Objective To investigate the role of autophagy in contrast-induced acute kidney injury(CI-AKI)in rats and to explore its possible mechanism.Methods SD rats were randomly divided into control group,acute kid-ney injury model group(intravenous injection of contrast medium ioversol via tail vein;model),rapamycin(RAPA)group and hydroxychloroquine(HCQ)group.Blood urea nitrogen(BUN)and serum creatinine(Scr)con-tents were measured and the potential change foun in renal pathology was detected by HE staining and microscopy.Transmission electron microscopy was used to observe auto-phagy-related changes in ultrastructure.Western blot was used to observe the expression of microtubule-associated protein 1 light chain 3(LC3)Ⅱ/LC3Ⅰ,ubiquitin-binding protein p62 and Histone deacetylase 4(HDAC4).The expression of HDAC4 was also observed by RT-qPCR.Results Compared with control group,the level of BUN,Scr and HDAC4 expression in the model and HCQ group was increased(P＜0.01),the proximal tubules of the kidney were significantly damaged.In the model group,auto-phagososomes and autolysosomes increased,accompanied by an increase of LC3Ⅱ/LC3Ⅰ and a decrease in the p62 level(P＜0.05,P＜0.01);Compared with model group,there were more autophagosomes and autolysosomes were found in RAPA group(P＜0.01),accompanied by increased LC3Ⅱ/LC3Ⅰratio and decrease in the p62 and HDAC4(P＜0.05,P＜0.01).In contrast,the number of autophagy related structures decreased in HCQ group(P＜0.01),accompanied by the simultaneous increase of LC3Ⅱ/LC3Ⅰ,p62 and the increase of HDAC4(P＜0.01).Conclusions Ioversol may induce autophagy activation,while enhancing autophagy by RAPA alleviates CI-AKI induced renal dysfunction.The mechanism is potentially atributed to the regulation of HDAC4.

The current situation of the construction and application of orthopaedic subspecialty nursing quality standards at home and abroad is reviewed, and the overview of orthopaedic subspecialty nursing quality standards, theoretical foundations, the content of the standard construction, the form and results of the application, and the shortcomings and outlooks are elaborated and illustrated, with a view to providing theoretical references for the further improvement and application of China′s orthopaedic subspecialty nursing quality standard system, and providing scientific suggestions and reflections for the promotion of the high-quality development of orthopaedic subspecialty nursing.

Objective:To deeply explore the experience and feelings of postpartum weight management in primiparas, so as to provide reference for optimizing postpartum management strategies.Methods:This study was qualitative. From May to June 2023, purposive sampling was used to select 15 primiparas who underwent postpartum follow-up at the Affiliated Suzhou Hospital of Nanjing Medical University as the research subject for semi-structured interviews. The Colaizzi 7-step analysis method was used to analyze data and extract themes.Results:The lived experience of postpartum weight management in primiparas was extracted into three themes and 11 sub-themes, including cognitive differences in postpartum weight management (awareness of importance and adoption of positive behaviors, neglect and avoidance), facilitators and obstacles in weight management (facilitators included self-expectations, positive evaluations and feedback from others, beneficial experiences, while obstacles included eating and exercise behavior disorders, physical symptom interference, role conflicts, negative emotions), and a desire to receive support from multiple aspects (continuous information support from medical institutions, support and acceptance from families and society) .Conclusions:Primiparas have a relatively insufficient cognition of postpartum weight management, and the weight management process is influenced by many factors. Medical and nursing staff should adopt effective strategies to correct cognitive biases in maternal weight management, make full use of facilitators, actively respond to obstacles, and pay attention to multiple sources of support, so as to promote postpartum recovery.

Objective:To construct a thirst management scheme for adult surgical patients and provide practical guidance for nurses to carry out perioperative thirst management.Methods:From April to May 2023, literature search was conducted to extract domestic and foreign evidence related to thirst, and after group discussion, a preliminary management plan for thirst in adult surgical patients was constructed. From May to June 2023, 18 experts were selected for two rounds of Delphi expert letter consultation, and a formal plan for thirst management of adult surgical patients was discussed and revised according to expert opinions.Results:A total of 18 experts completed two rounds of expert letter consultation. The effective recovery rate of the questionnaire was 100.00% and the expert authority coefficient was 0.915. The coefficients of variation for the importance and operability scores of the first round of expert inquiry were 0.05-0.25 and 0.06-0.42, respectively, and the Kendall's harmony coefficients were 0.224 and 0.184 ( P<0.01). The coefficients of variation for the importance and operability scores of the second round of inquiry were 0.05-0.23 and 0.06-0.24, respectively, and the Kendall's harmony coefficients were 0.166 and 0.154 ( P<0.01). The final thirst management scheme included five primary items (preliminary preparation, identification and evaluation, preoperative relief strategies, postoperative intervention measures and effectiveness evaluation) and 23 secondary items. Conclusions:The thirst management scheme for adult surgical patients constructed in this study is scientific and comprehensive, which can provide a reference basis for clinical practice.

Objective:To explore the changing trajectory of psychological distress in young and middle-aged patients during peridialysis period.Methods:Totally 122 patients in the peridialysis period were investigated with the Self-Designed General Data Questionnaire,Distress Screening Scale(DSS),Connor-Davidson Resilience Scale(CD-RISC),Social Support Revalued Scale(SSRS)and Self-Perceived Burden Scale(SPBS)at the time of diag-nosis,initial dialysis,and dialysis for 1 month,2 months and 3 months,respectively.The growth mix model was used to identify trajectory categories.Results:The time main effect of scores of DSS,CD-RISC and SPBS in peridi-alysis patients was statistically significant(Ps＜0.05),the scores of DSS and SPBS were the highest at the initial dialysis and the lowest at 3 months of dialysis.The CD-RISC scores were the lowest at the first dialysis and the highest at 3 months of dialysis.The trajectory of psychological distress was divided into 3 types,namely continuous high level(26.20％),high level decline(40.72％),and medium-low level decline(33.08％).Conclusion:The psychological distress of young and middle-aged peridialysis patients shows different trajectories from diagnosis to regular dialysis.Clinical staff should pay more attention to the psychological status of the first-time dialysis pa-tients.

Objective To discuss the current status of the discharge readiness in patients with Budd-Chiari syndrome undergoing interventional therapy,and to analyze its influencing factors.Methods A cross-sectional survey in 150 patients with Budd-Chiari syndrome,who were admitted to the Department of Interventional Radiology of a certain grade Ⅲ-A hospital in Xuzhou City of China between September 2022 and September 2023,was conducted.The revised Discharge Preparation Scale,the Discharge Guidance Quality Scale,and the self-designed general data collection form were used as the study tools.Results The results of the survey showed that the mean discharge readiness score in the 150 patients with Budd-Chiari syndrome undergoing interventional therapy was(102.59±7.88)points,and the quality of discharge guidance,education level,and per capita monthly household income,and the current disease status were the key factors affecting the patient's readiness for discharge(P＜0.001).Conclusion The overall level of readiness for discharge in patients with Budd-Chiari syndrome undergoing interventional therapy is high,but nurses should make key assessment of the current disease status,the discharge intentions and concerns of patients with low-education level and low-income,based on which give targeted health guidance so as to improve patient's readiness for discharge.(J Intervent Radiol,2024,33:674-678)

Objective To screen and verify the genes that play key role in the occurrence and development of esophageal cancer by u-sing bioinformatics and real-time fluorescence quantitative PCR(qRT-PCR)methods to find new markers for diagnosis of esophageal cancer(ESCA).Methods Using the TCGA database and Wayne plot analysis,the cross genes between the differentially expressed genes of ESCA and the genes which have the most significant impacts on disease-free survival(DFS)rate in esophageal cancer patients were preliminarily identified.Following conducting protein-protein interaction(PPI)network analysis on the overlapping genes,GO and KEGG functional analysis was performed to screen the potential key genes as the diagnostic markers of esophageal cancer.qRT-PCR was used to quantitatively analyze the expression of mRNA of the key gene in peripheral blood.Statistical analysis was con-ducted based on the clinico-pathological characteristics of the patients to determine its potential value as a new diagnostic marker for e-sophageal cancer.Results After overlapping of differentially expressed genes of ESCA and disease-free survival genes in the TCGA database,39 upregulated genes and 20 downregulated genes were found to be differentially expressed,all of which affected disease-free survival rate.After conducting PPI network analysis,15 upregulated genes with core interactions were identified,and the downregulat-ed genes did not form any interaction network.Further enrichment analysis of these 15 core interacting genes through GO and KEGG,revealed that fibronectin 1(FN1)may be a potential biomarker for ESCA diagnosis.The qRT-PCR results showed that compared with the healthy control group,the mRNA expression level of FN1 in the peripheral blood of esophageal cancer patients was significantly ele-vated.After analyzing the clinical characteristics of patients,it was found that the patients with poor differentiation and high clinico-pathological staging had significantly increased peripheral blood FN1 mRNA levels.The model with FN1 mRNA expression levels can distinguish esophageal cancer patients from healthy individuals.Conclusion FN1 mRNA may be a potential non-invasive diagnostic biomarker for esophageal cancer.

Qualitative content analysis is one of the commonly used data analysis methods in qualitative research,and it is increasingly widely used in the nursing field.This article briefly introduces the origin and development process of qualitative content analysis and the definition and background of 3 common types of content analysis.It also describes the analysis steps of the 3 common content analysis in detail by combining the latest research at home and abroad.In addition,it discusses the joint use of multiple content analysis methods.The goal of this article is to improve the understanding of qualitative content analysis among nursing staff and effectively promote the scientific,and standardized application of this method in the nursing field.

Objective To investigate the current postoperative physical activity levels of lung cancer patients after a month and to analyze the influencing factors.Methods From January to December 2023,a total of 1,195 lung cancer patients from 16 hospitals in eastem,central and westem China were selected as the survey subjects by the convenient sampling method.A cross-sectional survey was conducted by General Information Questionnaires,Health-Related Physical Fitness Surveys,MD Anderson Symptom Inventory,Hospital Anxiety and Depression Scale,Social Support Rating Scale,Self-Rated Abilities for Health Practices Scale,and the International Physical Activity Questionnaire.Results 36 questionnaires with missing data exceeding 10％and 13 duplicate questionnaires were excluded,resulting in the analysis of 1,146 questionnaires.After a month postoperatively,lung cancer patients with moderate and low levels of physical activity were 732(63.9％)and 204(17.8％),respectively.Multivariate regression analysis showed that the influencing factors included residence,average monthly family income,regional lymph node staging,family history of lung cancer,grip strength,hemoglobin,and depression score(P＜0.05).Conclusion The physical activity level of lung cancer patients a month after surgery is influenced by a combination of sociodemographic,disease-related,health-related physical fitness,and psychological factors.Clinical healthcare professionals should accurately assess the physical activity levels of lung cancer patients,identify those with insufficient physical activity,and develop and implement personalized intervention strategies based on their physical condition and potential influencing factors to enhance their physical activity levels and improve their quality of life.

Objective To construct a perioperative exercise program for older frail patients with colorectal cancer,and to verify its effect.Methods Based on Goal-directed Theory and literature review,expert consultation was carried out to establish the perioperative exercise program for older frail patients with colorectal cancer.Then,from July to December 2022,the perioperative exercise program was established for older frail patients with colorectal cancer hospitalized in the General Surgery Department of a tertiary A hospital in Suzhou by convenience sampling method for preliminary application.It was divided in to the intervention group and the control group by the ward.The intervention group was applied with the constructed perioperative exercise program on the basis of routine perioperative nursing.The safety,feasibility and intervention effect of the program were evaluated.Results 15 experts were included for 2 rounds of expert consultations.The authority coefficient was 0.880;the coefficient of variation was＜0.250;the Kendall concordance coefficient was 0.167 and 0.224,respectively.The final program contained 4 stages:preoperative exercise,postoperative bed rest,sitting and standing exercise.In the end,54 specific interventions were constructed.During the preliminary application,all the patients completed the program.Generalized estimation equation showed that,on the interaction effect,there was no statistical difference(P=0.752);there were significant differences on the intervention effect and the time effect(P＜0.05).At discharge,there were significant differences in timed up and go test and Barthel Index between the 2 groups(P＜0.05).Only 2 patients experienced mild pain in the intervention group,and no other adverse events occurred.Conclusion The perioperative exercise program for older frail patients with colorectal cancer,based on Goal-directed Theory,is scientific,reliable and safe.It has been preliminarily verified in improving postoperative physical function,activities of daily living and early postoperative recovery of elderly frail patients with colorectal cancer.