Objective To investigate uncertainty in illness of family members of patients with malignant tumor,to explore the factors that affect uncertainty in illness of family members of patients with malignant tumor,and to provide clinical basis for clinical doctors and nurses implementing effective interventions for their patients.Methods Questionnaires were conduted to investigate uncertainty in illness of family members of patients with malignant tumor and explore the related factors.The measurements included three parts,Chinese version of Mishel uncertainty in illness scale for family member,self-designed questionnaire about family general condition,patients disease information.Results The total score of uncertainty in illness was 82.71±9.93,more than 50 ％ (75 score) of the highest PPUS-FM score.There were statistical significances of uncertainty in illness in education (F =8.06,P ＜ 0.05),family income (F=3.14,P ＜ 0.05),residence place (F =3.99,P ＜ 0.05) and frequency of hospitalization (F =4.85,P ＜ 0.05).Conclusion Family members of patients with malignant tumor have a higher level of uncertainty in illness.Education,family income,residence place and frequency of hospitalization have a certain effect on uncertainty in illness of family members of patients with malignant tumor.

Objective To discuss the cause, clinical features, diagnosis, treatment and prognosis of bladder and urethra leiomyoma combined with uterine leiomyoma. Methods The clinical data of 5 patients with bladder and urethra leiomyoma combined with uterine leiomyoma was analyzed retrospectively. All patients underwent surgical treatment, 3 cases were treated with enucleation of bladder leiomyoma, 1 case was treated with transurethral resection of bladder tumor (TURBT), 1 case was treated with enucleation of urethra leiomyoma,at the same time all patients were underwent hysteromyoma surgery, 1 case was treated with enucleation of partial uterine, 4 cases were treated with enucleation of hysteromyoma. Results Pathology examination showed that 4 cases were bladder leiomyoma, 1 case was urethra leiomyoma,5 cases combined with uterine leiomyoma. Patients were followed up 1-3 years,no tumor recurrence and metastasis. Conclusions Bladder and urethra leiomyoma is a kind of benign non-epithelial tumor without specific symptom,clinical rare,often merging with uterine leiomyoma, ultrasonography ,CT and cystoscopy scan could be main techniques for diagnosis mainly with surgical resection,prognosis is good. From clinical discovery bladder leiomyoma must notice patient whether at the same time merges with uterine leiomyoma.

Objective To explore the influence of core competence evaluation on continuing education of training nurses in operation room.Methods Questionnaires were administered to 42 training nurses by using the registered nurse core competence scale (CIRN) in operation room.Results The level of core competence of training nurses in operation room was medium (3.25 ± 0.45).Legal and ethical practice dimension of scores was the highest (3.55 ± 0.63).The single average of clinical nursing dimension was the advanced lowest (3.11 ± 0.54).The nurses self identity was the core influencing factors by multiple stepwise regression analysis in regression.Conclusions The core competence of training nurses in operation room is on the middle level,The focus is to improve the ability of clinical nursing in continuing education.To give more attention and support in self identity of the operation room training nurses,and to provide the scientific basis for the training plan and specialist training for them,in order to promote the continuing education projects of training nurses.

Objective : To investigate the serum levels of antibodies against SARS-CoV-2 after inoculation of an inactivated SARS-CoV-2 vaccine, so as to provide insights into the evaluation of the vaccine immunogenicity. Methods : In this single-arm Objective performance criteria trial, residents aged 18 to 59 years and inoculated with an inactivated SARS-CoV-2 vaccine in Xihu District, Hangzhou City from October to December of 2020 were selected using a cluster sampling method. Blood samples were collected prior to inoculation, 14 and 28 days post-inoculation of the first dose, and 28 days post-inoculation of the second dose. Serum levels of anti-SARS-CoV-2 IgM and IgG antibodies were detected using the magnetic particle-based chemiluminescence immunoassay. The seroconversion of antibodies and dynamic changes of antibody levels were analyzed. Results : Totally 310 participants were enrolled, including 133 subjects on day 14 post-inoculation of the first dose, 97 subjects on day 28 post-inoculation of the first dose and 254 subjects on day 28 post-inoculation of the second dose. The seroconversion rates of anti-SARS-CoV-2 IgG antibody were 6.02%, 28.87% and 98.43%, and the median IgG antibody levels were 1.76 ( interquartile range, 3.25 ), 5.69 ( 9.95 ) and 52.05 ( 47.60 ) AU/mL ( P<0.05 ), respectively, while the seroconversion rates of anti-SARS-CoV-2 IgM antibody were 9.02%, 11.34% and 12.99%, and the median IgG antibody levels were 1.89 ( 3.28 ), 2.06 ( 4.71 ) and 2.65 ( 4.01 ) AU/mL ( P>0.05 ), respectively. In addition, higher serum levels of anti-SARS-CoV-2 IgG and IgM antibodies were detected post-inoculation relative to pre-inoculation ( P<0.05 ), and higher serum IgG antibody levels were found in subjects aged 18 to 39 years than in those aged 40 to 59 years ( P<0.05 ). Conclusions Inoculation of two doses of the inactivated SARS-CoV-2 vaccine achieves a high immunogenicity among residents aged 18 to 59 years 28 days post-inoculation, and the anti-SARS-CoV-2 IgM antibody is detectable in some residents following inoculation of the first dose.

OBJECTIVELooking for an objective biomedical index to distinguish types and phases of hemangioma in order to provide an objective basis for selecting clinical treatment to hemangioma.

METHODSELISA (enzyme-linked immunosorbent assay) was used to determine serum VEGF concentration of 15 patients with proliferative hemangioma, 6 with involuted hemangioma, 6 with vascular malformation and 8 infants of the control group.

RESULTSThe serum VEGF concentrations of 15 proliferative hemangioma patients were significantly higher than those of involuted hemangioma patients, vascular malformation patients and control group infants. The serum VEGF concentrations of involuted hemangioma patients were a little bit higher than those of vascular malformation patients and control group infants, but without statistic significance.

CONCLUSIONSELISA could easily and accurately determine the serum VEGF concentration of different types and different phases of hemangioma. The determination of serum VEGF concentration could provide guidance for selecting a protocol of systemic corticosteroid treatment for proliferative hemangioma. Combined with gene expression and distribution of VEGF and its receptors and some other cytokines, the determination of serum VEGF concentration could help elucidate the mechanism of proliferative hemangioma.

Endothelial Growth Factors ; blood ; Enzyme-Linked Immunosorbent Assay ; Hemangioma ; blood ; Humans ; Infant ; Lymphokines ; blood ; Vascular Endothelial Growth Factor A ; Vascular Endothelial Growth Factors

Objective:To investigate whether octyl ester derivative of ginsenoside Rh2(Rh2-O)can induce immunogenic cell death of Huh-7 hepatocellular carcinoma cells and possible mechanism.Methods:Huh-7 cells were cultured in vitro,and divided into control group,Rh2-O group,positive control group(mitoxantrone treatment).Viability and apoptosis of cells were detected by CCK-8 and flow cytometry,respectively.Concentrations of high mobility family protein 1(HMGB1)and adenosine triphosphate(ATP)in supernatant were detected by ELISA and chemiluminescence assay,respectively.Membrane eversion of calreticulin(CRT)was detected by immunofluorescence assay.ROS level in cells was detected by fluorescence probe DCFH-DA,and expressions of proteins associated with endoplasmic reticulum stress signaling pathway were detected by Western blot.Results:Rh2-O treatment significantly reduced cell viability,promoted apoptosis,induced secretion of HMGB1,ATP,membrane eversion of CRT,increased accumulation of ROS in cells,and enhanced expressions of endoplasmic reticulum stress-related proteins PERK,eIF2α,p-eIF2α(all P<0.05).After addition of endoplasmic reticulum stress inhibitor 4-phenylbutyric acid(4-PBA),membrane eversion of CRT induced by Rh2-O was significantly inhibited(P<0.05).Conclusion:Rh2-O can induce immunogenic cell death in hepatocellular carcinoma cells,whose mechanism may be associated with activation of endoplasmic reticulum stress and promotion of CRT membrane eversion.

Objective To explore the construction and practice of an intelligent prevention and treatment system for venous thromboembolism(VTE)in grassroots hospitals.Methods Based on rel-evant guidelines and expert consensuses on VTE prevention and treatment,domestic and foreign litera-ture was reviewed.A research and development team composed of clinical experts in VTE prevention and treatment,medical and nursing quality management experts,and information engineers conducted investigations and research in surrounding grassroots hospitals.Through evidence-based research and surveys,the team identified relevant business needs,user needs,and functional requirements of grass-roots hospitals,and finally formulated a detailed design plan.The main program of system was written in Java.The interface obtained data from the hospital's data platform through Webservice and view in-terfaces.To prevent issues of repeated data extraction when multiple applications perform time tasks to assess the same patient during later server usage and expansion,the XXL-JOB distributed task schedu-ling platform was adopted to handle VTE assessments by medical staff.Results After the clinical ap-plication of the intelligent VTE prevention and treatment system,the bleeding risk assessment rate in-creased from 26.20％at the initial system launch in January 2023 to 83.04％by the end of 2023.In January 2023,the implementation rates of mechanical prevention,pharmacological prevention,and combined prevention for medium-to-high-risk VTE patients were 21.39％,16.39％,and 5.26％,re-spectively,which increased to 51.75％,25.50％,and 25.65％in December 2023.Conclusion The VTE prevention and treatment software system developed by grassroots hospitals can improve devel-opment efficiency,enhance the clinical practicality of the system,reduce the workload of medical staff,promote standardization and normalization in VTE prevention and treatment,strengthen closed-loop management of medical quality for VTE as a single disease,and effectively improve the preven-tion and treatment capabilities and levels of VTE within hospitals.

Objective To explore the construction and practice of an intelligent prevention and treatment system for venous thromboembolism(VTE)in grassroots hospitals.Methods Based on rel-evant guidelines and expert consensuses on VTE prevention and treatment,domestic and foreign litera-ture was reviewed.A research and development team composed of clinical experts in VTE prevention and treatment,medical and nursing quality management experts,and information engineers conducted investigations and research in surrounding grassroots hospitals.Through evidence-based research and surveys,the team identified relevant business needs,user needs,and functional requirements of grass-roots hospitals,and finally formulated a detailed design plan.The main program of system was written in Java.The interface obtained data from the hospital's data platform through Webservice and view in-terfaces.To prevent issues of repeated data extraction when multiple applications perform time tasks to assess the same patient during later server usage and expansion,the XXL-JOB distributed task schedu-ling platform was adopted to handle VTE assessments by medical staff.Results After the clinical ap-plication of the intelligent VTE prevention and treatment system,the bleeding risk assessment rate in-creased from 26.20％at the initial system launch in January 2023 to 83.04％by the end of 2023.In January 2023,the implementation rates of mechanical prevention,pharmacological prevention,and combined prevention for medium-to-high-risk VTE patients were 21.39％,16.39％,and 5.26％,re-spectively,which increased to 51.75％,25.50％,and 25.65％in December 2023.Conclusion The VTE prevention and treatment software system developed by grassroots hospitals can improve devel-opment efficiency,enhance the clinical practicality of the system,reduce the workload of medical staff,promote standardization and normalization in VTE prevention and treatment,strengthen closed-loop management of medical quality for VTE as a single disease,and effectively improve the preven-tion and treatment capabilities and levels of VTE within hospitals.

Objective:To detect the serum levels of SARS-CoV-2-specific IgM and IgG antibodies in patients infected with SARS-CoV-2 and recipients of inactivated vaccine in different periods for understanding their variation patterns in vivo. Methods:Chemiluminescence immunoassay was used to detect the levels of SARS-CoV-2-specific IgM and IgG antibodies in 144 serum samples of 44 COVID-19 patients, 381 serum samples of 118 asymptomatic infected cases and 398 serum samples of 273 inactivated vaccine recipients collected at different periods. The results were statistically analyzed together with basic characteristics and vaccination status.Results:The positive rates of IgM antibody in COVID-19 patients, asymptomatic infected cases and inactivated vaccine recipients were 52.27% (23/44), 23.73% (28/118) and 14.29% (39/273). The positive rate of IgM antibody was higher in COVID-19 patients than in asymptomatic infected cases and vaccine recipients (χ 2=12.106, P=0.001; χ 2=34.755, P<0.001). The positive rates of IgG antibody in the three populations were 100.00% (44/44), 97.46% (115/118) and 98.81% (166/168), and the differences were not statistically significant (χ 2=2.944, P=0.229). In COVID-19 patients, the concentration of IgM antibody in <40 years old group was lower than that in ≥40 years old group (Waldχ 2=6.609, P=0.010), and the concentration of IgG antibody in patients with vaccination was higher than that in patients without vaccination (Waldχ 2=12.402, P<0.001). In asymptomatic infected cases, the concentration of IgG antibody was higher in people with vaccination than in those without vaccination (Waldχ 2=4.530, P=0.033). In SARS-CoV-2 vaccine recipients, the concentration of IgG antibody in <40 years old group was higher than that in ≥40 years old group (Waldχ 2=9.565, P=0.002). Dynamic analysis of antibody levels showed that from week 1 to week 9, the concentrations of IgM and IgG antibodies in COVID-19 patients were higher than those in asymptomatic infected cases and vaccine recipients. Conclusions:The concentrations of IgM and IgG antibodies in COVID-19 patients were higher than those in asymptomatic infected cases and inactivated vaccine recipients. COVID-19 patients aged ≥40 years had higher level of IgM antibody. COVID-19 patients and asymptomatic infected cases who had received vaccination had higher concentration of IgG antibody. Inactivated vaccine showed good immunogenicity after whole course of immunization, and the IgG antibody level in <40 years old group was higher.

Objective:To construct and validate a predictive model for the risk of excessive blood loss in pa-tients with ruptured tubal pregnancy,and to provide a basis and tool for the assessment of changes in the condi-tion of patients with ruptured tubal pregnancy.Methods:Clinical data of inpatients with ruptured tubal pregnancy from January 2014 to July 2021 were retrospectively analyzed,who underwent surgical treatment in the Depart-ment of Gynecology,Dongguan Maternal and Child Health Hospital.The pelvic blood volume was categorized into excessive blood loss and non-excessive blood loss groups based on whether the amount of pelvic blood was found to be≥750 ml intraoperatively.Factors influencing the occurrence of excessive blood loss were screened and modeled by univariate analysis,Lasso regression,and multi-factor Logistic stepwise regression.The area un-der the subject working characteristic curve(AUC)was used to evaluate the discrimination of the predictive mod-el,the model's consistency was evaluated by calibration curve and goodness-of-fit test,and the clinical utility of the model was evaluated and validated by the decision analysis curve.Finally,column line plots were drawn.Results:①A total of 386 patients with ruptured tubal pregnancy were included,of whom 124(32.12%)had blood loss≥750 ml.②The optimal predictors for predicting concomitant blood loss in patients with ruptured tubal preg-nancy were screened,including:days of abdominal pain,dizziness,pallor,fatigue,the maximum diameter of para-metrial mass,human chorionic gonadotropin(β-hCG),and hemoglobin(Hb)and the model and the column line graphswere constructed accordingly.③The prediction model AUC was 0.827(95%CI 0.781-0.873);the cut-off value was 0.391,at which point the specificity and sensitivity were 68.55%and 84.35%,respectively,and the AUC validated within the model by resampling was 0.804.Clinical decision curves showed that the threshold probability intervals for the maximum net benefit values ranged from 8.5%-97%,respectively.Conclusions:The constructed prediction model was validated to suggest good discriminatory efficacy and degree of consistency.As a tool,it has clinical application value in predicting the risk of hemorrhage in patients with ruptured tubal pregnan-cy.It can help to determine the occurrence of adverse events such as hemorrhagic shock at an early stage and improve the success rate of rescue treatment.