BackgroundSchizophrenia is a complex， chronic and severe mental disorder， and the pathogenesis of which has not been fully elucidated. The abnormalities in lipid metabolism and circulating metabolomes have already been implicated in the pathophysiology of schizophrenia. However， available studies have mainly focused on a few liposomes and circulating metabolites， failing to systematically reveal the mediating role of circulating metabolomes in the causal relationship between liposomes and schizophrenia. ObjectiveTo uncover mediating role of circulating metabolomes in the causal relationship between liposomes and schizophrenia， thereby providing biomarkers and potential therapeutic targets for the prevention and treatment of schizophrenia. MethodsData from Genome-Wide Association Studies （GWAS） were analyzed， taking data on 179 liposomes as exposure variables， data on 123 circulating metabolites as intermediate variables， and data on schizophrenia as outcome variable. A two-step， two-sample Mendelian randomization analysis was conducted using the inverse-variance weighted （IVW）， MR- Egger， Weighted median， and Weighted mode methods to study the causal relationship of liposomes with schizophrenia and the mediating role of circulating metabolomes in the relationship. ResultsIVW model identified 8 lipids associated with schizophrenia without reverse causality. There were 5 circulating metabolomes strongly associated with schizophrenia. Acetate played a significant mediating role in the causal relationship between phosphatidylinositol （18：0_18：2） and schizophrenia （P=0.023， 95% CI： 0.036~0.532）， accounting for 28.4% of the causal relationship. ConclusionThis study demonstrates a causal relationship between liposomes and schizophrenia， with phosphatidylinositol being a risk factor in the progression of schizophrenia， and acetate playing a mediating role in this process. ［Fund by National Natural Science Foundation of China General Program （number， 82271546）； Shanxi Merit Funding for Overseas Students Sci-Tech Activities Project （number， 20240041）； Shanxi Province Science and Technology Innovation Leading Talent Team Project （number， 202304051001049）； Shanxi Scientific Research Foundation for the Returned Overseas Chinese Scholars （number， 2022-190）； "Six Measures for Health Care Prosperity" Specialized Research Program （number， Y2024008）］

Objective To explore the correlation between serum macrophage migration inhibitory factor(MIF),25-hydroxyvitamin D[25(OH)D]and cognitive function in patients with vestibular migraine(VM).Methods A total of 200 patients with VM were selected and used as the VM group.Based on the Montreal Cognitive Assessment(MoCA)criteria,patients were divided into the cognitively normal group(128 cases)and the cognitively impaired group(72 cases).Additionally,200 healthy individuals undergoing routine health examination were selected as the control group.Serum MIF and 25(OH)D levels were measured using enzyme-linked immunosorbent assay.Multivariate Logistic regression was used to analyze influencing factors of cognitive impairment in VM patients.The value of serum MIF and 25(OH)D levels in diagnosing cognitive impairment in patients with VM was analyzed by using the receiver operating characteristic(ROC)curve.Results The serum MIF was higher in the VM group than that of the control group,and serum 25(OH)D was lower in the VM group(P＜0.05).The serum MIF was higher in the cognitive impairment group than that of the cognitive normal group,while the serum 25(OH)D was lower in the cognitive impairment group than that of the cognitive normal group(P＜0.05).Multivariate Logistic regression found that increased serum MIF level and decreased 25(OH)D level were independent risk factors for cognitive impairment in VM patients(P＜0.05).ROC curve analysis showed that the AUC(95%CI)of the combined diagnosis of cognitive impairment in VM patients using serum MIF and 25(OH)D levels was 0.900(0.850-0.938),which was higher than that of MIF diagnosed alone[0.797(0.735-0.851)]and 25(OH)D alone[0.817(0.756-0.868),P＜0.05].Conclusion VM patients with cognitive impairment have elevated serum MIF levels and decreased 25(OH)D levels.The combined diagnostic value of the two markers has a relatively high value for VM patients with cognitive impairment.

Objective To develop a Knowledge-Attitude-Practice Questionnaire for Nursing Assistants on Humanistic Care and test its reliability and validity,in order to provide a valid tool for evaluating their humanistic care competence.Methods Based on the theory of knowledge,attitude and practice,the first draft of the questionnaire was developed through literature review,semi-structured interviews,2 rounds of Delphi expert consultation,and pre-surveys.All nursing assistants from 4 tertiary hospitals in Hubei Province were investigated by convenient sample,and the reliability and validity were tested from May to July,2024.Results 412 questionnaires were distributed and 399 valid questionnaires were recovered,with a valid questionnaire recovery rate of 96.84％.The final knowledge-attitude-practice questionnaire include 3 dimensions of knowledge,attitude and practice,with a total of 24 items and cumulative contribution rate was 65.338％.The CVI of each item in the questionnaire ranged from 0.800 to 1.000,with an average of 0.981.The confirmatory factor analysis showed that the scale model had a good fit.The total Cronbach's α coefficient of the questionnaire was 0.941,and the test-retest reliability coefficient of the questionnaire after 2 weeks was 0.923.Conclusion The knowledge-attitude-practice questionnaire has good reliability and validity,and it can be used as a valid tool for evaluating the competence of humanistic care of nursing assistants.

Objective To investigate the application value of bedside ultrasound measurement of gastric antrum cross-sectional area(CSA)combined with acute gastrointestinal injury ultrasound(AGIUS)score in guiding early individualized enteral nutrition therapy for sepsis patients.Methods From January 2023 to July 2024,61 sepsis patients meeting diagnostic criteria were enrolled and divided into an observation group(n=30)and a control group(n=31).The observation group underwent bedside ultrasound monitoring of gastric antrum CSA to calculate gastric residual volume(GRV)and AGIUS score for formulating individualized en-teral nutrition strategies.The control group used gastric tube withdrawal method for GRV measurement to guide enteral nutrition.Clinical baseline characteristics,enteral nutrition-related complications,nutritional/in-fection indicators,and disease severity parameters were compared between groups.Predictive efficacy was ana-lyzed using receiver operating characteristic(ROC)curve and area under the curve(AUC).Results Both groups showed gradual increases in enteral nutrition feeding rates and total volumes over time,with the obser-vation group demonstrating significantly higher values than the control group at each time point(P＜0.05).The observation group started nasogastric feeding earlier than the control group(P＜0.05).Target calorie a-chievement rates on day 3,5,and 7 were better in the observation group(P＜0.05).The incidence of feeding intolerance progressively decreased in the observation group but increased in the control group over day 1,3,and 5,with significant intergroup differences at each time point(P＜0.05).By day 7,the observation group exhibited significantly higher prealbumin(PA),albumin(ALB),and transferrin(TF)levels compared to day 1 and the control group(P＜0.05).Both groups showed reductions in APACHE Ⅱ,SOFA,and AGI scores by day 7,with the observation group displaying significantly lower scores than the control group(P＜0.05).The observation group had shorter ICU stays[(10.83±3.26)d vs.(14.55±3.14)d,P＜0.05].The combination of gastric antrum CSA measurement and AGIUS scoring demonstrated excellent predictive value for feeding intolerance(AUC=0.920,95％CI:0.848-0.963),with 95.50％sensitivity and 82.50％specificity,achieving 87.60％predictive accuracy.Conclusion Bedside ultrasound measurement of gastric antrum cross-sectional area(CSA)combined with AGIUS scoring shows good effect as a safe and effective monitoring modality for guiding early individualized enteral nutrition therapy in sepsis patients.

Parkinson′s disease is a common neurodegenerative disorder, and cognitive impairment is a frequent non-motor symptom of the disease. The pathogenesis of cognitive impairment in Parkinson′s disease remains unclear, and effective treatment methods are still under investigation. Idebenone exhibits multiple protective effects, including scavenging free radicals, antioxidative stress, mitochondrial protection, anti-inflammation, and enhancing autophagy. It has shown preliminary efficacy in treating cognitive impairment associated with Parkinson′s disease. This article explores the potential of idebenone in treating cognitive impairment in Parkinson′s disease by examining the underlying pathogenic mechanisms and the specific properties of idebenone, providing a reference for clinical practice.

Objective To explore the correlation between serum macrophage migration inhibitory factor(MIF),25-hydroxyvitamin D[25(OH)D]and cognitive function in patients with vestibular migraine(VM).Methods A total of 200 patients with VM were selected and used as the VM group.Based on the Montreal Cognitive Assessment(MoCA)criteria,patients were divided into the cognitively normal group(128 cases)and the cognitively impaired group(72 cases).Additionally,200 healthy individuals undergoing routine health examination were selected as the control group.Serum MIF and 25(OH)D levels were measured using enzyme-linked immunosorbent assay.Multivariate Logistic regression was used to analyze influencing factors of cognitive impairment in VM patients.The value of serum MIF and 25(OH)D levels in diagnosing cognitive impairment in patients with VM was analyzed by using the receiver operating characteristic(ROC)curve.Results The serum MIF was higher in the VM group than that of the control group,and serum 25(OH)D was lower in the VM group(P＜0.05).The serum MIF was higher in the cognitive impairment group than that of the cognitive normal group,while the serum 25(OH)D was lower in the cognitive impairment group than that of the cognitive normal group(P＜0.05).Multivariate Logistic regression found that increased serum MIF level and decreased 25(OH)D level were independent risk factors for cognitive impairment in VM patients(P＜0.05).ROC curve analysis showed that the AUC(95%CI)of the combined diagnosis of cognitive impairment in VM patients using serum MIF and 25(OH)D levels was 0.900(0.850-0.938),which was higher than that of MIF diagnosed alone[0.797(0.735-0.851)]and 25(OH)D alone[0.817(0.756-0.868),P＜0.05].Conclusion VM patients with cognitive impairment have elevated serum MIF levels and decreased 25(OH)D levels.The combined diagnostic value of the two markers has a relatively high value for VM patients with cognitive impairment.

Objective To develop a Knowledge-Attitude-Practice Questionnaire for Nursing Assistants on Humanistic Care and test its reliability and validity,in order to provide a valid tool for evaluating their humanistic care competence.Methods Based on the theory of knowledge,attitude and practice,the first draft of the questionnaire was developed through literature review,semi-structured interviews,2 rounds of Delphi expert consultation,and pre-surveys.All nursing assistants from 4 tertiary hospitals in Hubei Province were investigated by convenient sample,and the reliability and validity were tested from May to July,2024.Results 412 questionnaires were distributed and 399 valid questionnaires were recovered,with a valid questionnaire recovery rate of 96.84％.The final knowledge-attitude-practice questionnaire include 3 dimensions of knowledge,attitude and practice,with a total of 24 items and cumulative contribution rate was 65.338％.The CVI of each item in the questionnaire ranged from 0.800 to 1.000,with an average of 0.981.The confirmatory factor analysis showed that the scale model had a good fit.The total Cronbach's α coefficient of the questionnaire was 0.941,and the test-retest reliability coefficient of the questionnaire after 2 weeks was 0.923.Conclusion The knowledge-attitude-practice questionnaire has good reliability and validity,and it can be used as a valid tool for evaluating the competence of humanistic care of nursing assistants.

Parkinson′s disease is a common neurodegenerative disorder, and cognitive impairment is a frequent non-motor symptom of the disease. The pathogenesis of cognitive impairment in Parkinson′s disease remains unclear, and effective treatment methods are still under investigation. Idebenone exhibits multiple protective effects, including scavenging free radicals, antioxidative stress, mitochondrial protection, anti-inflammation, and enhancing autophagy. It has shown preliminary efficacy in treating cognitive impairment associated with Parkinson′s disease. This article explores the potential of idebenone in treating cognitive impairment in Parkinson′s disease by examining the underlying pathogenic mechanisms and the specific properties of idebenone, providing a reference for clinical practice.

Objective To systematically evaluate the efficacy of traditional Chinese medicine(TCM)in the treatment of recurrent spontaneous abortion and their regulatory effects of levels of peripheral blood Th17 cells and Treg cells.Methods Computer retrieval of CNKI,WanFang,VIP,SinoMed,FMRS,PubMed,Cochrane Library,Embase,Web of science and other databases were carried out.RCTS related to the regulation of Th17 and Treg cells by TCM in the treatment of recurrent spontaneous abortion,published from the establishment of the database to June 2023 were screened.Two reviewers evaluated the quality of the literature according to the Cochrane handbook.RevMan5.4 software was used for Meta-Analysis.Results A total of 10 studies that involved 1 052 patients were included.The Meta-Analysis results showed that compared to the control group,the effective rate[RR=1.20,95%CI(1.11,1.30),P＜0.000 01],live birth rate[RR=1.32,95%CI(1.16,1.50),P＜0.000 01]and the reduction of adverse drug reactions[RR=0.34,95%CI(0.14,0.83),P=0.02]were significantly improved by the intervention of TCM.After treatment with TCM,the expression of Th17 cells was decreased[MD=-0.71,95%CI(-1.01,-0.41),P＜0.000 01],and the expression of Treg cells was increased[SMD=1.21,95%CI(0.80,1.62),P＜0.000 01].The ratio of Th17/Treg cells was decreased[SMD=-2.62,95%CI(-4.09,-1.14),P=0.000 5].Conclusion TCM used for post-pregnancy or before and after pregnancy can significantly improve the clinical symptoms and live birth rate of patients with recurrent spontaneous abortion,wihch showed high safety.Moreover,TCM can reduce the expression of Th17 cells,up-regulate the expression of Treg cells and regulate the immune balance of Th17/Treg cells,which is conducive to embryonic development after pregnancy.