Objective:To construct a fuzzy comprehensive evaluation model for life support equipment of hospital,so as to improve quality of management for equipment.Methods:Based on the operating status of life support equipment in Jiangmen Maternal and Child Health Care Hospital of Guangdong Province,a fuzzy comprehensive evaluation model was constructed,and the indicators of different levels were set.The index weights were calculated according to the Analytic Hierarchy Process(AHP),and the equipment management strategy was formulated based on the evaluated results.A total of 98 life support equipment in clinical use in our hospital from January 2023 to July 2024 were selected.In them,49 equipment were managed under the conventional management mode,and the other 49 equipment were managed under the assessment system management mode of the kind of life support equipment based on fuzzy comprehensive evaluation model(model management mode)according to the random number table method.The timeliness,management effect and management efficiency of the two management modes for equipment were compared.A self-made satisfaction questionnaire was used to investigate the satisfaction scores of equipment engineers,clinicians and managers of relevant departments in usage management for equipment in the equipment usage of the two management modes.Results:The timeliness of equipment early warning,the timeliness of maintenance personnel's arrival,and the timeliness of proposing maintenance opinions were respectively(0.78±0.14)min,(5.14±2.11)min,and(10.69±3.11)min in the model management mode,all which were shorter than those in the conventional management mode,and the differences were statistically significant(t=16.697,11.857,16.117,P<0.05).The regular maintenance rate of equipment adopting the model management mode was higher than that adopting the conventional management mode,and the failure rate was lower than that adopting the conventional management mode,and the differences were statistically significant(x2=12.274,12.261,P<0.05),respectively.The maintenance time of the model management mode was shorter than that of the conventional management mode,and the operation and maintenance cost of the model management mode was lower than that of the conventional management mode,and the differences were statistically significant(t=17.451,12.707,P<0.05).The scores of management efficiencies of resource allocation,technical support,environmental guarantee and information infrastructure of the model management mode were all higher than those of the conventional management mode,and the differences were statistically significant(t=12.268,14.908,16.128,13.920,P<0.05).In usage management for equipment,the satisfaction scores of equipment engineers,clinicians and managers of relevant departments for equipment management adopting the model management mode were higher than those adopting the conventional management mode,and the differences were statistically significant(t=13.118,16.209,12.557,P<0.05).Conclusion:The assessment system of hospital for life support equipment based on the fuzzy comprehensive evaluation model can enhance the quality of management and operation for equipment,and improve the service level of equipment,and increase the operational efficiency of equipment.

BACKGROUND:Traditional Chinese medicine has been proved to have a significant role in anti-osteoporosis,and the effectiveness and mechanism of Ligustri Lucidi Fructus and its the active ingredients against osteoporosis have gradually gained the attention of scholars.OBJECTIVE:To analyze and summarize the research progress of Ligustri Lucidi Fructus and its active ingredients against osteoporosis in vitro and in vivo.METHODS:We searched the relevant literature included in CNKI and PubMed databases using the search terms of"Osteoporosis,Bone marrow mesenchymal stem cells,Osteoblast,Osteoclast,Ligustri Lucidi Fructus,Signal path"in Chinese and English,respectively.According to the needs of the research,we established the corresponding criteria and screened the literature.A total of 82 papers were included in the final review.RESULTS AND CONCLUSION:(1)The active ingredients of Ligustri Lucidi Fructus that exert anti-osteoporotic effects in vitro and in vivo mainly involve the following:Salidroside activates the Wnt/β-catenin signaling pathway by inhibiting the expression of Sclerostin and Dickkopf-related protein 1.This activation process enhances the expression of phosphorylated low-density lipoprotein receptor-related protein 6 in ovariectomized rats and primary osteoblasts,while decreasing the expression of glycogen synthase kinase 3β.Further,it promotes the expression of β-catenin,runt-related transcription factor 2 and cellular myelocytomatosis oncogene in the nucleus,thereby promoting the bone formation capacity of osteoblasts.The advantage is that it acts directly on osteoblasts to promote bone formation,which provides a new strategy for the treatment of osteoporosis.(2)Olive bittersweet significantly increases bone mineral density and regulates bone metabolism by decreasing terminal interleukin-6 and alkaline phosphatase concentrations in Sprague-Dawley rats.In vitro experiments showed that olive bittersweet promotes the proliferation of osteoblasts and up-regulates the protein and mRNA expression of osteoprotegerin,while inhibiting the protein and mRNA expression of receptor activator of nuclear factor-κB ligand.This mechanism of action is closely related to the regulation of the balance of the osteoprotegerin/receptor activator of nuclear factor-κB ligand system,demonstrating the advantage of increasing bone mineral density and maintaining bone health by regulating factors related to bone metabolism,but there is no significant effect on Ca2+concentration,which may limit its use in some specific types of osteoporosis.(3)By decreasing the expression of phosphatidylinositol 3 kinase,reducing the phosphorylation of protein kinase B and the expression of osteoclast-specific marker protein c-Fos,pineconiferin effectively inhibits the activation of phosphatidylinositol 3 kinase/protein kinase B/c-Fos pathway in osteoclasts.This inhibition reduces the proliferation and maturation of osteoclasts,which can help to reduce bone resorption.The advantage of this inhibition is that it can directly target osteoclasts,which provides a new target for osteoporosis treatment.However,the specific regulatory mechanism of osteoclasts needs to be studied in depth,and its long-term effect and safety need to be further evaluated.(4)The active ingredients of Ligustri Lucidi Fructus have shown good therapeutic effects on osteoporosis,but their mechanism of action is complex,involving the interaction of multiple genes,proteins and signaling pathways.In the future,large-scale clinical trials need to be carried out to verify its effectiveness and safety,and the strategy of combining the active ingredients of Ligustri Lucidi Fructus with other drugs needs to be further explored in order to obtain better therapeutic effects.

Objective To evaluate the current status of knowledge,attitudes,and practices(KAP)regarding home bathing among ostomy patients and analyze the influencing factors,aiming to provide targeted improvement suggestions for clinical nursing practice.Methods A convenient sampling method was used to select 435 ostomy patients who were followed up at specialized ostomy care clinics in 16 tertiary hospitals across 1 1 prefecture-level cities in Zhejiang Province from July to October 2023.Data were collected using a general information survey and a questionnaire assessing KAP of home bathing for ostomy patients.Univariate analysis and multiple linear regression analysis were conducted to explore the influencing factors.Results A total of 418 valid questionnaires were recovered,with an effective recovery rate of 96.09％.The scores on the Ostomy Patients'Home Bathing KAP Assessment Questionnaire ranged from 40 to 104 points(72.32±12.95),with a passing score of 72 points.221 patients passed,achieving a pass rate of 52.87％.Multiple linear regression analysis showed that educational level,type of caregivers,postoperative time,and changes in postoperative bathing methods and frequency were significant influencing factors for the current status of home bathing among ostomy patients(P＜0.05).Conclusion Ostomy patients have a moderate level of knowledge about home bathing,a relatively negative attitude,and behaviors that need improvement.It is recommended that clinical nursing staff timely assess the bathing abilities and needs of patients,develop personalized bathing guidance and follow-up plans based on specific circumstances,promote self-care awareness,assist in the early recovery of bathing habits,and thereby enhance the knowledge,attitudes,and practices of home bathing in patients with ostomy to meet their hygiene needs.

Objective:To construct a fuzzy comprehensive evaluation model for life support equipment of hospital,so as to improve quality of management for equipment.Methods:Based on the operating status of life support equipment in Jiangmen Maternal and Child Health Care Hospital of Guangdong Province,a fuzzy comprehensive evaluation model was constructed,and the indicators of different levels were set.The index weights were calculated according to the Analytic Hierarchy Process(AHP),and the equipment management strategy was formulated based on the evaluated results.A total of 98 life support equipment in clinical use in our hospital from January 2023 to July 2024 were selected.In them,49 equipment were managed under the conventional management mode,and the other 49 equipment were managed under the assessment system management mode of the kind of life support equipment based on fuzzy comprehensive evaluation model(model management mode)according to the random number table method.The timeliness,management effect and management efficiency of the two management modes for equipment were compared.A self-made satisfaction questionnaire was used to investigate the satisfaction scores of equipment engineers,clinicians and managers of relevant departments in usage management for equipment in the equipment usage of the two management modes.Results:The timeliness of equipment early warning,the timeliness of maintenance personnel's arrival,and the timeliness of proposing maintenance opinions were respectively(0.78±0.14)min,(5.14±2.11)min,and(10.69±3.11)min in the model management mode,all which were shorter than those in the conventional management mode,and the differences were statistically significant(t=16.697,11.857,16.117,P<0.05).The regular maintenance rate of equipment adopting the model management mode was higher than that adopting the conventional management mode,and the failure rate was lower than that adopting the conventional management mode,and the differences were statistically significant(x2=12.274,12.261,P<0.05),respectively.The maintenance time of the model management mode was shorter than that of the conventional management mode,and the operation and maintenance cost of the model management mode was lower than that of the conventional management mode,and the differences were statistically significant(t=17.451,12.707,P<0.05).The scores of management efficiencies of resource allocation,technical support,environmental guarantee and information infrastructure of the model management mode were all higher than those of the conventional management mode,and the differences were statistically significant(t=12.268,14.908,16.128,13.920,P<0.05).In usage management for equipment,the satisfaction scores of equipment engineers,clinicians and managers of relevant departments for equipment management adopting the model management mode were higher than those adopting the conventional management mode,and the differences were statistically significant(t=13.118,16.209,12.557,P<0.05).Conclusion:The assessment system of hospital for life support equipment based on the fuzzy comprehensive evaluation model can enhance the quality of management and operation for equipment,and improve the service level of equipment,and increase the operational efficiency of equipment.

Objective To retrospectively analyze the clinical risk factors and prognosis of perioperative myocardial injury(MINS)in non-cardiac surgery patients admitted to the intensive care unit(ICU).Methods A total of 478 postoperative patients admitted to the Department of Intensive Medicine,Minhang Hospital,Fudan University from Jan 2020 to Dec 2023 were selected.They were divided into MINS group(n=302)and normal group(n=176)based on whether myocardial injury occurred within 7 days after surgery.The differences in clinical characteristics between the two groups were compared,and risk factors for perioperative myocardial injury were identified.Risk factors for mortality in the MINS group were analyzed with 30-day mortality as the clinical endpoint.Results The prevalence of acute physiology and chronic health evaluation Ⅱ(Apache Ⅱ)score,coronary artery disease,and chronic kidney disease were all higher in the MINS group than those in the normal group,with statistically significant differences(P<0.05).The proportion of emergency surgeries,co-infection,and perioperative hypotension were significantly different between the MINS group and the normal group(P<0.05).Multivariate logistic regression analysis revealed that chronic kidney disease,emergency surgery,co-infection,and intraoperative and postoperative hypotension were risk factors for MINS occurrence.Prognostic analysis indicated that perioperative hypotension was a risk factor for 30-day mortality in MINS patients.Conclusion MINS is closely associated with patients'underlying conditions,timing of surgery,and perioperative hypotension status,and especially perioperative hypotension affects the final outcomes.

Objective To retrospectively analyze the clinical risk factors and prognosis of perioperative myocardial injury(MINS)in non-cardiac surgery patients admitted to the intensive care unit(ICU).Methods A total of 478 postoperative patients admitted to the Department of Intensive Medicine,Minhang Hospital,Fudan University from Jan 2020 to Dec 2023 were selected.They were divided into MINS group(n=302)and normal group(n=176)based on whether myocardial injury occurred within 7 days after surgery.The differences in clinical characteristics between the two groups were compared,and risk factors for perioperative myocardial injury were identified.Risk factors for mortality in the MINS group were analyzed with 30-day mortality as the clinical endpoint.Results The prevalence of acute physiology and chronic health evaluation Ⅱ(Apache Ⅱ)score,coronary artery disease,and chronic kidney disease were all higher in the MINS group than those in the normal group,with statistically significant differences(P<0.05).The proportion of emergency surgeries,co-infection,and perioperative hypotension were significantly different between the MINS group and the normal group(P<0.05).Multivariate logistic regression analysis revealed that chronic kidney disease,emergency surgery,co-infection,and intraoperative and postoperative hypotension were risk factors for MINS occurrence.Prognostic analysis indicated that perioperative hypotension was a risk factor for 30-day mortality in MINS patients.Conclusion MINS is closely associated with patients'underlying conditions,timing of surgery,and perioperative hypotension status,and especially perioperative hypotension affects the final outcomes.

BACKGROUND:Traditional Chinese medicine has been proved to have a significant role in anti-osteoporosis,and the effectiveness and mechanism of Ligustri Lucidi Fructus and its the active ingredients against osteoporosis have gradually gained the attention of scholars.OBJECTIVE:To analyze and summarize the research progress of Ligustri Lucidi Fructus and its active ingredients against osteoporosis in vitro and in vivo.METHODS:We searched the relevant literature included in CNKI and PubMed databases using the search terms of"Osteoporosis,Bone marrow mesenchymal stem cells,Osteoblast,Osteoclast,Ligustri Lucidi Fructus,Signal path"in Chinese and English,respectively.According to the needs of the research,we established the corresponding criteria and screened the literature.A total of 82 papers were included in the final review.RESULTS AND CONCLUSION:(1)The active ingredients of Ligustri Lucidi Fructus that exert anti-osteoporotic effects in vitro and in vivo mainly involve the following:Salidroside activates the Wnt/β-catenin signaling pathway by inhibiting the expression of Sclerostin and Dickkopf-related protein 1.This activation process enhances the expression of phosphorylated low-density lipoprotein receptor-related protein 6 in ovariectomized rats and primary osteoblasts,while decreasing the expression of glycogen synthase kinase 3β.Further,it promotes the expression of β-catenin,runt-related transcription factor 2 and cellular myelocytomatosis oncogene in the nucleus,thereby promoting the bone formation capacity of osteoblasts.The advantage is that it acts directly on osteoblasts to promote bone formation,which provides a new strategy for the treatment of osteoporosis.(2)Olive bittersweet significantly increases bone mineral density and regulates bone metabolism by decreasing terminal interleukin-6 and alkaline phosphatase concentrations in Sprague-Dawley rats.In vitro experiments showed that olive bittersweet promotes the proliferation of osteoblasts and up-regulates the protein and mRNA expression of osteoprotegerin,while inhibiting the protein and mRNA expression of receptor activator of nuclear factor-κB ligand.This mechanism of action is closely related to the regulation of the balance of the osteoprotegerin/receptor activator of nuclear factor-κB ligand system,demonstrating the advantage of increasing bone mineral density and maintaining bone health by regulating factors related to bone metabolism,but there is no significant effect on Ca2+concentration,which may limit its use in some specific types of osteoporosis.(3)By decreasing the expression of phosphatidylinositol 3 kinase,reducing the phosphorylation of protein kinase B and the expression of osteoclast-specific marker protein c-Fos,pineconiferin effectively inhibits the activation of phosphatidylinositol 3 kinase/protein kinase B/c-Fos pathway in osteoclasts.This inhibition reduces the proliferation and maturation of osteoclasts,which can help to reduce bone resorption.The advantage of this inhibition is that it can directly target osteoclasts,which provides a new target for osteoporosis treatment.However,the specific regulatory mechanism of osteoclasts needs to be studied in depth,and its long-term effect and safety need to be further evaluated.(4)The active ingredients of Ligustri Lucidi Fructus have shown good therapeutic effects on osteoporosis,but their mechanism of action is complex,involving the interaction of multiple genes,proteins and signaling pathways.In the future,large-scale clinical trials need to be carried out to verify its effectiveness and safety,and the strategy of combining the active ingredients of Ligustri Lucidi Fructus with other drugs needs to be further explored in order to obtain better therapeutic effects.

Theory and technology of Medical Immunology are widely used in scientific research.Our teaching and research group uses experimental teaching of Medical Immunology as a platform to carry out practice of scientific research project-based experi-mental system among"5+3"integration students.By completing a mini-project research including experimental design-experimental operation-research article writing,students cultivated scientific research thinking and exercised scientific research practice ability,and generally reported that the course is very difficult,but after completing it,it is very rewarding.

Objective To evaluate the current status of knowledge,attitudes,and practices(KAP)regarding home bathing among ostomy patients and analyze the influencing factors,aiming to provide targeted improvement suggestions for clinical nursing practice.Methods A convenient sampling method was used to select 435 ostomy patients who were followed up at specialized ostomy care clinics in 16 tertiary hospitals across 1 1 prefecture-level cities in Zhejiang Province from July to October 2023.Data were collected using a general information survey and a questionnaire assessing KAP of home bathing for ostomy patients.Univariate analysis and multiple linear regression analysis were conducted to explore the influencing factors.Results A total of 418 valid questionnaires were recovered,with an effective recovery rate of 96.09％.The scores on the Ostomy Patients'Home Bathing KAP Assessment Questionnaire ranged from 40 to 104 points(72.32±12.95),with a passing score of 72 points.221 patients passed,achieving a pass rate of 52.87％.Multiple linear regression analysis showed that educational level,type of caregivers,postoperative time,and changes in postoperative bathing methods and frequency were significant influencing factors for the current status of home bathing among ostomy patients(P＜0.05).Conclusion Ostomy patients have a moderate level of knowledge about home bathing,a relatively negative attitude,and behaviors that need improvement.It is recommended that clinical nursing staff timely assess the bathing abilities and needs of patients,develop personalized bathing guidance and follow-up plans based on specific circumstances,promote self-care awareness,assist in the early recovery of bathing habits,and thereby enhance the knowledge,attitudes,and practices of home bathing in patients with ostomy to meet their hygiene needs.

Objective·To compare the safety and short-term outcomes of robot-assisted versus laparoscopic-assisted proximal gastrectomy combined with double-flap esophagogastrostomy in the treatment of early upper gastric cancer.Methods·A retrospective cohort study was conducted to analyze the clinical and pathological data of 31 early gastric cancer patients who underwent proximal gastrectomy combined with double-flap esophagogastrostomy for gastrointestinal reconstruction at the Department of Gastrointestinal Surgery,Renji Hospital,Shanghai Jiao Tong University School of Medicine,from September 2023 to March 2024.Based on the surgical approach,patients were divided into the robot-assisted surgery group(robotic group,20 cases)and the laparoscope-assisted surgery group(laparoscopic group,11 cases).General clinical data,intraoperative conditions,and postoperative recovery between the two groups were compared.At the 6-month postoperative follow-up,upper gastrointestinal radiography and esophagogastroscopy were performed to assess anastomotic stricture and gastroesophageal reflux disease.Additionally,the gastric cancer-specific module of the European Organization for Research and Treatment of Cancer(EORTC),Quality of Life Questionnaire-Stomach 22(QLQ-STO22),was used to evaluate the patients' quality of life.Results·The general data of the two groups,including gender,age,preoperative comorbidities,American Society of Anesthesiologists(ASA)classification,Siewert classification,and pathological staging of tumors,showed no statistically significant differences(all P>0.05).All patients successfully underwent the procedure without conversion to open surgery.The time for gastroesophageal anastomosis was significantly shorter in the robotic group compared to the laparoscopic group[(31.09±8.23)min vs(43.73±8.83)min,P<0.001],while there were no statistically significant differences in other intraoperative and postoperative parameters,including operative time,intraoperative blood loss,number of lymph nodes removed,duration of gastric tube placement,time to start a liquid diet,length of postoperative hospital stay,and incidence of postoperative complications(all P>0.05).At the 6-month postoperative follow-up,30 patients completed the follow-up,with one patient lost to follow-up in the robotic group.Upper gastrointestinal radiography and esophagogastroscopy results showed that only one patient in the laparoscopic group developed an anastomotic stricture,while one patient in the robotic group developed grade A and one developed grade B gastroesophageal reflux disease(GERD).In addition,one patient in the laparoscopic group also developed grade B GERD.The incidences of GERD and anastomotic stricture showed no statistically significant differences between the two groups(both P>0.05).EORTC QLQ-STO22 results indicated that the robotic group had significantly lower scores in the dimensions of dysphagia,gastroesophageal reflux,and dietary restrictions,as well as in the total score,compared to the laparoscopic group(all P<0.05).Conclusion·Robot-assisted proximal gastrectomy combined with double-flap esophagogastrostomy is safe and feasible.It shortens anastomosis time and offers potential advantages in postoperative functional recovery and quality of life improvement.