Objective:To construct a medical student professionalism evaluation system based on the Delphi method and provide a scientific tool for evaluation of medical education and clinical practice.Methods:Based on the Accreditation Council for Graduate Medical Education, the Canadian Medical Education Directives for Specialists, and the Chinese Resident Core Competency Framework, the indicators were selected through two rounds of Delphi consultation with 11 experts. The final medical professionalism evaluation system included 29 indicators in eight categories: professional ethics, dedication, humanistic qualities, systematic improvement ability, the process of medical professionalism, personal growth and help-seeking, patient-centered care, and teamwork. SPSS 29.0 software was used for data analysis, including descriptive statistics (mean ± standard deviation), analytic hierarchy process to determine the weights, and calculation of Cronbach's α coefficient, Spearman-Brown split-half reliability coefficient (0.929), and scale-level content validity index. The significance level was set at α=0.05. Results:The expert authority coefficients for the two rounds of consultation were 0.863 and 0.867, and the variations of Kendall coefficient of coordination were all <25.00%. The final evaluation system contained eight first-level indexes (the highest weight was 14.362% for professional ethics) and 29 second-level indicators. The system demonstrated high reliability and validity (Cronbach's α coefficient=0.912, scale-level content validity index/average=0.910). Conclusions:The professionalism evaluation system for medical students constructed in this study is scientific and practical, and can provide a reference for the quality assessment of medical education. The high reliability and validity of the evaluation system suggest that it is suitable for clinical practice and teaching feedback, though further localization to align with Chinese characteristics is necessary for further refinement.

Objective:To carry out a systematic review of the development, introduction or validation of drug literacy assessment tools for adults at home and abroad, and to summarize and analyze the characteristics of the assessment tools.Methods:The research framework of the scoping review was used to systematically search 8 Chinese and English databases, such as China National Knowledge Infrastructure, China Biology Medicine disc, PubMed, Web of Science, and Embase. The search period was from database establishment to October 31, 2023. Studies on adult drug literacy assessment tools were screened and included, tool characteristics were extracted and analyzed, and ultimately the extracts were standardized for reporting.Results:A total of 31 articles that met the criteria were included, of which 26 were on the development and validation of assessment tools, three were on the localization and application of assessment tools, and two were on the revision of assessment tools, covering 33 assessment tools.Conclusions:It is needed to recognize the importance of drug literacy assessment, actively explore the diversity of drug literacy assessment tools, clarify the limitations of existing drug literacy assessment tools, further improve the reliability and validity of existing tools, continue to develop and introduce assessment tools suitable for China's national conditions, so as to increase the accuracy of drug literacy assessment.

Objective:To explore the potential profile characteristics and influencing factors of rehabilitation motivation in elderly patients with first stroke, so as to provide reference for promoting precise rehabilitation mode.Methods:A convenience sampling method was employed to conduct a cross-sectional survey of elderly patients with first stroke admitted to the Huanhu Hospital Affiliated to Tianjin Medical University from October 2024 to March 2025. The survey utilized a general information questionnaire, the Motivation in Stroke Patients for Rehabilitation Scale, the Perceived Social Support Scale (PSSS), the Exercise Adherence Questionnaire (EAQ), and the Stroke Stigma Scale (SSS). Potential categories of rehabilitation motivation among elderly patients with first stroke were identified using latent profile analysis, and the influencing factors of these potential categories were explored using the ordered multinomial Logistic regression.Results:A total of 290 survey questionnaires were distributed, and 281 valid questionnaires were collected, with an effective response rate of 96.9%(281/290). Among 281 elderly patients with first stroke, there were 152 males and 129 females, with an age of (68.68 ± 6.89) years. The score of the Motivation in Stroke Patients for Rehabilitation Scale was 56.00 (36.00, 68.00) points. Rehabilitation motivation among elderly patients with first stroke could be categorized into three groups: low motivation-lack of family support and unclear goals group (44.1%, 124/281), moderate motivation-social reintegration driven but insufficient behavior group (41.3%, 116/281), and high motivation autonomous planning adaptation and value internalization group (14.6%, 41/281). The ordered multinomial Logistic regression analysis showed that compared to patients aged ≥80 years, patients aged 60-69 years were less likely to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=0.231, P<0.05). Compared to patients with a per capita monthly income of ≥5 001 yuan, patients with a per capita monthly income of 3 001-5 000 yuan were more likely to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=2.340, P<0.05). Compared to heavily dependent patients, patients who were completely independent ( OR=0.160, P<0.05), mildly dependent ( OR=0.155, P<0.01), and moderately dependent ( OR=0.211, P<0.05) were less likely to belong to the high motivation autonomous planning adaptation and value internalization group. The higher the EAQ score, the more likely patients were to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=1.139, P<0.01). The higher the PSSS score, the more likely patients were to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=1.108, P<0.01). The higher the SSS score, the less likely patients were to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=0.787, P<0.01). Conclusions:Healthcare professionals can develop targeted intervention strategies based on the characteristics and influencing factors of patients' different rehabilitation motivations, thereby enhancing their rehabilitation motivation and promoting patient recovery.

Objective:To explore the potential categories of internal ability of elderly patients with ischemic stroke, identify the influencing factors and propose corresponding nursing interventions.Methods:This was a cross-sectional study. From January 2025 to May 2025, the elderly patients with ischemic stroke in Tianjin Huanhu Hospital were selected by convenient sampling method. The general information questionnaire, the Internal Capacity Assessment Scale for the Older People, the Health Literacy Scale for stroke patients and the Perceived Social Support Scale were used to investigate. To determine latent categories of patients' intrinsic capacity, potential profile analysis was employed. Subsequently, multivariable Logistic regression examined factors associated with these categories.Results:A total of 260 survey questionnaires were distributed, and 256 valid questionnaires were finally collected, with an effective response rate of 98.46% (256/260). Among of them, there were 166 males and 90 females, aged 68.00 (63.00, 74.00) years.The intrinsic ability of elderly patients with ischemic stroke could be divided into three potential categories: low sensation-low exercise group (27.0%, 69/256), relatively stable intrinsic ability group (37.5%, 96/256) and low cognition-low psychology group (35.5%, 91/256). Multivariable Logistic regression showed that advanced age (compared to the low sensation-low exercise group, OR=0.902; compared to the relatively stable intrinsic ability group, OR=0.813), smoking (compared to the low sensation-low exercise group, OR=0.459; compared to the relatively stable intrinsic ability group, OR=0.442), the lower the Barthel index (compared to the low sensation-low exercise group, ≤40 points with OR=0.157; 41-60 points with OR=0.285) were more likely to enter the low cognition-low psychology group (all P<0.05); other chronic disease types ≤1 (compared to the low cognition-low psychology group, OR=2.630), higher health literacy scores (compared to the low cognition-low psychology group, OR=1.033) were more likely to enter the relatively stable intrinsic ability group (both P<0.05); and stroke frequency was the first occurrence (compared to the low cognition-low psychology group, OR=2.725) was more likely to enter the low sensation-low exercise group ( P<0.05). Conclusions:In older adults with ischemic stroke, the characteristics of intrinsic ability are clearly categorized. To enhance patient outcomes, healthcare professionals are advised to tailor nursing interventions based on the unique features and specific influencing factors associated with each potential category.

Objective To investigate the evaluation value of serum 25-hydroxyvitamin D[25-(OH)D],heart-type fatty acid-binding protein(H-FABP),and N-terminal pro-brain natriuret-ic peptide(NT-ProBNP)in early myocardial injury in patients with acute exacerbation of chronic ob-structive pulmonary disease(AECOPD).Methods A total of 120 patients with AECOPD(AECOPD group)were enrolled in this study.Based on the presence of early myocardial injury,they were divided into injury group(n=68)and non-injury group(n=52).Additionally,40 healthy individuals undergoing physical examinations during the same period were included as control group.The differences in serum 25-(OH)D,H-FABP,and NT-ProBNP levels were compared,and the correlations between these markers and clinical data were analyzed.Binary logistic regression analysis was used to explore the relationships between these markers and the occurrence of early myocardial injury.Receiver op-erating characteristic(ROC)curve analysis was employed to assess the diagnostic value of these markers for early myocardial injury in AECOPD patients.Results The forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),the ratio of FEV1 to FVC(FEV1/FVC),and arterial partial pressure of oxygen[pa(O2)]levels in the AECOPD group were lower than those in the control group,while the arterial partial pressure of carbon dioxide[p a(CO2)]level was high-er,with statistically significant differences(P＜0.05).The serum 25-(OH)D levels in the AECOPD group and the injury group were lower than those in the control group and the non-injury group,re-spectively,while the H-FABP and NT-ProBNP levels were higher,with statistically significant differences(P＜0.05).In AECOPD patients,serum 25-(OH)D was positively correlated with FEV1,FVC,FEV1/FVC,and pa(O2),and negatively correlated with pa(CO2)(P＜0.05).In contrast,H-FABP and NT-ProBNP were negatively correlated with FEV1,FVC,FEV1/FVC,and pa(O2),and positively correlated with pa(CO2)(P＜0.05).Binary Logistic regression analysis revealed that 25-(OH)D,H-FABP,and NT-ProBNP were related influencing factors for early myo-cardial injury in AECOPD patients(P＜0.05).ROC curve analysis showed that the areas under the curve(AUCs)for evaluating myocardial injury status based on 25-(OH)D,H-FABP,and NT-ProBNP values were 0.814,0.959,and 0.837,respectively.The AUC of their combination was 0.983,with a sensitivity of 97.06％and a specificity of 80.77％.Conclusion During early myocardial injury in AECOPD patients,there is low expression of serum 25-(OH)D and high ex-pression of H-FABP and NT-ProBNP.These three markers are correlated with early myocardial inju-ry and can serve as reference indicators for clinical diagnosis.

This study was aimed at exploring the prevalence and drug sensitivity of Gordonia strains isolated from sputum samples in Henan Province,to provide data to aid in the prevention and treatment of Gordonia infection.A combination of 16S rDNA and sec A1 gene sequencing was used to identify the isolated strains,and susceptibility to16 drugs was determined with the broth microdilution method.A total of 21 strains were identified through 16S rDNA gene and sec A1 gene sequencing,including five strains of Gordonia broncians,eight strains of Gordonia paraphernivans,seven strains of Gordonia sputi,and one strain of Gordonia aichiensis.Drug sensi-tivity testing showed high Gordonia sensitivity to drugs such as ceftriaxone,linezolid,doxycycline,amoxicillin/clavulanic acid,mino-cycline,cefotaxime,trimethoprim/sulfamethoxazole,imipenem,tobramycin,and clarithromycin.The sensitivity rates of the isolated strains were 90.48%(19/21),100%(21/21),90.48%(19/21),90.48%(19/21),95.24%(20/21),90.48%(19/21),90.48%(19/21),90.48%(19/21),and 95.24%(20/21),respectively.Gordonia showed high resistance to rifampicin and cefepime,with rates of 28.57%(6/21)and 19.05%(4/21),respectively.Meanwhile,the resistance varied among bacterial strains.The resistance rate of G.sputi to rifampicin reached 71.43%(5/7),whereas that of G.parapffinivoras to cefepime was 37.5%(3/8).The main species of Gordo-nia isolated from sputum samples of patients in Henan Province were G.bronchialis,G.paraffinivoras,G.sputi,and G.aichiensis.Drug sensitivity tests indicated that drugs including amoxicillin/clavulanic acid,ceftriaxone,cefotaxime,tobramycin,clarithromycin,mi-nocycline,trimethoprim/sulfamethoxazole,linezolid,and doxycycline had good antibacterial effects against Gordonia.

This study was aimed at exploring the prevalence and drug sensitivity of Gordonia strains isolated from sputum samples in Henan Province,to provide data to aid in the prevention and treatment of Gordonia infection.A combination of 16S rDNA and sec A1 gene sequencing was used to identify the isolated strains,and susceptibility to16 drugs was determined with the broth microdilution method.A total of 21 strains were identified through 16S rDNA gene and sec A1 gene sequencing,including five strains of Gordonia broncians,eight strains of Gordonia paraphernivans,seven strains of Gordonia sputi,and one strain of Gordonia aichiensis.Drug sensi-tivity testing showed high Gordonia sensitivity to drugs such as ceftriaxone,linezolid,doxycycline,amoxicillin/clavulanic acid,mino-cycline,cefotaxime,trimethoprim/sulfamethoxazole,imipenem,tobramycin,and clarithromycin.The sensitivity rates of the isolated strains were 90.48%(19/21),100%(21/21),90.48%(19/21),90.48%(19/21),95.24%(20/21),90.48%(19/21),90.48%(19/21),90.48%(19/21),and 95.24%(20/21),respectively.Gordonia showed high resistance to rifampicin and cefepime,with rates of 28.57%(6/21)and 19.05%(4/21),respectively.Meanwhile,the resistance varied among bacterial strains.The resistance rate of G.sputi to rifampicin reached 71.43%(5/7),whereas that of G.parapffinivoras to cefepime was 37.5%(3/8).The main species of Gordo-nia isolated from sputum samples of patients in Henan Province were G.bronchialis,G.paraffinivoras,G.sputi,and G.aichiensis.Drug sensitivity tests indicated that drugs including amoxicillin/clavulanic acid,ceftriaxone,cefotaxime,tobramycin,clarithromycin,mi-nocycline,trimethoprim/sulfamethoxazole,linezolid,and doxycycline had good antibacterial effects against Gordonia.

Objective:To construct a medical student professionalism evaluation system based on the Delphi method and provide a scientific tool for evaluation of medical education and clinical practice.Methods:Based on the Accreditation Council for Graduate Medical Education, the Canadian Medical Education Directives for Specialists, and the Chinese Resident Core Competency Framework, the indicators were selected through two rounds of Delphi consultation with 11 experts. The final medical professionalism evaluation system included 29 indicators in eight categories: professional ethics, dedication, humanistic qualities, systematic improvement ability, the process of medical professionalism, personal growth and help-seeking, patient-centered care, and teamwork. SPSS 29.0 software was used for data analysis, including descriptive statistics (mean ± standard deviation), analytic hierarchy process to determine the weights, and calculation of Cronbach's α coefficient, Spearman-Brown split-half reliability coefficient (0.929), and scale-level content validity index. The significance level was set at α=0.05. Results:The expert authority coefficients for the two rounds of consultation were 0.863 and 0.867, and the variations of Kendall coefficient of coordination were all <25.00%. The final evaluation system contained eight first-level indexes (the highest weight was 14.362% for professional ethics) and 29 second-level indicators. The system demonstrated high reliability and validity (Cronbach's α coefficient=0.912, scale-level content validity index/average=0.910). Conclusions:The professionalism evaluation system for medical students constructed in this study is scientific and practical, and can provide a reference for the quality assessment of medical education. The high reliability and validity of the evaluation system suggest that it is suitable for clinical practice and teaching feedback, though further localization to align with Chinese characteristics is necessary for further refinement.

Objective:To explore the potential profile characteristics and influencing factors of rehabilitation motivation in elderly patients with first stroke, so as to provide reference for promoting precise rehabilitation mode.Methods:A convenience sampling method was employed to conduct a cross-sectional survey of elderly patients with first stroke admitted to the Huanhu Hospital Affiliated to Tianjin Medical University from October 2024 to March 2025. The survey utilized a general information questionnaire, the Motivation in Stroke Patients for Rehabilitation Scale, the Perceived Social Support Scale (PSSS), the Exercise Adherence Questionnaire (EAQ), and the Stroke Stigma Scale (SSS). Potential categories of rehabilitation motivation among elderly patients with first stroke were identified using latent profile analysis, and the influencing factors of these potential categories were explored using the ordered multinomial Logistic regression.Results:A total of 290 survey questionnaires were distributed, and 281 valid questionnaires were collected, with an effective response rate of 96.9%(281/290). Among 281 elderly patients with first stroke, there were 152 males and 129 females, with an age of (68.68 ± 6.89) years. The score of the Motivation in Stroke Patients for Rehabilitation Scale was 56.00 (36.00, 68.00) points. Rehabilitation motivation among elderly patients with first stroke could be categorized into three groups: low motivation-lack of family support and unclear goals group (44.1%, 124/281), moderate motivation-social reintegration driven but insufficient behavior group (41.3%, 116/281), and high motivation autonomous planning adaptation and value internalization group (14.6%, 41/281). The ordered multinomial Logistic regression analysis showed that compared to patients aged ≥80 years, patients aged 60-69 years were less likely to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=0.231, P<0.05). Compared to patients with a per capita monthly income of ≥5 001 yuan, patients with a per capita monthly income of 3 001-5 000 yuan were more likely to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=2.340, P<0.05). Compared to heavily dependent patients, patients who were completely independent ( OR=0.160, P<0.05), mildly dependent ( OR=0.155, P<0.01), and moderately dependent ( OR=0.211, P<0.05) were less likely to belong to the high motivation autonomous planning adaptation and value internalization group. The higher the EAQ score, the more likely patients were to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=1.139, P<0.01). The higher the PSSS score, the more likely patients were to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=1.108, P<0.01). The higher the SSS score, the less likely patients were to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=0.787, P<0.01). Conclusions:Healthcare professionals can develop targeted intervention strategies based on the characteristics and influencing factors of patients' different rehabilitation motivations, thereby enhancing their rehabilitation motivation and promoting patient recovery.

Objective:To explore the potential categories of internal ability of elderly patients with ischemic stroke, identify the influencing factors and propose corresponding nursing interventions.Methods:This was a cross-sectional study. From January 2025 to May 2025, the elderly patients with ischemic stroke in Tianjin Huanhu Hospital were selected by convenient sampling method. The general information questionnaire, the Internal Capacity Assessment Scale for the Older People, the Health Literacy Scale for stroke patients and the Perceived Social Support Scale were used to investigate. To determine latent categories of patients' intrinsic capacity, potential profile analysis was employed. Subsequently, multivariable Logistic regression examined factors associated with these categories.Results:A total of 260 survey questionnaires were distributed, and 256 valid questionnaires were finally collected, with an effective response rate of 98.46% (256/260). Among of them, there were 166 males and 90 females, aged 68.00 (63.00, 74.00) years.The intrinsic ability of elderly patients with ischemic stroke could be divided into three potential categories: low sensation-low exercise group (27.0%, 69/256), relatively stable intrinsic ability group (37.5%, 96/256) and low cognition-low psychology group (35.5%, 91/256). Multivariable Logistic regression showed that advanced age (compared to the low sensation-low exercise group, OR=0.902; compared to the relatively stable intrinsic ability group, OR=0.813), smoking (compared to the low sensation-low exercise group, OR=0.459; compared to the relatively stable intrinsic ability group, OR=0.442), the lower the Barthel index (compared to the low sensation-low exercise group, ≤40 points with OR=0.157; 41-60 points with OR=0.285) were more likely to enter the low cognition-low psychology group (all P<0.05); other chronic disease types ≤1 (compared to the low cognition-low psychology group, OR=2.630), higher health literacy scores (compared to the low cognition-low psychology group, OR=1.033) were more likely to enter the relatively stable intrinsic ability group (both P<0.05); and stroke frequency was the first occurrence (compared to the low cognition-low psychology group, OR=2.725) was more likely to enter the low sensation-low exercise group ( P<0.05). Conclusions:In older adults with ischemic stroke, the characteristics of intrinsic ability are clearly categorized. To enhance patient outcomes, healthcare professionals are advised to tailor nursing interventions based on the unique features and specific influencing factors associated with each potential category.