Objective:To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for hypopharyngeal hemangioma.Methods:A retrospective analysis was performed on data of patients with hypopharyngeal hemangioma who were treated with ESD at the endoscopy center of Zhongshan Hospital, Fudan University from October 2023 to February 2024. The en bloc resection rate, complete resection rate, procedure time, length of hospital stay, and incidence of adverse events were recorded.Results:A total of five patients were included, aged 28-78, four females and one male, with a median tumor long diameter of 1.5 cm (1.0-4.0 cm). All ESD procedures were successfully performed for hypopharyngeal hemangioma, and the rate of en bloc resection was 80.0% (4/5). Complete resection rate was 100.0% (5/5). The median procedure time was 35 minutes (18-60 minutes). None of them underwent prophylactic tracheotomy, and all of them were confirmed as hemangiomas by postoperative pathology. Open diet 1 day postoperatively, and the median length of hospital stay was 6 days (3-8 days). There were no serious adverse events related to ESD during or after the procedure.Conclusion:ESD can be a potential new method for the treatment of hypopharyngeal hemangioma, demonstrating satisfactory effectiveness and safety.

Objective:To revise and enlarge the specification of pharmaceutical excipient sucrose palmitate.Methods:Reference to JP2018,USP-NF 2023,EP1 1.0,Chinese Pharmacopoeia 2020 edition of the four general rules and the first supplement of sucrose stearate pharmacopoeia standards and other relevant requirements for standard research.Results:According to the quality of the product and the actual application in the formulation,the quality standards for the pharmaceutical excipient sucrose palmitate will be studied.At present,the quality standard of sucrose palmitate for pharmaceutical excipients has been disclosed.Conclusion:The established stand-ard will provide the quality guarantee for the application of sucrose palmitate in medicines.

Objective:To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for hypopharyngeal hemangioma.Methods:A retrospective analysis was performed on data of patients with hypopharyngeal hemangioma who were treated with ESD at the endoscopy center of Zhongshan Hospital, Fudan University from October 2023 to February 2024. The en bloc resection rate, complete resection rate, procedure time, length of hospital stay, and incidence of adverse events were recorded.Results:A total of five patients were included, aged 28-78, four females and one male, with a median tumor long diameter of 1.5 cm (1.0-4.0 cm). All ESD procedures were successfully performed for hypopharyngeal hemangioma, and the rate of en bloc resection was 80.0% (4/5). Complete resection rate was 100.0% (5/5). The median procedure time was 35 minutes (18-60 minutes). None of them underwent prophylactic tracheotomy, and all of them were confirmed as hemangiomas by postoperative pathology. Open diet 1 day postoperatively, and the median length of hospital stay was 6 days (3-8 days). There were no serious adverse events related to ESD during or after the procedure.Conclusion:ESD can be a potential new method for the treatment of hypopharyngeal hemangioma, demonstrating satisfactory effectiveness and safety.

Objective:To revise and enlarge the specification of pharmaceutical excipient sucrose palmitate.Methods:Reference to JP2018,USP-NF 2023,EP1 1.0,Chinese Pharmacopoeia 2020 edition of the four general rules and the first supplement of sucrose stearate pharmacopoeia standards and other relevant requirements for standard research.Results:According to the quality of the product and the actual application in the formulation,the quality standards for the pharmaceutical excipient sucrose palmitate will be studied.At present,the quality standard of sucrose palmitate for pharmaceutical excipients has been disclosed.Conclusion:The established stand-ard will provide the quality guarantee for the application of sucrose palmitate in medicines.

Malignant tumors in children are one of the most important diseases that threaten the health and quality of life of children and are the second most common cause of death in children.With the continuous improvement and progress of treatment technology, the long-term survival rate of children with tumor has been significantly improved, but both the disease itself and the treatment can impair the immune function of children, which makes them vulnerable to various infectious diseases and secondary serious complications, and even become a source of infection, endangering the health of others. Vaccination is the most cost-effective measure to prevent infectious diseases. For children with normal immune functions, the benefits of vaccination usually outweigh the disadvantages. However, there is a lack of detailed data on the vaccination situation, efficacy and safety of vaccine use for such immunocompromised tumor survivors, and there are no authoritative and uniform vaccination recommendations. This article reviewed and summarized the literature and consensus of some domestic and foreign scholars on current status of post-treatment vaccination status, efficacy and safety of vaccination for children with tumors after treatment, with the aim of providing a reference for the practice in this field in China.

Objective To comprehensively evaluate the current clinical application status of evidence regarding immunosuppressive medication compliance management in kidney transplant patients,construct review indicators,analyze the obstacles and promoting factors,and further formulate reform strategies.Methods Using the Joanna Briggs Institute evidence-based health care model as the theoretical framework,clinical nursing issues were identified,and a systematic search,evaluation,and summarization of 38 items of evidence were conducted.An evidence-based practice group was established;review indicators were constructed;review methods were clarified.Baseline reviews of systems,healthcare professionals,patients,and their families were conducted from November 1,2022,to January 31,2023.According to the review results,the obstacles and promoting factors in the process of evidence-based practice were analyzed,and corresponding strategies were formulated.Results A total of 23 review indicators were constructed.Among them,the accurate execution rate of 15 indicators was less than 60％,and the accurate execution rate of 4 indicators was 0.The main obstacles include a lack of systems and processes in departments,poor knowledge,attitude,and practice of medical staff,a lack of standardized risk assessment,and a lack of information support for out-of-hospital management.The primary promoting factors are strong organizational leadership,multidisciplinary team support,and high participation enthusiasm of recipients and their families.Corresponding reform strategies are formulated accordingly,including process and system improvement,continuous quality monitoring,enhanced standardized training and assessment,electronic health intervention for medication compliance,and involving patients and their families in the medication compliance management process.Conclusion There is a significant gap between the evidence on immunosuppressive medication compliance management in kidney transplant patients and its clinical practice.It is essential to assess the obstacles and facilitators scientifically and comprehensively in clinical situations,employ targeted reform strategies,facilitate the translation of evidence into clinical practice,and enhance the quality of nursing care.

Objective To analyze the application of a nursing outcome classification system in postoperative nursing of liver transplantation patients and its influence on the quality of clinical nursing records.Methods A total of 44 patients who underwent liver transplantation in a tertiary A general hospital in Zhejiang Province from March to August 2023 were selected by convenience sampling method.According to the North American Nursing Diagnosis Association International-Nursing Outcomes Classification linked scale of liver transplantation,nurses used the five-level classification method to score and review the liver transplantation patients on the day after surgery,3d after surgery,7d after surgery,14d after surgery,and on the day of discharge.The nursing outcome classification scores at 5 time points were statistically analyzed.The nursing records of 44 patients with liver transplantation from June to December 2022 were retrospectively collected by convenient sampling,and 44 nursing records before Nursing Outcomes Classification application and 44 nursing records after Nursing Outcomes Classification implementation were measured by Quality of Documentation of Nursing Diagnoses,Interventions and Outcomes.Results The Nursing Outcomes Classification scores of 15 nursing diagnoses were analyzed by single factor repeated measurement,and 9 of them showed continuous improvement and significant difference at 4 measurement time points(P＜0.05).After Nursing Outcomes Classification implementation,the total score of nursing record quality,nursing diagnosis and nursing outcome record quality scores were higher than those before implementation,with statistically significant differences(P＜0.05).Conclusion The nursing outcome classification system can be used to evaluate the postoperative health status and nursing effect of adult liver transplantation patients.It has high specialty specificity and can improve the quality of nursing records.

Objective:To analyze the risk factors for surgical site infections（SSI）in liver transplant recipients.Methods:Relevant studies on the risk factors for SSI in liver transplant recipients were searched in PubMed，Web of Science，EMbase，The Cochrane Library，CNKI，Wanfang，Vep，and the Chinese Biomedical Literature Database from inception to July 10，2023. The literature quality was assessed，and meta-analysis was performed using RevMan 5.4 and Stata 16 software.Results:A total of 10 studies involving 3 113 adult liver transplant recipients were included，and 723 cases of SSI were reported. Meta-analysis revealed that Roux-en-Y biliary reconstruction（ OR=2.60，95% CI 1.45-4.65），bile leakage（ OR=17.22，95% CI 8.48-34.96），repeat surgery（ OR=7.22，95% CI 4.25-12.26），re-transplantation（ OR=13.88，95% CI 7.71-24.97），prolonged surgical duration（ MD=0.52，95% CI 0.19-0.84），dialysis（ OR=3.44，95% CI 2.41-4.91），and extended hospital stay（ MD=11.42，95% CI 5.73-17.12）were independent risk factors for SSI in liver transplant recipients. Conclusion:The identified risk factors for SSI in liver transplant recipients include Roux-en-Y biliary reconstruction，bile leakage，repeat surgery，re-transplantation，prolonged surgical duration，dialysis，and extended hospital stay. Clinicians should enhance the assessment of these factors and take effective intervention to improve clinical outcomes for liver transplant recipients.

Objective:To construct a postoperative nursing plan for liver transplant recipients using the NANDA international, nursing outcomes classification, nursing intervention classification (NANDA-I-NOC-NIC) link (referred to as NNN-link) as the theoretical framework, so as to optimize the nursing process after liver transplantation and improve the quality of nursing.Methods:This study retrospectively collected nursing diagnoses with a postoperative usage rate of over 50% from 300 liver transplant recipients at Shulan (Hangzhou) Hospital from January 2019 to December 2021, and matched nursing outcomes and measures based on the NNN-link theory framework. After two rounds of Delphi expert consultation and group discussion, the entry content was rated, discussed, and modified to form the final version of the postoperative NNN-link for liver transplant recipients.Results:In two rounds of expert consultation, the recovery rates were 96.67% (29/30) and 100.00% (29/29) , respectively. The expert authority coefficients were 0.83 and 0.84, respectively. The Kendall harmony coefficients for the second round were 0.50, 0.38, 0.35. The final postoperative NNN-link for liver transplant recipients included 15 nursing diagnoses, 42 nursing outcomes, and 106 nursing measures.Conclusions:The process of constructing the postoperative NNN-link for liver transplant recipients is scientific and reasonable, and the entries are highly specialized, which can provide reference for clinical nursing after liver transplantation.

Enterotoxigenic Escherichia coli（ETEC）infection can induce watery diarrhea，leading to dehydration，electrolyte disturbance，and even death in severe cases. Recombinant B subunit/inactivated whole-cell cholera（rBS/WC）vaccine is effective in preventing ETEC infectious diarrhea. On the basis of the latest evidence on etiology and epidemiology of ETEC，as well as the effectiveness，safety，and health economics of rBS/WC vaccine，National Clinical Research Center for Child Health（The Children’s Hospital，Zhejiang University School of Medicine）and Zhejiang Provincial Center for Disease Control and Prevention invited experts to develop expert consensus on rBS/WC vaccine in prevention of ETEC infectious diarrhea. It aims to provide the clinicians and vaccination professionals with guidelines on using rBS/WC vaccine to reduce the incidence of ETEC infectious diarrhea.