Rapid and ultrasensitive detection of pathogen-associated biomarkers is vital for the early diagnosis and therapy of bacterial infections. Herein, we developed a close-packed and ordered Au@AgPt array coupled with a cascade triggering strategy for surface-enhanced Raman scattering (SERS) and colorimetric identification of the Staphylococcus aureus biomarker micrococcal nuclease (MNase) in serum samples. The trimetallic Au@AgPt nanozymes can catalyze the oxidation of 3,3',5,5'-tetramethylbenzidine (TMB) molecules to SERS-enhanced oxidized TMB (oxTMB), accompanied by the color change from colorless to blue. In the presence of S. aureus, the secreted MNase preferentially cut the nucleobase AT-rich regions of DNA sequences on magnetic beads (MBs) to release alkaline phosphatase (ALP), which subsequently mediated the oxTMB reduction for inducing the colorimetric/SERS signal fade away. Using this "on-to-off" triggering strategy, the target S. aureus can be recorded in a wide linear range with a limit of detection of 38 CFU/mL in the colorimetric mode and 6 CFU/mL in the SERS mode. Meanwhile, the MNase-mediated strategy characterized by high specificity and sensitivity successfully discriminated between patients with sepsis (n = 7) and healthy participants (n = 3), as well as monitored the prognostic progression of the disease (n = 2). Overall, benefiting from highly active and dense "hot spot" substrate, MNase-mediated cascade response strategy, and colorimetric/SERS dual-signal output, this methodology will offer a promising avenue for the early diagnosis of S. aureus infection.

Rapid and ultrasensitive detection of pathogen-associated biomarkers is vital for the early diagnosis and therapy of bacterial infections.Herein,we developed a close-packed and ordered Au@AgPt array coupled with a cascade triggering strategy for surface-enhanced Raman scattering(SERS)and colorimetric identification of the Staphylococcus aureus biomarker micrococcal nuclease(MNase)in serum samples.The trimetallic Au@AgPt nanozymes can catalyze the oxidation of 3,3',5,5'-tetramethylbenzidine(TMB)molecules to SERS-enhanced oxidized TMB(oxTMB),accompanied by the color change from colorless to blue.In the presence of S.aureus,the secreted MNase preferentially cut the nucleobase AT-rich regions of DNA sequences on magnetic beads(MBs)to release alkaline phosphatase(ALP),which subsequently mediated the oxTMB reduction for inducing the colorimetric/SERS signal fade away.Using this"on-to-off"triggering strategy,the target S.aureus can be recorded in a wide linear range with a limit of detection of 38 CFU/mL in the colorimetric mode and 6 CFU/mL in the SERS mode.Meanwhile,the MNase-mediated strategy characterized by high specificity and sensitivity successfully discriminated between patients with sepsis(n=7)and healthy participants(n=3),as well as monitored the prog-nostic progression of the disease(n=2).Overall,benefiting from highly active and dense"hot spot"substrate,MNase-mediated cascade response strategy,and colorimetric/SERS dual-signal output,this methodology will offer a promising avenue for the early diagnosis of S.aureus infection.

Objective To explore the application effects of a discharge planning service program based on King's Goal Attainment Theory in patients undergoing transcatheter heart valve surgery.Methods Using convenience sampling method,80 patients who underwent transcatheter heart valve surgery at a tertiary comprehensive hospital in Zhejiang Province from August 2023 to January 2024 were selected as the research subjects.Among them,40 patients from November 2023 to January 2024 were selected as an experimental group.A discharge preparation service plan for patients undergoing transcatheter heart valve surgery based on King's Goal Attainment Theory was adopted.Totally 40 patients who underwent transcatheter heart valve surgery from August to October 2023 were selected as a control group and underwent routine measures for discharge preparation.The differences in the scores of the discharge preparation scale,discharge guidance quality scale,self-management scale for patients after mechanical heart valve replacement surgery,and unplanned readmission rate were compared between 2 groups before and after intervention.Results During the application of the plan,a total of 2 cases were excluded,and 38 cases were included in the experimental group and 40 cases were included in the control group.After intervention,the experimental group had higher scores in discharge readiness,discharge guidance quality,and self-management ability than the control group,and the differences were statistically significant(P＜0.001).The unplanned readmission rate within 30 days in the experimental group(2.63％)was lower than that in the control group(7.50％),and the difference was not statistically significant(P＞0.05).Conclusion The discharge preparation service plan for patients undergoing transcatheter heart valve surgery based on King's Goal Attainment Theory can improve the discharge preparation,discharge guidance quality,and self-management ability of patients undergoing transcatheter heart valve surgery,and has a positive effect on improving their quality of life.

Objective:To analyze the clinical characteristics and prognosis of dengue fever inpatients in Guangzhou area, so that to provide references for clinical diagnosis and treatment.Methods:The demographic data, laboratory findings, clinical manifestations, and outcomes of 116 dengue fever cases admitted to Guangzhou Red Cross Hospital, Jinan University and the First Affiliated Hospital, Jinan University from August 1st to December 21st, 2024 were retrospectively analyzed.Results:Among the 116 patients, 99 cases (85.34%) were classified as non-severe dengue, while 17(14.66%) progressed to severe dengue (SD). The cohort was comprised of 62(53.45%) males and 54(46.55%) females, with an age of 63.5(22.0) years, and the hospitalization duration was 6(4) days, with the fever duration of 6(2) days. Sixty-two patients (53.45%) were complicated with comorbidities, among which hypertension (66.13%(41/62)), diabetes mellitus (25.81%(16/62)) and coronary atherosclerotic heart disease (22.58%(14/62)) accounted for the highest proportion. Primary clinical manifestations included fever (113 cases, 97.41%), with 86.21%(100/116) experiencing fever ≥five days, followed by fatigue (92 cases, 79.31%), myalgia (65 cases, 56.03%), anorexia (56 cases, 48.28%), cough/sputum (55 cases, 47.41%), and headache (54 cases, 46.55%). Early laboratory findings revealed leukopenia (2.22(1.75)×10 9/L], lymphopenia (0.63(0.50)×10 9/L), and thrombocytopenia (77.00(57.00)×10 9/L). Among 17 SD cases, 17 cases experienced severe organ damage, two cases had severe gastrointestinal bleeding, and two cases had septic shock. Among the patients with severe organ damage, there were eight cases of severe cardiac injury, followed by six cases of severe respiratory system injury, four cases of multiple organ dysfunction syndrome, three cases of acute kidney injury, three cases of neurological injury, and three cases of disseminated intravascular coagulation. Severe cardiac injury was manifested with acute heart failure in five cases, malignant arrhythmia in three cases, stress cardiomyopathy in one case, and acute myocardial infarction in one case. Severe respiratory system injuries were manifested with acute respiratory distress syndrome in five cases, severe pneumonia in three cases, and acute pulmonary embolism in one case. Neurological damage was manifested with viral meningitis in one case, acute cerebral infarction in one case, and sensorineural hearing loss in one case. All patients were cured or discharged after symptomatic supportive treatment and active prevention and treatment of complications. Conclusions:In 2024, dengue fever inpatients in Guangzhou area predominantly consist of elderly patients, who are complicated with comorbidities and present a high proportion of severe cases. Severe patients are primarily characterized by organ damage, with cardiovascular system injury being the most common severe manifestation. Dengue patients have a good prognosis.

Objective To explore the application effects of a discharge planning service program based on King's Goal Attainment Theory in patients undergoing transcatheter heart valve surgery.Methods Using convenience sampling method,80 patients who underwent transcatheter heart valve surgery at a tertiary comprehensive hospital in Zhejiang Province from August 2023 to January 2024 were selected as the research subjects.Among them,40 patients from November 2023 to January 2024 were selected as an experimental group.A discharge preparation service plan for patients undergoing transcatheter heart valve surgery based on King's Goal Attainment Theory was adopted.Totally 40 patients who underwent transcatheter heart valve surgery from August to October 2023 were selected as a control group and underwent routine measures for discharge preparation.The differences in the scores of the discharge preparation scale,discharge guidance quality scale,self-management scale for patients after mechanical heart valve replacement surgery,and unplanned readmission rate were compared between 2 groups before and after intervention.Results During the application of the plan,a total of 2 cases were excluded,and 38 cases were included in the experimental group and 40 cases were included in the control group.After intervention,the experimental group had higher scores in discharge readiness,discharge guidance quality,and self-management ability than the control group,and the differences were statistically significant(P＜0.001).The unplanned readmission rate within 30 days in the experimental group(2.63％)was lower than that in the control group(7.50％),and the difference was not statistically significant(P＞0.05).Conclusion The discharge preparation service plan for patients undergoing transcatheter heart valve surgery based on King's Goal Attainment Theory can improve the discharge preparation,discharge guidance quality,and self-management ability of patients undergoing transcatheter heart valve surgery,and has a positive effect on improving their quality of life.

Objective:To analyze the clinical characteristics and prognosis of dengue fever inpatients in Guangzhou area, so that to provide references for clinical diagnosis and treatment.Methods:The demographic data, laboratory findings, clinical manifestations, and outcomes of 116 dengue fever cases admitted to Guangzhou Red Cross Hospital, Jinan University and the First Affiliated Hospital, Jinan University from August 1st to December 21st, 2024 were retrospectively analyzed.Results:Among the 116 patients, 99 cases (85.34%) were classified as non-severe dengue, while 17(14.66%) progressed to severe dengue (SD). The cohort was comprised of 62(53.45%) males and 54(46.55%) females, with an age of 63.5(22.0) years, and the hospitalization duration was 6(4) days, with the fever duration of 6(2) days. Sixty-two patients (53.45%) were complicated with comorbidities, among which hypertension (66.13%(41/62)), diabetes mellitus (25.81%(16/62)) and coronary atherosclerotic heart disease (22.58%(14/62)) accounted for the highest proportion. Primary clinical manifestations included fever (113 cases, 97.41%), with 86.21%(100/116) experiencing fever ≥five days, followed by fatigue (92 cases, 79.31%), myalgia (65 cases, 56.03%), anorexia (56 cases, 48.28%), cough/sputum (55 cases, 47.41%), and headache (54 cases, 46.55%). Early laboratory findings revealed leukopenia (2.22(1.75)×10 9/L], lymphopenia (0.63(0.50)×10 9/L), and thrombocytopenia (77.00(57.00)×10 9/L). Among 17 SD cases, 17 cases experienced severe organ damage, two cases had severe gastrointestinal bleeding, and two cases had septic shock. Among the patients with severe organ damage, there were eight cases of severe cardiac injury, followed by six cases of severe respiratory system injury, four cases of multiple organ dysfunction syndrome, three cases of acute kidney injury, three cases of neurological injury, and three cases of disseminated intravascular coagulation. Severe cardiac injury was manifested with acute heart failure in five cases, malignant arrhythmia in three cases, stress cardiomyopathy in one case, and acute myocardial infarction in one case. Severe respiratory system injuries were manifested with acute respiratory distress syndrome in five cases, severe pneumonia in three cases, and acute pulmonary embolism in one case. Neurological damage was manifested with viral meningitis in one case, acute cerebral infarction in one case, and sensorineural hearing loss in one case. All patients were cured or discharged after symptomatic supportive treatment and active prevention and treatment of complications. Conclusions:In 2024, dengue fever inpatients in Guangzhou area predominantly consist of elderly patients, who are complicated with comorbidities and present a high proportion of severe cases. Severe patients are primarily characterized by organ damage, with cardiovascular system injury being the most common severe manifestation. Dengue patients have a good prognosis.

Hospital culture plays an important role in the orderly operation of large shelter hospitals as well as epidemic prevention and control.From April to May 2022, the shelter hospital of the National Convention and Exhibition Center(Shanghai) had created the large shelter hospital culture co-built by doctors and patients with a greater sense of belonging by taking measures such as joint party building between doctors and patients, giving play to the vanguard force of party members, carrying out various forms of cultural, sports and science popularization activities, encouraging enthusiastic patients to participate in activity planning, focusing on key groups, formulating shelter " residents convention", and so on. These measures ultimately formed cultural adaptation, cultural synchronization and cultural shaping, which were conducive to enhancing the empathy of doctors and patients, improving the effectiveness of medical implementation, and promoting the standardization of shelter management system. This harmonious, warm and autonomous culture co-built by doctors and patients effectively ensures the safe and orderly operation of the shelter hospital, and provides reference for the construction of the cultural system of large shelter hospitals in China.

Objective:To explore the feasibility of high-flow nasal cannula(HFNC)therapy for respiratory failure in elderly patients.Methods:A total of 300 patients with respiratory failure admitted to Peking University Shougang Hospital from December 2016 to March 2019 were enrolled in this prospective study.Patients were divided into three groups: the HFNC group, the conventional oxygen therapy(COT)group and the non-invasive positive pressure ventilation(NPPV)group(n=100 in each group). Arterial oxygen saturation(SPO 2), oxygen index(OI), heart rate(HR), respiratory rate(RR), mean arterial pressure(MAP), comfort level, discharge rate, tracheal intubation rate, rate of referral to ICU, mortality and rate of referral to another group after therapy were compared between the HFNC and COT groups and between the HFNC and NPPV groups. Results:SPO 2 after oxygen therapy for 30 minutes( t=-2.992, P=0.003), 1 hour( t=-2.884, P=0.005)and 6 hours( t=-3.196, P=0.002)and OI before discharge( t=-2.060, P=0.048)were higher in the HFNC group than in the COT group.The HR in the above two groups was lower before discharge than before therapy, and the HR in the COT group was even lower(73.1±25.1 beat per minute vs.75.1±25.9 beat per minute), but both were within the normal range.The discharge rate was higher( χ2=-1.969, P=0.049), while the rate of referral to another group was lower in the HFNC group than in the COT group( χ2=-3.115, P=0.002). There was no significant difference in the tracheal intubation rate, ICU transfer rate and mortality between the HFNC and COT groups.SPO 2 after oxygen therapy for 30 minutes( t=-2.026, P=0.046)and 6 hours( t=-2.101, P=0.040)were higher in the HFNC group than in the NPPV group, but there was no significant difference in OI and SPO 2 between the two groups before discharge.The HR in both HFNC and NPPV groups was lower before discharge than before therapy, and there was no statistical difference between the two groups.The mortality, discharge rate, tracheal intubation rate, ICU transfer rate and rate of referral to another group had no significant difference between the HFNC and NPPV groups.The comfort level was higher in the HFNC group than in the COT and NPPV groups( t=-3.758 and -19.180, both P=0.000). Conclusions:HFNC is a new type of oxygen therapy equipment introduced after COT and NPPV, and possesses more advantages for elderly patients with respiratory failure.

Objective To investigate the application effect of APP in continuing care of discharged patients with condylar fracture after operation. Methods By convenience sampling,from September 2016 to March 2017 in a ward of oral and maxillofacial surgery and received surgical treatment of condylar fracture patients 81 cases, randomly divided into observation group (41 cases) and control group (40 cases).On the basis of routine health education,the observation group carried out continuous care by APP, while the control group received routine health education. The opening type, opening degree, occlusion relation and temporomandibular joint pain in two groups were compared at 6 months after discharge. Results The results of 6 months, the patients in the observation group were open type, occlusion and TMJ pain were better than the control group, the opening degree of the observation group was (35.51 ± 4.34) mm, control group was (31.28 ± 4.57) mm, the difference between the two groups was statistically significant(t=-4.28,P<0.05).There was no statistical difference between the two groups of occlusion and temporomandibular joint pain (P>0.05). Conclusions APP can improve the open type, opening and occlusal relation and temporomandibular joint pain in patients with condylar fracture after operation.

Objective To understand the current situation of mastering the knowledge of nurses' professional relevant laws and regulations for nursing students.Methods Two hundred and sixty-two nursing students were surveyed by the self-designed questionnaire.Results The nursing students lacked a full understanding of the knowledge of nurses' professional relevant laws and regulations.The accuracy of mastering the knowledge of the laws and regulations which were closely related to clinic including the period of validity of the registration of practicing nurses,the apphcation time after revoking the practicing certificate and the evaluation of medical accidents in undergraduates nurse students were respectively 26.46％,24.43％,27.23％,and the junior college nursing students were 18.18％,30.36％,24.24％,and the differences were not statistically significant (x2 =2.509 5,1.145 9,0.297 3,respectively; P ＞ 0.05).Most nursing students had positive attitude about receiving the training of the knowledge of laws and regulations in the process of the practice,and 204 (77.90％) respondents thought it was very necessary to learn and master the knowledge of nurses' professional relevant laws and regulations.Condusions Both the schools and hospitals should pay attention to the training of the knowledge of nurses' professional relevant laws and regulations,and cultivate their legal consciousness.The nursing students should consciously learn about the relevant knowledge to prepare for the clinical work in the future.