Objective:To evaluate and summarize the relevant evidence of comprehensive detumescence treatment of lower limb lymphedema in patients with gynecological malignant tumors, and to provide evidence-based basis for clinical intervention of comprehensive detumescence treatment of lymphedema.Methods:This study was an evidence - based nursing research. Databases such as BMJ Best Practice, UpToDate, PubMed, CNKI, Wanfang and other domestic and foreign databases, as well as websites such as the Australian Lymphology Society, the International Lymphedema, and the European Clinical Oncology Association were searched for relevant evidence and evaluation of comprehensive treatment of gynecological malignant tumor-related lower limb lymphedema. The search time was from the establishment of the database to April 1, 2022.Results:A total of 18 articles were included, including 2 guidelines, 5 systematic reviews, 4 expert consensus, 2 evidence summaries, 4 randomized controlled trials and 1 best practice. Twenty-eight evidence were summarized from 7 aspects : treatment cycle and edema stage, free-hand lymphatic drainage, graduated compression stockings, skin care, elastic socks, functional exercise and health education.Conclusions:The evidence summarized in this study can provide reference for clinical medical staff to formulate comprehensive treatment plans for lower limb lymphedema. Evidence-based practice should consider the individual status of patients and clinical scenarios, and provide personalized comprehensive treatment plans for patients with lower limb lymphedema of gynecological malignant tumors as soon as possible to improve the quality of life of patients.

Objective:To retrieve, obtain and summarize the best evidence for the prevention of recurrence in patients with diabetic foot, and to provide reference for clinical practice.Methods:According to the "6S" model of evidence-based resources, JBI, UpToDate, BMJ Best Practice, Cochrane Library, International Working Group on the Diabetic Foot, International Diabetes Federation, National Istitute for Health and Clinical Excellence, PubMed, EmBase, China National Knowledge Internet, Wanfang and China Biology Medicine disc were searched by computer for the prevention of recurrence of diabetic foot patients. The retrieval time limit was from the establishment of the database to April 2022. Two researchers independently evaluated the included literature and extracted the literature that met the quality standards.Results:Totally 12 articles were included at last, including 5 guidelines, 3 expert consensus and 4 Meta-analysis. From the six dimensions of the necessity and risk factors of recurrence prevention in diabetic foot patients, decompression brace prevention, surgery and wound management prevention, nutritional therapy prevention, health education and lifestyle prevention, monitoring and analysis, 18 pieces of best evidence were summarized.Conclusions:The best evidence for the prevention of recurrence of diabetic foot patients was summarized to provide evidence-based basis for management decision makers and decision implementers to prevent recurrence of diabetic foot. In the process of practice, medical workers should also fully evaluate the promoting factors and hindering factors in order to ensure that evidence can be better applied to clinical practice and serve patients.

Objective:To explore the clinical effect of digital endoscopic-assisted one-stage rhinoplasty and septoplasty by using subjective and objective methods.Methods:Thirty-two patients with skeletal crooked nose and nasal septum deviated who underwent endoscopic-assisted rhinoplasty and septoplasty were included in this study from January 2015 to January 2020. This study used objective measurements such as 3D digital imaging technology and CT scans, as well as subjective measurements such as Visual Analogue Scale (VAS), Rhinoplasty Outcomes Evaluation (ROE) scale, Nasal Obstruction Symptom Evaluation (NOSE) and Functional Rhinoplasty Outcome Inventory (FROI-17) to evaluate the crooked nose morphology and nasal respiratory function before and after surgery.Results:Compared with preoperatively, postoperative 3D facial imaging results showed that the deviation distance and deviation angle of the crooked nose were significantly improved (both P<0.05), and the long-term effect of the operation was stable. Subjectively, the patient＇s appearance VAS score and ROE score were significantly higher than those before surgery, while the NOSE score and FROI-17 score of nasal congestion symptoms were lower than those before surgery. Conclusions:Endoscope-assisted one-stage rhinoplasty and septoplasty can achieve the purpose of repairing the nose appearance and improving the nasal respiratory function at the same time. Through a combination of subjective and objective evaluations, our study found that this procedure had the advantages of minimally invasive, stable effect and shorter recover time; meanwhile, this procedure has high patients＇ satisfaction and is worthy of clinical promotion.

Objective:To observe the therapeutic effect of quercetin (QUE) on triggering receptor expressed on myeloid cells (TREM-1) activated macrophage inflammation and lipopolysaccharide (LPS) induced acute lung injury (ALI) in mice, and explore its possible mechanism.Methods:In vitro cell experiment: The primary peritoneal macrophages of mice were collected by intraperitoneal injection of 3% calcium mercaptan acetate. The collected cells were divided into blank control group, dimethylsulfoxide (DMSO) vehicle group, TREM-1 agonist group (10 μg/ml), QUE group (10 μmol/L) and TREM-1 agonist + QUE group (cells were pretreated with 10 μmol/L QUE for 30 min before adding agonist). Enzyme linked immunosorbent assay (ELISA) was used to detect the secretion of interleukin (IL)-1β, tumor necrosis factor (TNF)-α and IL-6 in the culture supernatant of primary macrophages; To observe the effect of QUE on LPS-induced TREM-1 protein levels, macrophages were divided into: normal control group, LPS group (100 ng/ml) and LPS+ QUE treatment group [macrophages were pretreated with 10 μmol/L QUE for 2 hours, and then incubated with LPS (100 ng/ml) for 16 hours]. Western blot was used to detect the expression of TREM-1 protein. In animal experiments: 80 male C57BL/6 mice were randomly divided into 4 groups (20 in each group): normal control group, ALI model group, QUE group and QUE treatment group (LPS+ QUE). In the ALI model group, the ALI model was established by intratracheal injection of 5 mg/kg LPS; The mouse ALI model was established by intratracheal injection of LPS 5 mg/kg in the QUE treatment group, and then intraperitoneal injection of 15 mg/kg QUE. The control group was given the same amount of normal saline intratracheal followed by intraperitoneal injection of DMSO, and the QUE group was given the same amount of normal saline intratracheal followed by intraperitoneal injection of 15 mg/kg QUE. Hematoxylin-eosin (HE) staining was used to observe the pathological changes of lung tissue in each group; Inflammatory cells including IL-1β, TNF- α and IL-6 in bronchoalveolar lavage fluid (BLAF) of mice in each group were counted ; The expression of TREM-1 mRNA and protein in lung tissue of mice in each group was detected by real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) and Western blot. Results:In vitro cell experiment: the secretion of IL-1β, TNF-α and IL-6 in the supernatant of primary macrophages in TREM-1 agonist group was higher than those in DMSO vehicle group, while the secretion of IL-1β, TNF-αand IL-6 in the supernatant of primary macrophages in TREM-1 agonist + QUE group were lower than that of TREM-1 agonist group (all P<0.001). The expression of TREM-1 protein in LPS group was higher than that in control group ( P<0.05), while the expression of TREM-1 protein in LPS + QUE group was lower than that in LPS group ( P<0.05). Animal experiments showed that compared with the control group, the ALI model group had higher lung pathological injury score, more total cells, macrophages and neutrophils in BALF and increased TNF-α, IL-6, IL-1β content (all P<0.001). The above indexes in QUE group were lower than those in ALI model group (all P<0.001). The results of qRT-PCR and Western blot showed that compared with the control group, the expression of TREM-1 mRNA and protein in the lung tissue of ALI model group was increased, while the expression of TREM-1 mRNA and protein in the lung tissue of QUE group was lower than that of ALI model group (all P<0.05). Conclusions:Quercetin can inhibit TREM-1 activation, reduce macrophage inflammatory response and LPS induced acute lung injury in mice.

The expert committee is an important force in promoting the scientific,democratic,and standardized decision-making and management of hospitals.At present,although hospitals can establish a categorized expert committee system in accordance with the requirements of the health administrative department,there is still a gap between the role of the expert committee and the original intention of the system design.It is based on the perspec-tive of evaluation standards and normative document requirements for graded hospitals,summarizes and analyzes the main expert committee category system in hospitals,explores the problems,constraints,and improvement sug-gestions for the role of expert committees,in order to better promote scientific,democratic,and standardized deci-sion-making in hospitals.

In recent years, China has issued many laws and regulations on enhancing hospital security order management, and the related system has been gradually improved. However, the management requirements of hospitals are hard to implement. In this way, hospitals have burdened intensive internal pressure to implement the policies, with the dilemma of insufficient external support. Based on the perspective of social co-governance, this study discussed the development of policies related to hospital security order management in China. Also, it summarized the best practices about how to ensure hospitals security order from the aspects of the government, hospitals as well as social organizations. Additionally, it analysed current existing problems, such as the lack of sufficient cooperation of the police-doctor linkage mechanism, the inadequate implementation of technical prevention measures, the delayed mediation and disposal of doctor-patient contradiction, the imperfect of supporting policies and etc.Finally, this paper provided relevant suggestions on long-term mechanism to ensure the security order of hospitals.

Objectives:To investigate the current research status and focus of multi-campus construction and management in public hospitals, and to provide research reference and policy recommendations.Methods:The CNKI and Wanfang databases were searched from the establishment of the databases to October 31, 2020. Literatures of multi-campus construction and management in public hospitals were screened following inclusion and exclusion criteria. Bibliometric analysis was used to analyze the characteristics of the included literatures.Results:A total of 99 articles were included. In 2019, there were 18 articles, which was the most over the years. The number of published literatures has increased significantly since 2014. The most common origin cities of publications were Shanghai, Wuhan and Beijing. Literature research focused on integration, homogeneity, economic operation, cultural construction and development strategy.Conclusions:The development of multi-campus in public hospitals has attracted more and more attention, but it has not yet involved in the research of setting access, functional positioning, construction mode, peacetime and wartime transformation, and it is predicted that it will become a research hotspot in the future.

Public welfare orientation is the core requirement of public hospital reform. A profound understanding of the connotation of public welfare in public hospitals is related to the effectiveness of deepening the reform and implementation of public hospitals guided by public welfare. The author reviewed and sorted out the historical evolution process of public hospital reform guided by public welfare, summarized and condensed the core connotation of public hospital public welfare, including " legal obligations, system concepts, people′s positions, and inclusive goals", and introduced the practice of deepening the public welfare reform of public hospitals based on the connotation of Union Hospital affiliated with Tongji Medical College of Huazhong University of Science and Technology based on this connotation, focusing on " party building, medical technology, health emergency response, improvement of services, salary distribution, economic operation, resource expansion and sinking" .

It is of great significance to construct an information platform for performance appraisal of tertiary public hospitals to realize real-time monitoring and intervention of appraisal indicators, which is conducive to the transmission of responsibility for index optimization to departments and medical groups, and to promote the fine management of hospitals and promote high-quality development.This paper introduced the practice and effect of building a performance appraisal information platform for tertiary public hospitals in four aspects: accurate data filling, timely dynamic monitoring, visual display and safety management since 2022. At the same time, suggestions were put forward for platform optimization from four aspects: data quality control, co-construction and sharing, promotion and application, and system integration, in order to provide reference for other hospitals.

Objective To observe the dynamic changes of cardiac lymphangiogenesis in Doxorubicin(DOX)-induced dilated cardiomyopathy(DCM)model mice,and to study the the protective mechanism of Kuoxin Decoction.Methods The DCM mouse model was established by intraperitoneal injection of DOX,and the dynamic observation was performed every week.On this basis,60 C57BL/6 mice were randomly divided into 6 groups(n=10):control group,Model group,L-KXD,M-KXD and H-KXD groups and Captopril group.After successful modeling,the KXD and the positive control drug Captopril were administered continuously for 28 days.Echocardiography was used to detect cardiac function in mice,HE staining and Masson staining were used to observe pathological and morphological changes of the heart,Whole-mount immunofluorescent staining was used to detect the expression of LYVE-1 and Podoplanin in epicardial lymphatic vessels,Western blot was used to detect the expression of VEGFR-3 protein,and qPCR was used to detect the expression of VEGFR-3 mRNA.Results DCM mice induced by DOX showed significant cardiac function decline from the third week(DOX:15 mg·kg-1,P<0.05),and significant ventricular remodeling at the fifth week(DOX:15 mg·kg-1,P<0.01);The lymphatic vessel area of the mouse heart decreased significantly from the fourth week(DOX:20 mg·kg-1,P<0.0001),and the expression of VEGFR-3 decreased significantly from the third week(DOX:15 mg·kg-1,P<0.01).Conclusion KXD can improve ventricular remodeling and cardiac function in DOX-induced DCM mice,promote cardiac lymphangiogenesis,and upregulate the expression of VEGFR-3 at protein and mRNA levels,with a better effect than captopril.DOX-induced cardiac lymphangiogenesis in DCM mice leads to severe myocardial fibrosis and weakened cardiac function,which gradually worsens with the accumulation of modeling time and dose.KXD can promote cardiac lymphangiogenesis and improve cardiac function in DOX-induced DCM mice.The mechanism may be related to the up-regulation of VEGFR-3 expression.