Objective:To explore the longitudinal trajectory of sleep disorders and their influencing factors in newly diagnosed breast cancer patients, and provide theoretical basis for formulating intervention measures to improve sleep quality of breast cancer patients.Methods:A longitudinal study was conducted using convenience sampling to select newly diagnosed breast cancer patients from Shandong Provincial Third Hospital and Shandong First Medical University Affiliated Provincial Hospital from April 2023 to June 2024. General information questionnaires, the Pittsburgh Sleep Quality Index (PSQI), the Concerns About Recurrence Scale (CARS), and the Distress Disclosure Index (DDI) were used for the survey. The Kruskal-Wallis H test and generalized estimating equation models were used to examine sleep disorders and their influencing factors. Results:A total of 473 valid questionnaires were collected. Among the 473 newly diagnosed breast cancer patients, 435 were female and 38 were male, aged (49.5 ± 11.0) years old. The CARS score at admission was (3.00 ± 1.12) points, with concerns about death (0.71 ± 0.67) points and concerns about female characteristics (0.81 ± 0.72) points. The DDI score at admission was (27.00 ± 10.03) points. The PSQI scores at admission, discharge, and one month after discharge were (15.34 ± 3.05), (12.12 ± 3.01), and (10.13 ± 1.78) points, respectively, the difference was statistically significant ( H =33.19, P<0.05). The PSQI scores at these three time points were positively correlated with the CARS score and concerns about death and female characteristics ( r values were 0.42-0.79, all P<0.05), and negatively correlated with the DDI score ( r =-0.41, -0.37, -0.31, all P<0.05). The generalized estimating equation model showed that female gender ( β=1.35, 95% CI 0.27-2.30), education level of junior high school or below ( β=1.89, 95% CI 0.24-3.19), severe pain ( β=1.72, 95% CI 0.32-3.12), moderate pain ( β=2.51, 95% CI 0.37-4.66), invasive special cancer ( β=2.57, 95% CI 1.67-4.07), invasive non-special cancer ( β=2.11, 95% CI 1.98-3.12), partial understanding of the condition ( β=1.91, 95% CI 1.23-3.01), concerns about death ( β=1.61, 95% CI 0.17-2.78), and concerns about femininity ( β=1.34, 95% CI 0.37-2.15) positively predicted the sleep quality index in newly diagnosed breast cancer patients (all P<0.05). Non-invasive cancer ( β=-3.82, 95% CI -6.79--3.36), lack of understanding of the condition ( β=-3.96, 95% CI -7.09--4.62), and DDI score ( β=-1.45, 95% CI -2.14--0.15) negatively predicted the sleep quality index (all P<0.05). Conclusions:The overall sleep quality of newly diagnosed breast cancer patients is low, with the lowest at admission and gradual improvement at discharge and one month after discharge. Medical staff should pay attention to high-risk patients who are female, have lower education levels, higher pain scores, poorer pathological types, and partial understanding of their condition.

Stroke is a critical health issue in China, and carotid artery stenosis and plaque play key roles in its prevalence. Despite the acknowledged significance of this condition, detailed information regarding the prevalence of carotid artery stenosis and plaque across the Chinese population has been scarce. This study analyzed data from the China Stroke High-risk Population Screening and Intervention Program for 2020-2021, focusing on 194 878 Chinese adults aged 40 years and above. It assessed the prevalence of carotid artery stenosis and plaque and identified their associated risk factors. Results revealed a standardized prevalence of 0.40% for carotid artery stenosis and 36.27% for carotid plaque. Notably, the highest rates of stenosis were observed in north and south China at 0.61%, while southwestern China exhibited the highest plaque prevalence at 43.17%. Key risk factors included older age, male gender, hypertension, diabetes, stroke, smoking, and atrial fibrillation. This study highlights significant geographical and demographic disparities in the prevalence of these conditions, underlining the urgent need for targeted interventions and policy reforms. These measures are essential for reducing the incidence of stroke and improving patient outcomes, addressing this significant health challenge in China.
Humans ; China/epidemiology* ; Male ; Female ; Prevalence ; Middle Aged ; Carotid Stenosis/epidemiology* ; Risk Factors ; Aged ; Adult ; Plaque, Atherosclerotic/epidemiology* ; Stroke/epidemiology* ; Aged, 80 and over

Objective:To investigate the preventive and therapeutic effects and mechanisms of Dachaihu decoction(DCD)on dextran sodium sulfate(DSS)-induced ulcerative colitis(UC)and liver injury in mice,as well as the association between DCD benefits and gut microbiota modulation.Methods:Mice were treated with DCD(20.10 and 10.05 g/kg)for 2 weeks,with free access to drinking water containing 3%DSS in the second week to induce UC.Histopathological examination,RT-qPCR and 16S rRNA sequencing were used to investigate the effect of DCD on UC mice.Results:DCD pretreatment significantly alleviated weight loss,bloody diarrhea with mucus,histopathological abnormalities of the colon,and colon shortening in mice with DSS-induced UC.In addition,DCD pretreat-ment significantly upregulated the levels of Occludin,ZO-1,and MUC-2 in the colon and protected the intestinal barrier of mice.DCD pretreatment also alleviated inflammatory cell infiltration in the colon and the liver and significantly reduced the expression levels of the proinflammatory factors such as IL-1β,IL-6,TNF-α,iNOS,COX-2,and NLRP3,thereby exerting a protective effect against UC and liver injury.It should be noted that DCD corrected gut micro-biota imbalance in UC mice by enriching probiotic bacteria such as Lactobacillus and Bifidobacterium and reducing harmful bacteria such as Norank_f_Desulfovibrionaceae and Escherichia-Shigella.Conclusion:DCD can alleviate DSS-induced UC and exert a liver-protecting effect by protecting intestinal barrier,inhibiting inflam-mation,and regulating gut microbiota.

Objective:To explore the longitudinal trajectory of sleep disorders and their influencing factors in newly diagnosed breast cancer patients, and provide theoretical basis for formulating intervention measures to improve sleep quality of breast cancer patients.Methods:A longitudinal study was conducted using convenience sampling to select newly diagnosed breast cancer patients from Shandong Provincial Third Hospital and Shandong First Medical University Affiliated Provincial Hospital from April 2023 to June 2024. General information questionnaires, the Pittsburgh Sleep Quality Index (PSQI), the Concerns About Recurrence Scale (CARS), and the Distress Disclosure Index (DDI) were used for the survey. The Kruskal-Wallis H test and generalized estimating equation models were used to examine sleep disorders and their influencing factors. Results:A total of 473 valid questionnaires were collected. Among the 473 newly diagnosed breast cancer patients, 435 were female and 38 were male, aged (49.5 ± 11.0) years old. The CARS score at admission was (3.00 ± 1.12) points, with concerns about death (0.71 ± 0.67) points and concerns about female characteristics (0.81 ± 0.72) points. The DDI score at admission was (27.00 ± 10.03) points. The PSQI scores at admission, discharge, and one month after discharge were (15.34 ± 3.05), (12.12 ± 3.01), and (10.13 ± 1.78) points, respectively, the difference was statistically significant ( H =33.19, P<0.05). The PSQI scores at these three time points were positively correlated with the CARS score and concerns about death and female characteristics ( r values were 0.42-0.79, all P<0.05), and negatively correlated with the DDI score ( r =-0.41, -0.37, -0.31, all P<0.05). The generalized estimating equation model showed that female gender ( β=1.35, 95% CI 0.27-2.30), education level of junior high school or below ( β=1.89, 95% CI 0.24-3.19), severe pain ( β=1.72, 95% CI 0.32-3.12), moderate pain ( β=2.51, 95% CI 0.37-4.66), invasive special cancer ( β=2.57, 95% CI 1.67-4.07), invasive non-special cancer ( β=2.11, 95% CI 1.98-3.12), partial understanding of the condition ( β=1.91, 95% CI 1.23-3.01), concerns about death ( β=1.61, 95% CI 0.17-2.78), and concerns about femininity ( β=1.34, 95% CI 0.37-2.15) positively predicted the sleep quality index in newly diagnosed breast cancer patients (all P<0.05). Non-invasive cancer ( β=-3.82, 95% CI -6.79--3.36), lack of understanding of the condition ( β=-3.96, 95% CI -7.09--4.62), and DDI score ( β=-1.45, 95% CI -2.14--0.15) negatively predicted the sleep quality index (all P<0.05). Conclusions:The overall sleep quality of newly diagnosed breast cancer patients is low, with the lowest at admission and gradual improvement at discharge and one month after discharge. Medical staff should pay attention to high-risk patients who are female, have lower education levels, higher pain scores, poorer pathological types, and partial understanding of their condition.

Objective:A scoping review of factors influencing eHealth literacy in older adults to inform future research and clinical practice.Methods:Accordance with the scope review methodological framework, research questions were established, and PubMed, Web of Science, Medline, CINAHL, Embase, Cochrane Library, CBM, CNKI, Wanfang, and VIP databases were systematically searched for the timeframe of the search from the time the database was constructed to November 24, 2023.Results:A total of 29 articles were included in the literature, which met the criteria of inclusion exclusion. The main factors influencing eHealth literacy among older adults included sociodemographic factors, disease-related factors, Internet use characteristics, psychosocial factors, healthy aging, and perceived health risks.Conclusions:eHealth literacy in older adults is affected by many complex factors. Most of the measurement tools are universal scales, and there are differences in the results of studies in different groups and regions. Future studies may consider using or developing specific eHealth literacy assessment tools for older adults, and carrying out targeted studies on older adults with different group characteristics.

Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) has a wide range of symptoms, and it is difficult for clinicians to make a quick and correct diagnosis. On November 11, 2021, a 36-year-old male patient with AAV was admitted to the emergency and critical care department of Yichang Central People's Hospital. He was admitted to the emergency intensive care unit (EICU) with gastrointestinal symptoms (abdominal pain, black stool) as the main physical signs, and was initially diagnosed as AAV with gastrointestinal hemorrhage (GIH). No bleeding point was found after repeated gastroscopy and colonoscopy. Abdominal emission CT (ECT) showed diffuse hemorrhage in the ileum, ascending colon and transverse colon. Multi-disciplinary consultation in the whole hospital considered the diffuse hemorrhage caused by small vascular lesions in the digestive tract caused by AAV. Pulse therapy with methylprednisolone 1 000 mg/d and immunosuppressive therapy with cyclophosphamide (CTX) 0.2 g/d were administered. The patient's symptoms quickly relieved and transferred out of the EICU. After 17 days of treatment, the patient finally died of massive gastrointestinal bleeding. A systematic review of relevant literatures combined with the case diagnosis and treatment process found that only a minority of AAV patients present with gastrointestinal symptoms as their first symptoms, and patients with GIH were very rare. Such patients had a poor prognosis. This patient delayed the use of induced remission and immunosuppressive agents due to the treatment of gastrointestinal bleeding, which may be the main cause of life-threatening GIH secondary to AAV. Gastrointestinal bleeding is a rare and fatal complication of vasculitis. Timely and effective induction and remission treatment is the key to survival. Whether patients should receive maintenance therapy, the duration of maintenance therapy, and the search for markers of disease diagnosis and treatment response are directions and challenges for further research.
Male ; Humans ; Adult ; Gastrointestinal Hemorrhage ; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis ; Critical Care ; Cyclophosphamide ; Death

Objective:To explore the effects of online supportive disclosure therapy on the self-expression level, professional identity, dimission intention, and turnover rate of pre-dimission nurses, in order to provide a reference for nursing managers to stabilize the nursing team.Methods:A quasi experimental research method was used, and a convenient sampling method was used to select 192 pre resigned nurses from Shandong Provincial Third Hospital, the First Affiliated Hospital of Shandong First Medical University, and Shandong First Medical University Affiliated Provincial Hospital from October 2021 to December 2022 as the research subjects. They were divided into a control group and an experimental group by random number table method, with 96 nurses in each group. The control group received routine exit interviews, while the experimental group received online supportive disclosure therapy intervention based on this. The self-expression level, professional identity, dimission intention, and turnover rate of two groups of nurses before and 1, 2 months after the intervention were evaluated.Results:Finally, 94 nurses in the control group and 92 nurses in the experimental group completed the study. There were no significant differences in the self-expression level, professional identity, dimission intention before the intervention between the two groups ( P>0.05). After 1 and 2 months of the intervention, the scores of the Pain Self Disclosure Index, Nurse Professional Identity Rating Scale, and Resignation Intention Scale of the experimental group were 36.33 ± 5.13, 73.88 ± 8.72, 14.18 ± 1.12 and 34.22 ± 6.78, 98.26 ± 11.29, 6.16 ± 1.19, respectively,and the control group were 28.06 ± 8.23, 64.72 ± 10.39, 17.82 ± 1.37 and 44.26 ± 7.62, 79.82 ± 8.66, 9.18 ± 1.06, there were statistically significant differences between the two groups ( t values were -13.54 to -2.11, all P<0.05); there were statistically significant differences in the inter group effects, time effects, and interaction effects of the scores on the Pain Self Disclosure Index, Professional Identity Rating Scale, and Resignation Intention Scale between the two groups ( F values were 5.12 to 14.82, all P<0.05). The turnover rate of nurses in the experimental group was 1.09% (1/92), lower than 8.51% (8/94) in the control group, and the difference between the two groups was statistically significant ( χ2=1.59, P<0.05). Conclusions:Online supportive disclosure therapy can improve the self-expression level and professional identity of pre-dimission nurses, and reduce their willingness to resign and turnover rate.

Tumor radiotherapy is established on the basis of clinical oncology, radio-physics and radiobiology, and has become one of the three major therapeutic methods for malignant tumors. With the pace of socialist construction in China, the subject of radiotherapy in Shanxi province has developed from scratch and from small to large for more than 60 years. Remarkable achievements have been made in the establishment of departments, the updating of technical equipment, the increase of employees and clinical scientific research. This article reviews and summarizes the development history of tumor radiotherapy in Shanxi province.

Objective To investigate the neurodevelopmental toxicity of ACR by studying the expression of DCX and GAP-43 in the hippocampal dentate gyrus of rats after maternal exposure to acrylamide. Methods Pregnant rats were randomly divided into low-dose ACR(4.5 mg/kg),medium-dose(9 mg/kg),high dose groups(18 mg/kg)and the control group(0 mg/kg),8 in each group,and were exposed to toxicant from gestation-al day 15 to postnatal day 13. All rats and their pups were killed on postnatal day 14. ABC immunohistochemistry was used to detect the expression of GFAP in the hippocampus of mother rats and offspring. Results Compared with the control group,the expression of DCX and GAP-43 in hippocampus dentate gyrus of the pregnant rats in middle and high dose groups was significantly decreased(P < 0.05). Conclusion ACR may interfere with the growth and development of neurons by reducing the expression of DCX and GAP-43.

Objective To understand the prevalence of goiter and nodule as well as the iodine nutritional status of 8 to 10 years old children after changing water source with lower iodine so as to evaluate its intervention effectiveness.Methods From 2014 to 2017,Machang Village and Liangzhang Village of Haixing County in Haixing County were selected as monitoring sites in the water-sourced high iodine area in Hebei Province.Using the cross-sectional survey method,100 children aged 8 to 10 years old were randomly selected in each village,half male and half female.Dynamic monitoring of drinking water iodine content,children's prevalence of goiter and nodule as well as urinary iodine content were conducted before and 1-3 years after changing water resource.Iodine detection was performed using an arsenic cerium-catalyzed spectrophotometric method suitable for iodine-deficient and high-iodine areas (recommended method for national iodine deficiency disease reference experiment);urinary iodine was detected by arsenic cerium catalytic spectrophotometry (WS/T 107-2006).The thyroid test was performed using the B-ultrasound method and the criterion was based on the "Diagnostic Criteria for Endemic Goiter" (WS 276-2007).Results The median iodine content of water in the two villages before the reformation was 861.0 μg/L,and it was 71.6,29.1 and 30.4 μg/L in 1-3 years after water was changed.The overall difference before and after water change was statistically significant (x2 =8.48,P ＜ 0.05).The median urine iodine of children in the two villages before the change of water was 705.0 μg/L,and the median urine iodine of children was 306.0,143.0 and 140.0 μg/L after 1-3 years.The differences were statistically significant (Z =6.56,10.82,11.19,P ＜ 0.05).The goiter rate was 10.3％ (21/203) before changing water,and the goiter rate was 6.3％ (13/205),6.4％ (13/203) and 3.8％ (8/208) in 1-3 years after water exchange,and the difference between before and 3 years after water exchange was statistically significant (x2 =6.61,P ＜ 0.05).Children's nodule prevalence before and 3 years after changing water was 11.3％ (23/203) and 1.4％ (3/208),the difference was statistically significant (x2 =13.42,P ＜ 0.05).Conclusion Three years after changing water resource,children's goiter prevalence is back to normal in general,and nodule prevalence is decreased significantly,which indicates sound intervention effectiveness.