This case study summarizes the nursing experience of a patient with right forearm damage who underwent total shape combined replantation reconstruction after heterotopic limb salvage.Key nursing points included:preoperative assessment of the patient's injury and emergency treatment,formulation of a personalized surgical plan in collaboration with multiple departments,and complete preoperative preparation.Postoperatively,implement phased individualized nursing care postoperatively,strengthen monitoring and prevention of vascular emergencies,control and treat wound infections,implement multidimensional pain management strategies,provide comprehensive psychological care,and conduct stepwise functional rehabilitation training.After 2 stages of surgery and 112 days of treatment and nursing care,the patient's right forearm showed good functional recovery,and the patient was discharged successfully.

Objective To explore the serial mediating roles of physical functional impairment and cognitive function between chronic comorbidity and depression in older adults.Methods Based on 5773 older adults with at least one chronic disease from the 2020 China Health and Retirement Longitudinal Survey as study subjects,Spearman correlation analysis was used to explore the correlation between chronic comorbidities,physical functional impairment,cognitive function,and depression in older adults,and serial mediating effects were analyzed using the model 6 in Process 3.3 of SPSS.Results 4465 older adults(77.34%)had chronic comorbidities,and the direct effect of chronic comorbidities on depression in older adults was significant,with an effect size of 1.737(95%CI:1.373-2.101),the separate mediating effect of physical functional impairment was significant,with an effect size of 0.535(95%CI:0.432-0.642);the separate mediating effect of cognitive function was not significant,with an effect size of-0.037(95%CI:-0.086 to 0.011);the serial mediating effect of physical functional impairment and cognitive function was significant,with an effect size of 0.027(95%CI:0.018 to 0.037).Conclusion Chronic comorbidity promotes the development of depression in older adults and indirectly influences the development of depression through physical functional impairment and poorer cognitive function.Therefore,in order to avoid the onset or exacerbation of depression in older adults with chronic diseases,it is important to enhance the ability of this group to care for themselves in daily life as well as to promote the recovery of cognitive function,especially in older adults with chronic comorbidities.

Objective To explore the serial mediating roles of physical functional impairment and cognitive function between chronic comorbidity and depression in older adults.Methods Based on 5773 older adults with at least one chronic disease from the 2020 China Health and Retirement Longitudinal Survey as study subjects,Spearman correlation analysis was used to explore the correlation between chronic comorbidities,physical functional impairment,cognitive function,and depression in older adults,and serial mediating effects were analyzed using the model 6 in Process 3.3 of SPSS.Results 4465 older adults(77.34%)had chronic comorbidities,and the direct effect of chronic comorbidities on depression in older adults was significant,with an effect size of 1.737(95%CI:1.373-2.101),the separate mediating effect of physical functional impairment was significant,with an effect size of 0.535(95%CI:0.432-0.642);the separate mediating effect of cognitive function was not significant,with an effect size of-0.037(95%CI:-0.086 to 0.011);the serial mediating effect of physical functional impairment and cognitive function was significant,with an effect size of 0.027(95%CI:0.018 to 0.037).Conclusion Chronic comorbidity promotes the development of depression in older adults and indirectly influences the development of depression through physical functional impairment and poorer cognitive function.Therefore,in order to avoid the onset or exacerbation of depression in older adults with chronic diseases,it is important to enhance the ability of this group to care for themselves in daily life as well as to promote the recovery of cognitive function,especially in older adults with chronic comorbidities.

This case study summarizes the nursing experience of a patient with right forearm damage who underwent total shape combined replantation reconstruction after heterotopic limb salvage.Key nursing points included:preoperative assessment of the patient's injury and emergency treatment,formulation of a personalized surgical plan in collaboration with multiple departments,and complete preoperative preparation.Postoperatively,implement phased individualized nursing care postoperatively,strengthen monitoring and prevention of vascular emergencies,control and treat wound infections,implement multidimensional pain management strategies,provide comprehensive psychological care,and conduct stepwise functional rehabilitation training.After 2 stages of surgery and 112 days of treatment and nursing care,the patient's right forearm showed good functional recovery,and the patient was discharged successfully.

Serine/arginine-rich splicing factor 7 (SRSF7), a known splicing factor, has been revealed to play oncogenic roles in multiple cancers. However, the mechanisms underlying its oncogenic roles have not been well addressed. Here, based on N⁶-methyladenosine (m⁶A) co-methylation network analysis across diverse cell lines, we find that the gene expression of SRSF7 is positively correlated with glioblastoma (GBM) cell-specific m⁶A methylation. We then indicate that SRSF7 is a novel m⁶A regulator, which specifically facilitates the m⁶A methylation near its binding sites on the mRNAs involved in cell proliferation and migration, through recruiting the methyltransferase complex. Moreover, SRSF7 promotes the proliferation and migration of GBM cells largely dependent on the presence of the m⁶A methyltransferase. The two m⁶A sites on the mRNA for PDZ-binding kinase (PBK) are regulated by SRSF7 and partially mediate the effects of SRSF7 in GBM cells through recognition by insulin-like growth factor 2 mRNA-binding protein 2 (IGF2BP2). Together, our discovery reveals a novel role of SRSF7 in regulating m⁶A and validates the presence and functional importance of temporal- and spatial-specific regulation of m⁶A mediated by RNA-binding proteins (RBPs).
Humans ; Cell Line, Tumor ; Cell Proliferation ; Gene Expression Regulation, Neoplastic ; Glioblastoma/genetics* ; Methyltransferases/metabolism* ; RNA Splicing Factors/metabolism* ; RNA, Messenger/genetics* ; RNA-Binding Proteins/metabolism* ; Serine-Arginine Splicing Factors/metabolism* ; RNA Methylation/genetics*

Objective:To construct the concept and its conceptual framework of hospital health literacy(HHL) for exploring the HHL promotion mechanism in the country.Methods:Based on the proceduralised grounded theory, twelve middle or senior managers of hospitals were selected for in-depth interviews and three hospitals were selected for field research from July 2021 to February 2022. Open coding, axial coding, and selective coding were used in data analysis, establishing the concept of HHL and its conceptual framework in China.Results:The conceptual framework of HHL was composed of an internal driver mechanism(hospitals improve their health literacy promotion management system, staff-led health literacy promotion, health literacy promoting physical environment construction), and an external driver mechanism(cooperate with external organizations and institutions to conduct health literacy promotion). The concept of HHL in China was derived as follows: the combination of supportive environments and human resources that health care organizations have in place can improve access and understandability of health information and simplify healthcare services to help patients of different health literacy levels more easily obtain, process, and understand health information as well as to make the most of medical services.Conclusions:Hospital health literacy promotion mechanism in China is a synergy between internal and external driver mechanisms.

Objective To compare the therapeutic effects between three-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiotherapy (IMRT) in patients with stage Ⅱ/Ⅲ esophageal cancer and investigate the prognostic factors.Methods Medical record of 2 132 patients with stage Ⅱ/Ⅲ esophageal cancer who underwent definitive radiotherapy with/without chemotherapy in 10 hospitals from January 2002 to December 2016 from were retrospectively analyzed.Among these patients,37.9％ of them were aged ≥ 70 years,33.9％ with neck and upper esophageal tumors and 66.1％ with middle and lower esophageal and borderline tumors.The median gross tumor volume (GTV) and lymph node gross tumor volume (GTVnd) was 41.6 cm3.Among them,32％ were stage Ⅱ] and 68％ were stage Ⅲ.A total of 723 patients received 3DCRT and 1 409 cases received IMRT.Patients received an equivalent dose in 2 Gy (EQD2) ≥ 60 Gy accounted for 86.1％,and 41.1％ of them received concurrent chemoradiotherapy.Results The median follow-up time was 60.8 months.The 1-,3-and 5-year overall survival (OS) of all patients was 73.9％,41.7％ and 32.6％,and the 1-,3-and 5-year progression-free survival (PFS) was 62.2％,37.3％ and 32％,respectively.Multivariate analysis demonstrated that age,primary tumor location,clinical stage,tumor target volume,EQD2 and concurrent chemoradiotherapy were the independent prognostic factors for OS.Age,primary tumor location,clinical stage,tumor target volume and EQD2 were the independent prognostic factors for PFS.The OS and PFS did not significantly differ among the low-risk,low-/moderate-risk,moderate-/high-risk and high-risk groups according to age≥70 years,tumor diameter＞5 cm,tumor volume ≥41.6 cm3 and stage Ⅲ (P＜0.001).After the propensity score matching (PSM) method,neither 3DCRT nor IMRT yielded significant advantages in OS or PFS (P=0.971;P=0.658).However,IMRT tended to yield survival benefits in low-risk patients (P=0.125).Conclusions Both 3DCRT and IMRT yield relatively high OS rate in patients with stage Ⅱ/Ⅲ esophageal cancer.The prognosis model established in this investigation can properly predict the survival of patients.Low-risk patients tend to obtain survival benefits from IMRT.

Objectives To analyze the distribution and drug resistance of pathogenic bacteria in neonatal department,and to provide criteria for rational clinical use of antibiotics. Methods Totally 15,796 specimens ob-tained from neonates were cultured according to the operation specification. The isolated pure strains were identified and their drug susceptibility was tested by VITEK-2 automated microorganism identification system. Results A to-tal of 1,125 strains of bacteria were isolated and the total detection rate was 7.1%. Of the total,742(66.0%)were gram-negative bacteria ,355(31.6%)gram-positive bacteria and 28(2.4%)fungi. K pneumonia was the most fre-quently isolated pathogen in gram-negative bacteria ,and staphylococcus the most frequently isolated pathogen in gram-positive bacteria. G-bacteria were highly resistant to ampicillin ,1st and 2nd generation cephalosporin. The re-sistant rates of K pneumonia,P aeruginosa and A baumannii to imipenem were>24.0%.Among the staphylococ-cus,35.7%were MRSA and 73.3%MRSCN. The antibiotic sensitivities of staphylococcusto vancomycin,Rina thia-zole alkanes and Tigecycline were 100.0%,but those to penicillin,cephalosporin and erythromycin low. Conclu-sion The dominant bacteria isolated from specimens obtained from neonates are gram-negativebacteria ,and they present extensive antibiotic resistance.

Objective To analyze iodine nutrition and its correlation with thyroid function in pregnant women.Methods A total of 295 pregnant women were enrolled from Jun.to Oct.2016,and detected for serum levels of thyroid stimulating hormone(TSH),free thyroxine(FT4) and thyroid-peroxidase antibody(TPOAb) by using electrochemiluminescence analysis,and for urinary iodine concentration(UIC) by cold digestion method according to iodine catalytic effect of arsenic-cerium.Results The median of UIC was 174.90 μg/L.The prevalence of iodine deficiency and iodine excess were 40.00% and 7.12% respectively.The prevalence of TPOAb positivity and thyroid dysfunction in the iodine deficiency group and iodine excess group were significantly higher than those of iodine proper group(P<0.05).The levels of TSH and FT4 of iodine excess group were significantly higher than those of iodine proper group(P<0.05).Conclusion The abnormality of iodine nutrition could be common in pregnant women.Monitoring of UIC and thyroid hormones should be highlighted.

Objective To describe the clinical characteristics and outcomes of dengue virus infection during pregnancy . Methods A retrospective study was performed based on the clinical data of manifestations ,pregnancy outcomes and neonates in patients with dengue virus infection during pregnancy from January 1st ,2014 to December 31th ,2014 at maternity ward in Guangzhou .Results The most common manifestations in patients with dengue virus infection during pregnancy were fever (100 .0％ ) , body soreness (42 .9％ ) ,headache (41 .3％ ) ,cutaneous rash (41 .3％ ) ,fatigue (34 .9％ ) and muscle pain or arthralgia (17 .5％ ) , nausea and vomiting (12 .7％ ) . The decline proportions of leukocyte , platelet and neutrophil count were 17 .5％ ,20 .6％ and 6 .3％ ,respectively ,and the lowest point was observed on 5 — 6 days after the onset of illness .Miscarriage was observed in 3 pregnant patients (4 .8％ , all in the first trimester ) ,intra-uterine death in one patient (1 .6％ ,at 22 weeks of gestation) and artificial abortion in 2 cases .A total of 48 patients delivered ,among whom caesarean section rate was 37 .5％ , prematurity rate was 12 .5％ and low birth weight rate was 8 .2％ .Maternal – foetal vertical transmission happened in 2 cases .Sequence alignment demonstrated that the homologies of the nucleic acids and amino acids within each dengue virus vertical transmission mother-infant pairs were > 99 .9％ .Conclusions The manifestations of dengue virus infected women with pregnancy are not specific .Early detection and early diagnosis should be made according to the history of epidemiology for women with reproductive age in endemic areas .Maternal dengue virus infection during pregnancy might cause vertical transmission and is correlated with bad outcomes of pregnancy , including miscarriage , intra-uterine death and premature birth .Perinatal infection might cause maternal-foetal vertical transmission .