Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Objective:To develop a risk prediction model for postoperative catheter-associated urinary tract infection (CAUTI) in patients with gynecologic malignancies, so as to provide a reference for the prevention of CAUTI.Methods:From January to June 2020, convenience sampling was adopted to select postoperative 800 patients with gynecologic malignancies and indwelling urinary catheters in Zhejiang Cancer Hospital as the research object. The patients were divided into derivation samples (derivation group) and validation samples (validation group) according to the ratio of 3∶1 by random number table method. In the derivation group of 600 cases, the predictive factors were analyzed by binomial Logistic regression analysis and the risk prediction model was developed. In the validation group of 200 cases, the receiver operating characteristic curve was used to evaluate the prediction performance of the model.Results:Binomial Logistic regression analysis showed that age ≥ 60 years old, intraoperative urinary tract injury, postoperative bladder irrigation, and indwelling catheter for more than 7 days were risk factors for CAUTI, and the difference was statistical ( P<0.05) . Model evaluation showed that the area under the receiver operating characteristic curve of the validation group was 0.79 with a statistical difference [95% CI (0.72, 0.87) , P<0.01], and the sensitivity, specificity and Youden index were 71.8%, 78.3% and 50.1% respectively. Conclusions:The prediction performance of the model is good, which helps medical and nursing staff to monitor high-risk patients and reduce the occurrence of CAUTI.

OBJECTIVE：To evaluate th e effectiveness ，safety and economy of albu min-bound paclitaxel （nab-PTX）in the treatment of breast cancer by using rapid health technology assessment （HTA），and to provide evidence-based reference for drug selection. METHODS ：Retrieved from PubMed ，the Cochrane Library ，CNKI，Wangfang database and other databases ，systematic evaluation/Meta-analysis，HTA and pharmacoeconomic studies about nab-PTX in the treatment of breast cancer were included ；the conclusions were classified and analyzed by using descriptive analysis. RESULTS ：A total of 5 systematic reviews/Meta-analysis ， 8 pharmacoeconomic studies were included in this study. Compared with conventional taxanes ，nab-PTX increased pathological complete response （pCR）rate [OR ＝1.39，95％CI（1.16，1.67），P＜0.001] and event-free survival （EFS）[HR＝0.69，95％CI（0.57， 0.85），P＜0.001] in neoadjuvant chemotherapy （NAC）-treated breast cancer patients. However ，there were no significant differences in overall survival （OS），progression-free survival （PFS），objective response rate （ORR）and disease control rate （DCR）in metastatic breast cancer （MBC）patients between 2 groups. In the terms of safety ，nab-PTX increased the incidence of grade 3-4 sensory neuropathy [OR ＝1.89，95％CI（1.36，2.61），P＜0.001] in MBC patients ，and increased the incidence of neutropenia [OR ＝ 1.52，95％CI（1.23，1.88，P＜0.001]，sensory neuropathy [OR ＝ 2.17，95％CI（1.38，3.40），P＜0.001]，rash [OR ＝1.46，95％CI mei1213@163.com （1.18，1.80），P＜0.001] and fatigue [OR ＝1.28，95％CI（1.04， 1.56）， P＝0.02] in NAC -treated breast cancer patients.Pharmacoeconomic studies showed that nab-PTX could improve the quality adjusted lif e years of MBC patients compared with traditional taxanes ，and it was a economical option. CONCLUSIONS：Nab-PTX enhances pCR in NAC-treated breast cancer patients ，but has no significant advantage in the effectiveness of MBC patients ，and increases the occurrence of ADR. Nab-PTX may have a cost-utility advantage over conventional taxanes for MBC.

OBJECTIVE：To inve stigate the effects of polymorphism of CYP3A4，CYP3A5 and other genes on the increasing of tacrolimus blood concentration by Wuzhi capsules in renal transplantation patients. METHODS ：Totally 194 patients in Han nationality underwent renal transplantation and rece ived outpatient follow-up after surgery were selected from the First Affiliated Hospital of Anhui Medical University during Aug. 2015-Nov. 2018，and then divided into single drug group （107 cases）and combination group （87 cases）according to using of Wuzhi capsules or not. Single drug group was given Tacrolimus capsules 0.1-0.15 mg/kg，po，bid+Mycophenolate mofetil capsule s 0.5-0.75 g，bid or Mycophenolate sodium enteric-coated tablets 360-540 mg，bid+Prednisone acetate tablets 10 mg，qd；combination group was additionally given two Wuzhi capsules ，bid，on the basis of single drug group. Two groups were treated at least 7 d. The clinical data （such as patients ’sex and age ）were collected ，and enzyme amplification immunoassay was used to detect steady-state valley concentration of tacrolimus ，and calculate valley concentration/daily dose （C/D）value. PCR was adopted to detect patient genotyping of CYP3A5 gene rs 4646457，rs15524 and rs776746 locus，CYP3A4 gene rs 4646437，rs2242480 and rs 35599367 locus，ABCB1 gene rs 1128503 locus，ABCC2 gene rs3740066 locus，NR1I2 gene rs 3814055 locus，POR gene rs 1057868 locus，PPARA gene rs 4253728 locus，IL-3 gene rs 181781 locus， IL-10 gene rs 1800896 locus，CTLA4 gene rs 4553808 locus，CYP2C19 gene rs 4244285 and rs 4986893 locus，respectively. The correlation of each factor and tacrolimus C/D value was analyzed by Kruskal-Wallis test or Spearman rank test. Multivariate linear regression was conducted. RESULTS ：In 194 renal transplanation patients ，only wild type at rs 3599367 locus of CYP3A4 gene and rs4253728 locus of PPARA gene were detected ，and each genotype distribution of other genes was consistent with the Hardy-Weinberg equilibrium （P＞0.05）. Single factor analysis and multiple linear regression analysis showed that the combination of Wuzhi capsules and rs 776746 polymorphism of CYP3A5 gene were related to tacrolimus C/D value（P＜0.05）. There was statistical significance in tacrolimus C/D values among different genotypes of CYP3A5 gene in single drug group and combnation group（P＜0.05）. C/D value of GG and AG genotype in single drug group were significantly lower than combination group （P＜ 0.05），while there was no statistical significance in tacrolimus C/D value of AA genotype between 2 groups （P＞0.05）. CONCLUSIONS：Combination of Wuzhi capsules or not and polymorphism of CYP3A5 gene rs 776746 locus are associated with blood concentration of tacrolimus in renal transplantation patients in Han nationality. Combined use of Wuzhi capsules can increase blood concentration of tacrolimus in GG and AG genotype ，but have no significant effect on AA genotype.

Objective: To investigate the lens and ora serrata safety during 23G vitrectomy with sclera incisions at 5.0 mm or 4.0 mm posterior to the limbus. Methods: A prospective case-controlled study was adopted. From April 2016 to January 2018, 290 consecutive primary 23G vitrectomy patients (300 eyes) with vitreoretinal disease in Department of Ophthalmology of Subei People’s Hospital Affiliated to Yangzhou University were enrolled in this study. Among them, 146 patients (150 eyes) received 23G pars plana vitrectomy (PPV) with scleral incisions at 5.0 mm posterior to the limbus (5.0 mm group), and 144 patients(150 eyes) at 4.0 mm (4.0 mm group). No statistically significant difference was found in age, axial length(t=−1.324, 0.867; P=0.186, 0.387) and in gender, right/left eyes, proportion of indications (χ²=1.366, 2.615, 10.195; P=0.242, 0.106, 0.070) between the two groups. The incidence rate of complications between the two groups were comparatively observed, such as lens injury, retinal tears close to the scleral incision, retinal hemorrhage, supra-choroidal expulsive hemorrhage and iatrogenic retinal detachment. Independent sample t test and χ² test were performed for comparison between the two groups. Results: Lens injury was observed in 4 eyes(2.67%) and 14 eyes (9.33%) respectively in the 5.0 mm and 4.0 mm group during surgery (χ²=5.910, P=0.015). Retinal tears close to the scleral incision sites were observed in 5 eyes (3.33%) and 6 eyes (4.00%) respectively in the 5.0 mm and 4.0 mm group during surgery (χ²=0.094, P=0.759). The mean time of removing the vitreous base was 6.17±2.76 min and 10.03±5.56 min respectively in the 5.0 mm and 4.0 mm group (t=7.599, P <0.01). No other surgical complications occurred in any group, such as retinal hemorrhage, supra-choroidal expulsive hemorrhage and iatrogenic retinal detachment, etc. Conclusion In primary 23G PPV, the safety of ora serrata with incisions at 5.0 mm posterior to limbus is similar to that at 4.0 mm, but the safety of lens and the efficiency of vitreous resection is higher with incisions at 5.0 mm.

OBJECTIVE： To study the relationship of CYP3A4， CYP2C8 and CYP3A5 gene polymorphism with ADR/blood concentration of hydroxychloroquine in patients with autoimmune disease （AID）， and to provide reference for individual medication of hydroxychloroquine. METHODS： Totally 77 AID patients，who were treated with hydroxychloroquine （daily dose of 200 mg to 400 mg） for a long-term （＞6 months）， were selected from the department of rheumatology and immunology， the First Affiliated Hospital of Anhui Medical University during Jul. 2017 to Aug. 2018. The information， blood sample and ADR of them were collected. Those patients were divided into normal liver function group， abnormal liver function group， normal renal function group， abnormal renal function group， normal eye group and abnormal eye group according to the site of ADR. The concentration of hydroxychloroquine was determined by HPLC. Genotype of CYP3A4， CYP2C8 and CYP3A5 were detected by MassARRAY microarray system. The differences of hydroxychloroquine-induced ADR in different genotypes were analyzed by χ2 test. The blood concentration difference of hydroxychloroquine in different genotypes were analyzed by independent sample t-test and one-way ANOVA. RESULTS： There was statistical significance in the distribution of CYP3A5 rs4646453 locus between normal renal function group and abnormal renal function group（P＜0.05）. The incidence of CC genotype was higher than that of AA+AC genotype in abnormal renal function group. There was statistical significance in the distribution of CYP2C8 rs10882526 locus between normal liver function group and abnormal liver function group（P＜0.05）. The incidence of allele G was higher than that of allele A in abnormal liver function group， and the incidence of AG genotype was higher than that of AA genotype. There was no significant correlation of the gene polymorphisms of CYP3A4， CYP2C8 and CYP3A5 with blood concentration among 77 AID patients. In subgroup analysis， blood concentration of GT， GG and TT genotypes of CYP2C8 rs10882521 in 58 patients with systemic lupus erythematosus （SLE） were 514.1，735.3 and 785.9 ng/mL， respectively； GG and TT genotypes were significantly higher than GT genotype （P＜0.05）. CONCLUSIONS： AID patients with CYP3A5 rs4646453 CC genotype have a higher incidence of renal dysfunction due to taking hydroxychloroquine； patients with CYP2C8 rs10882526 locus allele G and AG have a relatively high incidence of renal dysfunction due to taking hydroxychloroquine. When SLE patients taking the same dose of hydroxychloroquine， the blood concentration of hydroxychloroquine in patients carrying CYP2C8 rs10882521 GT genotype is lower than other genotypes.

Objective: To investigate the relationship of stigma, coping style and psychosocial adjustment in young patients with breast cancer after operation, and the mediating effect of different coping style between stigma and psychosocial adjustment. Methods: The general information questionnaire, Social Impact Scale (SIS), Medical Coping Style Questionnaire (MCMQ) and psychosocial adjustment questionnaire for breast cancer were used to investigate the stigma, coping style and psychosocial adjustment of 292 young patients with breast cancer after operation in the affiliated hospital of Qingdao University. Results: There was a negative correlation between stigma and confrontation coping, psychosocial adjustment(r=-0.687--0.519, all P<0.01), but a positive correlation with yield coping and avoidance coping (r=0.426-0.500, all P<0.01).There was a positive correlation between psychosocial adjustment and confrontation coping(r=0.594, P<0.01), and was a negative correlation between psychosocial adjustment and avoidance copying, yield copying(r=-0.643--0.519, all P<0.05). The mediating effects of confrontation coping and avoidance coping were 32.86% and 18.81% respectively. Conclusions The stigma and coping style of young patients with breast cancer after operation were closely related to psychosocial adjustment. Nursing staff should guide the patients to adopt positive coping style, reduce the stigma, promote the psychosocial adjustment, and help the patients to return to normal life as soon as possible.

Objective To investigate the cognition and attitude about human papillomavirus (HPV) and HPV vaccines among nurses, so as to provide a certain basis for the popularization of HPV vaccine. Methods A self-designed questionnaire was used to survey the cognition and attitude about HPV and its vaccine among nurses in Zhejiang Cancer Hospital by a professional platform named "Wenjuanxing" from August to September 2017. A total of 206 questionnaires were collected.Results Among 206 nurses, 98.5％ of the nurses had heard of HPV, only 14.1％ knew HPV could spread through touching and 41.3％ knew that HPV infection can be self subsided. 90.3％ of the nurses had heard of HPV vaccine. 78.6％ of the nurses would like to take HPV vaccine, and 70.2％ of the nurses agreed their daughters to take HPV vaccine. Over 60％ nurses worried about the safety and efficacy of HPV vaccine.Conclusions Nurses have some knowledge about HPV and HPV vaccine, but it is not comprehensive enough. The government should strengthen the publicity of knowledge about HPV and HPV vaccine.

Objective To investigate the capability of empathy to pain under the explicit and implicit task in the depressed patients.Methods 37 patients with depression and 36 healthy controls matched for age,gender and education were recruited.Empathy to pain paradigm was used.Chinese Version of Interpersonal Reactivity Index (IRI-C) was used to measure empathy.Results (1)Patients showed lower scores in factors of perspective taking ((9.0±4.2) vs.(11.2±4.4)),fantasy ((12.9±4.6) vs.(15.7±3.8)) (t=-2.3,P＜0.01;t=-3.0,P＜0.05),higher scores in factors of personal distress((11.3±4.7) vs.(7.2±4.2)) (t=4.1,P＜0.01) in IRI-C.(2)In accurate rate,repeated measures analysis of variance (ANOVAs) showed a significant effect for task(F(1,71)=61.82,P＜0.01),emotion (F(1,71)=65.79,P＜0.01),the interaction effect of the task and group was significant (F(1,71)=4.37,P＜0.05).In explicit task,emotion showed a significant effect (F(1.71) =28.25,P＜0.01),there was significant difference between two groups (F(1,71)=4.04,P＜0.05),furthermore,compared to the controls,the accuracy of painful pictures was significantly lower in patients (F(1,71) =4.07,P＜ 0.05),but not different in the accuracy of the neutral pictures (P＞0.05) by the one-way ANOVA.(3)In reaction time,repeated measures analysis of variance (ANOVAs) showed a significant effect for task (F(1,71)=65.56,P＜0.01),emotion (F(1,71)=9.54,P＜0.05),and the interaction effect among the task,emotion and group was not significant (P＞0.05).Couclusion Depressed patients may have a declined capability of empathy toward other people's pain.