Objective This paper focuses on the manufacturing technique of bubble microneedles and temperature-sensitive materials in order to design and prepare a temperature-sensitive reservoir microneedle.The objective is to evaluate the feasibility of addressing the issue of low drug load in traditional Chinese medicine(TCM)external preparations using microneedles.Methods The study involved the utilization of sinomenine hydrochloride as the model drug.The drug,along with the temperature-sensitive material N-isopropylacrylamide,was filled into the cavity of the bubble microneedle made from chitosan.Through positioning and curing processes,a temperature-sensitive sinomenine hydrochloride reservoir microneedle was prepared.The microneedle consisted of a needle body,a positioning layer,a basal layer,and a drug reservoir.The drug load,size,length,mechanical properties,and puncture ability of the prepared reservoir microneedle were measured to characterize and evaluate its drug load and mechanical properties.In addition,the in vitro release characteristics of the microneedles were determined using Franz diffusion cells,while the in vivo release characteristics were evaluated using the percutaneous microdialysis technique.Results The research result demonstrated that the prepared temperature-sensitive reservoir microneedle had a drug load of approximately 5.76 mg/cm2.The exposed needle tip had a conical shape with a height of around 650 μm,exhibiting good mechanical strength and skin puncture ability.The in vitro release tests showed that the microneedle could simulate the temperature of the skin and release the drug in a controlled and gradual manner,displaying characteristics of diffusion and dissolution of the skeleton.Furthermore,compared to conventional external preparations,the reservoir microneedles significantly enhanced transdermal permeation of the drug in the in vivo percutaneous studies.Conclusion The study demonstrated that reservoir-type microneedles prepared using temperature-sensitive materials and bubble microneedle preparation techniques could significantly increase the drug load of microneedles,providing the advantage of microinvasion.

Objective In order to address the issues of inconvenience,high medical costs,and lack of universality associated with traditional knee rehabilitation equipment,a portable intelligent wheelchair for knee rehabilitation was designed in this study.Methods Based on the analysis of the knee joint's structure and rehabilitation mechanisms,an electric pushrod-driven rehabilitation institution was developed.A multi-functional module was designed with a modular approach,and the control of the wheelchair body and each functional module was implemented using an STM32 single-chip microcomputer.A three-dimensional model was established using SolidWorks software.In conjunction with Adams and Ansys simulation software,kinematic and static analyses were conducted on the knee joint rehabilitation institution and its core components.A prototype was constructed to verify the equipment's actual performance.Results According to the prototype testing,the actual range of motion for the knee joint swing rod is 15.1°～88.9°,the angular speed of the swing rod ranges from-7.9 to 8.1°/s,the angular acceleration of the swing rod varies from-4.2 to 1.6°/s2,the thrust range of the electric pushrod is-82.6 to 153.1 N,and the maximum displacement of the load pedal is approximately 1.7 mm,with the leg support exhibiting a maximum deformation of about 1.5 mm.Conclusion The intelligent knee joint rehabilitation wheelchair meets the designed functions and its actual performance aligns with the design criteria,thus validating the rationality and feasibility of the structural design.

Objective:To investigate the depersonalization status and to analyze the effect of workplace incivility perception, intrusive rumination and fear of negative evaluation on depersonalization in clinical nurses.Methods:In May 2019, 10 cities were selected as sampling cities by the method of grabbing random ball in Henan Province and Fujian Province. Using the stratified sampling, clinical nurses were selected as the research objects for a questionnaire survey in 22 tertiary hospitals and 23 secondary hospitals, included 1200 nurses. A total of 1200 questionnaires were issued and collected, and 1159 valid questionnaires were collected with effective recovery of 96.6%. Clinical nurses were investigated by Workplace Incivility Scale, Event Related Rumination Inventory, Fear of Negative Evaluation Scale, Maslach Burnout Inventory-General Survey. The demographic characteristics of nurses' depersonalization were compared and analyzed with t test and single factor analysis of variance. The influence mechanism of workplace incivility perception, intrusive rumination and fear of negative evaluation on depersonalization was analyzed with Bootstrap. Results:Depersonalization scores were (9.3±2.6) points, 467 of those had depersonalization symptoms in clinical nurses (40.3%). The scores of depersonalization of those with <3 years of service [ (10.5±2.9) points] was higher than those with 3-10 years [ (9.1±2.8) points] and 11-31 years [ (9.0±2.9) points]. The scores of depersonalization of those with monthly earning of <3000 yuan [ (10.1±2.8) points] was higher than those with 3000-7999 yuan [ (8.4±2.7) points] and 8000-12000 yuan [ (8.0±2.9) points]. The scores of depersonalization of clinical nurses in surgical departments [ (10.0±2.9) points] was higher than those in non-surgical departments [ (8.7±2.6) points]. The scores of depersonalization of clinical nurses in tertiary hospitals [ (10.0±2.7) points] was higher than those in secondary hospitals [ (8.6±2.8) points]. The differences were statistically significant ( P<0.05). Workplace incivility perception affected depersonalization through the single mediating role of intrusive rumination, fear of negative evaluation and the chain mediating role of intrusive rumination and fear of negative evaluation ( β=0.16, 0.17, 0.07, 95% CI: 0.15-0.20, 0.15-0.21, 0.03-0.09, P<0.05) . Conclusion:Workplace incivility perception directly or through the independent mediating effects of intrusive rumination or fear of negative evaluation, and the chain mediating effects of intrusive rumination and fear of negative evaluation influences the depersonalization of clinical nurses.

To analyze simulated patient studies and their developmental trajectory, a comprehensive review was conducted using VOS viewer software. PubMed and CNKI databases were searched for 4 164 articles related to simulated patients. By creating keyword clouds and comparison tables, the current status and development trends of simulated patient studies at home and abroad were analyzed, and visual analysis was conducted based on these findings. Additionally, the analysis encompassed various metrics such as the number of published articles, journals, authors, and institutions involved. The findings reveal that the simulated patient studies focus on education, examination, and communication. Chinese studies on simulated patients initially demonstrated an upward trend but followed with a decline, whereas English studies have exhibited a steady upward trajectory. The application of simulated patients spans diverse fields including diagnostics, internal medicine, surgery, and medical practitioner exams, thereby greatly contributing to the advancement of medical education. It is anticipated that the number of simulated patient studies will continue to surge in the upcoming years.

Background::Although the treatment of peripheral T-cell lymphoma (PTCL) has undergone advancements during the past several years, the response rate and long-term effects with respect to patients with PTCL remain unsatisfactory—particularly for relapsed or refractory (R/R) patients. This phase II trial was designed to explore the efficacy and safety of an all-oral regimen of chidamide plus prednisone, cyclophosphamide, and thalidomide (CPCT) for R/R PTCL patients who could not tolerate the standard chemotherapy for a variety of reasons.Methods::We conducted a multicenter phase II clinical trial in which we combined chidamide (30 mg twice weekly) with prednisone (20 mg daily after breakfast), cyclophosphamide (50 mg daily after lunch), and thalidomide (100 mg daily at bedtime) (the CPCT regimen) for a total of fewer than 12 cycles as an induction-combined treatment period, and then applied chidamide as single-drug maintenance. Forty-five patients were ultimately enrolled from August 2016 to April 2021 with respect to Chinese patients at nine centers. Our primary objective was to assess the overall response rate (ORR) after the treatment with CPCT.Results::Of the 45 enrolled patients, the optimal ORR and complete response (CR)/CR unconfirmed (CRu) were 71.1% (32/45) and 28.9% (13/45), respectively, and after a median follow-up period of 56 months, the median progression-free survival (PFS) and overall survival (OS) were 8.5 months and 17.2 months, respectively. The five-year PFS and OS rates were 21.2% (95% confidence interval [CI], 7.9-34.5%) and 43.8% (95% CI, 28.3-59.3%), respectively. The most common adverse event was neutropenia (20/45, 44.4%), but we observed no treatment-related death.Conclusion::The all-oral CPCT regimen was an effective and safe regimen for R/R PTCL patients who could not tolerate standard chemotherapy for various reasons.Trial Registration::ClinicalTrials.gov, NCT02879526.

Objective:To investigate the depersonalization status and to analyze the effect of workplace incivility perception, intrusive rumination and fear of negative evaluation on depersonalization in clinical nurses.Methods:In May 2019, 10 cities were selected as sampling cities by the method of grabbing random ball in Henan Province and Fujian Province. Using the stratified sampling, clinical nurses were selected as the research objects for a questionnaire survey in 22 tertiary hospitals and 23 secondary hospitals, included 1200 nurses. A total of 1200 questionnaires were issued and collected, and 1159 valid questionnaires were collected with effective recovery of 96.6%. Clinical nurses were investigated by Workplace Incivility Scale, Event Related Rumination Inventory, Fear of Negative Evaluation Scale, Maslach Burnout Inventory-General Survey. The demographic characteristics of nurses' depersonalization were compared and analyzed with t test and single factor analysis of variance. The influence mechanism of workplace incivility perception, intrusive rumination and fear of negative evaluation on depersonalization was analyzed with Bootstrap. Results:Depersonalization scores were (9.3±2.6) points, 467 of those had depersonalization symptoms in clinical nurses (40.3%). The scores of depersonalization of those with <3 years of service [ (10.5±2.9) points] was higher than those with 3-10 years [ (9.1±2.8) points] and 11-31 years [ (9.0±2.9) points]. The scores of depersonalization of those with monthly earning of <3000 yuan [ (10.1±2.8) points] was higher than those with 3000-7999 yuan [ (8.4±2.7) points] and 8000-12000 yuan [ (8.0±2.9) points]. The scores of depersonalization of clinical nurses in surgical departments [ (10.0±2.9) points] was higher than those in non-surgical departments [ (8.7±2.6) points]. The scores of depersonalization of clinical nurses in tertiary hospitals [ (10.0±2.7) points] was higher than those in secondary hospitals [ (8.6±2.8) points]. The differences were statistically significant ( P<0.05). Workplace incivility perception affected depersonalization through the single mediating role of intrusive rumination, fear of negative evaluation and the chain mediating role of intrusive rumination and fear of negative evaluation ( β=0.16, 0.17, 0.07, 95% CI: 0.15-0.20, 0.15-0.21, 0.03-0.09, P<0.05) . Conclusion:Workplace incivility perception directly or through the independent mediating effects of intrusive rumination or fear of negative evaluation, and the chain mediating effects of intrusive rumination and fear of negative evaluation influences the depersonalization of clinical nurses.

Objective:To explore the value of baseline PET/CT parameters for predicting prognosis in patients with double-expression lymphoma (DEL).Methods:The clinical and 18F-FDG PET/CT data of 118 patients (66 males, 52 females; age: 28-85 years) with diffuse large B-cell lymphoma (DLBCL) diagnosed in Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University and the First Affiliated Hospital of Nanjing Medical University from June 2015 to September 2022 were retrospectively analyzed. The optimal thresholds for SUV max, total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) in predicting overall survival (OS) rate were determined using ROC curve analysis. Univariate and multivariate analyses, along with Kaplan-Meier survival analysis were performed to construct a survival prediction model. The effect of the model was evaluated by the calibration curve for the model, the time-dependent ROC curve analysis and decision curve analysis. Results:As of the last follow-up, 25 patients died, and the OS rate was 78.8%(93/118). The AUC of the ROC curve for TMTV was 0.705, with a corresponding optimal threshold of 230.9 cm 3. In multivariate analysis, Eastern Cooperative Oncology Group performance status (ECOG PS) score (hazard ratio ( HR)=3.886, 95% CI: 1.455-10.375; P=0.007) and TMTV ( HR=4.649, 95% CI: 1.665-12.979; P=0.003) were identified as independent predictors of OS. The combined model of ECOG PS score and TMTV was superior to ECOG PS score model and TMTV model alone in predicting OS. Conclusion:TMTV, a metabolic indicator, and ECOG PS score, a clinical risk factor, are independent predictors of OS in patients with DEL, and their combination can provide more accurate prognostic predictions.

Objective:To explore the effect of health education based on outcome-based concept on self-management ability and glycemic control in hospitalized patients with type 2 diabetes melittus (T2DM).Methods:A total of 103 T2DM patients admitted in the Endocrinology Department of 903 Hospital of PLA from March 2022 to September 2022 were recruited and randomly divided into study group ( n=52) and control group ( n=51). Routine health education was given to all patients, while additional outcome-based health education was provided by diabetes specialist nurses for the study group during hospitalization. At 12 weeks after discharge, the self-management ability and glycemic control were compared between the two groups. Results:At 12 weeks after discharge, patients in the study group had significantly better self-management ability (dietary control: (4.06±0.75) vs. (3.70±0.88), t=2.50, regular exercise: (3.88±0.62) vs. (3.52±0.94), t=2.30, medical compliance: (4.47±0.51) vs. (4.12±0.64), t=3.14, self blood glucose monitoring: (3.43±0.87) vs. (2.94±0.95), t=2.71, foot care: (3.56±0.57) vs. (2.77±0.87), t=5.42, and management of hyper or hypoglycemia:(3.65±0.72) vs. (3.24±0.96), t=2.48); glycemic control (fasting blood glucose: (6.31±0.90) vs. (6.88±1.37)mmol/L, t=-2.46, 2-h postprandial blood glucose: (8.39±1.64) vs. (9.27±2.50)mmol/L, t=-2.11, HbA1c: (6.76±0.98)% vs. (7.17±0.93)%, t=-2.22). The control rate of HbA1c in the study group was significantly higher and the incidence of hypoglycemia was significantly lower than those in the control group (78.8%(41/52) vs. 58.8%(30/51), χ 2=4.82 and 11.5%(6/52) vs. 29.4%(15/51), χ 2=5.07, respectively). Conclusions:The outcome-based health education can effectively enhance self-management ability and glycemic control in hospitalized type 2 diabetic patients.

Objective:To scope review of studies on the risk factors for vessel catheter associated infection in children with intestinal failure was reviewed, so as to provide a reference for clinical medical staff to prevent and control infection.Methods:Based on the framework of scope review method, PubMed, Embase, CINAHL, APA PsycInfo, Web of Science, Scopus, Cochrane Library, China Biomedical Literature Database, China Knowledge Networkand Wanfang database are retrieved. The retrieval period was from the database construction to February 1, 2022. The included literatures were Summarized and analyzed.Results:A total of 28 articles were included, and the risk factors of vessel catheter associated infection in children with intestinal failure were found to include 7 aspects: basic information of children, catheter nursing measures, type of tube-sealing solution, catheter factors, residual intestinal condition of children, nursing level of caregivers, therapeutic factors.Conclusions:The risk factors of vessel catheter associated infection in children with intestinal failure were found to include 7 aspects, which are complex and diverse with distinctive disease characteristics. In the future, medical staff can optimize the pipeline nursing measures; construct the model of cross-specialty health education and improve the nursing level of caregivers to reduce the incidence of vessel catheter associated infection.

Objective: To study the relationship between compassion fatigue and workplace psychological violence, alexithymia, and empathy in clinical nurses. Methods: A total of 1 159 clinical nurses from 10 cities in Henan and Fujian Provinces were enrolled using the method of grabbing random balls. Questionnaires including Workplace Psychologically Violent Behaviors Instrument, the Toronto Alexithymia Scale, Jefferson Scale of Empathy Health Professionals, Professional Quality of Life Scale were used to investigate the status of workplace psychological violence, alexithymia, empathy, and compassion fatigue in participants. Bootstrap analysis was used to analyze the relationship between workplace psychological violence, alexithymia, empathy, and compassion fatigue scores. Results: The average score for workplace psychological violence among clinical nurses was (26.2±6.5), with 405 nurses (34.9%) having experienced workplace psychological violence. The scores for alexithymia, empathy and compassion fatigue were (58.3±12.3), (104.3±18.6) and (48.5±6.7) respectively. Mild compassion fatigue was detected in 34.9% of participants, while moderate to severe compassion fatigue accounted for 48.8%. Bootstrap test result showed that workplace psychological violence had a positive impact on compassion fatigue ［standardized effect value (β)=0.40, 95% confidence interval(CI)： 0.35-0.44］. Workplace psychological violence had separate mediating effects through alexithymia (β=0.15, 95%CI： 0.10-0.19), empathy (β=0.16, 95%CI： 0.10-0.21) , and a chain mediating effect through alexithymia and empathy on compassion fatigue (β=0.06, 95%CI： 0.03-0.09). Conclusion: Compassion fatigue symptoms are relatively common among clinical nurses. Experiencing workplace psychological violence directly affects compassion fatigue and can indirectly affect it through the mediating effects of alexithymia and empathy.