Objective:To explore the influencing factors of stigma and to construct a nomogram model for stigma perceptionin enterostomy patients. The basis for prevention of stigmatization in enterostomy patients.Methods:This was a prospective survey. By convenient sampling, 300 with enterostomy patients from the stoma clinic of the Sixth Medical Center of PLA General Hospital from March 2022 to July 2023 were investigated. Univariate analysis and logistic regression were explored the risk factors of stigma.R 4.2.2 software was constructed a nomogram to achieve the visualization display. Using receiver operating characteristic curve, Hosmer-Leme show test and calibration curves tested model predictive performance.Results:Totally 284 valid questionnaires were ultimately collected, including 161 males and 123 females. There were 21 cases aged 20-40, 117 cases aged 41-60, and 146 cases aged 60 and above. The incidence of stigma among 284 patients was 69.37% (197/284). Predictive model was constructed and validated based on six risk factors: fecal status ( OR=0.63, 95% CI 0.42-0.95), level of accept from spouse ( OR=0.56, 95% CI 0.34-0.94), body image change ( OR=0.51, 95% CI 0.28-0.91), effectiveness of WeChat platform ( OR=0.31, 95% CI 0.13-0.78), support from friends ( OR=0.34, 95% CI 0.14-0.82), confidence diet ( OR=0.37, 95% CI 0.19-0.71). The area under the ROC curve of the modeling group was 0.837, with a sensitivity of 0.923 and a specificity of 0.649. The area under the ROC curve of the validation group was 0.841, with a sensitivity of 0.846 and a specificity of 0.740. Conclusions:This study had a good prediction effect in constructing a model. The model can provide reference for medical staff to quickly identify the risk of stigma and in a timely manner take preventive management measuresin enterostomy patients.

Objective To explore the track of professional identity of undergraduate nursing students,so as to provide reference for improving their professional identity and reducing the brain drain of nursing students.Methods In-depth interviews were conducted with 12 undergraduate nursing students,and the data were analyzed by grounded theory.Results One core category is the track of professional identity,and five categories are the reasons of major choice,inherent professional cognition,systematic learning improvement,practical experience change and career choice inclination.Conclusion Inherent professional cognition may run through all stages of nursing stu-dents'professional identity.Systematic study and clinical practice will change nursing students'professional iden-tity,and professional identity is no longer a sufficient and necessary condition for determining nursing students'career choice.Nursing educators and nursing managers should understand the track of nursing students'profes-sional identity,improve their professional identity,reduce the brain drain of nursing talents and promote the stabili-ty of nurses.

Objective To explore the track of professional identity of undergraduate nursing students,so as to provide reference for improving their professional identity and reducing the brain drain of nursing students.Methods In-depth interviews were conducted with 12 undergraduate nursing students,and the data were analyzed by grounded theory.Results One core category is the track of professional identity,and five categories are the reasons of major choice,inherent professional cognition,systematic learning improvement,practical experience change and career choice inclination.Conclusion Inherent professional cognition may run through all stages of nursing stu-dents'professional identity.Systematic study and clinical practice will change nursing students'professional iden-tity,and professional identity is no longer a sufficient and necessary condition for determining nursing students'career choice.Nursing educators and nursing managers should understand the track of nursing students'profes-sional identity,improve their professional identity,reduce the brain drain of nursing talents and promote the stabili-ty of nurses.

Since the first operational definition of cognitive frailty was proposed by the expert consensus group of the International Academy of Nutrition and Aging and the International Association of Gerontology and Geriatrics in 2013, frailty and neurocognitive assessment has become the standard diagnostic tool.Since then, the reported prevalence in the literature for cognitive frailty in community-dwelling elderly people vary by dozens of times, as a result of different scales and diagnostic cut-off points, seriously affecting health decision-making.This article reviewed the current literature with a focus on the re-recognition of the clinical significance of cognitive frailty, the limitations of existing assessment tools for diagnosis, and possible solutions in the future.

Objective:To compare the surgical outcomes of robotic natural orifice specimen extraction surgery (NOSES) and robotic-assisted radical resection for rectal cancer.Methods:A retrospective analysis using propensity score matching (PSM) was conducted on 547 patients who had undergone radical resection of rectal cancer at the First Affiliated Hospital of Nanchang University from June 2018 to March 2024. The study cohort comprised 157 patients in the robotic NOSES group and 390 in the robotic-assisted group. PSM was used in a 1:1 manner to match relevant general clinical preoperative data of the study patients (age, sex, body mass index, preoperative comorbidities, abnormal preoperative carcinoembryonic antigen (>6.5 μg/L) and carbohydrate antigen 19-9 levels (>27 kU/L), preoperative American Society of Anesthesiologists score, tumor diameter, tumor distance from the anal margin, and TNM stage), with a clamp value of 0.05. After performing PSM to match the general clinical data of the two groups of patients, 77 patients in each of the robotic NOSES and robotic-assisted groups were included in the analysis. We found no statistically significant difference in preoperative general clinical data between the robot NOSES and robot-assisted groups ( P>0.05). We compared the surgical outcomes, postoperative recovery, postoperative pathological data, and incidence of complications between the robotic NOSES and robot-assisted groups. Results:Compared with the robot-assisted groups. the robot NOSES group had a significantly shorter time to first postoperative passage of flatus (48 [38, 50] hours vs. 56 [50, 60] hours, Z=-7.513, P<0.001), time to taking a liquid diet (60 [54,63] hours vs. 66 [62, 72] hours, Z=-6.303, P<0.001), lower pain scores (3 [3, 4] vs. 4 [4, 5], Z=-5.237, P<0.001), and lower incision infection rates (0 vs. 5 [6.5%], χ 2=5.237, P=0.028) within 24 hours after surgery ( P<0.05). However, there were no significant differences in surgical time, intraoperative blood loss, postoperative hospital stay, postoperative anastomotic complications, or incidence of other complications between the two groups (all P>0.05). Conclusion:Robotic NOSES surgery is a safe and feasible procedure for resecting rectal cancer and postoperative recovery is faster after robotic NOSES than after standard robot-assisted surgery.

Objective To retrospectively analyze the efficacy and safety of abatacept(ABA)in anti citrullinated peptide antibody(ACPA)positive rheumatoid arthritis(RA).Methods Clinical data from ACPA positive RA patients who visited the Department of Rheumatology and Immunology at the Second Hospital of Hebei Medical University from May 2020 to January 2023 and were treated with ABA were retrospectively collected and analyzed,to evaluate the efficacy and safety of ABA at 12 weeks and 24 weeks of treatment.Efficacy evaluation measures included RA disease activity score-28(DAS-28),clinical disease activity index(CDAI),and remission criteria of RA of American College of Rheumatology(ACR).Results A total of 35 ACPA-positive RA patients were included in the final analysis.The DAS-28,CDAI,ACR20,ACR50,and ACR70 remission rates at 12 weeks after treatment were 34.29%,31.43%,60.00%,28.57%,and 14.29%,respectively;the DAS-28,CDAI,ACR20,ACR50,and ACR70 remission rates at 24 weeks after treatment were 74.29%,82.86%,85.71%,54.29%,and 31.43%,respectively;in addition,the remission rate at 24 weeks was significantly higher than that at 12 weeks(P﹤0.05).Among the 35 patients included in the analysis,4 patients experienced respiratory tract infections,3 patients experienced transient creatinine elevation,and 4 patients experienced elevated blood uric acid.Conclusion In the real world,ABA's clinical remission rate is consistent with expectations,and clinical combination drug regimens are flexible and diverse,with high drug safety.

Caloric restriction (CR) is a well-established dietary intervention known to extend healthy lifespan and exert positive effects on aging-related diseases, including cardiovascular conditions. Sirtuins, a family of nicotinamide adenine dinucleotide (NAD +)-dependent histone deacetylases, have emerged as key regulators of cellular metabolism, stress responses, and the aging process, serving as energy status sensors in response to CR. However, the mechanism through which CR regulates Sirtuin function to ameliorate cardiovascular disease remains unclear. This review not only provided an overview of recent research investigating the interplay between Sirtuins and CR, specifically focusing on their potential implications for cardiovascular health, but also provided a comprehensive summary of the benefits of CR for the cardiovascular system mediated directly via Sirtuins. CR has also been shown to have considerable impact on specific metabolic organs, leading to the production of small molecules that enter systemic circulation and subsequently regulate Sirtuin activity within the cardiovascular system. The direct and indirect effects of CR offer a potential mechanism for Sirtuin modulation and subsequent cardiovascular protection. Understanding the interplay between CR and Sirtuins will provide new insights for the development of interventions to prevent and treat cardiovascular diseases.

Objective To explore the track of professional identity of undergraduate nursing students,so as to provide reference for improving their professional identity and reducing the brain drain of nursing students.Methods In-depth interviews were conducted with 12 undergraduate nursing students,and the data were analyzed by grounded theory.Results One core category is the track of professional identity,and five categories are the reasons of major choice,inherent professional cognition,systematic learning improvement,practical experience change and career choice inclination.Conclusion Inherent professional cognition may run through all stages of nursing stu-dents'professional identity.Systematic study and clinical practice will change nursing students'professional iden-tity,and professional identity is no longer a sufficient and necessary condition for determining nursing students'career choice.Nursing educators and nursing managers should understand the track of nursing students'profes-sional identity,improve their professional identity,reduce the brain drain of nursing talents and promote the stabili-ty of nurses.

Objective To explore the track of professional identity of undergraduate nursing students,so as to provide reference for improving their professional identity and reducing the brain drain of nursing students.Methods In-depth interviews were conducted with 12 undergraduate nursing students,and the data were analyzed by grounded theory.Results One core category is the track of professional identity,and five categories are the reasons of major choice,inherent professional cognition,systematic learning improvement,practical experience change and career choice inclination.Conclusion Inherent professional cognition may run through all stages of nursing stu-dents'professional identity.Systematic study and clinical practice will change nursing students'professional iden-tity,and professional identity is no longer a sufficient and necessary condition for determining nursing students'career choice.Nursing educators and nursing managers should understand the track of nursing students'profes-sional identity,improve their professional identity,reduce the brain drain of nursing talents and promote the stabili-ty of nurses.

Objective To explore the track of professional identity of undergraduate nursing students,so as to provide reference for improving their professional identity and reducing the brain drain of nursing students.Methods In-depth interviews were conducted with 12 undergraduate nursing students,and the data were analyzed by grounded theory.Results One core category is the track of professional identity,and five categories are the reasons of major choice,inherent professional cognition,systematic learning improvement,practical experience change and career choice inclination.Conclusion Inherent professional cognition may run through all stages of nursing stu-dents'professional identity.Systematic study and clinical practice will change nursing students'professional iden-tity,and professional identity is no longer a sufficient and necessary condition for determining nursing students'career choice.Nursing educators and nursing managers should understand the track of nursing students'profes-sional identity,improve their professional identity,reduce the brain drain of nursing talents and promote the stabili-ty of nurses.