Objective:To synthesize evidence regarding discharge preparation services for patients with severe acute pancreatitis (SAP) .Methods:Systematic search of relevant domestic and international websites and databases for diverse evidence concerning discharge preparation in SAP patients were conducted. Literature quality of the included studies was evaluated, and related evidence was extracted and graded.Results:Based on the researchers' evaluation and synthesis, 25 pieces of evidence related to discharge preparation services for patients with SAP were identified and summarized. These were categorized into five key areas: comprehensive assessment, care planning, multidimensional interventions, post-discharge follow-up, and ongoing evaluation. Among them, the evidence with stronger recommendation levels included multidisciplinary team assessment within 24 hours of admission, the assignment of dedicated personnel to coordinate, monitoring the discharge plan and continuous evaluation of the effectiveness of discharge preparation services.Conclusions:This study summarizes the best evidence available regarding discharge preparation services for SAP patients. It may provide an evidence-based foundation for nursing staff to standardize clinical practice and to further develop discharge preparation programs.

Objective To investigate alterations in serum NOV/CCN3 levels among women during mid-to-late pregnancy and elucidate its association with gestational diabetes mellitus(GDM)and pregnancy outcomes.Methods Based on the results of an oral glucose tolerance test(OGTT),we categorized 252 pregnant women into two groups:the GDM group and the control group.Within the GDM group,participants were further stratified based on pre-pregnancy body mass index levels and pregnancy outcomes.We collected clinical data for all study subjects and compared differences in general information,biochemical indicators,as well as NOV/CCN3 levels between these groups.Results The serum levels of NOV/CCN3 in the GDM group were significantly higher compared to those in the control group(P<0.001).Spearman correlation analysis revealed a positive association between serum NOV/CCN3 and pre-pregnancy body weight,pre-pregnancy body mass index,insulin resistance index,and total cholesterol;while a negative correlation was observed with insulin sensitivity index(P<0.05).Logistic regression analysis demonstrated that NOV/CCN3 is an independent risk factor for the development of GDM[OR=1.097,95%CI(1.020～1.179),P=0.013],as well as adverse pregnancy outcomes in GDM patients[OR=1.032,95%CI(1.020～1.045),P<0.001].ROC analysis indicated AUCs of 0.840 and 0.784 for these associations respectively(P<0.05).Conclusions Serum levels of NOV/CCN3 in pregnant women at mid-to late-stage are associated with obesity,insulin resistance,and glucose-lipid metabolism,suggesting a potential role of NOV/CCN3 in glycolipid metabolism during gestational diabetes mellitus(GDM).These findings provide novel insights for assessing the occurrence of GDM and predicting pregnancy outcomes in mid-to late-stage pregnancies.

Objective To investigate alterations in serum NOV/CCN3 levels among women during mid-to-late pregnancy and elucidate its association with gestational diabetes mellitus(GDM)and pregnancy outcomes.Methods Based on the results of an oral glucose tolerance test(OGTT),we categorized 252 pregnant women into two groups:the GDM group and the control group.Within the GDM group,participants were further stratified based on pre-pregnancy body mass index levels and pregnancy outcomes.We collected clinical data for all study subjects and compared differences in general information,biochemical indicators,as well as NOV/CCN3 levels between these groups.Results The serum levels of NOV/CCN3 in the GDM group were significantly higher compared to those in the control group(P<0.001).Spearman correlation analysis revealed a positive association between serum NOV/CCN3 and pre-pregnancy body weight,pre-pregnancy body mass index,insulin resistance index,and total cholesterol;while a negative correlation was observed with insulin sensitivity index(P<0.05).Logistic regression analysis demonstrated that NOV/CCN3 is an independent risk factor for the development of GDM[OR=1.097,95%CI(1.020～1.179),P=0.013],as well as adverse pregnancy outcomes in GDM patients[OR=1.032,95%CI(1.020～1.045),P<0.001].ROC analysis indicated AUCs of 0.840 and 0.784 for these associations respectively(P<0.05).Conclusions Serum levels of NOV/CCN3 in pregnant women at mid-to late-stage are associated with obesity,insulin resistance,and glucose-lipid metabolism,suggesting a potential role of NOV/CCN3 in glycolipid metabolism during gestational diabetes mellitus(GDM).These findings provide novel insights for assessing the occurrence of GDM and predicting pregnancy outcomes in mid-to late-stage pregnancies.

Objective:To synthesize evidence regarding discharge preparation services for patients with severe acute pancreatitis (SAP) .Methods:Systematic search of relevant domestic and international websites and databases for diverse evidence concerning discharge preparation in SAP patients were conducted. Literature quality of the included studies was evaluated, and related evidence was extracted and graded.Results:Based on the researchers' evaluation and synthesis, 25 pieces of evidence related to discharge preparation services for patients with SAP were identified and summarized. These were categorized into five key areas: comprehensive assessment, care planning, multidimensional interventions, post-discharge follow-up, and ongoing evaluation. Among them, the evidence with stronger recommendation levels included multidisciplinary team assessment within 24 hours of admission, the assignment of dedicated personnel to coordinate, monitoring the discharge plan and continuous evaluation of the effectiveness of discharge preparation services.Conclusions:This study summarizes the best evidence available regarding discharge preparation services for SAP patients. It may provide an evidence-based foundation for nursing staff to standardize clinical practice and to further develop discharge preparation programs.

Objective:To compare the outcomes of multiple scales, primarily the speech, spatial, and other qualities of hearing scale for parents（SSQ-P）, in children with ipsilateral vs. Contralateral cochleareimplantat ion（CRI）. Methods: A total of 69 children who received cochlear implantation surgery from April 1999 to June 2024 were included. Patients were divided into two groups based on whether the implantation was on the same side. General information such as gender, age, age at initial implantation and reimplantation was collected. The primary caregivers of the children were followed up by telephone using the categories of auditory performance（CAP）, speech intelligibility rating（SIR）, and SSQ-P questionnaires. Statistical methods including stepwise regression, linear regression, and permutation tests were employed to investigate if there were any statistically significant differences in the scores of CAP, SIR, SSQ-P total, SSQ-P speech perception, SSQ-P spatial hearing, and SSQ-P auditory quality dimensions between the ipsilateral and contralateral reimplantation groups. Results:Of the 69 children included, 62 were in the ipsilateral reimplantation group with a mean age of 11.1 years, and 7 were in the contralateral reimplantation group with a mean age of 11.7 years. Statistical analysis showed that patients in the contralateral reimplantation group had significantly lower SSQ-P total scores （P<0.05） and spatial hearing dimension scores （P<0.05） than those in the ipsilateral reimplantation group after controlling for the corresponding confounders. Conclusion:The effect of ipsilateral reimplantation of cochlear implants is superior to that of contralateral reimplantation in terms of overall auditory function and spatial hearing in daily life for children, but the mechanisms require further investigation.
Humans ; Cochlear Implantation ; Child ; Parents ; Speech Perception ; Male ; Cochlear Implants ; Female ; Hearing ; Surveys and Questionnaires ; Speech ; Child, Preschool

Objective To investigate the application of the Health Effective Data and Information System(HEDIS)-based phased health education in infertile patients treated with assisted reproductive technology(ART).Methods A total of 120 infertile patients who were admitted to The First Affiliated Hospital of Naval Medical University from March 2023 to September 2023 were consecutively selected and randomly assigned to observation group or control group at a ratio of 1:1 using a random number table.During the ART treatment period,the control group was given conventional nursing care,while the observation group was given HEDIS based phased health education for nursing intervention.The negative emotion score,shame score,self-management ability score,and nursing satisfaction were compared between the two groups.Results After intervention,the Hamilton Anxiety Scale(HAMA)score and Hamilton Depression Scale(HAMD)score,and self-rating scale(ISS)scores of the observation group were lower than those of the control group(P<0.05).The degree of nursing satisfaction of the observation group was higher than that of the control group(P<0.05).Conclusion The HEDIS-based phased health education can alleviate the negative emotions of anxiety and depression,reduce the sense of shame,and enhance nursing satisfaction in infertile patients during ART treatment.

OBJECTIVE: To prepare decellularized nerve grafts from alpha-1, 3-galactosyltransferase (GGTA1) gene-edited pigs and explore their biocompatibility for xenotransplantation. METHODS: The sciatic nerves from wild-type pigs and GGTA1 gene-edited pigs were obtained and underwent decellularization. The alpha-galactosidase (α-gal) content in the sciatic nerves of GGTA1 gene-edited pigs was detected by using IB4 fluorescence staining and ELISA method to verify the knockout status of the GGTA1 gene, and using human sciatic nerve as a control. HE staining and scanning electron microscopy observation were used to observe the structure of the nerve samples. Immunofluorescence staining and DNA content determination were used to evaluate the degree of decellularization of the nerve samples. Fourteen nude mice were taken, and subcutaneous capsules were prepared on both sides of the spine. Decellularized nerve samples of wild-type pigs ( n=7) and GGTA1 gene-edited pigs ( n=7) were randomly implanted in the subcutaneous capsules. Blood was drawn at 1, 3, 5, and 7 days after implantation to detect neutrophil counting. RESULTS: IB4 fluorescence staining and ELISA detection showed that GGTA1 gene was successfully knocked out in the nerves of GGTA1 gene-edited pigs. HE staining showed that the structure of the decellularized nerve from GGTA1 gene-edited pigs was well preserved; the nerve basement membrane tube structure was visible under scanning electron microscopy; no cell nuclei was observed, and the extracellular matrix components was retained in the nerve grafts by immunofluorescence staining; and the DNA content was significantly reduced when compared with the normal nerves ( P<0.05). In vivo experiments showed that the number of neutrophils in the two groups were similar at 1, 3, and 7 days after implantation, with no significant difference ( P>0.05); only at 5 days, the number of neutrophils was significantly lower in the GGTA1 gene-edited pigs than in the wild-type pigs ( P<0.05). CONCLUSION The decellularized nerve grafts from GGTA1 gene-edited pigs have well-preserved nerve structure, complete decellularization, retain the natural nerve basement membrane tube structure and components, and low immune response after xenotransplantation through in vitro experiments.
Animals ; Transplantation, Heterologous ; Galactosyltransferases/genetics* ; Sciatic Nerve/immunology* ; Swine ; Tissue Engineering/methods* ; Humans ; Graft Rejection/prevention & control* ; Gene Editing ; Mice ; Mice, Nude ; Heterografts/immunology* ; Animals, Genetically Modified ; Tissue Scaffolds ; Decellularized Extracellular Matrix

AIM: To compare the effect of small-incision lenticule extraction(SMILE)with different corneal cap thicknesses on postoperative astigmatism and short-term visual quality of patients with myopic astigmatism.METHODS: A total of 54 patients(108 eyes)with myopic astigmatism who underwent SMILE from June 2020 to June 2022 in our hospital were selected for the prospective controlled study, and patients were randomly assigned into two groups, with 27 cases(54 eyes)each. The corneal cap thickness design was 110 μm for the group A and 120 μm for the group B, while other operation parameters were consistent. Additionally, the uncorrected visual acuity(UCVA), spherical equivalent(SE), stiffness parameter A1(SP-A1), visual quality and vector parameters at baseline, 1 d,1 wk and 1 mo after surgery were compared between two groups.RESULTS: There was a statistically significant difference in UCVA, SE, and SP-A1 between the two groups at various time points before and after surgery(all P<0.05), and UCVA in the group A was better than that in the group B at 1 d after surgery(P<0.05). There was no statistically significant difference in the results of astigmatism vector analysis between the two groups of patients(both P>0.05). The objective scattering index(OSI)of the group A was lower than that of the group B, while Strehl ratio(SR)of the group A was higher than that of the group B at 1 d after surgery(both P<0.05). There was no significant difference in modulation transfer function cutoff frequency(MTF cut off), contrast vision, visual symptoms and overall satisfaction, postoperative complications between the two groups(all P>0.05).CONCLUSION: SMILE procedures with both 110 μm and 120 μm corneal cap thicknesses are safe and effective in correcting myopic astigmatism without affecting postoperative SE, astigmatism, SP-A1 or contrast visual acuity. Whereas 110 μm corneal cap thickness results in faster early postoperative visual recovery and better early visual quality than 120 μm.

Objective To construct myeloid-specific Spi1 gene knockout mice and analyze their genotypes,so as to provide animal model basis for the study of pathological mechanism of diseases and drug targets.Methods Ac-cording to the principle of CRISPR/Cas9 technology and Cre/LoxP system,sgRNA and Donor vectors were de-signed and constructed.The transcript of Exon 2(Exon 2)was used as the knockout region,and Loxp elements were placed on both sides of Exon 2.Cas9 protein,sgRNA and Donor vector were mixed and microinjected into the fertilized eggs of C57BL/6J mice,the fertilized eggs were transplanted into the uterus of C57BL/6J pregnant female mice,and F0 generation was obtained after 19～20 days.Positive F0 mice were mated with C57BL/6J mice to ob-tain stable F1 Spi1flox/+mice.Spi1flox/+mice of F1 generation were selfed to obtain Spi1flox/flox mice.Spi1flox/flox mated with Lyz2-Cre+mice to obtain Spi1flox/+/Lyz2-Cre+mice,and then mated with Spi1flox/flox,the Spi1flox/flox/Lyz2-Cre+mice were myeloid-specific Spi1 gene knockout(KO)mice.Spi1flox/flox/Lyz2-cre-mice were used as wild-type(WT)mice.DNA of WT and KO mice was extracted,and the genotypes were identified by agarose gel electro-phoresis after PCR amplification.Western blot was used to detect the expression of spleen focus forming virus provi-ral integration oncogene,Spi-1/purine rich box-1(PU.1)in immune cells of WT and KO mice.Results The results of PCR identification showed that the genotype of mice with only 220 bp amplified by flox primer was Spi1flox/flox homozygote,and the genotype of mice with 700 bp amplified by Lyz2-Cre primer was Lyz2-Cre+.Western blot showed that compared with WT group,the protein PU.1 was not expressed in bone marrow-derived macropha-ges(BMDMs)and peritoneal macrophages(PM)in KO group(P<0.01).There was no significant difference of statistics in the expression level of PU.1 in T cells between KO mice and WT mice.The results of PCR and West-ern blot showed that myeloid-specific Spi1 KO mice were successfully constructed.Conclusion The myeloid-spe-cific Spi1 gene KO mice are successfully constructed and identified,which provides animal model basis for further revealing the potential mechanism of PU.1 inimmune regulation.

Objective To breed and identify the T lymphocyte-conditional Spi1 knockout mice for the further in-vestgation of the specific role of Spi1-encoded protein PU.1.Methods The Lck-Cre mice were mated with Spi1flox/flox mice to obtain Lck-Cre×Spi1flox/flox mice(T lymphocyte-specific Spi1 knockout mice),and the genotype was determined by polymerase chain reaction(PCR)and agarose gel electrophoresis.Magnetic beads were used to sort out the splenic T lymphocytes,and the knockdown efficiency of PU.1 in T cells was detected by Western blot,quantitative real-time PCR(qPCR)and flow cytometry.Results The Lck-Cre×Spi1flox/flox mouse genotype was stably inherited.Compared with Spi1flox/flox mice,the expression level of PU.1 was significantly reduced in splenic T cells of Lck-Cre×Spi1flox/flox mice.Conclusion In this study,the T lymphocyte-specific Spi1 knockout mice was successfully constructed by applying Cre/LoxP system and CRISPR/Cas9 technology,which provided a reliable an-imal model for the subsequent experiments of the specific role of PU.1 in T cell-related diseases.