Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Objective:To evaluate the cumulative live birth rate (CLBR) and cost-effectiveness of fixed versus adjusted follicle-stimulation hormone (FSH) dosages in infertile women with different ovarian responses during their first assisted reproductive technology (ART) cycle.Methods:A retrospective real-world cohort study was conducted on 5 419 infertile women who underwent their first ART treatment at the Department of Reproductive Medicine of the First Affiliated Hospital of Nanjing Medical University between January 2013 and December 2017. All patients received an individualized starting dosage of gonadotropin. Based on whether FSH dosages were adjusted during controlled ovarian stimulation (COS), patients were divided into fixed-dosage group ( n=2 061) and adjusted-dosage group ( n=3 358). Clinical outcomes and FSH cost-effectiveness were compared between the two groups across different ovarian response groups, with CLBR as the primary outcome. Propensity score matching (PSM) and multivariable logistic regression were used to adjust for potential confounders. Results:FSH dosage adjustments were found in 62.0% (3 358/5 419) of cycles during COS. After PSM, baseline characteristics were comparable between the two groups (all P>0.05). After adjusting for confounders using multivariable logistic regression, FSH dosage adjustment was not significantly associated with CLBR ( OR=1.06, 95% CI: 0.94-1.20, P=0.332). Compared with the adjusted-dosage group, the fixed-dosage group showed no significant differences in CLBR in poor-, normal-, and high-responder groups (all P>0.05). The incidence of ovarian hyperstimulation syndrome (OHSS) did not differ significantly between the two groups ( P>0.05). In poor-, normal-, and high-responder groups, the total FSH dosages in the fixed-dose group [1 350 (375, 1 825) U, 1 200 (375, 1 500) U and 525 (375, 1 128) U, respectively] were significantly lower than those in the adjusted-dose group [1 875 (1 425, 2 294) U, P=0.001; 1 425 (450, 1 875) U, P<0.001; 600 (375, 1 425) U, P=0.020]. Similarly, average FSH costs in different ovarian response groups in the fixed-dosage group [4 725.0 (1 312.5, 6 387.5) yuan, 4 200.0 (1 312.5, 5 250.0) yuan and 1 837.5 (1 312.5, 3 947.3) yuan, respectively] were significantly lower than those in the adjusted-dosage group [6 562.5 (4 987.5, 8 028.1) yuan, P=0.001; 4 987.5 (1 575.0, 6 562.5) yuan, P<0.001; 2 100.0 (1 312.5, 4 987.5) yuan, P=0.020]. For normal-responders, the FSH cost per high-quality embryo in the fixed-dosage group [1 365.0 (875.0, 2 537.5) yuan] was significantly lower than that in the adjusted-dosage group [2 056.3 (1 268.8, 3 412.5) yuan, P<0.001]. Conclusion:FSH dosage adjustment during COS is not associated with CLBR or the incidence of OHSS. However, the fixed-dose group exhibited lower total FSH dosages and costs across different ovarian response populations. In the context of ART being covered by medical insurance, fixed FSH dosage may represent a more cost-effective ovarian stimulation protocol.

Objective:To evaluate the cumulative live birth rate (CLBR) and cost-effectiveness of fixed versus adjusted follicle-stimulation hormone (FSH) dosages in infertile women with different ovarian responses during their first assisted reproductive technology (ART) cycle.Methods:A retrospective real-world cohort study was conducted on 5 419 infertile women who underwent their first ART treatment at the Department of Reproductive Medicine of the First Affiliated Hospital of Nanjing Medical University between January 2013 and December 2017. All patients received an individualized starting dosage of gonadotropin. Based on whether FSH dosages were adjusted during controlled ovarian stimulation (COS), patients were divided into fixed-dosage group ( n=2 061) and adjusted-dosage group ( n=3 358). Clinical outcomes and FSH cost-effectiveness were compared between the two groups across different ovarian response groups, with CLBR as the primary outcome. Propensity score matching (PSM) and multivariable logistic regression were used to adjust for potential confounders. Results:FSH dosage adjustments were found in 62.0% (3 358/5 419) of cycles during COS. After PSM, baseline characteristics were comparable between the two groups (all P>0.05). After adjusting for confounders using multivariable logistic regression, FSH dosage adjustment was not significantly associated with CLBR ( OR=1.06, 95% CI: 0.94-1.20, P=0.332). Compared with the adjusted-dosage group, the fixed-dosage group showed no significant differences in CLBR in poor-, normal-, and high-responder groups (all P>0.05). The incidence of ovarian hyperstimulation syndrome (OHSS) did not differ significantly between the two groups ( P>0.05). In poor-, normal-, and high-responder groups, the total FSH dosages in the fixed-dose group [1 350 (375, 1 825) U, 1 200 (375, 1 500) U and 525 (375, 1 128) U, respectively] were significantly lower than those in the adjusted-dose group [1 875 (1 425, 2 294) U, P=0.001; 1 425 (450, 1 875) U, P<0.001; 600 (375, 1 425) U, P=0.020]. Similarly, average FSH costs in different ovarian response groups in the fixed-dosage group [4 725.0 (1 312.5, 6 387.5) yuan, 4 200.0 (1 312.5, 5 250.0) yuan and 1 837.5 (1 312.5, 3 947.3) yuan, respectively] were significantly lower than those in the adjusted-dosage group [6 562.5 (4 987.5, 8 028.1) yuan, P=0.001; 4 987.5 (1 575.0, 6 562.5) yuan, P<0.001; 2 100.0 (1 312.5, 4 987.5) yuan, P=0.020]. For normal-responders, the FSH cost per high-quality embryo in the fixed-dosage group [1 365.0 (875.0, 2 537.5) yuan] was significantly lower than that in the adjusted-dosage group [2 056.3 (1 268.8, 3 412.5) yuan, P<0.001]. Conclusion:FSH dosage adjustment during COS is not associated with CLBR or the incidence of OHSS. However, the fixed-dose group exhibited lower total FSH dosages and costs across different ovarian response populations. In the context of ART being covered by medical insurance, fixed FSH dosage may represent a more cost-effective ovarian stimulation protocol.

Humanistic caring for patients in the operating room refers to providing the whole process of caring medical services for patients in the operating room. In order to standardize humanistic caring services for patients in the operating room of medical institutions, improve the comprehensive service level of the operating room, and enhance the surgical experience of patients, the Chinese Association for Life Care released the group standard " Humanistic Caring Management Standards for Patients in the Operating Room" in December 2023. This article interpreted the basic requirements for humanistic caring of patients in the operating room, the environment and facilities for humanistic caring, the procedures and measures for humanistic caring, and the quality management framework, aiming to assist administrators and clinical practitioners across various levels of medical institutions in accurately understanding and effectively implementing the standard, and to provide essential textual reference and practical guidance for promoting the application of the standard.

Objective To detect the association between rs4646999 polymorphisms in the promoter region of the c-Jun and the prognosis of sporadic colorectal cancer. Methods rs4646999-673C>T genetypes were deter-mined by Taqman-MGB probes in 436 colorectal cancer cases. The survival curve was analyzed by Kaplan-Meier analysis and Cox regression.Western blot was used to analyze the expression levels of c-Jun protein in different gen-otypes. Results Univariate analysis showed that the cumulative survival rate of patients with rs4646999TT geno-type was significantly higher than that of patients with CT and CC genotype. Multivariate Cox regression analysis showed that the differentiation,lymph node metastasis,distant metastasis,TNM stage and rs4646999 genetypes were prognostic factors.Compared with the carriers of TT genotype,CT/CC complex genotypes were associated with poor prognosis of colorectal cancer(P<0.05).Protein expression analysis showed that the expression of c-Jun pro-tein in CC genotype was increased.In contrast,the TT genotype was decreased.Conclusions This study provided the evidence that rs4646999-673C>T genetic variant in c-Jun promoter regions is associated with the poor survival prognosis of colorectal cancer,possibly by elevating the protein expression levels that appeared to up-regulate activ-ity of c-Jun thus tumorigenesis.

Objective To explore the distribution of specific allergens for children in Sichuan Province and provide the evidences of clinical diagnosis and treatment.Methods Totally 451 cases in West China Second University Hospital,from April to August of 2016,were detected for 20 kinds of allergen-specific immunoglobulin E (IgE) by a new reverse enzyme-allergosorbent test,SPSS 18.0 statistical analysis was used to evaluate allergen-specific IgE levels in different groups of age,gender and diverse population distribution of disease.Results A total of 282 cases among 451 subjects were detected as IgE positive and the positive rate was 62.53%,among which 248 cases were positive for inhaled allergen-specific IgE,and the positive rate was 54.99%.There were 261 positive cases in food allergen-specific IgE,and the positive rate was 57.87%.For inhaled allergens,the highest positive rate was dermatophagoides pteronyssinus (n=111,24.61%),then dermatophagoides farina (n=110,24.39%),and house dust (n=108,23.95%);For food allergens,the highest positive rate was milk (n=159,35.25%),then egg (n=111,24.61%),and house dust (n=108,23.95%).Conclusions Both Inhaled allergens and food allergens were the important cause of allergic disease for children in Sichuan area.Serum allergen specific IgE determination was helpful to understand the patient′s allergy status,and diagnose the allergic disease.

Objective To investigate the magnetic resonance imaging (MRI)features and pathologic characteristics of the fungal ball (FB)of the nasal sinuses,for the purpose to provide reference for surgical treatment.Methods The MRI data of 27 patients of nasal sinuses who were diagnosed by surgical pathology were retrospectively analyzed.Of 27 patients,there were 14 male and 13 female,aged from 49 to 86,anverage age 57.6,with course of disease from 6 months to 5 years.All patients preoperatively recieved 1.5 T high field strength mri scan and enhanced scan and functional nasal endoscopic surgical radical resection lesions.Results Maxillary sinus disease,which unilateral 92%(25 /27),bilateral 4% (1 /27),sphenoid sinus disease 4%(1 /27),FB was located in the sinus cavity central.FB isointense signal (com-pared with the white matter of the brain),hypointense on T2WI,DWI (b value =1000)was mixed high and low signal,Gd DTPA enhanced no enhancement,with around mucosal thickening isointense signal,high signal intensity on T2WI,ring enhancement.The histopathology slices of 27 cases were found wrapped fungal hyphae,which confirmed for FB.The pathological basis of FB was fungal silk containing manganese (paramagnetic substances),FB calcium phosphate and calcium sulfate and other substances,due to the magnetic susceptibility effect of T2WI was low signal,DWI high and low mixed signal changes.Conclusion MRI can reflect the histopathological characteristics of FB,and it is of great value in diagnosis and differential diagnosis,as well as providing important imaging evidence for patients undergoing surgical treatment.

Male breast cancer (MBC)is one of rare malignant carcinomas,of which the pathogenesis and biological characteristics remain elusive.Recently,it has been reported that breast cancer susceptibility gene (BRCA)1 ,BRCA2,checkpoint kinase 2 (CHEK2)and partner and localizer of BRCA2 (PALB2)play important roles in the pathogenesis of MBC.Whereas the relationship between BRCA1 -interacting protein 1 (BRIP1 )and MBC is still controversial.

Objective To provide experience of others and thinking for the standardized training of anesthesia nurses under current domestic system, through the introduction to the current training status in our hospital.Methods In accordance with the rec-ommendations specified in"the Duties and Working Procedures of China Surgical Anesthesia Nurses ( Draft)", our hospital actively de-veloped the training scheme of surgical anesthesia nurses.Through the format of training combined with assessment, training of anesthe-sia nurses was conducted according to their levels.Results After about 3 years of theoretical and clinical practice training, the anesthe-sia nurses of our Department had developed into a relatively independent team with strong specialized skills, which could provide relia-ble support for anesthesia nursing in operation rooms.Conclusion Standardized training of surgical nurse anesthetists was imperative under the present circumstances.However, to cultivate a batch of professional personnel who could adapt to our operation room anesthe-sia nursing was still a problem that was worth our further thinking and exploration.

ObjectiveTo explore the methods to improve the social support of HIV/AIDS patients in order to improve their quality of life. Methods115 cases of HIV/AIDS patients beginning to receive the anti-viral therapy were given nursing intervention.Social support rating scale (SSRS),quality of lifeKarnofsky scale were adopted to evaluate the social support and quality of life before and 3 months after nursing intervention. ResultsThe social support and quality of life of patients improved after intervention compared with those before intervention,and with improvement of social support,the quality of life was accordingly increased. ConclusionsSocial support under nursing intervention help to improve quality of life of HIV/AIDS patients,and can support evidence for education and strategies implementation of treatment compliance for HIV/AIDS patients receiving antiretroviral therapy.