Objective To explore the psychological feelings and coping resources of patients waiting for a liver transplantation,in order to provide references for implementing psychological nursing care.Methods Using purposive sampling,15 patients waiting liver transplantation surgery from June to November 2024 at a tertiary hospital in Qingdao were selected as study subjects.Semi-structured in-depth interviews were conducted,and data were analyzed using interpretative phenomenological analysis to extract themes.Results The psychological feelings of patients waiting for a liver transplantation included 2 main themes with 6 sub-themes,namely,the complex and contradictory psychological feelings of liver transplant patients during the waiting period(expectations for transplanta-tion and future outlook,multiple psychological burdens intertwining,introspection and growth),and mobilizing psychological resilience resources to deal with complex psychological feelings(core resources,internal resources,external resources).Conclusion Clinical medical staff should implement psychological care for patients waiting for a liver transplantation based on the complex and contradictory psychological feelings they experience.Also,they should target the coping resources for psychological feelings to construct coping strategies,thereby comprehensively improving patients' psychological health during the waiting period.The coping strategies include promoting patients' health behaviors,improving their psychological status,and providing multidimensional social support for them.

Objective:To investigate the influence of cytochrome P450 2A6 (CYP2A6) gene polymorphisms on liver function injury in patients with hyperthyroidism treated with methimazole.Methods:The study selected 90 patients with hyperthyroidism who were treated with methimazole in the Department of Thyroid Surgery at the First Affiliated Hospital of Zhengzhou University from Sept. 2023 to Aug. 2024 as the research subjects. Based on the occurrence of liver injury, they were divided into a liver injury group ( n=36) and a non-liver injury group (n=54). Peripheral blood DNA was extracted from the patients, and the CYP2A6 gene genotypes (rs8192725, rs8192720, and rs28399433) were detected using the polymerase chain reaction (PCR) amplification method. The association between CYP2A6 gene polymorphisms and liver injury induced by methimazole treatment in hyperthyroidism was analyzed. Results:The comparison of genotype distribution frequencies at the rs8192725 locus between the liver injury group and the non-liver injury group showed a statistically significant difference ( P<0.05). The AG and GG genotypes at the rs8192725 locus were protective factors against liver injury in patients with hyperthyroidism (AG vs. AA, OR: 0.21; 95% CI: 0.08-0.57; P<0.05; GG vs. AA, OR: 0.24; 95% CI: 0.06-0.89; P<0.05; AG+GG vs. AA, OR: 0.22; 95% CI: 0.09-0.54; P<0.05). The frequency of the G allele of rs8192725 in the liver injury group was significantly lower than that in the non-liver injury group (G vs. A, OR: 0.36; 95% CI: 0.19-0.70; P<0.05), indicating that it is a protective factor for liver injury in hyperthyroid patients receiving methimazole treatment. Conclusions:The CYP2A6 gene polymorphism at the rs8192725 locus is associated with the occurrence of liver injury in patients with hyperthyroidism treated with methimazole. The G allele may be a protective factor against liver injury in patients with hyperthyroidism, suggesting that individualized treatment plans can be developed based on the patient's genotype.

Objective:To investigate the influence of cytochrome P450 2A6 (CYP2A6) gene polymorphisms on liver function injury in patients with hyperthyroidism treated with methimazole.Methods:The study selected 90 patients with hyperthyroidism who were treated with methimazole in the Department of Thyroid Surgery at the First Affiliated Hospital of Zhengzhou University from Sept. 2023 to Aug. 2024 as the research subjects. Based on the occurrence of liver injury, they were divided into a liver injury group ( n=36) and a non-liver injury group (n=54). Peripheral blood DNA was extracted from the patients, and the CYP2A6 gene genotypes (rs8192725, rs8192720, and rs28399433) were detected using the polymerase chain reaction (PCR) amplification method. The association between CYP2A6 gene polymorphisms and liver injury induced by methimazole treatment in hyperthyroidism was analyzed. Results:The comparison of genotype distribution frequencies at the rs8192725 locus between the liver injury group and the non-liver injury group showed a statistically significant difference ( P<0.05). The AG and GG genotypes at the rs8192725 locus were protective factors against liver injury in patients with hyperthyroidism (AG vs. AA, OR: 0.21; 95% CI: 0.08-0.57; P<0.05; GG vs. AA, OR: 0.24; 95% CI: 0.06-0.89; P<0.05; AG+GG vs. AA, OR: 0.22; 95% CI: 0.09-0.54; P<0.05). The frequency of the G allele of rs8192725 in the liver injury group was significantly lower than that in the non-liver injury group (G vs. A, OR: 0.36; 95% CI: 0.19-0.70; P<0.05), indicating that it is a protective factor for liver injury in hyperthyroid patients receiving methimazole treatment. Conclusions:The CYP2A6 gene polymorphism at the rs8192725 locus is associated with the occurrence of liver injury in patients with hyperthyroidism treated with methimazole. The G allele may be a protective factor against liver injury in patients with hyperthyroidism, suggesting that individualized treatment plans can be developed based on the patient's genotype.

Objective To explore the psychological feelings and coping resources of patients waiting for a liver transplantation,in order to provide references for implementing psychological nursing care.Methods Using purposive sampling,15 patients waiting liver transplantation surgery from June to November 2024 at a tertiary hospital in Qingdao were selected as study subjects.Semi-structured in-depth interviews were conducted,and data were analyzed using interpretative phenomenological analysis to extract themes.Results The psychological feelings of patients waiting for a liver transplantation included 2 main themes with 6 sub-themes,namely,the complex and contradictory psychological feelings of liver transplant patients during the waiting period(expectations for transplanta-tion and future outlook,multiple psychological burdens intertwining,introspection and growth),and mobilizing psychological resilience resources to deal with complex psychological feelings(core resources,internal resources,external resources).Conclusion Clinical medical staff should implement psychological care for patients waiting for a liver transplantation based on the complex and contradictory psychological feelings they experience.Also,they should target the coping resources for psychological feelings to construct coping strategies,thereby comprehensively improving patients' psychological health during the waiting period.The coping strategies include promoting patients' health behaviors,improving their psychological status,and providing multidimensional social support for them.

Objective To investigate the clinical characteristics,treatment methods,and prognosis of a-cute leukemia patients with extramedullary infiltration.Methods The clinical characteristics and treatment methods of 47 acute leukemia patients with extramedullary infiltration admitted to the Affiliated Hospital of Guizhou Medical University from April 2014 to April 2023 were retrospectively analyzed.Subgroup analysis was performed according to whether there was extramedullary infiltration before transplantation,and whether there was isolated extramedullary recurrence after transplantation.Based on this analysis,the patients were di-vided into the pre-transplantation radiotherapy group and pre-transplantation non-radiotherapy group,the post-transplantation radiotherapy group and post-transplantation non-radiotherapy group.According to the treatment methods of central nervous system leukemia(CNSL),the patients were divided into the intrathecal injection group(n=12)and combination of intrathecal injection and radiotherapy group(n=13).The local remission situation,survival duration,and toxic and side effects of radiotherapy and chemotherapy were com-pared.Results For acute leukemia patients with extramedullary infiltration,the overall survival time(OS)in the radiotherapy group was better than that in the non-radiotherapy group(median OS:706 d vs.151 d,P=0.015).Subgroup analysis showed that the OS of the pre-transplantation radiotherapy group was better than that of the pre-transplantation non-radiotherapy group(median OS:592 d vs.386 d,P=0.035).For CNSL,the combination of intrathecal injection and radiotherapy group had a better OS than the intrathecal injection group(median OS:547 d vs.388 d,P=0.045).The event-free survival time(EFS)of the radiotherapy group was better than that of the non-radiotherapy group(median EFS:175 d vs.50 d,P=0.005).The COX pro-portional-hazards model showed that treatment with or without radiotherapy had a significant impact on the OS of acute leukemia patients with extramedullary infiltration.The risk of death in the pre-transplantation non-radiotherapy group was 2.231 times higher than that in the pre-transplantation radiotherapy group(HR=3.231,95％CI:1.021-10.227,P=0.046).Compared with the non-radiotherapy group,the radiother-apy group had a higher local remission and a lower risk of haematological toxicity,infection,and haemorrhage.Conclusion Radiotherapy can rapidly alleviate the local symptoms of acute leukemia complicated with extr-amedullary infiltration,prolong the survival time of these patients,and reduce the risk of hematologic toxicity,infection,and haemorrhage.

Objective To investigate the influence of peripheral blood neutrophil-to-lymphocyte ratio (NLR),monocyte-to-lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR) on the prognosis in the patients with multiple myeloma (MM).Methods A total of 159 newly diagnosed MM admitted and treated in the Affiliated Hospital of Guizhou Medical University from January 2019 to May 2023 were selected as the study subjects.The general clinical data,blood biochemical and marrow routine detection results before the in-itial treatment were collected.NLR,MLR and PLR were calculated.The univariate and multivariate Cox-re-gression model was adopted to analyze the influencing factors.The receiver operating characteristic (ROC) curve was used to analyze the predictive value.The Kaplan-Meier survival curve and Log-Rank test were used to conduct the survival analysis.Results The ROC curve showed that the critical values of NLR,MLR and PLR were 2.682,0.317 and 147.786 respectively.The patients were divided into the high/low NLR groups (n=61,n=98),high/low MLR group (n=76,n=83) and high/low PLR groups (n=59,n=100).The pro-portions of blood calcium<2.5 mmol/L and creatinine<177 μmmol/L in the low NLR group in the low NLR group were higher compared with the high NLR group (P<0.05);the blood calcium,creatinine and DS stage had statistical differences between the low MLR group and high MLR group (P<0.05);blood calcium had statistical difference between the low PLR group and high PLR group (P<0.05).After 3 treatment courses,the complete remission rate in the high NLR group,high MLR group and high PLR group was significantly lower than that in the corresponding low group (P<0.05).The multivariate Cox-regression analysis results showed that hemoglobin<100 g/L and high PLR were the independent risk factors affecting the progress free survival (PFS) stage in the patients with MM (P<0.05).The age>60 years old was the independent risk factors affecting the overall survival (OS) in the patients with MM (P<0.05).Conclusion NLR,MLR and PLR could serve as the assisted tool to evaluate the prognosis in the patients with MM.

Objective:To summarize the best evidence for non-pharmacological management of postoperative delirium in adult liver transplant recipients, providing reference for postoperative delirium management in liver transplant recipients.Methods:Evidence on non-pharmacological management of postoperative delirium in adult liver transplant recipients was retrieved through computer in databases such as UpToDate, British Medical Journal (BMJ) Best Practice, Embase, PubMed, Cochrane Library, Joanna Briggs Institute Evidence-Based Health Care Center Database, Guidelines International Network, China Biology Medicine disc, China National Knowledge Infrastructure, WanFang Data, and VIP. The search period was from database establishment to January 31, 2023. The types of literature included guidelines, clinical decision-making, best practices, systematic review, summary of evidence, and expert consensus. Two researchers conducted quality evaluation and evidence extraction on the included literature.Results:A total of 10 articles were included, involving 1 clinical decision-making, 4 guidelines, 3 systematic reviews, and 2 expert consensuses. A total of 25 best pieces of evidence for non-pharmacological management of postoperative delirium in adult liver transplant recipients were summarized from four aspects, including screening, evaluation, non-pharmacological prevention, and non-pharmacological treatment.Conclusions:The best evidence on non-pharmacological management of postoperative delirium in adult liver transplant recipients summarized provides a reference for postoperative delirium management in liver transplant recipients.

Objective:To explore the relationship between individual resilience, work stress, and work engagement among nurses in Emergency Department.Methods:A questionnaire survey was conducted on 350 nurses from six Class Ⅲ Grade A hospitals in Shandong Province from April to September 2022, using the General Information Questionnaire, the Chinese version of the Stressor Scale for Emergency Nurse, the Chinese version of the Utrecht Work Engagement Scale, and the Medical Staff Composition Resilience Scale. Pearson correlation was used to analyze the correlation between nurse work stress, work engagement, and individual resilience. The structural equation model was constructed using a mediating effect testing program to analyze the relationships between variables.Results:A total of 350 questionnaires were distributed, and 330 valid questionnaires were collected, with an effective response rate of 94.28%. The scores of nurse work engagement, work stress, and individual resilience were (54.26±10.08), (77.36±25.48), and (67.76±12.33), respectively. Work stress was negatively correlated with work engagement and individual resilience (all P<0.01), while individual resilience was positively correlated with work engagement ( P<0.01). Individual resilience was a mediating variable between work stress and work engagement among nurses in Emergency Department, with a mediating effect accounting for 31.38% of the total effect. Conclusions:Most nurses of Emergency Department have moderate levels of work stress, work engagement, and individual resilience. Individual resilience partially mediates the relationship between work stress and work engagement among nurses in Emergency Department. Nursing managers should attach importance to the organizational culture atmosphere and develop corresponding measures to enhance the individual resilience of nurses and encourage them to be energetic and enthusiastic in their work.

Objective:To investigate the relationship between telomere length of bone marrow mononuclear cells and prognosis of patients with acute myeloid leukemia (AML) who received allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:Telomere length of bone marrow mononuclear cells before transplantation, after transplantation and before donor mobilization as well as information related to follow-up of 33 AML patients who received allo-HSCT in the Affiliated Hospital of Guizhou Medical University between June 2020 and June 2021 were retrospectively analyzed. Telomere length was detected by using telomeric terminal restriction fragment (TRF) method. Telomere length was compared among patients with different prognoses. The recurrence within 1 year was treated as the gold standard and receiver operating characteristic (ROC) curve was used to analyze the effect of telomere length before transplantation or before donor mobilization in the judgement of the recurrence within 1 year after transplantation. The patients were stratified according to the optimal threshold value of telomere length for patients or donors, and Kaplan-Meier method was used to compare the progression-free survival (PFS) of patients with different stratification, and log-rank test was performed.Results:The median age of 33 patients was 34 years (14-61 years), and there were 17 males and 16 females; 31 patients were initially diagnosed with AML, 1 patient transferred from myelodysplastic syndrome (MDS) to AML, and 1 patient transferred from chronic granulocytic leukemia (CML) to AML; 14 received identical sibling transplantation and 19 received haploidentical sibling transplantation. The median age of the donors was 30 years (20-65 years), including 24 males and 9 females. Telomere length of bone marrow mononuclear cells before mobilization in 33 donors was longer than that in patients before transplantation (33 cases) and at +30 d after transplantation (31 cases) [(6.67±0.31) kb, (6.40±0.33) kb, (6.48±0.33) kb, respectively; all P < 0.05], and the difference between patients before and at +30 d after transplantation was not statistically significant ( t = 0.89, P = 0.378), and the telomere length of bone marrow mononuclear cells in 11 patients +180 d after transplantation was (6.66±0.18) kb. The incidence of acute graft-versus-host disease (aGVHD) after transplantation was 45.5% (15/33), the incidence of infection with clear imaging and pathogenic basis was 39.4% (13/33), the mortality rate within 1 year after transplantation was 3.0% (1/33), and the recurrence rate within 1 year after transplantation was 15.2% (5/33). There were no statistically significant differences in telomere length of donor pre-mobilization bone marrow mononuclear cells between the groups with and without aGVHD and between the infected and non-infected groups (all P > 0.05).Compared with patients who had not relapsed within 1 year after transplantation, telomere length of donor pre-mobilization bone marrow mononuclear cells was shorter in patients who relapsed within 1 year after transplantation [(6.39±0.19) kb vs. (6.72±0.30) kb, t = -3.23, P = 0.011], telomere length was longer in patients before transplantation [(6.75±0.16) kb vs. (6.35±0.36) kb, t = 4.17, P = 0.001]. ROC curve analysis showed that the optimal threshold values for telomere length of pre-transplantation and donor pre-mobilization bone marrow mononuclear cells were 6.48 and 6.42 kb, respectively for patients who relapsed within 1 year after transplantation. PFS in patients with pre-transplantation bone marrow mononuclear cells telomere length < 6.48 kb was better than that in patients with telomere length ≥ 6.48 kb ( P = 0.003); PFS in patients with pre-mobilization bone marrow mononuclear cells telomere length>6.42 kb was better than that in patients with telomere length ≤ 6.42 kb ( P < 0.001). Conclusions:In allo-HSCT for AML, patients have an increased risk of relapse within 1 year after transplantation when their pre-transplantation bone marrow mononuclear cells telomere length is long and the donor bone marrow mononuclear cells telomere length is short.

Objective:To translate the Stressor Scale for Emergency Nurse (SSEN), and to test the reliability and validity of the Chinese version.Methods:According to the Brislin model to translate and back-translate the orginal English version, the Chinese version of the scale was determined after cross-cultural adaptation and pretesting. From October 2021 to January 2022, 401 emergency nurses in the Affiliated Hospital of Qingdao University were selected for a questionnaire survey to evaluate the reliability and validity of the translated Chinese scale.Results:The Chinese version of the SSEN retains 27 items, 4 common factors were extracted by exploratory factor analysis, and the factor cumulative variance contribution rate was 78.463%. Confirmatory factor analysis showed that χ2/ df=2.280, comparative fitness index=0.933, Tucker-Lewis index=0.924, incremental fit index=0.933, root mean square of approximate residual=0.079, all within the acceptable range. The item-level content validity index of the Chinese SSEN was 0.80-1.00; the scale-level content validity index was 0.97; it was positively correlated with the Maslach Burnout Inventory manual, and the correlation coefficient was 0.456 ( P<0.001); the Cronbach α coefficient of the total table was 0.971, the split-half reliability was 0.877, and the test-retest reliability was 0.958. Conclusions:The Chinese version of the SSEN has good reliability and validity, and it can be used to investgate the occupattional stressors for emergency nurses in the context of Chinese culture.