BackgroundIn Sichuan Province， most healthcare institutions providing mental health services have adopted self-developed evaluation indicators for the quality of nursing care in psychiatric closed wards， lacking unified standards. This results in insufficient authority and homogeneity， which is unfavorable for the standardized assessment and continuous improvement of nursing quality. ObjectiveTo construct a standardized evaluation indicator system for nursing quality of psychiatric closed wards in Sichuan Province， so as to provide references for nursing quality management and assessment. MethodsBased on bio-psycho-social medical model and guided by "Structure-Process-Outcome" quality evaluation framework， preliminary evaluation indicators for nursing quality in psychiatric closed wards were developed through literature analysis， research team discussions and clinical experience. Through two rounds of Delphi expert consultation， the indicators were revised and finalized. ResultsThe response rates for two rounds of Delphi expert consultation questionnaire were 100%. The expert authority coefficients were 0.845 and 0.864， respectively， and the Kendall's coordination coefficients ranged from 0.119 to 0.210 （P<0.01）. Ultimately， a nursing quality evaluation index system for psychiatric closed wards was established， comprising 3 first-level indicators， 9 second-level indicators and 46 third-level indicators. ConclusionThe nursing quality evaluation indicators for psychiatric closed wards constructed based on the Delphi method can provide references for nursing quality management and evaluation in such wards. ［Funded by Research Project Fund of Sichuan Nursing Society （number， H20004）； Sichuan Hospital Association Hospital Management Research Special Fund （number， YG2323）］

The aim of this study is to identify the cause of death of a South China tiger cub at the Meihuashan breeding institute of Fujian Province.Pathogenic bacteria were isolated and cultured from liver,spleen,lung and other tissue samples of the dead South China tiger aseptically.The iso-lated bacteria were identified through morphological observation,biochemical characterization,sequence analysis of housekeeping gene gyrB,virulence gene detection,animal pathogenicity test and drug sensitivity test.A pathogenic Aeromonas hydrophila strain,designated FJ/Tiger-201809 was successfully isolated from the trachea of dead South China tiger.The nucleotide sequence ho-mology between the isolate and 11 strains of Aeromonas gyrB ranged from 91.2％to 99.1％,with the highest homology of 99.1％observed with Aeromonas hydrophila(AF208251.1).Genetic evo-lution analysis showed that the isolated strain FJ/Tiger-201809 was in the same evolutionary branch as other reference strains of Aeromonas hydrophila and was closely related.The pathoge-nicity test in mice showed artificial infection of mice with the strain resulted in varying degrees of lesions in several organs of the mice,and the median lethal dose(LD50)was 1 × 107.8 CFU/mL.Virulence gene test results showed that the isolate FJ/Tiger-201809 carried two virulence genes,aer and act.The results of drug sensitivity test showed that FJ/Tiger-201809 was highly sensitive to enrofloxacin and ampicillin among 18 commonly used antibiotics,relatively sensitive to penicil-lin G and doxycycline,and resistant to the other 14 antibiotics.In conclusion,this study isolated and identified a strain of Aeromonas hydrophila from a dead South China tiger with multiple drug resistance and strong pathogenicity,which provided an important reference for the prevention and control of bacterial diseases in South China tiger.

The aim of this study is to identify the cause of death of a South China tiger cub at the Meihuashan breeding institute of Fujian Province.Pathogenic bacteria were isolated and cultured from liver,spleen,lung and other tissue samples of the dead South China tiger aseptically.The iso-lated bacteria were identified through morphological observation,biochemical characterization,sequence analysis of housekeeping gene gyrB,virulence gene detection,animal pathogenicity test and drug sensitivity test.A pathogenic Aeromonas hydrophila strain,designated FJ/Tiger-201809 was successfully isolated from the trachea of dead South China tiger.The nucleotide sequence ho-mology between the isolate and 11 strains of Aeromonas gyrB ranged from 91.2％to 99.1％,with the highest homology of 99.1％observed with Aeromonas hydrophila(AF208251.1).Genetic evo-lution analysis showed that the isolated strain FJ/Tiger-201809 was in the same evolutionary branch as other reference strains of Aeromonas hydrophila and was closely related.The pathoge-nicity test in mice showed artificial infection of mice with the strain resulted in varying degrees of lesions in several organs of the mice,and the median lethal dose(LD50)was 1 × 107.8 CFU/mL.Virulence gene test results showed that the isolate FJ/Tiger-201809 carried two virulence genes,aer and act.The results of drug sensitivity test showed that FJ/Tiger-201809 was highly sensitive to enrofloxacin and ampicillin among 18 commonly used antibiotics,relatively sensitive to penicil-lin G and doxycycline,and resistant to the other 14 antibiotics.In conclusion,this study isolated and identified a strain of Aeromonas hydrophila from a dead South China tiger with multiple drug resistance and strong pathogenicity,which provided an important reference for the prevention and control of bacterial diseases in South China tiger.

Objective:To establish a time control mode for component blood collection and to discuss its application value in the operation management of blood separator.Methods:The causes for delay in blood separation time in blood component collection were analyzed,the correlation between influencing factors and time control level was analyzed by using data mining algorithm,and time control management countermeasures were developed by running time prediction.A total of 600 blood donors and 17 blood separators in clinical use in Shanghai Xuhui District Central Hospital from 2019 to 2022 were selected and divided into a control group(300 blood donors,14 blood separators)and an observation group(300 blood donors,15 blood separators,including 12 of control groups and 3 newly added)according to different management modes.The control group adopted the quality control mode,the observation group adopted the time control mode.The number of problems,the proportion of delay,the number of satisfied people and the assessment results of relevant medical staff in the blood component collection process were compared between the two groups.Results:The number of blood donors with problems related to equipment,medical consumables,medical staff and blood donors during the blood component collection process in the observation group was 11(accounting for 3.7%),17(accounting for 5.7%),7(accounting for 2.3%)and 18(accounting for 6.0%),respectively,which were lower than those in the control group,the difference was statistically significant(x2=7.192,6.822,8.153,11.405,P<0.05).The number of blood donors whose blood separators were in normal operation,apparent delay and significant delay in the observation group were 236(accounting for 78.7%),46(accounting for 15.3%)and 18(accounting for 6.0%),respectively,and the proportions of normal operation were higher than those in the control group,the proportions of apparent delay and significant delay were lower than those in the control group,the difference was statistically significant(x2=17.821,7.131,8.549,P<0.05).The proportion of blood donors satisfied was 284(accounting for 94.7%)in the observation group,which was higher than that in the control group,the difference was statistically significant(x2=30.171,P<0.05).The assessment score of medical staff involved in blood donors in the observation group was(91.14±4.86),which was higher than that in the control group,the difference was statistically significant(t=4.587,P<0.05).Conclusion:Time control mode can control the probability of the problems in the operation of blood separator,shorten the delay time of blood separator operation,improve blood donation experience of blood donors and blood collection service quality,and improve the professional level of medical staff.

Objective:To investigate the efficacy and safety of kidney sparing treatment based on Thulium laser ablation and systematic therapy in localized high-risk upper urinary tract urothelial carcinoma (UTUC).Methods:The data of 10 patients with UTUC who received combined treatment based on Thulium laser and systematic treatment from January 2020 to December 2021 in West China Hospital were retrospectively analysed. There were 5 males and 5 females with a median age of 76 (range 52 to 87)years old. Three cases were renal pelvis tumor and 7 cases were ureter tumor including 5 cases in lower ureter and 2 cases in upper and middle ureter. Five cases were with positive urine cytology and 6 cases were with hydronephrosis. One case was muscular invasion UTUC confirmed by biopsy(cT 2+), 7 cases were high-grade invasive urothelial carcinoma (cT 1+), and 2 cases were high-grade papillary urothelial carcinoma (cT a). Among 10 cases, 5 patients refused radical nephroureterectomy(RUN), among whom 3 patients were too old or in poor general condition to tolerate RNU. One case had a solitary kidney and 1 case had bilateral tumours. Patients were treated with Thulium laser tumor ablation under ureteroscopy combined with systemic therapy. The perioperative systemic treatment included platinum-based chemotherapy±immunotherapy, RC48+ immunotherapy, and immunotherapy alone. The postoperative treatment was immunotherapy maintenance±local radiotherapy. Strict follow-up was conducted after the completion of treatment. Results:Nine patients received systemic therapy before ablation. Four cycles of platinum-based chemotherapy (cisplatin in 2 cases, carboplatin in 1 case) were used in 3 cases, and platinum-based chemotherapy + immunotherapy (6 cycles of cisplatin + toripalimab in 1 case, 4 cycles of cisplatin + toripalimab in 1 case, 4 cycles of carboplatin+ trelizumab in 1 case) was used in 3 cases, four cycle of RC48 + immunotherapy (toripalimab or trelizumab) were used in 2 cases, and four cycles of immunotherapy (toripalimab) were used in 1 case. The operations of 10 cases were successfully completed without serious complications during the perioperative period and the laser working time (42.4 ± 15.2) min. Of the 10 cases, 4 achieved complete ablation at the first ablation, and 6 patients had incomplete ablation. Among them, 2 patients achieved clinical complete remission after 1-2 cycles of systemic therapy, and 4 patients achieved complete ablation after Thulium laser ablation again.All the 10 patients were treated with immunotherapy for 1 year, and 2 of them received additional adjuvant radiotherapy. The patients were followed-up for median 40 months(range 26 to 53 months). Recurrence occurred in 5 cases, of which 3 cases underwent salvage nephroureterectomy and 2 cases underwent Thulium laser ablation under ureteroscopy again. Five patients had no tumor recurrence. None of the 10 patients had distant metastasis. At the last follow-up, 1 patient died of complications and 6 patients kept the affected kidney alive. Perioperative complications including macroscopic hematuria (8 cases), fever (3 cases), the long-term complications of ureter stenosis (4 cases).Conclusions:For localized high-risk UTUC, local Thulium laser ablation combined with systemic therapy can achieve good tumor control while preserving the affected kidney in selected patients, and its potential application value should be further evaluated.

This article aims to provide a review of the domestic and foreign studies on the quality indicators for evaluating the psychiatric nursing care in recent years. According to Donabedian model， the research progress of quality indicators for evaluating the psychiatric nursing care were described from the three dimensions of structure quality， process quality and outcome quality. This paper summarizes the status of the research， points out the shortcomings of existing research， and provides references for the future research on the quality indicators for evaluating the psychiatric nursing care.

Objective:To integrate qualitative research on the experience of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD) , to understand the experience of patients with pulmonary rehabilitation and its influencing factors, so as to provide evidence support for pulmonary rehabilitation.Methods:Qualitative research on pulmonary rehabilitation experience of COPD patients was retrieved by computer in 8 databases including the Cochrane Library, Web of Science, Embase, PubMed, CINAHL, China National Knowledge Infrastructure, WanFang and VIP. The retrieval time limit was from the establishment of the database to August 20, 2021. The quality of the articles those met the requirements were evaluated by the quality evaluation criteria for qualitative research of the Australian Joanna Briggs Institute Evidence-Based Health Care Center, and the results of each study were further integrated and analyzed.Results:A total of 12 articles were included, and 47 clear topics were extracted, and similar topics were summarized into 7 new categories. A total of 3 integrated results were synthesized, namely rehabilitation efficacy, pulmonary rehabilitation motivation, and pulmonary rehabilitation obstacles.Conclusions:COPD patients who can persist in training perceive the benefits of pulmonary rehabilitation, and both the pulmonary rehabilitation environment and interpersonal support are factors that promote their pulmonary rehabilitation. The patients' own condition and transportation and economic difficulties are the main obstacles. Therefore, the patients' physical and economic status should be comprehensively evaluated during pulmonary rehabilitation, and the most suitable pulmonary rehabilitation program should be selected.

Issues caused by maxillofacial tumours involve not only dealing with tumours but also repairing jaw bone defects. In traditional tumour therapy, the systemic toxicity of chemotherapeutic drugs, invasive surgical resection, intractable tumour recurrence, and metastasis are major threats to the patients' lives in the clinic. Fortunately, biomaterial-based intervention can improve the efficiency of tumour treatment and decrease the possibility of recurrence and metastasis, suggesting new promising antitumour therapies. In addition, maxillofacial bone tissue defects caused by tumours and their treatment can negatively affect the physiological and psychological health of patients, and investment in treatment can result in a multitude of burdens to society. Biomaterials are promising options because they have good biocompatibility and bioactive properties for stimulation of bone regeneration. More interestingly, an integrated material regimen that combines tumour therapy with bone repair is a promising treatment option. Herein, we summarized traditional and biomaterial-mediated maxillofacial tumour treatments and analysed biomaterials for bone defect repair. Furthermore, we proposed a promising and superior design of dual-functional biomaterials for simultaneous tumour therapy and bone regeneration to provide a new strategy for managing maxillofacial tumours and improve the quality of life of patients in the future.
Biocompatible Materials ; Bone Regeneration ; Bone and Bones ; Humans ; Quality of Life

Objective:To investigate the occurrence of pain symptoms and risk factors of carpal tunnel syndrome (CTS) in automobile manufacturing workers and provide theoretical basis for the prevention of CTS.Methods:From Nov.5th to Nov.19th, 2017, 446 workers in an automobile factory whose work age was above one year participate in questionnaires by cluster sampling. Chi square test and multifactor logistics regression analysis were used to analyze the factors related to the occurrence of CTS pain symptoms in workers.Results:The incidence of CTS pain among workers in this automobile factory was 20.8%. Working in the same position for a long time ( OR=2.137, 95% CI:1.183-3.862) and unable to work reasonably because of uncomfortable posture ( OR =2.067, 95% CI: 1.075-3.974) were identified as the risk factors of CTS pain symptoms by multifactor logistics regression analysis. Working age ( OR=0.537, 95% CI:0.311-0.926) and work break ( OR= 0.489, 95% CI: 0.282-0.849) were identified as the benefit factors of CTS pain symptoms. Conclusion:The incidence of CTS pain in automobile manufacturing workers is related to the posture in the process of labor . Effective ergonomic interventions should be carried out to prevent the occurrence of CTS pain in automobile manufacturing workers.

Objective:To investigate the occurrence of pain symptoms and risk factors of carpal tunnel syndrome (CTS) in automobile manufacturing workers and provide theoretical basis for the prevention of CTS.Methods:From Nov.5th to Nov.19th, 2017, 446 workers in an automobile factory whose work age was above one year participate in questionnaires by cluster sampling. Chi square test and multifactor logistics regression analysis were used to analyze the factors related to the occurrence of CTS pain symptoms in workers.Results:The incidence of CTS pain among workers in this automobile factory was 20.8%. Working in the same position for a long time ( OR=2.137, 95% CI:1.183-3.862) and unable to work reasonably because of uncomfortable posture ( OR =2.067, 95% CI: 1.075-3.974) were identified as the risk factors of CTS pain symptoms by multifactor logistics regression analysis. Working age ( OR=0.537, 95% CI:0.311-0.926) and work break ( OR= 0.489, 95% CI: 0.282-0.849) were identified as the benefit factors of CTS pain symptoms. Conclusion:The incidence of CTS pain in automobile manufacturing workers is related to the posture in the process of labor . Effective ergonomic interventions should be carried out to prevent the occurrence of CTS pain in automobile manufacturing workers.