Intraoperative cell salvage (IOCS) has been widely applied as an important blood conservation measure in surgical operations. However, there is currently a lack of clinical practice guidelines for the implementation of IOCS in patients with malignant tumors. This report aims to provide clinicians with recommendations on the use of IOCS in patients with malignant tumors based on the review and assessment of the existed evidence. Data were derived from databases such as PubMed, Embase, the Cochrane Library and Wanfang. The guideline development team formulated recommendations based on the quality of evidence, balance of benefits and harms, patient preferences, and health economic assessments. This study constructed seven major clinical questions. The main conclusions of this guideline are as follows: 1) Compared with no perioperative allogeneic blood transfusion (NPABT), perioperative allogeneic blood transfusion (PABT) leads to a more unfavorable prognosis in cancer patients (Recommended); 2) Compared with the transfusion of allogeneic blood or no transfusion, IOCS does not lead to a more unfavorable prognosis in cancer patients (Recommended); 3) The implementation of IOCS in cancer patients is economically feasible (Recommended); 4) Leukocyte depletion filters (LDF) should be used when implementing IOCS in cancer patients (Strongly Recommended); 5) Irradiation treatment of autologous blood to be reinfused can be used when implementing IOCS in cancer patients (Recommended); 6) A careful assessment of the condition of cancer patients (meeting indications and excluding contraindications) should be conducted before implementing IOCS (Strongly Recommended); 7) Informed consent from cancer patients should be obtained when implementing IOCS, with a thorough pre-assessment of the patient's condition and the likelihood of blood loss, adherence to standardized internally audited management procedures, meeting corresponding conditions, and obtaining corresponding qualifications (Recommended). In brief, current evidence indicates that IOCS can be implemented for some malignant tumor patients who need allogeneic blood transfusion after physician full evaluation, and LDF or irradiation should be used during the implementation process.

Aim To evaluate the tyrosine nitration modification of specific proteins in vascular endothelial cells and its impact on mitochondria-mediated apoptosis.Methods Human umbilical vein endothelial cells were cultured in vitro and divided into three groups:control group(treatment with dimethyl sulfoxide),3-morphansulam(SIN-1)group,and SIN-1+Fe(Ⅲ)5,10,15,20-(tetraphenyl)porphyrin(FeTPP)group.After 24 h,the levels of hexokinase 1(HK1)nitration modification,mitochondrial membrane potential,reactive oxygen species(ROS)production,and endothelial cell proliferation and apoptosis were assessed.A human umbilical vein endothelial cell line knockout of HK1 was constructed using gene editing technology,and its proliferation and apoptosis levels were detected.Results After treatment of hu-man umbilical vein endothelial cells with peroxynitrite generator SIN-1,the level of HK1 protein nitration modification sig-nificantly increased(P＜0.01),reactive oxygen species production significantly increased,mitochondrial membrane poten-tial significantly decreased,endothelial cell proliferation ability significantly decreased,and endothelial cell apoptosis level significantly increased(all P＜0.01).Peroxynitrite decomposition catalyst FeTPP could reverse the above effect(P＜0.01).In addition,HK1 gene knockout also exhibited similar antioxidant effects,with a significant decrease in endothe-lial cell proliferation ability and a significant increase in apoptosis levels(P＜0.01).Conclusion Peroxynitrite can induce an increase in the level of nitration modification of HK1 in vascular endothelial cells,which may be achieved by pro-moting the production of mitochondrial reactive oxygen species,thereby accelerating the process of endothelial cell apoptosis.

Objective To explore the mediating effect of psychological resilience between perceived spousal support and dignity loss in breast cancer patients.Methods A convenience sampling method was employed,involving 377 breast cancer patients who met the study criteria and received treatment at a tertiary oncology hospital in Yunnan Province from March to September 2023.Data were collected using a general information questionnaire,the Dignity Scale,the Perceived Spousal Support Scale,and the Psychological Resilience Scale.Data analysis was conducted using IBM SPSS 26.0 software.Results The scores for dignity loss,perceived spousal support,and psychological resilience of breast cancer patients were(41.72±6.77),(100.42±6.93),and(75.27±8.50),respectively.Pearson correlation analysis showed that dignity loss was negatively correlated with both perceived spousal support and psychological resilience(r1=-0.568,r2=-0.640,both P＜0.05).Mediation effect analysis indicated that psychological resilience had a mediating effect between perceived spousal support and dignity loss,with a value of-0.320(95％CI-0.409 to-0.246),accounting for 57.1％of the total effect.Conclusion The dignity of breast cancer patients in this study is in a state of mild loss,and psychological resilience plays a partial mediating role between perceived spousal support and dignity loss.This suggests that clinical medical staff should pay attention to the spousal support situation of breast cancer patients,provide timely guidance and health education to spouses,enhance the level of support from spouses,and strengthen the confidence and capability of couples in jointly coping with the disease,thereby alleviating dignity loss in breast cancer patients and improving their quality of life.

Objective To systematically evaluate the incidence and influencing factors of falls in adult cancer patients,and provide evidence support for early identification and prevention of falls.Methods Eight Chinese and English databases,including PubMed,Embase,CNKI,and Wanfang Database,were searched by computer.The databases were established until January 2024 and included in cross-sectional,cohort,and case-control studies based on the incidence and/or influencing factors of falls in adult cancer patients.Two researchers independently screened and reviewed literature,evaluated literature quality,and extracted data before conducting meta-analysis using RevMan 5.4 software.Results A total of 19 articles were incorporated into the research,with a total sample population size of 70508 cases.The results showed that the incidence of comorbid falls in adult tumor patients was 23.0%(95%CI 0.23,0.24).Age,female,low education level,fall history,fall fear,middle and late stage of tumor,tumor type(breast cancer,reproductive system tumor,prostate cancer),comorbidity,chemotherapy,radiotherapy,multiple drugs(n≥5),drugs(antidepressants,antipsychotics,sedatives and hypnotics),related symptoms(fever,peripheral neuropathy,fatigue,depression),malnutrition,low weight,cognitive dysfunction,balance disorders,gait abnormalities,and low ability of daily living were the influencing factors for falls of adult tumor patients.Conclusion Cancer professionals should identify the influencing factors of falls early and take targeted measures to reduce the occurrence of falls.

Objective To explore the current status of oncology nurses'medical narrative competence and to analyze its influencing factors.Methods 931 nurses from the oncological departments of 17 3A grade hospitals in Yunnan Province were selected from June to August 2023 and were surveyed using the Medical Narrative Competence Scale,the General Self-Efficacy Scale,and the Humanistic Care Scale.Results The score of medical narrative competence of oncology nurses was(151.52±14.61).The results of multiple linear regression showed that general self-efficacy,humanistic competence,years of experience,department,peer support,family support,familiarity with medical narratives,and job satisfaction were the factors influencing oncology nurses'competence in medical narratives(P<0.05),which explained 38.0%of the total variation.Conclusion The medical narrative competence of oncology nurses,moderately level,is influenced by multiple factors.

Objective:To explore the chain mediating role of general self-efficacy and humanistic care competence between oncology nurses' empathy and medical narrative competence, with a view to informing the development of targeted medical narrative competence enhancement strategies.Methods:Convenience sampling was used to select 1 104 oncology nurses from 17 ClassⅢ Grade A hospitals in Yunnan Province from May to August 2023 for the study. The General Information Questionnaire, Narrative Competence Scale, Chinese version of the Jefferson Scale of Empathy, Caring Ability Inventory, and General Self-Efficacy Scale were used to survey oncology nurses. Pearson correlation was used to analyze the correlation among oncology nurses' general self-efficacy, empathy, humanistic care competence, and medical narrative competence. Mediating effects were analyzed using Model 6 in the SPSS macro program PROCESS 4.0 plug-in. Bootstrap method was used to repeat the sampling 5 000 times for the chained mediating effect test.Results:A total of 1 104 questionnaires were distributed and the number of valid questionnaires recovered was 931, with a valid recovery rate of 84.33% (931/1 104). Among 931 oncology nurses, the scores of Narrative Competence Scale, Caring Ability Inventory, Chinese version of Jefferson Scale of Empathy, and General Self-Efficacy Scale were (151.52±17.61), (191.68±18.80), (95.31±13.96), and (27.59±6.02), respectively. There was a positive two-by-two correlation among oncology nurses' medical narrative competence, empathy, humanistic care competence, and general self-efficacy ( P<0.01). General self-efficacy and humanistic care competence acted as chain mediators between oncology nurses' empathy and medical narrative competence, with the mediating effect accounting for 43.13% of the total effect. Conclusions:General self-efficacy and humanistic care are mediating variables between oncology nurses' empathy and medical narrative competence. Nursing managers should focus on the cultivation of nurses' empathy, stimulate nurses' self-efficacy, and promote the practice of nursing humanistic care, which in turn improves oncology nurses' medical narrative competence and the quality of nursing services.

Aim To evaluate the tyrosine nitration modification of specific proteins in vascular endothelial cells and its impact on mitochondria-mediated apoptosis.Methods Human umbilical vein endothelial cells were cultured in vitro and divided into three groups:control group(treatment with dimethyl sulfoxide),3-morphansulam(SIN-1)group,and SIN-1+Fe(Ⅲ)5,10,15,20-(tetraphenyl)porphyrin(FeTPP)group.After 24 h,the levels of hexokinase 1(HK1)nitration modification,mitochondrial membrane potential,reactive oxygen species(ROS)production,and endothelial cell proliferation and apoptosis were assessed.A human umbilical vein endothelial cell line knockout of HK1 was constructed using gene editing technology,and its proliferation and apoptosis levels were detected.Results After treatment of hu-man umbilical vein endothelial cells with peroxynitrite generator SIN-1,the level of HK1 protein nitration modification sig-nificantly increased(P＜0.01),reactive oxygen species production significantly increased,mitochondrial membrane poten-tial significantly decreased,endothelial cell proliferation ability significantly decreased,and endothelial cell apoptosis level significantly increased(all P＜0.01).Peroxynitrite decomposition catalyst FeTPP could reverse the above effect(P＜0.01).In addition,HK1 gene knockout also exhibited similar antioxidant effects,with a significant decrease in endothe-lial cell proliferation ability and a significant increase in apoptosis levels(P＜0.01).Conclusion Peroxynitrite can induce an increase in the level of nitration modification of HK1 in vascular endothelial cells,which may be achieved by pro-moting the production of mitochondrial reactive oxygen species,thereby accelerating the process of endothelial cell apoptosis.

Objective:To explore the chain mediating role of general self-efficacy and humanistic care competence between oncology nurses' empathy and medical narrative competence, with a view to informing the development of targeted medical narrative competence enhancement strategies.Methods:Convenience sampling was used to select 1 104 oncology nurses from 17 ClassⅢ Grade A hospitals in Yunnan Province from May to August 2023 for the study. The General Information Questionnaire, Narrative Competence Scale, Chinese version of the Jefferson Scale of Empathy, Caring Ability Inventory, and General Self-Efficacy Scale were used to survey oncology nurses. Pearson correlation was used to analyze the correlation among oncology nurses' general self-efficacy, empathy, humanistic care competence, and medical narrative competence. Mediating effects were analyzed using Model 6 in the SPSS macro program PROCESS 4.0 plug-in. Bootstrap method was used to repeat the sampling 5 000 times for the chained mediating effect test.Results:A total of 1 104 questionnaires were distributed and the number of valid questionnaires recovered was 931, with a valid recovery rate of 84.33% (931/1 104). Among 931 oncology nurses, the scores of Narrative Competence Scale, Caring Ability Inventory, Chinese version of Jefferson Scale of Empathy, and General Self-Efficacy Scale were (151.52±17.61), (191.68±18.80), (95.31±13.96), and (27.59±6.02), respectively. There was a positive two-by-two correlation among oncology nurses' medical narrative competence, empathy, humanistic care competence, and general self-efficacy ( P<0.01). General self-efficacy and humanistic care competence acted as chain mediators between oncology nurses' empathy and medical narrative competence, with the mediating effect accounting for 43.13% of the total effect. Conclusions:General self-efficacy and humanistic care are mediating variables between oncology nurses' empathy and medical narrative competence. Nursing managers should focus on the cultivation of nurses' empathy, stimulate nurses' self-efficacy, and promote the practice of nursing humanistic care, which in turn improves oncology nurses' medical narrative competence and the quality of nursing services.

Objective To investigate the research status and the research hotspots on male nurses at home and abroad in last decade,so as to provide references for further research in male nurses.Methods Literature between 2013 and 2024 on male nurses were retrieved from the Web of Science(WOS)and CNKI.CiteSpace 6.2.6 R7 software was used to analyse the volume of publication,keyword co-occurrence,keyword clustering and emergence.Results A total of 736 articles were included in the study.From 2013 to 2023,the number of published papers of male nurses in CNKI and WOS showed an increasing trend.The research was primarily affiliated with 263 institutions across 62 countries.The country with the highest volume of publication is China,followed by the United States,although there was a need to enhance collaboration with other nations.The institution with the most publications is the Hong Kong Polytechnic University.A comprehensive analysis of keyword co-occurrence,clustering,and emerging trends revealed that the research hotspots in the field of male nursing in CNKI mainly includes the advantages of male nurses,psychological capital,humanistic care,development,needs,professional identification.Whereas WOS focuses on the topics such as gender bias against male nurses,mental health,workplace violence,ambivalent sexism,motivational barriers,individual differences,societal prejudice and knowledge and attitucle.Both domestic and international research on male nurses primarily consist of cross-sectional surveys and qualitative studies,with fewer intervention studies.Currently,the researches regarding male nursing focus on the qualitative study of mental health of male nurses.Conclusion Focusing on the mental health and professional status of male nurses,domestic scholars need to increase the formulation and implementation of interventions in this field in order to address the practical issues faced by male nurses,therefore to promote the comprehensive development of the nursing profession,enhance the overall quality and service quality of the nursing team,and provide patients with higher quality in nursing services.

Objective:To investigate the status of hepatitis E virus infection in unpaid blood donors in Wenzhou.Methods:A total of 5 241 blood samples were selected from donors who successfully donated blood between October 2022 and March 2023. These samples were tested for hepatitis E virus (HEV) through HEV-IgG antibodies, HEV-IgM antibodies, and nucleic acid tests (HEV RNA). Samples that tested positive for HEV RNA underwent quantitative detection and sequencing. Data regarding the blood donors were collected, the positive rates of each test result were recorded, and the HEV infection status among different populations was analyzed.Results:The positive rate of the HEV-IgG antibody test was 23.60% (1 237/5 241), while the positive rate of the HEV-IgM antibody test was 0.29% (15/5 241). The positive rate of the HEV RNA test was 0.08% (4/5 241). The positive rate of the HEV-IgG test increased with age ( χ2 = 379.493, P < 0.05), and males had a higher positive rate than females ( χ2 = 5.12, P < 0.05). Both the positive rates of HEV-IgG and HEV-IgM tests increased as the number of blood donations increased ( χ2 = 40.87, 8.30, both P < 0.05). Furthermore, the positive rates were significantly higher in 2023 than in 2022 ( χ2 = 51.03, 13.35, both P < 0.05), and they were also significantly higher in spring than in winter ( χ2 = 51.03, 13.35, both P < 0.05). Only one HEV RNA-positive blood donor tested positive for both HEV-IgG and HEV-IgM antibodies, while the remaining three donors tested negative. Only one case was genotyped, and it belonged to genotype Ⅳ. Conclusion:The incidence of HEV infection among unpaid blood donors in Wenzhou of Zhejiang Province is relatively high, with the prevalent HEV genotype being type Ⅳ. Characteristics such as sex, age, and the number of blood donations can be utilized as auxiliary screening reference indicators.