Objective:To develop a scale on hospice care perception and attitude in family members of critically ill patients, so as to provide a valid tool for measuring the cognition and attitude level of hospice care among family members of critically ill patients.Methods:During May 2022 to 2023, an initial pool of scale entries was formed through the literature analysis method and group discussion. The scale′s first draft was formed by applying the Delphi correspondence method and a small sample pre-survey. The developed scale was administered to 98 family members of critically ill patients in Shandong Provincial Hospital Affiliated to Shandong First Medical University to test the reliability and validity of scale.Results:The results of exploratory factor analysis extracted 5 explanatory factors with a cumulative contribution rate of 77.65%. The developed Hospice Care Perceptions and Attitudes of Families of Critically Ill Patients Scale had 19 items. The content validity of 0.922 and a Cronbach alpha coefficient of 0.816 showed good validity and reliability.Conclusions:The scale has sufficient reliability and can be used to assess cognitive and attitudinal levels of hospice care in family members of critically ill patients.

OBJECTIVE To conduct the epidemiological survey for 4 patients with carbapenem-resistant Klebsiella pneumoniae(CRAB)that gathered to emerge in intensive care unit(ICU)within a short period so as to find out the sources of suspected CRAB.METHODS The clinical data and epidemiological history of the 4 patients with hospital-associated infection with CRAB who were treated in Shandong Provincial Hospital Affiliated to Shandong First Medical University from Mar.31,2023 to Apr.7,2023 were retrospectively analyzed.The whole genome second-generation sequencing was carried out for the CRAB strains isolated from the patients and their surround-ings,and the sources of the CRAB strains were traced by means of the whole genome sequencing.RESULTS The result of the epidemiological survey showed that the case 1,2,3 and 4 were close in spatial position and had the similar drug resistance spectrum,and there might be cross infection.With the combination of the result of genome analysis,it was found that the strain from the case 1 was brought from the community and was the evolutionary branch different from other CRAB strains causing nosocomial infection;the strains from the case 2,3 and 4 had the close original sources with the CRAB strains from surroundings.CONCLUSIONS The CRAB strain from the case 1 is brought from community,which differs in the evolution branch with the strains from the cases of hospi-tal-associated CRAB infection.The transmission of CRAB leading to the incident of suspected hospital-associated infection outbreak is multiple sources.It is an effective measure to early identify the outbreak of hospital-associated infection and take targeted prevention measures so as to control the outbreak of hospital-associated infection.

Objective:To develop a scale on hospice care perception and attitude in family members of critically ill patients, so as to provide a valid tool for measuring the cognition and attitude level of hospice care among family members of critically ill patients.Methods:During May 2022 to 2023, an initial pool of scale entries was formed through the literature analysis method and group discussion. The scale′s first draft was formed by applying the Delphi correspondence method and a small sample pre-survey. The developed scale was administered to 98 family members of critically ill patients in Shandong Provincial Hospital Affiliated to Shandong First Medical University to test the reliability and validity of scale.Results:The results of exploratory factor analysis extracted 5 explanatory factors with a cumulative contribution rate of 77.65%. The developed Hospice Care Perceptions and Attitudes of Families of Critically Ill Patients Scale had 19 items. The content validity of 0.922 and a Cronbach alpha coefficient of 0.816 showed good validity and reliability.Conclusions:The scale has sufficient reliability and can be used to assess cognitive and attitudinal levels of hospice care in family members of critically ill patients.

A 75-year-old male patient with non-small cell lung cancer in the lower lobe of the left lung underwent left lobectomy, followed by 4 cycles of adjuvant chemotherapy with paclitaxel and platinum, 4 cycles of chemotherapy with docetaxel and cisplatin, and immunotherapy with sintilimab, 13 cycles of immunotherapy with sintilimab monotherapy, and 5 cycles of endostatin and sintilimab, spanning a total of 5 years. Due to disease progression, he received the monotherapy with anlotinib, 42 days later, the patient developed intestinal perforation, and laparoscopic ileal perforation repair surgery was performed. During the operation, a perforation with a diameter of about 1 cm was observed in the ileum, indicating the outflow of digestive fluid and a large amount of purulent fluid accumulation in the pelvic cavity; no signs of gastrointestinal tumor metastasis were observed. After surgery, the patient developed abdominal infection and peritonitis, and was given symptomatic and supportive treatments such as anti-infection for 7 days. However, the patient developed severe complications such as lung infection, heart failure, sepsis, and respiratory failure, and died.

Objective To investigate the impacts of long non coding RNA(LncRNA)-PH domain containing 5 antisense RNA 1(FGD5-AS1)on the proliferation,migration,and invasion of colorectal cancer(CRC)cells by regulating the miR-299-5p/recombinant lysine specific demethylase 4B(KDM4B)axis.Methods The expressions of LncRNA FGD5-AS1,miR-299-5p,and KDM4B were detected by qRT-PCR in the surgically resected CRC tissues and adjacent tissues of 34 CRC patients CRC cells HCT116 were separated into si-NC group,si-FGD5-AS1 group,si-FGD5-AS1+inhibitor NC group,and si-FGD5-AS1+miR-299-5p inhibitor group.The levels of mRNA in each group were detected.CCK8,scratch assay,and Transwell assay were ap[plied to detect the proliferation,migration,and invasion of HCT116 cells in each group.Western blot was applied to detect the expression of proteins.Dual luciferase reporter gene assay verified the interaction mechanism between LncRNA FGD5-AS1 and miR-299-5p,and between miR-299-5p and KDM4B.Results LncRNA FGD5-AS1 and KDM4B were highly expressed in CRC tissue,while miR-299-5p was low expressed in CRC tissue(P＜0.05).The expression of LncRNA FGD5-AS1 mRNA,KDM4B mRNA,OD450,scratch healing rate,invasion number,PCNA,MMP-2,MMP-9,KDM4B in the si-FGD5-AS1 group were lower than those in the si-NC group,the expression of miR-299-5p mRNA was higher than that in the si-NC group(P＜0.05).Compared with the si-FGD5-AS1 group and si-FGD5-AS1+inhibitor NC group,the expression of miR-299-5p in the si-FGD5-AS1+miR-299-5p inhibitor group decreased(P＜0.05),the KDM4B mRNA,OD450,scratch healing rate,number of invasions,and expression of PCNA,MMP-2,MMP-9,KDM4B increased(P＜0.05).LncRNA FGD5-AS1 targeted negative regulation of miR-299-5p,while miR-299-5p targeted negative regulation of KDM4B.Conclusion Knocking down LncRNA FGD5-AS1 may inhibit the proliferation,migration,and invasion of CRC cells,and its mechanism may be achieved by regulating the miR-299-5p/KDM4B signaling axis.

Objective To rescue a strain of Chikungunya virus(CHIKV)using reverse genetics system.Methods Molecular cloning experiments,including PCR,agarose gel electrophoresis and homologous recombination were employed to generate an infectious cDNA clone(pFK-CHIKV-LN)derived from the isolated Caribbean Chikungunya strain(Caribbean strain,isolate M100,Genbank LN898083.1).The mRNA obtained from vitro transcription were transfected into BHK-21 to rescue the CHIKV.The viral titer was determined by 50%tissue culture infection dose(TCID50),with calculations performed using the Reed-Muench method.Western blot(WB)and real time quantitative polymerase chain reaction(RT-qPCR)were employed to assess the levels of viral protein and mRNA at various time points during infection.Results The full-length cDNA clone of CHIKV was successfully constructed,enabling the rescue of CHIKV progeny.RT-qPCR and WB confirmed the significant increasing expression levels of NS1 mRNA and proteins(NS3,E1)of BHK-21 during the infection process.Conclusion The full-length infectious clone of CHIKV has been constructed successfully,which provides a good tool for subsequent studies on the gene structure,protein function and pathogenic mechanism of CHIKV.

Objective To rescue a strain of Chikungunya virus(CHIKV)using reverse genetics system.Methods Molecular cloning experiments,including PCR,agarose gel electrophoresis and homologous recombination were employed to generate an infectious cDNA clone(pFK-CHIKV-LN)derived from the isolated Caribbean Chikungunya strain(Caribbean strain,isolate M100,Genbank LN898083.1).The mRNA obtained from vitro transcription were transfected into BHK-21 to rescue the CHIKV.The viral titer was determined by 50%tissue culture infection dose(TCID50),with calculations performed using the Reed-Muench method.Western blot(WB)and real time quantitative polymerase chain reaction(RT-qPCR)were employed to assess the levels of viral protein and mRNA at various time points during infection.Results The full-length cDNA clone of CHIKV was successfully constructed,enabling the rescue of CHIKV progeny.RT-qPCR and WB confirmed the significant increasing expression levels of NS1 mRNA and proteins(NS3,E1)of BHK-21 during the infection process.Conclusion The full-length infectious clone of CHIKV has been constructed successfully,which provides a good tool for subsequent studies on the gene structure,protein function and pathogenic mechanism of CHIKV.

OBJECTIVE To conduct the epidemiological survey for 4 patients with carbapenem-resistant Klebsiella pneumoniae(CRAB)that gathered to emerge in intensive care unit(ICU)within a short period so as to find out the sources of suspected CRAB.METHODS The clinical data and epidemiological history of the 4 patients with hospital-associated infection with CRAB who were treated in Shandong Provincial Hospital Affiliated to Shandong First Medical University from Mar.31,2023 to Apr.7,2023 were retrospectively analyzed.The whole genome second-generation sequencing was carried out for the CRAB strains isolated from the patients and their surround-ings,and the sources of the CRAB strains were traced by means of the whole genome sequencing.RESULTS The result of the epidemiological survey showed that the case 1,2,3 and 4 were close in spatial position and had the similar drug resistance spectrum,and there might be cross infection.With the combination of the result of genome analysis,it was found that the strain from the case 1 was brought from the community and was the evolutionary branch different from other CRAB strains causing nosocomial infection;the strains from the case 2,3 and 4 had the close original sources with the CRAB strains from surroundings.CONCLUSIONS The CRAB strain from the case 1 is brought from community,which differs in the evolution branch with the strains from the cases of hospi-tal-associated CRAB infection.The transmission of CRAB leading to the incident of suspected hospital-associated infection outbreak is multiple sources.It is an effective measure to early identify the outbreak of hospital-associated infection and take targeted prevention measures so as to control the outbreak of hospital-associated infection.

ObjectiveTo explore the current situation and influencing factors of humanistic care experience among patients visiting traditional Chinese medicine （TCM） outpatient clinics in China， and to provide a basis for optimizing TCM-characterized services in both TCM and Western medicine hospitals. MethodsA multi-center cross-sectional study was conducted using convenience sampling to select 35 hospitals across 13 provinces in China （including 3 TCM hospitals and 32 TCM outpatient clinics in general hospitals）. A total of 3，430 patients were surveyed using the general information questionnaire and the Outpatient Humanistic Care Experience Questionnaire， with data collected via Questionnaire Star. Univariate analysis and multiple linear regression were employed to examine the impacts of patient characteristics， visit characteristics， hospital type （TCM hospital/general hospital）， and geographic region （eastern/central/western） on humanistic care experience. ResultsThe total score of humanistic care experience was 194 （188， 233）. Univariate analysis showed that gender， educational level， current residence， per capita monthly household income， location attribute of medical institutions， number of previous visits to this hospital， payment method of medical expenses， previous hospitalization history in this hospital， frequency of outpatient visits within the past 12 months， self-rated disease severity， familiarity with the outpatient procedures， implementation of the follow-up service provided by the hospital， satisfaction with follow-up services， the grade of the hospital visited， geographical region of the hospital visited， and the department visited had an impact on the humanistic care experience during outpatient visits （P<0.05）. Multivariate analysis demonstrated that educational level （β=0.609， P=0.011）， self-rated disease severity （β=-0.646， P=0.047）， familiarity with outpatient procedures （β=4.784， P<0.001）， satisfaction with follow-up services （β=6.365， P<0.001）， and the grade of the hospital visited （β=-5.487， P<0.001） affected the humanistic care experience in outpatient medical treatment， explaining 24.4% of the total variation. ConclusionHumanistic care experience in TCM outpatient clinics is influenced by multiple factors. It is recommended to optimize the medical treatment process， strengthen doctor-patient communication training， and establish a precise follow-up mechanism， with a focus on improving care perceptions among patients with lower education levels and those attending primary-level hospitals， to refine the TCM-characterized service system.

Objective To investigate the impacts of long non coding RNA(LncRNA)-PH domain containing 5 antisense RNA 1(FGD5-AS1)on the proliferation,migration,and invasion of colorectal cancer(CRC)cells by regulating the miR-299-5p/recombinant lysine specific demethylase 4B(KDM4B)axis.Methods The expressions of LncRNA FGD5-AS1,miR-299-5p,and KDM4B were detected by qRT-PCR in the surgically resected CRC tissues and adjacent tissues of 34 CRC patients CRC cells HCT116 were separated into si-NC group,si-FGD5-AS1 group,si-FGD5-AS1+inhibitor NC group,and si-FGD5-AS1+miR-299-5p inhibitor group.The levels of mRNA in each group were detected.CCK8,scratch assay,and Transwell assay were ap[plied to detect the proliferation,migration,and invasion of HCT116 cells in each group.Western blot was applied to detect the expression of proteins.Dual luciferase reporter gene assay verified the interaction mechanism between LncRNA FGD5-AS1 and miR-299-5p,and between miR-299-5p and KDM4B.Results LncRNA FGD5-AS1 and KDM4B were highly expressed in CRC tissue,while miR-299-5p was low expressed in CRC tissue(P＜0.05).The expression of LncRNA FGD5-AS1 mRNA,KDM4B mRNA,OD450,scratch healing rate,invasion number,PCNA,MMP-2,MMP-9,KDM4B in the si-FGD5-AS1 group were lower than those in the si-NC group,the expression of miR-299-5p mRNA was higher than that in the si-NC group(P＜0.05).Compared with the si-FGD5-AS1 group and si-FGD5-AS1+inhibitor NC group,the expression of miR-299-5p in the si-FGD5-AS1+miR-299-5p inhibitor group decreased(P＜0.05),the KDM4B mRNA,OD450,scratch healing rate,number of invasions,and expression of PCNA,MMP-2,MMP-9,KDM4B increased(P＜0.05).LncRNA FGD5-AS1 targeted negative regulation of miR-299-5p,while miR-299-5p targeted negative regulation of KDM4B.Conclusion Knocking down LncRNA FGD5-AS1 may inhibit the proliferation,migration,and invasion of CRC cells,and its mechanism may be achieved by regulating the miR-299-5p/KDM4B signaling axis.