Objective: To evaluate the impact of comprehensive nursing based on the behavioral goal attainment model on the clinical intervention effect among elderly female patients with stress urinary incontinence (SUI), so as to provide a basis for optimizing the nursing strategies for patients with SUI and improving their quality of life. Methods: A total of 190 elderly female patients with SUI who were treated in the Department of Gynecology of the First Hospital of Jilin University from January 2023 to August 2024 were selected and randomly divided into the intervention group and the control group. The control group received routine nursing care, while the intervention group received comprehensive nursing based on the behavioral goal attainment model. The 1-hour pad test was used to assess urinary incontinence symptoms. The bio-electrical stimulation feedback instrument was employed to detect the electromyogram (EMG) values in the pre-resting stage and slow-muscle stage for evaluating pelvic floor function. The bladder function scale was utilized to evaluate bladder function. The Chinese version of urinary incontinence ego-efficacy rating scales and incontinence quality of life assessment scale (IQOL) were used to assess self-efficacy and quality of life. The data on intervention compliance and nursing satisfaction were collected by a questionnaire survey. The differences between the two groups before and after the intervention were compared using the analysis of variance for repeated-measures data to evaluate the intervention effect. Results: There were 95 cases in the control group and 95 cases in the intervention group, with median ages were 64.00 (interquartile range, 23.50) and 64.50 (interquartile range, 19.50) years, respectively. The proportion of patients with cesarean section as the last delivery method was 21.05% in the control group and 12.63% in the intervention group. The proportion of patients with moderate disease severity was 67.36% in the control group and 58.95% in the intervention group. There were no statistically significant differences in age, body mass index, number of pregnancies, number of deliveries, marital status, educational level, mode of last delivery and severity of the disease between the two groups of patients (all P>0.05). The analysis of variance of repeated-measures data showed that there were significant interactions between time and group for the urine leakage volume in the 1-hour pad test, the EMG values in the pre-resting stage, the EMG values in the slow-muscle stage, the scores of the bladder function, the self-efficacy scores, and the IQOL scores (all P<0.05). After 12 weeks of intervention, the EMG values in the slow-muscle stage, the scores of the bladder function, the self-efficacy scores, the IQOL scores in the intervention group were higher than those in the control group, while the urine leakage volume in the 1-hour pad test and the EMG values in the pre-resting stage in the intervention group were lower than those in the control group (all P<0.05). The good compliance rate of intervention and the satisfaction rate of nursing in the intervention group were higher than those in the control group (83.16% vs. 60.00%, 90.53% vs. 75.79%, both P<0.05). Conclusion Comprehensive nursing based on the behavioral goal attainment model can improve urinary incontinence symptoms, pelvic floor function, bladder function, self-efficacy, quality of life, and intervention compliance of elderly female patients with SUI.

BACKGROUND: It is inaccurate to reflect the level of dust exposure through working years. Furthermore, identifying a predictive indicator for lung function decline is significant for coal miners. The study aimed to explored whether club cell secretory protein (CC16) levels can reflect early lung function changes. METHODS: The cumulative respiratory dust exposure (CDE) levels of 1,461 coal miners were retrospectively assessed by constructed a job-exposure matrix to replace working years. Important factors affecting lung function and CC16 were selected by establishing random forest models. Subsequently, the potential of CC16 to reflect lung injury was explored from multiple perspectives. First, restricted cubic spline (RCS) models were used to compare the trends of changes in lung function indicators and plasma CC16 levels after dust exposure. Then mediating analysis was performed to investigate the role of CC16 in the association between dust exposure and lung function decline. Finally, the association between baseline CC16 levels and follow-up lung function was explored. RESULTS: The median CDE were 35.13 mg/m³-years. RCS models revealed a rapid decline in forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁), and their percentages of predicted values when CDE exceeded 25 mg/m³-years. The dust exposure level (<5 mg/m³-years) causing significant changes in CC16 was much lower than the level (25 mg/m³-years) that caused changes in lung function indicators. CC16 mediated 11.1% to 26.0% of dust-related lung function decline. Additionally, workers with low baseline CC16 levels experienced greater reductions in lung function in the future. CONCLUSIONS CC16 levels are more sensitive than lung indicators in reflecting early lung function injury and plays mediating role in lung function decline induced by dust exposure. Low baseline CC16 levels predict poor future lung function.
Uteroglobin/blood* ; Humans ; Dust/analysis* ; Occupational Exposure/analysis* ; Male ; Middle Aged ; Adult ; Retrospective Studies ; Lung Injury/chemically induced* ; Coal Mining ; Biomarkers/blood* ; China/epidemiology* ; Air Pollutants, Occupational ; Female

Objective To make a comprehensive review about transitional care practice for patients receiving percutaneous transhepatic biliary drainage(PTBD)and to analyze the current transitional care contents and evaluation indexes so as to provide guidance for improving the quality of transitional care services for discharged patients carrying a PTBD tube.Methods A scoping review study design was used to conduct a computerized retrieval of academic papers concerning the transitional care practice for discharged patients carrying a PTBD tube from the databases of PubMed,WOS Core Collection,CINAHL,Embase,Cochrane Library,CNKI,VIP,Wanfang med online,and Sinomed.The retrieval time period was from the establishment of the database to August 20,2024.Two investigators independently screened the literature to determine the studies to be included and the relevant information to be extracted.Results A total of 18 papers were enrolled in this study.The transitional care ways included telephone follow-up,home visit,online platform follow-up,and outpatient clinic follow-up.The intervention contents extended from in-hospital to out-of-hospital for up to 6 months.The evaluation indexes focused on the patient's knowledge about PTBD tube,the incidence of tube-related complications,the satisfaction with care,self-care ability,etc.Conclusion At present,the transitional care for discharged patients carrying a PTBD tube has a variety of content elements,which can improve the self-care ability and quality of life of the discharged patients carrying a PTBD tube to a certain extent,although more individualized transitional care modes need to be further explored.The evaluation indexes are mainly the outcome assessment of PTBD tube care.It is necessary to strengthen the quality supervision of organizational structure and nursing process.

Clinical practice guideline adaptation(hereinafter referred to as"guideline adaptation")is the consolidation and revision of existing high-quality guidelines so that the recommendations are better suited to the specific needs of different regions,thereby guiding optimal clinical practice.Currently,the guideline adap-tations is increasing in number internationally,but their reporting quality still needs to be improved.In 2022,the RIGHT-Ad@pt guideline adaptation reporting checklist was released.It provides a detailed description of the guideline adaptation process and reporting content,which will significantly enhance the rigor,transparency,and standardization of guideline adaptations.This paper interprets and analyzes the 34 items on the checklist,with the aim of providing reference for guideline adapters to standardize the reporting process.

OBJECTIVE To study the improvement effects of poria acid on insulin resistance in rats with polycystic ovary syndrome （PCOS） and its mechanism. METHODS One hundred and twenty-six female rats were randomly separated into blank group， PCOS group， poria acid low-dose group （8.33 mg/kg）， pachymic acid high-dose group （33.32 mg/kg）， ethinylestradiol cyproterone group （positive control group， 0.34 mg/kg）， recombinant rat high mobility group protein B1 protein （rHMGB1） group （8 μg/kg）， and poria acid high dose+rHMGB1 group （33.32 mg/kg poria acid+8 μg/kg rHMGB1）， with 18 rats in each group. Except for the blank group， the rats in all other groups were given Letrozole suspension intragastrically to construct the PCOS model. After successful modeling， administration was performed once a day for 4 weeks. After medication， the fasting blood glucose and fasting insulin levels， and insulin resistance index （HOMA-IR） were measured in rats； the levels of follicle-stimulating hormone （FSH）， luteinizing hormone （LH） and testosterone （T） in rat serum， and the levels of interleukin-1β （IL-1β） and tumor necrosis factor- α （TNF- α） in ovarian tissue were detected； ovarian coefficients of rats were calculated； the pathological changes of ovarian tissue were observed； the expressions of HMGB1， receptor for advanced glycosylation elaine_ tanghong@sina.com end product （RAGE） and phosphorylated nuclear factor κB p65 （p-NF-κB p65） proteins were determined in ovarian tissue of rats. RESULTS Compared with the blank group， the pathological injury of ovarian tissue of rats in the PCOS group was serious， the levels of fasting blood glucose and fasting insulin， HOMA-IR and ovarian coefficient were increased， the levels of serum LH and T were increased， while the levels of FSH were decreased； the levels of IL-1β and TNF-α， the expressions of HMGB1， RAGE and p-NF-κB p65 protein in ovarian tissue were increased， with statistical significance （P＜0.05）. Compared with the PCOS group， pathological damage of ovarian tissue was reduced in poria acid low-dose and high-dose groups and ethinylestradiol cyproterone group， and fasting blood glucose， fasting insulin levels， HOMA-IR and ovarian coefficient were decreased； serum LH and T levels were decreased， while FSH levels were increased； the levels of IL-1β and TNF-α and the expressions of HMGB1， RAGE and p-NF-κB p65 protein in ovarian tissue were decreased， with statistical significance （P＜0.05）. The trend of corresponding indexes in rHMGB1 group was opposite to the above （P＜0.05）. Compared with poria acid high-dose group， the changes of the above indexes were reversed significantly in poria acid high-dose+rHMGB1 group （P＜0.05）. CONCLUSIONS Poria acid may improve insulin resistance and inhibit inflammatory reaction in PCOS rats by inhibiting HMGB1/ RAGE pathway.

Objective To understand the epidemiological characteristics and incidence trend of syphilis in Shiyan City, and to provide a scientific basis for formulating syphilis control strategies. Methods Descriptive epidemiological statistical analysis on the data of syphilis cases from 2008 to 2020 in Shiyan City was performed. Results A total of 9 578 syphilis cases were reported in Shiyan City from 2008 to 2020, with the reported incidence rate ranging from 16.80/100 000 to 27.48/100 000. The reported incidence rate of syphilis showed a downward trend from 2008 to 2014 (χ² trend=44.869, P=0.000), and an upward trend from 2015 to 2020 (χ² trend=69.642, P=0.000). The composition ratio of syphilis in each stage had changed, with a decreasing trend in stage I and II syphilis. The composition ratio of recessive syphilis cases increased from 58.90% in 2008 to 93.10% in 2020, and gradually became the main epidemic type. No cases of fetal syphilis were reported in the past three years. The incidence rate of syphilis reported from 2008 to 2020 was generally higher in women than that in men, with a male to female ratio of 0.67:1. Occupations were mainly farmer, housework, and unemployment. The high incidence areas of syphilis in Shiyan City included mainly Maojian District, Zhangwan District, and Fangxian County, with the annual reported incidence rates being 38.40/100 000, 37.97/100 000, and 29.37/100 000, respectively. Conclusion The syphilis epidemic in Shiyan City from 2008 to 2020 has showed a trend of first decline and then rise. The prevention and treatment of syphilis in key populations and key areas should be strengthened according to the epidemiological characteristics of syphilis to control the spread of syphilis and reduce the harm to the public.

Objective:To explore the correlation between abnormal expression of serum 25(OH)D and immune-related fac-tors and subclinical atherosclerosis(AS)in patients with impaired glucose regulation.Methods:A total of 142 patients with im-paired glucose regulation admitted to Zaozhuang Municipal Hospital from December 2019 to April 2021 were selected.The patients with impaired glucose regulation were selected as the control group(n=86)and patients with subclinical atherosclerosis were selected as the observation group(n=56)according to carotid ultrasound examination and bramolecular pulse wave conduction velocity.The serum 25(OH)D and immune factors were compared between the two groups.Carotid ultrasound was used to measure the carotid inti-media thickness,and Pearson method was used to determine the correlation between the intimedia thickness,25(OH)D and immune factors.Baseline data and hematological indicators were collected,univariate and multivariate Logistic regression analysis was per-formed to determine the influencing factors of subclinical atherosclerosis,and ROC curve was used to evaluate the diagnostic efficacy of serum 25(OH)D and immune factors in subclinical atherosclerosis.Results:The serum 25(OH)D[(24.01±4.87)mmol/L vs(30.74±5.01)mmol/L,t=7.909,P=0.000)in the observation group was significantly lower than that of control group.TNF-α[(48.32±8.02)ng/L vs(33.21±9.00)ng/L,t=10.199,P=0.000)and IL-6[(41.22±9.43)ng/L vs(30.21±7.01)ng/L,t=7.492,P=0.000)in ob-servation group were significantly higher than those in control group.Carotid intima-media thickness was negatively correlated with se-rum 25(OH)D(r=-0.428,P<0.001),and was positively correlated with serum TNF-α and IL-6(r=0.574,0.577,P<0.001).Logis-tic regression analysis showed that serum 25(OH)D(OR=0.520,95%CI:0.401～0.675),serum TNF-α(OR=1.667,95%CI:1.131～2.457)and serum IL-6(OR=1.478,95%CI:1.213～1.802)were the influencing factors of subclinical atherosclerosis.ROC curve showed that the optimal cut-off value of serum 25(OH)D was 28.32 mmol/L,and the corresponding sensitivity,specificity and AUC were 69.64%,70.93%and 0.803(95%CI:0.749～0.855),respectively.The critical value of serum TNF-α was 40.56 ng/L,corre-sponding sensitivity was 71.43%,specificity was 72.09%,and AUC was 0.761(95%CI:0.717～0.823).Serum IL-6 cut-off value was 36.13 ng/L,corresponding sensitivity was 60.71%,specificity was 60.47%,and AUC was 0.627(95%CI:0.566～0.702).The sensitivity,specificity and AUC of regression analysis were 85.71%,81.40%and 0.889(95%CI:0.830～0.915).Conclusion:Serum 25(OH)D and immune-related factors alone and in combination can effectively predict the occurrence of subclinical atherosclerosis,which is correlated with carotid intima-media thickness,and serum 25(OH)D and immune-related factors are predictors of subclinical atherosclerosis.

Objective This study aims to develop a prognostic risk prediction model for gastric cancer based on m1A/m5C/m6A/m7G regulated genes and to investigate the relationship between this model and immunology.Methods The Cancer Genome Atlas(TCGA)gastric cancer dataset was utilized to identify m1A/m5C/m6A/m7G regulated genes with significant expression differences.A prognostic risk score(RS)model was constructed using univariate Cox regression analysis and the LASSO algorithm.The RS model was validated using the Kaplan-Meier(K-M)statistic and cell lines for RT-qPCR biological validation.A nomogram model was created using univariate and multivariate Cox regression analyses.The CIBERSORT algorithm and ESTIMATE package were employed to conduct immune correlation analysis.Results A prognostic RS model based on eight methylation regulated genes was developed to classify patients with gastric cancer as high-risk or low-risk.These eight genes showed significant expression in gastric cancer cell lines(P＜0.05).The TCGA-gastric cancer training set and GSE62254-validation set showed a substantial connection(P＜0.001)between overall survival rate(OS)and grouping status.The nomogram survival models accurately predicted 1-year(C-index = 0.703),3-year(C-index = 0.729),and 5-year(C-index = 0.734)survival rates.Immune correlation analysis showed that compared to the low-risk group,the high-risk group had higher immune scores and higher expression of immune checkpoint-related genes(P＜0.05).Conclusion We created a reliable prognostic RS model based on m1A/m5C/m6A/m7G regulated genes that can predict gastric cancer prognosis and guide individualized immunotherapy decisions.

Objective:To retrospectively analyze the clinical and genetic characteristics of six patients with Acromicric dysplasia due to variants of the FBN1 gene. Methods:Six patients who had visited the Affiliated Hospital of Qingdao University between February 2018 and October 2020 were selected as the study subjects. Clinical data of the patients were collected. High-throughput sequencing was carried out. And candidate variants were verified by Sanger sequencing.Results:All of the six patients had presented with severe short stature (< 3 s), brachydactyly, short and broad hands and feet. Other manifestations included joint stiffness, facial dysmorphism, delayed bone age, liver enlargement, coracoid femoral head, and lumbar lordosis. Genetic testing revealed that all had harbored heterozygous variants of the FBN1 gene. Patient 1 had harbored a c. 5183C>T (p.A1728V) missense variant in exon 42, which had derived from his father (patient 2). Patient 3 had harbored a c. 5284G>A (p.G1762S) missense variant in exon 43, which had derived from her mother (patient 4). Patient 5 had harbored a c. 5156G>T (p.C1719F) missense variant in exon 42, which was de novo in origin. Patient 6 had harbored a c. 5272G>T (p.D1758Y) missense variant in exon 43, which was also de novo in origin. The variants carried by patients 1, 3 and 6 were known to be pathogenic. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the FBN1: c. 5156G>T was rated as a pathogenic variant (PS2+ PM1+ PM2_Supporting + PM5+ PP3). Conclusion:All of the six patients had severe short stature and a variety of other clinical manifestations, which may be attributed to the variants of the FBN1 gene.