Objective To explore the correlation of MET status in patients with advanced prostatic acinar adenocarcinoma with the clinical pathological parameters and prognosis. Methods The specimen from 135 patients with advanced prostatic acinar adenocarcinoma was included. The expression of c-MET protein was detected via immunohistochemistry, and MET gene amplification was assessed by fluorescence in situ hybridization. The relationships of c-MET expression and gene amplification with clinicopathological features and prognosis were analyzed. Results The positive expression rate of c-MET was 52.60% (71/135). Compared with the c-MET expression in adjacent tissues, that in tumor tissues showed lower heterogeneous expression. Among the cases, 1.71% (2/117) exhibited MET gene polyploidy, but no gene amplification was detected. Positive c-MET expression was significantly correlated with high Gleason scores and grade groups (P=0.0073). However, no significant relationship was found between c-MET expression and progression-free survival or post-treatment t-PSA levels. Conclusion c-MET protein is expressed at a relatively low level in advanced prostatic acinar adenocarcinoma, suggesting that c-MET may not be a viable target for ADC drug development in prostatic acinar adenocarcinoma.

Objective To observe the effect of Jiawei Jianshen prescription on idiopathic membranous nephropathy(IMN)with spleen-kidney deficiency and its influence on phospholipase A2 receptor(PLA2R)titer.Methods A total of 60 patients with IMN who were hospitalized or outpatients in Liuzhou Traditional Chinese Medical Hospital from January 2021 to July 2022 were selected and divided into control group and treatment group by simple random sampling method,with 30 cases in each group.The control group was given basic treatment alone,and the treatment group was given Jiawei Jianshen prescription + basic treatment.Blood urea nitrogen(BUN),serum creatinine(SCr),serum albumin(ALB),24h urinary protein quantitative and PLA2R titer were compared between two groups before and after treatment.The therapeutic effect of two groups was evaluated.Results The total effective rate of treatment group was significantly higher than that of control group(χ2=60.000,P<0.001).After treatment,the scores of edema,abdominal distension,fatigue,soreness and weakness of waist and knees in treatment group were significantly lower than those in control group(P<0.05).24h urinary protein and PLA2R titer in treatment group were significantly lower than those in control group,and ALB was significantly higher than that in control group(P<0.05).Conclusion Jiawei Jianshen prescription can significantly improve the clinical symptoms of IMN patients with spleen-kidney deficiency,increase serum ALB level,reduce 24h urinary protein quantity and PLA2R titer.

Establishing a full-cycle contract management model for comprehensive public hospitals has practical signifi-cance for the development of smart hospitals.The aim is to create a hierarchical and classified contract management system fo-cused on information sharing.The method involves outlining the systematic processes of contract management within the hospital,analyzing common issues from multiple dimensions-such as management processes,level of information technology,and process supervision-and proposing solutions to meet the requirements of modern public smart hospital contract management.Based on in-formation sharing and hierarchical management,this approach offers ideas for refined management in hospitals and promotes the high-quality development of comprehensive medical services in smart hospitals..

Objective:To explore the influencing factors of postoperative abdominal infection in critically ill patients with trauma.Methods:A retrospective case-control analysis was conducted on the clinical data of 82 patients who underwent critical surgery in Beijing Shijingshan Hospital from July 2020 to September 2023. There were 52 males and 30 females. Age ranged from 19 to 63 years old, with an average age of (44.50±14.55) years. According to whether the patient has developed infection after surgery, they were divided into an infected group ( n=20) and an uninfected group ( n=62). To compare the differences between the two groups intraoperative data (bleeding volume, cholangioenterostomy, crystal infusion volume, colloid infusion volume, laparoscopic use, operation time and surgical incision length) and postoperative data (ascites, anastomotic leakage, preventive stoma, pulmonary infection). Normally distributed measurement data were expressed as mean±standard deviation ( ± s), and independent samples t-test was used for comparison between groups; Chi-square test was used for comparison between groups for count data. Single factor analysis and multivariate Logistic regression were used to analyze the risk factors for postoperative abdominal infection in critically ill patients with trauma. Results:The number of cases of biliary intestinal anastomosis, bleeding volume, crystal infusion volume, and colloid infusion volume in the infected group were 12 cases, (573.26±206.21) mL, (4 531.0±258.0) mL, and (1 612.0±96.0) mL, respectively. The uninfected group was 14 cases, (468.25±174.21) mL, (2 753.0±226.0) mL, and (1 105.0±85.0) mL, respectively. The difference between the two groups was statistically significant ( P<0.05). The incidence rates of postoperative ascites, anastomotic fistula, prophylactic stoma, and postoperative pulmonary infection in the infected group were 25.00%, 65.00%, 25.00%, and 55.00%, respectively, while those in the non infected group were 9.68%, 27.42%, 51.61%, and 24.19%, respectively. The difference between the two groups was statistically significant ( P<0.05). Multivariate logistic regression analysis showed that postoperative ascites, biliary intestinal anastomosis, postoperative anastomotic fistula, and postoperative pulmonary infection ( OR=5.504, 4.432, 18.172, 7.687, 95% CI: 1.456-20.754, 1.175-16.669, 4.752-69.418, 2.141-27.595, P<0.05) were risk factors for the risk of postoperative abdominal infection. Conclusion:The risk factors for postoperative abdominal infection in critically ill patients with trauma include postoperative ascites, biliary intestinal anastomosis, postoperative anastomotic fistula, and postoperative pulmonary infection. Special attention needs to be paid to postoperative monitoring and treatment.

Objective To explore the role of quality control circle in reducing the rate of extravasation during"bolus-type"intravenous injection of radiopharmaceuticals.Methods A total of 624 patients who underwent emission computed tomography(ECT)examinations were retrospectively selected as the pre-quality control circle use analysis group,125 patients who underwent ECT examinations were selected as the post-quality control circle use experiment group,and 70 patients were selected as the control group.This study applied the continuous quality improvement tools of the quality control circle,including grasping the current situation,selecting injection tools,personnel training,brainstorming,root cause analysis,key factor evaluation,true cause verification,strategy formulation and measure implementation,to continuously improve the quality of"bolus-type"radioisotope injection and reduce the rate of radiopharmaceuticals extravasation.Results In the experiment group,the rate of radioisotope extravasation after nurses performed"bolus-type"intravenous injection was 14.2％,compared to 33.3％in the control group,an improvement of 19％,and the situation of radiopharmaceuticals extravasation was significantly improved.Skillful use of quality improvement tools,especially in areas such as insufficient compression time,improper compression method,slow blood flow speed in fine blood vessels,and failed puncture,was crucial for radioisotope sur-face imaging.Conclusion Through continuous quality improvement by the quality control circle,this study successfully reduces the rate of extravasation during"bolus-type"intravenous injection of radiopharmaceuticals,reduces skin contamination,and improves the quality of nuclear medicine images,which is of great significance for improving the safety and diagnostic accuracy of nuclear medicine ECT examinations.

Objective:To develop a post-stroke insomnia (PSI) evidence-based nursing practice protocol to provide reference for the implementation of insomnia nursing in stroke patients.Methods:In January 2022, a research team was formed. Based on evidence-based principles, systematically searched and summarized high-quality evidence of Western medicine care and Chinese medicine care related to PSI to develop the first draft of the evidence-based nursing practice protocol for PSI, invited medical experts and nursing experts in the field of stroke care, medical treatment, research and teaching, and the protocol was revised through 2 rounds of Delphi expert consultation to form the final draft of the protocol.Results:A total of 15 experts were invited, 3 males and 12 females; 2 between 31 and 40 years of age, 6 between 41 and 50 years of age, and 7 between 51 and 60 years of age.The positive coefficient for both rounds of expert consultation was 100% and the expert authority coefficient was 0.89; the Kendall coordination coefficients for the importance and feasibility scores of the entries in the 2 rounds expert consultation were 0.188 and 0.146, 0.224 and 0.188 (all P<0.01). The PSI evidence-based nursing practice protocol included 27 entries in 6 dimensions: assessment of sleep quality, diagnosis of PSI, development of an individualized plan, non-pharmacological interventions, Chinese medicine nursing interventions, preparation for discharge and follow-up. Conclusions:The PSI evidence-based nursing practice protocol is scientific, reliable and applicable, and can provide a reference for the nursing practice of PSI patients.

Objective:To explore the sleep status and impact factor analysis of patients in clinical trials of antineoplastic drugs, and provide a basis for improving the sleep status and impact analysis of patients in clinical trials of antineoplastic drugs.Methods:From April to May 2023, 107 oncology patients in the Phase I Clinical Trial Ward of the Affiliated East Hospital of Tongji University were selected as the research objects by convenient sampling method. The general information questionnaire, Pittsburgh Sleep Quality Index Scale (PSQI), Numeric rating scale (NRS), Generalized Anxiety Disorder Scale (GAD-7) and Depression Self-Ration Tool Scale (PHQ-9). Multivariate Logistic regression analysis methods were used to carry out a cross-sectional investigation and the relevant factors affecting patients′sleep.Results:Totally 103 questionnaires were effectively collected. The 103 patients′ age ranged from 20 to 75 years old, including 61 males and 42 females. 47.57% (49/103) patients in clinical trials of antineoplastic drugs had abnormal sleep. The average score of patients (PSQI) (7.66 ± 3.93) was higher than the average score of the domestic norm (3.88 ± 2.52), and there was significant statistical difference ( t = 9.76, P<0.01). Logistic regression analysis showed that pain ( OR = 3.004, 95% CI 1.135-7.948, P<0.05) and trial cycle ( OR = 0.432, 95% CI 0.191-0.978, P<0.05) were significant risk factors for abnormal sleep quality. Conclusions:The incidence of abnormal sleep quality in patients of clinical trials of antineoplastic drugs is high, but the sleep quality is poor. The factors that affect the sleep quality of patients in clinical trials of antineoplastic drugs are mainly related to the patient′s trial cycle and cancer pain. According to these characteristics, individualized programs should be developed to improve the sleep quality of patients with advanced cancer, so as to improve the quality of life of patients with advanced cancer.

Objective:To investigate the status quo of the whole process nursing needs of patients with gastrointestinal tumor surgery based on Kano model, and to provide a theoretical reference for the development of high quality nursing service.Methods:From August to September 2023, a cross-sectional survey was conducted on 284 patients undergoing gastrointestinal tumor surgery in Renji Hospital Affiliated to Shanghai Jiao Tong University by simple sampling method. Based on the Kano model as the theoretical framework, referring to the relevant literature, the questionnaire of the whole process nursing needs of patients with gastrointestinal tumor surgery was determined by two rounds of Delphi method, and the 'maximum frequency method' was used to classify the attributes of the whole process nursing needs of patients with gastrointestinal tumor surgery.Results:A total of 270 valid questionnaires were retrieved. Among 270 patients, 159 were males and 111 were females, aged 22-94 (65.34 ± 8.77) years. Among the 26 items, 16 nursing needs were expected attributes, and the first two nursing needs were pain care and relieving oral dryness. 7 essential attributes, the top 2 were relieving insomnia / drowsiness and preoperative preparation and nursing; 2 charm attributes, for postoperative follow-up and follow-up process nursing; 1 indifference attribute, which was the introduction of the surgical environment. The results of quadrant analysis showed that there were 46.15%(12/26) demands in the first quadrant (dominant area), 23.08%(6/26) in the third quadrant (observation area), and both 15.38%(4/26) in each of the other two quadrants.Conclusions:The whole process nursing needs of patients with gastrointestinal tumor surgery are diversified, and the hospital should actively meet the expected attributes and essentials of patients. On this basis, it should provide and innovate charm attribute services to improve patient satisfaction and improve the core competitiveness of the hospital.

Obstructive sleep apnea(OSA)is an independent risk factor for several cardiovascular diseases,and its characteristic intermittent hypoxic environment induces dysregulation of miRNA in cells and circulation,which promotes cellular dysfunction and metabolic disorders,and participates in the formation of atherosclerosis(As).This article re-views the potential role of miRNA in the occurrence and progression of OSA-related As,which helps to understand the mo-lecular pathways underlying the pathogenesis of OSA-related As and provides new insights for the development of miRNA based therapies for OSA-related cardiovascular diseases.

Objective:To compare the results of invasive prenatal diagnosis and preimplantation genetic testing (PGT) and explore the underlying mechanism.Methods:Clinical data of pregnant women undergoing PGT and invasive prenatal diagnosis at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2019 to December 2022 were collected. The results of PGT and invasive prenatal diagnosis were compared, and the outcomes of pregnancies were followed up. This study has been approved by the Medical Ethics Committee of the the Sixth Affiliated Hospital of Sun Yat-sen University (No. 2022SLYEC-491).Results:A total of 172 couples were included in this study, and 26 non-targeted variants were discovered upon prenatal diagnosis, including 10 cases (38.5%) by chromosomal karyotyping, 15 (57.7%) by chromosomal microarray analysis (CMA), and 1 (3.8%) by whole exome sequencing. The 10 karyotypic anomalies had included 6 chromosomal polymorphisms, 2 chromosomal mosaicisms, 1 paternally derived translocation, and 1 missed maternal chromosomal inversion. CMA has identified 15 copy number variations (CNVs), which included 11 microdeletions and microduplications, 3 loss of heterozygosity, and 1 low-level mosaicism of paternal uniparental disomy. One CNV was classified as pathogenic, and another one was likely pathogenic, whilst the remaining 13 were classified as variants of uncertain significance. Therefore, 8.7% of CNVs was detected by invasive prenatal diagnosis after PGT. 92.3% (24/26) of the non-targeted variants have been due to technological limitations of next-generation sequencing (NGS).Conclusion:Invasive prenatal diagnosis after PGT can detect non-targeted variants, which may further reduce the incidence of birth defects.