Objective:To systematically and comprehensively retrieve studies on urethra care for patients with urinary catheter at home and abroad, so as to provide a reference for removing low-value care measures in the future.Methods:Arksey and O'?Malley scoping review method was used to systematically search the China National Knowledge Infrastructure, China Biology Medicine disc, WanFang Data, VIP, PubMed, Cochrane Library, CINAHL, Embase, and Web of Science. The search period was from database establishment to January 1, 2024. Literature was screened based on inclusion and exclusion criteria, and catheter care site, disinfection/cleaner type, frequency, institutional norms, and determinants were independently extracted by two researchers, where determinants were framed based on the theoretical domains framework.Results:A total of 21 papers were included. Urethra low-value care measures were reflected in the selection of nursing solutions that differed significantly from guideline recommendations and were inconsistently standardized across hospitals. Thirteen strategies were proposed to remove urethra low-value care measures. Factors that influenced the removal of low-value care behaviors included knowledge, reinforcement, environment and resources, social influences, personal roles and identities, outcome beliefs and memories, and attention and decision-making processes.Conclusions:Future researchers should further refine the evidence on urethra care and develop contextualized care for complex, multilevel healthcare settings to achieve continuous improvement and high quality care at low cost.

Objective:To systematically and comprehensively retrieve studies on urethra care for patients with urinary catheter at home and abroad, so as to provide a reference for removing low-value care measures in the future.Methods:Arksey and O'?Malley scoping review method was used to systematically search the China National Knowledge Infrastructure, China Biology Medicine disc, WanFang Data, VIP, PubMed, Cochrane Library, CINAHL, Embase, and Web of Science. The search period was from database establishment to January 1, 2024. Literature was screened based on inclusion and exclusion criteria, and catheter care site, disinfection/cleaner type, frequency, institutional norms, and determinants were independently extracted by two researchers, where determinants were framed based on the theoretical domains framework.Results:A total of 21 papers were included. Urethra low-value care measures were reflected in the selection of nursing solutions that differed significantly from guideline recommendations and were inconsistently standardized across hospitals. Thirteen strategies were proposed to remove urethra low-value care measures. Factors that influenced the removal of low-value care behaviors included knowledge, reinforcement, environment and resources, social influences, personal roles and identities, outcome beliefs and memories, and attention and decision-making processes.Conclusions:Future researchers should further refine the evidence on urethra care and develop contextualized care for complex, multilevel healthcare settings to achieve continuous improvement and high quality care at low cost.

Studies have shown that plasma apolipoprotein B (ApoB) has a good predictive value for ischemic stroke and plays an important role in the prevention and treatment of ischemic stroke. More and more guidelines and consensus opinions began to recommend ApoB as a routine intervention target. This article reviews the biological characteristics, clinical detection advantages, and role and treatment prospect of ApoB in the prevention and treatment of ischemic stroke.

The shared decision-making between doctors arel patients has great significance for clarifying patients' wishes and preferences, reducing decision-making regret and decision-making conflicts and improving quality of life of patients. However, the research and exploration of shared decision-making in China is still in its infancy. In June 2021, National Institute for Health and Care Excellence (NICE) released the 2021 NICE Guidelines for Shared Decision- Making. The guideline provides comprehensive overview of organizational policies, practical preparation, decision support tools, communication skills, and current implementation dilemmas in the shared decision-making domain. This article will integrate and interpret the core content of the guidelines, in order to provide Chinese researchers with future research directions in this field.

Objective:To formulate sustainable development strategies for the newly-found clinical science and technology innovation park to improve the clinical research and disease diagnosis and treatment.Methods:PEST-SWOT model was used to analyze the internal and external environmental factors that impact the development of the park.Results:The advantages and disadvantages of the park were analyzed as well as the opportunities and challenges. Effective strategies for the construction and development of the park were put forward from four aspects, such as SO, ST, WO and WT.Conclusions:The development strategy proposed in this study is conducive to establish a well-known clinical science and technology innovation park which is an institute integrating clinical and scientific research.

Background: Metabolic diseases pose considerable burden on the healthcare system worldwide, indi-cating the significance of prevention and treatment. In constitution theory of traditional Chinese med-icine, phlegm-dampness constitution (PDC) is the common basis of metabolic diseases. In clinical practice, Huatan Qushi (HTQS) decoction targeting on PDC can effectively improve metabolic indicators. However, its underlying biochemical mechanism still remains unclear.Methods: Eight PDC participants received HTQS decoction for three months. Their blood was collected at baseline and 1 and 3 months after intervention started. Related biomedical indicators were detected. High-throughput sequencing and RT-qPCR were used for validation. Due to the missing data, repeated measures with missing values in mixed models were used. Results: After 3-month treatment, HDL-C level increased (P<.001) and FBG, FINS, and HbA1c all showed decreasing trend at different time points (all P < .05). After miRNA high-throughput sequencing, compared with the baseline, differential miRNAs at 1 and 3 months were screened, and target gene prediction and KEGG pathway enrichment analysis were performed. The results displayed that metabolic disease-related pathways mainly included pathways in cancer, PI3K-Akt signaling pathway, etc. Further, RT-qPCR showed that hsa-miR-1237-3p differed statistically (P =.008). Then we validated the target genes of hsa-miR-1237-3p in the"Pathways in Cancer"pathway including SDF1, AC, CRK, and HGF, also known as upstream target genes of PI3K/AKT pathway. The results showed that two indicators of CRK and HGF were in statistical significance (P=.045 and P=.036, respectively). Conclusion: PDC serves as a common basis for various metabolic diseases. Through adjusting PDC, HTQS decoction can improve biomedical indicators including blood glucose, HbA1c, insulin, and HDL-C. The target pathway is"Pathways in cancer". Specifically, HTQS decoction acts on targets of CRK and HGF by regulating hsa-miR-1237-3p, and probably exerts effects on their downstream PI3K/AKT pathway.

Objective To investigate the effect of hyperbaric oxygen ( HBO ) combined with escitalopram oxalate on the patients with post-stroke depression ( PSD) and the expression levels of serum Hp and retinol-binding protein 4 (RBP4). Methods Sixty patients with PSD treated in the Qingdao Mental Health Center from January 2017 to January 2018 were enrolled as research subjects. By random double-blind lottery method, the patients were divided into the control group and the observation group, each consisting of 30 patients. The patients in the control group were treated only with escitalopram oxalate, while the patients in the observation group received HBO in addition to the treatment received by the control group. The expression levels of monoamine neurotransmitters and inflammatory factors were detected before and after treatment, and the scores of depression and neurological function were assessed as well. At the same time, the expression levels of Hp and RBP4 were also detected. Results Three months after treatment, monoamine neurotransmitter level of the observation group significantly elevated, while inflammatory factor level obviously decreased, with the change rate of the observation group all being higher than those of the control group, and statistical significance could be seen when comparisons were made between the 2 groups (P<0. 05 or P<0. 01). Scores of Montgomery Asberg Depression Rating Scale ( MADRS ) and Chinese Stroke Scale ( CSS ) scores in the observation group were significantly lower than those in the control group, and improvement was superior to that in the control group, and statistical significance could be noticed when comparisons were made between them (P<0. 05 or P<0. 01). The levels of serum Hp and RBP4 in the observation group significantly decreased as compared with those before treatment, and were also lower than those in the control group, also with statistical significance (P<0. 05 or P<0. 01). Conclusion HBO combined with escitalopram oxalate could improve patient depression and clinical efficacy by the approaches of increasing serum monoamine neurotransmitter level and decreasing inflammatory factor and serum Hp/RBP4 levels in the treatment of the patients with post-stroke depression.

Objective To investigate the effect of hyperbaric oxygen ( HBO ) combined with escitalopram oxalate on the patients with post-stroke depression ( PSD) and the expression levels of serum Hp and retinol-binding protein 4 (RBP4). Methods Sixty patients with PSD treated in the Qingdao Mental Health Center from January 2017 to January 2018 were enrolled as research subjects. By random double-blind lottery method, the patients were divided into the control group and the observation group, each consisting of 30 patients. The patients in the control group were treated only with escitalopram oxalate, while the patients in the observation group received HBO in addition to the treatment received by the control group. The expression levels of monoamine neurotransmitters and inflammatory factors were detected before and after treatment, and the scores of depression and neurological function were assessed as well. At the same time, the expression levels of Hp and RBP4 were also detected. Results Three months after treatment, monoamine neurotransmitter level of the observation group significantly elevated, while inflammatory factor level obviously decreased, with the change rate of the observation group all being higher than those of the control group, and statistical significance could be seen when comparisons were made between the 2 groups (P<0. 05 or P<0. 01). Scores of Montgomery Asberg Depression Rating Scale ( MADRS ) and Chinese Stroke Scale ( CSS ) scores in the observation group were significantly lower than those in the control group, and improvement was superior to that in the control group, and statistical significance could be noticed when comparisons were made between them (P<0. 05 or P<0. 01). The levels of serum Hp and RBP4 in the observation group significantly decreased as compared with those before treatment, and were also lower than those in the control group, also with statistical significance (P<0. 05 or P<0. 01). Conclusion HBO combined with escitalopram oxalate could improve patient depression and clinical efficacy by the approaches of increasing serum monoamine neurotransmitter level and decreasing inflammatory factor and serum Hp/RBP4 levels in the treatment of the patients with post-stroke depression.

Objective To observe the clinical efficacy ofTiaozhong YifeiPrescription combined with Western therapy for treatment of cough variant asthma (CVA) remission. Methods Totally 90 patients with CVA remission were randomly divided into TCM group, Western therapy group and TCM and Western therapy group, 30 cases in each group. TCM group was givenTiaozhong YifeiPrescription, 1 dose per day, morning and evening; Western therapy group was given salmeterol xinafoate and fluticasone propionate powder for inhalation, each 1 suction, 2 times a day, inhalation; a mixture ofTiaozhong YifeiPrescription and xinafoate and fluticasone propionate powder for inhalation was given to TCM and Western therapy group, the same as above, continuous treatment for 12 weeks. TCM syndrome score, EOS, IgE, pulmonary function and safety index were observed in the three groups before and after treatment. The recurrence rate and the number of colds after three-month treatment were observed.Results TCM syndrome scores in the three groups decreased after treatment (P<0.05). There was statistical significance between TCM group and TCM and Western therapy group after treatment (P<0.05). The total effective rate of TCM group was 96.67% (29/30), 100.00% (30/30) of Western therapy group, 76.67% (23/30) of TCM and Western therapy group, with statistical significance (P<0.05). After three-month treatment, 1, 0 and 11 cases relapsed in TCM group, TCM and Western therapy group and Western therapy group, respectively, with statistical significance (P<0.001). Compared with the Western therapy group, the number of colds in the TCM group and TCM and Western therapy group significantly decreased (P<0.05). Compared with before treatment, IgE decreased significantly (P<0.05). There was no significant difference in EOS among the three groups before and after treatment (P>0.05). After treatment, the maximum expiratory flow in TCM and Western therapy groupwas higher than that before treatment and lower than that in the Western therapy group (P<0.01), and the other lung function indexes were not statistically significant (P>0.05). 1 mild adverse reaction was found in the TCM and Western therapy, and no obvious adverse reactions were found in other groups (P<0.05).ConclusionTiaozhong Yifei Prescription has good clinical efficacy for CVA.

Objective To investigate the mechanism of linezolid resistance in methicillin-resistant Staphylococcus epidermidis ( MRSE) strains isolated in Hangzhou area. Methods Twenty-three linezolid-re-sistant Staphylococcus epidermidis ( LRSE) strains were isolated from the patients with septicaemia, urinary tract infection or infectious pleuritis in several hospitals in Hangzhou area during May, 2013 to April, 2015. The minimal inhibition concentrations ( MICs) of thirteen different antibiotics against the LRSE strains were detected by using E-test. Pulsed-field gel electrophoresis ( PFGE) and cluster analysis were performed for homology analysis. Correlations between linezolid resistance in the LRSE strains and G2576T mutation at theⅤ functional region of 23S rRNA gene or cfr gene were determined by PCR and sequencing analysis. Re-sults The MICs of linezolid to 15 LRSE strains were higher than 256 μg/ml while to the other 8 LRSE strains were 6 or 8 μg/ml. All of the 23 LRSE strains were resistant to both oxacillin and cefoxitin. Among the LRSE strains with high linezolid MICs (MIC>256 μg/ml), LRSE1 and LRSE2, LRSE3-LRSE6 and LRSE9-LRSE12 respectively belonged to the same clone line and came from the same hospital. All of the 23 LRSE strains carried the cfr gene. Moreover, the G2576T mutation at theⅤfunctional region of 23S rRNA gene was detected in the 15 LRSE strains with high linezolid MICs ( MIC>256 μg/ml ) , but not in the 8 strains with lower linezolid MICs ( MIC=6 or 8 μg/ml) . Conclusion There are significant differences in linezolid resistance among LRSE strains isolated in Hangzhou area. The LRSE strains are methicillin-resist-ant coagulase negative Staphylococcus ( MRCNS) strains and widely distributed. The linezolid resistance in LRSE strains is related to the G2576T mutation at theⅤfunctional region of 23S rRNA gene and cfr gene.