Objective To discuss the application effect of zero OT-U type bionics urine bag in neurology critically ill patients to reduce the indwelling catheterization complications. Methods A total of 50 cases of critically ill patients with indwelling catheter were chosen from July 2014 to May 2015. They were randomly divided into the experimental group and the control group with 25 cases in each group according to the time of admission. The control group used common urine bags and the experimental group adopted bionics urine bag. The excessive urine, urinary tract infection, incontinence associated dermatitis, the time with indwelling urinary catheter,replacing the urine tube to urinate in two groups were compared. Results The rate of excessive urine, urinary tract infection, incontinence associated dermatitis and the time with indwelling urinary catheter in the experimental group were 12%(3/25), 4%(1/25), 32%(8/25) and (10.120 ±3.295) days, while the results were 84%(21/25), 48%(12/25), 80%(20/25) and (28.040±9.480) days in the control group, the differences were different (χ2=27.931,7.741, 7.018, t=8.927, P<0.01). The cases of voluntary micturition, induced micturition and secondary catheterization were 17, 5 and 3, and the results in the control group were 3, 12 and 10, the differences were were different ( χ2=16.452, P < 0.01). Conclusions The zero OT-U type bionics urine bag has a bigger superiority in reducing the related complications in neurology critically ill patients with indwelling catheter. At the same time , the zero OT-U type bionics urine bag reduced the patient's pain, improved the family satisfaction and reduced the pressure on care and treatment.

Objective:This study aimed to explore and analyze correlated factors of the characteristics of moderate and severe pain in head and neck cancer (HNC) patients after tissue flap repairment, to provide the basis for the following pain management.Methods:The convenience sampling method was used to enroll 239 patients who underwent tissue flap repairment at the Department of Oral and Maxillofacial Surgery, Peking University Hospital of Stomatology between December 2017 and December 2018 in this study. To classify the types of pain, Verbal Rating Scale (VRS) scores were used to collect the pain symptoms of patients with 6 time periods of wound, throat, infusion, other and non-intervention for 6 days, and analyze the characteristics and correlated factors of moderate and severe pain.Results:Eighty-seven of the 239 patients complained of moderate or severe pain. The distribution of patients age and education level had statistical differences in the presence or absence of moderate to severe pain ( P<0.05) . The cases of sore throat and frequency occurred most frequently among all types of pain. Conclusions:Although patient-controlled analgesia is given to patients after flap repairment, more than one-third of patients still complained of moderate and severe pain. Different types of pain have different characteristics, and throat pain occurred more frequently. Moderate pain was more common in male patients, while severe pain has a much higher proportion in female patients.

The article introduces the content and organization of the training program for newly recruited nurses in the three hospitals of Massachusetts General Hospital, Mayo Clinic, and University of Illinois Chicago Medical Center in the United States. This article also summarizes the characteristics and highlights of the program implementation, and discusses and analyzes the training program by combining the current situation of newly recruited nurses training in my country, and makes suggestions for further improvement in the future.

Myelodysplastic syndrome(MDS)is a heterogeneous myeloid tumor that originates from hematopoietic stem cells(HSCs)and is associated with a high risk of progression to acute myeloid leukemia(AML).Studies have shown that 90%of patients with MDS have gene mutations,of whom approximately 25%have SF3B1 mutations.In patients with MDS carrying this mutation,the TGF-β pathway is upregu-lated,inducing cell cycle arrest and thereby leading to erythroid ineffective hematopoiesis and pathological hematopoiesis.Luspatercept can be used as a ligand trap to capture TGF-β ligands,inhibit SMAD2/3 pathway activation,downregulate TGF-β pathway,and promote ad-vanced red blood cell maturation.Currently,it has been approved by the Food and Drug Administration(FDA)for the treatment of anemia in patients with low-risk MDS,and studies have shown that the response rate is higher in patients with SF3B1 mutations.This article will re-view the current status of luspatercept in the treatment of SF3B1 mutation-related MDS;it will also analyze its effectiveness and safety and provide therapeutic strategies for clinical use.

Telomeres are DNA tandem repeats at the ends of chromosomes in eukaryotic cells and play important roles in maintaining the stability and integrity of chromosomes.Telomeres are gradually shortened with cell proliferation,and when they are shortened to a certain length,the cells experience senescence and apoptosis.However,a small number of cells can maintain the length of telomeres and restore their function through related mechanisms (activation of telomerase or other mechanisms),and some cells may even be immortalized.Therefore,telomere and telomerase are thought to be closely associated with tumor development and progression.It has been confirmed that telomerase activation is an early event in the development of primary liver cancer,especially the important component of telomerase telomerase reverse transcriptase (TERT),which plays an important role in this process.Here this article reviews the latest research advances in the function and regulation mechanisms of telomerase and the role of TERT in the development,progression,and treatment of primary liver cancer,especially hepatocellular carcinoma,so as to provide a molecular genetic basis for intervention of liver cancer and related targeted therapy.

Objective To objectively evaluate the clinical efficacy and safety of acupuncture in regulating the mood of patients with post-stroke depression(PSD)and explore the possible target of acupuncture intervention.Methods 76 patients with PSD were randomly divided into treatment group and control group.The control group was treated with routine treatment measures for stroke,and the treatment group was treated with acupuncture on this basis.The main acupoints were Shangxing,Baihui,Shenting,Fengchi and Dugu,supplemented by acupuncture on Taichong,Hegu,Quchi,Neiguan,Yanglingquan,Zusanli and Taixi,5 times a week,continuously treated for 4 weeks,followed up on the 90th day after treatment.The levels of serum 5-hydroxytryptamine,norepinephrine and intestinal microflora before and after treatment were compared with the 17 Hamilton Depression Scale scores(HAMD),modified Barthel Index(MBI),and the levels of serum 5-hydroxytryptamine and norepinephrine before and after treatment.Results The HAMD score and MBI index of the two groups after treatment and follow-up were lower than those before treatment.The levels of 5-hydroxytryptamine and norepinephrine in the treatment group after treatment were higher than those before treatment(P<0.01),and significantly higher than those in the control group(P<0.01).After acupuncture,the dominant bacterial groups of Bacteroides,Thick-wall bacteria and Broughter bacteria in patients showed an upward trend(P>0.05).The difference of bacteria before and after treatment was mainly concentrated in signal pathways such as ECM-receptor interaction,and the difference was statistically significant(P<0.01).Conclusion Acupuncture can help patients improve their ability of daily living,and also improve the relative abundance of intestinal flora in PSD patients to a certain extent,so as to regulate the levels of 5-HT and NE to relieve the depression of patients,which is worthy of promotion in clinical practice.

The tumor microenvironment,particularly the hypoxic property and glutathione(GSH)overexpression,substantially inhibits the efficacy of cancer therapy.In this article,we present the design of a magnetic nanoplatform(MNPT)comprised of a photosensitizer(Ce6)and an iron oxide(Fe3O4)/manganese oxide(MnO2)composite nanozyme.Reactive oxygen species(ROS),such as singlet oxygen(1O2)radicals produced by light irradiation and hydroxyl radicals(·OH)produced by catalysis,are therapeutic species.These therapeutic substances stimulate cell apoptosis by increasing oxidative stress.This apoptosis then triggers the immunological response,which combines photodynamic therapy and T-cell-mediated immunotherapy to treat cancer.Furthermore,MNPT can be utilized as a contrast agent in magnetic resonance and fluorescence dual-modality imaging to give real-time tracking and feedback on treatment.

OBJECTIVE To analyze the efficacy and safety of luspatercept in the treatment of myelodysplastic syndromes （MDS） anemia， and provide reference for clinical medication. METHODS The literature related to luspatercept for MDS anemia in PubMed， Cochrane Library， Embase and Web of Science were searched by computer， and the search time was from the establishment of the database to January 2024. The quality of literature was evaluated after they were screened according to inclusion and exclusion criteria， the single-group rate meta-analysis and sensitivity analysis were performed by using RevMan 5.4 software， and the subgroup analysis was conducted. RESULTS A total of 756 patients in 9 articles were included in this study. The results of meta-analysis showed that the proportion of MDS patients who reached ≥8 weeks of red blood cell transfusion independence （RBC-TI） was 46% after using luspatercept [95%CI （0.28， 0.64）， P＜0.000 01]. The proportion of MDS patients whose hematological improvement in erythrocyte （HI-E） was 59% [95%CI （0.43， 0.74）， P＜0.000 01]. Among them， 5 articles reported that the proportion of MDS patients with grade 3-4 adverse reactions was 14% [95%CI （0.07， 0.22）， P＝0.000 2]， and the poor general condition， infection， blood and lymphatic system disease were the common adverse reactions. Subgroup analysis showed that the source of heterogeneity was the blood transfusion burden in the proportion of MDS patients with RBC-TI≥8 weeks， and the source of heterogeneity was the 0931-8356251。revised international prognostic scoring system （IPSS-R） risk grade， SF3B1 mutation status and blood transfusion burden in the proportion of MDS patients with HI-E. Sensitivity analysis showed that the results of this study were stable. CONCLUSIONS Luspatercept can significantly improve blood transfusion dependence， reduce blood transfusion burden and promote hematology improvement in MDS patients. But attention should be paid to the occurrence of grade 3-4 adverse events； adverse events such as poor general condition， infection， blood and lymphatic system diseases are more common.

Pancreatic cancer remains one of the most lethal malignancies worldwide. The combination of the first-line standard agent gemcitabine (GEM) with the molecular-targeted drug erlotinib (Er) has emerged as a promising strategy for pancreatic cancer treatment. However, the clinical benefit from this combination is still far from satisfactory due to the unfavorable drug antagonism and the fibrotic tumor microenvironment. Herein, we propose a membrane-camouflaged dual stimuli-responsive delivery system for the co-delivery of GEM and Er into pancreatic cancer cells and tissues to block the antagonism, as well as reshapes profibrotic tumor microenvironment via simultaneous delivery of small interference RNA (siRNA) for synergistic pancreatic cancer treatment. This "all-in-one" delivery system exhibits sensitive GSH and pH-dependent drug release profiles and enhances the inhibitory effects on the proliferation and migration of tumor cells in vitro. Excitingly, the systemic injection of such a biomimetic drug co-delivery system not only resulted in superior inhibitory effects against orthotopic pancreatic tumor and patient-derived tumor (PDX), but also greatly extended the survival rate of tumor-bearing mice. Our findings provide a promising therapeutic strategy against pancreatic cancer through the enhanced synergistic effect of target therapy, chemotherapy and anti-fibrotic therapy, which represents an appealing way for pancreatic cancer treatment.