Objective:To explore the application effect of a childlike cognition-empowered collaborative nursing model in pediatric burn patients aged 3 years and younger and their elderly caregivers, so as to provide reference for improving the cooperative nursing ability of elderly caregivers and improving the treatment and rehabilitation effect of burn children.Methods:This quasi-experimental study enrolled 80 pediatric burn patients aged 3 years and younger admitted to Children′s Hospital of Nanjing Medical University from January 2022 to December 2023 via convenience sampling, each paired with one elderly caregiver. Based on admission time, they were divided into the control group (40 patients and caregivers admitted from January to December in 2022) and the intervention group (40 patients and caregivers admitted from January to December in 2023). The control group received routine nursing, while the intervention group received a childlike cognition-empowered collaborative nursing model. Self-rating Anxiety Scale (SAS) and Chinese version of Positive Aspects of Caregiving (PAC) were used to evaluate the degree of anxiety and positive feelings of the elderly caregivers in the 2 groups. FLACC (F: face; L: legs; A: activity; C: cry; C: consol ability) Pain Assessment Scale, Child Medical Fear Scale (CMFS) and Vancouver Scar Scale (VSS) were used to evaluate dressing change pain, medical fear and scar status of the patients in the 2 groups.Results:A total of 80 pediatric burn patients and 80 elderly caregivers were included. The patients were (2.5 ± 0.2) years old in the control group, with 23 males and 17 females, and were (2.6 ± 0.1) years old in the intervention group, with 24 males and 16 females. The elderly caregivers were (62.0 ± 1.5) years old in the control group, with 9 males and 31 females, and were (61.0 ± 1.2) years old in the intervention group, with 8 males and 32 females. There were no significant differences in SAS and PAC scores between the 2 groups of elderly caregivers before intervention (both P>0.05). There were no significant differences in FLACC Pain Assessment Scale, CMFS before intervention and VSS scores within 1 week after wound healing between the 2 groups of patients (all P>0.05). After the intervention, the SAS score of the elderly caregivers in the intervention group was (45.80 ± 2.81) points, lower than (57.78 ± 4.63) points in the control group, the difference was statistically significant ( t=13.99, P<0.05), and the PAC score in the intervention group was (38.85 ± 3.03) points, higher than (30.15 ± 3.03) points in the control group, the difference was statistically significant ( t=-15.24, P<0.05). The FLACC Pain Assessment Scale, CMFS after intervention, VSS scores at 6 months of rehabilitation treatment of the patients in the intervention group were (3.35 ± 0.45), (22.20 ± 1.07), (6.50 ± 0.68) points, lower than (7.00 ± 0.45), (51.43 ± 2.26), (8.68 ± 0.76) points in the control group, the differences were statistically significant ( t=34.86, 73.87, 13.45, all P<0.05). Conclusions:The childlike cognition-empowered collaborative nursing model can enhance the caregiving enthusiasm of elderly caregivers, alleviate negative emotions among both elderly caregivers and pediatric burn patients aged 3 and younger, improve the collaborative nursing abilities of elderly caregivers, and enhance the treatment and rehabilitation outcomes of pediatric burn patients.

Objective:To explore the application effect of a childlike cognition-empowered collaborative nursing model in pediatric burn patients aged 3 years and younger and their elderly caregivers, so as to provide reference for improving the cooperative nursing ability of elderly caregivers and improving the treatment and rehabilitation effect of burn children.Methods:This quasi-experimental study enrolled 80 pediatric burn patients aged 3 years and younger admitted to Children′s Hospital of Nanjing Medical University from January 2022 to December 2023 via convenience sampling, each paired with one elderly caregiver. Based on admission time, they were divided into the control group (40 patients and caregivers admitted from January to December in 2022) and the intervention group (40 patients and caregivers admitted from January to December in 2023). The control group received routine nursing, while the intervention group received a childlike cognition-empowered collaborative nursing model. Self-rating Anxiety Scale (SAS) and Chinese version of Positive Aspects of Caregiving (PAC) were used to evaluate the degree of anxiety and positive feelings of the elderly caregivers in the 2 groups. FLACC (F: face; L: legs; A: activity; C: cry; C: consol ability) Pain Assessment Scale, Child Medical Fear Scale (CMFS) and Vancouver Scar Scale (VSS) were used to evaluate dressing change pain, medical fear and scar status of the patients in the 2 groups.Results:A total of 80 pediatric burn patients and 80 elderly caregivers were included. The patients were (2.5 ± 0.2) years old in the control group, with 23 males and 17 females, and were (2.6 ± 0.1) years old in the intervention group, with 24 males and 16 females. The elderly caregivers were (62.0 ± 1.5) years old in the control group, with 9 males and 31 females, and were (61.0 ± 1.2) years old in the intervention group, with 8 males and 32 females. There were no significant differences in SAS and PAC scores between the 2 groups of elderly caregivers before intervention (both P>0.05). There were no significant differences in FLACC Pain Assessment Scale, CMFS before intervention and VSS scores within 1 week after wound healing between the 2 groups of patients (all P>0.05). After the intervention, the SAS score of the elderly caregivers in the intervention group was (45.80 ± 2.81) points, lower than (57.78 ± 4.63) points in the control group, the difference was statistically significant ( t=13.99, P<0.05), and the PAC score in the intervention group was (38.85 ± 3.03) points, higher than (30.15 ± 3.03) points in the control group, the difference was statistically significant ( t=-15.24, P<0.05). The FLACC Pain Assessment Scale, CMFS after intervention, VSS scores at 6 months of rehabilitation treatment of the patients in the intervention group were (3.35 ± 0.45), (22.20 ± 1.07), (6.50 ± 0.68) points, lower than (7.00 ± 0.45), (51.43 ± 2.26), (8.68 ± 0.76) points in the control group, the differences were statistically significant ( t=34.86, 73.87, 13.45, all P<0.05). Conclusions:The childlike cognition-empowered collaborative nursing model can enhance the caregiving enthusiasm of elderly caregivers, alleviate negative emotions among both elderly caregivers and pediatric burn patients aged 3 and younger, improve the collaborative nursing abilities of elderly caregivers, and enhance the treatment and rehabilitation outcomes of pediatric burn patients.

Catheter-associated urinary tract infection (CAUTI) is one of the common nosocomial infections in burn patients. It not only extends the length of hospital stay of patients, increases the economic burden on family and society, but also seriously affects the prognosis and quality of life of patients, increases the risk of death of patients. In this paper, the epidemiological characteristics, influencing factors, and prevention measures of CAUTI in burn patients are reviewed to draw high attention of clinical medical staff and to provide some reference for clinical practice.

Objective: To investigate the trends in incidence of HIV/AIDS in China from 1990 to 2019 and to examine the effect of age, period and cohort on the incidence of HIV/AIDS, so as to provide insights into the improvements of the HIV/AIDS control measures. Methods: Data pertaining to incidence of HIV/AIDS in China from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019 (GBD 2019) datasets, and the trends in incidence of HIV/AIDS in China from 1990 to 2019 was analyzed with annual percentage change (APC) and average annual percentage change (AAPC) using a jointpoint regression model. The effects of age, period and cohort on the incidence of HIV/AIDS in China were examined with an age-period-cohort model. Results: The age-standardized incidence of HIV/AIDS appeared an overall tendency towards a rise in China from 1990 (0.80/105) to 2019 (2.21/105) (AAPC=3.209%, P<0.05), and the incidence of HIV/AIDS showed a tendency towards a rise from 1990 to 1997 (AAPC=9.044%, P<0.05) and from 1997 to 2003 (AAPC=17.598%, P<0.05), a decline from 2006 to 2014 (AAPC=-8.412%, P<0.05) and remained relatively stable from 2003 to 2006 and from 2014 to 2019 (both P>0.05). The incidence of HIV/AIDS appeared a tendency towards a rise with age, and peaked among patients at ages of 25 to 29 years (4.93/105) and 75 to 79 years (7.38/105). The risk of HIV/AIDS appeared a tendency towards a rise followed by a decline with time, and a reduced risk of HIV/AIDS was found from 1990 to 1994 (RR=0.297), from 1995 to 1999 (RR=0.523), from 2005 to 2009 (RR=0.737), from 2010 to 2014 (RR=0.412) and from 2015 to 2019 (RR=0.351) in relative to the period from 2000 to 2004. The risk of HIV/AIDS appeared a tendency towards a rise with the cohort, and a higher risk of HIV/AIDS was found in the 1930-1934 cohort (RR=1.880) and 2000-2004 cohort (RR=2.978) in relative to the 1955-1959 cohort. Conclusions The incidence of HIV/AIDS appeared a tendency towards a rise followed by a decline in China from 1990 to 2019, and remained at a low level since 2014. The adolescents and elderly were high-risk groups of HIV/AIDS. A variety of health education interventions and intensified active HIV/AIDS screening are recommended.

Objective:To establish and evaluate a new real-time quality control method that can identify the random errors by using the backpropagation neural network (BPNN) algorithm and taking blood glucose test as an example.Methods:A total of 219 000 blood glucose results measured by Siemens advia 2 400 analytical system from January 2019 to July 2020 and derived from Laboratory Information System of Beijing Chaoyang Hospital Laboratory Department was regarded as the unbiased data of our study. Six deviations with different sizes were introduced to generate the corresponding biased data. With each biased data, BPNN and MovSD algorithms were used and tested, and then evaluated by traceability method and clinical method.Results:For BPNN algorithm, the block size was pre-set to 10 and the false-positive rate in all biases was within 0.1%. For MovSD, however, the optimal block size and exclusive limit were 150 and 10% separately and its false-positive rate in all biases was 0.38%, which was 0.28% higher than BPNN. Especially, for the least two error factors of 0.5 and 1, all the random errors were not detected by MovSD; for the error factor larger than 1, random errors could be detected by MovSD but the MNPed was higher than that of BPNN under all deviations. The difference was up to 91.67 times. 460 000 reference data were produced by traceability procedure. The uncertainty of BPNN algorithm evaluated by these reference data was only 0.078%.Conclusion:A real-time quality control method based on BPNN algorithm was successfully established to identify random errors in analytical phase, which was more efficient than MovSD method and provided a new idea and method for the identification of random errors in clinical practice.

Objective 聽 聽To investigate the influence of mechanical and biological valves on clinical benefits of elderly patients with valvular heart disease. Methods 聽 聽We retrospectively analyzed the clinical data of 280 elderly patients with valvular heart disease treated by valve replacement between 2008 and 2014 year. The patients were divided into two groups by tendency score matching including a group A with biological valves and a group B with mechanical valves. Finally, there were 96 patients in each group. There were 43 males and 53 females at age of 64.41卤6.52 years in the group A, 44 males and 52 females at age of 64.07卤6.20 years in the group B. Results 聽 聽The bleeding rate of skin and mucosa of the group B was significantly higher than that of the group A (P<0.05). There was no statistical difference in mortality within 30 days after operation, all-cause mortality, re-hospitalization rate, re-valve replacement rate, combined atrial flutter/atrial fibrillation ratio, drug use, incidence of cerebral infarction, cerebral hemorrhage, new peripheral vascular embolism and visceral hemorrhage, heart function (NYHA) classification, the cumulative survival rate of all the patients during follow-up (P=0.63), or the cumulative survival rate of the patients with no thrombus/hemorrhage (P=0.75) between the two groups (P>0.05). Conclusion 聽 聽Mechanical valve replacement and bioprosthetic valve replacement in the treatment of valvular heart disease in the elderly can achieve similar clinical benefits and both have clinical application value.

Objective: To analyze the relationship between tumor deposits(TD) and clinicopathological features of locally advanced gastric cancer(LAGC) patients. Methods: The clinicopathological characteristics of 300 LAGC patients undergoing radical gastrectomy in Renmin Hospital of Wuhan University from Jan 2014 to Jul 2017 were collected. The relationship between clinicopathological features and prognosis of LAGC patients and TD status in LAGC patients were analyzed retrospectively. Results: TD were positive in 65(21.7%) patients. Univariate analysis showed that the depth of invasion, lymph node metastasis, pTNM stage, tumor size, vascular invasion, preoperative tumor markers were correlated with the status of TD(all P<0.05). Multivariate Logistic regression analysis showed that lymph node metastasis, pTNM stage, vascular invasion and depth of invasion were independent risk factors for positive TD (allP<0.05). Univariate analysis on prognosis of LAGC patients showed lesion location, degree of differentiation, lymph node metastasis, pTNM stage, tumor size, positive TD, number of TD and vascular invasion are associated with prognosis of LAGC (all P<0.05). Multivariate COX regression analysis showed that the number of TD >3 was an independent risk factor for the prognosis of LAGC patients(HR=2.242, 95% CI: 1.484-3.386, P=0.000). The median survival time of TD-positive LAGC was less than TD-negative group(χ²=91.077, P<0.001). The median survival time of TD number>3 group was significantly shorter than that in TD number<3 group and TD-negative group(χ²=192.969, P<0.001). Conclusions TD are closely related to tumor stage in LAGC patients. The status of TD is an independent risk factor for the prognosis of LAGC. Multiple TDs indicate poor prognosis of LAGC patients.

AIM:To study the expression of Jagged 2/Notch3 signaling molecules in pulmonary vascular wall of pulmonary hypertensive rats induced by monocrotaline .METHODS: SD rats were randomly divided into normal control group (C group,n=15), solvent control group (S group,n=15) and monocrotaline model groups (M group,n=15).The model of pulmonary hypertension was established by a single subcutaneous injection of monocrotaline (50 mg/kg).The rats in S group were given a single subcutaneous injection of the same dose of solvent .After 4 weeks, the pulmonary vascular remodeling was assessed by HE staining , and the mean pulmonary artery pressure ( mPAP) and right ventricular systolic pressure (RVSP) were determined by right heart catheterization .The expression of Jagged2/Notch3 /Hes5 molecules in the pulmonary vascular wall was detected by immunohistochemical method and real -time PCR.RESULTS:Compared with S group and C group , the percentage of medial wall thickness of smaller arteries in model group increased significantly (P<0.01).The levels of mPAP and RVSP in M group were significantly higher than those in S group and C groups (P<0.01).The results of real-time PCR showed that the expression of Jagged 2, Notch3 and Hes5 was significantly increased in M group compared with S group and C group .The data from immunohistochemical detection indicated that Jagged 2 mainly expressed in the intima of small lung artery , Notch3 and Hes5 mainly expressed in the medial smooth muscle cells .Com-pared with S group and C group , the expression of Jagged 2 and Notch3 was significantly increased in the lung small arteries of M group.CONCLUSION:The activation of Jagged2/Notch3 signaling pathway might play an important role in the for-mation of pulmonary hypertension .

Objective This study is aimed to explore the effect of rhTNFR:Fc and methotrexate (MTX)-rhTN FR:Fc on joint destruction of collagen-induced arthritis ( CIA ) rat by establishing CIA rat model which imitates pathogenic factors of rheumatoid arthritis (RA).Methods CIA rat model were developed by subcutaneous injection of bovine type Ⅱ collagen.The rats with inflammation scores of two or above were randomly divided into four groups:the sterilized water treatment group (0.4 ml/w,intra-peritoneal injection),the MTX treatment group (1 mg/w,intra-peritoneal injection),the rhTNFR:Fc treatment group(0.8 mg Biw,intra-peritoneal injection),the MTX + rhTNFR:Fc treatment group (MTX 1 mg/w and rhTNFR:Fc 0.8 mg Biw,intraperitoneal injection).After treatment for 8 weeks,the rats were sacrificed and took the ankle radiography.Micro-CT scan of proximal tibia was performed and hard-tissue slices were made,and then the ankle's bone damage of each group was observed in order to evaluate trabecular variation and bone quantity changes of proximal tibia.Statisstical analysis was conducted with ANK-q test.Results After treatment for 8 weeks,the percentage of trabecular area and the trabecular number of the rhTNFR:Fc treatment group and the MTX-rhTNFR:Fc treatment were [(29.1±0.3)％,(26.7±0.6)％,(4.4±0.5)/mm,(4.0±0.6)/mm] (P＜0.01),which were evidently higher than the sterilized water treatment group and MTX treatment group (P＜0.01).The trabecular separation of Etanercept treatment group and MTX-rhTNFR:Fc group was obviously less than the sterilized water treatment group and MTX treatment group [(12.9±0.5)％,(13.2±0.4)％ vs (2.0±0.3)/mm,(2.2t0.2)/mm] (P＜0.01).Conclusion rhTNFR:Fc and MTX-rhTNFR:Fc can remarkably inhibit joint destruction of CIA rat.And their effect on inhibiting of inflammation and increasing peri-articular bone quantity.In addition,they are effective on inhibiting the reduction of local trabecular structure and increase of trabecular separation.

To investigate the influence of Drynaria total flavonoids on proliferation and apoptosis of osteoblasts in tumor necrosis factor-α (TNF-α)- mediated medium, so as to explore the mechanism of Drynaria total flavonoids in preventing and treating osteoporosis of rheumatoid arthritis.