Objective:To explore the oral health behavior cognition and care experience of the primary caregivers for children with ectodermal dysplasia.Methods:From February to April 2023, purposive sampling was used to select 10 primary caregivers of children with ectodermal dysplasia who visited the Department of Dental Implantation of the Affiliated Stomatological Hospital of Nanjing Medical University as the research subject. Semi-structured interviews were used to collect data, and Colaizzi 7-step analysis method was used to sort out and analyze the data.Results:The oral health behavior cognition of the primary caregivers for children with ectodermal dysplasia were summarized into three themes, including incomplete oral health behavior cognition, insufficient emphasis on continuity of health education, and high expectations for disease treatment effectiveness. The care experience was summarized into three themes, namely insufficient family and social support, excessive psychological pressure, and feeling confused and unable to cope with the education and guidance of the child.Conclusions:There are many misconceptions among the primary caregivers of children with ectodermal dysplasia regarding oral health behaviors, including insufficient cognition, high psychological pressure, and numerous care issues. We should strengthen the knowledge training of caregivers through various means, increase their cognitive level, attach importance to their psychological guidance, enhance their emotional response ability, reduce the burden of care and improve their care experience.

Objective:To investigate the status quo of illness perception of middle-aged and elderly male patients with abnormal prostate cancer screening in the community and analyze its influencing factors, so as to provide a reference for carrying out health promotion and promoting early treatment of prostate cancer.Methods:From September 2021 to April 2023, the convenient sampling was used to select 750 patients with abnormal prostate cancer screening in 15 community health service centers in Nanjing as research objects according to the prostate cancer screening system of Department of Urology of Nanjing Drum Tower Hospital. The general information questionnaire, the Brief Illness Perception Questionnaire (BIPQ), Self-Perceived Burden Scale (SPBS), The eHealth Literacy Scale (eHEALS) and Social Support Rating Scale (SSRS) were used to conduct the questionnaire survey. Pearson correlation analysis was used to investigate the correlation between illness perception and eHealth literacy, self-perceived burden and social support in middle-aged and elderly men with abnormal prostate cancer screening in community. Multiple linear regression was used to analyze the influencing factors of illness perception of middle-aged and elderly men with abnormal prostate cancer screening in the community.Results:A total of 750 questionnaires were sent out in this study, and 703 valid questionnaires were collected, with an effective recovery rate of 93.73% (703/750). BIPQ score of 703 middle-aged and elderly men with abnormal prostate cancer screening in the community was (45.68±8.73). The results of univariate analysis showed that there were statistically significant differences in BIPQ scores among middle-aged and elderly men with abnormal prostate cancer screening in different ages, marital status, educational level, income level, medical expenses and whether there were other chronic diseases ( P<0.05). Illness perception was negatively correlated with eHealth literacy and social support ( P<0.01), and positively correlated with self-perceived burden ( P<0.01). Multiple linear regression analysis showed that income level, medical expenses, self-perceived burden, eHealth literacy and social support were the influential factors for illness perception of middle-aged and elderly men with abnormal prostate cancer screening in the community ( P<0.05) . Conclusions:The illness perception of middle-aged and elderly men with abnormal prostate cancer screening in the community needs to be improved urgently. The society and medical staff should pay more attention to the patients with abnormal prostate cancer screening, take effective intervention measures to improve the correct cognition of the disease and improve patients' medical treatment behavior, so as to achieve "early detection, early diagnosis, early treatment".

Objective To construct a perioperative exercise program for older frail patients with colorectal cancer,and to verify its effect.Methods Based on Goal-directed Theory and literature review,expert consultation was carried out to establish the perioperative exercise program for older frail patients with colorectal cancer.Then,from July to December 2022,the perioperative exercise program was established for older frail patients with colorectal cancer hospitalized in the General Surgery Department of a tertiary A hospital in Suzhou by convenience sampling method for preliminary application.It was divided in to the intervention group and the control group by the ward.The intervention group was applied with the constructed perioperative exercise program on the basis of routine perioperative nursing.The safety,feasibility and intervention effect of the program were evaluated.Results 15 experts were included for 2 rounds of expert consultations.The authority coefficient was 0.880;the coefficient of variation was＜0.250;the Kendall concordance coefficient was 0.167 and 0.224,respectively.The final program contained 4 stages:preoperative exercise,postoperative bed rest,sitting and standing exercise.In the end,54 specific interventions were constructed.During the preliminary application,all the patients completed the program.Generalized estimation equation showed that,on the interaction effect,there was no statistical difference(P=0.752);there were significant differences on the intervention effect and the time effect(P＜0.05).At discharge,there were significant differences in timed up and go test and Barthel Index between the 2 groups(P＜0.05).Only 2 patients experienced mild pain in the intervention group,and no other adverse events occurred.Conclusion The perioperative exercise program for older frail patients with colorectal cancer,based on Goal-directed Theory,is scientific,reliable and safe.It has been preliminarily verified in improving postoperative physical function,activities of daily living and early postoperative recovery of elderly frail patients with colorectal cancer.

Objective:To explore the drugs and clinical characteristics causing drug-induced liver injury (DILI) in recent years, as well as identify drug-induced liver failure, and chronic DILI risk factors, in order to better manage them timely.Methods:A retrospective investigation and analysis was conducted on 224 cases diagnosed with DILI and followed up for at least six months between January 2018 and December 2020. Univariate and multivariate logistic regression analyses were used to identify risk factors for drug-induced liver failure and chronic DILI.Results:Traditional Chinese medicine (accounting for 62.5%), herbal medicine (accounting for 84.3% of traditional Chinese medicine), and some Chinese patent medicines were the main causes of DILI found in this study. Severe and chronic DILI was associated with cholestatic type. Preexisting gallbladder disease, initial total bilirubin, initial prothrombin time, and initial antinuclear antibody titer were independent risk factors for DILI. Prolonged time interval between alkaline phosphatase (ALP) and alanine aminotransferase (ALT) falling from the peak to half of the peak (T 0.5ALP and T 0.5ALT) was an independent risk factor for chronic DILI [area under the receiver operating characteristic curve (AUC)?=?0.787, 95%CI: 0.697~0.878, P ?

Objective:In chronic hepatitis B (CHB) patients with previous 96-week treatment with tenofovir amibufenamide (TMF) or tenofovir disoproxil fumarate (TDF), we investigated the efficacy of sequential TMF treatment from 96 to 144 weeks.Methods:Enrolled subjects who were previously assigned (2:1) to receive either 25 mg TMF or 300 mg TDF with matching placebo for 96 weeks received extended or switched TMF treatment for 48 weeks. Efficacy was evaluated based on virological, serological, biological parameters, and fibrosis staging. Statistical analysis was performed using the McNemar test, t-test, or Log-Rank test according to the data. Results:593 subjects from the initial TMF group and 287 subjects from the TDF group were included at week 144, with the proportions of HBV DNA<20 IU/ml at week 144 being 86.2% and 83.3%, respectively, and 78.1% and 73.8% in patients with baseline HBV DNA levels ≥8 log10 IU/ml. Resistance to tenofovir was not detected in both groups. For HBeAg loss and seroconversion rates, both groups showed a further increase from week 96 to 144 and the 3-year cumulative rates of HBeAg loss were about 35% in each group. However, HBsAg levels were less affected during 96 to 144 weeks. For patients switched from TDF to TMF, a substantial further increase in the alanine aminotransferase (ALT) normalization rate was observed (11.4%), along with improved FIB-4 scores.Conclusion:After 144 weeks of TMF treatment, CHB patients achieved high rates of virological, serological, and biochemical responses, as well as improved liver fibrosis outcomes. Also, switching to TMF resulted in significant benefits in ALT normalization rates (NCT03903796).

Objective:In chronic hepatitis B (CHB) patients with previous 96-week treatment with tenofovir amibufenamide (TMF) or tenofovir disoproxil fumarate (TDF), we investigated the safety profile of sequential TMF treatment from 96 to 144 weeks.Methods:Enrolled subjects that previously assigned (2:1) to receive either 25 mg TMF or 300 mg TDF with matching placebo for 96 weeks received extending or switching TMF treatment for 48 weeks. Safety profiles of kidney, bone, metabolism, body weight, and others were evaluated.Results:666 subjects from the initial TMF group and 336 subjects from TDF group with at least one dose of assigned treatment were included at week 144. The overall safety profile was favorable in each group and generally similar between extended or switched TMF treatments from week 96 to 144. In subjects switching from TDF to TMF, the non-indexed estimated glomerular filtration rate (by non-indexed CKD-EPI formula) and creatinine clearance (by Cockcroft-Gault formula) were both increased, which were (2.31±8.33) ml/min and (4.24±13.94) ml/min, respectively. These changes were also higher than those in subjects with extending TMF treatment [(0.91±8.06) ml/min and (1.30±13.94) ml/min]. Meanwhile, switching to TMF also led to an increase of the bone mineral density (BMD) by 0.75% in hip and 1.41% in spine. On the other side, a slight change in TC/HDL ratio by 0.16 (IQR: 0.00, 0.43) and an increase in body mass index (BMI) by (0.54±0.98) kg/m 2 were oberved with patients switched to TMF, which were significantly higher than that in TMF group. Conclusion:CHB patients receiving 144 weeks of TMF treatment showed favorable safety profile. After switching to TMF, the bone and renal safety was significantly improved in TDF group, though experienceing change in metabolic parameters and weight gain (NCT03903796).

Objective To explore the short-term efficacy of endovascular isolation treatment for type A aortic intramural hematoma(AIH)with pericardial effusion,and to discuss the endovascular isolation treatment strategy for type A AIH with pericardial effusion.Methods A total of 12 patients with type A AIH complicated by pericardial effusion,who were admitted to the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine of China between February 2018 and November 2021,were enrolled in this study.Before surgery,the intima of the ascending aorta was intact in all patients,but a rupture at the proximal intima of the aortic arch or the thoracic descending aorta was detected.All patients received endovascular isolation treatment.Among them,4 patients received endovascular isolation treatment within one week after the onset of disease,and 8 patients received selective operation after receiving conservative treatment for one week.The patients were followed up for one year.Results Among the patients who received endovascular isolation treatment within one week after the onset of disease,one patient recovered smoothly,two patients developed type A dissection within 3 months after surgery,and one died early after surgery.All the 8 patients,who received selective operation after receiving conservative treatment for one week,recovered smoothly.Conclusion For patients with type A AIH complicated by mild to moderate pericardial effusion,selective endovascular isolation treatment after receiving the conservative treatment to alleviate the ascending aortic hematoma can achieve ideal therapeutic effect.

Objective To analyze the literature on urinary incontinence after radical prostatectomy by bibliometric method, and to understand the research status and development trend in this field. Methods The Web of Science core collection database was searched for articles on urinary incontinence after radical prostatectomy from January, 1 2013 to March, 25 2023, and the visual analysis of the annual number of publications, countries, institutions, authors, source journals and keywords was performed by VOS viewer and CiteSpace software. Results A total of 1 212 relevant literatures were retrieved, and the annual number of publications was on the rise. The United States ranked the first in the number of publications, followed by Germany and Italy, among which the United States cooperated more with other countries. The institutions ranking top 10 were mostly concentrated in the United States, and the high-contribution institutions were mainly Memorial Sloan-Kettering Cancer Center and University of California, San Francisco. The author with the largest number of articles was MATTHEW R, and many stable cooperation teams had been formed among the authors. The main journals in this field included Journal of Urology, European Urology, etc. The research hotspots in this field mostly focused on the relationship between influencing factors, evaluation diagnosis, treatment methods and outcome indicators of urinary incontinence after radical prostatectomy. Urinary incontinence rehabilitation, biofeedback, local therapy, robot-assisted radical prostatectomy, and patient reported outcomes have been active topics in recent years. Conclusion Urinary incontinence after radical prostatectomy has attracted more and more attention from scholars. However, compared with the developed countries such as the United States, the total number of papers published in China is less, and the academic influence and exchanges between scholars are weak. In the future, it is advisable to learn from relevant research results of foreign countries, strengthen international scientific research exchange and cooperation, and promote the development of related research on urinary incontinenceafter radical prostatectomy in China.

Objective:To compare the consistency of preoperative frailty assessment in elderly colorectal cancer patients using Frailty Phenotype (FP), FRAIL Scale (FS), Clinical Frailty Scale (CFS), and Edmonton Frailty Scale (EFS), and their predictive performance in predicting the postoperative complication, so as to provide reference for nurses to choose appropriate frailty assessment tools.Methods:From December 2020 to October 2021, 207 elderly patients who underwent radical surgery for colorectal cancer at the General Surgery of the First Affiliated Hospital of Soochow University were selected as the study subject by convenience sampling. FP, FS, CFS, and EFS were used to assess patients' frailty. Taking postoperative complications as the outcome indicator, the predictive performance of four frailty assessment tools was compared using the receiver operating characteristic (ROC) curve and Bayes discriminant analysis.Results:The frailty detection rates of FP, FS, CFS, and EFS in 207 elderly colorectal cancer patients were 19.8% (41/207), 11.6% (24/207), 22.2% (46/207), and 10.1% (21/207), respectively. The areas under the ROC curves of FP, FS, CFS, and EFS were 0.714, 0.643, 0.737, and 0.665, respectively, with statistically significant differences (all P<0.01). Pairwise comparison found that there were statistically significant differences in the area under the ROC curve between FP and FS, FS and CFS, CFS and EFS ( P<0.05). The cross validation accuracy of FP, FS, CFS and EFS in predicting the postoperative complication in elderly colorectal cancer patients was 78.7%, 68.6%, 76.3%, and 75.8%, respectively. Conclusions:FP and CFS have moderate predictive performance for postoperative complications in elderly colorectal cancer patients, and there is no difference in predictive performance between the two. Both CFS and FP can be used for the assessment of preoperative frailty in elderly colorectal cancer patients, but considering clinical applicability, CFS is recommended.

Objective:To retrieve, evaluate, and sum up the evidence on target temperature management in stroke patients, and summarize the best evidence.Methods:Based on the "6S" pyramid model, clinical practice guidelines, expert consensus, evidence summary, and systematic review on target temperature management in stroke patients were searched from top to bottom in British Medical Journal Best Practice, UpToDate, Joanna Briggs Institute Evidence-Based Health Care Center, Guidelines International Network, Agency for Healthcare Research and Quality, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses' Association of Ontario, American Heart Association, American Stroke Association, European Stroke Organization, Medlive, Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure, WanFang Data, VIP and China Biology Medicine Disc. The search period was from database establishment to October 7, 2022. Two researchers received evidence-based nursing training independently evaluated the quality of the article, extracted, integrated, and summarized the best evidence.Results:A total of 12 articles were included, including three clinical practice guidelines, four systematic reviews, and five expert consensuses. 24 best pieces of evidence were summarized from five aspects, involving target temperature population, target temperature implementation, complication monitoring, nutritional support, and prognosis evaluation.Conclusions:This study adopts an evidence-based approach to systematically summarize the best evidence for target temperature management in stroke patients, which can provide the best decision-making basis for clinical medical and nursing staff to manage temperature in stroke patients, further standardize temperature monitoring and management, and offer scientific basis for future research and practice.