Objective: To establish a prenatal non-invasive method for combined detection of fetal ABO, RhD, and RhCE blood group genotypes based on fluorescence quantitative PCR (FQ-PCR) technology, and to evaluate its clinical value in the early prenatal diagnosis of hemolytic disease of the fetus and newborn (HDFN). Methods: A total of 200 high-risk singleton pregnant women who underwent prenatal examinations in our hospital from January 2022 to December 2024 were prospectively enrolled. They were divided into four groups: the ABO incompatibility group (n=100), the RhD incompatibility group (n=50), the RhCE incompatibility group (n=50), and the control group (n=200). FQ-PCR technology was used to detect cell-free fetal DNA (cff-DNA) in maternal plasma, targeting the ABO system (261delG, 796C>A), exons 5/7 of the RHD gene, and the key loci of RhCE system (C/c, E/e). After delivery, the blood group of newborn was verified by serological testing of umbilical cord blood., and the hemolysis panel tests (direct antiglobulin test, free antibody test, and antibody release test) were performed to evaluate the detection consistency and identify high-risk factors. Results: The detection coincidence rates for ABO, RhD, and RhCE blood groups were 98.0% (98/100), 100.0% (50/50), and 96.0% (48/50), respectively. The incidence of HDFN in the ABO incompatibility group was 69.0% (69/100), which is significantly higher than that in the RhD incompatibility group (10.0%, 5/50) and the RhCE incompatibility group (2.0%, 1/50). Multivariate analysis identified maternal blood type O (OR=3.021), maternal RhD-negative (OR=5.253), and maternal age ≥35 years (OR=1.950) as independent risk factors for HDFN (all P<0.05). Conclusion: Prenatal non-invasive combined detection of multiple blood group antigen genotypes can significantly improve the efficiency of early diagnosis of HDFN and provide accurate early warning for high-risk pregnant women.

Objective:To systematically synthesize qualitative research on the illness experience of patients with mild cognitive impairment (MCI) , so as to provide a basis for developing effective intervention plans and implementing extended care.Methods:Qualitative studies on the illness experience of MCI patients were searched in WanFang Data, China National Knowledge Infrastructure, VIP, China Biomedical Medicine Disc, PubMed, Embase, CINAHL, Web of Science, and Cochrane Library. The search period was from the establishment of the database to June 2023. The article quality was evaluated using the quality evaluation criteria for qualitative research of the Joanna Briggs Institute Evidence-Based Health Care Center. The aggregation integration method was used to synthesize the results.Results:A total of 14 articles were included, and 55 research results were extracted to form 11 categories, which were combined into four synthesized results. The synthesized results included patients experiencing multi-dimensional functional changes, current and future challenges, patients with low levels of disease cognition, and a desire to receive support from multiple aspects, and vastly different coping styles among patients.Conclusions:MCI patients face cognitive, physical, psychological, and social challenges. Families and hospitals should pay attention to the problems and needs of patients, provide them with continuous and dynamic emotional support and comprehensive intervention, and guide them to actively respond to the illness.

When this paper was first published, the authors’ affiliation

OBJECTIVE To improve the utilization rate of intravenous infusion in inpatients and enhance the level of rational drug use. METHODS PDCA cycle method was used to formulate and implement countermeasures from the aspects of institution， system， person and management. The utilization rate of intravenous infusion and the average daily number of bags （bottles） per bed for intravenous infusion were used as indicators to evaluate the implementation effect of PDCA. RESULTS The utilization rate of intravenous infusion decreased from （92.58±0.11）% 3 months before PDCA cycle to （89.72±0.62）% 3 months after PDCA cycle， and the average daily number of bags （bottles） per bed from intravenous infusion decreased from 5.20±0.09 to 4.64±0.24 （P＜ 0.05）. The utilization rate of intravenous infusion decreased from 92.55% 6 months before PDCA cycle to 89.98% 6 months after PDCA cycle （P＜0.05）； but average daily number of bags （bottles） per bed for intravenous infusion decreased from 5.36±0.26 6 months before PDCA cycle to 4.97±0.39 6 months after PDCA cycle， without statistical significance （P＞0.05）. CONCLUSIONS PDCA cycle method can effectively reduce the utilization rate and average daily number of bags （bottles） per bed for intravenous infusion in the inpatients and improve the level of rational drug use.

Objective:To understand the status quo and problems of clinical nursing fund paper publication in China from 2015 to 2018.Methods:The clinical nursing fund papers published in 12 core nursing journals and published by Chinese Authors in WOS database were analyzed by using bibliometrics methodology. Information analyzed including year distribution, number of authors, regional distribution, the number of institutions, research nature, research type, statistical application, specialty distribution and research content.Results:From 2015 to 2018, the proportion of clinical nursing fund papers was increasing, the proportion of funded papers in Chinese and WOS was 44.06% and 51.46% respectively, the main funding sources of each project came from provinces or direct-controlled municipalities level(42.02% in Chinese and 33.06% in WOS). Chinese fund papers were mainly co-authored by four people (20.18%) and mostly from the same institution (67.83%), the fund papers collected by WOS were mainly co-authored by six people (21.14%) and mainly produced by two institutions (40.65%). Clinical trials (26.64%) were the main research types of Chinese funded papers, and statistical inference (73.15%) was the main application of statistical methods. Jiangsu (14.58%) produced the most Chinese fund papers, and the first authors of the fund papers collected by WOS mostly came from Taiwan (43.90%); the main research topics were oncology nursing (16.65% in Chinese and 22.49% in WOS) and disease and symptom nursing (23.57% in Chinese and 23.04% in WOS).Conclusions:The number of papers on clinical nursing fund was increasing year by year, the application of statistics is basically stable, the sources of fund funding were increasingly diversified, and the trend of scientific research cooperation was increasing. Economically developed areas were the main force of scientific research output. The focus of clinical nursing research was oncology nursing and disease and symptom nursing.

Objective To explore the zero cited fund papers in clinical nursing in China,in order to provide evidence for improving the academic quality and cite rate of nursing papers.Methods Bibliometric statistical analysis was used to summarize zero cited papers published in 12 nursing core journals from 2012 to 2014.Indicators collected including the distribution of time,journals,funding number,funding sources,research methods,research design type,statistics method,number of cooperative people,nature of the authors' organizations,as well as the conditions of cited papers and the distribution of themes.Results The overall zero cited rate of clinical nursing zero cited fund papers was 74.64％.Affiliated hospital of colleges account for a large proportion of 42.53％,and the zero cited rate in the national disease research center and the affiliated hospital of army colleges was the highest (100.00％ and 80.52％).The oncology nursing,disease and symptoms care proportion was 13.94％ and 23.10％.The output of TCM care and rehabilitation care fund paper accounted only 3 and 8 respectively,and none was cited.The zero cited rates of social support,care coordination,treatment and care attitude and evidence-based research were 96.3％,94.12％,91.67％,90.32％.Strengthened their awareness of research applications,managers focused on research papers in the number of outputs at the same time and paid attention to the paper quality,and promoted scientific research into nursing,and promoted the development of nursing discipline.Conclusions The current paper-citing situation in clinical nursing was not optimistic,nursing research personnel should correct the attitude of scientific research,strengthen their own sense of scientific achievement applications.The management personnel should pay more attention to the paper quality,and promote nursing research outcome transformation,promote the development of nursing discipline.

Objective To explore the issues related to the standardized training of resident doctors at the primary hospital and provide basis for the standardization of doctors' training. Methods Questionnaires were used to investigate the resident titles, ages, and education background in the Huanxian People's Hospital. The self-assessment of the competency of resident doctors and professional contents necessary for their improvement were analyzed to identify the medical topics should be recommended to improve their clinical knowledge and techniques. Results Forty-six of 52 registered residents in the Huanxian People's Hospital participated in the survey with a participation rate of 88.5%. In this hospital, mainly the title of physicians was resident, accounting for 43.3% (52/120), the ages were chiefly in the range of 31 - 35 years, and their education levels were college degree 42.3% (22/52) and bachelor degree 48.1% (25/52). 76.1% (35/46) of the residents found they had difficulties in working and not competent enough on the present post, and 71.7% (33/46) of residents considered that they were in urgent need to strengthen their trainings of clinical thinking and clinical skills. Conclusions Strengthening the residents' self academic qualifications, improving the hospital teaching system, enhancing the teaching management, and focusing on clinical thinking and clinical skills training are the main issues in the current standardized training in primary hospitals. By accelerating the standardized training of residents, they may have the chance to transform to be the middle-level physicians and improve the unreasonable structure of doctor title distribution that will play the key role in the development of primary hospitals.

Objective To understand effects of the interventional operation on thyroid,peripheral blood indexes and chromosomal aberrations (CA) of peripheral lymphocyte of children with congenital heart disease (CHD).Methods Follow-up studies were conducted in 70 child patients undergoing cardiac catheterization and 23 with open heart surgery as control from 2010 to 2013.Postoperative follow-up examinations included thyroid ultrasound,blood routine indexes and analyses of CAs.Results Difference in thyroid ultrasound abnormality rate was not statistically significant between children with cardiac catheterization and control group (40.0％ vs.43.5％,P ＞ 0.05).There was no significant difference in white blood cell (WBC) count between interventional group and control group (P ＞ 0.05).The effects of disease type and operation time on thyroid ultrasound and WBC count were not observed (P ＞ 0.05).The frequency of chromosome aberrations,including acentric fragment,dicentrics and translocation in interventional group [(0.76 ± 0.07) ％],was higher than in control group [(0.25 ± 0.07) ％,(Z =-3.631,P ＜ 0.05],and the rates of acentric fragment and translocation were also higher in interventional group (Z =-2.531,-2.397,P ＜ 0.05).Conclusions Effect of intervention therapy on thyroid structure and WBC count in children with CHD was not observed,but the genotoxic effects remain in children with cardiac catheterization.

Objective To investigate the habits that literatures using by nursing staffs during 2010 to 2012 in China.Methods The publication from Chinese Journal of Nursing, Nursing Research, Chinese Journal of Practical Nursing, Journal of Nurses Training and Journal of Nursing Science from year of 2010 to 2012 were statistically analyzed using literature metrology method.The statistics results were compared with data from 2007 to 2009.Results In past 3 years, the quantity,quantity of papers with citations, average number of citations, citations of theses with citations published in-mentioned above five periodicals increased year by year.In 2010 to 2012, the average number of citations and citations rate of papers also improved compared with 2007 to 2009.The type citation is mainly from Journals,and the language was mainly in Chinese.Conclusions In the past 3 years, the nursing staff's literature utilization was improved.However, in the situation of using references with foreign language, nursing staff was poor comparing with medical personnel.On the scientific research ability of nursing personnel training should be strengthened,and the application of new technology and new theory in domestic and international should be strengthened as well..

Objective To investigate the atypical CT ,MRI findings of pancreatic neuroendocrine tumors (PanNETs) ,in order to improve diagnosis .Methods The clinical ,imaging and pathological data of 6 patients with PanNETs confirmed by pathology were analyzed retrospectively .Results In all 6 cases ,2 lesions were located in the pancreatic head ,3 lesions in the pancreatic body ,and 1 lesion in the pancreatic tail .There were 2 functional PanNETs with an average size of 2 .1 cm × 2 .6 cm ,which showed homogeneous density or signal .There were 4 nonfunctional PanNETs with an average size of 2 .7 cm × 4 .3 cm ,one of which had calcification ,and two of which had obviously cystic change ,including intracapsular bleeding in one case .Contrast‐enhanced examinations showed that all 6 lesions had mild or moderate enhancement .Three lesions were manifested as relatively intense enhancement in the arterial and portal venous phase ,but decreased enhancement in the delayed phase ,including annular envelope enhancement in one case .Two le‐sions were manifested as progressive enhancement .The last case was manifested as inwardly filled enhancement .Three lesions had unclear boundaries ,while one lesion had splenic vein invasion .Two cases accompanied with mild expansion of the common bile duct or pancreatic duct .Conclusion PanNETs can be ma+nifested as atypical findings such as obviously cystic changes ,and(or) mild to moderate enhancement .It is suggested that the atypical imaging findings of PanNETs should be recognized well to improve the diag‐nostic accuracy .