Background and purposeAccurately defining cognitive function trajectories in elderly ischemic stroke patients is crucial for identifying high-risk groups for cognitive decline, enabling timely personalized interventions to improve long-term outcomes and reduce familial and societal burdens. However, research on the heterogeneity of cognitive trajectories and their underlying causes in elderly Chinese patients with ischemic stroke remains limited. This prospective longitudinal study aimed to detect unique trends in cognitive trajectories among these patients and assess the contributing factors.MethodsValidated assessment tools were utilized to systematically evaluate cognitive function at various specified intervals. Latent variable growth models were employed to delineate distinct subgroups of cognitive trajectories and to assess the predictive relevance of baseline pathophysiological markers and influencing factors in distinguishing these trajectories.ResultsCognitive trajectories were categorized into three latent groups: the High Cognitive Function-Slow Decline Group (51%), the Low Cognitive Function-Intermediate Decline Group (34%), and the Low Cognitive Function-Rapid Decline Group (15%). Logistic regression analysis revealed that age, temporal lobe infarction, serum homocysteine levels, National Institutes of Health Stroke Scale score, and Multidimensional Perceived Social Support Scale score, were significant predictors of cognitive function (p < 0.05).ConclusionGeriatric patients with ischemic stroke have a gradual decline in cognitive function over time. Cognitive change trajectories can be categorized into three latent groups: High Cognitive Function-Slow Decline Group, Low Cognitive Function-Intermediate Decline Group, and Low Cognitive Function-Rapid Decline Group. Healthcare practitioners can develop tailored intervention strategies based on individual patients’ cognitive trajectories and influencing factors to reduce cognitive decline and improve quality of life.

[This corrects the article DOI: 10.3389/fnagi.2026.1733972.].

Objective:To explore the current situation of nursing human caring in hospital wards and analyze its influencing factors, so as to facilitate the development of nursing human caring practice.Methods:From July to November 2022, a total of 107 hospitals were surveyed through stratified convenience sampling method, and 4 072 ward nursing managers were recruited to finish the general information questionnaire and the ward nursing human caring status questionnaire. The general information included the region, class and type of the hospital, etc. The ward nursing human caring status questionnaire included 38 items in 5 dimensions of nursing human caring system and process, humanistic quality and training of nursing staff, humanistic environment and facilities, human caring procedures and measures, and human caring quality evaluation and improvement, with a full score of 190 points. Descriptive statistics were used to analyze the general data, independent samples t-test, ANOVA and correlation analysis were used to analyze the factors influencing the current status of nursing human caring in the ward, while multiple linear regression analysis was used to conduct a multivariate analysis. Results:The score of nursing human caring in hospital wards was 156.91±27.78. Whether the hospital had carried out nursing human caring pilot(demonstration) wards, whether the ward had previously been a hospital nursing human caring pilot(demonstration) nursing unit, the type of ward, and whether nursing managers had participated in human caring training were the influencing factors of the implication of nursing humanistic caring in wards( P<0.05). Conclusions:The practice of nursing human caring in hospital wards is at a good level, but needs to be further strengthened. Nursing managers should take systematically strategies to promote the development of nursing human caring practice.

BackgroundHumanistic care pertains to the abilities, attitudes, and behaviors central to patient-centered care, contributing to patients' sense of safety and wellbeing. This study aimed to assess the satisfaction of patients with humanistic nursing care in Chinese secondary and tertiary public hospitals.MethodsA national cross-sectional survey was conducted across 30 provinces and 83 hospitals in China. Patient satisfaction with humanistic care was assessed using the Methodist Health Care System Nurse Caring Instrument (NCI), which encompasses 20 items across 12 dimensions. Each item was rated on a 7-point Likert scale, yielding a total score of 140. Multiple linear regression analysis was employed to identify factors associated with patients' satisfaction.ResultsModerate satisfaction (mean score 91.26 ± 13.14) with humanistic nursing care was observed among the 17,593 participants. Factors significantly associated with patient satisfaction included age, hospital type, presence of children, educational attainment, place of residence, family monthly income, and medical insurance type.ConclusionThe study findings highlight the importance of tailored interventions, evidence-based practice guidelines, and patient-centered care in improving patients' satisfaction with humanistic nursing care. Continuous emphasis on nursing education and professional development is crucial for enhancing humanistic care and patient satisfaction.

伦理困境在重大传染病疫情防控期间普遍存在于护士中,会影响护士身心健康和护理质量.从重大传染病疫情防控护士伦理困境相关概念、现状、评估工具、影响因素四个方面进行综述,旨在提高护士、护理管理者、卫生管理机构对重大传染病疫情防控护士伦理困境的关注,为进一步制定策略提供理论参考.在重大传染病疫情防控期间护士伦理困境研究方面,国内外研究多采用量表和质性访谈进行调查.研究发现该时期护士伦理困境包括探视限制的伦理困境、稀缺资源公正分配的伦理困境和护士权利与义务的伦理困境.影响因素主要有人口学因素、心理因素、风险感知和社会支持等.建议今后从伦理学的角度开发适宜的评估工具,及时掌握重大传染病疫情防控时期护士伦理困境现况,深入挖掘影响因素.

从高级重症实践护士的概念和起源、资格认证、临床价值、角色职能以及国内重症专科APN的培养现状等方面进行综述，以期为我国高级实践护理的规范化管理提供参考，提高护理质量，减少人才流失。

目的 探讨基于云随访管理平台的中医外治护理对慢性肾脏病(CKD)患者血瘀证及肾脏排毒的影响.方法 选取2019年8月-2021年1月在我院肾病科住院治疗的CKD患者60例,采用随机数字表法分为对照组和观察组,各30例.对照组采取居家常规治疗与护理随访措施,观察组在对照组基础上采用基于云随访管理平台的中医外治护理(持续督导患者居家实施中药封包联合穴位按摩居家自护),干预周期为12周.比较2组患者干预前后血瘀证严重程度和和肾脏排毒功能.结果 (1)干预前,2组患者血瘀证症候量化评分及各症状得分比较,差异均无统计学意义(P＞0.05);干预后,观察组血瘀证症候总分及面色晦暗、刺痛并痛有定处拒按、脉络瘀血、涩脉或无脉、舌质紫暗有舌体瘀斑或瘀点与痴癫狂躁方面均优于对照组(P＜0.05),但2组皮下瘀斑、出血、肌肤甲错、肢体麻木与善忘方面比较,差异无统计学意义(P＞0.05).(2)干预前,2组患者肾脏排毒指标血肌酐和血尿素氮比较,差异无统计学意义(P＞0.05);干预后,2组患者肾脏排毒指标血肌酐和血尿素氮比较,差异仍无统计学意义(P＞0.05),但观察组血肌酐与血尿素氮干预后均低于对照组,干预前后差值有统计学差异(P＜0.05).结论 居家患者长期实施中药封包联合穴位按摩技术可改善CKD患者血瘀证的同时,还有促进肾脏排毒的作用,适合患者长期居家自护干预.

艾灸是常用中医疗法。背部是常用的施灸部位，经络腧穴覆盖广泛，灸背部督脉及足太阳膀胱经之穴，可温煦五脏、温经通络，起到防病治病、养生保健、养容美颜的目的。但目前推广背部艾灸存在以下局限性：取穴和使用方式不便、存在烫伤风险、灸疗中灸条调节不便、灸盒清洁不便、遗忘施灸时间。基于此，笔者设计了一种多功能背部艾灸装置，现报道如下。

目的 调查缺血性脑卒中后认知障碍发生状况,分析其危险因素.方法 采用前瞻性队列研究方法,选取2020年12月—2021年12月间于上海2家中西医结合三级甲等医院诊断为缺血性脑卒中的患者作为研究对象,收集患者入院病历资料,卒中后3个月在神经内科门诊采用简易智力状态检查量表进行评估.采用单因素分析及多因素Logistic回归分析缺血性脑卒中后认知障碍的危险因素.结果 415例缺血性脑卒中患者完成调查,发生认知障碍178例,缺血性脑卒中后认知障碍发生率为42.9％.Logistic回归分析结果显示,缺血性脑卒中后认知障碍的危险因素包括:年龄(OR=1.094,95％CI为1.061～1.129)、载脂蛋白E(OR=1.320,95％CI为1.108～1.573)、同型半胱氨酸(OR=1.056,95％CI为1.027～1.085)、NIHSS评分(OR=1.155,95％CI为1.023～1.305)、吸烟史(OR=2.408,95％CI为1.296～4.475)、既往卒中史(OR=2.932,95％CI为1.697～5.066)、颞叶梗死(OR=2.776,95％CI为1.094～7.039)、气虚血瘀证(OR=8.694,95％CI为4.160～18.167)、痰热内闭证(OR=4.134,95％CI为1.131～15.111).结论 缺血性脑卒中后认知障碍发生率较高,年龄、载脂蛋白E、同型半胱氨酸、NIHSS评分、吸烟史、既往卒中史、颞叶梗死、气虚血瘀证、痰热内闭证是缺血性脑卒中后认知障碍的独立危险因素.

Background and PurposeMalnutrition is highly prevalent in ischemic stroke patients. We aimed to investigate whether malnutrition indexes may be useful in predicting mortality at 90 days in ischemic stroke patients treated with intravenous thrombolysis.MethodsWe retrospectively analyzed consecutive patients who underwent thrombolytic therapy at three comprehensive stroke centers. Malnutrition was assessed using the controlling nutritional status (CONUT) score, geriatric nutritional risk index (GNRI), and prognostic nutritional index (PNI).ResultsOf 979 patients (mean age, 66.8 years; males, 63.6%) included in this study, 91 (9.3%; 95% confidence interval [CI]: 8.4–10.2%) died at 3-month follow up. According to the CONUT, GNRI, and PNI scores, 9.9, 33.7, and 7.0% of patients were moderately or severely malnourished, respectively; 64.0% were at least mildly malnourished by at least 1 malnutrition index. In the multivariate regression model after adjusting for potential confounders, malnutrition (severe risk versus normal nutritional status) was significantly associated with an increased risk of mortality for CONUT scores (adjusted odds ratio [OR] 16.16, 95%CI, 7.86-67.11; P < 0.001), GNRI scores (adjusted OR 9.82, 4.10-23.51; P < 0.001) and PNI scores (adjusted OR 12.74, 5.56-29.19; P < 0.001). Similar results were found when the malnutrition scores were analyzed as continuous variables. Adding the three malnutrition indexes to models containing conventional risk factors significantly improved risk reclassification for 3-month mortality.ConclusionOur study showed that malnutrition may be associated with a higher risk of mortality at 3 months in ischemic stroke after intravenous thrombolysis.

This paper sorted out latest developments of traditional Chinese medicine characteristic nursing of patients with post⁃stroke cognitive impairment（PSCI），and summarized traditional Chinese medicine nursing technology，traditional Chinese exercises，emotional control，dialectical feeding and so on.It was aimed at providing reference for developing traditional Chinese medicine characteristic nursing suitable for PSCI patients，and providing direction for follow⁃up research.

目的 探讨引阳入阴推拿对剖宫产后心脾两虚证睡眠障碍产妇睡眠障碍以及负性情绪的影响.方法 选取产科病房行剖宫产的100例心脾两虚证睡眠障碍产妇为研究对象,随机分为观察组和对照组,每组50例.对照组实施常规产后心理护理,观察组在对照组基础上实施引阳入阴推拿.比较2组匹兹堡睡眠质量指数量表(PSQI)评分、中医证候积分、焦虑自评量表(SAS)评分以及抑郁自评量表(SDS)评分.结果 干预后,观察组产妇PSQI评分以及中医证候积分均低于对照组,SAS和SDS评分均低于对照组,差异有统计学意义(P＜0.05).结论 引阳入阴推拿能有效改善心脾两虚证剖宫产产妇的睡眠障碍,缓解负性情绪.

Objective:To investigate the current situation of the patients receiving the appropriate technical service of Traditional Chinese Medicine (TCM) nursing at home in Shanghai community health service centers, so as to provide reference for the supervision, management and policy making of health administrative departments.Methods:This study is a cross-sectional survey. The convenient sampling method was used to select 700 patients who were treated in 9 community health service centers in Shanghai from October 2020 to January 2021. The self-developed questionnaire on the Status of Home Care Services with Suitable Chinese Medical Care Technology (patient version) was used to investigate patients. A total of 700 questionnaires were sent out and 688 were effectively received, with the effective recovery of 98.3% (688/700) .Results:Among the 688 patients, 39.2% (270/688) of the patients knew that home care services could provide suitable TCM care technology, 1.7% (12/688) of patients had received TCM care suitable technology home care services; 66.0% (454/668) of patients had a higher willingness to receive home care services with appropriate technologies for TCM nursing. Service price and service quality were the main concerns of patients receiving home nursing service with suitable technology of TCM nursing.Conclusions:Home nursing service with appropriate technology of TCM nursing is still in its infancy, so it is necessary to further strengthen the promotion of home nursing service with appropriate technology of TCM nursing and improve nurses' ability of TCM nursing service to ensure patient safety and medical quality.

Objective: To investigate the efficacy of intermittent pneumatic compression (IPC) in prevention of deep venous thrombosis (DVT) in severe traumatic brain injury (TBI) patients and to observe the effects of IPC on hemorheological and coagulation indices, as well as high-mobility group box 1 (HMGB1) in severe TBI patients. Methods: The present prospective open randomized controlled research recruited 332 severe TBI cases seen during May 2017~November 2019. All patients were randomly divided into two groups, with 166 cases in the control group and 166 cases in the IPC group. The serum levels of HMGB1 were determined using an enzyme linked immunosorbent assay (ELISA). The flow velocity of common femoral vein was also evaluated using Doppler ultrasound before treatment, as well as at 1 d, 3 d, 7 d and 14 d after admission. Levels of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and D-Dimer (D-D) were also evaluated before treatment, as well as at 7 d and 14 d after admission. Results: DVT occurred in a total of 35 (10.54%) cases of all patients, with 6 (3.61%) cases in IPC group, which was significantly lower than 29 (17.47%) cases in the control group. Serum FIB levels were significantly lower in the IPC group at 7 d and 14 d after treatment compared with the control. At 3 d, 7 d and 14 d after treatment, the levels of flow velocity of common femoral vein were markedly higher in IPC group compared with the control and after 3 d treatment, the levels of HMGB1 at 1 d, 3 d, 7 d and 14 d were all markedly lower in IPC group than the control. After admission, the serum levels of HMGB1 were markedly higher in DVT patients compared with the non-DVT patients at 1 d, 3 d, 7 d and 14 d and were negatively correlated with the flow velocity of common femoral vein at 3 d, 7 d and 14 d. Conclusion: IPC treatment could prevent DVT in severe TBI patients, which was associated with increased velocity of common femoral vein and decreased FIB and HMGB1 levels. HMGB1 may be useful as a potential biomarker for DVT in severe TBI patients.

BACKGROUND:Geriatric cognitive impairment often occurs in conjunction with depressive symptoms. This study focuses on categorising the Chinese elderly with such co-occurring symptoms into homogeneous groups using latent profile analysis (LPA), a person-centred statistical approach. METHODS:Information on cognitive function and depressive states of the elderly was extracted from the China Health and Retirement Longitudinal Study. The underlying characteristics were identified by LPA, and based on those findings, differences in demographic characteristics of different subgroups were explored by chi-squared test and analysis of variance. RESULTS:A total of 6710 Chinese elderly who met the inclusion criteria were selected from the dataset. Four subgroups were identified among this sample by LPA, based on cognitive function associated with depressive symptoms, and named in this study as follows: mild cognitive impairment (n = 3747, 55.84%), moderate cognitive impairment (n = 1306, 19.46%), mild cognitive impairment combined with depressive symptoms (n = 1114, 16.6%), and moderate cognitive impairment combined with depression (n = 543, 8.09%). Age, gender, marital status, and educational level were all significantly different across subgroups (P < 0.001); religious belief and pension mode, however, were not (P > 0.05). CONCLUSIONS:In the present study, four subgroups of cognitive function combined with depressive symptoms were found in Chinese elderly individuals, and differences in demographic factors were noted between the subgroups. In clinical practise, these findings could help clinical workers identify patients accurately and consider the demographic features of each subgroup when designing medical treatment, care, and rehabilitation programmes for those with cognitive impairment and concomitant depressive symptoms.

梳理卒中后认知障碍(PSCI)病人的中医特色护理最新进展,从中医护理技术、中医传统功法、情志调摄、辨证施膳等方面进行综述,旨在为开展适合PSCI病人的中医特色护理提供参考,为后续研究提供方向.

Cognitive impairment is the most common and often underestimated complication after ischemic stroke, which seriously affects the rehabilitation of patients. This article reviews the risk factors and prevention strategies of cognitive impairment after ischemic stroke, in order to provide a reference for the prevention of cognitive impairment after ischemic stroke.

目的 以循证理念为指导,构建髋关节置换术后患者早期下床活动的方案框架,旨在促进患者术后康复.方法 检索髋关节置换术后早期下床活动的相关文献并评价其质量,同时整合现有证据形成方案初稿;通过2轮德尔菲专家咨询形成最终方案框架.结果 针对髋关节置换术后早期下床活动的具体实施,构建了涉及术前、术后两个阶段共60项条目的方案框架.其中,术前阶段包括多学科管理、健康教育、疼痛管理、营养管理、术前运动5个方面共25项具体内容;术后阶段包括营养管理、提高自我效能、疼痛管理、下床活动4个方面共35项具体内容.2轮专家咨询的积极度均为100％,权威系数为0.900,协调系数分别为0.288和0.307(P<0.001).结论 结合髋关节置换术后早期下床活动循证证据构建的具体活动方案框架,可为指导髋关节置换术后患者早期下床活动提供实践参考.

目的 探讨伊立替康+卡培他滨(CAPIRI)方案治疗老年转移性结直肠癌一线奥沙利铂+甲酰四氢叶酸钙+氟尿嘧啶(FOLFOX)方案治疗失败患者的有效性及安全性.方法 收集2018年7月-2020年12月上海中医药大学附属曙光医院确诊并收治的老年转移性结直肠癌一线FOLFOX方案治疗失败患者122例,按照计算机随机分配法分成观察组与对照组,每组61例.对照组患者予以伊立替康+氟尿嘧啶(FOLFIRI)方案治疗,观察组予以CAPIRI方案治疗,2组连续治疗6个月.观察并比较2组临床疗效、不良反应和生存时间;观察并比较2组治疗前后的生活质量量表(SF-36)评分及血清基质金属蛋白酶-2(MMP-2)、转化生长因子β1 (TGF-β1)、基质金属蛋白酶-9(MMP-9)水平.结果 2组患者的疾病控制率、客观缓解率、总生存时间及患者无进展生存时间差异均无统计学意义(P＞0.05);治疗前,两组MMP-2、TGF-β1、MMP-9、SF-36评分差异无统计学意义(P＞0.05);治疗后,2组血清MMP-2、MMP-9及TGF-β1水平较同组治疗前下降(P＜0.05),观察组血清MMP-2、MMP-9及TGF-β1水平较对照组差异均无统计学意义(P＞0.05);治疗后,2组SF-36评分相较于同组治疗前升高(P＜0.05),观察组SF-36评分高于对照组(P＜0.05);观察组患者总不良反应发生率较对照组减少(P＜0.05).结论 CAPIRI方案治疗老年转移性结直肠癌一线FOLFOX方案治疗失败患者的有效性及安全性较好,不良反应较少,有助于改善患者生存质量.