Objective:To summarize the best evidence of ICU acquired weakness(ICUAW) clinical nursing strategies and measures in adult patients and provide evidence-based basis for clinical practice.Methods:By using "6S" evidence model, related literature on ICUAW prevention and management was systematically retrieved from UpToDate, BMJ Best Practice, the National Guideline Clearinghouse, the National Institute for Health and Care Excellence, the Registered Nurses′ Association of Ontario, Cochrane Library, PubMed, Yimaitong Guidelines, CNKI, Wanfang Data, VIP and China Biomedical Literature Database, the retrieval time was from the establishment of the database to september 30, 2023. Two researchers who receieved evidence-based nursing training was independently completed literature quality evaluation. The evidence of the literature were extracted and summarized.Results:Totally, 17 articles were included, including 3 guidelines, 3 expert consensus, 4 systematic review/Meta analysis, 2 crosssectional studies and 5 randomized controlled trials. A total of 30 pieces of best evidence were constructed, including intervention evaluation, daily awakening, safety standards, rehabilitation time, rehabilitation content, rehabilitation intensity, precautions, bundled management, blood pressure/blood glucose control.Conclusions:The present study summarized the best evidence of nursing strategies and measures for adult ICUAW, medical staff should transform and apply the best evidence in combination with clinical contexts to reduce the adverse prognosis of ICUAW.

Objective:To summarize the best evidence of ICU acquired weakness(ICUAW) clinical nursing strategies and measures in adult patients and provide evidence-based basis for clinical practice.Methods:By using "6S" evidence model, related literature on ICUAW prevention and management was systematically retrieved from UpToDate, BMJ Best Practice, the National Guideline Clearinghouse, the National Institute for Health and Care Excellence, the Registered Nurses′ Association of Ontario, Cochrane Library, PubMed, Yimaitong Guidelines, CNKI, Wanfang Data, VIP and China Biomedical Literature Database, the retrieval time was from the establishment of the database to september 30, 2023. Two researchers who receieved evidence-based nursing training was independently completed literature quality evaluation. The evidence of the literature were extracted and summarized.Results:Totally, 17 articles were included, including 3 guidelines, 3 expert consensus, 4 systematic review/Meta analysis, 2 crosssectional studies and 5 randomized controlled trials. A total of 30 pieces of best evidence were constructed, including intervention evaluation, daily awakening, safety standards, rehabilitation time, rehabilitation content, rehabilitation intensity, precautions, bundled management, blood pressure/blood glucose control.Conclusions:The present study summarized the best evidence of nursing strategies and measures for adult ICUAW, medical staff should transform and apply the best evidence in combination with clinical contexts to reduce the adverse prognosis of ICUAW.

Objective To investigate the influencing factors of unplanned rehospitalization within one year after surgery among adult renal transplant recipients. Methods The clinical data of 299 recipients who underwent renal transplant surgery in the Department of Organ Transplantation of the Affiliated Hospital of Guizhou Medical University from January 2020 to December 2022 were retrospectively analyzed. The recipients were divided into unplanned rehospitalization group and non-rehospitalization group based on whether they experienced unplanned rehospitalization within one year after surgery. Univariate analysis and binary Logistic regression analysis were performed to explore the influencing factors of unplanned rehospitalization within one year after renal transplantation. Results Among the 299 recipients, 102 experienced unplanned rehospitalization, with an incidence rate of 34.11%. Univariate analysis revealedstatistically significant differences were noted between the two groups in terms of gender, occupational status, preoperative underlying disease, rejection reactions, nosocomial infections, immunosuppressive medication regimens, serum creatinine, cystatin C, serum phosphorus, serum potassium, and initial hospitalization duration (P < 0.05). Binary Logistic regression analysis showed that having ≥3 kinds of preoperative underlying disease (OR=2.122, 95%CI, 1.198 to 3.759) and experiencing rejection reactions (OR=3.162, 95%CI, 1.217 to 8.218) were independent risk factors for unplanned rehospitalization within one year after renal transplantation (P < 0.05). Conclusion The rate of unplanned rehospitalization within one year after surgery is relatively high among adult renal transplant recipients. Having ≥3 preoperative underlying disease and experiencing rejection reactions are independent risk factors for unplanned rehospitalization within one year after surgery. Transplantation healthcare teams can develop corresponding strategies targeting these risk factors to reduce the rate of unplanned rehospitalization and alleviate the burden of disease.

Objective To observe the effects of green fluorescence protein mediated by lentivirus in bladder, and to de?termine the amount of virus obtained good transfection effects. Methods lentivirus carring GFP gene was perfused using transurethral approach into bladder of guinea pigs. Samples of bladder, liver, kidney and lungs were collected for frozen sec?tions after feeding seven days. The distribution of green fluorescence was observed using laser confocal microscopy. Re?sults The titer of lentivirus was 4 × 108. GFP was found under the mucosa when the amount of lentivirus transurethral was 30μL. GFP was distributed widely in muscle layer using 40μL lentivirus. GFP was detected even stronger in muscle layer when the amount was 50μL. GFP was found in muscle layer when 25μL lentivirus was injected intravenously. GFP was not found in other tissues than in bladder via transurethral perfusion. There was higher GFP in liver, lungs and other organs than in bladder via intravenous injection. Conclusion Lentivirus can mediate GFP transfecting bladder of guinea pig successful?ly and escape the distribution of GFP all over the body intravenously, which will bring new research direction and method for clinical treatment of diseases in bladder.

Objective To investigate the expressions of calcium sensitive receptor (CaSR) and tight junction protein (Claudin)-14 in renal calcium oxalate stone rat model. Methods Thirty male SD rats were randomly divided into control group (n=15) and model group (n=15). The rat model of renal calcium oxalate stone was established by gavaging 1%glycol (2 mL/d) and 2% ammonium chloride. The expression of CaSR protein was detected using immunohistochemical assay. RT-PCR was used to detect the Claudin-14 mRNA expression. The expression levels of CaSR and Claudin-14 protein were de-tected by Western blot assay respectively. The full automatic biochemical analyzer was used to detect rat renal function and changes of blood and urine biochemical indices. Results A large stone crystallization was observed under light microscope in model group. The serum levels of Cr, BUN, 24-h urine calcium and urine volume were significantly higher in model group than those of control group (P<0.01). There were no significant differences in serum calcium level and urinary pH value be-tween two groups. The expression levels of Claudin-14 mRNA and CaSR protein were significantly higher in model group than those of control group (P<0.01). The Claudin-14 protein expression was specifically higher in renal tissues of model group. There was no Claudin-14 protein expression in control group. There was a positive correlation between CaSR and Claudin-14 protein expression in renal tissues of model group. Also, CaSR and Claudin-14 protein expressions were posi-tively correlated with the 24-h urine volume. Conclusion The increased expressions of CaSR and Claudin-14 involved in the formation of kidney stone by increasing the urinary calcium excretion.

Objective The calcium oxalate stone is the most common type of the kidney stones.By building the rat renal calcium oxalate stone model, preliminary study the function of CaSR-Claudin14 regulating pathways on renal calcium oxalate stone for-mation model in rats. Methods 30 Male S-D rats were randomly divided into control group (n=15) and model group (n=15). Adult male S-D rats were given ethylene glycol and ammonium chloride to induce urolithiasis.Application of full automatic biochemical analyzer to test rat renal function and the changes of urine biochemical index.Immunohistochemistry was used to detect the expression of CaSR protein;RT-PCR was used to detect the Claudin-14 mRNA expression;Western Blotting was used to detect the expression of CaSR and Claudin-14 protein respectively. Results By observing model group has large stones crystallization under light microsco-py;model group rats 24 h urine calcium are significantly higher than control group([9.66 ±1.10]mmol vs [3.26 ±0.60]mmol, P<0.01); and model group 24 h urine volume are significantly higher than control group ([21.27 ±1.08]mL vs [13.2 ±0.55]mL, P<0.01 ); and urinary PH has no significant difference between the groups( P >0.05 ) .Expression of Claudin-14 mRNA in the model group is significantly higher than normal control group([0.150 ± 0.004] vs [0.047 ±0.008], P<0.01); Expression of Claudin-14 protein in the model group is significantly higher than normal control group([1.526 ±0.089] vs 0, P<0.01).Expression of CaSR protein in the model group is significantly higher than normal control group([6.697 ±0.051] vs [5.016 ±0.053], P<0.05). Conclusion CaSR can raise the expression of Claudin-14, increase re-nal tubular urinary calcium excretion to promote renal calcium oxalate stone formation.

Objective To study the beneficial effect and mechanism of Alcea rosea roots in nephrolithiasis model in-duced by 1%ethylene glycol in rats. Methods We randomly divided 60 male Wistar rats into six groups,including control group, model group, Alcea rosea roots lower-dose preventive group, Alcea rosea roots high-dose preventive group, Alcea ro-sea roots lower-dose curative group, Alcea rosea roots high-dose curative group. Control group was free to access food and water;model group was given 1%ethylene glycol drinking water and was fed with normal diet, preventive group was given 1%ethylene glycol drink and Alcea rosea roots in low (250 mg/kg) or high dose (500 mg/kg) each day, curative group re-ceived 1%ethylene glycol drink each day and Alcea rosea roots in low or high dose from day 15 to day 28. At the end of the experiment, various renal functional and injury markers such as urine volume, calcium, phosphate, magnesium, urea, creati-nine, and oxalate were evaluated using urine, serum, and kidney homogenates. The kidneys were removed and prepared for histological evaluation of calcium oxalate deposits. Results In model groups, urine output, urea, creatinine, 24 h urine Ca2+, and oxalate and MDA were increased compared to those in control group(P＜0.05). GSH and SOD were increased in preventative and curative groups compared to those in the model group(P ＜ 0.05). The urea, creatinine, 24 h urine Ca2+, urine oxalate, MDA were reduced in preventive and curative groups compared to those in the model group(P＜0.05). The number and size of calcium oxalate crystal deposits were also less and smaller, and the kidney damage was less severe in pre-ventive and curative groups compared to in the model group. Conclusion The extract of Alcea rosea roots can prevent and treat calcium oxalate urinary stone formation in rats and protect renal function.

AIM: To determine the expression of c-kit mRNA and protein in the bladders in guinea pigs with diabetic cystopathy (DCP) and to explore the correlation and mechanisms between c-kit expression and DCP. METHODS: Sixty guinea pigs were divided randomly into control group (n=20) and experimental group (n=40). The guinea pigs in experimental group were injected with streptozotocin (STZ) to induce diabetes mellitus. After fed for 10 weeks, the animals in both groups were tested with urodynamics, and the guinea pigs in experimental group were divided into the subgroups of DCP and the diabetic no-cystopathy (NDCP) group according to the results of urodynamics. mRNA expression of c-kit was detected by reverse transcription polymerase chain reaction (RT-PCR) and protein expression of c-kit was tested and analyzed by laser scanning confocal microscope. RESULTS: Decreased expression of c-kit mRNA was observed in DCP group compared to control and the NDCP group. The ratio of c-kit mRNA and GAPDH was 5.66±0.54 in controls (P<0.05), 5.54±1.28 in NDCP group (P<0.05) and 4.65 ±0.47 in DCP group. c-kit protein expression significantly declined in DCP group. The mean value of fluorescence intensity was 856.52± 53.03 in control group, 844.67± 59.24 in NDCP group and 548.69± 48.51 in DCP (P<0.01).CONCLUSION: The declined expression of c-kit) gene at transcription and translation levels destroys the SCF/c-kit signal pathway, leading to the dysfunction of Cajal-like) cells in DCP guinea pig, so the abnormal expression of c-kit gene is involved in the pathogenesis of DCP.

Objective To determine vascular endothelial growth factor(VEGF)-460 gene polymorphism in Uyghurs and its relationship to urolithiasis in south Xinjiang. Methods Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP),gene sequencing and genetic analysis methods were used in 200 urolithiasis patients of Uyghurs, and 200 healthy Uyghurs. Results The distribution of genotype and allele had no significant difference between urolithiasis patients and normal controls (P＞0. 05). The frequencies for the CC,TT and CT genotypes in patients with urolithiasis and normal controls were 1.5 %, 29.0 %, 69.5 % and 0. 5 %, 27.5 %, 72.0 %, respectively. The frequencies for C and T allele were 36.2%,63.7% and 36.9% ,63.1%, respectively. Conclusions The results of VEGF-460 gene polymorphisms indicate no significant relationship between patients with turolithiasis and normal controls in Uyghurs in south Xinjiang,which may not be urolithiasis susceptibility genetic locus.

Objective To discuss the types of ICC and characteristics of spontaneous Ca2+ waves of different types of ICC in the bladder of guinea pig. Methods Frozen-sections were made from the bladder of guinea pig and ICC were cultured in vitro. Cells were stained by indirect immunofluorescent method and detected by Laser scanning confocal microscope. The ICC cultured in vitro were divided randomly into 4 group: dimmer ICC,monomer ICC,dimmer ICC treated with 2-APB group and monomer ICC treated with 2-APB group according to the cell morphology and disrupted with 2-APB.The calcium concentration of ICC cultured in vitro were marked with Fluo-4 AM and disrupted by 2-aminoethoxydipheylbrate (2-APB, 100 μmol/L) in dimmer ICC treated with 2-APB group and monomer ICC treated with 2-APB group. The calcium oscillation function of ICC was observed under Laser scanning confocal microscope. Results For the monomer ICC and dimmer ICC in frozen sections and cultured in vitro,there were increased frequency (P＜0.01) and amplitude (P＜0.05) of spontaneous Ca2+ waves in dimmer ICC compared with the monomer monomer ICC. But after the cells disrupted by 2-APB after 15 min,There were decreased frequency (P＜0.01) and amplitude (P＜0.01) of spontaneous Ca2+ waves in the dimmer ICC treated with 2-ABP group compared with the dimmer ICC. The changes(P＞0.05) of spontaneous Ca2+ waves was not statistical significance in monomer ICC treated with 2-ABP group compared with monomer ICC group. Conclusions The bladder of guinea pig may exist 2 different types of ICC, dimmer ICC and monomer ICC. The excitability of spontaneous Ca2+ waves of dimmer ICC could be higher than in monomer ICC. The special structure of dimmer ICC may contribute to the formation of high spontaneous Ca2+ waves.