Objective To analyze the differences in distribution of traditional Chinese medicine (TCM) syndrome elements and salivary microbiota between the individuals with pulmonary nodules and those without, and to explore the potential correlation between the distribution of TCM syndrome elements and salivary microbiota in patients with pulmonary nodules. Methods We retrospectively recruited 173 patients with pulmonary nodules (PN) and 40 healthy controls (HC). The four diagnostic information was collected from all participants, and syndrome differentiation method was used to analyze the distribution of TCM syndrome elements in both groups. Saliva samples were obtained from the subjects for 16S rRNA high-throughput sequencing to obtain differential microbiota and to explore the correlation between TCM syndrome elements and salivary microbiota in the evolution of the pulmonary nodule disease. Results The study found that in the PN group, the primary TCM syndrome elements related to disease location were the lung and liver, and the primary TCM syndrome elements related to disease nature were yin deficiency and phlegm. In the HC group, the primary TCM syndrome elements related to disease location were the lung and spleen, and the primary TCM syndrome elements related to disease nature were dampness and qi deficiency. There were differences between the two groups in the distribution of TCM syndrome elements related to disease location (lung, liver, kidney, exterior, heart) and disease nature (yin deficiency, phlegm, qi stagnation, qi deficiency, dampness, blood deficiency, heat, blood stasis) (P<0.05). The species abundance of the salivary microbiota was higher in the PN group than that in the HC group (P<0.05), and there was significant difference in community composition between the two groups (P<0.05). Correlation analysis using multiple methods, including Mantel test network heatmap analysis and Spearman correlation analysis and so on, the results showed that in the PN group, Prevotella and Porphyromonas were positively correlated with disease location in the lung, and Porphyromonas and Granulicatella were positively correlated with disease nature in yin deficiency (P<0.05). Conclusion The study concludes that there are notable differences in the distribution of TCM syndrome elements and the species abundance and composition of salivary microbiota between the patients with pulmonary nodules and the healthy individuals. The distinct external syndrome manifestations in patients with pulmonary nodules, compared to healthy individuals, may be a cascade event triggered by changes in the salivary microbiota. The dual correlation of Porphyromonas with both disease location and nature suggests that changes in its abundance may serve as an objective indicator for the improvement of symptoms in patients with yin deficiency-type pulmonary nodules.

Objective:To construct the quality evaluation scale of specification of management for humanistic caring in outpatients and test its reliability and validity.Methods:Referring to the group standards in Specification of Management for Humanistic Caring in Outpatients released by the China Association for Life Care,as well as relevant guidelines and literature,a pool of items for the quality evaluation scale of specification of management for humanistic caring in outpatients was formed.After expert consultation and expert argumentation,a quality evaluation scale of specification of management for humanistic caring in outpatients was constructed.From January to February 2024,243 hospital managers from 5 hospitals in Zhengzhou were selected as survey subjects to conduct item analysis,and reliability and validity testing on the scale.Results:Two rounds of expert inquiry and two rounds of expert argumentation were conducted,with questionnaire response rates of 92.00%and 100.00%,respectively,and expert authority coefficients of 0.952.In the second round of the expert inquiry scale,the mean importance score of the first-level indicators was 4.80 to 5.00,the full score ratio was 88.00%to 100.00%,the coefficient of variation was 0.04 to 0.17,and Kendall's coefficient of concordance was 0.857(P＜0.001);the mean importance score of the second-level indicators was 4.60 to 5.00,the full score ratio was 80.00%to 100.00%,the coefficient of variation was 0.00 to 0.21,and Kendall's coefficient of concordance was 0.775(P＜0.001);the mean importance score of the third-level indicators was 4.60 to 5.00,the full score ratio was 76.00%to 100.00%,the coefficient of variation was 0.00 to 0.21,and Kendall's coefficient of concordance was 0.830(P＜0.001).Finally,a quality evaluation scale of specification of management for humanistic caring in outpatients was formed,including 5 first-level indicators,25 second-level indicators,and 58 third-level indicators.Exploratory factor analysis produced 5 common factors with a cumulative variance contribution rate of 74.628%.The Pearson correlation coefficients between the five-factor scores ranged from 0.648 to 0.798,and the correlation coefficients between the factor scores and the total score of the scale ranged from 0.784 to 0.938.The scale-level content validity index(S-CVI)of the scale was 0.945,the item-content validity index(I-CVI)was 0.725 to 1.000,the Cronbach's alpha coefficient of the total scale was 0.973,and the retest reliability coefficient was 0.934.Conclusion:The constructed quality evaluation scale of specification of management for humanistic caring in outpatients has good scientific validity and reliability,and can be used as an evaluation tool for specification of management for humanistic caring in outpatients.

Objective To investigate the clinical distribution,antimicrobial resistance,carbapenemase resistance genes,virulence genes,capsular serotypes and ST subtypes of carbapenem-resistant Klebsiella pneumoniae(CRKP)strains in intensive care unit of a tertiary hospital in Hunan Province for better management of CRKP infections.Methods CRKP strains were isolated from 8 intensive care units of the First People's Hospital of Chenzhou City from January 2020 to December 2021.The isolates were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and tested by VITEK Compact 2 for antimicrobial susceptibility.Carbapenemase phenotype was detected by modified carbapenem inactivation method(mCIM).The capsular serotypes were determined by wzi sequencing.Carbapenem resistance genes and virulence genes were identified by PCR and Sanger sequencing.The strains were also analyzed by multilocus sequence typing(MLST)in terms of ST subtypes.Results The 75 CRKP strains were mainly isolated from geriatric ICU(28.0％)and neurosurgery ICU(20.0％).Overall,6.7％(5/75)and 16.0％(12/75)of the CRKP strains were resistant to tigecycline and ceftazidime-avibactam,respectively.The CRKP strains(＞96.0％resistant)were highly resistant to carbapenems,cephalosporins,β-lactam/β-lactamase inhibitor combinations,and levofloxacin.PCR and sequencing analysis found blaKPC-2 gene in 61 strains(81.3％),blaNDM-1 gene in 11 strains(14.7％),blaNDM-5 gene in 1 strain(1.3％),and blaOXA-48 gene in 2 strains(2.7％).MLST revealed that ST11(54.7％,41/75),ST1883(13.3％,10/75),and ST307(6.7％,5/75)were the top three ST subtypes.All ST11 and ST1883 CRKP strains harbored blaKPC-2.KL64(38.7％,29/75)and KL47(25.3％,19/75)were the most prevalent capsular serotypes among the 75 CRKP strains.The most common virulence genes among these CRKP strains were rmpA2(48.0％,36/75),iroN(38.7％,23/75)and iucA(37.3％,15/75).Conclusions The CRKP strains isolated from the intensive care units were mainly ST11-KL64 and ST11-KL47 types.Most of the strains harbor blaKPC-2 and virulence gene,and associated with high level antimicrobial resistance.It is urgent to strengthen the monitoring of molecular epidemiological characteristics of CRKP in order to inform individualized and precision treatment of CRKP infections.

Objective:To explore the effectiveness of motor imagery training (MIT) on knee function, kinesiophobia, and functional exercise compliance in patients after knee replacement.Methods:From June 2022 to August 2023, convenience sampling was used to select patients who underwent knee replacement and were admitted to the Fourth Clinical College of Xinxiang Medical University as participants. The patients were divided into control group ( n=98 cases) and observation group ( n=98 cases) according to their enrollment time. The control group received routine postoperative rehabilitation, while the observation group was treated with MIT in addition to the control group. The knee function, kinesiophobia, and functional exercise compliance of two groups of patients were compared before and after intervention. Results:After intervention, in observation group, the Western Ontario and McMaster Universities Osteoarthritis Index score was lower than that in control group, the score of Hospital for Special Surgery was higher than that in control group, the Tampa Scale of Kinesiophobia score was lower than that in control group, and the compliance with functional exercise was higher than that in control group, with statistical differences ( P<0.05) . Conclusions:Applying MIT on the basis of rehabilitation training can alleviate the kinesiophobia in patients after knee replacement, improve their exercise compliance and knee function.

Objective:To summarize the best evidence for preventing and managing radiotherapy-induced oral mucositis in patients with head and neck cancer.Methods:The clinical decisions, best practices, guidelines, expert consensus, systematic reviews, and evidence summaries regarding the prevention and management of radiotherapy-induced oral mucositis in patients with head and neck cancer were retrieved from UpToDate, British Medical Journal (BMJ) Best Practice, Agency for Healthcare Research and Quality, Medlive, National Comprehensive Cancer Network, European Society for Medical Oncology, Cochrane Library, Joanna Briggs Institute (JBI) Evidence-Based Health Care Center Database, PubMed, Embase, Web of Science, China National Knowledge Infrastructure, WanFang Data, China Biology Medicine disc and so on. The search period was from database establishment to November 30, 2023.Results:A total of 18 articles were included, involving six guidelines, two expert consensus, eight systematic reviews, and two evidence summaries. Thirty-four best pieces of evidence were summarized from six aspects of assessment: drug prevention, non-drug prevention, anti-infection and analgesic management, health education, and multidisciplinary team management.Conclusions:This study summarizes the best evidence for preventing and managing radiotherapy-induced oral mucositis in patients with head and neck cancer. Medical and nursing staff should consider the patient's characteristics, disease condition, and willingness when selecting and applying evidence.

Information construction helps hospitals to accurately manage the blood glucose levels of hospitalized patients and improve the quality and safety of medical care. In July 2022, a large tertiary public hospital launched an information management of perioperative patient blood glucose. By establishing a multidisciplinary support and information management team, building an information-based blood glucose management system, establishing standardized management processes, implementing automatic hierarchical blood glucose warning, blood glucose critical value warning and control, abnormal blood glucose consultation, and insulin pump management, the hospital had achieved the information sharing of blood glucose perioperative patients, as well as timely warning and handling of abnormal blood glucose, ensuring patient safety. As of June 2023, the hospital had deployed a total of 364 intelligent blood glucose meters in clinical departments, and monitored blood glucose levels for 12 216 perioperative patients. The blood glucose compliance rate of perioperative patients increased from 81.81% in July 2022 to 82.95% in June 2023. This practice brought convenience to the work of clinical departments, improved the overall quality of medical services in hospitals, and could provide references for other hospitals to carry out blood glucose information management.

Purpose: To construct an index system to evaluate the competencies of nurses in enhanced recovery after surgery (ERAS) programs and provide a scientific foundation for their training and assessment. Methods: Utilizing a literature review and semi-structured interviews, a preliminary indicator system was constructed. Based on the preliminary indicator system, a Delphi questionnaire was developed and utilized to achieve consensus among experts in two rounds of Delphi studies. The indicators were selected based on a mean importance score greater than 4 and a coefficient of variation less than .25. The weights of the indicators were calculated using the Analytic Hierarchy Process. Results: The study developed a system that evaluates the competencies of nurses involved in ERAS programs, offering a reference for their training and evaluation. The final index system includes 7 primary indicators, 20 secondary indicators, and 66 tertiary indicators. The primary indicators consist of competencies in the following components: 1) Direct clinical practice (20 items); 2) Expert coaching and guidance (9 items); 3) Consultation (6 items); 4) Research (7 items); 5) Leadership (11 items); 6) Collaboration (8 items); and 7) Ethical decision-making (5 items). Conclusion The developed competency evaluation index system is reliable and can serve as a foundation for the selection, training, and assessment of ERAS nurses.

Purpose: To construct an index system to evaluate the competencies of nurses in enhanced recovery after surgery (ERAS) programs and provide a scientific foundation for their training and assessment. Methods: Utilizing a literature review and semi-structured interviews, a preliminary indicator system was constructed. Based on the preliminary indicator system, a Delphi questionnaire was developed and utilized to achieve consensus among experts in two rounds of Delphi studies. The indicators were selected based on a mean importance score greater than 4 and a coefficient of variation less than .25. The weights of the indicators were calculated using the Analytic Hierarchy Process. Results: The study developed a system that evaluates the competencies of nurses involved in ERAS programs, offering a reference for their training and evaluation. The final index system includes 7 primary indicators, 20 secondary indicators, and 66 tertiary indicators. The primary indicators consist of competencies in the following components: 1) Direct clinical practice (20 items); 2) Expert coaching and guidance (9 items); 3) Consultation (6 items); 4) Research (7 items); 5) Leadership (11 items); 6) Collaboration (8 items); and 7) Ethical decision-making (5 items). Conclusion The developed competency evaluation index system is reliable and can serve as a foundation for the selection, training, and assessment of ERAS nurses.

Purpose: To construct an index system to evaluate the competencies of nurses in enhanced recovery after surgery (ERAS) programs and provide a scientific foundation for their training and assessment. Methods: Utilizing a literature review and semi-structured interviews, a preliminary indicator system was constructed. Based on the preliminary indicator system, a Delphi questionnaire was developed and utilized to achieve consensus among experts in two rounds of Delphi studies. The indicators were selected based on a mean importance score greater than 4 and a coefficient of variation less than .25. The weights of the indicators were calculated using the Analytic Hierarchy Process. Results: The study developed a system that evaluates the competencies of nurses involved in ERAS programs, offering a reference for their training and evaluation. The final index system includes 7 primary indicators, 20 secondary indicators, and 66 tertiary indicators. The primary indicators consist of competencies in the following components: 1) Direct clinical practice (20 items); 2) Expert coaching and guidance (9 items); 3) Consultation (6 items); 4) Research (7 items); 5) Leadership (11 items); 6) Collaboration (8 items); and 7) Ethical decision-making (5 items). Conclusion The developed competency evaluation index system is reliable and can serve as a foundation for the selection, training, and assessment of ERAS nurses.

Objective To investigate the epidemiological characteristics of Salmonella infection in foodborne diseases in Shanxi Province, and to provide a scientific basis for the prevention and control of Salmonella infection. Methods Automatic microbial biochemical identification system was used to identify Salmonella , and descriptive epidemiological methods were used to analyze the characteristics of Salmonella infections in foodborne diseases in Shanxi Province from 2016 to 2021. Results The basic information of 10 037 cases of foodborne diseases and their Salmonella detection results were analyzed. The detection rate of Salmonella was 5.25%, and the main serotype was Salmonella enteritidis (209/522). The positive detection rate of Salmonella in the 0-10 years old age group was the highest (6.04%), and the difference was statistically significant (χ²= 19.23, P = 0.01). The positive detection rate of Salmonella in kindergarteners was the highest at 10.71%, and there was a significant difference in the positive detection rate among different occupations (χ²= 43.31, P < 0.05). The detection rate of bulk foods (5.16%) was higher than that of pre-packaged foods (3.70%), and the difference was statistically significant (χ²= 4.43, P = 0.04). Cases involving food stores had a higher Salmonella detection rate (9.54%), and the peak period of Salmonella infection was from May 24 to August 23. Conclusion The incidence of Salmonella infection in foodborne diseases is high in summer and autumn. Foods in food stores and bulk foods are more likely to cause Salmonella infection. Supervision and management of food stores should be strengthened, and special attention should be paid to children in kindergartens during the epidemic peak.