Objective:To explore the typology and influencing factors of nursing undergraduates'career willingness to care for terminally ill elderly patients.Methods:Using a convenience sampling method,a survey was conducted among 488 nursing undergraduates from three universities in Hunan Province between May and June 2024.Latent profile analysis(LPA)was employed to classify career willingness to care for terminally ill elderly patients,and logistic regression analysis was used to analyze factors influencing the career willingness.Results:Heterogeneity was observed in nursing undergraduates'career willingness,which was categorized into three groups:low positive attitude-low care awareness group(24.8%),high positive attitude-low care awareness group(56.7%),and high positive attitude-high care awareness group(18.5%).Logistic regression analysis revealed that gender,cohabitation with terminally ill elderly patients,only-child status,experience in caring for terminally ill patients,geriatric nursing training,and hospice care education were statistically significant factors influencing career willingness(P＜0.05).Conclusions:Nursing undergraduates'career willingness to care for terminally ill elderly patients exhibits distinct categorical characteristics.Individualized educational strategies should be developed to enhance their professional identity and career intention in this field.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

OBJECTIVE: To investigate the effectiveness of three-dimentional (3D) printed personalized guide plate-assisted wrist arthroscopic repair for Palmer type ⅠB triangular fibrocartilage complex (TFCC) injury. METHODS: A retrospective analysis was conducted on the clinical data of 20 patients with Palmer type ⅠB TFCC injuries admitted between January 2023 and March 2024 who met the selection criteria. Among them, 13 were male and 7 were female; ages ranged from 23 to 35 years, with a mean age of 30.3 years. All patients had a history of trauma, 12 cases involved falls and 8 cases involved sprains. All patients demonstrated a positive "piano key sign". MRI revealed deep ulnar-side tears of the TFCC. Conservative treatment for 6 weeks yielded poor or no clinical improvement. The interval from injury to surgery ranged from 2 to 9 months, with a mean of 5.0 months. Patients underwent wrist arthroscopic repair assisted by 3D printed personalized guide plate. Functional recovery was assessed preoperatively and postoperatively using the visual analogue scale (VAS) score for pain, modified Mayo wrist score, and range of motion (ROM) measurements for wrist flexion-extension, ulnar-radial deviation, and pronation-supination. At last follow-up, MRI was performed to evaluate the healing of TFCC. RESULTS: All 20 patients underwent successful surgery without complications such as vascular or nerve injury, fracture, incisional infection, or joint stiffness. All patients were followed up 9-18 months (mean, 12.4 months). At last follow-up, patients demonstrated significant improvements in VAS scores, modified Mayo wrist scores, wrist flexion-extension ROM, ulnar-radial deviation ROM, and pronation-supination ROM compared to preoperative levels ( P<0.05). MRI at last follow-up showed preserved TFCC continuity, excellent healing, and secure fixation. CONCLUSION 3D-printed personalized guide plate significantly improve outcomes in wrist arthroscopic TFCC repair for Palmer type ⅠB injuries. They enable high-quality suturing, facilitate anatomical reconstruction, and markedly enhance wrist function.
Humans ; Arthroscopy/methods* ; Male ; Adult ; Triangular Fibrocartilage/diagnostic imaging* ; Female ; Retrospective Studies ; Printing, Three-Dimensional ; Wrist Injuries/diagnostic imaging* ; Young Adult ; Bone Plates ; Treatment Outcome ; Wrist Joint/surgery* ; Magnetic Resonance Imaging ; Range of Motion, Articular

Objective:To explore the typology and influencing factors of nursing undergraduates'career willingness to care for terminally ill elderly patients.Methods:Using a convenience sampling method,a survey was conducted among 488 nursing undergraduates from three universities in Hunan Province between May and June 2024.Latent profile analysis(LPA)was employed to classify career willingness to care for terminally ill elderly patients,and logistic regression analysis was used to analyze factors influencing the career willingness.Results:Heterogeneity was observed in nursing undergraduates'career willingness,which was categorized into three groups:low positive attitude-low care awareness group(24.8%),high positive attitude-low care awareness group(56.7%),and high positive attitude-high care awareness group(18.5%).Logistic regression analysis revealed that gender,cohabitation with terminally ill elderly patients,only-child status,experience in caring for terminally ill patients,geriatric nursing training,and hospice care education were statistically significant factors influencing career willingness(P＜0.05).Conclusions:Nursing undergraduates'career willingness to care for terminally ill elderly patients exhibits distinct categorical characteristics.Individualized educational strategies should be developed to enhance their professional identity and career intention in this field.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Severe muscle injury is hard to heal and always results in a poor prognosis. Recent studies found that extracellular vesicle-based therapy has promising prospects for regeneration medicine, however, whether extracellular vesicles have therapeutic effects on severe muscle injury is still unknown. Herein, we extracted apoptotic extracellular vesicles derived from mesenchymal stem cells (MSCs-ApoEVs) to treat cardiotoxin induced tibialis anterior (TA) injury and found that MSCs-ApoEVs promoted muscles regeneration and increased the proportion of multinucleated cells. Besides that, we also found that apoptosis was synchronized during myoblasts fusion and MSCs-ApoEVs promoted the apoptosis ratio as well as the fusion index of myoblasts. Furthermore, we revealed that MSCs-ApoEVs increased the relative level of creatine during myoblasts fusion, which was released via activated Pannexin 1 channel. Moreover, we also found that activated Pannexin 1 channel was highly expressed on the membrane of myoblasts-derived ApoEVs (Myo-ApoEVs) instead of apoptotic myoblasts, and creatine was the pivotal metabolite involved in myoblasts fusion. Collectively, our findings firstly revealed that MSCs-ApoEVs can promote muscle regeneration and elucidated that the new function of ApoEVs as passing inter-cell messages through releasing metabolites from activated Pannexin 1 channel, which will provide new evidence for extracellular vesicles-based therapy as well as improving the understanding of new functions of extracellular vesicles.
Creatine/metabolism* ; Extracellular Vesicles ; Muscle, Skeletal/metabolism* ; Myoblasts/metabolism* ; Regeneration ; Connexins/metabolism*

Objective To evaluate the performance of MRI in predicting pathological response of different breast cancer subtypes after neoadjuvant chemotherapy(NAC).Methods The MRI images and postoperative pathological results of 91 patients with breast cancer after NAC were analyzed retrospectively.The correlation between the imaging features of different molecular subtypes of breast cancer and postoperative pathological results was studied,and the diagnostic performance of MRI in predicting pathological response after NAC was evaluated,with postoperative pathological results referred as the diagnostic standard.Results Of 91 patients,27(29.7％)and 35(38.5％)cases were diagnosed as imaging complete response(iCR)and pathological complete response(pCR),respectively.The accuracy of MRI in predicting pathological response after NAC was 84.62％,with 94.64％sensitivity,68.57％specificity,and positive predictive value(PPV)and negative predictive value(NPV)of 82.81％and 88.89％,respectively.Conclusion MRI can accurately predict the pathological response of the human epidermal growth factor receptor-2(HER-2)+and triple-negative breast cancer after NAC.

Sympathetic cues via the adrenergic signaling critically regulate bone homeostasis and contribute to neurostress-induced bone loss, but the mechanisms and therapeutics remain incompletely elucidated. Here, we reveal an osteoclastogenesis-centered functionally important osteopenic pathogenesis under sympatho-adrenergic activation with characterized microRNA response and efficient therapeutics. We discovered that osteoclastic miR-21 was tightly regulated by sympatho-adrenergic cues downstream the β2-adrenergic receptor (β₂AR) signaling, critically modulated osteoclastogenesis in vivo by inhibiting programmed cell death 4 (Pdcd4), and mediated detrimental effects of both isoproterenol (ISO) and chronic variable stress (CVS) on bone. Intriguingly, without affecting osteoblastic bone formation, bone protection against ISO and CVS was sufficiently achieved by a (D-Asp₈)-lipid nanoparticle-mediated targeted inhibition of osteoclastic miR-21 or by clinically relevant drugs to suppress osteoclastogenesis. Collectively, these results unravel a previously underdetermined molecular and functional paradigm that osteoclastogenesis crucially contributes to sympatho-adrenergic regulation of bone and establish multiple targeted therapeutic strategies to counteract osteopenias under stresses.
Adrenergic Agents/pharmacology* ; Apoptosis Regulatory Proteins/pharmacology* ; Bone Diseases, Metabolic/metabolism* ; Humans ; Liposomes ; MicroRNAs/genetics* ; Nanoparticles ; Osteoclasts ; Osteogenesis/physiology* ; RNA-Binding Proteins/pharmacology*

Objective:To evaluate the influence of the clinical staging and different risk factors for the prognosis of ocular adnexal lymphoma.Methods:An ambispective cohort study was conducted.Seventy-four patients diagnosed with primary ocular adnexal lymphoma by pathology at Tianjin Medical University Eye Hospital from November 2010 to December 2018 were enrolled.TNM staging was performed according to local tumor extent, lymph node or systemic involvement.Ann Arbor staging was carried out according to lymph node involvement and extranodal extension.The pathological subtype was classified according to World Health Organization classification of lymphoma.The outcome of disease progression or death was analyzed.Kaplan-Meier method was used for univariate survival analysis.Cox proportional hazard model was employed for multivariate survival analysis to predict the risk factors affecting prognosis, hazard ratio ( HR) and 95% confidence interval ( CI) were estimated.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Tianjin Medical University Eye Hospital (No.2021KY[L]-32). Written informed consent was obtained from all patients before entering the cohort. Results:For TNM staging, there were 68 cases in stage

Bedside ultrasound plays an important role in the evaluation of critically ill patients. In order to standardize the application of bedside ultrasound, Chinese Research Hospital Association of Critical Care Medicine and Nursing Research Group of Chinese Research Hospital Association of Critical Care Medicine organized the experts in related fields in China to analyze, discuss and summarize the following contents: ① bedside ultrasound assessment of lungs; ② bedside ultrasound -guided nutrition tube placement; ③ bedside ultrasound assessment of gastric residual volume; ④ bedside ultrasound -guided endovascular catheterization. Finally, the Evidence-based nursing expert consensus on adult bedside ultrasound was formulated.