Palliative care has become an important medical measure to provide professional healthcare and alleviate patients' suffering. Nurse-led palliative care models enable patients to access palliative care services in a timely manner and can be applied across various healthcare settings. This paper reviews the current status of nurse-led palliative care models in China and internationally, summarizes the summarizes the intervention settings, care forms, implementation contents, and effects of nurse-led palliative care models, and expounds on the existing barriers and improvement strategies of nurse-led palliative care models in China. The aim is to provide a reference for the implementation and development of palliative care.

Palliative care has become an important medical measure to provide professional healthcare and alleviate patients' suffering. Nurse-led palliative care models enable patients to access palliative care services in a timely manner and can be applied across various healthcare settings. This paper reviews the current status of nurse-led palliative care models in China and internationally, summarizes the summarizes the intervention settings, care forms, implementation contents, and effects of nurse-led palliative care models, and expounds on the existing barriers and improvement strategies of nurse-led palliative care models in China. The aim is to provide a reference for the implementation and development of palliative care.

Objective To compare the success rate and stability of rat pulmonary fibrosis(PF)models induced by intratracheal instillation of different doses of bleomycin(BLM).Methods One hundred and fifty Sprague Dawley rats were divided randomly into control,low-dose BLM 3 mg/kg(BL-L),and high-dose BLM 5 mg/kg(BL-H)groups.General status,mortality,and weight changes were observed,and the lung inspiratory capacity(IC),vital capacity(VC),chord compliance(Cchord),and dynamic compliance(Cdyn)were detected on days 28,42,56,and 84.Lung coefficients were recorded and pathological changes in lung tissue were observed by hematoxylin and eosin and Masson staining.The lung hydroxyproline(HYP)content was detected and collagen type Ⅲ(COL Ⅲ)was detected by immunohistochemistry.Results The mortality rates in the BL-L and BL-H groups were 20％and 28％,respectively.Body weight was significantly lower in the BL-L group compared with the control group on days 0～56,and weight recovery after day 56.Body weight was significantly lower in the BL-H group compared with the control and BL-L groups from days 0～56(P＜0.01).Regarding lung function,IC,VC,Cchord,and Cdyn were significantly lower in the BL-L group compared with the control group on day 28(P＜0.01,P＜0.05),and IC and Cdyn were significantly lower in the BL-H group(P＜0.01).IC,VC,and Cchord were significantly decreased in the BL-L group on day 42(P＜0.01,P＜0.05),while IC,VC,Cchord,and Cdyn were significantly decreased in the BL-H group(P＜0.01,P＜0.05),and IC,VC,and Cchord were significantly lower compared with in the BL-L group(P＜0.01).Cchord was significantly lower in the BL-H group compared with the control and BL-L groups on day 56(P＜0.01).The lung coefficients on day 28 were significantly higher in the BL-L and BL-H groups compared with the control group(P＜0.01),and were significantly higher in the BL-H group from days 42～56 compared with the BL-L and control groups(P＜0.01).Regarding lung histopathology and immunohistochemistry,inflammatory infiltration,fibrotic streaks,and COL Ⅲ expression were observed in the BL-L group from days 28～56,and almost complete disappearance of the fibrotic lesions on day 84.In contrast,fibrotic lesions could be observed from days 28～84 in the BL-H group,with significantly elevated COL Ⅲ expression compared with the control group(P＜0.01).The HYP content was significantly higher in the BL-L group compared with the control group from days 28～42(P＜0.05,P＜0.01),and then gradually decreased,and the HYP content was significantly higher in the BL-H group than in the control group from days 28～84(P＜0.01).Conclusions Both 3 and 5 mg/kg BLM can successfully induce PF rat models.Rats treated with 3 mg/kg BLM developed fibrosis on day 28,which lasted until day 42 and then gradually recovered.Rats treated with 5 mg/kg BLM developed fibrosis on day 28,and the degree of fibrosis was more severe with the higher compared with the lower dose,with stable fibrotic lesions up to day 56 and moderate-to-severe fibrosis still present in half of the rats until day 84.

Objective A rat model of pulmonary fibrosis was constructed using a single or two intratracheal drops of bleomycin(BLM)and the modeling rate and stability of the two modeling modalities were compared.Methods A total of 150 specific pathogen-free SD rats were divided randomly into blank control(control),single intratracheal drop of bleomycin(BLM-S),and two intratracheal drops of bleomycin(BLM-M)groups.Rats in the BLM-S group received a single dose of 3 mg/kg BLM by noninvasive intratracheal instillation,and rats in BLM-M group received 3 mg/kg BLM on day 1 and BLM 2 mg/kg on day 14.Rats in the control group were given intratracheal instillation of 0.9％sodium chloride(1 mL/kg).The rats were euthanized on days 28,42,56,and 84 after modelling,respectively.Deep inspiratory capacity(IC),vital capacity(VC),static lung compliance(Cchord),and dynamic lung complication(Cdyn)were measured in all rats.Pathological changes in lung tissue were observed,and the extent of alveolitis and fibrosis was graded.Collagen-Ⅲ(COL-Ⅲ)expression in rat lung tissue was detected by immunohistochemistry.Results(1)The survival rates in the control,BLM-S,and BLM-M groups were 100％,80％,and 66％,respectively.Rats in the BLM-S and BLM-M groups had significantly lower body weights on days 14～42 compared with the control group(P＜0.05,P＜0.01),and rats in the BLM-M group had significantly lower body weight on days 28～42 than rats in the control and BLM-S groups(P＜0.05,P＜0.01).(2)Regarding lung function,IC,VC,Cchord,and Cdyn were all markedly decreased in the BLM-S group compared with the control group(P＜0.05,P＜0.01)and IC,VC,and Cchord were significantly decreased in the BLM-M group(P＜0.05,P＜0.01)on day 28.IC,VC,and Cchord were significantly decreased in rats in the BLM-S group on day 42(P＜0.05,P＜0.01),and were also significantly decreased in rats in the BLM-M group on days 42～84(P＜0.05,P＜0.01).(3)In terms of lung pathology,inflammatory infiltration and fibrous cords appeared in the BLM-S group from days 28～84 and then gradually decreased(P＜0.05,P＜0.01),while fibrosis and alveolitis were relatively stable in the BLM-M group(P＜0.05,P＜0.01).(4)COL-Ⅲ expression levels in lung tissue were significantly higher in rats in the BLM-S and BLM-M groups compared with the control group(P＜0.05,P＜0.01),and the COL-Ⅲ content in the BLM-S group was significantly lower at 42～84 days than at 28 days(P＜0.05).Conclusions Both method are capable of effectively creating pulmonary fibrosis models.The single-dose approach is straightforward,has a lower death rate,and the degree of fibrosis is clearly visible by day 28,but progressively recovers after 42 days.In contrast,the two-dose instillation model has a greater success rate and better stability,with over half the rats still exhibiting visible fibrosis on day 84.

Objective: To investigate craniofacial differences in individuals with hypodontia and explore the relationship between craniofacial features and the number of congenitally missing teeth. Methods: A cross-sectional study was conducted among 261 Chinese patients (males, 124; females, 137; age, 7–24 years), divided into four groups (without hypodontia: no teeth missing, mild: one or two missing teeth, moderate: three to five missing teeth, severe: six or more missing teeth) according to the number of congenitally missing teeth. Differences in cephalometric measurements among the groups were analyzed. Further, multivariate linear regression and smooth curve fitting were performed to evaluate the relationship between the number of congenitally missing teeth and the cephalometric measurements. Results: In patients with hypodontia, SNA, NA-AP, FH-NA, ANB, Wits, ANS-Me/N-Me, GoGn-SN, UL-EP, and LL-EP significantly decreased, while Pog-NB, AB-NP, N-ANS, and S-Go/N-Me significantly increased. In multivariate linear regression analysis, SNB, Pog-NB, and S-Go/N-Me were positively related to the number of congenitally missing teeth. In contrast, NA-AP, FH-NA, ANB, Wits, N-Me, ANS-Me, ANS-Me/N-Me, GoGn-SN, SGn-FH (Y-axis), UL-EP, and LL-EP were negatively related, with absolute values of regression coefficients ranging from 0.147 to 0.357. Further, NA-AP, Pog-NB, S-Go/N-Me, and GoGn-SN showed the same tendency in both sexes, whereas UL-EP and LL-EP were different. Conclusions Compared with controls, patients with hypodontia tend toward a Class III skeletal relationship, reduced lower anterior face height, flatter mandibular plane, and more retrusive lips. The number of congenitally missing teeth had a greater effect on certain characteristics of craniofacial morphology in males than in females.

Objective:To analyze the influencing factors for depression in primary school children aged 9-10 years in Jiangsu Province, and to construct a risk prediction model.Methods:A retrospective study.A total of 1 162 primary school children aged 9-10 years from 3 primary schools in 3 regions of Jiangsu Province were recruited.Their demographic data were collected, and they were surveyed by the Depression Anxiety Stress Scales-21 (DASS-21), the Strengths and Difficulties Questionnaire (SDQ), and the Family Environment Scale (FES). Children were divided into control group (1 059 cases) and depression group (103 cases) based on the depression scores obtained from the DASS-21 scale.Multivariate Logistic regression analysis was used to analyze the influencing factors for depression in primary school students aged 9-10 and construct a risk prediction model. Results:There were significant differences in the economic development region, physical activities, academic performance, student cadres, parents′ education level, frequency of parental quarrels, SDQ and FES dimension scores between control group and depression group (all P<0.05). Among them, economic development areas (Northern Jiangsu and Southern Jiangsu), student cadres, father′s education level (elementary school and below) and intimacy of the FES scale were protective factors for depression in elementary school children; while emotional symptoms, peer problems and the total difficulty score in the SDQ scale, and the conflict in the FES scale were the risk factors for depression in elementary school children.The prediction model was created based on the influencing factors: Logit ( P)=-1.390×economic development area (Northern Jiangsu) -1.508×economic development area (Southern Jiangsu) -1.248×student cadres -2.206×father′s education level (primary school and below) -1.145×father′s education level (junior high school)+ 3.316×emotional symptoms in the SDQ+ 0.979×peer problems in the SDQ+ 2.520×total difficulty score in the SDQ -1.697×cohesion in the FES + 0.760×conflict in the FES -0.678.The area under the curve of receiver operating characteristic was 0.931, with the sensitivity and specificity of 85.42% and 91.83%, respectively. Conclusions:The regional level of economic development, class or school cadres, father′s education level, peer problems, total difficulty score, cohesion and conflict in the family are influencing factors for depression among primary school children aged 9-10 years in Jiangsu Province.The created prediction model can effectively assess the depressive risk factors in this population, which is conductive to achieve the early recognition and intervention of depression in them.

Pulmonary fibrosis(PF)is a progressive,interstitial fibrotic lung disease characterized by persistent scar formation in the lung parenchyma,and a reduced quality of life and poor prognosis for patients.The pathogenesis of PF is unknown and there is a lack of effective therapeutic agents;however,animal models are currently the main tool used to explore the pathogenesis of the disease and to find effective therapeutic agents.PF can be induced by various factors and to different degrees according to known etiologies.Among these,bleomycin-induced models are widely used because of their reproducibility and the similarity between the fibrosis pathology and clinical conditions.The main induction method include intratracheal drip,intratracheal nebulization,tail vein injection,intraperitoneal injection,and transnasal inhalation,and these can be classified into single and multiple doses,according to the frequency of induction.Based on the relevant literature,the current review summarizes the characteristics of the bleomycin-induced PF model using different induction frequencies and method,to provide a basis for the application of this model.

Objective:To explore the speech features of female patients with anhedonic depression and their recognition of pleasure deficient symptoms.Methods:A total of 102 female depression patients who were hospitalized at Nanjing Brain Hospital from September 2020 to October 2021 were selected, including 62 anhedonic depression patients (anhedonic group) and 40 non-anhedonic depression patients (non-anhedonic group). A total of 50 female healthy controls were recruited during the same period.All participants were evaluated by the 17-item Hamilton depression scale (HAMD-17), Snaith-Hamilton pleasure scale (SHAPS), and the temporal experience of pleasure scale (TEPS), as well as voice acquisition.SPSS 23.0 software was used for data processing.Statistical analysis was conducted using one-way ANOVA, non-parametric tests, Logistic regression, and receiver operating characteristic curve.Results:Compared with the non-anhedonic group, the anhedonic group showed significant changes in 15 voice features(all P<0.05), including Mel-frequency cepstral coefficients, formant frequencies, intensity, and energy features.Among these features, Mel-frequency cepstral coefficients exhibited the highest accuracy in identifying anhedonic depression, with sensitivity of 47.5%, specificity of 91.9%, area under curve (AUC) of 0.751, 95% CI=0.686-0.866.Formant frequencies could identify female anhedonic depression, with a sensitivity of 90.0%, a specificity of 40.3%, an AUC of 0.647, and 95% CI=0.605-0.824.Energy features could identify anhedonic deficient depression, with a sensitivity of 60.0%, a specificity of 74.2%, an AUC of 0.679, and 95% CI=0.587-0.804.Intensity features could identify female anhedonic depression, with a sensitivity of 70.0%, a specificity of 58.1%, an AUC of 0.640, and 95% CI=0.554-0.769. Conclusion:Mel-frequency cepstral coefficients, formant frequencies, intensity features, and energy features may have specific changes in female patients with anhedonic depression.The Mel-frequency cepstral coefficients has the highest recognition accuracy for anhedonic symptoms in female depression patients, and is expected to become an objective evaluation index for female anhedonic depression.

Objective To exploring the mechanism of Jinshui Chenfei formula(JCF)in ameliorating silica(SiO2)-induced silicosis fibrosis based on endogenous metabolite changes.Methods A total of 32 SPF male Sprague-Dawley(SD)rats were divided into normal control group,model group,JCF group(9.72 g·kg-1·d-1),and Tetrandrine group(27 mg·kg-1·d-1)according to random number table method.The experimental silicosis model was established by intratracheal injection with SiO2 suspension(250 mg/kg)on day 1.From week 5-8,silicosis rats were treated with tetrandrine or JCF.On the end of week 8,the changes of pulmonary function index,including forced vital capacity(FVC),tidal volume(TV)and lung dynamic compliance(Cydn)were detected.The pathological changes of lung tissue were analyzed by hematoxyline-osin(HE)staining and Masson staining,the severity of focal alveolitis and fibrosis was also evaluated using the Szapiel scale and the Ashcroft scale,the positive staining of collagen Ⅰ(COL Ⅰ)and COL Ⅲ was detected using immunohistochemistry;the protein expression of transforming growth factor-β1(TGF-β1),fibronectin(FN),andα-smooth muscle actin(α-SMA)were measured by Western blotting.The rat serum samples were further screened for differential metabolites using ultra performance liquid chromatographytandem quadrupole time of flight mass spectrometr(UPLC-Q-TOF-MS)and pathway analysis was performed based on MetaboAnalyst 5.0.Results Compared with those in the normal control group,pathological changes such as alveolar structure destruction,the fibrous nodules encapsulated SiO2 particles were increased in lung tissues of rats in model group,alveolitis score and pulmonary fibrosis score were significantly higher(alveolitis score:2.62±0.27 vs.0.20±0.15,pulmonary fibrosis score:5.42±0.66 vs.0.50±0.84,both P<0.01);pulmonary function index including Cydn,FVC,and TV were significantly decreased[Cdyn(mL/cmH2O):0.26±0.03 vs.0.33±0.03,FVC(mL):8.09±0.47 vs.10.99±0.38,TV(mL):1.95±0.19 vs.2.53±0.26,all P<0.01];positive staining of COL Ⅰ,COL Ⅲ and ɑ-SMA,FN,TGF-β1 proteins expression showed higher in lung tissues[positive staining of COL Ⅰ(A value):13.47±1.76 vs.5.77±0.45;positive staining of COL Ⅲ(A value):10.39±0.47 vs.6.19±0.77,FN protein expression(FN/GAPDH):0.33±0.02 vs.0.21±0.07,α-SMA protein expression(α-SMA/GAPDH):1.78±0.16 vs.1.11±0.24,TGF-β1 protein expression(TGF-β1/GAPDH):0.52±0.10 vs.0.11±0.46,all P<0.01].Compared with the model group,the pathological changes of lung tissues were almost restored,alveolitis score and lung fibrosis score were significantly reduced in JCF and Tetrandrine groups(alveolitis score:1.10±0.15,1.33±0.31 vs.2.62±0.27,pulmonary fibrosis score:3.50±0.45,4.33±0.98 vs.5.42±0.66,all P<0.01);the pulmonary function index Cydn,FVC and TV were significantly increased[Cdyn(mL/cmH2O):0.32±0.05,0.31±0.04 vs.0.26±0.03,FVC(mL):9.41±0.85,8.70±0.92 vs.8.09±0.47,TV(mL):2.70±0.19,2.27±0.15 vs.1.95±0.19,all P<0.05];positive staining of COL Ⅰ,COL Ⅲ,and protein expression of FN,ɑ-SMA,and TGF-β1 in lung tissues was significantly decreased[COL Ⅰ(A value):7.09±0.67,8.13±0.64 vs.13.47±1.76,COL Ⅲ(A value):8.19±0.66,8.52±0.22 vs.10.39±0.47,FN protein expression(FN/GAPDH):0.19±0.06,0.24±0.03 vs.0.33±0.02,α-SMA protein expression(α-SMA/GAPDH):0.89±0.41,0.88±0.08 vs.1.78±0.16,TGF-β1 protein expression(TGF-β1/GAPDH):0.04±0.03,0.06±0.01 vs.0.52±0.10,all P<0.05].Metabolomics analysis showed that a total of 10 major differential metabolites were identified between normal control group,model group and JCF group,including arachidonic acid,palmitic acid,indole-3-acetic acid,propionylcarnitine,(S)-4-hydroxymandelonitrile,nalidixic acid,benzocaine,gramine,4-ethylphenol,N-benzylfor mamide.The differential metabolites in silicosis rats reversed by JCF treatment were mainly enriched,including unsaturated fatty acid biosynthesis,arachidonic acid metabolism,tryptophan metabolism,fatty acid elongation,fatty acid degradation and biosynthesis.Conclusion JCF could effectively improve the silicosis fibrosis,which is mainly related to biosynthesis of unsaturated fatty acids biosynthesis,arachidonic acid metabolism,tryptophan metabolism,fatty acid elongation,fatty acid degradation and biosynthesis.

Objective:To explore the effect of precision nursing based on evidence-based concept in the perioperative period of patients with total knee arthroplasty (TKA) .Methods:From January 2018 to December 2020, 200 TKA patients admitted to the First Affiliated Hospital of Zhengzhou University were selected as the study subject by convenience sampling. The patients were divided into the control group and the observation group according to simple random sampling with 100 cases in each group. The control group adopted routine nursing, while the observation group conducted precise nursing based on evidence-based concept on the basis of the control group. The incidence of postoperative complications and knee function between the two groups were compared.Results:The incidence of complications in the observation group was lower than that in the control group, with a statistically significant difference ( P<0.05) . At one, three and six months after operation, the knee function score of New York Hospital for Special Surgery (HSS) in both groups showed an upward trend. The HSS scores of the observation group at one, three, six months after operation were higher than those of the control group, and the difference was statistically significant ( P<0.01) . Conclusions:The precision nursing based on the evidence-based concept has a definite effect in the perioperative nursing of patients with TKA, which can reduce complications and improve the knee function.