Objective To summarize the best evidence of early rehabilitation management of hand function in patients with hand burn,and provide basis for medical personnel to carry out early rehabilitation management of hand burn.Methods According to the 5S model,all evidence on early rehabilitation management of hand function in patients with hand burns was retrieved from databases and websites including UpToDate,BMJ Best Practice,NICE,RNAO,GIN,and so on.The retrieved evidence included clinical decisions,guidelines,evidence summaries,expert consensuses,systematic reviews,Meta analysis.The search period of the summary of best evidence,expert concensus and guidelines are from the establishment of the database to December 20,2024,and the search period of the systematic reviews is from January 1,2019 to December 20,2024.Quality evaluation of literature,evidence extraction and summary were conducted.The evidence was graded according to JBI evidence pre-grading system 2014.Results Totally 17 pieces of the literature were included,including 1 clinical decision,4 guidelines,6 evidence summaries,3 expert consensus articles,and 3 systematic reviews.Totally pieces of best evidence were summarized,including 7 aspects of assessment,hand positioning,treatment of edema,dressing,use of orthotics,joint mobility training,and health education.Conclusion This study summarized the best evidence of early rehabilitation management of hand function in patients with hand burn,and provided evidence-based evidence for clinical rehabilitation management plan.According to the clinical situation,the medical staff can apply the evidence to clinical practice,so as to improve the hand function and quality of life of patients.

OBJECTIVE To observe the clinical efficacy of Yangyin Yifei Decoction in treating type 2 diabetes mellitus(T2DM)patients with of qi-yin deficiency and elevated serum keratin 19 fragment(Cyfra21-1).METHODS Sixty patients with T2DM of qi-yin deficiency type and elevated serum Cyfra21-1 who met the inclusion criteria were selected and randomly divided into an observation group and a control group,30 cases in each group.The control group was given oral hypoglycemic treatment with metformin hydrochlo-ride sustained-release tablets and dapagliflozin tablets,and the observation group was given Yangyin Yifei Decoction on the basis of the treatment of the control group.The treatment course of both groups was 12 weeks.Before and after treatment,the changes of traditional Chinese medicine(TCM)syndrome scores,fasting blood glucose(FBG)and 2-hour postprandial glucose(2 h PG),glycosylated he-moglobin(HbAlc),serum Cyfra21-1 and Cyfra21-1 specific T cell response,triglycerides(TG),total cholesterol(TC),alanine ami-notransferase(ALT),aspartate aminotransferase(AST),urea(UR),and creatinine(CREA)were observed in the two groups.RE-SULTS After treatment,FBG,2 h PG,HbAlc,and TCM syndrome scores of the two groups of patients decreased significantly(P<0.05,P<0.01),and the observation group was better than the control group(P<0.05,P<0.01);TG and TC in the observation group were significantly reduced(P<0.01),serum Cyfra21-1 was significantly decreased(P<0.01),and Cyfra21-1-specific T cells in PBMCs were significantly increased(P<0.01),which was better than the control group(P<0.01);there was no significant change in liver and kidney function in the two groups.CONCLUSION Yangyin Yifei Decoction combined with basic hypoglycemic regimen can significantly improve blood glucose and lipid metabolism in T2DM patients with qi-yin deficiency and elevated serum Cyfra21-1,enhance the function of Cyfra21-1-specific T cells,and improve the body's immunity,with high safety.

Objective To explore the effectiveness and practical pathways of integrating narrative education into higher vocational nursing courses for cultivating students' humanistic care ability.Methods A total of 156 nursing students from a higher vocational college were randomly divided into an observation group(narrative education intervention)and a control group(traditional teaching).Quantitative evaluations were conducted using the Caring Ability Inventory(CAI)and a self-developed Humanistic Care Quality Scale,supplemented by semi-structured interviews for qualitative thematic analysis.Results The ob-servation group demonstrated significantly higher total caring ability scores(180.1±10.9 vs 145.2±14.3),humanistic care quality(97.5±3.8 vs 77.7±5.9),and course satisfaction(9.5±0.6 vs 7.0±1.3)compared to the control group(P＜0.01).Qualitative findings revealed that narrative education enhanced professional beliefs and practical skills through empathy training,reflective writing,and team collaboration.Conclusion Narrative education systematically improves the humanistic care ability and professional of higher vocational nursing students,providing empirical support for nursing education reform.

Objective To explore the effectiveness and practical pathways of integrating narrative education into higher vocational nursing courses for cultivating students' humanistic care ability.Methods A total of 156 nursing students from a higher vocational college were randomly divided into an observation group(narrative education intervention)and a control group(traditional teaching).Quantitative evaluations were conducted using the Caring Ability Inventory(CAI)and a self-developed Humanistic Care Quality Scale,supplemented by semi-structured interviews for qualitative thematic analysis.Results The ob-servation group demonstrated significantly higher total caring ability scores(180.1±10.9 vs 145.2±14.3),humanistic care quality(97.5±3.8 vs 77.7±5.9),and course satisfaction(9.5±0.6 vs 7.0±1.3)compared to the control group(P＜0.01).Qualitative findings revealed that narrative education enhanced professional beliefs and practical skills through empathy training,reflective writing,and team collaboration.Conclusion Narrative education systematically improves the humanistic care ability and professional of higher vocational nursing students,providing empirical support for nursing education reform.

Objective To summarize the best evidence of early rehabilitation management of hand function in patients with hand burn,and provide basis for medical personnel to carry out early rehabilitation management of hand burn.Methods According to the 5S model,all evidence on early rehabilitation management of hand function in patients with hand burns was retrieved from databases and websites including UpToDate,BMJ Best Practice,NICE,RNAO,GIN,and so on.The retrieved evidence included clinical decisions,guidelines,evidence summaries,expert consensuses,systematic reviews,Meta analysis.The search period of the summary of best evidence,expert concensus and guidelines are from the establishment of the database to December 20,2024,and the search period of the systematic reviews is from January 1,2019 to December 20,2024.Quality evaluation of literature,evidence extraction and summary were conducted.The evidence was graded according to JBI evidence pre-grading system 2014.Results Totally 17 pieces of the literature were included,including 1 clinical decision,4 guidelines,6 evidence summaries,3 expert consensus articles,and 3 systematic reviews.Totally pieces of best evidence were summarized,including 7 aspects of assessment,hand positioning,treatment of edema,dressing,use of orthotics,joint mobility training,and health education.Conclusion This study summarized the best evidence of early rehabilitation management of hand function in patients with hand burn,and provided evidence-based evidence for clinical rehabilitation management plan.According to the clinical situation,the medical staff can apply the evidence to clinical practice,so as to improve the hand function and quality of life of patients.

OBJECTIVE To observe the clinical efficacy of Yangyin Yifei Decoction in treating type 2 diabetes mellitus(T2DM)patients with of qi-yin deficiency and elevated serum keratin 19 fragment(Cyfra21-1).METHODS Sixty patients with T2DM of qi-yin deficiency type and elevated serum Cyfra21-1 who met the inclusion criteria were selected and randomly divided into an observation group and a control group,30 cases in each group.The control group was given oral hypoglycemic treatment with metformin hydrochlo-ride sustained-release tablets and dapagliflozin tablets,and the observation group was given Yangyin Yifei Decoction on the basis of the treatment of the control group.The treatment course of both groups was 12 weeks.Before and after treatment,the changes of traditional Chinese medicine(TCM)syndrome scores,fasting blood glucose(FBG)and 2-hour postprandial glucose(2 h PG),glycosylated he-moglobin(HbAlc),serum Cyfra21-1 and Cyfra21-1 specific T cell response,triglycerides(TG),total cholesterol(TC),alanine ami-notransferase(ALT),aspartate aminotransferase(AST),urea(UR),and creatinine(CREA)were observed in the two groups.RE-SULTS After treatment,FBG,2 h PG,HbAlc,and TCM syndrome scores of the two groups of patients decreased significantly(P<0.05,P<0.01),and the observation group was better than the control group(P<0.05,P<0.01);TG and TC in the observation group were significantly reduced(P<0.01),serum Cyfra21-1 was significantly decreased(P<0.01),and Cyfra21-1-specific T cells in PBMCs were significantly increased(P<0.01),which was better than the control group(P<0.01);there was no significant change in liver and kidney function in the two groups.CONCLUSION Yangyin Yifei Decoction combined with basic hypoglycemic regimen can significantly improve blood glucose and lipid metabolism in T2DM patients with qi-yin deficiency and elevated serum Cyfra21-1,enhance the function of Cyfra21-1-specific T cells,and improve the body's immunity,with high safety.

A deep learning-based model for automatic diagnosis and classification of adolescent idiopathic scoliosis has been constructed.This model mainly included key points detection and Cobb angle measurement.748 full-length standing spinal X-ray images were retrospectively collected,of which 602 images were used to train and validate the model,and 146 images were used to test the model performance.The results showed that the model had good diagnostic and classification performance,with an accuracy of 94.5%.Compared with experts'measurement,94.9%of its Cobb angle measurement results were within the clinically acceptable range.The average absolute difference was 2.1°,and the consistency was also excellent(r2≥0.9552,P<0.001).In the future,this model could be applied clinically to improve doctors'diagnostic efficiency.

ObjectiveTo investigate the effect of modified Weijingtang on the pyroptosis of RAW264.7 macrophages via the cysteinyl aspartate-specific protease-1 （Caspase-1）/gasdermin D （GSDMD） pathway. MethodLipopolysaccharide （LPS） was used to induce pyroptosis of RAW264.7 cells. The blank group was treated with the blank serum， and the intervention groups were treated with the sera containing different doses of modified Weijingtang. After 24 h， the viability of cells in different groups was examined by the cell counting kit-8 （CCK-8）. The pyroptosis and morphology of cells in each group were observed by a scanning electron microscope and a phase-contrast microscope， respectively. The mRNA and protein levels of nucleotide-binding oligomerization domain-like receptor protein 3 （NLRP3）， Caspase-1， and GSDMD in each group were determined by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot， respectively. The levels of interleukin （IL）-18 and IL-1β in each group were measured by enzyme-linked immunosorbent assay. ResultUnder the electron microscope， RAW264.7 cells presented the best morphology and structure in the blank group and obvious pyroptosis and leakage of cell contents in the model （LPS） group. Compared with the model group， the intervention groups showed reduced pyroptosis to varying degrees， and the high-dose group had the closest cell morphology and structure to the blank group. Under the optical microscope， RAW264.7 cells were spherical in the blank group and irregular with protrusions in the model group. Compared with the model group， the intervention groups showed improved cell morphology， and the cell morphology in the group with the dose of 20% was the closest to that in the blank group. The mRNA and protein levels of NLRP3， Caspase-1， and GSDMD in the model group were higher than those in the blank group （P<0.05）. Compared with the model group， each intervention group showed down-regulated expression of the above indicators （P<0.05）. Compared with the blank group， the model group presented elevated levels of IL-18 and IL-1β （P<0.05）， which were lowered in the intervention （10%， 20%） groups （P<0.01）. ConclusionModified Weijingtang inhibits the pyroptosis of macrophages by down-regulating the Caspase-1/GSDMD pathway and reducing the release of proinflammatory cytokines.

Hypoxemia is a common complication of pneumonia, asthma, and bronchopulmonary dysplasia in children.Rapid identification of hypoxemia is of great significance for the disposal and management of critical children.Pulse oximetry is recognized by the World Health Organization as the best way to monitor hypoxemia in children, and it can monitor pulse oxygen saturation noninvasively and continuously.Based on the related literature at home and abroad, combined with the clinical needs of pediatrics, the " Expert consensus on clinical application of pulse oximetry in children" is formulated to improve the understanding of pediatricians and nurses on the application in pediatric clinical practice, principle, operation techniques, and limitations of pulse oximetry.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.