Objective:To explore the lived experiences of family members of terminal ICU patients regarding their humanistic care needs and provide theoretical foundations for developing nursing care plans tailored to their needs.Methods:This study was a descriptive qualitative study. From April to December 2023, 16 family members of terminally ill ICU patients in Shanghai East Hospital, Tongji University were selected for semi-structured interviews using purposive sampling method, and the interview data were qualitatively analyzed using Colaizzi 7-step analysis.Results:The humanistic care needs of family members of terminally ill ICU patients can be categorized into five themes, namely, the need to know the condition at the first time; the need to participate in treatment and decision-making; the need to respect the wishes of terminally ill patients; the need for psychological care; and the need for social support.Conclusions:The humanistic care needs of family members of terminal ICU patients remain largely unmet. Nursing professionals should consider these needs and preferences and provide family members with professional guidance to help them establish positive coping mechanisms.

Objective To investigate the effects of lncRNA/Hedgehog signaling pathway-mediated autophagy on chondrocyte function in osteoarthritis(OA).Methods Established an LPS-induced inflammatory chondrocyte model in OA chondrocytes(SW1353),and identified it through collagen Ⅱ immunofluorescence staining and toluidine blue staining,dividing the groups into Normal,LPS,LPS/lncRNA HHIP-AS1 inhibitor,and LPS/Scr groups.RT-qPCR was used to detect lncRNA HHIP-AS1 and HHIP expression in chondrocytes,Western blot was used to assess HHIP,Gli1,Gli2,LC3B-Ⅰ/Ⅱ,and p62 protein expression,TUNEL staining and flow cytometry(FC)were used to detect cell apoptosis,and immunofluorescence assay(IFA)was used to detect autophagy LC3B expression.Results When SW1 cells were treated with LPS,compared with normal chondrocytes,after LPS induction,the volume of chondrocytes increased,the number of vacuoli in the cytoplasm increased,the volume of the nucleus increased,the morphology of some cells was irregular,and the number relatively decreased.Toluidine blue staining and type Ⅱ collagen immunohistochemical staining decreased.LPS stimulation would induce cell death and autophagy.lncRNA HIP-AS1 and HHIP were upregulated(P<0.05),the key molecules of the Hedgehog signaling pathway HHIP,Gli1 and Gli2 were continuously upregulated(P<0.05),chondrocytes treated with LPS showed obvious apoptosis(P<0.05),and LC3B(green)accumulated.The biosynthesis and processing of LC3B increased(the levels of LC3B Ⅰ and Ⅱ increased),the degradation of p62 increased(P<0.05),and the lncRNA HIP-AS1 inhibitor reduced LPS-induced apoptosis of OA chondrocytes(decreased apoptosis rate)and autophagy(decreased autophagy rate of chondrocytes treated with LPS).The biosynthesis and processing of LC3B decreased(the levels of LC3B Ⅰ and Ⅱ decreased),and the degradation of p62 weakened),and the difference was statistically significant(P<0.05).Conclusion The lncRNA HHIP-AS1 may inhibit LPS-induced OA chondrocyte apoptosis and autophagy by regulating the Hedgehog signaling pathway.

Objective:To evaluate the correlation between corneal biomechanical parameters and Schlemm canal (SC) and trabecular meshwork (TM) in patients with myopia.Methods:Eighty-one consecutive patients who underwent refractive surgery at Wuhan EyeGood Ophthalmology Hospital from May to December 2021 were enrolled.Patients were divided into two groups according to spherical equivalent (SE) and axial length (AL), including 39 patients with 39 eyes in low to moderate myopia group (SE: -0.5 to -6.0 D, AL<26 mm) and 42 patients with 42 eyes in high myopia group (SE≤-6.0 D, AL≥26 mm).Another 20 cases (20 eyes) from the same period of health examinations were included as a healthy control group, with 10 males and 10 females.All subjects' right eye data were included for analysis.The corneal biomechanical parameters were measured with Corvis ST.The morphology of the SC and TM was observed with Zeiss Cirrus HD-OCT 5000.The differences in corneal biomechanical parameters, nasal SC (SC-N) area, temporal SC (SC-T) area, nasal TM (TM-N) width and thickness and temporal TM (TM-T) width were compared between the two groups.Correlations between corneal biomechanical parameters and SC, TM and biomechanically corrected intraocular pressure (bIOP) in myopic patients were analyzed using Pearson linear correlation analysis.The study followed the Declaration of Helsinki, and the study protocol was reviewed and approved by the Ethics Committee of Wuhan EyeGood Ophthalmology Hospital (No.AGQGSS-06).All patients were aware of the purpose and significance of this study and voluntarily signed the informed consent form.Results:The distance between the two peaks of the cornea at highest concavity (PD) was (5.49±0.28)mm in high myopia group, which was higher than (5.36±0.28)mm in low to moderate myopia and (5.05±0.29)mm in healthy control group, and the radius of curvature at highest concavity (HCR) and the stress-strain index (SSI) values in high myopia group were lower than those in low to moderate myopia and healthy control groups, with statistically significant differences (all P<0.05).The SC-T area and SC-N area were significantly higher and TM-T thickness was lower in high myopia group than those in low to moderate myopia and healthy control groups (all P<0.05).PD was positively correlated with SC-N area in myopic patients ( r=0.26, P=0.02).bIOP was negatively correlated with PD, the amount of corneal displacement at highest degree of concavity (DA), inverse concave radius (IR) and deformation amplitude ratio (DA ratio) ( r=-0.79, -0.81, -0.45, -0.50; all P=0.00) and positively correlated with stiffness parameters at applanation 1 (SP-A1) and SSI ( r=0.45, 0.46; all P=0.00). Conclusions:PD values are greater in myopic patients.The greater the PD, the greater the SC-N area.The greater the refractive error, the longer the AL, and the thinner the TM thickness.

Objective:To investigate the influencing factors for dysphagia in the elderly,to construct a predictive model for dysphagia,and to provide a theoretical basis for clinical practice.Methods:In this case-control study,the patients with dysphagia who attended Department of Geriatrics in the first affiliated hospital of Chongqing Medical University from March 2016 to June 2023 were enrolled as case group,and the patients without dysphagia who attended the same department during the same period of time were enrolled as con-trol group.The correlation analysis,least absolute shrinkage and selection operator(LASSO)regression,and multivariate logistic re-gression analysis were used to investigate the influencing factors for dysphagia;the 10-fold cross-validation Extreme Gradient Boosting(XGBoost)model was used to predict dysphagia,and the SHapley additive exPlanations(SHAP)method was used for model visualiza-tion.Results:There were 1009 cases in the case group and 2125 cases in the control group.The correlation analysis and LASSO re-gression analysis identified 12 factors for the multivariate logistic re-gression analysis,and the results showed that sarcopenia,increasing age,children or caretakers as caregivers,frail health,poor oral health,poor self-care ability,depression,and cognitive impairment were risk factors for dysphagia(odds ratio[OR]>1,P<0.05),and fe-male sex and participation in community activities were protective factors against dysphagia(OR<1,P<0.05).The XGBoost model had a good predictive efficacy,with an accuracy rate of 0.795,a preci-sion rate of 0.711,a sensitivity of 0.613,a specificity of 0.881,an F1 value of 0.661,and an area under the ROC curve of 0.855.The SHAP plot showed that the top five important characteristics were caregiver,oral score,frail health condition,activities of daily living,and cognitive function.Conclusion:There are various influencing factors for dysphagia in the elderly,and the elderly patients with poor oral health,frailty,dependence on others for daily life,and cognitive impairment should be taken seriously in clinical practice.The XGBoost model has a good performance in predicting dysphagia in the elderly,which can provide a reference for clinical practice.

Objective:To investigate the influencing factors for sarcopenia in hospitalized patients,to construct a risk prediction model for sarcopenia in elderly hospitalized patients,and to provide a quantitative tool for early screening and intervention of sarcopenia based on the integration of multi-dimensional indicators.Methods:A retrospective analysis was performed for the data of 2105 elderly patients who were hospitalized in The First Affiliated Hospital of Chongqing Medical University from March 2016 to June 2023.The least absolute shrinkage and selection operator analysis was used for the screening of variables,and the logistic regression analysis was used to investigate the influencing factors for sarcopenia.A predictive model was constructed,and internal and external validation was performed.The Shapley additive explanations model was used to analyze feature contributions,and a nomogram model was constructed to visualize and interpret the results.Results:The 1259 patients from March 2016 to December 2020 were randomly divided into a training set with 882 patients and an internal test set with 377 patients at a ratio of 7∶3,and the 846 patients from January 2021 to June 2023 were established as the external validation set.A total of 489 cases of sarcopenia(55.44%)were detected in the training set.The logistic regression analysis based on the training set showed that asthenia,dependence on Activity of Daily Living,malnutrition,and in-creasing age were risk factors for sarcopenia(odds ratio[OR]>1,P<0.05),and male sex,normal body mass index,and overweight were protective factors against sarcopenia(OR<1,P<0.05).The model had an AUC of 0.876(95%CI=0.854-0.899)in the training set,0.883(95%CI=0.849-0.918)in the internal test set,and 0.750(95%CI=0.717-0.783)in the external validation set,suggesting that the model had good performance.The decision curve analysis showed that the nomogram model had a good clinical value.Conclu-sion:The predictive model for sarcopenia has good performance and holds promise for clinical application.

Under the background of the Healthy China Strategy, public hospitals urgently need to break through the limitations of the traditional medical mode, build a precise and continuous medical service system to meet the growing personalized health needs of the people. In 2022, a tertiary public hospital launched a multidisciplinary whole course management service practice. By integrating multidisciplinary medical and health resources, clarifying service targets and contents, forming a whole course management service team, constructing a supporting information platform, linking full process services, creating standardized service processes, and providing patients with comprehensive, full process, professional, and accurate full cycle intervention management and care. The hospital covered diseases in stages, ensuring continuous medical for patients after leaving the hospital, improving their medical experience, and supporting the high-quality development of the hospital. As of June 2024, the hospital′s multidisciplinary whole course management services had covered 25 departments and 41 disease, and 43 management teams have been established. A total of 7 453 patients signed up for the whole course service. This practice achieved good results, could provide references for the implementation of whole course management services led by public hospitals.

Objective:To evaluate the efficacy and safety of transdermal delivery of compound glycyrrhizin injection as an adjunctive treatment for erythematotelangiectatic rosacea (ETR).Methods:This was a randomized controlled trial conducted from March to October 2024. At Sichuan Provincial People′s Hospital, 60 patients with newly diagnosed ETR were prospectively enrolled and randomized by a random number table into study group [ n=30; 6 male and 24 female; aged 18-60 (38.9±9.8) years] and control group [ n=30; 4 male and 26 female; aged 18-60 (35.7±10.1) years]. The study group received transdermal delivery of compound glycyrrhizin injection by a medium-frequency drug-delivery therapeutic apparatus together with oral azithromycin and hydroxychloroquine sulfate, whereas the control group received oral azithromycin and hydroxychloroquine sulfate. The efficacy evaluations were conducted at baseline and at weeks 2, 4, 6, and 8 post-treatment. Outcome measures included percentage of erythema area, stratum corneum hydration, transepidermal water loss (TEWL), clinician′s erythema assessment (CEA), erythema and telangiectasia scores, dermatology life quality index (DLQI), and efficacy rate. Adverse reactions during treatment were also recorded. Results:Compared with baseline, both groups exhibited significant reductions in percentage of erythema area, TEWL, CEA, erythema and telangiectasia score, and DLQI, and significant increases in stratum corneum hydration at each post-treatment time point (all P<0.05). After 2, 4, 6, and 8 weeks of treatment, the percentage of erythema area, erythema and telangiectasia scores in the study group were all lower than those in the control group, while the stratum corneum hydration level in the study group was higher than that in the control group (all P<0.05). After 4, 6, and 8 weeks of treatment, TEWL, CEA, and DLQI in the study group were all lower than those in the control group (all P<0.05). After 4 weeks of treatment, the efficacy rate in the study group was 56.7% (17/30), which was higher than that of the control group at 23.3% (7/30, P=0.046). After 6 weeks of treatment, the efficacy rate in the study group was 83.3% (25/30), higher than that of the control group at 50.0% (15/30, P=0.020). After 8 weeks of treatment, the efficacy rate in the study group was 86.7% (26/30), higher than that of the control group at 66.7% (20/30, P<0.001). No severe adverse reactions were observed in either group. Conclusion:Transdermal delivery of compound glycyrrhizin injection as an adjunctive treatment for ETR demonstrates favorable efficacy and good safety.

Metastasis serves as an indicator of malignancy and is a biological characteristic of carcinomas. Epithelial-mesenchymal transition (EMT) plays a key role in the promotion of tumor invasion and metastasis and in the enhancement of tumor cell aggressiveness. Prostaglandin E synthase 3 (p23) is a cochaperone for heat shock protein 90 (HSP90). Our previous study showed that p23 is an HSP90-independent transcription factor in cancer-associated inflammation. The effect and mechanism of action of p23 on lung cancer metastasis are tested in this study. By utilizing cell models in vitro and mouse tail vein metastasis models in vivo, the results provide solid evidence that p23 is critical for promoting lung cancer metastases by regulating downstream CXCL1 expression. Rather than acting independently, p23 forms a complex with RNA-binding motif protein 14 (RBM14) to facilitate EMT progression in lung cancer. Therefore, our study provides evidence for the potential role of the RBM14-p23-CXCL1-EMT axis in the metastasis of lung cancer.

Objective:To evaluate the correlation between corneal biomechanical parameters and Schlemm canal (SC) and trabecular meshwork (TM) in patients with myopia.Methods:Eighty-one consecutive patients who underwent refractive surgery at Wuhan EyeGood Ophthalmology Hospital from May to December 2021 were enrolled.Patients were divided into two groups according to spherical equivalent (SE) and axial length (AL), including 39 patients with 39 eyes in low to moderate myopia group (SE: -0.5 to -6.0 D, AL<26 mm) and 42 patients with 42 eyes in high myopia group (SE≤-6.0 D, AL≥26 mm).Another 20 cases (20 eyes) from the same period of health examinations were included as a healthy control group, with 10 males and 10 females.All subjects' right eye data were included for analysis.The corneal biomechanical parameters were measured with Corvis ST.The morphology of the SC and TM was observed with Zeiss Cirrus HD-OCT 5000.The differences in corneal biomechanical parameters, nasal SC (SC-N) area, temporal SC (SC-T) area, nasal TM (TM-N) width and thickness and temporal TM (TM-T) width were compared between the two groups.Correlations between corneal biomechanical parameters and SC, TM and biomechanically corrected intraocular pressure (bIOP) in myopic patients were analyzed using Pearson linear correlation analysis.The study followed the Declaration of Helsinki, and the study protocol was reviewed and approved by the Ethics Committee of Wuhan EyeGood Ophthalmology Hospital (No.AGQGSS-06).All patients were aware of the purpose and significance of this study and voluntarily signed the informed consent form.Results:The distance between the two peaks of the cornea at highest concavity (PD) was (5.49±0.28)mm in high myopia group, which was higher than (5.36±0.28)mm in low to moderate myopia and (5.05±0.29)mm in healthy control group, and the radius of curvature at highest concavity (HCR) and the stress-strain index (SSI) values in high myopia group were lower than those in low to moderate myopia and healthy control groups, with statistically significant differences (all P<0.05).The SC-T area and SC-N area were significantly higher and TM-T thickness was lower in high myopia group than those in low to moderate myopia and healthy control groups (all P<0.05).PD was positively correlated with SC-N area in myopic patients ( r=0.26, P=0.02).bIOP was negatively correlated with PD, the amount of corneal displacement at highest degree of concavity (DA), inverse concave radius (IR) and deformation amplitude ratio (DA ratio) ( r=-0.79, -0.81, -0.45, -0.50; all P=0.00) and positively correlated with stiffness parameters at applanation 1 (SP-A1) and SSI ( r=0.45, 0.46; all P=0.00). Conclusions:PD values are greater in myopic patients.The greater the PD, the greater the SC-N area.The greater the refractive error, the longer the AL, and the thinner the TM thickness.

Objective:To explore the lived experiences of family members of terminal ICU patients regarding their humanistic care needs and provide theoretical foundations for developing nursing care plans tailored to their needs.Methods:This study was a descriptive qualitative study. From April to December 2023, 16 family members of terminally ill ICU patients in Shanghai East Hospital, Tongji University were selected for semi-structured interviews using purposive sampling method, and the interview data were qualitatively analyzed using Colaizzi 7-step analysis.Results:The humanistic care needs of family members of terminally ill ICU patients can be categorized into five themes, namely, the need to know the condition at the first time; the need to participate in treatment and decision-making; the need to respect the wishes of terminally ill patients; the need for psychological care; and the need for social support.Conclusions:The humanistic care needs of family members of terminal ICU patients remain largely unmet. Nursing professionals should consider these needs and preferences and provide family members with professional guidance to help them establish positive coping mechanisms.