between the two groups.Variables showing significant differences were analyzed for their correlation with GLS.Multivariate logistic regression and multiple stepwise linear regression analyses were performed to identify factors associated with GLS impairment.Results Compared with GLS≤-11.3%group,GLS>-11.3%group had significantly higher peak levels of creatine kinase-MB(CK-MB)and troponin T(TnT)(P<0.001).A higher proportion of patients in GLS>-11.3%group had the left anterior descending artery(LAD)as the culprit vessel,while a lower proportion had the right coronary artery(RCA)as the culprit vessel(P<0.001).Additionally,GLS>-11.3%group had longer QRS duration(P<0.001)and a higher incidence of pathological Q waves(P=0.001).Regarding CMR parameters,GLS>-11.3%group exhibited larger global circumferential strain(GCS),infarct size(IS),and left ventricular end-systolic volume(LVESV),as well as lower global radial strain(GRS)and left ventricular ejection fraction(LVEF)(P<0.001).Multivariate logistic regression indicated that peak TnT(OR=1.092,P=0.001),LAD culprit vessel(OR=3.744,P<0.001),and QRS duration(OR=1.026,P<0.001)were significantly associated with severely impaired GLS.Multiple stepwise linear regression analysis showed that the logarithmic value of peak TnT,LAD as the culprit vessel,and the square root of QRS duration were linearly correlated with GLS values(adjusted R2=0.301,P<0.001),and these independent variables explained 30.1%of the variation in GLS.Conclusion Elevated peak TnT,prolonged QRS duration,and LAD as the culprit vessel are significantly associated with severe GLS impairment in STEMI patients,indicating more severe myocardial infarction and worse left ventricular function.

Objective:To investigate the current status of nutritional support specialist nurses' knowledge, attitude and practice about nutrition nursing practice and analyze their influencing factors, so as to provide reference for optimizing and improving the level of nutritional support specialist nurses' knowledge, attitude and practice, and constructing a training program for nutritional support specialist nurses.Methods:From October to November 2023, 557 nutritional support specialist nurses in 28 provinces, autonomous regions, and municipalities directly under the central government of China were selected for the survey using the convenience sampling method. General information questionnaire and Nutrition Nursing Practice Knowledge, Attitude and Practice Questionnaire were used to conduct the survey. Multiple linear regression was used to explore the influencing factors of knowledge, attitude and practice.Results:A total of 557 questionnaires were distributed and 507 questionnaires were effectively recovered, with an effective recovery rate of 91.0%. The nutrition nursing practice knowledge dimension scores, attitude dimension scores, and practice dimension scores of 507 nutritional support specialist nurses were 30.00 (28.00, 31.00) , 47.00 (41.00, 50.00) , (22.65±6.77) , respectively. Multiple linear regression analyses showed that education was an influencing factor in the knowledge dimension of nutrition nursing practice among nutritional support nurse specialists ( P<0.05) ; title, hospital level, and years of experience as a nutritional support nurse specialist were influencing factors in the attitude dimension of nutrition nursing practice ( P<0.05) . Conclusions:Nutritional support specialist nurses have a good knowledge base of nutrition nursing practice and a positive attitude, but their practices need to be further improved. Knowledge, attitude, and practice are affected by multiple factors such as education, title, hospital level, and number of years in the professional field. In the process of nurse specialist training, managers should pay attention to the learning needs of nurses at different levels, carry out targeted training, establish a standard workflow for nurse specialists, and emphasize the construction of talents in primary hospitals, so as to promote the high-quality development of nutrition support specialist nurses.

The participation of nurses in nutritional screening and assessment is not only the foundation for achieving full coverage of nutritional screening and assessment for hospitalized patients, but also an important guarantee for preventing and improving adverse clinical outcomes in hospitalized patients. Nurses should start by distinguishing between the concepts of nutritional screening and nutritional assessment, selecting patient-appropriate nutritional screening and assessment tools, and accurately timing nutritional screening and assessment to correctly perform nutritional screening and assessment. At the same time, nurses have a unique role and value in identifying nutritional risks in hospitalized patients, performing nutritional screening and assessment, and multidisciplinary nutritional diagnosis and treatment. Although nurses face many challenges in practice, they can address these challenges through artificial intelligence empowerment, the development of nutritional screening and assessment standard processes, the provision of health education to assist patients in self-management, and the establishment of training systems.

Objective:To investigate factors influencing frequent episodes (≥ 4 episodes within 1 year) in children with moderate-to-severe atopic dermatitis (AD) in China.Methods:A national multicenter cross-sectional study was conducted. Patients under the age of 18 years diagnosed with moderate-to-severe AD were enrolled at dermatology clinics in 18 medical institutions across 12 provinces and municipalities in China between June 12 and August 8, 2023. At the time of the visit, their guardians completed a structured questionnaire covering demographic characteristics, clinical features of AD, personal and family history, factors associated with frequent episodes of moderate-to-severe AD, compliance with treatment, and disease awareness. Statistical analyses included t tests, one-way analysis of variance, rank-sum tests, and chi-square tests, with multiple-response analysis applied for multiple-choice questions. Results:A total of 965 valid questionnaires were collected, and 965 children with moderate-to-severe AD were included. Among them, there were 531 males and 434 females, 678 (70.3%) were aged 2 - < 12 years, 837 (86.7%) were from urban areas, the age at onset was 2.47 ± 3.03 years, and the median frequency of AD episodes in the past year was 4 times. These children were divided into 2 groups based on the median episode frequency: < 4-episode group (439 cases, 45.5%) and ≥ 4-episode group (526 cases, 54.5%). Compared with the < 4-episode group, children in the ≥ 4-episode group showed younger ages at onset (2.22 ± 2.98 years vs. 2.76 ± 3.06 years, P = 0.006) and higher proportions of patients with comorbid allergic diseases in both the children themselves (82.9% [436/526] vs. 69.7% [306/439], χ2 = 23.42, P < 0.001) and their relatives (66.0% [347/526] vs. 57.4% [252/439], χ2 = 7.46, P = 0.006). Children in the ≥ 4- episode group also had higher monthly usage of moisturizers (150 [30, 300] g vs. 60 [6, 200] g) and daily frequency of moisturizer use, greater disease awareness, but more severe fear of medication use (all P < 0.05). The region and the human development index level were both significantly associated with the episode frequency (both P < 0.001), with the highest proportion of children from South China in the ≥ 4- episode group (36.3%, 191/526). Children in the ≥ 4-episode group also had a longer duration of topical glucocorticoid use than those in the < 4-episode group ( Z = -2.21, P = 0.027). External triggers associated with AD episodes mainly included heat exposure (50.36%, 486/965), hot water bathing (40.73%, 393/965), seafood (23.52%, 227/965), and dust mites (33.37%, 322/965) . Conclusion:In children with moderate-to-severe AD in China, factors influencing frequent episodes may include residence in southern or economically developed regions, earlier age at onset, having a personal or family history of allergic diseases, and fear of medication use.

Depression is a highly heterogeneous psychiatric disorder with complex pathogenesis influenced by the interplay of biological,psychological,and social-environmental factors.Based on the 2021 edition of the Chinese Guidelines for the Prevention and Treatment of Depressive Disorders,which explicitly identify gender as a significant risk factor for depression onset,this paper systematically reviews the gender-differentiated pathogenesis and therapeutic advances in depression from both traditional Chinese medicine(TCM)and Western medical perspectives.In Western medicine,a large number of studies have demonstrated the sex-specific mechanism of estrogen/testosterone fluctuations and monoamine transmitter system regulation.While in TCM,although the constitution theory proposes that there are significant gender differences in congenital constitution and that qi depression and qi deficiency are associated with susceptibility to depression,current evidence primarily relies on cross-sectional surveys and lacks validation through high-quality RCTs.Compared with Western medicine,the direct research on gender-differentiated antidepressant effects in TCM remains relatively underdeveloped.In future study,it may be possible to deepen and improve the research on anti-depression in TCM from the biological markers of particular constitutions in the gender dimension.This paper advocates establishing a bio-psycho-social integrated intervention model,advancing mechanistic exploration through prospective cohort studies and multi-omics technologies,and promoting precision diagnosis and treatment systems based on gender differences,and to form a three-dimensional diagnosis and treatment and research system that covers biomarkers,social role assessment,and TCM constitution identification,in order to provide a new theoretical framework and a practical pathway for the precise medical treatment of depression.

Objective:To investigate factors influencing frequent episodes (≥ 4 episodes within 1 year) in children with moderate-to-severe atopic dermatitis (AD) in China.Methods:A national multicenter cross-sectional study was conducted. Patients under the age of 18 years diagnosed with moderate-to-severe AD were enrolled at dermatology clinics in 18 medical institutions across 12 provinces and municipalities in China between June 12 and August 8, 2023. At the time of the visit, their guardians completed a structured questionnaire covering demographic characteristics, clinical features of AD, personal and family history, factors associated with frequent episodes of moderate-to-severe AD, compliance with treatment, and disease awareness. Statistical analyses included t tests, one-way analysis of variance, rank-sum tests, and chi-square tests, with multiple-response analysis applied for multiple-choice questions. Results:A total of 965 valid questionnaires were collected, and 965 children with moderate-to-severe AD were included. Among them, there were 531 males and 434 females, 678 (70.3%) were aged 2 - < 12 years, 837 (86.7%) were from urban areas, the age at onset was 2.47 ± 3.03 years, and the median frequency of AD episodes in the past year was 4 times. These children were divided into 2 groups based on the median episode frequency: < 4-episode group (439 cases, 45.5%) and ≥ 4-episode group (526 cases, 54.5%). Compared with the < 4-episode group, children in the ≥ 4-episode group showed younger ages at onset (2.22 ± 2.98 years vs. 2.76 ± 3.06 years, P = 0.006) and higher proportions of patients with comorbid allergic diseases in both the children themselves (82.9% [436/526] vs. 69.7% [306/439], χ2 = 23.42, P < 0.001) and their relatives (66.0% [347/526] vs. 57.4% [252/439], χ2 = 7.46, P = 0.006). Children in the ≥ 4- episode group also had higher monthly usage of moisturizers (150 [30, 300] g vs. 60 [6, 200] g) and daily frequency of moisturizer use, greater disease awareness, but more severe fear of medication use (all P < 0.05). The region and the human development index level were both significantly associated with the episode frequency (both P < 0.001), with the highest proportion of children from South China in the ≥ 4- episode group (36.3%, 191/526). Children in the ≥ 4-episode group also had a longer duration of topical glucocorticoid use than those in the < 4-episode group ( Z = -2.21, P = 0.027). External triggers associated with AD episodes mainly included heat exposure (50.36%, 486/965), hot water bathing (40.73%, 393/965), seafood (23.52%, 227/965), and dust mites (33.37%, 322/965) . Conclusion:In children with moderate-to-severe AD in China, factors influencing frequent episodes may include residence in southern or economically developed regions, earlier age at onset, having a personal or family history of allergic diseases, and fear of medication use.