Objective To construct quality evaluation indicators for perioperative nursing in heart transplantation,and to provide standard and professional quantitative bases for monitoring and management of perioperative nursing quality.Methods This study was conducted based on the frame work of the three-dimensional"structure-process-outcome"quality model,using literature review,Delphi method and analytic hierarchy to determine the content of the indicators,and the weight of each index.Results A total of 22 experts from 14 qualified heart transplantation hospitals were included,and a total of 2 rounds of consultations were conducted.The effective recovery rates of 2 rounds of expert consultation questionnaires were 100％.The authority coefficients were 0.817.The variation coefficients of each item ranged from 0.025～0.169 and 0.039～0.157.The Kendall harmony coefficients were 0.126 and 0.225(P＜0.001).The final evaluation indicators for perioperative nursing quality in heart transplantation included 3 first-level indicators,12 second-lever indicators and 59 third-level indicators.Conclusion The evaluation indicators of perioperative nursing quality in heart transplantation was scientific,comprehensive and specialized,which can provide references for the evaluation of perioperative nursing quality in heart transplantation.

Objective:To systematically search, evaluate and integrate the relevant evidence of nutrition management in breast cancer patients, and summarize the best evidence, so as to provide evidence for the clinical practice of nutrition management in breast cancer patients.Methods:Evidence-based nursing method was adopted. The BMJ Best Practice, Cochrane Library, etc. and websites were systematically searched for relevant clinical decisions, guidelines, expert consensus,etc. on nutrition management in breast cancer patients. The search period was from the establishment of the database to June 21, 2023. Three researchers independently evaluated the quality of the included literature and the level of evidence and recommendation.Results:A total of 17 pieces of literature were included, including 2 clinical decisions, 6 guidelines, 1 expert consensus and 8 systematic reviews. A total of 33 pieces of best evidence were summarized on 8 aspects, including objective, nutrition screening and assessment, nutrition management population, body mass index management, nutrient structure, diet type and quantity, the use of health products and nutritional supplements, and nutritional monitoring and follow-up.Conclusions:The study summarized the best evidence on nutrition management in breast cancer patients, and provided evidence-based basis for healthcare professionals to better manage nutrition in breast cancer patients. In the practical application of evidence, the differences in dietary habits, structures and religious beliefs of different regions and cultures should be considered, and the best evidence appropriate for individuals should be reasonably selected, taking patients′ own wishes and preferences into account, so as to provide more scientific and comprehensive nutrition management for breast cancer patients.

Chemogenetic technology is a receptor-ligand system that regulates cell viability and function by changing receptor specificity and affinity, and it achieves precise neuronal regulation by specifically regulating neurons and neural circuits. At present, this technique is widely used in the study of neural circuits. This article briefly describes the application and progress of chemogenetic technology in the study of depression neural circuits, reviews the application of chemogenetic technology in several brain regions closely related to depression, such as ventral tegmental area, nucleus accumbens, prefrontal cortex, hippocampus and lateral habenula, and discusses the potential and challenges of chemogenetic technology as a technology for precise regulation of neural activity in future research, in order to provide reliable ideas and directions for chemogenetic technology in the study of depression neural circuits.

The treatment and nursing experience of a patient with acute coronary syndrome with ketoacidosis and chronic gastric volvulus were summarized.The nursing points are as follows:dynamic assessment of chest pain,timely warning of disease changes,helping early identification of chest pain etiology;accurately monitoring hemodynamics,ensuring rapid fluid resuscitation,preventing heart failure;closely observation of bleeding and bleeding tendency,doing gastrointestinal bleeding care;phased posture therapy and cardiac rehabilitation to improve chronic gastric volvulus;applying positive dual intervention strategy and implementing psychological nursing.After active diagnosis and treatment and careful care,the patient was discharged smoothly after 20 d of hospitalization and followed up for 1 year in good condition.

The treatment and nursing experience of a patient with acute coronary syndrome with ketoacidosis and chronic gastric volvulus were summarized.The nursing points are as follows:dynamic assessment of chest pain,timely warning of disease changes,helping early identification of chest pain etiology;accurately monitoring hemodynamics,ensuring rapid fluid resuscitation,preventing heart failure;closely observation of bleeding and bleeding tendency,doing gastrointestinal bleeding care;phased posture therapy and cardiac rehabilitation to improve chronic gastric volvulus;applying positive dual intervention strategy and implementing psychological nursing.After active diagnosis and treatment and careful care,the patient was discharged smoothly after 20 d of hospitalization and followed up for 1 year in good condition.

Objective: To summarize the clinical phenotypes of epilepsy in patients with GABRA1 gene variants. Methods: A total of 11 epileptic patients (4 boys and 7 girls) who were treated in the Department of Pediatrics, Peking University First Hospital from March 2016 to July 2019 and detected with GABRA1 gene heterozygous pathogenic variants by targeted next-generation sequencing were enrolled. The features of clinical manifestations, electroencephalogram (EEG), and neuroimaging were analyzed retrospectively. Results: A total of 11 epileptic patients carried GABRA1 gene pathogenic variants, of whom 10 were de novo variants and the other one was inherited from the patient′s mother. Two patients had the same variants. Six variants were novel. Ages at seizure onset ranged from 3 to 14 months, and the median age was 8 months. The seizure was first observed within 1 year in 10 patients and beyond 1 year of age in 1 patient. Multiple seizure types were observed, including focal seizures in 10 patients, generalized tonic clonic seizures (GTCS) in 3 patients, myoclonic seizures in 3 patients, and epileptic spasm in 2 patients. There were 5 patients with multiple seizure types. Sensitivity to fever was observed in 9 patients, among whom 6 patients had a history of status epilepticus. Two patients had photoparoxysmal response. Five patients had abnormal EEG background, and 6 patients had abnormal discharges in EEG during interictal phase. Brain magnetic resonance imaging (MRI) was normal in all patients. Developmental delay in various degrees was present in 9 patients. Among the 11 patients, Dravet syndrome was diagnosed in 5 patients, West syndrome in 2 patients, undiagnosed early-onset epileptic encephalopathy in 1 patient, and focal epilepsy in the other 3 patients. The ages at the last follow-up ranged from 8 months to 12 years. During follow-up, 8 patients were seizure-free for 6 months to 8 years, and 1 patient had discontinuation of medication. Conclusions In epilepsy associated with GABRA1 gene variants, de novo pathogenic variants are more common than inherited. Most epilepsy caused by GABRA1 gene variants occurs in infancy. Most patients have multiple seizures and focal seizures are common. Most patients have a comparatively favorable prognosis, but they may still have varied degrees of developmental delay.

This paper reviewed the present nursing manager succession planning at home and abroad, covering the succession standard of nursing managers, the content and form of pre-job training, and the evaluation tool of management ability. These efforts aim to provide references for the construction of nursing management talents teams in China.

Objective To analyze the clinical features and risk factors of urinary tract infection in patients with gestational diabetes mellitus ( GDM).Methods A total of 1 068 patients with GDM were enrolled from Nanshan People's Hospital between January and December 2014.The incidence of urinary tract infection, pathogens distribution and drug resistance rate were retrospectively analyzed.Multivariate Logistic regression was performed to analyze the risk factors of urinary tract infection in GDM patients . Results Among 1 068 patients with GDM, 130 (12.17%) were compliacated with urinary tract infection One hundred of forty-two strains of pathogens were detected in the middle urine culture sample from urinary tract infection patients, Escherichia coli (67.61%,96/142) and Klebsiella pneumonia (11.97%,17/142) were the most frequent strains.Escherichia coli has high resistance to semi-synthetic penicillins, quinolones and sulfonamides, and relatively low resistance rate to carbapenems , aminoglycoside antibiotics and nitrofurantoin.Klebsiella pneumoniae was completely resistant to ampicillin , while was completely sensitive to carbapenems, aminoglycoside antibiotics , piperacillin/tazobactam, aztreonam.Logistic regression analysis showed that glycated hemoglobin ＞6.5%(OR＝8.631, 95%CI 2.969-25.090, P＜0.01), fasting blood glucose＞5.3 mmol/L(OR＝3.116, 95%CI 2.040-4.761,P＜0.01), low density lipoprotein ＞2.6 mmol/L (OR＝1.649, 95%CI 1.083-2.511, P＜0.05), triglyceride＞1.7 mmol/L(OR＝2.986, 95%CI 1.256-7.112, P＜0.05), history of urinary tract infection (OR＝5.561,95%CI 1.315-23.519, P＜0.05) and history of maternity(OR＝1.631, 95%CI 1.018-2.614, P＜0.05) were the independent risk factors for urinary tract infection in GDM.Conclusion The incidence of urinary tract infection in patients with GDM is high.The control of blood glucose and blood lipids , enhanced health education for pregnant women with history of urinary tract infection and history of childbirth may reduce the occurrence of urinary tract infection in GDM patients.

Objective To study the application of transcatheter superselective arterial embolization for the spinal tumorectomy preopera-tive.Methods From January 2009 to September 2015,the data of 65 patients with spinal tumor were collected.Before operation,all the pa-tients had been performed the transcatheter superselective arterial embolization by Seldinger technology,the embolization effect and the blood loss volume were recorded.Results The pathological vertebral body of 62 patients were significantly dyed and the tumor-feeding artery were obvious.But no obvious tumor-feeding artery and the tumor dyeing was found in 3 cases.The tumor-feeding artery positive incidence of angi-ography was 95.3%(62/65).All cases intubation was successful but one.After embolization, the pathological vertebral body was removed completely.The blood loss volume was 500-3 000 mL,with an average (1 400.65 ±230.62) mL.Conclusion The transcatheter superse-lective arterial embolization could reduce the blood loss in spinal tumorectomy and the operation risks,and increase the possibilities of radical resection,which is an effective preoperative intervention.