Objective To observe the effect of rehabilitation nursing pathway in transjugular intrahepatic portosystemic shunt(TIPS).Methods From January 2022 to December 2024,160 patients with cirrhotic esopha-geal and gastric varices bleeding and intractable hydrothorax and ascites who underwent TIPS surgery were selected and randomly divided into path group and control group,with 80 cases in each group.The clinical treatment schemes of the two groups were consistent.The control group was given routine nursing,and the path group was intervened by rehabilitation nursing path model.Six-minute walking test(6 MWT)distance,Activity of Daily Living,ADL)scores,self-rating anxiety scale(SAS)and self-rating depression scale(SDS)scores,as well as the incidence of postoperative complications(hepatic encephalopathy and abdominal hemorrhage),hospitalization days,hospitalization expenses and nursing satisfaction scores were compared between the two groups.Results The incidence of postoperative complications in the pathway group was 6.25%(5/80),which was lower than that in the control group(16.25%,13/80).The 6MWT distance,ADL score,SAS score and SDS score in the path group were better than those in the control group,and the difference was statistically significant(P<0.05).The hospital-ization days in the path group were(10.50±2.50)days,which were shorter than those in the control group(12.70±3.50)days.The hospitalization expense was(8.31±0.71)million yuan,which was lower than that of the control group(8.92±0.53)million yuan.The nursing satisfaction score was(93.90±3.31),which was higher than that of the control group(89.50±4.21),and the difference was statistically significant(P<0.05).Conclusion TIPS rehabilitation nursing path can effectively promote patients'rehabilitation,reduce medical costs and improve patients'satisfaction.

OBJECTIVE To explore the effect of bundled intervention measures on early infections in patients with malignant biliary obstruction(MBO)after intrabiliary stent implantation under the percutaneous transhepatic cholangial drainage(PTCD)route.METHOD Through convenience sampling method,37 patients with MBO ad-mitted to the First Affiliated Hospital of Fujian Medical University from Jan.2020 to Dec.2021 who received in-trabiliary stent implantation under the PTCD route were selected as the control group,43 patients admitted to the hospital from Jan.2022 to Dec.2023 who received the same procedure were selected as the study group,the control group received conventional infection prevention measures during the perioperative period,the study group added bundled inter-vention measures on this basis,and the postoperative infection status,white blood cell counts,C-reactive protein,and lowering levels of the two groups of patients.procalcitonin,blood amylase,blood lipase levels,hospitalization days and hospitalization costs between the two groups were compared.RESULTS The infection rate of the study group was 9.30％(4/43),lower than that of the control group(P=0.005).White blood cell counts,C-reactive protein,procalcitonin,blood amylase and blood lipase were elevated in both groups of patients on the first postoperative day,while the above in-dicators decreased in both groups of patients on the third postoperative day,with the study group lower than the control group.The hospitalization days in the study group was(7.33±2.55)days,lower than that in the control group(P＜0.001),the hospitalization cost of the study group was(20.32±3.70)thousand yuan,lower than that of the control group(P＜0.001).CONCLUSION Perioperative bundled measures can effectively reduce the risk of early infections in the patients with MBO after intrabiliary stent implantation under the PTCD route,decrease the occurrence of complications,shorten the length of hospital stay and reduce hospitalization costs.

Objective To observe the effect of rehabilitation nursing pathway in transjugular intrahepatic portosystemic shunt(TIPS).Methods From January 2022 to December 2024,160 patients with cirrhotic esopha-geal and gastric varices bleeding and intractable hydrothorax and ascites who underwent TIPS surgery were selected and randomly divided into path group and control group,with 80 cases in each group.The clinical treatment schemes of the two groups were consistent.The control group was given routine nursing,and the path group was intervened by rehabilitation nursing path model.Six-minute walking test(6 MWT)distance,Activity of Daily Living,ADL)scores,self-rating anxiety scale(SAS)and self-rating depression scale(SDS)scores,as well as the incidence of postoperative complications(hepatic encephalopathy and abdominal hemorrhage),hospitalization days,hospitalization expenses and nursing satisfaction scores were compared between the two groups.Results The incidence of postoperative complications in the pathway group was 6.25%(5/80),which was lower than that in the control group(16.25%,13/80).The 6MWT distance,ADL score,SAS score and SDS score in the path group were better than those in the control group,and the difference was statistically significant(P<0.05).The hospital-ization days in the path group were(10.50±2.50)days,which were shorter than those in the control group(12.70±3.50)days.The hospitalization expense was(8.31±0.71)million yuan,which was lower than that of the control group(8.92±0.53)million yuan.The nursing satisfaction score was(93.90±3.31),which was higher than that of the control group(89.50±4.21),and the difference was statistically significant(P<0.05).Conclusion TIPS rehabilitation nursing path can effectively promote patients'rehabilitation,reduce medical costs and improve patients'satisfaction.

OBJECTIVE To explore the effect of bundled intervention measures on early infections in patients with malignant biliary obstruction(MBO)after intrabiliary stent implantation under the percutaneous transhepatic cholangial drainage(PTCD)route.METHOD Through convenience sampling method,37 patients with MBO ad-mitted to the First Affiliated Hospital of Fujian Medical University from Jan.2020 to Dec.2021 who received in-trabiliary stent implantation under the PTCD route were selected as the control group,43 patients admitted to the hospital from Jan.2022 to Dec.2023 who received the same procedure were selected as the study group,the control group received conventional infection prevention measures during the perioperative period,the study group added bundled inter-vention measures on this basis,and the postoperative infection status,white blood cell counts,C-reactive protein,and lowering levels of the two groups of patients.procalcitonin,blood amylase,blood lipase levels,hospitalization days and hospitalization costs between the two groups were compared.RESULTS The infection rate of the study group was 9.30％(4/43),lower than that of the control group(P=0.005).White blood cell counts,C-reactive protein,procalcitonin,blood amylase and blood lipase were elevated in both groups of patients on the first postoperative day,while the above in-dicators decreased in both groups of patients on the third postoperative day,with the study group lower than the control group.The hospitalization days in the study group was(7.33±2.55)days,lower than that in the control group(P＜0.001),the hospitalization cost of the study group was(20.32±3.70)thousand yuan,lower than that of the control group(P＜0.001).CONCLUSION Perioperative bundled measures can effectively reduce the risk of early infections in the patients with MBO after intrabiliary stent implantation under the PTCD route,decrease the occurrence of complications,shorten the length of hospital stay and reduce hospitalization costs.

Objective To establish a quality control method for monitoring the blood concentrations of cyclosporin A and tacrolimus by HPLC-MS/MS,and to evaluate the quality control samples using the Westgard multi-rule theory.Methods HPLC-MS/MS was used to determine the concentration of cyclosporin A and tacrolimus in human whole blood.The quality control samples of low,medium and high concentration levels in the therapeutic drug monitoring process were statistically analyzed,Levery-Jennings and Z-score quality control charts were drawn,and the Westgard multi-rule theory was applied for in-house quality control evaluation.Results The established method was fully validated with linear ranges of 10.40-1 040.00 ng·mL-1 and 0.50-49.50 ng·mL-1,the quantification limits were 10.40 and 0.50 ng·mL-1,respectively.The extraction recoveries were 108.61％-113.24％and 101.99％-109.37％,respectively.The matrix factors normalized by internal standard were 106.68％-111.27％and 95.70％-97.81％for cyclosporin A and tacrolimus,respectively.The intra-day and inter-day accuracy and precision were less than 15.0％.Other parameters were also validated and met the acceptance criteria.Levery-Jennings and Z-score quality control charts showed that there were 4 warnings(violation of the 12s rule)in the results of the 26 groups of quality control samples in the third quarter of 2022,and no phenomenon was observed to be out of control.Conclusion The established in-house quality control system for therapeutic drug monitoring of cyclosporin A and tacrolimus can effectively ensure the accuracy of blood drug concentration detection.

Objective:In order to explore the impact of corona virus disease 2019(COVID-19)on the hospitalization of children with bronchiolitis and to improve clinicians′ understanding of the characteristics of bronchiolitis during the COVID-19 epidemic.Methods:This was a multicenter clinical study, and the data have been collected from 23 children′s medical centers in China.All the clinical data were retrospectively collected from children with bronchiolitis who were hospitalized at each study center from January 1, 2019 to December 31, 2021.The results included gender, age at hospitalization, length of stay, respiratory syncytial virus(RSV) test results, severity rating, ICU treatment, and the total number of children hospitalized with respiratory tract infection during the same period.The clinical data of children with bronchiolitis in 2019 before COVID-19 epidemic and in 2020、2021 during COVID-19 epidemic were statistically analyzed and compared.Results:According to a summary of data provided by 23 children′s medical centers, there were 4 909 cases of bronchiolitis in 2019, 2 654 cases in 2020, and 3 500 cases in 2021.Compared with 2019, the number of bronchiolitis cases decreased by 45.94% in 2020 and 28.70% in 2021.In 2019, 2020 and 2021, there were no significant differences in gender ratio, age, and duration of hospitalization.Compared with 2019, the ratio of bronchiolitis to the total number of hospitalizations for respiratory tract infection decreased significantly in 2020 and 2021( χ2=12.762, P<0.05; χ2=84.845, P<0.05).The proportion of moderate to severe bronchiolitis cases in both 2020 and 2021 was lower than that in 2019, and the difference was statistically significant ( χ2=4.054, P<0.05; χ2=8.109, P<0.05).There was no statistically significant difference in the proportion of bronchiolitis cases requiring ICU treatment between 2019, 2020, and 2021 ( χ2=1.914, P>0.05).In 2019, a total of 52.60%(2 582/4 909) of children with bronchiolitis underwent RSV pathogen testing, and among them, there were 708 cases with RSV positive, accounting for 28.00%.In 2020, 54.14%(1 437/2 654) of children with bronchiolitis underwent RSV pathogen testing, and there were 403 cases with RSV positive, accounting for 28.04%.In 2021, 66.80%(2 238/3 500) of children with bronchiolitis underwent RSV pathogen testing, and there were 935 cases with RSV positive, accounting for 41.78%.Compared with 2019 and 2020, the RSV positive rate in 2021 showed a significant increase( χ2=99.673, P<0.05; χ2=71.292, P<0.05). Conclusion:During the COVID-19 epidemic, the implementation of epidemic prevention and control measures reduced the hospitalization rate and severity of bronchiolitis, but did not reduce the positive rate of RSV detection.

With the outbreak of COVID-19 in the world, Beijing is one of the main areas of the imported cases. As a designated hospital for treatment in Beijing, our hospital set up a negative pressure isolation ward for suspected COVID-19 patients in an emergency, and we quickly organized nursing training, implemented classified management of hospitalized patients. During the whole process of setting up the new ward, all the related staff started working quickly, the logistics department provided goods timely, and the isolation facilities were set tightly. Owing to those, we completed the task of receiving and treating the suspected COVID-19 cases.

Objective:To investigate the role of Sestrin2 overexpression in regulating mitochondrial fission and its mechanism in human neuroblastoma SH-SY5Y cell model of glucose and oxygen deprivation/recovery (OGD/R). Methods:(1) SH-SY5Y cells were divided into normal control group, OGD/R group, Vector group, and Sestrin2 overexpression group; Sestrin2 overexpression or empty vector stable cell lines in the Sestrin2 overexpression group and Vector group were constructed by lentivirus infection; cells in the later 3 groups were subjected to oxygen-glucose deprivation (OGD) for 4 h followed by restoration of O 2 supply for 18 h. The cell survival rate was detected by cell counting kit (CCK)-8 assay. The protein levels of Sestrin2, dynamin-related protein 1 (Drp1), mitochondrial fission protein 1 (Fis1), B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X protein (Bax), Kelch-like ECH-related protein 1 (Keap1) in the cytoplasm and nuclear factor E2-related factor (Nrf2) in the nucleus were detected by Western blotting. The mitochondria ultrastructure was observed by transmission electron microscope. The Nrf2 nuclear translocation was detected by immunofluorescence staining. (2) Cell lines with Sestrin2 overexpression were divided into Sestrin2 overexpression group, Brusatol+ Sestrin2 overexpression group, and DMSO+ Sestrin2 overexpression group. Cells in the Brusatol+ Sestrin2 overexpression group were pretreated with normal medium containing Brusatol (Keap1/Nrf2 pathway inhibitor, final concentration: 100 nmol/L) for 4 h before OGD/R; cells in the DMSO+ Sestrin2 group were pretreated with normal medium containing DMSO (final volume fraction: 0.1%) for 4 h before OGD/R. Cells in these groups were then subjected to OGD for 4 h followed by restoration of O 2 supply for 18 h. The protein levels of Drp1, Fis1, Keap1 in the cytoplasm, and Nrf2 in the nucleus were measured by Western blotting. Results:(1) As compared with those in the OGD/R group, cells in the Sestrin2 overexpression group had significantly increased survival rate (61.33%±1.15% vs. 81.00%±3.00%), significantly up-regulated Bcl-2/Bax ratio (0.467±0.006 vs. 0.880±0.010), significantly decreased Drp1, Fis1 and cytoplasmic Keap1 protein levels (1.089±0.033 vs. 0.865±0.014; 0.829±0.009 vs. 0.350±0.007; 0.967±0.017 vs. 0.881±0.024), and significantly up-regulated nuclear Nrf2 protein level (0.627±0.025 vs. 0.957±0.015, P<0.05). The mitochondrial structure in the Sestrin2 overexpression group under electron microscope was more complete than that in the OGD/R group, and obvious nuclear translocation of Nrf2 was noted. (2) As compared with the Sestrin2 overexpression group, Brusatol+ Sestrin2 overexpression group had significantly decreased nuclear Nrf2 protein level (0.920±0.013 vs. 0.627±0.035), and statistically increased Drp1 and Fis1 protein levels (0.994±0.020 vs. 1.084±0.005; 0.728±0.010 vs. 0.906±0.022, P<0.05). Conclusion:Sestrin2 overexpression could suppress mitochondrial fission, reduce cell apoptosis, and attenuate OGD/R injury of SH-SY5Y cells by activating Keap1/Nrf2 pathway via down-regulating cytoplasmic Keap1 protein level and promoting Nrf2 nuclear translocation.

According to the etiological characteristics of the SARS-CoV-2, our hospital specially sets up a ' Sterilized exclusive cabin ' for the personal hygiene treatment of patients, which is used for the disinfection of discharged patients and their clothes. We adopt different disinfection methods for different items and establish relevant standard procedures. A reasonable end-sterilized process at discharge can effectively eliminate the source of infection, cut off the transmission route, and relieve patients' ideological concerns.

Objective:To investigate the clinical effect of plasma exchange in the treatment of patients with severe hepatitis.Methods:From December 2011 to December 2018, 84 patients with severe hepatitis admitted to the Third People's Hospital of Linfen were selected, and they were divided into control group ( n=41) and observation group ( n=41)according to the random digital table method.The control group was treated with routine treatment, and the observation group was treated with plasma exchange at the same time.The therapeutic effect of the two groups was observed. Results:The total effective rate of the observation group was 73.17%(30/41), which was significantly higher than that of the control group[51.22%(21/41)] (χ 2=4.201, P<0.05). After treatment, the ALB, AST, ALT, TBIL levels in the control group were (36.74±4.25)g/L, (247.85±12.36)U/L, (214.57±10.14)U/L, (288.96±16.30)μmol/L, respectively, which in the observation group were (45.14±5.30)g/L, (162.65±8.30)U/L, (120.74±6.33)U/L, (241.74±15.02)μmol/L, respectively, the differences between the two groups were statistically significant( t=7.917, 36.642, 50.261, 13.641, all P<0.05). After treatment, the interferon gamma(IFN-γ), tumor necrosis factor alpha(TNF-α), interleukin 6(IL-6) levels in the control group were (318.96±92.15)ng/L, (334.74±102.58)ng/L, (65.89±6.33)ng/L, respectively, which in the observation group were (261.15±89.62)ng/L, (274.15±85.12)ng/L, (54.36±5.23)ng/L, respectively, the differences between the two groups were statistically significant( t=2.879, 2.910, 8.991, all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups ( P>0.05). Conclusion:Plasma exchange in the treatment of severe hepatitis can improve the clinical therapeutic effect, improve its liver function, reduce the level of inflammatory cytokines, and has no adverse reactions.