The recombinant human thyroid-stimulating hormone (rhTSH) can be used for differentiated thyroid cancer (DTC) preparation before ¹³¹I therapy, and follow-up. Since its approval by the American Food and Drug Administration (FDA) in 1998, rhTSH has been clinically used in European countries, the United States, and other countries for nearly 30 years. In April 2024, China’s first independently developed rhTSH agent was approved. Based on clinical experience and evidence from domestic and international studies, an expert consensus on the application of rhTSH has been developed following thorough consultations among experts. The consensus offers evidence-based recommendations to guide the appropriate use of rhTSH in clinical practice.

Objective The aim of this study was to analyze the incidence trend and age-specific characteristics of esophage-al cancer in cancer registration areas of Gansu Province from 2010 to 2021,and predict the incidence of esophageal cancer from 2022 to 2030.Methods Based on the incidence data of esophageal cancer in 15 cancer registries in Gansu Province from 2010 to 2021,the incidence was calculated by age,sex,urban and rural areas.The age-standardized incidence by Chinese standard population(ASIRC)was standardized using the 2000 Chinese standard population.Joinpoint regression model was used to analyze the change trend of esophageal cancer incidence,and the average annual percentage change(AAPC)was calculated to quantify the overall rate of change.A birth cohort model was constructed to analyze incidence trend of different birth groups from 1930 to 2021,and the Bayesian age-period-cohort(BAPC)model was used to predict incidence.Results From 2010 to 2021,the ASIRC of esophageal cancer in Gansu Province showed a significant downward trend(AAPC=-14.47％,95％CI:-18.72％--9.99％,P＜0.001).The ASIRC in men decreased at an annual rate of 13.02％(AAPC=-13.02％,95％CI:-17.28％--8.54％,P＜0.001),the incidence of esophage-al cancer in women at a rate of 15.80％per year(AAPC=-15.80％,95％CI:-20.69％--10.61％,P＜0.001).The ASIRC of e-sophageal cancer in urban areas decreased at an annual rate of 15.32％(AAPC=-15.32％,95％CI:-21.04％--9.18％,P＜0.001);ASIRC of esophageal cancer in rural areas decreased at a rate of 5.33％per year(AAPC=-5.33％,95％CI:-8.94％--1.58％,P＜0.001).From 2010 to 2021,the incidence of esophageal cancer in all age groups showed a significant downward trend(AAPC:-19.59％to-9.18％).The birth cohort analysis revealed that the incidence of esophageal cancer in people over 40 years old in the province,men,women,urban and rural areas showed a downward trend with increase of birth years.BAPC model predicted that that the ASIRC of esophageal cancer for the total province population,men and women would decrease from 6.47/100,000,10.02/100,000,and 2.95/100,000 in 2021 to 1.31/100,000,1.72/100,000,and 0.91/100,000 in 2030,respectively.Conclu-sions The incidence of esophageal cancer in Gansu Province showed a downward trend from 2010 to 2021,but men and rural areas were still the focus of high incidence.The prediction indicates that the incidence of esophageal cancer in Gansu Province will further decline by 2030,suggesting that the prevention and control measures have achieved results;however,it is still necessary to strengthen the intervention and long-term monitoring of high-risk groups.

Objective To investigate the impact of blood sampling from different sites on coagula-tion results during systemic heparin anticoagulation period treated by continuous renal replacement therapy(CRRT).Methods Seventy-eight patients undergoing CRRT with systemic heparin anticoag-ulation were selected.Using a self-control method,blood samples were simultaneously collected from sampling port at input end of the CRRT extracorporeal circuit,the arterial pressure monitoring cathe-ter,and the peripheral vein of the patients.The four coagulation parameters were tested,and the differences in coagulation results among the blood sampling sites were compared.Results During CRRT with systemic heparin anticoagulation,the four coagulation parameters using blood samples col-lected from the sampling port at the input end of the CRRT extracorporeal circuit,the arterial pressure monitoring catheter,and the peripheral vein showed no statistically significant differences(P＞0.05).Subgroup analyses based on different hemofiltration machines and heparin doses also showed no statisti-cally significant differences(P＞0.05).Conclusion During CRRT,blood sampling from the sam-pling port at the input end of the circuit or the arterial pressure monitoring catheter can be used as an alternative to peripheral venous blood sampling,with no impact on coagulation results.

Objective The aim of this study was to analyze the incidence trend and age-specific characteristics of esophage-al cancer in cancer registration areas of Gansu Province from 2010 to 2021,and predict the incidence of esophageal cancer from 2022 to 2030.Methods Based on the incidence data of esophageal cancer in 15 cancer registries in Gansu Province from 2010 to 2021,the incidence was calculated by age,sex,urban and rural areas.The age-standardized incidence by Chinese standard population(ASIRC)was standardized using the 2000 Chinese standard population.Joinpoint regression model was used to analyze the change trend of esophageal cancer incidence,and the average annual percentage change(AAPC)was calculated to quantify the overall rate of change.A birth cohort model was constructed to analyze incidence trend of different birth groups from 1930 to 2021,and the Bayesian age-period-cohort(BAPC)model was used to predict incidence.Results From 2010 to 2021,the ASIRC of esophageal cancer in Gansu Province showed a significant downward trend(AAPC=-14.47％,95％CI:-18.72％--9.99％,P＜0.001).The ASIRC in men decreased at an annual rate of 13.02％(AAPC=-13.02％,95％CI:-17.28％--8.54％,P＜0.001),the incidence of esophage-al cancer in women at a rate of 15.80％per year(AAPC=-15.80％,95％CI:-20.69％--10.61％,P＜0.001).The ASIRC of e-sophageal cancer in urban areas decreased at an annual rate of 15.32％(AAPC=-15.32％,95％CI:-21.04％--9.18％,P＜0.001);ASIRC of esophageal cancer in rural areas decreased at a rate of 5.33％per year(AAPC=-5.33％,95％CI:-8.94％--1.58％,P＜0.001).From 2010 to 2021,the incidence of esophageal cancer in all age groups showed a significant downward trend(AAPC:-19.59％to-9.18％).The birth cohort analysis revealed that the incidence of esophageal cancer in people over 40 years old in the province,men,women,urban and rural areas showed a downward trend with increase of birth years.BAPC model predicted that that the ASIRC of esophageal cancer for the total province population,men and women would decrease from 6.47/100,000,10.02/100,000,and 2.95/100,000 in 2021 to 1.31/100,000,1.72/100,000,and 0.91/100,000 in 2030,respectively.Conclu-sions The incidence of esophageal cancer in Gansu Province showed a downward trend from 2010 to 2021,but men and rural areas were still the focus of high incidence.The prediction indicates that the incidence of esophageal cancer in Gansu Province will further decline by 2030,suggesting that the prevention and control measures have achieved results;however,it is still necessary to strengthen the intervention and long-term monitoring of high-risk groups.

Objective: To study the effect of using modified prone position to reduce the occurrence of pressure injury in patients with prone position ventilation. Method: Totally 64 patients with prone position ventilation from February 2014 to February 2018 were selected in the Department of Intensive Care of the Drum Tower Hospital, Medical College of Nanjing University. Twenty-six patients with prone position ventilation From February 2014 to February 2016 were selected as the control group. The patients in the control group were in a horizontal prone position, with soft pillows under both sides of the shoulders and hips along the longitudinal axis of the patient (vertical axis), and gel pads under chests; Thirty-eight patients with prone position ventilation from March 2016 to February 2018 were selected as the experimental group. The patients in the experimental group were positioned on turnover sliding cloth, soft pillows were placed under the sliding cloth, on one side along the vertical axis (vertical axis) of the patients, and the soft pillows were repositioned to other side of the patients every 4 hours, i.e. the patients were turned over in the prone position. The incidence of pressure injury, the number of occurrences (each site marked as 1) and the incidence of other related complications were compared between the two groups. Results: The incidence of pressure injury in the experimental group was 10.53% (4/38) and 46.15% (12/26), in the control group. The median and quartile of the number of pressure injuries in the experimental group were 0 (0,0), and 0 (0,2) in the control group. Statistical analysis was performed using the rank sum test. The difference was statistically significant (F=10.287,11.469, P<0.05). Among other related complications, the unplanned extubation rate was 0.38%(1/26) in the control group and 0 in the experimental group. No aspiration occurred in both groups. Conclusions The use of a modified prone position can reduce the incidence of pressure injuries and reduce the incidence of other related complications, by reducing the duration of skin pressure and decreasing the friction and shear force. It is worthy of popularization and application in clinical practice.

Objective To investigate the prevention effect of chlorhexidine gluconate (CHG) gel dressings combined with chlorhexidine wipe bath on femoral venous central line-associated bloodstream infections (CLABSI) in continue renal replacement therapy (CRRT). Methods A total of 593 cases of patients with femoral venous catheter who receipted CRRT were divided into the experimental group and the control group. 282 cases of patients who hospitalized in ICU from January 2016 to December 2016 were assigned into the control group and received 3M transparent dressings and whole-body warm water bathing.Those hospitalized in ICU from January 2017 to November 2017 were assigned into the experimental group including 311cases and received 3M CHG gel dressingscombined with 2％chlorhexidine wipe bathing. Incidence of CLABSI were compared between the two groups. Results 4 cases of patients occurred CLABSI in the experimental group and 12 cases occurred CLABSI in the control group, the difference between groups was statistically significant(χ2=3.900,P<0.05). In the experimental group, 311 cases were retained for 3219 catheter-days, and 282 cases in the control group were retained for 2249 catheter-days. Compared with transparent dressings and whole-body warm water bathing, chlorhexidine gluconate gel decreasescombined with 2％ chlorhexidine wipe bath could reduce the morbidity of CLABSIs from 5.3‰(12/2249) to 1.2‰(4/3219). The on onsite time of CLABSI in the experimental group was (12.5 ± 8.23) days, which in the control group was (10.50 ± 6.46) days, the differenceare not statistically significant (t=0.504,P>0.05). Conclusions CHG gel dressings combined with chlorhexidine wipe bathing would be more effective to prevent CLABSI in CRRT.

Objective To make a reasonable evidence-based nursing scheme for the oxygen non-humidified of continuing nasal cannula oxygen therapy. Method Adopting the JBI clinical evidence application system, make sure the evidence baseline investigated before application, used during clinical application, and reviewed after application. Based on the now available best evidence, making examination standard and apply it to clinical care. During the application of evidence, 81 continuing low-flow (oxygen flow≤4L/min) nasal cannula oxygen patients were taken. Making assessment on the experiment group(oxygen non-humidified) and control group (oxygen humidified) in three aspects: the comfort level and effect of oxygen therapy, and humidification bottles contamination. Results During the application of evidence, the difference between experiment group and control group shows no statistical significance (P>0.05);the experiment group in oxygen therapy operating time was (162.93±40.18) s, the control group operating time was (258.60 ± 56.97) s, the difference of two groups in shows statistical significance (t=8.752, P<0.01). Conclusion The continuing low-flow (oxygen flow≤4L/min) nasal cannula oxygen therapy do not need humidification. And the clinical application of this best evidence standardizes the clinical nurses oxygen nursing behavior, reduces the nursing cost and enhances the quality of clinical nursing.

Objective To evaluate the application effect of cluster nursing intervention in early enteral nutrition (EN) using transnasal jejunum three-cavity feeding tube for patients with severe acute pancreatitis (SAP).Methods A total of 45 patients with SAP in intensive care unit (ICU) were as control group and received routine nursing,while another 43 were as observation group and treated with cluster nursing intervention on the basis of control group.The initiating time of EN was compared between two groups,and the occurrence of complications such as diarrhea,abdominal distention,skin pressure sores around nostril and tube plugging were observed.Results The initiating time of EN was (5.1 ± 1.7) d in observation group,which was evidently shorter than (6.8 ± 2.1) d in control group,and there was significant difference (P ＜ 0.01).And there was also significant difference between two groups in the total occurrence of complications such as diarrhea,abdominal distention,skin pressure sores around nostril and tube plugging (P ＜ 0.05).Conclusion Cluster nursing intervention can effectually improve the initiating time of EN using transnasal jejunum three-cavity feeding tube and reduce the occurrence of complications for patients with SAP.

Objective To evaluate the application effect of cluster nursing intervention in early enteral nutrition (EN) using transnasal jejunum three-cavity feeding tube for patients with severe acute pancreatitis (SAP).Methods A total of 45 patients with SAP in intensive care unit (ICU) were as control group and received routine nursing,while another 43 were as observation group and treated with cluster nursing intervention on the basis of control group.The initiating time of EN was compared between two groups,and the occurrence of complications such as diarrhea,abdominal distention,skin pressure sores around nostril and tube plugging were observed.Results The initiating time of EN was (5.1 ± 1.7) d in observation group,which was evidently shorter than (6.8 ± 2.1) d in control group,and there was significant difference (P ＜ 0.01).And there was also significant difference between two groups in the total occurrence of complications such as diarrhea,abdominal distention,skin pressure sores around nostril and tube plugging (P ＜ 0.05).Conclusion Cluster nursing intervention can effectually improve the initiating time of EN using transnasal jejunum three-cavity feeding tube and reduce the occurrence of complications for patients with SAP.