Objective: To understand the current status of short video addiction among vocational nursing students in higher vocational colleges (hereinafter referred to as "nursing students") and its related factors, so as to provide a reference for formulating online education programs in colleges. Methods: From March to May 2025, a stratified random sample of 2 223 nursing students from four vocational colleges in Henan Province was selected. Short Video Addiction Scale for College Students, Short form Egna Minnen av Barndoms Uppfostran for Chinese, Peer Rejection Scale, and University of California at Los Angels Loneliness Scale were used for investigation. Chi square test and multivariate Logistic regression analysis were used to explore the related factors of short video addiction among nursing students. Results: The detection rate of short video addiction of higher vocational nursing students was 26.95%, and the scores for avoidance, loss of control, inefficiency and withdrawal were (8.05±2.97) (10.24±3.09) (4.99±1.88) and (11.97±4.10), respectively. Multivariate Logistic regression analysis showed that sophomore year 2 ( OR=1.83, 95%CI =1.39-2.40), higher maternal education level (secondary school/vocational college: OR =1.34, 95% CI =1.06-1.68; college/undergraduate: OR =1.38, 95% CI =1.05-1.82), paternal overprotection ( OR=1.59, 95%CI =1.27-2.00), high peer rejection ( OR=1.40, 95%CI =1.19-1.66), and strong loneliness ( OR=1.57, 95%CI =1.07-2.28) were associated with a higher risk of short video addiction among nursing students (all P <0.05). Paternal affectionate and warm rearing style ( OR=0.82, 95%CI = 0.71- 0.95) was associated with a lower risk of short video addiction ( P <0.05). Conclusions The detection rate of short video addiction among nursing students is relatively high. Short video addiction is related to the nursing students grade, maternal education level, paternal overprotection and affectionate rearing style, peer rejection, and loneliness.

Objective:To explore the latent class characteristics of demoralization in severely disabled stroke patients, and analyze the differences and influencing factors of each class by latent class analysis.Methods:Convenience sampling was used to select 335 patients in the Neurointensive Care Unit of three Class Ⅲ Grade A hospitals in Anhui Province from October 2023 to March 2024, and were confirmed to be with post-stroke disability through follow-up as research subjects. General Information Questionnaire and Demoralization Scale-Ⅱ were used for a survey. Latent class analysis was used to identify latent classes of demoralization, and multiple logistic regression was used to analyze the influencing factors of different latent classes.Results:A total of 335 questionnaires were distributed, and 321 valid questionnaires were retrieved. The effective recovery rate of the questionnaires was 95.8%. Demoralization of severe stroke patients with disability was classified into four categories of low demoralization (40.2%, 129/321), moderate demoralization with coping loss (12.1%, 39/321), moderate demoralization with goal loss (21.2%, 68/321), and high disability (26.5%, 85/321). Multiple Logistic regression analysis showed that age, gender, per capita monthly income of the family, whether was the economic pillar of the family, long-term residence, and relationship with cohabitants were the influencing factors of demoralization in severe stroke patients with disability (all P<0.05) . Conclusions:There are four latent classes of demoralization in stroke patients with disability, and age, gender, per capita monthly income of the family, whether they are the economic pillar of the family, long-term residence, and relationship with cohabitants are the influencing factors of demoralization in severe stroke patients with disability.

Objective:To carry out evidence-based practice in the management of exercise rehabilitation for kinesiophobia patients after degenerative lumbar spine disease surgery, construct review indicators, analyze barriers and facilitators to evidence-based practice, and develop strategies for action change.Methods:Using the integrated-promoting action on research implementation in health services model (i-PARIHS model) as a theoretical framework, clinical nursing problems were identified, the evidence-based practice group was built, evidence was systematically retrieved, evaluated, and summarized, and review indicators were developed and review methodology was clarified. An evidence-based baseline review of 36 healthcare professionals in the Department of Orthopedics of the First Affiliated Hospital of Bengbu Medical University was conducted from October 2023 to January 2024 using the Evidence-based Readiness Scale. Barriers and facilitators to the evidence-based practice were analyzed based on the results of the baseline review, strategies for action were developed accordingly.Results:A total of 23 pieces of best evidence were included and 32 review indicators were developed. In the baseline review, 25 of the review indicators had an accurate implementation rate of < 60% and 14 had an implementation rate of 0. The main barriers of evidence-based practice were lack of effective feedback systems, lack of kinesiophobia mentoring programs, and lack of management processes and educational materials. The main facilitators were active support from organizational leadership and high motivation of patients and their families to participate. A total of 15 action strategies were eventually developed.Conclusions:This study constructed review indicators for the management of exercise rehabilitation in kinesiophobia patients after degenerative lumbar spine disease surgery based on the best evidence. There are several barriers in clinical practice. The action change strategy developed is scientifically sound and feasible.

Objective:To evaluate the image quality and radiation dose in contrast-enhanced thoracic-abdominal-pelvic CT using automatic tube voltage modulation (ATVM) coupled with artificial intelligence iterative reconstruction (AIIR) versus routine tube voltage combined with Karl-3D iterative reconstruction (Karl-3D IR), and to determine the optimal noise level for AIIR in contrast-enhanced thoracic-abdominal-pelvic CT.Methods:A total of 100 patients who underwent contrast-enhanced thoracic-abdominal-pelvic CT examination in the Affiliated Hospital of Hebei University from April to October, 2023 were randomly divided into group A and group B using a random number table, with 50 patients in each group. Group A was scanned using ATVM, and images were reconstructed using AIIR with 1-5 noise levels. Group B was scanned using tube voltage 120 kVp and images were reconstructed with Karl-3D IR and noise level 5. The single-to-noise ratio (SNR), contrast-to-noise ratio (CNR), effective dose (E), and size-specific dose estimate (SSDE) were recorded or calculated for all patients or images. Subjective evaluations of all images were performed. The quality of the reconstructed images using AIIR with 1-5 noise levels were compared and the optimal noise level of AIIR for image reconstruction was determined. Image quality and radiation dose were statistically analyzed for Group A (image reconstruction with optimal AIIR noise level) and Group B.Results:The mean SNR and mean CNR of the reconstructed images using AIIR with noise levels 1, 2, and 3 in group A were higher than those using AIIR with noise levels 4 and 5. The images reconstructed using AIIR with noise levels 3 and 4 scored higher in subjective assessment than those reconstructed using AIIR with noise levels 1, 2, and 5. Therefore, noise level 3 was optimal for AIIR in reconstruction of contrast-enhanced thoracic-abdominal-pelvic CT images. The mean SNR, mean CNR, and subjective evaluation score of group A using AIIR with noise level 3 were higher than those of group B using Karl-3D IR with noise level 5 ( P<0.001). The mean SSDE and the mean E of group A were reduced by 46% and 41%, respectively, compared with those of group B. Conclusions:ATVM technology combined with the AIIR algorithm can improve image quality and reduced patient radiation dose in contrast-enhanced thoracic-abdominal-pelvic CT. Noise level 3 is optimal for AIIR in the reconstruction of arterial-phase and venous-phase contrast-enhanced thoracic-abdominal-pelvic CT images.

Objective To excavate the TCM syndrome of chronic heart failure from 1973 to 2023 and summarize the evolution of the characteristics of medical syndrome.Methods The relevant literature on clinical research on TCM syndromes in three databases including CNKI from January 1,1973 to October 1,2023 was searched,and SPSS 21.0 and Rstudio software were used to conduct descriptive statistical analysis,association rule analysis,and cluster analysis on the distribution characteristics of TCM syndrome types and pattern elements in the final literature.Results A total of 218 literatures,including 41604 patients,covering 29 provinces,municipalities and autonomous regions across the country,were included,of which 179 articles explicitly reported the TCM composite syndrome type,including 31123 patients.A total of 71996 pattern elements were extracted,and the common elements included qi deficiency,blood stasis,phlegm turbidity,etc.The main location of the disease include heart,liver,spleen,etc.The characteristics of TCM syndromes in different regions and different periods show certain evolution rules,from 1973 to 2023,the proportion of qi deficiency and blood stasis pattern and phlegm and stasis mutual obstruction pattern showed an upward trend.The proportion of simple false evidence increased from 1994 to 2003 compared with 1973 to 1993,but decreased from 2004 to 2023,and was lower than that from 1973 to 1993.The proportion of yang deficiency water pan syndrome showed a downward trend;The evolution of syndromes in different regions has changed from deficiency to deficiency and real mixed syndrome,for example,North China,which has the highest proportion,has changed from cardiopulmonary qi deficiency to qi deficiency and blood stasis.In recent years,the proportion of heart,liver and spleen in the chronic heart failure syndrome pattern showed an overall upward trend,the proportion of the syndrome elements of the deficiency syndrome showed a downward trend,and the proportion of the syndrome elements of the standard disease syndrome showed an upward trend.Conclusion The characteristics of chronic heart failure syndrome are always the evidence of deficiency and reality,with"deficiency and qi retention"as the core pathogenesis,and the main disease sites are the heart,liver,and spleen,and the pattern elements composed of qi deficiency,phlegm turbidity,blood stasis,and water drinking gradually occupy a dominant position,and the TCM pattern type of chronic heart failure may show a trend of"deficiency of phlegm and stasis"in the future.

Objective This study aims to investigate and analyze the effects of the incentive-coordination-supervision mechanism applied to training management of medical staff under the modern hospital management system.Methods A total of 84 medical staff members working at the hospital from February 2022 to February 2024 were selected for the study.They were di-vided into a reference group(n=42,February 2022 to February 2023)and a study group(n=42,March 2023 to February 2024)based on the time period.The reference group underwent routine management,while the study group underwent manage-ment based on the incentive-coordination-supervision mechanism.The quality of management,occurrence of adverse events,management satisfaction,and core competencies were compared between the two groups.Results The study group had higher scores in cultural construction,reward and punishment mechanism,reporting system,and communication and coordination mech-anism than the reference group(all P＜0.05).The occurrence rate of adverse events was lower in the study group than in the reference group(7.14％vs 23.81％)(P＜0.05).The study group had higher satisfaction rates in management methods,man-agement content,management forms,and communication skills(95.24％,92.86％,97.62％,and 95.24％,respectively)compared to the reference group(78.57％,73.81％,76.19％,and 73.81％,respectively)(all P＜0.05).The study group had higher scores in all core competencies compared to the reference group(all P＜0.05).Conclusion The application of the incentive-coordination-supervision mechanism in training management of medical staff shows favorable effects,improving the qual-ity of management,management satisfaction,and core competencies,and reducing the occurrence of adverse events.

Objective To analyze and clarify the concept and connotation of care-resistant behavior in dementia patients,so as to provide references for the evaluation and practice of care-resistant behavior in clinical dementia patients.Methods PubMed,Scopus,Web of Science,Cochrane Library,Embase,CINAHL,CNKI,VIP,Wanfang database and Chinese Biomedical Literature Database were systematically searched for the literature on care-resistant behavior in dementia patients.The search time limit was from the establishment of the database to December 2024.Walker and Avant's classical concept analysis method was used to analyze the literature.Results The care-resistant behav-ior in dementia patients included 5 conceptual attributes,including nursing background,perceived threat,unmet needs,lack of understanding and multi-dimensional performance.The antecedent factors include patient factors,care-giver factors,environmental factors and organizational factors.Post-impact includes the impact on patients and the impact on caregivers.Conclusion This study clarified the conceptual attributes,antecedents and post-effects of care-resistant behavior in dementia patients through concept analysis.In the future,researchers should combine the connotation of dementia patients' care-resistant behavior,develop localized assessment tools for dementia patients' care-resistant behavior,and construct targeted intervention programs,so as to improve the quality of nursing staff and enhance the care experience of dementia patients.

Objective:To explore the application value of cinematic rendering reconstruction technology in laparoscopic resection of giant adrenal tumors.Methods:As many as 21 patients with large adrenal tumors who underwent laparoscopic resection in Yongchuan Hospital Affiliated to Chongqing Medical University from January 2021 to January 2024 were retrospectively analyzed, with a median age of 54.0 (40.5, 58.0) years and a median tumor diameter of 7.3 (6.8, 8.8) cm. All patients underwent preoperative cinematic rendering 3D reconstruction imaging. All patients underwent enhanced CT scans. Their CT images were three-dimensionally reconstructed on the post-processing workstation platform. By changing image perspectives, adjusting the visualization of organs or blood vessels, and using physical volume rendering, real-shadow-rendered images were obtained. With these images, surgeons can intuitively understand important preoperative information, like the relationship between the tumor and surrounding organs and the path of tumor-feeding blood vessels, for preoperative planning. Following thorough preoperative preparation, laparoscopic transabdominal resection was performed. During surgery, 20 tumors were found to be located in the adrenal gland, and 1 in the retroperitoneum, with 13 on the left side and 8 on the right side. Preoperative cinematic rendering 3D imaging was consistent with intraoperative findings.Results:All 21 patients underwent successful surgeries, with an average operation time of (199.0±95.3) minutes, a median blood loss of 220 (150, 500) ml, and a median blood transfusion volume of 200 (150, 400) ml. No significant damage of vital organs or major blood vessels occurred, and there were no case of conversion to open surgery.Conclusions:For retroperitoneal giant adrenal tumors, utilizing cinematic rendering 3D reconstruction imaging enables a comprehensive understanding of the relationship between the tumor and surrounding organs and vessels preoperatively. This approach can reduce intraoperative bleeding and collateral injuries, improve the success rate of laparoscopic resection, and enhance overall surgical safety.

Objective:To evaluate the image quality and radiation dose in contrast-enhanced thoracic-abdominal-pelvic CT using automatic tube voltage modulation (ATVM) coupled with artificial intelligence iterative reconstruction (AIIR) versus routine tube voltage combined with Karl-3D iterative reconstruction (Karl-3D IR), and to determine the optimal noise level for AIIR in contrast-enhanced thoracic-abdominal-pelvic CT.Methods:A total of 100 patients who underwent contrast-enhanced thoracic-abdominal-pelvic CT examination in the Affiliated Hospital of Hebei University from April to October, 2023 were randomly divided into group A and group B using a random number table, with 50 patients in each group. Group A was scanned using ATVM, and images were reconstructed using AIIR with 1-5 noise levels. Group B was scanned using tube voltage 120 kVp and images were reconstructed with Karl-3D IR and noise level 5. The single-to-noise ratio (SNR), contrast-to-noise ratio (CNR), effective dose (E), and size-specific dose estimate (SSDE) were recorded or calculated for all patients or images. Subjective evaluations of all images were performed. The quality of the reconstructed images using AIIR with 1-5 noise levels were compared and the optimal noise level of AIIR for image reconstruction was determined. Image quality and radiation dose were statistically analyzed for Group A (image reconstruction with optimal AIIR noise level) and Group B.Results:The mean SNR and mean CNR of the reconstructed images using AIIR with noise levels 1, 2, and 3 in group A were higher than those using AIIR with noise levels 4 and 5. The images reconstructed using AIIR with noise levels 3 and 4 scored higher in subjective assessment than those reconstructed using AIIR with noise levels 1, 2, and 5. Therefore, noise level 3 was optimal for AIIR in reconstruction of contrast-enhanced thoracic-abdominal-pelvic CT images. The mean SNR, mean CNR, and subjective evaluation score of group A using AIIR with noise level 3 were higher than those of group B using Karl-3D IR with noise level 5 ( P<0.001). The mean SSDE and the mean E of group A were reduced by 46% and 41%, respectively, compared with those of group B. Conclusions:ATVM technology combined with the AIIR algorithm can improve image quality and reduced patient radiation dose in contrast-enhanced thoracic-abdominal-pelvic CT. Noise level 3 is optimal for AIIR in the reconstruction of arterial-phase and venous-phase contrast-enhanced thoracic-abdominal-pelvic CT images.

Objective To review the application scope of risk communication based on eHealth technology in the primary prevention of cardiovascular diseases,so as to provide references for future research and application.Methods A systematic search was conducted in PubMed,Cochrane Library,Embase,Web of Science,CINAHL,PsycINFO,CNKI,Wanfang database,and SinoMed.The search time limit was from the establishment of databases to March 1,2024.The included literature was summarized and analyzed.Results A total of 24 articles were included.The forms of eHealth technology applied in risk communication for primary prevention of cardiovascular include online websites,computerized decision support systems,electronic health records,mobile applications,email,telephone,and text messages.The functions include risk assessment,risk notification,personalized advice,risk tracking and reminders.The outcome indicators include risk perception,physiological indicators,lifestyle and behavior,psychological indicators,feasibility evaluation,decision correlation,doctor-patient communication,intention,risk score,and physician drug prescription.Conclusion The use of eHealth technology in risk communication of cardiovascular diseases has potential value in improving patients'risk perception and promoting healthy behaviors.It is necessary to continuously improve the functions of eHealth technology and enhance its precision and intelligence,so as to better meet the needs of medical staff and patients and promote the efficient implementation of primary prevention of cardiovascular diseases.