Objective:To explore the formation pathway of sleep deprivation in shift work nurses so as to provide a reference for improving their sleep.Methods:Purposive and theoretical sampling methods were used to select 18 shift work nurses from the clinical departments of six Class Ⅲ Grade A hospitals in Hangzhou City, Zhejiang Province, from January to April 2024 for semi-structured interviews. The interview data were coded and analyzed by searching literature and interviewing shift work nurses, applying Strauss procedural grounded theory to inductively develop relevant concepts and categories.Results:After three levels of coding, 26 initial categories and 10 main categories were refined. Three core categories, namely, doctor-patient tension, institutional mechanism imbalance, and work pressure overload, were finally summarized to construct a formation pathway of sleep deprivation in shift work nurses.Conclusions:External doctor-patient tension, misaligned institutional mechanisms in healthcare organizations, and work pressure overload among shift work nurses are important factors in the formation of sleep deprivation, with work pressure overload being a core factor. It is recommended that sleep deprivation be alleviated through impartial reporting of medical incidents, rational handling of medical disputes, optimization of scheduling arrangements, provision of psychological counselling and enhanced staff training.

Objective:To explore the formation pathway of sleep deprivation in shift work nurses so as to provide a reference for improving their sleep.Methods:Purposive and theoretical sampling methods were used to select 18 shift work nurses from the clinical departments of six Class Ⅲ Grade A hospitals in Hangzhou City, Zhejiang Province, from January to April 2024 for semi-structured interviews. The interview data were coded and analyzed by searching literature and interviewing shift work nurses, applying Strauss procedural grounded theory to inductively develop relevant concepts and categories.Results:After three levels of coding, 26 initial categories and 10 main categories were refined. Three core categories, namely, doctor-patient tension, institutional mechanism imbalance, and work pressure overload, were finally summarized to construct a formation pathway of sleep deprivation in shift work nurses.Conclusions:External doctor-patient tension, misaligned institutional mechanisms in healthcare organizations, and work pressure overload among shift work nurses are important factors in the formation of sleep deprivation, with work pressure overload being a core factor. It is recommended that sleep deprivation be alleviated through impartial reporting of medical incidents, rational handling of medical disputes, optimization of scheduling arrangements, provision of psychological counselling and enhanced staff training.

Toxascaris leonina is a common parasitic nematode of wild mammals and has significant impacts on the protection of rare wild animals. To analyze population genetic characteristics of T. leonina from South China tiger, its mitochondrial (mt) genome was sequenced. Its complete circular mt genome was 14,277 bp in length, including 12 protein-coding genes, 22 tRNA genes, 2 rRNA genes, and 2 non-coding regions. The nucleotide composition was biased toward A and T. The most common start codon and stop codon were TTG and TAG, and 4 genes ended with an incomplete stop codon. There were 13 intergenic regions ranging 1 to 10 bp in size. Phylogenetically, T. leonina from a South China tiger was close to canine T. leonina. This study reports for the first time a complete mt genome sequence of T. leonina from the South China tiger, and provides a scientific basis for studying the genetic diversity of nematodes between different hosts.
Animals ; Animals, Wild ; Bias (Epidemiology) ; China* ; Codon, Initiator ; Codon, Terminator ; DNA, Intergenic ; Genes, rRNA ; Genetic Variation ; Genome ; Genome, Mitochondrial* ; Mammals ; Phylogeny ; RNA, Transfer ; Sequence Analysis* ; Tigers* ; Toxascaris*

BACKGROUND:Massive blood loss was caused by an over-reactive fibrinolytic system, as a sequence of tourniquet usage and surgery trauma in total knee arthroplasty. As an antifibrinolytic drug, tranexamic acid has been proven to decrease not only the obvious and total blood loss, but also the ratio of alograft blood transfusion in total knee arthroplasty. Nevertheless, the effect of tranexamic acid on hidden blood loss in total knee arthroplasty had not been clarified yet. OBJECTIVE: To observe the effect of intravenous infusion of tranexamic acid on hidden blood loss in primary total knee arthroplasty. METHODS:Clinical data of 54 patients who received primary unilateral total knee arthroplasty in the Third Hospital, Peking University from June to December 2013 were retrospectively analyzed. They were divided into two groups according to the use of tranexamic acid. 22 patients in the tranexamic acid group were given 2 g tranexamic acid by intravenous infusion during surgery. 32 patients in the control group were given an equal volume of physiological saline. Patients in both groups were oraly given anticoagulant rivaroxaban after replacement. Hemoglobin level and blood hematocrit were recorded before and after surgery for 5 consecutive days. The total amount of blood loss and hidden blood loss were calculated by using Cross equation. The difference in the amount of blood loss was compared between the two groups. Lower extremity venous ultrasound examination was conducted at 1 week after replacement to determine deep venous thrombosis in the lower limb. RESULTS AND CONCLUSION:No significant difference in general data and perioperative conditions was detected between the two groups (P > 0.05). Postoperative drainage, dominant blood loss, total blood volume, the amount of autologous blood transfusion and the amount of alogeneic blood transfusion were significantly less in the tranexamic acid group than in the control group (P < 0.05). According to Gross formula, the difference of hidden blood loss was statisticaly significant between the tranexamic acid group (302.9±189.9) mL and the control group (596.8±271.4) mL (P < 0.05). Deep vein thrombosis appeared in one case between the two groups after replacement. Results indicate that intravenous infusion of tranexamic acid dramaticaly decreased the hidden blood loss in unilateral total knee arthroplasty, reduced alogeneic blood transfusion, and simultaneously did not increase the incidence of deep vein thrombosis in the lower limb.