Objective:To construct an evaluation framework with detailed indices for demonstration units (wards) of enteral nutrition nursing, in order to improve the competence of nurses in enteral nutrition nursing and inform the specialized development of enteral nutrition demonstration units (wards).Method:On the basis of literature review and expert discussion, a preliminary draft was developed, and the Delphi expert consultation method was used to conduct two rounds of consultation with 15 clinical experts in the field of enteral nutrition nursing from 15 tertiary hospitals.Results:The effective response rates of questionnaires in two rounds of consultations were both 100%. The first round of expert consultation showed an authority coefficient of 0.90 and a coefficient of variation of 0 to 0.167, while the second round showed an authority coefficient of 0.93 and a coefficient of variation of 0 to 0.113. The Kendall harmony coefficients were 0.338 and 0.368, respectively. Finally, the evaluation framework with detailed indices for the demonstration unit (ward) of enteral nutrition nursing was formed, which consisted of 3 primary indicators, 16 secondary indicators, 54 tertiary indicators, and 62 detailed items.Conclusions:The evaluation framework we developed for the demonstration unit of enteral nutrition nursing follows the diagnosis and treatment process of enteral nutrition management for inpatients, including the triad of structure, process, and outcome. The framework is objective and practical, and can inform the daily practice of enteral nutrition nursing demonstration units (wards) and the development of enteral nutrition nursing specialties.

Objective:To understand the nutritional nursing competence in the enteral nutrition demonstration wards at this stage, so as to inform subsequent training plan.Methods:From September to October in 2023, nurses from 287 institutions involved in the enteral nutrition demonstration ward construction project were selected using convenience sampling. Questionnaires on general characteristics and self-assessment scale on nutrition nursing competence were used for online survey. The status quo and influencing factors of nutrition nursing competence in included institutions were analyzed.Results:A total of 5 409 valid questionnaires were collected, with a response rate of 62.63%. The total score of nutrition nursing competence was 74.74±16.11, with the least subtotals in the domain of nutrtion knowledge. Multiple linear regression showed that influencing factors of nutrition nursing competence includes years of working, department, registered dietitian or not, nutrition management specialist or not, completion of the curriculum in enteral nutrition demonstration ward construction project, and training/supervision arranged by their department concerning nutrtion nursing and relevant evaluation criteria ( P<0.05). Conclusions:The nutritional nursing competence of clinical nurses in the wards involved in enteral nutrition demonstration ward construction project still needs to be improved. Seniors should take into consideration the varying nutritional nursing competence among junior nurses and nurses from different departments, and strengthen the training on nutrition knowledge. It should be encouraged for nurses to actively participate in nutritionist training. Actions including enhancing nutrition specialist training, establishing the multidisciplinary collaborative nutrition care team and conducting regular supervision and assessment should be implemented in the future, to improve the nutritional nursing competence among nurses.

Objective To explore the relationship between serum lipoprotein(a),Apelin-13,and transforming growth factor beta 1(TGF-β1)and left atrial diameter(LAD)in patients with atrial fibrillation(AF).Methods A total of 100 patients who were admitted to Chuzhou First People's Hospital between December 2022 and January 2024 were selected as research objects.There were 50 patients with AF(AF group)and 50 patients without AF(NAF group).Serum levels of lipoprotein(a),Apelin-13,and TGF-β1 were detected,and LAD were measured by transthoracic echocardiography.Results Compared with those in the NAF group,lipoprotein(a),TGF-β1 and LAD were increased significantly in the AF group,while Apelin-13 was decreased significantly(P<0.05).Multivariable logistic regression revealed that lipoprotein(a),TGF-β1,diastolic blood pressure and LAD were risk factors of AF,while Apelin-13 was a protective factor of AF(P<0.05).Furthermore,lipoprotein(a),TGF-β1,LAD and Apelin-13 had predictive value for AF(P<0.05).Linear regression results showed that the coefficients of lipoprotein(a),TGF-β1 and Apelin-13 influencing on LAD were 0.01(P>0.05),-0.04(P>0.05)and-1.22(P<0.05),respectively.Conclusion Lipoprotein(a),TGF-β1 and LAD are independent risk factors of AF.However,lipoprotein(a)and TGF-β1 have no notable relation with LAD.As an independent protective factor of AF,Apelin-13 is significantly negatively correlated with LAD.

【Objective:】 To explore the relationship between the moral courage of nurses in Intensive Care Unit (ICU) and the hospital ethical climate, and to provide a theoretical basis for enhancing the moral courage of ICU nurses. 【Methods:】 A total of 468 ICU nurses from 8 tertiary A hospitals in Shaanxi Province were selected as the subjects by convenience sampling method, and the General Information Form, Hospital Ethical Climate Survey, and Nurses’ Moral Courage Scale were used for the questionnaire survey. 【Results:】 A total of 468 questionnaires were distributed and 463 valid questionnaires were returned, with an effective recovery rate of 98.93%. The score of hospital ethical climate for ICU nurses was (100.69±19.76), and the score of moral courage was (83.67±15.48). There was a positive correlation between hospital ethical climate and moral courage (r=0.866, P<0.001). Hierarchical multiple regression analysis showed that hospital ethical climate entered the influencing factor model of ICU nurses’ moral courage, which can independently explain 57% of the variation in ICU nurses’ moral courage. 【Conclusion:】 The moral courage of ICU nurses was at a medium level, and positively correlated with the hospital ethical climate, that is, the better the hospital ethical climate perceived by ICU nurses, the higher their level of moral courage. Nursing managers should focus on deepening the hospital ethical climate, and enhance the level of hospital ethical climate through scientific methods to promote the improvement of ICU nurses’ moral courage.

BACKGROUND/AIMS: In recent years, endoscopic submucosal tunnel dissection (ESTD) has gained popularity worldwide. The aim of this study was to evaluate the safety and efficacy of ESTD in treating upper gastrointestinal submucosal tumors (SMTs) in a large-volume endoscopic center. METHODS: Patients with SMTs were enrolled in this study between January 2012 and January 2015. Demographic data, clinical data, and treatment outcome were collected and analyzed. RESULTS: Seventy SMTs originating from the muscularis propria (MP) layer were identified in 69 patients. All patients successfully underwent the ESTD procedure. The mean procedure time was 49.0±29.5 minutes, and the mean tumor size was 18.7±7.2 mm. Among all lesions, the majority (70.0%) were located in the esophagus, 12.9% in the cardia, and 17.1% in the stomach. Complete resection was achieved in 67 lesions (95.7%). Perforation occurred in three patients (4.3%), who were treated by endoclips. Pneumothorax occurred in two patients (2.9%) and was successfully managed by thoracic drainage. During a median follow-up of 18.1 months, patients were free of local recurrence or distant metastasis. CONCLUSIONS: Our results demonstrated the feasibility and safety of ESTD in treating upper gastrointestinal SMTs originating from the MP layer. Large-scale comparative studies with other treatment methods should be conducted in the future.
Cardia ; Drainage ; Esophagus ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Pneumothorax ; Recurrence ; Stomach ; Treatment Outcome

Objective To analyze the documents regarding the occupational commitment of nurses in China to provide reference for nursing managers. Methods Literature analysis was applied. Paper on occupational commitment of nurses in China from 2002 to 2016 were collected and periodicals collection, authors,scientific research funding,distribution of the research objects,sampling methods and related factors to occupational commitment were analyized. Results A total of 25 articles were collected. The research objects were mainly from general hospitals,Chinese medicine hospitals,psychiatry and community. The main research content was influencing factors analysis. No intervention research and lack of randomization were the existing problems. Conclusions Rsearch on occupational commitment of nurses has been valued in China while the research process needs to be enhanced because of lack of intervention research.

Objective To evaluate the effects of dietary intervention with low glycemic index (LGI) and low glycemic load (LGL) on dietary knowledge and dietary modification of patients with type 2 diabetes mellitus (T2DM).Methods This study was a cluster randomized controlled study.From June to September 2010,105 T2DM patients were randomly sampled from 3 residential areas (n =35 in each) in Jin Pen Ling community,Changsha,Hunan province and divided into three groups with a random number table:whole-day dietary intervention group (group A,n =35),breakfast dietary intervention group (group B,n =35),and control group (group C,n =35).Interventions included 3-month health education and dietary intervention.Dietary knowledge,dietary oils,glycemic index (GI),and glycemic load (GL) of the three groups were compared before and after intervention.Results Before intervention,all the three groups showed a low level of knowledge about GI (57.7 ％),and high levels of average GI value of each meal (69.71 ± 8.55),GL value per day (132.45 ± 16.25),and daily cooking oil intake [(39.95 ± 20.64)g].The average knowledge level about GI increased after intervention in both group A (96.3％ vs.57.1％,P ＜0.05) and group B (94.5％ vs.60.5％,P＜0.05),but not in group C (54.8％ vs.55.3％,P＞0.05).The reduction of daily cooking oilintake in group A was larger than those in group B and group C [(7.81 ± 3.91) g vs.(-5.12 ± 1.37) g,(7.81 ± 3.91) g vs.(-3.45 ± 5.95) g,both P ＜ 0.05];so was the average GI value of each meal [group A,(5.95±2.27);groupB (-0.85±1.87);groupC,(-2.87±1.93);allP＜0.05].The changes of GL values in group A (11.31 ±4.31) was better than in group B (1.23 ±27.82) and group C (-0.43 ± 18.40)(both P ＜0.05).Conclusions The average GI value,GL value,and daily cooking oil intake of T2DM patients were all at a high level before intervention,while the level of knowledge about GI was at a low level.Health education providing GI knowledge may effectively improve the knowledge about GI in T2DM patients,while LGI and LGL dietary intervention may promote diet modification.Whole-day dietary intervention may be more effective than breakfast intervention.

Objective To explore the predictive value of ventricle late potential (LP) for arrhythmic events in the patients with Brugada syndrome. Methods Totally 43 patients with Brugada syndrome were divided into symptom group (n=24) and asymptom group (n=19).Signalaveraged electrocardiography(SAECG) was performed to analyze characteristics of LP in all subjects.The occurrence of arrhythmic events was observed in all patients during the dynamic follow-up for (33.8±9.0) months.Results There were 22 cases (91.7％) and 7 cases (36.8％) with LP positive in patients with symptom and asymptom,respectively.The incidences of arrhythmic events were 72.4％ in Brugada syndrome patients with positive LP and 14.3％ in patients with negative LP,respectively.The relative risk (RR,95％ CI) for LP prediction of the arrhythmic events was [5.1,(1.4～ 18.6)] (P =0.002). ConclusionsLP may be one of effective factors predicting arrhythmic events in the patients with Brugada syndrome.

Treating tumors with electric field is an interdisciplinary integrated and comprehensive research which applies electro-technology to tumor treatment.This therapy has the characteristics of safe,practical to its users and the parameters are easily to be controlled,which has attracted considerable attention in recent years.The main types of electric field in current research or application are pulsed electric field and direct current electric field.Both of the types can change the environment where tumors grow with different mechanisms,and the tumors would be killed through their pathological changes.Alternating electric field in intermediate frequency is a new type of tumor treating field,which has a promising application prospect.This article reviews the international and domestic research progress of the effects and mechanisms of the three kinds of electric fields used in the treatment of tumors.

OBJECTIVETo investigate the role of autophagy on the pathogenesis of spinocerebellar ataxia 3/Machado-Joseph disease (SCA3/MJD).

METHODSHEK293 cells expressing polyglutamine-expanded ataxin-3 were used as cell model for SCA3/MJD. The level of polyglutamine-expanded ataxin-3 was detected after cells were treated with different inhibitors or inducer of autophagy.

RESULTSInhibition of autophagy increased aggregate formation and cell death in HEK293 cells expressing mutated ataxin-3, and vice versa.

CONCLUSIONThe data suggested that autophagy is involved in the degradation of mutant ataxin-3, resulting in a decrease in the proportions of aggregate-containing cells and cell death in HEK293 cells expressing polyglutamine-expanded ataxin-3. It is possible that autophagy may be applied as a potential therapeutic approach for SCA3/MJD.

Ataxin-3 ; Autophagy ; Cell Line ; Humans ; Machado-Joseph Disease ; genetics ; metabolism ; physiopathology ; Mutation ; Nerve Tissue Proteins ; genetics ; metabolism ; Nuclear Proteins ; genetics ; metabolism ; Peptides ; metabolism ; Repressor Proteins ; genetics ; metabolism