Objective To evaluate the diagnostic value of monocyte chemokine-1(MCP-1)and CD40 ligand(CD40L)levels in patients with bronchiectasis(BE)complicated with pulmonary infection.Methods A total of 94 patients with BE complicated with pulmonary infection who received treatment in Department of Geriat-rics in the hospital from March 2021 to March 2023 were included as the BE complicated infection group.Ac-cording to the Clinical Pulmonary Infection Score(CPIS),they were divided into severe infection group(17 cases).moderate infection group(52 cases).and mild infection group(25 cases).Another 94 cases of BE with-out pulmonary infection were selected as the BE group.94 healthy people who underwent the physical exami-nation during the same period in the hospital were selected as the control group.The distribution of pathogenic bacteria in BE patients complicated with pulmonary infection was analyzed.The levels of serum MCP-1 and CD40L in each group were compared.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum MCP-1 and CD40L in BE complicated with pulmonary infection.Results Total-ly 99 strains of pathogenic bacteria were isolated from 94 BE patients complicated with pulmonary infection.Among them,73 strains(73.74％)were Gram-negative bacteria,mainly Klebsiella pneumoniae.17 strains(17.17％)were Gram-positive bacteria,mainly Staphylococcus aureus.9 strains(9.09％)were fungal strains,mainly composed of Candida albicans.The serum levels of MCP-1 and CD40L in the BE combined with infec-tion group were obviously higher than those in the BE group and the control group(P＜0.05).The levels of serum MCP-1 and CD40L in the severe infection group and the moderate infection group were obviously high-er than those in the mild infection group(P＜0.05),and the serum levels of MCP-1 and CD40L in the severe infection group were obviously higher than those in the moderate infection group(P＜0.05).The area under the curve of the combined diagnosis of serum MCP-1 and CD40L for BE complicated with pulmonary infection was larger than that of the single detection(Z combination-MCP-1=2.896,P=0.005,Zcombination-CD40L=4.547,P＜0.001),with sensitivity of 91.49％and specificity of 76.60％.Conclusion The levels of serum MCP-1 and CD40L in patients with BE complicated with pulmonary infection are elevated,which could be used to assess the severity of pulmonary infection,and the combination of the two has high diagnostic value for BE compli-cated with pulmonary infection.

Objective:To introduce the application of 3D printing technology in standardized residency training of percutaneous precise biopsy.Methods:Twenty-two residents were randomly divided into innovative teaching group and traditional teaching group, with 11 ones in each group. Residents in both groups received standardized training of percutaneous biopsy procedure. Innovative teaching group was given 3D printing template combined with guided operation, while traditional teaching group used bare hand operation. The time spent in biopsy, the times of needle adjustment, the frequency of CT scanning during operation, the positive rate of material sampling and the incidence of complications were compared between the two groups.Results:During the percutaneous lung biopsy, two groups of physicians performed the procedure. There was no significant difference between the two groups in operation time [(22.34±3.12) vs. (23.56±4.21)] and the positive rate of sampling (72.73% vs. 90.91%) ( P> 0.05), but there were significant differences in the times of adjusting biopsy needle during operation [(2.11±0.67) vs. (1.02±0.93)], the frequency of intraoperative CT scanning [(4.35±0.76) vs. (3.12±0.84)] and the incidence of complications (54.55% vs. 27.27%) ( P< 0.05). In percutaneous peritoneal organ biopsy, there was no significant difference among the two groups in the operation time [(16.25±2.89) vs. (15.12±2.59)], the number of CT scans [(3.45±0.79) vs. (2.98±0.23)] and the positive rate (78.57% vs. 88.24%) ( P> 0.05), but there were significant differences in times of intraoperative biopsy needle adjustments [(2.43±0.43) vs. (1.84±0.89)] and the incidence of complications (35.71% vs. 5.88%) ( P< 0.05). Conclusion:The application of 3D printing technology combined with the teaching of three-dimensional guided stent can make percutaneous biopsy technique stylized and standardized. It is of great significance to standardize the operation for improving the quality of medical treatment, and it is worth popularizing in clinical teaching.

OBJECTIVE: To explore the influence of clinical practice on mental health of male nursing college students,and to investigate the effects of psychological intervention. METHODS: Using the cluster sampling method,408 clinical practice male nursing students from 5 medical colleges in Jilin Province were randomly divided into intervention group and control group. The male nursing students were investigated with Chinese Perceived Stress Scale(CPSS),M to R sections of Cornell Medical Index(CMI) and Symptom Checklist 90(SCL-90). After the first questionnaire survey in the 9 weeks of clinical practice(before psychological intervention),male nursing students in intervention group received psychological intervention,while those in control group received no action. The investigation were then performed in the 20th(11 weeks of intervention) and 30 th weeks(21 weeks of intervention) of clinical practice. RESULTS: In the 11 and 21 weeks of intervention,the positive rates of CPSS,M-R and mental symptoms in intervention group were lower than those of timematched control group(P < 0. 01),and were significantly lower than those before intervention(P < 0. 01). Before intervention,the scores of CPSS,M-R and SCL-90 in two groups had no statistical significance(P > 0. 05). After the 11 and 21 weeks of intervention,the scores of CPSS,M-R and SCL-90 in intervention group were lower than those of control group(P < 0. 01). With the increasing time of intervention,the scores of CPSS and M-R in intervention group decreased(P < 0. 01). After the 11 and 21 weeks of intervention,the scores of SCL-90 in intervention group were lower than those before intervention(P < 0. 01). CONCLUSION: The results suggest that clinical practice is a stress for the mental health of male nursing college students. Psychological supporting system can be used to improve students' psychological health.

Objective To investigate the awareness , the nursing position demand and capacity requirements of mobile nurses , so as to provide the basis for setting and development of the mobile nurses . Methods Investigated 1 415 nursing staff from 120 hospitals in four provinces about mobile nurse awareness , willingness and ability requirements .Results The awareness of mobile nurses to nurses was 84.45%, only 20.83%of the hospital departments had mobile nurses .Position demand scores of tertiary hospitals , wards with bed utilization rate 90%or higher, and surgery departments respectively were (4.40 ±0.98), (4.46 ±0.87), and(4.35 ±1.04),more higher than that of second-class hospital, wards with bed utilization rate less than 90%, and medicine departments, and significant difference was statistically significant (t/F=20.17,207.49, 10.92,respectively;P<0.05).Conclusions The management and operation of mobile nurses in China is in the initial stage, mobile nurses are urgent needed in the surgical ward of tertiary hospitals .Mobile nurses should possess general nurses ability and emergency care skills .