Objective To explore the application effect of the"safe harbor"humanistic care program in mechanically ventilated patients.Methods A quasi experimental study design method was used to select 106 mechanically ventilated patients admitted to the department of intensive care unit(ICU)of the First Affiliated Hospital of Nanchang University from December 2024 to February 2025 as the study subjects.They were randomly divided into a control group and an experimental group,with 53 patients in each group.The control group adopted a conventional nursing mode(pain relief and sedation management,daily awakening,active and passive limb activities,respiratory function exercise,nutritional and psychological support,etc.),while the experimental group implemented a"safe harbor"humanistic care mode plan based on conventional nursing(structured visit management,therapeutic environment creation,professional nursing process optimization,and multidimensional safety guarantee system,including 6 dimensions and 16 measures,mainly including:family support system reconstruction,progressive activity training,structured visit management,therapeutic environment creation,professional nursing process optimization,and multidimensional safety guarantee system).The difference in the incidence of anxiety and depression,ICU-acquired weakness(ICU-AW),ICU delirium and mechanical ventilation time,ICU hospitalization time,Barthel index scores were compared between the two groups.Results Ultimately,97 patients completed the study,with 52 in the control group and 45 in the experimental group.The incidence of anxiety and depression,ICU-AW,delirium in the experimental group was significantly reduced compared to the control group[anxiety and depression incidence:26.67%(12/45)vs.46.15%(24/52),ICU-AW incidence:13.33%(6/45)vs.40.38%(21/52),delirium incidence:17.78%(8/45)vs.42.31%(22/52),all P<0.05],the ICU hospitalization time and mechanical ventilation time in the experimental group were significantly shortened compared to the control group[ICU hospitalization time(days):9(8,10)vs.10(9,11),mechanical ventilation time(hours):67.0(60.5,78.5)vs.85.0(63.0,75.0),both P<0.05].The Barthel index score significantly increased[66.0(56.0,75.5)vs.58.0(48.5,69.5),P<0.05].Conclusion The"safe harbor"humanistic care model can improve the physical and mental outcomes of mechanically ventilated patients and has clinical promotion value.

Objective To explore the application effect of the"safe harbor"humanistic care program in mechanically ventilated patients.Methods A quasi experimental study design method was used to select 106 mechanically ventilated patients admitted to the department of intensive care unit(ICU)of the First Affiliated Hospital of Nanchang University from December 2024 to February 2025 as the study subjects.They were randomly divided into a control group and an experimental group,with 53 patients in each group.The control group adopted a conventional nursing mode(pain relief and sedation management,daily awakening,active and passive limb activities,respiratory function exercise,nutritional and psychological support,etc.),while the experimental group implemented a"safe harbor"humanistic care mode plan based on conventional nursing(structured visit management,therapeutic environment creation,professional nursing process optimization,and multidimensional safety guarantee system,including 6 dimensions and 16 measures,mainly including:family support system reconstruction,progressive activity training,structured visit management,therapeutic environment creation,professional nursing process optimization,and multidimensional safety guarantee system).The difference in the incidence of anxiety and depression,ICU-acquired weakness(ICU-AW),ICU delirium and mechanical ventilation time,ICU hospitalization time,Barthel index scores were compared between the two groups.Results Ultimately,97 patients completed the study,with 52 in the control group and 45 in the experimental group.The incidence of anxiety and depression,ICU-AW,delirium in the experimental group was significantly reduced compared to the control group[anxiety and depression incidence:26.67%(12/45)vs.46.15%(24/52),ICU-AW incidence:13.33%(6/45)vs.40.38%(21/52),delirium incidence:17.78%(8/45)vs.42.31%(22/52),all P<0.05],the ICU hospitalization time and mechanical ventilation time in the experimental group were significantly shortened compared to the control group[ICU hospitalization time(days):9(8,10)vs.10(9,11),mechanical ventilation time(hours):67.0(60.5,78.5)vs.85.0(63.0,75.0),both P<0.05].The Barthel index score significantly increased[66.0(56.0,75.5)vs.58.0(48.5,69.5),P<0.05].Conclusion The"safe harbor"humanistic care model can improve the physical and mental outcomes of mechanically ventilated patients and has clinical promotion value.

Objective To investigate the relationship between serum L-carnitine and its related metabolites[trimethylamine(TMA)and trimethylamine N-oxide(TMAO)]levels and gestational diabetes mellitus(GDM)in the second trimester of pregnant women in Shanghai.Methods A case-control study was conducted in 280 pregnant women between 18 and 23 weeks of gestation from January 2018 to January 2021.Among them,134 cases of GDM were the case group(GDM),and 146 cases with normal blood glucose(BG)were the control group(Con).Serum L-carnitine,TMA and TMAO levels were quantified by ultra high performance liquid chromatography-mass spectrometry.Logistic regression analysis,stratified analysis and linear regression were used to explore the relationship between L-carnitine,TMA and TMAO levels and GDM and glucolipid metabolism.Results Serum L-carnitinelevelwas significantly lower in GDM group than that in Con group(P<0.01).After adjusting for confounders,logistic regression showed a 70%reduction in the risk of GDM in the group with highest tertile of L-carnitine compared with the group with lowest tertile(OR 0.30,95%CI 0.15～0.63).The risk of GDM decreased by 14%for each 1 μmol/L increase in serum L-carnitine(OR 0.86,95%CI 0.80～0.93).Serum L-carnitine was negatively correlated with 1 hPG(r=-0.21,P<0.01)and 2 hPG(r=-0.15,P<0.05),respectively,TMA was negatively correlated with 2 hPG(r=-0.21,P<0.01).Conclusions Higher serum L-carnitine level may be negatively associated with GDM.Serum L-carnitine and TMA levels were negatively correlated with blood glucose levels.

AIM:To analyze the Pharmaceutical Care Network Europe(PCNE)classification system used for evaluating the drug related problems(DRPs)of tacrolimus concentration fluctuations in kidney transplant recipients.METHODS:Kidney transplant recipients were selected as the study subjects,who experienced fluctuations in tacrolim-us blood concentrations and clinical pharmacist in-tervention during outpatient follow-up.PCNE(9.0)classification system was used to evaluate the DRPs of tacrolimus.And the DRP problems,causes,inter-vention plans,acceptance and status were ana-lyzed.RESULTS:A total of 700 kidney transplant re-cipients were enrolled from July 2019 to December 2021,and 1014 DRPs were found.The problems of DRPs included the occurrence of adverse drug events(P2.1,60.16％)and poor treatment out-comes(P1.2,39.84％);The main reasons included dosage selection(C3,43％),others(C9,38.4％),and drug selection(C1,9.41％);Clinical pharmacists ac-tively intervened at the recipient level(I2,98.92％)and drug level(I3,1.08％);The acceptance rate of the intervention plan(A1.1+A1.3)reached 98.62％,and the complete implementation rate(A1.1)reached 72.09％;79.29％of DPRs were fully or par-tially resolved(O1.1 and O2.1).CONCLUSION:Clini-cal pharmacists can use PCNE to evaluate tacrolim-us therapeutic drug monitoring(TDM)related DRPs,help standardize TDM pharmaceutical ser-vice models,standardize TDM abnormal result in-terpretation and intervention workflows,and pro-mote safe and rational drug utilization.

AIM:To analyze the Pharmaceutical Care Network Europe(PCNE)classification system used for evaluating the drug related problems(DRPs)of tacrolimus concentration fluctuations in kidney transplant recipients.METHODS:Kidney transplant recipients were selected as the study subjects,who experienced fluctuations in tacrolim-us blood concentrations and clinical pharmacist in-tervention during outpatient follow-up.PCNE(9.0)classification system was used to evaluate the DRPs of tacrolimus.And the DRP problems,causes,inter-vention plans,acceptance and status were ana-lyzed.RESULTS:A total of 700 kidney transplant re-cipients were enrolled from July 2019 to December 2021,and 1014 DRPs were found.The problems of DRPs included the occurrence of adverse drug events(P2.1,60.16％)and poor treatment out-comes(P1.2,39.84％);The main reasons included dosage selection(C3,43％),others(C9,38.4％),and drug selection(C1,9.41％);Clinical pharmacists ac-tively intervened at the recipient level(I2,98.92％)and drug level(I3,1.08％);The acceptance rate of the intervention plan(A1.1+A1.3)reached 98.62％,and the complete implementation rate(A1.1)reached 72.09％;79.29％of DPRs were fully or par-tially resolved(O1.1 and O2.1).CONCLUSION:Clini-cal pharmacists can use PCNE to evaluate tacrolim-us therapeutic drug monitoring(TDM)related DRPs,help standardize TDM pharmaceutical ser-vice models,standardize TDM abnormal result in-terpretation and intervention workflows,and pro-mote safe and rational drug utilization.

Objective:To investigate the application effect of the best evidence for prevention of perioperative delirium in elderly patients with hip fracture.Methods:Using the convenient sampling method, a total of 62 elderly patients with hip fractures admitted to the Trauma Department of Provincial Hospital Affiliated to Shandong First Medical University from January to August 2021 were selected as the control group, and 62 elderly patients with hip fractures admitted from September 2021 to April 2022 were selected as the observation group. At the same time, 17 nurses from the same department were selected as the research objects. According to the standard procedures and clinical conversion system application methods of the Evidence Based Clinical Evidence Practice System at the Joanna Briggs Institute in Australia, the best evidences were applied to the prevention of delirium in elderly hip fracture patients during the perioperative period. Before and after the application of evidence, the compliance rates of the review indicators, the scores of knowledge and attitude on prevention of delirium in elderly patients with hip fracture and the occurrence of delirium in patients were compared.Results:After the application of evidence, the compliance rates of review indicators were higher than those before the application, and the differences were statistically significant ( P < 0.05). The knowledge accuracy and attitude scores of delirium prevention in elderly nurses with hip fractures during perioperative period were higher than those before application, and the differences were statistically significant ( P<0.05). The number of delirium cases in the observation group was lower than that in the control group, and the duration of delirium was shorter than that in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The clinical application of the best evidence for perioperative delirium prevention in elderly hip fractures can improve nurses' awareness and attitude towards perioperative delirium prevention in elderly hip fractures, and reduce the occurrence of delirium in patients.

Objective: To study changes of peripheral blood lymphocyte calcineurin/ nuclear factor of activated T cells (CaN/NFAT) signaling pathway and calcium activated potassium channel (KCa3.1) expression in Kazak hypertensive patients with high high sensitive C reactive protein (hsCRP) level from Xinjiang, and explore the mechanism of lymphocyte potassium channel involving in inflammation of hypertension.Methods: Kazak hypertensive patients from Xinjiang, who were first diagnosed in our heart center without antihypertensive therapy from Feb 2014 to Nov 2014, were selected.According to detected hsCRP level, a total of 50 hsCRP≥3mg/L patients were enrolled as high hsCRP group, and 50 hsCRP<3mg/L patients were enrolled as normal hsCRP group.Gene and protein expression levels of KCa3.1 and tumor necrosis factor (TNF)-α, and activities of lymphocyte CaN and NFAT were measured and compared between two groups.Results: Compared with normal hsCRP group, there were significant rise in expression levels of lymphocyte KCa3.1 mRNA [(0.86±0.16) vs.(2.48±0.22)], TNF-α mRNA [(1.02±0.15) vs.(2.90±0.13)], KCa3.1 protein [(1.00±0.02) vs.(2.46±0.04)] and TNF-α protein [(1.01±0.02) vs.(2.04±0.06)], and activities of CaN [(1.04±0.15) vs.(2.83±0.08)] and NFAT [(0.96±0.06) vs.(2.65±0.07)] in high hsCRP group, P<0.01 all.Conclusion: In Kazak hypertensive patients with inflammatory reaction from Xinjiang, KCa3.1 and CaN-NFAT signaling pathway expression rises, suggesting that lymphocyte KCa3.1 may be involved in occurrence and development of hypertension via CaN/NFAT signaling pathway.

Objective To observe the contents of acid phosphatase (ACP) of Oncomelania snails infected with Schistosma japonicum.Methods Both the blood lymphocytes of positive and negative Oncomelania snails were dyed with the histochemistry staining method and their ACPs were observed under a microscope. Results The contents of ACP in the positive Oncomelania snails increased, being significantly higher than those in the negative snails. Conclusion The contents of ACP increase in Oncomelania snails infected with Schistosoma japonicum and ACP may have the defence function.