Objective: To investigate the impact of extracurricular physical activity on heart rate variability (HRV) among primary and secondary school students in Chengdu City, so ao to provide references for scientific exercise prescription. Methods: Using a convenient sampling method, 1 323 primary and secondary students were enrolled from central Chengdu who underwent physical fitness assessments at Sichuan Provincial Institute of Sports Science from September 2020 to January 2022. According to the standards of the National Physical Fitness Monitoring Center, boys and girls were divided into groups with and without extracurricular physical exercise habits. HRV was monitored using the SA-3000P device. Key HRV parameters were evaluated separately by gender, including standard deviation of normal to normal intervals (SDNN), root mean square of successive differences (rMSSD), total power (TP), low frequency power (LF) and high frequency power (HF). Statistical analyses were employed by t-test, Mann-Whitney U-test and Chi square test. Results: lgSDNN, lgrMSSD, TP, LF and HF in the group without extracurricular physical exercise habit [boys:(1.67±0.13)ms, (1.59±0.20)ms, (7.34±0.73)ms 2, (6.11±0.74)ms 2, (6.05±0.87)ms 2; girls:(1.67± 0.13)ms , (1.59±0.19)ms, (7.35±0.60)ms 2, (6.06±0.69)ms 2, (6.12±0.87)ms 2] were lower than those in the group with extracurricular physical exercise habit [boys:(1.75±0.13)ms, (1.72±0.18)ms, (7.69±0.62)ms 2, (6.41±0.76)ms 2, (6.44±0.79)ms 2；girls:(1.73±0.13)ms, (1.68±0.20)ms, (7.60±0.65)ms 2, (6.26±0.86)ms 2, (6.36±0.90)ms 2] ( t =-8.24, -8.75, -6.54, -5.35 , -6.33；-5.10，-4.90，-4.47，-2.71，-2.93, all P ＜0.01). Only the group of boys without extracurricular physical exercise habits showed a decrease in lgLF/HF [0.04(-0.19,0.27)] compared to the group with extracurricular physical exercise habits [ -0.03 (-0.25,0.20)] ( Z=-2.01, P <0.05). When the score classes of autonomic nerve activity, stress index and fatigue index were compared between boys and girls groups without and with extracurricular physical exercise habits, the proportion of boys normal and above scores increased from 79.3%, 84.1%, 71.8% to 91.4%, 95.7%, 87.3%, respectively, and the differences were statistically significant ( χ 2=47.42, 63.66, 38.28); the proportion of girls normal score and above increased from 79.8%, 85.7%, 75.0% to 85.4%, 92.1%, 79.4%, and the differences were statistically significant ( χ 2=48.31, 22.18, 22.22) (all P <0.01). Conclusion The primary and secondary school students who have the habit of extracurricular physical exercise have enhanced compliance in indicators related to HRV, showing more complex heart rate variability.

Diabetic foot is one of the most common and serious chronic complications in diabetic patients.With the advancement of digital healthcare,digital therapy has been gradually implemented and promoted among diabetic foot patients as an emerging tool with the advantages of safety,efficiency,and intelligence that can make up for the shortcomings of traditional diabetic foot risk assessment,health education,and self-management.This study provides an overview of digital therapeutics,summarizes its application in patients with diabetic foot,and proposes relevant recommendations,aiming to provide a reference for improving the quality of life and satisfaction of patients with diabetic foot and reducing the recurrence of diabetic foot.

Diabetic foot is one of the most common and serious chronic complications in diabetic patients.With the advancement of digital healthcare,digital therapy has been gradually implemented and promoted among diabetic foot patients as an emerging tool with the advantages of safety,efficiency,and intelligence that can make up for the shortcomings of traditional diabetic foot risk assessment,health education,and self-management.This study provides an overview of digital therapeutics,summarizes its application in patients with diabetic foot,and proposes relevant recommendations,aiming to provide a reference for improving the quality of life and satisfaction of patients with diabetic foot and reducing the recurrence of diabetic foot.

OBJECTIVE To investigate the effects of different drying methods on the quality of Chrysanthemum morifolium， and to provide a basis for the harvesting and processing of C. morifolium. METHODS Twenty-five samples were obtained by drying the fresh products using 7 types and 25 kinds of drying methods， and the unqualified samples were removed by taking their appearance and moisture content as elimination indexes. The contents of six active ingredients （chlorogenic acid， luteoloside， 3，5- O-dicaffeoylquinic acid， quercetin， lignoceroside， baicalin） were used as indicators， and combined with principal component analysis （PCA）， partial least square method-discriminant analysis （PLS-DA）， PCA comprehensive score ranking and the best samples obtained from each drying method to select 6 experimental samples comprehensively. The quality of 6 kinds of samples was evaluated using the activities and stability of oxidation-related enzymes （polyphenol oxidase， peroxidase） and the microscopic morphology of the petal surface as evaluation indexes. RESULTS The results of PCA and PLS-DA showed significant differences in the quality of samples obtained by different drying methods， and chlorogenic acid， 3，5-O-dicaffeoylquinic acid and baicalin might be the main reasons for the differences among the samples. The herbs treated with 100 ℃ steam fixation for 1 min combined with blast drying at 50 ℃ for 4 hours had the highest comprehensive score of active ingredients. The oxidation-related enzymes in C. morifolium treated with microwave 800 W fixation for 1 minute followed by 50 ℃ air drying for 4 hours and 100 ℃ steam sterilization for 1 minute followed by 50 ℃ drying for 4 hours were completely inactivated， and the stability was better than that of samples obtained by other drying methods. The observation results of the microstructure of the petal surface showed that the sample obtained by drying at a microwave power of 400 W for 6 minutes had the highest integrity and flatness compared to the above two samples. CONCLUSIONS From the perspective of finished product quality and drying efficiency， 100 ℃ steam fixation for 1 min combined with blast drying at 50 ℃ for 4 hours is the best drying method for C. morifolium.

Purpose: To construct an index system to evaluate the competencies of nurses in enhanced recovery after surgery (ERAS) programs and provide a scientific foundation for their training and assessment. Methods: Utilizing a literature review and semi-structured interviews, a preliminary indicator system was constructed. Based on the preliminary indicator system, a Delphi questionnaire was developed and utilized to achieve consensus among experts in two rounds of Delphi studies. The indicators were selected based on a mean importance score greater than 4 and a coefficient of variation less than .25. The weights of the indicators were calculated using the Analytic Hierarchy Process. Results: The study developed a system that evaluates the competencies of nurses involved in ERAS programs, offering a reference for their training and evaluation. The final index system includes 7 primary indicators, 20 secondary indicators, and 66 tertiary indicators. The primary indicators consist of competencies in the following components: 1) Direct clinical practice (20 items); 2) Expert coaching and guidance (9 items); 3) Consultation (6 items); 4) Research (7 items); 5) Leadership (11 items); 6) Collaboration (8 items); and 7) Ethical decision-making (5 items). Conclusion The developed competency evaluation index system is reliable and can serve as a foundation for the selection, training, and assessment of ERAS nurses.

Purpose: To construct an index system to evaluate the competencies of nurses in enhanced recovery after surgery (ERAS) programs and provide a scientific foundation for their training and assessment. Methods: Utilizing a literature review and semi-structured interviews, a preliminary indicator system was constructed. Based on the preliminary indicator system, a Delphi questionnaire was developed and utilized to achieve consensus among experts in two rounds of Delphi studies. The indicators were selected based on a mean importance score greater than 4 and a coefficient of variation less than .25. The weights of the indicators were calculated using the Analytic Hierarchy Process. Results: The study developed a system that evaluates the competencies of nurses involved in ERAS programs, offering a reference for their training and evaluation. The final index system includes 7 primary indicators, 20 secondary indicators, and 66 tertiary indicators. The primary indicators consist of competencies in the following components: 1) Direct clinical practice (20 items); 2) Expert coaching and guidance (9 items); 3) Consultation (6 items); 4) Research (7 items); 5) Leadership (11 items); 6) Collaboration (8 items); and 7) Ethical decision-making (5 items). Conclusion The developed competency evaluation index system is reliable and can serve as a foundation for the selection, training, and assessment of ERAS nurses.

Purpose: To construct an index system to evaluate the competencies of nurses in enhanced recovery after surgery (ERAS) programs and provide a scientific foundation for their training and assessment. Methods: Utilizing a literature review and semi-structured interviews, a preliminary indicator system was constructed. Based on the preliminary indicator system, a Delphi questionnaire was developed and utilized to achieve consensus among experts in two rounds of Delphi studies. The indicators were selected based on a mean importance score greater than 4 and a coefficient of variation less than .25. The weights of the indicators were calculated using the Analytic Hierarchy Process. Results: The study developed a system that evaluates the competencies of nurses involved in ERAS programs, offering a reference for their training and evaluation. The final index system includes 7 primary indicators, 20 secondary indicators, and 66 tertiary indicators. The primary indicators consist of competencies in the following components: 1) Direct clinical practice (20 items); 2) Expert coaching and guidance (9 items); 3) Consultation (6 items); 4) Research (7 items); 5) Leadership (11 items); 6) Collaboration (8 items); and 7) Ethical decision-making (5 items). Conclusion The developed competency evaluation index system is reliable and can serve as a foundation for the selection, training, and assessment of ERAS nurses.

Objective:To explore the real experiences of patients during the preoperative decision-making process for metabolic-bariatric surgery, providing a reference for developing targeted decision-support interventions.Methods:This descriptive phenomenological study used purposive sampling to select 21 patients who underwent metabolic-bariatric surgery at Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine, from September 2022 to February 2023. Interviews were conducted, and the data were analyzed using Colaizzi's seven-step method.Results:Four themes and 14 sub-themes were extracted: decision-making motivation (health threats, pursuit of higher quality of life, diminished self-esteem, family responsibility drive) ; pre-decision assessment (failure of other weight-loss methods, surgery as a last resort) ; decision-making dilemmas (low quality of accessible information, low social acceptance of surgery, lack of medical insurance coverage, concerns about surgical outcomes) ; and decision-making support (professional medical support, family support, peer support, self-support) .Conclusions:Patients considering metabolic-bariatric surgery have diverse decision-making motivations and face significant dilemmas. It is recommended that relevant authorities, healthcare providers, and family members work together to create a comprehensive decision-supportive environment from the patients' perspective.

Objective:To explore the real experiences of patients during the preoperative decision-making process for metabolic-bariatric surgery, providing a reference for developing targeted decision-support interventions.Methods:This descriptive phenomenological study used purposive sampling to select 21 patients who underwent metabolic-bariatric surgery at Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine, from September 2022 to February 2023. Interviews were conducted, and the data were analyzed using Colaizzi's seven-step method.Results:Four themes and 14 sub-themes were extracted: decision-making motivation (health threats, pursuit of higher quality of life, diminished self-esteem, family responsibility drive) ; pre-decision assessment (failure of other weight-loss methods, surgery as a last resort) ; decision-making dilemmas (low quality of accessible information, low social acceptance of surgery, lack of medical insurance coverage, concerns about surgical outcomes) ; and decision-making support (professional medical support, family support, peer support, self-support) .Conclusions:Patients considering metabolic-bariatric surgery have diverse decision-making motivations and face significant dilemmas. It is recommended that relevant authorities, healthcare providers, and family members work together to create a comprehensive decision-supportive environment from the patients' perspective.

The standardized residency training of general practice is a complex project, the functional departments of the training base should play an active role for its management. The functional department of education in Zhongshan Hospital constantly explores its position and role, connects relevant departments vertically and horizontally to provides management and service for general practice residency training. That means that it should not only to provide advice for leadership decision-making, but also coordinate with all functional departments of the training base. The department has participated in the teaching management and supervision, educational research and training quality control, and accomplished positive results in general practice residency training for last 35 years.