Objective To explore the predicting value of plasma asymmetric dimethylarginine (ADMA) in cardiac structure and function of patients with chronic kidney diseases (CKD).Methods A total of 100 CKD patients were enrolled in this cross-sectional study.According to staging of the K-DOQI guideline,CKD patients were divided into five groups.Twenty healthy people were enrolled as control.Plasma level of ADMA was determined by reversed-phase high performance liquid chromatography.Cardiac structure and function were detected by color echocardiography.Results Plasma levels (μmol/L) of ADMA in CKD stage 3 to 5 patients (1.3318±0.4684,1.5712±0.4210,2.1093±0.7714) were significantly higher than those in CKD stage 1,2 patients (0.4387±0.2575,0.4809±0.2846) and healthy control (0.4611±0.1615) (all P＜ 0.01).Meanwhile,ADMA level of CKD stage 5 was significantly higher as compared to CKD stage 3-4.The left ventricular mass index (LVMI) was significantly higher in stage 4-5 patients than that in stage 1-3 and healthy control.Plasma ADMA was positively correlated with LVMI (r=0.476,P=0.028) and negatively correlated with left ventricular ejection fraction (EF) (r=-0.327,P=0.041).Multivariate stepwise Logistic regression analysis revealed plasma ADMA level was an independent predictors for EF (OR=0.984,P＜0.01).Conclusions Plasma level of ADMA begins to increase in CKD patients of stage 3 and rises proportionally to the decline of renal function.Plasma ADMA level is useful in predicting the cardiovascular complications of CKD patients.

Life review therapy is an effective psychological intervention for cancer patients. This article reviews the overview, implementation methods, requirements of practitioners of life review therapy and precautions for its implementation in cancer patients, so as to provide a clinical reference for the extensive application of life review therapy in cancer patients, and reduce the bad emotion of cancer patients, and improve their quality of life.

Objective:To explore the relationship between aortic arch calcification (AoAC) and arteriovenous fistula (AVF) failure in maintenance hemodialysis (MHD) patients.Methods:The patients who underwent initial AVF and started MHD in the General Hospital of Ningxia Medical University from September 2016 to September 2017 were retrospectively recruited and prospectively followed up until two years after AVF surgery or withdrawal from MHD or death. Calcification of the aortic arch was estimated with plain chest radiology. The patients were divided into four groups (0-3 grade) according to the aortic arch calcification score (AoACs). Spearman correlation analysis was used to analyze the relationship between AoACs and AVF failure. Multivariate logistic regression was used to analyze the influencing factors of AVF failure.Results:A total of 165 MHD patients were included in this study, with age of (55.52±14.06) years old and 102 males (61.82%). Among 128 AoAC patients (77.6%), 45 patients were categorized as grade 1 (27.3%), 35 patients as grade 2 (21.2%) and 48 patients as grade 3 (29.1%). There was significant difference in the, age, pulse pressure, corrected calcium, phosphorus, diastolic blood pressure, intact parathyroid hormone and AVF failure between AoAC group and no AoAC group (grade 0 calcification) (all P<0.05). The results of Spearman correlation analysis showed that AoACs was positively correlated with AVF failure ( r=0.759, P=0.010), age ( r=0.407, P<0.001), pulse pressure ( r=0.575, P=0.006), and diabetes history ( r=0.848, P=0.049), blood calcium ( r=0.591, P=0.018), and blood phosphorus ( r=0.509, P=0.012), and negatively correlated with diastolic blood pressure ( r=-0.614, P=0.013). Multivariate logistic regression analysis showed that diabetes history ( OR=6.702, 95% CI 1.431-31.396, P=0.016), high corrected calcium ( OR=10.830, 95% CI 3.479-35.300, P=0.008), high phosphorus ( OR=3.792, 95% CI 1.128-12.750, P=0.031) and AoAC ( OR=4.473, 95% CI 1.490-13.428, P=0.008) were the independent influencing factors of AVF failure. Conclusions:AoAC is an independent risk factor for AVF failure in MHD patients. Evaluation of AoAC has predictive value for AVF failure.

Objective:To conduct a scoping review on symptom cluster of hematopoietic stem cell transplantation (HSCT) patients, aiming to provide reference for improving postoperative symptom management in HSCT patients.Methods:The study on postoperative symptom clusters in HSCT patients was searched in PubMed, Web of Science, CINAHL, Embase, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Database, VIP, and WanFang Data. The search period was from database establishment to July 17, 2023.Results:A total of 10 articles were included, and 9 symptom clusters were extracted. The top three symptom clusters in terms of frequency were fatigue related, gastrointestinal related, and psychological symptom clusters. The influencing factors of symptom cluster mainly included chronic graft-versus-host disease, transplant type, conditioning regimen, gender, depression level and so on. The heterogeneity of HSCT patient symptom cluster assessment tools was relatively high.Conclusions:The dynamic changes of postoperative symptom clusters in HSCT patients are influenced by multiple factors, and specific assessment tools still need to be developed.

Objective:To retrieve, appraise and integrate the best evidence of exercise rehabilitation in adult aplastic anemia patients after hematopoietic stem cell transplantation, so as to provide a reference for developing exercise rehabilitation program.Methods:All the evidences of exercise rehabilitation for aplastic anemia patients after hematopoietic stem cell transplantation were searched from the computer decision support systems, guideline websites, association official websites and databases, including guidelines, systematic reviews, evidence summaries, best practice, recommended practice, expert consensuses and randomized controlled trials. The retrieval period was from January 2010 to July 2021. Australian JBI Evidence Based Health Care Centre Evidence Grading and Evidence Recommendation Grading System was used to evaluate literature quality and evidence rating.Results:A total of 14 articles were included, and 35 evidences were summarized from 8 aspects, including exercise effectiveness, exercise principles, exercise evaluation, exercise methods, exercise intensity, exercise time, exercise site and notes.Conclusions:The summary of the best evidence for exercise rehabilitation in adult aplastic anemia patients after hematopoietic stem cell can provide a reference for clinical nursing practice. Medical and nursing staff should provide exercise guidance for patients according to the clinical practice and their own condition.

Objective:To retrieve, evaluate, and summarize evidence on the assessment and management of diarrhea in hematopoietic stem cell transplantation (HSCT) patients both domestically and internationally, providing evidence-based support for clinical practice.Methods:According to the "6S" model, guidelines, clinical decisions, recommended practices, evidence summaries, systematic reviews, and expert consensus related to the assessment and management of diarrhea in HSCT patients were systematically retrieved from relevant databases and websites both domestically and internationally. The search period was from January 1, 2013 to November 30, 2023. Seven researchers conducted literature screening, quality evaluation, evidence extraction, and summarization.Results:A total of 15 articles were included, including four guidelines, three clinical decisions, two recommended practices, one evidence summary, two systematic reviews, and three expert consensus. Thirty-one pieces of evidence were summarized from seven aspects of multidisciplinary management, risk factor management, assessment and monitoring, medication intervention, diet and nutrition management, health education, and daily management.Conclusions:The best evidence for HSCT patient assessment and management summarized can provide reference for clinical practice, and nursing staff should carefully apply evidence based on the actual situation of patients.

Objective To construct an"Internet+TCM nursing service"talent cultivation model in Zhejiang Province and to evaluate its application effect.Methods Based on the literature review and expert panels,the"Internet+TCM nursing service"talent cultivation model was constructed in Zhejiang Province.A total of 63 trainees from 63 TCM and integrated traditional Chinese and Western medicine hospitals in the province were selected to carry out for 45 days of theoretical training and 9 days of clinical skills training.After the training,the training effect was evaluated by theoretical knowledge,TCM nursing skills,scenario simulation case assessment,trainees'satisfaction,as well as a survey on the results of practice.Results The constructed talent cultivation model contains course contents including theoretical learning,skill training and emergency home treatment management and corresponding assessment programs.Sixty-three trainees successfully completed the course with the theoretical score of(92.24±3.64),the skill score of(97.13±2.53),and the situational case score of(95.78±3.02).Fifty-five trainees(87.30％)were assessed as"excellent"and 8(12.70％)as"good".The trainees'satisfaction about the overall module design of the project was(4.93±0.23)and 415 cases of"Internet+TCM nursing service"were carried out.Conclusion The"Internet+TCM nursing service"talent cultivation model in Zhejiang Province has strong applicability and remarkable training effect,which can provide references for the implementation of"Internet+TCM nursing service"in other regions.

Objective:To explore the changes of biparietal diameter, head circumference and cerebrovascular hemodynamics in fetuses with hypoplastic left heart syndrome (HLHS) during middle pregnancy.Methods:The biparietal diameter, head circumference, middle cerebral artery pulsatility index (MCA-PI), umbilical artery pulsatility index (UA-PI) and MCA-PI/UA-PI (CPR) of 41 fetuses with HLHS(HLHS group) were retrospectively analyzed from January 2015 to December 2019 in Beijing Anzhen Hospital, and were compared with those of 82 normal fetuses matched for gestational age at the same period (control group).Results:The Z-scores of head circumference, MCA-PI and CPR in with HLHS group were lower than in control group(all P<0.05); Head circumference in HLHS group were weakly and positively correlated with the MCA-PI and CPR ( r=0.385, 0.416; all P<0.05). Conclusions:There are some changes in the head circumference and cerebral hemodynamics in fetuses with HLHS during mid-gestational age, and the head circumference is weakly and positively correlated with MCA-PI and CPR, which has clinical significance.

Objective To develop the Quality of Life Scale for Patients with Aplastic Anemia(QLS-AA)and to test its reliability and validity.Methods According to the concept category and the four-dimensional model of quality of life,the scale item pool was initially constructed through literature review and qualitative interview.The draft of the QLS-AA was formed through expert inquiry,cognitive interviews and expert consultation.A questionnaire survey was conducted on 429 patients with aplastic anemia from the hematology departments of a tertiary general hospital in Zhejiang Province and a tertiary hematology hospital in Tianjin with the convenient sampling method from December 2021 to November 2022,and the item analysis and reliability,validity test of the pre-test scale were carried out.Results 422 valid questionnaires were collected,and the effective questionnaire recovery rate was 98.37％.3 common factors were extracted by exploratory factor analysis,and the cumulative variance contribution rate was 66.113％.The scale level consensus content validity index was 0.821,the scale level average content validity index was 0.970,the item level content validity index was 0.833～1.000,and the correlation coefficient with SF-36 was 0.719.The Cronbach's α was 0.944,and the split half reliability was 0.882,and retest reliability was 0.931.The final QLS-AA includes 3 dimensions with 39 items.Conclusion The process of developing QLS-AA in this study is scientifically standardized,and the scale has good reliability and validity,which can effectively evaluate the quality of life for patients with aplastic anemia.