Objective:To analyze the characteristics of patients with chronic rhinosinusitis (CRS) in the South China region based on pathological tissue biomarkers for regional comparison.Methods:The study population consisted of CRS in-patients in the First Affiliated Hospital of Sun Yat-sen University from October 2019 to June 2022. Among all the 181 cases, 123 of them were male and 58 were female, with an average age of 40. Retrospectively collected clinical data included demographic information, preoperative symptom scores, preoperative endoscopic images, preoperative paranasal sinus computed tomography scanning images, and inflammatory serological features. In addition, 52 variables of pathological tissue biomarkers including cytokines, chemokines and remodeling factors were collected for analysis. Cluster analysis was performed on the integrated data of training set through centroid-based clustering algorithm, and the inflammatory characteristics, post-operation control status, and airway diseases comorbidity of each endotype were analyzed. R project (version 4.2.2) was used in statistical analysis.Results:Cluster analysis divided 181 patients with CRS into 4 endotypes. Cluster 1 ( n=101, 55.80%) showed a locally low inflammatory status. Cluster 2 ( n=23, 12.71%) showed a mixed type of inflammation with predominantly neutrophilic inflammation and tissue remodeling. Cluster 3 ( n=11, 6.08%) was characterized by type Ⅱ inflammation without tissue remodeling. Cluster 4 ( n=46, 25.41%) was mainly characterized by type Ⅱ inflammation with tissue remodeling, showing higher comorbidity rate of asthma and allergic rhinitis. This cluster presented more severe symptoms, significant olfactory dysfunction, extensive overall inflammation based on objective examination results, a notable increase in total eosinophil count and proportion in peripheral blood, and the highest uncontrolled rate observed one year post-surgery. In comparison to other regions, the endotype classification of CRS in Southern China was characterized by a predominant pattern of locally low inflammatory status, a moderate level of type Ⅱ inflammation with tissue remodeling, and a lesser presence of neutrophilic inflammation. Conclusion:CRS distribution in Southern China is mainly characterized by low inflammatory endotype and type Ⅱ inflammation with tissue remodeling. The latter shows more severe clinical manifestations and higher uncontrol rate after surgery.

The utilization of optimal orthodontic force is crucial to prevent undesirable side effects and ensure efficient tooth movement during orthodontic treatment.However,the sensitivity of existing detection techniques is not sufficient,and the criteria for evaluating optimal force have not been yet established.Here,by employing 3D finite element analysis methodology,we found that the apical distal region(A-D region)of mesial roots is particularly sensitive to orthodontic force in rats.Tartrate-resistant acidic phosphatase(TRAP)-positive osteoclasts began accumulating in the A-D region under the force of 40 grams(g),leading to alveolar bone resorption and tooth movement.When the force reached 80 g,TRAP-positive osteoclasts started appearing on the root surface in the A-D region.Additionally,micro-computed tomography revealed a significant root resorption at 80 g.Notably,the A-D region was identified as a major contributor to whole root resorption.It was determined that 40 g is the minimum effective force for tooth movement with minimal side effects according to the analysis of tooth movement,inclination,and hyalinization.These findings suggest that the A-D region with its changes on the root surface is an important consideration and sensitive indicator when evaluating orthodontic forces for a rat model.Collectively,our investigations into this region would aid in offering valuable implications for preventing and minimizing root resorption during patients'orthodontic treatment.

Objective:To explore the real experience of "shadow" nurses acting as family members of hospitalized patients and provide references for improving patients' medical experience.Methods:From October to November 2019, a total of 19 "shadow" nurses from the the Affiliated Hospital of Qingdao University were given semi-structured interviews with the guidance of service quality gap model using the purposive sampling method and qualitative research. The phenomenological analysis method and Nvivo 11.0 Chinese software were applied to assist the data analysis.Results:The real experience of "shadow" nurses acting as family members of inpatients can be summarized into five thematic groups. Firstly, there was a gap between patients' and nurses' cognition of nursing service. Second, some current system standards could not meet the needs of patients. Third, nursing services didn't fully implement the established rules and systems. Fourth, there was a difference between patient perception and nursing services. The fifth theme was feelings and reflections.Conclusions:The "shadow" nurse experience activity can explore the medical experience and needs of inpatients, analyze the problems in nursing services and improve the medical experience of patients and meet their needs in a targeted manner.

Objective:To explore the reasons for delayed medical seeking in patients with heart failure, and to provide new ideas for guiding patients with heart failure to seek medical treatment in time, increasing the scope of in-hospital and out-of-hospital nursing and optimizing the nursing mode.Methods:Using the purposive sampling method, patients with heart failure who had delayed medical seeking in Department of Cardiovascular Medicine in the Affiliated Hospital of Qingdao University were selected as the research objects from June to July 2020. Based on the theory of "health ecology model", 15 patients with heart failure were given semi-structured in-depth interviews. The descriptive phenomenological analysis method in qualitative research and Chinese version of Nvivo11.0 software were used to analyze and refine the interview data.Results:The delayed medical treatment time of 15 patients with heart failure was 7 to 44 days. The reasons for delayed medical seeking were summarized into 5 thematic groups, including insufficient symptom cognition, lack of disease management ability, cognition and experience of special population, insufficient family social support and medical delay.Conclusions:Medical staff should optimize the content and mode of health education for patients with heart failure, improve the self-management ability of patients with heart failure, timely identify special patients and give targeted intervention, and explore the way for patients with heart failure to obtain the support of high-quality medical resources outside the hospital so as to improve the occurrence of delayed medical treatment.

Objective:To form an evidence-based practice standard for early ambulation after radiofrequency catheter ablation via femoral artery (RFCA) , so as to improve the awareness of nurses' evidence and the rate of clinical practice standards, and reduce the incidence of patient complications.Methods:Totals of 2 evidence summaries, 4 systematic reviews and 2 guidelines were included through searching domestic and foreign databases. The innovation-Promoting Action on Research Implementation in Health Services (i-PARIHS) was used to analyze the obstacles to the application of evidence and formulate available solutions. From June 2019 to November 2020, convenience sampling was used to select 180 patients who underwent RFCA and 39 nurses in the Department of Cardiovascular of the Affiliated Hospital of Qingdao University for evidence-based.Results:A standardized procedure and evaluation record form for the guidance of ambulation after RFCA were formed, and the nursing norms after RFCA were updated. After 2 rounds of evidence application, the awareness and implementation rates of the nurses' review indicators increased, and the differences were statistically significant ( P<0.01) . After 2 rounds of evidence application, the patients' low back pain score and anxiety score were lower than those before the evidence application, and the differences were statistically significant ( P<0.01) . The incidence of dysuria and the vagus nerve firing in patients were lower than those before the evidence application, and the differences were statistically significant ( P<0.05) . Conclusions:The development of this evidence-based project promotes early postoperative ambulation of patients and reduces the incidence of complications.

Objective:To establish an evidence-based nursing practice standard for subcutaneous injection of low-molecular-weight heparin in inpatients so as to improve the evidence awareness of nurses and the standard rate of clinical practice and reduce the incidence of adverse reactions in patients.Methods:From June 2018 to June 2019, we analyzed the obstacle to evidence application and formulated available solutions according to the standard procedure of evidence-based continuous quality improvement and by combining promotion framework (i-PARIHS) . We selected 44 nurses and 80 patients of Department of Cardiovascular Medicine at a general Class Ⅲ Grade A hospital in Qingdao as the research object to carry out quality review and effect evaluation before evidence application, in the first round and the second round after evidence application.Results:In the second round of review after evidence application, the awareness and implementation rate were significantly improved, and the incidence of ecchymosis, induration, bleeding and the VAS score were significantly reduced with statistical differences ( P<0.05) . The department related work process was improved, and the evidence-based nursing practice standard for subcutaneous injection of low-molecular-weight heparin in inpatients was formed. Conclusions:The clinical development of the evidence-based project can standardize nurses' operation behavior of subcutaneous injection of low molecular weight heparin and reduce the incidence of adverse reactions in patients.

This article briefly overviews the basic knowledge, application status and importance of checklist and focused on the background, specific application status and existing problems of checklist in clinical nursing with an attempt to guide the application of checklist in nursing practice at the theoretical and practical levels.

Viral myocarditis (VMC) is a clinical frequent cardiovascular disease with extremely high mortality and disability rate ,which seriously impairs the health of children and young adults ,and its pathogenesis has not been fully elucidated .It is generally believed that VMC pathogenesis is mainly related to direct damage on myocardial cells ,immune damage ,cell apoptosis and cytokines .The present article made a summary about the research progress of its pathogenesis .

Interin-linked kinase (ILK)is a kind of effector of intra-and extracellular biological signal transduction,partici-pating in the formation of multiple signal pathways,it plays an important role for occurrence and development of heart dis-eases such as cardiac hypertrophy,coronary heart disease,viral myocarditis,dilated cardiomyopathy etc..

Objective To investigate the endoluminal ultrasonographie characteristics of adenoearcinoma and mucous adenocareinoma of the rectum. Methods The ultrasonographie characteristics of thirty eases of advanced adenoeareinoma of the rectum and twenty-eight eases of rectal mucous adenoearcinoma were analyzed retrospectively in comparison with their eorresponding pathologic images. Results In advanced adenocareinoma of the rectum, 28 eases manifested rough endoluminal surface, of which 19 marked by thickened changes without arrangement of layers, 10 had indistinct arrangement of layers in some areas and one had clear arrangement of layers. In the deepest margin of infiltration, 17 eases manifested sentus, homed or knot-like protuberance, while 5 marked by wavy margins, and 8 cases had clear and fiat margins. In 25 eases of rectal mucous adenocareinoma, 20 manifested smooth endoluminal surface. With regard to infiltration of tumors to rectal wall, 6 cases manifested clear arrangement of layers, while 13 had clear arrangement of layers in part and 6 had no clear arrangement. In the deepest part of infiltration, 8 eases manifested slippery and fiat margins and 10 manifested wavy margins and 7 had a few sentus, homed or knot-like protuberance locally. According to ultrasonic results of the depth of infiltration to rectal wall in comparison with pathologic findings, 25 eases were diagnosed accurately, while in two cases the diagnosis was too shallow and in three eases it was too deep. In rectal mucous adenocarcinoma, 10 cases got correct diagnosis and 14 were diagnosed superficially and one got too deep. The accuracy of ultrasonic diagnosis on rectal mueoas adenoearcinoma was apparently lower than that of adenoeareinoma and most of the misdiagnosis were too superfieiai. Conclusion There are different ultrasonographie characteristics of rectal adenoeareinoma and rectal mucous adenoeareinoma, which can be helpful for the typing of rectal carcinoma and avoiding excessively superficial misdiagnosis.