Summarizing the nursing experience of nutritional support therapy during the perioperative period for a child with short bowel syndrome undergoing small intestine transplantation.Nursing key points:dynamic assessment of nutritional risk,development and timely adjustment of nutritional support programs;implementation of nutritional support strategies to promote growth and development;combination with exercise interventions to improve nutritional status;to strengthen the monitoring of rejection,to promote the recovery of intestinal function;to strengthen the continuity of care,and do a good job of nutritional monitoring and guidance.After 141 days of careful treatment and nursing care,the child was discharged successfully.

Objective To retrieve and evaluate the evidence related to surgical instrument management,and to integrate the evidence to provide an evidence-based basis for clinical surgical instrument management practice.Methods Evidence on surgical instrument management,including guidelines,expert consensuses,and clinical decision-making,was systematically searched from domestic and international databases and related websites.The search timeframe was from database construction to 4 November 2024.Literature was screened and evaluated,and the evidence was integrated by 2 researchers.Results A total of 16 papers were included,including 2 systematic evaluations,1 class experimental study,2 clinical decisions,4 expert consensuses,5 guidelines,and 2 evidence summaries,resulting in a total of 33 pieces of evidence in 5 areas,including requirements for surgical instrument management,general principles of surgical instrument handling,logistics and supply chain management of surgical instruments,surgical instrument pre-treatment and cleaning,disinfection,and sterilisation processes,and personnel training.Conclusion This study summarises the best available evidence on the management of surgical instruments in hospitals and provides an evidence-based basis for healthcare professionals to manage surgical instruments,thereby improving the quality and efficiency of surgical instrument disposal.

Objective:To investigate the causal impact of maternal smoking around birth(MSAB)on off-spring's risk of attention deficit hyperactivity disorder(ADHD),autism spectrum disorder(ASD),bipolar disorder(BD),and major depressive disorder(MDD).Methods:The datasets for MSAB and 4 psychiatric disorders were extracted from genome-wide association studies(GWAS).Mendelian randomization(MR)was employed,using in-verse variance weighting(IVW)as the primary analysis method.Sensitivity analyses and outlier correction were conducted using weighted median(WM),MR-Egger regression,and MR-PRESSO.The results were expressed as odds ratios(OR)and corrected for false discovery rate(FDR).Results:MR analysis showed significant causal re-lationships between MSAB and increased risk of ADHD(OR=5.36,95％CI=2.58-7.63,PFDR=0.003),MDD(OR=1.92,95％CI=1.29-2.88,PFDR=0.003),and BD(OR=6.33,95％CI=1.56-8.73,PFDR=0.013).However,no statistically significant association was found between MSAB and ASD(OR=1.66,95％CI=0.23-5.87,PFDR=0.616).Conclusion:This study suggests a potential causal link between maternal smoking around the time of birth and an increased risk of attention deficit hyperactivity disorder,bipolar disorder,and major depressive disorder in offspring.

Objective To retrieve and evaluate the evidence related to surgical instrument management,and to integrate the evidence to provide an evidence-based basis for clinical surgical instrument management practice.Methods Evidence on surgical instrument management,including guidelines,expert consensuses,and clinical decision-making,was systematically searched from domestic and international databases and related websites.The search timeframe was from database construction to 4 November 2024.Literature was screened and evaluated,and the evidence was integrated by 2 researchers.Results A total of 16 papers were included,including 2 systematic evaluations,1 class experimental study,2 clinical decisions,4 expert consensuses,5 guidelines,and 2 evidence summaries,resulting in a total of 33 pieces of evidence in 5 areas,including requirements for surgical instrument management,general principles of surgical instrument handling,logistics and supply chain management of surgical instruments,surgical instrument pre-treatment and cleaning,disinfection,and sterilisation processes,and personnel training.Conclusion This study summarises the best available evidence on the management of surgical instruments in hospitals and provides an evidence-based basis for healthcare professionals to manage surgical instruments,thereby improving the quality and efficiency of surgical instrument disposal.

Objective:To investigate the causal impact of maternal smoking around birth(MSAB)on off-spring's risk of attention deficit hyperactivity disorder(ADHD),autism spectrum disorder(ASD),bipolar disorder(BD),and major depressive disorder(MDD).Methods:The datasets for MSAB and 4 psychiatric disorders were extracted from genome-wide association studies(GWAS).Mendelian randomization(MR)was employed,using in-verse variance weighting(IVW)as the primary analysis method.Sensitivity analyses and outlier correction were conducted using weighted median(WM),MR-Egger regression,and MR-PRESSO.The results were expressed as odds ratios(OR)and corrected for false discovery rate(FDR).Results:MR analysis showed significant causal re-lationships between MSAB and increased risk of ADHD(OR=5.36,95％CI=2.58-7.63,PFDR=0.003),MDD(OR=1.92,95％CI=1.29-2.88,PFDR=0.003),and BD(OR=6.33,95％CI=1.56-8.73,PFDR=0.013).However,no statistically significant association was found between MSAB and ASD(OR=1.66,95％CI=0.23-5.87,PFDR=0.616).Conclusion:This study suggests a potential causal link between maternal smoking around the time of birth and an increased risk of attention deficit hyperactivity disorder,bipolar disorder,and major depressive disorder in offspring.

Summarizing the nursing experience of nutritional support therapy during the perioperative period for a child with short bowel syndrome undergoing small intestine transplantation.Nursing key points:dynamic assessment of nutritional risk,development and timely adjustment of nutritional support programs;implementation of nutritional support strategies to promote growth and development;combination with exercise interventions to improve nutritional status;to strengthen the monitoring of rejection,to promote the recovery of intestinal function;to strengthen the continuity of care,and do a good job of nutritional monitoring and guidance.After 141 days of careful treatment and nursing care,the child was discharged successfully.

This study was designed to investigate the effect of silencing microtubule-affinity regulating kinase 4(MARK4)on the apoptosis,inflammatory cytokine release and intestinal barrier protein expression of FHC cells in a lipopolysaccharide(LPS)-induced ulcerative colitis(UC)model,and the underlying molecular mechanisms.Western blot analysis was used to measure the expression levels of MARK4 and apoptosis-related factors including Caspase-1,NLRP3,and GSDMD in colon tissues from both UC patients and healthy individuals,as well as in LPS-induced FHC cell inflammation model.FHC cells was transfected with shRNA to silence MARK4.In control(normal FHC cells),LPS(LPS-stimulated FHC cells),and MARK4-silenced+LPS(shRNA-and LPS-treated FHC cells)groups,the expression levels of Caspase-1,NLRP3,GSDMD,intestinal barrier proteins,and NF-κB pathway-related proteins were assessed by Western blotting.ELISA and RT-qPCR were used to measure the expression levels of inflammatory cytokines IL-1β,IL-6,and TNF-α;flow cytometry was utilized to assess apoptosis.Data showed that both in UC patient colon tissues and the in vitro LPS-induced FHC cell UC inflammation model,there was a significant increase in the expression of MARK4 and apoptosis-related proteins including NLRP3,Caspase-1,and GSDMD.Silencing MARK4 inhibited the expression of these apoptosis-related proteins and downregulated the inflammatory cytokines IL-1β,IL-6,and TNF-α in LPS-induced FHC cells.Silencing MARK4 also reduced apoptosis,increased the expression of intestinal barrier proteins ZO-1,Occludin,and upregulated Claudin2.Gene Set Enrichment Analysis(GSEA)indicated a positive correlation between MARK4 and the NF-κB signaling pathway.Furthermore,silencing of MARK4 inhibited the expression levels of p-P65 and p-IKKα in the NF-κB pathway.In conclusion,MARK4 is significantly upregulated in UC tissues and cells.Silencing MARK4 inhibits the activation of the NF-κB signaling pathway,thereby inhibiting the apoptosis and inflammatory factor expression of UC cells.Thus,MARK4 could be a potential therapeutic target for UC patients.

Objective? To determine tourniquet pressure based on limb occlusion pressure(LOP) and to explore its effects on laparoscopic surgery in adults. Methods? Totally 200 adult patients who received laparoscopic surgery in a Class Ⅲ Grade A hospital between June and December 2017 were selected by cluster sampling and divided into the control group (n=100) and the observation group (n=100) according to the random number table. The conventional pressure of 450 mmHg (60 kPa) for lower exterminates was applied to the patients in the control group, while the pressure for the patients in the observation group was determined on limb occlusion pressure with the arterial pulse probe in air pressure tourniquet in accordance with the guideline of the Association of Perioperative Registered Nurses (AORN, 2013) and the care guideline for surgical patients using air pressure tourniquet. The surgical vision score, air pressure tourniquet pressure, color of skin at tourniquet cuff and change of skin morphology were observed and recorded. Results? The clearance of surgical vision of the two groups was 86% and 82%, respectively (P＞ 0.05). The pressure of air pressure tourniquet of the observation group was (316.48±20.10) mmHg, while the fixed pressure of the control group was 450 mmHg (P＜0.05). The incidence of cutaneous injury comorbidities in the control group was 65%, while the incidence of postoperative skin injury in the observation group was 20% (P＜ 0.05). Conclusions? The tourniquet pressure determined based on limb occlusion pressure in laparoscopic surgery for adult patients does not affect the vision of surgeons and can effectively reduce the adverse effects of tourniquet used during operation.

Objective To investigate APP mobile information technology innovation methods in preoperative visits to patients in the clinical application effect. Methods A total of 840 patients undergoing elective surgery were divided into control group and experimental group by random digits table method with 420 cases each and control group by adopting the method of the nurse oral interpretation of the preoperative visit list and health education leaflets oral interpretation information, experimental group using mobile medical technology innovation preoperative visit method, combining with specialized subject characteristic in APP software design way of cartoon animation and video surgery in patients with preoperative visit. The comparison of two groups of patients with the patients know about the operation, cooperate with surgery, perioperative anxiety levels, hospitalized experience satisfaction four dimensions of experience were performed. Results The patients know about the operation was (7.6 ± 2.3) points in control group and(8.5 ± 2.5)points in experimental group, and there was significant difference between two groups (t=5.430,P<0.01). The cooperate with surgery was 92.62%(389/420) in experimental group and 75.71%(318/420) in control group, and there was significant difference between two groups(χ2=45.032, P<0.01). The perioperative anxiety levels was (38.27 ± 2.50) points in experimental group and (47.21 ± 3.84) points in control group, and there was significant difference between two groups (t=8.420, P<0.01). The hospitalized experience satisfaction was (96.41±2.30) points in experimental group and (93.70±1.51)points in control group, and there was significant difference between two groups (t=3.297, P <0.01). Conclusions Using APP for clinical preoperative visit mobile information technology, which can effectively improve the patients know about the operation and the matching degree, reduce the perioperative patients with anxiety, improve surgical patients during hospitalization medical treatment satisfaction.

Objective To detect the serum level of vitamin D in infants with atopic dermatitis (AD),and to investigate the relationship between the serum level of vitamin D and severity of AD in infants.Methods Clinical data were collected from patients with moderate to severe AD (AD group)through a questionnaire survey in Children's Hospital of Shanxi from February to April in 2016,and the severity of AD was evaluated by the SCORing atopic dermatitis (SCORAD) score.A total of 95 health checkup examinees served as the control group.Enzyme-linked immunosorbent assay (ELISA)was performed to detect the serum level of 25 (OH) D3 in the AD group and control group,as well as the total serum IgE level in the AD group.Blood cell analyzer was used to determine the proportion of blood eosinophils in the AD group.Results A total of 97 patients with AD were enrolled into the study,including 43 (44.3 ％) patients with moderate AD and 54 (55.7％) patients with severe AD.The serum level of 25 (OH) D3 was significantly lower in the AD group than in the healthy control group ([66.71 ± 21.07] nmol/L vs.[85.43 ± 14.87] nmol/L,P ＜ 0.01),as well as in the patients with severe AD than in the patients with moderate AD ([47.54 ± 29.36] nmol/L vs.[63.89 ± 26.67] nmol/L,P =0.006).The proportion of blood eosinophils was significantly higher in the severe AD group than in the moderate AD group (0.124 ± 0.094 vs.0.061 ± 0.060,P ＜ 0.001).There was no significant difference in the total serum IgE level between the moderate AD group and severe AD group (P =0.375).Among the patients with AD,the serum level of 25 (OH) D3 was negatively correlated with the proportion of blood eosinophils (r =-0.336,P ＜ 0.05),but there was no correlation between the serum level of 25 (OH)D3 and total serum IgE level (r =-0.174,P ＞ 0.05).The serum level of 25 (OH)D3 was significantly associated with breastfeeding and vitamin D supplementation (P ＜ 0.05),but unrelated to age,gender,course of disease and acute exudative phase (all P ＞ 0.05).Conclusion The serum level of 25 (OH) D3 is evidently decreased in infants with AD,and vitamin D deficiency is closely related to the severity of AD in infancy.