Patient satisfaction reflects the patients' subjective feelings which are subject to several factors.The physician-patient relationship is the critical factor of patients' satisfaction with the hospital.Harmonious doctor-patient relationship is the bridge of promoting mutual understanding,trust,and communication,and also improves patients' satisfaction and loyalty with the hospital.The establishment of effective mechanisms for the management in improving patient satisfaction will be an important link with the harmonious doctor-patient relationship,at the same time raise the reputation of hospital to build up a harmonious society.

Objective To estimate the success rate of emergency endoscopic treatment in patients with esophagogastric variceal bleeding using self-made gastroscope outer casing and to investigate bow to prevent complications. Methods A total of 11 patients with esophagogastric variceal bleeding underwent endoscopic treatment with self-made gastroscope outer casing, which consisted of a wire reinforced plastic casing (1.05 cm in inner diameter, 1.35 cm in outer diameter and 50 cm in length), a 3.8 cm×3.8 cm balloon fixed on the casing head and its cavity connected to the gas pipeline placed in casing tail, an anti-reflux pad in the insert entrance of the endoscope tail as well.as a flushing hole. The endoscopy was introduced to the esophagus or stomch together with outer casing to wash and pump the hematocele out from the side of flushing hole. In patients with hemorrhagic lesion in esophageal vein, the balloon was used to press bleeding vein and intravascular sclerotherapy was performed simutanously. In those with hemorrhagic lesion in gastric vein, the balloon was pressed on esophageal vein near to the cardia and intravascular sclerotherapy was performed. Results During the process of examination, the hemorrhagic lesion was fully exposed because of flushing, and bleeding was controlted in all patients after sclerotherapy. No complication such as aspiration or perforation was seen. Conclusions For emergency endoscopic treatment of esophagogastric variceal bleeding, gastroscope outer casing is helpful in removing intragastric hematocele and maintaining a clear field of vision. It can be effectively improving the efficacy of sclerot herapy.

Objective To explore the influencing factors of career planning for nurses aged 30 to 40 years old. Methods Based on descriptive qualitative study, purposive sampling and the maximum variation strategy were used, nurses aged 30 to 40 years old who work at hospitals in Zhejiang province were selected as participants. Face-to-face semi-structured interviews were conducted focusing on influencing factors of career planning and field notes were written. Traditional content analysis was used for analyzing the data, and themes were extracted. The sample size was based on the criteria of saturation. Results A total of 12 participants were included. After analysis, the main influencing factors of career planning were identified: self- perception (such as their own personality, interests and expertise, professional ability, physical condition), knowledge of nursing work (including the cognition of nursing specialty and the nature of nurses' work), career development space (such as career development platform, career development path, career development bottleneck, learning and promotion opportunities), family factors (including family support and family outlook), hospital culture(including interpersonal relationships, leadership support, management style), career planning knowledge(including knowledge of career planning and guidance on career planning in work). Conclusions There are many factors influence career planning. Relevant departments and nursing managers should assist these nurses in making reasonable career planning according to their situation.

Objective To explore innovative forms of health education in nursing management of ambulatory surgery under the health care reform situation.Methods Single disease health education guidelines were established according to standard clinical nursing path.Health education manager model was formed by combination of health education information platform and personal responsible nurses.By applying four-grade quality control management,individualized and overall health education was conducted to the patients.Therapeutic effect of patients in the ambulatory surgery ward was evaluated.1 300 discharged patients were surveyed by phone about their satisfaction to the nursing.Results Hospitalized days and expenses of patients undergone ambolatory surgery were fewer than patients with the same disease yet in general wards;0.08％ of the patients were transferred to general wards,and another 0.08％ were readmitted because of accident.Patients' satisfaction to the nurses' technique,service,communication and education was 100.0％,98.2％,100.0％ and 100.0％.Conclusions Health education manager model in ambulatory surgery ward can guarantee therapeutic effect of the surgery and meet the patients' need of health education.

Objective To explore the application of clinical nursing path in 1 000 cases of day surgery. Methods Retrospective analysis was used in this comparative study, and totally 1 000 cases of patients who underwent day surgery under the clinical nursing path from November 2015 to May 2016 in Wuxi Second People′s Hospital, Nanjing Medical University were surveyed, and their hospitalization time, average costs, and security were compared with conventional inpatients who had the same disease and same stage. Results The hospitalization time and average costs of patients with day surgery under clinical nursing path were lower than patients with conventional surgery, and its security after surgery was good with less adverse effects. Conclusions The clinical nursing path in day surgery is a new medical model. This modle satisfies the needs of medical-sanitary system reform and is applicable to the society. However, its development also depends on the support of health insurance policy.

Objective:To understand the current clinical practice status of evidence on blood glucose management in ICU patients with insulin intravenous infusion, analyze barriers and formulate action strategies, so as to provide reference for the translation of evidence into clinical practice.Methods:Based on the clinical evidence application model of the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center, clinical nursing problems were identified, literature search, evaluating and summarizing evidence were carried out, and review indicators and methods were developed. From July to August 2023, convenience sampling was used to select 42 nurses and 80 patients with insulin intravenous infusion from the comprehensive ICU of Wuxi Second People's Hospital as participants for baseline review. Barriers were analyzed and change strategies were developed based on baseline review results.Results:A total of 16 pieces of evidence were introduced regarding blood glucose management in ICU patients with insulin intravenous infusion. Nineteen review indicators were formulated, of which 13 had a compliance rate of less than 60%. Analysis identified 18 barriers and 13 facilitators. Sixteen change strategies were developed based on barriers and facilitators.Conclusions:There is still a significant gap between the evidence of ICU insulin intravenous infusion blood glucose management and clinical practice. Evidence-based practice programs should be constructed based on intervention strategies to effectively promote the application of evidence in clinical practice.

To investigate the cellular target selectivity of small molecules targeting thioredoxin reductase 1, we reported the construction and functional research of a stable TrxR1 gene (encode thioredoxin reductase 1) knockout HCT-116 cell line. We designed and selected TrxR1 knockout sites according to the TrxR1 gene sequence and CRISPR/Cas9 target designing principles. SgRNA oligos based on the selected TrxR1 knockout sites were obtained. Next, we constructed knockout plasmid by cloning the sgRNA into the pCasCMV-Puro-U6 vector. After transfection of the plasmid into HCT-116 cells, TrxR1 knockout HCT-116 cells were selected using puromycin resistance. The TrxR1 knockout efficiency was identified and verified by DNA sequencing, immunoblotting, TRFS-green fluorescent probe, and cellular TrxR1 enzyme activity detection. Finally, the correlation between TrxR1 expression and cellular effects of drugs specifically targeting TrxR1 was investigated by CCK-8 assay. The results demonstrated that the knockout plasmid expressing the sgRNA effectively knocked-out TrxR1 gene within HCT-116 cells, and no expression of TrxR1 protein could be observed in stable TrxR1 knockout HCT-116 (HCT116-TrxR1-KO) cells. The TrxR1-targeting inhibitor auranofin did not show any inhibitory activity against either cellular TrxR1 enzyme activity or cell proliferation. Based on these results, we conclude that a stable TrxR1 gene knockout HCT-116 cell line was obtained through CRISPR/Cas9 techniques, which may facilitate investigating the role of TrxR1 in various diseases.
CRISPR-Cas Systems/genetics* ; Gene Editing ; Gene Knockout Techniques ; HCT116 Cells ; Humans ; RNA, Guide/metabolism*

Aged ; Aged, 80 and over ; Cytarabine ; administration & dosage ; therapeutic use ; Female ; Harringtonines ; administration & dosage ; therapeutic use ; Humans ; Induction Chemotherapy ; methods ; Leukemia, Myeloid, Acute ; drug therapy ; Male ; Middle Aged