Objective:To explore latent class of symptoms related to psychological trauma and characteristics in patients with pregnancy loss, and to analyze the related influencing factors.Methods:From July 2022 to June 2024, a convenience sampling method was used to select 709 cases of pregnancy loss patients who visited the Maternity Department of the First Affiliated Hospital of Zhengzhou University as the survey subjects. The survey was conducted using the general information questionnaire, the post-traumatic stress disorder (PTSD) self-assessment scale, the hospital anxiety and depression scale, and the pittsburgh sleep index scale. Exploratory latent class analysis (LCA) of symptoms related to psychological trauma was performed by Mplus8.3, and then multivariate logistic regression was used to identify the factors influencing the latent classes.Results:A total of 691 patients with pregnancy loss were eventually investigated, with a total PTSD score of 24.00 (19.00, 33.00), a total anxiety score of 6.00 (3.00, 9.00), a total depression score of 6.00 (3.00, 9.00), and a total sleep disorder score of 7.00 (4.00, 9.00). Symptoms related to psychological trauma could be classified into 3 potential categories named high symptom group [20.4% (141/691)], anxiety-depression group [15.3% (106/691)] and low symptom group [64.3% (444/691)]. The result of multivariate logistic regression analysis showed that per capita monthly household income >8 000 yuan ( OR=0.477, 95% CI: 0.272-0.835, P=0.010) and having a spouse accompanying the patient at the time of admission ( OR=0.352, 95% CI: 0.234-0.532, P<0.001) were protective factors for the high symptom group, and gestational week≥28 weeks ( OR=3.192, 95% CI: 1.619-6.292, P=0.001) and assisted reproductive pregnancy ( OR=1.877, 95% CI: 1.075-3.277, P=0.027) were risk factors for the high symptom group. Conclusion:Symptoms associated with psychological trauma in patients with pregnancy loss have distinct categorical characteristics, and healthcare professionals should focus on patients with pregnancy loss in the high symptom group during hospitalization, and adopt targeted interventions according to the symptoms related to psychological trauma in different categories of patients with pregnancy loss in order to avoid serious psychological problems.

Objective:To explore latent class of symptoms related to psychological trauma and characteristics in patients with pregnancy loss, and to analyze the related influencing factors.Methods:From July 2022 to June 2024, a convenience sampling method was used to select 709 cases of pregnancy loss patients who visited the Maternity Department of the First Affiliated Hospital of Zhengzhou University as the survey subjects. The survey was conducted using the general information questionnaire, the post-traumatic stress disorder (PTSD) self-assessment scale, the hospital anxiety and depression scale, and the pittsburgh sleep index scale. Exploratory latent class analysis (LCA) of symptoms related to psychological trauma was performed by Mplus8.3, and then multivariate logistic regression was used to identify the factors influencing the latent classes.Results:A total of 691 patients with pregnancy loss were eventually investigated, with a total PTSD score of 24.00 (19.00, 33.00), a total anxiety score of 6.00 (3.00, 9.00), a total depression score of 6.00 (3.00, 9.00), and a total sleep disorder score of 7.00 (4.00, 9.00). Symptoms related to psychological trauma could be classified into 3 potential categories named high symptom group [20.4% (141/691)], anxiety-depression group [15.3% (106/691)] and low symptom group [64.3% (444/691)]. The result of multivariate logistic regression analysis showed that per capita monthly household income >8 000 yuan ( OR=0.477, 95% CI: 0.272-0.835, P=0.010) and having a spouse accompanying the patient at the time of admission ( OR=0.352, 95% CI: 0.234-0.532, P<0.001) were protective factors for the high symptom group, and gestational week≥28 weeks ( OR=3.192, 95% CI: 1.619-6.292, P=0.001) and assisted reproductive pregnancy ( OR=1.877, 95% CI: 1.075-3.277, P=0.027) were risk factors for the high symptom group. Conclusion:Symptoms associated with psychological trauma in patients with pregnancy loss have distinct categorical characteristics, and healthcare professionals should focus on patients with pregnancy loss in the high symptom group during hospitalization, and adopt targeted interventions according to the symptoms related to psychological trauma in different categories of patients with pregnancy loss in order to avoid serious psychological problems.

Objective To analyze the causes of acute intestinal obstruction after intracerebral hemorrhage,and the therapeutic effect of rectal dripping with Dachengqi decoction and Fusu agent on acute intestinal obstruction complicated with septic shock.Methods The clinical data of a patient with acute intestinal obstruction complicated with septic shock after intracerebral hemorrhage,who was admitted to the Hospital of Chengdu University of Traditional Chinese Medicine(TCM)on March 5,2022,were retrospectively analyzed.The study aimed to observe the effects of rectal dripping with TCM on the recovery of intestinal function and improvement of shock.Results The patient was a 52-year-old male who underwent"left temporal craniotomy intracranial decompression,craniocerebral hematoma removal,cerebrospinal fluid leak repair"on February 19,2022 due to cerebral hemorrhage.On the 7th day after operation,the patient had hiccups and abdominal distension,and after treatment,the patient developed fever,consciousness disorders,hypotension and other symptoms.Abdominal CT showed extensive intestinal fluid,gas and expansion.Hemodynamic monitoring indicated high discharge and low resistance,intra-abdominal pressure was 21 cmH2O(1 cmH2O≈0.098 kPa),and laboratory examination showed increased inflammatory indexes and abnormal biochemical indexes.The western medicine diagnosis was acute intestinal obstruction complicated with septic shock,and the symptomatic treatments such as organ support(lung,circulation,kidney),anti-infection,fluid resuscitation,analgesia and sedation were given.The TCM diagnosis was intestinal knot(yangming visceral substantive,sudden collapse of yang-qi),with treatment principles focusing on tongfu heat relief,wenshen qianyang,Dachengqi decoction and Fusu agent was added and reduced according to the syndrome differentiation,with medications administered rectally.After the use of TCM decoction,the patient's defecation volume increased significantly,the intra-abdominal pressure decreased to the normal range,abdominal distension was significantly reduced,and the shock was relieved.On the 17th day after the operation,the patient's symptoms improved,the respiratory cycle was stable,and the patient was successfully transferred out of intensive care unit(ICU).Conclusion The treatment of acute intestinal obstruction complicated with septic shock by rectal dripping with Dachengqi decoction and Fusu agent can quickly relieve the condition and promote the recovery of intestinal function.

Objective:To investigate the current state of missed nursing care during labor, explore the reasons why nursing care was missed, and examine the influencing factors of missed nursing care.Methods:Data were collected from 14 medical institutions of different levels in southwest China using a convenience sampling from February to April, 2023. A total of 491 midwives were included. A cross-sectional survey was conducted using a general information questionnaire and the Chinese version of the Perinatal Missed Care. Multiple linear regression analysis was conducted to identify the influencing factors on missed nursing care.Results:Among 491 midwives, there are 6 males and 485 females. 194 midwives aged ≤ 30, 205 midwives aged 31-40 years, and 92 midwives aged ≥41 years. 80.45%(395/491) of midwives reported missing at least one item of nursing care during labor in the past week, and the missing rate of single item ranged from 13.24% (65/491) to 53.36% (262/491). The average score across 23 items of missed nursing care during labor was 1.49 ± 0.58. The average scores of items spanning the three dimensions of basic care, necessary care and postnatal care were 1.67 ± 0.68, 1.36 ± 0.56, and 1.51 ± 0.70, respectively. The average score of 13 items representing reasons for missed nursing care was 1.82 ± 0.71. The average scores of items in three dimensions of communication, labor resources, and material resources were 1.75 ± 0.73, 1.97 ± 0.87, and 1.74 ± 0.83, respectively. The multiple linear regression analyses showed that gender, monthly average income level, and whether overtime hours were included in total working hours were independently associated with missed nursing care (all P<0.05). Conclusions:The current state of missed nursing care during labor needs to be improved. Missed basic care is common, and labor resources are the significant reasons, and is influenced by factors such as demographic and sociological factors. Human resource factors are an important reason for nursing deficiency, and targeted measures should be taken to reduce the occurrence of nursing deficiency.

Background::Atopic dermatitis (AD) affects approximately 10% of adults worldwide. CM310 is a humanized monoclonal antibody targeting interleukin-4 receptor alpha that blocks interleukin-4 and interleukin-13 signaling. This trial aimed to evaluate the efficacy and safety of CM310 in Chinese adults with moderate-to-severe AD.Methods::This multicenter, randomized, double-blind, placebo-controlled, phase 2b trial was conducted in 21 medical institutions in China from February to November 2021. Totally 120 eligible patients were enrolled and randomized (1:1:1) to receive subcutaneous injections of 300 mg CM310, 150 mg CM310, or placebo every 2 weeks for 16 weeks, followed by an 8-week follow-up period. The primary endpoint was the proportion of patients achieving ≥75% improvement in the Eczema Area and Severity Index (EASI-75) score from baseline at week 16. Safety and pharmacodynamics were also studied.Results::At week 16, the proportion of EASI-75 responders from baseline was significantly higher in the CM310 groups (70% [28/40] for high-dose and 65% [26/40] for low-dose) than that in the placebo group (20%[8/40]). The differences in EASI-75 response rate were 50% (high vs. placebo, 95% CI 31%–69%) and 45% (low vs. placebo, 95% CI 26%–64%), with both P values <0.0001. CM310 at both doses also significantly improved the EASI score, Investigator’s Global Assessment score, daily peak pruritus Numerical Rating Scale, AD-affected body surface area, and Dermatology Life Quality Index compared with placebo. CM310 treatment reduced levels of thymus and activation-regulated chemokine, total immunoglobulin E, lactate dehydrogenase, and blood eosinophils. The incidence of treatment-emergent adverse events (TEAEs) was similar among all three groups, with the most common TEAEs reported being upper respiratory tract infection, atopic dermatitis, hyperlipidemia, and hyperuricemia. No severe adverse events were deemed to be attributed to CM310. Conclusion::CM310 at 150 mg and 300 mg every 2 weeks demonstrated significant efficacy and was well-tolerated in adults with moderate-to-severe AD.Trial Registration::ClinicalTrials.gov, NCT04805411.

Objective:To explore a teaching rounds model tailored for the ophthalmology day ward in standardized resident training.Methods:Based on the guidelines for teaching rounds in standardized resident training, we set up a teaching round working group and designed a teaching rounds model combining disease-based learning (DBL) and slit lamp-side (SLS) teaching. This teaching rounds model was implemented in 71 ophthalmology residents undergoing standardized training. The teaching effectiveness was evaluated through a questionnaire survey, including the rationality of the process design, the practicality of round content, the smoothness of round process, trainee engagement, and knowledge on the diseases involved. The results were compared with those of residents who received traditional bedside teaching rounds during the same period in 2022.Results:In the survey of satisfaction for the teaching rounds model combining DBL and SLS, 63 (88.73%) trainees were very satisfied with the rationality of the teaching round process design, trainee engagement, and knowledge on the diseases involved, 66 (92.96%) trainees were very satisfied with the practicality of the round content, and 64 (90.14%) trainees were very satisfied with the smoothness of the ward round process. Compared with the traditional bedside teaching rounds, the above five aspects of satisfaction were significantly improved ( P=0.022, P=0.023, P=0.003, P=0.019, P=0.025). Conclusions:The novel ophthalmology teaching rounds model combining DBL and SLS can be effectively integrated into the diagnosis and treatment processes in the day ward. The resident trainees showed high satisfaction with this model. This is an innovative teaching model well-suited for the operation of ophthalmology day wards.

Objective:To explore a teaching rounds model tailored for the ophthalmology day ward in standardized resident training.Methods:Based on the guidelines for teaching rounds in standardized resident training, we set up a teaching round working group and designed a teaching rounds model combining disease-based learning (DBL) and slit lamp-side (SLS) teaching. This teaching rounds model was implemented in 71 ophthalmology residents undergoing standardized training. The teaching effectiveness was evaluated through a questionnaire survey, including the rationality of the process design, the practicality of round content, the smoothness of round process, trainee engagement, and knowledge on the diseases involved. The results were compared with those of residents who received traditional bedside teaching rounds during the same period in 2022.Results:In the survey of satisfaction for the teaching rounds model combining DBL and SLS, 63 (88.73%) trainees were very satisfied with the rationality of the teaching round process design, trainee engagement, and knowledge on the diseases involved, 66 (92.96%) trainees were very satisfied with the practicality of the round content, and 64 (90.14%) trainees were very satisfied with the smoothness of the ward round process. Compared with the traditional bedside teaching rounds, the above five aspects of satisfaction were significantly improved ( P=0.022, P=0.023, P=0.003, P=0.019, P=0.025). Conclusions:The novel ophthalmology teaching rounds model combining DBL and SLS can be effectively integrated into the diagnosis and treatment processes in the day ward. The resident trainees showed high satisfaction with this model. This is an innovative teaching model well-suited for the operation of ophthalmology day wards.

Objective To observe the clinical efficacy of Jiangshabanxia nano-paste on nausea and vomiting in end-stage patients and its effect on the quality-of-life (QOL) in cancer patients. Methods 120 end-stage patients with nausea and vomiting symptoms above grade III were randomly divided into observation group and control group. They were treated with Jiangshabanxia nano-paste and placebo paste respectively. The paste patch was changed every 24 hours and used continuously for 7 days. The nausea and vomiting symptom score, the quality-of-life measurement score and KPS score of cancer patients in the two groups were observed to evaluate the curative effect. Results After 7 days of treatment, the symptom scores of nausea and vomiting in the observation group decreased significantly, the KPS score of the observation group increased, and the effective rate was higher than that in the control group. The score of QOL measurement showed that after treatment, the score of main symptom areas and other symptom areas (except external dyspnea, diarrhea and economic difficulties) in the observation group decreased, and the score of overall health area increased. After treatment, the score of main symptom areas and other symptom areas (except external dyspnea, diarrhea and economic difficulties) in the observation group was lower than that in the control group, and the scores of overall health area in the observation group were higher than those in the control group. Conclusion Jiangshabanxia nano-paste has a good clinical efficacy nausea and vomiting in end-stage patients, it also can improve the quality of life end-stage cancer patients.

Objective To evaluate the impact of overall burden of cerebral small vessel disease(CSVD)combined with intracranial large artery atherosclerosis(ICAS)on cognitive function in very old patients.Methods A total of 178 advanced elderly patients admitted to Department of General Medicine of Wuhan Central Hospital between January 2013 and December 2022 were re-cruited in this retrospective study.According to the results of Montreal Cognitive Assessment Scale,they were divided into dementia group(n=83)and non-dementia group(n=95).All pa-tients underwent brain MRI imaging,MRI susceptibility weighted imaging and cerebral angiogra-phy.Based on these imaging findings of MRI,the effect of total burden score of CSVD and athero-sclerosis on cognition were evaluated.The volumes of 14 different gyri in the left and right brain were measured in the patients with CSVD burden score ≤2 and those ≥3.Results There were significantly more patients with numbers of microbleeding foci＞10 and lacunar foci ≥5 in the dementia group than the non-dementia group(P＜0.01).But,no statistical difference was seen in intracranial and extracranial arterial stenosis between the two groups(P＞0.05).The volumes of left and right anterior cingulate gyrus,left and right paracingulate cortex,right hippocampus,left parahippocampal gyrus,right transverse temporal gyrus and left inferior temporal gyrus were no-tably smaller in the CSVD score ≥3 group than the CSVD ≤2 group(1723.444 vs 1867.167,1590.167 vs 1595.670,1481.466 vs 1509.540,1543.831 vs 1585.505,1038.345 vs 1305.831,1220.525 vs 1392.352,P＜0.05).Conclusion Cognitive function in the advanced elderly is mainly affected by the burden of CSVD,and atherosclerotic stenosis of large arteries is not the main fac-tor affecting cognitive function.The total burden of CSVD is correlated with atrophy of some gyri.

Sarcopenia is a systemic syndrome characterized by decreased muscle mass and muscle strength and decline of motor function.Sarcopenia affects quality of life and disease prognosis of patients seriously, because of the low awareness rate, low treatment rate and high cardiovascular risk. Patients with uremia undergoing peritoneal dialysis are likely to suffer from sarcopenia due to dietary restriction, loss of protein and high catabolism. This article summarizes the diagnostic methods, risk factors, predictive markers and intervention measures for sarcopenia in peritoneal dialysis patients.