Objective:To construct a training program for expert patients with type 2 diabetes mellitus (T2DM), so as to provide reference for T2DM education and management.Methods:Guided by the iceberg quality model, a preliminary training program was developed based on literature analysis and qualitative interviews. Using convenience sampling method, 22 experts were selected for two rounds of Delphi expert consultation from March to April 2024, and the final draft of the training program was discussed and revised based on the experts' opinions.Results:In the two rounds of expert consultation, the effective response rates of the questionnaire were 100.00% (22/22) and 95.45% (21/22), respectively, and the authority coefficient of the experts was all 0.905. The Kendall harmony coefficients ranged from 0.110 to 0.293 and 0.139 to 0.301, respectively ( P<0.05). The finalized training program included five modules of training content, assessment evaluation, training instructors, training time, and training forms. Conclusions:The constructed training program for expert patients with T2DM is scientific, reliable, and comprehensive, which can provide guidance for the next step of T2DM expert patient training.

Objective:To analyze the clinical characteristics of the Chikungunya fever outbreak in Shunde District, Foshan City, Guangdong Province in July 2025 and the risk factors associated with delayed viral RNA clearance.Methods:A total of 562 patients with Chikungunya fever admitted to three designated hospitals in Shunde District from July 10 to 30, 2025 were enrolled. Demographic data, clinical manifestations, and laboratory findings were collected. Patients were categorized into four age groups including minors (<18 years), young adults (18 to 39 years), middle-aged adults (40 to 64 years) and elderly adults (≥65 years). The differences of clinical characteristics among these age groups were analyzed. Intergroup comparisons were performed using chi-square test, one-way analysis of variance, or Kruskal-Wallis H test. Pairwise comparisons between groups were conducted using the Bonferroni or Games-Howell or Dunn method. Binary logistic regression was employed to analyze risk factors associated with delayed viral RNA clearance (>7 days). Results:The mean age of the 562 enrolled Chikungunya fever patients was (44.8±21.3) years. Fever, arthralgia and rash were the three core symptoms, with incidence rates of 87.5% (492/562), 88.4%(497/562) and 69.6%(391/562), respectively. At discharge, only 54.1%(304/562) of patients achieved complete symptom resolution, while 26.5%(149/562) still had arthralgia and 36.1%(203/562) had residual rash. Significant differences were observed among age groups in the incidence of fever ( χ2=9.43, P=0.024), peak body temperature ( F=6.54, P<0.001), incidence of arthralgia ( χ2=26.89, P<0.001), duration of arthralgia ( F=12.68, P=0.001), incidence of rash ( χ2=68.99, P<0.001), rate of residual rash at discharge ( χ2=32.37, P<0.001), lymphocyte count ( F=12.94, P<0.001), platelet count ( F=14.95, P<0.001), and C-reactive protein levels (CRP) ( H=94.18, P<0.001). Further pairwise comparisons revealed that compared to the middle-aged and elderly groups, the minor group had a higher incidence of fever and a lower incidence of arthralgia, and the duration of arthralgia was shorter than the elderly group (all P<0.008 3). Compared with the other three groups, the elderly group had lower incidence and residual rate of rash, and lower platelet counts (all P<0.008 3), and higher levels of CRP (all P<0.05). The elderly group had lower lymphocyte counts compared to the minor and young adult groups (both P<0.05). Significant differences were found among age groups in the time to viral RNA clearance ( F=5.77, P=0.003) and length of hospital stay ( F=11.64, P<0.001), with the elderly group having significantly longer duration for both compared to the other three groups (all P<0.05). Multivariate analysis showed that advanced age (odds ratio ( OR)=1.049, 95% confidence interval ( CI) 1.015 to 1.083), longer duration of fever ( OR=1.529, 95% CI 1.086 to 2.155) and longer duration of arthralgia ( OR=1.927, 95% CI 1.318 to 2.817) were independent risk factors for delayed viral RNA clearance (all P<0.05). Conclusions:Patients with Chikungunya fever in Shunde District primarily present with fever, arthralgia and rash. The incidence and characteristics of these three core symptoms show age-related variations. Elderly patients and those with longer durations of fever or arthralgia are more likely to experience delayed viral clearance.

The term yin excess originated in the Huang Di Nei Jing, which refers to the phenomenon of "heavy yin" when wind pathogens invades the human body and defensive qi enters the yin part of the human body. Later doctors have played a role in yin excess. Theoretically, yin and yang are out of balance in the human body, and yin is too much and yang is not enough, which is the process of physiological transformation to pathology; from the diagnosis point of view, patients with yin deficiency have less pulse and more blood; from the clinical manifestations, patients with yin excess appear cold from the back, hands and feet cold reverse; from the point of view of treatment, bitter cold products can cause yin excess. Modern research specifies yin as phlegm, dampness, stasis and other pathological products, and emphasize the relation between yin excess and yang deficiency. Yin excess includes pathological factors such as phlegm stasis cold, external cold straight in the liver wood, set in the hypochasm, resulting in mass; or overthinking and cold drink injury spleen, phlegm turbidiousness, long and hard phlegm forming lumps, thus resulting yin excess; or it may deplete the yang energy of the heart, leading to neglect of the warming function and stagnation of blood stasis; or if the kidney yang is deficient and the body lacks warmth, and there is no true yang in the ridge, then the wood will sink and congest blood stasis; the above etiology and pathogenesis lead to the occupation of yin pathogens, resulting in liver cancer. The treatment methods include liver cold turbidizing, warming liver and dispelling cold, with Wuzhuyu Decoction; spleen-deficiency phlegm production, the treatment should be warm the middle and resolving the phlegm, with Linggui Zhugan Decoction and Zhenwu Decoction; Yang deficiency and stasis, the treatment should warm kidney to remove blood stasis, with Poyu Decoction.

Objective:This study aims to systematically compare the differences in severity, clinical manifestations, and treatment processes between patients with foodborne and iatrogenic botulism, thereby providing evidence-based support for clinical diagnosis and management.Methods:A retrospective analysis was conducted on botulism patients admitted to the Second Hospital of Hebei Medical University between January 2010 and July 2024. The foodborne group was diagnosed according to the WS/T 83-1996 standard. The iatrogenic group required a documented history of type A botulinum toxin injection and typical clinical manifestations. Individuals with comorbid neurological disorders or incomplete clinical data were excluded. The severity of poisoning was classified into three groups: mild, moderate, and severe, according to the "Diagnosis and Treatment Protocol for Botulism". SPSS 26.0 software was used to statistically analyze the distribution of poisoning severity between groups and to compare clinical symptoms and course indicators across severity grades.Results:A total of 220 botulism patients were included in this study, comprising 86 cases of foodborne poisoning (39.1%) and 134 cases of iatrogenic poisoning (60.9%). There was a significant difference in the distribution of poisoning severity between the two groups ( P=0.001), the proportion of severe poisoning was significantly higher in the foodborne group. Analysis of clinical symptoms indicated that, among patients with mild poisoning, the incidence of nausea and vomiting was significantly higher in the foodborne group, compared to that in the iatrogenic group (44.0% vs. 16.4%, P=0.006). In patients with moderate poisoning, the iatrogenic group exhibited a significantly higher prevalence of hoarseness (60.5% vs. 35.7%, P=0.041) and neck weakness (53.5% vs. 17.9%, P=0.003) compared to the foodborne group. Conversely, the foodborne cohort experienced a notably longer interval before seeking medical attention when compared to their iatrogenic counterparts (2.25 d vs. 1.50 d, P=0.003). Among severe poisoning patients, the foodborne group exhibited a higher likelihood of experiencing fever (51.5% vs. 25.0%, P=0.044) and abdominal distension accompanied by constipation (69.7% vs. 41.7%, P=0.034) when compared to the iatrogenic group. Furthermore, the foodborne cohort demonstrated a significantly shorter incubation period (1.00 d vs. 2.45 d, P<0.001), an extended length of hospitalization (22.0 d vs. 16.00 d, P=0.001), and a prolonged duration of antitoxin therapy (14.00 d vs. 9.50 d, P<0.001), alongside a markedly higher total dosage administered (315 900 U vs. 163 300 U, P<0.001) compared to their iatrogenic counterparts. Conclusions:Statistically significant differences exist between food-borne and iatrogenic botulism. Food-borne botulism is characterized by acute onset, greater severity, and a prolonged course, predominantly featuring systemic symptoms and gastrointestinal dysfunction. In contrast, iatrogenic botulism primarily manifests with ocular and oropharyngeal muscle symptoms and is generally less severe.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective:To construct a training program for expert patients with type 2 diabetes mellitus (T2DM), so as to provide reference for T2DM education and management.Methods:Guided by the iceberg quality model, a preliminary training program was developed based on literature analysis and qualitative interviews. Using convenience sampling method, 22 experts were selected for two rounds of Delphi expert consultation from March to April 2024, and the final draft of the training program was discussed and revised based on the experts' opinions.Results:In the two rounds of expert consultation, the effective response rates of the questionnaire were 100.00% (22/22) and 95.45% (21/22), respectively, and the authority coefficient of the experts was all 0.905. The Kendall harmony coefficients ranged from 0.110 to 0.293 and 0.139 to 0.301, respectively ( P<0.05). The finalized training program included five modules of training content, assessment evaluation, training instructors, training time, and training forms. Conclusions:The constructed training program for expert patients with T2DM is scientific, reliable, and comprehensive, which can provide guidance for the next step of T2DM expert patient training.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective:To analyze the clinical characteristics of the Chikungunya fever outbreak in Shunde District, Foshan City, Guangdong Province in July 2025 and the risk factors associated with delayed viral RNA clearance.Methods:A total of 562 patients with Chikungunya fever admitted to three designated hospitals in Shunde District from July 10 to 30, 2025 were enrolled. Demographic data, clinical manifestations, and laboratory findings were collected. Patients were categorized into four age groups including minors (<18 years), young adults (18 to 39 years), middle-aged adults (40 to 64 years) and elderly adults (≥65 years). The differences of clinical characteristics among these age groups were analyzed. Intergroup comparisons were performed using chi-square test, one-way analysis of variance, or Kruskal-Wallis H test. Pairwise comparisons between groups were conducted using the Bonferroni or Games-Howell or Dunn method. Binary logistic regression was employed to analyze risk factors associated with delayed viral RNA clearance (>7 days). Results:The mean age of the 562 enrolled Chikungunya fever patients was (44.8±21.3) years. Fever, arthralgia and rash were the three core symptoms, with incidence rates of 87.5% (492/562), 88.4%(497/562) and 69.6%(391/562), respectively. At discharge, only 54.1%(304/562) of patients achieved complete symptom resolution, while 26.5%(149/562) still had arthralgia and 36.1%(203/562) had residual rash. Significant differences were observed among age groups in the incidence of fever ( χ2=9.43, P=0.024), peak body temperature ( F=6.54, P<0.001), incidence of arthralgia ( χ2=26.89, P<0.001), duration of arthralgia ( F=12.68, P=0.001), incidence of rash ( χ2=68.99, P<0.001), rate of residual rash at discharge ( χ2=32.37, P<0.001), lymphocyte count ( F=12.94, P<0.001), platelet count ( F=14.95, P<0.001), and C-reactive protein levels (CRP) ( H=94.18, P<0.001). Further pairwise comparisons revealed that compared to the middle-aged and elderly groups, the minor group had a higher incidence of fever and a lower incidence of arthralgia, and the duration of arthralgia was shorter than the elderly group (all P<0.008 3). Compared with the other three groups, the elderly group had lower incidence and residual rate of rash, and lower platelet counts (all P<0.008 3), and higher levels of CRP (all P<0.05). The elderly group had lower lymphocyte counts compared to the minor and young adult groups (both P<0.05). Significant differences were found among age groups in the time to viral RNA clearance ( F=5.77, P=0.003) and length of hospital stay ( F=11.64, P<0.001), with the elderly group having significantly longer duration for both compared to the other three groups (all P<0.05). Multivariate analysis showed that advanced age (odds ratio ( OR)=1.049, 95% confidence interval ( CI) 1.015 to 1.083), longer duration of fever ( OR=1.529, 95% CI 1.086 to 2.155) and longer duration of arthralgia ( OR=1.927, 95% CI 1.318 to 2.817) were independent risk factors for delayed viral RNA clearance (all P<0.05). Conclusions:Patients with Chikungunya fever in Shunde District primarily present with fever, arthralgia and rash. The incidence and characteristics of these three core symptoms show age-related variations. Elderly patients and those with longer durations of fever or arthralgia are more likely to experience delayed viral clearance.

The 19 th Chinese Symposium of Burns and Wounds was successfully held in Foshan of Guangdong Province from June 20 th to 22 nd in 2024. There were more than 700 delegates attending the academic event. The theme of the congress was expansion, integration and standardization, which could promote academic exchanges, multi-disciplinary fusion, and standardization of clinical treatment of burns and wounds. A total of nearly 200 famous experts and scholars had their speeches on the two-day keynote forum and special academic seminars including critical care, wound repair, scar prevention and treatment, rehabilitation nursing, and disciplinary integration sessions. The congress ended successfully with abundant fruits and friendship.

Objective:To explore the feature of FOS expression in oxytocin-and vasopressin-positive neurons in the hypothalamic paraventricular nucleus(PVN)under different status of diabetes mellitus(DM).Methods:Intraperito-neal injection of vehicle or STZ in mice was conducted to establish control or diabetes model.Mechanical sensitivity was evaluated by von Frey filament tests to distinguish diabetic neuropathic pain(DNP)from without-pain group(DWP).The expression of FOS,oxytocin(OXT)-and vasopressin(VP)-positive neurons,as well as their double labeling was detected by immunohistochemical and immunofluorescent staining.Cell counting and comparison were made in groups.Results:FOS expression was easily detected in the PVN in the three groups(Control group,DNP group and DWP group)at 7 days,while that in DWP and DNP groups at 28 days was hardly detectable,with the number being signifi-cantly different from the 7 days group(P＜0.05 or 0.001).Likewise,compared with the control group,immunofluo-rescent signals for VP and OXT staining in the DNP and DWP groups also showed a trend of weakening as the modeling time increased(P＜0.05).The cell counting after double staining for VP or OXT with FOS showed that,in the DWP group at 7 days,the number of VP and FOS double-labeled neurons was 74.33±22.10,accounting for(56.64± 7.52)％of VP-positive cells,whereas the double labeling rate for OXT and FOS was only(10.44±3.14)％.In the DNP group at 7 days,the number of OXT and FOS double-labeled neurons was 51.00±31.80,accounting for(18.50 ±9.51)％of OXT-positive neurons,whereas the double labeling rate for VP and FOS was only(9.34±3.27)％.In contrast to these changes in 7 days group,the expression of FOS decreased sharply in the group of 28 days,thereby al-most no double-labeled neurons.Conclusion:The plasticity changes of oxytocin-and vasopressin-positive neurons in the PVN are different depending on the status of pain and non-pain,and the stage of disease progression.Understanding the changes is of great significance for unravelling the neural mechanism of diabetes and its complications.