Objective To explore the application effect of enteral nutrition-related diarrhea in postoperative esophageal cancer patients.Methods Based on literature search and expert meeting,a management process for enteral nutrition-associated diarrhea in postoperative esophageal cancer patients was constructed.A convenience sampling method was used to select a total of 68 patients with enteral nutrition-related diarrhea after esophageal cancer surgery admitted to the thoracic surgery department of a tertiary A cancer hospital in Jiangsu Province.Among them,patients admitted from January 2022 to December 2022 were set as an experimental group.The experimental group was implemented the management process for enteral nutrition-associated diarrhea in postoperative esophageal cancer patients.Those admitted from January 2021 to December 2021 were set as a control group with routine nursing.Then,the time of stopping diarrhea,the King's of Stool Chart(KSC-Tr)diarrhea score,and abnormal incidence of nutrition-related indexes,electrolytes abnormalities(low sodium,low potassium,and low calcium)were compared between 2 groups.Results The time of stopping diarrhea,KSC diarrhea score after 3 days of intervention and the time to achieve target feeding volume of the experimental group were lower than those in the control group,and the difference was statistically significant(P＜0.05).There were no significant differences in hemoglobin,albumin,prealbumin after 3 days of intervention,the incidence of electrolyte abnormalities(low sodium,low potassium,and low calcium)after 3 days of intervention,and the BMI index after 7 days of intervention between 2 groups(P＞0.05).Conclusion The management process for enteral nutrition-associated diarrhea in postoperative esophageal cancer patients can reduce the time of diarrhea,improve the severity of diarrhea,and shorten the time to achieve the target feeding,but has no significant change in the incidence of electrolyte abnormalities.

Objective:To investigate the relationship between the in vivo metabolic ratio (MR) of Aripiprazole (ARI) and CYP2D6 gene polymorphism in children with tic disorders (TD) and its effect on dose-exposure (DE), so as to promote precision drug use. Methods:In this study, a real-world observational study design was used to collect 81 children with TD who visited the Department of Neurology of Wuhan Children′s Hospital from January 2021 to January 2024, the concentration of the prototype drug and the main metabolite Dehydroaripiprazole (DARI), the detection data of CYP2D6 single nucleotide gene polymorphism (SNP) and clinical data were collected, and the relationship between the DARI/ARI metabolic ratio (MR) and CYP2D6 metabolic type was analyzed by the receiver operating characteristic (ROC) curve.A DE model between ARI dose and steady-state trough concentration was established by population modeling, and the effects of CYP2D6 metabolic type, MR and body weight on DE were analyzed.Goodness-of-fit diagram (GOF), visual predictive check (VPC) and prediction error analysis were used to verify the prediction performance of the DE model.Results:ROC analysis showed that there was a correlation between MR and CYP2D6 metabolic type, the MR sensitivity cut-point of CYP2D6 ultrafast metabolic (UM) patients was 0.399, and the cut-point of MR in intermediate metabolic (IM) patients was 0.252.Based on this, the patients were divided into three categories: MR TYPE Ⅰ: MR≥0.399, MR TYPE Ⅱ: 0.252

Objective:To analyze the status and influencing factors of empathy fatigue in hospice nurses based on ABC-X model (A: stressor event; B:resources available to a family; C: family sperceptions of the stressor; X: likelihood of crisis), so as to provide a reliable basis for developing comprehensive intervention strategies.Methods:A total of 325 nurses engaged in hospice care in China from April 2022 to June 2022 were selected by convenient sampling method. The influencing factors of empathy fatigue of hospice care nurses were analyzed by ABC-X model (working environment, resilience and coping style). The hospice care nurses were investigated by self-made general questionnaire, Chinese version of Empathy Fatigue Scale, Simplified Coping Style Questionnaire, Coping Style Resilience Scale and Nursing Work Environment Scale. The statistical analysis was performed by SPSS.26.0 statistical software.Results:There were 316 females and 9 males with age of (33.0 ± 7.9) years old. The total score of empathy fatigue in 325 hospice nurses was (91.16 ± 9.60) points, the scores of empathy satisfaction, ocupational burnout and secondary traumatic stress were (31.35 ± 6.01), (28.43 ± 5.86), (31.38 ± 5.76) points respectively. The scores of positive coping style, negative coping style, psychological resilience and nursing working environment were (37.46 ± 5.69), (21.28 ± 6.90), (89.84 ± 16.46), (117.13 ± 19.95) points respectively. The negative predictive factor for empathy satisfaction among nurses with the professional title of palliative care ( t=-4.22, P<0.05), and the positive predictive factors for simple coping strategies, psychological resilience, and nursing work environment ( t=4.52, 3.05, 9.03, all P<0.05), could explain 56.7% of the total variation. Psychological resilience, simplified coping strategies, nursing work environment were negative predictive factors for occupational burnout among hospice nurses ( t=-6.93, -3.54, -2.51, all P<0.05), while work nature was a positive predictive factor ( t=2.36, P<0.05), which could explain 49.4% of the total variation. Simplified coping strategies, psychological resilience, and nursing work environment were all negative predictors of secondary traumatic stress in hospice nurses ( t=-5.40, -3.25, -5.95, all P<0.05), which could explain 48.8% of the total variation. Conclusions:Based on the ABC-X model, it is found that the empathic fatigue of hospice nurses is mainly affected by the nursing work environment, mental resilience and coping styles. It is necessary for nursing managers to actively take measures to improve the working environment and coping styles of nurses, enhance their mental resilience and reduce their empathic fatigue.

Objective To investigate the effects of dulaglutide combined with insulin glargine on glucose and lipid metabolism, pancreatic islet function, oxidative stress and bone metabolism indicators in patients with type 2 diabetes mellitus. Methods A total of 98 patients with type 2 diabetes mellitus were randomly divided into insulin glargine group and combined group, with 49 cases in each group. The insulin glargine group was treated with insulin glargine and metformin, while the combined group was treated with dulaglutide, insulin glargine and metformin. The levels of blood glucose, blood lipids and pancreatic islet function were compared between the two groups before and after treatment; enzyme immunoassay analyzer was used to detect the levels of oxidative stress indicators; immunoturbidimetry was used to detect bone metabolism indicators; the urinary microalbumin to creatinine ratio (UACR) was calculated in both groups, and the therapeutic effect was compared between the two groups. Results After treatment, the levels of fasting plasma glucose (FPG), 2-hour postprandial glucose (2 hPG) and glycated hemoglobin (HbA1c) in the combined group were significantly lower than those in the insulin glargine group (P<0.05). After treatment, the levels of total cholesterol (TC), triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) in the combined group were significantly lower than those in the insulin glargine group, while the level of high-density lipoprotein (HDL) was significantly higher than that in the insulin glargine group (P<0.05). After treatment, the homeostatic model assessment of insulin secretion (HOMA-IS) in the combined group was significantly higher than that in the insulin glargine group, while the homeostatic model assessment of insulin resistance (HOMA-IR) was significantly lower than that in the insulin glargine group (P<0.05). After treatment, the levels of catalase (CAT) and osteocalcin (OC) in the combined group were significantly higher than those in the insulin glargine group, while the levels of lipid peroxide (LPO) and β-collagen degradation products (β-CTX) were significantly lower than those in the insulin glargine group (P<0.05). After treatment, the UACR in the combined group was (33.26±3.37) mg/g, which was significantly higher than (25.49±2.83) mg/g in the insulin glargine group (P<0.05). The total effective rate in the combined group was 93.88%, which was significantly higher than 79.59% in the insulin glargine group (P<0.05). Conclusion Dulaglutide combined with insulin glargine can effectively regulate the blood glucose and lipid levels of patients with type 2 diabetes, improve the function of pancreatic islets, alleviate the oxidative stress reaction, improve bone metabolism, and regulate the UACR level.

Objective:To study the effect of Compound Duzhong Jiangu Granules on joint function, quality of life and inflammatory factors in patients with Kashin-Beck disease.Methods:By group design, 135 patients with Kashin-Beck disease in Chongxin County, Pingliang City, Gansu Province, were selected and divided into intervention group (100 cases treated with Compound Duzhong Jiangu Granules, 12 g/bag, 1 bag/time, 3 times/day, treatment for 1 month) and control group (35 cases treated with ibuprofen, 0.3 g/capsule, 1 capsule/time, 2 times/day, treatment for 2 weeks) according to the randomized, single-blind principle. The changes of joint dysfunction index score, joint function improvement rate, total scores of Kashin-Beck disease quality of life (KBDQOL) and scores of each dimension were analyzed before treatment, 1 month and 3 months after treatment. The serum levels of interleukin-6 (IL-6), nuclear factor κB (NFκB)-p65, inducible nitric oxide synthase (NOS2), nitric oxide (NO), and prostaglandin E2 (PGE2) were detected by enzyme-linked immunosorbent assay before treatment and 1 month after treatment.Results:The total scores of joint dysfunction index of the intervention group and the control group 1 month after treatment and 3 months after treatment were lower than those before treatment, but 3 months after treatment was higher than 1 month after treatment ( P < 0.001). One month after treatment, the total effective rates of joint function improvement in the intervention group and the control group were 68.00% (68/100) and 54.55% (18/33), respectively; 3 months after treatment, the total effective rates of the intervention group and the control group were 36.00% (36/100) and 39.39%(13/33), respectively. The total scores and scores of each dimension of KBDQOL were not significant for the main effect of the group ( P > 0.05), but significant for the main effect at the time point ( P < 0.05), and there was no interactive effect ( P > 0.05). There were significant differences in the scores of social support and mental status dimensions in the intervention group at different time points ( P < 0.001). And in the intervention group, the total score, the scores of physical function, activity limitation, economy and overall health dimensions were statistically significant between before treatment and 1 month after treatment, 1 month after treatment and 3 months after treatment( P < 0.05); however, there was no significant difference between before treatment and 3 months after treatment ( P > 0.05). One month after treatment, the serum PGE2 levels of both groups were decreased ( P < 0.05), and there was no difference in other inflammatory factors at different groups and time points ( P > 0.05). Conclusion:Compound Duzhong Jiangu Granules can effectively inhibit the inflammatory reaction of patients with Kashin-Beck disease, promote the improvement of joint function and improve the quality of life in various aspects.

Objective:To explore the correlation between lateral violence, leadership empowering, psychological capital and work alienation among nurses in Oncology Department.Methods:From July to September 2022, a survey was conducted on 327 nurses of Oncology Department in Jiangsu Province using the Nurse Lateral Violence Scale, Chinese version of Empowering Leadership Scale, Chinese version of Psychological Capital Questionnaire and Nurse Work Alienation Questionnaire. The PROCESS program was used to analyze the moderated mediation model.Results:The lateral violence of nurses in Oncology Department had a positive predictive effect on work alienation, and the difference was statistically significant (β=0.339, P<0.01) . Leadership empowering had a partial mediating effect on the correlation between lateral violence and work alienation with a statistical difference, the effect value was 0.071, accounting for 20.94% of the total effect. Psychological capital had a moderating effect on the second half of the mediating effect of leadership empowering, and the difference was statistically significant (β=-0.360, P<0.01) , and the impact of lateral violence on work alienation increased with the increase of psychological capital level. Conclusions:The lateral violence among nurses in Oncology Department can affect work alienation through leadership empowering. The mediating model of psychological capital regulating the correlation between leadership empowering and work alienation is established.

Objective:To develop the Sexual Health Education Needs Assessment Scale for Breast Cancer Patients and test its reliability and validity.Methods:Guided by Maslow's hierarchy of needs theory and knowledge, belief, and practice theory, an initial scale was formed through literature review, semi-structured interviews and Delphi expert consultation. Through cognitive interviews with 9 patients, the scale was further revised and improved to form a clinical trial version. From December 2021 to September 2022, 397 breast cancer patients from 9 ClassⅢ hospitals in 6 provinces, municipalities and autonomous regions were selected by convenience sampling to conduct a questionnaire survey, test the reliability and validity of the scale and grade it.Results:The Sexual Health Education Needs Assessment Scale for Breast Cancer Patients included four dimensions and 32 items in total. Exploratory factor analysis extracted a total of four common factors, with a cumulative variance contribution rate of 72.258%. The content validity index of the scale was 0.865, and the content validity index of each item was 0.929 to 1.000. The correlation coefficients between each dimension of the scale and the total scale were 0.789 to 0.956, and the correlation coefficients between dimensions were 0.635 to 0.863. The Cronbach's α coefficient of the total scale was 0.979, and the Cronbach's α coefficients of each dimension were 0.897 to 0.969. The half reliability of the total scale was 0.941, and the half reliability of each dimension was 0.851 to 0.946. The total score of the scale was 32 to 160, with 32 to 77 being at a low level, 78 to 117 being at a medium level, and 118 to 160 being at a high level.Conclusions:The developed Sexual Health Education Needs Assessment Scale for Breast Cancer Patients has good reliability and validity, and is suitable for breast cancer patients' sexual health education needs assessment.

Objective To explore the effect of seamless nursing mode under Six Sigma management on nosocomial infection,nursing quality,and overall rehabilitation of premature infants.Methods A total of 92 premature infants born in affiliated matemal and child health care hospital of nantong university from March 2019 to March 2022 were enrolled.According to the length of hospital stay,they were assigned to the control group or the study group,with 46 cases in each group.The control group was given routine nursing management,and the research group was given seamless nursing under Six Sigma management on the basis of routine nursing.The incidence of complications related to nosocomial infection,nursing quality,and neuropsychological development were compared between the two groups one month later.The weight and height of premature infants at 3 months,6 months,and 12 months after discharge were compared between the two groups.Results Before nursing,there were no significant differences in nursing quality,neuropsychological development,weight,or height between the two groups(P>0.05).After nursing,the total incidence of intestinal infection,septicemia,and other infections in the study group was significantly lower than that in the control group(P<0.05).The scores of ward management,basic nursing operation,nursing document record,nursing service attitude,risk management,and communication ability in the study group were significantly higher than those in the control group(P<0.05).The scores of gross and fine movements in the study group were significantly higher than those in the control group(P<0.05).The body weight and height of the study group were significantly higher than those of the control group at 3 months,6 months,and 12 months after discharge(P<0.05).Conclusion The seamless nursing under Six Sigma management is helpful to reduce the incidence of nosocomial infection-related complications of premature infants,improve the quality of nursing,promote neuropsychological development of premature infants,and increase their weight and height.

Relying only on the ethics committee to protect subjects is not enough, and the construction of the subject protection system is an inevitable trend for the protection of subjects’ rights. This paper elaborated on the current situation of Chinese subject protection system from four aspects: the lack of laws and regulations and administrative supervision, the insufficient attention of hospitals, poor construction of the subject protection system, and the absence of responsibilities of relevant personnel. Then this paper put forward countermeasures from three aspects: improving laws and regulations and strengthening supervision, mobilizing relevant departments to participate, and strengthening relevant training, in order to standardize the construction of the subject protection system and promote the development of the subject protection work.

Objective:To test whether the constructed intervention model of advance care planning (ACP) for patients with advanced cancer can be successfully implemented and the preliminary intervention effect, which provides reference for empirical research.Methods:32 cases of advanced cancer patients and 25 cases of their families at the Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai were selected. The patients were subdivided into the experimental group and the control group by random number table method. The control group received routine nursing, while the experimental group adopted the intervention model of "VIP for future care" on the basis of customary nursing. We measured the main outcome indicators: enrollment rate, consent rate, completion rate and loss of follow-up rate and secondary outcome indicators: decision-making certainty, end-of-life care preference and post-intervention satisfaction of patients and their families, within 1 week and 1 month after intervention.Results:The enrollment rate, consent rate and loss of follow-up rate were 74.6% (206/276), 36.9% (76/151)and 15.6% (5/32), respectively. After intervention, the completion rates of the experimental group and the control group were 16/16 and 15/16 within one week, and 14/16 and 13/16 within one month. All of the family members were conducted during the follow-up period. The intervention mode of "VIP for future care" had a statistically significant difference in decision-making certainty between the two groups of patients ( β=0.63, 95% CI 0.08-1.18, P<0.05), no statistically significant difference in end-of-life care preference between the two groups of patients and their families ( P>0.05), and had a statistically significant difference in "whether to recommend this project to others" between the two groups ( χ2 value was 4.167 , P<0.05). Conclusions:On the premise of sufficient preparation, the "VIP for future care" intervention mode can be successfully implemented in advanced cancer patients in mainland China, can improve the decision-making certainty of patients and the satisfaction of patients and their families, and it is recommended. And should be applied to ACP intervention for patients with advanced cancer.