Objective:This study aimed to develop a Nursing Retrieval-Augmented Generation(NurRAG)system based on large language models(LLMs)and to evaluate its accuracy and clinical applicability in nursing question answering.Me...Objective:This study aimed to develop a Nursing Retrieval-Augmented Generation(NurRAG)system based on large language models(LLMs)and to evaluate its accuracy and clinical applicability in nursing question answering.Methods:A multidisciplinary team consisting of nursing experts,artificial intelligence researchers,and information engineers collaboratively designed the NurRAG framework following the principles of retrieval-augmented generation.The system included four functional modules:1)construction of a nursing knowledge base through document normalization,embedding,and vector indexing;2)nursing question filtering using a supervised classifier;3)semantic retrieval and re-ranking for evidence selection;and 4)evidence-conditioned language model generation to produce citation-based nursing answers.The system was securely deployed on hospital intranet servers using Docker containers.Performance evaluation was conducted with 1,000 expert-verified nursing question–answer pairs.Semantic fidelity was assessed using Recall Oriented Understudy for Gisting Evaluation–Longest Common Subsequence(ROUGE-L),and clinical correctness was measured using Accuracy.Results:The NurRAG system achieved significant improvements in both semantic fidelity and answer accuracy compared with conventional large language models.For ChatGLM2-6B,ROUGE-L increased from(30.73±1.48)%to(64.27±0.27)%,and accuracy increased from(49.08±0.92)%to(75.83±0.35)%.For LLaMA2-7B,ROUGE-L increased from(28.76±0.89)%to(60.33±0.21)%,and accuracy increased from(43.27±0.83)%to(73.29±0.33)%.All differences were statistically significant(P<0.001).A quantitative case analysis further demonstrated that NurRAG effectively reduced hallucinated outputs and generated evidence-based,guideline-concordant nursing responses.Conclusion:The NurRAG system integrates domain-specific retrieval with LLMs generation to provide accurate,reliable,and traceable evidence-based nursing answers.The findings demonstrate the system’s feasibility and potential to improve the accuracy of clinical knowledge access,support evidence-based nursing decision-making,and promote the safe application of artificial intelligence in nursing practice.展开更多
With the accelerating pace of population aging in China,various issues related to elderly care have emerged one after another,becoming a severe social problem.Especially against the backdrop of increasing economic pre...With the accelerating pace of population aging in China,various issues related to elderly care have emerged one after another,becoming a severe social problem.Especially against the backdrop of increasing economic pressure,the traditional family-based elderly care model is facing significant challenges and can hardly meet the elderly care needs.At present,the geriatric nursing models are relatively backward,which directly affects the quality of daily life,physical health and mental well-being of the elderly.Therefore,it is necessary to explore an appropriate geriatric nursing model to address the aging problem.Based on this,this paper analyzes and studies the current situation of geriatric nursing models under the background of healthy aging,providing references for relevant research and practice.展开更多
Objective: To explore the application effect of optimizing the nursing model in community health centers for elderly health examinations, providing a reference for enhancing the management level of elderly health at t...Objective: To explore the application effect of optimizing the nursing model in community health centers for elderly health examinations, providing a reference for enhancing the management level of elderly health at the grassroots level. Methods: A total of 300 elderly individuals who underwent health examinations at our center from January 2024 to December 2024 were selected as the study subjects. They were randomly divided into a control group and an observation group, with 150 cases in each group. The control group underwent the conventional health examination nursing process, while the observation group adopted an optimized community nursing model, which included stratified education and appointment scheduling before the examination, full-time accompaniment and safety care during the examination, and the establishment of electronic medical records and continuous follow-up after the examination. Differences in health management awareness rates and satisfaction with health examination services between the two groups of elderly individuals were compared. Results: The health management awareness rate in the observation group was 94.67%, significantly higher than that in the control group (78.00%;p < 0.001). The satisfaction rate with health examination services in the observation group was 96.00%, also significantly higher than that in the control group (82.00%;p < 0.001). Conclusion: The optimized community nursing model can effectively enhance the health awareness level and service satisfaction of elderly individuals during health examinations, demonstrating strong practicality and promotion value. It contributes to achieving continuity and precision in grassroots elderly health management.展开更多
Nursing models at home and abroad for breast cancer patients during the perioperative period were screened, including eight types of models： the nursing model guided by self-care theory, the plan-do-check-a...Nursing models at home and abroad for breast cancer patients during the perioperative period were screened, including eight types of models： the nursing model guided by self-care theory, the plan-do-check-act cycle combined with the four-in-one model, the peer support nursing model, the nursing model guided by transcultural theory, the multidisciplinary cooperative nursing model, the knowledge-attitude-practice nursing model, the safe nursing management model, and the case nursing model. These models were analyzed and described with the aim of providing a reference for the clinical breast surgery nursing staff in China and for promoting the development of nursing in China for breast cancer the perioperative period.展开更多
Objectives＂ To deepen our understanding of the status quo and to identify the hot topics and develop- mental trends of research on nursing models in countries other than China in the most recent decade. Methods： The...Objectives＂ To deepen our understanding of the status quo and to identify the hot topics and develop- mental trends of research on nursing models in countries other than China in the most recent decade. Methods： The study subjects were the publications retrieved from the PubMed database using the MeSH terms of ＂Models, Nursing＂. Bibliographic item co-occurrence mining system （BICOMS） software was used for conventional bibliometric analysis of publications during two time periods, 2005-2009 and 2010-2014. The number of published journal articles, journal distribution, authors of publications, country of origin of journals, and language of publications were analyzed to establish a high-frequency keyword profile and co-occurrence matrix. Graphical clustering toolkit （gCLUTO） software was applied for two-way clustering analysis and visualized analysis. Results： A total of 1472 journal articles with a key theme of nursing models were retrieved for final analysis, including 771 published during 2005-2009 and 701 during 2010-2014. The bibliometric analysis revealed that publications other than China concerning nursing models were mostly concentrated in the United States and the United Kingdom and that the number of relevant publications has been continuously decreasing. The two-way clustering analysis showed that there were mainly four types of research themes in the relevant publications in countries other than China during 2005-2009, i.e., nursing education and theoretical research, clinical nursing and psychological care, nursing administration, and models of nursing education, whereas there were five types during 2010-2014, i.e., nursing theories and clinical nursing practice, nursing administration models and assessments of nurses＇ knowledge and skills, community nursing administration models, nursing human resource management, and nursing education models and approaches. Conclusions： Research on nursing models in countries other than China is relatively mature and stable with a broader view, but it has shown a declining trend in recent years. It emphasizes both theory and practice, with research content tending to be structured into four modules, i.e., nursing education, administration, clinical practice, and theoretical research. Community nursing models may become a key research direction in the international research on nursing models in the future.展开更多
Objective: To explore the effectiveness of applying patient simulators combined with Internet Plus scenario simulation teaching models on intravenous (IV) infusion nursing education, and to provide scientific evidence...Objective: To explore the effectiveness of applying patient simulators combined with Internet Plus scenario simulation teaching models on intravenous (IV) infusion nursing education, and to provide scientific evidence for the implementation of advanced teaching models in future nursing education. Methods: Enrolled 60 nurses who took the IV infusion therapy training program in our hospital from January 2022 to December 2023 for research. 30 nurses who were trained in traditional teaching models from January to December 2022 were selected as the control group, and 30 nurses who were trained with simulation-based teaching models with methods including simulated patients, internet, online meetings which can be replayed and scenario simulation, etc. from January to December 2023 were selected as the experimental group. Evaluated the learning outcomes based on the Competency Inventory for Nursing Students (CINS), Problem-Solving Inventory (PSI), comprehensive learning ability, scientific research ability, and proficiency in the theoretical knowledge and practical skills of IV infusion therapy. Nursing quality, the incidence of IV infusion therapy complications and nurse satisfaction with different teaching models were also measured. Results: The scientific research ability, PSI scores, CINS scores, and comprehensive learning ability of the experimental group were better than those of the control group (P 0.05), and their assessment results of practical skills, nursing quality of IV infusion therapy during training, and satisfaction with teaching models were all better than those of the control group with statistical significance (P < 0.05). The incidence of IV infusion therapy complications in the experimental group was lower than that in the control group, indicating statistical significance (P < 0.05). Conclusions: Teaching models based on patient simulators combined with Internet Plus scenario simulation enable nursing students to learn more directly and practice at any time and in any place, and can improve their proficiency in IV infusion theoretical knowledge and skills (e.g. PICC catheterization), core competencies, problem-solving ability, comprehensive learning ability, scientific research ability and the ability to deal with complicated cases. Also, it helps provide high-quality nursing education, improve the nursing quality of IV therapy, reduce the incidence of related complications, and ensure the safety of patients with IV therapy.展开更多
Purpose:This pilot study aimed to assess the reliability and validity of a modified Dundee Ready Educational Environment Measure(m-DREEM)tool used to evaluate the effects of different pedagogical approaches in a clini...Purpose:This pilot study aimed to assess the reliability and validity of a modified Dundee Ready Educational Environment Measure(m-DREEM)tool used to evaluate the effects of different pedagogical approaches in a clinical learning environment on nursing students'learning perceptions.Methods:A sample consisting of 130 nursing students in two different models of clinical education was surveyed.Results:This pilot study demonstrated that m-DREEM yields a high internal consistency.This tool can be used to evaluate nursing students'perceptions of their clinical learning environment on the basis of five sub-scales:students'learning perceptions,facilitators,academic self-perception,atmosphere,social self-perception,and mentorship.Conclusion:A definitive and inferential relationship between sub-scales and clinical models,namely,block and non-block dispersed models,could not be determined because of the small sample size of the block clinical model.Hence,further research should be performed.展开更多
Purpose:To analyze the role of the seminar teaching method+case-based learning(CBL)teaching method+problem-based learning(PBL)teaching method in oral clinical nursing teaching.Methods:13 undergraduate nursing students...Purpose:To analyze the role of the seminar teaching method+case-based learning(CBL)teaching method+problem-based learning(PBL)teaching method in oral clinical nursing teaching.Methods:13 undergraduate nursing students who entered the department from September 2020 to September 2021 were selected as the control group,adopting conventional nursing teaching methods;13 undergraduate nursing students who entered the department from September 2021 to August 2022 were selected as the observation group,adopting the seminar+CBL+PBL teaching method.The teaching effects were compared between the two groups.Results:All assessment scores of the observation group were higher than those of the control group;all teaching satisfaction levels were higher than those of the control group(P<0.05).Conclusion:Adopting the seminar+CBL+PBL teaching method during oral clinical nursing teaching can improve nursing students’assessment scores,strengthen their core competencies,and enhance teaching satisfaction.展开更多
Recently,inflammatory cytokine profiles have been linked to suicide risk in adolescents with non-suicidal self-injury,highlighting a promising biological dimension of suicide risk assessment.Clinical translation of th...Recently,inflammatory cytokine profiles have been linked to suicide risk in adolescents with non-suicidal self-injury,highlighting a promising biological dimension of suicide risk assessment.Clinical translation of the cytokine profiles into practice will require frontline engagement of the workforce.Mental health nurses are frequently the most accessible professionals in schools,communities,and low-resource settings and are prime candidates to bridge this gap.By integrating psychosocial evaluation with emerging biomarker data,they can deliver systematic risk assessment,continuous monitoring,and timely intervention.This role would not replace psychiatric expertise;it would extend the reach of psychiatric services,embedding suicide prevention across the continuum of care.For health systems,nurse-led integration may enhance capacity,equity,and resilience in responding to adolescent suicide risk.This editorial demonstrates that empowering nurses to operationalize biomarker-informed strategies is needed for advancing effective and sustainable suicide prevention in this vulnerable population.展开更多
BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and...BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and high postoperative complication rates,which threaten patient safety and functional outcomes.Enhanced recovery after surgery(ERAS)principles have been shown to improve perioperative outcomes through evidence-based,multidisciplinary care pathways.Despite its widespread adoption,there is a paucity of research focusing specifically on optimizing ERAS-guided nursing processes in the post-anesthesia care unit(PACU)and evaluating its impact on perioperative safety in patients undergoing GI tumor surgery.This study aimed to investigate whether an ERASbased PACU nursing protocol could enhance recovery,reduce complications,and improve patient safety in this surgical population.AIM To explore the impact of optimizing the recovery room nursing process based on ERAS on the perioperative safety of patients with GI tumors.METHODS A total of 260 patients with GI tumors who underwent elective surgeries under general anesthesia in our hospital from August 2023 to August 2025 and were then observed in the recovery unit(PACU)were selected.They were randomly divided into the observation group(the PACU nursing process was optimized based on ERAS)and the control group(the conventional PACU nursing process was adopted)by the random number grouping method,with 130 cases in each group.The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,time of leaving the room after tube removal,retention time in the recovery room,occurrence of complications,satisfaction and readmission rate were compared between the two groups after entering the room.Compare the occurrence of adverse events in the PACU nursing process between the two groups.RESULTS The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,retention time in the recovery room,total incidence of complications and readmission rate in the observation group were significantly lower than those in the control group,and the satisfaction rate was higher than that in the control group(P<0.05).The occurrence of adverse events in the PACU nursing process in the observation group was lower than that in the control group(P<0.05).CONCLUSION Optimizing the PACU nursing process based on ERAS can effectively accelerate the recovery process of patients undergoing GI tumor surgery,reduce adverse events,improve nursing satisfaction,and at the same time,lower the incidence of adverse events in the PACU nursing process,providing a more refined management basis for clinical practice.展开更多
Gastrointestinal(GI)cancers represent a major global health concern due to their high incidence and mortality rates.Foundation models(FMs),also referred to as large models,represent a novel class of artificial intelli...Gastrointestinal(GI)cancers represent a major global health concern due to their high incidence and mortality rates.Foundation models(FMs),also referred to as large models,represent a novel class of artificial intelligence technologies that have demonstrated considerable potential in addressing these challenges.These models encompass large language models(LLMs),vision FMs(VFMs),and multimodal LLMs(MLLMs),all of which utilize transformer architectures and self-supervised pre-training on extensive unlabeled datasets to achieve robust cross-domain generalization.This review delineates the principal applications of these models:LLMs facilitate the structuring of clinical narratives,extraction of insights from medical records,and enhancement of physician-patient communication;VFMs are employed in the analysis of endoscopic,radiological,and pathological images for lesion detection and staging;MLLMs integrate heterogeneous data modalities,including imaging,textual information,and genomic data,to support diagnostic processes,treatment prediction,and prognostic evaluation.Despite these promising developments,several challenges remain,such as the need for data standardization,limited diversity within training datasets,substantial computational resource requirements,and ethical-legal concerns.In conclusion,FMs exhibit significant potential to advance research and clinical management of GI cancers.Future research efforts should prioritize the refinement of these models,promote international collaborations,and adopt interdisciplinary approaches.Such a comprehensive strategy is essential to fully harness the capabilities of FMs,driving substantial progress in the fight against GI malignancies.展开更多
Myasthenia gravis is a chronic autoimmune disorder that affects the neuromuscular junction leading to fluctuating skeletal muscle fatigability. The majority of myasthenia gravis patients have detectable antibodies in ...Myasthenia gravis is a chronic autoimmune disorder that affects the neuromuscular junction leading to fluctuating skeletal muscle fatigability. The majority of myasthenia gravis patients have detectable antibodies in their serum, targeting acetylcholine receptor, muscle-specific kinase, or related proteins. Current treatment for myasthenia gravis involves symptomatic therapy, immunosuppressive drugs such as corticosteroids, azathioprine, and mycophenolate mofetil, and thymectomy, which is primarily indicated in patients with thymoma or thymic hyperplasia. However, this condition continues to pose significant challenges including an unpredictable and variable disease progression, differing response to individual therapies, and substantial longterm side effects associated with standard treatments(including an increased risk of infections, osteoporosis, and diabetes), underscoring the necessity for a more personalized approach to treatment. Furthermore, about fifteen percent of patients, called “refractory myasthenia gravis patients”, do not respond adequately to standard therapies. In this context, the introduction of molecular therapies has marked a significant advance in myasthenia gravis management. Advances in understanding myasthenia gravis pathogenesis, especially the role of pathogenic antibodies, have driven the development of these biological drugs, which offer more selective, rapid, and safer alternatives to traditional immunosuppressants. This review aims to provide a comprehensive overview of emerging therapeutic strategies targeting specific immune pathways in myasthenia gravis, with a particular focus on preclinical evidence, therapeutic rationale, and clinical translation of B-cell depletion therapies, neonatal Fc receptor inhibitors, and complement inhibitors.展开更多
Objective:This study aimed to explore the effect of standardized patient(SP)-narrative nursing in the experimental teaching of surgical nursing.Methods:A quasi-experimental study design was adopted.A total of 200 unde...Objective:This study aimed to explore the effect of standardized patient(SP)-narrative nursing in the experimental teaching of surgical nursing.Methods:A quasi-experimental study design was adopted.A total of 200 undergraduate nursing students were recruited from the Nursing College of Guilin Medical University in China from March 2023 to December 2024.The intervention group recruited students from the Class of 2022(n=100),and the control group recruited students from the Class of 2021(n=100).The intervention group adopted a teaching model combining standardized patients with narrative nursing based on traditional scenariobased simulation teaching,which was applied to the nursing of perioperative patients(4 class hours)and scenario-based case drills(4 class hours)in the experimental teaching of surgical nursing.The control group used traditional scenario-based simulation teaching.The Nurse Humanistic Care Quality Evaluation Scale,Clinical Thinking Ability Evaluation Index System Scale for Medical Students,and Nurse-Patient Communication Ability Evaluation Scale for Nursing Students were used to investigate and compare the teaching effects between the two groups of students.Results:The total scores of the intervention group on humanistic care(91.39±3.97),clinical thinking(79.64±6.33),and nurse-patient communication(157.22±7.95)abilities were significantly higher than those of the control group(82.29±3.62,65.11±7.24,and 147.05±7.84,respectively),with statistically significant differences(P<0.01).Conclusion:This study confirms that integrating the dual teaching model of standardized patients and narrative nursing in experimental teaching of surgical nursing has significantly optimized the theoretical and practical structure of teaching strategies.This innovative teaching method provides a promotable paradigm for nursing humanities education and is of positive significance for improving the effectiveness of cultivating the core literacy of nursing talents.展开更多
Objective:To investigate the impact of programmed harmonious nursing combined with hierarchical management on nursing quality and satisfaction in a health management center.Methods:A total of 100 patients who received...Objective:To investigate the impact of programmed harmonious nursing combined with hierarchical management on nursing quality and satisfaction in a health management center.Methods:A total of 100 patients who received care at this health management center from January 2024 to January 2025 were selected as subjects.Using a random number table method,they were divided into an observation group(n=50)and a control group(n=50).The control group followed traditional methods,while the observation group integrated programmed harmonious nursing with hierarchical management.Comparative analysis was conducted on nursing quality scores,adverse event occurrence rates,and patient satisfaction between the two groups.Results:The observation group showed significantly improved nursing quality scores(P<0.05)and markedly reduced incidence of adverse events(P<0.05),with statistically significant differences compared to pre-treatment conditions(P<0.05).Conclusion:The combination of hierarchical management and programmed harmonious nursing demonstrates effectiveness in enhancing medical service quality,reducing adverse reactions,and improving patient satisfaction—a method worthy of promotion.展开更多
Dear,Journal of Integrative Nursing(JIN,p-ISSN 2666-9854,e-ISSN 2663-4481),founded in March 2019,is an international peer reviewed,open-access,quarterly academic journal.JIN is co-sponsored by Association of Integrati...Dear,Journal of Integrative Nursing(JIN,p-ISSN 2666-9854,e-ISSN 2663-4481),founded in March 2019,is an international peer reviewed,open-access,quarterly academic journal.JIN is co-sponsored by Association of Integrative Nursing and Beijing Office of Traditional Chinese Medicine Nursing Competence Improvement Project,and published by Wolters Kluwer Medknow Publications.展开更多
Dear,Journal of Integrative Nursing(JIN,p-ISSN 2666-9854,e-ISSN 2663-4481),founded in March 2019,is an international peer reviewed,open-access,quarterly academic journal.JIN is co-sponsored by Association of Integrati...Dear,Journal of Integrative Nursing(JIN,p-ISSN 2666-9854,e-ISSN 2663-4481),founded in March 2019,is an international peer reviewed,open-access,quarterly academic journal.JIN is co-sponsored by Association of Integrative Nursing and Beijing Office of Traditional Chinese Medicine Nursing Competence Improvement Project,and published by Wolters Kluwer Medknow Publications.展开更多
Dear,Journal of Integrative Nursing(JIN,p-ISSN 2666-9854,e-ISSN 2663-4481),founded in March 2019,is an international peer reviewed,open-access,quarterly academic journal.JIN is co-sponsored by Association of Integrati...Dear,Journal of Integrative Nursing(JIN,p-ISSN 2666-9854,e-ISSN 2663-4481),founded in March 2019,is an international peer reviewed,open-access,quarterly academic journal.JIN is co-sponsored by Association of Integrative Nursing and Beijing Office of Traditional Chinese Medicine Nursing Competence Improvement Project,and published by Wolters Kluwer Medknow Publications.展开更多
The application of visual-language large models in the field of medical health has gradually become a research focus.The models combine the capability for image understanding and natural language processing,and can si...The application of visual-language large models in the field of medical health has gradually become a research focus.The models combine the capability for image understanding and natural language processing,and can simultaneously process multi-modality data such as medical images and medical reports.These models can not only recognize images,but also understand the semantic relationship between images and texts,effectively realize the integration of medical information,and provide strong support for clinical decision-making and disease diagnosis.The visual-language large model has good performance for specific medical tasks,and also shows strong potential and high intelligence in the general task models.This paper provides a comprehensive review of the visual-language large model in the field of medical health.Specifically,this paper first introduces the basic theoretical basis and technical principles.Then,this paper introduces the specific application scenarios in the field of medical health,including modality fusion,semi-supervised learning,weakly supervised learning,unsupervised learning,cross-domain model and general models.Finally,the challenges including insufficient data,interpretability,and practical deployment are discussed.According to the existing challenges,four potential future development directions are given.展开更多
In the era of AI,especially large models,the importance of open source has become increasingly prominent.First,open source allows innovation to avoid starting from scratch.Through iterative innovation,it promotes tech...In the era of AI,especially large models,the importance of open source has become increasingly prominent.First,open source allows innovation to avoid starting from scratch.Through iterative innovation,it promotes technical exchanges and learning globally.Second,resources required for large model R&D are difficult for a single institution to obtain.The evaluation of general large models also requires the participation of experts from various industries.Third,without open source collaboration,it is difficult to form a unified upper-layer software ecosystem.Therefore,open source has become an important cooperation mechanism to promote the development of AI and large models.There are two cases to illustrate how open source and international standards interact with each other.展开更多
Lung cancer has one of the highest rates of incidence and mortality worldwide,mak-ing research on its mechanisms and treatments crucial.Animal models are essential in lung cancer research as they accurately replicate ...Lung cancer has one of the highest rates of incidence and mortality worldwide,mak-ing research on its mechanisms and treatments crucial.Animal models are essential in lung cancer research as they accurately replicate the biological characteristics and treatment outcomes seen in human diseases.Currently,various lung cancer models have been established,including chemical induction models,orthotopic transplan-tation models,ectopic transplantation models,metastasis models,and gene editing mouse models.Additionally,lung cancer grafts can be categorized into two types:tissue-based and cell-based grafts.This paper summarizes the phenotypes,advan-tages,and disadvantages of various induction methods based on their modeling tech-niques.The goal is to enhance the simulation of clinical lung cancer characteristics and to establish a solid foundation for future clinical research.展开更多
基金supported by the Young and Middle-aged Research Fund Project of Shenzhen People's Hospital(Grant No.SYHL2024-N0010)the Shenzhen Basic Research Program(General Program,Grant No.JCYJ20240813104409013)。
文摘Objective:This study aimed to develop a Nursing Retrieval-Augmented Generation(NurRAG)system based on large language models(LLMs)and to evaluate its accuracy and clinical applicability in nursing question answering.Methods:A multidisciplinary team consisting of nursing experts,artificial intelligence researchers,and information engineers collaboratively designed the NurRAG framework following the principles of retrieval-augmented generation.The system included four functional modules:1)construction of a nursing knowledge base through document normalization,embedding,and vector indexing;2)nursing question filtering using a supervised classifier;3)semantic retrieval and re-ranking for evidence selection;and 4)evidence-conditioned language model generation to produce citation-based nursing answers.The system was securely deployed on hospital intranet servers using Docker containers.Performance evaluation was conducted with 1,000 expert-verified nursing question–answer pairs.Semantic fidelity was assessed using Recall Oriented Understudy for Gisting Evaluation–Longest Common Subsequence(ROUGE-L),and clinical correctness was measured using Accuracy.Results:The NurRAG system achieved significant improvements in both semantic fidelity and answer accuracy compared with conventional large language models.For ChatGLM2-6B,ROUGE-L increased from(30.73±1.48)%to(64.27±0.27)%,and accuracy increased from(49.08±0.92)%to(75.83±0.35)%.For LLaMA2-7B,ROUGE-L increased from(28.76±0.89)%to(60.33±0.21)%,and accuracy increased from(43.27±0.83)%to(73.29±0.33)%.All differences were statistically significant(P<0.001).A quantitative case analysis further demonstrated that NurRAG effectively reduced hallucinated outputs and generated evidence-based,guideline-concordant nursing responses.Conclusion:The NurRAG system integrates domain-specific retrieval with LLMs generation to provide accurate,reliable,and traceable evidence-based nursing answers.The findings demonstrate the system’s feasibility and potential to improve the accuracy of clinical knowledge access,support evidence-based nursing decision-making,and promote the safe application of artificial intelligence in nursing practice.
文摘With the accelerating pace of population aging in China,various issues related to elderly care have emerged one after another,becoming a severe social problem.Especially against the backdrop of increasing economic pressure,the traditional family-based elderly care model is facing significant challenges and can hardly meet the elderly care needs.At present,the geriatric nursing models are relatively backward,which directly affects the quality of daily life,physical health and mental well-being of the elderly.Therefore,it is necessary to explore an appropriate geriatric nursing model to address the aging problem.Based on this,this paper analyzes and studies the current situation of geriatric nursing models under the background of healthy aging,providing references for relevant research and practice.
文摘Objective: To explore the application effect of optimizing the nursing model in community health centers for elderly health examinations, providing a reference for enhancing the management level of elderly health at the grassroots level. Methods: A total of 300 elderly individuals who underwent health examinations at our center from January 2024 to December 2024 were selected as the study subjects. They were randomly divided into a control group and an observation group, with 150 cases in each group. The control group underwent the conventional health examination nursing process, while the observation group adopted an optimized community nursing model, which included stratified education and appointment scheduling before the examination, full-time accompaniment and safety care during the examination, and the establishment of electronic medical records and continuous follow-up after the examination. Differences in health management awareness rates and satisfaction with health examination services between the two groups of elderly individuals were compared. Results: The health management awareness rate in the observation group was 94.67%, significantly higher than that in the control group (78.00%;p < 0.001). The satisfaction rate with health examination services in the observation group was 96.00%, also significantly higher than that in the control group (82.00%;p < 0.001). Conclusion: The optimized community nursing model can effectively enhance the health awareness level and service satisfaction of elderly individuals during health examinations, demonstrating strong practicality and promotion value. It contributes to achieving continuity and precision in grassroots elderly health management.
基金supported by a scientific research project of the Hubei Province Health and Family Planning Commission,China(No.WJ2017M100)
文摘Nursing models at home and abroad for breast cancer patients during the perioperative period were screened, including eight types of models： the nursing model guided by self-care theory, the plan-do-check-act cycle combined with the four-in-one model, the peer support nursing model, the nursing model guided by transcultural theory, the multidisciplinary cooperative nursing model, the knowledge-attitude-practice nursing model, the safe nursing management model, and the case nursing model. These models were analyzed and described with the aim of providing a reference for the clinical breast surgery nursing staff in China and for promoting the development of nursing in China for breast cancer the perioperative period.
基金supported by Shanxi Provincial Health Department(No.201201031)
文摘Objectives＂ To deepen our understanding of the status quo and to identify the hot topics and develop- mental trends of research on nursing models in countries other than China in the most recent decade. Methods： The study subjects were the publications retrieved from the PubMed database using the MeSH terms of ＂Models, Nursing＂. Bibliographic item co-occurrence mining system （BICOMS） software was used for conventional bibliometric analysis of publications during two time periods, 2005-2009 and 2010-2014. The number of published journal articles, journal distribution, authors of publications, country of origin of journals, and language of publications were analyzed to establish a high-frequency keyword profile and co-occurrence matrix. Graphical clustering toolkit （gCLUTO） software was applied for two-way clustering analysis and visualized analysis. Results： A total of 1472 journal articles with a key theme of nursing models were retrieved for final analysis, including 771 published during 2005-2009 and 701 during 2010-2014. The bibliometric analysis revealed that publications other than China concerning nursing models were mostly concentrated in the United States and the United Kingdom and that the number of relevant publications has been continuously decreasing. The two-way clustering analysis showed that there were mainly four types of research themes in the relevant publications in countries other than China during 2005-2009, i.e., nursing education and theoretical research, clinical nursing and psychological care, nursing administration, and models of nursing education, whereas there were five types during 2010-2014, i.e., nursing theories and clinical nursing practice, nursing administration models and assessments of nurses＇ knowledge and skills, community nursing administration models, nursing human resource management, and nursing education models and approaches. Conclusions： Research on nursing models in countries other than China is relatively mature and stable with a broader view, but it has shown a declining trend in recent years. It emphasizes both theory and practice, with research content tending to be structured into four modules, i.e., nursing education, administration, clinical practice, and theoretical research. Community nursing models may become a key research direction in the international research on nursing models in the future.
文摘Objective: To explore the effectiveness of applying patient simulators combined with Internet Plus scenario simulation teaching models on intravenous (IV) infusion nursing education, and to provide scientific evidence for the implementation of advanced teaching models in future nursing education. Methods: Enrolled 60 nurses who took the IV infusion therapy training program in our hospital from January 2022 to December 2023 for research. 30 nurses who were trained in traditional teaching models from January to December 2022 were selected as the control group, and 30 nurses who were trained with simulation-based teaching models with methods including simulated patients, internet, online meetings which can be replayed and scenario simulation, etc. from January to December 2023 were selected as the experimental group. Evaluated the learning outcomes based on the Competency Inventory for Nursing Students (CINS), Problem-Solving Inventory (PSI), comprehensive learning ability, scientific research ability, and proficiency in the theoretical knowledge and practical skills of IV infusion therapy. Nursing quality, the incidence of IV infusion therapy complications and nurse satisfaction with different teaching models were also measured. Results: The scientific research ability, PSI scores, CINS scores, and comprehensive learning ability of the experimental group were better than those of the control group (P 0.05), and their assessment results of practical skills, nursing quality of IV infusion therapy during training, and satisfaction with teaching models were all better than those of the control group with statistical significance (P < 0.05). The incidence of IV infusion therapy complications in the experimental group was lower than that in the control group, indicating statistical significance (P < 0.05). Conclusions: Teaching models based on patient simulators combined with Internet Plus scenario simulation enable nursing students to learn more directly and practice at any time and in any place, and can improve their proficiency in IV infusion theoretical knowledge and skills (e.g. PICC catheterization), core competencies, problem-solving ability, comprehensive learning ability, scientific research ability and the ability to deal with complicated cases. Also, it helps provide high-quality nursing education, improve the nursing quality of IV therapy, reduce the incidence of related complications, and ensure the safety of patients with IV therapy.
基金the receipt of financial support for this research from an internal granting institution.
文摘Purpose:This pilot study aimed to assess the reliability and validity of a modified Dundee Ready Educational Environment Measure(m-DREEM)tool used to evaluate the effects of different pedagogical approaches in a clinical learning environment on nursing students'learning perceptions.Methods:A sample consisting of 130 nursing students in two different models of clinical education was surveyed.Results:This pilot study demonstrated that m-DREEM yields a high internal consistency.This tool can be used to evaluate nursing students'perceptions of their clinical learning environment on the basis of five sub-scales:students'learning perceptions,facilitators,academic self-perception,atmosphere,social self-perception,and mentorship.Conclusion:A definitive and inferential relationship between sub-scales and clinical models,namely,block and non-block dispersed models,could not be determined because of the small sample size of the block clinical model.Hence,further research should be performed.
文摘Purpose:To analyze the role of the seminar teaching method+case-based learning(CBL)teaching method+problem-based learning(PBL)teaching method in oral clinical nursing teaching.Methods:13 undergraduate nursing students who entered the department from September 2020 to September 2021 were selected as the control group,adopting conventional nursing teaching methods;13 undergraduate nursing students who entered the department from September 2021 to August 2022 were selected as the observation group,adopting the seminar+CBL+PBL teaching method.The teaching effects were compared between the two groups.Results:All assessment scores of the observation group were higher than those of the control group;all teaching satisfaction levels were higher than those of the control group(P<0.05).Conclusion:Adopting the seminar+CBL+PBL teaching method during oral clinical nursing teaching can improve nursing students’assessment scores,strengthen their core competencies,and enhance teaching satisfaction.
文摘Recently,inflammatory cytokine profiles have been linked to suicide risk in adolescents with non-suicidal self-injury,highlighting a promising biological dimension of suicide risk assessment.Clinical translation of the cytokine profiles into practice will require frontline engagement of the workforce.Mental health nurses are frequently the most accessible professionals in schools,communities,and low-resource settings and are prime candidates to bridge this gap.By integrating psychosocial evaluation with emerging biomarker data,they can deliver systematic risk assessment,continuous monitoring,and timely intervention.This role would not replace psychiatric expertise;it would extend the reach of psychiatric services,embedding suicide prevention across the continuum of care.For health systems,nurse-led integration may enhance capacity,equity,and resilience in responding to adolescent suicide risk.This editorial demonstrates that empowering nurses to operationalize biomarker-informed strategies is needed for advancing effective and sustainable suicide prevention in this vulnerable population.
基金Supported by 2025 Henan Medical Education Research Project,No.WJLX2025038.
文摘BACKGROUND Gastrointestinal(GI)tumors are among the most prevalent malignancies,and surgical intervention remains a primary treatment modality.However,the complexity of GI surgery often leads to prolonged recovery and high postoperative complication rates,which threaten patient safety and functional outcomes.Enhanced recovery after surgery(ERAS)principles have been shown to improve perioperative outcomes through evidence-based,multidisciplinary care pathways.Despite its widespread adoption,there is a paucity of research focusing specifically on optimizing ERAS-guided nursing processes in the post-anesthesia care unit(PACU)and evaluating its impact on perioperative safety in patients undergoing GI tumor surgery.This study aimed to investigate whether an ERASbased PACU nursing protocol could enhance recovery,reduce complications,and improve patient safety in this surgical population.AIM To explore the impact of optimizing the recovery room nursing process based on ERAS on the perioperative safety of patients with GI tumors.METHODS A total of 260 patients with GI tumors who underwent elective surgeries under general anesthesia in our hospital from August 2023 to August 2025 and were then observed in the recovery unit(PACU)were selected.They were randomly divided into the observation group(the PACU nursing process was optimized based on ERAS)and the control group(the conventional PACU nursing process was adopted)by the random number grouping method,with 130 cases in each group.The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,time of leaving the room after tube removal,retention time in the recovery room,occurrence of complications,satisfaction and readmission rate were compared between the two groups after entering the room.Compare the occurrence of adverse events in the PACU nursing process between the two groups.RESULTS The time of gastric tube removal,urinary catheter removal,defecation time,hospital stay,retention time in the recovery room,total incidence of complications and readmission rate in the observation group were significantly lower than those in the control group,and the satisfaction rate was higher than that in the control group(P<0.05).The occurrence of adverse events in the PACU nursing process in the observation group was lower than that in the control group(P<0.05).CONCLUSION Optimizing the PACU nursing process based on ERAS can effectively accelerate the recovery process of patients undergoing GI tumor surgery,reduce adverse events,improve nursing satisfaction,and at the same time,lower the incidence of adverse events in the PACU nursing process,providing a more refined management basis for clinical practice.
基金Supported by the Open Project Program of Panxi Crops Research and Utilization Key Laboratory of Sichuan Province,No.SZKF202302the Fundamental Research Funds for the Central Universities No.2019CDYGYB024.
文摘Gastrointestinal(GI)cancers represent a major global health concern due to their high incidence and mortality rates.Foundation models(FMs),also referred to as large models,represent a novel class of artificial intelligence technologies that have demonstrated considerable potential in addressing these challenges.These models encompass large language models(LLMs),vision FMs(VFMs),and multimodal LLMs(MLLMs),all of which utilize transformer architectures and self-supervised pre-training on extensive unlabeled datasets to achieve robust cross-domain generalization.This review delineates the principal applications of these models:LLMs facilitate the structuring of clinical narratives,extraction of insights from medical records,and enhancement of physician-patient communication;VFMs are employed in the analysis of endoscopic,radiological,and pathological images for lesion detection and staging;MLLMs integrate heterogeneous data modalities,including imaging,textual information,and genomic data,to support diagnostic processes,treatment prediction,and prognostic evaluation.Despite these promising developments,several challenges remain,such as the need for data standardization,limited diversity within training datasets,substantial computational resource requirements,and ethical-legal concerns.In conclusion,FMs exhibit significant potential to advance research and clinical management of GI cancers.Future research efforts should prioritize the refinement of these models,promote international collaborations,and adopt interdisciplinary approaches.Such a comprehensive strategy is essential to fully harness the capabilities of FMs,driving substantial progress in the fight against GI malignancies.
文摘Myasthenia gravis is a chronic autoimmune disorder that affects the neuromuscular junction leading to fluctuating skeletal muscle fatigability. The majority of myasthenia gravis patients have detectable antibodies in their serum, targeting acetylcholine receptor, muscle-specific kinase, or related proteins. Current treatment for myasthenia gravis involves symptomatic therapy, immunosuppressive drugs such as corticosteroids, azathioprine, and mycophenolate mofetil, and thymectomy, which is primarily indicated in patients with thymoma or thymic hyperplasia. However, this condition continues to pose significant challenges including an unpredictable and variable disease progression, differing response to individual therapies, and substantial longterm side effects associated with standard treatments(including an increased risk of infections, osteoporosis, and diabetes), underscoring the necessity for a more personalized approach to treatment. Furthermore, about fifteen percent of patients, called “refractory myasthenia gravis patients”, do not respond adequately to standard therapies. In this context, the introduction of molecular therapies has marked a significant advance in myasthenia gravis management. Advances in understanding myasthenia gravis pathogenesis, especially the role of pathogenic antibodies, have driven the development of these biological drugs, which offer more selective, rapid, and safer alternatives to traditional immunosuppressants. This review aims to provide a comprehensive overview of emerging therapeutic strategies targeting specific immune pathways in myasthenia gravis, with a particular focus on preclinical evidence, therapeutic rationale, and clinical translation of B-cell depletion therapies, neonatal Fc receptor inhibitors, and complement inhibitors.
基金supported by the Undergraduate Teaching Innovation Project of Guangxi Higher Education(grant number:2023JGB307,Department of Education of Guangxi Zhuang Autonomous Region,China)the Guangxi Autonomous Regionlevel Research and Practice Project on New Engineering,New Medicine,New Agriculture and New Liberal Arts"Research on the Reform of the Integration of Undergraduate Courses in Nursing Major under the Background of Grand Health"(grant number:XYK202414).
文摘Objective:This study aimed to explore the effect of standardized patient(SP)-narrative nursing in the experimental teaching of surgical nursing.Methods:A quasi-experimental study design was adopted.A total of 200 undergraduate nursing students were recruited from the Nursing College of Guilin Medical University in China from March 2023 to December 2024.The intervention group recruited students from the Class of 2022(n=100),and the control group recruited students from the Class of 2021(n=100).The intervention group adopted a teaching model combining standardized patients with narrative nursing based on traditional scenariobased simulation teaching,which was applied to the nursing of perioperative patients(4 class hours)and scenario-based case drills(4 class hours)in the experimental teaching of surgical nursing.The control group used traditional scenario-based simulation teaching.The Nurse Humanistic Care Quality Evaluation Scale,Clinical Thinking Ability Evaluation Index System Scale for Medical Students,and Nurse-Patient Communication Ability Evaluation Scale for Nursing Students were used to investigate and compare the teaching effects between the two groups of students.Results:The total scores of the intervention group on humanistic care(91.39±3.97),clinical thinking(79.64±6.33),and nurse-patient communication(157.22±7.95)abilities were significantly higher than those of the control group(82.29±3.62,65.11±7.24,and 147.05±7.84,respectively),with statistically significant differences(P<0.01).Conclusion:This study confirms that integrating the dual teaching model of standardized patients and narrative nursing in experimental teaching of surgical nursing has significantly optimized the theoretical and practical structure of teaching strategies.This innovative teaching method provides a promotable paradigm for nursing humanities education and is of positive significance for improving the effectiveness of cultivating the core literacy of nursing talents.
文摘Objective:To investigate the impact of programmed harmonious nursing combined with hierarchical management on nursing quality and satisfaction in a health management center.Methods:A total of 100 patients who received care at this health management center from January 2024 to January 2025 were selected as subjects.Using a random number table method,they were divided into an observation group(n=50)and a control group(n=50).The control group followed traditional methods,while the observation group integrated programmed harmonious nursing with hierarchical management.Comparative analysis was conducted on nursing quality scores,adverse event occurrence rates,and patient satisfaction between the two groups.Results:The observation group showed significantly improved nursing quality scores(P<0.05)and markedly reduced incidence of adverse events(P<0.05),with statistically significant differences compared to pre-treatment conditions(P<0.05).Conclusion:The combination of hierarchical management and programmed harmonious nursing demonstrates effectiveness in enhancing medical service quality,reducing adverse reactions,and improving patient satisfaction—a method worthy of promotion.
文摘Dear,Journal of Integrative Nursing(JIN,p-ISSN 2666-9854,e-ISSN 2663-4481),founded in March 2019,is an international peer reviewed,open-access,quarterly academic journal.JIN is co-sponsored by Association of Integrative Nursing and Beijing Office of Traditional Chinese Medicine Nursing Competence Improvement Project,and published by Wolters Kluwer Medknow Publications.
文摘Dear,Journal of Integrative Nursing(JIN,p-ISSN 2666-9854,e-ISSN 2663-4481),founded in March 2019,is an international peer reviewed,open-access,quarterly academic journal.JIN is co-sponsored by Association of Integrative Nursing and Beijing Office of Traditional Chinese Medicine Nursing Competence Improvement Project,and published by Wolters Kluwer Medknow Publications.
文摘Dear,Journal of Integrative Nursing(JIN,p-ISSN 2666-9854,e-ISSN 2663-4481),founded in March 2019,is an international peer reviewed,open-access,quarterly academic journal.JIN is co-sponsored by Association of Integrative Nursing and Beijing Office of Traditional Chinese Medicine Nursing Competence Improvement Project,and published by Wolters Kluwer Medknow Publications.
基金The Natural Science Foundation of Hebei Province(F2024501044).
文摘The application of visual-language large models in the field of medical health has gradually become a research focus.The models combine the capability for image understanding and natural language processing,and can simultaneously process multi-modality data such as medical images and medical reports.These models can not only recognize images,but also understand the semantic relationship between images and texts,effectively realize the integration of medical information,and provide strong support for clinical decision-making and disease diagnosis.The visual-language large model has good performance for specific medical tasks,and also shows strong potential and high intelligence in the general task models.This paper provides a comprehensive review of the visual-language large model in the field of medical health.Specifically,this paper first introduces the basic theoretical basis and technical principles.Then,this paper introduces the specific application scenarios in the field of medical health,including modality fusion,semi-supervised learning,weakly supervised learning,unsupervised learning,cross-domain model and general models.Finally,the challenges including insufficient data,interpretability,and practical deployment are discussed.According to the existing challenges,four potential future development directions are given.
文摘In the era of AI,especially large models,the importance of open source has become increasingly prominent.First,open source allows innovation to avoid starting from scratch.Through iterative innovation,it promotes technical exchanges and learning globally.Second,resources required for large model R&D are difficult for a single institution to obtain.The evaluation of general large models also requires the participation of experts from various industries.Third,without open source collaboration,it is difficult to form a unified upper-layer software ecosystem.Therefore,open source has become an important cooperation mechanism to promote the development of AI and large models.There are two cases to illustrate how open source and international standards interact with each other.
基金Sichuan Provincial Administration of Traditional Chinese Medicine,Grant/Award Number:2023MS564National Natural Science Foundation of China,Grant/Award Number:82474436。
文摘Lung cancer has one of the highest rates of incidence and mortality worldwide,mak-ing research on its mechanisms and treatments crucial.Animal models are essential in lung cancer research as they accurately replicate the biological characteristics and treatment outcomes seen in human diseases.Currently,various lung cancer models have been established,including chemical induction models,orthotopic transplan-tation models,ectopic transplantation models,metastasis models,and gene editing mouse models.Additionally,lung cancer grafts can be categorized into two types:tissue-based and cell-based grafts.This paper summarizes the phenotypes,advan-tages,and disadvantages of various induction methods based on their modeling tech-niques.The goal is to enhance the simulation of clinical lung cancer characteristics and to establish a solid foundation for future clinical research.
