After ostomy surgery, patients lose the ability to control their anal sphincter, relying on ostomy pouches for excretion. Convex baseplates offer several advantages, including preventing leakage, reducing the risk of stoma and peripheral skin complications, and adapting to the dynamic stoma shapes caused by peristaltic expansion and contraction of the stoma. This article reviews the structure and features of convex baseplates, usage considerations, existing challenges, and future prospects, aiming to provide a reference for the standardized clinical use of convex baseplates and to improve patient health outcomes.

The classification of stoma skin barriers varies based on their specific features. The curvature design of convex skin barriers provides a secure and effective seal for patients with flat, retracted stomas or peristomal skin folds. The secure sealing ability of convex skin barriers is attributed to several critical structural components. Although convex skin barriers offer many clinical advantages, there is currently no unified standard for measuring their characteristics, resulting in confusion among healthcare professionals when selecting stoma care products. To address this issue, the 2021 International Stoma Care Expert Meeting proposed the Expert Consensus on Characteristics of Convex Skin Barriers and Clinical Application, which clearly defines five essential properties and clinical application guidelines for convex barriers. However, as most consensus contributors are from Europe and North America, its applicability in Chinese healthcare settings may be limited. Therefore, this paper provides a detailed interpretation of the five characteristics and clinical application statements of convex skin barriers, aiming to offer practical guidance to clinical nurses in selecting appropriate convex products and managing stoma-related complications.

After ostomy surgery, patients lose the ability to control their anal sphincter, relying on ostomy pouches for excretion. Convex baseplates offer several advantages, including preventing leakage, reducing the risk of stoma and peripheral skin complications, and adapting to the dynamic stoma shapes caused by peristaltic expansion and contraction of the stoma. This article reviews the structure and features of convex baseplates, usage considerations, existing challenges, and future prospects, aiming to provide a reference for the standardized clinical use of convex baseplates and to improve patient health outcomes.

The classification of stoma skin barriers varies based on their specific features. The curvature design of convex skin barriers provides a secure and effective seal for patients with flat, retracted stomas or peristomal skin folds. The secure sealing ability of convex skin barriers is attributed to several critical structural components. Although convex skin barriers offer many clinical advantages, there is currently no unified standard for measuring their characteristics, resulting in confusion among healthcare professionals when selecting stoma care products. To address this issue, the 2021 International Stoma Care Expert Meeting proposed the Expert Consensus on Characteristics of Convex Skin Barriers and Clinical Application, which clearly defines five essential properties and clinical application guidelines for convex barriers. However, as most consensus contributors are from Europe and North America, its applicability in Chinese healthcare settings may be limited. Therefore, this paper provides a detailed interpretation of the five characteristics and clinical application statements of convex skin barriers, aiming to offer practical guidance to clinical nurses in selecting appropriate convex products and managing stoma-related complications.

ObjectiveTo explore the syndrome elements and evolving patterns of patients with hepatitis B virus-related acute on chronic liver failure （HBV-ACLF） at different stages. MethodsClinical information of 1,058 hospitalized HBV-ACLF patients， including 618 in the early stage， 355 in the middle stage， and 85 in the late stage， were collected from 18 clinical centers across 12 regions nationwide from January 1， 2012 to February 28， 2015. The “Hepatitis B-related Chronic and Acute Liver Failure Chinese Medicine Clinical Questionnaire” were designed to investigate the basic information of the patients， like the four diagnostic information （including symptoms， tongue， pulse） of traditional Chinese medicine （TCM）， and to count the frequency of the appearance of the four diagnostic information. Factor analysis and cluster analysis were employed to determine and statistically analyze the syndrome elements and patterns of HBV-ACLF patients at different stages. ResultsThere were 76 four diagnostic information from 1058 HBV-ACLF patients， and 53 four diagnostic information with a frequency of occurrence ≥ 5% were used as factor analysis entries， including 36 symptom information， 12 tongue information， and 5 pulse information. Four types of TCM patterns were identified in HBV-ACLF， which were liver-gallbladder damp-heat pattern， qi deficiency and blood stasis pattern， liver-kidney yin deficiency pattern， and spleen-kidney yang-deficiency pattern. In the early stage， heat （39.4%， 359/912） and dampness （27.5%， 251/912） were most common， and the pattern of the disease was dominated by liver-gallbladder damp-heat pattern （74.6%， 461/618）； in the middle stage， dampness （30.2%， 187/619） and blood stasis （20.7%， 128/619） were most common， and the patterns of the disease were dominated by liver-gallbladder damp-heat pattern （53.2%， 189/355）， and qi deficiency and blood stasis pattern （27.6%， 98/355）； and in the late stage， the pattern of the disease was dominated by qi deficiency （26.3%， 40/152） and yin deficiency （20.4%， 31/152）， and the patterns were dominated by qi deficiency and blood stasis pattern （36.5%， 31/85）， and liver-gallbladder damp-heat pattern （25.9%， 22/85）. ConclusionThere are significant differences in the distribution of syndrome elements and patterns at different stages of HBV-ACLF， presenting an overall trend of evolving patterns as "from excess to deficiency， transforming from excess to deficiency"， which is damp-heat → blood stasis → qi-blood yin-yang deficiency.

Objective:To construct the training content system of aspiration prevention and management for ICU nurses, in order to improve the ability of ICU nurses in aspiration prevention and management, and provide a basis for nursing managers to carry out aspiration related training.Methods:This study preliminarily developed an item pool for the training content system of aspiration prevention and management through literature search and semi-structured interviews. From May to June 2023, the purposive sampling method was used to select 19 experts from Beijing, Shandong Province, Hubei Province and other places for two rounds of Delphi expert consultations, to determine the training content system for the prevention and management of aspiration among ICU nurses.Results:The effective response rates of the two-rounds of inquiry questionnaires were 95.5% (21/22) and 90.5% (19/21), respectively. The expert authority coefficients were 0.91 and 0.93, and the Kendall's harmony coefficients were 0.121 and 0.148 ( P<0.01). The final determination of the training content system for ICU nurse aspiration prevention and management included 10 primary indicators and 33 secondary indicators. Conclusions:The construction process of the training content system of aspiration prevention and management for ICU nurses is more scientific, reliable and full, which can guide the clinical practice of ICU nurses and provide reference for nursing managers to carry out education and training related to aspiration.

Objective:To construct a nursing training content system of acquired swallowing disorders for intensive care unit (ICU) nurses to provide a reference for clinical nurse training.Methods:Based on a literature review and semi-structured interviews, the first draft of a nursing training content system of acquired swallowing disorders for ICU nurses was formulated. 19 experts participated in 2 rounds of expert correspondence from March to May, 2023. The indicators were screened and assigned values by combining the screening criteria and expert opinions. Finally, the nursing training content system of acquired swallowing disorders for ICU nurses was formed.Results:The effective recovery rates of the second-round expert correspondence questionnaires were 100.0%(21/21) and 90.5% (19/21), respectively; the expert authority coefficients were 0.908 and 0.932, respectively; and the expert coordination coefficients were 0.149 and 0.201, respectively (both P<0.01). The final nursing training content system of acquired swallowing disorders for ICU nurses included 8 primary indicators and 37 secondary indicators. Conclusions:The nursing training content system of acquired swallowing disorders for ICU nurses had scientificity and reliability, and could provide reference and guidance for ICU-acquired swallowing disorders nursing training.

Objective : To investigate the effects of C-type lectin domain family 5，member A( CLEC5A) on the pro- liferation，apoptosis，and cell cycle of leukemia cell lines THP-1 and K562，and the underlying mechanism． Methods : The expression of CLEC5A in leukemia patients was investigated in the GEPIA database. Recombined plasmid containing CLEC5A was transfected into THP-1 and K562 cells for overexpression of CLEC5A．Small interfering RNA(siRNA) was used to knock down the endogenous CLEC5A in leukemia cells．CCK-8 and EdU assays were used to assess the leukemia cells proliferation．Flow cytometry was used to assess cell cycle．Flow cytometry was used to assess cell apoptosis under hydrogen peroxide( H2 O2 ) stress．The RNA sequencing( RNA-seq) and pathway enrichment analysis were used to analyze the signal pathways of significant enrichment of up-regulated or down-reg- ulated genes after knocking down CLEC5A gene．Protein expression levels of several members in AKT1 / mTOR and p53 signaling pathways were detected by Western blot assays. Results : CLEC5A was significantly up-regulated in bone marrow tissues of leukemia patients compared to the matched non-tumor tissues of healthy individuals．Knock- down of CLEC5A significantly reduced the proliferation(all P＜0. 01) and S phase progression(all P＜0. 05) ，and increased the apoptosis(all P＜0. 001) under H2 O2 stress，in THP-1 and K562 cells．Conversely，overexpression of CLEC5A significantly increased the proliferation(all P ＜0. 001) and S phase progression ( all P ＜0. 01) ，and re- duced the apoptosis(all P＜0. 01) under H2 O2 stress，in THP-1 and K562 cells．The uregulated genes were sig- nificantly enriched in AKT1-mTOR and other signal pathways after knocking down CLEC5A，while the down-regula- ted genes were significantly enriched in cell cycle signal pathways．CLEC5A in leukemia cells significantly reduced the genes expression levels of BAX and p53，and significantly induced the gene expression levels of BCL-2 and phosphorylation levels of AKT1 and mTOR proteins． Conclusion CLEC5A increases the cell cycle and proliferation and inhibits cells apoptosis in THP-1 and K562 cells，and the mechanism may be related to activating the AKT / mTOR and p53 signaling pathways.

Objective : To investigate the expression of N6-methyladenosine modification ( m6 A) and related en- zymes FTO，METTL3 and YTHDF2 in gastric epithelial cells infected with Helicobacter pylori (Hp) ，and to analyze its expression and clinical significance in gastric cancer by using online websites． Methods : Gastric epithelial cells GES-1 and AGS were infected with Hp GZ7 strain，and the multiplicity of infection was 30 ∶ 1．Total RNA and total protein were collected after infecting 24 h，and the m6 A modification level of total RNA was detected by RNA dot hybridization．The mRNA and protein expressions of FTO ，METTL3 and YTHDF2 were detected by q-PCR and Western blot．The expression difference of FTO，METTL3 and YTHDF2 in gastric cancer tissues and normal tissues and their expression in Stage classification were analyzed by GEPIA，and the relationship between the expression of FTO，METTL3 and YTHDF2 and prognosis was analyzed by Kaplan-Meier Plotter. Results : Compared with the un- infected group，the m6 A modification level of total RNA in both Hp-infected GES-1 and AGS cells significantly de- creased，the mRNA and protein expression levels of FTO increased，and the mRNA and protein levels of METTL3 and YTHDF2 decreased，with statistical significance (P＜0. 05) ．The expression level of FTO in gastric cancer tis- sues was higher than that in normal tissues，with statistical significance (P＜0. 05) ，YTHDF2 was higher than that in normal tissues，with no statistical significance，and the expression level of METTL3 was lower than that in nor- mal tissues，with no statistical significance．Patients with high expression of FTO and METTL3 had a lower survival rate，while patients with high expression of YTHDF2 had a higher survival rate．The expression of FTO was signifi- cantly correlated with Stage classification (P＜0. 05) ，while the expression of METTL3 and YTHDF2 was not sig- nificantly correlated with Stage classification． Conclusion Hp infection can change the level of m6 A and the ex- pression of related enzymes FTO，YTHDF2 and METTL3，suggesting that m6 A methylation may play a role in the occurrence and development of Hp-induced gastric cancer.

Object:To conduct a scoping review of maternal readiness for hospital discharge, so as to provide references for future clinical research and practice on maternal and infant care.Methods:Using the scoping review guidelines of Joanna Briggs Institute in Australia as the methodological framework, the relevant studies on maternal readiness for hospital discharge were searched by computer on PubMed, Web of Science, Scopus, CNKI, Wanfang Database, Chinese Science and Technology Journal Database and China Biology Medicine disc. The search period was from the establishment of the databases to October 20, 2022.Results:A total of 24 artiles were included. The influencing factors of maternal readiness for hospital discharge included sociodemographic factors, maternity factors, psychological factors, children factors, family social factors, medical staff related factors and other factors. The intervention measures of maternal readiness for hospital discharge included the establishment of discharge preparation team, the measures from hospital admission to prenatal period, the measures from postpartum to the day of discharge and the measures after discharge. There were many kinds of scales for maternal readiness for hospital discharge, and there was no unified assessment standard.Conclusions:The level of maternal readiness for hospital discharge is different, and its influencing factors should be paid attention to. In the future, further research can be conducted on intervention measures and evaluation standards for maternal discharge readiness, providing references for improving the level of maternal discharge readiness.