Objective To develop a knowledge-attitude-practice assessment scale for home prevention and man-agement of parastostomy hernia in ostomy patients,and to test its reliability and validity,to provide a reliable tool for evaluating the knowledge and practice level of home prevention and management of parastostomy hernia in pa-tients with ostomy.Methods Based on the theory of knowledge,attitude and practice,the initial scale was generat-ed through literature review,semi-structured interviews,expert correspondence,research group discussion and pre-sur-vey.From May to December 2023,685 patients with ostomy from the ostomy clinic of a tertiary hospital in Tianjin were investigated by purpose sampling method,and the reliability and validity were tested.Results A total of 673 valid questionnaires were collected,the results showed that the knowledge-attitude-practice assessment scale for pre-venting and managing parastomal hernia of ostomy patients at home included 3 dimensions of knowledge,attitude and practice,with a total of 27 items.The response rates of 2 rounds of the questionnaire were both 100％;the au-thority coefficients were all 0.915;the Kendall's coefficients of concordance were 0.279 and 0.301,respectively.The content validity index of each item was 0.875～1.000;the content validity index of the average scale level was 0.988;after 2 exploratory factor analysis,the cumulative variance contribution rate was 65.920％.The results of con-firmatory factor analysis showed that the model had a good fit,with a chi-square degree of freedom ratio(/df)of 1.945,the fitting goodness index(GFI)of 0.851,the comparative goodness of fit index(CFI)of 0.919,the root means square error of approximation(RMSEA)of 0.060.The Cronbach's alpha coefficient result of the scale is 0.957,with a test-retest reliability of 0.826 and a half reliability of 0.934.Conclusion The knowledge-attitude-practice assessment scale has good reliability and validity,and can be used as an assessment tool for home prevention and management of parastostomy hernia in ostomy patients.

Objective To develop a knowledge-attitude-practice assessment scale for home prevention and man-agement of parastostomy hernia in ostomy patients,and to test its reliability and validity,to provide a reliable tool for evaluating the knowledge and practice level of home prevention and management of parastostomy hernia in pa-tients with ostomy.Methods Based on the theory of knowledge,attitude and practice,the initial scale was generat-ed through literature review,semi-structured interviews,expert correspondence,research group discussion and pre-sur-vey.From May to December 2023,685 patients with ostomy from the ostomy clinic of a tertiary hospital in Tianjin were investigated by purpose sampling method,and the reliability and validity were tested.Results A total of 673 valid questionnaires were collected,the results showed that the knowledge-attitude-practice assessment scale for pre-venting and managing parastomal hernia of ostomy patients at home included 3 dimensions of knowledge,attitude and practice,with a total of 27 items.The response rates of 2 rounds of the questionnaire were both 100％;the au-thority coefficients were all 0.915;the Kendall's coefficients of concordance were 0.279 and 0.301,respectively.The content validity index of each item was 0.875～1.000;the content validity index of the average scale level was 0.988;after 2 exploratory factor analysis,the cumulative variance contribution rate was 65.920％.The results of con-firmatory factor analysis showed that the model had a good fit,with a chi-square degree of freedom ratio(/df)of 1.945,the fitting goodness index(GFI)of 0.851,the comparative goodness of fit index(CFI)of 0.919,the root means square error of approximation(RMSEA)of 0.060.The Cronbach's alpha coefficient result of the scale is 0.957,with a test-retest reliability of 0.826 and a half reliability of 0.934.Conclusion The knowledge-attitude-practice assessment scale has good reliability and validity,and can be used as an assessment tool for home prevention and management of parastostomy hernia in ostomy patients.

Objective:To investigate the experience of body quality management in overweight or obese patients with breast cancer during chemotherapy, and to provide reference for formulating targeted nursing interventions.Methods:This study was a phenomenological study of qualitative research. Objective selected 10 obese patients with breast cancer from breast surgery of Provincial Hospital Affiliated to Shandong First Medical University and the First Affiliated Hospital of Shandong First Medical University to conduct semi-structured interviews during chemotherapy from March to May 2023. Colaizzi 7-step analysis method was used to sort out and analyze the data and extract the theme.Results:The average age of 10 overweight or obese breast cancer patients was 43.2 years. Three themes and eight subthemes were extracted, including insufficient motivation of body quality management (insufficient cognition, insufficient drive, insufficient motivation), disturbing experience of body quality management (uncertainty of disease, symptom distress during chemotherapy, inability to identify the correctness of information), regulation and support of body quality management (mastering correct methods of body quality regulation and support in all aspects).Conclusions:The motivation of body quality management in overweight or obese patients with breast cancer during chemotherapy is insufficient and there are many problems. Medical staff can take effective measures from clarifying the significance of body quality management, providing targeted information support, establishing a good social support system and providing effective body quality management guidance, so as to improve the effectiveness of body quality management in obese patients with breast cancer during chemotherapy.

Objectives:To investigate the effect of body mass index(BMI)on perioperative and long-term prognosis of patients with severe aortic stenosis(AS)after transcatheter aortic valve replacement(TAVR). Methods:This retrospective study imcluded 180 patients with severe AS who received TAVR in Fujian Provincial Hospital from January 2019 to January 2022.According to the BMI,patients were divided into four groups:low weight group(BMI<18.5 kg/m2,n=23),normal weight group(18.5 kg/m2≤BMI<24.0 kg/m2,n=65),overweight group(24.0 kg/m2≤BMI<28.0 kg/m2,n=57),obesity group(BMI≥28.0 kg/m2,n=35).The general clinical characteristics,imaging parameters,perioperative indexes,all-cause death and the incidence of other adverse cardiac events during(18.0±6.8)months follow-up were compared among different groups.Risk factors for the perioperative complications and long-term outcomes of TAVR were evaluated. Results:The prevalence of hypertension and diabetes,left ventricular end-diastolic diameter,ventricular septal thickness and left ventricular posterior wall thickness were significantly higher in the obese group than in normal weight group(all P<0.05).The level of prealbumin in low weight group was lower than in normal weight group(P<0.05).The total perioperative complications in low weight group were higher than in normal weight group(60.9%vs.12.3%,P=0.042).During(18.0±6.8)months follow-up,the incidence of all-cause death in the low weight group was significantly higher than that in normal weight group,overweight group and obese group(17.4%vs.4.6%vs.3.5%vs.5.7%,P=0.003).Kaplan-Meier survival analysis evidenced higher mortality rate in low weight group at 18 months after TAVR(log-rank P<0.01).Multivariate Cox regression analysis showed that the risk of long-term adverse cardiovascular events was significantly higher in low weight group than in normal weight group(HR=7.633,95%CI:1.012-57.564,P=0.049). Conclusions:Low weight patients with severe AS have a higher incidence of perioperative complications and a poor long-term prognosis.Such patients should appropriately strengthen their nutritional intake and adjust their body weight to normal levels before performing TAVR.

Background::Psychological stress has been reported to be a potential risk factor for hypertension among females, but it remains unclear whether spousal chronic stress levels alter the risk of hypertension among women. We examined the associations between stress within the family and hypertension among married women.Methods::Reproductive-aged women who were planning for pregnancy and their husbands were recruited from the National Free Pre-pregnancy Checkup Projects (NFPCP) across 31 provinces in China in 2016 and 2017. Perceived stress of wives or husbands was measured with a 5-point Likert-type scale, and assessed from three domains: work/life-related stress, economic stress, and overall stress. Multivariable-adjusted logistic regression models were used to assess the associations between stress status and the prevalence of hypertension.Results::Of 10,027,644 couples, 261,098 (2.60%) women had hypertension. The results showed that higher stress levels among themselves or their husbands were associated with a higher prevalence of hypertension in women ( Pfor trend <0.001). Compared with non-stressed participants, female participants with the highest stress themselves were at a greater risk of hypertension, with adjusted odds ratio (OR) of 1.31 (95% confidence interval [CI]: 1.25-1.37); and compared with participants whose husbands had no stress, those whose husbands had the highest stress level were at a higher risk of hypertension with adjusted OR of 1.24 (95% CI: 1.20-1.29). Moreover, compared with non-stressed status for both couples, only-wife-stressed, only-husband-stressed, and both-stressed couples were found to be significantly associated with increased risks of wives’ hypertension, with adjusted ORs of 1.28 (95% CI: 1.25-1.31), 1.19 (95% CI: 1.17-1.21), and 1.28 (95% CI: 1.26-1.31), respectively. Conclusion::Moderate to severe stress in both spouses might be associated with female hypertension prevalence, which highlights the importance of paying attention to the psychological stresses of couples within the family.

Objective:To understand the cognition and practice of nurses in anesthesia and resuscitation room on patients with xerostomia after general anesthesia, and to provide reference for improving xerostomia.Methods:This was a phenomenological research methods in qualitative research. From January to March 2021, the purpose of sampling method was used to select 10 nurses in anesthesia and recovery rooms from 3 grade A tertiary hospitals in Jinan City, Shandong Province as the research objects. The 7-step Colaizzi analysis method was used to analyze the data and refines the themes.Results:A total of 2 themes and 8 sub-themes were extracted: cognition of the practice process of patients with xerostomia (high recognition and affirmation, support for patients to participate in xerostomia management, focus on children with xerostomia), obstructive factors during practice of patients(intensive nursing human resources, lack of practice atmosphere, lack of standardized assessment tools, incomplete management measures, insufficient nurses′ self-efficacy).Conclusions:Nurses in anesthesia and resuscitation room play a guiding role in the management of patients with xerostomia after general anesthesia. It is necessary to understand nurses′ cognition of xerostomia and the factors that affect their practical behavior in order to supply reference to formulate scientific and systematic management system for xerostomia patients.

The aim of this study was to synthesize and evaluate the necrosis avidity of MRI contrast agent based on rhein and linked by ether. The novel ligand 10-{［6-(1, 8-dihydroxyanthraquinone-3-carboxamido)ethoxyethyl］amino}carbonylmethyl-1, 4, 7, 10-tetraazacyclododecan-1, 4, 7-triacetic acid(DO3A-Ether-Rhein, E1)was synthesized by two steps of acylation and deprotection reaction. The paramagnetic gadolinium 10-{［6-(1, 8-dihydroxyanthraquinone-3-carboxamido)ethoxyethyl］amino}carbonylmethyl-1, 4, 7, 10-tetraazacyclododecan-1, 4, 7-triacetic acid(Gd-DO3A-Ether-Rhein, GdE1)was obtained by coordination of Gd3+ with the above ligand. We examined the necrotic avidity of GdE1 in human hepatocellular carcinoma HepG2 cell necrosis induced by hyperthermia in vitro and in rat model with muscular necrosis induced by microwave ablation in vivo by MRI. The MRI was implemented before administration of GdE1 and during 0-9 h after administration of GdE1(0. 1 mmol/kg), and Gd-DOTA(gadolinium 1, 4, 7, 10-tetraacetic acid-1, 4, 7, 10-tetraazacyclo dodecane)was used as control. The signal intensity of necrotic cells(4 369±70)was significantly higher than that of normal cells(2 555±84)(P< 0. 05). Similarly, the contrast ratio between necrotic and normal muscle at 3 h after administration of GdE1(2. 00±0. 12)was remarkblely higher than that at 0 h after administration of GdE1(1. 27±0. 03)(P< 0. 05). Therefore, GdE1 presents good necrosis affinity and has the potential to be used in the diagnosis of necrosis-related diseases.

In order to investigate the therapeutic effects of scutellarein on acute pharyngitis, 60 rats were randomly divided into five groups: blank group, model group, low-dose scutellarein group, high-dose scutellarein group and positive drug group. HE staining, blood-cell-analyzer, IL-6, IL-1β and TNF-α ELISA kit were used to study the effects of scutellarein on acute pharyngitis in pharyngeal tissue morphology, the counts of white blood cells and neutrophil and the serum concentrations of TNF-α, IL-1β and IL-6. Meanwhile, forty mice were randomly divided into four groups: blank group, low-dose scutellarein group, high-dose scutellarein group and positive drug group. Then, hot plate and writhing test of mice were carried out to study the analgesic effects of scutellarein. Results showed that, compared to the model group, scutellarein improved the physical status of acute pharyngitis rats, reduced the number of white blood cells significantly(P< 0. 05)and decreased the number of neutrophils and the levels of TNF-α, IL-1β and IL-6 in rats serum significantly(P< 0. 01). Meanwhile, scutellarein dramatically improved the pain threshold in hot plate test and decreased the number of writhing mice(P< 0. 01). It can be concluded that scutellarein can be used to treat acute pharyngitis with its anti-inflammatory and analgesic effect.

Objective To analyze the effect of evidence based practice on feeding after spinal operation. Methods To formulate an answerable question, find the best available evidence, appraise the evidence and formulate the recommendations by using the method of evidence-based medicine. A total of 60 postoperative patients who received spinal operation were divided into observation group and control group (30 cases in each group). Those patients in control group received the routine diet guidance and the guidelines for the standardization of intake and consumption after spinal cord surgery were used for patients in observation group. The outcomes were evaluated by postoperative recovery and complications of patients after spinal operation. Results There were no significant difference in the incidence of nausea, vomiting , bloating and celialgia in the 5 hours after surgery and 2 hours after feeding between the two groups (P>0.05). The incidence of thirst and hunger in the 5 hours after surgery in observation group were 3.33％(1/30) and 13.33％(4/30).The incidence of thirst and hunger in the 5 hours after surgery in control group were 80.00％(24/30) and 83.33％(25/30). There were statistically significant in the incidence of thirst and hunger in the 5 hours after surgery between the two groups (χ2=36.27, 24.09, P<0.05). There were not statistically significant in the time of anal exsufflation and first defecation time between the two groups(P>0.05). Conclusions Evidence-based practice in the use of guidelines for the standardization of intake and consumption after spinal cord surgery can guide clinical practice.

This study was aimed to verify the hypothesis that Ge-Xia Zhu-Yu (GXZY) decoction protects liver from porcine serum-induced oxidative stress through the thioredoxin system.SD rats were randomly divided into the blank control group,model group,normal rat + GXZY decoction group,model rat + GXZY group.The rat autoimmune hepatic fibrosis model was induced with porcine serum by intraperitoneal injection (0.5 mL/each rat) twice a week.And GXZY decoction (7.37 g raw material/kg· d) was simultaneously administered daily by gavage.Lipid peroxidation (LPO) levels and thioredoxin reductase (TrxR) activity in liver tissues were determined by the colorimetric method.Polymerase chain reaction (PCR) was used to analyze the transcription factor nuclear factor erythroid 2-related factor 2 (Nfe2l2,previously known as Nrf2) mRNA expression.And the western blot was used to analyze the thioredoxin-1 (Trx1) protein expression and Akt phosphorylation in the liver.The results showed that compared to the model control group,the GXZY decoction group attenuated porcine serum-induced oxidative stress,as indicated by the LPO level,in liver tissues.Furthermore,GXZY decoction significantly enhanced TrxR activity,Trx1 protein expression,Nfe2l2 mRNA expression,and Akt phosphorylation (all P＜0.05).It was concluded that the strong antioxidant properties of GXZY decoction in the porcine serum rat model was due to the enhancement of the hepatic thioredoxin system via activating Akt-Nrf2 signaling pathway.The study results provided experimental evidences for the supporting of this hypothesis.