Idiopathic pulmonary fibrosis (IPF), a chronic interstitial lung disease, is characterized by aberrant wound healing, excessive scarring and the formation of myofibroblastic foci. Although the role of alternative splicing (AS) in the pathogenesis of organ fibrosis has garnered increasing attention, its specific contribution to pulmonary fibrosis remains incompletely understood. In this study, we identified an up-regulation of serine/arginine-rich splicing factor 7 (SRSF7) in lung fibroblasts derived from IPF patients and a bleomycin (BLM)-induced mouse model, and further characterized its functional role in both human fetal lung fibroblasts and mice. We demonstrated that enhanced expression of Srsf7 in mice spontaneously induced alveolar collagen accumulation. Mechanistically, we investigated alternative splicing events and revealed that SRSF7 modulates the alternative splicing of pyruvate kinase (PKM), leading to metabolic dysregulation and fibroblast activation. In vivo studies showed that fibroblast-specific knockout of Srsf7 in conditional knockout mice conferred resistance to bleomycin-induced pulmonary fibrosis. Importantly, through drug screening, we identified lomitapide as a novel modulator of SRSF7, which effectively mitigated experimental pulmonary fibrosis. Collectively, our findings elucidate a molecular pathway by which SRSF7 drives fibroblast metabolic dysregulation and propose a potential therapeutic strategy for pulmonary fibrosis.

Objective To develop a tiered training framework for operating room nurses in tertiary hospitals,provi-ding guidance for corresponding training curriculum development and clinical competency evaluation.Methods Delphi method was used to conduct two rounds of expert consultation on the preliminary training indicators,estab-lishing a comprehensive tiered training framework for operating room nurses.Results After two rounds of expert consultation,a tiered training framework for operating room nurses was constructed,which includes 6 primary indi-cators,19 secondary indicators and 62 tertiary indicators.The response rate of the two rounds of expert consultation for valid questionnaires were all over 99％and the expert authority coefficients were all over 0.87.Conclusions The consulted experts have good enthusiasm and authority;the developed framework comprehensively covers training content,laying a foundation for designing and implementing tiered training programs for operating room nurses.

Purpose/Significance To analyze the network security risk events monitored by the situational awareness platform of large hospitals,to find out the causes,and to put forward solutions and suggestions for improvement.Method/Process Taking the First Affiliated Hospital of Zhengzhou University as an example,the paper analyzes risk events on the situational awareness platform,screens the risky ter-minals on the hospital intranet,carries out rectification and reinforcement,analyzes the department distribution and causes of risky termi-nals,and puts forward suggestions for improvement.Result/Conclusion The number of risky terminals in medical and technical depart-ments is large,mainly due to the lack of management and the lack of full coverage of antivirus software.Through the rectification and rein-forcement of risky terminals,the number of network security risk events has been significantly reduced.Strengthening the hospital terminal security management,enhancing staff awareness of network security,and strengthening network security protection in different areas can ef-fectively reduce the incidence of hospital network security risk events and improve the hospital network security protection capability.

Objective:To translate the Dysfunctional Beliefs and Attitudes about Sleep Scale for Cancer Patients (C-DBAS-14) into Chinese and test its reliability and validity.Methods:The Korean version of C-DBAS-14 was translated, back-translated, and culturally adapted into Chinese based on Brislin's translation model, forming the Chinese version of C-DBAS-14. From October 2022 to May 2023, 361 hospitalized cancer patients at the First Affiliated Hospital of Anhui Medical University were selected as research objects by convenient sampling method. They were surveyed using a general information questionnaire, the Chinese version of C-DBAS-14, the Insomnia Severity Index (ISI), and the Hospital Anxiety and Depression Scale (HADS) to evaluate the reliability and validity of the scale. The scale's item analysis was based on correlation coefficients and critical ratio values; structural validity, content validity, and convergent validity were used to evaluate the scale's validity; Cronbach's α coefficient and intraclass correlation coefficient were used to assess its reliability.Results:A total of 361 questionnaires were distributed, 356 were effectively returned, with an effective response rate of 98.6% (356/361). The Chinese version of C-DBAS-14 contained 14 items across four dimensions. The scale-level content validity index was 0.976, and the item-level content validity index ranged from 0.833 to 1.000. Totally four common factors were extracted in exploratory factor analysis, explaining 78.8% of the total variance. Confirmatory factor analysis showed a Chi-square/degrees of freedom ratio of 1.286, comparative fit index of 0.991, goodness of fit index of 0.945, incremental fit index of 0.991, Tucker-Lewis index of 0.988, and root mean square error of approximation of 0.036. The total Cronbach's α coefficient of the scale was 0.874, and the intraclass correlation coefficient was 0.863. The C-DBAS-14 score was negatively correlated with the ISI and HADS scores ( r=-0.734, -0.639; P<0.01) . Conclusions:The Chinese version of C-DBAS-14 has good reliability and validity and can be used as an assessment tool for irrational sleep beliefs in Chinese cancer patients.

Objective:To systematically evaluate qualitative studies on disease experience in diabetic retinopathy patients.Methods:Qualitative studies on the disease experience of diabetic retinopathy patients were searched by computer from Web of Science, PubMed, Cochrane Library, Embase, CINAHL, EBSCO, China National Knowledge Infrastructure, WanFang Data, China Biology Medicine disc, VIP, and other databases. The search period was from the establishment of the databases to July 1, 2023. The qualitative research quality evaluation criteria of the Evidence-based Health Care Center of Briggs Institute in Australia were used to evaluate the literature quality, and the results were integrated by the pooled integration method.Results:A total of 12 articles were included, and 47 research results were extracted, which were summarized into 11 categories and integrated into three integrated results, that was, multiple aspects affected by diseases and low quality of life, utterly different coping styles of patients with different emotional experiences including post-traumatic growth and self-abandonment, and a lack of disease-related knowledge and is eager to receive comprehensive support.Conclusions:The physiology and psychology of patients with diabetes retinopathy are affected by the disease. Nurses should pay attention to early prevention education, strengthen disease knowledge publicity, help cope with difficulties in daily life, attach importance to patients' psychological feelings, provide multi-dimensional social support, improve patients' coping strategies, and improve their quality of life.

Objective:To construct an evaluation index system for clinical practice effectiveness of undergraduate nursing students, so as to provide a basis for the evaluation of clinical practice effectiveness of undergraduate nursing students.Methods:Based on the improved Miller's pyramid theory, a preliminary evaluation index system for clinical practice effectiveness of nursing undergraduate students was formed by literature analysis and semi-structured interview method. From April to July 2023, purposive sampling was used to select 20 experts in nursing education, clinical nursing teaching, and other fields. After two rounds of Delphi expert consultation, a final evaluation index system for clinical practice effectiveness of undergraduate nursing students was formed, and the weights of each index were determined.Results:After two rounds of consultation, the effective response rates of the questionnaire were 95.00% (19/20) and 100.00% (19/19), respectively. The expert authority coefficients were 0.86 and 0.88, and the Kendall harmony coefficients were 0.226 and 0.183 ( P<0.01). The final established evaluation index system for clinical practice effectiveness of undergraduate nursing students included five primary indicators, 13 secondary indicators, and 56 tertiary indicators. Conclusions:Based on the improved Miller's pyramid theory, the evaluation index system for clinical practice effectiveness of undergraduate nursing students constructed is scientific, reliable, and practical, which can provide reference for the evaluation of clinical practice for undergraduate nursing students.

Objective:To systematically review the transitional care experience of family caregivers for adolescents with type 1 diabetes mellitus.Methods:The qualitative research on transitional care experience of family caregivers for adolescents with type 1 diabetes mellitus was electronically searched on Web of Science, PubMed, Cochrane Library, Embase, CINAHL, EBSCO, China National Knowledge Infrastructure, WanFang Data, China Biology Medicine disc, and VIP. The search period was from database establishment to June 2023.Results:A total of 11 articles were included, and 35 research results were extracted, which were integrated into 8 new categories and 4 integration results, respectively, the complex emotional experience of family caregivers for adolescents with type 1 diabetes mellitus during the transition period, the difference in the role transformation of different caregivers, the desire for support, and the active response to the transition period.Conclusions:Medical and nursing staff should pay attention to the transitional care experience of family caregivers for adolescents with type 1 diabetes mellitus, build personalized support systems according to the needs of caregivers, improve the quality of care and life in the transition period, and provide basis for the construction of family centered intervention programs in the transition period.

Objective To utilize a 3D technology in the design of a female bed urinal and to evaluate its clinical efficacy.Methods A total of 102 adult female fracture patients with normal urination function admitted to a tertiary hospital in Hangzhou City from October 2022 to June 2023 were included in the study.They were divided into a control group(n=51)and an experimental group(n=51)according to random number method.Patients in control group used a regular urinal,while patients in the experimental group used the 3D technology-based female bed urinal.The level of physical pain caused by urination,the rate of urine immersion in the sacrococcygeal or gluteal cleft and the rate of bed unit or clothing of contamination were compared between the 2 groups.Results There was no significant difference in the rate of bed unit or clothing contamination between the 2 groups(P＞0.05).However,the experimental group experienced significantly lower pain caused by urination,a lower rate of urine impregnation in the sacrococcygeal or gluteal fissure(P＜0.001),compared to the control group.Conclusion The 3D technology-based female bed urinal has reasonable structure and simple operation,which can significantly reduce the physical pain caused by the change of body position,reduce the incidence of urine immersion events.

Objective:To analyze the clinical characteristics and outcomes of patients with invasive fungal sinusitis (invasive fungal rhinosinusitis, IFR) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and explored the risk factors for IFR after allo-HSCT.Methods:Nineteen patients with IFR after allo-HSCT at Peking University People’s Hospital from January 2012 to December 2021 were selected as the study group, and 95 patients without IFR after allo-HSCT during this period were randomly selected as the control group (1:5 ratio) .Results:Nineteen patients, including 10 males and 9 females, had IFR after allo-HSCT. The median age was 36 (10–59) years. The median IFR onset time was 68 (9–880) days after allo-HSCT. There were seven patients with acute myeloid leukemia, five with acute lymphoblastic leukemia, two with myelodysplastic syndrome, two with chronic myeloid leukemia, one with acute mixed-cell leukemia, one with multiple myeloma, and one with T-lymphoblastic lymph node tumor. There were 13 confirmed cases and 6 clinically diagnosed cases. The responsible fungus was Mucor in two cases, Rhizopus in four, Aspergillus in four, and Candida in three. Five patients received combined treatment comprising amphotericin B and posaconazole, one patient received combined treatment comprising voriconazole and posaconazole, nine patients received voriconazole, and four patients received amphotericin B. In addition to antifungal treatment, 10 patients underwent surgery. After antifungal treatment and surgery, 15 patients achieved a response, including 13 patients with a complete response and 2 patients with a partial response. Multivariate analysis revealed that neutropenia before transplantation ( P=0.021) , hemorrhagic cystitis after transplantation ( P=0.012) , delayed platelet engraftment ( P=0.008) , and lower transplant mononuclear cell count ( P=0.012) were independent risk factors for IFR after allo-HSCT. The 5-year overall survival rates in the IFR and control groups after transplantation were 29.00%±0.12% and 91.00%±0.03%, respectively ( P<0.01) . Conclusion:Although IFR is rare, it is associated with poor outcomes in patients undergoing allo-HSCT. The combination of antifungal treatment and surgery might be effective.