Objective To explore the application effect of the"safe harbor"humanistic care program in mechanically ventilated patients.Methods A quasi experimental study design method was used to select 106 mechanically ventilated patients admitted to the department of intensive care unit(ICU)of the First Affiliated Hospital of Nanchang University from December 2024 to February 2025 as the study subjects.They were randomly divided into a control group and an experimental group,with 53 patients in each group.The control group adopted a conventional nursing mode(pain relief and sedation management,daily awakening,active and passive limb activities,respiratory function exercise,nutritional and psychological support,etc.),while the experimental group implemented a"safe harbor"humanistic care mode plan based on conventional nursing(structured visit management,therapeutic environment creation,professional nursing process optimization,and multidimensional safety guarantee system,including 6 dimensions and 16 measures,mainly including:family support system reconstruction,progressive activity training,structured visit management,therapeutic environment creation,professional nursing process optimization,and multidimensional safety guarantee system).The difference in the incidence of anxiety and depression,ICU-acquired weakness(ICU-AW),ICU delirium and mechanical ventilation time,ICU hospitalization time,Barthel index scores were compared between the two groups.Results Ultimately,97 patients completed the study,with 52 in the control group and 45 in the experimental group.The incidence of anxiety and depression,ICU-AW,delirium in the experimental group was significantly reduced compared to the control group[anxiety and depression incidence:26.67%(12/45)vs.46.15%(24/52),ICU-AW incidence:13.33%(6/45)vs.40.38%(21/52),delirium incidence:17.78%(8/45)vs.42.31%(22/52),all P<0.05],the ICU hospitalization time and mechanical ventilation time in the experimental group were significantly shortened compared to the control group[ICU hospitalization time(days):9(8,10)vs.10(9,11),mechanical ventilation time(hours):67.0(60.5,78.5)vs.85.0(63.0,75.0),both P<0.05].The Barthel index score significantly increased[66.0(56.0,75.5)vs.58.0(48.5,69.5),P<0.05].Conclusion The"safe harbor"humanistic care model can improve the physical and mental outcomes of mechanically ventilated patients and has clinical promotion value.

Objective To explore the application effect of the"safe harbor"humanistic care program in mechanically ventilated patients.Methods A quasi experimental study design method was used to select 106 mechanically ventilated patients admitted to the department of intensive care unit(ICU)of the First Affiliated Hospital of Nanchang University from December 2024 to February 2025 as the study subjects.They were randomly divided into a control group and an experimental group,with 53 patients in each group.The control group adopted a conventional nursing mode(pain relief and sedation management,daily awakening,active and passive limb activities,respiratory function exercise,nutritional and psychological support,etc.),while the experimental group implemented a"safe harbor"humanistic care mode plan based on conventional nursing(structured visit management,therapeutic environment creation,professional nursing process optimization,and multidimensional safety guarantee system,including 6 dimensions and 16 measures,mainly including:family support system reconstruction,progressive activity training,structured visit management,therapeutic environment creation,professional nursing process optimization,and multidimensional safety guarantee system).The difference in the incidence of anxiety and depression,ICU-acquired weakness(ICU-AW),ICU delirium and mechanical ventilation time,ICU hospitalization time,Barthel index scores were compared between the two groups.Results Ultimately,97 patients completed the study,with 52 in the control group and 45 in the experimental group.The incidence of anxiety and depression,ICU-AW,delirium in the experimental group was significantly reduced compared to the control group[anxiety and depression incidence:26.67%(12/45)vs.46.15%(24/52),ICU-AW incidence:13.33%(6/45)vs.40.38%(21/52),delirium incidence:17.78%(8/45)vs.42.31%(22/52),all P<0.05],the ICU hospitalization time and mechanical ventilation time in the experimental group were significantly shortened compared to the control group[ICU hospitalization time(days):9(8,10)vs.10(9,11),mechanical ventilation time(hours):67.0(60.5,78.5)vs.85.0(63.0,75.0),both P<0.05].The Barthel index score significantly increased[66.0(56.0,75.5)vs.58.0(48.5,69.5),P<0.05].Conclusion The"safe harbor"humanistic care model can improve the physical and mental outcomes of mechanically ventilated patients and has clinical promotion value.

Objective:To explore the relationship between white matter integrity and cognitive function in first-episode children and adolescents with schizophrenia by diffusion tensor imaging (DTI).Methods:Totally 84 children and adolescents with first-episode schizophrenia who were hospitalized in the Department of Child and Adolescent Psychiatry at the Second Affiliated Hospital of Xinxiang Medical University from September 2017 to June 2021 were selected as the study group, and 35 healthy children and adolescents matched with the study group were selected as the control group. Positive and negative symptom scale (PANSS) was used to assess the patient's mental symptoms. Diffusion tensor imaging (DTI) scans were performed, and the structural integrity of white matter fibers in the brain was measured by tract-based spatial statistics (TBSS), with the indicators including fractional anisotropy (FA). The Chinese version of measurement and treatment research to improve cognition in schizophrenia consensus cognitive battery (MCCB) and the Stroop color-word test were used to evaluate the cognitive function of all subjects. SPSS 26.0 software was used to analyse the data by analysis of variance, independent sample t-test, Mann Whitney U-test and Pearson correlation analysis. Results:(1)The FA values of the right superior longitudinal tract (MNI: x=49, y=-40, z=31) and the left corticospinal tract (MNI: x=-27, y=-22, z=-19) in the study group were higher than those in the control group(both P<0.05). The FA values of the bilateral cingulate gyrus (MNI: x=-7, y=25, z=14; x=20, y=-50, z=25) and the occipital part of the corpus callosum radiation line (MNI: x=-19, y=-50, z=21) in the study group were lower than those in the control group(both P<0.05).(2)The trail making test score of the study group was higher than that of the control group( t=4.344, P<0.01), and the scores of the symbol coding, Hopkins verbal learning test-revised( HVLT-R), brief visuospatial memory test-revised(BVMT-R), word fluency test, number span, maze, Stroop word, Stroop color and Stroop color words were lower than those in the control group( t=-13.041--3.204, all P<0.05). (3) The FA value of right cingulate gyrus (hippocampus) was negatively correlated with the number span ( r=-0.269, P=0.023).The FA value in occipital part of the corpus callosum radiation line was positively correlated with the symbol code ( r=0.237, P=0.047).The FA value of the left lower longitudinal bundle was negatively correlated with the Stroop color and maze ( r=-0.289, -0.275; P=0.010, 0.020).The FA value of the right inferior longitudinal fasciculus was negatively correlated with the score of maze ( r=-0.254, P=0.032). The FA value of occipital part of the corpus callosum radiation line was positively correlated with positive symptom score ( r=0.170, P=0.040). Conclusion:Cognitive dysfunction in children and adolescent with first-episode schizophrenia may be related to abnormal white matter integrity in the brain.

Objective To investigate the correlation between serum indirect bilirubin(IBIL)levels and carotid intima-media thickness(CIMT)of acute cerebral infarction patients.Methods A total of 229 patients with acute cerebral infarction at Wuxi No.2 Chinese Medicine Hospital from July 2021 to November 2023 were divided into the intima-media thickness group(CIMT≥0.9mm,n=108)and intima-media normal group(CIMT<0.9mm,n=121)according to CIMT values.The differences in gender,age,body mass index,smoking history,history of alcohol drinking,hypertension,coronary heart disease,diabetes,hyperlipidemia,total bilirubin(TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL),total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,triglyceride,fasting blood glucose,uric acid,and cystatin C were compared between the two groups.To further elucidate the association between serum bilirubin levels and CIMT using both univariate and multivariate analysis.Results The two groups showed significant differences in gender,body mass index and IBIL in the results(P<0.05).However,there was no significant difference in age,history of alcohol drinking,smoking history,diabetes,coronary heart disease,hypertension,hyperlipidemia,TBIL,DBIL,total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,triglyceride,fasting blood glucose,uric acid and cystatin C levels(P>0.05).Binary Logistic regression analysis indicated that gender,body mass index and IBIL were significant independent predictors of CIMT values(P<0.05).Conclusion Serum indirect bilirubin level is inversely associated with CIMT in acute cerebral infarction patients,which may be one of the protective factors of atherosclerosis.

Gene editing technology is a genetic operation technology that can modify the DNA sequence at the genomic level. The precision gene editing technology based on CRISPR/Cas9 system is a gene editing technology that is easy to operate and widely used. Unlike the traditional CRISPR/Cas9 system, the precision gene editing technology can perform site-directed mutation of genes without DNA template. This review summarizes the recent development of precision gene editing technology based on CRISPR/Cas9, and prospects the challenges and opportunities of this technology.
Gene Editing ; CRISPR-Cas Systems/genetics* ; Mutation ; Genome

Objective To detect the expression difference of dynactin 2(DCTN2)and cell-cycle-related and expression-elevat-ed protein in tumor(CREPT)in gastric cancer and paracancer tissues,and to explore the relationship between DCTN2 and CREPT ex-pressions and the clinicopathological characteristics and prognosis of gastric cancer patients.Methods A total of 90 patients who received gastric cancer surgery from March 2014 to September 2015 in Affiliated Hospital of Xuzhou Medical University and were confirmed by his-tology were enrolled.The expression levels of DCTN2 and CREPT in gastric cancer tissues and paracancer tissues were detected by immu-nohistochemistry,and the Spearman correlation analysis was used to analyze the relationship between DCTN2 and CREPT in gastric cancer tissues;the relationship between their levels and clinicopathological characteristics were analyzed;Kaplan-Meier and Log-rank analysis were used to analyze the relationship between the expression levels of DCTN2 and CREPT and the overall survival time of gastric cancer patients;univariate and multivariate COX regression analysis were used to analyze the independent risk factors influencing prognosis of gastric cancer patients.Results The expression levels of DCTN2 and CREPT in gastric cancer tissues were significantly higher than that in paracancer tissues,and DCTN2 was positively correlated with CREPT in gastric cancer tissues(P<0.05).The expression levels of DCTN2 and CREPT were correlated with the tumor differentiation,TNM stage,invasion depth,lymph node metastasis(P<0.05),but were not significantly correlated with gender,age and distant metastasis(P>0.05);the results of prognosis analysis showed that the 1-year,3-year and 5-year cumulative survival rate and overall survival rate of gastric cancer patients in the DCTN2high-expression group were significantly lower than those in the DCTN2 low-expression group,and the 5-year cumulative survival rate and overall sur-vival rate of gastric cancer patients in the CREPT high-expression group were significantly lower than those in the CREPT low-expres-sion group(P<0.05).Univariate and multivariate COX regression analysis showed that both DCTN2 and CREPT were independent risk factors on the prognosis of gastric cancer patients.Conclusion DCTN2 and CREPT are highly expressed in gastric cancer tissues and their high expression were closely related to the poor prognosis of gastric cancer patients.DCTN2 and CREPT were expected to be potential markers and new therapeutic targets for gastric cancer diagnosis,and help to judge the prognosis of gastric cancer patients.

Objective:This study aims to analyze the structural characteristics and fibrous structural integrity of the white matter of the brain and their relationship with obsessive-compulsive symptoms in children and adolescents with first-onset obsessive-compulsive disorder (OCD).Methods:Thirty-eight patients with OCD (OCD group) and 35 age-, sex-, and education-matched controls (control group) were included. The brain white matter volume was measured using voxel-based morphometry (VBM) with diffusion tensor imaging (DTI) scans. The tract-based spatial statistics (TBSS), including fractional anisotropy (FA), mean diffusivity (MD), and axial diffusivity (AD), were applied to measure the structural integrity of white matter fibres. The independent samples t-test was used to compare FA, MD, and AD values in differential brain areas between the 2 groups. The clinical characteristics of the patients were assessed using the Yale-Brown Obsessive-Compulsive Symptom Scale for Children. Pearson′s correlation analysis was used to analyze the relationship between the severity of the obsessive-compulsive symptoms and the white matter volume of the brain and the FA, MD, and AD values of the significantly different brain areas in the OCD group. Results:Compared to the control group, the OCD group had lower white matter volumes in the left inferior frontal gyrus, right inferior temporal gyrus, right inferior frontal gyrus, left parietal gyrus, and left limbic lobe ( t=-3.67, -4.21, -3.58, -3.70, -4.34, all P<0.01); had higher FA, MD, and AD values in the left corticospinal tract, left superior longitudinal tract; had higher MD and AD values in the right corticospinal tract, right and left anterior thalamic radiations, right and left inferior fronto-occipital gyrus, and left inferior longitudinal gyrus; had higher FA, MD, and AD values in the occipital and frontal part of the corpus callosum radiation; had a lower FA value in the left and right anterior thalamic radiation, left and right inferior frontal gyrus, left cingulate gyrus, left and right inferior longitudinal gyrus, and right superior longitudinal gyrus (temporal); and had a lower AD value in the left hook gyrus and right superior longitudinal gyrus. In the OCD group, the Pearson′s correlation analysis showed that the white matter volume of the right inferior frontal gyrus was negatively correlated with the obsessive-compulsive thinking factor score ( r=-0.355, P<0.05), and the left parietal gyrus was negatively correlated with the total obsessive-compulsive score, the obsessive-compulsive thinking factor score, and the obsessive-compulsive behavior factor score ( r=-0.361, -0.350, -0.376, all P<0.05); that the FA value in the occipital part of the corpus callosum radiation was negatively correlated with the total obsessive-compulsive score and the obsessive-compulsive behavior factor score ( r=-0.410, -0.411, both P<0.05), the MD values in the left and right anterior thalamic radiation were both negatively correlated with total compulsive scores ( r=-0.389, P<0.05; -0.489, P<0.01), the AD values in the left and right anterior thalamic radiation were both negatively correlated with total compulsive scores ( r=-0.446, -0.405, both P<0.05),the MD and AD values in the left and right anterior thalamic radiation were both negatively correlated with compulsive behavior factor scores ( r=-0.558, -0.631, -0.530, -0.539, all P<0.01), and the AD value in the left subfrontal occipital tract was negatively correlated with compulsive total score and compulsive thinking factor score ( r=-0.359, P<0.05; r=-0.499, P<0.01). Conclusion:Children and adolescents with OCD have reduced white matter volume and impaired structural integrity of white matter fibres, involving the cortico-striato-thalamo-cortical circuit and several brain regions, such as the parietal lobe, limbic lobe, corpus callosum, corticospinal tract, and inferior longitudinal tract. The abnormalities in white matter structure and structural integrity of fibres are correlated with the severity of OCD symptoms.

Objective:This study aims to analyze the structural characteristics and fibrous structural integrity of the white matter of the brain and their relationship with obsessive-compulsive symptoms in children and adolescents with first-onset obsessive-compulsive disorder (OCD).Methods:Thirty-eight patients with OCD (OCD group) and 35 age-, sex-, and education-matched controls (control group) were included. The brain white matter volume was measured using voxel-based morphometry (VBM) with diffusion tensor imaging (DTI) scans. The tract-based spatial statistics (TBSS), including fractional anisotropy (FA), mean diffusivity (MD), and axial diffusivity (AD), were applied to measure the structural integrity of white matter fibres. The independent samples t-test was used to compare FA, MD, and AD values in differential brain areas between the 2 groups. The clinical characteristics of the patients were assessed using the Yale-Brown Obsessive-Compulsive Symptom Scale for Children. Pearson′s correlation analysis was used to analyze the relationship between the severity of the obsessive-compulsive symptoms and the white matter volume of the brain and the FA, MD, and AD values of the significantly different brain areas in the OCD group. Results:Compared to the control group, the OCD group had lower white matter volumes in the left inferior frontal gyrus, right inferior temporal gyrus, right inferior frontal gyrus, left parietal gyrus, and left limbic lobe ( t=-3.67, -4.21, -3.58, -3.70, -4.34, all P<0.01); had higher FA, MD, and AD values in the left corticospinal tract, left superior longitudinal tract; had higher MD and AD values in the right corticospinal tract, right and left anterior thalamic radiations, right and left inferior fronto-occipital gyrus, and left inferior longitudinal gyrus; had higher FA, MD, and AD values in the occipital and frontal part of the corpus callosum radiation; had a lower FA value in the left and right anterior thalamic radiation, left and right inferior frontal gyrus, left cingulate gyrus, left and right inferior longitudinal gyrus, and right superior longitudinal gyrus (temporal); and had a lower AD value in the left hook gyrus and right superior longitudinal gyrus. In the OCD group, the Pearson′s correlation analysis showed that the white matter volume of the right inferior frontal gyrus was negatively correlated with the obsessive-compulsive thinking factor score ( r=-0.355, P<0.05), and the left parietal gyrus was negatively correlated with the total obsessive-compulsive score, the obsessive-compulsive thinking factor score, and the obsessive-compulsive behavior factor score ( r=-0.361, -0.350, -0.376, all P<0.05); that the FA value in the occipital part of the corpus callosum radiation was negatively correlated with the total obsessive-compulsive score and the obsessive-compulsive behavior factor score ( r=-0.410, -0.411, both P<0.05), the MD values in the left and right anterior thalamic radiation were both negatively correlated with total compulsive scores ( r=-0.389, P<0.05; -0.489, P<0.01), the AD values in the left and right anterior thalamic radiation were both negatively correlated with total compulsive scores ( r=-0.446, -0.405, both P<0.05),the MD and AD values in the left and right anterior thalamic radiation were both negatively correlated with compulsive behavior factor scores ( r=-0.558, -0.631, -0.530, -0.539, all P<0.01), and the AD value in the left subfrontal occipital tract was negatively correlated with compulsive total score and compulsive thinking factor score ( r=-0.359, P<0.05; r=-0.499, P<0.01). Conclusion:Children and adolescents with OCD have reduced white matter volume and impaired structural integrity of white matter fibres, involving the cortico-striato-thalamo-cortical circuit and several brain regions, such as the parietal lobe, limbic lobe, corpus callosum, corticospinal tract, and inferior longitudinal tract. The abnormalities in white matter structure and structural integrity of fibres are correlated with the severity of OCD symptoms.

Objective:To explore the effect of positive psychological intervention based on PERMA model on the fear of cancer recurrence and psychological capital in breast cancer patients during chemotherapy.Methods:A total of 60 breast cancer patients who received chemotherapy from November 2019 to January 2020 were divided into intervention group and control group with 30 cases in each group. The control group received routine health education. On this basis, the intervention group was given 8 times of positive psychological intervention. The general situation questionnaire, Fear of Progression Questionnaire-Short Form (FoP-Q-SF) and Positive Psychological Capital Questionnaire (PPQ) were used to evaluate the results of the two groups before and after intervention.Results:Before, 4 weeks after and 8 weeks after the intervention, the score of fear of cancer recurrence in the intervention group were 39.67±4.24, 34.60±3.78 and 31.17±3.60. The difference of the score of fear of cancer recurrence at different time points was statistically significant ( F value was 257.757, P<0.05). The scores of psychological capital were 113.20±19.75, 125.57±18.79 and 134.43±17.59. The difference of psychological capital level at different time points was statistically significant ( F value was 154.225, P<0.05). Conclusions:Positive psychological intervention based on PERMA model can reduce the fear of cancer recurrence in breast cancer patients during chemotherapy and improve their psychological capital level.

Objective:To explore application and effect evaluation of group prenatal care model in primiparas.Methods:A total of primiparas were recruited from December 2019 to May 2020 in the department of Obstetric clinic. Group prenatal care was carried out in the intervention group and the routine nursing was implemented in the control group. Positive capital Questionnaire and pregnancy outcome were used to evaluate the effects of intervention.Results:The scores of pre-intervention, intervention for one month and post-intervention of PPQ was (123.87±18.86), (130.70±13.41) and (142.23±8.37) respectively. Higher level of natural childbirth rate([86.7%] versus [63.3%]; χ2=4.356; P=0.037<0.05) and lower rate of perineal injury([16.7%] versus [43.3%]; χ2=5.079; P=0.024<0.05). The rate of exclusive breastfeeding during hospitalization ([90.0%] versus [66.7%]; χ2=4.812; P=0.028<0.05) after intervention as compared with those who received routine care. Conclusion:Group prenatal care intervention model can improve the level of positive psychological capital and pregnancy outcome.