Objective To systematically evaluate and integrate the experiences of people living with HIV in peer support,and to provide references and suggestions for improving peer support for HIV patients in clinical practice.Methods The computer retrieval was performed in PubMed,CINAHL(EBSCO),Web of Science,ProQuest,CNKI and Wanfang Data from January 1,1996 to September 30,2022,to collect qualitative studies in the experience of people living with HIV participating in peer support.This qualitative systematic review was conducted under the Joanna Briggs Institute guideline.This paper was written according to the enhancing transparency in reporting the synthesis of qualitative research(ENTREQ).Results A total of 7 qualitative studies were included,and 26 findings were extracted,which were summarized into 12 categories and integrated into 4 synthesized findings.Findings included that peer support provides patients with information and help them establish and maintain a healthy lifestyle;patients receive emotional support in peer support;patients receive instrumental support in peer support;the objective requirements and scenarios of peer support.Conclusion AIDS peer support has a positive effect on AIDS prevention and treatment,and it is important to address the practical needs of people living with HIV/AIDS.The practice of HIV peer support needs further theoretical support and scientific guidance.Building an HIV peer support model,providing systematic training and professional guidance to HIV peers is conducive to improving the accuracy of HIV peer support behaviors,the development of HIV peer support activities,and optimizing the effectiveness and sustainability of peer support for people living with HIV/AIDS.

The number of expert consensus publications has been increasing year by year as an industry guidance document.However,due to the lack of unified reporting guidelines and methodological standards,the current published expert consensuses in nursing exhibit inconsistent writing formats and varying quality.This article combines the quality evaluation points for expert opinions from the Jonna Briggs Institute in Australia,focusing on 6 aspects,covering the authority of the expert team,clarity of viewpoint expression,adequacy of evidence-based foundation,standardization of the consensus-reaching process,taking into account of interests of relevant research populations,and the potential for application in specific clinical settings.These points are introduced as review criteria for expert consensus papers,aiming to provide references for improving the quality and standardization of expert consensus papers in the future.

Objective:To explore the classification and influencing factors of family resilience and post-traumatic growth in patients with spinal tumor.Methods:A cross-sectional investigation was conducted among 219 inpatients with spinal tumor admitted from July 2021 to July 2022. The General Demographic Information questionnaire, Chinese-Family Resilience Assessment Scale, Posttraumatic Growth Inventory, Family Crisis-Oriented Personal Evaluation Scales (F-COPES), and Social Support Rating Scale (SSRS) were used in the study. The ordinal and multivariate logistic regression analyses was applied to identify the factors associated with the classification of family resilience and post-traumatic growth.Results:Of the 219 patients, there were 62 cases of primary spinal tumors (28.3%). According to the results of latent profile analysis, the respondents were classified into three categories by family resilience and post-traumatic growth, namely family difficulty-resistant type ( n=38, 17.4%), general resilience-struggle type ( n=99, 45.2%) and family adaptation-growth type ( n=82, 37.4%). There were significant differences in occupational status, commitment to housework, family atmosphere( χ2=10.75, P=0.025; χ2=6.95, P=0.031; χ2=11.37, P=0.017), and total score of F-COPES and SSRS ( F=25.95, P<0.001; F=19.06, P<0.001)among three groups. Ordinal and multivariate logisitc regression analyses showed that retirement ( OR=2.928, 95% CI:1.098-7.808, P<0.05), family coping ( OR=1.113, 95% CI:1.063-1.165, P<0.05), and social support ( OR=1.226, 95% CI:1.103-1.362, P<0.05) were independently associated with family resilience and post-traumatic growth in patients with spinal tumor. Conclusion:Patients with spinal tumor have significant differences in characteristics by family resilience and post-traumatic growth. As a result, more targeted interventions should be provided for different categories of spinal tumor patients in the future.

OBJECTIVE To explore the self precipitation source of Erhuang powder, determine the content of related components and its efficacy on HeLa cells. METHODS Bifurcation study to identify the main compatibility of precipitating. The self precipitation, supernatant and extract of Erhuang powder were analyzed by UHPLC-Q-Exactive MS. The main compounds in Coptidis Rhizoma and Catechu, catechin, epicatechin, epicberberine, coptisine, berberine and palmatine were selected as controls. A analysis method of UHPLC for self precipitation, supernatant and extract of Erhuang powder was established and the related components were quantitatively determined. The effects of self precipitation, supernatant and extract on HeLa cells were evaluated by MTT method and flow cytometry. RESULTS A slight flocculation precipitate appeared when the decoction of Erhuang powder was mixed in pairs, while a large amount of flocculation appeared when the decoction of Coptidis Rhizoma and Catechu water was mixed. The self precipitation, supernatant and extract samples contained 39 compounds, which were mainly alkaloids and phenolic acids. The contents of catechin and berberine in the 6 index components were mostly, which accounted for 73.56% of the total content of the index components in self precipitation and 61.89% of the total content of the index components in extract. Inhibition effect on HeLa cells: extract ≈ self precipitation > supernatant, and inducing apoptosis: self precipitate ≈ extract, supernatant had no apoptosis-inducing effect. CONCLUSION Coptidis Rhizoma-Catechu is the main compatible formula for precipitation formation. The self precipitation and extracts of Erhuang powder are mainly alkaloids and phenolic acids, among which berberine and catechin are high in content and can be used as representative components. The effect of self-precipitation and extract on HeLa cells was better than that of supernatant. This basically indicates that the self precipitation components and pharmacological effects of Erhuang powder are similar to those of the extract.

Objective To explore the effect of Traditional Chinese Medicine's five-element music therapy com-bined with individualized emotional counseling intervention in patients with autoimmune liver disease of liver de-pression and spleen deficiency type.Methods 74 patients with autoimmune liver disease of liver depression and spleen deficiency type who were admitted to the hepatology department of a tertiary hospital from January 2021 to February 2022 were selected as research subjects,and they were divided into an experimental group and a control group by a random number table with 37 cases in each group.The control group was given routine treatment and nursing care,as well as Traditional Chinese Medicine's emotional nursing.The experimental group received Tradi-tional Chinese Medicine's five-element music therapy combined with individualized emotional counseling intervention on the basis of routine treatment and nursing care,with an intervention period of 4 weeks.The Generalized Anxiety Disorder Scale(GAD-7),Patient Health Questionnaire Depression Scale(PHQ-9)and Pittsburgh Sleep Quality Index(PSQI)were used to evaluate patients within 24 hours after admission and after 4 weeks of intervention.Results A total of 72 patients completed the study,with 36 in the experimental group and 36 in the control group.Before and after intervention,the scores of GAD-7,PHQ-9,and PSQI in the experimental group were compared,and the dif-ferences were statistically significant(P＜0.001).After the intervention,the GAD-7 score in the experimental group was(7.89±3.15),which was lower than(10.14±4.41)in the control group.The PHQ-9 score was(12.33±4.08)in the ex-perimental group,which was lower than(14.64±5.34)in the control group.The PSQI score was(12.39±3.06)points,which was lower than(14.22±3.37)in the control group,and the differences were statistically significant(P＜0.05).Conclusion The application of Traditional Chinese Medicine's five-element music therapy combined with individual-ized emotional guidance intervention can effectively improve the sleep quality and help alleviate negative emotions in patients with liver depression and spleen deficiency type of autoimmune liver disease.

Purpose/Significance To sort out and analyze the application status of artificial intelligence(AI)large models in medi-cine,so as to provide new perspectives for research in this domain.Method/Process Based on a review of relevant literatures,the paper outlines the application scenarios and examples of AI large models in the fields of smart medical care,medical metaverse,medical re-search and development,etc.It also summarizes the risks and challenges in the application of AI large models in medicine.Result/Con-clusion AI large models have great development potential in medicine,and it is necessary to promote the core technologies of AI large models and improve relevant regulations and laws.

Objective:To construct a structured education course for patients with neurogenic bladder during the rehabilitation period.Methods:This study consisted three stages of current situation survey, literature search, and expert consultation. From February 2022 to February 2023, a current survey was conducted on the self-management needs of 62 patients with neurogenic bladder. In April 2023, a literature search was conducted to summarize the best evidence on nursing and management of neurogenic bladder, and form the initial version of course indicators and content. From April to May 2023, 14 experts were selected for consultation, and the Delphi method was used to demonstrate the course indicators and content, and to construct the final draft of the course.Results:A total of 62 patients with neurogenic bladder were included, they have requirements for water management, bladder function training, and dietary requirements, etc. A total of 2 053 articles were retrieved, and 14 articles were ultimately included, including eight guidelines, four evidence summaries, one expert consensus, and one systematic review. The expert authority coefficients for the two rounds of expert consultation were 0.93 and 0.92, respectively. The Kendall coordination coefficient of various indicators in the second round of expert consultation was 0.227 to 0.288 ( P<0.01). After two rounds of expert consultation, a structured education course for patients with neurogenic bladder during the rehabilitation period was finally developed, including six primary indicators, 21 secondary indicators, and 30 tertiary indicators. Conclusions:The structured education course for patients with neurogenic bladder during the rehabilitation period, based on current situation survey, high-quality evidence, and expert consultation, is comprehensive in content and reasonably designed, which can provide supportive assistance for future nursing health education and management for patients with neurogenic bladder.

Objective:To search, evaluate and summarize the evidence of the safety and application of closed tracheal suction systems and to provide reference for clinical nursing work.Methods:BMJ Best Practice, UpToDate, Joanna Briggs Institute Evidence-based Health Care Center, Guidelines International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses' Association of Ontario, American Assocition for Respiratory Care, Society of Critical Care Medicine, Medlive, Cochrane Library, PubMed, Embase, CINAHL, CNKI, Wanfang Database, China Biology Medicine disc were searched for related guidelines, system reviews, expert consensus, best practices, etc. The retrieval time was from the database construction to February 28, 2021. Two researchers independently evaluated the quality of the included literature and extracted and summarized the evidence of the literature that met the quality standards.Results:A total of 20 literatures were included, including 3 clinical decisions, 2 guidelines, 11 systematic reviews and 4 expert consensuses. A total of 27 pieces of best evidence were compiled from five aspects, including indications for use, clinical effects, safety, methods of use and replacement.Conclusions:This study summarizes the best evidence on the clinical application of closed sputum suction devices in adults. When applying the evidence, clinical nurses need to select the best evidence in combination with the clinical environment to standardize the clinical application of closed tracheal suction systems.

Objective:To develop the discrimination experience questionnaire for HIV/acquired immunodeficiency syndrome(AIDS) patients and test the reliability and validity of the questionnaire.Methods:Based on the literature review and semi-structured interviews to clarify the operational definition of discrimination for HIV/AIDS and develop the item pool. The questionnaire was developed though 2 rounds Delphi consultation and a pilot test. A total of 410 HIV/AIDS patients in Shanghai Public Health Clinical Center of Fudan University from June to December 2020 were selected to investigate the questionnaire, item analysis was used to screen items. SPSS 22.0 software was used for reliability test and exploratory factor analysis, the AMOS 21.0 software was used for confirmatory factor analysis to test the reliability and validity of the questionnaire.Results:The questionnaire consisted 2 dimensions(external discrimination and internal discrimination) and 10 items. Exploratory factor analysis showed that two common factors were extracted from the frequency of discrimination and the degree of negative psychological impact of discrimination experience on patients, and the cumulative variance contribution rates were 48.367% and 55.403%, respectively. The confirmatory factor analysis on the frequency of discrimination showed that Chi square degree of freedom ratio ( χ2/ df) was 2.831, P<0.05, root mean square of approximation error (RMSEA) was 0.093, goodness of fit index (GFI) was 0.928, comparative fit index (CFI) was 0.925, incremental fit index (IFI) was 0.926; the confirmatory factor analysis on the negative psychological impact of discrimination experience on patients showed that χ2/ df was 1.740, P<0.05; RMSEA was 0.076, GFI was 0.925, CFI was 0.936, IFI was 0.938. The content validity of the questionnaire was 0.9. The Cronbach α coefficientof questionnaire was 0.811, and the test-retest coefficient was 0.862 ( P<0.01). Conclusions:The discrimination experience questionnaire for HIV/AIDS patients has good reliability and validity, and it can be used to measure the discrimination for HIV/AIDS patients.

Objective To investigate the effect of X-ray irradiation on the expression of free ubiquitin in the serum, small intestine, and heart tissues of C57 BL/6N mice. Methods The amount of free ubiquitin protein in the serum and tissue homogenates was analyzed quantitatively with ELISA and Western Blotting assay. The mRNA expressions of free ubiquitin in the tissues were detected by RT-PCR. Results At 24 or 48 h after radiation, the free ubiquitin level in the serum and small intestine tissue increased asymptotically with increasing of radiation dose (F=183?1, 435?3, P <0?01). After 5 and 10 Gy X-ray irradiation, the concentration of serum free ubiquitin increased asymptotically with the extended response time (F=131?4, 442?9, P<0?01). Compared with the normal control group, at 24 h after 10 Gy X-ray irradiation, the expressions of free ubiquitin protein and mRNA in small intestine tissue were significantly up-regulated (t= -18?7, -10?1, P<0?01). However, there was no difference in the expressions of free ubiquitin protein and mRNA in the heart tissues between irradiated and nonirradiated groups (t = -2?0, 3?1, P >0?05). Conclusions Because of the high expressions of free ubiquitin protein in the radiosensitive mice tissues, X-ray radiation could increase the concentration of free ubiquitin in serum. The changes of free ubiquitin may be related to cellular radiosensitivity and tissue injury.