Objective:To summarize the best evidence for the management of fatigue-related symptom clusters in HIV/AIDS patients.Methods:According to the "6S" model, clinical decisions, guidelines, expert consensus, systematic reviews, Meta-analysis, evidence summary, and randomized controlled trials on the management of fatigue-related symptom clusters of HIV/AIDS patients were searched from top to bottom in BMJ Best Practice, UpToDate, Joanna Briggs Institute Evidence-Based Health Care Center Database, Agency for Healthcare Research and Quality, National Institute for Health and Clinical Excellence, Medlive, Joint United Nations Programme on HIV/AIDS, Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure, WanFang data, China Biology Medicine disc and other databases and websites. The search period was from January 1, 2017, to July 30, 2023. Two researchers independently used corresponding quality evaluation tools to evaluate the methodological quality of the included literature. They extracted and summarized the best evidence for the management of fatigue-related symptom clusters in HIV/AIDS patients.Results:A total of 20 articles were included, including seven clinical decisions, three guidelines, two evidence summaries, one expert consensus, three systematic reviews, and four randomized controlled trials. Thirty-four pieces of evidence were summarized from four aspects: fatigue management, frailty management, sexual dysfunction management, and sleep disorder management.Conclusions:This study summarizes the best evidence for the management of fatigue-related symptom clusters in HIV/AIDS patients. Medical and nursing staff must select and apply the evidence in a targeted manner based on clinical situations.

Objective To explore whether hepatocyte Perilipin-2(Plin2)is involved in the development of fatty liver related to comparative gene identification-58(CGI-58)deficiency mice and compare the effects of Plin2 and Plin3 on lipid droplet formation and lipid accumulation.Methods Based on CGI-58Flox/Flox mice as animal model,the adeno-associated viruses targeting mouse liver,CGI-58 knockout and Plini2 knockdown were achieved by co-expression Cre protein and micro-RNA targeting Plin2(Mi-KD).Then CGI-58 deficiency mice were used as control(NC)to detect the differences in metabolic phenotype and liver pathology.AML-12 mouse hepatocytes were used as cellular model and interfered with siRNA to achieve Plin2/Plin3 knockdown in AML-12 cells.Lipid droplet formation and lipid accumulation were compared with Bodipy staining and enzyme colorimetry in basal condition or lipid-overloaded condition(OA inducement)after Plin2/Plin3 knockdown.Results Plin2 knockdown(Mi-KD)reduced PLIN2 protein level by＞99％in mouse livers.Mi-KD decreased hepatomegaly(P=0.019 5)and liver injury(P=0.000 4),while reduced the histological NAS score(P=0.000 2)and hepatic triglyceride content(P=0.016 6)in the CGI-58 deficiency female mice.Mi-KD prevented microvesicular hepatic steatosis in the CGI-58 deficient female mice.Plin3 knockdown significantly reduced the triglyceride content in basal condition of hepatocytes(P=0.001 4),and Plin2 knockdown just showed a decreased trend.Plin2 or Plin3 knockdown significantly reduced the triglyceride content separately in lipid-overloaded hepatocytes(P＜0.05).Conclusion Hepatocyte Plin2 is essential in the development of microvesicular hepatic steatosis caused by CGI-58 deficiency.Both Plin2 and Plin3 are involved in lipid droplet formation and lipid accumulation in hepatocytes,and Plin3 shows a stronger effect.

Objective:To understand the reliability and validity of quality of life instruments for cancer patients-brain neoplasm [QLICP-BN (V1.0)], a self-developed quality of life scale for cancer patients.Methods:The quality of life of 112 patients with brain neoplasms in Yunnan Cancer Hospital from March 2012 to November 2013 was measured. The general data questionnaire and QLICP-BN (V1.0) were used for data collection. The reliability, validity and responsiveness of the scale were tested, and then the metric characteristics of the scale were evaluated.Results:The split-half reliability of the total score of the scale was 0.95, the Cronbach αcoefficient was 0.92, and the test-retest correlation coefficient rwas 0.78. After extracting common factors by the principal component method and rotating with the maximum variance, the specific module obtained three principal components, and the cumulative variance contribution rate was 64.18%. The score of specific module was 75.30±17.44 before treatment and 78.91±12.20 after treatment ( t=-2.481, P=0.015). The total score of scale before treatment was 65.26±12.29, and that after treatment was 69.62±10.41, with a statistically significant difference ( t=-4.492, P<0.001). The total responsiveness of the scale was 0.456, showing moderate responsiveness. Conclusion:QLICP-BN (V1.0) has good reliability, validity and a certain degree of responsiveness. It can be used as a measurement tool for the quality of life of patients with brain neoplasms in China.

Objective: To compare the reliability of Internet Addiction Impairment Index (IAII), Revised Chen Internet Addiction Scale(CIAS-R)-Taiwan Revision, CIAS-R-Mainland Revision, Young Diagnostic Questionnaire (YDQ) and the consistency of Internet addiction using the four scales in college students. Methods: A total of 1 004 undergraduates from 3 universities in Hefei were selected to measure the tendency of internet addiction simultaneously using the four scales, and 122 students were re tested two weeks after the initial assessment. Correlation coefficient, coincidence rate and Kappa value were used to analyze the consistency of the four scales. Analysis of variance, t test and Logistic regression were used to determine the consistency of the factors related to internet addiction scale. Results: The reliability of the four Internet addiction scales were greater than 0.7( P <0.01). The correlation coefficient among all scales was greater than 0.5( P <0.01). The agreement between YDQ and CIAS-R-Mainland Revision was 0.87. The Kappa value of YDQ and CIAS-R-Taiwan Revision in the consistency analysis was 0.51( P <0.01), the Kappa value between the other scales was less than 0.5. Results showed that the four scales were consistent in Internet addiction prevalence by gender, grade and major, while CIAS-R-Taiwan Revision and YDQ were not consistent with the other two scales in sleep disorder. Conclusion The four Internet addiction scales all have good reliability, while low agreement in Internet addiction assessment, suggesting further improvement and revision in Internet addiction scales.

Objective:To investigate knowledge, attitude and practice intention of medical students on advance care planning (ACP) and to analyze the relevant influencing factors.Methods:This study was a cross-sectional study. From April to May 2019, the convenience sampling method was used to select medical students who were interning in 3 medical schools and affiliated hospitals in Guangdong Province as the research objects. General information questionnaire and self-designed ACP Knowledge, Attitude and Practice Intention Questionnaires were uesd to investigate. Multiple linear regression analysis was used to influencing factors. A total of 276 questionnaires were recovered in this survey, of which 274 were valid, the effective response rate was 99.3%.Results:The average accuracy rate of the ACP Knowledge Questionnaire for medical students was 48.75%. The average score of items of the ACP Attitude Questionnaire was (4.00±0.53) . The average score of items of the ACP Practice Intention Questionnaire for medical students was (3.94±0.59) . The results of multiple linear regression analysis showed that the attitude toward the major they studied, whether they had the part-time social experience, whether they heard of ACP and whether they received ACP training or courses were influencing factors of ACP knowledge for medical students ( P<0.05) . Whether they had clinical practice and whether they had the treatment experience of patients' death were the influencing factors of ACP attitude of medical students ( P<0.05) . Attitudes towards the major they learned and whether they had any experience in the treatment of patients' death were the influencing factors of ACP practice intention of medical students ( P<0.05) . Conclusions:Medical students have a certain acceptance of ACP, but the awareness rate of ACP is generally low. Consideration should be given to improving the relevant education methods and content to prepare for the role adaptation of medical students in future clinical work, improving the humanistic care literacy of medical students and promotion of ACP in the clinical practice.

Objective: To explore the mediating role played by college students social anxiety and social support in the relationship between internet addiction and depression. Methods: A cluster random sampling method was used to conduct a questionnaire survey among 3 536 college students in three higher vocational colleges in Anhui Province. The content included general demographic characteristics, depression, Internet addiction, social support, and social anxiety. The Process program was used to mediate and analysis of regulation. Results: Among the survey subjects, 1 552(43.90%) had depressive symptoms, including 561(45.65%) boys and 991(42.96%) girls.The total score of Internet addiction was significantly positively correlated with depression score(r=0.30, P<0.01); social anxiety(social fear, social avoidance) was positively correlated with depression(r=0.24, 0.27, P<0.01); social support(subjective support, objective support, support utilization) was significantly negatively correlated with depression(r=0.25, -0.23, -0.17, P<0.01). Conditional process analysis shows that social anxiety had a mediating role between internet addiction and depression(c'=0.06, P<0.01), and that Internet addiction and social anxiety were regulated by social support(β=-0.00，P=0.02). Conclusion By increasing the social support of college students to improve social anxiety, it might help to reduce the depression of college students caused by Internet addiction.

Objective:To compared theclinic effectiveness ofBikini incision with that of traditional incisionbased on a short-term following and provide a suggesting reference for surgeons.Methods:The data of patients who accepted total hip arthroplasty (THA) through direct anterior approach (DAA) from January to November in 2019 were collected, male 13 and female 73, age 67.5±11.8 years (42-90 years). Forty-three patients were recruited to analyzeas one retrospective study in each group. Bikini incision: male 5 and female 38; age 69.7±10.8 years (51-90 years), following up 5.7 months (3.0-8.5 months). Traditional incision: male 8 and female 35; age 66.1±10.6 years (42-90 years), following up 6.5 months (3.0-10.0 months). The length area of incision, duration of operation, intraoperative blood loss, the rate of infection, lateral femoral cutaneous nerve (LFCN) deficits, and the Harris score were analyzed between those two groups. The scars were evaluated according toPatients Scar Assessment Scale and Vancouver Scar Scale.Results:There were no significant difference in age, sex, BMI and diseases distribution between Bikini and traditional incision group. The length of incision, duration of operation, analgesic drugs dosage and hip Harris score wereanalysed no significant difference between those two groups. No patients in those twogroupssuffered from infection of incision. As to LFCN deficits, Bikini group had lower than traditional group (11.6% vs 32.6%, P=0.019). The scar area of Bikini group 1.0±0.4 cm 2 wasmeasured smaller rate than that of traditional group 16.5±28.7 cm 2. As to the Patients Scar Assessment Scale and Vancouver Scar Scale, Bikini group was 8.2±3.2 and 2.4±1.8, which was better than traditional group which was 17.0±5.8 and 4.2±3.0. Conclusion:Compared to traditional incision, Bikini incision was evaluated having significant lower rate of LFCN deficits and smaller scar,good cosmetic appearance and clinical application value.

Objective:To test whether the constructed intervention model of advance care planning (ACP) for patients with advanced cancer can be successfully implemented and the preliminary intervention effect, which provides reference for empirical research.Methods:32 cases of advanced cancer patients and 25 cases of their families at the Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai were selected. The patients were subdivided into the experimental group and the control group by random number table method. The control group received routine nursing, while the experimental group adopted the intervention model of "VIP for future care" on the basis of customary nursing. We measured the main outcome indicators: enrollment rate, consent rate, completion rate and loss of follow-up rate and secondary outcome indicators: decision-making certainty, end-of-life care preference and post-intervention satisfaction of patients and their families, within 1 week and 1 month after intervention.Results:The enrollment rate, consent rate and loss of follow-up rate were 74.6% (206/276), 36.9% (76/151)and 15.6% (5/32), respectively. After intervention, the completion rates of the experimental group and the control group were 16/16 and 15/16 within one week, and 14/16 and 13/16 within one month. All of the family members were conducted during the follow-up period. The intervention mode of "VIP for future care" had a statistically significant difference in decision-making certainty between the two groups of patients ( β=0.63, 95% CI 0.08-1.18, P<0.05), no statistically significant difference in end-of-life care preference between the two groups of patients and their families ( P>0.05), and had a statistically significant difference in "whether to recommend this project to others" between the two groups ( χ2 value was 4.167 , P<0.05). Conclusions:On the premise of sufficient preparation, the "VIP for future care" intervention mode can be successfully implemented in advanced cancer patients in mainland China, can improve the decision-making certainty of patients and the satisfaction of patients and their families, and it is recommended. And should be applied to ACP intervention for patients with advanced cancer.

Objective To analyze the CT features of cavitation between primary lung adenocarcinoma and squamous cell cancer.Methods The CT findings of cavity of primary lung adenocarcinoma and squamous cell carcinoma were evaluated in 57 patients,including 33 of squamous cell carcinoma and 24 of adenocarcinoma.The clinical data and CT features were analyzed retrospectively using the independent samples t-test,Pearson Chi-square test or Fisher's exact test.Results The mean age of ptients with squamous cell carcinoma was higher than that of patients with adenocarcinoma (65.57-4-9.26 vs 58.75 ± 11.12,P =0.015).Statistical differences were found in distribution of gender and smoking habit between the two kinds of carcinomas (P =0.014 and P =0.029).The T stages were also different between the two carcinomas (P=0.003).In addition,the maximum diameter of tumor (P =0.003),the maximum diameter of cavity (P =0.029) and the maximum thickness of the cavity wall (P=0.001) of squamous cell carcinoma were higher than those of adenocarcinoma.Moreover,the presence of ground-glass opacity (P =0.010),vessel passing through the cavity (P =0.001),septum inside the cavity (P＜0.001) and tumoral bronchogram (P =0.027) in adenocarcinoma were higher than those in squamous cell carcinoma.Conclusion There are significant differences between adenocarcinoma and squamous cell carcinoma in the population distribution and image features,comprehensive analysis helps the differential diagnosis.

Objective To observe optimized nursing strategy for thoracic closed drainage and its clinical outcomes.Methods A total of 109 patients treated with thoracic closed drainage were retrospectively analyzed, and the patients were divided into two groups according to the order of admission, 58 cases in observation group treated with optimized nursing care, and 51 in the control group treated with regular health care.The incidence of complications, SAS, SDS scores and nursing satisfaction in two groups were compared.Results The incidences of decubitus and atelectasis, and total incidence of complications in the observation group were significantly lower than that in the control group.The Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS) score in patients in the observation group given psychological counseling were significantly lower than that in the control group.The total satisfaction in the observation group was significantly higher than that in the control group(P<0.05).Conclusion The optimized nursing for patients with thoracic closed drainage can significantly reduce the risk of adverse reactions, alleviate the anxiety and depression and improve the satisfaction towards hospital nursing.Therefore, it is worthy of application in the future clinical nursing.