Objective:To explore the potential profile characteristics and influencing factors of rehabilitation motivation in elderly patients with first stroke, so as to provide reference for promoting precise rehabilitation mode.Methods:A convenience sampling method was employed to conduct a cross-sectional survey of elderly patients with first stroke admitted to the Huanhu Hospital Affiliated to Tianjin Medical University from October 2024 to March 2025. The survey utilized a general information questionnaire, the Motivation in Stroke Patients for Rehabilitation Scale, the Perceived Social Support Scale (PSSS), the Exercise Adherence Questionnaire (EAQ), and the Stroke Stigma Scale (SSS). Potential categories of rehabilitation motivation among elderly patients with first stroke were identified using latent profile analysis, and the influencing factors of these potential categories were explored using the ordered multinomial Logistic regression.Results:A total of 290 survey questionnaires were distributed, and 281 valid questionnaires were collected, with an effective response rate of 96.9%(281/290). Among 281 elderly patients with first stroke, there were 152 males and 129 females, with an age of (68.68 ± 6.89) years. The score of the Motivation in Stroke Patients for Rehabilitation Scale was 56.00 (36.00, 68.00) points. Rehabilitation motivation among elderly patients with first stroke could be categorized into three groups: low motivation-lack of family support and unclear goals group (44.1%, 124/281), moderate motivation-social reintegration driven but insufficient behavior group (41.3%, 116/281), and high motivation autonomous planning adaptation and value internalization group (14.6%, 41/281). The ordered multinomial Logistic regression analysis showed that compared to patients aged ≥80 years, patients aged 60-69 years were less likely to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=0.231, P<0.05). Compared to patients with a per capita monthly income of ≥5 001 yuan, patients with a per capita monthly income of 3 001-5 000 yuan were more likely to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=2.340, P<0.05). Compared to heavily dependent patients, patients who were completely independent ( OR=0.160, P<0.05), mildly dependent ( OR=0.155, P<0.01), and moderately dependent ( OR=0.211, P<0.05) were less likely to belong to the high motivation autonomous planning adaptation and value internalization group. The higher the EAQ score, the more likely patients were to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=1.139, P<0.01). The higher the PSSS score, the more likely patients were to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=1.108, P<0.01). The higher the SSS score, the less likely patients were to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=0.787, P<0.01). Conclusions:Healthcare professionals can develop targeted intervention strategies based on the characteristics and influencing factors of patients' different rehabilitation motivations, thereby enhancing their rehabilitation motivation and promoting patient recovery.

Objective:To explore the potential categories of internal ability of elderly patients with ischemic stroke, identify the influencing factors and propose corresponding nursing interventions.Methods:This was a cross-sectional study. From January 2025 to May 2025, the elderly patients with ischemic stroke in Tianjin Huanhu Hospital were selected by convenient sampling method. The general information questionnaire, the Internal Capacity Assessment Scale for the Older People, the Health Literacy Scale for stroke patients and the Perceived Social Support Scale were used to investigate. To determine latent categories of patients' intrinsic capacity, potential profile analysis was employed. Subsequently, multivariable Logistic regression examined factors associated with these categories.Results:A total of 260 survey questionnaires were distributed, and 256 valid questionnaires were finally collected, with an effective response rate of 98.46% (256/260). Among of them, there were 166 males and 90 females, aged 68.00 (63.00, 74.00) years.The intrinsic ability of elderly patients with ischemic stroke could be divided into three potential categories: low sensation-low exercise group (27.0%, 69/256), relatively stable intrinsic ability group (37.5%, 96/256) and low cognition-low psychology group (35.5%, 91/256). Multivariable Logistic regression showed that advanced age (compared to the low sensation-low exercise group, OR=0.902; compared to the relatively stable intrinsic ability group, OR=0.813), smoking (compared to the low sensation-low exercise group, OR=0.459; compared to the relatively stable intrinsic ability group, OR=0.442), the lower the Barthel index (compared to the low sensation-low exercise group, ≤40 points with OR=0.157; 41-60 points with OR=0.285) were more likely to enter the low cognition-low psychology group (all P<0.05); other chronic disease types ≤1 (compared to the low cognition-low psychology group, OR=2.630), higher health literacy scores (compared to the low cognition-low psychology group, OR=1.033) were more likely to enter the relatively stable intrinsic ability group (both P<0.05); and stroke frequency was the first occurrence (compared to the low cognition-low psychology group, OR=2.725) was more likely to enter the low sensation-low exercise group ( P<0.05). Conclusions:In older adults with ischemic stroke, the characteristics of intrinsic ability are clearly categorized. To enhance patient outcomes, healthcare professionals are advised to tailor nursing interventions based on the unique features and specific influencing factors associated with each potential category.

Objective:To explore the potential profile characteristics and influencing factors of rehabilitation motivation in elderly patients with first stroke, so as to provide reference for promoting precise rehabilitation mode.Methods:A convenience sampling method was employed to conduct a cross-sectional survey of elderly patients with first stroke admitted to the Huanhu Hospital Affiliated to Tianjin Medical University from October 2024 to March 2025. The survey utilized a general information questionnaire, the Motivation in Stroke Patients for Rehabilitation Scale, the Perceived Social Support Scale (PSSS), the Exercise Adherence Questionnaire (EAQ), and the Stroke Stigma Scale (SSS). Potential categories of rehabilitation motivation among elderly patients with first stroke were identified using latent profile analysis, and the influencing factors of these potential categories were explored using the ordered multinomial Logistic regression.Results:A total of 290 survey questionnaires were distributed, and 281 valid questionnaires were collected, with an effective response rate of 96.9%(281/290). Among 281 elderly patients with first stroke, there were 152 males and 129 females, with an age of (68.68 ± 6.89) years. The score of the Motivation in Stroke Patients for Rehabilitation Scale was 56.00 (36.00, 68.00) points. Rehabilitation motivation among elderly patients with first stroke could be categorized into three groups: low motivation-lack of family support and unclear goals group (44.1%, 124/281), moderate motivation-social reintegration driven but insufficient behavior group (41.3%, 116/281), and high motivation autonomous planning adaptation and value internalization group (14.6%, 41/281). The ordered multinomial Logistic regression analysis showed that compared to patients aged ≥80 years, patients aged 60-69 years were less likely to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=0.231, P<0.05). Compared to patients with a per capita monthly income of ≥5 001 yuan, patients with a per capita monthly income of 3 001-5 000 yuan were more likely to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=2.340, P<0.05). Compared to heavily dependent patients, patients who were completely independent ( OR=0.160, P<0.05), mildly dependent ( OR=0.155, P<0.01), and moderately dependent ( OR=0.211, P<0.05) were less likely to belong to the high motivation autonomous planning adaptation and value internalization group. The higher the EAQ score, the more likely patients were to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=1.139, P<0.01). The higher the PSSS score, the more likely patients were to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=1.108, P<0.01). The higher the SSS score, the less likely patients were to belong to the high motivation autonomous planning adaptation and value internalization group ( OR=0.787, P<0.01). Conclusions:Healthcare professionals can develop targeted intervention strategies based on the characteristics and influencing factors of patients' different rehabilitation motivations, thereby enhancing their rehabilitation motivation and promoting patient recovery.

Objective:To explore the potential categories of internal ability of elderly patients with ischemic stroke, identify the influencing factors and propose corresponding nursing interventions.Methods:This was a cross-sectional study. From January 2025 to May 2025, the elderly patients with ischemic stroke in Tianjin Huanhu Hospital were selected by convenient sampling method. The general information questionnaire, the Internal Capacity Assessment Scale for the Older People, the Health Literacy Scale for stroke patients and the Perceived Social Support Scale were used to investigate. To determine latent categories of patients' intrinsic capacity, potential profile analysis was employed. Subsequently, multivariable Logistic regression examined factors associated with these categories.Results:A total of 260 survey questionnaires were distributed, and 256 valid questionnaires were finally collected, with an effective response rate of 98.46% (256/260). Among of them, there were 166 males and 90 females, aged 68.00 (63.00, 74.00) years.The intrinsic ability of elderly patients with ischemic stroke could be divided into three potential categories: low sensation-low exercise group (27.0%, 69/256), relatively stable intrinsic ability group (37.5%, 96/256) and low cognition-low psychology group (35.5%, 91/256). Multivariable Logistic regression showed that advanced age (compared to the low sensation-low exercise group, OR=0.902; compared to the relatively stable intrinsic ability group, OR=0.813), smoking (compared to the low sensation-low exercise group, OR=0.459; compared to the relatively stable intrinsic ability group, OR=0.442), the lower the Barthel index (compared to the low sensation-low exercise group, ≤40 points with OR=0.157; 41-60 points with OR=0.285) were more likely to enter the low cognition-low psychology group (all P<0.05); other chronic disease types ≤1 (compared to the low cognition-low psychology group, OR=2.630), higher health literacy scores (compared to the low cognition-low psychology group, OR=1.033) were more likely to enter the relatively stable intrinsic ability group (both P<0.05); and stroke frequency was the first occurrence (compared to the low cognition-low psychology group, OR=2.725) was more likely to enter the low sensation-low exercise group ( P<0.05). Conclusions:In older adults with ischemic stroke, the characteristics of intrinsic ability are clearly categorized. To enhance patient outcomes, healthcare professionals are advised to tailor nursing interventions based on the unique features and specific influencing factors associated with each potential category.

Objective:This study aimed to assess the awareness of trainees in physician standardized training towards the consequences of scientific misconduct and identify the main influencing factors, additionally, to provide targeted suggestions.Methods:A questionnaire survey was conducted among 6 200 trainees from 17 National standardized training bases for residencies in Guangxi. The cognitive status of the consequences of scientific misconduct were analyzed and factors affecting trainees' cognition were examined in terms of grade, education level, research experience, publication experience, research integrity training experience, and research integrity knowledge level.Results:The findings indicated that the awareness of trainees towards the consequences of scientific misconduct requires improvement. Notably, trainees from the 2020 and 2021 grade cohorts, with a master′s degree or above, having led research projects, having participated in research integrity training, and with a high level of research integrity knowledge scored higher on the cognitive assessment of the impact of research misconduct.Conclusions:Training bases should prioritize the education of research integrity among trainees, enhance their identification with scientific research integrity, raise their awareness of the seriousness of the consequences of scientific misconduct, and uphold the belief of adhering to the bottom line of academic ethics.

Lung cancer， the most common malignant tumor， is characterized by a complex pathogenesis and high malignancy， and poses a significant threat to the health and lives of affected individuals. p53 signaling pathway plays a crucial role in the progression of lung cancer and is considered one of the potential targets for targeted therapy. In recent years， multiple studies have indicated that traditional Chinese medicine （TCM） can exert anticancer effects by modulating the p53 signaling pathway. Based on this， this article systematically summarizes the current status and progress of research on TCM intervening in lung cancer by regulating p53 signaling pathway. It was found that TCM formula and preparations， such as Qingjin desheng tablet， Tiaoqi xiaoji decoction， Bufei tongluo jiedu formula， Jianpi bushen formula and Yiqi fuzheng jiedu formula， can promote autophagy and apoptosis of lung cancer cells， inhibit the growth and metastasis of lung cancer cells and strengthen the immune function of the body by activating p53 signaling pathway， thereby inhibiting lung cancer. TCM monomers， such as pseudoginsenoside-Rh2， saikosaponin D， polyphyllin Ⅶ， dendrobiine， sophoridine， gambogic acid， triptolide and triptolide succinate monoester YJ-4， can accelerate cell apoptosis， inhibit the proliferation of lung cancer cells and regulate cell cycle by activating p53 signaling pathway， thereby inhibiting lung cancer.

Lung cancer， the most common malignant tumor， is characterized by a complex pathogenesis and high malignancy， and poses a significant threat to the health and lives of affected individuals. p53 signaling pathway plays a crucial role in the progression of lung cancer and is considered one of the potential targets for targeted therapy. In recent years， multiple studies have indicated that traditional Chinese medicine （TCM） can exert anticancer effects by modulating the p53 signaling pathway. Based on this， this article systematically summarizes the current status and progress of research on TCM intervening in lung cancer by regulating p53 signaling pathway. It was found that TCM formula and preparations， such as Qingjin desheng tablet， Tiaoqi xiaoji decoction， Bufei tongluo jiedu formula， Jianpi bushen formula and Yiqi fuzheng jiedu formula， can promote autophagy and apoptosis of lung cancer cells， inhibit the growth and metastasis of lung cancer cells and strengthen the immune function of the body by activating p53 signaling pathway， thereby inhibiting lung cancer. TCM monomers， such as pseudoginsenoside-Rh2， saikosaponin D， polyphyllin Ⅶ， dendrobiine， sophoridine， gambogic acid， triptolide and triptolide succinate monoester YJ-4， can accelerate cell apoptosis， inhibit the proliferation of lung cancer cells and regulate cell cycle by activating p53 signaling pathway， thereby inhibiting lung cancer.

Notoginseng Radix et Rhizoma as a traditional Chinese herbal medicine has now been recognized and paid attention to by the pharmaceutical community.Modern phytochemical studies have shown that Panax notoginseng saponin is the main chemical compo-nent of Notoginseng Radix et Rhizoma.Modern pharmacological studies and clinical applications have revealed that it has anti-cancer,antioxidant and cardiovascular disease effects.In this study,we reviewed the research progress of the main chemical components and pharmacological effects of Notoginseng Radix et Rhizoma,with the aim of providing assistance for the clinical application and later stud-ies of Notoginseng Radix et Rhizoma.

Objective:To discuss the clinical efficacy of laparoscopic radical cystectomy in the treatment of bladder cancer after partial cystectomy.Methods:The clinical data of 30 patients who underwent laparoscopic radical cystectomy after PC in Sichuan Provincial People's Hospital from March 2016 to August 2020 were retrospectively analyzed. Including 24 males and 6 females with an average age was 62.5 (45.5-82.5)years.6 out of 30 cases underwent pelvic lymph node dissection during PC. All patients had definite pathological diagnosis for the high-grade urothelial carcinoma after PC, and the tumor staging was pT 2-3bN 0M 0.5 patients received postoperative adjuvant chemotherapy with gemcitabine and cisplatin, 6 received postoperative adjuvant radiotherapy, 13 received postoperative adjuvant radiotherapy and chemotherapy, and all patients were received maintenance intravesical instillation. Median time for local tumor recurrence after PC was 9(5-29) months, all patients had pathological diagnosis for the high-grade papillary urothelial carcinoma, cT 2-4N 0M 0 stage.The average tumor diameter was 3.5(2.5-4.5)cm, an average number of tumors was 2(1-3). Laparoscopic salvage cystectomy was performed after recurrence.General anesthesia, supine position, 5 ports were inserted through the abdominal approach. Standard pelvic lymph node dissection (PLND) was used to clean the pelvic lymph nodes. Those who had underwent PLND no longer clean the obturator and peripheral iliac vessels, but including the common iliac vessel and the bifurcation of the abdominal aorta and lymphatic tissues around the inferior vena cava, as well as the presacral lymph nodes. Results:All 30surgeries were successfully performed. The average operative time was 270(240-310)min, average estimated intraoperative blood loss was 180(50-300)ml, and there was no blood transfusion during the perioperative period.The average number of lymph nodes dissected was 18 (10-27). There were 4 cases with positive lymph nodes, of which 3 cases were positive for 2 obturator lymph nodes, and 1 case was positive for 3 obturator and external iliac lymph nodes. No serious intraoperative complications occurred.No lymphatic leakage occurred. The average drainage duration was 4(3-7) d, and postoperative hospital stays was 9(7-20)d. The postoperative pathology was invasive high-grade papillary urothelial carcinoma, and pathological TNM stage was pT 2-4aN 0-2M 0.13 patients received postoperative adjuvant chemotherapy. The average postoperative follow-up time was 23(3-31) months. There were 2 cases of pelvic recurrence and 1 case of retroperitoneal lymph node metastasis. These 3 cases received adjuvant chemotherapy and radiotherapy. Conclusions:Radical cystectomy should be the primary treatment for recurrence of bladder cancer after partial cystectomy.

Objective:To explore the different design of readiness assurance process (RAP) and application in TBL teaching of rehabilitation medicine, and to compare the teaching effects.Methods:A total of 40 students who had clinical rotation in our department were chose as research subjects, and they were taught with TBL teaching. Two chapters of "Stroke Rehabilitation" and "Spinal Cord Injury Rehabilitation" were chosen for the two lectures. During the course of "Stroke Rehabilitation", the RAP adopted open-ended questions, and the application part simulated Teamwork meetings. In the course of "Spinal Cord Injury Rehabilitation", the RAP used close-ended multiple-choice questions, and the application part simulated making rehabilitation plan. At the end of the two lectures, questionnaires were send to students.Results:For the RAP part, more students preferred open-ended questions. In the application part, students preferred to make rehabilitation plan.Conclusion:The process of clinical diagnosis and treatment and the formulation of rehabilitation plan in clinical practice of rehabilitation medicine has been applied to different parts of TBL teachings, and students are favor of this teaching method, which provides a reference for the future TBL teaching design of rehabilitation medicine.