Objective The purpose of writing the"Expert consensus on the prevention and control of intracranial hypertension in adult critical illness"(here in after referred to as the"Consensus")aimed to standardize the nursing work related to the prevention and control of elevated intracranial pressure in adult critical illness,and prevent the occurrence of complications such as cerebral herniation.Methods Guided by evidence-based practice,domestic and foreign databases were searched for guidelines,expert consensuses,systematic evaluation,evidence summaries,and original research related to increased intracranial pressure.The search period is from database establishment to March 2024.The high-quality evidence and suggestions in the field was evaluated,extracted,and summarized to form a preliminary consensus.27 experts were invited to conduct 2 rounds of expert inquiry and 8 experts were invited to conduct 2 expert discussion meetings,to revise and improve the content of the initial draft,and to ultimately form a final consensus.Results The effective response rates for both rounds of inquiry questionnaires were 100％,with expert authority coefficients of 0.884,judgment coefficients of 0.964,and familiarity levels of 0.804.The Kendall harmony coefficients for 2 rounds of inquiry were 0.107 and 0.083(P＜0.01),respectively.The consensus includes 4 aspects,including identification,monitoring,prevention and control strategies,emergency treatment and care for increased intracranial pressure.Conclusion This"Consensus"has strong scientific validity and can provide reference basis for nurses to carry out prevention and control of intracranial pressure increase.

Objective: To design the proficiency testing (PT) project (No. NIFDC-PT-183) for assays of bismuth potassium citrate capsules and organize to assess the proficiency of complexometric titration in laboratories, and provide some technical analyses and advices.
Methods: Two groups of samples with different concentration were prepared. The uniformity was evaluated with one-way analysis of variance and the stability was confirmed with t-test, whose results all conformed the requirements. The samples with three combinations were randomly distributed to 279 laboratories. The determination was performed according to the assays of bismuth potassium citrate capsules in Volume Ⅱ of the Chinese Pharmacopoeia 2015. The median value and normalized interquartile range (NIQR) of robust statistical analysis was adopted and Z-scores were used to evaluate the results from each of laboratories.
Results: Among 279 laboratories, 240 laboratories results were satisfactory, 23 were questionable, and the other 16 were unsatisfied. The satisfaction rate was 86.0%.
Conclusion: The overall capacity of national laboratories for assays of bismuth potassium citrate capsules is good while a portion of participants require further improvement.

ObjectiveTo observe and compare the intervention effect of modified Cangfu Daotantang on glucose and lipid metabolism in simple obese children with phlegm dampness and stagnation. MethodA total of 60 children with simple obesity were randomly divided into two groups according to the simple randomization method of the random number table. The odd number was included in the test group， and the even number was included in the basic treatment group， with 30 cases in each group. On the basis of signing the informed consent notice， the treatment group was given modified Cangfu Daotantang combined with basic treatment， while the control group was only given basic treatment. After three months of treatment， the body mass index （BMI）， glucose and lipid metabolism level ［total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein cholesterol （LDL-C）， fasting plasma glucose （FPG）， fasting insulin （FINS）， and homeostasis model assessment-insulin resistance （HOMA-IR）］， the change in the total score of traditional Chinese medicine （TCM） syndromes， and the effective rate of treatment were observed and compared. ResultAfter treatment， the BMI of the observation group and the control group decreased significantly （P<0.01）. Compared with the control group， the BMI level in the observation group decreased significantly （P<0.05）. After treatment， the levels of TC， TG， and LDL-C in the observation group and the control group decreased significantly （P<0.01）. Compared with the control group， the levels of TC， TG， and LDL-C in the observation group decreased significantly （P<0.05）. In addition， the level of TC in the observation group improved significantly compared with that in the control group （P<0.01）. The levels of FPG， FINS， and HOMA-IR in the observation group and the control group were significantly lower than those before treatment （P<0.05）. After treatment， compared with the control group， the levels of FPG， FINS， and HOMA-IR in the observation group were significantly reduced （P<0.05）. The level of FPG in the observation group was significantly improved compared with that in the control group （P<0.01）. After treatment， the total score of TCM syndromes in the two groups decreased significantly （P<0.01）. Compared with the control group， the total score of TCM syndromes in the observation group was lower （P<0.01）. After treatment， the total effective rate of treatment was 86.67% （26/30） in the observation group and 73.33% （22/30） in the control group. By rank sum test， the total effective rate of the observation group was better than that of the control group （Z=-2.100， P<0.05）. ConclusionModified Cangfu Daotantang combined with basic treatment can effectively reduce the BMI of obese children and improve their glucose and lipid metabolism. It has good clinical effects and high clinical application value， which is worth further in-depth research and promotion.

Objective:To form the expert consensus on nursing care of adults with status epilepticus (SE), promote nurses to provide standardized and safe first aid, monitoring and support to SE patients, and effectively prevent and control complications, with a view to controlling seizures as soon as possible.Methods:The medical and nursing evidence on SE was retrieved, evaluated and summarized, and the retrieval time limit was from the establishment of the database to March 31, 2022. Recommendations and studies were extracted to form a first draft of consensus. A total of 31 experts were selected to conduct two rounds of Delphi expert consultation and expert demonstration meetings to analyze, revise and improve the experts' suggestions and form a consensus final draft.Results:The expert positive coefficient was 100.00% (31/31), the expert judgment coefficient was 0.93, the familiarity degree was 0.87, and the authority coefficient was 0.90. Kendall's harmony coefficient was 0.25 to 0.27 ( P<0.05). The final consensus included adult SE identification, first aid, monitoring and support, complication prevention and control, and effect evaluation of terminating SE. Conclusions:This consensus is practical and provides guidance for clinical nursing practice and quality control of SE patients.

Objective: To analyze the characteristics and abnormalities of electrocardiograms (ECG) in patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), and to provide evidences for the prevention and treatment of cardiovascular diseases in HIV/AIDS patients. Methods: The ECG results of 1 131 HIV/AIDS patients and 5 622 non-HIV/AIDS subjects from Shanghai Public Health Clinical Center were involved. The abnormality rates and characteristics of ECG were compared between the two groups. CD4⁺ T lymphocyte counts, CD8⁺ T lymphocyte counts and CD4/CD8 ratios were measured in HIV/AIDS patients. The comparison between two groups was conducted by chi-square test. Logistic regression model was used to explore the factors associated with ECG abnormalities in HIV/AIDS patients. Results: There were 611 cases (54.02%) out of 1 131 HIV/AIDS patients with abnormal ECG. The common abnormal ECG types were sinus tachycardia 239 cases (39.12%), sinus rhythm with ST-T changes 115 cases (18.82%) and sinus bradycardia 55 cases (9.00%). There were 1 958 cases (34.83%) out of 5 622 cases of non-HIV/AIDS subjects with abnormal ECG. The common ECG abnormality types were sinus bradycardia 633 cases (32.33%), sinus rhythm with ST-T changes 463 cases (23.65%) and sinus arrhythmia 256 cases (13.07%). The abnormal rate of ECG in HIV/AIDS patients was significantly higher than that in non-HIV/AIDS subjects (χ²=140.39, P<0.01). The abnormal rates of ECG in HIV/AIDS patients <50 years old and ≥50 years old were both higher than those of non-HIV/AIDS subjects in the corresponding age group, and the differences were statistically significant (χ²=111.92 and 52.12, respectively, both P<0.01). Logistic regression analysis showed an increased risk of abnormal ECG in HIV-infected individuals compared with non-HIV/AIDS individuals (odds ratio (OR)=2.27, 95% confidence interval (CI) 2.00-2.60, P<0.01). The risk of ECG abnormality increased in patients aged ≥50 years(OR=1.60, 95%CI 1.45-1.77, P<0.01). The ECG abnormal distribution patterns were significantly different between different levels of CD4⁺ T lymphocyte counts, CD8⁺ T lymphocyte counts and CD4/CD8 ratios in HIV/AIDS patients (χ²= 12.92, 10.99 and 16.48, respectively, all P<0.05 ). The risk of ECG abnormality increased in HIV/AIDS patients aged ≥50 years (OR=1.50, 95%CI 1.15-1.96, P<0.01). When CD8⁺ T lymphocyte counts ≥500/μL, the risk of ECG abnormalities reduced (OR=0.75, 95%CI 0.58-0.96, P<0.01). Conclusions The abnormal rate of ECG in patients with HIV/AIDS is high. The sinus tachycardia and sinus rhythm with ST-T segment changes are common. The risk of ECG abnormality increases in HIV/AIDS patients aged ≥50 years old and reduces when the CD8⁺ T lymphocyte counts ≥500/μL. Type distribution of ECG abnormalities is associated with cellular immune status of patients.

Objective To study the risk of bloodstream infection in relation with peripherally inserted central venous catheter (PICC) in hospitalized non-cancer patients.Methods Clinical data of 172 non-cancer patients admitted to our hospital for PICC were collected.The risk of PICC-related bloodstream infection (CRBSI) in domestic hospitalized non-cancer patients was analyzed and systematically assessed.Results Of the 183 PICCs placed in 172 patients included in this study,61.7％ were placed in general wards,38.3％ were placed in ICU,87.8％ were placed in combination with indwelling urinary catheter,29.7％ were placed in combination with mechanical ventilation.The median PICC indwelling time was 35 days.CRBSI occurred in 6 patients with an incidence of 0.6/1000 PICCs/day.The risk of CRBSI was centralized in domestic tumor patients after PICC.The reported CRBSI was significantly different in hospitalized non-cancer patients (0.26-33.10/100 PICC).Conclusion The risk of CRBSI is lower in hospitalized patients after PICC placement than after traditional central venous catheter placement.Further studies are needed to assess its value in ICU.

Objective To study the effect of nurse hierarchical management on nurse core competence and responsibility system nursing level.Methods A total of 79 nursing staff in our hospitalwere selected as research objects.Nurses before the implementation of the new nursing management measures (March 2015 to March 2016) were carried out nurse conventional hierarchical management,and those after implementation (April 2016 to April 2017) took new hierarchical management model.The quality of nursing management,the core competency score and the satisfaction of doctors and patients were compared before and after the implementation of new hierarchical management model.Results After implementation,the core competence scores of nursing staff in medical records writing ability and language communication ability were significantly lower than implementation before,the difference was statistically significant (P ＜ 0.05).After the implementation,the nursing management quality in informing precautions after discharge,obligation to inform before operation,and initiative to carry out life care were significantly higher than implementation before (P ＜0.05).Conclusion Nurse level management can improve core competence of nurses,enhance the level of responsibility system and the application effect is more obvious,so it is worthy of promotion.

Objective To study the effect of nurse hierarchical management on nurse core competence and responsibility system nursing level.Methods A total of 79 nursing staff in our hospitalwere selected as research objects.Nurses before the implementation of the new nursing management measures (March 2015 to March 2016) were carried out nurse conventional hierarchical management,and those after implementation (April 2016 to April 2017) took new hierarchical management model.The quality of nursing management,the core competency score and the satisfaction of doctors and patients were compared before and after the implementation of new hierarchical management model.Results After implementation,the core competence scores of nursing staff in medical records writing ability and language communication ability were significantly lower than implementation before,the difference was statistically significant (P ＜ 0.05).After the implementation,the nursing management quality in informing precautions after discharge,obligation to inform before operation,and initiative to carry out life care were significantly higher than implementation before (P ＜0.05).Conclusion Nurse level management can improve core competence of nurses,enhance the level of responsibility system and the application effect is more obvious,so it is worthy of promotion.

Objective The aim of this study was to determine whether active part of Glycyrrhiza extract (GL)induced apoptosis in Hela cells and its inhibitory mechanism.Methods HeLa cells were treated with 25 g/mL of GL for 24hs.Cell viability and apoptosis in HeLa cells were determined by MTT,AO/EB fluorescent double staining,transmission electron microscope(TEM),and Western blot.Results The MTT results showed that GL significantly inhibited the proliferation of HeLa cells in a dose-response.After treatment for 24 hrs,large number of early apoptotitc cell were observed using AO/EB fluorescent double staining and TEM.The expression of Pro-caspase-9 and Cleaved-caspase-3 protein was higher in GL-treated cells them those of the control cells(P<0.05).Conclusion GL can activate Caspase-3 and Caspase-9 genes to induce apoptosis in HeLa cells.

Objective To observe the clinical effect of inserted central catheter (PICC) tip localization guided by ultrasound combined with endocaridal electrogram (ECG).Methods A total of 115 PICC catheter patients were as research objects, and ultrasound combined with endocaridal electrogram guided PICC tip positioning were carried out for these patients, which was compared with tube X-ray results, its application value in the location of the tip of PICC was analyzed.Results Ultrasound combined with intracavitary electrocardiogram guided PICC tip localization rate was 95.7%, ectopic rate was 4.3%, while the X-ray results suggested that the PICC tip localization rate was 97.4%, and ectopic rate was 2.6%, but there was no statistically significant difference (P>0.05);P wave prediction and X-ray coincidence rate of ultrasound combined with intracavitary electrocardiogram guided PICC tip positioning was 98.3%, Kappa test showed a better consistence(P<0.05).Conclusion The success rate of PICC tip localization guided by ultrasound combined with endocaridal electrogram is high, which can reduce the adverse effects of the tip dislocation, and it can be used as priority.