1.Analysis of factors influencing kinesiophobia in patients with conservative treatment of chronic pain caused by lumbar disc herniation based on random forest algorithm
Yanxin XU ; Lishan HUANG ; Jing CHEN ; Lin WANG ; Xuan REN ; Jiawen HUO ; Rui LI ; Aoxiang LUO
Chinese Journal of Practical Nursing 2025;41(7):506-514
Objective:To investigate the prevalence and influencing factors of kinesiophobia in chronic pain patients undergoing conservative treatment for lumbar disc herniation (LDH), providing reference and basis for reducing the occurrence of kinesiophobia in this patient population.Methods:A cross-sectional study was conducted from May 2023 to January 2024. A convenience sample of chronic pain patients undergoing conservative treatment for LDH in Guangdong Second Provincial General Hospital was selected as the study population. Data were collected by the general information questionnaire, Numerical Rating Scale, Tampa Scale of Kinesiophobia-11, Psychological Inflexibility in Pain Scale, and Chronic Pain Self-efficacy Scale. A random forest model was constructed to rank variable importance, and binary Logistic regression was used to analyze the influencing factors of kinesiophobia.Results:The effective response rate of the questionnaire was 96.8% (270/279). Among 270 patients, there were 139 males and 131 females, 92 patients aged 18-40 years, 132 patients aged 41-60 years, and 46 patients aged >60 years old. The total kinesiophobia score for chronic pain patients undergoing conservative treatment for LDH was (31.00 ± 5.09) points, with a kinesiophobia prevalence of 79.6% (215/270). The random forest algorithm identified eight influencing factors: pain self-efficacy, psychological flexibility, physical exercise after low back pain onset, duration of pain, pain status, understanding of LDH, marital status, and pain intensity. Binary Logistic regression analysis showed that physical exercise after low back pain onset ( OR=0.583, 95% CI 0.344-0.986), pain status ( OR=0.424, 95% CI 0.206-0.873), psychological flexibility ( OR=1.102, 95% CI 1.052-1.155), pain self-efficacy ( OR=0.923, 95% CI 0.895-0.953) were significant influencing factors of kinesiophobia in chronic pain patients undergoing conservative treatment for LDH (all P<0.05). Conclusions:The prevalence of kinesiophobia is high among chronic pain patients undergoing conservative treatment for LDH. Physical exercise after low back pain onset, pain status, psychological flexibility, and pain self-efficacy are significant influencing factors. Healthcare professionals should pay increased attention to kinesiophobia in chronic pain patients undergoing conservative treatment for LDH and implement targeted early interventions to reduce its occurrence.
2.Survey of current status of prevention and control of traditional Chinese medicine diagnosis and treatment technique-related infections in Jiangsu Province
Xuan WU ; Jing KONG ; Zihan SUN ; Ge QIU ; Shanshan XU ; Quan CHEN ; Li RUI ; Zhengxiang DAI
Chinese Journal of Nosocomiology 2025;35(9):1385-1390
OBJECTIVE To understand the current status of prevention and control of traditional Chinese medicine(TCM)diagnosis and treatment technique-related infections in various grades of hospitals in Jiangsu Province so as to provide bases for management departments to put forward the norms.METHODS The questionnaire was de-signed by the methods such as Delphic correspondence,the current status of prevalence,prevention and control of TCM diagnosis and treatment technique-related infections among the health care workers in the hospitals of Jiang-su Province was investigated by using convenience sampling method.RESULTS A total of 508 questionnaires were collected from 13 cities of Jiangsu Province.The results showed that the TCM treatment room(63.64%)was the most common operation site for minimally invasive TCM diagnosis and treatment techniques,the bedside(62.50%)of the patients was the major operation site for Chinese medicine enema,and the central sterile supply department(55.31%)was the preferred choice of cleaning and disinfection site for daily recycled TCM apparatu-ses.'One person used for once,airing and preparing for later use after cleaning and disinfection for once'was the major approach taken for the cleaning and disinfection of Gua Sha boards(82.45%)and TCM pots(87.50%).67.87%of the health care workers said that they wound cleaned and disinfected the medical apparatuses of dress-ing,ironing and fumigation every time after the use.The natural ventilation and ultraviolet light(50.39%)was the major method that was taken for the ventilation and disinfection of the treatment rooms for TCM operations.Quick-drying hand disinfectant and non-touch hand-washing equipment(39.37%)were the most commonly e-quipped hand hygiene facilities.CONCLUSIONS The prevention and control of TCM diagnosis and treatment tech-nique-related infections and the health care workers' capabilities for prevention and control of the infection have made remarkable progress in the various grades of hospitals in Jiangsu Province.However,there is still room for further improvement,and the standardized management and construction should be completed so as to safeguard the TCM diagnosis and treatment techniques.
3.Mediating effect of psychological flexibility between pain self-efficacy and kinesiophobia on patients with lumbar disc herniation
Yanxin XU ; Lishan HUANG ; Jing CHEN ; Lin WANG ; Xuan REN ; Jiawen HUO ; Rui LI ; Aoxiang LUO
Modern Clinical Nursing 2025;24(2):48-54
Objective To investigate the mediating effect of psychological flexibility on the relationship between pain self-efficacy and kinesiophobia in patients with lumbar disc herniation(LDH),so as to provide references for relief from kinesiophobia of the patients.Methods Convenience sampling was used to select 256 patients with LDH as the research subjects from the Outpatient Department of Spinal Orthopaedics of a Grade IIIA hospital in Guangdong Province between May and December 2023.The subjects were surveyed with a general information questionnaire,the kinesiophobia assessment scale,psychological flexibility inventory for pain patients,and chronic pain self-efficacy scale.The mediation effect of psychological flexibility on pain self-efficacy and kinesiophobia was analysed using SPSS 26.0 and the PROCESS 3.5 macro.Results The scores for kinesiophobia,psychological flexibility and pain self-efficacy among the LDH patients were 31.66±4.73,55.26±11.06 and 68.14±17.48,respectively.Kinesiophobia was positively correlated with the psychological flexibility(r=0.545,P<0.001)and negatively correlated with the pain self-efficacy(r=-0.599,P<0.001).The psychological flexibility was negatively correlated with the pain self-efficacy(r=-0.510,P<0.001).Psychological flexibility partially mediated the relationship between pain self-efficacy and kinesiophobia,with a mediating effect of-0.045,accounting for 27.78%of the total effect.Conclusion The patients who have LDH and under conservative treatment exhibit a high level of kinesiophobia and with a moderate levels of pain self-efficacy and psychological flexibility.The medical staff can improve the self-efficacy and psychological flexibility of patients,so as to reduce kinesiophobia level and its incidence.
4.Analysis of factors influencing kinesiophobia in patients with conservative treatment of chronic pain caused by lumbar disc herniation based on random forest algorithm
Yanxin XU ; Lishan HUANG ; Jing CHEN ; Lin WANG ; Xuan REN ; Jiawen HUO ; Rui LI ; Aoxiang LUO
Chinese Journal of Practical Nursing 2025;41(7):506-514
Objective:To investigate the prevalence and influencing factors of kinesiophobia in chronic pain patients undergoing conservative treatment for lumbar disc herniation (LDH), providing reference and basis for reducing the occurrence of kinesiophobia in this patient population.Methods:A cross-sectional study was conducted from May 2023 to January 2024. A convenience sample of chronic pain patients undergoing conservative treatment for LDH in Guangdong Second Provincial General Hospital was selected as the study population. Data were collected by the general information questionnaire, Numerical Rating Scale, Tampa Scale of Kinesiophobia-11, Psychological Inflexibility in Pain Scale, and Chronic Pain Self-efficacy Scale. A random forest model was constructed to rank variable importance, and binary Logistic regression was used to analyze the influencing factors of kinesiophobia.Results:The effective response rate of the questionnaire was 96.8% (270/279). Among 270 patients, there were 139 males and 131 females, 92 patients aged 18-40 years, 132 patients aged 41-60 years, and 46 patients aged >60 years old. The total kinesiophobia score for chronic pain patients undergoing conservative treatment for LDH was (31.00 ± 5.09) points, with a kinesiophobia prevalence of 79.6% (215/270). The random forest algorithm identified eight influencing factors: pain self-efficacy, psychological flexibility, physical exercise after low back pain onset, duration of pain, pain status, understanding of LDH, marital status, and pain intensity. Binary Logistic regression analysis showed that physical exercise after low back pain onset ( OR=0.583, 95% CI 0.344-0.986), pain status ( OR=0.424, 95% CI 0.206-0.873), psychological flexibility ( OR=1.102, 95% CI 1.052-1.155), pain self-efficacy ( OR=0.923, 95% CI 0.895-0.953) were significant influencing factors of kinesiophobia in chronic pain patients undergoing conservative treatment for LDH (all P<0.05). Conclusions:The prevalence of kinesiophobia is high among chronic pain patients undergoing conservative treatment for LDH. Physical exercise after low back pain onset, pain status, psychological flexibility, and pain self-efficacy are significant influencing factors. Healthcare professionals should pay increased attention to kinesiophobia in chronic pain patients undergoing conservative treatment for LDH and implement targeted early interventions to reduce its occurrence.
5.Latent profiles and influencing factors of knowledge,attitude and practice of ideology,politics in nursing undergraduate courses
Jing CHEN ; Yanxin XU ; Rui LI ; Xuan REN ; Shuyi ZHU ; Jiawen HUO ; Aoxiang LUO
Modern Clinical Nursing 2025;24(6):16-23
Objective To investigate the types of latent profiles and influencing factors of knowledge,attitudes and practice(KAP)in curriculum-based ideological and political education in undergraduate nursing students and to provide evidence for design of ideological and political courses tailored to different types of nursing undergraduates.Methods A convenience sampling method was used to recruit 671 undergraduate nursing students from our school between March and July 2024.Data were collected using a general data survey form,a KAP questionnaire on nursing curriculum-based ideological and political education,a professional identity survey for nursing undergraduates,and the Jefferson empathy scale nursing student edition(JSPE-NS).Latent profile analysis(LPA)was conducted using 22 items of the KAP questionnaire as observed variables,and a logistic regression analysis was used to assess the influencing factors of different KAP latent profiles in ideological and political education.Results A total of 663 nursing undergraduate students completed the survey.They spread in three latent groups:a mediocre group(172/663,25.9%),a competent group(378/663,57.0%),and an exceptional group(113/663,17.1%).From a single-child family,grade point average(GPA),professional identity and empathy were identified as the factors that influenced KAP latent profiles in curriculum based ideological and political education among the undergraduate nursing students(all P<0.05).Conclusion There exists a heterogeneity in KAP in curriculum based ideological and political education among the undergraduate nursing students.Nursing educators should develop targeted enhancement measures according to the characteristics of latent profile groups therefore to facilitate the comprehensive development of the undergraduate nursing students.
6.Survey of current status of prevention and control of traditional Chinese medicine diagnosis and treatment technique-related infections in Jiangsu Province
Xuan WU ; Jing KONG ; Zihan SUN ; Ge QIU ; Shanshan XU ; Quan CHEN ; Li RUI ; Zhengxiang DAI
Chinese Journal of Nosocomiology 2025;35(9):1385-1390
OBJECTIVE To understand the current status of prevention and control of traditional Chinese medicine(TCM)diagnosis and treatment technique-related infections in various grades of hospitals in Jiangsu Province so as to provide bases for management departments to put forward the norms.METHODS The questionnaire was de-signed by the methods such as Delphic correspondence,the current status of prevalence,prevention and control of TCM diagnosis and treatment technique-related infections among the health care workers in the hospitals of Jiang-su Province was investigated by using convenience sampling method.RESULTS A total of 508 questionnaires were collected from 13 cities of Jiangsu Province.The results showed that the TCM treatment room(63.64%)was the most common operation site for minimally invasive TCM diagnosis and treatment techniques,the bedside(62.50%)of the patients was the major operation site for Chinese medicine enema,and the central sterile supply department(55.31%)was the preferred choice of cleaning and disinfection site for daily recycled TCM apparatu-ses.'One person used for once,airing and preparing for later use after cleaning and disinfection for once'was the major approach taken for the cleaning and disinfection of Gua Sha boards(82.45%)and TCM pots(87.50%).67.87%of the health care workers said that they wound cleaned and disinfected the medical apparatuses of dress-ing,ironing and fumigation every time after the use.The natural ventilation and ultraviolet light(50.39%)was the major method that was taken for the ventilation and disinfection of the treatment rooms for TCM operations.Quick-drying hand disinfectant and non-touch hand-washing equipment(39.37%)were the most commonly e-quipped hand hygiene facilities.CONCLUSIONS The prevention and control of TCM diagnosis and treatment tech-nique-related infections and the health care workers' capabilities for prevention and control of the infection have made remarkable progress in the various grades of hospitals in Jiangsu Province.However,there is still room for further improvement,and the standardized management and construction should be completed so as to safeguard the TCM diagnosis and treatment techniques.
7.Latent profiles and influencing factors of knowledge,attitude and practice of ideology,politics in nursing undergraduate courses
Jing CHEN ; Yanxin XU ; Rui LI ; Xuan REN ; Shuyi ZHU ; Jiawen HUO ; Aoxiang LUO
Modern Clinical Nursing 2025;24(6):16-23
Objective To investigate the types of latent profiles and influencing factors of knowledge,attitudes and practice(KAP)in curriculum-based ideological and political education in undergraduate nursing students and to provide evidence for design of ideological and political courses tailored to different types of nursing undergraduates.Methods A convenience sampling method was used to recruit 671 undergraduate nursing students from our school between March and July 2024.Data were collected using a general data survey form,a KAP questionnaire on nursing curriculum-based ideological and political education,a professional identity survey for nursing undergraduates,and the Jefferson empathy scale nursing student edition(JSPE-NS).Latent profile analysis(LPA)was conducted using 22 items of the KAP questionnaire as observed variables,and a logistic regression analysis was used to assess the influencing factors of different KAP latent profiles in ideological and political education.Results A total of 663 nursing undergraduate students completed the survey.They spread in three latent groups:a mediocre group(172/663,25.9%),a competent group(378/663,57.0%),and an exceptional group(113/663,17.1%).From a single-child family,grade point average(GPA),professional identity and empathy were identified as the factors that influenced KAP latent profiles in curriculum based ideological and political education among the undergraduate nursing students(all P<0.05).Conclusion There exists a heterogeneity in KAP in curriculum based ideological and political education among the undergraduate nursing students.Nursing educators should develop targeted enhancement measures according to the characteristics of latent profile groups therefore to facilitate the comprehensive development of the undergraduate nursing students.
8.Mediating effect of psychological flexibility between pain self-efficacy and kinesiophobia on patients with lumbar disc herniation
Yanxin XU ; Lishan HUANG ; Jing CHEN ; Lin WANG ; Xuan REN ; Jiawen HUO ; Rui LI ; Aoxiang LUO
Modern Clinical Nursing 2025;24(2):48-54
Objective To investigate the mediating effect of psychological flexibility on the relationship between pain self-efficacy and kinesiophobia in patients with lumbar disc herniation(LDH),so as to provide references for relief from kinesiophobia of the patients.Methods Convenience sampling was used to select 256 patients with LDH as the research subjects from the Outpatient Department of Spinal Orthopaedics of a Grade IIIA hospital in Guangdong Province between May and December 2023.The subjects were surveyed with a general information questionnaire,the kinesiophobia assessment scale,psychological flexibility inventory for pain patients,and chronic pain self-efficacy scale.The mediation effect of psychological flexibility on pain self-efficacy and kinesiophobia was analysed using SPSS 26.0 and the PROCESS 3.5 macro.Results The scores for kinesiophobia,psychological flexibility and pain self-efficacy among the LDH patients were 31.66±4.73,55.26±11.06 and 68.14±17.48,respectively.Kinesiophobia was positively correlated with the psychological flexibility(r=0.545,P<0.001)and negatively correlated with the pain self-efficacy(r=-0.599,P<0.001).The psychological flexibility was negatively correlated with the pain self-efficacy(r=-0.510,P<0.001).Psychological flexibility partially mediated the relationship between pain self-efficacy and kinesiophobia,with a mediating effect of-0.045,accounting for 27.78%of the total effect.Conclusion The patients who have LDH and under conservative treatment exhibit a high level of kinesiophobia and with a moderate levels of pain self-efficacy and psychological flexibility.The medical staff can improve the self-efficacy and psychological flexibility of patients,so as to reduce kinesiophobia level and its incidence.
9.Non-target metabolomic analysis of buccal pouch squamous cell carcinoma in Chinese hamsters
Ruihu ZHANG ; Yuan WANG ; Guoqiang XU ; Jiping GAO ; Guohua SONG ; Zhaoyang CHEN ; Rui-Jing XUAN
Journal of Practical Stomatology 2024;40(5):608-613
Objective:To explore the metabolic basis and related molecular mechanism of oral squamous cell carcinoma(OSCC)path-ogenesis.Methods:20 Chinese hamsters were divided into 2 groups(n=10).OSCC models were induced by dimethylbenzanthracene(DMBA)in 10 of the animals and the other 10 were used as the controls.LC-MS chromatography-mass spectrometry was used to iden-tify the metabolites in the buccal pouch,and multidimensional statistical analysis of the metabolites was performed with the orthogonal partial least squares discriminant analysis model.Variable Importance for the Projection(VIP)>1 and P<0.05 were used as the criteria to screen the differential metabolites between the 2 groups.KEGG pathway annotation and enrichment analysis for the metabolites were performed to screen the significantly differential pathways.Results:The hamster cheek pouches painted with 0.5%DMBA for 18 weeks were diffused with leukoplakia and loaded obvious papillary protrusions,which were diagnosed as OSCC by pathological examination.Lipids and lipid-like molecules were the main differential metabolites.Reprogramming of unsaturated fatty acid biosynthesis,cholesterol accumulation,enhanced catabolism of tryptophan,up-regulation of aspartate,increased synthesis of pyrimidine and purine,etc.were important metabolic features in the occurrence and development of OSCC.Conclusion:Molecular intervention targeting the related met-abolic pathways is expected to inhibit OSCC pathogenesis and progression.
10.Retrospective cohort study on the relationship between MTHFR and ABCB1 gene polymorphisms and high-dose methotrexate toxicity in children with acute lymphoblastic leukemia
Rui XU ; Jing LI ; Yu HU ; Li-fu Wu-jü-dan·A MAI ; Rui ZHANG ; Wen JIANG ; Xuan SUN ; Lin WANG ; Jun ZHAO
The Chinese Journal of Clinical Pharmacology 2024;40(13):1963-1967
Objective To determine the relationship between methylenetetrahydrofolate reductase(MTHFR)C677T,A1298C and multidrug resistance 1(ABCB1)C3435T gene polymorphisms and the adverse reactions of high-dose methotrexate(HD-MTX)in children with acute lymphoblastic leukemia(ALL).Methods Blood samples of ALL children treated with HD-MTX chemotherapy were collected,and the polymorphic polymorphism of MTHFR C677T,A1298C and ABCB1 C3435T genes were detected by sequencing method.The adverse drug reactions after MTX chemotherapy were evaluated according to the common adverse drug reaction grading criteria.The relationship between MTHFR C677T,A1298C and ABCB1 C3435T gene polymorphisms and HD-MTX adverse drug reactions was analyzed.Results The risk of MTHFR A1298C AC+CC type hepatic injury(grade 2)was higher than AA type[odds ratio(OR)2.350,95%confidence interval(CI)=1.038-5.320,P<0.05],no correlations were found between MTHFR A1298C and myelosuppression,mucositis,gastrointestinal reaction and acute renal impair(all P>0.05).ABCB1 C3435T CT type hepatic injury(grade 2)was higher than TT type(OR 5.161,95%CI 1.371-19.424,P<0.05),ABCB1 C3435T CC+CT type hepatic injury(grade 2)was higher than TT type(OR 4.231,95%CI 1.165-15.362,P<0.05);no correlations were found between ABCB1 C3435T and myelosuppression,mucositis,gastrointestinal reaction and acute renal impair(all P>0.05).No correlations wre found between MTHFR C677T and HD-MTX adverse drug reactions(all P>0.05).Conclusion When treating ALL with HD-MTX,adverse drug reactions can be predicted by detecting MTHFR A1298C and ABCB1 C3435T genotypes,so as to implement more scientific individualized medication.

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