Objective:To analyze the colonization rate and molecular types of Staphylococcus aureus (SA) on the tracheotomy wounds of neonates at early postoperative stage in neonatal intensive care unit (NICU). Methods:This was a case series study. Patients who were admitted and underwent tracheotomy in NICU of Beijing Children′s Hospital, Capital Medical University from January 1 st 2020 to December 31 st 2023 were enrolled. Swabs on the skin around the incision or on the nasal mucosa were collected and cultured at 24, 72 and 168 h after operation. Coagulase test and Staphytect Plus kits were used for SA identification. The nuc gene amplification and molecular types of SA were assessed by PCR. The patients were divided into SA colonization group and non-colonization group based on the presence or absence of SA colonization, and into infection group and non-infection group based on the presence or absence of infection. Demographic data, hospitalization information, colonization and infection status of SA were collected from the digital medical record system of the hospital. Differences between groups were analyzed using the independent sample t test or Fisher exact test. Results:Totally 19 patients were enrolled, among whom 13 were male. The gestation age was 39.0 (38.1, 40.0) weeks, and the birth weight was 3 150 (2 600, 3 400) g. Tracheotomy was done at 8.2(4.1, 19.6) days after diagnosis and indication confirmed. Corrected gestational age of patients on the operation day was 43.6 (42.2, 45.4) weeks. The NICU stay time was (34.0±3.1) days. SA colonization was confirmed around the incision of 8 patients. Out of the 18 strains of colonized bacteria, 10 were methicillin-resistant Staphylococcus aureus (MRSA). The most common molecular type of MRSA was ST59-SCCmec Ⅳ-t437 strain (8 strains). A total of 10 patients presented typical clinical manifestations of bacterial infection at the lungs, 3 patients in the blood stream and 2 patients in the central nervous system. Among 10 patients with bacterial infection, 3 patients were MRSA positive by boby fluid culture and affected by the ST59-SCCmec Ⅳ-t437 strain. The infection rate was different between patients with or without SA colonization on the tracheotomy incision (7/8 vs. 3/11, P=0.020). Conclusions:The colonization rate and infection rate were high on the tracheotomy incision in neonates. The major type was MRSA, and the most common molecular strain was ST59-SCCmec Ⅳ-t437 .

Objective:To analyze the colonization rate and molecular types of Staphylococcus aureus (SA) on the tracheotomy wounds of neonates at early postoperative stage in neonatal intensive care unit (NICU). Methods:This was a case series study. Patients who were admitted and underwent tracheotomy in NICU of Beijing Children′s Hospital, Capital Medical University from January 1 st 2020 to December 31 st 2023 were enrolled. Swabs on the skin around the incision or on the nasal mucosa were collected and cultured at 24, 72 and 168 h after operation. Coagulase test and Staphytect Plus kits were used for SA identification. The nuc gene amplification and molecular types of SA were assessed by PCR. The patients were divided into SA colonization group and non-colonization group based on the presence or absence of SA colonization, and into infection group and non-infection group based on the presence or absence of infection. Demographic data, hospitalization information, colonization and infection status of SA were collected from the digital medical record system of the hospital. Differences between groups were analyzed using the independent sample t test or Fisher exact test. Results:Totally 19 patients were enrolled, among whom 13 were male. The gestation age was 39.0 (38.1, 40.0) weeks, and the birth weight was 3 150 (2 600, 3 400) g. Tracheotomy was done at 8.2 (4.1, 19.6) days after diagnosis and indication confirmed. Corrected gestational age of patients on the operation day was 43.6 (42.2, 45.4) weeks. The NICU stay time was (34.0±3.1) days. SA colonization was confirmed around the incision of 8 patients. Out of the 18 strains of colonized bacteria, 10 were methicillin-resistant Staphylococcus aureus (MRSA). The most common molecular type of MRSA was ST59-SCCmec Ⅳ-t437 strain (8 strains). A total of 10 patients presented typical clinical manifestations of bacterial infection at the lungs, 3 patients in the blood stream and 2 patients in the central nervous system. Among 10 patients with bacterial infection, 3 patients were MRSA positive by boby fluid culture and affected by the ST59-SCCmec Ⅳ-t437 strain. The infection rate was different between patients with or without SA colonization on the tracheotomy incision (7/8 vs. 3/11, P=0.020). Conclusions:The colonization rate and infection rate are high on the tracheotomy incision in neonates. The major type is MRSA, and the most common molecular strain is ST59-SCCmec Ⅳ-t437 .

Objective:To explore the efficacy and safety of the combination therapy of lenalidomide and rituximab (R2) for short-cycle maintenance therapy in patients with B-cell non-Hodgkin lymphoma (B-NHL).Methods:A retrospective case series study was conducted. The clinical data of 19 B-NHL patients who received R2 regimen maintenance therapy after achieving complete remission through chemotherapy or autologous hematopoietic stem cell transplantation at Dongguan Kanghua Hospital from February 2018 to January 2024 were collected, and the overall survival (OS), progression-free survival (PFS), adverse reactions, changes in lymphocyte subsets and cytokine levels before and after treatment were analyzed.Results:Among the 19 patients, there were 7 males and 12 females, with a median age [ M ( Q1, Q3)] of 49 (45, 65) years. The median follow-up time was 56 months, ranging from 5 to 77 months. The 1-year OS and PFS rates were 89.2% and 88.9%, respectively. The 2-year and 5-year PFS rates were both 83.2%, and the 2-year and 5-year OS rates were both 88.9%. Common adverse reactions included hematological adverse reactions and infections, with 4 cases (21.1%) experiencing grade 3-4 hematological adverse reactions and 4 cases (21.1%) experiencing infections. There was no statistically significant difference in the levels of lymphocyte subsets (total T cells, helper T cells, regulatory T cells, NK cells, B cells, and CD4/CD8) and cytokines [interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor-α, and interferon-γ] before and after treatment (all P > 0.05). Conclusions:The R2 regimen for short-cycle maintenance therapy of B-NHL is effective and well tolerated by patients.

Objective To explore the expression of urinary exosomal microRNA-145-5p(miR-145-5p)and the targeted relationship with SLIT-ROBO guanosine triphosphatase activating protein 2(Srgap2)in diabetic kidney disease(DKD)mice.Methods A total of 11 db/db mice with random blood glucose≥16.7 mmol/L were selected to construct DKD model,and 10 C57BL/6J wild-type mice were assigned to the normal control(NC)group.The urine exosomes were isolated from each group.The expression of miR-145-5p in urinary exosomes and renal tissue were detected using RT-qPCR.Pearson correlation analysis was used to analyze the correlation between urinary exosomal miR-145-5p and UACR as well as the glycolipid metabolism indicators.Luciferase activity was performed to verify the targeting relationship between miR-145-5p and Srgap2.The expression Srgap2 and the ROCK activity in the renal tissues were detected using Western blot.Results Compared with NC group,the body weight,fasting plasma glucose(FPG),FIns,HbA1c,TC,UACR,urinary exosomal miR-145-5p and the expression of miR-145-5p in renal tissue and p-MYPT1 protein expression were significantly higher(P<0.05),while the expression of Srgap2 protein was significantly lower in DKD group(P<0.05).Pearson correlation analysis revealed that the exosomal miR-145-5p was positively correlated with UACR,FPG,HbA1c and TC(r=0.836,0.888,0.843,0.882,P<0.05).MiR-145-5p could directly target the Srgap2 protein and activate the ROCK pathway.Conclusions The expression of urinary exosomal miR-145-5p was significantly increased and the miR-145-5p/Srgap2/ROCK axis may be closely related to renal damage in DKD mice,and it is a promising diagnostic biomarker and future therapeutic target for DKD.

Objective To explore the expression of urinary exosomal microRNA-145-5p(miR-145-5p)and the targeted relationship with SLIT-ROBO guanosine triphosphatase activating protein 2(Srgap2)in diabetic kidney disease(DKD)mice.Methods A total of 11 db/db mice with random blood glucose≥16.7 mmol/L were selected to construct DKD model,and 10 C57BL/6J wild-type mice were assigned to the normal control(NC)group.The urine exosomes were isolated from each group.The expression of miR-145-5p in urinary exosomes and renal tissue were detected using RT-qPCR.Pearson correlation analysis was used to analyze the correlation between urinary exosomal miR-145-5p and UACR as well as the glycolipid metabolism indicators.Luciferase activity was performed to verify the targeting relationship between miR-145-5p and Srgap2.The expression Srgap2 and the ROCK activity in the renal tissues were detected using Western blot.Results Compared with NC group,the body weight,fasting plasma glucose(FPG),FIns,HbA1c,TC,UACR,urinary exosomal miR-145-5p and the expression of miR-145-5p in renal tissue and p-MYPT1 protein expression were significantly higher(P<0.05),while the expression of Srgap2 protein was significantly lower in DKD group(P<0.05).Pearson correlation analysis revealed that the exosomal miR-145-5p was positively correlated with UACR,FPG,HbA1c and TC(r=0.836,0.888,0.843,0.882,P<0.05).MiR-145-5p could directly target the Srgap2 protein and activate the ROCK pathway.Conclusions The expression of urinary exosomal miR-145-5p was significantly increased and the miR-145-5p/Srgap2/ROCK axis may be closely related to renal damage in DKD mice,and it is a promising diagnostic biomarker and future therapeutic target for DKD.

Objective:To analyze the colonization rate and molecular types of Staphylococcus aureus (SA) on the tracheotomy wounds of neonates at early postoperative stage in neonatal intensive care unit (NICU). Methods:This was a case series study. Patients who were admitted and underwent tracheotomy in NICU of Beijing Children′s Hospital, Capital Medical University from January 1 st 2020 to December 31 st 2023 were enrolled. Swabs on the skin around the incision or on the nasal mucosa were collected and cultured at 24, 72 and 168 h after operation. Coagulase test and Staphytect Plus kits were used for SA identification. The nuc gene amplification and molecular types of SA were assessed by PCR. The patients were divided into SA colonization group and non-colonization group based on the presence or absence of SA colonization, and into infection group and non-infection group based on the presence or absence of infection. Demographic data, hospitalization information, colonization and infection status of SA were collected from the digital medical record system of the hospital. Differences between groups were analyzed using the independent sample t test or Fisher exact test. Results:Totally 19 patients were enrolled, among whom 13 were male. The gestation age was 39.0 (38.1, 40.0) weeks, and the birth weight was 3 150 (2 600, 3 400) g. Tracheotomy was done at 8.2(4.1, 19.6) days after diagnosis and indication confirmed. Corrected gestational age of patients on the operation day was 43.6 (42.2, 45.4) weeks. The NICU stay time was (34.0±3.1) days. SA colonization was confirmed around the incision of 8 patients. Out of the 18 strains of colonized bacteria, 10 were methicillin-resistant Staphylococcus aureus (MRSA). The most common molecular type of MRSA was ST59-SCCmec Ⅳ-t437 strain (8 strains). A total of 10 patients presented typical clinical manifestations of bacterial infection at the lungs, 3 patients in the blood stream and 2 patients in the central nervous system. Among 10 patients with bacterial infection, 3 patients were MRSA positive by boby fluid culture and affected by the ST59-SCCmec Ⅳ-t437 strain. The infection rate was different between patients with or without SA colonization on the tracheotomy incision (7/8 vs. 3/11, P=0.020). Conclusions:The colonization rate and infection rate were high on the tracheotomy incision in neonates. The major type was MRSA, and the most common molecular strain was ST59-SCCmec Ⅳ-t437 .

Objective:To analyze the colonization rate and molecular types of Staphylococcus aureus (SA) on the tracheotomy wounds of neonates at early postoperative stage in neonatal intensive care unit (NICU). Methods:This was a case series study. Patients who were admitted and underwent tracheotomy in NICU of Beijing Children′s Hospital, Capital Medical University from January 1 st 2020 to December 31 st 2023 were enrolled. Swabs on the skin around the incision or on the nasal mucosa were collected and cultured at 24, 72 and 168 h after operation. Coagulase test and Staphytect Plus kits were used for SA identification. The nuc gene amplification and molecular types of SA were assessed by PCR. The patients were divided into SA colonization group and non-colonization group based on the presence or absence of SA colonization, and into infection group and non-infection group based on the presence or absence of infection. Demographic data, hospitalization information, colonization and infection status of SA were collected from the digital medical record system of the hospital. Differences between groups were analyzed using the independent sample t test or Fisher exact test. Results:Totally 19 patients were enrolled, among whom 13 were male. The gestation age was 39.0 (38.1, 40.0) weeks, and the birth weight was 3 150 (2 600, 3 400) g. Tracheotomy was done at 8.2 (4.1, 19.6) days after diagnosis and indication confirmed. Corrected gestational age of patients on the operation day was 43.6 (42.2, 45.4) weeks. The NICU stay time was (34.0±3.1) days. SA colonization was confirmed around the incision of 8 patients. Out of the 18 strains of colonized bacteria, 10 were methicillin-resistant Staphylococcus aureus (MRSA). The most common molecular type of MRSA was ST59-SCCmec Ⅳ-t437 strain (8 strains). A total of 10 patients presented typical clinical manifestations of bacterial infection at the lungs, 3 patients in the blood stream and 2 patients in the central nervous system. Among 10 patients with bacterial infection, 3 patients were MRSA positive by boby fluid culture and affected by the ST59-SCCmec Ⅳ-t437 strain. The infection rate was different between patients with or without SA colonization on the tracheotomy incision (7/8 vs. 3/11, P=0.020). Conclusions:The colonization rate and infection rate are high on the tracheotomy incision in neonates. The major type is MRSA, and the most common molecular strain is ST59-SCCmec Ⅳ-t437 .

Objective:To explore the efficacy and safety of the combination therapy of lenalidomide and rituximab (R2) for short-cycle maintenance therapy in patients with B-cell non-Hodgkin lymphoma (B-NHL).Methods:A retrospective case series study was conducted. The clinical data of 19 B-NHL patients who received R2 regimen maintenance therapy after achieving complete remission through chemotherapy or autologous hematopoietic stem cell transplantation at Dongguan Kanghua Hospital from February 2018 to January 2024 were collected, and the overall survival (OS), progression-free survival (PFS), adverse reactions, changes in lymphocyte subsets and cytokine levels before and after treatment were analyzed.Results:Among the 19 patients, there were 7 males and 12 females, with a median age [ M ( Q1, Q3)] of 49 (45, 65) years. The median follow-up time was 56 months, ranging from 5 to 77 months. The 1-year OS and PFS rates were 89.2% and 88.9%, respectively. The 2-year and 5-year PFS rates were both 83.2%, and the 2-year and 5-year OS rates were both 88.9%. Common adverse reactions included hematological adverse reactions and infections, with 4 cases (21.1%) experiencing grade 3-4 hematological adverse reactions and 4 cases (21.1%) experiencing infections. There was no statistically significant difference in the levels of lymphocyte subsets (total T cells, helper T cells, regulatory T cells, NK cells, B cells, and CD4/CD8) and cytokines [interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor-α, and interferon-γ] before and after treatment (all P > 0.05). Conclusions:The R2 regimen for short-cycle maintenance therapy of B-NHL is effective and well tolerated by patients.

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 formulate the quantitative grip strength training program for application in the postoperative patients with autogenous arteriovenous internal fistula,and to evaluate its effect on the mat-uration and initial use of autogenous arteriovenous internal fistula.Methods A total of 98 patients with ce-phalic venous radial arterial anastomosis internal fistula formation surgery in Shenzhen Hospital of Southern Medical University from September 2021 to November 2022 were selected as the study subjects by the conven-ience sampling method.According to the follow-up time,they were divided into the observation group (n=41) and control group (n=42).The observation group adopted the quantitative grip strength training for function-al exercise of the limb on the side of internal fistula,while the control group adopted the conventional grip training for functional exercise of the limb on the side of internal fistula.In postoperative 8 weeks,the matura-tion rate of internal fistula,natural blood flow amount of internal fistula,internal diameter of cephalic vein,pre-pump pressure used in the initial stage of internal fistula and the incidence rate of internal fistula complica-tions were evaluated in the two groups.Results Compared with the control group,the maturation rate of in-ternal fistula in the observation group was higher (97.6％ vs. 83.3％).The inner diameter of cephalic vein and natural blood flow amount of internal fistula in the observation group were larger than those in the control group[(5.24±0.66)mm vs. (4.63±0.59)mm;(1215.38±562.99)mL/min vs. (955.75±341.94)mL/min],the pre-pump pressure used at the initial stage of internal fistula in the observation group was lower than that in the control group[(119.20±19.83)mmHg vs. (135.74±17.07)mmHg],and the differences were statistically significant (P<0.05).Conclusion The quantitative grip strength training could increase the postoperative maturity rate of patients's internal fistula,and is beneficial to the use in the initial stage of internal fistula.