Objective To develop a continuous care program for patients with cardiac implantable electronic devices(CIED)utilizing the Omaha system,and to assess its effectiveness.This study aims to provide a reference for the continuous care of patients with CIED.Methods Using the Omaha system as the theoretical framework,based on literature search and semi-structured interviews,a continuity of care program for CIED patients based on the Omaha system was constructed through 2 rounds of expert inquiry.Convenience sampling method was used to select CIED implant patients from the cardiovascular department of a tertiary hospital in Wuhan as the research subjects.61 patients admitted from April to June 2024 were assigned as an experimental group with a continuity of care program based on the Omaha system;61 patients admitted from December 2023 to March 2024 were designated as a control group and received routine nursing measures.The Omaha performance indicators and quality of life at 3 months after discharge were compared between 2 groups upon admission and 1 month after discharge.Results The final 2 groups each included 59 patients.A month after discharge,the Omaha efficacy index in the experimental group was higher than that in the control group,and 3 months after discharge,the quality of life in the experimental group was higher than that in the control group(P＜0.001).Conclusion The CIED patient continuity of care program based on the Omaha system could improve patients'cognitive level,promote healthy behavior,enhance their self-efficacy,and improve their quality of life.

OBJECTIVES: The neurotoxicity of carbon monoxide (CO) to the central nervous system is a key pathogenesis of delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). Our previous study found that retinoic acid (RA) can suppress the neurotoxic effects of CO. This study further explores, in vivo and in vitro, the molecular mechanisms by which RA alleviates CO-induced central nervous system damage. METHODS: A cytotoxic model was established using the mouse hippocampal neuronal cell line HT22 and primary oligodendrocytes exposed to CO, and a DEACMP animal model was established in adult Kunming mice. Cell viability and apoptosis of hippocampal neurons and oligodendrocytes were assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and Annexin V/propidium iodide (PI) double staining. The transcriptional and protein expression of each gene was detected using real-time fluorescence quantitative PCR (RT-qPCR) and Western blotting. Long noncoding RNA (lncRNA) SNHG15 and LINGO-1 were knocked down or overexpressed to observe changes in neurons and oligodendrocytes. In DEACMP mice, SNHG15 or LINGO-1 were knocked down to assess changes in central nervous tissue and downstream protein expression. RESULTS: RA at 10 and 20 μmol/L significantly reversed CO-induced apoptosis of hippocampal neurons and oligodendrocytes, downregulation of SNHG15 and LINGO-1, and upregulation of brain-derived neurotrophic factor (BDNF) and tyrosine kinase receptor B (TrkB) (all P<0.05). Overexpression of SNHG15 or LINGO-1 weakened the protective effect of RA against CO-induced cytotoxicity (all P<0.05). Knockdown of SNHG15 or LINGO-1 alleviated CO-induced apoptosis of hippocampal neurons and oligodendrocytes and upregulated BDNF and TrkB expression levels (all P<0.05). Experiments in DEACMP model mice showed that knockdown of SNHG15 or LINGO-1 mitigated central nervous system injury in DEACMP (all P<0.05). CONCLUSIONS RA alleviates CO-induced apoptosis of hippocampal neurons and oligodendrocytes, thereby reducing central nervous system injury and exerting neuroprotective effects. LncRNA SNHG15 and LINGO-1 are key molecules mediating RA-induced inhibition of neuronal apoptosis and are associated with the BDNF/TrkB pathway. These findings provide a theoretical framework for optimizing the clinical treatment of DEACMP and lay an experimental foundation for elucidating its molecular mechanisms.
Animals ; RNA, Long Noncoding/physiology* ; Brain-Derived Neurotrophic Factor/genetics* ; Carbon Monoxide Poisoning/complications* ; Mice ; Tretinoin/pharmacology* ; Nerve Tissue Proteins/metabolism* ; Membrane Proteins/metabolism* ; Apoptosis/drug effects* ; Hippocampus/cytology* ; Receptor, trkB/metabolism* ; Neurons/drug effects* ; Male ; Brain Diseases/etiology* ; Oligodendroglia/drug effects* ; Signal Transduction ; Cell Line

Objective To develop a continuous care program for patients with cardiac implantable electronic devices(CIED)utilizing the Omaha system,and to assess its effectiveness.This study aims to provide a reference for the continuous care of patients with CIED.Methods Using the Omaha system as the theoretical framework,based on literature search and semi-structured interviews,a continuity of care program for CIED patients based on the Omaha system was constructed through 2 rounds of expert inquiry.Convenience sampling method was used to select CIED implant patients from the cardiovascular department of a tertiary hospital in Wuhan as the research subjects.61 patients admitted from April to June 2024 were assigned as an experimental group with a continuity of care program based on the Omaha system;61 patients admitted from December 2023 to March 2024 were designated as a control group and received routine nursing measures.The Omaha performance indicators and quality of life at 3 months after discharge were compared between 2 groups upon admission and 1 month after discharge.Results The final 2 groups each included 59 patients.A month after discharge,the Omaha efficacy index in the experimental group was higher than that in the control group,and 3 months after discharge,the quality of life in the experimental group was higher than that in the control group(P＜0.001).Conclusion The CIED patient continuity of care program based on the Omaha system could improve patients'cognitive level,promote healthy behavior,enhance their self-efficacy,and improve their quality of life.

ObjectiveTo explore the effect of emotional catharsis on the mental health status， coping style and satisfaction with the intervention among adolescents in Nanchong in the post-pandemic period. MethodsCompletely random sampling method was used to recruit 390 adolescents from 2 general secondary schools， 2 county secondary schools and 2 universities in Nanchong from January 2021 to April 2022. The subjects were divided into study group （n=195） and control group （n=195） by random number table method. The study group received emotional catharsis intervention. The control group received self-regulation and relaxation without any other intervention. Interventions for both groups lasted for 3 months. Before and after the intervention， the mental health status and coping style of the adolescents were assessed using the Symptom Checklist 90 （SCL-90） and the Simplified Coping Style Questionnaire （SCSQ）. Also， the participants rated the satisfaction with the intervention via self-made satisfaction questionnaire after the intervention. ResultsAfter intervention， the total SCL-90 score of study group was lower than that of control group （t=68.312， P<0.01）. In terms of SCSQ， study group scored higher on the positive coping dimension （t=30.488， P<0.01）， and lower on negative coping dimension （t=46.562， P<0.01） than those of control group. There were 190 （98.96%） cases satisfied with the intervention in the study group and 175 （89.74%） cases in the control group， the difference of intervention satisfaction rate between the two groups was statistically significant （χ²=15.321， P<0.01）. ConclusionIn the post-pandemic period， emotional catharsis may be conducive to improve the mental health status and coping style among adolescents in Nanchong， and adolescents have high levels of satisfaction with the intervention.

Cancer immunotherapy can effectively inhibit cancer progression by activating the autoimmune system, with low toxicity and high effectiveness. Some of cancer immunotherapy had positive effects on clinical cancer treatment. However, cancer immunotherapy is still restricted by cancer heterogeneity, immune cell disability, tumor immunosuppressive microenvironment and systemic immune toxicity. Cell membrane-coated nanoparticles (CMCNs) inherit abundant source cell-relevant functions, including "self" markers, cross-talking with the immune system, biological targeting, and homing to specific regions. These enable them to possess preferred characteristics, including better biological compatibility, weak immunogenicity, immune escaping, a prolonged circulation, and tumor targeting. Therefore, they are applied to precisely deliver drugs and promote the effect of cancer immunotherapy. In the review, we summarize the latest researches of biomimetic CMCNs for cancer immunotherapy, outline the existing specific cancer immune therapies, explore the unique functions and molecular mechanisms of various cell membrane-coated nanoparticles, and analyze the challenges which CMCNs face in clinical translation.

Objective:To investigate the exposure level of ionizing radiation in medical radiation workers in Guangdong province, as well as their abnormality in the lens of the eye, and to analyze associated influence factors.Methods:In this study, 1 501 radiation workers from 60 hospitals were selected by using convenient sampling method for retrospecotive analysis of absorbed doses ( DL) to the lens of the eye, health examination information and the relevant influence factors. Results:The median value M and the 25 th and 75 th percentile values ( P25, P75)of the distribution of absorbed doses were 4.86, 2.99 and 7.90 mGy, respectively. The median values for male and female were 5.14 and 3.94 mGy, respectively. The median values for the Levels I, Ⅱ and Ⅲ medical institutions were 2.95, 3.51 and 5.06 mGy, respectively. The median values were radiotherapy 4.05 mGy, radiodiagnosis 4.84 mGy, interventional radiology 5.39 mGy and nuclear medicine 6.71 mGy, as well as nurses 3.48 mGy, physicians 5.03 mGy and technologists 5.03 mGy, respectively. There were statistically significant differences in dose distribution for different gender, age, length of radiation service, age at the beginning of radiation exposure, level of medical institution, occupational category and post ( Z=-6.72, H=389.64, 511.17, 70.29, 53.29, 49.06, 39.89, P<0.05). The detectable rate for increased cortical density of lens was 22.45% (337/1 501) and for lens turbidity was 8.19% (123/1 501). The detectable rate of increased cortical density showed a linear increasing trend with the increase in age, age of radiation service, age at the beginning of exposure to radiation, level of medical institution and dose ( χ2=366.36, 313.77, 15.18, 21.61, 92.13, P<0.05). The detectable rate of lens opacity increased linearly with the increase in age, length of radiation service, level of medical institution and dose( χ2=69.64, 67.65, 67.65, 37.37, P<0.05), and decreased linearly with the increase in age at the beginning of radiation exposure ( χ2=4.25, P<0.05). Logistic regression analysis showed that age was the influencing factor of increased cortical density ( χ2=165.98, P<0.05), and the risk of cortical densification increased with age ( OR=1.33, 95% CI: 1.27-1.39). Age, length of radiation service and occupation were the influencing factors of lens opacity ( χ2=25.78, 4.99, 6.88, P<0.05). The risk of lens opacity increased with age ( OR=1.17, 95% CI: 1.10-1.24). The risk of lens opacity increased with age of radiation service ( OR=1.06, 95% CI: 1.01-1.12). The risk of ocular opacity was higher in interventional radiology than that in diagnostic radiology, radiotherapy and nuclear medicine ( OR=2.59, 95% CI: 1.27-5.25). Conclusions:Long-term exposure to low dose ionizing radiation has a certain correlation with the abnormal lens detectable rate of medical radiation workers. Age, length of radiation service and occupation are the influencing factors of lens opacity.

Objective:To explore the application effect of perioperative pain management based on nurse-based, anesthesiologist and specialist-supervised APS (NBASS-APS) model in patients undergoing radical resection of esophageal cancer under general anesthesia during perioperative period.Methods:A total of 520 patients with esophageal cancer who were admitted to Department of Thoracic Oncology in Affiliated Cancer Hospital of Zhengzhou University from October 2020 to September 2021 were selected as the research objects by the convenient sampling method. A total of 260 patients with esophageal cancer admitted from October 2020 to March 2021 were set as the control group, and 260 patients with esophageal cancer admitted from April to September 2021 were set as the observation group. The control group received conventional perioperative pain management, while the observation group received perioperative pain management based on NBASS-APS model. The operation, postoperative pain, postoperative recovery and adverse events were compared between the two groups.Results:The highest visual analogue scale (VAS) score, average VAS score, duration of the highest VAS level and duration of VAS score in the observation group were (4.59±1.54) , (1.72±1.34) , (2.56±1.62) h and (3.64±2.41) h, respectively. Compared with the control group, the differences were statistically significant ( P<0.01) . The first time to get out of bed and the length of hospital stay in the observation group were respectively (78.33±12.31) h and (8.16±2.53) d, which were shorter than those in the control group, and the differences were statistically significant ( P<0.05) . The incidence of excessive sedation, nausea, vomiting and other adverse reactions in the observation group were respectively 3.08%, 3.85%, 4.23%, which were lower than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The application of NBASS-APS model in perioperative pain management can effectively relieve the pain level of patients undergoing radical esophagectomy under general anesthesia, promote the postoperative recovery of patients and reduce the occurrence of adverse reactions.

Objective:To explore the clinical effect of multidisciplinary cooperative intervention in improving self-management and improving fluid retention in the elderly patients with chronic heart failure.Methods:Totally 130 cases of the elderly patients with chronic heart failure from January to December 2018 were enrolled and were divided into control group and observation group with 65 cases randomly. The control group received routine nursing instruction and telephone follow-up. The observation group was given multidisciplinary team guidance to patients self-management in addition to routine nursing instruction and telephone follow-up. After 3 months, the self-management and fluid retention of the two groups were compared.Results:After 3 months of intervention, the scores and total scores of the observation group in the four dimensions of drug management, diet management, psychological and social adaptation management, symptom management were 19.43±0.71,11.51±0.59,19.07±0.65,25.24±1.31, 72.65±7.16, the control group was 11.09±3.40, 6.05±1.71, 12.73±2.49, 15.72±4.18, 46.35±7.83. The scores and total scores of the observation group were better than those of the control group ( t value was 4.835-13.727, all P < 0.05).After intervention for 3 months, the proportion of severe edema, moderate edema and mild edema in the observation group was 4.61% (3/65), 13.85% (9/65), 81.54% (53/65), respectively, and the control group was 38.46% (25/65), 52.31% (34/65) and 9.23% (6/65) respectively. The degree of fluid retention in the observation group was better than that in the control group ( Z value was -2.373, all P < 0.05). Conclusion:Multidisciplinary cooperative intervention can improve self-management and improve fluid retention in elderly patients with chronic heart failure.

Objective: To explore prevalence of childhood neglect and autonomic nervous function, and its association in sixth graders students in Harbin, and to provide clues to improve physical and mental health of children and adolescents. Methods: Cluster sampling method was used to select 1 259 students from grade 6 in 5 schools in two districts of Harbin, and Childhood Trauma Questionnaire-Short Form (CTQ-SF) and TOHO University Medical Index (TMI) were filled in. Results: The total rate of childhood neglect was 45.7%, of which the rate of emotional neglect and physical neglect were 18.8%, 40.8%. The rate of autonomic nerves disorder was 47.2%. The rate of autonomic nerves disorder in students suffered from neglect, emotional neglect, physical neglect are higher than those without any of neglect(χ2=50.52, 32.02, 43.61, P<0.01), and with the increase of the degree of neglect, the rate of autonomic nervous disorder were gradually increasing(χ2=47.99, 47.07, 49.24, P<0.01). After controlled for gender, neglect, emotional neglect, physical neglect were positively associated with autonomic nerves disorder(OR=1.53-2.34, P<0.05), and the odd ratio for autonomic nerves disorder among those with mild-to-moderate,moderate-to-severe and extremely servere neglect was 1.37, 1.83, 5.10 compared to those with none or mild neglect. Conclusion Childhood neglect is closely related to adolescent the autonomic nerves disorder in sixth graders students in Harbin. Moreover, the more serious the childhood neglect is, the higher the detection rate of autonomic nerves disorder is. In order to improve the physical and mental health of children and adolescents, it is necessary to pay attention to childhood neglect and early assessment of their autonomic function.

To explore the mediating role of psychological resilience to childhood abuse and binge eating. This study assessed the childhood abuse, binge eating and psychological resilience of 3 453 middle school students in Harbin city, Heilongjiang Province. SPSS PROCESS macro program, combined with Bootstrap method, was employed to explore the mediating effect of psychological resilience. The incidence of middle school students experiencing at least one type of abuse in their childhood was 81.3% (2 807/3 453). Childhood abuse, psychological resilience and binge eating were all significantly different in terms of gender, household registration and whether they were only child (all P values<0.05). There was a significant positive correlation between childhood abuse and binge eating. Psychological resilience was negatively associated with childhood abuse and binge eating. Childhood abuse could not only directly predict the binge eating behavior of adolescents, but also could indirectly affect it via psychological resilience.