Objective:To explore the effect of online acceptance and commitment therapy(ACT)on the psy-chological flexibility in patients with depression during recovery.Methods:A total of 58 patients with depression during the recovery period were randomly divided into the online ACT intervention group(n=27)and the waiting control group(n=31).The intervention group received 20-day online ACT intervention,while the control group re-mained waiting.The Comprehensive Assessment of Acceptance and Commitment Therapy(CompACT),Patient Health Questionnaire-9(PHQ-9),Five-Factor Mindfulness Questionnaire(FFMQ)and Mental Health Continuum Short Form(MHC-SF)were used to evaluate the two groups at the baseline,at the end of the 20-day intervention and 1 month after the intervention.Results:The scores of CompACT and MHC-SF were lower in the intervention group than in the control group at the end of the 20-day intervention and 1 month after the intervention(Ps＜0.05).The scores of CompACT,PHQ-9,FFMQ and MHC-SF in the intervention group were lower at the end of the 20-day intervention and 1 month after the intervention than at the baseline(Ps＜0.01).Conclusion:Online ac-ceptance and commitment therapy could improve the level of psychological flexibility,mindfulness and mental health of patients with depression during recovery period,and reduce their depression level.

Objective To investigate the status quo of pain crisis in advanced lung cancer patients and analyze its influencing factors.Methods From August to November 2023,318 patients with advanced lung cancer were selected from 6 wards of respiratory department of a tertiary A hospital in Zhengzhou.The Numerical Rating Scale,Perceptive Social Support Scale,Self-rating Anxiety Scale and Self-rating Depression Scale were used to investigate the influencing factors of pain crisis in advanced lung cancer patients by Logistic regression.Results Among 318 patients with advanced lung cancer,102 patients had painful crisis,with the incidence rate of 32.08％.0lder age and high level of social support were protective factors for pain crisis,and bone metastasis,anxiety and mild to moderate depression were risk factors for pain crisis.Conclusion The incidence of pain crisis was high in advanced lung cancer patients.Medical staff should pay attention to those with younger age,bone metastasis,low level of social support,high level of anxiety and mild to moderate level of depression,and take timely intervention measures to reduce the occurrence of pain crisis.

Objective To systematically evaluate the risk prediction model for central venous catheter-related bloodstream infections and provide references for clinical practice.Methods Databases such as CNKI,Wanfang,CBM,VIP,PubMed,Web of Science,Cochrane Library,etc.were retrieved.The search period is from database establishment to June 2,2023.There are 2 researchers who independently screened and extracted the literature,and evaluated the quality of the literature using bias assessment tools of predictive model risk.Results A total of 9 articles were included,including 9 risk prediction models for catheter-related bloodstream infections.The total sample size was 80～11 901 cases;the number of outcome events was 19～403 cases;the C index of the included model was 0.81～0.93.The area under the curve of the subjects ranged from 0.73～0.90.The predictors that appear more frequently in the model mainly included the history of diabetes,albumin value,the number of days of catheterization,the location of catheterization.The evaluation results of the bias assessment tool of predictive model risk for research show that the overall applicability of the included risk prediction models is good,but the bias risk is high.The reasons are related to the improper source of research sample data,inappropriate processing of continuous variable methods,failure to process missing data,insufficient model performance evaluation,and non-standard evaluation indicators.Conclusion There are still some shortcomings in the risk prediction model for central venous catheter-related bloodstream infections.In the future,the quality of related model research should be further improved,especially in terms of predictive factor analysis,model evaluation indicators,etc.,which should be further standardized.

Objective:To analyze the research status,research hot topics and trends in the field of domestic medical device disinfection supply,and to provide reference for clinical practice and scientific research of disinfection supply.Methods:Literature related to disinfection supply included in CNKI database from January 1,2008 to December 31,2023 were searched.CiteSpace visualization software was used to perform keyword co-occurrence analysis,cluster analysis,and emergence analysis.Results:A preliminary search of 1 527 articles was obtained,and 1,499 valid articles were finally included in the study,including 87 in 2008,and the number of publications related to disinfection supply increased year by year,reaching a peak of 258 articles in 2012,and gradually decreased and stabilized since then.A total of 12 keyword cluster tags were formed in 1 499 articles,and the three keywords with the highest frequency were cleaning quality,nosocomial infection and management.The implant keyword appeared in 2019 and lasted until 2023,which can be studied in depth as a potential research topic.Conclusion:Cleaning quality,nosocomial infection and management were the focus of researchers in the field of disinfection supply from 2008 to 2023,and the research direction has gradually developed from management research around industry standards to refinement,specialization and technology,and has become a research trend in the future.

Objective:To evaluate the clinical efficacy of Pixu Jiuxie Prescription in the treatment of chronic and prolonged non-infectious diarrhea (spleen kidney yang deficiency type) in children; To discuss its effects on immune function of patients.Methods:Randomized controlled trial study was conducted. 76 children with chronic and prolonged non-infectious diarrhea of spleen and kidney yang deficiency type who were treated at the Pediatric Clinic of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from December 2021 to February 2023 were selected as the research subjects. They were divided into two groups, with 38 cases in each group. The observation group was orally treated with Pixu Jiuxie Prescription, and the control group was orally treated with Diosmectite and Bifidobacterium Quadruple Viable Tablets. The treatment for both groups lasted for 30 d. Main symptoms, TCM syndromes, and TCM symptoms were scored before and after the treatment. Immunoassay was used to detect the levels of immunoglobulin IgM, IgA, and IgG, and clinical efficacy was evaluated.Results:After treatment, the total effective rate of the observation group was 94.74% (36/38), which was significantly higher than that of the control group 78.95% (30/38), with statistical significance ( χ2=14.05, P=0.003); Main symptoms: the number of stools in the observation group (1.86 ± 0.25 vs. 2.03 ± 0.49, t=7.14), and stool characteristics (1.62 ± 0.26 vs. 1.98 ± 0.37, t=8.26) were lower than those in the control group ( P<0.001). TCM syndrome: after treatment, the abdominal pain (0.68 ± 0.13 vs. 0.74 ± 0.37, t=7.38), abdominal distension (0.43 ± 0.25 vs. 0.75 ± 0.23, t=2.16), appetite (0.50 ± 0.10 vs. 0.88 ± 0.15, t=4.35), nausea and vomiting (0.18 ± 0.33 vs. 0.34 ± 0.36, t=6.53), fatigue and weakness (0.34 ± 0.24 vs. 0.43 ± 0.25, t=5.62), and dehydration (0.30 ± 0.11 vs. 0.68 ± 0.13, t=5.87) integration and the total score of (5.63 ± 4.33 vs. 9.63 ± 5.53, t=16.07) observation group were lower than those in the control group ( P<0.01 or P<0.05). TCM symptoms: after treatment, the scores of color deficiency (0.18 ± 0.33 vs. 0.24 ± 0.13, t=2.63), cold limbs (0.20 ± 0.11 vs. 0.28 ± 0.14, t=4.13), prolapse (0.08 ± 0.33 vs. 0.14 ± 0.37, t=3.64), and clear urine (0.23 ± 0.11 vs. 0.28 ± 0.13, t=8.27) in the observation group were lower than those in the control group ( P<0.01 or P<0.05). After treatment, the levels of immunoglobulin IgA [(0.52 ± 0.21) g/L vs. (0.40 ± 0.26) g/L, t=8.15], IgM [(8.76 ± 1.16) g/L vs. (7.68 ± 1.43) g/L, t=10.67], and IgG [(0.89 ± 0.39) g/L vs. (0.62 ± 0.33) g/L, t=12.15] in the observation group were higher than those in the control group ( P<0.01). Conclusion:Pixu Jiuxie Prescription can effectively improve the clinical symptoms and signs of children with chronic and prolonged non-infectious diarrhea with spleen kidney yang deficiency syndrome, enhance their immunity, and improve clinical efficacy.

Objective:To investigate the effect of online acceptance and commitment therapy(ACT) group intervention on psychological flexibility of undergraduate students with facial negative physical self.Methods:From March to June 2022, thirty-two undergraduates with facial negative physical self-image were recruited, assessed and selected from a university in Zhejiang Province.The subjects were randomly divided into the training group( n=16) and the control group( n=16). The training group received 20 days of online ACT group intervention, while the control group kept waiting.The cognitive fusion questionnaire(CFQ), acceptance and action questionnaire version Ⅱ(AAQ-Ⅱ) and negative physical self scale-face(NPSS-F) were used to measure the two groups before and after intervention and 1 month after intervention.Repeated measurement analysis of variance(ANOVA) conducted was used to compare scale results with SPSS 26.0. Results:(1)The interaction effect between group and time of CFQ scores was statistically significant( F(1.625, 48.755)=4.316, P=0.025, ηp2=0.126). After intervention, the CFQ score of the training group was significantly lower than those of the control group(34.38±8.66, 40.94±8.82, P<0.05). The CFQ scores of the training group after intervention and 1 month after intervention(36.00±9.49) were both significantly lower than those before intervention(41.87±8.72, all P<0.05). (2)The interaction effect between group and time of AAQ-Ⅱ scores was marginally statistically significant( F(2, 29)=3.009, P=0.065, ηp2=0.172). After intervention, the AAQ-Ⅱ score of the training group was significantly lower than those of the control group(24.12±4.97, 28.69±6.78, P<0.05). The AAQ-Ⅱ score of the training group after intervention was significantly lower than those before intervention(28.75±6.11, P<0.05). (3)The interaction effect between group and time of NPSS-F scores was not statistically significant( F(2, 29)=1.509, P=0.238, ηp2=0.094), while the main effect of time was marginally statistically significant between the two groups( F(2, 29)=3.315, P=0.051, ηp2=0.186). The NPSS-F score of the training group after intervention was significantly lower than those before intervention(16.06±6.67, 18.81±7.85, P<0.05). Conclusion:Online ACT group intervention can effectively reduce the cognitive fusion and experiential avoidance of undergraduate students with facial negative physical self, then can improve their psychological flexibility.

Objective:To explore status and influencing factors of medication deviation in elderly patients with brain infarction during the hospital-family transition, and to explore the relationship between medication deviation and adverse drug events.Methods:From November 2021 to May 2022, 218 elderly patients with brain infarction from Neurology Department of the First Affiliated Hospital of Chengdu Medical College were selected as the research objects by the convenience sampling method. General data questionnaire and Self-Efficacy for Appropriate Medication Use Scale were used to investigate patients. One month after discharge, patients were investigated by telephone using Medication Discrepancy Tool and Morisky Medication Adherence Scale with Eight-Item, and the incidence of adverse drug events was collected. Logistic regression analysis was used to explore the influencing factors of medication deviation. Spearman correlation analysis was used to investigate the correlation between adverse drug events and medication deviation. A total of 218 questionnaires were distributed in this study, and 207 valid questionnaires were effectively recovered, with an effective recovery rate of 95.0%.Results:The incidence of medication deviation in elderly patients with brain infarction was 48.8% (101/207) . Logistic regression analysis results showed that hypertension, stroke severity, medication compliance and medication quantity were the influencing factors of medication deviation ( P<0.05) . Spearman correlation analysis results showed that adverse drug events were positively correlated with medication deviation ( r=0.234, P<0.01) . Conclusions:The incidence of medication deviation in elderly patients with brain infarction during the hospital-family transition was higher. Hypertension, stroke severity, medication compliance and medication quantity were the influencing factors of medication deviation. Medical staff should formulate targeted intervention measures based on the influencing factors of medication deviation, so as to reduce the incidence of medication deviation.

Objective:To explore the effect of the evidence-based practice nursing program for severe patients with physical constraints based on the guideline in Intensive Care Unit (ICU) patients.Methods:From February 2019 to July 2020, 4 663 patients in the Surgical Intensive Care Unit (SICU), Medicine Intensive Care Unit (MICU), Coronary Care Unit (CCU), and Emergency Intensive Care Unit (EICU) of the China-Japan Friendship Hospital were selected as the research object by purposive sampling. The evidence-based practice nursing program for severe patients with physical constraints based on the guideline of Promoting Safety: Alternative Approaches to the Use of Restraints was applied in clinical practice. We recorded the constraint duration, constraint rate, and substitution constraint rate of severe patients after the implementation of the program, and compared the differences in ICU nurses' scores on physical constraint knowledge, attitude, and practice before and after the implementation of the program. Results:Out of 4 663 patients, 871 received restraint, with a restraint rate of 18.68% and a restraint duration of (102.35±82.67) hours. The number of substitution constraint cases was 421, and the substitution constraint rate was 9.03%. The constraint rates in SICU, MICU, CCU and EICU were 23.68% (475/2 006), 28.26% (219/775), 7.29% (97/1 331) and 14.52% (80/551), respectively, and the differences in constraint rates among different departments were statistically significant ( P<0.05). Before and after the implementation of the program, there were statistically significant differences in the scores of ICU nurses on physical constraint knowledge, attitude, and practice dimensions and total scores ( P<0.05) . Conclusions:The evidence-based practice nursing plan program for severe patients with physical constraints based the guideline effectively reduces the rate and duration of physical constraint of ICU patients, improves the substitution constraint rate, standardizes the practice of physical constraint of ICU patients, and ensures patient safety.

Objective:To investigate the changes of T helper cell (Th), regulatory T-cell (Treg cell) related cytokines in vaginal lavage fluid of patients with high risk-human papilloma virus 16 (HR-HPV16) positive and its predictive effect on the development of cervical neoplasms.Methods:A total of 200 cases of HR-HPV16 positive patients who admitted to Xingtai People's Hospital from January 2022 to December 2022 were selected as the experimental group. According to the results of pathological examination, all patients in the experimental group were divided into non pathological group (78 cases), low grade squamous intraepithelial lesion (LSIL) group (49 cases), high grade squamous intraepithelial lesion (HSIL) group (39 cases) and cervical cancer group (34 cases); and 100 healthy people undergoing the physical examination in the same period were taken as the healthy control group. Enzyme-linked immunosorbent assay (ELISA) double-antibody sandwich method was used to detect the levels of interleukin (IL)-2, IL-4, IL-6, IL-10, IL-12, IL-17, tumor necrosis factor α (TNF-α), interferon γ (IFN-γ) and transforming growth factor β (TGF-β) in vaginal lavage fluid of patients in different groups. Multivariate logistics regression was used to analyze the risk factors of cervical cancer, and a nomogram model was established. The receiver operating characteristics (ROC) curve was drawn with pathological results as the gold standard, and the area under the curve (AUC) was calculated to evaluate the predictive ability of the nomogram model.Results:The levels of IL-6, IL-10, IL-17, TNF-α, TGF-β in vaginal lavage fluid of patients in the experimental group were higher than those in the healthy control group, while the levels of IL-2, IL-12 and IFN-γ in the experimental group were lower than those in the healthy control group, and the differences were statistically significant (all P < 0.05); the difference in IL-4 level of both groups was not statistically significant ( P > 0.05). There were statistically significant differences in IL-6, IL-10, IL-17, TNF-α, TGF-β, IL-2, IL-12 and IFN-γ among non pathological group, LSIL group, HSIL group and cervical cancer group (all P < 0.05); the levels of IL-6, IL-10, IL-17, TNF-α, TGF-β in cervical cancer group were the highest, the levels of IL-2, IL-12 and IFN-γ were the lowest; the level of IL-4 in non pathological group, LSIL group, HSIL group and cervical cancer group had no statistically significant difference ( P > 0.05). Logistics regression analysis showed that low IL-2, high IL-4, high IL-6, high IL-10, low IL-12, high IL-17, high TNF-α, low IFN- γ and low TGF-β expressions in vaginal lavage fluid of patients with HR-HPV16 positive were independent risk factors for the development of cervical cancer (all P < 0.05). The results of nomogram analysis showed that IL-6, IL-10, IL-17, TNF-α, TGF-β in vaginal lavage fluid were the factors predicting the development of cervical cancer in HR-HPV16 positive patients. The ROC curve analysis showed that the AUC of nomogram model in predicting the development of cervical cancer in HR-HPV16 positive patients was 0.945 (95% CI 0.901-0.988), and the predictive efficacy was good. Conclusions:Th and Treg cell related cytokines levels in vaginal lavage fluid of patients with HR-HPV16 positive show pathological changes in cervical cancer patients and the above indicators have a high value in predicting the development of cervical cancer.

Objective To investigate the relationship between exposure to famine in early life stage and hypertension phenotype and grade in middle and old age. Methods People born between 1951 and 1965 in the 2015 China Health and Elderly Care Follow-up Survey were included in the study, and were divided into unexposed group, fetal exposed group, childhood exposed group and adolescent exposed group according to the time of famine occurrence and birth year of the participants. Logistic regression model was used to explore the effects of different famine exposure periods in early life stage on hypertension classification （including normal high value, grade I, grade II and grade III） and phenotype （including isolated systolic hypertension[ISH], isolated diastolic hypertension [IDH] and combined systolic and diastolic hypertension [SDH]）. Results Compared with unexposed group, fetal famine exposure （OR=1.59, 95% CI :1.10-2.30）, childhood famine exposure （OR=1.67, 95% CI :1.04-2.70） and adolescent famine exposure （OR=3.42, 95% CI : 2.51-4.66） were the risk factors for ISH. Only famine exposure during adolescence （OR=1.54, 95% CI: 1.07-2.21） was a risk factor for SDH. In addition, fetal famine exposure （OR=1.41, 95% CI: 1.05-1.89） and adolescent famine exposure （OR=2.22 , 95% CI: 1.71-2.88） were risk factors for developing grade I hypertension. Famine exposure in childhood （OR=2.45, 95% CI: 1.21-4.94） and famine exposure in adolescence （OR=2.45, 95% CI: 1.44-4.19） were risk factors for grade 2 hypertension. Conclusion Famine exposure in early life stage was associated with the phenotype and grade of hypertension. Therefore, balanced nutrition in early life is important to prevent hypertension in adulthood.