To explore the genetic causal association between six sleep characteristics and constipation using Mendelian randomization analysis.

This study selected the genome-wide association study data of six sleep characteristics from the OpenGWAS database of the Medical Research Council Integrative Epidemiology Unit at University of Bristol and the genome-wide association study data of constipation from the catalog database of Genome Wide Association Study.The inverse variance weighted method(IVW) was adopted as the main analysis method to evaluate the causal relationship between the six sleep characteristics and constipation.MR-Egger and weighted median method(WM) were used as supplementary evidence for the IVW results.At the same time,heterogeneity and horizontal pleiotropy tests were conducted to ensure the stability of the results.The instrumental variables of the positive results were annotated,and enrichment analysis of related genes was performed to predict their potential mechanisms.

The IVW method results showed that insomnia increased the risk of constipation(P=0.002),and sleep duration also affected constipation(P=0.026).Sensitivity analysis indicated that the results were stable.Gene enrichment analysis revealed that insomnia may affect the occurrence of constipation through the immune system pathway,while sleep duration may exert its effect through mechanisms such as regulating the intestinal-brain neural function and catecholamine secretion.

Insomnia is a risk factor for constipation.Ensuring adequate sleep has guiding significance for the prevention and treatment of constipation.

To construct the social frailty risk prediction model for elderly people with chronic diseases in communities,and to explore the predictive value of intrinsic capacity for social frailty among them.

A total of 785 elderly patients with chronic diseases in the communities,who were surveyed in Lu'nan district of Tangshan city from July 2024 to May 2025,were selected as research subjects.LASSO regression was used to screen the variables.Logistic regression analysis was conducted to analyze the influencing factors.A column chart was drawn,and a baseline model without intrinsic ability variables and a prediction model including intrinsic capacity variables were constructed.

The detection rate of social frailty among community-dwelling elderly with chronic diseases was 23.69%.The results of Logistic regression analysis showed that age,educational level,duration of chronic disease,level of e-health literacy,satisfaction with community public services,family function,and intrinsic capacity were the influencing factors of social frailty in community-dwelling elderly with chronic diseases(all P<0.05).Two models were established,one without the intrinsic ability variable and the other with the intrinsic ability variable.The results showed that the prediction model had significantly improved reclassification ability and discriminative ability compared to the baseline model.The area under the ROC curve of the prediction model training set and validation set was 0.828 and 0.856 respectively.The DCA curve indicated that the model had good clinical practicability.

The social frailty risk prediction model for elderly people with chronic diseases in the communities had certain predictive efficacy.It could be used to identify the risk of social frailty in elderly people with chronic diseases in the communities at an early stage.It could provide basis for taking timely preventive and intervention measures.

To analyze the influencing factors of the duration of stress hyperglycemia in patients with acute pancreatitis,and to construct its predictive model.

By using the convenience sampling method,a total of 206 patients with acute pancreatitis admitted to Suqian Hospital of Jiangsu Provincial People's Hospital from March 2022 to November 2024 were selected as the research subjects.The clinical data of the patients were collected.They were divided into the stress hyperglycemia≥48 hours group and the stress hyperglycemia<48 hours group according to the duration.Univariate and multivariate Logistic regression analysis were used to explore the influencing factors of the duration of stress hyperglycemia in patients.A risk prediction model for stress hyperglycemia of patients ≥48 hours was constructed based on the decision tree algorithm.The predictive efficacy of the Logistic regression model and the decision tree model was evaluated by using the receiver operating characteristic curve(ROC).

Among 206 patients with acute pancreatitis,41 cases(19.90%) had stress hyperglycemia for ≥48 hours.There were statistically significant differences in hypertension,admission blood glucose level,Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ) scores,systemic inflammatory response syndrome(SIRS),pain,and nutritional risk between the stress hyperglycemia ≥48 hours group and the stress hyperglycemia <48 hours group(P<0.05).Multivariate Logistic regression analysis showed that the patients' admission blood glucose level,APACHEⅡ scores,SIRS,pain,and nutritional risk were the influencing factors of stress hyperglycemia ≥48 hours in patients with acute pancreatitis(P<0.05).The decision tree model screened out four influencing factors(pain,blood glucose level at admission,APACHEⅡ scores,and nutritional risk),with a prediction accuracy rate of 86.4%.The correlation between pain and stress hyperglycemia ≥48 hours in patients with acute pancreatitis was relatively stronger.When the pain score was >2 points,the admission blood glucose level was >13.07 mmol/L.The APACHEⅡ score was >7.The risk probability of stress hyperglycemia ≥48 hours in patients with acute pancreatitis was the highest(88.2%).The area under curve(AUC) of the Logistic regression model was 0.824,with a sensitivity of 82.9% and a specificity of 68.5%.The AUC predicted by the decision tree model was 0.828,with a sensitivity of 78.0% and a specificity of 77.6%.There was no statistically significant difference in terms of the predictive efficacy between the two models(Z=0.075,P=0.940).

The duration of stress hyperglycemia in patients with acute pancreatitis was influenced by multiple factors.Both the decision tree model and the Logistic regression model have good predictive value.However,the decision tree model demonstrates the interactive influence of various factors.Therefore,the two models could be used in combination to promote the targeted and specific natures of nursing intervention strategies from different levels.

To explore the independent influencing factors of delirium in elderly inpatients in internal medicine department using the Mayo Delirium Prediction Model(MDP) and Delirium Risk Tool(DELIKT),and to analyze the predictive performance of the two models.

The study subjects were elderly inpatients in the internal medicine department of a tertiary grade A general hospital in Beijing city from January to December 2024.The occurrence of delirium in patients was predicted using MDP and DELIKT.The performance of the model was evaluated using the area under the receiver operating characteristic curve(AUC) and diagnostic indicators.Univariate analysis and Logistic regression analysis were conducted on 22 predictive factors to determine the independent influencing factors related to delirium.

The AUC values for external validation of MDP and DELIKT were 0.955 and 0.869 respectively,with sensitivities of 92.50% and 77.50% respectively,and specificities of 93.50% and 86.30% respectively.The results of Logistic analysis showed that history of delirium,CrAS scores,indwelling urinary catheter,age,and fall risk score were independent influencing factors for delirium in elderly inpatients in internal medicine department(P<0.05).

Both MDP and DELIKT could be used for predicting the risk of delirium in elderly inpatients in internal medicine department.In the future,these two models could be integrated to develop a delirium prediction tool for elderly inpatients in internal medicine department in China.

To explore the potential categories and influencing factors of symptom cluster trajectories in breast cancer patients undergoing chemotherapy.

A convenience sampling method was adopted to select 225 breast cancer inpatients who underwent their first chemotherapy at a tertiary grade A hospital in a certain city from July to December 2024 as the survey subjects.General information questionnaires,Memorial Symptom Assessment Scale,Sense of Coherence Scale,and Female Self-Advocacy in Cancer Survivorship were used to conduct the survey on 1st day before chemotherapy,7th day after the first chemotherapy,7th day after the second chemotherapy,7th day after the third chemotherapy,and 7th day after the fourth chemotherapy.Data analysis was performed using the latent class growth model.

There were two potential categories in the symptom cluster trajectories of breast cancer patients undergoing chemotherapy,namely the high-level significant increase group(20.4%) and the low-level slow increase group(79.6%).Logistic regression analysis showed that occupation,place of residence,presence of comorbidities,self-advocacy ability,and sense of coherence were the influencing factors for the symptom cluster trajectory categories of breast cancer patients undergoing chemotherapy(P<0.05).

The symptom clusters of breast cancer patients undergoing chemotherapy could be divided into two different trajectories.There is also group heterogeneity.Nursing staff should provide personalized support care for patients belonging to different trajectory categories.

To construct the risk prediction model for pediatric nurses' effort-reward imbalance based on interpretable machine learning,and to compare the predictive performance of different models.To explain the results of the optimal model using SHAP interpretation.

Using the convenience sampling method,a total of 414 pediatric nurses from 6 hospitals in Anhui province,Shanxi province,Jiangxi province and Hunan province in June 2025 were selected as the research subjects.They were randomly divided into training set and validation set at a ratio of 7∶3.The Chinese Nurse Stressor Scale and the Effort-Reward Imbalance Questionnaire scale were used for investigation.LASSO regression was employed to screen the characteristic variables and identify the important predictors.The important predictors were incorporated into the machine learning model to construct three risk prediction models for pediatric nurses' effort-reward imbalance:Logistic regression model,Extreme Gradient Boosting model,and Random Forest model.The areas under the receiver operating characteristic curves(AUC),accuracy,sensitivity,and F1 score of the models were compared to evaluate the predictive performance of the models and select the optimal model.The SHAP explanation was used to interpret the optimal model.

LASSO regression identified three important factors:the number of night shifts per month,workload and time allocation,and educational background.The AUC values of the three prediction models(Logistic regression model,Extreme Gradient Boosting model,and Random Forest model) were 0.725,0.890,and 0.903 respectively,with accuracies of 0.673,0.794,and 0.801,sensitivities of 0.421,0.731,and 0.813,and F1 scores of 0.547,0.773,and 0.798.The SHAP explanation results showed that the importance ranking of the influencing factors were the number of night shifts per month,workload and time allocation,and educational background.

The risk prediction model for pediatric nurses' effort-reward imbalance based on interpretable machine learning constructed by Random Forest has better performance than Logistic regression and Extreme Gradient Boosting model.Personalized predictions should be made based on the number of night shifts each nurse takes per month,workload and time allocation,and educational backgroun.It provides a reference for the early identification of the imbalance between effort and reward for the nurses and the formulation of personalized intervention measures.

To explore the occurrence rate of cognitive impairment among older adults in China and its influencing factors based on the health ecological model,and to construct the identification model to provide data support and theoretical basis for the early and accurate identification of cognitive impairment in older adults.

A total of 4 204 older adults aged 60 and above from the 2018 data of the China health and retirement longitudinal study(CHARLS) were selected as the research subjects.They were randomly divided into training set and validation set at a ratio of 7∶3.LASSO regression was used to screen variables.Cognitive impairment identification model was constructed based on Logistic regression.The performance of the model was evaluated using the area under the receiver operating characteristic curve(AUC),sensitivity,and specificity.

The incidence of cognitive impairment among older adults aged 60 and above in China was 19.60%.The results of the Logistic regression analysis showed that personal traits(IADL),interpersonal networks(being married,frequency of meeting with children,social participation level),work and life conditions(retirement,heating facilities of housing),and policy environment(endowment insurance,medical insurance) were protective factors of cognitive impairment in older adults(P<0.05),and personal traits(age,disability,depression),behavioral characteristics(smoking),and policy environment(central region,western region) were risk factors of cognitive impairment in older adults(P<0.05).The AUC of the training set and validation set of the elderly cognitive impairment identification model constructed were 0.81 and 0.78, respectively.

The incidence of cognitive impairment among older adults was relatively high.The influencing factors included five aspects:personal traits,behavioral characteristics,interpersonal networks,working and living conditions,and policy environment.The constructed cognitive impairment identification model for the elderly was helpful for achieving early and accurate identification of cognitive impairment among people aged 60 and above.

To reveal the spatiotemporal evolution patterns of the coupling and coordination between nursing human resources and medical and healthcare service capacity in the Chuan-Yu region,and to analyze the spatial heterogeneity of influencing factors,in order to provide scientific basis for the optimal allocation of regional public health resources.

Based on the coupling coordination degree model,the coupling coordination degree between nursing human resources and healthcare service capacity in the Chuan-Yu region from 2011 to 2021 was analyzed.The time series dynamic characteristics of the coupling coordination degree were depicted using the kernel density estimation method.Spatial agglomeration patterns were identified through global and local spatial autocorrelation analysis.Geographically and temporally weighted regression(GTWR) model was constructed to quantify the strength and spatial differentiation of the effects of multiple influencing factors.

From the perspective of temporal evolution,the coupling coordination degree of nursing human resources and healthcare service capacity in the Chuan-Yu region increased from 0.239 in 2011 to 0.273 in 2021.The kernel density curve presented a multimodal structure with increased peak values.The width gradually expanded,and the left trailing extension was widened.From the perspective of spatial pattern,the global Moran's index increased from -0.282 in 2011 to 0.299 in 2021.In 2021,the local spatial autocorrelation analysis clustering was dominated by "high-high" and "low-low",forming "core-periphery" polarization structure.From the perspective of influencing factors,the factors that have a positive influence on the coupling coordination degree were the end-of-year permanent resident population,urbanization rate,average salary,and the number of insured people for urban basic medical insurance.The factors that have a negative impact were the total length of highways and per capita regional GDP.

The coupling coordination degree of the two systems in the Chuan-Yu region has been continuously improving.The clustering trend of the coupling coordination degree is obvious,and regional differentiation has intensified.The coordination relationship showed positive spatial correlation,and the degree of being driven by real factors varies.Relevant departments should promote the balanced development of nursing human resources and improve the investment mechanism for medical and health services.

To explore the dynamic changes of disease adaptation dilemma in patients undergoing lung transplantation at different stages,and to provide basis for formulating precise rehabilitation intervention strategies.

Using purposive sampling,a total of 15 lung transplant patients who were hospitalized in a tertiary grade A hospital in Henan province from June 2024 to March 2025 were selected as the research subjects.According to the timing theory,semi-structured interviews were conducted with the patients.The data were analyzed using the Colaizzi's 7-step analysis method.

Based on the timing theory,five stages of development for lung transplant patients were formed.Five themes were extracted:the diagnosis stage(the dual dilemma of cognitive disruption and life decision-making),the hospital stabilization stage(the adaptation dilemma of life transition and physical and mental upheaval),the discharge preparation stage(the dilemma of rapid recovery desire and lack of discharge preparation ability),the adjustment stage(the dilemma of establishing a new normal and reconstructing life),and the adaptation stage(accumulation of negative emotions and persistent existence of adaptation dilemmas).

The disease adaptation dilemma of lung transplant patients at different stages were dynamically changing.Medical staff should provide lung transplant rehabilitation management in a phased, planned, and continuous manner based on the adaptation difficulties at each stage,so as to facilitate the rapid recovery of lung transplant patients.

To study the application effect of convex base combined with body position nursing intervention in patients with enterostomy.

From May 2024 to March 2025,a total of 166 patients who underwent colorectal cancer surgery and received enterostomy at the gastrointestinal center of a tertiary grade A hospital were selected and randomly divided into an observation group of 84 cases and a control group of 82 cases.The observation group received convex base combined with body position nursing for the enterostomy,while the control group received traditional flat base combined with lying position care for the enterostomy.The hospitalization duration,incidence of enterostomy-related complications,quality of life scores,biomechanical indicators,and nursing satisfaction of the two groups were compared.

The hospitalization duration,incidence of complications,biomechanical indicators quality of life scores,and nursing satisfaction of the observation group were all better than those of the control group(P<0.05).

Convex base combined with body position nursing for patients with enterostomy could effectively shorten the hospitalization duration of patients,reduce the incidence of enterostomy-related complications,and improve patient satisfaction.

To summarize the nursing care of patients with recurrent and refractory malignant tumors undergoing T cell receptor-engineered T cell(TCR-T) therapy.

The treatment and nursing measures for 4 patients with recurrent and refractory malignant tumors undergoing TCR-T therapy were reviewed,including fever care,bone marrow suppression care,renal function impairment care,monitoring of neurotoxic reactions,and psychological care.

Through meticulous treatment and care,all 4 patients successfully completed TCR-T therapy and were discharged.

Through the thorough understanding and effective management of the adverse reactions caused by TCR-T cell therapy,it was possible to enhance the safety and efficacy of the treatment for patients.

To explore the application effect of integrated traditional Chinese and western medicine nursing based on the health promotion model in postoperative care of patients in the hepatobiliary surgery department.

A total of 80 patients who underwent surgery in the hepatobiliary surgery department of our hospital from August 2024 to January 2025 were selected as the research subjects.They were divided into control group and observation group by random number table method,40 cases each.The control group received routine care,while the observation group received integrated traditional Chinese and Western medicine nursing based on the health promotion model in addition to the routine care.The postoperative comfort,quality of life,and complication occurrence of the two groups of patients were compared.

After 6 months of intervention,the comfort scores and quality of life scores of the observation group were significantly higher than those of the control group.The total incidence of complications of the observation group were lower than those of the control group(P<0.05).

Integrated traditional Chinese and western medicine nursing based on health promotion model could improve the postoperative comfort and quality of life of patients in the hepatobiliary surgery department.It could provide support for the construction of systematic postoperative nursing plan for patients in the hepatobiliary surgery department.

To explore the participating attitudes of advanced cancer patients towards advance care planning based on the Q methodology.

Using the Q methodology,by constructing Q samples,selecting P samples,conducting Q sorting and Q analysis,the participating attitudes of advanced cancer patients towards advance care planning was sorted and classified.

A total of 25 patients with advanced cancer were included.Their participating attitudes towards advance care planning were classified into four types:guidance need type,active participation type,family-centered type,and cultural avoidance type.

The participating attitudes of each type of patients towards advance care planning were different.Targeted intervention measures could be formulated based on the relevant attitudes types.

To explore the application effect of nursing intervention based on business process reengineering in the position placement of patients undergoing kidney surgery in urology department.

A total of 120 patients who underwent kidney surgery in the urology department of a tertiary grade A hospital from January to December 2024 were selected as the research subjects.They were divided into control group and observation group,60 cases each,according to the random number table method.The control group adopted traditional nursing process.The observation group introduced the concept of business process reengineering and systematically sorted out and optimized the position placement process of patients undergoing kidney surgery,including the formulation of standardized operating procedures,the establishment of a multidisciplinary communication model,the application of work forms and visualization tools,and the improvement of position aids.The time of kidney position placement,the correct rate of position placement,the incidence of perioperative complications, and the postoperative satisfaction of the two groups were compared.

There were statistically significant differences in the time of kidney position placement,the correct rate of position placement,the incidence of perioperative complications,and the satisfaction score of patients between the two groups(P<0.05).

The application of nursing intervention based on business process reengineering in the position placement of patients undergoing kidney surgery in urology department could effectively improve the standardization and efficiency of the nursing process,provide practical references for clinical nursing quality control and continuous improvement.

To understand the current status of high-level disinfection item management for central sterile supply department in hospitals,and to provide reference basis for standardizing the management of high-level disinfection items.

Using the convenience sampling method,a self-designed questionnaire on the current status of high-level disinfection item management in hospital disinfection supply centers was used to investigate the current status of high-level disinfection item management for central sterile supply department in 253 hospitals.

The top three categories of high-level disinfection items in terms of quantity were tourniquets(199 hospitals), humidification bottles(168 hospitals),and simple respirators (132 hospitals).The disinfection methods mainly included chlorine-containing disinfectants,moist heat,and acidified water.There were 19 packaging methods for high-level disinfection items,and the top three were self-sealing bags(54.52%),paper-plastic bags(17.33%),and plastic storage boxes(7.53%).The validity period of high-level disinfection items ranged from 6 days to 180 days.The most common validity period was 7 days(110 hospitals,43.48%).A total of 86 hospitals(33.98%) only marked the processing date of high-level disinfection on the packaging,without indicating the expiration date.

There were significant differences in the management of high-level disinfection items among different central sterile supply department in hospitals,and there was considerable room for improvement.The relevant departments and industry associations should promptly formulate relevant guidelines and standards to regulate the management of high-level disinfection items.

To explore the application effect of the oral nutrition supplements(ONS) compliance nursing intervention scheme based on the behavior change wheel(BCW) theory in patients with gastrointestinal tumors after surgery.

By using the convenience sampling method,a total of 95 patients with gastrointestinal tumors who underwent surgical treatment in the gastrointestinal surgery department of a tertiary grade A hospital in Changzhou city from July to September 2024 were selected as the observation group,and 90 patients with gastrointestinal tumors who underwent surgical treatment in the gastrointestinal surgery department from April to June 2024 were selected as the control group.The patients in control group received conventional care based on the guidelines,while the patients in observation group received the postoperative ONS compliance nursing intervention program for gastrointestinal tumor patients based on the BCW theory.The compliance of ONS,the level of ONS knowledge,the changes in nutritional indicators,and the quality of life scores of two groups of patients were compared at the time of discharge,the 4th week after discharge,and the 8th week after discharge.

The generalized estimating equation results showed that the time and group interaction effects of the objective,subjective compliance of ONS,and the knowledge level of ONS,as well as the changes in nutritional indicators between two groups were significant(P<0.05).Simple effect analysis revealed that at the 4th week and the 8th week after discharge,the objective and subjective compliance of ONS,the knowledge level of ONS, as well as the changes in nutritional indicators in the observation group were significantly higher than those in the control group(P<0.05).Repeated measures variance analysis showed that the time and group interaction effects of the quality of life scores were significantly different between two groups(P<0.05).Simple effect analysis indicated that at the 4th week and the 8th weeks after discharge,the quality of life scores in the observation group were significantly better than those in the control group(P<0.05).

The ONS compliance nursing intervention program based on the BCW theory could significantly improve the ONS compliance of patients after gastrointestinal tumor surgery,enhance their ONS knowledge level,and improve their condition of nutrition and quality of life.

To summarize the related contents of oral health guidelines for pregnant women at home and abroad,so as to provide reference for further optimization of oral health guidelines for pregnant women in China.

This study systematically retrieved guidelines on oral health for pregnant women from databases such as PubMed,EMbase,CINAHL,Cochrane Library,CNKI and Wanfang,as well as relevant guideline websites and Google Scholar.The search period was from the establishment of the databases to February 28,2025.

A total of 21 guidelines were included,from the United States,Australia,Canada,China and Europe.The main contents of the guidelines included oral assessment,disease prevention and control,health education,and multidisciplinary collaboration.There has been certain consensus on the optimal timing and safety of oral treatment for pregnant women.Although some guidelines mentioned oral health care before and after pregnancy,the covered content was limited.

The core recommendations of the oral health guidelines for pregnant women are largely consistent.However,there is still room for improvement in aspects such as service coverage during the service stage,multidisciplinary collaboration,and clinical operability.It is suggested that the service stage of the guidelines should include pre-pregnancy and post-pregnancy periods,strengthen multidisciplinary collaboration,enhance the clinical operability of the guidelines,and promote the standardization of oral health management for pregnant women.

To conduct a scoping review of the application of generative artificial intelligence in the dietary management of patients with chronic diseases.

Systematic search was conducted in Chinese and English databases such as PubMed,Web of Science(WOS),EMbase,Cochrane Library,CINAHL,Scopus,IEEE Xplore,Association for Computing Machinery Digital Library(ACM),Chinese Biomedical Literature Service System(SinoMed),China National Knowledge Infrastructure(CNKI),WanFang Data Knowledge Service Platform,and VIP Database.The search period was from January 1,2014 to August 20,2025.Two researchers independently screened the literature according to the inclusion and exclusion criteria and extracted the basic characteristics of the literature.

A total of 22 articles were included.The studies involved a wide range of populations,with a majority being patients with diabetes.The application scope of generative artificial intelligence in patient diet management included food image recognition,diet assessment,dietary recommendations,diet intervention plan formulation,and diet consultation.The application technologies included recommendation algorithms,data mining,time series modeling,neural networks,knowledge graphs,patient profiling,deep learning,chatbots.

The application of generative artificial intelligence in the dietary management of patients with chronic diseases had achieved good results and significant advantages.However,its application was still in its infancy.In the future,large-scale clinical randomized controlled trials need to be conducted,and communication and cooperation among multiple disciplines should be strengthened.