Objective: To identify the latent classes of acceptance and striving and their associated factors among nursing students, and to examine the mediating role of positive acceptance and striving in the association between self transcendence and subjective well being, so as to provide evidence for targeted interventions to improve subjective well being among nursing students. Methods: From July to October 2025, a convenience sample of 861 nursing students was recruited from five schools in Sichuan and Chongqing, China. Participants were surveyed using the Self transcendence Scale, the Positive Acceptance and Striving Scale, and the General Well being Scale. Latent profile analysis was conducted to identify profiles of positive acceptance and striving. Logistic regression analysis was used to examine associated factors, and relative mediation analysis was performed to assess differences in the mediating effect across latent profiles. Results: Three latent classes of acceptance and striving were identified: the low acceptance-low striving profile (46.34%, n =399), the moderate acceptance-moderate striving profile (40.88%, n =352), and the high acceptance-high striving profile (12.78%, n =110). Multivariable Logistic regression analysis showed that, with the low acceptance-low striving profile as the reference, nursing students with higher self transcendence scores ( OR =151.85) and those who studied nursing because of personal preference ( OR =14.72) or parental expectations ( OR =11.16) were more likely to be classified into the high acceptance-high striving profile (all P <0.05). Male students ( OR =0.19), those perceiving nurses social status as average ( OR =0.35), and those receiving moderate teacher support ( OR =0.23) were less likely to be classified into the high acceptance-high striving profile (all P <0.05). Positive acceptance and striving partially mediated the association between self transcendence and subjective well being, with a total effect of β =0.97 and a mediating effect of β =0.48; the mediating effect accounted for 49.34% of the total effect. Relative mediation analysis showed that the mediating effect was statistically significant only in the low acceptance-low striving profile ( β =0.21), whereas the direct effects were stronger in the moderate acceptance-moderate striving and high acceptance-high striving profiles ( β =0.39, 1.06)(all P <0.05). Conclusions Positive acceptance and striving among nursing students exhibit substantial heterogeneity. Its predictive effect on subjective well being and the underlying mediating mechanism vary across latent profiles. Profile specific interventions should therefore be implemented to improve subjective well being among nursing students.

The Chinese medicine Zha Gui,the senior manager of traditional Chinese medicine dispensing,plays an important role and key function in the"front store and back factory"Chinese medicine pharmacy.Inheriting the valuable experience and excellent culture of Chinese medicine Zha Gui is of great academic value and practical significance in clarifying the development of the discipline of traditional Chinese medicine,standardizing the technical operation of traditional Chinese medicine preparation,and promoting the"living inheritance"of the old pharmacist's skills.At the start of the new era and opening up to new thinking,this paper examined the rise of old Chinese medicine stores and Chinese medicine Zha Gui,analyzed the post responsibility,inheritance path and future development of Chinese medicine Zha Gui,and put forward the strategy of cultivating high-quality Chinese medicine Zha Gui talents,aiming at cultivating compound innovative talents in the traditional Chinese medicine industry in line with the needs of the contemporary society.

Objective:To identify competency evaluation indicators for psychological hotline professionals,provi-ding scientific reference for their training and assessment.Methods:Through literature review,initial competency evalua-tion indicators were selected,followed by Delphi consultation with sixteen experts across China.The analytic hierarchy process(AHP)was used to assign weights to each indicators.Results:The response rate of expert consultation question-naire was 100％,and the expert authority coefficients for the two rounds of consultation were 0.92 and 0.90 respective-ly.After two rounds of expert consultation,a competency evaluation index system for professional counselors of psycho-logical aids hotline was constructed,including four first-level indexes,nine second-level indexes,and 34 third-level inde-xes.The weight of each index was determined using the AHP.The Kendall coefficient of concordance of all level's inde-xes in the two rounds of consultation were 0.16-0.18 and 0.16-0.25,respectively.Conclusion:The expert consensus developed in this study serves as an reference for evaluating the competency of psychological hotline professionals,sup-porting their training and assessment.

OBJECTIVE To identify tortoiseshell glue and antler glue in Qichong zuogui granules,and determine the contents of 12 chemical components.METHODS Identification and content determination were performed by using liquid chromatography-tandem mass spectrometry(LC-MS/MS)method.The identification was performed on Hypersil GOLD column with a mobile phase consisted of acetonitrile-0.1％formic acid solution(gradient elution);the electrospray ion source was used to scan in the positive ion multi-reaction detection mode.The mass charge ratio(m/z)631.3→546.4,631.3→921.4 was the detection ion pair for tortoiseshell glue,and the m/z 765.4→554.0,765.4→733.0 was the detection ion pair for antler glue.The determination method for 12 chemical components was as follows:Accucore C18 column,methanol-0.1％formic acid as mobile phase(gradient elution);scanning range of positive and negative ions was m/z 100→1 000 with the electric spray ion source and single ion detection scanning mode.RESULTS Average retention times of the molecular ion peaks for characteristic peptide segments of tortoiseshell glue and antler glue were 6.28 and 6.77 min,respectively;the linear relationship of 12 chemical components was good within their respective concentration ranges,such as astragaloside Ⅳ,calycosin-7-O-β-D-glucoside,calycosin,chlorogenic acid,ferulic acid,betaine,amygdalin,rutin,hydroxysafflor yellow A,hyperoside,loganin,cyasterone(r＞0.999);RSDs for precision,stability(24 h)and reproducibility tests were all less than 5％.The average sample recovery rates ranged from 98.04％to 101.08％.The average contents of 12 components were 1.83,25.73,13.76,56.71,23.80,49.82,807.49,15.01,317.02,60.21,202.71 and 17.70 μg/g,respectively.CONCLUSIONS In this study,tortoiseshell glue and antler glue in Qixiong zuogui granules are identified,and the contents of 12 chemical components therein are determined.This provides a reference for the quality control of this granule.

Objective:To identify competency evaluation indicators for psychological hotline professionals,provi-ding scientific reference for their training and assessment.Methods:Through literature review,initial competency evalua-tion indicators were selected,followed by Delphi consultation with sixteen experts across China.The analytic hierarchy process(AHP)was used to assign weights to each indicators.Results:The response rate of expert consultation question-naire was 100％,and the expert authority coefficients for the two rounds of consultation were 0.92 and 0.90 respective-ly.After two rounds of expert consultation,a competency evaluation index system for professional counselors of psycho-logical aids hotline was constructed,including four first-level indexes,nine second-level indexes,and 34 third-level inde-xes.The weight of each index was determined using the AHP.The Kendall coefficient of concordance of all level's inde-xes in the two rounds of consultation were 0.16-0.18 and 0.16-0.25,respectively.Conclusion:The expert consensus developed in this study serves as an reference for evaluating the competency of psychological hotline professionals,sup-porting their training and assessment.

The Chinese medicine Zha Gui,the senior manager of traditional Chinese medicine dispensing,plays an important role and key function in the"front store and back factory"Chinese medicine pharmacy.Inheriting the valuable experience and excellent culture of Chinese medicine Zha Gui is of great academic value and practical significance in clarifying the development of the discipline of traditional Chinese medicine,standardizing the technical operation of traditional Chinese medicine preparation,and promoting the"living inheritance"of the old pharmacist's skills.At the start of the new era and opening up to new thinking,this paper examined the rise of old Chinese medicine stores and Chinese medicine Zha Gui,analyzed the post responsibility,inheritance path and future development of Chinese medicine Zha Gui,and put forward the strategy of cultivating high-quality Chinese medicine Zha Gui talents,aiming at cultivating compound innovative talents in the traditional Chinese medicine industry in line with the needs of the contemporary society.

Objective:To construct the clinical practice pathway for narrative medicine in traditional Chinese medicine(TCM),with a view to providing clinical practice guidelines for narrative medicine in TCM for frontline practitioners.Methods:Using the realistic literature review and the Nominal Group Technique(NGT),the paper systematically sorted out the practices of humanistic care in ancient Chinese medical books and famous medical cases,as well as constructed the first draft of the clinical practice pathway and details for narrative medicine in TCM.Subsequently,experts from multiple fields were invited to demonstrate by using the NGT.After in-depth discussion and collective voting,various operational modules,and their detailed rules and supporting tools were determined,thus completing the construction of the entire practical pathway.Results:A complete set of clinical practice pathways for narrative medicine in TCM had been established.It encompassed six core modules,including"start of diagnosis and treatment","communication of disease conditions","diagnosis and explanation","joint decision-making","end of diagnosis and treatment",and"reflection and summary".Besides,detailed operating rules and supporting tools were also provided.Conclusion:The clinical practice pathway for narrative medicine in TCM integrates the humanistic spirit of TCM,the core concepts of narrative medicine,and the communication skills of psychology,providing medical workers with standardized,procedural,and operationally flexible practice guidance,which helps both doctors and patients to better communicate,empathize,and make joint decisions throughout the entire process of diagnosis and treatment.

Objective:To investigate the relationship between serum calcium levels and pain in patients with Parkinson's disease(PD).Methods:A total of 111 patients with PD and 50 healthy volunteers were recruited from our hospital between July 2019 and June 2020.Motor symptoms of PD patients were assessed using the Hoehn-Yahr(H&Y)stages and the Unified Parkinson's Disease Rating Scale-Ⅲ(UPDRSⅢ).Non-motor symptoms were evaluated using Mini-Mental State Examination(MMSE), 17-item Hamilton Depression Rating Scale(HAMD-17), 14-item Hamilton Anxiety Rating Scale(HAMA-14), questionnaire for rapid eye movement(REM)sleep behavior disorder(RBDQ-HK), King Parkinson's pain scale(KPPS), Pittsburgh Sleep Quality Index(PSQI), Parkinson's Disease Sleep Scale(PDSS), and Epworth Sleepiness Scale(ESS).The quality of life of PD patients was assessed using the 39-item Parkinson's Disease Questionnaire(PDQ-39).Results:The levels of serum calcium in PD patients were significantly lower than those in the control group( t=3.733, P<0.001).Additionally, the levels of serum calcium in PD patients with pain were higher than those in PD patients without pain( t=-3.238, P<0.05).This suggests a significant positive correlation between serum calcium levels and pain in PD patients( r=0.320, P=0.001).When analyzing serum calcium levels for PD with pain using binary logistic regression, the area under the curve(AUC=0.662)and sensitivity(28.9%)were found to be low.Furthermore, a correlation analysis of KPPS scores in PD patients with pain revealed that KPPS scores were correlated with UPDRSⅢ( r=0.383, P=0.009), HAMD-17( r=0.303, P=0.043), HAMA-14( r=0.303, P=0.043), PSQI( r=0.304, P=0.042), and PDSS( r=-0.417, P=0.004)scores. Conclusions:The levels of serum calcium are decreased in patients with Parkinson's disease(PD), and there is a correlation between serum calcium levels and pain experienced by PD patients.However, it is important to note that pain in PD patients is influenced by various other factors.

Objective:To examine the potential of combining the blood urea nitrogen(BUN)/albumin(ALB)ratio(BAR)with soluble growth stimulation expressed gene 2(sST2)as an early warning indicator for myocardial injury in elderly patients with sepsis in the emergency intensive care unit(EICU).Methods:The clinical data of elderly patients with sepsis admitted to the EICU of the Emergency Medicine Department at Harrison International Peace Hospital of Hebei Medical University from August 2018 to August 2022 were prospectively analyzed.The patients were divided into two groups based on the presence or absence of myocardial injury: the myocardial injury group and the non-myocardial injury group.The general clinical data and laboratory indexes of the two groups were compared, and the BAR was calculated.The correlation between BAR and myocardial injury in elderly patients with sepsis was analyzed.Binary Logistic regression analysis was used to identify the risk factors for myocardial injury in elderly patients with sepsis in the EICU.MedCalc software was employed to determine the early warning value of the combined sST2 and BAR for myocardial injury in elderly patients with sepsis in the EICU.Results:A total of 165 cases were analyzed, with 106 cases(64.24%)showing myocardial injury.It was found that elderly sepsis patients with lung and abdominal infection were more likely to experience myocardial injury( P<0.05 for all).In comparison to the group without myocardial injury, the levels of inflammatory markers such as white blood cell count(WBC), neutrophil to lymphocyte ratio(NLR), lactic acid, and procalcitonin(PCT), as well as combined markers BAR and sST2, were higher in elderly sepsis patients with myocardial injury upon admission.Correlation analysis results revealed significant positive correlations between BAR and lactic acid, PCT, and C-reactive protein(CRP)within 24 hours of admission to EICU in elderly sepsis patients with myocardial injury.Among these correlations, the strongest was observed between BAR and PCT( r=0.417, P<0.001).Additionally, BAR exhibited a positive correlation with acute physiology and chronic health evaluation scoring system(APACHEⅡ)scores( r=0.241, P=0.002).Furthermore, BAR showed positive correlations with myocardial injury markers sST2 and cTnI( r=0.327, 0.307, P<0.05 for all).Logistic regression analysis revealed that septic shock( OR=2.406, P=0.008), decreased left ventricular ejection fraction(EF)( OR=0.939, P=0.015), BAR( OR=2.205, P=0.044), lactic acid( OR=1.137, P=0.014), and sST2 elevation( OR=1.016, P=0.020)were identified as independent risk factors for predicting myocardial injury in elderly patients with sepsis.The results of ROC analysis indicated that BAR had a high early warning value for the occurrence of myocardial injury in elderly patients with EICU sepsis[area under curve(AUC)0.651, P<0.05], with an optimal cut-off value of 0.32(sensitivity 77.4%, specificity 60.2%).Furthermore, the combined detection of BAR and sST2 demonstrated a higher early warning value for the occurrence of myocardial injury in elderly patients with sepsis(AUC 0.697, P<0.05).The mortality rate of patients with myocardial injury below a cut-off value of 0.32 was 36.00%(9/25), while the mortality rate of patients with myocardial injury equal to or above 0.32 was 66.67%(54/81).The difference between the two groups was statistically significant( χ2=8.624, P=0.003). Conclusions:Both BAR and sST2 are considered independent risk factors for myocardial injury in elderly patients with sepsis.The combined detection of BAR and sST2 provides a more accurate prediction for the occurrence of myocardial injury in these patients.

Objective:To investigate the relationship between serum calcium levels and pain in patients with Parkinson's disease(PD).Methods:A total of 111 patients with PD and 50 healthy volunteers were recruited from our hospital between July 2019 and June 2020.Motor symptoms of PD patients were assessed using the Hoehn-Yahr(H&Y)stages and the Unified Parkinson's Disease Rating Scale-Ⅲ(UPDRSⅢ).Non-motor symptoms were evaluated using Mini-Mental State Examination(MMSE), 17-item Hamilton Depression Rating Scale(HAMD-17), 14-item Hamilton Anxiety Rating Scale(HAMA-14), questionnaire for rapid eye movement(REM)sleep behavior disorder(RBDQ-HK), King Parkinson's pain scale(KPPS), Pittsburgh Sleep Quality Index(PSQI), Parkinson's Disease Sleep Scale(PDSS), and Epworth Sleepiness Scale(ESS).The quality of life of PD patients was assessed using the 39-item Parkinson's Disease Questionnaire(PDQ-39).Results:The levels of serum calcium in PD patients were significantly lower than those in the control group( t=3.733, P<0.001).Additionally, the levels of serum calcium in PD patients with pain were higher than those in PD patients without pain( t=-3.238, P<0.05).This suggests a significant positive correlation between serum calcium levels and pain in PD patients( r=0.320, P=0.001).When analyzing serum calcium levels for PD with pain using binary logistic regression, the area under the curve(AUC=0.662)and sensitivity(28.9%)were found to be low.Furthermore, a correlation analysis of KPPS scores in PD patients with pain revealed that KPPS scores were correlated with UPDRSⅢ( r=0.383, P=0.009), HAMD-17( r=0.303, P=0.043), HAMA-14( r=0.303, P=0.043), PSQI( r=0.304, P=0.042), and PDSS( r=-0.417, P=0.004)scores. Conclusions:The levels of serum calcium are decreased in patients with Parkinson's disease(PD), and there is a correlation between serum calcium levels and pain experienced by PD patients.However, it is important to note that pain in PD patients is influenced by various other factors.