To estimate tuberculosis (TB) incidence trends in the high-altitude Xizang, China, and to explore the key intervention strategies on achieving the WHO 2030 TB control target.

We developed a susceptible–exposed–infectious–recovered transmission model using routinely reported TB surveillance data from 2004 to 2022. Scenario-based simulations were conducted to project future TB incidence under alternative intervention strategies. Model assumptions are as follows: (1) a stable population, (2) lifelong vaccine-induced immunity, (3) infectiousness of active TB cases, (4) relapse risk after recovery and (5) homogeneous mixing within the population.

Seven prefectures of Xizang Autonomous Region on the Tibetan Plateau, China.

An estimated population of approximately 3 million individuals residing in Xizang.

We assessed the epidemiological impact of four interventions implemented independently: increasing vaccine efficacy rate, reducing transmission rates of susceptible individuals, decreasing progression rate from latent TB infection to active disease and reducing relapse rate among successfully treated patients, compared with continuation of current control measures.

The estimated basic reproduction number (R₀ ) for TB in Xizang was 0.39 (95% CI 0.21 to 0.71) in the absence of additional interventions, which was the highest among all regions of China. Model simulations indicated that all four evaluated interventions were each likely to reduce TB incidence, but only reducing the latent-to-active TB progression had a substantial effect. A 50% reduction in the progression rate was predicted to lower TB incidence from 66.56 (62.00–70.11) to 40.54 (37.15–43.77) cases per 100 000 population, meeting the WHO 2030 TB control target.

Targeted management of individuals with latent TB infection should be strengthened to substantially reduce TB transmission in high-altitude areas.

Hand dysfunction following stroke, especially during the flaccid paralysis phase, significantly impairs patients’ motor abilities and daily functioning. Electroacupuncture (EA) is widely used in post-stroke rehabilitation; however, inconsistent clinical outcomes and lack of standardised treatment parameters have limited its broader adoption.

This protocol describes a randomised controlled trial designed to determine optimal EA parameters for post-stroke hand dysfunction using an orthogonal experimental design.

This protocol presents a single-centre, randomised controlled trial design with 10 arms. A total of 110 patients with post-stroke hand dysfunction will be randomly assigned to nine electroacupuncture groups or one sham acupuncture group in equal proportions. Participants will receive 12 treatment sessions over 2 weeks. The EA groups are designed based on a four-factor, three-level orthogonal design to systematically evaluate the main effects of acupoint selection, stimulation frequency, needle thickness and treatment duration. The primary outcome is the effective response rate, defined as reduction in the Chinese Stroke Scale (CSS) score at 2 weeks. Secondary outcomes include assessments with the Modified Lindmark Rating Scale, range of motion measures, Modified Barthel Index and hand motor subscores of the CSS. As this is a trial protocol, results are not yet available. Statistical analyses will be conducted after completion of recruitment and follow-up according to the prespecified analysis plan. Safety and adverse events will be monitored throughout the study.

This trial is designed to address the current lack of evidence-based standardisation of EA parameters for post-stroke hand dysfunction. By systematically evaluating key treatment components using an orthogonal experimental design, the study aims to identify optimal EA strategies and provide a methodological framework to improve consistency, reproducibility and clinical effectiveness in post-stroke hand rehabilitation.

This manuscript describes a study protocol and does not report any data from participants at this stage. Ethical approval for the planned trial was obtained from the Medical Ethics Committee of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine (Approval No. TYLL2024(K)072). Written informed consent will be obtained from all participants prior to enrolment. The results of the study will be disseminated through peer-reviewed journals and academic conferences.

ITMCTR2024000819.

Mentoring has been identified as a promising strategy for implementing and sustaining evidence-based practice (EBP) in healthcare organisation. However, no appropriate tools were specifically developed or cross-culturally adapted into Chinese context to assess nurse’s perceived EBP mentoring, impeding comprehensive evaluation of the effects of mentoring intervention studies. This study aimed to cross-cultural adapt the Evidence-Based Practice Mentoring (EBPM) scale into Mainland China and evaluate its psychometric properties, including validity and reliability.

A comprehensive translation and adaptation process was adopted to achieve the Chinese version of the EBPM (C-EBPM) scale. It consists of four steps: (1) trilateral translation procedure, (2) cognitive interview, (3) psychometric testing and (4) cross-time confirmatory factor analysis (CFA).

This study was conducted in four 3A-level hospitals located in Shaanxi and Zhejiang provinces, China, during two different data collection periods.

A total of 598 registered nurses participated in this study.

After two rounds of the trilateral translation procedure, a 9-item version of the C-EBPM scale was generated. Ten registered nurses participated in cognitive interview understood the meaning of all items but the response options. All items had significant critical ratio values (t=15.866~20.584, p²/df=65.681/27 0.950, Tucker-Lewis Index=0.966 > 0.950, and standardised root mean square residual=0.026 0.70) and average variance extracted was 0.60 (>0.50).

The 9-item C-EBPM scale demonstrated robust reliability and validity and is suitable for assessing EBP mentoring among nurses.

Ultrasound guidance improves the success rate and efficiency of radial arterial catheterisation (RAC). However, the procedure remains more challenging in obese patients, in whom excess subcutaneous tissue can impair anatomical visualisation. Additionally, frequent head shifts between the procedural site and ultrasound screen usually increase procedural complexity, prolong the procedural time and adversely affect both patient comfort and clinician performance. Smart glasses that project real-time ultrasound images directly into the clinician’s field of view offer a potential solution. The study aimed to evaluate whether the use of smart glasses improves the efficiency of ultrasound-guided RAC in obese patients.

In this prospective, single-centre, randomised controlled trial, a total of 176 eligible obese patients (body mass index ≥30 kg/m²) requiring RAC for perioperative monitoring will be enrolled. Participants will be randomly assigned in a 1:1 ratio to either the control group, receiving conventional ultrasound-guided RAC, or the smart-glasses group, undergoing ultrasound-guided RAC with real-time image display and needle-tracking assistance via smart glasses. The primary outcome is the first-attempt success rate. Secondary outcomes include the second-attempt success rate, time to successful catheterisation within the first and second attempts, overall procedural time, overall number of arterial catheterisation attempts; ultrasound scanning time, number of probe repositionings and needle redirections; incidence of RAC-related complications, and satisfaction scores of both patients and clinicians. Statistical analyses will be performed using Statistical Package for the Social Sciences (SPSS) and GraphPad Prism.

This study will be conducted in accordance with the principles of the Declaration of Helsinki. Written informed consent will be obtained from all participants before enrolment. The study protocol has been reviewed and approved by the Medical Research Ethics Committee of the Second Affiliated Hospital of Anhui Medical University. This study has been prospectively registered at Chinese Clinical Trial Registry. Study results will be disseminated through presentations at scientific conferences and publication in peer-reviewed scientific journals.

ChiCTR2500108023.

Postoperative ileus (POI) is a common complication after colorectal surgery, characterised by impaired gastrointestinal motility leading to abdominal distension, delayed flatus and defecation, nausea and vomiting. Self-abdominal massage (SM) can promote bowel peristalsis, but its clinical efficacy on improving colorectal cancer patients with POI treated with an intestinal decompression tube remains to be further verified. Therefore, this study aims to evaluate the efficacy and safety of SM in improving gastrointestinal function in colorectal cancer patients with POI treated with an intestinal decompression tube.

This is a prospective, single-centre, randomised controlled, assessor-blinded and statistician-blinded trial. A total of 102 colorectal cancer patients with POI undergoing intestinal decompression tube placement will be recruited. Participants will be randomised in a 1:1:1 ratio to receive basic treatment (BT), BT plus SM (BT-SM) or BT plus simple physical stimulation (BT-SPS). The primary outcome is the time to first defecation after intestinal decompression tube placement. Secondary outcomes include time to first flatus, radiological evaluation, time to tolerability of semiliquid and solid foods, severity of nausea, vomiting, pain and abdominal distension, analgesic consumption, time to intestinal decompression tube removal, incidence of complications and adverse events after intestinal decompression tube placement. Outcome measures are collected at baseline, at 1, 2, 3 and 4 days after the end of the intervention. The primary time point will be 4 days postintervention.

This study has been approved by the ethical application of the Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine Ethics Committee (2025-K-49-01). All patients will be required to provide informed consent. Study results will be disseminated through publication in peer-reviewed journals and international conferences.

ITMCTR2025001401.

Patient self-testing (PST) for warfarin management is well-established in developed countries but remains underused in developing regions. This study compared the safety and effectiveness of PST with usual care (UC) in China.

A multicentre, open-label, randomised, controlled trial.

A total of five centres participated in this study, including one provincial tertiary hospital, two municipal tertiary hospitals and two primary hospitals.

Patients undergoing mechanical heart valve (MHV) replacement at five centres were prospectively enrolled. Patients were trained and stratified according to time on warfarin at enrolment and were randomly assigned to the PST or UC group.

The PST group used a point-of-care testing device for at-home international normalised ratio (INR) monitoring with pharmacist-guided warfarin dosing, while the UC group attended outpatient clinics for INR monitoring and dosing.

The primary outcome was the difference in time in therapeutic range (TTR). The secondary outcomes were incidences of major bleeding, thromboembolism and all-cause deaths in 12 months.

From March 2021 to March 2023, a total of 556 patients were enrolled, with a mean age of 47.5 years, 45.1% being male. 342 were newly initiating warfarin therapy, while 214 had been on warfarin for over 6 months. Baseline characteristics were similar between the PST and UC groups. The PST group showed significantly higher TTR (67.2% vs 55.1%, p

A pharmacist-led PST intervention with ongoing education and counselling led to improved TTR and clinical outcomes in patients with MHV in China.

China Clinical Trial Registry (ChiCTR2000038984).

Administering supplemental oxygen to prevent hypoxaemia is a fundamental treatment for patients hospitalised with acute injury or illness. However, the amount of oxygen administered frequently exceeds that needed to maintain normoxaemia, causing patients to experience hyperoxaemia and wasting supplemental oxygen. Closed-loop, autonomous oxygen titration systems are designed to optimise oxygen delivery by administering the lowest possible oxygen flow that maintains peripheral oxygen saturation (SpO₂) within a predefined range. For adults hospitalised with an acute injury or illness, it remains uncertain whether the use of a closed-loop, autonomous oxygen titration system safely increases the proportion of time spent in normoxaemia (SpO₂ 90%–96%) compared with usual care.

The Strategy to Avoid Excessive Oxygen using Autonomous Oxygen Titration Intervention trial is a multicentre, unblinded, parallel-group, randomised trial being conducted at four level 1 trauma centres in the USA. The trial compares an autonomous oxygen titration system versus usual care among 300 adults hospitalised for major trauma, burn, acute care surgery or acute respiratory illness. The primary outcome is the proportion of patient-time spent within the targeted normoxaemia range (SpO₂ 90%–96%) as measured by continuous non-invasive pulse oximetry, during the first 72 hours after randomisation. Secondary outcomes include the amount of supplemental oxygen administered and the proportion of time spent in hypoxaemia (SpO₂2 >96%). Specifying the protocol and statistical analysis plan before the conclusion of enrolment increases the rigour, reproducibility and interpretability of the trial. Enrolment began on 6 May 2024.

The trial protocol was approved by the single institutional review board at the University of Colorado School of Medicine and the Office of Human Research Oversight at the Department of Defense. We will present the results at scientific conferences and submit them for publication in a peer-reviewed journal.

NCT06374225.

To explore how young and middle-aged Chinese women with breast cancer perceive and emotionally respond to changes in their physical appearance and function during treatment and social interactions.

A descriptive phenomenological qualitative study using Colaizzi’s seven-step analysis method.

Breast surgery departments of two tertiary hospitals in North and Central China.

This study included a purposive sample of 18 young and middle-aged women (18–59 years old) with pathologically confirmed breast cancer who had received a mastectomy and obtained a score ≥10 on the Body Image Scale.

In-depth, semi-structured face-to-face interviews were conducted from January to October 2024 to collect data. The data were analysed using Colaizzi’s phenomenological analysis method to identify and interpret the main themes representing participants’ lived experiences.

Four main themes and 11 sub-themes were identified. Theme 1, ‘Perceived social group pressure’, included family burdens, peer influence and public scrutiny. Theme 2, ‘Emotional reactions to social pressure’, covered strong desire to survive, ambivalence towards visits and existential confusion. Theme 3, ‘Perception of physical changes’, involved feelings of physical weakness, hair loss and body shame, weight and self-image bias. In Theme 4, ‘Coping and Meaning Reconstruction’, there were social withdrawal and the experience of positive psychological growth after encountering adversity.

The research describes the psychological and social pressures breast cancer patients and survivors experience during treatment and gives recommendations to garner understanding and support for this patient group concerning body image disturbance.

Not applicable.

To characterise the risk of subsequent primary non-keratinocyte skin cancers (NKSCs) among adult-onset cancer survivors.

Data analysis of this population-based cohort study was conducted from September to November 2024.

The data are based on 17 Surveillance, Epidemiology and End Results (SEER) registries from 2000 to 2021.

Survivors of first primary cancers diagnosed in individuals aged 20–84 years between 2000 and 2021, across 17 registries in the SEER Program

Primary outcomes were a statistically significant increase in the incidence of subsequent NKSCs. Standardised incidence rate (SIR) and excess risk analysis were used to evaluate the risk of subsequent NKSCs after different primary cancers.

Among 5 691 336 survivors (51.3% male), 31 529 subsequent NKSCs were observed during a total follow-up of 36 440 569 person-years (mean, 6.4 years). The risk of subsequent NKSCs was increased after the first primary cancer (SIR, 1.12 (95% CI 1.10 to 1.13)). Across 35 first primary cancers, 19 showed a statistically significant rise in subsequent NKSC incidence. The highest SIR for subsequent NKSCs was observed after eye and orbit cancer (SIR, 2.96 (95% CI 2.55 to 3.41)), followed by cutaneous melanoma (SIR, 2.67 (95% CI 2.41 to 2.94)) and chronic lymphocytic leukaemia (SIR, 2.24 (95% CI 2.10 to 2.38)). Across NKSC types, cancer survivors were more likely to develop subsequent hemangiosarcoma (SIR, 2.66 (95% CI 2.31 to 3.05)), adenocarcinoma, not otherwise specified (SIR, 2.14 (95% CI 1.53 to 2.91)) and sebaceous adenocarcinoma (SIR, 1.70 (95% CI 1.57 to 1.83)). 10 specific first primary cancers demonstrated a consistently high risk of several specific NKSCs throughout the study period. Furthermore, the risk of subsequent NKSCs among cancer survivors was largely elevated following radiotherapy or chemotherapy (range, 13%–18%), especially for hemangiosarcoma.

Several types of primary cancers were strongly linked to an increased risk of subsequent NKSCs, underscoring the critical importance of implementing continuous surveillance and proactive prevention strategies to mitigate the risk of developing subsequent primary NKSCs among cancer survivors.

Tourette syndrome is a common, disabling childhood-onset condition. Exposure and response prevention (ERP) is an effective treatment for tics, yet access remains limited due to a shortage of trained therapists and uneven geographical distribution of services. The ORBIT trial demonstrated that internet-delivered ERP is both clinically and cost-effective, but was developed on a university research platform, not suitable for widescale roll-out. To enable adoption by the National Health Service (NHS) in England, ORBIT has been redeveloped on an NHS compliant platform. This study will evaluate the usability, acceptability and preliminary outcomes of ORBIT on the new platform within an NHS tic disorder service.

This single-cohort usability study will recruit 20 children and young people (aged 9–17) with tics and their chosen supporters (parents/carers). Participants will receive a 10-week online ERP intervention supported by trained coaches. Outcomes include uptake, adherence, system usability, satisfaction and clinical measures such as the Yale Global Tic Severity Scale, Parent Tic Questionnaire and Goal-Based Outcomes. Qualitative feedback will be collected via semi-structured exit interviews. Usability metrics and adverse events will be monitored throughout.

The study has received ethical approval from North West Greater Manchester Research Ethics Committee (ref: 25/NW/0107). The findings from the study will inform future NHS adoption. The results will be submitted for publication in peer-reviewed journals.

ISRCTN82718960. Registered 10 July 2025. https://doi.org/10.1186/ISRCTN82718960

Maternal thyroid function affects fetal birth weight and age is an important factor in regulating thyroid function. Thus, we aimed to explore the association between age-specific preconception thyroid-stimulating hormone (TSH) and birth weight.

Cohort study.

A total of 97 755 preconception Chinese women aged 20–39 years old from the National Free Preconception Checkups Project were included.

Participants were divided into four age groups: 20–25 years, 25–29 years, 30–34 years and 35–39 years. The preconception TSH levels within 6 months before pregnancy and fetal birth weight, including large for gestational age (LGA), small for gestational age (SGA) and appropriate for gestational age (AGA), were collected and analysed using restricted cubic spline regression. Logistic regression investigated the relationship between various TSH groups and birth weight.

(1) Preconception TSH levels differed among four age groups; (2) in the 20-24 years group, preconception TSH was associated with the incidence of LGA and AGA (p2.12 mIU/L) TSH were associated with a higher risk of LGA and lower incidence of AGA in 20–24 years.

Preconception TSH exhibited a significant association with LGA and AGA in the 20–24 years age group, but not in the 25–39 years age group. Young preconception women should not neglect paying attention to their thyroid function, associated with the risk of LGA.