Objective:To evaluate the application of blood glucose management evidence in hemodialysis patients with diabetic nephropathy within clinical practice, establish review indicators, and analyze both obstacles and enablers.Methods:Based on the feasibility, appropriateness, meaningfulness, and effectiveness (FAME) principle, the best evidence for blood glucose management in hemodialysis patients with diabetic nephropathy was evaluated. Ultimately, 21 pieces of evidence were included, and review indicators were established. A baseline review was conducted at the Hemodialysis Center of the Department of Nephrology, Zhongshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, from August to September 2024. Based on the review findings, obstacles and enablers in the evidence-based practice process were analyzed, and change strategies were developed.Results:A total of 39 review indicators were established. Among these, one indicator achieved a 100.00% implementation rate, four indicators achieved an implementation rate between 80.00% and <100.00%, six indicators achieved an implementation rate between 60.00% and<80.00%, 19 indicators achieved an implementation rate between>0 and<60.00%, and nine indicators achieved a 0 implementation rate. After analyzing each review indicator, the primary obstacles included evidence not being transformed into clear and accessible formats, low awareness among healthcare providers and patients, lack of incentive mechanisms, significant gaps from existing nursing processes, insufficient manpower, need for external support, and requirement for additional training. Additionally, factors that promoted evidence translation included reliable sources of evidence, recognition and support for change from administrators and teams, a culture and experience of change within the team, the potential for change to yield significant benefits, and the availability of resources within the hospital to support the change.Conclusions:There is a significant gap between blood glucose management evidence and clinical practice among hemodialysis patients with diabetic nephropathy. Appropriate change strategies should be developed through clinical review and analysis of obstacles and enablers to promote the translation and application of evidence in clinical practice.

Objective:To evaluate the application of blood glucose management evidence in hemodialysis patients with diabetic nephropathy within clinical practice, establish review indicators, and analyze both obstacles and enablers.Methods:Based on the feasibility, appropriateness, meaningfulness, and effectiveness (FAME) principle, the best evidence for blood glucose management in hemodialysis patients with diabetic nephropathy was evaluated. Ultimately, 21 pieces of evidence were included, and review indicators were established. A baseline review was conducted at the Hemodialysis Center of the Department of Nephrology, Zhongshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, from August to September 2024. Based on the review findings, obstacles and enablers in the evidence-based practice process were analyzed, and change strategies were developed.Results:A total of 39 review indicators were established. Among these, one indicator achieved a 100.00% implementation rate, four indicators achieved an implementation rate between 80.00% and <100.00%, six indicators achieved an implementation rate between 60.00% and<80.00%, 19 indicators achieved an implementation rate between>0 and<60.00%, and nine indicators achieved a 0 implementation rate. After analyzing each review indicator, the primary obstacles included evidence not being transformed into clear and accessible formats, low awareness among healthcare providers and patients, lack of incentive mechanisms, significant gaps from existing nursing processes, insufficient manpower, need for external support, and requirement for additional training. Additionally, factors that promoted evidence translation included reliable sources of evidence, recognition and support for change from administrators and teams, a culture and experience of change within the team, the potential for change to yield significant benefits, and the availability of resources within the hospital to support the change.Conclusions:There is a significant gap between blood glucose management evidence and clinical practice among hemodialysis patients with diabetic nephropathy. Appropriate change strategies should be developed through clinical review and analysis of obstacles and enablers to promote the translation and application of evidence in clinical practice.

OBJECTIVE: To explore the effect and mechanism of miR-125a-5p targeted regulation of scavenger receptor B1 (Scarb1) gene on anoxia/reoxygenation injury of rat cardiomyocytes. METHODS: H9c2 rat cardiomyocytes were randomly divided into blank control group, hypoxia/reoxygenation group, transfection control group and mir-125a-5p transfection group. The expression of miR-125a-5p, cardiomyocyte viability, apoptosis rate, ATP content and the expression of Scarb1, Cyt C, Bax, Bcl-2 and NF-κB signaling pathway related proteins were determined. Target gene of miR-125a-5p was predicted with Targetscan software, and the targeting of miR-125a-5p on Scarb1 was verified by double luciferase reporter gene experiment. RESULTS: Compared with the blank control group, the expression of miR-125a-5p, Bax, Cyt C and the apoptotic rate of cardiomyocytes in the hypoxia/reoxygenation group were significantly increased (P<0.05), while the expression of Scarb1, Bcl-2 and the content of ATP were significantly decreased (P<0.05). Compared with the control group, the situation of mir-125a-5p transfection group was just the opposite. Double luciferase reporter gene experiment has confirmed Scarb1 to be the target of miR-125a-5p. Hypoxia/reoxygenation can promote the expression of NF-κB p65, C-myc and Cyclin D1 in cardiomyocytes, while down-regulating the expression of miR-125a-5p can inhibit the expression of such proteins. CONCLUSION Hypoxia/reoxygenation can induce the expression of miR-125a-5p in rat cardiomyocytes. Inhibition of miR-125a-5p can protect cardiomyocytes from hypoxia/reoxygenation by up-regulating the expression of Scarb1. The mechanism may be related to the inhibition of activation of NF-κB signaling pathway.

Objective : To explore the effects of“radiotherapy assistant”application on lung cancer patients who receive radiotherapy. Methods : A total of 120 patients with lung cancer who received radiotherapy in Hangzhou Cancer Hospital from March to September 2017 were recruited and randomly divided into a control group and an experimental group. The patients in the control group received the routine health education,while the ones in the experimental group performed the“radiotherapy assistant”application focused on interactive guidance. Before and after the intervention,the scores of treatment-nursing compliance and self-management efficacy between the two groups were compared. Results : After the intervention,the compliance scores of radiotherapy treatment,health behaviors,regular review,moderate exercise,medication and diets in the experimental group were 2.77±0.43,2.67±0.51,2.68±0.50,2.45±0.75,2.77±0.43 and 2.65±0.55;the ones in the control group were 2.62±0.49,2.42±0.59,2.55±0.50,2.37±0.64,2.67±0.48 and 2.37±0.69. The scores of the six items of compliance in the two groups were all improved compared to the ones before the intervention,but the interaction between the groups and intervention time was not statistically significant（P>0.05）. The scores of positive attitude,self-decompression,self-decision and total self- management efficacy in the experimental group were 52.48±7.69,10.51±3.31,36.88±6.15 and 97.62±12.87,respectively;the ones in the control group were 37.38±10.44,5.70±1.51,27.58±9.41,and 92.17±11.19. The scores of the two groups were all improved compared to the ones before the intervention,and the ranges of the scores improved in the experimental group were wider than those in the control group. Conclusion The“radiotherapy assistant”application can significantly improve the self-management efficacy of patients who receive the lung cancer radiotherapy,but its effect on the improvement of treatment compliance requires long-term intervention to verify.

Objective to investigate the clinical efficacy of decompression and pedicle screw fixation through posterior approach for complete thoracic spine fracture dislocation.Methods The clinical data of six patients with complete thoracic spine fracture and dislocation treated from September 2002 to June 2016 were analyzed retrospectively by case series study.There were five males and one female,aged 21-67 years old (mean,47.2 years).The injury segments were T3～4 dislocation in one case,T5～6 dislocation in two cases,T6 ～7 dislocation in two cases and T8 ～9 dislocation in one case.There was one case of ASIA grade E and five cases of Grade A,and all of six cases were associated with multiple rib fractures and hemopneumothorax.The companied status was one case of sternal fracture,one case of atlantoaxial complex fractures and three cases of pulmonary contusion.The posterior median incision decompression and pedicle screw system fixation were performed,and the intervertebral bone grafting was conducted after restoration.The surgery time,bleeding volume during surgery,fracture restoration,bone grafting fusion,failure of internal fixation and other complications were recorded.The Visual Analogue Scale (VAS) and American Spinal Injury Association (ASIA) classification were used to assess the pain and neurological function improvement between the preoperative visit and final follow-up visit.Results The surgery time was 150-240 minutes (mean,205 minutes).The bleeding volume during the surgery was 700-2 100 ml (mean,1167 ml).One case was died of pulmonary infection at one week after surgery,the others were followed up for 3-14 months (mean,7.4 months).After operation,five patients were satisfied with the reduction,and the lateral displacement was partially restored in one cases.Five cases of intervertebral bone grafting all had bone fusion.There was no fixation failure.The VAS was (7.4 ± 0.6) points before surgery,(4.5 ± 1.6) points at one week after surgery and (1.8 ± 0.3) points at final visit of follow-up,which had significant difference from the preoperative status (P ＜ 0.05).One case of ASIA grade E had no postoperative aggravation and four cases of grade A had no improvement.Conclusion Posterior decompression and pedicle screw fixation system is optimal choice of treatment for complete thoracic fractures and dislocations for it can attain reduction of fracture and dislocation as well as bone fusion,provide stability for spine and relieve pain.