Cardiac remodeling in microgravity exerts effects on astronauts'health and space mission efficiency.This paper analyzes the etiology,pathogenesis,prevention,and treatment of cardiac remodeling in microgravity based on the Trinity View of"Physique-Qi-Spirit"of traditional Chinese medicine.The microgravity environment disrupts the heaven-earth qi interaction law described in"Suwen Yin Yang Ying Xiang Da Lun":"Earth qi ascends to form clouds through heavenly evaporation,while heaven qi descends as rain".This disruption causes upward reversal of human qi and cephalad fluid shift,consequently influencing the dynamic balance of the physique-qi-spirit system and inducing cardiac remodeling.The core pathogenesis initiates with qi upward reversal at the initial stage,advances through spiritual disturbance during progression,and culminates in physical impairment at the terminal stage.We therefore propose a holistic"physique-qi-spirit"co-regulation strategy implemented via three therapeutic principles:regulating qi,stabilizing spirit,and restoring physique.This approach aims to restore the dynamic balance of the"physique-qi-spirit"system in microgravity,apply the concept of"preventive treatment of diseases",holistically prevent or delay cardiac remodeling,and provide Traditional Chinese Medicine solutions for safeguarding astronauts'cardiovascular health.

Objective:To explore the practical effect of applied talent training model based on the"Four Combinations"among students majoring in Traditional Chinese Medicine in a Medical College.Methods:The undergraduate students majoring in Traditional Chinese Medicine at a medical college from grade 2021 and 2022 were selected as the research subjects and divided into two groups.Experimental group were students who had participated in various extracurricular competitions and innovation and entrepreneurship projects,while control group were students who had not participated in any competitions or projects.The final intellectual education scores of the two groups of students were compared(excluding the scores of Marxist basic principles).A questionnaire survey was conducted on the satisfaction of talent cultivation models among the above undergraduate students,and the validity and satisfaction analysis of the survey results were conducted.Results:The experimental group had significantly higher intellectual education scores than the control group(P＜0.05).The results of factor analysis indicated that the sample suitability and the questionnaire validity seem plausible(KMO=0.874).The overall satisfaction score of students towards the"Four Combinations"talent cultivation model was 4.16±0.2(out of 5),reflecting their high recognition of the model.Conclusion:The construction of a"Four Combinations"characteristic Traditional Chinese Medicine applied talent cultivation model is beneficial for improving the quality of cultivating high-quality and composite applied talents in Traditional Chinese Medicine,so as to provide high-quality applied talents with solid theoretical foundation and practical innovation capabilities for the Liaoshen region.

This paper reviews the current status, problems, challenges, and considerations of enhanced recovery after surgery (ERAS) nursing for hip fracture patients in China, and systematically elaborates on the ERAS nursing programs, nursing pathways, and quality evaluation standards for hip fracture patients in China. In response to the challenges of differentiated starting, difficult clinical practice, and incomplete quality evaluation system in implementing ERAS nursing for hip fracture patients in China, suggestions are proposed to focus on national policies, standardize basic service content, optimize perioperative treatment and nursing processes for elderly hip fracture patients, strengthen the construction of ERAS nursing teams, and implement full cycle process management.

Objective:To analyze the predictive value of age-adjusted Charlson comorbidity index (ACCI) on the risk of falls in elderly patients with femoral neck fractures.Methods:This study was a retrospective cohort study. From June 2021 to June 2022, cluster sampling was used to select 1 050 patients with femoral neck fractures at the Honghui Hospital affiliated with Xi'an Jiaotong University as the study subject. This study calculated the total ACCI score based on patient comorbidities, and divided patients into a low-risk fall group ( n=282) and a high-risk fall group ( n=768) based on whether the fall risk factor assessment score was ≥4.This study compared the differences in age, gender, American Society of Anesthesiologists (ASA) grading, ACCI score, white blood cell count, red blood cell count, platelet count, lymphocyte count, serum albumin, hemoglobin, creatinine, and urea nitrogen between the two groups. Independent variables with P<0.05 were included in binary Logistic regression to analyze the factors affecting the risk of falls in patients, and a receiver operating characteristic (ROC) curve was plotted. Results:There were statistically significant differences in age, ASA grading, red blood cell count, lymphocyte count, ACCI score, serum albumin, hemoglobin, creatinine, and urea nitrogen between the two groups of patients ( P<0.05). Logistic regression analysis found that age, ASA score, and ACCI score were independent risk factors for fall risk ( P<0.05), while serum albumin was an independent protective factor for fall risk ( P<0.05). The area under the ROC curve of ACCI for predicting fall risk was 0.892, and a score of 4 in ACCI was the cutoff value for predicting fall risk. Conclusions:ACCI can serve as an auxiliary tool for evaluating and predicting the risk of falls in elderly patients with femoral neck fractures, and can provide reference for clinical screening of high-risk individuals for falls.

ObjectiveTo analyze the characteristics of kidney Yang deficiency syndrome in different stages and time evolution of chronic kidney disease （CKD） to explore the evolution patterns of kidney Yang deficiency syndrome in CKD. MethodThe evidence information of 256 patients with CKD was collected from October 2020 to September 2022 according to relevant standards， and the "Kidney Yang Deficiency Syndrome Evaluation Scale for Chronic Kidney Disease" was developed. With SPSS Statistics 20.0， SPSS Modeler 18.0， Gephi 0.9.2， and R 4.2.1， the syndrome information of CKD patients at various stages and the syndrome changes after one year were statistically analyzed using complex network analysis， association rule analysis， probability transition matrix analysis， and chi-square test， and the kidney Yang deficiency syndrome of patients at various stages was comprehensively evaluated. ResultIn the CKD population， the proportion of females with kidney Yang deficiency syndrome was higher than that of males （P<0.01）， and the proportion of people over 65 years old was higher than in people under 65 years old. The proportion of people with kidney Yang deficiency syndrome increased with the progression of kidney disease， and the proportion of Ⅳ-Ⅴ CKD patients with kidney Yang deficiency syndrome was higher than that of Ⅰ-Ⅱ CKD patients （P<0.01）. From Ⅰ CKD to Ⅴ CKD， the frequency of dull tongue continued to increase， and the frequency of enlarged tongue and tooth-marked tongue continued to increase after Ⅲ CKD. The frequency of thick coating and greasy coating ranked in the top 3 of frequency distribution in Ⅴ CKD. After Ⅲ CKD， the top 3 tongue characteristics were weak pulse， deep pulse， and thready pulse， all of which were characteristics of kidney Yang deficiency syndrome. Complex network analysis of the tongue and pulse showed that the core tongue and pulse characteristics of patients with end-stage CKD were tooth-marked tongue with white coating and deep and thready pulse. The results of symptom frequency analysis and complex network analysis showed that aversion to cold and preference for warmth， weakness of the knees， and cold extremities were the top 3 symptoms in Ⅰ-Ⅲ CKD patients with kidney Yang deficiency syndrome， and in Ⅳ-Ⅴ CKD， the manifestations of the syndrome of Yang deficiency and water diffusion， such as drowsiness and fatigue， edema， and frequent urination at night became characteristic symptoms. The scores of edema， pale complexion， soreness and weakness of the waist and knees， loose stools， and mental depression symptoms， as well as the total score of kidney Yang deficiency syndrome gradually increased with disease progression， with statistical differences between different stages of CKD （P<0.05， P<0.01）. The frequency analysis of disease-related syndrome elements showed that the frequencies of Yang deficiency syndrome， phlegm-dampness syndrome， blood stasis syndrome， and turbidity-toxin syndrome gradually increased with disease progression， and there were statistically significant differences in the distribution between different stages of CKD （P<0.05， P<0.01）. The results of complex network analysis showed that Yang deficiency syndrome was the core syndrome element throughout all stages of CKD and was the main syndrome element type of CKD， while phlegm-dampness syndrome， blood stasis syndrome， and turbidity-toxin syndrome were gradually revealed in the middle and late stages of CKD. In the CKD population with kidney-Yang deficiency syndrome， the distribution of phlegm-dampness syndrome， blood stasis syndrome， and turbidity-toxin syndrome as concurrent syndromes in different CKD stages had statistically significant differences （P<0.05， P<0.01）. The association rule analysis showed that as the disease progressed， associations between the concurrent syndromes， such as phlegm-dampness syndrome， blood stasis syndrome， turbidity-toxin syndrome， and fluid retention syndrome， and kidney-Yang deficiency syndrome were gradually enhanced. The comparison of the changes in CKD with kidney Yang deficiency syndrome within one year showed that the disease location was centered on the kidney and transmitted between the spleen， stomach， heart， and liver. There is a 23.81% probability of kidney-Yang deficiency syndrome transforming into Qi deficiency syndromes （Qi deficiency in the spleen and kidney， Qi deficiency in the liver， and Qi deficiency in the heart）， 23.79% into Yin deficiency syndromes （Yin deficiency in the liver and kidney， Qi and Yin deficiency， and Yin deficiency in the liver and stomach）， and 9.52% into dampness syndromes （phlegm-dampness internal obstruction and wind-dampness obstruction）. In contrast， 20% of spleen and kidney Qi deficiency syndrome transformed into kidney Yang deficiency syndrome， and 33.33% of Qi deficiency and blood stasis syndrome transformed into kidney Yang deficiency syndrome. ConclusionAs Ⅰ CKD progresses to Ⅴ CKD， the severity of kidney Yang deficiency syndrome gradually increases， and the syndrome characteristics of kidney Yang deficiency become pronounced. Furthermore， the pathogenic factors， such as phlegm-dampness， blood stasis， and turbidity-toxin， gradually increase. With the change of time， kidney Yang deficiency syndrome in CKD tends to evolve into syndromes related to Qi deficiency， Yin deficiency， and dampness. The discovery of these rules provides a theoretical basis and reference guidance for the treatment of CKD based on syndrome differentiation.

Objective:Under the background of "new medical science", to construct a whole-process education path with "education as the driving force - moral cultivation as the core", and to provide a decision-making basis for the reform, innovation, and development of humanistic quality education in medical colleges.Methods:Five-year clinical medical students (freshman to fifth graders) from Qiqihar Medical University were selected as the research objects. The evaluation model and questionnaire of humanistic quality of clinical medical students were constructed by literature analysis. The Questionnaire Star platform was used to investigate and collect data by random sampling of clinical medical undergraduates, and the data results were analyzed by SPSS 26.0 to explore the path of building the whole-process education.Results:The empirical research on the cultivation of humanistic quality of medical students showed that the average humanistic attitude score of medical students was (3.47±0.75) points. From the perspective of gender, the scores of humanistic cognition, attitude, and behavior of male students were 2.81, 3.68, and 3.22 points, respectively, which were all significantly higher than those of female students (2.52, 3.22, and 2.95 points, respectively) ( P<0.05). The data from freshmen to the fifth graders showed that humanistic cognition, attitude, and behavior scores all presented an increasing trend with the grade. Using the "Knowledge, Attitude/Belief, Practice" model, it was found that the cognitive rate of humanistic quality of medical students was relatively ideal, and the awareness rate of medical students in different grades was different. The cross analysis showed that the effect of ideological morality and political literacy education on medical students in medical colleges had a significant cross-relationship with multiple choice questions. Conclusion:The humanistic quality of clinical medical students needs to be improved, and the cultivation of medical humanistic quality should run through the whole process from the first year to the fifth year, so as to improve the comprehensive training of professional ability and promote the all-round development of medical students.

Objective Through factor analysis of the quantified syndrome information of 558 cases of kidney yang deficiency syndrome,the constructing feature of kidney yang deficiency syndrome was revealed,which provides clinical data support for the objectification,standardization and normalization of kidney Yang deficiency syndrome.Methods Firstly,the frequency analysis of symptoms,tongue and pulse signs of 558 patients with kidney Yang deficiency syndrome was carried out,and then the main syndrome information of the patients with kidney Yang deficiency syndrome was quantified.Finally,the common factors and their representative variables of kidney Yang deficiency syndrome were screened out through factor analysis,and the constructing feature of kidney Yang deficiency syndrome was analyzed combined with TCM syndrome knowledge.Results Eight common factors with eigenvalues greater than 1 were extracted by principal component analysis,and the cumulative contribution rate was 60.483%.After the factor rotation,the representative variables with the absolute value of load coefficient greater than 0.45 in each common factor were selected.The representative variables of F1 are afraid of cold and fond of warmth(0.947)and intolerance to cold(0.932).The representative variables of F2 are waist pain(0.754),waist and knee weakness(0.720)and cold in waist and knees(0.466).The representative variables of F3 are depression(0.749),insomnia(0.711)and diarrhoea(0.470).The representative variables of F4 are thin fur(0.819)and white fur(0.768).The representative variable of F5 are tinnitus and deafness(0.687),frequent nocturnal urination(0.591)and decreased libido(0.587).The representative variables of F6 are pulse sinking(0.766)and pulse weakness(0.736).The representative variables of F7 is thready pulse(0.942).The representative variable of F8 is pale tongue(0.961).External syndrome of disease location involved in these common factors are waist,bone,brain,ear,anterior Yin,posterior Yin and reproductive function.The disease nature involved in these common factors is deficiency and cold.Conclusion The basic constituent units of kidney Yang deficiency syndrome include disease location syndrome elements and disease nature syndrome elements.The disease location is kidney,and the abnormal changes of kidney location are mainly external symptoms of waist,bone,brain,ear,anterior Yin,posterior Yin and reproductive function.Its disease nature is deficiency and cold.Yang deficiency leads to external cold.Yang Qi deficiency can not warm the body surface resulting in the appearance of external cold syndrome.

Objective:This article conducted a metrology analysis of the literatures about orthopaedic rehabilitation, and to understand the research status, hot spot and advanced trend of orthopedic rehabilitation.Methods:Literatures related to orthopedic rehabilitation were retrieved from Web of Science core collection database from January 1, 2017 to March 30, 2022. CiteSpace 5.8. R3 software was used to analyze the countries, institutions, keyword co-occurrence, keyword clustering, keyword emergence and so on.Results:A total of 918 literatures were included, and the number of publications was relatively stable in the past 5 years. The United States was the country with the largest number of publications, Monash University was the research institution with the largest number of publications, and the journal with the highest citation frequency was J Bone Joint Surg Am. Burst keywords "questionnaire" and "predictor" would become the development trend and research focus in this field. Conclusions:The literatures related to orthopedic rehabilitation cover a wide range, but the depth of the research is insufficient, the published journals are scattered, and the cooperation between the state and institutions needs to be strengthened.

Objective:To understand the current situation and influencing factors of disease benefit of family caregivers of patients with lung cancer.Methods:Using the convenient sampling method, a total of 210 family caregivers of lung cancer patients treated in Department of Thoracic Surgery in of Cancer Hospital of Peking Union Medical College, Chinese Academy of Medical Sciences from January to February 2021 were selected as research objects. The family caregivers of lung cancer patients were investigated by general information questionnaire, Disease Benefit Finding Scale and Caregiver Preparedness Scale, and influencing factors of disease benefit were analyzed.Results:A total of 210 questionnaires were distributed and 207 were recovered. The score of disease benefit of caregivers was (87.87±12.26) . The results of multiple linear regression analysis showed that the educational level and preparation of caregivers were the influencing factors of disease benefit of family caregivers of lung cancer patients ( P<0.01) . Conclusions:The educational level and readiness of caregivers are influencing factors of disease benefit of family caregivers of patients with lung cancer. Medical staff should pay attention to the evaluation of the educational level and readiness of family caregivers.

Objective: To explore the influence of self-determination theory (SDT) on adolescent physical activity promotion. Methods: Six electronic databases including EBSCO host, Science Direct, Sports Discus, Springer Link, Pubmed, and Web of Science. The search period is from all databases to all relevant documents from the start date to May 18, 2019. An exhaustive collection of studies was selected to assess the relationship between motivation and physical activity in children and adolescents. Results: A total of 41 studies met the inclusion criteria. The overall level of self-determination motivation had a weak to moderate promotion of physical activity level (ρ=0.21-0.31). Autonomous forms of motivation (internal motivation and identification regulation) had a moderate role in promoting physical activity(ρ=0.27-0.38), while controlled forms of motivation (ie, introversion regulation and external motivation) had weak inhibition(ρ=-0.17--0.03). Lack of motivation showed a weak inhibitory effect on physical activity(ρ=-0.21--0.11). Conclusion Self-determination motives are significatly correlated with continued health promotion behaviors. Therefore, it is an effective method to promote physical health among children and adolescents with self-determination motive as an objective in the intervention.