Objective:To investigate the application and management status of midline catheters in 1 954 hospitals, providing a basis for optimizing intravenous therapy nursing practices.Methods:This study used convenience sampling. From November 2023, members of the Intravenous Therapy Nursing Professional Committee of the Chinese Nursing Association selected 1 954 hospitals across various regions of China. Questionnaire on the Current Status of Intravenous Therapy in Hospitals at All Levels designed by the committee, based on literature review and expert discussions, was used to collect data on intravenous therapy practices in different hospitals. Multiple response analysis was applied to analysis the results of multiple-choice questions, where response numbers represent the total number of times each option was selected, and response rates refer to the proportion of selected times for each option out of all selected responses.Results:A total of 1 954 questionnaires were distributed across 31 provinces/municipalities/autonomous regions, and 1 954 valid questionnaires were returned, achieving a 100.0% valid response rate. Among the hospitals surveyed, 844 used midline catheters. Regarding the skin disinfection area for midline catheter insertion, the highest response rate was for a range of>20 cm. The highest response rate for catheter insertion techniques was ultrasound-guided Seldinger puncture. The highest response rate for maintenance interval was once a week. The top three responses for nursing documentation related to midline catheters were informed consent for intubation, puncture record, and maintenance record. The most frequently chosen processes were catheter placement, maintenance, removal, and complication management processes. The qualification for midline catheter intravenous therapy specialist nurses was mostly obtained through specialized nurse training, followed by hospital-based and department-based training.Conclusions:The application of midline catheters has rapidly developed but still reveals some deficiencies, including the choice of puncture tools, infection control, and catheter maintenance. It is recommended to improve nursing documentation and management processes related to midline catheters, establish industry standards suitable for China's national conditions, and strengthen and standardize the specialized training of intravenous therapy nurses to promote the healthy development of intravenous therapy in China.

Objective:To investigate the application and management status of midline catheters in 1 954 hospitals, providing a basis for optimizing intravenous therapy nursing practices.Methods:This study used convenience sampling. From November 2023, members of the Intravenous Therapy Nursing Professional Committee of the Chinese Nursing Association selected 1 954 hospitals across various regions of China. Questionnaire on the Current Status of Intravenous Therapy in Hospitals at All Levels designed by the committee, based on literature review and expert discussions, was used to collect data on intravenous therapy practices in different hospitals. Multiple response analysis was applied to analysis the results of multiple-choice questions, where response numbers represent the total number of times each option was selected, and response rates refer to the proportion of selected times for each option out of all selected responses.Results:A total of 1 954 questionnaires were distributed across 31 provinces/municipalities/autonomous regions, and 1 954 valid questionnaires were returned, achieving a 100.0% valid response rate. Among the hospitals surveyed, 844 used midline catheters. Regarding the skin disinfection area for midline catheter insertion, the highest response rate was for a range of>20 cm. The highest response rate for catheter insertion techniques was ultrasound-guided Seldinger puncture. The highest response rate for maintenance interval was once a week. The top three responses for nursing documentation related to midline catheters were informed consent for intubation, puncture record, and maintenance record. The most frequently chosen processes were catheter placement, maintenance, removal, and complication management processes. The qualification for midline catheter intravenous therapy specialist nurses was mostly obtained through specialized nurse training, followed by hospital-based and department-based training.Conclusions:The application of midline catheters has rapidly developed but still reveals some deficiencies, including the choice of puncture tools, infection control, and catheter maintenance. It is recommended to improve nursing documentation and management processes related to midline catheters, establish industry standards suitable for China's national conditions, and strengthen and standardize the specialized training of intravenous therapy nurses to promote the healthy development of intravenous therapy in China.

Objective To investigate the current state of quality management on intravenous therapy in secondary and tertiary hospitals in China.This study aims to provide a reference for the development of relevant policies,promoting the professionalization,standardization,and homogenization of intravenous therapy.Methods By a convenience sampling method,intravenous therapy nursing managers from secondary and tertiary hospitals in 31 provinces,autonomous regions,and municipalities were selected as survey participants in November 2023.A self-designed questionnaire was used for the survey.Results A total of 2 129 questionnaires were collected,of which 1,926 were valid,resulting in a response rate of 90.47％.Among the 1926 hospitals,1 733(89.98％)had established quality evaluation standards for intravenous therapy,and 1 734(90.03％)conducted regular quality inspections for intravenous therapy or peripherally inserted central catheter(PICC)insertion and maintenance.Additionally,1 604 hospitals(83.28％)had established protocols for handling and reporting intravenous therapy or PICC-related complications,and 1 574 hospitals(81.72％)regularly collected and analyzed data related to intravenous therapy or PICC insertion and maintenance.Moreover,371 hospitals(19.26％)had implemented intravenous therapy information management systems.Regarding various types of intravenous therapy documents,the highest rate of document types was informed consent forms,with a compliance rate of over 80.00％,followed by insertion records and catheter maintenance records,respectively.The lowest rate was complication management records,with a compliance rate of less than 50.00％.For catheter maintenance protocols,the highest compliance rate was for maintenance procedures,at over 85.00％,followed by insertion procedures.Except for PICCs,the compliance rate for establishing catheter removal and complication management procedures for other types of catheters was less than 65.00％.In terms of quality management of intravenous therapy,there are significant differences between secondary and tertiary hospitals.Conclusion The quality evaluation standards for intravenous therapy are relatively comprehensive,but the informatization of intravenous therapy quality management is still underdeveloped.Furthermore,there is a need to further standardize the documentation and procedures related to intravenous therapy,and there are differences in the level of intravenous therapy management among hospitals of different levels.

Objective To gain an in-depth understanding of the construction and use of the intravenous therapy specialist nurse teams in tertiary general hospitals in China,and to provide a reference for the development and standardized management of the intravenous therapy specialist nurse teams.Methods A convenience sampling method was used to survey tertiary general hospitals across the country in November 2023 using a self-designed questionnaire on the current status of the intravenous therapy specialist nurse teams.Results A total of 1,097 questionnaires were collected,of which 958 were valid,with a response rate of 87.33％.The survey results showed that there were 15,249 intravenous therapy specialist nurses in 958 tertiary general hospitals.These nurses generally had a bachelor's degree(13 346,87.52％)and most had more than 10 years of work experience(10 294,67.51％).Their main tasks included PICC and PORT placement and maintenance.In terms of the management of intravenous therapy specialist nurses,68.37％of hospitals had an open and transparent selection method,and 73.17％of hospitals implemented regular assessments,and 68.79％of hospitals provided retraining opportunities.The certification of intravenous therapy specialist nurses was mostly undertaken by provincial and municipal nursing associations,and the appointment method was the appointment system.In terms of remuneration,67.22％of hospitals reimbursed all training costs,but 47.60％of hospitals had no change in remuneration before and after training.In addition,79.33％of hospitals had intravenous therapy specialist nursing clinics.Intravenous therapy specialist nurses mainly worked throughout the hospital,mostly independently on a part-time basis,and the main charges were treatment costs and material costs.Conclusion The team of intravenous therapy nurses in tertiary general hospitals in China is large in size and has a high level of education.However,hospitals and management departments still need to pay more attention and support to the expansion of the work content,training,assessment,retraining and salary guarantee of intravenous therapy nurses in order to further strengthen the construction of intravenous therapy nurses and promote their sustainable development.

Objective To determine whether local gradient fluid shear stress(FSS)causes a specific distribution of intracellular calcium ion concentration,which ultimately determines the direction of cell migration.Methods Numerical simulations were performed using COMSOL software.The method of staining intracellular calcium ion for RAW264.7 osteoclast precursors was established.After applying gradient FSS on the cells,the distribution and dynamic changes of intracellular calcium ion concentration and cell migration parameters were analyzed.Results Osteoclast precursors tended to migrate towards regions with lower FSS,and oscillatory flow regulated the distribution of intracellular calcium ions along the direction of cell migration.After blocking phospholipase C(PLC),mechanosensitive cation-selective channels(MSCC),endoplasmic reticulum(ER),and removing extracellular calcium,the migration speed of cells towards the low FSS direction was significantly reduced,but the migration speed along the liquid flow direction was significantly enhanced.Meanwhile,the calcium ion distribution along the liquid flow direction was significantly increased.Conclusions Osteoclast precursors can sense the FSS gradient,resulting in a specific distribution of intracellular calcium ions along the direction of migration.This ultimately leads to the migration of osteoclast precursors towards regions with lower FSS.This study provides important basic data for ultimately elucidating the cellular and molecular mechanisms of bone tissue remodeling under dynamic external forces.

With continuous advancements in medical technology, the tools and techniques for intravenous therapy and infusion are also evolving and innovating. This paper summarizes and analyzes the current application status of intravenous therapy infusion tools and techniques, thus providing deep reflections and suggestions to serve as a beneficial reference and guide for the development of these tools and techniques in China.

Objective To investigate the relationship between serum survivin,adenosine triphosphate bind-ing cassette transporter Al(ABCA1)and poor coronary collateral circulation(CCC)in patients with single coronary artery occlusion in acute myocardial infarction(AMI).Methods A total of 155 patients with single coronary artery occlusion in AMI admitted to Handan Fist Hospital from May 2021 to May 2023 were selected as the study objects,and were divided into poor CCC group(n=80)and good CCC group(n=75)according to their CCC status.Serum survivin and ABCA1 levels were compared between the two groups,univariate and multivariate Logistic regression models were used to analyze the influencing factors of poor CCC,and the effi-cacy of serum survivin and ABCA1 in predicting poor CCC was analyzed by receiver operating characteristic curve.Results Compared with good CCC group,serum survivin and ABCA1 in poor CCC group were signifi-cantly decreased,and the difference was statistically significant(P＜0.05).Compared with good CCC group,Gensini score,creatinine kinase isoenzyme-MB(CK-MB),Killip heart function grade≥Ⅱ and history of hy-pertension in poor CCC group were significantly increased,and the differences were statistically significant(P＜0.05).Multivariate Logistic regression model showed that high Gensini score,high CK-MB,Killip heart function grade≥Ⅱ and history of hypertension were risk factors for poor CCC(P＜0.05),while high sur-vivin and high ABCA1 were protective factors(P＜0.05).The area under the curve,sensitivity and specificity of the two indexes combined to predict poor CCC were 0.949,90.70％and 92.52％,which were significantly better than the single detection.Conclusion Serum survivin and ABCA1 are closely relate to poor CCC in pa-tients with single coronary artery occlusion in AMI,the lower the serum levels of survivin and ABCA1,the greater the risk of poor CCC,the combine detection of the two has a high predictive value for poor CCC in pa-tients with single coronary artery occlusion in AMI.

Objective To gain an in-depth understanding of the construction and use of the intravenous therapy specialist nurse teams in tertiary general hospitals in China,and to provide a reference for the development and standardized management of the intravenous therapy specialist nurse teams.Methods A convenience sampling method was used to survey tertiary general hospitals across the country in November 2023 using a self-designed questionnaire on the current status of the intravenous therapy specialist nurse teams.Results A total of 1,097 questionnaires were collected,of which 958 were valid,with a response rate of 87.33％.The survey results showed that there were 15,249 intravenous therapy specialist nurses in 958 tertiary general hospitals.These nurses generally had a bachelor's degree(13 346,87.52％)and most had more than 10 years of work experience(10 294,67.51％).Their main tasks included PICC and PORT placement and maintenance.In terms of the management of intravenous therapy specialist nurses,68.37％of hospitals had an open and transparent selection method,and 73.17％of hospitals implemented regular assessments,and 68.79％of hospitals provided retraining opportunities.The certification of intravenous therapy specialist nurses was mostly undertaken by provincial and municipal nursing associations,and the appointment method was the appointment system.In terms of remuneration,67.22％of hospitals reimbursed all training costs,but 47.60％of hospitals had no change in remuneration before and after training.In addition,79.33％of hospitals had intravenous therapy specialist nursing clinics.Intravenous therapy specialist nurses mainly worked throughout the hospital,mostly independently on a part-time basis,and the main charges were treatment costs and material costs.Conclusion The team of intravenous therapy nurses in tertiary general hospitals in China is large in size and has a high level of education.However,hospitals and management departments still need to pay more attention and support to the expansion of the work content,training,assessment,retraining and salary guarantee of intravenous therapy nurses in order to further strengthen the construction of intravenous therapy nurses and promote their sustainable development.

Objective:To construct a clinical prediction model for early postoperative parastomal hernia in patients with enterostomy and to conduct internal and external validation and evaluation of clinical benefit.Methods:A total of 1 071 patients with enterostomy treated in Zhongshan Hospital Affiliated to Fudan University from October 2013 to December 2020 were selected as the research objects by the convenient sampling method. Patients from October 2013 to December 2019 were selected as the modeling group ( n=943) . The data of patients were obtained by questionnaire and other methods. The clinical prediction model of early postoperative parastomal hernia in patients with enterostomy was constructed based on Cox regression analysis and the model was internally verified by Bootstrap method. Patients from January to December 2020 were selected as the validation group ( n=128) for external validation of the model. C-statistic, area under receiver operating characteristic curve and calibration map were used to evaluate the discrimination and calibration of the model. Decision curve analysis was used to draw decision curve analysis chart to evaluate the clinical benefit of the prediction model. Results:Age, history of alcohol consumption, postoperative body mass index, diabetes mellitus, respiratory diseases, history of abdominal surgery, stoma route, stoma nature and C-reactive protein were independent influencing factors for early postoperative parastomal hernia in patients with enterostomy ( P<0.05) . The C- index value of early postoperative nomogram was 0.710 (95% CI: 0.660-0.750) . Conclusions:The clinical prediction model of early parastomal hernia in patients with enterostomy has good predictive performance, which can help clinical medical staff to screen out high-risk groups in time and guide medical staff to focus on prevention.

Objective:To construct a clinical prediction model for early postoperative parastomal hernia in patients with enterostomy and to conduct internal and external validation and evaluation of clinical benefit.Methods:A total of 1 071 patients with enterostomy treated in Zhongshan Hospital Affiliated to Fudan University from October 2013 to December 2020 were selected as the research objects by the convenient sampling method. Patients from October 2013 to December 2019 were selected as the modeling group ( n=943) . The data of patients were obtained by questionnaire and other methods. The clinical prediction model of early postoperative parastomal hernia in patients with enterostomy was constructed based on Cox regression analysis and the model was internally verified by Bootstrap method. Patients from January to December 2020 were selected as the validation group ( n=128) for external validation of the model. C-statistic, area under receiver operating characteristic curve and calibration map were used to evaluate the discrimination and calibration of the model. Decision curve analysis was used to draw decision curve analysis chart to evaluate the clinical benefit of the prediction model. Results:Age, history of alcohol consumption, postoperative body mass index, diabetes mellitus, respiratory diseases, history of abdominal surgery, stoma route, stoma nature and C-reactive protein were independent influencing factors for early postoperative parastomal hernia in patients with enterostomy ( P<0.05) . The C- index value of early postoperative nomogram was 0.710 (95% CI: 0.660-0.750) . Conclusions:The clinical prediction model of early parastomal hernia in patients with enterostomy has good predictive performance, which can help clinical medical staff to screen out high-risk groups in time and guide medical staff to focus on prevention.