Objective:To investigate the current situation of adverse events in hemodialysis nursing in class-A tertiary hospitals in China and analyze their nursing human resources related influencing factors, aiming at provide references for hemodialysis centers to adjust nursing human resources scientifically to reduce the occurrence of nursing adverse events.Methods:A convenient sampling method was used. From August to October 2021, a self-designed questionnaire was used to investigate nursing adverse events in hemodialysis centers of 860 class-A tertiary hospitals during 2020 in China. Multivariate Logistic regression was used to analyze the influencing factors of blood loss, hemodialysis catheter-related blood stream infection (CRBSI) and venous needle dislodgement (VND) in hemodialysis centers.Results:A total of 826 valid questionnaires were received, with an effective response rate of 96.05%(826/860). There were 826 hemodialysis centers covering 31 provinces, municipalities and autonomous regions in China. The establishment period of each center was 24(18, 30) years. There were 45(30, 62) dialysis machines, 180(110, 260) patients and 19(13, 27) registered nurses. Blood loss, hemodialysis CRBSI and VND occurred in 70.94% (586/826), 68.04%(562/826) and 46.97% (388/826) of hemodialysis centers, respectively. Multivariate Logistic regression results showed that the daily treatment shift ( OR=0.730, 95% CI 0.536-0.994), the proportion of nurses with bachelor's degree or above ( OR=1.635, 95% CI 1.142-2.342), and whether nurses worked part-time on peritoneal dialysis treatment ( OR=0.225, 95% CI 0.052-0.965) were the influencing factors for blood loss in hemodialysis centers (all P<0.05). The daily treatment shift ( OR=0.566, 95% CI 0.413-0.777), the number of patients which each nurse was responsible for per shift simultaneously ( OR=0.549, 95% CI 0.400-0.753), proportion of blood purification specialized nurses ( OR=1.661, 95% CI 1.216-2.269), whether nurses worked part-time on CRRT ( OR=0.700, 95% CI 0.511-0.957), the education level of the nursing manager was junior college and below ( OR=3.789, 95% CI 1.576-9.113) and bachelor′s degree ( OR=2.585, 95% CI 1.328-5.033) were the influencing factors for the hemodialysis catheter-associated bloodstream infection in hemodialysis centers (all P<0.05). The number of patients which each nurse ( OR=0.580, 95% CI 0.433-0.777) was responsible for per shift simultaneously was the influencing factor in the occurrence of VND in hemodialysis centers ( P<0.05). Conclusions:The nursing adverse events of blood loss, hemodialysis catheter-associated bloodstream infection and VND were relatively common in hemodialysis centers. The hospital managers should take corresponding measures aiming at the above influencing factors to prevent the occurrence of nursing adverse events and improve the quality and safety of nursing.

Objective:To investigate the current situation of adverse events in hemodialysis nursing in class-A tertiary hospitals in China and analyze their nursing human resources related influencing factors, aiming at provide references for hemodialysis centers to adjust nursing human resources scientifically to reduce the occurrence of nursing adverse events.Methods:A convenient sampling method was used. From August to October 2021, a self-designed questionnaire was used to investigate nursing adverse events in hemodialysis centers of 860 class-A tertiary hospitals during 2020 in China. Multivariate Logistic regression was used to analyze the influencing factors of blood loss, hemodialysis catheter-related blood stream infection (CRBSI) and venous needle dislodgement (VND) in hemodialysis centers.Results:A total of 826 valid questionnaires were received, with an effective response rate of 96.05%(826/860). There were 826 hemodialysis centers covering 31 provinces, municipalities and autonomous regions in China. The establishment period of each center was 24(18, 30) years. There were 45(30, 62) dialysis machines, 180(110, 260) patients and 19(13, 27) registered nurses. Blood loss, hemodialysis CRBSI and VND occurred in 70.94% (586/826), 68.04%(562/826) and 46.97% (388/826) of hemodialysis centers, respectively. Multivariate Logistic regression results showed that the daily treatment shift ( OR=0.730, 95% CI 0.536-0.994), the proportion of nurses with bachelor's degree or above ( OR=1.635, 95% CI 1.142-2.342), and whether nurses worked part-time on peritoneal dialysis treatment ( OR=0.225, 95% CI 0.052-0.965) were the influencing factors for blood loss in hemodialysis centers (all P<0.05). The daily treatment shift ( OR=0.566, 95% CI 0.413-0.777), the number of patients which each nurse was responsible for per shift simultaneously ( OR=0.549, 95% CI 0.400-0.753), proportion of blood purification specialized nurses ( OR=1.661, 95% CI 1.216-2.269), whether nurses worked part-time on CRRT ( OR=0.700, 95% CI 0.511-0.957), the education level of the nursing manager was junior college and below ( OR=3.789, 95% CI 1.576-9.113) and bachelor′s degree ( OR=2.585, 95% CI 1.328-5.033) were the influencing factors for the hemodialysis catheter-associated bloodstream infection in hemodialysis centers (all P<0.05). The number of patients which each nurse ( OR=0.580, 95% CI 0.433-0.777) was responsible for per shift simultaneously was the influencing factor in the occurrence of VND in hemodialysis centers ( P<0.05). Conclusions:The nursing adverse events of blood loss, hemodialysis catheter-associated bloodstream infection and VND were relatively common in hemodialysis centers. The hospital managers should take corresponding measures aiming at the above influencing factors to prevent the occurrence of nursing adverse events and improve the quality and safety of nursing.

ObjectiveTo investigate the association between physical activity (PA), sedentary level and exercise self-efficacy for adolescents with visual impairment, and impacts of gender, age, body mass index (BMI), degree of visual impairment and exercise self-efficacy on PA. MethodsFrom October to December, 2022, 79 students aged 13 to 18 years with visual impairment from Nanjing School for the Blind were measured PA and sedentary level with accelerometer. The average percentage of daily sedentary time (ST), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) were recorded. The students fininshed the Exercise Self-Efficacy Questionnaire with the help of teachers, and their height and body mass was measured. ResultsThe average percentage of daily LPA, MVPA and ST was (15.45±5.99)%, (4.55±2.15)% and (80.00±6.99)%, respectively. Compared with the girls, the boys spent more time in LPA (F = 5.330, P < 0.05) and less in ST (F = 5.760, P < 0.05). Compared with students aged 16 to 18 years, those aged 13 to 15 years spent more time in MVPA (F = 11.292, P < 0.001) and less in ST (F = 8.279, P < 0.01). The score of exercise self-efficacy correlated with ST, LPA, MVPA and age (|r| > 0.254, P < 0.05). The result of multiple linear regression showed that the exercise self-efficacy (β = 0.224) and age (β = -0.495) were the independently factors related with MVPA, which explained 34.7% of MVPA variation. ConclusionAdolescents with visual impairment aged 13 to 18 years spend more time in sedentary, and their PA level is very low. Improvement of exercise self-efficacy may help to improve PA level of them.

Objective To carry out quality assessment and content analysis on guidelines on arteriovenous fistula (AVF) dysfunction monitoring in hemodialysis patients so as to provide a reference for building the localized clinical practice plan. MethodsDocuments were retrieved in guideline websites, professional society websites and electronic databases at home and abroad by computer. Quality assessment was carried out with the appraisal of guidelines for research and AGREEⅡ and JBI quality assessment tool on consensuses, and the recommendations of included guidelines were summarized. ResultsTotals of 4 evidence-based guidelines and one consensus were included with three of them in the level A and one in the level B of overall quality evaluation. A total of 12 items in 7 aspects were extracted including policy-making, team building, monitoring technology, training of personnel, continuous quality improvement, risk assessment and health education. Intraclass correlation coefficients of 4 evidence-based guidelines ranged from 0.866 to 0.935. Conclusions The guidelines have high levels of overall quality, but applicability needs to be improved. The recommendations are in general accord with each other, which can provide a basis for building the localized clinical practice plan.

Objective To prepare multi-modality melanin-based lipid nanobubbles (MNBs) contrast agents,and to investigate their manifestations of ultrasound (US),photoacoustic (PA) and MRI in vitro.Methods MNBs and lipid nanobubbles (NBs) were prepared with the method of CHCl3-injection,freeze-drying and C3F8-inflation.The characteristics (shape,grain diameter,loading capacity of melanin and stability) of MNBs were obseved.US,PA and MRI were detected in vitro and the images were quantitatively analyzed.Results MNBs presented with homogenized size distribution,and transmission electron microscope (TEM) images demonstrated that the melanin particles were successfully entrapped into nanobubbles.Meanwhile,the loading capacity of melanin was 90.53 μg/mg.US signal increased in vitro with the rise of MNBs and NBs concentration.The ultrasonic manifestations of MNBs and NBs were the same,and the relative signal enhancement had no significant difference (P＞0.05).With the increased concentration of MNBs,the PA and MRI signals were stronger,but NBs showed no evident enhancement.Conclusion Multi-modality MNBs contrast agents are prepared successfully,which can enhance US,PA and MR imaging.

Natural polymeric materials and their derivatives are organic macromolecular compounds which exist in plants, animals, and micro-organisms. They have been widely used in the preparation of scaffolds for skin tissue engineering recently because of their good histocompatibility and degradability, and low immunogenicity. With the improvement of the preparation technics, composite materials are more commonly used to make scaffolds for dermal tissue engineering. This article summarizes the classification and research status of the commonly used natural polymer materials, their derivatives, and composite scaffold materials, as well as makes a prospect of the research trends of dermal scaffold in the future.
Biocompatible Materials ; chemistry ; Humans ; Polymers ; chemistry ; Skin ; growth & development ; Tissue Engineering ; Tissue Scaffolds ; chemistry

Objective To explore the promoting effects of bio-polymer composite film as a micro-skin auto-graft covering on wound healing. Methods The full thickness skin defect models were made on both sides of 30 experimental rabbits. Then, the rabbits were randomly divided into experimental group and control group. In the for-mer group, the side was covered with chitosan/glucomannan composite membrane and in the latter, the side cov-ered with acelluar porcine skin after micro-skin autograft. We obtained wound tissues at week 1 , 2, 3, 4 and 5 af-ter operation. The conditions of wound healing were observed, the rate of wound healing was calculated, HE stain-ing was made, and PCNA and CD31 were detected by immunohistochemistry. Results (1) During 2~4 weeks af-ter operation, the rate of wound healing in the experimental group was significantly higher than that of the control wound (P<0.01). (2) The amount of neutrophil in experimental group was less than that of the control after oper-ation. (3) During 1 ~ 2 weeks after operation, the expression of PCNA in the experimental group was higher than that of the control group (P < 0.01), but lower than the control wounds during 1 ~ 2 weeks after operation (P <0.01). (4) During 1 ~ 5 weeks after operation, the expression of CD31 in the experimental group was higher than that of the control group (P < 0.01). Conclusion Chitosan/glucan-mannan composite membrane as a micro-skin autograft covering may promote wound healing.

OBJECTIVETo investigate the effect of high-intensity focused ultrasound (HIFU) on tumor metastasis in mouse model bearing melanoma xenograft.

METHODSMice bearing murine melanoma B16-F10 cell xenograft were randomized for sham-HIFU or HIFU exposure when the tumors grew to a maximum diameter of 7-10 mm, and the tumor size was measured every 3 days. The cumulative survival rate of the mice and tumor metastasis rate were calculated, and the circulating melanoma cells were detected using qRT-PCR. At 14 days after HIFU treatment, B16-F10 cells were retransplanted via the tail vein and the pulmonary metastatic nodules were counted.

RESULTSThe median survival time of the mice was 19.00 days (95% CI 17.14-20.86 days) in the sham group and 26.00 days (95%CI 24.76-27.25 days) in HIFU group. The cumulative survival rate in the HIFU group was significantly higher than that in sham-HIFU group (P<0.01), and the tumor size was significantly smaller in HIFU group at 20, 23, and 26 days after HIFU treatment (P<0.05). Compared with the sham-HIFU group, HIFU group had significantly lower levels of MAGE-A3, MART1 and PAX3 at 7 days after HIFU (P<0.05) with still lower MAGE-A3 level at 14 days (P<0.05). HIFU group showed a significantly smaller number of pulmonary metastatic nodules following tumor cell retransplantation than in sham-HIFU group (P<0.01) with a metastasis inhibition rate of 42.4%.

CONCLUSIONHIFU treatment can inhibit tumor metastasis in melanoma-bearing mice possibly by reducing tumor cell detachment from the primary tumor site and suppressing colonization of the circulating melanoma cells.

Objective To investigate the effect of high-intensity focused ultrasound (HIFU) on tumor metastasis in mouse model bearing melanoma xenograft. Methods Mice bearing murine melanoma B16-F10 cell xenograft were randomized for sham-HIFU or HIFU exposure when the tumors grew to a maximum diameter of 7-10 mm, and the tumor size was measured every 3 days. The cumulative survival rate of the mice and tumor metastasis rate were calculated, and the circulating melanoma cells were detected using qRT-PCR. At 14 days after HIFU treatment, B16-F10 cells were retransplanted via the tail vein and the pulmonary metastatic nodules were counted. Results The median survival time of the mice was 19.00 days (95 % CI 17.14-20.86 days) in the sham group and 26.00 days (95%CI 24.76-27.25 days) in HIFU group. The cumulative survival rate in the HIFU group was significantly higher than that in sham-HIFU group (P<0.01), and the tumor size was significantly smaller in HIFU group at 20, 23, and 26 days after HIFU treatment (P<0.05). Compared with the sham-HIFU group, HIFU group had significantly lower levels of MAGE-A3, MART1 and PAX3 at 7 days after HIFU (P<0.05) with still lower MAGE-A3 level at 14 days (P<0.05). HIFU group showed a significantly smaller number of pulmonary metastatic nodules following tumor cell retransplantation than in sham-HIFU group (P<0.01) with a metastasis inhibition rate of 42.4%. Conclusion HIFU treatment can inhibit tumor metastasis in melanoma-bearing mice possibly by reducing tumor cell detachment from the primary tumor site and suppressing colonization of the circulating melanoma cells.

Objective To investigate effect of the integrated care model based on patients′demand in in-charge patients with chronic kidney disease ( CKD) .Methods Established CKD integrated care team , and a questionnaire survey about knowledge and disease management was conducted in hospitalized CKD patients from January to May, 2013, and established the CKD care referral model in hospital .Results A total of 150 cases of hospitalized patients with CKD received a questionnaire .The scores of patients′awareness of CKD was (4.41 ± 1.11), and the knowledge about kidney disease was (3.21 ±0.84), and the degree of concern for knowledge of disease was (2.75 ±1.30), and disease self-care technology mastery was (1.39 ±0.83).88.67% and 60.00%patients considered disease knowledge received from healthcare professionals , but there were still a large number of patients received knowledge from the media , friends, etc.105 patients (70.00%) hoped to get nursing care of outpatient follow up and education .The integrated care referral pattern in hospital was initially established after team discussion which could provide targeted patients pre-referral care and education , coordinated with one by one referral patterns with one transfer form , post-referral care and education .There were 81 nurses joined the post-referral care and gave their suggestions .Conclusions CKD patients need long-term, continuous, complete and individualized health care and education .Establishment of integrated CKD care referral patterns may be an appropriate way to solve this issue .