Sepsis constitutes one of the principal causes of death globally, and the mortality rate of patients complicated with sepsis-induced cardiomyopathy (SIC) surges by over 50%. Early identification of patients with sepsis, particularly SIC, and implementing clinical intervention are vital measures to reduce the mortality. In recent years, biomarkers for the diagnosis and prognosis of SIC have emerged rapidly. Among classical myocardial injury biomarkers, cardiac troponin (cTn), brain natriuretic peptide (BNP), and soluble growth stimulation gene 2 protein (sST2) have predictive value for the prognosis of SIC. Meanwhile, heart-type fatty acid-binding protein (h-FABP) possess relatively high value in diagnosis. Moreover, plasma metabolites, microRNA (miRNA), as well as recently identified markers related to sepsis or cardiovascular diseases also demonstrate outstanding predictive value in both the diagnosis and prognosis of SIC. For instance, exosomal miR-150-5p, blood miR-155, blood miR-378a-3p, blood miR-21-3p, blood miR-233, blood miR-23b, blood miR-135, lipocalin (LCN), heme oxygenase-1 (HO-1), fibroblast growth factor-21 (FGF-21), and growth differentiation factor-15 (GDF-15) show varying degrees of predictive value when it comes to diagnosing SIC. S100A8/A9 protein, triglyceride-glucose (TyG) index, angiotensinogen II (Ang II) and lactoferrin are correlated with the prognosis of SIC. Meanwhile, it has been discovered that the combination of multiple biomarkers outperforms a single biomarker, and certain combinations exhibit superior diagnostic performance. However, most of these studies use single-center clinical data, which has certain limitations and still calls for more high-quality evidence support. Therefore, identifying biomarker combinations that are supported by high-quality evidence, have bedside application potential, and possess high sensitivity and specificity is of crucial importance for the prevention, diagnosis, and treatment of SIC. This review is carried out on the current articles that report biomarkers with predictive value and the diagnosis and prediction of multiple biomarkers in combination, in the hope of continuously optimizing the diagnostic strategy for the specific identification of early SIC.
Humans ; Biomarkers/blood* ; Cardiomyopathies/etiology* ; Sepsis/diagnosis* ; MicroRNAs/blood* ; Prognosis ; Fatty Acid-Binding Proteins/blood*

Objective To explore the application effect of team-based learning(TBL)teaching method combined with scenario simulation in the team-based cardiopulmonary resuscitation(CPR)training for standardized training of resident physicians in department of emergency.Methods A total of 86 standardized training resident physicians rotating in the department of emergency of Guangdong Provincial People's Hospital Southern Medical University from May 2022 to July 2023 were included as study subjects.These resident physicians were divided into a control group(n=42)and an observation group(n=44)according to different teaching methods.The control group was taught using the conventional teaching method,whereas the observation group was taught using a combination of TBL and scenario simulation-based method.The difference of theoretical assessment scores,practical skill competency and training satisfaction were compared before and after training between groups.Results The theoretical and practice skill assessment scores of both groups significantly improved after training(all P<0.05).However,there was no significant difference in the theoretical assessment scores or the score increase between the two groups before and after training.In the subcategory of theoretical assessment scores,the observation group had significantly higher points than the control group in the precautions category after training(21.09±2.07 vs.20.07±1.85,P<0.05).Compared with the control group,the observation group had significantly higher post-training practical skill scores and a significantly greater score increase(scores:86.77±3.89 vs.81.17±4.18,score increase:11±5.15 vs.8±4.60,both P<0.05).Among the subcategory practical skill scores,the observation group outperformed the control group in communication skills,emergency skills and teamwork+humanistic care(communication skills points:21.36±1.71 vs.20.07±1.54,emergency skills points:21.73±1.35 vs.20.21±1.79,teamwork+humanistic care points:22.27±1.76 vs.19.71±2.71,all P<0.05).The degree of satisfaction in overall training satisfaction,the novelty of the teaching method,teacher affinity,interests in learning,developing teamwork ability,class atmosphere,communication and expression ability,and confidence in skill mastery were significantly higher in the observation group than in the control group[overall training satisfaction:97.73%(43/44)vs.50.00%(21/42),the novelty of the teaching method:90.91%(40/44)vs.47.62%(20/42),teacher affinity:93.18%(41/44)vs.57.14%(24/42),interests in learning:97.73%(43/44)vs.59.52%(25/42),developing teamwork ability:95.45%(42/44)vs.52.38%(22/42),class atmosphere:93.18%(41/44)vs.57.14%(24/42),improve communication and expression ability:100.00%(44/44)vs.50.00%(21/42),and confidence in skill mastery:93.18%(41/44)vs.45.24%(19/42),all P<0.05].Conclusion The application of TBL teaching method combined with scenario simulation in CPR training for standardized training of resident physicians can effectively improve quality of clinical skill training.

Objective To explore the effects of different CO2 pneumoperitoneum pressures during surgery on overweight or obese patients with laparoscopic panhysterectomy in Trendelenburg position.Methods A total of 88 overweight or obese patients who underwent laparoscopic panhysterectomy were selected and randomly divided into the low-pressure group and the high-pressure group according to random number table method,with 44 patients in each group.All patients used CO2 as the pneumoperitoneum medium during surgery,with 10 mmHg of CO2 pneumoperitoneum pressure in the low-pressure group and 15 mmHg of CO2 pneumoperitoneum pressure in the high-pressure group.The operation-related indexes,respiratory indicators,nasopharyngeal temperature and adverse reactions of patients were compared between the two groups.Results There was no significant difference in the surgical time,blood loss,intraoperative infusion volume,incidence of organ injury,and laparotomy rate between the two groups(P>0.05).The recovery time of anesthesia of patients in the low-pressure group was shorter than that in the high-pressure group(P<0.05).At 30 minutes after the establishment of pneumoperitoneum,the peak airway pressure(Ppeak)and plateau pressure(Pplat)of patients in the high-pressure group were significantly higher than those in the low-pressure group(P<0.05),while the dynamic lung compliance(Cdyn)of patients in the high-pressure group was significantly lower than that in the low-pressure group(P<0.05).At 60 minutes after the establishment of pneumoperitoneum and the end of pneumoperitoneum,the nasopharyngeal temperature of patients in the high-pressure group were significantly lower than those in the low-pressure group(P<0.05).The incidences of intraoperative hypothermia and shivering in the high-pressure group were significantly higher than those in the low-pressure group(P<0.05).Conclusion Compared with 15 mmHg of CO2 pneumoperitoneum pressure,10 mmHg of CO2 pneumoperitoneum pressure on overweight or obese patients with laparoscopic panhysterectomy in Trendelenburg position does not increase surgical difficulty,and the patients has lower airway pressure,better lung compliance,fewer adverse reactions,and faster recovery,which can also avoid intraoperative hypothermia.

Objective:To systematically evaluate the unmet needs and challenges of caregivers of cancer patients at home and clarify their unmet needs.Methods:A computerized search was conducted in PubMed, Web of Science, Embase, Cochrane Library, ProQuest, Scopus, CINAHL, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc for qualitative studies on the unmet needs and challenges of caregivers of cancer patients in the home environment. The search time limit was from the establishment of the databases to April 30, 2024. The Joanna Briggs Institute Centre for Evidence-Based Healthcare's quality assessment criteria for qualitative research were used to evaluate the quality of the literatures, and the aggregative integration method was used to summarize and integrate the research results.Results:A total of 17 articles were finally included, which were summarized into eight new categories. Further synthesis yielded three integrated results: caregivers in the home environment face multi-dimensional unmet needs and challenges related to patients; caregivers in the home environment face challenges and unmet needs in self-care; caregivers in the home environment are hesitant to obtain external support, and continuity and sustainability are hindered.Conclusions:Medical staff should accurately assess the unmet needs of caregivers of cancer patients at home, pay attention to their negative experiences, promote positive coping, optimize the patient-and family-centered cancer care model, and strengthen social support.

Objective:To investigate the effect of Gexia Zhuyu decoction on Toll-like receptor 4 (TLR4)/Nuclear factor-kappaB (NF-κB) signaling pathway on ulcerative colitis and intestinal mucosal barrier.Methods:A total of 86 cases of ulcerative colitis admitted to Xi′an Traditional Chinese Medicine (TCM) Hospital from March 2019 to July 2023 were prospectively included and divided into observation group and control group according to random number table method, with 43 cases in each group. The control group was treated with mesalazine enteric-coated tablets; The observation group was treated with mesalazine enteric-coated tablets combined with Gexia Zhuyu decoction for removing stasis. The clinical efficacy of the two groups was compared in terms of TCM syndrome score, intestinal mucosal barrier function index [diamine oxidase (DAO), D-lactic acid (D-LA)], TLR4/NF-κB signaling pathway expression and inflammatory factor index [interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α)] before and after treatment. The occurrence of adverse reactions was also compared.Results:The total effective rate of observation group was higher than that of control group (χ 2=4.074, P=0.044). Before treatment, there was no significant difference in TCM syndrome scores between the two groups (all P>0.05). After treatment, the TCM syndrome scores of both groups were lower than those before treatment (all P<0.05), and the TCM syndrome scores of the observation group were lower than those of the control group (all P<0.05). Before treatment, there were no significant differences in D-LA and DAO levels between the two groups (all P>0.05). After treatment, the levels of D-LA and DAO in both groups were lower than before treatment (all P<0.05), and the levels of D-LA and DAO in the observation group were lower than those in the control group (all P<0.05). After treatment, the mRNA expressions of TLR4 and NF-κB in both groups were decreased compared with those before treatment, and the mRNA expressions of TLR4 and NF-κB in the observation group were lower than those in the control group (all P<0.05). After treatment, the levels of IL-6, IL-8 and TNF-α in both groups were decreased compared with those before treatment (all P<0.05), and the levels of IL-6, IL-8 and TNF-α in the observation group were lower than those in the control group (all P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (χ 2=2.346, P=0.126). Conclusions:The application of Gexia Zhuyu decoction in the treatment of ulcerative colitis can not only effectively improve the clinical symptoms, signs and intestinal mucosal barrier function, but also improve the inflammatory response by mediating TLR4/NF-κB signaling pathway.

Objective:To investigate the effect of Gexia Zhuyu decoction on Toll-like receptor 4 (TLR4)/Nuclear factor-kappaB (NF-κB) signaling pathway on ulcerative colitis and intestinal mucosal barrier.Methods:A total of 86 cases of ulcerative colitis admitted to Xi′an Traditional Chinese Medicine (TCM) Hospital from March 2019 to July 2023 were prospectively included and divided into observation group and control group according to random number table method, with 43 cases in each group. The control group was treated with mesalazine enteric-coated tablets; The observation group was treated with mesalazine enteric-coated tablets combined with Gexia Zhuyu decoction for removing stasis. The clinical efficacy of the two groups was compared in terms of TCM syndrome score, intestinal mucosal barrier function index [diamine oxidase (DAO), D-lactic acid (D-LA)], TLR4/NF-κB signaling pathway expression and inflammatory factor index [interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α)] before and after treatment. The occurrence of adverse reactions was also compared.Results:The total effective rate of observation group was higher than that of control group (χ 2=4.074, P=0.044). Before treatment, there was no significant difference in TCM syndrome scores between the two groups (all P>0.05). After treatment, the TCM syndrome scores of both groups were lower than those before treatment (all P<0.05), and the TCM syndrome scores of the observation group were lower than those of the control group (all P<0.05). Before treatment, there were no significant differences in D-LA and DAO levels between the two groups (all P>0.05). After treatment, the levels of D-LA and DAO in both groups were lower than before treatment (all P<0.05), and the levels of D-LA and DAO in the observation group were lower than those in the control group (all P<0.05). After treatment, the mRNA expressions of TLR4 and NF-κB in both groups were decreased compared with those before treatment, and the mRNA expressions of TLR4 and NF-κB in the observation group were lower than those in the control group (all P<0.05). After treatment, the levels of IL-6, IL-8 and TNF-α in both groups were decreased compared with those before treatment (all P<0.05), and the levels of IL-6, IL-8 and TNF-α in the observation group were lower than those in the control group (all P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (χ 2=2.346, P=0.126). Conclusions:The application of Gexia Zhuyu decoction in the treatment of ulcerative colitis can not only effectively improve the clinical symptoms, signs and intestinal mucosal barrier function, but also improve the inflammatory response by mediating TLR4/NF-κB signaling pathway.

Objective To explore the effects of different CO2 pneumoperitoneum pressures during surgery on overweight or obese patients with laparoscopic panhysterectomy in Trendelenburg position.Methods A total of 88 overweight or obese patients who underwent laparoscopic panhysterectomy were selected and randomly divided into the low-pressure group and the high-pressure group according to random number table method,with 44 patients in each group.All patients used CO2 as the pneumoperitoneum medium during surgery,with 10 mmHg of CO2 pneumoperitoneum pressure in the low-pressure group and 15 mmHg of CO2 pneumoperitoneum pressure in the high-pressure group.The operation-related indexes,respiratory indicators,nasopharyngeal temperature and adverse reactions of patients were compared between the two groups.Results There was no significant difference in the surgical time,blood loss,intraoperative infusion volume,incidence of organ injury,and laparotomy rate between the two groups(P>0.05).The recovery time of anesthesia of patients in the low-pressure group was shorter than that in the high-pressure group(P<0.05).At 30 minutes after the establishment of pneumoperitoneum,the peak airway pressure(Ppeak)and plateau pressure(Pplat)of patients in the high-pressure group were significantly higher than those in the low-pressure group(P<0.05),while the dynamic lung compliance(Cdyn)of patients in the high-pressure group was significantly lower than that in the low-pressure group(P<0.05).At 60 minutes after the establishment of pneumoperitoneum and the end of pneumoperitoneum,the nasopharyngeal temperature of patients in the high-pressure group were significantly lower than those in the low-pressure group(P<0.05).The incidences of intraoperative hypothermia and shivering in the high-pressure group were significantly higher than those in the low-pressure group(P<0.05).Conclusion Compared with 15 mmHg of CO2 pneumoperitoneum pressure,10 mmHg of CO2 pneumoperitoneum pressure on overweight or obese patients with laparoscopic panhysterectomy in Trendelenburg position does not increase surgical difficulty,and the patients has lower airway pressure,better lung compliance,fewer adverse reactions,and faster recovery,which can also avoid intraoperative hypothermia.

Objective:To systematically evaluate the unmet needs and challenges of caregivers of cancer patients at home and clarify their unmet needs.Methods:A computerized search was conducted in PubMed, Web of Science, Embase, Cochrane Library, ProQuest, Scopus, CINAHL, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc for qualitative studies on the unmet needs and challenges of caregivers of cancer patients in the home environment. The search time limit was from the establishment of the databases to April 30, 2024. The Joanna Briggs Institute Centre for Evidence-Based Healthcare's quality assessment criteria for qualitative research were used to evaluate the quality of the literatures, and the aggregative integration method was used to summarize and integrate the research results.Results:A total of 17 articles were finally included, which were summarized into eight new categories. Further synthesis yielded three integrated results: caregivers in the home environment face multi-dimensional unmet needs and challenges related to patients; caregivers in the home environment face challenges and unmet needs in self-care; caregivers in the home environment are hesitant to obtain external support, and continuity and sustainability are hindered.Conclusions:Medical staff should accurately assess the unmet needs of caregivers of cancer patients at home, pay attention to their negative experiences, promote positive coping, optimize the patient-and family-centered cancer care model, and strengthen social support.

Objective To explore the application effect of team-based learning(TBL)teaching method combined with scenario simulation in the team-based cardiopulmonary resuscitation(CPR)training for standardized training of resident physicians in department of emergency.Methods A total of 86 standardized training resident physicians rotating in the department of emergency of Guangdong Provincial People's Hospital Southern Medical University from May 2022 to July 2023 were included as study subjects.These resident physicians were divided into a control group(n=42)and an observation group(n=44)according to different teaching methods.The control group was taught using the conventional teaching method,whereas the observation group was taught using a combination of TBL and scenario simulation-based method.The difference of theoretical assessment scores,practical skill competency and training satisfaction were compared before and after training between groups.Results The theoretical and practice skill assessment scores of both groups significantly improved after training(all P<0.05).However,there was no significant difference in the theoretical assessment scores or the score increase between the two groups before and after training.In the subcategory of theoretical assessment scores,the observation group had significantly higher points than the control group in the precautions category after training(21.09±2.07 vs.20.07±1.85,P<0.05).Compared with the control group,the observation group had significantly higher post-training practical skill scores and a significantly greater score increase(scores:86.77±3.89 vs.81.17±4.18,score increase:11±5.15 vs.8±4.60,both P<0.05).Among the subcategory practical skill scores,the observation group outperformed the control group in communication skills,emergency skills and teamwork+humanistic care(communication skills points:21.36±1.71 vs.20.07±1.54,emergency skills points:21.73±1.35 vs.20.21±1.79,teamwork+humanistic care points:22.27±1.76 vs.19.71±2.71,all P<0.05).The degree of satisfaction in overall training satisfaction,the novelty of the teaching method,teacher affinity,interests in learning,developing teamwork ability,class atmosphere,communication and expression ability,and confidence in skill mastery were significantly higher in the observation group than in the control group[overall training satisfaction:97.73%(43/44)vs.50.00%(21/42),the novelty of the teaching method:90.91%(40/44)vs.47.62%(20/42),teacher affinity:93.18%(41/44)vs.57.14%(24/42),interests in learning:97.73%(43/44)vs.59.52%(25/42),developing teamwork ability:95.45%(42/44)vs.52.38%(22/42),class atmosphere:93.18%(41/44)vs.57.14%(24/42),improve communication and expression ability:100.00%(44/44)vs.50.00%(21/42),and confidence in skill mastery:93.18%(41/44)vs.45.24%(19/42),all P<0.05].Conclusion The application of TBL teaching method combined with scenario simulation in CPR training for standardized training of resident physicians can effectively improve quality of clinical skill training.

Objective To investigate the publication status of papers written by key nursing staff of vascular interventional academic organizations and to analyze its influencing factors so as to provide a theoretical basis for improving the scientific research output of vascular interventional nursing staff.Methods The questionnaire was designed by reading and referring to the domestic and foreign literature.A survey was conducted in a total of 346 members of the Nursing Professional Committee of the China Branch of the International Vascular Alliance,who were from 22 provinces,autonomous regions,and municipalities of China.Results Of the 346 key vascular interventional nursing staff,190 had published one paper(54.91％)and 156(45.09％)had published multiple papers in the past 5 years as the first author or corresponding author,and among them 267(77.17％)wrote papers for the purpose to make a promotion.Multiple regression analysis showed that academic position,first education degree,professional position,length of nursing service,knowledge of the English literature,and source of scientific research knowledge(school study)were the independent factors affecting the paper publication by vascular interventional nursing staff(all P＜0.05).The survey showed that vascular interventional nursing staff had difficulties in carrying out scientific research because they were lack of scientific research-related knowledge,busy with daily work,and lack of scientific research atmosphere.Conclusion The publication of academic papers written by key nursing staff of vascular interventional academic organizations is influenced by many factors.It is recommended that the hospital administration should strengthen the training of English literature retrieval ability for nursing staff so as to fundamentally improve the overall scientific research level of nursing staff.(J Intervent Radiol,2024,33:309-313)