The identification of clinical questions for clinical practice guidelines of Chinese patent medicine （CPM） is important for subsequent evidence retrieval， evaluation of evidence quality， formation of recommendations. This paper described a methodological proposal for the identification of clinical questions for CPM guidelines to highlight the characteristics of Chinese patent medicine and reflect its effect in specific stage of the disease. Considering four aspects， namely， the drug of Chinese patent medicine （D）， the specific disease stage （S）， comparison （C）， and specific outcome （O）， DSCO framework has been proposed to formulate the clinical questions. Multi-source information through scientific research， policy or standard documents， and clinical data are suggested for collecting clinical questions， and clear selection criteria should be set to finalize the clinical questions to be addressed by the guideline. In addition， the above process needs to be transparently and publicly reported in order to ensure the clarity and completeness of the guidelines.

Postoperative pain seriously affects the recovery process of patients, resulting in prolonged hospital stay and increased care costs. Appropriate application of patient-controlled analgesia devices can effectively relieve perioperative acute pain. In 1994 patient-controlled analgesia began to be used in Peking Union Medical College Hospital, and the Acute Pain Service Working Group was established in 2004. With the cooperation of anesthesiologists and specialist nurses, the group jointly has implemented the whole process and standardized management based on patient-controlled analgesia, and constantly improved and innovated working methods, laying a solid foundation for the development of postoperative pain management. This paper systematically reviews and summarizes the work from the aspects of clinical focus, nursing management experience, promotion and dissemination of pain treatment concepts, and development of acute pain service model under the new situation, with the hope of providing valuable reference for comprehensively strengthening pain management in the process of diagnosis and treatment, and enhancing patients' satisfaction with perioperative analgesia services.

Objective:To explore the effect of progressive case teaching based on Omaha system in standardized training for new nurses.Methods:Using convenience sampling method, 58 new nurses from Yantai Affiliated Hospital of Binzhou Medical University from January to December 2021 were selected as control group, and 58 new nurses from January to December 2022 were selected as experimental group. Experimental group received progressive case teaching based on Omaha system, while control group received routine standardized training. Both groups received training for six months. After six months of training, the academic performance, clinical thinking ability, and satisfaction of the two groups were compared.Results:After intervention, experimental group scored higher in various dimensions of academic performance and clinical thinking ability, as well as satisfaction scores with the teacher, teaching methods, and teaching effectiveness, compared to the control group, with statistical differences ( P<0.05) . Conclusions:The progressive case teaching based on Omaha system in standardized training for new nurses can improve academic performance, enhance clinical thinking abilities, and gain recognition from new nurses.

Drug-induced interstitial lung disease(DI-ILD)is the most common form of drug-induced pulmonary adverse events,with antican-cer drugs being the primary cause.DI-ILD first gained attention as a notable adverse event due to the use of antibody-drug conjugates(ADC).As the development of drugs,particularly ADCs,continues to expand and more ADCs are approved or nearing approved for clinical use,DI-ILD has become an area of growing concern.However,the mechanisms by which ADCs induce ILD remain unclear.This article reviews the mechanisms of DI-ILD in the most commonly used ADCs targeting human epidermal growth factor receptor 2(HER2).

Objective:To investigate the relationship between plasma atherogenic index (AIP) trajectory and the risk of hypertension in health examination population.Methods:In this retrospective cohort study, a total of 15 389 subjects who had undergone health examinations at the Health Management Center of the Second Affiliated Hospital of Dalian Medical University three or more times from January 2012 to December 2022 were consecutively selected. The general data, anthropometric parameters and laboratory parameters were collected. The study population without hypertension at baseline inclusion was screened, and AIP trajectory groups of different genders were determined by group-based trajectory modeling. The baseline characteristics and the incidence of hypertension at the end of follow-up were observed in each AIP trajectory group of men and women. Cox proportional hazards regression models were used to analyze the association of AIP trajectories with the risk of hypertension.Results:Four AIP trajectory groups (low level group, low gain group, medium gain group and high gain group) were identified in both male and female subjects, with the highest incidence of hypertension in the low gain group (38.18% in females and 40.92% in males). After adjusting for all confounders, the risk of hypertension was positively associated with increased AIP trajectories in the low ( HR=1.29, 95% CI: 1.02-1.63), medium ( HR=1.66, 95% CI: 1.23-2.23), and high ( HR=1.89, 95% CI: 1.26-2.85) gain groups in women; the risk of hypertension was positively associated with increased AIP trajectories in only the high gain group in men ( HR=1.33, 95% CI: 1.01-1.74). Conclusion:Elevated AIP trajectory is positively correlated with the risk of hypertension in health examination population.

Purpose: The long-term fertility impact of cancer treatments is a significant concern for young breast cancer survivors. These reproductive concerns often become a persistent source of stress, negatively affecting their quality of life. This study aims to explore the reproductive concerns experienced by young breast cancer survivors post-treatment and the factors influencing their perceptions. Methods: This phenomenological study utilized semi-structured interviews to collect data. Eighteen participants were recruited from a tertiary hospital in Mainland China. The interviews were transcribed verbatim and analyzed using Colaizzi's method. Results: Data analysis revealed five themes and fourteen subthemes: (1) multiple emotional burdens interwoven with concerns about fertility; (2) concerns about risks associated with reproduction; (3) dilemma of childrearing; (4) the significance of reproduction; (5) support needs from family, peers, and professionals. Conclusion Young breast cancer survivors in China face significant challenges related to reproductive issues. Reproductive health is a crucial aspect of breast cancer survivorship care. Healthcare providers must be attentive to the reproductive concerns of survivors, recognize the importance of multidimensional support for positive adaptation, and offer tailored and ongoing interventions to manage reproductive health in young breast cancer survivors.

Purpose: The long-term fertility impact of cancer treatments is a significant concern for young breast cancer survivors. These reproductive concerns often become a persistent source of stress, negatively affecting their quality of life. This study aims to explore the reproductive concerns experienced by young breast cancer survivors post-treatment and the factors influencing their perceptions. Methods: This phenomenological study utilized semi-structured interviews to collect data. Eighteen participants were recruited from a tertiary hospital in Mainland China. The interviews were transcribed verbatim and analyzed using Colaizzi's method. Results: Data analysis revealed five themes and fourteen subthemes: (1) multiple emotional burdens interwoven with concerns about fertility; (2) concerns about risks associated with reproduction; (3) dilemma of childrearing; (4) the significance of reproduction; (5) support needs from family, peers, and professionals. Conclusion Young breast cancer survivors in China face significant challenges related to reproductive issues. Reproductive health is a crucial aspect of breast cancer survivorship care. Healthcare providers must be attentive to the reproductive concerns of survivors, recognize the importance of multidimensional support for positive adaptation, and offer tailored and ongoing interventions to manage reproductive health in young breast cancer survivors.

Purpose: The long-term fertility impact of cancer treatments is a significant concern for young breast cancer survivors. These reproductive concerns often become a persistent source of stress, negatively affecting their quality of life. This study aims to explore the reproductive concerns experienced by young breast cancer survivors post-treatment and the factors influencing their perceptions. Methods: This phenomenological study utilized semi-structured interviews to collect data. Eighteen participants were recruited from a tertiary hospital in Mainland China. The interviews were transcribed verbatim and analyzed using Colaizzi's method. Results: Data analysis revealed five themes and fourteen subthemes: (1) multiple emotional burdens interwoven with concerns about fertility; (2) concerns about risks associated with reproduction; (3) dilemma of childrearing; (4) the significance of reproduction; (5) support needs from family, peers, and professionals. Conclusion Young breast cancer survivors in China face significant challenges related to reproductive issues. Reproductive health is a crucial aspect of breast cancer survivorship care. Healthcare providers must be attentive to the reproductive concerns of survivors, recognize the importance of multidimensional support for positive adaptation, and offer tailored and ongoing interventions to manage reproductive health in young breast cancer survivors.

ObjectiveTo investigate the regulatory effect and molecular mechanism of berberine （BBR） on lipophagy in the prevention and treatment of atherosclerotic （AS） lesions in mice. MethodFifty apolipoprotein E-knockout （ApoE^-/-） mice were randomly divided into an AS model group， an atorvastatin group （5 mg·kg^-1）， and low-， medium-， and high-dose BBR groups （2.5， 5， 10 mg·kg^-1）. Ten C57BL/6J mice were assigned to the control group. After 12 weeks， hematoxylin-eosin （HE） and oil red O staining were performed to assess the histopathological changes of AS plaques in the aorta. Biochemical analysis was used to measure serum lipid levels， and enzyme-linked immunosorbent assay （ELISA） was employed to measure the levels of inflammatory cytokines interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α）， oxidative stress marker reactive oxygen species （ROS）， and serum lipophagy marker Beclin1 and microtubule-associated protein 1 light chain 3 Ⅱ （LC3Ⅱ）. The xanthine oxidase method was used to measure serum superoxide dismutase （SOD） activity. Immunohistochemistry （IHC） was used to detect the distribution of wingless-type MMTV integration site family member 5a （Wnt5a） and Nieman Pick type C1 （NPC1） in the aorta， and Western blot was used to determine the protein expression of Wnt5a and NPC1 in the aorta. ResultCompared with the control group， the AS model group showed significant AS plaque formation， significantly elevated levels of serum total cholesterol （TC）， triglycerides （TG）， low-density lipoprotein cholesterol （LDL-C）， IL-6， TNF-α， and ROS， aortic Wnt5a distribution and protein expression （P<0.01）， and significantly reduced levels of serum high-density lipoprotein cholesterol （HDL-C）， SOD， Beclin1， LC3Ⅱ， and aortic NPC1 distribution and protein expression （P<0.01）. Compared with the AS model group， the atorvastatin group， and high- and medium-dose BBR groups showed a significant reduction in AS plaque area （P<0.05， P<0.01）， significantly decreased levels of serum TC， TG， LDL-C， IL-6， TNF-α， ROS， and aortic Wnt5a distribution and protein expression （P<0.05， P<0.01）， and significantly increased levels of serum HDL-C， SOD， Beclin1， LC3Ⅱ， and aortic NPC1 distribution and protein expression （P<0.05， P<0.01）. There was no statistically significant difference in the above indicators between the atorvastatin group and the medium-dose BBR group. ConclusionBBR can competitively bind to Wnt5a to activate NPC1 expression， upregulate lipophagy levels， reduce blood lipids， and inhibit the release of inflammatory mediators and oxidative stress damage， thereby exerting a preventive and therapeutic effect on AS.

Objective:To explore the relationship between challenge-hindrance stressors and thriving at work in clinical nurses, and to analyze the mediating role of intrinsic motivation.Methods:This was a cross-sectional survey. A total of 319 nurses from the Provincial Hospital Affiliated to Shandong First Medical University, Qilu Hospital of Shandong University, Shandong Provincial Qianfoshan Hospital from May to June 2022 were investigated by general data questionnaire, Challenge-Hindrance Stressors Scale, Intrinsic Motivation Scale and Thriving At Work Scale. Pearson was used to analyze the correlation between various variables, and Amos 23.0 was used to construct a structural equation model to analyze the mediating role of intrinsic motivation between challenging stressors, hindrance stressors, and thriving at work.Results:The score for challenging stressors was (21.22 ± 4.42) points, the score for hindrance stressors was (13.51 ± 3.59) points, the score for intrinsic motivation was (78.96 ± 11.52) points, and the score for thriving at work was (51.27 ± 8.03) points. Challenging stressors was positively associated with intrinsic motivation and thriving at work ( r=0.222, 0.221, both P<0.01), hindrance stressors was negatively associated with intrinsic motivation and thriving at work ( r=-0.152, -0.337, both P<0.01), intrinsic motivation was positively correlated with thriving at work ( r=0.564, P<0.01). Intrinsic motivation was partially mediated between challenging stressors, hindrance stressors and thriving at work, respectively accounting for 16.02% and 13.79%. Conclusions:Challenging stressors and hindrance stressors can indirectly influence their thriving at work through intrinsic motivation. Nursing managers should help nurses treat different stressors correctly to enhance their intrinsic motivation and promote their thriving at work.