[Objective] To investigate the differences in metabolomics between apheresis platelets stored at 4℃ and at 22℃ with agitation, aiming to provide a theoretical basis for the cold storage of apheresis platelets. [Methods] Samples were collected at four time points (d1, d5, d10, d15) for platelets stored at 4℃ (experimental group) and two time points (d1, d5) for platelets stored at 22℃ with agitation (control group). Liquid chromatography-tandem mass spectrometry (LC-MS/MS) technology was used to detect changes in platelet metabolome levels under different storage conditions. Platelet functional activity was assessed by thromboelastography (TEG) for maximum amplitude (MA) values and flow cytometry for CD62P activation rates. [Results] Metabolites in the glycolytic pathway, key metabolites in the tricarboxylic acid cycle (citrate, α-ketoglutarate), metabolites in the purine metabolism pathway (adenine, inosine monophosphate, guanine, etc.) and amino acid metabolites significantly decreased by d5 in the control group, whereas they remained stable in the experimental group. The content of fatty acid metabolites, such as prostaglandin G2, 13(S)-HOTrE, and linoleic acid, significantly increased in the control group. Statistically significant differences in MA values were observed between the two groups at d1 and d5 (P<0.05). However, in the experimental group, as the storage time extended, the MA values at d10 and d15 showed no significant difference compared to the control group at d5 (P>0.05). The CD62P activation rate between the two groups was statistically significant (P<0.05). Additionally, the CD62P activation rate of platelets in the 22℃ group increased rapidly from d1, while it rose gradually in the 4 ℃ group. [Conclusion] Platelets stored at 4 ℃ exhibit more stable metabolic activity and slower functional deterioration, which is beneficial for extending the effective storage period of platelets.

Objective A scoping review was performed to identify the effectiveness,characteristics,and behavior change techniques of intervention strategies for reducing sedentary behavior among older adults.Methods This study was guided by the scope review methodology framework proposed by Arksey and O'Malley.A comprehensive search of databases was conducted in PubMed,Embase,PsycINFO,Cochrane Library,CINAHL,and Sedentary Behavior Research Database to collect the literature on intervention strategies for reducing sedentary behavior among older adults.The search period was from the establishment of the databases to September 20,2022.The study selection and data extraction were performed independently by 2 reviewers.The resulting data were analyzed and arranged using the descriptive analysis and the social network analysis.Results A total of 31 separate studies published between 2011 and 2022 were included in this study.Most intervention strategies were developed based on the Social Cognitive Theory.Almost all sedentary behavior intervention strategies targeted the psychological and behavioral levels of the individual.The main contents of the intervention strategies included goals and plans,feedback and monitoring,natural consequences,social support,repetition and substitution.In the social network analysis,the behavior change techniques that ranked high in degree centrality included goal-setting(behavior),self-monitoring of behavior,action planning,information about health consequences,and feedback on behavior.These intervention strategies could reduce sedentary time from 23 to 151 min/day.Conclusion Domestic nursing researchers should pay attention to sedentary behavior in older adults,and develop intervention strategies for reducing sedentary behavior in local contexts based on the effectiveness,characteristics,and behavior change techniques of the existing sedentary behavior intervention strategies.

Objective To investigate the influence factors of lymphovascular space invasion(LVSI)in patients with low-grade endometrioid carcinoma.Methods Clinical data of 167 patients with low-grade(G1,G2)endometrioid carcinoma of uterus diagnosed by surgical pathology from January 2015 to May 2023 were retrospectively analyzed.Univariate analysis of the following 9 indicators was performed:age,postmenopausal status,abnormal vaginal bleeding duration,combined with metabolic syndrome,increased CA125(≥ 35 U/ml),endometrial thickness,uterine occupation,combined with adenomyosis of uterus,stage of the International Federation of Gynecology and Obstetrics(FIGO)2009 standards.The binary logistic refression analysis was made on factors with P＜0.05.Results Among the 167 patients with low-grade endometrioid carcinoma of uterus,24 cases(14.4％)had LVSI.The binary logistic regression analysis was performed for 4 factors(abnormal vaginal bleeding duration ≥ 4 months,increased CA125,combined with adenomyosis of uterus,stage Ⅱ and above)with P＜0.05 in the univariate analysis,and the results showed stage Ⅱ and above(OR=7.357,95％CI:2.140-25.288,P=0.002)and increased CA125(OR=4.883,95％CI:1.612-14.794,P=0.005)were an independent prognostic factor for LVSI in low-grade endometrial carcinoma of uterus.Conclusion Stage Ⅱ(FIGO 2009)and above and CA125≥35 U/ml are associated with LVSI in patients with low-grade endometrioid carcinoma,indirectly suggesting the risk of lymph node metastasis,which should be paid close attention to before surgery in order to develop a more accurate surgical plan.

Objective:To observe the clinical and imaging features of patients with retinal vein occlusion (RVO) complicated with retinal artery occlusion (RAO).Methods:A retrospective clinical study. Fifteen patients with 15 eyes with RVO combined with RAO and macular edema diagnosed by ophthalmology examination in the Department of Ophthalmology, First People's Hospital of Xianyang City during 2 years from February 1, 2022 to January 31, 2024 were included in the study. Branch retinal vein occlusion (BRVO) combined with branch retinal artery occlusion (BRAO) occurred in 3 cases and 3 eyes. Central retinal vein occlusion (CRVO) complicated with central retinal artery occlusion (CRAO) in 12 eyes. Best corrected visual acuity (BCVA), intraocular pressure, scanning laser ophthalmoscope, optical coherence tomography (OCT), fluorescein fundus angiography (FFA) and serum homocysteine were all performed. OCT angiography (OCTA) was performed in 6 eyes. All eyes were treated with intravitreal injection of anti-vascular endothelial growth factor drugs. After the initial 1 treatment, dosage was assessed as needed. Follow-up was performed every month for 12 months after treatment. FFA inspection was performed at 3 months. During follow-up, it was found that there were no perfusion areas of capillaries, and retinal laser photocoagulation therapy was given in time. Fundus manifestations, FFA, OCT, OCTA characteristics and causes of disease were analyzed retrospectively.Results:There were 15 eyes in 15 cases, 9 eyes in 9 males; 6 women with 6 eyes. Age was (61.0±9.7) years. All complained of painless vision loss in one eye. All eyes were positive for relative afferent pupillary disorder. Contralateral congenital optic disc defect was in 1 case; hypertension was in 6 cases; hyperhomocysteinemia was in 2 cases; cerebral infarction was in 3 cases; coronary heart disease was in 1 case. CRVO combined with CRAO was in 12 eyes BCVA light sensitivity-0.25. The BCVA of BRVO combined with BRAO were 0.1, 0.4 and 0.25, respectively. All the patients had retinal edema in the posterior pole of the eye, venous sinuous, dilated, thin arteries and stiff shape. The retina presents with flaky or flame-like bleeding. Posterior polar retinal lint patch was in 13 eyes. In 12 eyes with CRVO combined with CRAO, optic disc edema was observed and the boundary was not clear. In 3 eyes with BRVO combined with BRAO, no obvious abnormality was found in the optic disc, and the boundary was clear. FFA examination showed no or prolonged arterial filling, delayed retinal vein laminar flow, relatively slow or even no capillary filling, macular arteriole atretosis to varying degrees, arch ring structure destruction, optic disc telangiectasia and fluorescein leakage. OCT examination showed that the middle and inner layers of the retina were thickened to varying degrees, the diffuse reflex was enhanced, the interlayer structure was unclear, and the reflex of the lower retinal tissue was weakened. The blood flow density of superficial capillary plexus and deep capillary plexus (DCP) decreased in 6 eyes undergoing OCTA examination. Decreased or interrupted blood flow in the vascular bed of DCP. During the follow-up period, there were 13 eyes with no perfusion area of retinal capillary. The time of occurrence was (1.14±0.95) (0-2) months, and the area was 10-75 disc area. Optic nerve atrophy occurred in 5 eyes. At the last follow-up, visual acuity increased, unchanged and decreased in 12, 2 and 1 eyes, respectively.Conclusions:The pathogenesis of RVO-RAO is complicated. Most RVO and RAO occurred simultaneously, and a few RVO occurred several days after RAO. Although the RAO manifestations are not typical, the radiographic features are both RVO and RAO. Compared with BVRO combined with BRAO, the prognosis of visual acuity in CRAO patients with CRVO is worse.

【Objective】 To explore the precautions of pre-transfusion examination in patients with antibodies to erythrocyte protective solution, discrepant ABO blood typing results, and positive unexpected antibodies, so as to ensure the safety of blood transfusion. 【Methods】 The screen cells were divided into two groups according to the presence or absence of washing reagent red blood cells in normal saline. One group had untreated forward typing cells, antibody screening cells and identification panel, and the other group had saline-washed reverse typing cells, antibody screening cells and identification panel. The experiments were carried out by microcolumn gel method, saline medium method and polyamine method to analyze the effect of red blood cell preservation solution on serum agglutination reaction of specific patients. 【Results】 Among the 8 patients, forward typing was AB (+ ) in 1 patient, B (+ ) in 4, and A(+ ) in 3, and the reverse typing were interfered. The plasma of 8 patients agglutinated with unwashed reverse typing cells (saline tube method), screen cells and identification panels (saline tube method plus cassette method), while not agglutinated with the polybrene method. The interference was eliminated as using washed reverse typing cells (salinetube method), screen cells and identification panels (saline tube method plus cassette method). 【Conclusion】 The erythrocyte preservation solution affected patients’ blood group typing, but not affected the outcome of blood transfusion as no adverse reactions occurred.

Objective:To explore the methodology of the evidence-based expert consensus formulation process of traditional Chinese medicine(TCM)nursing taking stroke as an example.Methods:First,preliminary and comprehensive presentation of all stroke-related symptoms and corre-sponding TCM nursing techniques involved were revealed through bibliometric analysis.Then,selection of stroke symptoms and TCM nursing techniques for inclusion in the consensus was performed using an expert consultation method.Next,we determined the search strategy for a precise evidence search;conducted an evaluation of evidence quality and the grade of the evidence;and completed evidence extraction,evidence analysis,and evidence synthesis based on the included symptoms and TCM nursing techniques.The Delphi method was then applied to determine the strength of each recommendation and the choice of nursing care points by referring to the Grading of Recommendations,Assessment,Devel-opment,and Evaluations grid.Finally,we conducted an external expert validation of the Delphi results to form an expert consensus guideline.Results:Through the bibliometric analysis,22 stroke symptoms and 18 TCM nursing techniques were identified in the literature.Then,after expert consultation,22 symptoms and 111 pairs of symptoms combined with TCM nursing techniques were selected for the evidence search.Evidence integration yielded 10 stroke symptoms corresponding to 29 bodies of evidence;these 10 symptoms were retained through the Delphi consultation,and recommendation strength results for 26 recommendations were obtained.A total of 9 symptoms were further retained for expert external validation to form 24 rec-ommendations,with a recommendation process score range of 7.64-9.99 points and a more scientific and standardized recommendation-formation process.Conclusion:Owing to the current limited conditions of evidence-based resources for TCM nursing,the present consensus-building process represents only a preliminary exploration of an evidence-based expert consensus for TCM nursing to provide a reference for a more scientific and standardized methodology.

The shared decision-making between doctors arel patients has great significance for clarifying patients' wishes and preferences, reducing decision-making regret and decision-making conflicts and improving quality of life of patients. However, the research and exploration of shared decision-making in China is still in its infancy. In June 2021, National Institute for Health and Care Excellence (NICE) released the 2021 NICE Guidelines for Shared Decision- Making. The guideline provides comprehensive overview of organizational policies, practical preparation, decision support tools, communication skills, and current implementation dilemmas in the shared decision-making domain. This article will integrate and interpret the core content of the guidelines, in order to provide Chinese researchers with future research directions in this field.

With the gradual rise of the shared-decision making model, the means to promote the joint participation of patients and doctors in medical decision-making are also increasing and developing. Patient decision aids (PDAs) are one of the most representative interventions. The main features include targeting patients, content based on the best evidence, easy-to-understand language, diverse presentation styles and overall clear and concise content. Research on PDAs is increasing year by year. In order to make it more scientific, normative and applicable, research institutions in Canada, the United States and the United Kingdom have all explored their construction methods and evaluation standards and have successively released international standards, reporting standards and standard framework for PDAs, etc. This paper introduces the conceptual connotation, construction method and presentation standards of PDAs, in order to provide reference and reference for PDAs researchers in China.

Objective:To investigate the asymmetric geometry of middle cerebral artery (MCA) bifurcations and aneurysm formation.Methods:From January 2017 to April 2020, 65 patients with MCA aneurysm underwent 3D-digital subtraction angiography (DSA) in our hospital were recruited in this study; 170 patients without arterial stenosis or cerebral aneurysm at the same time period were selected as normal control group; their corresponding morphological parameters of MCA bifurcations in the imaging data were analyzed. Bifurcation angle was termed as φ1, while small and large lateral angles were termed as φ2 and φ3, respectively. D2, S2, C2, T2 and E2 represented diameter, sectional area, circumference, tortuosity and ellipticity of the branch forming angle φ2 with parent vessel, respectively; whereas D3, S3, C3, T3 and E3 represented diameter, sectional area, circumference, tortuosity and ellipticity of the branch forming angle φ2 with parent vessel on the contralateral branch, respectively. The independent factors affecting the formation of MCA aneurysm were screened by binary Logistic regression, and the predictive value of independent factors affecting the formation of MCA aneurysm was evaluated by receiver operating characteristic (ROC) curve.Results:(1) The aneurysmal group had significantly larger φ1, significantly smaller φ2 and φ3 than the normal control group ( P<0.05); D3, S3, C3, T2, T3 and E2 in the aneurysmal group were significantly higher/larger than those in the normal control group ( P<0.05). In terms of the symmetry of bilateral branches of blood vessels, the difference of φ3/φ2 ratio between the normal control group and aneurysm group was statistically significant ( P<0.05). (2) Binary Logistic regression results showed that φ2 was the protective factor for aneurysm formation ( OR=0.880, 9 5%CI: 0.844-0.918, P=0.000), while D3 and φ3/φ2 ratio were the risk factors for aneurysm formation ( OR=4.493, 9 5%CI: 1.414-14.278, P=0.011; OR=30.676, 95%CI: 9.884-95.202, P=0.000). (3) The ROC curve showed that the area under the curve of φ2 was the largest, reaching 0.93, and the optimal cut-off point was 104.59°, enjoying sensitivity and specificity of 87.7% and 85.9%, respectively. Conclusion:Normal MCA bifurcations almost show symmetrical morphology, whereas aneurysmal MCA bifurcations show asymmetrical morphology in both lateral angles and daughter branches; φ2 is the best morphological parameter to predict the aneurysm formation of MCA bifurcations.

Objective:To analyze the current research status, hotspots, and trends in the field of cancer symptom management in recent 10 years, and to provide a reference for further research.Methods:Articles published from January 2010 to December 2019 were retrieved with "cancer OR tumor OR neoplasm" and "symptom management" as the subject terms from the core collection of Web of Science database. CiteSpace 5.7.R1 was used for analysis and visualization of researchers, countries, institutions, journals, documents, keywords and other content.Results:The number of papers published in the field of cancer symptom management was basically on the rise, but the number of co-authored papers by multiple authors and institutions was insufficient. The United States, the United Kingdom, Canada, and Australia were the main countries in the field of cancer symptom management. They occupied a key position in this field and cooperated closely with each other. China's number of publications ranked the fifth, but it did not take a central place, and it had less international cooperation. Journal of Clinical Oncology, Journal of Pain and Symptom Management, and Supportive Care in Cancer were the core journals in this field. The related articles published on them reflected the foundation of this field, and provided important reference for this field. Cancer, symptoms, intervention measures, self-care, remote management, etc. have been research hotspots in recent years. Conclusions:This study provides a perspective for understanding the related research in cancer symptom management, and supplies valuable information for researchers to identify potential collaborators and cooperative institutions, core journals, hot topics, and research frontiers. In the future, researchers may focus on such hotspots and frontiers as symptoms, interventions, self-care, and remote management.