Procedural pain refers to the acute and transient pain caused by medical diagnosis, treatment and nursing for the purpose of medical health care. This paper reviews the application of virtual reality technology in adult procedural pain, including the related concepts and analgesic mechanisms of virtual reality technology and procedural pain, the application status of virtual reality technology in reducing adult procedural pain, and analyzes the shortcomings and prospects of virtual reality technology in clinical application, so as to provide guidance for medical nursing practice.

Objective To establish a quality indicator system of interventional nursing.Methods Taking Donabedian quality structure model as the theoretical basis and through literature analysis,expert meeting and summarizing the clinical problems,the first draft about interventional nursing care quality indicators was composed,which included 3 first-level indicators,12 second-level indicators and 55 third-level indicators.A total of 27 experts on interventional nursing and nursing administration were selected from 25 grade-3A level hospitals in 13 provinces and cities of China.The Delphi method was used to conduct two rounds of expert correspondence consultation,and the quality indicator system of interventional nursing was established.Results Finally,a quality indicator system of interventional nursing,which included 3 first-level indicators,7 second-level indicators and 29 third-level indicators,was formulated.In both the two rounds of expert letter inquiry,the positive coefficient and authority coefficient were 100％and 0.95 respectively.The coefficient of variation of each index in the first and the second round of expert letter inquiry was 0-0.25 and 0-0.21 respectively.In the first round of expert letter inquiry,the Kendall harmony coefficients of the first-level,second-level and third-level indexes were 0.672,0.271 and 0.341 respectively,while in the second round of expert letter inquiry,the Kendall harmony coefficients of the first-level,second-level and third-level indexes were 0.462,0.475 and 0.330 respectively,the differences were statistically significant(all P＜0.01).Conclusion The quality indicator system of interventional nursing established in this study carries a relatively high reliability and scientific nature,and it can provide reference for evaluating and monitoring the safety and quality control in interventional nursing.

Objective To explore the effect of virtual reality(VR)technology on relieving intraoperative pain in patients receiving transcatheter hepatic artery chemoembolization(TACE).Methods A total of 76 patients,who received TACE from June 2023 to January 2024,were enrolled in this study.Using random number table method,the patients were divided into control group(n=38)and study group(n=38).Intraoperative routine nursing was carried out for the patients of the control group,while on the basis of routine nursing additional VR technology was adopted to relieve the intraoperative pain for the patients of the study group.The degree of intraoperative pain,anxiety symptoms,incidence of intraoperative adverse reactions and patient satisfaction with nursing were compared between the two groups.Results The degree of intraoperative pain in the study group was lower than that in the control group,but the difference between the two groups was not statistically significant(P＞0.05).The analgesic effect of VR was much obvious in patients aged≤55 years and in patients with vascular invasion of liver cancer(P＜0.05).The anxiety score in the study group was lower than that in the control group,the patient satisfaction score in the study group was higher than that in the control group,and the differences between the two groups were statistically significant(both P＜0.05).No statistically significant difference in the incidence of adverse reactions existed between the two groups(P＞0.05).Conclusion Immersive VR technology can effectively reduce the degree of intraoperative pain in patients receiving TACE,especially in patients aged ≤55 years.Besides,VR technology can also reduce the anxiety degree of patients,and improve the degree of intraoperative patient satisfaction with nursing.

Objective To evaluate the effect of conversion from mycophenolic acid (MPA) to mizoribine (MZR) in renal transplant recipients with gastrointestinal tract (GI) symptoms.Methods A total of 355 renal transplant recipients with GI symptoms caused by MPA administration were enrolled from April 2015 to March 2017 in 25 different renal transplant centers in China.The symptomatic improvement of GI before (baseline) and after conversion to MZR (1,2,4 weeks) was assessed by each item of GI symptoms indication.In addition,the efficacy and safety of the conversion therapy during 12 months were determined.Results Patients showed improvement in GI symptoms including diarrhea,abdominal pain,abdominal distention and stomachache after conversion to MZR 1,2,4 weeks (P＜0.05).In patients with different severity of diarrhea,conversion to MZR therapy significantly improved diarrhea (P＜0.05).During 12 months,no patient experienced clinical immune rejection.We did not observe any infections,leucopenia and other serious side effects.Conclusion MZR could markedly improve GI symptoms caused by MPA administration in renal transplant recipients.

Objective The policy of quota payment for specific diseases has been carried out at the hospital for several years, yet proven a failure. This paper aims at searching for a new way of management.Methods Since 2013,attempts have been made for classification of medical costs and the quota setting for specific diseases, and for development of a real-time supervision software for classification of disease-specific costs.The attempts prove a success with a new model for management of quota management for specific diseases.Results This practice has proved to be effective in 2014,and used in other likewise diseases,which has been embraced by administrators of medical insurance sector. Conclusion This model proves useful for reducing inpatient expenses and regulating medical behaviors. but also shorten the average hospitalization days,improve the satisfaction of patient.The method of management control can be expanded and imitated.

Objective To investigate the changes of β-adrenergic receptor (βAR) in peripheral lymphocytes and β2AR mRNA levels at different stages of bronchial asthma. Methods β2AR density and β2AR mRNA level in peripheral lymphocytes, cAMP and cGMP levels in blood plasma were estimated by radioligand binding assay, radioimmunoassay and RT-PCR.Results (1) Maximum bound volume (Bmax) and equilibrium dissociation constant (Kd) of β2AR of lymphocyte in asthma patients at remission stage were markedly higher than that in normal subjects, while cAMP levels in blood plasma showed no difference. Bmax of β2AR and cAMP levels in asthma patients at acute exacerbation stage were significantly lower than that in normal subjects, and Kds between these two groups were not much different. (2) Expression of β2ARmRNA in peripheral lymphocytes of asthmatics at remission stage was not significantly different compared with that in normals. Conclusions Amount and function of βAR and β2ARmRNA levels are related to asthmatic conditions. Changes of βAR and β2ARmRNA in asthma might rather be a pathological change accompanied by the course of the disease than a primary defect.

AIM:To study the changes of ?-adrenoceptors in peripheral lymphocytes at different stages of asthma. METHODS:?-adrenoceptors in peripheral lymphocytes, cAMP and cGMP levels in blood plasma were measured by radioligand binding assay and radioimmunoassay.RESULTS:Bmax and Kd of ?-adrenoceptors in asthma at remission stage were markedly higher than that in normal subjects, while cAMP levels in blood plasma were not different between them. Bmax of ?-adrenoceptors and cAMP levels in blood plasma in asthma at acute exacerbation stage were significantly lower than that in normal subjects, Kds between these two groups were not much different. There was no correlation between ?-adrenoceptors, cAMP and cGMP levels in blood plasma and ventilatory functions.CONCLUSIONS:Changes of ?-adrenoceptors in asthma rather be a pathological change accompanied by the course of the disease than a primary defect.

Our previous study showed that malignant phenotype of human promyelocytic leukemia cells could he suppressed by fusion of them with mouse reticulocytes. In order to investigate the morphological changes for malignancy reversion, the present experiment was designed to study the microscepic and submicroscopic structure of cybrid cells and compared with their parental tumor cells. The results indicated that during the short period of cybrid cell cultivation, nuclei of numerous cybrid cells became pyknotic and eccentric, and some cells showed the process of nuclear expulsion (denucleation). The cybrids which cultivated for long period in vitro developed into more mature cells along both myeloid and erythroid differentiation pathway. The effects of mouse reticulocyte cytoplasmic factor on differentiation pathway of human promyelocytic leukemia cells were discussed.

The present study is designed to establish a xenograft model of human promyelocytic leukemia cell mutant (HL-60-AR) deficient in hypoxanthine guanine phosphoribosyltransferase (HGPRT) in nude mice. A solid leukemia sarcoma developed after subcutaneous inoculation with HL-60-AR cells. Comparative studies of HL-60-AR/Nu tumor cells in nude mice and cultured HL-60-AR cells in vitro revealed virtual identity as shown by light microscopic morphology, ultrastructure of cell, cytochemistry, chromosome analysis, LDH isoenzyme pattern, genetic markers and differentiated characters assay. Up to now, twelve generations haw been transmitted in rive by inoculating with the solid tumor Cells developed in nude mice. This nude mice model in which human leukemia cells grew could be considered as a useful model for in rive studies of human leukemic cells proliferation, differentiation and the screening for anti-leukemia drugs.

The heterospecies hybrid cells(HL-N)from the fusion of human promyelocy-tic leukemia mutant cells(HL-60-AR)and mouse bone marrow nucleated red cellswere established in HAT selective medium.Malignant phenotype comparative analy-sis between parental tumor cells and hybrid cells showed that growth ability ofhybrid cells was decreased.The hybrid cells reduced their DNA synthesis rate andlost the ability of colony-forming in 0.3% soft agar medium.The cells lost tumor-producing ability when they were transplanted into nude mice also.Inhibition orreduction of c-myc oncogene expression was demonstrated by Northern molecularhybridization techniques.The ultrastructure of hybrid cells were also different fromtheir parental cells.These results mentioned above showed that the mouse bone mar-row nucleated red cells might provide some peculiar factors(both nuclear factorsand cytoplasmic factors)to inhibit the expression of HL-60-AR cell malignant phe-notypes.