Palliative care has become an important medical measure to provide professional healthcare and alleviate patients' suffering. Nurse-led palliative care models enable patients to access palliative care services in a timely manner and can be applied across various healthcare settings. This paper reviews the current status of nurse-led palliative care models in China and internationally, summarizes the summarizes the intervention settings, care forms, implementation contents, and effects of nurse-led palliative care models, and expounds on the existing barriers and improvement strategies of nurse-led palliative care models in China. The aim is to provide a reference for the implementation and development of palliative care.

Objective The present study aims to explore the mediating role of rumination and coping styles in social support and post-traumatic stress disorder(PTSD)in young and middle-aged spinal cord injury(SCI)patients.The study will provide a basis for developing targeted interventions.Methods Two hundred and forty young and middle-aged SCI patients hospitalized for treatment were selected by convenience sampling and questionnaires were administered using the General Information Questionnaire,the Perceived Social Support Scale(PSSS),the Simplified Coping Style Questionnaire(SCSQ),the Event Related Rumination Inventory(ERRI),and the Post-traumatic Stress Disorder Self-assessment Scale(PCL-C),Mediation analysis using Model-6 with Process4.1 plugin in SPSS 25.0.Results The mean scores for PTSD,social support,rumination,positive coping,and negative coping in young and middle-aged SCI patients were 29.00(26.00,35.75),67.00(62.00,70.00),and 37.00(34.00,4 1.00),and 36.00(33.00,42.00),respectively.PTSD demonstrated a negative correlation(r=-0.553,r=-0.484,P＜0.001)and a negative correlation with positive coping and rumination(r=0.499,r=0.472,P＜0.001).The mediation modelling test demonstrated that rumination and positive and negative coping mediated significantly between social support and PTSD,with effect values of-0.078 1,-0.097 0 and-0.049 6,accounting for 17.81％,22.12％and 11.31％of the total effect,respectively.Furthermore,the chain mediation effects of rumination and positive coping and negative coping were also significant,with effect values of-0.026 3 and-0.026 2,accounting for 5.99％and 5.97％of the total effect,respectively.Conclusions The present study hypothesises that rumination,thinking and coping styles play a simple and chain-mediating role between social sup-port and PTSD in young and middle-aged SCI patients.Medical professionals should focus on the mediating role of rumination and coping styles when developing interventions related to improving and preventing PTSD in patients,which can be done by increasing the level of social support for patients,decreasing the level of rumination,and guiding patients to positively cope with their illness.

OBJECTIVE To investigate the causes of intracranial infection after endoscopic microvascular decom-pression for the treatment of trigeminal neuralgia in a teaching hospital.METHODS An epidemiological survey was conducted on 2 patients(F and Z)who developed intracranial infections after microvascular decompression for trigemi-nal neuralgia in the department of neurosurgery of the Affiliated Hospital of Qingdao University in July 2024.Bacteriolog-ical sampling and culture were carried out for the staff,environment and materials involved in the surgery.The homology of strains between the strains recovered from the patients and those from the environmental was analyzed by means of pulsed-field gel electrophoresis(PFGE)and second-generation illumina sequencing.RESULTS All the three electric ra-zors that were used for preoperative shaving of the patients were found to be contaminated with Enterobacter hor-maechei and Klebsiella pneumoniae.Enterobacter hormaechei strain(E1)and K.pneumoniae strains(K1 to K4)were isolated from the cerebrospinal fluid of patient F.Enterobacter hormaechei strains(E2 and E3)were isolated from the cerebrospinal fluid and wound secretion of patient Z.PFGE analysis showed that the E.hormaechei strains(E1,E2 and E3)isolated from the patients were homologous to the strains of E.hormaechei isolated from the electric shavers(B2-E,B3-E and B4-E),and all these strains were of ST50 type and carried blaACT-15 and 6laCTX-M-3 genes,and that the K.pneumoniae strains(K1-K4)were also homologous to the K.pneumoniae strains isolated from the electric shavers(B2-K,B3-K and B4-K),and all these strains were of ST8 type and car-riedblaSHV-164 and blaTEM-1A genes.CONCLUSIONS The intracranial infections that occur after endoscopic microvas-cular decompression for the treatment of trigeminal neuralgia are related to the preoperative use of electric shavers contaminated with E.hormaechei and K.pneumonia during skin preparation.Therefore,it is necessary to carry out the disinfection of electric shavers that are used for skin preparation and monitor the disinfection effect.

Objective To study the effects of cognitive behavioral therapy(CBT)on nutritional status and postoperative recovery in patients after gastric cancer surgery.Methods Sixty patients diagnosed with gastric cancer between January 1,2023,and December 30,2023,at the hospital in the department of gastroin-testinal and gland surgery were included in this study.Patients were randomly divided by drawing lots into ei-ther the observation group(received routine care plus CBT—based nursing program)or the control group(received routine care),with 30 patients in each group.Nutritional indicators and postoperative recovery out-comes were compared between the two groups.Results After the intervention,patients in the observation group showed significantly higher levels of albumin and hemoglobin compared to the control group(P＜0.05).However,there was no statistically significant difference in prealbumin levels between the two groups(P＞0.05).Furthermore,patients in the observation group scored higher on the Quality of Recovery-40 scale in terms of emotional state,physical comfort,psychological support,and overall score compared to the control group(P＜0.05).After the intervention,the observation group showed significantly lower HADS scores com-pared to the control group,with a statistically significant difference(P＜0.05).Conclusion CBT demon-strates significant positive effects in improving nutritional status and postoperative recovery quality in gastric cancer patients.CBT improves patients'emotional state,thereby affecting appetite and nutritional status,and promotes postoperative physical function recovery.

Objective The present study aims to explore the mediating role of rumination and coping styles in social support and post-traumatic stress disorder(PTSD)in young and middle-aged spinal cord injury(SCI)patients.The study will provide a basis for developing targeted interventions.Methods Two hundred and forty young and middle-aged SCI patients hospitalized for treatment were selected by convenience sampling and questionnaires were administered using the General Information Questionnaire,the Perceived Social Support Scale(PSSS),the Simplified Coping Style Questionnaire(SCSQ),the Event Related Rumination Inventory(ERRI),and the Post-traumatic Stress Disorder Self-assessment Scale(PCL-C),Mediation analysis using Model-6 with Process4.1 plugin in SPSS 25.0.Results The mean scores for PTSD,social support,rumination,positive coping,and negative coping in young and middle-aged SCI patients were 29.00(26.00,35.75),67.00(62.00,70.00),and 37.00(34.00,4 1.00),and 36.00(33.00,42.00),respectively.PTSD demonstrated a negative correlation(r=-0.553,r=-0.484,P＜0.001)and a negative correlation with positive coping and rumination(r=0.499,r=0.472,P＜0.001).The mediation modelling test demonstrated that rumination and positive and negative coping mediated significantly between social support and PTSD,with effect values of-0.078 1,-0.097 0 and-0.049 6,accounting for 17.81％,22.12％and 11.31％of the total effect,respectively.Furthermore,the chain mediation effects of rumination and positive coping and negative coping were also significant,with effect values of-0.026 3 and-0.026 2,accounting for 5.99％and 5.97％of the total effect,respectively.Conclusions The present study hypothesises that rumination,thinking and coping styles play a simple and chain-mediating role between social sup-port and PTSD in young and middle-aged SCI patients.Medical professionals should focus on the mediating role of rumination and coping styles when developing interventions related to improving and preventing PTSD in patients,which can be done by increasing the level of social support for patients,decreasing the level of rumination,and guiding patients to positively cope with their illness.

Palliative care has become an important medical measure to provide professional healthcare and alleviate patients' suffering. Nurse-led palliative care models enable patients to access palliative care services in a timely manner and can be applied across various healthcare settings. This paper reviews the current status of nurse-led palliative care models in China and internationally, summarizes the summarizes the intervention settings, care forms, implementation contents, and effects of nurse-led palliative care models, and expounds on the existing barriers and improvement strategies of nurse-led palliative care models in China. The aim is to provide a reference for the implementation and development of palliative care.

OBJECTIVE To investigate the causes of intracranial infection after endoscopic microvascular decom-pression for the treatment of trigeminal neuralgia in a teaching hospital.METHODS An epidemiological survey was conducted on 2 patients(F and Z)who developed intracranial infections after microvascular decompression for trigemi-nal neuralgia in the department of neurosurgery of the Affiliated Hospital of Qingdao University in July 2024.Bacteriolog-ical sampling and culture were carried out for the staff,environment and materials involved in the surgery.The homology of strains between the strains recovered from the patients and those from the environmental was analyzed by means of pulsed-field gel electrophoresis(PFGE)and second-generation illumina sequencing.RESULTS All the three electric ra-zors that were used for preoperative shaving of the patients were found to be contaminated with Enterobacter hor-maechei and Klebsiella pneumoniae.Enterobacter hormaechei strain(E1)and K.pneumoniae strains(K1 to K4)were isolated from the cerebrospinal fluid of patient F.Enterobacter hormaechei strains(E2 and E3)were isolated from the cerebrospinal fluid and wound secretion of patient Z.PFGE analysis showed that the E.hormaechei strains(E1,E2 and E3)isolated from the patients were homologous to the strains of E.hormaechei isolated from the electric shavers(B2-E,B3-E and B4-E),and all these strains were of ST50 type and carried blaACT-15 and 6laCTX-M-3 genes,and that the K.pneumoniae strains(K1-K4)were also homologous to the K.pneumoniae strains isolated from the electric shavers(B2-K,B3-K and B4-K),and all these strains were of ST8 type and car-riedblaSHV-164 and blaTEM-1A genes.CONCLUSIONS The intracranial infections that occur after endoscopic microvas-cular decompression for the treatment of trigeminal neuralgia are related to the preoperative use of electric shavers contaminated with E.hormaechei and K.pneumonia during skin preparation.Therefore,it is necessary to carry out the disinfection of electric shavers that are used for skin preparation and monitor the disinfection effect.

With the continuous development of medical science and the widespread use of antibiotics,the problem of bacterial resistance is increasing,especially the increasing carbapenem-resistant Enterobacteriaceae(CRE)infection,and the high mortality rate,which brings great challenges to clinical treatment.In this paper,the mechanism of drug resistance,existing antibac-terial drugs,and exploratory treatment options for CRE are reviewed,and the research progress in treating CRE infection is dis-cussed to provide more reliable evidence and a theoretical basis for clinical practice.

Objective:To evaluate the efficacy and safety of first-line anti-tuberculosis (TB) drugs combined with linezolid in treatment of children with tuberculous meningitis (TBM).Methods:A retrospective cohort study design was performed . Eight-nine Children diagnosed as TBM during January 1 st 2016 and December 31 st 2023 in Department of Infectious Disease, Children′s Hospital of Chongqing Medical University were enrolled in the study. According to different treatment regimens, children were divided into a group of first-line anti-tuberculous drugs (isoniazid, rifampicin, pyrazinamide, ethambutol (HRZE)) and a group of HRZE and linezolid combination (HRZEL). The efficacy and safety of the 2 regimens were compared and the relationship between linezolid drug concentration and adverse reactions were analyzed. Comparisons between groups were performed using χ2 test and Mann-Whitney U test. Results:The 89 children with TBM included 53 males and 36 females with an onset age of 4.6 (1.4, 9.6) years. There were 27 cases in the HZREL group and 62 cases in the HRZE group. Before treatment, positive rate of interferon-gamma release assays (IGRA) in HRZEL group was lower than that in HRZE group (64% (16/25) vs.92% (55/60), χ2=9.82, P<0.05), but protein level of cerebrospinal fluid (CSF) was higher than that in HRZE group (1.2 (1.0, 2.0) vs.0.8 (0.4,1.4) g/L, Z=0.32, P<0.05). By the end of the intensive phase, there were no significant differences of rates of CSF improvement and etiology negativity between HRZEL group and HRZE group (both P>0.05).The 44 TBM children with high CSF protein (>1 g/L) included 25 males and 19 females with an onset age of 6.7 (3.0, 11.8) years. There were 21 cases in the HZREL group and 23 cases in the HRZE group accordingly. Before treatment, there were no significant differences of positive rate of IGRA test and CSF protein level between the 2 groups (62% (13/21) vs. 87% (20/23), 1.7 (1.1, 2.2) vs. 1.5 (1.2, 1.9) g/L, χ2=3.67, Z=0.23, both P>0.05). There were no significant differences in CSF indicators, etiology negativity or imaging remission between the two groups by the end of intensive phase (all P>0.05). Higher frequencies of granulocytopenia, gastrointestinal symptoms as well as withdrawal or change of drugs were found in HRZEL group when compared to those in HRZE group (44% (12/27) vs. 19% (12/62), 7% (2/27) vs. 0, 33% (9/27) vs. 3% (2/62), χ2=6.01, 4.70, 15.74, all P<0.05). Conclusions:The efficacy of HRZEL regimen is similar to conventional HRZE regimen in children with TBM, but with higher adverse effect. Prudentially evaluating the pros and cons of linezolid in the usage of drug-susceptible TB and carefully monitoring of linezolid associated adverse effects is suggested.

Objective To investigate the ameliorative effects and potential mechanism of Lithocarpus litseifoliu on renal function and inflammation in mice with hyperuricemic nephropathy(HN).Methods The HN model was established by the combined administration of adenine and potassium oxyzate.The mice were randomly divided into normal control group,model control group,benzbromarone group,and high,medium and low dose groups of Lithocarpus litseifoliu.Different drugs were given to the mice,and their body mass was recorded once a week.The levels of uric acid(UA),creatinine(Cr),urine protein(UP),blood urea nitrogen(BUN)and urine urea nitrogen(UUN)as well as the levels of tumor necrosis factor α(TNF-α)and interleukin 6(IL-6)in serum or urine of each group were collected and measured on the 21st day.Hematoxylin-eosin(HE)staining was performed to observe kidney tissue injury in mice;real-time PCR(RT-PCR)was performed to determine ATP-binding cassette subfamily G member 2(ABCG2),urate transporter protein(URAT1),glucose transporter protein 9(GLUT9),and cytosolic factor NF-κB p50(κB p50)in kidney tissues.Results Compared with the normal control group,the body mass of mice in the model control group was significantly lower after the second weeks of modeling(P＜0.05),and the levels of UA,Cr,UP,BUN,UUN,TNF-α,IL-6 contents and GLUT9 mRNA and κB p50 mRNA expression contents of kidney tissues were significantly higher(P＜0.01,P＜0.05).Compared with the model control group,the levels of Cr,UP,BUN and UUN contents and renal tissue nuclear cytokine κB p50 mRNA expression were significantly lower in the high,medium and low dose groups of Lithocarpus litseifoliu(P＜0.01,P＜0.05).The UA levels were significantly lower in the high dose group of Lithocarpus litseifoliu(P＜0.05),and renal ABCG2 mRNA expression was significantly higher in the medium dose group(P＜0.01).The renal URAT1 mRNA expression was significantly decreased in the low dose group(P＜0.01).Conclusion Lithocarpus litseifoliu has shown ameliorative effects on HN mice,and the mechanism may be related to the modulation of renal uric acid transporters,improvement of renal function and anti-inflammation effects.