Objective The core competence index system of nurses providing"internet+postpartum maternal and infant home care"service was constructed and preliminarily verified,so as to provide references for objective evaluation of their core competence.Methods Based on literature review and semi-structured interviews,the core competence index system of nurses in"internet+postpartum maternal and infant home care"service was initially constructed with the iceberg model as the theoretical framework.In April to May 2024,the indicators are organized and analyzed using the Delphi method to form a final indicator system.In December 2024,30 nurses providing"internet+postpartum maternal and infant home care"service in a tertiary A obstetrics and gynecology hospital in Hangzhou were selected as the survey subjects,and the index system was preliminarily verified by questionnaires.Results A total of 20 experts completed 2 rounds of correspondence.The authoritative coefficients of the 2 rounds of expert inquiry were 0.88 and 0.90,respectively;the Kendall coordination coefficients were 0.34 and 0.39,respectively(P＜0.001);the variation coefficients were 0～0.17 and 0.05～0.18,respectively.The final index system includes 3 first-class indicators,12 second-class indicators and 68 third-class indicators.The comprehensive,specialized,necessary,applicable,and overall satisfaction scores of the indicator system are(4.27±0.77)points,(4.43±0.56)points,(4.43±0.72)points,(4.47±0.56)points,and(4.46±0.56)points,respectively.Conclusion The core competence index system of nurses in"internet+postpartum maternal and infant home care"service is comprehensive,specialized,scientific and reliable,and can provide references for the training,assessment and evaluation of"internet+postpartum maternal and infant home care"talents.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective The core competence index system of nurses providing"internet+postpartum maternal and infant home care"service was constructed and preliminarily verified,so as to provide references for objective evaluation of their core competence.Methods Based on literature review and semi-structured interviews,the core competence index system of nurses in"internet+postpartum maternal and infant home care"service was initially constructed with the iceberg model as the theoretical framework.In April to May 2024,the indicators are organized and analyzed using the Delphi method to form a final indicator system.In December 2024,30 nurses providing"internet+postpartum maternal and infant home care"service in a tertiary A obstetrics and gynecology hospital in Hangzhou were selected as the survey subjects,and the index system was preliminarily verified by questionnaires.Results A total of 20 experts completed 2 rounds of correspondence.The authoritative coefficients of the 2 rounds of expert inquiry were 0.88 and 0.90,respectively;the Kendall coordination coefficients were 0.34 and 0.39,respectively(P＜0.001);the variation coefficients were 0～0.17 and 0.05～0.18,respectively.The final index system includes 3 first-class indicators,12 second-class indicators and 68 third-class indicators.The comprehensive,specialized,necessary,applicable,and overall satisfaction scores of the indicator system are(4.27±0.77)points,(4.43±0.56)points,(4.43±0.72)points,(4.47±0.56)points,and(4.46±0.56)points,respectively.Conclusion The core competence index system of nurses in"internet+postpartum maternal and infant home care"service is comprehensive,specialized,scientific and reliable,and can provide references for the training,assessment and evaluation of"internet+postpartum maternal and infant home care"talents.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective To explore the influence of IL-6 secreted by cancer-associated fibroblasts(CAFs)on pro-moting the proliferation and invasion of ovarian cancer cells and the possible mechanisms.Methods CAFs and normal ovarian fibroblasts(NFs)were isolated and cultured respectively from epithelial ovarian cancer and normal ovarian epithelial tissues.Cell markers alpha-smooth muscle actin(α-SMA),E-cadherin were detected by West-ern blot and immunofluorescence.CAFs and normal ovarian fibroblasts(NFs)were collected and cultured,and their supernatants were used to establish an indirect co-culture system with ovarian cancer SKOV3 cells,including SKOV3 cells alone(SKOV3)group,SKOV3 combined with the supernatants of NFs(NFs)group and SKOV3 combined with the supernatants of CAFs(CAFs)group.Cell immunochemistry was used to detect the expression of alcohol dehydrogenase 1B(ADH1B)in SKOV3 cells co-cultured with the supernatant of CAFs or NFs.Before and after treatment with the methylation inhibitor 5-aza-2'-deoxycytidine(5-Aza-dC),methylation-specific PCR(MSP),Reverse transcription quantitative real-time PCR(RT-qPCR),enzyme-linked immunosorbent assay(ELISA),and Western blot were used to detect the mRNA level and methylation status of ADH1B,and the phos-phorylation level of signal transducers and activators of transcription 3(p-STAT3).The cell counting kit-8(CCK-8)method and Transwell assay were used to investigate the effects of the IL-6 inhibitor LMT-286 and recombinant human interleukin-6(rhIL-6)on cell proliferation and invasion.Results The protein levels of α-SMA was highly expressed,however,CAFs and NFs cells almost lacked the E-cadherin protein.Compared with the SKOV3 and NFs groups,CAFs group exhibited significantly downregulated mRNA and protein expression of ADH1B.After treatment with 5-Aza-dC,ADH1B methylation was partially reversed,and the mRNA and protein expression of ADH1B increased in all groups.The phosphorylation level of STAT3 proteins was significantly reduced in CAFs group,while there were no significant changes in SKOV3 and NFs groups.Intervention with LMT-286 and rhIL-6 only inhibited or promoted the proliferation and invasion of cells in CAFs group,while there were no significant changes in SKOV3 and NFs groups.Conclusion CAFs can enhance the methylation of ADH1B in ovarian cancer cells via IL-6/STAT3 pathway,and may promote the proliferation and invasion.

Objective To investigate the correlation between Yes-associated protein(YAP)nuclear expression and tumor size with prognosis of patients with epithelial ovarian cancer(EOC)and to study the role of YAP in EOC.Methods 120 patients with EOC were selected as the experimental group,including 38 patients with early stage(Ⅰ+Ⅱ)EOC and 8 2 patients with advanced stage(Ⅲ+Ⅳ)EOC.3 0 normal ovarian tissues obtained from patients with uterine leiomyoma were enrolled as the control group.Immunohistochemical(IHC)assay was em-ployed to determine YAP expression and sub-location.The relationship between YAP expression and the pathologi-cal parameters of the 120 patients with EOC was analyzed,so as to the prognosis of these patients.EOC cells(C13K and OV2008)were cultured with varying initial cell volumes.Ki67 expression and cell proliferation were tested by immunofluorescence and cloning assay respectively.YAP expression at mRNA and protein levels were de-tected by q-PCR and Western blot respectively when the cell conference of EOC cells reached to low(60％)and high(90％)cell density.Results The YAP nuclear expression was significantly higher in the EOC group com-pared to the control group(P＜0.05).The average diameter of stage Ⅰ+Ⅱ EOC was larger than that of stage Ⅲ+Ⅳ EOC(P＜0.01).The high nuclear expression of YAP was positively associated with pathological grade,clinical stage and the level of Ca125＞1 000 IU/ml,while negatively correlated with tumor size(all P＜0.05).Survival analyses showed that smaller tumor size(＜10 cm)and higher YAP nuclear expression were negatively as-sociated with the 3-year overall survival rate of EOC patients(P＜0.01).C13K and OV2008 cells cultured in the low density group exhibited a high number of clone formation,high Ki67 and YAP expression(P＜0.01).The down-regulation of YAP expression could decrease the cell viability of EOC cells in the low-and high-density groups(P＜0.05).Conclusion Higher level of YAP nuclear expression and smaller tumour size are inversely associated with the clinical prognosis of patients with EOC.Inhibiting YAP nuclear expression leads to a decrease in the prolif-eration capacity of EOC cells.

Objective:To explore the effects of pulmonary rehabilitation exercise on anxiety and quality of life in patients with first diagnosed lung cancer undergoing chemotherapy.Methods:A total of 78 patients who received chemotherapy for first diagnosed lung cancer admitted to the Affiliated Hospital of Qingdao University from May 2018 to May 2020 were selected as research objects by the convenient sampling method. 39 patients admitted from May 2018 to May 2019 were set as control group and 39 patients admitted from June 2019 to May 2020 were set as the intervention group. The control group was given lung cancer nursing routine, while the intervention group was given 16-week lung rehabilitation exercise intervention on the basis of the control group. Self-Rating Anxiety Scale (SAS) and European Organization for Research and Treatment (EORTC-QLQ-C30) were used to compare the scores of anxiety and quality of life between the two groups before intervention and 16 weeks after intervention.Results:Before intervention, there was no statistically significant difference in anxiety score and quality of life score between the two groups ( P>0.05) . After intervention, consistent results were obtained through intention to treat (ITT) analysis and per-protocol (PP) analysis. The anxiety score of the intervention group was lower than that of the control group, the role function, emotional function, social function and general health status of the quality of life scores were higher than that of the control group and the scores of fatigue, shortness of breath and loss of appetite were lower than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Pulmonary rehabilitation exercise can improve anxiety and quality of life in patients with first-diagnosed lung cancer treated with chemotherapy, but its long-term effects still need further follow-up evaluation.

Objective:To investigate and analyze the mental health status and influencing factors of the troops stationed and training in remote islands and reefs during COVID-19 pandemic.Methods:A total of 577 officers and sailors were selected as objects of study from the troops stationed and training in remote islands and reefs in 2020 by convenient sampling method．The investigation was carried out by handing out and returning a questionnaire on-the-spot．The questionnaire was developed from the 90-item symptom list（SCL-90），and all the questions and choices in the questionnaire were uniformed according to the same instruction．A total of 579 questionnaires were handed out，and 577 valid questionnaires were collected；the effective rate was 99.65%．The univariate and multivariate analyses were used to screen the influencing factors related to the results of the above-mentioned investigation.Results:The average score of SCL-90 was 122.7±49.76，which was significantly lower than the military norm（ P<0.01）．The multivariate analysis showed that the total score was negatively correlated with the relationship with other colleagues，the relationship with parents，and the relationship with spouse（ P<0.01）；while it was positively correlated with the military situation in the South China Sea and the family economic situation（ P<0.05）. Conclusion:The mental health status of the troops stationed and training in remote islands and reefs were generally good．The mental status of the troops were closely related to intimate relationship，interpersonal relationship，and military environment.

Objective:To investigate and analyze the mental health status and influencing factors of the troops stationed and training in remote islands and reefs during COVID-19 pandemic.Methods:A total of 577 officers and sailors were selected as objects of study from the troops stationed and training in remote islands and reefs in 2020 by convenient sampling method．The investigation was carried out by handing out and returning a questionnaire on-the-spot．The questionnaire was developed from the 90-item symptom list（SCL-90），and all the questions and choices in the questionnaire were uniformed according to the same instruction．A total of 579 questionnaires were handed out，and 577 valid questionnaires were collected；the effective rate was 99.65%．The univariate and multivariate analyses were used to screen the influencing factors related to the results of the above-mentioned investigation.Results:The average score of SCL-90 was 122.7±49.76，which was significantly lower than the military norm（ P<0.01）．The multivariate analysis showed that the total score was negatively correlated with the relationship with other colleagues，the relationship with parents，and the relationship with spouse（ P<0.01）；while it was positively correlated with the military situation in the South China Sea and the family economic situation（ P<0.05）. Conclusion:The mental health status of the troops stationed and training in remote islands and reefs were generally good．The mental status of the troops were closely related to intimate relationship，interpersonal relationship，and military environment.

Objective:To investigate the clinical features, imaging features, treatment options and prognosis of linear scleroderma with central nervous system involvement.Methods:One case of linear scleroderma " en coup de sabre" (LSES) school-age child suffering from dizziness, vomiting and blurred vision was admitted to the Department of Pediatrics, Peking University First Hospital on March 25, 2019.The curative effect was observed after treatment.The relevant literature was searched, and the characteristics of cases and therapeutic effects were reviewed.Results:The clinical features of this case included recurrent and transient dizziness, vomiting, and blurred vision.Cranial imaging indicated abnormal signals in the left frontotemporal lobe white matter, cingulate gyrus, basal ganglia region, and corpus callosum proximal pressure part, multiple soft meningeal line enhancement and abnormal brain substance enhancement on the brain surface in the lesion area.After 2 months of combined treatment with Methotrexate(MTX) and corticosteroids, some symptoms such as dizziness and vomiting disappeared.Three months after the treatment, in the primary cerebral hemisphere and multiple calcifications in the brain parenchyma, the lesions significantly reduced in cranial imaging.The child was followed up for 11 months and displayed no clinical symptoms.New hair was dense at the alopecia area, and skin color, texture and grain were close to normal at the damaged area.In the review of domestic literature, treatment and prognosis were not involved.Foreign literatures reported 5 cases of children, with the first choice of Methylprednisolone being combined with MTX treatment, significant effect was observed, and consistent with the treatment of this case.Conclusions:In order to detect and treat them as early as possible and improve the prognosis, LSES patients should undergo cranial integrity assessment and neurological imaging examination at an early stage, regardless of clinical manifestations of nervous system involvement.