Objective:To observe the therapeutic effect and toxicity of local Kanseran injection in combination with chemotherapy in advanced NSCLC patients.Methods:A total of 18 cases was recruited in this study. After desensitization,Kanseran injection was injected into tumor mass through fibrobronchoscope,2 mg every time,once per week. Meanwhile,MVP regimen was administered.Results:Of the 18 patients,1 was completely relieved,7 cases were partially relieved. The response rate was 44.4%. After treatment,when examined by fibrobronchoscope the tumor masses of 15 patients became smaller. The main side effects were fever,alopecia and gastrointestinal reaction,which were mild and tolerable.Conclusion:Local Kanseran injection into tumor mass in conjunction with chemotherapy is effective and safe in the treatment of advanced NSCLC patients with bronchus obstruction.

Objective To explore clinical characteristics and prognostic risk factors in patients with community ac-quired pneumonia(CAP)complicated with acute kidney injury(AKI).Methods In total, 456 CAP patients were included based on the diagnostic guide.According to whether the patients were accompanied with AKI,the patients were divided in-to two groups(non-AKI group and AKI group). AKI group were further divided into risk group, injury group and failure group by RIFLE criteria using admission creatinine.Severity in CAP patients,clinical indexes and prognostic evaluation in-dexes were compared between different groups. Multiple factors were analyzed using Logistic regression model,survival analysis were examined by Kaplan-Meier, which analyzed the risk factors of poor prognosis in CAP patients and the role of RIFLE criteria in prognostic evaluation. Results Thirty percent(135)of the total 456 CAP patients were accompanied with AKI. Patients in AKI group were further divided into risked group (45.2%, 61 patients), injury group (17%, 23 pa-tients) and failure group (37.8%, 51 patients) according to the RIFLE diagnostic criteria using basal creatinine level. Among the 300 patients with PSI gradeⅠtoⅢ,23.3%(70)of patients developed AKI while among 156 patients who are with PSI gradeⅣor over, 65 patients (41.7%) developed AKI(P<0.01).The 30-day mortality of CAP patients accompanied with AKI were increased compared to Non-AKI group(Non-AKI:6.2%;Risk:14.8%;Injury:21.7%;Failure:45.1%).With de-teriorating in RIFLE criteria,the portion of patients who required mechanical ventilation, inotropic support(MV/IS)and re-nal replacement therapy(RRT)increased too. Logistic analysis revealed that AKI,age of 75 years or older and extra-renal or-gan failure were the risk factors of poor prognosis in patients with CAP. The rate of survivors was decreased in the CAP pa-tients accompanied with AKI compared with those who did not.Conclusion There is certain incidence of AKI to compli-cate CAP patients who will have a poor prognosis.RIFLE diagnostic criteria is a valuable tool to evaluate prognosis of CAP patients complicated with AKI.

Groups of mice were administered intragastrically either with primaquine alone or in combination with pyronaridine. The number of mice died in groups treated by pyronaridine 293-507 mg/kg combined with primaquine 50 mg/kg were not more than those in group by primaquine alone, but significantly less than those in groups by combination of chloroquine 102-253 mg/kg and primaquine. The tests of primary tissue schizontocidal activity in rhesus monkeys inoculated, with Pladmodium cynomolgi sporozoitcs showed that all monkeys were cured either by treatment of ig primaquine alone, 3 mg/kg/d ? 3, or by a single im dose of pyronaridine 10 mg/kg combined with primaquine starting on the day of infection. No influence of pyronaridine on primaquine was observed in P. yoelii sporozoites-infected mice.

Objective To understand the status of implementation of invasive ventilator circuit changes in ICU nurses at the 3A general hospitals in Shanxi Province, and mastering and demand of related knowledge of ICU nurses, and by this discuss the possible causes of execution inconsistency in invasive ventilator circuit changes interval so as to provide a clear basis for the specification and circuit changes. Methods After a review of relevant literature at home and abroad as well as expert consultation, a self-designed questionnaire was established, take two ways of on-site issuance and mailing, ICU nurses from 13 hospitals were selected randomly to investigate about the invasive circuit changes interval in Shanxi Province. Results A total of 724 nurses from 34 ICU of 13 hospitals were surveyed. A unified circuit changes interval of ICU accounted for 73.5% (527/717). ICU nurses currently provisions and practical implementation of invasive ventilator circuit changes interval tend to 7 d. Different ICU provisions and ICU nurses actual implementation of circuit change were significantly different (χ2=24.839, 35.760, P < 0.01). Conclusions Hospitals should choose the right way to strengthen the ICU nurses invasive ventilator circuit changes training interval and knowledge, to develop the term for their own security environment, thereby reduce the workload of nurses, reduce medical costs and improve care service quality.

Objective To explore the true experience of patients living with end-stage heart failure Methods The phenomenological methodology was used in the study.Eleven inpatients with end-stage heart failure were treated with semi-structured interviews and recorded live. Colaizzi method was used for data analysis with Nvivo11.0. Results Four themes were extracted:perceivestressful heart failuresymptoms; complex psychological experience, both negative and positive response coexist;perceive insufficient medical system support;ambivalent attitude toward death. Conclusion Health care providers should pay attention to the physical and psychological feelings of patients with end-stage heart failure, take targeted interventions to alleviate their suffering, provide palliative care while providing heart failure management to patients, and attach importance to communication with patients to help them recognize death correctly. At the same time, we should promote the development of grass-roots health institutions and provide patients with more convenient and adequate medical resources.

Objective To investigate the status quo of hope level as well as the relationship between the hope level and social support in patients with chronic heart failure (CHF). Method A total of 120 CHF patients were surveyed by Herth hope index (HHI) and social support rating scale (SSRS). Results The overall HHI score and SSRS were (30.2±4.2) and (38.4±6.2), respectively. Both were at a medium level. The general score of HHI was positively related to general SSRS (r=0.527, P＜0.01). Conclusions Both of HHI and SSRS of patients with CHF are at moderate level. The patients with higher level of social support have better hope level. Nurses should take pertinent interventions to improve the social support of CHF, helping them to improve their hope and respond to diseases effectively.

Enteral nutrition plays an irreplaceable role in the nutritional treatment of critically ill patients. In order to help clinical medical staff to manage the common complications during the implementations of enteral nutrition for critically ill patients, the consensus writing team carried out literature retrieval, literature quality evaluation, evidence synthesis. Several topics such as diarrhea, aspiration, high gastric residual volume, abdominal distension, etc. were assessed by evidence-based methodology and Delphi method. After two rounds of expert investigations, Expert consensus on prevention and management of enteral nutrition therapy complications for critically ill patients in China (2021 edition) developed, and provided guidance for clinical medical staff.

Objective? To investigate the dietary sodium intake level of patients with heart failure and analyze its influencing factors, so as to provide reference for formulating dietary intervention strategies for patients with heart failure. Methods? From July 2018 to April 2019, 153 patients with heart failure in the First Affiliated Hospital of Nanjing Medical University were selected as the subject by convenient sampling. The General Questionnaire and Dietary Sodium Restriction Questionnaire(DSRQ) were collected, and 24-hour urine sodium determination was used to assess the patient's dietary sodium intake level. Results? A total of 155 questionnaires were distributed and 153 questionnaires were returned. The average dietary sodium intake of 153 patients with heart failure was (3 725.39±1 741.84) mg/d. The dietary sodium intake of 24 patients was within the recommended range (2 000-3 000 mg/d), accounting for 15.7%(24/153). The total score of the DSRQ was (54.83±9.15), and the scores of attitude and subjective normative dimension, cognitive dimension and perceptual behavior control were (23.24±3.15), (11.77±2.08), and (19.82±6.13), respectively.Univariate analysis showed different genders, tastes, dental health status, and whether the dietary sodium intake was different for patients prescribed a low-sodium diet, the differences were statistically significant (P＜ 0.05);correlation analysis showed that appetite score and sodium intake in patients with heart failure was correlated, the difference was statistically significant (r=0.174, P=0.031), and the sodium-stable diet behavioral control score was associated with sodium intake in patients with heart failure (r=-0.329, P＜ 0.001). Multiple linear regression analysis showed that the patient's gender, taste, and patient's perceptual behavioral control of sodium-restricted diet were the main influencing factors of dietary sodium intake in patients with heart failure, explaining 21.5% of the total variation in dietary sodium intake. Conclusions? The dietary sodium intake of patients with heart failure is higher than the recommended amount of the guideline, and the current situation is not optimistic. In particular, health care workers should pay attention to individualized dietary guidance and interventions in men with low salty taste and low sodium-stable dietary behavioral scores to reduce heart failure and readmission rates.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.