This paper reviewed the epidemiology,comorbidity mechanisms,risk factors, prediction models,and prevention and control strategies for cardiovascular and cerebrovascular comorbidity in cancer survivors.The aim is to provide insights for the co⁃management,co⁃prevention,and co⁃treatment of these comorbidity in cancer survivors,thereby supporting the enhancement of chronic disease prevention and control effectiveness under the Healthy China strategy.

BackgroundBioterrorism involves the intentional release of biological agents capable of causing mass casualties, public health emergencies, and societal disruption. As frontline healthcare providers, nurses play a critical role in early detection, isolation, emergency care, and surveillance. However, substantial gaps exist in nursing bioterrorism preparedness across healthcare settings, and implementation determinants influencing preparedness remain insufficiently synthesised.ObjectiveTo systematically synthesise quantitative and qualitative evidence on barriers and facilitators influencing nurses’ bioterrorism preparedness using the Consolidated Framework for Implementation Research (CFIR 2.0).MethodsThis mixed-methods systematic review will follow the Joanna Briggs Institute (JBI) methodology for mixed-methods systematic reviews and adhere to PRISMA-P guidelines, with CFIR 2.0 serving as the guiding analytical framework. A comprehensive literature search will be performed across CINAHL, PubMed, Embase, Scopus, Web of Science, ProQuest, Cochrane Library, and Medline electronic databases from their inception until March 2026, including English and Chinese publications. Two independent reviewers will screen identified records against predefined eligibility criteria and appraise the methodological quality of included studies using the Mixed Methods Appraisal Tool (MMAT). Data synthesis will be thematically mapped to CFIR 2.0 constructs and integrated using a convergent integrated approach.Anticipated contributionsThis review is expected to provide the first synthesis informed by implementation science of determinants influencing nurses’ bioterrorism preparedness. By integrating evidence across methodological traditions, the review will generate a comprehensive understanding of individual, organisational, and contextual factors shaping preparedness implementation.DiscussionThis protocol describes a mixed-methods systematic review informed by implementation science and guided by the Consolidated Framework for Implementation Research (CFIR 2.0) to examine barriers and facilitators influencing nurses’ bioterrorism preparedness. The findings are expected to support a more comprehensive understanding of factors shaping preparedness in healthcare settings and to inform evidence-informed preparedness planning, nursing education, and organisational support strategies aimed at strengthening healthcare system resilience to biological threats.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251273403, Identifier CRD420251273403.

OBJECTIVE:This study aimed to critically assess existing risk prediction models for postoperative mortality in older individuals with hip fractures, with the objective of offering substantive insights for their clinical application.DESIGN:A comprehensive search was conducted across prominent databases, including PubMed, Embase, Cochrane Library, SinoMed, CNKI, VIP, and Wanfang, spanning original articles in both Chinese and English up until 1 December 2023. Two researchers independently extracted pertinent research characteristics, such as predictors, model performance metrics, and modeling methodologies. Additionally, the bias risk and applicability of the incorporated risk prediction models were systematically evaluated using the Prediction Model Risk of Bias Assessment Tool (PROBAST).RESULTS:Within the purview of this investigation, a total of 21 studies were identified, constituting 21 original risk prediction models. The discriminatory capacity of the included risk prediction models, as denoted by the minimum and maximum areas under the subject operating characteristic curve, ranged from 0.710 to 0.964. Noteworthy predictors, recurrent across various models, included age, sex, comorbidities, and nutritional status. However, among the models assessed through the PROBAST framework, only one was deemed to exhibit a low risk of bias. Beyond this assessment, the principal limitations observed in risk prediction models pertain to deficiencies in data analysis, encompassing insufficient sample size and suboptimal handling of missing data.CONCLUSION:Subsequent research endeavors should adopt more stringent experimental designs and employ advanced statistical methodologies in the construction of risk prediction models. Moreover, large-scale external validation studies are warranted to rigorously assess the generalizability and clinical utility of existing models, thereby enhancing their relevance as valuable clinical references.

Background Older people with chronic diseases in the community have a higher risk of impaired cognitive function,which seriously threatens their quality of life.Improving cognitive function is crucial for enhancing their quality of life.However,there is heterogeneity in the forms of individual cognitive impairment,and how to effectively improve their cognitive function needs to be further explored.Objective To explore the Latent class of cognitive function among older people with chronic diseases in the community,and analyze the influence factors of different categories,to provide a reference for formulating targeted cognitive function improvement strategies for older people with chronic diseases in the community.Methods Convenience sampling was used to recruit 502 older people with chronic diseases in the community who visited the Tianjin University of Traditional Chinese Medicine Affiliated Baokang Hospital from September to December 2022,using the General Information Questionnaire,Mini-mental State Examination(MMSE),Activity of Daily Living Scale(ADLS),Social Support Rating Scale(SSRS),and Cognitive Reserve Questionnaire(CR).Mplus 8.3 was used to conduct a latent class analysis of cognitive function among older people with chronic diseases in the community and establish a subgroup model.Univariate analysis and unordered multiple Logistic regression were used to analyze the influence factors of cognitive function among older people with chronic diseases in different categories.Results In this study,a total of 526 questionnaires were distributed and 502 valid questionnaires were recovered,with an effective response rate of 95.44%.The cognitive function among 502 older people with chronic diseases in the community was classified into three categories:high cognition with memory impairment group(n=253),moderate cognition with attention impairment group(n=158),and low cognition with overall impairment group(n=91).Unordered multivariate Logistic regression analysis showed that the high cognition with memory impairment group compared to the low cognition with overall impairment group,older people aged 60-74 years(OR=2.315,95%CI=1.163-4.608,P=0.017),with two chronic diseases(OR=4.105,95%CI=1.807-9.327,P=0.001),normal blood pressure(OR=2.763,95%CI=1.414-5.400,P=0.003),normal blood lipids(OR=2.016,95%CI=1.014-4.008,P=0.046),higher CR scores(OR=1.031,95%CI=1.005-1.057,P=0.018),and higher SSRS scores(OR=1.055,95%CI=1.007-1.105,P=0.023)were more likely to belong to the high cognition with memory impairment group,while those with higher ADLS scores(OR=0.920,95%CI=0.885-0.957,P＜0.001)were more likely to belong to the low cognition with overall impairment group.Similarly,in the moderate cognition with attention impairment group compared to the low cognition with overall impairment group,older people with chronic diseases in the community with two chronic diseases(OR=2.862,95%CI=1.254-6.529,P=0.012),normal blood pressure(OR=2.655,95%CI=1.350-5.225,P=0.005),normal blood lipids(OR=2.310,95%CI=1.147-4.652,P=0.019),and higher SSRS scores(OR=1.077,95%CI=1.027-1.129,P=0.002)were more likely to belong to the moderate cognition with attention impairment group,while those with higher ADLS scores(OR=0.948,95%CI=0.913-0.984,P=0.005)were more likely to belong to the low cognition with overall impairment group.Conclusion There are significant differences in the classification characteristics of cognitive function among older people with chronic diseases in the community.Age,number of chronic diseases,blood pressure,blood lipids,cognitive reserve,social support,and activities of daily living are the influencing factors of the latent classes of cognitive function.Medical staff should actively identify the cognitive function characteristics of different categories of older people with chronic diseases in the community,and provide timely and effective intervention measures to improve the cognitive function level of older people with chronic diseases in the community.

Patients with diabetic foot ulcer have a significantly lower quality of life. Quality of life could be connected to other psychological or social processes. The purpose of this study was to examine the relationships between social support, decision regret, self-stigma, and quality of life in patients with diabetic foot ulcers. The sample of the study consisted of 229 diabetic foot ulcer patients. Data were collected from September 2019 to March 2020. The demographic and clinical information, the Stigma Scale for Chronic Illness, Medical Coping Scale, Social Support Scale, and Quality of Life scale were used to assess the quality life for diabetic foot ulcer. Pearson correlation coefficient and structural equation modelling were used for data analysis. The quality of life was negatively correlated with self-stigma, positively correlated with social support, giving up coping, and not significantly correlated with confrontation coping and avoidance coping. Self-stigma has significant indirect effects on quality of life through social support and coping style. Further clinical intervention strategies for decreasing self-stigma as well as strengthening social support and positive coping styles are needed to inform diabetic foot ulcer patients, thus improving their quality of life.

Background: Immunosenescence, an age-related deficit in immunity, associated with multiple disorders and making the successful aging a challenge. Although nearly 4000 articles have been published, only few review articles have summarized the research status. In order to better understand the most recent advances, hotspots and development trends in immunosenescence, it is very necessary to conduct a comprehensive bibliometric analysis. Hence, commonly used bibliometric analysis software CiteSpace and VOSviewer were employed to conduct a quantitative analysis and critical evaluation of publications in this study. Methods: Immunosenescence publications were screened from the Web of Science Core Collection (WoSCC). Microsoft Excel 2021, CiteSpace 5.8.R3, and VOSviewer 1.6.17 were used for bibliometric study.Results: A total of 3875 publications were retrieved from WoSCC. After screening by document type (article or review) (352 publications were excluded) and language of English (85 were excluded), 3438 studies were finally used for bibliometric analysis. The literature on immunosenescence had been continuously growing since 1991, and by 2020 it has skyrocketed 312 publications from 240 in 2019. USA (1111 publications, 35.01%) was the leading country of publications, followed by ITALY (379, 11.94%) and ENGLAND (366, 11.53%). Of the authors, Pawelec G from the Tubingen University of GERMANY contributed the greatest articles (93 publications). All the keywords could be divided into five clusters, and additional potent visualization bursts revealed that "gut microbiota," "health," "dysfunction," and "nivolumab" were the active hotspots presently.Conclusion: Based on the current data, we firstly concluded that there will be a dramatically rising publications on immunosenescence, and research teams from USA or GERMANY might be the best chooses for collaboration. Moreover, We particularly emphasized the development potential of mechanism and intervening strateges like "gut microbiota" and "nivolumab" in immunosenescence. We hope to provide new ideas for promoting the basic research and clinical application of immunosenescence.

本森放松技术(BRT)是一种简单有效的放松疗法,国外已与多项学科相结合,并广泛用于临床.笔者对BRT的概念、作用机制、其在护理领域中的应用现状等方面进行综述,以期促进该技术在我国的推广及应用,并丰富护理干预形式,为护理干预的进一步发展提供参考.

Objective To systematically analyze the influence factors of depression among maintenance hemodialysis（MHD） patients, so as to provide references for developing effective interventions in clinic.Methods The databases of CNKI,Wanfang, VIP,PubMed, Web of Science, Embase were systematically searched, and the RevMan 5.3 software was used for meta-analysis.Results A total of 38 articles were involved, covering 2462 cases in the depressed group and 3012 cases in the non-depressed group.Rural residence, non-employment, living without spouse, having complications, affected self-image, low activities of daily living, low level of social support, poor sleep quality, low hemoglobin, low serum albumin, rural cooperative medical service, having comorbidity, and low education level were the risk factors of maintenance hemodialysis combined with depression.Conclusions Medical staff should identify the MHD patients who are at a high risk of depression according to those risk factors, and take targeted interventions as early as possible.

Objective:To explore the current status and influencing factors of self-management in colorectal cancer patients with stoma.Methods:From June to September 2022, a total of 390 colorectal cancer patients with stoma at a Class Ⅲ Grade A hospital in Tianjin were selected as study subjects using convenience sampling method, and were investigated by General Information Questionnaire, Enterostomy Self-Management Questionnaire, Connor-Davidson Resilience Scale, and Acceptance of Disability Scale. Pearson correlation analysis was used to investigate the correlation between self-management, psychological resilience and stoma acceptance of colorectal cancer patients with stoma. Multiple linear regression analysis was used to explore the influencing factors of self-management in colorectal cancer patients with stoma. A total of 390 questionnaires were distributed in this study, and 386 valid questionnaires were collected, with an effective response rate of 98.97% (386/390) .Results:The self-management, psychological resilience and stoma acceptance score of colorectal cancer patients with stoma was (99.07±12.40), (69.43±9.76), (82.00±10.56). Pearson correlation analysis results showed that the score of self-management in colorectal cancer patients with stoma was positively correlated with psychological resilience and stoma acceptance scores ( r=0.640, 0.727; P<0.01). The results of multiple linear regression showed that age, time after enterostomy, tumor node metastasis (TNM) staging, postoperative radiation and chemotherapy, psychological resilience, and stoma acceptance were the influencing factors of self-management in colorectal cancer patients with stoma ( P<0.05) . Conclusions:The self-management of colorectal cancer patients with stoma is at a moderate level and needs to be improved. Medical and nursing staff should take targeted intervention measures to improve patients' self-management and quality of life.

AbstractAimTo explore the physical and mental health status of community residents and to identify the risk factors of chronic diseases.DesignA cross‐sectional, descriptive correlational study was conducted.MethodsA total of 579 participants were recruited from 15 communities in Tianjin. The demographic information sheet, 7‐item Generalized Anxiety Disorder scale (GAD‐7) and Patient Health Questionnaire (PHQ‐9) were used. Data collection was undertaken based on the health management system on mobile phones from April to May 2019.ResultsEighty‐four participants of the total number of surveyed were with chronic disease. The incidence of depression and anxiety in participants was 44.2% and 41.3%. Logistic regression analysis showed that age (OR = 4.905, 95%CI: 2.619–9.187), religious belief (OR = 0.445, 95%CI: 1.510–11.181) and working condition (OR = 0.161, 95%CI: 0.299–0.664) entered the regression equation. Old age is a risk factor for chronic diseases. No religious belief and working condition are protective factors for chronic diseases.

Purpose The aim of this study was to identify symptom clusters in breast cancer patients undergoing adjuvant chemotherapy. Methods A prospective longitudinal study was conducted. And a sample of 620 breast cancer patients receiving adjuvant chemotherapy was recruited using convenience sampling from May 20, 2020, to March 31, 2021. Data were collected eight times: the first chemotherapy cycle (T1) to the eighth cycle of chemotherapy (T8). Exploratory factor analysis was used to explore the composition of symptom clusters. Results Symptoms with an incidence of less than 20% were deleted and the remaining symptoms were included in the factor analysis. Three common factors were extracted in T1, including gastrointestinal symptom cluster, emotional and psychological symptom cluster, and menopausal symptom cluster. Five common factors were extracted from T2 to T7, including gastrointestinal symptom cluster, emotional and psychological symptom cluster, neurological symptom cluster, menopausal symptom cluster, and self-image disorder symptom cluster. Four common factors were extracted at T8, including gastrointestinal symptom cluster, emotional and psychological symptom cluster, neurological symptom cluster, and menopausal symptom cluster. Conclusion Breast cancer patients undergoing adjuvant chemotherapy experience multiple symptoms and different symptom clusters in different chemotherapy cycles. It is a benefit for health care providers to better understand and care for breast cancer patients. It will also help such women to manage concurrent symptoms ahead to promote their quality of life.

Although dance interventions may have lots of advantages in improving frailty, there are few papers focusing on the effects such interventions have on frail older adults living in the community setting. This study investigates whether a dance intervention can improve the level of frailty among Chinese older adults living in the community setting. The dance intervention was done five times a week for 16 weeks. Participants in the control group maintained their normal daily activities. Assessments were conducted at baseline, 8 weeks, and 16 weeks. Mixed models were used to test for the effects on frailty, depression, short physical performance battery, and grip strength between the groups over time. The level of frailty (p < .05) and depression (p < .001) decreased, and short physical performance battery (p < .001) increased over time in the dance group compared with the control group. A dance intervention lasting 16 weeks showed improved frailty, depression, and physical performance among Chinese older adults living in the community setting.

Objective: Trust is an essential part of the physician-patient relationship. Yet physicians' perspectives in physician-patient trust has always been ignored, and the concept has not yet been clearly defined and analyzed. This study explores the conceptual understanding of physicians' trust in patients in the context of healthcare and clinical practice and provides a theoretical frameworks foundation for practitioners and researchers.Methods: Seven databases were systematically searched for relevant studies, including Pubmed, CINAHL, ScienceDirect, Web of Science, CNKI, Wanfang and Weipu. Walker and Avant's approach to concept analysis was performed to extract the concept attributes, antecedents, consequences, and define empirical referents.Results: Of the 8028 articles identified, 43 met the inclusion criteria. Five core attributes were identified: (a) Interaction and support; (b) Confidence and expectation in building trust; (c) Motivation for medical treatment; (d) Socially and medically epistemic competence of patients; (e) Self-reported accuracy. Antecedents were divided into a physician-patient relationship and the social context of medicine. Consequences included treatment outcomes, patient outcomes, and treatment efficiency for physicians and patients.Conclusions: Our findings offer insights into refining the concept of trust. By collaborating across healthcare trusts, we can contribute to the development of theoretical models and empirical research. This concept analysis serves as a foundation to develop instruments to measure the concept and highlight the need to design a qualitative study and enhancement strategy for physician trust in patients. Practice implications: Trust in Physicians' perspectives is an essential part of the physician-patient relationship. Establishing and strengthening physicians' trust in patients is significant to healthcare and clinical practice. Concept analysis of physicians' trust in patients will give policymakers a more evident concept and understanding of the importance of the trust improvement strategy and guide healthcare managers to improve theoretical development.

OBJECTIVE:Infections and death have been a part of our daily lives since the COVID-2019 pandemic outbreak in 2019, and the societal and economic consequences have lingered for an unanticipated duration. Novel and effective treatments are still desperately needed around the world to combat the infection. Here, we discovered a novel traditional Chinese medicine formula (TCMF) to potentially combat COVID-19 through reverse systematic pharmacology (disease → targets → TCMF → disease).METHODS:Combining Integrative network pharmacology and the traditional Chinese medicine (TCM) theory, a TCMF for COVID-19 was identified. In silico physiological interactions between herbs and disease hub targets were validated by molecular docking and dynamics simulation.RESULTS:Based on disease-related gene/pathway targets and a combination of reverse pharmacology and TCM meridian tropism theory, a COVID-19-associated herb database was constructed. A new TCMF, including Gancao, Baitouweng, Congbai, and Diyu (GBCD), was discovered for anti-COVID-19 therapy. The KEGG and GO analyses of 49 intersecting genes suggested that GBCD could combat COVID-19 through antiviral, antiinflammation, immunoregulation, and cytoprotection activities. Moreover, these possible effects were validated through docking and MD simulation.CONCLUSIONS:To the best of our knowledge, this study is the first to combine reverse pharmacology and meridian tropism theories for TCMF development, and a novel herbal combination, GBCD, was discovered for anti-COVID-19 therapy.

目的 分析我国近20年来关于农村留守老人领域的研究现状,探讨农村留守老人领域的研究热点和进展趋势.方法 全面检索CNKI、VIP及WanFang中文数据库2001年1月1日—2021年3月24日关于农村留守老人的相关研究,运用Citespace 5.7 R2软件进行可视化分析.结果 共纳入有效文献682篇.2001-2021年发文量总体呈逐年上升趋势,可分为缓慢起步期、快速发展期及持续稳定期3个阶段.最强突出关键词分别为留守家庭、生存质量、乡村振兴.研究机构和作者主要集中在各大高校,未形成明显合作关系网.结论 我国农村留守老人日益受到重视,研究广度不断增大,解决农村养老问题、提供社会支持、实现乡村振兴是农村留守老人的研究前沿热点.但作者和机构间合作较少,缺乏用于实践应用的深层次可行性研究.

Objectives To systematically evaluate the efficacy of auricular acupressure on sleep disorders, depression, pruritus, xerostomia and daily net weight gain (%) in maintenance haemodialysispatients. Background Auricular acupressure has been used for various complications in maintenance haemodialysispatients patients, such as sleep disorders, depression, pruritus and xerostomia, but the efficacy has not yet been unified. Design Systematic review and meta-analysis. Methods Randomised controlled trials comparing Auricular acupressure intervention with non-AA intervention in maintenance haemodialysispatients patients were included. We searched English databases (PubMed, Cochrane Library, Embase, Web of Science) and Chinese databases (CNKI, WanFang, CBM and VIP database) from the inception to 27 November 2020. The risk of bias was assessed by the Cochrane risk of bias tool. The RevMan 5.3 software was used to perform the meta-analysis. A descriptive analysis was conducted if the data were high of heterogeneity or could not be meta-analysed. The PRISMA statement was used to report systematic review and meta-analysis. Results A total of 12 RCTs with 805 MHD patients were included. Meta-analysis showed that auricular acupressure had a significant difference for improving sleep disorders (MD = -1.97 points, 95% CI: -2.62 to -1.32, p < .0001), pruritus (MD = -1.55 points, 95% CI: -2.01 to -1.08, p < .0001), and daily net weight gain (%) (MD = -0.29, 95% CI: -0.37 to -0.21, p < .0001). The efficacy of depression and xerostomia were analysed descriptively due to insufficient data. Conclusions The meta-analysis results indicated that auricular acupressure had a positive efficacy in maintenance haemodialysispatients patients to improve sleep disorders, pruritus and daily net weight gain (%). But the results should be treated conservatively on account of the low quality of included studies. Future researchers need to conduct more high-quality, large sample, multi-centre randomised controlled studies to provide a solid basis to demonstrate of the efficacy of auricular acupressure in maintenance haemodialysispatients patients. Relevance to clinical practice Auricular acupressure has the advantages of low cost, non-invasive and easy to be accepted by patients. This review suggested that auricular acupressure could be considered a non-pharmacological intervention for maintenance haemodialysispatients patients. Medical staff could teach maintenance haemodialysispatients patients auricular acupressure to help them self-manage some complications at home.

文章综述了授权的概念与相关理论,并分析了授权理论在护理管理领域的作用,以期为国内研究者对授权理论及其在护理管理领域的研究提供参考.

目的 探讨骨质疏松椎体压缩性骨折患者术后的居家康复体验.方法 采用描述性现象学研究法,于2020年7月—9月对符合标准的骨质疏松椎体压缩性骨折术后门诊患者、主要照护者、临床护理人员进行面对面半结构化访谈,采用Colaizzi现象学分析法分析原始资料.结果 提炼出包括躯体障碍、心理感知、健康素养、活动需求、康复外部环境5个核心主题及13个亚主题.结论 骨质疏松椎体压缩性骨折患者术后的居家康复体验较丰富,关注患者和主要照护者身体和心理障碍,提升患者的健康素养和满足健康需求,并积极借助外部条件提升居家康复质量,可为居家康复方案的制订提供参考.

BACKGROUND:and purpose: Cognitive behavioral therapy (CBT) has gained increasing attention in the treatment of psychological disorders, but evidence is required to support practice. This systematic review was conducted to evaluate the current evidence for CBT's effectiveness in relieving symptoms of anxiety and depression experienced by patients with an implantable cardioverter-defibrillator (ICD). METHODS:PubMed, Cochrane Library, Web of Science, and Embase databases were systematically searched from inception to March 27, 2020. Both randomized controlled trials and cluster-randomized controlled trials were included in our review. Meta-analysis was conducted using RevMan 5.3 and Stata 15.1 software. RESULTS:A total of six trials, including 675 participants, were analyzed. The results demonstrated that CBT was superior to standard care in relieving symptoms of depression (standardized mean difference = -0.20; 95% confidence interval (CI): -0.39 to -0.01; P = 0.004). The effectiveness of CBT in relieving symptoms of anxiety experienced by patients with ICDs (standardized mean difference = -0.70; 95% CI: -1.10 to -0.30; P < 0.001) as well as the heterogeneity (I2 = 77%) were significant. CONCLUSION:This meta-analysis indicates that CBT effectively relieves symptoms of anxiety and depression experienced by patients with ICDs. Clinical personnel should pay close attention to the mental health of patients with ICDs and adopt CBT as a management strategy for such patients.

刻板印象是按照性别、种族等进行社会分类而形成的关于某类人群的固定印象,普遍认为与某些特征和行为相联系.由于传统观念和性别关系等因素,男性在护理职业中较易受到职业性别刻板印象影响,不利于男性护士的职业发展和护理管理.我们通过综述职业性别刻板印象的概念、职业性别刻板印象的评估方法、影响因素,概括国内外男性护理职业性别刻板印象的研究现状,旨在为改善男性护理职业性别刻板印象提供参考依据.