ObjectiveQi deficiency and phlegm dampness syndrome is a common type of clinical traditional Chinese medicine（TCM） syndrome. However， there is no standard， scientific， and accurate report on the construction of animal models of Qi deficiency and phlegm dampness syndrome. This study aims to construct a mouse model of Qi deficiency and phlegm dampness syndrome by using a multi-factor composite modeling method and to evaluate the model. MethodsTwenty-one C57BL/6 mice were randomly divided into three groups with seven mice in each group， which were the normal group， model group， and Shenling Baizhusan （SLBZ） group. The control group was fed with ordinary diet and kept in a normal environment. The model group and SLBZ group were fed with a high-fat diet in a high-humidity environment. Swimming with heavy weights until exhaustion and gavage with cold water or lard were used to establish the mouse model of Qi deficiency and phlegm dampness syndrome. In order to test the syndrome by prescription， mice in the SLBZ group were treated with SLBZ for 14 days after model construction. The exhaustive swimming time， body weight， serum lipid levels， tongue changes， "Qi deficiency and phlegm dampness" assessment scale score， and cecal index of mice in each group were measured. The feces of each group of mice were sent for metagenomics and metabolome sequencing， and the changes in intestinal flora and metabolites were analyzed. ResultsAfter the modeling of Qi deficiency and phlegm dampness syndrome， the exhaustive swimming time of mice was obviously shortened （P<0.01）. The serum total cholesterol， low density lipoprotein cholesterol， and non-high density lipoprotein cholesterol of mice were significantly increased （all P<0.01）. The tongue of mice was significantly different from that of the normal group， and the score of the assessment scale was significantly higher than that of the control group （P<0.01）. Cecal index decreased significantly （P<0.01）. The serum lipid level， tongue image， assessment scale score， and cecal index were reversed in the SLBZ group. Metagenomic and metabolome sequencing results showed that intestinal flora and fecal metabolites were significantly changed in mice with Qi deficiency and phlegm dampness syndrome. Akkermansia_muciniphila， Faecalibaculum_rodentium， Eubacterium_plexicaudatum， Eubacterium sp 14_2， Candida glabrata， Romboutsia_ilealis， Turicibacter sp TS3， and other bacteria had significant changes， and the expressions of intestinal metabolites such as chenodeoxycholic acid， choline， L-phenylalanine betaine， and 2-phenylbutyric acid were significantly changed. Related metabolic pathways such as linoleic acid metabolism， primary bile acid biosynthesis， lysine degradation， arginine biosynthesis， and alpha-linolenic acid metabolism were affected. ConclusionThe Qi deficiency and phlegm dampness model of mice can be constructed by the multi-factor composite modeling method of high-fat diet feeding， high-humidity environment feeding， exhaustive swimming with heavy weight， and intragastric administration with cold water or lard. The blood lipid level， tongue change， score of "Qi deficiency and phlegm dampness assessment scale"， cecal index， and changes in related intestinal flora and metabolites of mice can be used as key indicators for model evaluation.

To summarize the distribution characteristics of human papillomavirus(HPV) infection types in patients with cervical squamous intraepithelial lesion(SIL) and cervical cancer(CC), and to explore the impact of HPV vaccination, HPV infection types, and general clinical data on different grades of cervical lesions.

ObjectiveTo investigate the clinical effect of Ershen Zhenwu Decoction on chronic heart failure （CHF） due to heart-kidney Yang deficiency and blood stasis and its regulatory effects on miR-423-5p/Smad7/transforming growth factor-β₁ （TGF-β₁）/Smads axis and myocardial fibrosis indicators. MethodsOne hundred and fourteen patients with heart failure with reduced ejection fraction （HFrEF） and heart failure with mildly reduced ejection fraction （HFmrEF） were randomly allocated into a control group and an observation group. The control group was treated with dapagliflozin tablets， sacubitril-valsartan sodium tablets， metoprolol succinate， and spironolactone， and the observation group was treated with Ershen Zhenwu Decoction on the basis of the therapy in the control group. The course of treatment was 8 weeks in both groups. The 6-min walking distance， New York Heart Association （NYHA） heart function grade， Minnesota Living with Heart Failure Questionnaire （MLHFQ） score， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， angiotensin Ⅱ （Ang Ⅱ）， left ventricular ejection fraction （LVEF）， left ventricular end-diastolic diameter （LVIDd）， left ventricular end-systolic diameter （LVIDs）， interventricular septum thickness at diastole （IVSd）， left ventricular end-diastolic posterior wall thickness （LVPWd）， left ventricular shortening fraction （FS）， miR-423-5p， Smad7， Smad2， Smad3， Smad4， TGF-β₁， Ang Ⅱ， type Ⅰ collagen （Col Ⅰ）， type Ⅲ collagen （Col Ⅲ）， mRNA levels of fibronectin （Fn） and α-smooth muscle actin （α-SMA） in the myocardial tissue were observed before and after treatment in both groups to evaluate the efficacy of cardiac function and drug safety. ResultsAfter treatment， both groups showed declined levels of NT-proBNP， Ang Ⅱ， miR-423-5p， Smad2， Smad3， Smad4， TGF-β₁， Col Ⅰ， Col Ⅲ， and mRNA levels of Fn and α-SMA （P0.05）， and the levels of the indicators above were lower in the observation group than in the control group （P0.05）. After treatment， the Smad7 level increased obviously in both groups （P0.05） and was higher in the observation group than in the control group （P0.05）. After treatment， both groups showed decreased MLHFQ scores and increased 6-min walking distance （P0.05）， and the observation group had lower MLHFQ score and longer 6-min walking distance than the control group （P0.05）. After treatment， the control group showed increased LVEF and FS （P0.05） and the observation group showcased decreased LVIDd and LVIDs and increased LVEF and FS （P0.05）. Moreover， the observation group had lower LVIDd and LVIDs （P0.05） and higher LVEF and FS （P0.05） than the control group. The total response rate of cardiac function in the observation group was 90.38% （47/52）， which was higher than that （70.59%， 36/51） in the control group （P0.05）. No adverse reactions associated with Ershen Zhenwu Decoction were observed during the study period. ConclusionErshen Zhenwu Decoction can improve the cardiac function， exercise tolerance， and quality of life， regulate neuroendocrine factors， and slow down/reverse myocardial remodeling in the patients with HFrEF and HFmrEF （syndrome of heart-kidney Yang deficiency and blood stasis by regulating the miR-423-5p/Smad7/TGF-β₁/Smads axis， inhibiting α-SMA and Fn expression， and alleviating myocardial fibrosis. It is worthy of further study.

ObjectiveTo investigate the clinical effect of Ershen Zhenwu Decoction on chronic heart failure （CHF） due to heart-kidney Yang deficiency and blood stasis and its regulatory effects on miR-423-5p/Smad7/transforming growth factor-β₁ （TGF-β₁）/Smads axis and myocardial fibrosis indicators. MethodsOne hundred and fourteen patients with heart failure with reduced ejection fraction （HFrEF） and heart failure with mildly reduced ejection fraction （HFmrEF） were randomly allocated into a control group and an observation group. The control group was treated with dapagliflozin tablets， sacubitril-valsartan sodium tablets， metoprolol succinate， and spironolactone， and the observation group was treated with Ershen Zhenwu Decoction on the basis of the therapy in the control group. The course of treatment was 8 weeks in both groups. The 6-min walking distance， New York Heart Association （NYHA） heart function grade， Minnesota Living with Heart Failure Questionnaire （MLHFQ） score， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， angiotensin Ⅱ （Ang Ⅱ）， left ventricular ejection fraction （LVEF）， left ventricular end-diastolic diameter （LVIDd）， left ventricular end-systolic diameter （LVIDs）， interventricular septum thickness at diastole （IVSd）， left ventricular end-diastolic posterior wall thickness （LVPWd）， left ventricular shortening fraction （FS）， miR-423-5p， Smad7， Smad2， Smad3， Smad4， TGF-β₁， Ang Ⅱ， type Ⅰ collagen （Col Ⅰ）， type Ⅲ collagen （Col Ⅲ）， mRNA levels of fibronectin （Fn） and α-smooth muscle actin （α-SMA） in the myocardial tissue were observed before and after treatment in both groups to evaluate the efficacy of cardiac function and drug safety. ResultsAfter treatment， both groups showed declined levels of NT-proBNP， Ang Ⅱ， miR-423-5p， Smad2， Smad3， Smad4， TGF-β₁， Col Ⅰ， Col Ⅲ， and mRNA levels of Fn and α-SMA （P0.05）， and the levels of the indicators above were lower in the observation group than in the control group （P0.05）. After treatment， the Smad7 level increased obviously in both groups （P0.05） and was higher in the observation group than in the control group （P0.05）. After treatment， both groups showed decreased MLHFQ scores and increased 6-min walking distance （P0.05）， and the observation group had lower MLHFQ score and longer 6-min walking distance than the control group （P0.05）. After treatment， the control group showed increased LVEF and FS （P0.05） and the observation group showcased decreased LVIDd and LVIDs and increased LVEF and FS （P0.05）. Moreover， the observation group had lower LVIDd and LVIDs （P0.05） and higher LVEF and FS （P0.05） than the control group. The total response rate of cardiac function in the observation group was 90.38% （47/52）， which was higher than that （70.59%， 36/51） in the control group （P0.05）. No adverse reactions associated with Ershen Zhenwu Decoction were observed during the study period. ConclusionErshen Zhenwu Decoction can improve the cardiac function， exercise tolerance， and quality of life， regulate neuroendocrine factors， and slow down/reverse myocardial remodeling in the patients with HFrEF and HFmrEF （syndrome of heart-kidney Yang deficiency and blood stasis by regulating the miR-423-5p/Smad7/TGF-β₁/Smads axis， inhibiting α-SMA and Fn expression， and alleviating myocardial fibrosis. It is worthy of further study.

Objective To explore the correlations between interleukin-6(IL-6),interleukin-8(IL-8),antimicrobial peptide LL-37 and the microbial abundance and the degree of mucosal injury in patients with trichomonal vaginitis(TV).Methods A total of 120 TV patients admitted from January 2022 to December 2024 were selected and divided into the occurrence group(n=63)and the non-occurrence group(n=57)according to presence and absence of mucosal injury.The general data,IL-6,IL-8,LL-37 and microbial abundance were compared between the two groups.According to the degree of mucosal injury,the occurrence group was divided into the mild subgroup(n=34),the moderate subgroup(n=20),and the severe subgroup(n=9).Pearson correlation analysis was applied to investigate the correlations between IL-6,IL-10,antimicrobial peptide LL-37,microbial abundance and the degree of mucosal injury.Multivariate logistic regression was used to analyze the influencing factors of mucosal injury in TV patients.The receiver operating characteristic curve(ROC)was used to evaluate the predictive value of relevant indicators for mucosal injury in TV patients.Result The levels of IL-6,IL-8,antimicrobial peptide LL-37,and the abundance of Actinobacteria and Gardnerella in the occurrence group were higher than those in the non-occurrence group,while the abundance of Firmicutes and Lactobacillus was lower than that in the non-occurrence group(P<0.05,P<0.01).Pearson correlation analysis showed that IL-6,IL-8,antimicrobial peptide LL-37,and abundance of Actinobacteria and Gardnerella were positively correlated with the degree of mucosal injury(r=0.543,0.713,0.352,0.409,0.659,P<0.01),while the abundance of Firmicutes and Lactobacillus was negatively correlated with the degree of mucosal injury(r=-0.540,-0.504,P<0.01).Multivariate logistic regression analysis showed that IL-6,IL-8,antimicrobial peptide LL-37,and abundance of Actinobacteria were risk factors for mucosal injury in TV patients,while the abundance of Firmicutes and the abundance of Lactobacillus were protective factors(P<0.05).The ROC curve showed that the area under the ROC curve(AUC)of the combined detection of IL-6,IL-8,antibacterial peptide 37,and the abundance of Actinobacteria,Firmicutes,and Lactobacillus in evaluating mucosal injury in TV patients was higher than that of the single detection(P<0.01).Conclusion IL-6,IL-8,antimicrobial peptide LL-37 and microbial abundance are closely related to the degree of mucosal injury in TV patients.The combined detection has a high value in evaluating the occurrence of mucosal injury in TV patients.

Objective:To construct a nursing quality evaluation indicator system for pulse indicator continuous cardiac output (PiCCO) monitoring and provide a basis for evaluating the nursing quality of PiCCO monitoring.Methods:Using Donabedian′s "structure-process-result" three-dimensional quality evaluation model as the theoretical framework, the nursing quality evaluation indicator system for PiCCO was established through literature search, Delphi expert correspondence, and hierarchical analysis during the period May to August 2023.Results:Of the 22 experts, 6 were male and 16 were female, aged (46.59 ± 4.34) years. The return rates of the questionnaires of the 2 rounds of expert correspondence were both 100%, the coefficients of expert authority were both 0.945, and the Kendall coordination coefficients were 0.045-0.186 ( χ2 values were 2.00-221.46, all P<0.05) and 0.045-0.132 ( χ2 values were 2.00-82.16, all P<0.05), respectively. The finalized nursing quality evaluation indicator system for PiCCO included 3 primary indicators, 7 secondary indicators, and 36 tertiary indicators. Conclusions:The nursing quality evaluation indicator system for PiCCO is practical and scientific, which can provide reference for PiCCO monitoring nursing quality evaluation.

Objective:To investigate level and influencing factors of information overload of intensive care unit (ICU) patients′ decision-making agents in order to provide positive clinical interventions for improving their information overload.Methods:During March 2023 to February 2024, 302 ICU patients′ decision-making agents from the Second Affiliated Hospital of Naval Medical University of the People′s Liberation Army of China were cross-sectional surveyed by Basic Information Questionnaire, Information Overloading Scale, Decision Participation Expectancy Scale, Multidimensional Perceived Social Support Scale, State Trait Anxiety Inventory, Vickers Forest Physician Trust Scale, Decision Preparation Scale, Decision Fatigue Scale and Information Literacy Scale through convenience sampling methods.Results:In the valid 297 questionnaires, there were 172 males and 125 females in ICU patients′ decision-making agents aged 28-69(47.94 ± 8.71) years. The score of information overload was (19.65 ± 7.71), the score of perceived social support was (52.34 ± 7.87), the score of state anxiety was (60.88 ± 6.16), the score of trait anxiety was (60.09 ± 5.49), the score of physician trust was (35.34 ± 4.30), the score of preparation of decision was (27.90 ± 3.01), the score of decision fatigue was (20.61 ± 3.30), and the score of information literacy was (56.18 ± 11.46) in ICU patients′ decision-making agents. Linear regression analysis showed that age, educational level, having a common decision-maker, times of making medical decisions, type of participating in medical decision (cooperative type and proactive type), perceived social support, state anxiety, physician trust, preparation for decision making, decision fatigue and information literacy were all significant influencing factors of information overload of ICU patients′ decision-making agents ( t values were -6.76 to 7.57, all P<0.05). Conclusions:The level of information overload of ICU patients′ decision-making agents was above average. Therefore, while educating them about patients′ illness situation and inviting them to participate in decision-making, ICU medical staff should pay attention on their level of information overload, and then select simply easy communication methods and content to help them quickly understand information and make decisions according to their characteristics and information processing ability.

Objective To construct a scientific and effective evaluation system for the medical science popularization a-bility of public hospitals,providing a reference for the evaluation and improvement of their medical science popularization abili-ties.Methods 27 experts from 6 public hospitals and 2 science popularization committees were invited to participate in two rounds of consultations.The Delphi method was used to screen evaluation indicators for medical science popularization ability,and the Analytic Hierarchy Process(AHP)was adopted to determine the weight of each indicator.Results The constructed e-valuation system for the medical science popularization ability of public hospitals includes 3 first-level indicators,7 second-level indicators,and 23 third-level indicators.The comprehensive weights of the third-level indicators range from 0.013 to 0.086.Conclusion The constructed evaluation system for the medical science popularization ability of public hospitals has a certain au-thority and scientific validity,which can provide a reference for promoting the evaluation of medical science popularization abili-ties in public hospitals.

Objective:To analyze the application value of the Health Action Process Approach(HAPA)model in re-habilitation exercise intervention of patients with supraventricular tachyarrhythmia.Methods:We enrolled clinical data of 117 patients diagnosed as supraventricular tachyarrhythmia in Xinzhou District People's Hospital of Wuhan between February 2019 and January 2023.They were divided into routine group(n=57)and HAPA model group(n=60)according to different intervention method.Participants in routine group received routine rehabilitation exer-cise,while those in HAPA model group received HAPA model rehabilitation exercise.Both groups were intervened for 6 months.Cardiac function,medication compliance[Morisky medication adherence scale(MMAS-8)],daily living capacity(Barthel index),quality of life[the short-form 36 health survey(SF-36)],total effective rate of intervention,incidence of adverse events within 6-month follow-up were compared between two groups.Results:Compared with patients in routine group,those in HAPA model group had significant higher left ventricular ejection fraction(LVEF)[(56.75±1.13)％vs.(52.65±1.57)％],Barthel index[(65.60±9.76)points vs.(56.37±9.98)points],MMAS-8 score[(6.73±1.83)points vs.(4.91±1.33)points],SF-36 total score[(67.50±15.25)points vs.(55.28±9.05)points]and total effective rate(88.33％ vs.71.93％)(P＜0.01 all),and signifi-cant lower left ventricular end-systolic volume(LVESV)[(54.97±2.60)ml vs.(64.61±2.50)ml],left ventric-ular end-diastolic volume(LVEDV)[(117.50±4.23)ml vs.(133.38±4.47)ml]and incidence of adverse events within 6-month follow-up(5.00％ vs.22.81％)(P＜0.01 all).Conclusion:Rehabilitation exercise based on HAPA model could significantly improve cardiac function,medication compliance,daily living capacity and quality of life with good safety in patients with supraventricular tachyarrhythmia.

Objective:To analyze the application value of the Health Action Process Approach(HAPA)model in re-habilitation exercise intervention of patients with supraventricular tachyarrhythmia.Methods:We enrolled clinical data of 117 patients diagnosed as supraventricular tachyarrhythmia in Xinzhou District People's Hospital of Wuhan between February 2019 and January 2023.They were divided into routine group(n=57)and HAPA model group(n=60)according to different intervention method.Participants in routine group received routine rehabilitation exer-cise,while those in HAPA model group received HAPA model rehabilitation exercise.Both groups were intervened for 6 months.Cardiac function,medication compliance[Morisky medication adherence scale(MMAS-8)],daily living capacity(Barthel index),quality of life[the short-form 36 health survey(SF-36)],total effective rate of intervention,incidence of adverse events within 6-month follow-up were compared between two groups.Results:Compared with patients in routine group,those in HAPA model group had significant higher left ventricular ejection fraction(LVEF)[(56.75±1.13)％vs.(52.65±1.57)％],Barthel index[(65.60±9.76)points vs.(56.37±9.98)points],MMAS-8 score[(6.73±1.83)points vs.(4.91±1.33)points],SF-36 total score[(67.50±15.25)points vs.(55.28±9.05)points]and total effective rate(88.33％ vs.71.93％)(P＜0.01 all),and signifi-cant lower left ventricular end-systolic volume(LVESV)[(54.97±2.60)ml vs.(64.61±2.50)ml],left ventric-ular end-diastolic volume(LVEDV)[(117.50±4.23)ml vs.(133.38±4.47)ml]and incidence of adverse events within 6-month follow-up(5.00％ vs.22.81％)(P＜0.01 all).Conclusion:Rehabilitation exercise based on HAPA model could significantly improve cardiac function,medication compliance,daily living capacity and quality of life with good safety in patients with supraventricular tachyarrhythmia.