Objective To investigate the relationship between dyslipidemia and distant metastases in pa-tients with hormone receptor( HR) negative breast cancer,and to explore the impact of blood lipid change during chemotherapy on clinical response.Methods We collected the complete clinicopathological data and fasting blood lipid in 154 patients with HR negative breast cancer.The secondary blood lipid level were measured on day14 after two cycles of chemotherapy in patients with distant metastases.Single factor chi -square test was choosen to analyze the relationship between clinicopathological characteristics,including baseline lipid level,and distant metastases,then independent risk factor for distant metastases were evaluated by logistic regression model. Data about altered blood lipid and clinical response analysis were performed using paired t-test pre-or post-chemotherapy.Results Our results from single chi-square test showed that distant metastasis from breast canc-er was significantly associated with tumor size,local lymph node metastases,grade,higher total cholesterol( TC) , higher triglycerides(TG)and higher low-density lipoprotein(LDL)(P<0.05).For distant metastases,inde-pendent risk factors were tumor size(OR=1.563),local lymph node metastases(OR=1.983),higher TC(OR=1.502),higher TG(OR=1.877).Decreased trend of TC,TG and LDL and increased trend of HDL were showed in disease control( PR+SD) group,and TG had significantly tend in objective response( PR) group.Conclusion Hyperlipidmia is significantly associated with distant metastases in patients with HR negative breast cancer,andblood lipid levels decrease with effective anti -tumor chemotherapy.Dynamic monitoring of blood lipid levelscould be a candidate surrogate biomarker for outcome prediction and distant metastases in patients with HR negativebreast cancer.

This paper interprets the background, content overview and characteristics, clinical practice significance and disciplinary development of Nursing Standards for Clinical Operation Techniques in Critical Care Ultrasound (hereinafter referred to as the Standards) and puts forward reflections on the clinical application of the Standards, aiming to improve the critical care ultrasound techniques of clinical nursing staff, solve nursing challenges and make clinical nursing ultrasound techniques more scientific, standardized and homogenized.

Objective:To comprehensively search and summarize the evidence on critical ultrasound nursing practice training courses, with the aim of providing a basis for critical ultrasound nursing practice training.Methods:Taking the evidence-based clinical translation model of Fudan University Centre for Evidence-based Nursing as the theoretical framework, the evidence was retrieved, evaluated, and summarized to determine the evidence to be introduced into clinical practice, forming a training program for critical ultrasound nursing practice. From July to August 2023, 25 experts from 10 provinces/municipalities across the country were selected for two rounds of consultation to determine the practical training course system for critical ultrasound nursing.Results:A total of 14 articles were included, including one clinical decision, nine expert consensus, and four systematic reviews. In the two rounds of consultation, the positive coefficients of experts were 90.0% (27/30) and 92.6% (25/27), the authority coefficients of experts were 0.956 and 0.964, and the coefficients of Kendall's harmony were 0.303 and 0.350 ( P<0.01), respectively. The final practical training course system for critical ultrasound nursing included five first-level indicators, 25 second-level indicators, and 67 third-level indicators. Conclusions:Ultrasound examination is a complex skill. The construction method of the practical training course system for critical ultrasound nursing is scientific, reasonable, with strong practicality in content, which can provide reference for the development and evaluation of critical ultrasound nursing training courses.

Objective To investigate short-term clinical efficacy of autologous leukocyte-poor platelet-rich plasma(LP-PRP)treatment of knee osteoarthritis(KO A).Methods 85 cases of patients with Keligren Lawrence grade Ⅰ-Ⅲ knee os-teoarthritis in Peking University First Hospital Taiyuan Hospital(Taiyuan Central Hospital)from 2022 to 2023 were collect-ed for autologous LP-PRP collection and quality assessment using a blood component separator,and all patients were treated with autologous LP-PRP.The degree and function of knee pain were assessed by visual analog scale(VAS)and knee arthri-tis index scale(WOMAC)at 1,3 and 6 months after injection.Knee MRI was performed after 6 months of treatment,and the MRI imaging changes before and after treatment were compared.Different influencing factors in the treatment results were grouped and analyzed,mainly including platelet concentration in LP-PRP and K-L grading of knee joint.According to the platelet concentration in LP-PRP,it was divided into three grades,which are low concentration[(＜800)×109/L],medium concentration[(800-1 000)×109/L],and high concentration[(＞1 000)× 109/L];According to the K-L grade of the knee joint,the severity of knee osteoarthritis was divided into three grades:Ⅰ、Ⅱ、Ⅲ.Results The VAS and WOMAC scores at 1,3 and 6 months after LP-PRP treatment were significantly lower than those before treatment,and the difference was sta-tistically significant(P＜0.05).There was a statistically significant difference in the therapeutic effect of different levels of platelet concentration,and when the platelet concentration was more than 1 000×109/L,the significant effect was the most obvious(P＜0.05).The therapeutic effect of different levels of platelet concentration was statistically significant(P＜0.05).MRI showed that the articular cartilage signal was significantly improved after treatment.Conclusion Autologous LP-PRP injection into knee cavity for the treatment of KO A has a good short-term clinical effect in relieving knee pain.

Objective To investigate the status on accuracy of estimation in applying Richmond Agitation-Sedation Scale (RASS) by nurses of Intensive Care Unit (ICU) for sedation of critically ill patients and to explore its influencing factors. Methods From November 2016 to January 2017, we selected 206 ICU patients and 38 ICU nurses of a ClassⅢ Grade A hospital in Beijing by convenience sampling. Research group and ICU nurses respectively assessed patients' agitation-sedation state with the RASS and analyzed its differences as well as influencing factors. Results There were 143 patients assessed by ICU nurses with the RASS in accordance with that in research group with 69.4% for the accuracy rate. Logistic regression analysis showed that the influencing factors of accuracy of estimation in RASS included sedative, score of Glasgow and delirium (OR=0.065, 1.424, 0.201;P＜0.05). Conclusions The accuracy of estimation in applying RASS by ICU nurses is at a middle level. We should pay attention to patients with sedative, delirium and the low score of Glasgow during applying RASS for critically ill patients.