Objective: To investigate the immune response in patients under persistent vegetative state (PVS) resulting from trauma.Methods: Peripheral blood monocytes were obtained from 12 PVS patients (Group PVS )and individuals in normal control group by density gradient centrifugation;the enzyme linked immunosorbent assay kit was then used to measure monocyte HLA-DR antigen expression on the surface of peripheral blood monocytes before and after monocyte activation with either IFN-γ or LPS.Results: Compared with normal control group, the peripheral blood monocyte HLA-DR antigen expression in the Group PVC fell significantly in PVS patients (P ＜0.001); the level of HLA-DR antigen expression on the monocyte surface rose notably after stimulation with either IFN-γ or LPS (P ＜0.01). As for PVS patients, it was still difficult to restore to normal (P ＜ 0.05).Conclusions: The level of HLA-DR antigen expression on the surface of peripheral blood monocytes in PVS patients decreases obviously. Therefore, the function of non-specific immunity in PVS patients is suppressed.

Audiogenic seizures(AGS)are the result of an epilepsy caused by strong acoustic stimulation and are characterized by generalized muscle spasms.AGS models are vital for studies of epileptogenesis,the search for causative genes and regulatory channels,and the screening of new antiepileptic drugs(AEDs).This paper summarizes the current progress of research on common animal models of AGS in terms of their pathogenetic features,possible pathogenesis,and causative genes to provide new research directions and targets for the development of AEDs.

OBJECTIVE: To assess the relationship between the prognosis of the patients with diffuse traumatic brain swelling (DTBS) and the changes of the ventricles and the cisterns in CT scans. METHODS: The outcome of the patients with DTBS and the changes of the ventricles and the cisterns in CT scans were studied and analyzed in a group of 268 cases. We focused on the changes of the third ventricle and the basal cistern, age and Glasgow Coma Scale (GCS). RESULTS: Of 268 cases, there were changes of the third ventricle and/or the basal cistern in 124, 65 died. In l8 cases, the third ventricle and the basal cistern were both absent and l6 died (88.9%). The third ventricle changed significantly in 59 cases, 33 died (55.9%), while the basal cistern changed in 47 cases and 16 died (34%). Of the 124 patients with changes of the third ventricle and/or the basal cistern, 26 were children, 8 died; 98 adults, 57 died. CONCLUSIONS: For patients with DTBS, the outcome was in direct correlation with the change of the third ventricle and/or the basal cistern, the change of the third ventricle was much more important in assessment of the outcome than that of basal cisterns. There is no significant difference in, the incidence of DTBS between children and adults while the outcome of children is much better than that of adults. The patients with the changes of the third ventricle and the basal cistern accompanied with lower GCS scores have poor outcome.

Objective To investigate the clinical,psychological,and economic impacts of the initial dressing change timing following peripherally inserted central catheter(PICC)placement in postoperative breast cancer patients.Methods We enrolled a total of 120 patients who underwent PICC placement following breast cancer surgery at a tertiary hospital in Guangzhou between April and October 2023 for this study.Based on predefined inclusion and exclusion criteria,the patients were divided into an observation group and a control group,with each group comprising 60 patients.In the observation group,the first dressing change was performed 48 hours after PICC placement,whereas in the control group it was done within 24 hours post-placement.The primary outcomes assessed included pain intensity at the puncture site during the initial dressing change,occurrence of bleeding at the puncture site within one week,psychological state evaluated using validated scales such as PHQ-9 depression scale and GAD-7 anxiety scale,as well as maintenance frequency and associated costs over a three-week period.Results There were no significant differences in baseline characteristics between the two groups.The obser-vation group exhibited significantly lower pain levels at the puncture site during the initial dressing change,reduced bleeding at the puncture site within one week,and a shorter duration of bleeding compared to the control group(P<0.001).Moreover,the observation group demonstrated statistically significant decreases in depression and anxiety scores,as well as maintenance frequency and costs within three weeks post-placement when compared to the control group(P<0.001).Conclusions The implementation of an early dressing change within 48 hours after PICC cath-eterization in breast cancer patients undergoing surgery has been demonstrated to effectively ameliorate hemorrhage and discomfort at the puncture site,consequently mitigating patient distress and anxiety.Moreover,this intervention facilitates a decrease in dressing change frequency while reducing financial burdens on patients.

Objective? To construct the training content for gerontological advanced practice specialty nurses based on advanced practice nurse (APN) core competence. Methods? From January 2017 to February 2018, the frame of gerontological advanced practice specialty nurses core competence and training content was built preliminarily with the methods of literature review and theoretical analysis. The training content for gerontological advanced practice specialty nurses was confirmed finally by the Delphi method involving 18 expert enquiries. Results? After two rounds of expert consultation, the core competence was established finally including 5 primary indicators and 37 secondary indicators. Besides, the core competence training content included 9 primary indicators and 103 secondary indicators. The authoritative coefficients of experts were greater than 0.80, and the P value of Kendall coordination coefficients test of two rounds of expert consultation were less than 0.05. Conclusions? The results of the Delphi expert's consultation are concentrated, the research results are true and reliable with a certain practical significance. It can provide a reference for the training of gerontological advanced practice specialty nurses, but still need to be tested in practice.

Objective:To analyze the influence of work engagement and self-efficacy of nurses on clinical practice ability in burn intensive care unit (BICU), and to explore its potential pathways of action.Methods:A cross-sectional survey was conducted. From May to October 2020, a total of 30 hospitals with BICU in China were selected by stratified sampling method. Among BICU nurses who met the inclusion criteria, their clinical practice ability, work engagement, and self-efficacy were evaluated by self-evaluation scale of oriented problem-solving behavior in nursing practice (OPSN), Utrecht work engagement scale (UWES), and general self-efficacy scale (GSES), respectively. The total scale scores of each index and the average item scores were recorded. The self-designed general data questionnaire was used to investigate the nurses' gender, age, marital status, education background, working years, professional title, and the economic region of the hospital that they belonged to. The total scale scores of the above-mentioned three evaluation indexes were compared after the classification of nurses according to general data, and the data were statistically analyzed with independent sample t test or one-way analysis of variance. Pearson correlation analysis was used to analyze the correlation between the total scale scores of the three evaluation indexes. Based on the total scale scores of the above-mentioned three evaluation indexes, a structural equation model was established, the mediation analysis of the relationship among the three evaluation indexes and the pathway analysis of the structural model were conducted, and the Bootstrap method was used to verify the pathways of action. Results:A total of 401 questionnaires were distributed, and 337 valid questionnaires were returned, with a valid return rate of 84.04%. The total scale scores of clinical practice ability, work engagement, and self-efficacy of 337 nurses were 98.2±11.7, 67.7±18.6, and 26.6±5.6, respectively, and the average item scores were 3.9±0.5, 4.5±1.2, and 2.7±0.6, respectively. Among the 337 nurses, the majority were female, aged 40 or below, married, and had a bachelor's degree with work experience of ≤10 years; both nurses with professional nurse title and nurses from the Southeast region accounted for about 50%. There were statistically significant differences in the total scale score of clinical practice ability among nurses with different ages, education backgrounds, working years, and professional titles (with F values of 3.26, 4.36, 3.12, and 2.80, respectively, P<0.05). There was statistically significant difference in the total scale score of work engagement among nurses with different working years ( F=4.50, P<0.05). There were statistically significant differences in the total scale score of self-efficacy among nurses with different ages, working years, and professional titles (with F values of 4.91, 4.50, and 2.91, respectively, P<0.05). The total scale score of nurses' work engagement was significantly positively correlated with the total scale score of clinical practice ability and the total scale score of self-efficacy (with r values of 0.30 and 0.51, respectively, P<0.05). The total scale score of nurses' self-efficacy was significantly positively correlated with the total scale score of clinical practice ability ( r=0.37, P<0.05). The model had good adaptability, and the intermediary model was established. Nurses' work engagement had a significantly positive effect on both self-efficacy and clinical practice ability (with β values of 0.54 and 0.16, respectively, P<0.05), and nurses' self-efficacy had a significantly positive effect on clinical practice ability ( β=0.29, P<0.05). Work engagement had a direct effect on self-efficacy and clinical practice ability, and self-efficacy had a direct effect on clinical practice ability and played a mediating role between work engagement and clinical practice ability. Bootstrap validation showed that self-efficacy played a significantly mediating role in the influence of work engagement on clinical practice ability (with effect size of 0.16, with 95% confidence interval of 0.08-0.24, P<0.05), accounting for half of the total effect of work engagement on clinical practice ability (with effect size of 0.32). Conclusions:BICU nurses have an above-average level of clinical practice ability, a medium level of self-efficacy, and a high level of work engagement. Work engagement and self-efficacy are positively correlated with clinical practice ability. Work engagement can directly affect clinical practice ability or indirectly affect clinical practice ability through the mediating role of self-efficacy.