This article summarizes the experience of providing remote nursing care for a pediatric patient with severe burns using augmented reality(AR)technology.Key nursing points include:to establish a remote management team to enhance multidisciplinary collaboration;to conduct remote nursing ward rounds to provide real-time guidance for clinical nursing practice;to remotely guide PICC(Peripherally Inserted Central Catheter)insertions and conduct precise fluid management;to remotely assess ward environments and provide guidance on disinfection and isolation measures;to alleviate pediatric pain through comprehensive management measures.After meticulous care and treatment,the patient's condition stabilized after 23 days,and the patient was transferred to a specialized hospital for continued treatment requiring skin grafting.

Objective:To explore any effect of electrical stimulation of the right median nerve (RMNS) in modulating arousal patterns in the prefrontal cortex of a healthy adult.Methods:Twenty-three right-handed healthy participants received block-designed patterns of RMNS arousal. Functional near-infrared spectroscopy (fNIRS) was used to record any hemodynamic response in their prefrontal cortex. Changes in oxyhemoglobin (HbO), deoxyhemoglobin (HbR), and total hemoglobin (HbT) were analyzed by comparing the levels in stimulation blocks with resting-state periods.Results:fNIRS revealed significant activation of HbO signals in the left frontopolar area (channel 15) and the right frontopolar area (channels 37, 43 and 48) following RMNS arousal. There were significant differences in the HbR signals from the right frontopolar area (channel 41). There were, however, no significant differences in the HbT signals across all the measured channels.Conclusion:RMNS arousal enhances neurometabolic activity within the frontopolar sub-region of the prefrontal cortex in healthy adults.

AIM:To establish a population phar-macokinetic(PPK)model of high-dose methotrex-ate in pediatric patients with diverse malignancies.METHODS:The PPK model of methotrexate was de-veloped using non-linear mixed-effects model;body surface area(BSA)was incorporated by allo-metric size modelling.RESULTS:A two-compart-ment linear model best fitted the concentration da-ta,typical values for clearance(CL)and central compartment distribution volume(Vd)were re-vealed to be 4.51 L/(h·1.73 m2)and 15.47 L/1.73 m2,respectively.Age,BSA,serum creatinine(SCr)and genotypes of ABCC2 rs717620 and ABCC4 rs2274407 were retained in the final model.CON-CLUSION:Age,BSA,SCr and genotypes of ABCC2 rs717620 and ABCC4 rs2274407 were identified to be significantly affecting the clearance.

This article summarizes the experience of providing remote nursing care for a pediatric patient with severe burns using augmented reality(AR)technology.Key nursing points include:to establish a remote management team to enhance multidisciplinary collaboration;to conduct remote nursing ward rounds to provide real-time guidance for clinical nursing practice;to remotely guide PICC(Peripherally Inserted Central Catheter)insertions and conduct precise fluid management;to remotely assess ward environments and provide guidance on disinfection and isolation measures;to alleviate pediatric pain through comprehensive management measures.After meticulous care and treatment,the patient's condition stabilized after 23 days,and the patient was transferred to a specialized hospital for continued treatment requiring skin grafting.

AIM:To establish a population phar-macokinetic(PPK)model of high-dose methotrex-ate in pediatric patients with diverse malignancies.METHODS:The PPK model of methotrexate was de-veloped using non-linear mixed-effects model;body surface area(BSA)was incorporated by allo-metric size modelling.RESULTS:A two-compart-ment linear model best fitted the concentration da-ta,typical values for clearance(CL)and central compartment distribution volume(Vd)were re-vealed to be 4.51 L/(h·1.73 m2)and 15.47 L/1.73 m2,respectively.Age,BSA,serum creatinine(SCr)and genotypes of ABCC2 rs717620 and ABCC4 rs2274407 were retained in the final model.CON-CLUSION:Age,BSA,SCr and genotypes of ABCC2 rs717620 and ABCC4 rs2274407 were identified to be significantly affecting the clearance.

Objective:To explore any effect of electrical stimulation of the right median nerve (RMNS) in modulating arousal patterns in the prefrontal cortex of a healthy adult.Methods:Twenty-three right-handed healthy participants received block-designed patterns of RMNS arousal. Functional near-infrared spectroscopy (fNIRS) was used to record any hemodynamic response in their prefrontal cortex. Changes in oxyhemoglobin (HbO), deoxyhemoglobin (HbR), and total hemoglobin (HbT) were analyzed by comparing the levels in stimulation blocks with resting-state periods.Results:fNIRS revealed significant activation of HbO signals in the left frontopolar area (channel 15) and the right frontopolar area (channels 37, 43 and 48) following RMNS arousal. There were significant differences in the HbR signals from the right frontopolar area (channel 41). There were, however, no significant differences in the HbT signals across all the measured channels.Conclusion:RMNS arousal enhances neurometabolic activity within the frontopolar sub-region of the prefrontal cortex in healthy adults.

Objective:To explore the characteristics of functional connectivity (FC) and regional spontaneous brain activity in patients in a minimally-conscious state (MCS).Methods:Resting-state functional near-infrared spectroscopy (rs-fNIRS) was used. Ten minimally-conscious patients were studied along with 12 healthy counterparts as healthy controls (HC). Five minutes of rs-fNIRS data were recorded from each subject and FC and the fractional amplitude of low-frequency fluctuations (fALFFs) of 53 channels were computed using the NIRS-KIT toolbox. The results were compared between the two groups.Results:Compared with the HC group, a significant decrease was observed in the average FC strength of seventeen channel pairs after false discovery rate (FDR) correction. Most were in the right and left frontal pole, as well as the dorsolateral prefrontal lobe. Compared with the HC group, the average fALFF values of Broca′s area (channel 2), the premotor cortex and the supplementary motor cortex (channels 4, 10, and 40), the dorsolateral prefrontal lobe (channels 6, 11, 25, 39), the eye motor area of the frontal lobe (channel 12) and the frontal pole (channels 23, 27, 36) were significantly greater in the MCS group. The fluctuations of the frontal pole (channel 19) were significantly less (after FDR correction).Conclusion:In an MCS spontaneous neural activity is over-active in the prefrontal lobe and some speech- and motor-related brain regions, and coordination of the internal prefrontal functional network is disordered.

Objective:This study aimed to explore the feasibility and clinical value of monitoring the progression of early kidney injury in type 2 diabetic patients by assessment of the urinary C-terminal agrin fragment (uCAF) with enzymatic chemiluminescence immunoassay.Methods:A total of 251 patients with type 2 diabetes, who attended the Second Affiliated Hospital of Wenzhou Medical University from October 2018 to March 2020, were included in this retrospective analysis. One hundred and fifty-six participants undergoing health check-up at the Second Affiliated Hospital of Zhejiang University School of Medicine in February 2021 served as controls. Basic clinical information, glycosylated hemoglobin type A 1c and serum creatinine values were recorded, and urine specimens were collected for urinary creatinine, urinary α 1 microglobulin(uα 1M), urinary immunoglobulin G (uIgG), urinary albumin, urinary N-Acetyl-B-D-glycosaminidase (uNAG) and uCAF measurements. Based on the estimated glomerular filtration rate (eGFR), 251 patients were classified into G1~G5 stage groups with 116, 22, 28, 55 and 30 patients in each group. One hundred and sixty-six patients with early diabetic kidney disease (stage G1-G3) were divided into subgroups A1 (79), A2 (48) and A3 (39) according to the urinary albumin/creatinine ratio (UACR), the uα1M levels were divided into uα1M subgroup 1 (83 cases), uα1M subgroup 2 (42 cases), and uα1M subgroup 3 (41 cases), and uIgG subgroup 1 (83 cases), uIgG subgroup 2 (42 cases), and uIgG subgroup 3 (41 cases) according to uIgG levels. The Spearman method was used to analyze the correlation between uCAF levels and eGFR, UACR, uα1M and uIgG levels. Results:(1) The linear range of the uCAF detected by enzymatic chemiluminescence immunoassay was 3.97-2 000.00 ng/ml, with a detection limit of 2.28 ng/ml, intra-batch coefficients of variation of 1.15% and 1.57%, inter-batch coefficients of variation of 1.63% and 5.78%, and a biological reference interval of <95.35 μg/g Cr. (2) The uCAF level and positive rate (UACR≥30 mg/g) increased with the decrease of eGFR from G1-G3, uCAF level was negatively correlated with eGFR value ( r=-0.543, P<0.000 1), and the positive rate increased from 24.14% (28/116) to 85.71% (24/28) from G1-G3. The uCAF level and positivity rate decreased with the decrease of eGFR from G4 to G5. uCAF level was positively correlated with eGFR value ( r=0.495, P<0.001), and the positivity rate decreased from 30.91% (17/55) to 23.33% (7/30) from G4 to G5. (3) In patients with early diabetic kidney disease, uCAF levels and positivity rates increased gradually with the increase of UACR. uCAF levels were positively correlated with UACR values ( r=0.602, P<0.001), and the uCAF positivity rate reached 21.52% (17/79) in the A1 subgroup. (4) uCAF level was positively correlated with uα1M and uIgG levels in patients with early diabetic kidney disease ( r=0.757, 0.596, both P<0.001). Conclusion:Analytical performance of enzyme chemiluminescence immunoassay for the detection of CAF is satisfactory and could be used a biomarker for monitoring damage and progression of early diabetic kidney disease in patients with type 2 diabetes.

Objective:In order to analyze the current research status of handover shift in nursing management, summarize, analyze and judge the existing literature, in order to provide reference for clinical nursing practice.Methods:Through literature review, it is planned to review the current situation, shortcomings and future development of nursing handover classes.Results:The handover process was generally divided into four stages, of which SBAR was the best practice tool for handing over key information. For the performance of handover shifts, NASR, PVNC-BR, HES and Handoff CEX were often used to evaluate the performance of shifts, and for the results of shifts, evaluations were mostly conducted at the levels of patient safety, process elements, and organizational management. At present, the use of electronic information systems, benign organizational culture and patient and family-centered clinical practice could effectively improve the efficiency and effectiveness of handover.Conclusions:The process and elements of the current shift mode are relatively complete, and the communication strategy is reasonable, but there are still many shortcomings and defects. This suggests that nursing managers should adopt scientific intervention methods and evaluation tools when paying attention to and reforming nursing handover in the future to continuously improve the quality of handover.

AIM:We investigated how AT 1-R stimulated by mechanical stresses induces cardiac fibrosis .METHODS:We produced in vivo cardiac pressure overload model in angiotensinogen knockout ( ATG-/-) mice and in vitro mechanically-stretched cell model in cultured neonatal cardiac cells of ATG-/-mice both lack the participation of Ang II .RESULTS: Pressure overload for 4 weeks in ATG-/-mice induced myocardial hypertrophy accompanied by the significant interstitial fibrosis , however , the TGF-β, a key regulatory factor of fibrosis, was not significantly increased in these ATG-/-mice.Meanwhile, the inhibitor for AT1-R significantly inhibited mechani-cal stress-induced cardiac fibrosis in these ATG-/-models whereas inhibition of TGF-βdid not.CONCLUSION:The results showed that mechanical stress-induced fibrotic responses through AT 1-R required the phosphorylation of Smad 2 but not the involvement of TGF-β.