Objective To probe into the clinical effect of the sickbed management system for student nurses.Methods The student nurses at the first department of gynecology from June 2010 to April 2012 were set as the experiment group,in which the sickbed management system was used so that they completed their nursing work at fixed shifts and sickbeds under the nursing teacher’s instructions.The student nurses at the second department of gynecology during the same period were set as the control group,in which the student nurses took different tasks for unfixed sickbeds at different shifts every day.The two groups were compared in terms of the student nurses’knowledge about the patients’diseases and the degree of patients’satisfaction with their nursing work.Result The experiment group was significantly better than the control one in terms of student nurses’knowledge about the patients’diseases and the degree of patients’satisfaction with their nursing work(both P<0.05).Conclusion The sickbed management system for the student nurses may not only enhance nurses’sense of responsibility for their work,but also improve the quality of nursing teaching and patients’ satisfaction with the nursing service.

Objective:To explore the influence of mindfulness meditation intervention on the professional identity and turnover tendency of the second victim of nurses.Methods:The convenience sampling method was used to select the second victim of 46 nurses who experienced medical adverse events within six months from January to June 2019 in Zhongnan Hospital of Wuhan University, and then an 8 weeks of mindfulness meditation intervention was carried out for them. In the entire intervention process, a self-control study was conducted, the Second Victim Experience and Support Scale (SVSET) and the Nurse Occupational Identity Scale were used to assess nurses' turnover intentions, absence and professional identity before the intervention and at 2 hours, 4 weeks, and 8 weeks after the intervention.Results:By analyzing the data, the results showed that after the mindfulness meditation intervention, the second victim of the nurse before intervention, 2h, 4 weeks, and 8 weeks of intervention were 3.28±0.87, 3.20±0.83, 2.85±0.92, 2.71±0.87, the difference was statistically significant ( F time value was 6.609, P<0.05). Before and after the intervention of the sense of grasp in professional identity were 4.91±0.83, 5.47±0.81, 5.83±0.91, 5.94±0.80, the difference was statistically significant ( F time value was 20.973, P<0.01). Consensus before and after intervention were 4.61±0.78, 5.09±0.85, 5.54±1.12, 5.76±0.85, the difference was statistically significant ( F time value was 22.237, P<0.01). The meaningful sense before and after intervention were 4.38±1.03, 5.04±0.75, 5.44±0.86, 5.59±0.76, the difference was statistically significant ( F time value was 23.656, P<0.01). The self-efficacy before and after intervention were 4.71±0.82, 5.33±0.63, 5.83±0.84, 5.90±0.77, the difference was statistically significant ( F time value was 28.866, P<0.01). The self-determination before and after intervention were 4.43±0.97, 5.06±0.81, 5.59±0.91, 5.62±0.87, the difference was statistically significant ( F time value was 25.237, P<0.01). Before and after intervention, the influence of tissue was 4.17±0.96, 4.71±0.85, 4.96±0.99, 5.30±0.88, the difference was statistically significant ( F time value was 16.487, P<0.01). Before and after intervention, the patients' feelings were 4.59±0.96, 5.08±0.84, 5.70±0.83, 5.83±0.68, the difference was statistically significant ( F time value was 25.406, P<0.01). Conclusion:This article provides an effective method to help nurses' second victims out of their predicament which confirms that mindfulness meditation intervention can effectively reduce turnover tendency of nurses 'second victims and improve their professional identity.

Objective To explore the effect of NGAL knockdown by NGAL siRNA encapsulated with urocanic acid-modified chitosan nanoparticles (UAC).MethodsNGAL siRNA encapsulated by UAC and chitosan (CTS) respectively, which were then used to transfect human colon cancer cell lines HT29.The expression level of NGAL protein were detected by Enzyme Linked Immunosorbent Assay(ELISA).ResultsThe ELISA study revealed that the expression level of NGAL protein in UAC group(average 0.583μg/L) was significantly lower than in CTS group (average 0.772μg/L) and control group(average 1.071μg/L) (P<0.05).ConclusionThe NGAL expression of mRNA and protein in HT29 cells could be down-regulated by siRNA encapsulated by UAC.

Objective To study the clinical value of combination dection of inhibin A,progesterone and fetal fibronectin in predicting the outcome of threatened abortion.Methods One hundred and seventy patient with symptoms of threatened abortion were selected as the object of this study.After miscarriage treatment,75 patients continued the pregnancy as the threatened abortion group and 45 patients miscarriage after miscarriage treatment as the abortion group,another 50 normal pregnant women at same period in our hospital were as the control group.Inhibin A,progesterone and fetal fibronectin were detected and compared between the three groups.Results The inhibin A and progesterone levels increased in turn from abortion group,threatened abortion group to normal pregnancy group.fFN positive rates were lower in turn.The difference were statistically significant (P ＜ 0.05).The area under the ROC curve (AUC) of inhibin A,and progesterone levels fFN positive rate for prediction of threatened abortion were 0.899,0.866,0.785,while the AUC of the combine that three index was 0.944.The sensitivity of the combined detection was 92.04％,the specificity was 89.17％,accuracy was 87.95％,positive predictive value was 98.45％,negative predictive value was 89.38％,and Youden index was 0.812.Conclusion Combined detection of inhibin A,progesterone and fetal fibronectin in predicting the outcomes of threatened abortion of pregnant women have a better predictive value than single index,it can enhance the accuracy,specificity and accuracy of forecasts.

Objective:To explore the psychological recovery pathway and support needs of second victims of nurses who have experienced medical adverse events through qualitative research.Methods:From June to December 2022, a purposive sampling method was used to select 20 nurses who had experienced level Ⅲ or above adverse events and voluntarily participated in this study from 3 grade A tertiary hospitals in Hubei Province and 1 grade A tertiary hospital in Sichuan Province. Semi-structured interviews were conducted with the research subjects and the data was analyze by using thematic analysis.Results:The psychological recovery path of nurses who had experienced medical adverse events included three stages, named as the plateau period, stress response period, and coping and growth period. The second victim of nurses hoped to receive support from the department′s environmental culture, organizational atmosphere, and non punitive culture, and nurses in the platform stage had a stronger need for the first two types of support; the nurses preferred emotional support from superiors, colleagues, family/friends during the stress response period, and preferred knowledge learning and training support during the coping and growth period.Conclusions:The psychological recovery of the second victim of nurses will go through a plateau period, a stress response period, and a coping and growth period. There are differences in support needs during each period, and more targeted intervention plans should be developed.

With basal medium, we studied the growth status, lipid droplet distribution, total lipid content of Chlorella protothecoides CS-41 treated with different concentrations of sodium chloride (0, 150, 300 and 600 mmol/L) by optical microscopy, electron microscopy, confocal laser focusing and Nile red staining. Results show that the addition of NaCl affected the growth of Chlorella protothecoides CS-41. With the increase of NaCl concentration, the growth rate of Chlorella was inhibited. Chlorella cell wall became thicker, and lipid droplets increased. At the early stage, the amount of lipid droplets in the 600 mmol/L NaCl culture was the highest, but at the late-log stage, the amount of lipid droplets increased with the increase of the biomass of culture in 150 and 300 mmol/L NaCl culture. At the stable stage, biomass (dry weight) in 300 mmol/L NaCl culture was 73.55% of that in the control, but the total lipid content was 2.22 times higher than that in the control. A certain concentration of sodium chloride treatment can significantly increase the lipid content of Chlorella protothecoides CS-41.

OBJECTIVETo explore the impact of neutrophil gelatinase-associated lipocalin (NGAL) knockdown by NGAL siRNA encapsulated with urocanic acid-modified chitosan nanoparticles (UAC) on the proliferation, migration and apoptosis of human colon cancer cells.

METHODSNGAL siRNA was encapsulated by UAC and chitosan (CTS) respectively, and then was transfected into human colon cancer cell lines HT29. The NGAL mRNA was detected by real-time quantitative PCR (RT-QPCR). Relationships of NGAL gene silencing with the proliferation, migration and apoptosis of HT29 cell were analyzed.

RESULTSUnder the fluorescence microscope, the transfection efficiency of siRNA in UAC group was (37.52±7.17)%, which was significantly higher than (11.32±3.39)% in CTS group (t=6.102, P=0.005). Forty-eight hours after transfection, RT-QPCR examination showed that the level of NGAL mRNA expression was 0.350 in UAC group and 0.529 in CTS group with significant difference (t=-3.743, P=0.02), meanwhile both levels were significantly lower as compared to control group(F=163.538, P<0.001). Proliferation analysis revealed that after silencing NGAL gene, proliferation rate of UAC group and CTS group was slightly lower than control group, and no significant differences were found (F=9.520, P=0.438). However, migration assay demonstrated that the 24-hour migration rate of UAC group and CTS group was significantly lower than that of control group (F=6.756, P=0.029), meanwhile the migration rate of UAC group was slightly lower than that of CTS group [(77.90±7.14)% vs. (87.67±3.98)%, t=-1.704, P=0.164]. Apoptosis detection revealed that the apoptosis rate in UAC group was significantly higher than that in CTS group and the control group 2 days after transfection [(15.800±1.054)% vs. (12.900±0.656)%, (11.933±1.914)%, F=7.004, P=0.027].

CONCLUSIONSThe encapsulated ability and transfection efficiency of chitosan modified by urocanic acid elevate significantly. Silencing NGAL gene by UAC carrier can down-regulate the expression of NGAL mRNA in HT29 colon cell line, inhibit their migration and facilitate their apoptosis.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.