Objective To establish a quality indicator system of interventional nursing.Methods Taking Donabedian quality structure model as the theoretical basis and through literature analysis,expert meeting and summarizing the clinical problems,the first draft about interventional nursing care quality indicators was composed,which included 3 first-level indicators,12 second-level indicators and 55 third-level indicators.A total of 27 experts on interventional nursing and nursing administration were selected from 25 grade-3A level hospitals in 13 provinces and cities of China.The Delphi method was used to conduct two rounds of expert correspondence consultation,and the quality indicator system of interventional nursing was established.Results Finally,a quality indicator system of interventional nursing,which included 3 first-level indicators,7 second-level indicators and 29 third-level indicators,was formulated.In both the two rounds of expert letter inquiry,the positive coefficient and authority coefficient were 100％and 0.95 respectively.The coefficient of variation of each index in the first and the second round of expert letter inquiry was 0-0.25 and 0-0.21 respectively.In the first round of expert letter inquiry,the Kendall harmony coefficients of the first-level,second-level and third-level indexes were 0.672,0.271 and 0.341 respectively,while in the second round of expert letter inquiry,the Kendall harmony coefficients of the first-level,second-level and third-level indexes were 0.462,0.475 and 0.330 respectively,the differences were statistically significant(all P＜0.01).Conclusion The quality indicator system of interventional nursing established in this study carries a relatively high reliability and scientific nature,and it can provide reference for evaluating and monitoring the safety and quality control in interventional nursing.

Objective To explore the effect of virtual reality(VR)technology on relieving intraoperative pain in patients receiving transcatheter hepatic artery chemoembolization(TACE).Methods A total of 76 patients,who received TACE from June 2023 to January 2024,were enrolled in this study.Using random number table method,the patients were divided into control group(n=38)and study group(n=38).Intraoperative routine nursing was carried out for the patients of the control group,while on the basis of routine nursing additional VR technology was adopted to relieve the intraoperative pain for the patients of the study group.The degree of intraoperative pain,anxiety symptoms,incidence of intraoperative adverse reactions and patient satisfaction with nursing were compared between the two groups.Results The degree of intraoperative pain in the study group was lower than that in the control group,but the difference between the two groups was not statistically significant(P＞0.05).The analgesic effect of VR was much obvious in patients aged≤55 years and in patients with vascular invasion of liver cancer(P＜0.05).The anxiety score in the study group was lower than that in the control group,the patient satisfaction score in the study group was higher than that in the control group,and the differences between the two groups were statistically significant(both P＜0.05).No statistically significant difference in the incidence of adverse reactions existed between the two groups(P＞0.05).Conclusion Immersive VR technology can effectively reduce the degree of intraoperative pain in patients receiving TACE,especially in patients aged ≤55 years.Besides,VR technology can also reduce the anxiety degree of patients,and improve the degree of intraoperative patient satisfaction with nursing.

Background The benchmark dose (BMD) method calculates the dose associated with a specific change in response based on a specific dose-response relationship. Compared with the traditional no observed adverse effect level (NOAEL) method, the BMD method has many advantages, and the 95% lower confidence limit of benchmark dose lower limit (BMDL) is recommended to replace NOAEL in deriving biological exposure limits. No authority has yet published any health-based guideline for rare earth elements. Objective To evaluate genotoxicity threshold induced by acute exposure to neodymium nitrate in mice using BMD modeling through micronucleus test and comet assay. Methods SPF grade mice (n=90) were randomly divided into nine groups, including seven neodymium nitrate exposure groups, one control group (distilled water), and one positive control group (200 mg·kg⁻¹ ethyl methanesulfonate), 10 mice in each group, half male and half female. The seven dose groups were fed by gavage with different concentrations of neodymium nitrate solution (male: 14, 27, 39, 55, 77, 109, and 219 mg·kg⁻¹; female: 24, 49, 69, 97, 138, 195, and 389 mg·kg⁻¹) twice at an interval of 21 h. Three hours after the last exposure, the animals were neutralized by cervical dislocation. The bone marrow of mice femur was taken to calculate the micronucleus rate of bone marrow cells, and the liver and stomach were taken for comet test. Results The best fitting models for the increase of polychromatophil micronucleus rate in bone marrow of female and male mice induced by neodymium nitrate were the exponential 4 model and the hill model, respectively. The BMD and the BMDL of female mice were calculated to be 31.37 mg·kg⁻¹ and 21.90 mg·kg⁻¹, and those of male mice were calculated to be 58.62 mg·kg⁻¹ and 54.31 mg·kg⁻¹, respectively. The best fitting models for DNA damage induced by neodymium nitrate in female and male mouse hepatocytes were the exponential 5 model and the exponential 4 model, respectively, and the calculated BMD and BMDL were 27.15 mg·kg⁻¹ and 11.99 mg·kg⁻¹ for female mice, and 16.28 mg·kg⁻¹ and 10.47 mg·kg⁻¹ for male mice, respectively. The hill model was the best fitting model for DNA damage of gastric adenocytes in both female and male mice, and the calculated BMD and BMDL were 36.73 mg·kg⁻¹ and 19.92 mg·kg⁻¹ for female mice, and 24.74 mg·kg⁻¹ and 14.08 mg·kg⁻¹ for male mice, respectively. Conclusion Taken the micronucleus rate of bone marrow cells, DNA damage of liver cells and gastric gland cells as the end points of genotoxicity, the BMDL of neodymium nitrate is 10.47 mg·kg⁻¹, which can be used as the threshold of genotoxic effects induced by acute exposure to neodymium nitrate in mice.

Background The respiratory toxicity of inhaled polyhexamethylene guanidine (PHMG) has been extensively studied since the humidifier disinfectant incident. However, the impacts of inhalation of PHMG on the immune system are not comprehensively studied yet. Objective To explore the effects of inhalation of PHMG disinfectant aerosol on major immune organs and immune cells in mice. Methods Thirty male C57BL/6J mice (6-8 weeks old) were randomly divided into three groups: control, low-dose (0.1 mg·m⁻³ PHMG), and high-dose (1.0 mg·m⁻³ PHMG), with ten mice in each group. The mice were administered by oral-nasal inhalation of PHMG aerosol for 4 h per day, 5 d per week for 4 weeks consecutively. After designed treatment, venous blood was collected from the inner canthus of the eyes of mice and peripheral hematological indicators were measured with a blood analyzer. Then the mice were sacrificed by cervical dislocation and the lung, thymus, spleen, and femur were isolated. Lung, thymus, and spleen were weighed and organ coefficients were calculated, and single cell suspensions of thymus, spleen, and bone marrow were prepared to analyze lymphocytes phenotypes and proportions by flow cytometry. Results The body weight of mice in the high-dose group was lower than that of mice in the control group (P<0.01) from the 7th day of inhalation, and decreased by 15.74% compared with that of mice in the control group at the end of inhalation (P<0.01). The lung coefficients of both the low-dose and high-dose groups were higher than that of the control group (P<0.01), the thymus coefficient of mice in the high-dose group was lower than that of the control group (P<0.05), but the spleen coefficient did not change significantly (P>0.05). Leukocyte count [(1.49±0.22)×10⁹·L⁻¹], lymphocyte count [(0.96±0.36)×10⁹·L⁻¹] and its proportion [(63.13±14.96)%] in the peripheral blood of mice in the high-dose group were lower than those in the control group [(2.69±0.25)×10⁹·L⁻¹, (2.33±0.28)×10⁹·L⁻¹, and (86.23±3.40)%, respectively] (P<0.01), whereas red blood cell count [(12.32±0.46)×10¹²·L⁻¹], hemoglobin count [(175.25±4.65) g·L⁻¹], and hematocrit [(53.55±0.70)%] in the peripheral blood of mice in the high-dose group were higher than those in the control group [(11.11±0.37)×10¹²·L⁻¹, (160.67±4.04) g·L⁻¹, and (45.10±9.75)%, respectively] (P<0.05). Compared with the control group, the proportion of CD4+ CD8+ double-positive T cells decreased (P<0.05), the proportions of CD4+ T cells and CD8+ T cells increased (P<0.05), and the amounts of CD8+, CD4+ CD8+, CD4+, and CD4- CD8- cells decreased (P<0.05) in the thymus of mice of the high-dose group, the proportion of CD4+ T cells in the spleen of the high-dose group increased (P<0.05), the proportions and amounts of T cells, CD4+ T cells, and CD8+ T cells in the bone marrow of the high-dose group increased (P<0.05). Conclusion Inhalation of PHMG may cause thymic atrophy, disrupt T-lymphocyte development, and lead to an imbalance in the number of immune cells in the bone marrow, peripheral blood, and spleen, suggesting that inhalation of PHMG induces immune dysfunction.

Polyhexamethyl guanidine (PHMG) is a widely used guanidine disinfectant. Since a lung injury incident induced by humidifier disinfectant (PHMG was identified as a main component) was reported in Korea, its inhalation toxicity has attracted the attention of researchers. At present, there are few domestic studies on inhalation toxicity of PHMG. In this paper, based on the domestic and foreign studies of PHMG, the toxicities of PHMG, including inhalation toxicity and associated toxic mechanism, and other potential toxicities, such as liver toxicities, cardiovascular toxicity, immunotoxicity, and reproductive and developmental toxicity, were systematically introduced, revealing that the effects of use of PHMG in a non-standard manner on the body and its possible mechanisms, which could provide reference for the use of PHMG properly and to lay a theoretical foundation and provide a scientific basis for follow-up study.

Objective To explore the imaging biomarker for early diagnosis and disease course monitoring of Parkinson disease (PD) in arterial spin labeling (ASL) technique. Methods Between July, 2014 and May, 2017, 23 patients with PD underwent magnetic resonance imaging (MRI) and ASL examinations in our hospital, including 13 in the early stage and 10 in advanced stages. Voxel-based analysis (VBA) was used to observe the regional cerebral blood flow (rCBF) characteristics in PD patients in different stages and three-dimensional continuous arterial spin labeling (3D CASL) was used to analyze the mean cerebral blood flow (mCBF). Results No significant difference was found in mCBF among PD patients in the early stage, patients in advanced stages and normal control subjects (P=0.30). Compared with the normal control group, the patients with early-stage PD had decreased rCBF in resting state mainly in the right superior occipital gyrus and the right superior frontal gyrus as revealed by VBA (P<0.001);the patients with advanced PD showed decreased rCBF mainly in the left precentral gyrus and the postcentral gyrus (P<0.001). The patients with advanced PD exhibited lowered rCBF in the right substantia nigra and the bilateral corpus callosum as compared with the early-stage patients (P<0.001). Conclusions VBA of ASL reveals rCBF alterations in association with the disease progression in PD patients, suggesting that this technique might provide assistance in identification of potential markers for early PD diagnosis and for monitoring the disease course.

Objective To explore the imaging biomarker for early diagnosis and disease course monitoring of Parkinson disease (PD) in arterial spin labeling (ASL) technique. Methods Between July, 2014 and May, 2017, 23 patients with PD underwent magnetic resonance imaging (MRI) and ASL examinations in our hospital, including 13 in the early stage and 10 in advanced stages. Voxel-based analysis (VBA) was used to observe the regional cerebral blood flow (rCBF) characteristics in PD patients in different stages and three-dimensional continuous arterial spin labeling (3D CASL) was used to analyze the mean cerebral blood flow (mCBF). Results No significant difference was found in mCBF among PD patients in the early stage, patients in advanced stages and normal control subjects (P=0.30). Compared with the normal control group, the patients with early-stage PD had decreased rCBF in resting state mainly in the right superior occipital gyrus and the right superior frontal gyrus as revealed by VBA (P<0.001);the patients with advanced PD showed decreased rCBF mainly in the left precentral gyrus and the postcentral gyrus (P<0.001). The patients with advanced PD exhibited lowered rCBF in the right substantia nigra and the bilateral corpus callosum as compared with the early-stage patients (P<0.001). Conclusions VBA of ASL reveals rCBF alterations in association with the disease progression in PD patients, suggesting that this technique might provide assistance in identification of potential markers for early PD diagnosis and for monitoring the disease course.

Objective: To analyze the differences between the social support for breast cancer patients and healthy female, and to explore the correlation between social support and quality of life (QOL) in the patients. Methods: From January 2013 to December 2014, 101 patients with operable breast cancer treated at Xinyu City People′s Hospital were recruited as the experimental group. They completed questionnaires in the preoperative, postoperative chemoradiotherapy and rehabilitation periods, respectively.101 healthy female volunteers recruited from the community were included as control group, whose age and level of education were matched with those of the experimental group.The general questionnaire including basic information, disease conditions and other projects, perceived social support scale (PSSS), quality of life of breast cancer patients (FACT-B) were applied to evaluate the general situation, social support and QOL of the subjects. The differences in PSSS scores between the experimental and control groups were compared. The correlation between PSSS score and FACT-B score in the experimental group was analyzed. SPSS 18.0 software was used for statistical analysis. Results: The general situations of the experimental and control groups were comparable (all P>0.05). The rates of the total social support score ≥50 in the experimental and control groups were not significantly different (93.6% vs. 94.7%, P=0.067). Compared with that of the control group (23.2±4.8), the scores of family support in the experimental group in preoperative, postoperative chemoradiotherapy and rehabilitation periods were statistically higher (25.6±3.2, 24.2±4.2 and 24.0±3.4, respectively, P=0.034). The social support scores of patients with different demographic characteristics were different. Among the demographic characteristics, years of education and place of residence had the largest impact. The scores of social support in patients with longer education years and living in the urban area were higher than those with shorter education years and living in the rural areas (P<0.001). The scores of QOL among preoperative, postoperative chemoradiotherapy and rehabilitation periods in the experimental group were significantly different (all P<0.05). The patients gained the highest score of QOL in the preoperative period (110.7±5.1) and the lowest in the postoperative chemoradiotherapy period (95.3±18.1). The QOL of patients in the experimental group in preoperative, postoperative chemoradiotherapy and rehabilitation periods were all positively correlated with the overall social support (all P<0.01). Conclusions The QOL of breast cancer patients at different periods of treatment is positively correlated with the social support. The quality of life can be enhanced by improving the social support for the patients.

BACKGROUND:Vacuum sealing drainage is currently considered as a safe and effective for fasciotomy wounds in the treatment of compartment syndrome. But the wounds after treatment are often not self-closed, which needs skin grafts that can cause secondary injury. Studies have shown that shoelaces technology is useful for leg fasciotomy wounds in the surgical treatment of lower leg compartment syndrome, but so far there are few domestic reports. OBJECTIVE:To compare the vacuum sealing drainage and shoelace technique for treatment of leg fasciotomy wounds. METHODS:A total of 36 patients, with 46 leg fasciotomy wounds, were randomized into vacuum sealing drainage and shoelace technique groups, 23 wounds in each group. In the vacuum sealing drainage group, patients were subjected to vacuum sealing drainage after fasciotomy based on fracture reduction and external fixation;in the shoelace technique group, the fasciotomy wounds were covered with polyethylene/ethanol hydrated seaweed salt foam fol owed by shoelace technique. After 1 month, wound size, wound closure time, infection, further intervention and daily treatment cost were compared between the two groups. RESULTS AND CONCLUSION: Wound closure time was significantly higher in the vacuum sealing drainage group compared to the shoelace technique group (P < 0.05). Eight wounds in the vacuum sealing drainage group required skin grafts; while, no skin graft was necessary in the shoelace technique group. In the shoelace technique group, the vessel loops had to be replaced in five wounds. There was no wound infection, increased compartment pressure and skin flap necrosis postoperatively in both two groups. Both vacuum sealing drainage and the shoelace technique are safe, reliable and effective methods for closure of leg fasciotomy wounds. Vacuum sealing drainage requires longer time to definite wound closure and is far more expensive than the shoelace technique, especially when additional skin grafting is required.

Objective To explore Chongqing migrant workers Suiqian children′s mental health status and related factors .Meth-ods In this study 740 children from grade 7 to grade 9 in 3 schools which specify recruit migrant workers′children ,including the 399 migration children of migrant workers and 341 urban household registration students were involved .They were investigated with symptom rating scale(SCL-90) and self-made general questionnaire .Results There were no significant differences in SCL-90 scores between the migrant workers migration children group and urban household registration students group (P>0 .05) .Conclu-sion Generally speaking ,Chongqing migrant workers Suiqian children′s mental health status is good ,but there are still some prob-lems .We need do some further study on the mode of psychological intervention to maintain their physical and mental health .