Objective To explore the changes in ability to cope with ethical conflicts in palliative care in neonatal intensive care units(NI CU)before and after ethical sensitivity theory training.Methods A descriptive phenomenological research method was employed.Using purposive sampling,we recruited 16 NICU nurses from a tertiary general comprehensive hospital in the city.After ethical sensitivity theory training between January and March 2025,the nurses participated in a semi-structured interview.Data were analyzed using Colaizzi's seven-step analysis method.Results All participants completed the interview.The data were abstracted to three main themes encompassing eight sub-themes:experiences of ethical conflict dilemmas before ethical sensitivity theory training(conflicts between treatment decision-making and family expectations,trust crises triggered by family cognitive biases),the changes of strategy to cope with ethical conflicts after ethical sensitivity theory training(individualized coping strategies,teamwork and communication,introduction and support of external resources),and the role of ethical sensitivity theory training in enhancing coping ability(improving the ability to identify ethical issues,optimizing the decision-making process,and promoting effective communication).Conclusion Palliative care nurses in the NICU face various ethical conflicts,and ethical sensitivity training can enhance their ability to manage these conflicts.

Objective To investigate the association between polymorphic susceptibility loci for diabetes mellitus and clinical characteristics of type 2 diabetes mellitus(T2DM)in the Han Chinese population in the Qinghai region.Methods A total of 286 T2DM patients treated in Qinghai Provincial People's Hospital from December 2021 to July 2023 were selected as the study subjects.DNA samples were sequenced by Illumina sequencing.LASSO regression model and Kolmogorov-Smirnov(K-S)test were used to analyze the association between SNP and age of onset in T2DM patients.Logistic regression model was used to analyze the association between SNP and DM family history,FPG,HbA1c,HOMA-IR and HOMA-β.Results The age of onset,smoking history,drinking history and WC of male patients were higher than those of female patients(P<0.05),and the HOMA-β,HDL-C,LDL-C and TC were lower than those of female patients(P<0.05).LASSO regression model and K-S test analysis showed that 7 SNPs were associated with the age of onset of T2DM(P<0.05).Logistic regression analysis showed that 13 SNPs were correlated with family history of DM(P<0.05),13 SNPs were correlated with FPG(P<0.05),11 SNPs were correlated with HbA1c(P<0.05),20 SNPs were correlated with HOMA-IR(P<0.05),16 SNPs were associated with HOMA-β(P<0.05).Conclusions In Chinese Han patients with T2DM in Qinghai province,multiple SNPs variants may affect the disease phenotype through different biological pathways,including age of onset,blood glucose index and islet function.

Objective:To investigate the effect of computed tomography (CT)-guided minimally invasive drainage surgery on serum Omentin-1 and human astroglial derived protein (S100B) levels in patients with hypertensive intracerebral hemorrhage. Methods:A total of 120 patients with hypertensive intracerebral hemorrhage who were diagnosed in The First Affiliated Hospital of Harbin Medical University from January 2021 to December 2023 were included as the research subjects. According to the principle of random grouping,these patients were randomly divided into a study group and a control group,with 60 cases in each group. The study group adopted CT-located minimally invasive drainage surgery to conduct treatment,and the control group adopted conventional craniotomy to conduct treatment. The differences of curative effect,neurological function,cerebral edema,serum Omentin-1 and S100B levels between the two groups were compared. Results:In 60 patients of study group,45 cases showed significant improvement (75.00％),and 11 cases showed effective improvement (18.33％),and 4 cases showed invalid (6.67％),with an overall effective rate of 93.33％. In 60 patients of control group,6 cases showed significant improvement (10.00％),and 42 cases showed effective improvement (70.00％),and 12 cases showed invalid (20.00％),with an overall effective rate of 80.00％. The overall effective rate of study group was significantly higher than that of control group,and the difference was statistically significant (x2=4.621,P<0.05). The results of Glasgow Outcome Scale (GOS) scores of study group showed that 0 case was grade 1 (0.00％),and 6 cases were grade 2 (10.00％),and 10 cases were grade 3 (16.67％),and 2 cases were grade 4 (3.33％),and 42 cases were grade 5 (70.00％). At the 6th month after surgery,the GOS scores of control group indicated that 2 cases were grade 1 (3.33％),and 15 cases were grade 2 (25.00％),and 5 cases were grade 3 (8.33％),and 6 cases were grade 4 (10.00％),and 32 cases were grade 5 (53.33％). There was a statistically significant difference in GOS scores between the two groups (U=2.112,P<0.05). Both groups showed significant improvement in brain edema after surgery,and the volumes of brain edema at the 2nd week and the 1st month after surgery in study group were significantly lower than those in control group (t=41.675,29.750,P<0.05),respectively. Both groups obtained significant improvement in serum Omentin-1 and S100B levels,and the serum Omentin-1 and S100B levels after surgery in study group were significantly lower than those in control group,and the differences of them between two groups were significant (t=22.675,10.157,P<0.05),respectively. Conclusion:CT-located minimally invasive drainage surgery can effectively reduce the pressure at hemorrhagic region,and promote clearing hematoma through the precision CT-located guidance for patients with hypertensive intracerebral hemorrhage. At the same time,it can reduce cerebral edema,and relieve damage of brain tissue through regulates serum Omentin-1 and S100B levels. The postoperative recovery of neurological function is remarkable,and the overall treatment outcome is favorable.

OBJECTIVE To evaluate the value of matrix-assisted laser desorption ionization time-of-flight-mass spectrometry(MALDI-TOF MS)in direct identification of carbapenem-resistant Escherichia coli and Klebsiella pneumoniae positive for blood culture.METHODS The blood culture bottles that were positive for E.coli or K.pneumoniae were collected from the patients with bloodstream infection who were treated in Zhongshan Hospi-tal,Fudan University from Jul.2021 to Jun.2023.The isolates were collected by using a gel-contact clotting tube,then the tested strains were respectively mixed with 4 μg/ml of imipenem,4 μg/ml of meropenem and 2 μg/ml of ertapenem for coculture and were incubated at 35 ℃ for 4 and 5 hours,finally,the strains were i-dentified by using the mass spectrum.The minimum inhibitory concentrations(MICs)of the three types of drugs were tested by microbroth dilution method and were set as the golden standards for the test.RESULTS Totally 31 strains of E.coli and 28 strains of K.pneumoniae that were positive in blood culture bottles were collected,both of the effective rates of controlled growth of the E.coli strains were 100.00％after the incuba-tion for 4 and 5 hours,and the effective rates of controlled growth of the K.pneumoniae strains were 9 6.43％and 100.00％after the incubation for 4 and hours,respectively.The sensitivity,specificity,positive predictive value and negative predictive value of the K.pneumoniae strains against the three types of drugs were 100.00％after the incubation for 5 hours.The specificity and positive predictive value of the E.coli strains against imipenem,meropenem and ertapenem were 100.00％after the incubation for 5 hours;the sensitivities were 73.58％,78.93％and 78.93％,respectively;the negative predictive values were 70.60％,75.00％and 75.00％,respectively.CONCLUSIONS MALDI-TOF MS is rapid and accurate for direct identification of the carbapenem-resistant E.coli and K.pneumoniae strains positive in blood culture bottles,and the accuracy reaches at 100.00％for the test of drug-resistant K.pneumoniae strains after the incubation for 5 hours.The method may provide evidence for clinical treatment of bloodstream infections induced by carbapenem-resistant Enterobacteriaceae.

Objective To investigate the association between polymorphic susceptibility loci for diabetes mellitus and clinical characteristics of type 2 diabetes mellitus(T2DM)in the Han Chinese population in the Qinghai region.Methods A total of 286 T2DM patients treated in Qinghai Provincial People's Hospital from December 2021 to July 2023 were selected as the study subjects.DNA samples were sequenced by Illumina sequencing.LASSO regression model and Kolmogorov-Smirnov(K-S)test were used to analyze the association between SNP and age of onset in T2DM patients.Logistic regression model was used to analyze the association between SNP and DM family history,FPG,HbA1c,HOMA-IR and HOMA-β.Results The age of onset,smoking history,drinking history and WC of male patients were higher than those of female patients(P<0.05),and the HOMA-β,HDL-C,LDL-C and TC were lower than those of female patients(P<0.05).LASSO regression model and K-S test analysis showed that 7 SNPs were associated with the age of onset of T2DM(P<0.05).Logistic regression analysis showed that 13 SNPs were correlated with family history of DM(P<0.05),13 SNPs were correlated with FPG(P<0.05),11 SNPs were correlated with HbA1c(P<0.05),20 SNPs were correlated with HOMA-IR(P<0.05),16 SNPs were associated with HOMA-β(P<0.05).Conclusions In Chinese Han patients with T2DM in Qinghai province,multiple SNPs variants may affect the disease phenotype through different biological pathways,including age of onset,blood glucose index and islet function.

Objective To establish atopic dermatitis(AD)-like models in BALB/c mice using three chemical inducers,calcipotriol(MC903),2,4-dinitrochlorobenzene(DNCB),and oxazolone(OXA),and to explore the occurrence of ferroptosis in the different models.Methods Healthy 7-week-old female BALB/c mice were divided randomly into eight groups(n=8 mice per group)based on the induction site(ear/dorsal skin)and inducer:ear/dorsal control groups,MC903 ear/dorsal model groups,DNCB ear/dorsal model groups,and OXA ear/dorsal model groups.Models were established by topical application of the respective agents at specified concentrations.Mice in the MC903 ear/dorsal groups underwent continuous induction for 14 d.Mice in the DNCB and OXA ear/dorsal groups were sensitized for 3 consecutive days,4 days after the sensitization was completedand then challenged 12 times on day 8 and every other day for up to day 30.Skin lesions were observed and skin thickness was measured.Plasma levels of reactive oxygen species(ROS),interleukin(IL)-4,interferon(IFN)-γ,and malondialdehyde(MDA)were detected,the skin was examined by histopathological staining and ultrastructural observation,and expression levels of ferroptosis-related proteins(glutathione peroxidase 4(GPX4),ferritin heavy chain 1(FTH1),long-chain-fatty-acid-CoA ligase 4(ACSL4),transferrin receptor 1(TfR1))were detected by Western Blot.Results Compared with each control mice,all model mice exhibited obvious redness,swelling,scratching,desquamation,and rough thickening of the skin,and skin thickness was significantly increased(P＜0.01).ROS,IFN-γ,IL-4,and MDA levels were elevated to varying extents(P＜0.05)and histopathological features,including epidermal hyperplasia,keratinocyte degeneration,dermal vascular congestion,and immune cell infiltration,were detected in model mice.Transmission electron microscopy also revealed mitochondrial membrane rupture,increased density,and cristae reduction.Expression levels of ferroptosis markers were dysregulated,including significantly decreased GPX4/FTH1(P＜0.05)and increased ACSL4/TfR1 expression(P＜0.05).Conclusions All three chemicals successfully induced AD-like phenotypes in BALB/c mice through site-specific applications.Ferroptosis is involved in the pathological process of AD,but heterogeneity exists among inducers and modeling sites.

Objective:To investigate the effect of computed tomography (CT)-guided minimally invasive drainage surgery on serum Omentin-1 and human astroglial derived protein (S100B) levels in patients with hypertensive intracerebral hemorrhage. Methods:A total of 120 patients with hypertensive intracerebral hemorrhage who were diagnosed in The First Affiliated Hospital of Harbin Medical University from January 2021 to December 2023 were included as the research subjects. According to the principle of random grouping,these patients were randomly divided into a study group and a control group,with 60 cases in each group. The study group adopted CT-located minimally invasive drainage surgery to conduct treatment,and the control group adopted conventional craniotomy to conduct treatment. The differences of curative effect,neurological function,cerebral edema,serum Omentin-1 and S100B levels between the two groups were compared. Results:In 60 patients of study group,45 cases showed significant improvement (75.00％),and 11 cases showed effective improvement (18.33％),and 4 cases showed invalid (6.67％),with an overall effective rate of 93.33％. In 60 patients of control group,6 cases showed significant improvement (10.00％),and 42 cases showed effective improvement (70.00％),and 12 cases showed invalid (20.00％),with an overall effective rate of 80.00％. The overall effective rate of study group was significantly higher than that of control group,and the difference was statistically significant (x2=4.621,P<0.05). The results of Glasgow Outcome Scale (GOS) scores of study group showed that 0 case was grade 1 (0.00％),and 6 cases were grade 2 (10.00％),and 10 cases were grade 3 (16.67％),and 2 cases were grade 4 (3.33％),and 42 cases were grade 5 (70.00％). At the 6th month after surgery,the GOS scores of control group indicated that 2 cases were grade 1 (3.33％),and 15 cases were grade 2 (25.00％),and 5 cases were grade 3 (8.33％),and 6 cases were grade 4 (10.00％),and 32 cases were grade 5 (53.33％). There was a statistically significant difference in GOS scores between the two groups (U=2.112,P<0.05). Both groups showed significant improvement in brain edema after surgery,and the volumes of brain edema at the 2nd week and the 1st month after surgery in study group were significantly lower than those in control group (t=41.675,29.750,P<0.05),respectively. Both groups obtained significant improvement in serum Omentin-1 and S100B levels,and the serum Omentin-1 and S100B levels after surgery in study group were significantly lower than those in control group,and the differences of them between two groups were significant (t=22.675,10.157,P<0.05),respectively. Conclusion:CT-located minimally invasive drainage surgery can effectively reduce the pressure at hemorrhagic region,and promote clearing hematoma through the precision CT-located guidance for patients with hypertensive intracerebral hemorrhage. At the same time,it can reduce cerebral edema,and relieve damage of brain tissue through regulates serum Omentin-1 and S100B levels. The postoperative recovery of neurological function is remarkable,and the overall treatment outcome is favorable.

Objective To explore the changes in ability to cope with ethical conflicts in palliative care in neonatal intensive care units(NI CU)before and after ethical sensitivity theory training.Methods A descriptive phenomenological research method was employed.Using purposive sampling,we recruited 16 NICU nurses from a tertiary general comprehensive hospital in the city.After ethical sensitivity theory training between January and March 2025,the nurses participated in a semi-structured interview.Data were analyzed using Colaizzi's seven-step analysis method.Results All participants completed the interview.The data were abstracted to three main themes encompassing eight sub-themes:experiences of ethical conflict dilemmas before ethical sensitivity theory training(conflicts between treatment decision-making and family expectations,trust crises triggered by family cognitive biases),the changes of strategy to cope with ethical conflicts after ethical sensitivity theory training(individualized coping strategies,teamwork and communication,introduction and support of external resources),and the role of ethical sensitivity theory training in enhancing coping ability(improving the ability to identify ethical issues,optimizing the decision-making process,and promoting effective communication).Conclusion Palliative care nurses in the NICU face various ethical conflicts,and ethical sensitivity training can enhance their ability to manage these conflicts.

Objective To evaluate the impact of setting a 4-day incubation time on the detection performance of bloodstream infection(BSI)pathogens by the BacTALERT VIRTUO blood culture system(VIRTUO).Methods Retrospectively collecting blood culture(BC)results from Zhongshan Hospital,Fudan University,from June 2021 to December 2023,and comparing the time-to-detection for clinically significant microorganisms.Results A total of 87 052 BC bottles were collected,of which 7 167(8.23%)were positive.95%of aerobic and anaerobic bottles were reported positive at 65.67 h and 91.2 h respectively.The average(median)time-to-detection for Staphylococcus aureus(S.aureus)was 21.76(16.08)h,Klebsiella pneumoniae(KP)was 15.32(11.65)h,Escherichia coli(E.coli)was 16.14(10.87)h,and Candida species was 35.2(28.5)h.Only 213 bottles(0.24%)were reported positive after 4 days of incubation;among them,88 bottles(41.31%)cultured Propionibacterium acnes(P.acnse).Medical chart reviews for BC reported positive after 96 h(4 days)showed no clinical significance.Simulated growth experiments were conducted on 11 fastidious bacteria,and the median detection time was only 10.8 h,indicating that an incubation time of 4 days is sufficient for fastidious bacteria.Conclusion A 4-day incubation is adequate for VIRTUO system.Reporting 1 day earlier to the doctors can reduce the positive rate of contaminants and the use of antimicrobial agents.

Tissue-resident memory T cells(TRM)are a key immune memory cell type responsible for the recurrence of many skin diseases.TRM cells remain in the skin tissue following infection or injury and maintain immune memory by forming a memory reservoir.When the same or similar external stimuli are encountered again,TRM cells can be rapidly activated,releasing inflammatory cytokines and cytotoxic substances,leading to local tissue damage and/or disease recurrence.The formation and function of TRM cells are regulated by various factors,such as T cell receptor signals,cytokines,co-stimulatory molecules,etc.Furthermore,TRM cells may exhibit different phenotypes and functions in different types of skin diseases.Therefore,understanding the characteristics and regulatory mechanisms of TRM cells is of great significance for studying the mechanisms of skin disease recurrence as well as for developing therapeutic strategies targeting TRM cells.