To explore the development trajectory and influencing factors of sleep quality in patients with chronic rhinosinusitis(CRS).

A total of 236 CRS patients admitted to our hospital from February 2023 to February 2025 were selected.The Pittsburgh Sleep Quality Index(PSQI) was used to assess sleep quality at baseline and after 1 month,3 months,6 months of treatment.Growth mixture modeling identified distinct trajectory classes.Clinical data were collected for univariate and correlation analyses,and multiple Logistic regression identified independent influencing factors.

The sleep quality of CRS patients presented three heterogeneous trajectories:rapid improvement type(44.92%),slow improvement type(35.17%),and limited improvement type(19.92%).Regression analysis showed that body mass index(BMI),nasal polyps,combined asthma/allergy,combined obstructive sleep apnea(OSA),Lund-Mackay CT score,Visual Analogue Scale(VAS) score,22-item Sinonasal Outcome Test(SNOT-22),and Hospital Anxiety and Depression Scale-Anxiety subscale(HADS-A) score were the influencing factors of their latent categories(all P<0.05).

There is significant heterogeneity in sleep quality among patients with CRS.Medical staff should implement early identification and stratified intervention based on the influencing factors of different trajectories.

To explore the application effect of the family-centered empowerment care model in patients with coronary heart disease complicated with heart failure and their caregivers.

From December 2023 to August 2025,a total of 70 patients with coronary heart disease complicated with heart failure who were hospitalized in the department of cardiovascular medicine of our hospital,as well as 70 of their caregivers,were selected,and randomly divided into the observation group and the control group,with 35 cases in each.The control group received routine nursing,while the observation group received family-centered empowerment care model care.Both groups were intervened for 3 months.The clinical indicators and Coronary Artery Disease Treatment Adherence Scale(CADTAS),Minnesota Living with Heart Failure Questionnaire(MLHFQ),and main caregiver's Care Preparedness Scale(CPS),Family Caregiver Task Inventory(FCTI) scores were compared between the two groups.

The symptom improvement time,total hospital stay,and readmission rate of the observation group were all shorter or lower than those of the control group(P<0.05).At 3 months after intervention,the scores of CADTAS and CPS of both groups increased,while the scores of FCTI and MLHFQ decreased.Moreover,the CADTAS and CPS scores of the observation group were higher than those of the control group,and the FCTI and MLHFQ scores were lower than those of the control group(P<0.05).

The family-centered empowerment care model could shorten the symptom improvement time and total hospital stay of patients with coronary heart disease complicated with heart failure,reduce the readmission rate,improve the treatment compliance of patients,enhance the care preparation and care ability of caregivers,and improve the quality of life for patients.

To construct an early rehabilitation nursing program for critically ill patients driven by digital twin technology and multi-dimensional assessment,and to verify its clinical value in improving muscle strength and ICU-acquired weakness(ICU-AW).

Early rehabilitation nursing program for critically ill patients driven by digital twin technology was developed using the modified Delphi method,establishing a 4-level intelligent rehabilitation plan centered on real-time Medical Research Council(MRC) muscle strength assessment scores.A total of 120 patients admitted to the emergency intensive care unit(EICU) of our hospital from January 2024 to March 2025 were randomly divided into an observation group and a control group,60 cases each.Patients in the control group received a graded rehabilitation plan based on the conventional care process,while those in the observation group received the early rehabilitation nursing program for critically ill patients driven by digital twin technology.The MRC score,Barthel Index,improvement rate of ICU-AW,mechanical ventilation time,oxygenation index,adverse event rate,and serum albumin level were compared between two groups.

After the intervention,the MRC score,Barthel Index,improvement rate of ICU-AW,oxygenation index,and serum albumin level in the observation group were better than those in the control group.The mechanical ventilation time was shorter.The adverse event rate was lower(all P<0.05).

The constructed early rehabilitation nursing program for critically ill patients driven by digital twin technology could achieve dynamic and precise intervention as well as intelligent early warning,improve the patient's muscle strength,reduce the risk of ICU-AW,and provide an intelligent solution for critically ill patients' rehabilitation.

To explore the impact of long-term care insurance(LTCI) policy on the progression of frailty among older adults in China.

Based on the data from five rounds of the China Health and Retirement Longitudinal Study(CHARLS) from 2011 to 2020,a frailty index covering physical,psychological,cognitive,social,and subjective health dimensions was constructed.The elderly in the pilot cities for long-term care insurance policies were taken as the treatment group, while the non-pilot cities were the control group.The difference-in-differences(DID) model was employed to assess the impact of the policy on the progression of frailty.

After the implementation of the LTCI policy,the progression rates of physical frailty,psychological frailty and cognitive frailty among older adults were significantly slowed.Parallel trend tests and winsorization results supported the robustness of these findings.Heterogeneity analyses revealed that the LTCI policy had more pronounced delaying effects on frailty progression among older adults who were of advanced age,male,residing in rural areas or with lower educational attainment(P<0.05).

The LTCI policy is beneficial in slowing frailty progression in older adults. We recommend further expanding the policy coverage,promoting the development of care service systems,and enhancing policy targeting and equity to better facilitate healthy aging.

To investigate the status quo of the ability levels for disabled elderly people,and to analyze its influencing factors,so as to provide some references for reducing the degree of ability impairment of disabled elderly people and carrying out targeted elderly care services.

Using a multi-stage stratified sampling method,a total of 420 disabled elderly people in Chengdu city were selected as the research subjects.General information questionnaires and the Elderly Capacity Assessment Scale were used for the investigation.

Among the 420 disabled elderly people,220(52.38%) had mild disability,103(24.52%) had moderate disability,64(15.24%) had severe disability,and 33(7.86%) were completely disabled.Based on the variable selection results of the random forest model,9 core influencing factors were extracted.The results of the ordered multi-class Logistic regression analysis showed that age,educational level,living situation,family per capita monthly income,main caregiver,and life status evaluation were the influencing factors of the ability levels of disabled elderly people(P<0.05).

The proportion of severe and complete disability among disabled elderly people is relatively high.It is recommended that relevant departments promote the elderly ability assessment work.Through relevant interventions,to delay the process of elderly disability,and to improve the quality of life of the elderly.

To explore the trajectory of breast milk sodium ion concentration change in pregnant women with gestational diabetes mellitus and its relationship with delayed onset of lactogenesis.

Using the convenience sampling method,a total of 169 pregnant women with gestational diabetes mellitus from two tertiary grade A hospitals in Guangdong province from August 2024 to April 2025 were selected as the research subjects.They were surveyed using a general information questionnaire.Breast milk sodium ion concentrations were measured at 24 hours,48 hours,and 72 hours after delivery.

The breast milk sodium ion concentrations of pregnant women with gestational diabetes mellitus at 24 hours,48 hours,and 72 hours after delivery were (62.92±8.83) mmol/L,(42.58±9.72) mmol/L,and (27.17±12.95) mmol/L,respectively.Based on the trajectory model,two trajectories of breast milk sodium ion concentration changes were determined:the low sodium ion concentration-rapid decline group(69.8%) and the high sodium ion concentration-slow decline group(30.2%).The incidence of delayed lactation initiation in the low sodium ion concentration-rapid decline group was 13.6%,and that in the high sodium ion concentration-slow decline group was 76.5%.There was statistically significant difference in terms of the incidence of delayed onset of lactogenesis between the two groups(P<0.001).The high sodium ion concentration-slow decline group had a higher risk of delayed onset of lactogenesis as the reference group.

The changes in breast milk sodium ion concentration in pregnant women with gestational diabetes mellitus are correlated with delayed onset of lactogenesis.The trajectory of breast milk sodium ion concentration changes could objectively predict the occurrence of delayed onset of lactogenesis.Clinical medical staff could use the changes in breast milk sodium ion concentration to predict the occurrence of delayed onset of lactogenesis.

To investigate the application value of serum interleukin-23(IL-23),tumor necrosis factor-α(TNF-α) and microRNA-146b-5p(miR-146b-5p) in nursing evaluation of full-term neonates with hypoxic-ischemic encephalopathy(HIE),and to analyze their guiding significance for prognostic nursing management.

A total of 95 full-term neonates diagnosed with HIE admitted to our hospital from January 2020 to December 2024 were enrolled as the HIE group.According to the Diagnostic Criteria and Clinical Grading for Neonatal Hypoxic-Ischemic Encephalopathy,they were subdivided into mild subgroup(29 cases),moderate subgroup(44 cases) and severe subgroup(22 cases).Meanwhile,95 healthy full-term neonates were recruited as the control group.Venous blood samples of all subjects were collected within 1 day after admission to detect serum levels of IL-23 and TNF-α.Quantitative real-time polymerase chain reaction(qRT-PCR) was performed to detect the relative expression of miR-146b-5p.All neonates in the HIE group received standardized nursing interventions,including therapeutic hypothermia care,vital sign monitoring, neurological function protection nursing and so on.After 1 year of follow-up,there was one case of loss to follow-up.The patients were divided into favorable prognosis subgroup(70 cases) and poor prognosis subgroup(24 cases).The correlations of the three indicators with disease severity,nursing evaluation and long-term prognosis were analyzed.

Serum IL-23 and TNF-α levels were significantly higher,while the relative expression of miR-146b-5p was markedly lower in the HIE group compared with the control group(P<0.05).The levels of IL-23,TNF-α and miR-146b-5p were significantly correlated with the severity of HIE(P<0.05).Neonates with poor prognosis exhibited elevated IL-23 and TNF-α levels as well as reduced miR-146b-5p expression relative to those with favorable prognosis(P<0.05).After adjusting for confounding factors,IL-23,TNF-α and miR-146b-5p remained independently correlated with neonatal prognosis(P<0.05).Receiver operating characteristic(ROC) curve analysis revealed that the area under the curve(AUC) of combined detection of IL-23,TNF-α and miR-146b-5p for predicting neonatal prognosis reached 0.945,which possessed significantly superior predictive efficiency compared with single indicator detection(P<0.05).

Serum IL-23,TNF-α,and miR-146b-5p could be used as objective quantitative indicators for the assessment and stratification of the condition of full-term neonates with HIE.The combined detection of these three could improve the accuracy of predicting the prognosis risk,in order to provide scientific support for optimizing nursing plans,to allocate nursing resources,and to improve the long-term outcome of the children.

To systematically search for assessment tools for bladder cancer specific patient-reported outcome at home and abroad,so as to provide references for tool selection and development.

Systematic search was conducted in China National Knowledge Infrastructure(CNKI),WanFang Database,China Biomedical Literature Database,VIP Database,PubMed,EMbase,Web of Science,and Cochrane Library for assessment tools related to bladder cancer patient-reported outcome.The retrieval period spanned from the establishment of the databases to May 15, 2025.

A total of 32 articles were included,and 13 assessment tools for bladder cancer were summarized.Among them,4 assessment tools have been translated into Chinese versions.

The assessment tools for bladder cancer specific patient-reported outcome are in the development stage.Their clinical application requires comprehensive consideration of multiple factors.Future research need to validate and improve the existing assessment tools,and to develop specific assessment tools for bladder cancer patients in China.

To review the application of new media health education in improving parenting concerns among young and middle-aged cancer patients,and to provide a reference for alleviating such concerns.

Relevant literature on the application of new media health education interventions to improve parenting concerns in young and middle-aged cancer patients was retrieved from Web of Science,PubMed,MedLine,Elsevier,Cochrane Library,CNKI,WanFang Database,VIP,and Chinese Biomedical Literature database.The search period covered from the inception of each database to November 30, 2025.

A total of 9 articles were included,among which 1 was a Chinese article and 8 were English articles.The intervention targets of new media health education included the patients,their spouses,and medical staff.The intervention contents mainly covered psychological support,health education,communication and parenting skills training,behavioral and lifestyle intervention,personalized intervention and resource provision,family daily life and end-of-life preparation,and caregiver support.The outcome indicators mainly involved anxiety and depression,parenting stress,parenting efficacy,communication skills,family and behavioral functions,coping styles,and quality of life.

New media health education interventions could improve parenting concerns in young and middle-aged cancer patients.Future research may employ large‑sample surveys to map parenting concerns across different cancer types,stages,and treatment phases,and integrate virtual reality and artificial intelligence technologies to develop innovative and personalized interventions,thereby maximizing the improvement of patients' parenting concerns.

To review the risk prediction models of unplanned discontinuation of continuous renal replacement therapy(CRRT) in ICU patients,and to provide evidence-based guidance for healthcare providers in selecting or developing appropriate risk prediction models.

This study systematically retrieved relevant studies from Chinese and English databases such as OVID,CINAHL,PubMed,Web of Science,Cochrane Library,EMbase,CNKI,VIP,WanFang,and China Biomedical Literature Database.The search period was from the establishment of the databases to August 12, 2025.

A total of 19 studies were included,involving 28 models.Sample sizes ranged from 79 to 2 531 cases.The area under curve(AUC) for the 28 models ranged from 0.705 to 0.978.Calibration methods were reported in 17 studies.The overall applicability of the 19 studies was good,but there was still a relatively high risk of bias,mainly concentrated in the field of data analysis.

The risk prediction models of unplanned discontinuation of CRRT in ICU patients are still in the development stage.Future research should further improve the quality of related model studies,especially in aspects such as the selection of predictive factors and model evaluation,so as to provide effective tools for clinical practitioners to formulate individualized intervention strategies.