The burden of atrial fibrillation (AF) in China is increasing, and catheter ablation has become a first-line treatment. The perioperative symptom clusters of AF patients undergoing catheter ablation are complex and diverse, closely related to patients´ quality of life, disease prognosis, and healthcare resource utilization, and therefore, warrant significant attention. This paper systematically reviews the research related to the perioperative symptom clusters of AF patients undergoing catheter ablation. It introduces the types and current status of these symptom clusters, summarizes the influencing factors of perioperative symptom clusters, organizes the assessment tools for AF symptom clusters, and finally elucidates the management strategies for perioperative symptom clusters in AF patients. The goal is to provide insights for developing innovative comprehensive management models for perioperative symptom clusters in AF patients.

Background Under the background of new medical science, the deep integration of information technology and medical education is encouraged to train first-class medical talents to serve the construction of healthy China.Currently, empathy training in doctor-patient communication mainly consists of simulated communication and group discussion, with less reliance on artificial intelligence technology for learning. Objective To develop a system for teaching and evaluating doctor-patient communication empathy language. This system will be used in course teaching to pave the way for future doctor-patient communication empathy teaching methods. Carry out teaching applications to enhance the communication and empathy language expression skills of medical students and doctors, and gather feedback to optimize and improve the system. Methods Between September 2021 and February 2022, the research group focus on utilizing iFlytek speech recognition technology and the empathy semantic recognition algorithm. A system called the "Doctor-patient Communication Virtual Simulation Teaching and Evaluation System of empathic language" was developed using 10 typical cases of doctor-patient communication, demonstrations of empathic language, a semantic database of empathic language, empathic language skills, and an overall scoring standard.A total of 950 students from Nanjing Medical University, including 515 undergraduates, 102 medical doctoral students, and 333 clinicians participating in doctor-patient communication courses or training, were selected as the research subjects from March to May 2022. Based on this system, the Doctor-patient Communication Skills Course (2 class hours) teaching experiment was conducted at Nanjing Medical University. A self-designed questionnaire was used to gather information on the subjects' understanding of empathetic language connotations, their improved empathetic language skills, their perception of system ease of use, and their perception of how the system integrates into the rationality of teaching. NVivo software was used to analyze the subjects' feedback, comments, and suggestions. Results Following the implementation of the system, there were statistically significant differences in the mastery of empathic language connotation, the degree of enhancement of empathic language ability, the degree of convenience of the system, and the degree of integration of the system into teaching rationality among undergraduate students, clinicians, and medical doctoral students (P<0.05). 76.1% (723/950) of the participants evaluated that they had "fully mastered" or "highly mastered" the connotation of empathic language. 93.8% (891/950) of the study subjects indicated that the system could "significantly enhance" or "somewhat enhance" the empathic language ability, and 89.5% (850/950) of the study subjects rated the convenience of the system as "very convenient" or "relatively convenient". 95.1% (903/950) of the study subjects rated the degree of cognition of the rationality of integrating the system into teaching as "very reasonable" or "relatively reasonable". The top five words mentioned in the feedback and suggestions are communication, pronunciation, teaching, program, and standard. Conclusion This system can help improve medical student and doctors'ability to empathize in doctor-patient communication by learning from individual cases and applying those lessons more broadly. Additionally, the use of an autonomous teaching evaluation system frees up the constraints of time and space in teacher-student interactions. The system's standardized teaching method has received positive and rational feedback from participants, indicating its potential for a wide range of applications. However, the system is still in the early stages of exploration and requires further refinement.

The health and nutrition survey databases of China, the United States, and Korea are all focused on national health and nutrition surveillance, which have become important public resources for data mining in recent years. The construction status, brief histories, sampling methods, and survey contents of the three health and nutrition survey databases were compared and analyzed, it was found that the main difference lies in the types of study design, with cohort study used in China, cross-sectional survey used in both the United States and Korea. Then, the database-based publication volume and research hotspots were visually analyzed and found that the upward trend is more prominent in the United States, the research hotspots of the three databases were consistent with the themes of the health and nutrition survey. Finally, the construction and application of the databases were discussed and recommendations were made, which was expected to provide a path for relevant researches and better encourage the generation of scientific evidence.

Background Although type 2 diabetes mellitus (T2DM) cannot be completely cured, however, there is a consensus that timely community management of T2DM patients following guidelines can lead to good glycemic control. However, blood glucose of the patients is chronically suboptimal due to T2DM-related clinical inertia. It is crucial for improving the effectiveness of diabetes control to determine the current status and influencing factors of clinical inertia in T2DM patients in community, but there is limited literature on this topic. Objective To investigate current status and influencing factors of clinical inertia during health management in T2DM patients in community. Methods From January to December 2020, T2DM patients receiving health management services from the national basic public health services in Qingjiangpu and Huaian Districts, Huaian City, Jiangsu Province, were recruited using cluster random sampling method to perform face-to-face questionnaire survey, physical examination, and laboratory tests. Clinical inertia was defined as the absence of intensification in antidiabetic treatment for patients with inadequate HbA1c control (HbA1c≥7.0%) in the past three months. Stepwise multiple Logistic regression analysis was performed to identify influencing factors of the detection of clinical inertia in T2DM patients in community. Results A total of 3 346 T2DM patients with inadequate glycemic control (HbA1c≥7.0%) were included in the study, with the overall detection rate of clinical inertia in T2DM patients of 93.96% (3 144/3 346), 94.84% (1 139/1 201) in men and 93.47% (2 005/2 145) in women, respectively. There were significant differences in the detection rate of clinical inertia among T2DM patients with different levels of dietary control, physical activity, blood glucose monitoring periods, diabetic complications, dyslipidemia (history), and history of coronary heart disease, stroke, and cancer. Stepwise multiple Logistic regression analysis showed that dietary control〔OR (95%CI) =0.585 (0.382, 0.894) 〕, glucose monitoring period≤1 week〔OR (95%CI) =0.470 (0.344, 0.644) 〕, presence of diabetic complications〔OR (95%CI) =0.606 (0.423, 0.868) 〕, dyslipidemia (history) 〔OR (95%CI) =0.725 (0.532, 0.988) 〕, history of coronary artery disease〔OR (95%CI) =0.659 (0.458, 0.949) 〕, and stroke〔OR (95%CI) =0.699 (0.511, 0.955) 〕were associated with a lower prevalence of clinical inertia in T2DM patients (P<0.05) . Conclusion There is a serious problem of clinical inertia in T2DM patients undergoing health management in community, the prevalence of clinical inertia is closely related to patients' dietary control, glucose monitoring period, presence of diabetic complications, and comorbid diseases (history) .

Background One key to the development of the tiered diagnosis and treatment system lies in the establishment of a gatekeeping system in primary care supporting the implementation of first contact in primary care and the achievement of orderly healthcare-seeking. And the serving capacities of primary care professionals are essential in implementing first contact in primary care. Objective To understand the overall level of Henan primary care physicians' capabilities of diagnosing and treating common diseases, and to put recommendations for solving the problems. Methods In August 2020, by use of typical sampling method, physicians were selected from all primary care hospitals in four areas of Henan Province (Kaifeng's Xiangfu District and Lankao County, and Jiaozuo's Weidu District and Yanling County) . An online self-administered questionnaire survey was conducted with them for collecting information about their demographics, and capabilities of diagnosing and treating common diseases (involving the identification and diagnosis of common diseases, interpretation of relevant auxiliary examinations, and prescription of common medications) . Results In all, 1 844 cases attended the survey, and 1 669 of them (90.51%) who effectively responded to the survey were included for final analysis. Among the 1 669 respondents, 917 (54.94%) had secondary health school education level or below, 663 (39.72%) had no professional title, 524 (31.40%) had a rural doctor certificate, and 509 (30.50%) had a practicing certificate. Among the 1 117 village doctors, 722 (64.64%) were 45 years old and above, 83 (7.43%) were 60 years old and above, and 848 (75.92%) had secondary health school education level or below. Among 1 631 respondents, 1 564 (95.89%) were basically able to diagnose and identify common diseases, 1 402 (86.00%) could interpret the results of common auxiliary examinations, 1 542 (94.54%) could prescribe common medications, and 1 336 (81.91%) had capabilities to diagnose and treat common diseases. Compared with urban primary care physicians, rural primary care physicians had higher level of capabilities in identifying and diagnosing common diseases as well as prescribing common medications, but lower level of capabilities in interpreting biochemical tests and electrocardiogram results (P<0.05) . Conclusion In general, the overall level of professional qualities was unsatisfactory in Henan primary care physicians, especially in those working in rural areas. Their level of capabilities for diagnosing and treating common diseases was generally satisfactory, although there is still much room for improvement. A sound cooperative mechanism between primary care hospitals and higher level hospitals should be established to ensure the safety in primary care.