With the extensive application of low-dose ionizing radiation (LDIR) in medicine, aerospace, and other fields, the potential for exposure among the general population and occupationally exposed workers has increased, raising growing public health concerns regarding its possible effects on cognitive function. Current occupational and environmental radiation protection frameworks are primarily established based on cancer risk estimates derived from epidemiological evidence under high-dose exposure and extrapolation across dose ranges, whereas evidence regarding non-cancer outcomes, including potential cognitive effects of LDIR, remains limited and inconsistent, and the underlying neurobiological mechanisms have not been fully elucidated. This review summarized recent advances in research on the effects of LDIR on cognitive function and the associated neural mechanisms. Existing evidence indicates that LDIR may adversely affect cognitive domains including spatial memory and object recognition memory under certain exposure conditions, with potential mechanisms involving alterations in synaptic plasticity, microglia activation, neurodevelopmental processes, epigenetic regulation, and DNA damage and repair pathways. In contrast, studies using pathological models, including stroke and neurodegenerative diseases, have reported potential protective effects of LDIR, which may be mediated by attenuation of oxidative stress, neuroinflammation and activation of endogenous repair pathways. This indicates that LDIR has both damaging and protective effects on brain function; a deeper understanding of its patterns and mechanisms can provide a scientific basis for establishing occupational and environmental radiation protection standards. Furthermore, re-examining the LDIR risk assessment system may also offer new insights into exploring the therapeutic potential of LDIR for brain diseases.

Case managers, as a type of advanced practice nurses, can not only fully meet patient needs and improve patient outcomes, but also innovate nurses′ workplaces and provide nurses with new directions for career development. This article provides an overview of the origin and development of case managers at home and abroad, their practice models, role responsibilities, current training status, current certification status, and current application status, and puts forward suggestions such as the development of practice standards for case managers, and the establishment of a standardized training system and certification body, with a view to providing references for the development of case managers in China.

Objective To retrieve the anticoagulation management related evidences in postoperative patients with heart valve operation to provide an evidence-based basis for medical professionals conducting the antithrombotic therapy in postoperative patients with heart valve operation.Methods The related evidences of anticoagulation management after heart valve surgery were retrieved from major databases and websites at home and abroad based on the"6S"evidence resource pyramid modeling system.The retrieval time was from January 1,2017 to February 29,2024.Two researchers trained by evidence-based care evaluated the quality of the literatures and extracted the relevant evidences meeting the criteria by combining with clinical situation.Results A total of 12 literatures were included,including 5 guidelines,4 clinical practices and 3 expert consen-sus.Thirty pieces of best evidences were summarized in eight aspects:contraindications,postoperative an-tithrombotic regimens,warfarin use method,vitamin K use precautions,daily life precautions,anticoagulation complications,long term perioperative anticoagulation bridging and complicating pregnancy.Conclusion The evidences summarized in this study could provide a reference for standardizing anticoagulation management in postoperative pa-tients with heart valve operation and for clinical healthcare workers in order to standardize the anticoagulation therapy after heart valve replacement and reduce the occurrence of anticoagulation-related complications.

Objective:To search, evaluate, and summarize the best evidence of built-in fecal incontinence management device, to inform the management of incontinence dermatitis by clinical healthcare professionals.Methods:BMJ Best Practice, UpToDate, Guideline International Network, Joanna Briggs Institute, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses′Association of Ontario, The Cochrane Library, Medline, Embase, SinoMed, CINAHL, PubMed, Web of Science, OVID, China National Knowledge Infrastructure, Wanfang Database were systematically searched for all evidence regarding the application of fecal collection devices. It included clinical practice, guidelines, systematic reviews, expert consensuses, evidence summaries, and randomized controlled trial. Two researchers independently evaluated the literature quality and extracted the literature that met the standards.Results:A total of 12 pieces of the literature were involved, including 2 best practice, 5 guidelines, 3 expert consensuses, and 2 systematic reviews. This study summarized 26 pieces of best evidence in relation to the following 5 themes: indications and contraindications, device insertion, device maintenance, device removal and effectiveness evaluation.Conclusions:This study scientifically and systematically summarized the best evidence regarding the insertion and maintenance of built-in fecal incontinence management device. We recommend that clinical practitioners integrate this evidence into their practice, while considering individual patient preferences and medical contexts. Adhering to individualization for evidence translation improves standardization and benefits patients in the clinical use of fecal collection devices.

Objective:To search, evaluate, and summarize the best evidence of built-in fecal incontinence management device, to inform the management of incontinence dermatitis by clinical healthcare professionals.Methods:BMJ Best Practice, UpToDate, Guideline International Network, Joanna Briggs Institute, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses′Association of Ontario, The Cochrane Library, Medline, Embase, SinoMed, CINAHL, PubMed, Web of Science, OVID, China National Knowledge Infrastructure, Wanfang Database were systematically searched for all evidence regarding the application of fecal collection devices. It included clinical practice, guidelines, systematic reviews, expert consensuses, evidence summaries, and randomized controlled trial. Two researchers independently evaluated the literature quality and extracted the literature that met the standards.Results:A total of 12 pieces of the literature were involved, including 2 best practice, 5 guidelines, 3 expert consensuses, and 2 systematic reviews. This study summarized 26 pieces of best evidence in relation to the following 5 themes: indications and contraindications, device insertion, device maintenance, device removal and effectiveness evaluation.Conclusions:This study scientifically and systematically summarized the best evidence regarding the insertion and maintenance of built-in fecal incontinence management device. We recommend that clinical practitioners integrate this evidence into their practice, while considering individual patient preferences and medical contexts. Adhering to individualization for evidence translation improves standardization and benefits patients in the clinical use of fecal collection devices.

Case managers, as a type of advanced practice nurses, can not only fully meet patient needs and improve patient outcomes, but also innovate nurses′ workplaces and provide nurses with new directions for career development. This article provides an overview of the origin and development of case managers at home and abroad, their practice models, role responsibilities, current training status, current certification status, and current application status, and puts forward suggestions such as the development of practice standards for case managers, and the establishment of a standardized training system and certification body, with a view to providing references for the development of case managers in China.

With the rapid advancement and wide application of microwave technology, it enhances convenience while potentially endangering health. The immune system, as a vital shield, is an important protective barrier and also one of the sensitive targets of microwave radiation. The immune system is particularly affected by microwave radiation via innate and adaptive immune responses, which is supported by both population surveys and experimental studies; however, the precise mechanism of immunotoxicity of microwave radiation remains under investigation. In light of recent scientific advances in the correlation between microwave radiation and the immune system, the deleterious impact of microwave radiation on innate immunity was delineated. Microwave radiation can induce irregular innate immune function by damaging macrophages, neutrophils, natural killer cells, and dendritic cells. The effects of microwave radiation on adaptive immunity were also elucidated. Microwave radiation can impair cellular immune response by influencing T cell proliferation, maturation and activation, and distribution of T cell subpopulation, and also hinder humoral immune function by influencing B lymphocyte protein expression, maturation during development, and number of B cells. Disparity in the immune function of the body can precipitate the onset of various immune-associated diseases, so the immunotoxic effects of microwave radiation and associated protection need considerable attention and detailed investigation. This article reviewed the shortcomings of existing studies, and suggested that future experimental studies should use experimental parameters that are more similar to the actual scene of life and work, pay more attention to the biological effects of combined multi-frequency microwave exposure on the immune system, use standardized and unified experimental methods, and incorporate more sophisticated experimental technologies to further elucidate the laws of damage effect and exact mechanism of microwave radiation on the immune system, so as to provide a scientific basis for potent protection against the damage effect of microwave radiation on the immune system.

Microwave technology has been widely applied in various fields such as military affairs, communication, transportation, medical treatment, and industrial and agricultural production. Nevertheless, such technology poses potential threats to human health while bringing convenience to production and life. Previous studies have shown that the reproductive system is one of the most sensitive targets to microwave radiation, and its microwave damage effect and treatment have garnered wide concern. This paper reviews the recent domestic and foreign studies on the impacts of microwave radiation on reproductive health and its treatment, especially the damage effects, mechanisms, and treatment method, from the aspects of epidemiological investigations and animal experiments. The purpose is to provide suggestions and references for future research on the effects of microwave radiation on reproductive damage and its treatment.

The central nervous system is one of the most sensitive targets of microwave radiation. Microwave radiation can affect spatial learning and memory and neural information transmission. The effects of microwave radiation on neurotransmitters in the hippocampus and the underlying mechanisms are still unclear. This paper reviews the effects of microwave radiation on learning/memory and neurotransmitters as well as the mechanisms of action on neurotransmitters. This paper aims to provide a scientific basis for future research in this area.

OBJECTIVE: To investigate the implementation and application effect of 1-hour bundle in the treatment of patients with sepsis. METHODS: A convenient sampling method was conducted. 102 patients with sepsis admitted to central intensive care unit (ICU) of Henan Provincial People's Hospital from January 2018 to February 2019 were enrolled. Thirty-five patients with 3-hour and 6-hour bundle from January to September in 2018 were served as the control group, and 67 patients who received 1-hour bundle from October 2018 to February 2019 were served as the observation group. The patients in the control group was treated with 3-hour and 6-hour bundle according to 2012 international guidelines for the diagnosis and treatment of severe sepsis and septic shock; and those in the observation group were treated and nursed according to the 1-hour bundle published by Surviving Sepsis Campaign (SSC) update 2018, and the sepsis cluster treatment medical team was established. The team members were trained in relevant knowledge and discussed the possible obstacles within the team and propose feasible measures. The implementation of the 1-hour bundle in the observation group was recorded. The general data of the patients in both groups including gender, age, acute physiology and chronic health evaluation II (APACHE II), etc. were collected, and the outcome indicators (duration of mechanical ventilation, length of ICU stay, 28-day mortality) were observed. RESULTS: In the observation group, 37 of 67 patients receiving 1-hour bundle met the target, with the overall achievement rate of 55.2% (37/67). Of the 37 eligible patients, 5 patients receiving 1-hour bundle met the target before the training of 1-hour bundle, accounting for only 33.3% (5/15) of the 15 patients who received 1-hour bundle during the same period. With the extension of training time, the achievement rate of sepsis 1-hour bundle was gradually increased [the achievement rate at 1 week and 4 weeks of training was 40.0% (4/10) and 52.4% (11/21), respectively], and increased to 81.0% (17/21) at the end of 12 weeks training. Thirty-seven patients who received 1-hour bundle and met the criteria were enrolled and compared with the control group. There was no significant difference in gender, age, or APACHE II score between the two groups. Compared with the control group, the duration of mechanical ventilation and length of ICU stay of the observation group were significantly shortened (days: 6.15±0.49 vs. 7.24±0.53, days: 8.21±1.49 vs. 9.51±1.92), and the 28-day mortality was decreased significantly [10.8% (4/37) vs. 31.4% (11/35)], with statistically significant differences (all P < 0.05). CONCLUSIONS Through teamwork, discussion and improvement, the achievement rate of sepsis 1-hour bundle can be significantly improved. The use of sepsis 1-hour bundle can effectively decrease the duration of mechanical ventilation and length of ICU stay, and reduce the 28-day mortality.
APACHE ; Humans ; Intensive Care Units ; Prognosis ; Sepsis/therapy* ; Shock, Septic