Acute skin failure is a common condition of skin damage in critically ill patients, which seriously affects the prognosis of patients. This article summarizes the evaluation indicators, techniques, and comparison of evaluation indicators and techniques for acute skin failure, in order to provide references for the development of acute skin failure evaluation tools and the formulation of nursing measures.

This paper interprets the background, content overview and characteristics, clinical practice significance and disciplinary development of Nursing Standards for Clinical Operation Techniques in Critical Care Ultrasound (hereinafter referred to as the Standards) and puts forward reflections on the clinical application of the Standards, aiming to improve the critical care ultrasound techniques of clinical nursing staff, solve nursing challenges and make clinical nursing ultrasound techniques more scientific, standardized and homogenized.

Objectives To explore the establishment and effects of a multilevel and inter-disciplinary management scheme for specialist nurses.Methods The multilevel and inter-disciplinary management scheme included establishing the pyramid hierarchical training model,exploring superimposed training mechanism for specialist nurses with horizontal expansion,vertical extension,and deep development,and constructing stereoscopic clinical evaluation and quantitative assessment system.Four hundred-forty two specialized nurses have been recruited to join the multilevel and inter-disciplinary management scheme from July 2021 to August 2023.The core competencies of specialized nurses were compared before and after the implementation of management scheme.Results The quality development of specialized nursing have been improved,and the total scores and the scores of 3 dimensions(research innovation,management,and professional development)in core competencies of specialized nurses after the intervention of multilevel and inter-disciplinary management scheme were higher than those before(P＜0.05).Conclusion The multilevel and inter-disciplinary management scheme can effectively improve the core competencies of specialized nurses,and promote the high-quality development of specialized nursing.

Background::Artificial intelligence (AI) technology represented by deep learning has made remarkable achievements in digital pathology, enhancing the accuracy and reliability of diagnosis and prognosis evaluation. The spatial distribution of CD3 + and CD8 + T cells within the tumor microenvironment has been demonstrated to have a significant impact on the prognosis of colorectal cancer (CRC). This study aimed to investigate CD3 CT (CD3 + T cells density in the core of the tumor [CT]) prognostic ability in patients with CRC by using AI technology. Methods::The study involved the enrollment of 492 patients from two distinct medical centers, with 358 patients assigned to the training cohort and an additional 134 patients allocated to the validation cohort. To facilitate tissue segmentation and T-cells quantification in whole-slide images (WSIs), a fully automated workflow based on deep learning was devised. Upon the completion of tissue segmentation and subsequent cell segmentation, a comprehensive analysis was conducted.Results::The evaluation of various positive T cell densities revealed comparable discriminatory ability between CD3 CT and CD3-CD8 (the combination of CD3 + and CD8 + T cells density within the CT and invasive margin) in predicting mortality (C-index in training cohort: 0.65 vs. 0.64; validation cohort: 0.69 vs. 0.69). The CD3 CT was confirmed as an independent prognostic factor, with high CD3 CT density associated with increased overall survival (OS) in the training cohort (hazard ratio [HR] = 0.22, 95% confidence interval [CI]: 0.12–0.38, P <0.001) and validation cohort (HR = 0.21, 95% CI: 0.05–0.92, P = 0.037). Conclusions::We quantify the spatial distribution of CD3 + and CD8 + T cells within tissue regions in WSIs using AI technology. The CD3 CT confirmed as a stage-independent predictor for OS in CRC patients. Moreover, CD3 CT shows promise in simplifying the CD3-CD8 system and facilitating its practical application in clinical settings.

Indocyanine Green/therapeutic use* ; Photochemotherapy ; Combined Modality Therapy ; Anti-Infective Agents

Objective:To analyze postoperative adverse reactions in patients with acne scars treated with punch elevation.Methods:Totally, 27 patients with moderate or severe acne scars, who were treated with punch elevation, were collected from the Department of Dermatology, Xijing Hospital, Air Force Medical University from June 2020 to March 2021. The patients received local infiltration anesthesia during the operation, and were cared for with tensile adhesive plaster bandaging, cold compresses, and waterproofing after the operation; telephone and face-to-face follow-up visits were conducted immediately, 3, 7, 14, 21, 30, and 60 days after the operation, and numerical rating scale (NRS) of intraoperative pain, postoperative swelling duration, postoperative erythema duration, and the incidence of post-inflammatory hyperpigmentation were recorded.Results:Among the 27 patients, the severity score of acne scars was 77.76 ± 43.76 points. The intraoperative pain NRS score was 3.75 ± 2.95 points after local infiltration anesthesia, the postoperative swelling lasted 3.42 ± 2.43 days, postoperative erythema lasted 4.74 ± 3.25 weeks, and the duration of postoperative erythema was not significantly correlated with the severity score of acne scars ( r = -0.13, P = 0.449). After the operation, post-inflammatory hyperpigmentation occurred in 2 patients, and no local infections or fulminant acne was observed. The patient satisfaction rate was 100% (27/27) . Conclusion:The main adverse reactions to punch elevation for acne scars were postoperative swelling and erythema, which subsided spontaneously about 1 month after the operation.

Objective:To explore the current situation of nursing human caring in hospital wards and analyze its influencing factors, so as to facilitate the development of nursing human caring practice.Methods:From July to November 2022, a total of 107 hospitals were surveyed through stratified convenience sampling method, and 4 072 ward nursing managers were recruited to finish the general information questionnaire and the ward nursing human caring status questionnaire. The general information included the region, class and type of the hospital, etc. The ward nursing human caring status questionnaire included 38 items in 5 dimensions of nursing human caring system and process, humanistic quality and training of nursing staff, humanistic environment and facilities, human caring procedures and measures, and human caring quality evaluation and improvement, with a full score of 190 points. Descriptive statistics were used to analyze the general data, independent samples t-test, ANOVA and correlation analysis were used to analyze the factors influencing the current status of nursing human caring in the ward, while multiple linear regression analysis was used to conduct a multivariate analysis. Results:The score of nursing human caring in hospital wards was 156.91±27.78. Whether the hospital had carried out nursing human caring pilot(demonstration) wards, whether the ward had previously been a hospital nursing human caring pilot(demonstration) nursing unit, the type of ward, and whether nursing managers had participated in human caring training were the influencing factors of the implication of nursing humanistic caring in wards( P<0.05). Conclusions:The practice of nursing human caring in hospital wards is at a good level, but needs to be further strengthened. Nursing managers should take systematically strategies to promote the development of nursing human caring practice.

Objective:To understand the current status of knowledge, attitude and practice of exercise rehabilitation nursing of clinical nurses in ClassⅢ Grade A hospitals in China.Methods:The convenient sampling method was adopted to conduct an online survey of 9 091 nurses from 31 Class Ⅲ Grade A hospitals in 31 provinces, municipalities and autonomous regions by using a self-designed questionnaire on Nurses' Knowledge, Attitude and Practice of Exercise Rehabilitation from May to July 2019. There were 34 items in the questionnaire, which mainly included the basic information of the survey objects, the knowledge and skills of sports rehabilitation nursing that nurses needed to master, the willingness of nurses to provide sports rehabilitation guidance and the current status of clinical implementation. A total of 9 091 questionnaires were distributed in this study, and the effective response rate was 100%.Results:Among the 9 091 nurses, 3 728 nurses (41.0%, 3 728/9 091) and 3 749 nurses (41.2%, 3 749/9 091) respectively indicated that they had not received relevant courses or skills training in school. 8 565 nurses (94.2%, 8 565/9 091) thought it was important to provide sports rehabilitation guidance, but they lacked the corresponding guidance ability, motivation and energy. In practice, 8 493 nurses (93.4%, 8 493/9 091) would provide suggestions and guidance related to sports rehabilitation to patients, mainly based on departmental nursing routine, relevant training, personal experience and literature.Conclusions:Clinical nurses in ClassⅢ Grade A hospitals in China have a positive attitude to participate in the exercise rehabilitation guidance of patients, but the level of knowledge and skills is low, and the behavior of rehabilitation guidance needs to be standardized. In the future, it should be further strengthened in terms of professional training, personnel training and related guidelines and standard construction.

AIM: To investigate the effects of sodium hydrosulfide ( NaHS ) , a donor of hydrogen sulfide ( H2 S) , on the membrane permeability , intracellular Ca 2+concentration ( [ Ca2+] i ) and the release of IL-1βinduced by a-denosine triphosphate (ATP) in rat microglia, and to explore the effect of H2S on ATP-P2X purinergic signaling pathway and the molecular mechanism of its neuroprotective effect .METHODS: Rat microglia in logarithmic growth phase were used in the study.The [Ca2+]i was detected by Fura-2/AM staining.Fluorescent dye YO-PRO-1 was used to observe the membrane permeability.Interleukin-1β(IL-1β) was measured by rat IL-1βELISA kits.RESULTS:The YO-PRO-1 flu-orescence intensity was obviously elevated by ATP induction in a dose -dependent manner in the rat microglia , but this effect was counteracted by NaHS pretreatment (P<0.05).[Ca2+]i rapidly increased and then decreased slowly , forming a sta-ble platform for a long time when rat microglia were treated with ATP .Ca2+spike activity induced by ATP had no change , but the platform disappeared (P<0.05) after NaHS pretreatment.The ATP and LPS together facilitated the release of IL-1β, but the phenomenon was inhibited by NaHS (P<0.05).CONCLUSION:Hydrogen sulfide may decrease the mem-brane permeability , calcium inflow and IL-1βrelease in rat microglia activated by high dose of ATP .The cytoprotection of hydrogen sulfide may be mediated by purinergic signaling pathway .

This paper aims to explore the barriers of the special courses of Chinese medicine nursing development in advanced traditional Chinese medicine universities from the perspectives of students , education system and social determinants .Related-suggestions and strategies are also referred to the barriers in order to provide references for further course optimization .