Objective In order to understand the current status and influencing factors of perioperative pulmonary rehabilitation knowledge,attitude,and practice among Chinese thoracic surgery nurses,and to provide references for managers to take targeted measures to improve their pulmonary rehabilitation knowledge,attitude,and practice level.Methods From August to October 2023,a convenience sampling method and cross-sectional descriptive survey were used to anonymously survey 1 167 thoracic surgery nurses from tertiary-level A cancer specialty hospitals and tertiary-level A general hospitals in 24 provinces through the Wenjuanxing platform.A general information questionnaire and a knowledge,attitude and practice questionnaire for lung cancer perioperative pulmonary rehabilitation nurses were used,including knowledge dimension(14 items),belief dimension(6 items),and behavior dimension(14 items),totaling 34 items.Univariate analysis and linear regression multivariate analysis were used to determine the influencing factors of the knowledge,attitude and practice level of thoracic surgery nurses in perioperative pulmonary rehabilitation.Results 1 089 nurses completed the investigation.The total standard score and the dimension scores on knowledge,attitude,and behavior of the perioperative pulmonary rehabilitation questionnaire for thoracic surgery nurses were(80.45±11.84)(73.72±14.68)(89.61±11.38)and(83.46±14.48),respectively.The nature of the hospital,whether there is an administrative position,whether the department carries out ERAS,and whether they have received pulmonary rehabilitation training are the influencing factors of the perioperative pulmonary rehabilitation knowledge,attitude,and practice level of thoracic surgery nurses(P＜0.05).Conclusion The knowledge,attitude,and practice of perioperative lung rehabilitation among thoracic surgery nurses are generally at a moderate level.However,their knowledge of perioperative lung rehabilitation is relatively insufficient,and there are many influencing factors.Managers should strengthen pulmonary rehabilitation training for thoracic surgery nurses,improve their knowledge reserves and evidence conversion capabilities,and coordinate cross-integration among multidisciplinary teams to improve their knowledge,attitude and practice in perioperative pulmonary rehabilitation.

Objective In order to understand the current status and influencing factors of perioperative pulmonary rehabilitation knowledge,attitude,and practice among Chinese thoracic surgery nurses,and to provide references for managers to take targeted measures to improve their pulmonary rehabilitation knowledge,attitude,and practice level.Methods From August to October 2023,a convenience sampling method and cross-sectional descriptive survey were used to anonymously survey 1 167 thoracic surgery nurses from tertiary-level A cancer specialty hospitals and tertiary-level A general hospitals in 24 provinces through the Wenjuanxing platform.A general information questionnaire and a knowledge,attitude and practice questionnaire for lung cancer perioperative pulmonary rehabilitation nurses were used,including knowledge dimension(14 items),belief dimension(6 items),and behavior dimension(14 items),totaling 34 items.Univariate analysis and linear regression multivariate analysis were used to determine the influencing factors of the knowledge,attitude and practice level of thoracic surgery nurses in perioperative pulmonary rehabilitation.Results 1 089 nurses completed the investigation.The total standard score and the dimension scores on knowledge,attitude,and behavior of the perioperative pulmonary rehabilitation questionnaire for thoracic surgery nurses were(80.45±11.84)(73.72±14.68)(89.61±11.38)and(83.46±14.48),respectively.The nature of the hospital,whether there is an administrative position,whether the department carries out ERAS,and whether they have received pulmonary rehabilitation training are the influencing factors of the perioperative pulmonary rehabilitation knowledge,attitude,and practice level of thoracic surgery nurses(P＜0.05).Conclusion The knowledge,attitude,and practice of perioperative lung rehabilitation among thoracic surgery nurses are generally at a moderate level.However,their knowledge of perioperative lung rehabilitation is relatively insufficient,and there are many influencing factors.Managers should strengthen pulmonary rehabilitation training for thoracic surgery nurses,improve their knowledge reserves and evidence conversion capabilities,and coordinate cross-integration among multidisciplinary teams to improve their knowledge,attitude and practice in perioperative pulmonary rehabilitation.

Objective To investigate the curative effect of early hemoperfusion(HP)in treating patients with sepsis.Methods Early stage sepsis patients admitted to the First People's Hospital of Nanyang City Affiliated to Henan University from January 2020 to December 2022 were selected as the research subjects.These patients were randomly divided into experimental group(62 patients)and control group(31 patients).Early bundle therapy combined with continuous renal replacement therapy(CRRT)were used in both groups as the standard treatment,but only the standard treatment was used in control group.Based on the treatment of control group,the patients in experimental group were treated with HP,the"2-2-1"plan(on the first and second days,connecting resin HP device HA380 in series every 12 hours,and connecting one perfusion device in series on the third day)was applied.The white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukins(IL-6,IL-10),the hemodynamic indicators(systolic blood pressure,diastolic blood pressure),lactic acid(Lac),sequential organ failure assessment(SOFA),acute physiology and chronic health evaluationⅡ(APACHEⅡ),and the difference in intensive care unit(ICU)hospitalization time of the patients before admission and after 3 day treatment were compared between the two groups.The Kaplan-Meier method was used to draw survival curves and the difference in 28-day survival rates was compared between the two groups.Results After 3 days of treatment,the inflammatory indexes TNF-α,IL-6,IL-10,PCT,CRP,WBC and SOFA score,APACHEⅡscore,Lac in the experimental group all decreased significantly(all P<0.05).In the control group,only the PCT and CRP indexes significantly decreased compared with those before treatment(both P<0.05).Compared with the control group,the difference before and after the change of PCT,CRP,IL-6,IL-10 and SOFA score,APACHEⅡscore,Lac in the experimental group were significant[PCT(μg/L):12.31(6.95,42.69)vs.3.84(1.06,14.47),CRP(mg/L):78.69±64.60 vs.31.49±81.14,IL-6(ng/L):1 357.20(243.96,7 205.50)vs.110.00(-1 749.00,1 377.00),IL-10(ng/L):36.87(5.43,1 218.80)vs.2.67(-11.00,22.79),SOFA score:5(3,7)vs.1(-3,6),APACHEⅡscore:8(5,11)vs.5(-2,7),Lac(mmol/L):3.93±2.89 vs.2.42±2.89,all P<0.05].The clearance rate of inflammatory cytokines IL-6 and IL-10 in the experimental group was higher than that in the control group(IL-6:F=17.93,P<0.001,IL-10:F=6.62,P=0.012).The Kaplan-Meier curve showed the 28-day survival rate of the experimental group was higher than that of the control group(79.03%vs.58.06%),the differences were statistically significant(Log-Rank test:χ2=4.706,P=0.030).Multivariate Cox regression analysis showed that no HP treatment,Lac level before treatment and high APACHEⅡ score were risk factors for death Conclusion HP in the early interventional treatment of sepsis can reduce the levels of inflammatory cytokines and control the inflammatory storm.The HP"2-2-1"treatment frequency can effectively improve the prognosis of septic patients and increase their survival rate.

Objective To investigate the curative effect of early hemoperfusion(HP)in treating patients with sepsis.Methods Early stage sepsis patients admitted to the First People's Hospital of Nanyang City Affiliated to Henan University from January 2020 to December 2022 were selected as the research subjects.These patients were randomly divided into experimental group(62 patients)and control group(31 patients).Early bundle therapy combined with continuous renal replacement therapy(CRRT)were used in both groups as the standard treatment,but only the standard treatment was used in control group.Based on the treatment of control group,the patients in experimental group were treated with HP,the"2-2-1"plan(on the first and second days,connecting resin HP device HA380 in series every 12 hours,and connecting one perfusion device in series on the third day)was applied.The white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukins(IL-6,IL-10),the hemodynamic indicators(systolic blood pressure,diastolic blood pressure),lactic acid(Lac),sequential organ failure assessment(SOFA),acute physiology and chronic health evaluationⅡ(APACHEⅡ),and the difference in intensive care unit(ICU)hospitalization time of the patients before admission and after 3 day treatment were compared between the two groups.The Kaplan-Meier method was used to draw survival curves and the difference in 28-day survival rates was compared between the two groups.Results After 3 days of treatment,the inflammatory indexes TNF-α,IL-6,IL-10,PCT,CRP,WBC and SOFA score,APACHEⅡscore,Lac in the experimental group all decreased significantly(all P<0.05).In the control group,only the PCT and CRP indexes significantly decreased compared with those before treatment(both P<0.05).Compared with the control group,the difference before and after the change of PCT,CRP,IL-6,IL-10 and SOFA score,APACHEⅡscore,Lac in the experimental group were significant[PCT(μg/L):12.31(6.95,42.69)vs.3.84(1.06,14.47),CRP(mg/L):78.69±64.60 vs.31.49±81.14,IL-6(ng/L):1 357.20(243.96,7 205.50)vs.110.00(-1 749.00,1 377.00),IL-10(ng/L):36.87(5.43,1 218.80)vs.2.67(-11.00,22.79),SOFA score:5(3,7)vs.1(-3,6),APACHEⅡscore:8(5,11)vs.5(-2,7),Lac(mmol/L):3.93±2.89 vs.2.42±2.89,all P<0.05].The clearance rate of inflammatory cytokines IL-6 and IL-10 in the experimental group was higher than that in the control group(IL-6:F=17.93,P<0.001,IL-10:F=6.62,P=0.012).The Kaplan-Meier curve showed the 28-day survival rate of the experimental group was higher than that of the control group(79.03%vs.58.06%),the differences were statistically significant(Log-Rank test:χ2=4.706,P=0.030).Multivariate Cox regression analysis showed that no HP treatment,Lac level before treatment and high APACHEⅡ score were risk factors for death Conclusion HP in the early interventional treatment of sepsis can reduce the levels of inflammatory cytokines and control the inflammatory storm.The HP"2-2-1"treatment frequency can effectively improve the prognosis of septic patients and increase their survival rate.

Drug transportation is impeded by various barriers in the hypoxic solid tumor, resulting in compromised anticancer efficacy. Herein, a solid lipid monostearin (MS)-coated CaO2/MnO2 nanocarrier was designed to optimize doxorubicin (DOX) transportation comprehensively for chemotherapy enhancement. The MS shell of nanoparticles could be destroyed selectively by highly-expressed lipase within cancer cells, exposing water-sensitive cores to release DOX and produce O2. After the cancer cell death, the core-exposed nanoparticles could be further liberated and continue to react with water in the tumor extracellular matrix (ECM) and thoroughly release O2 and DOX, which exhibited cytotoxicity to neighboring cells. Small DOX molecules could readily diffuse through ECM, in which the collagen deposition was decreased by O2-mediated hypoxia-inducible factor-1 inhibition, leading to synergistically improved drug penetration. Concurrently, DOX-efflux-associated P-glycoprotein was also inhibited by O2, prolonging drug retention in cancer cells. Overall, the DOX transporting processes from nanoparticles to deep tumor cells including drug release, penetration, and retention were optimized comprehensively, which significantly boosted antitumor benefits.

Objective: To understand the level and risk factor of lead exposure among children in one city of Jiangsu. Methods: In northern Jiangsu Province, 373 children from 2 primary schools were enrolled and were tested for blood lead and heavy metal exposure. Lead exposure was tested in household dust of 46 children. A multivariate Logistic regression was used for lead exposure risk analysis. Spatial distribution of lead contamination in household dust was conducted and compared with the location of industrial enterprises. Results: The geometric mean of blood lead in 373 children was 25.80 mg/L,the blood lead of 3 children (0.8%) was more than 100 mg/L. Pencil biting ( OR=4.26, 95%CI=1.61-10.68, P <0.05) and lead contamination in surrounding environment ( OR=2.93, 95%CI=1.24-7.34, P =0.02) was positively related to high blood lead level in children. The geometric mean household dust lead concentrations in 46 children was 302.27 μg/mg, and household with high dust lead levels were mainly located around manufacturing enterprises. Conclusion Environmental factors correlate with blood lead level in children. Efficient strategies and public health policies are urgently needed to control and prevent environmental lead pollution. Families and schools should actively carry out health education to engourage children good hygiene habits, and effectively reduce lead exposure.

Objective To explore the change of copeptin in plasma and its significance in patients with intracerebral hemorrhage combined with stress ulcer.Methods Eighty patients with intracerebral hemorrhage were collected.Forty-nine patients of pure intracerebral hemorrhage and 31 patients of intracerebral hemorrhage combined with stress ulcer were included.Thirty healthy people were taken as controls.The level of copeptin in plasma was measured and compared in all subjects.Results The level of copeptin in plasma in patients with pure intracerebral hemorrhage and intracerebral hemorrhage combined with stress ulcer was significantly higher than that in controls:(303.684 ± 68.691),(527.034 ± 74.111) ng/L vs.(121.460 ± 53.364) ng/L,and the level of copeptin in plasma in patients with intracerebral hemorrhage combined with stress ulcer was significantly higher than that in patients with pure intracerebral hemorrhage.The differences were statistically significant (P ＜ 0.05).Conclusion The level of copeptin in plasma in patients with pure intracerebral hemorrhage increases significantly,and it is much higher in patients with intracerebral hemorrhage combined with stress ulcer.

Objective To investigate the voiding patterns of term and preterm newborns and whether voiding in term and preterm neonates was accompanied by any cortical arousal. Methods Between May 2013 and September 2013,64 hospitalized newborns at Neonatal Intensive Cave Unit in the Frist Affiliated Hospital of Zhengzhou University were recruited in this study. In these patients,31 cases were term newborns(20 male,11 female)and 33 cases were preterm newborns(19 male,14 female). The term and preterm newborns gestational ages at birth were(38. 2 ± 1. 2) weeks and(32. 1 ± 1. 6)weeks,weighted(3. 3 ± 0. 4)kg and(1. 7 ± 0. 3)kg,respectively and postnatal ages at study were[4 - 16(10. 5 ± 3. 6)]days and[4 - 16(11. 2 ± 3. 1)]days. The voiding volume(VV),post - void residual volumes(PRV),body movement rate and voiding frequency(VF)in 4 hours as well as the volume of milk and liquid fed at the same time frame were recorded and analyzed,retrospectively. At the same time electrocardiogram(ECG)and electroencephalogram(EEG)were recorded. The changes of heart rate(HR),EEG frequency,respiratory frequency (RF)during the 5 s period and 30 s before and after voiding onset were compared respectively. For cortical arousal definition the recommendations of the International Pediatric Work Group on Arousals(2005)were used. Results A total of 184 times of voiding were recorded. In preterm newborns,the VV and body movements rate were significantly lower compared with the term newborns[(21. 8 ± 7. 9)mL and(41 ± 21)% vs(26. 4 ± 8. 7)mL and(62 ± 19)% , t = 3. 75,4. 20,all P ﹤ 0. 05]. However,the VF and PRV were significantly higher in preterm newborns[(1. 7 ± 0. 9) mL and(3. 2 ± 1. 1)times vs(1. 2 ± 0. 7)mL and(2. 6 ± 0. 9)times,t = 2. 47,2. 38,all P ﹤ 0. 05]. Bladder voiding in these infants happened only during QS. In term newborns,HR frequency was higher during the 5 s interval before and after voiding onset when compared with the 30 s period before voiding onset[(152 ± 6)times/ min and(152 ± 5) times/ min vs(147 ± 6)times/ min,t = 5. 30,5. 76,all P ﹤ 0. 05]and the EEG frequency[(2. 6 ± 0. 1)Hz and (2. 6 ± 0. 1)Hz vs(1. 5 ± 0. 1)Hz,t = 70. 0,70. 0,all P ﹤ 0. 05]. While the HR and EEG frequency of preterm neo-nate was not changed before and after bladder voiding onset. The RF of both term and preterm neonates were not changed before and after bladder voiding onset. Conclusions The voiding patterns between term and preterm were sig-nificantly different and cortical arousal was found only in term neonates,which indicate the term newborns have better mature bladder function and development of nervous system.