We took the surface spike S protein of transmissible gastroenteritis virus(TGEV)as the research object.Based on the Gram-positive enhancer matrix(GEM)-anchor protein(PA)display platform,two kinds of bacteria-like particles(BLPs)with surface-displayed TGEV DA and S1 were prepared using the insect cell-baculovirus expression system.The results showed that the lev-els of IL-4,IFN-γ,IgG,IgA,and sIgA induced by 50 μg BLP-DA were higher than those of the 25μg group.The levels of IL-4,IFN-γ,and sIgA induced by 50 μg BLP-S1 were higher than those of the 25 μg group,while the levels of IgG and IgA were lower than those of the 25 μg group.Under the same dose,when the dose was 25 μg,the levels of IFN-γ,IgG,IgA,and sIgA induced by BLP-S1 were higher than those of BLP-DA,while the level of IL-4 was lower than that of BLP-DA.When the dose was 50 μg,the level of IgG induced by BLP-DA was higher than that of BLP-S1,while the other indicators were lower than those of BLP-S1.Under different immunization routes,the levels of IgA and sIgA in the gavage group were higher than those in the intramuscular injec-tion group,and the levels of some cytokines were significantly higher in the gavage group than in the intramuscular injection group at specific time points,but there was no significant difference in the levels of IgG antibodies.In conclusion,the two types of TGEV BLPs constructed in this study both have good immunogenicity and can induce cellular and humoral immunity in mice.When the immunization doses are the same,the immunogenicity of BLP-S1 is better than that of BLP-DA.

Objective:To construct a nursing norm for extracorporeal membrane oxygenation in adults, so as to provide a reference for improving the nursing care of adult extracorporeal membrane oxygenation.Methods:The first draft was developed through literature search and expert discussion. From September to October 2023, 16 experts were selected using the Delphi method to conduct two rounds of expert consultation on the first draft, and the final draft was revised with reference to the experts' comments. The expert positivity coefficient was expressed as the effective recovery rate of the questionnaire, and the degree of expert authority was evaluated with the authority coefficient, and the degree of harmonization of expert opinions was assessed with the Kendall's harmony coefficient.Results:Literature search screened a total of four guidelines and five expert consensus. In the two rounds of consultation, the effective recovery rates of the questionnaires were all 100% (16/16), and the expert authority coefficients were all 0.900, and the Kendall's harmony coefficients of the overall indicators were 0.581 and 0.666, respectively (both P<0.01). The final constructed nursing norm for extracorporeal membrane oxygenation in adults included five primary indicators, 27 secondary indicators, and 17 tertiary indicators. Conclusions:The constructed nursing norm for extracorporeal membrane oxygenation in adults is scientific, reliable and feasible, and can guide clinical nursing staff to carry out nursing care for extracorporeal membrane oxygenation.

Objective:To optimize the anticoagulation monitoring process for extracorporeal membrane oxygenation (ECMO) patients by constructing an informatization module and evaluate its application effect.Methods:An informatization team was established, and based on literature review, an anticoagulation monitoring information sheet for ECMO patients was developed. Using a data-sharing architecture, existing hospital information management system, laboratory information management system, picture archiving and communication system, and ICU monitoring system were integrated to construct an ECMO anticoagulation monitoring informatization module with data sharing, real-time alerts, and information support functions. Clinical applications were observed for effect. A convenience sampling method was employed to select 60 ECMO patients treated in the ICU of the Affiliated Hospital of Qingdao University from October 2022 to September 2023. The patients admitted from October 2022 to March 2023 were designated as the control group ( n=30), using the conventional anticoagulation monitoring method; those admitted from April to September 2023 were designated as the experimental group ( n=30), using the anticoagulation monitoring informatization module. The anticoagulation monitoring timeliness rate, anticoagulant drug adjustment timeliness rate, and the incidence rates of thrombosis and bleeding were compared between the two groups. Results:The timeliness rate of anticoagulation monitoring and the timeliness rate of anticoagulant drug adjustment in the experimental group were (93.38±6.31) % and (91.90±4.71) %, respectively, which were higher than those in the control group (83.01±9.94) % and (83.49±12.83) %, with statistically significant differences (both P<0.01). The incidence rates of thrombosis and bleeding in the experimental group were 16.67% (5/30) and 26.67% (8/30), respectively, which were lower than those in the control group 40.00% (12/30) and 53.33% (16/30), with statistically significant differences (both P<0.05) . Conclusions:The optimized anticoagulation monitoring informatization process based on the anticoagulation monitoring informatization module demonstrates a good clinical application effect and can reduce the incidence of bleeding and thrombosis in ECMO patients.

We took the surface spike S protein of transmissible gastroenteritis virus(TGEV)as the research object.Based on the Gram-positive enhancer matrix(GEM)-anchor protein(PA)display platform,two kinds of bacteria-like particles(BLPs)with surface-displayed TGEV DA and S1 were prepared using the insect cell-baculovirus expression system.The results showed that the lev-els of IL-4,IFN-γ,IgG,IgA,and sIgA induced by 50 μg BLP-DA were higher than those of the 25μg group.The levels of IL-4,IFN-γ,and sIgA induced by 50 μg BLP-S1 were higher than those of the 25 μg group,while the levels of IgG and IgA were lower than those of the 25 μg group.Under the same dose,when the dose was 25 μg,the levels of IFN-γ,IgG,IgA,and sIgA induced by BLP-S1 were higher than those of BLP-DA,while the level of IL-4 was lower than that of BLP-DA.When the dose was 50 μg,the level of IgG induced by BLP-DA was higher than that of BLP-S1,while the other indicators were lower than those of BLP-S1.Under different immunization routes,the levels of IgA and sIgA in the gavage group were higher than those in the intramuscular injec-tion group,and the levels of some cytokines were significantly higher in the gavage group than in the intramuscular injection group at specific time points,but there was no significant difference in the levels of IgG antibodies.In conclusion,the two types of TGEV BLPs constructed in this study both have good immunogenicity and can induce cellular and humoral immunity in mice.When the immunization doses are the same,the immunogenicity of BLP-S1 is better than that of BLP-DA.

Objective:To construct a nursing norm for extracorporeal membrane oxygenation in adults, so as to provide a reference for improving the nursing care of adult extracorporeal membrane oxygenation.Methods:The first draft was developed through literature search and expert discussion. From September to October 2023, 16 experts were selected using the Delphi method to conduct two rounds of expert consultation on the first draft, and the final draft was revised with reference to the experts' comments. The expert positivity coefficient was expressed as the effective recovery rate of the questionnaire, and the degree of expert authority was evaluated with the authority coefficient, and the degree of harmonization of expert opinions was assessed with the Kendall's harmony coefficient.Results:Literature search screened a total of four guidelines and five expert consensus. In the two rounds of consultation, the effective recovery rates of the questionnaires were all 100% (16/16), and the expert authority coefficients were all 0.900, and the Kendall's harmony coefficients of the overall indicators were 0.581 and 0.666, respectively (both P<0.01). The final constructed nursing norm for extracorporeal membrane oxygenation in adults included five primary indicators, 27 secondary indicators, and 17 tertiary indicators. Conclusions:The constructed nursing norm for extracorporeal membrane oxygenation in adults is scientific, reliable and feasible, and can guide clinical nursing staff to carry out nursing care for extracorporeal membrane oxygenation.

Objective:To optimize the anticoagulation monitoring process for extracorporeal membrane oxygenation (ECMO) patients by constructing an informatization module and evaluate its application effect.Methods:An informatization team was established, and based on literature review, an anticoagulation monitoring information sheet for ECMO patients was developed. Using a data-sharing architecture, existing hospital information management system, laboratory information management system, picture archiving and communication system, and ICU monitoring system were integrated to construct an ECMO anticoagulation monitoring informatization module with data sharing, real-time alerts, and information support functions. Clinical applications were observed for effect. A convenience sampling method was employed to select 60 ECMO patients treated in the ICU of the Affiliated Hospital of Qingdao University from October 2022 to September 2023. The patients admitted from October 2022 to March 2023 were designated as the control group ( n=30), using the conventional anticoagulation monitoring method; those admitted from April to September 2023 were designated as the experimental group ( n=30), using the anticoagulation monitoring informatization module. The anticoagulation monitoring timeliness rate, anticoagulant drug adjustment timeliness rate, and the incidence rates of thrombosis and bleeding were compared between the two groups. Results:The timeliness rate of anticoagulation monitoring and the timeliness rate of anticoagulant drug adjustment in the experimental group were (93.38±6.31) % and (91.90±4.71) %, respectively, which were higher than those in the control group (83.01±9.94) % and (83.49±12.83) %, with statistically significant differences (both P<0.01). The incidence rates of thrombosis and bleeding in the experimental group were 16.67% (5/30) and 26.67% (8/30), respectively, which were lower than those in the control group 40.00% (12/30) and 53.33% (16/30), with statistically significant differences (both P<0.05) . Conclusions:The optimized anticoagulation monitoring informatization process based on the anticoagulation monitoring informatization module demonstrates a good clinical application effect and can reduce the incidence of bleeding and thrombosis in ECMO patients.

Acute skin failure is a common condition of skin damage in critically ill patients, which seriously affects the prognosis of patients. This article summarizes the evaluation indicators, techniques, and comparison of evaluation indicators and techniques for acute skin failure, in order to provide references for the development of acute skin failure evaluation tools and the formulation of nursing measures.

Infectious bronchitis in chickens is a serious threat to the global poultry industry.Despite the availability of commercial vaccines,the epidemic has not been effectively controlled.Therefore,the development of novel vaccines may provide new ways to prevent and control this disease.In this study,BLP-S1,a bacterium-like particle displaying the S1 subunit of infectious bronchitis virus on its surface,was constructed using the GEM-PA system.The immunoprotection results showed that BLP-S1 effectively induced the production of specific IgG and sIgA in commercial chickens and provided effective protection against a heterologous strain with a protection rate of up to 90％.This study demonstrated that BLP-S1 has good immunogenicity and immunoprotection,with the poten-tial to develop a novel vaccine against infectious bronchitis.

Objective:To evaluate and summarize the best evidence for early rehabilitation of adults with veno-venous extracorporeal membrane oxygenation (VV-ECMO).Methods:Evidence on early rehabilitation of adult VV-ECMO patients was searched by computer from 7 English literature databases [PubMed database, cumulative index to nursing and allied health literature (CINAHL), Embase database, Cochrane library database, UpToDate clinical consultant, BMJ best clinical practice, JBI database], 5 Chinese literature databases (China biomedical literature database, China Yimai Tong, China national knowledge infrastructure, Wanfang data, VIP database), 5 guideline networks [National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), China Guide Network] and 2 professional association websites [Extracorporeal Life Support Organization (ELSO), Chinese Association of Rehabilitation Medicine]. The search period is from January 2011 to December 2021. The appraisal of guidelines for research and evaluation Ⅱ (AGREE ) and JBI 2014 quality assessment tools were used to evaluate the quality of inclusion guidelines, systematic reviews, expert consensus and original studies, respectively, and to extract and summarize the best evidence for early rehabilitation of adults with VV-ECMO.Results:A total of 2 guidelines, 2 expert consensuses, 2 systematic reviews and 8 original studies [including 1 randomized controlled trial (RCT), 1 non-randomized controlled study, 3 cohort studies and 3 case reports] were included. The evidence was summarized from 9 aspects including the necessity of early rehabilitation, rehabilitation initiation time, rehabilitation location, pre-rehabilitation preparation, pre-rehabilitation assessment, rehabilitation method, rehabilitation frequency and duration, rehabilitation process monitoring and effect evaluation,and finally 24 pieces of the best evidence were summarized.Conclusion:Early rehabilitation of adults with VV-ECMO is safe and feasible. The summary of the best evidence can provide evidence-based guidance for clinical medical staff to reasonably carry out early rehabilitation.

Objective To explore the key initiatives and effective methods for preparing the constructions of emergency-oriented hospitals under COVID-19 pandemic. Methods The wartime mechanism was strengthened by adhering to unified leadership, trengthening the top-level design and clarifying the division of responsibilities. Objective management was used as a means to take into account the key of personnel allocation and training, prevention and control of hospital infection, transformation of contagious ward, logistic support, equipment and material supply and construction of system and process. Results The preparations and constructions of the emergency-oriented hospitals were completed in 72 hours，which passed the acceptance and inspections from infection control experts，who appraised our work to be “the highest in difficulty, the fastest in project progress and the highest in quality". Totally, upon to the preparations，14 medical teams were set up and the layout process reestablishment of 14 wards was completed, the installation and preparation of nearly 10000 sets/pieces of medical equipment and medical materials were completed as well and more than 80 work systems and process systems for 9 major modules were established. Conclusion The preparations and constructions of emergency-oriented hospitals should be performed upon the thorough implementation of the decisions and arrangements by the municipal Party committee and the municipal government, insisting on the wartime thinking and establishment of high-quality management team and effective goal management focusing on details and actual needs of medical staff.