Background/Aims: Liver transplantation is the most effective treatment for the sickest patients with acute-on-chronic liver failure (ACLF). However, the influence of donor age on liver transplantation, especially in ACLF patients, is still unclear. Methods: In this study, we used the data of the Scientific Registry of Transplant Recipients. We included patients with ACLF who received liver transplantation from January 1, 2007, to December 31, 2017, and the total number was 13,857. We allocated the ACLF recipients by age intogroup I (donor age ≤17 years, n=647); group II (donor age 18–59 years, n=11,423); and group III (donor age ≥60 years, n=1,787). Overall survival (OS), graft survival, and mortality were com-pared among the three age groups and the four ACLF grades. Cox regression was also analyzed. Results: The 1-, 3-, and 5-year OS rates were 89.6%, 85.5%, and 82.0% in group I; 89.4%, 83.4%, and 78.2% in group II; and 86.8%, 78.4%, and 71.4% in group III, respectively (p<0.001).When we analyzed the different effects of donor age on OS with different ACLF grades, in groupsII and III, we observed statistical differences. Finally, the cubic spline curve told us that the relative death rate changed linearly with increasing donor age. Conclusions Donor age is related to OS and graft survival of ACLF patients after transplanta-tion, and poorer results were associated with elderly donors. In addition, different donor ages have different effects on recipients with different ACLF grades.

Background/Aims: Liver transplantation is the most effective treatment for the sickest patients with acute-on-chronic liver failure (ACLF). However, the influence of donor age on liver transplantation, especially in ACLF patients, is still unclear. Methods: In this study, we used the data of the Scientific Registry of Transplant Recipients. We included patients with ACLF who received liver transplantation from January 1, 2007, to December 31, 2017, and the total number was 13,857. We allocated the ACLF recipients by age intogroup I (donor age ≤17 years, n=647); group II (donor age 18–59 years, n=11,423); and group III (donor age ≥60 years, n=1,787). Overall survival (OS), graft survival, and mortality were com-pared among the three age groups and the four ACLF grades. Cox regression was also analyzed. Results: The 1-, 3-, and 5-year OS rates were 89.6%, 85.5%, and 82.0% in group I; 89.4%, 83.4%, and 78.2% in group II; and 86.8%, 78.4%, and 71.4% in group III, respectively (p<0.001).When we analyzed the different effects of donor age on OS with different ACLF grades, in groupsII and III, we observed statistical differences. Finally, the cubic spline curve told us that the relative death rate changed linearly with increasing donor age. Conclusions Donor age is related to OS and graft survival of ACLF patients after transplanta-tion, and poorer results were associated with elderly donors. In addition, different donor ages have different effects on recipients with different ACLF grades.

Background/Aims: Liver transplantation is the most effective treatment for the sickest patients with acute-on-chronic liver failure (ACLF). However, the influence of donor age on liver transplantation, especially in ACLF patients, is still unclear. Methods: In this study, we used the data of the Scientific Registry of Transplant Recipients. We included patients with ACLF who received liver transplantation from January 1, 2007, to December 31, 2017, and the total number was 13,857. We allocated the ACLF recipients by age intogroup I (donor age ≤17 years, n=647); group II (donor age 18–59 years, n=11,423); and group III (donor age ≥60 years, n=1,787). Overall survival (OS), graft survival, and mortality were com-pared among the three age groups and the four ACLF grades. Cox regression was also analyzed. Results: The 1-, 3-, and 5-year OS rates were 89.6%, 85.5%, and 82.0% in group I; 89.4%, 83.4%, and 78.2% in group II; and 86.8%, 78.4%, and 71.4% in group III, respectively (p<0.001).When we analyzed the different effects of donor age on OS with different ACLF grades, in groupsII and III, we observed statistical differences. Finally, the cubic spline curve told us that the relative death rate changed linearly with increasing donor age. Conclusions Donor age is related to OS and graft survival of ACLF patients after transplanta-tion, and poorer results were associated with elderly donors. In addition, different donor ages have different effects on recipients with different ACLF grades.

Background/Aims: Liver transplantation is the most effective treatment for the sickest patients with acute-on-chronic liver failure (ACLF). However, the influence of donor age on liver transplantation, especially in ACLF patients, is still unclear. Methods: In this study, we used the data of the Scientific Registry of Transplant Recipients. We included patients with ACLF who received liver transplantation from January 1, 2007, to December 31, 2017, and the total number was 13,857. We allocated the ACLF recipients by age intogroup I (donor age ≤17 years, n=647); group II (donor age 18–59 years, n=11,423); and group III (donor age ≥60 years, n=1,787). Overall survival (OS), graft survival, and mortality were com-pared among the three age groups and the four ACLF grades. Cox regression was also analyzed. Results: The 1-, 3-, and 5-year OS rates were 89.6%, 85.5%, and 82.0% in group I; 89.4%, 83.4%, and 78.2% in group II; and 86.8%, 78.4%, and 71.4% in group III, respectively (p<0.001).When we analyzed the different effects of donor age on OS with different ACLF grades, in groupsII and III, we observed statistical differences. Finally, the cubic spline curve told us that the relative death rate changed linearly with increasing donor age. Conclusions Donor age is related to OS and graft survival of ACLF patients after transplanta-tion, and poorer results were associated with elderly donors. In addition, different donor ages have different effects on recipients with different ACLF grades.

Objective To explore the association of working hours and shift work with occupational stress, fatigue accumulation, and depressive symptoms among primary community medical workers. Methods A total of 516 medical workers from five community medical service centers in Pudong New Area, Shanghai City, were selected as the research subjects using the convenience sampling method. The Core Scale of Occupational Stress Measurement, the Workers' Fatigue Accumulation Self-diagnosis Questionnaire, and the Patient Health Questionnaire were used to assess research subjects' occupational stress, fatigue accumulation, and depressive symptoms, respectively. Results Long working hours (>40 hours/week) were reported by 50.4% of workers among the research subjects, while shift works were reported by 16.9% of the workers. The detection rates of occupational stress, fatigue accumulation, and depressive symptoms were 26.6%, 41.7%, and 30.8%, respectively. Multivariate logistic regression analysis result revealed that, after adjusting for confounders such as age, sex, and education level, longer working hours were associated with higher risks of occupational stress, fatigue accumulation, and depressive symptoms (all P<0.05). Shift workers in community medical centers had higher risks of occupational stress, fatigue accumulation, and depressive symptoms compared with non-shift workers (all P<0.05). Conclusion Long working hours and shift work could increase the risks of occupational stress, fatigue accumulation, and depressive symptoms among community medical workers.

Objective:To deeply understand the inner experiences of undergraduate nursing interns using Nursing Information Systems (NIS) and provide references for formulating relevant intervention strategies.Methods:A descriptive phenomenological approach was adopted for this qualitative study. Purposeful sampling was used to select undergraduate nursing interns from four comprehensive hospitals in Hangzhou during February to May 2023 for semi-structured interviews. The interview data were analyzed using Colaizzi's seven-step method to extract themes.Results:Four themes were identified in this study: insufficient preparedness of undergraduate nursing interns in using NIS, low engagement of undergraduate nursing interns in using NIS, perceived benefits of using NIS by undergraduate nursing interns, and adaptation strategies of undergraduate nursing interns using NIS.Conclusions:There are issues such as insufficient preparedness and low engagement among undergraduate nursing interns in using NIS. Some respondents experience emotions such as anxiety, fatigue, and decreased enthusiasm. It is recommended that colleges and internship hospitals pay attention to the clinical work demands and the learning needs of nursing interns, thus providing education and support for the use of NIS.

Objective:To explore the research status of artificial intelligence in nursing in China, so as to provide reference for conducting research domestically.Methods:The relevant literature collected from January 1, 2003 to May 1, 2023 was searched on China National Knowledge Infrastructure, WanFang Data, and VIP. CiteSpace and VOS viewer were used to visually analyze the research status, hotspots, and frontiers of artificial intelligence in nursing in China from the aspects of annual publication volume, region, institution, author, high-frequency keywords, and emerging words.Results:A total of 494 articles were included. In terms of publication volume, domestic research showed an overall upward trend, with publishing institutions mostly concentrated in economically developed and medically advanced regions. The authors of the articles often collaborated with research groups, with a co-authorship rate of 81.17% (401/494), but there was relatively little collaboration between groups. Research hotspots were focused on the application of artificial intelligence in geriatric nursing, rehabilitation nursing, Operating Rooms, and drug formulation, with a majority of research related to robots.Conclusions:The research enthusiasm in related fields in China is currently on the rise. Research on artificial intelligence in nursing management, nursing education, and psychological nursing can be strengthened, and the application of artificial intelligence can be enriched. At the same time, research institutions and personnel should strengthen mutual cooperation, and relevant national departments should improve laws and regulations to promote the vigorous development of this research field.

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is the main pathogen that causes COVID-19,which is fast-mutating and highly transmissible.The infection has led to a global epidemic.As the main preventive and control measure,vaccination plays a critical role in fighting a-gainst COVID-19.Although a large number of epitope-based and mucosal vaccines have been stud-ied,few peptide epitope vaccines targeting the mucosa and their functional evaluation have been re-ported.In this study,we used SARS-CoV-2 structural protein M peptide epitope predicted by the IEDB database as an antigenic target to design the MS-3S gene containing 3 050 and 1 229 signal peptides and DCpep optimized for insertion into MS2 phage coat proteins.The expression plasmid pSIP:MS-3S was constructed by cloning the PCR fragments seamlessly and was transformed into Lactiplantibacillus plantarum 18 to obtain the recombinant bacterium LP18:MS-3S.Expression conditions such as induction time,inducer concentration,rotational speed and initial pH were opti-mized.The intranasal immunization experiments were performed to examine the vaccine efficacy.The results showed that the 916 bp-long target gene MS-3S modified and optimized was amplified and used to successfully construct the recombinant bacterial strain LP18:MS-3S.The optimal con-ditions for recombinant protein expression were obtained and verified by Western blot,flow cy-tometry,immunofluorescence and other detection methods.The optimal expression conditions were determined as follows:induction time was 4 h with 100 pg/L of SppIP as the optimal induction concentration.Antibody-specific for the epitope was verified by ELISA experiments in serum,alve-olar lavage fluid and fecal dilutions of mice.In summary,a recombinant bacterial strain expressing the epitope antigen of the SARS-CoV-2 M protein peptide was constructed.The obtained protein can induce the body to produce humoral and mucosal immunity,which lays the foundation for the development of a vaccine candidate for the mucosal immunity of COVID-19.

Purpose: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can infect the human placenta and has been shown to have an adverse effect on Doppler ultrasound parameters and placental features. However, the specific effects of the SAS-CoV-2 infection on the fetal-placental unit in pregnant women remain unclear. The aim of this systematic review and meta-analysis was to evaluate the impact of SARS-CoV-2 infection on Doppler ultrasound and placental findings in pregnant women. Methods: A systematic search was conducted using four electronic databases (PubMed, Embase, Scopus, and Cochrane Library) to select publications published in peer-reviewed journals written in English. Odds ratios (ORs) were calculated, along with their 95% confidence intervals (CIs). Heterogeneity was assessed using Cochrane Q and I² statistics and the appropriate P-value. The analysis used RevMan 5.3. Results: This meta-analysis included 1,210 pregnant women from 10 case-control studies. SARS-CoV-2–infected pregnant women exhibited higher likelihoods of placental abnormalities (OR, 2.62; 95% CI, 1.66 to 4.13), aberrant Doppler values (OR, 1.95; 95% CI, 1.16 to 3.27), an abnormal cerebroplacental ratio (OR, 2.68; 95% CI, 1.52 to 4.75), altered fetoplacental circulation (OR, 1.56; 95% CI, 1.07 to 2.28), and increased placental thickness and placental venous lakes (OR, 1.85; 95% CI, 1.25 to 2.72). Conclusion According to this meta-analysis, pregnant women infected with SARS-CoV-2 are more likely to experience altered Doppler ultrasonography parameters and placental abnormalities, including increased placental thickness, placental venous lakes, altered fetoplacental circulation, and cerebroplacental ratio. However, the limited number of case-control studies requires larger sample sizes to validate and enhance the evidence.

Objective This study aimed to explore the potential categories and characteristics of the fear of falling in the initial ambulation day among patients who underwent major abdominal surgery,analyze the factors influencing different potential categories,and propose implications for the care of such patients.Methods A total of 213 patients who u nderwent elective major abdominal surgery in the Department of Gastrointestinal Gland Surgery and Hepatobiliary Surgery in the First Affiliated Hospital of Guangxi Medical University from April to August 2023 were selected as the study subjects.The general data questionnaire and the Revised Version of the Fall Fear Scale and Patient Fall Risk Perception Scale were used to investigate the patients on the day they first got out of bed after surgery.The potential profile of the fall fear characteristics of the study subjects was analyzed,and the relevant influencing factors among different categories were explored by univariate analysis,variance analysis,and logistic regression analysis.Results A total of 202 patients who underwent major abdominal surgery were included in this study.The total score of the fear of falling when getting out of bed for the first time was(35.28±8.85).The fear of falling showed 3 potential categories:low-level fear(22.28％),medium-level fear(47.52％),and high-level fear(30.20％).A significant difference was found in the first time of getting out of bed among different types of fear(H=19.292,P＜0.001).Results of multi-factor logistic regression analysis showed that patients with high levels of personal activity factors in fall perception and those who underwent pancreatic surgery were likely to develop medium-level fear(P=0.037).Patients with high levels of perceived environmental factors,high levels of perceived personal activity factors,and low self-efficacy were likely to develop high-level fear(P＜0.05).Conclusion The fear of falling on the initial ambulation day in patients who underwent major abdominal surgery was distributed in categories,and the proportion of patients with medium and high fear levels was high.Patients'fall risk perception,self-efficacy,and surgical site are important factors influencing fear of falling.Therefore,postoperative nursing staff should focus on developing targeted health education and activity programs to reduce the level of fall fear.