Objective:To explore the mediating effect of intrinsic motivation of nurses between empowering leadership and job performance, with the aim of providing a reference basis for managers to develop a scientific and effective intervention programme to improve nurses′ job performance.Methods:Convenience sampling method was used to select 1 213 clinical nurses from four tertiary general hospitals in Shandong Province, Henan Province, Yunnan Province, and Fujian Province from November to December 2023, and General Information Questionnaire, Empowering Leadership Scale, Intrinsic Motivation Scale, and Job Performance Scale were used to conduct a cross-sectional survey. AMOS26.0 software was used to test the mediating effect of intrinsic motivation of nurses between empowering leadership and job performance.Results:A total of 1 100 nurses completed the survey finally. Among them, there were 58 males and 1 042 females, 474 under 31 years old, 448 between 31-40 years old, and 178 over 40 years old.The total scores of the Empowering Leadership Scale, Intrinsic Motivation Scale, and Job Performance Scale were 49.44 ± 10.04, 82.35 ± 13.54 and 46.27 ± 6.20 in that order. Nurses' job performance were positive correlation with the empowered leadership and intrinsic motivation ( r=0.486, 0.703, both P<0.01), there was a positive correlation between nurse empowerment leadership and intrinsic motivation ( r=0.452, P<0.01). Nurses′ intrinsic motivation partially mediates the relationship between empowering leadership and job performance, accounting for 62.69% of the total effect. Conclusions:Intrinsic motivation of nurses is a mediating variable between empowered leadership and job performance. Nursing managers should focus on nurses' participation in autonomous decision-making to enhance nurses′ sense of competence and meaning at work, and mobilise their motivation to improve job performance.

Objective:To analyze the registration status of clinical trials related to contraceptives based on the data of World Health Organization International Clinical Trials Registry Platform (ICTRP), so as to understand the situation of contraceptives development, and provide reference for improving the quality of clinical trials.Methods:All records in the database of ICTRP before January 1, 2025 was researched to screen out contraceptives clinical trials, and the registration time, registration platform, regional distribution, trial design and research content were analyzed.Results:A total of 206 clinical trials related to contraceptives were included. The projects were mainly carried out in the United States, Germany, and India. About 95.63% (197/206) of the study subjects were women of reproductive age. The　main　type　of　study　was　intervention [89.32% (184/206)], among which random trials accounted for 53.26% (98/184), and parallel group trials were the most common [82.65% (81/98)]. Over 64.56% (133/206) of the trials were indicated with open-label. Most of the clinical trials were in phase Ⅲ [47.57% (98/206)] and phase Ⅳ [16.50% (34/206)]. The interventions in female studies were mainly in three aspects: oral contraceptive [42.64% (84/197)], intrauterine delivery [15.23% (30/197)], and vaginal delivery [15.23% (30/197)], and the primary outcome included pregnancy rate [54.82% (108/197)], adverse drug reactions [13.20% (26/197)], ovulation inhibition [8.63% (17/197)], and vaginal infection [4.06% (8/197)].Conclusion:The　clinical　trials　of contraceptives were unevenly distributed, the research types were mainly randomized interventional trials, the included participants were mainly women of reproductive age, the intervention measures were mostly oral contraceptive, intrauterine delivery and vaginal delivery.

Objective:To explore the mediating effect of self-rated health status between living space and social frailty of the elderly in community, and to provide reference for intervention strategies.Methods:From December 2023 to March 2024, 550 community elderly in Yandun Community, Yicheng Community and Binhu Community in Baohe District of Hefei City were selected as the research objects by convenient sampling method. The general information questionnaire, self-rated health questionnaire, social frailty index and living space assessment scale were used to investigate a cross-sectional survey. Spearman correlation analysis was used to explore the correlation between self-rated health, living space and social frailty of community elderly. Bootstrap method was used to test the mediating effect.Results:A total of 542 valid questionnaires were collected. Among the 542 elderly residents in the community, aged 65-94 (71.69 ± 6.54) years, there were 267 males and 275 females. Among the 542 community elderly, the self-rated health score, living space score and social frailty index were (2.52 ± 0.95), (73.39 ± 16.77) and 0.0 (0.0, 3.0), respectively. Spearman analysis showed that the total score of living space was negatively correlated with the scores of self-rated health and social frailty ( r=-0.477, -0.538, both P<0.01), and the score of self-rated health was positively correlated with the score of social frailty ( r=0.711, P<0.01).The mediating effect results showed that the living space could play a partial mediating effect on social frailty through the mediating variable of self-rated health (-0.028), accounting for 49.12% of the total effect. Conclusions:The self-rated health status of the elderly in the community has an indirect mediating effect between living space and social frailty. Medical workers should take the improvement of the living space mobility of the elderly as the starting point, and improve their self-rated health level through diversified intervention means, so as to reduce the occurrence of social frailty and promote active aging.

With the rapid advancement of artificial intelligence (AI) technology, particularly breakthroughs in large models, AI applications in healthcare are becoming increasingly widespread.Ophthalmology, as a critical branch of medicine, has emerged as a clinical specialty with comprehensive AI research and applications, especially in the AI-driven analysis of ophthalmic imaging.Currently, AI in ophthalmology is undergoing profound transformation driven by large model technology.AI large models, with their robust data comprehension and multimodal interaction capabilities, offer new possibilities for the diagnosis, treatment, and health education of ophthalmic diseases, powerfully propelling the evolution of current AI paradigms in ophthalmology.This article explores the novel opportunities brought by the extensive application of AI large models in ophthalmic research and practice, and provides recommendations for ophthalmologists and insights for industry development.

In recent years, generative artificial intelligence (AI) technologies have achieved remarkable progress in the early screening, risk prediction, disease progression assessment, and clinical trial design of glaucoma.Using advanced algorithms, such as generative adversarial networks, variational autoencoders, and diffusion models, researchers have synthesized high-quality structural images of the optic disc, macular region, and retinal nerve fiber layer, which effectively alleviates the limitations of scarce clinical imaging data and label imbalance.These methods have substantially improved the accuracy and generalization of deep learning models in visual field defect prediction, structure-function mapping, and longitudinal disease progression simulation.Meanwhile, multimodal generative approaches that integrate imaging data, visual field tests, and clinical features have facilitated individualized prediction of glaucoma progression.In addition, large language models have shown preliminary potential in ophthalmic image interpretation, clinical text information extraction, and decision support, providing new insights into intelligent ophthalmic diagnosis and treatment.However, the clinical implementation of generative AI in glaucoma faces challenges.The pathological authenticity and cross-device consistency of generated images require further validation, which may affect the reliability of early glaucoma detection.The heterogeneous characteristics of different glaucoma subtypes, such as open-angle and angle-closure glaucoma, also limit the generalization of synthetic data.Moreover, issues related to model interpretability (" black-box" nature), artifact generation, data privacy, and ethical governance remain key barriers to clinical translation.In the future, it is expected that establishing large-scale training frameworks that incorporate multicenter, multimodal, and multiethnic datasets will enhance model robustness and clinical applicability.Furthermore, generative AI may contribute to remote ophthalmic care and personalized precision therapy by enhancing low-quality image, reconstructing missing data, and simulating dynamic disease courses.This article reviews the current applications, core technologies, and challenges of generative AI in glaucoma diagnosis and management, and discusses its future directions and translational potential in clinical ophthalmology.

Negative logarithm of the acid dissociation constant (pK _a) significantly influences the absorption, distribution, metabolism, excretion, and toxicity (ADMET) properties of molecules and is a crucial indicator in drug research. Given the rapid and accurate characteristics of computational methods, their role in predicting drug properties is increasingly important. Although many pK _a prediction models currently exist, they often focus on enhancing model precision while neglecting interpretability. In this study, we present GraFpK _a, a pK _a prediction model using graph neural networks (GNNs) and molecular fingerprints. The results show that our acidic and basic models achieved mean absolute errors (MAEs) of 0.621 and 0.402, respectively, on the test set, demonstrating good predictive performance. Notably, to improve interpretability, GraFpK _a also incorporates Integrated Gradients (IGs), providing a clearer visual description of the atoms significantly affecting the pK _a values. The high reliability and interpretability of GraFpK _a ensure accurate pK _a predictions while also facilitating a deeper understanding of the relationship between molecular structure and pK _a values, making it a valuable tool in the field of pK _a prediction.

Objective:To explore the latent categories and influencing factors of health activation among community-dwelling older adults with chronic diseases.Methods:Older patients with chronic diseases attending three community health centers in Hefei City from August to December 2023 were selected for the study using the convenience sampling method. The survey utilized the General Information Questionnaire, Consumer Health Activation Index, Chinese version of the Life-Space Assessment, Social Support Rating Scale, and Simplified Coping Style Questionnaire. Mplus 8.3 software was applied for latent profile analysis to examine patients' health activation, and unordered multicategory Logistic regression was used to explore the factors influencing different categories of health activation.Results:A total of 382 questionnaires were distributed, and 368 valid questionnaires were recovered, with a valid recovery rate of 96.34%. Three latent categories of health activation existed in community-dwelling older adults with chronic diseases, which were named as low health activation-high efficiency-coping inability group (16.85%, 62/368) , medium health activation group (27.99%, 103/368) , and high activation perception-action group (55.16%, 203/368) . Multicategory logistic regression analysis indicated that place of residence, age, self-rated health status, life space, social support, and active coping strategies were significant factors influencing the health activation of different latent categories of community-dwelling older adults with chronic diseases (all P<0.05) . Conclusions:The health activation of community-dwelling older adults with chronic diseases can be classified into three latent categories. Primary healthcare providers should identify the characteristics of patients in different categories and implement targeted nursing interventions to enhance their health activation levels.

Objective Based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses(PRISMA)guidelines,to obtain precise and reliable comprehensive effect conclusions by quantitatively combining pharmacodynamic results from animal experiments investigating Astragali Radix(single-entity Astragali Radix preparation)or its ingredients for treatment of acute pancreatitis(AP)in literature reports through meta-analysis.Methods Databases including China National Knowledge Infrastructure(CNKI),VIP Database for Chinese Technical Periodicals(VIP),Wanfang Data Knowledge Service Platform,China Biomedical Literature Database(CBMdisc),PubMed,and Web of Science(WOS)were searched from inception to March 2025 for animal studies related to Astragali Radix(single-entity Astragali Radix preparation)or its ingredients for AP treatment.Risk of bias for included studies was assessed with SYRCLE tool.Heterogeneity among studies was evaluated according to Cochrane Handbook using Cochrane's Qtest and/2statistic.Sensitivity analysis was performed using the leave-one-out method,and publication bias risk was detected using Egger's test.Results A total of 297 articles were retrieved,and after screening and evaluation,19 animal studies were finally included for meta-analysis.These 19 publications cover SD rats,as well as three breeds of mice:C57BL/6 mice,BALB/c mice,and Kunming mice.SYRCLE scores ranged from 3 to 4.The results of the sensitivity analysis showed that no study significantly affected the heterogeneity index.The results of Egger's test showed a significant publication bias with P＜0.05.Cochrane's Qtest and I2statistic indicated substantial heterogeneity among studies.Meta-analysis results of 19 animal studies showed that single-entity Astragali Radix preparation(Astragali Radix injection)could reduce serum amylase(AMY)levels,an AP-specific indicator.The Astragali Radix ingredients could decrease both AMY and lipase(LPS)levels.Astragali Radix injection or its ingredients could reduce serum levels of tumor necrosis factor-α(TNF-α),interleukin(IL)-6,and IL-1 β,while increasing IL-10 levels;could increase serum levels of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px),and decrease malondialdehyde(MDA)levels.High-dose groups of Astragali Radix injection or Astragali Radix ingredients were more effective than low-dose groups in reducing AMY,TNF-α,and IL-6 levels and increasing SOD levels,but dosage effect on MDA levels was not demonstrated.Conclusion Evidence-based analysis of animal experiment results shows that in various animal models including SD rats,C57BL/6 mice,BALB/c mice,and Kunming mice,Astragali Radix injection or its ingredients can effectively reduce expression or secretion levels of AP-specific indicators(AMY and LPS).The mechanisms may be related to some inflammatory mediators,including reducing TNF-α,IL-6,and IL-1 β levels and increasing IL-10 levels;They may also intervene in oxidative/antioxidative equilibrium,such as increasing SOD and GSH-Px levels and reducing MDA levels.Except for MDA,dose-response relationships are shown for reducing AMY,TNF-α,and IL-6 levels and increasing SOD levels with Astragali Radix injection or its ingredients.However,due to high heterogeneity,potential publication bias risk,and species differences between animal models and human diseases in existing studies,further high-quality clinical trials or animal experiments are still needed in the future.

AIM:To investigate the association between single nucleotide polymorphisms(SNPs)in the silent information regulator 1(SIRT1)gene and breast cancer risk in the Han Chinese population.METHODS:A total of 105 Han Chinese patients with breast cancer and 90 healthy controls were enrolled.Sequenom MassARRAY was used to detect the genotypes of SIRT1 gene loci,rs3740051,rs3758391,rs12778366 and rs2394443.The Hardy-Weinberg equilibrium(HWE)was analysed using the chi-square test.Multivariate logistic regression was employed to analyze the correlation be-tween each SNP and breast cancer susceptibility,as well as the relationship between the rs3758391 genotype and the clini-copathological characteristics of breast cancer in Han Chinese women.SHEsis software was used to assess linkage disequi-librium and haplotypes of the selected SNPs.The impact of genotypes at rs3758391 locus on SIRT1 protein expression was examined using Western blot.An additional 150 Han Chinese women with breast cancer and 150 healthy controls were en-rolled,and SIRT1 protein expression was assessed using immunohistochemistry.Logistic regression was performed to as-sess the relationship between high and low SIRT1 expression and the clinical characteristics of breast cancer.Kaplan-Mei-er website was used to determine the association between SIRT1 expression and patient prognosis.RESULTS:All four SNP loci conformed to the HWE test(P>0.05).The TC/TC+CC genotype of the SIRT1 rs3758391 locus significantly re-duced the risk of breast cancer compared with the TT genotype(TT vs TC:ORadj=0.348,95%CI:0.157～0.773,Padj=0.010;TT vs TC+CC:ORadj=0.381,95%CI:0.179～0.811,Padj=0.012),and correlated with earlier disease course(stage I/II),smaller tumor volume,and higher SIRT1 protein expression levels(P<0.05).SIRT1 expression was signifi-cantly lower in breast cancer tissues,and low SIRT1 expression was associated with larger tumor size,lymph node metasta-sis,and reduced recurrence-free survival(P<0.05).CONCLUSION:The TC/TC+CC genotype of the SIRT1 rs3758391 locus may be a protective factor for breast cancer in Han Chinese women,potentially reducing the risk of breast cancer and delaying disease progression by regulating SIRT1 expression.In addition,SIRT1 expression level is closely related to the clinical characteristics and prognosis of breast cancer.

Theory and technology of Medical Immunology are widely used in scientific research.Our teaching and research group uses experimental teaching of Medical Immunology as a platform to carry out practice of scientific research project-based experi-mental system among"5+3"integration students.By completing a mini-project research including experimental design-experimental operation-research article writing,students cultivated scientific research thinking and exercised scientific research practice ability,and generally reported that the course is very difficult,but after completing it,it is very rewarding.