OBJECTIVE To establish the an optimal prediction model for carbapenem-resistant Acinetobacter bau-mannii(CRAB)infection in ICU patients based on machine learning(ML)so as to help clinicians to diagnose and make decisions.METHODS The clinical data were collected from the patients who were hospitalized in ICUs of a three-A hospital from Jan.1,2017 to Dec.31,2024 and were randomly divided into the training set and the test set in a 7∶3 ratio.The characteristic variables were selected by means of LASSO regression analysis in combina-tion with multivariate logistic regression analysis.Five types of M L classification models were integrated,the opti-mal model was analyzed and identified.The performance of the prediction model for CRAB infection in the ICU patients was evaluated with the use of sensitivity,specificity,accuracy,areas under receiver operating characteris-tic curves(AUCs),calibration curves,Hosmer-Lemeshow test and decision curve analysis(DCA).The outputs of the ML models were interpreted by Shapley additive explanations(SHAP)and permutation importance.RESULTS A total of 2 904 patients were enrolled in the study,695(23.93％)of whom had CRAB infection.The AUC of XGBoost model was highest in the training set and the test set,respectively(0.994 and 0.907).The result of Hosmer-Lemeshow test showed that the calibration curves of the XGBoost model indicated that the predicated risk was highly con-sistent with the observed risk(x2=7.323 and 4.609,P=0.513 and 0.764,respectively).The DCA curves showed that the XGBoost model performed best within the whole range of threshold,with the highest net profit.The length of ICU stay,use of tigecycline,central venous catheterization,use of carbapenems and use of ventilator were determined as the major predictive factors by means of SHAP.CONCLUSIONS The XGBoost model is established and interpreted by SHAP.It provides bases for screening of the ICU patients at high risk of CRAB infection.

In June 2021, the Registered Nurses' Association of Ontario (RNAO) released the best practice guideline Promoting 2SLGBTQI+ Health Equity. This article interprets the recommendations made in the guideline on five key areas: inclusive communication, safe spaces, risk assessment and screening, population-based interventions, and education within academic and healthcare organizations. The goal is to provide evidence-based advice for nurses, interdisciplinary teams, healthcare services, and academic institutions to enhance the equity of healthcare services for the 2SLGBTQI+ community, promoting access to inclusive and safe care.

OBJECTIVE To establish the an optimal prediction model for carbapenem-resistant Acinetobacter bau-mannii(CRAB)infection in ICU patients based on machine learning(ML)so as to help clinicians to diagnose and make decisions.METHODS The clinical data were collected from the patients who were hospitalized in ICUs of a three-A hospital from Jan.1,2017 to Dec.31,2024 and were randomly divided into the training set and the test set in a 7∶3 ratio.The characteristic variables were selected by means of LASSO regression analysis in combina-tion with multivariate logistic regression analysis.Five types of M L classification models were integrated,the opti-mal model was analyzed and identified.The performance of the prediction model for CRAB infection in the ICU patients was evaluated with the use of sensitivity,specificity,accuracy,areas under receiver operating characteris-tic curves(AUCs),calibration curves,Hosmer-Lemeshow test and decision curve analysis(DCA).The outputs of the ML models were interpreted by Shapley additive explanations(SHAP)and permutation importance.RESULTS A total of 2 904 patients were enrolled in the study,695(23.93％)of whom had CRAB infection.The AUC of XGBoost model was highest in the training set and the test set,respectively(0.994 and 0.907).The result of Hosmer-Lemeshow test showed that the calibration curves of the XGBoost model indicated that the predicated risk was highly con-sistent with the observed risk(x2=7.323 and 4.609,P=0.513 and 0.764,respectively).The DCA curves showed that the XGBoost model performed best within the whole range of threshold,with the highest net profit.The length of ICU stay,use of tigecycline,central venous catheterization,use of carbapenems and use of ventilator were determined as the major predictive factors by means of SHAP.CONCLUSIONS The XGBoost model is established and interpreted by SHAP.It provides bases for screening of the ICU patients at high risk of CRAB infection.

In June 2021, the Registered Nurses' Association of Ontario (RNAO) released the best practice guideline Promoting 2SLGBTQI+ Health Equity. This article interprets the recommendations made in the guideline on five key areas: inclusive communication, safe spaces, risk assessment and screening, population-based interventions, and education within academic and healthcare organizations. The goal is to provide evidence-based advice for nurses, interdisciplinary teams, healthcare services, and academic institutions to enhance the equity of healthcare services for the 2SLGBTQI+ community, promoting access to inclusive and safe care.

In order to ensure that the patients smoothly complete the nursing transition,major hospitals in China continuously improve the quality of nursing and optimize the nursing procedures.In view of the fact that the nursing transition is still in the development stage in China,this study interprets the best practice guidelines for Transition of Nursing and Services issued by the Registered Nurses' Association of Ontario in 2023,aiming to provide standardized guidance for the nursing transition of healthcare professionals in China and provide scientific basis for the formulation of relevant strategies,thus the occurrence of adverse events can be reduced and the patients' quality of life can be improved.

Natural killer (NK) cells are an important part of the body's innate immune system. As the first line of defense against pathogens, they need to be transformed into a mature state under the control of various cell signaling molecules and transcription factors to play cytotoxic and immune regulatory roles. Under the interaction of activated receptors and inhibitory receptors, NK cells are activated to perform a direct cell killing effect by secreting perforin and granzyme, or indirectly eliminate pathogenic microorganisms in the body by secreting various cytokines, such as type I and type II interferons. These functions of NK cells play a very important role in antiviral and anti-autoimmune diseases, especially in anti-tumor.
Humans ; Killer Cells, Natural ; Interferon-gamma ; Apoptosis ; Autoimmune Diseases ; Cytokines

Traditional Chinese medicine fumigation device is the carrier of traditional Chinese medicine fumigation treatment. In recent years, with the rapid development of new technology and new materials, the development of fumigation device changes with each passing day, and a variety of new products continue to emerge. However, at present, the lack of corresponding evaluation norms, resulting in some difficulties in the registration, marketing, quality control, evaluation scale and other aspects of the product. Some products have many disadvantages in clinical use. From the perspective of technical review, this paper elaborates and analyzes the main concerns in technical review, such as product structure, main risks, performance requirements, clinical evaluation, etc., in order to provide a basis for the design, development, production, registration, use and post-marketing supervision of the devices.
Fumigation ; Medicine, Chinese Traditional ; Marketing ; Quality Control

Objective To explore the transitive regularity of holistic constituents from the crude slices of the medicinal raw materials (MCS) to the formula granules (FG), fufang decoction (FD), and finally, the concentrated pills (CP) of Liuwei Dihuang Fufang (六味地黄复方, LWDHF). Methods Samples for MCS, FG, FD, and CP of LWDHF were obtained, and a fingerprint database was established using high-performance liquid chromatography (HPLC), by separating the samples in an XB-C18 column and analyzing the transitive regularity of components using the total quantum statistical moment (TQSM), including total quantum zero moment (AUCT), total quantum first moment (MRTT), total quantum second moment (VRTT), and its similarity approach. The AUCT, MRTT, and VRTT were calculated based on the representative HPLC chromatograms of FG, FD, and CP of LWDHF. Results AUCT of FG, FD, and CP of LWDHF was 71 804, 46 553, and 144 646 µV·s, respectively; MRTT was 14.43, 14.54, and 18.85 min, respectively; and VRTT was 106.98, 112.84, and 269.12 min2, respectively. Comparing the similarity of FG/FD, FG/CP and FD/CP of LWDHF, the TQSM similarity values were 98.66%, 76.62%, and 75.37%, respectively, whereas the traditional similarity evaluation values were 98.68%, 85.43%, and 85.60%, respectively. Conclusion The results perform little distinction in the total composition between FG and FD, whereas some distinction existed between FD and CP. Experimental evidence, therefore indicates that FG could be used as the alternative of MCS in clinical applications.

AIM: To probe into the related influencing factors of serum lipoprotein associated phospholipase A2(Lp-PLA2)level in patients with diabetic retinopathy.

METHODS: Totally 174 cases of patients with type 2 diabetes mellitus and who treated in Department of Endocrinology from September 2015 to September 2017 were selected as the research objects, and were divided into the non-diabetic retinopathy group(NDR), non-proliferative diabetic retinopathy group(NPDR)and proliferative diabetic retinopathy group(PDR)according to the results of fundus examination. Then, the age, sex, body mass index(BMI), blood pressure, blood glucose, blood lipids, vascular endothelial growth factor(VEGF), C-reactive protein(CRP), and Lp-PLA2 levels and other clinical data of three groups of patients were collected and compared.

RESULTS: There was significant differences in the duration of diabetes, fasting blood glucose(FBP), 2h postprandial blood glucose(2hBP), HbA1c, triacylglycerol(TG), total cholesterol(TC), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), VEGF, CRP, Lp-PLA2 between the three groups of patients(P<0.05). There was no significant difference in serum TG, TC, HDL-C and CRP levels between NPDR group and NDR group(P>0.05). While there was significant difference in biochemical indexes of patients between PDR group and NDR group(P<0.05). The VEGF, CRP and Lp-PLA2 in the PDR group were significantly higher than those in the NPDR group, and the difference was statistically significant(P<0.05). Pearson correlation analysis found that the serum Lp-PLA2 was positively correlated with age, course of disease, 2hBG, TG, VEGF and CRP(P<0.05). Multiple linear regression analysis showed that serum Lp-PLA2 was positively correlated with the course of diabetes mellitus and serum level of VEGF(P<0.05).

CONCLUSION: The level of serum Lp-PLA2 in patients with diabetic retinopathy are significantly increased, which the level is positively correlated with the duration of diabetes and serum VEGF level, thus it can be used as diagnostic index for diabetic retinopathy.

Objective To retrospect the literature review related psychological resilience of cancer patients at home and abroad in recent 10 years, and analyze the application status, main problems and provide the corresponding countermeasures. Methods The literature review was searched by the way of key words in China National Knowledge Infrastructure database ( CNKI) and basic search in Pubmed from 2006 to 2015. Then the year, number, design and contents of the research were concluded into analysis. Results Research about psychological resilience of cancer patients was developed late but the number was rising; the research design were mostly observational study and lots of research focused on the adult patients with breast cancer or gynecological cancer; research contents mainly included current situation and affecting factors of quantitative analysis.Conclusions We find out psychological resilience of cancer patients has been attracted great attention by domestic scholars but with limited research content, uneven distribution of study. The experimental research, qualitative research has not been carried out, so the quality of nursing literature still needs to be improved.