Objective:To develop an evidence-based nursing practice program based on the Stetler model to extend the lifespan of arteriovenous fistulas (AVF) in maintenance hemodialysis (MHD) patients and evaluate its effectiveness.Methods:An evidence-based nursing practice program was constructed based on the best evidence for extending AVF lifespan in MHD patients. Expert group discussions were held to determine review indicators. A baseline survey was conducted among 100 MHD patients and 42 nurses using covenience sompling at the Blood Purification Center of Wuxi People's Hospital from January to December 2023, to identify barriers and facilitators. In the following year, from January to December 2024, the evidence-based practice was implemented at the same hospital, and the AVF surgical intervention rate and AVF self-management levels of MHD patients were compared before and after the practice.Results:No statistically significant difference was found in the AVF surgery rates before and after the evidence-based practice ( P>0.05) . However, after implementing the evidence-based practice, MHD patients' scores on the AVF self-management scale significantly improved, and the difference was statistically significant ( P<0.01) . Conclusions:The evidence-based practice based on the Stetler model is beneficial for standardizing the clinical management of AVF, reducing the need for surgical interventions, and improving MHD patients' ability to self-manage their AVF.

Objective:To develop an evidence-based nursing practice program based on the Stetler model to extend the lifespan of arteriovenous fistulas (AVF) in maintenance hemodialysis (MHD) patients and evaluate its effectiveness.Methods:An evidence-based nursing practice program was constructed based on the best evidence for extending AVF lifespan in MHD patients. Expert group discussions were held to determine review indicators. A baseline survey was conducted among 100 MHD patients and 42 nurses using covenience sompling at the Blood Purification Center of Wuxi People's Hospital from January to December 2023, to identify barriers and facilitators. In the following year, from January to December 2024, the evidence-based practice was implemented at the same hospital, and the AVF surgical intervention rate and AVF self-management levels of MHD patients were compared before and after the practice.Results:No statistically significant difference was found in the AVF surgery rates before and after the evidence-based practice ( P>0.05) . However, after implementing the evidence-based practice, MHD patients' scores on the AVF self-management scale significantly improved, and the difference was statistically significant ( P<0.01) . Conclusions:The evidence-based practice based on the Stetler model is beneficial for standardizing the clinical management of AVF, reducing the need for surgical interventions, and improving MHD patients' ability to self-manage their AVF.

Objective To explore association between childhood trauma,resilience and non-suicidal self-injury in adolescents.Methods One hundred and fifty-eight first-episode adolescent patients with mood disorders were selected and divided into NSSI group(n=94)and non-NSSI group(n=64)based on presence or absence of NSSI.The Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA),childhood trauma questionnaire(CTQ-SF)and Connor-Davidson resilience scale(CD-RISC)were used to evaluate the depression and anxiety symptoms,childhood trauma and resilience.Results There were more cases of younger age(16.17±1.67 vs.16.73±1.37),lower education level(30.9% vs.15.6% ),left behind experience(48.9% vs.29.7% ),school bullying(46.8% vs.25.0% ),suicide ideation(85.1% vs.37.5% )and history of attempted suicide(29.8% vs.6.3% )in the group with NSSI compared to those without NSSI.The HAMD score(27.99±5.94 vs.24.19±5.19),HAMA score(18.02±5.94 vs.15.45±4.99),CTQ total score(48.43±15.40 vs.41.97±9.75),emotional abuse score(12.77±6.06 vs.10.19±4.06),and emotional neglect score(11.40±5.34 vs.9.14±3.55)were higher in the group with NSSI,and the differences between the two groups were significant(P<0.05).The total scores of psychological resilience(39.83±10.27 vs.28.66±12.75),resilience(19.59±4.92 vs.12.28±6.47),strength(12.03±3.98 vs.9.99±4.67),and optimism(8.98±2.97 vs.6.47±3.73)in the group without NSSI were higher than those in the group with NSSI(P<0.05).Logistic regression analysis showed that left behind experience(OR=4.494,95% CI:1.192-16.940),school bullying(OR=5.983,95% CI:1.329-26.945),suicidal ideation(OR=13.225,95% CI:2.908-60.146),history of attempted suicide(OR=16.769,95% CI:1.845-152.379),HAMD(OR=1.264,95% CI:1.046-1.626),emotional abuse(OR=1.327,95% CI:1.093-1.612),and resilience(OR=0.468,95% CI:0.266-0.823)were significantly associated with adolescent mood disorders with NSSI(P<0.05).Conclusion Left behind experience,campus bullying,suicidal ideation and attempted suicide,emotional abuse,degree of depression,and psychological resilience may be associated with NSSI behavior in adolescents with mood disorders.

The transition process of adolescents with chronic diseases from child to adult medical treatment is full of challenges. As the core part of transitional care, the level of transition readiness is particularly important for the success or failure of the transition. Inadequate transition readiness will cause serious complications for adolescents with chronic diseases, increasing morbidity and mortality, and reducing the quality of life. Helping adolescents with chronic diseases to prepare for the transition period can reduce their anxiety and improve their self-management ability and quality of life. By exploring the influencing factors of transition readiness for adolescents with chronic diseases, targeted interventions can be provided to help them improve the level of transition readiness and achieve medical transition. This article summarizes the influencing factors of the transition readiness of adolescents with chronic diseases from the perspectives of individual, family, and society, so as to provide a reference for constructing effective intervention programs to improve the transition readiness of patients.

Objective To understand the impact of Qionghai Lake wetland ecological protection construction on the preva?lence of schistosomiasis,so as to provide the evidence for formulating the strategies for schistosomiasis control and prevention. Methods A retrospective survey of the construction of Qionghai Lake wetland was performed,and eleven villages around the wetland were surveyed for schistosomiasis endemic situation. The influence of the wetland project on the schistosomiasis preva?lence and Oncomelania hupensis snail status were investigated. Results Before the construction of Qionghai Lake wetland,the snail elimination and extended chemotherapy for residents was performed. After the project was finished,the roads and ditches were hardened. From 2009 to 2014,the schistosome infection rate of residents declined from 0.37% to 0. No schistosome infect?ed snails were found and in recent 2 years,no snails were found. No mice were infected in the sentinel tests. Conclusions The construction of Qionghai Lake wetland effectively eliminates snails,and interrupts the transmission of schistosomiasis. Howev?er,the environment of the wetland is more suitable for snail breeding,and therefore,the surveillance still should be strength?ened.

Objective To explore the cognitive function of the patients with bipolar depression (BP), unipolar depression (UP) and their first-degree relatives.Methods 52 patients with BP and 49 their first-degree relatives ,67 patients with UP and 59 their fi~t-degree relatives, 97 normal controls were tested by information, arithmetic, digital symbol, digital span test, block design,logical memory (included immediately and delayed) , visual memory(included immediately and delayed), Stroop Test (included Stroop C and Stroop CW), trail making test (included Part A and Part B) ,verbal fluency and modified Wisconsin card sorting test(M-WCST).Results The scores of digital symbol, block design, immediately logical memory, delayed logical memory, immediately visual memory,delayed visual memory,trail making test B and WCST in the patients with BP and UP were worse than those in normal control(P＜0.01).The score of WCST in the patients with BP was lower than that in the patients with UP ((3.02± 1.96), (4.40± 1.13), P＜0.01).The score of WCST in the relatives of the patients with bipolar depression was worse than that in the normal control((4.32±1.66), (5.15±1.27), P＜ 0.05).Conclusion The patterns of impaired cognitive function on sustained attention,concept of visual space,visual memory,verbal memory and executive function are similar in the patients with BP and UP.The executive function of the patients with BP is worse than the patients with UP.

Gelastic epilepsy is a special refractory epilepsy accompany with ictal laughing and/or crying which can be divided into cortical induced gelastic epilepsy and hypothalamic hamartomas induced gelastic epilepsy according to their epileptogenic focus.Currently, domestic scholars had lack of systematic understanding of the mechanism and clinical treatment involved in gelastic epilepsy.Recently, foreign scholars had achieved great progress in the research of gelastic epilepsy which included the ictal laughing mechanism in gelastic epilepsy, the primary molecular mechanism in hypothalamic hamartomas induced gelastic epilepsy, the secondary epileptogenesis mechanism in hypothalamic hamartomas induced gelastic epilepsy and the clinical treatment of gelastic epilepsy.Now, the study progress of pathogenesis and clinical treatment of gelastic epilepsy were reviewed.

Objective To observe the effect of very early intervention with cerebellar fastigial nucleus electrical stimulation and neurodevelopmental treatment on infants of central coordination disturbance(CCD).Methods 86 infants(0～6 months)with central coordination disturbance were divided into intervention group and control group.The intervention group was treated with neurodevelopmental treatment,cerebellar fastigial nucleus(FN)electrical stimulation and family interference.The control group was treated with neurodevelopmental treatment and family interference.The effect of infant was assessment with Gross Motor Function Measure(GMFM)and Gesell Development Test after 3 months treatment.Results The total improved incidence of the intervention group was 95.6%,which was significantly higher than that of the control group(P<0.01).The difference of scores in social,adaptive and motor area improved in the intervention group compared with that of control group(P<0.05).Conclusion Very early intervention with cerebellar fastigial nucleus electrical stimulation can facilitate the development of gross motor,social,adaptive capability of infants with CCD treated with neurodevelopmental therapy.

OBJECTIVE To identify if Trichosporon asahii exist cph1 gene homolog of Candida albicans,and analyze its nucleotide sequence.METHODS Nuclear DNA was extracted from the cells of T.asahii by using a simplified protocol,designed 29 pairs of primers according to the cph1 gene sequence of C.albicans and amplify by PCR.The PCR products were cloned and sequenced using the ABI377 nucleotide sequenator,and BLAST analysis.RESULTS An 827 bp gene was amplified successfully,which was homolog with the cph1 gene of C.albicans and their identity was 97.3%.CONCLUSIONS This trial determines the clone cph1 gene in T.asahii for the first time,which makes bases for the role of cph1 gene in the hypha formation.

OBJECTIVE To observe the significance of(1,3)-?-D-glucan in different humor samples on the rat model of systemic trichosporosis.METHODS Established the animal model with systemic infection of trichosporosis,to collect the bronchoalveolar lavage fluid(BALF),plasma and urine samples for determining,and checked with G-test,nested PCR and fungus culture.RESULTS In the earlier infection(10d),the sensitivity of G-test in the samples of plasma,BALF and urine were 80.00%,86.67%,and 6.67%,respectively,and had significant difference with control group.In the 30 plasma samples,the average sensitivity of G-test and nested-PCR blood fungus culture was 76.76%,68.85%,and 3.33%,respectively.With the statistical analysis,the sensitivity of G-test had significant deviation than fungus culture(P