Objective: To analyze the trends in incidence and mortality of prostate cancer in Jinhua City, Zhejiang Province from 2016 to 2024, so as to provide the evidence for the improvement of prostate cancer prevention and control measures. Methods: The incidence and mortality data of prostate cancer in Jinhua City from 2016 to 2024 were collected from the Chronic Disease Surveillance Information Management System of Zhejiang Province, and the crude incidence and mortality were calculated. The Chinese Sixth National Population Census in 2010 was used to calculate standardized incidence and mortality. The trends in incidence and mortality of prostate cancer were evaluated using average annual percent change (AAPC). Results: A total of 8 357 cases of prostate cancer were diagnosed in Jinhua City from 2016 to 2024. The crude incidence and standardized incidence were 37.36/100 000 and 21.17/100 000, respectively, showing upward trends (AAPC=16.275%, 12.511%, both P<0.05). There were 1 615 deaths of prostate cancer, and the crude mortality was 7.22/100 000, showing an upward trend (AAPC=5.451%, P<0.05). The standardized mortality was 3.49/105, and the trend showed no statistically significant (P>0.05). There were 28 cases of prostate cancer in individuals under 50 years old, accounting for 0.34%. The crude incidence and crude mortality of patients aged ≥50 years increased with age (both P<0.05). From 2016 to 2024, the crude incidence of prostate cancer in the 50-<60, 60-<70, 70-<80, and ≥80 age groups showed upward trends (AAPC=17.849%, 14.704%, 12.654% and 8.081%, all P<0.05), and the 50-<60 age group increased more quickly. There was no significant change in the crude mortality of prostate cancer among different age groups (all P>0.05). Conclusion From 2016 to 2024, the incidence of prostate cancer in Jinhua City showed an upward trend and had a trend of becoming younger, while the mortality remained relatively stable.

Objective:To establish a risk predictive model nomogram of acute kidney injury (AKI) in critically ill patients by combining urinary tissue inhibitor of metalloproteinase 2 (TIMP2) and insulin-like growth factor-binding protein 7 (IGFBP7), and to verify the predictive value of the model.Methods:A prospective observational study was conducted. The patients with acute respiratory failure or circulatory disorder admitted to the intensive care unit (ICU) of Northern Jiangsu People's Hospital from November 2017 to April 2020 were enrolled. The patients were enrolled within 24 hours of ICU admission, and their general conditions and relevant laboratory test indicators were collected. At the same time, urine was collected to determine the levels of biomarkers TIMP2 and IGFBP7, and TIMP2·IGFBP7 was calculated. Patients were divided into non-AKI and AKI groups according to whether grade 2 or 3 AKI occurred within 12 hours after enrollment. The general clinical data and urinary TIMP2·IGFBP7 levels of patients between the two groups were compared. The indicators with P < 0.1 in univariate analysis were included in the multivariate Logistic regression analysis to obtain the independent risk factors for grade 2 or 3 AKI within 12 hours in critical patients. An AKI risk predictive model nomogram was established, and the application value of the model was evaluated. Results:A total of 206 patients were finally enrolled, of whom 54 (26.2%) developed grade 2 or 3 AKI within 12 hours of enrollment, and 152 (73.8%) did not. Compared with the non-AKI group, the patients in the AKI group had higher body mass index (BMI), pre-enrollment serum creatinine (SCr), urinary TIMP2·IGFBP7 and proportion of using vasoactive drugs, and additional exposure to AKI (use of nephrotoxic drugs before enrollment) was more common. Multivariate Logistic regression analysis showed that BMI [odds ratio ( OR) = 1.23, 95% confidence interval (95% CI) was 1.10-1.37, P = 0.000], pre-enrollment SCr ( OR = 1.01, 95% CI was 1.00-1.02, P = 0.042), use of nephrotoxic drugs ( OR = 2.84, 95% CI was 1.34-6.03, P = 0.007) and urinary TIMP2·IGFBP7 ( OR = 2.19, 95% CI was 1.56-3.08, P = 0.000) was an independent risk factor for the occurrence of grade 2 or 3 AKI in critical patients. An AKI risk predictive model nomogram was constructed based on the independent risk factors of AKI. Bootstrap validation results showed that the model had good discrimination and calibration in internal validation. Receiver operator characteristic curve (ROC curve) analysis showed that the area under the ROC curve (AUC) of urinary TIMP2·IGFBP7 alone in predicting grade 2 or 3 AKI within 12 hours in critical patients was 0.74 (95% CI was 0.66-0.83), the optimal cut-off value was 1.40 (μg/L) 2/1?000 (sensitivity was 66.7%, specificity was 85.0%), and the predictive performance of the model incorporating urinary TIMP2·IGFBP7 was significantly better than that of the model without urinary TIMP2·IGFBP7 [AUC (95% CI): 0.85 (0.79-0.91) vs. 0.77 (0.70-0.84), P = 0.005], net reclassification index (NRI) was 0.29 (95% CI was 0.08-0.50, P = 0.008), integrated discrimination improvement (IDI) was 0.13 (95% CI was 0.07-0.19, P < 0.001). Conclusion:The AKI risk predictive model based on urinary TIMP2·IGFBP7 has high clinical value and is expected to be used to early predict the occurrence of AKI in critically ill 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 application effect of the forgetting curve combined with blended learning in extracorporeal membrane oxygenation (ECMO) nursing training for ICU nurses.Methods:A randomized controlled trial was conducted from June to November 2022. Sixty-three ICU nurses from the First Hospital of Quanzhou City were selected using cluster sampling and divided into an observation group ( n=30) and a control group ( n=33). The control group received traditional teaching methods for training, while the observation group received training using the forgetting curve combined with blended learning. Compared the ECMO theoretical scores and skill operation scores of two groups of nurses after 1 day, 1 month, and 3 months of training; observed the core competencies and training satisfaction of ECMO nurses before and after training in two groups of nurses. Results:In the control group, there were 7 males and 26 females with an average age of (27.88 ± 4.36) years old; in the observation group, there were 6 males and 24 females with an average age of (28.67 ± 4.24) years old.Prior to training, there were no statistically significant differences in theoretical scores, skill operation scores, and core competencies between the two groups (all P>0.05). After 1 day, 1 month, and 3 months of training, the observation group′s ECMO theoretical scores were (80.33 ± 3.11), (78.13 ± 3.70), (76.73 ± 3.30) points respectively, higher than those of the control group which were (75.18 ± 3.30), (73.88 ± 2.75), (70.48 ± 2.96) points, with statistically significant differences ( t=6.36, 5.21, 7.92, all P<0.01); the observation group′s ECMO skill operation scores were (84.10 ± 4.16), (82.73 ± 3.71), (81.50 ± 3.40) points respectively, higher than the control group′s (78.09 ± 4.30), (74.97 ± 4.17), (71.85 ± 4.03) points, with statistically significant differences ( t=5.63, 7.77, 10.22, all P<0.01). There were statistically significant differences between two groups of nurses in terms of ECMO theory score and skill operation score, as well as time and interactive effect after training ( Finteraction=11.16, 84.76, both P<0.05). After training, the observation group′s total score for ECMO nurse core competency was (280.23 ± 9.23) points, superior to the control group′s (245.39 ± 14.90) points, with a statistically significant difference ( t=11.26, P<0.01). The observation group′s satisfaction total score and the scores in various dimensions were (99.17 ± 10.79), (4.43 ± 0.50), (4.30 ± 0.53), (4.57 ± 0.68), (4.37 ± 0.67), (4.23 ± 0.57) points, all higher than those of the control group which were (84.30 ± 12.61), (3.67 ± 0.96), (3.48 ± 0.71), (3.67 ± 0.74), (3.73 ± 0.72), (3.82 ± 0.77) points, with statistically significant differences ( t values were 2.42 to 5.09, all P<0.05). Conclusions:The application of the forgetting curve combined with blended learning in ECMO nursing training for ICU nurses is scientifically feasible. It helps nurses master ECMO theory and skill operations, improve ECMO nurse core competencies, enhance training satisfaction, and provides a new method for ECMO nursing training.

Objective To summarize the clinical characteristics of children with drug-induced hypersensitivity syndrome(DIHS)complicated with herpesvirus reactivation,and to promote the early and accurate identification,diagnosis,and treatment of DIHS in children.Methods The medication history,clinical manifestations,treatment,and prognosis of 12 children confirmed DIHS complicated with herpesvirus reactivation in Guangzhou Women and Children's Medical Center between January 2018 and March 2023 were retrospectively analyzed.The changes in hematological parameters,inflammatory indexes,and hepatic and renal function within 5 d before the eruption,5 d,and 6-10 d after eruption were compared.Results Of the 12 patients,the male-to-female ratio was 5∶1,with a median age of 27(interquartile range 20.50-34.75)months.Two or more antibiotics were used at least two to six weeks before onset,with a combination of 3 or more antibiotics in 7 children,and a combined or sequential application of 2 antibiotics in 5 children.The antibiotics included cephalosporins(n=12),semisynthetic penicillins(n=5),vancomycin(n=4)and azithromycins(n=7).All 12 patients presented fever,rashes,and multiple organ involvement.The rashes were red maculopapules in the early stage and then gradually developed into massive fusion exceeding 50%of the whole body.Among them,seven children were accompanied by facial edema,and two had purplish-red facial rashes.11 children suffered from exfoliative dermatitis in the later stage.12 children presented obviously enlarged lymph nodes.Liver involvement was the most common(100%,simple increase of transaminase in four children,cholestasis in six children,and hepatic failure in two children),and lung involvement was found in nine children.Laboratory examination showed no significant increase in leukocytes or eosinophils within 5 d before the eruption,but low levels of atypical lymphocytes.After the eruption,leukocytes,eosinophils,and atypical lymphocytes increased progressively.Inflammatory indexes of hypersensitive C-reactive protein(CRP),procalcitonin(PCT)increased dramatically before and after the eruption.All the children received intravenous immunoglobulin(IVIG)and methylprednisolone,two children were given antiviral therapy,and nine children were treated with multiple plasma exchanges.After treatment,nine children were cured,one developed immune reconstitution syndrome,and two died of hepatic failure.Conclusions Antibiotics are common allergenic drugs for DIHS in children.Its clinical manifestations include fever and rashes,accompanied by multiple organ involvement,such as the liver and lung.When leukocytes,eosinophils,and atypical lymphocytes are progressively elevated after the eruption,DIHS should be highly suspected,herpesvirus activation should be monitored,medication history should be traced,and early active immunotherapy and antiviral therapy should be conducted if necessary.

Objective To investigate the efficacy and safety of a single induction dose of cyclopofol in painless four-dimensional hysterosalpingography,this study aims to assess its academic significance and adherence to Nature journal's publication standards.Methods A total of 120 patients admitted to Guangdong Reproductive Hospital between February 2022 and December 2022,requiring painless vaginal four-dimensional ultrasound hysterosalpin-gography,were selected as the study population.Random selection was performed with 40 patients in each group.The dosage of cyclopofol administered was 0.3 mg/kg(C1 group),0.5 mg/kg(C2 group),and 0.7 mg/kg(C3 group).Heart rate(HR),mean arterial pressure measured non-invasively using a cuff,time to wake after surgery,and incidence of adverse reactions were observed at three time points:before examination(T1),during contrast agent injection(T2),and after examination(T3).Results There were no significant differences in heart rate(HR)and mean arterial pressure(MAP)between T1 and T3 among the three groups(P>0.05).However,at T2,group C1 exhibited significantly higher HR and MAP compared to group C2(P<0.05),while there was no statistically significant difference in HR and MAP between group C2 and C3 at T2(P>0.05).The duration of wakefulness was shorter in group C2 than in group C3(P<0.05),but there was no statistical significance in wakefulness duration between group C1 and C2(P>0.05).The incidence of adverse reactions was lower in group C2(10.0%)compared to both group C1(32.5%)and group C3(37.5%)with statistical significance(P<0.05).Conclusion The admin-istration of cyclopofol at a dosage of 0.5 mg/kg exhibits notable advantages in painless four-dimensional hysterotubal ultrasonography,including effective sedation,prompt wakefulness,and a low occurrence rate of adverse reactions.

Objective To establish an ultra-performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)method for determination of tobramycin in human serum,and examine the utility of the method in a clinical pharmacokinetic study of tobramycin inhalation.Methods Serum samples were pretreated by solid phase extraction with tobramycin-D12 as internal standard.Chromatographic separation was performed on a TitankHilic(2.1 mm × 100 mm,3 μm)column.The mobile phase consisted of0.1％formic acid-acetonitrile and 0.1％formic acid aqueous solution at a flow rate of 0.4 mL/min.Electrospray ionization source and multiple reaction monitoring(MRM)scanning were used for monitoring the quantitative ion pairs with m/z 468.3→m/z 163.3(tobramycin)and m/z 480.6→m/z 166.2(tobramycin-D12).The established method was investigated in terms of selectivity,interaction,concomitant medication,standard curve and lower limit of quantitation,precision and accuracy,recovery,matrix effect,and stability of tobramycinin.Results The linear range of tobramycin was 0.050 0-10.0 mg/L(R2=0.999 5).The intra-and inter-batch precision was satisfactory(coefficient of variation[CV]≤3.6％).The accuracy ranged from-0.4％to 6.0％.The matrix effect factor(MF)in human serum samples(including hemolysis and lipemia)ranged from 92.2％to 94.9％(CV≤2.7％).The recovery of tobramycinin was 79.5％-81.9％in serum samples,while the recovery of internal standard was 78.9％.The analyte was stable in serum samples for 72 h at room temperature and for 274 days at-20℃/-70℃.The pharmacokinetic study of tobramycin inhalation in bronchiectasis patients showed that after continuous administration of tobramycin 300 mg twice a day to 3 patients,the mean Cmax of tobramycin was(0.72±0.61)mg/L on Day 1 and(0.76±0.73)mg/L on Day 28,respectively.The corresponding Tmax was(1.83±0.61)h and(1.50±0.50)h,respectively.Conclusions The UPLC-MS/MS method established in this study is sensitive,accurate and rapid.It is successfully applied to the clinical pharmacokinetic study of tobramycin inhalation.The method may be suitable for therapeutic drug monitoring of tobramycin in clinical practice.

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.

This article explores the standardized management of colorectal polyps, including classification, treatment, follow-up, and preventive control. Corresponding treatment strategies, including endoscopic resection and surgical intervention, are employed for different types of polyps. Currently, there is debate over whether to choose endoscopic resection or surgical intervention for malignant polyps at pT1 stage. Drawing on the latest literature and guidelines, the article elaborates on polyp classification, treatment modalities, follow-up, and preventive measures. Standardized management of colorectal polyps is important for reducing the incidence of colorectal cancer and improving the cure rate of early-stage colorectal cancer.

ObjectiveTo understand the process and influencing factors affecting the utilization of influenza vaccination services and vaccination decision-making among the elderly in Shanghai, to explore the delivery of influenza vaccination services and the difficulties faced by the health service system, and to provide guidance for optimizing immunization strategies. MethodsBased on the vaccine hesitancy determinants matrix, semi-structured personal interviews were conducted with stakeholders involved in influenza vaccination services in Shanghai from January to February 2024, using a purposive sampling method. Participants were included until thematic saturation was achieved. Interview data were audio-recorded, transcribed, coded, and organized using NVivo 20 software, and analyzed using the thematic framework method. ResultsA total of 25 interviewees were included, including 9 medical staff, 12 elderly people aged 60 and above, and 4 family members. The study found that Shanghai had a well-managed and standardized influenza vaccination service. However, the promotion of vaccine-related information at the grassroots level was passive and limited. Out-of-pocket payment of the vaccine and cultural beliefs of the elderly negatively impacted vaccination rates. Meanwhile, recommendations from family, friends, and medical staff facilitated vaccination, although the impact varied depending on the type of medical staff. Neighborhood committees in townships and streets played a crucial role in delivering vaccination information to the target population. Additionally, the internet, social media, and the COVID-19 vaccine had both positive and negative impacts on influenza vaccination. Strategic optimization of vaccination should prioritize price concessions, enhance publicity strategies, and improve awareness, professionalism, and willingness among medical and healthcare workers to recommend vaccination. ConclusionThe influenza vaccination service in Shanghai is well-managed and standardized. However, it is essential to consider the influence of family and other support systems on the elderly. It is also necessary to enhance the professionalism, service awareness, and willingness to recommend among the medical staff. Furthermore, systematic interventions and publicity efforts should be effectively integrated with social media and the functions of neighborhood committees.