To summarize the nursing management experience of 9 patients with lung transplantation undergoing extracorporeal membrane oxygenation(ECMO)combined with continuous renal replacement therapy(CRRT)during perioperative period.The key points of nursing include forming a professional team to ensure the whole process management;comprehensive evaluation and pretreatment of adverse events during the operation to maintain the safe operation of the equipment;refined volume management based on the surgical process ensures intraoperative hemodynamic stability;optimization of intraoperative anticoagulation management to reduce the incidence of complications;multi-device safe transport management ensures the continuity of postoperative treatment.Through comprehensive and targeted nursing intervention,9 patients were successfully treated with ECMO combined with CRRT during the operation.The patients were transferred out of ICU 3～12 days after the operation,and were followed up for 3 months.The patient's condition is good.

To summarize the nursing management experience of 9 patients with lung transplantation undergoing extracorporeal membrane oxygenation(ECMO)combined with continuous renal replacement therapy(CRRT)during perioperative period.The key points of nursing include forming a professional team to ensure the whole process management;comprehensive evaluation and pretreatment of adverse events during the operation to maintain the safe operation of the equipment;refined volume management based on the surgical process ensures intraoperative hemodynamic stability;optimization of intraoperative anticoagulation management to reduce the incidence of complications;multi-device safe transport management ensures the continuity of postoperative treatment.Through comprehensive and targeted nursing intervention,9 patients were successfully treated with ECMO combined with CRRT during the operation.The patients were transferred out of ICU 3～12 days after the operation,and were followed up for 3 months.The patient's condition is good.

Objective:To investigate the current situation of the use of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension, which should aid the development of TIPS in China.Methods:The China Portal Hypertension Alliance (CHESS) initiated this study that comprehensively investigated the basic situation of TIPS for portal hypertension in China through network research. The survey included the following: the number of surgical cases, main indications, the development of Early-TIPS, TIPS for portal vein cavernous transformation, collateral circulation embolization, intraoperative portal pressure gradient measurement, commonly used stent types, conventional anticoagulation and time, postoperative follow-up, obstacles, and the application of domestic instruments.Results:According to the survey, a total of 13 527 TIPS operations were carried out in 545 hospitals participating in the survey in 2021, and 94.1% of the hospital had the habit of routine follow-up after TIPS. Most hospitals believed that the main indications of TIPS were the control of acute bleeding (42.6%) and the prevention of rebleeding (40.7%). 48.1% of the teams carried out early or priority TIPS, 53.0% of the teams carried out TIPS for the cavernous transformation of the portal vein, and 81.0% chose routine embolization of collateral circulation during operation. Most of them used coils and biological glue as embolic materials, and 78.5% of the team routinely performed intraoperative portal pressure gradient measurements. In selecting TIPS stents, 57.1% of the hospitals woulel choose Viator-specific stents, 57.2% woulel choose conventional anticoagulation after TIPS, and the duration of anticoagulation was between 3-6 months (55.4%). The limitation of TIPS surgery was mainly due to cost (72.3%) and insufficient understanding of doctors in related departments (77.4%). Most teams accepted the domestic instruments used in TIPS (92.7%).Conclusions:This survey shows that TIPS treatment is an essential part of treating portal hypertension in China. The total number of TIPS cases is far from that of patients with portal hypertension. In the future, it is still necessary to popularize TIPS technology and further standardize surgical indications, routine operations, and instrument application.

Objective::Pulmonary arterial hypertension (PAH) is a cardiovascular disease caused by primary proliferative lesions in pulmonary arterioles. Competing endogenous RNAs (ceRNAs) have been reported to act as sponges for microRNAs (miRNAs). To date, however, the mechanisms underlying ceRNA involvement in PAH have not been investigated. This study aimed to construct a PAH-related ceRNA network to further explore the mechanisms of PAH.Methods::A probe reannotation was conducted to identify the long non-coding RNAs (lncRNAs) and messenger RNAs (mRNAs) involved in PAH. Based on the reannotation results, the "limma" package was used to identify the differentially expressed genes (DEGs) and lncRNAs. The miRcode database was used to predict the lncRNA-miRNA interactions. Then, the mRNAs targeted by the miRNAs were predicted by using TargetScan, miRTarBase, and miRDB. Based on the above interactions, a ceRNA network was constructed, which was mapped and visualized with Cytoscape 3.6.1 software. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses were performed using the database. To predict possible drugs or molecules that may mitigate PAH, C-Map analysis was applied to find relevant molecular compounds that can reverse the expression of DEGs in cell lines.Results::The ceRNA network consisted of 174 nodes and 304 links, which included 10 lncRNAs, 23 miRNAs, and 53 mRNAs. The hub genes of the ceRNA network for PAH included hsa-miR-17-5p, hsa-miR-20b-5p, MEG3, HCP5, hsa-miR-27a-3p, hsa-miR-107, hsa-miR-142-3p, hsa-miR-363-3p, hsa-miR-301b-3p, and hsa-miR-23b-3p. Calprotectin, irinotecan, and medrysone were found to be the 3 significant compounds.Conclusion::This study found that hsa-miR-17-5p, hsa-miR-20b-5p, MEG3, HCP5, hsa-miR-27a-3p, hsa-miR-107, hsa-miR-142-3p, hsa-miR-363-3p, hsa-miR-301b-3p, and hsa-miR-23b-3p maybe the underlying biomarkers and targets for diagnosis and treatment of PAH.

Objective::Pulmonary arterial hypertension (PAH) is a cardiovascular disease caused by primary proliferative lesions in pulmonary arterioles. Competing endogenous RNAs (ceRNAs) have been reported to act as sponges for microRNAs (miRNAs). To date, however, the mechanisms underlying ceRNA involvement in PAH have not been investigated. This study aimed to construct a PAH-related ceRNA network to further explore the mechanisms of PAH.Methods::A probe reannotation was conducted to identify the long non-coding RNAs (lncRNAs) and messenger RNAs (mRNAs) involved in PAH. Based on the reannotation results, the "limma" package was used to identify the differentially expressed genes (DEGs) and lncRNAs. The miRcode database was used to predict the lncRNA-miRNA interactions. Then, the mRNAs targeted by the miRNAs were predicted by using TargetScan, miRTarBase, and miRDB. Based on the above interactions, a ceRNA network was constructed, which was mapped and visualized with Cytoscape 3.6.1 software. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses were performed using the database. To predict possible drugs or molecules that may mitigate PAH, C-Map analysis was applied to find relevant molecular compounds that can reverse the expression of DEGs in cell lines.Results::The ceRNA network consisted of 174 nodes and 304 links, which included 10 lncRNAs, 23 miRNAs, and 53 mRNAs. The hub genes of the ceRNA network for PAH included hsa-miR-17-5p, hsa-miR-20b-5p, MEG3, HCP5, hsa-miR-27a-3p, hsa-miR-107, hsa-miR-142-3p, hsa-miR-363-3p, hsa-miR-301b-3p, and hsa-miR-23b-3p. Calprotectin, irinotecan, and medrysone were found to be the 3 significant compounds.Conclusion::This study found that hsa-miR-17-5p, hsa-miR-20b-5p, MEG3, HCP5, hsa-miR-27a-3p, hsa-miR-107, hsa-miR-142-3p, hsa-miR-363-3p, hsa-miR-301b-3p, and hsa-miR-23b-3p maybe the underlying biomarkers and targets for diagnosis and treatment of PAH.

With the improvement of the quality of obstetric medical care, postpartum hemorrhage, the leading cause of maternal death, has received high attention. And pregnancy associated venous thromboembolism (PA-VTE) has gradually become one of the leading causes of maternal death. The clinical characteristics of PA-VTE and the particularity of treatment determine the importance of early assessment and prevention. This article reviews the risk factors and current assessment status of PA-VTE, in order to provide references for clinical risk assessment and prevention of VTE in pregnant women.

Objective: To study the frequency of clinical nuclear medicine procedures and the distribution of examinees in Jiangxi povince, and to estimate the annual frequency of clinical nuclear medicine procedures in Jiangxi in 2017. Methods: A survey was made with questionnaires on all medical institutions carrying out clinical nuclear medicine practices in the province. Results: Except for positron emission tomography (PET) examinations, the frequency of nuclear medicine procedures for females was much higher than that for males. The total frequency of nuclear medicine procedures was 0.67 examinations per 1 000 population in 2017, and the frequencies for diagnosis and treatment were 0.58 and 0.09 examinations per 1 000 population, respectively. Conclusions The frequency of clinical nuclear medicine procedures in Jiangxi increased rapidly after the "Ninth Five-Year Plan" period. It is necessary to further standardize the diagnosis and treatment of nuclear medicine procedures, to enhance the awareness of radiation protection of nuclear medicine staff and to promote the healthy and orderly development of nuclear medicine.

Objective To investigate the status and analyze the influencing factors of structural empowerment and psychological empowerment of midwives in Suzhou.Methods Using convenience sampling,totally 309 midwives from fifteen hospitals in Suzhou were investigated with the Conditions of Work Effectiveness Questionnaire-Ⅱ (CWEQ-Ⅱ) and Psychological Empowerment Scale (PES).Results The scores of structural and psychological empowerment of midwives were (18.07±3.12) and (14.82±2.01).There was a significantly positive correlation between midwives' structural and psychological empowerment (r=0.396,P＜0.01).Hospital level and whether participate in midwifery standardization training had an impact on structural empowerment score(P＜0.05).Age,parental status,job title,salary,delivery room working hours,number of night shifts per month,and whether or not participate in teaching had an impact on psychological empowerment score(P＜0.05).Conclusion Midwives' structural and psychological empowerments are at a moderate level.Administrators should take targeted intervention to create an empowerment-allowing working environment for midwives,stabilize midwives work force,strengthen midwifery discipline construction and make full specialized features of midwives.

Objective To investigate the expression of fibroblast growth factor 4 (FGF4) in serum of active rheumatoid arthritis (RA) and its role in RA synoviocyte proliferation. Methods The serum level of FGF4 were detected by protein arrays in 20 patients with RA, and 20 age and gender matched healthy controls. FLSs were isolated from RA synovium,and were co-cultured with recombinant human FGF4 (rhFGF4). Cell proliferation was quantified by Cell Counting Kit-8 assay and cell cycle distribution was evaluated by flow-cytometry. The protein levels of cyclin D1, phospho-Akt (p-Akt) and phospho-p38 (p-p38) were measured by western blot. Results The serum expression of FGF4 in RA group was higher than that in control group (P=0.041). After being treated with different concentrations of rhFGF4 (12.5, 25, 50, and 100 ng/ml), RA-FLS showed significant increase in cell proliferation, with different rates of [(121 ±8)％], [(126 ±12)％], [(129 ± 12)％], a nd [(134 ±14)％] respectively, comparing with that of the controls [(100 ±0)％, (P12.5=0.049, P25=0.009, P50=0.004, P100=0.001).]. Among them, the percentage of G2/M+S phase cells were [(12.6±3.6)％], [(15.3±4.5)％], [(17.1±5.1)％], [(19.6±4.1)％] respectively, and except the lowest rhFGF4 concentration treatment group of 12.5 ng/ml, G2/M+S phase cells in other groups was significantly increased compared with the controls [(5.4±2.4)％] (P12.5=0.159, P25=0.042, P50=0.018, P100=0.005). And the protein expression of cyclin D1 was up-regulated after being treated with 50 ng/ml and 100 ng/ml rhFGF4 (P50=0.035, P100=0.027). FGF4 transiently increased the expression of p-Akt and p-p38 protein at the concentration of 50 ng/ml. Comparisons of data between groups were performed by independent sample Student's t-test. Statistical significant differences among groups were tested by one-way analysis of variance (ANOVA) or the Kruskal-Wallis test. The Dunnett's t-test was used for multiple comparisons. A P-value of <0.05 was considered statistically significant. Conclusion Our results suggest that FGF4 is highly expressed in the serum of active RA patients. FGF4 may promote the proliferation of RA-FLS via modulating PI3K/Akt and p38-MAPK signaling pathways, which subsequently contributs to synovial hyperplasia.