Objective:Investigating the correlation between postoperative stress levels and intraoperative sufentanil dosage in breast cancer patients.Method:A retrospective selection was made of 100 BC patients who underwent surgery at Shaanxi Cancer Hospital from Apr. 2023 to Apr. 2025 as the research subjects. According to the dosage of sufentanil during the operation, they were divided into low-dose ( n=33), medium-dose ( n=34), and high-dose ( n=33) groups. The general data and postoperative stress levels of the three groups were compared and analyzed. Based on the results of stress levels, BC patients were further divided into the normal group ( n=75) and the elevated group ( n=25). The clinical data, laboratory indicators, and intraoperative sufentanil dosage of the two groups were compared and analyzed. Binary Logistic regression was used to analyze the factors influencing the postoperative stress level of patients, and a nomogram was constructed. ROC and DCA were used to analyze the predictive value and net benefit of the nomogram. Pearson correlation analysis was used to analyze the correlation between the factors influencing the stress state of patients and the postoperative stress level. Results:The levels of endothelin-1 (ET-1), norepinephrine (NE), and cortisol (Cor) in the high-dose group after surgery were significantly lower than those in the low-dose group and the medium-dose group ( t=9.55, 11.07, 82.91, P<0.05). The stress levels and the levels of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), brain-derived neurotrophic factor (BDNF), and adrenocorticotropic hormone (ACTH) in the stress group were significantly higher than those in the normal group. However, the levels of sufentanil drug, glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) were lower than those in the normal group ( t=2.02, 2.04, 2.15, P<0.05). Multivariate analysis of binary logistic regression showed that the dosage of sufentanil ( t=2.02, 2.04, 2.15, P<0.05) ; Multivariate analysis of binary logistic regression showed that sufentanil dosage ( OR=0.58, 95 %CI: 0.24-0.93), SOD ( OR= 0.63, 95 %CI:0.41~0.84) were protective factors, and ACTH ( OR=1.57, 95%CI:1.23-1.92), CRP ( OR=1.53, 95 %CI: 1.06-2.00) 、BDNF ( OR=1.43, 95 %CI:1.11-1.75) were risk factors affecting the stress state of patients ( P<0.05) ; The construction of a risk nomogram model based on the above influencing factors and the ROC analysis indicated that its AUC=0.829, indicating a good predictive ability. The correction curve is close to the ideal curve, indicating that the model has good discrimination and consistency. DCA curve verification revealed that its predicted probability was 68%, indicating a positive net benefit. Correlation analysis showed that the intraoperative sufentanil dose, SOD, ACTH, CRP, BDNF were significantly correlated with the postoperative stress level-related indicators NE, ET-1, Cor. Among them, the intraoperative sufentanil dose and SOD were negatively correlated with NE, ET-1, Cor, while the other indicators were positively correlated with them ( P<0.05) . Conclusions:High levels of ACTH, CRP and BDNF are independent risk factors for postoperative stress in patients with BC, while sufentanil fibroids and SOD during the operation are protective factors. Moreover, the intraoperative sufentanil dose has a significant correlation with the related indicators of emergency levels. Clinically, this can be used as a biomarker for predicting postoperative stress in patients with BC and individualized intervention measures can be implemented, providing a new monitoring perspective for clinical prediction of the occurrence of stress.

Objective:Investigating the correlation between postoperative stress levels and intraoperative sufentanil dosage in breast cancer patients.Method:A retrospective selection was made of 100 BC patients who underwent surgery at Shaanxi Cancer Hospital from Apr. 2023 to Apr. 2025 as the research subjects. According to the dosage of sufentanil during the operation, they were divided into low-dose ( n=33), medium-dose ( n=34), and high-dose ( n=33) groups. The general data and postoperative stress levels of the three groups were compared and analyzed. Based on the results of stress levels, BC patients were further divided into the normal group ( n=75) and the elevated group ( n=25). The clinical data, laboratory indicators, and intraoperative sufentanil dosage of the two groups were compared and analyzed. Binary Logistic regression was used to analyze the factors influencing the postoperative stress level of patients, and a nomogram was constructed. ROC and DCA were used to analyze the predictive value and net benefit of the nomogram. Pearson correlation analysis was used to analyze the correlation between the factors influencing the stress state of patients and the postoperative stress level. Results:The levels of endothelin-1 (ET-1), norepinephrine (NE), and cortisol (Cor) in the high-dose group after surgery were significantly lower than those in the low-dose group and the medium-dose group ( t=9.55, 11.07, 82.91, P<0.05). The stress levels and the levels of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), brain-derived neurotrophic factor (BDNF), and adrenocorticotropic hormone (ACTH) in the stress group were significantly higher than those in the normal group. However, the levels of sufentanil drug, glutathione peroxidase (GSH-Px), and superoxide dismutase (SOD) were lower than those in the normal group ( t=2.02, 2.04, 2.15, P<0.05). Multivariate analysis of binary logistic regression showed that the dosage of sufentanil ( t=2.02, 2.04, 2.15, P<0.05) ; Multivariate analysis of binary logistic regression showed that sufentanil dosage ( OR=0.58, 95 %CI: 0.24-0.93), SOD ( OR= 0.63, 95 %CI:0.41~0.84) were protective factors, and ACTH ( OR=1.57, 95%CI:1.23-1.92), CRP ( OR=1.53, 95 %CI: 1.06-2.00) 、BDNF ( OR=1.43, 95 %CI:1.11-1.75) were risk factors affecting the stress state of patients ( P<0.05) ; The construction of a risk nomogram model based on the above influencing factors and the ROC analysis indicated that its AUC=0.829, indicating a good predictive ability. The correction curve is close to the ideal curve, indicating that the model has good discrimination and consistency. DCA curve verification revealed that its predicted probability was 68%, indicating a positive net benefit. Correlation analysis showed that the intraoperative sufentanil dose, SOD, ACTH, CRP, BDNF were significantly correlated with the postoperative stress level-related indicators NE, ET-1, Cor. Among them, the intraoperative sufentanil dose and SOD were negatively correlated with NE, ET-1, Cor, while the other indicators were positively correlated with them ( P<0.05) . Conclusions:High levels of ACTH, CRP and BDNF are independent risk factors for postoperative stress in patients with BC, while sufentanil fibroids and SOD during the operation are protective factors. Moreover, the intraoperative sufentanil dose has a significant correlation with the related indicators of emergency levels. Clinically, this can be used as a biomarker for predicting postoperative stress in patients with BC and individualized intervention measures can be implemented, providing a new monitoring perspective for clinical prediction of the occurrence of stress.

Shift handover is a process of transferring power and responsibility between medical staff,and it is also a basic part of medical activities.Intensive care unit(ICU)is the core area for the treatment of critically ill patients,with complex patient conditions and fine and diverse treatment.If clinical information cannot be shared accurately and in time,it will lead to the delay of the patient's condition,diagnosis and treatment plan.At the same time,the omission of handover information and communication problems can easily lead to safety risks,prolonged hospital stay and increased number of readmissions.Therefore,as one of the important links in ICU diagnosis and treatment and nursing work,accurate,complete and effective handover can ensure the rapid and accurate transmission of patient information and promote the smooth development of diagnosis and treatment and nursing work.This paper reviews the application scope of ICU shift handover model,analyzes the main characteristics,application status and application effects of ICU shift model,and discusses the problems and shortcomings of the existing ICU shift model,in order to provide a reference for further optimizing the quality of ICU shift.PRISMA extension for scoping reviews(PRISMA-ScR)as methodological guidance,we conducted a systematic search across major databases including PubMed,Web of Science,Embase,Cumulative Index to Nursing and Allied Health Literature(CINAHL),and Chinese databases(Wanfang,CNKI,Chinese Medical Association,CBM)using both subject headings and free-text terms).The search time limit was from the establishment of the database to July 18,2024.The preliminary retrieved literature bibliographer was imported into Endnote 20.0 software,and the obtained literature was selected and screened by two researchers.A total of 14 articles were included,of which 10 were from China and 4 were from the United States,and all were published between 2012 and 2022.The analysis showed that the ICU shift mode mainly included improved shift mode,group system shift mode,anti-shift mode,checklist type shift sheet mode and electronic information ICU shift.The shift mode showed diversified characteristics,optimized staffing to a certain extent,standardized the specific content and process of shift,and improved the quality of shift.Significant advances have been made in information delivery and quality of care.However,domestic research is mostly focused on the improvement of the shift mode,which faces the shortcomings of increasing workload,coordination and communication challenges,and the scientification and standardization of tools.Electronic information technology makes up for the shortcomings of information omission in the traditional shift process through the advantages of automatic data collection and information collection,and shows positive results in the process of shift.Future research needs to further explore the basis of not increasing the load of ICU clinical medical staff,ensuring the efficiency of shift and normal work flow.Pay attention to the intelligent,standardized and personalized construction of ICU shift,improve the quality of diagnosis and treatment and nursing,and ensure the safety of patients.

Shift handover is a process of transferring power and responsibility between medical staff,and it is also a basic part of medical activities.Intensive care unit(ICU)is the core area for the treatment of critically ill patients,with complex patient conditions and fine and diverse treatment.If clinical information cannot be shared accurately and in time,it will lead to the delay of the patient's condition,diagnosis and treatment plan.At the same time,the omission of handover information and communication problems can easily lead to safety risks,prolonged hospital stay and increased number of readmissions.Therefore,as one of the important links in ICU diagnosis and treatment and nursing work,accurate,complete and effective handover can ensure the rapid and accurate transmission of patient information and promote the smooth development of diagnosis and treatment and nursing work.This paper reviews the application scope of ICU shift handover model,analyzes the main characteristics,application status and application effects of ICU shift model,and discusses the problems and shortcomings of the existing ICU shift model,in order to provide a reference for further optimizing the quality of ICU shift.PRISMA extension for scoping reviews(PRISMA-ScR)as methodological guidance,we conducted a systematic search across major databases including PubMed,Web of Science,Embase,Cumulative Index to Nursing and Allied Health Literature(CINAHL),and Chinese databases(Wanfang,CNKI,Chinese Medical Association,CBM)using both subject headings and free-text terms).The search time limit was from the establishment of the database to July 18,2024.The preliminary retrieved literature bibliographer was imported into Endnote 20.0 software,and the obtained literature was selected and screened by two researchers.A total of 14 articles were included,of which 10 were from China and 4 were from the United States,and all were published between 2012 and 2022.The analysis showed that the ICU shift mode mainly included improved shift mode,group system shift mode,anti-shift mode,checklist type shift sheet mode and electronic information ICU shift.The shift mode showed diversified characteristics,optimized staffing to a certain extent,standardized the specific content and process of shift,and improved the quality of shift.Significant advances have been made in information delivery and quality of care.However,domestic research is mostly focused on the improvement of the shift mode,which faces the shortcomings of increasing workload,coordination and communication challenges,and the scientification and standardization of tools.Electronic information technology makes up for the shortcomings of information omission in the traditional shift process through the advantages of automatic data collection and information collection,and shows positive results in the process of shift.Future research needs to further explore the basis of not increasing the load of ICU clinical medical staff,ensuring the efficiency of shift and normal work flow.Pay attention to the intelligent,standardized and personalized construction of ICU shift,improve the quality of diagnosis and treatment and nursing,and ensure the safety of patients.

Nano-metallic materials are playing an important role in the application of medicine, catalysis, antibacterial and anti-toxin due to their obvious advantages, including nanocrystalline strengthening effect, high photo-absorptivity, high surface energy and single magnetic region performance. In recent years, with the increasing consumption of global petrochemical resources and the aggravation of environmental pollution, nanomaterials based on bio-based molecules have aroused great concern. Bio-based molecules refer to small molecules and macromolecules directly or indirectly derived from biomass. They usually have good biocompatibility, low toxicity, degradability, wide source and low price. Besides, most bio-based molecules have unique physical, chemical properties and physiological activity, such as optical activity, acid/alkali amphoteric property, hydrophilic property and easy coordination with metal ions. Thus, the corresponding nano-materials based on bio-based molecules also have unique functions, such as anti-inflammatory, anti-cancer, anti-oxidation, antiviral fall blood sugar and blood fat etc. In this paper, we give a comprehensive overview of the preparation and application of nano-metallic materials based on bio-based molecules in recent years.
Anti-Infective Agents ; Catalysis ; Metals ; Nanostructures

Objective To investigate the expression of inflammtory factor genes change induced by sodium sulfite.Methods MTS assay was used to detect the cell toxicity to human embryonic kidney cell line 293(HEK293) of 0,0.0025,0.01,0.039,0.156,0.625,2.5,10 mmol/L sodium sulfite,morphological changes were observed with inversion microscope and RT-PCR was used to study the expression of mRNA changes of TNF-?,MCP-1 and IL-8.Results Cytotoxicity analysis showed that treatment of cells with 0.625,2.5,10 mmol/L Na2SO3 could significantly decrease the OD value,with the OD value of(0.354 75 ?0.021 24),(0.600 50?0.012 77),(0.784 75?0.009 85) respectively,compared with control group(2.514 5?0.202 265).When treated with ≤0.156 mmol/L Na2SO3,it sould not significantly affect cell viability,with the OD value of(2.473 75?0.069 99)-(2.625 00? 0.120 29).Morphological observation showed that exposure of ≥0.625 mmol/L Na2SO3 could decrease cell numbers significantly and living cells seemed narrower and longer than the usual way with fewer evection.But lower concentrations of Na2SO3(≤0.156 mmol/L) did not change cell numbers and cell morphology.RT-PCR result showed that treatment of 0.039-10 mmol/L Na2SO3 could not induce the expression of TNF-?,MCP-1 and IL-8.Conclusion Na2SO3 can cause significant inhibition and injury in HEK293,but can not up regulate the expression of mRNA of TNF-?,MCP-1 and IL-8,and there is no obvious relation between them.