Objective Develop a general patient-reported outcome(PRO)measure for cancer patients,which will be suitable for Chinese demographic characteristics.It can reflect disease burden from patients' perspective.Methods Theoretical framework of the PRO measure was constructed according to the PRO guide draft.The initial version of the PRO measure was formed after literature search,experts' consultation,and recognition tests of patients.The pre-survey and formal survey were conducted respectively in provincial,municipal,county level hospitals.Items were screened by the combination of classical test theory and item response theory.Its reliability,validity and feasibility were analyzed.The minimal detectable change of three domains were estimated using a distribution-based methods.Results A total of 2213 valid questionnaires were collected.The demographic data of cancer patients and non-cancer patients were comparable(P＞0.05).19 items were deleted after classical test theory.Item responsiveness of four disease systems were analyzed by the Bayesian item response theory.Four items were deleted.The formal PRO measure included 4 domains,13 dimensions and 49 items.And its reliability,validity and feasibility results met the expected criteria.The minimal detectable change in physiological,psychological and social domains were 5.63,3.42 and 4.16,respectively.Conclusion The general PRO measure for cancer patients was reliable and feasible.The tool can effectively measure and evaluate the quality of life for cancer patients.

Objective Fasting hypometabolism regulation technology has broad application potential in long-term space flight and survival in extreme extraterrestrial environments.In-depth research on the substrate conversion of energy metabolism and the formation of new steady states under fasting hypometabolism will provide theoretical basis and experimental data support for formulating effective prolonged fasting application mode.Methods 30 SD rats were randomly divided into control group and fasting group(fasting for 1,2,3,and 5 days).Blood biochemical examination,qRT-PCR,and western blotting were performed to analyze the body weight,blood biochemistry,and expression changes of genes and proteins related to glucose and lipid metabolism during different fasting periods.Results Prolonged fasting significantly reduced the body weight,blood glucose,and triglyceride levels of rats;increased the blood ketone level,and replaced glucose as the main energy substance in the body.There are temporal and tissue-specific changes as a whole.Hepatic and renal gluconeogenesis play major roles respectively during different fasting periods.As the fasting time prolongs,the level of hepatic gluconeogenesis gradually decreases,the content of FFA in the blood increases,the expression level of genes related to fat synthesis decreases,fatty acid oxidation is enhanced,and the expression level of the key gene HMGCS2 for ketone body generation increases.Conclusion During prolonged fasting,there is a significant conversion of glucose-ketone energy supply substrates,and a new steady state of energy metabolism mainly supplied by ketone bodies is formed within 2-5 days of fasting.The body maintains a low metabolic state by regulating changes in key genes in pathways such as glucose and lipid metabolism.

Objective To explore the correlation of complex inflammation indexes,neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)with the severity of acute ische-mic stroke(AIS).Methods A total of 278 patients with brain MRI-confirmed AIS admitted in our department between March 2018 and September 2023 were enrolled retrospectively,and according to the National Institutes of Health Stroke Scale(NIHSS)score at admission,they were divided into a mild stroke group(NIHSS score≤3,n=157)and a moderate-severe stroke group(NIHSS score＞3,n=121).Clinical data and results of laboratory tests at admission were collec-ted,and NLR and PLR were calculated.Multivariate logistic regression analysis was performed to assess the association of NLR and PLR with AIS severity.Results Compared with the mild stroke group,the moderate-severe stroke group had significantly older age,larger proportions of atrial fibrillation and pre-morbid Modified Rankin Scale(mRS)score＞1,higher NLR and PLR,and higher ratio of culprit large vessel stenosis,and a lower rate of transient ischemic attack(TIA)(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that TIA(95％CI:0.017-0.455,P=0.004)was a protective factor,and pre-morbid mRS＞1(95％CI:1.451-6.700,P=0.004),NLR(95％CI:1.041-1.346,P=0.010)and culprit large vessel stenosis(95％CI:1.370-4.415,P=0.003)were risk factors for the severity of AIS.Conclusion Inflammation is involved in the pathogenesis of AIS,and the complex inflammatory index,NLR may be an inde-pendent risk factor for the severity of AIS.

Objective Develop a general patient-reported outcome(PRO)measure for cancer patients,which will be suitable for Chinese demographic characteristics.It can reflect disease burden from patients' perspective.Methods Theoretical framework of the PRO measure was constructed according to the PRO guide draft.The initial version of the PRO measure was formed after literature search,experts' consultation,and recognition tests of patients.The pre-survey and formal survey were conducted respectively in provincial,municipal,county level hospitals.Items were screened by the combination of classical test theory and item response theory.Its reliability,validity and feasibility were analyzed.The minimal detectable change of three domains were estimated using a distribution-based methods.Results A total of 2213 valid questionnaires were collected.The demographic data of cancer patients and non-cancer patients were comparable(P＞0.05).19 items were deleted after classical test theory.Item responsiveness of four disease systems were analyzed by the Bayesian item response theory.Four items were deleted.The formal PRO measure included 4 domains,13 dimensions and 49 items.And its reliability,validity and feasibility results met the expected criteria.The minimal detectable change in physiological,psychological and social domains were 5.63,3.42 and 4.16,respectively.Conclusion The general PRO measure for cancer patients was reliable and feasible.The tool can effectively measure and evaluate the quality of life for cancer patients.

Objective:To explore the effectiveness of rapid cycle deliberate practice (RCDP) in training newly hired nurses′comprehensive emergency competence and to provide references for enhancing their capabilities.Methods:A quasi-experimental study was conducted using purposeful sampling. From September to December 2022, newly hired nurses at Liaocheng Second People′s Hospital were selected as research subjects and randomly assigned to a controlor an observation group using random number table. The control group received traditional group drill training, while the observation group underwent RCDP training. The study compared pre- and post-training scores of emergency theory and skill assessments, scores on the Chinese version of the Perceived Cognitive Ability Scale in Emergency Situations (PCAS), and training satisfaction levels between the two groups.Results:Each group comprised 30 nurses. The control group consisted of 3 males and 27 females, with a mean age of (22.70 ± 1.09) years; the observation group included 2 males and 28 females, with a mean age of (22.93 ± 0.87) years. Post-training comprehensive emergency competence assessment scores was (89.19 ± 1.47) in the control group and (93.00 ± 1.41) in the observation group, with a statistically significant difference ( t = - 4.60, P<0.01). The scores and total scores of PCAS in the observation group were (34.23 ± 1.91), (12.70 ± 1.62), (10.03 ± 1.52) and (56.97 ± 3.09), respectively, which were higher than the (31.70 ± 2.42), (11.90 ± 1.16), (9.10 ± 1.42), and (52.47 ± 3.65) in the control group, the difference between the two groups were statistically significant ( t value were - 5.16 - - 2.20, all P<0.05). The total score of training satisfaction of nurses in the observation group was (41.93 ± 2.53) points, and the difference was statistically significant compared with the (33.80 ± 2.58) pointsin the control group ( t = - 12.33, P<0.01). Conclusions:The application of the RCDP method in training newly recruited nurses′comprehensive emergency competence effectively enhances their learning enthusiasm and initiative, thereby improving training outcomes.

Objective:To explore the effectiveness of rapid cycle deliberate practice (RCDP) in training newly hired nurses′comprehensive emergency competence and to provide references for enhancing their capabilities.Methods:A quasi-experimental study was conducted using purposeful sampling. From September to December 2022, newly hired nurses at Liaocheng Second People′s Hospital were selected as research subjects and randomly assigned to a controlor an observation group using random number table. The control group received traditional group drill training, while the observation group underwent RCDP training. The study compared pre- and post-training scores of emergency theory and skill assessments, scores on the Chinese version of the Perceived Cognitive Ability Scale in Emergency Situations (PCAS), and training satisfaction levels between the two groups.Results:Each group comprised 30 nurses. The control group consisted of 3 males and 27 females, with a mean age of (22.70 ± 1.09) years; the observation group included 2 males and 28 females, with a mean age of (22.93 ± 0.87) years. Post-training comprehensive emergency competence assessment scores was (89.19 ± 1.47) in the control group and (93.00 ± 1.41) in the observation group, with a statistically significant difference ( t = - 4.60, P<0.01). The scores and total scores of PCAS in the observation group were (34.23 ± 1.91), (12.70 ± 1.62), (10.03 ± 1.52) and (56.97 ± 3.09), respectively, which were higher than the (31.70 ± 2.42), (11.90 ± 1.16), (9.10 ± 1.42), and (52.47 ± 3.65) in the control group, the difference between the two groups were statistically significant ( t value were - 5.16 - - 2.20, all P<0.05). The total score of training satisfaction of nurses in the observation group was (41.93 ± 2.53) points, and the difference was statistically significant compared with the (33.80 ± 2.58) pointsin the control group ( t = - 12.33, P<0.01). Conclusions:The application of the RCDP method in training newly recruited nurses′comprehensive emergency competence effectively enhances their learning enthusiasm and initiative, thereby improving training outcomes.

Objective To explore the correlation of complex inflammation indexes,neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)with the severity of acute ische-mic stroke(AIS).Methods A total of 278 patients with brain MRI-confirmed AIS admitted in our department between March 2018 and September 2023 were enrolled retrospectively,and according to the National Institutes of Health Stroke Scale(NIHSS)score at admission,they were divided into a mild stroke group(NIHSS score≤3,n=157)and a moderate-severe stroke group(NIHSS score＞3,n=121).Clinical data and results of laboratory tests at admission were collec-ted,and NLR and PLR were calculated.Multivariate logistic regression analysis was performed to assess the association of NLR and PLR with AIS severity.Results Compared with the mild stroke group,the moderate-severe stroke group had significantly older age,larger proportions of atrial fibrillation and pre-morbid Modified Rankin Scale(mRS)score＞1,higher NLR and PLR,and higher ratio of culprit large vessel stenosis,and a lower rate of transient ischemic attack(TIA)(P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that TIA(95％CI:0.017-0.455,P=0.004)was a protective factor,and pre-morbid mRS＞1(95％CI:1.451-6.700,P=0.004),NLR(95％CI:1.041-1.346,P=0.010)and culprit large vessel stenosis(95％CI:1.370-4.415,P=0.003)were risk factors for the severity of AIS.Conclusion Inflammation is involved in the pathogenesis of AIS,and the complex inflammatory index,NLR may be an inde-pendent risk factor for the severity of AIS.

OBJECTIVE To establish an HPLC fingerprint of Xiao’er resuqing oral liquid， and to determine the contents of twelve index components. METHODS HPLC method was adopted. The determination was performed on Venusil MP C18 column with mobile phase consisting of acetonitrile-0.1% phosphate aqueous solution （gradient elution） at a flow rate of 1.0 mL/min. The detection wavelength was set at 210 nm， the column temperature was 30 ℃， the injection volume was 10 μL. HPLC fingerprint of Xiao’er resuqing oral liquid was established by using the Similarity Evaluation System of Chromatographic Fingerprint of TCM （2012 edition） to evaluate the similarity. The contents of 12 components were determined， including （R， S）-goitrin， 3，5-O-dicaffeoyl quinic acid， puerarin， forsythin， forsythoside A， chlorogenic acid， baicalin， saikosaponins d， wogonoside， baicalein， emodin and chrysophanol. RESULTS The similarity of HPLC fingerprints of 13 batches of Xiao’er resuqing oral liquid was greater than 0.97， and 14 common peaks were confirmed. The contents of the above 12 index components in 13 batches of Xiao’er resuqing oral liquid were as follows： 0.078-0.172， 1.564-2.736， 1.338-2.578， 0.426-0.872， 1.477-2.628， 1.396-2.447， 4.052-9.146， 0.367- 0.692， 1.974-4.674， 1.274-2.969， 0.085-0.167 and 0.155-0.307 mg/mL. CONCLUSIONS The established HPLC fingerprint and content determination methods have high accuracy and high specificity， which can be used for the quality evaluation of Xiao’er resuqing oral liquid.

A series of new monobactam sulfonates is continuously synthesized and evaluated for their antimicrobial efficacies against Gram-negative bacteria. Compound 33a (IMBZ18G) is highly effective in vitro and in vivo against clinically intractable multi-drug-resistant (MDR) Gram-negative strains, with a highly druglike nature. The checkerboard assay reveals its significant synergistic effect with β-lactamase inhibitor avibactam, and the MIC values against MDR enterobacteria were reduced up to 4-512 folds. X-ray co-crystal and chemoproteomic assays indicate that the anti-MDR bacteria effect of 33a results from the dual inhibition of the common PBP3 and some class A and C β-lactamases. Accordingly, preclinical studies of 33a alone and 33a‒avibactam combination as potential innovative candidates are actively going on, in the treatment of β-lactamase-producing MDR Gram-negative bacterial infections.

Polymyxin B and polymyxin E (colistin) are presently considered the last line of defense against human infections caused by multidrug-resistant Gram-negative organisms such as carbapenemase-producer Enterobacterales, Acinetobacter baumannii, and Klebsiella pneumoniae. Yet resistance to this last-line drugs is a major public health threat and is rapidly increasing. Polymyxin S₂ (S₂) is a polymyxin B analogue previously synthesized in our institute with obviously high antibacterial activity and lower toxicity than polymyxin B and colistin. To predict the possible resistant mechanism of S₂ for wide clinical application, we experimentally induced bacterial resistant mutants and studied the preliminary resistance mechanisms. Mut-S, a resistant mutant of K. pneumoniae ATCC BAA-2146 (Kpn2146) induced by S₂, was analyzed by whole genome sequencing, transcriptomics, mass spectrometry and complementation experiment. Surprisingly, large-scale genomic inversion (LSGI) of approximately 1.1 Mbp in the chromosome caused by IS26 mediated intramolecular transposition was found in Mut-S, which led to mgrB truncation, lipid A modification and hence S₂ resistance. The resistance can be complemented by plasmid carrying intact mgrB. The same mechanism was also found in polymyxin B and colistin induced drug-resistant mutants of Kpn2146 (Mut-B and Mut-E, respectively). This is the first report of polymyxin resistance caused by IS26 intramolecular transposition mediated mgrB truncation in chromosome in K. pneumoniae. The findings broaden our scope of knowledge for polymyxin resistance and enriched our understanding of how bacteria can manage to survive in the presence of antibiotics.