Background::Pancreatic ductal adenocarcinoma (PDAC) is one of the main types of malignant tumor of the digestive system, and patient prognosis is affected by difficulties in early diagnosis, poor treatment response, and a high postoperative recurrence rate. Carbohydrate antigen 19-9 (CA19-9) has been widely used as a biomarker for the diagnosis and postoperative follow-up of PDAC patients. Nevertheless, the production mechanism and potential role of CA19-9 in PDAC progression have not yet been elucidated.Methods::We performed single-cell RNA sequencing on six samples pathologically diagnosed as PDAC (three CA19-9-positive and three CA19-9-negative PDAC samples) and two paracarcinoma samples. We also downloaded and integrated PDAC samples (each from three CA19-9-positive and CA19-9-negative patients) from an online database. The dynamics of the proportion and potential function of each cell type were verified through immunofluorescence. Moreover, we built an in vitro coculture cellular model to confirm the potential function of CA19-9. Results::Three subtypes of cancer cells with a high ability to produce CA19-9 were identified by the markers TOP2A, AQP5, and MUC5AC. CA19-9 production bypass was discovered on antigen-presenting cancer-associated fibroblasts (apCAFs). Importantly, the proportion of immature ficolin-1 positive (FCN1+) macrophages was high in the CA19-9-negative group, and the proportion of mature M2-like macrophages was high in the CA19-9-positive group. High proportions of these two macrophage subtypes were associated with an unfavourable clinical prognosis. Further experiments indicated that CA19-9 could facilitate the transformation of M0 macrophages into M2 macrophages in the tumor microenvironment. Conclusions::Our study described CA19-9 production at single-cell resolution and the dynamics of the immune atlas in CA19-9-positive and CA19-9-negative PDAC. CA19-9 could promote M2 polarization of macrophage in the pancreatic tumor microenvironment.

Objective:To understand the contents of edible salt iodine and urinary iodine of children and pregnant women in Yunnan Province, and to evaluate the iodine nutrition status, so as to provide a basis for scientific prevention and treatment of iodine deficiency disorders (IDD).Methods:From November to December 2020, one county (city) was selected from each prefecture (city), two townships (towns and streets) were selected from each county (city) and two villages (neighborhood committees) were selected from each township (town and street) from each of the 16 prefectures (cities) in Yunnan Province as the investigation sites. A total of 20 non-boarding children (male and female balanced) aged 8 - 10 years old were selected from each primary school in each village (neighborhood committee) to collect salt and urine samples. A total of 80 children were investigated in each county (city). A total of 20 pregnant women were selected from each township (town and street) to collect salt and urine samples. A total of 40 pregnant women were investigated in each county (city). All salt samples and urine samples were tested for iodine contents.Results:A total of 2 009 salt samples and 2 041 urine samples (1 375 for children, 666 for pregnant women) were collected from children aged 8 - 10 years old and pregnant women in 16 counties (cities) of Yunnan Province. Among them, the median salt iodine was 26.0 mg/kg, the coverage rate of iodized salt was 100.0% (2 009/2 009), the qualified rate of iodized salt was 98.7% (1 982/2 009), and the consumption rate of qualified iodized salt was 98.7% (1 982/2 009). The difference of salt iodine content in key populations in different counties (cities) was statistically significant ( H = 258.98, P < 0.01). The median urinary iodine of children aged 8 - 10 years old was 188.5 μg/L. There was statistically significant difference in urinary iodine content among children of different ages ( H = 29.45, P < 0.01), but there was no statistically significant difference in urinary iodine content among children of different genders ( H = 1.43, P > 0.05). In addition, the median urinary iodine of pregnant women was 141.9 μg/L, 52.1% (347/666) was < 150 μg/L. There was statistically significant difference in urinary iodine content of pregnant women in different counties (cities, H = 88.32, P < 0.01). Conclusions:The qualified rate of iodized salt, the coverage rate of iodized salt and the consumption rate of qualified iodized salt in key populations of Yunnan Province are more than 90%, and the iodized salt supply is good. Iodine nutrition of children aged 8 - 10 years old is at an appropriate level (100 - 199 μg/L); iodine nutrition of pregnant women is in an state of iodine deficiency ( < 150 μg/L). It is suggested to strengthen IDD monitoring and health education among key populations, improve residents' awareness of disease prevention, and make scientific iodine supplementation.

Objective:To analyze the clinical features of post-pancreaticoduodenectomy hemorrhage, and explore effective and practical nursing strategies.Methods:Clinical data of 62 patients with post-pancreaticoduodenectomy hemorrhage from Jan 2014 to Dec 2019 in the First Affiliated Hospital of Naval Medical University were retrospectively analyzed. The bleeding time, location, vital signs, accompanying symptoms and surgical treatment measures and clinical outcomes were analyzed.Results:Among the 62 cases, early (within 24 h) hemorrhage occurred in 19/62 patients (30.6%), and late hemorrhage occurred in 43/62 patients (69.4%). 36/62 patients (58.1%) had arterial bleeding; And 43/62 patients (69.4%) had abdominal hemorrhage. Grade C hemorrhage occurred in 32/62 patients (51.6%). Sentinel hemorrhage occurred in 8/62 patients (12.9%). The manifestation of hemorrhage in 42 patients was bloody fluid from abdominal drainage tube (67.7%). Hemorrhage occurred in 23 patients with pancreatic fistula(37.1%), 12 patients with abdominal infection and other complications (19.4%). Shock symptoms occurred in 41 cases (66.1%) with postoperative hemorrhage. Pancreaticoduodenectomy hemorrhage were early detected in 0.3 h and last detected in 869 h, with a median time of 192.00 (14.63, 297.00) h. 30/62 cases (48.4%) of hemorrhage patients occurred 1 hour before and after nursing shift. When hemorrhage was found, emergency treatments such as blood transfusion to maintain blood volume ( n=47, 75.8%), hemostasis ( n=35, 56.5%) and vasoactive drugs to increase blood pressure ( n=32, 51.6%) were usually given immediately. 31/62 patients (50.0%) underwent emergency secondary surgery within 4 h of hemorrhage, and 45/62 patients (72.6%) were cured by emergency surgical treatment. A written treatment pre-plan for surgical nurses was established. Conclusions:Surgical nurses should be familiar with the clinical manifestations of post-pancreaticoduodenectomy hemorrhage, and improve the alarming ability of identifying the complications of post-operative hemorrhage. The establishment of an emergency pre-plan for surgical nurses could help to treat such patients timely and effectively.

Gastrointestinal tract is the main site of human immunodeficiency virus (HIV) infection. Intestinal flora and its metabolites can affect the physicochemical properties, nutritional status and immune function of the intestinal tract. Improving the state of intestinal flora of AIDS patients can improve the immune function of patients and suppress the damage caused by HIV virus to the body. Moringa oleifera combined enteral nutrition can improve the intestinal microecology of AIDS patients and effectively improve the nutritional status of the patients, but there is the possibility of interaction with antiviral drugs, garlic, hypericum perforatum and other herbs. The microbial ecological agents have a weak regulation effect on the intestinal flora of AIDS patients, but it can improve the immune function of patients to a certain extent. Fecal microbiota transplantation does not significantly change the diversity of intestinal flora in AIDS patients, and the long-term complications are still to be clarified, but it can improve the immunity of patients to some extent. The preservation of microbial ecological agents, dietary regulation of intestinal flora and nursing after fecal microbiota transplantation in AIDS patients are still to be studied.

Wechat has been widely used in nursing clinical clerkship teaching now. The application of Wechat in nursing clinical teaching mainly takes the form of Wechat group chat, Wechat public signal platform, Wechat friendship circle, online test and so on. Among them, Wechat group chat and Wechat public signal platform are used widely. Wechat enriches the teaching way, and improve the effectiveness of teaching, moreover, it facilitates the relationship between teachers and students. However, there are the ongoing challenges such as lacking of supervision and protection of intellectual property rights.

Postprandial hypotension is an abnormal regulation of blood pressure, which is common in the elderly. Due to insidious symptoms, postprandial hypotension is easily neglected by patients and medical staff in clinical practice, but it has a high degree of harm. There are many factors related to the occurrence of postprandial hypotension, including demographic factors, disease-related factors, lifestyle factors, postprandial postural factors and so on. Among demographic factors, age is positively associated with the occurrence of postprandial hypotension. Among disease-related factors, the existence of some basic diseases such as hypertension and diabetes, and the use of most kinds of anti-hypertensive drugs can increase the risk of postprandial hypotension. Among lifestyle factors, smoking is a risk factor for postprandial hypotension: while reducing the intake of staple foods, drinking large amounts of water or drinking green tea before meals may reduce the risk of postprandial hypotension. By taking different postures after meals, postural factors affect the rate of gastrointestinal emptying and then affect the occurrence of postprandial hypotension. Among the above factors, it is feasible to prevent postprandial hypotension by changing postprandial posture.

This article reviewed the application status of traditional Chinese medicine (TCM) nursing in acquired immune deficiency syndrome (AIDS) fever, pain, AIDS related diarrhea, anxiety and depression. TCM dialectic nursing and cupping had good effects on dropping in temperature for AIDS fever; ear acupoint pressure could ease the AIDS pain; moxibustion could improve AIDS related diarrhea with weakness of the spleen and stomach and reduce the healing time;TCM emotional nursing could relieve anxiety and depression of AIDS patients. Overall, the application of TCM nursing in AIDS symptom management is less and study quality is still need to be improved.

Nurses from all medical environments have close contacts with asthma patients, it can recognize the early indicators of poor asthma control, and provide self-management education and play important roles in the promotion of asthma control. In order to improve the quality of nursing practice in adult asthma control, Registered Nurses＇ Association of Ontario(RNAO) in Canada published the guidelines of Adult Asthma Care: Promoting Control of Asthma (Second Version) in 2017 after summarizing the latest evidence in order to provide systematic guidance. This articles analyzed the suggestions in the nursing practice guidelines and introduce the suggestions from all sections including nursing assessment, planning, implementation and evaluation in nursing practice.

Objective: To show development status of postprandial hypotension studies comprehensively and intuitively in order to provide a reference for nursing research on postprandial hypotension. Methods: The data was from the literatures included in Web of Science database from 1986 to 2019 related to postprandial hypotension, and CiteSpace information visualization software was used to analyze the issuing country and institution, cited authors, Cited journals, keywords and cited references to postprandial hypotension. Results: A total of 1 140 literatures were obtained. 187 papers were finally included after screening. University of Adelaide in Australia has the most of published articles and the most of cited authors; The cited journals mainly include international high-impact journals such as Annals of Internal Medicine and Journal of the American Geriatrics Society. Through keywords clustering, a total of 5 research hotspots were obtained, including falls, insulin, autonomic nervous system, aged cared, gastrointestinal. Conclusions Postprandial hypotension is one of the convergence points of interdisciplinary fusion. At present, preliminary results have been obtained, but the research on its mechanism is still in the exploratory stage. Falls, insulin, autonomic nervous system, aged cared, gastrointestinal are currently the main focus of postprandial hypotension researches. The prevention of postprandial hypotension has made some achievements, but there are also some risks. It is necessary to conduct further studies on more convenient and safe measures to prevent postprandial hypotension.

Objective To explore the mediating effect of coping styles on the relationship between social support and self-management among young patients with newly-diagnosed type 2 diabetes(T2DM).Methods A total of 169 young patients with newly-diagnosed T2DM at China-Japan Friendship Hospital were investigated with the Medical Coping Mmodes Questionnaire,Social Support Rating Scale and the Summary of Diabetes Self-Care Activities.Results Among young patients with newly-diagnosed T2DM,there was a positive correlation between social support and confronce coping style(r =0.250,P＜0.01).The confronce coping style was positively correlated with self-management(r=0.367,P＜0.01).Confronce coping style could explain 15.3%variance of self-management(P＜0.01).Confronce coping style had a mediating effect on the relationship between social support and self-management.Conclusions Confronce coping style has a predictive role on self-management among young patients with newly-diagnosed T2DM,and confronce coping style has a mediating effect between social support and self-management.