BackgroundIn Sichuan Province， most healthcare institutions providing mental health services have adopted self-developed evaluation indicators for the quality of nursing care in psychiatric closed wards， lacking unified standards. This results in insufficient authority and homogeneity， which is unfavorable for the standardized assessment and continuous improvement of nursing quality. ObjectiveTo construct a standardized evaluation indicator system for nursing quality of psychiatric closed wards in Sichuan Province， so as to provide references for nursing quality management and assessment. MethodsBased on bio-psycho-social medical model and guided by "Structure-Process-Outcome" quality evaluation framework， preliminary evaluation indicators for nursing quality in psychiatric closed wards were developed through literature analysis， research team discussions and clinical experience. Through two rounds of Delphi expert consultation， the indicators were revised and finalized. ResultsThe response rates for two rounds of Delphi expert consultation questionnaire were 100%. The expert authority coefficients were 0.845 and 0.864， respectively， and the Kendall's coordination coefficients ranged from 0.119 to 0.210 （P<0.01）. Ultimately， a nursing quality evaluation index system for psychiatric closed wards was established， comprising 3 first-level indicators， 9 second-level indicators and 46 third-level indicators. ConclusionThe nursing quality evaluation indicators for psychiatric closed wards constructed based on the Delphi method can provide references for nursing quality management and evaluation in such wards. ［Funded by Research Project Fund of Sichuan Nursing Society （number， H20004）； Sichuan Hospital Association Hospital Management Research Special Fund （number， YG2323）］

Ferroptosis, an iron-dependent programmed cell death process driven by reactive oxygen species-mediated lipid peroxidation, is regulated by several metabolic processes, including iron metabolism, lipid metabolism, and redox system. Macrophages are a group of innate immune cells that are widely distributed throughout the body, and play pivotal roles in maintaining metabolic balance by its phagocytic and efferocytotic effects. There is a profound association between the biological functions of macrophage and ferroptosis. Therefore, this review aims to elucidate three key aspects of the unique relationship between macrophages and ferroptosis, including macrophage metabolism and their regulation of cellular ferroptosis; ferroptotic stress that modulates functions of macrophage and promotion of inflammation; and the effects of macrophage ferroptosis and its role in diseases. Finally, we also summarize the possible mechanisms of macrophages in regulating the ferroptosis process at the global and local levels, as well as the role of ferroptosis in the macrophage-mediated inflammatory process, to provide new therapeutic insights for a variety of diseases.
Ferroptosis/physiology* ; Macrophages/metabolism* ; Humans ; Animals ; Iron/metabolism* ; Reactive Oxygen Species/metabolism* ; Lipid Peroxidation/physiology* ; Inflammation/metabolism*

As human deep space exploration enters a practical phase, ensuring astronaut health and safety has become a critical determinant of mission success. The cerebrovascular system, essential for maintaining brain function, is highly sensitive to environmental changes. Cerebrovascular diseases represent one of the characteristic adverse effects of deep space conditions such as microgravity and high-energy radiation, and have emerged as a frontier challenge in space medicine. Based on experiences from manned space missions, major research challenges persist, particularly the lack of experimental data specific to the lunar environment and the unclear threshold for low-dose radiation-induced injury. Elucidating the mechanisms and multifactorial interactions by which deep space environments impact cerebrovascular structure and function, and summarizing the key risk factors, pathological processes, and recent advances in monitoring and early-warning technologies for cerebrovascular diseases in lunar astronauts, and of crucial importance. A comprehensive understanding of the interplay between deep space environmental stressors and cerebrovascular injury, as well as the development of personalized prevention and intervention strategies, will provide both theoretical and practical foundations for safeguarding cerebrovascular health in future Chinese deep space missions, while promoting progress in related biomedical research, technological innovation, and international collaboration.
Humans ; Astronauts ; Cerebrovascular Disorders/etiology* ; Space Flight ; Weightlessness/adverse effects* ; Risk Factors ; Moon

Objective:To explore the application value of E-learning+mind mapping in nursing internship teaching in the department of neurology.Methods:A total of 215 nursing students admitted for internships in February 2021 were selected as research subjects. They were randomly divided into two groups. The observation group received teaching method combining E-learning and mind mapping, while the control group received conventional teaching method. The two groups of nursing students were compared in terms of internship assessment results, learning engagement (learning engagement scale), clinical thinking ability (clinical thinking ability evaluation scale), and student self-recognition. SPSS 20.0 was used for t test and chi-square test. Results:After 1 month of internship, the scores of theories and practical operation were significantly higher in the observation group than in the control group [(90.05±3.02) vs. (85.29±4.17) and (81.33±5.26) vs. (78.62±4.69), all P<0.05]. The score of learning engagement scale, score of clinical thinking ability evaluation scale, and self-recognition rate were significantly higher in the observation group than in the control group (all P<0.05). Conclusions:E-learning+mind mapping can significantly enhance the learning efficiency of intern nursing students in the department of neurology and improve their clinical nursing thinking ability, making it worthy of widespread application.

OBJECTIVE To observe the efficacy and safety of hydromorphone in patient-controlled intravenous analgesia(PCIA)after uvulopalatopharyngoplasty.METHODS A total of 90 patients who received uvulopalatopharyngoplasty in Central Theater General Hospital from January 2022 to June 2023 were selected and divided into three groups(n=30 in each group)by using random number table method.Control group was given sufentanil 2.0 μg/kg,group A was given hydromorphone 0.20 mg/kg and group B was given hydromorphone 0.30 mg/kg.The analgesic parameters of three groups were background infusion rate of 1.2 ml/h,PCA amount of 2 ml,and lock-up time of 10 min.VAS score and Ramsay sedation score at 2 h,6 h,12 h,24 h and 48 h after surgery were recorded,as well as the number of compressions within 48 h after surgery,and the incidence of adverse reactions were analyzed.RESULTS There were no significant differences in intraoperative blood loss,operation time and intraoperative urine volume among the three groups(P>0.05).VAS score in group A and group B at 2 h(2.0±0.3,2.2±0.4),6 h(1.8±0.4,1.9±0.4),12 h(1.8±0.4,1.7±0.4),24 h(1.6±0.3,1.5±0.4)and 48 h(1.1±0.3,1.2±0.4)were significantly lower than those in control group(2.8±0.5,2.3±0.5,2.1±0.4,2.0±0.5,1.7±0.5)(P<0.05),but there was no significant difference between group A and group B(P>0.05).The Ramsay score of group A and group B at 2 h,6 h,12 h,24 h,and 48 h after operation was significantly lower than that of the control group(P<0.05).There was no significant difference in Ramsay score between group A and group B(P>0.05).The total number of compressions and effective number of compressions in group A and group B at 12 h,24 h and 48 h after surgery were lower than those in control group(P<0.05),but there was no significant difference between group A and group B(P>0.05).The incidence of total adverse reactions in group B was higher than that in group A and control group(P<0.05).There was no significant difference in the incidence of total adverse reactions between group A and control group(P<0.05).CONCLUSION Hydromorphone can effectively be used for postoperative self-controlled analgesia in patients with uvulopalatopharyngoplasty,and the efficacy is better than sufentanil,but the dose of 0.20 mg/kg hydromorphone has better safety than that of 0.3 mg/kg hydromorphone.

Objective To explore the value of vesical imaging reporting and data system(VI-RADS)combined with absolute tumor-wall contact length(ABTCL)and actual tumor-wall contact length(ACTCL)in diagnosing muscle invasive bladder cancer(MIBC).Methods The MRI data of 113 patients with pathologically confirmed bladder cancer(BCa)were analyzed retrospectively.All patients underwent conventional MRI,diffusion weighted imaging(DWI)and dynamic contrast enhanced(DCE)MRI before sur-gery.Two radiologists independently evaluated MRI images based on VI-RADS score,and measured quantitative parameters,inclu-ding ABTCL and ACTCL.The Chi-square test was used to compare the difference of VI-RADS scores between MIBC and non-mus-cle invasive bladder cancer(NMIBC).Quantitative parameters between MIBC and NMIBC were compared by Mann-Whitney U test.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of VI-RADS,quantitative parameters and VI-RADS combined with quantitative parameters in the diagnosis of MIBC.Results VI-RADS,ABTCL and ACTCL had significant differences between MIBC and NMIBC(P＜0.05).The area under the curve(AUC)for VI-RADS,ABTCL and ACTCL in diagno-sing MIBC were 0.89,0.76 and 0.77,respectively.There was no significant difference between the AUC for ABTCL and ACTCL(P＞0.05).The AUC for VI-RADS combined with ABTCL or ACTCL in diagnosing MIBC was 0.93,higher than that of only VI-RADS(P＜0.05).Conclusion The combination of VI-RADS with either ABTCL or ACTCL can effectively improve the diagnostic performance of MIBC.ABTCL obtainedby linear measurement is easier to implement in clinical practice than ACTCL obtained by curved measurement.

This report describes a case of maturity-onset diabetes of the young(MODY)type 3(MODY3)complicated with type 5(MODY5),including the patient's clinical features,diagnosis,and treatment,and reviews relevant literature.Using next-generation sequencing of MODY(types 1-14)gene exons and Sanger sequencing for verification,the patient and her mother were assessed.Based on the clinical phenotype and genetic test results,the patient was diagnosed as MODY3 combined with MODY5.Treatment included insulin and linagliptin,with monitoring of blood glucose changes.Clinicians should enhance their understanding of MODY clinical phenotypes.In adolescents with diabetes who have congenital pancreatic and renal developmental defects,elevated high-density lipoprotein cholesterol,no spontaneous ketosis,insulin secretion defects,negative pancreatic autoantibodies,no significant insulin resistance,and who are not obese,gene testing should be conducted to screen for MODY.Accurate diagnosis and personalized treatment can aid in achieving glycemic control,improving quality of life,and optimizing reproductive planning.

Objective:In order to truly realize the deep integration of ideological and political education and professional edu-cation in the course of Animal Immunology and effectively improve the comprehensive quality of students.Methods:The experiment adopts the teaching method of integrating the online and offline hybrid teaching of Animal Immunology into the ideology and politics of the course,studies the course design concept,teaching objectives,teaching design and teaching implementation,and will conduct an evaluation of the teaching effect from the examination results and ideological and political effect.Results:The results show that the teaching model has stimulated students'interest in learning and improved their overall ability.Conclusion:It shows that the teaching effect of this method is good and the basic task of moral education is realized.

Objective:To investigate the current situation of medical equipment allocation in 103 tertiary public hospitals,analyze and compare the proportion of medical equipment in different regional hospitals in our country,and provide basis for scientific and reasonable allocation of medical equipment.Methods:A questionnaire was designed by literature research and expert consultation,and an electronic questionnaire was released through the public account of"China Medical Equipment"and the platform of"Good Medical Workers"to analyze the correlation between the number of medical equipment configuration,the proportion of domestic products,the region where the hospital was located and the number of hospital beds.Results:A total of 103 valid questionnaires were collected,involving 103 tertiary public hospitals in East China,North China,Central China,South China,Southwest,Northwest and Northeast China,of which 18%were in North China,37%were in East China and 9%were in South China.In North China,South China and East China,the average number of medical equipment in the tertiary public hospitals in the region was 9785 units per hospital,9245 units per hospital and 8153 units per hospital,and the number of the expensive equipment was relatively small,which had no correlation with the number of beds.There were statistically significant differences between North China and East China in the number of beds,the number of pieces of equipment per 100 beds and the amount of equipment per 100 beds(t=-2.582,2.939,4.653,P＜0.05).The number of life support equipment configuration was significantly positively correlated with the number of beds,and the domestic share,especially the domestic share of life support equipment,increased.Conclusion:The analysis of medical equipment allocation in public hospitals in China can provide data support for hospitals to better adapt to the adjustment of the new expensive medical equipment catalogue,provide reference for the demonstration and promotion of large medical equipment allocation and localization in tertiary hospitals,and provide reference for relevant health management departments.

OBJECTIVE To investigate the correlation between polymorphisms of MTHFR(1298A>C) and MTHFR (677C>T) and the blood concentration and adverse reactions of methotrexate(MTX). METHODS A total of 185 children with acutelymphoblastic leukemia(ALL) admitted to Shanghai Children′s Hospital from October 2014 to December 2021 were selected to collect laboratory test indicators such as MTHFR(1298A>C) and MTHFR(677C>T) genotype, adverse reactions, and blood concentration. RESULTS The overall incidence of adverse reactions after using MTX in 185 children was 95.1%. The incidence of adverse reactions between the two genotypes of MTHFR(A1298C) was not statistically significant, except for the difference in neutropenia(P=0.006); the incidence of adverse reactions in ALL children with three genotypes of MTHFR(C677T) was not statistically significant except for neutropenia(P=0.041/0.012), gastrointestinal reactions(P=0.037/0.011), and mucosal toxicity(P=0.039/0.016); there was a statistically significant difference in MTX plasma concentration among ALL patients with three genotypes of MTHFR(C677T) at 24 h(P=0.021); there was a statistically significant difference in the incidence of calcium folinate doubling rescue among ALL patients with three genotypes of MTHFR(677C>T)(P=0.007/0.002). CONCLUSION Polymorphisms in MTHFR(1298A>C) and MTHFR(677C>T) may not be good indicators for predicting MTX chemotherapy in children with ALL. The importance of doubling rescue is emphasized, as doubling rescue can significantly reduce the incidence of such adverse reactions in children with high incidence of mucosal toxicity and bone marrow toxicity.