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.

Objective:To investigate the association between reproductive lifespan duration (RLD) and urinary albumin-creatinine ratio (UACR) in a Chinese postmenopausal population.Methods:This cross-sectional study included 11 055 naturally postmenopausal women from seven regions of China from May to December 2011. RLD was divided into four groups. Propensity score matching was performed to reduce bias, and logistic regressions and stratifications were conducted to investigate the association between RLD and increased UACR (≥30 mg/g). Mediation effect analysis was performed to quantify the effect of RLD on cardiovascular disease (CVD) induced by elevated UACR.Results:There were 2 373 participants with a RLD of 18-31 years, 2 888 participants with a RLD of 32-34 years, 2 472 participants with a RLD of 35-36 years, and 3 322 participants with a RLD of 37-50 years. The shortest RLD (18-31 years) group was characterized with older age ( P<0.001), a higher incidence of CVD ( P=0.025), and the highest level of UACR ( P<0.001). After adjusting for confounders, women with a longer RLD (37-50 years group) exhibited a lower risk of UACR elevation compared with those with the shortest RLD (18-31 years group) ( OR=0.72, 95% CI 0.64-0.82, P<0.001). Every 1-year extension in RLD was linked to a 2% reduction in the risk of UACR elevation ( OR=0.98, 95% CI 0.97-0.99, P<0.001). Stratified analysis revealed a more significant association between RLD and UACR in women who were a normal weight ( P=0.003) or overweight ( P=0.001), in those without CVD history ( P=0.001), and in those with impaired estimated glomerular filtration rate ( P=0.004). The mediation casual analysis showed that 3.0% of proteinuria inducing CVD events was mediated by RLD ( P=0.048). Conclusion:A longer RLD (37-50 years) is associated with a lower UACR in Chinese postmenopausal women.

Objective:To summarize the best evidence of prevention strategies for pressure injury in adult hospitalized burn patients.Methods:A bibliometric approach was used. Systematic searches were carried out to retrieve the published evidence of prevention strategies for pressure injury in adult hospitalized burn patients in the official websites of relevant academic organizations such as International Society for Burn injury, American Burn Association, and Japanese Dermatology Association, National Pressure Injury Advisory Panel, European Pressure Injury Advisory Panel, Pan Pacific Pressure Injury Alliance International Guidelines Website, foreign language databases such as UpToDate, BMJ Best Practice, MedSci, Joanna Briggs Institute Evidence-Based Practice Database, Cochrane Library, Web of Science, Embase, and PubMed, and Chinese databases such as China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang Database, and China Clinical Guidelines Library. The literature types include clinical decision-making, evidence summary, guidelines, systematic review, and expert consensus. The search time was till February 21 st, 2023. Two researchers independently screened the literature and evaluated the quality, and other researchers extracted and graded the evidence according to the topic. Results:A total of 10 papers were included, including 6 evidence summaries, 3 guidelines, and 1 expert consensus, all with high literature quality. After extracting evidence and classifying, 27 pieces of best evidences were summarized from three aspects, including prevention training and supervision, risk assessment, and prevention measures of pressure injury.Conclusions:A total of 27 pieces of best evidences of prevention strategies for pressure injury in adult hospitalized burn patients were summarized from 3 aspects. Medical workers can follow the best evidence and give personalized prevention strategies according to the specific condition of adult hospitalized burn patients to reduce the incidence of pressure injury.

Objective:To investigate the current status and evolutionary trajectory of research on the information management of pressure injury care in hospitals of China.Methods:The bibliometric method was used for analysis. Using the China National Knowledge Infrastructure (CNKI) database as the data source, the literature on information management of pressure injury care in hospitals was retrieved, covering the time period from the establishment of the CNKI database to July 31, 2022, and various types of literature such as guidelines, expert consensus, case studies, reviews, and survey reports, etc. Visualized analysis of clustering and co-occurrence on the keywords, authors, publishing institutions, and number of journals of the included literature were performed using CiteSpace 6.1.R2 software.Results:A total of 378 articles were retrieved, and 323 articles were included after collation. The number of literatures related to nursing information management of pressure injury in hospitals showed a significantly upward trend since 2012. Ten core authors published two or more articles as the first author. There were eight groups of co-authors with ≥3 people. Furthermore, 306 institutions contributed articles related to the information management of pressure injury care, with Peking University Shenzhen Hospital as the institution publishing the most articles (4 articles). Cooperation between institutions was relatively decentralized. The 323 included literature were sourced from 142 journals, six of which had published ten or more articles. A comprehensive co-occurrence analysis of 282 Chinese keywords was performed, with the top three keywords in terms of frequency being pressure ulcer, nursing management, and nursing. A total of 13 clusters were formed, and the persistent clusters were #1 quality of care, #2 nursing, and #6 surgical patients. The top 8 emergent keywords of emergence intensity in the database included early warning intervention, early warning management, early warning mechanism, information system, nursing safety, adverse events, operating room, and quality of care. In the past three years (2020-2022), the top two emergent keywords in terms of emergy intensity included operating room and quality of care. The key word with the longest duration (2005-2012) and the highest intensity was early warning intervention.Conclusions:The research hotspots on information management of pressure injury care in domestic hospitals have been formed. Early studies focus on the intervention after the pressure injury developed, while later studies focus more on the overall management of pressure injuries. Collaboration between institutions within research areas and correlations between studies are still lacking.

Objective:To study the clinical characteristics, diagnostic methods and genotypes of neonatal chronic granulomatous disease(CGD).Methods:From April 2013 to August 2020, neonates admitted to our hospital, diagnosed with neonatal CGD and confirmed using neutrophil respiratory burst test and genetic testing were retrospectively studied. Their clinical characteristics and diagnostic methods were summarized.Results:A total of eleven neonates with CGD were enrolled, including ten males and one female. The age of onset was 3-23 d and the age of admission was 11-28 d. 3 cases had family history. The initial symptoms were fever (10 cases) and coughing (1 case). The accompanying symptoms included coughing (6 cases), dyspnea (4 cases), skin pustules (3 cases), fever (1 case) and diarrhea (1 case). Lung CT showed patchy shadows (6 cases), pulmonary nodules (3 cases), round and irregular high-density shadow (1 case), pulmonary consolidation (1 case), pleural effusion (1 case) and pleural thickening (2 cases). CGD was pathologically diagnosed in one patient. Sputum culture showed Candida albicans (3 cases), Aspergillus fumigatum (2 cases), Aspergillus fumigatum combined with Klebsiella pneumoniae and Escherichia coli (1 case), Aspergillus fumigatum combined with Staphylococcus aureus (1 case). GM tests were positive in two cases and negative in other two cases. Blood and cerebrospinal fluid cultures were negative. White blood cell counts were (10.0-44.0)×10 9/L and C-reactive proteins were (14-165) mg/L. 11 cases had positive neutrophil respiratory burst test. Genetic tests showed CYBB gene mutations (9 cases) , NCF1 gene mutation(1 case) and NCF2 gene mutation (1 case). All cases received antibacterial and antifungal treatments for 2-5 weeks and were discharged with improvement. 8 patients survived, 5 received hematopoietic stem cell transplantation, 4 succeeded and one failed and continued to survive on oral medication. 3 cases took sulfamethoxazole, voriconazole or itraconazole orally for long periods. 3 cases died of severe infections after withdrawal of medication. Conclusions:Neonatal CGD is characterized by lung infections. Pulmonary CT shows mostly nodular or patchy shadows with occasional pulmonary consolidation or pleural effusion. It can be diagnosed by neutrophil respiratory burst test and genetic testing. X-linked CYBB gene mutations are common and autosomal recessive NCF1/NCF2 gene mutations less common.

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.