Objective:To explore the relevant factors affecting the accuracy of scanning glucose monitoring (FGM) technology in critically ill patients.Methods:A total of 53 patients who were admitted to the Intensive Care Unit (ICU) of the Second Affiliated Hospital of Soochow University and used FGM glucose monitoring from September 2022 to December 2023 were selected by means of a convenience sampling method. The paired data of arterial blood glucose and FGM glucose were analysed. The accuracy of FGM blood glucose measurement in critically ill patients was evaluated using Bland-Altman analysis. The blood glucose data were divided into two groups: the FGM monitoring accuracy group and the FGM monitoring non-accuracy group.. The t-test and χ2 test were used for the comparison of one-way analysis of arterial versus FGM accuracy among critically ill patients with different demographic characteristics. Logistic regression analysis was used to analyze the factors influencing the accuracy of FGM. Results:The results of Bland-Altman analysis of the 53 patients indicated that the mean bias value of FGM blood glucose was elevated at 1.215 mmol/L in comparison with arterial-blood gas analysis blood glucose values. An incidence of exceeding the upper and lower limits of the range was observed, amounting to 6.349%. The discrepancy between the studies was found to be statistically significant (95% CI:1.0394~1.3908, P<0.001). The effects of the changes in height ( OR=0.877, 95% CI:0.780~0.987, P=0.029), changes in leukocyte counts( OR=0.917, 95% CI:0.868~0.969, P=0.002), changes in C-reactive protein( OR=1.009, 95% CI:1.002~1.017, P=0.016), changes in albumin counts( OR=0.986, 95% CI:0.974~0.999, P=0.031), and whether or not sepsis ( OR=3.937, 95% CI:1.192~13.008, P=0.025) on the accuracy of FGM had a statistically significant. Conclusion:The mean bias value of the accuracy of FGM was relatively higher compared with that of arterial blood gas analysis blood glucose values, and the influencing factors involved height, white blood cells, C-reactive protein, albumin, and whether or not sepsis was present. With the development of science and technology, applying the FGM system to critically ill patients has an absolute advantage in determining the overall glycemic trend, and the application value of FGM technology deserves further study.

This report detailed a case of intrauterine intervention for fetal left-sided congenital cystic adenomatoid malformation with intralobar pulmonary sequestration. The mother had no significant medical history. Ultrasound at 22 gestational weeks showed a giant cystic-solid thoracic mass [32 mm×46 mm×61 mm; congenital pulmonary airway malformation volume ratio (CVR) 2.57], and the diagnosis was congenital cystic adenomatoid malformation complicated by intralobar pulmonary sequestration. After disease progression despite one course of antenatal corticosteroids (55 mm×47 mm×56 mm; CVR 3.33), ultrasound-guided percutaneous intrauterine laser ablation was performed at 24 +6 weeks to precisely coagulate the lesion's dominant feeding artery (confirmed by Doppler). Postoperatively, the mass showed progressive regression with normalized hemodynamic parameters. The infant was delivered vaginally at 37 weeks of gestation. The infant underwent resection of residual left lower lung lesions at five months of age, with normal cardiopulmonary function and developmental milestones confirmed at 15-month follow-up.

This report detailed a case of intrauterine intervention for fetal left-sided congenital cystic adenomatoid malformation with intralobar pulmonary sequestration. The mother had no significant medical history. Ultrasound at 22 gestational weeks showed a giant cystic-solid thoracic mass [32 mm×46 mm×61 mm; congenital pulmonary airway malformation volume ratio (CVR) 2.57], and the diagnosis was congenital cystic adenomatoid malformation complicated by intralobar pulmonary sequestration. After disease progression despite one course of antenatal corticosteroids (55 mm×47 mm×56 mm; CVR 3.33), ultrasound-guided percutaneous intrauterine laser ablation was performed at 24 +6 weeks to precisely coagulate the lesion's dominant feeding artery (confirmed by Doppler). Postoperatively, the mass showed progressive regression with normalized hemodynamic parameters. The infant was delivered vaginally at 37 weeks of gestation. The infant underwent resection of residual left lower lung lesions at five months of age, with normal cardiopulmonary function and developmental milestones confirmed at 15-month follow-up.

Objective:To explore the dosimetry difference between intensity-modulated radiotherapy (IMRT) and volumetric intensity modulated arc therapy (VMAT) based on the inner edge tangent field (IETF) after left-sided breast conserving surgery.Methods:The localization CT and target organ at risk (OAR) data of 35 patients with left-sided breast cancer treated with IMRT after breast conserving surgery at Department of Radiotherapy in Yunnan Cancer Hospital from June 2022 to June 2023 were selected. The IETF-IMRT and the IETF-VMAT plans were designed for the same patient based on IETF, the dosimetry differences of target areas and OAR, as well as the planned execution time were compared between the two groups.Results:Dosimetry of target areas: for IETF-IMRT and IETF-VMAT, the D 98% of the planning target volume were (47.92±0.51) and (48.21±0.33) Gy, respectively, while the D 50% were (52.04±0.22) and (51.91±0.26) Gy, respectively, and the D 2% were (53.93±0.36) and (53.62±0.41) Gy, respectively, the conformity index were 0.84±0.03 and 0.87±0.02, respectively, while the homogeneity index were 0.12±0.01 and 0.10±0.01, respectively, with statistically significant differences ( t=-3.87, P<0.001; t=3.53, P=0.001; t=5.30, P<0.001; t=-13.60, P<0.001; t=6.24, P<0.001). Dosimetry of OAR: for IETF-IMRT and IETF-VMAT, the left lung V 5 were (31.91±6.28) % and (33.99±6.31) %, respectively, and the V 20 were (11.71±2.06) % and (9.73±2.12) %, respectively, with statistically significant differences ( t=-4.18, P<0.001; t=12.40, P<0.001). The right lung V 5 were (0.11±0.08) % and (7.13±3.12) %, respectively, and the D mean were (1.05±0.12) and (2.71±0.27) Gy, respectively, with statistically significant differences ( t=-33.62, P<0.001; t=-13.30, P<0.001). The spinal cord D 2% were (1.08±0.11) and (4.83±1.40) Gy, respectively, with a statistically significant difference ( t=-15.99, P<0.001). The left lung D mean were (7.45±1.08) and (7.37±1.03) Gy, the heart D mean were (4.21±0.96) and (4.41±0.48) Gy, and the right-sided breast D mean were (3.74±1.52) and (3.48±1.11) Gy, respectively, with no statistically significant difference ( t=1.16, P=0.253; t=-1.76, P=0.088; t=1.41, P=0.169). Planned execution time: the execution time of IETF-IMRT and IETF-VMAT was (10.73±1.21) and (2.18±0.17) min, respectively, with a statistically significant difference ( t=44.71, P<0.001) . Conclusion:Both IETF-IMRT and IETF-VMAT can meet clinical requirements, however the two techniques have their own characteristics. IETF-VMAT has better conformity and homogeneity of target region. The planned OAR dosimetry in both plans are significantly lower than the dose limit of postoperative radiotherapy for breast cancer, among which the left lung V 5, the right lung V 5, D mean and spinal cord D 2% of IETF-IMRT are slightly lower, the left lung V 20 of IETF-VMAT is slightly lower. IETF-VMAT significantly reduces the planned execution time compared with IETF-IMRT, thus can greatly reduce the dose deviation caused by patient position change, and significantly improve patients experience and comfort of radiotherapy. Taken together, IETF-VMAT has advantages over IETF-IMRT in radiotherapy after breast conserving surgery of left-sided breast cancer.

As one of the important factors to realize the rational allocation of resources and the establishment of interpersonal network, the concept and theory of social capital have been developing continuously in the global health service system, which has attracted the attention of nursing managers at home and abroad. This paper introduces the theory of social capital and its development in the field of nursing, summarizes the measurement tools of social capital of medical staff, analyzes and summarizes the application of social capital theory in nurse leadership, nursing risk management, nursing talent team construction, nurse job satisfaction, nurse retention intention and other aspects and points out the shortcomings and development trends of the current research in this field. It is suggested to construct and develop the theoretical framework and measurement tools of social capital suitable for China's nursing industry, increase the research on the application effect of social capital theory in human resource management, risk management and quality management in nursing management and provide effective management methods for nursing managers, so as to provide reference for improving the level of nurses' social capital and improving the quality of nursing service.

Objective:To explore the dosimetry difference between volumetric modulated arc therapy (VMAT) and tomo direct (TD) in tumor bed simultaneous push radiotherapy after left breast-conserving surgery, and to provide more dosimetry reference for clinic.Methods:A total of 22 patients with left breast cancer who underwent simultaneous quantitative radiotherapy after breast-conserving surgery were selected from the Department of Radiation Oncology, Yunnan Cancer Hospital from December 2018 to June 2020. The localized CT images and target organs at risk and other structural data were collected. Two radiotherapy plans, VMAT and TD, were designed for the same patient, and the dosimetry differences of target areas and organs at risk were compared and analyzed between the two groups.Results:In terms of target dosimetry, there were statistically significant differences in the D 2% [ (59.99±0.19) Gy vs. (59.55±0.51) Gy, t=4.09, P<0.001], D 98% [ (57.19±0.08) Gy vs. (57.46±0.22) Gy, t=-5.10, P<0.001], conformal index (CI) (0.76±0.05 vs. 0.58±0.13, t=8.19, P<0.001) and homogeneity index (HI) (0.05±0.00 vs. 0.04±0.01, t=4.89, P<0.001) of the planning gross tumor volume (PGTV) between VMAT and TD plans. However, there was no statistically significant difference in the D 50% [ (58.73±0.10) Gy vs. (58.73±0.24) Gy, t=-0.03, P=0.974]. There were statistically significant differences in the D 50% [ (52.21±0.33) Gy vs. (53.00±0.72) Gy, t=-4.81, P<0.001], D 98% [ (48.44±0.43) Gy vs. (49.09±0.21) Gy, t=-6.80, P<0.001], CI (0.83±0.06 vs. 0.67±0.06, t=10.52, P<0.001) and HI (0.20±0.01 vs. 0.19±0.01, t=8.75, P<0.001) of the planned target volume (PTV) between the two plans. However, there was no statistically significant difference in the D 2% [ (59.01±0.45) Gy vs. (59.00±0.48) Gy, t=0.22, P=0.830]. In terms of organs at risk, there were statistically significant differences in the V 20 [ (18.81±2.86) % vs. (22.03±1.91) %, t=-5.36, P<0.001] and D mean [ (11.66±1.32) Gy vs. (12.85±1.46) Gy, t=-4.10, P=0.007] of left lung, V 5 [ (5.70±2.90) % vs. (0.30±0.13) %, t=16.44, P<0.001] and D mean [ (2.45±0.29) Gy vs. (0.43±0.14) Gy, t=9.09, P<0.001] of right lung, D mean [ (3.22±0.72) Gy vs. (1.69±0.80) Gy, t=5.41, P<0.001] of right breast, D 2% [ (5.37±1.97) Gy vs. (0.46±0.09) Gy, t=11.75, P<0.001] of cord between VMAT and TD plans. There were no significant differences in the V 5 of left lung [ (53.00±5.99) % vs. (50.00±7.69) %, t=1.91, P=0.061], V 5 of right breast [ (11.51±4.60) % vs. (8.06±3.49) %, t=1.59, P=0.120], V 30 [ (1.49±0.69) % vs. (1.51±0.71) %, t=-0.06, P=0.952] and D mean [ (3.99±0.97) Gy vs. (3.90±1.03) Gy, t=0.56, P=0.581] of heart between the two plans. Conclusion:TD and VMAT can meet the clinical dosimetry requirements for patients with left breast cancer after breast-conserving surgery. However, the two techniques have their own characteristics. VMAT has better conformity and TD has better uniformity. TD is significantly better than VMAT in protecting the right lung, right breast and spinal cord of healthy organs at risk. VMAT is better in protecting the left lung. Both VMAT and TD basically achieve the same protection for heart.

Coronavirus disease 2019 has attracted worldwide attention. Different populations have different levels of risk perception in the face of public health emergencies, and risk perception is related to reported preventive health behaviors. This article reviews relevant theories and assessment tools of risk perception of public health emergencies and influencing factors of risk perception of public health emergencies among different populations, in order to provide theoretical basis for the formulation of relevant measures and provide reference for improving the prevention and control behavior of individuals.

Objective:To explore the effects of different approaches for second-trimester multifetal pregnancy reduction on pregnancy outcome in women with dichorionic triamniotic (DCTA) triplet.Methods:A retrospective study was performed on 51 women with DCTA triplet pregnancies who were referred to Guangdong Women and Children Hospital for second-trimester multifetal pregnancy reduction from January 2014 to January 2020. All participants were divided into either preventive group ( n=39) or treatment group ( n=12) according to the indication for multifetal pregnancy reduction, and they were further allocated to three subgroups based on different reduction methods, which were reduction to dichorionic twin by radiofrequency ablation (RFA) (RFA subgroup), reduction to monochorionic singleton (KCl-singleton subgroup) or monochorionic twin (KCl-twin subgroup) by cardiac injection of potassium chloride. Pregnancy loss rate, neonatal birth weight, gestational age at delivery, incidence of intrauterine death, and neonatal death were compared and analyzed between different groups using t-test, analysis of variance, Chi-square test, Fisher's exact test and Bonferroni correction. Results:(1) The mean gestational week at operation in the treatment group was significantly later than that in the preventive group [(18.5±3.1) vs (15.0±2.3) weeks, t=-4.209, P<0.001]. In the preventive group, the mean gestational week at operation in the RFA subgroup was later than the KCl-singleton and KCl-twin subgroup[(17.2±1.6) vs (13.8±1.5) and (12.7±1.0) weeks, t=6.630 and 3.875, respectively, both P<0.05]. (2) The postoperative pregnancy loss rate in the preventive group was decreased compared with the treatment group [10.3%(4/39) vs 5/12, Fisher's exact test, P<0.05], and the live birth ratio was increased [ 85.7%(48/56) vs 10/18, χ2=5.640, P=0.018]. No live birth infants with birth weight <1 500 g was reported in the KCl-singleton subgroup in preventive group, and the statistical significance was observed in the intra-group differences ( P<0.05) rather than the pairwise comparison differences in the preventive group. For the proportion of live births, there was a statistically significant difference in the intra-group comparison in the treatment group, which was higher in the RFA subgroup than that in the KCl-twin subgroup (6/6 vs 1/6, P=0.045). No significant difference was revealed among pregnancy loss rate, gestational weeks at delivery, the mean birth weight, premature delivery <32 gestational weeks, and full-term birth rate among three different approaches within the two groups. (3) No monochorionic twin complications or perinatal death occurred in any RFA or KCl-singleton subgroups in the two groups. In the KCl-twin subgroups including five cases with ten fetuses, including three live birth, four miscarriage, three intrauterine death occured, while no neonatal death was reported. One case with selective fetal uterine growth restriction in the preventive group delivered two live births, and one case with twin-to-twin transfusion syndrome in the treatment group had intrauterine death in one fetus and one survival neonate. Conclusions:The pregnancy outcome of multifetal pregnancy reduction to dichorionic diamniotic twins by RFA or reduction to singleton by cardiac injection of potassium chloride are comparative in women with DCTA triplet, regardless of whether it is a preventive or therapeutic reduction.

Objective To observe the effects of two different gauze folding patterns used in local hemostasis after peripherally inserted central catheters (PICC).Methods A total of 152 patients were selected and divided into two groups according to PICC date sequence as control group of 72 patients using 2.0 cm× 2.0 cm little gauze to oppress the puncture point and observation group of 80 patients using 1.0 cm× 1.5 cm gauze ball made by ourselves to oppress the puncture point.The oozing of the puncture point was observed in patients of the two groups.Results The hemostasis was better in the observation group than in the control group (x2=15.88,P＜0.01).No limb swelling happened to the patients in the observation group (x2=58.064,P＜0.01).There was statistically significant difference in hemostatic effect between the two groups.Conclusion The sterile gauze ball made by ourselves has a good effect on local hemostasis through oppressing the puncture point without any impact on blood circulation of limbs.

OBJECTIVEThis study will explore whether reactive oxygen species (ROS) is involved in TGF-β1-induced JNK activation, pulmonary fibroblast proliferation and collagen type I and III synthesis.

METHODSPulmonary fibroblasts were randomly divided into control (0.4% serum) and TGF-β1 (5 µg/L) groups to detect whether TGF-β1 could induce pulmonary fibroblast proliferation, synthesis of collagen I and III, phosphorylated-JNK (p-JNK) and 8-OHdG (indicator of ROS); while in the part to explore whether NAC (N-acetyl-L-cysteine, antioxidants) has the inhibitory role in TGF-β1-induced pulmonary fibroblast, it did control (0.4% serum), H2O2 (0.1 mmol/L, positive control), H2O2+NAC (10 mmol/L), TGF-β1 (5 µg/L), TGF-β1+NAC groups. Pulmonary fibroblast proliferation, 8-OHdG levels, expressions of JNK and collagen I and III were used by MTT assay, immunofluorescence and western blot respectively.

RESULTSIn the experiments to detect the effect of TGF-β1 on pulmonary fibroblasts, compared with control, TGF-β1 significantly stimulated pulmonary fibroblast proliferation and increased collagen I and III protein, p-JNK and 8-OHdG levels. In the next experiments to explore whether NAC has the inhibitory role in TGF-β1-induced pulmonary fibroblasts, compared with control, pulmonary fibroblast proliferation and the levels of collagen I and II, p-JNK, 8-OHdG were all significantly increased in H2O2 and TGF-β1 groups; while these changes were markedly blocked with the treatment of NAC.

CONCLUSIONTGF-β1 induces pulmonary fibroblasts to generate ROS, which contributes to JNK activation and pulmonary fibroblast proliferation as well as collagen synthesis, while ROS inhibition suppresses this effet of TGF-β1 in pulmonary fibroblasts.

Acetylcysteine ; Cell Proliferation ; Collagen ; biosynthesis ; Collagen Type I ; Fibroblasts ; cytology ; Hydrogen Peroxide ; Lung ; cytology ; MAP Kinase Signaling System ; Phosphorylation ; Reactive Oxygen Species ; metabolism ; Transforming Growth Factor beta ; metabolism ; Transforming Growth Factor beta1 ; metabolism