After ostomy surgery, patients lose the ability to control their anal sphincter, relying on ostomy pouches for excretion. Convex baseplates offer several advantages, including preventing leakage, reducing the risk of stoma and peripheral skin complications, and adapting to the dynamic stoma shapes caused by peristaltic expansion and contraction of the stoma. This article reviews the structure and features of convex baseplates, usage considerations, existing challenges, and future prospects, aiming to provide a reference for the standardized clinical use of convex baseplates and to improve patient health outcomes.

Objective:To investigate the current status of convex baseplate selection and use among clinical nurses.Methods:A convenience sampling method was employed to survey 1 873 nurses from 180 hospitals across China between November and December 2024 using a general information questionnaire and a self-designed questionnaire on convex baseplate selection and use. A total of 1 873 questionnaires were distributed, and 1 860 valid responses were collected, yielding a response rate of 99.31% (1 860/1 873) .Results:Among the 1 860 nurses, 88.98% (1 655/1 860) had access to convex baseplates in clinical practice. However, only 8.82% (146/1 655) used them immediately postoperatively, and only 4.53% (75/1 655) chose convex baseplates without considering any product features. The five common clinical indications for convex baseplate use included stoma retraction (96.62%, 1 599/1 655) , peristomal skin folds or depressions (96.56%, 1 598/1 655) , flush stomas (80.12%, 1 326/1 655) , leakage (70.03%, 1 159/1 655) , and abdominal laxity (66.89%, 1 107/1 655) . Common contraindications for use included peristomal varicose veins (77.46%, 1 282/1 655) , peristoma pressure injuries (75.35%, 1 247/1 655) , stoma prolapse (74.50%, 1 233/1 655) , parastomal hernia (72.87%, 1 206/1 655) , and pyoderma gangrenosum (67.01%, 1 109/1 655) . Key assessment areas when selecting convex baseplates included the stoma itself (97.28%, 1 610/1 655) , peristomal skin (96.50%, 1 597/1 655) , abdominal wall contour (95.41%, 1 579/1 655) , excretion patterns (87.37%, 1 446/1 655) , and previous convex baseplate use (82.36%, 1 363/1 655) . Measures commonly used by nurses to enhance adhesion included the use of stoma belts (95.29%, 1 577/1 655) , barrier rings or paste (94.80%, 1 569/1 655) , smoothing peristomal skin folds (90.57%, 1 499/1 655) , advising patients to limit bending (82.96%, 1 373/1 655) , and abdominal binders (57.28%, 948/1 655) .Conclusions:The clinical application of convex baseplates requires further promotion. Nursing administrators should strengthen training on the selection, characteristics, and indications of convex baseplates, with particular emphasis on the understanding of the five key product features.

OBJECTIVE To analyze the risk factors of neonatal pneumonia(NP)and construct the risk prediction model for NP.METHODS A total of 60 cases of neonatal pneumonia admitted to neonatology department of Chan-gzhou Children's Hospital from Dec.2022 to Dec.2023 were selected in the study group,and another 60 healthy neonates during the same period were randomly selected as the healthy group.The risk factors of neonatal pneu-monia were summarized by logistic regression analysis,the prediction model was established,the discrimination of the model was evaluated by receiver's operating characteristic(ROC)curves,and the correction capability was as-sessed by Hosmer-Lemeshow test.RESULTS Birth 1 min Apgar score＜7 points(OR=5.930,95％CI:2.877-12.222,P＜0.001)and amniotic fluid pollution(OR=4.175,95％CI:1.251-13.935,P=0.021)were the risk factors for neonatal pneumonia,while prophylactic antimicrobial drug application(OR=0.471,95％CI:0.226-0.982,P=0.044)was a protective factor(P＜0.05).Based on the results of Logistic regression analysis,the formula of the relevant risk prediction model was established as logit(P)=20.780×1 min Apgar score-23.429 × amniotic fluid pollution+3.024 × prophylactic use of antibiotics+1.056.The results of ROC curves analysis showed that AUC of the risk prediction model was 0.774(95％CI:0.691-0.857),suggesting that the risk pre-diction model had a good discrimination,and Hosmer-Lemeshow x2=7.028,P=0.941,and there was good cali-bration degree of the model.CONCLUSION Birth 1 min Apgar score＜7 points and amniotic fluid pollution are in-dependent risk factors of NP,while prophylactic antimicrobial drug application is a protective factor,and the risk prediction model for the development of NP based on logistic regression analysis had good predictive efficiency and accuracy.

OBJECTIVE To analyze the risk factors of neonatal pneumonia(NP)and construct the risk prediction model for NP.METHODS A total of 60 cases of neonatal pneumonia admitted to neonatology department of Chan-gzhou Children's Hospital from Dec.2022 to Dec.2023 were selected in the study group,and another 60 healthy neonates during the same period were randomly selected as the healthy group.The risk factors of neonatal pneu-monia were summarized by logistic regression analysis,the prediction model was established,the discrimination of the model was evaluated by receiver's operating characteristic(ROC)curves,and the correction capability was as-sessed by Hosmer-Lemeshow test.RESULTS Birth 1 min Apgar score＜7 points(OR=5.930,95％CI:2.877-12.222,P＜0.001)and amniotic fluid pollution(OR=4.175,95％CI:1.251-13.935,P=0.021)were the risk factors for neonatal pneumonia,while prophylactic antimicrobial drug application(OR=0.471,95％CI:0.226-0.982,P=0.044)was a protective factor(P＜0.05).Based on the results of Logistic regression analysis,the formula of the relevant risk prediction model was established as logit(P)=20.780×1 min Apgar score-23.429 × amniotic fluid pollution+3.024 × prophylactic use of antibiotics+1.056.The results of ROC curves analysis showed that AUC of the risk prediction model was 0.774(95％CI:0.691-0.857),suggesting that the risk pre-diction model had a good discrimination,and Hosmer-Lemeshow x2=7.028,P=0.941,and there was good cali-bration degree of the model.CONCLUSION Birth 1 min Apgar score＜7 points and amniotic fluid pollution are in-dependent risk factors of NP,while prophylactic antimicrobial drug application is a protective factor,and the risk prediction model for the development of NP based on logistic regression analysis had good predictive efficiency and accuracy.

After ostomy surgery, patients lose the ability to control their anal sphincter, relying on ostomy pouches for excretion. Convex baseplates offer several advantages, including preventing leakage, reducing the risk of stoma and peripheral skin complications, and adapting to the dynamic stoma shapes caused by peristaltic expansion and contraction of the stoma. This article reviews the structure and features of convex baseplates, usage considerations, existing challenges, and future prospects, aiming to provide a reference for the standardized clinical use of convex baseplates and to improve patient health outcomes.

Objective:To investigate the current status of convex baseplate selection and use among clinical nurses.Methods:A convenience sampling method was employed to survey 1 873 nurses from 180 hospitals across China between November and December 2024 using a general information questionnaire and a self-designed questionnaire on convex baseplate selection and use. A total of 1 873 questionnaires were distributed, and 1 860 valid responses were collected, yielding a response rate of 99.31% (1 860/1 873) .Results:Among the 1 860 nurses, 88.98% (1 655/1 860) had access to convex baseplates in clinical practice. However, only 8.82% (146/1 655) used them immediately postoperatively, and only 4.53% (75/1 655) chose convex baseplates without considering any product features. The five common clinical indications for convex baseplate use included stoma retraction (96.62%, 1 599/1 655) , peristomal skin folds or depressions (96.56%, 1 598/1 655) , flush stomas (80.12%, 1 326/1 655) , leakage (70.03%, 1 159/1 655) , and abdominal laxity (66.89%, 1 107/1 655) . Common contraindications for use included peristomal varicose veins (77.46%, 1 282/1 655) , peristoma pressure injuries (75.35%, 1 247/1 655) , stoma prolapse (74.50%, 1 233/1 655) , parastomal hernia (72.87%, 1 206/1 655) , and pyoderma gangrenosum (67.01%, 1 109/1 655) . Key assessment areas when selecting convex baseplates included the stoma itself (97.28%, 1 610/1 655) , peristomal skin (96.50%, 1 597/1 655) , abdominal wall contour (95.41%, 1 579/1 655) , excretion patterns (87.37%, 1 446/1 655) , and previous convex baseplate use (82.36%, 1 363/1 655) . Measures commonly used by nurses to enhance adhesion included the use of stoma belts (95.29%, 1 577/1 655) , barrier rings or paste (94.80%, 1 569/1 655) , smoothing peristomal skin folds (90.57%, 1 499/1 655) , advising patients to limit bending (82.96%, 1 373/1 655) , and abdominal binders (57.28%, 948/1 655) .Conclusions:The clinical application of convex baseplates requires further promotion. Nursing administrators should strengthen training on the selection, characteristics, and indications of convex baseplates, with particular emphasis on the understanding of the five key product features.

Objective:To study the application effect of the Benner's theory stratified training based on the "Protect the World" platform for nurses specialized in neurological rehabilitation.Methods:A total of 70 nurses who underwent on-the-job training for neurorehabilitation nursing specialists in 2023 were divided into control group ( n=35) and observation group ( n=35) based on random odd and even numbers to receive different training methods. The control group received routine nursing training, while the observation group received Benner's theory stratified training based on the "Protect the World" platform. The theoretical and skill assessment scores, job competency, and satisfaction scores of two groups of nurses were compared before and after training. SPSS 25.0 was used for t-test and chi-square test. Results:Before training, there were no significant differences between the two groups of nurses in terms of theory scores [(88.35±4.41) vs. (89.43±4.07)] and skill assessment scores [(89.22±3.27) vs. (88.43±3.16)]. After training, the theoretical and skill assessment scores were significantly higher in the observation group as compared with the control group [(95.51±5.01) vs. (90.24±4.99) and (95.15±4.24) vs. (91.13±4.33), both P<0.05]. After training, the competency scores and total scores of education guidance, management function, diagnostic function, assistance role, and intervention treatment were significantly higher in the observation group than in the control group ( P<0.05). The satisfaction survey scores were significantly higher in the observation group than in the control group ( P<0.05). Conclusions:The Benner's theory stratified training based on the "Protect the World" platform can improve the theoretical and skill assessment scores of nurses specialized in neurological rehabilitation. This approach significantly boosts their overall professional competence and holds considerable potential for broader adoption.

Objective To construct a Nomogram prediction model based on body position exercise training for patients with chronic constipation. Methods A total of 327 patients with chronic constipation from March 2021 to March 2023 were divided into qualified group (n=279) and unqualified group (n=48) according to their performance in body position exercises. General clinical materials of the patients were collected, and univariate and multivariate Logistic regression analyses were performed to identify risk factors for unqualified body position exercises in patients with chronic constipation; the R software was used to construct a Nomogram model for predicting unqualified body position exercises in patients with chronic constipation, and the receiver operating characteristic (ROC) curve and calibration curve were applied to verify the discrimination and consistency of the Nomogram model. Results There were no significant differences in gender, education level, history of smoking, history of alcohol abuse, history of hypertension, history of abdominal surgery, history of colonoscopy, and correct medication administration ratio between the two groups (P>0.05); the unqualified group had higher age, longer duration of chronic constipation, and a higher proportion of diabetes history compared to the qualified group (P < 0.05); age, duration of chronic constipation, and diabetes history were independent risk factors for unqualified body position exercises in patients with chronic constipation (P < 0.05). The constructed Nomogram prediction model demonstrated excellent discrimination (area under the curve was 0.923, 95%CI, 0.888 to 0.949, with sensitivity and specificity of 87.50% and 81.00% respectively) and consistency (H-L goodness-of-fit test χ²=2.246, P=0.973). The clinical value of this Nomogram model in predicting unqualified body position exercises for patients with chronic constipation was high when the high-risk threshold probability ranged from 0.06 to 0.80. Conclusion Age, duration of chronic constipation, and diabetes history are independent risk factors for unqualified body position exercises in patients with chronic constipation, and the Nomogram model constructed based on these multi-factor results has high discrimination and consistency in predicting unqualified body position exercises for patients with chronic constipation.

Background::Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease characterized by complex and various clinical manifestations. The study aimed to analyze clinical features and cerebral magnetic resonance imaging (MRI) changes of hyperintense white matter (WM) lesions in SLE patients.Methods::This was a retrospective study based on a consecutive cohort of 1191 SLE patients; 273 patients for whom cerebral MRI data were available were enrolled to assess hyperintense WM lesions associated with SLE. Patients were assigned to two groups, ie, with or without hyperintense WM lesions. The MRI assessment showed that the hyperintense WM lesions could be classified into three categories: type A, periventricular hyperintense WM lesions; type B, subcortical hyperintense WM lesions; and type C, multiple discrete hyperintense WM lesions. The clinical and MRI characteristics were analyzed. Factors related to hyperintense WM lesions were identified by multivariate logistic regression analysis.Results::Among the 273 SLE patients with available cerebral MRI scans, 35.9% (98/273) had hyperintense WM lesions associated with SLE. The proportions of types A, B, and C were 54.1% (53/98), 11.2% (11/98), and 92.9% (91/98), respectively. Fifty-one percents of the patients showed an overlap of two or three types. Type C was the most common subgroup to be combined with other types. Compared with those without hyperintense WM lesions, the patients with hyperintense WM lesions were associated with neuropsychiatric SLE (NPSLE), lupus nephritis (LN), hypertension, and hyperuricemia ( P = 0.002, P = 0.018, P = 0.045, and P = 0.036, respectively). Significantly higher rates of polyserous effusions and cardiac involvement were found in the patients with hyperintense WM lesions ( P = 0.029 and P = 0.027, respectively), and these patients were more likely to present with disease damage ( P < 0.001). In addition, the patients with hyperintense WM lesions exhibited a higher frequency of proteinuria ( P = 0.009) and higher levels of CD8 + T cells ( P = 0.005). In the multivariate logistic analysis, hyperuricemia and higher CD8 + T cells percentages were significantly correlated with hyperintense WM lesions in SLE patients ( P= 0.019; OR 2.129, 95% confidence interval [CI] 1.313-4.006 and P < 0.001; OR 1.056, 95% CI 1.023-1.098, respectively). Conclusions::Hyperintense WM lesions are common in SLE patients and significantly associated with systemic involvement, including NPSLE, LN, polyserous effusions, cardiac involvement, and disease damage. Hyperuricemia and a higher number of CD8 + T cells were independent factors associated with hyperintense WM lesions in SLE.

[摘 要] 目的：探索南蛇藤提取物齐墩果烷型五环三萜（28-hydroxy-3-oxoolean-12-en-2-oic acid）协同miR-451对人胃癌AGS细胞增殖、迁移的影响及其可能的分子机制。方法：用miR-451过表达慢病毒感染AGS细胞，并用盐酸多西环素（DOX）10或100 ng/ml诱导24 h，构建过表达miR-451的细胞AGS/miR-451+。采用10、20、40、80、160 μmol/L的齐墩果烷型五环三萜处理AGS/miR-451+细胞，MTT法、划痕实验分别检测细胞增殖和迁移能力的变化，WB法检测细胞中mTOR通路及凋亡相关蛋白表达水平的变化。结果：成功构建过表达miR-451的AGS/miR-451+细胞。与未加药对照组相比，齐墩果烷型五环三萜处理后AGS/miR-451+细胞的增殖抑制率均呈时间和浓度依赖性升高（P<0.05或P<0.01），细胞迁移率均显著降低（P<0.05或P<0.01）。齐墩果烷型五环三萜处理组细胞中，mTOR 信号通路相关蛋白的表达量均有所降低（P<0.05或P<0.01）；凋亡相关蛋白中，Bcl2的表达量下降，BAX、caspase-3、caspase-1及细胞色素c的表达量升高（P<0.05或P<0.01）。结论：齐墩果烷型五环三萜能够协同miR-451抑制人胃癌AGS细胞的增殖与迁移，其机制可能与影响凋亡和mTOR信号通路相关蛋白的表达有关。