Objective:To deeply understand the experience of neurosurgery nurses on the lack of perioperative nursing for intracranial tumors patients, so as to provide reference for reducing the lack of nursing and improving the quality of nursing and patients′ medical experience.Methods:From December 2023 to February 2024, the neurosurgical nurses of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were selected by the purpose sampling method with maximum differentiation. Semi-structured interviews were conducted with phenomenological research methods. The interview data were transcribed, coded, categorized and described.Results:A total of 17 neurosurgical nurses were enrolled, including 6 males and 11 females, aged 24-45(33.29 ± 6.74) years. Three themes of perioperative nursing lack experience of neurosurgery nurses were obtained, including nursing lack experience (lack of safety nursing, lack of timely nursing, lack of high efficiency nursing, lack of effectiveness nursing, lack of fair nursing, and lack of patient-centered), the physical and mental effects of nursing lack on nurses (impacts of lack of nursing on nurses′ physiology and psychology), and reasons for lack of nursing (personnel, equipment, materials, organization management, environment).Conclusions:Neurosurgical nurses lack of perioperative nursing for patients with intracranial tumor, which has a certain impact on the physical and mental health of nurses, suggesting that neurosurgical nurses should attach great importance to the lack of nursing for patients with intracranial tumor and formulate a scientific and effective management system.

Objective To analyze the latent classes of social alienation in colorectal cancer patients and further explore the influencing factors and cumulative effects of risk factors across different classes,thereby providing a reference for individualized interventions.Methods Convenience sampling was used to select colorectal cancer patients hospitalized in the gastrointestinal surgery and oncology departments of 3 tertiary-level hospitals in Shandong Province from January to June 2023 as the study subjects.A questionnaire survey was conducted using the General Information Questionnaire,Social Avoidance Scale,Social Anxiety Scale,UCLA Loneliness Scale,Sense of Coherence Scale,Family Cohesion Scale,and Social Support Rating Scale.Data analysis was performed using latent profile analysis and multivariate logistic regression analysis.Results A total of 292 questionnaires were distributed,with 270 valid responses collected,yielding a response rate of 92.47％.The results of the latent profile analysis indicated that social alienation among colorectal cancer patients could be categorized into 3 latent groups:the"low alienation group"(42.59％),the"high alienation-high social avoidance group"(14.08％),and the"moderate alienation-high social anxiety group"(43.33％).Results of logistic regression analysis revealed that employment status,stoma status,metastasis,sense of coherence,family cohesion,and social support were influencing factors across different categories.Moreover,a cumulative effect of sense of coherence,family cohesion,and social support on distinct categories was observed(P＜0.05).Conclusion Social alienation among colorectal cancer patients exhibits group heterogeneity.Healthcare professionals should identify the characteristic differences among patients,prioritise those with multiple risk factors,and develop targeted intervention measures to help them better integrate into society.

Objective To observe the effect of Kaixin Powder on neuroinflammation in APP/PS1 mice by regulating WDFY1/TLR4/NF-κB signaling pathway;To explore its mechanism of intervening in Alzheimer disease(AD).Methods APP/PS1 transgenic mice were randomly divided into model group,donepezil hydrochloride group(0.66 mg/kg),and Kaixin Powder low-,medium-and high-dosage groups(1.625,3.25,6.5 g/kg),C57BL/6J mice were set as blank control group,with 8 mice in each group,and corresponding drug intervention was given to medicaction group for 24 weeks.Morris water maze,Y maze and novel object recognition experiments were conducted to assess the cognitive function and learning and memory abilities of mice,immunohistochemical staining was used to detect the deposition of β-amyloid protein(Aβ)in hippocampus,the morphology and Nissl bodies of hippocampal CA1 neurons were observed using HE staining and Nissl staining,ELISA was used to detect the serum contents of interleukin(IL)-6,IL-17,IL-1β and tumor necrosis factor-α(TNF-α),Western blot was used to detect the protein expression of calcium-binding adapter molecule 1(Iba1),glial fibrillary acidic protein(GFAP),WDFY1,Toll like receptor 4(TLR4),Toll like receptor associated molecule(TRAM),TIR domain adapter protein(TRIF),NF-κB p65 and p-NF-κB p65 in hippocampal tissue,RT-qPCR was used to detect the mRNA expression of WDFY1,TLR4,TRAM,TRIF and NF-κB p65 in hippocampal tissue.Results Compared with the blank control group,the model group had significantly prolonged escape latency,reduced platform crossings,decreased autonomous reaction alternation rate and relative recognition index(P<0.05,P<0.01),with increased deposition of Aβ in hippocampal tissue(P<0.01),damaged morphological structure of neurons,reduced number of neurons and Nissl bodies,the serum contents of IL-6,IL-17,IL-1β and TNF-α significantly increased,the expression of Iba1,GFAP,WDFY1,TLR4,TRAM,TRIF,p-NF-κB p65 protein and WDFY1,TLR4,TRAM,TRIF mRNA in hippocampal tissue significantly increased(P<0.01).Compared with the model group,Kaixin Powder groups and donepezil hydrochloride group had significantly shortened escape latency and increased platform crossings,autonomous reaction alternation rate and relative recognition index(P<0.05,P<0.01),hippocampal Aβ deposition reduced in Kaixin Powder medium-,high-dosage groups and donepezil hydrochloride group,the morphological structure of neurons recovered,the number of neurons and Nissl bodies increased,the serum contents of IL-6,IL-17,IL-1β and TNF-α significantly decreased(P<0.05,P<0.01),and the protein expression of Iba1,GFAP,WDFY1,TLR4,TRAM,TRIF,p-NF-κB p65 and the mRNA expressions of WDFY1,TLR4,TRAM and TRIF in hippocampal tissue significantly decreased(P<0.05,P<0.01).Conclusion Kaixin Powder can improve cognitive function and learning and memory abilities in AD model mice,alleviate hippocampal neuron damage and Aβ deposition,inhibit the activation of microglia and astrocytes,and thereby reduce serum inflammatory cytokine release.Its mechanism may be related to regulating the WDFY1/TLR4/NF-κB signaling pathway to inhibit neuroinflammation.

OBJECTIVE To explore the clinical value of metagenomic next generation sequencing(mNGS)in detec-tion of pathogens from the patients with pulmonary infection.METHODS The clinical data were collected from 103 patients with pulmonary infection who were treated in respiratory and critical care medicine department of Gansu Province People's Hospital from Jun.2021 to Jun.2023.The pathogens were detected from all of the patients with the use of mNGS for bronchoalveolar lavage fluid(BALF)and traditional cultures(including sputum culture and BALF culture).The positive rates,consistency,distribution,efficacy and curative effects were observed and sys-tematically compared between the two detection methods.RESULTS Totally 122 strains of bacteria,47 strains of fungi,94 strains of viruses,3 strains of Mycoplasma and 2 strains of Chlamydia were detected from the 103 pa-tients by mNGS,as compared with only 45 strains of bacteria and 20 strains of fungi that were detected by the tra-ditional culture method.The positive rate of detection of pathogens was 89.32％by mNGS,higher than 38.83％of the traditional culture method(P＜0.001).There was certain difference in the distribution of pathogens be-tween the two detection method,the two detection method showed the poor consistency of detection efficacy,and the effect of targeted drug therapy based on the mNGS-detected pathogens was higher than that of the mNGS-negative empirical therapy(P＜0.001).In addition,some of drug resistance genes could be detected by mNGS.CONCLUSIONS The mNGS shows remarkable higher efficacy in detection of the pathogens causing pul-monary infections than the traditional culture method and can detect various types of pathogens.The effect of the targeted drug therapy based on the pathogens detected by mNGS is remarkable.It plays an imorptant role in guid-ing the clinical diagnosis and treatment of the patients with pulmonary infections.

Objective:To explore the risk factors of quality of life(QoL)being below normal levels in patients undergo-ing total knee arthroplasty(TKA)at 6 months after surgery,and to construct a nomogram prediction model.Method:Two-hundred and sixty-seven patients who underwent TKA at Qingdao Hospital,University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital)from April 2021 to October 2022 were selected.Clini-cal data were collected on admission and within 6 months after surgery.According to the QoL assessment at 6 months after surgery,they were divided into a high-quality group(n=136)and a non-high-quality group(n=131).LASSO regression was used to screen the predictors,and multivariate Logistic regression was established to construct the predictive model of QoL of TKA patients at 6 months after surgery.Receiver operating character-istic curve(ROC curve),calibration curve and decision curve were drawn to evaluate its predictive value.Result:A total of 131(49.06%)patients had lower QoL than normal 6 months after TKA.LASSO regression selected age,surgical side,education level,duration of knee osteoarthritis(KOA),perioperative recovery,and visual analog scale(VAS)during preoperative rest as predictors.Multivariate logistic regression analysis showed that age(OR,1.08;95%CI,1.01-1.15),duration of KOA(OR,1.13;95%CI,1.05-1.22),VAS during preoperative rest(OR,1.94;95%CI,1.20-3.15),and perioperative rehabilitation(OR,0.42;95%CI,0.18-0.97)were independent risk factors for lower than normal QoL in TKA patients at 6 months after surgery(P<0.05).Statistically significant indicators in multivariate logistic regression analysis were includ-ed in the nomogram model,which underwent internal validation.The area under the ROC curve was 0.829(95%CI,0.779-0.879),indicating good predictive ability of the model.The calibration curve showed good consistency between the predicted probability and the actual probability.The decision curve analysis showed that this model is clinically applicable.Conclusion:Age,duration of KOA,VAS during preoperative rest,and perioperative rehabilitation are indepen-dent predictors of lower-than-normal QoL in TKA patients at 6 months after surgery,and the nomogram mod-el based on the above indicators had good predictive performance.

Objective:To evaluate the role of NOD-like receptor protein 3 (NLRP3) inflammasome-mediated microglia activation in myocardial ischaemia-reperfusion-induced brain injury in mice.Methods:Fifty-two SPF healthy male wild-type C57BL/6 mice and 52 NLRP3 -/- mice, aged 8-10 weeks, were divided into 4 groups ( n=26 each) using a random number table method: wild type sham operation group (W-S group), wild type myocardial ischemia-reperfusion group (W-IR group), NLRP3 -/- sham operation group (NLRP3 -/--S group), and NLRP3 -/- myocardial ischemia-reperfusion group (NLRP3 -/--IR group). The myocardial ischemia-reperfusion-induced brain injury model was established by ligating the left anterior descending coronary artery for 45 min followed by 24 h of reperfusion in anesthetized mice. The cognitive function was evaluated using the modified Morris water maze test at 24 h of reperfusion. The mice were sacrificed after blood specimens were collected, and brain tissues were obtained for measurement of the blood-brain barrier permeability and water content, for microscopic examination of the pathological changes of brain tissues, and for determination of serum S-100β protein and neuron-specific enolase (NSE) concentrations, contents of interleukin-1 beta (IL-1β), IL-6 and tumor necrosis factor-alpha (TNF-α) in hippocampal tissues (by enzyme-linked immunosorbent assay), expression of NLRP3, apoptosis-associated speck-like protein (ASC), cleaved cysteine aspartate protease 1 (cleaved-caspase-1), gasdermin D (GSDMD), ionized calcium-binding adapter molecule 1 (Iba-1), and occludin in hippocampal tissues (by immunofluorescence and/or Western blot). The apoptosis rate of neurons and density of dendritic spine were calculated. Results:Compared with sham operation group, the escape latency was significantly prolonged, the number of crossing the original platform was decreased, and the time spent in the target quadrant was shortened, the concentrations of serum S-100β protein and NSE were increased, the blood-brain barrier permeability and brain water content were increased, the dendritic spine density in the hippocampal CA1 area was decreased, the contents of IL-1β, IL-6 and TNF-α were increased, the expression of NLRP3, ASC, cleaved-caspase-1, GSDMD and Iba-1 was up-regulated, and the expression of occludin was down-regulated ( P<0.05), and the pathological injury to brain tissues was found in ischemia-reperfusion group. Compared with W-IR group, the escape latency was significantly shortened, the number of crossing the original platform was increased, and the time spent in the target quadrant was prolonged, the concentrations of serum S-100β protein and NSE were decreased, the blood-brain barrier permeability and brain water content were decreased, the dendritic spine density in the hippocampal CA1 area was increased, the contents of IL-1β, IL-6 and TNF-α were decreased, the expression of NLRP3, ASC, cleaved-caspase-1, GSDMD and Iba-1 was down-regulated, and the expression of occludin was up-regulated ( P<0.05), and the pathological injury to brain tissues was alleviated in NLRP3 -/--IR group. Conclusions:NLRP3 inflammasome-mediated microglia activation is involved in myocardial ischaemia-reperfusion-induced brain injury in mice.

Uveal melanoma (UM) is a common type of adult ocular malignancy, and its metastasis potential and prognosis are closely related to tumor stage, histopathological features and genetic molecular markers. Currently, eyeball-preserving radiation therapy, including adhesive radiotherapy and proton beam radiotherapy, has become the preferred method for UM treatment. Despite this, overall survival is low, with about 50% of patients eventually developing distant metastases. Recently, remarkable progress has been made in the field of treatment for metastatic uveal melanoma, especially in the development of new technologies and new drugs. These advances reduce the risk of tumor metastasis and spread while improving the cure rate for patients. Tibenfox is a major breakthrough in the treatment of UM. Through these explorations, it is hoped that in the future, early diagnosis of the disease can guide prognosis assessment and implement personalized treatment strategies aimed at protecting patient vision, controlling tumor metastasis, and improving survival.

Objective:To explore the lived experiences of family members of terminal ICU patients regarding their humanistic care needs and provide theoretical foundations for developing nursing care plans tailored to their needs.Methods:This study was a descriptive qualitative study. From April to December 2023, 16 family members of terminally ill ICU patients in Shanghai East Hospital, Tongji University were selected for semi-structured interviews using purposive sampling method, and the interview data were qualitatively analyzed using Colaizzi 7-step analysis.Results:The humanistic care needs of family members of terminally ill ICU patients can be categorized into five themes, namely, the need to know the condition at the first time; the need to participate in treatment and decision-making; the need to respect the wishes of terminally ill patients; the need for psychological care; and the need for social support.Conclusions:The humanistic care needs of family members of terminal ICU patients remain largely unmet. Nursing professionals should consider these needs and preferences and provide family members with professional guidance to help them establish positive coping mechanisms.

Objective:To explore the risk factors of quality of life(QoL)being below normal levels in patients undergo-ing total knee arthroplasty(TKA)at 6 months after surgery,and to construct a nomogram prediction model.Method:Two-hundred and sixty-seven patients who underwent TKA at Qingdao Hospital,University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital)from April 2021 to October 2022 were selected.Clini-cal data were collected on admission and within 6 months after surgery.According to the QoL assessment at 6 months after surgery,they were divided into a high-quality group(n=136)and a non-high-quality group(n=131).LASSO regression was used to screen the predictors,and multivariate Logistic regression was established to construct the predictive model of QoL of TKA patients at 6 months after surgery.Receiver operating character-istic curve(ROC curve),calibration curve and decision curve were drawn to evaluate its predictive value.Result:A total of 131(49.06%)patients had lower QoL than normal 6 months after TKA.LASSO regression selected age,surgical side,education level,duration of knee osteoarthritis(KOA),perioperative recovery,and visual analog scale(VAS)during preoperative rest as predictors.Multivariate logistic regression analysis showed that age(OR,1.08;95%CI,1.01-1.15),duration of KOA(OR,1.13;95%CI,1.05-1.22),VAS during preoperative rest(OR,1.94;95%CI,1.20-3.15),and perioperative rehabilitation(OR,0.42;95%CI,0.18-0.97)were independent risk factors for lower than normal QoL in TKA patients at 6 months after surgery(P<0.05).Statistically significant indicators in multivariate logistic regression analysis were includ-ed in the nomogram model,which underwent internal validation.The area under the ROC curve was 0.829(95%CI,0.779-0.879),indicating good predictive ability of the model.The calibration curve showed good consistency between the predicted probability and the actual probability.The decision curve analysis showed that this model is clinically applicable.Conclusion:Age,duration of KOA,VAS during preoperative rest,and perioperative rehabilitation are indepen-dent predictors of lower-than-normal QoL in TKA patients at 6 months after surgery,and the nomogram mod-el based on the above indicators had good predictive performance.

A case report of adult skeletal class Ⅲ patient with high angle open bite is presented in this article.The patient underwent extraction of bilateral mandibular first molars and straightening the third molars,open bite was resolved,normal over bite,over jet and good occlusion were established.