Background: Spinal arteriovenous malformations (SAVMs) are rare, Early insidious, non-specific symptoms cause diagnostic delay-higher in adolescents-leading to psychological distress, educational interruption, poor prognosis, and more. Timely intervention improves outcomes, but research on young patients' pre-admission clinical trajectory is limited. Case presentation: A 20-year-old male with 1-month lower limb weakness/numbness and sphincter disturbance was diagnosed with SAVMs. Initial low back pain was ignored due to his intense training but symptoms progressed to urinary/defecatory dysfunction. Spinal CT was normal, MRI showed T9-L3 abnormal signals and T8-T12 spinal cord edema. Even with worsening symptoms every day the time from the discovery of the symptoms to the acceptance of the correct treatment was 40 days. Intervention: The young man had endovascular embolization (DSA + EMB) at a tertiary hospital. Access to the right common femoral artery was gained via the Seldinger method, delivering embolic agents(N-butyl cyanoacrylate NBCA) into this vessel, control angiography confirmed a significant reduction in both blood flow velocity and volume within the malformed vasculature. Post-rehabilitation, 3-month follow-up showed normal walking, recovered defecation, Urinary Functionand improved neurological function (Aminoff & Logue Scale changed from 7to 0. Conclusion: Diagnostic delays stem from atypical symptoms, primary physicians' limited experience, and poor early screening. Strategies like physician training, optimized diagnostics, and public education are recommended to improve timely SAVM care.

Background and Objectives : Pelvic inflammatory disease (PID) is a common upper genital tract infection associated with serious long-term sequelae. Its clinical diagnosis is challenging due to non-specific symptoms, creating an urgent need for accurate, accessible biomarkers. While C-reactive protein (CRP) is commonly used, its specificity is limited. Novel, composite inflammatory indices derived from routine complete blood counts (CBC) have emerged as promising biomarkers in other fields.​This study aims to evaluate the diagnostic performance of CBC-derived inflammatory indices against the conventional marker CRP in PID, and to exploratorily assess their association with descriptive anatomical findings on imaging. Methods : In this retrospective case-control study, 135 PID patients were compared with 135 age-matched non-PID controls. Key hematological indices—including the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR)—were calculated from routine CBCs obtained at initial clinical presentation. Diagnostic accuracy was evaluated using receiver operating characteristic (ROC) curve analysis, and independent associations were assessed via multivariable logistic regression. To explore potential links with local disease, the PID cohort was categorized based on baseline ultrasound using a descriptive, non-grading system. Results : PID patients exhibited significantly elevated levels of all novel inflammatory indices compared to controls (all p < 0.001). In multivariable analyses adjusted for clinical and laboratory confounders, SII, SIRI, NLR, MLR, and PLR remained strong and independent factors associated with PID (all p < 0.01). ROC analysis revealed that SII possessed the highest diagnostic accuracy (AUC = 0.870, 95% CI: 0.830–0.911), significantly outperforming CRP (AUC = 0.648, P < 0.001) and other single ratios. SIRI demonstrated comparable efficacy to SII (AUC = 0.832). A disease-specific synergistic network among the indices was observed exclusively in the PID group. Notably, the highest median levels of SII, SIRI, and NLR were associated with the simplest sonographic finding (isolated pelvic fluid) rather than with more complex anatomical damage. Conclusions : The CBC-derived indices SII and SIRI demonstrate superior diagnostic accuracy for PID compared to CRP. As inexpensive, routine tests, they represent highly promising tools to aid timely and accurate PID diagnosis in clinical practice. Their distinct association with early inflammatory presentations warrants further investigation.

Pelvic inflammatory disease (PID) is a common upper genital tract infection associated with serious long-term sequelae. Its clinical diagnosis is challenging due to non-specific symptoms, creating an urgent need for accurate, accessible biomarkers. While C-reactive protein (CRP) is commonly used, its specificity is limited. Novel, composite inflammatory indices derived from routine complete blood counts (CBC) have emerged as promising biomarkers in other fields. This study aims to evaluate the diagnostic performance of CBC-derived inflammatory indices against the conventional marker CRP in differentiating PID from non-inflammatory gynecological conditions and to exploratorily assess their association with descriptive ultrasound categories. In this retrospective case-control study, 135 PID patients were compared with 135 age-matched non-PID controls. Key hematological indices—including the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR)—were calculated from routine CBCs obtained at initial clinical presentation. Diagnostic accuracy was evaluated using receiver operating characteristic (ROC) curve analysis, and independent associations were assessed via multivariable logistic regression. As an exploratory analysis, the PID cohort was also subcategorized according to a novel, purely descriptive classification of ultrasound findings to investigate patterns of systemic inflammation across different anatomical presentations. PID patients exhibited significantly elevated levels of all novel inflammatory indices compared to controls (all p < 0.001). In multivariable analyses adjusted for clinical and laboratory confounders, SII, SIRI, NLR, MLR, and PLR remained strong and independent factors associated with PID (all p < 0.01). ROC analysis revealed that SII possessed the highest diagnostic accuracy (AUC = 0.870, 95

The objective of this study is to analyze the relevant literature on acupoint massage applied to patients with poststroke constipation, to explore the research status, research hotspots, and research frontiers of poststroke constipation, and to provide reference for clinical practice and scientific research. With the help of CiteSpace software, the related literatures published in the China National Knowledge Infrastructure database on the application of acupoint massage to constipation after stroke were analyzed, and scientific atlas for visual analysis was drawn. The hot keywords in the field of acupoint massage for post-stroke constipation are constipation, nursing intervention, and traditional Chinese medicine (TCM) nursing, indicating the great importance of TCM nursing for such patients. In mutation word detection, words such as constipation, nursing, stroke, and defecation reflex have earlier mutation times. Massage is the keyword with the longest mutation time, suggesting it is an effective intervention for post-stroke patients and is widely recognized. The commonly used acupoints for poststroke constipation are Tianshu (ST 25), Zhongwan (CV 12), and Qihai (CV 6). These acupoints can regulate qi and blood and enhance gastrointestinal peristalsis, providing guiding significance for formulating relevant clinical practice guidelines. The research of acupoint massage in the nursing of poststroke constipation is still in the stage of practice and exploration, and the specific definition of operation process, technique, acupoint, time, and intensity is still not clear. Multicenter, large-sample, in-depth intervention research, and cohort studies hold immense significance for the future development of this discipline.

As an appropriate technique in Traditional Chinese Medicine nursing, intradermal acupuncture involves inserting a small needle into the skin at an acupoint or within the skin to treat diseases. This fully embodies the characteristics of Traditional Chinese Medicine nursing techniques: simplicity, convenience, affordability, and effectiveness. Currently, intradermal acupuncture has been widely used in clinical practice. This paper introduces the history, mechanism of action, and principle of acupoint selection of intradermal acupuncture and summarizes the application of intradermal acupuncture in common internal medicine diseases to promote their dissemination and use.

The Interpretation of Nursing Guidelines for Intravenous Thrombolysis in Acute Ischemic Stroke offers comprehensive recommendations across five key domains: hospital organizational management, patient condition monitoring, complication observation and management, positioning and mobility away from the bed, and quality assurance. These Guidelines encompass all the phases of intravenous thrombolysis care for patients experiencing acute ischemic stroke. This article aims to elucidate the Guidelines by discussing their developmental background, the designation process, usage recommendations, and the interpretation of evolving perspectives, thereby providing valuable insights for clinical practice.

BackgroundClinical practice guidelines (CPGs) have an indispensable role in guiding the selection of various non-pharmaceutical interventions (NPIs) for post-stroke emotional disorders (PSED). However, little is known about their quality and recommendations. This study aims to critically appraise the quality of existing NPIs for PSED CPGs and extract relevant recommendations, present the research distribution of various NPIs in an evidence map, and assist clinicians in making decisions.MethodsA systematic search was undertaken in PubMed, Embase, CINAHL, Web of Science, China National Knowledge Infrastructure, Wanfang, VIP, SinoMed, and international guideline developing institutions from origin to November 20, 2024, to identify the CPGs on NPIs for PSED. The CPGs finally selected were blindly evaluated by two reviewers using the Appraisal of Guidelines Research & Evaluation (AGREE) II instrument and the reporting quality was evaluated using the RIGHT statement. The overall agreement among reviewers was analyzed using intraclass correlation coefficient (ICC).ResultsNine guidelines were included and evaluated. Two CPGs were grade A (recommended) and seven CPGs were grade B (recommended with modification). The reporting rate of RIGHT ranged from 40.00 to 80.00%. Nine NPIs were extracted, and there were similarities and differences between the recommendations.ConclusionThis study provides specific direction for improving the quality of CPGs for NPIs for PSED, and provides useful information for clinicians and stakeholders, and provides a basis for clinical decision-making.

Introduction Baihu Jia Renshen Decoction is composed of Gypsum Fibrosum, Anemarrhenae Rhizoma, Oryza Sativa L., Glycyrrhizae Radix et Rhizoma and Ginseng Radix et Rhizoma. It is recommended by five guidelines in China for the treatment of type 2 diabetes mellitus (T2DM). However, evaluations of its efficacy involve a diverse range of outcomes. This multi-method study aims to identify clinical outcomes that traditional Chinese medicine (TCM) practitioners consider both predictive of T2DM progression and responsive to the formula, and to explore the herbal formula’s mechanisms of action on these outcomes. Methods We searched eight databases and collated clinical outcomes reported in randomized controlled trials, as well as signs and symptoms of clinical response listed in TCM clinical guidelines. A panel of eight TCM clinicians participated in three rounds of Delphi surveys to select the most important outcomes. Finally, overlapping genes between responsive outcomes-related genes and the targets of formula were obtained. Based on the enrichment analysis results, the“herb-compound-target-pathway-outcome” relationship was constructed to show how the formula affect clinical outcomes. Results Seventy-six outcomes were shortlisted from the literature, from which consensus was reached in the Delphi survey on eight. These were xerostomia, polydipsia, preference for cold drinks, red tongue, dry tongue, tongue coating dryness, large pulse and fasting blood glucose (FBG). Fifteen overlapping gene targets were identified. Based on enrichment analysis, we hypothesized that diosgenin, nicotinic acid, and anhydroicaritin from Anemarrhenae Rhizoma may act on SOD1, PPARGC1A, CHRM3, modulating AMPK signaling pathway and thereby influencing xerostomia and tongue dryness. The 29 components were found to act on PPARG, PPARGC1A, SHBG, etc, regulating insulin signaling pathway and the AMPK signaling pathway, ultimately affecting FBG. Conclusion Based on the network pharmacology studies, the potential mechanisms of action of Baihu Jia Renshen Decoction on the eight core clinical outcomes are as follows. Anemarrhenae Rhizoma may regulate dryness of the tongue and xerostomia. Anemarrhenae Rhizoma, Ginseng Radix et Rhizoma and Glycyrrhizae Radix et Rhizoma may modulate FBG levels. Further research is needed to explore the formula’s mechanisms of action for the remaining five outcomes and T2DM.

Objective: The objective of this study is to explore the current situation of nurses’ participant activation for self-management of low back pain, analyze its influencing factors, and provide a reference for improving the participant activation for self-management of low back pain. Materials and Methods: A cross-sectional study was conducted with 5,120 nurses recruited through convenience sampling from hospitals across 25 provinces and municipalities in China. Participants completed two standardized instruments: General Information Questionnaire which collected demographic characteristics and work-related factors, and the Participant Activation for Self-Management of Back Pain Questionnaire which measured activation levels across three dimensions (including self-management beliefs, self-management awareness, and knowledge related to low back pain). Results: The score of nurses’ participant activation for low back pain self-management was 38.00 (33.00, 44.00). The results of multiple linear regression showed that nurses of different gender, age, and professional titles, whether they had administrative positions, and whether they had back pain in the past year were influencing factors of nurses’ participant activation for low back pain management. Conclusion: The overall participant activation for self-management of low back pain is at a medium level. Their self-management awareness is strong, but their beliefs about management of low back pain are insufficient. Targeted intervention measures can be taken to improve their activation for management of back pain and reduce the incidence of occupational low back pain.

The objective of this study is to summarize the efficacy and safety of traditional Chinese medicine (TCM) enema in the treatment of ulcerative colitis (UC). The randomized controlled trials on TCM enema intervention in the treatment of UC were searched in seven databases: PubMed, Embase, Web of Science, CBM, CNKI, Wanfang Database, and VIP Database from January 1, 2013 to June 6, 2022, and the data were analyzed using RevMan 5.3 software. A total of 18 studies involving 1514 UC patients were included. Meta analysis results showed that compared with conventional Western medicine, Chinese medicine enema had a significant effect on UC, and the clinical effective rate of the experimental group using Chinese medicine enema was 4.45 times that of the control group using conventional Western medicine (odds ratio = 4.45, 95% confidence interval [3.27, 6.06]). Therefore, Chinese medicine enema is effective in the treatment of UC, and can significantly reduce related symptoms.

ObjectiveTo assess and compare the composition of tongue coating microbiota among patients at different stages of rheumatoid arthritis (RA).MethodsA total of 47 patients diagnosed with RA, as per the American College of Rheumatology criteria, and 10 healthy individuals were enrolled in this study. The RA patients were stratified considering their Disease Activity Score 28 (DAS28), a composite measure based on the 28 tender and swollen joint count and erythrocyte sedimentation rate (ESR). The study population was further categorized into active phase group (LMH group) and inactive phase group (RE group) according to their DAS28 values. DNA extraction was extracted from tongue coating samples. Subsequently, the V3-V4 16S rDNA region was selectively amplified and sequenced through high-throughput 16S rDNA analysis. The resulting data were then utilized to ascertain the microbial contents.ResultsSignificant variations were observed in the tongue coating microbiota of patients with RA during active and inactive phases, in comparison to healthy individuals (p < 0.05). At the genus level, the presence of Prevotellan, Veillonella, Rothia, and Neisseria in RA patients was notably more evident than in the healthy control (HC) group. These disparities find support in existing research on gut and oral microbiota. During the active phase of RA, the relative abundance of Veillonella, Rothia, and Neisseria in the tongue coating microbiota of patients was significantly higher than in those with inactive RA. These findings underscore the need for further and in-depth research on the potential impact of these microorganisms on the progression of RA disease.ConclusionThe results substantiate the hypothesis that tongue coating microbes actively contribute to the progression of RA.

Objective: The objective of this study is to comprehensively understand the psychological experience of primiparous women during breastfeeding while dealing with lactating mastitis and to establish a reliable foundation for tailored support measures. Methods: Twenty primiparous mothers from a tertiary hospital in Beijing between January and March 2023 were chosen using purposive sampling for semi-structured interviews. After conducting 20 interviews, data saturation was achieved. The Colaizzi’s seven-step analytical approach was employed to analyze, summarize, and refine the identified themes. Results: Among primiparous women afflicted by lactating mastitis, the primary themes regarding breastfeeding attitudes included three key aspects: (1) uncertainty during the initial diagnosis phase, (2) intricate emotional journey during treatment, and (3) positive psychological outlook during the recovery stage. Conclusion: Primiparous women undergoing lactating mastitis experience substantial physical and psychological strain. It is crucial for medical personnel, family caregivers, and society at large to be attuned to the emotions of these patients. Tailored support measures should be offered to enhance patients’ physical and mental well-being and facilitate disease recovery.

本文总结一例气管插管合并重症肺炎患者鼻饲肠内营养液的护理干预措施，主要从气管插管，肠内营养的护理以及预防误吸等方面进行护理干预，旨在控制感染，改善患者肺炎情况，减少并发症的发生。

根据临床观察采用中药泡洗技术治疗尪痹类风湿关节炎(rheumatoidarthritis，RA)有不错的效果，本文选取1例尪痹患者进行护理评估，日常生活能力评分（Barthel指数）来观察临床疗效。通过治疗后该患者Barthel评分增高。可以有效地缓解患者关节轻微肿胀和疼痛等症状，改善其在关节疼痛处的活动，对于类风湿性型关患者的整体日常生活或者工作质量会有所显著性的提升，改善了患者的病情，是一种有效的治疗解决方案。

壮医药物竹罐疗法为壮医特色外治疗法之一，疗效确切，操作简便，无毒副作用，具有“简、便、验、捷”等优势，临床广泛用于内、外、妇科，治疗关节炎疗效突出。现代医家更是在古人的基础上对该疗法的操作规范进行了深入研究，期望能够更准确地把握疾病本质，合理运用该疗法。本文从近年来关于壮医竹罐疗法治疗文献入手，对文献进行梳理总结，旨在探讨该疗法在临床治疗的研究进展。

睡眠是人类正常的生理活动，正常的睡眠可以清除积聚在中枢神经系统中的潜在神经毒性废物，并且能够促进突触的可塑性从而促进记忆和学习。睡眠和觉醒的相互转换是通过大脑中各种神经递质和内源性促进睡眠的物质的相互作用来实现的，它们受昼夜节律和内部环境的稳态调节。但随着现代生活节奏的加快，熬夜、饮食不规律等各种不良生活习惯所导致的昼夜颠倒，身体内外环境紊乱而引发的失眠愈发普遍，这直接影响到了人的生理和心理健康状况。研究表明，耳穴压豆疗法，能够刺激相应穴位，疏通全身气血运行，调节脏腑功能，对失眠有较好疗效，且操作简便， 易于掌握，无不良反应。从卫生经济学角度来看，耳穴压丸法符合社会需求，同时不会为患者增加过重的医疗开支，适合在各种医疗机构，甚至是社区医院、农村卫生院中开展。

In order to further strengthen the standardization and homogenization of nursing care for severe and critical patients and give full play to the advantages of integrated traditional Chinese and Western medicine nursing, BeijingAdministration of Traditional Chinese Medicine (TCM)commissionedthe Beijing Office of TCM Nursing Capacity Improvement Projectto organize the specialized group to compile Nursing Specification of Integrated Traditional Chinese and Western Medicine for severe and critical patients with COVID-19.This specification elaborates the nursing contents of integrated traditional Chinese and Western Medicine for severe and critical patients with COVID-19 in detail,includingetiologyand pathogenesis,severe/critical high-risk groups,clinical classification and nursing measures,etc.Among them,nursing measures include disease observationand nursing,medication nursing,respiratory support care,prone position treatment and nursing,nutritional support nursing,general nursing,convalescent nursing,etc.This specification is convenient for clinical nurses in various medical institutions to use as reference,and provides reference for clinical application of integrated Chinese and western medicine in nursing severe and critical patients infected with COVID-19.