Journal of Clinical and Nursing Research

Association of Vitamin A and E Nutritional Status with Recurrent Respiratory Tract Infections in Children Aged 0–14 Years in Liangshan Region and Construction of a Precision Prevention and Control System

Shuhong Xu, Yunli Mao, Changyong Lu, Shijing Zhao, Xu Song, Jiangping Huang — Wed, 22 Jul 2026 15:26:30 +0800

Objective: Through a prospective observational study, this research systematically analyzes the nutritional distribution characteristics of serum vitamins A (VA) and E (VE) in children aged 0–14 in the Yi ethnic minority settlement areas of Liangshan, clarifies the pathways through which these two fat-soluble nutrients affect recurrent upper respiratory tract infections via the respiratory mucosal barrier, immune regulation, and antioxidant pathways, and quantifies the dose-effect relationship between serum nutrient levels and infection frequency. It compares the detection rates of nutritional abnormalities and disease characteristics among children of different genders to determine the influence of gender factors. Based on large-sample real-world data, it constructs an integrated prevention and control system of “precise detection–risk stratification– individualized intervention”, providing localized evidence-based foundations and practical solutions for comprehensive prevention and control of respiratory tract infections in children in Liangshan and surrounding areas. Methods: The study was conducted at Huili and Huidong Maternal and Child Health Hospitals, involving 1,148 children aged 0–14 who visited the pediatric and child health departments of the two hospitals from June 2023 to November 2025. Face-to-face surveys were conducted using a uniformly designed questionnaire to collect children’s demographic characteristics, frequency of upper respiratory tract infections in the past year, daily dietary structure, and nutrient supplementation behaviors. Venous or capillary blood samples were collected following standardized procedures, and serum VA and VE concentrations were measured using liquid chromatography-tandem mass spectrometry. Subgroups were divided based on annual infection frequency to analyze the changing patterns of serum VA and VE concentrations and the detection rates of nutritional abnormalities across different frequencies. Observational indicators were compared between genders. Pearson linear correlation analysis was used to assess the strength of the association between nutrient levels and infection frequency. This study is observational and did not implement uniform interventions for children with nutritional abnormalities, nor did it evaluate intervention effects. Prevention and control strategies were derived solely from baseline observational data. Results: Among the 1,148 children, 835 had one episode of upper respiratory tract infection in the past year, 139 had two episodes, 90 had three episodes, 41 had four episodes, 24 had five episodes, 10 had six episodes, and 9 had seven or more episodes. As the frequency of infection episodes increased, the average serum concentrations of VA and VE in children showed a continuous gradient decline, while the detection rates of marginal VA deficiency, clinical VA deficiency, and potential VE deficiency increased simultaneously. Gender-stratified analysis revealed no statistically significant differences (p > 0.05) in serum VA/VE levels, detection rates of various nutritional abnormalities, or annual infection frequencies between male and female children. Pearson correlation analysis showed a significant negative correlation between serum VA and VE levels and the annual frequency of upper respiratory tract infections (r = -0.711, r = -0.620, p < 0.001). VA primarily reduces infection risk by maintaining the integrity of the respiratory epithelium and regulating immune cell function; VE alleviates airway inflammatory responses through antioxidant effects, with both exhibiting synergistic protective effects. Higher infection frequencies were associated with elevated levels of inflammatory markers such as peripheral blood leukocytes, neutrophils, and C-reactive protein, and lower hemoglobin levels (p < 0.001). Children who regularly took vitamin AD preparations had higher baseline serum VA levels and lower annual frequencies of upper respiratory tract infections. Conclusion: There is a clear negative gradient correlation between serum VA and VE levels and the frequency of upper respiratory tract infections in children aged 0–14 in Liangshan. Vitamins A and E influence the occurrence and persistence of respiratory tract infections from multiple dimensions, including mucosal defense, immune regulation, and antioxidation. Nutritional deficiencies significantly increase children’s susceptibility to infections; recurrent infections, in turn, accelerate nutrient consumption, forming a vicious cycle. There are no significant differences in nutritional status and respiratory infection characteristics between male and female children, so gender-specific considerations are unnecessary for nutritional screening and infection prevention in the region. Regular precise serological testing and early identification of nutritional abnormalities are core prerequisites for proactive prevention. On this basis, implementing individualized precise interventions can effectively break the vicious cycle of “nutritional deficiency–recurrent infections”. The integrated precise prevention and control system constructed in this study is well-suited to the primary healthcare conditions in ethnic minority areas of Liangshan, demonstrating strong practicality and potential for widespread application.

Research on the Foot Care Journey Map for Patients with Diabetic High-Risk Feet

Wed, 29 Jul 2026 17:37:30 +0800

Objective: To explore the full-cycle foot care experiences and real needs of patients with high-risk diabetic feet based on patient journey maps, providing a reference for optimizing the entire preventive care model and delaying the onset and progression of diabetic foot. Methods: A phenomenological research method from qualitative research was employed. From September to December 2025, 15 patients with high-risk diabetic feet were selected as the study subjects. Longitudinal semi-structured interviews were conducted on the first day of admission, the day before discharge, three months after discharge, and six months after discharge. Content analysis was used to extract themes and construct and draw a foot care journey map for patients with high-risk diabetic feet. Results: The patients’ full-cycle care experiences were summarized into three stages: examination and diagnosis, hospitalization, and home care after discharge. A total of 21 themes were extracted, revealing significant stage-specific differences in care tasks, emotional states, distressing issues, and care needs across different treatment stages. Conclusion: Foot care for patients with high-risk diabetic feet spans the entire treatment process. Clinical healthcare professionals should establish a phased, continuous, and individualized foot preventive care system to effectively prevent and control the onset and progression of diabetic foot.

Investigation of Factors Associated with Excessive Residual Volume in Patient-Controlled Analgesia Pumps Under an Intelligent Closed-Loop Management Model

Zemin Zhan, Nan Chen, Jiexuan Zheng, Milan Xiao, Yi Wu, Hongyu Shen — Thu, 30 Jul 2026 00:00:00 +0800

Objective: To analyze the causes of excessive residual volume (≥ 100 mL) upon removal of patient‑controlled analgesia (PCA) pumps in patients undergoing lower abdominal surgery under an intelligent closed‑loop management model, and to provide evidence for optimizing analgesic regimens and drug management. Methods: A retrospective survey was conducted among 292 eligible patients from September 2022 to August 2023. Data on departmental distribution, timing of pump removal, adverse reactions, and antiemetic addition were collected. Results: Among the 292 patients, gastrointestinal surgery accounted for 78.42%. Pump removal was concentrated on postoperative days 3–4 (51% combined). The most prevalent adverse reactions were poor sleep (28.42%), nausea (19.86%), and non‑pain complaints (23.96%). Notably, 97.94% of PCA pumps were prescribed without antiemetics. Conclusion: Postoperative nausea and vomiting, non‑pain discomfort, and sleep disturbances are key surface manifestations leading to premature pump discontinuation or clamping, resulting in residual drug volume. The insufficient addition of antiemetics and the urgent need for training in adverse reaction differentiation within the intelligent closed‑loop management system require immediate attention.

Diabetes Self-Management in Community-Dwelling Older Adults: Status Assessment and Targeted Intervention Strategies

Chunling Wu, Xuefeng Chen, Shixuan Deng, Yi Yang — Fri, 31 Jul 2026 00:00:00 +0800

Objective: To assess self-management behaviors and service needs among older adults with diabetes in Guojicun Community, Yuzhong District, Chongqing, and to provide empirical evidence for improving community-based diabetes care. Methods: A cross-sectional survey was conducted among eligible older community-dwelling adults with diabetes. Data were collected using a standardized self-management scale and a service-needs questionnaire, and analyzed descriptively with supply-demand matching. Results: Overall self-management was low to moderate and uneven across domains. Medication adherence and fruit and vegetable intake were relatively better, whereas exercise, prescribed blood glucose monitoring, and foot care remained weak. Patients reported substantial needs for home-based glucose monitoring and complication prevention, whereas community service coverage remained limited; psychological support was particularly underprovided. Health education relied mainly on offline lectures, with predominantly one-way delivery and limited interaction or individualized feedback. Conclusion: Older adults with diabetes in this community had relatively weak self-management capacity, and current service provision was structurally misaligned with actual needs. Primary care should adopt assessment-based, stratified interventions, prioritize home monitoring and psychological support, improve interactive and context-sensitive health education, and integrate family, community and policy resources to strengthen chronic disease management.

Observation on the Effect of Supportive Nursing Intervention in Patients Receiving Home Enteral Nutrition After Esophageal Cancer Surgery

Jinxiang Yu, Lu Chen — Tue, 11 Aug 2026 19:44:38 +0800

Objective: To analyze the application effect of supportive nursing intervention in patients receiving home enteral nutrition after esophageal cancer surgery. Methods: A total of 102 esophageal cancer patients who underwent surgical treatment at Taizhou Second People’s Hospital from November 2025 to March 2026 were selected and divided into a control group (conventional nursing intervention, 51 cases) and an observation group (supportive nursing intervention, 51 cases) based on different postoperative intervention plans. Both groups received interventions until 3 months after discharge. Nutritional status, cellular immune function, and the occurrence of adverse events were compared. Results: After the intervention, the nutritional status (Hb, ALB, PA, TRF) and cellular immune function (CD4⁺, CD4⁺/CD8⁺, CD8⁺) levels in both groups improved compared to those before the intervention, and the improvement in the observation group was significantly better than that in the control group. The total incidence of enteral nutrition-related adverse events in the observation group was 1.96%, which was significantly lower than that in the control group (13.73%) (p < 0.05 for all). Conclusion: Implementing supportive nursing intervention in patients receiving home enteral nutrition after esophageal cancer surgery can effectively improve their nutritional status, regulate cellular immune function, and reduce the risk of enteral nutrition-related adverse events such as abdominal pain, diarrhea, tube blockage, and reflux aspiration, demonstrating high clinical application value.

Medicated Thread Moxibustion of Zhuang Medicine for the Treatment of Skin Diseases Recent Advances in Clinical Application

Qingqing Zhu, Yuyun Wang, Jiaqi Zhu, Feisheng Xiong — Fri, 31 Jul 2026 00:00:00 +0800

Medicated thread moxibustion of Zhuang medicine is a distinctive external treatment technique of the Zhuang ethnic group. In recent years, it has been widely applied in the treatment of various skin conditions, including eczema, herpes zoster, acne, vitiligo, psoriasis and chronic urticaria. Clinical studies have demonstrated that this therapy is effective and offers advantages such as being minimally invasive and painless, high patient compliance and low cost; it also produces significant synergistic benefits when used in combination with both Chinese and Western medicines. Experimental studies suggest that its mechanism of action involves immunomodulatory pathways, such as the regulation of T-lymphocyte subsets, the reduction of serum IgE levels, and the inhibition of inflammatory cytokine release. However, existing research consists predominantly of small-sample, single-center exploratory studies, lacking unified standardized operating procedures and a quantitative system for evaluating therapeutic efficacy; the specific targets and molecular mechanisms remain unclear. Future research should involve large-scale, multicentre, randomized controlled trials to strengthen the evidence base, clarify the molecular mechanisms and establish standardized protocols, thereby promoting the standardized clinical application of this technique with distinctive ethnic characteristics.

Identification of a Novel Pathogenic Variant in the PHEX Gene and Its Mechanistic Implications in X-Linked Hypophosphatemia

Yanhua Zhao — Fri, 31 Jul 2026 00:00:00 +0800

Purpose: X-linked hypophosphatemia (XLH) arises from PHEX loss-of-function mutations driven by excess FGF23. This study aimed to characterize a novel PHEX frameshift variant in a Chinese pediatric patient, clarify its pathogenic mechanism, and report real-world conventional therapy outcomes under limited economic resources. Materials and Methods: Targeted NGS and Sanger sequencing identified the variant; ACMG criteria determined pathogenicity. Western blot, ELISA, molecular docking, and protein structural modeling assessed variant-induced functional defects. The patient received oral phosphate + calcitriol instead of burosumab for 3 months. Results: A de novo frameshift deletion chrX(GRCh37):g.22112134_22112135del (c.766_767del p.Thr256Cysfs*7) was detected, classified as pathogenic. Truncated mutant PHEX showed negligible expression, lost MEPE binding capacity, and elevated MEPE/FGF23. Conventional treatment partially improved biochemical and clinical manifestations without severe adverse events. Conclusion: This novel truncating variant expands the PHEX mutational spectrum. Complete PHEX functional inactivation disrupts the PHEX-MEPE-FGF23 axis to trigger XLH. Conventional phosphate-calcitriol therapy serves as a safe alternative for patients unable to access costly anti-FGF23 targeted agents.

Research on the Influencing Mechanism of Clinical Nurses’ Turnover Intention Under the Background of Organizational Change: Based on a Chain Mediating Model

Shuqi Fan, Xiangchuan Hou — Fri, 31 Jul 2026 00:00:00 +0800

Objectives: To analyze the influence of change fatigue on clinical nurses’ turnover intention, and explore the mediating roles of emotional exhaustion and job satisfaction, so as to provide references for reducing nurses’ turnover intention. Methods: From October to December 2025, a questionnaire survey was conducted among 281 clinical nurses in a Grade A tertiary hospital in Foshan using a general information questionnaire as well as scales of change fatigue, job burnout, job satisfaction, and turnover intention. Pearson correlation and multiple linear regression analyses were adopted to analyze variable relationships, and the Bootstrap method was used to test mediating effects. Results: Change fatigue and emotional exhaustion were positively correlated with turnover intention (r = 0.429, 0.523, p < 0.01), while turnover intention was negatively correlated with job satisfaction (r = -0.429, p < 0.01). All three variables were important predictors of turnover intention, among which emotional exhaustion exerted the greatest impact. Emotional exhaustion and job satisfaction played significant partial mediating roles between change fatigue and turnover intention, with the total indirect effect accounting for 60.86%. Moreover, a chain mediating path of “change fatigue à emotional exhaustion à job satisfaction à turnover intention” was verified. Conclusion: Change can directly affect clinical nurses’ turnover intention, and also exert an indirect impact through the above mediating pathways. Nursing managers should pay attention to nurses’ psychological adaptation during organizational changes. By alleviating change fatigue, relieving emotional exhaustion, and improving job satisfaction, turnover intention can be reduced, and the nursing workforce stabilized.

First-line Treatment for Wound Healing of Tophi Ulceration in a Patient with Gout and Type 2 Diabetes: A Case Report

Ning Xu, Yadong Lin, Jiaqi Dong, Aimin Li — Fri, 31 Jul 2026 00:00:00 +0800

Background: Tophi ulceration with infection and refractory wound healing remains a clinical challenge, particularly in patients with concurrent diabetes. Interleukin-1β (IL-1β) is a central mediator of gouty inflammation; targeted IL-1 inhibition may rapidly suppress inflammation and facilitate tissue repair. Case Presentation: This study reported the case of a 27-year-old male with a 6-year history of gouty arthritis, multiple tophi, infected left foot ulceration, and type 2 diabetes. Despite conventional anti-infective therapy, glycemic control, and local wound care, the ulcer showed limited improvement. Following a single subcutaneous injection of firsekibart (200 mg), wound exudate decreased rapidly, granulation tissue developed satisfactorily, and the ulcer healed progressively. At the 4-month follow-up, complete wound closure was achieved without recurrence or adverse events. Conclusion: Firsekibart demonstrated favorable anti-inflammatory and wound-healing effects in a patient with tophi ulceration complicated by diabetes, suggesting its potential as a therapeutic option for refractory cases. Prospective studies are warranted to confirm these findings.

Research on Endoscopic Cardiac Constriction for the Treatment of Cardiac Relaxation

Guoli You, Danying Xu, Mengwei Jiang, Yang Shen — Fri, 31 Jul 2026 00:00:00 +0800

This study analyzes the efficacy of endoscopic cardiac constriction, an emerging surgical procedure, in treating cardiac relaxation and evaluates its therapeutic effectiveness and safety. A randomized controlled trial was conducted, enrolling patients with cardiac relaxation according to relevant criteria. Pre- and post-operative examination indicators and symptom improvements were compared, while postoperative complications were also analyzed. Based on clinical practice analysis, endoscopic cardiac constriction effectively alleviated symptoms such as heartburn and reflux in patients, improved objective examination indicators, and reduced the incidence of complications. These findings provide a scientific basis for the treatment of cardiac relaxation and suggest that endoscopic cardiac constriction is a relatively safe procedure.

Analysis of the Application Value of Integrated Nursing for Specific Diseases in Nutritional Status Management and Quality of Life Improvement in Patients with Liver Cirrhosis

Fang Cheng, Yanting Wu, Zhilan Yang, Chunxia Yue, Yingchun Yan — Fri, 31 Jul 2026 00:00:00 +0800

Objective: To explore the application effect of integrated nursing for specific diseases in nutritional status management and quality of life improvement in patients with liver cirrhosis, providing a reference for optimizing clinical nursing plans for liver cirrhosis. Methods: A total of 70 patients with liver cirrhosis admitted to the hospital from January 2023 to December 2024 were selected as the study subjects. They were randomly divided into a study group (35 cases, receiving integrated nursing for specific diseases) and a control group (35 cases, receiving conventional nursing) using the random number table method. Nutritional status indicators [body mass index (BMI), hemoglobin (Hb), albumin (ALB), total protein (TP)], quality of life scores (physical pain, physiological function, emotional role, mental state), and liver function indicators [total bilirubin (TBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST)] were compared between the two groups before and after the intervention. Results: Before the intervention, there were no statistically significant differences in BMI, Hb, ALB, TP, scores in each dimension of the SF-36 scale, and levels of TBil, ALT, and AST between the two groups (p > 0.05). After the intervention, the study group had higher BMI, Hb, ALB, and TP than the control group; higher scores in physical pain, physiological function, emotional role, and mental state in the SF-36 scale than the control group; and lower TBil, ALT, and AST levels than the control group, with all differences being statistically significant (p < 0.05). Conclusion: Integrated nursing for specific diseases can effectively improve the nutritional status and quality of life of patients with liver cirrhosis and assist in improving liver function, demonstrating high clinical application value.

Functional Characterization of p53 in NPC C666-1 cells by CRISPR-based Gene Knockout and Transcriptome Sequencing

Jing Lei, Qinjin Wang, Zhenqi Qin — Fri, 31 Jul 2026 00:00:00 +0800

Introduction: Nasopharyngeal carcinoma (NPC) is a head and neck cancer associated with Epstein-Barr virus (EBV) in Southern China and Southeast Asia. Although mutation of the p53 tumor suppressor gene is a rare event in NPC, NPC has a high frequency of over-expressed/accumulated p53 protein, which is considered to be a dysfunction or inactivation by EBV in NPC. However, the activity and role of p53 in the NPC remain controversial. Methods: The CRISPR-Cas9 gene editing system was used to establish NPC C666-1 cell lines with p53 knockout (KO), and transcriptome sequencing was performed to identify differentially expressed mRNAs and miRNAs in the p53 KO and control C666-1 cell lines. EdU incorporation assay, soft agar colony formation assay, and plate colony formation assay were performed to detect cell proliferation, and flow cytometry was used to analyze cell cycle and apoptosis. Results: 766 differentially expressed genes (DEGs) and 46 differentially expressed miRNAs were identified. The KEGG pathway enrichment analysis of both the DEGs and miRNAs target genes showed that the p53 signaling pathway was significantly enriched. In the enriched p53 signaling pathway, genes involved in cell cycle arrest and apoptosis induction were significantly downregulated by p53 KO, and re-expression of exogenous p53 rescued their expression in the C666-1 cells. Moreover, p53 KO promoted cell proliferation, decreased cell apoptosis, and accelerated G1/S phase progression in the C666-1 cells, and re-expression of exogenous p53 rescued these phenotypes in the C666-1 cells. Conclusions: Our data indicate that p53 retains tumor suppressor function in NPC C666-1 cells.

Application of PDCA Cycle Combined with Predictive Nursing in Pain Management after Video-Assisted Thoracoscopic Lobectomy

Yingjie Wang — Fri, 31 Jul 2026 00:00:00 +0800

Objective: To explore the application effect of the PDCA cycle combined with predictive nursing in pain management after video-assisted thoracoscopic lobectomy. Methods: A total of 156 patients who underwent video-assisted thoracoscopic lobectomy in our hospital from January 2024 to December 2025 were selected and divided into a control group and an intervention group according to the nursing protocol, with 78 cases in each group. The Visual Analog Scale (VAS) scores at 6 h, 24 h, and 48 h after surgery, the number of effective presses on the analgesic pump, the rate of rescue analgesia, and the incidence of adverse reactions were compared between the two groups. Results: The VAS scores at each time point after surgery in the intervention group were lower than those in the control group (p < 0.05). The number of effective presses on the analgesic pump and the rate of rescue analgesia were significantly reduced in the intervention group (p < 0.05), and the incidence of adverse reactions such as nausea and vomiting was lower than that in the control group (p < 0.05). Conclusion: The PDCA cycle combined with predictive nursing can effectively relieve pain after video-assisted thoracoscopic lobectomy, improve the quality of analgesia, and reduce adverse reactions, which is worthy of clinical promotion and application.

Research on a Nursing Plan for Respiratory Function Training After Radical Resection of Lung Cancer Based on Self-Efficacy Theory

Luping Xu — Fri, 31 Jul 2026 00:00:00 +0800

Objective: To conduct an in-depth analysis of the effectiveness and value of applying a nursing plan for respiratory function training based on self-efficacy theory in patients after radical resection of lung cancer. Methods: The study subjects were patients undergoing radical resection of lung cancer, all of whom were sourced from our hospital. A total of 60 patients were included, with the time frame spanning from January 2024 to December 2025. Using a random number table method, all patients were divided into a control group and an observation group (n = 30). The control group received conventional nursing care, while the observation group received respiratory function training nursing care based on self-efficacy theory. Relevant indicators were quantified for both groups. Results: After nursing care, the observation group showed significant improvements in pulmonary function indicators, blood gas indicators, as well as inflammatory factor and oxidative stress indicators, which were superior to those of the control group (p < 0.05). Conclusion: For patients after radical resection of lung cancer, the nursing care plan for respiratory function training based on self-efficacy theory has yielded remarkable results, improving indicators such as pulmonary function and blood gas. It is worthy of promotion and application.

Application of Problem-based Teaching Combined with Case Simulation Teaching and Film Reading Mode in the Training of Geriatric Residents

Fang Chen, Wei Xia — Fri, 31 Jul 2026 00:00:00 +0800

Objective: To explore the practical application effect of problem‑based learning (PBL) combined with case simulation in the standardized training of geriatric residents and its impact on the trainees’ clinical comprehensive ability. Methods: From January 2020 to December 2024, 80 trainees who completed their training in the Department of Geriatrics of our hospital were enrolled and randomly divided into two groups, with 40 cases in each. The control group received conventional film‑reading teaching, while the observation group received PBL combined with case‑simulation film‑reading teaching; both groups underwent an 18‑month training period. Results: Compared with the control group, the observation group had significantly higher scores in theoretical assessment, practical skills, film‑reading ability, and case analysis (p < 0.05), as well as better performance in clinical reasoning ability, overall coordination, information processing, and interpersonal communication (p < 0.05), and also reported higher teaching satisfaction (p < 0.05). Conclusion: The teaching model of PBL combined with case simulation can effectively improve the theoretical knowledge, clinical thinking ability, and post competence of geriatric residents, and thus deserves wider promotion.

Mechanisms and Efficacy of Paraffin Therapy in Sports Injuries

Xue Wang, Shuting Duan, Huanru Deng, Ying Ma, Xueqiao Zhou — Fri, 31 Jul 2026 00:00:00 +0800

Paraffin therapy is a widely applied physical modality in the treatment of sport-related injury. The present study aimed to elucidate its mechanisms of action and clinical efficacy, and thus to give theoretical insight as well as practical guidelines for sports medicine therapeutic use.

Research Advances in Multidisciplinary Management of Metabolic Dysfunction-Associated Steatotic Liver Disease from a Proactive Health Perspective

Yidan Quan, Jiayin Xu, Yanbei Li, Yang Chen, Wei Zhang — Fri, 31 Jul 2026 00:00:00 +0800

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), as the most prevalent chronic liver disease, poses challenges that a single department cannot adequately address. Proactive health is an original concept proposed by China to advance the transformation of its healthcare service system. This paper reviews the current state of multidisciplinary management research for MASLD, analyzes the difficulties and challenges in implementing such management, and introduces the concept of proactive health. It explores the division of responsibilities among individuals, hospitals, and communities within the proactive health framework, providing a basis for the practical implementation of multidisciplinary management for MASLD.

Application of Esketamine in Laparoscopic Gynecological Malignancy Surgery

Jie Ren, Xue Cao, Yuhua Ma, Lijing Zhong — Fri, 31 Jul 2026 00:00:00 +0800

This article systematically analyzes the impact of esketamine on postoperative pain levels, cognitive function, and adverse reactions in patients undergoing laparoscopic gynecological malignancy surgery. A prospective, double-blind, randomized controlled study was conducted, selecting 22 patients from our hospital who underwent laparoscopic gynecological malignancy surgery. They were randomly divided into an experimental group (Group K) and a control group (Group C) using a random number table method, with 11 patients in each group. Group K received a single intravenous infusion of 0.5 mg/kg esketamine before skin incision and a continuous infusion of normal saline during surgery; Group C received an equivalent amount of normal saline before skin incision and did not use any NMDA receptor antagonists throughout the procedure. Within 48 hours postoperatively, the numerical rating scale (NRS) scores for pain in Group K were lower than those in Group C (p < 0.05); there was no significant difference in preoperative Mini-Mental State Examination (MMSE) scores between the two groups (p > 0.05), but the postoperative decrease in MMSE scores was smaller in Group K than in Group C; the incidence of adverse reactions in Group K was 9.09% (1/11), which was lower than the 54.55% (6/11) in Group C. The use of esketamine in laparoscopic gynecological malignancy surgery can alleviate postoperative pain, reduce cognitive impairment, and lower the incidence of adverse reactions, making it suitable for clinical promotion.

Research on the Prevention of Cataracts and Age-Related Macular Degeneration by Black Rice Anthocyanins

Guang Han, Yu Jiang, Rui Liu, Qin Wang — Fri, 31 Jul 2026 00:00:00 +0800

Objective: To observe the effectiveness and safety of black rice anthocyanins in preventing cataracts and age-related macular degeneration (dry form). Methods: Patients with cataracts and age-related macular degeneration who were outpatients or inpatients at the Ophthalmology Department of Changchun Hospital of Traditional Chinese Medicine from December 2024 to December 2025 were selected as the study subjects. They were randomly divided into an observation group and a control group, with 50 cases in each group, using a random number table method. The observation group received oral black rice anthocyanins, while the control group received oral vitamin C pills. Both groups were treated for 20 days and observed for 3 months. Visual acuity, lens, and retina conditions were compared before and after treatment to verify whether black rice anthocyanins could effectively prevent the occurrence and development of cataracts and age-related macular degeneration (dry form) and delay disease progression. Results: Comparing the clinical efficacy of the two groups, the observation group had a total effective rate of 84%, while the control group had a total effective rate of 62%. The observation group was significantly superior to the control group. After χ² testing, p = 0.013, p < 0.05, indicating a significant difference in the total effective rates between the two groups. In terms of visual acuity and the number of lines improved, the observation group was significantly superior to the control group. Conclusion: Black rice anthocyanins effectively improve visual acuity, lens opacity, and retinal conditions in patients with early-stage cataracts and age-related macular degeneration (dry form), demonstrating definite clinical efficacy and safety without side effects. This study provides a new approach for the early prevention of cataracts and age-related macular degeneration (dry form).

Research on the Application of Refined Management Model in Quality Control of Hospital Central Sterile Supply Department (CSSD)

Haiping Zhang — Fri, 31 Jul 2026 00:00:00 +0800

This study explores the application approaches of refined management methods in the quality control of the Hospital Central Sterile Supply Department (CSSD). In accordance with the requirements of the WS310 series of industry standards, the Supplementary Indicators for Quality Control of Disinfection Supply issued by the National Health Commission’s Institute of Hospital Management (2025 edition), and the special action plan of the provincial disinfection supply quality control center, this study systematically organizes practical approaches from four aspects: standardization of systems and processes, quality monitoring and data-driven improvement, application of information traceability systems, and job training and performance evaluation, starting from the concept of refined management. Refined management relies on specific means and institutional constraints to improve the operational standardization of all links in disinfection supply, achieving the goal of transforming quality control from extensive to precise. Practice has proven that this model can effectively enhance the quality control level of the CSSD and is worthy of promotion.

The Alienation of Emotional Labor and the Reconstruction of Dual-dimensional Incentives in Rural Areas under the Long-term Care Insurance System—Qualitative Study Based on Rural Doctors in Guilin City

Fri, 31 Jul 2026 00:00:00 +0800

As China’s long-term care insurance (LTCI) system expands into rural areas, village doctors in aging mountainous cities like Guilin will become core providers of home care. Although Guilin has not formally implemented LTCI, emotional labor is already a key variable in rural “quasi-long-term care”. This study employs an interpretative sequential mixed method: a word frequency analysis of 249 policy documents from 29 pilot cities nationwide, combined with in-depth interviews with village doctors in Guilin to simulate future LTCI scenarios. The study finds a significant policy bias toward “strong control and neglect of emotional support,” with emotional and incentive terms accounting for less than 0.1% of texts. Under administrative and social network pressures, village doctors use “quasi-kinship” strategies to compensate for care resource shortages. However, the current mechanism treats emotional labor as an unpaid obligation, leading to dignity erosion and emotional exhaustion. We propose a dual-dimensional incentive scheme (“emotional points + care difficulty coefficient”) to incorporate trust-building costs and emotional value into the payment system, shifting LTCI from “payment based on quantity” to “payment based on quality” to stabilize the rural doctor team.

Evaluation of Peer Education Intervention in Health Management for Elderly Hypertensive Patients

Xiaojing Ren, Wenjing Zhang — Fri, 31 Jul 2026 00:00:00 +0800

Objective: To investigate the effectiveness of peer education interventions in health management for elderly hypertensive patients, providing evidence for enhancing self-management capabilities, improving blood pressure control, and promoting long-term behavioral change. Methods: A total of 82 elderly hypertensive patients admitted to a tertiary hospital in Shanxi Province in March 2024 were selected, with 41 patients in each of the control and observation groups. The control group received routine health management, while the observation group additionally underwent peer education intervention. Changes in blood pressure levels, scores on the Hypertension Self-Management Scale, and medication adherence were compared between groups before and after intervention. Results: Post-intervention, the observation group exhibited greater reductions in systolic and diastolic blood pressure compared to pre-intervention levels than the control group (p < 0.05). Scores on the Hypertension Self-Management Scale dimensions, diet management, medication management, emotional management, condition monitoring, work and rest management, along with the total score, improved significantly compared to pre-intervention levels and were superior to the control group (p < 0.05). However, improvement in the exercise management dimension was not significant. Post-intervention, the medication adherence scores in the intervention group were also higher than those in the control group (p < 0.05). Conclusion: Peer education intervention can effectively promote blood pressure improvement in elderly hypertensive patients, enhance self-health management capabilities and medication adherence, and is suitable as an important supplement to community and hospital-based continuing care models.

A Nursing Report of Primary Tuberculous Otitis Media with Middle Ear Tuberculosis and Mastoiditis Based on the Concept of Precision Nursing: A Case Study

Xiaobing Wang, Hailei Zhang, Hongyu Yang — Fri, 31 Jul 2026 00:00:00 +0800

Objective: To explore clinical nursing key points and management strategies for patients with primary eustachian tube tuberculosis complicated by middle ear tuberculosis and mastoiditis, providing practical evidence for early identification, precision nursing, and comprehensive management of rare extrapulmonary tuberculosis. Methods: A retrospective analysis was conducted on a case presenting with refractory ear fullness, ear pain, and conductive hearing loss, which was initially misdiagnosed as secretory otitis media and later confirmed as primary eustachian tube tuberculosis complicated by middle ear tuberculosis through pathological examination. Nursing interventions included strict isolation protocols, enhanced multidisciplinary team (MDT) specialized nursing procedures, visualized local drug administration, multidimensional intelligent medication management, individualized psychological care, systematic nutritional support, and standardized discharge guidance. Results: After 28 days of standardized anti-tuberculosis treatment and comprehensive nursing interventions, the patient exhibited significant improvement in otological symptoms and hearing function, with patent tympanic tubes and no adverse drug reactions or nosocomial cross-infections. Discharge was achieved successfully. Follow-up at 3 months demonstrated good treatment adherence, progressive lesion absorption, and favorable prognosis. Conclusion: Primary eustachian tube tuberculosis has an extremely low clinical incidence rate, particularly when complicated by middle ear tuberculosis, with insidious and atypical symptoms prone to misdiagnosis and missed diagnosis. This case innovatively integrates endoscopic techniques, rehabilitation medicine, intelligent management, and multidisciplinary collaboration into clinical nursing workflows. Systematic, individualized, and precision nursing interventions significantly improved treatment outcomes, hearing function, and quality of life, warranting clinical promotion and application.

Influence of Diversified Training and Fragmented Time Management on Post-Competence of Nurses in the Cardiology Department

Yuchan Chen, Meifang Leng, Wenyuan Zeng, Mengxia Guan, Heling Liu — Fri, 31 Jul 2026 00:00:00 +0800

Objective: To explore the influence of diversified training on the post-competence of nurses in the cardiology department under fragmented time management. Methods: The training data of 80 in-service nurses in the Cardiovascular Hospital of our hospital from January 2025 to December 2025 were analyzed retrospectively. From January 2025 to June 2025, 40 nurses who received the conventional single centralized teaching training method were used as the conventional training group, and from July to December 2025, 40 nurses who received diversified training under fragmented time management were used as the diversified training group. The annual theoretical and operational achievements, adverse events, and nurses’ core competence of the two groups were compared. Results: The theoretical and operational achievements of the diversified training group were higher than those of the routine training group, and the difference was statistically significant (p < 0.05). The incidence of adverse events among nurses in the diversified training group was lower than that in the routine training group, and the difference was statistically significant (p < 0.05). The core competence of nurses in the diversified training group was higher than that in the routine training group, and the difference was statistically significant (p < 0.05). Conclusion: Diversified training methods under fragmented time management can improve nurses’ specialized knowledge level and clinical comprehensive ability in the training of cardiology nurses, train nurses at all post levels who are more competent in cardiology, and provide high-quality nursing services for patients.

Discussion on the Application and Nursing Countermeasures of Psychological Intervention in Cirrhosis Nursing

Yueting Lu — Fri, 31 Jul 2026 00:00:00 +0800

Objective: To explore the clinical value of a systematic psychological intervention program in nursing for hospitalized patients with cirrhosis, and sort out psychological nursing implementation countermeasures suitable for cirrhosis patients. Methods: A total of 84 patients with cirrhosis admitted from October 2023 to October 2025 were selected as research subjects and randomly divided into a control group and an observation group with 42 cases in each group by random number table. The control group received routine liver disease nursing, while the observation group received hierarchical and multi-dimensional psychological interventions on the basis of routine nursing. Six indicators, including anxiety, self-management ability, treatment compliance, health behaviors, disease coping styles, and quality of life, were compared between the two groups before and after intervention. Results: There was no statistically significant difference in baseline data of all observed indicators between the two groups before intervention (p > 0.05). After intervention, the Hamilton Anxiety Scale (HAMA) scores of both groups decreased, and the scores of the observation group were significantly lower than those of the control group (p < 0.05). The improvement ranges of self-management ability, treatment compliance, and Health-Promoting Lifestyle Profile (HPL) scores in the observation group were higher than those in the control group (p < 0.05). The negative coping scores of the observation group decreased significantly while the positive coping scores increased remarkably, with statistically significant differences compared with the control group (p < 0.05). Conclusion: Constructing standardized psychological intervention nursing countermeasures for patients with cirrhosis can effectively relieve negative emotions such as anxiety and fear, correct negative disease coping modes, strengthen patients’ self-management and treatment compliance, standardize healthy behaviors, and comprehensively improve patients’ quality of life. It is worthy of standardized promotion in clinical nursing of liver diseases.

Rescue and Nursing Strategies for a Case of Cardiac Arrest Induced by Vagal Reflex After Lumbar Spine Surgery Under the ERAS Concept

Shuping Gao, Yongling Zheng, Ran Wang, Zhijun Ren, Jianyun He — Fri, 31 Jul 2026 00:00:00 +0800

This paper summarizes the nursing experience in rescuing a patient who developed a severe circulatory collapse due to an exaggerated vagal reflex following posterior lumbar decompression, bone graft fusion, and internal fixation surgery. In response to this rapidly onset complication, the nursing team implemented proactive interventions: early warning monitoring based on multidimensional risk assessment and blocking pain management targeting key links in the “Baroreceptor-Vagal Reflex Arc“. When the patient experienced sudden cardiac arrest, seamless integration with the ICU and advanced life support were ensured within the “golden 2 minutes“ of cardiopulmonary resuscitation (CPR). After stabilization, the Enhanced Recovery After Surgery (ERAS) protocol was individually adjusted based on evidence. Through systematic rescue and nursing, the patient achieved stable circulation without neurological sequelae and recovered successfully.

A Study on the Application of Remote Ischemic Postconditioning Training in Patients after Mechanical Thrombectomy for Acute Ischemic Stroke

Fri, 31 Jul 2026 00:00:00 +0800

Objective: This study examines the impact of remote ischemia post-conditioning (RIPostC) on clinical outcomes in patients who have undergone mechanical thrombectomy for acute ischemic stroke (AIS), with the aim of guiding improvements in patient outcomes. Methods: We selected 78 patients with acute ischemic stroke (AIS) who underwent mechanical thrombectomy in the Neurointensive Care Unit (NICU) of our hospital from January to December 2024 as study subjects. Patients were randomly assigned to either the experimental group or the control group using a random number table. All patients received identical standard general treatment, routine post-mechanical thrombectomy therapy, and nursing care. The experimental group additionally received remote ischemic postconditioning (RIPostC) treatment for 7 consecutive days, twice daily, with 5 cycles per session. An ischemic adaptation training device was used to alternately inflate and deflate both upper limbs for 5 minutes per session. The total training duration was 7 days. For the experimental group, the inflation pressure was set at 200 mmHg, and one complete RIPostC session was defined as five cycles (45 minutes). The control group received sham RIPostC treatment for 7 days. In the control group, the inflation pressure was set at 60 mmHg, which induced a sensation of limb constriction while maintaining palpable radial and brachial artery pulses. One complete sham session was also defined as five cycles (45 minutes). Both groups completed a total of 14 RIPostC/sham sessions. Evaluations were performed before the intervention, at 3 days and 7 days after the intervention, assessing NIHSS scores, modified Rankin Scale (mRS) scores, and laboratory markers (PCT, CRP, IL-6). Additional assessments of NIHSS and mRS scores were conducted before discharge and at the 90-day follow-up. Transcranial Doppler ultrasound (TCD) was used to evaluate blood flow velocity in the affected cerebral vessels, including peak systolic velocity (Vs), diastolic velocity (Vd), mean velocity (Vm), and pulsatility index (PI). Results: Of the 78 enrolled patients, 62 completed the study, including 32 in the experimental group and 30 in the control group. There were no statistically significant differences between the two groups in baseline characteristics such as gender, age, history of smoking and alcohol consumption, and past medical history (p > 0.05), indicating comparability. Seven days after intervention, the experimental group demonstrated significantly better outcomes than the control group in Vd, Vm, PI, mRS scores, NIHSS scores, PCT levels, and IL-6 levels (all p < 0.05). Similarly, at 3 days, 7 days, pre-discharge, and during the 90-day follow-up assessments, the experimental group showed consistently superior mRS and NIHSS scores compared to the control group (all p < 0.05). Repeated measures ANOVA indicated significant interaction effects between time and group for Vs, Vd, Vm, PI, mRS scores, NIHSS scores, CRP, and IL-6 (all p < 0.05). Notably, there were significant main effects of both time and group on mRS and NIHSS scores (p < 0.05), as well as significant main effects of time on Vs, Vd, Vm, PI, CRP, PCT, and IL-6 (p < 0.05). A total of 19 patients experienced adverse reactions in this study, including 15 in the experimental group and 4 in the control group. While the incidence of skin petechiae, dizziness, palpitations, and chest tightness showed no significant between-group differences (p > 0.05), the experimental group had a significantly higher incidence of skin ecchymosis and overall adverse event rate compared to the control group (both p < 0.05). All adverse reactions resolved after symptomatic treatment, and no serious adverse events occurred. Conclusion: RIPostC training can reduce the inflammatory response in patients with acute ischemic stroke (AIS) and improve cerebral blood flow perfusion in the affected area, and promote neurological recovery.

A A Scoping Review of Shared Decision-Making and Patient Decision Aids for Patients with Peripheral Arterial Disease

Jiabei Lu, Yuexian Tao, Qiuying Lou, Yating Liu, Yeqin Xu, Siying Qiu — Fri, 31 Jul 2026 00:00:00 +0800

Objective: To review the current evidence on shared decision-making (SDM) and patient decision aids (PDAs) for patients with peripheral arterial disease (PAD), focusing on application characteristics, intervention effects, and implementation factors to inform clinical decision support models. Methods: A scoping review was conducted following the Joanna Briggs Institute (JBI) framework and PRISMA-ScR guidelines. A systematic search was performed in eight Chinese and English databases, including PubMed, Embase, the Cochrane Library, CINAHL, CNKI, Wanfang, VIP, and the China Biomedical Literature Database, up to 2025. Eligible studies included randomized controlled trials, cross-sectional studies, qualitative studies, and mixed-methods studies. Data were extracted and descriptively synthesized. Results: Fifteen studies published between 2011 and 2025 were included, mainly from Europe, North America, and Asia. Studies explored SDM preferences, the development and application of PDAs, decision support tools, SDM training, multimedia decision-making interventions, and patients’ experiences. SDM and PDAs improved patient knowledge, participation, decision quality, and satisfaction, while reducing decisional conflict and negative emotions. Implementation was affected by time constraints, information complexity, provider–patient communication, and healthcare system factors. Conclusion: SDM and PDA research in PAD is increasing; however, tool standardization and clinical integration remain limited. Future research should develop patient-centered decision-support tools and promote nurse-led SDM models to improve long-term PAD management and patient decision-making experiences.

Mechanisms of Zone 2 Aerobic Exercise on Glycemic Control in Prediabetic Populations: A Narrative Review

Luran Huang — Fri, 31 Jul 2026 00:00:00 +0800

Prediabetes represents a critical window for the development of type 2 diabetes, with exercise intervention serving as a core management strategy. Zone 2 aerobic exercise, characterized by low-to-moderate intensity and sustained fat oxidation, has recently attracted attention for its potential to improve glucose metabolism. This narrative review synthesizes domestic and international research to explore the underlying mechanisms by which Zone 2 aerobic exercise improves glycemic control in prediabetic populations, including enhanced mitochondrial biogenesis, improved fatty acid oxidation capacity, ameliorated insulin signaling pathways, modulation of chronic low-grade inflammation, and gut microbiota remodeling. Current evidence suggests that Zone 2 aerobic exercise can improve insulin sensitivity through multi-target, multi-pathway synergistic effects, thereby reducing the risk of diabetes progression. Future high-quality randomized controlled trials are needed to validate its long-term efficacy and optimal exercise prescription parameters.

Characteristics Analysis of Patients with SET-NUP214 Fusion Gene-Positive Acute Leukemia

Bingxia Li — Fri, 31 Jul 2026 00:00:00 +0800

Patients with SET-NUP214 fusion gene-positive acute leukemia are mainly young and middle-aged males, most of whom are diagnosed with T-cell acute lymphoblastic leukemia (T-ALL). Immunophenotyping is often accompanied by the expression of myeloid markers such as CD13 and CD33. Karyotype analysis presents normal karyotypes in some patients and abnormalities, including 9q34 deletion, in others. This type of leukemia is frequently accompanied by mutations of PHF6, NOTCH1, JAK3, and other genes. In terms of treatment, conventional chemotherapy has a low remission rate and tends to induce drug resistance, while allogeneic hematopoietic stem cell transplantation can bring benefits to some patients. The expression level of SET-NUP214 can be used as an indicator for follow-up of minimal residual disease and prognostic monitoring, but further expansion of sample size is required for verification to achieve better detection results.

Study on the Effect of Auricular Point Pressing with Vaccaria Seeds Combined with Traditional Chinese Medicine Emotional Intervention on Patients with Migraine

Qianqian Li, Qiuxia Xie — Fri, 31 Jul 2026 00:00:00 +0800

Objective: To analyze the clinical efficacy of auricular point pressing with vaccaria seeds combined with traditional Chinese medicine emotional intervention applied to migraine patients, and observe the influence of this combined intervention program on patients’ headache symptoms, psychological status, sleep quality, and quality of life, so as to provide a reliable basis for clinical integrated traditional Chinese and Western medicine nursing intervention of migraine. Methods: A total of 86 migraine patients admitted to our hospital from January 2025 to December 2025 were selected as research objects, and the patients were divided into two groups by random number table method, with 43 cases in each group. Results: Before intervention, there were no statistically significant differences in VAS score, headache attack frequency, SAS, SDS, PSQI, and MSQ scores between the two groups (p > 0.05). After 8 weeks of intervention, all indicators of the two groups were significantly improved compared with those before intervention; the VAS score, headache attack frequency, SAS, SDS and PSQI scores of the observation group were significantly lower than those of the control group, while the MSQ score was significantly higher than that of the control group, and all differences were statistically significant (p < 0.05). The total clinical effective rate of the observation group was 95.35%, which was obviously higher than 81.40% of the control group, with statistical significance (p < 0.05). Conclusion: Auricular point pressing with vaccaria seeds combined with traditional Chinese medicine emotional intervention can effectively relieve headache symptoms of migraine patients and reduce the frequency of headache attacks, improve patients’ negative emotions such as anxiety and depression, as well as enhance their sleep quality and quality of life. It has an obvious clinical intervention effect and good safety, and can be popularized and applied in clinical nursing of migraine.

Clinical Study on Xinhuanglong Decoction in Treating Severe Pneumonia with Qi-Yin Deficiency Syndrome Based on the Theory of “Lung and Large Intestine Being Interrelated”

Xiaoyan Wang — Fri, 31 Jul 2026 00:00:00 +0800

Guided by the TCM theory of “the lung and large intestine are interrelated”, this paper analyzes severe pneumonia with Qi-Yin deficiency syndrome. Combined with the connotation of Zang-Fu viscera correlation theory and modern research on lung-intestine correlation, it sorts out the core pathogenesis of simultaneous lung and intestinal disease complicated with deficiency of both Qi and unobstructed Fu Qi in this disease, and elaborates the formula logic and clinical application value of Xinhuanglong Decoction for replenishing Qi and nourishing Yin, unblocking Fu organs and clearing heat. Most patients with severe pneumonia are accompanied by varying degrees of gastrointestinal injury and severe systemic inflammatory response. The elderly and patients with chronic illnesses and physical weakness are more prone to develop a complicated pathogenesis of intermingled deficiency and excess. With simultaneous purgation and tonification, Xinhuanglong Decoction can effectively improve gastrointestinal motility and reduce the level of inflammatory indicators, shorten the duration of mechanical ventilation and ICU hospitalization, and is more suitable for elderly and chronically ill patients with severe pneumonia of Qi-Yin deficiency syndrome. This prescription embodies the TCM diagnosis and treatment idea of simultaneous treatment of lung and intestine, possesses high clinical application potential, and can provide references for integrated traditional Chinese and Western medicine treatment of severe pneumonia, worthy of further verification and promotion through large-sample clinical studies.

Construction and Application of Maintenance Intervention Program for Autologous Arteriovenous Fistula in Elderly Hemodialysis Patients Based on IFSMT Theory

Fri, 31 Jul 2026 00:00:00 +0800

Objective: To analyze contextual factors influencing self-management of arteriovenous fistulas (AVFs) among elderly patients on maintenance hemodialysis based on the Individual and Family Self-Management Theory (IFSMT), to develop an intervention model centered on patient-family-healthcare collaboration for AVF maintenance, and to evaluate its effectiveness. Methods: This study consisted of two phases. The first phase was a cross-sectional survey involving 165 participants, with 157 valid questionnaires collected to identify contextual factors affecting AVF self-management in elderly maintenance hemodialysis (MHD) patients. The second phase was a randomized controlled trial designed to assess the effectiveness of the intervention model developed based on IFSMT. Elderly AVF patients admitted to the hemodialysis unit of a tertiary hospital in Hebei Province between September 2025 and March 2026 were randomly assigned to either a control group or an intervention group using a random number table, with 63 patients in each group; ultimately, 60 patients completed follow-up in each group. The control group received standard care, while the intervention group received the IFSMT-based intervention in addition to standard care over a three-month period. Results: The mean self-management score for elderly AVF patients was 45.662 ± 7.701, indicating a moderate overall level. Factors including dialysis duration, daily care, daily AVF exercise, daily AVF self-checking, history of AVF failure or complications, anxiety, depression, general self-efficacy, and family support were identified as significant contextual factors influencing AVF self-management. After the intervention, the incidence of AVF abnormalities and failure was significantly lower in the intervention group compared to the control group (p < 0.05). The total scores and subscale scores of the AVF self-management scale were higher in the intervention group than in the control group (p < 0.05). The self-efficacy scores and family support index scores were also significantly higher in the intervention group (p < 0.05). Additionally, quality-of-life scores were higher in the intervention group (p < 0.05). Conclusion: The self-management program based on IFSMT can improve AVF maintenance outcomes, reduce the occurrence of AVF complications and failure rates, enhance patients’ self-management capacity and general self-efficacy, and improve family support and quality of life.

Research Hotspots and Development Trends of Reablement From 1999 to 2025: A Bibliometric Analysis

Hongxi Jin, Xiaoyun Yu, Ying Qian, Keying Yang, Minghui Ren, Yifan Qin — Fri, 31 Jul 2026 00:00:00 +0800

Aims: This study aims to explore the current research status, hotspots, and emerging trends of reablement and provide references for further research in this field. Methods: English-language literature related to reablement was retrieved from the Web of Science Core Collection database, covering the period from January 1, 1999 to October 20, 2025. The software CiteSpace and VOSviewer were used to conduct visual bibliometric analyses of eligible publications, including annual publication output, countries, authors, institutions, cited references, and keywords. Results: A total of 276 publications were included. Overall, the number of publications showed an increasing trend over time. The United States contributed the largest number of publications, followed by Australia and Norway, and Resnick was the most productive author. The top five keywords by frequency were “older adults”, “reablement”, “intervention”, “people”, and “physical activity”. Intervention studies and qualitative studies were the main research types, with application-focused research hotspots primarily concentrated on improving physical activity among service recipients. Conclusions: Research on reablement has attracted increasing attention. Future studies should focus on conducting high-quality empirical research to identify optimal intervention strategies, as well as sensitive assessment tools and outcome indicators. In addition, researchers are encouraged to draw on existing experiences to actively promote home-based reablement services and explore the development of reablement models tailored to national contexts.

One Case of Undifferentiated Embryonal Tumor of Adult Liver

Dingfeng Liu, Chao Jiang, Xiaohui Wang — Fri, 31 Jul 2026 00:00:00 +0800

Undifferentiated embryonal sarcoma of the liver (UESL) is rare in adults, and its clinical manifestations, laboratory tests, and imaging findings lack specificity. Diagnosis relies on pathological diagnosis. This article reports a 55-year-old male patient with UESL who was admitted to the hospital due to right upper abdominal pain for 3 months. He had no history of chronic hepatitis or cirrhosis, and the tumor marker was only elevated CA-125. CT showed a huge cystic solid exogenous mass in the right lobe of the liver. The patient underwent right hemihepatectomy due to tumor rupture and bleeding. Postoperative pathology confirmed UESL, and genetic testing revealed FGFR2 amplification and TP53 mutation. This disease needs to be differentiated from hepatocellular carcinoma and liver abscess. Surgical resection is the preferred treatment, and postoperative combined chemotherapy can effectively improve prognosis.

Research Progress on Current Status and Influencing Factors of Occupational Burnout Among ICU Nurses

Shaoyan Yuan, Fang Xu — Fri, 31 Jul 2026 00:00:00 +0800

Nurses working in intensive care units face highly stressful working conditions, critically ill patients and persistent emotional engagement, rendering them a high-risk group for occupational burnout. Occupational burnout not only seriously damages nurses’ physical and mental health and reduces job satisfaction and retention rate, but also poses a significant threat to nursing quality and medical safety of patients. This paper reviews the concept, epidemiological status and influencing factors of occupational burnout among ICU nurses, so as to provide references for optimizing ICU nurse management, improving nursing quality and safeguarding the occupational health of ICU nurses.

A Study on the Correlation between Levels of 25-Hydroxyvitamin D and Parathyroid Hormone and the Degree of Skeletal Development in Children

Yong Gao, Xuebing Zhang, Caisu Qin — Fri, 31 Jul 2026 00:00:00 +0800

Objective: To analyze the correlation between 25-hydroxyvitamin D (25(OH)D) and parathyroid hormone (PTH) levels and bone development in children. Methods: 85 healthy children who underwent routine physical examination in our hospital from January 2022 to December 2023 were selected as the research objects. All children received bone mineral density measurement. According to the results, they were divided into the normal skeletal development group (Z value -1–1) and the skeletal dysplasia group (Z value < -1). The clinical general data and laboratory examination results of the two groups were compared. A multivariate logistic regression model was used to analyze the influencing factors of children’s skeletal development. Results: The level of 25 (OH) D in the skeletal dysplasia group was lower than that in the normal skeletal development group, and the level of PTH was higher than that in the normal skeletal development group. There were differences in body mass index (BMI), exercise frequency, eating habits, 25 (OH) D, and PTH between the two groups (p < 0.05). Multivariate logistic regression analysis showed that it was a risk factor for children with skeletal dysplasia (OR > 1). Conclusion: The degree of skeletal development in children is correlated with 25 (OH) D and PTH levels. According to the changes of the above indicators, it can guide the clinical supervision of children’s body mass, establish good diet and exercise habits, and promote the normal development of children’s bones.

Bibliometric Analysis of the Effect of Orofacial Myofunctional Training on Postoperative Mouth Breathing in Children with OSA

Weini Hu, Huali Li, Shaohua Li, Yiming Yuan — Fri, 31 Jul 2026 00:00:00 +0800

Objective: To conduct a bibliometric and visualized analysis on studies related to the application of orofacial myofunctional therapy (OMT) in the context of improving habitual mouth breathing after adenotonsillectomy in children with obstructive sleep apnea (OSA). This analysis will be done using the BERTopic method. Methods: From the China National Knowledge Infrastructure (CNKI) database, we searched for relevant articles. These articles were used as the study objects. The Sentence-BERT model was employed for text encoding, and then dimensionality reduction was done using UMAP, and clustering was done with HDBSCAN. Topic keywords were extracted via class-based term frequency-inverse document frequency (c-TF-IDF). Then, thematic structure was analyzed with intertopic distance maps, similarity heatmaps, document distribution maps, and hierarchical clustering maps. BERTopic is a topic modeling technique that employs transformer embeddings and c-TF-IDF to derive interpretable topics from text data. Results: The related studies mainly have two research lines. The first was a diagnostic and therapeutic line focusing on sleep-disordered breathing, perioperative management, and minimally invasive techniques. The second one was a functional rehabilitation line focused on OMT, orofacial functional assessment, and morphological and functional improvement. Current studies mainly focus on adenotonsillectomy and technical optimization, but OMT is an adjunctive intervention, which has a certain research basis for improving postoperative mouth breathing, sleep quality, and orofacial function in children with OSA. Conclusion: OMT holds potential clinical value as an essential adjunctive approach for enhancing postoperative habitual mouth breathing and promoting orofacial functional reconstruction. Future studies need to further evaluate its long-term efficacy and standardized application to promote an integrated diagnostic and therapeutic model of “surgical treatment plus functional rehabilitation”.